Cases Of Gastric Cancer Patients Research Articles

Vitamin D and gastric cancer - A systematic review and meta-analysis.

Objective: to explore the association between serum vitamin D level and the occurrence and pathological grade of gastric cancer. Material a nd methods: search PubMed, Embase, Web of Science, Cochrane and Chinese database; all articles about the association between serum vitamin D levels and gastric cancer published before July 2021. Results: 10 trials with 1159 cases of gastric cancer patients and 33,387 cases of regular control patients were analyzed. The serum vitamin D level of the gastric cancer group (15.56 ± 7.46 ng/ml) was lower than in the control group (17.60 ± 1.61 ng/ml), and the difference was statistically significant. The patients with gastric cancer, clinical stage III/IV (16.19 ± 8.04 ng/ml) had lower vitamin D levels than those with stage I/II (19.61 ± 9.61 ng/ml), and the patients with low differentiation of gastric cancer (17.5 ± 9.5 ng/ml) had lower levels than those with well- or moderately-differentiated cancer (18.04 ± 7.92 ng/ml). The patients with lymph node metastasis (19.41 ± 8.63 ng/ml) had lower vitamin D levels than the patients without lymph node metastasis (20.65 ± 7.96 ng/ml), and the difference was statistically significant. Conclusion: vitamin D levels were negatively associated with gastric cancer. Vitamin D levels were significantly associated with different clinical stages, degrees of differentiation, and lymph node metastasis, suggesting that low vitamin D levels might predict poor prognosis in gastric cancer.

Study on the Characteristics of Intestinal Flora Composition in Gastric Cancer Patients and Healthy People in the Qinghai-Tibet Plateau

The aim of this study is to compare and analyze the structure and diversity of intestinal flora between gastric cancer patients and healthy people in the Qinghai-Tibet Plateau and to explore the characteristics of the intestinal flora composition in gastric cancer patients in the plateau area, and to determine the possible correlation between the intestinal flora and gastric cancer. Fresh feces from 22 cases of gastric cancer patients diagnosed in a tertiary hospital in Qinghai Province and 30 cases of healthy people during the same period were collected. The 52 subjects were undergone for 16S rDNA gene sequencing of intestinal bacteria to analyze and compare the diversity and compositional characteristics of intestinal flora. Analysis of the diversity of intestinal flora between the gastric cancer group and the healthy group was based on the Chao1 index of species richness, Shannon diversity index, and Simpson index. It showed that the gastric cancer group had no statistically difference from the healthy group (P > 0.05). In the Venn diagram, the number of OTU units shared by the gastric cancer group and the healthy group is 6997, and the number of unique OTU units in the healthy group is 2282, while the number of OTU units in the gastric cancer group is 896 and the difference is statistically significant (χ2 = 495.829), P < 0.000). Analysis of the composition and abundance distribution of intestinal flora showed that at the phylum level, there is no significant deference in abundance between the healthy group of Bacteroides and Firmicutes compared with the gastric cancer group (P > 0.05). However, there is a statistically significant difference in abundance between the healthy groups of Proteobacteria compared with the gastric cancer group (P < 0.05). At the genus level, the gastric cancer group of Prevotella_9 is significantly different from the healthy group (P < 0.05). Meanwhile, the gastric cancer group of Streptococcus and Lactobacillus are significantly different from the healthy group (P < 0.001). There are differences in the composition and abundance of intestinal flora between patients with gastric cancer and healthy people in plateau areas, suggesting that Proteobacteria, Prevotella_9, Streptococcus, and Lactobacillus have increased in the Qinghai-Tibet Plateau and becoming one of the factors related to the incidence of gastric cancer in the region.

Diagnostic value of MRI-DWI signal intensity value combined with serum PGI, PGII and CA199 in early gastric cancer.

