Construction and validation of a prediction model for public acceptance of kidney xenotransplantation in China / 器官移植

Objective To explore the public attitude towards kidney xenotransplantation in China by constructing and validating the prediction model based on xenotransplantation questionnaire. Methods A convenient sampling survey was conducted among the public in China with the platform of Wenjuanxing to analyze public acceptance of kidney xenotransplantation and influencing factors. Using random distribution method, all included questionnaires (n=2 280) were divided into the training and validation sets according to a ratio of 7:3. A prediction model was constructed and validated. Results A total of 2 280 questionnaires were included. The public acceptance rate of xenotransplantation was 71.3%. Multivariate analysis showed that gender, marital status, resident area, medical insurance coverage, religious belief, vegetarianism, awareness of kidney xenotransplantation and whether on the waiting list for kidney transplantation were the independent influencing factors for public acceptance of kidney xenotransplantation (all P<0.05). The area under the curve (AUC) of receiver operating characteristic (ROC) of the prediction model in the training set was 0.773, and 0.785 in the validation set. The calibration curves in the training and validation sets indicated that the prediction models yielded good prediction value. Decision curve analysis (DCA) suggested that the prediction efficiency of the model was high. Conclusions In China, public acceptance of kidney xenotransplantation is relatively high, whereas it remains to be significantly enhanced. The prediction model based on questionnaire survey has favorable prediction efficiency, which provides reference for subsequent research.

Research report of living donor kidney harvesting in Bama miniature pigs with six gene modified / 器官移植

Objective To summarize the experience and practical value of living donor kidney harvesting in Bama miniature pigs with six gene modified. Methods The left kidney of Bama miniature pigs with six gene modified was obtained by living donor kidney harvesting technique. First, the ureter was occluded, and then the inferior vena cava and abdominal aorta were freed. During the harvesting process, the ureter, renal vein and renal artery were exposed and freed in sequence. The vascular forceps were used at the abdominal aorta and inferior vena cava, and the renal artery and vein were immediately perfused with 4℃ renal preservation solution, and stored in ice normal saline for subsequent transplantation. Simultaneously, the donor abdominal aorta and inferior vena cava gap were sutured. The operation time, blood loss, warm and cold ischemia time, postoperative complications and the survival of donors and recipients were recorded. Results The left kidney of the genetically modified pig was successfully harvested. Intraoperative bleeding was 5 mL, warm ischemia time was 45 s, and cold ischemia time was 2.5 h. Neither donor nor recipient pig received blood transfusion, and urinary function of the kidney transplanted into the recipient was recovered. The donor survived for more than 8 months after the left kidney was resected. Conclusions Living donor kidney harvesting is safe and reliable in genetically modified pigs. Branch blood vessels could be processed during kidney harvesting, which shortens the process of kidney repair and the time of cold ischemia. Living donor kidney harvesting contributes to subsequent survival of donors and other scientific researches.

Application of xenotransplantation in clinical practice / 器官移植

Organ transplantation is the optimal treatment for end-stage organ failure. Nevertheless, organ shortage is a global problem, which limits further development of organ transplantation. Recent research shows that genetically modified pig may become a realistic alternative source of clinical organ transplantation donor. Xenotransplantation may serve as one of the effective measures to resolve the problem of organ shortage. Since 2021, 2 cases of living xenotransplantation and 6 cases of xenotransplantation in brain death recipients have been performed worldwide, and phase Ⅰ clinical trial of xenotransplantation has been launched, and the results have exceeded expectations. Therefore, in this article, recent clinical trial results of xenotransplantation in living and brain death recipients were retrospectively analyzed, and scientific, technical and ethical issues related to clinical research of xenotransplantation were illustrated, hoping to provide reference for clinical research of xenotransplantation in China and promote the development of xenotransplantation in clinical practice.

