M2-like macrophages and CD8+T cells are key immune components that influence tumor behavior and treatment response. Ubiquitin-specific protease 32 (USP32) is established as a key oncogenic factor in gastric cancer (GC). This study aimed to investigate the role of USP32 in regulating M2 macrophage polarization and CD8+T cell dysfunction in GC. Macrophages derived from THP1 cells (THP1-M0) or CD8+T cells were co-cultured with transfected AGS and HGC-27 GC cells. The proportion of CD206+ M2 macrophages and the apoptosis of CD8+T cells were assessed by flow cytometry. Cell invasion was analyzed by transwell assay. The interaction between USP32 and death-associated protein kinase 1 (DAPK1) was verified by GST pull down and Co-immunoprecipitation (Co-IP) experiments. The effect on tumor growth was tested by subcutaneous xenograft studies. USP32 and DAPK1 were overexpressed in GC tissues and cell lines. Mechanistically, USP32 stabilized DAPK1 protein through deubiquitination. DAPK1 downregulation reversed USP32-mediated enhancement in GC cell invasion, macrophage M2 polarization, and CD8+T cell apoptosis in vitro. USP32 depletion exhibited an in vivo anti-growth effect on AGS subcutaneous xenografts. This study identifies the USP32/DAPK1 cascade as a crucial regulator of M2 macrophage polarization and CD8+T cell apoptosis in GC, providing a novel mechanistic link between post-translational regulation and tumor immune evasion.

Background:Distant lymph node metastasis (LNM) from esophageal cancer is relatively difficult to detect and is associated with a poor prognosis. Our study aimed to develop machine learning models for predicting distant LNM in esophageal cancer, with the goal of enhancing diagnostic accuracy, optimizing treatment strategies, and identifying high-risk patients for personalized clinical management. Methods:The demographic and clinicopathological data of patients diagnosed with esophageal cancer were extracted from the Surveillance, Epidemiology, and End Results (SEER) database, 17 Registries, November 2023 (2000-2021). Univariate and multivariate logistic regression analyses were applied to select correlation variances related to distant LNM. Seven machine learning models were constructed, including random forest (RF), decision tree (DT), extreme gradient boosting (XGBoost), gradient boosting (GB), Naïve Bayes, artificial neural network (ANN), and adaptive boosting (ADB) models. The predictive performance of the models was evaluated in terms of accuracy, F1 score, recall rate, and area under the curve (AUC). Importance rank and Shapley additive explanation (SHAP) were performed to explain the machine learning models. We validated the machine learning model in 53 patients with esophageal cancer at our clinical center, Beijing Friendship Hospital. Results:Among the machine learning models, the GB model outperformed the other models, with an accuracy of 0.929, a recall of 0.427, an F1 score of 0.414, and an AUC of 0.912. The interpretable module revealed that tumor (T) stage, node (N) stage, age, liver metastasis, and lung metastasis were significant predictors. T stage was the most significant predictor of distant LNM in patients with esophageal cancer. The validation dataset revealed a high accuracy of 0.818, a recall of 0.857, and an AUC of 0.857. Conclusions:The GB model emerged as the best model for predicting LNM in the esophageal cancer model. The importance rankings provide a degree of explanation, and the model can assist physicians in the initial prediction of LNM, providing a clinical reference and guidance.

