Air Pollutants, Occupational ; analysis ; Chromatography, Gas ; methods ; Indenes ; analysis ; Workplace

Carbon Monoxide ; analysis ; Spectroscopy, Fourier Transform Infrared ; methods

Objective To investigate the common reasons for the misdiagnosis of rectal cancer. Methods A retrospective study was performed in 568 cases of rectal cancer in the Changhai Hospital from January 2007 to December 2008. Age at diagnosis, gender distribution, symptom, delay in diagnosis, TNM stage, and grade of differentiation were recorded and analyzed. The importance of digital examination and colonoscopy were addressed. Results Two hundred and seventy-one(47.7%) out of 568 patients were misdiagnosed for iatrogenic reasons. Rectal cancer patients who presented hematochezia were more likely to be misdiagnosed. There were 110 cases of stage Ⅲ(40.6%) and 68 cases of stage Ⅳ(12.5%) in patients who were misdiagnosed, which was significantly higher than those who were diagnosed correctly(P＜0.05). Patients under 40 years old were more likely to be misdiagnosed, and their correct diagnosis was often delayed longer and the tumors were in more advanced stage as compared to the older groups(P＜0.05). Conclusions The misdiagnosis rate of rectal cancer is high. Tumor stage of patients misdiagnosed is significantly more advanced than those who are correctly diagnosed. Digital examination and colonoscopy should be emphasized, especially for patients under the age of 40.

Objective To investigate the common reasons for the misdiagnosis of rectal cancer. Methods A retrospective study was performed in 568 cases of rectal cancer in the Changhai Hospital from January 2007 to December 2008. Age at diagnosis, gender distribution, symptom, delay in diagnosis, TNM stage, and grade of differentiation were recorded and analyzed. The importance of digital examination and colonoscopy were addressed. Results Two hundred and seventy-one(47.7%) out of 568 patients were misdiagnosed for iatrogenic reasons. Rectal cancer patients who presented hematochezia were more likely to be misdiagnosed. There were 110 cases of stage Ⅲ(40.6%) and 68 cases of stage Ⅳ(12.5%) in patients who were misdiagnosed, which was significantly higher than those who were diagnosed correctly(P＜0.05). Patients under 40 years old were more likely to be misdiagnosed, and their correct diagnosis was often delayed longer and the tumors were in more advanced stage as compared to the older groups(P＜0.05). Conclusions The misdiagnosis rate of rectal cancer is high. Tumor stage of patients misdiagnosed is significantly more advanced than those who are correctly diagnosed. Digital examination and colonoscopy should be emphasized, especially for patients under the age of 40.

OBJECTIVETo investigate the principle of management of colorectal high-grade intraepithelial neoplasia(HGIN) based on colonoscopic biopsy.

METHODSPatients diagnosed as colorectal HGIN based on colonoscopic biopsy in the Changhai Hospital from January 2002 to December 2009 were enrolled in the study. The clinical data of all the patients were collected and analyzed. According to the subsequent operation, cases were divided into local complete resection group and radical operation group. The discrepancy between the biopsy diagnosis and postoperative diagnosis was investigated.

RESULTSOf the 203 biopsy-based colorectal HGIN lesions, 156 underwent radical resection, while 47 received local complete resection. Univariate analyses indicated that tumors located in colon(P=0.02), tumors with sessile growth (P=0.00) and large tumors (P=0.00) were more likely to be treated with radical resection. Postoperative diagnosis revealed that 163 cases(80.3%) were invasive cancers, while the other 40 cases(19.7%) were HGIN lesions. Of the 156 cases resected radically, 140 cases were invasive cancers, 16 cases were diagnosed as HGIN. Of the 47 cases who underwent local complete resection, 24 cases were confirmed as HGIN but the other 23 cases were invasive cancers, in which 15 cases received subsequent radical operation.

CONCLUSIONSA large proportion of biopsy-proven colorectal HGIN lesions are invasive cancers. Therefore, local resection should be performed to confirm diagnosis. For highly suspected malignant tumors which can not be removed completely by local resection, if anus can be reserved, a radical transabdominal surgery is recommended even without biopsy-proven malignancy in order to avoid treatment delay.

Adult ; Aged ; Aged, 80 and over ; Biopsy ; Carcinoma in Situ ; diagnosis ; pathology ; surgery ; Colorectal Neoplasms ; diagnosis ; pathology ; surgery ; Endoscopy, Gastrointestinal ; Female ; Humans ; Male ; Middle Aged

BACKGROUNDNeoadjuvant chemoradiation is now considered the standard care for locally advanced rectal carcinoma (T3-4 or/and N1-2 lesions), but the accuracy of staging examinations including endorectal ultrasonography (ERUS) and MRI is far from excellent. In addition, the above staging equipment or professionals who perform the examinations may not be available in some hospitals, while preoperative colonoscopy and biopsy are usually obtainable in most hospitals. The objective of the present study was to investigate the clinical and pathological characteristics of locally advanced rectal carcinoma and identify candidates for neoadjuvant chemoradiation.

METHODSThis was a retrospective study. Patients who were treated for rectal cancer at Changhai Hospital from January 1999 to July 2008 were identified from our prospectively collected database. Statistical analysis was performed using SPSS Software System (version 15.0). The Mann-Whitney test, chi-square test and multivariate Logistic regression analysis were performed.

RESULTSA total of 1005 cases were included in this research, of which 761 cases were identified as locally advanced rectal carcinoma depending on postoperative TNM staging. The results of multivariate Logistic regression analysis indicated seven independent risk factors that could be used to predict a locally advanced rectal carcinoma independently: a high grade (including poor differentiation and undifferentiation) (OR: 3.856; 95% CI: 2.064 to 7.204; P = 0.000); large tumor size (OR: 2.455; 95% CI: 1.755 to 3.436; P = 0.000); elevated preoperative serum CEA level (OR: 1.823; 95% CI: 1.309 to 2.537; P = 0.000); non-polypoid tumor type (OR: 1.758; 95% CI: 1.273 to 2.427; P = 0.001); the absence of synchronous polyps (OR: 1.602; 95% CI: 1.103 to 2.327; P = 0.013); the absence of blood in stool (OR: 1.659; 95% CI: 1.049 to 2.624; P = 0.030); and a greater circumferential tumor extent (OR: 1.813; 95% CI: 1.055 to 3.113; P = 0.031). Based on these findings, a Logistic equation was established, the accuracy of which was 64% according to the information of the additional 50 cases.

CONCLUSIONSSome independent risk factors related with locally advanced rectal carcinoma were identified, based on which it is possible to establish a Logistic equation as a tool to predict candidates of neoadjuvant chemoradiation. Further research about optimization of the equation is warranted.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Colonoscopy ; methods ; Endosonography ; Female ; Humans ; Logistic Models ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Staging ; Rectal Neoplasms ; diagnosis ; pathology ; Retrospective Studies

OBJECTIVETo investigate the association between the polymorphism of serotonin transporter gene-linked polymorphic region(5-HTTLPR) and slow transit constipation(STC).

METHODSPolymerase chain reaction was used to assess 5-HTTLPR polymorphism of SERT gene in 54 patients with STC and 100 healthy controls.

RESULTSThe frequencies of serotonin transporter short/short(S/S) and allele S genotypes were significantly higher in STC patients than those in controls(72.2% vs 50.0%; 83.3% vs 72.5%; both P< 0.05). There were no significant differences in 5-HTTLPR polymorphism respectively between the two groups according to gender and age(less than 45 and more than 45 years old). The frequency of S/S genotype was higher in the patients with less than 40% of the ingested markers evacuated within 72 h than those with more than 40% evacuated(71.7% vs 42.6%, P< 0.05).

CONCLUSIONThe presence of 5-HTTLPR allele S may contribute to the pathogenesis of STC.

Adolescent ; Adult ; Aged ; Alleles ; Chronic Disease ; Constipation ; genetics ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Middle Aged ; Polymorphism, Genetic ; Serotonin Plasma Membrane Transport Proteins ; genetics ; Young Adult

OBJECTIVETo explore the angiogenesis and its maturation of hepatocellular carcinoma (HCC) and its correlation with deoxyhemoglobin parameters R2 * and T2 * values and the lesion/muscle R2*, T2 * ratio by using noninvasive magnetic resonance imaging (MRI).

METHODST2 *, R2 * values and the lesion/muscle R2 *, T2 * ratio in tumor periphery and center were calculated via series T2 * images in a total of 31 patients with surgically and pathologically confirmed HCC. After surgery, all sections were obtained from the specimen periphery in accordance with the MR analyzed areas. Continuous slices of each lesion were stained with hematoxylin-eosin (HE), and immunohistochemical staining was performed in vascular endothelial growth factor (VEGF), Flk-1, proliferating cell nuclear antigen (PCNA), CD34, and alpha smooth muscle actin (SMA). The expressions of VEGF, Flk-1, and PCNA index (PI) were evaluated. According to CD34 and SMA, some vascular parameters, including number, mean vessel area, total vessel area, circumference, diameter, distance between adjacent vessels, and variety index of microvessel and mature vessel, were calculated with a computed analysis system. The amounts of arterioles and veinlets, mature vessel index, and mean perfused fraction (mPF) were also recorded. All vessel parameters were compared with the calculated values of MRI.

RESULTSR2 * value or lesion/muscle R2 * ratio decreased and T2 * value or the lesion/muscle T2 * ratio increased in HCC when compared with hepatic parenchyma (P < 0.05); however, those values between lesion periphery and center and among different pathological grades were not significantly different (P > 0.05). T2 * value and the lesion/muscle T2 * ratio significantly decreased when the expression of VEGF was positive (P < 0.05). T2 * value was negatively correlated with microvessel amount (P = 0.047, r = - 0.639), while T2 * value and the lesion/muscle T2 * ratio were positively correlated with mPF (P = 0.040, r = 0.655; P = 0.048, r = 0.40, respectively). R2 * value was also positively correlated with mean area (P = 0.028, r = 0.688), total area (P = 0.021, r = 0.712) or circumference (P = 0.037, r = 0.663) of microvessel, and negatively correlated with mPF (P = 0.024, r = - 0.702). Meanwhile, the lesion/muscle R2 * ratio was positively correlated with mean area (P = 0.043, r = 0.647) and circumference (P = 0.026, r = 0.694) of microvessels.

CONCLUSIONR2 * or T2 * value may be influenced by the variation of deoxyhemoglobin caused by the heterogeneity of angiogenesis.

Adult ; Aged ; Carcinoma, Hepatocellular ; blood supply ; Female ; Hemoglobins ; Humans ; Liver ; pathology ; Liver Neoplasms ; blood supply ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Neovascularization, Pathologic

MicroRNAs are negative regulators of mRNA, and latest studies show that "mRNAs can also inhibit microRNAs". With these reciprocal interactions, different mRNAs with identical "microRNA binding site" cim regulate each other by competitively binding to the same microRNA pool. This is the novel competing endogenous RNA (ceRN A)regulating mechanism. The ceRN A mechanism, which is a totally new regulating mechanism , greatly expands the regulatory network across genes. It has been proved by experimental evidence that, in HCT116 colon cancer cells,KRAS and PTEN , ZEB2 and PTEN can regulate each other by ceRNA mechanism.
Colorectal Neoplasms ; genetics ; HCT116 Cells ; Humans ; MicroRNAs ; genetics ; PTEN Phosphohydrolase ; RNA, Messenger

OBJECTIVETo investigate factors associated with lymph node metastasis and prognosis in patients with T1-2 colorectal cancer.

METHODSPatients with pT1-2 colorectal cancer between January 1999 to January 2005 were included. Chi-square test and multivariable logistic analysis were performed to evaluate risk factors associated with lymph node metastasis. Survival outcomes were analyzed using Kaplan-Meier and Cox regression model.

RESULTSTumor location and depth of invasion were independent risk factors for lymph node metastasis(P<0.01 and P<0.05). Gender, age, tumor gross pattern, tumor differentiation, carcinoembryonic antigen level, and tumor diameter were not associated with lymph node metastasis. Lymph node metastasis and distant metastasis on postoperative follow-up were independent risk factors for survival(P<0.05 and P<0.01).

CONCLUSIONFactors associated with lymph node metastasis in pT1-2 colorectal cancer do not affect the survival. However, lymph node metastasis and distant metastasis are predictive for survival.

Adult ; Aged ; Aged, 80 and over ; Chi-Square Distribution ; Colorectal Neoplasms ; diagnosis ; pathology ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; diagnosis ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors