Objective To provide a current language for clinical and pathological discription of gastric cancer. Methods The literature in recent years on the distribution of lymph nodes and staging of gastric cancer were reviewed. Results The lymph nodes of gastric cancer are distributed near the blood vessel and organs of gastric milieu. To ensure radical gastrectomy rational and scientific, the anatomic structure of gastric milieu should be familiarized. Conclusion The excellent outcome of surgery will be achieved by the effective dissection and removel of lymph nodes in gastric cancer.
Objective To discussion the diagnostic significance of CT three dimension reconstruction in local recurrence after surgery for gastric cancer. Methods Thirty-nine patients with gastric cancer recurrence after radical surgery were performed multislice CT scan between December 2004 and December 2008 in The Third Affiliated Hospital of Harbin Medical University, and the images were reconstructed by three dimension reconstruction in workstation. The axial CT images and three dimension images of gastric cancer recurrence patients were diagnosed and compared. Results The detection rates of axial images and three dimensional CT images were 82.1% (23/28) and 100% (28/28) for pathological morphology, 62.5% (10/16) and 93.8%(15/16) for extension of tumors, 66.7% (10/15) and 93.3% (14/15) for lymph node metastasis, 87.5% (7/8) and 87.5% (7/8) for distant metastasis, respectively. Conclusions CT three dimension reconstruction can carry out more direct and solid results, such as measuring the vertical thickness of the thickened gastric wall, observing the infiltration situation with proximal organ, and metastasis of the lymph node. The method of three dimension reconstruction used for the diagnosis of local recurrence after surgery for gastric cancer is better than the axial image, and it can supply data which would be useful for the tumor advancing treatment.
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.
Ｔｈｅ ｔｈｅｒａｐｅｕｔｉｃ ｒｅｓｕｌｔｓ ｏｆ ３６ ｃａｓｅｓ ｏｆ ｇａｓｔｒｉｃ ｃａｎｃｅｒ ｗｉｔｈ ｈｅｐａｔｉｃ ｍｅｔａｓｔａｓｅｓ ｃｏｎｆｉｒｍｅｄ ｂｙ ｏｐｅｒａｔｉｏｎ ａｎｄ ｐａｔｈｏｌｏｇｉｃａｌ ｅｘａｍｉｎａｔｉｏｎ ａｒｅ ｒｅｐｏｒｔｅｄ．Ｉｔ ｓｕｇｇｅｓｔｓ ｔｈａｔ ｏｐｅｒａｔｉｏｎｓ ｓｈｏｕｌｄ ｎｏｔ ｂｅ ｇｉｖｅｎ ｕｐ ｅｖｅｎ ｈｅｐａｔｉｃ ｍｅｔａｓｔａｓｅｓ ｈａｖｅ ｏｃｃｕｒｅｄ．Ｒａｄｉｃａｌ ｒｅｓｅｃｔｉｏｎ ｏｆ ｐｒｉｍａｒｙ ｃａｎｃｅｒ ｃｏｎｃｏｍｉｔａｎｔ ｗｉｔｈ ｔｒｅａｔｍｅｎｔ ｏｆ ｍｅｔａｓｔａｓｉｓ ａｎｄ ｏｔｈｅｒ ｐｒｏｃｅｄｕｒｅｄ ｃｏｕｌｄ ｒｅｌｉｅｖｅ ｓｙｍｐｔｏｍｓ，ｐｒｏｍｏｔｅ ｓｕｒｉｖａｌ ｄｕｒａｔｉｏｎ ａｎｄ ｑｕａｌｉｔｙ．Ｐｒｏｃｅｄｕｒｅｄ ｆｏｒ ｔｒｅａｔｉｎｇ ｐｒｉｍａｒｙ ｈｅｐａｔｉｃ ｃａｎｃｅｒ ａｒｅ ａｌｓｏ ｕｓｅｆｕｌ ａｓ ｗｅｌｌ ａｓ ｍｅｔａｓｔａｔｉｃ ｈｅｐａｔｉｃ ｃａｎｃｅｒ．
ObjectiveTo analyze the factors influencing the total number of harvested lymph nodes in laparoscopic radical gastrectomy for advanced gastric cancer.MethodsThe clinicopathologic data of patients who underwent laparoscopic D2 radical resection of gastric cancer in this hospital for advanced gastric cancer from January 2018 to July 2020 were retrospectively analyzed. The statistical analysis was conducted to analyze the influence factors (age, gender, tumor size, tumor site, body mass index, infiltration depth, lymph node metastasis, HER-2 gene amplification status, presence or absence of vascular tumor thrombus, presence or absence of nerve infiltration, differentiation type, pTNM, Borrmann type, and type of gastrectomy) on the number of harvested lymph nodes.ResultsA total of 536 patients met the inclusion and exclusion criteria were included. The results of univariate analysis showed that the total number of harvested lymph nodes during laparoscopic radical gastrectomy for advanced gastric cancer was correlated with age, tumor size, tumor infiltration depth, lymph node metastasis, pTNM stage, Borrmann type, and type of gastrectomy. That was, the younger the patient was (≤ 54 years old), the larger the tumor was (long diameter >3.5 cm), the later the Borrmann classification was (type Ⅲ, Ⅳ), the deeper the tumor invasion was, the more the number of lymph node metastasis was, the later the pTNM stage was, and the more the number of lymph nodes was detected in patients undergoing total gastrectomy (all P<0.05). The multiple linear regression analysis showed that the age, lymph node metastasis, and PTNM stage had significant effects on the number of harvested lymph nodes. The multiple linear regression model was statistically significant (F=6.754, P<0.001). 11.2% of the variation in the number of harvested lymph nodes could be explained by the age, lymph node metastasis, and pTNM stage (adjusted R2=11.2%). ConclusionsNumber of harvested lymph nodes in laparoscopic radical gastrectomy for advanced gastric cancer is greatly affected by the age of patients, lymph node metastasis, and pTNM stage. So patients should be evaluated objectively and individually according to their age so as to harvest sufficient number of lymph nodes, which is conducive to accurately judge pTNM stage, formulate accurate adjuvant treatment scheme, and improve prognosis of patients.
