结直肠癌组织PTEN、NDRG1和LDH-5表达与临床病理特征和预后的关系

【目的】探讨结直肠癌组织人第10号染色体缺失的磷酸酶及张力蛋白同源基因(PTEN)、N-MYC下游调节基因-1(NDRG-1)和乳酸脱氢酶-5(LDH-5)表达与临床病理特征和预后的关系。【方法】回顾性分析2014年3月至2017年5月在本院接受手术切除治疗的168例结直肠癌患者的临床资料。采集患者结直肠癌组织以及距离癌组织边缘5cm的癌旁组织,采用免疫组织化学法检测结直肠癌组织及癌旁组织PTEN、NDRG1和LDH-5表达。分析PTEN、NDRG1和LDH-5表达与直肠癌临床病理特征和预后的关系。【结果】结直肠癌组织中PTEN阳性率明显低于癌旁组织(49.4%vs92.9%),而NDRG1阳性率(79.8%vs54.8%)、LDH-5阳性率(67.9%vs8.9%)明显高于癌旁组织,其差异均有统计学意义(P<0.05)。结直肠癌组织中PTEN、NDRG1表达与淋巴结转移有关(P<0.05);LDH-5表达与分化程度、TNM分期和淋巴结转移有关。PTEN阳性患者5年生存率明显大于阴性者(46.9%vs20.0%),LDH-5阳性者5年生存率明显小于阴性者(26.3%vs50.0%),其差异均有统计学意义(P<0.05)。【结论】结直肠癌组织PTEN表达减少,NDRG1、LDH-5表达增加,且与患者临床病理特征相关,其中PTEN和LDH-5与患者5年生存率密切相关,可作为结直肠癌患者远期生存情况的评估指标。     

结直肠癌组织多配体蛋白聚糖-4(SDC4)蛋白表达与临床病理参数及短期预后的关联

目的 探究结直肠癌组织多配体蛋白聚糖-4(SDC4)蛋白表达与临床病理参数及短期预后的关联。方法选取2016年1月至2020年1月收治的结直肠癌患者70例。收集患者临床资料,免疫组化法检测结直肠癌组织SDC4表达,并分析其与临床病理特征以及短期预后的关系。结果 在结直肠癌组织中SDC4与年龄、性别、肿瘤直径、淋巴结转移、Dykes分期等病理特征无关(P>0.05),在分化程度低、浸润程度深(浆膜外)的结直肠癌患者中SDC4的表达显著降低(P<0.05)。经过2年随访后,70例结直肠癌患者生存率为72.86%(51/70)。SDC4低或无表达组的生存率为67.27%(37/55),SDC4高表达组的生存率为93.33%(14/15),两组比较差异有统计学意义(χ²=4.048,P=0.044)。单因素分析发现SDC4表达、分化程度、Dukes分期与结直肠癌的不良预后有关,将上述单因素引入多因素Cox回归模型分析发现SDC4表达、分化程度、Dukes分期是结直肠癌患者独立预后的指标。结论 结直肠癌组织SDC4的表达与临床病理特征及短期预后密切相关,有成为预...     

KPNA2在结直肠癌组织中的表达及临床意义

目的探讨结直肠癌组织中核转运蛋白KPNA2的表达及其与结直肠癌临床病理特征之间的关系。方法收集110例原发性结直肠癌患者的肿瘤组织及对应的正常肠黏膜组织,应用免疫组化法检测组织中KPNA2的表达水平,分析其表达与临床病理特征及预后的关系。结果 KPNA2在结直肠癌组织中的表达明显高于正常组织,并且其高表达与组织分化、Dukes分期、T分期、N分期及M分期有关(P 0. 05)。Kaplan-Meier法分析结果显示,KPNA2蛋白高表达的患者5年总生存率低于低表达的患者(P 0. 05)。结论结直肠癌组织中KPNA2的表达明显升高,KPNA2高表达可能促进了结直肠癌的发生和发展,具有成为判断结直肠癌预后的潜在价值。     

结直肠癌患者癌组织DPD和CISD2及NAT10表达与预后的相关性

目的 观察结直肠癌患者癌组织DPD、CISD2、NAT10表达变化,探讨其与结直肠癌患者预后的相关性。方法 2016年1月—2017年1月中国人民解放军北部战区总医院诊治结直肠癌患者143例,均行手术治疗,术后采用5-氟尿嘧啶化疗。记录患者临床分期、远处转移情况等临床病理资料,采用免疫组织化学法检测手术切除的结直肠癌及癌旁组织DPD、CISD2、NAT10表达情况,分析癌组织DPD、CISD2、NAT10表达与结直肠癌患者临床病理特征的关系。随访5年,根据生存情况将143例患者分为预后良好组101例和预后不良组42例,比较2组临床病理特征及癌组织DPD、CISD2、NAT10阳性表达率;采用多因素Cox回归分析结直肠癌患者预后不良的影响因素;采用相加模型分析结直肠癌组织CISD2、NAT10表达对DPD表达的交互作用。结果 结直肠癌组织DPD、CISD2、NAT10阳性表达率(56.64%、51.75%、53.15%)均高于癌旁组织(18.88%、28.67%、26.57%)(P<0.05)。癌组织DPD、CISD2、NAT10阳性表达的结直肠癌患者临床分期Ⅲ期(64.20%、6...     

