Resultados perioperatorios de la implementación de la resección completa del mesocolon por vía laparoscópica en cáncer de colon derecho y transverso

Introducción: La técnica de resección completa del mesocolon (RCM) en la hemicolectomía derecha consiste en la disección por planos embriológicos para lograr la resección completa del envoltorio mesocolónico, además de una ligadura vascular central (LVC) con linfadenectomía D3, que no se realiza normalmente con la técnica estándar. Esta técnica se asocia a mejores resultados de sobrevida global y libre de enfermedad que la cirugía convencional en trabajos retrospectivos. Sin embargo, no existen datos de su implementación a nivel nacional. El objetivo de este estudio es evaluar los resultados perioperatorios de la implementación del RCM en un centro universitario en nuestro medio. Materiales y Método: Estudio retrospectivo de cohorte de pacientes consecutivos sometidos a hemicolectomía derecha laparoscópica con técnica de RCM-LVC entre Enero 2022 y Junio 2023. Se recopilaron variables demográficas, perioperatorias, postoperatorias e histopatológicas. Los resultados se analizaron utilizando estadística descriptiva. Resultados: En el periodo, 29 pacientes se sometieron a RCM laparoscópica (mediana de edad 66(57-76) y 15(52%) sexo femenino). La mediana del tiempo quirúrgico fue 202,9 minutos. No hubo casos de conversión, filtración anastomótica, ni mortalidad. Hubo morbilidad en 9 casos (31%) y de estos solo 1(3,4%) fue Clavien-Dindo III (hematoma Pfannenstiel reintervenido). No hubo lesiones vasculares intraoperatorias. Mediana de hospitalización de 3 días. Doce casos (41%) eran etapa II y 8(28%) etapa III. La mediana de linfonodos resecados fue 23(18-28). Conclusión: Esta serie demuestra que la implementación de la RCM-LVC por vía laparoscópica para el tratamiento del cáncer de colon derecho y transverso es factible en centros con experiencia en cirugía colorrectal laparoscópica avanzada.

Introduction: Complete mesocolic excision (CME) consists in the dissection on embryologic planes in order to achieve a complete resection of the mesocolic envelope and performing a central vascular ligation (CVL) with a D3 lymphadenectomy which is not routinely done for standard right colectomies. CME has been associated with better overall survival and disease-free survival in comparison with conventional surgery in retrospective studies. However, there is no data on its implementation in Chile. The aim of this study is to assess the perioperative results of the implementation of CME in our center. Methods: A retrospective cohort study was conducted. Consecutive patients undergoing a laparoscopic right hemicolectomy with CME-CVL between January 2022 and June 2023 were included. Demographic, perioperative, postoperative and histopathological data were collected. Results were analyzed using descriptive statistics. Results: During the study period, 34 patients underwent CME; 29 of them underwent laparoscopic CMECVL (median age 66 (57-76) and 15 (52%) female). The median operating time was 202,9 minutes. There were no cases of conversion, anastomotic leakage or mortality. There was morbidity in 9 cases (31%) and one of these (3,4%) was a Clavien-Dindo III morbidity (reoperation due to a Pfannenstiel haematoma). There were no intraoperative vascular injuries. The median length of stay was 3 days. Twelve cases (41%) were stage II and 8(28%) stage III. The median number of lymph nodes harvested was 23(18-28). Conclusion: This series demonstrate that the implementation of laparoscopic CME-CVL for right and transverse colon cancer is feasible in centers with experience in advanced laparoscopic colorectal cancer.

Manejo y resultados de pacientes con diverticulitis aguda: experiencia de cinco años en el Hospital San Vicente Fundación / Management and results of patients with acute diverticulitis. Five year-experience at the San Vicente Fundación Hospital

Introducción. Los datos epidemiológicos de la diverticulitis en Colombia son limitados. El objetivo de este artículo fue caracterizar una población que ingresó con diverticulitis aguda al Hospital Universitario San Vicente Fundación, un centro de referencia de la ciudad de Medellín, Colombia, para analizar la presentación y comportamiento de la enfermedad en la población local, con estadísticas propias y desenlaces de la enfermedad en los últimos años. Métodos. Estudio observacional retrospectivo, descriptivo, entre enero de 2015 y diciembre de 2019. Se hizo un estudio exploratorio uni-, bi- y multivariado de factores de riesgo para fallo en el tratamiento y la mortalidad. Resultados. Se incluyeron 103 pacientes. Se presentó principalmente en mujeres y la edad promedio fue de 65 años. La diverticulitis Hinchey Ia fue la más frecuente (41,7 %) y el manejo médico fue exitoso en todos los casos, mientras que en las tipo III y IV, todos se manejaron de forma quirúrgica, con tasas de éxito entre el 50 y el 64 %. La presencia de signos de irritación peritoneal al examen físico, el recuento de leucocitos y la PCR, el ingreso a la Unidad de Cuidados Intensivos y la mortalidad aumentaron de forma directamente proporcional con el estadio de Hinchey. Conclusiones. Existe una relación directamente proporcional entre la clasificación de Hinchey y los signos de respuesta inflamatoria clínicos y paraclínicos, la necesidad de manejo quirúrgico, la estancia en la Unidad de Cuidados Intensivos y la mortalidad.

Introduction. Epidemiological data on diverticulitis in Colombia are limited. The objective of this article was to characterize a population that was admitted with acute diverticulitis to the San Vicente Fundación University Hospital, a reference center in the city of Medellín, Colombia, to analyze the presentation and behavior of the disease in the local population, with its own statistics, and outcomes of the disease in recent years. Methods. Retrospective descriptive observational study between January 2015 and December 2019. An exploratory uni-, bi- and multivariate study of risk factors for treatment failure and mortality was performed. Results. A total of 103 patients were included. The most frequent Hinchey classification was Ia (41.7%). It occurs mainly in women, mean age 65 years. Hinchey Ia diverticulitis is the most frequent and medical management is successful in 100% of cases; while in III and IV, 100% were managed surgically with success rates between 50 and 64%. The presence of peritoneal signs on physical examination, leukocyte count and CRP, ICU admission and mortality increased directly proportional with Hinchey stage. Conclusions. There is a directly proportional relationship between Hinchey staging with clinical and paraclinical signs of inflammatory response, need for surgical management, ICU stay and mortality.

Schwannoma de colon derecho: a propósito de un caso / Schwannoma of the right colon: case report

RESUMEN El schwannoma de colon es una entidad sumamente rara que puede debutar como lesión subepitelial con signos ulcerativos de melena y anemia. El estudio de imágenes nos orienta a la localización mientras que la biopsia colonoscópica no es de ayuda. Muchas veces el diagnóstico y tratamiento se efectúa con la resección de la lesión en tanto que el diagnóstico final se realiza en el posoperatorio por histopatología y por la inmunohistoquímica, la cual muestra positividad intensa para S100 y vimentina en las células tumorales con un índice de proliferación KI67 menor al 1%, por lo que se concluye que se trata de una lesión benigna. Presentamos el siguiente caso por su dificultad diagnóstica pre e intraoperatoria, clínica inespecífica y diagnóstico definitivo por inmunohistoquímica.

ABSTRACT Colon schwannoma is an extremely rare entity that may debut as a subepithelial lesion with ulceration signs, such as melena and anemia. Imaging studies guide us to localization, while a colonoscopy biopsy is not helpful. Many times, the diagnosis and treatment are made with lesion resection, and the final diagnosis is postoperatively made with histopathology and immunohistochemistry, which shows intense positivity for S100 and vimentin in tumor cells with a KI67 proliferation index of less than 1%, therefore, it is concluded that this is a benign lesion. We present this case due to its pre- and intraoperative diagnostic difficulty, non-specific symptoms, and its definitive diagnosis that was achieved with immunohistochemistry.

Inhibitory effect of royal jelly acid on proliferation of human colon cancer SW620 cells and its network pharmacological analysis / 吉林大学学报(医学版)

Objective:To discuss the effect of royal jelly acid(10-HDA)on the proliferation and migration of the human colon cancer SW620 cells based on the network pharmacology,and to clarify its related molecular mechanism.Methods:The active ingredients such as 10-HDA and their corresponding targets were retrieved by using the keyword"royal jelly"from the Traditiomal Chinese Medicine Systems Pharmacology(TMSCP)Database and the Traditiomal Chinese Medicine Integrated Database(TCMID);the small molecule targets were predicted by the Swiss Target Prediction Database.The GeneCards Database and the Online Mendelian Inheritance in Man(OMIM)Database were used to obtain the targets with the keyword"Colon Cancer";the protein-protein interaction(PPI)network was constructed by using the String Database and Cytoscape 3.8.0 Software to screen the core targets;the Gene Ontology(GO)function enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling pathway enrichment analysis were analyzed by Metascape Database;the specific ingredient 10-HDA was screened for the in vitro activity experiments.The human colon cancer SW620 cells with good growth status were divided into control group and different doses(1,5,10,15,and 20 mmol·L-1)of 10-HDA groups.The viabilities of the cells in various groups were detected by MTT method and the survival rates of the cells were calculated.The SW620 cells were divided into control group,low dose(5 mmol·L-1)of 10-HDA group,middle dose(10 mmol·L-1)of 10-HDA group,and high dose(15 mmol·L-1)of 10-HDA group;Hoechst33342 staining method was used to observe the morphology of the cells in various groups;cell scratch test was used to detect the scratch healing rates of the cells in various groups;flow cytometry was used to detect the percentages of the cells at different cell cycles in various groups;biochemical method was used to detect the activities of total antioxidant capacity(T-AOC)and superoxide dismutase(SOD)in the cells in various groups;Western blotting method was used to detect the expression levels of B-cell lymphoma 2(Bcl-2),Bcl-2-associated X protein(Bax),cysteine-containing aspartate proteolytic enzyme-3(Caspase-3),cysteine-containing aspartate proteolytic enzyme-9(Caspase-9),glycogen synthase kinase 3β(GSK3β),β-catenin,and cyclin D1 proteins in the cells in various groups.Results:Six active ingredients of royal jelly were screened out by the TCMSP Database,and 28 core targets of 10-HDA in the treatment of colon cancer were obtained.The GO function enrichment analysis mainly included the signaling pathways such as cell proliferation and apoptosis.The KEGG signaling pathway enrichment analysis included the cell cycle,prostate cancer,cell senescence,and p53 signaling pathways;the GSK3β/β-catenin signaling pathway was closely related to the cell cycle.Compared with control group,the viabilities of the cells in 5,10,15,and 20 mmol·L-110-HDA groups were decreased in a dose-dependent manner(P<0.05 or P<0.01),the numbers of apoptotic cells in different doses of 10-HDA groups were significantly increased,and the scratch healing rates of the cells were significantly decreased(P<0.05 or P<0.01);the percentages of the cells at S phase in middle and high doses of 10-HDA groups were significantly increased(P<0.05 or P<0.01),the activities of T-AOC and SOD in the cells in different doses of 10-HDA groups were significantly decreased(P<0.05 or P<0.01).Compared with control group,the expression level of Bcl-2 protein in the cells in low dose of 10-HDA group was significantly decreased(P<0.01),and the expression level of GSK3β protein was significantly increased(P<0.05);compared with control group,the expression levels of Bax,Caspase-3,Caspase-9,and GSK3β proteins in the cells in middle and high doses of 10-HDA groups were significantly increased(P<0.05 or P<0.01),and the expression levels of Bcl-2,β-catenin,and CyclinD1 proteins were significantly decreased(P<0.01).Conclusion:10-HDA can significantly inhibit the proliferation and migration of the colon cancer cells and promote the apoptosis and oxidation levels of the colon cancer cells,and its mechanism may be related to the activation of the GSK3β/β-catenin signaling pathway.

The effect of growth hormone on invasion and migration of colon cancer cells / 重庆医学

Objective To explore the effects of growth hormone(GH)on the proliferation,cycle,inva-sion,and migration of colon cancer cells and its possible mechanism.Methods GH3 cells with growth hor-mone-type pituitary adenoma were cultured in vitro,and the secretion of growth hormone in the supernatant of GH3 cells was detected by ELISA.Colon cancer LoVo cells in logarithmic growth phase were randomly divid-ed into the control group and the experimental group.PBS was added to the control group,while high concen-trations of recombinant GH were added to the experimental group.The two groups of cells were cultured in vitro under the same conditions.CCK-8 method was used to detect the proliferation of the cells.Flow cytome-try was used to detect the cell cycle.Transwell assay was used to detect the effect of growth hormone on the invasion and migration of the cells.Western blot was used to detect the expressions levels of E-cadherin,N-cadherin,Vimentin,and Snail-1 proteins in the cells.Results The results of ELISA showed that GH3 cells could secrete a large amount of GH,and the concentration of GH in the supernatant was(1 208±9)ng/mL.GH promoted cell growth in a dose-dependent manner within a certain concentration range,and GH 200 ng/mL was the optimal intervention concentration for subsequent experiments.Compared with the control group,the cell cycle in the experimental group changed from G1 phase to S phase and G2 phase,the ratio of G1 phase cells decreased,and the ratio of S phase cells and G2 phase cells increased(P<0.05).Compared with the control group,the number of the cell invasion and migration increased in the experimental group(P<0.05),the expression levels of N-cadherin,Vimentin,and Snail-1 was up-regulated,while the expression level of E-cadherin was down-regulated(P<0.05).Conclusion High concentration of GH promotes the prolifera-tion,invasion and migration of colon cancer cells,and induces the transition of cell cycle from G1 to S and G2 phases.The mechanism may be related to the epithelial-mesenchymal transition(EMT)of colon cancer cells promoted by high concentration of GH.

Clinical features of CpG island methylation in colon cancer and its prognostic significance in dMMR colon cancer / 国际外科学杂志

Objective:To investigate the clinical characteristics and prognosis of CpG island methylator phenotype (CIMP+ ) colon cancer, and the significance of CIMP status in the diagnosis and prognosis prediction in defective mismatch repair (dMMR) colon cancer.Methods:The keywords "colorectal cancer" "patient" and "CpG Island Methylator Phenotype" were used to search the Gene Expression Omnibus (GEO) database, and the GSE39582 was obtained, which included the clinical data of 585 patients with colorectal cancer and the sequencing data of the whole transcriptome of the tumor tissues. After excluding 72 cases with missing CIMP values, 513 cases were included for further analysis, including 278 males and 235 females, with a mean age of (67±13) years. According to the CIMP status, they were divided into CIMP+ group ( n=93) and CIMP-group ( n=420), then compare the differences in clinical characteristics, the Kaplan-Meier survival curves were plotted to compare the overall survival and disease-free survival; 71 dMMR cases were divided into CIMP+ group ( n=43) and CIMP-group ( n=28), and the K-M curves were plotted to analyze the differences in overall survival (OS) and disease free survival (DFS). Comparisons between groups were performed by t-test, χ2 test or Mann-Whitney U nonparametric test, and the difference in survival curves was tested by Long-rank test. Results:Patients in the CIMP+ group were significantly older than those in the CIMP-group [(70.84±12.60) years vs (66.21±13.08) years, t=3.18, P=0.002]. Right colon tumors originating from the CIMP+ molecular pathway were 9.3 times more likely to be CIMP+ than those of the left colon cancers ( OR=9.3, 95% CI: 5.2-17.9). BRAF mutant colon cancer originating from CIMP+ was 215.2 times more common than BRAF wild-type colon cancer originating with CIMP+ ( OR=215.2, 95% CI: 53.2-1906.7); and patients with dMMR colon cancer originated 12.8 times more common than patients with pMMR ( OR=12.8, 95% CI: 7.0-23.9). The difference between the CIMP+ and CIMP-groups was not statistically significant in terms of overall survival and disease-free survival ( P=0.590, 0.220). In the dMMR colon cancer subgroup, CIMP status did not correlate with patients′ overall survival and disease-free survival ( P>0.05). Conclusions:CIMP+ colon cancer patients were mostly of advanced age, with tumors originating from the right colon, mostly combined with BRAF gene mutations, and manifested as mismatch repair-deficient colon cancers. CIMP status had no correlation with TNM stage and survival of colon cancers patients. There was no significant difference in the survival between dMMR colon cancers caused by CIMP+ and those caused by MMR gene mutations.

Regulatory Effect and Mechanism of Yichang Sanjie Granules on Intestinal Flora and Immune Function in Mice with Colon Cancer / 广州中医药大学学报

