Retraction Notice to: lncRNA GAS5 Inhibits Cell Migration and Invasion and Promotes Autophagy by Targeting miR-222-3p via the GAS5/PTEN-Signaling Pathway in CRC.

[This retracts the article DOI: 10.1016/j.omtn.2019.06.009.].

MiR-103a-3p promotes tumour glycolysis in colorectal cancer via hippo/YAP1/HIF1A axis.

BACKGROUND: Glycolysis plays an essential role in the growth and metastasis of solid cancer and has received increasing attention in recent years. However, the complex regulatory mechanisms of tumour glycolysis remain elusive. This study aimed to explore the molecular effect and mechanism of the noncoding RNA miR-103a-3p on glycolysis in colorectal cancer (CRC). METHODS: We explored the effects of miR-103a-3p on glycolysis and the biological functions of CRC cells in vitro and in vivo. Furthermore, we investigated whether miR-103a-3p regulates HIF1A expression through the Hippo/YAP1 pathway, and evaluated the role of the miR-103a-3p-LATS2/SAV1-YAP1-HIF1A axis in promoting glycolysis and angiogenesis in CRC cells and contributed to invasion and metastasis of CRC cells. RESULTS: We found that miR-103a-3p was highly expressed in CRC tissues and cell lines compared with matched controls and the high expression of miR-103a-3p was associated with poor patient prognosis. Under hypoxic conditions, a high level of miR-103a-3p promoted the proliferation, invasion, migration, angiogenesis and glycolysis of CRC cells. Moreover, miR-103a-3p knockdown inhibited the growth, proliferation, and glycolysis of CRC cells and promoted the Hippo-YAP1 signalling pathway in nude mice in a xenograft model. Here, we demonstrated that miR-103a-3p could directly target LATS2 and SAV1. Subsequently, we verified that TEAD1, a transcriptional coactivator of Yes-associated protein 1 (YAP1), directly bound to the HIF1A promoter region and the YAP1 and TEAD1 proteins co-regulated the expression of HIF1A, thus promoting tumour glycolysis. CONCLUSIONS: MiR-103a-3p, which is highly expressed in CRC cells, promotes HIF1A expression by targeting the core molecules LATS2 and SAV1 of the Hippo/YAP1 pathway, contributing to enhanced proliferation, invasion, migration, glycolysis and angiogenesis in CRC. Our study revealed the functional mechanisms of miR-103a-3p/YAP1/HIF1A axis in CRC glycolysis, which would provide potential intervention targets for molecular targeted therapy of CRC.

lncRNA GAS5 Inhibits Cell Migration and Invasion and Promotes Autophagy by Targeting miR-222-3p via the GAS5/PTEN-Signaling Pathway in CRC.

Colorectal cancer (CRC) is a frequently occurring lethal disorder with heterogeneous outcomes and drug responses. Recent studies have demonstrated that long non-coding RNAs (lncRNAs) play a critical role in carcinogenesis. Hence, the aim of this study was to investigate the role of lncRNA growth arrest-specific 5 (GAS5) in CRC cells via mediation of the microRNA-222-3p (miR-222-3p)/GAS5/phosphatase and tensin homolog (PTEN)-signaling pathway. HCT116 and SW480 cells were collected and treated with small interfering (si)-lncRNA GAS5, overexpressing (oe)-lncRNA GAS5, miR-222-3p mimic, miR-222-3p inhibitor, or si-lncRNA GAS5 + miR-222-3p mimic. The miR-222-3p level and mRNA and protein levels of GAS5, Beclin1, light-chain 3B (LC3B), PTEN, and Akt were detected. Besides, cell migration, invasion, and apoptosis as well as acidic vesicular organelles (AVOs) were examined respectively. Xenografts in nude mice were also performed to detect tumorigenesis in vivo. Results suggested that the downregulation of lncRNA GAS5 decreased the expressions of Beclin1, LC3B, and PTEN. When treated with oe-lncRNA GAS5 or miR-222-3p inhibitor, HCT116 and SW480 cells exhibited suppressed invasion and migration abilities and increased apoptotic cells and autophagosome and AVO activities. Moreover, overexpression of GAS5 inhibited the tumorigenesis of CRC cells in vivo. Taken together, lncRNA GAS5 upregulated the expression of PTEN by functioning as a competing endogenous RNA (ceRNA) of miR-222-3p, thus inhibiting CRC cell migration and invasion and promoting cell autophagy.

