Risk factors for anastomotic fistula development after radical colon cancer surgery and their impact on prognosis.

BACKGROUND: Colon cancer is a common malignant tumor in the gastrointestinal tract that is typically treated surgically. However, postradical surgery is prone to complications such as anastomotic fistulas. AIM: To investigate the risk factors for postoperative anastomotic fistulas and their impact on the prognosis of patients with colon cancer. METHODS: We conducted a retrospective analysis of 488 patients with colon cancer who underwent radical surgery. This study was performed between April 2016 and April 2019 at a tertiary hospital in Wuxi, Jiangsu Province, China. A t-test was used to compare laboratory indicators between patients with and those without postoperative anastomotic fistulas. Multiple logistic regression analysis was performed to identify independent risk factors for postoperative anastomotic fistulas. The Functional Assessment of Cancer Therapy-Colorectal Cancer was also used to assess postoperative recovery. RESULTS: Binary logistic regression analysis revealed that age [odds ratio (OR) = 1.043, P = 0.015], tumor, node, metastasis stage (OR = 2.337, P = 0.041), and surgical procedure were independent risk factors for postoperative anastomotic fistulas. Multiple linear regression analysis showed that the development of postoperative anastomotic fistula (P = 0.000), advanced age (P = 0.003), and the presence of diabetes mellitus (P = 0.015), among other factors, independently affected prognosis. CONCLUSION: Postoperative anastomotic fistulas significantly affect prognosis and survival rates. Therefore, focusing on the clinical characteristics and risk factors and immediately implementing individualized preventive measures are important to minimize their occurrence.

HER-2, ER, PR status concordance in primary breast cancer and corresponding metastatic lesion in lymph node in Chinese women.

AIMS AND BACKGROUND: To compare the expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) in the primary site and the metastatic lesion of lymph nodes in invasive breast cancer for investigating whether the expression of these biomarkers in the primary site could act as a surrogate to the lymphatic metastatic lesion in the same patient. METHODS: In lymphatic metastatic lesion and corresponding primary lesion of 107 cases of invasive breast cancer, ER and PR statuses were assessed by immunohistochemistry (IHC). HER-2 expression level was evaluated by IHC and/or fluorescence in situ hybridization (FISH). RESULTS: In the primary lesions, 43.9% were ER positive; 46.7% were PR positive; 34.6% were HER-2 positive. In corresponding lymphatic metastatic lesions, the HER-2 status was concordant in 90 patients; 9 patients were diagnosed positive in metastatic lesion while negative in primary lesion; 8 patients were negative in metastatic lesion while positive in primary site (agreement, 84.1%; κ=0.647). A change in ER status was observed in 24 cases: 17 cases positive in metastatic site while negative in primary site; 7 cases negative in metastatic site while positive in primary site (agreement, 77.6%; κ=0.534). PR status discordance between the primary lesion and the metastatic regional lymph nodes was reported in 19 cases (agreement, 82.2%; κ=0.640). CONCLUSIONS: This study revealed that there was only a moderate concordance of ER, PR and HER-2 status between primary tumors and metastatic lymph nodes. These results indicate that it was inappropriate to predict the status of ER, PR and HER-2 in metastatic lymph nodes based on the results of evaluation of that in primary lesions.

Down-regulated miRNA-214 induces a cell cycle G1 arrest in gastric cancer cells by up-regulating the PTEN protein.

To detect the expression of miRNA-214 in human gastric cancer cell lines of BGC823, MKN45 and SGC7901, and to identify the effect of miRNA-214 on cell cycle and apoptosis of these cells. Expression of miRNA-214 in human normal gastric mucosal cell line GES-1 and human gastric cancer cell lines was detected by real-time reverse-transcription polymerase chain reaction. Antisense-miRNA-214 oligonucleotides were transfected transiently into gastric cancer cell lines to down-regulate the expression of miRNA-214. The cell cycle and apoptosis were studied by flow cytometry assay. PTEN, one of the target genes of miRNA-214 was detected by using of immunocytochemistry and Western blotting. MiRNA-214 was overexpressed in gastric cancer cell lines of BGC823, MKN45 and SGC7901 compared with normal gastric mucosal cell line GES-1. Antisense-miRNA-214 oligonucleotides significantly down-regulated the expression of miRNA-214, and increased the portion of G1-phase and decreased the portion of S-phase in BGC823 and MKN45 cells. The immunocytochemistry test and Western blotting analysis showed that the down-regulation of miRNA-214 could significantly up-regulate the expression of PTEN in BGC823 and MKN45 cells. MiRNA-214 is overexpressed in human gastric cancer cell lines of BGC823, MKN45 and SGC7901. The down-regulation of miRNA-214 could induce a G1 cell cycle arrest in them, the up-regulation of PTEN maybe one of the mechanism.