Distant Colon Research Articles

A probiotic Limosilactobacillus fermentum GR-3 mitigates colitis-associated tumorigenesis in mice via modulating gut microbiome

Bacterial therapy for colorectal cancer (CRC) represents a burgeoning frontier. The probiotic Limosilactobacillus fermentum GR-3, derived from traditional food “Jiangshui”, exhibited superior antioxidant capacity by producing indole derivatives ICA and IPA. In an AOM/DSS-induced CRC mouse model, GR-3 treatment alleviated weight loss, colon shortening, rectal bleeding and intestinal barrier disruption by reducing oxidative stress and inflammation. GR-3 colonization in distant colon induced apoptosis and reduced tumor incidence by 51.2%, outperforming the control strain and vitamin C. The beneficial effect of GR-3 on CRC was associated with gut microbiome modulation, increasing SCFA producer Lachnospiraceae NK4A136 group and suppressing pro-inflammatory strain Bacteroides. Metagenomic and metabolic analyses revealed that GR-3 intervention upregulated antioxidant genes (xseA, ALDH) and butyrate synthesis gene (bcd), while increasing beneficial metabolites (SCFAs, ICA, IPA, VB12 and VD3) and reducing harmful secondary bile acids. Overall, GR-3 emerges as a promising candidate in CRC therapy, offering effective gut microbiome remediation.

Trends in incidence, treatment, and relative survival of colorectal cancer in the Netherlands between 2000 and 2021

BackgroundThe epidemiology of colorectal cancer (CRC) has changed rapidly over the years. The aim of this study was to assess the trends in incidence, treatment, and relative survival (RS) of patients diagnosed with CRC in the Netherlands between 2000 and 2021. Patients and methods2 75667 patients diagnosed with CRC between 2000 and 2021 were included from the Netherlands Cancer Registry. Analyses were stratified for disease extent (localised: T1-3N0M0; regional: T4N0M0/T1-4N1-2M0; distant: T1-4N0-2M1) and localisation (colon; rectum). Trends were assessed with joinpoint regression. ResultsCRC incidence increased until the mid-2010s but decreased strongly thereafter to rates comparable with the early 2000s. Amongst other trend changes, local excision rates increased for patients with localised colon (2021: 13.6 %) and rectal cancer (2021: 34.9 %). Moreover, primary tumour resection became less common in patients with distant colon (2000–2021: 60.9–12.5 %) or rectal cancer (2000–2021: 47.8–6.9 %), while local treatment of metastases rates increased. Five-year RS improved continuously for localised and regional colon (97.7 % and 72.0 % in 2017, respectively) and rectal cancer (95.2 % and 76.3 % in 2017, respectively). The rate of anti-cancer treatments decreased in distant colon (2010–2021: 80.3 % to 67.2 %; p < 0.001) and rectal cancer (2011–2021: 86.0 % to 77.0 %; p < 0.001). The improvement of five-year RS stagnated for distant colon (2010–2017: 11.2 % to 11.9 %; average percentage of change [APC]: 2.1, 95 % confidence interval [CI]: −7.6, 4.7) and rectal cancer (2009–2017: 12.7 % to 15.6 %; APC: 1.4, 95 % CI: −19.1, 5.5). ConclusionsMajor changes in the incidence and treatment of CRC between 2000 and 2021 were identified and quantified. Five-year RS increased continuously for patients with localised and regional CRC, but stagnated for patients with distant CRC, likely caused by decreased rates of anti-cancer treatment in this group.

Shifts in the Proportion of Distant Stage Early-Onset Colorectal Adenocarcinoma in the United States.

