Objective To explore the relationship between D-dimer and carcinoembryonic antigen (CEA) levels before treatment and clinicopathologic features of colorectal cancer and the value of prognosis. Methods A total of 209 patients who underwent radical colorectal cancer surgery in Wujin Hospital Affiliated of Jiangsu University from January 2017 to December 2018 were selected as the study objects. D-dimer and CEA levels were detected before treatment,and their relationship with clinicopathologic features and prognosis were analyzed. Results Before treatment,D-dimer was correlated with tumor site (P<0.001),pathological type (P=0.007),depth of invasion (P<0.001),lymph node metastasis (P=0.007) and tumor stage (P<0.001). CEA was associated with pathological type (P<0.001) and tumor stage (P=0.035). The postoperative tumor-free survival rate (x2=21.659,P<0.001) and overall survival rate (x2=22.887,P<0.001) in patients with both D-dimer and CEA positive expression before treatment were significantly lower than those in patients without both positive expression. The area under the curve for predicting overall survival of colorectal cancer patients with both D-dimer and CEA positive before treatment was 0.723. Pearson correlation analysis showed a positive correlation between D-dimer and CEA in colorectal cancer patients before treatment (r=0.144,P=0.037). Cox proportional risk regression analysis showed that simultaneous positive D-dimer and CEA,lymph node metastasis and distant metastasis were independent risk factors affecting postoperative tumor-free survival and overall survival of colorectal cancer patients (P<0.05). Conclusion D-dimer and CEA before treatment are of great value in the diagnosis and prognosis of colorectal cancer,and the combination of D-dimer and CEA has a definite effect on the accuracy of postoperative survival assessment of colorectal cancer.

Objective To explore the relationship between D-dimer and carcinoembryonic antigen (CEA) levels before treatment and clinicopathologic features of colorectal cancer and the value of prognosis. Methods A total of 209 patients who underwent radical colorectal cancer surgery in Wujin Hospital Affiliated of Jiangsu University from January 2017 to December 2018 were selected as the study objects. D-dimer and CEA levels were detected before treatment,and their relationship with clinicopathologic features and prognosis were analyzed. Results Before treatment,D-dimer was correlated with tumor site (P<0.001),pathological type (P=0.007),depth of invasion (P<0.001),lymph node metastasis (P=0.007) and tumor stage (P<0.001). CEA was associated with pathological type (P<0.001) and tumor stage (P=0.035). The postoperative tumor-free survival rate (x2=21.659,P<0.001) and overall survival rate (x2=22.887,P<0.001) in patients with both D-dimer and CEA positive expression before treatment were significantly lower than those in patients without both positive expression. The area under the curve for predicting overall survival of colorectal cancer patients with both D-dimer and CEA positive before treatment was 0.723. Pearson correlation analysis showed a positive correlation between D-dimer and CEA in colorectal cancer patients before treatment (r=0.144,P=0.037). Cox proportional risk regression analysis showed that simultaneous positive D-dimer and CEA,lymph node metastasis and distant metastasis were independent risk factors affecting postoperative tumor-free survival and overall survival of colorectal cancer patients (P<0.05). Conclusion D-dimer and CEA before treatment are of great value in the diagnosis and prognosis of colorectal cancer,and the combination of D-dimer and CEA has a definite effect on the accuracy of postoperative survival assessment of colorectal cancer.

Objective To discuss the effect of main organ-preserving pancreatectomy operations on the postoperative complications and the long-term quality of life.Methods The clinical data of 320 patients undergoing pancreatic surgery from January 2013 to December 2016 in the First Affiliated Hospital of Soochow University were retrospectively analyzed and all the patients were divided into traditional pancreatectomy surgery group and organ-preserving pancreatectomy surgery group.The traditional pancreatectomy surgery group included pancreaticoduodenectomy (PD),distal pancreatectomy (DP),and laparoscopic distal pancreatectomy (LDP);and the organ-preserving pancreatectomy surgery group included pylorus-preserving pancreaticoduodenectomy (PPPD),spleen-preserving distal pancreatectomy (SPDP),enucleation pancreatectomy (EP),and middle-preserving pancreatectomy (MSP).Face to face clinic visit or telephone follow-up was scheduled every three months until May 31,2017.The operation time,intraoperative hemorrhage,intraoperative blood transfusion,postoperative complications (hemorrhage,pancreatic fistula,biliary fistula,abdominal infection,delayed gastric emptying),postoperative hospitalization stay,secondary surgery and the survival status within 30 days after surgery,the pancreatic endocrine function,exocrine function and the long-term quality of life were recorded.Results The operation time,intraoperative hemorrhage and intraoperative blood transfusion were not statistically different between PD and PPPD groups,DP and SPDP groups,LDP and LSPDP groups,DP and MSP groups,and DP and EP groups,respectively (all P values ＞0.05).Compared with MSP group,the hospitalization time in DP group was shorter [(18.61 ±12.46)d vs (26.88 ± 15.22)d],the occurrence rate of postoperative pancreatic fistula (24.07％ vs 56.25％),bleeding (3.70％ vs 25.00％),abdominal infection (1.85％ vs 18.75％),delayed gastric emptying (5.56％ vs 31.25％),secondary surgery (0 vs 25.00％),and glycemic control rate were decreased (27.78％ vs 0),and all the differences were statistically significant (all P values ＜ 0.05).After discharge,the incidence of chronic diarrhea in the PD group was higher than that in the PPPD group (17.31％ vs 2.08％).The fatigue in the DP group was higher than that in the SPDP,MSP and EP groups,and fatigue,social function,overall health score of the LDP group were lower than those in LSPDP group;emotional function in the DP group was better than that in MSP group,and all the differences were statistically significant (all P values ＜ 0.05).Conclusions The organ-preserving pancreatectomy can reduce the trauma of the operation,postoperative complications and postoperative pancreatic endocrine and exocrine dysfunction,and improve the long-term quality of life.