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1.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(3): 314-319, 2020 Mar 06.
Artículo en Chino | MEDLINE | ID: mdl-32187938

RESUMEN

Objective: To systematically evaluate the quality of gastric cancer screening guidelines/recommendations, and provide a reference for the update of gastric cancer screening guidelines/recommendations in China. Methods: "guidelines/consensus/specifications/standards" , "stomach/gastric tumors" , "screening/diagnosis" , "guideline/recommendation" , "gastric cancer/gastric tumor," "early detection of cancer/screening" were searched as keywords in PubMed, Embase, Web of knowledge, China Knowledge Network, Wanfang, China Biomedical Literature Database, and Cochrane Library, as well as the US Preventive Services Working Group, the American Cancer Society, the International Agency for Research on Cancer, the Australia Cancer Council and the International Guide Collaboration Network at the end of July 2018. The inclusion criteria were independent guidelines/recommendation documents for gastric cancer screening. The exclusion criteria were guideline abstracts, interpretation and evaluation literature, duplicate publications, updated original guidelines, and clinical treatment or practice guidelines for gastric cancer. The language was limited to Chinese and English. The European Guide to Research and Evaluation Tools (AGREE Ⅱ) and Practice Guideline Reporting Standard (RIGHT) for Gastric Cancer Screening Guidelines/Recommendations were used to compare and evaluate the quality and reporting standard of gastric cancer screening guidelines/recommendations. Results: A total of five guides/recommendations were included. The results of the AGREE Ⅱ quality evaluation showed that the overall quality of five guides/recommendations was different, including one recommended for "A", one for "B", and three for "C". Each guide/recommendation scored higher in the scope and purpose, clarity, and scores were more significant in the areas of rigor and independence. In the participants, the application field scores were generally low. The RIGHT evaluation results showed that the quality of five guides/recommendations should be improved. The six items with poor report quality were background, evidence, recommendations, review and quality assurance, funding and conflict of interest statement and management, and other aspects. Conclusion: The quality of the included gastric cancer screening guidelines/recommendations is generally low, and the standardization should be strengthened.


Asunto(s)
Detección Precóz del Cáncer/normas , Guías de Práctica Clínica como Asunto/normas , Neoplasias Gástricas/diagnóstico , China , Consenso , Detección Precóz del Cáncer/métodos , Humanos , Estándares de Referencia
2.
Sheng Wu Gong Cheng Xue Bao ; 36(2): 320-331, 2020 Feb 25.
Artículo en Chino | MEDLINE | ID: mdl-32148004

RESUMEN

Gastric cancer is the fourth most common cancer in the world and the second leading cause of death in cancer worldwide. In order to reduce the mortality rate of gastric cancer, the problem that needs to be solved at present is to find new specific markers of early gastric cancer and increase the detection rate of early gastric cancer, thus fundamentally solving the problem of high mortality of gastric cancer. Previous studies in our laboratory found that Peroxiredoxin 4 (PRDX4) has the potential for early gastric cancer markers. In this study, the role of PRDX4 in transformed cells was studied by establishing a malignant transformation model and transforming cell overexpression, the experiment proves that PRDX4 is responsible for growth and proliferation by reducing the content of reactive oxygen species (ROS) in transformed cells. In the microenvironment, it promotes the malignant transformation of cells, that is, PRDX4 promotes the development of gastric cancer via eliminating ROS.


Asunto(s)
Neoplasias Gástricas , Carcinogénesis , Transformación Celular Neoplásica , Humanos , Peroxirredoxinas , Especies Reactivas de Oxígeno , Neoplasias Gástricas/diagnóstico , Microambiente Tumoral
3.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(2): 109-114, 2020 Feb 25.
Artículo en Chino | MEDLINE | ID: mdl-32074788

RESUMEN

As early as in the 1960s, China has begun to conduct exploratory clinical researches on gastric cancer. In the past 10 years, the research projects have increased significantly. Among them, the minimally invasive surgery represented by laparoscopy (CLASS Trial), the hot spot of the esophagogastric junction cancer (5010 Trial), the perioperative adjuvant treatment of advanced gastric cancer (CGOG1001 and RESOLVE Trials), the conversion treatment of late gastric cancer (DRAGON Trial) and high quality clinical research such as real-world research based on large database have made great progress. But there are still many deficiencies, such as few multi-center prospective research, limited research return, and the quality and innovation of scientific research data need to be further improved. However, it should also be noted that the clinical researches of gastric cancer in China have greater advantages and development space. The characteristics of large population base, rich cases and large proportion of advanced gastric cancer are conducive to real-world research. In the future, we should follow the international frontier and combine with national conditions to deepen clinical research, so that more "Chinese elements" can be introduced into the international guidelines for gastric cancer, and promote the overall level of diagnosis and treatment of gastric cancer in China.


