PURPOSE: Cyclooxygenase (COX)-2 is an inducible isoform responsive to cytokines, mitogens, and growth factors, and is believed to be an important enzyme related to colorectal cancer (CRC). Existing evidence suggests that COX-2 expression is normally suppressed by wild-type p53 but not mutant p53, suggesting that loss of p53 function may result in the induction of COX-2 expression. The aim of this study was to determine the relationship between COX-2 expression and p53 levels in CRC. MATERIALS AND METHODS: Patients with sporadic colorectal adenocarcinoma (n=161) who underwent curative surgery in Chosun University Hospital were enrolled in this study. Expression of COX-2 and p53 proteins was examined by immunohistochemistry in paraffin-embedded cancer tissue blocks, and the relationship between COX-2 and/or p53 expression with clinicopathologic parameters was analyzed. RESUTLS: Expression of COX- 2 was positive in 47.8% of colorectal cancers, and significantly associated with the depth of tumor invasion (p= 0.042). In contrast, p53 was positive in 50.3% of the cases, and was associated with both age (p=0.025) and the depth of tumor invasion (p=0.014). There was no correlation between COX-2 expression and p53 expression (p=0.118). CONCLUSION: These results suggest that COX-2 expression might play an important role in the progression of colorectal cancer. However, COX-2 expression was not associated with mutational p53. Further studies are needed to clarify the regulatory mechanisms governing COX-2 overexpression in colorectal cancers.
Adenocarcinoma/*metabolism/pathology/surgery ; Aged ; Colorectal Neoplasms/*metabolism/pathology/surgery ; Cyclooxygenase 2/*metabolism ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Mutation ; Tumor Suppressor Protein p53/genetics/*metabolism

Adenocarcinoma ; metabolism ; pathology ; surgery ; Adenoma ; metabolism ; pathology ; surgery ; Adult ; Aged ; Colorectal Neoplasms ; metabolism ; pathology ; surgery ; Female ; Humans ; Intestinal Mucosa ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Receptors, CXCR ; metabolism ; Young Adult

OBJECTIVETo assess the influence of laparoscopic colorectal cancer resection on the peritoneal microstructure injury and expression of t-PA/PAI-1 molecules.

METHODSA total of 50 patients with colorectal cancer were prospectively enrolled between June 2011 and February 2012 in the Shanxi Provincial Hospital and were assigned into laparoscopic group (LO, n=27) and conventional laparotomy group (CO, n=23) based on patients expectancy and surgeon decision. Optical microscope and scanning electron microscope were employed for comparison of the postoperative peritoneal injury between LO and CO. Before and after surgery, t-PA and PAI-1 of peritoneal tissue were determined by ELISA in both groups.

RESULTSOptical microscope and scanning electronic microscopy scan indicated less serosal injury in LO group than that in CO group with regard to serosa integrity, continuity of covering adipocytes and mesothelial cells, and the aggregation level of inflammatory cells (P<0.01). The injury score was 38.22 in CO in and 14.67 in LO and the difference was statistically significant (P<0.01). No significant differences were found between LO and CO in terms of postoperative t-PA in the omentum, t-PA and PAI-1 in the intestinal serosa tissue (P>0.05), however PAI-1 in the omentum was significantly lower in LO group compared to CO group (P<0.05).

CONCLUSIONLaparoscopic radical resection for colorectal cancer causes less peritoneal structural injury and less influence on the fibrinolytic capacity, which may contribute to less postoperative adhesion.

Adolescent ; Adult ; Aged ; Colorectal Neoplasms ; metabolism ; surgery ; Colorectal Surgery ; adverse effects ; methods ; Female ; Humans ; Laparoscopy ; adverse effects ; Male ; Middle Aged ; Peritoneum ; metabolism ; pathology ; Plasminogen Activator Inhibitor 1 ; metabolism ; Prospective Studies ; Tissue Plasminogen Activator ; metabolism ; Young Adult

