摘要:目的: 探讨PCNA,VEGF在胃癌组织中的表达关系及其意义。 方法 :免疫组织化学法检测正常胃和胃癌组织中PCNA和VEGF的表达,并分析其与胃癌临床病理特征的相关性。 结果 :胃癌组织中PCNA、VEGF的阳性表达率分别为850%、683%,二者在正常胃组织中均为隐性表达。PCNA的表达与肿瘤分期、淋巴结转移有关(〖WTBX〗P lt;005),而与年龄、性别、肿瘤大小、组织分化程度无关(〖WTBX〗P gt;005);PCNA的表达与肿瘤分期、淋巴结转移有关(〖WTBX〗P lt;005),而与年龄、性别、肿瘤大小、组织分化程度无关(〖WTBX〗P gt;005)。PCNA和VEGF在胃癌中的表达呈正相关。 结论 :PCNA和VEGF在胃癌组织中的高表达促进了胃癌的发生发展。Abstract: Objective: To study the significance and relationship of expression of proliferating cell nuclear antigen(PCNA) and vascular endothelial growth factor (VEGF) in gastric cancer. Methods : The expression of VEGF and PCNA in normal gastric tissues and gastric cancer tissues were detected by immunohistochemistry (SP),and clinic pathological correlation with gastric cancer was analyzed. Results : The positive exression rates of PCNA and VEGF in gastric cancer were 850%、683%, respectively, while negative expression was shown in normal gastric tissues. It was found that the expressions of PCNA and VEGF were both in significant relation to TNM stages and lymph node metastasis (P lt;005), but in no relation to age, gender, diameter of tumor and tumor cell differentiation (P gt;005). The expressions of PCNA and VEGF were positively correlated with each other. Conclusion : It was indicated that the highlevel expressions of PCNA and VEGF might corporately accelerate the progression of gastric cancer.
Objective To investigate the role of vascular endothelial growth factor-C (VEGF-C) and its receptors in the formation of lymphatic vessels and lymphatic metastasis in gastric cancer. Methods By the domestic and overseas literatures review, the expressions of VEGF-C and its receptors in gastric cancer, their role in tumor lymphatic metastasis and prospect in treatment of gastric cancer were summarized.Results There was a significant correlation between VEGF-C and its receptors and the formation of lymphatic vessels and lymphatic metastasis in gastric cancer. VEGF-C high expression might be an early event in lymphatic metastasis and could be considered as an independent predictive factor of lymphaticmicrometastasis. By inhibition of gastric cancer cell from secrete VEGF-C or blockage of the interaction of VEGF-C with VEGFR3, it was possible to inhibit tumor angiogenesis and the invasion and distant spread of cancer cells, thereby decreased mortality and improve survival. ConclusionVEGF-C and its receptors may promote the formation of lymphatic vessels and lymphatic metastasis in gastric cancer. It may be an effective way to gastric cancer for the treatments against VEGF-C and its receptors.
ObjectiveTo summarise the application research progress of clinical prediction models in postoperative complications of gastric cancer, in order to reduce the risk of complications after gastric cancer surgery. MethodThe literature on the study of postoperative complications of gastric cancer at home and abroad was read and reviewed. ResultsAt present, the main way of treating gastric cancer was still radical resection, and the occurrence of complications after surgical treatment seriously affected the recovery and survival quality of patients. With the deepening of research, the prediction models of postoperative complications in gastric cancer were constantly constructed, and these models provided strong evidence for the early judgement of postoperative complications in gastric cancer, and provided a scientific basis for the improvement of patients’ life quality. ConclusionClinical predictive models are expected to become risk screening tools for predicting the risk of postoperative complications of gastric cancer with clinical utility.
Objective To compare the effect of laparoscopic surgery and open surgery on the blood coagulation state in patients with gastric cancer, and to provide evidence for the prevention measurement of thrombosis in perioperative period. Methods One hundred patients with gastric cancer who received treatment in our hospital from Feb. 2014 to Aug. 2014, were randomly divided into laparoscopy group and laparotomy group, 50 patients in each group. The patients in laparotomy group were treated by traditionally open surgery, while patients in the laparoscopy group accepted laparoscopic surgery. The clinically therapeutic effect of 2 groups was compared. Results ① Operative indexes. The operation time, blood loss, anal exhaust time, hospital stay, and morbidity of laparoscopy group were all lower than those of laparotomy group (P<0.05). ② Coagulation function. Compared with preoperative indexes, the prothrombin time (PT) at 24 h after operation in laparoscopy group and laparotomy group were both shorter (P<0.05), but there was no significant difference in activated partial thromboplastin time (APTT) and international normalized ratio (INR) between the 2 time points (before operation and 24 h after operation) in both 2 groups (P>0.05). Both at 2 time points (before operation and 24 h after operation), there was no significant difference in PT, APTT, and INR between 2 groups (P>0.05). ③ Fibrinolysis indexes. Compared with preoperative indexes, the fibrinogen (FIB) and D-dimer at 24 h after operation in laparoscopy group and laparotomy group were higher (P<0.05). The FIB and D-dimer at 24 h after operation in laparoscopy group were both higher than those of laparotomy group (P<0.05). ④ Follow-up results. There was no significant difference in metastasis rate, recurrence rate, and mortality between the 2 groups (P>0.05), but the incidence of thrombus was higher in laparoscopy group than that of laparotomy group (P<0.05). Conclusions In the treatment of patients with gastric cancer, laparoscopic surgery has the advantages of less trauma, less blood loss, less complications, and so on. Laparoscopic surgery and open surgery both can lead to hypercoagulable state, but the effect of laparoscopic surgery is stronger than open surgery.
