Utility of circulating tumor cells in stage II colorectal cancer patients undergoing curative resection.

BACKGROUND: The aim of this study was to determine whether circulating tumor cells (CTCs) have utility as a prognostic biomarker in stage II colorectal cancer (CRC), as well as a biomarker for the selection of patients for adjuvant chemotherapy. METHODS: CTCs were detected in peripheral blood samples obtained from 73 stage II CRC patients, using a negative enrichment and immune-fluorescence in situ hybridization (imFISH) staining method. The follow-up time ranged from 3.5 to 35.9 months, and the clinic-pathologic characteristics and recurrence free survival (RFS) were collected and analyzed. RESULTS: Seventy-three stage II CRC patients were included in this study. The positive rate of CTCs was 65.8% in all patients, 87.5% in recurrent patients and 59.6% in no recurrence patients. The mean RFS was 30.6 months for all patients, 28.7 months for CTC-positive patients and 34.0 months for CTC-negative patients (P=0.043). The mean RFS of CTC-positive and CTC-negative patients with adjuvant chemotherapy were not reached, and those without adjuvant chemotherapy were 27.7 and 33.4 months, respectively. CONCLUSIONS: The level of CTCs may be an effective prognostic factor to predict RFS in stage II CRC patients, and has potential in selecting stage II CRC patients for adjuvant chemotherapy.

Laparoscopic-assisted Transanal Total Mesorectal Excision for Middle-Low Rectal Carcinoma: A Clinical Study of 19 Cases.

AIM: To explore the safety, feasibility and short-term outcomes of laparoscopic-assisted transanal total mesorectal excision (La-TaTME) of middle-low rectal carcinoma. MATERIALS AND METHODS: This retrospective research collected and analyzed the clinical data of 19 patients diagnosed with middle and low rectal carcinoma who underwent La-TaTME from August 2015 to February 2017. RESULTS: No case was converted to laparotomy. In none of the enrolled cases, did the circumferential resection margin test positive by histopathology examination. Also, there was no detected residual tumor at the proximal and distal resection margins. The rate of postoperative morbidity was 15.8% (Clavien-Dindo grade 2). During the follow-up period, no local recurrence or metastasis was observed. CONCLUSION: La-TaTME is a safe alternative to standard laparoscopic TME in middle-low rectal carcinoma when operated by an experienced colorectal surgeon. However, large-scaled randomized multi-centered comparative trials are still needed to further test its oncological effectiveness.

Synchronous collision neuroendocrine tumor and rectal adenocarcinoma: a case report.

Collision tumors are thought to arise from the accidental meeting of two independent tumors. Adenocarcinoma is the most common malignant rectal tumor, while neuroendocrine tumor (NET) is relatively rare. Due to the endoscopy and reporting, the overall incidence of NETs was increasing recently but still less than 1 per 100,000. This means that a combination of an adenocarcinoma and NET is a very rare finding and an actual collision of these tumors even more so. We report here a highly unusual case of a 64-year-old woman who had collision tumors composed of a primary rectal adenocarcinoma and NET showing a "side by side" pattern. Resection margins are free of both the tumors. The postoperative course was uneventful. The patient underwent a protocol CT scan at 3 months after surgery, which did not show any recurrence. Both the malignant adenocarcinoma and the NET would make a great influence in the rest lifetime and a follow up will be continued, although the CT did not show any recurrence until now. To the best of our knowledge, this is the first reported case of such an occurrence.

Genetic association of single nucleotide polymorphisms in P53 pathway with gastric cancer risk in a Chinese Han population.

The tumor suppressor gene P53 plays an important role in carcinogenesis, and the P53 pathway is central both in reducing cancer frequency and in mediating the response of cancer therapies. MDM2, MDM4 and Hausp genes are all critical regulators of the tumor suppressor P53. Many studies have evaluated the association of single nucleotide polymorphisms (SNPs) in P53 pathway with the risk of common cancers. However, the results are still inconclusive. In this work, we analyzed the association of SNPs in P53 (rs1042522), MDM2 (rs2279744), MDM4 (rs1380576) and Hausp (rs1529916) genes with gastric cancer in a hospital-based Chinese Han population (642 cases and 720 cancer-free controls). We found that the polymorphisms of P53 (rs1042522) and MDM2 (rs2279744) are associated with gastric cancer risk, whereas no significant association was observed between variant genotype of other two polymorphisms (MDM4 rs1380576 and Hausp rs1529916) and gastric cancer risk.

Role of c-Src activity in the regulation of gastric cancer cell migration.

Gastric cancer is associated with increased migration and invasion. In the present study, we explored the role of c-Src in gastric cancer cell migration and invasion. BGC-823 gastric cancer cells were used to investigate migration following treatment of these cells with the c-Src inhibitors, PP2 and SU6656. Migration and invasion were analyzed by wound healing and Transwell assays. Western blot analysis was used to detect the expression of MT1-MMP and VEGF-C, while the activity of MMP2 and MMP9 was monitored with gelatin zymography assay. Immunoprecipitation was used to detect interactions among furin, pro-MT1-MMP and pro-VEGF-C. MT1-MMP and VEGF-C expression levels were inhibited by PP2 and SU6656 treatment, in accordance with decreased c-Src activity. Similarly, the zymography assay demonstrated that the activity of MMP2 and MMP9 was decreased following PP2 or SU6656 treatment. Blockade of c-Src also inhibited the invasive and migratory capacity of BGC-823 cells. Notably, c-Src interacted with furin in vivo, while interactions between furin and its substrates, pro-MT1-MMP and pro-VEGF-C, were decreased by c-Src inhibitors. In conclusion, the interaction among furin and pro-MT1-MMP or pro-VEGF-C or other tumor-associated precursor enzymes can be regulated by c-Src activity, thus reducing or changing the expression of these enzymes in order to reduce the development of gastric cancer, invasion and metastasis.

