阶梯式心理护理+聚焦解决模式对胃癌免疫治疗患者负性情绪的改善评价

观察胃癌免疫治疗患者的负性情绪经阶梯式心理护理与聚焦解决模式综合方案干预后的改善情况。方法 2022年3月、2023年10月分别为设定的研究起止时间,研究的疾病是胃癌,设定的研究对象均为接受免疫治疗的胃癌患者,达标数量为44例,随机数字表为此次研究的分组方案,将常规、阶梯式心理护理与聚焦式解决模式综合护理方案分别引入对照组、观察组,对比差异。结果 干预后,观察组的心理状态、自我管理能力、生活质量及护理满意度等指标均更优(P<0.05)。结论 胃癌免疫治疗患者经阶梯式护理方案的科学干预后,负面情绪得以明显改善,欠佳的自我管理能力也有了明显的强化,生活质量水平提升幅度较大,患者对此较为满意。

胃癌的免疫治疗及疗效预测进展

目的:了解胃癌免疫治疗及疗效预测最新研究进展。方法:检索近年来国内外有关胃癌免疫治疗及疗效预测研究的相关文献并进行综述。结果:胃癌免疫治疗研究最多的是免疫检查点抑制剂,尤其是针对抗程序性细胞死亡蛋白-1 (PD-1)/程序性死亡配体-1 (PD-L1)抗体和细胞毒性T淋巴细胞相关抗原4 (CTLA-4抗体)三种类型的研究较多。目前研究火热的免疫PET、CT、MRI和氟脱氧葡萄糖PET的新应用在疗效预测方面都有极大的应用价值。结论:随着免疫治疗研究的深入,胃癌免疫治疗的策略也在不断改进,免疫治疗过程中疗效预测愈发显得重要,针对相应的治疗方法筛选适宜的患者及采用精准治疗手段可进一步让胃癌患者生存获益。Objective: To recognize the latest research progress of gastric cancer immunotherapy and efficacy evaluation. Methods: The domestic and international literature on immunotherapy and efficacy evaluation for GC in recent years were retrieved and reviewed. Results: The most immunotherapy researched was ICIs, especially for programmed death protein-1 (PD-1)/programmed death protein ligand 1 (PD-L1), cytotoxic T lymphocyte associated antigen 4 (CTLA-4 antibody). At present, the new applications of immune PET, CT, MRI and fluorodeoxyglucose PET are of great application value in the efficacy evaluation. Conclusion: With the further study of immunotherapy research, the strategy of immunotherapy for gastric cancer is also constantly improving, and the efficacy evaluation in the process of immunotherapy is becoming more and more important. Screening suitable patients for the corresponding treatment methods and adopting precise treatment methods can further benefit gastric cancer patients.

探讨胃癌免疫治疗中采取PBL教学方式在消化肿瘤内科规培医生临床教学中的应用效果

探讨胃癌免疫治疗中采取PBL教学方式在消化肿瘤内科规培医生临床教学中的应用效果。方法 选取我院消化肿瘤内科2022年3月至5月接受规培的学员共20例作为研究对象,以随机平均分组的方式将相关学员分为观察组及对照组,两组各10名,对照组采取传统LBL教学方法,观察组采取PBL教学方法,对比两组学员的学习效果、学习兴趣和满意程度。结果 观察组在临床综合能力方面显著优于对照组(P<0.05),观察组在学习兴趣方面评分显著高于对照组(P<0.05),观察组满意度显著高于对照组(P<0.05)。结论 PBL教学方式在消化肿瘤内科规培医生临床教学中具有良好的效果。

Detection of let-7a microRNA by real-time PCR in gastric carcinoma

AIM: To establish an accurate and rapid stem-loop reverse transcriptional real-time PCR (RT-PCR) method to quantify human let-7a miRNA in gastric cancer. METHODS: According to the sequence of let-7a miRNA,the stem-loop reverse transcriptional primer,the primers and quantitative MGB probes of real-time PCR were designed and synthesized. The dynamic range and the sensitivity of quantitative reverse transcriptional real-time PCR were determined. The levels of let-7a miRNA were examined in 32 gastric carcinoma samples by stem-loop RT-PCR method. RESULTS: The dynamic range and sensitivity of the let-7a miRNA quantification scheme were evaluated,the result showed the assay could precisely detect 10 copies of mature let-7a miRNA in as few as 0.05 ng of total RNA of gastric mucosa. The results of specificity analysis showed no fluorescence signal occurred even though 50 ng of human genomic DNA was added to the reverse transcription (RT) reaction. The expression level of let-7a miRNA in gastric tumor tissues was significantly lower compared to normal tissues in 14 samples from 32 patients. CONCLUSION: The stem-loop RT-PCR is a reliable method to detect let-7a miRNA which may play an important role in the development of gastric carcinoma.

