Identification of key genes controlling cancer stem cell characteristics in gastric cancer

BACKGROUND Self-renewal of gastric cancer stem cells(GCSCs)is considered to be the underlying cause of the metastasis,drug resistance,and recurrence of gastric cancer(GC).AIM To characterize the expression of stem cell-related genes in GC.METHODS RNA sequencing results and clinical data for gastric adenoma and adenocarcinoma samples were obtained from The Cancer Genome Atlas database,and the results of the GC mRNA expression-based stemness index(mRNAsi)were analyzed.Weighted gene coexpression network analysis was then used to find modules of interest and their key genes.Survival analysis of key genes was performed using the online tool Kaplan-Meier Plotter,and the online database Oncomine was used to assess the expression of key genes in GC.RESULTS mRNAsi was significantly upregulated in GC tissues compared to normal gastric tissues(P<0.0001).A total of 16 modules were obtained from the gene coexpression network;the brown module was most positively correlated with mRNAsi.Sixteen key genes(BUB1,BUB1 B,NCAPH,KIF14,RACGAP1,RAD54 L,TPX2,KIF15,KIF18 B,CENPF,TTK,KIF4 A,SGOL2,PLK4,XRCC2,a n d C1 orf112)were identified in the brown module.The functional and pathway enrichment analyses showed that the key genes were significantly enriched in the spindle cellular component,the sister chromatid segregation biological process,the motor activity molecular function,and the cell cycle and homologous recombination pathways.Survival analysis and Oncomine analysis revealed that the prognosis of patients with GC and the expression of three genes(RAD54 L,TPX2,and XRCC2)were consistently related.CONCLUSION Sixteen key genes are primarily associated with stem cell self-renewal and cell proliferation characteristics.RAD54 L,TPX2,and XRCC2 are the most likely therapeutic targets for inhibiting the stemness characteristics of GC cells.

Identification of key pathways and genes from gastric precancerous lesions to gastric cancer by integrated bioinformatics analysis

Objective:This work aimed to illuminate the potential key genes and pathways in GC tumorigenesis based on bioinfOrmatics analysis.Methods:The differentially expressed genes(DEGs)between GPL tissue samples and GC tissue samples were investigated using the GSE55696 and GSE87666 microarray data from the Gene Expression Omnibus(GEO)database.DEGs were identified by an empirical Bayes method based on the Limma R package.Then,KEGG and GO enrichment analyses of DEGs were performed followed by protein-protein interaction(PPI)network construction.Finally,the overall survival(OS)analysis of key genes was performed by the Kaplan-Meier plotter online tool.Results:A total of 250 DEGs were obtained,of which 216 were up-regulated and 34 were down-regulated.KEGG pathways analysis showed that the up-regulated DEGs were enriched in cytokine-cytokine receptor interaction,chemokine signaling pathway,metabolic pathways,PI3K-Akt signaling pathway,NF-kappa B signaling pathway,and other signaling pathways about cancer,while no down-regulated pathways were enriched.A PPI network of DEGs was constructed with 117 nodes and 660 edges,and 20 genes were selected as hub genes owing to high degrees in the network.According to the Kaplan-Meier analysis,6 out of 20 hub genes including CCR7,FPR1,C3,CXCR5,GNB4,and PPBP with high mRNA expression were associated with poor OS for GC patients.Conclusion:The results of this study provide possible factors for the occurrence of GC,and the identification of the genes and pathways associated with the progression from GPL to GC provides valuable data for investigating the pathogenesis in future studies.