Efficacy and safety of neoadjuvant chemotherapy with modified FOLFOX7 regimen on the treatment of advanced gastric cancer.

BACKGROUND: Gastric cancer is one of the most common types of malignant tumors in China and East Asia and has the highest mortality rate of the malignant gastrointestinal tumors. Neoadjuvant chemotherapy is a systemic or local chemotherapy that is given prior to the local treatment of malignant tumors. Neoadjuvant therapy is currently showing some positive prospects; however, its clinical effects remain controversial. In this study, we used the modified FOLFOX7 (mFOLFOX7) regimen as a neoadjuvant chemotherapy regimen. Perioperative clinical and pathological efficacy, toxicity, effects of surgery, postoperative observation, and prognosis were studied to investigate its clinical efficacy and safety. METHODS: Eighty patients with advanced gastric cancer were treated in our surgery department from 2005 to 2009; 38 of these patients received mFOLFOX7 neoadjuvant chemotherapy, the other 42 patients assigned to the control group. The perioperative effects of mFOLFOX7 chemotherapy, including clinical effects and toxicity, were observed in each patient. RESULTS: After mFOLFOX7 chemotherapy, clinical and pathologic stages decreased in 21.1% and 36.8% of the patients, respectively, but the results were not statistically significant (P = 0.129). The clinical response rate was 50% (19/38). Toxicity was mild; most adverse events were grade I or II and involved no severe infections or deaths. Compared with the control group, the radical resection rate increased (92.1% vs. 85.7%; P = 0.437); surgical effects were completed without an increased incidence of perioperative complications. The 1-, 2-, and 3-year survival rates were 78.70%, 57.40%, and 51.66%, respectively, in the neoadjuvant chemotherapy group and 78.57%, 56.87%, and 43.16%, respectively, in the control group. CONCLUSIONS: The mFOLFOX7 regimen was very effective and well-tolerated as a neoadjuvant chemotherapy for advanced gastric cancer. However, the 1-, 2-, and 3-year survival rates in the mFOLFOX7 group were not significantly different from the control group.

Gangliocytic paraganglioma of the duodenum: a case report.

Gangliocytic paraganglioma of the duodenum is an extremely rare disease. Few cases have been reported in the literature from 1957 to 2010. We reported a 67-year-old man with gangliocytic paraganglioma of the duodenum.

[Prevention and treatment of hepatitis B virus reinfection after liver transplantation].

OBJECTIVE: To study the efficacy of the protocol of combination of lamivudine with low dosage hepatitis B immuno-globulin (HBIG) to prevent HBV reinfection and of the treatment for HBV reinfection after liver transplantation. METHODS: From December 2000 to May 2003, 11 patients (follow-up is more than 1 year) had been transplanted due to HBV related end-stage liver disease or hepatocellular carcinoma. All patients received the protocol of combination of lamivudine with low dosage HBIG to prevent HBV reinfection after liver transplantation. Lamivudine was administered for more than 2 weeks. Preoperatively patients with HBV-DNA(-) and HBeAg(-) accepted HBIG 2000 IU intramuscular injection. Patients with HBV-DNA(+) or HBeAg(+) before operation accepted HBIG 4000 IU intramuscular injection, and patients with both HBV-DNA(+) and HBeAg(+) before operation accepted HBIG 6000 IU intramuscular injection. All patients took long-term lamivudine postoperatively. They accepted HBIG 800 IU/d for 1 week after transplantation. Two weeks after operation, dosage of HBIG was adjusted so that the titer of HBsAb was higher than 500 IU/L, but lower than 1000 IU/L, and this treatment lasted for 6 months. 6 months after operation, dosage of HBIG was adjusted so that tite of HBsAb higher than 300 IU/L but lower than 500 IU/L, and this treatment lasted for 6 months. One year after operation, dosage of HBIG was adjusted so that tite of HBsAb was higher than 100 IU/L but lower than 300 IU/L, and this treatment lasted for a long time. Examinations of liver function, HBV-DNA and hepatitis B were regularly taken. To observe the early turning to be negative rate, the later HBV reinfection rate, and the efficacy of the treatment for HBV reinfection. RESULTS: HBsAg, HBeAg and HBV-DNA in all patients turned to be negative in 1-4 days after operation. All patients responded to HBIG, and level of titer of HBsAb was elevated gradually. All patients was alive during the observation time. The regular examination of HBsAb showed that of HBsAb was in line with our expectation. Hepatitis B recurrence occurred in 1 patient 25 months after transplantation. Through using adefovir and adding the dosage of HBIG, the hepatitis B is in control. CONCLUSIONS: The protocol of combination of lamivudine with low dosage HBIG proved to be highly effective and safe in preventing the recurrence of HBV after liver transplantation. It also reduced the cost obviously.