目的探讨原发性胃鳞状细胞癌的预后影响因素,并绘制列线图以预测胃鳞状细胞癌患者的存活期。方法通过SEER Stat 8.3.5软件获取美国国家癌症研究所SEER数据库中2004–2015年期间的199例原发性胃鳞状细胞癌患者的数据。使用X-tile软件确...目的探讨原发性胃鳞状细胞癌的预后影响因素,并绘制列线图以预测胃鳞状细胞癌患者的存活期。方法通过SEER Stat 8.3.5软件获取美国国家癌症研究所SEER数据库中2004–2015年期间的199例原发性胃鳞状细胞癌患者的数据。使用X-tile软件确定年龄的最佳临界值,采用SPSS 25.0软件分析胃鳞状细胞癌的预后因素并绘制Kaplan-Meier曲线,再进行Cox比例风险回归模型分析胃鳞状细胞癌的独立预后因素。使用R studio软件将模型可视化,绘制成列线图。使用C-index评估列线图的预测效果。使用1000次重采样绘制校正曲线,以完成列线图的内部验证。结果199例患者的1、3和5年生存率分别为40.7%、22.4%和15.4%。单因素分析结果显示,年龄(χ^2=6.886,P=0.009)、原发部位(χ^2=14.918,P=0.037)、种族(χ^2=7.668,P=0.022)、手术(χ^2=16.523,P<0.001)、病理分级(χ^2=9.372,P=0.009)、T分期(χ^2=11.639,P=0.009)和M分期(χ^2=31.091,P<0.001)与患者的预后有关。Cox比例风险回归模型结果显示,年龄[HR=1.831,95%CI为(1.289,2.601)]、原发部位[HR=1.105,95%CI为(1.019,1.199)]、M分期[HR=2.222,95%CI为(1.552,3.179)]和手术[HR=0.561,95%CI为(0.377,0.835)]是影响胃鳞状细胞癌生存的独立预后因素。本研究绘制的列线图的一致性指数(C-index)为0.700。结论本研究构建了可靠的预测模型并绘制成了列线图,可供临床借鉴。展开更多
AIM: To investigate the possible association of G→A single nucleotide polymorphism (SNP) at the -1082 position of interleukin (IL)-10 promoter with susceptibility to esophageal squamous cell carcinoma (ESCC) and gast...AIM: To investigate the possible association of G→A single nucleotide polymorphism (SNP) at the -1082 position of interleukin (IL)-10 promoter with susceptibility to esophageal squamous cell carcinoma (ESCC) and gastric cardiac adenocarcinoma (GCA) in a population of a high incidence region of North China.METHODS: IL-10-G1082A promoter SNP was genotyped by polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) in 355 cancer patients (203ESCC and 152 GCA) and 443 healthy controls.RESULTS: Smoking significantly increased the risk of ESCC and GCA development (the age and sex adjusted OR = 1.42and 2.64, 95%CI = 1.11-1.81 and 1.46-4.76, respectively).Similarly, family history of upper gastrointestinal cancer (UGIC) significantly increased the risk of developing ESCC and GCA (the age and sex adjusted OR = 1.44 and 3.10,95%CI = 1.18-1.75 and 1.94-4.97, respectively). The A/A, A/G and G/G genotype frequencies of IL-10-G1082A were 60.3%, 37.0% and 2.7% in healthy controls, 57.6%,39.9% and 2.5% in ESCC and 61.2%, 36.8% and 2.0% in GCA patients, respectively. The frequencies of A and G alleles were 78.8% and 21.2% in healthy controls, 77.6%and 22.4% in ESCC patients and 79.6%, 20.4% in GCA patients. The distribution of genotype and allelotype in ESCC and GCA patients was not significantly different from that in healthy controls (P＞0.05). Compared to the A/A genotype, the combination of A/G and G/G genotypes did not show a significant effect on the risk of developing ESCC and GCA; the adjusted odds ratio was 0.92 (95%CI = 0.76-1.11) in ESCC and 0.95 (95% CI = 0.61-1.46)in GCA, respectively. When stratified for smoking status and family history of UGIC, the combination of A/G and G/G genotypes also did not show any significant influence on the risk of ESCC and GCA development compared to A/A genotypes.CONCLUSION: IL-10-G1082A polymorphism might not be used as a stratification marker to predicate the risk of ESCC and GCA development in North China.展开更多
AIM： To establish whether there are fundamental differences in the biochemistries of adenocarcinomas of the gastroesophageal junction （GEJ） and the squamous cell carcinomas of the lower third of the esophagus （LTE...AIM： To establish whether there are fundamental differences in the biochemistries of adenocarcinomas of the gastroesophageal junction （GEJ） and the squamous cell carcinomas of the lower third of the esophagus （LTE）. METHODS： Between February 1, 1997 and February 1, 2000, we obtained tissue samples at the moment of resection from 54 patients for biochemical analysis. The full set of data could be comprehensively analyzed in 47 of 54 patients＇ samples （81%）. Of these, 29 were adenocarcinomas of the GEJ Siewert type Ⅰ （n = 8）, type Ⅱ （n = 12）, type Ⅲ （n = 9）, and 18 presented as squamous cell carcinomas of the LTE. We evaluated the mean values of 11-lysosomal enzyme and 1-cytosol protease