Tenofovir Alafenamide for Pregnant Chinese Women With Active Chronic Hepatitis B: A Multicenter Prospective Study

BACKGROUND & AIMS

Data on long-term tenofovir alafenamide (TAF) therapy for pregnant women with active chronic hepatitis B (CHB) (immune clearance and reactivation phases, currently and previously diagnosed) and their infants are lacking.

METHODS

Pregnant women with active CHB treated with TAF and tenofovir disoproxil fumarate (TDF) were enrolled in this multicenter prospective study, and infants received immunoprophylaxis. The primary outcomes were rates of adverse (safety) events in pregnant women and defects in infants and fetuses. The secondary outcomes were virologic responses in pregnant women, infants' safety, hepatitis B surface antigen (HBsAg) status, and growth conditions.

RESULTS

One hundred three and 104 pregnant women were enrolled and 102 and 104 infants were born in the TAF and TDF groups, respectively. In the TAF group, the mean age, gestational age, alanine aminotransferase level, and viral loads at treatment initiation were 29.3 years, 1.3 weeks, 122.2 U/L, and 5.1 log₁₀ IU/mL, respectively. TAF was well-tolerated, and the most common adverse event was nausea (29.1%) during a mean of 2 years of treatment. Notably, 1 (1.0%) TAF-treated pregnant woman underwent induced abortion due to noncausal fetal cleft lip and palate. No infants in either group had birth defects. In the TAF group, the hepatitis B e antigen seroconversion rate was 20.7% at postpartum month 6, infants had normal growth parameters, and no infants were positive for HBsAg at 7 months. The TDF group had comparable safety and effectiveness profiles.

CONCLUSIONS

TAF administered throughout or beginning in early pregnancy is generally safe and effective for pregnant women with active CHB and their infants.

Sofosbuvir-based Therapy for Late Pregnant Women and Infant with Severe Chronic Hepatitis C: A Case Series Study

Data on sofosbuvir-based therapy for pregnant women and infant with severe chronic hepatitis C (CHC) are lacking. Two late pregnant women and one female infant with severe CHC were enrolled for treatment. Pregnant women 1 and 2 and infant 3 were 30, 33, and 1.2 years old, respectively; the gestational ages of pregnant women 1 and 2 were 31 and 26 weeks, respectively. Notably, pregnant women 1 and 2 and infant 3 had hepatitis C virus (HCV) RNA levels of 139000, 198000, and 8450000 IU/ml; alanine aminotransferase levels of 420, 781, and 220 U/L; and received sofosbuvir/ledipasvir, sofosbuvir/velpatasvir, and sofosbuvir/ledipasvir for 12 weeks, respectively. All three patients were safely cured with favorable tolerance, and two newborns were both breastfeeding and were consistently negative for the anti-HCV antibody during the one-year follow-up after birth. Additionally, two newborns and infant 3 had normal growth parameters during the follow-up year one. In conclusion, this case series study found that sofosbuvir-based therapy for pregnant women and infant with severe CHC is safe and effective. The data may fill the gap and provide evidence of the use of sofosbuvir-based therapy as a reference when similar severe CHC situations are encountered during clinical practice. This article is protected by copyright. All rights reserved.

[Long term prognosis of fulminant myocarditis and predictors related to impaired cardiac function post discharge]

