Underwater endoscopic mucosal resection for neoplasms in the pyloric ring of the stomach: Four case reports

BACKGROUND Tumors located in the pylorus are technically more complex to resect by endoscopic resection,as the anatomical characteristics of this region can affect the adequate assessment of margins and performance of the procedure.We reported the results of underwater endoscopic mucosal resection(UEMR)of benign mucosal neoplasms located in the pyloric ring.CASE SUMMARY This case series describes 4 patients with 4 mucosal neoplasms located in the pyloric ring.The diameter of each neoplasm was less than 15 mm.We performed UEMR for the lesions.Water immersion enabled slight floating of the lesions,resulting in easy identification.We achieved en bloc resection with a snare and electrosurgical unit.All procedure were performed within 3 min without adverse events.Pathologic examination showed low-grade dysplasia with clear resection margins in one case and hyperplastic polyps in three cases.CONCLUSION UEMR can be an effective and safe treatment method for neoplasms in the gastric pyloric ring.

Experimental study on effect of recombinant human growth hormone combined with chemotherapy on stomach neoplasms implanted in nude mice

Objective: To investigate the effect of different doses of recombined growth hormone (rhGH) on stomach neo- plasms implanted in nude mice, and its efficacy in combining with chemotherapy (flurouracil, 5-FU). Methods: Human stom- ach neoplasms model was established in nude mice. The nude mice were divided into control group, moderate-dose of rhGH group, low-dose rhGH group, 5-FU group, moderate-dose rhGH/5-FU group, and low-dose rhGH/5-FU group. The results of each group were observed after ten days. Results: After therapy, the body mass of rhGH groups was significantly increased compared with control group (P<0.05), the body mass of rhGH/5-FU groups was significantly increased compared with 5-FU group (P<0.05), but it was no significant difference between rhGH/5-FU groups and control group (P>0.05). The average tumor mass and volume of rhGH groups were not significantly increased compared with control group (P>0.05), but they were significantly reduced in 5-FU group and rhGH/5-FU groups (P<0.05). They were no significant difference between rhGH/5- FU groups and 5-FU group (P>0.05). After treatment, the percentages of S, G0/G1 and G2/M phases and proliferation index (PI) were not significantly changed in rhGH groups compared with control group (P>0.05), and the same with rhGH/5-FU groups compared with 5-FU group (P>0.05). The difference caused by dose of rhGH was not significant. Conclusion: rhGH enhances body mass, does not stimulate tumor growth, and has no adverse effects on tumor bearing nude mice. Combined with flurouracil, rhGH does not influence the efficacy of chemotherapy, and has no effect on tumor cell cycle kinetics.

Inhibitory effects of RRR-α-tocopheryl succinate on benzo (a) pyrene (B (a) P)-induced forestomach carcinogenesis in female mice

AIM To study the inhibitory effects of VES( RRR-α-tocopheryl Succinate, VES ), aderivative of natural Vitamin E, on benzo (a)pyrene (B (a) P)-induced forestomach tumor infemale mice.METHODS The model of B (a)P-inducedforestomach tumor was established according tothe methods of Wattenberg with slightmodifications. One hundred and eighty femalemice (6 weeks old) were divided into six groupsequally; negative control (Succinic acid),vehicle control ( Succinate + B (a) P), positivecontrol(B(a) P), high VES(2.5g/kg. b. w + B(a)P), Iow VES(1 .25 g/kg. b. w + B(a) P) ig as wellas VES by ip (20 mg/kg, b. w + B(a) P). Exceptthe negative control group, the mice wereadministrated with B(a)P ig. and correspondingtreatments for 4 weeks to study the anti-carcinogenetic effect of VES during the initiationperiod. The experiment lasted 29 weeks, inwhich the inhibitory effects of VES both ontumor incidence and tumor size were tested.RESULTS The models of B (a)P-inducedforestomach tumor in female mice wereestablished successfully. Some werecauliflower-like, others looked like papilla, evena few were formed into the ulcer cavities. VES at1.25 g/kg. b. w, 2.5 g/kg. b.w. by ig and 20 mg/kg. b. w. via ip could decrease the number oftumors per mouse (1.7 ± 0. 41, 1.6 ± 0.34 and 1.1±0.43), being lower than that of B(a)P group(5.4 ± 0.32, P＜0.05). The tumor incidence wasinhibited by 18.2%, 23.1% and 50.0%. VES at1.25g/kg.b.w., 2.5 g/ kg.b.w. by ig and20 mg/kg. b.w. via ip reduced the total volumeof tumors per mouse (54.8 ± 8.84, 28.4 ± 8.32and 23.9± 16.05), being significantly lower thanthat of B(a)P group (150.2±20.93, P＜0.01).The inhibitory rates were 63.5%, 81.1% and84.1%, respectively.CONCLUSION VES has inhibitory effects on B(a) P-induced forestomach carcinogenesis infemale mice, especially by ip and it may be apotential anti-cancer agent in vivo.