activities of the tumorous and surrounding mucosae as well as their relative activities, measured as the ratio of activity in tumor and normal tissues from the same patient. These data were further analyzed to establish the correlation with tumor localization, TNM stage （lymph-node involvement）, histological type （papillary, signet-ring cell, tubular）, state of differentiation （good, moderate, poor）, and survival （≤24 or ≥24 mo）. RESULTS： In adenocarcinomas, the activity of α-mannosidase （AMAN）, cathepsin B （CB） and dipeptidyl-peptidase Ⅰ （DPP Ⅰ） increased significantly as compared to the normal gastric mucosa. In squamous cell carcinomas of the esophagus, we also found a significant difference in the activity of cathepsin L and tripeptidyl-peptidase Ⅰ in addition to these three. There was a statistical correlation of AMAN, CB, and DPP Ⅰ activity between the level of differentiation of adenocarcinomas of the GEJ and lymph node involvement,because tumors with no lymph node metastases histologically confirmed as well-differentiated, showed a significantly lower activity. The differences in CB and DPP Ⅰ activity correlated well with the differences in survival rates, since the CB and DPP Ⅰ values of those who died within 24 mo following surgical intervention were significantly higher than of those who survived for 2 years or more. CONCLUSION： Adenocarcinomas of the GEJ form a homogenous group from a tumor-biochemical aspect, and differ from the biochemical characteristics of squamous cell carcinomas of the LTE on many points. When adenocarcinomas of the GEJs are examined at the preoperative phase, the ratio of the performed AMAN, CB, and DPP Ⅰ enzymatic activity of the tissue sample from the tumor and adjacent intact mucosa within 2 cm of the tumor may have a prognostic value even in the preoperative examination period, and may indicate that ranking of these patients into the neo-adjuvant treatment group should be considered.展开更多
AIM: To investigate association of the 2Gor1Gsingle nudeotide polymorphism (SNP) in matrix metalloproteinase 1 (MMP1) promoter with susceptibility to esophageal squam-ous cell carcinoma (ESCC) and gastric cardiac aden...AIM: To investigate association of the 2Gor1Gsingle nudeotide polymorphism (SNP) in matrix metalloproteinase 1 (MMP1) promoter with susceptibility to esophageal squam-ous cell carcinoma (ESCC) and gastric cardiac adenocarcinoma (GCA) in a population of North China. METHODS: MMP1 promoter SNP was genotyped by polymerase-chain reaction (PCR)-restriction fragment length polymorphism (RFLP) analysis in 417 cancer patients (234 ESCC and 183 GCA) and 350 healthy controls. RESULTS: The genotype frequencies of the MMP1 promoter SNP in healthy controls were 55.4% (2G/2G), 30% (1G/2G) and 14.6% (1G/1G), respectively. The genotype and allelotype distribution in ESCC and GCA patients was not significantly different from that in healthy controls (all lvalues were above 0.05). Compared with the 1G/1Ggenotype, neither the 2G/2Gnor in combination with the 1G/2G genotype significantly modified the risk of developing ESCC and GCA, the adjusted odds ratio was 1.28 (95%CI = 0.78-2.09), 1.23 (95%CI = 0.38-2.05) in ESCC and 1.39 (95%CI = 0.80-2.41), 1.34 (95%CI = 0.74-2.40) in GCA, respectively. When stratified by smoking status and family history of upper gastrointestinal cancer, the 2G/2Ggenotype alone or in combination with the 1G/2G genotype also did not show any significant influence on the risk of ESCC and GCA development. In addition, influence of the MMP1 SNP on lymphatic metastasis in ESCC and GCA was also not obs-erved. CONCLUSION: The 2Gor 1GSNP in the MMP1 promoter might not modify the risk of ESCC and GCA development and might not be used as a stratification marker to predict the potential of lymphatic metastasis in these two tumor types.展开更多
