Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 9.516
Filtrar
1.
Medicine (Baltimore) ; 98(37): e16974, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517816

RESUMO

BACKGROUND: Growing evidence showed that high pretreatment plasma fibrinogen could be used as a potential prognostic marker in colorectal cancer (CRC). However, the conclusions were controversial. Therefore, this meta-analysis was conducted to evaluate the prognostic value of pretreatment plasma fibrinogen in patients with CRC. METHODS: Relevant studies were searched in the databases including PubMed, EMBASE, Web of Science, Cochrane library, and China National Knowledge Infrastructure up until December 10th, 2018. Pooled hazard ratios (HRs) with their 95% confidence intervals (CIs) were used to estimate the effects. RESULTS: A total of 17 articles with 6863 patients were included in this meta-analysis. The results revealed that elevated pretreatment plasma fibrinogen was significantly associated with both poor overall survival (univariate analysis: HR = 1.69, 95% CI 1.47-1.95, P = .000; multivariate analysis: HR = 1.50, 95% CI 1.28-1.77, P = .000) and poor disease-free survival (univariate analysis: HR = 1.90, 95% CI 1.49-2.41, P = .000; multivariate analysis: HR = 2.08, 95% CI 1.52-2.86, P = .000) in patients with CRC. CONCLUSIONS: High pretreatment plasma fibrinogen level is significantly associated with worse survival outcomes in CRC patients. Plasma fibrinogen may be used as an effective prognostic marker and potential therapeutic target. Further studies are required to support these results.


Assuntos
Neoplasias Colorretais/sangue , Fibrinogênio/análise , Biomarcadores/sangue , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/terapia , Humanos , Prognóstico
2.
Medicine (Baltimore) ; 98(37): e17178, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517873

RESUMO

The role of palliative primary tumor resection (PPTR) in improving survival in patients with synchronous unresectable metastatic colorectal cancer (mCRC) is controversial. In this study, we aimed to evaluate whether our novel scoring system could predict survival benefits of PPTR in mCRC patients.In this retrospective cohort study consecutive patients with synchronous mCRC and unresectable metastases admitted to Sir Run Run Shaw Hospital between January 2005 and December 2013 were identified. A scoring system was established by the serum levels of carcinoembryonic antigen (CEA), cancer antigen 19-9 (CA19-9), neutrophil/lymphocyte ratio (NLR), and lactate dehydrogenase (LDH). Patients with scores of 0, 1-2, or 3-4 were considered as being in the low, intermediate, and high score group, respectively. Primary outcome was overall survival (OS).A total of 138 eligible patients were included in the analysis, of whom 103 patients had undergone PPTR and 35 had not. The median OS of the PPTR group was better than that of the Non-PPTR group, with 26.2 and 18.9 months, respectively (P < .01). However, the subgroup of PPTR with a high score (3-4) showed no OS benefit (13.3 months) compared with that of the Non-PPTR group (18.9 months, P = .11). The subgroup of PPTR with a low score (52.1 months) or intermediate score (26.2 months) had better OS than that of the Non-PPTR group (P < .001, P = .017, respectively).A novel scoring system composed of CEA, CA19-9, NLR, and LDH values is a feasible method to evaluate whether mCRC patients would benefit from PPTR. It might guide clinical decision making in selecting patients with unresectable mCRC for primary tumor resection.


Assuntos
Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/cirurgia , Metástase Neoplásica/terapia , Cuidados Paliativos , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/patologia , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Projetos de Pesquisa , Estudos Retrospectivos , Adulto Jovem
3.
Anticancer Res ; 39(9): 4729-4736, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519572

RESUMO

BACKGROUND/AIM: Amphiregulin (AREG) and epiregulin (EREG) mRNA expression levels are predictors of response to anti-EGFR antibody therapy. Left-sided colon cancer is more sensitive to anti-EGFR antibodies than right-sided, although the mechanism is unclear. The aim of this study was to determine the relationship between AREG, EREG mRNA expression levels and tumor location as well as the efficacy of anti-EGFR antibody agents. MATERIALS AND METHODS: Real-time PCR was used to assess AREG and EREG mRNA expression in metastatic colorectal cancer (CRC) samples from 153 patients. RESULTS: Among KRASwt samples, high AREG expression (AREGHigh) was significantly more common in left-sided tumors than in right-sided. Among patients who received anti-EGFR antibody, response rates were significantly higher in AREGHigh than in AREGLow In the left-sided tumor group, overall survival was significantly longer in patients with high EREG levels than with low levels, whereas the right-sided tumor group showed no survival difference between them. CONCLUSION: AREG and EREG mRNA expression levels in left-sided CRC were higher than in right-sided tumors. This may help explain why left-sided CRC is more responsive to anti-EGFR antibodies.


