Objective To summarize the clinical experience of interspineter resection in treating ultra-lower rectal tumor. Methods Twenty-six ultra-lower rectal tumor cases (24 cases of rectal cancer, 2 cases of giant villous adenoma) without extrasphincter involvement underwent total mesoreetal excision and interspineter resection. Partial, subtotal or total innerspineter resection was performed respectively for patients in which the tumor lower margin was over 2 cm, between 1 -2 cm, and less than 1.0 cm above thedentate line respectively. Alimentary tract continuity was constructed by end to end anastomsis of the colon and anus. Results The lower margin of tumor in 26 patients was within 0 - 3 cm above the dentate line.The pathology was highly differentiated in 6 cases and medium differentiated in 16 cases, papillary carcinoma in 2 cases, giant villous adenoma in 2 cases. There were 11 cases of stage Ⅰ , 8 of stage Ⅱ A, 4 of stage Ⅲ A, and 1 of stage Ⅲ B according to pTNM system; 8 cases of T1, 15 of T2, and 1 of T3 according to T stage criteria. There was no mortality nor major complications. Two cases suffered from anastomotic stricture. The stool seepage was common at early stage after surgery, with immediately postoperative daily defecation of 3 -10, and one year later, most patients were able to hold back the defecation impulse for more than 5 min, and have daily defecation of 0. 5 to 4 times. Occasional seepage was reported in one patient with total innersphincter resection. The average postoperative follow up was 28 months. One recurrence was found on the 5th month, one suffered from liver metastasis in the 10 month, and one died of cardiac arrest in 26 month. Conclusion To those patients with very lower rectal cancer restricted within rectal wall,interspincter resection fulfils curative purpose while preserving the anal function.

Objective To evaluate the value of spiral CT volume reconstruetion(VR) technique in high complex anal fistula fistulography. Methods To analyze retrospectively internal openings and secondary tracts of 35 eases with high complex anal fistula verified by operation and follow-up above 3 months with VR,and compared with operation and outcome of follow-up. Results In 35 eases with high complex anal fistula, for detection of the presence of internal openings ,VR has a sensitivity of 72.7% ,a specificity of 100% ,a accuracy of 74.3% ,a positive predictive value of 100% ,and a negative predictive value of 18.1%. Secondary tracts have a sensitivity of 93.8% ,a specificity of 100.0% ,a accuracy of 94.6% ,a positive predictive value of 100.0% ,and a negative predictive value of 72.7%. Conclusion VR can demonstrate the 3D shape of fistula and is reliable in the diagnosis of internal openings and sec-ondary ducts, and is very valuable in the analysis of high complex anal fistula fistulography.

OBJECTIVETo screen long non-coding RNA (lncRNA) associated with radiosensitivity in colorectal carcinoma cell lines.

METHODSColony formation assay was performed in colorectal cancer cell lines HT29, SW480, RKO, Lovo and HCT116 after irradiation with different radiation doses. Radiation sensitivity of these 5 cell lines was detected through survival fraction at 2 Gy (SF2 value). High-throughput lncRNA chip was used to screen lncRNA genes with expression differences more than 2 folds among SW480, RKO and Lovo. Further experiment on the expression differences of lncRNAs selected was conducted by realtime PCR.

RESULTSThe radiosensitivity order of these 5 cell lines from low to high (SF2 value from high to low) was HT29 (0.83 ± 0.03), SW480 (0.69 ± 0.02), RKO(0.53 ± 0.02), Lovo (0.47 ± 0.05), HCT116 (0.32 ± 0.03) (P < 0.01). Five lncRNAs associated with radiation sensitivity were screened. Among them, expression levels of R05532, NR_015441, and NR_033374 were positively correlated with radiation resistance(all P < 0.01), and expression levels of the other 2 lncRNAs, NR_073156 and AA745020, were not correlated with radiation resistance of colorectal cancer cells (both P>0.05).

CONCLUSIONSlncRNA R05532, NR_015441 and NR_033374 may be used as the predictive marker of radiosensitivity of colorectal cancer cells. Higher expression of these genes shows radiation resistance.

Cell Line, Tumor ; Colorectal Neoplasms ; genetics ; radiotherapy ; Humans ; Oligonucleotide Array Sequence Analysis ; RNA, Long Noncoding ; genetics ; Radiation Tolerance