Abstract:

Objective: To systematically evaluate the effect of combined vascular resection (VR) in surgical treatment of hilar cholangiocarcinoma (HCCA). Methods: The literature of studies comparing surgical treatment of HCCA in combination with VR versus that without VR was collected by searching several national and international databases. The safety and efficacy of combined VR were evaluated, and the subgroups analysis was also performed according to the types of the simultaneously resected blood vessel. Results: Twenty seven studies with a total of 3 218 HCCA patients were included, of whom 888 cases underwent combined VR treatment (VR combination group), and 2 330 cases had no combined VR treatment (control group). The results of Meta-analysis for overall group showed that the safety profile was unfavorable (mortality: OR=2.83, 95% CI=1.80–4.44; postoperative complications: OR=2.48, 95% CI=1.44–4.28) and the efficacy was less favorable (1-, 3- and 5-year overall survival: OR=0.60, 95% CI=0.49–0.73; OR=0.57, 95% CI=0.47–0.69; OR=0.61, 95% CI=0.41–0.91) in VR combination group compared with control group (all P<0.05). In portal vein resection subgroup compared with control group, although the incidence of complications was increased (P<0.05), no difference was found in other variables (all P>0.05); in hepatic artery resection subgroup, all the pooled results were consistent with the overall findings (all P<0.05). Conclusion: In HCCA patients, surgical treatment combined with VR is feasible for those with portal vein invasion, but VR should be made cautiously if the hepatic artery is involved.

Abstract:

Objective: To determine the application value of three-dimensional reconstruction in preoperative assessment of hilar cholangiocarcinoma. Methods: The clinical data of 34 patients with hilar cholangiocarcinoma undergoing hilar resection in combination with partial liver resection were collected. Of the patients, 15 cases had preoperative three-dimensional surgical planning (observational group), while 19 cases did not (control group). The relevant surgical variables between the two groups were compared. In observational group, the coincidence degree between tumor classifications from three-dimensional reconstruction data and postoperative actual findings, and the difference between two- and three-dimensional images for estimation of liver volume were analyzed. Results: In observational group versus control group, the average intraoperative blood loss (525.4 mL vs. 676.3 mL), operative time (5.0 h vs. 5.8 h) and time of tube removal (8.9 d vs. 11.4 d) were significantly reduced (P=0.014, P=0.020, and P=0.037), but the length of postoperative hospital stay and overall incidence of complications between the two groups had no statistical difference (both P>0.05). In observational group of patients, the coincidence rate of Bismuth-Corlette classification by three-dimensional reconstruction to actual results was 86.7% (13/15); the estimated liver resection volume calculated by the two- and three-dimensional techniques showed no statistical difference (404.9 mL vs. 411.2 mL, P>0.05). Conclusion: Three-dimensional reconstruction can provide a precise preoperative assessment for hilar cholangiocarcinoma, so it has certain guiding significance in surgical treatment of hilar cholangiocarcinoma.

Abstract:Objective: To investigate the clinical features of intrahepatic biliary cystadenoma (IBCA), so as to provide reference for clinical use. Methods: The clinical articles concerning IBCA published over 15 years involving a total of 151 patients were collected, and diagnosis, treatment methods and outcomes of the patients were analyzed. Results: Of the 151 IBCA patients, 81 cases had preoperative misdiagnosis, so the misdiagnostic rate was 53.6%, which in the 23 reports of single case reached 91.3%. Of the patients, the average age was 49.5 years, number of females was higher than that of males (4.3:1), the general disease course was around 6 years, and the lesion was more frequently seen in the left liver than that in right liver (1.4:1). Both the imaging examinations and laboratory tests had less specificity in the early stage. After complete tumor resection, most cases had better outcomes and few cases had malignant transformation during follow-up. Conclusion: IBCA has no specific clinical manifestations, with high preoperative misdiagnostic rate, and intraoperative rapid frozen section procedure is important. Surgical resection is the main method of treatment. IBCA has a tendency to become malignant, so if possible, total resection of IBCA should be performed.

