Objective To analyze the prognostic characteristics of different invasion sites and the risk factors affecting overall prognosis, in patients with pT4b stage colorectal cancer who underwent radical resection and showed no lymph node metastasis （N0） by pathology. Methods The clinical and pathological data of colorectal cancer patients received surgical resection in China National Petroleum Corporation Central Hospital from 2017-01-01 to 2021-12-21 were calculated and followed up to 2022-12-31. The time of operation, the time of local recurrence or distant metastasis and the time of death were recorded. Risk factor analysis was grouped based on whether there was disease progression during follow-up. Prognosis of different groups was compared and logistic binary regression was used to screen for meaningful risk factors. Results Survival analysis showed that the disease-free survival (DFS) of patients with tumor invasion of abdominal wall or omentum was (22.2±3.2) months, DFS of tumor invasion of stomach or intestine was (28.3±5.6) months, DFS of tumor invasion of uterus or adnexal was (35.7±2.6) months, and DFS of tumor invasion of the bladder or ureteral was (30.1±3.4) months, Log-rank P=0.001 among groups. Multivariate analysis showed that the right colon (OR=6.829, 95%CI:1.603-29.093, P=0.009), tumor invasion of abdominal wall, omentum (OR=6.198, 95%CI:1.231-31.210, P=0.027), tumor maximum diameter (OR=0.565, 95%CI:0.365-0.874, P=0.010) were independent factors affecting the progression of colorectal cancer. Conclusion Among colorectal cancer patients with pathological staging pT4bN0M0, patients with tumor invasion of the uterus and appendix have the best prognosis, while patients with invasion of the abdominal wall and omentum have the worst prognosis. Patients with tumors located in the right colon and invading the abdominal wall, omentum, or smaller tumor lesions are more likely to experience regional recurrence or distant metastasis after surgery.

Colorectal cancer (CRC) has brought great healthy burden for patients. Neutrophil extracellular traps (NETs) have been explored in several tumors, while it remains largely unclear in CRC. CRC-related data were downloaded from Cancer Genome Atlas and Gene Expression Omnibus databases. Then, a NET risk score was built after univariate Cox and LASSO Cox regression analysis. Prognostic value was evaluated via survival analysis, stratification analysis, and ROC analysis. The functional enrichment analysis was conducted basing on bulk and scRNA-seq data. The immune landscape difference was analyzed using CIBERSORT, XCell, and MCPcounter portals. NET risk score was built for CRC patients, basing on G0S2, HIST1H2BC, CRISPLD2, and IL17A. In TCGA-CRC and validation datasets, regardless of age or gender, high-risk CRC patients had significantly worse prognosis, besides higher NET risk score was mainly found in samples with MSI-H and advanced T, N, and M stages. Employing multiple databases, we noticed that M0 and M2 Macrophages infiltrated the most in high-risk CRC patients, besides M2 Macrophages and neutrophils showed positive correlation with NET risk score. A novel reliable prognostic NET risk score was developed for CRC patients, and high-risk patients had unfavorable prognosis with advanced disease status.

目的 研究胃癌超声双重造影(DCEUS)参数与临床病理特征、miR-134-3p及潜在靶基因血管内皮生长因子(VEGF)、基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)表达的关系.方法 选择 2015 年 1月至 2016 年 12 月在河北中石油中心医院接受手术治疗的 128 例胃癌患者为研究对象,术前进行DCEUS,术中收集胃癌组织与癌旁组织,计算并比较各组胃癌组织及正常胃壁组织的造影剂达峰时间(TTP)、峰值强度(PI)、始增时间(RT);检测并比较不同DCEUS造影参数胃癌组织中miR-134-3p、VEGF、MMP-2、MMP-9 的mRNA表达水平.术后随访无病生存期.结果 与正常胃壁组织比较,胃癌组织的TTP、RT水平降低,PI水平增加(P均＜0.05).不同T分期、脉管侵犯情况的胃癌组织比较,TTP、RT、PI的差异均有统计学意义(P均＜0.05).与TTP及RT＞中位数、PI≤中位数的胃癌组织比较,TTP及RT≤中位数、PI＞中位数的胃癌组织中miR-134-3p的表达水平降低,VEGF、MMP-2、MMP-9 mRNA表达水平增加(P均＜0.05).与TTP及RT＞中位数、PI≤中位数的胃癌患者比较,TTP及RT≤中位数、PI＞中位数的胃癌患者无病生存期缩短(P＜0.05).结论 胃癌DCEUS参数的变化与T分期增加、脉管侵犯的病理特征恶化及无病生存期缩短有关,也与miR-134-3p及潜在靶基因VEGF、MMP-2、MMP-9 表达改变有关.