Objective To observe the regulating effect and mechanism of Yichang Sanjie Granules on intestinal flora and immune function in mice with colon cancer.Methods Sixty mice were randomly divided into six groups,i.e.,the normal group,the model group,the low-,medium-and high-dose groups of Yichang Sanjie Granules,and the overexpression of melanoma absent gene 2(AIM2)plasmid(pcDNA-AIM2)intervention group,with 10 mice in each group.Colorectal cancer model was prepared by oxidized azomethine(AOM)/dextran sulfate sodium(DSS)induction method in all groups except normal group.After drug administration,the survival curves of mice in each group were plotted and the tumor volume was calculated;serum levels of immunoglobulin(Ig)G,IgM,interleukin(IL)-1β and IL-18 were detected by enzyme-linked immunosorbent assay(ELISA);peripheral blood levels of CD3+,CD4+,CD8+ T cells were detected by flow cytometry;the splenic index was determined;Hematoxylin-eosin(HE)staining was used to observe the pathological changes in colon tissues;16S-rDNA intestinal flora sequencing was used to detect the α-diversity of intestinal flora and the structure of intestinal flora communities;and protein immunoblotting(Wetsern Blot)was used to detect the protein expressions of AIM2,apoptosis-associated speckled-like protein containing a CARD(ASC),and cystatinase-1(caspase-1)in colon tissues.Results Compared with the normal group,the survival rate,serum levels of IgG and IgM,peripheral blood levels of CD3+ and CD4+ and CD4+/CD8+ ratio,protein expression levels of colon tissue AIM2,ASC and caspase-1 in the model group were significantly decreased,and the tumor volume,serum levels of IL-1β and IL-18,peripheral blood level of CD8+,and splenic index were significantly increased(all P＜0.05),and the HE staining results showed the characteristic manifestations of colon cancer;compared with the model group,the survival rate,serum levels of IgG and IgM,peripheral blood levels of CD3+ and CD4+ and CD4+/CD8+ ratio,protein expression levels of colon tissue AIM2,ASC and caspase-1 in the low-,medium-and high-dose groups of Yichang Sanjie Granules and the pcDNA-AIM2 group were significantly increased,and the tumor volume,serum levels of IL-1β and IL-18,level of peripheral blood CD8+,and splenic index were significantly decreased(all P＜0.05),and the HE staining results showed the manifestations of colon cancer were improved.Compared with the normal group,the Observed index,Chao1 index,Shannon index,the relative abundance of Bacteroidetes,Proteobacteria,Muribaculaceae,Lachnospiraceae-NK4A136group,and Ruminiclostridium in the model group were significantly decreased,while the relative abundance of Firmicutes,Actinobacteria,Patescibateria,Lactobacillus,Odoribacter,Alistipes,Ruminococcaceae-uncultured and Bacteroides was increased in the model group(P＜0.05);compared with the model group,the Observed index,Chao1 index,Shannon index,the relative abundance of Bacteroidetes,Proteobacteria,Muribaculaceae,Lachnospiraceae-NK4A136group and Ruminiclostridium were significantly increased,and the relative abundance of Firmicutes,Actinobacteria,Patescibateria,Lactobacillus,Odoribacter,Alistipes,Ruminococcaceae-uncultured and Bacteroides was decreased in the low-,medium-and high-dose groups of Yichang Sanjie Granules and the pcDNA-AIM2 group(all P＜0.05).Conclusion Yichang Sanjie Granules can increase autoimmunity and improve intestinal flora structure in mice with colon cancer,and its mechanism is related to the activation of AIM2 inflammatory vesicles.

Study on the Difference of Gene Expression Between Left and Right Colon Cancer and the Mechanism of Sophorae Flavescentis Radix-Sargentodoxae Caulis-Scutellariae Barbatae Herba Based on TCGA / 广州中医药大学学报

Abstact:Objective To investigate the gene expression differences between left-sided colon cancer and right-sided colon cancer and the mechanism differences between the colorectal cancer core drug pairs of Sophorae Flavescentis Radix-Sargentodoxae Caulis-Scutellariae Barbatae Herba acting on left-sided and right-sided colon cancer.Methods The transcriptome data of 134 patients with left-sided colon cancer and 194 patients with right-sided colon cancer from The Cancer Genome Atlas(TCGA)were downloaded,and the R software was applied to realize the differential gene analysis of the two groups and the enrichment analysis of Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway;the BATMAN-TCM database was used to obtain the active ingredients and targets of the drug pair of Sophorae Flavescentis Radix-Sargentodoxae Caulis-Scutellariae Barbatae Herba,and based on the different genes of the left-and right-sided colon cancers,KEGG enrichment analysis of the drug pair-left/right-sided colon cancers was performed respectively,and the protein-protein-interaction(PPI)network was constructed to compare the differences of the biosignaling pathways enriched by the drug pairs for the treatment of left-and right-sided colon cancers,as well as the differences of the key target points.Results There were 6 051 differentially expressed genes common to left-and right-sided colon cancers relative to normal paracancerous tissues,1958 differentially expressed genes specific to left-sided colon cancer,and 1739 differentially expressed genes specific to right-sided colon cancer;14 KEGG-enriched pathways specific to left-sided colon cancer,and 23 KEGG-enriched pathways specific to right-sided colon cancer.There were 85 active compounds in the drug-pair of Sophorae Flavescentis Radix-Sargentodoxae Caulis-Scutellariae Barbatae Herba,corresponding to a total of 469 targets.The drug-pair-left-sided colon cancer targets were enriched in 10 KEGG signaling pathways,with the key targets being DRD2,CACNA1C,HTR3A,COMT,and TH;and the drug-pair-right-sided colon cancer targets were enriched in 1 KEGG signaling pathway,with the core targets being HTR3A,DRD2 TH,AGT,GRIN2B.Conclusion There are gene expression differences between left-and right-sided colon cancers:left-sided colon cancer is associated with abnormal immune function,abnormal AMPK signaling pathway and other mechanisms,and right-sided colon cancer is associated with neutrophil extracellular trap formation,alcoholism,abnormal Hippo signaling pathway and other mechanisms.In addition to regulating cell cycle and essential amino acid metabolism and other mechanisms,Sophorae Flavescentis Radix-Sargentodoxae Caulis-Scutellariae Barbatae Herba drug pairs have specific effects on regulating the intestinal endocrine function of the left-sided colon cancer,inhibiting inflammatory response of the right-sided colon cancer,and may also have mood-regulating effects on patients with colon cancer.