EXPRESSION OF IL-2R ON PERIPHERAL BLOOD LYMPHOCYTES OF PATIENTS WITH COLORECTAL CANCER AND ITS CLINICAL SIGNIFICANCE

Objective: To study expression of membrane receptors of interleukin-2 (CD25) on the peripheral blood lymphocytes (PBL) of patients with colorectal cancer and its clinical significance. Methods: CD25 percentages (CD25%) in PBL of 105 colorectal cancer patients before operation and 100 normal individuals were examined by flow cytometer, and the results were clinically and pathologically analyzed. Results: The mean of CD25% in PBL of the normal individuals was 17.24±5.33, it was significantly lower (P<0.01) than that of the colon cancer patients (21.29±7.95) or rectal cancer patients (21.62±6.11). In contrast to the normal individuals, the means of CD25% in PBL in ulcer type (20.53±6.50) or protruded type (21.56±6.16) colorectal cancer patients were notably elevated (P<0.01). The significant difference (P<0.01) of means of CD25% in PBL was observed between the normal individuals and patients with less than 4 cm mass (22.10±5.43) or 4cm–8cm mass (20.90±6.96). The significant difference (P<0.05) of means of CD25% in PBL was also observed between the normal individuals and patients with greater than 8 cm mass (21.56±5.41). The mean of CD25% in PBL in patients with well differentiation colorectal cancer was 22.20±5.50, it was significantly higher than that in normal individuals (P<0.05). The means of CD25% in PBL in patients with middle or poor differentiation colorectal cancer were 21.30±6.89 and 22.15±5.71 respectively, they were obviously higher than that in normal individuals (P<0.01). The significant difference (P<0.01) of means of CD25% in PBL was present between the colorectal cancer patients without metastatic lymph nodes (22.06±6.90) and normal individuals. The significant difference (P<0.05) of means of CD25% in PBL was present between the colorectal cancer patients with metastatic lymph nodes (20.73±6.40) and normal individuals. The means of CD25% in PBL in colorectal cancer patients in various clinic stages were significantly higher than that in the health subjects (P<0.01). The significant difference (P<0.01) of means of CD25% in PBL was present between the patients whose ages were equal to or less than 60 (21.00±5.76) and normal individuals in the same age group. The significant difference (P<0.05) of means of CD25% in PBL was also present between the patients whose ages were greater than 60 (22.54±7.75) and normal individuals in the same age group. The significant difference (P<0.01) of means of CD25% in PBL was present between the male patients (22.55±7.05) and normal men. The significant difference (P<0.05) of means of CD25% in PBL was also present between the female patients (20.09±5.48) and normal women. Conclusion: The mean of CD25% in PBL of colorectal cancer patients was significantly higher than that in health subjects. Abnormally elevated CD25% were correlative with site of tumor growth, macropathology type of tumor, the degree of tumor differentiation, clinical stage and patient’s age and sex. It may be helpful to detect CD25% in PBL of colorectal cancer patients before operation for diagnosis, immune treatment and judging prognosis.

miRNA145作为抑癌基因在胃癌中的表达及其功能研究

近年来随着miRNA成为新的研究热点,越来越多的研究表明miRNA在肿瘤中发挥促癌基因或抑癌基因的作用。该文通过介绍miRNA145的生物合成和作用机制,进一步探讨其作为抑癌基因在胃癌的发生发展、侵袭转移、早期发现、治疗及预后中的表达及功能研究。

经鼻胃管早期规范化肠内营养的有效监护对胃癌患者的影响

目的:探讨经鼻胃管早期规范化肠内营养的有效监护对胃癌患者的影响.方法:选取青海大学附属医院重症监护病房收治的80例部分胃切除且吻合方式为胃空肠吻合术的胃癌患者随机分为观察组和对照组,各40例,对照组在术后3 d后开始常规的肠内营养支持治疗,观察组术后2 d内给予早期规范化肠内营养支持治疗,并进行有效监护.对比两组患者治疗过程中并发症的发生情况、营养状况指标的变化情况、重症监护病房住院时间及预后的差异.结果:观察组呕吐、反流误吸,腹胀腹泻,消化系出血,菌群失调症的发生率分别为17.5%、10.0%、7.5%、7.5%,均显著低于对照组(55.0%、47.5%、32.5%、32.5%)(P<0.05)对照组治疗后的各项营养状况指标均较治疗前显著下降(P<0.05);观察组治疗后各项营养状况指标均显著高于对照组(P<0.05);观察组在重症监护病房的住院天数(115.92 d±7.73 d)显著少于对照组(153.38 d±11.42 d)(P<0.05),观察组的死亡率为7.5%,显著低于对照组(15.0%)(P<0.05).结论:经鼻胃管早期规范化肠内营养支持治疗配合有效监护能够维持患者较为理想的营养状况,改善患者的免疫功能,减少并发症的发生,促进患者的康复,改善患者的预后,值得在临床上进一步推广应用.

ER-α36介导的胃癌中miRNA表达的研究

目的:探讨胃癌中与雌激素受体(estrogen receptor,ER)-α36有关的miRNA表达差异.方法:构建稳定转染低表达ER-α36和高表达ER-α36的SGC7901细胞系,进行miRNA测序;对20例人体胃癌组织行ER-α36免疫组织化学染色,将其分为阳性组和阴性组后通过Realtime PCR检测miR-184和miR-143的表达.结果:与对照组SGC7901细胞相比,高表达ER-α36的SGC7901细胞出现miR-184、m i R-143等m i R N A表达下调(m i R-184下调2.78倍;miR-143下调2.95倍),低表达ER-α36的SGC7901细胞反之(miR-184上调3.17倍;miR-143上调3.11倍).PCR结果显示人体胃癌组织中ER-α36阴性表达组与ER-α36阳性表达组相比,miR-184上调14.2倍,miR-143上调9.67倍.结论:miR-184和miR-143可能是调控ER-α36的重要分子,参与介导胃癌的发生与发展.

基于电子病历的胃癌治疗方案辅助选择

目的:通过挖掘电子病历文本中的信息,探索有效的文本挖掘方法,以期实现电子病历的决策支持价值。方法:将2500份胃癌患者电子病历随机分为训练组和测试组,利用词典结合统计的方法对训练组病历文本进行分词,根据每个切分词与从病历中抽取的治疗方案的共现频次对切分词进行聚类,统计训练组病历中的文本在各个聚类中词的匹配数,并以训练组病历文本在各类中的匹配词数和治疗方案建立起Bayes判别函数作为决策支持模型,对测试组病历进行验证,对分词方法及判别模型进行评价。结果:随机抽取50份发现分词召回率为74.24%,准确率为82.30%,F-1值为78.06%。在切分词聚为五类时,所建立的判别模型对测试组病历的判定准确率为62%。结论:词典结合统计的分词方法在电子病历文本分词中的效果较好,基于聚类的电子病历文本挖掘可实现病历的决策支持价值,但建立的决策支持模型准确度不高,仍需对建模过程中病历文本分词及切分词的处理进行进一步研究。

胃癌患者术前营养不良诊断及临床应用的研究进展

本文旨在探讨胃癌患者术前发生营养不良的原因、诊断方法和营养不良与胃癌预后的关系,为临床医师对胃癌患者术前诊断营养不良、改善临床结局提供指导。以"胃癌"、"营养不良"等作为关键词在CNKI和Pubmed中查阅相关文献,对胃癌患者术前营养不良的定义、诊断方法、胃癌患者发生营养不良的原因、营养不良与胃癌患者预后的关系、营养不良的诊断与治疗在胃癌加速康复外科临床应用的价值等方面进行归纳总结。研究结果提示,首先,胃癌患者术前可通过营养筛查、营养评估、综合测定的方法诊断营养不良并实施营养治疗。其次,能量摄入、吸收和利用减少,炎性和应激水平增高以及代谢紊乱,是胃癌患者术前发生营养不良的主要原因,并且营养不良是影响胃癌患者预后的危险因素。从而我们发现,联合营养筛查和评估明确诊断营养不良及评估其程度,及时有效地进行营养干预,合理优化营养治疗,可降低术后并发症的发生率和住院费用,缩短总住院时间和术后住院时间,对改善临床预后有重要的意义。

“五字诀”手疗对胃癌术后患者生活态度的影响

目的探讨普外科"五字诀"手疗对胃癌术后患者生活态度的影响.方法选取2015-01/2016-12在中国人民解放军第九八医院外科就诊的胃癌手术患者87例,按照随机数表法将患者分为观察组(44例)和对照组(43例),对照组采用常规护理方式,观察组患者在对照组的基础上给予"五字诀"手疗,采用医学应对方式问卷对两组患者的应对方式进行测评,采用中文版Herth希望量表测评患者干预前后的希望水平,采用状态-特质焦虑量表对患者干预前后焦虑情绪测评.结果观察组应对评分显著优于对照组(19.39分±4.32分vs 15.84分±4.30分,t=12.933,P=0.000),回避、屈服评分均显著低于对照组,差异有统计学意义(t=4.854,P=0.006;t=11.934,P=0.000).观察组患者希望水平显著高于对照组,差异有统计学意义(t=5.932,P=0.003;t=7.092,P=0.001),观察组患者特质焦虑和状态焦虑评分显著低于对照组(31.20分±3.34分vs 38.30分±3.48分,30.22分±3.52分vs 39.94分±3.47分),差异有统计学意义(t=9.049,P=0.000;t=12.930,P=0.000).结论 "五字诀"手疗能够显著提高胃癌术后患者的希望水平,改善患者积极的应对方式和负性情绪,具有较好的临床使用价值.

基于电子胃镜影像数据库的胃癌辅助分析系统

设计了基于电子胃镜影像数据库的胃癌辅助分析系统。根据瑞金医院2004年~2006年的病例资料,建立了涵盖胃镜影像和诊断信息的电子胃镜影像数据库,规范化胃镜影像的描述。利用局部二元模式提取胃镜影像的纹理特征,采用支持向量机进行样本训练,对胃镜影像病灶进行分类识别,结合数据库中的病人相关信息,做出辅助分析,为医生诊断提供参考。