ObjectiveTo describe the constructive process of neoadjuvant therapy for colorectal cancer part in the West China Colorectal Cancer Database (DACCA).MethodWe used the form of text description.ResultsThe specific concept of neoadjuvant therapy for colorectal cancer including neoadjuvant treatment therapies, compliance of patients with neoadjuvant therapy, neoadjuvant therapy intensity scheme, the CEA value of patients during neoadjuvant therapy, changes of symptoms, changes of primary tumor size in colorectal cancer, and TRG grading of the DACCA in the West China Hospital were defined. Then the neoadjuvant therapies were detailed for their definition, label, structure, error correction, and update.ConclusionThrough detailed description and specification of neoadjuvant therapy for colorectal cancer in DACCA in West China Hospital, it can provide a reference for the standardized treatment of colorectal cancer and also provide experiences for the peers who wish to build a colorectal cancer database.
Objective To discuss the strategies for building the framework of team culture of multi-disciplinary team (MDT) for colorectal cancer. Methods By comprehending the traditional concept of volunteer and probing into the value of traditional team culture, combining the needs of MDT for colorectal cancer, build appropriate team culture and core idea of MDT for colorectal cancer. Results Confirm that building of volunteers groups and the volunteers culture is the core of the team culture of MDT for colorectal cancer. Analyze characters of volunteers groups and the operation strategies, and find the way of maintaining the volunteers culture. Conclusion With the development of volunteers groups and increased participants, the team culture of MDT for colorectal cancer will show more sociality and extent. And it is also the important idea and direction for development in future. As team culture, organization structure and personnel structure supplements each other, adjusting and perfecting the team culture in practice continually is a long-term work for MDT.
Objective To explore the safety, effectiveness, operation mode and clinical value of the laparoscopic colorectal resection. Methods The clinical data and experiences of laparoscopic resection for 18 cases with colorectal neoplasm from Jun. 2007 to Mar. 2008 were studied retrospectively. Results Among 18 cases, there were 5 cases of rectal cancer, 6 cases of sigmoid colon carcinoma, 2 cases of sigmoid colonic polyp, 2 cases of descending colon carcinoma, 2 cases of ascending colon carcinoma and 1 case of ascending colonic lipoma. Fifteen cases of laparoscopic colorectal resection were performed successfully, including Dixon procedure 4 cases, Miles operation 1 case, radical resection of sigmoid colon 5 cases, palliative resection of sigmoid colon 2 cases, left hemicolectomy 2 cases and right hemicolectomy 1 case. Three cases converted to laparotomy due to adiposity or advanced status of local disease. Average intraoperative blood loss was 110 ml. The average number of lymph nodes dissected was 13.5. It took about 40 hours to restore intestinal function. The average time of hospitalization was 9 days. No one died during operation and no complications such as anastomotic leakage and postoperative hemorrhage occurred. Conclusion Laparoscopic resection for colorectal neoplasms possesses less trauma and rapid postoperative recovery. Laparoscopic colorectal surgery is safe and effective with skill and indication.
Objective To determine whether tumor angiogenesis correlates with progression of colorectal carcinoma. Methods Microvessel counts (MVC) of 102 specimens resected from patients with colorectal carcinoma were investigated by immunohistological staining with a monocolonal antibody against FⅧ RAg, the mean number of microvessels in three areas of highest vascular density were counted under 200 times magnification microscope. Correlation of MVC with various clinicopathologic factors, and prognosis was studied. Results MVC was increased with Dukes stage, the MVC of patients with advanced stage disease was significantly higher than that of early stage patients (P＜0.01). MVC was significantly higher in tumors with lymph node metastasis and liver metastasis (P＜0.01) than in those without such metastasis. The recurrence rate after curative resection in hypervascular group (MVC≥14, 60.4%) was significantly higher (P＜0.01) than that in the hypovascular group (MVC＜14,26.5%).Moreover, the prognosis of patients with a high MVC was significantly poorer than that of those with a low MVC (P＜0.01). Conclusion Angiogenesis within colorectal cancer is an indicator of tumor behavior and may identify patients at higher risk for recurrence and poorer prognosis.
Objective To explore the microRNA （miRNA） expression changes and related miRNA characteristics of colorectal cancer （CRC） with hepatic metastasis by miRNA microarray. Methods The fresh specimens of primary CRC were collected in 10 patients during operation， which with hepatic metastasis or not. miRNA microarray analysis was performed to compare the miRNA expression levels in two groups. The different expression levels of miRNA were validated by quantitative real-time PCR analysis. Results A total of six dysregulated miRNAs were identified in the CRC patients with hepatic metastasis comparing with CRC patients without hepatic metastasis， including 3 up-regulated miRNAs （miR-224， miR-1236， and miR-622） and 3 down-regulated miRNAs （miR-155， miR-342-5p， and miR-363）， and the quantitative real-time PCR result of miR-224 consisted with the microarray finding. Conclusions miR-224 may be involved in the process of CRC with hepatic metastasis pathogenesis. miR-224 would be a research direction on a new biomarker or therapic method in CRC with hepatic metastasis.
