Clinical Significance of the C-Reactive Protein to Albumin Ratio for Survival After Surgery for Colorectal Cancer.

OBJECTIVE: This study was designed to estimate the clinical significance of the C-reactive protein (CRP)/albumin ratio (CAR) for prediction of postoperative survival in patients with colorectal cancer (CRC). BACKGROUND: The Glasgow Prognostic Score (GPS), calculated from the serum levels of CRP and albumin, is well known to be a valuable inflammation-based prognostic system for several types of cancer. A recent study has demonstrated that the CAR is also useful for prediction of treatment outcome in patients with hepatocellular carcinoma. METHODS: Uni- and multivariate analyses using the Cox proportional hazards model were performed to detect the clinical characteristics that were most closely associated with overall survival (OS). All recommended cutoff values were defined using receiver operating characteristic curve analyses. Kaplan-Meier analysis was used to compare OS curves between the two groups. RESULTS: A total of 627 patients who had undergone elective CRC surgery were enrolled. Multivariate analysis using the results of univariate analyses demonstrated that CAR (>0.038/≤0.038) was associated with OS (hazard ratio 2.596; 95% confidence interval 1.603-4.204; P < 0.001) along with pathological differentiation (others/well or moderately), carcinoembryonic antigen level (>8.7/≤8.7, ng/ml), stage (III, IV/0, I, II), neutrophil to lymphocyte ratio (NLR) (>2.9/≤2.9), and GPS (2/0, 1). Kaplan-Meier analysis and log rank test demonstrated a significant difference in OS curves between patients with low CAR (≤0.038) and those with high CAR (>0.038; P < 0.001). CONCLUSIONS: CAR is as useful for predicting the postoperative survival of patients with CRC as previously reported inflammation-based prognostic systems, such as GPS and NLR.

Inflammation-based prognostic system predicts postoperative survival of colorectal cancer patients with a normal preoperative serum level of carcinoembryonic antigen.

BACKGROUND: Although carcinoembryonic antigen (CEA) is a valuable indicator for estimating the progression of colorectal cancer (CRC), some patients with advanced CRC show no elevation of the CEA level. On the other hand, inflammation-based prognosis, assessed by the Glasgow Prognostic Score (GPS), has been established as one of the important prognostic factors of survival after surgery for several types of cancer. We estimated the postoperative survival of CRC patients with a normal preoperative serum level of CEA on the basis of the GPS. METHODS: Among 491 patients who had undergone elective CRC surgery, 271 with a normal preoperative serum CEA level (≤5.0 ng/ml) were enrolled. Uni- and multivariate analyses were performed to evaluate the relationship to overall survival. Kaplan-Meier analysis and log rank test were used to compare the survival curves between patients with GPS 0 (group A), and 1 or 2 (group B). RESULTS: Univariate analyses using clinical characteristics revealed that lymphatic invasion, lymph node metastasis, platelet count, the serum levels of CEA and C-reactive protein, tumor, node, metastasis staging system (stage 0, I, II/III, IV), and the GPS (0/1, 2) were associated with overall survival. Among these characteristics, multivariate analysis demonstrated that the GPS and platelet count were associated with overall survival. Kaplan-Meier analysis and log rank test demonstrated a significant difference in overall survival between groups A and B (P < 0.001). CONCLUSIONS: Even if CRC patients have a normal preoperative serum level of CEA before surgery, the GPS is able to predict their postoperative survival.

Preoperative thrombocytosis is associated with survival after surgery for colorectal cancer.

OBJECTIVE: To evaluate the influence of preoperative thrombocytosis on survival after surgery in patients with colorectal cancer (CRC). METHODS: Four hundred fifty-three patients who had undergone CRC surgery were retrospectively identified from institutional database. On the basis of receiver operating characteristic (ROC) curve analysis, they were classified into two groups: group A, with a preoperative platelet count of ≤300 (×10(9) /L), and Group B, with a preoperative platelet count of >300 (×10(9) /L). Uni- and multivariate analyses were performed to evaluate the relationship to overall survival. Kaplan-Meier analysis and log rank test were used to compare the survival curves between groups A and B. RESULTS: There was a significant difference in overall survival between the two groups (P = 0.007). Multivariate analysis of selected preoperative clinicolaboratory characteristics showed that overall survival was associated with the platelet count (Group A/B) (odds ratio, 1.642; 95% CI, 1.025-2.629; P = 0.039) as well as the number of tumors (1/≥2), and the serum levels of C-reactive protein (CRP) and carcinoembryonic antigen (CEA). CONCLUSION: Preoperative thrombocytosis is associated with survival after surgery in CRC patients, and is able to divide such patients into two independent groups before surgery.