Carcinoids, frequently classified as "colorectal cancer" contribute to rising early-onset colorectal cancer (EOCRC) incidence rates (IR) and have distinct staging distributions compared to often advanced stage adenocarcinomas (screening target). Thus, assessing temporal shifts in early-onset distant stage adenocarcinoma can impact public health. 2000-2016 Surveillance Epidemiology and End Results (SEER) 18 yearly adenocarcinoma IRs were stratified by stage (in situ, localized, regional, distant), age (20-29, 30-39, 40-49, 50-54-year-olds), subsite (colorectal, rectal-only, colon-only), and race [non-Hispanic whites, non-Hispanic Blacks (NHB), Hispanics] in 103,975 patients. Three-year average annual IR changes (pooled 2000-2002 IRs compared with 2014-2016) and cancer stage proportions (percent contribution of each cancer stage) were calculated. Comparing 2000-2002 with 2014-2016, the steepest percent increases are in distant stage cancers. Colon-only, distant adenocarcinoma increased most in 30-39-year-olds (49%, 0.75/100,000→1.12/100,00, P < 0.05). Rectal-only, distant stage increases were steepest in 20-29-year-olds (133%, 0.06/100,000→0.14/100,000, P < 0.05), followed by 30-39-year-olds (97%, 0.39/100,000→0.77/100,000, P < 0.05) and 40-49-year-olds (48%, 1.38/100,000→2.04/100,000, P < 0.05). Distant stage proportions (2000-2002 to 2014-2016) increased for colon-only and rectal-only subsites in young patients with the largest increases for rectal-only in 20-29-year-olds (18%→31%) and 30-39-year-olds (20%→29%). By race, distant stage proportion increases were largest for rectal-only in 20-29-year-old NHBs (0%→46%) and Hispanics (28%→41%). Distant colon proportion increased most in 20-29-year-old NHBs (20%→34%). Youngest patients show greatest burdens of distant colorectal adenocarcinoma. Although affecting all races, burdens are higher in NHB and Hispanic subgroups, although case counts remain relatively low. Optimizing earlier screening initiatives and risk-stratifying younger patients by symptoms and family history are critical to counteract rising distant stage disease.

Immunostimulatory photochemotherapeutic nanocapsule for enhanced colon cancer treatment

Abstract Immunotherapy has made great progress in recent years while most cancer patients cannot benefit from it. Photochemotherapy combination strategy holds great promise for developing novel immunotherapy for the patients bearing immunosuppressive tumors such as colon cancer. In this research, a novel core/shell-structured polydopamine (PDA)-based nanoplatform is constructed to load two Food and Drug Administration (FDA)-approved cytotoxic drugs, i.e. immunostimulatory doxorubicin (Dox) and immunomodulatory curcumin (Cur) to achieve immunostimulatory photochemotherapy of primary colon tumors upon 808 nm near infrared (NIR) irradiation (1 W/cm2 for 5 min) and subsequent prevention of rechallenged distant colon tumors. The experimental data have shown that PDA-mediated photothermal therapy (PTT) synergized two therapeutic drugs in inducing colon cancer cell death and very efficiently inhibited the primary tumor growth (by ∼92%) at very low doses of therapeutics (0.25, 5, and 30 mg/kg of Dox, Cur, and PDA, respectively). More significantly, the combined photochemotherapy promoted strong adaptive antitumor immune responses and successfully prevented tumorigenesis in the setting of tumor rechallenge model. Our research has thus demonstrated the promising efficacy of this photochemotherapeutic nanoformulation for colon cancer treatment and provided a way to improve immunostimulatory effects of conventional chemotherapeutic drugs.

Abstract 1914: Orally available oncolytic reovirus, RC402, effectively promotes anti-cancer immunity and synergizes with immune checkpoint blockade in colon cancer