Objective: To compare the long-term prognosis of fulminant myocarditis (FM) and non-fulminant myocarditis (NFM) patients who survived and discharged from hospital, and to explore the factors associated with the long-term prognosis and impaired cardiac function. Methods: This study was a retrospective study. Consecutive patients with acute myocarditis hospitalized in Tongji Hospital from January 2017 to December 2020 were enrolled and divided into FM group and NFM group according to the type of myocarditis. Then, patients in the FM group were further divided into normal cardiac function group and impaired cardiac function group according the left ventricular ejection fraction (LVEF). All patients with acute myocarditis were treated with antiviral, immunomodulatory, immunosuppressive medications and symptomatic and supportive treatment, while FM patients were treated with comprehensive treatment plan. Clinical data at admission of enrolled patients were collected through the electronic medical record system. Patients were clinically followed-up at 1, 3, 6 and 12 months, then once a year after discharge by clinical visit. The primary endpoints included major cardiovascular events, impaired cardiac function was defined by LVEF<55%. Kaplan-Meier survival curve was used to analyze the occurrence of LVEF<55% and left ventricular enlargement during the follow-up of patients in FM group and NFM group, and Log-rank test was used for comparison between groups. Cox regression model was used to analyze the risk factors of impaired cardiac function in patients with FM during follow-up. Results: A total of 125 patients with acute myocarditis were enrolled (66 in FM group and 59 in NFM group). Compared with NFM group, the proportion of FM patients with the lowest LVEF<55% during hospitalization was higher (P<0.01), and the recovery time of normal LVEF during hospitalization was longer (P<0.01). The proportion of LVEF<55% at discharge was similar between the two groups (P=0.071). During the follow-up of 12 (6, 24) months, 1 patient (1.5%) died due to cardiac reasons in FM group after discharge, 16 patients (24.2%) had sustained LVEF<55% after discharge, and 8 patients (12.1%) had left ventricular enlargement. In NFM group, 3 patients (5.1%) had sustained LVEF<55%, and 1 patient (1.7%) had left ventricular enlargement. Kaplan-Meier survival curve analysis showed that the incidence of sustained LVEF<55% in FM group was higher than that in NFM group (P=0.003), and the incidence of left ventricular enlargement was also higher than that in NFM group (P=0.024). Subgroup analysis of patients in the FM group showed that, compared with the normal cardiac function group, the time from onset to admission was shorter (P=0.011), the proportion of LVEF<55% at discharge was higher (P=0.039), the proportion of coronary angiography was higher (P=0.014), and the LVEF recovery time during hospitalization was longer (P=0.036) in FM patients with impaired cardiac function. Multivariate Cox regression analysis showed that longer LVEF recovery time during hospitalization was an independent risk factor for cardiac function impairment after discharge of FM patients (HR=1.199, 95%CI 1.023-1.406, P=0.025). Conclusions: The incidence of reduced LVEF is significantly higher in FM patients than that in NFM patients. Longer LVEF recovery time during hospitalization is an independent risk factor for cardiac function impairment in FM patients after discharge.

Dynamic changes in liver function parameters in patients with coronavirus disease 2019: a multicentre, retrospective study

BACKGROUND

Liver injuries have been reported in patients with coronavirus disease 2019 (COVID-19). This study aimed to investigate the clinical role played by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

METHODS

In this multicentre, retrospective study, the parameters of liver function tests in COVID-19 inpatients were compared between various time-points in reference to SARS-CoV-2 shedding, and 3 to 7 days before the first detection of viral shedding was regarded as the reference baseline.

RESULTS

In total, 70 COVID-19 inpatients were enrolled. Twenty-two (31.4%) patients had a self-medication history after illness. At baseline, 10 (14.3%), 7 (10%), 9 (12.9%), 2 (2.9%), 15 (21.4%), and 4 (5.7%) patients already had abnormal alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), albumin, and total bilirubin (TBIL) values, respectively. ALT and AST abnormal rates and levels did not show any significant dynamic changes during the full period of viral shedding (all p > 0.05). The GGT abnormal rate (p = 0.008) and level (p = 0.033) significantly increased on day 10 of viral shedding. Meanwhile, no simultaneous significant increases in abnormal ALP rates and levels were observed. TBIL abnormal rates and levels significantly increased on days 1 and 5 of viral shedding (all p < 0.05). Albumin abnormal decrease rates increased, and levels decreased consistently from baseline to SARS-CoV-2 clearance day (all p < 0.05). Thirteen (18.6%) patients had chronic liver disease, two of whom died. The ALT and AST abnormal rates and levels did not increase in patients with chronic liver disease during SARS-CoV-2 shedding.

CONCLUSIONS

SARS-CoV-2 does not directly lead to elevations in ALT and AST but may result in elevations in GGT and TBIL; albumin decreased extraordinarily even when SARS-CoV-2 shedding ended.

