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ABSTRACT: Gastrointestinal stromal tumor(GIST) represents the most common mesenchymal tumor of the gastrointestinal tract. With decades of development, surgical excision combined with molecular targeted agents is becoming the mode for the GIST treatment. Imatinib mesylate (IM) is the first-line therapy medicine for GIST adjuvant treatment, and it significantly reduces recurrence or metastasis and increases survival. According to the recently results of SSGXVIII(/AIO study, imatinib adjuvant therapy should be administered for at least 3 years for the GIST patients with a high estimated risk of recurrence and metastasis after surgery. Nevertheless, the optimal duration of the adjuvant therapy or the follow-up policy remains unclear, and we look forward to standard assessment criteria for individualized treatment.
Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery 03/2013; 16(3):212-215.
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ABSTRACT: OBJECTIVE: To explore the associated biomarkers influencing recurrence, metastasis and prognosis in patients with gastrointestinal stromal tumors(GIST) after complete resection. METHODS: Tumor tissue samples of 148 patients with GIST undergoing complete resection from January 1990 to December 2008 in Sun Yat-sen University Cancer Center were collected. The expressions of Ki-67, E-cadherin, MMP7, CD44, nm23, P53, survivin, Cyclin D1, COX-2, and VEGF in tumor tissue samples were detected by tissue microarray and immunohistochemistry(IHC). The association of above factors expressions with recurrence, metastasis and prognosis was examined. RESULTS: Log-rank test showed that Ki-67, E-cadherin, MMP7, CD44, P53 and survivin were associated to disease-free duration after complete GIST resection(all P<0.05), and the Ki-67, E-cadherin, P53 and survivin were associated to overall survival(all P<0.05). Cox multivariate analysis revealed that disease-free survival was associated with Ki-67, CD44 and P53(all P<0.05), and the overall survival was only associated with Ki-67(P<0.05). CONCLUSION: Ki-67, CD44 and P53 are closely associated with recurrence and metastasis after complete GIST resection, and Ki-67 can predict the prognosis of GIST.
Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery 03/2013; 16(3):242-246.
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ABSTRACT: To investigate the compliance and associated factors of postoperative chemotherapy for elderly patients with colorectal cancer.
A total of 386 elderly patients (>70 years old) with stage II(-IIII( colorectal cancer underwent surgery between January 2000 and January 2010. The clinicopathological data were retrospectively reviewed. There were 226 patients received postoperative chemotherapy and 160(41.4%) refused. Logistic regression model was used to analyze factors associated with patients compliance to chemotherapy. Patients were followed up by phone call regarding the reason for refusal.
Multivariate analysis showed that gender, body mass index (BMI), body surface area (BSA), age, and complication were independent risk factors associated with chemotherapy compliance(All P<0.05). Follow-up phone questionnaire showed that 63.8%(51/80) of patients with stage II( cancer did not received chemotherapy because of the doctor's uncertainty of chemotherapy benefit. For stage III( patients, fear of chemotherapy (31.2%, 15/48), feeling uncomfortable (18.8%, 9/48), and financial issues(18.8%, 9/48) were the main factors. The desperate feeling was the predominant reason for stage IIII( patients(56.2%, 18/32).
Gender, BSA, age, and postoperative complication are the main factors associated with compliance to postoperative chemotherapy. Doctors' recommendation should be emphasized for stage II( patients. For stage III( patients, treatment recommendation should be enthusiastic.
Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery 10/2012; 15(10):1032-5.
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Yu-Jing Fang,
Guo-Qiang Wang,
Zhen-Hai Lu,
Lin Zhang,
Ji-Bin Li, Xiao-Jun Wu,
Pei-Rong Ding,
Qing-Jian Ou,
Mei-Fang Zhang,
Wu Jiang,
Zhi-Zhong Pan,
De-Sen Wan
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ABSTRACT: Estrogen receptor beta (ERβ) and TROP2 expressed in colon carcinoma and might play an important role there. We explored the relationship of ERβ and TROP2 expression with the prognosis of early-stage colon cancer. ERβ and TROP2 levels were assessed by immunohistochemistry in normal mucosa and tumoral tissues from 220 Chinese patients with T(3)N(0)M(0) (stage IIa) and T(4)N(0)M(0) (stage IIb) colon cancer in the Cancer Center, Sun Yat-sen University, who underwent curative surgical resection between 1995 and 2003. The Cox proportional hazards regression model was applied to analyze the overall survival (OS) data, and the ROC curve, Kaplan-Meier estimate, log rank test, and Jackknife method were used to show the effect of ERβ and TROP2 expression at different stages of cancer. The 5-year survival rates were not significantly different between the patients with stage IIa and stage IIb colon cancer (83 vs. 80 %, respectively). The high expression of ERβ was related to decreasing OS in stage IIa and stage IIb colon cancer, while the high expression of TROP2 was related to decreasing OS in stage IIb colon cancer. The expression of ERβ and TROP2 has tumor-suppressive and tumor-promoting effect in stage IIa and stage IIb colon cancer, respectively.
