It has been demonstrated that even localized tumors withottt chnically apparent metastasis give rise to circulating tumor cells （CTCs）. A growing number of technically diverse platforms are being developed for detec...It has been demonstrated that even localized tumors withottt chnically apparent metastasis give rise to circulating tumor cells （CTCs）. A growing number of technically diverse platforms are being developed for detecting/isolating CTCs in the circulating blood. Despite the technical challenges of isolating rare CTCs from blood, recent studies have already shown the predictive value of CTCs enumeration. Thus, it is becoming increasingly accepted that CTC numbers are linked to patients＇ outcome and may also be used to monitor treatment response and disease relapse, respectively. Further CTCs provide a non-invasive source for tumor material, ＇liquid biopsy＇, which is particularly important for patients, where no biopsy material can be obtained or where serial biopsies of the tumor, e.g., following treatment, are practically impossible. On the other hand the molecular and biological characterization of CTCs has still remained at a rather experimental stage. Future studies are necessary to define CTC heterogeneity to establish the crucial role of circulating cancer stem cells for driving metastasis, which represent a distinct subpopulation of CTCs that bear metastasis-initiating capabilities based on their sternness properties and invasiveness and thus are critical for the patients＇ clinical outcome. As compared to non-tumorigenic/metastatic bulk CTCs, circulating cancer stem cells may not only be capable of evading from the primary tumor, but also escape from immune surveillance, survive in the circulating blood and subsequently form metastases in distant organs. Thus, circulating cancer stem cells represent a subset of exclusively tumorigenic cancer stem cells characterized by their invasive characteristics and are potential therapeutic targets for preventing disease progression. To date, only a few original reports and reviews have been published focusing on circulating cancer stem cells. This review discusses the potential importance of isolating and characterizing these circulating cancer stem cells, but also highlights current technological limitations.展开更多
AIM:To investigate the comorbid disease could be the predictors for the elective colectomy in colonic diverticulitis.METHODS:A retrospective chart review of 246 patients with colonic diverticulitis admitted between 20...AIM:To investigate the comorbid disease could be the predictors for the elective colectomy in colonic diverticulitis.METHODS:A retrospective chart review of 246 patients with colonic diverticulitis admitted between 2000and 2008 was conducted,and 19 patients received emergent operation were identified and analyzed.Data were collected with regard to age,sex,albumin level on admission,left or right inflammation site,the history of recurrent diverticulitis,preoperative comorbidity,smoking habits,medication,treatment policy,morbidity,and mortality.Preoperative comorbid diseases included cardiovascular disease,diabetes,pulmonary disease,peptic ulcer disease,gouty arthritis,and uremia.Medications in use included non-steroidal anti-inflammatory drugs,acetylsalicylic acid(Aspirin),and corticosteroids.Univariate and multivariate logistic regression analyses were performed to identify the relevant risk factors correlating to colectomy.RESULTS:The mean age of the 246 patients was 69.5years(range,24-94 years).Most diverticulitis could be managed with conservative treatment(n=227,92.3%),and urgent colectomy was performed in 19patients(7.7%).There were three deaths in the surgical group and four deaths in the nonsurgical group.The overall mortality rate in the study was 1.7%among patients with conservative treatment and 15.7%among patients undergoing urgent colectomy.Multiple logistic regression analysis indicated that comorbidities were risk factors for urgent colectomy for diverticulitis.CONCLUSION:To avoid high mortality and morbidity related to urgent colectomy,we suggest that patients with colonic diverticulitis and comorbid diseases may require elective colectomy.展开更多
基金supported by an ERC Advanced Investigator Grant(Pa-CSC 233460)the European Community's Seventh Framework Programme(FP7/20072013) under grant agreement n° 256974(EPC-TM-NET) and n° 602783(CAM-PaC)+2 种基金the Subdireccion General de Evaluacion y Fomento de la Investigacion,Fondo de Investigacion Sanitaria(PS09/02129 & PI12/02643)the Programa Nacional de Internacionalizacion de la I+D, Subprogramma:FCCI 2009[PLE2009-0105both Ministerio de Economia y Competitividad(es),Spain],awarded to C.H.
文摘It has been demonstrated that even localized tumors withottt chnically apparent metastasis give rise to circulating tumor cells （CTCs）. A growing number of technically diverse platforms are being developed for detecting/isolating CTCs in the circulating blood. Despite the technical challenges of isolating rare CTCs from blood, recent studies have already shown the predictive value of CTCs enumeration. Thus, it is becoming increasingly accepted that CTC numbers are linked to patients＇ outcome and may also be used to monitor treatment response and disease relapse, respectively. Further CTCs provide a non-invasive source for tumor material, ＇liquid biopsy＇, which is particularly important for patients, where no biopsy material can be obtained or where serial biopsies of the tumor, e.g., following treatment, are practically impossible. On the other hand the molecular and biological characterization of CTCs has still remained at a rather experimental stage. Future studies are necessary to define CTC heterogeneity to establish the crucial role of circulating cancer stem cells for driving metastasis, which represent a distinct subpopulation of CTCs that bear metastasis-initiating capabilities based on their sternness properties and invasiveness and thus are critical for the patients＇ clinical outcome. As compared to non-tumorigenic/metastatic bulk CTCs, circulating cancer stem cells may not only be capable of evading from the primary tumor, but also escape from immune surveillance, survive in the circulating blood and subsequently form metastases in distant organs. Thus, circulating cancer stem cells represent a subset of exclusively tumorigenic cancer stem cells characterized by their invasive characteristics and are potential therapeutic targets for preventing disease progression. To date, only a few original reports and reviews have been published focusing on circulating cancer stem cells. This review discusses the potential importance of isolating and characterizing these circulating cancer stem cells, but also highlights current technological limitations.
文摘AIM:To investigate the comorbid disease could be the predictors for the elective colectomy in colonic diverticulitis.METHODS:A retrospective chart review of 246 patients with colonic diverticulitis admitted between 2000and 2008 was conducted,and 19 patients received emergent operation were identified and analyzed.Data were collected with regard to age,sex,albumin level on admission,left or right inflammation site,the history of recurrent diverticulitis,preoperative comorbidity,smoking habits,medication,treatment policy,morbidity,and mortality.Preoperative comorbid diseases included cardiovascular disease,diabetes,pulmonary disease,peptic ulcer disease,gouty arthritis,and uremia.Medications in use included non-steroidal anti-inflammatory drugs,acetylsalicylic acid(Aspirin),and corticosteroids.Univariate and multivariate logistic regression analyses were performed to identify the relevant risk factors correlating to colectomy.RESULTS:The mean age of the 246 patients was 69.5years(range,24-94 years).Most diverticulitis could be managed with conservative treatment(n=227,92.3%),and urgent colectomy was performed in 19patients(7.7%).There were three deaths in the surgical group and four deaths in the nonsurgical group.The overall mortality rate in the study was 1.7%among patients with conservative treatment and 15.7%among patients undergoing urgent colectomy.Multiple logistic regression analysis indicated that comorbidities were risk factors for urgent colectomy for diverticulitis.CONCLUSION:To avoid high mortality and morbidity related to urgent colectomy,we suggest that patients with colonic diverticulitis and comorbid diseases may require elective colectomy.
