AIM： To investigate the clinicopathologic features which predict surgical overall survival in patients with proxima gastric carcinoma involving the esophagus （PGCE）. METHODS： Electronic pathology database establis...AIM： To investigate the clinicopathologic features which predict surgical overall survival in patients with proxima gastric carcinoma involving the esophagus （PGCE）. METHODS： Electronic pathology database established in the Department of Pathology of the Nanjing Drum Tower Hospital was searched for consecutive resection cases of proximal gastric carcinoma over the period from May 2004 through July 2009. Each retrieved pa- thology report was reviewed and the cases with tumors crossing the gastroesophageal junction line were se- lected as PGCE. Each tumor was re-staged, following the guidelines on esophageal adenocarcinoma, accord- ing to the 7th edition of the American Joint Commission on Cancer Staging Manual. All histology slides were studied along with the pathology report for a retrospec- tive analysis of 13 clinicopathologic features, i.e., age, gender, Helicobacter pylori （H. pylon} infection, surgical modality, Siewert type, tumor Bormann＇s type, size, dif- ferentiation, histology type, surgical margin, lympho- vascular and perineural invasion, and pathologic stage in relation to survival after surgical resection. Prognos- tic factors for overall survival were assessed with uni- and multi-variate analyses. RESULTS： Patients＇ mean age was 65 years （range： 47-90 years）. The male： female ratio was 3.3. The 1-, 3- and 5-year overall survival rates were 87%, 61% and 32%, respectively. By univariate analysis, age, male gender, H. pylori, tumor Bormann＇s type, size, histology type, surgical modality, positive surgical margin, lym- phovascular invasion, and pT stage were not predictive for overall survival; in contrast, perineural invasion （P = 0.003）, poor differentiation （P = 0.0003）, 〉 15 to- tal lymph nodes retrieved （P = 0.008）, positive lymph nodes （P = 0.001）, and distant metastasis （P = 0.005） predicted poor post-operative overall survival. Celiac axis nodal metastasis was associated with significantly worse overall survival （P = 0.007）. By multivariate analysis, ≥ 16 positive nodes （P = 0.018）, lymph node ratio 〉 0.2 （P = 0.003）, and overall pathologic stage （P= 0.002） were independent predictors for poor overa survival after resection. CONCLUSION： Patients with PGCE showed worse over- all survival in elderly, high nodal burden and advanced pathologic stage. This cancer may be more accurately staged as gastric, than esophageal, cancer.展开更多
Objective： To reveal the effect of Jianpi Jiedu recipe （JPJDR） on angiogenesis and the PTEN （Phosphatase and tensinhomolog deleted on chromosome ten）/PI3K/AKT signaling pathway in the course of H. pylori infectio...Objective： To reveal the effect of Jianpi Jiedu recipe （JPJDR） on angiogenesis and the PTEN （Phosphatase and tensinhomolog deleted on chromosome ten）/PI3K/AKT signaling pathway in the course of H. pylori infection-inducedcarcinogenesis of gastric mucosa in C57BL/6 mice. Methods： Two-hundred C57BL/6 mice were randomly divided intofive groups （control group, model group, JPJDR low-dose group, JPJDR medium-dose group, and JPJDR high-dosegroup）, 40 in each group. A mouse model of gastric cancer, induced by H. pylori standard strain infection, wasestablished. The mice of JPJDR low-dose, middle-dose, and high-dose groups were intragastrically administered 250,500, and 1000 mg/kg JPJDR per day, respectively. After 72 weeks, the H. pylori infection in gastric mucosa of the micewas analyzed by rapid urease test; the pathological changes in the gastric mucosa of mice were assessed byhistopathological examination, and micro-vessel density （MVD）, vascular endothelial growth factor （VEGF）, andPTEN/PI3K/AKT levels were determined. Results： The incidence of gastric cancer in each group （control group, modelgroup, JPJDR low-dose, medium-dose, high-dose group） was 0%, 26.3%, 13.2%, 10%, and 7.5% respectively. Theincidence of gastric cancer in the Chinese medicine group was significantly lower than that of the model group （P =0.020, P = 0.023, P = 0.007）. The expression of MVD and VEGF in the model group was significantly higher than thatin the control group （P = 0.002, P 〈 0.001）, while the expression of MVD and VEGF decreased in the Chinese medicinegroup. The expression of p-PTEN and p-AKT in the model group was significantly higher than that in the control group（All P 〈 0.001）, while Chinese medicine could reduce the expression of p-PTEN and p-AKT to varying extents.Conclusion： Long-term infection of C57BL/6 mice with H. pylori induces gastric carcinogenesis, by increasing gastricmucosal MVD, promoting the expression of VEGF, inhibiting the activity of PTEN, and activating the PI3K/AKTsignaling pathway. JPJDR can reduce the infection rate of H. pylori in mouse gastric mucosa, inhibit the expression ofMVD and VEGF, and reduce the inactivation of PTEN.展开更多
Esophageal and gastric cancer(GC) are related to obesity and bariatric surgery. Risk factors, such as gastroesophageal reflux and Helicobacter pylori, must be investigated and treated in obese population. After surger...Esophageal and gastric cancer(GC) are related to obesity and bariatric surgery. Risk factors, such as gastroesophageal reflux and Helicobacter pylori, must be investigated and treated in obese population. After surgery, GC reports are anecdotal and treatment is not standardized. This review aims to discuss GC related to obesity before and after bariatric surgery.展开更多
