Objective To understand role of chemokines and their receptors in pathogenesis, progression, and metastasis of gastric cancer, and to provide a better approach for diagnosis and treatment of gastric cancer. Method The literatures about the relationship between chemokines and their receptors and gastric cancer were reviewed. Results There were about 50 various chemokines and their receptors abnormally expressed in the tumor microenvironment. The main types related gastric cancer were the CXC, CC and CX3C chemokines and their receptors, which could promote the proliferation, invasion, and metastasis of the gastric cancer through several pathways like mTOR pathway, JAK2-STAT3 pathway, etc.. Conclusions Chemokines and their receptors play an important role in occurrence and development of gastric cancer. Further studies on chemokines and their receptors will not only assist in early diagnosis of gastric cancer, as well as estimation of clinical prognosis, but also provide an intervention target for gastric cancer.
ObjectiveTo evaluate the therapeutic effect and adverse reaction of paclitaxel liposome combined with continuous infusion of large-dose 5-fluorouracil(5-fu) in treatment for advance gastric cancer(AGC). MethodsFrom May 2009 to August 2012, 63 consecutive patients with AGC in this hospital were enrolled in this study. All the patients were given chemotherapy including paclitaxel liposome and continuous infusion of large-dose(2.5 g/m2) 5-fu. The efficacy and toxicity of this regimen were observed. ResultsThere was no patient who could not tolerate adverse reaction related to such regimen. Five cases achieved complete response and 31 cases achieved partial response, the overall response rate was 57.1%(36/63). Hematologic toxicity included gradeⅢ/Ⅳleucopenia 8 cases(12.7%) and neutropenia 10 cases(15.9%), while there was no occurrence of gradeⅢ/Ⅳanemia or thrombopenia. Non-hematologic toxicity was fairly mild. ConclusionsPaclitaxel liposome is safe, well tolerated, highly targeted, and has long duration of effect. Paclitaxel liposome combined with continuous infusion of large-dose 5-fu is safe and effective in treatment for patients with AGC.
摘要:目的：观察复方苦参注射液配合化疗治疗晚期胃癌的临床疗效。方法：将60例晚期胃癌患者分为两组,两组均采用FOLFOX方案化疗,21天为1个周期；2个周期评价效疗。治疗组30例加用复方苦参注射液治疗,14天为1疗程,2个疗程评价疗效。观察近期疗效及临床证候变化、生存质量及毒副反应变化。结果:两组近期疗效比较,治疗组与对照组总缓解率分别为433%和400%（P＞005）；两组临床证候变化比较,治疗组与对照组总改善率分别为800%和600%（P＜005）；两组生存质量变化比较,治疗组与对照组提高稳定率分别为867%和567%（P＜005）；中位生存期分别为8个月和5个月；两组毒副反应比较,治疗组毒副反应明显低于对照组（P＜005）。结论:复方苦参注射液配合化疗治疗晚期胃癌具有一定抗肿瘤作用,能缓解疼痛症状及临床症状,减轻化疗毒副反应,提高生活质量,延长生存期。Abstract: Objective: To study the effect of combination FuFang Ku Shen Zhusheye and chemotherapy for treatment of advanced gastric cancer. Methods: Sixty patientswith advanced gastric cancer were divided into two groups, all used with FOLFOXregimen, 21 days a cycle; twocycle assessment of treatment effect. The treatment group were treated with the FuFang Ku Shen Zhusheye plus treatment, a course of treatment for 14 days, the effect were evaluated after two courses. The clinical symptoms and living quality, toxicity were dynamically observed. Results: Both shortterm effect of comparison, the overall response rates of the treatment group and the control group were 433% and 400% (P＞005); The rates of clinical symptoms of the treatment group and the controlgroup were 800% and 600% respectively (P＜005); the rates of increasing of living quality were respectively 867% and 567% (P＜005); the median survival time was 8 months and 5 months; the toxicity of the treatment group was significantly lower than that of the control group (P ＜005).Conclusion: Treating advanced gastric cancer by use of FuFang Ku Shen Zhusheye combination with chemotherapy is helpful to reducing the pain symptoms, promoting the clinical symptoms, reducing the chemotherapy side effects, improving quality of life and prolonging the survival time.
