Abstract:

Objective: To assess the safety, efficacy and minimal invasiveness of totally laparoscopic distal gastrectomy (TLDG). Methods: The English literature comparing TLDG and laparoscopically assisted distal gastrectomy (LADG) publicly published from January 2007 to August 2013 were searched from several international online databases. After screening for inclusion, data extraction, and quality assessment, Meta-analysis was conducted by the Review Manager 5.2 software. Results: Five studies were finally included, with a total of 849 patients, of whom, 359 cases underwent TLDG and 490 cases were subjected to LADG. Results of Meta-analysis indicated that TLDG, compared with LADG, had decreased intraoperative blood loss, increased number of removed lymph nodes, and shortened length of time to postoperative flatus and first liquid intake (all P<0.05), but showed no significant difference in operative time, length of proximal surgical margin, length of postoperative hospital stay or incidence of complications (all P>0.05). Conclusion: TLDG is safe, effective and minimally invasive in treatment of distal gastric cancer, with no increase of postoperative complications.

Abstract:

Objective: To evaluate the clinical efficacy of laparoscopic total gastrectomy with D2 lymph node dissection in treatment of advanced gastric cancer. Methods: The clinical data of 126 patients with advanced gastric cancer undergoing total gastrectomy with D2 lymph node dissection from January 2005 to December 2011 were retrospectively analyzed. Of the patients, 59 cases received laparoscopic-assisted operation (laparoscopic group) while 67 cases were subjected to open surgery (laparotomy group), and the clinical efficacies between the two groups were compared. Results: The difference in operative time and hospitalization expenses between the two groups had no statistical significance (both P>0.05), but the parameters that included time to bowel function recovery and food intake, length of postoperative hospital stay, intraoperative blood loss, and size of incision in laparoscopic group were superior to those in laparotomy group (all P<0.05). The overall incidence of postoperative complications between the two groups showed no statistical difference (P>0.05), but the incidence of surgery-related complications in laparoscopic group was lower than that in laparotomy group (P<0.05); the length of proximal or distal surgical margin, and number of resected lymph nodes of the two group were similar (all P>0.05), and the difference in 1-, 3-, 5-year overall survival or free tumor survival between the two groups showed no statistical significance (all P>0.05). Conclusion: Laparoscopic total gastrectomy with D2 lymph node dissection for advanced gastric cancer is safe and effective.

Abstract:

Objective: To compare the efficacy between preoperative and postoperative docetaxel-based adjuvant chemotherapy for locally advanced gastric cancer (LAGC). Methods: From February 2011 to February 2012, 72 patients definitely diagnosed with LAGC were randomized into observational group and control group. Patients in observational group underwent preoperative chemotherapy, while those in control group were subjected to postoperative chemotherapy. Patients in both groups were followed up for 12 months after treatment, and the cycles of chemotherapy, surgical resection rate and pathological remission rate, as well as the incidence of adverse reactions and complications between the two groups were compared. Results: In total, 189 cycles of chemotherapy were performed for the two groups, in which observational group accounted for 62.43% (118/189), and control group accounted for 37.57% (71/189); one cycle chemotherapy administration accounted for 4.24% (5/118) in observational group, which was 22.54% (16/71) in control group, and all differences were statistically significant (both P<0.05). The complete response rate was 27.78% (10/36) and partial response rate was 63.89% (23/36) in observational group, which was 8.33% (3/36) and 38.89% (14/36) respectively in control group, and the differences were statistically significant (both P<0.05). The difference in surgical resection rate and lymph node removal between the two groups showed no statistical significance (both P>0.05). The incidence of adverse reactions was significantly lower in observational group than that in control group (P<0.05), while the incidence of complications and re-operation between the two groups had no statistical significance (both P>0.05). Conclusion: Preoperative docetaxel-based adjuvant chemotherapy can significantly improve the therapeutic efficacy for LAGC patients, improve the tolerance of patients to chemotherapy, and reduce adverse reactions.

