Asunto(s)
Antimetabolitos Antineoplásicos/administración & dosificación , Neoplasias del Recto/tratamiento farmacológico , Tegafur/administración & dosificación , Adulto , Anciano , Anciano de 80 o más Años , Quimioterapia Adyuvante , Dihidrouracilo Deshidrogenasa (NADP)/metabolismo , Resistencia a Antineoplásicos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuidados Preoperatorios , Pronóstico , Neoplasias del Recto/enzimología , Neoplasias del Recto/cirugía , Supositorios , Tegafur/efectos adversosRESUMEN
MBD4/MED1 is a newly identified mismatch repair gene, which is mutated in colon, endometrial, and pancreatic high-frequency microsatellite instability (MSI-H) tumors. To assess its role in gastric cancers, we investigated MBD4/MED1 mutations in sporadic gastric cancers, compared with colon cancers. Frameshift mutations were found in 29% of gastric and 20% of colon MSI-H cancers, but not in any low-frequency microsatellite instability/microsatellite stable cancers. MBD4/MED1 is mutated in gastric cancers as frequently as in colon cancers; these mutations reduce the accuracy of DNA repair, and may lead to cancer progression.
Asunto(s)
Endodesoxirribonucleasas/genética , Anciano , Disparidad de Par Base , Neoplasias del Colon/genética , Análisis Mutacional de ADN , Femenino , Mutación del Sistema de Lectura , Humanos , Masculino , Repeticiones de Microsatélite , Persona de Mediana Edad , Neoplasias GástricasRESUMEN
BACKGROUND/AIMS: Omentoplasty--wrapping the omentum around the alimentary tract anastomosis is thought to lower the rate of anastomotic leakage. We evaluated the role of omentoplasty to reinforce cervical esophagogastrostomy after radical esophagectomy. METHODOLOGY: We compared anastomotic leakage, stricture formation, and related deaths in 63 patients who underwent radical esophagectomy and cervical esophagogastrostomy, with (n = 48) or without (n = 15) omentoplasty, between 1995 and 1999. RESULTS: An esophageal anastomotic leakage was diagnosed in 1 of the 48 patients (2.1%) with omentoplasty versus 3 of the 15 patients (20.0%) without omentoplasty (P < 0.01). Anastomotic stricture occurred in 2 (4.2%) of the omentoplasty group and 1 (6.7%) of the no omentoplasty group (P < 0.01). Death within 1 month was zero in the omentoplasty group and one (6.7%) in the no-omentoplasty group, despite no differences in lethal anastomotic leakage. CONCLUSIONS: Omentoplasty of cervical esophagogastrostomy reduced anastomotic leakage. Although promising, these observations require confirmation with a randomized prospective study.