ObjectiveTo summarize research progress of quality of life in patients after colorectal cancer surgery.MethodsThe literatures about quality of life of patients with colorectal cancer surgery in recent years are reviewed.ResultsQuality of life had became an important criterion for evaluating the therapeutic effect and prognosis of cancer. At present, the assessment tools for the quality of life of colorectal cancer patients mainly included the universal scale [such as Short Form Health Survey (SF-36)], the applicable scales for cancer patients [such as European Organization for Research and Treatment of Cancer: quality of life questionaire-C30 (EORTC QLQ-C30) and European Organization for Research and Treatment of Cancer: quality of life questionaire-CR38 (EORTC QLQ-CR38)], and the special scales for stoma patients represented by City of Hope Quality of Life-Ostomy Questionnaire (COH-QOL-OQ), Stoma Quality Of Life (Stoma-QOL), Stoma Quality Of Life Scale (SQOLS), and so on. The short-term quality of life of colorectal cancer patients was lower at 1 month after operation and recovered at 3 months after operation. Five years after surgery, attention should also be paid to the long-term quality of life. Besides, postoperative quality of life of colorectal cancer patients was affected by age, occupational status, economy, preoperative physical activity level, psychological and social factor, personality, surgical method, co-morbidity, complication, stoma, and so on.ConclusionsUnderstand the longitudinal changes and influencing factors of patients’ quality of life after operation, grasp the time point of effective intervention, and select appropriate assessment tools are necessary for medical staff. It is of great significance to further optimize the clinical management pathway and improve the quality of life of patients with colorectal cancer after operation.
ObjectiveTo investigate the value of different minimally invasive surgical techniques, stent placement, laparoscopic surgery, and sustained-releasing 5-fluorouracil, in solving intestinal obstruction due to colorectal cancer. MethodsFrom May 2000 to May 2010, total 68 patients with obstructed colorectal cancers in three centers were treated in two ways in terms of the stage: The first, patients with resectable tumors underwent colorectal stent placement as a ‘bridge to surgery’ guided by enteroscope under X-ray. After clinical decompression and bowel preparation, laparoscopic radical resection was performed. The second, patients with unresectable tumors underwent rectal stent placement just for palliation. Sustained-releasing 5-fluorouracil was implanted into the local cancerous intestinal tract through stent walls. ResultsFifty-one of 52 patients underwent laparoscopic radical resection successfully following stent placement, while one failed and died during follow-up 93 d postoperatively. Forty patients with successful laparoscopic surgery were followed up in 3 to 36 months (with an average of 15 months) without tumor planting in the incision, postoperative local recurrence or anastomotic stricture. Fifteen unresectable patients and one high-risk, intolerable patient underwent rectal stent placement and implantation of sustained-releasing 5fluorouracil. During follow-up 3 to 24 months (with an average of 14 months), 11 died, who survived for (350±222) d (range 101-720 d), and 5 were still alive for 3 to 13 months (with an average of 9 months) without intestinal obstruction. ConclusionsLaparoscopic surgery combined with stent placement is an effective and safe procedure for resectable obstructed colorectal cancer. For unresectal obstructed rectal cancer, rectal stent placement combined with sustained-releasing 5-fluorouracil can prolong survival time avoiding colostomy.
摘要:目的： 檢測大腸癌組織中Kras基因的突變情況以指導臨床治療。 方法 ：通過提取15例大腸癌石蠟組織中的DNA并進行PCR擴增,之后采用國際金標準方法直接測序法進行檢測獲得突變信息。 結果 ：15例大腸癌石蠟組織樣本中Kras有4例發生突變,突變率為266%。值得注意的是發現一個新的突變位點密碼子42,并且與密碼子12突變共存。 結論 ：密碼子42的突變進一步證明Kras突變不僅局限于密碼子12,13,61,還有與密碼子12共存的42位突變。Abstract: Objective: To detect the mutation status of Kras gene in colorectal cancers and to assist the clinical treatments Methods : DNA was extracted from fifteen formalinfixed, paraffinembedded tumor samples of colorectal cancers, and then the fragments containing codons 12,13 and codon 61 were amplified by PCR The sequences were indentified by direct sequencing which is gold standard for the detection of mutation Results : In the 15 samples of colorectal cancer patients, 4 mutations were observed, with 2 in codon 12 and 2 in codon 13 Suprisingly, a novel point mutation at codon 42 of Kras was found, and coexisted with mutation in codon 12 Conclusion : Except for codons 12,13,61 mutation, Kras has other mutation at codon 42 with coexisted with codon 12 point mutation
Objective To study the relationships between expressions of somatostatin receptor subtypes（SSTR1-SSTR5） and angiogenesis in colorectal cancer. Methods The expressions of SSTR1-SSTR5, VEGF, and CD34 in the paraffin sections of colorectal cancer tissues from 127 cases were detected by the standard streptavidin-peroxidase (SP) technique. CD34 was used as a marker to account microvessel density (MVD) in colorectal cancer tissues. The relationships between the expressions of SSTR1-SSTR5 and VEGF expression, or MVD were analyzed. Results The positive expression rate of SSTR1, SSTR2, SSTR3, SSTR4, and SSTR5 was 64.6% （82/127）, 36.2% （46/127）, 18.9% （24/127）, 18.9% （24/127）, and 38.6% （49/127） in colorectal cancer tissues, meanwhile, the positive expression rate of VEGF was 63.8% （81/127） and MVD was (34.67±16.62)/HP in colorectal cancer tissues. The positive expression rate of VEGF (47.8%， 22/46) and MVD 〔(29.00±15.32)/HP〕 in colorectal cancer tissues with SSTR2 positive expression were significantly lower than those in colorectal cancer tissues with SSTR2 negative expression 〔72.8%， 59/81； (37.90±16.56)/HP〕, Plt;0.05. There were no relationships between SSTR1, SSTR3, SSTR4, and SSTR5 expression and VEGF expression or MVD （Pgt;0.05）. Conclusion The positive expression of SSTR2 is related with angiogenesis in colorectal cancer tissues.
Objective To explore the operative safety of HIV-infected patients with colorectal cancer in different degrees of immunodeficiency. Methods A total of 56 patients, including 26 cases of HIV positive (HIV-positive group) and 28 cases of HIV negative (HIV-negative group), who underwent radical operation for colorectal cancer between January 2012 and December 2015, were enrolled in our study. We divided HIV-positive patients into three groups according to CD4+ T cells count in peripheral venous blood before 1 day (D0) of the surgery (HIV-positive Ⅰgroup with CD4+ T cells count >500/μL, HIV-positive Ⅱgroup with CD 4+ T cells count among 200–500/μL, and HIV-positive Ⅲ group with CD4+ T cells count <200/μL). Non-infective patients were enrolled in HIV-negative group. Leukocyte count, neutrophil percentage, lymphocyte percentage, CD 4+ T cells subsets count, and CD8+ T cells subsets count of the 4 groups in different time points were tested. In addition, we compared postoperative complications, carcinoembryonic antigen (CEA), and postoperative survival rate between the HIV-positive group and the HIV-negative group. Results In 56 cases, there were 26 cases of HIV-positive patients (including 10 cases of HIV-positive Ⅰ group, 8 cases of HIV-positive Ⅱ group and 10 cases of HIV-positive Ⅲ group). Variance results about repeated measurement data showed that, variation of leukocyte count, neutrophil percentage, lymphocyte percentage, and CD8+ T cells count among 4 groups after surgery had no statistical significance (P>0.05), in addition there was no significant on time effect and interactive effect of time and group (P>0.05). CD4+ T cells count in the 4 groups showed a trend from decline to rising with time going, and the time effect had statistical significance (P<0.05). The speed and amplitude of decline and recovery of CD4+ T cells count were different among groups, and the group effect had statistical significance (P<0.05). CEA showed a trend of decline after surgery in both HIV-positive group and HIV-negative group, and the time effect had statistical significance (P<0.05), but the group effect and interactive effect of time and group had no statistical significance (P>0.05). No statistically significant differences in amount of blood loss, duration of surgery, postoperative stay, nor complication rate (including incision infection, pulmonary infection, and opportunistic infections after surgery) were found between the HIV-positive group and the HIV-negative group (P>0.05). The overall survival situation of the HIV-positive group and the HIV-negative group had no statistical significance (P>0.05). Conclusions Radical operation for HIV-infected patients with colorectal cancer has an impact of " first inhibition and recovery” on cellular immunity over a period of time. Incidence of postoperative complications and survival rates are similar in HIV-positive patients and HIV-negative patients. In a word, it’s safe to have radical operation for colorectal cancer in HIV-positive patients under the proper perioperative treatment.
