A Study On The Influence Of Laparoscopic Radical Resection Of Colorectal Cancer On Hematogenous Metastasis Of Tumor Cells

PART I A STUDY ON THE INFLUENCE OF LAPAROSCOPIC RADICAL RESECTION OF COLORECTAL CANCER ON HEMATOGENOUS MICROMETASTASISObjective: To detect CK20 mRNA expression in peripheral blood in patients underwent laparoscopic radical resection of colorectal cancer and to investigate the influence of laparoscopic resection of colorectal cancer(CRC) on postoperative micrometastasis of tumor cells,and to discuss its clinical significance.Methods :CK20 mRNA was detected in peripheral blood of 24 colorectal cancer patients underwent laparoscopic radical resection of colorectal cancer and 31 patients with open radical resection of colorectal cancer by FQ-PCR.CK20 and CD44 v6 were determined in tissu samples of colorectal cancer by immunohistochemical (IHC)SP method.Results : The CK20 mRNA expression was significantly higher in the patients categorized to phaseШthan phase I/II according to TNM staging(P<0.05).The preoperative positive rate of CK20mRNA was 29.16%(7/24),while the postoperative positive rate was 37.50%(9/24)in patients underwent laparoscopic radical resection of colorectal cancer,and there was no significant difference between the two groups(P>0.05).The positive rate of CK20 mRNA expression had no significant difference between the laparoscopic and open radical resection of colorectal cancer either preoperatively or postoperatively(P>0.05).The expression of CK20 and CD44 v6 of tissu samples of colorectal cancer were higher in patients with positive expression of CK20 mRNA than that in patients with negative expression of CK20 mRNA(P<0.05).Conclusions: The expression of CK20 mRNA in peripheral blood of colorectal cancer patients concern with TNM staging,tissue differentiation, and metastasis of lymph node.Laparoscopic radical resection of colorectal cancer does not increase the positive rate of cancer cells in peripheral blood, as in laparatomy group.Laparoscopic resection of colorectal cancer does not increase the risk of hematogenous micrometastasis of tumor cell. PART II THE INFLUENCE OF LAPAROSCOPIC RADICAL RESECTION OF COLORECTAL CANCER ON HEMATOGENOUS ADHESION MOLECULESObjective :To explore the effect of laparoscopic radical resection of colorectal cancer on the expression of adhesion molecules and tumor growth of colorectal cancer, and the clinical significance of determining sCD44v6,sICAM-1 and sVCAM-1 in serum of patients with colorectal cancer(CRC) in diagnoosis and prognosis judgement .Methods :The levels of serum sCD44v6,sICAM-1 and sVCAM-1 were tested in 24 patients underwent laparoscopic radical resection of colorectal cancer ,31 patients underwent open radical resection of colorectal cancer , by using double antibody sandwich enzyme-linked immnunoadsordent assay(ELISA),and investigate the changes of sCD44v6,sICAM-1 and sVCAM-1 levels in the patients with colorectal cancer in pre-opemtion and post-operation,laparoscopy and laparotomy.Results: Colorectal cancer showed significantly higher serum levels of sCD44v6,sICAM-1 and sVCAM-1 compared with those in healthy controls (P<0.05).The levels of sCD44v6,sICAM-1 and sVCAM-1 had no significant difference between low differentiation and higer /mediate differentiation(P>0.05).The expression of sCD44v6,sICAM-1 and sVCAM-1 was significantly higher in the patients categorized to phaseⅢ than phase I/II according to TNM staging(P<0.05).The concentration of sCD44v6,sICAM-1 and sVCAM-1 had no significant difference between the laparoscopic and open radical resection of colorectal cancer either preoperatively or postoperatively(P>0.05).Conclusions:The expression of sCD44v6,sICAM-1 and sVCAM-1 was not correlated with tissue difierentiation, was closely related to the stage and metastasis of lymph node. sCD44v6,sICAM-1 and and sVCAM-1 may serve as a useful marker for colorectal cancer and may closely reflect its development and progress ,help in prognosis prediction,effect assessment and guidance of multiporpose therapy of colorectal cancer.Laparoscopic radical resection of colorectal cancer does not promote the expression of adhesion molecules ,does not increases the metastatic potential of colorectal cancer cells.