Objective To explore the risk factors of ulcerative colitis-associated colorectal cancer (UC-CRC).Methods The retrospective case-control study was conducted.The clinicopathological data of 536 patients with ulcerative colitis (UC) who were admitted to the Henan Tumor Hospital from March 2004 to June 2015 were collected.Observation indicators:(1) follow-up results:cases with follow-up,follow-up time,cases of UC-CRC,age of onset,pathological type of UC-CRC;(2) risk factors analysis affecting occurrence of UC-CRC:gender,age of onset,course of disease,severity of disease,disease classification,extent of lesion,smoking history,family history of colorectal cancer,anemia,hypoproteinemia,body weight loss,extraintestinal manifestations,colonic polyps,backwash ileitis,atypical hyperplasia,anxiety or depression,treatment method and regular endoscopy reexamination.Follow-up using outpatient examination and telephone interview was performed to detect prognosis of patients up to April 2017.Patients underwent colonoscopy once every 6 months within 3 years after diagnosis and once every 1 year after 3 years.Measurement data with skewed distribution were described as M (range).The univariate analysis was done using the chi-square test and Fisher exact probability.The multivariate analysis was done using the Logistic regression model.Results (1) Follow-up results:of 536 patients,450 were followed up for 26.0-120.0 months,with a median time of 76.4 months.During the follow-up,16 patients were complicated with UC-CRC,including 9 males and 7 females.Age of onset of colorectal cancer was 14-78 years,with an average age of onset of 44 years.Pathological type:high-differentiated right colon adenocarcinoma was detected in 5 patients,high-and moderate-differentiated left colon adenocarcinoma in 3 patients,left colon signetring cell carcinoma in 2 patients,moderate-differentiated rectal tubular adenocarcinoma in 3 patients,highdifferentiated rectal papillary adenocarcinoma in 2 patients and malignant lymphoma in 1 patient.(2) Risk factors analysis affecting occurrence of UC-CRC:the results of univariate analysis showed that course of disease,extent of lesion,colonic polyps and atypical hyperplasia were risk factors affecting occurrence of UC-CRC (x2 =14.848,18.885,10.554,P＜0.05).The results of multivariate analysis showed that course of disease ＞ 10 years,lesion involving the whole colon,colonic polyps and atypical hyperplasia were independent risk factors affecting occurrence of UC-CRC (OR=12.893,17.847,7.326,19.742,95％ confidence interval:1.726-74.337,1.445-89.793,1.263-43.128,3.625-96.524,P＜0.05).Conclusion The course of disease ＞ 10 years,lesion involving the whole colon,atypical hyperplasia and colonic polyps are independent risk factors affecting occurrence of UC-CRC.

Objective To evaluate the result of early repair for urinary fistula caused by iatrogenic injury to ureter,bladder and urethra during resection of rectal cancer.Methods We retrospectively analyzed 26 cases of urinary fistula after resection of rectal cancer patients encountered in Department of General Surgery,Henan Tumor Hospital from October 2005 to May 2016.Urinary fistula was divided into four types according to the site of fistula.Results Surgery was performed ever after the diagnosis of the fistula was identified.In type Ⅰ fistula (6 cases of posterior urethral fistula) the treatment was stent placement and packing of the greater omentum.2 cases of bladder top fistula (type Ⅱ),were treated by fistula repair and cystostomy.Type Ⅲ involved 12 cases (bladder triangle fistula).The treatment was ureter stenting replantation,and cystostomy Type Ⅳ:ureteral fistula in 6 cases,the treatment was end-to-end anastomosis and stenting.After surgery 24 cases were cured and 2 cases (all of type Ⅲ fistula) ended up with permanent bilateral ureterocutaneostomy.Conclusion It is safe and effective to make early remedy repair for ureter,bladder and urethral fistula iatrogenically during rectal cancer resection.

