Objective To investigate the cause of the positive cancer cell incisal margin in gastrectomy for gastric carcinoma. Methods Thirty-two cases with positive incisal margin in gastrectomy for gastric carcinoma from 1988-1993 in this hospital were retrospectively studied. Results The overall cancer cell positive rate (CCPR) was 7.5%, and that of radical and palliative resection were 5.5% and 12.6%, respectively (Ｐ＜0.05). The CCPR of distal and proximal incisal margin were 5.9% and 13.0% respectively (Ｐ＜0.05), which was related to the gross type, size of cancer, and the degree of differentiation and infiltration. Conclusion The CCPR is high in the infiltrating type, lesions larger than 5 cm in diameter and undifferentiated cancer. To prevent the incisal margin positive for cancer cell in gastrectomy, frozen biopsy should be done if possible.
ObjectiveTo systematically review the value of mass screening of serum pepsinogen test for Asian population with high-risk gastric carcinoma. MethodsWe electronically searched databases including PubMed, EMbase, The Cochrane Library (Issue 12, 2013), CNKI, WanFang Data, VIP and CBM for diagnostic tests on serum pepsinogen test versus with pathological biopsy/X-ray examination (gold standard) between January 2004 and January 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Then meta-analysis was conducted using Meta-DiSc software (version 1.4). ResultsA total of 15 studies involving 180 934 subjects were included. ROC curve showed "shoulder-arm shape" distribution. The results of Spearman correlation analysis suggested a significance of the threshold effect (P=0.001). The results of meta-analysis showed that, the area under curve (AUC) was 0.74. ConclusionSerum pepsinogen has good value in the screening of gastric carcinoma among Asian permanent residents. Due to limited quality of studies, the above conclusion should be verified by conducting more high quality studies.
【Abstract】ObjectiveTo study the relationship between expression of CD44v6 in gastric carcinoma and neoplasm metastasis and prognosis. MethodsExpression of CD44v6 in 52 cases of gastric carcinoma was assayed by flow immunocytometry, and its relation with clinical pathology and prognosis was analyzed. ResultsIn 52 cases of gastric carcinoma tissue, the positive rate of CD44v6 expression was 67.31%(35/52); but the positive rate of CD44v6 expression in normal gastric tissue was 25.00% (13/52). The positive rate of expression was significantly different (P＜0.01). The positive rate of CD44v6 expression in gastric carcinoma tissues was related to the depth of carcinoma infiltration, lymph node metastasis and pTNM stage （P＜0.05）. ConclusionExpression of CD44v6 plays an important role in invasion, metastasis and pTNM stage of gastric carcinoma. It may be used as a new indicator to predict metastatic potential and prognosis of gastric carcinoma.
One thousand four hundred and fifty-four cases of operations for gastric carcinoma in this hospital from 1983 to 1994 are reviewed. 121 out of 1454 patients sustained 168 occurrences of early postoperative complications. The patiets involvement rate was 8.32% and the occurrence rate of complications was 11.55%. Complications could be divided into two groups, the general complication after surery (8.25%) and complication relavent to gastrointestinal reconstruction (3.30%). Most common complications were wound infection, pulmonary infection, anastomotic obstruction or leakage. The authors stress the prevention of surgical complications that would furhter improve the therapeutic result of gastric cancer.
ObjectiveTo evaluate the effect of neoadjuvant chemotherapy and find the mechanism of multidrug resistance. MethodsTwenty patients with gastric cancer and 31 patients with colorectal cancer underwent neoadjuvant chemotherapy and then operations. The preoperative specimens were stained by immunohistochemical techniques for testing p53,multidrug resistanceassociated protein (MRP), glutathione S transferase（GST）, telomerase. Resection specimens were evaluated for chemotherapy effect by routine histology; at the same time, the postoperative morbidity and mortality were observed. ResultsIn 51 patients, the response rate of neoadjuvant chemotherapy was 27.45%(14/51),so multidrug resistance was a kind of common phenomena in gastrointestinal carcinomas. The postoperative morbidity was 15.69%(8/15), the main operation complication was infection,the mortality was 1.96%(1/51),only one person died from severe infection.The expression rate of p53, MRP, GST, telomerase was 58.0%,51.0%,66.7%,74.0%respectively, the location of p53 was at cell nucleus,location of MRP,GST was at cell memberane and cytoplasm,location of telomerase was at cytoplasm.The response rate had nothing to do with age, sex and metastasis. But it was related with p53 and telomerase expression. ConclusionNeoadjuvant chemotherapy is an effective, safe therapy. But the rate of drug resistance is high in gastrointestinal carcinomas, and the response rate is related to p53, telomerase expression.
