微卫星不稳定Ⅲ期结肠癌患者术后单纯辅助化疗复发及转移危险因素

目的 探讨微卫星不稳定Ⅲ期结肠癌患者术后单纯辅助化疗复发及转移危险因素.方法 将82例Ⅲ期结肠癌患者术后通过免疫组化检测病灶组织的hMLH1、hMSH2及hMSH6抗体表达,分为高频组和普通组,对两组病理、化疗效果及生存预后等进行相关性分析.结果 应用hMLH1、hMSH2及hMSH检测82例Ⅲ期术后结肠癌患者发现:高...     

术后辅助化疗对伴有复发危险因素的ⅠB期非小细胞肺癌患者复发的影响研究

目的 探讨术后辅助化疗对伴有复发危险因素的ⅠB期非小细胞肺癌（NSCLC）患者复发的影响。方法 选取2016年1月至2019年1月沧州市中心医院肿瘤科收治的ⅠB期NSCLC患者380例。收集患者的临床资料[包括年龄、性别、肿瘤原发位置、肿瘤分化程度、病理学分型、手术类型、肿瘤直径、淋巴结清扫数量、美国东部肿瘤协作组（ECOG）评分、术后辅助化疗情况、胸膜浸润情况、吸烟史、脉管癌栓（分为血管癌栓和淋巴管癌栓）及合并脑血管病、心血管病、糖尿病、高血压情况]及无复发生存期（RFS）、无复发生存率。采用多因素Logistic回归分析探讨ⅠB期NSCLC患者复发的影响因素,采用Kaplan-Meier法绘制生存曲线。结果 380例患者中有194例复发,将其作为复发组,其余为无复发组。多因素Logistic回归分析结果显示,术后辅助化疗是ⅠB期NSCLC患者复发的保护因素,脉管癌栓、合并脑血管病是ⅠB期NSCLC患者复发的危险因素（P<0.05）。伴有复发危险因素（发生脉管癌栓、合并脑血管病）的ⅠB期NSCLC患者共238例,根据是否接受术后辅助化疗分为辅助化疗组（n=190）和未辅助化疗组...     

结直肠癌患者癌结节分期方法的初步研究

目的寻找更恰当的癌结节分期方法。 方法采用回顾性分析方法,收集2007年3月1日至2009年12月31日云南省肿瘤医院（昆明医科大学第三附属医院）大肠癌科收治的经病理学证实并行肠癌根治手术的原发性结直肠癌患者的临床资料和生存资料,进行统计分析。 结果淋巴结转移患者在癌结节阳性时的预后明显差于无癌结节患者（51.3% vs 74.9%,P=0.007）。多因素分析发现癌结节、术后辅助化疗是影响淋巴结转移结直肠癌患者总生存期的独立危险因素(P<0.05）;将癌结节纳入淋巴结转移计数后形成新nN分期和TNM分期（nN）中各分期有明显的预后差异（P<0.05）。多因素分析发现TNM分期（nN）仍是结直肠癌患者的预后影响因素,而第七版TNM分期已不是;将癌结节阳性患者按照癌结节检出1个、2个、3个为临界值分别分为两组,并比较两组患者的预后差异,结果只有按癌结节（tumor deposits,TD）=1来分组两组具有显著的预后差异（31.2% vs 61%,P=0.018）。 结论在淋巴结转移患者中第七版癌结节分期方法并不恰当,将癌结节纳入转移淋巴结计数形成的TNM分期评估预后的价值优于七版TNM分期标准,且较七版TNM分期标准更简化。     

术后全身化疗或腹腔化疗疗效比较——84例胃癌、结直肠癌分析

目的对84例老年胃癌．结直肠癌患者术后全身化疗或腹腔化疗作回顾性比较。方法分四组：A组剖腹探查术后全身化疗16例；B组剖腹探查术后全身化疗加腹腔化疗12例；C组根除术后全身化疗36例：D组根治术后腹腔化疗20例。结果腹腔化疗的毒副反应和对血象的影响较全身化疗小，术后18个月复查、C组发现转移1l／36例，D组3／20例，D组的腹腔扩散和脏器转移少，五年生存率最高45％，A、B组平均生存时间仅625月和630月。结论腹腔化疗的毒副反应小，患者耐受剂量大，对降低术后复发具有积极作用，是老年胃癌、结直肠癌患者根治术后比较理想的化疗方法。     

