Objective To explore the perioperative management of the coexisting diseases for the elderly patients with gastric cancer. Methods The clinical data of perioperative management for coexisting diseases in 528 patients with gastric cancer over 70 years old treated in the First Affiliated Hospital of China Medical University from March 1980 to November 2008 were analyzed retrospectively. Results The main coexisting diseases included cardiovascuclar disease (259 cases, 49.05%), respiratory disease (161 cases, 30.49%), diabetes (72 cases, 13.64%). Adjusting blood pressure and blood glucose, improving cardiopulmonary function, and hepatic and renal function were mainly given. The common postoperative complications included intestinal obstruction (10 cases), pneumonia (10 cases), reflux esophagitis (9 cases), functional evacuation disorder of gastric remnant (7 cases), and anastomotic leakage (5 cases). Ten patients died during perioperative period: 6 died of heart and lung failure, 2 of acute myocardial infarction, 1 of anastomotic leakage, 1 of intestinal obstruction. Conclusions The common coexisting diseases in the elderly patients with gastric cancer are hypertension， bronchitis and diabetes. Complete assessment of the patient’s general health before operation and intensive perioperative management of the coexisting diseases not only can decrease the risk of surgical procedures， but also decrease the incidence of complication and perioperative mortality.
Objective To explore the perioperative management of the coexisting diseases for the elderly patients with gastric cancer. Methods The clinical data of perioperative management for coexisting diseases in 528 patients with gastric cancer over 70 years old treated in the First Affiliated Hospital of China Medical University from March 1980 to November 2008 were analyzed retrospectively. Results The main coexisting diseases included cardiovascuclar disease (259 cases, 49.05%), respiratory disease (161 cases, 30.49%), diabetes (72 cases, 13.64%). Adjusting blood pressure and blood glucose, improving cardiopulmonary function, and hepatic and renal function were mainly given. The common postoperative complications included intestinal obstruction (10 cases), pneumonia (10 cases), reflux esophagitis (9 cases), functional evacuation disorder of gastric remnant (7 cases), and anastomotic leakage (5 cases). Ten patients died during perioperative period: 6 died of heart and lung failure, 2 of acute myocardial infarction, 1 of anastomotic leakage, 1 of intestinal obstruction. Conclusions The common coexisting diseases in the elderly patients with gastric cancer are hypertension， bronchitis and diabetes. Complete assessment of the patient’s general health before operation and intensive perioperative management of the coexisting diseases not only can decrease the risk of surgical procedures， but also decrease the incidence of complication and perioperative mortality.
Objective To investigate the expression of syndecan-1 protein in gastric carcinoma and normal gastric mucosa tissues, and find out the correlation between the expression of syndecan-1 protein and the clinicopathologic characteristics of gastric carcinoma. Methods The expression of syndecan-1 protein was detected by immunohistochemistry (ABC) in 60 cases of gastric carcinoma, including gastric carcinoma tissues and normal gastric mucosa tissues. Results Syndecan-1 protein expressed in all of the 60 normal gastric mucosa tissues, however, only 10 of 60 gastric carcinoma tissues (16.67%) showed positive expression. The positive rate of syndecan-1 expression in normal gastric mucosa tissues was higher than that in gastric carcinoma tissues, and this difference was statistically significant (χ2=65.88, P＜0.05). The expression level of syndecan-1 protein in gastric carcinoma tissues with lymph node metastasis was lower than that without lymph node metastasis, and this difference was also statistically significant (χ2 =18.62, P＜0.05). In addition, syndecan-1 expression was not correlated with patients’ age and position of tumor (Pgt;0.05), but correlated with the diameter， invasion depth and TNM stage of tumor (Plt;0.05). Conclusion The positive expression of syndecan-1 protein is low in gastric carcinoma tissue and has b correlation with tumor stage and lymph node metastasis.
【Abstract】ObjectiveTo investigate the role of apoptosis-related gene survivin, caspase-3 and cyclin-B1 in gastric carcinoma by detecting the expressions of survivin, caspase-3 and cyclin-B1 in gastric carcinoma. Methods The expressions of survivin mRNA, caspase-3 mRNA and cyclin-B1 mRNA were determined by reverse transcription-polymerase chain reaction (RT-PCR) method in 30 gastric carcinoma specimens and 10 normal gastric tissue specimens. ResultsThe positive expression rate of survivin mRNA in 30 gastric carcinoma specimens was 66.7%(20/30). While 10 normal gastric tissue specimens did not express survivin mRNA. Although all of 30 gastric carcinoma tissues and 10 normal gastric tissues expressed caspase-3 mRNA and cyclin-B1 mRNA, the expressions of caspase-3 and cyclin-B1 in 20 survivin-positive gastric carcinoma tissues were significantly lower than those of 10 survivin-negative gastric carcinoma tissues (P＜0.01) and 10 normal gastric tissues (P＜0.01). The expressions of caspase-3 mRNA and cyclinB1 mRNA in 10 survivin-negative gastric carcinoma tissues were significantly lower than those of 10 normal gastric tissues (P＜0.01). And in gastric carcinoma tissues the expression of survivin mRNA was negatively related with that of caspase-3 mRNA （r=-0.923,P＜0.01） and cyclin-B1 mRNA (r=-0.886,P＜0.01), the expression of caspase-3 mRNA was positively related with that of cyclin-B1 mRNA (r=0.892, P＜0.01). Conclusionsurvivin enhances gastric tumorigenesis, caspase-3 and cyclin-B1 inhibit gastric tumorigenesis.
【Abstract】ObjectiveTo study the relationship between expression of CD44v6 in gastric carcinoma and neoplasm metastasis and prognosis. MethodsExpression of CD44v6 in 52 cases of gastric carcinoma was assayed by flow immunocytometry, and its relation with clinical pathology and prognosis was analyzed. ResultsIn 52 cases of gastric carcinoma tissue, the positive rate of CD44v6 expression was 67.31%(35/52); but the positive rate of CD44v6 expression in normal gastric tissue was 25.00% (13/52). The positive rate of expression was significantly different (P＜0.01). The positive rate of CD44v6 expression in gastric carcinoma tissues was related to the depth of carcinoma infiltration, lymph node metastasis and pTNM stage （P＜0.05）. ConclusionExpression of CD44v6 plays an important role in invasion, metastasis and pTNM stage of gastric carcinoma. It may be used as a new indicator to predict metastatic potential and prognosis of gastric carcinoma.
【Abstract】Objective To study the correlation between focal adhesion kinase (FAK) expression and biological behavior of invasion and metastasis in gastric carcinoma. MethodsThe immunoreactivity of FAK was revealed by immunohistochemical method in gastric carcinoma tissues,canceradjacent tissues, normal gastric mucosa,and 200 regional lymph nodes in 50 collected specimens when radical resection of gastric carcinoma were carried out. ResultsThe percentage of FAK bly positive immunoreactivity were 10.0%（5/50）， 20.0%（10/50） and 78.0%（39/50） in normal gastric mucosa， cancer-adjacent tissues and gastric carcinoma tissues respectively. The b immunoreactivity was obviously higher in gastric carcinoma tissues than that in normal gastric mucosa or canceradjacent tissues (P＜0.01). There were no difference between normal gastric mucosa and canceradjacent tissues (Pgt;0.05). The percentage of bly positive immunoreactivity of FAK were 68.8%（22/32） and 33.3%（6/18） in cases with metastasis and without metastasis of lymph node respectively. The immunoreactivity of FAK in cases with metastasis of lymph node was significantly higher than that without metastasis of lymph node (P＜0.05).The b immunoreactivity of FAK were 87.2%（136/156） and 40.9%(18/44) in withmetastatic lymph node and withoutmetastatic lymph node. The immunoreactivity of FAK in withmetastatic lymph node was significantly higher than that withoutmetastatic lymph node （P＜0.01）. The percentage of FAK bly positive immunoreactivity showed correlation with the cellular differentiation and depth of infiltration of gastric carcinoma. The deeper infiltration and lower differentiation, the ber expression rate was obtained (P＜0.05), which showed no correlation with Borrmann type, location and size of tumor (Pgt;0.05). ConclusionIncreased immunoreactivity of FAK is an important role of invasion and metastasis for gastric carcinoma cells. Detection of FAK expression in cancer tissues can be helpful to understand the carcinogenic biological behavior of gastric carcinoma as well as to make judgment and treatment of prognosis of patients.