胸苷磷酸化酶在结直肠癌中的表达及其对预后的影响

目的检测胸苷磷酸化酶（thymidine phosphorylase,TP）在人结直肠癌组织中的表达水平,分析其与结直肠癌不同临床病理特征、预后的关系。方法对42例术后病理证实为结直肠癌的患者,采用免疫组织化学S-P法检测TP的表达水平。并对全部病例进行随访。评价患者TP表达情况与患者临床病理特征、预后的相关性。结果TP表达的阳性率随Dukes分期的升高而升高（χ^2=6.528,P〈0.05）。TP表达的阳性率随病理分级的增加而升高（χ^2=14.143,P〈0.01）。TP阳性表达者5年生存率为15.4%,而TP阴性表达者则为87.5%,二者远期生存之间差异有统计学意义（χ^2=21.618,P〈0.01）。结论 TP的高表达与结直肠癌患者预后不良有关,TP表达可作为结直肠癌患者的独立预后因素。     

结直肠癌患者转录因子PRR13的表达与肿瘤临床和病理特征及预后的相关性研究

目的研究PRR13基因在结直肠癌组织和正常组织中的表达特点,分析不同染色程度所代表的意义与结直肠癌临床及病理特征之间的联系,以及该基因与结直肠癌患者生存预后的可能相关性。方法采用回顾性研究方法,收集2012年1月至2013年12月于首都医科大学附属北京友谊医院经病理确诊的161例结直肠癌患者的手术肿瘤标本和包含肿瘤部位、浸润深度、分化类型、p TNM分期、淋巴转移、和远处转移及生存预后等信息的临床资料。采用免疫组织化学法检测正常结直肠黏膜、结直肠癌病灶中PRR13蛋白的表达,分析结直肠癌组织中PRR13蛋白表达与临床病理因素的关系,采用Kaplan-Meier生存曲线分析结直肠癌组织中PRR13蛋白表达与患者预后的关系,采用Cox单因素回归和多因素回归分析结直肠癌预后的影响因素。结果在结直肠正常组织中PRR13蛋白大部分在细胞核中表达(142/145,97.9%),仅少部分正常组织标本细胞质中存在该蛋白(27/145,18.6%);在癌组织中,PRR13蛋白在细胞核中的表达明显降低(30/145,20.7%),大部分是无表达(131/145,79.3%),而在细胞质的表达较正常组织的表达明显升高(61/145,42.1%)。PRR13基因表达的高低,与肿瘤的分化类型、p TNM分期、淋巴转移、远处转移有显著的统计学相关性(P 0.05);而与患者性别、年龄、肿瘤部位、黏液结构、浸润深度等因素无相关性(P 0.05)。此外,PRR13高表达的患者较低表达的患者,其5年生存率显著下降,差异具有统计学意义(P 0.01)。结论结直肠癌中PRR13基因表达的强弱,可在一定程度上反映其相应的临床及病理特征,并且PRR13的表达可作为判断结直肠癌患者预后的指标之一。     

术前中性粒细胞/淋巴细胞比值在结直肠癌患者预后评估中的价值

目的探讨结直肠癌患者术前外周血中性粒细胞/淋巴细胞比值(NLR)对预后的影响及预测价值。方法回顾性分析166例结直肠癌患者的临床病理资料,根据术前外周血NLR,将患者分为低NLR组(NLR4)和高NLR组(NLR≥4),比较两组患者的临床病理特征和术后5年生存率,并进行预后分析。结果低NLR组和高NLR组结直肠癌患者术后5年生存率分别为57.2%和31.4%,差异有统计学意义(P0.05)。单因素分析显示,高NLR、临床分期晚、淋巴结转移及肿瘤远处转移是结直肠癌患者预后的危险因素(P0.05)。多因素预后分析证实,NLR是影响结直肠癌患者预后的独立危险因素(P0.05)。结论术前外周血NLR可作为结直肠癌患者的预后指标,NLR高者预后差。     