To explore the diagnostic value of MRI-DWI signal intensity value combined with serum PGI. PGII and CA199 in early gastric cancer. Sixty cases of gastric cancer patients admitted to our hospital from December 2019 to December 2020 were selected as the gastric cancer group and 80 cases of healthy volunteers who underwent physical examination in our hospital during the same period were selected as the healthy group. All the 60 patients underwent MRI-DWI examination, and the pathological diagnosis results were regarded as the gold standard. MRI-DWI images, MRI-DWI signal intensity values of patients with different degrees of gastric cancer differentiation. Serum PGI, PGII and CA199 levels of subjects in the two groups were compared. AUC was used to evaluate the diagnostic value of MRI-DWI signal intensity value combined with serum PGI, PG II and CA199 for early gastric cancer. In the healthy group, T1W1 showed relatively uniform low signal intensity. While T2WI showed no significant increase in signal intensity. In the gastric cancer group. There was diffuse gastric wall thickening, local thickening or mass formation; T1WI and WATS showed slightly lower signal intensity in the lesion area. T2WI, FLAIR and B-TFE showed slightly uneven or moderately increased signal intensity. DWI showed limited diffusion, and the signal intensity increased uniformly or more uniformly, and the range of increase was clear. The signal intensity of MRI-DWI was 89.12 ± 8.14 in patients with low differentiation, 82.17 ± 6.35 in patients with moderate differentiation, and 74.52 ± 4.53 in patients with high differentiation. There were significant differences in the signal intensity of MRI-DWI among the three groups, and the difference was statistically significant (F=12.214, P <0.05). Serum PGI levels of subjects in the gastric cancer group were significantly lower than those in the healthy group, and the levels of PGII and CA199 were significantly higher than that in the healthy group, with statistical significance (P <0.05). The AUC, sensitivity and specificity of MRI-DWI signal intensity value and serum PGI, PGII and CA199 combined indexes in the diagnosis of gastric cancer were significantly higher than those of the independent indexes, with statistical significance (P <0.05). Conclusion: MRI-DWI signal strength value, serum PGI, PGII and CA199 levels are closely related to the occurrence and development of early gastric cancer. The combined detection and diagnosis efficiency is higher, which is helpful to improve the detection rate of early gastric cancer and is worthy of extensive clinical application.

Adoption of Computed Tomography Images under Iterative Reconstruction Algorithm in Diagnosis of Gastric Cancer

Objective. This work aimed to study the application of iterative reconstruction algorithm-based computed tomography (CT) imaging in the diagnosis of gastric cancer (GC). Methods. 40 cases of GC patients diagnosed by gastroscopy biopsy and pathology in hospital were retrospectively analyzed. Scanning images of the upper abdomen were obtained after plain scanning and double-phase enhanced scanning. Then, the image was reconstructed by the iterative reconstruction algorithm, and the CT value under the algorithm was analyzed statistically. Results. It was revealed that the detection rate of both spiral CT and iterative reconstruction algorithm-based CT was 100%. After the iterative reconstruction algorithm, the image quality, image information, and image mean square error (MSE) were notably improved. The degree of tumor invasion (T) staging accuracy was 82.6%, lymph node metastasis (N) staging accuracy was 73.2%, and tumor node metastasis (TNM) staging accuracy was 79.1%. The accuracy of the iterative reconstruction algorithm-based CT was 90% for T staging, 83% for N staging, and 85.5% for TNM staging. Conclusion. Iterative reconstruction algorithm can effectively improve the spatial resolution of CT images in GC diagnosis, with high accuracy. It can provide reliable and objective imaging data for the diagnosis of GC clinically, which was worthy of further application in clinical practice.

Prediction of prognosis and survival of patients with gastric cancer by a weighted improved random forest model: an application of machine learning in medicine.

IntroductionIt is essential to predict the survival status of patients based on their prognosis. This can assist physicians in evaluating treatment decisions. Random forest is an excellent machine learning algorithm even without any modification. We propose a new random forest weighting method and apply it to the gastric cancer patient data from the Surveillance, Epidemiology, and End Results (SEER) program. We evaluated the generalization ability of this weighted random forest algorithm on 10 public medical datasets. Furthermore, for the same weighting mode, the difference between using out-of-bag (OOB) data and all training sets as the weighting basis is explored.Material and methods110 697 cases of gastric cancer patients diagnosed between 1975 and 2016 obtained from the SEER database were included in the experiment. In addition, 10 public medical datasets were used for the generalization ability evaluation of this weighted random forest algorithm.ResultsThrough experimental verification, on the SEER gastric cancer patient data, the weighted random forest algorithm improves the accuracy by 0.79% compared with the original random forest. In AUC, macro-averaging increased by 2.32% and micro-averaging increased by 0.51% on average. Among the 10 public datasets, the random forest weighted in accuracy has the best performance on 6 datasets, with an average increase of 1.44% in accuracy and an average increase of 1.2% in AUC.ConclusionsCompared with the original random forest, the weighted random forest model shows a significant improvement in performance, and the effect of using all training data as the weighting basis is better than using OOB data.

