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Background and aim: Intestinal-type gastric carcinomas progress through chronic inflammation and atrophic gastritis. Heat shock protein 27(HSP27), a stress-induced molecular chaperone, inhibit reactive oxygen species (ROS) accumulation. In previous reports have been suggested that HSP27 plays an important role in inflammation and carcinogenesis. We investigated HSP27 expression in gastric neoplasia and background gastric mucosa to assess its involvement in gastric carcinogenesis. Methods:We used real-time quantitative polymerase chain reaction to examine HSP27 expression in gastric neoplasias and in gastric mucosae of 30 patients with intraepithelial neoplasias and in gastric mucosae of 30 patients without gastric neoplasia. Immunohistochemical staining was performed on 30 advanced gastric cancer tissues. Results: HSP27 expression was negatively associated with atrophic gastritis. HSP27 expression in the background gastric mucosa of those without gastric neoplasia(P= 0.004).In tumor necrosis factor -treated gastric cancer cell,HSP27 knockdown increased cell death and ROS accumulation that link inflammation to cancer. Poorly differentiated tumors most frequently had high HSP27 levels. Dedifferentiated of cancer cells is associated with an epithelial-mesenchymal transition signaling pathway. In gastric cancer MKN-1 cells, HSP27 knockdown upregulated E-cadherin and downregulated vimentin and smooth muscle actin, but this did not occur in MKN-74 cells. Conclusion: HSP27 expression in gastric mucosae is negatively correlated with intraepithelial neoplasia, a probable precursor to gastric cancer and HSP27 expression in cancer is positively correlated with poor differentiation.

Aim. We assessed the usefulness of post-vascular images on contrast-enhanced ultrasonography (CE-US) in the gross classification of hepatcellular carcinoma (HCC) in comparison with contrast-enhanced CT (CE-CT) findings. Methods. 51 patients with 61 HCCs underwent hepatectomy, and the gross type of HCCwas estimated by CE-US and CE-CT.We assessed the tumor shape by defect images during the post-vascular phase onCE-US using perfluorocarbon microbubbles, whereas the positive enhancement in the arterial phase and wash-out in the equilibrium phase on CE-CT. Patients were divided into two subgroups according to the gross classification: simple nodular type and non-simple nodular type. The capability of each imaging modality to correctly depict tumor shapes was compared. Results. Thirty-nine tumors were macroscopically diagnosed as simple nodule type, 19 tumors as simple nodular type with extranodular growth, and 3 tumors as confluent multinodular type from the resected specimen. The sensitivity and specificity of CE-US to diagnose the non-simple nodule type HCC were 86.4% and 89.7%, while those of CE-CT were 68.2% and 76.9%, respectively. The accuracy was significantly better in CE-US compared with CE-CT (88.5% vs 73.8%; p=0.037). Conclusion. The post-vascular phase image of CE-US is a more reliable tool to evaluate the gross type of HCC than CE-CT and is considered to be essential for the determination of treatment strategy and to estimate the prognosis of HCC patients. The sensitivity, specificity and accuracy of the gross type of HCC on CE-CT and CE-US