胸腺肽α1联合LV／5-Fu持续灌注预防老年结直肠癌术后复发

目的观察胸腺肽α1联合亚叶酸钙（LV）／5-氟尿嘧啶（5-Fu）化疗对老年结直肠癌术后患者治疗前后T淋巴细胞亚群变化,探讨该疗法预防老年结直肠癌术后复发的作用。方法将42例结直肠癌根治术后患者随机分为两组,对照组术后4—8周用LV／5-Fu方案持续灌注化疗6个周期;在此基础上,治疗组加用胸腺肽α1皮下注射,连续3a。治疗期间检测T淋巴细胞亚群变化。结果与对照组比较,治疗后1、2、38,治疗组CD3^＋、CD4^＋和CD4^＋／CD8^＋比值明显升高（P均〈0．05）;治疗后3a对照组复发率明显高于治疗组（P〈0．05）。结论老年结直肠癌患者术后化疗后定期给予胸腺肽α1治疗,可改善细胞免疫功能,对预防术后复发、转移有一定作用。     

综合评价EUS在结直肠癌分期及治疗中的应用价值

目的:评价超声内镜在结直肠癌分期及治疗中的应用价值.方法:对我科电子肠镜下病理活检确诊的56例结直肠癌患者行超声内镜术前TN分期,根据分期结果,行不同的手术方式治疗,结合术后病理分期,对2期及3期患者给予辅助化疗.并以术后病理为金标准,统计EUS检查TN分期诊断准确率,随访患者,分析2年内不同分期患者的复发率.结果:结、直肠癌EUS(T)分期准确率分别为:88.89%(T1),83.33%(T2),85.71%(T3),75.00%(T4),总准确率为83.23%;EUS(N)分期准确率分别为:81.25%(uN(+))和80.00%(uN(-)),总准确率为80.63%;随访显示共有6例患者出现复发,2期患者复发1例,3期患者复发5例,总复发率为10.71%.结论:EUS在结直肠癌分期及治疗中有指导价值.     

结直肠癌肝转移的预后因素

目的:评价结直肠癌肝转移的临床预后因素及治疗方案对预后的影响.方法:收集71例结直肠癌肝转移患者的临床资料及预后情况,用Kaplan-Meier生存分析及Log-rank检验进行单因素分析,将有统计学意义的预后因素纳入Cox回归模型进行多因素分析.结果:Kaplan-Meier单因素分析及Log-rank检验显示,肝转移灶最大直径、有无区域淋巴结转移及诊断肝转移时碱性磷酸酶(ALP)最高值3个因素对其预后影响有显著意义;将这3个预后因素纳入Cox回归多因素分析显示,有无区域淋巴结转移、诊断肝转移时ALP最高值是结直肠癌肝转移的独立预后因素.全组3种治疗方式比较差别无统计学意义,但对手术切除组和化疗组两组进行比较,差异有统计学意义(P<0.05),而局部治疗组和手术组之间,局部治疗组和化疗组之间差别无统计学意义.结论:肝转移灶最大直径、原发病灶有无区域淋巴结转移、诊断肝转移时最高ALP值是结直肠癌肝转移患者的预后因素;肝转移灶最大直径越小、无区域淋巴结转移、诊断肝转移时最高ALP值正常的患者预后越好;手术切除联合化疗目前是结直肠癌肝转移的首选治疗方案,可获得较好的远期生存.     