Genomic Epidemiology of SARS-CoV-2 From Mainland China With Newly Obtained Genomes From Henan Province

Even though the COVID-19 epidemic in China has been successfully put under control within a few months, it is still very important to infer the origin time and genetic diversity from the perspective of the whole genome sequence of its agent, SARS-CoV-2. Yet, the sequence of the entire virus genome from China in the current public database is very unevenly distributed with reference to time and place of collection. In particular, only one sequence was obtained in Henan province, adjacent to China's worst-case province, Hubei Province. Herein, we used high-throughput sequencing techniques to get 19 whole-genome sequences of SARS-CoV-2 from 18 severe patients admitted to the First Affiliated Hospital of Zhengzhou University, a provincial designated hospital for the treatment of severe COVID-19 cases in Henan province. The demographic, baseline, and clinical characteristics of these patients were described. To investigate the molecular epidemiology of SARS-CoV-2 of the current COVID-19 outbreak in China, 729 genome sequences (including 19 sequences from this study) sampled from Mainland China were analyzed with state-of-the-art comprehensive methods, including likelihood-mapping, split network, ML phylogenetic, and Bayesian time-scaled phylogenetic analyses. We estimated that the evolutionary rate and the time to the most recent common ancestor (TMRCA) of SARS-CoV-2 from Mainland China were 9.25 × 10⁻⁴ substitutions per site per year (95% BCI: 6.75 × 10⁻⁴ to 1.28 × 10⁻³) and October 1, 2019 (95% BCI: August 22, 2019 to November 6, 2019), respectively. Our results contribute to studying the molecular epidemiology and genetic diversity of SARS-CoV-2 over time in Mainland China.

Tenofovir Alafenamide to Prevent Perinatal Hepatitis B Transmission: A Multicenter, Prospective, Observational Study

BACKGROUND

Few safety and effectiveness results have been published regarding the administration of tenofovir alafenamide fumarate (TAF) during pregnancy for the prevention of mother-to-child transmission (MTCT) of hepatitis B virus (HBV).

METHODS

In this multicenter prospective observational study, pregnant women with HBV DNA levels higher than 200,000 IU/ml who received TAF or tenofovir disoproxil fumarate (TDF) from gestational weeks 24-35 to delivery were 1:1 enrolled and followed until postpartum month 6. Infants received immunoprophylaxis. The primary endpoint was the safety of mothers and infants. The secondary endpoint was the hepatitis B surface antigen (HBsAg)-positive rate at 7 months for infants.

RESULTS

In total, 116 and 116 mothers were enrolled, and 117 and 116 infants were born, in the TAF and TDF groups, respectively. TAF was well tolerated during a mean treatment duration of 11.0 weeks. The most common maternal adverse event was nausea (19.0%). One (0.9%), 3 (2.6%), and 9 (7.8%) mothers had abnormal alanine aminotransferase levels at delivery and at postpartum months 3 and 6, respectively. The TDF group had safety profiles that were comparable to those of the TAF group. No infants had birth defects in either group. The infants' physical and neurological development at birth and at 7 months in the TAF group were comparable with those in the TDF group. The HBsAg positive rate was 0% at 7 months in all 233 infants.

CONCLUSION

Antiviral prophylaxis with TAF was determined to be generally safe for both mothers and infants and reduced the MTCT rate to 0%.

[Quality grading standard of Citrus aurantium seedlings]

Forty-three annual Citrus aurantium grafted seedlings from Chongqing, Sichuan, Hunan, Jiangxi and other main producing areas were collected, and the plant height, rootstock diameter, scion diameter, root length, root diameter, lateral root number, root breadth, branch number, branch length, green leaf number, leaf length, leaf width, thorns and other indicators were measured. Through the K-cluster analysis of SPSS 19.0 software, the classification standards were obtained. Combined with the production practice, plant height, scion diameter and branch number were taken as the quality classification indexes of C. aurantium seedlings(annual grafted seedlings), and three classification standards were established. If it does not meet the three-level standard, it is unqualified seedling and cannot be used as seedling. It is suggested to use the first and second level seedlings in production.

Effect of Convalescent Plasma Therapy on Viral Shedding and Survival in Patients With Coronavirus Disease 2019

Currently, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease 2019 (COVID-19) has been reported in almost all countries globally, and no effective therapy has been documented for COVID-19 and the role of convalescent plasma therapy is unknown. In current study, 6 COVID-19 subjects with respiratory failure received convalescent plasma at a median of 21.5 days after first detection of viral shedding, all tested negative for SARS-CoV-2 RNA by 3 days after infusion, and 5 died eventually. In conclusion, convalescent plasma treatment can discontinue SARS-CoV-2 shedding but cannot reduce mortality in critically end-stage COVID-19 patients, and treatment should be initiated earlier.

