ObjectiveTo evaluate safety and effectiveness of stent placement and emergency surgery in treatment of proximal colon cancer obstruction.MethodsThe PubMed, Embase, Cochrane Library, ClinicalTrials, CNKI, CBM, Wanfang Data, etc. were searched comprehensively. The literatures of Chinese and English randomized controlled trial and retrospective comparative study of stent placement and emergency surgery for the proximal colon cancer obstruction were retrieved. The RevMan 5.3 and Stata 12.0 softwares were used. The meta-analysis was made on the safety and effectiveness of these two treatments.ResultsA total of 9 literatures involving 636 patients were included, all of them were the retrospective studies, 4 of them only reported the clinical success rate and technical success rate. The technical success rate of stent placement was 0.94 [95% CI (0.91, 0.96)]. The clinical success rate was 0.90 [95% CI (0.87, 0.93)]. Compared with the emergency surgery group, the total complication rate and the temporary stoma rate were lower [OR=0.32, 95% CI (0.11, 0.94), P=0.04; OR=0.18, 95% CI (0.05, 0.65), P=0.009] and the hospital stay was shorter [MD=–2.97, 95% CI (–4.52, –1.41), P=0.000 2] in the stent placement group. The perioperative mortality rate, laparoscopic surgery rate, 5-year disease-free survival rate, and 5-year overall survival rate had no significant differences between these two groups (P>0.05).ConclusionCompared with emergency surgery, endoscopic stent placement for treatment of proximal colon cancer obstruction has a lower incidence of complications, temporary colostomy rate, shorter hospital stay, and it has no significant differences in mortality, laparoscopic surgery rate, and survival rate.
ObjectiveTo summarize value of preoperative inflammatory markers in diagnosis and prognosis of colorectal cancer.MethodThe literatures on the preoperative inflammatory markers in the diagnosis and prognosis prediction of colorectal cancer at home and abroad were searched and reviewed.ResultsThe chronic inflammation might promote the occurrence and development of tumor, the tumor related inflammatory markers could be used for the auxiliary diagnosis and assessment of prognosis, such as the neutrophil to lymphocyte ratio, tumor-associated neutrophils, platelet to lymphocyte ratio, Glasgow prognostic score, and C-reactive protein/albumin ratio were obviously correlated with the prognosis of patients with colorectal cancer. What’s more, the D-dimer and fibrinogen to albumin or prealbumin ratio were valuable in the diagnosis and prognosis of colorectal cancer.ConclusionsMore and more inflammatory factors are applied in diagnosis and prognosis prediction of tumors. However, in general, specificity and sensitivity of a single indicator for tumor diagnosis are poor. In future, while studying new inflammatory indicators, diagnosis can be conducted in combination with various indicators, which is expected to improve specificity and sensitivity. Similarly, prognostic efficacy of a single indicator is low, so it can be combined with various indicators to improve prognostic efficacy of patients with colorectal cancer, and Nomogram model can be established to achieve individualized prediction and guide clinical work.