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OBJECTIVE@#To investigate the correlation of stress-inducible phosphoprotein 1 (STIP1) expression level with prognosis of different cancers and its potential role in immunotherapy.@*METHODS@#TCGA, TARGET and GTEx databases were used for bioinformatic analysis of STIP1 expression level and its prognostic value in different cancers. We also detected STIP1 expression immunohistochemically in 10 pairs of colorectal cancer and adjacent tissues. We further analyzed the correlation of STIP1 expression level with tumor mutational burden, microsatellite instability, immune cell infiltration, immune regulators and outcomes of different cancers. STIP1- related proteins were identified using protein- protein interaction (PPI) network analysis, and functional enrichment analysis was performed to analyze the regulatory pathways involving STIP1.@*RESULTS@#Bioinformatics analysis showed that STIP1 was highly expressed in most tumors compared with the normal tissues (P < 0.05), which was confirmed by immunohistochemistry of the 10 pairs of colorectal cancer tissues. STIP1 expression level was correlated with clinical stages of multiple cancers (P < 0.05), and in some cancer types, an upregulated STIP1 expression was correlated with a poor prognosis of the patients in terms of overall survival, disease-specific survival, disease-free survival and progression-free survival (P < 0.05). STIP1 expression was significantly correlated with tumor mutational burden, microsatellite instability, immune cell infiltration and immunomodulatory factors in most tumors (P < 0.05). PPI network analysis indicated that STIP1-related proteins included HSPA4, HSPA8, and HSP90AA1. KEGG enrichment analysis suggested that the high expression of STIP1 in liver cancer was related mainly with valerate metabolism, tryptophan metabolism, and butyrate metabolism pathways; HALLMARK enrichment analysis suggested high STIP1 expression in liver cancer was involved in bile acid and fatty acid metabolism.@*CONCLUSION@#STIP1 is up-regulated in multiple cancer types and its expression level is correlated with clinical tumor stage, tumor mutational burden, microsatellite instability, immune cell infiltration and immunomodulatory factors.
Subject(s)
Humans , Microsatellite Instability , Liver Neoplasms , Immunotherapy , Prognosis , Computational Biology , Heat-Shock Proteins , Colorectal NeoplasmsABSTRACT
OBJECTIVES@#Gastrointestinal endoscopy plays an important role in the diagnosis and treatment of gastrointestinal diseases. The satisfaction degree of gastrointestinal endoscopy can directly affect the patient's compliance and further impact the treating effect. At present, there is no scale to evaluate the satisfaction degree of gastrointestinal endoscopy in China. This study aims to develop a satisfaction scale of gastrointestinal endoscopy suitable for national conditions and to evaluate its reliability and validity, which provides a tool for clinic to evaluate patients' satisfaction with gastrointestinal endoscopy.@*METHODS@#The original gastrointestinal endoscopy satisfaction scale was compiled by literature review, consulting senior endoscopists and experts. Through the first round of survey about 120 patients, the original scale was analyzed and modified according to the results to get the gastrointestinal endoscopy satisfaction scale (formal scale). The formal scale was used to conduct the second round of survey about 200 patients. The reliability and validity of the scale were analyzed and evaluated according to the survey results.@*RESULTS@#The reliability of the original scale was good but the validity was poor. The formal scale had 2 dimensions and 10 items, the Cronbach's alpha and split-half reliability were 0.889 and 0.823. The structure validity index χ2/df was 2.513, root mean square error of approximation (RMSEA) was 0.094, goodness of fit index (GFI) was 0.914, adjusted goodness of fit index (AGFI) was 0.861, comparative fit index (CFI) was 0.946, normed fit index (NFI) was 0.915. The aggregate validity was general, the discriminative validity was good, and the direct score of patients was strongly correlated with the total score of the scale.@*CONCLUSIONS@#The gastrointestinal endoscopy satisfaction scale has good reliability and validity, which can be used as a tool to evaluate patients' satisfaction with gastrointestinal endoscopy in China.
