Size of the largest lymph node visualized on multi-detector-row computed tomography (MDCT) is useful in predicting metastatic lymph node status of gastric cancer.

This study was designed to investigate whether the size of the largest lymph node (long-axis diameter [LAD] and short-axis diameter [SAD]) visualized using multi-detector-row computed tomography (MDCT) was useful for predicting the metastatic lymph node (MLN) status of gastric cancer. A retrospective analysis of 305 gastric cancer patients who underwent pre-operative MDCT was performed, followed by a prospective study in 61 gastric cancer patients to determine the diagnostic effectiveness of LAD and SAD. In the retrospective study, the accuracy of LAD and SAD for predicting the MLN status of gastric cancer was 51.1% and 45.9%, respectively. In the prospective study, the accuracy of LAD and SAD measurement and the traditional MDCT method of counting MLNs was 52.5%, 49.2% and 57.4%, respectively; the differences were not significant. In conclusion, the size of the largest lymph node in terms of LAD and SAD visualized on MDCT was useful for predicting the MLN status of gastric cancer, with accuracy comparable to the traditional MDCT method of counting the total number of MLNs detected.

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.

Effects of Linomide on growth and metastasis of implanted human gastric cancer in nude mice.

AIM: To elucidate the effect of angiogenesis inhibitor, Linomide, on tumor growth and metastasis in nude mice implanted with human gastric cancer. METHODS: A metastatic model of gastric cancer was established using orthotopic implantation of histologically intact tumor tissues into the gastric wall of nude mice. Linomide (0, 80, 160 mg·kg(-1)) was given p.o. every day after the implantation, and the mice were sacrificed after 10 wk to detect tumor size and metastasis. The microvessel counts were measured by immunohistochemical staining using a monoclonal antibody against Human Factor VIII related antigen. RESULTS: Linomide treatment significantly decreased the size of the implanted tumors (control group: 1.36 ± 0.81 cm(3) vs Linomide treated group: 0.84 ± 0.51 cm(3) and 0.62 ± 0.35 cm(3), P < 0.05 and 0.01, respectively). Additionally, an antimetastatic effect of Linomide was clearly demonstrated in a dose dependent manner: mice given 80 mg·kg(-1) Linomide developed liver metastasis in 4 of 10 cases, mice given 160 mg/kg developed metastasis in only 1 of 10 mice, while it developed in 19 of 28 mice of the control group (P < 0.05 and 0.01, respectively). The number of metastatic foci was also significantly less in the treated group. Furthermore, the microvessel counts in tumors of treated mice was reduced by 33%-42% as compared with the control tumors (P < 0.01). CONCLUSION: Linomide has a strong inhibitory activity against in vivo tumor growth and metastasis of gastric cancer, effectively suppressing the growth of the primary tumor, preventing liver metastasis, and attenuating the rate of neovascularization.

[Effects of preoperative parenteral nutritional support with chemotherapy on tumor cell kinetics in gastric cancer patients].

The purpose of this study is to elucidate the effect of preoperative parenteral nutritional support (PNS) plus chemotherapy on tumor cell kinetics. 19 advanced gastric cancer (AGC) patients were divided into the following groups: group A (n = 7): in addition to their oral intake, received a PNS for 5 days, which yielded 117 Kj.kg-1.d-1 of non-protein calories and 0.15g.kg-1.d-1 of nitrogen. Group B(n = 6): were infused with 5-Fu at 8-10mg.kg-1.d-1 for 5 days and mitomycin C at 6-8mg.d-1 on the first and fifth day. Group C (n = 6): received a PNS plus 5-Fu with MMC as group A and B did. Specimens of gastric cancer and normal gastric mucosa were taken endoscopically before and after PNS. All specimens were studied by flow cytometry for cell cycle analysis. The results showed that the frequency of cells in S and proliferative phases were significantly increased after PNS (P < 0.01, P < 0.001), but decreased after PNS+chemotherapy (P < 0.05, P < 0.025). No significant change after single chemotherapy was observed. In conclusion, PNS might enhance the effect of chemotherapy in AGC patients, probably, by stimulation of tumor cell kinetics.

The results of transplant livers from selected non-heart-beating cadaver donors.

The clinical experience following transplantation of livers obtained from non-heart-beating cadaver donors (NHBD) with the use of core cooling method is presented here. Six livers procured from such cadavers were transplanted into 6 recipients with hepatoma involving right and left lobes but without distant metastases. The first liver subjected to 75 minutes of warm ischemia had insufficient function after transplantation. The recipient died of graft failure 54 days later. The other 5 livers with 32 to 45 minutes of warm ischemia had a good or excellent immediate function. These 5 recipients died of tumor recurrence, acute rejection or septicemia 131 to 261 days after transplantation. The utilization of selected NHBD is suggested by our practice as a possible approach to help alleviate the acute organ shortage in the areas where heart-beating cadaver donors of brain death are not available.