Delineation of fatty acid metabolism in gastric cancer:Therapeutic implications

BACKGROUND The prognosis of gastric cancer is extremely poor.Metabolic reprogramming involving lipids has been associated with cancer occurrence and progression.AIM To illustrate fatty acid metabolic mechanisms in gastric cancer,detect core genes,develop a prognostic model,and provide treatment options.METHODS Raw data from The Cancer Genome Atlas and Gene Expression Omnibus databases were collected and analyzed.Differentially expressed fatty acid metabolism genes were identified and incorporated into a risk model based on least absolute shrinkage and selection operator regression analysis.Then,patients from The Cancer Genome Atlas were assigned to high-and low-risk cohorts according to the mean value of the risk score as the threshold,which was verified in the Gene Expression Omnibus database.Relationships between chemotherapeutic sensitivity and tumor microenvironment features were assessed.RESULTS An integrated evaluation was performed in this study.Fatty acid metabolismrelated genes were used to construct the risk model.Patients classified into the high-risk cohort were considered to be resistant to chemotherapy based on results of the“pRRophetic”R package.Patients in the high-risk cohort were associated with type Ⅰ/Ⅱ interferon activation,increased inflammation level,immune cell infiltration,and tumor immune dysfunction based on the exclusion algorithm,indicating the potential benefit of immunotherapy in these patients.CONCLUSION We constructed a fatty acid-related risk score model to assess the comprehensive fatty acid features in gastric cancer and validated its vital role in prognosis,chemotherapy sensitivity,and immunotherapy.

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.

Gastric leiomyoma presenting as an endophytic growth of cardia of the stomach: A case report

Gastric leiomyomas are rare submucosal neoplasms arising from smooth muscle cells.It accounts for approximately 2.5%of all gastric tumours,is slow growing and rarely causes symptoms such as upper abdominal discomfort and dyspepsia.1 On imaging,they appear similar to gastrointestinal stromal tumours(GISTs)and can be intraluminal or extraluminal.Diagnosis is mostly confirmed by histopathological examination of the tumour.Surgical resection of the tumour is the main treatment option.Here,we present a case of laparoscopic resection of an endophytic gastric tumour that turned out to be a leiomyoma.

Metastatic stomach lymphoepithelioma-like carcinoma and immune checkpoint inhibitor therapy:A case report

BACKGROUND Pulmonary lymphoepithelioma-like carcinoma(PLELC)is a rare type of nonsmall-cell lung cancer.Stomach lymphoepithelioma-like carcinoma(LELC)metastasis secondary to PLELC has not been reported recently.CASE SUMMARY A 64-year-old female was admitted to our hospital for a regular gastroscopy examination with a 6-year history of surgical resection for left PLELC.Positron emission tomography/computed tomography suggested high accumulation of 18F-fludeoxyglucose in the gastric cardia region.Upper gastrointestinal endoscopy confirmed a large mass at the stomach fundus.Immunohistochemistry(IHC)of the biopsy suggested metastatic stomach LELC.Proximal gastrectomy showed that this 6.5 cm×5.0 cm mass was located in the stomach fundus near the cardia.Histopathological examination showed a poorly differentiated carcinoma with prominent lymphoplasmacytic infiltration.IHC demonstrated that the tumor was positive for CK(AE1/AE3),p63,p40,p53,Ki-67(70%),and EGFR(3+)and negative for CK7,CK20,Her2,and CD10.In situ hybridization analysis showed positive staining Epstein-Barr virus-encoded RNA.Tumor programmed cell death ligand 1(PD-L1)expression score was 98%,and the combined positive score was 100,with no evidence of microsatellite instability.Thus,the patient was unequivocally diagnosed with metastatic stomach LELC secondary to pulmonary LELC.After discharge,this patient underwent PD-1 inhibitor treatment(toripalimab,240 mg)every 3 wk for ten cycles,and she has had no tumor recurrence.CONCLUSION For gastric LELC metastasis,PD-1 inhibitor therapy could become a new therapeutic approach,though there is still no evidence from large data sets to support this.

A novel copper metabolism-related signature model for predicting the prognosis,target drugs,and immunotherapy in stomach adenocarcinoma

Stomach adenocarcinoma(STAD)is one of the most common gastric neoplasms with a high death rate.Therefore,there is an urgent need to propose an efficient therapy for STAD.Copper plays key roles in regulating the distribution of immune cells and affecting the tumor immune escape,and may be a novel indicator of immunotherapy in STAD.However,the specific impact of copper metabolism-related genes(CMRGs)on the patient’s prognosis,tumor microenvironment,and immunotherapeutic response remains unelucidated.

Influence of L-methionine-deprived total parenteral nutrition with 5-fluorouracil on gastric cancer and host metabolism

AIM: To investigate the influence of L-methionine-deprived total parenteral nutrition with 5-FU on gastric cancer and host metabolism. METHODS: N-methyl-N'-nitro-nitrosoguanidine (MNNG) induced gastric cancer rats were randomly divided into four groups: Met-containing TPN group (n=11), Met-deprived TPN group (n =12), Met-containing TPN+5-FU group (n=11) and Met-deprived TPN+5-FU group (n=12). Five rats in each group were sacrificed after 7 days of treatment and the samples were taken for examination. The remaining rats in each group were then fed separately with normal diet after the treatment until death, the life span was noted. RESULTS: The tumors were enlarged in Met-containing group and shrank in Met-deprived group markedly after the treatment. The DNA index (DI) of tumor cells and the body weight (BW) of rats had no significant change in the two groups, however, the ratio of tumor cells'S phase was increased. The ratio of G2M phase went up in Met-containing group, but down in Met-deprived group. In the other two groups that 5-FU was added, the BW of rats, and the diameter of tumors, the DI of tumor cells, the S and G2M phase ratio of tumor cells were all decreased, particularly in Met-deprived plus 5-FU group. Pathological examination revealed that the necrotic foci of the tumor tissue increased after Met-deprived TPN treatment, and the nucleoli of tumor cells enlarged. In MetTPN+5-FU group, severe nuclear damage was also found by karyopyknosis and karyorrhexis, meanwhile there was slight degeneration in some liver and kidney cells. The serum free Met and Cysteine decreased markedly (P【0.001), while other amino acids, such as serum free serine and glutamine increased significantly (P【0.005). All the rats died of multiple organ failure caused by cancer metastasis. The average survival time was 18.6 days in Met-containing TPN group, 31 days in Met-deprived TPN group, 27.5 days in Met-containing TPN+5-FU group, and 43 days in Met-deprived TPN+5-FU group (P【0.05). CONCLUSION: Met-deprived TPN causes methionine starvation of tumor cells, and can enhance the anti-tumor effect of 5-FU and prolong the life span of gastric cancer bearing rats.

Prognostic value and clinical correlations of18-fluorodeoxyglucose metabolism quantifiers in gastriccancer

AIM： To investigate the correlations of pre-treatmentpositron emission tomography-computer tomography（PET-CT） metabolic quantifiers with clinical data ofunstratified gastric cancer （GC） patients.METHODS： Forty PET-CT scans utilising 18-fluorodeoxyglucosein patients who received no prior treatmentwere analysed. Analysis involved measurements ofmaximum and mean standardised uptake volumes（SUV）, coefficient of variation （COV）, metabolictumour volumes and total lesion glycolysis of differentthresholds above which the tumor volumes wereidentified. The threshold values were： SUV absolutevalue of 2.5, 30% of SUVmax, 40% of SUVmax,and liver uptake-based （marked 2.5, 30, 40 and liv,respectively）. Clinical variables such as age, sex,clinical stage, performance index, weight loss, tumorhistological type and grade, and CEA and CA19.9 levelswere included in survival analysis. Patients receivedvarious treatment modalities appropriate to theirdisease stage and the outcome was defined by time tometastasis （TTM） and overall survival （OS）. Clinical andmetabolic parameters were evaluated by analysis of variance, receiver operating characteristics, univariateKaplan-Meier, and multivariate Cox models. P 〈 0.05was considered statistically significant.RESULTS： Significant differences were observedbetween initially disseminated and non-disseminatedpatients in mean SUV （6.05 vs 4.13, P = 0.008）, TLG2.5（802 cm3 vs 226 cm3; P = 0.031）, and TLG30 （436 cm3vs 247 cm3, P = 0.018）. Higher COV was associatedwith poor tumour differentiation （0.47 for G3 vs0.28 for G1 and G2; P = 0.03）. MTV2.5 was positivelycorrelated to patient weight loss （〈 5%, 5%-10%and 〉 10%： 40.4 cm3 vs 123.6 cm3 vs 181.8 cm3,respectively, P = 0.003）. In multivariate Cox analysis,TLG30 was prognostic for OS （HR = 1.001, 95%CI：1.0009-1.0017; P = 0.047） for the whole group ofpatients. In the same model yet only including patientswithout initial disease dissemination TLG30 （HR = 1.009,95%CI： 1.003-1.014; P = 0.004） and MTV2.5 （HR = 1.02,95%CI： 1.002-1.036; P = 0.025） were prognostic forOS; for TTM TLG30 was the only significant prognosticvariable （HR = 1.006, 95%CI： 1.001-1.012; P = 0.02）.CONCLUSION： PET-CT in GC may represent a valuablediagnostic and prognostic tool that requires furtherevaluation in highly standardised environments such asrandomised clinical trials.

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.

Diffusion tensor imaging and proton magnetic resonance spectroscopy in brain tumor Correlation between structure and metabolism

Proton magnetic resonance spectroscopy and diffusion tensor imaging are non-invasive techniques used to detect metabolites and water diffusion in vivo. Previous studies have confirmed a positive correlation of individual fractional anisotropy values with N-acetylaspartate/creatine and N-acetylaspartate/choline ratios in tumors, edema, and normal white matter. This study divided the brain parenchyma into tumor, pedtumoral edema, and normal-appearing white matter according to MRI data, and analyzed the correlation of metabolites with water molecular diffusion. Results demonstrated that in normal-appearing white matter, N-acetylaspartate/creatine ratios were positively correlated with fractional anisotropy values, negatively correlated with radial diffusivities, and positively correlated with maximum eigenvalues. Maximum eigenvalues and radial diffusivities in peritumoral edema showed a negative correlation with choline, N-acetylaspartate, and creatine. Radial diffusivities in tumor demonstrated a negative correlation with choline. These data suggest that the relationship between metabolism and structure is markedly changed from normal white matter to peritumoral edema and tumor. Neural metabolism in the peritumoral edema area decreased with expanding extracellular space. The normal relationship of neural function and microstructure disappeared in the tumor region.

Protein,carbohydrate and lipid metabolism

950255 Effects of TPN and indomethacin on stressresponse and protein metabolism after surgery.QUANZhufu(全竹富),et al.General Hosp,Nanjing Com-mand,Nanjing,210002.Med J Chin PLA 1995;20(1):24-26.The study was planned to evaluate effects of TPNand indomethacin on stress response after trauma,andprotein metabolism in patients who had received totalgastrectomy for cardiac cancer of stomach.19 caseswere divided into control,TPN,and

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.

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。

PLR、NLR、CRP联合评估进展期胃癌腹膜腔转移的价值研究

目的探讨血小板计数/淋巴细胞计数(platelet count/lymphocyte count,PLR)、中性粒细胞计数/淋巴细胞计数(neutrophil count/lymphocyte count,NLR)、C反应蛋白(C-reactive protein,CRP)评估进展期胃癌腹膜腔转移的价值。方法回顾性选取江苏省徐州市肿瘤医院进展期胃癌患者124例,根据是出现腹膜腔转移分为腹腔转移组36例、非腹腔转移组88例。比较2组临床资料、病理学参数及CRP、PLR、NLR,Logistic分析进展期胃癌腹膜腔转移影响因素,构建Logistic回归模型,受试者工作特征(receiver operating characteristics,ROC)曲线评估其对腹膜腔转移的预测价值。结果腹腔转移组肿瘤直径大于非腹腔转移组,浸润深度、TNM分期及PLR、NLR、CRP水平高于腹腔转移组,组织学分化程度低于非腹腔转移组(P<0.05);排除PLR、NLR和CRP之外的混杂因素肿瘤大小、浸润深度、TNM分期和组织学分化,建立Logistic模型,对其行多因素分析,显示PLR、NLR和CRP是进展期胃癌腹膜腔转移的危险因素(P<0.05);构建风险预测模型:logit(p)=PLR×1.416+NLR×1.149+CRP×1.088;模型预测价值:ROC分析,logit(p)>0.5时,AUC值为0.755,χ^(2)为10.212,诊断敏感度为80.95%,特异度为61.64%。结论进展期胃癌腹膜腔转移与PLR、NLR、CRP水平及相关临床特征相关,根据PLR、NLR、CRP和相关临床因素构建的预测模型对其具有较高预测价值,可为临床决策提供依据。

661例胃癌患者临床病理特征分析

目的探讨新乡医学院第一附属医院收治的胃癌的临床病理特征。方法回顾性分析2019年5月至2023年4月该院收治的661例连续胃癌手术病例临床病理资料。统计分析年龄、性别、癌肿部位、pT分期、淋巴结转移及脉管癌栓、神经侵犯情况。结果661例胃癌病例中男性499例,女性162例。661例胃癌患者年龄多处于46岁~75岁之间,56岁~70岁为发病高峰,平均年龄为(63.03±9.07)岁,其中男性平均年龄为(63.23±8.95)岁,女性平均年龄为(62.42±9.44)岁。不同性别组年龄相比差异无统计学意义(P>0.05)。癌肿部位以食管胃结合部腺癌为主(72.61%),不同性别组胃癌癌肿分布部位差异无统计学意义(P>0.05)。组织学类型以腺癌为主(98.18%);分化程度以低-中分化胃癌为主(88.65%)。胃癌T分期pT3组和pT4a组分别占39.49%和31.47%,随着pT分期的升高,淋巴结转移、神经侵犯、脉管癌栓阳性率逐渐增高,其中,pT3组与pT2组相比,淋巴结转移、神经侵犯、脉管癌栓阳性率差异均有统计学意义(P<0.05)。胃癌癌肿部位不同,淋巴结转移、神经侵犯、脉管癌栓阳性率无显著差别(P>0.05)。结论该院收治的胃癌的临床病理特征如下:多见于中老年男性;以食管胃结合部腺癌为主;分化程度以低-中分化腺癌为主,且与胃癌的原发部位无关;T分期多为T3和T4a期;淋巴结转移、神经侵犯、脉管癌栓的发生与T分期呈正相关,但不同部位胃癌的淋巴结转移、神经侵犯和脉管癌栓发生无明显差异。

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。

临床资料联合CT影像组学特征评估胃癌程序性死亡配体1状态

目的观察临床资料联合CT影像组学特征评估胃癌程序性死亡配体1(PD-L1)状态的价值。方法回顾性按7∶3比例将277例胃癌患者随机分为训练集(n=195)与验证集(n=82):训练集含PD-L1阳性亚组88例、阴性亚组107例,验证集各含37及45例。比较不同集别亚组间临床及常规CT特征,分析胃癌PD-L1状态的独立影响因素,基于CT筛选影像组学特征,建立临床模型、影像组学模型及临床-影像组学联合模型,观察各模型评估胃癌PD-L1状态的效能。结果训练集亚组间Borrmann分型、cN分期、cM分期、临床分期、肿瘤最大径及厚径差异均有统计学意义(P均<0.05);Borrmann分型、临床分期及肿瘤厚径均为PD-L1阳性的独立影响因素(P均<0.05)。临床模型、影像组学模型及临床-影像组学联合模型评估训练集胃癌PD-L1状态的曲线下面积(AUC)分别为0.748、0.832及0.841,在验证集分别为0.657、0.801及0.789;临床模型的AUC均低于其他模型(P均<0.05)。结论临床资料联合CT影像组学特征有助于评估胃癌PD-L1状态。

晚期胃癌患者预立医疗照护计划准备度现状及影响因素分析

目的调查晚期胃癌患者预立医疗照护计划准备度现状并分析影响因素。方法选取2023年3月-6月我院收治的晚期胃癌患者209例为研究对象,采用一般资料调查表、预立医疗照护计划准备度量表进行调查。结果晚期胃癌患者预立医疗照护计划准备度总分为(66.22±8.02)分,处于中等偏上水平;多元线性回归分析结果显示,年龄、病程、ECOG评分、文化程度是晚期胃癌患者预立医疗照护计划准备度的独立影响因素(P<0.05)。结论晚期胃癌患者预立医疗照护计划准备度处于中等偏上水平,医护人员应提高患者对ACP重要性的认识,同时关注年龄大、病程短、文化程度低、ECOG评分高的患者,促进预立医疗照护计划的普及应用。

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。