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Objective To investigate the risk factors on rectovaginal fistula after resection in rectal canc-er and clinical strategy. Methods Our retrospective study included 1123 patients of recter cancer who un-derwent anterior resection with TME technique. Results 3.03% patients(34/1123) developed reetovaginal fistula. Rectovaginal fistulas were raleted with menopausal, location tumor in rectal wall and distance between tumor and anal verge, anastomotic technique, while not with age, T stage, preoperative radiotherapy, diversion stoma construction. Among 34 patients 12 were cured conservatively, fistula repair and colon stoma were performed for the other patients. Conclusions Menopausal, location tumor in rectal wall, distance between tumor and anal verge, anastomotic technique were risk factors for rectovaginal fistula after resection in rectal cancer. Correct choice of surgical procedures, suitable operative timing, enough preoperative preparation are important.
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<p><b>OBJECTIVES</b>To detect aberrant p16 promoter methylation in serum of patients with colorectal cancer (CRC), and to explore the possibility of using this assay in early detection or as a prognostic marker.</p><p><b>METHODS</b>Methylation-specific PCR was used to detect p16 methylation in DNA extracted from 52 CRCs and corresponding serum samples. Serum samples from 34 patients with adenomatous polyps and 10 healthy individuals were used as controls. The association of p16 hypermethylation in serum DNA of CRC patients with clinicopathological characteristics was analyzed.</p><p><b>RESULTS</b>p16 methylation was found in 38% (20 of 52) of CRC tissues. Among the 20 patients with aberrant methylation in the tumor tissues, similar changes were also detected in the serum of 14 (70%) patients. No methylated p16 sequences were detected in the peripheral serum of the 32 CRC patients without these changes in the tumor, in 34 paitents with adenomatous polyps, or in 10 healthy controls. Clinicopathological analysis revealed that p16 methylation in serum was significantly associated with later Dukes' stage (chi(2) = 5.7, P = 0.03).</p><p><b>CONCLUSION</b>This assay offers a potential means for the serum-based detection and/or monitoring of CRC patients.</p>
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Humans , Colorectal Neoplasms , Genetics , DNA Methylation , Polymerase Chain Reaction , Promoter Regions, GeneticABSTRACT
Objective To study the clinical and pathological features of rectal carcinoid and factors influencing the prognosis.Methods Data of 33 rectal carcinoid patients were analyzed retrospectively. 29 patients were followed up postoperatively. Primary tumors were classified by size (2*!cm) and muscularis invasion respectively.Results The main symptoms were changes in bowel habits(17/33,52%) and hematochezia (14/33, 42%), or rectal mass (14/33,42%), asymptomatic patients were detected during a survey.Only 4(12%) patients had tumors larger than 2 cm and tumors invading muscularis.The 10 year survival rate was 84% for all patients( n =29), and 94% for those with tumors 2*!cm( n =3) died in 5 years( P = 1 0?10 -9 ) and only one out of the 4 with muscularis invasion lived longer than 5 years( P =1 2?10 -5 ).Conclusions Most rectum carcinoid are at early stage suitable for local excision.