Assuntos
Anfirregulina/genética , Neoplasias Colorretais/genética , Epirregulina/genética , Regulação Neoplásica da Expressão Gênica , RNA Mensageiro/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos Imunológicos/farmacologia , Linhagem Celular Tumoral , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Estadiamento de Neoplasias , Especificidade de Órgãos/genética , Prognóstico , Proteínas Proto-Oncogênicas p21(ras)/genética
4.
Anticancer Res ; 39(9): 4853-4864, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519588

RESUMO

BACKGROUND/AIM: Colorectal cancer (CRC) is the leading cause of cancer mortality worldwide. Its poor prognosis can be ascribed primarily to high recurrence rates. Accordingly, the aim of this study was to identify novel prognostic biomarkers and therapeutic targets for management of CRC. MATERIALS AND METHODS: To develop prognostic biomarkers, we performed RNA-seq analysis and real-time RT-PCR in primary cancer tissues with or without systemic recurrence. To characterize the molecular functions of the encoded proteins, CRC cells underexpressing or overexpressing the candidate genes were established and appropriate cell-based assays were applied. RESULTS: ITGB1 and RHOC mRNA levels were up-regulated in the recurrence group of CRC patients. Overexpression of ITGB1 or RHOC stimulated CRC cell proliferation, invasion and migration, whereas the opposite effects were observed in cells underexpressing either protein. Five-year recurrence-free survival rates were significantly higher in the ITGB1- and RHOC-underexpression groups than those in the overexpression. CONCLUSION: ITGB1 and RHOC are potential predictors of recurrence and therapeutic targets for CRC, possibly predicting a high-risk group of stage II patients.


Assuntos
Neoplasias Colorretais/genética , Neoplasias Colorretais/metabolismo , Integrina beta1/metabolismo , Proteína de Ligação a GTP rhoC/metabolismo , Idoso , Biomarcadores Tumorais , Proliferação de Células , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/patologia , Feminino , Perfilação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Técnicas de Inativação de Genes , Humanos , Masculino , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Prognóstico , RNA Interferente Pequeno/genética , Recidiva , Análise de Sobrevida
5.
Anticancer Res ; 39(9): 4917-4924, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519596

RESUMO

BACKGROUND/AIM: Recent data highlighted that location of metastatic colorectal cancer (mCRC) may have a prognostic impact and also a predictive value of the outcomes of first-line therapy. MATERIALS AND METHODS: The records of mCRC patients who underwent first-line therapy from 2011 to April 2018 at our Institute were retrospectively reviewed. Progression-free survival (PFS), overall survival (OS) and objective response rate (ORR) according to the primary tumor location were investigated. RESULTS: Overall, 130 patients were eligible. Two-year OS was 82.9% in left-sided colon cancers (LCC) and 67.5% in right-sided (RCC) (p=0.32). One-year mPFS was statistically longer in LCC (46.8% vs. 24.2%, p=0.0005). mPFS was longer in LCC treated with anti-VEGF vs. anti-EGFR (p=0.06). ORR was 51.1% in LCC, 25% in RCC (p=0.008). Overall, 11 complete responses all in LCC were observed (p=0.03). CONCLUSION: Tumor location has a prognostic impact and might influence the outcomes of mCRC patients.


Assuntos
Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/patologia , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/terapia , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento
6.
Anticancer Res ; 39(9): 4933-4940, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519598

RESUMO

BACKGROUND: Interleukin 2 (IL2) is a significant factor activating T-cell-mediated immune response by stimulation of natural killer cells, T-cells and in development of regulatory T (Treg) cells. Recent studies have that IL2 participates in cancer development by modifying the local immune response. Based on the suggested role of the single nucleotide polymorphisms (SNPs) rs2069762, rs6822844 and rs11938795 of IL2 in the pathogenesis of certain diseases, the relationship of these SNPs with clinicopathological variables and their possible implication for prognosis and disease outcome were evaluated in a cohort of Swedish patients with colorectal cancer (CRC). MATERIALS AND METHODS: TaqMan SNP genotype assays based on polymerase chain reaction were used for analysis of the IL2 SNPs in 467 patients with CRC and 467 healthy controls. Expression analysis of IL2 in plasma and CRC tissue was also performed. RESULTS: The allelic variants T in rs11938795 and G in rs6822844 were significantly associated with a higher risk of CRC. Kaplan-Meier analysis showed that cancer-specific survival was worse for individuals with C allele for rs2069762 with stage II CRC and with T allele for rs6822844 with stage III CRC. CONCLUSION: SNPs rs2069762, rs6822844 and rs11938795 of the IL2 gene may be helpful as prognostic biomarkers in the follow-up and management of the patients.