Subject(s)
Humans , Reproducibility of Results , China , Endoscopy, Gastrointestinal , Patient Compliance , Personal SatisfactionABSTRACT
Objective@#To evaluate the short-term and oncologic outcomes of single-incision plus one port laparoscopic surgery (SILS+ 1) for sigmoid colon and upper rectal cancer.@*Methods@#The clinic data of 46 patients with sigmoid colon and upper rectal cancer underwent SILS+ 1 at Department of General Surgery, Nanfang Hospital, Southern Medical University from September 2013 to September 2014 were retrospectively reviewed (SILS+ 1 group). After generating 1∶1 ration propensity scores given the covariates of age, gender, body mass index, American Society of Anesthesiologists score, surgeons, tumor location, the distance of tumor from anal, tumor diameter, and pathologic TNM stage, 46 patients with sigmoid colon and upper rectal cancer underwent conventional laparoscopic surgery (CLS) in the same time were matched as CLS group. The baseline characteristics and short-term outcomes were compared using t test, χ2 test or Wilcoxon signed ranks test. Kaplan-Meier survival curves and Log-rank tests demonstrated the distribution of disease free survival.@*Results@#The two study groups were well balanced with respect to the baseline characteristics of the propensity score derivation model. As compared to the CLS group, patients in SILS+ 1 group had a smaller incision ((6.9±1.1) cm vs. (8.4±1.2) cm, t=6.502, P=0.000), less estimated blood loss (20(11) ml vs. 50(30) ml, Z=2.414, P=0.016), shorter intracorporeal operating time ((67.0±25.8) minutes vs. (75.5±27.7) minutes, t=2.062, P=0.042) and significantly faster recovery course including shorter time to first ambulation ((46.7±20.3) hours vs. (78.6±28.0) hours, t=6.255, P=0.000), shorter time to first oral diet ((64.7±28.8) hours vs. (77.1±30.0) hours, t=2.026, P=0.047), shorter time of postoperative hospital stay ((7.8±2.2) days vs. (6.5±2.2) days, t=2.680, P=0.009), and lower postoperative visual analogue scale scores (F=4.721, P=0.032). No significant difference was observed in total operating time, postoperative morbidity, first time to flatus and defecation, analgesic use, number of retrieved lymph nodes and resection margin. During the median follow-up period of 33 months (ranging from 7 to 39 months) , there was no significant difference between the two groups in terms of 3-year disease-free survival (SILS+ 1: 91.3%, CLS: 93.4%, P=1.000). The recurrence rates of SILS+ 1 group and CLS groups were 8.7% (4/46) and 6.5% (3/46), respectively.@*Conclusion@#For experienced CLS surgeons, the SILS+ 1 for sigmoid colon and upper rectal cancer would be easiness, safe and efficient alternative.
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For further maximizing the minimally invasive benefits for colorectal cancer patients, laparoscopic surgeons have been dedicating to improve the surgery through single-port (SILES) or natural orifice transluminal endoscopic surgery (NOTES), which is supported by amount of single-port devices and flexible laparoscopic instruments.Many small sample studies of single institution have suggested that SILES for colorectal cancer has similar oncological outcomes with conventional laparoscopic surgery (CLS), could improve the cosmetic results, and is more minimally invasive than CLS. However, evidences of advantages for SILES are limited, because of there has been only 4 published studies of prospective randomized clinical trial so far. Due to the technical difficulties and long learning curves, SILES and NOTES are relatively hard to be widely promoted. Thus, a balance between minimally invasive pursuit and laparoscopic technical challenge should be sought. In this way, modified SILES and reduced-port laparoscopic surgery have emerged in recent years, which might be minimally invasive solutions with lower technical demanding for laparoscopic colorectal cancer surgeries. Adding a port as the surgeon′s dominant operation channel improved the collisions or overlapping of instruments with movement to reduce the technical difficulties. SILS+ 1 is safe and feasible, would be supported by more and more evidences.
