INTRODUCTION: Preoperative, long-course chemoradiot-herapy is recommended for rectal cancers involving or threatening the mesorectal resection margin, but tumor response is variable. Some highly radiosensitive cancers...INTRODUCTION: Preoperative, long-course chemoradiot-herapy is recommended for rectal cancers involving or threatening the mesorectal resection margin, but tumor response is variable. Some highly radiosensitive cancers completely regress, leading to reduced local recurrence and improved survival. This study was designed to evaluate the influence of anemia during chemoradiotherapy on tumor response, local and distant recurrence, and overall survival. METHODS: Mean hemoglobins during chemoradiotherapy of consecutive patients with rectal cancer undergoing chemoradiotherapy and surgerywere calculated and ranked. Anemia was defined as lowest quartile for males and females. Tumor response was histologically quantified using rectal cancer regression grade. RESULTS: Of 100 patients, 5 females and 20 males were anemic. Nonanemic patients achieved better tumor response (54 percent regression Grade 1) than anemic patients (28 percent, P = 0.028). There were more locally advanced cancers in anemic (48 percent T4) compared with nonanemic patients (21 percent T4), but radiologic T stage did not influence tumor response (50 percent T3 vs. 43 percent T4 regression Grade 1, P = 0.53) or overall survival. Mesorectal margin positivity was less in nonanemic (15 percent) compared with anemic patients (36 percent, P = 0.021). At median follow-up of 39 months, nonanemic patients (7 percent) suffered less local recurrence than anemic patients did (38 percent, P = 0.003). Overall survival at two years was improved in nonanemic (91 percent) compared with anemic patients (64 percent, P = 0.021), but was similar for T3 and T4 patients. CONCLUSIONS: Patients with normal hemoglobin during chemoradiotherapy achieved better tumor response, less local recurrence, and improved overall survival compared with anemic patients, independent of radiologic T stage. Correcting anemia before chemoradiotherapy might improve tumor response and oncologic outcomes.展开更多
目的探讨辣椒素受体(TRPV1)及瞬时性受体电位通道香草酸受体4(TRPV4)与癌胚抗原相关细胞黏附分子6(CEACAM6)共表达对结直肠癌(CRC)患者预后的影响。方法使用GEPIA交互分析软件根据基因表达中值将620例CRC患者分为高表达和低表达两组(中...目的探讨辣椒素受体(TRPV1)及瞬时性受体电位通道香草酸受体4(TRPV4)与癌胚抗原相关细胞黏附分子6(CEACAM6)共表达对结直肠癌(CRC)患者预后的影响。方法使用GEPIA交互分析软件根据基因表达中值将620例CRC患者分为高表达和低表达两组(中值1例不入组),以设定阈值对TCGA和GTEX数据库中TRPV1和TRPV4基因的表达量进行log2(TPM+1)转换及差异分析,采用Wilcoxon检验分析TRPV1/TRPV4和CEACAM6基因共表达与CRC患者总体生存期(OS)的关系,采用基因组数据分析及免疫组化染色法对上述结果进行验证。结果CRC患者癌组织中TRPV1的表达量显著低于癌旁组织(1.70±0.51 vs 3.10±0.46,t=-53.56,P<0.01),而TRPV4显著高于癌旁组织(1.47±0.78 vs 0.67±0.33,t=25.98,P<0.01)。TRPV1和CEACAM6双高表达组CRC患者的OS显著高于CEACAM6单高表达患者(中位OS:6.8年vs 5.5年,log-rank P=0.0479)。结论检测TRPV1及TRPV4水平可有效评估CEACAM6高表达CRC患者的预后。展开更多
文摘INTRODUCTION: Preoperative, long-course chemoradiot-herapy is recommended for rectal cancers involving or threatening the mesorectal resection margin, but tumor response is variable. Some highly radiosensitive cancers completely regress, leading to reduced local recurrence and improved survival. This study was designed to evaluate the influence of anemia during chemoradiotherapy on tumor response, local and distant recurrence, and overall survival. METHODS: Mean hemoglobins during chemoradiotherapy of consecutive patients with rectal cancer undergoing chemoradiotherapy and surgerywere calculated and ranked. Anemia was defined as lowest quartile for males and females. Tumor response was histologically quantified using rectal cancer regression grade. RESULTS: Of 100 patients, 5 females and 20 males were anemic. Nonanemic patients achieved better tumor response (54 percent regression Grade 1) than anemic patients (28 percent, P = 0.028). There were more locally advanced cancers in anemic (48 percent T4) compared with nonanemic patients (21 percent T4), but radiologic T stage did not influence tumor response (50 percent T3 vs. 43 percent T4 regression Grade 1, P = 0.53) or overall survival. Mesorectal margin positivity was less in nonanemic (15 percent) compared with anemic patients (36 percent, P = 0.021). At median follow-up of 39 months, nonanemic patients (7 percent) suffered less local recurrence than anemic patients did (38 percent, P = 0.003). Overall survival at two years was improved in nonanemic (91 percent) compared with anemic patients (64 percent, P = 0.021), but was similar for T3 and T4 patients. CONCLUSIONS: Patients with normal hemoglobin during chemoradiotherapy achieved better tumor response, less local recurrence, and improved overall survival compared with anemic patients, independent of radiologic T stage. Correcting anemia before chemoradiotherapy might improve tumor response and oncologic outcomes.
文摘目的探讨辣椒素受体(TRPV1)及瞬时性受体电位通道香草酸受体4(TRPV4)与癌胚抗原相关细胞黏附分子6(CEACAM6)共表达对结直肠癌(CRC)患者预后的影响。方法使用GEPIA交互分析软件根据基因表达中值将620例CRC患者分为高表达和低表达两组(中值1例不入组),以设定阈值对TCGA和GTEX数据库中TRPV1和TRPV4基因的表达量进行log2(TPM+1)转换及差异分析,采用Wilcoxon检验分析TRPV1/TRPV4和CEACAM6基因共表达与CRC患者总体生存期(OS)的关系,采用基因组数据分析及免疫组化染色法对上述结果进行验证。结果CRC患者癌组织中TRPV1的表达量显著低于癌旁组织(1.70±0.51 vs 3.10±0.46,t=-53.56,P<0.01),而TRPV4显著高于癌旁组织(1.47±0.78 vs 0.67±0.33,t=25.98,P<0.01)。TRPV1和CEACAM6双高表达组CRC患者的OS显著高于CEACAM6单高表达患者(中位OS:6.8年vs 5.5年,log-rank P=0.0479)。结论检测TRPV1及TRPV4水平可有效评估CEACAM6高表达CRC患者的预后。
