Value of Preoperative Serum Amyloid A Protein Concentration in Choice of Surgical Treatment in Low Locally Advanced Rectal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Xiaodong ¹ , DENG Lei ² , QIN Changlong ² , Lu Donghao ² , PENG Xiaying ² , NA Feifei ² , LI Zhengyan ³ , LI Li ¹

1.Department of Anal-Colorectal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;;
2.West China School of Medicine, Sichuan University, Chengdu 610041, China;;
3.Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding?author：

Keywords：

Rectal neoplasm; Locally advanced rectal cancer; Surgical operation; Serum amyloid A protein; Preoperative evaluation

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Objective To investigate the relationship of serum amyloid A protein (SAA) and surgical choice in low locally advanced rectal cancer (LLARC).
Methods Fifty-two patients with LLARC at West China Hospital of Sichuan University were retrospectively analyzed. According to operative methods the patients were divided into 2 groups: curative surgery group (n=35) and palliative surgery group (n=17). Then, venous blood specimens were taken to measure preoperative serum SAA level.
Results The analysis showed the option of surgical procedures was associated with preoperative SAA concentration (P=0.004) in LLARC, but irrelative with pathological characteristics and preoperative imaginologic staging (P gt;0.05). High concentration of serum SAA (≥10.5 mg/L) significantly increased the odds of palliative surgery 〔OR=7.47, 95% CI (1.62-34.40), P＝0.010〕.
Conclusion High level of SAA is a useful marker to predict the possibility of palliative surgery in LLARC, which is helpful to screen the patients for the surgical decision and adjuvant therapy.

Citation： WANG Xiaodong ,DENG Lei,QIN Changlong,Lu Donghao,PENG Xiaying,NA Feifei,LI Zhengyan,LI Li. Value of Preoperative Serum Amyloid A Protein Concentration in Choice of Surgical Treatment in Low Locally Advanced Rectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(8): 667-670. doi: Copy