腹腔内温热灌注化疗对结直肠癌术后腹腔内复发的预防效果探讨

目的研究分析腹腔内温热灌注化疗对结直肠癌术后腹腔内复发的预防效果。方法将入四川省泸州市人民医院进行手术治疗的结直肠癌患者62例作为研究对象,所有患者就诊时间为2016年1月—2017年6月期间,将62例患者随机分为观察组和对照组,各31例。观察组患者术后进行腹腔内温热灌注化疗,对照组患者术后以常温进行灌洗,比较两组的治疗效果。结果术中、术后1个月、术后2个月,观察组患者IL-2、TNF-α水平明显高于对照组,差异有统计学意义(P<0.05);观察组患者腹腔内复发、肝转移人数比对照组低,3年生存人数高于对照组,差异有统计学意义(P<0.05)。结论腹腔内温热灌注化疗对结直肠癌术后腹腔内复发的预防效果较好,临床应用价值较高,应推广采纳。     

进展期结直肠癌患者术中行氟尿嘧啶腹腔区域性量化缓释化疗的效果观察

目的探讨进展期结直肠癌患者术中行氟尿嘧啶腹腔区域性量化缓释化疗的效果和安全性。方法将82例行结直肠癌根治术的患者随机分为植入组40例和对照组42例,两组均行标准根治手术,其中植入组于手术关腹前在瘤床、已侵犯组织的剥离面、淋巴清扫区域和血管根部以及肿瘤容易脱落的部位分多点植入氟尿嘧啶植入剂。观察两组肛门排气时间、伤口感染情况、引流量、吻合口漏及肠梗阻发生情况、住院时间、1 a内局部复发情况。结果两组手术均顺利,术后均无吻合口漏、肠梗阻发生,肛门排气时间、伤口感染率及住院时间均无显著差异;植入组每日引流量显著大于对照组,1 a内局部复发率显著低于对照组(P均<0.05)。结论进展期结直肠癌患者术中行腹腔区域性量化缓释化疗安全可靠,是预防结直肠癌局部复发的有效途径。     

老年结直肠癌患者手术风险及预后

目的分析老年结直肠癌患者的临床病理特点及影响手术预后因素。方法手术治疗的结直肠癌患者300例,分析不同年龄结直肠癌患者的临床及病理资料,采用多因素COX分析评价影响老年组术后复发的危险因素及3、5年生存率和无病生存率。结果≥70岁组高中分化腺癌比例、TNM分期Ⅲ~Ⅳ期、区域淋巴结转移、腹腔及远处转移发生率均显著高于70岁组(P0.05)。COX多因素分析提示,TNM分期、组织类型、区域淋巴结转移、腹腔及远处转移均为影响≥70岁结直肠癌患者预后的相关因素。≥70岁组3年生存率为57.66%(79/137),3年无病生存率为48.91%(67/137);5年生存率为24.82%(34/137),5年无病生存率为21.17%(29/137)。结论应对TNM分期高、组织类型为高中分化腺癌、存在区域淋巴结转移、腹腔及远处转移的≥70岁结直肠癌患者加强术后监测,以降低术后复发率,提升患者术后生存率。     

Decreased plasma gelsolin levels in patients with Plasmodium falciparum malaria: a consequence of hemolysis?

Mammalian plasma contains a high-affinity actin-binding protein, plasma gelsolin, that severs actin filaments. Destruction of erythrocytes could result in the release of erythrocyte cytoskeletal actin into the plasma where it could bind to gelsolin. If the clearance of actin- gelsolin complexes exceeds its synthesis, lowering of the plasma gelsolin concentration might follow. To test this hypothesis, we measured plasma gelsolin levels in patients with falciparum malaria, a disease where at least part of the hemolysis takes place in the intravascular space and that is usually not accompanied by dysfunction of other organs. Two functional gelsolin assays showed that the mean plasma gelsolin concentration of 18 Nigerian children with Plasmodium falciparum malaria was less than 50% (P less than .001) of healthy Nigerian control subjects tested at the same time. Patients with pneumonia and febrile seizures also had depressed gelsolin levels, which indicates that factors other than hemolysis can lower gelsolin concentrations. Gelsolin levels were measured in 11 patients from The Gambia with P falciparum malaria before and approximately 3 weeks after treatment. In all cases the gelsolin level increased after treatment. To confirm the hypothesis that hemolysis can result in a lowering of plasma gelsolin levels, hemolysis was induced in rabbits, either acutely (by the injection of human serum) or subacutely (by the administration of phenylhydrazine). A fall in plasma gelsolin levels was seen, the rate of fall differing with the extent of hemolysis. Affinity adsorption of plasma from animals undergoing acute hemolysis with Sepharose beads coupled to the actin-binding protein DNase I, followed by immunoblotting of adherent proteins with antiactin antiserum demonstrated the presence of actin in circulating rabbit plasma. These studies suggest that under some conditions components of the red cell cytoskeleton are exposed to plasma proteins and that accelerated clearance of actin-gelsolin complexes may explain in part the depressed plasma gelsolin levels seen in patients with falciparum malaria.     

