Proliferation Inhibitory Activity of Quinones from Blaps rynchopetera Defense Secretion on Colorectal Tumor Cells / 中国结合医学杂志

OBJECTIVE@#To explore the proliferation inhibitory effect of quinones from Blaps rynchopetera defense secretion on colorectal tumor cell lines.@*METHODS@#Human colorectal cancer cell HT-29, human colorectal adenocarcinoma cell Caco-2 and normal human colon epithelial cell CCD841 were chosen for the evaluation of inhibitory activity of the main quinones of B. rynchopetera defense secretion, including methyl p-benzoquinone (MBQ), ethyl p-benzoquinone (EBQ), and methyl hydroquinone (MHQ), through methyl thiazolyl tetrazolium assay. The tumor-related factors, cell cycles, related gene expressions and protein levels were detected by enzyme-linked immunosorbent assy, flow cytometry, RT-polymerase chain reaction and Western blot, respectively.@*RESULTS@#MBQ, EBQ, and MHQ could significantly inhibit the proliferation of Caco-2, with half maximal inhibitory concentration (IC50) values of 7.04 ± 0.88, 10.92 ± 0.32, 9.35 ± 0.83, HT-29, with IC50 values of 14.90 ± 2.71, 20.50 ± 6.37, 13.90 ± 1.30, and CCD841, with IC50 values of 11.40 ± 0.68, 7.02 ± 0.44 and 7.83 ± 0.05 µg/mL, respectively. Tested quinones can reduce the expression of tumor-related factors tumor necrosis factor α, interleukin (IL)-10, and IL-6 in HT-29 cells, selectively promote apoptosis, and regulate the cell cycle which can reduce the proportion of cells in the G1 phase and increase the proportion of the S phase. Meanwhile, tested quinones could up-regulate mRNA and protein expression of GSK-3β and APC, while down-regulate that of β-catenin, Frizzled1, c-Myc, and CyclinD1 in the Wnt/β-catenin pathway of HT-29 cells.@*CONCLUSION@#Quinones from B. rynchopetera defense secretion could inhibit the proliferation of colorectal tumor cells and reduce the expression of related factors, which would be functioned by regulating cell cycle, selectively promoting apoptosis, and affecting Wnt/β-catenin pathway-related mRNA and protein expressions.

Expression of Cyclooxygenase-2 in Patients With Snow-White Sign of Advanced Colorectal Adenomas / 中国医学科学院学报

Objective To analyze the expression of cyclooxygenase-2 (COX-2) in the patients with snow-white sign of advanced colorectal adenoma (ACA) and explore its clinical significance.Method Western blotting was employed to determine the expression of COX-2 in the adenoma tissue and the normal tissue adjacent to the adenoma tissue (>5 cm away from the distal end of the adenoma tissue) of 40 ACA patients with snow-white sign and 40 ACA patients without snow-white sign.Results The appearance of snow-white sign in ACA patients was associated with patient age (P=0.001) and not associated with sex,smoking history,drinking history,ethnic groups,family history of colorectal cancer,abdominal pain,diarrhea,constipation,fecal occult blood,or tumor markers (all P>0.05).Snow-white sign mainly appeared in the ACA patients with multiple adenomas (P=0.004),large adenomas (P=0.006),adenomas in distal colon (P=0.015),protruding polyps (P=0.044),and late-stage pathology (P=0.010).The occurrence of snow-white sign showed no difference in the ACA patients with different results of Japan NBI Expert Team classification (P=0.502).The expression of COX-2 in the adenoma tissue was higher than that in the adjacent normal tissue in the patients with and without snow-white sign (P<0.001,P=0.004).The patients with snow-white sign had higher expression of COX-2 protein in the adenoma tissue than the patients without snow-white sign (P=0.001).The expression of COX-2 protein in the adjacent healthy tissue had no significant difference between the patients with and without snow-white sign (P=0.603).Conclusions Snow-white sign is more like to appear in the ACA patients with young age,multiple and large adenomas,adenomas in distal colon,protruding polyps,and late-stage pathology.Moreover,the expression of COX-2 in the ACA patients with snow-white sign is significantly higher than that in the ACA patients without snow-white sign.The adults with snow-white sign are prone to cancerization than those without snow-white sign.