Clinical course and treatment efficacy of COVID-19 near Hubei Province, China: A multicentre, retrospective study

Currently, COVID‐19 has been reported in nearly all countries globally. To date, little is known about the viral shedding duration, clinical course and treatment efficacy of COVID‐19 near Hubei Province, China. This multicentre, retrospective study was performed in 12 hospitals in Henan and Shaanxi Provinces from 20 January to 8 February 2020. Clinical outcomes were followed up until 26 March 2020. The viral shedding duration, full clinical course and treatment efficacy were analysed in different subgroups of patients. A total of 149 COVID‐19 patients were enrolled. The median age was 42 years, and 61.1% (91) were males. Of them, 133 (89.3%) had fever, 131 of 144 (91%) had pneumonia, 27 (18.1%) required intensive care unit (ICU) management, 3 (2%) were pregnant, and 3 (2%) died. Two premature newborns were negative for SARS‐CoV‐2. In total, the median SARS‐CoV‐2 shedding period and clinical course were 12 (IQR: 9–17; mean: 13.4, 95% CI: 12.5, 14.2) and 20 (IQR: 16–24; mean: 21.2, 95% CI: 20.1, 22.3) days, respectively, and ICU patients had longer median viral shedding periods (21 [17–24] versus 11 [9–15]) and clinical courses (30 [22–33] vs. 19 [15.8–22]) than non‐ICU patients (both p < .0001). SARS‐CoV‐2 clearances occurred at least 2 days before fatality in 3 non‐survivors. Current treatment with any anti‐viral agent or combination did not present the benefit of shortening viral shedding period and clinical course (all p > .05) in real‐life settings. In conclusion, the viral shedding duration and clinical course in Henan and Shaanxi Provinces were shorter than those in Hubei Province, and current anti‐viral therapies were ineffective for shortening viral shedding duration and clinical course in real‐world settings. These findings expand our knowledge of the SARS‐CoV‐2 infection and may be helpful for management of the epidemic outbreak of COVID‐19 worldwide. Further studies concerning effective anti‐viral agents and vaccines are urgently needed.

1137A life support based comprehensive treatment regimen dramatically lowers the in-hospital mortality of patients with fulminant myocarditis —- a multiple center study

Background

Fulminant myocarditis (FM) is characterized by rapid onset and progression to cardiac and circulatory failure. It has high mortality; however, patients may benefit from short-term circulatory support. This study evaluated the therapeutic efficacy of a life support–based comprehensive treatment regimen (LSBCTR) for FM and demonstrated that it saved the lives of FM patients.

Methods

One hundred and fourteen FM patients were recruited from January 2007 to October 2017 were divided into two groups: those who received LSBCTR (65 cases), including management of fluids and nutrients, use of antiviral drugs and large doses of glucocorticoids (methylprednisolone over 200 mg) and immunoglobulins, continuous renal replacement therapy (CRRT), and life support (artificial positive pressure respiration, intra-aortic balloon pump [IABP] with or without extracorporeal membrane oxygenation [ECMO]), and those who received traditional methods (74 cases). The primary endpoints were in-hospital death and length of hospital stay for survivors.

Results

Of the population, 41 patients (36.0%) died in the hospital. In-hospital mortality rates were 3.0% (2/65) for the LSBCTR group and 52.7% (39/74) for the traditional treatment group (P<0.001). Early life support (IABP with or without ECMO and a respirator) and early applications of CRRT, antiviral therapy, and sufficient doses of glucocorticoids and immunoglobulins individually contribute to the efficiency of reducing in-hospital mortality. Vasoactive agents did not improve prognosis, especially noradrenaline, which dramatically increased the incidence of death.

Conclusion

Our data described comprehensive treatment for patients with FM that can dramatically reduce in-hospital mortality. Its generalization and application in clinical practice will efficiently save lives.