ObjectiveTo investigate the completion of early ambulation in patients with gastric cancer under the enhanced recovery after surgery (ERAS) management mode in the West China Hospital of Sichuan University, and analyze the influencing factors. MethodsFrom November 1, 2021 to March 31, 2022, the patients with gastric cancer who met the inclusion criteria of this study in the West China Hospital of Sichuan University were selected as the survey objects. At 48 h after the operation, the patients were enquired at the bedside and the electronic medical records were accessed to collect the general information, diseases information, etc. of the patients. The postoperative data were also investigated, and the time of early ambulation was investigated, and the influencing factors were analyzed by logistic regression. ResultsAccording to the inclusion and exclusion criteria of this study and the sample size requirements, 140 eligible patients with gastric cancer were investigated, 34 of whom got out of bed early, and the rate of early ambulation was 24.3%. The results of binary logistic regression analysis showed that indwelling urinary catheter within 48 h after operation [OR=10.031, 95%CI（1.037, 97.061）, P=0.046] and American Society of Anaesthesiologists (ASA) grade Ⅲ [OR=4.209, 95%CI（1.792, 9.886）, P=0.001] decreased the probability of early ambulation after operation in patients with gastric cancer. ConclusionsFrom the results of this survey, the completion rate of early ambulation in patients with gastric cancer under ERAS mode is lower, which may be improved by reducing the placement of the urinary catheter or shortening the indwelling time of the urinary catheter. For patients with ASA grade Ⅲ having functional decline before surgery, doctor or nurse needs to evaluate their mobility after surgery and help them to finish early ambulation or exercise on hospital bed within their tolerances.
Objective To investigate the safe distance of upper gastric cancer by pokemon protein. Methods In 60 cases of upper gastric cancer， specimens were get from tumors’ tissue and every 0.5 cm from the proximal of tumor margin beginning at the 1.0 cm to distal. Western blot method was used to test the expression of pokemon protein. Results There were 38 cases （63.3%） positively expressed pokemon protein. Compared with the center of tumor， the positive expression rates of pokemon protein at every sites of 2.5-5.0 cm from margin were lower （P＜0.003）， but didn’t signi-ficantly differed at every sites of 1.0-2.0 cm from margin （P≥0.003）. When the incisal margin distance of more than 3.5 cm of both sides， the positive expression rate of pokemon protein were 0. There were no significant difference between the corresponding sites of the upper resection margin and lower resection margin （P＞0.05）. Conclusions The results show that 3.5 cm may be the molecular margin basing on the positive expression of pokemon protein in the surgical margin of upper gastric cancer， which may have guiding significance to the surgical margin.
Objective To study effect of carcinoembryonic antigen (CEA) positive targeted lymphocytes on gastric cancer cells in vitro and in vivo. Methods The peripheral blood mononuclear cells (PBMCs) were isolated from the peripheral blood of healthy volunteers. The recombinant vector anti-CEA-scFv-CD3ζ-pcDNA3.0 was transfected into the PBMCs by lipofectamine 2000, by this means, the CEA special lymphocytes were obtained. Meanwhile, the PBMCs transfected with empty plasmid pcDNA3.0 were used as control (empty vector lymphocytes). The different lymphocytes and gastric cancer cells (CEA positive KATOⅢ gastric cancer cells and CEA negative BGC-823 gastric cancer cells) were co-cultured, then the ability to identify the gastric cancer cells and it’s effect on apoptosis of gastric cancer cells were observed at 24 h or 36 h later respectively. The CEA special lymphocytes and empty vector lymphocytes were injected by the tail vein of nude mice bearing gastric cancer cells, then it’s effect on the tumor was observed. Results ① The CEA special lymphocytes could strongly identify the KATOⅢ gastric cancer cells (identification rate was 72.3%), which could weakly identify the BGC-823 gastric cancer cells (identification rate was 7.8%). ② The apoptosis rate of the co-culture of CEA special lymphocytes and KATOⅢ gastric cancer cells was significantly higher than that of the co-culture of empty vector lymphocytes and KATOⅢ gastric cancer cells (P=0.032), which had no significant difference between the co-culture of CEA special lymphocytes and BGC-823 gastric cancer cells and the co-culture of empty vector lymphocytes and BGC-823 gastric cancer cells (P=0.118). ③ The tumor volume of the co-culture of CEA special lymphocytes and KATOⅢ gastric cancer cells was significantly smaller than that of the co-culture of empty vector lymphocytes and KATOⅢ gastric cancer cells (F=5.010, P<0.01) or the co-culture of CEA special lymphocytes and BGC-823 gastric cancer cells (F=4.982, P<0.01), which had no significant difference between the co-culture of CEA special lymphocytes and BGC-823 gastric cancer cells and the co-culture of empty vector lymphocytes and BGC-823 gastric cancer cells (F=1.210, P>0.05). Conclusion CEA special lymphocytes can promote cell apoptosis and inhabit tumor reproduction of CEA positive gastric cancer cells in vitro and in vivo.
