Corrosion Resistance of CeO2-GO/Epoxy Nanocomposite Coating in Simulated Seawater and Concrete Pore Solutions.

Reinforced concrete structures in the marine environment face serious corrosion risks. Coating protection and adding corrosion inhibitors are the most economical and effective methods. In this study, a nano-composite anti-corrosion filler with a mass ratio of CeO2:GO = 4:1 was prepared by hydrothermally growing cerium oxide on the surface of graphene oxide. The filler was mixed with pure epoxy resin at a mass fraction of 0.5% to prepare a nano-composite epoxy coating. The basic properties of the prepared coating were evaluated from the aspects of surface hardness, adhesion grade, and anti-corrosion performance on Q235 low carbon steel subjected to simulated seawater and simulated concrete pore solutions. Results showed that after 90 days of service, the corrosion current density of the nanocomposite coating mixed with corrosion inhibitor was the lowest (Icorr = 1.001 × 10-9 A/cm2), and the protection efficiency was up to 99.92%. This study provides a theoretical foundation for solving the corrosion problem of Q235 low carbon steel in the marine environment.

Pain mediates the improvement of social functions of repeated intravenous ketamine in patients with unipolar and bipolar depression.

OBJECTIVE: Previous research has shown that ketamine can improve social functions. In addition, evidence also suggests that ketamine can alleviate pain. Herein, we propose that ketamine-induced improvements in pain and depression are partially mediated by a reduction in pain. We aimed to determine whether improvements in pain-mediated changes in psychological function were associated with ketamine treatment. METHOD: This trial included unipolar or bipolar patients (n = 103) who received 6 intravenous infusions (0.5 mg/kg) of ketamine over 2 weeks. The severity of current depressive symptoms and social function were evaluated by the Montgomery-Åsberg Depression Scale (MADRS), Self-Rating Depression Scale (SDS) and Global Assessment Function (GAF), respectively, at baseline and on day 13 and day 26. At the same time points, the three dimensions of pain, including the sensory index, affective index and present pain intensity (PPI), were measured by the Simple McGill Pain Scale (SF-MPQ). RESULTS: The mixed model results showed that ketamine plays an important role in improving the psychosocial functioning of patients. There was a significant decrease from baseline to the day 13 and day 26, indicating that the pain index of the patient improved significantly. Mediation analysis showed that for SDS score (coef = -5.171, 95 % CI[-6.317, -4.025]) and GAF score (coef = 1.021, 95 % CI[0.848, 1.194]), the overall effect of ketamine was observable. The overall indirect and direct effects of ketamine on social functioning were significant (SDS: direct: coef = -1949 to -2114; total indirect: from 0.594 to 0.664; GAF: from 0.399 to 0.427; total indirect: coef = 0.593 to 0.664). The MADRS total score and emotional index were important mediators of the association between ketamine treatment and improvements in subjective and objective social functioning. CONCLUSION: Depressive symptom severity and the affective index of pain partially mediated improvements in social function after six repeated ketamine treatments among patients with bipolar or unipolar depressive disorder.

Investigation on the interaction of catalase with sodium lauryl sulfonate and the underlying mechanisms.

As a classic type of anionic surfactants, sodium lauryl sulfonate (SLS) might change the structure and function of antioxidant enzyme catalase (CAT) through their direct interactions. However, the underlying molecular mechanism is still unknown. This study investigated the direct interaction of SLS with CAT molecule and the underlying mechanisms using multi-spectroscopic methods, isothermal titration calorimetry, and molecular docking studies. No obvious effects were observed on CAT structure and activity under low SLS concentration exposure. The particle size of CAT molecule decreased and CAT activity was slightly inhibited under high SLS concentration exposure. SLS prefers to bind to the interface of CAT mainly via van der Waals' forces and hydrogen bonds. Subsequently, SLS interacts with the amino acid residues around the heme groups of CAT via hydrophobic interactions and might inhibit CAT activity.

