Comparison of incidence rate of anastomotic stricture between conventional anastomosis and double-layers anastomosis after operation of esophageal cancer / 中华老年医学杂志

Objective To explore how to decrease the incidence of anastomotic stricture after the operation of esophageal cancer by improving anastomosis.Methods Clinical data of 374 cases aged ＞ 60 years who had undergone left thoracotomy radical resection of esophagus cancer at our hospital from April 2013 to August 2015 were collected.Patients were divided into double-layers anastomosis group (n=187) and conventional anastomosis group (n=187).During process of stapling anastomosis,double purse string anastomosis on esophagus and gastric wall were performed in doublelayers anastomosis group,with no purse string suture in conventional anastomosis group.Incidence rate of anastomotic stricture was compared between the two groups.Results Conventional anastomosis group versus double-layers anastomosis group showed that a mild anastomotic stricture occurred in 17 cases (9.1 ％) versus 7 cases (3.7 ％) (x2 =4.452,P =0.035),a moderate anastomotic stricture in 12 cases(6.4 ％) vs.4 cases (2.1 ％) (x2 =4.179,P =0.041),a severe anastomotic stricture in 9 cases (4.8％)vs.3 cases(1.6％)(x2 =3.099,P=0.078),total number of anastomotic stricture in 38 cases vs.14 cases (x2 =12.866,P =0.000),showing that double-layers anastomosis was relatively superior to conventional anastomosis.Conclusions Double-layers anastomosis can effectively reduce the incidence of anastomotic stricture after surgery.

The expression and clinical significance of hsa-miR-144 in esophageal squamous cell carcinoma / 天津医药

Objective To investigate the expression of hsa-miR-144 in esophageal squamous cell carcinoma, and its relationship with clinicopathological features and prognosis. Methods Reverse transcriptase polymerase chain reaction (RT-PCR) method was used to detect the hsa-miR-144 in 46 cases of esophageal squamous cell carcinoma and adjacent normal tissue. The expression of hsa-miR-144 in esophageal squamous cell carcinoma and its difference in the clinicopatho?logical characteristics including gender, age, and tumor size were investigated. The relationship between the expression of hsa-miR-144 and prognosis of patients with esophageal squamous cell carcinoma was analyzed. Kaplan-Meier method and Log-rank test were used to analyse the differences in survival rates in different pathological characteristics. Results The ex?pression level of hsa-miR-144 was lower in esophageal squamous cell carcinoma 0.97(0.22-24.48)×10-6 than that of adjacent normal tissue 8.60(0.09-258.20)×10-6, the difference was statistically significant (Z=2.221, P0.05). There was no correlation between the expression of hsa-miR-144 and prognosis in patients with esophageal squamous cell carcino?ma (rs=0.031, P=0.839). In the survival rate, there was no statistic significance between high expressive of hsa-miR-144 group and low expressive group (P=0.828). The survival rate was lower in patients with lymph node metastasis than that of pa?tients without lymph node metastasis. The survival rates were lower in patients with relatively deep invasion and higher patho?logic stage (P<0.05). Conclusion The expression of hsa-miR-144 is down regulated in esophageal squamous cell carcino?ma, and which is associated with lymph node metastasis and pathological staging of esophageal carcinoma. It shows that hsa-miR-144 may serve as an anti-oncogene in the occurrence and development of esophageal squamous cell carcinoma.

Analysis of prognostic factors in patients with recurrent and metastatic esophageal carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The aim of this study was to explore the influencing factors of prognosis for recurrent and metastatic esophageal carcinoma, and to provide reference for clinical treatment for these patients.</p><p><b>METHODS</b>The clinicopathological and follow-up data of 247 patients with recurrent and metastatic esophageal squamous cell carcinoma after radical resection were retrospectively reviewed, combined with analysis of prognostic factors in these patients. Kaplan-Meier method was used to analyze the survival, difference between groups was compared by Log rank test, and Cox model was used for multivariate analysis.</p><p><b>RESULTS</b>Among the 247 recurrent and metastatic patients, locoregional recurrence was in 139 patients (56.3%), distant metastasis in 60 patients (24.3%), and combined recurrence in 48 patients (19.4%). The survival time was 1 to 42 months in the 247 patients, and the median survival time was 10 months. The 1-, 3- and 5-year survival rate after recurrence and metastasis was 26.4%, 6.3% and 2.4%, respectively. Univariate analysis indicated that regional lymph node metastasis of the primary tumor, distant lymph node metastasis, clinical staging, interval between operation and recurrence, recurrent and metastatic patterns, and treatment methods after recurrence and metastasis were influencing factors of prognosis (all P<0.05). Cox multivariate analysis indicated that clinical staging of the primary tumor, interval between operation and recurrence, recurrent and metastatic patterns, and treatment methods after recurrence and metastasis were independent factors influencing prognosis (all P<0.05).</p><p><b>CONCLUSIONS</b>The prognosis of patients with recurrent and metastatic esophageal carcinoma is poor, and it is affected by many factors. Comprehensive treatment is effective in prolonging the survival time of the patients.</p>