Background The American Society of Colon and Rectal Surgeons is suggesting laparoscopic surgeries for colorectal cancer. Conventional perioperative procedures like long preoperative fasting and bowel procedures are not useful and harmful to patients undergoing surgeries for colorectal cancer. The objectives of the study were to compare surgery outcomes, hospital stays, and survival of patients who received fast-track (laparoscopy/open) surgical procedure followed by chemotherapy against those who received conventional (laparoscopy/open) surgical procedure followed by chemotherapy for colorectal cancer. Methods The study analyzes the outcomes of a total of 542 colorectal cancer (preoperative biopsies stage II or III) patients submitted to surgery and adjuvant chemotherapy. The study cohort is retrospectively subdivided in 4 groups submitted to open or laparoscopic resection with or without fast-track protocol appliance and two different chemotherapy regimens. Patients who ended up being TNM stage I have not received the adjuvant chemotherapy. Results The fast-track surgical procedure had shorter total hospital stays and postoperative hospital stays than the conventional surgical procedures. Flatus resumption time, the time until first defecation, and intraoperative blood loss were shorter for the fast-track surgical procedures than the conventional surgical procedures. Those surgery outcomes were also shorter for the fast-track laparoscopy than the open fast-track. Resumption of a fluid diet and ambulation onset time were shorter for the fast-track surgical procedures than the conventional surgical procedures. The surgical checkpoints that were compliance by patient of fast-track surgeries were significantly fewer than those of the conventional surgeries. Clinically significant difference for QLQ-C30/CR38 score after chemotherapy was reported between patients who received open conventional surgeries and those patients who received fast-track laparoscopy (59.63 ± 2.26 score/patient vs. 71.67 ± 5.19 score/patient). There were no significant differences for the number of patients with any grade adverse effects ( p = 0.431) or with grade 3–4 adverse effects ( p = 0.858), and the disease-free and overall survival among cohorts. Conclusions The fast-track surgical procedure is effective and safe even in a multidisciplinary scenario as colorectal cancer treatment in which surgery is only a part of management. Level of evidence: III Technical efficacy stage: 4.

目的:探讨垂体肿瘤转化基因(PTTG1)调控结直肠癌细胞凋亡及其与磷脂酰肌醇-3-激酶(PI3K)/丝氨酸-苏氨酸蛋白激酶(AKT)信号通路的关系.方法:使用慢病毒感染系统构建PTTG1基因过表达和干扰表达的HCT116人结直肠癌细胞稳定细胞株,随机分为空白对照组(A组),阴性对照组(B组),PTTG1敲除组(C组)和PTTG1过表达组(D组).采用免疫印迹实验(Western blotting法)及实时RT-PCR检测不同稳定细胞株中PTTG1及PTTG1 mRNA的表达,分别采用CCK-8、流式细胞术、Transwells小室对细胞的增殖、凋亡、迁移和侵袭情况进行检测.比较各组PTTG1及PTTG1 mRNA水平的表达、细胞的增殖、凋亡、迁移和侵袭情况,并分析PTTG1对PI3K/AKT信号通路的影响.结果:与A组比较,C组的PTTG1 mRNA表达明显降低,D组的明显升高(P<0.05).C组PTTG1蛋白表达低于B组,D组高于B组(P<0.05).A组、B组、C组的细胞增殖能力比较,差异无统计学意义(P>0.05);D组的细胞增殖能力明显低于其他3组(P<0.05).D组凋亡的细胞数均明显高于其他3组(P<0.05).D组的细胞迁移个数和侵袭个数均明显低于其他3组(P<0.05).PTTG1上调可抑制PI3K表达,造成PI3K/AKT通路失活.进一步使用PI3K激动剂(740Y-P)和AKT激动剂(PDGF)反向逆转,发现PTTG1对PI3K/AKT信号通路同样存在抑制作用.结论:PTTG1基因过表达能够抑制结直肠癌细胞增殖,促进凋亡,并抑制肿瘤细胞的浸润和转移,且这一过程与PTTG1基因对PI3K/AKT信号通路的抑制相关.

