To study the effects of arginine supplementation in total parenteral nutrition (TPN) on lymphocytic immune function in postoperative patients with gastric cancer. Thirty six patients with gastric cancer receiving TPN were eligible for entry into randomized and prospective clinical trial of the study. T cell subsets, NK cell activity, plasma IL-2 content and peripheral blood CD25 were measured in before and after parenteral nutrition of the patients. Results: usual TPN could not improve lymphocytic immunosuppression of postoperative patients with gastric cancer. The patients receiving arginine supplementation in TPN might enhance lymphocytic immune function by increasing CD4 level, IL-2 production and NK cell activity, but there was no significant effect of arginine on CD25 expression. Conclusion: there are some effects of supplement with arginine on releasing of the cellular immunosuppression and restoring of lymphocytic immune function.
With immunohistochemical technique, epithelial membrane antigen monoclonal antibody (EMA) has been used to detect the micrometastatic focus in bone marrow of patients with primary gastric cancer since 1992. In the exmamination of 65 patients, the positive rate of bone metastasis was 58.46%. After comprehensive treatment to these patients, comparative observation showed that there were marked differences between pre-therapeutic (9.45) and post-therapeutic (2.19). The result demonstrates that this technique provides identification of blood micrometastases and has insttructive signnificance for clinical comprehensive treatment.
Objective To systematically review the prognostic significance of extranodal extension in gastric cancer, esophageal cancer and gastroesophageal junction cancer. Methods We searched EMbase, The Cochrane Library (Issue 9, 2016), PubMed, CBM, CNKI, VIP and WanFang Data databases from inception to August 2016, to collect cohort studies about the prognostic significance of extranodal extension. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.2 software. Results A total of 16 studies involving 9 445 participants were included. The results of meta-analysis showed that for gastric cancer patients, the overall survival (OS) (HR=1.71, 95%CI 1.49 to 2.00,P<0.000 01), disease free survival (DFS) (HR=1.39, 95%CI 1.12 to 1.73,P=0.003) and cancer specific survival (HR=1.52, 95%CI 1.18 to 1.96,P=0.001) in ENE(+) group were lower than ENE(–) group. For esophageal cancer and gastroesophageal junction cancer patients, the overall survival (OS) (HR=1.84, 95%CI 1.49 to 2.27,P<0.000 01), disease free survival (DFS) (HR=2.18, 95%CI 1.70 to 2.81,P<0.000 01) and cancer specific survival (HR=1.73, 95%CI 1.19 to 2.52,P=0.004) in ENE(+) group were lower than ENE(–) group. Conclusion Current evidence indicates that ENE(+) was correlated with a poor prognosis in gastric cancer, esophageal cancer and gastroesophageal junction cancer patients. Due to the quantity and quality limitations of included studies, more high quality cohort studies are needed to verify the above conclusions.
Objective To evaluate the rational of peritoneal warm perfusion chemotherapy after the operation. MethodsOne hundred and two patients with gastric cancer were included in this study. One hundred milliliter of peritoneal fluid were collected respectively after opening the abdomen,before closing the peritoneal cavity,and after hyperthermic peritoneal perfusion chemotherapy for free cancer cells examination. ResultsAfter opening the abdomen, the positive rate of free cancer cells was 36.3%(37/102), and the positive rate before closure of peritoneal cavity was 52.9%(54/102), 31 cases of free cancer cells were found killed after the warm perfusion chemotherapy,the effect rate was 57.4%(31/54).The free cancer cells positive rate related to the tumor infiltration depth, serous membrane invasion area and the type of histopathology. Conclusion In the peritoneal cavity of patients with gastric cancer, free cancer cells are able to survive and have a high degree of activity. Hyperthermic peritoneal perfusion chemotherapy is an effective method to kill free cancer cells.
Objective To research the effect of ω-3 polyunsaturated fatty acid (PUFA) on inflammatory response and nutritional condition after operation for patients with gastrointestinal malignancies. Methods Forty patients with gastrointestinal malignancies were included in this study from February 1st, 2009 to June 1st, 2009. Forty cases were randomly allocated to experimental group (20 cases) and control group (20 cases). Parenteral nutrition was conducted in continuous 7 days after operation. Comparing with control group, a dose of 10 g of ω-3 PUFA was given to experimental group every day in 7 days after operation in addition. Blood samples were gained before operation, the 2nd and 8th day after operation respectively to measure relative indexes about inflammatory response (WBC, neutrophilic granulocyte and C-reaction protein) and nutrition (total protein, albumin, prealbumin, siderophilin and lymphocyte). Reduction of body mass was also recorded. Results The baseline between experimental group and control group was comparable (Pgt;0.05). The levels of indexes about inflammatory response (WBC, neutrophilic granulocytem and C-reaction protein) and nutrition (total protein, albumin, prealbumin, siderophilin and lymphocyte) between experimental and control group did not reach statistically significant difference in the 2nd day after operation (Pgt;0.05). The levels of neutrophilic granulocyte and C-reaction protein in experimental group were lower than those of control group, and the level of lymphocyte in experimental group was higher than that of control group in the 8th day after operation, and all of them reached statistical significance (Plt;0.05). There was no statistical different in reduction of body mass between experimentalgroupandcontrolgroup.Conclusion ω-3 PUFA can depress the excessively inflammatory reaction and improve the nutritional condition of patients with gastrointestinal malignancies after operation.
In this report, 1175 cases of resected gastric cancer were staged, followed up and statistincally calculated by using the international unifying new TNM staging system for gastric cancer. The prognostic value of the TNM staging system was also tested with relevant statistics. The results showed that:(1)the 5-year survival rates of Ⅰa、Ⅰb、Ⅱ、Ⅲa、Ⅲb and Ⅳ were 100%,84%,65%,43%,25% and 13% respectively; (2)The 5-year survival rates of the subgroups withing same stage were quite; (3)the analysys of correlation and regression between the new staging and the prognosis provided that correlation coefficient r equals to -0.990(Ｐ＜0.005), and regression coefficient b equals to -0.1345(Ｐ＜0.005). These results indicate that there is statistical identity beween the new TNM staging for gastric cancer and the prognosis, and certify the rationality for the new staging in application and its accuracy to reflect the prognosis.
Objective To detect the expressions of epidermal growth factor receptor (EGFR), epidermal growth factor receptor-2 (C-erbB-2), vascular endothelial growth factor (VEGF) and cyclooxgenase-2 (COX-2) in gastric cancer tissues, and to analyze the relationship among them and the clinicopathologic factors of gastric cancer. Methods The SP immunohistochemical stain was used to detect EGFR, C-erbB-2, VEGF and COX-2 protein expressions in sample of 68 gastric cancer tissues. And their corresponding clinical data were analyzed retrospectively. Results The expression rates of EGFR, C-erbB-2, VEGF and COX-2 protein in gastric cancer tissue were 38.2% (26/68), 42.6% (29/68), 52.9% (36/68) and 60.3% (41/68) corresponding. An obvious increasing tendency as the differentiation of the cancer degraded, invasion depth deepened, lymphatic metastasis occurred and TNM stage upgraded was showed by the positive expression rates of them （P＜0.05，P＜0.01）; but there was no correlation with the patient’s sex, age, tumour site and size （Pgt;0.05）. There was a stable positive correlation among EGFR, C-erbB-2, VEGF and COX-2 expressions in gastric cancer tissue, respectively （P＜0.05）. Conclusion EGFR, C-erbB-2, VEGF and COX-2 expressions participate in the development, invasion and metastasis process of gastric cancer. Joint detection of them can be looked as an important symbol for judging the prognosis of gastric cancer and screening the high-risk metastasis patients, and guiding the molecular targeting therapy of gastric cancer.