Assuntos
Neoplasias Colorretais/genética , Neoplasias Colorretais/mortalidade , Variação Genética , Interleucina-2/genética , Adulto , Idoso , Alelos , Biomarcadores Tumorais , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/imunologia , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Imunomodulação , Interleucina-2/sangue , Interleucina-2/metabolismo , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Polimorfismo de Nucleotídeo Único , Prognóstico , Medição de Risco
7.
BMC Surg ; 19(1): 137, 2019 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-31521147

RESUMO

BACKGROUND: Colorectal cancer is common in elderly patients. Laparoscopy is widely used to approach this kind of disease. This study was to examine short-term outcomes and long-term survival for laparoscopic and open surgery in elderly patients with colorectal cancer. METHODS: From January 2007 to December 2018, patients with colorectal cancer older than 80 operated at China National Cancer Center were included in the study. Propensity score matching (PSM) was used to minimize the adverse effects. The clinical data between open and laparoscopic surgery was compared, and the effect of factors on overall survival (OS) and disease-free survival (DFS) was analyzed by Cox proportional hazard model. RESULTS: Ninety-three pairs were selected after PSM. Patients in laparoscopic group had less intraoperative blood loss, postoperative complications, time to first flatus, time to oral feeding, postoperative hospital stay, and higher retrieved lymph node (P < 0.05). The OS and DFS rates were similar (P > 0.05), besides the CEA level, III/IV stage, and perineural invasion were independent predictors of survival (P < 0.05). CONCLUSION: In elderly patients with colorectal cancer, laparoscopic surgery had better short-term outcomes than open surgery. CEA level, III/IV stage, and perineural invasion were reliable predictors for OS and DFS.


Assuntos
Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/cirurgia , Idoso de 80 Anos ou mais , Neoplasias Colorretais/patologia , Intervalo Livre de Doença , Feminino , Humanos , Laparoscopia , Masculino , Prognóstico , Pontuação de Propensão , Análise de Sobrevida , Resultado do Tratamento
8.
Medicine (Baltimore) ; 98(35): e16941, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464932

RESUMO

Population-based cancer registries (PBCR) participate in epidemiological surveillance and in the evaluation of cancer types by enabling analysis of incidence and survival data over time. The aim of this study was to examine overall survival (OS) in patients with colorectal cancer (CRC) by analyzing data from the Martinique population-based cancer registry between 1993 and 2012. All colorectal cancer cases diagnosed in Martinique between 1993 and 2012 were included. Characteristics of CRC patients were analyzed according to age subgroups, namely: <50 years, 50 to 74 years and over 75 years.We recorded the following socio-demographic and clinical variables: year of diagnosis, age at diagnosis, sex, histology, zone of residence, and subsite of the cancer. Incidence of malignant neoplasms of the colon and rectum (ICD-10 C18-21) was extracted from the Martinique Cancer Registry database. Stage at diagnosis (localized: stage I-II, regional: stage III and metastatic stage: stage IV) were also analyzed for the 2008 to 2012 period.A total of 2230 cases of incident invasive CRC were included during the study period (1993-2012): 1171 were women (52.5%); 1588 patients (71.2%) had colon cancer. Stage at diagnosis was evaluated in 779 patients (89.6%): 486/779 (62.4%) had stage III-IV at diagnosis, including 285 (36.6%) patients with metastases at diagnosis (stage IV). One-year, 5-year and 10-year OS for the study period 1993 to 2012 was 74.6%, 43.8% and 33.0% respectively. There was a statistical difference in overall survival according to gender (P = .0153), age at diagnosis (P < .001) and stage (P < .001).Median OS was 2.0 years (95% CI [1.4-2.1]) in the stage III-IV group during the period 2008 to 2012, whereas it was unreached in the stage I-II group. Multivariable analysis confirmed that stage III-IV at diagnosis (hazard ratio (HR) = 3.70 [2.89-4.99]; P < .0001) and colon cancer (HR = 1.30 [1.01-1.69]; P = .04) were main prognostic factors for OS. Women had a HR of 0.78 [0.62-0.96], P = .02. CRC patients in the 50 to 74 years age group had a HR of 0.63 [0.50-0.80], P = .0001.This study underlines the importance of structuring management of CRC cancer patients.


Assuntos
Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/patologia , Sistema de Registros/estatística & dados numéricos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Martinica/epidemiologia , Pessoa de Meia-Idade , Metástase Neoplásica , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores Sexuais
9.
Arq Gastroenterol ; 56(2): 172-177, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31460582

RESUMO

BACKGROUND: Considering the high incidence of colorectal cancer (CRC) related deaths, many studies have investigated variables that can affect survival, with the aim of prolonging survival. The nutritional status can also be predict survival in patients with CRC. OBJECTIVE: The aim of the present study was to evaluate if BMI, %FAT, PhA, PG-SGA, adiponectin levels, and vitamin D levels are relevant to the characterization and differentiation of patients with advanced CRC and patients with a history of CRC. METHODS: The study was carried out by patients with advanced colorectal cancer (Group 1) and patients in follow-up after colorectal cancer treatment (Group 2). Nutritional status was assessed using the body mass index, body fat percentage, phase angle from bioelectrical impedance, Patient-Generated Subjective Global Assessment score. Adiponectin concentrations were determined using an enzyme-linked immunosorbent assay, and vitamin D levels were measured using high performance liquid chromatography. RESULTS: Groups 1 and 2 consisted of 23 and 27 patients, respectively. The body mass index, body fat percentage, phase angle, vitamin D and adiponectin levels were not significantly different between the groups. The mean Patient-Generated Subjective Global Assessment score was significantly higher in group 1 compared with group 2, and was significantly correlated with the long-term mortality risk. CONCLUSION: Among the nutritional status parameters, only the Patient-Generated Subjective Global Assessment score was significantly different between the groups and was an important predictor of survival in patients with advanced colorectal cancer.