Clinicopathological features of serrated adenocarcinoma defined by Mäkinen in dukes' B colorectal carcinoma.

OBJECTIVE: Serrated adenocarcinoma (SAC), proposed as a new pathologic type, arises predominantly in the right side of the colon and has a poorer prognosis than conventional colorectal carcinoma. The prognosis of colorectal carcinoma is variable in Dukes' B, so the aim of this study was to determine whether or not SAC has a poor prognosis in Dukes' B. METHODS: The study group comprised 64 patients who underwent surgery for colorectal carcinoma. We undertook a statistical analysis of the association of SAC and non-SAC with sex, age, histologic type, depth of tumor, location of tumor, venous invasion and lymphatic invasion. RESULTS: SACs were encountered in 17.5% of cases (n = 11). SAC had a less favorable 5-year survival than non-SAC (p = 0.0396 log-rank, Kaplan-Meier). The factors that achieved statistical significance in the univariate analysis were subsequently included in a multivariate analysis and we found that SAC was an independent factor (p = 0.027). CONCLUSIONS: SAC has a poor prognosis and is not affected by other factors confirming that SAC is an independently less favorable prognostic factor.

Fluorescence imaging visualizes three sets of regional lymph nodes in patients with lower rectal cancer.

BACKGROUND/AIMS: To demonstrate the usefulness of a fluorescence imager (photodynamic eye; PDE) for observation of lymph flow in lower rectal cancer (LRC). METHODOLOGY: Between October 2006 and January 2010, PDE observations were performed in 14 patients with LRC. After induction of general anesthesia, a total of 2mL of indocyanine green (ICG) (2.5mg/mL) was injected into the submucosal layer on the dentate line or the anal margin of the LRC. RESULTS: Preoperative PDE observation was able to demonstrate several lymph flows running to the bilateral inguinal areas from the perianal area immediately after ICG injection in 13 of the patients (92.9%). Although these flows were pooled in the bilateral inguinal areas, there was no pooling of such lymph flows in the perianal area. Intraoperative PDE observation was able to demonstrate not only mesenteric lymph nodes in all patients but also bilateral lateral lymph nodes in 13 patients (92.9%). Although 6 patients had undergone sphincter-preserving surgery (SPS), no local recurrence was observed in such patients during the observation period. CONCLUSIONS: PDE is able to visualize three sets of regional lymph nodes in patients with LRC, suggesting that it would be useful for determining the effectiveness of SPS for such patients.

Sequential evaluations of trace elements in patients receiving parenteral nutrition.

BACKGROUND/AIMS: To evaluate alterations of serum trace element (TE) levels in critically ill patients receiving parenteral nutrition (PN) including the recommended doses of TEs. METHODOLOGY: Measurements of serum levels of TEs such as zinc, iron, copper, manganese and iodine were performed on the day before, and two and four weeks after, administration of PN. RESULTS: Forty-six patients who received PN from October 2007 to August 2009, were enrolled. All patients received 100µmol (6.5mg) zinc, 35µmol (2mg) iron, 5µmol (0.3mg) copper, 1µmol (0.05mg) manganese and 1µmol (0.13mg) iodine as the recommended daily doses. There were no significant differences in the serum levels of iron, copper and manganese among the three measurement points. On the other hand, there were significant differences in the serum levels of zinc (p<0.001), triiodothyronine (T3) (p=0.010) and unbound T3 (p=0.006) among the three points, but not for thyroxine (T4) and unbound T4. CONCLUSIONS: The recommended doses of TEs are justified for critically ill patients in terms of constant serum levels, except for zinc and iodine.

Dressing change reduces the central venous catheter-related bloodstream infection.

BACKGROUND/AIMS: To compare the time interval from insertion until development of central venous catheter related bloodstream infection (CVC-RBSI) between patients who received non-routine dressing change group (Group 1) and patients who received routine dressing change group (Group 2). METHODOLOGY: Between March 2006 and July 2008, patients who underwent CVC were randomly divided into Groups 1 and 2. Comparative study between the two groups was performed by reference to the incidences of CVC-RBSI from the prospectively obtained database. RESULTS: One hundred-eighty nine patients underwent 530 CVC insertions. Group 1 had 254 CVCs and Group 2 had 276 CVCs. There were no significant inter-group differences in patient background factors, except for gender. In addition, Group 1 had a shorter duration of catheter insertion than Group 2. Nevertheless, Group 1 had not only a significantly shorter period from insertion until the development of CVC-RBSI but also a higher frequency of fever than Group 2. CONCLUSIONS: The results of our comparison between non-routine dressing change group and routine dressing change group indicate that routine dressing change can reduce the incidence of CVC-RBSI in patients undergoing CVC insertions.

