【Abstract】Objective To analyze the clinical features of multiple primary colorectal carcinoma(MPCC). Methods Data in 21 patients with MPCC during the past 10 years in our hospital were analyzed retrospectively. Results The incidence of synchronous and metachronous carcinoma was 1.1% and 1.2% respectively. The sites and pathologic stages of tumors showed no significant difference compared with single colorectal carcinoma. 47.6% of the cases accompanied with colorectal adenoma. 77.8% of the MPCC could be found during operation. Patients with carcinoma involved rectum had relatively poor survival. Conclusion The full-course colonoscopy, careful intraoperative exploration and regular postoperative colonoscopic follow-up are essential in improving the diagnosis and prognosis of patients with MPCC.
Objective To study the relationship between gastrin and c-myc, c-fos expression in colorectal cancerous tissue and the mechanism of gastrin effect on colorectal cancer.Methods The gastrin and c-myc, c-fos expression in 48 cases of colorectal cancerous tissue and canceradjacent mucosa were detected with immunohistochemistry techniques.Results The positive rate of gastrin in colorectal cancerous tissue was 39.58%. The rate of the well differentiated adenocarcinoma was higher than that of the poorly differentiated and mucinous adenocarcinoma(P＜0.05). The positive rates of c-myc and c-fos in colorectal cancerous tissue were higher than those in canceradjacent and normal mucosa. The positive rate of c-myc and c-fos in the group with gastrin positive expression were 78.94% and 73.68%, higher than those in the group with negative gastrin expression(37.93% and 31.04%). Conclusion Some of colorectal cancer cells formed and secreted gastrin through autocrine. The increase of cmyc, c-fos etc oncogene expression probably stimulate the cancer cells proliferation.
ObjectiveTo understand the latest progress of transcatheter arterial chemoembolization (TACE)-based combination therapies for unresectable liver metastasis from colorectal carcinoma, and to explore the safe and effective combination therapies in order to controlling the rapid progress of disease and improving the quality of life of patients. MethodsThe literatures about TACE-based combination therapies of liver metastasis from colorectal carcinoma and the latest advance in researches of this field at home and abroad were collected, and the application of combination therapies, the advantages and features of the combined treatments were reviewed. ResultsTACE was a safe and effective therapeutic modality in treating primary liver cancer or secondary liver cancer.Compared with a single treatment, TACE-based combination therapies had distinct advantages to patients with liver metastasis from colorectal carcinoma not only improved the quality of life but also prolonged the survival time.With the emerging of various kinds of new drugs and the rapid development of a variety of interventional treatments, it could bring long-term survival benifit for patients with liver metastasis from colorectal carcinoma. ConclusionsDoctors should pay attention to the combined treatments of patients with liver metastasis from colorectal carcinoma, improve the knowledge of personalized medication about advanced tumors and actively promote more usage of combination therapies.
Objective To compare diagnosis values of computed tomography (CT) and magnetic resonance imaging (MRI) in preoperative staging of rectal carcinoma. Methods The imaging data of 81 patients with rectal carcinoma from January 2013 to January 2017 in the Hefei Second People’s Hospital were retrospectively analyzed. Based on the postoperative pathological results, the diagnostic accordance rates of CT and MRI on the T staging and N staging were calculated. Results The sensitivities of the CT and MRI on the preoperative T staging of rectal carcinoma were 69.1% (56/81) and 82.5% (52/63), the difference was not statistically significant (χ2=3.396, P=0.065), the Kappa values was 0.521 and 0.371, respectively, the MRI on the T staging was in a good agreement with the pathological diagnosis. The sensitivitie of the T1-2, T3, and T4 stagings with CT was 70.0%, 66.7%, and 72.0%, respectively, with MRI was 83.3%, 83.3%, and 81.0%, respectively, which had no significant difference respectively between the CT and the MRI. The areas under the receiver operating characteristic curve of the T1-2, T3, and T4 stagings with the CT and MRI were 0.809, 0.689, 0.798 and 0.897, 0.826, 0.869, respectively. The sensitivities of the CT and MRI on the preoperative N staging of rectal carcinoma were 59.3% (48/81) and 65.1% (41/63), the difference was not statistically significant (χ2=0.509, P=0.476), the Kappa values were 0.371 and 0.463, respectively. The sensitivities of the N0, N1, N2 stagings with CT were 64.7%, 45.5%, 64.0%, with MRI were 70.3%, 63.2%, 72.5%, which had no significant difference respectively between the CT and the MRI. Conclusions Results of in this study show that MRI is superior to CT for judgment of tumor infiltration. Neither CT nor MRI is able to provide satisfactory assessment of lymph node metastasis.
ObjectiveTo study the expression and significance of proliferating cell nuclear antigen (PCNA) and argyrophilia nucleolar organizer regions (AgNORs) in colorectal carcinoma (CRC) and carcinoma adjacent mucosa (CAM).MethodsThe expression of PCNA in 48 cases of colorectal carcinoma tissue, CAM and 10 cases of normal mucosa was detected by immunohistochemistry techniques. AgNORs was determined with argyrophilia stain. ResultsThe PCNAlabeling index (PCNALI) and AgNORs count in CRC were higher than that in CAM and normal mucosa(P＜0.01).The PCNALI in Dukes C and D stage was higher than that in Dukes A(P＜0.05). The AgNORs count in 3 cmCAM was higher than 6 cmCAM (P＜0.01) and normal mucosa(P＜0.05). ConclusionSome cells proliferative activity were abnormal in CAM. It indicates that CAM is in an unstable premalignant state, which might have some correlation with the relapse of colorectal carcinoma.
