Association between serotonin transporter promoter gene polymorphism and clinicopathological factors and effect of the polymorphism on the prognosis of colorectal cancer patients / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To examine the association between the genotype (LL, LS and SS) of serotonin transporter promoter gene polymorphism(5-HTTLPR) and clinicopathological factors, and to investigate the effect of 5-HTTLPR on the prognosis of colorectal cancer patients.</p><p><b>METHODS</b>Data of peripheral blood samples of 161 colorectal cancer patients at the Second Affiliated Hospital of Guangzhou Medical University from October 2009 to January 2014 were collected retrospectively. The genotyping of 5-HTTLPR was determined by PCR and agarose gel electrophoresis. Coincidence Chi-square test was used to examine the 5-HTTLPR genotype with Hardy-Weinberg law. Chi-square test and Cox multifactor model were used to analyze the association of 5-HTTLPR genotype with clinicopathology and prognosis. All the patients were informed and agreed to participate in the study. This study was approved by the Hospital Ethics Committee (2015056).</p><p><b>RESULTS</b>Of 161 colorectal cancer patients, 89 were male and 72 were female; the median age was 64 (25-85) years; 86 (53.5%) cases were colon cancer and 75 (46.5%) were rectal cancer. Genotype was LL in 12 cases, LS in 59 cases and SS in 90 cases, which complied with the law of Hardy-Weinberg genetic balance (χ²=0.288, P=0.592). Univariate analysis showed that 5-HTTLPR gene polymorphism was only associated with lymph node metastasis [lymph node metastasis rate: LL and LS genotype 21.1% (15/71);SS genotype 40.0% (36/90), χ²= 6.532, P=0.011]. The 3-year and 5-year overall survival rates of whole patients were 71% and 63% respectively. Multivariate analysis revealed that the SS genotype was an independent risk factor affecting the overall survival of colorectal cancer patients(HR=1.933, 95%CI:1.090-3.428, P=0.024).</p><p><b>CONCLUSION</b>Among genotypes of 5-HTTLPR gene, colorectal cancer patients with SS genotype have higher risk of lymph node metastasis and poorer prognosis.</p>

Impact of platelet count on prognosis of stage II-III colorectal cancer receiving adjuvant chemotherapy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To analyze the impact of platelet count on the prognosis of stage II-III colorectal cancer receiving adjuvant chemotherapy.</p><p><b>METHODS</b>Clinical and follow-up data of 286 patients with stage II-III colorectal cancer receiving adjuvant FOLFOX chemotherapy from March 2003 to October 2011 were analyzed retrospectively. Associations of baseline blood platelet count before chemotherapy and nadir blood platelet count during chemotherapy with relapse and death after adjuvant chemotherapy were analyzed by ROC curve and the optimal cutoff was selected. The association of the blood platelet count and the prognosis was analyzed by Kaplan-Meier and Cox regression model.</p><p><b>RESULTS</b>ROC curve showed the baseline blood platelet count was associated with recurrence (AUC=0.588, P=0.034). The optimal cutoff affecting recurrence was 276×10(9)/L. Kaplan-Meier showed those with baseline platelet count >276×10(9)/L receiving adjuvant chemotherapy had worse disease free survival (DFS) than those with baseline platelet count ≤276×10(9)/L, whose 5-year disease free survival(DFS) was 66% and 80% respectively (P=0.013). Cox regression analysis revealed baseline platelet count >276×10(9)/L was an independent unfavorable factor for DFS of adjuvant chemotherapy in colorectal cancer (HR=1.865, 95% CI: 1.108-3.141, P=0.019).</p><p><b>CONCLUSION</b>Colorectal cancer patients receiving adjuvant chemotherapy with baseline platelet count >276×10(9)/L have worse prognosis.</p>

Impact of -1304T→G polymorphism in MKK4 promoter on prognosis of colorectal cancer cases receiving adjuvant cheomotherapy / 实用医学杂志

Objective To analyze the impact of rs3826392 polymorphism in MKK4 promoter on prognosis of colorectal cancer cases (CRC) receiving adjuvant chemotherapy. Methods The associations between rs3826392 genotype of 203 CRC cases receiving adjuvant chemotherapy and clinicopathologic factors,overall survival (OS), disease free survival (DFS) were analyzed retrospectively. Results No association was found between rs3826392 genotype and clinicopathologic factors (P > 0.05). TG+GG genotype had better OS (P = 0.018) and DFS (P =0.019) when compared with TT genotype. Cox multivariate model showed rs3826392 TG+GG genotype remained independent favorable factor for OS(HR = 0.389;95%CI = 0.177-0.855) and DFS(HR=0.491;95%CI = 0.271-0.890) respectively. Conclusion -1304G variant genotypes (i.e., TG+GG) in rs3826392 may be the biomarker of better prognosis in CRC receiving adjuvant chemotherapy.

Metastatic lymph node ratio and outcome of surgical patients with stage III colorectal cancer / 南方医科大学学报

<p><b>OBJECTIVE</b>Evaluate the prognostic value of lymph node ratio (LNR) in patients undergoing resection of stage III colorectal cancer.</p><p><b>METHODS</b>The clinicopathological and follow-up data were collected from 174 surgical patients with stage III colorectal cancer. The 5-year disease-free survival (DFS) and overall survival (OS) were evaluated using Kaplan-Meier method. The impact of LNR and clinicopathological factors on DFS and OS were evaluated using univariate and multivariate analysis.</p><p><b>RESULTS</b>After a median follow-up of 62.5 months, the 5-year DFS and OS of the patients were 51.8% and 56.3%, respectively. The median number of lymph nodes harvested and the median number of positive lymph nodes examined were 10 and 3, respectively. The patients were stratified into 4 groups according to LNR quartiles (LNR1, LNR≤0.125; LNR2, 0.125<LNR≤0.260; LNR3, 0.260<LNR≤0.500; LNR4, LNR>0.500), whose 5-year DFS and OS were 64.2%, 53.5%, 41.8%, and 25.7% (P<0.05) and 68.1%, 60.8%, 49.2%, and 32.7% (P<0.05), respectively. Multivariate analysis identified age, T stage and LNR as the independent predictors of both DFS and OS. Subgroup analysis showed that LNR had an independent prognostic value on DFS and OS irrespective of the number of lymph nodes harvested.</p><p><b>CONCLUSION</b>LNR is an independent prognostic factor for survival in patients with stage III colorectal cancer and is superior to the pN category in TNM staging.</p>

