Résumé
Some biological factors play a role in stimulation of malignant growth, metastasis and angiogenesis; however, their clinical relevance has not yet been well established for most of them. This work was aimed at studying the clinical relevance of serum vascular endothelial growth factor [VEGF] and interleukin-6 [IL-6], in patients with colorectal cancer [CRC]. Preoperative serum levels of VEGF and IL-6 were measured by enzyme-linked immuno-assay in 35 CRC patients and in 30 healthy controls. CRC patients with or without metastasis had significantly higher VEGF and IL-6 levels than healthy controls [all P <0.001]. Patients with advanced clinical stage had significantly higher levels of VEGF and IL-6 than those with early clinical stage [all P <0.001]. Also, patients with metastatic disease had significantly higher VEGF and IL-6levels than those with localized disease [all P<0.001]. The diagnostic accuracy for invasiveness was 83% for VEGF [cut off value = 240 pg/ml] and 66% for IL-6 [cut off value = 6.7 pg/ml], with sensitivity 79% and 74% and specificity 68% and 59%, respectively. In CRC patients, preoperative measurement of serum VEGF and IL-6 may prove useful non-invasive diagnostic indicators associated with advanced clinical stage and tumor metastasis that warrants further investigations
Résumé
P53 gene mutation occurs in about 50-60% of colorectal carcinoma [CRC] patients. The key enzymes responsible for extracellular matrix breakdown are matrix metalloproteinases [MMPs]. These have been reported to plug an important role in tumor cell invasion and metastasis, which are major factors in the morbidity and mortality of CRC. The study included 46 patients with CRC who were diagnosed and treated in Mansoura University Hospital d w the period between January 1999 to January 2001. They were treated with left or right hemicolectomy, anterior resection or total mesolectal excision. These included 24 males and 22 females with age ranged from 22-70 year with median age of 46 years [+/- 1 4] Immunohistochemically staining of both tumor and positive lymph nodes was performed on paraffin sections for p53 and MMP2. Twenty one patients were stage C with lymph node metastasis. P53 diffuse positive staining of the tumor cell nuclei was identified in 16 out of 46 [3596] tumor cases and 10 out of 21 [48%] of metastatic tumors. Cytoplasmic MMP-2 expression was positive in 20 out of 46 [43%] tumors, where its expression in the stroma was positive in 17[37%] In lymph node metastasis, cytoplasmic MMP-2 was positive in 11 out of 21 [52%] of tumors. There was a statistical correlation between p53 and MMP-2 expression in lymph node metastatic tumors [p<0.05]M. MP-2 was seen more in tumor cells invading the muscular is with little staining in more superficial areas. Poor survival was associated with MMP2, p53 expression in patients with 1ymph node metastasis. Lymph node metastatic tumors have higher incidence of p53 and MMP2 staining. These data suggest a role for MMP-2 in colorectal cancer with lymph node metastasis. These results confirm the prognostic value of MMP-2 and p53 on survival of CRC
Résumé
Distal hypospadias represents the most common male genital malformation. Many surgical procedures had been practiced for repair of distal hypospadias, and only few reports had follow up more than one year, The objective of this study was to evaluate the long term results of distal hypospadias repair using distal urethral advancement and glanuloplasty technique. This study comprised 87 patients admitted to the Surgical Department, Mansoura University Hospital with the diagnosis of distal hypospadias and underwent surgical repair using distal urethral advancement and glanuloplasty technique. Their mean a.ge was 6.7 [+4.6] range 2-20 years, and the mean follow up was 48.3 [range 12-78] months. Good outcome was achieved in 79 [90.8%] patients, and complications occurred in only 8 [9.20%] patients including urethral fistula in 2 [2.30%] meatal stenosis in 3 [3.45%], meatal retraction in 1 [1.15%], and poor cosmetic results in 2 [2.30%] patients. We concluded that long-term follow up confirms the validity of this procedure with good outcome and low complication rate