Isolated splenic metastasis arising from colorectal carcinoma is very rare and there has been only 6 cases reported in the English literature. A new case is esented, and its possible pathogenesis was considered with previously reported ses. A 65-year-old male patient had received a right hemicolectomy for cending colon cancer 36 months earlier. He was followed up regularly with rial measurement of serum carcinoembryonic antigen (CEA). Rising serum CEA was scovered from 33 months postoperatively and CT revealed an isolated splenic tastasis. He therefore underwent splenectomy, which was proven to be a tastatic adenocarcinoma with similar histological feature to the original mor. As all reported cases showed elevated serum CEA at the time of tastasis, isolated splenic metastasis might be associated with CEA in regard its biological functions of immunosuppression and adhesion.
Adenocarcinoma/surgery ; Adenocarcinoma/secondary* ; Adenocarcinoma/pathology ; Adenocarcinoma/blood ; Aged ; Carcinoembryonic Antigen/blood ; Case Report ; Colorectal Neoplasms/surgery ; Colorectal Neoplasms/pathology* ; Colorectal Neoplasms/blood ; Human ; Male ; Splenic Neoplasms/surgery ; Splenic Neoplasms/secondary* ; Splenic Neoplasms/blood ; Tomography Scanners, X-Ray Computed

BACKGROUND/AIMS: Although it has been known that folate will participate in colorectal carcinogenesis, the relationship between blood folate level and colorectal cancer is less consistent. The blood folate level does not reflect the systemic folate status. By contrast, serum homocysteine has become a sensitive marker for the folate deficiency. We attempted to explain the correlation between folate and colorectal cancer according to the serum homocysteine level. METHODS: We reviewed the clinical records, including alcohol history of 184 patients taking the colonoscopy and measurement of the serum homocysteine level at Health Promotion Center from 2001 to 2002. One hundred fifty-one of 184 were included, excluding 33 patients with previous history of colonic polyp, cerebrovascular, cardiovascular attack and thromboembolism. They were divided into the normal control (n=111) and the adenomatous polyp group (n=40). We had selected the colorectal cancer group (n=50) from the collection list of the tissue and blood bank less than 3 months storage interval. RESULTS: There was no significant difference in the mean serum homocysteine level among three groups. However, in the subjects with high alcohol consumption, there was a significant difference in the mean serum homocysteine between the normal control (n=7) and the adenomatous polyp group (n=9) (10.2 vs 15.1 micromol/L, p<0.05). CONCLUSIONS: There was no correlation of serum homocysteine and colorectal tumor. However, in the subjects with high alcohol consumption, high serum homocysteine might be related to the development of adenomatous polyp.
Adenomatous Polyps/*blood/pathology ; Alcohol Drinking/blood ; Colonoscopy ; Colorectal Neoplasms/*blood/pathology ; Female ; Homocysteine/*blood ; Humans ; Male ; Middle Aged

OBJECTIVETo explore the potential markers of colorectal cancer metastasis and the influence of 5-FU on differentially expressed proteins by using proteomic technology, and to elucidate the mechanism of colorectal cancer metastasis.

METHODSHuman colorectal carcinoma cell lines of different metastatic potential, Lovo and SW480 were conventionally cultured, and the protein was extracted. 50% inhibitory concentration (IC(50)) of 5-FU to these two cell lines was measured by MTT assay. Proteins of these two cell lines after intervention by 5-FU at IC(50) were extracted, then 2-dimensional gel electrophoresis was conducted for the proteins. The differential protein spots were examined by mass spectrometry and analyzed by bioinformatics. Difference of expressed proteins in two cell lines before and after the intervention of 5-FU was validated by Western blot and immunofluorescence.

RESULTSEleven differentially expressed proteins were identified by 2-dimensional gel electrophoresis and mass spectrometry. The hnRNP K protein and PDI were selected to be examined by Western blot and immunofluorescence. Results revealed that the expression of hnRNP K in Lovo was higher than that in SW480, while the expression of PDI was lower in Lovo. After intervention by 5-FU at IC(50), the expression of hnRNP K in Lovo decreased more as compared to SW480, while the expression of PDI in SW480 increased more as compared to Lovo.

CONCLUSIONThere are significant differences in expression of hnRNP K and PDI proteins between Lovo and SW480 cell lines, and the proteins alter regularly after 5-FU intervention.

Biomarkers, Tumor ; blood ; Cell Line, Tumor ; Colorectal Neoplasms ; metabolism ; pathology ; Fluorouracil ; pharmacology ; Humans ; Neoplasm Metastasis ; Proteomics

Screening and early diagnosis and treatment have been proven effective in reducing the incidence and mortality of colorectal cancer. Colonoscopy combined with pathological examination is the gold standard for colorectal cancer screening. However, due to the invasiveness, high cost and the need for professional endoscopists of colonoscopy, it is not feasible to directly use this method for mass population screening. Fecal immunochemical test (FIT) is one of the screening techniques recommended by authoritative international guidelines for colorectal cancer screening, and has been widely used in population-based colorectal cancer screening programs in countries around the world. This paper elaborates on the value of FIT in colorectal cancer screening from different aspects, such as the technical principles, the screening efficiency, the screening strategies, and the population effects and benefits. Additionally, it describes the current situation of colorectal cancer screening in China and summarizes the challenges faced in colorectal cancer screening in order to optimize the FIT-based colorectal cancer screening strategies in the population and provide theoretical reference for effective colorectal cancer screening.
Humans ; Early Detection of Cancer/methods* ; Colonoscopy ; Mass Screening ; Colorectal Neoplasms/pathology* ; Occult Blood

Screening and early diagnosis and treatment have been proven effective in reducing the incidence and mortality of colorectal cancer. Colonoscopy combined with pathological examination is the gold standard for colorectal cancer screening. However, due to the invasiveness, high cost and the need for professional endoscopists of colonoscopy, it is not feasible to directly use this method for mass population screening. Fecal immunochemical test (FIT) is one of the screening techniques recommended by authoritative international guidelines for colorectal cancer screening, and has been widely used in population-based colorectal cancer screening programs in countries around the world. This paper elaborates on the value of FIT in colorectal cancer screening from different aspects, such as the technical principles, the screening efficiency, the screening strategies, and the population effects and benefits. Additionally, it describes the current situation of colorectal cancer screening in China and summarizes the challenges faced in colorectal cancer screening in order to optimize the FIT-based colorectal cancer screening strategies in the population and provide theoretical reference for effective colorectal cancer screening.
Humans ; Early Detection of Cancer/methods* ; Colonoscopy ; Mass Screening ; Colorectal Neoplasms/pathology* ; Occult Blood

OBJECTIVE: To explore the technique and effect of liver hanging maneuver in anterior approach for isolated complete liver caudate lobectomy. METHODS: We recruited 17 patients with liver caudate lobe tumor (13 primary hepatocellular carcinoma, 3 cholangiocarcinoma and 1 liver metastasis from colorectal cancer). Isolated complete caudate lobectomy with liver hanging maneuver was performed in 17 patients. RESULTS: All 17 patients were successfully received the above-mentioned operation. The operative time was 166-427 (211.5 ± 20.1) min and the intraoperative blood loss was 372-1 208 (472.7 ± 83.6) mL. There was no operative death. The survival rates of follow up for 1, 3 and 5 years were 76.5%, 52.9% and 23.5%, respectively. CONCLUSION Liver hanging maneuver for isolated complete resection of the caudate lobe is an ideal approach for liver neoplasms resection.
Blood Loss, Surgical ; Carcinoma, Hepatocellular ; surgery ; Cholangiocarcinoma ; surgery ; Colorectal Neoplasms ; pathology ; Hepatectomy ; methods ; Humans ; Liver Neoplasms ; secondary ; surgery ; Survival Rate

Objective: To compare the application effect of the colonoscopy, fecal immunochemical test (FIT) and novel risk-adapted screening approach in colorectal cancer screening in Xuzhou population. Methods: From May 2018 to April 2019, 4 280 subjects aged 50-74 were recruited from Gulou district, Yunlong district and Quanshan district of Xuzhou. They were randomly assigned to the colonoscopy group (n=863), FIT group (n=1 723) and novel risk-adapted screening approach group (n=1 694) according to the ratio of 1∶2∶2. For the novel risk-adapted screening approach group, after the risk assessment, high-risk subjects were invited to undergo colonoscopy and low-risk subjects were invited to undergo FIT examination. All FIT positive subjects were invited to undergo colonoscopy. Colonoscopy participation rate [(the number of colonoscopies completed/the number of colonoscopies invited to participate)×100%], detection rate of colorectal lesions [(the number of diagnosed patients/the number of colonoscopies completed)×100%], colonoscopy resource load (the number of colonoscopies completed/the number of diagnosed advanced tumors) and FIT resource load in each group were calculated and compared. Results: The age of all subjects was (61±6) years old, including 1 816 males (42.43%). There was no statistically significant difference in the socio-demographic characteristics of the subjects in different screening groups. The colonoscopy participation rate was 22.60% (195/863) in the colonoscopy group, 57.04% (77/135) in the FIT group, and 33.94% (149/439) in the novel risk-adapted screening approach group, respectively. The colonoscopy participation rate was higher in the FIT group than in the colonoscopy group and the novel risk-adapted screening approach group (P<0.001). The colonoscopy participation rate of novel risk-adapted screening group was significantly higher than the colonoscopy group (P<0.001). The detection rates of advanced tumors were 6.67% (13/195), 9.09% (7/77) and 8.72% (13/149), respectively, and the difference was not statistically significant (P>0.05). The colonoscopy resource load (95%CI) was 15 (13-17) in the colonoscopy group, 11 (9-14) in the FIT group and 11 (10-13) in the novel risk-adapted screening approach group, respectively. Among them, the colonoscopy resource load of high-risk individuals in the novel risk-adapted screening approach group was 12 (9-15). FIT resource loads (95%CI) were 207 (196-218) and 88 (83-94) in the FIT group and the novel risk-adapted screening approach group. Conclusion: The combined application of risk-adapted screening approach and FIT may have a good application effect in colorectal cancer screening.
Aged ; Colonoscopy ; Colorectal Neoplasms/pathology* ; Early Detection of Cancer ; Feces ; Female ; Humans ; Male ; Mass Screening ; Middle Aged ; Occult Blood

OBJECTIVETo evaluate the clinical significance of CK20 mRNA expression in detecting disseminated tumor cells in peripheral blood of gastric and colorectal cancer patients.

METHODSExpression of CK20 mRNA was investigated by RT-PCR in bone marrow, portal vein and peripheral blood in 47 gastric, 58 colorectal cancer patients and 6 non-cancer volunteers. All the patients were followed-up for one year.

RESULTSThere was no positive expression of CK20 mRNA in 6 non-cancer volunteers. The positive rates of CK20 mRNA in bone marrow, portal vein were 87.2% (41/47) and 85.1% (40/47) in gastric cancer, and were 77.6% (45/58) and 74.1% (43/58) in colorectal cancer. The positive rates of CK20 mRNA in peripheral blood in gastric and colorectal cancer patients were 42.6% (20/47) and 44.8% (26/58) by one single test, and were 74.5% (35/47) and 69.0% (40/58) by two tests. The overall positive rate of CK20 mRNA in peripheral blood (two tests) was similar to that in bone marrow and portal vein. The overall positive rate of CK20 mRNA in peripheral blood was higher in two tests than in one single test (P < 0.05) and in advanced than early lesions. The relapse rate within one year was higher in CK20 mRNA positive patients than the negative ones (P < 0.05).

CONCLUSIONDetection of cancer cells by RT-PCR for CK20 mRNA in peripheral blood, being as sensitive and specific as in bone marrow and portal vein, is reliable and convenient in diagnosing micrometastasis of gastric and colorectal cancer, which possesses clinical significance in assessing the prognosis and scheme of therapy.

Adolescent ; Adult ; Aged ; Biomarkers, Tumor ; blood ; Colorectal Neoplasms ; blood ; pathology ; Female ; Humans ; Intermediate Filament Proteins ; blood ; genetics ; Keratin-20 ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplastic Cells, Circulating ; chemistry ; RNA, Neoplasm ; blood ; Reverse Transcriptase Polymerase Chain Reaction ; Stomach Neoplasms ; blood ; pathology

OBJECTIVETo explore the value of detection of adenomatous polyposis coli (APC) gene and K-ras gene mutations in fecal and blood samples in colorectal neoplasm screening.

METHODSFrom 84 subjects undergoing colonoscopic examination (including 31 with colorectal carcinoma, 26 with colorectal adenoma, and 27 healthy subjects) between October, 2003 and March, 2004, 5 ml of heparinized peripheral blood and 3-5 g fecal specimens were collected. The DNA was extracted from the specimens for detecting the mutation of APC and K-ras gene using polymerase chain reaction-single strand conformation polymorphism and the results were analyzed statistically.

RESULTS AND CONCLUSION(1) The incidence of APC gene mutation was 41.9% and 57.7% in the plasma, and 34.8% and 26.8% in the fecal specimens of colorectal carcinoma patients and adenoma patients, respectively, both higher than that in normal subjects (P<0.05), suggesting high consistency between fecal and plasma APC gene mutation detection (K=0.811, P<0.05). (2) The incidence of plasma K-ras mutation was 48.4% in colorectal carcinoma patients, 3.8% in adenoma patients and 0% in normal control subjects, and in the feces, the incidences were 54.8%, 7.7% and 11.1%, respectively. The mutation rate was higher in carcinoma patients than in adenoma patients and normal subjects (P<0.05). Fecal K-ras gene mutation detection was consistent with plasma detection (K=0.662, P=0.000). (3) APC gene mutation detection showed a low sensitivity and specificity in the diagnosis of colorectal carcinoma, but K-ras mutation detection showed a high specificity. The diagnostic sensitivity increased when combining APC and K-ras gene detection in the plasma or fecal specimens, but there was no evidence to suggest that APC and K-ras mutation detection in the plasma could be better than detection in the feces. (4) For colorectal carcinoma, APC gene mutation is associated with lymphoid node metastasis, but not with the patient's gender, age, tumor location, differentiation, distant organ metastasis or CEA level (P>0.05), and the mutation of K-ras gene is related to the degree of tumor differentiation.

Adenomatous Polyposis Coli ; blood ; genetics ; Case-Control Studies ; Colorectal Neoplasms ; blood ; diagnosis ; genetics ; pathology ; DNA ; blood ; Feces ; Female ; Genes, ras ; genetics ; Humans ; Male ; Middle Aged ; Mutation

OBJECTIVETo assess the value of preoperative neutrophil-lymphocyte ratio (NLR) for prognosis in patients with colorectal cancer after radical operation.

METHODSClinical data of 140 patients with colorectal cancer undergoing radical operation in the Department of General Surgery of General Hospital of PLA from July 2005 to July 2011 were analyzed retrospectively. According to preoperative NLR, patients were divided into the low NLR group (NLR<5, n=105) and the high NLR group (NLR≥5, n=35). The overall 5-year survival rates of two groups were compared and the independent risk factors were examined by univariate analysis and Cox model.

RESULTSThe overall 5-year survival rates of the low and high NLR groups were 74.8% and 54.7% respectively with significant difference (P=0.03). Univariate analysis revealed depth of tumor, lymph nodes metastasis, TMN stage and NLR were associated with survival (P<0.05, P<0.01). Cox model showed that NLR was independent risk factor of prognosis (RR=1.068, 95%CI:1.009-1.129, P=0.02).

CONCLUSIONPreoperative NLR≥5 predicts poorer prognosis of colorectal cancer patients.

Aged ; Colorectal Neoplasms ; blood ; diagnosis ; pathology ; Female ; Humans ; Lymphatic Metastasis ; Lymphocytes ; pathology ; Male ; Neutrophils ; pathology ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate