Expressions of connexin and par-3 in the distal margin of rectal cancer after ultra-low anterior resection |
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Authors: | Jun Liu Weikang Zhang Jinlin Liu Xiaoming Lu Yaoping Long Yancai Zhou Shenghong Liu |
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Institution: | 1. Department of Gastroenterological Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology,Wuhan 430022, China 2. Department of Histology and Embryology, School of Basic Medical Sciences, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China |
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Abstract: | Summary This study examined the expression of connexin and protease-activated receptor 3 (par-3) in the distal resection margin of
rectal cancer and the correlation of the expression of the two proteins with tumor relapse. A total of 40 patients with rectal
cancer underwent ultra-low anterior resection with curved cutter stapler. The pathological specimens were divided into 3 groups
in terms of sampling sites: tumor group, 2.0-cm group (in which the tissues were harvested 2.0 cm distal to the tumor tissues),
3.0-cm group (in which the tissues were taken 3.0 cm away from the tumor tissues). All the samples were pathologically observed
and then measured for the expression of connexin and par-3 by employing immunohistochemistry and Western blotting. The operations
in this series went uneventfully. No anastomotic stoma bleeding, stenosis and death occurred postoperatively. Histopathologically,
in the tumor group, epithelial cells lost normal pattern of arrangement and polarity, and were loosely connected and even
detached. In the 3.0-cm group, the epithelia had normal appearance, obvious cell polarity and essentially intact cell junction.
Immunohistochemistry and Western blotting indicated that the 3.0-cm group had the strongest expression of connexin and par-3,
and the expression in the 2.0-cm group and the tumor group was relatively weak. There existed significant difference in the
expression of the two proteins among the three groups (P<0.05 for all). It was concluded that the down-regulated connexin and par-3 in the distal margin of rectal cancer tissues
may indicate the progression of the disease and high likelihood of recurrence and metastasis. Although no tumor cells were
found in the sections of the 2.0-cm group, the decreased expression of connexin and par-3 may suggest the development of anaplasia
and the increased odds of tumor relapse. Therefore, we are led to speculate that tumor resection only including 2.0 cm of
unaffected rectum could not completely avoid the distant metastasis and local relapse. |
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Keywords: | rectal neoplasma curved cutter stapler ultra-low anterior resection protease-activated receptor-3 connexin |
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