目的 探究动脉灌注化疗序贯放疗治疗乳腺癌改良根治术后胸壁复发的临床效果.方法 选取2013年5月-2018年5月在我院接受手术治疗后140例乳腺癌胸壁复发患者,根据治疗方法将其分为单纯放疗组和灌注化疗+放疗组,每组70例.单纯放疗组患者采用单纯放疗的方法,灌注化疗+放疗组患者采用灌注化疗+放疗的方法.观察并记录两组患者的具体情况.结果 灌注化疗+放疗组患者的临床治疗效果明显优于单纯放疗组(P<0.05),治疗后,灌注化疗+放疗组患者的白介素6(IL-6)、C反应蛋白(CRP)以及肿瘤坏死因子α(TNF-α)等炎症因子水平明显低于单纯放疗组(P<0.05),灌注化疗+放疗组患者腋下复发、锁骨上复发、内乳复发以及胸壁复发概率明显低于单纯放疗组(P<0.05),灌注化疗+放疗组患者的精神状况评分、情感状态评分、躯体功能评分以及总体健康评分明显高于单纯放疗组(P<0.05).结论 在临床上,对乳腺癌术后胸壁复发患者采用灌注化疗+放疗的治疗效果较好,对患者的局部控制率较高,值得进一步推广.

目的 观察动脉灌注多西他赛和表柔比星联合静脉输入贝伐单抗治疗乳腺癌术后胸壁复发的效果.方法 随机选取2016年5月-2019年5月河北中石油中心医院治疗的乳腺癌术后胸壁复发患者60例,随机分为2组.动脉灌注组(30例):动脉灌注多西他赛、表柔比星联合静脉输入贝伐单抗治疗;静脉化疗组(30例):静脉输入多西他赛、表柔比星、贝伐单抗治疗.统计分析两组患者的临床疗效、主要不良反应发生情况和生命质量评分情况.结果 治疗后,动脉灌注组患者的总缓解率53.3％,显著高于静脉化疗组的33.3％ (P＜0.05).动脉灌注组患者中消化道反应Ⅰ级6例,Ⅱ级5例,Ⅲ级1例,总发生率为40.0％;骨髓抑制Ⅰ级2例,Ⅱ级2例,Ⅲ级1例,总发生率为16.7％.静脉化疗组患者中消化道反应Ⅰ级6例,Ⅱ级7例,Ⅲ级3例,Ⅳ级1例,总发生率为56.7％;骨髓抑制Ⅰ级4例,Ⅱ级3例,Ⅲ级1例,Ⅳ级1例,总发生率为30.0％.动脉灌注组患者的消化道反应、骨髓抑制发生率均显著低于静脉化疗组(P＜0.05).两组患者治疗后躯体、情感、认知、角色、社会功能及整体生命质量评分均显著高于治疗前(P＜0.05),动脉灌注治疗组患者的提升幅度显著高于静脉治疗组(P＜0.05).结论 动脉灌注多西他赛、表柔比星联合静脉输入贝伐单抗治疗乳腺癌术后胸壁复发的效果优于静脉输入多西他赛、表柔比星、贝伐单抗治疗组.

