Objective To study the relationships between expressions of somatostatin receptor subtypes（SSTR1-SSTR5） and angiogenesis in colorectal cancer. Methods The expressions of SSTR1-SSTR5, VEGF, and CD34 in the paraffin sections of colorectal cancer tissues from 127 cases were detected by the standard streptavidin-peroxidase (SP) technique. CD34 was used as a marker to account microvessel density (MVD) in colorectal cancer tissues. The relationships between the expressions of SSTR1-SSTR5 and VEGF expression, or MVD were analyzed. Results The positive expression rate of SSTR1, SSTR2, SSTR3, SSTR4, and SSTR5 was 64.6% （82/127）, 36.2% （46/127）, 18.9% （24/127）, 18.9% （24/127）, and 38.6% （49/127） in colorectal cancer tissues, meanwhile, the positive expression rate of VEGF was 63.8% （81/127） and MVD was (34.67±16.62)/HP in colorectal cancer tissues. The positive expression rate of VEGF (47.8%， 22/46) and MVD 〔(29.00±15.32)/HP〕 in colorectal cancer tissues with SSTR2 positive expression were significantly lower than those in colorectal cancer tissues with SSTR2 negative expression 〔72.8%， 59/81； (37.90±16.56)/HP〕, Plt;0.05. There were no relationships between SSTR1, SSTR3, SSTR4, and SSTR5 expression and VEGF expression or MVD （Pgt;0.05）. Conclusion The positive expression of SSTR2 is related with angiogenesis in colorectal cancer tissues.
ObjectiveTo analyze the impact of the residence of patients with colorectal cancer (CRC) on surgical characteristics in the current version Database from Colorectal Cancer (DACCA). MethodsAccording to the established screening conditions, the patients with CRC were collected from the updated version of DACCA on January 23, 2023. The analysis indicators enrolled in this study included: the grouping indicator was residence, the surgical characteristic indicators included the surgical timing, surgical nature, expanded resection, intersphincteric resection (ISR) type, patient’s willingness of preserving the anus, and whether preserving the anus. The patients were categorized into three groups based on the residence: inside Chengdu City, outside Chengdu City within Sichuan Province, and outside Sichuan Province. The surgical characteristic indicators of patients with CRC from different residences were comparatively analyzed. ResultsA total of 6 832 analyzable data rows were enrolled. The results of statistical analysis revealed the following findings: there were no statistical differences in the surgery timing and surgery nature among the patients with colon cancer or rectal cancer from the different residences (Surgery timing: H=1.665, P=0.435; H=4.153, P=0.125. Surgery nature: χ2=1.586, P=0.453; χ2=0.990, P=0.610); For the patients with rectal cancer from the different residences, the distributions of the ISR type (H=0.514, P=0.773), patients’ willingness of preserving the anus (χ2=1.437, P=0.487), and whether preserving the anus (χ2=5.513, P=0.064) had no statistical differences. In addition, although there was no statistical difference in the distribution of expanded resection or not among the patients with rectal cancer in different residences (χ2=2.363, P=0.307), it was found that there was statistical difference in the distribution of enlarged resection or not among the patients with colon cancer in different residences (χ2=17.324, P＜0.001). ConclusionsFrom the data analysis in DACCA, there are not statistical differences in surgical characteristic indicators such as surgical timing, surgical nature, ISR type, patients’ willingness of preserving the anus, and whether preserving the anus among patients with colon or rectal cancer from different residences. However, the proportion of underwent expanded surgery in the colon cancer patients who from outside Sichuan Province as compared with inside Sichuan Province is relatively higher, this suggests that surgical difficulty is more difficult for the patients from outside Sichuan Province.
目的 探讨CT仿真内镜（CT virtual endoscopy，CTVE）在低位直肠癌术前分期中的价值。方法 收集我院2008年8月1日至2011年3月1日期间的直肠癌患者57例，术前行直肠CTVE检查，详细记录患者直肠癌周围组织浸润和淋巴结转移的情况；患者术后常规进行病理检查，比较两者结果的差异。结果 术前直肠CTVE检查与术后石蜡病理检查对直肠癌周围淋巴结转移的判断经四格表χ2检验，差异无统计学意义（χ2=2.5，P＞0.05），其对直肠癌周围淋巴结转移预测的敏感性为66.67%，特异性为93.94%。术前直肠CTVE预测直肠癌周围组织浸润和术后病理检查结果经四格表χ2检验，差异有统计学意义（χ2=4.4，P＜0.05），其对直肠癌周围组织浸润判断的敏感性为27.78%，特异性为42.86%。结论 CTVE在术前评估直肠癌周围淋巴结转移有较高的可信性，但对直肠癌周围组织浸润的评价较差。
ObjectiveTo analyze the relationship between occupational type of patients with colorectal cancer (CRC) and decision-making and curative effect of neoadjuvant therapy in the current version of the Database from Colorectal Cancer (DACCA). MethodsThe eligible CRC patients were collected from June 29, 2022 updated DACCA according to the screening criteria, in which the data items analyzed included: gender, age, BMI, blood type, marriage, occupation, neoadjuvant therapy, symptomatic changes, imaging changes, and tumor regression grade (TRG), and the occupations were classified into the mental labour group, physical labour group, and the unemployed and resident groups according to the type of labour, then compared the decision-making and curative effect of neoadjuvant therapy among the 3 groups. ResultsA total of 2 415 eligible data were screened, of which 1 160 (48.0%) were the most in the manual labour group, followed by 877 (36.3%) in the unemployed and resident group, and finally 378 (15.7%) in the mental labour group. The proportion of those who did not use targeted drugs was higher in both patients ≤60 years old and >60 years old [75.6% (958/1 267) vs. 82.5% (947/1 148)], with both differences being statistically significant (P=0.004 and P=0.019), and among patients >60 years old, the different occupational types were associated with symptomatic changes and imaging changes after neoadjuvant therapy, with the highest number of both changes to partial remission [71.5% (161/225) vs. 66.7% (148/222)], both differences being statistically significant (P=0.001 and P=0.017). ConclusionThe analysis results of DACCA data reveal that the occupational type of CRC patients was associated with the choice of neoadjuvant therapy, and that different occupational types were associated with changes in curative effect before and after neoadjuvant therapy in CRC patients >60 years old, which needs to be further analysis for the reasons.
