Objective To discuss the strategies for building the framework of team culture of multi-disciplinary team (MDT) for colorectal cancer. Methods By comprehending the traditional concept of volunteer and probing into the value of traditional team culture, combining the needs of MDT for colorectal cancer, build appropriate team culture and core idea of MDT for colorectal cancer. Results Confirm that building of volunteers groups and the volunteers culture is the core of the team culture of MDT for colorectal cancer. Analyze characters of volunteers groups and the operation strategies, and find the way of maintaining the volunteers culture. Conclusion With the development of volunteers groups and increased participants, the team culture of MDT for colorectal cancer will show more sociality and extent. And it is also the important idea and direction for development in future. As team culture, organization structure and personnel structure supplements each other, adjusting and perfecting the team culture in practice continually is a long-term work for MDT.
Objective To determine whether tumor angiogenesis correlates with progression of colorectal carcinoma. Methods Microvessel counts (MVC) of 102 specimens resected from patients with colorectal carcinoma were investigated by immunohistological staining with a monocolonal antibody against FⅧ RAg, the mean number of microvessels in three areas of highest vascular density were counted under 200 times magnification microscope. Correlation of MVC with various clinicopathologic factors, and prognosis was studied. Results MVC was increased with Dukes stage, the MVC of patients with advanced stage disease was significantly higher than that of early stage patients (P＜0.01). MVC was significantly higher in tumors with lymph node metastasis and liver metastasis (P＜0.01) than in those without such metastasis. The recurrence rate after curative resection in hypervascular group (MVC≥14, 60.4%) was significantly higher (P＜0.01) than that in the hypovascular group (MVC＜14,26.5%).Moreover, the prognosis of patients with a high MVC was significantly poorer than that of those with a low MVC (P＜0.01). Conclusion Angiogenesis within colorectal cancer is an indicator of tumor behavior and may identify patients at higher risk for recurrence and poorer prognosis.
【Abstract】ObjectiveTo detect the expression of human papilloma virus(HPV) 16 E7 was detected in colorectal adenocarcinoma tissue and normal mucosa. MethodsEighty-two patients with primary colorectal adenocarcinoma were selected in this study. The samples were taken from the tumor and the adjacent normal mucosa (10 cm away from the tumor) in each patient. Polymerase chain reaction (PCR) and immunohistochemistry were used to detect HPV16 E7 DNA and protein respectively. ResultsHPV16 E7 DNA expression was significantly higher in colorectal carcinoma (51.22%,42/82) than that in adjacent normal mucosa (4.88%,4/82), P＜0.01. A correlation was found between HPV16 E7 DNA expression and tumor location (P＜0.05)，18.18% in the ascending colon carcinoma and 64.10% in the rectal carcinoma. HPV16 E7 DNA expression was also associated with Dukes stage（P＜0.01）, but was not correlated with cancer differentiation. HPV16 E7 protein expression was mainly dectected in the nuclei of tumor cells with immunohistochemistry. There was a correlation between the expression of HPV16 E7 protein and HPV16 E7 gene. PCR had a higher sensitivity than immunohistochemistry. ConclusionHPV16 infection rate is much higher in the colorectal carcinoma than that in the adjacent normal mucosa, which indicates that HPV16 infection exists in some colorectal carcinomas. The high infection rate of HPV16 E7 is associated with advanced Dukes stage and proximity to anus.