The application of quantitative immune fecal occult blood test for the screening of colorectal cancer in health check?up participants / 中华健康管理学杂志

Objective To evaluate the application value of quantitative immune fecal occult blood test (FOBT) in colonoscopy for the screening of colorectal cancer in health check-up participants. Methods The subjects were selected from July 2017 to June 2018 in the Health Management Center of the Second Affiliated Hospital of Suzhou University. The subjects were the healthy individuals who chose quantitative immune FOBT or chemical method plus immunogold double-method FOBT (referred to as"double-method FOBT"), excluding those who had interfering factors. Individuals with a positive result in primary screening were selected and conducted with colorectal cancer by colonoscopy. If the polyploidy lesions were observed during colonoscopy, the biopsy or excision was performed, and the pathological diagnosis was performed. The positive rate of primary screening, compliance rate of colonoscopy and pathological results of colonoscopy were compared between the two methods. Quantitative immunoassay FOBT was analyzed in different gender, age group, physical examination nature, positive rate of primary screening, compliance rate of colonoscopy and pathological results of colonoscopy. Results 18 728 people chose quantitative immunoassay FOBT and 6 212 people chose double-method FOBT at the same time. There was no significant difference in gender and age between the two groups (all P>0.05), which was comparable. The detection rate of quantitative immune FOBT was higher than double-method FOBT (74.62% vs 32.23%, P<0.001). The positive rate of quantitative immune FOBT in primary screening was lower than double-method FOBT (4.11% vs 5.34%, P=0.003). The colonoscopy screening rate in positive population by quantitative immune FOBT was higher than double-method FOBT (27.83% vs 13.08%, P=0.001). These differences were statistically significant. The detection rate of total lesions by colonoscopy was 71.88% in positive population by quantitative immune FOBT. It was 42.86% in double-method FOBT. There was no statistical difference between the two methods (P=0.05). The detection rates of quantitative immune FOBT were significantly different among different genders, ages and physical properties (all P<0.001). The detection rate was higher in males than in females (79.14% vs 68.75%). The detection rate was highest in the group between 40 and 59 years old (79.96%). The individual detection rate was higher than the group (90.08% vs 66.07%). The positive rates in primary screening were significantly different among different ages (P=0.001).It was highest in the group aged 60 or above (5.59%). The colonoscopy screening rate in positive population by quantitative immune FOBT was highest in the group aged 50 or above (36.96%). The detection rate of inflammatory lesions were significantly different among different ages (P<0.001). The detection rate of colorectal cancer in males was higher than in females (11.11% vs 0.00%, P=0.009). In addition, with the increasing of fecal occult blood value, the detection rate of cancer was increased (P=0.041). Conclusion The quantitative immune FOBT is an ideal non-invasive examination for early screening of colorectal cancer. It has important application values.

Risk factors of delayed bleeding after endoscopic submucosal dissection for early colorectal cancer and pre-cancerous lesions / 实用医学杂志

Objective To investgate risk factors of delayed bleeding after endoscopic submucosal dissec-tion(ESD)for early colorectal tumor and precancerrous lesions. Methods We retrospectively reviewed clinical date of 138 patients with early colorectal tumor and precancerrous lesions who received ESD in Hubei Cancer Hos-pital from October 2012 to October 2016. Risk factors of delayed bleeding were analysed by univariate and multi-variable logistic regression analysis. Results Ten(7.2%)of 138 patients occurred delayed bleeding after ESD. Univariate analysis showed that there was significent difference between the bleeding group and the non-bleeding group in location of the lesion(P = 0.022),severe fibrosis of submucosa(P = 0.016),Obvious intraoperative bleeding(P = 0.032)and inadequate endosopic experience of endoscopist(P = 0.045). Multivariate Logistic re-gression analysis showed that location of lesion(P = 0.003,OR = 4.64,95%CI:1.71~12.58),severe fibrosis of submucosa(P = 0.009,OR = 4.83,95% CI:1.49~15.60)were independent risk factors of delayed bleeding after ESD for early colorectal tumor and precancerrous lesions. Conclusion Patients with early colorectal tumor and precancerrous lesions in the rectum and severe fibrosis of submucosa are prone to delayed bleeding after ESD.

