2014| December | Volume 10 | Issue 8
Updates in colorectal cancer stem cell research
Chun-Jie Li, Xueqian Zhang, Guan-Wei Fan
December 2014, 10(8):233-239
Colorectal cancer (CRC) is one of the world most common malignant tumors, also is the main disease, which cause tumor-associated death. Surgery and chemotherapy are the most used treatment of CRC. Recent research reported that, cancer stem cells (CSCs) are considered as the origin of tumor genesis, development, metastasis and recurrence in theory. At present, it has been proved that, CSCs existed in many tumors including CRC. In this review, we summary the identification of CSCs according to the cell surface markers, and the development of drugs that target colorectal cancer stem cells.
Recent advances of histone modification in gastric cancer
Wen-Yan Yang, Jing-Liang Gu, Tian-Min Zhen
Epigenetics play important roles during development progress of tumor. The histone modifications are the most important constituted field. Recently, accumulating research focused on exploring the roles of those modifications in regulating tumorigenesis. Moreover, the dysregulation of histone modifications is supposed to have vital clinical significance. Numerous histone modifications have the potential to be prognostic biomarkers, monitoring response of therapy, early diagnostic markers. Herein, we review the recent advances of histone modifications involving development of gastric cancer.
The diagnostic value of serum carcino-embryonic antigen, alpha fetoprotein and carbohydrate antigen 19-9 for colorectal cancer
Yan-Rong Wang, Jian-Xia Yan, Li-Na Wang
Objective: The aim of this study is to investigate whether or not serum carcino-embryonic antigen (CEA), alpha fetoprotein (AFP) and carbohydrate antigen 19-9 (CA19-9) can be used as potential biomarkers for colorectal cancer (CRC) diagnosis. Materials and Methods: Forty-six patients with pathology or cytology confirmed CRC and 36 cases with non-malignant colorectal disease (NMCD) were included in this retrospective study. The serum level of CEA, AFP and CA19-9 were arrayed and recorded for the two groups. The diagnosis sensitivity, specificity and area under the receiver-operating characteristic (ROC) curve for serum CEA, AFP and CA19-9 were calculated by the STATA-10.0 software. Results: We found that serum CEA, AFP and CA19-9 level in CRC patients were significantly higher than in NMCDs cases (all P < 0.05). The diagnosis sensitivity of CRC for CEA, AFP and CA19-9 were 80.43%, 73.91% and 69.57%; the diagnosis specificity of CRC for CEA, AFP and CA19-9 were 75.00%, 69.44% and 61.11%. The areas under the ROC curves for CEA, AFP and CA19-9, were 0.88, 0.78 and 0.77 respectively. Conclusion: These findings suggest that serum CEA, AFP and CA19-9 may be a useful biomarker for diagnosis of colorectal carcinoma against NMCD.
High levels of D-dimer correlated with disease status and poor prognosis of inoperable metastatic colorectal cancer patients treated with bevacizumab
Liming Zhu, Bixia Liu, Yazhen Zhao, Luying Liu, Chen Yang, Yunshan Yang, Haijun Zhong
Purpose: To assess the levels of D-dimer baseline levels in inoperable metastatic colorectal cancer (mCRC) patients treated with bevacizumab and its relationship with prognosis. Materials and Methods: From June 1, 2011 to December 31, 2013, a total of 121 patients with mCRC received beacizumab combined with chemotherapy and 74 of them were included in the present study. A nonparametric statistical test was performed to analyze the relationship between plasma D-dimer levels and clinical pathological factors. The Cox proportional model was used to analyze the effects of D-dimer on progression-free survival (PFS) time and overall survival (OS). Results: Of the 74 cases, 40 were men and 34 women (aged 31-74 years), with a median age of 55.5 years. The median of PFS and OS were 6.3 and 17.8 months respectively. High levels of baseline plasma D-dimer were correlated with high scoring of Eastern Cooperative Oncology Group-Performance Status (P = 0.001), IV phase of disease at the first visit (P = 0.001), unremoval primary focal (P = 0.006), the number of metastatic organs ≥ 2 (P = 0.034), abdominal cavity effusion (P = 0.004) and no history of adjuvant chemotherapy (P = 0.003). It was found by single factor analysis that plasma baseline D-dimer levels ≥ 1.9 μg/mL were closely related with a short PFS (hazard ratio [HR] 2.14, 95% confidence interval [CI] 1.04-4.40, P = 0.038) and OS (HR 5.22, 95% CI 2.05-13.28, P = 0.001). After adjustment for other factors, plasma baseline D-dimer levels ≥ 1.9 μg/mL were still closely correlated with a short OS (HR 3.52, 95% CI 1.28-9.67, P = 0.015). Conclusion: High levels of plasma baseline D-dimer correlated with high tumor load, advanced disease status and poor prognosis of inoperable mCRC patients treated with bevacizumab. However, clinical research on a much larger cohort of patients will be required to verify these findings.
