Time pattern and prognostic evaluation of the recurrence of rectal cancer after resection / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the regular pattern and prognostic evaluation of patients with recurrent rectal cancer after resection.</p><p><b>METHODS</b>Three hundred and fourteen cases with recurrent rectal cancer after resection treated between May 1979 and November 2006 were classified into three groups according to the recurrence intervals (<3 years, 3-5 years, >5 years). The survival rates and prognosis in the three groups were analyzed and compared retrospectively.</p><p><b>RESULTS</b>Of the 314 patients, the cancer relapsed in 247 cases (78.7%) in less than 3 years, and the recurrence occurred predominantly within 2 years (207 cases, 65.9%) after the operation. The neoplasm in 41 cases (13.3%) recurred in 3-5 years after the operation, and 26 cases (8. 3%) in more than 5 years after the resection. Disease-free interval, Dukes stage, neoplasm gross type, histological type, T stage, lymphatic and distant metastasis were associated with the prognosis on univariate analysis. And disease-free interval and tumor Dukes stage were independent prognostic factors for survival rate on multivariate analysis. Disease-free interval and progression-free survival were related positively with survival time.</p><p><b>CONCLUSIONS</b>The rectal cancer patients should be followed-up intensively for 2 years after the operation and moderately from then on. Disease-free interval and progression-free survival could be taken as the best predictors of long-term cure and prognosis.</p>

Inhibitory effect of resveratrol on the growth of human colon cancer ls174t cells and its subcutaneously transplanted tumor in nude mice and the mechanism of action / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the effect and mechanism of resveratrol against human colon cancer ls174t cells in vitro and the growth of colon cancer in tumor-bearing nude mice.</p><p><b>METHODS</b>MTT method was used to test the inhibiting effect of resveratrol on the growth and proliferation of ls174t cells. Transmission electron microscopy was used to observe the morphological changes of cell apoptosis, and FCM assay was performed to measure the changes of cell apoptosis rate and cell cycle. RT-PCR method was used to detect the expression of bcl-2 and bax mRNA, and Western blot was used to detect the expression of bcl-2 and bax protein.</p><p><b>RESULTS</b>MTT test revealed that resveratrol showed significant inhibiting effect on ls174t cells in a concentration- and time-dependent manner. In the concentration range of 25, 50, 100, 200 and 400 micromol/L, the inhibition rate after resveratrol treatment for 24 hours was respectively 1.0%, 9.1%, 17.4%, 27.8% and 66.5%, while the inhibition rate after treatment for 48 hours was respectively 3.6%, 13.7%, 30.2%, 58.4% and 86.1%, and the inhibition rate after treatment for 72 hours was 18.1%, 33.0%, 48.6%, 61.2% and 89.4%, respectively, showing a very significant difference (P < 0.01). Typical ultrastructural apoptotic changes were observed in resveratrol-treated ls174t cells. It was found through FCM assay that resveratrol caused apoptosis in ls174 cells and blocked the cell cycle at S phase. RT-PCR and Western blot test showed that after the treatment of colon cancer cells with resveratrol at different concentrations (25, 50, 100 and 200 micromol/L), the expression level of bcl-2 was decreased, while expression level of bax was increased. The highest inhibition rate was 47.9%. In 200 mg/kg and 800 mg/kg resveratrol treatment groups, the weight of subcutaneously transplanted tumors in nude mice was 4.10 +/- 0.18 g and 3.05 +/- 0.35 g, respectively, the difference was significant compared with that of the control group (P < 0.01).</p><p><b>CONCLUSION</b>Resveratrol can inhibit the growth of ls174t cells through apoptosis induction. The mechanism is probably related to inhibition of anti-apoptotic factor bcl-2 and enhancement of expression of apoptotic factor bax.</p>