Abstract LB-139: The effects and mechanisms of TNF-α/TNFR2 in regulatory T cells on microenvironment and progression in gastric cancer

Abstract Background: Regulatory T cells (Tregs) are potent immunosuppressive cells of the immune system. They facilitate the survival and progression of tumor through their ability to suppress the antitumor immunity. The expression of tumor necrosis factor receptor type II (TNFR2) on Tregs is reported to identify the maximally suppressive Treg population in both mice and human. According to our previous research, expression of TNFR2 appeared to correlate better than CD25+ and CD127− with FoxP3 expression. Aim: The effects and mechanisms of TNF-α/TNFR2 in regulatory T cells on microenvironment and progression in gastric cancer are needed to be studied. Methods: The expression and phenotype of TNFR2 + Tregs in peripheral blood and tumor tissues of 33 cases of gastric cancer patients and in peripheral blood of 15 normal controls were detected by flow cytometry. The ratio of Foxp3+Tregs and TNFR2+Tregs of 145 cases of gastric cancer patients was analyzed by multicolor immunofluorescence assay. We analyzed their relationship with gastric cancer stage, metastasis and other clinical indicators by clinical and pathological data. Results: Flow cytometry showed that the expression of TNFR2 in human peripheral blood Tregs was significantly higher than that in conventional T cells (Tconvs) in peripheral blood CD4 + T cell subsets of gastric cancer patients and healthy individuals (P&amp;lt;0.05). The proportion of TNFR2 + cells in peripheral blood Tregs cells was significantly higher in patients with gastric cancer than in normal subjects (P &amp;lt;0.05). Tregs and Tconvs cells expressed very low level of CTLA-4 and TIM-3 in both normal controls and gastric cancer patients. Multicolour immunofluorescence showed that the ratio of Foxp3 + Tregs and TNFR2 + Tregs was increased in the tumor tissue, and TNFR2 + Tregs cells showed a tendency to increase with tumor progression and lymphatic metastasis. Higher levels of infiltration of TNFR2+ Tregs cells are significantly associated with patients’ OS (P&amp;lt;0.05) and DFS (P&amp;lt;0.05). Conclusion: Our findings revealed that TNFR2 could be a promising molecular marker associated with poor prognosis. The mechanism by which TNFR2+Tregs promote tumor survival and progression in gastric cancer is still needed further research. Citation Format: Yang Qu, Gang Zhao, Hui Li. The effects and mechanisms of TNF-α/TNFR2 in regulatory T cells on microenvironment and progression in gastric cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr LB-139.

Investigation of analgesic dose of nalbuphine combined with remifentanil after radical gastrectomy.

Clinical analgesic effect of different doses of nalbuphine combined with remifentanil on postoperative gastric cancer patients was explored. One hundred cases of gastric cancer patients treated from December 2014 to December 2016 in the Xiangyang No. 1 People's Hospital were selected and separated into group A and group B. The dose in group A was 0.2 mg/kg of nalbuphine plus 0.2 µg/kg of remifentanil, and 0.3 mg/kg of nalbuphine plus 0.1 µg/kg of remifentanil in group B. Analgesia was performed by self-controlled intravenous injection. The Visual Analogue Scale (VAS) pain scores and the Brinell Comfort Score (BCS) at 2, 6, 12, 24 and 48 h after operation, and the incidence of adverse reactions were compared between the two groups. The VAS scores in group A were higher than those in group B, but the BCS scores in group A were lower (P<0.05). Postoperative patient-controlled intravenous analgesia (PCIA) press times in group A were lower than those in group B (P<0.05); the incidence of adverse reactions such as nausea and vomiting in group A was higher than that in group B (P<0.05). The analgesic effect of intravenous analgesia scheme of 0.3 mg/kg of nalbuphine and 0.1 µg/kg of remifentanil on gastric cancer patients after operation is better than that of 0.2 mg/kg of nalbuphine and 0.2 µg/kg of remifentanil, which reduces the incidence of adverse reactions, has greater security, and can be promoted.