Abstract Introduction: Reoviruses are replication-competent and selectively infect and destroy cancer cells. Although the most common route of oncolytic virotherapy is intratumoral or intravenous administration, these routes are often not clinically feasible because of tumor inaccessibility, tumor multiplicity, and systemic toxicities. Here, we developed an orally available oncolytic reovirus, RC402, to elicit potent anti-tumor immune responses without the above mentioned limitations and thereby maximize the efficacy of PD-1 immune checkpoint blockade in colon cancer. Method: MC38 or CT26 colon cancer-bearing immunocompetent mice were treated with RC402 and/or anti-PD-1 antibody. Tumor growth was monitored after treatment and comprehensively analyzed by flow cytometry and/or multiplex tissue imaging. Results: RC402 treatment effectively delayed tumor growth regardless of the route of administration (per os as well as intratumorally). In particular, orally administered RC402 was well tolerated without gross toxicity and interacted with intestinal immune cells, eliciting adaptive T cell responses within intestinal lymphoid organs such as Peyer's patch. Most of the RC402 was cleared in the gastrointestinal tract within 10 days of the first treatment, and it was not detectable in the blood stream or major organs after oral administration. However, RC402 selectively induced strong and durable anti-tumor immunity in distant tumor tissues. Oral RC402 monotherapy markedly increased CD8+ cytotoxic T cells and decreased CD4+CD25+Foxp3+ regulatory T cells in distant colon cancers, while there were no significant changes in tumor-associated myeloid cells. Finally, oral RC402 treatment cooperated with anti-PD-1 blockade to further suppress colon cancer growth and augment anti-tumor immunity within the tumor microenvironment, leading to complete regression of tumors and survival benefit of tumor-bearing mice. Conclusion: Our study demonstrates that orally available oncolytic reovirus, RC402, could induce potent anti-cancer immune responses and effectively suppress colon cancer progression in combination with anti-PD-1 blockade. Citation Format: Chan Kim, Hong Jae Chon, Hye Jin Lee, Won Suk Lee, Hannah Yang, Jeong Hun Kim, So Jung Kong, Yu Seong Lee, Seung Joon Lee, Enkhtaivan Gansukh, Ki-Hoon Song, Yeon-Sook Lee, Beodeul Kang. Orally available oncolytic reovirus, RC402, effectively promotes anti-cancer immunity and synergizes with immune checkpoint blockade in colon cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1914.

Colon and rectal cancer survival in seven high-income countries 2010–2014: variation by age and stage at diagnosis (the ICBP SURVMARK-2 project)

ObjectivesAs part of the International Cancer Benchmarking Partnership (ICBP) SURVMARK-2 project, we provide the most recent estimates of colon and rectal cancer survival in seven high-income countries by age and...

Identification of hub genes and outcome in colon cancer based on bioinformatics analysis.

BackgroundColon cancer is one of the leading malignant neoplasms worldwide. Until now, the concrete mechanisms of colonic cancerogenesis are largely unknown; identification of driven genes and pathways is, therefore, of great importance for monitoring and conquering this disease. This study aims to explore the potential biomarkers and therapeutic targets for colon cancer treatment.MethodsThe gene expression profile of GSE44076 from Gene Expression Omnibus database, including 98 primary colon cancers and 98 normal distant colon mucosa, was deeply analyzed. GEO2R tool was used to screen the differentially expressed genes (DEGs) between colon cancer tissues and normal samples. Gene Ontology analysis and Kyoto Encyclopedia of Genes and Genomes pathway analysis were performed for screening DEGs using Database for Annotation, Visualization and Integrated Discovery database and Panther database. Moreover, Search Tool for the Retrieval of Interacting Genes, Cytoscape software, and Molecular Complex Detection plug-in were used to visualize the protein–protein interaction of these DEGs.ResultsA total of 497 DEGs were obtained, including 129 upregulated genes mainly enriched in Hippo signaling pathway, Wnt signaling pathway, and cytokine–cytokine receptor interaction and 368 downregulated genes enriched in retinol metabolism, steroid hormone biosynthesis, drug metabolism, and chemical carcinogenesis. Using Molecular Complex Detection software, three important modules were selected from the protein–protein interaction network. Moreover, 20 hub genes with high degree of connectivity were selected, including COL1A1, CXCL5, GNG4, TIMP1, and so on. The Kaplan–Meier analysis for overall survival and correlation analysis were applied among the hub genes.ConclusionTaken together, DEGs, especially the hub genes such as COL1A1, might be the driven genes in colon cancer progression. More importantly, they might be the novel biomarkers for diagnosis and guiding therapeutic strategies of colon cancer.

