Ink4a/Arf−/− Dlk+ cells were transduced with either control enhanced green fluorescent protein (EGFP) or Bmi1 12-18 hours after purification. Enforced expression of Bmi1 was verified by western blot analysis (Fig. 4A). Exogenous Bmi1 in Ink4a/Arf−/− Dlk+ cells did not significantly increase colony number (Fig. 4B). Of note, however, the diameter of Bmi1-overexpressing colonies was significantly larger than that of the control colonies (Fig. 4C).

Furthermore, flow cytometric analyses showed that the percentage of Ink4a/Arf−/− Dlk+ cells labeled with EGFP was higher in Bmi1 cultures than in control cultures (22.6% ± 2.3%, 14.0% ± 1.2%, and 8.8% ± 0.7% versus 8.4% ± 1.1%, 3.4% ± 0.5%, and 2.1% ± 0.2% at days 7, 14, and 28 of culture, respectively) (Fig. selleck inhibitor 4D). We next carried out single-cell sorting of Dlk+ cells contained in primary colonies at days 14 and 28 of culture in order to evaluate their self-renewal capacity in terms of replating activity. Dlk+ cells overexpressing Bmi1 gave rise to

3.1-fold to 4.0-fold more secondary colonies than the control Navitoclax nmr (Fig. 5A). Secondary colonies were generated in a similar fashion to the original colonies. Immunocytochemical analyses demonstrated that the frequency of Alb+CK7+ bipotent cells was significantly higher in secondary colonies derived from Dlk+ cells collected from the primary Bmi1-transduced Ink4a/Arf−/− colonies at days 14 and 28 of culture (Fig. 5B,C). In contrast, Bmi1−/−Ink4a/Arf−/− Dlk+ cells behaved like Ink4a/Arf−/− Dlk+ cells (Supporting Fig. 5). Although loss of Bmi1 still affected the function of Ink4a/Arf−/− hepatic stem/progenitor cells to some extent, these findings indicate that Ink4a/Arf is the major target of Bmi1 in hepatic stem MCE cells as in HSCs and NSCs. We then tested whether the loss of both Ink4a and Arf is enough for the transformation of hepatic stem cells. Considering

that a large number of cells were necessary for transplantations assays, these cells were allowed to form colonies in culture for 28 days. Immunocytochemical analyses showed that more than 90% of cells transduced with Bmi1 expressed both EGFP, a marker antigen for retrovirus integration, and Flag-tagged Bmi1 (Supporting Fig. 6). Subsequently, a total of 2 × 106 transduced cells were transplanted into the subcutaneous space of NOD/SCID mice (Fig. 5D). Although all the mice transplanted with Bmi1-transduced Ink4a/Arf−/− Dlk+ cells developed tumors, none of those transplanted with control Ink4a/Arf−/− Dlk+ cells did. Histological analyses revealed that the subcutaneous tumors consisted of both Alb+ parenchymal cells and a CK7+ glandular structure (Fig. 5D). The histological finding is consistent with our previous observation in tumors derived from Bmi1-transduced wild-type hepatic stem cells.3 These findings clearly indicate that repression of the Ink4a and Arf genes is not enough for Bmi1 to achieve its tumorigenic potential in hepatic stem cells.

Ink4a/Arf−/− Dlk+ cells were transduced with either control enhanced green fluorescent protein (EGFP) or Bmi1 12-18 hours after purification. Enforced expression of Bmi1 was verified by western blot analysis (Fig. 4A). Exogenous Bmi1 in Ink4a/Arf−/− Dlk+ cells did not significantly increase colony number (Fig. 4B). Of note, however, the diameter of Bmi1-overexpressing colonies was significantly larger than that of the control colonies (Fig. 4C).