Anti-colorectal cancer effects of tripolinolate A from Tripolium vulgare / 中国天然药物

Tripolinolate A (TLA) is recently identified as a new compound from a halophyte plant Tripolium vulgare and has been shown to have significant in vitro activity against the proliferation of colorectal cancer and glioma cells. This study was designed to further investigate the effects of TLA on the proliferation of human normal cells, and the apoptosis and cell cycle in colorectal cancer cells, and the growth of tumors in the colorectal cancer-bearing animals. The data obtained from this study demonstrated that: 1) TLA had much less cytotoxicity in the human normal cells than the colorectal cancer cells; 2) TLA remarkably induced apoptosis in the human colorectal cancer cells and blocked cell cycle at G/M phase, and 3) TLA had significant anti-colorectal cancer activity in the tumor-bearing animals.

Outcomes of endoscopic submucosal dissection for colorectal large laterally spreading tumors / 中国内镜杂志

Objective To evaluate the efficacy and safety of endoscopic submucosal dissection for the treatment of colorectal large laterally spreading tumor. Methods ESD was applied to treat 150 cases of colorectal LST with diameter larger than 4 cm. The morphological features of LST, distribution, the clinicopathological data and the en-bloc resection rate, complete resection rate, complications were retrospectively evaluated. Results There were 87 patients with LST-granular lesions and 63 patients with LST-nongranular lesions. Colorectal LST mainly distributed in the rectum for 109 cases (72.7%), sigmoid colon for 13 cases (8.7%), descending colon for 5 cases (3.3%), transverse colon for 8 cases (5.3%), ascending colon for 13 cases (8.7%), cecum for 2 cases (1.3%). There were 23 patients with low-grade neoplasia, 104 patients with high-grade intraepithelial neoplasia, 7 with intramucosal carcinoma and 16 with submucosal carcinoma. The en-bloc resection rate and complete resection rate were 92.7% (139/150) and 89.3%(134/150). Adverse events were intra-operative bleeding in 12 patients (8.0%), postoperative bleeding in 2 patients (1.3%), perforation in 3 patients (2.0%), postoperative stenosis in 3 patients (2.0%). Conclusion Colorectal large LST-NG has higher potential for malignancy. ESD is a safe and effective method to provide en-bloc and complete resection of colorectal large LST.

Correlation between Hypermethylation of SFRP2 promoter CpG island and colorectal cancer / 中国现代普通外科进展

Objective:SFRP2 gene is a member of the SFRPs family.The gene is located on chromosome 4q31.3 with 3 exons and 2 introns and first exons have higher density near the island of CpG.Many studies showed that the methylation level of SFRP2 gene and colon cancer,esophageal cancer,gastric cancer and other tumor occurrence relating to,development and prog nosis.This study aims to study the clinical characteristics of CpG SFRP2 promoter island hypermethylation in colorectal cancer and whether there is a certain correlation.Methods:by matrix assisted laser desorption ionization time of flight mass spectrometry for detecting specific CpG island methylation.Methylation status of SFRP2 promoter by Sequenom EpiTYPER was detected in 20 cases of normal tissue of colorectal cancer and tumor tissues.Results:Our study using multiple linear regression analysis in tumor tissue of SFRP2 methylation at promoter Ⅰ and Ⅱ,found that SFRP2 promoter methylation and clinical features of.SFRP2_01_CpG_5 significantly correlated (P=0.018),SFRP2_02_CpG_5 (P=0.018) associated with the location of the tumor,SFRP2_02_CpG_6,7,8,9(P=0.039) and the number of lymph node metastasis of.SFRP2_01_CpG_1.2(P=0.043),SFRP2_02_CpG_16 (P=0.044) correlated with tumor size.Conclusion:we from epigenetic aspects of its promoter CpG methylation level and colorectal cancer clinical and pathological features,found a correlation between clinical and pathological features of colorectal cancer and CpG methylation in its promoter,suggesting that the SFRP2 promoter may be at this stage of colorectal cancer and future biological genetics the progress of the potential surface markers.

Application and advances of diffusion-weighted imaging in colorectal tumor and inflammatory bowel disease / 复旦学报（医学版）

As a novel magnetic resonance functional imaging technique,diffusion-weighted imaging (DWI) has been widely used in the diagnosis of diseases of central nervous system.Recent years,DWI application is getting more and more to evaluate the biological characteritics of human body,espercially in liver,pancreas,kidneys and pelvic cavity.While,research of DWI in intestinal disease is relatively few.This article aims to review the application advances of DWI in colorectal tumor and inflammatory bowel disease (IBD).

