[Analysis of clinicopathological features and prognosis of sporadic synchronous multiple primary colorectal cancers]

Objective: To investigate the impact of relative locations of multiple foci and microsatellite status of sporadic, synchronous, multiple, primary, colorectal carcinomas on clinicopathological features and prognosis. Methods: The clinicopathologic and prognostic data of 278 patients with sporadic, synchronous, multiple, primary, colorectal carcinomas who had been admitted to the Department of Colorectal Surgery at Zhejiang Cancer Hospital from January 2008 to July 2022 were retrospectively collected. The patients were categorized into three groups based on the relative locations of their multiple cancer foci: (1) a right-sided group that comprised patients with multiple cancer foci in the cecum, ascending colon, hepatic flexure of the colon, and transverse colon; (2) a left-sided group that comprised patients with multiple cancer foci in the splenic flexure of the colon, descending colon, sigmoid colon, and rectum; and (3) a left- and right-sided group that comprised patients with multiple cancer foci in the right half of the colon and left half of the colon/rectum. Additionally, the patients were further divided into two groups based on microsatellite status: a high microsatellite instability (MSI-H) and a low MSI/stable MSI (MSI/L&MSS) group. We compared differences in clinical characteristics and prognostic indicators between these groups. The χ2 test was utilized to compare selected clinical characteristics, whereas Kaplan-Meier survival analyses and log-rank tests were performed to compare their effects on prognosis. Result: Among 278 patients with SSCRC, 256 (92.1%) presented with two cancer foci and 22 (7.9%) with more than two foci. Additionally, 255 patients (91.7%) had adenocarcinomas, whereas the remaining 23 (8.3%) had mucinous adenocarcinomas. Lymph node metastases were identified in 136 patients (48.9%); the cancer foci had infiltrated beyond the muscular layer in 238 (85.6%); and 147 patients (52.9%) were diagnosed with TNM Stage III-IV disease. There were 155 patients (55.8%) in the left-sided group, 55 (19.8%) in the right-sided group, and 68 (24.5%) in the left- and right-sided group. Immunohistochemical examination of all four mismatch repair proteins were performed in 199 cases, revealing that 166 of these patients had MSI/L&MSS and 33 MSI-H disease. In the left-sided, left- and right-sided, and right-sided groups, the proportion of women was 16.8% (26/155), 26.5% (18/68), and 49.1% (27/55), respectively; these differences are statistically significant (χ2=22.335, P<0.001). The proportions of patients with more than three cancer foci were 5.2% (8/155), 16.2% (11/68), and 5.5% (3/55), respectively; these differences are statistically significant (χ2=8.438, P=0.015). The proportions of mucinous adenocarcinomas were 4.5% (7/155), 8.8% (6/68), and 18.2% (10/55), respectively; these differences are statistically significant (χ2=10.026, P=0.007). The proportions of patients with lymph node metastases were 55.5% (86/155), 48.5% (33/68), and 30.9% (17/55); these differences are statistically significant (χ2=9.817, P=0.007). The proportions of patients with Stage T3 & T4 disease in each group according to location were 81.3% (126/155), 88.2% (60/68), and 94.5% (52/55), respectively; these differences are statistically significant (χ2=6.293,P=0.043). The proportions of TNM Stage III-IV tumors were 59.4% (92/155), 54.4% (37/68), and 32.7% (18/55), respectively; these differences are statistically significant (χ2=11.637, P=0.003). Age, size of cancer foci, presence of distant metastasis, adenoma, nerve invasion, and vascular invasion did not differ significantly between the three groups (all P>0.05). Compared with those with MSI-H, patients with MSI/L&MSS disease were more likely to be aged >65 years and male (50.6% [84/166] vs. 15.2% [5/33], χ2=13.994,P<0.001; 80.7% [134/166] vs. 54.5% [18/33], χ2=10.457,P=0.001), more likely to be in the left-sided group (63.3% [105/166] vs. 24.2% [8/33], χ2=18.232, P<0.001), had a higher proportion of cancer foci of diameter <4 cm (54.8% [91/166] vs. 33.3% [11/33], χ2=5.086,P=0.024), and a lower proportion of mucinous adenocarcinomas (4.2% [7/166] vs. 27.3% [9/33], χ2=19.791,P<0.001), more likely to develop distant metastases (22.3% [37/166] vs. 6.1% [2/33], χ2=4.601,P=0.032), more likely to have lymph node metastases (57.2% [95/166) vs. 24.2% [8/33], χ2=11.996,P<0.001) and nerve invasion (28.9% [48/166] vs. 6.1% [2/33], χ2=7.643, P=0.006), had a higher proportion of TNM Stage III-IV disease (60.2% [100/166] vs. 24.2% [8/33], χ2=14.374, P<0.001), and a smaller proportion of family history of tumors (28.9% [48/166] vs. 60.6% [20/33], χ2=12.228, P<0.001). All the above-listed differences are statistically significant (all P<0.05). The differences in number of cancer foci, depth of infiltration, presence or absence of adenomas, and vascular invasion were not statistically significant (all P>0.05). In the 33 patients with MSI-H status and mismatch repair protein loss, the highest frequency of deletion was found in PMS-2 (66.7%, 22/33), followed by MLH-1 (57.6%, 19/33), whereas the proportions of MSH-2 (33.3%, 11/33) and MSH-6 (24.2%, 8/33) deletions were relatively low. There were statistically significant differences in the 3-year overall survival rates among the groups according to relative locations of cancer foci. The 3-year overall survival rates were 96.8%, 79.6%, and 88.5% in the right-sided, left- and right-sided, and left-sided groups, respectively (P=0.021). As to microsatellite status, the 3-year overall survival rate of patients with MSI-H disease was 93.8%, which is significantly better than the 78.4% for those with MSI/L & MSS (P=0.026). Conclusions: Among sporadic, synchronous, multiple, primary, colorectal carcinomas, those with right-sided disease had the deepest local infiltration, whereas those with left-sided disease had the greatest number of lymph node metastases, most advanced clinical TNM stage, lowest percentage of MSI-H disease, and the poorest prognosis.