Clinicopathological Characteristics and Prognosis of Proximal and Distal Gastric Cancer during 1997–2017 in China National Cancer Center

Background The prognostic relevance of gastric tumor location has been reported and debated. Our study was conducted to examine the differences in clinicopathological features, prognostic factors, and overall survival (OS) between patients with proximal gastric cancer (PGC) and distal gastric cancer (DGC). Patients and Methods Patients with PGC or DGC were identified from the China National Cancer Center Gastric Cancer Database (NCCGCDB) during 1997–2017. Survival analysis was performed via Kaplan-Meier estimates and Cox proportional hazards models. Results We reviewed 16,119 cases of gastric cancer patients, including 6,479 of PGC and 9,640 of DGC. PGC patients presented as older patients (61.5 versus 56.4 years, P<0.001) and more males (82.9% versus 68.2%, P<0.001). Compared with DGC, PGC was more likely to be in later pT stage (pT3 and pT4, 65.0% versus 52.8%, P<0.001) and lymph node metastasis (54.8% versus 50.9%, P<0.001). In univariate analysis, PGC patients had a worse survival outcome in stage I (Hazard ratio [HR] = 2.04, 95% CI: 1.42-2.94) but a better prognosis in stage IV (HR = 0.85, 95% CI: 0.73-0.98) when compared to DGC patients. However, multivariate analysis demonstrated that PGC was not an independent predictor for poor survival (HR = 1.07, 95% CI: 1.00-1.14). Results from multivariate analysis also revealed that pT4, lymph node metastasis, distant metastasis, no gastrectomy, and Borrmann IV were independent predictors associated with poor survival for both PGC and DGC patients. Additional prognostic factors for PGC patients included underweight (BMI < 18.5) (HR = 1.29, 95% CI: 1.06-1.58), linitis plastica (HR = 2.13, 95% CI: 1.25-3.65), and overweight (23 ≤ BMI <27.5) (HR = 0.80, 95% CI: 0.71-0.90). During the 20-year study period, the 5-year OS increased significantly for both PGC and DGC, with the increase rate of 91.7% and 67.7%, respectively. Conclusion In China, PGC significantly differed from DGC in clinicopathological characteristics and prognostic factors. However, there was no significant relationship between survival outcome and gastric tumor location.

The effects and mechanisms of TNF-α/TNFR2 in regulatory T cells on microenvironment and progression in gastric cancer

Background & Aim Background Regulatory T cells (Tregs) are potent immunosuppressive cells of the immune system. They facilitate the survival and progression of tumor through their ability to suppress the antitumor immunity. The expression of tumor necrosis factor receptor type II (TNFR2) on Tregs is reported to identify the maximally suppressive Treg population in both mice and human. According to our previous research, expression of TNFR2 appeared to correlate better than CD25+ and CD127− with FoxP3 expression. Aim The effects and mechanisms of TNF-α/TNFR2 in regulatory T cells on microenvironment and progression in gastric cancer are needed to be studied. Methods, Results & Conclusion Methods The expression and phenotype of TNFR2 + Tregs in peripheral blood and tumor tissues of 33 cases of gastric cancer patients and in peripheral blood of 15 normal controls were detected by flow cytometry. The ratio of Foxp3+Tregs and TNFR2+Tregs of 145 cases of gastric cancer patients was analyzed by multicolor immunofluorescence assay. We analyzed their relationship with gastric cancer stage, metastasis and other clinical indicators by clinical and pathological data. Results Flow cytometry showed that the expression of TNFR2 in human peripheral blood Tregs was significantly higher than that in conventional T cells (Tconvs) in peripheral blood CD4 + T cell subsets of gastric cancer patients and healthy individuals (P Conclusion Our findings revealed that TNFR2 could be a promising molecular marker associated with poor prognosis. The mechanism by which TNFR2+Tregs promote tumor survival and progression in gastric cancer is still needed further research.

