Objective To study the relationship between angiopoietin and the angiogenesis of gastric carcinoma, and to investigate the inter-regulation effect between different vascular growth factors which exist in microenvironment of gastric carcinoma. Methods Literatures about angiopoietin and angiogenesis of gastric carcinoma were collected and reviewed. Results There is a relationship between the expression of angiopoietin in microcirculation and the angiogenesis of gastric carcinoma. Yet, it is still a disputable issue on the inter-regulation effect of different vascular growth factors. Conclusion Angiopoietin may play an important role in the processes of sprouting, development and apoptosis of the microvessel of gastric carcinoma.
【Abstract】 Objective To introduce the recent studies about the lymph node-targeted chemotherapy for gastric carcinoma. Methods The literatures on the lymph node-targeted chemotherapy for gastric carcinoma in recent years were collected and reviewed. Results The lymph node-targeted chemotherapy for gastric carcinoma was effective because it couled improve the drug concentrations in regional lymph node. Conclusion As a part of multiple treatments for gastric carcinoma, lymph node-targeted chemotherapy will be further developed.
Objective To investigate the significance and surgical skill for lymphadenectomy around common hepatic artery in gastric cancer. Methods Two hundred and fifty-seven cases with undergoing lymphadenectomy around common hepatic artery in gastric cancer between January 2001 and December 2006 were retrospectively reviewed. Experiences and understanding of dealing with this procedure in curative gastrectomy for gastric cancer were concluded. Results The number of dissected No.8 lymph node was 2.2±1.7, and the positive rate of No.8 lymph node was 30.35%. There were no lymphadenectomy related complications, such as anastomotic leakage, lymphatic fistula and postoperative hemorrhage in this series. Dissection around common hepatic artery lymph nodes along artery intrathecal space, division and ligation of left gastric vein at its root, and sufficient exposure of anatomic structures were important to dissection lymph nodes around the common hepatic artery. The exposure of anatomic structures included liberation of common hepatic artery by traction with the band, and the exposure of posterior side of pancreas by Kocher incision.Conclusion Being familiar with the anatomy around common hepatic artery, careful dissection, and attention to the surgical skill of lymphadenectomy are very important to improve the effectiveness of lymphadenectomy around common hepatic artery in gastric cancer.
Objective To provide a current language for clinical and pathological discription of gastric cancer. Methods The literature in recent years on the distribution of lymph nodes and staging of gastric cancer were reviewed. Results The lymph nodes of gastric cancer are distributed near the blood vessel and organs of gastric milieu. To ensure radical gastrectomy rational and scientific, the anatomic structure of gastric milieu should be familiarized. Conclusion The excellent outcome of surgery will be achieved by the effective dissection and removel of lymph nodes in gastric cancer.
Objective To summarize functions and mechanisms of fibroblast activation protein (FAP) and its application in targeted therapy. Method Literatures about FAP in recent years were collected to make a review. Results Thereis an important relationship between the FAP and the dipeptidyl peptidase-Ⅳ. FAP has a serine protease activity and is an important immunosuppressive component in the tumor microenvironment. FAP participate in the pathological process of the neoplastic and the non-neoplastic diseases. In the targeted therapy, the enzyme inhibitors, antibodies, vaccines, and prodrugs of FAP had been extensively studied. Conclusion FAP have various functions and participates in pathological process of many diseases, and it is of great significance to research of tumor targeted therapy.
Objective To investigate the differences of postoperative quality of life （QOL） between proximal gas-trectomy （PG） and total gastrectomy （TG） in patients with adenocarcinoma of esophagogastric junction （AEG）. Methods Eighty five patients with AEG （Siewert type Ⅱ or Ⅲ） who were underwent PG or TG surgery between Jan. 2011 andMar. 2012 at West China Hospital of Sichuan University were enrolled， to measure the QOL by using the Chineseversion of quality of life questionnaire core-30 （QLQ-C30） and the site-specific module for gastric cancer （QLQ-STO22）which were drawed up by the European Organization for Research and Treatment of Cancer （EORTC） in 12 months afteroperation. Results There were no any difference of clinicopathological features between patients in 2 groups （P＞0.05），such as age， gender， and so on. The scores of eating restriction， diarrhea， and dyspnea in PG group were lower than those of TG group （P＜0.05）， but scores of reflux and taste change were higher （P＜0.05）， no other significant differ-ence was found between the patients of 2 groups （P＞0.05）. Conclusion Both of PG＋gastric tube reconstruction and TG＋Roux-en-Y anastomosis in treatment of patients with Siewert type Ⅱ or Ⅲ AEG may lead to complications， but patients who underwent former surgery have better situation in eating restriction， diarrhea， and dyspnea， and patients who underwent later surgery have better situation in reflux and taste change.