Plasma amino acid levels in patients with colorectal cancers and liver cirrhosis with hepatocellular carcinoma

BACKGROUND/AIMS: A variety of cancer-bearing patients have been shown to have disturbances in carbohydrate, lipid and protein metabolism. The complex of metabolic derangements of protein in cancer patients may be reflected by alteration in the plasma free amino acid profile. In this study, we try to investigate the plasma free amino acid profile in patients with colorectal cancer and liver cirrhosis with hepatocellular carcinoma, which are the most common cancers in Taiwan. METHODOLOGY: Fasting venous blood samples were drawn from sixteen control volunteers and 42 cancer-bearing patients including 14 early stage colorectal cancer patients (Duke A and B), 18 late stage ones (Duke C and D) and 10 liver cirrhotic patients with hepatocellular carcinoma. Seventeen amino acid levels were measured using a Beckman amino acid analyzer. RESULTS: About one third of early or late colorectal cancer patients had body weight loss more than 10% in half a year and were defined as malnourished. For individual amino acids, in early colorectal cancer patients, the plasma level of most essential amino acids and non-essential amino acids decreased (significantly in Tyr, Ala, Met, Phe and Thr). In late stage colorectal cancer patients and patients with liver cirrhosis with hepatocellular carcinoma, plasma levels of most essential amino acids and non-essential amino acids decreased more obviously. For group amino acids, the plasma levels of essential amino acids, non-essential amino acids, gluconeogenic amino acids and branched-chain amino acids were also lower in the cancer patients than those in control volunteers. The difference was also noticeably significant in patients with late stage colorectal cancer and liver cirrhosis with hepatocellular carcinoma. The plasma free amino acid patterns in colorectal cancer patients are quite different from those in patients with non-gastrointestinal cancer and weight loss. The plasma level of essential amino acids and branched-chain amino acids was not kept within normal range in colorectal cancer patients. Elevation of plasma aromatic amino acids and methionine levels usually observed in liver cirrhotic patients without hepatocellular carcinoma was not apparent in our cirrhotic patients with hepatocellular carcinoma. CONCLUSIONS: The plasma free amino acid patterns in our colorectal cancer patients and cirrhotic patients with hepatocellular carcinoma were rather characteristic. The results will offer useful tools for improving diagnosis and therapy.     

Selenoprotein levels in patients with colorectal adenomas and cancer

OBJECTIVES: Selenium is a trace mineral that, as a constituent of certain selenoproteins, acts as an antioxidant. Results of studies addressing a cancer protective effect of selenium have been controversial. The present study measured selenoprotein-P, extracellular glutathione peroxidase, and plasma selenium in patients with colon cancer and adenomatous colon polyps to determine whether patients who develop colorectal adenomas or cancer are selenium deficient. METHODS: Patients who presented to an endoscopy center for colonoscopy or who were referred to our institution with a newly diagnosed colorectal cancer were offered enrollment in the trial. Each patient underwent phlebotomy, usually immediately after colonoscopy. In all, 103 patients were enrolled in the study. Of these, 33 patients were found to have colorectal cancer, 35 adenomatous colon polyps, and 17 normal examinations. A total of 18 patients had other diagnoses and were not included in the study group. RESULTS: The mean age for the colorectal cancer group was 69 yr, for the adenomatous colon polyp group 62 yr, and for the normal group was 56 yr. The adenomatous colon polyp and normal groups were predominantly female. Based on one way analysis of variance tests, there was no significant difference in selenoprotein-P or plasma selenium levels or extracellular glutathione peroxidase activity among the three groups (p = 0.28, 0.098, and 0.35 respectively). CONCLUSIONS: The present data suggest that patients with adenomatous colon polyps and those with colorectal cancer are not selenium deficient.     