Mercury self-poisoning. Case report

A clinical case of a self-poisoning with a single ingestion of 40-45 mL of alleged metal mercury with suicid­al purpose by a 50-year-old man is described. On the following day he was admitted to the Toxicology Clinic with symptoms of nausea, strong abdominal colic, diarrhea, and feces with macroscopic admixture of mer­cury drops. At the inspection of the residue of the substance, an unusual black-grey color on its surface was noted. Later, mercurous oxide was proven by chemical analysis. No toxic symptoms of the central nervous system, respiratory system or kidneys were observed. X-rays of the abdomen were performed and tracked dynamically: the first one showed numerous round shadows with metal density along the whole colon, the second - after 5 days - showed reduced number of similar shadows only in the distant colon, and the third X-ray on the 9th day was normal. Mercury was discovered in the blood: 0.250 μmol L-1 on the fourth day after the ingestion and 0.120 μmol L-1 - on the tenth day. Some therapeutic problems of acute mercury intoxica­tion of present interest are discussed.

Disparities in age-related incidence of colon and rectal cancer in the United States, 1975-2010.

6579 Background: The overall incidence of colorectal cancer (CRC) has been decreasing since 1998, but there has been an apparent rise in the incidence of CRC in young adults. The primary aim of this study was to evaluate age-related disparities in secular trends in CRC incidence in the United States. Methods: A retrospective cohort study was performed using the Surveillance, Epidemiology, and End Results (SEER) registry. All patients diagnosed with colon or rectal cancer from 1975 to 2010 was queried. SEER*Stat (version 8.04, National Cancer Institute) was used to obtain the annual cancer incidence rates, annual percent change (APC), and corresponding p-values for the secular trends. Results: Overall age-adjusted CRC incidence decreased by 0.92% between 1975 and 2010. There has been a steady decline in the incidence of CRC in patients age 50 years or older, but the opposite trend has been observed in patients 20 to 34 years of age. The APC for patients with localized, regional, and distant colon cancer at...

Increasing disparities in age-related incidence of colon and rectal cancer in the United States, 1975-2010.

392 Background: The overall incidence of colorectal cancer (CRC) has been decreasing since 1998, but there has been an apparent rise in the incidence of CRC in young adults. The primary aim of this study was to evaluate age-related disparities in secular trends in CRC incidence in the United States. Methods: A retrospective cohort study was performed using the Surveillance, Epidemiology, and End Results (SEER) registry. All patients diagnosed with colon or rectal cancer from 1975 to 2010 was queried. SEER*Stat (version 8.04, National Cancer Institute) was used to obtain the annual cancer incidence rates, annual percent change (APC), and corresponding p values for the secular trends. Results: Overall age-adjusted CRC incidence decreased by 0.92% between 1975 and 2010. There has been a steady decline in the incidence of CRC in patients age 50 years or older, but the opposite trend has been observed in patients 20 to 34 years of age. The APC for patients with localized, regional, and distant colon cancer at diagnosis in the 20 to 34 year age group was 1.10 (95% CI 0.28 to 1.93; p=0.01), 0.91 (95% CI 0.23 to 1.61; p=0.01) and 1.81 (95% CI 0.88 to 2.75; p&lt;0.001). The APC for patients with localized, regional ,and distant rectal cancer in the 20 to 34 year age group was 4.03 (95% CI 3.02 to 5.05; p&lt;0.001), 3.05 (95% CI 1.95 to 4.17; p&lt;0.001) and 2.66 (95% CI 1.33 to 3.99; p&lt;0.001). Based on current trends, in 2030 the incidence rate for colon and rectal cancer will increase by 90% and 124.2% respectively for patients 20 to 34 years of age while decreasing by 37.8% and 34.3% for patients 50 to 75 years of age. Conclusions: There has been a significant increase in the incidence of CRC diagnosed in patients age 20 to 34, with a decline in older patients. Further studies are needed to determine the cause for these trends and identify potential preventive and early detection strategies. [Table: see text]

Trends in chemotherapy-related treatment of advanced-stage colorectal (CRC) cancer.