Abstract:Objective: To investigate the effectiveness and necessity of the prophylactic placement of abdominal irrigation tube for postoperative pancreatic fistula (POPF) following D2 radical total gastrectomy. Methods: From March 2012 to September 2013, 196 patients undergoing D2 radical total gastrectomy were equally randomized into control group and observational group. Patients in control group underwent routine abdominal drainage tube placement while, in addition to abdominal drainage tube placement, those in observational group had an irrigation tube placed at the antero-superior aspect of the pancreas, and by the latter tube, the cases who developed POPF underwent irrigation of the pancreatic region with normal saline instillation. The incidence of POPF between the two groups, and the amylase concentration in the postoperative drainage fluid, time to bowel function recovery and hospitalization costs in POPF cases between the two groups were compared. Results: The difference in the incidence of POPF between the two group had no statistical significance (P>0.05), but the incidence of grade B-C POPF in observational group was significantly decreased compared with control group (P<0.05). Comparison in POPF patients between the two groups showed that the amylase concentration in the postoperative drainage fluid was significantly decreased, time to bowel function recovery was significantly shortened and hospitalization cost is significantly reduced (all P<0.05), but the incidence of other complications had no statistical difference (P>0.05). Conclusion: Prophylactic placement of abdominal irrigation tube has demonstrable therapeutic effect for POPF, which is recommended for use in those patients with suspected pancreatic injury during surgery.

Abstract:bjective: To investigate prognostic significance of HER2/neu expression and different clinicopathological parameters in patients with early gastric cancer (EGC) without lymph node metastasis (pN0). Methods: Data of 70 patients with N0 EGC undergoing radical gastrectomy and complete follow-up, and whose histopathological paraffin blocks were available were collected. The histopathological sections were examined for Her-2/neu expression by immunohistochemical sataining, and the relations of Her-2/neu status and other clinicopathological factors with the outcomes of the patients were analyzed. Results: Her-2/neu positive expression rate was 25.0% of all tissue sections. There was no significant association between Her-2/neu expression and age, gender, or tumor size, differentiation and depth of invasion (all P>0.05). The overall 5-year survival rate was 87.8% for the entire group of patients. Univariate analysis showed that gender, age, tumor size, depth of invasion, and degree of differentiation had no significant influence on survival of the patients (all P>0.05). The 5-year survival rate in patients with Her-2/neu positive expression was 72%, while in those with negative expression was 93%, and the difference was statistically significant (P<0.05). Multivariate regression analysis showed that Her-2/neu expression was a risk factor for prognosis (OR=5.036, P=0.035). Conclusion: Her-2/neu expression is a risk factor for prognosis of pN0 EGC patients, and has potential value for guiding clinical treatment of EGC.

Abstract:Objective: To compare the surgical effects of transumbilical single-port laparoscopic, conventional multi-port laparoscopic and open approach for colectomy. Methods: The clinical data of 34 patients undergoing transumbilical single-port laparoscopic colectomy (single-port group) between January 2011 and December 2012 along with 22 patients receiving multi-port laparoscopic colectomy (multiport group) and 70 patients subjected to open colectomy (open surgery group) during the same period were retrospectively analyzed. The perioperative variables, surgical effects and quality of life of the patients among the groups were compared. Results: The general clinical data showed no statistical significance among the three groups of patients (all P>0.05). The average operative time in multi-port group was significantly prolonged compared with single-port group or open surgery group (both P<0.05), which in latter two groups showed no statistical difference (P>0.05). The parameters that included intraoperative blood loss, length of incision, postoperative pain index, and time to flatus, liquid diet, and ambulation, as well as length of hospital stay in the single-port group and multi-port group were all superior to those in open surgery group (all P<0.05), but between single-port group and multi-port group, these parameters had no statistical significance (all P>0.05). There was no statistical difference in perioperative costs, incidence of postoperative complications and recurrence rate among the groups (all P>0.05). The cosmetic scale and self-perceived body-image scale in single-port group and multi-port group were significantly higher than those in open surgery group (all P<0.05), and the cosmetic scale in single-port group was also higher than that in multi-port group (P<0.05). Conclusion: Laparoscopic colectomy offers similar efficacy to open surgery with the advantages of minimal invasiveness, quick recovery and little effect on quality of life, and as for the cosmetic results, single-port approach is the best option.

