BackgroundThe aim of this study was to investigate the association between plasma levels of homocysteine and the occurrence and progression of rectal cancer.Material/MethodsThe 320 study participants included healthy controls (n=80). and patients with rectal tumors (n=240), including 155 patients with rectal cancer, Stage I (n=32), Stage II (n=38), Stage III (n=50), and Stage IV (n=35), and patients with low-risk rectal adenomas (n=31), and high-risk rectal adenomas (n=54). All study participants had fasting blood samples taken, and plasma levels of homocysteine and carcinoembryonic antigen (CEA) were measured and compared. Receiver operating characteristic (ROC) curves were prepared to determine whether single, combined, or series levels of the two markers were diagnostic.ResultsA significantly increasing trend in the plasma levels of homocysteine from the healthy controls, to the individuals with low-risk rectal adenoma, high-risk rectal adenoma, and Stage I–IV rectal cancer were found. There were no statistically significant differences in the area under the curve (AUC) between the two single factors of plasma homocysteine and CEA. The AUC showed that the use of combined or parallel measurement of plasma CEA and homocysteine had the greatest diagnostic associations.ConclusionsPlasma levels of homocysteine were significantly associated with occurrence and progression of rectal cancer. The combined use of measurement of plasma homocysteine and CEA levels might have the potential to increase the diagnostic efficiency of screening for early rectal cancer.

AIMTo introduce a novel, modified primary closure technique of laparoscopic extralevator abdominal perineal excision (LELAPE) for low rectal cancer.METHODSWe retrospectively analyzed data from 76 patients with rectal cancer who underwent LELAPE from March 2013 to May 2016. Patients were classified into the modified primary closure group (32 patients) and the biological mesh closure group (44 patients). The total operating time, reconstruction time, postoperative stay duration, total cost, postoperative complications and tumor recurrence were compared.RESULTSAll surgery was successfully performed. The pelvic reconstruction time was 14.6 ± 3.7 min for the modified primary closure group, which was significantly longer than that of the biological mesh closure group (7.2 ± 1.9 min, P < 0.001). The total operating time was not different between the two groups (236 ± 20 min vs 248 ± 43 min, P = 0.143). The postoperative hospital stay duration was 8.1 ± 1.9 d, and the total cost was 9297 ± 1260 USD for the modified primary closure group. Notably, both of these categories were significantly lower in this group than those of the biological mesh closure group (P = 0.001 and P = 0.003, respectively). There were no differences observed between groups when comparing other perioperative data, long-term complications or oncological outcomes.CONCLUSIONThe modified primary closure method for reconstruction of the pelvic floor in LELAPE for low rectal cancer is technically feasible, safe and cost-effective.

The presence of TPGS remarkably increased the anticancer effect of OXL in HT-29 colon cancer cells. The IC50 value of free OXL was 4.25 μg/ml whereas IC50 value of OXL-loaded TPGS-based lipid nanoparticles (OXL/TLNP) was 1.12 μg/ml. The 3-fold lower IC50 value of OXL/TLNP indicates the superior anticancer effect of nanoparticle-based OXL. Consistently, OXL/TLNP induced a remarkable apoptosis of cancer cells. Approximately, ~52% of cells were in early apoptosis phase and ~13% of cells were in late apoptosis phase indicating the potent anticancer effect of the formulations. The findings from this study provide novel insights into the use of TPGS and lipid nanoparticle together for the better antitumor effect in colon cancers. Future studies will involve the detailed in vitro and in vivo studies on clinically relevant animals.

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