Considerations about gastric cancer proteomics.

The frequency of molecular studies aimed to analyze promoter methylation of tumor suppressor genes and global proteomics in gastric carcinogenesis is increasing. Nonetheless, only a few considered the different types of stomach cells, the tumor location and the influence of Helicobacter pylori and Epstein Barr virus infection (EBV). Molecular differences relating to anatomical and histological tumor areas were also recently described. The authors propose a molecular classification of gastric cancer, dividing it into four subtypes: tumors positive for EBV; microsatellite unstable tumors; genomically stable tumors and tumors with chromosomal instability. RESUMO A frequência de estudos moleculares visando a analisar os promotores de metilação de genes supressores de tumor e proteômica globais na carcinogênese gástrica está aumentando. No entanto, apenas alguns consideraram os diferentes tipos de células do estômago, a localização do tumor e a influência da infecção por Helicobacter pylori e pelo vírus Epstein-Barr (EBV). Diferenças moleculares relacionadas com áreas tumorais anatômicas e histológicas também foram recentemente descritas. Os autores propõem uma classificação molecular de câncer gástrico, dividindo-o em quatro subtipos: tumores positivos para o EBV; tumores microssatélite instáveis; tumores genomicamente estáveis ​​e tumores com instabilidade cromossômica.

Técnica segura para a realizacao do pneumoperitônio e passagem do trocáter da regiao umbilical na cirurgia laparoscópica / Safe technique to performe the pneumoperitoneum and the trocar insertion for laparoscopic surgery

A new technique to perform the pneumoperitoneum and trocar insertion for laparoscopic surgery is presented. After a small incision of the intraumbilical skin, the aponeurosis is exposed and adequate traction is obtained by insertion of two sutures. A small incision is made in the aponeurosis to overcome its resistence to the insertion of the Veress needle and the first trocar. Thirty-two laparoscopic procedure were performed using the conventional technique and the results were compared to 404 cases using the above described modification. No intestinal or vascular injury was observed in any of the groups. The incidence of umbilical infection and postoperative hernia were significantly lower in the modified technique group. We conclude that the described modification is safer and helps the surgeon to avoid complications in laparoscopic surgery