AIM: To describe a new surgical technique and evaluate the early results of segmental gastrectomy (SG) with modified D2 lymph node (LN) dissection for early gastric cancer (EGC). METHODS: Fourteen patients with EGC un...AIM: To describe a new surgical technique and evaluate the early results of segmental gastrectomy (SG) with modified D2 lymph node (LN) dissection for early gastric cancer (EGC). METHODS: Fourteen patients with EGC underwent SG with modified D2 dissection from 2006 to 2008. Their operative results and postoperative courses were compared with those of 17 patients who had distal gastrectomy (DG) for EGC during the same period. RESULTS: Operating time, blood loss, and hospital stay were similar between the 2 groups. Postoperative complications developed significantly more frequently in the DG group than in the SG group. Mean number of dissected LNs per each station in the SG group was comparable with that in the DG group. Postoperative recovery of body weight was significantly better in the SG group than in the DG group. The incidence of reflux esophagitis and gastritis after surgery was less frequent in the SG group than in the DG group.CONCLUSION: SG with modified D2 LN dissection may be a new function-preserving gastrectomy that is feasible for treatment of EGC with possible LN involvement.展开更多
The molecular genetics of gastric carcinoma(GC) dictates their biology and clinical behavior. The two morphologically distinct types of gastric carcinoma by Lauren classification, i.e., intestinal and diffuse cell typ...The molecular genetics of gastric carcinoma(GC) dictates their biology and clinical behavior. The two morphologically distinct types of gastric carcinoma by Lauren classification, i.e., intestinal and diffuse cell types, have a significant difference in clinical outcome. These two types of GC have different molecular pathogenetic pathways with unique genetic alterations. In addition to environmental and other etiologies, intestinal type GC is associated with Helicobacter pylori(H. pylori) infection and involves a multistep molecular pathway driving the normal epithelium to intestinal metaplasia, dysplasia, and malignant transformation by chromosomal and/or microsatellite instability(MSI), mutation of tumor suppressor genes, and loss of heterozygosity among others. Diffuse type shows no clear causal relationship with H. pylori infection, but is commonly associated with deficiency of cell-cell adhesion due to mutation of the E-cadherin gene(CDH1), and a manifestation of the hereditary gastric cancer syndrome. Thus, detection of CDH1 mutation or loss of expression of E-cadherin may aid in early diagnosis or screening of diffuse type GC. Detection of certain genetic markers, for example, MSI and matrix metalloproteinases, mayprovide prognostic information, particularly for intestinal type. The common genetic alterations may offer therapeutic targets for treatment of GC. Polymorphisms in Thymidylate synthase to metabolize 5-fluorouracil, glutathione S-transferase for degradation of Cisplatin, and amplification/overexpression of human epidermal growth factor receptor 2 targeted by monoclonal antibody Trastuzumab, are a few examples. P13K/Akt/mT OR pathway, c-Met pathways, epidermal growth factor receptor, insulin-like growth factor receptor, vascular endothelial growth factor receptor fibroblast growth factor receptor, and micro RNAs are several potential therapeutic biomarkers for GC under investigation.展开更多
目的:探讨胰岛素样生长因子-1受体(insulinlike growth factor type 1 receptor,IGF-1R)、胰岛素样生长因子-1(insulin-like growth factor type 1,IGF-1)表达与临床病理特征之间的关系.方法:采用免疫组织化学的方法检测IGF-1R、IGF-1...目的:探讨胰岛素样生长因子-1受体(insulinlike growth factor type 1 receptor,IGF-1R)、胰岛素样生长因子-1(insulin-like growth factor type 1,IGF-1)表达与临床病理特征之间的关系.方法:采用免疫组织化学的方法检测IGF-1R、IGF-1在70例胃癌组织及部分相应癌旁组织中的表达,结合患者的性别、年龄、肿瘤大小、部位、分化程度、Borrmann分型、浸润深度、淋巴结转移和TNM分期等临床病理参数进行综合分析.结果:胃癌组织和癌旁组织中IGF-1R、IGF-1蛋白阳性表达分别为39例(55.71%)、8例(25.00%)和37例(52.86%)、5例(15.63%),差别有统计学意义(P<0.05);IGF-1R在低分化组阳性表达与中高分化组阳性表达两组间比较差异有统计学差异(P<0.05,χ2=4.124);IGF-1R、IGF-1在T1组、T2组、T3组、T4组阳性表达四组间有统计学差异(P<0.05);IGF-1R、IGF-1在无淋巴结转移组与有淋巴结转移组中阳性表达,两者间比较有显著统计学差异(P<0.05);IGF-1R、IGF-1在Ⅰ+Ⅱ期与Ⅲ+Ⅳ组内阳性表达两组间表达比较差异有显著统计学差异(P<0.05);IGF-1R阳性表达与患者的性别、年龄、肿瘤大小、部位及Borrmann分型均无明显相关(P>0.05).IGF-1阳性表达与患者的性别、年龄、肿瘤大小、部位、分化程度及Borrmann分型均无明显相关(P>0.05).经Spearman秩相关分析,IGF-1R与IGF-1在胃癌组织的表达呈正相关(r=0.310,P<0.01).结论:IGF-1R、IGF-1在胃癌组织中存在着过表达,在评估胃癌的发生、发展中有一定的临床价值.IGF-1R表达水平与肿瘤组织分化程度、浸润深度、淋巴结有无转移、TNM分期有关,IGF-1表达水平与肿瘤浸润深度、淋巴结有无转移、TNM分期有关.IGF-1R与IGF-1在胃癌组织中的表达呈正相关性,两者在胃癌的发生发展中起协同作用,未来可能会成为胃部肿瘤新型标志物.展开更多
文摘AIM: To describe a new surgical technique and evaluate the early results of segmental gastrectomy (SG) with modified D2 lymph node (LN) dissection for early gastric cancer (EGC). METHODS: Fourteen patients with EGC underwent SG with modified D2 dissection from 2006 to 2008. Their operative results and postoperative courses were compared with those of 17 patients who had distal gastrectomy (DG) for EGC during the same period. RESULTS: Operating time, blood loss, and hospital stay were similar between the 2 groups. Postoperative complications developed significantly more frequently in the DG group than in the SG group. Mean number of dissected LNs per each station in the SG group was comparable with that in the DG group. Postoperative recovery of body weight was significantly better in the SG group than in the DG group. The incidence of reflux esophagitis and gastritis after surgery was less frequent in the SG group than in the DG group.CONCLUSION: SG with modified D2 LN dissection may be a new function-preserving gastrectomy that is feasible for treatment of EGC with possible LN involvement.
