• 文章类型: Journal Article
    真核细胞不仅可以在线粒体中而且可以在细胞质中在一定程度上合成含甲酰基-甲硫氨酸(fMet)的蛋白质。我们先前的研究揭示了SW480结直肠癌细胞的胞质溶胶中含有N末端(Nt)-fMet的蛋白质的大量上调。然而,功能和病理生理意义仍不清楚。这里,我们证明,去除含Nt-fMet蛋白的Nt-甲酰部分(通过表达大肠杆菌PDF肽脱甲酰基酶)导致SW480结直肠癌细胞的增殖显着增加。这种增殖与癌症干细胞特征的获得相吻合,包括减小的细胞大小,增强自我更新能力,以及癌症干细胞表面标志物CD24和多能转录因子SOX2的水平升高。此外,在体内异种移植小鼠模型中,含Nt-fMet蛋白的去形化促进SW480结直肠癌细胞的致瘤性。一起来看,这些发现表明,细胞溶质去形化具有肿瘤增强作用,突出其治疗癌症的潜力。
    Eukaryotic cells can synthesize formyl-methionine (fMet)-containing proteins not only in mitochondria but also in the cytosol to some extent. Our previous study revealed substantial upregulation of N-terminal (Nt)-fMet-containing proteins in the cytosol of SW480 colorectal cancer cells. However, the functional and pathophysiological implications remain unclear. Here, we demonstrated that removal of the Nt-formyl moiety of Nt-fMet-containing proteins (via expressing Escherichia coli PDF peptide deformylase) resulted in a dramatic increase in the proliferation of SW480 colorectal cancer cells. This proliferation coincided with the acquisition of cancer stem cell features, including reduced cell size, enhanced self-renewal capacity, and elevated levels of the cancer stem cell surface marker CD24 and pluripotent transcription factor SOX2. Furthermore, deformylation of Nt-fMet-containing proteins promoted the tumorigenicity of SW480 colorectal cancer cells in an in vivo xenograft mouse model. Taken together, these findings suggest that cytosolic deformylation has a tumor-enhancing effect, highlighting its therapeutic potential for cancer treatment.
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  • 文章类型: Journal Article
    分析腹部手术切除(APR)术后乙状结肠造口并发症的危险因素,以指导临床实践。回顾性纳入2013年6月至2021年6月诊断为直肠癌并接受APR手术的患者。比较造口并发症组和无造口并发症组的特点,采用单因素和多因素logistic分析确定乙状结肠造口相关并发症的危险因素.本研究共纳入379例诊断为直肠癌并接受APR手术的患者。患者平均年龄为61.7±12.1岁,226例(59.6%)患者为男性。短期造口并发症组患者年龄较小(55.7vs62.0,P<0.05),肿瘤分期较晚期(P<0.05)。然而,长期造口并发症组和无造口并发症组之间无显著差异。多因素logistic回归分析显示手术时间是造口短期并发症的独立危险因素(P<0.05,OR=1.005,95%CI=1.000~1.010)。我们机构的短期和长期造口并发症发生率均较低。手术时间较长是APR术后造口短期并发症的独立危险因素。
    To analyze the risk factors for intraperitoneal sigmoid stoma complications after abdominoperineal resection (APR) surgery to guide clinical practice. Patients who were diagnosed with rectal cancer and underwent APR surgery from June 2013 to June 2021 were retrospectively enrolled. The characteristics of the stoma complication group and the no stoma complication group were compared, and univariate and multivariate logistic analyses were employed to identify risk factors for sigmoid stoma-related complications. A total of 379 patients who were diagnosed with rectal cancer and underwent APR surgery were enrolled in this study. The average age of the patients was 61.7 ± 12.1 years, and 226 (59.6%) patients were males. Patients in the short-term stoma complication group were younger (55.7 vs 62.0, P < .05) and had a more advanced tumor stage (P < .05). However, there was no significant difference between the long-term stoma complication group and the no stoma complication group. Multivariate logistic regression analysis revealed that operation time was an independent risk factor (P < .05, OR = 1.005, 95% CI = 1.000-1.010) for short-term stoma complications. Both the short-term and long-term stoma complication rates in our institution were low. A longer operation time was an independent risk factor for short-term stoma complications after APR surgery.