Efficacy of XELOX regimen neoadjuvant chemotherapy in the treatment of stage Ⅱ(T4)and Ⅲ colon cancer / 临床外科杂志

Objective To evaluate the efficacy of XELOX regimen as neoadjuvant chemotherapy in the treatment of stage Ⅱ and Ⅲ colon cancer.Methods The clinical data of 50 patients with clinical stage Ⅱ(T4)Ⅲ colon cancer who underwent laparoscopic radical resection at general surgery department of our hospital from January 1,2012 to January 1,2021 were retrospectively analyzed.Patients were divided into neoadjuvant chemotherapy group(NACT)and adjuvant chemotherapy group(ACT)according to whether they received neoadjuvant chemotherapy with XELOX regimen.The general clinical data,adverse reactions of chemotherapy,surgical complications,operation time,intraoperative blood loss,hospitalization time,hospitalization cost,negative conversion rate of tumor markers,tumor remission rate,tumor downstaging rate,tumor response grade after chemotherapy,postoperative disease-free survival curve,and overall survival curve were retrospectively analyzed and compared among the groups.Results There were no significant differences in operative complications,postoperative exhaust time and hospital stay between NACT group and ACT group(P＞0.05).The adverse reactions of chemotherapy,the negative conversion rate of postoperative CEA and CA19-9,the duration of operation,the amount of bleeding,and the hospitalization cost in NACT group were significantly better than those in ACT group(P＜0.05).In terms of DFS and OS survival curves,with the extension of time,the decline of the NACT survival curve was smaller than that of the ACT group,and there was a significant difference in DFS survival curve(P＜0.05),but no significant difference in OS survival curve(P＞0.05).Conclusion XELOX neoadjuvant chemotherapy is safe and effective in the treatment of stage Ⅱ(T4)and stage Ⅲcolon cancer.

Clinical analysis of 29 cases of postsurgical gastroparesis syndrome after laparoscopic radical resection of right-side colon cancer / 临床外科杂志

Objective To investigate the influencing factors of postoperative gastroparesis syndrome(PSG)after laparoscopic right hemicolon cancer resection.Methods A total of 1070 patients with laparoscopic right hemicolon cancer resection(complete right hemicolon mesoresection)were selected from Wuhan General Hospital of Yangtze River Shipping and Wuhan Union Hospital Cancer Department from December 2012 to June 2022.According to whether the patients got postoperative gastroparesis,were divided into the postoperative gastroparesis syndrome(PSG)group or the normal control group.Univariate and multivariate Logistic regression analysis were used to analyze the risk factors of PGS after right hemicolon resection.Results There were 29 patients in the gastroparesis group and 1041 patients in the normal control group.Univariate analysis showed that age,perioperative blood glucose level,surgical resection range,and surgical approach were related to the occurrence of PGS(P＜0.05).Multivariate Logistic analysis showed that age,high perioperative blood glucose level,caudal approach plus combined approach,and large surgical resection range were independent influencing factors of PGS(P＜0.05).Conclusions Age,high perioperative blood glucose level,caudal approach plus combined approach,and large surgical resection range are influencing factors of PGS.

Effects of Rap1 GTP-activating protein on proliferation,invasion and migration of colon cancer cells / 临床与实验病理学杂志

Purpose To investigate the corr-elation between Rap1 GAP expression in colon cancer tissues and clinicopatho-logical features and prognosis.Methods Immunohistochemistry was used to detect Rap1 GAP protein expression in 125 cases of colon cancer,and its correlation with clinicopathological features and prognosis was analyzed.Rap1 GAP protein expression in co-lon cancer LOVO,HCT116,SW480 cells and normal colon epi-thelial HCoEPiC cells was detected by Western blot.The expres-sion of Rap1 GAP was down-regulated and up-regulated in LO-VO,HCT116 and SW480 cells by lentivirus transfection,and di-vided into no-load group(sh-NON,LV-NON),sh-Rap1 GAP group(low expression Rap1 GAP)and LV-Rap1 GAP group(overexpression Rap1 GAP)according to different treatments.The transfection efficiency was verified by Western blotting.MTT assay and Transwell assay were used to detect cell proliferation,invasion and migration in each group.Results In 125 colon cancer samples,83 cases(66.4％)had the loss of Rap1 GAP expression,which was higher than that in paracancer control(7.2％,P＜0.001).The rate of loss of Rap1 GAP expression was correlated with the degree of tumor differentiation(x2=6.152,P=0.011)and the presence of mucinous adenocarcino-ma(x2=4.908,P=0.028),but not with gender,age,tumor location,tumor stage,or lymph node metastasis(P＞0.05).Western blotting results showed that compared with HCoEPiC(0.189±0.081)cells,Rap1 GAP protein expression was in-creased in colon cancer LOVO(0.238±0.008)cells.Rap1 GAP protein expression was decreased in HCT116(0.064± 0.002)and SW480(0.152±0.026)cells(F=159.6,P＜0.05).After LOVO cells were transfected with Rap1 GAP low expression lentivirus,the expression level of Rap1 GAP in sh-Rap1 GAP-1 group(0.733±0.071)and sh-Rap1 GAP-2 group(0.559±0.136)and sh-Rap1 GAP-3 group(0.606±0.037)was significantly lower than that in LOVO group(1.880± 0.129)(F=49.57,P＜0.05).Compared with sh-NON(1.260±0.109)group,the proliferation ability of sh-Rap1 GAP-2(1.569±0.059)and sh-Rap1 GAP-3(1.548±0.087)cells was significantly increased at 72 h(F=28.36,P＜0.05).Its invasion and migration ability were significantly increased(P＜0.05).After HCT116 cells transfected with overexpression lentivirus,the expression of Rap1 GAP protein in LV-Rap1 GAP group(1.395±0.137)was relatively higher than that in LV-NON group(0.485±0.097)(P＜0.05).The results of MTT assay showed that compared with LV-NON(0.652±0.047)group,the proliferation ability of cells in LV-Rap1 GAP(1.212 ±0.038)group was decreased,and the invasion and migration ability were significantly decreased(P＜0.05).The transfection results,proliferation,invasion and migration of SW480 cells were consistent with those of HCT116 cells.Conclusion The loss rate of Rap1 GAP expression is related to the differentiation degree of colon cancer and whether it is accompanied by mucin-ous adenocarcinoma.The up-regulation of Rap1 GAP expression can inhibit the proliferation,invasion and migration of colon cancer cells,providing a theoretical basis for exploring the occur-rence and development of colon cancer.