Asunto(s)
Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/terapia , China , Ensayos Clínicos como Asunto , Gastrectomía , Humanos , Laparoscopía
4.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(2): 115-122, 2020 Feb 25.
Artículo en Chino | MEDLINE | ID: mdl-32074789

RESUMEN

Perioperative whole-process management (WPM) for patients with advanced gastric cancer (AGC) mainly focuses on some clinical issues which are easily neglected or underappreciated. WPM is helpful in making a scientific and rational therapeutic plan, and avoiding inadequate communication in multi-disciplinary participation, so that the diagnosis, treatment and rehabilitation for AGC patients can be integrated organically. Based on the current clinical practice for AGC patients, eight key issues in WPM should be emphasized.(1) Preoperative clinical staging. An accurate preoperative staging by endoscopy and imaging technique is helpful in setting up a rational therapeutic plan, and is also a prerequisite to start WPM. (2) Indications and value of diagnostic laparoscopy. Laparoscopic exploration is beneficial to find intraperitoneal micro-metastases so as to avoid unnecessary laparotomy. For cases of AGC infiltrating serosal layer or suspected of peritoneal metastasis, preoperative laparoscopic exploration should be routinely performed. (3) Neoadjuvant therapy. Multiple RCT studies have shown that neoadjuvant chemotherapy can benefit a majority of patients with AGC, improving prognosis and prolonging their overall survival. Therefore, neoadjuvant therapy should be considered first for stage III and IVA AGC patients. (4) Prediction of efficacy in neoadjuvant chemotherapy. Endoscopy, MDCT scan, PET-CT and liquid biopsy have certain predictive value individually, which can be used together or separately to improve the accuracy of prediction. (5) Effective prevention of postoperative peritoneal metastasis. Extensive intraoperative peritoneal lavage (EIPL), neoadjuvant intraperitoneal and systemic chemotherapy (NIPS), hyperthermic intraperitoneal chemotherapy (HIPEC), early postoperative intraperitoneal chemotherapy (EPIC), and normothermic intraperitoneal chemotherapy (NIPEC) have been shown to be of various efficacy in preventing peritoneal metastases. (6) Prediction of postoperative prognosis of AGC patients. The key pathological indicators are tumor regression grade (TRG) and ypTNM staging, especially if there is lymph node metastasis. Usually for AGC patients who received neoajuvant chemotherapy with TRG 0 or ypN0, their prognosis was comparable to that of patients with cTNM stage I.(7) Postoperative adjuvant chemotherapy. Postoperative adjuvant therapy is always an important part of the WPM management of AGC patients. Several recent RCT studies have shown that duplet chemotherapy can significantly reduce the risk of death after D2 radical gastrectomy compared to singlet chemotherapy, especially for stage III patients. (8) Perioperative nutritional support. Due to different degrees of malnutrition in AGC patients, enhanced nutritional treatment in the perioperative period can not only reduce surgical complications, but also enable patients to complete necessary course of chemotherapy, and ultimately further improve their survival rate.


Asunto(s)
Atención Perioperativa , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirugía , Quimioterapia Adyuvante , Gastrectomía , Humanos , Laparoscopía , Terapia Neoadyuvante , Estadificación de Neoplasias , Tomografía Computarizada por Tomografía de Emisión de Positrones
5.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(2): 152-157, 2020 Feb 25.
Artículo en Chino | MEDLINE | ID: mdl-32074795

RESUMEN

Objective: To evaluate the accuracy of the clinical staging by comparing preoperative clinical stage and pathological stage in gastric cancer patients, and to explore the potential beneficial population of neoadjuvant chemotherapy for gastric cancer. Methods: We retrospectively collected the clinical data of consecutive patients with gastric cancer who met the inclusion criteria (gastric adenocarcinoma, undergoing laparoscopic or open D2 radical operation, definite cTNM and pTNM) for admission of the Gastrointestinal Center of Peking University Cancer Hospital from July 2013 to April 2019. Patients with the number of harvested lymph nodes less than 16, history of gastric operation or preoperative radiochemotherapy were excluded. Preoperative clinical stage was obtained from abdominal and pelvic enhanced CT by radiologists, and postoperative pathological stage was derived from postoperative pathology reports. The concordance rate between preoperative clinical stage and postoperative pathological stage, and the proportion of pathological stage I in patients with specific preoperative clinical TNM stage were analyzed and compared. The potential beneficial population of neoadjuvant chemotherapy were considered as pI < 5%. Relationship between clinical features and concordance rate of stage was further analysed. Results: A total of 459 patients were included in the analysis, including 321 males and 138 females with mean age of 60 (23 to 85) years old. The concordance rate from T1 to T4 between preoperative clinical T staging and postoperative pathological T staging was 82.5% (33/40), 31.1% (28/90), 34.4% (62/180), and 55.0% (96/149), respectively. The concordance rate from N0 to N3 between preoperative clinical N staging and postoperative pathological N staging was 58.8% (134/228), 22.1% (19/86), 23.6% (26/110), and 54.3% (19/35), respectively. The sensitivity and specificity of abdominal enhanced CT in the diagnosis of lymph node metastasis were 64.5% (171/265) and 69.1% (134/194) respectively. The clinical stage of cT3/T4 patients with pathological stage I was 9.1% (30/329), and the sensitivity of corresponding pathological stage III was 94.8% (164/173), while the cT3/4+cN1-3 patients with pathological stage I stage was 1.4% (3/218), and the sensitivity of corresponding pathological phase III was 76.9% (133/173). Tumor location was associated with the concordance of cT/pT staging [gastroesophageal junction: 64 (56.6%), upper stomach: 9 (9/17), middle stomach: 31 (40.3%), lower stomach: 97 (39.9%), whole stomach: 4(4/9), χ(2)=9.845, P=0.043]; the degree of tumor differentiation was associated with the concordance of cN/pN staging [poorly differentiated: 94 (42.3%), moderated differentiated: 92 (41.1%), well differentiated: 12 (12/13), χ(2)=13.261, P=0.001], whose differences were statistically significant (all P<0.05). Conclusion: Based on a single-center retrospective data from Peking University Cancer Hospital, we think that the potential beneficial population of neoadjuvant chemotherapy for gastric cancer are those clinically staged as cT3/4+N1-3.


Asunto(s)
Terapia Neoadyuvante , Estadificación de Neoplasias , Neoplasias Gástricas/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Neoplasias Gástricas/diagnóstico , Adulto Joven
6.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(2): 170-176, 2020 Feb 25.
Artículo en Chino | MEDLINE | ID: mdl-32074798

RESUMEN

Objective: To explore the clinical significance of laparoscopic exploration combined with abdominal exfoliative cytology in the diagnosis and treatment of patients with locally advanced gastric cancer. Methods: Inclusion criteria: (1) cancer confirmed by gastroscopy and pathology without preoperative anti-tumor treatment; (2) no distant metastases found in preoperative imaging examinations; (3) patients without surgical contraindications and being tolerant to surgery; (4) patients were willing to undergo laparoscopic exploration and abdominal exfoliative cytology examination, and signed informed consent. A retrospective cohort study method was used to collect and analyze the clinicopathological data of 225 patients with advanced gastric cancer based on the above inclusion criteria from a prospective, multicenter, open, randomized controlled phase III clinical trial (registration No. NCT01516944) conducted between February 2012 and December 2018 in The Fourth Hospital of Hebei Medical University, including 162 males and 63 females with age ranged from 23 to 78 years old. Forty-five patients (20.0%) were classified as Borrmann type I to II, and 180 (80.0%) were classified as type III to IV. All the patients underwent laparoscopy and peritoneal lavage cytology under general anesthesia. Laparoscopic exploration sequence: left and right diaphragm→liver and spleen→parietal peritoneum→pelvic cavity→greater omentum, small intestine, mesentery→transverse colon mesentery →stomach. Contents of exploration: (1) with or without ascites; (2) whether metastatic lesions existed in the peritoneum, mesentery, omentum and Douglas pouch; (3) whether metastasis existed on the liver surface; (4) whether the gastric lymph nodes were swollen; (5) whether infiltration occurred on the gastric serosa surface; (6) whether gastric wall was stiff. The left and right subphrenic, the abdominal and pelvic peritoneum, and the mesentery were rinsed with 500 ml of sterilized normal saline. Position of the reverse Trendelenburg was used in the Douglas pouch. The peritoneal lavage fluid under the liver and spleen fossa was collected. Cytological examination was carried out for exfoliative tumor cells. Evaluation criteria: (1) peritoneal metastasis (P): P0 meant no peritoneal metastasis, P1 meant peritoneal metastasis; (2) free peritoneal cancer cells (CY): CY0 meant no cancer cells in peritoneal lavage fluid cytology, CY1 meant cancer cells in peritoneal lavage fluid cytology. The results of patients undergoing laparoscopic exploration combined with abdominal exfoliative cytology, treatment options and prognosis were analyzed. Kaplan-Meier method was used to calculate the survival rate and a survival curve was drawn. Log-rank test was used for survival analysis. Results: After laparoscopic exploration in 225 patients, clinical staging was corrected in 68 (30.2%) patients, of whom 7 (3.1%) downstaged and 61 (27.1%) increased in staging. Of 164 patients evaluated as P0CY0 after the first laparoscopy and peritoneal cytology examination, 126 underwent radical D2 surgery, and the other 38 patients were found to have later local lesions or extensive fusion of local lymph nodes, so then received neoadjuvant chemotherapy. Twenty-nine patients evaluated as P1CY0 or P1CY1 and 32 patients as P0CY1 underwent intraperitoneal hyperthermic chemotherapy+conversion therapy, and then a second laparoscopic exploration was performed to determine the treatment plan. In total, the original treatment regimens were changed after laparoscopic exploration in 99(44.0%) cases. The follow-up period ended in January 2019. The overall 2-year survival rate of 225 patients was 64.0%. As for those who were evaluated as P0CY0, P0CY1 and P1CY0-1 after the first laparoscopic exploration, the 2-year overall survival rate was 70.7%, 65.6% and 24.1%, respectively (P=0.002). The stratified analysis showed that among 180 patients with stage III tumor, after laparoscopic exploration combined with abdominal exfoliative cytology, 125 patients were found to be P0CY0, 28 were P0CY1, and 27 were P1CY0-1, whose 2-year overall survival rates were 70.4%, 64.3%, and 29.6% respectively, and the difference among these 3 groups was statistically significant (P=0.009). Conclusion: Laparoscopic exploration combined with abdominal exfoliative cytology in patients with locally advanced gastric cancer has important clinical guiding significance in improving accurate staging, treatment options and prognosis evaluation, and can avoid non-therapeutic open-close abdominal surgery.


