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Barriers to colorectal cancer screening:A case-control study

World Journal of Gastroenterology 2009年第20期15卷 2531-2536页

作者： Shan-Rong Cai su-zhan zhang Hong-Hong Zhu Shu Zheng Cancer Institute Zhejiang University 88 Jiefang Rd. Hangzhou 310009 Zhejiang Province China Division of Epidemiology Department of Community Health Saint Louis University School of Public Health 3545 Lafayette Ave. St Louis Missouri 63104 United States Department of Epidemiology Johns Hopkins University Bloomberg School of Public Health Baltimore Maryland 21205 United States

AIM:To investigate barriers to colorectal cancer(CRC) screening in a community ***:We conducted a community-based case-control study in an urban Chinese population by *** were selected from those completing both a fecal occult blood test(FOBT) case and colonoscopy in a CRC screening program in *** groups were matched by gender, age group and *** 1 included those having a positive FOBT but refusing a *** 2 included those who refused both an FOBT and ***:The impact of occupation on willingness to attend a colorectal screening program differed by gender.P for heterogeneity was 0.009 for case vs control group 1, 0.01 for case versus control group 2, and 0.80 for control group 1 vs *** awareness of CRC and its screening program, characteristics of screening tests, and lack of time affected the screening *** support, fear of pain and bowel preparation were barriers to a colonoscopy as a screening ***-two percent of control group 1 and 87.1% of control group 2 were willing attend if the colonoscopy was free, but only 56.3% and 53.1%, respectively, if it was *** odds ratios for case vs control group 1 were 0.10 among those unwilling to attend a free colonoscopy and 0.50 among those unwilling to attend a self-paid ***:Raising the public awareness of CRC and its screening, integrating CRC screening into the health care system, and using a painless colonoscopy would increase its screening rate.

关键词： Colorectal cancer screening Barrier Community-based case-control study Colonoscopy Fecal occult blood test

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Ursolic acid inhibits proliferation and induces apoptosis of HT-29 colon cancer cells by inhibiting the EGFR/MAPK pathway

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2009年第9期10卷 668-674页

作者： Jian-zhen SHAN Yan-yan XUAN Shu ZHENG Qi DONG su-zhan zhang Department of Traditional Chinese Medicine the Second Affiliated Hospital School of Medicine Zhejiang University Hangzhou 310009 China Cancer Institute School of Medicine Zhejiang University Hangzhou 310009 China

Objective： To investigate the effects ofursolic acid on the proliferation and apoptosis of human HT-29 colon cancer cells. Methods： 3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide （MTT） and flow cytometry assays were performed to evaluate the effects of ursolic acid on the growth and apoptosis of HT-29 cells. Western blot analysis was applied to investigate the inhibitory efibcts of ursolic acid on the phosphorylation of the epidermal growth factor receptor （EGFR）, extracellular signal-regulated kinase （ERK）, c-Jun N-terminal kinase （JNK）, and p38 mitogen-activated protein kinase （p38 MAPK）, and the activity of B cell leukemia-2 （Bcl-2）, B cell leukemia-xL （Bcl-xL）, caspase-3, and caspase-9. Results： Ursolic acid inhibited the growth of HT-29 cells in dose- and time-dependent manners. The median inhibition concentration （IC50） values for 24, 48, and 72 h treatment were 26, 20, and 18 pmol/L, respectively. The apoptotic rates of 10, 20, and 40 μmol/L ursolic acid treatments for 24 h were 5.74%, 14.49%, and 33.05%, and for 48 h were 9%, 21.39%, and 40.49%, respectively. Ursolic acid suppressed the phosphorylation of EGFR, ERK1/2, p38 MAPK, and JNK, which is well correlated with its growth inhibitory effect. 10, 20, and 40 μmol/L ursolic acid significantly inhibited the proliferation of EGF-stimulated HT-29 cells （P〈0.05）. Cell proliferation was most significantly inhibited when treated with 10 and 20 μmol/L ursolic acid combined with 200 nmol/L AG 1478 or 10 μmol/L U0126 （P〈0.01）. Besides, it also down-regulated the expression of Bcl-2 and Bcl-xL and activated caspase-3 and caspase-9. Conclusion： Ursolic acid induces apoptosis in HT-29 cells by suppressing the EGFR/MAPK pathway, suggesting that it may be a potent agent for the treatment of colorectal cancer.

