Correlation analysis of interstitial maturity and prognosis of colorectal cancer:Meta-analysis

BACKGROUND To investigate the relationship between interstitial maturity and prognosis of colorectal cancer.AIM To examine the correlation between interstitial maturity and the prognosis of colorectal cancer.METHODS The paper database PubMed,EMBASE,Cochranelibrary,Springerlink,CNKI,and Wanfang database were searched until December 2023."tumor stroma maturity""desmoplastic stroma reaction""desmoplastic reaction""stroma reaction""degree of stroma reaction""stroma classification""stroma density""colorectal cancer""colon cancer""rectal cancer""prognosis"were searched for the search terms.Two system assessors independently screened the literature quality according to the inclusion exclusion criteria,Quality evaluation and data extraction were performed for the included literatures,and meta-analysis was performed for randomized control trials included at using Review Manager 5.2 software.RESULTS Finally,data of 9849 patients with colorectal cancer from 19 cosets in 15 literatures were included,including 4339 patients with mature type(control group),3048 patients with intermediate type(intermediate group)and 2456 patients with immature type(immature group).The results of meta-analysis showed:Relapse-free survival[hazard ratio(HR)=2.66,95%confidence interval(CI):2.30-3.08;P<0.00001],disease-free survival(HR=3.68,95%CI:2.33-5.81;P<0.00001)and overall survival(HR=1.70,95%CI:1.53-1.87;P<0.00001)were significantly lower than those in mature group(control group);relapse-free survival(HR=1.36,95%CI:1.17-1.59;P<0.0001)and disease-free survival rate(HR=1.85,95%CI:1.53-2.24;P<0.0001)was significantly lower than the mature group(control group).CONCLUSION There is the correlation between tumor interstitial maturity and survival prognosis of colorectal cancer,and different degrees of tumor interstitial maturity have a certain impact on the quality of life of colorectal cancer patients.

Compare clinical efficacy and safety of neoadjuvant therapy and neoadjuvant chemoradiotherapy for locally advanced rectal cancer: Meta-analysis

BACKGROUND To compare the efficacy and safety of total neoadjuvant therapy(TNT)and neoadjuvant chemoradiotherapy(nCRT)in the treatment of middle and low locally advanced rectal cancer.Our study will systematically collect and integrate studies to evaluate the ability of these two treatments to improve tumor shrinkage rates,surgical resection rates,tumor-free survival,and severe adverse events.AIM To provide clinicians and patients with more reliable treatment options to optimize treatment outcomes and quality of life for patients with locally advanced rectal cancer by comparing the advantages and disadvantages of the two treatment options.METHODS A full search of all clinical studies on the effectiveness and safety of TNT and nCRT for treating locally advanced rectal cancer identified in Chinese(CNKI,Wanfang,China Biomedical Literature Database)and English(PubMed,Embase)databases was performed.Two system assessors independently screened the studies according to the inclusion and exclusion criteria.Quality evaluation and RESULTS Finally,14 studies were included,six of which were randomized controlled studies.A total of 3797 patients were included,including 1865 in the TNT group and 1932 in the nCRT group.The two sets of baseline data were comparable.The results of the meta-analysis showed that the pCR rate[odds ratio(OR)=1.57,95%confidence interval(CI):1.30-1.90,P<0.00001],T stage degradation rate(OR=2.16,95%CI:1.63-2.57,P<0.00001),and R0 resection rate(OR=1.42,95%CI:1.09-1.85,P=0.009)were significantly greater in the nCRT group than in the nCRT group.There was no significant difference in the incidence of grade 3/4 acute toxicity or perioperative complications between the two groups.The 5-year OS[hazard ratio(HR)=0.84,95%CI:0.69-1.02,P=0.08]and DFS(HR=0.94,95%CI:0.03-1.39,P=0.74)of the TNT group were similar to those of the nCRT group.CONCLUSION TNT has greater clinical efficacy and safety than nCRT in the treatment of locally advanced rectal cancer.

雷帕霉素对兔眼准分子激光角膜切削术后haze的影响

目的:探究调节自噬活性对兔眼准分子激光角膜切削术(PRK)术后角膜上皮下雾状混浊(haze)的影响。方法:新西兰大白兔64只行右眼PRK手术后,根据术后局部用药不同,随机分为4组:单纯手术组、14μmol/L二甲基亚砜组(DMSO)、50μmol/L雷帕霉素组、100μmol/L雷帕霉素组,每组16只。根据分组情况,术后2h开始给予上述滴眼液治疗,每天3次,1次1滴,持续7d,另选取16只兔为正常对照组。术后每天用手持裂隙灯显微镜照相系统,观察兔眼术后炎症反应及角膜上皮愈合情况。裂隙灯显微镜照相系统采集PRK术后1、4wk时各组兔眼haze的形成情况。各组分别于术后1、4wk采用空气栓塞法处死8只兔子,摘取角膜组织,冻存备用。免疫组化检测转化生长因子-β1(TGF-β1)、α-平滑肌肌动蛋白(α-SMA)、基质金属蛋白酶-2(MMP-2)的表达水平。Real Time-PCR技术检测自噬因子-5(ATG5)、自噬因子-12(ATG12)、B淋巴细胞瘤基因-2(Bcl-2)、半胱氨酸天冬氨酸蛋白酶-3(Caspase3)基因的相对表达量。结果:PRK术后兔眼角膜上皮均在3~4d完全愈合,各组兔眼术后角膜上皮愈合时间比较无差异(F=0.745,P=0.530)。在观察期间,各组术后haze均于4wk时最明显,单纯手术组和14μmol/L DMSO组haze症状均较严重,其次为50μmol/L雷帕霉素组,100μmol/L雷帕霉素组haze症状较其他组明显减轻,各组兔眼术后不同时间点haze分级比较有差异(均P<0.05)。免疫组化显示,术后1、4wk,单纯手术组和14μmol/L DMSO组TGF-β1、MMP-2和α-SMA的表达均较强,其次为50μmol/L雷帕霉素组,100μmol/L雷帕霉素组较其他组表达明显减弱(均P<0.05)。PCR法检测显示,术后1、4wk,50、100μmol/L雷帕霉素组ATG5、ATG12和Bcl-2 mRNA相对表达量较单纯手术组和14μmol/L DMSO组明显升高(均P<0.05);50、100μmol/L雷帕霉素组Caspase3 mRNA相对表达量较单纯手术组和14μmol/L DMSO组明显降低(均P<0.05)。结论:雷帕霉素可以增强自噬水平,抑制凋亡水平,从而减轻兔眼PRK术后haze的形成。