Objective
To understand role of chemokines and their receptors in pathogenesis, progression, and metastasis of gastric cancer, and to provide a better approach for diagnosis and treatment of gastric cancer.
Method
The literatures about the relationship between chemokines and their receptors and gastric cancer were reviewed.
Results
There were about 50 various chemokines and their receptors abnormally expressed in the tumor microenvironment. The main types related gastric cancer were the CXC, CC and CX3C chemokines and their receptors, which could promote the proliferation, invasion, and metastasis of the gastric cancer through several pathways like mTOR pathway, JAK2-STAT3 pathway, etc..
Conclusions
Chemokines and their receptors play an important role in occurrence and development of gastric cancer. Further studies on chemokines and their receptors will not only assist in early diagnosis of gastric cancer, as well as estimation of clinical prognosis, but also provide an intervention target for gastric cancer.
ObjectiveTo study the expression of matrilysin in gastric cancer and to evaluate the correlation between its expression and invasion, metastasis, and prognosis. MethodsA total of 52 patients with gastric cancer were selected and followed up. The expressions of matrilysin in gastric primary focus, normal gastric mucosa, and metastatic lymph nodes were examined by reverse transcriptionpolymerase chain reaction (RT-PCR), Western blot, and immunohistochemistry, respectively. The correlations between matrilysin expression and tumor invasion, metastasis, and prognosis were assessed. ResultsThe expressions of matrilysin in gastric primary focus and metastatic lymph nodes significantly increased, while decreased or loss in normal gastric mucosa (Plt;0.001). The higher concordance was seen between the levels of mRNA and protein (Plt;0.001). Among patients with infiltrating type, penetrated serosa, area of serosa involved more than 20 cm2, and metastatic lymph nodes more than 7, the expression of matrilysin was significantly higher (Plt;0.01). The survival rate of patients with matrilysin higher expression (34.1%) was significantly lower than that with matrilysin lower expression (55.6%), χ2=9.778， P=0.002. Conclusions Up-regulated expression of matrilysin plays an important role in tumor invasion, metastasis, and poor prognosis, and it is a good molecular marker to reflect the biological behaviors of gastric cancer.
Objective To study the necessity and feasibility of No.12b lymph node dissection in D2 lymphadenectomy for advanced distal gastric cancer, and the relation between No.12b lymph node metastasis and clinicopathologic factors. Methods Clinical data of sixty cases of advanced distal gastric cancer receiving D2 or D2+ radical correction were collected retrospectively, both of which were all plus No.12b lymph node dissections. The relationships between No.12b lymph node metastasis and clinicopathologic factors were analyzed. Results No death attributed to operation or severe operative complications were found. There were 12 cases (20.00%) with No.12b lymph node metastasis. The rates of No.12b lymph node metastasis in Borrmann Ⅲ-Ⅳ types, N2-3 of lymph node metastasis and T3-4 of tumor infiltration were 31.25% (10/32), 30.30% (10/33) and 29.73% (11/37), which were significantly higher than those in Borrmann Ⅰ-Ⅱ types 〔7.14% （2/28）〕, N0-1 〔7.41% （2/27）〕 and T1-2 〔4.35% （1/23）〕 respectively (Plt;0.05). There was no relationship between tumor size and No.12b lymph node metastasis. Conclusions No.12b lymph node dissection is safe and feasible for advanced distal gastric cancer. Further perspective studies on No.12b lymph node dissection influence on prognosis in more cases are required.
ObjectiveTo investigate the relationship between topical reactive lymphoid hyperplasia and postoperative recurrence and survival of gastric cancer patients.
MethodsThe clinical and pathological data of gastric cancer patients who underwent D2 radical gastrectomy from January 2007 to July 2009 were retrospectively analyzed. Based on the number of reactive lymph nodes, cases were divided in to topical reactive lymphoid hyperplasia group (RLH, n=18) and non-RLH group (n=43) by using a median method. The postoperative disease-free survival (DFS) and overall survival (OS) rates of patients in different groups were compared using Kaplan-Meier method and log-rank test, respectively.
ResultsThere were no significant difference between the two groups in age, gender, pathological stage, surgical approach, extent of surgery or methods of postoperative chemotherapy (P > 0.05). The median disease-free survival time was 50 months in RLH group, and the median disease-free survival time was 39 months in non-RLH group. DFS of patients in RLH group was significant higher than non-RLH group (66.7% vs. 34.9%, P=0.048). The median survival time was 53.6 months and 52.3 months, respectively, in RLH group and non-RLH group. No difference was found in OS between the two groups (72.2% vs. 60.5%, P=0.338).
ConclusionTopical reactive lymphoid hyperplasia reactive the immunity of gastric cancer patients and contact postoperative DFS rate.
Objective
To investigate the clinical effects and safety differences of open surgery and laparoscopy primary lesion resection combined with D2 lymph node dissection in the treatment of elderly patients with advanced gastric cancer.
Methods
One hundred and forty elderly patients with advanced gastric cancer were chosen and randomly divided into two group including open operative group (70 patients) with primary lesion resection combined with D2 lymph node dissection by open operation and laparoscopic surgery group (70 patients) with primary lesion resection combined with D2 lymph node dissection by laparoscopy; and the operative time, intraoperative bleeding amount, the levels of PaCO2 in operation, liquid diet eating time, postoperative anal exhaust time, postoperative gastric tube indwelling time, postoperative ambulation time, the level of haemoglobin (Hb) after operation, the hospitalization time, the number of lymph node dissection, the survival rate with followed-up and postoperative complication incidence of both groups were compared.
