Extremely well-differentiated adenocarcinoma of the stomach: Clinicopathological and immunohistochemical features

AIM： Minimal deviation carcinoma of the uterine cervix, otherwise known as extremely well-differentiated adenocarcinoma （EWDA）, is characterized by its benign microscopic appearance in contrast to its aggressive behavior. In order to elucidate the clinicopathological features and biological behavior of the gastric counterpart of EWDA, we, using immunohistochemistry, analyzed nine lesions for the phenotypic expression, proliferative activity, and the expression of oncogene-associated products. METHODS： Clinicopathological features, including preoperative biopsy diagnosis, were reviewed. Using immunohitstochemistry, Ki-67 labeling index and expression of p53 and c-erbB-2 protein in the gastric lesions were detected.RESULT： Locations in the middle or upper third of the stomach and polypoid macroscopic features are characteristic of EWDA of the stomach. Although 4 of the 9 lesions showed only focal lymphatic or venous invasion, lymph node metastasis was not present and none of the patients died of the lesions （mean follow-up period, 56 too）. All 9 cases of EWDA could be classified into gastric phenotype （5 lesions） and intestinal phenotype （4 lesions）. The former resembled gastric foveolar epithelium, mucous neck cells or pyloric glands, but their papillary structures were frequently elongated and the tumor cellsand their nuclei were slightly larger and more hyperchromatic compared to normal epithelium. The latter resembled intestinal metaplasia with minimal nulcear atypia and irregular glands; two of these lesions demonstrated complete intestinal phenotype, while two demonstrated incomplete intestinal phenotype. Ki-67 labeling index was low and none of the cases revealed over-expression of p53 and c-erbB-2 protein. CONCLUSION： Unlike minimal deviation carcinoma of the cervix, these findings suggest that EWDA of the stomach is a lesion of low-grade malignancy. This favorable biological behavior is supported by the data of a low Ki-67 labeling index and a lack of p53 or c-erbB-2 protein over-expression. Because of its resemblance to normal gastric mucosa or mucosa with intestinal metaplasia, EWDA is often misdiagnosed. To prevent the misdiagnosis of such lesions, the clinical and pathologic characteristics should be taken into consideration.

Changes of NF-kB,p53,Bcl-2 and caspase in apoptosis induced by JTE-522 in human gastric adenocarcinoma cell line AGS cells:role of reactive oxygen species

AIM: To identify whether JTE-522 can induce apoptosis in AGS cells and ROS also involved in the process, and to investigate the changes in NF-kB, p53, bcl-2 and caspase in the apoptosis process. METHODS: Cell culture, MTT, Electromicroscopy, agarose gel electrophoresis, lucigenin, Western blot and electrophoretic mobility shift assay (EMSA) analysis were employed to investigate the effect of JTE-522 on cell proliferation and apoptosis in AGS cells and related molecular mechanisms. RESULTS: JTE-522 inhibited the growth of AGS cells and induced the apoptosis. Lucigenin assay showed the generation of ROS in cells under incubation with JTE-522. The increased ROS generation might contribute to the induction of AGS cells to apoptosis. EMSA and Western blot revealed that NF-kB activity was almost completely inhibited by preventing the degradation of IkBalpha. Additionally, by using Western blot we confirmed that the level of bcl-2 was decreased, whereas p53 showed a great increase following JTE-522 treatment. Their changes were in a dose-dependent manner. CONCLUSION: These findings suggest that reactive oxygen species, NF-kB, p53, bcl-2 and caspase-3 may play an important role in the induction of apoptosis in AGS cells after treatment with JTE-522.

Gastric choriocarcinoma admixed with an α-fetoprotein-producing adenocarcinoma and separated adenocarcinoma

We report a case of gastric choriocarcinoma admixed with an α-fetoprotein (AFP)-producing adeno-carcinoma. A 70-year-old man was hospitalized for gastric cancer that was detected during screening by esophagogastroduodenoscopy (EGD). Initial laboratory data showed the increased serum level of AFP and EGD revealed a 5-cm ulcerofungating mass in the greater curvature of the gastric antrum. The patient underwent radical subtotal gastrectomywith D2 lymph node dissection and Billroth gastrojejunostomy. Histopathological evaluation confirmed double primary gastric cancer: gastric choriocarcinoma admixed with an AFP-producing adenocarcinoma and separated adenocarcinoma. At 2 wk postoperatively, his human chorionic gonadotropin and AFP levels had reduced and six cycles of adjuvant chemotherapy were initiated. No recurrence or distant metastasis was observed at 4 years postoperatively.

Effect of cis-9,trans-11-conjugated linoleic acid on cell cycle of gastric adenocarcinoma cell line(SGC-7901)

AIM: To determine the effect of cis -9, trans -11-conjugated linoleic acid (c9, t11-CLA) on the cell cycle of gastric cancer cells (SGC-7901) and its possible mechanism in inhibition cancer growth. METHODS: Using cell culture and immunocytochemical techniques, we examined the cell growth, DNA synthesis, expression of PCNA, cyclin A, B(1), D(1), p16(ink4a) and p21(cip/waf1) of SGC-7901 cells which were treated with various c9, t11-CLA concentrations (25, 50, 100 and 200 micromol.L(-1))of c 9, t 11-CLA for 24 and 48h, with a negative control (0.1% ethane). RESULTS: The cell growth and DNA synthesis of SGC-7901 cells were inhibited by c9, t11-CLA.SGC-7901 cells. Eight day after treatment with various concentrations of c9, t11-CLA mentioned above, the inhibition rates were 5.92%, 20.15%, 75.61% and 82.44%, respectively and inhibitory effect of c9, t11-CLA on DNA synthesis (except for 25 micromol.L, 24h) showed significantly less (3)H-TdR incorporation than that in the negative controls (P【0.05 and P【0.01). Immunocytochemical staining demonstrated that SGC-7901 cells preincubated in media supplemented with different c9, t11-CLA concentrations at various times significantly decreased the expressions of PCNA (the expression rates were 7.2-3.0%, 24h and 9.1-0.9% at 48h, respectively), Cyclin A (11.0-2.3%, 24h and 8.5-0.5%,48h), B(1) (4.8-1.8% at 24h and 5.5-0.6% at 48h)and D(1) (3.6-1.4% at 24h and 3.7%-0 at 48h) as compared with those in the negative controls(the expressions of PCNA, Cyclin A, B(1) and D(1) were 6.5% at 24h and 9.0% at 48h, 4.2% at 24h and 5.1% at 48h, 9.5% at 24h and 6.0% at 48h,respectively)(P【0.01), whereas the expressions of P16(ink4a) and P21(cip/waf1), cyclin-dependent kinases inhibitors(CDKI), were increased. CONCLUSION: The cell growth and proliferation of SGC-7901 cell is inhibited by c9, t11-CLA via blocking the cell cycle, with reduced expressions of cyclin A,B(1) and D(1) and enhanced expressions of CDKI(P16(ink4a) and p21(cip/waf1)).

Correlation of the expression of gonadotropin releasing hormone and its receptor in human gastric adenocarcinoma cell proliferation and differentiation

AIM:To investigate the possible correlation of the expression of gonadotropin releasing hormone(GnRH) and its receptor with of proliferating cell nuclear antigen(PCNA) in human gastric adenocarcinoma cell proliferation and differentiation.METHODS:GnRH and its receptor and PCNA were detected in 30 gastric adenocarcinoma by immunohistochemical ABC technique. RESULTS:GnRH and its receptor had the same distribution pattern in gastric adenocarcinoma cells.The positive signal was found mainly in cytoplasm.The content of GnRH and its receptor immunoreative product in high differentiatied adenocarcinoma was significantly higher than those of the other two groups and the low differentiatied adenocarcinoma was the lowest(P< 0.05).PCNA positive signal which was found mainly in nucleus was gradually abated along with the raising of the extent of the differentiation.The differences were significant among the three groups(P< 0.05). In human gastric adenocarcinoma,the expression of GnRH and its receptor was negative correlation with the expression of PCNA(r=0.9).CONCLUSION:GnRH might be involved in the regulation of human gastric adenocarcinoma cell proliferation and differentiation.

Development and validation of a CT-based radiomics nomogram for preoperative prediction of tumor histologic grade in gastric adenocarcinoma

Objectives:To develop and validate a radiomics nomogram for preoperative prediction of tumor histologic grade in gastric adenocarcinoma(GA).Methods:This retrospective study enrolled 592 patients with clinicopathologically confirmed GA(low-grade:n=154;high-grade:n=438)from January 2008 to March 2018 who were divided into training(n=450)and validation(n=142)sets according to the time of computed tomography(CT)examination.Radiomic features were extracted from the portal venous phase CT images.The Mann-Whitney U test and the least absolute shrinkage and selection operator(LASSO)regression model were used for feature selection,data dimension reduction and radiomics signature construction.Multivariable logistic regression analysis was applied to develop the prediction model.The radiomics signature and independent clinicopathologic risk factors were incorporated and presented as a radiomics nomogram.The performance of the nomogram was assessed with respect to its calibration and discrimination.Results:A radiomics signature containing 12 selected features was significantly associated with the histologic grade of GA(P<0.001 for both training and validation sets).A nomogram including the radiomics signature and tumor location as predictors was developed.The model showed both good calibration and good discrimination,in which C-index in the training set,0.752[95%confidence interval(95%CI):0.701-0.803];C-index in the validation set,0.793(95%CI:0.711-0.874).Conclusions:This study developed a radiomics nomogram that incorporates tumor location and radiomics signatures,which can be useful in facilitating preoperative individualized prediction of histologic grade of GA.

Prevalence and outcomes of pancreatic cystic neoplasms in liver transplant recipients

AIM To determine the prevalence,characteristics and clinical course of pancreatic cystic neoplasms(PCNs) in liver transplantation(LT) recipients.METHODS We retrospectively studied consecutive patients who underwent LT between January 1998 to April 2016. Clinical and laboratory data were obtained from patient medical records. Imaging findings on computed tomography and magnetic resonance cholangiopancreatography were reviewed by two radiologists.RESULTS During the study period,872 patients underwent cadaveric LT. Pancreatic cysts were identified in 53/872(6.1%) and 31/53(58.5%) were PCNs [28 intraductal papillary mucinous neoplasm(IPMN),2 mucinous cystic neoplasm(MCN),1 serous cystadenoma]. Patients with PCNs exhibited less male predominance(55% vs 73%,P = 0.03) compared to patients without pancreatic cysts. Thirteen patients(42%) were diagnosed with PCN pre-LT while 18 patients(58%) developed PCN post-LT. The median size of PCNs was 13 mm [interquartile range(IQR) 10-20 mm]. All IPMNs were side-branch type. Most PCNs were found in the head and body of pancreas(37% each),followed by the tail(25%). Five patients underwent further evaluation with endoscopic ultrasound. Progress imaging was performed on 81% of patients. PCNs remained stable in size and number in all but 2 patients. During a median follow up of 39 mo(IQR 26-58 mo),the 2(6%) patients with MCN underwent pancreatectomy. No PCN patient developed pancreatic adenocarcinoma,while 5 died from illnesses unrelated to the PCN. Among patients without PCN,1/841(0.1%) developed pancreatic adenocarcinoma.CONCLUSION The prevalence of PCNs in LT recipients was similar to the general population(3.6%,31/872). Side-branch IPMNs do not appear to have accelerated malignant potential in post-LT patients,indicating the current surveillance guidelines are applicable to this group.

胃肝样腺癌的CT特征

目的分析胃肝样腺癌的临床和CT特征,提高对本病的认识。资料与方法回顾性分析2012年9月—2023年4月苏州大学附属第一医院经病理证实的38例胃肝样腺癌患者的临床病理资料、实验室检查、CT资料,分析病灶大小、形态、密度、边界、强化方式、转移及侵犯等情况,总结其临床及CT特征。结果38例患者中,血清甲胎蛋白水平升高24例,免疫组化甲胎蛋白表达阳性32例。CT表现为胃壁增厚,门静脉期病变最大截面长径2.38~11.95cm,中位数为5.200(3.365,7.215)cm,23例伴溃疡,20例内见坏死,25例周围侵犯,14例出现肝脏转移,5例出现门静脉系统癌栓。结论胃肝样腺癌为罕见肿瘤,血清甲胎蛋白常增高,CT增强检查肿瘤常较大,可见坏死,渐进性或持续强化,易发生转移、侵犯门静脉,认识这些特征有助于提高诊断水平。

胃底腺型胃癌1例并文献复习

目的探讨胃底腺型胃癌(gastric adenocarcinoma of fundic gland type,GA-FG)的临床特征、诊断及鉴别诊断。方法回顾性分析1例GA-FG患者的诊疗经过,并复习相关文献。结果患者为54岁女性,因胃镜检查时发现胃体上部SMT样褪色调病变。该病变表面黏膜光滑,可见扩张的树枝样血管改变;放大内镜技术联合窄带成像技术(ME+NBI)示:病变周边黏膜呈典型蜂窝状结果,病变呈茶褐色,表面微腺管可见融合,腺管开口大小不一,白区不规则,表面微血管不规则;超声胃镜示:可见胃体黏膜层病变,呈中等偏低回声,起源于黏膜层,与黏膜肌层分界不清,黏膜下层完整,大小约0.8 cm×0.5 cm。内镜下切除后病理:胃底腺型腺癌,镜下面积约:0.3 cm×0.3 cm,浸润至黏膜下层(漫润深度约220μm);脉管浸润(-),神经侵犯(-);水平切缘及垂直切缘未见癌细胞;周围黏膜组织慢性炎。免疫组化:MUC6(+);MUC5AC(-);P53无义突变(-);Desmin(示黏膜肌不完整);Syn个别细胞(+);CgA个别细胞(+);CD31及D2-40(脉管内未见癌栓);Ki-67阳性率约10%。结论GA-FG是一种新的组织学类型胃癌,具有独特的临床内镜及病理特征,预后良好,但需要长期随访。

CT动态容积灌注成像检出早期胃癌并评估其病理分型

目的 观察CT动态容积灌注(DVPCT)成像检出早期胃癌并鉴别其病理分型的价值。方法 回顾性分析127例经病理证实的早期胃癌患者,根据术前检查方式分为增强CT组(n=67)或DVPCT组(n=60);比较组间一般资料、CT资料,以及DVPCT组内胃印戒细胞癌(SRCC)与胃腺癌的强化程度、门静脉期与延迟期峰值期相及峰值时间;绘制受试者工作特征(ROC)曲线,计算曲线下面积,评估DVPCT时间-密度曲线(TDC)鉴别早期SRCC与腺癌的效能。结果 DVPCT组肿瘤检出率、剂量长度乘积及有效剂量均高于增强CT组(P均<0.05);2组患者年龄、性别、病理分型、肿瘤位置及肿瘤最大径差异均无统计学意义(P均>0.05)。52例(52/60,86.67%)经DVPCT检出早期胃癌的患者中,SRCC 12例、腺癌39例、黏液腺癌1例;其中,早期胃SRCC与早期胃腺癌患者肿瘤强化程度、门静脉期及延迟期峰值期相及峰值时间差异均有统计学意义(P均<0.05)。以峰值时间37.3 s为最佳截断值,DVPCT TDC鉴别早期胃SRCC与早期胃腺癌的敏感度、特异度、阳性预测值、阴性预测值、准确率及曲线下面积分别为83.33%、84.62%、62.50%、94.29%、84.31%及0.895。结论 DVPCT检出早期胃癌效果优于常规增强CT;TDC可有效鉴别早期胃SRCC与早期胃腺癌。

食管胃结合部腺癌外科治疗中国专家共识(2024年版)