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  • 文章类型: Journal Article
    结直肠癌(CRC)是一个重要的公共卫生问题,因为它的广泛发生和大量的发病率和死亡率。最近的研究强调血清尿酸(SUA)水平可能是CRC的危险因素;然而,这些发现的不一致引起了人们的怀疑。我们利用来自英国BioBank和NHGRI-EBI全基因组关联研究(GWAS)目录的广泛队列数据进行了孟德尔随机化(MR)研究,以调查SUA水平与CRC发生率之间的因果关系。我们的MR研究解决了早期研究的局限性,包括有限的样本量和不一致的结果。考虑到SUA水平作为暴露,CRC作为结果,MR中的逆方差加权(IVW)方法显示,SUA每增加一个单位的CRC比值比(ORs)分别为0.232(OR0.094-0.570的95%置信区间[CI];P=.001)和0.551(OR0.325-0.934的95%CI;P=.027).多效性测试和敏感性分析证实了最小的水平多效性和因果关系的稳健性。我们的研究加深了对SUA水平与CRC之间关系的理解,提供对预防策略和患者预后预测的见解。
    Colorectal cancer (CRC) is a significant public health issue owing to its widespread occurrence and substantial morbidity and mortality rates. Recent studies have highlighted serum uric acid (SUA) level as a probable risk factor for CRC; however, the inconsistency in these findings has created doubt. We performed a Mendelian randomization (MR) study utilizing extensive cohort data from the UK BioBank and the NHGRI-EBI Genome-Wide Association Study (GWAS) Catalog to investigate the causal connection between SUA levels and CRC incidence. Our MR study addresses the constraints of earlier studies, including limited sample sizes and inconsistent results. Considering SUA levels as the exposure and CRC as the outcome, the inverse variance-weighted (IVW) approach in MR showed that the odds ratios (ORs) for CRC for each unit increase in SUA were 0.232 (95% confidence interval [CI] of OR 0.094-0.570; P = .001) and 0.551 (95% CI of OR 0.325-0.934; P = .027). Pleiotropic tests and sensitivity analysis confirmed minimal horizontal pleiotropy and the robustness of causality. Our research deepens the understanding of the association between SUA levels and CRC, offering insights into prevention strategies and patient outcomes prediction.
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  • 文章类型: Case Reports
    Introducción: los schwannomas son tumores benignos y frecuentes de las partes blandas. Habitualmente son asintomáticos y son descubiertos por otros motivos. Materiales y métodos: presentamos el caso de un paciente masculino de 82 años con diagnóstico reciente de adenocarcinoma de colon moderadamente diferenciado y con un nódulo periaórtico hipermetabólico como hallazgo incidental. Resultados: la biopsia percutánea del nódulo periaórtico confirmó el diagnóstico de schwannoma. Al año de seguimiento, se ha demostrado crecimiento del schwannoma. No hay signos de progresión de su enfermedad oncológica. Conclusión: los schwannomas son tumores benignos, infrecuentes en el retroperitoneo y pueden ser fuentes de resultados falsos positivos en tomografía por emisión de positrones.
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  • 文章类型: Journal Article
    目的:对进展的恐惧(FoP)导致结直肠癌患者的临床预后不良。本研究旨在阐明FoP在结直肠癌患者中的分布及影响因素。
    方法:对409例结直肠癌患者进行了一项横断面研究。采用便利抽样法选取南京某三级医院住院的结直肠癌患者作为调查对象。一般信息问卷,对进展的恐惧问卷-简表,困境披露指数,使用社会支持评定量表收集数据。潜在谱分析用于探索FoP在结直肠癌患者中的潜在概况。此外,采用单因素分析和二项Logistic回归分析对影响因素进行分析。
    结果:潜在特征分析确定了对疾病进展的恐惧的两个亚组:“恐惧低风险特征(83%)”,和“严重恐惧”(17%)。“年龄低的患者,社会支持利用率低,第一次住院,严重的医疗负担,术前肠道症状容易引起对疾病进展的严重恐惧。
    结论:结直肠癌患者术后对疾病进展的恐惧水平存在一定的异质性。医护人员应针对严重恐惧症患者,根据不同类别的分布特点,尽早采取针对性的预防和心理护理措施。
    OBJECTIVE: Fear of progression (FoP) leads to poor clinical outcomes in colorectal cancer patients. The study aimed to clarify the profiles and influencing factors of FoP among colorectal cancer patients.