ObjectiveTo detect the expression of somatostatin receptor Ⅱ(SSTR2) mRNA in the specimens of colorectal cancer patients and discuss the relationship between the expression and characteristics of the tumor.MethodsAll tissue samples of 36 cases, including normal colonic mucosa (10 cm beyond the tumor), mucosa adjacent to the tumor (within 2 cm of the tumor), tumor, and mesenteric lymph node, were collected immediately after surgical resection. The SSTR2 mRNA were detected by RT-PCR in 135 samples of the 36 cases. The SSTR2 mRNA expression rate in different samples was compared.ResultsThe SSTR2 mRNA expression rate of normal colonic mucosa, mucosa adjacent to tumor, tumor, mesenteric node without metastasis, and mesenteric node with metastasis was 67.6%(23/34), 75.0%(24/32),91.4%(32/35),93.8%(15/16) and 81.8%(9/11) respectively. Expression rate of tumor significantly increased compared with normal colonic mucosa (χ2=6.37, P＜0.05). The expression rate of the tumor in different groups, such as patients of different sex, serum CEA level, tumor size, location, histological grade and pathological stage, showed no difference (P＞0.05）.ConclusionThe expression rate of SSTR2 mRNA of colorectal adenocarcinoma increases. The expression rate does not correlate with the histological grade and pathological stage of the tumor.
The loss of heterozygosity and mutation for nm23-H1 gene in colorectal carcinomas were studied by Southern blot and RT-PCR-SSCP/silver staining sequencing. The rate of loss of heterozygosity for nm23-H1 was 29.63%. The cases of Duke’s stage D and distant metastatsis had higher frequency of the loss of heterozygosity. No mutation for nm23-H1 was found in colorectal carcinomas. These reaults indicate that the loss of heterozygosity for nm23-H1 may play a significant role in the malignant progression and distant metastasis in colorectal carcinomas.
ObjectivesTo systematically review the efficacy and safety of 3D laparoscopic in the treatment of colorectal cancer.MethodsPubMed, EMbase, The Cochrane Library, CBM, VIP, WanFang Data and CNKI databases were electronically searched online to collect clinical trials of 3D laparoscopic in the treatment of colorectal cancer from inception to September 1st, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 26 trials, including 4 randomized controlled trials and 22 cohort studies were included. The results of meta-analysis showed that: compared with 2D laparoscopic, 3D laparoscopic had shorter operative time (MD=–16.32, 95%CI –22.61 to –10.03, P<0.000 01), less amount of blood transfusion in operation (MD=–10.80, 95%CI –19.93 to –1.66, P=0.02), more lymph node dissection (MD=0.88, 95%CI 0.30 to 1.45, P=0.003), shorter recovery time of gastrointestinal function (MD=–0.18, 95%CI –0.31 to –0.04, P=0.01), lower incidence of postoperative complication (OR=0.63, 95%CI 0.44 to 0.89, P=0.009), and fewer days in hospital (MD=–0.84, 95%CI –1.40 to –0.28, P=0.003). Additionally, there was no significant difference in hospitalization costs (MD=–0.01, 95%CI –0.23 to 0.21, P=0.94).ConclusionsCurrent evidence shows that, compared with 2D laparoscopy, 3D laparoscopy assisted colorectal cancer surgery has obvious advantages such as less bleeding during operation, shorter operation time, lower incidence of complications after operation, shorter hospitalization time and no increase in hospitalization expenses. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
Objective To study ultrastructure and clinical significance of gastrin secretory granule in colorectal carcinoma cells. Methods The gastrin expression in colorectal carcinoma tissue and blood of 10 cases was examined by using radioimmunity analysis and immunohistochemistry. The ultrastructure of gastrin secretory granule of 10 cases, the positive of gastrin immunohistochemistry of colorectal carcinoma were examined by using immunoelectron microscopic technique. Results The gastrin concentration of the colorectal cancer group 〔（130.75 ±21.34） pg/ml〕 was significantly higher than that of control group 〔（95.63± 12.26） pg/ml〕，Plt;0.05. In 10 specimens of colorectal cancer, 5 cases were gastrin immunohistochemistry positive (+++), 4 moderate positive (++) and 1 weak positive (+). Cells in colorectal cancer were polyshaped, with unusual nucleoli different in size, concentrating on the edge, the cytoplasm mitochondrion was plentiful with vacuolates, and more secretion granules could be seen, 400-1500 nm in diameter with a clear border of membrane. There were two types of granular appearance: type A was largest in bulk size, low electrodensity was welldistributed, granular core appeared loose; type B was smaller in bulk size, high electrodensity was welldistributed, nucleus was usually compact.protein A gold (pAg) positive granules were located partially in secreting granules. pAg positive granules in highly differentiated cancer were mainly located in secreting granules of type A. pAg positive granules in low differentiated cancer were mainly located in secreting granules of type B. A part of cancer cell membrane, and inside and outside of microvillus membrane, adhering to pAg granules in line could be seen. Conclusion The colorectal carcinoma cells may synthesize and secrete gastrin themselves, which may be the mechanism of high gastrin levels in colorectal cancer. The use of gastrin antagonist and receptor antagonist may treat the patents with colorectal carcinoma.