Abstract:

Objective: To investigate the safety and effectiveness of using unidirectional barbed suture in laparoscopic hepatectomy with intraoperative bile duct exploration. Methods: The clinical data of 24 patients undergoing laparoscopic hepatectomy with synchronous bile duct exploration from December 2014 to August 2015 were retrospectively analyzed. Of the patients, the bile duct closure in 10 cases was accomplished with traditional suture (traditional suture group), and in 14 cases with unidirectional barbed suture (barbed suture group). The main clinical variables between the two groups of patients were compared. Results: The operations in all patients were successfully completed. The preoperative general data, intraoperative blood loss, incidence of postoperative complications (pulmonary infection), and length of postoperative hospital stay had no statistical difference between the two groups (all P>0.05), but the overall operative time (230.50 min vs. 354.68 min), and time for common bile duct (5.33 min vs. 33.82 min) and hepatic duct (9.04 min vs. 25.14 min) suturing were significantly reduced in barbed suture group compared with traditional suture group (all P<0.05). One month after discharge, all patient returned for T-tube cholangiography and T-tube removal, and no retained stones, bile leakage or biliary stricture was observed. Conclusion: Using unidirectional barbed suture in laparoscopic hepatectomy with bile duct exploration is safe and feasible, and the employment of the absorbable barbed suture can reduce the difficulty of laparoscopic suturing, and shorten the operative time and the technical learning curve, without increasing the risk of postoperative bile leakage.

Abstract:Objective: To determine the clinical efficacy of performing precise hepatectomy technique in surgery for intrahepatic stones. Methods: One-hundred and seven patients with intrahepatic stones admitted from March 2010 to December 2014 were selected, and were randomly assigned into observational group (54 cases undergoing precise liver resection) and control group (53 cases undergoing irregular liver resection). The relevant clinical variables between the two groups of patients were compared. Results: In observational group compared with control group, the operative time was prolonged (242.3 min vs. 203.4 min), but the intraoperative blood loss (361.3 mL vs. 518.6 mL), drainage volume during the day after surgery (131.7 mL vs. 208.6 mL), length of postoperative hospital stay (18.1 d vs. 20.9 d) and hospitalization expenses (22 000 yuan vs. 29 000 yuan) were reduced; the peak levels of transaminases on postoperative day 3 and 7 were decreased; the overall incidence of postoperative complications (5.56% vs. 18.87%) and stone recurrence rate (7.41 % vs. 20.75%) were lower, and all differences had statistical significance (all P<0.05). Conclusion: For patients with intrahepatic stones, performing precise hepatectomy can help alleviate surgical trauma, and reduce postoperative complications and stone recurrence rate.

Abstract:Objective: To assess the efficacy and safety of repeat biliary surgery for recurrent choledocholithiasis through laparoscopic procedure. Methods: One hundred and forty patients who had history of biliary surgery for bile duct stones and required repeat operation for recurrent choledocholithiasis were equally randomized into two groups, to receive laparoscopic (laparoscopic group) or open operation (laparotomy group), respectively. The main surgical variables between the two groups were compared. Results: In laparoscopic group compared with laparotomy group, the operative time (117.5 min vs. 125.3 min), intraoperative blood loss (67.3 mL vs. 113.2 mL), time to bowel function recovery (25.3 h vs. 55.2 h) and length of postoperative hospital stay (6.9 d vs. 12.4 d) were all significantly decreased (all P<0.05), while the hospitalization expense was increased (10 100 yuan vs. 9 600 yuan), but it did not reach a statistical significance (P>0.05). The number of patients using analgesics, and the incidence of wound infection in laparoscopic group were lower than those in laparotomy group (7 vs. 17; 2.9% vs. 12.9%, both P<0.05), while the incidence of bile leakage, biliary stricture, residual stone, and stone recurrence showed no statistical difference between the two groups (all P>0.05). Conclusion: Under the guidance of experienced surgeons, adequate preoperative preparation and assessment along with precise and meticulous operation, the repeat biliary surgery for recurrent choledocholithiasis by laparoscopic procedure is safe and effective, and also possesses the advantages of less bleeding, low incidence of postoperative infection and fast recovery.

Abstract:Objective: To compare the clinical efficacy of single-staged laparoscopic cholecystectomy (LC) and common bile duct exploration (LCBDE) with two-staged endoscopic retrograde cholangiopancreatography (ERCP) followed by LC in treatment of concomitant gallbladder stones and common bile duct stones. Methods: The clinical data of 112 patients with concomitant gallbladder stones and common bile duct stones, who underwent minimally invasive surgical treatment in the First Affiliated Hospital of Xian Jiaotong University from January 2013 to June 2014, were retrospectively analyzed. Of the patients, 52 cases received single-staged LC plus LCBDE (LCBDE group), and 60 cases underwent two-staged ERCP followed by LC 24 h later or elective LC (ERCP group), and the main clinical variables between the two groups of patients were compared. Results: Except for the average age in LCBDE group was younger than that in ERCP group (42.4 years vs. 57.4 years, P<0.05), all the other data between the two groups were comparable. No death occurred in either group, and no significant difference was noted in surgical success rate (94.3% vs. 98.4%), overall incidence of complications (8.2% vs. 10.1%) and residual stone rate (2.0% vs. 1.7%) between the two groups (all P>0.05). The incidence of hyperamylasemia was significantly higher in ERCP group than that in LCBDE group (16.9% vs. 4.1%, P<0.05), but all were transient amylase elevations. In LCBDE group compared with ERCP group, the length of postoperative hospital stay was shorter (4.9 d vs. 6.3 d) and total hospitalization cost was reduced (21 685.9 yuan vs. 30 354.3 yuan), but the operative time was prolonged (117.1 min vs. 97.4 min) (all P<0.05). Conclusion: Both single-staged LC plus LCBDE and two-staged ERCP plus LC are safe and effective in treatment of concomitant gallbladder stones and common bile duct stones, and either of them can be selected according to the individual patient’s condition.

Abstract:Objective: To assess the clinical efficacy of laparoscopic common bile duct exploration (LCBDE) in treatment of recurrent or residual common bile duct stones after cholecystectomy. Methods: The clinical data of 52 patients with recurrent or residual common bile duct stones after cholecystectomy undergoing LCBDE treatment from April 2012 to June 2015 were analyzed retrospectively. Results: Of the 52 patients, LCBDE was successfully performed in 48 cases (92.3%), and the remaining 4 cases were converted to open surgery due to severe abdominal adhesion. Of the 48 patients, 15 cases underwent T-tube placement during operation, and 33 cases received primary common bile duct closure; the operative time was (102.6±19.5) min, intraoperative blood loss was (38.6±12.7) mL, and length of postoperative hospital stay was (4.2±2.5) d. Mild bile leakage after operation occurred in 2 cases, and bile peritonitis occurred in one case after T tube removal, which were all resolved by conservative treatment; one case had remnant common bile duct stones after operation, and they were extracted by choledochoscopic net basket via the T-tube sinus tract at 6 weeks after operation. Conclusion: For recurrent or residual common bile duct stones after cholecystectomy, LCBDE has high success rate with minimal invasion and fast recovery, so it is recommended to be used.

Abstract:Objective: To determine the risk factors for complications of laparoscopic cholecystectomy (LC). Methods: The clinical data of 312 patients undergoing LC from September 2012 to September 2014 were collected. The occurrence of complications and the related risk factors were analyzed. Results: Complications occurred in a total of 81 patients (25.96%), which included rupture of gallbladder in 22 cases (7.05%), abdominal hemorrhage in 28 cases (8.97%), injury of hepatic artery in 17 cases (5.45%) and biliary fistula in 14 cases (4.48%). Univariate analysis showed that adhesions in Calot’s triangle, anatomic variations, acute stage of disease, use of electrocautery in dissection of Calot’s triangle and gallbladder wall thickness (>5 mm) were related to the occurrence of complications of LC (all P<0.05); multivariate analysis identified that adhesions in Calot’s triangle (OR=3.466, 95% CI=1.432-8.389), regional anatomic variations (OR=1.988, 95% CI=1.237-3.194) and use of electrocautery in dissection of Calot’s triangle (OR=1.089, 95% CI=1.015-1.168) were independent risk factors for complications of LC (all P<0.05). Conclusion: Preoperative evaluation should be performed thoroughly to identify the risk factors in patients undergoing LC, and use of electrocautery in dissection of Calot’s triangle should be avoided, so as to reduce the occurrence of postoperative complications.