ObjectiveTo detect the expression of somatostatin receptor Ⅱ(SSTR2) mRNA in the specimens of colorectal cancer patients and discuss the relationship between the expression and characteristics of the tumor.MethodsAll tissue samples of 36 cases, including normal colonic mucosa (10 cm beyond the tumor), mucosa adjacent to the tumor (within 2 cm of the tumor), tumor, and mesenteric lymph node, were collected immediately after surgical resection. The SSTR2 mRNA were detected by RT-PCR in 135 samples of the 36 cases. The SSTR2 mRNA expression rate in different samples was compared.ResultsThe SSTR2 mRNA expression rate of normal colonic mucosa, mucosa adjacent to tumor, tumor, mesenteric node without metastasis, and mesenteric node with metastasis was 67.6%(23/34), 75.0%(24/32),91.4%(32/35),93.8%(15/16) and 81.8%(9/11) respectively. Expression rate of tumor significantly increased compared with normal colonic mucosa (χ2=6.37, P＜0.05). The expression rate of the tumor in different groups, such as patients of different sex, serum CEA level, tumor size, location, histological grade and pathological stage, showed no difference (P＞0.05）.ConclusionThe expression rate of SSTR2 mRNA of colorectal adenocarcinoma increases. The expression rate does not correlate with the histological grade and pathological stage of the tumor.
Objective To explore the values of telomerase in the diagnosis, therapy and prognostic parameter of colorectal cancer. Methods Telomerase activity in colorectal cancer, peri-cancerous and normal mucosa was detected by PCRTRAP-ELISA assay. Results The positive rates of telomerase in colorectal cancer, peri-cancerous and normal mucosa were 84.8%, 20.0% and 0% respectively. 66.7% of the early stage colorectal cancer expressed telomerase. Telomerase activity was reversely correlated with tumor differentiation.Conclusion Telomerase may be an earlier event of malignant progression in colorectal cancer. It might be a parameter for diagnosis of colorectal cancer.
Objective To summarize the experience of single incision laparoscopic colorectal surgery and to discuss the operative techniques. Methods The clinical data of 21 cases who underwent single incision laparoscopic colorectal surgery in Shengjing Hospital from Jan. 2010 to Jun. 2011 were collected and analyzed. Results Of 21 cases underwent single incision laparoscopic surgery， right hemicolectomy performed in 5 cases， sigmoidectomy performed in 2 cases， rectal anterior resection performed in 9 cases， rectal abdominoperineal resection performed in 2 cases， total colectomy performed in 1 case， and colostomy performed in 2 cases. Twenty cases completed by single incision， but 1 case was added an extra 12 mm incision in order to dissect the lower segment of rectum. The operative time was （189±75） min （40-335min）；the postoperative hospitalization time was （11.5±3.4） d （7-16d）. There were no bleeding， anastomosis leakage or intestinal obstruction after operation， and no incision infection， rupture or hernia were founded. No recurrence was found within 6 months’ follow up after operation. Conclusions Under reasonable selection of indication， single incision laparoscopic colorectal surgery is safe and feasible， and it also has a satisfactory cosmetic effect and better minimally invasive effect.
ObjectiveTo investigate the surgical complications and its influence factors of radical surgery in the treatment of elderly patients with colorectal cancer. MethodsTwo hundreds and sixteen patients with colorectal cancer who were treated in the Second People's Hospital of Lianyungang City from January 2010 to September 2014 as the research object, the clinical data were collected by the self-made general data questionnaire, and they were analyzed by descriptive statistics and logistic regression analysis using SPSS 19.0. ResultsFor elderly patients with colorectal cancer radical operation, pulmonary infection and wound infection were the common complications.Single factor and logistic regression analysis showed that medical comorbidity, hypoproteinemia, operation time, Dukes staging, and smoking were risk factors of postoperative complications in the colorectal cancer patients. ConclusionFor elderly patients with colorectal cancer underwent radical operation, pulmonary infection and wound infection are the common complications.It's occurrence by various factors.
ObjectiveTo study the expression of c-Met in colorectal carcinoma cells and the effect of hepatocyte growth factor (HGF) on proliferation and invasion of colon carcinoma cells SW480. MethodsReal-time PCR and Western blot methods were respectively used to detect the expressions of c-Met mRNA and protein in the different colorectal carcinoma cells in order to screen the high c-Met expression cells. The SW480 cells were incubated with different concentrations (0, 20, 40, and 70 ng/mL) HGF. MTT assay and Transwell test were used to evaluate the effects of proliferation and invasion in the SW480 cells. Results①The c-Met was expressed in each colorectal carcinomar cells, especially highly expressed in the colon carcinoma cells SW480 in vitro.②MTT assay showed that the HGF could promote the proliferation of SW480 cells in a dose-dependent manner with some extent.③Transwell test showed that the HGF could increase the invasion of SW480 cells. ConclusionThe c-Met is highly expressed in colorectal carcinoma cells and HGF could promote proliferation and increase invasion of colorectal carcinoma cells in vitro.