Objective： The aim of our studywas to discuss changes in the clinicopathological characteristics of gastric cancer in Hehuang Valley of China in recent 10 years. Methods： A retrospective case-control study was perfo...Objective： The aim of our studywas to discuss changes in the clinicopathological characteristics of gastric cancer in Hehuang Valley of China in recent 10 years. Methods： A retrospective case-control study was performed on 2379 newly-diagnosed gastric cancer patients. All of them came from Hehuang Valley. The patients were divided into two groups [recent 5 years （R5Y） and late 5 years （L5Y）] from February 2003 to February 2013, and the clinicopathological data were surveyed retrospectively. Results： The constituent ratio of upper 1/3 gastric cancer in R5Y and L5Y was 33.5% and 20.7%, respectively, and it showed a significant difference between the two groups （X2 = 21.28, P = 0.00）, The constituent ratio of squamous carcinoma/adenosquamous carcinoma was 2.7% and 1.6%, respectively, and it also showed a significant differ- ence between two groups （X2 = 50.91, P = 0.00）. The constituent ratio of moderately-poorly differentiated/poorly differentiated gastric carcinoma was 84.2% and 50.2%, respectively, and it showed statistically significant difference （X2 = 30.28, P = 0.00）. The detection rate of early gastric cancer （EGC） was 1.47% （35/2379）. The constituent ratio of the types of Borrmann II and Borrmann IV of advanced gastric cancer （AGC） among 2379 cases was 47.6% and 40.8%, respectively, and that still showed statistically significant difference （X2 = 18,80, P = 0.00）. The constituent ratio of diffuse-type of gastric cancer in R5Y and L5Y was 36.2% and 30.8%, respectively, even there was a significant difference （X2 = 7.49, P = 0.01）. Furthermore, there were also significant differences in regional lymph nodes metastasis, perineural infiltration and vascular invasion （P 〈 0.05）. The positive detection rate of HER2, ER and PR was 14.88%, 17.23% and 15.93%, respectively. The constituent ratio of HP in two groups was 43.8% and 36.2% respectively, and it also showed a significant difference （~2 = 13.51, P = 0.00）. Conclusion： The pathogenic sites in gastric cancer change to the upper stomach in Hehuang Valley in recent 10 years, and the detection rate of squamous carcinoma/adenosquamous carcinoma reveals a sharp rise. Borrmann III is still one of the main types of advanced gastric cancer, but the detection rates of Borrmann II and IV are increasing. The main type of gastric cancer is the intestinal- type, but the ratio of diffuse-type is also increasing in recent 10 years. The HP detection rate is 40.65% （967/2379）, and it has a slight rise in recent 10 years. The detection rate of poorly differentiated adenocarcinoma is increasing despite the fact that the moderately/moderately-poorly differentiated adenocarcinoma is the main histologic types. High detection rates of lymph nodes metastasis, perineural infiltration and vascular invasion indicate poor prognosis in patients with gastric cancer. There is no change in HER2 positive rate, on the contrary, there are a little increase in ER and PR expression in Hehuang Valley.展开更多
Metastasis is the main reason for cancer-related death.S100A4 is one of the key molecules involved in this event.Several studies have shown that overexpression of S100A4 in non-metastatic cancer cells can make them be...Metastasis is the main reason for cancer-related death.S100A4 is one of the key molecules involved in this event.Several studies have shown that overexpression of S100A4 in non-metastatic cancer cells can make them become metastatic,and knockdown of S100A4 in metastatic cancer cells can curtail their invasive nature.A study by Chen et al published in the World J Gastroenterol 18(9):915-922,2012 is a typical example.This study showed in vitro and in vivo evidence that S100A4 expression level determines the invasiveness of esophageal squamous carcinoma.Considering the fact that more than half of the cancer-related deaths are caused by malignancies derived from the digestive system and esophageal cancer is the 4th top contributor to this fraction,this study warrants more attention.展开更多
