Objective To detect the expression of thromhospondin-1 （TSP-1） in gastric cancer and metastaticlymph node tissues， and to study its relationship of TSP-1 to clinicopathologic parameters or tumor angiogenesis. Methods The TSP-1 and vascular endothelial growth factor （VEGF） expressions and microvessel density （MVD） were evaluated by immunohistochemistry in 72 specimens obtained by gastric resection from patients with gastric cancer， including corres-ponding adjacent normal gastric mucosa tissues （distant from cancer ≥5 cm） and lymph nodes surrounding cancer. A semiquantitative scoring system was used for evaluating the staining. The relationship of TSP-1 to VEGF expression， MVD， or clinicopathologic parameters was analyzed. Results ① TSP-1 positive expression rate was 45.8% （33/72） in the primary gastric cancer tissues， 90.3% （65/72） in the corresponding adjacent normal gastric mucosa tissues， and 50.8% （30/59） in the metastatic lymph nodes tissues. The expressions of TSP-1 in the primary gastric cancer tissues and metastatic lymph nodes tissues were significantly lower than those in the adjacent normal gastric mucosa tissues （χ2=32.710，P=0.000；χ2=25.298， P=0.000）. The expression of TSP-1 had no statistical significance in the primary gastric cancer tissues as compared with in the metastatic lymph nodes tissues （χ2=0.327， P=0.568）. ② The expression of TSP-1 in the metastatic lymph nodes tissues was significantly lower than that in the non-metastatic lymph nodes tissues （Z=-2.573， P=0.010）. ③The expression of TSP-1 in the primary gastric cancer tissues and metastatic lymph nodes tissues suggested a negative correlation with VEGF （rs=-0.309， P=0.008；rs=-0.269， P=0.040） and MVD （rs=-0.348， P=0.003；rs=-0.272， P=0.037）. Conclusions TSP-1 expression is down-regulated and has a negative correlation with VEGF and MVD in the primary gastric cancer and the metastatic lymph nodes tissues. According to the present results， it seems likely that TSP-1 is a tumor angiogenesis inhibitor.
Objective To investigate the effect and surgical skill of ultracision harmonic scalpel in curative gastrectomy for patients with gastric carcinoma. Methods From January 2007 to May 2008, the data of 152 patients who were treated by curative gastrectomy with ultracision harmonic scalpel were analyzed retrospectively. Results The mean operative time was (189.5±24.2) min. Compared with the conventional operation, the number of harvested lymph nodes (mean: 30.4±11.6) in patients treated with ultracision harmonic scalpel was increased. The application of ultracision harmonic scalpel could shorten the operation time, decrease the intraoperative blood loss and make the operation field clear. There were no postoperative complications, such as anastomotic leakage, lymphatic leakage and massive hemorrhage. And there was no death in this series. Conclusion The usage of ultracision harmonic scalpel which could improve the curative degree of lymphadenectomy is safe in curative gastrectomy for patients with gastric carcinoma.
Objective To investigate the expression of suppressor gene Runt-related transcription factor 3 (Runx3) in gastric carcinoma and its relationship with clinicopathologic parameters. Methods RT-PCR and Western blot were used to determine the mRNA expression and protein expression of Runx3 gene in primary tumor and corresponding normal tissues respectively in 52 patients with gastric carcinoma. The relationship between Runx3 expression and clinicopathologic parameters was analyzed. Results RT-PCR and Western blot analysis in 52 patients with gastric carcinoma showed down-regulation of Runx3 mRNA and Runx3 protein in 59.6% (31/52) and 48.1% （25/52） of the primary tumors tested, and in none of the normal tissues (P＜0.05) respectively. There was a significant negative correlation between the expression level of Runx3 gene and the clinicopathologic parameters such as tumor size, differentiation, infiltrative depth, lymph node metastasis and TNM stage (P＜0.05， P＜0.01). Runx3 gene transcription was coincident with its protein expression (r=0.840, P＜0.01）. Conclusion The expression of Runx3 gene is down-regulated in gastric carcinoma, which suggests that Runx3 gene plays an important role in carcinogenesis and the progression of gastric carcinoma. It may be a new target of diagnosis and treatment of gastric carcinoma.
Objective To investigate the expression of growth hormone receptor (GHR) in human gastric cancer tissue. Methods The GHR was detected in samples of the human gastric cancer (57 cases) and the distal normal tissues (57 cases) by immunohistochemistry technique. Results The GHR expression positive rate was 80.7%(46/57) in the human gastric cancer tissues and 70.2%(40/57) in the distal normal tissues. There was no statistic difference between the human gastric cancer tissues and the distal normal tissues (Pgt;0.05). There were also no statistic differences among the gastric cancer tissues of different differentiation, different tissue type, different gender and different age ranges (Pgt;0.05). Conclusion It is similar that the expression of GHR between the human gastric cancer tissues and the distal normal tissues.
目的探讨胃癌穿孔的手术时机及术式选择。方法对我院1985年1月至2000年12月间急诊收治的64例胃癌穿孔患者的资料进行回顾性分析。结果保守治疗后行择期手术5例； 59例行急诊手术，其中行根治性切除术22例，姑息性切除术10例，穿孔修补后3周内二期行根治性手术6例，行单纯穿孔修补术14例，穿孔修补+短路手术7例。本组手术后30天内死亡6例，死亡率为9.4%，58例中获随访52例，随访5年，失访6例，其中根治性手术、姑息性切除、单纯穿孔修补和穿孔修补+短路手术者平均生存期分别为31个月、18个月、5个月和7个月。结论合理的手术时机及术式选择是延长患者生命和提高患者生存质量的关键所在。
Objective To summarize the current value of neoadjuvant chemotherapy (NAC) for potentially resectable gastric cancer. Methods The recent 5-year literatures searched through the PubMed with the key words: stomach neoplasm, gastric cancer/carcinoma, neoadjuvant therapy/chemotherapy and preoperative therapy/chemotherapy as well as the relevant reports presented in the ASCO Annual Meeting in 2007 and 2008 were analyzed. The present status of NAC for advanced gastric cancer was summarized, the necessity and feasibility were evaluated, and the patients features for selecting, the predictors for response, the mainly existing problems and development trend of NAC were analyzed. Results At present, there were 7 randomized control trails (RCT) published, and among them 3 were phase Ⅲ. It was safe, effective and feasible to most of trails in NAC for gastric cancer. However, it was still little to obtain survival benefit for NAC RCT, and short of randomized trial comparing strict preoperative chemotherapy to surgery alone or perioperative chemotherapy to surgery plus adjuvant chemotherapy. It remained lots of problems such as how to select the appropriate patients, the effective induced regimes and the predicted factors, the evaluated indices for response. Conclusion NAC is a safe, feasible and efficient method to potentially resectable gastric cancer, but strict phase Ⅲ randomized trials are needed. In the future, substantial improvements of treatment outcome will likely depend on the novel drugs and molecular biological targeted therapies.