Objective To evaluate the advantage of laparoscopic total mesorectal excision (TME) and the clinical value of pull-through anastomosis in the treatment of rectal carcinoma. Methods From November 2005 to December 2006, laparoscopic TME combined with pull-through anastomosis was carried out on 8 patients with rectal cancer. Results In all of the 8 patients, TME was completed under a laparoscope without additional incision, and the pull-through anastomosis was performed by hand.The mean operation time was 220 minutes (range, 180 to 300). The patients were followed up for 8-18 months (mean, 13 months), during which none of them developed implantation at puncture sites or local recurrence. Conclusions Laparoscopy provides a direct, magnified and reliable view for TME. Pull-though anastomosis is a convenient and low-cost method.

OBJECTIVETo investigate whether the functional polymorphisms in the promoter region of MMP-12 (-82A/G) and MMP-13(-77A/G) are associated with epithelial ovarian carcinoma (EOC).

METHODSThe MMP-12 -82A/G and MMP-13 -77A/G were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 300 epithelial ovarian carcinoma patients and 300 control women.

RESULTSThe A/G genotype frequency of the MMP-12 gene was significantly higher in the patients than in the controls (P= 0.003); similarly, the frequency of MMP-12 -82G allele was higher in the patient group (P= 0.004). Compared with the A/A genotype, the A/G genotype carriers significantly increased the risk of EOC development (OR= 2.81, 95%CI: 1.38-5.74). No overall association between the MMP-13 -77A/G polymorphism and EOC(P= 0.15) was observed. However, the A/A genotype carriers in the MMP-13 -77A/G locus had significantly higher risk of developing serous-papillary and mucinous ovarian cancer (OR= 1.93, 95% CI: 1.05-3.53; OR= 5.16, 95% CI: 1.62-16.44, respectively), comparing with the G/G genotype carriers. Combining the two SNPs, the haplotype distributions in patients were not significantly different from that in control women (P= 0.06).

CONCLUSIONThese results suggested that individuals with MMP-12 -82A/G and MMP-13 -77A/A might have higher risk of overall or special histological type of EOC development.

Adult ; Aged ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Matrix Metalloproteinase 12 ; genetics ; Matrix Metalloproteinase 13 ; genetics ; Middle Aged ; Neoplasms, Glandular and Epithelial ; genetics ; Ovarian Neoplasms ; genetics ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic ; genetics ; Young Adult

Objective To compare dosimetric parameters between automated and manualvolumetric modulated arc therapy(VMAT) plans in the treatment of postoperative cervical cancer patients,and to investigatethe feasibility and dosimetric advantage of the automated VMAT planning.Methods Automated and manual VMAT plans were generated with Pinnacle3 treatment planning system (TPS) for twenty-three postoperative cervical cancer patients,including eight patients in stage Ⅱ A and fifteen in stage Ⅱ B,respectively.The differences in D D95,conformity index (CI) and homogeneity index (HI) of target,as well as dose volume histogram (DVH) of organs at risk (OAR),planning time,average optimization time and monitor unit (MU) were compared between automated and manual VMAT plans.Results The average D CI and HI of automated VMAT plans were better than those of manual VMAT plans (t=4.65-14.92,P ＜0.05).There was no significant difference in D95 (P ＞0.05).The automated VMAT plans achieved better average dosimetric parameters on OARs compared with the manual VMAT plans (t =3.30-14.42,P ＜ 0.05).Automated VMAT plans had a significantly shorter planning time (72 min,t =3.85,P ＜ 0.05) and interruption frequency (twice,t =5.41,P ＜ 0.05) than manual VMAT plans.However,automated VMAT plans had a higher average MU than manual VMAT plans with an average MU of 819 ± 53 and 638 ± 41 for automated and manual VMAT plans,respectively.Conclusions It is feasible to generate automated VMAT plans with Pinnacle3 TPS for postoperative cervical cancer patients.The automated VMAT plans increase the plan quality and reduce the optimization time compare with manual VMAT plans.Automated technique also eliminates the influence of human factors on the plan quality.