Objective To investigate the feasibility of laparoscopic-assisted transanal everted pull-through resection and anastomosis in the treatment for ultra-low rectal cancer （the inferior margin of the tumor from the anal margin of less than 5cm）. Methods From December 2006 to December 2009，46 patients with ultra-low rectal cancer had been undergone laparoscopic-assisted transanal everted pull-through resection and anastomosis. The intraoperative condition，postoperative complications，and the result of follow-up were analyzed retrospectively. Results The operation was successfully performed on all the patients. The intraoperative blood loss was （202±56） ml （100-290m1）. The time of recovery of gastrointestinal function was （60±16） h （36-82 h）. No anastomotic bleeding or stomal leak was observed. All the patients were followed-up for （31±5） months （21-45months），15 patients developed mild to moderate anastomotic stricture，1 local recurrence， and 2 liver metastasis. All the patients had no anal incontinence 10months after stoma closure operation， the defecation of all the patients became normal （4.5±1.2） months（2-10months） later. Conclusions Laparoscopic-assisted transanal everted pull-through resection and anastomosis for ultra-low rectal cancer is safe and feasible， and the effect is satisfactory.
ObjectiveTo study the expression of c-Met in colorectal carcinoma cells and the effect of hepatocyte growth factor (HGF) on proliferation and invasion of colon carcinoma cells SW480.
MethodsReal-time PCR and Western blot methods were respectively used to detect the expressions of c-Met mRNA and protein in the different colorectal carcinoma cells in order to screen the high c-Met expression cells. The SW480 cells were incubated with different concentrations (0, 20, 40, and 70 ng/mL) HGF. MTT assay and Transwell test were used to evaluate the effects of proliferation and invasion in the SW480 cells.
Results①The c-Met was expressed in each colorectal carcinomar cells, especially highly expressed in the colon carcinoma cells SW480 in vitro.②MTT assay showed that the HGF could promote the proliferation of SW480 cells in a dose-dependent manner with some extent.③Transwell test showed that the HGF could increase the invasion of SW480 cells.
ConclusionThe c-Met is highly expressed in colorectal carcinoma cells and HGF could promote proliferation and increase invasion of colorectal carcinoma cells in vitro.
Objective To explore the microRNA （miRNA） expression changes and related miRNA characteristics of colorectal cancer （CRC） with hepatic metastasis by miRNA microarray. Methods The fresh specimens of primary CRC were collected in 10 patients during operation， which with hepatic metastasis or not. miRNA microarray analysis was performed to compare the miRNA expression levels in two groups. The different expression levels of miRNA were validated by quantitative real-time PCR analysis. Results A total of six dysregulated miRNAs were identified in the CRC patients with hepatic metastasis comparing with CRC patients without hepatic metastasis， including 3 up-regulated miRNAs （miR-224， miR-1236， and miR-622） and 3 down-regulated miRNAs （miR-155， miR-342-5p， and miR-363）， and the quantitative real-time PCR result of miR-224 consisted with the microarray finding. Conclusions miR-224 may be involved in the process of CRC with hepatic metastasis pathogenesis. miR-224 would be a research direction on a new biomarker or therapic method in CRC with hepatic metastasis.