Clinical Trial: NCT03268642.

miR-1322 regulates ChREBP expression via binding a 3'-UTR variant (rs1051943)

The carbohydrate response element‐binding protein (ChREBP), also referred to as MLXIPL, plays a crucial role in the regulation of glucose and lipid metabolism. Existing studies have shown an association between genetic variations of the ChREBP gene and lipid levels, such as triglycerides and high‐density lipoprotein cholesterol. However, mechanistic studies of this association are limited. In this study, bioinformatic analysis revealed that the polymorphism rs1051943A occurs in the complementary binding sequence of miR‐1322 in the ChREBP 3′‐untranslated region (UTR). Studies of potential mechanisms showed that the A allele could facilitate miR‐1322 binding, and luciferase activity significantly decreased when co‐transfected with a ChREBP 3′‐UTR luciferase reporter vector and miR‐1322 mimics in HepG2 cells. Furthermore, miR‐1322 significantly regulated the expression of ChREBP downstream genes and reduced the synthesis of lipids. The expression of miR‐1322 was up‐regulated by glucose and palmitic acid stimulation. Population studies showed that rs1051943‐A allele was only found in the Han Chinese and Uighur ethnic groups, different from European populations (G allele frequency = 0.07). In summary, we provide evidence that the rs1051943 A allele creates a functional miR‐1322 binding site in ChREBP 3′‐UTR and post‐transcriptionally down‐regulates its expression, possibly associated with levels of plasma lipids and glucose.

[Study on associated plants and spatial distribution pattern of Dipsacus asperoides populations]

In order to understand the associated species and the population distribution pattern, the investigation of 32 sample plotsfrom the main natural distribution area in Dipsacus asperoides community was carried by quadrat method .The results showed that there were 156 species, which belong to 131 genera and 60 families. There were more species in the two dominant families, Asteraceae and Rosaceae. There were many types of associated, but most appeared at a low frequency. The vegetation type were mostly herbaceous and shrub species, which accounted for 77.6% of the total species. The value of t was greater than t0.05 by methods of variance/mean, showed the difference was significant and the distribution pattern of D. asperoides were cluster distribution. The determination results of seven aggregation intensity index also showed that D. asperoides population accorded with the characteristics of cluster distribution（C>1，K>0，Ca>0，m*>1，m*/m>1，I>0，GI>0）.

[Interspecific association of companion species in Artemisia annua community in southwest of China]

The interspecific association of companion species in Artemisia annua community in 48 region of southwest China was analyzed by variance analysis, chi2-test and association indices. The total related variance ratio among species in A. annua community was 2.05. Among 45 species pairs of 10 main species in the community, only 4 pairs showed significant negative correlations. Chi2 test, PC, OI, DI and AC values indicated pairs 1-8 (A. annua- A. lactiflora), 1-9 (A. annua- Setaria viridis) and 1-10 (A. annua- Bidens pilosa) showed a high correlations, and common utilization to non-restrictive resources. The results indicated that there was a significant positive correlation among species,and the community was at a stable stage, showed strong ability to human interference.

Polymorphism of HMGA1 is associated with increased risk of type 2 diabetes among Chinese individuals

AIMS/HYPOTHESIS

Variants of the high-mobility group A1 (HMGA1) gene have been shown to be associated with insulin resistance and type 2 diabetes in individuals of European origin. We aimed to determine whether this locus confers significant susceptibility to type 2 diabetes in the Han Chinese population, and thus cross-race susceptibility to type 2 diabetes.

METHODS

Polymorphisms in HMGA1 were identified by direct sequencing of genomic DNA derived from 192 Chinese participants (96 patients with type 2 diabetes and 96 controls). We then genotyped the common variant IVS5-13insC (c.136-14_136-13insC) in two other independent cohorts, including a total of 2,533 cases and 2,643 ethnically matched controls.

RESULTS

We confirmed the association of the HMGA1 variant IVS5-13insC (c.136-14_136-13insC) with type 2 diabetes with an OR of 1.34 (95% CI 1.15, 1.56, p = 0.0002 under a dominant model, and 95% CI 1.16, 1.55, p = 0.0002 under an additive model) in the Han Chinese population, corresponding to a population attributable risk fraction of 5.0%.

CONCLUSIONS/INTERPRETATION

HMGA1 is an important susceptibility locus that confers a high cross-race risk of the development of type 2 diabetes.

Effects of anaesthetic agents on gastrin-stimulated and histamine-stimulated gastric acid secretion in the totally isolated vascularly perfused rat stomach

BACKGROUND

Anaesthetic agents affect gastric acid secretion, but the mechanisms behind this action have not been fully evaluated. The enterochromaffin-like (ECL) cell plays a key role in the regulation of gastric acid secretion, and anaesthetic agents have recently been described as inhibiting histamine release from the ECL cell. The present study examines the effect of anaesthetic agents on the ECL cell and on parietal cell functions.