Results
There was no significant difference in the operative time between 2 groups (P>0.05). The intraoperative bleeding amount, the level of PaCO2 in operation, liquid diet eating time, postoperative anal exhaust time, postoperative gastric tube indwelling time, postoperative ambulation time, the level of Hb after operation and the hospitalization time of laparoscopic surgery group were significantly better than open operative group (P<0.05). The level of PaCO2 in operation of laparoscopic surgery group was significantly higher than open operative group (P<0.05). There were no significant difference in the gastric lymph node dissection number and the peripheral lymph node dissection number of gastric artery between 2 groups (P>0.05). There were no significant difference in the survival rates between the 2 groups after 3-year followed-up (P>0.05). The complication incidence after operation of laparoscopic surgery group was significantly lower than open operative group (P<0.05). The quality of life scores of patients in laparoscopic surgery group were significantly higher than those in open operative group on 7 days and in 3 months after operation, and the difference were statistically significant (P<0.05).
Conclusion
Compared with open operation, primary lesion resection combined with D2 lymph node dissection by laparoscopy in the treatment of elderly patients with advanced gastric cancer can efficiently possess the advantages including minimally invasive, shorter recovery time and less postoperative complications.
Objective
To assess safety and feasibility of laparoscopic gastrectomy in the elderly with gastric cancer.
Methods
From January 2010 to September 2014, 146 elderly (age ≥65 years old) patients with gastric cancer underwent radical operations in the Department of General Surgery, Guangdong Academy of Medical Sciences and Guangdong General Hospital were collected, then were divided into a laparoscopy-assisted radical gastrectomy (LAG group, n=40) and an open radical gastrectomy (OG group, n=106) according to the operative mode. The differences of intraoperative and postoperative situation, and the postoperative complications were analyzed between the LAG group and the OG group.
Results
① The age, gender, body mass index, albumin, ASA grade, tumor location, differentiation degree, TNM stage, radical gastrectomy, and digestive tract anastomosis had no significant differences between the LAG group and the OG group (P>0.05). ② None of the patients died during the operative period and there was no significant difference in the mean number of retrieved lymph nodes between these two groups (P>0.05). In the aspects of the intraoperative blood loss, the first flatus time or the first feeding time, and the postoperative hospitalization stay in the LAG group were significantly less than those in the OG group (P<0.05). For the operative time, the OG group showed a distinctive advantage with a significantdifference than the LAG group (P<0.05). ③ The rate of postoperative complication in the LAG group and OG group was 10.0% (4/40) and 15.1% (16/106) respectively, and the difference was not significant (χ2=0.64, P=0.591), the grade of the Clavien-Dindo complications had no significant difference (χ2=0.63, P=0.592). ④ None of the patients died following operation in the LAG group and one case died in the OG group because of the respiratory and circulatory failure caused by the pulmonary embolism.
Conclusion
Preliminary results of limited cases in this study show that LAG in the elderly patients with gastric cancer could reduce intraoperative blood loss, shorten the first flatus time or the first feeding time, and postoperative hospitalization stay, could obtain same radical effect without increasing incidence of postoperative complications as compared with OG, so it is safety and feasible.
摘要:目的: 探討PCNA,VEGF在胃癌組織中的表達關系及其意義。 方法 :免疫組織化學法檢測正常胃和胃癌組織中PCNA和VEGF的表達,并分析其與胃癌臨床病理特征的相關性。 結果 :胃癌組織中PCNA、VEGF的陽性表達率分別為850%、683%,二者在正常胃組織中均為隱性表達。PCNA的表達與腫瘤分期、淋巴結轉移有關(〖WTBX〗P lt;005),而與年齡、性別、腫瘤大小、組織分化程度無關(〖WTBX〗P gt;005);PCNA的表達與腫瘤分期、淋巴結轉移有關(〖WTBX〗P lt;005),而與年齡、性別、腫瘤大小、組織分化程度無關(〖WTBX〗P gt;005)。PCNA和VEGF在胃癌中的表達呈正相關。 結論 :PCNA和VEGF在胃癌組織中的高表達促進了胃癌的發生發展。Abstract: Objective: To study the significance and relationship of expression of proliferating cell nuclear antigen(PCNA) and vascular endothelial growth factor (VEGF) in gastric cancer. Methods : The expression of VEGF and PCNA in normal gastric tissues and gastric cancer tissues were detected by immunohistochemistry (SP),and clinic pathological correlation with gastric cancer was analyzed. Results : The positive exression rates of PCNA and VEGF in gastric cancer were 850%、683%, respectively, while negative expression was shown in normal gastric tissues. It was found that the expressions of PCNA and VEGF were both in significant relation to TNM stages and lymph node metastasis (P lt;005), but in no relation to age, gender, diameter of tumor and tumor cell differentiation (P gt;005). The expressions of PCNA and VEGF were positively correlated with each other. Conclusion : It was indicated that the highlevel expressions of PCNA and VEGF might corporately accelerate the progression of gastric cancer.
