Surgical treatment for advanced gastric cancer / 中华胃肠外科杂志

Despite the incidence of gastric cancer is decreasing, it remains the fourth most common malignancy and the second leading cause of cancer-related death around the world. The prognosis of gastric cancer is still poor and surgery is the mainstay treatment. Lymph node dissection plays an important role in the surgery of gastric cancer due to the high incidence of lymph node metastasis and recurrence. There has been a consensus between the West and the East that D2 lymph node dissection is the standard dissection for advanced gastric cancer. Some clinical trials have showed good results of neoadjuvant chemotherapy in advanced gastric cancer. Large sample randomized controlled studies are needed to confirm the value of neoadjuvant chemotherapy.

Association of HER2 protein expression with clinicopathologic features and prognosis in Chinese patients with gastric carcinoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To evaluate the epidemiological status of HER2 protein expression in Chinese patients with gastric carcinoma, and to study its clinical and prognostic significance and the association with the clinicopathological features.</p><p><b>METHODS</b>The clinical data were reviewed in 860 patients with gastric carcinoma admitted to Guangdong General Hospital from 2003 to 2010. The HER2 status was evaluated using immunohistochemistry (IHC). The modified HercepTest scoring criterion was used to assess HER2 protein expression. The association between HER2 expression and clinicopathological features was analyzed by χ(2) test. Kaplan-Meier analysis, log-rank test and Cox regression model were used for the survival analysis.</p><p><b>RESULTS</b>The median age of the patients was 59 years, and the male-to-female ratio was 2.06:1. Positive expression of HER2 protein (3+) was found in 77 (9.0%) cases of gastric carcinoma, and in 69 (8.9%) advanced gastric cancers. There was significantly positive association between HER2 over-expression and tumor differentiation, Lauren classification and WHO classification. No significant association was observed between HER2 protein expression and patients' age, gender, tumor location and clinical stage. There was no statistically significant difference in survival rate between patients with positive HER2 expression and negative ones.</p><p><b>CONCLUSION</b>Though there was significantly positive association between HER2 expression status and tumor differentiation, histological type, it may be of limited prognostic value in gastric cancer patients.</p>

Clinical efficacy comparison between laparoscopy and open radical resection for 191 advanced colorectal cancer patients / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility, the radicalness and efficacy of laparoscopy for advanced colorectal cancer.</p><p><b>METHODS</b>From June 2006 to December 2007, laparoscopic surgery and open radical resection were performed in 191 cases of colorectal cancer. The curative effect and clinical data were collected and analyzed.</p><p><b>RESULTS</b>The patients were randomized to two groups, 98 patients underwent laparoscopic surgery and 93 open operation. Five cases(5.1%) were converted to open surgery in laparoscopic surgery group. The average intraoperative blood loss of open surgery group was(279.5+/-189.4) ml, while that of laparoscopic surgery group was(87.2+/-27.1) ml, the difference between the two groups was statistically significant(P=0.011). Within postoperative 48 hours, the intestinal function and early mobile physical activity were restored in 37.8% (37/98) and 30.6% (30/98) patients of laparoscopic surgery group, while in 6.5%(6/93, P=0.000) and 3.2% (3/93, P=0.000) patients of open surgery group, the differences between two groups were statistically significant. The average hospital stay of laparoscopic surgery group was (8.9+/-5.9) d, whereas open surgery group(12.1+/-7.6) d, the difference was statistically significant(P=0.036). No significant differences were found between the two groups in gender, age, tumor location, resection range of surgery, TNM staging, post-operative complication and lymph node harvest(P>0.05).</p><p><b>CONCLUSIONS</b>Laparoscopic surgery is feasible for the patients with advanced colorectal cancer. The radicalness of laparoscopic surgery is similar to that of open surgery, and laparoscopic surgery can provide less intraoperative blood loss, better intestinal function restoration, early mobile physical activity and shorter hospital stay.</p>