Effects of Physiotherapy in the prevention of lower extremity deep venous thrombosis in patients with colorectal tumors after operation / 现代临床护理

Objective To investigate the effects of Physiotherapy in the prevention of lower extremitydeep venous thrombosis in patients with colorectal tumors after operation. Methods About 55 cases of inpatients admitted to the hospital from November 2014 to November 2015 were selected as the control group, and they were given routine nursing before and after operation. Another 55 cases of inpatients admitted to the hospital from November 2015 to November 2016 were selected as the observation group. On the basis of the control group, the observation group were treated with Physiotherapy in 24h after operation, 30min for once, twice/d, lasting for 7 days. The coagulation function , lower extremity deep venous flow velocity and the incidence of deep venous thrombosis in two groups were compared before operation and 7 days after operation. Result About 7 days after operation, levels of fibrinogen and D-dimer in the observation group were lower than those in the control group (P<0.01), the lower extremity deep venous blood flow velocity was higher than that in the control group (P<0.01), and the incidence of lower limb deep venous thrombosis was lower than that in the control group (all P<0.05). Conclusion Physiotherapy can improve the coagulation function in patients undergoing colorectal operation, improve the lower extremity deep venous flow velocity and reduce the incidence of lower extremity deep venous thrombosis.

Study on APC,p53 and K-ras genes mutation of tissues and feces in the patients with colon tumor / 实用肿瘤学杂志

Objective To investigate the feasibility and clinical significance of fecal DNA tests for colon tumor diagnosis and screening,we inspected the mutations of APC,p53 and K-ras genes in the tissue and feces of patients with colorectal tumor.Methods We collected 46 patients with colorectal cancer(CRC),60 patients with colorectal adenomas( CRA) and 30 cases of normal person in Huizhou First People Hospital in Guangdong Province from Nov.2011 to Aug.2012.Then all the tumor tissues and feces of these people were detected the mu-tation rate about the APC,p53 and K-ras genes using polymerase chain reaction single strand conformation poly-morphism analysis method(PCR-SSCP).Results The mutation rates of APC,p53,K-ras genes of feces in CRC group,CRA group and normal group were 58.7%(27/46),65.2%(30/46)and 60.9%(28/46),20.0%(12/60),25.0%(15/60)and 23.3%(14/60),3.33%(1/30),0%(0/30)and 0%(0/30),respectively.How-ever the mutation rate in tissues were 63.0%(29/46),69.6%(32/46)and 63.0%(29/46),25.0%(15/60), 26.7%(16/60)and 26.7%(16/60),0%(0/30),0%(0/30) and 0%(0/30).Corresponding mutations could be found in feces and tumor tissues.Consistency checking for mutations rate in feces and tumor tissues of CRC group and CRA group showed that the Kappa value were 0.818(P<0.001),0.901(P<0.001),0.862(P<0.001)and 0.857(P<0.001),0.870(P<0.001),0.822(P<0.001).It means an excellent consistency.Con-clusion Fecal DNA testing is expected to become an effective noninvasive colon tumor early diagnosis and screening method.

Effect of dexmedetomidine combined with ulinastatin on postoperative delirium in elderly patients under-going resection of gastrointestinal tumor / 临床麻醉学杂志

Objective To investigate the effect of dexmedetomidine combined with ulinastatin on postoperative delirium in elderly patients undergoing resection of gastrointestinal tumor. Methods A total of 180 elderly patients (97 males,83 females,aged 65-80 years,ASA grade Ⅱ orⅢ)who underwent laparoscopic surgery for gastrointestinal tumor,were randomized into four groups (n =45 each):dexmedetomidine group (group D),ulinastatin group (group U),dexmedetomidine+ulinastatin group (group DU)and control group (group C).Patients in group D were given a loading dosage of dexmedetomidine 0.5 μg/kg intravenously 1 5 min before the induction of general anesthesia,followed by a continuous infusion of 0.3 μg·kg-1 ·h-1 ,and dexmedetomidine was ad-ministered till 40 min before the end of surgery.Patients in the group U were given a loading dosage of ulinastatin 10 000 U/kg intravenously in 20 min.In group DU,dexmedetomidine and ulinastatin were administered in accordance in group D and group U respectively.Patients in group C were given 0.9% saline solution.The volume of blood loss,the time of operation and recovery,the adverse reac-tions after surgery were recorded.The concentration of dopamine (DA),adrenaline (AD),norepi-nephrine (NE)were measured within the preoperative 1 d (T0 ),within the first hour of surgery (T1 ),within the postoperative 1 d (T2 ),2 d (T3 ),3 d (T4 ).The confusion assessment method Chi-nese reversion (CAM-CR)was used to screen POD on T0 ,T2-T4 .Results The levels of DA,AD and NE in the group C and group U at T1-T4 significantly elevated than those at T0 (P <0.05);the levels of DA at T1 and the levels of AD at T1 ,T2 in group D and group DU significantly elevated than those at T0 (P <0.05).The levels of DA,AD at T3 ,T4 and the levels of NE at T1-T4 in group D and group DU were significantly reduced compared with those in the group C and group D (P <0.05 ). Compared with the group C,the incidence of POD was significantly reduced in the group D,group U and group DU (P <0.05).Among the three groups (D,U and DU),the difference were not statisti-cally significant in the incidence of POD.Conclusion Dexmedetomidine or ulinastatin may reduce the rate of POD in elderly patients undergoing laparoscopic surgery for gastrointestinal tumor.Compared with the administration of ulinastatin or dexmedetomidine alone,combined application of dexmedeto-midine and ulinastatin does not reduce the incidence of POD.