Abstract:Objective: To investigate the value and risk of endoscopic colonic stents and planned surgery for obstructive left-sided colon cancer. Methods: The relevant randomized controlled trials (RCTs) were collected by searching several national and international online databases. After screening for inclusion, data extraction, and quality assessment, Meta-analysis was performed by the RevMan 5.2 software. Results: Six RCTs were finally included involving 322 patients, of whom 165 cases underwent endoscopic colonic stents and planned surgery (stenting group), and 157 cases received emergency surgery (emergency surgery group). Results of the Meta-analysis showed that, in stenting group versus emergency surgery group, the fistulization rate and incidence of wound infections were significantly decreased (OR=0.41, 95% CI=0.24–0.69, P=0.0009; OR=0.34, 95% CI=0.13–0.86, P=0.02), and the primary anastomosis rate was significantly increased (OR=2.84, 95% CI=1.68–4.80, P<0.0001), while the differences in mortality, and incidence of anastomotic leakage, overall complications, unplanned reoperations, and abdominal infection (P=0.58) had no statistical significance (all P>0.05). Conclusion: Endoscopic colonic stents and planned surgery can reduce the fistulization rate and incidence of wound infections, and increase the primary anastomosis rate, but has no beneficial effect in improvement of the overall rates of complications and mortality.

Abstract:Objective: To investigate the safety and feasibility of laparoscopic radical resection of mid/low rectal cancer after neoadjuvant therapy. Methods: The clinical data of 41 patients with mid/low rectal cancer undergoing laparoscopic radical resection after neoadjuvant therapy (observational group) along with 48 patients with the same condition receiving laparoscopic resection alone (control group) during the same period were retrospectively analyzed. The surgical parameters, postoperative recovery and incidence of postoperative complications between the two groups were compared. Results: The preoperative conditions between the two groups were comparable, and no surgery-related death occurred in either group. The number of resected lymph nodes in observational group was significantly lower than that in control group (8.3 vs. 15.2, P<0.01), while the differences in other surgical parameters and postoperative recovery variables as well as the incidence of postoperative complications between the two groups showed no statistical significance (all P>0.05). Conclusion: Laparoscopic radical resection is safe and feasible in patients with mid/low rectal cancer after neoadjuvant therapy.

Abstract:

Objective: To evaluate the feasibility of laparoscopic-assisted intersphincteric resection for ultra-low rectal cancer. Methods: The clinical data of 68 patients undergoing laparoscopic-assisted intersphincteric resection for ultra-low rectal cancer (laparoscopic group) between January 2010 and June 2012, along with 76 patients undergoing open intersphincteric resection for ultra-low rectal cancer (open surgery group) during the same period were retrospectively studied. The clinical parameters and efficacies between the two groups were compared. Results: Operations were successfully performed in all the 144 patients, and no open conversion was required in laparoscopic group. In laparoscopic group compared with open surgery group, the operative time was prolonged [(243.7±40.4) min vs. (150.5±32.1) min], but the intraoperative blood loss [(103.2±10.5) mL vs. (231.6±23.5) mL], number of cases with postoperative incision infection ( 1 vs. 8), time to flatus [(2.5±0.6) d vs. (4.6±0.5) d], and length of hospital stay [(10.5±0.4) d vs. (14.6±0.3) d] were all decreased, and all the differences had statistical significance (all P<0.05); the difference in number of resected lymph nodes, and number of cases who developed anastomotic fistula or intestinal obstruction, as well as the 1-year postoperative survival between the two groups had no statistical significance (all P>0.05). Conclusion: Laparoscopic-assisted intersphincteric resection for ultra-low rectal cancer is safe and efficient, and it also offers advantages such as minimal invasiveness and reduced postoperative incision infection.