Differentiation of hypoxic-ischemic encephalopathy and acute bilirubin encephalopathy with magnetic resonance imaging in neonates / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the value of conventional magnetic resonance imaging (MRI) and diffusion weighed imaging (DWI) in the differentiation of hypoxic-ischemic encephalopathy (HIE) and acute bilirubin encephalopathy in neonates.</p><p><b>METHODS</b>The MRI findings along with DWI characteristics in 15 neonates with HIE involving basal ganglia and in 18 neonates with acute bilirubin encephalopathy between November 2006 and June 2008 were retrospectively reviewed.</p><p><b>RESULTS</b>On T1WI, only 5 patients presented hyperintensity in the globus pallidus in the HIE group, but 16 in the acute bilirubin encephalopathy group (p<0.01). Nine patients in the HIE group showed hyperintensity in the putamen, but the hyperintensity in the putamen was not found in the acute bilirubin encephalopathy group. The frequency of hyperintensity in the subthalamus in the acute bilirubin encephalopathy group (55.6%) was significantly higher than that in the HIE group (13.3%) (p<0.05). Eight patients in the HIE group showed abnormal signals in the other regions on T1WI, but only two patients in the acute bilirubin encephalopathy group (p<0.05). On DWI, 7 out of 11 patients with HIE presented hyperintensity in the basal ganglia, while all 10 patients of the acute bilirubin encephalopathy group presented normal in the basal ganglia.</p><p><b>CONCLUSIONS</b>Conventional MRI along with DWI is useful in differentiating HIE from acute bilirubin encephalopathy in neonates.</p>

Preoperative evaluation of the 64-slice spiral CT three dimensional angiography for vascular invasion in gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the preoperative diagnosis value of 64-slice spiral CT three dimensional angiography (3D CTA) for the vascular invasion in gastric cancer.</p><p><b>METHODS</b>CT images of 40 patients diagnosed as gastric cancer by endoscope,who proceeded to surgical exploration from August 2006 to December 2007,were collected. These images were rebuilt by 3D CTA to judge vascular invasion by gastric cancer in comparison with the surgical finding as standard reference.</p><p><b>RESULTS</b>Successful 3D CTA reconstructions were performed for all these 40 patient images. Out of 40 cases, 14 cases presented vascular invasion in the 3D CTA, and 12 of 14 cases were proved to have vascular invasion in the surgery. For assessing vascular invasion with CTA, the sensitivity was 98.1% and the specificity was 96.4% respectively (Chi Square chi(2)=0.0099,P>0.05). There was no significant differences regarding vascular invasion in gastric cancer between preoperative 3D CTA assessment and surgical finding.</p><p><b>CONCLUSION</b>Sixty-four-slice spiral CT 3D angiography is effective in assessing vascular invasion in gastric cancer and is also valuable in clinical application.</p>

Screening peptides binding specifically to large intestinal cancer LoVo cells from phage random peptide library / 南方医科大学学报

<p><b>OBJECTIVE</b>To screen the polypeptides specifically binding to human large intestinal cancer LoVo cells from a phage-displayed peptide library for potential use as targeting vectors for large intestinal cancer therapy.</p><p><b>METHODS</b>With the LoVo cells as the target cells and human normal large intestinal mucosal epithelial cells as the absorber cells for subtraction biopanning from a c7c phage-display peptide library, the positive phage clones were identified by enzyme-linked immunosorbent assay (ELISA) and immunofluorescence detection. The amino acid sequences of the identified peptides were deduced by DNA sequencing.</p><p><b>RESULTS</b>After 3 rounds of screening, 5 positive phage clones showing specific binding to LoVo cells and containing conserved motif RPMP were obtained from the 20 randomly selected clones.</p><p><b>CONCLUSION</b>Specific peptide against large intestinal cancer cells can be obtained from a phage-display peptide library for use as potential vectors for targeting therapy of large intestinal cancer.</p>