Differential clinical significance of COL5A1 and COL5A2 in tongue squamous cell carcinoma.

BACKGROUND: Type V collagen (COL5), in the functional heterotrimer [α1(V)2 α2(V)] isoform, participates in the malignancies of various cancers. However, its role in tongue squamous cell carcinoma (TSCC) remains unclear. MATERIALS AND METHODS: The expression levels of COL5A1 and COL5A2 polypeptide chains were examined using the tissue microarray from 245 TSCC patients with immunohistochemistry. Paired t test and Wilcoxon signed-rank test were performed for comparisons among the groups. Survival rates were estimated by using the Kaplan-Meier method and compared with log-rank tests. A Cox proportional hazards model was used to evaluate the impact of protein expression level on survival rate. RESULTS: Expression level of COL5A1 was significantly increased in tumor tissues (P < 0.001) compared to that in corresponding adjacent normal tissues. High expression level of COL5A1 was associated with advanced pathological stage (III, IV, P = 0.015) and lymph node metastasis (P = 0.005) of TSCC patients. High expression level of COL5A1 was also correlated with poor disease-specific survival (DSS, P = 0.001) and disease-free survival (DFS, P = 0.003) in TSCC patients. However, high expression level of COL5A2 was correlated with better DFS in TSCC patients (P = 0.043). Moreover, co-expression level of high (COL5A1)2 /low (COL5A2) heterotrimer was correlated with worse DSS (P = 0.004) and DFS (P = 0.004). CONCLUSION: COL5A1 is an unfavorable factor for tumorigenesis, clinicopathological outcomes, and prognosis, whereas COL5A2 is only a favorable factor for prognosis in TSCC. The co-expression of high (COL5A1)2/low (COL5A2) heterotrimer is a more potential unfavorable factor for prognosis in TSCC.

Postoperative hypocaloric peripheral parenteral nutrition with branched-chain-enriched amino acids provides no better clinical advantage than fluid management in nonmalnourished colorectal cancer patients.

To assess clinical efficacy of using postoperative branched-chain amino acids (BCAAs)-enriched nutritional support in lower gastrointestinal cancer patients, we conducted a retrospective observational study comparing this regimen with traditional fluid management. Sixty-one eligible colorectal cancer patients consecutively admitted in the Colorectal Surgery Ward to receive postoperative hypocaloric peripheral parenteral nutrition (HPPN) were categorized into dextrose-only control group (n = 20), dextrose plus low-dose BCAA fat group (n = 20), and dextrose plus high-dose BCAA fat group (n = 21). Nutritional, clinical, and biochemical outcomes were collected on the day before and 7 days after surgery. Patients were nonmalnourished. Over the 7-day observation period, the control group had a significantly higher reduction in body mass index than the lower dose and the higher dose BCAA groups (P = 0.023 and P = 0.002, respectively). Compared to high-dose BCAA group, the control group also had a lower nitrogen excretion (P < 0.0001) and less reduction in nitrogen balance (P < 0.0001). There were no differences between study groups in biochemical measures, phlebitis, postoperative hospital stay, and in-hospital mortality. We found no better clinical advantage to the postoperative administration of BCAA-enriched HPPN than fluid management in nonmalnourished colorectal cancer patients.

Risk factors of undernutrition in children with spastic cerebral palsy.

BACKGROUND: This study was undertaken to investigate the nutritional status of children with spastic cerebral palsy (CP) and to identify the risk factors of undernutrition. METHODS: Seventy-five spastic CP children, 47 boys and 28 girls, (ages, 5 months to 10 years) underwent anthropometric assessment, including body weight, recumbent length, and knee height. Their functional status, medical condition, and feeding status were also recorded. The data were analyzed to estimate the influences of various factors on the nutritional status of the spastic CP children. RESULTS: The nutritional status of 31 of the 75 children (41.3%) were below the 10th percentile (undernutrition) and three (4%) were above 90th percentile (overnutrition) of healthy children. In the multivariate analysis, we found that undernutrition was significantly associated with: (1) girls (p = 0.006), (2) more feeding problems (p = 0.018), (3) shorter duration per meal (p = 0.022), and (4) poor communication ability (p = 0.001). CONCLUSION: It appears that periodic anthropometric assessments of CP children are indicated for the early identification of nutritional risk. Further nutritional management should be arranged for undernourished children to promote their nutritional status and improve growth and functional capacity.