IntroductionDown-regulation of E-cadherin (CDH1) and epithelial-mesenchymal transition (EMT) are considered critical events for invasion and metastasis of colorectal carcinoma. Here we tested whether the important regulators of E-cadherin expression SNAI1 and TWIST1 are already detectable in human colorectal adenomas.MethodsRNA was extracted from a set of randomly selected formalin-fixed and paraffin-embedded (FFPE) colorectal adenomas (n = 41) and normal colon mucosa (n = 10). Subsequently mRNA expression of CDH1, CDH2, SNAI1 and TWIST1 was analysed by quantitative RT-PCR analysis. CDH1 as well as SNAI1 protein expression were assessed by immunohistochemistry (IHC).ResultsSNAI1 mRNA was expressed in 78% (n = 32/41), TWIST1 mRNA in 41% (n = 17/41) and CDH2 mRNA in 41% (n = 17/41) of the colorectal adenoma tissue, while normal colon mucosa was negative for these transcription factors. We found a significant correlation between reduced CDH1 and the presence of SNAI1 mRNA expression and for combined SNAI1 and TWIST1 mRNA expression, respectively. A correlation between CDH2 mRNA expression and reduced CDH1 expression was not observed. We confirmed the relationship between SNAI1 expression and reduced E-cadherin expression on the protein level via IHC.ConclusionOur data show that SNAI1 and Twist1 are already expressed in benign precursor lesions of colorectal cancer and that SNAI1 expression was significantly correlated with lower expression of CDH1. Whether these findings reflect true EMT and/or are a sign of a more aggressive biology need to be investigated in further studies.
AIM: to work out a diagnostic program that allows to individualize approach in preoperative care and surgery for patients with colorectal cancer complicated by acute obstruction.PATIENTS AND METHODS: the study included 442 patients with colorectal cancer complicated by acute obstruction, at whom were used special diagnostic methods for the purpose of precise diagnosis.RESULTS: the most informative and safe methods for the diagnosis of tumor obstruction were abdominal X-ray, CT scan, colonoscopy (CS), barium enema (BE) and abdominal ultrasound. These methods allow to prove bowel obstruction and its stage, to detect the tumor site, depth of invasion, distant metastases, to control the efficacy of decompression and to make prognosis of the outcome in 87.2-96.4% patients.CONCLUSION: the information obtained allows to plan individually the use of conservative, endoscopic and surgical methods of treatment for patients with colorectal cancer complicated by acute bowel obstruction.
The article presents the results of treatment of 63 patients who were operated on colon cancer. As infusion therapy during surgery and preoperative preparation in 31 patients (the 1st group) the simple crystalloid solutions were used; the balanced polyionic solutions were used in 32 patients (the 2nd group) as infusion therapy. Results in the patients of the 2 groups were the following: the function of the digestive tract was restored on average 2 days earlier, the complications such as nausea and frequency of suppuration of postoperative wounds were decreased, pain syndrome was less pronounced. Failures anastomosis was revealed a 4% less in comparison with the patients of the 1st group. In patients of the 2nd group with edema of the intestinal wall, the thickness of which in the postoperative period was recovered in 2-3 days, in group 1, the recovery was on the 4-5th day. The results showed that the optimal scheme of infusion therapy is the combined use during surgery and in the preoperative period of low molecular weight solutions based hydroxyethylamine and balanced polyionic crystalloid solutions.
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