OBJECTIVE To investigate the clinical value in a comparison between intraoperative exposure and non-exposure of the recurrent laryngeal nerve （RLN） of the neck during left neck esophagogastric anastomosis following ...OBJECTIVE To investigate the clinical value in a comparison between intraoperative exposure and non-exposure of the recurrent laryngeal nerve （RLN） of the neck during left neck esophagogastric anastomosis following resection of carcinomas of the middle and inferior-segment esophagus. METHODS From January 2003 to April 2009, 237 patients were selected to undergo resection of esophageal squamous carcinoma via posteroexternal incision of the left chest plus gastroesophageal anastomosis at the left neck incision. The 237 cases were divided into 2 groups： 115 of the total cases were in group A （the study group）, cases of resections with neck RLN exposure. Of the patients in this group, 64 were male and 51 female, with a mean age of 49 ranging from 31 to 73 years. Another 122 cases were in group B （the control group）, cases of resections without neck RLN exposure. In this group, 51 of the patients were male and 71 female, with a mean age of 45 ranging from 33 to 75 years. In the 2 groups, there were 9 cases in total with symptoms induced by RLN injury. RESULTS Hoarseness, choking cough when drinking, and difficult expectoration were found in 1 of the cases （1/115） in group A （0.087%）, while there were 8 cases （8/122） presenting with these symptoms in group B （6.5%）. There is statistical signi.cance in the di.erences of RLN injury between the 2 groups （P 〈 0.05）. CONCLUSION Analysis of study cases of esophageal carcinoma resection with left-neck esophagogastric anastomosis in the 2 groups indicated that the exposure of the RLN in group A resulted in an obviously lower rate of neck RLN injury after the surgery, compared to group B, where the RLN was not exposed. Exposure can lead to the avoidance of complications induced by RLN injury, such as dysarthria and choking cough when eating. As a result, satisfactory expectoration, which would diminish the incidence of pulmonary complications, can be reached allowing the patients to recover as early as possible. The results of our study suggest that the exposure of the RLN during the left -neck esophagogastric anastomosis has signi.cant clinical value, and that this approach can be recommended with con.dence.展开更多
文摘目的探讨原发性胃鳞状细胞癌的预后影响因素,并绘制列线图以预测胃鳞状细胞癌患者的存活期。方法通过SEER Stat 8.3.5软件获取美国国家癌症研究所SEER数据库中2004–2015年期间的199例原发性胃鳞状细胞癌患者的数据。使用X-tile软件确定年龄的最佳临界值,采用SPSS 25.0软件分析胃鳞状细胞癌的预后因素并绘制Kaplan-Meier曲线,再进行Cox比例风险回归模型分析胃鳞状细胞癌的独立预后因素。使用R studio软件将模型可视化,绘制成列线图。使用C-index评估列线图的预测效果。使用1000次重采样绘制校正曲线,以完成列线图的内部验证。结果199例患者的1、3和5年生存率分别为40.7%、22.4%和15.4%。单因素分析结果显示,年龄(χ^2=6.886,P=0.009)、原发部位(χ^2=14.918,P=0.037)、种族(χ^2=7.668,P=0.022)、手术(χ^2=16.523,P<0.001)、病理分级(χ^2=9.372,P=0.009)、T分期(χ^2=11.639,P=0.009)和M分期(χ^2=31.091,P<0.001)与患者的预后有关。Cox比例风险回归模型结果显示,年龄[HR=1.831,95%CI为(1.289,2.601)]、原发部位[HR=1.105,95%CI为(1.019,1.199)]、M分期[HR=2.222,95%CI为(1.552,3.179)]和手术[HR=0.561,95%CI为(0.377,0.835)]是影响胃鳞状细胞癌生存的独立预后因素。本研究绘制的列线图的一致性指数(C-index)为0.700。结论本研究构建了可靠的预测模型并绘制成了列线图,可供临床借鉴。
基金Supported by the National Natural Science Foundation of China,No. 30371591
文摘AIM: To investigate the possible association of G→A single nucleotide polymorphism (SNP) at the -1082 position of interleukin (IL)-10 promoter with susceptibility to esophageal squamous cell carcinoma (ESCC) and gastric cardiac adenocarcinoma (GCA) in a population of a high incidence region of North China.METHODS: IL-10-G1082A promoter SNP was genotyped by polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) in 355 cancer patients (203ESCC and 152 GCA) and 443 healthy controls.RESULTS: Smoking significantly increased the risk of ESCC and GCA development (the age and sex adjusted OR = 1.42and 2.64, 95%CI = 1.11-1.81 and 