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.
ObjectiveTo investigate the levels of regulatory T cells (Treg) and FoxP3 gene in patients with gastric cancer before and after operation. MethodsTwenty patients with definite diagnosis of gastric cancer and 15 healthy volunteers were selected. The levels of Treg and T cell subsets in peripheral blood were determined by detecting of CD4 and CD25 with immunefluorescence stain and flow cytometry, the expressions of FoxP3 mRNA in these Treg were detected by RTPCR technique. The expression of FoxP3 protein in the gastric cancer tissue was measured by immunohistochemistry assay. ResultsThe percentage of Treg cells in total CD4+ T isolated from the patients with gastric cancer was higher than that of healthy volunteers 〔(19.39±5.58)% versus (9.91±3.23)%, Plt;0.01〕, and it markedly decreased after operation 〔（13.50±5.93）% versus (19.39±5.58)%, Plt;0.05〕. The FoxP3 mRNA expression in the patients with gastric cancer was also higher than that of healthy volunteers (0.86±0.03 versus 0.64±0.02, Plt;0.01), and decreased after operation (0.73±0.04 versus 0.86±0.03, Plt;0.05). The percentage of CD4+T cell in mononucleocytes of peripheral blood of patients with gastric cancer was significantly lower than that of healthy volunteers (Plt;0.01), but the difference was not significant between before and after operation. FoxP3 protein expressed in cytoplasm of 13 patients with gastric cancer, in which bly positive in 2 cases, middle positive in 6 cases, weakly positive in 5 cases. FoxP3 protein didn’t express in cytoplasm of 7 patients with gastric cancer. ConclusionsTreg may have a significant effect on the onset and development of gastric cancer through immunosuppressive effect. Tumor tissue is an important initiating agent on Treg proliferation.
The effects of preoperative selective arterial perfusion chemotherapy (PSAPC) in the treatment of 20 cases of histologically confirmed gastric cancers is reported in which 12 patients were operated on, and a comparison with that of general chemotherapy in 10 cases of gastric cancers (as controls) was made. In the PSAPC group, besides the improvement of clinical symptoms and singns, the cancer cells of lesions in situ and metastatic lymph nodes have different degrees of degeneration and necrosis. This result show significant differences in two group comparison (Plt;O.01). We conclude that the PSAPC has good short-term effect and little side-effect. It can improve the resection rate and radical resection rate, and prevent the iatrogenic metastasis and implantation during operation, and decrease the postoperative recurrence of the patients with gastric cancer.
ObjectiveTo analyze short-term outcomes of hand assisted laparoscopic (HAL) D2 radical distal gastrectomy for gastric cancer and summarize clinical experiences. MethodsThe clinical data of 199 patients with gastric cancer undergoing D2 radical distal gastrectomy from December 2010 to December 2013 in this hospital were analyzed. HAL (HAL group, n=92) and traditonal open (TO group, n=107) D2 radical distal gastrectomy were performed. The operation time, incision length, intraoperative blood loss, number of lymph nodes harvested, postoperative hospital stay, and postoperative complications were compared between these two groups. ResultsThere was no residue of cancer cells at the surgical margin in the HAL group and the TO group. Compared with the TO group, the average incision length was obviously shorter (P < 0.01) and the average intraoperative blood loss was obviously less (P < 0.05) in the HAL group. The average operation time, the average number of lymph nodes harvested, and the average postoperative hospital stay had no significant differences between the HAL group and the TO group (P > 0.05). One case was died of unknown gastrointestinal bleeding in the HAL group and the TO group, respectively. The postoperative complication rate was 9.78% (9/92) in the HAL group and 11.21% (12/107) in the TO group, there was no significant difference (P > 0.05). ConclusionsHAL D2 radical distal gastrectomy for gastric cancer don't increase operation time. It has some advantages of minimal invasion and safety as compared with traditional open surgery.
Objective To investigate the expression of tumor suppressor gene Lumican mRNA in gastric cancer and its role in the development of gastric cancer. Methods The expressions of Lumican mRNA in gastric cancer tissues, tissues near tumor and normal tissues were detected by using reverse transcription polymerase chain reaction (RT-PCR), clinical pathology for those tissues was studied as well. Results The expression absence rates of Lumican mRNA were 42.4% (28/66), 15.2% (10/66) and 0 in gastric cancer tissues, tissues near tumor and normal tissues respectively. The expression absence rate of Lumican mRNA in patients with lymph node metastasis was 61.1%, which was significantly higher than that of the patients without lymph node metastasis (20.0%, χ2=11.323, P=0.001). The expression absence rate of Lumican mRNA in the gastric cancer at the advanced stages (stages Ⅲ, Ⅳ) was 61.5%, which was significantly higher than that in the gastric cancer at the early stages (stages Ⅰ, Ⅱ, 30.0%, χ2=6.417， P=0.011). The expression absence rates of Lumican mRNA in the high, moderate and poor differentiation tumors were 38.5% (10/26), 38.5% (10/26) and 57.1% (8/14) respectively, the expression absence rate of Lumican mRNA was no significant association with the differentiation degree (χ2=1.576, P=0.455). Conclusion The expression absence of tumor suppressor gene Lumican mRNA may play an important role in the tumorgenesis and influences the prognosis of gastric cancer.