BackgroundBuccal mucosa squamous cell carcinoma (BMSCC) is an aggressive disease. This study investigated the clinicopathological significance of tumor budding (TB), depth of invasion (DOI), and mode of invasion (MOI) on occult cervical metastasis (CM) of BMSCC.MethodsSeventy-one cT1-2N0 BMSCC patients were included in this retrospective study. TB, DOI, MOI, and other clinicopathological features were reviewed. Risk factors for occult CM, locoregional recurrence-free survival (LRRFS), and overall survival (OS) were analyzed using logistic regression and Cox's proportional hazard models, respectively.ResultsMultivariate analysis with the logistic regression model revealed that MOI, DOI, and TB were significantly associated with occult CM in early-stage BMSCC after adjusting for variates. However, multivariate analysis with the Cox's proportional hazard model found only TB to be a prognostic factor for LRRFS (hazard ratio 15.03, 95% confidence interval [CI] 1.94-116.66; p = 0.01; trend test p = 0.03). No significant association was found between MOI, DOI, or TB and OS.ConclusionsThe optimal predictor of occult CM and prognosis of early-stage BMSCC is TB, which may assist clinicians in identifying patients at high risk of cervical metastasis.

BackgroundExtensive studies have highlighted the significance of estrogen receptor (ER) and progesterone receptor (PR) in breast cancer (BRCA). However, our understanding of patients with single hormone receptor (HR)-positive (sHR+) BRCA remains limited. This lack of understanding poses challenges in predicting prognosis and selecting appropriate treatments.Patients and MethodsWe collected data from a total of 825 human epidermal growth factor receptor 2 negative (HER2-) BRCA patients who underwent neoadjuvant chemotherapy (NAC) in two distinct cohorts. Four subgroups were created within each cohort based on their HR expression: ER+/PR+, ER+/PR-, ER-/PR+, and ER-/PR-. We conducted comparative analyses to assess clinicopathological characteristics, chemotherapy responsiveness, clinical outcomes, and intrinsic subtyping among these subgroups.ResultsER+/PR- constituted 11.1% and 14.9% of samples in two cohorts, respectively, whereas ER-/PR+ comprised 8.3% and 3.7%. Higher histologic grades were more common in the ER-/PR+ group as compared to the ER+/PR+ subgroup (p=0.0075 in cohort 1; p=0.026 in cohort 2). Additionally, after multivariable analysis, ER-/PR+ were more likely to achieve pathological complete response (pCR) (cohort 1: OR =6.67; 95% CI, 2.63-16.94; p<0.001; cohort 2: OR =3.70; 95% CI, 1.08-11.84; p=0.030;). Between ER+/PR- and ER+/PR+, the distant recurrence-free survival (DRFS) was comparable. The survival outcomes in the ER-/PR+ subgroup present a partial inconsistency between the two cohorts. Furthermore, the ER-/PR+ subgroup exhibited a higher incidence of the basal-like subtype, while the ER+/PR- subgroup had a higher proportion of luminal-like subtypes.ConclusionThis study highlighted the distinct clinical and genetic characteristics of sHR+ BRCA, emphasizing the potential need for optimized treatment strategies.MicroAbstractLimited studies compared the clinicopathological characteristics, chemotherapy responsiveness, clinical outcomes, and intrinsic subtyping between single hormone receptor-positive and other hormone receptor status breast cancer. We collected 825 breast cancer patients’ data who received neoadjuvant chemotherapy from two cohorts. Our research explored that patients diagnosed with single hormone receptor-positive breast cancer represent distinct clinical and genetic subgroups.

目的 探讨甲状腺手术相关的非返喉神经(NRLN)的临床特征与预判策略.方法 回顾性分析首都医科大学附属北京友谊医院医疗保健中心综合外科(以下简称"我科")2009年8月至2022年2月因甲状腺良、恶性肿瘤行甲状腺手术的175例患者的临床资料;另外以"非返喉神经""喉不返神经""非返性喉下神经""喉返神经""喉下神经""non-recurrent laryngeal nerve""non recurrent laryngeal nerve""non-recurrent inferior laryngeal nerve""recurrent laryngeal nerve""inferior laryngeal nerve""NRLN""NRILN"为检索词在中国知网、万方、PubMed 及 Web of Science数据库检索研究对象为中国人的文献,检索时间为2012年1月至2022年2月,统计NRLN总发生率、右侧发生率、Stewart分型、损伤率,以及术前应用影像学预判NRLN的结果.结果 我科术中发现1条右侧NRLN,Stewart Ⅰ型,NRLN总发生率为0.32％,右侧发生率为0.63％,所有患者术中无损伤.meta分析显示,NRLN总发生率为 0.46％(95％CI:0.26％～0.66％);右侧发生率为 0.45％(95％CI:0.22％～0.68％);Stewart Ⅰ 型发生率为 76.47％(95％CI:58.61％～94.33％),Ⅱ型发生率为 23.53％(95％CI:5.67％～41.39％);损伤率为 10.20％(95％CI:2.93％～17.47％).影像学预判结果显示,90％(81/90)存在异形右侧锁骨下动脉;CT预测NRLN的漏诊率为19.23％,胸部X线预测NRLN误诊率为56.67％,超声预测NRLN漏诊率为7.25％.结论 NRLN为少见变异,术中损伤率高,术前可通过影像学预判,CT及超声预测NRLN准确性较高.

