Impact of 5-fluorouracil on glucose metabolism and pancreatic pathology in rats / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the impact of 5-fluorouracil (5-FU) on glucose metabolism and pancreatic pathology.</p><p><b>METHODS</b>Twenty Wistar rats were divided into 5-FU group(n=10, chemotherapy was administered intraperitoneally to animals at a dose of 20 mg/kg daily for continuous 5 days) and control group (n=10, sodium chloride was administered intraperitoneally to animals with the same dose at the same time ). Glucose tolerance was evaluated 2 and 7 days following 5-FU treatment by serial measurement of blood glucose before and after an oral glucose load. Plasma insulin concentration was determined by radioimmunoassay. Pancreatic pathology was examined with morphological method and the ultrastructural changes of β cells were observed by transmission electron microscope.</p><p><b>RESULTS</b>Fasting blood glucose level was significantly higher in the 5-FU group than that in the control group [(7.6±0.9) mmol/L vs. (4.6±0.6) mmol/L at day 2; (8.9±1.0) mmol/L vs. (4.7±0.6) mmol/L at day 7, P<0.01]. Insulin releasing test indicated that the early phase insulin response to glucose load was significantly diminished in animals treated with 5-FU at day 2. Insulin level was significantly lower in the 5-FU group than that in the control group at 30 min (P<0.01). The peak secretion time of plasma insulin in 5-FU group was at 60 min, similar to the control group; and plasma insulin level decreased more slowly. Plasma insulin level was higher in 5-FU groups than in control groups on 120 min and 180 min. At day 7, Insulin level was lower in the 5-FU group than that in the control group on 60 min, and the peak secretion time of plasma insulin was delayed to 120 min. Plasma insulin level was significantly increased in 5-FU group than that in control group on 180 min(P<0.01). No gross histopathological damage to the pancreas was observed at day 2 and 7 following administration of 5-FU. The structural changes of mitochondria were mainly the quantities of secretory granule diminished at day 7 under transmission electron microscope. Dilated rough endoplasmic reticula, swollen mitochondria, and the presence of adipose drops in lysosomes were found in few cells.</p><p><b>CONCLUSIONS</b>5-FU-induced hyperglycemia appears to be mediated in part by a relatively deficient insulin secretion to glucose stimulation. A relative deficiency in insulin secretion following 5-FU treatment appears to be related to β cells function impairs with islet cell ultrastructural changes induced by 5-FU.</p>

Preliminary report about the screening program for colorectal cancer by sequential fecal occult blood in Wuhan area for 4 years / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the sequential fecal occult blood test (SFOBT) program for the screening of colorectal cancer and elucidate the prevalence of colorectal cancer in Wuhan area.</p><p><b>METHODS</b>At 19 screening sites, 63,961 residents were recruited as target population according to random cluster and stratified sampling for four years (between 2005 and 2008). Residents aged over 40 years old received SFOBT. Those with positive SFOBT underwent colonoscopy.</p><p><b>RESULTS</b>The target population was 63,961. There were 25,837 people whose age was over 40. Finally, 7784 participants received the SFOBT screening, with a medium age of 56 years old. The positive rate of SFOBT was 12.3% (956 persons). Of the 956 persons, 240 participants underwent colonoscopy. Colorectal cancer was found in 14 cases (6.5%), gastric cancer in 2 cases (0.9%), colorectal adenoma in 53 cases(24.8%), colorectal inflammation in 80 cases (37.3%) and hemorrhoids in 65 cases (30.4%).</p><p><b>CONCLUSIONS</b>The prevalence of colorectal cancer is relatively high in Wuhan area. The SFOBT is available and feasible in screening early changes of colorectal cancer.</p>

Study on the prognostic factors of colorectal cancer and on suggested model for prediction / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the factors related to the prognosis of colorectal cancer (CRC) and to establish a prognostic model for evaluating the prognosis of the patients with CRC.</p><p><b>METHODS</b>370 cases with CRC were selected in the study and clinical/pathological factors were collected and patients were followed. Kaplan-Meier method was used to calculate survival rate. Log-rank test and proportional-hazards regression model (Cox model) were used for univariate and multivariate analysis. Log cumulative hazards function plot was used to test Cox model proportional-hazards assumption (PH assumption). Prognostic index (P1) was calculated based on the results of multivariate analysis.</p><p><b>RESULTS</b>(1) One-year, three-year and five-year survival rates were 90.5%, 78.3% and 76.5% respectively. (2) Lymphatic metastasis, Duckes classification and therapeutic measure were independent prognostic factors of CRC and all passed PH assumption. (3) Patients with different PI were classified into 3 groups and there were significant differences noticed in survival rates (P < 0.001). (4) Individual survival rate was evaluated based on the prognostic Cox model and PI.</p><p><b>CONCLUSION</b>Lymphatic metastasis, Duckes classification and therapeutic measure were independent prognostic factors of CRC. To test PH assumption of the factors, selection of Cox model was essential. Cox model and PI seemed to be available in predicting the long term survivrate of patients with CRC.</p>

Comparative study on the exfoliative cytology of intraoperative peritoneal lavage in patients with rectal cancer pre- and post-tumor resection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical value of sequential intraoperative peritoneal lavage in reducing the positive rate of peritoneal exfoliated tumor cells.</p><p><b>METHODS</b>Six sequential intraoperative peritoneal lavages were performed in each of the 63 patients with rectal cancer, with three before resection and three post resection, which were then compared by using cytological smear examination.</p><p><b>RESULTS</b>Exfoliated tumor cells were positive in the first three intraoperative peritoneal lavages of all the 63 patients before resection. The cytological smear examination of the three peritoneal lavage fluids after excision revealed that 40 cases were positive at the first lavage, 33 at the second and 13 at the third. The positive rate between the first and the second post-resection peritoneal lavages showed no significant difference (P>0.05), while the positive rate of the third lavage was significantly lower than the second after resection (P<0.01).</p><p><b>CONCLUSION</b>Sequential intraoperative peritoneal lavages is a useful method in reducing the positive rate of peritoneal exfoliated tumor cells in patients with rectal cancer.</p>