INTRODUCTIONPreoperative staging is essential for the optimal treatment and surgical planning of colorectal cancers. This study was aimed to evaluate the accuracy of colorectal cancer staging done using contrast-enhanced multidetector computed tomographic colonography (CEMDCTC).

METHODSWe recruited 25 patients with 28 proven colorectal cancers. A 16-slice multidetector computed tomography scanner was used to generate two-dimensional multiplanar reformatted sagittal, coronal and oblique coronal images, and three-dimensional virtual colonography (endoluminal) images. Axial and reformatted views were analysed, and TNM staging was done. Patients underwent surgery and conventional colonoscopy, and surgical histopathological correlation was obtained.

RESULTSThe diagnostic accuracies for TNM colorectal cancer staging were 92.3% for T staging, 42.3% for N staging and 96.1% for M staging using CEMDCTC. There was excellent positive correlation for T staging between CEMDCTC and both surgery (κ-value = 0.686) and histopathology (κ-value = 0.838) (p < 0.0001), and moderate positive correlation for N staging between CEMDCTC and surgery (κ-value = 0.424; p < 0.0001). The correlation between CEMDCTC and histopathology for N staging was poor (κ-value = 0.186; p < 0.05); the negative predictive value was 100% for lymph node detection. Moderate positive correlation was seen for M staging between CEMDCTC and both surgery (κ-value = 0.462) and histopathology (κ-value = 0.649). No false negatives were identified in any of the M0 cases.

CONCLUSIONCEMDCTC correlated well with pathologic T and M stages, but poorly with pathologic N stage. It is an extremely accurate tool for T staging, but cannot reliably distinguish between malignant lymph nodes and enlarged reactive lymph nodes.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Colonography, Computed Tomographic ; methods ; standards ; Colorectal Neoplasms ; diagnosis ; pathology ; surgery ; Contrast Media ; Female ; Humans ; Lymph Nodes ; pathology ; Male ; Middle Aged ; Multidetector Computed Tomography ; standards ; Neoplasm Staging ; methods ; Prospective Studies ; Reproducibility of Results ; Young Adult

Objective: To investigat the mechanism of antitumor efficacy of Origanum dayi (O. dayi) and Ochradenus baccatus (O. baccatus) extracts by exploring apoptosis-inducing potential. Methods: The aqueous extracts of aerial parts of aforementioned plants were prepared and used for this study. HepG2 cells were treated with varying concentrations (0, 2 and 5 mg/mL) of each plant extract for 24 or 48 h. Cell apoptosis was measured by annexin V-fluorescein isothiocyanate binding assay and flow cytometry. The expression levels of various apoptosisrelated genes were determined by semi-quantitative reverse transcription-polymerase chain reaction. Results: O. dayi and O. baccatus extracts exerted apoptotic effects on HepG2 cells for 48 h following treatment. O. dayi extract was found to be a better apoptosis-inducing agent than O. baccatus extract as the former delivered greater efficacy at a lower concentration. Both extracts manifested upregulation of Bax, Bad, cytochrome c, caspase-3, caspase-7, caspase-9 and poly (adenosine diphosphate-ribose) polymerase. Conclusions: The aqueous extracts of O. dayi and O. baccatus are capable of inducing apoptosis in HepG2 cells through modulation of mitochondrial pathway which explains their antitumor activities. These desert plants may serve as useful resources to develop effective remedies for hepatocellular carcinoma and other human malignancies.