Furthermore, flow cytometric analyses showed that the percentage of Ink4a/Arf−/− Dlk+ cells labeled with EGFP was higher in Bmi1 cultures than in control cultures (22.6% ± 2.3%, 14.0% ± 1.2%, and 8.8% ± 0.7% versus 8.4% ± 1.1%, 3.4% ± 0.5%, and 2.1% ± 0.2% at days 7, 14, and 28 of culture, respectively) (Fig. Vismodegib in vitro 4D). We next carried out single-cell sorting of Dlk+ cells contained in primary colonies at days 14 and 28 of culture in order to evaluate their self-renewal capacity in terms of replating activity. Dlk+ cells overexpressing Bmi1 gave rise to

3.1-fold to 4.0-fold more secondary colonies than the control ICG-001 (Fig. 5A). Secondary colonies were generated in a similar fashion to the original colonies. Immunocytochemical analyses demonstrated that the frequency of Alb+CK7+ bipotent cells was significantly higher in secondary colonies derived from Dlk+ cells collected from the primary Bmi1-transduced Ink4a/Arf−/− colonies at days 14 and 28 of culture (Fig. 5B,C). In contrast, Bmi1−/−Ink4a/Arf−/− Dlk+ cells behaved like Ink4a/Arf−/− Dlk+ cells (Supporting Fig. 5). Although loss of Bmi1 still affected the function of Ink4a/Arf−/− hepatic stem/progenitor cells to some extent, these findings indicate that Ink4a/Arf is the major target of Bmi1 in hepatic stem medchemexpress cells as in HSCs and NSCs. We then tested whether the loss of both Ink4a and Arf is enough for the transformation of hepatic stem cells. Considering

that a large number of cells were necessary for transplantations assays, these cells were allowed to form colonies in culture for 28 days. Immunocytochemical analyses showed that more than 90% of cells transduced with Bmi1 expressed both EGFP, a marker antigen for retrovirus integration, and Flag-tagged Bmi1 (Supporting Fig. 6). Subsequently, a total of 2 × 106 transduced cells were transplanted into the subcutaneous space of NOD/SCID mice (Fig. 5D). Although all the mice transplanted with Bmi1-transduced Ink4a/Arf−/− Dlk+ cells developed tumors, none of those transplanted with control Ink4a/Arf−/− Dlk+ cells did. Histological analyses revealed that the subcutaneous tumors consisted of both Alb+ parenchymal cells and a CK7+ glandular structure (Fig. 5D). The histological finding is consistent with our previous observation in tumors derived from Bmi1-transduced wild-type hepatic stem cells.3 These findings clearly indicate that repression of the Ink4a and Arf genes is not enough for Bmi1 to achieve its tumorigenic potential in hepatic stem cells.

To further confirm the previous RT-PCR and western blot findings, we used immunohistochemical staining to assess the correlation between the expression levels of

thrombin see more and OPN in HCC tumor tissues from 230 patients. We also analyzed the association of thrombin and OPN levels with HCC prognosis in the same 230 HCC patients. Positive staining for thrombin and OPN was found in 33% (77/230) and 39% (90/230) of patients, respectively. HCC tissue from 36 (15.7%) patients was positive for both thrombin and OPN (Fig. 3A). As shown in Table 1, thrombin-positive expression in tumor tissue was significantly correlated with tumor size (P = 0.0438), vascular invasion (P = 0.0317), and TNM stage (P = 0.0352) of HCC. However, no statistically significant association was found between the thrombin expression and other clinical characteristics. In the patients with positive OPN (OPN+), positive thrombin staining in the tumor tissue was significantly correlated with preoperative serum alpha-fetoprotein (AFP) (P = 0.0304), tumor size (P = 0.0024), vascular RG7204 purchase invasion (P = 0.0018), TNM stage (P = 0.0080), tumor differentiation (P = 0.0373), and tumor encapsulation (P = 0.0477). However, no statistically significant correlation was found between thrombin expression and these characteristics in the patients with undetectable OPN expression (OPN−)

