Abstract:Objective: To investigate the clinical characteristics and the risk factors for occult central cervical lymph node metastasis in cN0 papillary thyroid microcarcinoma (PTMC). Methods: The clinical data of 372 patients with papillary thyroid carcinoma (PTC) at cN0 stage undergoing thyroidectomy plus prophylactic central neck dissection were retrospectively analyzed. Of the patients, 250 cases with PTMC (tumor diameter ≤1.0 cm) were regarded as study group and the other 122 cases with common PTC patients (tumor diameter >1.0–2.0 cm) served as control group. The clinical features and risk factors for central cervical lymph node metastasis of PTMC were analyzed by comparing the clinicopathologic and imaging data between the two groups of patients. Results: The incidence of central lymph node metastasis for study group and control group was 32.8% (82/250) and 42.6% (52/122) respectively, and the difference had no statistical significance (P>0.05). Univariate analysis showed that the central cervical lymph node metastasis in study group was significantly associated with tumor size, multifocality and extrathyroidal invasion (all P<0.05), but was unrelated to nodule ultrasound features and other factors (all P>0.05); the central cervical lymph node metastasis in control group was irrelevant to any of the analyzed factors (all P>0.05). Multivariate analysis identified that tumor size (OR=2.916, 95% CI=1.19–4.37), multifocality (OR=1.230, 95% CI=0.68–2.75) and extrathyroidal invasion (OR=1.923, 95% CI=1.06–3.70) were risk factors for central cervical lymph node metastasis of PTMC (all P<0.05). Conclusion: The incidence of central cervical lymph node metastasis in cN0 PTMC is similar to that in common PTC, and the risk factors are tumor size , multiple lesions and extrathyroidal invasion.

Abstract:Objective: To investigate the effect of intraoperative neuromonitoring (IOM) of the recurrent laryngeal nerve recurrent laryngeal nerve (RLN) in endoscopy-assisted thyroidectomy for early differentiated thyroid carcinoma (DTC). Methods: The clinical data of 180 patients with early DTC undergoing endoscopy-assisted thyroidectomy from June 2012 to January 2015 were retrospectively analyzed. Of the patients, 90 cases received IOM of RLN (monitoring group), and the other 80 cases did not receive IOM of RLN (non-monitoring group). The relevant surgical variables and the incidence of transient and permanent RLN injury between the two groups were compared. Results: In monitoring group compared with non-monitoring group, the mean operative time, intraoperative blood loss, postoperative drainage volume were significantly reduced [(90.2±20.2) min vs. (100.2±26.9) min; (16.3±13.2) mL vs. (24.4±9.8) mL; (25.5±8.5) mL vs. (29.7±5.6) mL, all P<0.05]; the number of removed lymph nodes and length of hospital stay showed no significant difference [(5.1±1.9) vs. (4.9±1.2); (3.8±2.5) d vs. (3.9±2.7) d, both P>0.05]. During a 12-week follow-up, the incidence of temporary RLN injury was 7.4% (8/105) in monitoring group and 19.0% (18/95) in non-monitoring group, and the difference had statistical significance (P<0.05), while incidence of permanent RLN damage was 1.0% (1/105) in monitoring group and 3.2% (3/95) in non-monitoring group which had no significant difference (P>0.05). Conclusion: Using IOM of RLN in endoscopy-assisted thyroidectomy for early DTC can effectively reduce the incidence of transient RLN injury, shorten the operative time and reduce intraoperative blood loss.

Abstract:Objective: To investigate the present status of diagnosis and treatment for thyroid microcarcinoma (TMC), and provide clinical basis for standardization of surgical procedure selection. Methods: The clinical data of 28 TMC patients confirmed by surgical and pathological findings from February 2013 to February 2015 were reviewed, and the diagnosis, surgical method and prognosis of the patients were analyzed. Results: Of the 28 TMC patients, all cases were detected with lesions by preoperative color Doppler ultrasound evaluation, 15 cases underwent ultrasound-guided fine-needle aspiration biopsy and diagnosis was made in 4 cases (26.7%), 27 cases (96.4%) were diagnosed by intraoperative frozen section, and one case (3.6%) was confirmed by postoperative pathology. All patients received surgical treatment that included total thyroidectomy in 8 cases (28.6%), subtotal thyroidectomy in 7 cases (25.0%), ipsilateral thyroidectomy plus isthmectomy in 10 cases (35.7%), and thyroid lobectomy in 3 cases (10.7%). All patients were followed up, and no recurrence, metastasis or death occurred. Conclusion: The detection rate of TMC shows an increasing trend, and currently, preoperative definite diagnosis is still difficult and surgery is the main treatment method. How to improve the preoperative detection rate and standardized surgical treatment is imperative.

Abstract:Objective: To investigate the risk factors for hypoparathyroidism following radical surgery for thyroid carcinoma and preventive measures. Methods: The clinical data of 75 cases of thyroid cancer surgery performed during the entire year of 2014 by the same main surgeon in Department of General Surgery of Beijing Tongren Hospital affiliated to Capital Medical University were retrospectively analyzed. Results: Hypoparathyroidism occurred in 20 patients (26.67%) in the entire group, including 19 cases (25.33%) of transient hypoparathyroidism and one case (1.33%) of permanent hypoparathyroidism. The incidence of postoperative hypoparathyroidism in patients undergoing total thyroidectomy was significantly higher than that in those undergoing nearly total thyroidectomy (46.88% vs. 11.63%, P<0.05), in patients receiving level VI neck dissection was significantly higher than that in those without level VI neck dissection (45.71% vs. 10.00%, P<0.05), and in patients with simultaneous autologous parathyroid transplantation was higher than that in those without parathyroid transplantation, but the difference did not reach statistical significance (50.00% vs. 22.22%, P>0.05). Conclusion: Total thyroidectomy and level VI neck dissection are risk factors for postoperative hypoparathyroidism. Meticulous dissection of the posterior thyroid capsule, especially maintaining the blood supply to the inferior parathyroid glands as best as possible, and postoperative use of preventive medicine may be helpful for protecting parathyroid function.

Abstract:Objective: To investigate the peripheral blood level of carcinoembryonic antigen-related cell adhesion molecular 1 (CEACAM1) in patients with thyroid cancer and its diagnostic value for thyroid cancer. Methods: Using ELISA assay, the serum CEACAM1 levels in 76 thyroid cancer patients, 48 patient with benign thyroid tumor and 38 healthy subjects were determined, and meanwhile, the levels of carcinoembryonic antigen (CEA) and thyroglobulin (TG) were also measured. The relations of CEACAM1 level with clinicopathologic characteristics of thyroid cancer were analyzed. Through drawing ROC curves, the diagnostic values for thyroid cancer among CEACAM1, CEA and TG were compared. Results: The serum CEACAM1 level in thyroid cancer patients was significantly higher than that in patients with benign thyroid tumor or healthy control individuals (547.11 ng/mL vs. 469.77 ng/mL and 369.04 ng/mL, both P<0.05). The serum CEACAM1 level was significantly associated with TNM stage and lymph node metastasis of thyroid cancer patients (both P<0.05). The area under the ROC curve of CEACAM1 for diagnosis of thyroid cancer was 0.94, with sensitivity of 97.4% and specificity of 80.3%, and the diagnostic value of CEACAM1 for thyroid cancer was superior to that of CEA or TG. Conclusion: Serum CEACAM1 detection has certain value for diagnosis and disease assessment of thyroid cancer.

Abstract:

Objective: To investigate the safety and feasibility of the nipple complex (NAC) sparing modified mastectomy with first-stage breast reconstruction in treatment of early breast cancer. Methods: During 2010 to 2014, 170 breast cancer patients, according to their own choice, received NAC sparing modified mastectomy with first-stage breast reconstruction (observational group, 102 cases), or modified subcutaneous mastectomy with NAC removal (control group, 68 cases), respectively. The relevant postoperative parameters and postoperative patient’s satisfaction with breast reconstruction and quality of life as well as the incidence of adverse events, recurrence and metastasis during follow-up of the two groups were compared. Results: The duration and volume of wound drainage showed no significant difference between the two groups (both P<0.05); the postoperative patient satisfaction rate (97.06% vs. 51.47%), overall FACT score (150.89±25.34) vs. (100.24±18.47) and high satisfaction rate (83.33% vs. 51.47%) in observational group were significantly higher than those in control group (all P<0.05); there was no significant difference in incidence of adverse events, local recurrence and distant metastasis between the two groups (all P>0.05). Conclusion: NAC sparing modified mastectomy with first-stage breast reconstruction is safe and feasible for early breast cancer, and it is evidently superior to modified subcutaneous mastectomy without NAC preservation with regard to postoperative cosmetic results and improving patient’s quality of life.