【Abstract】ObjectiveTo investigate the role of apoptosis-related gene survivin, caspase-3 and cyclin-B1 in gastric carcinoma by detecting the expressions of survivin, caspase-3 and cyclin-B1 in gastric carcinoma. Methods The expressions of survivin mRNA, caspase-3 mRNA and cyclin-B1 mRNA were determined by reverse transcription-polymerase chain reaction (RT-PCR) method in 30 gastric carcinoma specimens and 10 normal gastric tissue specimens. ResultsThe positive expression rate of survivin mRNA in 30 gastric carcinoma specimens was 66.7%(20/30). While 10 normal gastric tissue specimens did not express survivin mRNA. Although all of 30 gastric carcinoma tissues and 10 normal gastric tissues expressed caspase-3 mRNA and cyclin-B1 mRNA, the expressions of caspase-3 and cyclin-B1 in 20 survivin-positive gastric carcinoma tissues were significantly lower than those of 10 survivin-negative gastric carcinoma tissues (P＜0.01) and 10 normal gastric tissues (P＜0.01). The expressions of caspase-3 mRNA and cyclinB1 mRNA in 10 survivin-negative gastric carcinoma tissues were significantly lower than those of 10 normal gastric tissues (P＜0.01). And in gastric carcinoma tissues the expression of survivin mRNA was negatively related with that of caspase-3 mRNA （r=-0.923,P＜0.01） and cyclin-B1 mRNA (r=-0.886,P＜0.01), the expression of caspase-3 mRNA was positively related with that of cyclin-B1 mRNA (r=0.892, P＜0.01). Conclusionsurvivin enhances gastric tumorigenesis, caspase-3 and cyclin-B1 inhibit gastric tumorigenesis.
ObjectiveTo study the expression of cyclooxygenase2 (COX2) and its clinical significance in gastric carcinoma. MethodsThe expression of COX2 in 47 cases of gastric carcinoma and 16 cases of normal gastric tissue were detected by SP immunohistochemical technique. Helicobacter pylori (H.pylori) infection was diagnosed by urease experiment and Giemsa staining.ResultsThere was no positive signal of COX2 detected in normal gastric tissue. The positive expression rate of COX2 was 63.8%(30/47) in gastric carcinoma.The expression of COX2 was correlated with TNM stage, lymph node metastasis and H.pylori infection（P＜0.01）. Positive COX2 expression rate in H.pylori infection group was 72.4%(21/29), significantly higher than that in the group without H.pylori infection.Conclusion COX2 expression is involved in the carcinogenesis and malignant progression of gastric carcinoma.The examination of COX2 may be helpful to judge biological behavior of gastric carcinoma.
Objective To investigate the expression of syndecan-1 protein in gastric carcinoma and normal gastric mucosa tissues, and find out the correlation between the expression of syndecan-1 protein and the clinicopathologic characteristics of gastric carcinoma. Methods The expression of syndecan-1 protein was detected by immunohistochemistry (ABC) in 60 cases of gastric carcinoma, including gastric carcinoma tissues and normal gastric mucosa tissues. Results Syndecan-1 protein expressed in all of the 60 normal gastric mucosa tissues, however, only 10 of 60 gastric carcinoma tissues (16.67%) showed positive expression. The positive rate of syndecan-1 expression in normal gastric mucosa tissues was higher than that in gastric carcinoma tissues, and this difference was statistically significant (χ2=65.88, P＜0.05). The expression level of syndecan-1 protein in gastric carcinoma tissues with lymph node metastasis was lower than that without lymph node metastasis, and this difference was also statistically significant (χ2 =18.62, P＜0.05). In addition, syndecan-1 expression was not correlated with patients’ age and position of tumor (Pgt;0.05), but correlated with the diameter， invasion depth and TNM stage of tumor (Plt;0.05). Conclusion The positive expression of syndecan-1 protein is low in gastric carcinoma tissue and has b correlation with tumor stage and lymph node metastasis.
Objective To study the expression and its significance of cyclin D1,cyclin E and p27 protein in gastric carcinoma. Methods The expression of cyclin D1,cyclin E and p27 protein in 60 cases of gastric carcinoma were detected by immunostaining method. Results The positive rates of cyclin D1,cyclin E and p27 protein expression in gastric carcinoma were 41.7%（25/60）,38.3%（23/60）and 36.7%（22/60）,respectively.The expression of cyclin D1 was significantly correlated with Lauren type of tumor,the expression of cyclin E was significantly correlated with tumor differentiation,infiltration and stage,while the expression of p27 protein was significantly correlated with tumor infiltration,lymph nodes metastasis and stage. Further more, the expression of cyclin E was inversely correlated with the expression of p27. Conclusion Detection of cyclin D1,cyclin E and p27 expression in gastric carcinoma may be helpful in determining tumor progression.
Objective To evaluate the legitimate of regional artery infusion chemotherapy in the treatment of gastric carcinoma. MethodsThe pharmacokinetics of 5-Fu after different route of administration was studied. Results High concentration of 5-Fu found in portal vein via left-gastric intra-artetial administration were 4-40 folds higher than the group via intravenous administration.The time of high concentrations of 5-Fu via left-gastric intra-arterial administration maintained significantly longer than by intravenous administraion. The concentration of 5-Fu in tumor tissues and paratumorous lymph tissues by intra-arterial administration were 19 times and 23 times of the group by intravenous administration. Conclusion Regional arterial infusion chemotherapy can significantly increase the concentration of chemotherapeutic drugs in the tumorous region.