1.46-4.76, respectively).Similarly, family history of upper gastrointestinal cancer (UGIC) significantly increased the risk of developing ESCC and GCA (the age and sex adjusted OR = 1.44 and 3.10,95%CI = 1.18-1.75 and 1.94-4.97, respectively). The A/A, A/G and G/G genotype frequencies of IL-10-G1082A were 60.3%, 37.0% and 2.7% in healthy controls, 57.6%,39.9% and 2.5% in ESCC and 61.2%, 36.8% and 2.0% in GCA patients, respectively. The frequencies of A and G alleles were 78.8% and 21.2% in healthy controls, 77.6%and 22.4% in ESCC patients and 79.6%, 20.4% in GCA patients. The distribution of genotype and allelotype in ESCC and GCA patients was not significantly different from that in healthy controls (P＞0.05). Compared to the A/A genotype, the combination of A/G and G/G genotypes did not show a significant effect on the risk of developing ESCC and GCA; the adjusted odds ratio was 0.92 (95%CI = 0.76-1.11) in ESCC and 0.95 (95% CI = 0.61-1.46)in GCA, respectively. When stratified for smoking status and family history of UGIC, the combination of A/G and G/G genotypes also did not show any significant influence on the risk of ESCC and GCA development compared to A/A genotypes.CONCLUSION: IL-10-G1082A polymorphism might not be used as a stratification marker to predicate the risk of ESCC and GCA development in North China.
文摘AIM： To establish whether there are fundamental differences in the biochemistries of adenocarcinomas of the gastroesophageal junction （GEJ） and the squamous cell carcinomas of the lower third of the esophagus （LTE）. METHODS： Between February 1, 1997 and February 1, 2000, we obtained tissue samples at the moment of resection from 54 patients for biochemical analysis. The full set of data could be comprehensively analyzed in 47 of 54 patients＇ samples （81%）. Of these, 29 were adenocarcinomas of the GEJ Siewert type Ⅰ （n = 8）, type Ⅱ （n = 12）, type Ⅲ （n = 9）, and 18 presented as squamous cell carcinomas of the LTE. We evaluated the mean values of 11-lysosomal enzyme and 1-cytosol protease activities of the tumorous and surrounding mucosae as well as their relative activities, measured as the ratio of activity in tumor and normal tissues from the same patient. These data were further analyzed to establish the correlation with tumor localization, TNM stage （lymph-node involvement）, histological type （papillary, signet-ring cell, tubular）, state of differentiation （good, moderate, poor）, and survival （≤24 or ≥24 mo）. RESULTS： In adenocarcinomas, the activity of α-mannosidase （AMAN）, cathepsin B （CB） and dipeptidyl-peptidase Ⅰ （DPP Ⅰ） increased significantly as compared to the normal gastric mucosa. In squamous cell carcinomas of the esophagus, we also found a significant difference in the activity of cathepsin L and tripeptidyl-peptidase Ⅰ in addition to these three. There was a statistical correlation of AMAN, CB, and DPP Ⅰ activity between the level of differentiation of adenocarcinomas of the GEJ and lymph node involvement,because tumors with no lymph node metastases histologically confirmed as well-differentiated, showed a significantly lower activity. The differences in CB and DPP Ⅰ activity correlated well with the differences in survival rates, since the CB and DPP Ⅰ values of those who died within 24 mo following surgical intervention were significantly higher than of those who survived for 2 years or more. CONCLUSION： Adenocarcinomas of the GEJ form a homogenous group from a tumor-biochemical aspect, and differ from the biochemical characteristics of squamous cell carcinomas of the LTE on many points. When adenocarcinomas of the GEJs are examined at the preoperative phase, the ratio of the performed AMAN, CB, and DPP Ⅰ enzymatic activity of the tissue sample from the tumor and adjacent intact mucosa within 2 cm of the tumor may have a prognostic value even in the preoperative examination period, and may indicate that ranking of these patients into the neo-adjuvant treatment group should be considered.
