Objective: To investigate the safety and feasibility of laparoscopic colorectal cancer resection cancer in combination with intraoperative intraperitoneal hyperthermic perfusion chemotherapy (IHPC). Methods: One-hundred and twenty patients with advanced colorectal cancer were randomly divided into treatment group and control group with 60 cases in each group. All patients underwent laparoscopic colorectal cancer resection. Patients in treatment group received intraoperative IHPC combined with postoperative systemic chemotherapy with mFOLFOX6 regimen, while those in control group were given postoperative systemic chemotherapy with mFOLFOX6 regimen only. The surgery-related parameters, postoperative recovery, complications, adverse reactions, local recurrence and distant metastasis between the two groups of patients were compared. Results: There was no significant difference with respect to surgery-related parameters, postoperative recovery and incidence of postoperative complications between the two groups (all P>0.05). The incidences of postoperative hypoalbuminemia and hyponatremia were significantly increased in treatment group compared with control group (20.0% vs. 6.7%; 15.0% vs. 3.3%, both P<0.05), while the rates of peritoneal local recurrence and distant metastasis were significantly lower in treatment group than those in control group (6.7% vs. 18.3%; 8.3% vs. 23.3%, both P<0.05). The short-term overall survival rates were similar between the two groups (P>0.05). Conclusion: IHPC in laparoscopic colorectal cancer resection followed by postoperative systemic chemotherapy is safe and reliable, and has some efficacy in reducing local recurrence and distant metastasis.

Objective: To investigate the influence of laparoscopic-assisted transanal endoscopic total mesorectal excision (TME) on postoperative anal function in treatment of rectal cancer. Methods: Seventy-five patients with mid/low rectal cancer undergoing TME during May 2010 to January 2014 were selected. Of the patients, 23 cases received laparoscopic-assisted transanal endoscopic approach (transanal endoscopic group), 20 cases underwent open surgery (open surgery group) and 32 cases had laparoscopic procedure (laparoscopic group). The general surgical variables among the three groups were compared, and the function of the anus after operation of the three groups of patients was evaluated by using Wexner’s and Xu Zhongfa’s scoring system, respectively. Results: Compared with either open surgery group or laparoscopic group, the intraoperative blood loss was reduced, and time to first postoperative flatus was shortened, but the operative time was prolonged in transanal endoscopic group (all P<0.05). At one month after operation, both score by Wexner’s scoring system and good rate by Xu Zhongfa’s scoring system in transanal endoscopic group were lower than those in open surgery group or laparoscopic group (all P<0.05), but both of which showed no significant difference among the three groups at 3, 6 and 12 months after operation (all P>0.05). Conclusion: Compared with open and laparoscopic TME, the recovery of anal function after laparoscopic-assisted transanal endoscopic TME is poor for a short period of time, but has no obvious difference at a later period, and this procedure is more minimally invasive with fast postoperative recovery.

Objective: To compare the short-term outcomes of different techniques of colorectal anastomosis in extended left hemicolectomy. Methods: The clinical and follow-up data of 28 patients who underwent extended left colectomy from July 2000 to August 2013 were retrospectively analyzed. The patients were classified into conventional group (15 cases) and modified group (13 cases) according to the approaches used for colorectal anastomosis. Patients in conventional group underwent conventional colorectal anastomosis anterior to the small intestine, and those in modified group underwent colorectal anastomosis through the mesentery of the small intestine (8 cases) or posterior to the mesentery of the small intestine (5 cases). The intra- and postoperative variables between the two groups were compared. Results: There was no significant difference in operative time and intraoperative blood loss between the two groups (both P>0.05), but the average time to flatus and oral food intake, and length of postoperative hospital stay were shorter in modified group compared with conventional group (all P<0.05). The incidence of overall postoperative complications in modified group was significantly lower than that in conventional group (23.1% vs. 46.7%, P<0.05), where the main difference was due to the incidence of high-level small intestinal obstruction (26.7% vs. 0.0%, P<0.05). Conclusion: In extended left colectomy, using colorectal anastomosis through or posterior to the mesentery of the small intestine can decrease the tension at the anastomotic stoma, and avoid jejunal compression, and its efficacy is superior to that using anastomosis anterior to the small intestine.

