ABSTRACT
Complete mesocolic excision (CME) with central vascular ligation (CVL) in laparoscopic surgery for right-sided colon cancer (RSCC) requires a precise understanding of the vascular anatomy. The efficacy of intraoperative ultrasound (IUS) in the identification of blood vessels for RSCC surgery was not evaluated. The aim of this study was to compare the intraoperative and short-term outcomes of CME with CVL with or without IUS by laparoscopic surgery for RSCC. We performed IUS on 26 patients of RSCC and compared with a total of 124 patients who underwent the surgery for RSCC at our institution. Propensity score matching (PSM) was performed to reduce the confounding effects to imbalances in the use of IUS. The IUS identified the main feeding artery and the accompanying vein in all 26 cases. After PSM, the amount of intraoperative blood loss in the IUS group was significantly lower than that in the conventional group (5 ml vs. 30 ml, p = 0.035) and no significant difference of the postoperative complications was observed. The IUS reduced the risk of bleeding in the surgery for RSCC. The IUS is a safe and feasible technique that help the surgeons for anatomical understandings under real-time condition in the laparoscopic surgery of RSCC.
Subject(s)
Colonic Neoplasms , Laparoscopy , Humans , Colonic Neoplasms/diagnostic imaging , Colonic Neoplasms/surgery , Propensity Score , Colectomy/methods , Laparoscopy/methods , Lymph Node Excision/methods , Ligation , Treatment OutcomeABSTRACT
Cancer-associated fibroblasts(CAFs)remodel the extracellular matrix(ECM)and shape the tumor microenvironment (TME), resulting in immune escape and the promotion of tumor metastasis. Using an orthotopic tumor model of colorectal cancers(CRCs)in mice, we demonstrated that the single-cell RNA sequencing of orthotopic rectal tumors identified a subpopulation of CAFs that modulate the immune response. In this review, we report that understanding the role of CAFs in the TME concerning tumor immunity may lead to future avenues for CAF-targeted therapy.
Subject(s)
Cancer-Associated Fibroblasts , Colorectal Neoplasms , Animals , Mice , Cancer-Associated Fibroblasts/pathology , Colorectal Neoplasms/pathology , Tumor Microenvironment/genetics , Fibroblasts/pathologyABSTRACT
BACKGROUND/AIMS: Lysyl oxidase (LOX) family members play a key role in modifying the primary tumor microenvironment by crosslinking collagens and elastin in the extracellular matrix. The aim of this study was to analyze the LOX-like (LOXL)1, LOXL3, and LOXL4 expressions in gastric cancer tissue by immunohistochemical staining. METHODS: The correlations between the clinicopathological features of 597 primary gastric carcinomas and LOX family members - LOXL1, LOXL3, and LOXL4 - were investigated by immunohistochemical studies. The effect of the transforming growth -factor ß1 (TGFß1) on the expressions of LOXL1, LOXL3, and LOXL4 in gastric cancer was examined using diffuse-type gastric cancer cell lines in vitro. RESULTS: The expressions of LOXL1, LOXL3, and LOXL4 were correlated with T invasion, lymph node metastasis, and lymphatic and venous invasion. LOXL1 expression was associated with histological intestinal-type and expanding growth patterns. The overall survival of patients with LOXL1-, LOXL3-, or LOXL4-positive cancer was poorer than those with negative cancer. LOXL3 and LOXL4 mRNA expressions were significantly high in diffuse-type gastric cancer cells with high invasion ability. TGFß decreased the LOXL1 expression and increased LOXL3 and LOXL4 expression. CONCLUSION: LOXL1, LOXL3, and LOXL4 expressions are associated with distant metastasis of gastric cancer.
Subject(s)
Amino Acid Oxidoreductases/metabolism , Carcinoma/pathology , Stomach Neoplasms/pathology , Carcinoma/genetics , Carcinoma/mortality , Cell Line, Tumor , Female , Gastric Mucosa/pathology , Gene Expression Regulation, Neoplastic , Humans , Lymphatic Metastasis/pathology , Male , Middle Aged , Neoplasm Invasiveness/pathology , Protein-Lysine 6-Oxidase , Recombinant Proteins/metabolism , Stomach Neoplasms/genetics , Stomach Neoplasms/mortality , Survival Analysis , Transforming Growth Factor beta1/metabolism , Tumor MicroenvironmentABSTRACT
Tumor stromal cells play a critical role in the progression of diffuse-type gastric cancer (DGC). The aim of this study was to clarify where tumor stromal cells originate from and which factor(s) recruits them into the tumor stroma. Immunodeficient mice with bone marrow transplantation from the cytomegalovirus enhancer/chicken ß-actin promoter-enhanced green fluorescent protein mice were used for the in vivo experiments. An in vitro study analyzed the chemotaxis-stimulating factor from DGC cells using bone marrow-derived mesenchymal cells (BM-MCs). The influences of chemokine (C-X-C motif) receptor 2 (CXCR2) inhibitor on the migration of BM-MCs were examined both in vitro and in vivo. BM-MCs frequently migrated into stroma of DGC in vivo. The number of migrating BM-MCs was increased by conditioned medium from DGC cells. CXCL1 from DGC cells stimulated the chemoattractant ability of BM-MCs. Both anti-CXCL1 antibody and CXCR2 inhibitor decreased the migration of BM-MCs, stimulated by DGC cells. A CXCR2 inhibitor, SB225002, reduced the recruitment of BM-MCs into the tumor microenvironment in vivo, decreasing tumor size and lymph node metastasis, and prolonging the survival of gastric tumor-bearing mice. These findings suggested that most tumor stromal cells in DGC might originate from BM-MCs. CXCL1 from DGC cells stimulates the recruitment of BM-MCs into tumor stroma via CXCR2 signaling of BM-MCs. Inhibition of BM-MC recruitment via the CXCL1-CXCR2 axis appears a promising therapy for DGC.
Subject(s)
Chemokine CXCL1/metabolism , Mesenchymal Stem Cells/metabolism , Receptors, Interleukin-8B/metabolism , Signal Transduction , Stomach Neoplasms/pathology , Actins/genetics , Animals , Bone Marrow/metabolism , Bone Marrow/pathology , Chemokine CXCL1/genetics , Chemokines/metabolism , Disease Models, Animal , Disease Progression , Female , Green Fluorescent Proteins , Humans , Mice , Mice, Inbred BALB C , Mice, SCID , Receptors, Interleukin-8B/genetics , Stomach Neoplasms/etiology , Stomach Neoplasms/metabolism , Tumor MicroenvironmentABSTRACT
We report a patient who underwent 2-term surgery to treat focal progression of a huge liver metastasis and peritoneal dissemination from a gastric gastrointestinal stromal tumor(GIST)during imatinib mesylate treatment. A 59-year-old man underwent an emergency surgery for perforative peritonitis caused by gastric GIST in June 2006 and a partial resection of the stomach in September 2006. Four years later, abdominal computed tomography(CT)detected a huge liver tumor that occupied the entire right lobe. We initiated imatinib mesylate treatment(400mg/day), and the patient maintained stable disease for several months. However, focal progression of the huge liver tumor and a peritoneal tumor at the splenic hilum were revealed by CT; therefore, an extended right hepatic resection was performed in August 2011 and a distal pancreatectomy, splenectomy, and partial resection of the stomach were performed in February 2012. The patient died of the primary disease at 16 months after the hepatic resection for focal progression.