目的:分析小肠间质瘤临床、影像及病理学特征与术后转移复发和死亡的相关性.方法:回顾性分析2013年01月至2016年12月北京友谊医院及北京市房山区良乡医院普外科收治的经手术治疗且病理检查确诊的61例小肠间质瘤患者,术后对其进行为期3年的随访.观察指标包括患者的临床特征、影像学特征、临床病理特征以及预后情况.结果:单因素分析结果提示,小肠间质瘤患者术后复发或转移与肿瘤直径、CT肿瘤密度不均匀改变、核分裂象计数、是否浸润、改良NIH危险度分级、切除分级、是否服用伊马替尼相关;小肠间质瘤患者术后死亡与年龄、肿瘤直径、核分裂象计数、是否浸润、改良NIH危险度分级和切除分级相关.多因素分析提示肿瘤直径>5 cm和核分裂象>5/50高倍镜视野是小肠间质瘤患者复发或转移的独立危险因素;肿瘤直径>5 cm和改良NIH危险度中高危组是小肠间质瘤患者死亡的独立危险因素.结论:肿瘤大小、核分裂象计数以及改良NIH危险度分级是影响小肠间质瘤患者预后的独立相关因素.

Objective:To investigate the effect of obstruction on the prognosis and possible mechanisms in colorectal cancer patients.Methods:Among 1574 cases of colorectal cancer who were treated in Beijing Friendship Hospital, Capital Medical University from January 2003 to December. 2014, 194 cases had preoperative intestinal obstruction. Firstly, described the clinical characteristics of 194 patients with obstruction, then COX multivariate regression analysis was performed on the 1574 colorectal cancer cohort to confirm whether the preoperative obstruction was independent predictor for the overall survival. Finally, propensity score matching method was used to match obstruction and non-obstruction cases, then compared overall survival difference.Results:In 194 cases of obstructive colorectal cancer, 60.3% and 37.1% of the tumors were located in the left and right respectively. The 55.7% of the patients had tumors larger than 5 cm in diameter, the median survival time was 39.7 months (95% CI: 28.3-60.4). Multivariate COX analysis, after adjusted for related confounding factors, found that preoperative obstruction is still an independent risk factor for poor prognosis ( HR=1.41, 95% CI: 1.01-1.97). After propensity score matching, 140 and 560 patients were included in the obstructive group and the non-obstructive group. The two groups were more balanced in most baseline characteristics. The median survival time of the two groups was 42.4 and 116.3 months ( P<0.001), the overall survival of obstructive patients was significantly worse than that of non-obstructive patients. Conclusions:Preoperative obstruction is an independent risk factor for poor prognosis of colorectal cancer. This may be due to the difficulty of surgery and low radical cure rate for obstructive colorectal cancer.