Systemic inflammatory response associated with distant metastasis of T1 or T2 colorectal cancer.

BACKGROUND: There are currently no studies examining the relationship between systemic inflammatory response and distant metastasis in colorectal cancer patients. AIMS: The aim of this study was to evaluate the association of a systemic inflammatory response on distant metastasis by examining clinicopathological factors in patients with colorectal cancer infiltrating the submucosal layer (T1) or the proper muscular layer (T2). METHODS: Univariate analysis was performed to evaluate the influence of a systemic inflammatory response on distant metastasis in patients with T1 or T2 colorectal cancer using collected clinicopathological data. RESULTS: Between 1993 and 2008, 156 patients with pathologically diagnosed T1 or T2 colorectal cancer were enrolled. Univariate analysis using clinicopathological factors and Glasgow Prognostic Score (GPS) (0, 1/2) demonstrated that, as well as lymph node metastasis, administration of oral anti-cancer drug and CEA, CRP (odds ratio, 36.25; 95% CI 4.026-326.4; P = 0.001) and GPS (odds ratio, 24.50; 95% CI 1.715-349.9; P =0.018) were associated with distant metastasis. CONCLUSIONS: CRP and GPS are associated with distant metastasis of T1 or T2 colorectal cancer. Because of the small number of patients with stage IV disease (n =4), a multi-center retrospective study is needed to confirm these findings.

Influence of inflammation-based prognostic score on mortality of patients undergoing chemotherapy for far advanced or recurrent unresectable colorectal cancer.

BACKGROUND: Recent studies have revealed that the modified Glasgow Prognostic Score (mGPS), an inflammation-based prognostic score that includes only C-reactive protein (CRP) and albumin, is a useful tool for predicting postoperative outcome in cancer patients. However, few studies have investigated the mGPS in patients undergoing chemotherapy for far-advanced or recurrent unresectable colorectal cancer (AR-UCRC). OBJECTIVE: To demonstrate the influence of the mGPS for prognostication of patients undergoing chemotherapy for AR-UCRC. METHODS: The mGPS was calculated as follows: patients with an elevated level of CRP (>1.0 mg/dL) were allocated a mGPS of 1 or 2 depending on the absence or presence of hypoalbuminemia (<3.5 g/dL) and patients showing no elevated level of CRP (< or =1.0 mg/dL) were allocated a mGPS of 0. Prognostic significance was analyzed by Kaplan-Meier, univariate, and multivariate analyses. RESULTS: One hundred twelve patients who had undergone chemotherapy for AR-UCRC with regimens such as FOLFIRI (5-fluorouracil/l-leucovorin/irinotecan hydrochloride) or FOLFOX (5-fluorouracil/oxialiplatin) were evaluated retrospectively. Kaplan-Meier analysis and log-rank test revealed that mGPS 2 predicted a higher risk of mortality than mGPS 0 or 1 (P < 0.0001). Univariate analyses revealed that the neutrophil ratio (P = 0.0411), CA 19-9 (P = 0.0473), CRP (P = 0.0477), albumin (P = 0.0043), and mGPS (0, 1/2) (P < 0.0001) were associated with mortality. Multivariate analyses using these 5 factors revealed that only mGPS (0, 1/2) (odds ratio: 6.071; 95% CI: 1.625-22.68; P = 0.0073) was an independent risk factor of mortality. CONCLUSIONS: mGPS is an important and independent predictor of mortality in patients undergoing chemotherapy for AR-UCRC.

External jugular venous catheterization with a Groshong catheter for central venous access.

