11 Digestive Tract

11 Digestive Tract

2015086 The associations of ulcerative colitis with vascular endothelial grow th factor（-2578C/A）and（+936C/T）single nucleotide polym orphism s.YU Liqin（俞俐琴），et al.Dept Gastroenterol，2nd Affil Hosp，Wenzhou Med Univ，Wenzhou 325000.Chin J Intern Med 2014；53（10）：799-805.

Ob jectiveTo investigate the association of（-2 578C/A）and（+936C/T）single nucleotide polymorphism（SNPs）of vascular endothelial growth factor（VEGF）gene with the susceptibility to ulcerative colitis（UC）.M ethodsA total of 373 UC patients and 503 healthy controlswere recruited.The（-2 578C/A）and（+936C/T）polymorphism of VEGF genewere detected using a mini-sequencing technique.ResultsBy an unconditional logistic regression analysis，the frequencies of themutant allele T and genotype CT+TT of VEGF gene（+936C/T）were significantly decreased in patients with severe UC compared to the controls（10.4%vs 19.3%，OR=0.487，95%CI 0.248-0.954，P= 0.036；18.8%vs 33.8%，OR=0.452，95%CI 0.214-0.955，P=0.037，respectively）.Moreover，patientswith severe UC had significant lower rates ofmutant allele T and genotype CT+TT compared with patients with mild and moderate UC（10.4%vs 20.5%，OR=0.452，95%CI 0.229-0.894，P=0.022；18.8%vs 36.9%，OR=0.394，95%CI 0.185-0.842，P=0.016，respectively）.The frequencies ofmutant allele A and genotype CA+AA of VEGF（-2 578C/ A）gene were not statistically different between UC patients and the controls.Moreover，they were not significantly associated with the clinicopathologic features in UC patients.ConclusionThemutation of VEGF（+936C/T）gene is correlated with the severity of UC.However，the polymorphism of VEGF（-2 578C/A）gene is not significantly related to the susceptibility to UC.

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2015087 Correlations between DNA m ismatch repair（MMR）and p rognosis and prediction of treatm ent efficacy in stageⅡ/Ⅲcolon cancer.Qin Qiong（秦瓊），et al.Dept Oncol，Cancer Hosp，CAMS& PUMC，Beijing 100021.Chin JOncol 2014；36（11）：844-848.

Ob jectiveTo investigate the role of DNA mismatch repair（MMR）as a prognostic indicator of radical resection and predictor of fluorouracil-based adjuvant therapy benefit in patientswith stageⅡ/Ⅲcolon cancer.M ethodsThe clinicopathological characteristics of 172 patients with stageⅡ/Ⅲcolon cancer who underwent radical resection were retrospectively analyzed.Immunohistochemical staining was used to detect the expression of DNA mismatch repair（MLH1/MSH2/MSH6/PMS2）in the tumor tissues.ResultsAmong a total of 172 patients， there were 38（22.1%）cases with defective DNA mismatch repair（dMMR）and 134（77.9%）cases with proficient DNA mismatch repair（pMMR）.Among the 115 patients who did not receive adjuvant chemotherapy，those with tumor displaying dMMR had a better5-year overall survival（OS）rate and disease-free survival（DFS）rate than the patients with proficient DNA mismatch repair（pMMR）（88.0%vs.66.7%，P=0.040；84.0% vs.60.0%，P=0.034）.The benefitof adjuvant chemotherapy differed significantly according to the MMR status.Adjuvant5-Fu chemotherapy improved the 5-year overall survival rate among 134 patients with pMMR（86.4%）than that in patients treated with surgery alone（66.7%，P=0.012）.By contrast，there was no benefit of adjuvant 5-Fu chemotherapy in the patients with dMMR（61.5%vs.86.4%，P=0.062），which was even more 5-year disease-free survival rate（53.8%vs. 84.0%，P=0.038）.ConclusionMMR status is a predictor of the benefit of adjuvant chemotherapy with fluorouracil in stageⅡ/Ⅲcolon cancer.Patients with stageⅡ/Ⅲcolon cancer displaying dMMR have a better prognosis than those with pMMR.

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2015088 Expression of leptin and adiponectin in esophageal squam ous cell carcinoma and their clinical significance.DUAN Xiaofeng（段曉峰），et al.Dept E-sophageal Cancer，Tianjin Med Univ，Tianjin 300060. Chin JOncol 2014；36（11）：839-843.

Ob jectiveTo preliminarily investigate the expression and clinical significance of leptin and adiponectin in esophageal squamous cell carcinoma（ESCC）.MethodsThe expression of leptin and adiponectin in ESCC and normal esophagealmucosal tissue was detected by immunohistochemical staining with tissuemicroarray.The correlation between leptin，adiponectin and clinicalpathological features was statistically analyzed.ResultsThe expression of leptin was significantly upregulated in the ESCC than in the normal esophagealmucosa tissue［65.6%（80/122）versus 27.5%（11/40），P＜0.001］.Expression of leptin was significantly correlated with lymph node involvement and advanced tumor stage（P=0.009 and P=0.043，respectively）.Expression of adiponectin was significantly down-regulated in ESCC compared with that in normal esophageal mucosal tissue［22.1%（27/ 122）versus 47.5%（19/40），P=0.002］.Expression of adiponectin was significantly correlated with lymph node involvement（P=0.020）.Correlation analysis showed a positive correlation between the expression of leptin and lymph node metastasis and TNM stage（r= 0.235 and r=0.183，respectively），and a negative correlation between the expression of adiponectin and lymph nodemetastasis（r=-0.229）.There was no significant correlation between the expressions of leptin and adiponectin（P＞0.05），and between the body mass index and the expression of leptin and adiponectin，and lymph node metastasis（P＞0.05 for all）.ConclusionAn imbalanced expression of adipocytokines exits in ESCC.The expression of leptin and adiponectin is correlated with lymph node metastasis and/or tumor stage.Therefore，imbalanced expression of leptin and adiponectin may have a potential role in the carcinogenesis and disease progression of ESCC.

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2015089 Evaluation of op tim ized sequential screening p rogram of colorectal cancer in current China.LIQilong（李其龍），etal.Cancer Instit，Jiashan County，Jiaxing 314100.Chin J Prev Med 2014；48（11）：995-1000.

Ob jectiveTo evaluate the sensitivity and specificity of optimized sequential screening program of colorectal cancer，and provide evidence for the further optimization of colorectal cancer screening program.M ethodsUsing cluster sampling method，4 administrative villages were selected from Jiashan county as a census district in 2011 to 2013.Volunteers of 40 to 74 years old in the census were recruited，and tested by both optimized sequential screening（including questionnaire survey and fecal occult blood test）and colonoscopy for colorectal cancer.Sensitivity and specificity of different screening methods were calculated，respectively.Resu ltsA total of 2 607 volunteers underwent screening and colonoscopy at the same time.20 colorectal cancer cases，85 advanced adenoma cases，271 non-advanced adenomas cases，and 141 nonadenomatous polyps cases were detected.Sensitivity of optimized sequential screening for colorectal cancer，advanced adenomas，and non-advanced adenomas were 70.0%（14/20），57.6（49/85）and 36.5%（99/271），specificity was 68.7%（1 776/2 587），69.2%（1 746/ 2 522）and 68.9%（1 610/2 336），respectively.Sensitivity of the fecal occult blood test of colorectal cancer，advanced adenomas and non-advanced adenomas were 70.0%（14/20），47.1%（40/85）and 26.6%（72/ 271），specificity was 79.4%（2 053/2 587），79.9%（2 014/2 522）and 79.6%（1 860/2 336）.The sensitivity of fecal occult blood testand those of optimized sequential screening for colorectal cancer，advanced adenomaswas not significant（χ2=0.00，1.91，all P values＞0.05）.Sensitivity of questionnaire survey of colorectal cancer，advanced adenomas and non-advanced adenomas were 10.0%（2/20），14.1%（12/85），12.9%（35/ 271），specificity was 87.6%（2 266/2 587），87.7%（2 211/2 522），87.6%（2 046-2 336）.There were no significant difference between non-advanced adenomas. The sensitivity of advanced adenomas and non-advanced adenomas showed no significant decline when the following six term were removed from screening programs：chronic diarrhea，chronic constipation，mucus or bloody history，history of chronic appendicitis or appendectomy surgery，chronic cholecystitis or gallbladder surgery，adverse events in the history of life，while the sensitivity of colorectal cancer remained nearly the same 70.0%（14/20），52.9%（45/85），31.4%（85/271）（χ2=0.38，1.61，all P values＞0.05）.ConclusionCurrent optimized sequential screening programs for colorectal cancer in China have a high sensitivity and specificity.However，further optimization is viable and necessary.