258 Background: New drugs and technology are primary drivers of health care costs, but their marginal benefit is questionable, particularly in patients with incurable cancer. We examined trends in population-based treatment following diagnosis for metastatic colon and rectal cancer in elderly adults. Methods: We used the Surveillance, Epidemiology, and End Results (SEER) – Medicare linked database to identify persons aged 65 and older diagnosed with distant stage colon (N=16,086) and rectal cancer (N=4,003) between 2000 and 2009. For each year, we report the percent of patients who received cancer directed surgery, chemotherapy, antiemetics/premedications related to the chemotherapy, and hematopoietic growth factors, and the mean cost of care. All estimates are adjusted for patient characteristics, SEER region, survival, and year of diagnosis. Results: The percent of patients who had cancer directed surgery declined 12 and 11 percentage points for colon and rectal cancer patients, respectively. The percent of patients who received chemotherapy increased from 41% to 46% for colon patients and from 52% to 57% for rectal patients. Chemotherapy treatment intensified from 2000 to 2009, with longer duration in chemotherapy and more agents given. Over a third of colon and rectal cancer patients received three or more agents in 2009, often including oxaliplatin and/or bevacizumab. The percent of patients who received hematopoietic growth factors rose appreciably from 4% to 19% for colon patients and from 6% to 21% for rectal patients. Antiemetics/premedication use increased approximately 20 percentage points for all patients. Total costs of care rose from a mean of $61,171 to $74,567 per colon patient and from $68,213 to $82,031 per rectal patient. The percentage of costs due to hospitalizations declined for colon (56% to 47%) and rectal (47% to 40%) cancer patients. Conclusions: The use and intensity of chemotherapy, along with cost of care, for patients with advanced cancer increased markedly from 2000 to 2009. The inclusion of newer more expensive agents shifted the bulk of treatment costs from hospitalizations to the outpatient setting. The value of these treatments for advanced stage elderly patients is unknown.

Trends in chemotherapy-related treatment of late-stage colon and rectal cancer.

6604 Background: The appropriate intensity of treatment for patients with advanced incurable cancer remains uncertain. Our study examines trends in population-based treatment following diagnosis for metastatic colon and rectal cancer in elderly adults. Methods: We used the Surveillance, Epidemiology, and End Results – Medicare database to identify persons aged 65 and older who were diagnosed with distant stage colon (N=12156) and rectal cancer (N=3071) between 2000 and 2007. We assessed treatment patterns over the year after diagnosis with a focus on chemotherapy and related services. For each year, we report the percent of patients receiving chemotherapy, hematopoietic growth factors, and antiemetics/premedication. For those patients who received chemotherapy, we estimated, by year, the median number of days from the first to the last chemotherapy claim. Results: From 2000 to 2007, the percent of patients receiving chemotherapy increased from 39.6% to 44.4% for colon patients and from 46.6% to 59.2% for rectal patients. The median duration of chemotherapy increased by more than 40 days. The type of chemotherapy used changed dramatically. Oxaliplatin and Bevacizumab were not available in 2000, but by 2007, a substantial portion of colon and rectal cancer patients received Oxaliplatin (28.4% and 37.6%) and Bevacizumab (24.4%. and 33.2%). The percent of patients receiving hematopoietic growth factors rose appreciably from 3.7% to 23.2% for colon patients and from 5.2% to 27.4% for rectal patients. From 2000-2007, use of antiemetics/premedication increased from 27.2% to 44.3% for colon patients and from 32.9% to 56.9% for rectal patients. Conclusions: The use and intensity of chemotherapy related treatment for CRC patients with advanced cancer has increased markedly from 2000 to 2007. Many of these therapies are very expensive. ASCO has encouraged realistic conversations about the potential benefits and limitations of disease-directed therapy with the hope of improving patients’ quality of life while reducing medical treatment costs. Our findings demonstrate the need for physicians to assess their treatment practices relative to health care costs and patient prognosis.