METHODS

Different concentrations of urethane, pentobarbital and a mixture of fluanisone/fantanyl/midazolam (FFM) were examined for the effect on gastrin-stimulated histamine release and acid secretion and on histamine-stimulated acid secretion in the totally isolated vascularly perfused rat stomach. The luminal acid output and histamine concentrations in venous effluents were measured by titration and radioimmunoassay, respectively.

RESULTS

Pentobarbital caused an inhibition on both histamine release and acid output in gastrin-stimulated stomachs in a concentration-dependent way. The mixture of FFM at higher concentrations inhibited histamine release from the ECL cell and luminal H+ output in gastrin-stimulated acid secretion. Urethane exerted a slight inhibitory effect on histamine release only at the lowest concentration. Pentobarbital also reduced histamine-stimulated gastric acid secretion, while the mixture of FFM did not.

CONCLUSIONS

pentobarbital inhibits acid secretion both by reducing ECL cell histamine release and parietal cell H+ secretion, whereas FFM inhibits acid secretion by interaction with the ECL cell only. Urethane also had a slight inhibitory effect on the ECL cell histamine release at the lowest concentration.

Long-term omeprazole treatment suppresses body weight gain and bone mineralization in young male rats

BACKGROUND

The stomach is rich in endocrine cells, including those producing ghrelin, which is thought to play a role in the control of body growth. Omeprazole treatment is associated with hypergastrinaemia, resulting in growth of the oxyntic mucosa in general and the enterochromaffin-like (ECL) cells in particular. In the present study, we examined the effects of long-term omeprazole treatment on young male rats with respect to body growth and stomach.

METHODS

Male rats (24 days old) were treated with omeprazole (400 micromol/kg/day) or vehicle for 77 days. The body weight was recorded twice per week. At sacrifice, dual-energy X-ray absorptiometry (DXA) was used to assess total bone area, bone mineral content (BMC), bone mineral density (BMD) and body composition (fat and lean body mass). The lengths of the spine and the femur were recorded. The plasma concentrations of gastrin and histamine were determined by radioimmunoassays. The endocrine cells of the stomach were examined by immunocytochemistry.

RESULTS

The body weight gain was suppressed by omeprazole treatment. The bone area, BMC and BMD were reduced, while the lengths of the spine and the femur and the body composition were unchanged. Omeprazole-induced hypergastrinaemia was associated with enlargement of the oxyntic area and with hyperplasia of ECL cells but not of A-like cells and D cells. In contrast, the enterchromaffin (EC) cell density in the antrum was reduced.

CONCLUSIONS

Omeprazole treatment of young male rats reduces body weight and bone mass gain. The densities of ECL cells in the oxyntic mucosa was increased and of the EC cells in the antral mucosa reduced.

Immunohistochemical study on endocrine-like tumor cells in colorectal carcinomas

AIM: To evaluate the clinical significance of endocrine-like tumor cells in human colorectal carcinomas.

METHODS: The immunohistochemistry method (ABC) using a rabbit polyclonal antibody against human chromogranin A (CGA) was employed to determine changes in endocrine-like tumor cells from the surgically resected colorectal carcinoma tissues of patients (35 males and 27 females, aged from 19 to 78 years, with a mean age of 50.3 years). Of the 62 specimens, 44 were from rectal carcinomas, 18 from colonic carcinomas, 14 from lymph nodes and 48 from non-involvement. Dukes classification revealed 19 of the cases were in stage A, 29 cases were in stage B and 14 cases were in stage C. All of the specimens were fixed with 10% formalin, embedded with paraffin and cut into 5 μm sections. Additionally, the correlations among CGA-positive tumor cells, as well as the clinicopathologic data, age and sex of the patients, were also investigated.

RESULTS: CGA-positive tumor cells were found in 35.5% of the patients with colorectal cancers, representing 20.0% (5 of 25) and 45.9% (17 of 37) of the aged and non-aged, respectively. These differences were significant (χ² test, P < 0.05). Nevertheless, no significant correlations were found between the CGA-positive tumor cells and the sex, Dukes stages, tumor location, degree of histological differentiation or presence of lymph node metastasis.

CONCLUSION: The low incidence of endocrine-like tumor cells found in the aged patients may be a new pathological feature for colorectal carcinomas, which could explain why the aged patients usually had a better prognosis. The exact significance of these findings requires further characterization.