【Abstract】ObjectiveTo study the expressions of matrix metalloproteinase 2 (MMP2) and carbohydrate antigen 50 (CA50) in colorectal carcinoma, cancer-adjacent mucosa （2 cm from the nether edge of tumor）, cancerdistant mucosa （5 cm from the nether edge of tumor） and normal colorectal mucosa, and to elucidate their effects on the development of colorectal carcinoma. MethodsThe expressions of MMP2 and CA50 were detected immunohistochemically in 40 cases of colorectal carcinoma, cancer-adjacent mucosa, cancer-distant mucosa and 10 cases of normal colorectal mucosa. Results①The expression intensity and positive rates of MMP-2 and CA50 increased significantly in turn by normal mucosa, cancer-distant mucosa, cancer-adjacent mucosa and colorectal carcinoma. ②The expression of MMP2 was correlated with CA50 in colorectal carcinoma. ③The expression of CA50 in colorectal carcinoma was closely associated with tumor differentiation, and the expression of MMP2 in colorectal carcinoma was closely associated with differentiation and Dukes stages as well. ConclusionOver expression of MMP2 facilitates the malignant progress of colorectal carcinoma; CA50 is a reliable marker of malignance in colorectal carcinoma; CA50 and MMP2 may have synergetic effects on the development of colorectal carcinoma.
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.
Objective To detect expression of CK20 mRNA in peripheral blood of patients with colorectal carcinoma and its clinical significance. Methods Using the reverse transcriptase-polymerase chain reaction (RT-PCR),CK20 mRNA expression was examined in peripheral blood from 42 patients with colorectal carcinoma before and after operation, 20 healthy volunteers, 20 fresh colorectal carcinoma samples. Results The positive expression rates of CK20 mRNA were 45.24%(19/42) and 33.33%(14/42) before and after operation in 42 colorectal carcinoma patients respectively. All 20 fresh colorectal carcinoma samples revealed expression of CK20 mRNA, but the 20 normal blood samples did not. Conclusion The detection of CK20 mRNA in peripheral blood is helpful to early diagnose, assess the prognosis and make a correct treatment of colorectal carcinoma.
Abnormal activation of Wnt signaling pathway is closely related to the occurrence of tumor, and T cell factor 4 (Tcf4) and β-catenin are important signal transmission factors of this pathway. The aim of the present study is to explore the significance and correlation between expression of Tcf4, β-catenin and secreted frizzled related protein 1(SFRP1), suppressor gene of Wnt signaling pathway, in colorectal carcinoma and their correlations to the clinicopathological factors. The expressions of Tcf4, β-catenin and SFRP1 were performed with immunohistochemistry staining in 97 cases of primary colorectal carcinoma and 40 cases of normal colorectal mucosa tissues. The results showed that the abnormal expression rates of Tcf4 and β-catenin in colorectal carcinoma were significantly higher than those in the control groups (P<0.01). The positive rate of SFRP1 was significantly lower than those in the control groups (P<0.01). The abnormal expression rates of Tcf4 and β-catenin were also related to the lymph node metastasis and Dukes stage (P<0.05). A significant correlation was found between the expressions of SFRP1 and Tcf4, β-catenin (P<0.05). Over-expression of Tcf4 and β-catenin was related to poor prognosis (P<0.05). But the survival rates of the group with SFRP1 expressions were higher than those in group without SFRP1 expressions (P<0.05). Cox multifactor regression analysis indicated that Dukes stage, expression of β-catenin and SFRP1 were independent risk factors of colorectal carcinoma (P<0.05). The results suggested that the abnormal expression of Tcf4 and β-catenin in colorectal cancer may be related to the reduced or absent expression of SFRP1. β-catenin accumulation in the nuclei formed complexes with Tcf4 is one of the important molecular switch maintaining colorectal malignant phenotype. The combined detection of these indexes may perform an important role in predicting the progression and prognosis of colorectal cancer, and could provide new molecular targets for gene treatment of colorectal cancer.
Objective The article explained how to build the data system and its running strategy in the mode of multi-disciplinary team （MDT） for colorectal carcinoma. Methods It illuminated the cause of the data system building, also described the essential composition of the data system and how to support the running of the data system, and it discussed the value feedback of the data system, lastly the author proposed the prospect of the data system building. Results The data system could work normally through consultation of doctors, follow-up, clinical support and appropriate implement of construction of information flow-sheet in colorectal carcinoma MDT mode. Conclusion As the foundation of colorectal carcinoma MDT, data system could show both medical and social value through change of medical mode.
