Objective To investigate the safe distance of upper gastric cancer by pokemon protein. Methods In 60 cases of upper gastric cancer， specimens were get from tumors’ tissue and every 0.5 cm from the proximal of tumor margin beginning at the 1.0 cm to distal. Western blot method was used to test the expression of pokemon protein. Results There were 38 cases （63.3%） positively expressed pokemon protein. Compared with the center of tumor， the positive expression rates of pokemon protein at every sites of 2.5-5.0 cm from margin were lower （P＜0.003）， but didn’t signi-ficantly differed at every sites of 1.0-2.0 cm from margin （P≥0.003）. When the incisal margin distance of more than 3.5 cm of both sides， the positive expression rate of pokemon protein were 0. There were no significant difference between the corresponding sites of the upper resection margin and lower resection margin （P＞0.05）. Conclusions The results show that 3.5 cm may be the molecular margin basing on the positive expression of pokemon protein in the surgical margin of upper gastric cancer， which may have guiding significance to the surgical margin.
Objective To understand role of chemokines and their receptors in pathogenesis, progression, and metastasis of gastric cancer, and to provide a better approach for diagnosis and treatment of gastric cancer. Method The literatures about the relationship between chemokines and their receptors and gastric cancer were reviewed. Results There were about 50 various chemokines and their receptors abnormally expressed in the tumor microenvironment. The main types related gastric cancer were the CXC, CC and CX3C chemokines and their receptors, which could promote the proliferation, invasion, and metastasis of the gastric cancer through several pathways like mTOR pathway, JAK2-STAT3 pathway, etc.. Conclusions Chemokines and their receptors play an important role in occurrence and development of gastric cancer. Further studies on chemokines and their receptors will not only assist in early diagnosis of gastric cancer, as well as estimation of clinical prognosis, but also provide an intervention target for gastric cancer.
ObjectiveTo describe the research progress of long non-coding RNA (lncRNA) and gastric cancer in recent years, and to make reasonable prospect for future research direction.MethodWe collected a large amount of literatures on lncRNA and gastric cancer at home and abroad, and sort out various kinds of lncRNA, to make an in-depth interpretation of the relationship between lncRNA and gastric cancer and the mechanism of action, and then clarified the latest research progress.ResultsAt present, the molecular mechanism of the occurrence and development of gastric cancer had not been fully elucidated, but current studies had shown that lncRNA (H19, HOTTIP, UCA1, MEG3, MALAT1, HULC, HOTAIR, GAPLINC, and so on) had regulatory effects at multiple levels such as epigenetics, transcription, translation, chemoresistance, and more and more lncRNA had been discovered closely related to gastric cancer.ConclusionlncRNA is closely related to the occurrence and development of gastric cancer and may be a key target for the treatment of gastric cancer in the future.
Objective To study effect of carcinoembryonic antigen (CEA) positive targeted lymphocytes on gastric cancer cells in vitro and in vivo. Methods The peripheral blood mononuclear cells (PBMCs) were isolated from the peripheral blood of healthy volunteers. The recombinant vector anti-CEA-scFv-CD3ζ-pcDNA3.0 was transfected into the PBMCs by lipofectamine 2000, by this means, the CEA special lymphocytes were obtained. Meanwhile, the PBMCs transfected with empty plasmid pcDNA3.0 were used as control (empty vector lymphocytes). The different lymphocytes and gastric cancer cells (CEA positive KATOⅢ gastric cancer cells and CEA negative BGC-823 gastric cancer cells) were co-cultured, then the ability to identify the gastric cancer cells and it’s effect on apoptosis of gastric cancer cells were observed at 24 h or 36 h later respectively. The CEA special lymphocytes and empty vector lymphocytes were injected by the tail vein of nude mice bearing gastric cancer cells, then it’s effect on the tumor was observed. Results ① The CEA special lymphocytes could strongly identify the KATOⅢ gastric cancer cells (identification rate was 72.3%), which could weakly identify the BGC-823 gastric cancer cells (identification rate was 7.8%). ② The apoptosis rate of the co-culture of CEA special lymphocytes and KATOⅢ gastric cancer cells was significantly higher than that of the co-culture of empty vector lymphocytes and KATOⅢ gastric cancer cells (P=0.032), which had no significant difference between the co-culture of CEA special lymphocytes and BGC-823 gastric cancer cells and the co-culture of empty vector lymphocytes and BGC-823 gastric cancer cells (P=0.118). ③ The tumor volume of the co-culture of CEA special lymphocytes and KATOⅢ gastric cancer cells was significantly smaller than that of the co-culture of empty vector lymphocytes and KATOⅢ gastric cancer cells (F=5.010, P<0.01) or the co-culture of CEA special lymphocytes and BGC-823 gastric cancer cells (F=4.982, P<0.01), which had no significant difference between the co-culture of CEA special lymphocytes and BGC-823 gastric cancer cells and the co-culture of empty vector lymphocytes and BGC-823 gastric cancer cells (F=1.210, P>0.05). Conclusion CEA special lymphocytes can promote cell apoptosis and inhabit tumor reproduction of CEA positive gastric cancer cells in vitro and in vivo.