文摘The molecular genetics of gastric carcinoma(GC) dictates their biology and clinical behavior. The two morphologically distinct types of gastric carcinoma by Lauren classification, i.e., intestinal and diffuse cell types, have a significant difference in clinical outcome. These two types of GC have different molecular pathogenetic pathways with unique genetic alterations. In addition to environmental and other etiologies, intestinal type GC is associated with Helicobacter pylori(H. pylori) infection and involves a multistep molecular pathway driving the normal epithelium to intestinal metaplasia, dysplasia, and malignant transformation by chromosomal and/or microsatellite instability(MSI), mutation of tumor suppressor genes, and loss of heterozygosity among others. Diffuse type shows no clear causal relationship with H. pylori infection, but is commonly associated with deficiency of cell-cell adhesion due to mutation of the E-cadherin gene(CDH1), and a manifestation of the hereditary gastric cancer syndrome. Thus, detection of CDH1 mutation or loss of expression of E-cadherin may aid in early diagnosis or screening of diffuse type GC. Detection of certain genetic markers, for example, MSI and matrix metalloproteinases, mayprovide prognostic information, particularly for intestinal type. The common genetic alterations may offer therapeutic targets for treatment of GC. Polymorphisms in Thymidylate synthase to metabolize 5-fluorouracil, glutathione S-transferase for degradation of Cisplatin, and amplification/overexpression of human epidermal growth factor receptor 2 targeted by monoclonal antibody Trastuzumab, are a few examples. P13K/Akt/mT OR pathway, c-Met pathways, epidermal growth factor receptor, insulin-like growth factor receptor, vascular endothelial growth factor receptor fibroblast growth factor receptor, and micro RNAs are several potential therapeutic biomarkers for GC under investigation.
文摘目的:探讨胰岛素样生长因子-1受体(insulinlike growth factor type 1 receptor,IGF-1R)、胰岛素样生长因子-1(insulin-like growth factor type 1,IGF-1)表达与临床病理特征之间的关系.方法:采用免疫组织化学的方法检测IGF-1R、IGF-1在70例胃癌组织及部分相应癌旁组织中的表达,结合患者的性别、年龄、肿瘤大小、部位、分化程度、Borrmann分型、浸润深度、淋巴结转移和TNM分期等临床病理参数进行综合分析.结果:胃癌组织和癌旁组织中IGF-1R、IGF-1蛋白阳性表达分别为39例(55.71%)、8例(25.00%)和37例(52.86%)、5例(15.63%),差别有统计学意义(P<0.05);IGF-1R在低分化组阳性表达与中高分化组阳性表达两组间比较差异有统计学差异(P<0.05,χ2=4.124);IGF-1R、IGF-1在T1组、T2组、T3组、T4组阳性表达四组间有统计学差异(P<0.05);IGF-1R、IGF-1在无淋巴结转移组与有淋巴结转移组中阳性表达,两者间比较有显著统计学差异(P<0.05);IGF-1R、IGF-1在Ⅰ+Ⅱ期与Ⅲ+Ⅳ组内阳性表达两组间表达比较差异有显著统计学差异(P<0.05);IGF-1R阳性表达与患者的性别、年龄、肿瘤大小、部位及Borrmann分型均无明显相关(P>0.05).IGF-1阳性表达与患者的性别、年龄、肿瘤大小、部位、分化程度及Borrmann分型均无明显相关(P>0.05).经Spearman秩相关分析,IGF-1R与IGF-1在胃癌组织的表达呈正相关(r=0.310,P<0.01).结论:IGF-1R、IGF-1在胃癌组织中存在着过表达,在评估胃癌的发生、发展中有一定的临床价值.IGF-1R表达水平与肿瘤组织分化程度、浸润深度、淋巴结有无转移、TNM分期有关,IGF-1表达水平与肿瘤浸润深度、淋巴结有无转移、TNM分期有关.IGF-1R与IGF-1在胃癌组织中的表达呈正相关性,两者在胃癌的发生发展中起协同作用,未来可能会成为胃部肿瘤新型标志物.
