Colonic stent-induced mechanical compression may suppress cancer cell proliferation in malignant large bowel obstruction.

Surgical Endoscopy
Akihisa MatsudaHiroshi Yoshida

Abstract

The short-term safety and efficacy of insertion of a self-expandable metallic colonic stent (SEMS) followed by elective surgery, "bridge to surgery (BTS)", for malignant large bowel obstruction (MLBO) have been well described; however, the influence on long-term oncological outcomes is unclear. The aim of this study was to evaluate changes in oncological characteristics in colorectal cancer (CRC) tissues after SEMS insertion, focusing on growth factors, cell cycle and apoptosis. From January 2013 to September 2014, a total of 25 patients with MLBO who underwent BTS at our single institution were retrospectively included. Paired CRC tissue samples before (endoscopic biopsy) and after SEMS insertion (surgically resected) were collected from each patient. EGFR, VEGF, Ki-67, p27kip1 and TUNEL expression were determined by immunohistochemistry. No clinical or subclinical perforations evaluated by mechanical ulceration pathologically were observed. Epithelial exfoliation, tumour necrosis, infiltration of inflammatory cells and fibrosis were observed in SEMS-inserted surgically-resected specimens. Overall, 84% (21/25) and 60% (15/25) of patients exhibited no change or a decrease in staining category, respectively, for EGFR and VEGF ex...Continue Reading

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Citations

Sep 3, 2019·International Journal of Colorectal Disease·Patrick Anthony BolandJ O Larkin
Feb 16, 2021·World Journal of Surgical Oncology·Sigrid Skov Bennedsgaard, Lene Hjerrild Iversen
May 19, 2020·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Liam SpannenburgHaolu Wang
Sep 16, 2021·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Toshio KuwaiYoshihisa Saida

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