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Optical coherence tomography (OCT) is a real-time, cross-sectional optical imaging technology. It is analogous to ultrasonography, except that OCT uses light waves instead of sound waves, and can provide three-dimensional morphological images of living tissues with a micrometer resolution. Through the use of endoscopes, needles, catheters and laparoscopes, OCT has demonstrated tremendous imaging potential in tumor surgery. The current studies suggest that OCT has potential for clinical applications in the following fields of gastrointestinal tumor surgery: (1) Early tumor detection and diagnosis: OCT can distinguish differences between polyp tissue, normal tissue and malignant tissue. It could possibly identify premalignant lesions or conditions potentially predisposing to malignancy, such as gastric and intestinal metaplasia, gastritis associated with Helicobacter pylori, and early gastric cancer involving the mucosa or submucosa. In addition, OCT can differentiate between adenomatous polyps and hyperplastic polyps. (2) Optical biopsy of lymph nodes: As a high-resolution, near-IR imaging modality, OCT is capable of visualizing microscopic features within tissue, distinguishing lymph node tissue from surrounding adipose tissue, revealing nodal structures such as germinal centers and intra-nodal vessels. Consequently, OCT has the ability to show changes in node microarchitecture during metastatic tumor infiltration. (3) Intraoperative guidance for real-time determination of surgical margins: In other tumors such as oral squamous cell carcinoma and breast cancer, it has been demonstrated that OCT can be used to rapidly scan large areas of tissue, to guide at the cellular level the surgical resection of neoplastic disease, and to scan tumor margins for the presence of residual disease, tumor foci, and potentially even metastasizing tumor cells. It implies that colorectal neoplasms surgeons can possibly use the laparoscopic OCT to detect the intestinal tumor margin and lymph nodes during operation in the future, so as to determine the appropriate range of bowel resection and lymph node dissection. At present, there are few reports about the intra-operative application of OCT in the field of gastrointestinal tumor surgery. Thus there is a tremendous opportunity for further research in this field.
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<p><b>OBJECTIVE</b>To evaluate the efficacy and cosmetic result of suprapubic single incision laparoscopic surgery(SSILS) in the treatment of rectosigmoid cancer.</p><p><b>METHODS</b>Clinicopathological data of 16 patients undergoing SSILS and 122 undergoing conventional laparoscopic surgery(CLS) for sigmoid colon and upper rectal cancer in the Nanfang Hospital from August 2011 to July 2012 were retrospectively analyzed. The patients were analyzed with propensity score matching at a ratio of 1 to 2 by logistic regression analysis. The matching covariates included age, gender, body mass index, American Society of Anesthesiologists(ASA) score, tumor location, tumor diameter, pathologic TNM stage, previous abdominal surgery. After matching, 48 patients (16 SSILS and 32 CLS) were enrolled in the study. The SSILS group comprised of 13 (81.3%) males with mean age of (56.4±13.4) years. The CLS group comprised of 23(71.9%) males with mean age of (55.6±13.7) years. Postoperative short-term parameters, oncologic efficacy and cosmetic result were compared between the two groups.</p><p><b>RESULTS</b>The male gender ratio, age, body mass index, ASA score, tumor location, tumor diameter, tumor differentiation, depth of invasion, lymph node metastasis, TNM stage, previous abdominal surgery were comparable between the two groups. As compared to CLS group, less incision length [(4.8±1.5) cm vs. (6.8±1.2) cm, U=63.000, P=0.000], shorter time to ambulation [(2.6±1.0) days vs. (3.9±1.5) days, U=116.500, P=0.002], shorter hospital stay [(8.4±5.3) days vs.