Abstract:Objective: To investigate the influence of neoadjuvant therapy on quality of life in patients with locally advanced mid/low rectal cancer before and after surgery. Methods: In 132 patients with locally advanced mid/low rectal cancer, 47 cases receiving preoperative neoadjuvant therapy were designated as observational group, and the remaining 85 cases who did not undergo preoperative neoadjuvant therapy were used as control group. The quality of life of the two groups was compared by the questionnaire scores of QLQ-C30 and QLQ-CR29 scale issued by European Organization for Research and Treatment of Cancer (EORTC). Results: Before operation, the scores for overall quality of life and emotional functioning in observational group were significantly lower than those in control group, while the scores for fatigue, nausea/vomiting, appetite loss, diarrhea, and financial problems as well as the scores for some symptoms that included hair loss, dry mouth, change of taste, and anxiety in observational group were significantly higher than those in control group (all P<0.05). Six months after operation, the scores for overall quality of life showed no statistical difference between the two groups (P=0.167), but the scores for pain, diarrhea, flatus or fecal incontinence, and burning skin pain in observational group were significantly higher than those in control group (all P<0.05), and moreover, the difference in diarrhea score persisted for up to 12 months after operation (P=0.023). The scores for impotence and dyspareunia were significantly higher and correspondingly, the score for sexual function was significantly lower in observational group than those in control group, which persisted from the preoperative stage to 12 months after operation (all P<0.05), however, the score for female sexual function in observation group was significantly lower than that in control group only in preoperative stage (P=0.017). Conclusion: Neoadjuvant therapy exerts a negative effect on the quality of life, especially the gastrointestinal and sexual function, in patients with locally advanced low rectal cancer.

Abstract:Objective: To investigate the alterations in parameters related to hypercoagulability in colorectal patients before and after operation, and the influence of different types of operation on these parameters. Methods: Seventy-four patients with colorectal cancer were equally randomized into open surgery group and laparoscopic group, and then underwent conventional open surgery and laparoscopic resection, respectively. Thirty-seven subjects undergoing health maintenance examination served as control group. The serum levels of D-dimer, plasminogen activator inhibitor-1 (PAI-1), prothrombin fragment 1+2 (F1+2) and protein C in control group and the two groups of colorectal cancer patients before and after operation were measured. Results: Compared with healthy controls, the levels of D-dimer, PAI-1 and F1+2 were significantly increased, while the protein C level was significantly decreased in colorectal cancer patients (all P<0.05). In both groups of colorectal cancer patients, the levels of D-dimer and protein C were elevated, and the levels of PAI-1 and F1+2 were reduced compared with those values before operation (all P<0.05). The postoperative levels of D-dimer and protein C showed no statistical difference between laparoscopic group and open surgery group (both P>0.05), but the levels of PAI-1 and F1+2 in laparoscopic group were higher than those in open surgery group (both P<0.05). Conclusion: Colorectal patients have a hypercoagulable state that can improve after surgical resection. However, laparoscopic resection may probably exert a temporary and unfavorable influence on some hypercoagulable parameters, and this should be given due attention.

Abstract:Objective: To investigate the expressions of lysine-specific demethylase 1 (LSD1), E-cadherin (E-cad) and N-cadherin (N-cad) in colon cancer and their clinical significance. Methods: Cancer tissue specimens from 108 cases of colon cancer who underwent operation at Xiangya hospital from February 2006 to December 2008 were collected. The expressions of LSD1, E-cad and N-cad in these colon cancer tissues were determined by immunohistochemical staining, and their relations with clinicopathologic characteristics and prognosis of the patients were analyzed. Results: In the entire group, the positive expression rate of LSD1, E-cad and N-cad in colon was 66.7% (72/108), 85.2% (92/108) and 41.7% (45/108), respectively. Positive LSD1 expression rate was significantly increased in tumors with advanced TNM stage and distant metastasis, which for E-cad was the opposite (all P<0.05), while there were no statistical differences in N-cad expression among the groups divided according to clinicopathologic factors (all P>0.05). In colon cancer tissues, the LSD1 expression was negatively correlated with E-cad expression (r=–0.318, P=0.001), but showed no significant correlation with N-cad expression (r=0.182, P=0.06). The overall survival rate in LSD1 positive expression group and E-cad negative expression group was significantly lower than that in their respective negative expression group and positive expression group (both P<0.05), while positive or negative N-cad expression yielded no significant relation with the overall survival of the patients (P=0.410). Conclusion: LSD1 and E-cad expressions are closely related to colon cancer metastasis, and colon cancer with positive LSD1 and negative E-cad expression may herald a poor prognosis.