Familial bilateral pheochromocytoma: a case report / 中华泌尿外科杂志

Familial pheochromocytoma belongs to autosomal dominant inheritance, and has complex and variable clinical manifestations. A child with bilateral PHEO was admitted to our hospital. His grandmother, father and brother were all diagnosed with PHEO, and his aunt was diagnosed with paraganglioma. The child underwent laparoscopic left partial adrenalectomy and open surgery for the contralateral tumor, and was in good postoperative condition. The blood pressure returned to normal and there was no local recurrence and metastasis during the follow-up of 8 months after the second operation.

Effects of preoperative ureteroscopy on intravesical recurrence after radical nephroureterectomy of upper tract urothelial carcinoma / 现代泌尿外科杂志

【Objective】 To investigate the effects of preoperative ureteroscopy (URS) on the intravesical recurrence (IVR) in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). 【Methods】 The clinical data of 241 UTUC patients treated during May 2012 and Jan.2020 in the Second Hospital of Laozhou University were retrospectively analyzed. The patients were divided into URS before RNU group (URS group) and non-URS before RNU group (non-URS group). The cumulative IVR rate, progression-free survival (PFS) and overall survival (OS) after RNU were compared, and the survival curve was drawn. Cox proportional hazards models were used to assess risk factors affecting IVR. 【Results】 Of the 241 patients, 64 (26.6%) were included in the URS group and 177 (73.4%) in the non-URS group. In the URS group, 49 underwent biopsy and 15 did not. All patients were followed up for a median of 44 (3 to 122) months, with a median time to recurrence of 12 (3 to 56) months. IVR occurred in 18 patients (28.1%) in the URS group and 25 (14.1%) in the non-URS group. Kaplan-Meier survival analysis showed that the cumulative IVR rate was higher in the URS group than in the non-URS group (all P<0.05), regardless of whether patients had a history of bladder cancer (BC) or not, while PFS was lower in the URS group than in the non-URS group (P=0.007). Cox multivariate regression analysis showed that URS (P=0.031) and complicated renal pelvis tumor and ureteral tumor (P=0.004) were independent risk factors for IVR. 【Conclusion】 Preoperative URS increases the incidence of IVR in patients with UTUC, and routine preoperative use of URS is not recommended.

Preliminary report of perioperative monitoring of six-gene-edited pig-to-cynomolgus monkey kidney xenotransplantation / 器官移植

Objective To investigate the establishment of a six-gene-edited pig-to-non-human primate kidney xenotransplantation model. Methods The kidney of humanized genetically-edited pig (GTKO/β4GalNT2KO/CMAHKO/hCD55/hCD46/hTBM) was transplanted into a cynomolgus monkey. The survival of the recipient and kidney condition after blood perfusion were observed. The parenchymal echo, blood flow changes, and size of the kidney were monitored on a regular basis. Routine blood test, kidney function test and electrolyte assessment were carried out. Dynamic changes of urine, feces and body mass were monitored. At the end of life, the transplant kidney, heart, liver, spleen, lung, and cecum were collected for pathological examination. Results The recipient died at postoperative 7 d. After blood flow was restored, the kidney was properly perfused, the organ was soft and the color was normal. At the end of the recipient's life, a slight amount of purulent secretion was attached to the ventral side of the kidney, with evident congestion and swelling, showing the appearance of "red kidney". Postoperatively, the echo of renal parenchyma was increased, blood flow was decreased, the cortex was gradually thickened, and a slight amount of effusion surrounded the kidney and abdominal cavity over time. In the recipient, the amount of peripheral red blood cells, hemoglobin, albumin, and platelets was progressively decreased, and serum creatinine level was increased to 308 μmol/L at postoperative 7 d, whereas the K+ concentration did not significantly change. Light yellow urine was discharged immediately after surgery, diet and drinking water were resumed within postoperative 3 h, and light yellow and normal-shape stool was discharged. The reddish urine was gradually restored to normal color within postoperative 1 d, which were consistent with the results of the routine urine test. A large amount of brown bloody stool was discharged twice in the morning of 2 d after surgery. Omeprazole was given for acid suppression, and the stool returned to normal at postoperative 4 d. The β2-microglobulin level was increased to 0.75 mg/L at postoperative 7 d. The body mass was increased by 1.7 kg. Autopsy pathological examination showed interstitial edema and bleeding of the transplant kidney, a large amount of infiltration of lymphocytes and macrophages, infiltration of lymphocytes in the arteriole wall and arterial cavity, accompanied by arteritis changes, lymphocyte infiltration in the cecal stroma and congestion in the spleen tissues. No significant abnormal changes were observed in other organs. Conclusions The humanized genetically-edited pig-to-non-human primate kidney xenotransplantation model is successfully established, and postoperative survival of the recipient is 1 week.

Research progress on the role of costimulatory signaling pathway in xenotransplantation / 器官移植

Organ shortage is a critical factor limiting the development of organ transplantation. Xenotransplantation is expected to resolve the problem of organ shortage, which has become a new research hotspot. Study of costimulatory signaling pathway related to T cell regulation is a hot topic in terms of immunity of xenotransplantation. Since the discovery of costimulatory molecule CD28, multiple costimulatory molecules have been identified, including costimulatory and coinhibitory receptors and their related ligands. Specific T cell activation of donors is the key factor leading to acute immune rejection. The expression and induction of costimulatory molecules on T cells differ during different immune stages, and these costimulatory molecules play a key role in maintaining T cell tolerance and the balance of T cell immune response. At present, increasing attention has been diverted to the role of costimulatory signaling pathway in organ transplantation. In this article, the latest research progress in costimulatory signaling pathway related to xenotransplantation immunity was reviewed, aiming to provide reference for the optimization of xenotransplantation immunosuppression regimen.

Postoperative recurrence of pelvic solitary fibroma with bladder metastasis: a case report / 中华泌尿外科杂志

Solitary fibroma often occurs in the pleura, but rarely outside the pleura. Extrapleural solitary fibroma has atypical clinical symptoms and difficult imaging diagnosis. Here, we report a case of solitary fibroma recurred and metastasized to the bladder after pelvic surgery. He was treated with palliative resection in our hospital. The patient died of systemic metastasis 3 years after operation.

Knockout of MIF gene attenuates severe acute pancreatitis-associated lung injury in mice / 中华急诊医学杂志

Objective:To investigate the role of macrophage migration inhibitory factor (MIF) in severe acute pancreatitis (SAP) associated lung injury in mice.Methods:Totally 32 mice were randomly divided into 4 groups ( n=8/per group): wild type control group (WT+CON group), wild type SAP group (WT+SAP group), MIF gene knockout control group (KO+CON group), and MIF gene knockout SAP group (KO+SAP group). SAP model was established by intraperitoneal injection of L-arginine (4 mg/g). The expression of serum amylase, IL-6, TNF-α and MIF were detected by ELISA. The pathological changes of pancreatic and lung tissues were observed by HE staining. The expression of IL-6 and TNF-α in lung tissue was detected by immunohistochemistry. The expression of NF-κB in lung tissue was detected by Western blot. For measurement data, t test was used for comparison between two groups, and one-way analysis of variance was used for comparison between multiple groups. Results:Compared with the WT+CON group, pathological score of pancreatic and lung injury, serum amylase, TNF-α and IL-6 expression in serum and lung tissues were significantly increased in the WT+SAP group ( P<0.05), while the above indexes were significantly decreased in the KO+SAP group ( P<0.05). In addition, the expression of NF-κB protein in KO+SAP group was significantly lower than that in the WT+SAP group ( P<0.05). Conclusions:MIF gene knockout can alleviate severe acute pancreatitis associated acute lung injury in mice, and its mechanism may be related to NF-κB.

Characteristics of exosomes secreted by -infected mouse dendritic DC2.4 cells / 南方医科大学学报

OBJECTIVE@#To investigate the changes in the exosomes secreted by mouse dendritic cell line DC2.4 after infection with and to analyze the possible regulatory mechanisms underlying such changes.@*METHODS@#The exosomes were extracted by ultracentrifugation from DC2.4 cells at 28 h after infection with . The morphology of the exosomes was examined with transmission electron microscopy, and the exosome size and density were determined using a nanoparticle tracker. High-throughput sequencing was carried out to identify the differentially expressed small RNAs in the exosomes derived from the infected cells.@*RESULTS@# infection resulted in a significantly increased density of exosomes secreted by DC2.4 cells. Small RNA sequencing revealed that infection caused an increase in the number of miRNAs and piRNAs in the exosomes. The significantly up-regulated piRNAs after the infection included piR-mmu-159, piR-mmu-1526, piR-mmu-9082, piR-mmu-17405, and piR-mmu-25576.@*CONCLUSIONS@# infection causes accumulation and enrichment of exosomes secreted by DC2.4 cells with increased miRNAs and piRNAs in the exosomes.

Four-dimensional hysterosalpingo-contrast sonography with fluorocarbon in evaluation on fallopian tube patency in infertile women / 中国医学影像技术

Objective To explore the application value of four-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) with fluorocarbon in evaluation on fallopian tube patency in infertile women. Methods 4D-HyCoSy and X-ray hysterosalpingography (X-HSG) were performed in 138 infertile women. Taken the results of laparoscopy as gold standards, the diagnostic specificity and sensitivity of oviducts unobstructed, partially unobstructed and obstructed were compared between 4D-HyCoSy and X-HSG. Results The diagnostic specificity and sensitivity of oviducts unobstructed with 4D-HyCoSy was 96.32% (157/163) and 95.33% (102/107), of partially unobstructed was 97.75% (174/178) and 93.48% (86/92), while of obstructed was 96.98% (193/199) and 92.96% (66/71). The diagnostic specificity and sensitivity of oviducts unobstructed with X-HSG was 92.02% (150/163) and 92.52% (99/107), of partially unobstructed was 95.51% (170/178) and 86.96% (80/92), while of obstructed was 96.98%(193/199) and 90.14% (64/71). There was no significant difference of diagnostic specificity nor sensitivity of oviducts unobstructed, partially unobstructed and obstructed between 4D-HyCoSy and X-HSG (all P>0.05), and the consistency of 4D-HyCoSy and X-ray in diagnosis of fallopian tube patency was good (Kappa=0.887). Conclusion 4D-HyCoSy with fluorocarbon can be used to evaluate the fallopian tube patency, therefore being helpful to diagnosis and treatment of infertility.

Primary pulmonary peripheral T-cell lymphoma, not otherwise specified：two cases report and literature review / 白血病·淋巴瘤

Objective To study the clinical characteristics, diagnosis, treatment and prognosis of primary pulmonary peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS). Methods Two cases of primary pulmonary PTCL-NOS were studied and relevant literature were reviewed. Results Case 1 diagnosed as primary pulmonary PTCL-NOS was a 44 years old woman and disease progressed after GLD (Gem+L-OHP+DXM) chemotherapy regimen. At last, the patient died of respiratory failure after one month. Case 2 diagnosed as primary pulmonary PTCL-NOS was a 46 years old man and reach partial response after CHOP regimen, and still alive now.Conclusion Primary pulmonary PTCL-NOS is very rare. It is easy to be misdiagnosed due to non-specific clinical and imaging manifestations. Acquiring enough tissue specimens for pathologic examination is the key to a definitive diagnosis. At present, there is no standard chemotherapy regimen for these patients, the prognosis is relatively poor.

Oxaliplatin combined with tegafur as adjuvant chemotherapy for esophageal squamous cell carcinoma / 肿瘤研究与临床

Objective To investigate the survival benefit of patients with esophageal squamous cell carcinomas who recieved postoperative chemotherapy of tegafur combined with FT-207 radiotherapy.Methods Data from 126 patients with esophageal squamous were analyzed who undergone radical resection from January 2008 to December 2010,consisting of 92 patients underwent surgery alone and 34 patients took oxaliplatin combined with tegafur postoperatively (oxaliplatin 130 g/m2,d1,tegafur 500 mg/m2,d1-5,21 d for a cycle,every patient received at least two cycles).Results The 1-year survival rate and 3-year survival rate was 93.5 ％ and 75.0 ％ in the surgery alone group,was 97.1％ and 76.2 ％ in the surgery plus postoperative chemotherapy (P =0.590).There was no significant differences in survival in the two groups,even with Coxregression multivariate analysis and with stratifications of gender,age,tumor location,degree of cell differentiation,invasion depth,lymphatic metastasis and TNM stage.Conclusion Postoperative adjuvant chemotherapy with oxaliplatin combined with tegafur has not significantly improve the survival rate of patients with esophageal squamous cell carcinomas undergoing radical resection.It is still lack of an effective project for postoperative adjuvant chemotherapy for esophageal cancer,and it is necessary for further study.

Efficacy and safety of fixed dose rate gemcitabine infusion in combination with docetaxel in patients with relapsed/refractory soft tissue sarcoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of fixed dose rate (FDR) gemcitabine infusion in combination with docetaxel in patients with relapsed/refractory soft tissue sarcoma.</p><p><b>METHODS</b>Clinicopathological data of 28 patients with relapsed/refractory soft tissue sarcoma treated in our hospital from April 2008 to August 2013 were reviewed in this study. The patients received 900 mg/m² gemcitabine with a FDR infusion (10 mg/m²/min) in a total dose of 900 mg/m² on days 1 and 8, and 75 mg/m² docetaxel intravenously over 60 min on day 8 of a 21-day cycle. When irradiation was conducted before drug therapy, the dose of gemcitabine was reduced to 675 mg/m² on days 1 and 8. The clinicopathological characteristics, short-term response, long-term survival status and toxicity were analyzed retrospectively.</p><p><b>RESULTS</b>The 28 patients received a total of 118 cycles of therapy (range 1-8 cycles, median 4 cycles per patient). No patient achieved complete response (CR), 4 partial responses (PR) and 11 stable diseases (SD), with an overall response rate (ORR) of 14.3% and clinical benefit rate (CBR) of 53.6%. The median progression-free survival (PFS) was 3.2 months and the median overall survival (OS) was 8.5 months. PFS and OS were correlated with the response to this treatment regimen (P < 0.0001). Patients with clinical benefit had significantly better PFS and OS than the patients with progressive disease (P < 0.05 for all). The ORR, CBR, PFS and OS were better in patients with leiomyosarcoma than in patients with other histological subtypes in this study, but the differences were not significant (P > 0.05 for all). Grade 3-4 neutropenia, anemia and thrombocytopenia were 50.0%, 17.9% and 14.3%, respectively. Only one patient (3.6%) had febrile neutropenia. Grade 3 non-hematologic toxicities were nausea/vomiting (3.6%) and mucositis (3.6%). No grade 4 non-hematologic toxicities were observed. Almost all non-hematologic toxicities were grade 1-2 and manageable.</p><p><b>CONCLUSIONS</b>The fixed dose rate (FDR) gemcitabine infusion in combination with docetaxel is an effective treatment regimen for patients with relapsed/refractory soft tissue sarcoma, and with tolerable adverse reactions.</p>

Advances of mechanism of habenula in reward and its role in mental illness / 中国药理学与毒理学杂志

The habenula complex,an ancient and conservative nucleus during biological evolution, is involved in many i mportant biological functions,such as maternal behavior,pain,sleep,learning and reward.As an important node in the dopamine reward network,its functions(including the maintenance of individual survival while avoiding disadvantages)and mechanis m in the reward process have attracted wide attention.The dysfunction of habenula is closely related to many psychotic disorders,such as de-pression,schizophrenia and drug habituation.Habenula may also become a potential target for clinical treatment of these mental illnesses.So clarifying the role and neurobiological mechanisms of habenula in the central nervous system is of great theoretical and clinical value.

Research progress of SPARC in esophageal cancer / 国际肿瘤学杂志

Secreted protein acidic and rich in cysteine (SPARC) is expressed in esophageal cancer abnormally.On the one hand,recent studies show that high SPARC expression is correlated with progression and metastasis of esophageal cancer.On the other hand,high SPARC expression increases chemosensitivity and improves short-term efficacy in patients.

Highlights of the development in personalized treatment of patients with diffuse large B-cell lymphoma:reports in the 54 ASH annual meeting / 白血病·淋巴瘤

The outcome of diffuse.Large B-cell lymphoma (DLBCL) has been improved in the last decades and will be raised further with the development of novel agents in the future.Personalized treatment for DLBCL is based on its molecular heterogeneity.Except for concurrent translocation of myc and bcl-2,neither clinical nor biological factor is sufficiently available to be used to guide the deviation of R-CHOP therapy in DLBCL.Gene expression profiling and whole genomic analytic techniques are expected to be important approaches at present to determine personalized treatment for DLBCL.The advance in the field being reported by Laurie H.Sehn from University of British Columbia in the 54 ASH meeting was summarized in the paper.

Prognostic significance of p53 mutation protein in patients with diffuse large B-cell lymphoma / 白血病·淋巴瘤

Objective To explore the prognostic significance of p53 mutation protein in patients with diffuse large B-cell lymphoma for the purpose of individualized therapy. Methods Newly diagnosed 62 cases were randomly chosen from our hospital, p53 mutation protein and CD10, bcl-6, MUM1 were tested by immunohistochemistry. Correlation of p53 mutation protein with patients ' characteristics, genotype and survival were analysed in the study. Results p53 mutation protein was found in 48.4 % (30/62) of patients.Its expression was only related to initial treatment response (x2 =20.365, P =0.040), including complete remission rate of 33.3 % (10/30) in positive group and 59.4 % (19/32) in negative group, and non-germinal center genotype (x2=31.023, P =0.021) with 83.3 % in positive group and 56.2 % in negative group. No other correlation was not verified with clinical features. Multivariate survival analysis showed that p53 mutation protein was an independent predictor for shorter progress-free and overall survival in positive group (x2 =30.784, P =0.005 and x2 =35.276, P =0.006). Conclusion p53 mutation protein should be an independent predictor with poor prognosis and to direct personalized therapy.

Long-term effect on radiofrequency heat-coagulation endometrial ablation in the treatment of anovulatory dysfunctional uterine bleeding / 中华妇产科杂志