ObjectiveTo investigate the vaules of multi-slice spiral CT (MSCT) in diagnosing metastatic lymph nodes and judging N stage of resectable gastric cancer. MethodsFifty-nine patients with gastric cancer performed preoperative MSCT plain scan and triple enhanced scans from February 2019 to March 2021 in the First People’s Hospital of Wuhu City were collected. The results of postoperative pathology were taken as the gold standard, the short diameter, long diameter, short to long diameter ratio, CT values of triple enhanced scans and lymphatic hilar blur were compared between the metastatic lymph nodes and the non-metastatic lymph nodes. ResultsThe preoperative MSCT showed that there were 50 cases of metastatic lymph nodes and 9 cases of non-metastatic lymph nodes in 59 patients with gastric cancer. A total of 1 467 lymph nodes were harvested, including 562 metastatic lymph nodes and 905 non-metastatic lymph nodes. The short diameter, long diameter, short to long diameter ratio, and the CT values of plain scan, arterial phase, portal vein phase, and delayed phase of metastatic lymph nodes were higher than those of non-metastatic lymph nodes (P<0.05), and the incidence of lymphatic hilar blur was also higher than that of non-metastatic lymph nodes (P<0.05). Referring to the results of postoperative pathological examination, the accuracies of MSCT in judging of N0, N1, N2, N3a, and N3b stages were 88.9% (8/9), 83.3% (5/6), 85.7% (12/14), 92.3% (12/13), 88.2% (15/17), respectively, and the total accuracy was 88.1% (52/59), the specificity was 96.6% (57/59), and the sensitivity was 91.2% (52/57). ConclusionAccording to this study results, preoperative MSCT has higher specificity, sensitivity, and accuracy in diagnosing metastatic lymph nodes and judging N stage of resectable gastric cancer.
ObjectiveTo describe the research status of programmed death receptor protein 1 (PD-1) and its ligand(PD-L1) inhibitors in advanced gastric cancer and to understand the key issues of PD/PD-L1 inhibitors in order to provide atheoretical basis for future research.MethodThe classical and up to date literatures on the immunotherapy, especially thePD-1/PD-L1 inhibitors in the advanced gastric cancer were reviewed.ResultsThe PD-1/PD-L1 inhibitors were the hot spot in the current research of tumor immunotherapy. The pembrolizumab and nivolumab were the commonly immunosuppressive agents in the current clinical research, which had also achieved the great success in the clinical research of gastriccancer since it was shown the good results in the malignant melanoma and hematological malignancies. In some clinical studies, the PD-1/PD-L1 inhibitors treatment showed the longer overall survival than the conventional chemotherapy, especially in the patient with positive PD-1. However the study still had some issues to be solved, such as no accurate prediction for the beneficiary population, the tumor hyperprogression and so on. It was gratifying that the current research on the basic research of tumor immunity was increasing, then it provided a theoretical support for solving these problems.ConclusionsTumor immunosuppressive therapy such as PD-1/PD-L1 inhibitors brings a new idea in treatment of patients with advanced gastric cancer. Although there are still many problems need to be solved in clinical research, it is believed that PD-1/PD-L1 inhibitors will become one of key players in treatment of patients with advanced gastric cancer in the further study.