Abstract:Objective: To investigate c-Met expression in colorectal carcinoma tissue either with or without liver metastasis and its clinical significance. Methods: The c-Met mRNA and protein expressions in 48 specimens of primary colorectal cancer tissues with liver metastasis and 48 specimens of primary colorectal cancer tissues without liver metastasis were determined by real-time PCR method and Western blot analysis, respectively. The relations of c-Met expression with some clinicopathologic profiles were analyzed. Results: Both c-Met mRNA and protein expressions in primary colorectal cancer tissues with liver metastasis were higher than those in primary colorectal cancer tissues without liver metastasis, and the differences had statistical significance (both P<0.05). Both the c-Met mRNA and protein expression levels were significantly related to clinical stage and lymph node metastasis (both P<0.05), but irrelevant to sex, age, degree of differentiation and tumor location (all P>0.05). Conclusion: High c-Met expression is associated with colorectal cancer liver metastasis, and c-Met detection may have an important value for predicting colorectal cancer liver metastasis.

Abstract:

Objective: To investigate the relations of pleiotrophin (PTN) expression and its serum level with colorectal cancer. Methods: The PTN mRNA and protein expression in tumor tissue specimens of 46 cases of colorectal cancer and in their adjacent tissue was determined by real-time PCR and Western blot, respectively, and the PTN level in the blood samples from 76 patients with colorectal cancer and 58 subjects undergoing health maintenance examination was measured by ELISA assay. Results: Both the PTN mRNA expression level and PTN protein positive expression rate in colorectal cancer tissue were significantly higher than those in the adjacent normal tissue (both P<0.05), and either the PTN mRNA expression level or PTN positive rate was not associated with age of the patients or histological type of the tumor (all P>0.05), but showed a significantly negative relation with TNM classification (all P<0.05).The serum PTN level in colorectal cancer patients was significantly higher than that in normal subjects (P<0.05). Conclusion: PTN expression is increased in colorectal cancer tissue and serum PTN level may be used as one of the diagnostic tests for colorectal cancer.

Abstract:Objective: To investigate the expression and significance of microRNA-224 (miR-224) in colon cancer cells. Methods: The miR-224 expression in four colon cancer cell lines (Caco-2, HCT116, HT-29 and LoVo) and normal colonic mucosal tissue were detected by real-time RT-PCR; HCT116 cells were transfected with miR-224 mimics or scrambled negative control sequence respectively, using the untreated HCT116 cells as blank control, and then the miR-224 expression was determined by real-time PCR, proliferation status was measured by MTT assay and plate colony formation assay, and cell cycle phase distribution was analyzed by flow cytometry in each group of cells. Results: The miR-224 expression in each of the four colon cancer cell lines was higher than that in normal colonic mucosal tissue (all P<0.05). Compared with the HCT116 cells in blank control group, the miR-224 expression was significantly increased, proliferative ability was significantly enhanced, the number of colonies was significantly augmented (all P<0.05), and G1 to S phase transition showed an accelerating trend as well (P=0.074) in those in miR-224 mimics tranfection group; the differences in all the observed indexes showed no statistical significance in those in negative control sequence transfection group (all P>0.05). Conclusion: The miR-224 expression is up-regulated in colon cancer cells, which may promote cell proliferation and cell cycle progression, and thereby play a cancer-promoting gene role in the pathogenesis of colon cancer.

Abstract:Objective: To investigate the effect of tanshinone IIA on gastric cancer SGC7901 cells in vitro and its influence on the NF-κB signaling pathway. Methods: SGC7901 cells were exposed to different concentrations (0.5, 1, 2 and 4 μg/mL) of tanshinone IIA for different lengths of time (24, 48 and 72 h), and then the cell proliferation was determined by MTT assay. In SGC7901 cells after exposure to tanshinone IIA (2 μg/mL) for 48 h, the apoptosis rate was measured by flow cytometry; the protein expressions of p65 subunit, IκB-α, phosphorylated IκB-α, IKK-α/β, and phosphorylated IKK-α/β were detected by Western blot; the DNA binding activity of NF-κB p65 subunit was detected by ELISA assay. Results: Results of MTT assay showed that tanshinone IIA (1, 2, and 4 μg/mL) significantly inhibited the proliferation of SGC7901 cells in a time- and concentration-dependent manner (all P<0.05). Apoptosis analysis showed that the apoptosis rate in tanshinone IIA treated cells was significantly higher than that in the control cells (P<0.05); measurement of the NF-κB signaling pathway showed that in tanshinone IIA treated cells compared with the control cells, the expression levels of p65 subunit, and IKK-β along with its phosphorylated form were significantly decreased (all P<0.05), and IκB-α expression level had no significant change (P>0.05) but its phosphorylated form was significantly reduced (P<0.05), while the levels of IKK-α and its phosphorylated form had no significant change (both P>0.05); the DNA binding activity of p65 subunit was significantly decreased (P<0.05). Conclusion: Tanshinone IIA can inhibit proliferation and induce apoptosis in gastric cancer SGC7901 cells, and the mechanism may probably be related with its suppresson of the activity of NF-кB signaling pathway.

