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Objective To investigate the effect of omeprazole combined with FOLFOX scheme as an adjuvant therapy for stage Ⅱ or Ⅲ colon cancer patients after a radical resection.Methods 98 stage Ⅱ or Ⅲ colon cancer patients in our hospital from January 2008 to December 2009 were randomly divided into study group (48 cases) receiving regimen of omeprazole combined with FOLFOX and control group (50 cases) treated with FOLFOX chemotherapy after radical colectomy.Surgical specimens were examined for expression of V-ATPase protein.Chemotherapy period was 6 months,8-12 courses.We observed results of follow-up curative effect,comparing the side effects and postoperative 2 year,3 year and 5 year disease-free survival rate (DFS) difference using statistical analysis.Results Study was completed in all 93 cases,5 cases were lost to follow-up.The baseline data distribution in the two groups were balanced basically.In study group the gastrointestinal side effects of chemotherapy was lower than the control group (x2 =4.924 6,P =0.026).In the two groups,the 2-year,3-year and 5-year DFS were 73％ vs 60％ (x2 =1.743 7,P =0.187),62％ vs50％ (x2 =1.4075,P=0.235),49％ vs40％ (x2 =0.8159,P=0.366) (P＞0.05).V-ATPase protein expression was 71％ (70/98) in all samples.The 2-year and 3-year DFS of patients for V-ATPase protein positive expression in the two groups were 75％ vs 51％ (x2 =3.970 8,P =0.046),66％ vs 40％ (x2 =4.399 5,P =0.036).Compared with the control group,the 2-year,3-year DFS increased in the study group (P ＜ 0.05).In stage Ⅲ colon cancer patients,the 2-year DFS was 73％ vs 47％ (x2 =4.504 5,P =0.034).Conclusions PPI combined with FOLFOX in V-ATPase protein positive expression or Ⅲ stage colon cancer patients after radical colectemy improves long-term survival,as well as reduces the gastrointestinal side effects of chemotherapy.
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Objective To investigate the expression of Vacuolar-H +-ATPase (V-ATPase) and P-glyeoprotein (P-gp) protein in colon carcinoma tissues,the correlation between the expression of V-ATPase and P-gp and their clinicopathological significance.Methods In samples from 80 cases of colon cancer,20 cases of colon adenoma and 10 cases of normal colonic mucosa tissues,the expression of V-ATPase and P-gp protein were detected by immunohistochemical method,their relationship was analyzed,the clinicopathological features and prognosis were evaluated.Results In colon cancer,V-ATPase and P-gp protein expression was 72％ and 80％,higher than that in colon adenomas (40％,35％),and in normal colon mucosa (20％,20％),the difference was statistically significant (P ＜ 0.05).There was a positive correlation between the expression of V-ATPase and that of P-gp (r =0.567,P ＜0.01).V-ATPase and P-gp protein expression in colon cancer was associated with TNM stage,lymph node metastasis and tumor differentiation (P ＜ 0.05).Patients with high V-ATPase expression had lower 5-year survival rate than those with low V-ATPase expression (P =0.023),and 5-year recurrence rate was higher than those with low expression (P =0.024).Conclusions The expression of V-ATPase is up-regulated in colon cancer,there is a positive correlation with colon cancer progress and metastasis,and high V-ATPase protein expression predicts poor prognosis.
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Objective To evaluate the prognostic impact of a wide spectrum of pathologic parameters in a consecutive series of homogenously treated and well-characterized patients with stage Ⅰ and Ⅱ colorectal cancer, and to investigate the prognostic value of lymph node occult disease (micrometastasis) in disease-free survival rate detected by immunohistochemistry with epithelial membrane antigen and carcinoembryonic antigen. Methods The study included 126 patients operated on by a single surgeon for stage Ⅰ and Ⅱ colorectal tumors. The postoperative follow-up was performed for 64 to 106 months. At least 10 lymph nodes were harvested and examined in all the specimens. The prognostic value of 10 pathologic parameters, including lymph node occult disease (micrometastasis) detected by immunohistochemistry was investigated. Results Multivariate analysis identified lymphatic vessel invasion (absent or present;P=0.009) in lymph node positive and negative by immunohistochemistry. The five-year disease-free survival rates were 78.7%, 65.5% and 43.8% for the lymph node negative, isolated tumor cells and micrometastasis groups, respectively. There was significant difference between the lymph node negative and micrometastasis groups (P=0.005). However, the difference between the lymph node negative and isolated tumor cells groups was not statistically significant (P=0.144). Conclusions We propose that for patients found micrometastasis in lymph node with high-risk stage Ⅰ and Ⅱ colorectal cancer, adjuvant therapies are justified and effective.
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The occurrence of nanoparticle carriers has greatly changed the traditional remedies of gastric cancer and other malignant tumors which makes the chemotherapeutic drugs possess better distribution, better targeting, less side-effects, and the ability to withstand the drug-resistance of tumor cells. Utilization of nanoparticle carriers in lymph-targeted chemotherapy of gastric cancer can not only achieve a better curative effect,but also direct the operation and improve patients' quality of lives. It has an expansive application foreground.
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Objective To evaluate the impact of pathologic parameters and lymphatic mierometastasis on 5-year disease-frtee survival in patients with stages Ⅰ and Ⅱ colorectal cancer.Methods Surgical operation was performed in 126 patients with stage Ⅰ and Ⅱ colorectal cancer.Sixteen (range,10-28)lymph nodes were harvested in each specimen and immunohistochemical staning was performed. Theimpact of pathologic parameters and lymphatic micrometastases in survival was estimated by KaplanMeier.Results The mean follow up time was 64.11 (range,64-106) months. Multivariate analysisrevealed that lymphatic vessel invasion and depth of tumor invasion were correlated with positive CEA in lymph node,and unrelated with clinical pathologic factors.There was no significant difference between pathologic parameters and five year disease-free survival rates. The five-year diseasse-free survival rates was 75.4 percent in CEA negative patients,68.2 percent in patients with isolated tumor cells,and 46.2 percent in patients positive for micrometastasis.There was no significant difference in 5 year disease-free survival between CEA negative patients and patients with isolated tumor cells (P=0.245).However,the5-year disease-free survival was lower in patients positive for micrometastases compared to CEA negativepatients (P=0.003).Conclusions The presence of micrometastases in patients with stages Ⅰ and Ⅱ colorectal cancer may result in poor prognosis and high recurrence,and adjuvant chemotherapy will bejustified and effective.