Effects of zinc protoporphyrin on the colonic interstitial cells of Cajal and dysfunction in diabetic rats

Objective To assess the effects of zinc protoporphyrin (ZnPP), an inhibitor of the heme oxygenase (HO), on the colonic interstitial cells of Cajal (ICC) of diabetic rats with colonic slow transit. Methods Diabetes mellitus (DM) model was induced by intraperitoneal injection of streptozotocin (STZ) in Sprague-Dawley rats. Twenty four successfully established DM rats were selected, and 16 healthy rats were served as controls. Six weeks later, gastrointestional (GI) dysfunction was observed by charcoal propulsion experiment in 8 DM rats and 8 controls. The rest rats in DM group were divided into 2 groups: DM rats intraperitoneal injected with PBS (n=8) or with 10 μmol/kg of ZnPP (n = 8) every other day for 3 weeks. The rats in control group (n = 8) were intraperitoneally injected with PBS. The levels of HO and c-kit (the special receptor of ICC) expression were detected by Western blotting. The distribution of ICC was observed by immunohistochemistry and the area of c-kit positive cells was counted. Results The GI propulsion rate in DM rats interfered with PBS was significantly declined compared to that in the controls (63.0%± 1.2% vs 71.8%±2.0%, P 0.05). The expression of HO-1 in close and distant colon of DM rats interfered with ZnPP was decreased (P< 0.05). The expression of HO-2 in close colon and the area of c-kit positive cells of DM rats interfered with PBS was reduced compared with that in controls (P<0.05), but both were improved in DM rats interfered with ZnPP (P<0. 05). Conclusion Administration of ZnPP might be able to protect ICC by its blockage of HO-1 in DM rats with gastrointestinal dysfunction. Key words: Diabetes mellitus; Zinc protoporphyrin; Gastrointestinal motility; Rat

Abnormal lymphocyte homing and colon lesions in ulcerative colitis: experiment with rats

To investigate the relationship between abnormal lymphocyte homing and colon lesions in ulcerative colitis. 60 Sprague-Dawley rats were randomly divided into 3 equal groups: model group [undergoing enema of dinitrochlorobenzene to establish models of ulcerative colitis and then venous injection of normal saline (NS) once a day for 5 days], lymphocyte homing intervention group [undergoing venous injection of secondary lymphoid-tissue chemokine (SLC) antibody, and then venous injection of NS for 5 days], and control group [undergoing venous injection of NS for 5 days]. On the 6th day blood samples were collected from the portal vein to isolated lymphocytes. Distant colon was dissected to undergo pathological examination of submucosal aggregated lymphatic follicles, ulceration, and inflammation, thus observing the lymphocyte homing situation. Specimens of colon mucosa underwent detection cytokine of interleukin (IL)-2 and IL-6. RT-PCR was used to detect the mRNA expression of SLC gene and the chemokine receptor CCR7. The proportion of CCR7 positive lymphocytes which drainage from colonic vein were measured by flow cytometry (FC). Abnormal lymphocyte homing phenomenon under colonic mucosa was found in the model and intervention groups. The relative grey degree of SLC gene mRNA expression of the model and intervention groups were 0.85 +/- 0.05 and 0.77 +/- 0.14 respectively, both significantly higher than that of the control group (0.31 +/- 0.11, both P < 0.01), however, without significant difference between the 2 former groups. The relative grey degree of CCR7 mRNA expression of the model group was 0.79 +/- 0.11, significantly higher than that of the intervention groups (0.39 +/- 0.12, P = 0.0429), and both were significantly higher than that of the control group (0.11 +/- 0.03, both P < 0.01). FC showed that the proportion of CCR7(+) lymphocytes drainage from colonic vein of the model and the intervention groups were 69% +/- 5% and 77% +/- 10% respectively, both significantly higher than that of the control group (17% +/- 84%, both P < 0.01), however, without significant difference between these 2 former groups (P = 0.0837). Abnormal lymphocyte homing is associated with inflammation of the colonic mucosa. Blocking of the lymphocyte homing is effective in reducing the inflammation of colonic mucosa.

