【Abstract】ObjectiveTo study the current research status of minichromosome maintenance protein 2 (MCM2), the cell cycle proliferation marker, in the diagnosis of colorectal carcinoma. MethodsLiteratures about the application of MCM2 in the study of colorectal carcinoma were collected and reviewed.ResultsMCM2, as a marker of cell dysplasia and malignancy, was usually used in the study of carcinoma. The study on expression of MCM2 in the cell of colorectum in different proliferational stage might help to screen colorectal carcinoma as early as possible. ConclusionAs a relatively specific and sensitive marker of cell proliferation, MCM2 might become a promising mark for diagnosing colorectal carcinoma in the early stage.
Objective To detect expression of CK20 mRNA in peripheral blood of patients with colorectal carcinoma and its clinical significance. Methods Using the reverse transcriptase-polymerase chain reaction (RT-PCR),CK20 mRNA expression was examined in peripheral blood from 42 patients with colorectal carcinoma before and after operation, 20 healthy volunteers, 20 fresh colorectal carcinoma samples. Results The positive expression rates of CK20 mRNA were 45.24%(19/42) and 33.33%(14/42) before and after operation in 42 colorectal carcinoma patients respectively. All 20 fresh colorectal carcinoma samples revealed expression of CK20 mRNA, but the 20 normal blood samples did not. Conclusion The detection of CK20 mRNA in peripheral blood is helpful to early diagnose, assess the prognosis and make a correct treatment of colorectal carcinoma.
ObjectiveTo study the expression and significance of proliferating cell nuclear antigen (PCNA) and argyrophilia nucleolar organizer regions (AgNORs) in colorectal carcinoma (CRC) and carcinoma adjacent mucosa (CAM).MethodsThe expression of PCNA in 48 cases of colorectal carcinoma tissue, CAM and 10 cases of normal mucosa was detected by immunohistochemistry techniques. AgNORs was determined with argyrophilia stain. ResultsThe PCNAlabeling index (PCNALI) and AgNORs count in CRC were higher than that in CAM and normal mucosa(P＜0.01).The PCNALI in Dukes C and D stage was higher than that in Dukes A(P＜0.05). The AgNORs count in 3 cmCAM was higher than 6 cmCAM (P＜0.01) and normal mucosa(P＜0.05). ConclusionSome cells proliferative activity were abnormal in CAM. It indicates that CAM is in an unstable premalignant state, which might have some correlation with the relapse of colorectal carcinoma.
ObjectiveTo evaluate the significance and effect for surgery of Dukes D stage colorectal carcinoma. MethodsEightytwo cases of Dukes D stage colorectal carcinoma who underwent surgery from 1991 to 1998 were analyzed retrospectively. ResultsTwentyone patients experienced extended resections,29 patients palliative resection, 19 patients sideside anastomosis and 13 patients laparotomy and biopsy of the tumor. Patients with extended resections had significantly long survival time, quality of life in these patients were excellent in 71.4%, good in 23.8%, and fair in 4.8%; whereas quality of life in the group with palliative resections were excellent in 62.1%, good in 17.2%, fair in 13.8%, and poor in 6.9%. The other two groups had a bad postoperative effect, short survival time and poor quality of life. ConclusionIf the patients with Dukes D stage colorectal carcinoma have operative indications,surgical therapy should be actively performed and the postoperative survival rate and quality of life can be improved.
ObjectiveTo evaluate the effect of neoadjuvant chemotherapy and find the mechanism of multidrug resistance. MethodsTwenty patients with gastric cancer and 31 patients with colorectal cancer underwent neoadjuvant chemotherapy and then operations. The preoperative specimens were stained by immunohistochemical techniques for testing p53,multidrug resistanceassociated protein (MRP), glutathione S transferase（GST）, telomerase. Resection specimens were evaluated for chemotherapy effect by routine histology; at the same time, the postoperative morbidity and mortality were observed. ResultsIn 51 patients, the response rate of neoadjuvant chemotherapy was 27.45%(14/51),so multidrug resistance was a kind of common phenomena in gastrointestinal carcinomas. The postoperative morbidity was 15.69%(8/15), the main operation complication was infection,the mortality was 1.96%(1/51),only one person died from severe infection.The expression rate of p53, MRP, GST, telomerase was 58.0%,51.0%,66.7%,74.0%respectively, the location of p53 was at cell nucleus,location of MRP,GST was at cell memberane and cytoplasm,location of telomerase was at cytoplasm.The response rate had nothing to do with age, sex and metastasis. But it was related with p53 and telomerase expression. ConclusionNeoadjuvant chemotherapy is an effective, safe therapy. But the rate of drug resistance is high in gastrointestinal carcinomas, and the response rate is related to p53, telomerase expression.