【Abstract】Objective To investigate the correlation between the expression of fibronectin (FN) in extracellular matrix (ECM) and angiogenesis of gastric carcinoma.Methods The expressions of FN and vascular endothelial growth factor (VEGF) in 20 specimens of normal gastric tissue (normal group) and 80 specimens of gastric carcinoma tissue(gastric carcinoma group) were detected by EnVisonTM immunohistochemical technique. Tumor microvessel densit y (MVD) was evaluated by using antiCD34 antibody as an endothelial marker by the same technique as well. Results The immune complex of FN stained in brown were distributed around glands and in connective tissue of gastric specimens. In normal group, the staining of FN formed intact linear structure at basement membrane and presented regular striae form in connective tissue. In gastric carcinoma group, the integrity of linear structure of FN staining at basement membrane were destroyed to different extent and the staining of FN in connective tissue were changed deeper and distributed irregularly. The expression of VEGF and the value of MVD in the gastric carcinoma group was higher than those in normal group’s(P＜0.01, P＜0.01, respectively).This study indicated, that in gastric carcinoma group, the degree of FN expression in connective tissue had statistically positive correlations with the degree of VEGF expression and MVD value(P＜0.01, P＜0.05, respectively). Whereas the destruction extent of linear structure of FN staining at basement membrane showed no correlation with VEGF expression and MVD value(Pgt;0.05, Pgt;0.05, respectively).Conclusion The higher expression of FN in connective tissue of gastric carcinoma may well play a critical role in its process of angiogenesis and vasculogenesis. There may be an cooperative interactions between FN and VEGF in the process of angiogenesis and vasculogenesis of gastric carcinoma.
Objective To investigate the relation between CD44v6 and lymph node metastasis and prognosis of gastric carcinoma. Methods The expression of CD44v6 in 100 cases of advanced human gastric carcinoma was detected by immunohistochemical twostep method. Its relation with clinical pathology and prognosis was analyzed. Results CD44v6 expression occurred in 64%(64/100) of all gastric carcinomas; with the increase of depth of cancer invasion and local lymph node metastasis, the expression of CD44v6 elevated. Conclusion CD44v6 plays an important role in lymph node metastasis of human gastric carcinoma. It may be used as a new indicator to predict metastatic potential and prognosis of gastric carcinoma.
Objective To observe the turbulence of regional intra-artery implantation chemotherapy and peripheral venous chemotherapy on immunologic function of patients. Methods Two weeks after radical operation of gastric carcinoma, chemotherapy was performed. Eighty-three patients were divided into two groups, one (42 patients) received peripheral venous chemotherapy (PVC) and the other (41 patients) received regional intra-artery implantation pump chemotherapy (RAIPC). The serum T-lymphocyte subsets and immunoglobulin level before and 1-4 days after the chemotherapy were measured. Results After PVC, proportion of CD3 and CD4, CD4/CD8 and IgG, IgA, IgM concentration in PVC group were significantly decreased compared with those before PVC （P＜0.05， P＜0.01）, and it is the same when compared with postRAIPC patients except for CD4 and IgM （P＜0.05）. In RAIPC group, there were no significant changes in proportion of CD3, CD4 and CD8, CD4/CD8 and IgG, IgA concentration between pre- and post-RAIPC patients. Conclusion After radical operation of gastric carcinoma, RAIPC affects the immunologic function more moderate than PVC.
Objective To study the expression of nuclear factor-κBp65 (NF-κBp65) in gastric carcinoma and its relationship with vascular endothelial growth factor (VEGF). Methods The expression of NF-κBp65 and VEGF in 56 gastric carcinomas was detected with immunohistochemistry and compared with benign tissues. Results The positive rates of NF-κBp65 and VEGF in 56 gastric carcinomas were 62.5% and 76.8% respectively,and which were higher than those of gastric mucosal atypical hyperplasia (33.3% and 44.4%) and the normal gastric mucosa(0 and 8.3%) （P＜0.05,P＜0.01）.It was found that there was relationship between the expression of NF-κBp65 and the clinical stage, invasion depth of tumor and lymph node metastasis (P＜0.05),but there was no relation to the historica type (Pgt;0.05). There was positive correlation between NF-κBp65 and VEGF expression （r=0.36,P＜0.01）. Conclusion NF-κBp65 may play an important role in the development of gastric carcinoma by up-regulate the expression of VEGF.