Tumor Biology 09/2012; · 1.94 Impact Factor
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ABSTRACT: The correlation of ERβ/CD44 expression and progression of patients with stage II of colon cancer were explored in this work. A total of 220 paraffin-embedded specimens with stage II colon cancer from 1995 to 2003 were included for assessing ERβ and CD44 by immunohistochemistry in normal mucosa and tumor tissues. Kaplen-Meier method, log-rank test, and the Cox proportional hazards regression model were used to analyze the overall survival data. ROC curve was used to describe the capacity of variables in prognosis prediction. Jackknife method was used to perform cross validation of predictions. The survival rates were significantly different between the patients with high expression and low expression of CD44-tumor tissues (61 % vs. 90 %, p < 0.0001) and between the patients with high expression and low expression of ERβ-tumor tissue (99 % vs. 36 %, p < 0.0001), respectively. In addition, the interaction between expression of ERβ and CD44 was found that the impact of CD44 to the overall survive appeared only when expression of ERβ was low; and the high expression of ERβ-tumor could be regarded as a protective factor for overall survival. This study suggest that low expression of ERβ-tumor and high expression of CD44-tumor are risk factors for overall survival in patients with stage II colon cancer.
Tumor Biology 07/2012; · 1.94 Impact Factor
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ABSTRACT: PURPOSE: To explore the views of patients and enterostomal nurses regarding a telephone follow-up program for patients returning home with colostomies. METHODS AND SAMPLE: Semi-structured interviews were conducted with eleven patients who accepted a telephone intervention and seven enterostomal nurses who conducted telephone follow-ups. Qualitative data were analyzed using content analysis. KEY RESULTS: The enterostomal nurses indicated that the telephone follow-up was appreciated and well accepted by the patients. Both the patients and the enterostomal nurses perceived the telephone follow-up as efficient at solving stoma care problems in a timely manner, shortening the process of resuming normal life, and most importantly, providing psychological support. The enterostomal nurses found that telephone follow-up after a patient's hospital discharge was meaningful work. Additional nurse training and measures to overcome communication barriers are required. CONCLUSIONS: All of the patients benefited from the nurse-led telephone follow-up program as part of the continuity of nursing care. The sustainability of the service requires hospital support. Further dissemination of telephone follow-up to other discharged surgical patients might be warranted.
European journal of oncology nursing: the official journal of European Oncology Nursing Society 06/2012; · 1.13 Impact Factor
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ABSTRACT: It is not clear if sentinel lymph node (SLN) mapping can improve outcomes in patients with colorectal cancers. The purpose of this study was to determine the prognostic values of ex vivo sentinel lymph node (SLN) mapping and immunohistochemical (IHC) detection of SLN micrometastasis in colorectal cancers.
Colorectal cancer specimens were obtained during radical resections and the SLN was identified by injecting a 1% isosulfan blue solution submucosally and circumferentially around the tumor within 30 min after surgery. The first node to stain blue was defined as the SLN. SLNs negative by hematoxylin and eosin (HE) staining were further examined for micrometastasis using cytokeratin IHC.