Assuntos
Adiponectina/sangue , Neoplasias Colorretais/sangue , Estado Nutricional , Vitamina D/sangue , Idoso , Índice de Massa Corporal , Neoplasias Colorretais/mortalidade , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias
10.
Medicine (Baltimore) ; 98(27): e16237, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277140

RESUMO

Aberrant expression of SRY-box 8 (SOX8) is closely correlated with the development and progression of many types of cancers in human. Limited studies report the relationship between SOX8 expression and overall survival in colorectal cancer (CRC). This study aimed to collect the pathological tissues and clinical data in order to analyze the relationship between SOX8 expression and clinicopathological parameters and prognosis of CRC patients. Tissue microarrays were constructed from 424 primary CRC patients with clinicopathological information and follow-up data. Immunohistochemistry (IHC) was performed on tissue microarrays to explore the relationship between SOX8 expression and clinicopathological information and patient's prognosis. The expression of SOX8 was higher in CRC tissues than that in non-tumor adjacent tissues (NATs, P <.001). High expression of SOX8 was associated with tumor stage (P = .04) and shorter overall survival (OS) after operation of patients (P = .004). Subsequently, univariate COX analysis identified that high expression of SOX8 (P = .004), differentiation (P = .006), distant metastasis (P <.001), tumor stage (P = .003), and higher rate of lymph node metastasis (P <.001), all significantly predicted decrease in OS. Multivariate analysis demonstrated that distant metastasis (P <.001), high SOX8 expression, (P = .013) and lymph node metastasis (P <.001) were independent poor prognostic factors in CRC patients. This study showed that SOX8 is over-expressed in patients with high T stage, which affects the outcome of prognosis in CRC patients. High expression of SOX8 usually has a poor independent prognostic factor for CRC.


Assuntos
Neoplasias Colorretais/genética , DNA de Neoplasias/genética , Regulação Neoplásica da Expressão Gênica , Estadiamento de Neoplasias , Fatores de Transcrição SOXE/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/biossíntese , Biomarcadores Tumorais/genética , China/epidemiologia , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/mortalidade , Progressão da Doença , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Transcrição SOXE/biossíntese , Taxa de Sobrevida/tendências , Análise Serial de Tecidos
11.
J Surg Oncol ; 120(4): 729-735, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31290159

RESUMO

BACKGROUND AND OBJECTIVES: While knowledge has grown extensively regarding the impact of mutations on colorectal cancer prognosis, their role in outcomes after pulmonary metastasectomy (PM) remains minimally understood. We sought to determine the prognostic role of mutant disease on survival and recurrence after metastasectomy. METHODS: Patients with available tumor sequencing profiles who underwent PM for colorectal cancer at a single institution from 2011 to 2017 were reviewed. Various demographic and clinicopathologic factors, as well as mutational status, were tested in the Cox regression analyses to identify predictors of survival and disease-free survival (DFS). RESULTS: A total of 130 patients met inclusion criteria, among whom 78 (60%) were male and the mean age was 57 years. The median survival time and 5-year survival rate were 58.2 months and 47%, respectively. A single pulmonary nodule was present in 54%. Disease recurrence occurred for 87 (67%) patients, including 75 (58%) who had at least one lung recurrence after metastasectomy at a median time to recurrence of 19.4 months. Upon multivariable analysis, RAS and TP53 mutations were associated with shorter survival DFS, while APC is associated with prolonged survival. CONCLUSIONS: After metastasectomy for colorectal cancer, mutations in RAS, TP53, and APC play an important role in survival and recurrence.


Assuntos
Biomarcadores Tumorais/genética , Neoplasias Colorretais/mortalidade , Neoplasias Pulmonares/mortalidade , Metastasectomia/mortalidade , Mutação , Recidiva Local de Neoplasia/mortalidade , Pneumonectomia/mortalidade , Adulto , Idoso , Neoplasias Colorretais/genética , Neoplasias Colorretais/patologia , Feminino , Seguimentos , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/secundário , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/genética , Recidiva Local de Neoplasia/patologia , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
12.
J Surg Oncol ; 120(4): 794-802, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31309588