Colorectal cancer screening with fecal occult blood test: A 22-year cohort study.

The aim of the present study was to investigate the efficacy of colorectal cancer (CRC) screening with a three-tier fecal occult blood test (FOBT) in the Chinese population. The study was performed between 1987 and 2008 at the Beijing Military General Hospital, in a cohort of army service males and females aged >50 years. Between 1987 and 2005, a three-tier screening program, comprising guaiac-based FOBTs (gFOBTs), followed by immunochemical FOBTs for positive guaiac test samples and then colonoscopy for positive immunochemical test subjects, was performed annually. The cohort was followed up until 2008. The cohort included 5,104 subjects, of which, 3,863 subjects participated in screening (screening group) and 1,241 did not (non-screening group). The two groups did not differ in age, gender or other major risk factors for colon cancer. Overall, 36 CRCs occurred in the screening group and 21 in the non-screening group. Compared with the non-screening group, the relative risk for the incidence and mortality of CRC was 0.51 [95% confidence interval (CI), 0.30-0.87] and 0.36 (95% CI, 0.18-0.71), respectively, in the screening group. The general sensitivity of this three-tier FOBT was 80.6% (95% CI, 65.3-91.1). Thus, annual screening using the three-tier FOBT program may reduce the CRC incidence and mortality rate.

Mismatch repair gene mutation analysis and colonoscopy surveillance in Chinese Lynch syndrome families.

BACKGROUND: Lynch syndrome (or HNPCC) is a colorectal cancer syndrome caused by germline mutations in either one of the DNA mismatch repair (MMR) genes hMLH1, hMSH2, hMSH6 or hPMS2. Mutations in hMLH1 and hMSH2 are most prevalent. Here we aimed to determine the cancer risk of MMR gene mutation carriers and, in addition, the efficacy of colonoscopy surveillance in Chinese Lynch syndrome family members with and without MMR gene mutations. METHODS: A Lynch syndrome family registry encompassing 106 families in Northern China was recently established. Detailed pedigree data for each family were collected and hMLH1 and hMSH2 gene mutation analyses were performed. Germ-line mutations were identified in probands from 42 of these families, and additional genetic analyses were performed in each member of these 42 families to identify mutation and non-mutation carriers. Among the family members included, 180 received colonoscopy and the remaining cases were followed without colonoscopy. RESULTS: Overall 54.8 % of the Lynch syndrome family members carried MMR gene mutations, and these mutation carriers exhibited significantly higher colorectal cancer and other Lynch syndrome-associated cancer risks as compared to non-mutation carriers. The cumulative risk for all Lynch syndrome-related cancers at age 70 was 93.8 % for both hMLH1 and hMSH2 mutation carriers, and 81.7 % and 93.1 % for colorectal cancer at this age, respectively. Whereas 43 of 102 (42.2 %) mutation carriers exhibited significant colonoscopy findings, including 10 colorectal cancers, none of 78 non-mutation carriers exhibited significant findings, and no cancers were detected. In addition, in the mutation carriers, colonoscopy surveillance led to the detection of more early stage cancers than in the non-surveillance group (70.0 % versus 36.5 %, p < 0.01). CONCLUSION: In Lynch syndrome family members, we recommend pre-symptomatic MMR gene mutation analysis in order to identify high risk individuals for colonoscopy surveillance.

Dynamic changes and surveillance function of prion protein expression in gastric cancer drug resistance.