Objective:To explore the prognostic value of circulating tumor cell (CTC) for colorectal cancer.Method:We analyze the correlation between CTC and clinicopathological data, survival curve and overall survival.Results:The positive rates of preoperative and postoperative CTC in 181 colorectal cancer patients were 66.3% and 65.7% respectively ( χ2=0.012, P=0.912). The postoperative CTC positive rates for recurrence and non-recurrence of stage Ⅱ colorectal cancer were 29.2% and 8.0%, respectively ( χ2=4.303, P=0.038). The progress free survuval of CTC-positive and CTC-negative in postoperative stage Ⅱ colorectal cancer patients were 28.7 months and 34.0 months, respectively ( χ2=4.096, P=0.043). Conclusion:Postoperative CTC detection has predictive prognostic value for patients with stage Ⅱ colorectal cancer.

Objective:To explore the feasibility of wait and watch treatment for patients with high-risk pathology factors after endoscopic submucosal dissection (ESD) for early colorectal cancer.Methods:From December 2012 to June 2020, 104 patients, including 62 males and 42 females, aged from 31 to 89 years old, with the average of (59.5±10.8) years with early colorectal cancer after ESD operation were selected from the Department of General Surgery, Beijing Friendship Hospital, Capital Medical University. According to the follow-up treatment, the patients were divided into two groups: the additional surgical resection group and the wait and watch group. The measurement data of normal distribution were shown by mean standard deviation, the comparison between groups adopted t test, and the comparison of counting data between groups adopted χ2 test. The types of pathological high-risk factors after ESD were compared between the two groups, and the overall survival (OS) and progression free survival (PFS) of the two groups were compared by Log-Rank test. Results:The median follow-up time was(40.6±15.3) months. The OS and PFS of the additional surgical resection group and the wait and watch group were 100.0% vs 98.4% and 90.7% vs 90.2%, respectively, and there was no statistically significant difference between the two groups (OS: χ2=0.875, P=0.35; PFS: χ2=0.017, P=0.80). Conclusion:The wait and watch strategy is expected to be one of the follow-up choices for some patients with high risk factors after ESD operation for early colorectal cancer.

目的:探讨分析开腹消化道手术后发生延迟性肠麻痹(PPOI)对术后住院时间、医疗花费等的不良影响程度。方法:回顾性分析2016年10月—2018年11月首都医科大学北京友谊医院普外科行开腹消化道手术的126例消化道肿瘤患者资料，根据奥克兰大学提出的PPOI诊断标准，将纳入患者分为PPOI组( n＝14)和非PPOI组( n＝112)。选取术后并发症、术后住院时间以及住院期间医疗花费为研究终点指标。采用 t检验或者Fisher精确检验比较两组差异，并通过回归分析探讨PPOI对住院时间、医疗花费的独立影响。 结果:本研究队列PPOI发病率为11.1%。PPOI组总并发症发生率升高(64.29%比38.39%， P＝0.08)。PPOI组患者术后平均住院时间较非PPOI组较长[(21.21±14.83) d比(13.98±14.21) d， P＝0.070]。调整各种可能的混杂因素，影响住院时间的PPOI回归系数beta(95% CI)为[-0.43(-7.16，6.3)， P＝0.90]。PPOI组患者平均医疗花费较非PPOI组升高[(104 389.64±52 427.66)元比(79 111.41±50 832.29)元， P＝0.070]。调整各种可能的混杂因素，影响医疗花费的PPOI回归系数beta(95% CI)为[-134.12(-21656.85，21388.62)， P＝0.99]。 结论:延迟性术后肠麻痹导致术后康复的延迟，与术后并发症发生增加相关，增加住院时间和医疗花费。但尚需大样本数据进一步证实。