Asunto(s)
Citodiagnóstico , Laparoscopía , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirugía , Adulto , Anciano , Femenino , Gastrectomía , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Estudios Prospectivos , Estudios Retrospectivos , Adulto Joven
8.
DNA Cell Biol ; 39(2): 299-309, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31934786

RESUMEN

Integrated analysis of accumulated data is an effective way to obtain reliable potential diagnostic molecular in gastric cancer (GC). The study aimed to identify potential lncRNAs associated with the pathogenesis and prognosis in GC. Raw noncoding RNA microarray data (GSE53137, GSE95667, and GSE111762) was downloaded from Gene Expression Omnibus (GEO) database. Differentially expressed genes between GC and adjacent normal gastric tissue samples were screened by an integrated analysis of multiple gene expression profile after gene reannotation and batch normalization. Differentially expressed genes were further confirmed by the cancer genome atlas (TCGA) database. Competing endogenous RNA (ceRNA) network, survival analysis, and gene set enrichment analysis (GSEA) were extensively applied to identify hub lncRNAs and discover potential biomarkers related to diagnosis and prognosis of GC. qPCR was applied to confirm hub lncRNA expression levels in GC tissues. In total, 17 integrated differential lncRNAs were obtained after intersections of differential genes between GEO and TCGA database. Four lncRNAs (HMGA1P4, UBE2Q1-AS1, MAGI2-AS3, MIR22HG) concentrated in ceRNA network were validated by qPCR in GC tissues, which were consistent with informatics results. The clinicopathological association revealed that four lncRNAs might be effective in GC progression. Further study revealed that GC patients with lower MAGI2-AS3 expression was evidently longer than those with higher MAGI2-AS3 expression (p = 0.015). Multivariate analysis revealed MAGI2-AS3 was independently associated with overall survival in GC. GSEA showed GC samples were differentially enriched in pyrimidine metabolism, RNA degradation, cell cycle, oxidative phosphorylation etc., and most significantly enriched in ribosome pathway in MAGI2-AS3 low expression phenotype. Four lncRNAs, including HMGA1P4, UBE2Q1-AS1, MAGI2-AS3, and MIR22HG may contribute to GC development, and MAGI2-AS3 might be associated with the prognosis of GC.


Asunto(s)
Biomarcadores de Tumor/genética , Regulación Neoplásica de la Expresión Génica , ARN Largo no Codificante/genética , Neoplasias Gástricas/genética , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Redes Reguladoras de Genes/genética , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , ARN Mensajero/genética , Neoplasias Gástricas/diagnóstico , Transcriptoma/genética
9.
Nat Commun ; 11(1): 525, 2020 Jan 27.
Artículo en Inglés | MEDLINE | ID: mdl-31988276

RESUMEN

Liquid biopsies are providing new opportunities for detection of residual disease in cell-free DNA (cfDNA) after surgery but may be confounded through identification of alterations arising from clonal hematopoiesis. Here, we identify circulating tumor-derived DNA (ctDNA) alterations through ultrasensitive targeted sequencing analyses of matched cfDNA and white blood cells from the same patient. We apply this approach to analyze samples from patients in the CRITICS trial, a phase III randomized controlled study of perioperative treatment in patients with operable gastric cancer. After filtering alterations from matched white blood cells, the presence of ctDNA predicts recurrence when analyzed within nine weeks after preoperative treatment and after surgery in patients eligible for multimodal treatment. These analyses provide a facile method for distinguishing ctDNA from other cfDNA alterations and highlight the utility of ctDNA as a predictive biomarker of patient outcome to perioperative cancer therapy and surgical resection in patients with gastric cancer.


Asunto(s)
Ácidos Nucleicos Libres de Células/química , ADN de Neoplasias/análisis , Leucocitos/química , Recurrencia Local de Neoplasia/diagnóstico , Análisis de Secuencia de ADN , Neoplasias Gástricas/diagnóstico , ADN de Neoplasias/química , Hematopoyesis , Humanos , Pronóstico , Prueba de Estudio Conceptual , Ensayos Clínicos Controlados Aleatorios como Asunto , Neoplasias Gástricas/genética , Análisis de Supervivencia
10.
J Surg Oncol ; 121(3): 494-502, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31902137

RESUMEN

BACKGROUND: Socioeconomic disparities in gastric cancer have been associated with differences in care and inferior outcomes. We evaluated the presentation, treatment, and survival for patients with gastric cancer (GC) in a metropolitan setting with a large African American population. METHODS: Retrospective cohort analysis of patients with GC (2003-2018) across a multi-hospital system was performed. Associations between socioeconomic and clinicopathologic data with the presentation, treatment, and survival were examined. RESULTS: Of 359 patients, 255 (71%) were African American and 104 (29%) Caucasian. African Americans were more likely to present at a younger age (64.0 vs 72.5, P < .001), have state-sponsored or no insurance (19.7% vs 6.9%, P = .02), reside within the lowest 2 quintiles for median income (67.4% vs 32.7%, P < .001), and have higher rates of Helicobacter pylori (14.9% vs 4.8%, P = .02). Receipt of multi-modality therapy was not impacted by race or insurance status. On multivariable analysis, only AJCC T class (HR 1.68) and node positivity (HR 2.43) remained significant predictors of disease-specific survival. CONCLUSION: Despite socioeconomic disparities, African Americans, and Caucasians with GC had similar treatment and outcomes. African Americans presented at a younger age with higher rates of H. pylori positivity, warranting further investigation into differences in risk factors and tumor biology.


Asunto(s)
Grupos de Población Continentales/estadística & datos numéricos , Infecciones por Helicobacter/complicaciones , Clase Social , Neoplasias Gástricas/mortalidad , Anciano , Terapia Combinada , Manejo de la Enfermedad , Femenino , Estudios de Seguimiento , Infecciones por Helicobacter/virología , Helicobacter pylori/aislamiento & purificación , Humanos , Renta , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/etiología , Neoplasias Gástricas/terapia , Tasa de Supervivencia , Estados Unidos
11.
Anticancer Res ; 40(1): 75-80, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31892554

RESUMEN

BACKGROUND/AIM: The aim of the present study was to compare human epidermal growth factor receptor 2 (HER2) expression before and after trastuzumab-based chemotherapy in patients with advanced HER2-positive gastric cancer. MATERIALS AND METHODS: We assessed HER2 expression using immunohistochemistry and/or fluorescence in situ hybridization in pre-treatment biopsied specimens and post-treatment resected specimens obtained from seven patients with advanced HER2-positive gastric cancer receiving trastuzumab-based chemotherapy. RESULTS: Four patients maintained the HER2-positive status and three patients had a change in HER2 expression from positive to negative. In patients showing the loss of HER2 expression after treatments, HER2-positive tumor cells with a dominant histological type disappeared, and HER2-negative tumor cells with another dominant histological type were identified. CONCLUSION: HER2 expression can change after trastuzumab-based chemotherapy in patients with advanced HER2-positive gastric cancer. Continuous monitoring of HER2 expression after treatments may be utilized to determine whether the continued use of trastuzumab is advisable.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Receptor ErbB-2/antagonistas & inhibidores , Receptor ErbB-2/genética , Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/genética , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Biomarcadores de Tumor , Terapia Combinada , Femenino , Humanos , Inmunohistoquímica , Hibridación Fluorescente in Situ , Masculino , Persona de Mediana Edad , Terapia Molecular Dirigida , Imagen Multimodal/métodos , Metástasis de la Neoplasia , Estadificación de Neoplasias , Receptor ErbB-2/metabolismo , Recurrencia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/metabolismo , Trastuzumab/administración & dosificación , Resultado del Tratamiento
12.
Anticancer Res ; 40(1): 81-86, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31892555