Adaptor Proteins, Signal Transducing ; metabolism ; Adenocarcinoma, Clear Cell ; genetics ; metabolism ; pathology ; surgery ; Adenosine Triphosphatases ; metabolism ; Age Factors ; Carcinoma, Endometrioid ; genetics ; metabolism ; pathology ; surgery ; Colorectal Neoplasms, Hereditary Nonpolyposis ; genetics ; metabolism ; pathology ; surgery ; Cystadenocarcinoma, Serous ; genetics ; metabolism ; pathology ; surgery ; DNA Mismatch Repair ; DNA Repair Enzymes ; metabolism ; DNA-Binding Proteins ; metabolism ; Endometrial Neoplasms ; genetics ; metabolism ; pathology ; surgery ; Female ; Humans ; Mismatch Repair Endonuclease PMS2 ; MutL Protein Homolog 1 ; MutS Homolog 2 Protein ; metabolism ; Neoplasms, Multiple Primary ; genetics ; metabolism ; pathology ; surgery ; Nuclear Proteins ; metabolism

OBJECTIVETo study the expression and significance of PLAC1/CP1 genes in patients with primary colorectal carcinoma.

METHODSThe expression of PLAC1/CP1 genes in 97 cases of colorectal carcinoma was studied using tissue chip technology and immunohistochemistry.

RESULTSThe rate of PLAC1/CP1 proteins expression in the cases studied was 56.7% (55/97), with 27.8% (27/97) being nuclear staining and 43.3% (42/97) being cytoplasmic staining. The percentage of expression was higher in women than in men (χ(2) = 6.567, P = 0.010). The expression in poorly differentiated colorectal carcinoma was significantly higher than that in the well or moderately differentiated carcinoma (χ(2) = 8.321, P = 0.016). The expression was also significantly higher in stage TNM III or IV tumors than in stage TNM I or II tumors (χ(2) = 18.726, P = 0.000). The rate was higher in cases with lymph node metastasis than in those with negative lymph nodes (χ(2) = 17.407, P = 0.000), and was higher as the number of metastasis increasing (χ(2) = 22.632, P = 0.000).

CONCLUSIONThe expression of PLAC1/CP1 genes correlates with various clinical and pathologic parameters. It carries prognostic significance and may represent a potential target for immunotherapy.

Adenocarcinoma ; metabolism ; pathology ; surgery ; Adult ; Aged ; Aged, 80 and over ; Cell Nucleus ; metabolism ; Colorectal Neoplasms ; metabolism ; pathology ; surgery ; Cytoplasm ; metabolism ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Pregnancy Proteins ; metabolism ; Sex Factors

Basaloid squamous cell carcinoma is a rare and aggressive variant of squamous cell carcinoma, which mostly occurs in the upper aerodigestive tracts. Basaloid squamous cell carcinoma also typically arises in the anal canal, but is extremely rare in the lower gastrointestinal tract. A 70-year-old man presented with loose stool and intermittent hematochezia 2 months ago. Colonoscopy showed an ulceroinfiltrative mass on the rectosigmoid colon from 16 cm to 18 cm above the anal verge. Conventional colonoscope could not pass through the lesion but it was possible with pediatric colonoscope. Abdominal CT scan showed 1.6 cm sized wall thickening with circumferential luminal narrowing in the rectosigmoid colon and multiple ill-defined low density masses in both lobes of the liver. Therefore, colon cancer with liver metastasis was suspected. However, basaloid cells were noted on histologic examination, and they were weakly positive for synaptophysin on immunohistochemical study. After palliative lower anterior resection, histologic examination of the resected specimen revealed basaloid differentiation with keratin pearls, and tumor cells were positively stained with high molecular weighted cytokeratin (34BE12) and CK 5/6. Thus, the patient was finally diagnosed with basaloid squamous cell carcinoma of rectosigmoid colon with distant metastases.
Aged ; Carcinoma, Squamous Cell/*diagnosis/pathology/surgery ; Colonoscopy ; Colorectal Neoplasms/*diagnosis/pathology/surgery ; Humans ; Immunohistochemistry ; Keratins/metabolism ; Liver Neoplasms/radiography/secondary ; Lung Neoplasms/radionuclide imaging/secondary ; Male ; Positron-Emission Tomography ; Synaptophysin/metabolism ; Tomography, X-Ray Computed

OBJECTIVETo investigate the expression of miR-34a in stage II-III colorectal cancer and to elucidate its association with recurrence after radical resection.