Abstract:Objective: To isolate from human cholangiocarcinoma QBC-939 cells, the tumor cells with stem cell properties and provide material for subsequent investigations on cholangiocarcinoma stem cells. Methods: By means of serum-free culture and fluorescence-activated cell sorting, the CD133+EpCAMhigh stem cell-like cells with stem cell properties were isolated from QBC-939 cells, and were continuously cultured in the serum-free medium for observing their sphere forming ability. Then, the colony formation rate, drug resistance and cell proliferation ability, and the expressions of stem cell-associated nuclear transcription factors that included OCT-4, Bmi-1 and E-cadherin, as well as the tumor formation ability after subcutaneous implantation in BALB/c mice were compared between CD133+EpCAMhigh stem cell-like cells and QBC-939 cells. Results: CD133+EpCAMhigh stem cell-like cells showed a relatively strong sphere forming ability in the serum-free medium. In CD133+EpCAMhigh stem cell-like cells compared with QBC-939 cells, the colony formation rate, resistance to lobaplatin, and proliferative ability were significantly increased; the OCT-4 and Bmi-1 protein expressions were up-regulated, while the E-cadherin protein expression was down-regulated; the rate of subcutaneous xenograft formation was significantly increased. All the differences had statistical significance (all P<0.05). Conclusion: The stem cell-like cells derived from cholangiocarcinoma QBC-939 cells possess stem cell properties, and can be used for cholangiocarcinoma stem cell research.

Abstract:Objective: To investigate the expressions of Versican and TNF-α in gallbladder carcinoma and their significance. Methods: The expressions of Versican and TNF-α in specimens of 62 gallbladder carcinoma tissues (tumor group), 30 gallbladder tissues with gallstones and chronic inflammation (inflammation group) and 20 normal gallbladder tissues (normal group) were detected by immunohistochemical staining and compared, and the relations of their expressions with clinicopathologic variables and prognosis of gallbladder carcinoma patients were analyzed. Results: Both positive expression rates of Versican and TNF-α presented an ascending order in normal group, inflammation group and tumor group, with statistical difference (all P<0.05); there was a positive correlation between the Versican and TNF-α expression in gallbladder carcinoma tissue (r=0.501, P<0.05). Either Versican or TNF-α expression was significantly related to lymph node metastasis and TNM stage of the patients, and the Versican expression was also related to the degree of differentiation of gallbladder carcinoma (all P<0.05). Survival analysis showed that the survival rate in patients with positive Versican or TNF-α expression was significantly lower than that in their negative counterparts (χ2=5.240, 5.493, both P<0.05), but the survival rate in patients with positive expressions of both Versican and TNF-α had no statistical difference compared with those with the positive expression of either of them alone (both P>0.05). Conclusion: Versican and TNF-α may probably play an important role in the process of occurrence and development of gallbladder carcinoma, and the positive expression of Versican and TNF-α may predict a poor prognosis.

Abstract:Objective: To investigate the effect of honokiol on the growth of gallbladder cancer cells in vitro and its mechanism. Methods: Using CCK-8 assay, the inhibitory effect of honokiol on gallbladder cancer SGC-996 cells was observed and the 50% inhibitory concentration (IC50) values were calculated. After exposure of SGC-996 cells to different concentrations of honokiol for 48 h, the colony formation, apoptosis and cell cycle as well as the expressions of apoptosis and cell cycle related proteins were examined by plate colony formation assay, cytometry and Western blot analysis, respectively. Results: Honokiol significantly inhibited the growth of SGC-996 cells, and its IC50 value was 34.66, 23.20 and 18.87 μmol/L after 24, 48 and 72 h, respectively. After exposure of SGC-996 cells to honokiol, the number of colony forming units was decreased, apoptosis rate and percentage of G0/G1 cells were increased, and the expressions of pro-apoptotic proteins (Bax, cleaved-caspase-9, cleaved-caspase-3 and cleaved-PARP) were increased, while expressions of anti-apoptotic proteins (Bcl-2 and Bcl-2/Bax ratio) as well as cell cycle-related proteins (Cyclin D1, Cdk4 and Cdk6) were decreased. All of these effects showed significant concentration-dependent trend (all P<0.05). Conclusion: Honokiol has strong inhibitory effect on gallbladder cancer cells in vitro, and its mechanism may possibly be associated with inducing cell apoptosis via intrinsic apoptosis pathway and suppressing cell proliferation by regulating the expression of cell cycle-related proteins.