Objective: To investigate the efficacy and related prognostic factors in one-stage resection of colorectal cancer and lung metastases by combined laparoscopic and thoracoscopic (biscopic) approach. Methods: The clinical data of 35 patients with colorectal cancer and pulmonary metastases were retrospectively analyzed. Of the patients, 17 cases underwent biscopic one-stage resection followed by systemic chemotherapy (biscopic surgery group), and 18 cases received systemic chemotherapy only (non-surgery group). The treatment efficacy of the two groups was compared and prognostic factors for patients undergoing biscopic surgery were analyzed. Results: Both the primary tumor and pulmonary metastases achieved R0 resection in biscopic surgery group. The 1- and 2-year survival rate was 82.3% and 52.3% in biscopic surgery group, and 44.4% and 22.2% in non-surgery group respectively (P=0.028; P=0.001). Univariate analysis showed that the number of lung metastases (P=0.002) and positive mediastinal lymph nodes (P<0.001) were associated with the postoperative survival of the patients, while gender, age, the location of the primary tumor, pathological type, T stage, lung metastasis size and type of resection, preoperative CEA level and chemotherapy regimens were irrelevant to their postoperative survival (all P>0.05). Multivariate analysis indicated that the number of metastases (P=0.005) and mediastinal lymph node involvement (P=0.006) were independent influential factors for postoperative prognosis of the patients. Conclusion: Biscopic one-stage resection for colorectal cancer and lung metastases can improve the overall survival of the patients, and number of metastases and mediastinal lymph node involvement are the independent influential factors for postoperative prognosis.

Objective: To determine the appropriate cutoff value for tumor maximum diameter of colorectal cancer and its relations with the clinicopathologic characteristics and prognosis of the patients. Methods: To clinical data of 119 patients with colorectal cancer undergoing radical resection followed by standard adjuvant chemotherapy from January 2006 to July 2012 were collected. The best cut-off value for tumor maximum diameter of colorectal cancer was determined by Kaplan-Meier survival analysis, the relations of tumor maximum diameter with clinicopathologic characteristics of the patients were analyzed, and the prognostic factors for colorectal cancer were also analyzed. Results: Using 4 cm as a cut-off point, the difference in survival rate of patients between two sides was most remarkable (65.5% vs. 51.1%, χ2=9.922, P=0.002), so 4 cm was regarded as the best cut-off value for tumor maximum diameter of colorectal cancer. There was significant difference in T classification, total number of lymph node detection, serum CEA level between patients with tumor maximum diameter <4 cm and ≥4 cm (all P<0.05). Univariate analysis showed that tumor maximum diameter, T classification, M stage, serum CEA level, and blood transfusion were related to the prognosis of the patients with colorectal cancer (all P<0.05), and multivariate analysis revealed that tumor maximum diameter, T classification and blood transfusion were independent prognostic factors for colorectal cancer (all P<0.05). Analysis after stratification by tumor size identified that T classification was an independent prognostic factor for colorectal patients with tumor maximum diameter ≥4 cm (HR=2.244, 95% CI=1.079–4.665, P=0.030), but all factors had no significant influence on prognosis of those with tumor maximum diameter <4 cm (all P>0.05). Conclusion: Tumor maximum diameter can be regarded as an independent prognostic factor for colorectal cancer, and the best cut-off value for tumor maximum diameter is 4 cm, which may be helpful for estimating the clinical features and prognosis of the patients.

