Background Tailor-made strategies for assessing and improving cancer morbidity, malnutrition, a complex multifactorial syndrome, need to identify patients’ characteristics or individuality. Method Postoperative cancer patients (n=103), gastric, colorectal or breast, TNM stage I-III, and doctors/nurses (n=102) completed the EPQ-25, which measures individual characteristics on personality scores of extraversion (E), neuroticism (N), psychoticism (P) and conformity (L). Malnutrition parameters were obtained by the QOL-20 items and blood sample analysis. Explanation about disease severity from doctors, patient-family relationship, surgical procedure (total or partial gastrectomy), nutritional support (normal oral intake, hyperalimentation, fluid therapy) and radiation therapy of patients were recorded. Results Patients’ personality of less E, P and L and greater N predicted (P<0.05-0.001) higher anorexia, asthenia, pain, stress (impeding factors of food intake) or sodium, and lower quality of life (QOL), total protein, triglyceride, total-cholesterol, potassium or lymphocyte level [suggesting a risk of malnutrition], after controlling for tumor site, stage, age, sex, blood type and birth season. Doctors’/nurses’ personality interacting with patients’ personality, not either personality alone, significantly predicted QOL, nutritional, anemic and immune status, prognosis of patients after surgery, with doctors’ explanation about disease, family relationship, total gastrectomy and oral nutrient intake as differential factors. Intercorrelations (convergent validity) as a function of personality suggested: malnourished patients have a poor QOL, protein-energy undernutrition, muscle tissue depletion and bodily fluid imbalabces; their stress-related immune function, and anemia responsible for reduced energy metabolism, are influenced by personality. Conclusion Cancer patients’ personality score was an easy, rapid, non-invasive and cost-effective diagnostic tool for identifying which patient is at risk of developing malnutrition. Doctors’/nurses’ personality, congenial to patients’ personality, may alleviate this risk, with explanation about disease, family relationship, partial gastrectomy and oral nutrition.
PGE2 plays a key role in colon carcinogenesis. Evidence continues to accumulate that cyclooxygenase-2 (COX-2), an inducible COX isoform, represents a potential pharmacological target for the prevention and treatment of cancer, including tumors affecting the large bowels. Several mechanisms of COX-2 related tumor promotion have been identified. Some are dependent on PGE2 production (such as induction of cell proliferation, angiogenesis or local immunosuppression, inhibition of apoptosis, increase in cell motility). COX-2 expression has been demonstrated in epithelial cells of colorectal cancers and adenomas. Studies in experimental models of colon carcinogenesis show that selective COX-1 or COX-2 inhibitors reduce tumor formation and growth. Clinical studies have been initiated to determine the chemoprotective effects of selective COX-2 inhibitors in patients with familial adenomatous polyposis or sporadic adenoma. Possible cardiovascular effects will need to be taken into account in an assessment of the potential ability of any of these drugs to prevent neoplasia in the large bowel and other organs. Based on the fact that PGE2 is involved in almost all events concerning carcinogenesis, further examinations concerning mPGES-1, EP receptors, and 15-PGDH, should be promoted as a target for colon cancer prevention and therapeutics. Hence, detailed analyses are needed to clarify PGE2 related carcinogenesis.
In this study, immunohistochemistry was used to detect Topo-1 and Bax/ERCC-1 expression in patients who had lymph node metastasis of stage II/III gastric cancer with occult neoplastic cells (ONCs) in their lymph node sinuses. In addition, tumor sensitivity was compared between CPT-11 and platinum agents. In the recurrence group (RG) (n=28), immunohistochemistry revealed high Topo-1 expression in 3 patients (10.7%) and low expression in 25 patients (89.3%), while there was high expression in 1 patient (11.1%) and low expression in 8 patients (88.9%) from the non-recurrence group (N-RG) (n=9) (Not significant; N.S.). Immunostaining showed high Bax/low ERCC-1 expression in 11 patients (39.3%) from the RG and other patterns of expression in 17 patients (60.7%), while high Bax/low ERCC-1 expression was observed in 3 patients (33.3%) from the N-RG and other patterns were noted in 6 patients (66.7%) (N.S.). There was a significant difference between the rate of high-Bax/low-ERCC-1 expression and high Topo-1 expression in the RG (p=0.0136). These results suggest that platinum derivatives such as CDDP are more effective than CPT-11 in both RG and N-RG of stage II/III gastric cancer with ONCs.