Abstract:Objective: To investigate the expression of interferon-induced transmembrane protein 3 (IFITM3) in hepatocellular carcinoma (HCC) and its significance. Methods: Fifty-five specimens of paired HCC and adjacent tissues were collected, in which the IFITM3 protein expressions were determined by immunohistochemical staining and Western blot analysis, respectively, and the relations of IFITM3 expression with the clinicopathologic factors of HCC patients were also analyzed. After transfection with interfering sequences against IFITM3, the changes in invasion and migration ability in HCC HepG2 cells were observed. Results: Results of immunohistochemical staining showed that the IFITM3 positive expression rate in HCC tissue was significantly higher than that in its adjacent tissue (88.2% vs. 23.5%, P<0.05), and in low/moderate differentiated HCC tissue was significantly higher than that in high differentiated HCC tissue (80.0% vs. 8.3%, P<0.05); results of Western blot analysis demonstrated that IFITM3 protein expression level in HCC tissue was significantly higher than that in its adjacent tissue (1.2 399 vs. 0.9 565, P<0.05); IFITM3 expression level was significantly associated with portal vein tumor thrombosis, tumor size and TNM stage (all P<0.05). Both invasion and migration abilities in HepG2 cells were remarkably reduced after transfection with interfering sequences against IFITM3. Conclusion: IFITM3 expression is increased in HCC, and its increasing degree is closely associated with invasion and migration ability of HCC cells, which suggest that IFITM3 plays an important role in the process of malignant progression in HCC.

Abstract:Objective: To investigate the effect of peroxiredoxin 1 (Prx-1) inhibition on radiosensitivity of hepatocellular carcinoma (HCC) cells. Methods: Using human HCC HepG2 cells, the radioresistant HCC cells (RR-HepG2) were induced by fractionated irradiation with ascending radiation dose levels. In RR-HepG2 cells and their parental HepG2 cells, the Prx-1 expression was examined, and after undergoing the same radiation treatment, the survival rate and the invasion and migration abilities were determined. Then, in these two types of cells after transfection with the plasmids bearing shRNA-Prx-1, the above parameters were determined again. Results: In RR-HepG2 cells compared with their parental HepG2 cells, both Prx-1 mRNA and protein expressions were significantly increased; the survival rate, and invasion and migration abilities were significantly increased after radiation treatment (all P<0.05). After shRNA-Prx-1 transfection, in both types of cells compared with their counterparts transfected with negative control sequences, both Prx-1 mRNA and protein expressions were significantly decreased; the survival rate, and invasion and migration abilities were significantly decreased after radiation treatment (all P<0.05). Conclusion: The decreased radiosensitivity in HCC cells may probably be associated with Prx-1 expression, and regulating its expression could potentially be an effective approach for enhancing radiosensitivity of HCC cells.

Abstract:Objective: To investigate the domain containing 7A (THSD7A) expression in human hepatocellular carcinoma (HCC) and its clinical significance. Methods: The THSD7A mRNA expression in 30 fresh specimens of HCC with paired and adjacent tissues, and protein expression in 75 paraffin embedded specimens of HCC with paired adjacent tissues were detected by RT-PCR and immunohistochemical staining, respectively. The relations of THSD7A protein expression with clinicopathologic parameters and prognosis of HCC patients were analyzed. Results: The THSD7A mRNA expression in HCC tissue was significantly down-regulated compared with adjacent tissue (P<0.05), and the positive expression rate of THSD7A protein in HCC tissue was significantly lower than that in adjacent tissue (24.0% vs. 87.0%, P<0.05). The THSD7A protein expression was significantly related to the tumor numbers (P=0.011), Edmondson-Steiner grade (P=0.013) and BCLC stage (P=0.048) of the patients. Both overall survival and disease-free survival in patients with low THSD7A expression were significantly lower than those in patients with high THSD7A expression (P=0.016, P=0.013). Conclusion: THSD7A may play a tumor-suppressor role in HCC, and those with decreased THSD7A expression have a relatively poor prognosis.

Abstract:Objective: To assess the therapeutic effect of radical resection of hepatic alveolar echinococcosis. Methods: The clinical data of 163 patients with hepatic alveolar echinococcosis undergoing radical surgical resection between January 2013 and June 2015 were analyzed retrospectively. Results: The average operative time for radical surgery was (3.1±1.2) h, and intraoperative blood loss was (763±498) mL. The median time for the retention of intraperitoneal drainage tube was 6 d, and 11 patients underwent T-tube drainage that was removed one month after operation. The mean time to first passage of flatus and oral intake was (2.1±0.8) d and (2.7±1.1) d, respectively, and length of postoperative hospitalization was (7.9±3.4) d. Postoperative complications occurred in 8 patients, which included bile leakage in 5 cases, surgical site infection in one case, and ascites in 2 cases. Telephone contact or outpatient clinic follow-up was conducted for one month to 6 months postoperatively, and no death or recurrent echinococcosis was reported. Conclusion: Radical resection is still the first treatment option for hepatic alveolar echinococcosis. Based on adequate preoperative evaluation of the feasibility, and knowledge about the intraoperative techniques such as hepatic blood flow control, liver anatomy, and portal vein and biliary reconstruction, radical surgical resection can improve the quality of life and extend the survival time of the patients.

