[Risk factors associated with stress ulcer bleeding in postoperative rectal cancer patients].

OBJECTIVE: To explore the influence factor of stress ulcer bleeding(SUB) in postoperative rectal cancer patients. METHODS: Clinical data of rectal cancer patients undergoing operation in our hospital were analyzed retrospectively. Patients were divided into case group and control group according to the postoperative occurrence of SUB. Univariate analysis combined with multivariate analysis were used to evaluate the influence factors. RESULTS: Chronic diseases incidence of case group was higher than that of control group. Except for renal failure, the incidence of postoperative complications of case group was higher than that of control group. Univariate analysis revealed that age, chronic disease, preoperative, and postoperative complications had statistical significant differences(P<0.05). Multivariate analysis identified that age(OR=2.893, 95%CI:1.118-5.543), drinking history(OR=3.839, 95%CI:1.012-6.654), preoperative chronic disease(OR=4.646, 95%CI:1.872-8.892), intraoperative bleeding volume(OR=5.129, 95%CI:2.829-9.328), occurrence of severe complications after surgery(OR=6.576, 95%CI:4.539-13.278), postoperative application of glucocorticoid(OR=2.978, 95%CI:1.013-4.512), preoperative application of non-steroidal anti-inflammatory drugs(OR=2.126, 95%CI:1.287-7.636) were risk factors for SUB in rectal cancer patients after operation. Postoperative prophylactic use antacids(OR=0.102, 95%CI:0.017-0.196) was protective factor for SUB patients. CONCLUSION: Effective measures should be taken for high-risk patients, in order to improve the prognosis of patients.

Clinical and molecular analysis of hereditary non-polyposis colorectal cancer in Chinese colorectal cancer patients.

AIM: To analyze the frequency of hereditary non-polyposis colorectal cancer (HNPCC) in Chinese colorectal cancer (CRC) patients, and to discuss the value of microsatellite instability (MSI) and/or immunohistochemistry (IHC) for MSH2/MLH1 protein analysis as pre-screening tests in China. METHODS: The Amsterdam criteria I and II (clinical diagnosis) and/or germline hMLH1/hMSH2 mutations (genetic diagnosis) were used to classify HNPCC families. Genetic tests, including microsatellite instability, immunohistochemistry for MSH2/MLH1 proteins and hMSH2/hMLH1 genes, were performed in each proband. RESULTS: From July 2000 to June 2004, 1988 patients with colorectal cancer were analysed and 114 CRC patients (5.7%) from 48 families were categorized as having HNPCC, including 76 from 26 families diagnosed clinically and 38 from the other 22 families diagnosed genetically. The sensitivity and specificity of high MSI and IHC for predicting mutations were 100% and 54%, and 79% and 77%, respectively. CONCLUSION: The frequency of HNPCC is approximately 10% among all Chinese CRC cases. The MSI and IHC detections for hMSH2/hMLH1 proteins are reliable pre-screening tests for hMLH1/hMSH2 germline mutations in families suspected of having HNPCC.