Objective:To explore whether the protective ileostomy can reduce the incidence of anastomotic leakage after neoadjuvant treatment of rectal cancer and the relationship between protective ileostomy and anastomotic leakage.Methods:From May 2011 to August 2020, a total of 108 patients who underwent rectal cancer neoadjuvant radiotherapy and chemotherapy and then received anterior resection in Beijing Friendship Hospital, Capital Medical University were selected. Sixty-three cases were treated with protective ileostomy (Treatment group), while 45 cases were not (Control group). The chi-square test was used to compare the incidence of anastomotic leakage between the two groups. At the same time, Logistic regression was used to analyze the related factors of anastomotic leakage, and the rate of permanent stoma was calculated. SPSS19.0 software was used for statistical analysis.Results:The total incidence of postoperative anastomotic leakage in the Treatment group and Control group was 9.52% (6/63) and 6.66% (3/45) ( P=0.59). Among them, 2 cases of anastomotic leakage occurred in the Treatmentgroup, no A-grade anastomotic leakage occurred in the Control group, and there was no significant difference between the two groups (33.33% vs. 0, P=0.77). There were 4 cases of grade B anastomotic leakage occurred in the Treatment group, 2 cases in the Control group, there was no significant difference between the two groups (66.67% vs. 66.67%, P=0.45). There was no grade C anastomotic leakage in the Treatment group, and one case of grade C anastomotic leakage occurred in the Control group, there was no significant difference between the two groups (0 to 33.33%, P=0.70). Logistic regression analysis showed that whether protective stoma was implemented or not was not statistically related to the occurrence of anastomotic leakage ( P=0.26). The distance between the tumor and the anal margin ( P=0.01) affected the occurrence of anastomotic leakage. The permanent stoma rate in the Treatment group was 9/63 (16.67%). Conclusion:Protective ileostomy has no significant advantage in reducing the incidence of anastomotic leakage in patients with rectal cancer neoadjuvant radiotherapy and chemotherapy, and may lead to permanent stoma.