Neuroimaging and clinical characteristics of brain metastases from esophageal carcinoma in Chinese patients
Wei Feng, Peng Zhang, Xiao Zheng, Guoping Shan, Ming Chen, Weimin Mao
Objective: The objective was to describe the magnetic resonance imaging (MRI) and clinical characteristics of brain metastases from esophageal carcinoma diagnosed in patients from the Zhejiang Province of China, in order to provide a useful reference for the future diagnosis and treatment of similar patients. Materials and Methods: Medical data were obtained for 31 patients who received treatment for brain metastases from esophageal carcinoma at the Zhejiang Provincial Cancer Hospital between January 1998 and July 2013. For this retrospective analysis, the primary tumors were pathologically confirmed. In addition, 6 cases had both pathologic records of brain metastasis events and complete MRI records available. Survival follow-up data were also obtained. Results: Thirty-one patients (30 males, 1 female) with a total of 62 tumors were diagnosed with squamous cell carcinoma (n = 26), adenocarcinoma (n = 3), and small cell carcinoma (n = 2). While most patients complained of movement disturbance (51.6%) and headaches (32.3%), MRI characterized tumors with cystic elements (80.6%), tumors with thin cyst walls and enhancement (59.7%), and tumors with a peripheral edema zone <2 cm in diameter (59.7%). Moreover, a major radiological indicator for prognosis was a shift of midline. Conclusion: Most of the patients with brain metastases from esophageal carcinoma were male. Furthermore, many of the T1-weighted MRI images detected thin wall, enhanced single or multiple cystic lesions with an edema zone <2 cm in diameter. These imaging characteristics may represent this type of brain metastasis.
Submucosal tunneling endoscopic resection for the treatment of rectal submucosal tumors originating from the muscular propria layer
Jian-Wei Hu, Chen Zhang, Tao Chen, Ping-Hong Zhou, Yun-Shi Zhong, Yi-Qun Zhang, Wei-Feng Chen, Quan-Lin Li, Li-Qing Yao, Mei-Dong Xu
Objective: The objective was to evaluate the clinical value of submucosal tunneling endoscopic resection (STER) for the treatment of submucosal tumors (SMTs) originating from the muscular propria (MP) in the rectum. Patients and Methods: The clinicopathological data of 12 cases with rectal SMTs originating from the MP layer performed STER in our center from January 2012 to June 2014 were analyzed retrospectively. Results: Three males and nine females (M/F, 1/3) were studied in this series. The median age of the patients was 53.5 (range, 41-84) years. The tumors located 5-10 cm from the anal verge. En bloc STER was performed successfully in all of the 12 cases. The median size of resected specimens was 1.4 cm (range 1.0-3.0 cm). The median procedure time was 49.5 min (range 40-70 min). Three patients developed low fever after the operation and were all recovered after receiving intravenous antibiotics. One of these three cases developed mucosa perforation, which was closed immediately with metal clips. One patient developed subcutaneous emphysema in one lower limb, which disappeared with conservative treatments 2 weeks after the STER procedure. The median hospital stays were 3.1 (range 2-8) days. Postoperative pathological outcomes revealed schwannoma in 3 cases, leiomyoma in 2 cases, stromal tumor in 5 cases, and proliferation of collagen fibers nodular degeneration in 2 cases. No lesion residual or recurrence was found during postoperative follow-up of 4-33 months. Conclusion: STER is a feasible, safe, and effective method for treating SMTs originating from the MP layer in the rectum.