Capecitabine versus 5-fluorouracil in neoadjuvant chemoradiotherapy of locally advanced rectal cancer: A meta-analysis.

BACKGROUND: The differences in efficacy between capecitabine and 5-fuorouracil (5-FU) in neoadjuvant chemoradiotherapy (CRT) of locally advanced rectal cancer (LARC) are not well recognized. We performed this meta-analysis to analyze the effect of capecitabine and 5-FU on neoadjuvant CRT to more accurately understand the differences between the 2 drugs. METHODS: MEDLINE, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Database were performed to identify all published studies investigating the efficacy of capecitabine in neoadjuvant CRT of LARC versus 5-FU before August, 2017. Primary endpoint was the odds ratio (OR) for improving pathological complete response (pCR) rate of patients with LARC. Secondary endpoints were the ORs of efficiency for downstaging tumor and increasing R0 resection in patients with LARC. Safety analyses were also performed. The OR was the principal measurement of effect, which was calculated as capecitabine group versus 5-FU group, and was presented as a point estimate with 95% confidence intervals (CIs). All calculations and statistical tests were performed using RevMan 5.3 software. RESULTS: In all, 2916 patients with LARC enrolled in the 10 studies were divided into capecitabine group (n = 1451) and 5-FU group (n = 1465). The meta-analysis showed that capecitabine improved pCR (OR 1.34, 95% CI 1.10-1.63), and R0 resection rate (OR 1.92, 95% CI 1.10-3.36). There were no statistically significant differences either in overall downstaging rate (OR 1.31, 95% CI 0.79-2.16) or in the tumor downstaging rate (OR 1.24, 95% CI 0.79-1.92), but there was a significant difference of the nodal downstaging rate between the 2 groups (OR 1.68, 95% CI 1.11-2.54). There was no statistically significant difference in sphincter preservation rate between the 2 groups (OR 1.36, 95% CI 0.96-1.92). No obvious safety concerns about mortality and complications were raised in these studies. There were no statistically significant differences in 3-year disease-free-survival (OR 1.29, 95% CI 0.75-2.20), and in grade 3 to 4 acute toxicity during CRT (OR 0.63, 95% CI 0.31-1.30). CONCLUSIONS: Compared with 5-FU-based neoadjuvant CRT, capecitabine-based neoadjuvant CRT can safely improve pCR, nodal down-staging, ad R0 resection of patients with LARC.

Imatinib therapy after resection of high-risk gastrointestinal stromal tumors in Chinese patients: a median follow-up of 48 months.

PURPOSE: Adjuvant imatinib can be given for gastrointestinal stromal tumors (GISTs), but adequate risk stratification is necessary to select patients who will benefit from this therapy. We aimed to investigate the treatment methods and prognostic factors of high risk GISTs. METHODS: This retrospective study included 108 patients who underwent tumor resection for high-risk GISTs between January 2003 and February 2017. The patients were divided into two groups: a group of patients received postoperative imatinib adjuvant therapy (Adjuvant therapy group), and the other group was not treated with imatinib until they were found to have disease progression (Followup observation group). The progression-free survival (PFS) and overall survival (OS) were compared between the two groups, and the risk factors of prognosis were analyzed by Cox regression model. RESULTS: The median PFS was 45 months (range 23-67). The 1-, 3-, and 5-year PFS was 88.6, 70.4 and 59.0%, respectively. The PFS in the adjuvant therapy group was longer than in the follow-up observation group (p<0.001). The median OS was 117 months (range 93-141). The 1-, 3-, and 5-year OS was 97.0, 87.7 and 77.4%, respectively. There was no difference in OS between the two groups (p=0.737). Intra-operative tumor integrity (p=0.003) and postoperative adjuvant treatment (p<0.001) were independent prognostic factors of PFS. R0 resection (p=0.019) and low mitotic count (≤5/50 HPF) (p=0.031) were independent prognostic factors of OS. CONCLUSIONS: Avoiding intra-operative tumor rupture and administering postoperative adjuvant imatinib treatment improved PFS in patients with high-risk GISTs. Low mitotic count and R0 resection were associated with better survival.