(Table 2). The 1-, 3-, and 5-year tumor recurrence rates of those thrombin-positive (thrombin+) patients were 41.6, 67.5, and 68.8%, respectively; these tumor recurrence rates were

much higher than those of thrombin-negative (thrombin−) patients (24.8, 43.1, and 47.1%, respectively; P = 0.0001). The 1-, 3-, and 5-year OS rates of thrombin+ patients (75.3, 42.9, and 40.2%, respectively) were significantly lower than those of thrombin− patients (85.6, 59.5, and 57.5%, respectively; P = 0.005) (Fig. 3B). To further evaluate the prognostic value of thrombin for HCC patients, univariate and multivariate analyses were performed with the clinicopathological characteristics and 上海皓元医药股份有限公司 expression of thrombin and OPN (Supporting Information Tables S3 and S4). In the univariate analysis, tumor size, vascular invasion, TNM stage, and tumor differentiation were revealed to associate with OS and TTR of HCC patients. Thrombin expression was also significantly associated with both OS and TTR and, particularly, this association was much stronger in OPN+ patients (OS, P = 0.001; TTR, P < 0.0001) compared with OPN− patients (OS, P = 0.596; TTR, P = 0.728). No significant prognostic significance was found in the other characteristics including sex, age, and hepatitis B surface antigen (HBsAg) positivity of patients for OS or TTR (Supporting Information Table S3). Individual features that showed significance by univariate analysis were adopted as covariates in a multivariate Cox proportional hazards model and then combined variables were further analyzed.

To further confirm the previous RT-PCR and western blot findings, we used immunohistochemical staining to assess the correlation between the expression levels of

thrombin Pexidartinib nmr and OPN in HCC tumor tissues from 230 patients. We also analyzed the association of thrombin and OPN levels with HCC prognosis in the same 230 HCC patients. Positive staining for thrombin and OPN was found in 33% (77/230) and 39% (90/230) of patients, respectively. HCC tissue from 36 (15.7%) patients was positive for both thrombin and OPN (Fig. 3A). As shown in Table 1, thrombin-positive expression in tumor tissue was significantly correlated with tumor size (P = 0.0438), vascular invasion (P = 0.0317), and TNM stage (P = 0.0352) of HCC. However, no statistically significant association was found between the thrombin expression and other clinical characteristics. In the patients with positive OPN (OPN+), positive thrombin staining in the tumor tissue was significantly correlated with preoperative serum alpha-fetoprotein (AFP) (P = 0.0304), tumor size (P = 0.0024), vascular GSK1120212 invasion (P = 0.0018), TNM stage (P = 0.0080), tumor differentiation (P = 0.0373), and tumor encapsulation (P = 0.0477). However, no statistically significant correlation was found between thrombin expression and these characteristics in the patients with undetectable OPN expression (OPN−)

(Table 2). The 1-, 3-, and 5-year tumor recurrence rates of those thrombin-positive (thrombin+) patients were 41.6, 67.5, and 68.8%, respectively; these tumor recurrence rates were

much higher than those of thrombin-negative (thrombin−) patients (24.8, 43.1, and 47.1%, respectively; P = 0.0001). The 1-, 3-, and 5-year OS rates of thrombin+ patients (75.3, 42.9, and 40.2%, respectively) were significantly lower than those of thrombin− patients (85.6, 59.5, and 57.5%, respectively; P = 0.005) (Fig. 3B). To further evaluate the prognostic value of thrombin for HCC patients, univariate and multivariate analyses were performed with the clinicopathological characteristics and MCE expression of thrombin and OPN (Supporting Information Tables S3 and S4). In the univariate analysis, tumor size, vascular invasion, TNM stage, and tumor differentiation were revealed to associate with OS and TTR of HCC patients. Thrombin expression was also significantly associated with both OS and TTR and, particularly, this association was much stronger in OPN+ patients (OS, P = 0.001; TTR, P < 0.0001) compared with OPN− patients (OS, P = 0.596; TTR, P = 0.728). No significant prognostic significance was found in the other characteristics including sex, age, and hepatitis B surface antigen (HBsAg) positivity of patients for OS or TTR (Supporting Information Table S3). Individual features that showed significance by univariate analysis were adopted as covariates in a multivariate Cox proportional hazards model and then combined variables were further analyzed.