The Influence of Survival Analysis on Runx3 Gene Expression in the Primary Tumor of Patients Suffering from Stomach Carcinoma

Background: Runt domain transcription factor 3 (Runx3) is a putative tumor suppressor in human neoplasia. Previous researches suggested that a lack of Runx3 function contributed to human gastric carcinogenesis, however, it is not clear whether Runx3 is closely associated with clinicopathological features of primary stomach tumor and survival rate of patients. Aims: The article is to investigate the influence of survival analysis on Runx3 gene expression in the primary stomach tumor. Methods: Runx3 mRNA expression was detected in 108 primary gastric tumors and non-tumor tissue by semiquantitative reverse transcription-PCR (RT-PCR). All patients were followed up more than five years after radical gastrectomy. Results: There was a loss or substantial decrease of Runx3 mRNA expression in 108 cases of gastric tumors as compared with that in normal gastric mucosa (p 0.001). According to the gray scale median of Runx3 mRNA in primary tumors, the 108 cases were separated into two groups: The lower expressing group (≤0.403) and the over one (>0.403). By comparing analysis of clinical information between two groups, it was found that the lower expression of Runx3 mRNA in the primary tumor was not only associated with the poor clinicopathological factors, but also the inferior survival duration and cumulative survival rate of patients (p 0.05). Conclusions: These results strongly suggest that Runx3 was an independent prognostic factor and a potential therapeutic target for gastric cancer.

Incidence and survival of stomach cancer in a high-risk population of Chile

AIM:To study the incidence and survival rate of stomach cancer(SC)and its associated factors in a high risk population in Chile. METHODS:The population-based cancer registry of Valdivia,included in the International Agency for Research on Cancer system,covers 356 396 residents of Valdivia Province,Southern Chile.We studied all SC cases entered in this Registry during 1998-2002 (529 cases).Population data came from the Chilean census(2002).Standardized incidence rates per 100 000 inhabitants(SIR)using the world population, cumulative risk of developing cancer before age 75, and rate ratios by sex,age,ethnicity and social factors were estimated.Relative survival(EdererⅡmethod) and age-standardized estimates(Brenner method) were calculated.Specific survival rates(Kaplan-Meier) were measured at 3 and 5 years and survival curves were analyzed with the Logrank and Breslow tests. Survival was studied in relation to demographics, clinical presentation,laboratory results and medical management of the cases.Those variables significantly associated with survival were later included in a Cox multivariate model. RESULTS:Between 1998 and 2002,529 primary gastric cancers occurred in Valdivia(crude incidence rate 29.2 per 100000 inhabitants).Most cases were male(69.0%), residents of urban areas(57.5%)and Hispanic(83.2%), with a low education level(84.5%<8 school years). SC SIR was higher in men than women(40.8 and 14.8 respectively,P<0.001),risk factors were low education RR 4.4(95%CI:2.9-6.8)and 1.6,(95%CI:1.1-2.1) for women and men respectively and Mapuche ethnicity only significant for women(RR 2.2,95%CI:1.2-3.7).Of all cases,76.4%were histologically confirmed,11.5% had a death certificate only(DCO),56.1%were TNM stageⅣ;445 cases(84.1%)were eligible for survival analysis,all completed five years follow-up;42 remained alive,392 died of SC and 11 died from other causes. Specific 5-year survival,excluding cases with DCO,was 10.6%(95%CI:7.7-13.5);5-year relative survival rate was 12.3%(95%CI:9.1-16.1),men 10.9%(95%CI: 7.4-15.2)and women 16.1%(95%CI:9.5-24.5).Fiveyear specific survival was higher for patients aged<55 years(17.3%),with intestinal type of cancer(14.6%), without metastasis(22.2%),tumor size<4 cm(60.0%), without lymphatic invasion(77.1%),only involvement of the mucous membrane(100%).Statistically significant independent prognostic factors were:TNM staging, diffuse type,metastasis,supraclavicular adenopathy, palpable tumor,and hepatitis or ascites. CONCLUSION:Social determinants are the main risk factors for SC,but not for survival.An advanced clinical stage at consultation is the main cause of poor SC survival.

Examined lymph node count for gastric cancer patients after curative surgery

Lymph node(LN)metastasis is the most common form of metastasis in gastric cancer(GC).The status and stage of LN metastasis are important indicators that reflect the progress of GC.The number of LN metastases is still the most effective index to evaluate the prognosis of patients in all stages of LN metastasis.Examined LN(ELN)count refers to the number of LNs harvested from specimens by curative gastrectomy for pathological examination.This review summarizes the factors that influence ELN count,including individual and tumor factors,intraoperative dissection factors,postoperative sorting factors,and pathological examination factors.Different ELN counts will lead to prognosis-related stage migration.Fine LN sorting and regional LN sorting are the two most important LN sorting technologies.The most direct and effective way to harvest a large number of LNs is for surgeons to perform in vitro fine LN sorting.

Prolonged hyperthermic intraperitoneal chemotherapy duration with 90 minutes cisplatin might increase overall survival in gastric cancer patients with peritoneal metastases

BACKGROUND Advanced gastric cancer with synchronous peritoneal metastases(GC-PM)is associated with a poor prognosis.Although cytoreductive surgery with hyperthermic intraperitoneal chemotherapy(CRS-HIPEC)is a promising approach,only a limited number of Western studies exist.AIM To investigate the clinicopathological outcomes of patients who underwent CRSHIPEC for GC-PM.METHODS A retrospective analysis of patients with GC-PM was conducted.All patients were seen at the Department of General and Visceral Surgery,Hospital Barmherzige Brüder,Regensburg,Germany between January 2011 and July 2021 and underwent CRS-HIPEC.Preoperative laboratory results,the use of neoadjuvant trastuzumab,and the details of CRS-HIPEC,including peritoneal carcinomatosis index,completeness of cytoreduction,and surgical procedures were recorded.Disease-specific(DSS),and overall survival(OS)of patients were calculated.RESULTS A total of 73 patients were included in the study.Patients treated with neoadjuvant trastuzumab(n=5)showed longer DSS(P=0.0482).Higher white blood cell counts(DSS:P=0.0433)and carcinoembryonic antigen levels(OS and DSS:P<0.01),and lower hemoglobin(OS and DSS:P<0.05)and serum total protein(OS:P=0.0368)levels were associated with shorter survival.Longer HIPEC duration was associated with more advantageous median survival times[60-min(n=59):12.86 mo;90-min(n=14):27.30 mo],but without statistical difference.To obtain additional data from this observation,further separation of the study population was performed.First,propensity score-matched patient pairs(n=14 in each group)were created.Statistically different DSS was found between patient pairs(hazard ratio=0.2843;95%confidence interval:0.1119-0.7222;P=0.0082).Second,those patients who were treated with trastuzumab and/or had human epidermal growth factor receptor 2 positivity(median survival:12.68 mo vs 24.02 mo),or had to undergo the procedure before 2016(median survival:12.68 mo vs 27.30 mo;P=0.0493)were removed from the original study population.CONCLUSION Based on our experience,CRS-HIPEC is a safe and secure method to improve the survival of advanced GC-PM patients.Prolonged HIPEC duration may serve as a good therapy for these patients.

Proton pump inhibitors and stomach neoplasm

This study aimed to explore the relationship between proton pump inhibitors(PPIs)and gastric tumors and determine the reasons behind these connections.We reviewed studies on PPIs and stomach tumors.We explored the relationship between PPIs and different types of gastric neoplasms according to the classification of gastric neoplasms.Long-term use of PPIs is associated with stomach infection,high gastrin levels,and rebound acid hypersecretion,which are directly or indirectly related to the development of gastric neoplasms.PPIs can increase the risk of gastric fundal polyps.Further evidence is needed to prove that it can increase the risk of gastric cancer.

Extraskeletal Ewing sarcoma of the stomach:A rare case report

BACKGROUND Extraskeletal Ewing sarcoma(EES)is a rare and highly malignant small round cell tumor associated with a poor clinical outcome.Ewing sarcoma(ES)involving the stomach is an uncommon presentation and can be easily confused with other small round cell tumors.We herein present a rare case of ES involving the gastric area.CASE SUMMARY We report a case of gastric ES in a 19-year-old female patient who initially presented with a complaint of a tender epigastric mass for 5 d.Contrast-enhanced abdominal computed tomography revealed a soft-tissue-density mass with a diameter of 8.5 cm between the liver and stomach;the mass was connected to the gastric antrum.Then,the mass was surgically excised completely.Upon histopathological,immunophenotype and molecular analysis,the mass was identified to be a primary gastric ES.CONCLUSION EES is an aggressive tumor with poor prognosis.Therefore,early diagnosis and timely intervention are essential for a good prognosis.It is imperative for us to raise awareness about this rare tumor.Surgical resection is still the best treatment option.

基于倾向性评分匹配的T_(4a)期胃癌腔镜辅助与开腹手术近期疗效的对比分析

目的:探讨T_(4a)期胃癌行腹腔镜辅助D2根治术的近期疗效。方法:采用倾向性评分匹配,分析2014年1月至2020年12月为T_(4a)期胃腺癌患者行D2淋巴结清扫的临床资料。将患者分为开腹组(n=362)与腹腔镜组(n=134),通过倾向性评分匹配对数据进行1∶1匹配,匹配容差设为0.03。最终获得两组病例各134例。比较两组手术情况、术后并发症、术后炎性指标变化及2年总生存率。结果:倾向性匹配后,两组基线资料具有可比性(P>0.05)。两组术后首次进食时间、住院时间、并发症情况差异均无统计学意义(P>0.05);腹腔镜组与开腹组手术时间[240(203.75,256.25)min vs.140(120,190)min,P<0.05]、术中出血量[200(100,300)mL vs.200(200,300)mL,P<0.05]、淋巴结清扫数量[20.5(17,27.25)vs.16(10,23),P<0.05]、切口长度[5(5,6)cm vs.12(10,15)cm,P<0.05]、术后排气时间[4(3,6)d vs.5(3,6)d,P<0.05]、术后下床活动时间[2(2,3)d vs.3(2,3)d,P<0.05]差异均有统计学意义。两组术前中性粒细胞-淋巴细胞比值、血小板-淋巴细胞比值、淋巴细胞-单核细胞比值差异无统计学意义(P>0.05),术后血小板-淋巴细胞比值差异无统计学意义,腹腔镜组中性粒细胞-淋巴细胞比值低于开腹组,淋巴细胞-单核细胞比值高于开腹组,差异有统计学意义。开腹组与腹腔镜组术后2年总生存率为53.3%与48.3%,差异无统计学意义(P=0.211)。结论:对于T_(4a)期胃癌,腹腔镜手术后并发症发生率、2年生存率与开腹手术相当,但腹腔镜手术具有创伤小、美观、术后康复快的优势。

1例初始表现为急性弥散性血管内凝血的胃低分化腺癌伴多发转移:^(18)F-FDG PET/CT显像所见

患者女,20岁,无明显诱因阵发性下腹部疼痛伴牙龈出血、皮肤散在瘀斑及肛门坠胀感9天;既往体健。查体:贫血貌,全身皮肤散在片状瘀斑,四肢皮肤干燥;腹部柔软,无压痛及反跳痛。实验室检查:红细胞2.49×10^(12)/L,血小板36×10^(9)/L,血红蛋白70 g/L,血浆鱼精蛋白副凝固实验(+),D-二聚体>20 mg/L,纤维蛋白原降解产物>150.00 mg/L,糖类抗原12573.40 U/ml。

血清miR-345、miR-138及miR-22与晚期胃癌患者化疗敏感性的相关性分析

【目的】探讨血清微小RNA-345(miR-345)、miR-138及miR-22与晚期胃癌患者化疗敏感性的相关性。【方法】100例均接受同一化疗方案治疗的晚期胃癌患者,依据疗效分为有效组(n=69)及无效组(n=31),比较两组临床病理特征及血清相关指标,绘制受试者工作特征(ROC)曲线分析血清miR-345、miR-138及miR-22预测晚期胃癌化疗效果的价值,采用多因素Logistic回归分析影响患者化疗效果的因素。【结果】Ⅲ期患者的血清miR-345相对表达量低于Ⅳ期患者,miR-138及miR-22相对表达量高于Ⅳ期患者(P<0.05);有效组miR-345低于无效组,miR-138、miR-22高于无效组(P<0.05)。经ROC曲线分析证实,血清miR-345、miR-138及miR-22能用于预测晚期胃癌的化疗效果,其敏感度与特异性分别为0.855、0.935、0.971、0.839和0.884、0.903(均P<0.05)。多因素Logistic回归分析显示,病理分期为Ⅳ期、miR-345≥14.5、miR-138≤2及miR-22≤3.12为晚期胃癌患者化疗效果不佳的危险因素(P<0.05)。【结论】血清miR-345≥14.5、miR-138≤2、miR-22≤3.12均为导致化疗效果不佳的危险因素,其可作为评估患者化疗效果的生物学标志物。

吲哚菁绿标记近红外荧光腹腔镜胃癌根治术的应用研究

目的:探讨吲哚菁绿(ICG)在腹腔镜胃癌根治术中淋巴结定位及清扫的应用价值。方法:回顾分析2018年1月至2019年5月接受腹腔镜胃癌D2根治术的73例胃癌患者的临床资料。其中35例术前经ICG标记后行腹腔镜手术(ICG组),38例行常规腹腔镜胃癌根治术(对照组)。对比分析两组淋巴结清扫总数、手术时间、出血量、术后并发症及住院时间。结果:两组均顺利完成腹腔镜胃癌根治术。ICG组与对照组手术时间[(195.31±35.12)min vs.(201.48±36.57)min,P>0.05]、术中出血量[(90.58±18.27)mL vs.(92.44±20.25)mL,P>0.05]、术后排气时间[(3.25±1.35)d vs.(3.17±1.65)d,P>0.05]、术后住院时间[(12.55±3.25)d vs.(13.50±3.65)d,P>0.05]差异均无统计学意义。两组淋巴结清扫数量差异有统计学意义[(47.71±16.43)枚vs.(30.22±11.67)枚,P<0.05]。术后平均随访(27±13)个月,其中2例吻合口复发,予以手术切除,无死亡病例。结论:ICG成像技术方便、安全、有效,可确保淋巴结清扫的安全性、有效性,避免淋巴结残留。

蛋白质琥珀酰化参与丁酸抑制胃癌细胞增殖及迁移的作用

目的:研究丁酸对胃癌细胞增殖及代谢的影响,并探讨其潜在作用机制。方法:使用5 mmol/L丁酸钠处理胃癌细胞48 h后,通过EdU染色及Transwell法检测细胞增殖、迁移情况;收集丁酸处理后的胃癌细胞,提取代谢物进行代谢组学分析筛选出其中显著富集的代谢通路以及上调的代谢物;采用Western blot以及细胞免疫荧光检测丁酸钠处理后胃癌细胞蛋白质琥珀酰化程度,同时采用RT-qPCR检测SIRT5、SUCLG1、SUCLG2和SUCLA2的mRNA水平。结果:丁酸钠处理48 h后胃癌细胞增殖被显著抑制,细胞中检测到三羧酸循环及氧化磷酸化等代谢通路显著富集,其中三羧酸循环代谢物L-苹果酸、琥珀酰辅酶A及延胡索酸显著上调(均P<0.05);Western blot和免疫荧光显示丁酸处理后胃癌细胞蛋白琥珀酰化水平上调(P<0.05)。同时RT-qPCR证实了丁酸处理上调了琥珀酰辅酶A合成酶编码基因SUCLG1、SUCLG2和SUCLA2的mRNA表达水平(均P<0.05),但并未影响SIRT5表达(P>0.05)。结论:丁酸能够抑制胃癌细胞增殖及迁移,其可能通过促进SUCLs表达以及上调琥珀酰辅酶A水平并进一步促进胃癌细胞蛋白质琥珀酰化实现。

Survivin在早期胃癌及癌前病变中的表达及其与PTEN表达的关系

目的:探讨Survivin在早期胃癌及癌前病变中的表达及其与PTEN表达的关系。方法:采用免疫组化SP法检测Survivin、PTEN基因蛋白在30例正常胃黏膜、20例不完全型大肠化生,93例轻、中、重度不典型增生和54例早期胃癌中的表达。结果:Survivin在正常胃黏膜不表达(0/30),在不完全型大肠化生的阳性表达率为5.00%(1/20);在轻、中和重度不典型增生的阳性率分别为6.25%(2/32)、8.57%(3/35)和65.73%(17/26),其中轻、中度不典型增生与重度不典型增生的差异有统计学意义,P<0.05。在早期胃癌中阳性表达率为68.51%(37/54)。Survivin基因在早期胃癌中的阳性与阴性表达中PTEN的阳性表达呈明显负相关,r=-0.564,P=0.0000。结论:Survivin在早期胃癌中表达上调,说明该基因在早期胃癌的发生过程中作用重要,Survivin表达越高,早期胃癌的分化程度越低。早期胃癌中Survivin的阳性表达与PTEN阳性表达密切相关。

腹腔镜胃癌根治术中胃右系膜完整切除的体会

目的:探讨腹腔镜胃癌根治术中胃右系膜完整切除的体会。方法:收集2022年3月至2022年12月行基于膜解剖的3D腹腔镜根治性远端胃及全胃切除术的58例患者的临床资料,其中42例离断十二指肠后显露门静脉,切除门静脉前方的胃右系膜;16例于离断十二指肠前显露门静脉,切除门静脉前方的胃右系膜。记录胃右系膜内的淋巴结数量、术后相关并发症及术后恢复情况。结果:58例胃癌患者均在腹腔镜下成功完成胃右系膜的完整分离、血管离断。胃右系膜平均清扫淋巴结(1.2±0.5)枚。标本病理检查结果显示胃右系膜内淋巴结均为阴性。术后出现吻合口出血1例、胃瘫1例,均经保守治疗后治愈出院。结论:从后方将胃右系膜抬起分离,较从前方分离能更好、更完整地分离胃右系膜。离断十二指肠前或后完成门静脉前方胃右系膜的切除各有优势,离断前切除出血较少,离断后切除视野较开阔;完成门静脉前方胃右系膜切除时应防止过度牵拉导致胆总管牵拉从而损伤胆总管。

凋亡抑制蛋白survivin在胃癌组织中的表达及意义

目的:研究凋亡抑制蛋白survivin在胃癌组织中的表达情况,探讨该基因对胃癌复发、远处转移及预后的意义。方法:将胃癌组织中survivin的表达用免疫组化法进行检测,按survivin是否表达分为表达阳性与阴性两组,同时行相同的治疗(化疗与抗肿瘤)。对两组病例进行随访,比较两组患者的预后情况。结果:共有78例患者纳入研究和随访观察,47例患者标本survivin呈现不同程度的阳性表达,阳性率60.25%。survivin阳性组术后12～24个月复发率(51±2)%高于survivin阴性组(9±1)%,两者差异有显著性(P<0.05)。结论:随着胃癌浸润程度的加深,survivin的阳性表达率升高;survivin基因表达阳性患者术后复发转移较对照组早。Survivin蛋白可以作为胃癌预后判断的标志物之一。

Survivin在胃癌中的表达及其与COX-2相关性的研究

目的 :探究凋亡抑制基因survivin在胃癌组织中的表达与COX 2表达的相关性。方法 :运用S P免疫组化技术 ,检测survivin和COX 2蛋白在 93例胃癌组织、2 0例正常胃黏膜组织以及胃癌细胞株MGC 80 3中的阳性率。结果 :survivin蛋白在 2 0例正常胃黏膜组织中阴性 ,而 93例胃癌组织中有 66例阳性 ,占 71% ,差异有显著性 (P <0 .0 1) ,COX 2蛋白在胃癌组织中的阳性率为 76.3 % ,MGC 80 3细胞中survivin和COX 2蛋白均阳性。Survivin蛋白阳性率与胃癌组织的分化程度、淋巴结转移、TNM分期相关 ,而与浸润程度不相关 ,并与COX 2蛋白阳性呈正相关 (Pearson列联系数 0 .2 2 7P <0 .0 5)。结论 :肿瘤组织中survivin蛋白的特异性阳性在胃癌的发生发展中起重要作用 ;survivin蛋白与胃癌组织中COX 2蛋白的阳性密切相关 ,两者可能存在共同的激活机制 。

良恶性胃溃疡组织中PTEN、survivin的表达及意义

目的探讨良、恶性胃溃疡组织中PTEN和survivin的表达变化及临床意义。方法采用免疫组化SP法检测63例无癌前病变的胃溃疡、68例有癌前病变胃溃疡及83例溃疡型胃癌组织中PTEN和survivin蛋白的表达,分析二者的相关性及其与溃疡型胃癌病理特征的关系和临床价值。结果无癌前病变、有癌前病变的胃溃疡及溃疡型胃癌组织中PTEN表达逐渐下降(P<0.01),survivin表达逐渐升高(P<0.01),二者的表达呈负相关(r=-0.489,P<0.01)。PTEN表达与溃疡型胃癌分化类型有关(P<0.01),survivin表达与有癌前病变胃溃疡病理进展有关(P<0.05)。PTEN、survivin在溃疡型胃癌检测中特异度分别为79.39%、57.25%,灵敏度分别为52.38%、71.08%。结论良、恶性胃溃疡组织中PTEN和survivin蛋白表达不同,检测其组织中PTEN和survivin对良、恶性胃溃疡的鉴别及观察溃疡的组织演变可能具有重要意义。

腹部脂肪及骨骼肌CT测量在胃癌患者营养评估中的价值

目的探讨腹部脂肪及骨骼肌CT测量指标在胃癌患者营养评估中的价值。方法连续收集胃癌患者56例,记录临床营养评估指标、营养风险筛查2002(nutrition risk screening,NRS2002)评分及患者主观整体评估(patient-generated subjective global assessment,PG-SGA)评分。在患者术前腹部CT图像上测量脐平面及全腹内脏脂肪容积(visceral fat volume,VFV)、皮下脂肪容积(subcutaneous fat volume,SFV),计算内脏与皮下脂肪容积比(visceral-to-subcutaneous fat volume ratio,VSR)、内脏脂肪百分比(visceral fat percentage,VF%);测量腰3横突平面及腰3椎体水平骨骼肌容积(skeletal muscle volume,SMV),计算骨骼肌指数(skeletal muscle index,SMI)。分析CT测量指标与临床营养评分及定量指标的相关性。结果单次腹部脂肪及骨骼肌CT测量结果与NRS2002及PG-SGA评分无相关性。二维与三维测量的VFV、SFV呈正相关(r=0.906、0.921,P<0.001)。VFV、SFV与患者BMI呈正相关(P<0.001)。SMI、二维及三维SMV与右上臂肌围及握力呈正相关(P<0.001)。结论腹部脂肪及骨骼肌CT测量指标与临床营养评估定量指标具有相关性,对胃癌患者营养评估具有一定价值。