    METHODS: A cross-sectional study was conducted with 409 colorectal cancer patients. Convenience sampling method was used to select colorectal cancer patients hospitalized in a tertiary-level hospital in Nanjing as the survey subjects. General information questionnaire, Fear of Progression Questionnaire-Short Form, Distress Disclosure Index, and Social Support Rating Scale were used to collect the data. Latent profile analysis was used to explore the latent profiles of FoP in colorectal cancer patients. Additionally, the influencing factors of profiles were explored by Univariate Analysis and Binomial Logistic Regression Analysis.
    RESULTS: Latent profile analysis identified two subgroups of fear of disease progression: the \"fear low-risk profile (83%)\", and the \"severe fear profile (17%).\" Patients with low age, low social support utilization, first hospital admission, severe healthcare burden, and preoperative bowel symptoms were prone to severe fear of disease progression.
    CONCLUSIONS: There is some heterogeneity in the level of postoperative fear of disease progression in colorectal cancer patients. Doctors and nurses should focus on patients with severe fear and take targeted preventive and psychological care for patients\' fear of disease progression as early as possible according to the distribution characteristics of different categories.
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  • 文章类型: Journal Article
    靶向治疗对于遗传驱动因素阳性的晚期结直肠癌(CRC)至关重要。随着深度测序技术和新型靶向药物的进步,现有的标准分子病理学检测系统和治疗策略已不能满足对晚期CRC患者进行精心管理的要求.因此,罕见的遗传变异在临床实践中需要诊断和靶向治疗。罕见的基因突变,扩增,和重排通常与预后差和对常规治疗的反应差相关。本文综述了罕见遗传变异的临床诊断和治疗,在包括erb-b2受体酪氨酸激酶2(ERBB2)的基因中,B-Raf原癌基因,丝氨酸/苏氨酸激酶(BRAF),ALK受体酪氨酸激酶/ROS原癌基因1,受体酪氨酸激酶(ALK/ROS1),神经营养受体酪氨酸激酶(NTRKs),ret原癌基因(RET),成纤维细胞生长因子受体2(FGFR2),和表皮生长因子受体(EGFR),以增强对罕见遗传变异患者的理解并确定更准确的个性化治疗方法。
    Targeted therapy is crucial for advanced colorectal cancer (CRC) positive for genetic drivers. With advances in deep sequencing technology and new targeted drugs, existing standard molecular pathological detection systems and therapeutic strategies can no longer meet the requirements for careful management of patients with advanced CRC. Thus, rare genetic variations require diagnosis and targeted therapy in clinical practice. Rare gene mutations, amplifications, and rearrangements are usually associated with poor prognosis and poor response to conventional therapy. This review summarizes the clinical diagnosis and treatment of rare genetic variations, in genes including erb-b2 receptor tyrosine kinase 2 (ERBB2), B-Raf proto-oncogene, serine/threonine kinase (BRAF), ALK receptor tyrosine kinase/ROS proto-oncogene 1, receptor tyrosine kinase (ALK/ROS1), neurotrophic receptor tyrosine kinases (NTRKs), ret proto-oncogene (RET), fibroblast growth factor receptor 2 (FGFR2), and epidermal growth factor receptor (EGFR), to enhance understanding and identify more accurate personalized treatments for patients with rare genetic variations.