Non-coding RNA (ncRNA) is a newly discovered functional RNA different from messenger RNA, which can participate in the regulation of tumor occurrence and development. Studies have shown that ncRNA can participate in the regulation of radiotherapy response to gastric cancer, and its mechanism may be related to its influence on DNA damage repair, gastric cancer cell stemness, apoptosis, and activation of epidermal growth factor receptor signal pathway. This article summarizes the mechanism of ncRNA regulating the response of gastric cancer to radiotherapy, and looks forward to the potential clinical application of ncRNA in the resistance of gastric cancer to radiotherapy.
【Abstract】Objective To investigate the expression of PCNA in gastric cancer and its relationship with telomerase activity of peritoneal washings and peritoneal dissemination, and to compare the efficacy of telomerase activity and cytology of peritoneal washings for prediction of peritoneal metastasis of gastric cancer. MethodsTelomeric repeated amplification protocol (TRAP)enzymelinked immunosorbent assay (ELISA) was performed to measure the telomerase activity of peritoneal washings collected from 60 patients with gastric cancer. Exfoliate cytologic analysis of the corresponding samples was used for comparison.Expression of PCNA was measured with immunohistochemical staining.Their relationship with clinicopathologic features were evaluated. ResultsThe positive rate of telomerase activity in peritoneal washing collected from patients with gastric cancer was 41.7%,which well related to serosal invasion, histology types, depth of infiltration and peritoneal metastasis of gastric cancer. The positive rate of telomerase activity increased with the increased depth of infiltration and serosal involvement areas (P＜0.05).The positive rate of exfoliative cytology was 25.0%, which was obviously high in the group with macroscopic peritoneal metastasis (the group of P1-3). The positive rate of exfoliative cytology also increased with the increased depth of infiltration and serosal involvement areas (P＜0.05). Although the positive rate of telomerase activity in peritoneal washing collected from patients with gastric cancer was not significantly higher than that of exfoliative cytology in general, it was significantly higher than that of exfoliative cytology in the group of pT4, P1-3 and undifferentiated type.The PCNA proliferation index (PI) of positive telomerase activity group was significantly higher than that of negative. The PCNA PI was significantly higher in the group of P1-3 and serosal invasion thanthat of P0 and without serosal invasion. ConclusionTo detect telomerase activity in peritoneal washings and to detect tumor cells by cytologic method are useful to predict subclinical metastasis to the peritoneum in patients with gastric cancer,but telomerase activity is more sensitive than the other one.Telomerase activity is well related to proliferating activity of gastric cancer,which was the very important reason of peritoneal metastasis and serosal invasion.
ObjectiveTo investigate the expressions of contactin-1 (CNTN-1), vascular endothelial growth factor-C (VEGF-C), and its receptor VEGFR-3 (Flt-4) in primary gastric cancer and to explore the relevance among them and their correlation with clinicopathologic features of gastric cancer. MethodsThe VEGF-C, VEGFR-3, and CNTN-1 protein expressions of tumor tissues and normal gastric mucosa tissues in 68 patients with primary gastric cancer were analyzed by immunohistochemistry. The Flt-4-positive vessel density (FVD) and lymphatic vessel density (LVD) were also analyzed by VEGFR-3positive and D2-40-positive staining, respectively. ResultsThe positivity rate of VEGF-C, VEGFR-3, and CNTN-1 protein expression in the primary tumor was 57.4% (39/68), 60.3% (41/68), and 55.9% (38/68), respectively, which was significantly higher than that in the normal gastric mucosa tissues 〔20.6% (14/68), 23.5% (16/68), and 16.2% (11/68)〕， P=0.000. The expressions of VEGF-C, VEGFR-3, and CNTN-1 protein were significantly correlated with TNM stage, lymphatic vessel invasion, and lymph node metastasis (Plt;0.05). The expression of CNTN-1 protein was significantly correlated with VEGF-C (r=0.372, P=0.002) and VEGFR-3 protein expression (r=0.308, P=0.011). In tumor tissues of sixtyeight patients the FVD was (10.41±9.38)/HP, which was significantly lower than LVD 〔(18.19±7.44)/HP〕, P=0.000. Elevated FVD and LVD was significantly found in patients with tumor characterized by later TNM stage, severer lymphatic vessel invasion, and severer lymph node metastasis (Plt;0.05). The FVD of tumor was significantly correlated with VEGF-C (P=0.029) and CNTN-1 protein expression (P=0.003). The LVD of tumor was not significantly correlated with CNTN-1 (P=0.727), VEGF-C (P=0.173), and VEGFR-3 protein expression (P=0.924). The patients with positive expression of VEGF-C, VEGFR-3, and CNTN-1 protein showed poorer prognosis (Plt;0.05). ConclusionsElevated expression of CNTN-1 protein is observed in primary gastric cancer and correlated with VEGF-C and VEGFR-3 protein expression, indicating that combined detection has great value in prediction of invasive potential and prognosis. VEGF-C-mediated CNTN-1 overexpression may promote lymphatic invasion via lymphangiogenesis pathway in patients with gastric cancer.
Objective To introduce telomeres, telomerase and their expression in gastric carcinoma.MethodsThe related literatures were collected and reviewed.Rsults In summary, telomerase activity could be detected in 85%-90% of gastric cancer. Moreover, the patient with telomerase-positive tumors showed poorer prognosis than those with telomerase-negative tumours, indicating that telomerase-positive gastric cancer might have more malignant potential. ConclusionKnowledge of telomerase activity in gastric cancer may be useful in cancer diagnosis, as well as a prognostic indicator of clinical outcome. Future development of drugs aimed at telomerase inhibition may potentially provide a therapy with relatively less side effects.
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.