AIM: To explore the dynamic changes of prion protein (PrPc) in the process of gastric cancer drug resistance and the role of PrPc expression in the prognosis of gastric cancer patients receiving chemotherapy. METHODS: A series of gastric cancer cell lines resistant to different concentrations of adriamycin was established, and the expression of PrPc, Bcl-2 and Bax was detected in these cells. Apoptosis was determined using Annexin V staining. Western blotting and immunohistochemistry were performed to detect the expression of PrPc in patients receiving chemotherapy and to explore the role of PrPc expression in predicting the chemosensitivity and the outcome of gastric cancer patients receiving chemotherapy. Follow-up was performed for 2 years. RESULTS: PrPc expression was increased with the increase in drug resistance. Bcl-2, together with PrPc, increased the level of anti-apoptosis of cancer cells. Increased PrPc expression predicted the enhanced level of anti-apoptosis and resistance to anticancer drugs. PrPc expression could be used as a marker for predicting the efficacy of chemotherapy and the prognosis of gastric cancer. Increased PrPc expression predicted both poor chemosensitivity and a low 2-year survival rate. Contrarily, low PrPc expression predicted favorable chemosensitivity and a relatively high 2-year survival rate. CONCLUSION: PrPc expression is associated with histological types and differentiation of gastric cancer cells; The PrPc expression level might be a valuable marker in predicting the efficacy of chemotherapy and the prognosis of gastric cancer patients receiving chemotherapy.

Fecal cytology in conjunction with immunofecal occult blood test for colorectal cancer screening.

OBJECTIVE: To develop a simple method to extract and analyze the cytomorphology of epithelial cells from fecal samples and to compare the efficacy of fecal cytology with the immunofecal occult blood test (IFOBT) in colorectal cancer screening. STUDY DESIGN: Fecal cytology and IFOBT were performed on fecal samples obtained from 41 patients with colorectal cancer; 34 patients with a small, single adenoma (<0.5 cm); and 20 without abnormality. The samples were obtained prior to colonoscopic examination. For fecal cytology, epithelial cells were exacted through filtration, centrifugation and cytocentrifugation and stained with hematoxylin-eosin prior to morphologic analysis. RESULTS: Fecal cytology and IFOBT test had similar levels of sensitivity for detecting colorectal cancer (75.6% vs. 68.3%, respectively), but fecal cytology had higher specificity than IFOBT (100% as compared to 85.2%, respectively, p<0.05 by chi2 test). Seven of 41 colorectal cancer patients (17.1%) with negative IFOBT were positive by fecal cytology analysis. Combining fecal cytology with the IFOBT test in an either/or scenario significantly increased the sensitivity of IFOBT test to 92.68% for colorectal cancer detection (p<0.05 by chi2 test) without compromising the specificity. CONCLUSION: Fecal cytology augments the sensitivity of IFOBT in detecting colorectal cancers, and combining fecal cytology and IFOBT may provide an important simple and cost-effective alternative for colon cancer screening.

Expression of cyclooxygenase-2 and its relationship with mismatch repair and microsatellite instability in hereditary nonpolyposis colorectal cancer / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate cyclooxygenase-2 (COX-2) expression and its relationship with mismatch repair (MMR) protein expression and microsatellite instability (MSI) in hereditary nonpolyposis colorectal cancer (HNPCC).</p><p><b>METHODS</b>A total of 28 cases of colorectal adenoma and 14 cases of colorectal carcinoma were collected between July 2003 and July 2007 from 33 HNPCC families. Sporadic colorectal adenoma (n=32) and carcinoma patients (n=24) served as controls. With samples of tumor tissues and normal colonic mucosa collected from the patients, the protein expressions of COX-2 and MMR (hMLH1, hMSH2, and hMSH6) were examined with immunohistochemical assay. Frequency of MSI in five standard MSI loci BAT25, BAT26, D2S123, D5S346, and D17S250 were analyzed by means of polymerase chain reaction.</p><p><b>RESULTS</b>The rate of COX-2 high-expression was 53.6% (15/28) and 42.9% (6/14) in HNPCC adenoma and carcinoma; 62.5% (20/32) and 91.7% (22/24) in sporadic adenoma and carcinoma, respectively. That rate was lower in HNPCC carcinoma than in sporadic carcinoma (Pü0.05). MMR-deletion rate and percentage of high-frequency MSI (MSI-H) in HNPCC carcinoma were higher than those in sporadic colorectal carcinoma [both 71.4% (10/14) vs. 12.5% (3/24), both Pü0.01]. Among the 10 MMR-deficient HNPCC carcinoma patients, COX-2 low-expression was observed in 8 cases (80.0%), while COX-2 high-expression was observed in all of the 4 MMR-positive HNPCC carcinoma cases (Pü0.05). In comparison to MMR positive HNPCC carcinoma, HNPCC adenoma, and sporadic carcinoma, COX-2 expression was significantly lower in corresponding MMR-deficient cases (all Pü0.05). The rates of COX-2 low-expression in HNPCC adenoma, HNPCC carcinoma, and sporadic carcinoma with MSI-H were significantly higher than those in the cases with microsatellite stability (all Pü0.05).</p><p><b>CONCLUSION</b>COX-2 is expressed at a low level in HNPCC carcinoma, different from the high COX-2 expression in sporadic carcinoma.</p>