Association between Helicobacter pylori infection and colorectal neoplasm risk: A meta-analysis Based on East Asian population
Yu Guo, Hai-Yan Li
Objective: The association between Helicobacter pylori (HP) infection and colorectal neoplasm risk was not clear. The aim of this study was to evaluate whether HP infection can increase the risk of developing colorectal neoplasm by meta-analysis. Materials and Methods: A detailed literature search was performed on Medline, PubMed, Web of Science, and China National Knowledge Infrastructure for related research publications written in English and/or Chinese. The relevant case-control or cohort studies reporting an association between HP infection and colorectal neoplasm risk were screened and included in this meta-analysis. The association between HP infection and colorectal neoplasm risk was expressed by odds ratio (OR) and its 95% confidence interval (CI). The heterogeneity among the included articles was assessed by I 2 test, and the pooled OR was calculated by fixed effect model in case of no significant heterogeneity otherwise random effect model was employed. All the statistical analyses were done by STATA-11.0 and MetaAnalyst Beta 3.13 software. Results: Finally, a total of 2081 colorectal neoplasm patients and 5598 healthy controls from nine eligible studies were included in this meta-analysis. The pooled OR for the association between HP infection and colorectal neoplasm risk was 0.18 with its 95% CI of 0.99-1.40, (P > 0.05). We further divided the colorectal neoplasm into the hyperplastic polyps, adenomas and colorectal cancer sub-groups according to colorectal neoplasm types. The pooled ORs and their 95% CIs were OR Hyperplastic_polyps = 0.72, 95% CI: 0.44-1.18, (P > 0.05), OR Adenomas = 1.83, 95% CI: 1.35-2.51, (P < 0.01), OR Colorectal_cancer = 1.08, 95% CI: 0.89-1.68 (P > 0.05). For different region sub-groups, the pooled ORs and 95% CIs were OR South_Korea = 1.18, 95% CI: 0.84-1.66, (P > 0.05), OR China = 0.78, 95% CI: 0.53-1.13, (P > 0.05), OR Taiwan = 1.06, 95% CI: 0.69-1.62, (P > 0.05), OR Japan = 1.33, 95% CI: 1.07-1.65, (P < 0.05) for South Korea, China main land, Taiwan and Japanese. Conclusion: In general, no statistical association between HP infection and colorectal neoplasm risk was found in this meta-analysis. But, HP infection may increase the risk of developing colorectal adenomas.