《食管胃结合部腺癌外科治疗中国专家共识(2018版)》自颁布以来,很大程度上促进了我国食管胃结合部腺癌(AEG)的规范化、同质化诊疗,提升了我国AEG的外科治疗水平。经过5年的临床实践,该共识普适性和可行性已得到广泛证实。鉴于AEG发病率持续上升的趋势及其解剖部位、临床病理特征和分子生物学特征的特殊性,AEG成为近5年来外科临床研究的热点之一,并不断有新的临床研究证据发表。但是,对于AEG的定义、分型、分期、手术路径、切除范围、淋巴结清扫规范和消化道重建等外科问题,仍旧存在争议。鉴于此,有必要对2018版的共识进行更新。《食管胃结合部腺癌外科治疗中国专家共识(2024版)》在前一版的基础上,整合并分析5年来新的最佳临床证据,参考最新国际指南与共识,结合我国外科专家组意见,针对AEG外科治疗关键环节,包括AEG的定义和分型、手术径路、手术方式、淋巴结清扫范围、消化道重建方式及外科围手术期治疗等存在争议的问题,提出相关推荐建议,以期更好地规范AEG的外科治疗方式。在本共识中未解决的相关问题,尚需积极开展高质量的临床研究,以逐步探索和解决。

CD44 v6基因编码蛋白表达与胃癌转移和预后的关系

目的观察转移相关粘附分子拼接变异体ＣＤ４４ｖ６在人胃癌组织中的不同表达，探讨ＣＤ４４ｖ６与胃癌病理生物学行为之间的关系，评价ＣＤ４４ｖ６可否作为一个新的客观预测胃癌细胞转移潜能和胃癌患者预后的可靠生物学指标．方法采用鼠抗人ＣＤ４４ｖ６特异性ｍＡｂ，对４５例早期胃癌，２２例中期胃癌和１０３例晚期胃癌手术切除标本之胃原发灶与转移灶进行了ＡＢＣ免疫组化检测．应用χ２检验和Ｌｏｇｒａｎｋ检验方法对结果做统计学分析．结果ＣＤ４４ｖ６在晚期胃癌中的检出率为４６６％（４８／１０３），明显高于早期胃癌（２６７％，１２／４５）和中期胃癌（２７３％，６／２２，Ｐ＜００１）．伴淋巴结转移和伴肝脏转移之胃癌ＣＤ４４ｖ６检出率分别为４９％（５０／１０２）和７１４％（５／７），明显高于不伴转移的胃癌（１８６％，１１／５９，Ｐ＜００１）．肠型胃癌中ＣＤ４４ｖ６检出率为４４９％（４８／１０７），明显高于弥漫型胃癌（２７４％，１７／６２，Ｐ＜００５）．但是，ＣＤ４４ｖ６的表达与胃癌原发灶大小和组织学类型及分化程度未见明显相关．ＣＤ４４ｖ６阳性胃癌患者的术后生存期显著短于ＣＤ４４ｖ６阴性胃癌的患者（Ｐ＝００００２）．结论?

胃肠癌T抗原的表达及其意义

本文应用花生凝集素(PNA)对52例人胃癌和82例结直肠癌进行了亲合组织化学研究。结果表明,胃癌T抗原阳性率是100％,结直肠癌T抗原阳性率是86.6％;正常胃粘膜的部分细胞可见阳性,正常结直肠粘膜全不表达T抗原。作者认为,T抗原对结直肠癌具有较高的特异性,而对胃癌没有特异性,只是肿瘤相关标记。胃肠癌T抗原的定位呈现3种分布形式:(1)腔膜型:沿癌性腺体的腔面呈线状分布,局限于癌细胞的腔面细胞膜及紧邻腺腔的顶部胞浆;(2)胞浆型:定位于癌细胞的部分胞浆或整个胞浆,且失去极性分布;(3)混合型:即以上两型的混合形式。癌细胞T抗原的定位分布与胃肠癌的分化程度和组织学类型有关。

胃腺癌中c-MET、EGFR和HER-2的表达及其与临床病理特征的分析

目的探讨人胃腺癌中c-MET、EGFR和HER-2的表达及其与临床病理特征的关系。方法收集442例行D2/D3胃腺癌根治术R0切除标本,采用免疫组化En Vision两步法检测胃腺癌中c-MET、EGFR和HER-2的表达,并分析其与临床病理特征的相关性。结果胃腺癌中c-MET、EGFR和HER-2的高表达率分别为195/442(44. 1%)、47/442 (10. 6%)和152/442(34. 4%)。胃腺癌中其浸润深度深(P=0. 016)、有神经侵犯(P=0. 006)和弥漫型Lauren分型(P=0. 029)中多见c-MET的高表达。有脉管侵犯者(P=0. 012)多见EGFR的高表达。HER-2的高表达与远处转移(P=0. 031)、无神经侵犯(P=0. 024)、肠型Lauren分型(P <0. 001)及中高分化(P <0. 001)相关。结论受体酪氨酸激酶(receptors tyrosine kinase,RTKs)家族包括c-MET、EGFR和HER-2,与胃癌的侵袭性相关,如神经、脉管的侵犯以及远处转移;三者可作为危险因素的指标,更有望在未来指导胃癌患者酪氨酸激酶抑制剂(tyrosine kinase inhibitor,TKI)的个体化治疗。

胃癌患者术前免疫状态及影响因素

通过检测50例胃癌患者和30例非肿瘤患者外周血NK细胞活性和T细胞亚群来研究胃癌患者术前免疫状态及其影响因素。结果显示:术前胃癌患者免疫功能明显低于非肿瘤患者,而且胃癌患者免疫功能随着病期的进展呈进行性下降,但其免疫状态与肿瘤类型无明显直接关系,与患者的年龄、性别也无关系。而肿瘤患者术前免疫状态与肿瘤病灶大小有直接关系,即病期越晚,肿瘤病灶越大,免疫功能越低。这进一步提示肿瘤患者的免疫抑制是肿瘤源性的,可能由肿瘤细胞分泌的免疫抑制因子所造成。因此应尽可能地切除肿瘤组织以改善患者的免疫状态。

D2-40在原发性胃腺癌淋巴管浸润中的标记及临床病理意义

目的探讨一种新的淋巴管特异标记物D2-40在判断原发性胃腺癌淋巴管浸润中的作用及其临床病理意义。方法应用单克隆抗体D2-40检测74例原发性胃腺癌淋巴管浸润的情况,并分析其和临床病理参数之间及和癌周淋巴结微转移之间的关系。结果D2-40选择性地表达在CD31染色阴性的淋巴管内皮细胞。HE染色和D2-40染色判断肿瘤淋巴管浸润的阳性率分别是16.2%(12/74)和52.7%(39/74),两者间差异有统计学意义(P<0.001)。统计学相关分析显示借助D2-40(r=0.641)和HE(r=0.415)方法判断淋巴管浸润均相关于淋巴结微转移,但两者间差异有统计学意义(P<0.01),提示采用D2-40标记判断淋巴管浸润来预测淋巴结微转移是一种更可靠的手段。结论D2-40抗体的应用较HE染色方法更敏感和特异地检测出肿瘤的淋巴管浸润,并且在预测淋巴结微转移方面有更高的可靠性,因此具有良好的临床病理应用价值。

小胃癌及微小胃癌的诊断治疗:附28例报告

目的 探讨小胃癌及微小胃癌的诊断、治疗方法及病理特点。方法 对近 1 0年收治的2 8例小胃癌及微小胃癌的临床病理资料及诊断治疗方法进行回顾性分析。结果 本组微小胃癌 1 0例 ,小胃癌 1 8例 ,占同期早期胃癌手术病例的 34 .6 %。其中上消化道造影检出率为 8.3 % ,胃镜检查加活检的检出率为 78.8%。病灶均位于胃体和胃窦部。行胃癌D1根治术 6例 ,D2术 2 2例。小胃癌组的浸润深度显著深于微小胃癌组 (P <0 .0 5)。微小胃癌组无胃周淋巴结转移 ,小胃癌组淋巴结转移 2例 (1 1 .1 % )。术后 5年总生存率为 92 .9% ,其中微小胃癌组为 1 0 0 % ,小胃癌组为85.7%。结论 小胃癌及微小胃癌在早期胃癌中所占比例 >1 /3。胃镜检查加活检是诊断小胃癌及微小胃癌的主要手段 ,根治术后 5年生存率高 ,预后较好。

胃癌、胰腺癌患者术后血液高凝状态的临床对比研究

目的 对比研究胃癌、胰腺癌患者术后血液高凝状态的发生 ,发展及其相应的临床监测和有效的临床干预。方法 胃癌、胰腺癌患者各 3 0例 ,随机分为 4组 ;胃癌、胰腺癌患者各设对照组和低分子肝素 (LMWH )组 ,每组 15例。两个LMWH组术后第 1天开始预防性应用LMWH 5 0 0 0U /d× 7d。各组均于术前、术后 2周分别测定血液流变学指标及观察血凝状态。结果 60例胃癌、胰腺癌患者术前全血还原黏度 (BRV )低切、高切偏高 ,胃癌与胰腺癌差异无显著性 (P >0 .0 5 )。术后胃癌对照组BRV低切 (2 0 .3 2± 5 .42 )mPa·s ,高切 (7.96± 3 .16)mPa·s ,1例出现静脉血栓 ,占 3 .3 % ;LMWH组BRV低切 (11.42± 5 .0 3 )mPa·s ,高切 (3 .96± 3 .0 7)mPa·s ,两组间差异有显著性 (P <0 .0 5 )。术后胰癌对照组BRV低切 (2 1.82± 6.17)mPa·s ,高切 (8.62± 3 .48)mPa·s ,2例出现静脉血栓 ,占 6.7% ,胰癌LMWH组BRV低切 (13 .11± 5 .17)mPa·s ,高切 (4 .96± 3 .61)mPa·s ,两组间存在统计学差异(P <0 .0 5 )。胃癌LMWH组、胰腺癌LMWH组无 1例有出血等副作用。结论 胃癌、胰腺癌患者术后血液处于高凝状态 ,BRV明显升高 ,静脉血栓发生率较高 ,胰腺癌较胃癌表现更明显。术后及时进行LMWH的干预 ,可缓和血液高凝状态 。

E2F-1在胃腺癌细胞内质网应激反应中对Mcl-1的调控作用

目的探讨Mcl-1在胃腺癌细胞对内质网应激诱导细胞凋亡耐受中的作用,以及内质网应激状态下E2F-1调控Mcl-1的机制。方法采用PI单染法测定细胞凋亡率;Western blot检测GRP78、Mcl-1、Bcl-2、E2F-1蛋白变化;实时荧光定量PCR检测Mcl-1 mRNA水平变化;转染pcDNA-E2F-1-Flag质粒使细胞高表达E2F-1。结果胃腺癌细胞对衣霉素(TM)诱导的内质网应激性凋亡相对不敏感,这与Mcl-1在蛋白水平和mRNA水平的上调有关。Mcl-1的转录抑制因子E2F-1在TM诱导细胞后表达下调。在内质网应激状态下的胃腺癌细胞中高表达E2F-1可以减弱Mcl-1的上调。结论内质网应激反应引起Mcl-1上调可能在胃腺癌细胞对内质网应激诱导的凋亡耐受中起重要作用;转录因子E2F-1下调可能参与调控Mcl-1的表达。

上调miR-200a、miR-141表达对胃腺癌细胞生长的体外研究

目的探究上调microRNA(miR)-200a和miR-141表达对胃腺癌细胞系SGC-7901细胞侵袭迁移的影响。方法脂质体介导miR-200a(miR-200a组)、miR-141(miR-141组)、miR-200a+miR-141(miR-200a+miR-141组)拟似物转染SGC-7901细胞,同时设未转染组(对照组)、无义序列转染组。应用qRT-PCR检测转染后各组miR的表达,Transwell小室法和划痕实验检测转染后细胞侵袭、迁移能力的变化,Western blot检测转染后E-钙黏蛋白(E-cadherin)、N-钙黏蛋白(N-cadherin)、基质金属蛋白酶-9(MMP-9)的表达,并进行比较分析。结果与对照组和无义序列转染组相比,miR-200a、miR-141和miR-200a+miR-141组miR表达较高,细胞穿膜细胞数较少(均P<0.05),划痕法显示SGC-7901细胞阻滞效果更明显,E-cadherin表达增加,N-cadherin、MMP-9表达减少,且以上变化在miR-200a+miR-141组更显著。结论上调miR-200a、miR-141表达可有效抑制SGC-7901细胞的侵袭迁移。