机器人手术系统在结直肠手术的应用

腹腔镜手术改善了结直肠手术患者的短期预后且有着不劣于开腹手术的长期预后,但对骨盆狭窄的低位直肠癌男性患者或肥胖的右半结肠癌患者,因其空间窄、暴露困难及腔镜器械灵活不足,腹腔镜手术的开展存在一定难度。机器人手术系统有视野更清晰、操作更灵活等优点而逐渐在结直肠手术中得到推广,但目前对于机器人手术系统在结直肠领域的应用现状和效果并不明确。本文将从手术机器人在传统结直肠手术中应用、机器人结直肠手术新进展、机器人手术不足三方面进行综述。     

Preoperative Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio Cannot Predict Lymph Node Metastasis and Prognosis in Patients with Early Gastric Cancer: a Single Institution Investigation in China

In the present study, we aimed at exploring the applied value of preoperative neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) in the prediction of lymph node metastasis (LNM) and prognosis in patients with early gastric cancer (EGC). We retrospectively analyzed a total of248 consecutive patients who underwent curative gastrectomy to be identified T1 stage gastric adenocarcinoma between January 1, 2010 and May 1, 2016 in a single institution. According to median preoperative NLR and PLR value, we divided the patients into four groups: high NLR >1.73 and low NLR <1.73, high PLR >117.78 and low PLR <117.78. Furthermore, to evaluate the relationship between preoperative NLR and PLR values, we categorized patients according to cutoff preoperative NLR-PLR score of 2 [high NLR (>1.73) and high PLR (>117.78)], 1 [either high NLR or high PLR], and 0 [neither high NLR nor high PLR], Statistical analyses were conducted using SPSS 20.0 software. The results showed that the preoperative NLR or PLR values, lower or higher, could not predict the LNM in patients with EGC (both P=0.544>0.05). The invasive depth of tumor was significantly correlated with LNM of EGC (P0.001). Kaplan-Meier plots illustrated that preoperative NLR and PLR values were not associated with overall survival (OS) in patients with EGC. It was concluded that the preoperative NLR and PLR may be the predictors for LNM and prognosis in patients with advanced gastric cancer; nevertheless, they cannot predict LNM and prognosis in patients with EGC.     

TRIB3在未折叠蛋白反应中的作用

肿瘤细胞的内质网应激非常普遍,内质网内大量未折叠或错误折叠的蛋白质蓄积可诱发未折叠蛋白反应（UPR）.研究表明,初期UPR可保护细胞,恢复内质网功能和内环境稳态,后期则促进细胞凋亡.TRIB3是哺乳动物假性蛋白激酶家族Tribbles中的一员,其在UPR中起重要的枢纽作用,既能促进肿瘤细胞凋亡又可起保护作用.     

局部进展期中低位直肠癌新辅助放化疗疗效预测分子标志物的研究进展

新辅助放化疗作为局部进展期直肠癌推荐的术前标准治疗方案,在降低局部复发率、增加保肛率等方面具有明显优势。但因个体差异,不同病人对新辅助放化疗反应不同,部分病人不能从新辅助放化疗中获益甚至出现病情进展。目前用于预测局部进展期直肠癌新辅助放化疗疗效的分子标志物较多,但尚无分子标志物获得临床共识。随着生物组学技术发展,分子标志物的研究已从单个基因或蛋白向全基因组或蛋白组转变,为指导个体化新辅助放化疗提供更多依据。此文将探讨局部进展期中低位直肠癌新辅助分层治疗现状,综述新辅助疗效标志物。