Clinicopathological features of non-familial colorectal cancer with high-frequency microsatellite instability / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To explore the clinicopathological features of non-familial colorectal cancer with high-frequency microsatellite instability (MSI-H).</p><p><b>METHODS</b>One hundred and fifty patients with colorectal cancer who had no family history were enrolled in this study from June 2006 to June 2008. Five standard microsatellite loci including BAT25, BAT26, D2S123, D5S346, and D17S250 were amplified with immunofluorescent polymerase chain reaction. The patient information including age, sex, and tumor location was recorded. Pathological features including differentiation, mucinous differentiation, histological heterogeneity, and Crohn's-like reaction were observed under light microscope. The presence of tumor-infiltrating lymphocytes (TLs, CD4+ and CD8+) was detected by means of immunohistochemistry. A regression equation was obtained by stepwise logistic regression analysis to evaluate the relationship between MSI-H phenotype in colorectal cancer and pathological features.</p><p><b>RESULTS</b>MSI-H phenotype occurred in 13.33% of the 150 patients with non-familial colorectal cancer. Poor differentiation, histological heterogeneity, Crohn's-like reaction, and presence of TLs were found to be independent factors to identify MSI-H non-familial colorectal cancer. Logistic regression equation showed an overall sensitivity of 70.0%, specificity of 99.2%, and accuracy of 95.3% in identifying MSI-H non-familial colorectal cancer.</p><p><b>CONCLUSION</b>MSI-H non-familial colorectal cancer manifests specific pathological features, which may be relied upon for effective identification of that disease.</p>

[Effects of cyclooxygenase-2 and proliferating cell nuclear antigen on the onset and development of familial adenomatous polyposis].

BACKGROUND AND OBJECTIVE: Long-term use of cyclooxygenase-2 (COX-2) inhibitors can reduce the incidence of digestive cancers, such as colorectal cancers. Proliferating cell nuclear antigen (PCNA) is an important marker of cellular abnormal proliferation. This study was to evaluate the roles and correlation of COX-2 and PCNA in the onset and development of familial adenomatous polyposis (FAP) diseases. METHODS: Thirty-six specimens of FAP adenomas tissues and 32 specimens of FAP carcinoma tissues from 11 FAP families, and 34 specimens of normal colonic mucosa were collected under colonoscopy from November 2004 to July 2007 in the General Hospital of Beijing Military Command. Immunohistochemistry was used to detect the expressions of COX-2 and PCNA. RESULTS: The positive expression rates of COX-2 in normal colonic mucosa, FAP adenoma, and carcinoma tissues were 0 (0/34), 80.6% (29/36), and 93.8% (30/32), respectively. Proliferation index (PI) in normal mucosa, FAP adenoma, and carcinoma tissues were 17.79+/-7.49, 34.47+/-10.57, and 71.75+/-9.22, respectively. Expressions of COX-2 and PCNA were significantly higher in the FAP adenoma and the carcinoma tissues than in the normal colonic mucosa(P<0.01). The expression of PCNA was significantly higher in the FAP carcinoma tissues than in the FAP adenoma (P<0.01). The expression of PCNA was higher in the FAP adenoma tissues with positive COX-2 than in the FAP adenomas tissues with negative COX-2 (P<0.01). CONCLUSIONS: COX-2 may play an important role in the development of FAP adenomas and colorectal carcinogenesis. COX-2 and PCNA may be important factors in the research on colorectal precancerous lesions and interventional therapy for colorectal neoplasm.

[Expression of cyclooxygenase-2 and relationship with mismatch repair gene and microsatellite instability in hereditary non-polyposis colorectal cancer].

OBJECTIVE: To investigate the expression of Cyclooxygenase (COX)-2 and the relationship between cox-2, mismatch repair gene (MMR) proteins and microsatellite instability (MSI) in HNPCC. METHODS: Twenty-eight cases of adenomas and 14 cases of carcinomas were collected from 33 HNPCC families patients by colonoscopy. Sporadic adenomas (n = 32) and carcinomas (n = 24) were used as a control group. The expressions of COX-2 and mismatch repair gene hMLH1, hMSH2, hMSH6 proteins were examined by immunohistochemistry. MS1 were analyzed by using PCR with BAT25, BAT26, D2S123, D5S346 and D17S250 loci. RESULTS: The COX-2 high-expression rates were 53.6% (15/28) and 42.9% (6/14) in HNPCC adenomas and carcinomas, and were 62.5% (20/32) and 91.7% (22/24) in sporadic adenomas and carcinomas. COX-2 expression was lower in HNPCC carcinomas than that of sporadic carcinomas (P < 0.05). MMR deficiency rate and positive rate of MSI-H were both 71.4% (10/14) respectively in HNPCC carcinomas. It was higher than that in sporadic colorectal carcinomas [both 12.5% (3/24)]. Eight (80.0%) COX-2 low-expression were observed in 10 HNPCC carcinomas with MMR-deficient system while 4 cox-2 high-expression cases were observed in 4 HNPCC carcinomas with MMR-proficient system. COX-2 expression was lower in HNPCC carcinomas and adenomas, sporadic carcinomas with MMR-deficient system than that of MMR-proficient (P < 0.05). The COX-2 low-expression rates were 80.0% (8/10), 66.7% (12/18) and 66.7% (2/3) in HNPCC adenomas, HNPCC carcinomas and sporadic carcinomas with MSI-H. Cox-2 expression was lower in HNPCC and sporadic carcinomas (adenocarcinomas) with MSI-H than that of MSS (P < 0.05). CONCLUSION: Compared with sporadic carcinomas, the COX-2 expression was lower in HNPCC carcinomas. There was negative correlation between COX-2 expression and MMR-deficient (MSI-H). The detection of COX-2, MMR protein and MSI is of important significance in further studying the pathogenesis and interventional therapy of colorectal neoplasms.

Transferrin dipstick as a potential novel test for colon cancer screening: a comparative study with immuno fecal occult blood test.

Recent proteomic studies identified Transferrin (Tf) as a potential biomarker for cancer. We examined the efficacy of the newly developed Tf dipstick for detecting colorectal cancer and premalignant lesions, and compared that to Immuno Fecal Occult Blood test (IFOBT). Fecal samples from 110 patients including 40 colorectal cancer, 36 premalignant subjects (including 16 with high-risk adenomas and 20 with ulcerative colitis), and 34 low-risk subjects were collected before colonoscopic examination. Compared with IFOBT, Tf had a significantly higher positive rate in patients with colorectal cancer and premalignant lesions (76% for Tf versus 61% for IFOBT, respectively; chi(2) = 4.38; P < 0.05). The difference of positivity was mainly observed in patients with premalignant lesions (72% for Tf versus 44% for IFOBT; chi(2) = 5.71; P < 0.05), whereas the positive rates in cancer group and in low-risk group were similar (both P > 0.05). Combining Tf with IFOBT together (either/or) had 90% positive rate in cancer patients, 78% in premalignant patients, and 29% in low-risk subjects. The overall accuracy of IFOBT and Tf tests for detecting colorectal cancer and premalignant lesion was 69.0% and 76.4%, respectively. Tf dipstick test seems to be a highly sensitive test for detecting not only cancer, but also premalignant lesions, and provides an additional tool for colorectal cancer screening.

Genetic diagnosis strategy of hereditary non-polyposis colorectal cancer.

AIM: To study the characteristics of mismatch repair gene mutation of Chinese hereditary non-polyposis colorectal cancer (HNPCC) and hMLH1 gene promoter methylation, and to improve the screening strategy and explore the pertinent test methods. METHODS: A systematic analysis of 30 probands from HNPCC families in the north of China was performed by immunohistochemistry, microsatellite instability (MSI), gene mutation and methylation detection. RESULTS: High frequency microsatellite instability occurred in 25 probands (83.3%) of HNPCC family. Loss of hMLH1 and hMSH2 protein expression accounted for 88% of all microsatellite instability. Pathogenic mutation occurred in 14 samples and 3 novel mutational sites were discovered. Deletion of exons 1-6, 1-7 and 8 of hMSH2 was detected in 3 samples and no large fragment deletion was found in hMLH1. Of the 30 probands, hMLH1 gene promoter methylation occurred in 3 probands. The rate of gene micromutation detection combined with large fragment deletion detection was 46.7%-56.7%. The rate of the two methods in combination with methylation detection was 63.3%. CONCLUSION: Scientific and rational detection strategy can improve the detection rate of HNPCC. Based on traditional molecular genetics and combined with epigenetics, multiple detection methods can accurately diagnose HNPCC.

[Mutation of hMLH1 and hMSH2 genes in hereditary nonpolyposis colorectal cancer: analysis of 76 probands].

OBJECTIVE: To investigate the mutations of the mismatch repair genes hMLH1 and hMSH2 in hereditary nonpolyposis colorectal cancer (HNPCC). METHODS: The DNA samples of 76 probands of HNPCC families underwent PCR amplification and sequencing on 35 exons in hMLH1 and hMSH2 genes. RESULTS: (1) The overall mutation rate of the hMLH1 and hMSH2 genes was 33% (25/76). (2) 22 mutations were found, 16 in the hMLH1 gene and 6 in the hMSH2 gene. (3) The spectrum of mutation type included frame shift, nonsense, splice site, and missense mutations. Missense mutation was the most common mutation type. CONCLUSION: The hMLH1 and hMSH2 mutations in Chinese HNPCC families show a wide spectrum. It seems that hMLH1 gene is involved more frequently than hMSH2 gene. A certain number of HNPCC families can be benefited from the genetic screening for mutation of the mismatch repair genes.

New immunochemical fecal occult blood test with two-consecutive stool sample testing is a cost-effective approach for colon cancer screening: results of a prospective multicenter study in Chinese patients.

The purpose of the study is to evaluate a new immunochemical fecal occult blood test method (Hemosure IFOBT), and compare it to the Guaiac-based chemical method (CFOBT) for colorectal cancer detection. A hypothetical sequential method (SFOBT), in which IFOBT was used only as a confirmatory test for CFOBT, was also evaluated. A total of 324 patients were recruited from 5 major hospitals in Beijing, China. For each patient, 3 consecutive stool samples were collected for simultaneous CFOBT and IFOBT tests, followed by colonoscopic examination. We compared the sensitivity and specificity of the 3 methods (CFOBT, IFOBT and SFOBT) in two settings, with the first 2 consecutive samples versus all 3 samples. Although the sensitivity for the detection of cancer and large (>20 mm) or multiple adenoma was similar for all 3 methods in the three-sample setting, in the two-sample setting IFOBT had higher sensitivity than SFOBT for detecting cancer (87.8% vs. 75.5%, respectively, p < 0.05) and large (>20 mm) or multiple adenomas (65.4% vs. 42.3%, respectively, p < 0.05). The IFOBT also had a higher specificity than the CFOBT (89.2% vs. 75.5%, respectively, p < 0.01) in "normal" individuals defined by colonoscopy in the three-sample setting. Comparing two-sample setting to the three-sample setting, both CFOBT and SFOBT showed significant loss of sensitivity for the detection of cancer as well as adenoma, whereas the sensitivity for IFOBT did not change significantly. Overall, IFOBT with two-sample testing showed compatible sensitivity and specificity to the three-sample testing, and had a lower relative cost per cancer detected than the three-sample testing. In conclusion, the new Hemosure IFOBT with two consecutive stool samples appears to be the most cost-effective approach for colon cancer screening.

[Hereditary predisposition of colorectal cancer and prevalence of hereditary nonpolyposis colorectal cancer in general population of colorectal cancer patients in China].

OBJECTIVE: To analyze hereditary predisposition of CRC and the prevalence of HNPCC in general population of CRC patients in China. METHODS: CRC patients were from two sources. One is that we consecutively investigated 594 patients by ourselves. They were proved to be colorectal cancer by histology. The following data of all patients should be registered: sex, age diagnosed colorectal cancer, site, number and histological type of primary cancer. The other was the published Chinese and foreign literatures related to Chinese HNPCC prevalence, and there were cumulatively 3596 patients in all. Hereditary predisposition of CRC (or malignant tumors) is that CRC patients have two or more first- or second-degree relatives (or both) with CRC (or malignant tumors). HNPCC was diagnosed by Amsterdam Criteria I (AC I) or Amsterdam Criteria II (AC II), Japanese Criteria of HNPCC (JC). RESULTS: Hereditary predisposition of both malignant tumors and CRC were 17.2% and 5.2% in 594 patients with CRC, respectively. Multiple primary cancers and multiple CRC were 13.1% and 10.1% , respectively. Among them, multiple primary cancers and multiple CRCs without familial history were 9.1% and 6.7%, respectively. There was a correlation between familial history of malignant tumors and multiple primary cancers and multiple CRCs (both P < 0.01). Patients with familial history of malignant tumors had more frequently multiple primary cancers and multiple CRCs than patients without history of malignant tumors. Younger patients (< or = 50) were 21.4% in all CRC patients. there was a correlation between younger patients (< or =50) and familial history of malignant tumors and familial history of CRC (both P < 0.05). When CRC was diagnosed, patients with familial history of malignant tumors and familial history were younger than patients without them. In the population of CRC patients in China, prevalence of HNPCC diagnosed AC I, AC II and JC were 1.24%, 2.15% and 2.93%, respectively. CONCLUSIONS: Hereditary predispositions of malignant tumors and CRC were 17.2% and 5.2% in CRC patients, respectively. Familial history of malignant tumors, multiple primary cancers and younger patients with CRC (< or =50) were the clinical markers of hereditary predisposition of malignant tumors including CRC. Multiple primary cancers and younger patients with CRC (< or =50) were all correlated with familial history of malignant tumors. The prevalence of HNPCC in China was similar to that in Western countries.

[Comparison of three FOBT protocols for colorectal cancer screening in Chinese--a multicenter study].

