【Abstract】Objective To introduce the current studies of the role of vascular endothelial growth factorC (VEGFC) and VEGFD in lymphangiogenesis and lymph node metastasis of gastrointestinal neoplasma. Methods The related literatures in recent 5 years were reviewed. Results The growth factors VEGFC and VEGFD enhance lymphangiogenic metastasis of gastrointestinal neoplasma with the property of angiogenesis and lymphangiogenesis. In gastric adenocarcinoma, VEGFC mRNA and tissue protein expression correlate with lymphatic invasion, lymph node metastasis, venous invasion and reduced 5year survival rates. The role of VEGFC in esophageal squamous cancer and colorectal cancer and VEGFD in colorectal cancer is not certain, with conflicting reports in the published literatures.Conclusion The VEGFC, VEGFD/VEGFR3 signal pathway may become the ideal target for inhibition of tumor proliferation and metastases, antilymphangiogenesis therapy may be a novel potential strategy in tumor biological therapy.
Objective To investigate the feature of c-kit gene mutation in gastrointestinal stromal tumor （GIST） and its correlation with clinicolpathology， molecular targeted therapy，and prognosis. Methods The related literatures about the molecular genetic mechanism of GIST were reviewed. Results The c-kit gene mutation， which is prevalent in GIST， may be the early genomic events， and they are not the independent prognostic factor. However， different molecular subtype as a new indicator to regulate biological behaviors and assess prognosis of GIST is still controversial. Conclusions The study of genotype in GIST has advanced our understanding of pathogenesis， evaluating the prognosis and conducting treatment optimization. However， subsequent work remains to be done.
Objective To investigate the safety and efficiency of a blood glucose control method in diabetic patients with gastrointestinal neoplasm who were subjected to postoperative early enteral nutrition (EEN). Methods Thirty-seven diabetic patients with gastrointestinal neoplasm received enteral nutriment——Glucerna SR through nasojejunal tubes 24 hours after operation. The blood glucose level was safely controlled through injecting insulin intravenously and subcutaneously. Meanwhile, any change of blood and urine glucose level was monitored and the indexes representing the levels of nutrition, biochemistry and immunity were measured before the implementation of EN, 5 d and 8 d of EN after operation, respectively. Results All the patients were able to bear EEN and there was no severe complications occurred. Significant increase of serum levels of albumin, prealbumin and transferrin were observed after EEN support （P＜0.05）, as well as the serum levels of IgG， IgA and IgM （P＜0.01）. However, body weight， HGB and the serum levels of ALT and TBIL showed no significant changes （Pgt;0.05）. There were 81.1%（30/37） of patients whose blood glucose levels were controlled steadily within the range of (7.8±1.1) mmol/L. Conclusion Injecting insulin intravenously and subcutaneously after operation may be a safe and effective method to control blood glucose level. And the postoperative implementation of EEN can be considered as the first choice of nutrition support for diabetic patients with gastrointestinal neoplasm.
ObjectiveTo review cancer associated fibroblasts(CAFs) and its role in the evolution of gastrointestinal neoplasms. MethodDomestic and international publications in relation to CAFs and its role in the evolution of gastrointestinal neoplasms were collected and reviewed. ResultsIn the gastrointestinal cancers, as the largest number and the most important stromal cells of the tumor microenvironment, CAFs induce the homeostasis of cell microenviron-ment out of balance, promote the remodeling of the tumor metabolism and extracellular matrix(ECM), and thus impulse the generation, proliferation, invasion and metastasis of the tumor by secreting different kinds of cytokines. ConclusionsThe key role CAFs playing in the tumor generation and evolution makes themselves and the multiple relatively specific molecules they secrete a new target for prognosis and targeted therapy, and this gives us a new idea for the combined treatment of gastrointestinal tumor or any other tumors.
Objective To investigate the current situation and influencing factors of social phobia in patients with gastrointestinal neoplasms, and to provide evidence for psychological intervention and improving the quality life of patients with gastrointestinal neoplasms. MethodsGastrointestinal neoplasms patients admitted to the Colorectal Cancer Center Ward of West China Hospital, Sichuan University between December 2021 and March 2022 were continuously included. A self-made questionnaire, social phobia behavior professional test scale, and social support rating scale were used to investigate the included patients and analyze the possible influencing factors of social phobia in patients. Results A total of 483 patients were included. Among them, there were 299 males and 184 females. The median score of social support rating scale was 37 (31, 42), with 80.54% of patients received average levels of social support. The median score of social phobia behavior professional test scale was 14 (11, 17), with 98.34% of patients had mild social phobia symptoms and 1.66% had moderate social phobia symptoms. There were statistically significant differences in social phobia behavior professional test scale scores among patients with different levels of education and average monthly income. The results of multiple linear regression analysis showed that the average monthly income was a influencing factor for patients’ social phobia. Conclusions Generally, patients with gastrointestinal neoplasms have mild social phobia. However, patients with fixed income had a higher risk to suffer social phobia were compared to those without income. It is suggested that clinical workers should pay more attention to the mental health of gastrointestinal neoplasms patients and prevent the occurrence of anxiety and phobia.