COX-2 expression in gastric cancer and its relationship with angiogenesis using tissue microarray

AIM: To explore the expression and clinicopathological significance of cyclooxygenase-2 (COX-2) and microvessel density (MVD) in gastric carcinogenesis, and to investigate their roles in the invasion and the relationship between biological behaviors and prognosis of gastric cancer. METHODS: Using Envision immunohistochemistry, COX-2 and CD34 expressions in gastric cancer tissue array were examined. MVD was counted and the relationship between the biological behaviors and prognosis was analyzed. RESULTS: The expression of COX-2 in gastric cancer tissue was significantly higher than that in normal mucosa (χ2 = 12.191, P < 0.05). The over-expression of COX-2 in gastric cancer was obviously related to metastasis and depth of invasion (χ2 = 6.315, P < 0.05), but not related to the histological type and Borrmann type (χ2 = 5.391 and χ2 = 2.228, respectively). Moreover, MVD in gastric cancer tissues was significantly higher than that in the normal mucosa (65.49 ± 20.64 vs 36.21 ± 18.47, t/F = 7.53, P < 0. 05). MVD was related to the histologic type and metastasis (t/F = 3.68 and t/F = 4.214, respectively, P < 0. 05), but not related to the depth of invasion and Borrmann type (t/F = 0.583 and t/F = 0.459, respectively). MVD in COX-2-positive tissues was markedly higher compared to COX-2-negative tissues, indicating a positive correlation between COX-2 expression and MVD (t = 13.12, P < 0. 05). CONCLUSION: Tissue microarray (TMA) is a powerful tool for rapid identifi cation of the molecular alterations in gastric cancer. COX-2 expression, via inducingangiogenesis, may play an important role in gastric carcinogenesis. It could be served as a determinant factor for clinical prognosis and curative effect.

Measurement of circulating levels of VEGF-A,-C,and -D and their receptors,VEGFR-1 and -2 in gastric adenocarcinoma

AIM: To analyze the serum levels and prognostic significance of vascular endothelial growth factor (VEGF) -A,-C,and -D,and their receptors,VEGFR-1 and -2 in gastric adenocarcinomas. METHODS: The serum levels of VEGF family members were measured in 76 control subjects and 76 patients with gastric adenocarcinoma using an enzyme-linked immunosorbent assay (ELISA). These measurements were correlated with clinco-pathological features and survival rates. RESULTS: The serum levels of VEGF-A and its receptor,VEGFR-1,were signifi cantly higher in patients with gastric cancer than in healthy donors (t = 2.3,P = 0.02 and t = 4.2,P < 0.0001,respectively). In contrast,the serum levels of VEGF-D were signif icantly higher in control subjects than in patients (t = 2.9,P = 0.004). There was no significant difference in serum levels of VEGF-C and VEGFR-2 between patients and controls. VEGF-C was associated with advanced tumor stage and presence of metastasis. VEGFR-1 was associated with metastasis,advanced overall stage,tumor differentiation and survival. VEGFR-2 levels were associated with poor tumor differentiation. There was no significant prognostic value for any of the VEGF family members or their receptors except for VEGFR-1 where high levels were associated with a poor overall survival. CONCLUSION: Serum VEGF levels vary significantly in the same cohort of patients with variable clinico-pathological features and prognostic values. The simultaneous measurement of VEGF receptors levels in sera may overcome the limitations of a single biomarker assay.

Unusual gastric and pancreatic metastatic renal cell carcinoma presentation 10 years after surgery and immunotherapy: A case report and a review of literature

Renal cell carcinoma （RCC） is the most common renal tumor, accounting for 2%-3% of all malignancies. Though RCC is known to spread hematogenously, isolated RCC metastasis to the stomach is a rare event. In this article, we describe the clinical course of a patient who developed a pancreatic recurrence of RCC and 1 year later a gastric recurrence of RCC treated 10 years ago with a resection and interleukin-2 （IL-2）. Accumulating evidence indicates that metastatic involvement of the pancreas and stomach should be suspected in any patient with a history of RCC who presents with gastrointestinal symptoms even 10 years after RCC resection and immunotherapy.

ERCC1 expression is a predictor of survival in gastric cancer patients treated with surgery and adjuvant chemotherapy

Objective:The aim of this study was to evaluate the effect of the excision repair cross-complementing(ERCC1) expression on survival in advanced gastric cancer patients who underwent surgical resection and treated with oxaliplatin-based adjuvant chemotherapy.Methods:Sixty-three patients who underwent surgical resection for cure and treated with oxaliplatin-based adjuvant chemotherapy were included in this study.The expressions of ERCC1 of gastric cancer were examined by immunohistochemistry and the patients were categorized into ERCC1-(+) and ERCC1-(-) groups.The relation between ERCC1 expression and survival of patients was examined.Results:Of the 63 eligible patients,36 patients(57.1%) had tumor with a positive expression of ERCC1 and the remaining 27 patients had tumor with a negative ERCC1 expression.Expression differences of ERCC1 didn't correlated with age(P = 0.827),gender(P = 0.12),differentiation(P = 0.113),histological type(P = 0.942),site of tumor(P = 0.221),size of tumor(P = 0.608),stage(P = 0.815) and lymphatic invasion(P = 0.165).Overall survival(OS) was significantly longer in patients without ERCC1 expression,when compared to patients with ERCC1 expression(P = 0.023).Multivariate analysis revealed that ERCC1 expression significantly impacted on OS(HR:4.049;P = 0.000).Conclusion:We concluded that resected and treated with oxaliplatin-based adjuvant chemotherapy gastric cancer patients without ERCC1 expression have a better survival when compared to patients with ERCC1 expression.ERCC1 expression will hopefully provide a rational basis for improving adjuvant chemotherapeutic strategies for gastric cancer patients.ERCC1,itself,may be a prognostic factor for gastric cancer.