ObjectiveTo investigate the value of metastatic lymph node ratio (abbreviation: rN) in the prognosis of patients with gastric cancer.MethodsThe clinical data of 255 patients with gastric cancer who underwent the radical gastrec-tomy in the First Department of General Surgery of Lanzhou University Second Hospital from January 2014 to July 2019 were retrospectively reviewed. The survival analysis was performed using Kaplan-Meier survival curves and Cox regression model. The receiver operating characteristic (ROC) curve was used to compare the accuracy of rN stage and N stage for prognosis judgment of patients with gastric cancer, and the Spearman correlation analysis method was used to analyze the correlation between rN or number of metastatic lymph node and total number of lymph nodes detected.ResultsThe univariate survival analysis showed that the vascular invasion, nerve invasion, histologic grade, tumor diameter, T stage, N stage, and rN stage were significantly associated with the prognosis of patients with gastric cancer (P<0.05); The multivariate survival analysis demonstrated that the prognosis model based on the rN stage had a higher HR value (1.756 versus 1.610) and a smaller –2 log likelihood value (648.548 versus 649.469) than the N stage. Correlation analysis results showed that rN was indepen-dent of the number of lymph nodes detected when the number was <15 and ≥15 (rs=0.275, P=0.058; rs=0.075, P=0.285). In addition, when the number of lymph nodes detected was <15 and ≥15, the rN staging could accurately stratify the prognosis of gastric cancer patients (χ2=11.24, P=0.009; χ2=30.25, P<0.001). ROC curve analysis results showed that when the number of lymph nodes detected was less than 15, rN stage had a higher area under ROC curve value ［0.863, 95%CI (0.752, 0.974) and 0.813, 95%CI (0.687, 0.938)］ as compared with N stage.ConclusionrN stage might be more accurate than N stage in predicting prognosis of patients with gastric cancer when number of lymph nodes harvested is less than 15.
Objective To compare short-term effects of totally laparoscopic total gastrectomy (TLTG) and laparoscopic assisted total gastrectomy (TATG) in treatment of resectable gastric cancer. Methods The EMbase, PubMed, The Cochrane Library, Web of Science, CBM, CNKI, and WanFang Data databases were searched by computer. According to the inclusion and exclusion criteria of the literatures, the comparative research literatures were selected. The relevant data were extracted and the literature evaluation was applied. The Revman 5.3 software was applied for the meta-analysis. Results A total of 11 articles (6 Chinese literatures, 5 English literatures) were included, including 1 491 patients clinically diagnosed with the gastric cancer. The results of meta-analysis showed: compared with the LATG group, the TLTG group had the less intraoperative blood loss ［MD=–17.59, 95% CI (–30.81, –4.37), P=0.009］, shorter incision length ［MD=–4.50, 95% CI (–4.92, –4.09), P<0.000 01］, and earlier first anal exhaust time ［MD=–0.16, 95% CI (–0.28, –0.04), P=0.007］in the treatment of gastric cancer; Besides, the first time of postoperative fluid intake of the TLTG group was earlier ［MD=–0.47, 95% CI (–0.86, –0.08), P=0.02］ and the postoperative hospital stay of the TLTG group was shorter ［MD=–0.59, 95% CI (–0.94, –0.24), P=0.000 9］; In the TLTG group, the VAS score was lower on the first postoperative day ［MD=–3.10, 95% CI (–3.48, –2.72), P<0.000 01］ and on the third postoperative day ［MD=–2.30, 95% CI (–2.57, –2.03), P<0.000 01］. There were no significant differences in the operation time, proximal margin distance, distal margin distance, lymph node dissection, and postoperative adverse reactions between the two groups (P>0.05). The subgroup analysis of the postoperative adverse reactions showed that there were no significant differences in the anastomotic stricture, anastomotic leakage, and anastomotic bleeding (P>0.05). Conclusions TLTG has some advantages of less bleeding, shorter incision, earlier ventilation and feeding, shorter postoperative hospital stay, and light postoperative pain in treatment of resectable gastric cancer. However, due to quantitative and qualitative limitations of included studies, above conclusions still need to be carried out more and high quality researches are validated.
ObjectiveTo investigate relationship between galectin-1 (Gal-1) and invasion and metastasis of gastric cancer.MethodThe related literatures on the relationship between the Gal-1 and the invasion and metastasis of gastric cancer in recent years were reviewed.ResultsThe expression of Gal-1 in the gastric cancer tissue was closely related to the invasion, metastasis ability, immunosuppression, and angiogenesis of tumor cells, and played the important role in the progression and evolution of the gastric cancer. The expression of Gal-1 was higher, the malignancy of the tumor was higher, and the prognosis of the patient was worse.ConclusionExpression of Gal-1 can promote invasion and metastasis of gastric cancer, but further clinical trials need to be verified.