ObjectiveTo investigate the effects of intraoperative intermittent pneumatic compression (IPC) treatment on coagulation and fibrinolysis, lower extremity venous blood flow velocity, and deep venous thrombosis (DVT) in patients with gastric cancer (GC) after radical gastrectomy. MethodsThe patients with GC who underwent radical gastrectomy at Hebei Provincial People’s Hospital from July 2021 to July 2024 were retrospectively enrolled, then the patients were assigned into control group (the patients who did not receive intraoperative IPC) and study group (the patients who received intraoperative IPC), and the propensity score matching (PSM) method was used to conduct 1∶1 matching based on the basic characteristics such as age, gender, body mass index, comorbidities to ensure baseline comparability between the two groups. The incidences of postoperative DVT and lower extremity swelling, and coagulations [prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT)] and fibrinolysis [D-dimer (D-D), fibrinogen (FIB), and fibrin degradation products (FDP)], as well as lower extremity venous blood flow velocity were analyzed after PSM. The locally weighted regression was used to analyze the correlation between the coagulation and fibrinolytic functions indexes and the lower extremity venous blood flow velocity. ResultsA total of 120 patients were matched (60 cases per group). The baseline characteristics of both groups were comparable (P>0.05). The incidences of DVT on day 7 and lower extremity swelling on day 1, 3, and 7 after surgery in the study group were significantly lower than those in the control group (P<0.05). The results of repeated-measures analysis of variance showed that there were statistically significant differences in the inter-group, time-related, and group-by-time interaction effects of coagulation and fibrinolysis indexes as well as lower extrimety venous blood flow velocities (P<0.05). The impact of the time factor on coagulation and fibrinolysis indexes and lower extrimety venous blood flow velocities varied with intraoperative IPC intervention measures. After surgery, the PT, TT, APTT, and lower extrimety venous blood flow velocities in the study group first decreased and then increased as compared with those before surgery, and the decrease degree was smaller and the increase degree was larger than those in the control group. After surgery, the D-D, FIB, and FDP in the study group first increased and then decreased as compared with those before surgery, and the increase degree was smaller and the decrease degree was larger than those in the control group. Both PT and TT were significantly positively correlated with femoral vein blood flow velocity (r=0.21, P=0.042; r=0.22, P=0.040), and both also showed significant positive correlations with popliteal vein blood flow velocity (r=0.25, P＜0.001; r=0.20, P=0.032). APTT was only significantly positively correlated with popliteal vein blood flow velocity (r=0.33, P＜0.001). D-D was negatively correlated with the flow velocities of the femoral vein, external iliac vein, and popliteal vein (r=–0.23, P=0.012; r=–0.22, P=0.047; r=–0.37, P<0.001). Both FIB and FDP were negatively correlated with the flow velocity of the femoral vein (r=–0.23, P=0.036; r=–0.27, P=0.002). FIB was also negatively correlated with the flow velocity of the popliteal vein (r=–0.26, P=0.038), and FDP was negatively correlated with the flow velocity of the external iliac vein (r=–0.31, P<0.001). ConclusionBased on the results of this study, intraoperative IPC treatment could improve coagulation and fibrinolytic functions of patients with GC after surgery, and has a certain preventive effect on occurrence DVT of lower extremity.
