Objective To study the operational techniques and feasibility of superior rectal artery preserving laparoscopic resection of sigmoid colon carcinoma.Methods From Jan 2015 to Nov 2016,85 patients with sigmoid colon carcinoma were divided into artery preserving group (27 cases) and traditional surgical group (58 cases).Results The mean operation time was (283 ± 51) min,the mean lymph node dissection was (15 ± 8) and the mean blood loss was (62 ± 17) ml in the artery preserving group.The mean operation time was (179 ±e63) min,the mean lymph node dissection was (15 ±7) and the mean blood loss was (67 ± 17) ml in the traditional surgery group.The number of resected lymph nodes and blood loss had no statistical significance between these two groups (t =0.058,P ＞0.05).Longer operating time were observed in the retained vascular group as compared to the traditional surgical group (t =7.530,P ＜ 0.05).There was no anastomotic fistula in the retained vascular group,however,two anastomotic fistula cases occurred in the traditional surgical group (x2 =0.043,P ＞ 0.05).Conclusions Preservation of superior rectal artery was safe and feasible for laparoscopic resection of sigmoid colon carcinoma.

OBJECTIVETo investigate the predictive value of serum CA125 in peritoneal metastasis, and to examine the association of CA125 with the prognosis.

METHODSClinical data of 1285 gastric cancer patients admitted to the Qilu Hospital from March 2003 to September 2008 were retrospectively reviewed. The sensitivity, specificity and accuracy of serum CA125 for peritoneal metastasis were analyzed. Clinicopathological characteristics and survival were compared between patients with normal serum CA125 level(≤35 μg/L) and patients with elevated serum CA125 level(>35 μg/L).

RESULTSThe specificity, sensitivity and accuracy of serum CA125 for peritoneal metastasis were 96.0%, 13.8% and 81.2%, respectively. A significantly higher incidence of peritoneal metastasis was observed in the patients with elevated serum CA125 level as compared to those with normal serum CA125 level(43.2% vs. 16.5%). CA125 was an independent predictor of peritoneal metastasis(RR=3.475, 95% CI:2.124-5.685). The 5-year overall survival rate in patients with elevated serum CA125 level was 13.5%, which was significantly lower than that of patients with normal serum CA125 level (49.8%, P<0.01). CA125 was an independent prognostic factor of gastric cancers(HR=2.049, 95%CI:1.355-2.873).

CONCLUSIONSerum CA125 is useful in predicting peritoneal metastasis and prognosis of gastric cancer, which should be used as a routine examination of gastric cancer patients.

CA-125 Antigen ; blood ; Humans ; Neoplasm Staging ; Peritoneal Neoplasms ; blood ; secondary ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; blood ; pathology ; Survival Rate

Objective To compare the esophageal acid and alkaline exposure characteristics of patients with cardia carcinoma after proximal gastrectomy or total gastrectomy.Method A total of 77 patients of cardia carcinoma who underwent radical resection from Sep 2007 to Sep 2011 in our hospital were retrospectively reviewed.24 hour esophageal pH monitoring were performed in all patients.Result Patients were divided into three groups:group TG had total gastrectomy (n =25),group PP had proximal gastrectomy with pyloroplasty (n =33),group NP had proximal gastrectomy (n =19).It revealed that indicators of acid reflux including the overall time length of acid episodes,＞ 5 min times of acid episodes,duration of longest acid episodes,time length of pH ＜ 4.00 and the DeMeester Scores in group NP were significantly higher than in group PP(U =32,P ＜ 0.01 ; U =35,P ＜ 0.01 ; U =23,P ＜ 0.01 ; U =39,P ＜0.01 ;U =49,P ＜0.01 respectively).Only alkline reflux was observed in group TG.The total times of alkaline episodes in PP group was significantly lower than in group TG(U =52,P ＜0.01) and group NP (U =182,P ＜0.01).＞5 min times of alkaline episodes in group TG was larger than in group PP,and that in group PP was larger than in group NP(P ＜0.01).Duration of longest alkaline episodes and total period of pH ＞7.00 in group PP was significantly higher than in group TG(U =125,P ＜ 0.01 ; U =143.5,P ＜ 0.01),and that in group TG was higher than in group NP(U =23.5,P ＜ 0.01 ; U =14,P ＜ 0.01).Conclusions Alkaline reflux deserves more attention in evaluating esophageal reflux in patients with cardia carcinoma after resection.Pyloroplasty is not helpful to relieving esophageal acid episodes while causing severe alkaline reflux.

Objective To investigate the predictive value of serum CA125 in peritoneal metastasis, and to examine the association of CA125 with the prognosis. Methods Clinical data of 1285 gastric cancer patients admitted to the Qilu Hospital from March 2003 to September 2008 were retrospectively reviewed. The sensitivity, specificity and accuracy of serum CA125 for peritoneal metastasis were analyzed. Clinicopathological characteristics and survival were compared between patients with normal serum CA125 level(≤35 μg/L) and patients with elevated serum CA125 level (> 35 μg/L). Results The specificity, sensitivity and accuracy of serum CA125 for peritoneal metastasis were 96.0%, 13.8% and 81.2%, respectively. A significantly higher incidence of peritoneal metastasis was observed in the patients with elevated serum CA125 level as compared to those with normal serum CA125 level (43.2% vs. 16.5%). CA125 was an independent predictor of peritoneal metastasis (RR=3.475, 95% CI:2.124-5.685). The 5-year overall survival rate in patients with elevated serum CA125 level was 13.5%, which was significantly lower than that of patients with normal serum CA125 level (49.8%, P<0.01). CA125 was an independent prognostic factor of gastric cancers (HR=2.049, 95%CI:1.355-2.873). Conclusion Serum CA125 is useful in predicting peritoneal metastasis and prognosis of gastric cancer , which should be used as a routine examination of gastric cancer patients.

Objective To investigate the predictive value of serum CA125 in peritoneal metastasis, and to examine the association of CA125 with the prognosis. Methods Clinical data of 1285 gastric cancer patients admitted to the Qilu Hospital from March 2003 to September 2008 were retrospectively reviewed. The sensitivity, specificity and accuracy of serum CA125 for peritoneal metastasis were analyzed. Clinicopathological characteristics and survival were compared between patients with normal serum CA125 level(≤35 μg/L) and patients with elevated serum CA125 level (> 35 μg/L). Results The specificity, sensitivity and accuracy of serum CA125 for peritoneal metastasis were 96.0%, 13.8% and 81.2%, respectively. A significantly higher incidence of peritoneal metastasis was observed in the patients with elevated serum CA125 level as compared to those with normal serum CA125 level (43.2% vs. 16.5%). CA125 was an independent predictor of peritoneal metastasis (RR=3.475, 95% CI:2.124-5.685). The 5-year overall survival rate in patients with elevated serum CA125 level was 13.5%, which was significantly lower than that of patients with normal serum CA125 level (49.8%, P<0.01). CA125 was an independent prognostic factor of gastric cancers (HR=2.049, 95%CI:1.355-2.873). Conclusion Serum CA125 is useful in predicting peritoneal metastasis and prognosis of gastric cancer , which should be used as a routine examination of gastric cancer patients.

Objective To investigate the clinicopathological characteristics and prognosis of serumb alpha-fetoprotein(AFP)-producing gastric cancer.Methods A total of 1396 cases of gastric cancer in our hospital from 2002 to 2007 were retrospectively reviewed.The relationship between serum AFP with clinicopathological factors,survival rate,prognosis and liver metastasis were analyzed.Results There were 90 AFP-producing gastric cancer patients accounting for 6.45％ of all the gastric cancer cases during the time period.In those patients there was bigger tumor size,more T3 and T4 invasion (82.2％ vs.69.2％),higher incidence of lymph node metastasis (80.0％ vs.60.2％)and liver metastasis(6.67％ vs.1.68％),and later clinical stage than that in the AFP-negative group.The 1,3,5 year-overall survival (OS) rate in AFP-positive group were 52.2％,31.1％,20％ while those in AFP-negative group were 82.5％,59.9％,48.8％.The 1,3,5 year-disease free survival(DFS) rate in AFP-positive group were 47.8％,24.4％,15.6％ while those in AFP-negative group were 77.5％,54.8％,44.3％.The AFP-positive group had a shorter median time period than the AFP-negative group when liver metastasis happened (5 months vs.11 months).Conclusions Serum AFP-producing gastric cancer was higher malignancy,it was deeper in invasion and later in clinical stage,more patients with lymph nodes and liver metastasis,low survival rate and poorer prognosis.