RESUMEN

BACKGROUND/AIM: Zinc finger protein ZKSCAN3 (ZNF306) is a promising oncogene candidate in colon, bladder, breast, uterine cervical, and prostate cancers. The present study aimed to investigate ZKSCAN3 protein expression in gastric carcinoma patient tissues and to evaluate oncological outcomes in these patients. MATERIALS AND METHODS: ZKSCAN3 was detected using the anti-ZKSCAN3 rabbit polyclonal antibody. For immunohistochemical examination, we used paraffin-embedded specimens from 87 consecutive patients with gastric cancer who underwent gastrectomy. We investigated ZKSCAN3 expression in relation with patient prognosis and clinicopathological factors. RESULTS: ZKSCAN3 was detected in 28 (32.2%) tumour specimens, with significant association with lymphatic system invasion and distant metastasis. Patients with ZKSCAN3-positive tumours had worse overall survival (OS) than those with ZKSCAN3-negative tumours based on log-rank testing. Furthermore, multivariate analysis revealed that ZKSCAN3 was an independent prognostic parameter for OS (hazard ratio: 2.6379, p=0.0164). CONCLUSION: ZKSCAN3 is a potential novel prognostic factor in gastric cancer patients.


Asunto(s)
Biomarcadores de Tumor , Neoplasias Gástricas/genética , Neoplasias Gástricas/mortalidad , Factores de Transcripción/genética , Anciano , Anciano de 80 o más Años , Línea Celular Tumoral , Femenino , Expresión Génica , Humanos , Inmunohistoquímica , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Metástasis de la Neoplasia , Estadificación de Neoplasias , Pronóstico , Modelos de Riesgos Proporcionales , Recurrencia , Factores de Riesgo , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/metabolismo
13.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(1): 20-25, 2020 Jan 25.
Artículo en Chino | MEDLINE | ID: mdl-31958926

RESUMEN

Adenocarcinoma of esophagogastric junction (AEG) has a special anatomical position. In clinical practice, there are many overplays among thoracic surgeons, gastrointestinal surgeons, gastroenterologists and oncologists. In recent years, AEG has attracted more and more clinical attention with its increasing incidence. It has a tendency to be gradually separated from esophageal cancer and gastric cancer and be defined as a new special type of tumor. At present, there are still many controversies in the definition, classification, TNM staging, surgical approach, extent of resection, lymph node dissection, digestive tract reconstruction and neoadjuvant therapy of AEG. Meanwhile many problems still need to be solved, which is in a stage of gradual improvement and standardization. This article mainly reviews the important research progress in the field of AEG in 2019, summarizes the current clinical hotspots of AEG, especially the surgical treatment hotspots and the current application status of related new technologies, and aims the future development. We suggest that communication and cooperation among multiple disciplines should be strengthened. Through more clinical researches, basic experimental researches, and innovation and application of new technologies, personalized and accurate diagnosis and treatment will be carried out for patients with different conditions to ultimately achieve the common goal of maximizing the benefits of patients.


Asunto(s)
Adenocarcinoma/cirugía , Neoplasias Esofágicas/cirugía , Unión Esofagogástrica/cirugía , Neoplasias Gástricas/cirugía , Adenocarcinoma/clasificación , Adenocarcinoma/diagnóstico , Adenocarcinoma/patología , Neoplasias Esofágicas/clasificación , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/patología , Unión Esofagogástrica/patología , Humanos , Escisión del Ganglio Linfático/tendencias , Estadificación de Neoplasias , Neoplasias Gástricas/clasificación , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/patología
14.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(1): 38-43, 2020 Jan 25.
Artículo en Chino | MEDLINE | ID: mdl-31958929

