【Abstract】Objective To investigate the effects of selective cyclooxygenase-2 (COX-2) inhibitor nimesulide on the proliferation of colon adenocarcinoma cells in vitro and the expression of matrix metalloproteinase-2 (MMP-2). Methods The human colon cancer cell lines HT-29 and HCT-116 were employed in the study, grouped as nimesulide group, DMSO control group and blank control group. After treatment with nimesulide, the inhibitory effect of nimesulide on the proliferation of cancer cells was quantified by MTT assay, and the expression of MMP-2 in the cells was detected by quantitative zymography. Results Nimesulide inhibited the proliferation of HT-29 and HCT-116 cells in time and dosedependent manners. The inhibitory effect on HT-29 cells was ber than that on HCT-116 cells. Nimesulide downregulated the MMP-2 expression in HT-29 cells, whereas the expression in HCT-116 cells remained unchanged. Conclusion Nimesulide can obviously inhibit the growth of colon cancer HT-29 cells with positive COX-2 protein, suggesting that nimesulide may downregulate the expression of MMP-2 by inhibiting the activity of COX-2.
Objective To study the expression of p53 and vascular endothelial growth factor (VEGF) and its correlation with hematogenous metastasis in colorectal cancer. MethodsAvidinbiotin complex method was used to study the expression of p53 and VEGF in 79 cases of colorectal cancer.ResultsThe positive rates of p53 and VEGF were 48.1% and 58.2% respectively in 79 cases of colorectal cancer. p53 and VEGF expression were identical in 49 (62.0%) cases. There was significant association between p53 or VEGF expression and venous invasion or hematogenous metastasis (P＜0.05). The incidence of hematogenous metastasis in the p53（＋）/VEGF（＋） subgroup was 66.7% and was significantly higher than that in the p53（－）/VEGF（－） or p53（＋）/VEGF（－） subgroup （P＜0.01）. Neither synchronous nor metachronous hematogenous metastasis were found in the p53（－）/VEGF（－） subgroup.Conclusion The combination of p53 and VEGF expression is an important predictor for hematogenous metastasis in patients with colorectal cancer.
摘要:目的:探讨左半结肠癌合并肠梗阻Ⅰ期手术切除肠吻合的方法和注意事项。〖HTH〗方法:〖HTSS〗分析36例左半结肠癌合并肠梗阻患者Ⅰ期行手术切除肠吻合手术及术后恢复情况。结果:36例左半结肠癌并肠梗阻患者,Ⅰ期手术切除、肠吻合无一例吻合口瘘,术后恢复良好。〖HTH〗结论:〖HTSS〗只要围手术期、术中处理得当,左半结肠癌合并肠梗阻患者选择Ⅰ期手术切除肠吻合,可以减少患者痛苦、节约医疗费用,同时也是安全的。
ObjectiveTo investigate the clinicopathological characteristics and prognosis of elderly patients with colon cancer. MethodsThe clinicopathological and followup data of patients with colon cancer were compared retrospectively between those older than 60 years (405 patients) and those younger than 40 years (146 patients). ResultsFamily history, comorbidities, preoperative intestinal obstruction, and differentiation grade were significantly different between two groups (P＜0.05). The 5-year survival rate of patients in elder group and younger group was 64.9% and 56.8% respectively, and there was significant difference （P＜0.05）. The multivariate analysis indicated that the independent predictors of survival were comorbidities, perioperative CEA level, preoperative intestinal obstruction, tumor gross type, lymph node metastasis, hepatic metastasis, and TNM stage. ConclusionPatients older than 60 years with colon cancer have unique clinicopathological characteristics and better prognosis. The independent predictors of survival are comorbidities, perioperative CEA level, preoperative intestinal obstruction, tumor gross type, lymph node metastasis, hepatic metastasis, and TNM stage.
