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BACKGROUND: For treatment of hilar cholangiocarcinoma (HCCA), the rate of radical resection is low and prognosis is poor, and preoperative evaluation is not sufficiently accurate. 3D visualization has the advantage of giving a stereoscopic view, which makes accurate resection of HCCA possible. AIM: To establish precise resection of HCCA based on eOrganmap 3D reconstruction and full quantification technology. METHODS: We retrospectively analyzed the clinical data of 73 patients who underwent HCCA surgery. All patients were assigned to two groups. The traditional group received traditional 2D imaging planning before surgery (n = 35). The eOrganmap group underwent 3D reconstruction and full quantitative technical planning before surgery (n = 38). The preoperative evaluation, anatomical classification of hilar hepatic vessels, indicators associated with surgery, postoperative complications, liver function, and stress response indexes were compared between the groups. RESULTS: Compared with the traditional group, the amount of intraoperative blood loss in the eOrganmap group was lower, the operating time and postoperative intestinal ventilation time were shorter, and R0 resection rate and lymph node dissection number were higher (P < 0.05). The total complication rate in the eOrganmap group was 21.05% compared with 25.71% in the traditional group (P > 0.05). The levels of total bilirubin, Albumin (ALB) , aspartate transaminase, and alanine transaminase in the eOrganmap group were significantly different from those in the traditional group (intergroup effect: F = 450.400, 79.120, 95.730, and 13.240, respectively; all P < 0.001). Total bilirubin, aspartate transaminase, and alanine transaminase in both groups showed a decreasing trend with time (time effect: F = 30.270, 17.340, and 13.380, respectively; all P < 0.001). There was an interaction between patient group and time (interaction effect: F = 3.072, 2.965, and 2.703, respectively; P = 0.0282, 0.032, and 0.046, respectively); ALB levels in both groups tended to increase with time (time effect: F = 22.490, P < 0.001), and there was an interaction effect between groups and time (interaction effect: F = 4.607, P = 0.004). In the eOrganmap group, there was a high correlation between the actual volume of intraoperative liver specimen resection and the volume of preoperative virtual liver resection (t = 0.916, P < 0.001). CONCLUSION: The establishment of accurate laparoscopic resection of hilar cholangiocarcinoma based on preoperative eOrganmap 3D reconstruction and full quantization technology can make laparoscopic resection of hilar cholangiocarcinoma more accurate and safe.
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Objective: To analyze the efficacy of combining sintilimab with neoadjuvant chemotherapy in treating middle and advanced rectal cancer based on big data. Methods: According to the inclusion and exclusion criteria, 43 patients with middle and advanced rectal cancer, who were treated with sintilimab and neoadjuvant chemotherapy in General Surgery of the hospitals of Zhangjiakou city from January 2020 to January 2022, were selected for the retrospective study. The patients' short-term efficacy was scientifically evaluated, and the factors affecting efficacy and the correlation were analyzed. Results: Among the 43 enrolled patients, 30 of them had regional lymphatic metastasis but none had distant metastasis; most patients were at Broders II and TNM III, and all of them had adenocarcinoma; the total response rate was 69.77% (30 cases), with no grade IV and V adverse reactions; the patients were divided into the effective group and the ineffective group after treatment based on the evaluation results of short-term efficacy, and analysis of the relevant factors exposed in both groups revealed significant differences in age, tumor size, CEA, NLR value, PLR value, TNM stage, and presence of combined lymphatic metastasis between the two groups (P < 0.05); univariate analysis showed that tumor size, CEA, TNM stage, and combined lymphatic metastasis were the independent risk factors affecting the efficacy in patients with middle to advanced rectal cancer (P < 0.05); and through the Spearman correlation analysis of the above independent risk factors, it was further confirmed that tumor size, CEA, TNM stage, and combined lymphatic metastasis were negatively correlative with the efficacy of combining sintilimab with neoadjuvant chemotherapy in treating middle to advanced rectal cancer (P < 0.05). Conclusion: Combining sintilimab with neoadjuvant chemotherapy has good efficacy and safety profile, which is conducive to subsequent surgery; in contrast, larger tumor diameter, higher CEA level, higher TNM stage, and more serious lymphatic metastasis are all independent risk factors affecting treatment sensitivity and can lead to poor efficacy.
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BACKGROUND: Golgi Phosphoprotein 3 (GOLPH3) has been implicated in the development of colorectal cancer (CRC). Nevertheless, the clinicopathological and prognostic roles of GOLPH3 in CRC remain undefined. We thus did a meta-analysis to assess GOLPH3 association with the clinicopathological characteristics of patients and evaluate the prognostic significance of GOLPH3 in CRC. METHODS: An electronic search for relevant articles was conducted in the PubMed, Cochrane Library, Web of Science, Medline, Embase, CNKI, and WanFang databases. Two independent reviewers searched all the literature and finished the data extraction and quality assessment. Odds ratio (OR) or hazard ratio (HR) with 95% confidence interval (CI) were used to assess estimates. Stata software (version12.0) was employed to analyze the data. RESULTS: A total of 8 published studies were eligible (N = 723 participants). Meta-analysis revealed that GOLPH3 was found to be highly expressed in tumor tissues compared to that of adjacent colorectal tissues (OR, 2.63), and overexpression of GOLPH3 had significant relationship with advanced clinical stage (OR, 3.42). GOLPH3 expression was not correlated with gender (OR, 0.89), age (OR, 0.95), positive lymphatic metastasis (OR, 1.27), tumor size (OR, 1.12), poor differentiation of tumor (OR, 0.56) or T stage (OR, 0.70). Moreover, GOLPH3 overexpression was not associated with worse overall survival (OS) (HR = 1.14, 95% CI: 0.42-1.86, P>0.05) and disease-free survival (DFS) (HR = 0.80, 95% CI:-0.26-1.86, P>0.05). CONCLUSIONS: GOLPH3 overexpression is correlated with tumor stage, which is an adverse clinicopathological characteristic of CRC. But, GOLPH3 can not serve as a useful biomarker in evaluating the progression of CRC.