MiR-590-3p promotes proliferation and metastasis of colorectal cancer via Hippo pathway.

Studies reported that miR-590-3p was involved in human cancer progression. However, its roles of oncogene or anti-oncogene in malignancies still remain elusive. This study was aimed to investigate the effect of miR-590-3p on the cell proliferation and metastasis via Hippo pathway in colorectal cancer (CRC). In our study, miR-590-3p was demonstrated highly expressed in CRC tissues, compared with adjacent normal tissues (P<0.05). In addition, miR-590-3p was positively associated with TNM stage and distant metastasis. Survival analysis showed that high miR-590-3p was related with poor overall survival rate. Then, over-expressed miR-590-3p was demonstrated to promote proliferation, invasion and migration of colon caner cells. What's more, MST1, LATS1 and SAV1 mRNA were showed lowly expressed and YAP1 expression in mRNA and protein levels were highly expressed in CRC tissues, compared with adjacent normal tissues (all P<0.05). miR-590-3p expression was negatively associated with LATS1 and SAV1 mRNA respectively and positively related with YAP1 mRNA in CRC tissues, meanwhile, there was no relationship between miR-590-3p and MST1 mRNA. Furthermore, over-expressing miR-590-3p inhibited expressions of LATS1 and SAV1, promoted YAP1 expression and didn't effect MST1 expression in colon cancer cells. And luciferase assay showed that miR-590-3p over-expression inhibited the luciferase activity of LATS1 and SAV1 3'UTR, meanwhile it had no effect on the mutated form of these two plasmids. Taken together, these data suggest that highly-expressed miR-590-3p promotes biological effect of proliferation and metastasis via targeting Hippo pathway, and predicts worse clinical outcomes of CRC patients.

[Treatment and prognosis of 108 patients with high-risk gastrointestinal stromal tumor].

OBJECTIVE: To investigate the treatment methods and prognostic factors of high-risk gastrointestinal stromal tumor (GIST). METHODS: Clinicopathological date and follow-up data of 108 patients with high-risk GIST from January 2002 to February 2016 treated at our department were retrospectively reviewed. The patients were divided into two groups according to whether they received adjuvant therapy after surgery. A group of patients received imatinib adjuvant therapy(adjuvant therapy group, 69 cases). Another group of patients were not treated with imatinib until they were found to have disease progression(follow-up observation group, 39 cases). The survival rate and recurrence rate were compared between two groups, and the risk factors of prognosis were analyzed by Cox regression model. RESULTS: All the cases were followed up with a median time of 48 months(1 to 161 months). Recurrence and / or metastasis occurred in 57(52.8%) patients during follow-up. The postoperative recurrence and / or metastasis rate was 34.8%(24/69) and 84.6%(33/39) respectively in the adjuvant therapy group and the follow-up observation group, the difference was statistically significant(P=0.000). Twenty-eight(25.9%) patients died. The 1-, 3-, 5-, 10-year survival rates of the 108 patients undergoing follow-up were estimated to be 99.8%, 87.7%, 76.0% and 42.7% respectively. The 5-year survival rates were 79.3% and 72.3% in the adjuvant therapy group and the follow-up observation group, the difference was not statistically significant (P=0.648). Univariate analysis showed that mitotic count, radical degree and tumor rupture were predictive factors of survival after resection of primary high-risk GIST (all P<0.05). Multivariate analysis using Cox regression model revealed that the mitotic count (P=0.013, RR=2.400, 95%CI:1.206 to 4.779) and radical degree(P=0.003, RR=3.968, 95%CI:1.609 to 9.784) were independent prognostic factors. CONCLUSION: Comprehensive treatment of radical surgery combined with targeted therapy and close followed up can lead to better long-term survival of high-risk patients with GIST.

Factors affecting sphincter-preserving resection treatment for patients with low rectal cancer.

The aim of the present study was to identify the factors associated with the use of sphincter-preserving resection (SPR) surgery for the treatment of low rectal cancer. A total of 330 patients with histopathologically confirmed low rectal cancer were divided into two groups, namely the abdominoperineal resection (APR) and sphincter-preserving (SP) groups. For SPR factor analysis, the χ2 test was performed as the univariate analysis, while a logistic regression test was conducted as the multivariate analysis. Of the 330 patients, 192 cases (58.18%) received SPR surgery and 138 cases (41.82%) underwent an APR. Univariate analysis results revealed that the sphincter-preserving factor was significantly associated with age, gender, ethnicity, body mass index (BMI), total infiltrated circumference, distance of the tumor from the anal verge (DTAV), depth of invasion and tumor grade (P<0.05). However, there were no statistically significant associations with family medical history, diabetes history, venous tumor embolism, growth type, tumor length, lymphatic metastasis and level of preoperative carcinoembryonic antigen (P>0.05). Multivariate analysis indicated that the sphincter-preserving factor was strongly associated with DTAV and the depth of invasion, with significant statistical difference (P<0.05). Therefore, selecting SPR surgery for patients with low rectal cancer is dependent on age, gender, ethnicity, BMI, the total infiltrated circumference, DTAV, depth of invasion and tumor grade. In addition, DTAV and the depth of invasion are independent risk factors for the selection of SPR surgery.

Prognostic Value of Yes-Associated Protein 1 (YAP1) in Various Cancers: A Meta-Analysis.

BACKGROUND: Yes-associated protein 1 (YAP1) is an effector of Hippo pathway, which is critical for regulating organ size, cell proliferation and tumor growth in mammals. Many previous studies have explored the relationship between YAP1 and various types of cancer. However, these studies were limited by the small samples size and the findings were inconsistent among them. Therefore, a meta-analysis was conducted to assess the association between YAP1 and malignancies. METHODS: A systematic literature search was conducted for eligible studies in the PubMed, Corchane Library, Web of Knowledge, EMBASE and CBM disc databases from inception to August 1st 2014. After heterogeneity analysis, pooled harzad ratio (HR) with 95% confidence interval (95%CI) using both fixed and random effect models were estimated in STATA 10.0. Meta regression analysis, subgroup analysis and sensitivity analysis were performed to explore the potential sources of heterogeneity and to evaluate the robustness of the result. Publication bias was assessed by Egger's test and funnel plot. RESULTS: A total of 21 unique articles from 2009 to 2014, comprising 2983 patients, were analyzed in the meta-analysis. The association of YAP1 expression and overall survival time (OS) was evaluated in 20 studies including 2067 patients. Positive YAP1 showed poorer OS (HR = 1.826; 95% CI = 1.465-2.275; p <0.002). For evaluating disease-free survival time (DFS), 10 studies with 1139 patients were analyzed. Positive YAP1 indicated worse DFS (HR = 2.114; 95%CI = 1.406-3.179; p <0.001). Subgroup analysis showed that both positive nuclear YAP1 (HR = 1.390, 95% CI: 0.810-2.400, p = 0.729) and up-regulation overall YAP1 (HR = 2.237, 95% CI: 1.548-3.232, p <0.001) had poorer OS for patients with malignancies. Similarly, both positive nuclear YAP1 (HR = 3.733, 95% CI: 1.469-9.483, p = 0.001) and up-regulation overall YAP1 (HR = 1.481, 95% CI: 1.163-1.886, p = 0.554) showed worse DFS. The patients with urogenital system cancer had the poorest OS (HR = 2.133, 95% CI: 1.549-2.937, p = 0.020). The patients with alimentary system cancer had the most significant impact on DFS (HR = 1.879, 95% CI: 1.537-2.297, p <0.001). CONCLUSION: Both overall and nuclear YAP1 overexpression are intimately associated with adverse OS and DFS in numerous cancers, suggesting that YAP1 may act as a potential therapeutic targets of these malignancies in the future.