Abstract:Objective: To determine the sensitivity of different differentiated gastric cancer cell lines to various chemotherapeutic agents. Methods: The poor-differentiated gastric cancer MGC-803 cells and well-differentiated gastric cancer AGS cells as well as the normal gastric epithelial GES-1 cells were used, which were exposed to different concentrations of 5-fluorouracil (5-FU), oxaliplatin (L-OHP), irinotecan (CPT-11), docetaxel (DXT) and cisplatin (DDP) for 48 h respectively; the inhibitory effects of the chemotherapy drugs on those cells were determined by MTT assay, and the half maximal inhibitory concentrations (IC50) of the drugs were also calculated. The MGC-803 and AGS cells were exposed to IC50 concentrations of 5-FU, DDP and L-OHP for 48 h, respectively, and then the cell apoptosis and cell cycle distribution post treatment were measured. Results: All the 5 drugs exerted inhibitory effects on MGC-803, AGS and GES-1 cells (all P<0.05), in which, the effects of 5-FU, DDP and CPT-11 were relatively strong against AGS cells, L-OHP and DXT were relatively strong against MGC-803 cells, while DDP was relatively strong against GES-1 cells. Apoptosis was significantly increased in both types of gastric cancer cells after either of 5-FU, DDP or L-OHP exposure, and the apoptosis rate in 5-FU or L-OHP treated group of cells was higher than that in DDP treated group of cells (both P<0.05). Cell cycle analysis showed that L-OHP augmented S-phase arrest in both types of cells, DDP augmented S-phase arrest in MGC-803cells, and 5-FU and DDP augmented G1-phase arrest in AGS cells (all P<0.05), whereas 5-FU exhibited no obvious effect on the cell cycle distribution of MGC-803 cells (P>0.05). Conclusion: The inhibitory effects of chemotherapy drugs against gastric cancer cells are associated with the pathological types; and their effects on induction of apoptosis and the arrest of the cell cycle also varies among different gastric cancer cells.

Abstract:Objective: To investigate the method of in vitro isolation, culture and identification of interstitial cells of Cajal (ICC) from the small intestine of rats. Methods: Neonatal SD rats at 5-10 d after birth were sacrificed by cervical dislocation, and their small intestinal segments were excised under sterile conditions. Under a dissecting microscope, the layers of smooth muscle of the small bowel were cut into small pieces after the mesentery, mucosal and submucosal layers were carefully stripped off, and then the tissue pieces were cultured in the DMEM medium containing stem cell factor. After that, cells emanating around the tissue blocks and their morphological characteristics were successively observed with an inverted microscope, and the cell phenotype was identified by immunofluorescence staining using specific antibody against receptor tyrosine kinase c-kit. Results: One week after culture, cells were found growing from the tissue blocks under inverted microscope, which took on a fusiform or triangular shape with several short processes. As the length of culture period increased, the cellular processes were gradually elongated and interconnected with those from other cells, forming a net-work structure. These cells were positive for immunofluorescence staining of c-kit antibody. Conclusion: This study has successfully established a method for the primary culture of ICC from the small intestine of rats in vitro, which may provide a basis for research into the biological function of ICC and the relationship between the ICC and gastrointestinal motility disorders.