Experimental study of mustard seeds prevent colorectal tumor by antioxidation and immune deviation / 中国癌症杂志

Background and purpose:Recently, a large number of researches have shown that cruciferous plants have the chemopreventive effect on tumor. Mechanisms of antitumorigenesis were investigated on antioxidation, antimutation, immunity and inducing apoptosis, and so on. Mustard seeds (MS) are the seeds belong to the cruciferous plants. This study aimed to investigate antioxidation and immune deviation of MS on colorectal tumor in rats induced by 1, 2-dimethylhydrazine (DMH). Methods:A total of 48 male Wistar rats were randomly divided into four groups:DMH alone, DMH+5%MS, DMH+7.5%MS, and the untreated control group(Saline). Colorectal tumorigenesis was induced by intraperitoneal injecting 30 mg/kg DMH once a week for 20 weeks. At the end of 32 weeks, the rats were sacrificed, then colorectal tumor incidence was observed and histological type was determined by HE staining. A colorimetric assay was used to detect levels of the lipid peroxidation product malondialdehyde (MDA) and the activity of antioxidant enzymes in the serum of all rats. The levels of Th1 and Th2 cytokines were detected with Luminex200. Results: No tumorous lesion was found in the untreated control group. However, the total tumor incidence in DMH+5%MS group and DMH+7.5%MS group was signiifcantly decreased 33.3%and 58.3%respectively, compared with the DMH group’s (100%, P<0.05). As DMH induced colorectal tumorigenesis, MDA and Th2 cytokines in the serum were signiifcantly higher in the DMH group than those in the untreated control group (P<0.05), but the activities of antioxidant enzymes were signiifcantly lower (P<0.05). While the MS treatment, compared with the DMH group, signiifcantly suppressed the MDA level but enhanced the activities of antioxidant enzymes and levels of Th1 cytokines (P<0.05). Conclusion: MS significantly decrease prevalence rates of DMH-induced colorectal tumor in rats. The mechanism may be related with the antioxidation and immune balance deviation.

Feasibility of endoscopic submucosal dissection for gastric and colorectal lesions: Initial experience from the Gastrocentro - Unicamp

OBJECTIVE: Endoscopic submucosal dissection is a technique developed in Japan for en bloc resection with a lower rate of recurrence. It is considered technically difficult and performed only in specialized centers. This study sought to report the initial experience from the Gastrocentro - Campinas State University for the treatment of gastric and colorectal lesions by endoscopic submucosal dissection. MATERIALS AND METHODS: The guidelines of the Japanese Association of Gastric Cancer were used as evaluative criteria. For colorectal lesions, the recommended standards proposed by Uraoka et al. and Saito et al. were employed. The practicability of the method, the development of complications and histological analysis of the specimens were evaluated. RESULTS: Sixteen patients underwent endoscopic submucosal dissection from June 2010 to April 2011; nine patients were treated for gastric lesions, and seven were treated for colorectal lesions. The average diameter of the gastric lesions was 28.6 mm, and the duration of resection was 103 min without complications. All lesions presented lesion-free margins. Of the seven colorectal tumors, four were located in the rectum and three were located in the colon. The average size was 26 mm, and the average procedure time was 163 min. Two complications occurred during the rectal resection procedures: perforation, which was treated with an endoscopic clip, and controlled bleeding. One of the lesions presented a compromised lateral margin without relapse after 90 days. Depth margins were all free of lesions. CONCLUSION: Endoscopic submucosal dissection at our institution achieved high success rates, with few complications in preliminary procedures. The procedure also made appropriate lesion staging possible.