Objective:To retrospectively analyze related factors of subtype transformation and to identify prognostic factors for pa-tients with retroperitoneal liposarcoma (RPLS). Methods:This study retrospectively analyzed the clinical data of 92 patients with RPLS, which were confirmed by postoperative pathology from July 1997 to October 2014 in Henan Provincial Tumor Hospital. Related studies were reviewed, and the prognoses were followed up. The factors may affect subtype transformation or prognoses were applied to the statistical analysis. Results:A total of 74 patients with RPLS were included according to the recruiting standard. The 5-year survival rate was 48.65%. Lobulated tumors (P=0.013) were the correlative factors that influenced subtype transformation. The Log-rank test showed that the age at diagnosis (P=0.045), multi-visceral resection (P=0.042), tumor necrosis (P<0.001), subtype transformation (P<0.001), and malignant level of pathological subtypes of the first operation (P<0.001) influenced overall survival. Multivariate Cox re-gression analysis showed that tumor necrosis and the malignant level of the initial histological grade were independent factors of over-all survival. Conclusion:Lobulated tumors are likely to transform the subtype. The prognosis of patients with RPLS is correlated with multi-visceral resection, tumors necrosis, subtype transformation, and the malignant level of pathological subtypes of the first opera-tion. Multi-visceral resection could not improve the 5-year survival rate of RPLS, and adjuvant therapy could not improve the prognosis.

Objective To evaluate a novel lymph node (LN) sorting method on surgical resected sample guided by nanometer carbon staining and principle following the supplying artery tributory in rightsided colon carcinoma.Methods From May 2015 to June 2016,51 patients were randomly divided into two groups adopting traditional LN sorting method and that of a combination of nanometer carbon and artery guided.The final LN status were compared between the 2 groups.Results The total LN number and the positive LN in novel method group were higher than control group (437 vs.349,70 vs.54).The dissection time used,the number of harvested positive LN that was ＜ 5 mm were significantly different [(13.1 ± 3.2) minvs.(17.8 ±3.8)min,t=4.75,P=0.000;1.0±l.0vs.0.2 ±0.6,t=3.51,P=0.000].The number of patients with harvested LN less than 12,the rate of positive lymph nodes,the rate of metastasis were not significantly different (all P ＞ 0.05) between the two groups.Conclusions Use of nanometer carbon development combined with artery approach facilitates LN sorting,yielding more positive LNs,and increating the accuracy of pathological staging in right-sided colon cancer.

OBJECTIVETo explore the technical advantages of nano carbon development combined with artery approach in lymph node sorting of rectal cancer.

METHODSFrom December 2015 to June 2016, 70 patients with of rectal cancer in General Surgery Department of Henan Cancer Hospital were randomly divided into nano carbon development combined with artery approach group(artery approach group) and conventional group. Specimen of artery approach group was placed on the sorting table. Anatomy was performed from the root of inferior mesenteric artery to left colonic artery, sigmoid artery and superior rectal artery. Along the arterial vessel shape, the black-stained lymph nodes and non-stained lymph nodes (perhaps pink, pale yellow, white or pale brown) were examined carefully using visual and haptic combination method for identification of lymph node. From the root of inferior mesenteric artery, central lymph nodes were sorted. Along the vessel shape, vascular lymph nodes were sorted. Intestinal lymph nodes around the rectum were examined as well. Then, specimen was reversed on the sorting table and underwent sorting as above after the examination of obverse. The conventional group received routine method. The total number, the average harvested number, the number of positive lymph nodes and the number of patients with lymph nodes less than 12 were compared between two groups.

RESULTSAmong 70 cases, 37 were male and 33 were female with the median age of 57(32-88) years old. Dixon resection was performed in 46 cases, and Miles resection in 24 cases. Total sorting lymph node was 1 105, including 641 of artery approach group and 464 of control group with significant difference (t=20.717, P=0.000). Lymph node sorting time of artery approach group was (12.6±3.9) minutes, which was shorter than (18.2±4.1) minutes of control group (t=12.464, P=0.000). In artery approach group, number of lymph node with diameter less than 5 mm was 142, sorting rate was 22.2%(142/641), of which 29 were positive(20.4%). In conventional group, 37 lymph nodes with diameter less than 5 mm were found, and sorting rate was 8.0%(37/464), of which 6 were positive(16.2%). Number of the first station of lymph node sorting in artery approach group and conventional group was 282(44%) and 169(36.4%); number of the second station lymph node sorting was 230(35.9%) and 180(38.8%); number of the third station lymph node sorting was 129(20.1%) and 115(24.8%).