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  • 文章类型: Journal Article
    背景:C反应蛋白(CRP)是结直肠手术后感染并发症的有用阴性预测因子。尽管CRP水平低于术后第3至5天报告的截止值(POD)可以令人放心,很难解释高于这些临界值的CRP升高.这项研究评估了研究POD3-5的CRP升高是否可以更早地检测感染性并发症。
    方法:对接受择期结肠或直肠切除术的成年患者进行了连续两个时间段的前瞻性评估。第1组通过常规临床护理在POD3-5上测量CRP水平,而第2组遵循以下算法:CRP水平高于某些截止值(POD3为170mg/L,POD4为125mg/L或增加50个单位POD3-4或POD4-5)导致腹盆腔CT扫描和败血症筛查。根据Clavien-Dindo分类和综合并发症指数(CCI)对并发症进行分级。
    结果:120例患者纳入第1组,60例患者纳入第2组。两组患者之间没有显着差异,手术或疾病特征。虽然第2组的总并发症负担明显更大(CCI29.6对12.2,P<0.001),在诊断感染并发症的当天,两组之间没有显着差异,总体发病率,或并发症类型。
    结论:对择期大结直肠手术后POD3-5CRP升高或升高的早期调查不能早期发现感染性并发症。
    BACKGROUND: C-reactive protein (CRP) is a useful negative predictor of infectious complications following colorectal surgery. Whilst a CRP level below reported cut-offs on postoperative day (POD) 3 to 5 can be reassuring, it can be difficult to interpret an elevated CRP above these cut-offs. This study evaluated whether investigating an elevated CRP on POD 3-5 allows earlier detection of infectious complications.
    METHODS: Adult patients undergoing elective colonic or rectal resection were prospectively evaluated over two consecutive time periods. Group 1 had CRP levels measured on POD 3-5 with routine clinical care while Group 2 followed an algorithm where CRP levels above certain cut-offs (170 mg/L on POD3, 125 mg/L on POD4, or increase of 50 units from POD 3-4 or POD 4-5) led to an abdominopelvic CT scan and septic screen. Complications were graded as per the Clavien-Dindo classification and Comprehensive Complication Index (CCI).
    RESULTS: 120 patients were included in Group 1 and 60 patients were included in Group 2. There were no significant differences between the two groups with regards to patient, operation or disease characteristics. Whilst the overall complication burden was significantly greater in Group 2 (CCI 29.6 versus 12.2, P < 0.001), there were no significant differences between the groups in the day of diagnosis of infectious complication, the overall incidence, or type of complications.
    CONCLUSIONS: Early investigation of an elevated or increasing CRP on POD 3-5 following elective major colorectal surgery did not allow earlier detection of infectious complications.
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  • 文章类型: Journal Article
    背景:通过筛选和教育(CHANGE)计划的癌症健康意识提供了癌症意识教育,重点是可改变的危险因素和导航到前列腺筛查,乳房,和结肠直肠癌对公共住房社区的居民来说,他们经历了显著的负面健康社会决定因素。
    方法:五个社区的居民参与。招募社区顾问委员会成员,并向当地环境变化项目提供反馈,招募,以及每个站点的社区参与。在每个站点,由训练有素的主持人提供了四次关于癌症风险因素和病因的教育课程,种族差异,癌症筛查的资格,参与临床试验。出席,知识,对癌症的态度和信念,和高度,体重,在基线和更改后1周测量腰围.
    结果:90名居民(60%65岁及以上,33%男性,60%高中教育,93%AA)参加了该计划。95%完成干预后评估。参与者有资格获得乳房(n=12),前列腺(n=15),和结肠直肠筛查(n=25)基于美国癌症协会指南,和22个戒烟;21个参与者接受了这些服务的导航援助。在测试后,参与者对肥胖/超重癌症风险的知识和行为显着增加,营养,和身体活动。结肠直肠,前列腺,乳腺癌知识得分也有所提高,但并不重要。
    结论:CHANGE参与者表现出改善的健康知识和改善其可改变的健康行为的意图。参与者报告说,他们对寻求预防性护理和对社区参与工作的满意度有积极性和信心。在类似社区中复制该项目可能会改善服务不足人群的知识和健康公平性。
    BACKGROUND: The Cancer Health Awareness through screeNinG and Education (CHANGE) initiative delivers cancer awareness education with an emphasis on modifiable risk factors and navigation to screening for prostate, breast, and colorectal cancers to residents of public housing communities who experience significant negative social determinants of health.