ObjectiveTo study the significance, methods, and technique of group No.6 lymphadenectomy of the laparoscopic gastrectomy with D2 lymph node dissection for distal gastric cancer. MethodsThe relevant data of the 141 examples of group No.6 lymphadenectomy of the laparoscopic gastrectomy with D2 lymph node dissection for distal gastric cancer from Jan.1, 2008 to Dec.31, 2011 were retrospectively analysized. ResultsOne hundred and forty-one patients were successfully completed the group No.6 lymphadenectomy of laparoscopic distal gastrectomy with D2 lymph node dissection. With the number of cases of operation increasing, the operation time, bleeding volume, incidence rate of complication, and the number of operation transit cases stepped down year by year, and the number of the lymph node dissection stepped up (P < 0.000 1). No case died of the lymphadenectomy of the group No.6 lymph node. The medium vessels of colon, pancreas, and the gastroduodenal artery were the anatomic landmarks of the group No.6 lymphadenectomy. The space between the anterior lobe and the posterior lobe of transverse mesocolon and the prepancreatic space were the important surgical plane to carry out the group No.6 lymphadenectomy. ConclusionsOnly a team shall complete a certain amount of the operation, take the medium vessels of colon, pancreas, and the gastroduodenal artery as the anatomic landmark, accurately identify the space between the anterior lobe and the posterior lobe of transverse mesocolon, and the prepancreatic space, and take operation on the correct surgical plane, shall the group No.6 lymphadenectomy conform to the principle of the radical cure of the tumour and achieve the aim of the minimal invasion.
ObjectiveTo investigate the effect of up-regulation of microRNA-31(miR-31) on the biological behaviour in AGS cell of gastric cancer and on the expression of liver receptor homolog-1(LRH-1), and to analyze the possible mechanisms of miR-31 on initiation and development of gastric cancer. MethodsAGS cells were divided into 3 groups, receiving miR-31 transfection(MT group), empty liposomes transfection(NC group), and treatment of PBS (BC group). Then the cells' proliferation was determined by cell counting kit-8(CCK-8), the apoptosis situation was determined by flow cytometer, the migration was determined by Transwell test, the expression of LRH-1 protein was tested by Western blot method, and the target of miR-31 was tested by luciferase reporter assay. ResultsThe cell's proliferation results showed that the mean of A450 value in MT, NC, and BC groups were 1.31, 2.26, and 2.14 respectively on the 4 days after transfection, which lower in MT group(P<0.01).Results of flow cytometer experiment showed that the mean of apoptosis ratio of MT, NC, and BC groups were 39.5%, 9.3%, and 10.0% respectively, the mean of proportion of cell in G1+S stage were 92.54%, 73.23%, and 74.58% respectively, which both lower in MT group (P<0.05).Results of Transwell experiment showed that the mean of number of migrated cells in MT group was lower (P<0.05).Results of Western blot experiment demonstrated that the expression level of LRH-1 protein in MT group was lower than those of BC group and NC group(P<0.01). ConclusionsUp-regulation of miR-31 can obviously inhibit the proliferation of AGS cell, promoting its apoptosis and depressing its migration ability. On the other side, the up-regulation of miR-31 can also inhibit the expression level of LRH-1 protein, which indirectly induces the inhibition of proliferation of AGS cell. So miR-31 may be an important regulator in the initiation and development of gastric cancer through regulating LRH-1 gene.
ObjectiveTo investigate the clinicopathologic and epidemiological characteristics of patients with gastric cancer at our hospital in the past six years． Methods A total of 958 patients with gastric cancer were selected from January 2004 to December 2009 and clinicopathologic characteristics such as basic data, pathological type, tumor location, and TNM stage were retrospectively analyzed. ResultsOf the 958 patients，697 cases (72.8%) were male and 261 cases (27.2%) were female, and the age ranged from 26 to 91 years old (mean 62.6 years old). The occurrence rate of gastric cancer was higher in the patients of 46-65 years old (49.4%, 473/958) than that in the patients of ≥66 years old (42.3%, 405/958) and ≤45 years old (8.3%, 80/958). Regarding pathologic type, the majority of advanced gastric cancers (70.1%) were Borrmann Ⅱ, the adenocarcinoma and signetring cell carcinoma accounted for 82.3% and 7.8%, respectively. The cancer of gastric cardia accounted for 53.0%. Stagestratified analysis revealed that the majority of gastric cancers (47.4%) were stage Ⅲ. Conclusion①A prevalence of gastric cancer is found in middle, elderly male patients. Poorly differentiated adenocarcinoma in cardia is prominent. ②Patients with high malignant ganstrie cancer are younger. ③The majority of patients who underwent the surgical treatments have advanced or metastatic tumor, therefore it is necessary to improve the early diagnosis of gastric cancer.