目的 探讨腹腔镜全结肠切除术在家族性腺瘤性息肉病（FAP）中的应用价值。方法 回顾性分析我院2008年1月至2009年10月期间收治的行腹腔镜全结肠切除术的4例FAP患者的临床资料，对手术安全性和术后恢复情况进行分析。结果 4例患者均顺利行腹腔镜全结肠切除术，无中转开腹，无手术并发症及死亡。腹部切口长6.0 cm，手术时间300～380 min（平均330 min），术中出血量90～250 ml（平均160 ml）。术后2～3 d肛门开始排气，术后住院时间7～11 d（平均9 d）出院。出院后大便稀薄，8～12次/d，给予易蒙停治疗后缓解。随访2～22个月（平均14个月），无近期并发症发生。结论 腹腔镜全结肠切除术治疗FAP安全、有效，近期效果良好。
目的 探讨结肠癌和直肠癌并发肠穿孔的外科诊治方法。方法 分析13例结直肠癌并发肠穿孔患者的临床资料。结果 13例患者中4例行肿瘤所在肠段一期切除吻合术； 4例行一期病灶切除吻合术，近端肠段行外置双管造瘘术； 2例切除肿瘤所在肠段，近端行端式结肠造瘘术，远端行封闭（Hartmann）术； 3例行单纯肠造瘘术。术后并发症发生率为46.15%（6/13），手术死亡率为15.38%（2/13）。结论 重视对结直肠癌并发肠穿孔的认识及选择合适的手术方式是减少并发症、提高疗效的重要措施。
Objective To discuss the influence of combination of 64 multi-slice spiral computer tomography (MSCT) and serum amyloid A protein (SAA) for preoperative assessment on colon cancer surgery strategy. Methods Ｔhe examination data of 110 patients diagnosed definitely as colon cancer in the West China Hospital of Sichuan University from Nov. 2007 to Nov. 2008 were studied prospectively, and randomly assigned into the MSCT+SAA group and MSCT group, respectively. Both MSCT and SAA combinative assessment were made for preoperative evaluation in MSCT+SAA group, while only MSCT was made preoperatively in MSCT group. Furthermore, the preoperative staging and prediction of operative procedures were compared with postoperative pathologic staging and practical of operative procedures, respectively. Results According to the inclusion criteria, 99 colon cancer patients were actually included into MSCT+SAA group (n=49) and MSCT group (n=50). The baseline characteristics of two groups were statistically identical. For MSCT+SAA group, The accuracies of preoperative staging T, N, M and TNM were 81.6%, 79.6%, 100% and 77.6%, respectively. For MSCT group, the corresponding rates were 82.0%, 60.0%, 98.0% and 62.0%, respectively. The difference of accuracies on staging N between two groups was observed statistically (χ2=4.498, P=0.034). There was also a statistically significant difference of the accuracy of prediction of operative procedures in MSCT+SAA group and MSCT group (95.9% vs. 82.0%, χ2=4.854, P=0.028). The preoperative staging N (P=0.008), M (P=0.010), TNM (P=0.009) and level of SAA (P=0.004) were related to the selection of operative procedures when analyzed the relationship between the operative procedures and multiple clinicopathologic factors in colon cancer. Conclusion The strategy of the combinative assessment of MSCT and SAA could advance the accuracy of preoperative staging, thus serve surgeon the more accurate prediction to surgery strategy in colon cancer.
【摘要】 目的 总结右半结肠癌根治切除术中寻找解剖平面的体会。方法 回顾性分析沧州市中心医院2002 年1 月至2006 年3 月期间36 例进展期右半结肠癌根治术的结果。结果 全部病例术中无一例副损伤。术后病理共检出淋巴结310 枚,平均8. 6 枚/ 例。围手术期无死亡病例。局部复发1 例且伴肝内转移及门静脉癌栓,肝转移3 例。随访过程中死亡3 例。结论 从易显露的固定解剖结构入手,采取上、下结合,寻找右Toldt 筋膜与肾前筋膜之间的解剖间隙平面简单、易行,极少发生副损伤。