Abstract:Objective: To investigate the requirement for further axillary lymph node dissection in patients with early breast cancer and positive sentinel lymph node biopsy results. Methods: The clinical data of 112 patients with early breast cancer undergoing axillary lymph node dissection due to positive sentinel lymph node biopsy results were retrospectively analyzed. Results: Of the 112 patients with positive sentinel lymph node, pathological result of lymph nodes after axillary lymph node dissection was negative in 75 cases (67.0%). Univariate analysis showed that tumor size, number of positive sentinel lymph nodes, extra lymph node invasion, HER-2, Ki-67, and histological grade had influence on pathological results of axillary lymph nodes; further dummy variable analysis demonstrated that the risk of positive axillary lymph nodes was increased with the increase of lesion size and number of positive sentinel lymph nodes. Multivariate analysis revealed that lesion size, Ki-67 expression and sentinel lymph node biopsy results were independent influential factors for results of axillary lymph node dissection (all P<0.05). Conclusion: For early breast cancer patients with a single positive sentinel lymph node, lesion ≤2 cm, and low Ki-67 expression, avoidance of further axillary lymph node clearance may be recommended.

Abstract:

Objective: To compare the efficacy of ultrasonic scalpel and traditional electrocautery for mastectomy and axillary lymph node dissection in breast cancer surgery.
Methods: The relevant randomized controlled trials (RTCs) were collected by searching the national and international databases. After literature screening, quality assessment and data extraction, Meta-analysis was performed by using RevMan 5.2 software. 
Results: Eight RTCs were finally included, with a total sample size of 604 cases comprising 300 cases in ultrasonic scalpel group and 304 cases in electrocautery group. Results of Meta-analysis showed that in ultrasonic scalpel group compared with electrocautery group, the operative time had no significant difference (WMD=6.20, 95% CI=-5.02–17.41, P=0.28), but the intraoperative blood loss (WMD=–61.42, 95% CI=–83.76––39.09), postoperative drainage volume (WMD=–374.92, 95% CI=–453.90––295.95), drainage time (WMD=–3.30,
95% CI=–5.10––1.49), and the incidence of subcutaneous fluid collection (RR=0.51, 95% CI=0.38–0.68) were all significantly decreased (all P<0.05).
Conclusion: In breast cancer surgery, use of ultrasonic scalpel is superior to that of electrocautery in respects of intraoperative bleeding control, and reducing postoperative drainage and incidence of subcutaneous fluid collection.

Abstract:Objective: To investigate the clinicopathologic features, treatment patterns and prognostic factors in female breast cancer patients over 70 years of age. Methods: The clinical 203 female breast cancer patients over 70 admitted and undergoing surgical treatment in the Department of Breast Surgery, the Third Affiliated Hospital of Harbin Medical University from January 2007 to December 2010 were reviewed. The clinical features and prognosis of the patients were analyzed. Results: Of the 203 patients, 67 cases (33.0%) had TNM stage I and 117 cases (57.6%) had TNM stage II disease and 92 cases (53.5%) had no axillary lymph node metastasis; 166 cases (81.8%) were invasive ductal carcinoma which was the main pathological type. Immunohistochemical staining showed that ER and PR expression, and HER-2 overexpression was found in 123 cases (69.5%), 114 cases (64.4%), and 23 cases (13.0%) respectively. Of the patients, 153 cases (75.4%) underwent modified radical mastectomy that was the main surgical type, and 111 cases (54.7%) received endocrine therapy and 28 cases (13.8%) had chemotherapy after operation. Univariate analysis showed the overall survival (OS) was associated with age, lymph node status, ER, PR, histological grade and endocrine therapy of the patients, and disease-free survival (DFS) was related to lymph node status, ER, PR, HER-2, endocrine therapy and chemotherapy (all P<0.05); multivariate COX analysis indicated that age, lymph node status and PR were independent prognostic factors for OS, while lymph node status was an independent prognostic factor for DFS (all P<0.05). Conclusion: Breast cancer in elderly patients has distinct biological characteristics, and surgery is the main treatment method. Age, lymph node status and PR are independent prognostic factors for these patients.