To study the significance of T-lymphocytes rDNA transcription activity in diagnosis, differential diagnosis, therapeutical effect and evaluation of treatment for colorectal carcinoma, 59 cases of colorectal carcinoma, 20 cases of colorectal inflammatory disease and 9 volunteers were choosen to detect the T-lymphocyte rDNA transcription activity of peripheral blood T-lymphocyte by cell culture and CMIAS008 image analysis system of Ag-NOR. Results: T-lymphocytes rDNA transcription activity was decreased obviously in colorectal inflammatory patients. Compared with control group, both group showed markedly statistical difference (Ｐ＜0.01). Tlymphocytes rDNA transcription activity increased gradually to normal groups after operation and chemical treatment for colorectal carcinoma patients; but it decreased for recurrent patients three years after operation. Conclusions: The detection of T-lymphocytes transcription activity can be used as a differential criterion for colorectal carcinoma and colorectal inflammatory disease, meanwhile it also can be used as a reference criterion for evaluation of treatment and supervision of tumor recurrence.
ObjectiveTo evaluate the significance and effect for surgery of Dukes D stage colorectal carcinoma. MethodsEightytwo cases of Dukes D stage colorectal carcinoma who underwent surgery from 1991 to 1998 were analyzed retrospectively. ResultsTwentyone patients experienced extended resections,29 patients palliative resection, 19 patients sideside anastomosis and 13 patients laparotomy and biopsy of the tumor. Patients with extended resections had significantly long survival time, quality of life in these patients were excellent in 71.4%, good in 23.8%, and fair in 4.8%; whereas quality of life in the group with palliative resections were excellent in 62.1%, good in 17.2%, fair in 13.8%, and poor in 6.9%. The other two groups had a bad postoperative effect, short survival time and poor quality of life. ConclusionIf the patients with Dukes D stage colorectal carcinoma have operative indications,surgical therapy should be actively performed and the postoperative survival rate and quality of life can be improved.
The oncogene ras p21 expression and DNA content in 46 cases of colorectal tumor were analysed quantitatively with flow cytometry and cyto-immunofluorescence staining technique. The results showed that the positive rate of ras p21 expression was 65.7% and the rate of DNA aneuploid was 74.3% in colorectal carcinomas. Ras p21 expression was higher in colorectal adenocarcinomas than that of the adenomas and normal mucosa. DNA ploid and proliferative index had some association with ras p21 expresssion. Detection of ras p21 expression and DNA content in tumors may be helpful in predicting the outcome of colorectal cancer patients.
Objective To investigate the features of extracolonic carcinoma spectrum in Northeast Chinese with hereditary nonpolyposis colorectal cancer. Methods The extracolonic carcinoma spectrum’s characteristics of 85 families registered in strict conformity with the HNPCC Amsterdam criteriaⅡwere analyzed retrospectively. Results In the 85 HNPCC families， the tumorous patients were 509 cases，the primary tumors were 589 cases， among the total consisted of 219 cases of colon cancer， 91 cases of rectal cancer，and 279 cases of extracolonic cancer， the most common extracolonic carcinoma was lung cancer. Conclusions Extracolonic carcinoma is an important part of cancer spectrum in HNPCC family， and the common extracolonic carcinoma in Northeast of Chinese are lung cancer， gastric cancer， endometrial cancer， liver cancer， and esophagus carcinoma.
Objective To evaluate the relationship between leptin level in serum and clinicopathologic features of colorectal cancer. Methods ABC-ELLSA was used to detect the leptin level in 30 cases of colorectal cancer without dystrophy (cancer group) and 24 normal controls (control group). The expressions of K-ras， p53， adenomatous polyposis coli （APC） gene and delete in colorectal carcinoma gene (DCC) mRNA of the tumor were examined by RT-PCR, the levels of serum CEA and CA19-9, and other clinicopathologic features were also recorded. Results The leptin level in cancer group 〔（3.53±1.72） μg/L〕 was higher than that in control group 〔（2.27±1.01） μg/L〕, P＜0.05, and the difference was independent on gender. There were no significant differences of leptin level in different tumor stages and different tumor location （Pgt;0.05）. Leptin level of poorly differentiated tumor was obviously lower than that of well differentiated and moderately differentiated tumor （P＜0.05）. There were no associations between leptin level and the levels of CEA and CA19-9, likewise there were no associations between leptin level and the expressions of K-ras, p53, APC and DCC in tumor （Pgt;0.05）. Conclusion The leptin level of colorectal cancer patient is higher than that of normal person, which is affected by the differentiation of tumor. But there are no significant correlations between the level of leptin in serum and TNM stage, tumor location, tumor markers of serum, K-ras, p53, APC or DCC in tumor.