ABSTRACT
@#【Objective】To study the relationship between circulation tumor cell（CTC）and clinicopathological characteristics in early and middlestage colorectal cancer，and to evaluate the diagnostic and prognostic value of peripheral blood CTC through dynamically monitoring the changes of peripheral blood CTC in the patients before and after operation.【Methods】 Prospectively 67 patients with early and middle stage colorectal cancer were included，and 20 healthy volunteers served as contrast during the same period. Peripheral venous blood（7.5 mL）was collected 24 h before radical operation，3 months after radical operation and in control group. SE- iFISH technique was used to isolate and identify CTC. The cutoff value of CTC in diagnosis of colorectal cancer was determined by the receiver operating curve（ROC）and Youden index. Kaplan-Meier and log-rank methods were used for survival analysis and multivariate COX regression analysis for multivariate correction. The value of CTC in the diagnosis of early and middle stage colorectal cancer was evaluated comprehensively，and then the relationship between CTC in peripheral blood and clinicopathological characteristics and prognosis was synthetically evaluated combined with clinicopathological characteristics and postoperative follow- up data. 【Results】The positive rate of CTC in patients with early and middle stage colorectal cancer was significantly higher than that in healthy people（91.0% vs. 5.0% ，P<0.01）. The CTC enumeration was significantly correlated with the depth of invasion and tumor location（P = 0.001，P = 0.044），but not with gender，age，tumor size，lymph node metastasis，TNM stage ，CEA level and CA-199 level. The preoperative CTC enumeration were not correlated with the above-mentioned clinicopathological parameters. Preoperative CTC had no predictive significance for disease free survival（DFS）and total survival（OS）（AUC = 0.359，P = 0.068；AUC = 0.428，P = 0.423），and postoperative CTC critical point of 3/7.5 mL had predictive significance for DFS and OS（AUC = 0.936 ，P < 0.001 ；AUC = 0.863 ，P < 0.001）. It was found that patients with early and middle stage colorectal cancer were divided into two groups ：good prognosis group（CTC < 3 after operation or the number of CTC after operation was equal or decreased with the number of CTC before operation）and bad prognosis group（CTC ≥ 3 after operation or the number of CTC after operation was higher than the number of CTC before operation）. The DFS of the good prognosis group was significantly longer than that of the poor prognosis group （43.7 months vs. 20.4 months，P < 0.001；48.7 months vs. 26.8 months，P < 0.001），and the OS was also significantly longer （54.7 months vs. 43.3 months，P < 0.001；54.8 months vs. 45.1 months，P < 0.001）. Multivariate analysis showed that CTC ≥ 3/7.5 mL was a bad independent factor of DFS and OS.【Conclusions】CTC has high clinical value in patients with early and middle stage colorectal cancer. Preoperative CTC values can not predict the prognosis of early and middle stage colorectal cancer ，but postoperative CTC values and dynamic detection for CTC changes before and after operation can independently predict the prognosis of early and middle stage colorectal cancer.
ABSTRACT
Objective To explore the effect of cisapride combined with polyethylene glycol electrolytic solution on preoperative bowel preparation for patients receiving colorectal cancer operation. Methods One hundred and fifty-two patients received colorectal cancer opera-tion in our hospital from October 2010 to October 2014 were selected. Those who were treated with cisapride combined with polyethylene gly-col electrolytic solution for bowel preparation before operation were assigned to oberservation group(n=83),those who were treated with poly-ethylene glycol electrolytic solution for bowel preparation before operation were assigned to control group(n=69). The side effect after medi-cation, electrolyte concentration and incidence of incision infection between groups after operation were collected and compared. Results The incidence of nausea and vomiting was 7. 23% in observation group,which was significantly lower than 18. 84% in control group (χ2 =4. 64,P=0. 03). The difference of Na+,K+ and Cl- concentration between groups were not significant (t=1. 83,P=0. 07;t=0. 42,P=0. 68;t=1. 86,P=0. 07). The body temperature,leukocyte count and incidence of incision infection after operation in observation group were significantly lower than those in control group (t=2. 68,P<0. 01;t=3. 29,P<0. 01;χ2 =4. 90,P=0. 03). Conclusion Cisapride com-bined with polyethylene glycol electrolytic solution before operation can significantly decrease the incidence of gastrointestinal side effect after medicaiton and incision infection after operation and it is beneficial to recovery for patients with colorectal cancer operation.
ABSTRACT
Dietary habits in Japan have become more westernized in recent years. An increasing number of people are developing colorectal cancer, which may be considered a lifestyle disease. Moreover, many people develop post-operative problems following surgery for colorectal cancer. We present a patient who complained of excessive bowel movements and various nonspecific complaints after surgery for colorectal cancer. We performed acupuncture treatments, and in order to objectively examine changes in symptoms as well as to document the usefulness of acupuncture treatment, we used a health chart produced by the Nonspecific Symptoms Team, Research Department of the Japan Society of Acupuncture and Moxibustion. We performed <I>tanshijutsu</I> (treatment in which the practitioner continues holding the needle from insertion until removal), which included <I>zuishou</I> (therapy based on the symptoms), <I>taikyoku</I> (basic meridian points for total body adjustment according to the Kurono style), and topical therapies using 30mm 18-gauge needles. In total, 14 treatments were administered. The results objectively demonstrated the usefulness of acupuncture in treating the patient's postsurgical nonspecific complaints. Moreover, the acupuncture treatments were also effective in improving the patient's bowel problems. These findings suggest that acupuncture may be a useful method of postoperative care.