Clinical characteristics of patients with early gastric prematurity cancer and analysis of complications by endoscopic resection

BACKGROUND Gastric cancer,a prevalent malignancy,poses a severe threat to the health of residents in China.Timely intervention in early stages can extend patients’survival.AIM To analyze clinical characteristics of patients with early gastric cancer and efficacy and risk of complications associated with endoscopic resection.METHODS This study included 175 patients with early gastric cancer treated at our hospital,with no restrictions on sex or age.General data,pathological information,and endoscopic biopsy results were obtained.The clinical characteristics of early gastric cancer were analyzed,and endoscopic resection was performed.Postoperative efficacy and incidence of complications were monitored.Statistical analysis was performed using SPSS 26.0 and GraphPad Prism 8.0 software.RESULTS A total of 175 patients with early gastric cancer were included,with 75.43%(n=132)males and 24.57%(n=43)females.38.29%(n=67)and 35.43%(n=62)of patients had a history of smoking and alcohol consumption,respectively.Comorbidities included diabetes(8.57%,n=15),coronary heart disease(10.29%,n=18),and hypertension(43.43%,n=76),which was highly prevalent.A history of abdominal surgery and family history of digestive system cancer accounted for 21.14%and 17.14%,respectively.The most common lesion location was the antral part of the stomach(52.00%,n=91),followed by the gastric angle,body,and fundus.The pathological types were predominantly high-grade intraepithelial neoplasia(28.00%,n=49)and well-differentiated adenocarcinoma(26.86%,n=47),followed by moderately differentiated adenocarcinoma,high-moderately differentiated adenocarcinoma,and moderate-lowly differentiated adenocarcinoma.89.14%of the patients had intestinal metaplasia and 85.14%had atrophy.After endoscopic resection,re-examination revealed that 13 patients had cancer cells at the tissue margin,with a positive margin rate of 7.43%.Postoperative complications included no cases of gastrointestinal obstruction,but incisional infection(2.86%,n=5),gastric perforation(1.14%,n=2),and gastric bleeding(4%,n=7)were present,with an overall incidence of 8.00%.CONCLUSION Analysis of the clinical characteristics indicated that early gastric cancer is more prevalent in males with a history of hypertension,with lesions most commonly occurring in the antral region of the stomach.The pathological types are often high-grade intraepithelial neoplasia and well-differentiated adenocarcinoma,with over 85%of patients having comorbid intestinal metaplasia and atrophy.Despite endoscopic resection,a positive margin rate persisted,indicating a probability of residual cancer at the margins.Postoperative complications,such as gastrointestinal obstruction,incisional infection,gastric perforation,and gastric bleeding can occur and require timely symptomatic treatment.

New advances in targeted gastric cancer treatment

Despite a decrease in incidence over past decades,gastric cancer remains a major global health problem. In the more recent period, survival has shown only minor improvement, despite significant advances in diagnostic techniques, surgical and chemotherapeutic approaches, the development of novel therapeutic agents and treatment by multidisciplinary teams. Because multiple genetic mutations, epigenetic alterations, and aberrant molecular signalling pathways are involved in the development of gastric cancers, recent research has attempted to determine the molecular heterogeneity responsible for the processes of carcinogenesis, spread and metastasis. Currently, some novel agents targeting a part of these dysfunctional molecular signalling pathways have already been integrated into the standard treatment of gastric cancer, whereas others remain in phases of investigation within clinical trials. It is essential to identify the unique molecular patterns of tumours and specific biomarkers to develop treatments targeted to the individual tumour behaviour. This review analyses the global impact of gastric cancer, as well as the role of Helicobacter pylori infection and the efficacy of bacterial eradication in preventing gastric cancer development. Furthermore, the paper discusses the currently available targeted treatments and future directions of research using promising novel classes of molecular agents for advanced tumours.