The database for this analysis includes clinical and demographic data extracted from the original database. To estimate the population frequency of the IL28B genotypes, 202 healthy volunteers with normal liver enzymes and no serological markers

of HCV, hepatitis B virus, human immunodeficiency virus, or other hepatic infection were also evaluated as a control population. These patients were all Caucasian and were recruited from the same geographical area. The study was approved by a central ethics committee and conducted in accordance with the provisions of the Declaration Roxadustat purchase of Helsinki and Good Clinical Practice guidelines. We selected the polymorphism rs12979860, located 3kB upstream of the IL28B gene,16, 18 for genotyping by the allele specific discrimination kit (ABI TaqMan) and the ABI 7900HT sequence detection System (Applied Biosystems). Genotyping was conducted in Italy, as previously reported,18 in a blinded fashion relative to HCV treatment status and other patient or treatment response characteristics. Genotyping calls were manually inspected and STA-9090 verified prior to release. Hardy-Weinberg Equilibrium was assessed. HCV

RNA levels were quantitatively measured by way of sensitive reverse-transcription polymerase chain reaction (Amplicor Monitor HCV 2.0; Roche Molecular Diagnostics, Basel, Switzerland) with a lower limit of detection of 600 IU/mL. Qualitative measurement of serum HCV RNA was performed at treatment weeks 0, 4, 8, 12, 24, and 48 and at follow-up evaluation at week 24. HCV RNA was qualitatively analyzed by way of polymerase chain reaction (Amplicor HCV; Roche Molecular Systems, Branchburg, NJ) with

a lower limit of detection of 50 IU/mL during and off therapy. HCV genotyping was performed by way of reverse 上海皓元医药股份有限公司 hybridization (INNO-LiPA HCV; Innogenetics, Gent, Belgium) in all patients. Histological results were classified by local pathologists following standard criteria according to Scheuer’s scoring system.19 Comparisons between groups were performed using a Wilcoxon test for nonnormal continuous variables. For categorical data, the Pearson χ2 test/Fisher exact test was used. P < 0.05 (two-sided) were regarded as significant. To determine the association of the IL28B single-nucleotide polymorphism with SVR in comparison with other predictors, we stratified each parameter as reported and analyzed them together with the ILB28 mutation in a forward conditional stepwise logistic regression model using SVR as the outcome variable. Results are presented as means and 95% confidence intervals (CIs) unless indicated otherwise. Covariates included in the model were baseline viral load (log10 IU/mL), liver fibrosis stage, inflammatory activity, sex, age, body mass index (BMI), serum alanine aminotransferase level, and IL28B genotype.

0 cm, with more nodular calcification and more blood vessels than prior Ultrasound (Fig. 1). (highly suspicious of malignancy). This Ultrasound examination revealed confirmed diagnosis. CT scans also provided helpful information. CT scans demonstrated a mass composed adipose tissue, soft tissue and calcification invading spermatic cord (Fig.2). Compared the two results of Ultrasound, nodular

calcifications and blood vessels can be found easily increased with time, and hint malignant. CT scan may identify the mass arised from spermatic cord, and composed adipose tissue, around soft tissue and calcification invading. All pre-operative MK-8669 mw laboratory tests, including complete blood count, biochemistry and chest X-ray, were normal. The patient Buparlisib molecular weight was taken up for surgery through the inguinal approach. The spermatic cord was dissected and delivered out and it showed a hard lipomatous mass (7.0 cm × 5.0 cm × 2.8 cm). The gross appearance was a solid mass of adipose tissue with a yellowish lipoma-like texture of the cut-surface. It was encapsulated, and attached to the spermatic cord. Histological examination confirmed a well-differentiated liposarcoma. Conclusion: Ultrasound examination and CT scan may different liposarcomas from hernia and provide some characteristic imaging features of liposarcomas. Identifying