关键词： Colon cancer Ursolic acid Epidermal growth factor receptor (EGFR) Mitogen-activated protein kinase (MAPK) Apoptosis

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Performance value of high risk factors in colorectal cancer screening in China

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World Journal of Gastroenterology 2009年第48期15卷 6111-6116页

作者： Wen Meng Shan-Rong Cai Lun Zhou Qi Dong Shu Zheng su-zhan zhang Cancer Institute (Key Laboratory of Cancer Prevention and Intervention China National Ministry of Education Key Laboratory of Molecular Biology in Medical Sciences Zhejiang Province China) The Second Affiliated Hospital Zhejiang University School of Medicine Hangzhou 310009 Zhejiang Province China Department of Cardiothoracic surgery Hangzhou First People's Hospital Hangzhou 310006 Zhejiang Province China

AIM:To analyze the performance value of high risk factors in population-based colorectal cancer(CRC) screening in ***:We compared the performance value of the immunochemical fecal occult blood test(iFOBT) and other high risk factors questionnaire in a population sample of 13 214 community residents who completed both the iFOBT and questionnaire *** with either a positive iFOBT and/or questionnaire were regarded as a high risk population and those eligible were asked to undergo ***:The iFOBT had the highest positive predictive value and negative predictive value in screening for advanced *** iFOBT had the highest sensitivity,lowest number of extra false positive results associated with the detection of one extra abnormality for screening advanced neoplasias and adenomas.A history of chronic cholecystitis or cholecystectomy,chronic appendicitis or appendectomy,and chronic diarrhea also had a higher sensitivity than a history of adenomatous polyps in screening for advanced neoplasias and *** sensitivity of a history of chronic cholecystitis or cholecystectomy was highest among the 10 high risk factors in screening for nonadenomatous polyps.A history of chronic appendicitis or appendectomy,chronic constipation,chronic diarrhea,mucous and bloody stool,CRC in first degree relatives,malignant tumor and a positive iFOBT also had higher sensitivities than a history of adenomas polyps in screening for non-adenomatous *** for a history of malignant tumor in screening for non-adenomatous polyps,the gain in sensitivity was associated with an increase in extra false positive results associated with the detection of one extra ***:The iFOBT may be the best marker for screening for advanced neoplasias and *** unique high risk factors may play an important role in CRC screening in China.

关键词： Colorectal cancer Cancer screening Feces Occult blood Risk factors Predictive value of tests

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The 2002 AJCC TNM classification is a better predictor of primary small cell esophageal carcinoma outcome than the VALSG staging system

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Chinese Journal of Cancer 2013年第6期32卷 342-352页

作者： Sheng-Ye Wang Wei-Ming Mao Xiang-Hui Du Ya-Ping Xu su-zhan zhang Department of Radiation Oncology Zhejiang Cancer Hospital Department of Oncology Τhe Second Affiliated Hospital Zhejiang University

Small cell carcinoma of the esophagus (SCCE) is a rare and aggressive malignant tumor with a poor prognosis. The optimal disease staging system and treatment approaches have not yet been defined. This study aimed to evaluate the prediction of different staging systems for prognosis and treatment options of SCCE. We retrospectively accessed the clinicopathologic characteristics, treatment strategy, and prognosis of 76 patients diagnosed with primary SCCE between 2001 and 2011. The 1-, 2-, 3-, and 5-year overall survival rates were 58%, 31%, 19%, and 13%, respectively. Univariate analysis showed that the 2002 American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) classification (P=0.002), Veterans Administration Lung Study Group (VALSG) stage (P=0.001), predisposing factors (Psurvival. Multivariate analysis showed that the 2002 AJCC TNM stage (Psurvival. The value of the area under the receiver operator characteristic (ROC) curve (AUC) of the 2002 AJCC TNM staging system was larger than that of VALSG staging system with regard to predicting overall survival (0.774 vs. 0.620). None of the single treatment regimens showed any benefit for survival by Cox regression analysis. Thus, the 2002 AJCC TMN staging system improved the prediction of SCCE prognosis; however, the optimal treatment regimen for SCCE remains unclear.