Objective: To investigate the efficacy, adverse reactions and quality of life of elderly colorectal cancer patients treated with celecoxib plus Tegafur/gimeracil/oteracil (S-1). Methods: Thirty-one elderly patients diagnosed with advanced colorectal cancer from January 2010 to May 2014 were enrolled. All patients received oral administration of twice daily 40 mg of S-1 and 0.2 g celecoxib for two weeks followed by one-week break, with 3 weeks as a treatment cycle. The treatment response, patients’ quality of life and adverse reactions as well as the changes in D-Dimer, CEA and CA19-9 levels were observed after 6 treatment cycles. Results: In the 31 patients, the response rate was 64.5% and the disease control rate was 87.1%, respectively. Karnofsky score and physical, social and emotion function of the patients were all significantly improved, and the discomfort caused by tumor burden such as fatigue, pain, sleep disorders and anorexia were all significantly relieved after chemotherapy (all P<0.05). The levels of D-Dimer, CEA and CA19-9 were significantly decreased compared with pretreatment values (all P<0.05). The adverse reactions consisted mainly of myelosuppression, loss of appetite, nausea and vomiting, which were all relieved by symptomatic treatments. Conclusion: S-1 plus celecoxib has proven efficacy in treatment of elderly patients with advanced colorectal cancer, and it can also improve the patients’ quality of life and decrease the levels of D-Dimer, CEA and CA19-9, with tolerable toxicity.

Objective: To investigate the relations of CA19-9 and CEA levels with clinicopathological features and prognosis of patients with colorectal cancer. Methods: The clinicopathologic data of 356 patients with colorectal cancer undergoing radical surgery from January 2007 to July 2008 were collected. The relations of preoperative CEA and CA19-9 levels and clinicopathologic features and postoperative survival rate of the patients were analyzed. Results: Results of univariate analysis showed that the increased serum CEA level was related to depth of tumor invasion, lymph node metastasis, histological type, liver metastases, peripheral organ involvement (all P<0.05). and the increased serum CA19-9 level was associated with depth of tumor invasion, peritoneal metastasis, and liver metastasis (all P<0.05). Results of survival analysis indicated that survival rate in patients with increased serum CEA level was lower than that in those with normal serum CEA level (P<0.05); survival rate had no statistical difference between patients with increased serum CA19-9 level and normal serum CA19-9 level (P>0.05); survival rate in patients with both increased CEA and CA19-9 levels showed no statistical difference compared to those with increased serum CEA or increased serum CA19-9 level (both P>0.05), but was significantly lower than in those with both normal serum CEA and CA19-9 levels (P<0.05). Conclusion: Simultaneously increased levels of both CEA and CA19-9 is likely related to a late-stage event in colorectal cancer, which suggests an unfavorable prognosis for the patients.

Objective: To investigate the expressions of mutant p53 (mutp53) and nicotinamide phosphoribosyltransferase (Nampt) in gastric cancer tissue and their influences on prognosis of the patients. Methods: Immunohistochemical staining was performed for detection of the expressions of p53 (immunohistochemical positive stained p53 proteins are mainly mutant type) and Nampt in specimens of gastric cancer tissues along with the adjacent normal gastric mucosa from 68 gastric cancer patients, and the relations of expression statuses of p53 and Nampt with the clinicopathologic factors and prognosis of the patients were analyzed. Results: The positive expression rates of p53 and Nampt in gastric cancer tissue were significantly higher than those in adjacent normal gastric mucosa (both P<0.05). The p53 overexpression was related to tumor size, infiltration depth, lymph node metastasis and TNM stage, while the Nampt overexpression was associated with infiltration depth, lymph node metastasis and TNM stage (all P<0.05). The expression of p53 was positively correlated with that of Nampt in gastric cancer tissue (r=0.982, P<0.05). The median survival time in patients with p53 positive expression was significantly shorter than that in patients with negative p53 expression; moreover, among patients with positive p53 expression, the median survival time in those with concomitant positive Nampt expression was significantly shorter than in those with negative Nampt expression (both P<0.05). Conclusion: Both mutp53 and Nampt expressions are related to the malignant behavior of gastric cancer, further, there is certain relevance between them, and patients with both mutp53 and Nampt overexpressions may face a poor prognosis.

