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Objective To explore the application value of circulating tumor cell (CTC) counting in the diagnosis of patients with colorectal cancer.Methods From July to October in 2015,a total of 61 patients firstly diagnosed with colorectal cancer,at stagc] to Ⅳ were enrolled.At the same period,20 individuals (healthy volunteers or patients with benign colorectal diseases) were selected as controls.Peripheral blood (7.5 mL) was taken before therapy.Peripheral blood CTC were counted by immunomagnetic beads enrichment combined with fluorescent staining method in two hours.The positive detection rate of CTC for colorectal cancer,especially early colorectal cancer was analyzed.And the priority of combination it with carcino-embryonic antigen (CEA) was also investigated.Chi-square test,t test and rank-sum test were used for statistical analysis.Results Two patients could not be pathological staged,due to the lack of whole body imaging evaluation.There were 30 patients with colorectal cancer at early stage (stage Ⅰ to Ⅱ) and 29 patients at advanced stage (stage Ⅲ to Ⅳ).The difference in CEA level between patients at early stage and advanced stage ((3.3±1.1) μg/L vs (20.4±3.3) μg/L) was statistically significant (t=-2.74,P=0.008).The median cell number of CTC of colorectal cancer group and control group was 1 (interquartile range=4) and 0,respectively,and the difference was statistically significant (Z=2.721,P=0.007).Taken 0/7.5 mL and 5 μg/L as the cut-off value of CTC and CEA,the detection rates of CTC for colorectal cancer and early colorectal cancer were 65.6％ (40/61) and 63.3％ (19/30),respectively;the detection rates of CEA for colorectal cancer and early colorectal cancer were 29.5 ％ (18/61) and 13.3％ (4/30).When CTC combined with CEA,the detection rates for colorectal cancer and early colorectal cancer were 73.8％ (45/61) and 66.7％ (20/30),respectively.Conclusions CTC has certain detection value in colorectal cancer especially early colorectal cancer.If it combined with CEA,the detection rate is much higher.
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<p><b>OBJECTIVE</b>To analyze the clinicopathologic features and prognosis of α-fetoprotein (AFP)-producing gastric cancers (AFPGC).</p><p><b>METHODS</b>Fifty-one serum AFP-positive patients with positive immunohistochemical staining of AFP in the primary lesions (study group) and sixty-five gastric cancer cases with normal AFP level (control group) treated in our department from January 2005 to December 2007 were included in this study. Their clinicopathologic features and follow-up data were statistically analyzed.</p><p><b>RESULTS</b>Compared with the control group, the study group had a higher incidence of poorly differentiated adenocarcinoma (P=0.021) and liver metastasis (P=0.001) than that in the control group.The TNM stages in the study group were significantly higher than those in the control group (P=0.001). The 1-, 2-, and 5-year survival rates of the study group were 62.7%, 27.5% and 4.7%, respectively, and the median survival was 16 months, significantly lower than the 84.6%, 55.4%, 16.5%, and 30 months of the control group (P<0.001 for all). The serum AFP levels in the study group ranged from 58.63 µg/L to 12 100.00 µg/L, and could be classified into two groups:27 cases <500 µg/L, and 24 cases ≥500 µg/L. There was no significant difference of the immunohistochemical staining results between the two subgroups (P=0.912).</p><p><b>CONCLUSIONS</b>AFPGC is a special type of gastric cancer with high degree of malignancy and poor prognosis. Monitoring of serum AFP level can earlier detect the progression of disease and give corresponding treatment.</p>
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Humans , Adenocarcinoma , Incidence , Liver Neoplasms , Prognosis , Stomach Neoplasms , Diagnosis , Metabolism , Pathology , Survival Rate , alpha-Fetoproteins , MetabolismABSTRACT
Objective To detect the expressions of hTERT and MMP-7 mRNA in the peripheral blood of patients with colorectal cancer and their correlation,and discuss the clinical significance of peripheral blood micro-metastasis.Methods Total RNA was extracted from blood samples by TRIzol and was reverse transcribed into cDNA.The mRNA expressions of MMP-7 and hTERT were detected by real-time PCR.Results Positive mRNA expression of hTERT was found in 63 of 181 patients with colorectal cancer,while positive mRNA expression of MMP-7 was seen in 61 cases.The positive rates of hTERT and MMP-7 mRNA had no significant differences in the patients' sex and age (P ＞ 0.05).The positive rate of MMP-7 mRNA in the patients with poorly differentiated adenocarcinoma (43.9 ％) was higher than that in the patients with moderately and well differentiated adenocarcinoma (27.8 ％) (x2 =4.873,P ＜ 0.05).The positive rate of HTERT mRNA in the patients with stage Ⅲ-Ⅳ (42.5 ％) was higher than that in the patients with stage Ⅰ-Ⅱ (24.0 ％) (x2 =6.591,P ＜ 0.05).The positive rate of MMP-7 mRNA in the patients with stage Ⅲ-Ⅳ (39.6 ％) was higher than that in the patients with