【Abstract】ObjectiveTo study the specific cytotoxicity of amygdalin(a new prodrug) to LoVo cells in antibody directed enzyme prodrug therapy (ADEPT). MethodsThe specific activation of amygdalin by anti-CEA McAb-β-glucosidase conjugate and the cytotoxicity of amygdalin to LoVo cells were assessed throughTrypan blue exclusion. ResultsThe cytotoxicity of amygdalin itself to LoVo cells was low. However, when amygdalin was combinated with anti-CEA McAb-β-glucosidase conjugate, its cytotoxic effect was enhanced by nearly 40 times, and that effect was specific to to LoVo cells expressing CEA . When LoVo cells and MCF-7 cells were co-cultured in various ratios, the cytotoxic effect of amygdalin combinated with anti-CEA McAb-β-glucosidase conjugate was measured. The survival rate of cultured cells decreased while the percentage of LoVo cells increased, suggesting the cytotoxic effect to be specific to LoVo cells. ConclusionThe toxicity of amygdalin is low，and it can be activated by anti-CEA McAb-β-glucosidase conjugate effectively to kill targetd cells specifically which may be a new way for colorectal tumor therapy.
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.
ObjectiveTo summarize the changes of gut microbiota after cholecystectomy, the mechanisms of changes, and the relation with colorectal cancer, nonalcoholic fatty liver disease and post-cholecystectomy syndrome after cholecystectomy, in order to provide new ideas for the perioperative management of patients undergoing cholecystectomy. MethodThe studies related to gut microbiota after cholecystectomy at home and abroad were searched and analyzed for review. ResultsThe cholecystectomy disrupted the liver–bile acid–gut flora axis of the patients, and the composition and diversity of the gut microbiota of the patients were altered, and the alteration might lead to the occurrence of colorectal cancer, nonalcoholic fatty liver disease, and post-cholecystectomy syndrome, but the exact mechanism remained unclear. ConclusionsThe balance of intestinal microecology is disrupted after cholecystectomy, and the relation between cholecystectomy and gut microbiota may provide new ideas for the perioperative management of cholecystectomy patients and the prevention and treatment of diseases or symptoms after cholecystectomy, but the effect of cholecystectomy on gut microbiota and the relation with diseases or symptoms still need to be further studied.
The expression and rearrangement of bcl-2 gene in 64 cases with colorectal carcinoma were studied by immunohistochemical technique and semi-nest PCR respectively. The results showed the abnormal changes of the expression and rearrangement of bcl-2 gene had emerged in the early stage of colorectal carcinoma. The tumors with the expression of bcl-2 were associated with a higher incidence of metastasis to lymphatic node. The rearragement of bcl-2 was significantly higher in late-stage than that in early-stage. These suggest that bcl-2 gene involves in the regulation of the development of colorectal carcinoma. The state of the changes of bcl-2 gene in colorectal carcinoma may predict the therapeutic effect and prognosis of colorectal carcinoma.
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 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.
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.
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 evaluate the risk of management decision combined neo-adjuvant chemotherapy with operation for colorectal cancer by means of the colorectal cancer model of the Association of Coloproctology of Great Britain and Ireland (ACPGBI-CCM). Methods One hundred and eighty-one eligible patients (102 male, 79 female, mean age 58.78 years), which were pathologically proved colorectal cancer in our ward from July to November 2007, involved 62 colonic and 119 rectal cancer. The enrollment were assigned into multi-disciplinary team (MDT) group (n=65) or non-MDT group (n=116), according to whether the MDT was adopted, and the operative risk was analyzed by ACPGBI-CCM. Results The baseline characteristics of MDT and non-MDT group were coherent. The watershed of lower risk group (LRG) and higher risk group (HRG) was set as predictive mortality=2.07%. The time involving extraction of gastric, urethral and drainage tube, feeding, out-of-bed activity after operation in MDT group, whatever in LRG or HRG, were statistically earlier than those in non-MDT group (P＜0.05). The resectable rate in LRG was statistically higher than that in HRG (P＜0.05), and the proportion of Dukes staging was significantly different (P＜0.05) between two groups; Moreover, predictive mortality in HRG was statistically higher than that in LRG (P＜0.05), while actually there was no death in both groups. Conclusion Dukes staging which is included as an indispensable option by ACPGBI-CCM is responsible for the lower predictive mortality in LRG.Hence, the value of ACPGBI-CCM used to asses the morbidity of complications within 30 days postoperatively would be warranted by further research. The postoperative risk evaluation can serve as a novel routine to comprehensively analyze the short-term safe in the MDT.
Objective To study ultrastructure and clinical significance of gastrin secretory granule in colorectal carcinoma cells. Methods The gastrin expression in colorectal carcinoma tissue and blood of 10 cases was examined by using radioimmunity analysis and immunohistochemistry. The ultrastructure of gastrin secretory granule of 10 cases, the positive of gastrin immunohistochemistry of colorectal carcinoma were examined by using immunoelectron microscopic technique. Results The gastrin concentration of the colorectal cancer group 〔（130.75 ±21.34） pg/ml〕 was significantly higher than that of control group 〔（95.63± 12.26） pg/ml〕，Plt;0.05. In 10 specimens of colorectal cancer, 5 cases were gastrin immunohistochemistry positive (+++), 4 moderate positive (++) and 1 weak positive (+). Cells in colorectal cancer were polyshaped, with unusual nucleoli different in size, concentrating on the edge, the cytoplasm mitochondrion was plentiful with vacuolates, and more secretion granules could be seen, 400-1500 nm in diameter with a clear border of membrane. There were two types of granular appearance: type A was largest in bulk size, low electrodensity was welldistributed, granular core appeared loose; type B was smaller in bulk size, high electrodensity was welldistributed, nucleus was usually compact.protein A gold (pAg) positive granules were located partially in secreting granules. pAg positive granules in highly differentiated cancer were mainly located in secreting granules of type A. pAg positive granules in low differentiated cancer were mainly located in secreting granules of type B. A part of cancer cell membrane, and inside and outside of microvillus membrane, adhering to pAg granules in line could be seen. Conclusion The colorectal carcinoma cells may synthesize and secrete gastrin themselves, which may be the mechanism of high gastrin levels in colorectal cancer. The use of gastrin antagonist and receptor antagonist may treat the patents with colorectal carcinoma.