1.	Lafrenière R. What’s new in general surgery: surgical oncology [Ｊ]. J Am Coll Surg, 2004; 198(6): 966-988.
2.	吳俊華, 汪曉東, 高強, 等. 64排多層螺旋CT和血清淀粉樣蛋白A聯合評估下段直腸癌對手術方案選擇的影響 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(2): 156-161.
3.	汪曉東, 宋歡, 呂東昊, 等. 術前聯合評估直腸上段癌與手術方案選擇的隨機對照試驗 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(4): 322-326.
4.	汪曉東, 尹源, 陸玫竹, 等. 經直腸超聲聯合血清淀粉樣蛋白A術前評估中低位直腸癌與手術決策的隨機對照試驗 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(5): 407-412.
5.	汪曉東, 呂東昊, 宋歡, 等. 多模式術前評估系統對中低位直腸癌手術方案選擇的價值：一項隨機對照試驗 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(6): 487-492.
6.	Theoni RF. Colorectal cancer: cross-sectional imaging for st-aging of primary tumor and detection of local recurrence [Ｊ]. AJR Am J Roentgenol, 1991; 156(5): 909-915.
7.	Greene FL, Page DL, Fleming ID, et al. AJCC cancer staging manual [M]. 6th ed. New York (NY). Springer-Verlag, 2002: 113-124.
8.	Nelson H, Petrelli N, Carlin A, et al. Guidelines 2000 for colon and rectal cancer surgery [Ｊ]. J Natl Cancer Inst, 2001; 93(8): 583-596.
9.	汪曉東, 宋歡, 盧聰, 等. 骨盆測量在直腸癌手術中的應用進展 [Ｊ]. 醫學與哲學, 2009; 30(4): 45-46.
10.	汪曉東, 何帆, 鄧窈窕, 等. 直腸癌術前經直腸超聲評估保肛或非保肛手術方案的臨床前瞻性研究 [Ｊ]. 臨床外科雜志, 2008; 16(11): 755-757.
11.	Abbas MA. Sphincter preservation for distal rectal cancer: how low is too low? [Ｊ]. Am J Clin Oncol, 2008; 31(2): 195-198.
12.	汪曉東, 呂東昊, 宋歡, 等. 64排螺旋CT術前評估對直腸癌手術方案選擇的價值 [Ｊ]. 中華普通外科雜志, 2009; 24(3): 210-214.
13.	汪曉東, 呂東昊, 崔貝貝, 等. 術前經直腸超聲評估直腸癌手術方案的隨機對照試驗 [Ｊ]. 中國循證醫學雜志, 2008; 8(12): 1043-1046.
14.	Leroy J, Jamali F, Forbes L, et al. Laparoscopic total mesorectal excision (TME) for rectal cancer surgery: long-term outcomes [Ｊ]. Surg Endosc, 2004; 18(2): 281-289.
15.	Sugarbaker PH, Corlew S. Influence of surgical techniques on survival in patients with colorectal cancer [Ｊ]. Dis Colon Rectum, 1982; 25(6): 545-557.
16.	Lindsetmo RO, Joh YG, Delaney CP. Surgical treatment for rectal cancer: an international perspective on what the medical gastroenterologist needs to know [Ｊ]. World J Gastroenterol, 2008; 14(21): 3281-3289.
17.	Strassburg J, Lewin A, Ludwig K, et al. Optimised surgery (so-called TME surgery) and high-resolution MRI in the planning of treatment of rectal carcinoma [Ｊ]. Langenbecks Arch Surg, 2007; 392(2): 179-188.
18.	Wibe A, Mller B, Norstein J, et al. A national strategic change in treatment policy for rectal cancer-implementation of total mesorectal excision as routine treatment in Norway. A national audit [Ｊ]. Dis Colon Rectum, 2002; 45(7): 857-866.
19.	汪曉東, 高強, 周小雁, 等. 多層螺旋CT聯合纖維蛋白原或血清淀粉樣蛋白A對直腸癌外科決策的隨機對照研究 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(7): 575-580.
20.	Gutfeld O, Prus D, Ackerman Z, et al. Expression of serum amyloid A, in normal, dysplastic, and neoplastic human colonic mucosa: implication for a role in colonic tumorigenesis [Ｊ]. J Histochem Cytochem, 2006; 54(1): 63-73.
21.	汪曉東, 呂東昊, 高命, 等. 結直腸癌患者術前血清CRP與SAA檢測的意義 [Ｊ]. 中國腫瘤, 2009; 18(5): 416-419.
22.	汪曉東, 鄧磊, 呂東昊, 等. 結直腸癌患者術前SAA、CRP、CEA和CA19-9水平的臨床診斷價值 [Ｊ]. 四川醫學, 2009; 30(3): 340-342.
23.	劉展, 汪曉東, 李立. 在結直腸癌領域引入多學科協作管理模式的現狀 [Ｊ]. 中國普外基礎與臨床雜志, 2007; 14(1): 114-116.
24.	Daniels IR, Fisher SE, Heald RJ, et al. Accurate staging, selective preoperative therapy and optimal surgery improves outcome in rectal cancer: a review of the recent evidence [Ｊ]. Colorectal Dis, 2007; 9(4): 290-301.

