AIM To evaluate whether a high risk macroscopic appearance(Type Ⅳ and giant Type Ⅲ) is associated with a dismal prognosis after curative surgery, because its prognostic relevance remains elusive in pathological sta...AIM To evaluate whether a high risk macroscopic appearance(Type Ⅳ and giant Type Ⅲ) is associated with a dismal prognosis after curative surgery, because its prognostic relevance remains elusive in pathological stage Ⅱ/Ⅲ(p Stage Ⅱ/Ⅲ) gastric cancer.METHODS One hundred and seventy-two advanced gastric cancer(defined as pT2 or beyond) patients with p Stage Ⅱ/Ⅲ who underwent curative surgery plus adjuvant S1 chemotherapy were evaluated, and the prognostic relevance of a high-risk macroscopic appearance was examined. RESULTS Advanced gastric cancers with a high-risk macroscopic appearance were retrospectively identified by preoperative recorded images. A high-risk macroscopic appearance showed a significantly worse relapse free survival(RFS)(35.7%) and overall survival(OS)(34%) than an average risk appearance(P = 0.0003 and P < 0.0001, respectively). A high-risk macroscopic appearance was significantly associated with the 13^(th) Japanese Gastric Cancer Association(JGCA) pT(P = 0.01), but not with the 13^(th) JGCA pN. On univariate analysis for RFS and OS, prognostic factors included 13^(th) JGCA p Stage(P < 0.0001)and other clinicopathological factors including macroscopic appearance. A multivariate Cox proportional hazards model for univariate prognostic factors identified highrisk macroscopic appearance(P = 0.036, HR = 2.29 for RFS and P = 0.021, HR = 2.74 for OS) as an independent prognostic indicator. CONCLUSION A high-risk macroscopic appearance was associated with a poor prognosis, and it could be a prognostic factor independent of 13^(th) JGCA stage in p Stage Ⅱ/Ⅲ advanced gastric cancer.展开更多
目的研究胃癌患者癌组织中长链非编码RNA(long non-coding RNA,lncRNA)FOXC2-AS1及清道夫受体B组1型分子(scavenger receptor class B typeⅠ,SCARB1)的表达及其临床意义。方法选择2016年5月至2017年9月湖南省郴州市第一人民医院收治的9...目的研究胃癌患者癌组织中长链非编码RNA(long non-coding RNA,lncRNA)FOXC2-AS1及清道夫受体B组1型分子(scavenger receptor class B typeⅠ,SCARB1)的表达及其临床意义。方法选择2016年5月至2017年9月湖南省郴州市第一人民医院收治的96例胃癌患者,采用实时荧光定量PCR检测癌组织中FOXC2-AS1和SCARB1的表达,以癌旁正常组织为对照,分析癌组织中FOXC2-AS1、SCARB1表达与临床病理特征的关系,Pearson法分析FOXC2-AS1与SCARB1的相关性。Kaplan-Meier法(Log-rank检验)分析不同FOXC2-AS1、SCARB1表达水平患者的预后差异。结果与癌旁正常组织相比,癌组织中FOXC2-AS1表达水平明显较高,SCARB1表达水平明显较低。不同肿瘤分期、病理分级癌组织中FOXC2-AS1、SCARB1的表达差异具有显著性(P<0.05)。癌组织中FOXC2-AS1和SCARB1的表达呈显著负相关(r=-0.663,P=0.000)。高FOXC2-AS1表达组患者3年总体生存率明显低于低FOXC2-AS1表达组患者,低SCARB1表达组患者3年总体生存率明显低于高SCARB1表达组患者(P<0.05)。结论胃癌组织中FOXC2-AS1表达升高,SCARB1表达降低,二者均与肿瘤TNM分期、病理分级有关,可作为判断胃癌预后的肿瘤标志物。展开更多
Gastric cancer with distant metastases,such as para-aortic lymph node metastases,hepatic metastases,and peritoneal dissemination,is classified as stage IV.In this situation,cancer cells have formed micrometastases thr...Gastric cancer with distant metastases,such as para-aortic lymph node metastases,hepatic metastases,and peritoneal dissemination,is classified as stage IV.In this situation,cancer cells have formed micrometastases throughout the body;therefore,according to the algorithm of the Japanese guidelines,stage IV cancer is outside the indication for curative resection.Recent advances in some chemical agents have been remarkable,and some patients have survived for long periods even with stage IV gastric cancer.Thus,even in patients with stage IV gastric cancer,there is a possibility that gastrectomy as conversion surgery could play an important role in the treatment strategy.Gastrectomy as conversion therapy can be safely conducted without perioperative mortality and is considered a sufficiently acceptable treatment strategy.However,the significance of conversion surgery for stage IV gastric cancer remains controversial.In this review,we summarize the treatment strategies and outcomes of conversion surgery for stage IV gastric cancer.展开更多
文摘AIM To evaluate whether a high risk macroscopic appearance(Type Ⅳ and giant Type Ⅲ) is associated with a dismal prognosis after curative surgery, because its prognostic relevance remains elusive in pathological stage Ⅱ/Ⅲ(p Stage Ⅱ/Ⅲ) gastric cancer.METHODS One hundred and seventy-two advanced gastric cancer(defined as pT2 or beyond) patients with p Stage Ⅱ/Ⅲ who underwent curative surgery plus adjuvant S1 chemotherapy were evaluated, and the prognostic relevance of a high-risk macroscopic appearance was examined. RESULTS Advanced gastric cancers with a high-risk macroscopic appearance were retrospectively identified by preoperative recorded images. A high-risk macroscopic appearance showed a significantly worse relapse free survival(RFS)(35.7%) and overall survival(OS)(34%) than an average risk appearance(P = 0.0003 and P < 0.0001, respectively). A high-risk macroscopic appearance was significantly associated with the 13^(th) Japanese Gastric Cancer Association(JGCA) pT(P = 0.01), but not with the 13^(th) JGCA pN. On univariate analysis for RFS and OS, prognostic factors included 13^(th) JGCA p Stage(P < 0.0001)and other clinicopathological factors including macroscopic appearance. A multivariate Cox proportional hazards model for univariate prognostic factors identified highrisk macroscopic appearance(P = 0.036, HR = 2.29 for RFS and P = 0.021, HR = 2.74 for OS) as an independent prognostic indicator. CONCLUSION A high-risk macroscopic appearance was associated with a poor prognosis, and it could be a prognostic factor independent of 13^(th) JGCA stage in p Stage Ⅱ/Ⅲ advanced gastric cancer.
文摘目的研究胃癌患者癌组织中长链非编码RNA(long non-coding RNA,lncRNA)FOXC2-AS1及清道夫受体B组1型分子(scavenger receptor class B typeⅠ,SCARB1)的表达及其临床意义。方法选择2016年5月至2017年9月湖南省郴州市第一人民医院收治的96例胃癌患者,采用实时荧光定量PCR检测癌组织中FOXC2-AS1和SCARB1的表达,以癌旁正常组织为对照,分析癌组织中FOXC2-AS1、SCARB1表达与临床病理特征的关系,Pearson法分析FOXC2-AS1与SCARB1的相关性。Kaplan-Meier法(Log-rank检验)分析不同FOXC2-AS1、SCARB1表达水平患者的预后差异。结果与癌旁正常组织相比,癌组织中FOXC2-AS1表达水平明显较高,SCARB1表达水平明显较低。不同肿瘤分期、病理分级癌组织中FOXC2-AS1、SCARB1的表达差异具有显著性(P<0.05)。癌组织中FOXC2-AS1和SCARB1的表达呈显著负相关(r=-0.663,P=0.000)。高FOXC2-AS1表达组患者3年总体生存率明显低于低FOXC2-AS1表达组患者,低SCARB1表达组患者3年总体生存率明显低于高SCARB1表达组患者(P<0.05)。结论胃癌组织中FOXC2-AS1表达升高,SCARB1表达降低,二者均与肿瘤TNM分期、病理分级有关,可作为判断胃癌预后的肿瘤标志物。
文摘Gastric cancer with distant metastases,such as para-aortic lymph node metastases,hepatic metastases,and peritoneal dissemination,is classified as stage IV.In this situation,cancer cells have formed micrometastases throughout the body;therefore,according to the algorithm of the Japanese guidelines,stage IV cancer is outside the indication for curative resection.Recent advances in some chemical agents have been remarkable,and some patients have survived for long periods even with stage IV gastric cancer.Thus,even in patients with stage IV gastric cancer,there is a possibility that gastrectomy as conversion surgery could play an important role in the treatment strategy.Gastrectomy as conversion therapy can be safely conducted without perioperative mortality and is considered a sufficiently acceptable treatment strategy.However,the significance of conversion surgery for stage IV gastric cancer remains controversial.In this review,we summarize the treatment strategies and outcomes of conversion surgery for stage IV gastric cancer.