ObjectiveTo investigate long-term effect on radiofrequency heat-coagulation (RF)endometrial ablation in treatment of anovulatory dysfunctional uterine bleeding (DUB). MethodsFrom Jul.2001 to Nov. 2009, 1 196 patients with DUB who were failed by medical treatment( including 127 patients with dysmenorrheal) were enrolled into this study in Jinan Millitary General HospitaL Those patients were divided into two groups according to age:427 patients at age of or more than 45 years (average age 48 years) in Group A who were treated by RF procedure for amenorrhea;769 patients at age of less than 45 years old (average 37 years) in group B were treated by RF for controlling excessive menstrual bleeding. All the patients had the results of menstrual score (pictorial blood loss assessment chart, PBAC), hemoglobin (Hb) ,endometrial curettage pathology and hysteroscopy examination immediately after RF procedure; Some patients still had another endometrial curettage pathology and clinical results in 6 months after RF. The mean follow-up time was 72 months ( range:6 to 100 months). The evaluation criterion for RF treatment was to use optimal and significant effect measurements. For group A, the optimal treatment effect (cure) was defined as bleeding cessation and achieving amenorrhea that continued for more than 12 months after treatment. For group B, the optimal treatment effect (cure) was also defined as bleeding cessation and resuming normal menstruation which continued for more than 12 months after treatment. Significant treatment effect was defined as irregular, minor bleeding, but PBAC score less than 100 within 12 months. If patient symptoms and PBAC scores did not change compared with those before treatment, the treatment was defined as failure. For dysmenorrhea, the optimal treatment effect was disappearance for more than 12 months, the significant treatment effect was remission, and treatment failure was not changed from the pre-treatment baseline. The effective rate was the sum of that of the optimal and significant effect. One hundred and twentyfive patients with DUB treated by agents at the same time were chosen as control group. Results( 1 ) The recent and long-term effective rates for bleeding cessation by RF: the total recent effective rates within 1 months were 94. 82％ ( 1134/1196), including 96. 5％ (412/427) in group A and 93.9％ (722/769) in group B. The total curative rates for dysmenorrheal were 82. 7％ ( 105/127 ), including 86. 4％ ( 38/44 ) in group A and 80. 7％ ( 67/83 ) in group B. Pathology examination after hysteroscopy immediately after RF showed a completely and whole destroyed endometrium in group A, and a little rested endometrium in group B. The long-term effect rates for bleeding cessation by RF after 12, 24 and 36 months were 92. 55％ (969/1047), 93.9％ (866/922) and 93.7％ (609/650), respectively. PBAC and Hb in group A and group B within 12, 24, 36 and more than 36 months were improved significantly ( P ＜ 0. 05 ). (2) Complications : the major complication was irregular minor bleeding in 1 to 2 months after treatment, the rate was 8.03％ (96/ 1196). The second one was menorrhea in 3 months after RF, the rate was 5. 18％ (62/1 196 ). This condition was corrected by the second RF. No hysterectomy was performed on those patients. Conclusion RF is the safe, efficient and minimal invasive procedure in treatment for DUB. The mechanism of keeping longterm curative effect and preventing recurrence is due to endonetrium inactivation and fibrosis by thermocoagulation.

Survival predictive factors in completely resected high-risk Ⅱ/Ⅲ stage colorectal cancer after adjuvant chemotherapy / 肿瘤研究与临床

Objective To analyze predictive factors on survival in patients with completely resected high-risk Ⅱ/Ⅲ stage colorectal cancer after adjuvant chemotherapy.Methods According to random number table, 76 cases with completely resected high-risk Ⅱ/Ⅲ stage colorectal cancer after adjuvant chemotherapy were selected, who newly diagnosed and hospitalized in 2004. Their disease-free and overall survivals were followed up.Thymidylate synthase gene polymorphism and microsatellite instability were tested in these cases with microdissection combined with polymerase chain reaction and capillary electrophoresis. Correlation of these factors including clinical characteristics, thymidylate synthase gene polymorphism and microsatellite instability to survival was analyzed with SPSS13.0 software. Results Histologic grades and evaluated lymph node number had significantly difference between two groups of distinct prognosis (χ2 = 7.827, P =0.003 and χ2 = 9.265, P =0.018, respectively), which were also independent predictors on survival proved by COX regression analysis (χ2 = 40.472, P =0.000 and χ2 = 39.528, P =0.000, respectively).Kaplan-Meier survival analysis showed that the median disease-free and overall survival of poor-differentiated adenocarcinoma patients were significantly shorter than those of high and intermediate-differentiated ones (27.67 vs 61.13months, χ2 = 45.015, P =0.000 and 43.13 vs 64.21 months, χ2 = 35.514, P =0.000, respectively), as well, the median disease-free and overall survival of patients with the evaluated lymph node number less than 11 were poorer than those of more than 11 ( 45.65 vs 68.47 months, χ2 = 23.134, P =0.011 and 53.10 vs 70.18months, χ2 = 22.896, P =0.013, respectively).Conclusion Poor-differentiated adenocarcinoma and evaluated lymph node number less than 11 may be predictors on poor survival in patients with completely resected highrisk Ⅱ/Ⅲ stage colorectal cancer after adjuvant chemotherapy.