CONCLUSIONThe method of nano carbon development combined with artery approach in lymph node sorting of rectal cancer has some advantages, such as simple operation, more harvested lymph nodes, and more accurate pathological staging.

OBJECTIVETo explore the application of three-stitch preventive transverse colostomy in anterior resection of low rectal cancer.

METHODFrom May 2015 to March 2016, 70 consecutive low rectal cancer patients undergoing anterior resection and preventive transverse colostomy in our department were recruited in this prospective study. According to the random number table method, 70 patients were divided into three-stitch transverse colostomy group(observation group, n=35) and traditional transverse colostomy group(control group, n=35). Procedure of three-stitch preventive transverse colostomy was as follows: firstly, at the upper 1/3 incision 0.5-1.0 cm distance from the skin, 7# silk was used to suture from outside to inside, then the needle belt line went through the transverse edge of the mesangial avascular zone. At the lower 1/3 incision 0.5-1.0 cm distance from the skin, 7# silk was used to suture from inside to outside, then silk went through the transverse edge of the mesangial avascular zone again and was ligatured. Finally, in the upper and lower ends of the stoma, 7# silk was used to suture and fix transverse seromuscular layer and the skin. The operation time and morbidity of postoperative complications associated with colostomy were compared between two groups.

RESULTSThere were no significant differences in baseline data between the two groups(all P>0.05). The operative time of observation group was shorter than that of control group [(3.2±1.3) min vs. (15.5±3.4) min, P<0.05]. Incidences of colostomy skin-mucous separation, dermatitis, stoma rebound were significantly lower in observation group [5.7%(2/35) vs. 34.3%(12/35), P=0.007; 8.6%(3/35) vs. 31.4%(11/35), P=0.036; 0 vs. 17.1%(6/35), P=0.025, respectively], while incidences of parastomal hernia and stoma prolapse in two groups were similar (both P>0.05).

CONCLUSIONCompared with traditional transverse colostomy method, the three-stitch preventive transverse colostomy has more operating advantages and can reduce postoperative complications associated with colostomy.

Colostomy ; adverse effects ; methods ; Comparative Effectiveness Research ; Humans ; Operative Time ; Postoperative Complications ; epidemiology ; Prospective Studies ; Rectal Neoplasms ; surgery ; Surgical Stomas ; adverse effects ; Suture Techniques ; adverse effects ; instrumentation ; Sutures ; Treatment Outcome

Objective:To investigate the effect of neoadjuvant chemotherapy on the prognosis of gastric neuroendocrine cancer.Methods:This study included 102 patients with gastric neuroendocrine cancer, the disease-free survival rate (DFS) and overall survival rate (OS) were compared between two groups according whether they were given neoadjuvant chemotherapy before radical resection.Results:Ninteen of the 102 patients received neoadjuvant chemotherapy combined with surgery, while the other 83 patients received upfront surgery . The 1-year survival rate of the direct operation group and the NAC group was 83.0% and 51.8%, respectively, and the 3-year survival rate was 63.0% and 33.3%, respectively ( χ2=9.182, P=0.002). The 1-year disease-free survival rate was 80.4% and 38.5%, respectively, and the 3-year disease-free survival rate was 59.8% and 25.7%, respectively ( χ2=11.142, P=0.001). Subgroup analysis showed that the difference between the two groups was mainly significant between MANEC patients ( χ2=10.742, P=0.001). Multivariate analysis showed that neoadjuvant therapy was an independent risk factor affecting the overall survival rate (all P<0.05). Univariate analysis shows that only adjuvant chemotherapy is the risk factor affecting disease-free survival ( P<0.05). When the neoadjuvant chemotherapy and the direct surgery were matched 1∶1, the OS and DFS of the direct surgery group were better than those of the NAC patients ( χ2=4.014, 3.954; P=0.045, 0.047). Conclusion:Neoadjuvant chemotherapy failed to improve the prognosis of patients with gastric neuroendocrine cancer/MANEC.