A total of 54 patients between 25 and 82 years of age were enrolled, including 32 males and 22 females. More than 70% of patients were T3 or above, about 86% of patients were stage II or III, and approximately 90% of patients had lesions grade II or above. Sentinel lymph nodes were detected in all 54 patients. There were 32 patients in whom no lymph node micrometastasis were detected by HE staining and 22 patients with positive lymph nodes micrometastasis detected by HE staining in non-SLNs. In contrast only 7 SLNs stained positive with HE. Using HE examination as the standard, the sensitivity, non-detection rate, and accuracy rate of SLN micrometastasis detection were 31.8% (7/22), 68.2% (15/22), and 72.2%, respectively. Micrometastasis were identified by ICH in 4 of the 32 patients with HE-negative stained lymph nodes, resulting in an upstaging rate 12.5% (4/32). The 4 patients who were upstaged consisted of 2 stage I patients and 2 stage II patients who were upstaged to stage III. Those without lymph node metastasis by HE staining who were upstaged by IHC detection of micrometastasis had a significantly poorer disease-free survival (p = 0.001) and overall survival (p = 0.004).
Ex vivo localization and immunohistochemical detection of sentinel lymph node micrometastasis in patients with colorectal cancer can upgrade tumor staging, and may become a factor affecting prognosis and guiding treatment. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1350200526694475.
Diagnostic Pathology 06/2012; 7:71. · 1.64 Impact Factor
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Qing Xia,
Ya Ding, Xiao-Jun Wu,
Rui-Qing Peng,
Qiang Zhou,
Jing Zeng,
Jing-Hui Hou,
Xing Zhang,
Yi-Xin Zeng,
Xiao-Shi Zhang,
Ying-Bo Chen
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ABSTRACT: Mast cells (MC) reside in the mucosa of the digestive tract as the first line against bacteria and toxins. Clinical evidence has implied that the infiltration of mast cells in colorectal cancers is related to malignant phenotypes and a poor prognosis. This study compared the role of mast cells in adjacent normal colon mucosa and in the invasive margin during the progression of colon cancer.
Specimens were obtained from 39 patients with colon adenomas and 155 patients with colon cancers treated at the Sun Yat-sen University Cancer Center between January 1999 and July 2004. The density of mast cells was scored by an immunohistochemical assay. The pattern of mast cell distribution and its relationship with clinicopathologic parameters and 5-year survival were analyzed.
The majority of mast cells were located in the adjacent normal colon mucosa, followed by the invasive margin and least in the cancer stroma. Mast cell count in adjacent normal colon mucosa (MCC(adjacent)) was associated with pathologic classification, distant metastases and hepatic metastases, although it was not a prognostic factor. In contrast, mast cell count in the invasive margin (MCC(invasive)) was associated with neither the clinicopathlogic parameters nor overall survival.
Mast cells in the adjacent normal colon mucosa were related to the progression of colon cancer, suggesting that mast cells might modulate tumor progression via a long-distance mechanism.
Chinese Journal of Cancer Research 12/2011; 23(4):276-82. · 0.18 Impact Factor
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ABSTRACT: To explore the expression patterns of matrix metalloproteinase1 (MMP-1) in colon carcinoma and evaluate its clinical significance.
The expression of MMP-1 was detected by SP immunohistochemical method. The tissue microarray samples of 620 colon carcinoma patients were collected and the clinical data reviewed.
The positive expression rate of MMP-1 in cancer tissue was higher than that of normal tissue [72.5% (421/581) vs 30.8% (179/581), P = 0.0001]. And the difference was statistically significant (P = 0.0001). The positive rate in stages I and II [77.6% (235/303)] were higher than stages III and IV [66.9% (186/278), P = 0.0040], the former two stages showed a poor prognosis while the latter two stages a fair prognosis. The results of COX regression showed that a lower expression of MMP-1 (HR: 1.042, 95%CI: 0.770 - 1.410, P = 0.0001), tumor type (HR: 0.966, 95%CI: 0.571 - 1.633, P = 0.0150), local infiltration (HR: 0.576, 95%CI: 0.413 - 0.805, P = 0.0010) and infiltration of bowel wall (HR: 0.337, 95%CI: 0.197 - 0.575, P = 0.0001) were significant predictors of colon carcinoma.
As an independent prognostic factor of colon carcinoma, the expression of MMP-1 in cancer tissue has different prognostic implications according to various stages.
Zhonghua yi xue za zhi 11/2011; 91(41):2895-8.
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ABSTRACT: To investigate the outcome of surgical treatment for gastrointestinal stromal tumor(GIST) and the associated factors.
A total of 277 patients with GIST underwent primary surgical treatment from January 1990 to February 2010 at the Cancer Center of Sun Yat-sen University. The clinical data were retrospectively reviewed and the pathological examination was reviewed. Follow-up was performed.