Plasma levels of progastrin but not amidated gastrin or glycine extended gastrin are elevated in patients with colorectal carcinoma

BACKGROUND: The relationship between plasma gastrin levels and colorectal cancer is controversial. When confounding factors which increase plasma gastrin levels are taken into account, it has been shown that gastrin levels are not elevated in patients with colorectal cancer. However, these studies only measured amidated gastrin. Total gastrin (which includes unprocessed, partially processed, and mature forms of gastrin) has been shown to be elevated in patients with colorectal cancer. AIMS: The aim of this study was to determine whether fasting plasma levels of progastrin, amidated gastrin, or glycine extended gastrin are elevated in patients with colorectal cancer or colorectal polyps compared with controls. METHODS: Progastrin, amidated gastrin, and glycine extended gastrin were estimated by radioimmunoassay using the following antibodies: L289, 109-21, and L2. Blood samples were analysed for Helicobacter pylori by an enzyme linked immunosorbent assay. RESULTS: Median progastrin levels were significantly higher in the cancer group (27.5 pmol/l) than in the polyp (< or =15 pmol/l) or control (< or =15 pmol/l) group (p=0.0001 There was no difference in median levels of amidated gastrin between groups. Median levels of amidated gastrin were significantly higher in H pylori positive patients (19 pmol/l) than in H pylori negative patients (8 pmol/l) (p=0.0022). Median plasma progastrin levels were significantly higher for moderately dysplastic polyps (38 pmol/l) compared with mildly dysplastic (15 pmol/l) and severely dysplastic (15 pmol/l) polyps (p=0.05). CONCLUSIONS: Plasma levels of progastrin, but not amidated gastrin or glycine extended gastrin, are significantly elevated in patients with colorectal cancer compared with those with colorectal polyps or controls, irrespective of their H pylori status. We conclude that measuring plasma progastrin levels in patients with colorectal cancer is warranted.     

Relationship between plasma D-dimer levels and clinicopathologic parameters in resectable colorectal cancer patients

AIM: To assess the clinical significance of the D-dimer levels and the relationship between plasma D-dimer levels and clinicopathologic parameters in operable colorectal cancer patients. METHODS: The plasma levels of D-dimer were measured pre- and postoperatively in 35 patients with colorectal cancer, and 30 healthy subjects served as controls by the method of quantitative enzyme-linked immunosorbent assay (ELISA). RESULTS: The mean preoperative plasma levels of D-dimer in the patients with colorectal cancer (1.06+/-0.24 mg/L) were significantly higher than those of controls (0.33+/-0.12 mg/L,P<0.01). The D-dimer levels were remarkably elevated on the 1st day after operation (1.22+/-0.55 mg/L, P<0.01). On the 3rd day the level of D-dimer began to stepwise descend and on the 14(th) day nearly returned to control level. The preoperative levels of D-dimer were significantly correlated with the lymph node metastasis and Dukes stage but had no association with tumor location and the degree of differentiation. A stepwise increase in the mean D-dimer levels was found with increase of the tumor stage. CONCLUSION: Hypercoagulation and higher fibrinolytic activities occur in patients with colorectal cancer. The operative trauma could enhance the fibrinolysis in the patients with colorectal cancer. The measurement of preoperative D-dimer levels is considered to be useful for predicting lymph node metastasis and stage of colorectal cancer.     

Depression of plasma gelsolin level during acute liver injury.

Human plasma contains two actin-binding proteins, plasma gelsolin and vitamin D-binding protein. These proteins are considered to play an important role in the disposition of actin derived from injured tissue. To evaluate this actin-scavenger system, gelsolin concentrations were measured in serial plasma samples obtained from patients with acute liver injury using an enzyme-linked immunosorbent assay. Plasma gelsolin levels in 43 healthy persons were 226 +/- 52 micrograms/mL. They were markedly reduced to 80 +/- 40 micrograms/mL in 14 patients with an early stage of acute hepatitis and returned to normal levels of 232 +/- 38 micrograms/mL as the disease resolved. Moreover, they showed a significant negative correlation with serum aminotransferase and bilirubin levels. In 7 patients with hepatocellular carcinoma, plasma gelsolin levels rapidly decreased from 182 +/- 42 to 87 +/- 41 micrograms/mL after transcatheter arterial embolization therapy. Because plasma gelsolin is not a hepatic protein, the decreased levels are considered to depend exclusively on the extent of actin leakage from the injured liver.     

Activation Capacity of the Alternative and Classic Complement Pathways in Patients Operated on for Colorectal Cancer

PURPOSE: Tumor cells may suppress activation of the host's complement system, and the functional state of the complement system may be a prognostic marker of outcome in patients with malignancies. Serial plasma samples from patients undergoing intended curative surgery for colorectal cancer were analyzed for complement factor C3 activation capacity. METHODS: Samples were collected from 91 patients with colorectal cancer and 13 with benign colorectal diseases before surgery and 1, 2, and 7 days after surgery, between 8 and 13 days after surgery, and 3, 6, 12, 18, 24, 36, 48, and 60 months after surgery. The samples were analyzed with an enzyme-linked immunosorbent assay that measured C3 activation capacity by the alternative and classic complement pathways. Cancer patients were compared according to Dukes stage, type of surgery performed, transfusion of blood, development of infection, venous thromboembolism, and cancer recurrence. RESULTS: Plasma samples obtained from cancer patients before surgery showed C3 activation capacities corresponding to those of samples from patients with benign disease. For both patient groups, C3 activation capacity decreased after surgery and normalized within seven days. Significant differences in C3 activation capacities were observed between cancer patients that were related to Dukes stage and in patients with and without buffy coat-depleted red cells suspended in saline, adenine, glucose, and mannitol transfusion, infectious events, and deep venous thromboembolism. Measurement of C3 activation capacity was of predictive value in patients who developed infection. CONCLUSION: Serial measurements of C3 activation capacity in plasma from patients who had undergone surgery for colorectal cancer revealed significant differences related to Dukes staging after surgery and to the development of infections but not to cancer recurrence.     

Plasma von Willebrand factor level as a prognostic indicator of patients with metastatic colorectal carcinoma

AIM: To evaluate the correlations of plasma von Willebrand factor (vWF) level with the distant metastasis and prognosis of patients with colorectal cancer. METHODS: A total of 86 patients with historically confirmed metastatic colorectal cancers receiving treatment at Taipei Veterans General Hospital were enrolled. All patients had measurable metastatic lesions and life expectancies of more than 3 mo. Plasma vWF levels were measured by immuno-turbidimetric assay and compared with results from 40 non-metastatic colorectal cancer patients and 22 healthy controls. Patients with metastatic colorectal cancer were divided into two groups according to serum vWF levels and the differences between these two groups were analyzed using X2 test. Data on age, gender, performance status, location of primary tumor, extent of metastasis, site of metastases, histological differentiation, serum CEA and plasma vWF levels were analyzed to determine association with survival. Survival curves were constructed by Kaplan-Meier product limit method and the data was analyzed using log-rank test on a microcomputer. Multivariate analysis using the Cox's proportional hazards regression model was then performed to determine the independent prognostic indicators among all of the possible variables. RESULTS: Colorectal cancer patients were identified as having significantly higher plasma vWF concentrations than healthy controls (P<0.05). Moreover, higher vWF plasma levels were associated with advanced tumor stage (P<0.05) and the presence of multiple metastases (P=0.014). Patients with lower vWF plasma levels (≤160%) survived significantly longer than those with a higher plasma vWF level (log-rank test, P= 0.0043). By multivariate analysis, plasma vWF levels (P<0.001), the extent of metastasis (P= 0.012), and the performance status (P=0.014) were identified as independent prognostic factors. CONCLUSION: Our data indicates that high plasma vWF concentrations correlate with advanced diseases and significantly poor prognosis of patients with metastatic colorectal carcinoma. It may serve as a potential biological marker of disease progression in these patients.     

血浆中miR-144*直接扩增在大肠癌非侵入性诊断中的应用

目的:研究miR-144*在大肠癌(CRC)、大肠腺瘤、炎症性肠病(IBD)及健康对照组的血浆标本中直接扩增后的表达量,初步探索其在大肠癌的发生、发展中的作用.方法:分别收集CRC、大肠腺瘤、IBD及全结肠镜检查阴性的健康人的血浆标本55例、30例、30例、30例,上述标本均取自患者未治疗前;分别收集CRC、大肠腺瘤患者行肿瘤切除术后7d的血浆标本43例、30例.利用TRIzol试剂进行上述标本中RNA的提取,得到纯化后的RNA样本,逆转录及实时荧光定量PCR反应检测miR-144*的表达,进行统计学分析.结果:在人大肠癌组血浆标本中,miR-144*较非大肠癌组中表达增高,miR-144*的表达量与肿瘤的大小及浸润深度相关,肿瘤越大,浸润深度越深,miR-144*表达量越高.在43例大肠癌患者术后7d的血浆标本中,30例行大肠癌根治术患者中27例miR-144*的表达量较术前降低,13例行大肠癌姑息性手术患者的血浆miR-144*的表达量较术前无明显差异.大肠腺瘤组中,进展期腺瘤和非进展期腺瘤在行腺瘤切除术前后miR-144*的表达量无明显变化.结论:血浆中miRNA-144*表达水平的检测,可作为大肠癌非侵入性诊断方法并可以预测大肠癌的复发.     

Comparative studies of tissue inhibitor of metalloproteinases-1 in plasma, serum and tumour tissue extracts from patients with primary colorectal cancer

OBJECTIVE: We have recently shown that preoperative plasma tissue inhibitor of metalloproteinases-1 (TIMP-1) levels are significantly associated with prognosis of colorectal cancer patients. In addition, we have shown that measurement of plasma TIMP-1 yields information on specificity and sensitivity, which could be used for early detection of colorectal cancer. However, it is not clear whether the increased plasma TIMP-1 levels in colorectal cancer patients are derived from the tumour tissue itself in which it is mainly expressed by the stromal cells located in the vicinity of the cancer cells. The purpose of this study was to examine the association between blood TIMP-1 levels and tumour tissue TIMP-1 levels in colorectal cancer patients. MATERIAL AND METHODS: Preoperative EDTA plasma, citrate plasma and serum, as well as tumour tissue extracts from 49 colorectal cancer patients were measured with a TIMP-1 ELISA that measures total TIMP-1 levels (non-complexed and complexed TIMP-1). RESULTS: The median TIMP-1 level in the 49 tumour extracts was 18.7 ng/mg proteins (range 3.5-152.0 ng/mg protein). The median TIMP-1 value was 133.5 ng/ml (range 58.1-559.0 ng/ml) in EDTA plasma, 130.2 ng/ml (range 57.0-572.0 ng/ml) in citrate plasma and 207.2 ng/ml (range 72.6-828.0 ng/ml) in serum. No significant correlations were found between TIMP-1 content in the tumour extracts and in blood.However, EDTA and citrate plasma TIMP-1 levels (r=0.75; p <0.0001) as well as EDTA plasma and serum TIMP-1 levels (r= .064; p<0.0001) were highly correlated. CONCLUSIONS: The lack of correlation between tumour tissue TIMP-1 and blood levels of TIMP-1 suggests that other sources than the tumour tissue itself may contribute to the increased levels of plasma TIMP-1 in patients with colorectal cancer. However, degradation of cell membranes, rapid secretion into the blood stream and other factors may be responsible for the observed lack of association between TIMP-1 concentrations in blood and tumour tissue extracts.