关键词：系统预测 TNM 食管癌细胞原发性治疗方案分类病理特征

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Comparative features of colorectal and gastric cancers with microsatellite instability in Chinese patients

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2010年第9期11卷 647-653页

作者： Yan-qin HUANG Ying YUAN Wei-ting GE Han-guang HU su-zhan zhang Shu ZHENG Key Laboratory of Cancer Prevention and Intervention of Ministry of Education Key Laboratory of Molecular Biology in Medical Science of Zhejiang Province Cancer Institute the Second Affiliated Hospital School of Medicine Zhejiang University Hangzhou 310009 China

Objective:The purpose of this study was to determine the unique and universal features of microsatellite instability-high(MSI-H) colorectal cancer(CRC) and MSI-H gastric cancer(GC) in the Chinese ***:A new panel of mononucleotide MSI markers,BAT25,BAT26,NR21,NR24,and MONO-27,was used to define MSI status in 303 CRC and 288 GC *** features of both types of MSI-H tumors were *** analysis in the hMLH1 promoter region by methylation specific polymerase chain reaction(PCR) and mutation detection of hMSH2/hMLH1 genes by denaturing high-performance liquid chromatography(DHPLC) were carried out ***:MSI-H CRCs and MSI-H GCs account for 11.9% and 8.0% of unselected sporadic CRCs and GCs,***-H CRCs are strongly characterized by early onset,right-side location,low differentiation,mucinous tumor,less infiltration,less lymphatic metastasis,and more often familial ***-H GCs only showed site preference for the antrum and less lymphatic *** and epigenetic analyses were positive in 6/36 MSI-H CRCs and 0/23 MSI-H GCs with pathological mutation in major mismatch repair genes,and in 7/36 MSI-H CRCs and 18/23 MSI-H GCs with methylated hMLH1 promoter(P<0.01),***:Although there are many differences in the genetic basis and clinicopathological features between MSI-H CRC and MSI-H GC,when compared with their microsatellite stable(MSS) counterparts,site preference and lymphatic metastasis are features common to both types of MSI-H tumors.

关键词： Microsatellite instability Colorectal cancer Gastric cancer Mutation DNA methylation

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Case Report:Gastric duplication cyst lined by pseudostratified columnar ciliated epithelium: a case report and literature review

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2011年第1期12卷 28-31页

作者： Wu JIANG Bo zhang Yan-biao FU Jia-wei WANG Shun-liang GAO su-zhan zhang Yu-lian WU Department of surgical Oncology the Second Affiliated Hospital School of Medicine Zhejiang University Hangzhou 310009 China Department of General surgery the Second Affiliated Hospital School of Medicine Zhejiang University Hangzhou 310009 China Department of Pathology the Second Affiliated Hospital School of Medicine Zhejiang University Hangzhou 310009 China Department of Radiology the Second Affiliated Hospital School of Medicine Zhejiang University Hangzhou 310009 China

Gastric duplication cyst (GDC) lined by pseudostratified columnar ciliated epithelium (PCCE) is an uncommon lesion stemming from a foregut developmental *** clinical and radiological presentation is usually *** this study,we reported a 76-year-old man who presented with an incidentally found perigastric *** exploratory laparotomy revealed a non-communicating cyst below the gastroesophageal junction,measuring 4 cm×4 cm in ***,the gastric cyst was lined merely by *** rare,GDC lined by PCCE should be included in the differential diagnosis of gastric wall *** intervention is warranted in patients who have clinical symptoms,or who are aged more than 50 years.