Objective:To analyze the effects of cellular immunity assisted endostar,interventional embolization on medium and long term survival time in patients with advanced hepatocellular carcinoma. Methods:The patients with advanced hepatocellular carcinoma treated in our hospital from July 2011 to December 2014 were included in the study,and their clinical data were analyzed retrospectively. 30 patients treated with endostar and interventional emboli-zation were screened in the control group,and another 30 patients treated with cellular immune assisted therapy on this basis were included in the observation group. The clinical efficacy,the levels of T lymphocyte and NK cell and liver cancer specific biochemical markers alpha fetoprotein (AFP),the survival time and the incidence rates of complica-tions were compared between the two groups. Results:Among the patients with advanced hepatocellular carcinoma , the total effective rate in the observation group was significantly higher than that in the control group (90. 00% vs 70. 00%). After treatment,the levels of T lymphocytes CD3 +,CD4 +,CD4 +/CD8 +and NK cells in the observation group were significantly increased and higher than those in the control group,and the levels of CD8 +,regulatory T cells (Treg)and AFP were significantly decreased and lower than those in the control group,and there was only sta-tistically significant difference in the levels of CD4 +,CD8 +,CD4 +/CD8 +and AFP in the control group (P＜0. 05), and there was no difference in other indexes levels (P＞0. 05). And the incidence rate of complications in the obser-vation group was significantly lower than that in the control group (20. 00% vs 46. 67%),and the proportion of pa-tients with survival time more than 1 year was significantly higher than that in the control group (53. 33% vs 26. 67%). The disease-free survival time and the total survival time of the observation group were longer than those of the control group (P＜0. 05). Conclusion:Cellular immunity assisted endostar,interventional embolization for ad-vanced liver cancer can achieve the long survival time,and can increase the patient's treatment tolerance and have low incidence rate of complications.

目的 观察重组人血管内皮抑制素(恩度)联合化疗药物治疗恶性胸腔积液的疗效.方法 选取乳腺癌所致恶性胸腔积液患者90例,根据其不同的治疗方式将其分为观察组以及对照组,每组45例.观察组应用恩度联合化疗药物治疗,对照组单独应用化疗药物治疗,治疗前均先排尽胸腔积液.治疗组在胸腹腔内注入顺铂60 mg、恩度45～60 mg;对照组除不加入恩度外,其余同治疗组.比较2组治疗效果.结果 观察组的总有效率为77.78％(35/45),对照组为44.44％,组间差异有统计学意义(x2=5.372,P＜0.05).观察组生活质量改善率为55.26％;对照组为33.33％,组间差异有统计学意义(x2 =4.500,P＜0.05).2组的不良反应发生率分别达到了35.56％和33.33％,差异无统计学意义(P＞0.05).治疗前,2组红细胞数无统计学差异(P＞0.05);治疗后,观察组较对照组红细胞数显著减少(P＜0.05).结论 对于乳腺癌所致的恶性胸腔积液采用胸腔内灌注顺铂序贯恩度治疗安全、有效,值得临床推广应用.

Objective:To analyze the long term effect of artery infusion of docetaxel,epirubicin than traditional intravenous chemotherapy,on the chest wall recurrence after treatment of breast cancer patients (radical,modified radical mastectomy).Methods:From October 2013 to January 2016 in our hospital.To analyze the effect and side reaction of artery infusion of docetaxel,epirubicin than traditional intravenous chemotherapy,on the chest wall recurrence after treatment of breast cancer patients (radical,modified radicM mastectomy).Select the patients in each group of the research object.Study group (group Ⅰ):Arterial infusion chemotherapy drug group,a total of 25 cases.Control group (group Ⅱ):Central venous infusion chemotherapy drug group,a total of 40 cases.Through the follow-up,the time of local progress (the time of chest wall recurrence progress or regional lymph node metastasis),the time of distant metastasis and the time of death were recorded.The survival analysis was carried out on the two groups of patients.Results:All patients were followed up for 9 ～ 36 months,with a median follow-up of 23 months.Survival analysis:Group Ⅰ,group Ⅱ,median progression free survival (PFS) for 11 months,7 months,the difference was statistically significant (P =0.03).Median distant metastasis free survival (DMFS) for 17 months,14 months,the difference was not statistically significant (P =0.33).Median overall survival (OS) for 47 months,44 months,the difference was not statistically significant(P =0.71).Conclusion:After arterial infusion chemotherapy prolongs progression free survival in breast cancer patients with chest wall recurrence,and the data had statistical significance.While distant metastasis free survival and total survival time there is a difference,but not significant.Long term effect was slightly better than intravenous chemotherapy.