factors such as whether the fat is within the lesion, the origin of the lesions, and the presence of combined calcification is important for narrowing the differential diagnosis, MCE since liposarcomas are malignant tumors derived embryologically from mesodermal tissues. This finding of calcifications in association with liposarcoma

has been previously noted in prior reports, but the sample sizes of those published case series were too small to achieve statistical significance. In spite of this, the presence of calcifications should not be regardless. Liposarcomas are known for local recurrences and longterm follow-up. Ultrasound and CT are good surveillance option to follow-up. Key Word(s): 1. Liposarcomas; 2. calcification; 3. Ultrasound; 4. CT; Presenting Author: CHENGYAN WANG Additional Authors: YALING XIONG, HUI WANG, CHUNHONG HAO Corresponding Author: CHENGYAN WANG Affiliations: Jilin cancer hospital Objective: Our aim is to diagnose the intractable abdominal mass by biopsy under ultrasound-guiding which could not be made a definitive diagnosis and treatment in clinical. Methods: 4 cases of abdominal mass were found by ultrasound and CT but could not diagnose. We tested and record the size, echo, location of every mass by ultrasound. The boundary of first mass was distinct and no adhesion with surrounding tissue; the second mass was adhesion with gall bladder and intestinal canal; capsule was found in the third mass ultrasonoscopy; the last was irregular shape and schistose aggregated. Puncture were performed under ultrasonographic guidance (GE, Logiq E9). Puncture point and position depend on mass location.

0 cm, with more nodular calcification and more blood vessels than prior Ultrasound (Fig. 1). (highly suspicious of malignancy). This Ultrasound examination revealed confirmed diagnosis. CT scans also provided helpful information. CT scans demonstrated a mass composed adipose tissue, soft tissue and calcification invading spermatic cord (Fig.2). Compared the two results of Ultrasound, nodular

calcifications and blood vessels can be found easily increased with time, and hint malignant. CT scan may identify the mass arised from spermatic cord, and composed adipose tissue, around soft tissue and calcification invading. All pre-operative selleck compound laboratory tests, including complete blood count, biochemistry and chest X-ray, were normal. The patient this website was taken up for surgery through the inguinal approach. The spermatic cord was dissected and delivered out and it showed a hard lipomatous mass (7.0 cm × 5.0 cm × 2.8 cm). The gross appearance was a solid mass of adipose tissue with a yellowish lipoma-like texture of the cut-surface. It was encapsulated, and attached to the spermatic cord. Histological examination confirmed a well-differentiated liposarcoma. Conclusion: Ultrasound examination and CT scan may different liposarcomas from hernia and provide some characteristic imaging features of liposarcomas. Identifying

factors such as whether the fat is within the lesion, the origin of the lesions, and the presence of combined calcification is important for narrowing the differential diagnosis, medchemexpress since liposarcomas are malignant tumors derived embryologically from mesodermal tissues. This finding of calcifications in association with liposarcoma

has been previously noted in prior reports, but the sample sizes of those published case series were too small to achieve statistical significance. In spite of this, the presence of calcifications should not be regardless. Liposarcomas are known for local recurrences and longterm follow-up. Ultrasound and CT are good surveillance option to follow-up. Key Word(s): 1. Liposarcomas; 2. calcification; 3. Ultrasound; 4. CT; Presenting Author: CHENGYAN WANG Additional Authors: YALING XIONG, HUI WANG, CHUNHONG HAO Corresponding Author: CHENGYAN WANG Affiliations: Jilin cancer hospital Objective: Our aim is to diagnose the intractable abdominal mass by biopsy under ultrasound-guiding which could not be made a definitive diagnosis and treatment in clinical. Methods: 4 cases of abdominal mass were found by ultrasound and CT but could not diagnose. We tested and record the size, echo, location of every mass by ultrasound. The boundary of first mass was distinct and no adhesion with surrounding tissue; the second mass was adhesion with gall bladder and intestinal canal; capsule was found in the third mass ultrasonoscopy; the last was irregular shape and schistose aggregated. Puncture were performed under ultrasonographic guidance (GE, Logiq E9). Puncture point and position depend on mass location.