关键词： Gastric duplication cyst (GDC) Foregut Pseudostratified columnar ciliated epithelium (PCCE) Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA)

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Effect of SNC19/ST14qene overexpression on invasion of colorectal cancer cells

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World Journal of Gastroenterology 2005年第36期11卷 5651-5654页

作者： Ke-Feng Ding Li-Feng sun Wei-Ting Ge Han-Guang Hu su-zhan zhang Shu Zheng surgery of Oncology The Second Affiliated Hospital School of Medicine Zhejinag UniversityHangzhou 310009 Zhejiang Province China Cancer Institute School of Medicine Zhejinag University Hangzhou310009 Zhejiang Province China

AIM： TO study the effect of SNC19/ST14gene overexpression on invasion in vitro of colorectal cancer cells. METHODS： The adhesion of SlVC19/ST14gene-transfected cells to ECM was measured by MTT assay. The cell movement was evaluated by wound healing assay. Cell invasion and migration were determined by invasion assay in vitro. REsuLTS： SNC19/ST14 gene overexpression could enhance invasion of colorectal cancer cells in vitro significantly and influence early cell adherence to ECM, but could not change cell movement significantly. CONCLUSION： SNC19/ST14 gene overexpression increases the local invasion of colorectal cancer cells in vitro. 2005 The WJG Press and Elsevier Inc. All rights reserved.

关键词： Gene SNC19/ST14 Colorectal cancer Invasion

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Proteomic analysis of primary colon cancer-associated fibroblasts using the SELDI-ProteinChip platform

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2012年第3期13卷 159-167页

作者： zhan-huai WANG Ke-feng DING Jie-kai YU Xiao-hui ZHAI Shu-qin RUAN Shan-wei WANG Yong-liang ZHU Shu ZHENG su-zhan zhang Cancer Institute （Key Laboratory of Cancer Prevention and Intervention China National Ministry of Education Key Laboratory of Molecular Biology in Medical Sciences Zhejiang Province China） the Second Affiliated Hospital School of Medicine Zhejiang University Hangzhou 310009 China 2Department of Oncology the Second Affiliated Hospital School of Medicine Zhejiang University Hangzhou 310009 China Department of Gastroenterology the Second Aff~liated Hospital School of Medicine Zhejiang University Hangzhou 310009 China

Objective： Cancer-associated fibroblasts （CAFs） are one of the hallmarks of the cancer microenvironment. Recent evidence has indicated that CAFs are more competent in enhancing cancer cell growth and migration than normal fibroblasts. However, the unique protein expression of CAFs has not been fully elucidated. This study aims to investigate the characterizations of colon CAFs by comparing the differential protein expression between CAFs and normal fibroblasts. Methods： Primary fibroblasts were isolated from surgical specimen of human colon cancer and matched normal colonic tissue. Purity of the cell population was verified through immunostain analysis. Total cell lysates and conditioned media from each group of cells were extracted, and protein expression analysis was con- ducted using the surface-enhanced laser desorption/ionization time-of-flight mass spectrometry （SELDI-TOF-MS） ProteinChip platform. Results： Most primary cells showed typical fibroblast-like features after two weeks. Increased proportion of a-smooth muscle actin-positive myofibroblasts was detected within the CAFs in four of the six pairs of primary cells. Fibroblast activation protein was weakly expressed in most cells without differences. Using SELDI-TOF-MS ProteinChip platform, four protein peaks mass over charge ratio （m/z） 1142, 3011, 4035, and 4945 were detected in the total cell lysates, and two protein peaks m/z 1368 and 1389 were detected in the conditioned media. The potential candidate proteins found in the Swiss-Prot database include morphogenetic neuropeptides, FMRFamide-related peptides, insulin-like growth factor II, thymosin 13-4-like protein 3, and tight junction-associated protein 1. Conclusions： Using the SELDI-ProteinChip platform, differential protein expressions were identified in colon CAFs compared with normal colonic stromal fibroblasts. The complex proteomic alternations in colon CAFs may play important roles related to the colon cancer microenvironment.

关键词： Colon cancer Cancer microenvironment Cancer-associated fibroblasts Proteomics surface-enhancedlaser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS)

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Barrier-focused intervention to increase colonoscopy attendance among nonadherent high-risk populations

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World Journal of Gastroenterology 2009年第31期15卷 3920-3925页

作者： Wen Meng Xi-Wen Bi Xiao-Yin Bai Hua-Feng Pan Shan-Rong Cai Qi Zhao su-zhan zhang Key Laboratory of Cancer Prevention and Intervention China National Ministry of Education Key Laboratory of Molecular Biology in Medical Sciences Zhejiang Province China The Second Affiliated Hospital Zhejiang University School of Medicine Hangzhou 310009 Zhejiang Province China Department of Cardiothoracic surgery Hangzhou No. 1 People Hospital Hangzhou 310006 Zhejiang Province China Xiacheng District Center for Disease Control and Prevention Hangzhou 310003 Zhejiang Province China

