Comparison of the eighth version of the American Joint Committee on Cancer manual to the seventh version for colorectal cancer: A retrospective review of our data

AIM To analyze the survival trends in colorectal cancer(CRC) based on the different classifications recommended by the seventh and eighth editions of the American Joint Committee on Cancer staging system(AJCC-7^(th) and AJCC-8^(th)).METHODS The database from our institution was queried to identify patients with pathologically confirmed stage 0-Ⅳ CRC diagnosed between 2006 and 2012. Data from 2080 cases were collected and 1090 cases were evaluated through standardized inclusion and exclusion criteria. CRC was staged by AJCC-7^(th) and then restaged by AJCC-8^(th). Five-year disease-free survival(DFS) and overall survival(OS) were compared. SPSS 21.0 software was used for all data. DFS and OS were compared and analyzed by Kaplan-Meier and Log-rank test.RESULTS Linear regression and automatic linear regression showed lymph node positive functional equations by tumornode-metastasis staging from AJCC-7^(th) and tumornode-metastasis staging from AJCC-8^(th). Neurological invasion, venous infiltration, lymphatic infiltration, and tumor deposition put forward stricter requirements for pathological examination in AJCC-8^(th) compared to AJCC-7^(th). After re-analyzing our cohort with AJCC-8^(th),the percentage of stage ⅣB cases decreased from 2.8% to 0.8%. As a result 2% of the cases were classified under the new ⅣC staging. DFS and OS was significantly shorter(P = 0.012) in stage ⅣC patients compared to stage ⅣB patients.CONCLUSION The addition of stage ⅣC in AJCC-8^(th) has shown that peritoneal metastasis has a worse prognosis than distant organ metastasis in our institution's CRC cohort. Additional datasets should be analyzed to confirm these findings.

Development of hybrid-type modified chitosan derivative nanoparticles for the intracellular delivery of midkine-siR NA in hepatocellular carcinoma cells

BACKGROUND： Hepatocellular carcinoma（HCC） is one of the most common cancers worldwide. Most of the patients with HCC lose the surgical opportunity at the time of diagno sis. Some novel therapeutic modalities, like gene therapy, are promising for the treatment of HCC. However, the success of gene therapy depends on two aspects： efficient gene materials and gene delivery vectors. The present study was to develop new chitosan-based nanoparticles for a midkine-si RNA（anti HCC gene drug） delivery.METHODS： The novel gene delivery vector（MixN CH） was syn thesized by hybrid-type modification of chitosan with 2-chloro ethylamine hydrochloride and N, N-dimethyl-2-chloroethylamine hydrochloride. The chemical structure of Mix NCH was char acterized by FT-IR and 1HNMR. The cytotoxicity of Mix NCH was determined by MTS assay. The gene condensation ability and size, zeta potential and morphology of Mix NCH/MK si RNA nanoparticles were measured. The in vitro transfection and gene knockdown efficiency of midkine by Mix NCH/MK si RNA nanoparticles was detected by q RT-PCR and Western blotting. Gene knockdown effect at the molecule level on the proliferation of Hep G2 in vitro was determined by MTS assay.RESULTS： Mix NCH was successfully acquired by aminoalkyl ation modification of chitosan. The Mix NCH could condense MK-siR NA well above the weight ratio of 3. The average size of Mix NCH/MK-si RNA nanoparticles was 100-200 nm, and thesurface charge was about ＋5 m V. Morphologically, Mix NCH/MK-si RNA nanoparticles were in regular spherical shape-with no aggregation. Regarding to the in vitro transfection of nanoparticles, the MixN CH/MK-siR NA nanoparticles reduced MK m RNA level to 14.03%±4.03%, which were comparable to Biotrans（8.94%±3.77%）. Mix NCH/MK-si RNA effectively inhibited the proliferation of Hep G2 in vitro.-CONCLUSION： Mix NCH/MK-si RNA nanoparticles could be effective for the treatment of hepatocellular carcinoma.