Background: Platelets play important roles in tumorigenesis, angiogenesis and metastatic dissemination of tumor cells. Radiofrequency ablation (RFA) could increase the circulating tumor cells in patients with primary or metastatic lung tumors. Whether platelet lysates in hepatocellular carcinoma (HCC) after RFA promote tumor progression has not been elaborated. Methods: HCC patients within Milan Criteria and without taking anti-platelet drugs were selected in the study. MTT assay, colony formation assay, transwell assay, tube formation and western blot were used to evaluate the effect of platelet lysates on HCC cells in vitro. Lung metastatic assay was performed in vivo. Results: Platelet lysates from patients after RFA promoted cell proliferation, colony formation, migration, invasion and vasculogenic mimicry in Hep3B and HCCLM3 cells compared with those from patients before RFA. Platelet lysates after RFA significantly increased the expression of p-Akt, p-Smad3 and snail, and decreased the expression of E-cadherin compared with those before RFA in Hep3B and HCCLM3 cells. Hep3B-Luc2-tdT cells incubation with platelet lysates from patients after RFA displayed enhanced lung metastasis compared with those before RFA. Conclusions: Platelet lysates from HCC patients after RFA promoted the proliferation, migration, invasion and vasculogenic mimicry of HCC cells, which indicated that RFA in combination with anti-platelet drug may be used to improve the prognosis of HCC.
Introduction and importance
Gastrointestinal stromal tumor (GIST) in Meckel's diverticulum (MD) is rare but it seems to be a common phenomenon that GIST triggers MD perforation or rupture; the exact mechanism is unclear. In addition, the location of GIST in perforated or ruptrued MD is most common in ileum, rarely in jejunum. We herein report a GIST in ruptured MD Located in jejunum and severe peritoneal cavity infection leads to myelosuppression.
Case presentation
A female patient was admitted to our hospital with “abdominal pain”. Physical examination and laboratory tests revealed that the patient was in shock and myelosuppression. Abdominal X-ray photograph and computed tomography indicated perforation of digestive tract. Laparotomy revealed rupture of MD located 90 cm from the Treitz ligament and a tumor was also found in the MD. As the condition is critical, the MD was excisioned from its root and the small bowel gap was closed and repaired. Laboratory indicators showed that myelosuppression was removed 24 h after operation. The pathological findings established a GIST in the MD. The patient was discharged on postoperative day 5 without significant complications.
Clinical discussion
A GIST in ruptured MD Located in jejunum caused the severe peritoneal cavity infection and myelosuppression In a short time, as seen in this case. Failure to recognize the severity of the disease and delay in treatment will endanger the life of the patient.
Conclusion
GIST in MD Located in jejunum is very rare, and the rupture of the MD can be life-threatening at any time.
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