(9.2±3.1) days, U=139.000, P=0.010] and less postopertive pain(Visual Analogue Scale: 4.3±1.4 vs. 5.2±1.1 at day 3, t=2.457, P=0.018; 3.7±1.0 vs. 4.6±1.0 at day 4, t=2.700, P=0.010; 3.3±0.8 vs. 4.0±1.0 at day 5, t=2.466, P=0.017) were observed in SSILS group. The other short-term parameters(blood loss, operative time, insertion of additional port rate, time to flatus, defecation, time to liquid and soft diet, complication morbidity, number of lymph nodes harvested, proximal and distal resection margin) were not significantly different between 2 groups(all P>0.05). The median follow-up time was 41(22-49) months. There was no loco-regional recurrence in 2 groups. Distant metastasis was 18.8% (n=3, all liver metastasis) and 6.3% (n=2, one liver metastasis and one peritoneal metastasis) in SSILS and CLS groups (χ(2)=0.698, P=0.404) respectively. Three-year disease-free survival and 3-year overall survival were 81.3% vs 93.0%(χ(2)=1.355, P=0.244) and 100.0% vs 96.9%(χ(2)=0.500, P=0.480) in SSILS and CLS groups, respectively. Photograph questionnaire investigation showed that the cosmetic score was significantly higher in SSILS group than that in CLS group (8.9±1.1 vs. 7.6±1.1, U=100.500, P=0.000). Of 48 patients of 2 groups, 81.3%(39/48) case preferred SSILS.</p><p><b>CONCLUSION</b>In experienced laparoscopic treatment centers, SSILS for rectosigmoid cancer is feasible and safe with quite good oncological efficacy and certain advantages, such as fast recovery, less pain and better cosmetic result.</p>
Subject(s)
Adult , Aged , Humans , Male , Middle Aged , Digestive System Surgical Procedures , Methods , Disease-Free Survival , Laparoscopy , Length of Stay , Lymph Nodes , Lymphatic Metastasis , Neoplasm Recurrence, Local , Operative Time , Postoperative Period , Rectal Neoplasms , General Surgery , Retrospective Studies , Sigmoid Neoplasms , General SurgeryABSTRACT
<p><b>BACKGROUND</b>miR-338-3p is a recently discovered miRNA and is involved in cell differentiation. However, few data are yet available on the aberrant expression of miR-338-3p in human colorectal carcinoma (CRC). This work aimed to investigate the relationship between miR-338-3p expression pattern and clinicopathological features of human CRC and the possible regulative mechanisms.</p><p><b>METHODS</b>The 40 CRC, adjacent nontumorous tissues and 2 human CRC-derived cell lines (SW-480 and SW-620) were collected, respectively, and the total RNA and protein were isolated routinely. The miR-338-3p expression pattern was detected by real-time reverse transcription-polymerase chain reaction (RT-PCR) and Northern blotting. Smoothened (SMO, possible target of miR-338-3p) mRNA and corresponding protein expression pattern were detected by semiquantitative RT-PCR and Western blotting. miR-338-3p expression patterns were compared between nontumor mucosa and CRC samples, graded by progression-related factors. Disease outcome was calculated by Kaplan-Meier survival analysis to determine whether miR-338-3p was related to disease-free survival (DFS) and overall survival (OS) of patients. Moreover, SMO 3'-UTR fragment was PCR amplified from genome DNA of human colon and inserted into a luciferase reporter plasmid. The luciferase reporter plasmid construct was then transfected into CRC cells together with pre-miR-338-3p or anti-miR-338-3p and the luciferase activity in the transfected cells was detected.</p><p><b>RESULTS</b>The expression of miR-338-3p was significantly downregulated in CRCs than those in the adjacent nontumorous tissues, and the value was negatively related to advanced TNM stage and local invasion (P < 0.01). Furthermore, miR-338-3p value was decreased markedly in SW-620 cell line relative to SW-480 (P < 0.01). Low expression of miR-338-3p was associated with unfavorable outcome in DFS but not in OS independent of clinical covariates. Moreover, RT-PCR and Western blotting analysis demonstrated that there was no significant difference in SMO mRNA expression between the corresponding CRCs and nontumorous tissues, whereas SMO protein markedly increased in CRCs (P < 0.01). A significant increase in luciferase activity was detected in CRC cells, which were cotransfected with the luciferase reporter plasmid construct and anti-miR-338-3p (P < 0.01).