基金Supported by Key Grants from the Science and Technology Development Project of the Nanjing City,No.ZKX05013 and ZKX07011A Special Grant from the Nanjing Drum Tower Hospital,Nanjing,China
文摘AIM： To investigate the clinicopathologic features which predict surgical overall survival in patients with proxima gastric carcinoma involving the esophagus （PGCE）. METHODS： Electronic pathology database established in the Department of Pathology of the Nanjing Drum Tower Hospital was searched for consecutive resection cases of proximal gastric carcinoma over the period from May 2004 through July 2009. Each retrieved pa- thology report was reviewed and the cases with tumors crossing the gastroesophageal junction line were se- lected as PGCE. Each tumor was re-staged, following the guidelines on esophageal adenocarcinoma, accord- ing to the 7th edition of the American Joint Commission on Cancer Staging Manual. All histology slides were studied along with the pathology report for a retrospec- tive analysis of 13 clinicopathologic features, i.e., age, gender, Helicobacter pylori （H. pylon} infection, surgical modality, Siewert type, tumor Bormann＇s type, size, dif- ferentiation, histology type, surgical margin, lympho- vascular and perineural invasion, and pathologic stage in relation to survival after surgical resection. Prognos- tic factors for overall survival were assessed with uni- and multi-variate analyses. RESULTS： Patients＇ mean age was 65 years （range： 47-90 years）. The male： female ratio was 3.3. The 1-, 3- and 5-year overall survival rates were 87%, 61% and 32%, respectively. By univariate analysis, age, male gender, H. pylori, tumor Bormann＇s type, size, histology type, surgical modality, positive surgical margin, lym- phovascular invasion, and pT stage were not predictive for overall survival; in contrast, perineural invasion （P = 0.003）, poor differentiation （P = 0.0003）, 〉 15 to- tal lymph nodes retrieved （P = 0.008）, positive lymph nodes （P = 0.001）, and distant metastasis （P = 0.005） predicted poor post-operative overall survival. Celiac axis nodal metastasis was associated with significantly worse overall survival （P = 0.007）. By multivariate analysis, ≥ 16 positive nodes （P = 0.018）, lymph node ratio 〉 0.2 （P = 0.003）, and overall pathologic stage （P= 0.002） were independent predictors for poor overa survival after resection. CONCLUSION： Patients with PGCE showed worse over- all survival in elderly, high nodal burden and advanced pathologic stage. This cancer may be more accurately staged as gastric, than esophageal, cancer.
基金Funding： This study was supported by National Natural Science Foundation of China （81202663,81273958）, the NaturalScience Foundation of Shanghai, China （12ZR1449300）, the Shanghai Health and Family Planning Commission（20134309） Program for Outstanding Academic Leader of Shanghai, Program for Outstanding Medical AcademicLeader of Shanghai, the Xinglin Star Plan of Shanghai （ZY3-RCPY-2-2006）.
文摘Objective： To reveal the effect of Jianpi Jiedu recipe （JPJDR） on angiogenesis and the PTEN （Phosphatase and tensinhomolog deleted on chromosome ten）/PI3K/AKT signaling pathway in the course of H. pylori infection-inducedcarcinogenesis of gastric mucosa in C57BL/6 mice. Methods： Two-hundred C57BL/6 mice were randomly divided intofive groups （control group, model group, JPJDR low-dose group, JPJDR medium-dose group, and JPJDR high-dosegroup）, 40 in each group. A mouse model of gastric cancer, induced by H. pylori standard strain infection, wasestablished. The mice of JPJDR low-dose, middle-dose, and high-dose groups were intragastrically administered 250,500, and 1000 mg/kg JPJDR per day, respectively. After 72 weeks, the H. pylori infection in gastric mucosa of the micewas analyzed by rapid urease test; the pathological changes in the gastric mucosa of mice were assessed byhistopathological examination, and micro-vessel density （MVD）, vascular endothelial growth factor （VEGF）, andPTEN/PI3K/AKT levels were determined. Results： The incidence of gastric cancer in each group （control group, modelgroup, JPJDR low-dose, medium-dose, high-dose group） was 0%, 26.3%, 13.2%, 10%, and 7.5% respectively. Theincidence of gastric cancer in the Chinese medicine group was significantly lower than that of the model group （P =0.020, P = 0.023, P = 0.007）. The expression of MVD and VEGF in the model group was significantly higher than thatin the control group （P = 0.002, P 〈 0.001）, while the expression of MVD and VEGF decreased in the Chinese medicinegroup. The expression of p-PTEN and p-AKT in the model group was significantly higher than that in the control group（All P 〈 0.001）, while Chinese medicine could reduce the expression of p-PTEN and p-AKT to varying extents.Conclusion： Long-term infection of C57BL/6 mice with H. pylori induces gastric carcinogenesis, by increasing gastricmucosal MVD, promoting the expression of VEGF, inhibiting the activity of PTEN, and activating the PI3K/AKTsignaling pathway. JPJDR can reduce the infection rate of H. pylori in mouse gastric mucosa, inhibit the expression ofMVD and VEGF, and reduce the inactivation of PTEN.
文摘Esophageal and gastric cancer(GC) are related to obesity and bariatric surgery. Risk factors, such as gastroesophageal reflux and Helicobacter pylori, must be investigated and treated in obese population. After surgery, GC reports are anecdotal and treatment is not standardized. This review aims to discuss GC related to obesity before and after bariatric surgery.