stage Ⅰ-1Ⅱ (25.3 ％) (x2 =4.014,P ＜ 0.05).The positive rate of hTERT mRNA in the patients with distant metastasis (53.3 ％) was higher than that in the patients without distant metastasis (28.7 ％) (x2 =9.059,P ＜ 0.05).The positive rate of MMP-7 mRNA in the patients with distant metastasis(46.7 ％) was higher than that in the patients without distant metastasis (29.4 ％) (x2 =4.506,P ＜ 0.05).The positive rate of hTERT mRNA in the patients with positive CEA expression (52.6 ％) was significantly higher than that in the patients with negative CEA expression (30.1％) (x2 =6.735,P ＜ 0.05).The positive rate of MMP-7mRNA in the patients with positive CEA expression (60.5 ％) was significantly higher than those in the patients with negative CEA expression (26.6 ％) (x2 =15.490,P ＜ 0.05).In the patients without distant metastasis,any of hTERT and MMP-7 mRNA expression was thought to be blood micro-metastasis.The recurrence and metastasis rates after 6 months in the patients with blood micrometastasis (36.58 ％) were higher than those in the patients without blood micro-metastasis (7.14 ％)(x2 =13.027,P ＜ 0.05).The recurrence and metastasis rates after 12-month follow-up in the patients with blood micro-metastasis (68.29 ％) were higher than those in the patients without blood micro-metastasis (12.5 ％) (x2 =31.948,P ＜ 0.01).The sensitivity of combined detection was 80.00 ％,and the specificity was 79.03 ％ after 12-month follow-up.Spearman correlation analysis revealed that significant positive correlation existed between hTERT and MMP-7mRNA expression (r =0.341,P =0.000).Conclusion Detection of hTERT and MMP-7 mRNA expression can be used as reliable markers to predict peripheral blood micrometastasis in colorectal cancer patients.
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Objective To observe the short-term efficacy and adverse reactions of S-1 combined intrathoracic and intraperitoneal injection for the treatment of aged patients with gastric cancer and with malignant hydrothorax and ascites.Methods The patients were divided into treatment group (A group,22 cases) randomly and control group (B group,24 cases).The two groups underwent intrathoracic and intraperitoneal injection chemotherapy and biological therapy.Drainage tubes were placed in thoracic or abdominal cavity to discharge the effusion,cisplatin 40-60 mg,lentinan 4-6 mg,dexamethasone 10 mg were injected into the chest or abdomen,once per week,administered for 2-4 weeks.S-1 was added to the treatment group,S-1 capsules were administered orally on the first day of serous cavity drug injection,40-60 mg/m2,2 times per day,oral administration after morning and evening meal for 14 days,stop for 7 days,21 days were 1 cycle.The short-term curative effects,clinical quality of life and adverse reactions were compared between the two groups.Results Total effective rate of group A was 77.3 ％,50.0 ％ in B group,the difference of short-term effects of two groups was with statistical significance (P ＜ 0.05).The improvement rates of quality of life (QOL) of group A and group B were 86.4 ％ and 70.1％ respectively,with significant difference in the two groups (P ＜ 0.05).The major adverse reactions were gastrointestinal reaction and bone marrow suppression,nausea and vomiting rate in A group was 54.5 ％ (12/22),grade Ⅲ-Ⅳ neutropenia was 54.5 ％ (4/22),significantly higher than that in B group,there was significant difference in two groups (P ＜ 0.05).No treatment related death.Conclusion There is curative effect of S-1 combined with cisplatin and lentinan in treatment of the aged patients of gastric carcinoma and malignant hydrothorax and ascites.Gastrointestinal side efforts and bone marrow suppression in treatment group have been observed,but it is tolerable.This scheme can improve the QOL of patients and prolong the survival period.
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Objective To explore the relationship between expression of MDR1 gene in human esophageal and cardiac cancer and clinicopathological changes. Methods From Jan 2 000 to Dec 2001, a total of 161 patients with esophageal or cardiac carcinoma were recruited, and MDR1 were assayed by RT-PCR. Fresh tumor tissues were surgically resected without chemotherapy before operation. Results The positive rate of MDR1 was 34.78 % (56/161). Among them 5 cm 38.54 %, invasion to muscular layer 30.77 %, invasion to tunica serosa 35.14 %, squamous cell carcinoma 27.27 %, adenocarcinoma 41.67 %, lymphonode metastasis positive 35.19 %, negative 33.96 %, stage Ⅰ,Ⅱ 33.33 %, stage Ⅲ, Ⅳ 35.58 %. The correlation between MDR1 expression and the age and sex of patients, Tumor size depth of invasion histologic types lymph node involvement and TNM, was not significant. Conclusion Because of highly expressive level of MDR1 gene in untreated esophageal and cardiac carcinoma, we should choose appropriate chemotherapeutic regimen for esophageal and cardiac cancer. The expression of MDR1 gene in untreated cancer was independented of morphologic prognostic indexes without correlation between MDR1 gene expression and morphological indexes.