Objective To evaluate the status of lymph node metastasis and reasonable procedure in gastric cancer. Methods The incidence of metastases from gastric cancer to various regional lymph node stations was studied in 1 505 patients with gastric cancer. The patients underwent surgical resection from January 1995 to December 2004.Results Lymph node metastasis were observed in 928 of 1 505 cases (61.7%). Lymph node metastasis frequency was found in groups No.1 （32.9%），No.3 （28.7%）， No.2 （20.4%）， and No.7 （18.6%） at upper third stomach cancer；in groups No.3 （32.5%）， No.4 （24.7%）， No.7 （20.6%）， and No.1 （17.3%） at middle third stomach cancer； in groups No.6 （33.7%）， No.3 （31.3%）， No.4 （25.6%）， and No.7 （21.5%） at lower third stomach cancer. Conclusions Distribution of metastatic lymph node is clearly related to the location of the tumor. Anatomical extent of lymph node metastases in gastric cancer provid surgical guidance for surgeons.
ObjectiveTo study the expression of matrilysin in gastric cancer and to evaluate the correlation between its expression and invasion, metastasis, and prognosis. MethodsA total of 52 patients with gastric cancer were selected and followed up. The expressions of matrilysin in gastric primary focus, normal gastric mucosa, and metastatic lymph nodes were examined by reverse transcriptionpolymerase chain reaction (RT-PCR), Western blot, and immunohistochemistry, respectively. The correlations between matrilysin expression and tumor invasion, metastasis, and prognosis were assessed. ResultsThe expressions of matrilysin in gastric primary focus and metastatic lymph nodes significantly increased, while decreased or loss in normal gastric mucosa (Plt;0.001). The higher concordance was seen between the levels of mRNA and protein (Plt;0.001). Among patients with infiltrating type, penetrated serosa, area of serosa involved more than 20 cm2, and metastatic lymph nodes more than 7, the expression of matrilysin was significantly higher (Plt;0.01). The survival rate of patients with matrilysin higher expression (34.1%) was significantly lower than that with matrilysin lower expression (55.6%), χ2=9.778， P=0.002. Conclusions Up-regulated expression of matrilysin plays an important role in tumor invasion, metastasis, and poor prognosis, and it is a good molecular marker to reflect the biological behaviors of gastric cancer.
Objective To discuss the differences of the effects on open colorectal cancer operation between using ultracision harmonic scalpel (UHS) and monopolar electrosurgery. Methods Fifty-nine patients from April to December in 2007, suffering colorectal cancer in the same treatment group, underwent open radical operation, 29 by GEN300 UHS (UHS group) and 30 by monopolar electrosurgery as control group. There was no significant difference between two groups among the factors of age, gender, tumor location, Dukes staging, gross morphology and degree of histological differentiation (Pgt;0.05). Results Shorter incision was applied in UHS group than in the control group. The mean operation time of UHS group and control group were 126 and 119 min, respectively (Pgt;0.05). The mean operative blood loss was 50 (20-140) ml in UHS group and 90 (40-200) ml in control group (Pgt;0.05). There were no significant differences among factors of bowel function recovery, mean hospitalization and incidence of complications between two groups (Pgt;0.05). The mean time for postoperative drainage fluid changing from bloody to serous was 8 (2-20) h in UHS group, however, 48 (16-80) h in control group (Plt;0.05). Conclusion In open colorectal cancer operation, benefits of using UHS are shorter incision and minimally invasiveness.
Objective To explore the perioperative management of the coexisting diseases for the elderly patients with gastric cancer. Methods The clinical data of perioperative management for coexisting diseases in 528 patients with gastric cancer over 70 years old treated in the First Affiliated Hospital of China Medical University from March 1980 to November 2008 were analyzed retrospectively. Results The main coexisting diseases included cardiovascuclar disease (259 cases, 49.05%), respiratory disease (161 cases, 30.49%), diabetes (72 cases, 13.64%). Adjusting blood pressure and blood glucose, improving cardiopulmonary function, and hepatic and renal function were mainly given. The common postoperative complications included intestinal obstruction (10 cases), pneumonia (10 cases), reflux esophagitis (9 cases), functional evacuation disorder of gastric remnant (7 cases), and anastomotic leakage (5 cases). Ten patients died during perioperative period: 6 died of heart and lung failure, 2 of acute myocardial infarction, 1 of anastomotic leakage, 1 of intestinal obstruction. Conclusions The common coexisting diseases in the elderly patients with gastric cancer are hypertension， bronchitis and diabetes. Complete assessment of the patient’s general health before operation and intensive perioperative management of the coexisting diseases not only can decrease the risk of surgical procedures， but also decrease the incidence of complication and perioperative mortality.