Abstract:Objective: To investigate the clinical significance of the measurement of carcinoembryonic antigen (CEA) in abdominal drainage fluid after surgery for colorectal cancer. Methods: The CEA concentration in the serum before surgery and on postoperative day (POD) 1, as well as the CEA concentration on POD 1 in abdominal drainage fluid from 112 colorectal cancer patients were determined, and the CEA concentration on POD 1 in abdominal drainage fluid from 35 patients with benign intestinal disease was used for comparison. The change of serum CEA level before and after surgery in colorectal cancer patients, and the difference in postoperative CEA concentration in abdominal drainage fluid between patients with colorectal cancer and benign intestinal disease were determined, and the relations of the CEA concentration in abdominal drainage fluid with clinicopathologic features in colorectal cancer patients were also analyzed. Results: In the group of colorectal cancer patients, the serum CEA concentration on POD 1 was significantly decreased compared with its level before surgery, and the CEA concentration on POD 1 in abdominal drainage fluid was significantly higher than that in group of patients with benign intestinal disease (both P<0.05). The CEA concentration in abdominal drainage fluid was not associated with the degree of tumor differentiation in colorectal patients (P>0.05), but changed in the same direction as the depth of invasion and clinical stage of the tumor, and was significantly higher in group of patients with lymph node or distant metastases than that in non-metastasis group (all P<0.05). Conclusion: Measurement of the postoperative CEA concentration in abdominal drainage fluid has important predictive value for the outcome of colorectal cancer.

Abstract:Objective: To investigate the relationship between interleukin 16 (IL-16) gene polymorphism and risk of colorectal cancer (CRC) in Han nationality population in China’s Shandong province. Methods: From 164 CRC patients and 121 control healthy subjects, two single nucleotide polymorphism (SNP) sites, rs11556218 and rs4778889, in the IL-16 gene sequence were genotyped by means of amplification refractory mutation system (ARMS)-PCR. The relations of the allele frequency and distribution of the two polymorphic sites with CRC risk were analyzed. Results: In group of CRC patients, both the T/G allele frequency and distribution of rs11556218 were significantly different from control group (P=0.021 725, P=0.001 033), but the differences in the T/C allele frequency and distribution of rs4778889 had no statistical significance versus control group (P=0.057 946, P=0.064 229). Conclusion: IL-16 rs11556218 gene polymorphism is probably associated with the increased CRC susceptibility.

Abstract:

Objective: To investigate the clinical efficacy of left lateral hepatic lobectomy combined with choledochoscopic lithotomy for left intrahepatic duct stones. Methods: The clinical data of 52 patients with left intrahepatic duct stones treated from February 2009 to February 2013 were retrospectively analyzed. Of the patients, 27 cases undergoing left lateral hepatic lobectomy plus choledochoscopic lithotomy were taken as observational group, and another 25 cases undergoing left lateral hepatic lobectomy with choledocholithotomy served as control group. The intraoperative blood loss, operative time, postoperative complications and short-term efficacy between the two groups of patients were compared. Results: In observational group and control group, the intraoperative blood loss was (372.73±165.82) mL and (407.80 ± 202.77) mL, operative time was (191.63±38.84) min and (206.83±40.37) min, and incidence of postoperative complications was 11.1% and 16.0%, respectively, and all the differences had no statistical significance (all P>0.05). In observational group, the incidence of postoperative residual stones was lower and the excellent or good rate of treatment was higher than that in control group (3.70% vs. 20.0%; 92.59% vs. 80.0%), and the differences reached statistical significance (both P<0.05). Conclusion: Left lateral hepatic lobectomy plus choledochoscopic lithotomy for left intrahepatic duct stones is safe and effective, so it is appropriate for clinical use.

Abstract:Colorectal cancer (CRC) is one of the malignant tumors with the highest incidence and mortality worldwide. Reliable tumor markers of CRC are of prime importance in diagnosis, monitoring treatment and estimating prognosis. In addition to carcinoembryonic antigen (CEA), the first and most widely used tumor marker, the research in CRC-associated markers had made rapid progress in recent years. In this paper, the authors present the recent progress in CRC-associated protein markers that are mainly derived from serum, tissue and stool.

Abstract:Lymphangiogenesis and mechanisms of lymphatic metastasis have become the research focus of tumor metastasis with the findings of the specific markers of lymphatic endothelium. Hematogenous metastasis has been thought previously to be the common route for colorectal cancer liver metastasis, but some recent research suggests that lymphangiogenesis and lymph node metastasis play an equally pivotal role in colorectal cancer liver metastasis. In this paper, the authors address the mechanisms of action of lymphangiogenesis and lymphatic endothelial-specific markers in colorectal cancer liver metastasis.