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.
One thousand four hundred and fifty-four cases of operations for gastric carcinoma in this hospital from 1983 to 1994 are reviewed. 121 out of 1454 patients sustained 168 occurrences of early postoperative complications. The patiets involvement rate was 8.32% and the occurrence rate of complications was 11.55%. Complications could be divided into two groups, the general complication after surery (8.25%) and complication relavent to gastrointestinal reconstruction (3.30%). Most common complications were wound infection, pulmonary infection, anastomotic obstruction or leakage. The authors stress the prevention of surgical complications that would furhter improve the therapeutic result of gastric cancer.
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.
The substitution of ρ-shaped jejunum for stomach in 64 patients with gastric carcinoma after total gastrectomy is reported . Survival rate of the first, third anad fifth year afer surgery were 71.8%,42.2% and 34.4% respectively.Postoperative death and complications with fistula of anastomotic stoma , refulx esophagitis and dumping syndrome were not encountered in this all series. These results show that the operative procedure is a simple, safe, and can be accomplished within short time and that the quality of living of the patient is good.
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.
Objective To study the expression and its significance of cyclin D1,cyclin E and p27 protein in gastric carcinoma. Methods The expression of cyclin D1,cyclin E and p27 protein in 60 cases of gastric carcinoma were detected by immunostaining method. Results The positive rates of cyclin D1,cyclin E and p27 protein expression in gastric carcinoma were 41.7%（25/60）,38.3%（23/60）and 36.7%（22/60）,respectively.The expression of cyclin D1 was significantly correlated with Lauren type of tumor,the expression of cyclin E was significantly correlated with tumor differentiation,infiltration and stage,while the expression of p27 protein was significantly correlated with tumor infiltration,lymph nodes metastasis and stage. Further more, the expression of cyclin E was inversely correlated with the expression of p27. Conclusion Detection of cyclin D1,cyclin E and p27 expression in gastric carcinoma may be helpful in determining tumor progression.
Objective To investigate for a reasonable reconstruction method in patients undergoing total gastrectomy. Methods Data of 63 cases receiving total gastrectomy from January 2000 to October 2005 in Ganzhou District Hospital of Zhangye City were analyzed retrospectively, and the patients were divided into double pouch jejunum interposition （DPJI） group (n=30) and Roux-en-Y ρ pouch （RYρ） group (n=33) according to the operation methods, then operation time， morbidity of complications, amount and frequency of meat and drink, complications of digestive tract, amount of total protein and albumin were compared between two groups. Results There were no significant differences in operation time，morbidity of complications, the amount or frequency of meat and drink between two groups (Pgt;0.05); but the incidence of digestive tract complications of DPJI group was lower than that of RYρ group （P＜0.05). GradeⅠ/Ⅱof Vervaeck index and the amount of total protein and albumin in DPJI group were statistical significantly higher than those of RYρ group （P＜0.05）. Conclusion Functional DPJI is a reasonable digestive tract reconstruction method.
【Abstract】ObjectiveTo study the CT features of bare area involvement in gastric carcinoma and their anatomicpathological basis, and to evaluate the role of multi-detector CT in the diagnosis of bare area involvement. Methods In 196 consecutive gastric carcinoma cases, 56 were found bare area involvement and divided into proximal gastric carcinoma (PGC) group and distal gastric carcinoma (DGC) group according to anatomic position of primary tumor. CT images and incidence of gastric bare area (GBA) involvement in the PGC group were observed and compared with those of DGC group. Results The lesion appeared as nodule or mass in bare area in 46 cases and as metastatic lymphadenopathy in 10 cases. CT features of GBA involvement included: ① widening of gastric bare area and blurring or obliteration of the thin fat strip between gastric wall and diaphragm; ② irregular mass with heterogeneous enhancement or round lymph nodes in GBA; ③ irregular thickening of left diaphragmatic crus or gastrophrenic ligament with blurring border to the mass; ④ other metastatic lymph nodes in subphrenic extroperitoneal space. The incidence of GBA involvement in PGC group was 70.0%(42/60), significantly difference from those in DGC group (10.3%,14/136) ,P=0.025. Conclusion The incidence of GBA involvement in PGC group is significantly higher than those in DGC group. Multidetector CT is very useful for preoperative imaging evaluation of bare area involvement and lymphatic spread.
Objective To evaluate the legitimate of regional artery infusion chemotherapy in the treatment of gastric carcinoma. MethodsThe pharmacokinetics of 5-Fu after different route of administration was studied. Results High concentration of 5-Fu found in portal vein via left-gastric intra-artetial administration were 4-40 folds higher than the group via intravenous administration.The time of high concentrations of 5-Fu via left-gastric intra-arterial administration maintained significantly longer than by intravenous administraion. The concentration of 5-Fu in tumor tissues and paratumorous lymph tissues by intra-arterial administration were 19 times and 23 times of the group by intravenous administration. Conclusion Regional arterial infusion chemotherapy can significantly increase the concentration of chemotherapeutic drugs in the tumorous region.
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.