Surgical management of patients with bowel obstructions secondary to gastric cancer

AIM: To assess whole-body fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the management of small bowel obstructions (SBOs) secondary to gastric cancer and its role in treatment strategies. METHODS: The medical records of all of the patients who were admitted for an intestinal obstruction after curative resection for gastric cancer were retrospectively reviewed. PET/CT was performed before a clinical treatment strategy was established for each patient. The patients were divided into 2 groups: patients with no evidence of a tumor recurrence and patients with evidence of a tumor recurrence. Tumor recurrences included a local recurrence, peritoneal carcinomatosis or distant metastases. The primary endpoint was the 1-year survival rate, and other variables included patient demographics, the length of hospital stay, complications, and mortality. RESULTS: The median time between a diagnosis of gastric cancer and the detection of a SBO was 1.4 years. Overall, 31 of 65 patients (47.7%) had evidence of a tumor recurrence on the PET/CT scan, which was the only factor that was associated with poor survival. Open and close surgery was the main type of surgical procedure reported for the patients with tumor recurrences. R0 resections were performed in 2 patients, including 1 who underwent combined adjacent organ resection. In the group with no evidence of a tumor recurrence on PET/CT, bowel resections were performed in 7 patients, adhesiolysis was performed in 7 patients, and a bypass was performed in 1 patient. The 1-year survival curves according to PET/CT evidence of a tumor recurrence vs no PET/CT evidence of a tumor recurrence were significantly different, and the 1-year survival rates were 8.8% vs 93.5%, respectively. There were no significant differences (P = 0.71) in the 1-year survival rates based on surgical vs nonsurgical management (0% with nonoperative treatment vs 20% after exploratory laparotomy). CONCLUSION: 18 F-FDG PET/CT can be used to identify the causes of bowel obstructions in patients with a history of gastric cancer, and this method is useful for planning the surgical management of these patients.

Clinical characteristics and treatment of thyroid cancer in children and adolescents: a retrospective analysis of 83 patients

Objective： To study the clinical characteristics, treatment, and prognosis of thyroid cancer in children and adolescents. Methods： We performed a retrospective analysis of clinical data from 83 cases of thyroid cancer in children and adolescents from January 1990 to December 2010. We compared extra-thyroid extension, lymph node metastasis, distant metastasis, and prognosis between pediatric patients 〈12 years of age （27 cases） and those 〉 12 years of age （56 cases）. All the patients agreed to undergo thyroidectomy and endocrine therapy, and the consent was obtained from parents or guardians. Results： Histopathology included papillary carcinoma in 67 cases, papillary carcinoma with partial follicular growth pattern in 1 case, papillary carcinoma with squamous metaplasia in 4 cases, follicular carcinoma in 7 cases, medullary carcinoma in 3 cases, and poorly differentiated carcinoma in 1 case. The total lymph node metastasis rate was 78.31%. Patients ≤12 years of age showed a higher rate of lymph node me- tastasis than the older group （92.59% vs. 71.43%, P=0.028）. The incidence rate in females in the older group was higher than that in the younger group （80.36% vs. 59.26%, P=0.041）. There were no significant differences in extra-thyroid extension, distant metastasis, survival rate, or recurrent disease between the two groups. Conclusions： The lymph node metastasis of thyroid cancer is higher in patients ≤12 years of age than in those 〉12 years of age; the incidence rate is higher in females than in males. Childhood thyroid cancer has a good prognosis, surgery being the most effective treatment. Choosing a reasonable surgery method and comprehensive postoperative treatment can achieve a cure and satisfactory survival rate.

Clinical Characteristics of Prostate Cancer in Advanced Stage and Its Treatment by Chinese and Western Medicine

Prostate cancer is a common malignant tumor in male seniors,with the higher rates in the Europe and America.There has been obvious increase in the incidence of prostate cancer in China recently.It has been reported that the incidence of prostate cancer was only