AIM： To increase attendance tor colonoscopy among nonadherent high-risk individuals for colorectal cancer （CRC） screening in China. METHODS： During the first 12 mo without intervention, only 428 of the 2398 high-risk subjects attended a scheduled colonoscopy examination. The 1970 subjects who did not attend for CRC screening were enrolled in the present study. Prior barrier investigation was performed to ascertain the reasons for nonadherence. A barrier-focused intervention program was then established and implemented among eligible nonadherent subjects by telephone interviews and on-site consultations. The completion rates of colonoscopy during the first 12 mo without intervention and the second 12 mo with intervention were compared. Variations in the effect of the intervention on some high-risk factors and barrier characteristics were analyzed using logistic regression. REsuLTS： 540 subjects who were not eligible were excluded from the study. The colonoscopy attendance rate was 23.04% （428/1858） during the first 12 mo without intervention, and 37.69% （539/1430） during the second 12 mo with intervention （P 〈 0.001）. Logistic regression analysis showed that the intervention was more effective among subjects with only objective barriers （OR： 34.590, 95% CI： 23.204-51.563） or subjects with some specific highrisk characteristics： first-degree relatives diagnosed with CRC （OR： 1.778, 95% CI： 1.010-3.131）, personal history of intestinal polyps （OR： 3.815, 95% CI： 1.994-7.300） and positive result for immunochemical fecal occult blood testing （OR： 2.718, 95% CI： 1.479-4.996）. CONCLUSION： The barrier-focused telephone or on- site consultation intervention appears to be a feasible means to improve colonoscopy attendance among nonadherent high-risk subjects for CRC screening in China.

关键词： Colorectal cancer Screening Intervention Colonoscopy Attendance

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Clinical and genetic characteristics of Chinese hereditary nonpolyposis colorectal cancer families

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World Journal of Gastroenterology 2006年第25期12卷 4074-4077页

作者： Xu-Lin Wang Ying Yuan su-zhan zhang Shan-Rong Cai Yan-Qin Huang Qiang Jiang Shu Zheng Cancer Institute the 2nd Affiliated Hospital College of Medicine Zhejiang University 88 Jie-Fang Road Hangzhou 310009 Zhejiang Province China

AIM： To analyze the clinical characteristics of Chinese hereditary nonpolyposis colorectal cancer （HNPCC） families and to screen the germline mutations of human mismatch repair genes hMLH1 and hMSH2 in the probands. METHODS： Thirty-one independent Chinese HNPCC families were collected in Zhejiang Province. All of them met Chinese HNPCC criteria. Clinical data about patient gender, site of colorectal cancer, age of onset, history of multiple colorectal cancer, associated extracolonic cancer were recorded. PCR and denaturing high performance liquid chromatography （DHPLC） were employed to screen the mutations. Sequencing analysis was used to find out the exact mutation site and characteristics of the samples showing abnormal DHPLC profiles. REsuLTS： One hundred and thirty-six malignant neoplasms were found in 107 patients including 14 multiple cancers. One hundred and six of the 136 neoplasms （77.9%） were diagnosed as colorectal cancer, with an average age of onset at 48.57 ±29.00 years. Gastric cancer was the most common extracolonic cancer （10.3%） in these families. Twenty-three different sequence variations in hMLHI and hMSH2 genes were detected in these 17 families. Fifteen sequence variations were located in the exons, including 5 SNPs, 3 silent mutations, 3 missense mutations, 2 nonsense mutations and 2 frameshift mutations. The latter seven mutations seemed to be pathogenic. CONCLUSION： Germline mutations of hMLH1 and hMSH2 genes are identified in about one-third HNPCC kindreds fulfilling Chinese HNPCC criteria. Chinese HNPCC families have some particular clinical characteristics, such as a left-sided predominance, less synchronous or metachronous colorectal cancer, and frequent occurrence of gastric cancer.

关键词： Colorectal cancer Hereditary nonpolyposis DNA mutation analysis High pressure liquid Chromatography Oncogenes

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