Introduction: The purpose of this study was to clarify the usefulness of SILS for right-sided colon cancer by evaluating the short-term and midterm outcomes.Methods: Between 2012 and 2017, 65 selected patients with right-sided colon cancer underwent ileocecal resection, right hemicolectomy, or transverse colectomy; all were enrolled in the study. The same well-trained surgeon performed each procedure by using a multi-instrument access port with three channels, which was placed at the umbilicus via an approximately 3-cm skin incision.Results: The pathological disease stage distribution was stage 0, 4 cases; stage I, 23 cases; stage II, 19 cases; stage III, 17 cases; and stage IV, 2 cases. The surgical procedures performed were ileocecal resection, 23 cases; right hemicolectomy, 35 cases; and transverse colectomy, 7 cases. The median operative time and intraoperative blood loss were 216 min and 10 mL, respectively. Although 18 cases needed additional ports, none required conversion to open surgery. The median number of harvested lymph nodes was 24. No major perioperative morbidities occurred in this patient series. The median postoperative hospital stay was 7 days. The median follow-up period was 30 months, and the 3-year relapse-free and overall survival rates were 100% and 100%, respectively, in the stage 0-I cases and 89% and 96% in the stage II-III cases, respectively. Conclusion:We concluded that SILS is as feasible as multiport laparoscopic surgery and a reliable surgical option in selected cases of right-sided colon cancer.

Angiopoietin-like 4 (ANGPTL4) was recently shown to be associated with cancer progression but little is known about its contribution to cancer metabolism. The purpose of this study was to elucidate the role of ANGPTL4 in glucose metabolism in colorectal cancer (CRC). MethodsImmunohistochemical staining of CRC specimens classi ed 84 patients into two groups according to ANGPTL4 expression. Clinicopathological characteristics, gene mutation status obtained by nextgeneration sequencing, and uorodeoxyglucose (FDG) uptake measured by positron emission tomography/computed tomography (PET/CT) were compared between the two groups. Furthermore, the impact of ANGPTL4 expression on cancer metabolism was investigated by a subcutaneous xenograft mouse model using the ANGPTL4 knockout CRC cell line and glucose transporter (GLUT) expression was evaluated. ResultsThere were signi cantly more cases of T3/4 tumours (94.3% vs. 57.1%, P < 0.001) and perineural invasion (42.9% vs. 22.4%, P = 0.046) in the ANGPTL4-high group than in the low group. Genetic exploration revealed a higher frequency of KRAS mutation (54.3% vs. 22.4%, P = 0.003) in the ANGPTL4high tumours. All the FDG uptake parameters were signi cantly higher in ANGPTL4-high tumours. In vivo analysis showed a signi cant reduction in tumor size due to ANGPTL4 knockout with lower expression of GLUT1 and GLUT3, and suppression of AKT phosphorylation. ConclusionANGPTL4 regulates the expression of GLUTs by activating the PI3K-AKT pathway and thereby promoting glucose metabolism in CRC. These ndings establish a new functional role of ANGPTL4 in cancer progression and lay the foundation for developing a novel therapeutic target.

Colorectal mucinous adenocarcinoma (MAC) is one of the poorest prognostic types of histological diagnoses, and its mechanism of development is not well understood. In this study, we aimed to clarify the molecular characteristics of MAC from the perspective of chromosomal instability. In silico analysis using The Cancer Genome Atlas database revealed that there was a significant difference in copy number alteration of chromosome 20q (Chr20q) between MAC and nonmucinous adenocarcinoma (NMAC). In addition, the expression of genes on Chr20q was negatively associated with the expression of MUC2, which is a key molecule that can be used to distinguish the two histological types. We further identified 475 differentially expressed genes (DEGs) between MAC and NMAC, and some of the Chr20q genes in DEGs are considered to be pivotal genes used to define MAC. In vitro analysis showed that simultaneous knockdown of POFUT1 and PLAGL2, both of which are located on Chr20q, attenuated MUC2 expression. Moreover, these genes were highly expressed in NMAC but not in MAC according to the results of immunohistological studies using human samples. In conclusion, the genes on Chr20q are considered to be important for defining MAC.