Objective To study the relationship between gastrin and c-myc, c-fos expression in colorectal cancerous tissue and the mechanism of gastrin effect on colorectal cancer.Methods The gastrin and c-myc, c-fos expression in 48 cases of colorectal cancerous tissue and canceradjacent mucosa were detected with immunohistochemistry techniques.Results The positive rate of gastrin in colorectal cancerous tissue was 39.58%. The rate of the well differentiated adenocarcinoma was higher than that of the poorly differentiated and mucinous adenocarcinoma(P＜0.05). The positive rates of c-myc and c-fos in colorectal cancerous tissue were higher than those in canceradjacent and normal mucosa. The positive rate of c-myc and c-fos in the group with gastrin positive expression were 78.94% and 73.68%, higher than those in the group with negative gastrin expression(37.93% and 31.04%). Conclusion Some of colorectal cancer cells formed and secreted gastrin through autocrine. The increase of cmyc, c-fos etc oncogene expression probably stimulate the cancer cells proliferation.
Objective To investigate the level of cell adhesion molecule sialyl-LeX expression in colorectal carcinoma and its relation with carcinogenesis, differentiation, metastasis and prognosis. Methods Sialyl -LeX expression and its optical density in colorectal carcinoma (n=90) and remote normal mucosa (n=30) were quantitatively studied with microwave-LSAB immunohistochemical method combined with image analysis technique. Fifty-three patients were followed up. Results The weaker staining in remote normal colorectal mucosa was observed in very limited parts of some deep crypts. Positive rate of sialyl-LeX expression was only 16.7%(5/30). The positive expression of sialyl-LeX was observed in 83 of 90 patients with colorectal carcinoma(92.2%). The apical cytoplasma of cancer tubules, the luminal contents, and the cytoplasma of the cancer cells were bly stained. The mean integral optical density of sialyl-LeX positive cell in poorly differentiated adenocarcinoma was significantly higher than that in highly differentiated and mucinous ones (Plt;0.01). It was markedly higher in patients with positive lymphatic nodes than that in negative ones (Plt;0.01). With followed-up for longer than 5 years, it was much lower in the alive cases than that in the dead (Plt;0.01). Conclusion These findings indicate that changes of sialyl-LeX expression and its optical density is related to carcinogenesis, differentiation, invasion and metastasis of colorectal carcinoma. It may be a good predicter for the prognosis of patients with colorectal carcinoma.
【Abstract】Objective To analyze the clinical features of multiple primary colorectal carcinoma(MPCC). Methods Data in 21 patients with MPCC during the past 10 years in our hospital were analyzed retrospectively. Results The incidence of synchronous and metachronous carcinoma was 1.1% and 1.2% respectively. The sites and pathologic stages of tumors showed no significant difference compared with single colorectal carcinoma. 47.6% of the cases accompanied with colorectal adenoma. 77.8% of the MPCC could be found during operation. Patients with carcinoma involved rectum had relatively poor survival. Conclusion The full-course colonoscopy, careful intraoperative exploration and regular postoperative colonoscopic follow-up are essential in improving the diagnosis and prognosis of patients with MPCC.
In order to investigate the possible involvement of the antigen CA50 in patients with colorectal carcinoma， the carbohydrated antigen CA50 in serum was examined in 30 normal individual， 27 patients with benign colorectal diseases and 66 patients with colorectal carcinoma by immunoradiometric assay (IRMA). The results showed that the serum CA50 in patients with colorectal carcinoma was significantly higher than that in patients with benign colorectal diseases and normal individual (Ｐ＜0.01). It was significantly declined after radical operation (Ｐ＜0.01). However， no significant change was noted after palliative operation (Ｐ＞0.05) and elevation was noted in patients with tumor recurrence. The results suggest that the measurement of serum CA50 may be an useful marker for diagnosis and prognostic evaluation in patients with colorectal carcinoma.
We evaluated the surgical results in 32 patients with liver metastasis from colorectal carcinoma. Twenty four patients had 1-3 metastatic hepatic nodules and 20 patients had synchronous hepatic metastasis. Liver resection was carried out simultaneously with radical resection of the primary tumour in 15 patients, 5 patients experienced resection 2 to 4 weeks later. Liver and primary tumour were resected as a whole in 5 patients with infiltrating metastasis from colonic carcinoma.Other operative types included atypical resections, left lateral lobectom and right posterior lobectomy, and right hemihepatactomy, right trilobectomy.Hepatic metastasis were all documented by pathology. The 3year and 5year survival rate were 37.5% and 25.0%, with no operative death. The authors believed that the number of metastasis is the most important factor influencing the surgical result, and liver resection is an effective form of treatment for patients with resectable liver metastasis from colorectal carcinoma, but the type of surgery shall be choosed reasonably.