E-cadherin和整合素α5β1的表达与结直肠癌生物学行为和预后的关系

目的：探讨E-cadherin、整合素α5β1的表达与结直肠癌生物学行为及预后的关系。方法：采用免疫组织化学染色法检测41例结直肠癌组织标本中E-cadherin和整合素α5β1的表达情况,另外取距癌灶大于10 cm的肠组织为正常对照。结果：E-cadherin在结直肠癌的正常表达率为51%,显著低于正常组织（100%,P〈0.01）。E-cadherin低表达组5年生存率为43%,正常表达组5年生存率为61%（P﹤0.05）。在癌组织中整合素α5β1高表达的比例为61%,显著高于正常组织的20%（P〈0.01）;E-cadherin的表达与结直肠癌的Duke＇s分期和有无淋巴结转移有关,分期晚,E-cadherin低表达的比例高,且淋巴结有转移组低表达比例明显升高;整合素α5β1也与结直肠癌的Duke＇s分期和有无淋巴结转移有关,分期晚,整合素α5β1高表达的比例高（P〈0.01）,且淋巴结有转移组高表达比例明显升高（P〈0.01）;其高表达组5年生存率为41%,低表达组5年生存率为59%,比较差异有统计学意义（P〈0.05）。结论：E-cadherin及整合素α5β1对结直肠癌生物学行为均有明显影响,E-cadherin的正常表达将显著降低大肠癌的浸润和转移能力,患者预后较好;整合素α5β1高表达促进大肠癌浸润和转移,患者预后欠佳;E-cadherin和整合素α5β1在结直肠癌的发病机制中可能起着协同作用,两者的联合检测或许可以成为临床判断结直肠癌生物学行为及预后的重要参考指标。     

SULT2B1在结直肠癌组织中的表达及临床意义

目的探讨硫酸基转移酶2B1(SULT2B1)在结直肠癌组织中的表达及临床意义。方法选择山东阳光融和医院采用外科手术治疗的结直肠癌患者160例。采用PCR、免疫组化法测定结直肠癌组织、癌旁组织及淋巴结组织中SULT2B1蛋白表达情况。分析SULT2B1蛋白与结直肠癌患者临床病理特点及预后的关系。结果 SULT2B1 mRNA在癌组织和转移淋巴结中表达水平均高于癌旁组织和非转移淋巴结组织(P0.05),SULT2B1蛋白阳性111例(69.4%)高于癌旁组织52例(32.5%)(P0.05)。SULT2B1蛋白与结直肠癌患者的年龄、TNM分期、分化程度、浸润水平、淋巴结和远处转移情况相关(P0.05)。与结直肠癌患者的性别、脉管受累、肿瘤直径无关(P≥0.05)。结直肠癌患者的5年总生存率为51.78%,其中SULT2B1阴性患者为63.57%,阳性患者为28.75%,对比阳性表达者,SULT2B1阴性表达患者的生存时间更长(P0.05)。结论 SULT2B1在结直肠癌组织中呈高表达,SULT2B1阳性表达患者预后差。     

Pgp1和FoxP3在结直肠癌中的表达及其与预后的关系

目的探讨P-糖蛋白1(Pgp1)和核转录因子蛋白3(FoxP3)在结直肠癌中的表达及其与预后的关系。方法选取2012年2月至2015年2月我院保存的结直肠癌标本106例,同时选取癌旁组织标本64例作为对照,采用免疫组化染色法检测Pgp1和FoxP3表达,同时根据Pgp1和FoxP3表达情况将患者分为Pgp1和FoxP3双阴性表达(A组),Pgp1单阳性表达(B组)、FoxP3单阳性表达(C组),Pgp1和FoxP3双阳性表达(D组)。结果结直肠癌组织Pgp1和FoxP3蛋白阳性表达率分别为63.21%和43.40%,明显高于癌旁组织(P0.05);结肠癌Pgp1蛋白阳性表达率为78.95%,明显高于直肠癌(P0.05);FoxP3表达与患者临床病理特征以及治疗方案无明显关系(P0.05);B组中位总体生存时间为52个月(95%CI:40.01～63.99),明显高于A组、D组和C组(P0.05);A组和D组中位总体生存时间为40个月(95%CI:31.20～48.80)和34个月(95%CI:30.74～37.26),明显高于C组的24个月(95%CI:18.56～29.44),比较差异具有统计学意义(P0.05)。结论 Pgp1和FoxP3表达与结直肠癌临床病理特征关系较弱,其中仅Pgp1表达与肿瘤位置有一定相关性;Pgp1和FoxP3表达与结直肠癌患者预后有一定关系,其中Pgp1阳性表达,FoxP3阴性表达者预后较好。     

Hereditary colorectal cancer

This article summarizes the genetics of colorectal cancer (CRC), a disease in which 15% to 20% of cases are inherited. Familial adenomatous polyposis and hereditary nonpolyposis CRC represent the two most common forms of inherited CRC. One particular mutation, APC11307K, is associated with CRC in certain Jewish populations. Inherited cancers can be prevented with careful attention to regular and frequent sigmoidoscopy or colonoscopy screening intervals and the prompt removal of premalignant polyps. The role of the nurse should include the prompt identification and referral of high-risk individuals. Ongoing patient and family counseling and education, multidisciplinary collaboration, support for primary prevention, and intensive screening are essential.     

