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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
Comparison of non-schistosomal rectosigmoid cancer and schistosomal rectosigmoid cancer
Hao Feng, Ai-Guo Lu, Xue-Wei Zhao, Ding-Pei Han, Jing-Kun Zhao, Lei Shi, Tobias S Schiergens, Serene ML Lee, Wen-Peng Zhang, Wolfgang E Thasler
Hao Feng, Tobias S Schiergens, Serene ML Lee, Wolfgang E Thasler, Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Hospital of the University of Munich, 81377 Munich, Germany
Hao Feng, Ai-Guo Lu, Jing-Kun Zhao, Wen-Peng Zhang, Shanghai Minimally Invasive Surgical Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
Xue-Wei Zhao, the 309 Hospital of Chinese People’s Liberation Army, Beijing 100091, China
Ding-Pei Han, Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
Lei Shi, Department of Radiology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510275, Guangdong Province, China
Lei Shi, Department of Radiology, Ruijin Hospital, Shanghai Jiao-tong University School of Medicine, Shanghai 200025, China
Author contributions: Thasler WE contributed equally and should be considered as co-first author; Feng H and Zhang WP designed the research and wrote the manuscript; Thasler WE revised and finally approved the article to be published; Lu AG contributed equally to this work; Zhao JK and Han DP collected and interpreted the data; Zhao XW performed the statistical analysis; Shi L analyzed the radiology data; Schiergens TS and Lee SML were involved in editing the manuscript.
Ethics approval: The study protocol had previously been approved by the medical ethical committee of Shanghai Ruijin Hospital according to the Helsinki Declaration.
Informed consent: All study participants or their legal guardian, provided written informed consent prior to study enrollment.
Conflict-of-interest: The authors declare that they have no competing interests.
Data sharing: Dataset available from the corresponding author at hao.feng@campus.lmu.de. Participants gave informed consent for data sharing (anonymously). The patients’ personal information is presented after anonymization and every patient is linked to a mission number.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Wen-Peng Zhang, Shanghai Minimally Invasive Surgical Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Xu Jiahui Road 573, Shanghai 200025, China.
darvid0610@sina.com
Telephone: +86-21-64458887
Received: January 6, 2015
Peer-review started: January 6, 2015
First decision: February 10, 2015
Revised: March 13, 2015
Accepted: April 28, 2015
Article in press: April 28, 2015
Published online: June 21, 2015
Processing time: 165 Days and 17.6 Hours
AIM: To compare the clinicopathological features of patients with non-schistosomal rectosigmoid cancer and schistosomal rectosigmoid cancer.
METHODS: All the patients with rectosigmoid carcinoma who underwent laparoscopic radical surgical resection in the Shanghai Minimally Invasive Surgical Center at Ruijin Hospital affiliated to Shanghai Jiao-Tong University between October 2009 and October 2013 were included in this study. Twenty-six cases of colonic schistosomiasis diagnosed through colonoscopy and pathological examinations were collected. Symptoms, endoscopic findings and clinicopathological characteristics were evaluated retrospectively.
RESULTS: There were no significant differences between patients with and without schistosomiasis in gender, age, CEA, CA19-9, preoperative biopsy findings or postoperative pathology. Patients with rectosigmoid schistosomiasis had a significantly higher CA-125 level and a larger proportion of these patients were at an early tumor stage (P = 0.003). Various morphological characteristics of schistosomiasis combined with rectosigmoid cancer could be found by colonoscopic examination: 46% were fungating mass polyps, 23% were congestive and ulcerative polyps, 23% were cauliflower-like masses, 8% were annular masses. Only 27% of the patients were diagnosed with rectal carcinoma preoperatively after the biopsy. Computed tomography (CT) scans showed thickened intestinal walls combined with linear and tram-track calcifications in 26 patients.
CONCLUSION: Rectosigmoid carcinoma combined with schistosomiasis is associated with higher CA-125 values and early tumor stages. CA-125 and CT scans have a reasonable sensitivity for the accurate diagnosis.
Core tip: The association between schistosomiasis and colorectal malignancy has long been suggested in the literature. This study aimed to improve our understanding of the relationship between Schistosoma japonicum-related enteropathy and rectosigmoid carcinoma, with a particular focus on laboratory examination, endoscopic findings and clinicopathological characteristics of rectosigmoid schistosomiasis.
