Quality of life in gastric cancer

AIM: To summarize the empirical research on assessing quality of life (QOL) in patients with gastric carcinoma. METHODS: Literature searches were conducted in MedLine from 1966 to February 2004. RESULTS: Twenty-six studies were identified. QOL was used as an outcome measure in virtually all identified studies, such as those examining the effects of gastric cancer and various medical or surgical treatments in the patients. QOL was assessed mainly with generic measures; the social dimensions of QOL were largely neglected. The lack of gastric cancer-specific QOL measures hampers QOL research up to now. The gastric cancer-specific EORTCQLQ-STO22 and the FACT-Ga are important additions to the arsenal of disease-specific QOL measures. In most of the studies, the label QOL is used for questionnaires, which only assess symptoms or performance status, or are physician-reported rather than patient-reported outcomes. CONCLUSION: QOL in patients with gastric cancer deserves more systematic studies, especially as one of the outcome measures in randomized clinical trials. Results of studies that include QOL in patients with gastric cancer should be applied in clinical care, which aims at improving QOL of these patients.

TREATMENT OF 23 PATIENTS WITH ADVANCED GASTRIC CANCER BY INTRAVENOUSLY TRANSFER OF AUTOLOGOUS TUMOR-INFILTRATING LYMPHOCYTES COMBINED WITH rIL-2

Tumor-infiltrating lymphocytes (TIL)isolated from metastatic lymph nodes in patients with nonoperable advanced gastric cancer were induced to become LAK-like cytotoxic activrty of TIL after in vitro culture with rlL-2.Twenty-three patients with advanced gastric cancer were treated by intravenously transfer of autologous TIL combined with rlL-2. The tumor forus disappeared (complete remission, CR) in 3 patients (13. 0%) and significantly decreased (partial remission, PR) in 5 patients (21. 7%). Fifteen patients did not respond to the treatment. The amount of soluable IL-2 receptor in serum was significantly decreased after treatment, the cytotoxicity of NK cells and OT test were significantly increased. No significant difference in CD4/CD8 was found between before and after treatment. No serious side effect was obseved in the treatment.

Effect of activation of PPARγ on cell cycle progression in human gastric carcinoma cells

Objective： To investigate the effect of activation of peroxisome proliferator-activated receptor gamma （PPARy） on cell cycle arrest of gastric carcinoma cell line MGC803. Methods： The inhibitory of pioglitazone （PGZ） on proliferation of MGC803 cells was analyzed by MTT assay. Cell cycle was detected by flow cytometry （FCM）. The expressions of PPARy, cyclin D1 and cell cycle protein-dependent kinase CDK4 in MGC803 cells were detected by reverse transcriptase-polymerase chain reaction （RT-PCR）. Results： Treatment with 0.1-10 μmol/L PGZ for 96 h significantly inhibited cell proliferation. The proportion of MGC803 cells at G1 phase was significantly increased when treated with 10 μmol/L PGZ for 48, 72 and 96 h, and showed an apparent G1 phase arrest. The expression of PPARy was at a low level in MGC803 cells and significantly up-regulated when treated with 10 μmol/L PGZ for 48 h （P〈0.01）. The expression of CDK4 in MGC803 cells was remarkably down-regulated when treated with 10 μmol/L PGZ for 48 h and the expression of cyclin D1 was slightly down-regulated （P 〈 0.01）. Conclusion： Activation of PPARy significantly induced G1 phase arrest, which was associated with down-regulation of the expressions of CDK4 and cyclin DI.

“第88届日本胃癌学会年会”焦点解析

第15版日本胃癌处理规约外科修订主要集中在幽门下(No.6)淋巴结,将No.6细化为N.6a、No.6v、No6i。建议将上一版有明确腹膜转移者(P1)细化为P1a、P1b、P1c及P1x。特别强调了肿瘤浸润十二指肠的治疗原则。全球重要的胃癌临床研究中包括了13项来自我国的研究,涵盖了腹腔镜手术、新辅助化疗、术后辅助化疗、围手术期放化疗、腹腔热灌注化疗以及复发转移胃癌的三线抗血管治疗等。国际抗癌联盟及美国癌症联合会胃癌分期项目收集了全球17个国家的25 411例随访数据,建议在第8版TNM分期中Ⅲ期做适当调整。局部进展期胃癌的转化治疗取得了令人瞩目的成绩,将于不久发表的凤凰研究可为制定有关腹膜转移癌的治疗指南提供依据。