Objective: To investigate the influence of WTX gene on biological behaviors of human gastric cancer SGC-7901 cells. Methods: The recombinant plasmids bearing WTX gene or empty plasmid vectors were transfected into SGC-7901 cells by using Attractene reagent, and the untreated SGC-7901 cells were used as blank control. The EGFP-tagged transfection efficiency at different transfection times was determined, the WTX mRNA expression was measured by RT-PCR method, the cell proliferation was detected by CCK-8 assay, and the apoptosis and cell cycle were analyzed by flow cytometry. Results: The strongest expression of eGFP presented at 48 h after WTX gene transfection, when the transfection efficiency reached (33.10±4.16) %. In SGC-7901 cells of WTX transfection group compared with either blank control group or empty vector group, the WTX mRNA expression was increased significantly, proliferative ability was decreased significantly, and the number of S-phase cells was increased while the number of G1- and G2/M-phase cells was decreased significantly (all P<0.05). There was no significant apoptosis in any of the groups of cells. Conclusion: WTX gene can inhibit proliferation through inducing S-phase arrest in SGC-7901 cells, but has no influence on cell apoptosis.

Objective: To investigate the expression of the endoplasmic reticulum stress (ERS)-related protein CHOP/GADD153 in colon cancer and its relations with clinicopathologic characteristics. Methods: The specimens of colon cancer tissue and normal adjacent colonic tissue (>5 cm distance from cancer tissue) were taken from 82 colon cancer patients and casted into paraffin blocks for tissue microarray construction. The CHOP/GADD153 protein expression was detected by immunohistochemical staining and Western blot analysis respectively, and the relations of its expression with clinicopathologic characteristics of the patients were analyzed. Results: Both results of immunohistochemical and Western blot analysis showed that the expression level of CHOP/GADD153 protein in the colon cancer tissue was significantly higher than that in normal adjacent colonic tissue (P<0.05). The analysis of relationship between CHOP/GADD153 protein expression and clinicopathologic profiles indicated that the expression level of CHOP/GADD153 protein in colon cancer tissue was increased with the decrease of the degree of tumor differentiation (P<0.05), but was irrelevant to age, sex, tumor size, tumor infiltration depth and lymph node metastasis (all P>0.05). Conclusion: CHOP/GADD153 protein expression is increased in colon cancer tissue, and is closely related to degree of differentiation of colon cancer, which suggests that ERS may probably participate in the regulation of tumor differentiation.

Objective: To investigate the influence of n-3 polyunsaturated fatty acids (n-3 PUFAs) on colorectal tumor formation induced by N-methyl-N-nitrosourea (MNU) in rats and the mechanism. Methods: Sixty SD rats were equally randomized into experimental group and control group. Rats in both groups underwent administration of MNU by enema to induce colorectal cancer, and simultaneously, those in experimental group were gavaged with n-3 PUFAs, while those in control group were administered the same volume of saline in the same fashion. Sixteen weeks later, the general conditions between the two groups of rats were compared, after that, rats were sacrificed, the tumor occurrence and pathological features of the tumors were observed, the concentration of n-3 PUFAs in erythrocyte membrane was measured by gas chromatography, and global methylation level in peripheral blood cells was determined by liquid chromatography-mass spectrometry. Results: The incidence of hematochezia was lower, and food-intake as well as body weight gain were greater in experimental group than those in control group (all P<0.05). Colorectal tumor formation was found in both group of rats and all tumors were identified as adenocarcinoma, but the tumor formation rate in experimental group was significantly lower than that in control group (63.33% vs. 86.67%, P<0.05), with reduced tumor size and multiple lesions. The concentration of n-3 PUFAs in erythrocyte membrane and global methylation level in peripheral blood cells in experimental group were significantly higher than those in control group (both P<0.05). Conclusion: n-3 PUFAs can effectively inhibit the occurrence of colorectal cancer induced by MNU in rats, which may probably be associated with their promotion of DNA methylation.

Objective: To investigate the effects of autophagy inhibitor 3-methyladenine (3-MA) on growth and Notch1 protein expression in human colon cancer SW480 cells. Methods: In SW480 cells after exposure to 3-MA (5 mmol/L) for 24 h (using untreated SW480 cells cultured for the same time period as control), the Notch1 protein expression was determined by immunohistochemical staining and Western blot analysis, and cell proliferation and apoptosis was detected by CCK8 assay and Annexin/PI double staining, respectively. Results: Both results of immunohistochemical staining and Western blot analysis showed that the Notch1 protein expression was significantly down-regulated in SW480 cells after 3-MA treatment (both P<0.05). Results of cell proliferation and apoptosis assay showed that the proliferation was significantly decreased while apoptosis rate was significantly increased in SW480 cells after 3-MA treatment (both P<0.05). Conclusion: 3-MA can suppress the proliferation and promote apoptosis of colorectal cancer cells, which may probably be associated with its inhibition of notch1 protein expression and thereby altering autophagy level of the cells.