There were 176 males and 101 females. The age ranged from 20 to 81 years old (median,57). Location of the tumor included colorectum (n=28),small bowel(n=76), stomach(n=173). All the patients had en bloc resection, including local excision in 98 patients, organ resection in 64, and extended resection in 115. The 5-year survival rates were 83.5%, 71.9%, and 61.9% in the three different procedures, respectively, and the difference was not statistically significant(P>0.05). Cox model showed that the tumor size, recurrence and metastasis were independent risk factors associated with the prognosis in GIST patients(P<0.05).
Surgery remains the major approach for gastrointestinal GIST. Complete resection is the principal treatment. Extensive resection or extended lymph nodes dissection is not associated with improved survival.
Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery 10/2011; 14(10):778-80.
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ABSTRACT: Previous prognosis analyses of colorectal cancer (CRC) patients with stage II and III disease were done as separate categories. The purpose of this study was to analyze prognostic factors associated with survival in a group of patients who underwent radical resection of stages II and III CRC.
A retrospective review was performed for 141 consecutive stages II and III patients who had undergone radical resection of colorectal adenocarcinoma between May 2003 and November 2003. Univariate and multivariate analyses were performed to assess the effect of record variables on disease free survival and overall survival.
The median follow-up time was 59 months, and the 3- and 5-year survival rates were 76% and 68%, respectively. Four factors were independently associated with a worse disease-free survival: diabetes (hazard ratio (HR) 2.338; 95% confidence interval (CI) 1.011 - 5.407), expression of cyclooxygenase-2 (Cox-2) (HR 0.335; 95%CI 0.126 - 0.888), expression of matrix metalloproteinases 2 (MMP-2) (HR 0.233; 95%CI 0.101 - 0.541), expression of vascular endothelial growth factor (VEGF) (HR 0.295; 95%CI 0.088 - 0.996). Four factors were independently associated with a worse overall survival: lymph nodes metastasis (HR 1.67; 95%CI 1.29 - 2.14), Cox-2 positive (HR 0.056; 95%CI 0.247 - 0.731), MMP-2 positive (HR 0.398; 95%CI 0.190 - 0.836), VEGF (HR 0.364; 95%CI 0.090 - 0.716).
Diabetes, expression of Cox-2, MMP-2 and VEGF were independently associated with a worse disease- free survival. Lymph nodes metastasis, expression of Cox-2, MMP-2 and high level of VEGF predicted a poor overall survival.
Chinese medical journal 07/2011; 124(14):2132-5. · 0.86 Impact Factor
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ABSTRACT: Mast cells promote the progression of experimental tumors and might be a valuable therapeutic target. However, the relevant clinical evidence is still controversial. This study analyzed the relationship between the distribution of mast cells and the survival of patients with colon cancer to study whether mast cells contribute to tumor progression.
Ninety-three cases of pathologically confirmed primary cancer tissues matched with adjacent normal mucosa, metastases of regional-draining lymph nodes and regional-draining lymph nodes without metastases were collected from stage IIIB colon carcinoma patients between January 1997 and July 2004 at the Cancer Center of Sun Yat-Sen University. Tryptase-positive mast cells were counted. The relationships of the distribution of mast cells with clinicopathologic parameters and 5-year survival were analyzed.
Although the mast cell count in the mucosa adjacent to the primary colon cancer was significantly higher than that in the stroma of the primary colon cancer, no difference in mast cell counts was observed between the stroma in lymph node metastasis and the lymph tissue adjacent to the metastasis. Additionally, the mast cell count in the regional-draining lymph node without the invasion of cancer cells was significantly higher than that in the stroma of lymph node metastasis and adjacent lymph tissue. However, none of those mast cell counts was related to 5-year survival.
Although mast cell count varied with location, none of the mast cell counts was related to 5-year survival, suggesting that mast cells do not contribute to the progression of stage IIIB colon cancer.
Journal of Translational Medicine 06/2011; 9:88. · 3.41 Impact Factor
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Pei-Rong Ding,
Xin An,
Rong-Xin Zhang,
Yu-Jing Fang,
Li-Ren Li,
Gong Chen, Xiao-Jun Wu,
Zhen-Hai Lu,
Jun-Zhong Lin,
Ling-Heng Kong,
De-Sen Wan,
Zhi-Zhong Pan
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ABSTRACT: Adjuvant chemotherapy for stage II colon cancer remains controversial but may be considered for patients with high-risk features. Recent studies have shown that elevated neutrophil to lymphocyte ratio (NLR) is a worse prognostic factor and a predictor of response to chemotherapy in patients with advanced colorectal cancer. The purpose of this study was to evaluate whether NLR predicts risk of recurrence in patients with stage IIA colon cancer undergoing curative resection without adjuvant chemotherapy.