RESUMEN

Objective: To investigate clinicopathological features and prognostic factors of gastric neuroendocrine tumors (G-NEN). Methods: Clinical and pathological data of patients with G-NEN diagnosed by pathological examination in Chinese PLA General Hospital from January 2000 to June 2018 were retrospectively analyzed in this case-control study. Patients with complicated visceral lesions, other visceral primary tumors, mental disorders and incomplete clinicopathological data were excluded. Finally, 240 hospitalized patients who met the inclusion criteria were enrolled. Physical examination information, tumor characteristics and pathological characteristics of patients were summarized. The Cox regression models were used to analyze the risk factors affecting G-NEN and the survival conditions were described by Kaplan-Meier survival curves and log-rank test. Results: In 240 patients with G-NEN, the mean age was (60.3±10.1) years; 181 were male (75.4%) and 59 females (24.6%); mean tumor diameter was (4.2±2.8) cm; 51 cases (21.2%) were neuroendocrine tumor (NET), 139 cases (57.9%) neuroendocrine carcinoma (NEC), 50 cases (20.8%) mixed neuroendocrine carcinoma (MANEC); 28 cases (11.7%) were G1 low grades, 34 cases (14.2%) G2 medium grades, and 178 cases (74.2%) G3 high grades; tumor infiltration depth T1 to T4 were 44 cases (18.3%), 27 cases (11.2%), 60 cases (25.0%) and 109 cases (45.4%) respectively; 163 cases (67.9%) developed lymphatic metastasis and 46 patients (19.2%) distant metastasis; tumor stage from stage I to stage IV were 55 cases (22.9%), 42 cases (17.5%), 94 cases (39.2%) and 53 cases (22.1%) respectively. Of the 240 G-NEN patients, 223 cases (92.9%) were followed up. The median survival time of the patients was 39.2 (95% CI: 29.1 to 47.5) months. Univariate survival analysis showed that age ≥ 60 years, tumor diameter ≥ 4.2 cm, tumor grade G3, lymphatic metastasis, distant metastasis, and tumor stage III-IV were risk factors for G-NEN patients. Multivariate survival analysis revealed that lymphatic metastasis (HR=1.783, 95%CI: 1.007-3.155, P=0.047) and distant metastasis (HR=2.288, 95% CI: 1.307-4.008, P=0.004) were independent risk factors of the prognosis. Further analysis of the G3 subgroup of G-NEN showed that the 5-year survival rate of NET-G3 was 76.19%, which was significantly higher than that of NEC-G3 and MANEC-G3 (15.60% and 24.73%, P=0.012). Conclusions: Most G-NEN patients are in advanced stage at diagnosis. Lymphatic metastasis and distant metastasis indicate poor prognosis. The prognosis of high proliferation NET-G3 patients is better as compared to those of NEC-G3 and MANEC-G3. This classification is worth further attention.


Asunto(s)
Tumores Neuroendocrinos/diagnóstico , Neoplasias Gástricas/diagnóstico , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Tumores Neuroendocrinos/mortalidad , Tumores Neuroendocrinos/patología , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/patología , Tasa de Supervivencia
15.
Clin Biochem ; 76: 5-10, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31765635

RESUMEN

BACKGROUND: Identification and treatment in the early stage can significantly improve the prognosis of gastric cancer (GC). However, to date, there is still no ideal biomarker that can be used for the screening of early stage GC (EGC). The proteomics supported by mass spectrometry offers more possibilities for discovering tumor biomarkers. The aim of this study was to explore candidate protein biomarkers for EGC screening with mass spectrometry and bioinformatics technology. METHODS: Plasma samples were collected from 15 EGC patients and 15 healthy controls. After a selective immune-depletion to remove high abundance proteins, plasma samples were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) combined with the tandem mass tags (TMT) labeling. RESULTS: A total of 2040 proteins were identified, and 11 proteins were found to be differentially expressed. The results of the logistic regression model and orthogonal signal correction-partial least squares discriminant analysis (OPLS-DA) model showed that the changed proteins identified by plasma proteomics could help distinguish EGC patients from healthy controls. CONCLUSION: The proteins identified by plasma proteomics using LC-MS/MS combined with TMT labeling could help distinguish EGC from healthy controls.


Asunto(s)
Biomarcadores de Tumor/metabolismo , Proteínas Sanguíneas/metabolismo , Proteómica , Neoplasias Gástricas/metabolismo , Anciano , Estudios de Casos y Controles , Cromatografía Liquida , Detección Precóz del Cáncer , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Gástricas/diagnóstico , Espectrometría de Masas en Tándem
16.
Oncology ; 98(2): 111-116, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31600759