Objective: To investigate the influence of octreotide on apoptosis and cell cycle in human colon cancer cells and the mechanism. Methods: Human colon cancer SW480 cells were exposed to octreotide or GSK-3β inhibitor LiCl alone or in combination; the apoptosis and cell cycle in SW480 were analyzed by flow cytometry, and the apoptosis was also verified by DNA agarose gel electrophoresis. In addition, the expressions of GSK-3β, p-GSK3β (Tyr216) and p-GSK3β (Ser9) in SW480 cells were determined by Western blot analysis. Results: Compared with the blank control group of untreated SW480 cells, in SW480 cells after octreotide treatment, the apoptosis and ratio of G0/G1 phase cells were significantly increased, typical DNA ladders were present in the agarose gel electrophoresis, and the total GSK-3β protein and p-GSK3β (Tyr216) protein expressions were significantly increased, while the p-GSK3β (Ser9) protein expression was significantly decreased (all P<0.05); LiCl treatment alone exerted no influence on apoptosis and cell cycle in SW480 cells (both P>0.05), but it significantly weakened the apoptosis-inducing and cell cycle arrest effect of octreotide in SW480 cells in combination with octreotide (both P<0.05). Conclusion: Octreotide can effectively induce apoptosis and cell cycle arrest in SW480 cells, which may be related to its increasing GSK-3β protein expression and regulating phosphorylation level of GSK-3β.

Objective: To systematically evaluate the safety, efficacy and short-term results of robotic gastrectomy (RG) for gastric cancer. Methods: The literature in both Chinese and English regarding studies comparing RG and laparoscopic gastrectomy (LG) published between January 2005 and January 2015 were searched from national and international databases. Meta-analysis was performed by using RevMan 5.3 software. Results: Fifteen studies were finally included involving 5 286 patients, of whom 1 618 cases underwent RG (RG group) and 3 668 cases underwent LG (LG group). Results of Meta-analysis indicated that in RG group compared with LG group, the intraoperative blood loss was significantly reduced (WMD=–38.79, 95% CI=–53.73––23.84), number of dissected lymph nodes was increased (WMD=2.13, 95% CI=1.45–2.80), time to first flatus and oral intake, and length of hospital stay were shortened (WMD=–0.27, 95% CI=-0.37––0.16; WMD=–0.25, 95% CI=–0.37––0.14; WMD=–0.82, 95% CI=–1.32––0.32), but the operative time was significantly prolonged (WMD=37.39, 95% CI=26.79–47.98) (all P<0.05). There was no significant difference in the length of proximal and distal resection margin, or incidence of postoperative complications between the two groups (WMD=0.05, 95% CI=–0.11–0.20; WMD=0.30, 95% CI=–0.28–0.88; OR=0.97, 95% CI=0.79–1.19) (all P>0.05). Conclusion: RG is safe and feasible in treatment of gastric cancer, and can achieve comparable or better short-term and radical effect than LG.

Objective: To evaluate the efficacy of bursectomy in radical gastrectomy. Methods: The literature comparing gastrectomy with bursectomy and standard gastrectomy for gastric cancer publicly available by October 2014 was extensively searched. After screening for inclusion, quality assessment and extraction of relevant clinical variables, Meta-analysis of pooled data was performed by the RevMan 5.0 software. Results: Seven studies were finally included involving 1 224 patients, of whom 486 cases underwent gastrectomy with bursectomy (bursectomy group) and 738 cases underwent standard gastrectomy (non-bursectomy group). Results of Meta-analysis showed that the incidence of trauma-related complications in bursectomy group compared with non-bursectomy group was increased (OR=2.1, 95% CI=1.05–4.21, P=0.04); the incidence of overall complications and incidences of lleus, anastomotic complications and lung infection were similar between the two groups (all P>0.05); the postoperative 3- and 5-year survival rate (OR=1.35; 95% CI=0.82–2.21; OR=1.03; 95% CI=0.82–1.63) as well as recurrence rate (OR=0.90, 95% CI=0.66–1.22) had no significant difference between the two group (all P>0.05). Conclusion: Application of bursectomy in D1 and D2 radical gastrectomy may increase the risk of trauma-related complications, and offers no benefit for improvement of postoperative survival or tumor recurrence of the patients.