Objective To investigate the prevalence of cellular FLICE-like inhibitory protein (cFLIP) alterations in colorectal cancer and their possible implications for the progression of colorectal cancer. Methods The long type cFLIP (cFLIPL) was examined in 43 colorectal cancer specimens and the matched normal colorectal specimens by immunohistochemistry. Immunohistochemical staining for cFLIPL was assessed on an arbitrary semi-quantitative scoring system. Stained cells were counted under the magnification field (×100) and at least 20 fields per case were examined. Fields with non-stained cells were scored 0; fields with stained cells less than 5% were scored 1; fields with stained cells from 5% to 25% were scored 2; fields with stained cells between 26% and 50% were scored 3; and fields with stained cells more than 50% were scored 4. According to the above schedule， a mean score of each specimen was calculated. Results cFLIPL protein expressions of variable intensity and extent were detected in the normal colorectal mucosa and adenocarcinomas. cFLIPL was mainly expressed in the cytoplasma. The positive cells were distributed in diffuse manner. The mean expression score in normal mucosa ranged from 0 to 2.95 (mean score: 1.55±0.86); 4.7%(2/43) of all cases were unstained and 20.9%(9/43) showed a weakly stained pattern (0＜mean score≤1); 74.4%(32/43) of all cases were positively stained (1.00＜mean score≤2.95), respectively. cFLIPLprotein was expressed in all adenocarcinomas and the score ranged from 0.80-4.00 (mean score: 3.06±0.75); 62.8% (27/43) of the tumors examined were predominantly cFLIPL positive (mean score ＞3), 34.9%(15/43) of the tumors were cFLIPLpositive (1＜mean score ≤3) and only one case was cFLIPL weakly positive (score: 0.80). 72.1% (31/43) of adenocarcinomas expressed cFLIPLmore intensely and extensively than matched normal colonic mucosa. cFLIPL expression of colorectal cancer was significantly higher than that of matched normal mucosa, which was statistically significant (P＜0.01). The extent of cFLIPL expression in tumors was independent of Dukes stage, tumor stage, gross type of tumor, histological type, or lymph and hepatic metastasis. Conclusion The expression level of cFLIPL in adenocarcinomas is much higher than that in matched normal mucosa. Overexpression of cFLIPL is a tumor-specific phenomenon, which can provide a selective growth advantage for colorectal cancer cells to escape from death receptor-mediated apoptosis.
We evaluated the surgical results in 32 patients with liver metastasis from colorectal carcinoma. Twenty four patients had 1-3 metastatic hepatic nodules and 20 patients had synchronous hepatic metastasis. Liver resection was carried out simultaneously with radical resection of the primary tumour in 15 patients, 5 patients experienced resection 2 to 4 weeks later. Liver and primary tumour were resected as a whole in 5 patients with infiltrating metastasis from colonic carcinoma.Other operative types included atypical resections, left lateral lobectom and right posterior lobectomy, and right hemihepatactomy, right trilobectomy.Hepatic metastasis were all documented by pathology. The 3year and 5year survival rate were 37.5% and 25.0%, with no operative death. The authors believed that the number of metastasis is the most important factor influencing the surgical result, and liver resection is an effective form of treatment for patients with resectable liver metastasis from colorectal carcinoma, but the type of surgery shall be choosed reasonably.
【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 investigate the effects of X-ray dose on the expressions of microRNA-221 （miR-221） and phosphatase and a tensin homolog deleted from chromosome10 （PTEN） in human colorectal carcinoma （CRC） cells. Methods Human CRC-derived cell line， Caco2， was cultured conventionally. The cells were divided into five groups and exposed to different doses of X-ray （0， 2， 4， 6， and 8 Gy） respectively. The total RNA and protein of the Caco2 cells were extracted after irradiation， and the miR-221 and PTEN mRNA expressions were detected by real-time RT-PCR.Moreover， the protein alteration of PTEN in Caco2 cells was detected by Western-blot analysis. Results The radiation dose of X-ray significantly affected the expressions of miR-221 and PTEN protein in human Caco2 cells in a dose-depen-dent manner. Moreover， the miR-221 expression level was up-regulated gradually with the increase of irradiation dose， on the contrary， the PTEN protein expression level was down-regulated gradually （P＜0.01）. Conclusion The radiation dose can affect the miR-221 and PTEN protein expression pattern in CRC cells.
Objective To investigate the effect and clinical significance of 3 d and 1 d bowel preparation method for colorectal carcinoma surgery on preoperative gut mucosal barrier function. Methods Plasma levels of D-lactate (D-LAC), diamine oxidase (DAO) and endotoxin (ET) were measured at 2 h before operation in 3 d bowel preparation group (50 cases) and 1 d bowel preparation group (50 cases), 25 cases of inguinal hernia were included as control group. D-LAC, DAO and ET were detected by using enzymatic spectrophotometric assay, spectrophotometric assay and limulus lysate test with azo chromogenic substrate, respectively. Results Preoperative plasma levels of D-LAC, DAO and ET in 3 d bowel preparation group were (10.25±1.43) mg/L, (5.82±0.80) U/ml and (10.11±1.41) ng/L respectively. In 1 d bowel preparation group the corresponding values were (10.19±1.35) mg/L, (5.80±0.81) U/ml and (9.82±1.35) ng/L respectively. There were no significant differences between 3 d and 1 d bowel preparation group (Pgt;0.05), compared with hernia group, 1 d and 3 d bowel preparation group were also no statistically significant differences (Pgt;0.05). Conclusions There are no significant preoperative gut mucosal barrier function damages in patients with 1 d and 3 d bowel preparation for colorectal carcinoma surgery, 1 d bowel preparation for colorectal carcinoma surgery can be performed in colorectal carcinoma patients, and 3 d bowel preparation can be used for certain special colorectal carcinoma patients.