Objective:To investigate the relationship between systematic immune-inflamma-tion index(SII) and clinicopathological characteristics for colorectal cancer.Methods:The retrospec-tive cohort study was conducted. The clinicopathological data of 513 patients with colorectal cancer who were admitted to the Beijing Friendship Hospital of Capital Medical University from February 2019 to May 2021 were collected. There were 311 males and 202 females, aged (64±12)years. Observation indicators: (1) SII of colorectal cancer and relationship between SII and clinicopatholo-gical characteristics; (2) influencing factors for SII in colorectal cancer patients. According to the median of SII as the cutoff value, the patients were divided into high SII and low SII patients. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Count data were represented as absolute numbers or percen-tages, and comparison between groups was conducted using the chi-square test. Measurement data with skewed distribution were represented as M( P25, P75), and comparison between groups was analyzed using the non-parameter rank sum test. Comparison of ordinal data was analyzed using the Mann-Whitney U non-parameter test. Variables with statistically significant differences between groups were included for further analysis. Pearson correlation coefficient analysis was used for continuous data, and Wilcoxon or Kruskal-Willas analysis was used for categorical data and Bonferroni correction was performed. Univariate and multivariate linear regression analyses were conducted. Results:(1) SII of colorectal cancer and relationship between SII and clinicopathological charac-teristics: the SII of 513 patients was 355(253,507). Taking the median SII 355 as the cutoff value, 257 of 513 patients with SII>355 had high SII and 256 cases with SII≤355 had low SII. Of high SII patients, the Karnofsky performance status(KPS) score, preoperative albumin(Alb), CA125, cases with tumor located at left or right hemicolon, tumor diameter, cases with laparoscopic assisted surgery or laparotomy (surgical approach), cases in stage T0, T1, T2, T3, T4 (pathological T staging), cases in stage Ⅰ, Ⅱ, Ⅲ, Ⅳ (pathological TNM staging) were 87±17, (37±5)g/L, 8.80 U/mL(5.90 U/mL, 14.15 U/mL), 174, 83, (5.2±2.8)cm, 208, 44, 5, 19, 25, 131, 63, 34, 98, 94, 14. The above indicators of low SII patients were 91±13, (38±4)g/L, 7.20 U/mL(5.40 U/mL, 10.03 U/mL), 200, 56, (4.0±1.9)cm, 221, 24, 8, 39, 35, 118, 45, 61, 84, 79, 12. There were significant differences in above indicators between the two groups ( t=-2.770, -3.211, Z=-3.799, χ2=7.050, t=5.324, χ2=6.179, Z=-3.390, -2.227, P<0.05). Results of Pearson correlation coefficient analysis showed that SII was positively correlated with the tumor diameter ( r=0.390, P<0.05), and negatively correlated with preoperative Alb ( r=-0.200, P<0.05). Results of Wilcoxon analysis showed that SII was 447(311,720), 352(251,493) in patients with tumor located at right hemicolon and left hemicolon, 439(284,640), 345(243,481) in patients undergoing laparotomy and laparoscopic assisted surgery, respectively. There were signi-ficant differences in SII between patients with tumor located at right and left hemicolon,between patients undergoing laparotomy and laparoscopic assisted surgery ( P<0.05). Results of Kruskal-Willas analy-sis showed that SII was 289(201,463), 296(210,398), 329(252,446), 369(265,505), 434(274,631) in patients with pathological T staging as stage T0, stage T1, stage T2, stage T3, stage T4, respectively, and 307(226,400), 380(260,503), 381(272,563), 376(273,634) in patients with patho-logical TNM staging as stage Ⅰ, stage Ⅱ, stage Ⅲ, stage Ⅳ, respectively. There were significant differences in SII between patients with different pathological T staging and between patients with different pathological TNM staging ( P<0.05). (2) Influencing factors for SII in colorectal cancer patients: results of univariate analysis showed that KPS score, preoperative Alb, CA125, tumor location, tumor diameter, patholo-gical N staging, pathological TNM staging were related factors for SII in colorectal cancer patients ( Beta=-3.5, -15.8, 3.7, 106.3, 51.8, 115.1, 104.7, 141.2,95% confidence interval as -5.7 to -1.3, -22.6 to -9.1, 1.8 to 5.5,34.6 to 177.9, 38.5 to 65.2, 40.5 to 189.7, 11.2 to 198.2, 46.9 to 235.9, P<0.05). Multivariate analysis showed that tumor location and tumor diameter were independent influencing factors for SII in colorectal cancer patients ( Beta=79.5, 42.5, 95% confidence interval as 8.4 to 150.7, 26.6 to 58.4, P<0.05). Conclusions:The SII is correlated with tumor location, tumor diameter, preoperative Alb, pathological T staging, pathological TNM staging. Preoperative hypoproteinemia indicates a high SII score. The longer of tumor diameter, right hemicolon tumor and high TNM staging indicate the more serious immune-inflammatory imbalance. Tumor location and tumor diameter are independent influencing factors for SII in colorectal cancer patients.

Microsatellite instability (MSI) detection is widely used in the diagnosis and prognosis evaluation of colorectal cancer. However, for gastric cancer (GC), there is no standard panel of microsatellites (MSs) used in clinical guidance. The present study aimed to identify useful predictors of the clinical features and for the prognosis of GC, based on an investigation of MSI and loss of heterozygosity (LOH) in tumor-related genes. First, from 20 tumor-related genes which were proven to be important to the development of GC, 91 MSs were identified, and PCR amplification, short tandem repeat scanning analysis and TA clone sequencing were used to analyze MSI and LOH in the first set of 90 GC samples. Subsequently, the same method was used to detect the MSI/LOH of the optimized loci in the second set of 136 GC samples. MSI/LOH in the mismatch repair genes was highly consistent with that in oncogenes and tumor suppressor genes, respectively. The length of the core sequence was a main factor for the MSI/LOH rate. The MSI of 12 single loci was significantly associated with lymph node metastasis. The MSI in TP53-1 and the LOH in MGMT-10 were significantly associated with early stages of tumor infiltration depth. The LOH in MGMT-10, PTN-2 and MCC-17 was significantly associated with TNM stage. The LOH in TP53-1 and ERBB2-12 was associated with adenocarcinoma. The MSI/LOH in 6 single loci of 5 tumor-related genes was associated with poor prognosis of GC. The present study demonstrated that the MSI/LOH of loci in tumor-associated genes was associated with 4 clinicopathological characteristics and outcomes of GC. These results may provide potential specific biomarkers for the clinical prediction and treatment of GC.

