Association Between Peritoneal Carcinomatosis Index (PCI) Assessed by CT and Pathological Parameters and Short-Term Prognosis of Rectal Cancer.

Objective: The study aimed at explore the correlation between the CT-based Peritoneal Carcinomatosis Index (PCI) and pathological parameters of rectal cancer, as well as the correlation with short-term postoperative prognosis. Methods: A retrospective analysis was performed on 198 rectal cancer patients treated in our institution from January 2017 to December 2022. Based on preoperative CT-PCI, patients were classified into a normal and low CT-PCI groups. Baseline characteristics and short-term postoperative outcomes were compared between the two groups. Univariate and Multivariable logistic regression analyses were conducted to ascertain the independent risk factors for postoperative complications (Clavien-Dindo classification ≥ Grade II) following neoadjuvant treatment and radical rectal cancer surgery. Results: There were significant statistical differences between the two groups regarding age, ASA score, and surgical method (P < .05). Variations in overall postoperative complications and complications of Grade II or higher among patients with differing preoperative CT-PCI were statistically significant (P < .05). No significant statistical difference was found in the time to first liquid intake post-surgery between the preoperative low CT-PCI group and the normal CT-PCI group (P > .05); however, differences in the time to first flatus, duration of postoperative hospital stay, and total hospital expenditure were statistically meaningful (P < .05). Multivariate logistic regression revealed that CT-PCI (OR=2.254) was an influential factor for postoperative complications (Clavien-Dindo classification ≥ Grade II) (P < .05). The ROC curve demonstrated an AUC of 0.854 for CT-PCI in predicting postoperative complications (Clavien-Dindo classification ≥ Grade II). Conclusion: Preoperative CT-PCI may be utilized to evaluate the short-term prognosis of patients who undergo radical surgery for rectal cancer after neoadjuvant therapy. This evaluation assists in guiding clinical diagnostic and therapeutic decision-making, allowing for prompt interventions and enhancing short-term patient outcomes.

Lateral lymph node dissection can increase overall survival and 5­year survival rate of rectal cancer patients: A meta­analysis.

Rectal cancer is one of the most malignant tumors, and postoperative recurrence and metastasis are the main reasons for treatment failure. Lymph node metastasis is the main metastatic pathway of rectal cancer. The present study aimed to investigate the role of lateral lymph node dissection (LLND) in patients with rectal cancer using a meta-analysis. Articles in Chinese and English related to the application of LLND in patients with rectal cancer were retrieved and eligible studies were selected for data analysis. Evaluation indicators included the 5-year survival rate, recurrence rate, urinary system function and operation time. The random-effects model was utilized for the analysis. A total of 10 studies that met the eligibility criteria were selected, comprising 2,272 patients, including 1,101 cases in the LLND group and 1,171 cases in the non-LLND group. No significant difference was found between the two groups in terms of local recurrence rate, 5-year disease-free survival (DFS) rate, and DFS rate at the follow-up. It is noteworthy that cases in the LLND group had no significantly longer overall survival, but had a higher 5-year survival rate. However, cases in the LLND group had a longer operation time and worse urinary dysfunction. The results remained consistent throughout separate analyses for different research quality sources. The present meta-analysis showed that LLND provided a specific advantage in prolonging survival time. However, it was associated with prolonged operation time and an increased incidence of urinary dysfunction.

Iron regulatory protein from the hard tick Haemaphysalis longicornis: characterization, function and assessment as a protective antigen.

BACKGROUND: Ticks are blood-feeding ectoparasites with different host specificities and are capable of pathogen transmission. Iron regulatory proteins (IRPs) play crucial roles in iron homeostasis in vertebrates. However, their functions in ticks remain poorly understood. The aim of the present study was to investigate the characteristics, functions, molecular mechanisms, and the vaccine efficacy of IRP in the hard tick Haemaphysalis longicornis. RESULTS: The full-length complementary DNA of IRP from Haemaphysalis longicornis (HlIRP) was 2973 bp, including a 2772 bp open reading frame. It is expressed throughout three developmental stages (larvae, nymphs, and adult females) and in various tissues (salivary glands, ovaries, midgut, and Malpighian tubules). Recombinant Haemaphysalis longicornis IRP (rHlIRP) was obtained via a prokaryotic expression system and exhibited aconitase, iron chelation, radical-scavenging, and hemolytic activities in vitro. RNA interference-mediated IRP knockdown reduced tick engorgement weight, ovary weight, egg mass weight, egg hatching rate, and ovary vitellin content, as well as prolonging the egg incubation period. Proteomics revealed that IRP may affect tick reproduction and development through proteasome pathway-associated, ribosomal, reproduction-related, and iron metabolism-related proteins. A trial on rabbits against adult Haemaphysalis longicornis infestation demonstrated that rHlIRP vaccine could significantly decrease engorged weight (by 10%), egg mass weight (by 16%) and eggs hatching rate (by 22%) of ticks. The overall immunization efficacy using rHlIRP against adult females was 41%. CONCLUSION: IRP could limit reproduction and development in Haemaphysalis longicornis, and HlIRP was confirmed as a candidate vaccine antigen to impair tick iron metabolism and protect the host against tick infestation. © 2024 Society of Chemical Industry.