The effects of nuclear factor-kappaB decoy oligonucleotides on dextran sulphate sodium-induced colitis: experiment with mice

To investigate the effects of nuclear factor-kappaB (NF-kappaB) decoy oligonucleotide (ODN) on dextran sulphate sodium (DSS)-induced colitis. Nine female BABL/C mice underwent infusion of 0.15 ml normal saline into the distant colon and used as controls (Group 1). Twenty-seven female BABL/C mice were made into DSS-induced colitis models and then randomly divided into 3 groups: Group 2 (underwent infusion of 0.15 ml normal saline into the distant colon), Group 3 (infused with NF-kappaB decoy ODN 25 nmol solved in 0.15 ml), and Group 4 (infused with NF-kappaB scrambled decoy ODN 25 nmol solved in 0.15 ml). Disease active index (DAI) was observed every day. Nine days later the mice were killed and their colons were taken out to undergo histological examination. The tumor necrosis factor (TNF)-alpha level of the colon mucosa was measured by enzyme linked immunosorbent assay (ELISA). NF-kappaB expression was determined by immunohistochemical staining. The distribution of NF-kappaB decoy ODN was investigated by confocal laser microscopy. (1) The DAI scores, histological scores and TNF-a level in the colon mucosa of Groups 2 - 4 were all significantly higher than those of Group 1 (all P < 0.05). The DAI scores, histological scores and TNF-a level in the colon mucosa of Group 3 were all significantly lower than those of Groups 2 and 4 (all P < 0.01). (2) In the tissue sections NF-kappaB p65 was positive mainly in the nucleus in the 3 DSS-treated groups without significant differences among these 3 groups, and was mainly positive in the cytoplasm in the control group. (3) Confocal laser microscopy showed that NF-kappaB decoy ODN could be ingested efficiently into the mucosa and submucous layer of colon. (4) There were no significant differences in the liver function, kidney function, and blood glucose among all groups. NF-kappaB pathway is associated with the pathogenesis of DSS-induced colitis which is very similar to human UC. Blockade of NF-kappaB pathway by NF-kappaB decoy ODN shows protective effect on the mice with DSS-induced colitis.

Could Laparoscopic Colorectal Cancer Surgery Become the Adequate Procedure?

Laparoscopic surgery became popular in the early 1990s. The successful application of laparoscopic surgery to gallbladder disease has encouraged surgeon to develop this technology to care other pathologic disorders of the gastrointestinal tract. Laparoscopic technique are being applied to the management of colorectal malignant disease. The advantage of laparoscopic colectomy is to reduce postoperative pain and analgesic requirement, earlier return of bowel function and normal physical activities, and shorter hospital stay. Pathologic examination of laparoscopically resected specimens has shown that adequate mesenteric lymph node excision and distal resection margin. Laproscopic surgery can be accomplished with acceptable morbidity and mortality when performed by trained surgeons. Despite initial early alarming reports of port site cancer recurrence in laparoscopically assisted colectomy, port site recurrence is rare and its incidence is similar to incisional wound recurrences in conventional open colectomy. Recent prospective comparative studies have demonstrated equivalent patient survival and local or distant colon cancer recurrences for open versus laparoscopic curative resection of colon cancer. However, we must await the final result of large prospective randomized studies before drawing any definitive conclusion.

Laparoscopic colectomy for cancer: an oncologic feasible option

The conventional and accepted treatment for curative resection of colon cancer is laparotomy with hemicolectomy for right or left sided lesions. The technique of colon resection through an open laparotomy incision is well known. Over the past several years, laparoscopically assisted colectomy has been developed and studied, following the explosion of laparoscopic technology from the cholecystectomy experience and with acquisition of advanced general laparoscopic techniques. The right, left or sigmoid colon can be mobilized and regional lymphadenectomy performed using laparoscopic instruments and video-imaging equipment. The advantage of laparoscopic colectomy is the use of small abdominal port site and wound incisions which translate to reduced postoperative pain and analgesic requirement, earlier return of bowel function and normal physical activities, and shorter hospital stay without increasing health care costs. Laparoscopic colectomy compares favorably with open colectomy in terms of surgical morbidity and mortality. The laparoscopic approach has been shown to be technically and oncologically feasible with equivalent lymph node harvest from mesenteric lymphadenectomy and achieves adequate proximal and distal margins of colonic resection. Despite initial early anecdotal reports of port site cancer recurrence in laparoscopically assisted colectomy, port site recurrence is rare and its incidence is similar to incisional recurrences in conventional open colectomy. Recent prospective comparative studies have demonstated equivalent patient survival and equivalent local or distant colon cancer recurrences for open versus laparoscopic curative resection of colon cancer.