Risk factors associated with splenic hilar lymph node metastasis in patients with advanced gastric cancer in northwest China.

There are plenty of risk factors associated with splenic hilar lymph node metastasis (SHLNM) in patients with advanced gastric cancer (AGC). Whereas, their main influencing factors have not reached a consensus yet. The aim of the study is to investigate the related clinicopathological factors influencing SHLNM in AGC. A retrospective study was performed to investigate 150 patients who underwent D2 curative partial or total gastrectomy for gastric carcinoma from January 2007 to November 2012. Clinicopathological factors were analyzed by univariate and multivariate analysis. A total of 10.7% (16/150) of the patients had SHLNM. The overall ratio of metastatic lymph node (positive lymph nodes/lymph nodes harvested) in the splenic hilum was 17.5% (38/217). Univariate analysis results showed SHLNM was related with depth of invasion, tumor grade, tumor size, tumor location and Bormann type, with significant difference (P<0.05); Multivariate analysis demonstrated that SHLNM was related with depth of invasion and tumor size, with significant difference (P<0.05). Consequently, depth of invasion, tumor grade, tumor size, tumor location and Bormann type were associated with SHLNM in AGC, meanwhile depth of invasion and tumor size are independent risk factors. Preoperative predicting risk factors of SHLNM greatly benefits making more rational surgical scheme of treating AGC.

Gastrocolic fistula secondary to transverse colon cancer.

Gastrocolic fistula (GCF) secondary to colon carcinoma is a rare entity. Establishing the diagnosis of GCF is difficult because it has nonspecific symptoms on admission. The characteristic triad of clinical manifestations includes diarrhoea, faeculent vomiting, and weight loss. Surgical treatment of GCF involves en-bloc resection of the involved regions and appropriate reconstruction procedures for malignant cases. The authors hereby report a 54-year-old man with a 2 months history of weight loss, watery diarrhoea, fecal halitosis and melena. Laboratory tests showed severe anaemia and hypoalbuminaemia. The GCF was detected successfully by CT scan, barium meal and colonoscopy, but could not be seen on gastroscopy. A radical en-bloc resection was performed and histological examinations revealed a low-differentiated adenocarcinoma of the colon.

[Effects of increased body mass index upon laparoscopic radical rectal surgery and its clinical efficacy].

OBJECTIVE: To assess the feasibility, the safety and short-term outcomes of laparoscopic radical rectal surgery for rectal cancer patients with increased body mass index (BMI) . METHODS: Retrospectively data reviews were conducted for 405 consecutive patients undergoing laparoscopic surgery for rectal cancer from June 2008 to June 2012. They were classified as normal-weight (NW, BMI 18.6-22.9 kg/m(2), n = 165), overweight (OW, BMI 23.0-24.9 kg/m(2), n = 125), and obese (OB, BMI ≥ 25.0 kg/m(2), n = 115)groups according to the categories as proposed by 2007 Chinese Obesity Surgery Treatment Guidelines. The differences of oncologic, intraoperative and postoperative status, postoperative complications, number of resected lymph nodes and short-term survival rates were compared among three groups. The data were analyzed by χ(2) or Fisher exact test. The Mann-Whitney U test or analysis of variance (one-way ANOVA) was used for parametric comparisons. The survival curve was drawn by Kaplan Meier method and the survivals of 3 groups were by the Log-rank test. RESULTS: The comorbidity of patients in the NW and OW groups were less than that in the OB group(27.9% (46/165) and 30.4% (38/125) vs 47.0% (54/115), χ(2) = 12.066, P < 0.05). No significant difference existed among the groups in terms of conversion rate (9.1% (15/165), 10.4% (13/125) and 12.2% (14/115)), the rate of postoperative complications (20.6% (34/165), 21.6% (27/125) and 24.3% (28/115) ), intraoperative volume of blood loss ((105 ± 30), (110 ± 25) and (115 ± 45) ml), first flatus( (2.8 ± 1.2), (2.9 ± 1.1) and (3.1 ± 1.4) d), postoperative hospital stays ((13.7 ± 5.5), (14.3 ± 7.5) and (14.1 ± 8.5) d, all P > 0.05), and the mean number of retrieved lymph nodes(P > 0.05). While the operation duration in the OB group were longer than that in the NW and OW groups ((250 ± 35) vs (205 ± 20) and (210 ± 30) min, F = 7.216, P < 0.05) . And 368 patients (90.9%) were followed up for a median of 24 months(2-48 months). As for survival curves, no significant difference existed among three groups (P > 0.05). CONCLUSIONS: It is both safe and feasible for obese patients with increased BMI to undergo laparoscopic radical rectal cancer. And there is no effect upon immediate survival.