RESUMO

BACKGROUND AND OBJECTIVES: To review long-term survival outcomes of patients with Peritoneal metastasis (PM) who underwent colorectal cancer (CRS) and intraperitoneal chemotherapy (PIC). METHODS: Patients that underwent CRS, with or without PIC, from January 1996 to March 2018 at the Peritonectomy Unit of St. George Hospital, Sydney were retrospectively analyzed from a prospectively maintained database. RESULTS: The study comprised of 1225 cases, including 687 females (56.1%) and 538 males (43.9%). Diagnoses included CRC (n = 363), followed by HAMN (n = 317), LAMN (n = 297), mesothelioma (n = 101), ovarian cancer (n = 55), and others including gastric, sarcoma, and neuroendocrine tumor (n = 92). The median OS, 5- and 10-year survivals for CRC were 35 months, 33% and 8%, respectively. Patients with LAMN, in relative to HAMN, experienced a higher median OS, 5- and 10-year survivals (248 months vs 63 months; 82% vs 52% and 59% vs 28%). The median OS for mesothelioma was 60 months with 5- and 10-year survivals of 48% and 19%, respectively. In ovarian cancer, the median OS was 30 months with 5- and 10-year survivals of 26% and 10%, respectively. For the remaining histological diagnoses, median OS and 5-year survival were 28 months and 27%, respectively. CONCLUSION: Our large-cohort data showed that CRS/PIC can provide long-term survival benefit to patients with PM of gastrointestinal and ovarian origin.


Assuntos
Neoplasias do Apêndice/mortalidade , Quimioterapia do Câncer por Perfusão Regional/mortalidade , Neoplasias Colorretais/mortalidade , Procedimentos Cirúrgicos de Citorredução/mortalidade , Neoplasias Pulmonares/mortalidade , Mesotelioma/mortalidade , Neoplasias Ovarianas/mortalidade , Neoplasias Peritoneais/mortalidade , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias do Apêndice/patologia , Neoplasias do Apêndice/terapia , Neoplasias Colorretais/patologia , Neoplasias Colorretais/terapia , Terapia Combinada , Feminino , Seguimentos , Humanos , Injeções Intraperitoneais , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/terapia , Masculino , Mesotelioma/patologia , Mesotelioma/terapia , Pessoa de Meia-Idade , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/terapia , Assistência Perioperatória , Neoplasias Peritoneais/secundário , Neoplasias Peritoneais/terapia , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos , Taxa de Sobrevida
13.
Medicine (Baltimore) ; 98(26): e16131, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261535

RESUMO

BACKGROUND: The FOS gene is located on human chromosome 14q21-31 and encodes the nuclear oncoprotein c-Fos. This study analyzed the correlation between the FOS noncoding region rs7101 and rs1063169 polymorphisms and colorectal cancer susceptibility and prognosis. METHODS: We analyzed the FOS genotypes in 432 colorectal cancer patients and 315 healthy subjects by PCR/Sanger sequencing. Survival was analyzed by Kaplan-Meier and Cox regression analysis. Western blot was used to detect the expression of c-Fos protein in cancer tissues and adjacent tissues in colorectal cancer patients with different genotypes. RESULTS: The presence of a T allele at rs7101 and a T allele at rs1063169 in FOS carried a higher risk of colorectal cancer [adjusted odds ratio (OR) = 1.237, 95% confidence interval (95% CI) = 1.131-1.346, P ≤ .001 and adjusted OR = 1.218, 95% CI = 1.111-1.327, P ≤ .001, respectively]. c-Fos protein levels were significantly higher in variant cancer tissues than in normal mucosa tissues (P < .05), and c-Fos proteins levels were also higher in homozygous variant cancer tissues than in heterozygous variant cancer tissues. The 3-year survival rate of patients with wild-type FOS was higher than that of patients with variant FOS (P < .05). CONCLUSION: The rs7101 and rs1063169 polymorphisms in the noncoding region of FOS are associated with the risk of developing colorectal cancer and the progression of colorectal cancer, which may be because the mutation enhances the expression of c-Fos protein to promote the incidence and development of colorectal cancer.


Assuntos
Neoplasias Colorretais/genética , Neoplasias Colorretais/metabolismo , Predisposição Genética para Doença , Polimorfismo de Nucleotídeo Único , Proteínas Proto-Oncogênicas c-fos/genética , Proteínas Proto-Oncogênicas c-fos/metabolismo , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/patologia , Progressão da Doença , Feminino , Seguimentos , Expressão Gênica , Interação Gene-Ambiente , Estudos de Associação Genética , Humanos , Mucosa Intestinal/metabolismo , Mucosa Intestinal/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Análise de Sobrevida
14.
Anticancer Res ; 39(6): 3071-3077, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31177151

RESUMO

BACKGROUND: To compare outcomes for patients with colorectal cancer liver metastases (CRCLM) treated by drug-eluting bead chemoembolization (DEB-TACE) or radioembolization (TARE). PATIENTS AND METHODS: A single-center retrospective review was carried out on 202 patients with CRCLM, treated by DEB-TACE (n=47) or TARE (n=155) patients. Propensity-matching yielded 44 pairs. Paired statistical analysis was performed on matched pair demographics, treatment response, and survival. RESULTS: Patients treated with DEB-TACE had worse extra-hepatic metastasis (68.1 vs. 47.7%, p=0.014) and ≥10 liver lesions (42.2 vs. 68.8%, p=0.001). Matched patients treated with DEB-TACE had a trend towards worse toxicity (27% vs. 9.1% (p=0.057). Index DEB-TACE treatment was not a prognostic factor for overall survival (hazard ratio=0.94, 95% confidence intervaI=0.54-1.65; p=0.83). CONCLUSION: In the matched CRCLM cohort, there was a trend towards worse toxicity post-DEB-TACE treatment, but it was not an independent prognostic factor for survival.


Assuntos
Antineoplásicos/administração & dosagem , Quimioembolização Terapêutica/métodos , Neoplasias Colorretais/patologia , Doxorrubicina/administração & dosagem , Portadores de Fármacos , Irinotecano/administração & dosagem , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/terapia , Compostos Radiofarmacêuticos/administração & dosagem , Idoso , Antineoplásicos/efeitos adversos , Quimioembolização Terapêutica/efeitos adversos , Quimioembolização Terapêutica/mortalidade , Neoplasias Colorretais/mortalidade , Progressão da Doença , Doxorrubicina/efeitos adversos , Feminino , Humanos , Irinotecano/efeitos adversos , Neoplasias Hepáticas/mortalidade , Masculino , Pessoa de Meia-Idade , Intervalo Livre de Progressão , Compostos Radiofarmacêuticos/efeitos adversos , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo
15.
Tumour Biol ; 41(6): 1010428319846231, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31223065

RESUMO

5-fluorouracil in combination with the folate leucovorin is the cornerstone in treatment of colorectal cancer. Transport of leucovorin into cells, and subsequent metabolic action, require expression of several genes. The aim was to analyze if tumoral expression of genes putatively involved in leucovorin transport, polyglutamation, or metabolism was associated with outcome of patients with stage III colorectal cancer treated with adjuvant chemotherapy. A total of 363 stage III colorectal cancer patients who received adjuvant bolus 5-fluorouracil + leucovorin alone, or in combination with oxaliplatin according to Nordic bolus regimes were included. Expression of 11 folate pathway genes was determined in tumors using quantitative real-time polymerase chain reaction and related to disease-free survival. The median follow-up time was 5 years. During follow-up, 114 (31%) patients suffered from recurrent disease. A high tumoral expression of the genes SLC46A1/PCFT, SLC19A1/RFC-1, ABCC3/MRP3, GGH, and MTHFD1L, which are involved in folate transport, polyglutamation, or metabolism, was associated with longer disease-free survival of the patients. Each of these genes either encodes mitochondrial enzymes or is being regulated by mitochondrial transcription factors. Expression of the SLC46A1/PCFT gene was most strongly associated with disease-free survival, regardless of treatment regimen. In conclusion, the results show that expression of folate pathway genes are associated with outcome of colorectal cancer patients treated with adjuvant 5-fluorouracil in combination with leucovorin. A prospective study needs to be conducted to determine if expression of these genes can be used to predict response to leucovorin and other folates that are now being tested in clinical studies. Moreover, there seems to be a link between folate metabolism and mitochondrial biogenesis and respiration that deserves further exploration.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/genética , Respiração Celular , Neoplasias Colorretais/genética , Neoplasias Colorretais/mortalidade , Ácido Fólico/genética , Biogênese de Organelas , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/tratamento farmacológico , Feminino , Fluoruracila/administração & dosagem , Seguimentos , Perfilação da Expressão Gênica , Humanos , Leucovorina/administração & dosagem , Masculino , Pessoa de Meia-Idade , Oxaliplatina/administração & dosagem , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Adulto Jovem
16.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(6): 579-586, 2019 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-31238638