Abstract:Objective: To determine the risk factors for calcification in breast cancer. Methods: The clinicopathologic and imaging data of 196 patients with pathologically confirmed breast cancer between 2012 and 2014 by pathological diagnosis were retrospectively analyzed. The relations of clinicopathologic factors with breast calcification were determined by univariate and multivariate Logistic regression analysis. Results: In 196 patients, 140 cases (71%) had breast calcification and 56 cases (29%) had no breast calcification. Univariate analysis showed that lymph node metastasis, TNM stage, pathological type, and HER-2 status were associated with calcification (all P<0.05). Multivariate Logistic regression analysis revealed that pathological type (OR=0.299, 95% CI=0.134–0.665), tumor diameter (OR=2.436, 95% CI=1.108–5.357), and HER-2 expression (OR=2.827, 95% CI=1.363–5.864) were inferential factors for calcification (all P<0.05), and the calcification risk of invasive ductal carcinoma (IDC) was 0.299-fold that of ductal carcinoma in situ (DCIS), tumor ≥2 cm was 2.436-fold that of tumor <2 cm, positive HER-2 expression was 2.827-fold that of negative HER-2 expression. The constituent ratio of simple calcification was increased in patients with tumor size ≤2 cm, DCIS or HER-2 positive expression, and the constituent ratio of calcification with mass was higher than other calcification types in patients with IDC or tumor size >2 cm (all P<0.05). Conclusion: DCIS, HER-2 expression and tumor diameter are main risk factors for calcification in breast cancer.

Abstract:Objective: To investigate the alterations of peripheral blood T cell subsets and their relations with lymph node metastasis and histological grade in breast cancer patients. Methods: The percentages of T cell subsets in peripheral blood in 86 patients with breast cancer and 20 patients with mammary adenosis were determined by flow cytometry. Results: There was no significant difference in percentages of peripheral blood total T cells and CD4+ T cells between breast cancer patients and mammary adenosis patients (both P>0.05), but the percentage of peripheral blood CD8+ T cells in breast cancer patients was lower than that of mammary adenosis patients (P<0.05). In breast cancer patients, the percentage of CD4+ T cells in cases with lymph node metastasis was higher than that of cases without lymph node metastasis (P<0.05); the percentage of CD8+ T cells was increased with histological grade increase (P<0.05). Conclusion: There are cell-mediated immune disorders in breast cancer patients, and the alteration in proportion of CD4+ T cells and CD8+ T cells in peripheral blood is closely related to lymph node metastasis and tumor histological grade, respectively. Monitoring of the alterations in peripheral blood T cell subsets may be helpful for estimation of the disease status and prognosis.

Abstract:Objective: To systematically assess the prognostic difference between synchronous bilateral breast cancer (SBBC) and asynchronous bilateral breast cancer (ABBC). Methods: The relevant studies were collected by searching the national and international online databases. After literature screening, quality assessment and data extraction, Meta-analysis was performed by using RevMan 5.3 software. Results: Seven studies were finally included, involving 711 patients, with 225 SBBC cases and 486 ABBC cases. The results of Meta-analysis showed that the 1-, 5- and 10-year survival rates in SBBC patients were significantly lower than those in ABBC patients (OR=0.41, 95% CI=0.22–0.77, P=0.005; OR=0.52, 95% CI=0.39–0.69, P<0.00001; OR=0.43, 95% CI=0.25–0.74, P=0.003). Conclusion: The prognosis of SBBC is probably poorer than that of ABBC under the same medical circumstances and, however, further complete evaluation remains to be done.

Abstract:Objective: To investigate the expression of activated-leukocyte adhesion molecule (ALCAM) in thyroid cancer tissue and the clinical significance. Methods: ALCAM expressions in 52 samples of paired thyroid cancer and adjacent normal thyroid tissues were detected by immuohistochemical staining. The ALCAM expression difference between the two types of tissues was compared, and relations of ALCAM expression with clinicopathologic features and prognosis of the thyroid cancer patients were analyzed. Results: The positive ALCAM expression rate in thyroid cancer tissue was significantly higher than that in adjacent normal thyroid tissue (71.2% vs. 34.6%, P<0.05), but in thyroid cancer tissue, the lower ALCAM expression was associated with poorer histopathological differentiation of the thyroid cancer, and shorter 5-year overall survival of the patients (both P<0.01). Conclusion: Increased ALCAM expression may be involved with the occurrence and development of thyroid cancer. However, the phenomenon of ALCAM expression contrarily reduced in tumor tissues from highly malignant and poor prognostic thyroid cancer is speculated to be related to its detachment and release into the circulation.

Abstract:Objective: To investigate the expressions of chemokine CXCL12 as well as its receptor CXCR4 and CXCR7 in breast cancer tissue and the clinical significance. Methods: The mRNA expressions of CXCL12, CXCR4 and CXCR7 were determined by qRT-PCR method in fresh specimens of breast cancer tissue and their adjacent normal breast tissue from 35 patients. The protein expressions of CXCL12, CXCR4 and CXCR7 were detected by immunohistochemical staining in 120 paraffin-embedded samples of breast cancer tissue, and the relations of their expressions with clinicopathologic features of breast cancer were analyzed. Results: Results of qRT-PCR showed that the mRNA expression levels of CXCL12, CXCR4 and CXCR7 in breast cancer tissue were all significantly higher than those in adjacent normal breast tissue (all P<0.05). Results of immunohistochemical staining showed that the positive expression rate of CXCL12, CXCR4 and CXCR7 in breast carcinoma tissues was 70.8%, 65.8% and 63.3% respectively, and the positive expression rate of either protein was significantly increased in breast cancer tissue from those with lymph node metastasis or advanced TNM stage (all P<0.05). Conclusion: The high expressions of chemokine CXCL12 as well as its receptor CXCR4 and CXCR7 may be closely associated with the lymph node metastasis and malignant progression of breast cancer.

Abstract:

Objective: To investigate the Skp2 and p27 Kip1 expressions in breast cancer tissue and the significance.
Methods: The Skp2 and p27Kip1 expressions in normal breast tissues, atypical ductal hyperplasia (ADH) tissue and invasive ductal carcinoma (IDC) tissue were determined by immunohistochemical staining. The relations of their expressions with lymph node metastasis and histologic grade of breast cancer were also analyzed.
Results: The Skp2 positive expression rate was increased in ascending order in normal breast tissue, ADH tissue and IDC tissue, which was significantly higher in IDC tissue with axillary lymph node metastasis than that in IDC tissue without axillary lymph node metastasis, while the opposite was true for p27Kip1 positive expression rate (all P<0.05). Both Skp2 and p27Kip1 positive expression rates were significantly different among IDC tissues with different histologic grades (both P<0.05), moreover, Skp2 positive expression had a positive correlation with histologic grade of IDC (r=0.492, P<0.05), while p27Kip1 positive expression had a negative correlation with histologic grade of IDC (r=–0.327, P<0.05).
Conclusion: Skp2 expression is up-regulated and p27Kip1 expression is down-regulated in breast cancer tissue, and their changing degrees are closely related to the malignant biological behaviors of breast cancer.

Abstract:

Objective: To investigate the expression of collagen triple helix repeat containing 1 (CTHRC1) in pancreatic cancer tissue, and its influence on biobehavior of pancreatic cancer cells.
Methods: The expression of CTHRC1 mRNA in the specimens of cancer and adjacent tissue from 40 pancreatic cancer patients was detected by real time PCR (RT-PCR). Pancreatic cancer Panc28 cells were transfected with pcDNA3.1-CTHRC1 or CTHRC1 siRNA using untransfected Panc28 cells as control, and then the cell proliferation, migration and invasion ability were determined by colony formation assay, wound healing assay and Boyden chamber assay, respectively.
Results: Results of the RT-PCR showed that CTHRC1 expression level in pancreatic cancer tissue was significantly higher than that in adjacent tissue (P<0.05). Compared with control Panc28 cells, the number of colony formation was increased, percentage of wound width was reduced and number of invaded cells was increased significantly in Panc28 cells with up-regulated CTHRC1 expression after pcDNA3.1-CTHRC1 transfection, while the opposite changes were seen in those with down-regulated CTHRC1 expression after CTHRC1 siRNA transfection, and all the differences had statistical significance (all P<0.05).
Conclusion: CTHRC1 expression is increased in pancreatic cancer tissue, which may contribute to the occurrence and development of pancreatic cancer through promoting cell proliferation, and migration and invasion ability of the pancreatic cancer cells.

Abstract:Objective: To investigate the clinical characteristics and treatment measures of post-thyroidectomy hemorrhage. Methods: The clinical data of 3 417 patients undergoing thyroid surgery between April 2014 and May 2015 in the First Affiliated Hospital of Zhengzhou University were reviewed, from which 8 cases developing postoperative hemorrhage were picked up and analyzed. Results: The 8 patients included 2 cases of subcutaneous hematoma, 2 cases of anterior jugular vein hemorrhage, 2 cases of superior thyroid artery hemorrhage, one case of inferior thyroid artery hemorrhage, and one case of hemorrhage of the anterior muscles of the neck. All the 8 patients underwent corresponding management with no serious consequences, such as asphyxia, occurring in any of them, and they were discharged with grade-1 wound healing. Conclusion: Early detection and aggressive treatment are crucial for reducing the complications of post-thyroidectomy bleeding, and the traditional ligation or suture with silk thread should not be overlooked.

Abstract:

Objective: To compare the effects of ultrasound-guided Mammotome rotation cutting and wire-localized surgical resection for non-palpable breast lesion (NPBL), so as to provide the basis for procedure selection in clinical practice. Methods: The clinical data of 362 patients with NPBL undergoing surgical treatment were retrospectively analyzed. Of the patients, 293 cases underwent ultrasound-guided Mammotome procedure (rotation cutting group) and the other 69 cases underwent ultrasound-guided wire-localized surgical resection (open group). The relevant surgical parameters between the two groups were compared. Results: The general data between the two groups of patients showed no significant difference (all P>0.05). Rotation cutting group was superior to open group in variables of operative time, length of incision, and intraoperative blood loss, but the surgical cost in rotation cutting group was significantly higher than that in open group (all P<0.05). The incidence of postoperative complications in rotation cutting group was lower than that in open group, but the difference was not significant (P>0.05). The success rate of surgery in both groups reached 100%. No tumor recurrence occurred in the two groups during followed up for 1 month to 12 months, and evident scars of different sizes were seen in open group, while scars were small or invisible in rotation cutting group. Conclusion: Mammotome rotation cutting for NPBL is safe and effective, and has less bleeding, shorter operative time and favorable cosmetic results, but higher cost compared to wire-localized surgical resection.

Abstract:Objective: To investigate the application value of Mammotome rotation cutting in treatment of deep breast abscess. Methods: Eighty-one patients with deep breast abscess admitted from October 2010 to January 2015 were selected. Of the patients, 35 cases underwent catheter drainage via ultrasound-guided Mammotome procedure (observational group), and 46 cases were subjected to traditional incision and drainage (control group). The relevant surgical variables, degree of patient’s satisfaction, recurrence rate and postoperative complications between the two groups of patients were compared. Results: The surgical variables that included operative time, intraoperative blood loss, healing time, postoperative scar length, and pain NRS score in observational group were significantly superior to those in control group (all P<0.05). During the period of 3- to 6-month follow-up, in observational group, the degree of patient’s satisfaction was significantly better than that in control group (85.71% vs. 58.33%, P<0.05), and the recurrence rate and incidence of postoperative complications were significantly lower than those in control group (2.86% vs. 19.57%; 5.71% vs. 28.26%, both P<0.05). Conclusion: Mammotome rotation cutting for deep breast abscess has the advantages of minimal invasiveness, fast postoperative recovery, favorable cosmetic results, lower incidence of complications and with higher degree of patient’s satisfaction. So it is recommended to be used in clinical practice.

Abstract:Recurrent laryngeal nerve (RLN) injury is a common and serious complication of thyroid surgery. Especially in complicated or re-operative thyroid surgery, the risk of RLN injury is always increased due to indistinct anatomical planes and anatomic variations of RLN. Intraoperative neuromonitoring (IONM) is a technology for identifying the integrity of nerves during operation by electrophysiological means, and recent studies demonstrated that IONM of RLN can significantly reduce the chance of transient and permanent RLN injury compared to conventional RLN exposure in thyroid surgery. The authors address the application and progress of IONM technology in thyroid surgery.

Abstract:EMILIN protein family consists of extracellular matrix glycoproteins that participate in maintenance of the structure and function of the organism. Recent studies suggest that EMILIN protein family potentially involves in tumor apoptosis and angiogenesis activating certain signal pathways, and plays a critical role in tumor growth, invasion and metastasis. The authors address the recent research progress in EMILIN protein family.

Abstract:Surgery is the main treatment modality for rectal cancer at present, and laparoscopic techniques advocated in recent years are becoming increasingly preferred due to cosmetic incision, less blood loss, decreased pain, faster recovery and shorter length of hospital stay. Meanwhile, various complications associated with laparoscopic rectal cancer surgery such as intestinal injury, ureteral injury, anastomotic fistula, anastomotic bleeding and anastomotic stenosis are often reported. How to prevent, reduce and treat the related complications are crucial for operative success and postoperative recovery. The authors address the causes for those complications and the preventive measures.