Objective: To investigate the influence of resection scope on the prognosis of cancer in the gastric body. Methods: The clinical and follow-up data of 157 patients with cancer in the gastric body undergoing radical surgery from April 2003 to April 2008 were retrospectively analyzed. Of the patients, 104 cases were subjected to total gastrectomy (total gastrectomy group), and 53 cases received distal subtotal gastrectomy (distal gastrectomy group). The 5-year survival rate of the two groups was compared, and the independent prognostic factors for cancer in the gastric body were analyzed. Results: The 5-year survival rate in the entire group of patients was 37.6%, which in total gastrectomy group and distal gastrectomy group was 24.0% and 64.2% respectively, and the former was significantly lower than the latter (χ2=10.635, P=0.001); to balance the difference in preoperative baseline characteristics between the two groups, comparison after stratification by TNM stage showed that the survival rate in distal gastrectomy group was higher than that in total gastrectomy among patients with low TNM stage (P<0.05), but had no significant difference between the two groups among patients with high TNM stage (P>0.05). The results of the Cox regression model analysis identified that the TNM stage (HR=1.270, 95% CI=1.093–2.344) , degree of tumor differentiation (HR=1.764, 95% CI=1.372–2.746)were independent prognostic factors for cancer in the gastric body (both P<0.05), while scope of resection (HR=0.547, 95% CI=0.320–1.076) was not an independent prognostic factor (P>0.05). Conclusion: The scope of resection is not the independent influential factor in the prognosis of cancer of the gastric body, and distal subtotal gastrectomy is a more appropriate procedure to use based on the premise of ensuring a radical resection.

Objective: To evaluate feasibility and safety of laparoscopy-assisted proximal gastrectomy in treatment of early-stage proximal gastric cancer. Methods: The clinical data of 72 patients with early-stage proximal gastric cancer undergoing surgical treatment from June 2007 to December 2010 were retrospectively analyzed. Of the patients, 38 cases underwent laparoscopy-assisted proximal gastrectomy (LAPG group) and laparoscopy-assisted subtotal gastrectomy (LAG group). The general conditions, intra- and postoperative variables were compared, and the symptoms of gastroesophageal reflux after surgery between the two groups were also compared by using Visick score. Results: No significant difference was noted in age, gender, body mass index, concomitant disease, operative time and length of postoperative hospital stay between the two groups (all P>0.05), but the intraoperative blood loss in LAPG group was significantly reduced compared with LAG group (P<0.05). The time to first postoperative flatus and food intake, and incidence of early and delayed complications after surgery showed no significant difference between the two groups (all P>0.05), but the postoperative Visick score in LAPG group was significantly higher than that in LAG group (P<0.05). The postoperative pathological parameters, pre- and postoperative changes in nutritional parameters and postoperative survival rate between the two groups showed no significant difference (all P>0.05). Conclusion: laparoscopy-assisted proximal gastrectomy can be safely used in treatment of early proximal gastric cancer and however, the occurrence of postoperative gastroesophageal reflux should be monitored carefully.