BACKGROUND: The Groshong catheter (GC) is commonly used as a peripherally inserted central catheter (PICC), and the external jugular vein (EJV) is not a common route for central venous access (CVA). Therefore, external jugular venous catheterization (EJVC) using a GC is rare. However, our experience has shown that this procedure is safe and simple for CVA. PURPOSE: To assess the utility of EJVC using the GC for CVA. METHODS: CVA was done using a GC via the EJV with a single puncture employing the maximal barrier precaution technique. RESULTS: Between March 2005 and June 2007, we attempted to perform EJVC using a GC via the EJV for 331 patients. Among of these patients, 301 patients received successful catheterization (success rate: 301/331 = 90.9%). The total period of catheter insertion was 4601 days, and the mean insertion period was 15.1 days (range 2-147 days). The main complications of catheter insertion were malposition (8/301; 2.7%) and, oozing or hematoma formation (8/301; 2.7%). There were no severe complications such as nerve injury, pneumothorax or arterial bleeding. CONCLUSIONS: Our experience demonstrates that EJVC using the GC is acceptable for CVA.

Usefulness of Groshong catheters for central venous access via the external jugular vein.

This study was designed to evaluate the usefulness of central venous access via the external jugular vein (EJV) employing Groshong catheters, and to compare the complications with those of conventional internal jugular venous catheterization. Central venous access was achieved by insertion of a single-lumen 4.0 Fr Groshong catheter via the EJV or internal jugular vein (IJV) with a single puncture. Complications associated with insertion and central venous catheter-related bloodstream infection (CVC-RBSI) were evaluated from the database. Two hundred and twenty-five patients received 400 catheters for a total period of 5377 catheter-days. Ninety-six patients underwent 201 internal jugular venous catheter (IJV-C) procedures for 2381 catheter-days, and 129 patients underwent 199 external jugular venous catheter (EJV-C) procedures for 2996 catheter-days. Use of EJV-C was associated with a longer catheter insertion length (p < .01) and period (p < .01), a larger number of operations (p < .01), and more frequent use of total parenteral nutrition (TPN) (p < .01) and less frequent use of chemotherapy (p < .01) than for IJV-C. However, there were no significant differences (NS) in complications associated with insertion and CVC-RBSI between IJV-C and EJV-C. There were no significant differences such complications as malposition, oozing or hematoma formation of insertion site, arterial bleeding, nerve damage, pneumothorax, and phlebitis between IJV-C and EJV-C. Moreover, EJV-C was not associated with morbidities such as pneumothorax, arterial bleeding, and nerve damage. Thus the study concluded that EJV-C using Groshong catheters has no severe complications and has the same rates of CVC-RBSI as conventional IJV-C for central venous access.

External jugular Groshong catheter is associated with fewer complications than a subclavian Argyle catheter.

BACKGROUND: To demonstrate the efficacy and safety of insertion of a Groshong catheter via the external jugular vein (EJV) for central vein access. METHODS: Central venous access was done by either insertion of a Groshong catheter via the EJV or an Argyle catheter via the subclavian vein with single puncture. RESULTS: Eighty patients (group 1) were treated with 146 subclavian venous catheters for 2,770 catheter-days, and 98 patients (group 2) were treated with 147 external jugular venous catheters for 2,381 catheter-days. Fever appeared in 36.3% (53/146) and 16.3% (24/147) of the patients in groups 1 and 2, respectively (p < 0.01). The malposition and pneumothorax rates were 17.1% (25/146) and 2.0% (3/147; p < 0.01), and 2.7% (4/146) and 0% (0/147; p < 0.05) in the two groups, respectively. CONCLUSIONS: Insertion of a Groshong catheter via the EJV is more acceptable for central venous access than insertion of a conventional subclavian venous catheter.

POSSUM is an optimal system for predicting mortality due to colorectal perforation.

BACKGROUND/AIMS: The purpose of this study was to determine the most useful predictive scoring system for the postoperative mortality of patients with colorectal perforation using the Acute Physiological and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA) and Physiological and Operative Severity Score for the enUmeration of Mortality (POSSUM). METHODOLOGY: First, the 3 scoring systems were applied to all patients, and the efficacy of these systems was compared between survivors and non-survivors. Second, using receiver operating characteristic (ROC) curve analysis, optimal cut-off values were determined for each system and patients were divided into another two groups (high score group and low score group). Then statistical analyses were performed, respectively. RESULTS: All scoring systems gave significantly lower scores for survivors than for non-survivors. POSSUM was the most sensitive system for predicting operative mortality (POSSUM: sensitivity 87.5%). Kaplan-Meier analysis and log rank test revealed that there were significant differences between the high score group and the low score group, except for APACHE II. Multivariate logistic regression analysis revealed that only POSSUM was an independent predictor (odds ratio, 0.858; 95% C.I.; 0.736-1,000; p = 0.0498). CONCLUSIONS: POSSUM is an optimal predictor of mortality following emergency surgery for colorectal perforation.

