Distal resection of sacrum for the rectal cancer recurrence

Distal resection of sacrum for the rectal cancer recurrence

Prognostic and clinicopathological insights of phosphodiesterase 9A gene as novel biomarker in human colorectal cancer

Background PDE9A (Phosphodiesterase 9A) plays an important role in proliferation of cells, their differentiation and apoptosis via intracellular cGMP (cyclic guanosine monophosphate) signaling. The expression pattern of PDE9A is associated with diverse tumors and carcinomas. Therefore, PDE9A could be a prospective candidate as a therapeutic target in different types of carcinoma. The study presented here was designed to carry out the prognostic value as a biomarker of PDE9A in Colorectal cancer (CRC). The present study integrated several cancer databases with in-silico techniques to evaluate the cancer prognosis of CRC. Results The analyses suggested that the expression of PDE9A was significantly down-regulated in CRC tissues than in normal tissues. Moreover, methylation in the DNA promoter region might also manipulate PDE9A gene expression. The Kaplan–Meier curves indicated that high level of expression of PDE9A gene was associated to higher survival in OS, RFS, and DSS in CRC patients. PDE9A demonstrated the highest positive correlation for rectal cancer recurrence with a marker gene CEACAM7. Furtheremore, PDE9A shared consolidated pathways with MAPK14 to induce survival autophagy in CRC cells and showed interaction with GUCY1A2 to drive CRPC. Conclusions Overall, the prognostic value of PDE9A gene could be used as a potential tumor biomarker for CRC.

Prognostic and Clinicopathological Insights of Phosphodiesterase 9A Gene As Novel Biomarker in Human Colorectal Cancer

Background: PDE9A (Phosphodiesterase 9A) plays an important role in proliferation of cells, their differentiation and apoptosis via intracellular cGMP (cyclic guanosine monophosphate) signaling. The expression pattern of PDE9A is associated with diverse tumors and carcinomas. Therefore, PDE9A could be a prospective candidate as a therapeutic target in different types of carcinoma. The study presented here was designed to carry out the prognostic value as a biomarker of PDE9A in Colorectal cancer (CRC). The present study integrated several cancer databases with in-silico techniques to evaluate the cancer prognosis of CRC. Results: The analyses suggested that the expression of PDE9A was significantly down-regulated in CRC tissues than in normal tissues. Moreover, methylation in the DNA promoter region might also manipulate PDE9A gene expression. The Kaplan–Meier curves indicated that high level of expression of PDE9A gene was associated to higher survival in OS, RFS, and DSS in CRC patients. PDE9A demonstrated the highest positive correlation for rectal cancer recurrence with a marker gene CEACAM7. Furtheremore, PDE9A shared consolidated pathways with MAPK14 to induce survival autophagy in CRC cells and showed interaction with GUCY1A2 to drive CRPC. Conclusions: Overall, the prognostic value of PDE9A gene could be used as a potential tumor biomarker for CRC.

Procedures for Rectal Cancer

Cancer of the large bowel is the third most common cancer diagnosed in both men and women in the United States with the exclusion of skin cancers. Surgery represents the mainstay of therapy in early-stage rectal cancer and is frequently warranted in advanced cases for palliation. Complete resection and retention of gastrointestinal continuity with low recurrence rates are the ultimate goal in treating localized disease. Local recurrence in rectal cancer essentially represents a failure of surgical therapy and is avoidable in most cases. Radiation has been shown to reduce local recurrences. This review covers the surgical anatomy of the rectum, factors to consider when evaluating patients with rectal cancer, choosing a therapeutic protocol, obtaining patient consent, preoperative considerations, and surgical technique. Local (transanal local excision, transanal endoscopic microsurgery) and radical procedures (anterior resection technique, abdominoperineal resection) are described. Laparoscopic and robotic approaches, key intraoperative concepts in rectal cancer, perioperative care, adjuvant therapy, and follow-up regimens are also detailed. Tables describe general medical issues for surgeons to review, vital knowledge for the colorectal surgeon, American Joint Committee on Cancer TNM Clinical Classification of Colorectal Cancer, American Joint Committee on Cancer Staging System for Colon Cancer, the multidisciplinary team for treating rectal cancer, risk factors associated with high rectal cancer recurrence rate, National Comprehensive Cancer Network 2013 Guidelines for Transanal Excision, and total mesorectal excision score as categorized by Quirke. Figures show procedures for local, anterior, and abdominoperineal resection. This review contains 11 figures, 9 tables, and 64 references. Keywords: rectoscope, resection, excision, anastomosis, radiation, stapler, abdominoperineal resection