Three-dimensional Stereoscopic Visualization Shortens Operative Time in Laparoscopic Gastrectomy for Gastric Cancer

Laparoscopic gastrectomy for gastric cancer is now widely accepted and has become a standard surgery. This study investigated the advantages of three-dimensional (3D) stereoscopic visualization for laparoscopic gastrectomy over a conventional two-dimensional (2D) planar screen. The primary outcome of this study was operative time. Ninety-four consecutive cases of gastric cancer patients who underwent laparoscopic total gastrectomy (LTG) (25 cases) or laparoscopic distal gastrectomy (LDG) (69 cases) were enrolled in this study before and after the introduction of the 3D system. Operative time was significantly shorter in the 3D groups for both LTG (351 vs. 406 min, P = 0.026) and LDG (269 vs. 344 min, P < 0.01). During intracorporeal procedures, dissection time was significantly shorter in the 3D groups for both LTG (183 vs. 232 min, P = 0.011) and LDG (161 vs. 213 min, P < 0.01), although the time needed for anastomosis was similar between the groups. However, operators preferred intracorporeal knot-tying as a ligature for anastomosis under 3D (LTG, P = 0.012; LDG, P < 0.01). These data suggest that 3D stereoscopic visualization shortens the operative time of laparoscopic gastrectomy by reducing the intracorporeal dissection time.

Analysis of Clinicopathologic Characteristics of Gastric Cancer

Objective Western Inner Mongolia is a high risk area of gastric cancer. However, detailed clinical and pathological data of gastric cancer has been lacking. Our hospital is one of the largest gastric cancer diagnoses and treatment centers in western Inner Mongolia. This study was designed to investigate the characteristics of clinical data of patients with gastric cancer in Western Inner Mongolia at our hospital over the past eight years. Methods Data of 1548 cases of gastric cancer patients from 2007.01.01 to 2015.01.01 in our hospital was retrospectively analyzed for their clinical characteristics. Results Of the 1548 patients, 1251 cases (80.81%) were male and 297 (19.19%) were female, and the average age was 60.94±10.90 years old. The cancer location was mainly on the antrum, accounting for 40.76%. Different ages of gastric cancer location constituent ratio was different, and the difference was significant (χ2=39.836, P=0.000). Poorly differentiated adenocarcinoma was a major histological type, accounting for 46.58%. Different ages of histological classification and the differentiation constituent ratio was also different, and the difference was significant (χ2=67.300, P=0.000). There were 144 cases of early gastric cancer, accounting for 9.30%; 1404 cases of advanced gastric cancer, accounting for 90.70%. The majority pathologic type of advanced gastric cancers were Bormann Ⅲ(53.92%). Ⅲ+Ⅳ stage was a majority of TNM stage, accounting for 72.41％. Different ages of TNM stage was different, the difference was significant (χ2=9.013, P=0.029). Conclusion Advanced gastric cancer is the major type of patients with gastric cancer in Western Inner Mongolia. Gastric cancer has a higher incidence in older male patients. Poorly differentiated adenocarcinoma and cancer in antrum have a larger probability. Compared with older patients, there is higher occurrence of malignant cancer and earlier TNM stage in younger patients. Mongolian patients and Han patients showed no significant difference.

A study on clinicopathological features and prognostic factors of patients with upper gastric cancer and middle and lower gastric cancer

Objective: To compare the difference on clinicopathological features and prognostic factors in patients with upper gastric cancer and middle and lower gastric cancer. Methods: 168 cases of gastric cancer patients treated in our hospital from January 2010 to March 2013 were enrolled as the research objects. All of these patients have complete data and were confirmed by pathology and classified into stages I-III period, with 90 cases of upper gastric cancer and 78 cases of middle and lower gastric cancer respectively. Of the 168 cases, 150 cases (89.3%) underwent R0 treatment (no residue under microscope after resection), 18 cases (10.7%) underwent R1 treatment (microscopic residual) and 152 cases (90.5%) underwent D2 (radical type II) perigastric lymph node dissection treatment. Results: There were no significant differences on TNM stage, operation modes, the number of dissected lymph nodes and postoperative complications between the upper gastric cancer group and middle and lower gastric cancer group (P>0.05). There were significant differences on preoperative complications and postoperative adjuvant chemotherapy between the upper gastric cancer group and middle and lower gastric cancer group (P<0.05). 3 y Overall Survival (OS) and Progression-Free Survival (PFS) in the upper gastric cancer group were 35.6% (32/90 cases) and 47.8% (43/90) (P=0.026), and 43.6% (34/78 cases) and 51.3% (40/78) respectively in middle and lower gastric cancer group (P=0.035). Logistic regression analysis showed that risk factors affecting the prognosis of upper gastric cancer were preoperative complications and postoperative adjuvant chemotherapy, while the risk factors affecting the prognosis of middle and lower gastric cancer were TNM staging, preoperative complications and postoperative adjuvant chemotherapy. By the last follow-up on March 31, 2017, 51 of 90 (56.7%) patients with upper gastric cancer and 34 of 78 (43.6%) patients with middle and lower gastric cancer died respectively (P<0.05). Conclusion: There were significant differences on the clinical pathological features and prognosis between patients with upper gastric cancer and middle and lower gastric cancer patients, it is of great guiding significance to know the pathological features of cancer in different parts, it can provide individualized treatment options for patients and improve the prognosis of patients.