ObjectiveTo investigate the expression level of long non-coding RNA Down’s syndrome critical region 8 (LncRNA DSCR8) in gastric cancer and its clinical significance.MethodsEighty-six patients with gastric cancer who were hospitalized in our hospital from August 2014 to August 2015 were selected as the research object. Real-time quantitative PCR (qRT-PCR) was used to detect the expression level of LncRNA DSCR8 mRNA in gastric cancer tissues and its adjacent tissues. The relationship between the expression level of LncRNA DSCR8 mRNA and clinicopathological features of gastric cancer was analyzed. Kaplan-Meier method was used to analyze the relationship between the expression of LncRNA DSCR8 mRNA and the survival rate of patients, and multivariate Cox proportional hazards regression analysis was used to analyze the prognostic factors of gastric cancer.ResultsThe expression level of LncRNA DSCR8 mRNA in gastric cancer tissues was higher than that in the paracancerous tissues (P<0.001). The expression levels of LncRNA DSCR8 mRNA in patients with poorly differentiated, TNM Ⅲ–Ⅳ and lymph node metastasis were higher than those in patients with well/moderately differentiated, TNM Ⅰ–Ⅱ and no lymph node metastasis (P<0.05). The 1, 3 and 5-year survival rate of patients with low LncRNA DSCR8 mRNA expression (97.62%, 92.86%, 83.33%, respectively) were higher than those of patients with high LncRNA DSCR8 mRNA expression (63.64%, 38.64%, 31.82%, respectively), P<0.05. LncRNA DSCR8 mRNA and TNM stage were independent risk factors of death in patients with gastric cancer (P<0.05).ConclusionsLncRNA DSCR8 is associated with the occurrence, development and prognosis of gastric cancer. It may be an important molecular marker of tumor stage and lymph node metastasis in patients with gastric cancer.
Gastric cancer is common as one kind of digestive tract malignant tumor, and Helicobacter pylori (Hp) infection is the most important cause of gastric cancer. With the wide application of quadruple therapy, the incidence of Hp-related gastric cancer has been significantly decreased. In addition to the involvement of gastric microbes in the regulation of normal gastric physiological function, the imbalance of gastric microbes is also involved in the pathogenesis of gastritis and gastric cancer. The imbalance of gastric microbes also plays an important role in the development of gastric cancer after eradication of Hp, and the mechanism has also been preliminary studied. Based on this, this article reviews the research progress of gastric microbes in gastric cancer, in order to further understand the pathogenic mechanism of gastric cancer and provide reference for seeking safer and more effective treatment for gastric cancer.
Pathological images of gastric cancer serve as the gold standard for diagnosing this malignancy. However, the recurrence prediction task often encounters challenges such as insignificant morphological features of the lesions, insufficient fusion of multi-resolution features, and inability to leverage contextual information effectively. To address these issues, a three-stage recurrence prediction method based on pathological images of gastric cancer is proposed. In the first stage, the self-supervised learning framework SimCLR was adopted to train low-resolution patch images, aiming to diminish the interdependence among diverse tissue images and yield decoupled enhanced features. In the second stage, the obtained low-resolution enhanced features were fused with the corresponding high-resolution unenhanced features to achieve feature complementation across multiple resolutions. In the third stage, to address the position encoding difficulty caused by the large difference in the number of patch images, we performed position encoding based on multi-scale local neighborhoods and employed self-attention mechanism to obtain features with contextual information. The resulting contextual features were further combined with the local features extracted by the convolutional neural network. The evaluation results on clinically collected data showed that, compared with the best performance of traditional methods, the proposed network provided the best accuracy and area under curve (AUC), which were improved by 7.63% and 4.51%, respectively. These results have effectively validated the usefulness of this method in predicting gastric cancer recurrence.