ObjectiveTo analyze the expression of Hsa-miR-29c in gastric cancer and its mechanism of action, and to explore its relationship with clinicopathological characteristics and prognosis of gastric cancer patients.MethodsTheoverexpression of Hsa-miR-29c in gastric cancer cell lines of MKN28 and MKN45 were established by lentivirus transfection (transfection group), and the control group of empty lentivirus (negative control group) was established. The expressions of Hsa-miR-29c in cells of the two groups after transfection were detected by real time polymerase chain reaction (qRT-PCR), and the proliferation and clonogenesis of cells in the two groups were detected by CCK-8 and plate cloning. The expression of extracellular matrix protein 1 (ECM1), type Ⅰ collagen (Col Ⅰ), smooth muscle actin(α-SMA), matrix metalloproteinase-2 (MMP-2), and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the two groups were detected by Western blot. qRT-PCR and immunohistochemistry were used to detect the expression of Hsa-miR-29c in 70 gastric cancer tissues and adjacent tissues respectively, and then analyzed its relationship with the clinicopathological features and prognosis of gastric cancer.ResultsThe stable expression of Hsa-miR-29c gastric cancer cell line was successfully constructed in this research, the expression of Hsa-miR-29c in the transfection group was significantly higher than that in the negative control group (P<0.05). The proliferation and clone forming ability of MKN28 and MKN45 cells in the transfection group were significantly lower than those in the negative control group (P<0.05). Compared with the negative control group, the expression of Col Ⅰ and TIMP-1 in MKN28 and MKN45 cells were increased after transfection, while the expression levels of ECM1, α-SMA, and MMP-2 were significantly decreased, with significant differences between the two groups (P<0.05). The expression level of Hsa-miR-29c in gastric cancer tissues was significantly lower than that of adjacent tissues (P<0.05), and the positive expression rate was not related to age, sex, and pathological type (P>0.05), but related to tumor size, TNM stage, tumor differentiation, and lymph node metastasis (P<0.05). The mean survival time (MST) of patients with negative expression of Hsa-miR-29c was significantly shorter than that of patients with positive expression (P=0.029).ConclusionsHsa-miR-29c is down expressed in gastric cancer, and is related to the clinical characteristics and prognosis of it. The overexpression of Hsa-miR-29c can inhibit the proliferation of gastric cancer cells, and the mechanism may be related to the inhibition of extracellular matrix (ECM) signaling pathway.
Objective To investigate the feasibility and safety of laparoscopic-assisted gastrectomy for distant gastric cancer. Methods All 18 patients with distant gastric cancer receiving laparoscopic-assisted gastrectomy were analyzed. Results Laparoscopic-assisted distal gastrectomy was performed successfully in all patients. The mean operation time was (291.33±19.61) min. The mean blood loss was (151.32±71.78) ml. The mean numbers of harvested lymph node were 14.57±3.11. The mean time of gastrointestinal function recovery was (3.46±0.93) d, the mean out of bed activity time was (1.75±0.45) d. All patients were followed up for 1-24 months, mean 11 months. No local recurrence, trocar implant or distant metastasis happened. Conclusion Laparoscopic-assisted gastrectomy is a feasible and safe surgical procedure combined with minimal trauma and fast recovery.
ObjectiveTo compare and analyze the expenses of inpatients before and after the implementation of the adjustment plan for " abolition of the addition of drug expenses” (also called zero-addition of drug costs) in Sichuan Province, in order to provide a certain reference for understanding the effect of this reform policy and further optimizing the formulation.MethodsFrom the hospital information management system, the data of inpatients with gastric cancer in a tertiary general hospital in Sichuan Province from January to September 2016 (before implementation) and from January to September 2017 (after implementation) were collected and compared. The change in hospitalization expenses of relevant patients before and after the implementation of the adjustment plan for canceling the addition of drug expenses was analyzed.ResultsA total of 2 878 patients were included in the survey; from January to September 2016,1 453 patients were included, and from January to September 2017, 1 425 patients were included. Before and after the implementation of the policy, the median hospitalization expenses of patients with gastric cancer decreased from 7 331.31 yuan to 7 145.12 yuan, with a decrease of 2.54%; the median expenses of medicines decreased from 4 839.79yuan to 4 246.10 yuan, with an decrease of 12.27%; the median expenses of check and inspections increased from 740.00 yuan to 859.00 yuan, with an increase of 16.08%; the median expenses of treatment increased from 251.00 yuan to 424.00 yuan, with an increase of 68.92%; compared with the total expenses and drug expenses before implementation, the total expenses and drug expenses after implementation decreased significantly, while material expenses, treatment expenses, check and inspection expenses and other expenses increased somewhat (P<0.05); differences in radiotherapy expenses and surgical treatment expenses before and after the implementation of the policy were not statistically significant (P>0.05).ConclusionsAfter the implementation of the policy of " abolition of drug expenses addiction”, the total expenses is slightly reduced for the expenses composition of patients with gastric cancer. Through the strengthening of the internal operation and management of the hospital, the government should continually optimize the public medical institution. At the same time, the government should put the compensation mechanism in place and continuously improve the payment method of medical insurance to ensure that the medical value of medical personnel is respected and the medical needs of ordinary people are guaranteed.