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2015090 Expression and clinical significance of CCL5 in patients w ith esophageal carcinom a.LIU Jinyan（劉金燕），et al.Biotherap Center，1st Affil Hosp，Zhengzhou Univ，Zhengzhou 450052.Chin JOncol2014；36（11）：828-833.

Ob jectiveTo investigate the expression and significance of CCL5 in patients with esophageal carcinoma.MethodsUsing reverse transcriptase polymerase chain reaction（RT-PCR），the expressions of CCL5/CD8/ granzyme B/perforin in tumor and corresponding adjacent tissues from esophageal carcinoma patients were examined.Flow cytometry（FACS）was used to detect the percentages of CD8+T cells and CCR5+CD8+T cells in TIL and PBMC from the patients.Transwell assay was performed to study the effect of CCL5 on themigration of T cells in vitro.T test and Spearman correlation analysis were performed.ResultsThe mRNA expressions of CCL5 and perforin were 0.348 2±0.300 1 and 0.181 9±0.118 6，respectively，in the tumor samples，while their expressions in adjacent samples were 0.279 6±0.138 0 and 0.118 0±0.109 8，respectively，with no statistically significant differences between them（P＞0.05 for both）.The mRNA expressions of CD8 and granzyme B were significantly higher in the tumor tissues than in adjacent tissues（0.464 9±0.300 8 vs.0.279 0±0.173 4，0.648 7±0.516 0 vs. 0.469 7±0.259 1；P＜0.05 for both）.The relative expression of CCL5 was positively correlated with that of CD8，perforin and granzyme B（rCD8=0.272，P= 0.034；rperforin=0.305，P=0.026；rgranzymeB=0.108，P=0.012）in the tumor sites.FACS data revealed that the proportions of CD8+T cells in TIL and PBMC were（45.86±16.09）%and（34.05±15.07）%，respectively，showing a significant difference（P=0.022）. Similarly，CCR5+CD8+T cells fraction in TIL（48.12±26.75）%wasmuch higher than that in PBMC（19.53±13.67）%（P＜0.001）.Transwell assay showed that CCL5 protein enhanced the migration of T cells，supporting that CCL5 is crucial for CD8+T cells recruitment in vivo.Intriguingly，CCL5 expression was down-regulated in advanced patients（stageⅡb-Ⅳ）. The accumulation of CD8+T cells and CCR5+CD8+T cells was strongly reduced in advanced patients，suggesting that CCL5 expression may be involved in the local control of the disease and its reduction may be involved in disease progression.ConclusionThe current data indicate the involvement of CCL5 in the regulation of CD8+T cell entry into tumor lesions in esophageal carcinoma patients.This processmay affect the disease status and potentially as a prognostic factor for cancer patients. Enhancing local CCL5 expression in tumor lesions may represent a novel strategy in esophageal cancer therapy.

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