1. Lafrenière R. What’s new in general surgery: surgical oncology [Ｊ]. J Am Coll Surg, 2004; 198(6): 966-988.
2. 吳俊華, 汪曉東, 高強, 等. 64排多層螺旋CT和血清淀粉樣蛋白A聯合評估下段直腸癌對手術方案選擇的影響 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(2): 156-161.
3. 汪曉東, 宋歡, 呂東昊, 等. 術前聯合評估直腸上段癌與手術方案選擇的隨機對照試驗 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(4): 322-326.
4. 汪曉東, 尹源, 陸玫竹, 等. 經直腸超聲聯合血清淀粉樣蛋白A術前評估中低位直腸癌與手術決策的隨機對照試驗 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(5): 407-412.
5. 汪曉東, 呂東昊, 宋歡, 等. 多模式術前評估系統對中低位直腸癌手術方案選擇的價值：一項隨機對照試驗 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(6): 487-492.
6. Theoni RF. Colorectal cancer: cross-sectional imaging for st-aging of primary tumor and detection of local recurrence [Ｊ]. AJR Am J Roentgenol, 1991; 156(5): 909-915.
7. Greene FL, Page DL, Fleming ID, et al. AJCC cancer staging manual [M]. 6th ed. New York (NY). Springer-Verlag, 2002: 113-124.
8. Nelson H, Petrelli N, Carlin A, et al. Guidelines 2000 for colon and rectal cancer surgery [Ｊ]. J Natl Cancer Inst, 2001; 93(8): 583-596.
9. 汪曉東, 宋歡, 盧聰, 等. 骨盆測量在直腸癌手術中的應用進展 [Ｊ]. 醫學與哲學, 2009; 30(4): 45-46.
10. 汪曉東, 何帆, 鄧窈窕, 等. 直腸癌術前經直腸超聲評估保肛或非保肛手術方案的臨床前瞻性研究 [Ｊ]. 臨床外科雜志, 2008; 16(11): 755-757.
11. Abbas MA. Sphincter preservation for distal rectal cancer: how low is too low? [Ｊ]. Am J Clin Oncol, 2008; 31(2): 195-198.
12. 汪曉東, 呂東昊, 宋歡, 等. 64排螺旋CT術前評估對直腸癌手術方案選擇的價值 [Ｊ]. 中華普通外科雜志, 2009; 24(3): 210-214.
13. 汪曉東, 呂東昊, 崔貝貝, 等. 術前經直腸超聲評估直腸癌手術方案的隨機對照試驗 [Ｊ]. 中國循證醫學雜志, 2008; 8(12): 1043-1046.
14. Leroy J, Jamali F, Forbes L, et al. Laparoscopic total mesorectal excision (TME) for rectal cancer surgery: long-term outcomes [Ｊ]. Surg Endosc, 2004; 18(2): 281-289.
15. Sugarbaker PH, Corlew S. Influence of surgical techniques on survival in patients with colorectal cancer [Ｊ]. Dis Colon Rectum, 1982; 25(6): 545-557.
16. Lindsetmo RO, Joh YG, Delaney CP. Surgical treatment for rectal cancer: an international perspective on what the medical gastroenterologist needs to know [Ｊ]. World J Gastroenterol, 2008; 14(21): 3281-3289.
17. Strassburg J, Lewin A, Ludwig K, et al. Optimised surgery (so-called TME surgery) and high-resolution MRI in the planning of treatment of rectal carcinoma [Ｊ]. Langenbecks Arch Surg, 2007; 392(2): 179-188.
18. Wibe A, Mller B, Norstein J, et al. A national strategic change in treatment policy for rectal cancer-implementation of total mesorectal excision as routine treatment in Norway. A national audit [Ｊ]. Dis Colon Rectum, 2002; 45(7): 857-866.
19. 汪曉東, 高強, 周小雁, 等. 多層螺旋CT聯合纖維蛋白原或血清淀粉樣蛋白A對直腸癌外科決策的隨機對照研究 [Ｊ]. 中國普外基礎與臨床雜志, 2009; 16(7): 575-580.
20. Gutfeld O, Prus D, Ackerman Z, et al. Expression of serum amyloid A, in normal, dysplastic, and neoplastic human colonic mucosa: implication for a role in colonic tumorigenesis [Ｊ]. J Histochem Cytochem, 2006; 54(1): 63-73.
21. 汪曉東, 呂東昊, 高命, 等. 結直腸癌患者術前血清CRP與SAA檢測的意義 [Ｊ]. 中國腫瘤, 2009; 18(5): 416-419.
22. 汪曉東, 鄧磊, 呂東昊, 等. 結直腸癌患者術前SAA、CRP、CEA和CA19-9水平的臨床診斷價值 [Ｊ]. 四川醫學, 2009; 30(3): 340-342.
23. 劉展, 汪曉東, 李立. 在結直腸癌領域引入多學科協作管理模式的現狀 [Ｊ]. 中國普外基礎與臨床雜志, 2007; 14(1): 114-116.
24. Daniels IR, Fisher SE, Heald RJ, et al. Accurate staging, selective preoperative therapy and optimal surgery improves outcome in rectal cancer: a review of the recent evidence [Ｊ]. Colorectal Dis, 2007; 9(4): 290-301.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Value of Preoperative Serum Amyloid A Protein Concentration in Choice of Surgical Treatment in Low Locally Advanced Rectal Cancer

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