    METHODS: Residents of five communities participated. Community advisory board members were recruited and provided feedback to local environmental change projects, recruitment, and community engagement at each site. At each site, four education sessions were provided by trained facilitators on cancer risk factors and etiology, racial disparities, eligibility for cancer screening, and participation in clinical trials. Attendance, knowledge, attitudes and beliefs about cancer, and height, weight, and waist circumference were measured at baseline and 1-week post-CHANGE sessions.
    RESULTS: 90 residents (60% 65 and older years old, 33% male, 60% High School education, 93% AA) participated in the program. 95% completed post-intervention evaluation. Participants were eligible for breast (n = 12), prostate (n = 15), and colorectal screening (n = 25) based on American Cancer Society guidelines, and 22 for tobacco cessation; 21 participants accepted navigation assistance for these services. At post-test, participants significantly increased in knowledge and behaviors around obesity/overweight risk for cancer, nutrition, and physical activity. Colorectal, prostate, and breast cancer knowledge scores also increased, but were not significant.
    CONCLUSIONS: CHANGE participants demonstrated improved health knowledge and intentions to improve their modifiable health behaviors. Participants reported being motivated and confident in seeking preventive care and satisfaction with community engagement efforts. Replication of this project in similar communities may improve knowledge and health equity among underserved populations.
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  • 文章类型: Journal Article
    <b>br>简介:</b>回肠造口术是一种常见的外科手术,目前缺乏标准化的围手术期和手术方案。</br><b>br>目的:</b>LILEO研究旨在对许多围手术期参数进行多中心分析,并估计术后并发症的发生率。</br><b><br>材料与方法:</b>本研究是一项开放式多中心前瞻性队列研究。3个月后LILEO研究的初步结果可从18个波兰外科中心获得,包括59例接受回肠造口术逆转的患者的完整数据。</br><b><br>结果:</b>术前护理等参数,外科技术,对术后病程及并发症进行分析。49.1%的患者采用术前禁食。59%的吻合是手工缝制的,72.9%的患者进行了一次单缝线伤口闭合。平均住院时间为7.9天(最少2天,最长26天)。20例患者(33.9%)发生并发症。在Clavien-Dindo分类中,11.9%的患者并发症为III级A/B。</br><b><br>讨论:</b>回肠造口逆转组的围手术期护理仍缺乏规范化、优化的治疗。</br><b><br>结论:</b>回肠造口术是术后并发症风险较高的手术。基于进一步的多中心国家研究的围手术期护理标准化可能会降低并发症发生率。</br>.
    <b><br>Introduction:</b> Ileostomy reversal is a common surgical procedure and currently standardized perioperative and surgical protocols are lacking.</br> <b><br>Aim:</b> LILEO study was designed to perform a multicenter analysis on numerous perioperative parameters and estimation of the incidence of postoperative complications.</br> <b><br>Materials and methods:</b> The study is an open multicenter prospective cohort study. Preliminary results of the LILEO study after 3 months were available from 18 Polish surgical centers comprising full data of 59 patients who underwent ileostomy reversal.</br> <b><br>Results:</b> Parameters such as preoperative care, surgical technique, postoperative course and complications were analyzed. Preoperative fasting was used in 49.1% of patients. Fifty nine percent of anastomosis were handsewn and in 72.9% of patients had primary single suture wound closure. Mean length of hospital stay was 7.9 days (min 2 days, max 26 days). Complications occurred overall in 20 patients (33.9%). In 11.9% of patient\'s complications had grade III A/B in Clavien-Dindo classification.</br> <b><br>Discussion:</b> The perioperative care in the group of patients undergoing ileostomy reversal still lacks standardized and optimized treatment.</br> <b><br>Conclusions:</b> Ileostomy removal is a procedure with high risk of postoperative complications. Standardization of perioperative care based on further multicenter national study could result in a decrease of complications rate.</br>.