MicroRNA-146a rs2910164 G/C polymorphism and gastrointestinal cancer susceptibility: A meta-analysis based on East Asian population
Bei-Bei Chen, Xin-Guang Cao, Xiao-Bing Chen, Yi-Jie Ma, Wen-Ying Deng, Ning Li, Jin-Xi Huang, Su-Xia Luo, Er-Jiang Zhao
Objective: The relationship between microRNA (miR-146a) rs2910164G/C polymorphism and gastrointestinal cancer susceptibility is not consistent with each other of the published articles. The aim of this meta-analysis was to acquire a more precise effect of the association between the miR-146a rs2910164 G/C polymorphism and gastrointestinal cancer. Materials and Methods: Through searching of the MedLine, Embase, China National Knowledge Infrastructure, and Wanfang databases. Case-control or cohort studies about the relationship between miR-146a rs2910164 G/C polymorphism and gastrointestinal cancer susceptibility were screened and included in this meta-analysis. Quantitative data synthesis was conducted for the associations of miR-146a rs2910164 G/C polymorphism and gastrointestinal cancer risk by statistical software STATA-11.0. Results: Ten studies including 6473 gastrointestinal cancer patients and 7923 controls were identified and included in this meta-analysis. For recessive genetic model (CC vs. CG + GG), people with CG or GG is associated with the susceptibility of gastrointestinal cancer compared with genotype of CC (R = 0.73, 5% confidence interval [CI]: 0.55-0.97, [P = 0.03]); But for dominant model (CC + CG vs. GG) and homozygous model (CC vs. GG), no association of the miR-146a rs2910164G/C polymorphism and gastrointestinal cancer susceptibility were found (dominant: Odds ratio [OR] =0.94, 95% CI: 0.82-1.03, [P = 0.37]; homozygous: OR = 0.85, 95% CI: 0.71-1.03, [P = 0.10]). Sub-group analysis, for homozygous model, people with GG genotype had increased risk of developing colorectal cancer (OR = 0.77, 95% CI: 0.64-0.93, [P = 0.008]). Conclusion: No significant association between miR-146a rs2910164G/C polymorphism and gastrointestinal cancer susceptibility was found in this meta-analysis. But for homozygous model, people with GG genotype may have increased risk of developing colorectal cancer.
Clinical analysis of gastroenteropancreatic neuroendocrine tumor with liver metastasis, compared with primary hepatic neuroendocrine tumor
YH Shen, S Chen, WT Zhang, Y Ji, L Yu, HC Sun, SJ Qiu, N Ren, J Zhou
Objective: The objective was to study the clinicopathologic features, grading, treatment protocols, and prognostic of gastroenteropancreatic neuroendocrine tumor (NET) with liver metastasis and primary hepatic NET. Materials and Methods: The clinical data of 34 patients with hepatic NET were retrospectively reviewed. According to the primary tumor location and 2010 World Health Organization classification, the cases were categorized to analyze the clinicopathologic features, treatment condition, and prognostic factors. Results: There was a marked male predominance either in gastroenteropancreatic NET liver metastasis group or primary group. Primary hepatic NET is mostly single nodule located in the right lobe of liver, and the metastatic hepatic NET is mostly from pancreas with multiple nodules and metastasizes to both lobes of the liver, with a high degree of malignancy and poor prognosis. There are 17 cases (50%) of NET and 17 cases (50%) of neuroendocrine carcinoma (NEC) in all the 34 patients of this study. The mitotic figure and Ki-67 proliferation index are both higher in NEC group than in NET group, which indicated highly malignancy of the NEC. The 5-year disease-free survival (DFS) rates for primary group and metastatic group were 30% and 40%, respectively (P > 0.05), while the 5-year survival rates were 35% and 66%, respectively (P > 0.05). Different tumor grade was found closely associated with 5-year DFS (P < 0.05) and overall survival (OS) (P < 0.05) in both groups. Furthermore, we found 5-year DFS of patients with primary site of the tumor located in the gastrointestinal tract was much lower than that located in pancreas (P < 0.05), while the 5-year OS showed no significant differences between two groups (P > 0.05). Conclusions: Surgery is an effective method for the treatment of hepatic NET; tumor grading is an important determinant factor of prognosis.