基金Supported by the Grant from the Natural Science Foundation of China, No. 30371591Grant from Natural Science Foundation of Hebei Province, China, No. C200400062
文摘AIM: To investigate association of the 2Gor1Gsingle nudeotide polymorphism (SNP) in matrix metalloproteinase 1 (MMP1) promoter with susceptibility to esophageal squam-ous cell carcinoma (ESCC) and gastric cardiac adenocarcinoma (GCA) in a population of North China. METHODS: MMP1 promoter SNP was genotyped by polymerase-chain reaction (PCR)-restriction fragment length polymorphism (RFLP) analysis in 417 cancer patients (234 ESCC and 183 GCA) and 350 healthy controls. RESULTS: The genotype frequencies of the MMP1 promoter SNP in healthy controls were 55.4% (2G/2G), 30% (1G/2G) and 14.6% (1G/1G), respectively. The genotype and allelotype distribution in ESCC and GCA patients was not significantly different from that in healthy controls (all lvalues were above 0.05). Compared with the 1G/1Ggenotype, neither the 2G/2Gnor in combination with the 1G/2G genotype significantly modified the risk of developing ESCC and GCA, the adjusted odds ratio was 1.28 (95%CI = 0.78-2.09), 1.23 (95%CI = 0.38-2.05) in ESCC and 1.39 (95%CI = 0.80-2.41), 1.34 (95%CI = 0.74-2.40) in GCA, respectively. When stratified by smoking status and family history of upper gastrointestinal cancer, the 2G/2Ggenotype alone or in combination with the 1G/2G genotype also did not show any significant influence on the risk of ESCC and GCA development. In addition, influence of the MMP1 SNP on lymphatic metastasis in ESCC and GCA was also not obs-erved. CONCLUSION: The 2Gor 1GSNP in the MMP1 promoter might not modify the risk of ESCC and GCA development and might not be used as a stratification marker to predict the potential of lymphatic metastasis in these two tumor types.
基金Supported by a grant from the Basic Research Foundation of Qinghai Province(No.2011-Z-730)
文摘Objective： The aim of our studywas to discuss changes in the clinicopathological characteristics of gastric cancer in Hehuang Valley of China in recent 10 years. Methods： A retrospective case-control study was performed on 2379 newly-diagnosed gastric cancer patients. All of them came from Hehuang Valley. The patients were divided into two groups [recent 5 years （R5Y） and late 5 years （L5Y）] from February 2003 to February 2013, and the clinicopathological data were surveyed retrospectively. Results： The constituent ratio of upper 1/3 gastric cancer in R5Y and L5Y was 33.5% and 20.7%, respectively, and it showed a significant difference between the two groups （X2 = 21.28, P = 0.00）, The constituent ratio of squamous carcinoma/adenosquamous carcinoma was 2.7% and 1.6%, respectively, and it also showed a significant differ- ence between two groups （X2 = 50.91, P = 0.00）. The constituent ratio of moderately-poorly differentiated/poorly differentiated gastric carcinoma was 84.2% and 50.2%, respectively, and it showed statistically significant difference （X2 = 30.28, P = 0.00）. The detection rate of early gastric cancer （EGC） was 1.47% （35/2379）. The constituent ratio of the types of Borrmann II and Borrmann IV of advanced gastric cancer （AGC） among 2379 cases was 47.6% and 40.8%, respectively, and that still showed statistically significant difference （X2 = 18,80, P = 0.00）. The constituent ratio of diffuse-type of gastric cancer in R5Y and L5Y was 36.2% and 30.8%, respectively, even there was a significant difference （X2 = 7.49, P = 0.01）. Furthermore, there were also significant differences in regional lymph nodes metastasis, perineural infiltration and vascular invasion （P 〈 0.05）. The positive detection rate of HER2, ER and PR was 14.88%, 17.23% and 15.93%, respectively. The constituent ratio of HP in two groups was 43.8% and 36.2% respectively, and it also showed a significant difference （~2 = 13.51, P = 0.00）. Conclusion： The pathogenic sites in gastric cancer change to the upper stomach in Hehuang Valley in recent 