RESUMEN

INTRODUCTION: Postoperative pancreas-related complications (PPRC) can cause critical conditions, including sepsis and intra-abdominal bleeding. Thus, it is important to identify patients who are at risk of clinically significant PPRC as early as possible in the postoperative period. Some authors have reported the use of amylase concentration of the drainage fluid (dAmy) to predict PPRC. However, the positive predictive value of dAmy alone is not sufficient. OBJECTIVE: The aim of this study is to evaluate the predictive value of combined use of dAmy and serum C-reactive protein (sCRP) for PPRC. METHODS: The clinicopathological data of 327 patients who underwent elective gastrectomy for gastric cancer were reviewed. There were 18 patients who developed PPRC. Univariate and multivariate analyses were conducted to identify the risk factors of PPRC. Receiver operating characteristic curves were used to identify the cut-off values of dAmy and sCRP on postoperative day 3 (dAmy3 and sCRP3) to predict the risk of PPRC. RESULTS: In the multivariate analysis, splenectomy alone correlated with PPRC. The cut-off values of dAmy3 and sCRP3 were 761 IU/L and 15.15 mg/dL, respectively. Among the 17 patients with both dAmy3 and sCRP3 above the thresholds, 10 (58.8%) had PPRC with Clavien-Dindo classification (CD) ≥II and 7 (41.2%) had PPRC with CD ≥III. In contrast, among the 236 patients with both parameters below the thresholds, 233 (98.7%) did not develop PPRC, and only 1 (0.4%) had PPRC with CD ≥III. CONCLUSIONS: Splenectomy correlates with PPRC, which is consistent with results from large clinical trials. A combined use of dAmy3 and sCRP3 can be useful in predicting the risks of PPRC.


Asunto(s)
Amilasas/sangre , Proteína C-Reactiva , Gastrectomía/efectos adversos , Enfermedades Pancreáticas/sangre , Enfermedades Pancreáticas/etiología , Complicaciones Posoperatorias , Anciano , Biomarcadores , Proteína C-Reactiva/metabolismo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Pancreáticas/diagnóstico , Pronóstico , Curva ROC , Esplenectomía/efectos adversos , Neoplasias Gástricas/complicaciones , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirugía
17.
Chirurg ; 91(1): 41-50, 2020 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-31372677

RESUMEN

During the course of a malignant disease, the tumor needs to be classified repeatedly in order to facilitate decision-making in treatment and to estimate patients prognosis; however, a wrong classification of tumors can occur in different stages of the disease course with tremendous consequences for the affected patients. This review discusses the possible misclassifications which can occur in patients with esophageal cancer or adenocarcinoma of the esophagogastric junction (EGJ), along with the consequences.


Asunto(s)
Adenocarcinoma , Neoplasias Esofágicas , Neoplasias Gástricas , Adenocarcinoma/diagnóstico , Adenocarcinoma/terapia , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/terapia , Unión Esofagogástrica , Humanos , Estadificación de Neoplasias , Pronóstico , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/terapia
18.
Yonsei Med J ; 61(1): 15-19, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31887795

RESUMEN

PURPOSE: The purpose of this study was to assess the diagnostic and prognostic value of serum progastrin-releasing peptide (ProGRP) in patients with gastric cancer (GC). MATERIALS AND METHODS: A total of 150 patients with GC (89 males and 61 females) were recruited, including those with stage I (n=28), stage II (n=33), stage III (n=50), and stage IV (n=39) disease; 50 healthy controls and 66 patients with benign gastric diseases were also enrolled. Levels of serum ProGRP, carcinoembryonic antigen (CEA), and carbohydrate antigen 72-4 (CA72-4) were measured in all subjects. RESULTS: Serum ProGRP levels were significantly higher in GC patients than in controls (p<0.001), and ProGRP was significantly correlated with tumor size, tumor node metastasis stage, differentiation, invasion depth, and lymph node metastasis (p< 0.005). ProGRP levels were significantly decreased after chemotherapy (p<0.001). Receiver operating characteristic curves revealed a sensitivity and specificity for serum ProGRP in GC of 85.9% and 81.2%, respectively. ProGRP levels were positively correlated with CA72-4 and CEA (r=0.792 and 0.688, p<0.05, respectively). Combined detection of ProGRP, CEA, and CA72-4 showed the best diagnostic power for GC. CONCLUSION: ProGRP may be useful as a potential biomarker for GC diagnosis and therapy.


Asunto(s)
Progresión de la Enfermedad , Fragmentos de Péptidos/metabolismo , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/patología , Adulto , Anciano , Antígenos de Carbohidratos Asociados a Tumores/sangre , Biomarcadores de Tumor/sangre , Antígeno Carcinoembrionario/sangre , Estudios de Casos y Controles , Femenino , Proteínas Ligadas a GPI/sangre , Humanos , Masculino , Persona de Mediana Edad , Fragmentos de Péptidos/sangre , Pronóstico , Curva ROC , Proteínas Recombinantes/sangre , Proteínas Recombinantes/metabolismo , Sensibilidad y Especificidad , Neoplasias Gástricas/sangre , Neoplasias Gástricas/diagnóstico
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