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- Matthiessen, P., et al.
(författare)
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Increase of serum C-reactive protein is an early indicator of subsequent symptomatic anastomotic leakage after anterior resection
- 2008
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Ingår i: Colorectal Disease. - : Wiley. - 1462-8910 .- 1463-1318. ; 10:1, s. 75-80
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This prospective study investigated the factors which might indicate anastomotic leakage after low anterior resection. Method: Thirty-three patients who underwent anterior resection for rectal carcinoma (n = 32) and severe dysplasia (n = 1), were monitored daily by serum C-reactive protein (CRP) and white blood cell count (WBC) estimations until discharge from hospital. Computed tomography (CT) scans were performed on postoperative days 2 and 7 and the amount of presacral fluid collection was assessed. All patients had a pelvic drain and the volume of drainage was measured daily. Results: The level of the anastomosis was at a median 5 cm (3-12 cm) above the anal verge. There was no 30-day mortality. Nine (27.2%) of the 33 patients developed a symptomatic anastomotic leakage which was diagnosed at a median of 8 days (range 4-14) postoperatively. The serum CRP was increased in patients who leaked from postoperative day 2 onwards (P = 0.004 on day 2, P < 0.001 on day 3-8). The WBC was decreased in preoperatively irradiated patients on days 1-5 (P = 0.021), with no difference seen between patients with or without leakage. Patients with leakage had a larger presacral fluid collection on CT on day 7 (median 76 ml vs 52 ml, P = 0.016) and a larger increase in the fluid collection between the first and the second CT examinations (28 ml vs 3 ml, P = 0.046). Conclusion: An early rise in serum CRP was a strong indicator of leakage. Monitoring of CRP for possible early detection of symptomatic anastomotic leakage is recommended.
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- Murthy, RV, et al.
(författare)
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Legumain expression in relation to clinicopathologic and biological variables in colorectal cancer
- 2005
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Ingår i: Clinical Cancer Research. - 1078-0432 .- 1557-3265. ; 11:6, s. 2293-2299
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Legumain, a novel asparaginyl endopeptidase, has been observed to be highly expressed in several types of tumors including colorectal cancer. However, there is no study examining the relationship of legumain expression to clinocopatbologic and biological variables in colorectal cancers. Experimental Design: We investigated legumain expression in 164 primary colorectal cancers, 34 corresponding distant normal mucosa samples, 89 adjacent normal mucosa samples, and 33 lymph node metastases using immunohistochemistry. We also did Western blotting analysis on three additional colorectal cancers and three colonic cell lines. Results: Legumain expression was increased in primary tumors compared with distant or adjacent normal mucosa (P < 0.05), but there was no significant change between primary tumors and metastases (P > 0.05). Legumain expression was positively related to poorer differentiation/ mucinous carcinoma (P = 0.04), higher degree of necrosis (P = 0.03) and apoptosis (P < 0.0001), positive proliferating cell nuclear antigen (P < 0.0001) and p53 expression (P = 0.049), and had a positive tendency towards stromelysin 3 (P = 0.058) and PINCH positivity (P = 0.05). The patients with tumors that showed both weak and lower percentage of the legumain expression, either in tumor (P = 0.01) or in stroma (P = 0.04), had a better prognosis. Conclusions: The legumain expression may be involved in colorectal cancer development and have a prognostic value in the patients. ©2005 American Association for Cancer Research.
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