Purpose
Circulating microRNAs (miRNAs) are emerging as promising diagnostic biomarkers for colorectal cancer (CRC), but their usefulness for detecting early colorectal neoplasms (CRNs) remains unclear. This study aimed to identify serum miRNA biomarkers for the identification of patients with early CRNs.
Experimental Design
A cohort of 237 serum samples from 160 patients with early CRNs (148 precancerous lesions and 12 cancers) and 77 healthy subjects was analyzed in a three-step approach that included: a comprehensive literature review for published biomarkers, a screening phase, and a validation phase. RNA was extracted from sera, and levels of miRNAs were examined by real-time RT-PCR.
Results
Nine miRNAs (miR-18a, miR-19a, miR-19b, miR-20a, miR-21, miR-24, miR-29a, miR-92 and miR-125b) were selected as candidate biomarkers for initial analysis. In the screening phase, serum levels of miR-21, miR-29a and miR-125b were significantly higher in patients with early CRN compared to healthy controls. Elevated levels of miR-21, miR-29a and miR-125b were confirmed in the validation phase using an independent set of subjects. Area under the curve (AUC) values for serum miR-21, miR-29a, miR-125b, and their combined score in discriminating early CRN patients from healthy controls were 0.706, 0.741, 0.806 and 0.827 respectively. Serum levels of miR-29a and miR-125b were significantly higher in patients who only had small CRNs (≤5mm) compared to healthy subjects.
Conclusions
Since serum levels of miR-21, miR-29a and miR-125b discriminated early CRN patients from healthy controls, our data highlight the potential clinical use of these molecular signatures for noninvasive screening of patients with colorectal neoplasia.
BWL was the most important risk factor for the compliance of adjuvant chemotherapy with S-1 in the patients with stage 2/3 gastric cancer who underwent D2 gastrectomy. To improve drug compliance that leads to survival, it is a key to maintain body weight before starting S-1 adjuvant. Our study emphasizes the requirement for adequate studies of perioperative nutritional intervention in patients who receive gastrectomy for advanced gastric cancer.
The present study demonstrated that LBL might be an important risk factor for a decrease in compliance to adjuvant chemotherapy with S-1 in patients with stage II/III gastric cancer who underwent D2 gastrectomy. A multicenter, double-blinded, prospective cohort study is necessary to confirm whether LBL would affect adjuvant S-1 continuation.
Background and objectives We clarified the impact of omentectomy for advanced gastric cancer on patient survival from the surgical results of a high-volume center in Japan.Methods Patients who received curative gastrectomy were divided into two groups based on whether they underwent omentectomy. The propensity score-matching method was used to assemble a well-balanced cohort, and relapse-free survival and the pattern of recurrence were compared. Results For this study, 330 patients who fulfilled the inclusion criteria participated and were divided into two groups: group R, patients who received omentectomy, and group P, patients who received omentum-preserving gastrectomy. After performing score-matching, 196 patients were selected. The 3-and 5-year relapse-free survival rates were 72.9 % (95 % confidence interval, 64.1-81.7) and 66.2 % (56.6-75.8 %) in group R, and 76.7 % (67.9-81.2) and 67.3 % (55.1-79.5) in group P, which were not significantly different (P = 0.750). Regarding sites of relapses, no differences were observed between the groups (P = 0.863).
ConclusionsIn this series, omentum-preserving gastrectomy for advanced gastric cancer did not increase the peritoneal relapse rate or affect patient survival compared to conventional gastrectomy. The non-inferiority of the omission of omentectomy should be evaluated by a randomized controlled trial.
Initial nodal manifestation is useful to predict DFS in younger papillary thyroid carcinoma patients. Our findings will be beneficial to determine the treatment strategy. Conservative therapy is considered acceptable for patients without risk factors.
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