Objective To explore the perioperative management of the coexisting diseases for the elderly patients with gastric cancer. Methods The clinical data of perioperative management for coexisting diseases in 528 patients with gastric cancer over 70 years old treated in the First Affiliated Hospital of China Medical University from March 1980 to November 2008 were analyzed retrospectively. Results The main coexisting diseases included cardiovascuclar disease (259 cases, 49.05%), respiratory disease (161 cases, 30.49%), diabetes (72 cases, 13.64%). Adjusting blood pressure and blood glucose, improving cardiopulmonary function, and hepatic and renal function were mainly given. The common postoperative complications included intestinal obstruction (10 cases), pneumonia (10 cases), reflux esophagitis (9 cases), functional evacuation disorder of gastric remnant (7 cases), and anastomotic leakage (5 cases). Ten patients died during perioperative period: 6 died of heart and lung failure, 2 of acute myocardial infarction, 1 of anastomotic leakage, 1 of intestinal obstruction. Conclusions The common coexisting diseases in the elderly patients with gastric cancer are hypertension， bronchitis and diabetes. Complete assessment of the patient’s general health before operation and intensive perioperative management of the coexisting diseases not only can decrease the risk of surgical procedures， but also decrease the incidence of complication and perioperative mortality.
目的 研究胃癌细胞SGC-7901培养上清液及转化生长因子-β1（TGF-β1）是否可促进人类腹膜间皮细胞表达βig-h3蛋白。方法 培养胃癌细胞SGC-7901，取第3天培养液上清与DMEM培养液的混合液 （1∶4）以及0、1.0、10.0和50.0ng/ml的 TGF-β1分别刺激人类腹膜间皮细胞HMrSV50、3、6、12及24h，ELISA方法检测上清液中βig-h3蛋白浓度，Western blot法检测细胞内βig-h3蛋白浓度。结果 对照组有基础量的βig-h3蛋白表达； 胃癌细胞SGC-7901培养上清液及TGF-β1均可明显增加HMrSV5细胞上清液及细胞内的βig-h3蛋白浓度（P＜0.05），且TGF-β1的刺激作用呈时间及浓度依赖性。结论 胃癌细胞SGC-7901培养上清液及TGF-β1可明显刺激HMrSV5细胞表达和分泌βig-h3蛋白。
Objective To analyze the influencing factors on postoperative complications and mortality of gastric cancer after total gastrectomy. Methods The clinical data of 622 patients with gastric cancer received total gastrectomy were collected. According to the extent of lymph node dissection, the patients were divided into 2 groups: D0/D1 group (n=35) and D2/D3 group (n=587). The risk factors influencing postoperative morbidity and mortality were determined by logistic multiple regression analysis. Results The total postoperative complication morbidity and mortality for all patients were 9.81% (61/622) and 2.89% (18/622), respectively. The postoperative complication morbidity was 8.57% (3/35) and 9.88% (58/587) in the two groups, the postoperative mortality was 2.86% (1/35) and 2.90% (17/587) in the two groups, there were no significant differences between the two groups (Pgt;0.05). The most common postoperative complication was intestinal obstruction (18.03%, 11/61). Multivariate analysis revealed that risk factors on the postoperative complications and mortality were age ≥ 70 years, TNM stage Ⅳ, preoperative complication, palliative excision, merely manual or mechanical anastomosis, and multivisceral resection (Plt;0.05), however, the extent of lymph node was not influencing factor (Pgt;0.05). Conclusions Patients with advanced gastric cancer have a high risk of postoperative complications and mortality. Multiple organ resection should be avoided for patients with gastric cancer of TNM stage Ⅳ.