Objective: To investigate clinical efficacy and postoperative survival in proximal gastric cancer patients undergoing different types of radical gastrectomy and reconstruction. Methods: The clinical records of 82 patients with proximal gastric cancer undergoing radical gastrectomy from January 2006 to October 2011 were analyzed. Of the patients, 22 cases underwent proximal gastrectomy with esophageal-residual stomach anastomosis (esophagogastric anastomosis group), 40 cases underwent total gastrectomy with esophagojejunal Roux-en-Y anastomosis (esophagojejunal Roux-en-Y anastomosis group), and 20 cases underwent proximal gastrectomy with functional jejunal interposition (jejunal interposition group). The surgery-related parameters, and postoperative complications, nutritional status and survival rate among the three groups were compared. Results: The operative time and intraoperative blood loss in esophagogastric anastomosis group were significantly decreased compared with the other two groups, and the number of lymph nodes dissected was higher but the nutritional indexes were worse in esophagojejunal Roux-en-Y anastomosis group than those in the other two groups (all P<0.05). There was no statistical difference in incidence of overall postoperative complications (P>0.05), but the incidences of diarrhea and dumping syndrome in esophagojejunal Roux-Y anastomosis group were significantly higher than those in the other two groups (all P<0.05). No statistical difference was noted in 1- and 3- year survival rate among the three groups (χ2=0.891, P=0.554; χ2=0.419, P=0.831). Conclusion: The three procedures give similar postoperative survival rate for proximal gastric cancer, and of them, proximal gastrectomy plus esophageal-residual stomach anastomosis is less traumatic, while proximal gastrectomy with functional jejunal interposition offers better quality of life, so the procedure selection should be based on the actual clinical condition of the patient.

Objective: To investigate the risk factors for gastric cancer in young people under 40 years of age in Guangzhou area. Methods: A hospital-based case-control study with 1:1 matching was carried out, which enrolled 59 gastric cancer patients ≤40 years old in case group and 59 healthy adults ≤40 years of age in whom gastric cancer could be excluded were in control group. A self-designed questionnaire was used to obtain information on demographics, dietary habit, lifestyle, genetic factors, medical history, helicobacter pylori (Hp) infection and psychological factors from the subjects, and then the risk factors for gastric cancer were screened by univariate and multivariate conditional Logistic regression analysis. Results: Multivariate conditional Logistic regression analysis showed that fried or grilled food consumption (OR=3.552, 95% CI=1.066–11.840), pickled food consumption (OR=4.067, 95% CI=1.171–14.127), excessive drinking (OR=11.369, 95% CI=1.029–125.589), history of chronic gastritis and peptic ulcers (OR=6.500, 95% CI=1.625–25.996), history of gastric cancer in the first-degree relative (OR=29.664, 95% CI=2.368–371.576), type A blood (OR=4.962, 95% CI=1.344–18.320), Hp infection (OR=8.376, 95% CI=2.035–34.470) and low mood or depression (OR=7.981, 95% CI=1.098–58.020) were risk factors for occurrence of gastric cancer in young people (all P<0.05). Conclusion: Occurrence of gastric cancer in young people in Guangzhou area is associated with a number of factors, and those who have the above risk factors should change their eating habits and lifestyle behaviors, and be vigilant in preventing the occurrence of gastric cancer.

Colorectal cancer (CRC) is a major contributor to cancer morbidity and mortality worldwide. Recently, the clinical application of molecular targeting therapy brings hope for treatment of metastatic CRC (mCRC). Following the approval of bevacizumab as first- and second-line treatment of mCRC, the therapeutic agents targeting vascular endothelial growth factor (VEGF) have been emerging constantly, and also shown significant efficacy in clinical trials. In this paper, the authors address the progress in VEGF-targeted therapy and the related biomarkers for mCRC.

Colorectal cancer is one of the most common malignant tumors, with morbidity and mortality exhibiting an increasing trend. Appropriate therapy based on prognosis is an effective approach to reduce the mortality. In recent years, research concerning the prognosis prediction of colorectal cancer has increasingly become a hot-button field, and a lot of potential indicators have been proposed. In this paper, the authors, from the perspectives of histopathology, chromosomes, molecules and genes,describe the prognosis predictor for colorectal cancer.

Prognosis for patients with early gastric cancer is relatively favorable, however some of them with negative lymph nodes will still die from either postoperative recurrence or distant metastases. Some researchers proposed that lymph node micrometastasis is a potential cause for recurrence and metastasis in these patients. Detection of lymph node micrometastasis is more difficult compared to that of macroscopic lymph node metastasis, and its impact on prognosis of gastric cancer remains controversial. The authors, in this paper, address the research progress in lymph node micrometastasis of gastric cancer.