Staging the tumor and staging the host: A two centre, two country comparison of systemic inflammatory responses of patients undergoing resection of primary operable colorectal cancer.

BACKGROUND: How systemic inflammation-based prognostic scores such as the modified Glasgow Prognostic Score (mGPS) and neutrophil:lymphocyte ratio (NLR) differ across populations of patients with colorectal cancer (CRC) remains unknown. The present study examined the mGPS and NLR in patients from United Kingdom (UK) and Japan. METHODS: Patients undergoing resection of TNM I-III CRC in two centres in the UK and Japan were included. Differences in clinicopathological characteristics and mGPS (0-CRP≤10 mg/L, 1-CRP>10 mg/L, 2-CRP>10 mg/L, albumin<35 g/L) and NLR (≤5/>5) were examined. RESULTS: Patients from UK (n = 581) were more likely to be female, high ASA and BMI, present as an emergency (all P < 0.01) and have higher T stage compared to those from Japan (n = 559). After controlling for differences in tumor and host characteristics, patients from Japan were less likely to be systemically inflamed (OR: mGPS: 0.37, 95%CI 0.27-0.50, P < 0.001; NLR: 0.53, 95%CI 0.35-0.79, P = 0.002). CONCLUSION: Systemic inflammatory responses differ between populations with colorectal cancer. Given their prognostic value, reporting of systemic inflammation-based scores should be incorporated into future studies reporting patient outcomes.

Rectal angiolipoma diagnosed after surgical resection: a case report.

Angiolipoma is a common benign tumor with a characteristic vascular component that usually occurs in subcutaneous tissue. Although lipomas are frequently encountered at colonoscopy as submucosal tumors, angiolipomas are rarely found in the gastrointestinal tract including the large intestine. Here we report a 77-year old Japanese man who underwent transanal resection of a tumor that was diagnosed tentatively as a leiomyoma. Histologically, the tumor consisted of mature fat cells and blood vessels. Immunohistochemically, the tumor cells were negative for c-kit and HMB-45, which are consistently expressed in tumors such as gastrointestinal stromal tumor and angiomyolipoma. The tumor was therefore diagnosed as an angiolipoma. This is thought to be the first case report of a surgically resected angiolipoma of the rectum.

Hepatectomy for metastatic liver tumor in patients with liver dysfunction.

BACKGROUND/AIMS: In the present study, we evaluated the safety and long-term outcome of liver resection for metastatic liver tumor in patients with liver dysfunction. METHODOLOGY: Sixty-one patients, who underwent liver resection for metastatic liver tumor, were retrospectively divided into two groups, based on the retention rate of indocyanine green at 15 minutes (ICGR15). Group 1: ICGR15 < 10% (n = 34), Group 2: ICG R15 > 10% (n = 27). Patient background, perioperative data (operation time, blood loss, duration of Pringle's maneuver, volume of resected liver), duration of postoperative hospital stay, and three-year survival rate were compared between the two groups. All data were expressed as median values. RESULTS: There were no differences in patient backgrounds between the two groups. No significant differences were observed betweens Group 1 and 2 for operation time (383.5 vs. 345.0 min), blood loss (390 vs. 296mL), duration of Pringle's maneuver (55 vs. 42 min), volume of resected liver (402.5 vs. 110.0 mL), or duration of postoperative hospital stay (26 vs. 26 days). The three-year survival rates in Groups 1 and 2 were 72.9% and 87.8%, respectively (p = 0.937). CONCLUSIONS: Liver resection for metastatic liver tumor in patients with liver dysfunction can be performed safely, and the long-term outcome is comparable to that in patients with normal function.

Perioperative Administration of Traditional Japanese Herbal Medicine Daikenchuto Relieves Postoperative Ileus in Patients Undergoing Surgery for Gastrointestinal Cancer: A Systematic Review and Meta-analysis.