The relationship between P16 gene promoter methylation and gastric cancer: A meta-analysis based on Chinese patients
Defeng Peng, Heng Zhang, Guoping Sun
Objective: To evaluate the P16 gene promoter methylation rate in gastric cancer tissue and healthy controls. And further assess the clinical value of P16 gene promoter methylation as a biomarker for gastric cancer diagnosis. Materials and Methods: Four databases, Medline, VIP, CNKI, WANFANG were searched to find the diagnostic trials about P16 gene promoter methylation in gastric cancer and healthy control. The pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR) and the receiver operating characteristic curve (ROC) were calculated by Meta-DiSc1.4 (http://www.hrc.es/investigacion/metadisc.html) software. Results: Nine studies involving 487 gastric cancer patients and 271 healthy controls were included in this meta-analysis. The median methylation rate for gastric cancer group was 43.3% with its range of 28.3-64.4%. And the median methylation rate for healthy control group was 0.0% with its range of 0.0-13.3%. The methylation rate in gastric cancer was statistical higher than in the healthy control (P < 0.05). The pooled sensitivity, specificity, +LR, -LR and the area under the ROC curve were 0.44 (95% confidence interval [CI]: 0.40-0.49), 0.97 (95% CI: 0.95-0.99), 13.11 (95% CI: 4.02-42.63), 0.58 (95% CI: 0.49-0.70), 23.62 (95% CI: 6.90-80.90) and 0.44, respectively. Conclusion: Our meta-analysis indicates that P16 gene promoter methylation array is a useful method for diagnosis of gastric cancer with relatively low sensitivity and very high specificity.
Metastatic brain tumors from small-cell esophageal cancer: Clinical characteristics and outcome
Wei Feng, Hideyuki Harada, Peng Zhang, Koichi Mitsuya, Xiao Zheng, Hirofumi Yasui, Yoko Nakasu, Ming Chen, Tetsuo Nishimura
Aims: Few studies have examined the clinical characteristics of patients with brain metastases from small-cell esophageal cancer. In this study, we review the clinical characteristics and outcomes in patients with brain metastases from small-cell esophageal cancer. Patients and Methods: From August 2002 to August 2012, consecutive patients diagnosed with brain metastases from small-cell esophageal cancer and treated with radiotherapy were enrolled. Clinical features, diagnostic findings, and survival were analyzed. Results: Six patients treated with brain radiotherapy were identified. The median age was 64 (range 61-74) years. All patients had neurological impairments. Three patients had supra- and infra-tentorial metastases, and three patients had cerebrum metastases. Brain metastases were detected when esophageal cancer was initially diagnosed in two patients. In three patients, magnetic resonance imaging findings after radiotherapy confirmed a significant response to treatment. The median overall survival was 6.0 months. During the same period, 43 patients with squamous cell carcinoma and seven patients with adenocarcinoma who had brain metastases were identified. Survival periods for squamous cell carcinoma and adenocarcinoma patients who had brain metastases were 5.5 months and 4.2 months, respectively. There was no significant difference in overall survival according to the histological type. Conclusions: Brain metastases from small-cell esophageal cancer tend to spread to the cerebellum and impair patients' quality-of-life. Brain radiotherapy had a positive effect in this case series; however, overall survival remains short.
Clinical analysis of acute lung injury after esophagectomy
Wei-chun Wu, Yongqing Wang, Xiaolin Wang, Aizemaiti Rusidanmu
Objective: Acute lung injury (ALI) is one of the most severe postoperative complications after esophagectomy for esophageal cancer patients. In order to clarify the mechanism of ALI, we, therefore, studied the operative course of a group of patients who underwent elective esophagectomy. Materials and Methods: We retrospectively analyzed 75 patients underwent an esophagectomy and reconstruction for thoracic esophageal cancer. Results: No statistically significant differences were observed between the two groups regarding their clinical backgrounds, such as their age, smoking index, preoperative pulmonary function, the location of the main tumor, and the tumor nodes metastasis stage. Operative time is thus considered to be a significant factor. The odds ratio (OR) of ALI in cases whose preoperative pulmonary function was 6.70 in comparison to the abnormal preoperative pulmonary functions. The OR for more intraoperative bleeding (>1000 g) was 0.83, compared with a lesser intraoperative bleeding although the difference was not statistically significant (P = 0.076). Anastomotic leakage occurred in four patients (44%) in Group I while it only occurred in two patient (6%) among the 33 Group II patients (P = 0.011). Conclusion: Greater surgical stress, such as a longer operative time, is thus considered to be associated with the first attack of ALI. The adverse events developing in the extrathoracic site, such as necrosis and local infection around anastomosis may, therefore, be the second attack. Furthermore, ALI may cause not only systemic inflammatory response syndrome but also other complications such as anastomotic leakage.
