Objective To evaluate the diagnostic accuracy of the aberrant methylation of genes in stool for colorectal tumor. Methods Databases including The Cochrane Library, PubMed, EMbase, CBM, Web of Science, CNKI and WanFang Data were searched to collect the diagnostic trials on the aberrant methylation of genes in stool for colorectal tumor published from January 1990 to February 2012. QUADAS items were used to evaluate the quality of the included studies, and the meta-analysis was conducted using Meta-Disc 1.4 software. Results A total of 32 studies involving 3 951 patients were included. The results of meta-analysis showed that, for detecting the colorectal tumor, the weighted sensitivity, specificity, diagnostic odds ratio (DOR), area under the summary receiver operating characteristic (SROC) curve and Q were 92% (95%CI 91% to 93%), 63% (95%CI 61% to 65%), 20.79 (95%CI 15.13 to 28.57), 0.861 9 (SE=0.020 4), and 0.792 6 (SE=0.019 8), respectively. For detecting the colorectal cancer, the weighted sensitivity, specificity and area under the curve (AUC) were 91% (95%CI 89% to 92%), 75% (95%CI 73% to 77%), and 0.900 7, respectively. For detecting the colorectal adenoma, the weighted sensitivity, specificity and AUC were 79% (95%CI 76% to 83%), 75% (95%CI 73% to 77%), and 0.845 7, respectively. Conclusion With high sensitivity (92%) and moderate specificity (63%), aberrant methylation of genes in stool can be used as an optional noninvasive method for the diagnosis of colorectal tumor.
Objective To explore the expressions of Galectin-3, Fascin-1, and β-catenin protein in colorectal adenocarcinoma and the relations to clinicopathologic characteristics. Methods The expressions of Galectin-3, Fascin-1, and β-catenin protein were detected in 60 cases of colorectal adenocarcinoma, 30 cases of adenoma, and 30 cases of normal mucosa by microwave-EliVisionTM immunohistochemistry method, and analyzed the expressions of them and the relations to clinicopathologic characteristics. Results The expression rate of Galectin-3, Fascin-1, and β-catenin protein in CRC was 68.3% （41/60）, 53.3% （32/60）, and 81.7% （49/60） respectively, which was 46.7% （14/30）, 30.0% （9/30）, and 43.3% （13/30） respectively in adenoma, and 20.0% （6/30）, 3.3% （1/30）, and 13.3% （4/30） respectively in normal mucosa, the differences had statistical significance （P＜0.05）. The expressions of Galectin-3, Fascin-1, and β-catenin protein had statistically significant correlation with the TNM stage, invasive degree, and lymph node metastasis of colorectal adenocarcinoma （P＜0.05, P＜0.01）. The expressions of Galectin-3 and β-catenin protein had statistically significant correlation with the different differentiation degree of colorectal adenocarcinoma （P＜0.05）, but the expression of Fascin-1 protein was not related to differentiation degree of colorectal adenocarcinoma （P＞0.05）.The expressions of Galectin-3, Fascin-1, and β-catenin protein had not statistically significant correlation with the patient’s age and gender, and tumour size （P＞0.05）.There were positive correlations between the Galectin-3 and Fascin-1 or β-catenin （r=0.728，P＜0.01；r=0.696，P＜0.01）, and there was positive correlation between β-catenin and Fascin-1 （r=0.507，P＜0.01）. Conclusions The high expressions of Galectin-3, Fascin-1, and β-catenin protein in colorectal adenocarcinoma tissues are some extent correlated to the high invasive ability and lymph node metastasis, which could be used for the indexes to predict the invasion and metastasis in colorectal carcinoma potentially.
Objective To explore feasibility and efficacy of laparoscopic microsurgery by transanal glove port for excision of rectal tumor. Methods Seventeen patients with rectal tumor underwent laparoscopic microsurgery by transanal glove port for local excision of rectal tumor were chosen from March 2015 to March 2016. This device was constructed by using a incision protective sleeve and standard surgical glove. The laparoscopy was used as lighting equipment. The ultrasonic scalpel, operation forceps and lens were separately inserted into the fixed sheath card from the 3 finger gloves. Results The operations of 17 cases were completed successfully. The operative time was 35–90 min with an average 54 min. The closed glove access time was 11 to 26 min with an average 18 min. The diameter of tumor was 1.4–3.5 cm with an average 2.4 cm. The results of postoperative pathology included 8 cases of villos adenemas, 3 cases of high-grade intraepithelial neoplasia, 1 case of low-grade intraepithelial neoplasia, 3 cases of carcinoid , and 2 cases of adenocarcinoma. All resection margins were negative. No infection, intestinal fistula, bleeding, and other complications were found. The hospital stay was 4–9 d with an average of 5 d. No recurrence was found during a follow-up of 1–6 months. Conclusions The preliminary results of limited cases in this study show that laparoscopic microsurgery by transanal glove port for excision of rectal tumor is easy, safe, and effective. It also provides a new choice for individualized comprhensive treatment of rectal tumor.
Transrectal contrast-enhanced ultrasound (CEUS) is an important examination for rectal tumors. The inhomogeneity of the CEUS images has important clinical significance. However, there is no objective method to evaluate this index. In this study, a method based on gray-level co-occurrence matrix (GLCM) is proposed to extract texture features of images and grade these images according the inhomogeneity. Specific processes include compressing the gray level of the image, calculating the texture statistics of gray level co-occurrence matrix, combining feature selection and principal component analysis (PCA) for dimensionality reduction, and training and validating quadratic discriminant analysis (QDA). After ten cross-validation, the overall accuracy rate of machine classification was 87.01%, and the accuracy of each level was as follows: Grade Ⅰ 52.94%, Grade Ⅱ 96.48% and Grade Ⅲ 92.35% respectively. The proposed method has high accuracy in judging grade Ⅱ and Ⅲ images, which can help to identify the grade of inhomogeneity of contrast-enhanced ultrasound images of rectal tumors, and may be used to assist clinical doctors in judging the grade of inhomogeneity of contrast-enhanced ultrasound of rectal tumors.
Objective To summarize the research progress of transanal endoscopic microsurgery in the treatment of rectal tumors. Method The literatures on transanal endoscopic treatment of rectal tumors was collected and reviewed. ResultsTransanal endoscopic microsurgery was one of the local resection methods. It was a minimally invasive surgery combining laparoscopy and endoscopy. Transanal endoscopic microsurgery equipment was mainly composed of special rectal mirror lens and high-pressure pneumoperitoneum machine. After full-thickness resection of the lesion, the defect was sutured under endoscopy, so as to avoid serious postoperative complications caused by radical surgery. Transanal endoscopic microsurgery was suitable for T1 stage rectal cancer with benign lesions such as rectal adenoma and rectal polyps and no lymph node metastasis. There was still some controversy about the treatment of higher-grade rectal cancer. Neoadjuvant radiotherapy and chemotherapy combined with transanal endoscopic microsurgery is being actively carried out in the treatment of rectal cancer. Conclusions Transanal endoscopic microsurgery is a safe and effective method for some rectal tumors. It has the characteristics of low perioperative complication rate, fast postoperative recovery and low recurrence rate.