ObjectiveTo discuss diagnosis and treatment of peritoneal metastasis from colorectal cancer. MethodThe literatures about methods of diagnosis and treatment of peritoneal metastasis from colorectal cancer at home and abroad were reviewed. ResultsDiagnosis methods of peritoneal metastasis from colorectal cancer were constantly updated, mainly including hematology, immunology, and imaging methods. Prophylactic treatment mainly included infusion chemotherapy and postoperative systemic chemotherapy. The resection of primary tumor and cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy were performed for the patients diagnosed as peritoneal metastasis from colorectal cancer. ConclusionsThere is still no gold standard for diagnosis of peritoneal metastasis from colorectal cancer. Comprehensive assessment and comprehensive treatment would be performed, so that effect of treatment might be improved.
ObjectiveTo explore and hypothesize the potential mechanisms of cancer stem cell(CSC) in peritoneal metastasis of gastric cancer. MethodsThe databases of PubMed and CNKI were searched, and relevant literatures were reviewed to draw out systematic hypotheses. ResultsMetastatic cancer stem cell(MCSC) was the subpopulation of CSC with the capacity of metastasis, had still not been well investigated. MCSC transfer was the tendency of migration and planting to specific target tissue by multi-steps of "homing" process. Peritoneal metastasis of gastric cancer was a simplified "homing" process, and we thinked that the key steps were adhesion, migration, and niche establishment of MCSC in peritoneum. That capturing human MCSC of peritoneal metastases in gastric cancer and identifying its stemness feature to determine high tumorigenicity and high invasive ability of it were the important research fields. ConclusionMCSC might play certain role in multiple processes in peritoneal metastasis of gastric cancer, but currently it's lack of relevant researches.
【Abstract】ObjectiveTo investigate the molecular mechanism of peritoneal dissemination of gastric cancer. MethodsLiteratures in recent years about mechanisms of peritoneal metastasis in gastric cancer were reviewed and summarized.ResultsPeritoneal metastasis related to viability of cancer cells and peritoneal characteristics. Moreover, it is necessary that many adhesive moleculars, protein hydrolase, cell factors and vascular factors involved in peritoneal metastasis.ConclusionPeritoneal metastasis of gastric cancer was induced by multiple factors together.
In recent years, cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been increasingly used for the treatment of peritoneal metastases. Imaging examination plays an important role in the process of CRS+HIPEC in treatment of peritoneal metastasis. This article briefly introduces the preoperative imaging evaluation, postoperative imaging evaluation, and current limitations of CRS+HIPEC in the treatment of peritoneal metastases.
Gastric cancer remains one of the most prevalent and fatal malignancies in China. Peritoneal metastasis represents a frequent mode of dissemination or recurrence in patients with advanced disease and confers an extremely poor prognosis. In recent years, considerable progress has been made in imaging techniques, with modalities including CT, ultrasound, MRI and PET-CT being implemented to evaluate peritoneal metastasis. However, adequate detection remains challenging, particularly for occult peritoneal metastasis. With the advent of precision medicine, radiomics and artificial intelligence have undergone rapid development and show considerable promise for the early prediction of peritoneal metastasis in gastric cancer, providing a new means of diagnosis and treatment for patients with peritoneal metastasis.
Objective To detect expressions of CD31 and D2-40 in patients with simultaneous colorectal cancer with peritoneal metastasis and investigate their correlation between them. Method The expressions of CD31 and D2-40 protein in these 59 cases (there were 19 and 40 patients with or without peritoneal metastasis, respectively) of colorectal cancer were detected by immunohistochemical MaxVision method. Results ① The positive rates of CD31 and D2-40 protein expression in the colorectal cancer tissues with or without peritoneal metastasis were significantly higher than those of the normal colonic tissues (P<0.05), but which had no significant differences between the colorectal cancer tissues with or without peritoneal metastasis (P>0.05). ② The CD31 microvessel density (CD31-MVD) and D2-40 lymphatic microvessel density (D2-40-LMVD) in the colorectal cancer tissues with peritoneal metastasis were significantly higher than those of the normal colonic tissues (P<0.05) and the colorectal cancer tissues without peritoneal metastasis (P<0.05). ③ The CD31-MVD and D2-40-LMVD were not associated with all the clinicopathologic characteristics of the colorectal cancer patients without peritoneal metastasis (P>0.05), but which in the poorly differentiated adenocarcinoma and mucinous and signet ring cell carcinomas patients with peritoneal metastasis were significantly higher than those of the other types (P<0.05) and were not associated with the age, gender, and diamter of the tumor of it (P>0.05). ④ There was a positive correlation between the CD31-MVD and the D2-40-LMVD in the colorectal cancer patients with or without peritoneal metastasis (r=0.342, P=0.012; r=0.119, P=0.008). Conclusions CD31-MVD and D2-40-LMVD in colorectal cancer patients with peritoneal metastasis highly express and has a positive correlation, which means that they might have a certain relationship with peritoneal metastasis. There may be some common regulation way and collaboratively participate peritoneal metastasis of colorectal cancer.
Objective To understand research progress on peritoneal metastasis from gastric cancer at present stage briefly. Methods The literatures about mechanism, diagnosis, prevention and treatment of the peritoneal metastasis from gastric cancer at home and aboard were collected to make a review. Results The peritoneal metastasis is the common site of the distant metastasis in the advanced gastric cancer. It’s occurrence mechanism is complex, the diagnostic measure is varied, the prevention way is difficulty, and it give priority to with the comprehensive treatment and the transformed therapy. Conclusion It has a certain necessity to study occurrence mechanism, prevention methods and treatment measures so that improve survival rate and prognosis for patients with peritoneal metastasis from advanced gastric cancer.
ObjectiveTo investigate the curative effects of cytoreductive surgery (CRS) combined with hyper-thermic intraperitoneal chemotherapy (HIPEC) for treating the hepatocellular carcinoma with peritoneal metastasis. MethodsThe clinical data of 80 cases of hepatocellular carcinoma with peritoneal metastasis who were treated in our hospital from January 2004 to January 2012 were collected, and were classified into observation group (n=40) and control group (n=40) according to the treatment. Case of observation group received CRS+HIPEC, and cases of control group received CRS+conventional intraperitoneal injection of chemotherapy. Then the comparison of clinical effect and prog-nosis was performed. ResultsIn observation group, the results of completeness of cytoreduction (CC) grade was:31 cases in grade 0, 6 cases in grade 1, and 3 cases in grade 2. In control group, the results of CC grade was:32 cases in grade 0, 6 cases in grade 1, and 2 cases in grade 3. There was no significant difference between 2 groups in the CC grade (P=0.213). In addition, there were no significant differences between observation group and control group in operation time (6.8 hours vs. 6.5 hours), hospital stay (17.3 days vs.18.7 days), and incidence of adverse reactions[70.0% (28/40) vs. 60.0% (24/40)], P>0.05. All of the cases of observation group and control group were followed up for 10-61 months (average of 42.5 months) and 6-49 months (average of 30.2 months) respectively. During the follow up period, in observation group, there were 18 cases died, 12 cases suffered from recurrence, 5 cases suffered from metastasis, and the rest of 5 cases survived; in the control group, there were 26 cases died, 9 cases suffered from recurrence, and 5 cases suffered from metastasis. However, the survival situation was better in observation group than that of control group (P<0.01). ConclusionCombining CRS and HIPEC for treating hepatocellular carcinoma with peritoneal metastasis was safe and effective, which would be widely applied.
【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.