目的探讨老年胃癌患者合并糖尿病的围手术期处理。方法对我院1990年1月至2004年2月期间收治的297例老年胃癌中41例合并糖尿病患者的临床资料进行回顾性分析。结果术后并发感染率、吻合口漏、死亡率及住院时间，血糖正常者分别为19.9%（51/256）、0.4%（1/256）、0.8%（2/256）和（19.1±4.3） d，糖尿病患者分别为34.1%（14/41）、7.3%（3/41）、7.3%（3/41）和（24.3±5.1） d，后者均明显高于前者（P均＜0.05）。结论老年胃癌患者合并糖尿病术后并发症及病死率较高，其围手术期处理至关重要，应引起外科医生的高度重视。
In perioperation period, the dynamic changes of solubla interleulcin-2 receptor (sIL-2R) in serum were determined by ELISA in 60 patients with gastric cancer (GC), and then was compared with those of 30 normal individuals and 40 selective patients who necieved common abdominal surgery. Results: At the day before and ten days after operation, the sIL-2R of patients with GC was higher than that of normal individual. But twenty days after operation, the sIL-2R reduced to as normal level. Conclusion: As a immunodepressive index, the sIL-2R of patients with GC was increased obviously, and after radical gastrectomy, it decreased gradually. So by determining sIL-2R, we can evaluate the immunologic function of patientswith GC.
ObjectiveTo determine the frequency and type of p16 gene homozygous deletion and mutation with the progression of human gastric carcinogenesis.MethodsPCR （polymerase chain reaction），SSCP (single strand conformation polymorphism) and DNA sequencing were performed on 50 operative tissues, which included 7 early gastric cancer and 43 advanced gastric cancer. In this group there were 36 male and 14 female patients aged 35 to 68,which included 30 welldifferetiated adenocarcinoma and 20 poordifferentiated carcinoma; 19 patients with lymph node metastases.ResultsTotal mutation frequency of p16 gene was 8.00%(4/50), including 14.29%(1/7) of early cancer and 7.00%(3/43) of advanced cancer，there was no significant difference between early and advanced cancer （P＞0.05）. In addition, p16 gene mutation was not related to site，location，grade of tumor differentiation and lymph node metastases, respectively. Total deletion frequency of p16 gene was 16.00%(8/50), of which 18.60%(8/43) was detected in advanced cancer, but no cases in early cancers. There was a significant difference between early and advanced cancer （P＜0.05）, and frequency p16 gene homozygous deletion was related to grade of tumor differentiation and lymph node metastases, respectively. Direct DNA sequencing displayed that 4 point mutations detected in 99,125,433,441 base, there were 3 missense mutation and 1 samesense mutation, no deletion or insertion was found. Conclusionp16 gene mutation is an early event in gastric carcinogenesis，it helps early diagnosis of human gastric carcinoma. p16 gene homozygous deletion is a late event in gastric carcinogenesis，it might relate to metastases and recurrence of gastric cancer.
目的 探讨HIF-1α和BAK蛋白在胃癌中的表达情况，以及二者在胃癌中的相互关系及作用。方法 应用免疫组化SABC染色法检测80例胃癌组织和20例正常胃组织中的HIF-1α和BAK蛋白的表达情况。结果 胃癌中HIF-lα和BAK蛋白的表达阳性率分别为56.3%（45/80）和67.5%（54/80），而在胃正常组织中分别为5.0%（1/20）和20.0%（4/20），二者在胃癌中的表达显著高于胃正常组织，其差异有统计学意义（P＜0.05）。HIF-1α蛋白表达与胃癌组织的浸润范围、分化程度及淋巴结转移有关（P＜0.05），与临床分期、年龄及性别无关（P＞0.05）；BAK蛋白表达与胃癌浸润及分化程度相关（P＜0.05），与淋巴结转移、临床分期、年龄及性别无关（P＞0.05）。胃癌组织中HIF-1α与BAK蛋白的阳性表达之间呈正相关（列联系数r=0.056，P＜0.05）。结论 HIF-1α与BAK蛋白在胃癌的临床分期及浸润转移中存在关系，这对于研究胃癌的发生和发展，以及对于探索以二者为靶点的抗肿瘤治疗有重要意义。