Objective To study relationship between integrins and carcinogenesis, development, treatment or prognosis of gastric cancer. Methods The literatures about integrins and gastric cancer in recent years were reviewed and analyzed. Results The current study found that the β1 subunit integrins and αν subline integrins are closely associated with the gastric cancer. The β1 subunit integrins are associated with the invasion and metastasis of the gastric cancer, the αν subline integrins are associated with the typing, grading, and staging of the gastric cancer, and the ανβ3, ανβ5 and ανβ6 are associated with the prognosis of the gastric cancer, further more, the ανβ6 could be used as an independent effective prognostic factor. Conclusions Integrins are associated with occurrence, development, treatment, and prognosis of gastric cancer. It′s mechanism such as signal transduction pathway is not completely clarified. With further in-depth research, it′s molecular mechanism would be gradually elucidated and provide new ideas and methods for diagnosis, treatment, and prognosis of gastric cancer.
ObjectiveTo summarize advances in immunotherapy for gastric cancer.MethodThe relevant literatures about immunotherapy for gastric cancer in recent years were reviewed.ResultsRecently, the immunotherapy for the tumors mainly included the immune checkpoint blocking, tumor vaccine, and adoptive immunotherapy. There were many studies on the immune checkpoint blocking, mainly targeting the antibodies of programmed death receptor 1 (PD-1) and cytotoxic T-lymphocyte associated antigen 4 (CTLA-4). A series of studies had shown that the pembrolizumab was effective in the patients with advanced gastric cancer who expressed PD-1 ligand positive. The nivolumab had become the first immune checkpoint inhibitor approved for the treatment of advanced gastric cancer in Asia, and the patients with mismatch repair defects could benefit more from the PD-1 treatment. Although the CTLA-4 targeted immune checkpoint blocking therapy had been reported, some studies had found that the patients with advanced gastric cancer didn’t benefit from the treatment of CTLA-4 monoclonal antibody ipilimumab. The tumor vaccine therapy in the gastric cancer had been reported. Due to the high heterogeneity of tumor cells in the gastric cancer, the tumor vaccine efficacy of autoantibody was not stable, based on the high- throughput sequencing of neoantigens identification and screening process was complex, the vaccine preparation needed the longer period, how to individualized screening the neoantigen, and the selection of antigens that could effectively activate the T cells to recognize and kill the tumor cells still needed to be overcame.ConclusionsTumor immunotherapy has received worldwide attention. Anti-PD-1 and its ligand as representative immune checkpoint statin therapy in treatment of advanced gastric cancer has showed great potential, but at present there are still many problems need to be solved, such as number of applicable patients of immunotherapy is small, curative effect of immune checkpoint inhibitor screening index also is not clear, tumor vaccine and adoptive cell therapy are promising but there is lack of evidence from clinical research data, combined use of existing treatments and immunotherapy on curative effect still needs more clinical trials to explore.
ObjectiveTo explore the correlation between the texture features of gastric cancer plain CT images and the expression of HER2.MethodsA retrospective collection the datas of 62 patients with gastric cancer who underwent CT scans of the upper abdomen and (or) the whole abdomen from January 2017 to January 2021 in Leshan City People’s Hospital. The treatment method was surgery. The HER2 expression of gastric cancer tissue was detected after the operation. There were 45 male patients and 17 female patients. Lauren classification: 18 cases of intestinal type, 30 cases of diffuse type, and 14 cases of mixed type. Fifty-two cases were HER2 expression negative [age: (63.54±10.32) years], and 10 cases were HER2 expression positive [age: (61.70±11.70) years]. The MaZda module in the MaZda 4.6 version software was used to perform the image normalization, interest area delineation, texture feature extraction, and texture feature selection on the CT plain scan image, and perform texture feature discrimination and misjudgment rate analysis in the B11 module.ResultsThere was no correlation between HER2 expression and age, gender of patients and Lauren classification of tumors (P>0.05). The analysis methods of nonlinear discriminant analysis (NDA)/artificial neural network (ANN), linear discriminant analysis (LDA)/1-nearest-neighbor (1-NN), principal component analysis (PCA)/1-NN, and raw-data analysis (RDA)/1-NN can better correspond to the CT plain scan texture feature parameters of gastric cancer and the expression level of HER2.ConclusionsTexture analysis based on CT plain images has the potential to non-invasively detect the HER2 expression in gastric cancer. The best comprehensive performance texture discrimination method is NDA/ANN and LDA/1-NN.