Outcomes Following Surgery for Gastric Cancer at a Single Institution: A 16-Year Experience

Objective We analyzed the cases of gastric cancer patients who underwent surgical treatment during the 16 years from 1997 to 2012 at our department to clarify these trends. Methods The subjects were 810 patients who underwent surgery for gastric cancer between 1997 and 2012. We divided the cases into the early-period group (1997–2006) treated before the introduction of laparoscopy, and the late-period group (2007–2012). We compared the clinicopathological factor and survival rates between the early- and late-period groups. Results The average patient age was higher in the late-period group than in the early-period group. Tumor localization showed an increased proportion in the U-region in the late period, and histological type in the late period showed a higher proportion of poorly differentiated cases. The cases receiving adjuvant chemotherapy increased in the late period. The five-year survival rate in the late-period group was shown to be equivalent to that in early-period group. Although the proportion of poorly differentiated cases was increased in late-period group, their survival rate was equivalent, probably because of the use of adjuvant chemotherapy. Conclusions Distinct characteristics were seen over the period of 16 years. It is important to continue the analysis of surgical outcomes to identify trends that need to be addressed.

Relationship between gastric fundus gland polyps and Helicobacter pylori infection and acid inhibitor

Objective To investigate the relationship among infection of the gastric fundus gland polyps and Hp, and the use of proton pump inhibitors(PPI). Methods From January 2012 to January 2014, 89 cases of gastric fundus gland polyps who were treated in the First Central Hospital of Baoding were selected as the observation group.Fifty cases of the same period for the examination of the superficial gastritis were selected as the control group.First, the occurrence of glandular polyps in the observation group was counted statistically, and then Hp infection, taking PPI, H2RA and gastric mucosal protective agent were compared with control group.Another 50 cases of gastric cancer patients were selected, then the Ki-67 antigen test was used for contrast analysis among the three groups. Results The occurrence proportion of undic gland polyps occurred in fundic, gastric body, cardiac and gastric antrum were 34.83%(31/89), 43.82%(39/89), 12.36%(11/89) and 8.99%(8/89) respectively, the difference was significant (χ2=5.192, P=0.001), and more in the form of a single appearance, accounting for 65.17%(58/89). The Hp infection rate of the observation group was 50.56%(45/89), compared with 54.00%(27/59) of control group, the difference was not statistically significant(χ2=0.152, P=0.697), and the Hp infection intensity of observation group concentrated in the low and mild, while in the control group, the high intensity was the main.Ki-67 antigen test comparison showed that expression in the gastric cancer group was 82.00%(41/50), significantly higher than that of the observation group(23.60%(21/89)), the difference was statistically significant(χ2=44.196, P=0.000). Conclusion Hp infection and long-term administration of PPI, H2RA, gastric mucosal protective agent are not the risk factors of gastric gland polyps.And the gastric fundus gland polyps are in the benign disease condition, do not have the deterioration tendency. Key words: Gastric fundus gland polyps; Helicobacter pylori; Proton pump inhibitor; Gastric mucosal protective agents; Relationship study

Expressions and clinical significances of Hepcidin, BMP6 and HJV in gastric cancer