Significance of HPV infection and genic mutation of APC and K-ras in patients with rectal cancer.

BACKGROUND: Significance of HPV infection and genic mutation of APC and K-ras in rectal cancer has been investigated but not clarified. The objective of our study was to investigate these parameters in patients with rectal cancer to analyze correlations with biological behaviour, to determine relationships among the three, and also to demonstrate survival prognosis effects. METHODS: From December 2007 to September 2008, 75 rectal cancer cases confirmed by histopathology in the Tumor Hospital of Xinjiang Medical University were enrolled. The control group consisted of normal rectal mucous membrane taken simultaneously, a least 10 cm distant from the carcinoma fringe. HPV DNA, the MCR of APC and exon-1 of K-ras were detected by PCR and PCR-SSCP. All results were analyzed in relation to clinical pathological material, using chi-square and correlation analysis via SPSS.13 and Fisher's Exact Probability via STATA. 9.0. All 75 patients were followed up for survival analysis using Kaplan-Meier and Log-rank tests. RESULTS: 55 out of 75 cases demonstrated gene HPV L1 while it was not detected in normal rectal mucosa tissue. HPV infection was correlated with age and lymphatic metastasis (P<0.05) but not other characteristics, such as ethnicity, tumor size, histological type, tumor type, Duke's stage and infiltration depth. Some 43 cases exhibited APC genic mutation (57.3%) and 34 K-ras genic mutation (45.3%). APC genic mutation was correlated with gender( P<0.05), but not age, histological type, infiltration depth, lymphatic metastasis and Duke's stage. In 55 cases of rectal cancer with HPV infection, there were 31 cases with genic mutation of APC (56.4%) and 24 with genic mutation of K-ras (43.6%). For the 20 cases of rectal cancer with non-HPV infection, the figures were 12 cases (60%) and 10 (50.0%), respectively, with no significant relation. Survival analysis showed no statistical significance for K-ras genic mutation, APC genic mutation or HPV infection (P>0.05). However, the survival time of the patients with HPV infection was a little shorter than in cases without HPV infection. CONCLUSIONS: Our results suggest that HPV infection might be an important factor to bring about malignant phenotype of rectal cancer and influence prognosis. Genic mutation of APC and K-ras might be common early molecular events of rectal cancer, but without prognostic effects on medium-term or early stage patients with rectal cancer.

[Clinical characteristics and prognostic analysis of 45 patients with high-risk gastrointestinal stromal tumors].