Concurrent involved-field radiotherapy and XELOX in gastric cancer patients with postoperative oligometastatic recurrence
Cuiping Xu, Jian Xie, Ning Liang, Junrong Wang, Lili Qiao, Hui Luo, Jing Xin Zhang, Jiandong Zhang
Purpose: The aim of this study was to retrospectively observe gastric adenocarcinoma patients with postoperative oligometastatic recurrence and investigated the effects of concurrent involved-field radiotherapy (RT) and XELOX on progression-free survival (PFS). Patients and Methods: From 2008 to 2011, 246 patients underwent curative resection of gastric carcinoma was enrolled. A retrospective review was performed on 34 patients with distant recurrence. Among them, 19 patients were oligometastases patients, where 13 patients received involved-field RT with a dose of 40-60 Gy by an intensity-modulated RT technique and concurrent XELOX chemotherapy, four patients were treated with XELOX chemotherapy alone (oxaliplatin 130 mg/m 2 , capecitabine 1000 mg/m 2 , twice daily, 3 week each cycle), and two patients with only brain metastasis were not included in the analysis. Results: The median PFS was 11 months in the 13 oligometastatic patients who received concurrent involved-field RT and XELOX. The oligometastatic patients receiving concurrent radiochemotherapy trended toward a better median PFS when compared with those receiving chemotherapy alone. Conclusions: For patients with postoperative oligometastatic recurrence, concurrent involved-field RT and XELOX showed better responses and was a choice for first-line treatment.
Is the incidence of postoperative anastomotic leakage different between laparoscopic and open total mesorectal excision in patients with rectal cancer? A meta-analysis based on randomized controlled trials and controlled clinical trials
Long Hua, Chenyu Wang, Kunhou Yao, Junjie Zhang, Jiangtao Chen, Wanli Ma
Objective: The purpose of this meta-analysis was to assess whether the incidence of postoperative anastomotic leakage (PAL) was different between laparoscopic and open total mesorectal excision (TME) in patients with rectal cancer. Materials and Methods: The PubMed, Medline, Cochrane Library, Wanfang and China National Knowledge Infrastructure databases were searched for selecting the randomized controlled trials (RCTs) and controlled clinical trials (CCT) on the incidence of PAL between laparoscopic and open TME for rectal cancer. The incidence rate of PAL was extracted from each of the individual study and pooled by the STATA-11.0 statistical software. Results: Six RCTs and 19 CCTs were included in this meta-analysis. The pooled results indicated that no statistical difference of PAL rate was found between aparoscopic and open TME in patients with rectal cancer (odds ratio [OR] =0.81, 95% confidence interval [CI]: 0.61-1.07, [P > 0.05]); The sub-group analysis when pooling the RCTs and CCTs respectively also indicated that there was no statistical difference of PAL rate between the laparoscopic and open TME (OR = 0.70, 95% CI: 0.35-1.39, [P > 0.05] for RCTs and OR = 0.84, 95% CI: 0.61-1.14, [P > 0.05]). Conclusion: Based on present studies, laparoscopic TME does not increase the risk of PAL.