Objective:To observe the clinical efficacy of rh -endostatin (endostar)combined with capecitabine regimen and capecitabine regimen alone in elderly patients with advanced colorectal cancer.Methods:Totally 86 ca-ses of advanced colorectal cancer elderly patients in our hospital from 2010 to 2013 were randomly divided into the treatment group and the control group,43 cases in each group.Control group was treated by capecitabine regimen a-lone,while treatment group was treated by endostar combined with capecitabine regimen.The short time curative effect,adverse reactions and survival rate of patients in two groups were compared.Results:The effective rate in treat-ment group (44.2%)was higher than that in control group (23.3%)(P<0.05).The clinical benefit rate in treat-ment group (83.7%)was higher than that in control group (55.8%)(P<0.05).There was no statistical signifi-cance in the incidence of leucocyte decreasing,blood platelet decreasing,hand-foot syndrome,nausea and vomiting and diarrhea in two groups (P>0.05).There was also no statistical significance in the incidence of hypertension and serious event in cardiovascular system in two groups (P>0.05 ).1 -year survival rate and 2 -year survival rate in treatment group was higher than those in control group (P<0.05).Conclusion:Endostar combined with capecitabine regimen in the treatment of elderly advanced colorectal cancer will enhance the short time curative effect and survival rate,and with lower adverse reactions.It deserves to be further popularized clinically.

[目的]探索早期乳腺癌胸壁复发的危险因素.[方法]收集2005年8月至2016年3月我院收治的乳腺癌患者的临床资料,入组条件:术后分期T1N0M0、T2N0M0,清扫淋巴结总数≥10枚;且未行术后辅助放射治疗,共入组337例;其中首发转移部位为胸壁者共48例.[结果]单因素分析显示,原发灶大小、癌周血管侵犯、组织学分级、ER/PR表达、内分泌治疗等不同亚组在胸壁复发之间有统计学意义(P＜0.05).Logistic回归多因素分析显示,癌周血管侵犯(+)、组织学分级Grade 3与T1-2N0M0期乳腺癌术后胸壁复发相关(P＜0.05).[结论]乳腺癌术后分期T1-2N0M0的患者中,癌周血管侵犯(+)、组织学分级Grade3为术后胸壁复发的独立危险因素,此类患者行术后辅助放疗有可能临床获益.

目的:观察MGMT、XRCC1蛋白在大肠息肉中的表达.方法:采用免疫组织化学方法检测MGMT、XRCC1蛋白在45例大肠增生性息肉组织、50例大肠腺瘤性息肉组织及30例正常大肠黏膜组织中的表达,探讨BRCA1、BRCA2蛋白表达与大肠腺瘤性息肉患者的性别、年龄,息肉部位、直径及是否有蒂的关系,分析MGMT、XRCC1蛋白在腺瘤性息肉组织中表达的相关性.结果:MGMT、XRCC1蛋白在正常大肠黏膜、大肠增生性息肉以及大肠腺瘤性息肉组织中的表达依次增加,差异有统计学意义(P＜0.05);在大肠腺瘤性息肉组织中MGMT、XRCC1蛋白的表达与息肉的大小及是否有蒂有关(P＜0.05),与患者的性别、年龄及直径无关(P＞0.05);MG-MT、XRCC1蛋白在腺瘤性息肉组织中表达呈正相关(r=7.356,P＜0.05).结论:BRCA1、BRCA2蛋白的表达与大肠腺瘤性息肉有关.

目的 探讨动脉灌注多西他赛和表柔比星治疗乳腺癌术后胸壁复发的疗效及不良反应.方法 选取2013年10月至2016年1月间中国石油天然气集团公司中心医院收治的75例乳腺癌术后单纯胸壁复发患者,根据化疗药物给药方式不同分为研究组和对照组.研究组患者28例,通过锁骨下动脉造影,确认复发区供血动脉,行动脉灌注化疗,实际完成25例.对照组患者47例,静脉给药化疗,实际完成40例.比较两组患者化疗效果及不良反应发生率.结果 研究组患者化疗总有效率为80.0％,对照组患者为52.5％,差异有统计学意义(P＜0.05).两组患者主要不良反应为骨髓抑制和消化道反应,研究组骨髓抑制发生率为16.7％,对照组为29.2％.研究组患者消化道反应发生率为41.7％,对照组为57.7％,两组比较,差异均有统计学意义(均P＜0.05).结论 乳腺癌术后胸壁复发患者经动脉灌注化疗有效率高,不良反应少,安全有效,值得临床推广.