乳腺癌合并间质性肺疾病患者的临床特征及治疗情况

目的分析乳腺癌合并间质性肺疾病(ILD)患者的临床特征及治疗情况。方法收集76例乳腺癌患者的病历资料,分析其临床特征、检查结果、抗肿瘤药物的使用、ILD的发生及治疗情况。结果76例乳腺癌合并ILD患者中,9例患者无明显症状,其余67例均存在呼吸道等方面的症状;胸部CT检查均呈现不同程度的间质改变,其中52例患者表现为不同程度的低氧血症和呼吸衰竭;患者接受系统性化疗46例,靶向药物27例,恩美曲妥珠单抗2例,内分泌药物氟维司群1例;紫杉类药物ILD发生情况最多,靶向药物中依维莫司ILD发生情况最多,内分泌药物ILD发生情况最少;9例患者不良事件通用术语标准(CTCAE)分级为1级,59例CTCAE分级为2级,8例患者CTCAE分级为3级;所有患者经过治疗后ILD情况均明显好转。结论引起ILD的抗肿瘤药物主要以紫杉类及吉西他滨等细胞毒性药物和雷帕霉素靶蛋白(MTOR)抑制剂靶向药物为主。掌握ILD患者的临床特征及治疗方法,并有针对性地为乳腺癌合并ILD患者选择适宜的治疗方案,既可以增加药物疗效,也可以减少药物的不良反应,改善患者预后。

胃癌组织miR-597、miR-3188表达与患者临床病理特征及预后的关系

目的 探讨胃癌患者组织中微小RNA-597(miR-597)、微小RNA-3188(miR-3188)表达情况,以及与临床病理特征和预后的关系。方法 选取2019年1月至2020年6月在东莞市人民医院住院并行手术治疗的96例胃癌患者为研究对象,收集患者术中切除的胃癌组织标本和癌旁组织标本,同时整理收集患者的临床病理资料。采用实时荧光定量PCR(qPCR)法检测组织中miR-597、miR-3188相对表达水平,分析miR-597、miR-3188表达与患者临床病理特征的关系;采用Kaplan-Meier法分析胃癌组织miR-597、miR-3188表达与患者预后的关系,多因素COX回归分析胃癌患者预后的影响因素。结果 与癌旁组织相比,胃癌组织中miR-597和miR-3188相对表达水平均显著低于癌旁组织(P<0.05)。胃癌组织中miR-597的表达与患者的肿瘤分化程度、TNM分期和淋巴结转移有关(P<0.05),miR-3188的表达与患者的浸润深度、肿瘤分化程度、TNM分期和淋巴结转移有关(P<0.05)。胃癌组织miR-597高表达患者3年生存率高于低表达患者(P<0.05),胃癌组织miR-3188高表达患者3年生存率也高于低表达患者(P<0.05)。肿瘤分化程度、TNM分期和淋巴结转移是胃癌患者死亡的独立危险因素,miR-597和miR-3188是胃癌患者的独立保护因素(P<0.05)。结论 miR-597与miR-3188在胃癌组织中低表达,miR-597与miR-3188可能是评估胃癌患者预后的重要指标。

国医大师王晞星分期辨治胃癌癌因性疲乏经验采菁

王晞星教授认为,胃癌患者癌因性疲乏发生病机为脏腑功能失常、气血阴阳不足,具体可划分早期“脾胃两伤”、进展期“痰瘀互结”、末期“肾虚精亏”。针对此过程,提出不同阶段治法为早期“固本培元、清热解毒”、进展期“化瘀消痰、攻补兼施”、末期“抗癌托毒、滋补肝肾”。选用补中益气汤、六君子汤、血府逐瘀汤、桂枝茯苓丸、滋水清肝饮、三棱、莪术、浙贝母、蜈蚣等方药。临证治疗时注重“和”法思维,病证结合,效果显著。

青少年和年轻人结直肠癌特点及诊疗的研究进展

结直肠癌是较为常见的消化系统恶性肿瘤。近年来,随着人们生活方式、饮食结构的改变及环境污染的加剧,青少年和年轻人(AYAs)结直肠癌的发生率明显升高。AYAs是指15~39岁人群,与老年癌症患者相比,AYAs癌症患者具有更高的长期和晚期风险,预后更差,结直肠癌也成为导致AYAs死亡的重要原因。本研究以结直肠癌为切入点,分析AYAs结直肠癌的发病危险因素、临床特点,探讨AYAs结直肠癌的诊疗方法,以期为临床拟订防控措施提供依据。

胃癌类器官在基础研究与临床应用中的进展

胃癌在全球癌症发病率和死亡率中均位居第5,具有高度的侵袭性和异质性,但由于缺乏表征胃癌发生进展特性的研究模型,胃癌的研究和治疗比较局限。胃癌类器官是一种在体外培育而成的多细胞三维结构,能够模拟原发胃癌的结构和功能,在建立胃癌研究模型、模拟体内肿瘤微环境、药物高通量筛选、发现治疗新靶点、预测临床治疗反应、指导个体化治疗等方面拥有巨大的应用潜力与发展前景。本文对胃癌类器官在基础研究与临床应用中的进展进行综述,以期推动临床前基础研究的进展,为胃癌的临床治疗提供支持。

胃癌患者血浆hsa_circ_0001588水平与TLR4和T淋巴细胞亚群相关性

目的 探究胃癌患者血浆中hsa_circ_0001588水平,并分析其血浆水平与患者临床特征、Toll样受体4(Toll-like receptors 4,TLR4)、T淋巴细胞亚群的关系。方法 选取2021年3月至2022年5月于我院治疗的胃癌患者124例为研究组,另选取接受胃镜检查确诊为浅表性胃炎的患者130例作为良性组以及健康体检者130例作为对照组。采用实时荧光定量聚合酶链反应、Wmini5146流式细胞仪和双抗体夹心ELISA法检测受试者血浆hsa_circ_0001588水平、TLR4水平和CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平。分析血浆hsa_circ_0001588、TLR4、T淋巴细胞对于胃癌的诊断效能以及血浆hsa_circ_0001588水平与TLR4和T淋巴细胞水平的关系。结果 研究组血浆hsa_circ_0001588、TLR4和CD8^(+)表达水平高于良性组和对照组,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平低于良性组和对照组(P<0.05),且研究组患者术后hsa_circ_0001588水平下降。临床分期越高、浸润深度越深、分化程度越低,发生远端转移的患者血浆hsa_circ_0001588水平越高(P<0.05)。血浆hsa_circ_0001588、TLR4和T淋巴细胞对于胃癌均有较好的诊断效能,其联合诊断的整体效能最高。血浆hsa_circ_0001588高表达患者CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)表达较低,TLR4和CD8^(+)表达较高(P<0.05),其血浆hsa_circ_0001588水平与CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)表达呈负相关性,与TLR4和CD8^(+)呈正相关性。结论 胃癌患者血浆hsa_circ_0001588水平偏高,且与CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平呈负相关性,与TLR4、CD8^(+)呈正相关性。

BATF2在胃癌组织中的表达及与患者临床病理特征和预后的关系

目的 探讨碱性亮氨酸拉链转录因子2(basic leucine zipper ATF-like transcription factor 2,BATF2)在胃癌组织中的表达及与患者临床病理特征和预后的关系。方法 收集我院2016年6月至2017年11月134例胃癌患者手术切除的胃癌组织及癌旁组织标本,采用qRT-PCR法测定BATF2的mRNA表达,免疫组化法检测BATF2蛋白表达。分析胃癌患者BATF2表达与临床病理特征间的关系。采用Cox回归分析胃癌患者预后影响因素,Kaplan-Meier法分析BATF2表达与患者预后的关系。结果 胃癌组织中BATF2 mRNA和蛋白表达均显著低于癌旁组织(P<0.05),淋巴结转移、TNM分期为Ⅲ+Ⅳ期、细胞浸润程度为T_(3)~T_(4)、细胞分化程度为低分化的胃癌患者BATF2蛋白阳性表达比例显著低于淋巴结未转移、TNM分期为Ⅰ+Ⅱ期、细胞浸润程度为T_(0)~T_(2)、细胞分化程度为中/高分化的患者(P<0.05)。多因素Cox分析结果表明,淋巴结转移、TNM分期、细胞分化程度、BATF2是胃癌患者预后、复发或死亡的影响因素(P<0.05);Kaplan-Meier法分析结果表明,胃癌患者5年内预后良好率为74.63%(100/134),BATF2高表达患者5年预后良好率(93.33%)显著高于BATF2低表达患者(69.23%)(χ~2=6.445,P<0.05)。结论 BATF2表达与胃癌患者临床病理特征具有密切关系,是胃癌患者复发或死亡的影响因素,BATF2表达上调可能提高胃癌患者生存率。

F-NLR评分评估晚期非小细胞肺癌患者疗效的临床意义

目的探讨F-NLR评分在评估晚期非小细胞肺癌患者疗效和预后的作用。方法选择2018年3月至2019年4月收治的晚期非小细胞肺癌患者72例为观察组,患者连续完成6个周期化疗。根据治疗反应分为化疗不敏感组(出现复发或转移)和化疗敏感组;选择同期健康体检者49例为对照组。采用自动凝血分析仪检测纤维蛋白原(FIB)水平;采用自动细胞分析仪检测各组中性粒细胞计数和淋巴细胞计数,计算NLR;采用受试者工作特征(ROC)曲线确定FIB和NLR阈值后计算F-NLR评分。分析F-NLR评分与非小细胞肺癌患者临床病理特征的关系,采用Cox风险比例回归模型分析影响患者3年总生存的因素。结果ROC曲线显示,FIB水平为3.43 g/L、NLR为2.52时,能预测晚期非小细胞肺癌患者疗效(P<0.05)。观察组晚期非小细胞肺癌患者FIB、NLR及F-NLR评分均高于对照组,差异具有统计学意义(P<0.05)。化疗不敏感组FIB、NLR及F-NLR评分,均高于化疗敏感组,差异具有统计学意义(P<0.05)。F-NLR评分与分化程度及淋巴结转移有关(P<0.05)。Cox风险比例回归模型分析显示,分化程度、淋巴结转移及F-NLR评分是影响晚期非小细胞肺癌患者3年OS的影响因素(P<0.05)。结论高F-NLR评分与晚期非小细胞肺癌患者化疗治疗反应和预后不良有关,有望成为患者治疗反应和不良预后的预测指标。

程序性死亡配体-1和缺氧诱导因子-1α表达与胃癌病人临床病理特征及预后的关系

目的探讨程序性死亡配体-1(PD-L1)和缺氧诱导因子-1α(HIF-1α)表达与胃癌病人临床病理特征及预后的关系。方法2019年7月~2020年7月行胃癌根治术治疗的胃癌病人100例,取病人癌组织标本并选取其癌旁组织(距离癌组织≥5 cm处的正常组织)作为对照组。采用免疫组化SP法检测PD-L1、HIF-1α的表达。采用Spearman相关性分析分析胃癌组织中PD-L1和HIF-1α的相关性;采用Kaplan-Meier法进行胃癌病人3年生存关系分析;采用单因素、多因素Cox回归分析胃癌病人预后死亡的影响因素。结果100例胃癌病人中,PD-L1阳性表达52例,阴性表达48例;HIF-1α阳性表达67例,阴性表达33例,PD-L1和HIF-1α在胃癌组织中的阳性表达率分别为52.00%、67.00%,高于癌旁组织(11.00%、18.00%),差异有统计学意义(P<0.05)。Spearman相关性分析结果显示,胃癌组织中的PD-L1和HIF-1α表达呈正相关(r=0.730,P<0.001)。胃癌病人PD-L1和HIF-1α的表达与TNM分期、淋巴结有无转移、局部有无浸润有关(P<0.05)。胃癌病人术后3年总生存率为48.00%,PD-L1、HIF-1α阳性表达病人3年生存率为28.85%、31.34%,均低于PD-L1、HIF-1α阴性表达病人(68.75%、81.82%)(Log rankχ2=25.155,P<0.001,Log rankχ2=24.552,P<0.001);且PD-L1、HIF-1α阳性表达、TNM分期为Ⅲ~Ⅳ期、淋巴结转移和局部浸润均为胃癌病人不良预后的独立危险因素(P<0.05)。结论胃癌病人癌组织中PD-L1和HIF-1α均高表达,二者呈正相关,并与病人TNM分期、淋巴结转移等临床病理特征及不良预后有关。