METHODSmiR-34a expression level was detected in colorectal cancer patients with recurrence (40 cases) and without recurrence (40 cases) within 3 years after radical operation by real-time RT-PCR.

RESULTSNo association was observed between miR-34a and gender, age, location, local invasion, lymph node metastasis, cancer embolus, or tissue differentiation (all P>0.05). The expression level of miR-34a was lower in patients with recurrence compared to those without recurrence after radical surgery (P=0.039). Univariate analysis indicated that the median disease-free surviva l(DFS) of patients with low expression of miR-34a was worse as compared to those with high miR-34a expression (13.4 vs. 18.4 months, P=0.010), especially for stage III (P=0.003). In the recurrence group, the median DFS of patients with low miR-34a expression (n=14) was 13.4 months, which was shorter than that of patients with high miR-34a expression (n=26, 18.4 months, P=0.037). Multivariate analysis showed that miR-34a expression was an independent factor for colorectal cancer recurrence (RR=0.397, 95%CI:0.205-0.768, P=0.006).

CONCLUSIONThe down-regulated expression of miR-34a in colorectal cancer patients is associated with recurrence after radical operation. miR-34a may be a marker to predict tumor recurrence and metastasis of colorectal carcinoma.

Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; metabolism ; pathology ; surgery ; Down-Regulation ; Female ; Humans ; Lymphatic Metastasis ; Male ; MicroRNAs ; metabolism ; Middle Aged ; Neoplasm Recurrence, Local ; Postoperative Period ; Prognosis

OBJECTIVETo investigate the clinicopathological characteristics of colorectal neuroendocrine neoplasms (NENs) and the prognostic significance of the new WHO classification and staging system about gastroenteropancreatic NENs.

METHODSThe clinical and pathological records were reviewed in 73 patients with colorectal NENs (carcinoids). All slides were retrieved and reviewed, immunohistochemical staining (EnVision method) was performed and follow-up information retrieved.

RESULTSForty-one men and thirty-two women were included with a median age of 53 years (19 - 79 years). The location of the primary tumors in 65 patients was within 10 cm from the anorectal line. In 45 cases, the tumor diameter was ≤ 1 cm (no metastasis occurred); in 11 cases, the tumor diameter was > 1 cm but ≤ 2 cm (two patients had metastatic tumors); in 17 cases, the tumor diameter was > 2 cm (12 patients had metastatic tumors). The metastatic rate was significantly correlated with tumor size (P = 0.000). All tumors were immunoreactivity for synaptophysin and/or chromogranin A. According to the criteria of WHO classification and staging system about gastroenteropancreatic NENs, there were 65 cases of neuroendocrine tumors, including 51 cases of grade 1 (G1), 14 cases of grade 2 (G2), 4 cases of neuroendocrine carcinoma (G3) and 4 cases of mixed adenoneuroendocrine carcinoma. Following-up data showed that of the 34 patients with G1 tumor, there were no tumor-related death, but two patients showed metastases, and the remaining patients were disease free for 6 to 179 months. Of the 12 patients with G2 tumors, five developed metastasis, there were two tumor-related deaths, and the nine surviving patients were alive for 17 to 118 months. Of the four G3 patients, all developed metastasis and there were three tumor-related deaths. Of the four mixed adenoneuroendocrine carcinoma there were two tumor-related deaths. The difference of metastatic rate, tumor-related mortality, and overall survival among different grading groups in this series was statistically significant (P = 0.000).

CONCLUSIONSColorectal neuroendocrine neoplasm is a group of tumors with distinct prognostic difference, and most of these tumors show an indolent clinical behavior. There is a good correlation between the new WHO classification and staging system of gastroenteropancreatic NENs and their clinical behaviors.