Exploration on the modification of macroscopic classification of colorectal cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the feasibility and clinical significance of a modified macroscopic classification of colorectal cancer.</p><p><b>METHODS</b>The data of 1379 patients with colorectal cancer surgically treated between 1975 and 2003 were retrospectively analyzed. The patients were divided into four groups according to the primary macroscopic appearance: protruding type (group 1), local ulcerative type (group 2), invasive type (group 3) and non-invasive ulcerative type (group 4). The new classification system was simplified into two types: non-invasive type (group A, including group 1 and 2) and invasive type (group B, including group 3 and 4). The histo-differentiation, invasive depth into the intestinal wall, distance and number of lymph node metastasis and 5-year survival rate were analyzed and compared among the groups.</p><p><b>RESULTS</b>There was no significant difference between group 1 and 2, and between group 3 and 4 in histodifferentiation, invasive depth into the intestinal wall, distance and number of lymph node metastasis and 5-year survival rate (P>0.05). However, after modification of the primary macroscopic classification, a significant difference was observed in all the above mentioned parameters between group A and group B (P<0.05).</p><p><b>CONCLUSION</b>Our results demonstrate that the clinicopathological characteristics of the group 1 and 2, and of the group 3 and 4 are similar to each other. So it is reasonable to merge the protruding type and local ulcerative type into non-invasive type, while invasive type and non-invasive ulcerative type into invasive type. This simplified macroscopic classification should be practical and instructive in diagnosis, treatment and prognosis of colorectal cancer.</p>

The effect of As2O3 on induction of apoptosis and inhibition of telomerase activity in colon cancer LS-174T cells / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the impact of arsenic trioxide (As2O3) on human colorectal carcinoma LS-174T cells and their activity of telomerase.</p><p><b>METHODS</b>LS-174T cells and xenograft model of nude mice were treated with As2O3. The inhibitory effect of As2O3 on survival of LS-174T cells was determined by MTT assay. Apoptosis was determined by electron microscopy and fluorescence microscopy. Cell cycle was assessed by flow cytometry. Telomerase activity in LS-174T cells was determined by PCR-ELISA kit.</p><p><b>RESULTS</b>With the increasing concentration of As2O3, the ratio of living cells to dead cells decreased significantly, and the IC50 value was 5.23 micromol/L. Apoptosis curve appeared after 24 h and cells turned to apoptosis in a time-dependent manner. As2O3 inhibited the telomerase activity in cell extraction, obviously in a concentration-dependent and time-dependent manner. Inhibitiory effect of As2O3 on xenograft model of nude mice was observed by tumor volume and weight measurement, showing a significant difference between As2O3 and control groups (P < 0.05).</p><p><b>CONCLUSION</b>Both the experiments in vitro and in vivo showed an inhibitory effect of As2O3 on colonrectal cancer S-174T cell growth, probably by induction of apoptosis and inhibition of telomerase activity.</p>

Effect of lateral lymph nodes dissection and autonomic nerve preservation in anterior resection for rectal cancer: 124 cases review / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical effect of lateral lymph nodes dissection and autonomic nerve preservation in anterior resection for rectal cancer.</p><p><b>METHODS</b>One hundred and twenty-four patients with rectal cancer underwent anterior resection with lateral lymph nodes resection and autonomic nerve preservation. The patients were followed-up through post-operational questionnaire about the function of defecation, urination and sex after the operation. And post-operative survival was analyzed retrospectively.</p><p><b>RESULTS</b>Urinary catheters were removed in 112 cases (90.3%) in 3 days post operation, the mean time of indwelling catheter was (58.3 +/- 2.1) h. Nineteen patients experienced fecal incontinence, 12 cases of them recovered through release-training and one recovered spontaneously. Of the 98 questionnaire respondents, 61 cases (62.3%) could erect normally, and 56 cases (57.1%) had normal sexual function. The max-micturition-desire urine volume was (401.2 +/- 23.1) ml and the residual urine volume was (28.2 +/- 2.2) ml. Five year survival rate of all the patients was 61.2%.</p><p><b>CONCLUSIONS</b>Lateral lymph nodes dissection and autonomic nerve preservation in anterior resection for rectal cancer can decrease the post-operative dysfunction of defecation, urination and sex life and does not affect the survival.</p>

Extended radical resection with nerve-preservation for rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical value of extended radical resection with nerve- preservation for rectal cancer.</p><p><b>METHOD</b>Ninety-eight patients with rectal cancer received extended radical resection with nerve- preservation in our hospital. The questionnaire were used to collect the data of the patients urination and sexual function. The survival was analyzed retrospectively.</p><p><b>RESULTS</b>62.3% (61/98) of the patients could erect normally and 57.1% (56/98) of the patients had normal sexual function. The average time of catheterization in 57 patients was 60 hours, the residual urine volume (RUV) was 28 ml and the max-micturition-desire urine volume was 400 ml. The 5-year survival rate of those who underwent extended radical resection with nerve-preservation was 61.2%.</p><p><b>CONCLUSION</b>Extended radical resection with nerve-preservation,which could decrease the incidences of post-operative urination and sexual dysfunction, and have not affect the survival, was the most optimal operation for rectal cancer.</p>

Application of ring-like double tubes with negative pressure drainage after radical surgery of breast cancer / 中国基层医药

Objective To investigate the appropriate and pragmatic drainage after the breast cancer by radi- cal surgery.Methods 120 patients treated by the radical surgery from July 2003 to July 2005,were divided into the experimental group(ring-like double tubes with negative pressure drainage) and the control group(armpit single tube drainage with pressure bind).The differences between the two groups were analyzed in the same period,respectively sixty cases.Results The outflow of the first three days after operation in the experimental group was more than that in control group(P0.05).The incidence of sinoma and incision delaying healing in experimental group was lower than that in con- trol group(P

Application of transanus ilues tube in the case of left-semicolon cancer with intestinal obstruction / 中国基层医药

Objective To investigate the case of left-semicolon cancer with intestinal obstruction for the methods of one-stage resection and anastomosis.Methods The clinical data of ten patients with left-semicolon can- cer with intestinal obstruction treated by transanus ilues tube,were restrospectively analyzed from October 2004 to December 2006.Results No postoperative anastormotic leakage was found and the patients were clinically cured. Conclusion The technical problem that left-semicolon cancer with obstruction for one-stage resection and anastomo- sis was resolved by the application of transanus ilues tube.

Radiosensitivity on colorectal neoplasms by recombinant adenoviral-mediated wild-type p53 gene / 中华外科杂志

<p><b>OBJECTIVE</b>To study the radiosensitization on the cells of colorectal cancer transfected with recombinant adenovirus vector-mediated wild-type p53.</p><p><b>METHODS</b>SW480 cells transfected by wild-type p53 were treated with 4 Gy and 6 Gy radiation. The expression of recombinant adenovirus vector-mediated wild-type p53 gene was detected by Western blotting. The inhibition rate of SW480 cells was examined by MTT, apoptotic rate by TdT-mediated dUTP nick end labeling (TUNEL) and proliferating cell nuclear antigen (PCNA) by immunohistochemical method.</p><p><b>RESULTS</b>SW480 cells transfected by wild-type p53 were inhibited significantly by 4 Gy and 6 Gy radiation. The level of apoptosis increased and the expression of PCNA decreased.</p><p><b>CONCLUSION</b>Cells of colorectal carcinoma transfected with wild-type p53 increases their radiation sensitivity.</p>

On rationality of total mesorectal excision for rectal cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To discuss the rationality and clinical significance of total mesorectal excision (TME) assessed by the pattern of local recurrence of rectal cancer.</p><p><b>METHODS</b>207 rectal cancer patients treated by surgery from 1975 to 2001 who developed local recurrence were retrospectively studied as to the option of treatment based on their outcome. 172 of these 207 patients had complete record of follow-up with a follow-up rate of 83.0%.</p><p><b>RESULTS</b>The local recurrent sites of 207 patients were: anastomotic stoma 71, mesorectum 65, perineum 50, lymph nodes 59, multiple recurrences 89 and others sites rare. Among 81 patients who had been first treated by anterior resection (AR), 58 were again treated by abdomino-perineal resection (APR). Among 102 patients who had been treated by APR, 38 were treated by perineal tumor resection, 15 were treated by total and posterior pelvic organ resection, and 18 were supplemented with lymph node resection. By all modalities, the resection rate was 66.1% (137/207), in which the curable resection rate was 46% (63/137). The 5-year survival rate of patients with tumor resection was 23.3% (32/137), those treated by curable resection was 34.9% (22/63).</p><p><b>CONCLUSION</b>From the pattern of local recurrence, the operation for middle-lower rectal cancer must follow the principle of total mesorectum excision (TME). Patients with local recurrence should be energetically treated in the second operation if tolerable.</p>