Meta-analysis of the clinical efficacy of laparoscopic appendectomy in the treatment of acute appendicitis.

BACKGROUND: This paper compares the postoperative recovery of patients with acute appendicitis (AA) after laparoscopic appendectomy (LA) and open appendectomy (OA), aiming to determine the optimal diagnosis and treatment plan for appendectomy. METHODS: Related literature was retrieved from PubMed, Web of Science, Embase, CNKI and Wanfang databases. Articles on LA and OA for AA published between 2010 and 2021 were selected to extract data. Besides, Stata16.0 was used for meta-analysis. RESULTS: A total of 777 articles were retrieved, and 16 of them were finally selected. Totally, 1251 patients underwent LA, while 898 patients received OA. According to the results of meta-analysis, LA was associated with lower incidence of adverse reactions [OR = 0.257, 95% CI (0.162, 0.408), P < 0.001], shorter operation time (SMD = - 1.802, 95% CI - 2.435, - 1.169; P < 0.001) and hospitalization (SMD = - 1.184, 95% CI - 1.512, - 0.856; P < 0.001). In addition, compared with the OA group, LA was found with less intraoperative blood loss (SMD = - 3.650, 95% CI - 5.088, - 2.212; P < 0.001) and shorter recovery time of gastrointestinal function (SMD = - 3.010, 95% CI - 3.816, - 2.203; P < 0.001). Aside from all these, the counts of leukocyte (SMD = - 0.432, 95% CI: - 0.775, - 0.089; P = 0.013), neutrophil (SMD = - 1.346, 95% CI - 2.560, - 0.133; P = 0.030), and C-reactive protein (SMD = - 2.391, 95% CI - 3.901, - 0.882; P = 0.002) all decreased in a significant manner after LA. CONCLUSION: Compared with OA, LA boasts the advantages of less adverse reactions, shorter operation time and hospitalization, fewer complications, and lower inflammatory response, evidencing its safety and feasibility of applying in the treatment of AA.

Dietary Salt Intake and Gastric Cancer Risk: A Systematic Review and Meta-Analysis.

The results of prospective cohort studies regarding the role of salt intake and subsequent gastric cancer risk are inconsistent. Thus, we performed a systematic review and meta-analysis to summarize the strength of the association of salt intake with gastric cancer morbidity and mortality. PubMed, EmBase, and Cochrane Library were systematically searched to identify eligible studies published throughout September 2021. The effect estimates with 95% confidence intervals (CIs) for gastric cancer morbidity or mortality in each study were applied to calculate the pooled results; these analyses were performed using the random-effects model. Twenty-six prospective cohort studies involving 4,956,350 individuals were selected; these studies reported 19,301 cases of gastric cancer and 2,871 cases of gastric cancer-associated mortality. High (RR: 1.25; 95%CI: 1.10-1.41; P = 0.001) or moderate (RR: 1.20; 95%CI: 1.04-1.38; P = 0.012) salt intake was associated with a greater risk of gastric cancer. High pickled food intake was associated with an increased gastric cancer risk (RR: 1.28; 95%CI: 1.05-1.57; P = 0.017), while moderate pickled foods intake had no significant effect on gastric cancer risk (RR: 1.10; 95%CI: 0.88-1.37; P = 0.390). Neither high (RR: 1.14; 95%CI: 0.95-1.36; P = 0.161) nor moderate (RR: 1.10; 95%CI: 0.87-1.40; P = 0.436) salted fish intake were associated with gastric cancer risk. A high intake of processed meat was significantly associated with a higher risk of gastric cancer (RR: 1.24; 95%CI: 1.03-1.49; P = 0.023), while moderate processed meat intake had no significant effect on the gastric cancer risk (RR: 1.01; 95%CI: 0.92-1.11; P = 0.844). High (RR: 1.04; 95%CI: 0.90-1.19; P = 0.626) and moderate (RR: 1.02; 95%CI: 0.94-1.11; P = 0.594) miso-soup intake had no effects on the gastric cancer risk. High intakes of salt, pickled food, and processed meat are associated with significantly increased risks of gastric cancer; these increased risks are also seen when participants consumed moderate amounts of salt.

p53 protein expression affected by TP53 polymorphism is associated with the biological behavior and prognosis of low rectal cancer.