Correlation of Narrow Band Imaging with Magnifying Colonoscopy and Histology in Colorectal Tumors

BACKGROUND/AIMS: Narrow band imaging (NBI) is a new technique that uses optical filters for imaging of mucosal morphology. The aim of this study was to correlate findings of NBI with magnifying colonoscopy and histology for prediction of neoplastic colorectal lesion. METHODS: Between September 2005 and December 2007, 107 colon polyps from 68 patients were detected by conventional colonoscopy and subsequently evaluated by NBI with magnifying colonoscopy and analyzed for a pit pattern and a capillary pattern. More analysis was done regarding thickness and irregularity of capillary features. RESULTS: Pit pattern with NBI magnification to discriminate between neoplastic and non-neoplastic lesions had a sensitivity of 88.9% and a specificity of 87.5%; capillary pattern yielded test performance characteristics of 91.9% and 87.5%. In respect of capillary thickness, invisible capillaries were found significantly more often in hyperplastic lesions. All thick capillaries were found in neoplastic polyps, and found significantly more often in carcinomas with submucosal massive invasion (sm-m) (p<0.01). In respect of capillary irregularity, invisible capillaries were found significantly more often in hyperplasic lesions, and severely irregular capillaries were found significantly more often in sm-m lesions (p<0.01). CONCLUSIONS: Observation of capillary thickness and irregularity by NBI magnification is useful for correlating histological grade with carcinoma, especially with depth of submucosal invasion.

Correlation of Narrow Band Imaging with Magnifying Colonoscopy and Histology in Colorectal Tumors

BACKGROUND/AIMS: Narrow band imaging (NBI) is a new technique that uses optical filters for imaging of mucosal morphology. The aim of this study was to correlate findings of NBI with magnifying colonoscopy and histology for prediction of neoplastic colorectal lesion. METHODS: Between September 2005 and December 2007, 107 colon polyps from 68 patients were detected by conventional colonoscopy and subsequently evaluated by NBI with magnifying colonoscopy and analyzed for a pit pattern and a capillary pattern. More analysis was done regarding thickness and irregularity of capillary features. RESULTS: Pit pattern with NBI magnification to discriminate between neoplastic and non-neoplastic lesions had a sensitivity of 88.9% and a specificity of 87.5%; capillary pattern yielded test performance characteristics of 91.9% and 87.5%. In respect of capillary thickness, invisible capillaries were found significantly more often in hyperplastic lesions. All thick capillaries were found in neoplastic polyps, and found significantly more often in carcinomas with submucosal massive invasion (sm-m) (p<0.01). In respect of capillary irregularity, invisible capillaries were found significantly more often in hyperplasic lesions, and severely irregular capillaries were found significantly more often in sm-m lesions (p<0.01). CONCLUSIONS: Observation of capillary thickness and irregularity by NBI magnification is useful for correlating histological grade with carcinoma, especially with depth of submucosal invasion.

Endoscopic Submucosal Dissection for Colorectal Tumors / 대한소화기내시경학회지

Because screening gastrointestinal endoscopies have been widely performed recently, diagnosis rates of early stage cancer have been increasing rapidly. This trend has also led to advances in therapeutic endoscopy, which is less invasive than surgery. The state-of-the-art technique, endoscopic submucosal dissection (ESD), allows more favorable outcomes than conventional endoscopic mucosal resection (EMR) regarding en-bloc resection of the lesion, irrespective of the size of the lesion. ESD has already been established as the standard therapeutic option for neoplastic lesions in the upper gastrointestinal tract. However, the use of ESD for colorectal lesions is not yet established because of the unique pathological, organ specific characteristics of colonic lesions. Moreover, endoscopists are required to have higher qualifications to perform ESD and tend to cause complications more frequently. Nevertheless, it is obvious that ESD has a therapeutic advantage for certain colonic lesions and enables endoscopists to achieve a higher en-bloc resection rate, resulting in enhanced curability and more accurate histopathological assessment. Recent development of a special colonoscope for ESD and refinement of devices such as surgical knives and traction systems are expected to overcome some limitations of ESD and a standard protocol will be available in the near future. In this review, we will discuss the current status and future prospects of colorectal ESD.

Fish oil ingestion reduces the number of aberrant crypt foci and adenoma in 1, 2-dimethylhydrazine-induced colon cancer in rats

We determined the effect of fish oil (FO) ingestion on colonic carcinogenesis in rats. Male Wistar rats received 4 subcutaneous injections (40 mg/kg body weight each) of 1,2-dimethylhydrazine (DMH) at 3-day intervals and were fed a diet containing 18 percent by weight FO (N = 10) or soybean oil (SO, N = 10) for 36 weeks. At sacrifice, the colon was removed, aberrant crypt foci were counted and the fatty acid profile was determined. Intestinal tumors were removed and classified as adenoma or carcinoma. Liver and feces were collected and analyzed for fatty acid profile. FO reduced the mean (± SEM) number of aberrant crypt foci compared to SO (113.55 ± 6.97 vs 214.60 ± 18.61; P < 0.05) and the incidence of adenoma (FO: 20 percent vs SO: 100 percent), but carcinoma occurred equally in FO and SO rats (2 animals per group). The polyunsaturated fatty acid (PUFA) profile of the colon was affected by diet (P < 0.05): total ù-3 (FO: 8.18 ± 0.97 vs SO: 1.71 ± 0.54 percent) and total ù-6 (FO: 3.83 ± 0.59 vs SO: 10.43 ± 1.28 percent). The same occurred in the liver (P < 0.05): total ù-3 (FO: 34.41 ± 2.6 vs SO: 6.46 ± 0.59 percent) and total ù-6 (FO: 8.73 ± 1.37 vs SO: 42.12 ± 2.33 percent). The PUFA profile of the feces and liver polyamine levels did not differ between groups (P > 0.05). In conclusion, our findings indicate that chronic FO ingestion protected against the DMH-induced preneoplastic colon lesions and adenoma development, but not against carcinoma in rats.

Endoscopic Submucosal Dissection for Colorectal Neoplasia: Early Outcomes After 260 Cases

PURPOSE: Endoscopic submucosal dissection (ESD), a recently introduced endoscopic technique, makes it possible to perform an en-bloc resection of a lesion regardless of its size. The aim of this study was to report early experiences with colorectal ESD performed in our hospital. METHODS: Between October 2006 and December 2008, we performed an ESD for 260 consecutive cases of colorectal neoplasia in 255 patients. We evaluated the clinical outcomes, except for two failure cases of bowel perforation. RESULTS: The mean resected tumor size was 24.2+/-9.8 (5-60) mm. Our overall endoscopic en-bloc resection rate was 93.0% (240/258). and the pathologically margin free rate was 91.5% (236/258). Perforation occurred in 7.7% (20/260) of the cases. In 17 patients, perforation was managed by endoscopic clipping without salvage surgery; the other three patients underwent a laparoscopic operation. Pathological examination showed an adenocarcinoma in 35.4% of the cases (92/260). We recommended additional radical surgery in 13 cases (submucosal invasion less than 1 mm with unfavorable pathology: 1 case; unknown depth of submucosal invasion: 1 case; submucosal invasion > or =1 mm: 9 cases; invasion to proper muscle: 2 cases). We were able to check the recurrence rate through colonoscopy for 125 patients. During the mean follow-up period of 8.0+/-4.3 (3-21) mo, there were no recurrences. CONCLUSION: ESD was technically difficult, had a substantial risk of perforation, and needed a long procedure time. However, ESD enabled en-bloc resection of large colorectal tumors. As experience with the technique increases, ESD might gradually replace piecemeal endoscopic mucosal resection (EMR) and radical colon resection in the treatment of colorectal tumors.

Clinical significance of the number of lymph nodes detected for stage Ⅱ colorectal cancer / 国际外科学杂志

Colorectal cancer is a threat to human health, the disease rate of stage Ⅱ colorectal cancer is increasing. Some prognostic factors have been researched, and the number of harvested lymph nodes is a very important factor. Harvesting more lymph nodes will reduce the relapse rate and increase the survival rate. It remains controversial for the minimum number of lymph nodes, and UICC and AJCC recommended that the minimum number was 12. Some factors will influence the number of harvested lymph nodes,for ex-ample, the patient's situation, tumor itself, surgeon and pathologist's skills , and so on.