Perioperative efficacy on radical resection of rectal carcinoma: a comparafive analysis of laparoscopy with open approach / 国际外科学杂志

Objective To compare the efficacy of the radical resection by laparoscopy versus open approach in perioperative period on the patients with rectal carcinoma,and investigate the feasibility,safety and oncological clearance of the laparoscopy.Methods The clinical data of 44 patients who underwent radical resection of rectal carcinoma by laparoscopy in our hospital were reviewed and compared with another 53patients who underwent an open approach in the same period.The surgery-related data,postoperative recovery status,tumor radical resection index,and postoperative complications by laparoscopy were analyzed by statistics,and compared with those by open approach,and evaluated the deference of too kinds of operation.Results This study showed a longer surgical time (260.45 ± 67.46) min vs ( 179.25 ± 40.92) min,P ＜0.05,a less intra-operative blood loss( 125.20 ±61.80) mL vs ( 198.02 ± 131.24) mL,P ＜0.05,in laparoscopic group compared with open approach.Meanwhile,it also showed an earlier recovery of bowel functions for discharge gas from anus,taking in food,and out-of-bed activity (4.34 ± 1.55) d vs(5.45 ± 1.55) d,P ＜0.05,in the laparoscopic group compared with open approach.There was no statistical difference of incidence of post-operative complications (5 cases vs 11 cases,P ＞0.05) between the two groups and the laparoscopic approach was also equal to the open approach as regard to post-operative stay (15.34 ±6.62) d vs (16.82±5.73) d,P ＞0.05,and demand of intra-operative blood transfusion (4 case vs 8 cases,P＞0.05 ).Conclusions Compared with open surgery,the radical resection of rectal carcinoma by laparoscopy has shown obvious advantages in smaller incision,less blood loss,less pain,earlier recovery of bowel and bladder functions,and earlier out-of-bed activity.And it is also possible by laparoscopy approach to decrease the post-operative complications and post-operative stay.Meanwhile,there is no significant deference on oncological clearance for laparoscopy compared with open approach during perioperative period,while the long term follow-up data is still needed to support the results.

Expression of thymidine phosphorylase in human metastatic liver cancer tissues from colorectal cancer / 国际外科学杂志

Objective To detect the tbymidine pbospborylnse (TP) expression in metastatic liver cancer tissues from human colorectal cancer by immunohistochemistry, and analyze the correlation between TP ex-pression and the tumor-associated macrophages (TAM), and the prognosis of patients. Methods Twenty-eight metastatic liver cancer specimens resected from patients with colorectsl cancer, were immunohistochem-ically stained by 654-1, an anti-TP monoclonal antibody, IC6-203, another anti-TP monoclonal antibody, PG-M1, anti-macrophage marker CD68 monoclonal antibody. Morphometrical analysis and positive cell counting were performed, and the correlation of TP expression with the patient's prognosis was evaluated. Results In normal liver tissues, the hepatic cells apart from cancer nests were weakly positive for 654-1 as well as for 1C6-203. The most TP-positive cells were distributed mainly along the invasive margin of cancer or around the cancer nests. In the corresponding areas, CD68-positive macrophages were also increased. The distribution patterns of CD68-positive cells were similar to those of TP-pesitive cells. The numbers of the TP-positive cells stained by 654-1 were significantly correlated with numbers of 1C6-203 positive cells (r=0.697, P<0.01), also correlated with the numbors of CD68-positive cells (r=0.703, P<0.01). While the numbers of 1C6-203 positive cells had no significant differences with the numbers of CD68-positive cells (r=0.359, P>0.05). The TP-pesitive cancer cells both for 654-1 and for 1C6-203 were detected only in 2 of 28 specimens. Both the number of TP-pesitive cells for 654-1 and 1C6-203, and the number of CD68-positive cells had no correlation with the survival period of patients. Conclusions In the metastatic liver cancer tissues of human colorectsl cancer, the TP-expreasinn stained by 654-1 was coincidence with 1C6-203, and the most important source of TP-expreasion is the TAM in stromal tissues around cancer nests, while the cancer cells are little expressed. The numbers of TP-positive cells stained by 654-1 are significantly related with CD68-pesitive macrophages, but not with the post-operation survival period of patients.

A study on clinicopathologic characteristics and the diagnosis of gastrointestinal stormal tumor / 中国基层医药

Objective To investigate the speciality of clinical features,histology and immunohistochemical of GIST,and to explore the therapy of GIST.Methods The clinical datas and immunohistochemical of 32 patients with gastrointestinal stromal tumor were reviewed.Results Of them,18 tumorus originated in the stomach,10 cases were in small bowel;2 cases were originated in the colorectal.Positive of CD117 and CD34 in the GIST were 93.75% and 76.8%.Conclusions GIST is the most common tumor in gastrointestinal mesenchymal tumor,CD117 and CD34 is a senitive marker for GIST,which plays an important role in the differential diagnosis of gastrointestinal mesenchymal tumor.Surgical operation is the main method to manage GIST.