Objective To study retrospectively the relation of the number of all dissected and negative lymph nodes (LNs) to the prognosis of patients with stage Ⅲ rectal carcinoma after radical resection.Methods From 2002 to 2007,412 sage Ⅲ rectal carcinoma patients undergoing radical resection were enrolled.Patients were divided into five groups according to the number of dissected LNs as follows:1 to 6 lymph nodes,7 to 12 lymph nodes,13 to 18 lymph nodes,19 to 24 lymph nodes,and more than 24 lymph nodes.The association with the survival was analyzed.The Kaplan-Meier method was used to estimate survival as a function of time,and survival differences were analyzed with the log-rank test.The correlation between all dissected and negative lymph nodes was analyzed.The Cox proportional hazard model were used to investigate the risk factors for stage Ⅲ rectal carcinoma.Results The 1,3 and 5 years survival rates were respectively 79.9％,59.2％ and 43.0％.The 5-year survival rates increased with the increasing number of the examined LNs and the negative LNs,the differences were significant (20.0％、26.5％ 、43.9％ 、54.2％ 、53.5％,P =0.001 ; 10.3％ 、34.8％ 、51.9％ 、56.8％ 、70.8％,P =0.000).There were 7301 LNs dissected among which 5698 were pathology negative.The dissected LNs were correlated positively with negative LNs on the Pearson's correlation test(correlation coefficients r =0.899).The total number of dissected LNs and negative LNs were independent prognostic predictors.Conclusions The total number of dissected lymph node and negative lymph nodes are significantly correlated to prognosis of staged Ⅲ rectal carcinoma patient.On premise of standard procedure,we see all dissected and negative lymph nodes as a prognostic auxiliary index.

ObjectiveTo evaluate CT and MRI findings of the intrathoracic ganglioneuroma and to improve its diagnosis and differential diagnosis ability.MethodsClinical,CT( n = 14),MRI (n = 6) and pathology manifestations of 20 patients with the intrathoracic ganglioneuroma were retrospectively analyzed.All 20 cases had chest CT and MRI plain scanning and multiphase enhance scanning before operation.ResultsSeventeen of 20 lesions were located in posterior mediastinum,2 in pleura side and 1 in right thorax cavity.The CT value of the plain scans ranged from 20 to 40 HU ( mean 30.5 HU),Tubercle calcification were detected in four masses,one case with fat density was showed on CT scanning.After injecting contrast media,CT value ranged from 0 to 12 HU (mean 6.2 HU) in artery phase,ranging from 10 to 20 HU ( mean 14.3 HU) in delay phase.Five of 6 cases of MRI signals were homogeneously low intensity on T1 WI,1 case with fat signal was imhomogeneously low intensity on T1WI.Six cases were imhomogeneously high intensity on T2WI.A whorled appearance was visualized in one tumor on T2WI.The post-contrast enhancement MR images was slight enhancement imhomogeneously in artery phase and gradual increasing enhancement in delay phase.ConclusionOn CT and MR imaging,no enhancement or slight enhancement in artery phase and gradual increasing enhancement in delay phase are characteristic manifestations of ganglioneuroma in the thorax.

Objectives: To detect the expressions of mTOR and HIF-1?and their relationship with angiogenesis in gastric carcinomas. Methods: The expressions of mTOR and HIF-1?in gastric carcinomas tissues(n=70)and normal tissues(n=45)were measured by immunohistochemistry staining.CD34 immunostaining was used to measure the microvascular density(MVD).Results: The rates of the mTOR and HIF-1? positive expression were 51.4% and 67.1% respectively. MVD value of gastric cancer tissues was much higher than that of normal tissues(t=4.358, P

Objective:To investigate the expression and clinical significance of metastasis suppressor gene Kiss-1 and KAI-1 in colorectal cancer. Methods: In situ hybridization was used to detect and analyze the gene expression of Kiss-1 and KAI-1 in 61 cases of colorectal cancer and 20 cases of normal para cancer tissue. Results: In situ hybridization revealed that the positive expression rates of Kiss-1 and KAI-1 in colorectal cancer were significantly lower than those in normal para cancer tissue (P