A systematic review and meta-analysis of runt-related transcription factor 3 gene promoter hypermethylation and risk of gastric cancer
Yongxin Xia, Meng Zhang, Xiangdong Zhang, Xiaozheng Liu
Objective: To evaluate the association between runt-related transcription factor 3 (RUNX3) gene promoter hypermethylation and gastric cancer risk by meta-analysis. Materials and Methods: By searching Medline, EMBASE, Ovid, China National Knowledge Infrastructure and Wanfang databases, the open published articles reporting the relationship between RUNX3 gene promoter hypermethylation, and gastric carcinoma risk, were screened. The aggregated odds ratio of RUNX3 gene promoter hypermethylation in cancerous sample of gastric cancer patients compared to normal gastric tissue of gastric cancer patients was pooled by statistic software STATA-11.0. Results: Sixteen studies include 2631 samples were finally included in this meta-analysis. The aggregated results indicated that the hypermethylation rate in cancerous tissue was much higher than that in normal tissue (55.1% vs. 26.5%, P < 0.05). And the pooled results showed that the RUNX3 gene promoter methylation odds in tumor tissue in gastric cancer patients compared to normal gastric tissue was 5.47 (95% confidence interval: 3.34-8.96). Conclusion: RUNX3 gene promoter hypermethylation rate was much higher in tumor tissue than that in normal gastric tissue in the patient with gastric cancer.
Plasma interleukin 17 in the diagnosis of hepatocellular carcinoma: A retrospective study of 39 cases
Jianyong Liu, Guoqiang Zhou, Wei Lu
Objective: The purpose of this retrospective study was to evaluate the diagnosis efficacy of plasma interleukin 17 (IL-17) for hepatocellular carcinoma (HCC). Materials and Methods: Thirty-nine patients with confirmed HCC and 41 healthy controls were retrospectively analyzed in this study. The serum level of IL-17 was tested by enzyme-linked immunosorbent assay. And the plasma level of carcino-embryonic antigen (CEA) and alpha fetoprotein (AFP) were arrayed by radioimmunoassay. The plasma level of IL-17, CEA and AFP between HCC and healthy control group were compared. And the diagnostic sensitivity and specificity for IL-17, CEA and AFP in patients with HCC was calculated using the GraphPad Prism 5.0 software. Results: The plasma level of IL-17, CEA and AFP were 2.88 ± 1.75 (ng/L), 2.99 ± 2.12 (μg/L) and 6.91 ± 4.56 (mg/L) in healthy control group and 5.57 ± 1.59 (ng/L), 8.31 ± 5.40 (μg/L) and 190.50 ± 79.08 (mg/L) in HCC group. Plasma level of IL-17, CEA and AFP in HCC group was statistical higher than in healthy control group (all P < 0.05). For plasma IL-17, the diagnostic sensitivity and specificity were 74.36% and 75.61% at the cut-off value of 4.23 (ng/L) with the area under the receiver operating characteristic (ROC) curve of 0.86; For plasma CEA, the diagnostic sensitivity and specificity were 69.23% and 70.73% at the cut-off value of 4.14 (μg/L) with the area under the ROC curve of 0.80; For plasma AFP, he diagnostic sensitivity and specificity were 100.00% and 65.85% at the cut-off value of 10.25 (mg/L) with the area under the ROC curve of 0.96. Conclusion: Plasma IL-17 was significant elevated in patients with HCC compared to healthy control group which could be a potential biomarker for diagnosis of HCC.
The diagnostic value of DNA hypermethylation in stool for colorectal cancer: A meta-analysis
Li-Yu Qian, Wei Zhang
Objective: We performed this meta-analysis to document the diagnostic performance of DNA hypermethylation in stool for colorectal cancer (CRC). Materials and Methods: Relevant studies that reported the diagnostic performance of stool DNA hypermethylation in CRC and healthy control were searched and extracted from electronic databases. After careful evaluation of the included articles, the numbers of true positive, false positive, false negative and true negative cases identified by stool DNA hypermethylation were extracted and pooled for diagnostic sensitivity, specificity, positive likely hood ratio, negative likely hood ratio, diagnostic odds ratio and the summary receiver operating characteristic (SROC) curve. All the statistical analysis was done by MetaDiSc1.4 and STATA-11.0 software. Results: Thirty diagnostic trails including 1,629 CRC patients and 1,531 controls were included in this meta-analysis according to the inclusion and exclusion criteria. The overall diagnostic value of DNA hypermethylation in stool for CRC was: Pooled sensitivity, 0.71 (0.69-0.73); pooled specificity, 0.92 (0.90-0.93); pooled positive likely hood ratio, 7.59 (5.83-9389); pooled negative likely hood ratio, 0.33 (0.27-0.42); pooled diagnostic odds ratio, 27.78 (19.94-38.72) and area under the SROC curve was 0.93 (0.91-0.95). Conclusion: These results indicate a great diagnostic potential for DNA hypermethylation as a reliable marker in stool for CRC.
Diagnostic value of endorectal ultrasonography for rectal carcinoma: A meta-analysis
Yonghe Zhou, Wei Shao, Wei Lu
Objective: The aim of this meta-analysis was to evaluate the diagnosis efficacy of endorectal ultrasonography (ERUS) for rectal carcinoma. Materials and Methods: We searched all the published articles about ERUS in evaluation of rectal carcinoma in the electronic databases. The pooled diagnosis sensitivity, specificity, diagnosis odds ratio, a positive likelihood ratio, negative likelihood ratio, and area under the receiver operating characteristic (ROC) were calculated by MetaDiSc-1.4 software. Results: Fourteen studies with 1583 subjects meeting the inclusion criteria were recruited in this meta-analysis. For tumor invasion evaluated by ERUS, the pooled diagnosis sensitivity, specificity, diagnosis odds ratio, positive likelihood ratio, negative likelihood ratio and area under the ROC were 0.95 (0.92-0.97), 0.80 (0.71-0.86), 62.88 (9.30-425.33), 3.66 (2.48-5.39), 0.07 (0.01-0.40), and 0.86; for lymph node involvement evaluated by EU, the pooled diagnosis sensitivity, specificity, diagnosis odds ratio, positive likelihood ratio, negative likelihood ratio and area under the ROC were 0.58 (0.53-0.63), 0.80 (0.77-0.84), 5.93 (4.07-8.63), 2.85 (2.30-3.52), 0.54 (0.46-0.63) and 0.78. Conclusion: ERUS was a good method for the assessment of invasion of rectal tumors and lymph node involvement.
Endo-laparoscopic rendezvous approach for pericardia with gastric posterior wall of gastrointestinal stromal tumor: Analysis of 52 consecutive cases
Po Ding, Yongjie Zhao
Background: Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor in the gastrointestinal tract and most frequently developed in the stomach, and surgical therapy is limited on removal of the tumor lesion. The aim of this study was to investigate the clinical values of endo-laparoscopic rendezvous approach for pericardial GISTs within gastric posterior wall. Materials and Methods: Surgical outcome and clinical data of 52 patients with pericardial GISTs within gastric posterior wall treated at Tianjin Peoples' Hospital from January 2004 to October 2013 were analyzed. Endo-laparoscopic rendezvous approach was used as an operative procedure for tumor resection ranged from 10 to 50 mm. Endoscopic ultrasound, computed tomography and microscopic findings all certified the gastric spindle type GIST locating in the submucosa to muscle proper. Results: Endo-laparoscopic rendezvous approach was attempted in 52 patients (male/female: 31/21) with median age of 51 years (25-71 years). The median operating time was 80 min (range: 40-120 min) and median intra-operative blood loss was 26 ml (range: 10-50 ml). The median hospital stay was 5 days (range: 4-6 days), while the median tumor size was 25 mm (range: 7-50 mm). All operative margins were clear. There were no recurrences or metastases of all patients in a median follow-up of 24 months (range: 6-36 months). Conclusions: Endo-laparoscopic rendezvous approach is considered to represent the next revolution in surgery. The new technique is reliable and effective in clinical application, due to the advantages of accurate and quick localization for pericardial GIST within gastric posterior wall.