AIM: Although it has been widely demonstrated that administration of Daikenchuto (DKT), a traditional Japanese herbal medicine, improves gastrointestinal (GI) motility in patients undergoing abdominal surgery, few studies have investigated the efficacy of perioperative DKT administration for relief of postoperative ileus (PI) in patients undergoing surgery for GI cancer. Therefore, the aim of this study was to investigate whether perioperative administration of DKT relieves PI in patients with GI cancer. PATIENTS AND METHODS: We performed a comprehensive electronic search of the literature (Cochrane Library, PubMed, the Web of Science and ICHUSHI) up to December 2016 to identify studies that had shown the efficacy of perioperative DKT administration for relief of PI in patients with GI cancer. To integrate the individual effect of DKT, a meta-analysis was performed using random-effects models to calculate the risk ratio (RR) and 95% confidence interval (CI), and heterogeneity was analyzed using I2 statistics. RESULTS: Seven studies involving a total of 1,134 patients who had undergone GI cancer surgery were included in this meta-analysis. Among 588 patients who received DKT perioperatively, 67 (11.4%) had PI, whereas among 546 patients who did not receive DKT perioperatively, 87 (15.9%) had PI. Perioperative administration of DKT significantly reduced the occurrence of PI (RR=0.58, 95% CI=0.35-0.97, p=0.04, I2=48%) in comparison to patients who did not receive DKT or received placebo. CONCLUSION: The result of this meta-analysis suggests that perioperative administration of DKT relieves PI in patients undergoing surgery for GI cancer.

Usefulness of a laparoscopic approach for treatment of small-bowel obstruction due to intersigmoid hernia: a case report.

It is well known that intersigmoid hernia (ISH) is a rare condition. Here we describe our experience of laparoscopic surgery for small-bowel obstruction (SBO) due to ISH after sufficient decompression involving long-tube insertion.A 45-year-old woman with no history of abdominal surgery visited our hospital with epigastric pain. She was diagnosed as having SBO and underwent long-tube insertion as conservative therapy. However, her symptoms did not improve. Gastrografin contrast enema via the long-tube demonstrated a beak sign in the lower left abdomen and CT showed incarcerated small bowel was successively covered by sigmoid mesocolon, suggesting that the SBO was due to ISH, and she underwent laparoscopic surgery after sufficient decompression of the dilated small bowel.Intraoperative examination demonstrated incarceration of a loop of the small bowel in the intersigmoid fossa without strangulation. Because the incarcerated portion of the small bowel was not necrotized, herniation repair was performed by removing the incarcerated small bowel from the intersigmoid fossa without closure of the hernia orifice.The postoperative course was uneventful, and the patient is now free of symptoms and recurrence 12 months after surgery. Laparoscopic surgery after sufficient decompression is a useful treatment for SBO due to ISH.

α-taxilin overexpression correlates with proliferation activity but not with prognosis of colorectal cancer.

α-taxilin is a binding partner of syntaxins, which are the central coordinators of membrane traffic. Expression of α-taxilin has been implicated in the development of human glioblastoma, hepatocellular carcinoma and renal cell carcinoma. In the present study, the clinical significance of α-taxilin expression in colorectal cancer (CRC) was investigated. A total of 20 cases of colorectal intramucosal adenocarcinoma (IMA) with adenoma were analyzed using immunohistochemical analysis. The results demonstrated that α-taxilin expression was significantly associated with Ki-67 indices in adenoma and IMA. The patients expressed equally high levels of α-taxilin in the upper third of the intramucosal glands. These results suggest that α-taxilin expression is significantly associated with the proliferative activity of CRC, but that its overexpression alone is not a biomarker of malignancy. Next, α-taxilin expression was investigated in 57 advanced CRCs and its association with prognosis was determined. Well-differentiated and/or moderately differentiated adenocarcinomas in the left-sided colon with anatomic stage II and/or III were analyzed. α-taxilin expression levels were high on the surface of nearly all tumors, but variable at the deep advancing edge. α-taxilin levels at the advancing edge were not significantly associated with local invasiveness or prognosis. In conclusion, α-taxilin is a cell proliferation marker in colorectal epithelial neoplasms but cannot be a marker of malignancy or prognosis of CRCs.

Ulcerative Colitis-associated Cancer/Dysplasia Detected Using Surveillance Colonoscopy Performed in the Clinical Remission Phase: A Report of Five Cases.

We herein report five cases of ulcerative colitis-associated cancer/dysplasia. Although clinical remission had been achieved in all patients, mucosal inflammation had been resolved in only one patient. Thus, in order to prevent cancer from developing, appropriate medical therapy aiming not only to relieve the clinical symptoms, but also to suppress chronic inflammation appears to be necessary. Moreover, cancer occurred as early as 4 years after the diagnosis in one patient. In patients without complete resolution of mucosal inflammation, careful surveillance colonoscopy should be initiated in the early phase.