RESUMO

Objective: To investigate the mortality of colorectal cancer and its trend from 1999 to 2015 in Tianjin, China, and to explore the mortality features in different populations in order to provide data for prevention and control strategies of colorectal cancer. Methods: Colorectal cancer mortality data between 1999 and 2015 were collected from Tianjin population - based mortality surveillance system maintained by the Tianjin Centers for Disease Control and Prevention (CDC). Population data of permanent residents were collected from Tianjin Municipal Public Security Bureau. The number of new cases and deaths, incidence [including crude incidence, age-adjusted standardized incidence and 95% confidence interval (95% CI)], and mortality (including crude mortality, age-adjusted standardized mortality and 95% CI) of colorectal cancer were calculated. Standardized incidence and mortality of colorectal cancer were calculated using the Segi's world standard population, adjusted with age and gender. JoinPoint regression and Cochran-Armitage trend test were used to determine the statistical significance of differences in mortality trend. Results: A total of 31 376 new onset cases and 14 893 death cases of colorectal cancer were observed in Tianjin from 1999 to 2015. Colorectal cancer incidence increased from 1999 to 2015 with a standardized rate from 9.66/100 000 to 15.36/100 000 [annual percent change(APC)=3.48%, Z=23.21, P<0.001]. Colorectal cancer mortality increased from 1999 to 2015 with a standardized rate from 5.18/100 000 to 6.11/100 000 (APC=1.24%, Z=5.69, P<0.001). Both showed an increasing trend. The death proportion of colon cancer increased (39.67% in 1999 and 50.33% in 2015), while the death proportion of rectal caner decreased (60.33% in 1999 and 48.57% in 2015). The median age of colorectal cancer onset fluctuated steadily around 66 years old (APC=0.16, T=1.75, P=0.100); the median age of death increased from 69 to 73 years old (APC=0.43, T=8.81, P<0.001). From 1999 to 2015, the mortality of colorectal cancer showed a downward trend (all P<0.05) in the age groups of <35 and 35-44 years, while an upward trend (all P<0.05) in the age groups of 45-54 years, 55-64 years and ≥ 65 years. Colorectal cancer mortality in males increased with a standardized rate of 5.53/100 000 in 1999 to 7.33/100 000 in 2015(APC=2.29%, Z=7.86, P<0.001), while colorectal cancer mortality in females flatted with a standardized rate of 4.83/100 000 in 1999 to 4.89/100 000 in 2015 (APC=0.10%, Z=-0.30, P=0.752). Colorectal cancer mortality increased with a standardized rate of 6.75/100 000 in 1999 to 7.33/100 000 in 2015 (APC=0.54%, Z=1.98, P=0.048) in urban areas and of 3.18/100 000 in 1999 to 4.38/100 000 in 2015 (APC=2.47, Z=6.46, P<0.001) in rural areas, whose differences were significant. Standardized mortality rate in rural area was lower but the rising velocity was faster as compared to urban area. Conclusions: Crude mortality and standardized mortality of colorectal cancer increase from 1999 to 2015 in Tianjin population. The people of elder, male and urban area have higher mortality. The mortality in people of male and rural area presents a faster rising state. Further efforts to reduce colorectal cancer mortality in Tianjin are needed to prevention and control of colorectal cancer.


Assuntos
Neoplasias Colorretais/mortalidade , Mortalidade/tendências , Adulto , Idoso , China/epidemiologia , Neoplasias do Colo/epidemiologia , Neoplasias do Colo/mortalidade , Neoplasias Colorretais/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias Retais/epidemiologia , Neoplasias Retais/mortalidade
17.
Medicine (Baltimore) ; 98(18): e15164, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31045759

RESUMO

The aim of this study was to evaluate the cytomorphologic maturity and molecular activation of cancer-associated fibroblasts (CAFs) in the intratumoral stroma and invasive front in colorectal cancer and understand how they affect cancer invasion and long-term oncological outcomes.The cytomorphologic maturity of and α-smooth muscle actin (α-SMA), fibroblast activation protein α (FAPα), and fibroblast-specific protein 1 (FSP-1) expression in CAFs in the intratumoral stroma (CAF) and the invasive front (CAF) of colorectal cancer tissues were compared (n = 147). The correlations between CAF maturation, molecular activity markers, and cancer invasion were evaluated by network analysis. Overall survival and systemic recurrence were analyzed to assess the oncological effects of CAF properties.The cytomorphologic maturation rate was comparable between CAF and CAF. The presence of mature CAFs was related to epidermal growth factor receptor overexpression in cancer cells. Expression rates of α-SMA (96.6%-98.0%) and FAPα (18.6%-22.9%) were similar between CAF and CAF. FSP-1 expression was more frequent in CAF than in CAF (66.4% vs 58.2%, P = .038). There was a significant decrease in FSP-1 expression in CAF and CAF in higher stages. The infiltrating growth pattern of the tumor was more frequent in the immature CAF. In colorectal cancer with perineural invasion and lymph node metastasis, FSP-1 expression in CAF was significantly lower. On multivariate analysis using the Cox proportional hazards model, immature CAF was found to be an independent prognostic factor of overall survival. In non-metastatic (stage I-III) colorectal cancer patients, CAF maturity was not a prognostic factor for systemic recurrence.Cytomorphologic maturity and molecular activation markers were similar between CAFs in the intratumoral stroma and invasive front of colorectal cancer.


Assuntos
Biomarcadores Tumorais/metabolismo , Fibroblastos Associados a Câncer/patologia , Neoplasias Colorretais/patologia , Tumores do Estroma Gastrointestinal/patologia , Invasividade Neoplásica/patologia , Actinas/metabolismo , Idoso , Idoso de 80 Anos ou mais , Fibroblastos Associados a Câncer/metabolismo , Neoplasias Colorretais/metabolismo , Neoplasias Colorretais/mortalidade , Receptores ErbB/metabolismo , Feminino , Tumores do Estroma Gastrointestinal/metabolismo , Gelatinases/metabolismo , Humanos , Metástase Linfática/patologia , Masculino , Proteínas de Membrana/metabolismo , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Proteína A4 de Ligação a Cálcio da Família S100/metabolismo , Serina Endopeptidases/metabolismo , Análise de Sobrevida
18.
Medicine (Baltimore) ; 98(18): e15442, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31045812

