Preoperative Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio Cannot Predict Lymph Node Metastasis and Prognosis in Patients with Early Gastric Cancer:a Single Institution Investigation in China

In the present study,we aimed at exploring the applied value of preoperative neutrophil lymphocyte ratio(NLR)and platelet lymphocyte ratio(PLR)in the prediction of lymph node metastasis(LNM)and prognosis in patients with early gastric cancer(EGC).We retrospectively analyzed a total of 248 consecutive patients who underwent curative gastrectomy to be identified T1 stage gastric adenocarcinoma between January 1,2010 and May 1,2016 in a single institution.According to median preoperative NLR and PLR value,we divided the patients into four groups:high NLR≥1.73 and low NLR〈1.73,high PLR≥117.78 and low PLR〈117.78.Furthermore,to evaluate the relationship between preoperative NLR and PLR values,we categorized patients according to cutoff preoperative NLR-PLR score of 2[high NLR(≥1.73)and high PLR(≥117.78)],1[either high NLR or high PLR],and 0[neither high NLR nor high PLR].Statistical analyses were conducted using SPSS 20.0 software.The results showed that the preoperative NLR or PLR values,lower or higher,could not predict the LNM in patients with EGC(both P=0.5440.05).The invasive depth of tumor was significantly correlated with LNM of EGC(P〈0.001).Kaplan-Meier plots illustrated that preoperative NLR and PLR values were not associated with overall survival(OS)in patients with EGC.It was concluded that the preoperative NLR and PLR may be the predictors for LNM and prognosis in patients with advanced gastric cancer;nevertheless,they cannot predict LNM and prognosis in patients with EGC.

Lymph Node Mapping with Carbon Nanoparticles and the Risk Factors of Lymph Node Metastasis in Gastric Cancer

The study aimed to examine the applicability of carbon nanoparticles as a tracer for lymph node mapping and the related factors of lymph node and No.8p subgroup metastasis in patients with gastric cancer.Clinical data of 50 patients with gastric cancer,who had not received treatment preoperatively and underwent gastrectomy in Department of Gastrointestinal Surgery,Wuhan Union Hospital,between October 2014 and August 2015,were retrospectively analyzed.These patients were found to have no distant metastasis preoperatively.Thirty-five out of 50 patients were subjected to lymphatic mapping technique using carbon nanoparticles as the tracer,and the rest 15 cases did not experience the lymphatic mapping and served as controls.The sensitivity,specificity,false positive rate and false negative rate were calculated according to the number of lymph nodes,and the staining and metastasis condition of lymph nodes.The diagnostic value of carbon nanoparticles on metastatic lymph nodes was evaluated.The relationship between the metastasis of lymph nodes or subgroup No.8p lymph nodes and clinicopathologic features was analyzed by χ^2-test or Fisher＇s exact test.All patients underwent D2 surgery（lymph node dissection including all the group 1 and group 2 nodes） plus the dissection of the subgroup No.8p lymph nodes.It was found that the average number of harvested lymph nodes in lymphatic mapping technique group（45.7±14.5） was greater than that in control group（39.2±11.7）,but the difference was not significantly different（P=0.138〉0.05）.The success rate,the accuracy,sensitivity,specificity and false negative rate was 97%,57%,28%,62% and 72% respectively.The metastasis of lymph nodes was correlated to the depth of cancer invasion（T stage）（P=0.004〈0.05）,and the metastasis of No.8p lymph nodes was correlated to the extent of lymph node involvement（N stage）（P=0.007〈0.05）.Six cases had lymph node metastasis in subgroup No.8p,and their TNM stages and clinical stages were as follows：T1N2M0 ⅡA,T3N3M0 ⅢB,T4 a N3M0 ⅢC,T4 a N3M0 ⅢC,T4 a N3M0 ⅢC,and T4 b N3M0 ⅢC.In conclusion,our study indicated that carbon nanoparticles failed to show good selectivity for metastatic lymph nodes;the result of lymphatic mapping does not achieve a satisfactory performance;the incidence of lymph node metastasis may increase,accompanying with the increase of the depth of cancer invasion;No.8p lymph node metastasis tends to occur for gastric carcinoma patients with the extent of lymph node metastasis over N2 stage.

Development of a magnetite-gene complex for gene transfection

The key to successful gene therapy is tofind a suitable method and carrier for transfection to allow a gene to be transferred into a cell and integrated into the target gene.The aim of this study was to determine whether biomagnetic material could be combined with the nucleic acid for gene transfection.Dextran-coated iron oxide nanoparticles(DCIONPs)were prepared and mixed with the plasmid pGenesil-1 containing the test gene,which expresses enhanced greenfluorescent protein(eGFP).PGenesil-1 empty vector was used as a control.The binding ability was assessed by electrophoresis of the DNA on agarose gels and quantification using BANDS-CAN software.Using different gene carriers,Lipofecta-mine 2000,Sofast,and DCIONPs,the large intestine cancer(Lovo)cell line was transfected in vitro with or without a magneticfield.The expression of eGFP was observed byfluorescence microscopy,and the transfection efficiency was compared.The results showed there was a rapid increase in combining rate when the quality ratio of DCIONPs and pGenesil-1 ascended from 1∶1 to 5∶1.However,the combining rate increased less rapidly as the quality ratio continued ascending.The expression of eGFP showed that the early transfection rate could be improved by applying a magneticfield.In conclusion,the DCIONPs we synthesized are able to carry plasmid DNA and enhance the early transfection efficiency when using a magneticfield.