Objective To study the expressions of Hepcidin, bone morphogenetic protein 6 (BMP6) and hemojuvelin (HJV) in gastric cancer, and to explore their relationships with clinical pathological characte-ristics. Methods Hepcidin, BMP6 and HJV were detected by immunohistochemistry in 62 cases of gastric cancer patients, and the relationships among them and clinical pathological features were analyzed. Results Compared with normal gastric mucosa tissues, Hepcidin was highly expressed in gastric cancer tissues (13.3% vs. 56.5%, χ2=8.99, P 0.05; 93.3% vs. 83.9%, χ2=0.88, P>0.05). The expression of Hepcidin was related to T stage (χ2=6.98, P=0.02), but it was not related to age, sex, lymph node metastasis, distant metastasis and anemia. The expressions of BMP6 and HJV were not related to T stage, age, sex, lymph node metastasis, distant metastasis and anemia. Hepcidin was not related to the expressions of BMP6 and HJV (r=0.13, P>0.05; r=0.15, P>0.05). Conclusion Hepcidin is highly expressed in gastric cancer tissues, which is related to the T staging of gastric cancer, and can be used as an objective indicator of the biological behavior of gastric cancer. There were no differences in the expression of BMP6 and HJV between normal gastric mucosa and gastric cancer tissues. Key words: Stomach neoplasms; Anemia; Bone morphogenetic proteins; Hepcidin; Hemojuvelin

Efficacy of olanzapine in symptom relief and quality of life in gastric cancer patients receiving chemotherapy.

Background:Considering the incidence and prevalence rates of gastric cancer in Mazandaran Province of Iran, this research was performed to evaluate the efficacy and safety of olanzapine in symptom relief and quality of life (QOL) improvement of gastric patients receiving chemotherapy.Materials and Methods:This clinical trial was conducted on thirty new cases of gastric cancer patients whose treatment protocol was planned on chemotherapy and were allocated into two groups by simple random sampling. Intervention group (15 patients) received olanzapine tablets (2.5–10 mg/day) a day before the beginning of chemotherapy; in the 1st day of chemotherapy to 8 weeks after chemotherapy, besides the routine treatment regimens. The control group received only the routine treatment regimens. The patients were followed for 8 weeks after intervention. All of the patients were assessed with Hospital Anxiety and Depression Scale (HADS) and WHO-QOL-BREF questionnaires; further, Rhodes index was used to evaluate nausea and vomiting (N/V) status.Results:All the recruited patients continued the allocated interventions (no lost to follow-up). N/V decreased in the case group, but the difference was not statistically significant (P = 0.438). The patients' appetite and body mass index increased (P = 0.006). Anxiety and depression subscales of HADS had significant differences between the two groups (P < 0.001) in the 4th and 8th week after treatment. Among the different subdomains of QOL, only physical health improved significantly after intervention (P < 0.05), but no significant difference was observed in other subdomains and also total QOL score (P > 0.05). No significant increase was observed in fasting and 2-h postprandial blood glucose and lipid profile (P > 0.05).Conclusion:Olanzapine can be considered as an effective drug to increase appetite and decrease anxiety and depression in patients with gastric cancer.

The association between EGFR expression and clinical pathology characteristics in gastric cancer

AbstractObjectiveThe aim of this study was to investigate epidermal growth factor receptor (EGFR) expression in the gastric cancer tissues and the association of EGFR expression with clinical pathology characteristics.MethodsWe firstly analyzed the copy number alteration of EGFR gene in gastric cancer by utilizing the online TCGA resources. We then gathered 71 cases of gastric cancer patients from February 2010 to February 2015 in our hospital. The cancer tissues and normal gastric tissues were tested for EGFR expression by immunohistochemical (IHC) staining and western blotting methods. The association of EGFR expression with clinical pathology characteristics and the prognosis value of EGFR expression were evaluated by the statistical software.ResultsThe copy number of EGFR gene was found to be increased in gastric cancer patients. Western blotting confirmed that EGFR protein was obviously upregulated in tested gastric cancer tissues. Additionally, our IHC results showed that the positive rates of EGFR expression in gastric carcinoid tumors (CTs) and distant normal gastric tissues were 45.1% (32/71) and 25.0% (9/36), respectively. The former was significantly higher than the latter (P &lt; 0.05). The EGFR-positive expression in CTs was related to tumor size, invasion depth, and lymphatic metastasis. The median survival of the EGFR-positive patients was 15.6 months, which was less than that (23.0 months) of the EGFR-negative patients [HR = 2.12, 95%CI: 1.29-4.10 (P &lt; 0.05)]. Also, online survival analysis showed that high expression of EGFR predicted shorter overall survival of gastric cancer patients.ConclusionEGFR was highly expressed in gastric cancer tissues and associated with poor prognosis.

Tumor suppressive effect of PARP1 and FOXO3A in gastric cancers and its clinical implications.

Poly (ADP-ribose) polymerase1 (PARP1) has been reported as a possible target for chemotherapy in many cancer types. However, its action mechanisms and clinical implications for gastric cancer survival are not yet fully understood. Here, we investigated the effect of PARP1 inhibition in the growth of gastric cancer cells. PARP1 inhibition by Olaparib or PARP1 siRNA could significantly attenuate growth and colony formation of gastric cancer cells, and which were mediated through induction of G2/M cell cycle arrest but not apoptosis. FOXO3A expression was induced by PARP1 inhibition, suggesting that FOXO3A might be one of downstream target of the PARP1 effect on gastric cancer cell growth. In addition, by performing tissue microarrays on the 166 cases of gastric cancer patients, we could observe that the expression status of PARP1 and FOXO3A were significantly associated with overall survival (OS) and relapse-free survival (RFS). Strikingly, combined expression status of PARP1 and FOXO3A showed better prediction for patient's clinical outcomes. The patient group with PARP1+/FOXO3A- expression had the worst prognosis while the patient group with PARP1-/FOXO3A+ had the most favorable prognosis (OS: P = 6.0 × 10(-9), RFS: P = 2.2 × 10(-8)). In conclusion, we suggest that PARP1 and FOXO3A play critical roles in gastric cancer progression, and might have therapeutic and/or diagnostic potential in clinic.

Effect of perioperative blood transfusion on the prognosis of gastric cancer

To explore the association of perioperative blood transfusion (PBT) with survival of gastric cancer after surgery. We retrospectively reviewed the medical records of 1 000 gastric cancer patients, including 738 non-transfused (73.8%) and 262 transfused (26.2%) cases. A one to one match was created using propensity score analysis, except preoperative hemoglobin level and operative blood loss. The survival was analyzed by Kaplan-Meier survival model. The 5-year survival rate of the 1 000 cases of gastric cancer patients was 39.9%. Before matching, there was a significant difference between transfused group (33.6%) and non-transfused group (49.1%, P<0.005). Univariate analysis showed that age, tumor size, hemoglobin level, albumin level, depth of invasion, lymph node metastasis, lymph node dissection, surgery mode, adjuvant chemotherapy, blood loss and blood transfusion during perioperative period were associated with prognosis in the gastric cancer patients (all P<0.05). Multivariate analysis showed that tumor invasion, lymph node metastasis, lymph node dissection, chemotherapy and perioperative blood transfusion were independent prognostic factors in gastric cancer (all P<0.05). After matching, the 5-year survival rate of the 262 non-transfused patients was 37.7%, while that of the 262 transfused patients was 33.6% (P>0.05). Perioperative blood transfusion has no significant effect on the prognosis of gastric cancer patients.

Diagnostic sensitivity and specificity of combined detection of serum levels of OPN, MG7-Ag, TPS for gastric cancer

Objective To explore the combined detection of serum osteopontin(OPN), gastric cancer associated antigen(MG7-Ag) and tissue polypeptide specific antigen(TPS) for the clinical value of diagnosis of gastric cancer. Methods Enzyme linked immunosorbent test(ELISA) was used to detect serum levels of OPN, MG7-Ag and TPS of 60 cases of gastric cancer patients, gastric benign lesion group 20 cases were randomly selected at the same time, the group of 24 cases of precancerous lesions and 40 healthy people were also selected as control study. Results Gastric cancer group's serum levels of OPN, MG7-Ag and TPS were significantly higher than those of gastric benign lesions, the precancerous lesion group and healthy control group(F=50.993, 62.50, 41.396, all P<0.01). The single detection sensitivity were 71.7%, 80.0% and 67.3% respectively, three joint detection sensitivity was 91.7%. Conclusion Combined detection of serum OPN, MG7-Ag and TPS can improve the sensitivity of diagnosis of gastric cancer, and has higher diagnosis significance in the diagnosis of gastric cancer. Key words: Stomach neoplasms; Osteopontin; Antigens; Neoplasm