Pain as a risk factor of depression and anxiety symptoms with multiple myeloma during maintenance therapy.

Objective: To investigate the prevalence of depression or anxiety in patient with multiple myeloma (MM) in China during maintenance treatment and its associated influencing factors. Methods: Patients with MM (n = 160) received maintenance therapy, and control subjects (without MM, n = 160) matched on age, sex, and BMI were recruited. Patients completed questionnaires, including the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder 7-item Scale (GAD-7), and the Verbal Pain Rating Scale (VPRS). Data on the Clinical characteristics, biochemical indicators of de novo MM were from the database of the Hematology Department of Beijing Chao-yang Hospital. Multiple linear regression model analysis was used to compare the differences in PHQ-9 and GAD-7 scale scores between the control group and the case group after correction for relevant variables. Multiple logistic regression models were subsequently used to analyze the correlation between the presence or absence of anxiety and depression and clinical indicators in the MM groups. Results: Depression symptoms was present in 33.33% and anxiety symptoms in 24.68% of first-episode MM in the maintenance phase of treatment, and depression symptoms in the index-corrected MM group was significantly different from that in the control group (t = 2.54, P < 0.05). Analyses of multiple logistic regressions: biochemical indicators and clinical typing were not significantly associated with anxiety and depression. Compared to the pain rating 1, the risk of depressive mood was greater in the case group with the pain rating 2 (OR = 2.38) and the pain rating ≥ 3 (OR = 4.32). The risk of anxiety was greater in the case group with the pain rating ≥ 3 than the pain rating 1 (OR = 2.89). Conclusion: Despite being in clinical remission, depressive mood problems in patients with MM remain prominent. Clinicians should enhance mood assessment and management in patients with concomitant pain.

Expression profile of mucin-associated sialyl-Tn antigen in Chinese patients with different colorectal lesions (adenomas, carcinomas).

BACKGROUND: The sialyl-Tn (sTn) antigen is a mucin-associated carbohydrate antigen expressed by numerous human carcinomas, and is also claimed to be a prognostic factor in colorectal cancer. But the associations between sTn and colorectal cancer remain elusive and controversial. Here, we investigated the expression profile of sTn antigen in a series of human colorectal tissue samples including normal colon, colorectal adenomas, and colorectal carcinomas (CRCs), with an aim to analyzing whether sTn plays a role in the progression and development of Chinese patients with CRCs. METHODS: Immunohistochemical staining of sTn antigen was performed in formalin-fixed, paraffin-embedded colonic sections from 4 healthy controls, 44 patients with colorectal adenomas, and 186 patients with primary CRCs. RESULTS: No sTn antigen was detected in normal colonic tissues. There were 41 of 44 patients with colorectal adenomas (93.2%), and 141 of 186 patients with CRCs (75.8%) found to express sTn antigen. The patterns of sTn localization were different in adenomas and carcinomas of colonic tissues. Colorectal adenomas showed predominant supranuclear distribution of sTn antigen, while carcinomas revealed apical membrane, mucin droplet and diffuse cytoplasmic localization. Notably, sTn was significantly associated with the degree of differentiation (P = 0.006) and perineural invasion (P = 0.041) of the tumors, but was independent of age, gender, tumor location, depth of penetration, status of lymph nodes, lymphovascular invasion and TNM stage. CONCLUSIONS: These results indicate that sTn may play a role in initiating colorectal carcinogenesis and promoting tumor progression. Determination of sTn expression and localization may assist in evaluating malignant status of colorectal lesions.

Comparison of survival of patients receiving laparoscopic and open radical resection for stage II colon cancer.

BACKGROUND: The aim of the study was to compare the survival of patients receiving laparoscopic vs. open radical resection for stage II colon cancer. PATIENTS AND METHODS: Two hundred and twenty patients with stage II colon cancer were enrolled from Beijing Chaoyang Hospital of Capital Medical University from January 2000 to December 2009, including 61 patients in the laparoscopic radical resection group and 159 patients in the open radical resection group. The survival data in both groups were compared using the log rank test based on Kaplan-Meier survival curves. RESULTS: There was no statistically significant difference in the 3-year survival (88.5% vs. 80.5%; X(2)=1.98, P=0.159) and the 5-year survival (81.9% vs. 69.2%; X(2)=1.98, P=0.159) between both groups. However, statistically significant difference was found in median overall survival (mOS), which was 102.6 (95% CI: 76.8-122.7) months in the laparoscopic group and 90.0 (95% CI: 70.4-109.6) months in the open radical resection group (X(2)=4.183, P=0.041). mOS was 96 (95% CI: 68.6-111.4) months and 92.6 (95% CI: 56.8-107.2) months in those with and without postoperative chemotherapy, respectively (X(2)=6.389, P=0.011). For patients older than 75 years the mOS was 90.0 (95% CI: 25.3-105.0) months and 83.4 (95% CI: 13.1-96.9) months in the laparoscopic and open group, respectively. The difference between the both groups was statistically significant (X(2)=6.191, P=0.013). CONCLUSIONS: The mOS of patients receiving laparoscopic radical resection was better than open radical resection for stage II colon cancer, especially for patients over 75 years old.

[Clinical phenotypes of hereditary nonpolyposis colorectal cancer in Chinese population].

OBJECTIVE: To investigate the clinical phenotypes of hereditary nonpolyposis colorectal cancer (HNPCC) in Chinese population. METHODS: Data of 34 HNPCC families diagnosed according to Armsterdam II Criteria and Japan Criteria, including age of diagnosis, site of cancer inclusive of abenteric cancer, history of synchronous and/or metachronous colorectal cancer, histopathology of tumor, clinical manifestations, and genealogy were collected and analyzed. RESULTS: Out of the 612 members aged over 18 of these 34 families 140 persons were diagnosed as HNPCC patients with 154 cancer foci, 93 males and 47 females. The median age of confirmed diagnosis of HNPCC was 45.3 years. 62.1% of them developed the cancer before the age of 50 and 87.1% of them developed the cancer before the age of 60. Out of the 154 primary cancer foci, 31 were extracolonic (20.1%), including synchronous and/or metachronous cancers, with gastric cancer accounting for 41.9% (13/31), and 123 were colonic cancers (79.9%). Out of the 116 cases of colorectal cancer, there were 77 cases of proximal colon cancer (66.4%) and 39 cases of distal colon cancer (33.7%). There were 11 cases of synchronous and/or metachronous cancer (7.86%). The main clinical manifestations included hematochezia, anemia, abdominal mass, and abdominal pain. CONCLUSION: In comparison with the facts among Westerners, HNPCC occurred earlier; the proportions of proximal colon cancer, extracolonic cancer, and synchronous and/or metachronous cancers are larger; and gastric cancer accounts for a greater percentage among Chinese.