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Since the early 1990s, the laparoscopic technique has been increasingly used for the treatment of perforated peptic ulcer. It is important to validate a risk scoring system that can stratify patients into various risk groups before comparing the treatment outcome of laparoscopic repair against that of conventional open surgery. The scoring system should be able to predict the likelihood of mortality and morbidity. Boey score and APACHE II (Acute Physiology and Chronic Health Evaluation II) score may be of use in patient stratification.Design: Retrospective review of relevant case notes by one reviewer.Setting: A teaching hospital treating 0.5 million to 1 million patients during the study period.

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Purpose: Colorectal cancer is an important cause of cancer deaths. Here, we focused our investigation on the ␤-catenin gene which is implicated in colorectal carcinogenesis and tested whether ␤-catenin mRNA is detectable in the plasma of colorectal carcinoma and adenoma patients using quantitative reverse transcriptase-PCR.Experimental Design: Plasma ␤-catenin mRNA was measured from 58 colorectal carcinoma patients, 49 colorectal adenoma patients, and 43 apparently normal subjects using intron-spanning primers and Taqman probes. Five clinicopathological parameters were studied and correlated with plasma ␤-catenin mRNA concentration. Additionally, 19 colorectal carcinoma patients after tumor removal were also recruited for plasma ␤-catenin mRNA measurement to further demonstrate the clinical usefulness of this test.Results: ␤-catenin mRNA was detected with median concentrations of 8737 (range: 1480 -933,100), 1218 (range: 541-2,254) and 291 (range: 0 -1,366) copies/ml plasma in colorectal carcinoma, colorectal adenoma, and apparently normal subjects, respectively. Statistical analysis demonstrated that plasma ␤-catenin mRNA concentration was correlated to tumor stage but not sex, age, lymph node status, and degree in differentiation. Moreover, plasma ␤-catenin mRNA concentration decreased significantly after tumor removal in 16 of 19 (84%) colorectal carcinoma patients. Conclusions:We conclude that plasma ␤-catenin mRNA may potentially serve as a marker for colorectal cancer.