胃癌组织中lncRNA PTPRG-AS1、miR-599表达与临床病理特征及预后的关系

目的分析胃癌组织中长链非编码RNA(long non-coding RNA,lncRNA)蛋白酪氨酸磷酸酶受体G基因反义链1(protein tyrosine phosphatase receptor G gene antisense chain 1,PTPRG-AS1)和miR-599表达水平,探讨其与临床病理特征及预后的关系。方法选取华中科技大学同济医学院附属梨园医院2016年1月至2020年2月收治的106例胃癌患者为研究对象。检测胃癌组织及瘤旁组织中lncRNA PTPRG-AS1和miR-599水平。结果胃癌组织中lncRNA PTPRG-AS1水平显著高于瘤旁组织,miR-599水平显著低于瘤旁组织(P<0.05)。lncRNA PTPRG-AS1与miR-599水平呈负相关(r=-0.485,P<0.05)。lncRNA PTPRG-AS1、miR-599均与TNM分期、浸润深度、分化程度、淋巴结转移相关(P<0.05)。lncRNA PTPRG-AS1低表达组、miR-599高表达组生存率显著升高(χ^(2)=8.206、6.881,P<0.05)。lncRNA PTPRG-AS1、miR-599表达是影响胃癌患者不良预后的危险因素(P<0.05)。结论胃癌组织中lncRNA PTPRG-AS1和miR-599表达水平与患者临床病理特征及预后密切相关。

三阴性乳腺癌不同分子亚型临床病理特征分析

目的探讨三阴性乳腺癌(triple-negative breast cancer,TNBC)不同分子亚型(复旦四分型法)与患者临床病理特征的关系。方法收集63例乳腺三阴性浸润性癌,免疫组化法检测AR、CD8、FOXC1、DCLK1蛋白表达,并依据文献将其分为四种分子亚型,分析其临床病理各项指标的关系。结果63例样本中,LAR型13例(20.6%)、IM型25例(39.7%)、BLIS型16例(25.4%)、MEC型9例(14.3%);患者年龄、肿瘤最大径及淋巴结转移与否在四种亚型间无明显差异,而肿瘤病理分级及ki67增殖指数高低在四种亚型中有显著差异,表现为LAR型和IM型组织学级别较高(92.3%、84.0%),而BLIS型和MEC型高ki67增殖指数较多(93.4、100%)。结论复旦四分型法不同分子亚型在与预后相关临床病理特征方面有统计学差异,为TNBC的异质性提供了依据,也有望成为TNBC个体化治疗的新策略。

H.pylori阳性胃癌患者临床病理参数与miR-191/PLCd1表达的关系分析

目的分析H.pylori阳性胃癌患者临床病理参数与miR-191/磷脂酶C-delta-1(phospholipase C-delta-1,PLCd1)表达的关系。方法选取2021年1月至2022年12月收治的H.pylori阳性胃癌患者86例作为H.pylori组,80例H.pylori阴性胃癌患者作为无H.pylori组。回顾性分析两组患者临床资料。比较胃癌组织与癌旁组织miR-191、PLCd1表达及两者比值miR-191/PLCd1在两组间的差异;分析胃癌组织miR-191、PLCd1表达在H.pylori阳性胃癌患者中的相关性;比较并分析H.pylori阳性胃癌患者不同临床病理特征与癌组织miR-191/PLCd1比值的差异和相关性。结果H.pylori组和无H.pylori组癌组织miR-191相对表达量及miR-191/PLCd1比值均显著高于其癌旁组织(P<0.05),H.pylori组癌组织miR-191相对表达量及miR-191/PLCd1比值高于无H.pylori组癌组织(P<0.05);H.pylori组和无H.pylori组癌组织PLCd1相对表达量均明显低于其癌旁组织(P<0.05),H.pylori组癌组织PLCd1相对表达量低于无H.pylori组癌组织(P<0.05)。Pearson相关系数分析显示,癌组织miR-191相对表达量与PLCd1相对表达量呈负相关(r=-0.649,P<0.05)。H.pylori阳性胃癌患者中,浸润深度T_(3)~T_(4)者癌组织miR-191/PLCd1比值明显高于T_(1)~T_(2)者(P<0.05),淋巴结转移者癌组织miR-191/PLCd1比值明显高于无淋巴结转移者(P<0.05),Spearman秩相关性分析显示,癌组织miR-191/PLCd1比值与浸润深度、淋巴结转移呈正相关(r=0.775、0.728,P<0.05)。结论癌组织miR-191/PLCd1比值与H.pylori阳性胃癌生物学行为密切相关,有望成为胃癌诊疗的新靶点。

血清lncRNA CBSLR及ITIH4检测在老年早期胃癌诊断中的临床价值

目的探究血清长链非编码RNA(lncRNA)CBSLR、α胰蛋白酶H4重链(ITIH4)对老年早期胃癌的诊断价值。方法选取2020-2022年该院诊治的90例老年早期胃癌患者为早期胃癌组,选取同期诊治的45例慢性萎缩性胃炎患者作为萎缩性胃炎组,同期健康体检的45例健康人群为健康对照组。采用荧光定量PCR及酶联免疫吸附试验检测各组血清lncRNA CBSLR、ITIH4水平。采用Pearson相关分析血清lncRNA CBSLR、ITIH4水平与肿瘤标志物癌胚抗原(CEA)、糖类抗原(CA)19-9的相关性。比较不同临床病理特征血清lncRNA CBSLR、ITIH4水平差异。采用受试者工作特征曲线分析血清lncRNA CBSLR、ITIH4对老年早期胃癌的诊断价值。结果早期胃癌组血清lncRNA CBSLR、ITIH4、CEA、CA19-9水平均高于萎缩性胃炎组及健康对照组(均P<0.05)。早期胃癌患者血清lncRNA CBSLR、ITIH4与CEA、CA19-9水平均呈正相关(r=0.601~0.751,均P<0.05)。早期胃癌患者血清lncRNA CBSLR、ITIH4水平与肿瘤最大径、浸润深度、分化类型及淋巴结转移有关(均P<0.05),与患者年龄、性别、肿瘤位置、大体类型无关(均P>0.05)。血清lncRNA CBSLR、ITIH4、CEA、CA19-94项联合检测诊断早期胃癌的曲线下面积(0.912,95%CI:0.858~0.949)高于血清lncRNA CBSLR(0.833,95%CI:0.784~0.879),ITIH4(0.806,95%CI:0.760~0.847),CEA(0.791,95%CI:0.742~0.830),CA19-9(0.766,95%CI:0.710~0.815)单项指标检测(Z=4.482、5.130、5.231、6.117,均P<0.05)。结论老年早期胃癌患者血清lncRNA CBSLR、ITIH4水平升高,与胃癌不良临床病理特征有关,血清lncRNA CBSLR、ITIH4、CEA、CA19-94项联合对老年早期胃癌具有较高的诊断价值。

胃癌患者淋巴结转移的影响因素分析

目的探讨胃癌患者淋巴结转移的影响因素。方法根据是否发生淋巴结转移将130例胃癌患者分为转移组(n=21)和非转移组(n=109)。比较两组患者的临床特征,采用多因素Logistic回归模型分析胃癌患者淋巴结转移的影响因素。结果转移组和非转移组患者的吸烟史、病灶部位、肿瘤直径、分化程度、浸润深度、神经浸润情况、脉管及淋巴管浸润情况比较,差异均有统计学意义(P﹤0.05)。多因素Logistic回归分析结果显示,有吸烟史、病灶位于远端胃、肿瘤直径﹥3 cm、低分化、浸润深度M2以上、神经浸润、脉管及淋巴管浸润均是胃癌患者发生淋巴结转移的危险因素(P﹤0.05)。结论有吸烟史、病灶位于远端胃、肿瘤直径﹥3 cm、低分化、浸润深度M2以上、神经浸润、脉管及淋巴管浸润均是胃癌患者发生淋巴结转移的危险因素。临床应加强对高危人群的筛查和早期干预,以降低胃癌患者的淋巴结转移发生率,并采取更有效的治疗措施,提高患者的生存率。

多原发癌的临床特点分析

目的 分析多原发癌的临床特点,以提高多原发癌的诊治水平。方法 回顾性分析2020年11月至2023年1月收治的164例多原发癌患者的临床资料,就多原发癌的发病率、临床特点及治疗方式进行归纳分析。结果 多原发癌的总体发生率为0.64%,男女比例为1∶2.09。同时性多原发癌42例,异时性多原发癌122例。首发癌的好发部位依次为乳腺、呼吸系统及消化系统,第二癌的好发部位依次为呼吸系统、消化系统及生殖系统。手术、放化疗、免疫、内分泌、靶向及介入治疗均是首发癌及第二、三、四癌的重要治疗方式,第二癌的手术率低于首发癌。结论 多原发癌的治疗方式取决于每个肿瘤的病理类型、分期及患者个体差异,应提高对多原发癌的认知,做到早诊断、积极治疗,以提高患者生存质量,延长其生存期。