Chemoresistance often occurs during 5-fluorouracil (5-Fu) treatment of colorectal cancer (CRC). It is significant to explore the potential strategies to sensitize colorectal cancer cells to 5-Fu treatment. We studied the sensitization of Nephroblastoma overexpressed protein (NOV) on 5-Fu treatment. NOV was overexpressed and knocked down in HT115 and RKO cells respectively. Cell proliferation experiments and related mechanism studies by RT-qPCR and Western blot were performed Subsequently. Nude mouse xenograft model was established to test the inhibitory effect of 5-FU on CRC cells in vivo. In this study, we found that NOV mRNA expression was significantly lower in tumor tissues than that in the normal tissues (P < 0.05). The cell proliferation was reduced in the HT115-NOVexp groups (P < 0.05) and increased in the RKO-NOVkd groups (P < 0.05) than that in the control groups and NC groups. The RT-PCR and Western Blot results showed that NOV inhibited the expression of activator protein (AP)-1 (P < 0.05) and promoted the expression of Caspase-8/3 (P < 0.05) in CRC cells in vitro. NOV also improved the inhibitory effect of 5-Fu on inhibiting colorectal cancer proliferation in a tumor cell xenotransplantation nude mouse model. NOV inhibited the expression of AP-1 and JUK and promoted the expression of Caspase-8/3 in cancer tissues in a tumor cell xenotransplantation nude mouse model. In summary, NOV can sensitize CRC cells towards 5-Fu-mediated inhibitory effect on cell proliferation and its sensitization may be achieved by the JNK/AP-1/Caspase-8/Caspase-3 pathway.

OBJECTIVE:To explore whether protective ileostomy is beneficial in preventing anastomotic leakage after anterior resection of rectal cancer.METHODS:A total of 347 patients underwent anterior resection of rectal cancer in our hospital. Ninety-five patients were treated with protective ileostomy (treatment group), and 252 patients were not (control group). The incidences of anastomotic leakage and permanent stoma were compared between the two groups.RESULTS:The overall incidences of anastomotic leakage were 6.32% (6/95) and 8.73% (22/252) in the treatment group and control group, respectively. In the cohort of patients who underwent neoadjuvant radiotherapy, the incidence of anastomotic leakage was 5.88% (2/34) and 12.0% (3/25) in the treatment group and control group, respectively. Logistic regression showed that the incidence of anastomotic leakage was not statistically significant. However, diabetes and the anastomotic height significantly affected the occurrence of anastomotic leakage. The permanent stoma rate was 6.42% (6/95) and 5.95% (15/252) in the treatment group and control group, respectively.CONCLUSION:Protective ileostomy did not show a significant advantage in reducing the incidence of postoperative anastomotic leakage in patients with rectal cancer, and it may lead to a permanent stoma.