MicroRNA network analysis identifies key microRNAs and genes associated with precancerous lesions of gastric cancer

To identify potential targets for the early treatment and prevention of gastric cancer, microRNA (miRNA) expression profiles of precancerous lesions of gastric cancer were investigated. The miRNA microarray dataset GSE24839 was downloaded from Gene Expression Omnibus (GEO) and included 10 Helicobacter pylori-related gastritis samples and 10 gastric intestinal metaplasia samples. Differentially expressed miRNAs (DEMs) were screened using the Student t-test; P < 0.05 was considered to be statistically significant. Co-expression networks of total miRNAs and DEMs were constructed based on the Pearson correlation coefficient for the two diseases. Target genes of the DEMs were retrieved using miRecords and pathway-enrichment analysis was performed using a hypergeometric test. A total of 20 DEMs were obtained for H. pylori-related gastritis and gastric intestinal metaplasia samples, including 12 up-regulated and 8 down-regulated miRNAs. The identified DEMs appear to play key roles in gastric cancer, as the average degree of the DEM sub-network was higher than that of the total miRNA co-expression network. Furthermore, target genes for 6 DEMs (hsa-miR-106b, hsa-miR-193a-3p, hsa-miR-204, hsa-miR-30e, hsa-miR-519d, and hsa-miR-524-5p) are in Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways, including signal transduction, cell growth and death, and transport and catabolism. Among the target genes, 5 (RAB22A, SOX4, IKZF2, PLAG1, and BTBD7) were of interest because they can be simultaneously regulated by several DEMs. These findings suggest that these genes may be targets for modulating gastric cancer progression.

Vertical distribution of polybrominated diphenyl ethers (PBDEs) in soil cores taken from a typical electronic waste polluted area in South China

37 PBDE congeners were analyzed at six different depths in two soil cores taken from a typical electronic waste polluted area in South China. The PBDEs were congregated in the surface layer (0-5 cm) of soil cores and were 29 times in MK and 18 times in NW higher than the second lower layers (5-10 cm). As a whole, the concentrations of PBDEs were decreased with the soil depth increased in two cores. Lower brominated PBDE had higher penetrability than the deca-BDE in soil. The deca-BDE could be detected in deeper soil layers (15-20 cm in MK and 20-30 cm in NW) and the percentage of deca-BDE decreased with the increase of depth.

Tissue distribution of polybrominated diphenyl ethers (PBDEs) in captive domestic pigs, Sus scrofa, from a village near an electronic waste recycling site in South China

The dominant part of PBDEs residue in pig tissues was BDE-47 accounted for 48.2% approximately 66.9%, followed by BDE-99 from 15.9% to 24.2%. When the data were on lipid weight basis, the summation operatorPBDEs concentrations in tissues of individual pig showed the same order of liver > muscle, intestine > fat. Principal component analysis and PBDE congener mean concentration ratios of muscle versus liver (M/L), fat versus liver (F/L) and intestine versus liver (I/L) showed the higher accumulation ability of PBDEs in liver than in other tissues. And the PBDE mean concentration ratios of M/L, F/L and I/L had the trend of decrease with increasing bromination degree of PBDE congeners.

Polybrominated diphenyl ethers in mudsnails (Cipangopaludina cahayensis) and sediments from an electronic waste recycling region in South China

Mudsnails and sediments from an electronic waste recycling region in South China were chosen to study the polybrominated diphenyl ethers (PBDEs) bioavailability of mudsnail in different ambient levels. Significant (p < 0.05) correlations of biota-sediment accumulation factor (BSAF) versus the reciprocal of PBDE concentration in sediment (1/Sed) occurred in all quantitative PBDE congeners except BDE-209, showed that the BSAFs of PBDEs in mudsnails were increased with reciprocal increasing ambient levels. The BDE-183 correlation of mudsnail versus sediment (r = 0.580) was much lower than the correlation of BDE-209 versus BDE-183 in mudsnails (r = 0.812), indicated the main source of BDE-183 in mudsnails was from the debromination of higher brominated PBDEs.

Polybrominated diphenyl ethers in leaves and soil from typical electronic waste polluted area in South China

Polybrominated diphenyl ethers (PBDEs) in leaves and soil from typical e-waste polluted area in South China were investigated. The concentrations (ng/g dry weight) of PBDE congeners and summation operatorPBDE of five leaf samples were much lower than those in soil sample. The general patterns of summation di-BDEs to summation hepta-BDEs percentage distribution in leaf samples were similar to those of the soil sample, except the percentage of BDE209 which were lower than in soil. The percentages of summation di-BDEs to summation hepta-BDEs in soil were in the range of those in leaf samples. The results showed that the contamination of PBDEs in the leaf samples had good correlation with the soil around them.