Adult ; Aged ; Carcinoma, Neuroendocrine ; metabolism ; pathology ; radiotherapy ; secondary ; surgery ; Chromogranin A ; metabolism ; Colorectal Neoplasms ; metabolism ; pathology ; radiotherapy ; surgery ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; secondary ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Invasiveness ; Neuroendocrine Tumors ; metabolism ; pathology ; radiotherapy ; secondary ; surgery ; Survival Rate ; Synaptophysin ; metabolism ; Tumor Burden ; Young Adult

OBJECTIVE: To explore the clinicopathologic and molecular characteristics of hereditary nonpolyposis colorectal cancer (HNPCC), and to improve the level of diagnosis and treatments of HNPCC. METHODS: Thirty HNPCC patients (HNPCC group) who were treated in Xiangya Hospital were retrospectively analyzed, and 25 patients with sporadic colorectal cancer in the same duration were randomly chosen as a control group. The onset of age, location of tumor, pathological type, treatment method, and prognosis were compared in the 2 groups. The expression loss rate of mismatch repair gene (MMR) MLH1 and MSH2 in the 2 groups was detected by immunohistochemistry. RESULTS: The onset age in the HNPCC group was earlier than that in the control group (P<0.05). The rate of proximal colonic tumor the occurrence of multiple tumors, and the proportion of well differentiated adenocarcinoma in the HNPCC group were all higher than those in the control group (P<0.05). The expression loss rate of MLH1 and MSH2 in the HNPCC group was higher than that in the control group (P<0.05). One third in the HNPCC group received subtotal proctocolectomy. The prognosis of HNPCC patients was comparable with that of patients with sporadic colorectal cancer (P>0.05). CONCLUSION HNPCC patients are characterized with early onset associating with multiple tumors. The accuracy of diagnosis can be improved by combining the detection of MMR gene. Optimal surgical treatment and close follow-up may bring good result to HNPCC patients.
Adaptor Proteins, Signal Transducing ; genetics ; metabolism ; Adenocarcinoma ; diagnosis ; genetics ; pathology ; surgery ; Aged ; Case-Control Studies ; Colorectal Neoplasms, Hereditary Nonpolyposis ; diagnosis ; genetics ; pathology ; surgery ; Endometrial Neoplasms ; pathology ; Female ; Humans ; Male ; Middle Aged ; MutL Protein Homolog 1 ; MutS Homolog 2 Protein ; genetics ; metabolism ; Mutation ; Neoplasms, Second Primary ; pathology ; Nuclear Proteins ; genetics ; metabolism ; Retrospective Studies

OBJECTIVETo investigate the minimal invasiveness of laparoscopic operation for colorectal carcinoma.

METHODSForty cases with pathologically proven colorectal carcinoma were divided into laparoscopic group (n=20) and open surgical group (n=20). Perioperative alterations of peripheral blood IL-6, IL-8, TNF-alpha, CRP, sICAM-1 and WBC CD11b were compared between the two groups. TNF-alpha, IL- 6, IL- 8 and sICAM-1 were determined by ELISA, CRP by scattered radiation turbidity comparison and WBC CD11b by flow cytometry with monoclonal antibody PS- CD11b, M2Ab.

RESULTSThe postoperative cytokine levels of TNF-alpha, IL-6 and IL-8 in open surgery group were significantly higher than those in laparoscopic group (P< 0.05). Dynamic level of sICAM-1 at 6 and 24 hours after operation in open surgery group were significantly higher than those in laparoscopic group. Peripheral WBC CD11b decreased to the lowest level at 6 hours after operation in open surgery group,significantly lower than that in laparoscopic group (P< 0.05).

CONCLUSIONLaparoscopic surgery for colorectal carcinoma exerts less effects on patients than traditional open surgery, and can maintain patients defense function,therefore it is less invasive.

Aged ; C-Reactive Protein ; metabolism ; Colorectal Neoplasms ; blood ; pathology ; surgery ; Female ; Humans ; Intercellular Adhesion Molecule-1 ; blood ; Interleukin-6 ; blood ; Interleukin-8 ; blood ; Laparoscopy ; Male ; Middle Aged ; Postoperative Period ; Tumor Necrosis Factor-alpha ; blood