Search

Introduction: Colorectal Cancer (CRC) is a leading cause of death worldwide, and its incidence has been rising. It is important to identify novel markers that could predict the prognosis of the disease. Aim: To identify the impact of Programmed cell death-ligand 1 (PD-L1), Beclin 1, and Fascin 1 immunohistochemical expression on CRC behaviour and disease prognosis. Also, to assess the different surgical options (laparoscopic versus open) in the management of these patients. Materials and Methods: This cohort study included 72 cases of CRC, conducted in the Pathology, General Surgery, Internal Medicine, Clinical Oncology, and Medical Oncology Departments of the Faculty of Medicine, Zagazig University Hospitals, Egypt between June 2018 and June 2022. PD-L1, Beclin 1, and Fascin 1 expression were assessed immunohistochemically, and their prognostic significance were evaluated. Data were analysed using IBM Statistical Package for the Social Sciences (SPSS) 23.0 for Windows (SPSS Inc., Chicago, IL, USA) and NCSS 11 for Windows (NCSS LCC., Kaysville, UT, USA) in the Community Medicine Department, Faculty of Medicine, Zagazig University, Egypt. Results: A significant association was found between PDL1 expression and grading (p-value=0.02), lymphovascular invasion, distant metastasis (p-value=0.001), peritoneal spread (p-value=0.002), tumour budding (p-value=0.005), lymph node metastasis, and American Joint Committee on Cancer (AJCC) stage (p-value0.05). Conclusion: PD-L1, Beclin 1, and Fascin 1 expression are significantly elevated in CRC tissues and closely associated with adverse prognostic factors. PD-L1 and Fascin 1 expression have important prognostic value and may be of great help in identifying high-risk patients who will benefit the most from treatment.

Abstract Background This study aimed to evaluate the results of posterior component separation (CS) and transversus abdominis muscle release (TAR) with retro-muscular mesh reinforcement in patients with primary abdominal wall dehiscence (AWD). The secondary aims were to detect the incidence of postoperative surgical site occurrence and risk factors of incisional hernia (IH) development following AWD repair with posterior CS with TAR reinforced by retromuscular mesh. Methods Between June 2014 and April 2018, 202 patients with grade IA primary AWD (Björck's first classification) following midline laparotomies were treated using posterior CS with TAR release reinforced by a retro-muscular mesh in a prospective multicenter cohort study. Results The mean age was 42 ± 10 years, with female predominance (59.9%). The mean time from index surgery (midline laparotomy) to primary AWD was 7 ± 3 days. The mean vertical length of primary AWD was 16 ± 2 cm. The median time from primary AWD occurrence to posterior CS + TAR surgery was 3 ± 1 days. The mean operative time of posterior CS + TAR was 95 ± 12 min. No recurrent AWD occurred. Surgical site infections (SSI), seroma, hematoma, IH, and infected mesh occurred in 7.9%, 12.4%, 2%, 8.9%, and 3%, respectively. Mortality was reported in 2.5%. Old age, male gender, smoking, albumin level