e. 20–100 ng/mL) in a setting of concomitantly elevated ALT, the serum AFP level should not be incorporated into clinical judgment because it is not reliably distinguished from the confounding factor of active liver inflammation. In this circumstance, detection of HCC should rely solely on imaging studies to avoid a false positive AFP result. In conclusion, serum AFP is still helpful in the detection CYC202 of HCC recurrence after RFA in AFP-producing HCC. Mildly elevated AFP values in the setting of concomitantly elevated ALT should be interpreted

as inconclusive, and should not be used for clinical judgment. The performance of AFP may achieve higher sensitivity and accuracy by adjusting the AFP criteria to serum ALT levels as proposed herein. The main limitations of our study include its retrospective design and a relatively small sample size. The ideal method for determination

of HCC recurrence and detection of small foci of emerging HCC is the explanted Navitoclax clinical trial liver. However, this level of proof is impractical and limited to patients who have undergone liver transplantation. In general practice, contrast-enhanced CT/MRI, as recommended by AASLD, is an accepted standard for monitoring HCC recurrence after RFA. However, small new foci of HCC below the detection resolution of current imaging technology may still produce AFP and cause elevation in serum AFP that would be interpreted as a false positive.[29] Therefore, to detect early HCC recurrence in this study, the interval growth on subsequent imaging follow-up was also used as an additional

criterion to identify small early HCC that was equivocal on prior studies. Another limitation was that in some of the true positive cases, serum AFP may become elevated as a result of liver inflammation that coexisted with HCC recurrence, regardless of whether or not the tumor produced AFP. Because there is some overlap between liver inflammation and HCC recurrence, this may confound the interpretation of AFP levels. “
“I read with great interest the article by Chen et al.,1 who confirmed the association of diabetes with liver neoplasms and found that the incidence of primary malignant neoplasms of the liver was significantly higher in patients with diabetes versus control subjects. Even though multiple factors should be responsible for the association 上海皓元医药股份有限公司 between diabetes and an increased risk of malignant neoplasms of the liver, I propose that vitamin D deficiency potentially links the two disorders for the following reasons. First, vitamin D levels have been found to be significantly lower in diabetic populations versus subjects without diabetes.2, 3 It has been reported that vitamin D deficiency predisposes individuals to type 1 diabetes and type 2 diabetes and may be involved in the pathogenesis of both forms of diabetes.3, 4 Second, vitamin D deficiency has been proposed to contribute to high risks for various types of cancers.

We then compared the age and hematological parameters (WBC, CRP, Hb, BUN, Cre, Che, Alb and Tcho) between cases of early mortality and long-term survival. All readings were taken on the day before the PEG procedure. Results: Che and Tcho levels were found to

be significantly lower in cases of early mortality than in cases of long-term survival. Conclusion: PEG must be implemented only when the prognosis and estimated risk factors of the patients condition are understood. It is important to establish a good balance between the patients chance of long-term survival, and improvement in Tyrosine Kinase Inhibitor Library QOL. Key Word(s): 1. PEG risk Presenting Author: BING HU Additional Authors: HONG ZE ZENG Corresponding Author: HUI LIU Affiliations: West China Hospital, Sichuan University Objective: In recent years, laparoscopic and endoscopic cooperative surgery (LECS) has become increasingly