We retrospectively reviewed 141 consecutive patients with stage IIA colon cancer treated with curative surgery alone from 2002 to 2006. NLR, as well as demographics, clinical, histopathologic, and laboratory data were analyzed. Univariate and multivariate analyses were conducted to identify prognostic factors associated with recurrent-free survival (RFS).
Cox's regression analysis demonstrated that elevated NLR (>4) (hazard ratio, 4.88; P < 0.01) and less lymph node sampling (<15 lymph nodes; hazard ratio, 3.80; P < 0.05) were adverse prognostic factors for RFS. The 5-year RFS was 91.4% (95% CI, 88.6-94.2%) for patients with normal NLR and 63.8% (51.1-76.3%) for patients with elevated NLR. The 5-year RFS for patients with 0, 1, and 2 of the identified risk factors was 95.1%, 87.4%, and 33.3%, respectively (P < 0.001).
Elevated preoperative NLR is an independent predictor of worse RFS for patients with stage IIA colon cancer and a potential biomarker to identify candidates for adjuvant chemotherapy.
International Journal of Colorectal Disease 12/2010; 25(12):1427-33. · 2.38 Impact Factor
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ABSTRACT: To investigate the length of lymphangiogenesis in the rectal tissue distal to a rectal cancer and its effect on the resection margins of the rectum, 63 specimens of normal rectal tissue distal to the tumor were collected from the surgical resections of ten rectal cancer patients. The specimens were taken at 0.5-cm intervals between the distal end of tumor and the distal surgical margin. The mean amount of collected tissue in each patient was 6.3. The expression of VEGFR-3 and Prox1 was measured in the specimens using real-time quantitative reverse transcription polymerase chain reaction. VEGFR-3 and Prox1 were expressed in all harvested tissues. There was a reduction of expression of VEGFR-3 (nine cases) and Prox1 (ten cases) from tissue adjacent to the rectal tumor to the distal resection margin of the rectum. A downward slope of the expression levels of VEGFR-3 and Prox1 in all cases was found at less than 3.0 cm distal to the tumor. The median VEGFR-3 expression level in the tissues within 1.5 cm adjacent to the rectal cancer was higher than in those tissues beyond 1.5 cm (P = 0.024). The median Prox1 expression level in the tissues within 1.0 cm distal to the rectal cancer was higher than in those tissues beyond 1.0 cm (P = 0.003). Lymphangiogenesis may facilitate the mural spread of cancer cells. The length of development of new lymphatics in the rectal wall distal to a rectal cancer may be less than 3.0 cm. Resection of a rectal cancer should routinely include 3.0 cm distal to the tumor to ensure adequate excision of tissue subject to lymphangiogenesis and potential mural spread of the tumor.
Tumor Biology 12/2010; 31(6):667-71. · 1.94 Impact Factor
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ABSTRACT: Estrogen receptor beta (ERβ) is the most highly expressed protein in patients with colon cancer. Matrix metalloproteinase 7 (MMP7) is consistently expressed throughout cancer progression. We have previously shown that endocrine therapy can inhibit MMP7 expression in colon cancer cells. In this study, we aim to identify the prognostic effects and correlation of ERβ and MMP7 in the context of colon cancer. ERβ and MMP7 levels were assessed by immunohistochemistry in normal mucosa and tumoral tissues from 423 patients with stage I-III colon cancer. The Cox proportional hazards regression model was applied to analyze the lifetime data, including overall survival (OS) and cause-specific survival (CSS). The 5-year survival rate was significantly higher in patients with high expression of nuclear ERβ than in patients with low expression (84.3% vs. 63.9%, respectively, p < 0.05). High expression of MMP7 was related to decreased OS (72% vs. 90%, respectively, p = 0.008) and 5-year survival (86.6% vs. 88.8%, respectively, p = 0.005) compared to patients with low expression of MMP7. In the subset of patients with high expression levels of tumoral nuclear ERβ, high expression of MMP7 was related to OS and CSS among colon cancer patients with high expression of ERβ. In conclusion, our results suggest that low expression of ERβ was a risk factor in colon cancer, and high expression of MMP7 was an independent prognostic factor of ERβ-positive patients with colon cancer.