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  • 文章类型: Journal Article
    <b><br>简介:</b>结直肠癌(CRC)是2020年全球第三大常见癌症和第二大癌症死亡原因。其发病率在50岁以下的人群中急剧增加(早发性结肠直肠癌;EOCRC)。</br><b>br>目的:</b>这项研究的目的是比较两个年龄组的结直肠癌患者的分期,预后因素,生存率和复发率。</br><b><br>材料和方法:</b>研究组由1995年至2005年间在克拉科夫大学医院综合科进行手术的588名患者组成,肿瘤和胃肠病外科。采用回顾性文献分析方法。患者分为两个年龄组:40岁以下和45至65岁之间。</br><b>br>结果:</b>40岁以下,33.3%的患者诊断为IV期结直肠癌,而在45至65岁之间,诊断为26.1%。5年生存率因肿瘤分期而异。在分析的两组中,生存曲线之间存在显着差异(P=0.00000)。此外,在不包括癌症非依赖性死亡的配对组中比较复发时间显示,两组间差异有统计学意义(P=0.006).</br><b>br>讨论:因此,建议对这里提出的研究进行研究,并分析预后因素,鼓励多中心预防性研究结合高危人群的健康教育。在年轻患者中发生的癌症的特征是诊断晚期,五年生存率较低,预后较差。可用性是非常重要的早期诊断,以检测癌前和认为癌前状况是重要的。这涉及在疾病的较低阶段检测病变。</br><b>br>结论:</b>早期诊断以检测癌前病变和考虑癌前病变的可用性非常重要。这涉及在疾病的较低阶段检测病变。早期诊断结直肠癌并治疗癌前病变将改善治疗结果。导致更少的转移和更长的生存和复发时间。</br>.
    <b><br>Introduction:</b> Colorectal cancer (CRC) was the third most common cancer and the second cause of cancer deaths worldwide in 2020. Its incidence has increased dramatically in people under 50 years of age (early-onset colorectal cancer; EOCRC).</br> <b><br>Aim:</b> The aim of this study was to compare two age groups of patients with colorectal cancer in terms of stage, prognostic factors, survival and incidence of recurrence.</br> <b><br>Materials and methods:</b> The study group consisted of 588 patients operated on between 1995 and 2005 at the University Hospital in Krakow in the Clinical Department of General, Oncological and Gastroenterological Surgery. A method of retrospective documentation analysis was used. Patients were divided into two age groups: up to forty years of age and between 45 and 65 years of age.</br> <b><br>Results:</b> Up to 40 years of age, stage IV colorectal cancer was diagnosed in 33.3% of patients, while between 45 and 65 years of age, it was diagnosed in 26.1%. Five-year survival differed according to tumour stage. In the two groups analysed, there was a significant difference between the survival curves (P = 0.00000). Also, comparing recurrence times in the paired group excluding cancer-independent deaths revealed a statistically significant difference between the groups (P = 0.006).</br> <b><br>Discussion:</b> The incidence of colorectal cancer has increased worldwide in young people under 50 years of age, and it is therefore recommended that the research presented here be studied, and that prognostic factors be analysed and multicentre prophylactic studies combined with health education of those at risk be encouraged. Cancer occurring in younger patients is characterized by advanced stage at diagnosis and five-year survival is lower and has a poorer prognosis. The availability is very important of early diagnosis to detect pre-cancerous and considered pre-cancerous conditions is important. This involves detecting lesions at a lower stage of the disease.</br> <b><br>Conclusions:</b> The availability of early diagnosis to detect precancerous and considered pre-cancerous conditions is very important. This involves detecting lesions at a lower stage of the disease. Diagnosing colorectal cancer at an early stage and treating the pre-cancerous lesions will improve treatment outcomes, resulting in fewer metastases and longer survival and recurrence times.</br>.
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