frequently used for gastrointestinal stromal tumors (GISTs). The aim of our study is to hold a preliminary discussion to the choice between laparoscope-assisted ABT-263 datasheet endoscopic technique (LAET) and endoscope-assisted laparoscopic technique (EALT). Methods: From January 2006 to December 2011, a total of 72 patients received LECS in our hospital. All the patients underwent preoperative endoscopy, endoscopic ultrasonography (EUS) and upper abdominal CT scan. For endogenous tumors with neither serosal invasion nor surrounding organs or lymph nodes metastases, LAET was chosen if preoperative evaluation showed risks of massive bleeding or perforation and difficulties in simple endoscopic resection. For tumors located at cardia or pylorus, LAET was chosen if possible. For exogenous tumors or endogenous tumors with serosal invasion, EALT was chosen. Results: 32 MCE公司 cases were treated by LAET. 40 cases were treated by EALT, of which, 10 cases were indicated for LAET initially but turned to EALT during surgeries. Among the 10 cases, perforation occurred

in 6 cases during endoscopic dissection and high chance of serosal invasion was found in the other 4 cases with tumors located near cardia or pylorus during endoscopic surgeries. All the tumors were completely resected and none of the cases were converted to open surgery. During a median follow-up of 35 months, none of the patients suffered metastasis or recurrence. Conclusion: LECS is safe and effective for gastric GISTs. For endogenous tumors without serosal invasion which can be fully removed by endoscopy, LAET should be considered. Even if an endogenous tumor can be resected simply by endoscopy, LAET is safer. For exogenous tumors or endogenous tumors with invasion beyond the stomach wall, EALT should be chosen. Key Word(s): 1. gastrointestinal stromal tumor; 2.

We then compared the age and hematological parameters (WBC, CRP, Hb, BUN, Cre, Che, Alb and Tcho) between cases of early mortality and long-term survival. All readings were taken on the day before the PEG procedure. Results: Che and Tcho levels were found to

be significantly lower in cases of early mortality than in cases of long-term survival. Conclusion: PEG must be implemented only when the prognosis and estimated risk factors of the patients condition are understood. It is important to establish a good balance between the patients chance of long-term survival, and improvement in selleckchem QOL. Key Word(s): 1. PEG risk Presenting Author: BING HU Additional Authors: HONG ZE ZENG Corresponding Author: HUI LIU Affiliations: West China Hospital, Sichuan University Objective: In recent years, laparoscopic and endoscopic cooperative surgery (LECS) has become increasingly

frequently used for gastrointestinal stromal tumors (GISTs). The aim of our study is to hold a preliminary discussion to the choice between laparoscope-assisted Vemurafenib solubility dmso endoscopic technique (LAET) and endoscope-assisted laparoscopic technique (EALT). Methods: From January 2006 to December 2011, a total of 72 patients received LECS in our hospital. All the patients underwent preoperative endoscopy, endoscopic ultrasonography (EUS) and upper abdominal CT scan. For endogenous tumors with neither serosal invasion nor surrounding organs or lymph nodes metastases, LAET was chosen if preoperative evaluation showed risks of massive bleeding or perforation and difficulties in simple endoscopic resection. For tumors located at cardia or pylorus, LAET was chosen if possible. For exogenous tumors or endogenous tumors with serosal invasion, EALT was chosen. Results: 32 medchemexpress cases were treated by LAET. 40 cases were treated by EALT, of which, 10 cases were indicated for LAET initially but turned to EALT during surgeries. Among the 10 cases, perforation occurred

in 6 cases during endoscopic dissection and high chance of serosal invasion was found in the other 4 cases with tumors located near cardia or pylorus during endoscopic surgeries. All the tumors were completely resected and none of the cases were converted to open surgery. During a median follow-up of 35 months, none of the patients suffered metastasis or recurrence. Conclusion: LECS is safe and effective for gastric GISTs. For endogenous tumors without serosal invasion which can be fully removed by endoscopy, LAET should be considered. Even if an endogenous tumor can be resected simply by endoscopy, LAET is safer. For exogenous tumors or endogenous tumors with invasion beyond the stomach wall, EALT should be chosen. Key Word(s): 1. gastrointestinal stromal tumor; 2.