Low rectal cancer is a subtype of colorectal cancer at a special anatomic site with distinct biological behavior. TP53 is one of the most important cancer suppressor genes, and its structural variation and abnormal expression has been revealed to be associated with multiple cancer types. However, to the best of our knowledge, the association of p53 protein expression with its gene polymorphism, biological behavior and prognosis in low rectal cancer has not been clarified. Therefore, the current study aimed to explore these associations. In the present study, 347 patients with low rectal cancer and 353 controls were enrolled. Kompetitive Allele-Specific Polymerase Chain Reaction was used to detect five polymorphic sites of the TP53 gene (rs1042522, rs12947788, rs1625895, rs2909430 and rs12951053), while immunohistochemistry was used to detect the protein expression of TP53. The associations between p53 protein expression and TP53 polymorphism, biological behavior and prognosis in low rectal cancer were systematically analyzed. In low rectal cancer, p53 protein expression was markedly higher in TP53 rs1042522 mutant carriers compared with that in other genotypes where expression was higher in poorly differentiated, III-IV phase and T3-4 phase tumors, and in III-IV phase female patients. The survival time of patients with low p53 protein expression was evidently longer in females, non-smokers and patients >60 years old. In summary, p53 protein expression was identified to be affected by TP53 rs1042522 polymorphism, and was associated with the biological behavior and prognosis of low rectal cancer. TP53 rs1042522 and the associated protein expression could be used as indicators for biological behavior and prognosis in low rectal cancer.

Five P53 SNPs Involved in Low Rectal Cancer Risk and Prognosis in a Chinese Population.

Although the impact and potential mechanisms of p53 polymorphisms on human malignancies have been intensively studied, analyses for association between p53 polymorphisms and colorectal cancer (CRC) risk were still limited to some common variants. Moreover, the majority of previous studies did not classify the specimens of CRC based on tumor location. This case-control study aimed to evaluate the association of five p53 polymorphisms (rs1042522, rs12947788, rs1625895, rs2909430 and rs12951053) with the risk of low rectal cancer (LRC) and investigate the prognostic significance. A total of 347 cases and 353 controls from a Chinese population were recruited and genotyped using KASP assay. Individuals carrying the variant rs12947788 A allele were observed to associate with an increased risk of LRC. After stratification for clinicopathological parameters, rs12947788 was significantly co-related with the histological type of LRC under a dominant model. Although none of the selected p53 polymorphisms was significantly associated with patient prognosis in total population, significant associations with the overall survival were revealed in the heterozygosis carriers vs. wild type carriers model through subgroup analyses based on clinical characteristics. Moreover, haplotype analyses showed that C-A-G-A-A haplotype was associated with a significantly higher LRC risk as compared to the other haplotypes. In low rectal cancer, P53 protein expression was obviously higher in p53 rs1042522 mutant carriers than in other genotypes. Our study further proves the involvement of p53 polymorphisms in pathogenesis of LRC and may provide potential therapeutic implications.

Combining Red Blood Cell Distribution Width (RDW-CV) and CEA Predict Poor Prognosis for Survival Outcomes in Colorectal Cancer.

Background: Colorectal cancer is one of the common tumors that seriously threaten human health worldwide. Serum tumor markers, including CEA and CA19-9, have become the focus of research on colorectal cancer in recent years. As one of the classic blood test results, RDW is related to the pathological features, diagnosis and prognosis of various cancers in recent studies. We hope to search the correlation between RDW and the pathological features of colorectal cancer through the following studies, explore the potential relationship between RDW and the prognosis of colorectal cancer, and find a more effective prognostic evaluation method by combining other blood markers. Methods: We retrospectively analyzed 168 patients with colorectal cancer included in this study, collected their clinical data, tumor pathological features and their preoperative blood test results including RDW value and tumor markers, and grouped them. After 3 and 5 years of follow-up, the recurrence and survival status were defined, and the above data were statistically analyzed. Results: The distribution frequency/rate of abnormal RDW-CV in colorectal cancer patients was significantly increased in the elderly (>62), colon cancer, serosal permeability, lymph node metastasis, stage III and IV, peripheral adhesion (P < 0.05). Furthermore, RDW-CV was significantly positively correlated with abnormal high values of tumor serum markers CEA and CA19-9 (P < 0.05). More importantly, ROC curve analysis found that the abnormal increase in RDW-CV in colorectal cancer was associated with the shortening of DFS and OS in patients who were followed up for 3 and 5 years (P < 0.05). Further combined with CEA, it was found that the prognosis and survival of patients with colorectal cancer in 3 and 5 years were more accurate and effective than independent prediction (AUC of DFS in 3/5years=0.630/0.635, AUC of OS in 3/5 years=0.692/0.652). Conclusion: RDW-CV is correlated with the pathological features of colorectal cancer, indicating a worse malignant tendency of tumor. RDW-CV can independently evaluate the prognosis of colorectal cancer patients, and combined with the high value of CEA, it can effectively indicate the adverse recurrence and survival prognosis.