10 years, and the detection rate of squamous carcinoma/adenosquamous carcinoma reveals a sharp rise. Borrmann III is still one of the main types of advanced gastric cancer, but the detection rates of Borrmann II and IV are increasing. The main type of gastric cancer is the intestinal- type, but the ratio of diffuse-type is also increasing in recent 10 years. The HP detection rate is 40.65% （967/2379）, and it has a slight rise in recent 10 years. The detection rate of poorly differentiated adenocarcinoma is increasing despite the fact that the moderately/moderately-poorly differentiated adenocarcinoma is the main histologic types. High detection rates of lymph nodes metastasis, perineural infiltration and vascular invasion indicate poor prognosis in patients with gastric cancer. There is no change in HER2 positive rate, on the contrary, there are a little increase in ER and PR expression in Hehuang Valley.
基金Supported by The Department of Veterans Affairs of the United States
文摘Metastasis is the main reason for cancer-related death.S100A4 is one of the key molecules involved in this event.Several studies have shown that overexpression of S100A4 in non-metastatic cancer cells can make them become metastatic,and knockdown of S100A4 in metastatic cancer cells can curtail their invasive nature.A study by Chen et al published in the World J Gastroenterol 18(9):915-922,2012 is a typical example.This study showed in vitro and in vivo evidence that S100A4 expression level determines the invasiveness of esophageal squamous carcinoma.Considering the fact that more than half of the cancer-related deaths are caused by malignancies derived from the digestive system and esophageal cancer is the 4th top contributor to this fraction,this study warrants more attention.
文摘OBJECTIVE To investigate the clinical value in a comparison between intraoperative exposure and non-exposure of the recurrent laryngeal nerve （RLN） of the neck during left neck esophagogastric anastomosis following resection of carcinomas of the middle and inferior-segment esophagus. METHODS From January 2003 to April 2009, 237 patients were selected to undergo resection of esophageal squamous carcinoma via posteroexternal incision of the left chest plus gastroesophageal anastomosis at the left neck incision. The 237 cases were divided into 2 groups： 115 of the total cases were in group A （the study group）, cases of resections with neck RLN exposure. Of the patients in this group, 64 were male and 51 female, with a mean age of 49 ranging from 31 to 73 years. Another 122 cases were in group B （the control group）, cases of resections without neck RLN exposure. In this group, 51 of the patients were male and 71 female, with a mean age of 45 ranging from 33 to 75 years. In the 2 groups, there were 9 cases in total with symptoms induced by RLN injury. RESULTS Hoarseness, choking cough when drinking, and difficult expectoration were found in 1 of the cases （1/115） in group A （0.087%）, while there were 8 cases （8/122） presenting with these symptoms in group B （6.5%）. There is statistical signi.cance in the di.erences of RLN injury between the 2 groups （P 〈 0.05）. CONCLUSION Analysis of study cases of esophageal carcinoma resection with left-neck esophagogastric anastomosis in the 2 groups indicated that the exposure of the RLN in group A resulted in an obviously lower rate of neck RLN injury after the surgery, compared to group B, where the RLN was not exposed. Exposure can lead to the avoidance of complications induced by RLN injury, such as dysarthria and choking cough when eating. As a result, satisfactory expectoration, which would diminish the incidence of pulmonary complications, can be reached allowing the patients to recover as early as possible. The results of our study suggest that the exposure of the RLN during the left -neck esophagogastric anastomosis has signi.cant clinical value, and that this approach can be recommended with con.dence.