OBJECTIVE: To evaluate three FOBT protocols of colorectal cancer screening. METHODS: A multycenter study was conducted based on a consulted program. The effectiveness/cost of each protocole (CFOBT, IFOBT, SFOBT) were evaluated by the identifying patients who underwent CFOBT and IFOBT for 3 times consecutively as well as colonoscopy. RESULTS: 323 eligible patients including 49 colorectal cancers, 60 colon adenomas, 60 chronic colitis, 15 hemorrhoids and 139 normal colon were observed. The effect/cost of CRC screening protocols was following: 1). For 3 times of FOBT consecutively: There was no significant difference for their sensitivity among CFOBT, IFOBT and SFOBT (95.9%, 95.9% & 93.9%) but the specificity of IFOBT and SFOBT (89.21% and 94.24%) were higher significantly than CFOBT (75.54%). The specificity of SFOBT was higher than IFOBT. After adjusting their detecting number of cancer to same level the cost of SFOBT was the lowest. among these FOBTs.2). For 2 times of FOBT consecutively: The sensitivity of CFOBT, IFOBT and SFOBT were 77.8%, 87.8% and 75.5% respectively. The sensitivity of IFOBT was higher than SFOBT and CFOBT significantly. Their specificity were 88.5%, 96.4% and 98.6% respectively. The specificity of IFOBT and SFOBT were higher significantly than CFOBT. However, there was no significant difference for the specificity between IFOBT and SFOBT. After adjusting their detecting number of cancer to same level the cost of IFOBT was the lowest. among these FOBTs.3). The detected rate of early colorectal cancer was 60% for all of 3 protocols. 4). 41.6% approximately 48.3% of adenomas was found by the 3 protocols, and 87.5% of adenomas over 2 cm in diameter were detected by any one of FOBT. CONCLUSIONS: For the population with nice compliance 3 times of SFOBT will be recommended as a screening protocol of colorectal cancer. For that with poor compliance 2 times of IFOBT was recommended 3. The majority of adenomas in that advanced lesion existed might be detected by FOBT.

[Colorectal exfoliated cell in stool and its nuclear DNA quantitative analysis for diagnosis of colorectal cancer].

BACKGROUND AND OBJECTIVES: Detection of colorectal exfoliated epithelial cells and their nuclear DNA content may provide another non-invasive way of screening and early diagnosis of colorectal cancer. This study was designed to analyze the roles of exfoliated cells in stool and its nuclear DNA content in diagnosis of colorectal cancer. METHODS: 1. One hundred and seventy nine individuals were selected, forty-six of them had pathological confirmation of colorectal carcinoma. The other 133 persons had no colonoscopic evidence of colorectal malignancy and therefore served as control. Exfoliated cells in the stool were isolated by elutriation, and the elutriation means was modified Iyengar's method. All individuals in the study had stool specimens for occult blood test(FOBT). 2. Nuclear DNA content and morphometric quantitative analysis in the exfoliated cells was performed on the 33 patients with colorectal cancer and 30 individuals served as control. The parameters selected in this study were DNA content, nuclear area, nuclear irregular index, and percent of > or = 5C cells. RESULTS: 1 Exfoliative cytology and FOBT: In 35 of 46 cases of colorectal malignancy(76.09%), cytology was positive: 5 cases demonstrated dysplastic cells, 4 cases indicated suspected carcinoma cells, 26 cases showed carcinoma cells. The positive rate of exfoliated cells had no significant relation to locations, sizes, histomorphologies, histological differentiations, Dukes stages, and lymph node metastases of the lesion(P > 0.05). Exfoliative cytology had a 98.50% (131/133) specificity for colorectal cancer in the study. The sensitivity for colorectal cancer was no significant difference between the two methods of exfoliative cytology and FOBT (76.09% vs 84.78%, P > 0.05), but the specificity for colorectal cancer, exfoliative cytology was significant higher than FOBT(98.50% vs 73.68%, P < 0.05). 2. DNA analysis of exfoliated cells nuclear, DNA content, nuclear area, nuclear irregular index and percent of > or = 5C cells in the stool were significant higher in colorectal cancer than in control group(P < 0.05). The percentage of > or = 5C cells were significantly associated with histological grade (P < 0.05). CONCLUSIONS: 1. Detection of exfoliated cells in stool plays an important role in diagnosis of colorectal cancer. Testing of FOBT and exfoliated cells sequentially hopes to be a new useful non-invasive test for screening of colorectal cancer. 2. DNA analysis of exfoliated cell in stool may provide an objective method of determining malignant grades and diagnosis of colorectal cancer.