Objective To determine whether lymph node-targeted chemotherapy with carbon nanoparticles absorbing 5-FU affects expressions of bcl-2, bax and caspase-3 in gastric cancer tissues, metastatic lymph nodes and normal gastric mucosa. Methods Twenty-eight patients with gastric cancer in our department were divided into lymph node-targeted chemotherapy (LNTC) group and control group from October 2005 to August 2006. The patients were treated with carbon nanoparticles absorbing 5-FU before operation in LNTC group and those were operated directly in control group. The gastric cancer tissues, metastatic lymph nodes and normal gastric mucosa were collected after operation. The expressions of bcl-2, bax and caspase-3 in those tissues were determined by immunohistochemical technique. Results In LNTC group, the positive expression rate of bcl-2 in gastric cancer tissues and metastatic lymph nodes was significantly lower than those in control group (28.6% vs . 78.6% , 25.0% vs . 70.0% , P ＜ 0.05), the positive expression rate of bax (85.7% vs . 28.6% , 80.0% vs . 30.0% ) and caspase-3 (57.1% vs . 14.3% , 55.0% vs . 15.0% ) in gastric cancer tissues and metastatic lymph nodes was significantly higher than those in control group ( P ＜ 0.05). The positive expression rate of bcl-2, bax and caspase-3 in normal gastric mucosa was not significantly different between two groups ( P ＞ 0.05). Conclusion The lymph node-targeted chemotherapy with carbon nanoparticles absorbing 5-FU can down-regulate the expression of bcl-2 and up-regulate the expression of bax and caspase-3 in gastric cancer tissues and metastatic lymph nodes, and therefore by affecting the expression levels of these apoptosis molecules may be one of the ways to induce tumor cell apoptosis.
目的 探讨小肠间质瘤的临床表现、病理免疫组织化学特征与治疗方法。 方法 回顾性分析2007年1月－2011年7月70例小肠间质瘤患者的临床表现，免疫组织化学特征及治疗手段。 结果 小肠间质瘤患者并无特异性临床表现，主要临床表现包括腹痛、腹胀、血便，腹部包块等。极低风险5例，低风险18例，中风险13例，高风险34例。免疫组织化学显示CD117、DOG1、CD34、S-100、平滑肌肌动蛋白（SMA）、增殖细胞核抗原（Ki-67）、人结蛋白（Desmin）的阳性率分别为95.7%（67/70）、100%（11/11）、51.4%（36/70）、5.7%（4/70）、12.9%（9/70）、60.0% （42/70）、0% （0/70）。治疗上主要以手术完整切除为主，伊马替尼主要用于无法切除，转移或中、高危险度的患者。 结论 小肠间质瘤患者临床表现缺乏特异性表现，发现时往往肿瘤较大、风险度高，选择合理的辅助检查方法可以提高其检出率，目前手术是首选的治疗方式。
目的 探讨胃肠道外间质瘤（EGIST）的临床表现、外科治疗及预后。 方法 回顾性分析2004年1月－2010年6月收治的35例EGIST患者的临床资料。男26例，女9例；年龄33～78岁，平均56岁。病程5 d～8个月，平均2个月。临床表现主要有腹部不适、腹痛及腹部包块等。均在术前行CT或腹部增强CT等检查发现病灶，其中位于系膜16例，网膜15例，腹膜后4例。35例均行手术治疗。 结果 术后均由病理学检查及免疫组织化学检测确诊，肿瘤标本镜下均以梭形细胞为主；极低危险、低危险、中危险、高危险患者分别为0、3、0、32例。免疫组织化学检测示酪氨酸激酶受体（CD117）、DOG-1、骨髓干细胞抗原（CD34）、酸性钙结合蛋白、平滑肌肌动蛋白、结蛋白阳性率分别为91.4%（32/35）、100%（3/3）、71.4%（25/35）、8.6%（3/35）、22.9%（8/35）、0%（0/35）。15例患者均获随访，时间19～96个月，平均46个月。8例出现进展，7例病情稳定。 结论 EGIST发现时往往体积较大，预后较差，手术切除是首选治疗手段，甲磺酸伊马替尼对其具有较好的治疗效果。
Objective To investigate the clinical characteristics， diagnosis， and treatment of gastric stromal tumor. Methods Clinical data of 217 patients with gastric stromal tumor from October 2007 to July 2011 were analyzed. Results The main clinical manifestation were abdominal pain， abdominal distension， bloody stools， abdominal mass， and so on. The tumour located at cardiac part， fundus of stomach， body of stomach， and pylorus part was 24 cases （11.0%）， 103 cases （47.5%）， 59 cases （27.2%）， and 31 cases （14.3%）， respectively. All the 217 patients underwent endoscopic or surgical resection and diagnosed by pathology and immunohistochemistry. The patients of high-low risk， low risk， intermediate risk， and high risk was 56 cases （25.8%）， 67 cases （30.9%）， 41 cases （18.9%）， and 53 cases （24.4%）， respectively. One hundred and forty patients were followed-up for 7-52 months （average 35 months）. Thirty-five patients of high risk were investigated about the drug treatment after the first operation：19 cases were treated by using imatinib （tumor progressed in 2 cases） and 16 patients were not （tumor progressed in 9 patients）. The rate of progression of patients treated by imatinib was significantly lower than another group （χ2=8.426， P=0.004）. In 11 patients with tumor progressed， tumor recurrnce in 4 cases， tumor recurrence with diffused abdominal cavity metastasis in 1 case， tumor metastasized to humerus in 1 case， metastasized to liver and abdominal cavity in 1 case， and metastasized to liver in 4 cases. Conclusions Gastric stormal tumor is lack of specific clinical manifestations. Complete excision of the tumor is the main therapy method， and imatinib can improve prognosis.