Comparison of different blood vessels as markers in laparoscopic radical resection of right colon cancer / 实用医学杂志

Objective To compare the clinical efficacy and short-term prognosis of laparoscopic radical resection of right colon cancer guided by superior mesenteric artery and superior mesenteric vein.Methods 80 patients with right colon cancer of cT2-4 and/or N0-2M0 admitted from January 2020 to October 2022 were selected as the research objects,and they were randomly divided into observation group and control group,with 40 patients in each group.The observation group was treated with SMA-oriented laparoscopic radical resection of right colon cancer,while the control group was treated with SMV-oriented laparoscopic radical resection of right colon cancer.The curative effect and prognosis of the two groups were compared.Results There was no significant difference between the two groups in general condition,operation time,gastric tube placement time,recovery time of farting,postoperative fasting time,postoperative drainage time,postoperative nutritional index,total incidence of complications and postoperative hospitalization time(P>0.05).The lymph nodes in the observation group were significantly more than those in the control group,and the difference was statistically significant(P<0.05).In the observation group,the lymph nodes in the anterior and left side of superior mesenteric artery were examined(No.D3),and 273 lymph nodes were detected,and Seven patients(17.5% )were diagnosed with D3 metastasis,and 13 lymph nodes were positive(5.2% ).Conclusion Laparoscopic radical resection of right colon cancer guided by superior mesenteric artery,without increasing the incidence of complications and high safety,can more thoroughly clean lymph nodes and reduce tumor recurrence,which is expected to significantly improve the prognosis of patients.

Reversal effect of Lycium barbarum polysaccharide in combination with oxaliplatin on drug resistance of colon cancer stem cells / 中国组织工程研究

BACKGROUND:Clinical treatment for colon cancer mainly includes fluorouracil,irinotecan and oxaliplatin-based therapy.Studies have shown that membrane transport proteins such as ATP-binding cassette transport protein of G2(ABCG2)mediate the transport of these drugs.However,when patients develop resistance to these chemotherapeutic drugs,the high expression of ABCG2 leads to a significant decrease in the therapeutic effect and raises the problem of drug resistance in colon cancer.New drugs and treatments are urgently needed to improve the efficacy.Lycium barbarum polysaccharide has a wide range of biological activities.It can be used as anti-tumor drug to overcome the damage to normal cells in the process of chemotherapy and radiotherapy in tumor patients. OBJECTIVE:To explore the reversal effect of Lycium barbarum polysaccharide in combination with oxaliplatin on colon cancer drug-resistant cells through in vitro experiments to investigate the possible molecular mechanism of Lycium barbarum polysaccharide reversal on colon cancer drug-resistant cells. METHODS:Colon cancer cell line HCT116 and oxaliplatin-resistant cell line HCT116-OXR were selected for in vitro experiments.The optimal intervention concentration and intervention time of Lycium barbarum polysaccharide and oxaliplatin were determined by CCK8 assay of cell proliferation.Samples were further divided into the HCT116 control group,HCT116-OXR blank treatment group,Lycium barbarum polysaccharide group(2.5 mg/mL Lycium barbarum polysaccharide),and oxaliplatin group(10 μmol/L oxaliplatin),and Lycium barbarum polysaccharide + oxaliplatin group(2.5 mg/mL Lycium barbarum polysaccharide +10 μmol/L oxaliplatin).Cell apoptosis was detected by flow cytometry.The protein expression levels of phosphomannose isomerase(PMI)and ABCG2 were detected by immunofluorescence and western blot assay.Phosphatidylinositol3-kinase(PI3K),protein kinase B(AKT),B-cell lymphoma 2(Bcl-2)and BCL2-Associated X(Bax)were detected by western blot assay. RESULTS AND CONCLUSION:(1)HCT116-OXR was more sensitive to Lycium barbarum polysaccharide compared to HCT116(P<0.05).(2)Compared with the HCT116-OXR blank group,Lycium barbarum polysaccharide + oxaliplatin could promote apoptosis of HCT116-OXR cells(P<0.05).The protein expression of Bcl-2 was significantly down-regulated(P<0.05);the protein expression of Bax was significantly up-regulated(P<0.05);the protein expression of ABCG2,PMI,PI3K and AKT was significantly down-regulated(P<0.05).(3)These results indicate that Lycium barbarum polysaccharide reverses drug resistance in colon cancer by inhibiting PMI/PI3K/AKT signaling pathway,which lays the foundation for studying the molecular mechanism of Lycium barbarum polysaccharide's sensitizing chemotherapeutic effects.

Shikonin Inhibits APC-mutant Colon Cancer via Wnt/β-catenin Signaling / 肿瘤防治研究

Objective To identify small molecule inhibitors of APC-mutant colon cancer and provide lead compounds for targeted therapy of colon cancer. Methods APC-mutant colon cancer cell lines that stably express 7*Tcf-GFP/SV40-Cherry (7TGC) dual fluorescence reporter system was constructed for small-molecule inhibitor screening. Cell viability, colony formation, EdU incorporation, and xenograft tumor assay were used to evaluate the inhibitory effect of these inhibitors on APC-mutant colon cancer in vitro and in vivo. Western blot and co-immunoprecipitation assays were used to explore the molecular mechanism. Results Four small molecules that inhibited Wnt activity in APC-mutant colon cancer cells were discovered. Shikonin exhibited significant inhibition of cell viability and proliferation while inducing apoptosis of APC-mutant colon cancer cells. Xenograft tumor assay demonstrated that shikonin significantly reduced tumor growth in vivo. Furthermore, Western blot and co-immunoprecipitation assays revealed that shikonin markedly decreased β-catenin levels. Conclusion Shikonin effectively inhibits Wnt activity and suppresses tumor growth in APC-mutant colon cancer.