Tumor Biology 12/2010; 31(6):651-8. · 1.94 Impact Factor
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ABSTRACT: Hand-foot syndrome (HFS) is a common adverse event that can be induced by capecitabine. It is hypothesized that capecitabine (Hoffmann-La Roche Inc.) based chemotherapy can cause overexpression of COX-2 in tumor and healthy tissue, which finally induced HFS in hands and feet. Based on this, we believed that a selected COX-2 inhibitor (celecoxib, Pfizer Pharmaceuticals LLC) could ease HFS. We designed a prospective clinical study to test the hypothesis.
From August 2008 to January 2010, 110 patients with stage II/III colorectal cancer who were eligible for adjuvant chemotherapy were enrolled in the study and divided into 4 groups by random, but 9 patients did not finish at least 4 cycles of chemotherapy. There were sixteen patients in capecitabine group, and fifteen patients in capecitabine and celecoxib group. Thirty-four patients were in XELOX (capecitabine plus oxaliplatine) group, and thirty-six patients in XELOX+ celecoxib group. All 101 patients finished chemotherapy and follow-up interviews.
The group that had received capecitabine and celecoxib had a significantly reduced frequency of >grade 1 hand-foot syndrome (29 vs. 72% P < 0.001), and >grade 2 (11.76% vs. 30% P = 0.024). Five patients experienced grade 3 HFS in capecitabine group and only 1 patient had grade 3 HFS in capecitabine and celecoxib group. There were 5 patients in capecitabine group who refused to go on chemotherapy because of HFS, but there was none in capecitabine and celecoxib group.
From the result of this study, we could learn that celecoxib could reduce HFS that was induced by capecitabine. So we recommend that celecoxib can be used in capecitabine-based chemotherapy.
Journal of Cancer Research and Clinical Oncology 11/2010; 137(6):953-7. · 2.56 Impact Factor
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ABSTRACT: The aim of this study was to identify risk factors of lymph node metastasis (LNM) for T2 rectal cancer.
From a prospectively maintained single-institution database, we identified 346 consecutive pT2 rectal cancers treated with total mesorectal excision from 1998 to 2009. Univariate and multivariate analyses were performed to identify risk factors associated with overall and intermediate/apical LNM. The incidence of overall and intermediate/apical LNM was analyzed by tree analysis.
Age, tumor location, pathological features, and depth of invasion were independent predictors for overall LNM. Tumor location, pathological features, and depth of invasion were independent predictors for intermediate/apical LNM. Tree analysis showed that the incidence of LNM was 7.7% for upper rectal cancer with favorable pathological features, and 3.4% for mid/lower rectal cancer without other identified risk factors. The incidence of intermediate/apical LNM was 5.7% for superficial T2 rectal cancer with favorable pathological features, and 3.1% for deep T2 rectal cancer locating in upper rectum with favorable pathological features.
Depth of invasion is an independent predictor for LNM in T2 rectal cancer. Using tree analysis, we identified a subset of patients with low risk of LNM who may be candidates of local excision.
Journal of Gastrointestinal Surgery 10/2010; 15(1):130-6. · 2.83 Impact Factor
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ABSTRACT: To analyze the outcome of the patients with gastric gastrointestinal stromal tumor(GIST) after surgical treatment and identify the associated risk factors.
Clinical data and the tissue slices including immunohistochemistry staining of 140 patients with gastric GIST from January 1990 to December 2008 were retrospectively reviewed. SPSS 16.0 for Windows software package was used for statistical analysis.
The overall survival rates of 1-, 3-, 5-year were 96.8%, 86.7% and 79.3%, respectively. The survival rates of 1-, 3-, 5-year were 98.1%, 90.0% and 85.4% in patients who underwent complete tumor resection. But the survival rates of 1-, 3-, 5-year were 38.1%, 0 and 0 in patients with incomplete tumor resection. The differences were statistically significant (P<0.05). Gender, preoperative metastasis, tumor size,pathology type,karyokinesis, recurrence and metastasis were associated with survival rates in patients with complete tumor resection by univariate analysis. However, only tumor size, karyokinesis, recurrence and metastasis were associated with survival rates by Cox regression multivariable analysis(P<0.05).
Surgery remains the main treatment for gastric GIST. Local complete resection is the principal treatment.
Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery 06/2010; 13(6):417-20.
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Qiang Zhou,
Rui-Qing Peng, Xiao-Jun Wu,
Qing Xia,
Jing-Hui Hou,
Ya Ding,
Qi-Ming Zhou,
Xing Zhang,
Zhi-Zhong Pang,
De-Sen Wan,
Yi-Xin Zeng,
Xiao-Shi Zhang
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ABSTRACT: Although an abundance of evidence has indicated that tumor-associated macrophages (TAMs) are associated with a favorable prognosis in patients with colon cancer, it is still unknown how TAMs exert a protective effect. This study examined whether TAMs are involved in hepatic metastasis of colon cancer.
One hundred and sixty cases of pathologically-confirmed specimens were obtained from colon carcinoma patients with TNM stage IIIB and IV between January 1997 and July 2004 at the Cancer Center of Sun Yat-Sen University. The density of macrophages in the invasive front (CD68TFHotspot) was scored with an immunohistochemical assay. The relationship between the CD68TFHotspot and the clinicopathologic parameters, the potential of hepatic metastasis, and the 5-year survival rate were analyzed.
TAMs were associated with the incidence of hepatic metastasis and the 5-year survival rate in patients with colon cancers. Both univariate and multivariate analyses revealed that the CD68TFHotspot was independently prognostic of survival. A higher 5-year survival rate among patients with stage IIIB after radical resection occurred in patients with a higher macrophage infiltration in the invasive front (81.0%) than in those with a lower macrophage infiltration (48.6%). Most importantly, the CD68TFHotspot was associated with both the potential of hepatic metastasis and the interval between colon resection and the occurrence of hepatic metastasis.
This study showed evidence that TAMs infiltrated in the invasive front are associated with improvement in both hepatic metastasis and overall survival in colon cancer, implying that TAMs have protective potential in colon cancers and might serve as a novel therapeutic target.
Journal of Translational Medicine 02/2010; 8:13. · 3.41 Impact Factor
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Rui-Qing Peng, Xiao-Jun Wu,
Ya Ding,
Chun-Yan Li,
Xing-Juan Yu,
Xing Zhang,
Zhi-Zhong Pan,
De-Sen Wan,
Li-Ming Zheng,
Yi-Xin Zeng,
Xiao-Shi Zhang
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ABSTRACT: The intratumoral infiltration of T cells, especially memory T cells, is associated with a favorable prognosis in early colorectal cancers. However, the mechanism underlying this process remains elusive. This study examined whether high-mobility group box 1 (HMGB1), a damage-associated molecular pattern (DAMP) molecule, is involved in the infiltration of T cells and disease progression in locally advanced colon cancer.
Seventy-two cases of pathologically-confirmed specimens were obtained from patients with stage IIIB (T3N1M0) colon cancer who underwent radical resection between January 1999 and May 2002 at the Cancer Center of Sun Yat-Sen University. The density of tumor-infiltrating lymphocytes (TILs) within the tumor tissue and the expression of HMGB1 in the cancer cells were examined via immunohistochemical analysis. The phenotype of CD45RO+ cells was confirmed using a flow cytometric assay. The association between HMGB1 expression, the density of TILs, and the 5-year survival rate were analyzed.
The density of CD45RO+ T cells within the tumor was independently prognostic, although a higher density of CD3+ T cells was also associated with a favorable prognosis. More importantly, the expression of HMGB1 was observed in both the nucleus and the cytoplasm (co-expression pattern) in a subset of colon cancer tissues, whereas nuclear-only expression of HMGB1 (nuclear expression pattern) existed in most of the cancer tissues and normal mucosa. The co-expression pattern of HMGB1 in colon cancer cells was inversely associated with the infiltration of both CD3+ and CD45RO+ T cells and 5-year survival rates.
This study revealed that the co-expression of HMGB1 is inversely associated with the infiltration of CD45RO+ T cells and prognosis in patients with stage IIIB colon cancer, indicating that the distribution patterns of HMGB1 might contribute to the progression of colon cancer via modulation of the local immune response.
BMC Cancer 01/2010; 10:496. · 3.01 Impact Factor