Objective To compare the effects of double stapling technique （DST） and single stapling technique （SST） in the low or ultralow anterior rectal resection and colon-anal canal anastomosis for patients with rectal cancer. Methods The clinical data of 351 patients with rectal caner， who were treated with low or ultralow anterior resection and colon-anal canal anastomosis in West China Hospital from Jan. 2009 to Dec. 2010， were collected and analyzed retrospectively. Operative and postoperative indexes of patients treated with DST （n=302） and SST （n=49） were compared. Results Compared with DST group， the distance from the dentate line to the edge of tumor， the length of the distal surgical margin 〔（1.83±0.59） cm vs. （2.07±0.56） cm〕， and hospitalization cost 〔（24 350.48±7 812.73） yuan vs.（29 455.32±7 869.33） yuan〕 of SST group were shorter or lower （P＜0.05）， but operative time was longer 〔（112.86±39.29） min vs. （100.10±36.75） min， P＜0.05〕. There were no significant differences on blood loss， duration of firstambulation， duration of first passing flatus， duration of first bowel movement， duration of pulling out nasogastric tube， duration of pulling out urinary catheter， duration of pulling out drain， postoperative hospital stay， total length of hospital stay， and the incidence of complication between the 2 groups （P＞0.05）. All patients were in functional recovery of anal control after operation. All patients were followed-up for 6-24 months （average 16 months）. During the followed-up， only 1 case suffered local tumor recurrence （SST group）， 3 cases suffered distant metastases （all in DST group）， and 15 cases （4.27％） died， of which 13 cases （4.30％） in DST group and 2 cases （4.08％） in SST group. Conclusions As in the low or ultralow anterior rectal resection and colon-anal canal anastomosis for patients with rectal cancer， SST results in shorter distal surgical margin than DST， so SST is suitable for the patients with shorter distance from the dentate line to the edge of tumor. What’s more， it saves the hospitalization cost effectively.
ObjectiveTo summarizes the mechanisms of carcinogenesis of colorectal cells, the occurrence and development of cancer cells, and their interactions with the tumor niche of colorectal cancer (CRC) from the perspective of the tumor niche, exploring new ideas for the prevention, diagnosis, and treatment of CRC. MethodThe relevant literature at home and abroad in recent years on the researches of mechanism of the occurrence and development of CRC and its relation with the tumor niche of CRC was searched and reviewed. ResultsThe theory of tumor ecology indicates that the human normal body can be regarded as a relatively closed and perfect ecosystem. Each normal tissue and organ within the body represent a niche in this ecosystem, which interact, affect, and symbiotically coexist with each other, forming a dynamic ecological balance. Tumor cells, being a “new species” distinct from normal tissue cells, “invade” the ecological system of the normal body under specific conditions and interact with the surrounding microenvironment, which is defined as the tumor niche. Analysis of current literature retrieved from the perspective of the tumor niche suggested that, although genetic factors are involved in the carcinogenesis of colorectal cells, the majority of such carcinogenesis stems from the continuous stimulation of the colorectal niche. Current research primarily focuses on the conclusion that the carcinogenesis of colorectal cells is associated with factors such as chronic inflammatory response, intestinal microorganisms, oxidative stress, and pyroptosis. After carcinogenesis and the eventual formation of CRC, the growth of cancer cells and tissues first requires breaching the defense of the immune system in the colorectal niche. Immune cells in the immune system play a crucial role in the tumor niche during the occurrence and development of CRC. ConclusionsThe proposal of the tumor niche concept enables researchers, when studying the mechanisms of tumor occurrence and development, to no longer merely focus on the tumor and its microenvironment. Instead, the tumor as a part of the body’s ecosystem was studied. Components of the tumor niche, such as chronic inflammatory responses, intestinal microorganisms, oxidative stress, pyroptosis, and immune system, have a significant impact on the mechanisms of carcinogenesis of most colorectal cells, as well as the occurrence and development of cancer cells. These factors influence the progression of CRC in various aspects.
ObjectiveTo detect expressions of epidermal growth factor receptor (EGFR), BRAF, and K-Ras genes in colorectal carcinoma tissues and explore pathogenesis in colorectal carcinoma. MethodThe expressions of EGFR, BRAF, and K-Ras genes were detected in these 136 colorectal carcinoma tissues and their corresponding adjacent normal colorectal tissues by immunohistochemistry. ResultsThe expressions of EGFR and BRAF in the colorectal carcinoma tissues were significantly higher than those in their corresponding adjacent normal colorectal tissues (P<0.05), but the expression of K-Ras had no significant difference between these two tissues (P>0.05). The expression of EGFR gene was related to the TNM stage, lymphatic metastasis, or degree of differentiation. The expression of BRAF gene was related to the TNM stage. The expression of K-Ras gene wasn,t related to the TNM stage, lymphatic metastasis, or degree of differentiation. The correlation analysis results showed that there was no relation among the EGFR, K-Ras, or BRAF expression. ConclusionsUp-regulated of EGFR and BRAF gene expressions might be related to development of colorectal carcinoma, and role of K-Ras is unclear. Anti EGFR and BRAF target therapy might be benefited for patients with colorectal carcinoma.