Metastatic colon adenocarcinoma in pregnancy / Philippine Journal of Obstetrics and Gynecology

@#Colon cancer in pregnancy is rare. Symptoms are nonspecific; hence, patients are often diagnosed at an advanced stage with poor prognosis. We present a 40‑year‑old multigravid who had recurrent severe abdominal pain. She underwent surgeries at 9 and 21 weeks age of gestation with an initial assessment of ovarian malignancy. Further workup showed metastatic adenocarcinoma to the pelvis with colonic primary. Chemotherapy was subsequently deferred due to COVID‑19 infection. She eventually developed partial gut obstruction and underwent bowel diversion with intraoperative fetal monitoring at 31 weeks age of gestation. Although the fetus developed growth restriction, the pregnancy was successfully carried to term with a good outcome. Palliative chemotherapy was started postpartum and she completed eight cycles. Unfortunately, she succumbed to death after 1 year due to pulmonary metastases. Despite challenges in diagnosis and management, this case shows that it is possible to have a good outcome in a pregnancy complicated by advanced-stage colon cancer.

Tongxie Yaofang Regulates Expression of NKG2DL to Enhance Anti-tumor Effect of NK Cells in Colon Cancer under Chronic Stress / 中国实验方剂学杂志

ObjectiveTo observe the effect of Tongxie Yaofang on the function of tumor-related natural killer （NK） cells under chronic stress and explore the possible molecular mechanism. MethodFifty SPF-grade BABL/C male mice were randomized into normal， model， and low-， medium-， and high-dose （6.825， 13.65， and 27.3 g·kg-1， respectively） Tongxie Yaofang groups， with 10 mice in each group. Other groups except the blank group were subjected to 7 days of chronic restraint stress， and then forced swimming and tail suspension tests were carried out to evaluate the modeling performance. After the successful modeling， rats in Tongxie Yaofang groups were administrated with low-， medium-， and high-doses of Tongxie Yaofang by gavage， while those in the other groups were administrated with normal saline by gavage. After 14 days， each group of mice was inoculated with subcutaneous colon cancer to establish the model of colon cancer under chronic stress. The pathological changes of the tumor tissue in each group of mice were observed using hematoxylin-eosin （HE） staining. The content of CD49b-positive cells in the peripheral blood and tumor tissue of mice was measured by flow cytometry. Enzyme-linked immunosorbent assay （ELISA） was employed to measure the content of molecules associated with NK cell activation in the peripheral blood. Western blot was employed to determine the protein levels of major histocompatibility complex class Ⅰ polypeptide-related sequences A and B （MICA+MICB） and UL-16-binding protein 1 （ULBP1） in the tumor tissue. ResultCompared with the normal group， the model group showed a decrease in 5-hydroxytryptamine （5-HT） content and an increase in corticosterone （CORT） content in the serum （P<0.05）. Compared with the model group， Tongxie Yaofang increased the 5-HT content and decreased the CORT content （P<0.05， P<0.01）. Compared with the normal group， the modeling increased the tumor volume and weight （P<0.05）， while Tongxie Yaofang inhibited such increases with no statistical significance. The tumor cells in the model group presented neat arrangement， irregular shape， uneven size， obvious atypia， common nuclear division， and small necrotic area， and blood vessels were abundant surrounding the tumor cells. Compared with the model group， Tongxie Yaofang groups showed sparse arrangement of tumor cells， different degrees of patchy necrosis areas in the tumor， and karyorrhexis， dissolution， and nuclear debris in the necrotic part. Compared with the normal group， the model group showed reduced CD49b-positive cells in the peripheral blood and tumor tissue （P<0.01）. Compared with the model group， Tongxie Yaofang increased CD49b-positive cells （medium dose P<0.01， high dose P<0.05， P<0.01）. Compared with the normal group， the modeling lowered the serum levels of granzymes-B （Gzms-B）， perforin （PF）， interferon （IFN）-γ， and tumor necrosis factor （TNF）-α （P<0.05， P<0.01）. Compared with the model group， low-dose Tongxie Yaofang elevated the serum levels of PF， Gzms-B， and TNF-α （P<0.05， P<0.01）， and medium-dose Tongxie Yaofang elevated the serum levels of Gzms-B， PF， IFN-γ， and TNF-α （P<0.05， P<0.01）. In addition， high-dose Tongxie Yaofang elevated the serum levels of PF， IFN-γ， and TNF-α （P<0.01）. Compared with the normal group， the model group presented down-regulated protein level of ULBP1 （P<0.05）. Compared with the model group， low-， medium-， and high-dose Tongxie Yaofang up-regulated the protein level of ULBP1 （P<0.05， P<0.01）， and medium- and high-dose Tongxie Yaofang up-regulated the protein level of MICA+MICB （P<0.05， P<0.01）. ConclusionTongxie Yaofang may promote NK cell activation by up-regulating the expression of MICA+MICB and ULBP1， thereby delaying the progression of colon cancer under chronic stress.

Curcumin Induces Cycle Arrest of Colon Cancer HCT116 Cells via JAK1/STAT1/p21 Pathway / 中国实验方剂学杂志

ObjectiveTo investigate the effect of curcumin on the cycle arrest of human colon cancer HCT116 cells and decipher the possible molecular mechanism. MethodThe methyl thiazolyl tetrazolium （MTT） method was employed to examine the effects of curcumin （0， 12.5， 25， 50， 75， 100 μmol·L-1） and 5-fluorouracil （5-FU， 600 μmol·L-1） on the proliferation of HCT116 cells at different time points （24， 48， 72 h）. Flow cytometry was employed to examine the cycle of HCT116 cells treated with curcumin （0， 25， 50， 75 μmol·L-1） and 5-FU. Western blot was employed to determine the expression of proteins in the Janus kinase 1 （JAK1）/signal transducer and activator of transcription 1 （STAT1） /cyclin-dependent kinase inhibitor 1A （p21） pathway in HCT116 cells. The binding of STAT1 to p21 promoter region was detected by chromatin immunoprecipitation （ChIP）. Small interfering RNA （siRNA） was employed to measure the role of STAT1 in regulating the expression of p21 and that of JAK1 in regulating the activation of STAT1 by Western blot and cellular immunofluorescence， respectively. ResultCompared with the blank group， the HCT-116 cells treated with curcumin and 5-FU showed decreased viability （P<0.05）， increased proportions of cells in the G0/G1 phase （P<0.05）， decreased proportions of cells in the S phase and G2/M phase （P<0.05）， down-regulated protein level of phosphorylated p21 （P<0.05）， and up-regulated protein level of p21 （P<0.05）. Compared with the curcumin group， the p21 siRNA+ curcumin group presented decreased proportion of cells in G0/G1 phase （P<0.05）. Compared with the blank group， curcumin elevated the level of phosphorylated STAT1 （p-STAT1） （P<0.05）. Compared with the curcumin group， the curcumin + STAT1 siRNA group showcased up-regulated protein level of p21 in HCT116 cells （P<0.05）. The mechanism study showed that curcumin treatment enhanced the enrichment of STAT1 in the p21 promoter region （P<0.05） compared with the blank group. Compared with the blank group， curcumin up-regulated the level of phosphorylated JAK1 （p-JAK1） （P <0.05）. Compared with the curcumin group， the curcumin + STAT1 siRNA group demonstrated up-regulated protein levels of p-STAT1 and p21 in HCT116 cells （P<0.05）. ConclusionCurcumin may induce the cycle arrest of human colon cancer HCT116 cells by activating the JAK1/STAT1/p21 signaling pathway.

