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Objective To evaluate the feasibility and clinical efficacy of minimally invasive surgery combined with sentinel lymph node (SLN) biopsy for early gastric cancer (EGC).Methods The clinical data of 39 EGC patients undergoing minimally invasive surgery combined with sentinel lymph node biopsy from December 2008 to January 2014 were analyzed retrospectively.Results 36 SLN negative EGC patients received endoscopic submucosal dissection (ESD), and 3 SLN positive EGC patients underwent laparoscopic distal gastrectomy with D2 dissection.The mean number of SLN was (2.8 ± 1.0).The SLN detection rate and accuracy of determination of lymph node (LN) status were both 100％.The rate of LN metastasis in patients with EGC was 8％ with no false negative rate.In ESD group, local recurrence and liver metastasis developed in one each cases.Meanwhile 1 patient in laparoscopic group sufferd postoperative liver and lung metastasis.Total disease free survival was 95％.Conclusions Minimally invasive surgery combined with sentinel lymph node biopsy for EGC is both safe and feasible.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the guidance role of preoperative nutritional risk screening in perioperative nutrition support for colorectal cancer patients in order to provide evidence for the rational clinical application of nutrition support.</p><p><b>METHODS</b>Nutritional risk screening was carried out in 290 hospitalized colorectal cancer patients from The Fourth People's Hospital of Wuxi City, Tongji Hospital of Tongji University and The Second Hospital of Soochow University with the nutritional risk screening(NSR) 2002 score summary table. Postoperative bowel function recovery and associated nutritional indices were compared between patients who received preoperative nutrition support according to the risk screening results and those who did not.</p><p><b>RESULTS</b>Among 110 patients at nutritional risk, 65 received perioperative nutrition support and had faster recovery of intestinal function [time to first flatus (2.3±0.5) d vs. (3.3±0.5) d, time to first defecation (3.5±0.5) d vs. (4.6±0.6) d, semi-fluid intake (10.1±1.2) d vs. (12.4±2.2) d], shorter postoperative stay [(15.7±1.1) d vs. (18.8±1.4) d], and higher albumin, prealbumin and transferrin [(33.2±4.5) g/L vs. (26.0±4.0) g/L, (0.28±0.05) g/L vs. (0.16±0.04) g/L, (1.92±0.33) g/L vs. (1.75±0.45) g/L] at 7-day postoperatively (all P<0.05) as compared to those without perioperative nutrition support(n=45). While among 180 cases without nutritional risk, there were no significant differences in the above indices between patients who received preoperative nutrition support and those who did not (all P>0.05).</p><p><b>CONCLUSION</b>It is important to evaluate the nutritional risk in hospitalized patients with colorectal cancer, and to carry out nutrition support actively for those at nutritional risk.</p>
Subject(s)
Female , Humans , Male , Middle Aged , Colorectal Neoplasms , Therapeutics , Nutrition Assessment , Nutritional Support , Perioperative Care , Retrospective Studies , Risk AssessmentABSTRACT
MicroRNAs (miRNAs) that exert function by posttranscriptional suppression have recently brought insight in our understanding of the role of non-protein-coding RNAs in carcinogenesis and metastasis. In this study, we described the function and molecular mechanism of miR-139-5p in colorectal cancer (CRC) and its potential clinical application in CRC. We found that miR-139-5p was significantly downregulated in 73.8% CRC samples compared with adjacent noncancerous tissues (NCTs), and decreased miR-139-5p was associated with poor prognosis. Functional analyses demonstrated that ectopic expression of miR-139-5p suppressed CRC cell migration and invasion in vitro and metastasis in vivo. Mechanistic investigations revealed that miR-139-5p suppress CRC cell invasion and metastasis by targeting AMFR and NOTCH1. Knockdown of the two genes phenocopied the inhibitory effect of miR-139-5p on CRC metastasis. Furthermore, the protein levels of the two genes were upregulated in CRC samples compared with NCTs, and inversely correlated with the miR-139-5p expression. Increased NOTCH1 protein expression was correlated with poor prognosis of CRC patients. Together, our data indicate that miR-139-5p is a potential tumor suppressor and prognostic factor for CRC, and targeting miR-139-5p may repress the metastasis of CRC and improve survival.