RESUMO

Whether morphine used in human cancer surgery would exert tumor-promoting effects is unclear. This study aimed to investigate the effects of morphine dose on cancer prognosis after colorectal cancer (CRC) resection.In a retrospective study, 1248 patients with stage I through IV CRC undergoing primary tumor resections and using intravenous patient-controlled analgesia for acute surgical pain at a tertiary center between October 2005 and December 2014 were evaluated through August 2016. Progression-free survival (PFS) and overall survival (OS) were analyzed using proportional hazards regression models.Multivariable analysis demonstrated no dose-dependent association between the amount of morphine dose and PFS (adjusted hazard ratio, HR = 1.31, 95% confidence interval, CI = 0.85-2.03) or OS (adjusted HR = 0.86, 95% CI = 0.47-1.55). Patients were further classified into the high-dose and low-dose groups by the median of morphine consumption (49.7 mg), and the morphine doses were mean 75.5 ± standard deviation 28.8 mg and 30.1 ±â€Š12.4 mg in high-dose and low-dose groups, respectively. Multivariable models showed no significant difference in PFS or OS between groups, either (adjusted HR = 1.24, 95% CI = 0.97-1.58 for PFS; adjusted HR = 1.01, 95% CI = 0.71-1.43 for OS).Our results did not support a definite association between postoperative morphine consumption and cancer progression or all-cause mortality in patients following CRC resection.


Assuntos
Analgésicos Opioides/administração & dosagem , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/cirurgia , Morfina/administração & dosagem , Dor Pós-Operatória/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Analgesia Controlada pelo Paciente/métodos , Analgésicos Opioides/uso terapêutico , Progressão da Doença , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Morfina/uso terapêutico , Estadiamento de Neoplasias , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Análise de Sobrevida , Centros de Atenção Terciária
19.
Khirurgiia (Mosk) ; (4): 30-36, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31120444

RESUMO

AIM: To optimize surgical care for the hemorrhagic colorectal cancer. MATERIAL AND METHODS: 77 patients diagnosed with hemorrhagic colorectal cancer were reviewed: 9 patients of them were efficaciously treated with conservative therapy (I group); 47 - underwent successful endoscopic coagulation (I); 4 - arterial embolization (I), 2 - ligation of internal iliac arteries (I), 15 - acute resection (II group). 20 of 62 patients I group underwent plan surgery and radiation or chemotherapy during 7-10 days after hemostasis and normalization hemoglobin. The 3-year cumulative survival after resections (acute versus plan) was plotted on a Kaplan-Meier chart in 31 patients. RESULTS: Complications and postoperative mortality was significantly higher after acute resection (II group) compared with plan resection (I): 33,3% vs 20%; 15% vs 5%, respectively. The survival rate was higher after plan than acute resections: 0,8882 and 0,3571, respectively. CONCLUSION: Acute surgery for hemorrhagic colorectal cancer should only be carried out by appropriately trained surgeons in multi-specialty hospital. Endoscopy and arterial embolization are the most effective means of successfully controlling hemorrhage while minimizing potential complications. A bridging strategy may be a valid alternative in some of patients with hemorrhagic colorectal cancer, because a significantly lower postoperative mortality rate.


Assuntos
Neoplasias Colorretais/cirurgia , Hemorragia Gastrointestinal/terapia , Neoplasias Colorretais/complicações , Neoplasias Colorretais/mortalidade , Embolização Terapêutica , Endoscopia , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/mortalidade , Hemorragia Gastrointestinal/cirurgia , Humanos , Estudos Retrospectivos
20.
DNA Cell Biol ; 38(6): 541-548, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31140864

RESUMO

The aim of this research was to verify the mutation rate of the ring finger protein 43 (RNF43) of the transmembrane E3 ubiquitin ligase and investigate the influence of single nucleotide polymorphisms (SNPs) rs2257205 in RNF43 in a Chinese colorectal cancer (CRC) cohort. DNA from 177 diagnosed CRC patients' tissues or blood samples were extracted, amplified, and sequenced. Clinicopathological features, including age, gender, tumor location, tumor-lymph node-metastasis stage, and survival information, were analyzed. Four novel RNF43 mutations (including G659 and R117 sites) were validated in 177 CRC patients; all events were somatic frameshift mutations. Furthermore, we also found that an SNP (rs2257205) of the RNF43 X117 site was associated with overall survival (OS) instead of disease-free survival. G homozygote subjects were significantly correlated with poor OS compared with another group. Then we rescued RNF43 R117R (encoded by nucleotide CGC) and R117H (encoded by nucleotide CAC) expression in the HCT116 cells and analyzed the targets of the Wnt/ß-catenin pathway. The expression of CCND1 and c-Myc were decreased. The prognosis of CRC patients could be affected by the different functions of SNPs of RNF43.


Assuntos
Neoplasias Colorretais/mortalidade , Proteínas de Ligação a DNA/genética , Proteínas Oncogênicas/genética , Polimorfismo de Nucleotídeo Único , Idoso , Linhagem Celular Tumoral , China , Estudos de Coortes , Neoplasias Colorretais/genética , Neoplasias Colorretais/patologia , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Taxa de Mutação , Prognóstico , Estudos Retrospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA