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1.
Obes Surg ; 2020 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-32124218

RESUMO

BACKGROUND: The objective of this study was to observe alterations of serum uric acid (SUA) level and gut microbiota after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) surgery in a hyperuricemic rat model. METHOD: We performed Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) surgery in a hyperuricemic rat model. Serum uric acid (UA), xanthine oxidase (XO) activity, IL-6, TNF-α and lipopolysaccharide (LPS) level changes, and 16S rDNA of gut microbiota were analyzed. RESULTS: After the surgery, the RYGB and SG procedures significantly reduced body weight, serum UA, IL-6, TNF-α and LPS levels, and XO activity. In addition, the RYGB and SG procedures altered the diversity and taxonomic composition of the gut microbiota. Compared with Sham group, RYGB and SG procedures were enriched in the abundance of phylum Verrucomicrobia and species Akkermansia muciniphila, while the species Escherichia coli was reduced. DISCUSSION: We here concluded that bariatric surgery-induced weight loss and resolution of inflammatory remarkers as well as changes of gut microbiota may be responsible for the reduced XO activity and SUA level. To have a better understanding of the underlying mechanism of UA metabolism following bariatric surgery, further research is needed.

2.
J Med Internet Res ; 22(2): e14122, 2020 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-32130123

RESUMO

BACKGROUND: With the increasing number of cancer treatments, the emergence of multidisciplinary teams (MDTs) provides patients with personalized treatment options. In recent years, artificial intelligence (AI) has developed rapidly in the medical field. There has been a gradual tendency to replace traditional diagnosis and treatment with AI. IBM Watson for Oncology (WFO) has been proven to be useful for decision-making in breast cancer and lung cancer, but to date, research on gastric cancer is limited. OBJECTIVE: This study compared the concordance of WFO with MDT and investigated the impact on patient prognosis. METHODS: This study retrospectively analyzed eligible patients (N=235) with gastric cancer who were evaluated by an MDT, received corresponding recommended treatment, and underwent follow-up. Thereafter, physicians inputted the information of all patients into WFO manually, and the results were compared with the treatment programs recommended by the MDT. If the MDT treatment program was classified as "recommended" or "considered" by WFO, we considered the results concordant. All patients were divided into a concordant group and a nonconcordant group according to whether the WFO and MDT treatment programs were concordant. The prognoses of the two groups were analyzed. RESULTS: The overall concordance of WFO and the MDT was 54.5% (128/235) in this study. The subgroup analysis found that concordance was less likely in patients with human epidermal growth factor receptor 2 (HER2)-positive tumors than in patients with HER2-negative tumors (P=.02). Age, Eastern Cooperative Oncology Group performance status, differentiation type, and clinical stage were not found to affect concordance. Among all patients, the survival time was significantly better in concordant patients than in nonconcordant patients (P<.001). Multivariate analysis revealed that concordance was an independent prognostic factor of overall survival in patients with gastric cancer (hazard ratio 0.312 [95% CI 0.187-0.521]). CONCLUSIONS: The treatment recommendations made by WFO and the MDT were mostly concordant in gastric cancer patients. If the WFO options are updated to include local treatment programs, the concordance will greatly improve. The HER2 status of patients with gastric cancer had a strong effect on the likelihood of concordance. Generally, survival was better in concordant patients than in nonconcordant patients.

3.
Ann Surg Oncol ; 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-32040699

RESUMO

BACKGROUND: Most previous risk-prediction models for gastrointestinal stromal tumors (GISTs) were based on Western populations. In the current study, we collected data from 23 hospitals in Shandong Province, China, and used the data to examine prognostic factors in Chinese patients and establish a new recurrence-free survival (RFS) prediction model. METHODS: Records were analyzed for 5285 GIST patients. Independent prognostic factors were identified using Cox models. Receiver operating characteristic curve analysis was used to compare a novel RFS prediction model with current risk-prediction models. RESULTS: Overall, 4216 patients met the inclusion criteria and 3363 completed follow-up. One-, 3-, and 5-year RFS was 94.6% (95% confidence interval [CI] 93.8-95.4), 85.9% (95% CI 84.7-87.1), and 78.8% (95% CI 77.0-80.6), respectively. Sex, tumor location, size, mitotic count, and rupture were independent prognostic factors. A new prognostic index (PI) was developed: PI = 0.000 (if female) + 0.270 (if male) + 0.000 (if gastric GIST) + 0.350 (if non-gastric GIST) + 0.000 (if no tumor rupture) + 1.259 (if tumor rupture) + 0.000 (tumor mitotic count < 6 per 50 high-power fields [HPFs]) + 1.442 (tumor mitotic count between 6 and 10 per 50 HPFs) + 2.026 (tumor mitotic count > 10 per 50 HPFs) + 0.096 × tumor size (cm). Model-predicted 1-, 3-, and 5-year RFS was S(12, X) = 0.9926exp(PI), S(36, X) = 0.9739exp(PI) and S(60, X) = 0.9471exp(PI), respectively. CONCLUSIONS: Sex, tumor location, size, mitotic count, and rupture were independently prognostic for GIST recurrence. Our RFS prediction model is effective for Chinese GIST patients.

4.
Neuroendocrinology ; 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31940636

RESUMO

PURPOSE: To evaluate whether the European Neuroendocrine Tumor Society (ENETS) system or the 8th American Joint Committee on Cancer (AJCC) staging manual are suitable for gastric neuroendocrine carcinomas and/or mixed adenoneuroendocrine carcinomas (G-NECs/MANECs). METHODS: Patients in the a multicentric series with G-NEC/MANEC who underwent curative-intent surgical resection for a primary tumor were included. An optimal staging system was proposed base on analysis of the T and N status and validated by the SEER database. RESULTS: Compared with the ENETS system, the survival curves of the T category and N category in the 8th AJCC system were better separated and distributed in a more balanced way, but the survival curves of T2 vs T3, N0 vs N1, and N3a vs N3b overlapped. For the T category, the 8th AJCC T category was modified by combining T2 and T3, which was consistent with the T category in the 6th AJCC manual for GC. For the N category, the optimal cut-off values of metastatic lymph nodes using X-tile were also similar to those of the N category in the 6th AJCC system. The Kaplan-Meier plots of the 6th AJCC system showed statistically significant differences between individual substages. Compared with the other two classifications, the 6th AJCC system also showed superior prognostic stratification. Similar results were obtained in both multicentric and SEER validation sets. CONCLUSIONS: Compared to the 8th AJCC and ENETS systems, the 6th AJCC staging system for GC is more suitable for G-NEC/MANEC and can be adopted in clinical practice.

5.
J Gastrointest Surg ; 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31749096

RESUMO

PURPOSE: To establish a novel classification of perigastric arteries by computerized tomography angiography (CTA) and discuss its influence in patients' short-term clinical outcomes. METHODS: The clinical data were analyzed retrospectively from 680 gastric cancer patients. The types of the perigastric artery were classified according to CTA image and we compared the short-term clinical outcomes. RESULTS: The perigastric arteries can be divided into seven categories. Type I, trifurcation of the celiac trunk (CT) (294/343, 85.7%); type II, hepatosplenic trunk, left gastric artery (LGA) arising from the abdominal aorta (8/343, 2.3%); type III, hepatogastric trunk, splenic artery arising from the superior mesenteric artery (SMA) (2/343, 0.6%); type IV, celiacomesenteric trunk (5/343, 1.5%); type V, common hepatic artery (CHA) arising from the SMA, gastrosplenic trunk (11/343, 3.2%); type VI, aberrant (accessory or replaced) left hepatic artery arising from LGA (21/343, 6.1%); and type VII, CHA arising from LGA (2/343, 0.6%). The number of retrieved LNs in the CTA group was significantly higher than that in the non-CTA group. However, the operation time, estimated blood loss, intraoperative vascular injury, and medical cost of the CTA group were significantly less than those in the non-CTA group. Of note, in patients with BMI ≥ 25.0, higher LNs retrieval and less vascular injury were still present in the CTA group, which was of vital importance in clinical practice. Furthermore, the CTA group displayed shorter hospital stay (LOS). CONCLUSION: We established a new perigastric artery classification. Application of the classification can improve the short-term clinical outcomes of patients.

6.
Front Oncol ; 9: 846, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31632900

RESUMO

Background: The objective of this study is to identify independent risks and protective factors and to construct a mortality prediction model for gastrectomy in the Chinese population. Study design: This is a population-based prospective cohort at an institutional level. Seventy-two participating hospitals reported their annual gastrectomy data between 2014 and 2016, while 44 variables covering the institution and surgical information were included in the analysis. We used R software to encode and complete data pre-processing. The first difference model was applied to build the risk model. Data from 2014 and 2015 were assigned to risk model development, while data from 2016 was used for validation. Results: In the included centers with 94,277 gastric cancer cases, the in-hospital mortality rate was 0.32%. The regression model revealed that provinces with low-middle GDP, hospitals with annual gastrectomy volume between 100 and 500, greater volume of urgent surgeries performed, larger proportion of males, and a higher proportion of liver metastasis were independent risk factors for mortality following gastric surgeries, while higher laparoscopic resection volume, greater volume of distal gastrectomy with B2 reconstruction, and larger proportion of palliative surgery were independent protective factors (p < 0.05, respectively). In the prediction test, the mean square error of the training set was 0.948, while that of the test set was 0.728, demonstrating the effectiveness of this model. Conclusions: We constructed the first mortality risk prediction model for gastric cancer surgery in the Chinese population. The identified risk factors will help with the therapy selection, while further informing Chinese medical policy decision-makers.

7.
BMC Biol ; 17(1): 74, 2019 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-31530289

RESUMO

BACKGROUND: In mammals, cold exposure induces browning of white adipose tissue (WAT) and alters WAT gene expression and lipid metabolism to boost adaptive thermogenesis and maintain body temperature. Understanding the lipidomic and transcriptomic profiles of WAT upon cold exposure provides insights into the adaptive changes associated with this process. RESULTS: Here, we applied mass spectrometry and RNA sequencing (RNA-seq) to provide a comprehensive resource for describing the lipidomic or transcriptome profiles in cold-induced inguinal WAT (iWAT). We showed that short-term (3-day) cold exposure induces browning of iWAT, increases energy expenditure, and results in loss of body weight and fat mass. Lipidomic analysis shows that short-term cold exposure leads to dramatic changes of the overall composition of lipid classes WAT. Notably, cold exposure induces significant changes in the acyl-chain composition of triacylglycerols (TAGs), as well as the levels of glycerophospholipids and sphingolipids in iWAT. RNA-seq and qPCR analysis suggests that short-term cold exposure alters the expression of genes and pathways involved in fatty acid elongation, and the synthesis of TAGs, sphingolipids, and glycerophospholipids. Furthermore, the cold-induced lipid dynamics and gene expression pathways in iWAT are contrary to those previously observed in metabolic syndrome, neurodegenerative disorders, and aging, suggesting beneficial effects of cold-induced WAT browning on health and lifespan. CONCLUSION: We described the significant alterations in the composition of glyphospholipids, glycerolipids, and sphingolipids and expression of genes involved in thermogenesis, fatty acid elongation, and fatty acid metabolism during the response of iWAT to short-term cold exposure. We also found that some changes in the levels of specific lipid species happening after cold treatment of iWAT are negatively correlated to metabolic diseases, including obesity and T2D.

8.
Medicine (Baltimore) ; 98(28): e16418, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31305459

RESUMO

A 19-item surgical safety checklist (SSC) was published by the World Health Organization in 2008 and was proved to reduce postoperative complications. To date, however, the impacts of SSC implementation in China have not been evaluated clearly. The study was performed to evaluate the impacts of the SSC on postoperative clinical outcomes in gastrointestinal tumor patients.Between April 2007 and March 2013, 7209 patients with gastrointestinal tumor who underwent elective surgery at the Affiliated Hospital of Qingdao University were studied. Data on the clinical records and outcomes of 3238 consecutive surgeries prior to SSC implementation were retrospectively collected; data on another 3971 consecutive surgeries performed after SSC implementation were prospectively collected. The clinical outcomes (including mortality, morbidity, readmission, reoperation, unplanned intervention and postoperative hospital stay) within postoperative 30 days were compared between the two groups. Univariate and multivariate logistic regression analysis were performed to identify independent factors for postoperative complications.The rates of morbidity and in-hospital mortality before and after SSC implementation were 16.43% vs 14.33% (P = .018), 0.46% vs 0.18% (P = .028), respectively. Median of postoperative hospital stay in post-implementation group was shorter than that in pre-implementation group (8 vs 9 days, P < .001). Multivariable analysis demonstrated that the SSC was an independent factor influencing postoperative complications (odds ratio = 0.860; 95% CI, 0.750-0.988).Implementation of the SSC could improve the clinical outcomes in gastrointestinal tumor patients undergoing elective surgery in China.


Assuntos
Lista de Checagem , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Neoplasias Gastrointestinais/cirurgia , Segurança do Paciente , Idoso , Estudos de Coortes , Procedimentos Cirúrgicos Eletivos , Feminino , Neoplasias Gastrointestinais/epidemiologia , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Melhoria de Qualidade , Estudos Retrospectivos , Resultado do Tratamento
9.
J Gastrointest Surg ; 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30937714

RESUMO

BACKGROUND: The different advantages of laparoscopic gastrectomy (LG) and robotic gastrectomy (RG), two new minimally invasive surgical techniques for gastric cancer, remain controversial. PURPOSE: To compare the short-term clinical outcomes of LG and RG. METHODS: A retrospective, single-center comparative study of 1044 patients (LG = 750, RG = 294) was conducted. Patients undergoing LG and RG were matched (2:1 ratio) according to sex, age, BMI, extent of gastric resection, and pathologic stage. The primary outcomes were morbidity and mortality and perioperative recovery parameters; major types of complications were also analyzed. RESULTS: After matching, 798 patients (LG = 532, RG = 266) were included. Both the LG and RG groups showed similar overall complication rates (LG = 12.8% vs RG = 12.4%) and operative mortality (LG = 0.4% vs RG = 0.4%). Compared to those who underwent LG, patients undergoing RG had significantly longer operative times (236.92 ± 57.28 vs 217.77 ± 65.00 min, p < 0.001), higher total costs (US$16,241.42 vs US$12,497, p < 0.001), less operative blood loss (77.07 ± 64.37 vs 103.68 ± 86.92 ml, p < 0.001), higher numbers of retrieved lymph nodes (32.0 vs 29.9, p < 0.001), and higher rates of retrieving more than 16 lymph nodes (94.0 vs 85.5%; p < 0.001). No significant differences between groups were noted in terms of the rate of reoperation, time until a soft diet was consumed, or length of hospital stay. The major complication and readmission rates were similar in both groups. CONCLUSION: RG and LG produced similar short-term clinical outcomes, indicating that RG is a safe and beneficial surgical procedure.

10.
Cancer Epidemiol ; 59: 166-172, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30776583

RESUMO

BACKGROUND: Exposure to energy restriction during childhood is associated with a lower risk of developing colorectal cancer (CRC). To date, the association between this critical period of growth and prognosis of CRC has rarely been investigated. Changes in microbiota and epigenetic dysregulation may be key underlying mechanisms. METHODOLOGY: Tissues collected from patients born between 1956 and 1964 were grouped based on time-period. The differences in overall survival among patients from the three time-periods were examined via univariate analysis. The 16S rRNA gene sequencing approach was to determine differences in microbiota among the groups. Samples were randomly selected to detect BRAF mutations, microsatellite instability (MSI) and promoter CpG island methylator phenotype (CIMP) status. The chi-square test was to assess the relationship between alterations in these molecules and microbiota differences. RESULTS: Patients from the three groups differed in terms of location of CRC (P = 0.034) and carcinoembryonic antigen (CEA) level (P = 0.036). A survival advantage was observed in the famine group compared with the other two groups. Fusobacterium nucleatum, Bacteroides fragilis and Escherichia coli were more abundant in the two comparing groups. Abundance of B. fragilis was associated with BRAF mutations, microsatellite instability (MSI) and abundance of E. coli. Moreover, the incidence of CIMP and MSI was higher in patients with greater abundance of F. nucleatum. CONCLUSIONS: Limitation of energy intake during childhood may affect the composition of gut microbiota, resulting in persistent epigenetic changes that subsequently influence the prognosis of patients with CRC.


Assuntos
Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/microbiologia , Microbioma Gastrointestinal , Idoso , Criança , China/epidemiologia , Neoplasias Colorretais/genética , Neoplasias Colorretais/patologia , Ilhas de CpG , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Instabilidade de Microssatélites , Pessoa de Meia-Idade , Mutação , Projetos Piloto , Prognóstico
11.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(2): 112-118, 2019 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-30799533

RESUMO

The incidence of adenocarcinoma of esophagogastric junction (AEG) has been increasing in recent years and has become a major health problem worldwide. The completed phase III clinical trials have revealed that perioperative chemotherapy and radiochemotherapy can significantly improve prognosis and reduce local recurrence in patients with locally advanced AEG. The sudden emergence of targeted therapy and immunotherapy based on chemotherapy has showed a broad prospect. The location and gross type of tumors can provide valuable information for clinical decision making. Siewert classification is widely used in the world, which is helpful to the choice of the best surgical method. Partial gastrectomy and subtotal esophagectomy with thorough mediastinal lymph node dissection via right thorax approach and total gastrectomy with abdominal lymph node dissection are suitable for Siewert types I and III respectively. There is no consensus on the scope of lymph node dissection in Siewert type II procedure and further research is needed. In addition, regarding the rule of abdominal aortic lymph node metastasis and whether it is necessary to clean the para-aortic lymph nodes in patients with AEG, further research is still required.


Assuntos
Adenocarcinoma/terapia , Neoplasias Esofágicas/terapia , Junção Esofagogástrica , Neoplasias Gástricas/terapia , Adenocarcinoma/patologia , Terapia Combinada , Neoplasias Esofágicas/patologia , Esofagectomia , Gastrectomia , Humanos , Excisão de Linfonodo , Prognóstico , Neoplasias Gástricas/patologia
12.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(2): 156-163, 2019 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-30799538

RESUMO

OBJECTIVE: To compare the effects of robotic and laparoscopic-assisted radical total gastrectomy on lymph node dissection and short-term outcomes in patients with Siewert type II adenocarcinoma of esophagogastric junction (AEG). METHODS: Inclusion criteria: the tumor center was located between 2 cm above and below the esophagogastric junction and was confirmed as adenocarcinoma by endoscopic biopsy. EXCLUSION CRITERIA: tumor with local invasion of the liver,spleen, pancreas or other organs; intraoperative finding of tumor dissemination or distant metastasis; patients undergoing palliative surgical treatment or preoperative neoadjuvant chemotherapy; patients with serious heart diseases, lung diseases, liver diseases, kidney diseases and other comorbidities; patients with multiple primary cancers;patients receiving emergency surgery. According to the above criteria, 82 patients with Siewert type II AEG who underwent gastrointestinal surgery at the Affiliated Hospital of Qingdao University from October 2014 to October 2018 were enrolled in the study. They were randomly divided into robotic surgery groups (41 cases) and laparoscopic group (41 cases) according to a computer-generated randomized allocation table. Both groups underwent radical total gastrectomy plus D2 lymph node dissection through the transabdominal esophageal hiatus approach. The intraoperative conditions and postoperative short-term outcomes were compared between two groups, including surgery time, intraoperative blood loss, length of esophagectomy, postoperative complications, postoperative gastrointestinal recovery time, length of hospital stay, postoperative unplanned reoperation rate and rehospitalization rate. Mean±SD is used for the measurement data that conforms to the normal distribution, and two independent sample t-tests are used to compare the two groups; the comparison of the count data is performed by the χ² test. RESULTS: There were 35 males (85.4%) with age of (62.3±10.0) years and body mass index of (24.4±3.2) kg/m² in the robotic surgery group. There were 37 males (90.2%) with age of (62.5±10.0) years and body mass index of (23.8±2.6) kg/m² in the laparoscopic group. No significant differences in the baseline data between two groups were found (all P>0.05). All the patients of both groups completed R0 resection successfully without conversion to laparotomy or perioperative death. Compared with the laparoscopic group, the robotic group had less intraoperative blood loss [(70.7±39.9) ml vs. (110.2±70.6) ml, t=3.118, P=0.003], longer resected esophagus [(3.0±0.7) cm vs. (1.9±0.5) cm, t=8.759, P<0.001], but longer setup time [(56.5±7.4) minutes vs. (36.0±6.6) minutes, t=4.241, P<0.001], and higher hospitalization costs [(122 317.31±57 789.33) yuan vs. (99 401.56±39 349.53) yuan, t=2.099, P=0.039], whose differences were statistically significant (all P<0.05). The total number of harvested lymph node in the robotic surgery group was 39.2±15.3,which was significantly higher than that in the laparoscopic group (33.0±12.1) (t=0.733, P=0.047). In the robotic group and the laparoscopic group, the mediastinal lymph node No.110 and No.111 were 3.6±1.2 vs. 1.5±1.0 and 3.7±2.0 vs. 1.8±1.1, respectively, with significant difference (t=10.138, P<0.001, t=8.227, P<0.001); axillary lymph node No.19 and No.20 were 2.3±1.2 vs. 1.1±0.9 and 2.0±1.0 vs. 1.0±0.1, respectively, with significant difference (t=7.082, P<0.001,t=8.672,P<0.001). There were no significant differences in the total number of abdominal lymph node and the number of lymph node in abdominal stations between two group (all P>0.05). The highest lymph node metastasis rate was approximately 20% and observed in No.1, No.2, No.3, and No.7, followed by No.8a, No.9, No.11p, and No.110 with around 5%. The lymph node metastasis rate in other stations (No.4sa, No.4sb, No.4d, No.5, No.6, No.11d, No.12a, No.19, No.20 and No.111) was less than 5%.There were no significant differences in postoperative complication rate, postoperative fever time, postoperative exhaust and defecation time, fluid diet time, and postoperative hospital stay (all P>0.05). There were 2 patients(4.9%) with unplanned reoperation and 1 patient (2.4%) with unplanned re-admission in the laparoscopic group,while 3 patients (7.3%)with unplanned reoperation and 2 patients (4.9%)with unplanned re-admission in the robotic surgery group, whose differences were also not statistically significant (χ²=0.240,P=0.675;χ²=0.346,P=1.000). CONCLUSION: Robot-assisted radical total gastrectomy for Siewert II AEG is safe and feasible, which is characterized by more sophisticated operation, less blood loss and higher quality of lymph node dissection, especially for subphrenic and inferior mediastinal lymph nodes.


Assuntos
Adenocarcinoma/cirurgia , Neoplasias Esofágicas/cirurgia , Junção Esofagogástrica/cirurgia , Laparoscopia , Excisão de Linfonodo/métodos , Procedimentos Cirúrgicos Robóticos , Neoplasias Gástricas/cirurgia , Adenocarcinoma/classificação , Adenocarcinoma/patologia , Idoso , Neoplasias Esofágicas/classificação , Neoplasias Esofágicas/patologia , Esofagectomia , Junção Esofagogástrica/patologia , Feminino , Gastrectomia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias Gástricas/classificação , Neoplasias Gástricas/patologia , Resultado do Tratamento
13.
Oncol Lett ; 17(2): 2057-2062, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30675272

RESUMO

The biological features of pancreatic cancer and the associated hypoxic environment around the cancer cells often lead to resistance to radiotherapy and chemotherapy. The present study was performed in order to explore the effect pancreatic stellate cells (PSCs) have on the proliferation of pancreatic cancer cells. In the present study, PSCs from human pancreatic cancer tissues were isolated, and the PSCs markers α-smooth muscle actin and desmin were overexpressed in the cytoplasm of PSCs. An MTT assay revealed that PSCs promoted the viability of pancreatic cancer cells. However, the viability of pancreatic cancer cells promoted by PSCs was partially blocked by SB525334. Cellular invasion analysis demonstrated that PSCs promoted the invasion ability of pancreatic cancer cells. An apoptosis assay indicated that PSCs decreased the level of apoptosis induced by gemcitabine. In vivo experiments consisting of mice bearing MIA-PaCa-2 and PSCs demonstrated an increase in the rate of tumor growth compared with MIA-PaCA-2 alone, whereas SB525334 may delay the tumor progression induced by PSCs. The present findings indicated that PSCs promoted the viability and invasion of pancreatic cancer cells, and decreased the apoptosis of pancreatic cancer cells induced by gemcitabine.

14.
Cell Biosci ; 8: 62, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30534358

RESUMO

Evaluating the risk category of gastrointestinal stromal tumors (GISTs) is crucial for predicting prognosis and choosing treatment strategies, and tumor metastasis usually represent poor prognosis. Tumor necrosis factor-alpha-induced protein 8-like 2 (TIPE2) is a novel described tumor suppressor. In the present study, TIPE2 expression was detected using a total of 96 human GIST specimens by immunohistochemistry. The effect of TIPE2 on proliferation and invasiveness of GIST cells and its related mechanisms were explored in vitro. It was found that TIPE2 expression was gradually decreased in accordance with GIST risk grades and negatively associated with tumor size, mitotic count and risk category. Moreover, TIPE2 was identified as a biomarker for evaluating the risk grade of GIST. TIPE2 markedly suppressed the viability, colony formation, migration and invasion of GIST cells. Furthermore, TIPE2 induced apoptosis and suppressed MMP-9 expression of GIST cells by targeting Rac1. In conclusion, these results indicate that TIPE2 plays a pivotal role in the progression of GIST. TIPE2 serves as a promising biomarker for evaluating GIST risk grade and a potential target for treatment of GIST.

15.
Gastroenterol Res Pract ; 2018: 1359626, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30302088

RESUMO

Propose: The purpose of this study was to compare the accuracy of visceral fat area (VFA) and body mass index (BMI) in predicting the risk of laparoscopic-assisted gastrectomy. Methods: Clinicopathological and imaging data of 133 patients who underwent laparoscopy-assisted gastrectomy were recorded, including 17 cases of conversion to open surgery. The remaining 116 patients were retrospectively analyzed after we excluded 17 patients who had been transferred to laparotomy. The patients were divided into two groups according to BMI (≤25 kg/m2: BMI-L group; >25 kg/m2: BMI-H group) and VFA (≤100 cm2: VFA-L group; >100 cm2: VFA-H group). Clinical outcomes were compared between the BMI and VFA subgroups. Results: There were no differences in intraoperative blood loss and the number of harvested lymph nodes between low and high patients defined by BMI and VFA (p > 0.050). However, in the comparison of patients who underwent laparoscopic resection only, it was found that the operation time and intraoperative blood loss of the VFA-H group were more than those of the VFA-L group (p < 0.050). Compared to the VFA-L group, the VFA-H group had later first exhaust time (p = 0.018), more complications (p < 0.001), and longer hospital stays (p = 0.049). However, no similar conclusion was obtained in the BMI group (p > 0.050). Conclusion: This study demonstrates that VFA better evaluates the difficulty of laparoscopy-assisted gastrectomy and the risk of postoperative complications than BMI.

17.
Zhonghua Wei Chang Wai Ke Za Zhi ; 21(5): 535-540, 2018 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-29774935

RESUMO

OBJECTIVE: To evaluate the clinicopathological features and prognostic factors of carcinoma in the remnant stomach (CRS). METHODS: Clinicopathological data of 217 consecutive CRS patients from January 2000 to March 2017 at Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University were retrospectively analyzed. CRS was defined as the primary cancer arising from the remnant stomach following gastrectomy, regardless of the initial disease or operation, and at no special time interval. The clinicopathological features and treatment were compared between CRS after benign disease operation (CRS-B) group and CRS after gastric cancer operation (CRS-C) group, and factors influencing prognosis were analyzed using Cox regression model analysis. RESULTS: Of 217 patients, 189 were male and 28 were female with mean age of (60.9±11.2) years. The interval between the first and the second operations was (18.3±15.1) years. The CRS-B group comprised 108 patients and the CRS-C group comprised 109 patients. Compared to CRS-C group, CRS=B group had higher ratio of male [92.6% (100/108) vs. 81.7% (89/109), χ2=5.779, P=0.016], longer interval [30(25-40) years vs. 4(1.5-8.0) years, Z=-1.685, P=0.000], longer tumor diameter [(5.9±3.2) cm vs. (3.9±2.4) cm, t=3.390, P=0.000] and later tumor stage [patients in stage I(, II(, III(, and IIII(: 6 (8.0%), 14 (18.7%), 41 (54.7%), and 14 (18.7%) vs. 16 (25.4%), 14 (22.2%), 21(33.3%), and 12(19.0%), respectively, Z=-2.018, P=0.044]. A total of 138 patients underwent surgery, including 118(85.5%) patients of curative resection and 20(14.5%) patients of palliative resection. The other 79 patients did not receive surgery due to extensive metastasis or miscellaneous reasons. Among 138 patients receiving surgery, 3 patients underwent endoscopic resection, 6 patients underwent minimally invasive surgery (laparoscopy or robot), and 129 patients underwent laparotomy. Forty-eight patients underwent surgery involving combined resection. The median postoperative hospital stay was 10(8-14) days. The incidence of postoperative complication was 23.2%(32/138). A total of 91 patients were followed up for 7-120 months, including 51 patients in CRS-B group and 40 in CRS-C group. The overall 1-, 3-, and 5-year survival rates of the 75 patients receiving curative resection were 80.7%, 55.1%, and 41.6%, respectively. The overall 1-, 3-, and 5-year survival rates were 73.5%, 48.3%, and 29.0% respectively in CRS-B group and 83.1%, 51.2%, and 32.5% respectively in CRS-C group. There was no significant difference between two groups (P=0.527). Multivariate analysis showed that age (RR=1.879, 95%CI: 1.015-3.479, P=0.045), radical procedure (RR=2.956, 95%CI: 1.421-6.150, P=0.004) and TNM stage (RR=1.570, 95%CI: 1.047-2.354, P=0.029) were independent prognostic factors for CRS. CONCLUSIONS: As compared to the CRS-C group, the CRS-B group has higher percentage of male, longer interval, larger tumor diameter and later TNM stage. Radical resection indicates better prognosis.


Assuntos
Gastrectomia , Coto Gástrico/patologia , Neoplasias Gástricas/cirurgia , Idoso , Feminino , Coto Gástrico/cirurgia , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/patologia , Taxa de Sobrevida
18.
World J Gastroenterol ; 24(5): 593-601, 2018 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-29434448

RESUMO

AIM: To study the role of semaphorin 4D (Sema4D) expression promoted by tumor-associated macrophages (TAMs) in gastric carcinoma cells and its clinical significance in the invasion and metastasis of gastric carcinoma. METHODS: CD68 and Sema4D expression was analyzed in gastric carcinoma and adjacent normal tissues from 290 patients using the immunohistochemical streptavidin-peroxidase method, and their relationships with clinicopathological features were evaluated. Human M2 macrophages were induced in vitro and co-cultured in non-contact with gastric carcinoma SGC-7901 cells. Changes in the secretory Sema4D level in the SGC-7901 cell supernatant were measured using an enzyme-linked immunosorbent assay. The effects of TAMs on SGC-7901 cell invasion and migration were assessed with invasion and migration assays, respectively. RESULTS: CD68 and Sema4D protein expression was significantly higher in gastric carcinoma tissues than in adjacent normal tissues (71.7% vs 33.8% and 74.5% vs 42.8%, respectively; P < 0.01). CD68 and Sema4D protein expression was significantly associated with histological differentiation, TNM stage, and lymph node metastasis (P < 0.05), and their expression levels were positively correlated with one another (r = 0.467, P < 0.01). In the in vitro experiment, secretory Sema4D protein expression was significantly increased in the supernatant of SGC-7901 cells co-cultured with TAMs compared with the blank control (1224.13 ± 29.43 vs 637.15 ± 33.84, P < 0.01). Cell invasion and metastasis were enhanced in the Transwell invasion and migration assays (P < 0.01). CONCLUSION: TAMs promote the invasion and metastasis of gastric carcinoma cells possibly through upregulated secretory Sema4D protein expression. Combined detection of TAM markers, CD68 and Sema4D, in gastric carcinoma tissue shows potential to predict the trend of gastric carcinoma progression.


Assuntos
Antígenos CD/metabolismo , Antígenos de Diferenciação Mielomonocítica/metabolismo , Biomarcadores Tumorais/metabolismo , Carcinoma/patologia , Macrófagos/imunologia , Semaforinas/metabolismo , Neoplasias Gástricas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Linhagem Celular Tumoral , Movimento Celular/imunologia , Progressão da Doença , Feminino , Humanos , Imuno-Histoquímica , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/imunologia , Neoplasias Gástricas/imunologia , Regulação para Cima
19.
J Invest Surg ; 31(6): 548-554, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28829669

RESUMO

OBJECTIVE: To investigate the clinical values of preoperative use of antibiotics in transanal endoscopic microsurgery (TEM). METHODS: Thirty patients undergoing TEM surgery to treat rectal neoplasms in our hospital were selected in this study. All patients were randomly divided into two groups: antibiotic group that antibiotics were used before and after surgery, and control group that antibiotics were only used after surgery. Several markers were evaluated before and after surgery in all patients, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), changes procalcitonin (PCT), white blood cell count (WBC), neutrophils (NE%) and temperature (T). RESULTS: The patients in the antibiotic group at the first and third days after surgery showed lower values of ESR, CRP, WBC, NE% and T than the control group (p < 0.05), furthermore, the WBC and NE% were significantly decreased at the third day after surgery compared with the first day after surgery. For the PCT, there was a significant difference in the first day after surgery between the two groups (p < 0.05), but no significant difference was observed between them at the third day after surgery (p > 0.05). CONCLUSION: The preoperative use of antibiotics in TEM surgery to treat rectal neoplasms may become an effective method to reduce inflammation and prevent infecting after surgery, which will be verified by an amount of studies on large sample.


Assuntos
Neoplasias Retais , Microcirurgia Endoscópica Transanal , Antibacterianos , Sedimentação Sanguínea , Humanos , Contagem de Leucócitos
20.
Mol Med Rep ; 16(6): 9664-9670, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29152656

RESUMO

MicroRNAs (miRNAs) may function as tumor suppressor or onco­miRNAs and have critical roles in the pathogenesis of gastric cancer (GC). The exact function and mechanism of miRNA (miR)­320a in GC remains to be elucidated. The present study performed gain­ and loss­of­function analyses by transfecting cells with mimics or inhibitors and subsequently performing colony formation, proliferation and cisplatin­sensitivity assays. Additionally, in vivo xenograft models were also performed. Bioinformatics algorithms, luciferase reporter activity assay and western blotting were used to predict the potential target of miR­320a. Additionally, the effect of knockdown or overexpression of ADAM metallopeptidase domain 10 (ADAM10) on cell growth and chemosensitivity was examined. The expression of miR­320a and ADAM10 was also determined in primary tumors. The present study revealed that the expression of miR­320a was reduced in GC cells and ectopic miR­320a expression significantly inhibited cell growth in vitro and in vivo and enhanced the sensitivity of GC cells to cisplatin. ADAM10 was a direct target of miR­320a in GC. Knockdown of ADAM10 attenuated the proliferative ability of GC cells, and increased the sensitivity of GC cells to cisplatin. The upregulated ADAM10 accelerated cell growth rate and reduced the cisplatin­sensitivity of cells. Clinically, a significantly negative correlation was identified between the expression of miR­320a and mRNA levels of ADAM10 in tumors. The findings of the present study suggested that miR­320a may function as a tumor suppressor in GC progression and potential therapeutic strategies for GC may be based on the miR­320a/ADAM10 axis.


Assuntos
Proteína ADAM10/genética , Secretases da Proteína Precursora do Amiloide/genética , Proteínas de Membrana/genética , MicroRNAs/genética , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/genética , Adulto , Idoso , Linhagem Celular Tumoral , Movimento Celular/genética , Proliferação de Células/genética , Cisplatino/administração & dosagem , Cisplatino/efeitos adversos , Resistencia a Medicamentos Antineoplásicos/genética , Feminino , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , RNA Mensageiro/genética , Transdução de Sinais/efeitos dos fármacos , Neoplasias Gástricas/patologia
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