Preventing colorectal cancer

Knowledgeable patients should not die of colorectal cancer. Increasing the intake of dietary fiber, decreasing fat consumption, and increasing the use of modern technology to detect adenomatous polyps and early cancer can greatly decrease the mortality associated with colorectal cancer.     

Targeted therapy in colorectal cancer

Advances in chemotherapeutic agents have led to improved outcomes for patients with metastatic colorectal cancer (CRC). Chemotherapies, however, are limited by their toxicities and lack of specificity. Aberrations in the regulation and expression of growth factors have been implicated in the development of CRC, and this understanding has led to the development of targeted agents. In 2004, two novel agents, bevacizumab and cetuximab, were approved by the US Food and Drug Administration for the treatment of metastatic CRC. Bevacizumab, a humanized monoclonal antibody to vascular endothelial growth factor, and cetuximab, a human-mouse chimeric monoclonal antibody to the epidermal growth factor receptor, have changed the field dramatically. Bevacizumab appears to augment the efficacy of combination chemotherapy regimens for the treatment of metastatic CRC in both the first- and second-line settings, and the role of bevacizumab as part of adjuvant treatment is the subject of ongoing trials. However, because of the increased incidence of serious arterial thromboembolic events, gastrointestinal perforations, bleeding complications, and hypertension associated with bevacizumab, this agent is probably not indicated in all circumstances. Combination treatment with cetuximab and irinotecan appears appropriate in patients with advanced CRC who have failed irinotecan. Patients who are unable to receive additional irinotecan may be treated with cetuximab monotherapy. Positive epidermal growth factor receptor status by immunohistochemistry of a tumor specimen is presently mandated to determine candidacy for this therapy, although this assay appears to be suboptimal and newer assessment techniques to determine suitability for therapy must be developed. Phase III trials should shed light on the role of cetuximab in the first-line metastatic and adjuvant settings. Multitargeted strategies in CRC combining chemotherapy with bevacizumab and cetuximab are currently being explored. Further advances in the treatment of CRC are expected through continued scientific investigation and well-designed clinical trials.     

Biological therapy update in colorectal cancer

Introduction: At present, no drugs are available to hasten restoration of muscle function after injury. Platelet-rich plasma (PRP) therapies may help athletes by promoting muscle regeneration.

Areas covered: This is a systematic review assessing the evidence base for PRP therapies in the management of muscle injuries. A computerized literature search, citation tracking and hand searching for original studies assessing the effect of PRP therapies on skeletal muscle cell biology, skeletal muscle repair, or regeneration in animals or humans was performed. No randomized trials have studied the merits of PRP injections for muscle healing. Clinical studies indicated that PRP therapies may enhance muscle repair after strain or contusion, and laboratory data indicated that they can enhance diverse aspects of myogenesis. However muscle injuries present a complicated picture that includes many components other than muscle cells, such as blood vessels, connective tissue and neural components.

Expert opinion: The field is relevant but under-researched. No PRP formulation has yet displayed proven solid evidence for the stimulation of healing and recovery after sports muscle injuries. Therefore, major issues, including standardization of formulations and application procedures, need to be addressed to inform clinical studies before recommending best practice guidelines.     

Surgery for colorectal cancer in Greece

Objective The aim of this study is to analyse our experience and assess the outcome of surgery for colorectal cancer with curative intent in Greece.Methods During the last 10 years,550 patients were treated for colorectal cancer with curative intent.291(52.9%) of the patients suffered from colonic cancer while 259(47.1%) were operated for rectal cancer.Tumour site,Astler?Coller and TNM classifications and surgical procedures were recorded.Total mortality,morbidity and 5?year survival were evaluated.Results Morbidity rate was 12.0% and mortality rate was 0.68% for colonic cancer surgery,whereas the overall five year survival rate was 77.9%.Morbidity rate was 16.9% and mortality rate was of 0.38% for rectal cancer patients.The overall five year survival rate was 79.6%.Conclusion Morbidity,mortality rate and 5?year survival after colorectal surgery in our department in Greece are comparable to those published in the international literature.