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Chemotherapy has been one of the main treatments for colorectal cancer.5-fluorouracil combined with leucoverin has been the standard regimen of treatment in colorectal cancer since 1990,although its effectiveness is still unsatisfactory.Alteration in method of administration of the drug from injection to continuous infusion has been proved to improve its effects and reduce toxicities.Recently single oral capectiabine has been shown to be at least equivalent to one of the established adjuvant 5-FU/LV regimens in terms of both disease-free and overall survival and superior with respect to toxicity and resource utilization. Active new agents in advanced colorectal cancer have been used as neo-adjuvant treatment.Addition of oxalipilatin to 5-FU/LV showed a survival advantage compared to standard 5-Fu in stage Ⅲ colon cancer as the disease-free survival at 3 years is superior for the combined arm.This end point has been shown to be a good surrogate marker for overall survival at 5 years in adjuvant treatment programs for colon cancer.The neoadjuvant therapy combining capecitabine with radiation in the treatment of locally advanced low rectal cancer has showed a high rate of down-staging of the lesions and low local recurrence without disease progress.Chemotherapy has played a more and more important role in the multidisciplinary treatment of colorectal cancer.[
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Objective To investigate the relation of vascular endothelial growth factor (VEGF) and angiogenesis to the progression of colorectal carcinoma (CC). Methods VEGF protein expression and microvessel density (MVD) in 102 cases of human CC were examined by use of immunohistochemical staining. MVD and VEGF expression were analysed with their relation to histological grade, depth of invasion, Dukes stage, lymph node metastasis, liver metastasis and prognosis of CC. Results MVD was significantly higher in VEGF positive CC than in VEGF negative CC ( P
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ObjectiveTo determine the prognostic value of angiogenesis in non-metastatic colorectal carcinoma at the time of laparotomy.Methods Microvessel counts(MVC) of 58 specimens were investigated by immunohistological staining with a monoclonal antibody against F-Ⅷ RAg. Correlation between MVC, clinicopathologic factors, postoperative local recurrence, and liver metastasis was evaluated.Results MVC correlated positively with postoperative local recurrence(P21, the risk of liver metastasis and local recurrence significantly increased. MVC also correlated with prognosis (P
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Objective To evaluate the efficacy of Alvenor on acute attack of hemorrhoids Methods We have enrolled 1?103 cases with acute attack of hemorrihoids from 29 hospitals in all over the country treated by Alvenor. Dosage was 1?500 mg twice daily for four days followed by 1?000 mg twice daily for 3 days Signs and symptoms of pain, bleeding, prolapse, edema, pruritus were scored at day 0, day 4 and day 7 Global treatment efficacy assessment was conducted by both the doctors and the patients themselves Statistical analysis was conducted Results Pain, bleeding, prolapse, edema, pruritus etc were significantly improved Conclusion Alvenor is effective in the treatment of patients with acute attack of hemorrhoids especially in relief of symptoms such as pain, bleeding, prolapse etc
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0 05); Flatus, time to resume early activity and hospital stay in laparoscopic group were 2 24?0 56、 3 94?1 64、 13 94?6 5 days respectively, which was significantly shorter than those in open group ( P 0 05) The mean follow up time of the two groups were 23 15?7 95 and 22 19?7 46 months, respectively Local recurrence rate,metachronous metastases rate and cumulative survival probability at 36 months were similar for the two groups Conclusion These results suggest that laparoscopic right hemicolectomy for colon cancer can be performed safely, effectively and economically with the advantages of minimal invasiveness
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PURPOSE Anti-cancer drug treatment induces cell death by apoptosis, whether the gene p53 undergoes mutant changes is found to have a close relationship with anti-cancer drugs. The aim of this work is to investigate the role that p53 plays in the 5-FU-induced apoptosis of colorectal cancer cells in vitro. METHODS Thirty-nine col-orectal cancer samples from patients were treated with 5-FU (10?g/ml) and folinic acid (5?g/ml. 10?g/ml) in vitro, using the in situ Terminal Deoxynucleotidyl Transferase assay (TDT) to detect the chemosensitivity. p53 mutations from tumor DNA were detected, after amplication by PCR of exons 5 to 8. by non-radioactive single-strand conformation polymorphism(PCR-SSCP). RESULTS p53-gene mutations were observed in 43. 6% (17/39) of colorectal carcinomas. When TDT assay was used to detect the tumor apoptotic rate, cells with mutated p53 had less chemosensitivity than those without (16. 4% ?4. 89% vs 26. 6%? 6. 80% P
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0.05. All arose in the pelvis. 5 year′s survival rate in group Ⅰ was (53.2?1.9)% and (67.3?1.6)% in group Ⅱ, P
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ObjectiveTo determine the relationship between the expression of bax and bcl-2 gene in mucous adenocarcinoma of rectum and patient′s prognosis.MethodsImmunohistochemical method was used to evaluate monoclone antibody of bax and bcl-2 protein in 38 cases of mucous adenocarcinoma of the rectum. ResultsThe positive-staining rate of bax was 77.8% in Dukes′ A and B stage compared to 45.0% in Dukes′ C stage( ? 2=4.260,P=0.039).The intensity of positive-staining of bax over bcl-2 was significantly correlated with tumor stage(P=0.04) and the survival (P=0.001).ConclusionThe expression rate of bax and bcl-2 gene was very high in mucous adenocarcinoma of large bowel, and it might have a prognosis implications in patients with colonic mucous adenocarcinoma.