ObjectiveTo explore the value of geriatric nutritional risk index (GNRI) and sarcopenia on predicting postoperative complications in elderly patients with gastric cancer. MethodsAccording to the inclusion and exclusion criteria, the elderly (aged ≥60 years) patients with gastric cancer underwent radical gastrectomy in the Department of Gastrointestinal Surgery of Xuzhou Central Hospital from January 1, 2017 to December 31, 2021 were retrospectively gathered. The occurrence of postoperative complications (grade 2 or beyond by the Clavien-Dindo classification) was analyzed. The risk factors affecting postoperative complications were analyzed by univariate and multivariate logistic regression analyses to construct the prediction model, then was visualized by drawing a nomogram. The differentiation of the nomogram between the patients with postoperative complications and without postoperative complications was evaluated by the receiver operating characteristic (ROC) curve. The accuracy of the nomogram was evaluated by the calibration curve. Further, the clinical net benefit rate was analyzed by the decision curve analysis (DCA) to evaluate the clinical practicability. ResultsA total of 236 patients were gathered, 97 (41.1%) of whom had postoperative complications during hospitalization. The results of multivariate logistic regression analysis showed that the age, gender, GNRI, sarcopenia, surgical mode, and American Society of Aneshesiologists classification were the factors influencing the postoperative complications (P<0.05). The differentiation of nomogram based on the influencing factors was well, the area under the ROC curve was 0.732. The calibration curve showed that the model prediction curve was close to the ideal curve. The clinical net benefit rate by the DCA was higher when the probability of postoperative complications was 0.18 to 0.72. ConclusionsThe efficiency of nomogram based on GNRI and sarcopenia is well for predicting the occurrence of postoperative complications in elderly patients with gastric cancer. However, the nomogram needs to be further validated by prospective studies and external data.
Objective To study relationship between integrins and carcinogenesis, development, treatment or prognosis of gastric cancer. Methods The literatures about integrins and gastric cancer in recent years were reviewed and analyzed. Results The current study found that the β1 subunit integrins and αν subline integrins are closely associated with the gastric cancer. The β1 subunit integrins are associated with the invasion and metastasis of the gastric cancer, the αν subline integrins are associated with the typing, grading, and staging of the gastric cancer, and the ανβ3, ανβ5 and ανβ6 are associated with the prognosis of the gastric cancer, further more, the ανβ6 could be used as an independent effective prognostic factor. Conclusions Integrins are associated with occurrence, development, treatment, and prognosis of gastric cancer. It′s mechanism such as signal transduction pathway is not completely clarified. With further in-depth research, it′s molecular mechanism would be gradually elucidated and provide new ideas and methods for diagnosis, treatment, and prognosis of gastric cancer.
Objective To investigate expressions of silence signal regulating factor-1 (SIRT-1) and epithelial cadherin (E-cadherin) in gastric cancer and their clinical significances. Methods The immunohistochemistry SP technique was used to detect the expressions of SIRT-1 and E-cadherin in the gastric cancer tissues and their corresponding paracancerous gastric tissues. The relationship between the SIRT-1 expression and E-cadherin expression was analyzed using Spearman. Results The positive rate of the SIRT-1 protein expression in the gastric cancer tissues was significantly higher than that of the corresponding paracancerous gastric tissues (χ2=5.791, P=0.016). The SIRT-1 protein positive expression was related to the Lauren histological type of gastric cancer (χ2=4.941, P=0.026), in other words, in the intestinal type was significantly higher than that of the diffuse type, but which was not related to the age, gender, tumor size, tumor site, differentiation degree, TNM stage, or lymph node metastasis (P>0.05). While the positive rate of the E-cadherin protein expression in the gastric cancer tissues was significantly lower than that of the corresponding paracancerous gastric tissues (χ2=10.868, P=0.001), which in the intestinal type of gastric cancer was significantly lower than that in the diffuse type of gastric cancer (χ2=5.203, P=0.023), also not related to the age, gender, tumor size, tumor site, differentiation degree, TNM stage, or lymph node metastasis (P>0.05). There was a negative correlation between the SIRT-1 protein and the E-cadherin protein (rs=–0.381, P=0.013). Conclusions Gastric cancer with higher SIRT-1 expression might be way to achieve tumor development through E-cadherin as a facilitator. Upregulation of SIRT-1 and declining of E-cadherin might play a possible role in intestinal type gastric cancer.
ObjectiveTo explore the clinical applicability and safety of nanocarbon in patients with gastric cancer, and evaluate its application value in radical gastrectomy.MethodsCollectted relevant literatures on radical gastrectomy for nanocarbon scales from the time of construction of the library to February 2019, according to search databases included PubMed, Embase, Cochrane Library, China Journal Full-text Database (CNKI), and Wanfang. The data of lymph node detection, detection time, number of lymph node metastases, and postoperative complications were extracted from the two groups. We systematically evaluated it, and analyzed the two groups by using RevMan 5.3 software.ResultsWe searched 88 articles and selected 10 articles, including 5 randomized controlled trials and 5 case-control studies. There were 784 patients in the nanocarbon group and 695 patients in the non-nanocarbon group. Results of meta analysis on the clinical utility and safety of nanocarbon labeled lymph nodes showed that, the number of lymph node detection, lymph node detection time, and number of lymph node metastases in the nanocarbon group and non-nanocarbon group were statistically significant (P<0.05), they were better in the nanocarbon group. There was no significant difference in postoperative complications between the two groups (P>0.05).ConclusionsNanocarbon has a clear trace effect on lymph nodes of gastric cancer. It can reduce the difficulty of the number of lymph node detection, improve the detection rate of lymph nodes, and avoid blindness during traditional lymph node dissection.