ObjectiveTo evaluate the effect of neoadjuvant chemotherapy and find the mechanism of multidrug resistance. MethodsTwenty patients with gastric cancer and 31 patients with colorectal cancer underwent neoadjuvant chemotherapy and then operations. The preoperative specimens were stained by immunohistochemical techniques for testing p53,multidrug resistanceassociated protein (MRP), glutathione S transferase（GST）, telomerase. Resection specimens were evaluated for chemotherapy effect by routine histology; at the same time, the postoperative morbidity and mortality were observed. ResultsIn 51 patients, the response rate of neoadjuvant chemotherapy was 27.45%(14/51),so multidrug resistance was a kind of common phenomena in gastrointestinal carcinomas. The postoperative morbidity was 15.69%(8/15), the main operation complication was infection,the mortality was 1.96%(1/51),only one person died from severe infection.The expression rate of p53, MRP, GST, telomerase was 58.0%,51.0%,66.7%,74.0%respectively, the location of p53 was at cell nucleus,location of MRP,GST was at cell memberane and cytoplasm,location of telomerase was at cytoplasm.The response rate had nothing to do with age, sex and metastasis. But it was related with p53 and telomerase expression. ConclusionNeoadjuvant chemotherapy is an effective, safe therapy. But the rate of drug resistance is high in gastrointestinal carcinomas, and the response rate is related to p53, telomerase expression.
Objective To study the expression and its clinical significance of p16 in human gastric carcinomas. MethodsThe expression of p16 protein and mRNA in human gastric carcinomas using SP immunohistochemical and in situ hybridization (ISH) methods were examined. Results Of the 85 cases tested, 65.88% (56 cases) showed positive staining of p16 protein in the primary lesions. The positive rate of p16 protein was significantly lower in the cases with deep invasion, poor differentiation or shorter survival periods (Ｐ＜0.05). The positive rate of p16 mRNA expression in human gastric carcinomas was 47.37% (in 38 cases). Conclusion p16 gene may correlate with the development and progress of gastric carcinomas. The expression of p16 gene may be a useful tool for showing biological behavior and prognosis of human gastric carcinomas.
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.
ObjectiveTo systematically review the value of mass screening of serum pepsinogen test for Asian population with high-risk gastric carcinoma. MethodsWe electronically searched databases including PubMed, EMbase, The Cochrane Library (Issue 12, 2013), CNKI, WanFang Data, VIP and CBM for diagnostic tests on serum pepsinogen test versus with pathological biopsy/X-ray examination (gold standard) between January 2004 and January 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Then meta-analysis was conducted using Meta-DiSc software (version 1.4). ResultsA total of 15 studies involving 180 934 subjects were included. ROC curve showed "shoulder-arm shape" distribution. The results of Spearman correlation analysis suggested a significance of the threshold effect (P=0.001). The results of meta-analysis showed that, the area under curve (AUC) was 0.74. ConclusionSerum pepsinogen has good value in the screening of gastric carcinoma among Asian permanent residents. Due to limited quality of studies, the above conclusion should be verified by conducting more high quality studies.
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.
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.
CT texture analysis (CTTA) can objectively evaluate the heterogeneity of tissues and their lesions beyond the ability of subjective visual interpretation by extracting the texture features of CT images, then performing analysis and quantitative and objective evaluation, reflecting the tissue micro environmental information. This article reviews the recent studies on the applications of CTTA in gastric cancers, in the aspects of identification of gastric tumors, prediction of stage, correlation with Lauren classification, prediction of occult peritoneal carcinomatosis, evaluation of efficacy and prognosis, and prediction of biomarkers. It is regarded that CTTA has a good application prospect in gastric cancers.
【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.
To explain how to treat common gastric diseases like chronic gastritis, peptic ulcer, functional dyspepsia and gastric oesophageal reflux disease (GORD) based on evidence-based medicine. Through this paper, we try to help readers find and use clinical evidence to solve clinical problems.
Objective To investigate the cause of the positive cancer cell incisal margin in gastrectomy for gastric carcinoma. Methods Thirty-two cases with positive incisal margin in gastrectomy for gastric carcinoma from 1988-1993 in this hospital were retrospectively studied. Results The overall cancer cell positive rate (CCPR) was 7.5%, and that of radical and palliative resection were 5.5% and 12.6%, respectively (Ｐ＜0.05). The CCPR of distal and proximal incisal margin were 5.9% and 13.0% respectively (Ｐ＜0.05), which was related to the gross type, size of cancer, and the degree of differentiation and infiltration. Conclusion The CCPR is high in the infiltrating type, lesions larger than 5 cm in diameter and undifferentiated cancer. To prevent the incisal margin positive for cancer cell in gastrectomy, frozen biopsy should be done if possible.