Study on effect of Wumei Pill on apoptosis of colon cells in rats with ulcerative colitis and its mechanism by regulating miR-146a / 中国免疫学杂志

Objective:To investigate effect of Wumei Pill on colon cell apoptosis in ulcerative colitis(UC)rats by regulating miR-146a and its mechanism.Methods:A total of 50 SD rats were selected,with 10 rats in each group,and divided into control group,model group,Wumei Pill low,medium and high doses groups.Transfected with anti-miR-NC,anti-miR-146a,miR-NC,miR-146a as anti-miR-NC group,anti-miR-146a group,Wumei Pill+miR-NC group,Wumei Pill+miR-146a group.CCK-8 was used to de-tect cell proliferation;flow cytometry was used to detect cell apoptosis;RT-qPCR was used to detect cell miR-146a expression;ELI-SA was used to detect cell IL-1β and IL-13 contents;Western blot was used to detect expressions of B-cell lymphoma 2(Bcl-2)and Bax proteins.Results:Compared with control group,cell survival rate,Bcl-2 protein expression in model group were decreased,while apoptosis rate,Bax protein expression,IL-1β,IL-13 contents and miR-146a expression were increased(P<0.05).Compared with model group,Wumei Pill significantly increased cell survival rate and Bcl-2 protein expression,decreased cell apoptosis rate,Bax protein expression,IL-1β,IL-13 contents and miR-146a expression(P<0.05).Inhibition of miR-146a increased cell survival rate,Bcl-2 protein expression,decreased cell apoptosis rate,IL-1β,IL-13 contents and Bax protein expression(P<0.05).Overexpression of miR-146a reversed effects of Wumei Pills on proliferation and apoptosis of colon cells in UC rats.Conclusion:Wumei Pill can reduce apoptosis of colon cells in UC rats by up-regulating expression of miR-146a.

Development of a prognostic risk marker of colon adenocarcinoma based on a weighted gene co-expression network and its clinical significance / 中国比较医学杂志

Objective Because of the poor prognosis of colon adenocarcinoma(COAD),it is necessary to screen prognosis-related genes in COAD patients and establish a new prognostic risk assessment model.Methods COAD-related data from the cancer genome atlas(TCGA)and gene expression omnibus(GEO)were used as training and validation sets,respectively.Weighted gene co-expression network analysis(WGCNA),a Cox regression model and least absolute selection and shrinkage operator(LASSO)regression analysis were used to screen prognosis-related genes of COAD and establish a prognostic model.A receiver operating characteristic(ROC)curve was combined with a survival curve to verify the model accuracy,and a nomogram was constructed.Patients were divided into two groups by the median risk score.The immune cell proportion score(IPS)was used to evaluate the immunotherapy response of the two groups.Results A total of 15 feature genes were screened.The area under the ROC curve in the predictive model of COAD patients was＞0.6,and the survival rate of the high-risk group was significantly lower than that of the low-risk group(P＜0.05),suggesting a good distinguishing ability for high-and low-risk COAD patients.Patients in the low-risk group had a higher IPS(P=0.026),indicating a better response to immunotherapy.Conclusions The model developed for COAD in this study has a good ability to predict the survival of patients at high and low risk of COAD.

Expression levels and clinical significance of miR-183-5p and THEM4 in colon cancer tissues / 中国现代普通外科进展

Objective:To study the expression levels and clinical significance of microR-NA-183-5p(miR-183-5p)and thioesterase superfamily member 4(THEM4)in colon cancer tissues.Methods:A total of 96 patients with colon cancer who in Hebei China Petroleum Central Hospital gathered as the research objects.During the course of radical resection of colon cancer patients,the colon cancer tissues and adjacent normal tissues were collected.The relative expression levels of miR-183-5p and THEM4 mRNA in colon cancer tissues and adjacent normal tissues were detected.Analysis of the correlation between miR-183-5pand THEM4mRNA in colon cancer and their relation-ship with prognosis.COX regression was used to analyze the risk factors affecting the prognosis of pa-tients with colon cancer.Results:Compared with adjacent normal tissues,the expression level of miR-183-5p in colon cancer tissues increased(P＜0.05),and the expression level of THEM4 mRNA decreased(P＜0.05).MiR-183-5p was negatively correlated with THEM4 mRNA expression in colon cancer tissue(r=-0.529,P＜0.05).The survival rate of the high expression group of miR-183-5p lower than that of the low expression group(P＜0.05),the survival rate of the high expression group of THEM4 was obviously higher than that of the low expression group(P＜0.05).TNM stage(Ⅲ-Ⅳ),high expres-sion of miR-183-5p and low expression of THEM4 were risk factors for poor prognosis in patients with colon cancer(P＜0.05).Conclusion:The expression level of miR-183-5p in cancer tissues of patients with colon cancer is increased,and the expression level of THEM4 is decreased,both are closely relat-ed to the clinicopathological characteristics and prognosis of patients.