Background: Colorectal cancer (CRC) comprises a large proportion of malignant tumors, and early detection of CRC is critical for effective treatment and optimal prognosis. We aimed to discover and validate serum autoantibodies for early detection of CRC. Methods: Combined with CRC-associated autoantibodies discovered by serological proteome and multiplex analyses, 26 predefined autoantibodies were evaluated in 315 samples (130 CRCs, 75 advanced adenomas, and 110 healthy controls) by protein microarray analysis. Autoantibodies with potential detection value were verified by enzyme-linked immunosorbent assays (ELISAs). Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the accuracy of the biomarkers. Results: Four serum autoantibodies (ALDH1B1, UQCRC1, CTAG1, and CENPF) showed statistically different levels between patients with advanced neoplasm (CRC or advanced adenoma) and controls in microarray analysis, which were validated by ELISAs. Among the four biomarkers, the ALDH1B1 autoantibody showed the highest detection value with area under the curve (AUC) values of 0.70 and 0.74 to detect CRC and advanced adenoma with sensitivities of 75.68 and 62.31% and specificities of 63.06 and 73.87%, respectively. By combining the four biomarkers, the performance was improved with an AUC of 0.79 to detect CRC and advanced adenomas. Conclusion: The ALDH1B1 autoantibody has a good potential for early detection of CRC and advanced adenoma, and measuring serum autoantibodies against tumor-associated antigens may improve detection of early CRC.

目的 探讨应用皮下负压引流器预防下消化道开腹手术切口愈合不良的价值.方法 回顾性分析2018年10月至2020年1月首都医科大学附属北京友谊医院普外科收治的113例下消化道开放手术病人的临床资料.根据腹壁缝合时是否放置皮下引流器,分为皮下引流组(78例)和对照组(35例).比较两组病人切口愈合情况,分析切口愈合不良与临床特征的关系以及开放手术切口愈合不良的影响因素.结果 113例病人中,切口愈合不良发生率为14.2％(16/113),其中皮下引流组切口愈合不良发生率为5.1％(4/78),对照组为34.3％(12/35),两组差异具有统计学意义(P＜0.05).多因素分析提示,影响切口愈合不良发生的独立危险因素为未放置皮下引流器(OR=14.510,95％CI 3.411～61.735,P=0.001)、糖尿病(OR=7.064,95％CI 1.286～38.789,P=0.024)及吻合口漏/残端漏(OR=15.004,95％CI 1.876～119.996,P=0.011).结论 下消化道开放手术切口愈合不良发生率较高,应用皮下负压引流器能有效减少其发生,且操作方便、价格低廉.

BACKGROUND:The aim of this study was to determine whether circulating tumor cells (CTCs) have utility as a prognostic biomarker in stage II colorectal cancer (CRC), as well as a biomarker for the selection of patients for adjuvant chemotherapy.METHODS:CTCs were detected in peripheral blood samples obtained from 73 stage II CRC patients, using a negative enrichment and immune-fluorescence in situ hybridization (imFISH) staining method. The follow-up time ranged from 3.5 to 35.9 months, and the clinic-pathologic characteristics and recurrence free survival (RFS) were collected and analyzed.RESULTS:Seventy-three stage II CRC patients were included in this study. The positive rate of CTCs was 65.8% in all patients, 87.5% in recurrent patients and 59.6% in no recurrence patients. The mean RFS was 30.6 months for all patients, 28.7 months for CTC-positive patients and 34.0 months for CTC-negative patients (P=0.043). The mean RFS of CTC-positive and CTC-negative patients with adjuvant chemotherapy were not reached, and those without adjuvant chemotherapy were 27.7 and 33.4 months, respectively.CONCLUSIONS:The level of CTCs may be an effective prognostic factor to predict RFS in stage II CRC patients, and has potential in selecting stage II CRC patients for adjuvant chemotherapy.

Neoadjuvant chemoradiotherapy (nCRT)+ total mesorectal excision (TME) has become the standard mode of treatment for locally advanced rectal cancer(LARC). However, the sensitivity of different patients to nCRT varies greatly, some patients can get pathological complete response (pCR), and their long-term survival is significantly improved, Some patients'tumors continue to progress, therefore, accurate prediction of whether pCR can be achieved after nCRT is very important for guiding individualized treatment of patients. Current studies have shown that some accessible clinical factors, such as age, pathological types of tumors, TNM staging, circumferential extent of tumor, distance to the anal verge, CEA level, neutrophil lymphocyte ratio, can be used to predict whether pCR can be achieved.This article reviews the progress of clinical predictors of pCR in LARC after nCRT.