OBJECTIVE: To investigate the clinical characteristics and prognosis factors of primary resectable high-risk gastrointestinal stromal tumors (GIST). METHODS: The clinicopathological and follow-up data of 45 patients with primary resectable high-risk gastrointestinal stromal tumors between January 2002 and November 2010 were retrospectively reviewed. RESULTS: Forty-five patients included 18 males and 27 females with a median age of 48 years (range, 28-77 years). Of 45 tumors, 19 (42.2%) located in the stomach, 9 (20.0%) in the small intestine, 7 (15.6%) in the rectum, 4 (8.9%) in the mesentery, and 6 (13.3%) in the retroperitoneum. All the patients received surgical resection and 35 (77.8%) underwent complete resection, 10 (22.2%) underwent resection of ruptured tumors (before or during operation), 33 (73.3%) underwent R0 resection, 5 (11.1%) underwent R1 resection, and 7 (15.6%) underwent R2 resection. All the patients received targeted therapy of imatinib after surgery. The median duration of imatinib was 24 (10-99) months. The main side effect was noticed in all the patients, mainly including edema in 39 (86.7%) patients and leukopenia in 27 (60.0%) patients. The relapse rate was 37.8% (17/45). The 1-, 3-, and 5-year survival rates were 100%, 86.7% and 74.4%, respectively. Univariate and multivariate analysis revealed that the degree of resection was independently associated with the prognosis of high-risk GIST patients. CONCLUSIONS: Surgery is effective treatment for the GIST. Efforts to obtain R0 resection are important to improve the efficacy of primary resectable high-risk GIST.

Expression of smoothened protein in colon cancer and its prognostic value for postoperative liver metastasis.

UNLABELLED: BACKGROUDS: The hedgehog (Hh) signaling pathway is composed of patched (PTCH) and smoothened (SMO), two transmembrane proteins, and downstream glioma-associated oncogene homolog (Gli) transcription factors. Hh signaling plays a pathological role in the occurrence and development of various cancers. METHODS: To investigate the expression of SMO protein in colon cancer and its association with clinicopathological parameters and postoperative liver metastasis, immunohistochemistry was performed with paraffin-embedded specimens of 96 cases. Relationships between SMO protein expression and clinicopathological parameters, postoperative liver metastasis were analyzed. RESULTS: IHC examination showed that SMO protein expression was significantly increased in colon cancer tissues compared to normal colon tissues (P = 0.042), positively related to lymph node metastases (P = 0.018) and higher T stages (P = 0.026). Postoperative live metastasis-free survival was significantly longer in the low SMO expression group than in those with high SMO expression (48.7 ± 8.02 months vs 28.0 ± 6.86 months, P=0.036). Multivariate analysis showed SMO expression level to be an independent prognostic factor for postoperative live metastasis-free survival (95% confidence interval [CI] =1.46-2.82, P = 0.008). CONCLUSIONS: Our results suggest that in patients with colon cancer, the SMO expression level is an independent biomarker for postoperative liver metastasis, and SMO might play an important role in colon cancer progression.

Laparoscopic management of perforated Meckel's diverticulum in adults.

OBJECTIVE: To determine the role of laparoscopy in diagnosis and surgical treatment of perforated Meckel's diverticulum (MD) in adults. METHODS: Between July 2003 and July 2011, fifteen patients were seen with perforated MD. Eleven were male and four were female. The median age was 38 years (range, 21-68). All patients presented with a sudden onset of pain. Among them 9 had a past medical history of bloody stools and /or chronic recurrent abdominal pain. 2 were preoperatively diagnosed with perforated MD confirmly and 4 suspiciously, 9 with perforated acute appendicitis. All 15 patients underwent exploratory laparoscopy. RESULTS: 4 patients with broad-base(≧ 2 cm) and 2 patients with narrow-base(<2 cm) whose perforative site was near the base underwent laparoscopically assisted extracorporal bowel segment resection, the other 9 patients with narrow-base(<2 cm) underwent laparoscopically intraabdominal wedge resection of the MD. No intraoperative or postoperative complications occurred. The median hospital stay was 4 days (range, 2-7 days). The histopathologic studies showed heterotopic gastric mucosa (HGM) in 10 cases (66.7%). All patients recovered uneventfully. CONCLUSION: To patients with sudden abdomen pain mimic acute appendicitis accompanied by a past medical history of bloody stools and/or chronic recurrent abdominal pain, proferated MD should be kept in mind as a differential diagnosis. Laparoscopy is a safe and effective surgical modality for diagnosis of proferated MD and has a therapeutic role that results in an excellent cosmetic result.