Abstract:Objective: To systematically assess the factors that influence the prognosis of HER-2-positive breast cancer. Methods: Publicly published domestic studies regarding the prognosis of HER-2-positive breast cancer were searched, and the eligible studies were selected based on the inclusion and exclusion criteria, and then the 5-year survival rates for different observational factors were extracted and Meta-analysis was performed by RevMan 5.3 software. Results: A total of 4 studies with 558 patients were included. Results of Meta-analysis for different observational factors showed that the 5-year survival rate in patients ≥35 years of age was better than that in those <35 years of age (OR=0.01, 95% CI=0.01–0.02, P<0.00001), in patients without family history was better than those with a family history (OR=0.00, 95% CI=0.00–0.00, P<0.00001), in patients with tumor size < 5 cm was better that those with tumor size ≥5 cm (OR=14.83, 95% CI=1.03–212.53, P=0.05), in patients without lymph node metastasis was better than in those with lymph node metastasis (OR=0.47, 95% CI=0.27–0.82, P=0.007), in patients with histological grade I or II was better than in those with histological grade III (OR=2.84, 95% CI=1.63–4.97, P=0.0002), and in patients with other pathological types was better than in those with invasive ductal carcinoma (OR=35.5, 95% CI=21.71–58.03, P<0.00001); the menopausal status had no significant influence on prognosis of the patients (OR=0.64, 95% CI=0.26–1.59, P=0.34). Conclusion: Age, family history, tumor size, lymph node metastasis, histological grade and pathological type are associated with the prognosis of HER-2-positive breast cancer, but the influence of menopausal status on prognosis remains to be identified.

Abstract:Objective: To determine the efficacy of neoadjuvant chemotherapy combined with three-dimensional (3D) conformal radiation in conversion therapy for unresectable advanced rectal cancer. Methods: Fifty-six patients with unresectable advanced rectal cancer (12 patients with liver metastases) admitted from January 2008 to June 2013 were selected. Of the patients, 30 cases assigned to observational group received neoadjuvant chemotherapy plus 3D conformal radiation therapy, and 26 cases, serving as control group, underwent neoadjuvant chemotherapy and conventional radiation therapy. The conversion rate to resectability, postoperative survival, adverse reactions and incidence of complications after treatment between the two groups of patients were compared. Results: The conversion rate to resectability in observation group was significantly higher than that in control group at 16 weeks of treatment (60.0% vs. 26.9%, P=0.013); both progression-free survival and overall survival in observation group were significantly prolonged compared with control group (P=0.046, P=0.029); the incidence of adverse reactions and short-term complications between the two groups showed no significant difference (all P>0.05). Conclusion: Neoadjuvant chemotherapy combined with 3D conformal radiation therapy can effectively increase the conversion rate to resectability for unresectable rectal cancer, and prolong survival time of the patients without increasing the occurrence of adverse reactions and complications.

Abstract:

Cirrhosis is a common chronic liver disease, and is associated with an increased incidence of gallbladder stones. The pathological profile of liver cirrhosis consists of two major aspects: portal hypertension and liver function decline, which may further cause local and systemic physiological changes, and play an important role in the pathogenesis of gallstone formation. In this paper, the authors address the pathological changes and pathogenesis of gallbladder stones associated with liver cirrhosis.

Abstract:Many studies demonstrated that the growth and proliferation of malignant tumors are closely associated with the activation of kinases. Therefore, targeted inhibition of the activation of kinases could be an effective anti-cancer method. ROS1 is a receptor tyrosine kinase (RTK), and it has recently been found to harbor rearrangements in a variety of human cancers such as glioblastoma, non-small cell lung cancer (NSCLC), cholangiocarcinoma, gastricadenocarcinoma, colorectal cancer, inflammatory myofibroblastic tumor, and angiosarcoma. The constitutive activation of ROS1 fusion proteins can drive cell proliferation, and induce cell malignant transformation, migration and invasion. Recent study found that crizotinib, an inhibitor targeting ROS1 fusion proteins, had significant therapeutic effect on NSCLC patients with positive ROS1 rearrangement. Thus, further understanding the expression and mechanism of ROS1 fusion gene have important significance.