</p><p><b>CONCLUSIONS</b>miR-338-3p is expressed differentially in CRC and associated with progression and prognosis of CRC. SMO might be a possible target of miR-338-3p, which made it a potential antitumor candidate for treatment and prevention of CRC.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Colorectal Neoplasms , Genetics , Pathology , Disease Progression , Gene Expression Regulation, Neoplastic , Genetics , Physiology , MicroRNAs , Genetics , PrognosisABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of knocking-down microRNA-221 (miR-221) expression on the radiosensitivity of human colorectal carcinoma cells.</p><p><b>METHODS</b>Human colorectal carcinoma-derived cell line Caco2 was transfected with miR-221 antisense oligonucleotides (anti-miR-221) via Lipofectamine 2000. Real-time quantitative PCR was performed to detect the expression of miR-221 and PTEN mRNA in Caco2 cells. The changes in the protein expression of PTEN in the transfected cells were detected by Western blotting. The cell death after transfection and irradiation was detected by flow cytometry.</p><p><b>RESULTS</b>Transfection with anti-miR-221 caused a significant reduction in miR-221 expression (P<0.05) and up-regulated PTEN protein expression (P<0.05) in Caco2 cells. The percentage of cell death was significantly increased in anti-miR-221 group and anti-miR-221 with irradiation group (P<0.01). Anti-miR-221 significantly enhanced the radiosensitivity of Caco2 cells, which was partially reversed by PTEN-siRNA.</p><p><b>CONCLUSION</b>Anti-miR-221 can enhance the radiosensitivity of colorectal carcinoma cells by up-regulating the expression of PTEN.</p>
Subject(s)
Humans , Caco-2 Cells , Radiation Effects , Colorectal Neoplasms , Genetics , Metabolism , MicroRNAs , Genetics , Metabolism , PTEN Phosphohydrolase , Metabolism , RNA, Messenger , Genetics , Radiation Tolerance , Transfection , Up-RegulationABSTRACT
<p><b>OBJECTIVE</b>To construct a lentiviral expression vector of has-miR-338-3p and verify its target gene.</p><p><b>METHODS</b>The pre-miR-338-3p was synthesized and inserted into pLV-THM, and the recombinant plasmid pLV-THM-miR-338-3p was confirmed by restriction endonuclease analysis and DNA sequencing. 293T cells were co-transfected with the lentiviral vector pLV-THM-miR-338-3p, psPAX2 and pMD2.G, and the supernatant containing the lentivirus particles was harvested to determine the virus titer and used to infect SW-620 cells. Flow cytometry was employed for sorting the GFP-positive cells. The expression of miR-338-3p was determined using real-time RT-PCR and the expression of SMO protein was detected with Western blotting in the infected SW-620 cells. The invasiveness of the infected SW-620 cells was assessed using Transwell assay.</p><p><b>RESULTS</b>Restriction enzyme digestion and DNA sequencing demonstrated successful construction of the lentiviral vector pLV-THM-miR-338-3p. SW-620 cells infected with pLV-THM-miR-338-3p showed a significantly increased expression of miR-338-3p, and the overexpression of miR-338-3p suppressed the expression of SMO protein and the invasiveness of the cells.</p><p><b>CONCLUSION</b>The successful construction of the lentiviral vector pLV-THM-miR-338-3p and the establishment of a SW-620 cell line with miR-338-3p overexpression provide the basis for further study of the molecular function of miR-338-3p in colorectal carcinoma. MiR-338-3p can suppress SMO gene expression to inhibit the invasiveness of colorectal carcinoma cells.</p>