Objective:To study the effects of miR-128-3p on the migration and invasion of the gastric cancer cells.Methods:qRT-PCR was used to detect the expression of miR-128-3p in 126 gastric cancer tissues and adjacent tissues from Jan 2014 to Jan 2016 at He'nan Cancer Hospital. The effect of miR-128-3p on the invasion and migration of gastric cancer cell line was detected.The expression of miR-128-3p related proteins was detected by Western blotting, miRNA on-line target prediction tool for the prediction of miR-128-3p directly regulated downstream target genes.Results:the expression of miR-128-3p in gastric cancer was significantly higher than that in adjacent non-tumor tissues ( P<0.05). The expression of miR-128-3p was correlated with the vascular tumor thrombus, pN staging and pTNM staging, the prognosis of patients with high expression of miR-128-3p was poor (all P<0.05). MiR-128-3p expression was significantly higher in gastric cancer cell lines ( P<0.05). Online target prediction tool and double luciferase reporter gene showed that CLDN18 was a downstream target gene directly regulated by mir-128-3p. Conclusion:The high expression of miR-128-3p is related to the poor prognosis of gastric cancer patients.

Objective:To explore the prognostic value of combined fibrinogen/albumin ratio (FAR) and CA724 in patients with stage Ⅱ/Ⅲ gastric cancer after radical resection.Methods:A total of 932 patients were enrolled in the study, and the best cut-off values of CEA, FAR, NLR and other variables were obtained through ROC curve analysis. According to the FAR-CA724 score, patients were divided into 3 groups: FAR-CA724=0 (CA724<3.43 ng/ml and FAR<0.083), FAR-CA724=1 (CA724≥3.43 ng/ml and FAR≥0.083) and FAR-CA724=2 (CEA≥3.43 ng/ml and FAR≥0.083).Results:After FAR-CA724 grouping, the patient's age (χ 2=12.02, P=0.002), gender (χ 2=15.91, P<0.001), tumor size (χ 2=18.22, P<0.001), hypertension (χ 2=6.35, P=0.042), tumor location (χ 2=26.09, P<0.001), degree of differentiation (χ 2=12.46, P=0.002) and pTNM staging (χ 2=6.68, P=0.035) are significantly different. Survival analysis showed that there were significant differences in OS between the three groups of patients (FAR-CA724=0, 1, and 2: 88.2%, 64.3% and 37.8%, respectively, P<0.001). By multivariate analysis FAR-CA724 is an independent risk factor affecting OS in patients with stage Ⅱ/Ⅲ gastric cancer after radical surgery. Conclusions:Preoperative FAR-CA724 may be a potential blood marker for predicting the prognosis of GC patients.

Objective To investigate the effect of the first surgical treatment on progression-free survival (PFS)time of retroperitoneal liposarcoma and the prognosis.Methods We analyzed the clinical data of 74 cases of retroperitoneal liposarcoma from 1998 to 2016 in He'nan Cancer Hospital (Zhengzhou University Affiliated Tumor Hospital Department of General Surgery).Results The results demonstrated that progression-free survival time of the first surgical resection of retroperitoneal liposarcoma in patients related with tumor necrosis (P ＜ 0.001),lobulated tumor (P ＜ 0.001),symptoms (P =0.013),Ro resection (P =0.003),distant metastasis (P =0.028),postoperative chemotherapy (P =0.006) and tumor differentiation (P ＜ 0.001).Progression-free survival time was not correlated with gender,age of first diagnosis,the invasion of adjacent organs,tumor size,operation time and combined organ resection (all P＞0.05).The rate of 1-year,3-year,5-year survival time attached to PFS≤24 m and PFS ＞24 m were 93.7％ vs.94.7,90.5％ vs.80.9％,58.4％ vs.74.8％(P=0.111).Conclusion The first attempt of radical resection determines progression-free survival of retroperitoneal liposarcoma,however,patients' PFS was not related with their overall survival.