Objective To explore risk factors of lymph node metastasis (LNM) in T1 rectal cancer. Methods The retrospective case-control study was conducted. The clinicopathologic data of 247 patients with T1 rectal cancer underwent radical resection were analyzed in the pathological database of the West China Hospital from January 2000 to December 2016, including the tumor size (maximum diameter), gross type, differentiation degree, histological type, lymph vascular infiltration, perineural infiltration, and carcinoma nodule. The univariate analysis and multivariate analysis were done using the Chi-square test and logistic regression model, respectively. Results The rate of LNM in the patients with T1 rectal cancer was 8.50% (21/247). No lymph metastasis was found in the well differentiated T1 rectal cancer. The results of the univariate analysis showed that the differentiation degree, histological type, and carcinoma nodule were related to the LNM in the T1 rectal cancer (P<0.050). The results of the multivariate analysis revealed that the poor differentiation, mucinous adenocarcinoma, signet-ring cell carcinoma, and carcinoma nodule were the independent risk factors of the LNM in the T1 rectal cancer (OR=9.75, P=0.006; OR=5.98, P=0.042; OR=8.33, P=0.017; OR=10.87, P=0.026). Conclusion In this large population dataset, poor differentiation, mucinous adenocarcinoma, signet-ring cell carcinoma, and carcinoma nodule are risk factors of LNM in T1 rectal cancer.
ObjectiveTo comprehend the role of ABO blood groups antigens in the occurrence, development, screening, treatment, and prognosis of colorectal cancer (CRC). MethodThe literature on the researches relevant to relation between ABO blood groups and CRC in recent years was reviewed and analyzed. ResultsThere were two possible mechanisms relevant to the relation between the ABO blood groups antigens and the occurrence of CRC—Nucleotide polymorphisms in regulatory genes of the ABO blood groups antigens and lack of ABO blood groups antigens expression, and its abnormal expression in the cancer cells provided the clues for the screening of CRC. At present, it was found that the ABO blood groups were associated with the treatment and prognosis of the patients with CRC in the relatively fewer researches, but the detailed mechanism did not be clarified. ConclusionsFrom the summary of the literature results, researchers have studied the role of ABO blood groups in CRC, and have obtained some conclusions with clinical significance in the occurrence, development, screening, treatment, and prognosis of patients with CRC, suggesting that it has certain research prospects. However, relevant to research is less, the conclusions need to be further verified.
Objective To observe the life quality and the immune function of colorectal cancer patients treated by huaier granule combined with FOLFOX4 chemotherapy. Methods A total of 76 cases of colorectal cancer with chemotherapy indications were divided into two groups at random. Huaier granule and FOLFOX4 chemotherapy was applied in trial group， meanwhile， placebo and FOLFOX4 chemotherapy in control group. The changes of life quality， common condition， and immune state in two groups before and after treatment were abserved. Results The effective rate in the trial group was 92.1％ （35/38）， and in the control group was 65.8％ （25/38）， χ2=7.91， P＜0.005. The life quality improving rate in the trial group was 78.9％ （30/38）， and in the control group was 31.6％ （12/38）， χ2=6.33， P＜0.05. The CD3 increase rate in the trial group was 65.8％（25/38）， and in the control group was 23.7 ％ （9/38）， χ2=7.96， P＜0.005， the CD4/CD8 increase rate in the trial group was 68.4 ％（26/38） , and in the control group was 28.9％ （11/38）， χ2=10.53， P＜0.005. Conclusions Huaier granule can significantly improv the clinical symptoms, life quality, and immune state. Huaier granule combined with FOLFOX4 chemotherapy is a new effective scheme to cure colorectal cancer， is worth further generalization．
ObjectiveTo summarize the common mouse models and the latest research progress in the basic research of colorectal cancer, introducing advantages, disadvantages and applications of these various models, provide references for the researchers in the selection of mouse models for their experiments.MethodRetrieved the related literatures from databases including PubMed, Web of Science, CNKI and WanFang, and after reading the literatures, different methods were sorted out, analyzed and summarized.ResultsThe mouse models commonly used in colorectal cancer research include the cell-derived xenograft (CDX), patient-derived xenograft (PDX), chemical reagent-induced tumor in situ, transgenic mice (ApcMin/+ mice), tumor cells derived from mice themselves were inoculated to the normal mice, and models of colorectal metastatic tumors (including liver, lung, abdomen and bone metastases, etc.). The CDX model cost shorter time to establish, and the PDX model restored the authentic phenotype of the tumor in patients, but the tumor were both colonized under the skin of nude mice, which lacked authenticity tumor microenvironment. The colorectal cancer in mice induced by chemical reagents and genetically engineered mice imitated the development of colorectal tumor in the situ intestine of mouse, but both of them were time-consuming. The model established by the tumor of mouse own was convenient for basic immune research of colorectal cancer, but the disadvantage was the unreal tumor microenvironment. The colorectal cancer metastasis model was an essential model for the study of the mechanism and treatment in metastasis colorectal tumor, but its establishment required higher operating skills and required the image examination to determine the whether the metastasis tumor was successfully generated or not.ConclusionsDifferent mouse models of colorectal cancer have different emphases, advantages and disadvantages. Researchers need to make accurate selection according to the research purpose and design needs.
ObjectiveTo investigate the impact of primary tumor site on prognosis of colorectal cancer after radical resection in different stages.MethodsFour hundreds and twenty patients with colorectal cancer in our hospital from Jan. 2008 to Dec. 2016 were selected as study subjects, all patients were confirmed by pathology. According to the location of colorectal cancer, the patients were divided into rectum group (n=220), left colon group (n=105) and right colon group (n=95). The difference of clinicopathological features of patients with different group were compared. The risk factors affecting the prognosis of colorectal cancer patients were analyzed by single factor and multi factor unconditional Cox regression analysis, and the survival curve was drawn by Kaplan-Meier method, and the difference test was carried out by log-rank method.ResultsThere were no significant differences between the three groups in age, BMI, smoking history, alcohol history, family history, vascular tumor thrombus, N staging, tumor diameter, nerve invasion and cancer nodule (P>0.05). There were significant differences in sex, pathological type, anterior intestinal obstruction, TNM staging, T staging and M staging (P<0.05). The results of single factor Cox regression analysis showed that sex, pathological type, anterior intestinal obstruction, TNM staging, T staging, M staging, primary tumor site, nerve invasion and cancer nodule were the risk factors for the prognosis of the patients (P<0.05). Multivariate Cox regression analysis showed that TNM staging, location of primary tumor and nerve invasion were risk factors affecting prognosis of patients (P<0.05). The total 5-year survival rate of the rectal group was 80.45% (177/220), the total 5-year survival rate of the left hemicolon group was 67.62% (71/105), and the total 5-year survival rate of the right hemicolon group was 68.42% (65/95). The survival curves of Kaplan-Meier showed that the difference between the three groups was statistically significant (P<0.05).ConclusonsThe 5-year survival rate of patients with rectal cancer is significantly higher than that of patients with left colon cancer and right colon cancer. For patients with different stage of colorectal cancer after radical resection, the prognosis of colorectal cancer can be predicted by the location of primary tumor.