Evaluation of REG4 for early diagnosis and prognosis of gastric cancer

We explored the correlation between the development of gastric cancer and the concentration of REG4 and hence the suitability of REG4 as an indicator of the prognosis of patients with GC. Real-time polymerase chain reaction was conducted to detect REG4 messenger RNA expression. The amount of the REG4 protein was measured by immunohistochemistry staining of tissue and enzyme-linked immunosorbent assay of serum. Serum carcinoembryonic antigen and carbohydrate antigen 19-9 concentrations were measured using a commercial automated immunoassay. Real-time polymerase chain reaction results confirmed that REG4 was significantly up-regulated in gastric cancer compared with paired normal mucosa (P < .001). Immunohistochemistry staining revealed that high expression of REG4 correlated with diffuse type, poor differentiation, lymph node metastasis, distant metastasis, and TNM stage III or IV. The mean survival time for patients in the REG4-positive group was significantly less than that in the REG4-negative group (P = .013). The percentage of serum samples that were REG4 positive was 44.0%, which was higher than that for serum carcinoembryonic antigen (P = .039) or carbohydrate antigen 19-9 (P = .012) in TNM stage I and was significantly higher (P = .031) than that in TNM stage II. Thus, REG4 may be not only a prognostic indicator but also a better serum marker than carcinoembryonic antigen and carbohydrate antigen 19-9 for early diagnosis of gastric cancer.     

胃癌细胞株中NPRA基因启动子区CpG岛的甲基化分析

目的NPRA-cGMP信号通路系统可激活cGMP依赖的蛋白激酶,活化的蛋白激酶调控离子转运蛋白和转录因子的表达,从而最终影响细胞生长、凋亡、增殖和炎症反应。本研究旨在研究NPRA基因在胃癌细胞中的甲基化状态及其对下游mRNA表达的影响。方法应用亚硫酸氢钠处理基因组DNA后PCR并测序,我们分析了6株胃癌细胞株NPRA基因的甲基化状态及去甲基化试剂对下游mRNA表达的影响。结果在胃癌细胞中发现NPRA基因启动子区存在甲基化畸变并导致下游mRNA表达减少或沉默。去甲基化试剂可逆转mRNA表达沉默。结论胃癌细胞中存在NPRA基因甲基化畸变。     

Long non-coding RNAs in the gastric juice of gastric cancer patients

Differently from other digestive malignancies, gastric cancer (GC) carcinogenesis seems more heterogeneous and unclear. This entails failing in identification of reliable serum tumor markers for screening early GC (EGC) as well as persisting ominous prognosis of this disease. Recently, investigation of human noncoding genome, especially long noncoding molecules (lncRNAs), has provided promising data. As for GC, however, since the current information on GC-specific lncRNAs is still scarce and comes largely from analyses performed on tissue or serum of affected patients, we decided to review the current literature dealing with expression of such molecules in the gastric juice (GJ) of GC patients. In the case of GC, in fact, several cytological and molecular works have already demonstrated GJ to be an interesting biological material for improving clinicopathologic and prognostic knowledge of this cancer.For this review, we burrowed into the literature on lncRNAs expressed in GJ of GC patients. PubMed, Science Direct, Scopus, Web of Science, Google Scholar and ResearchGate were the search engines entertained. As of 2018, only seven studies have been reported. LINC00152, AA174084, UCA1, RMRP, ABHD11-AS1, LINC00982 and H19 were the GJ lncRNAs examined.Following our review, we can conclude that, due to their high specificity and reliability, GJ lncRNAs should deserve a prominent role in the field of GC research: importantly, they could be used for screening EGC, ameliorating the existing methods of staging (which are still far from being completely accurate), improving the prognostic capacity of the current diagnostic armamentarium and, finally, providing new and valuable therapeutic targets.     

抗体偶联药物在胃癌治疗中的研究与思考

抗体偶联药物(Antibody-Drug Conjugates,ADCs)是一类新型的肿瘤靶向治疗药物,一般由单克隆抗体和细胞毒药物通过连接子偶联而成,同时具有抗体药物高选择性和化疗药物高活性的优势。经过几十年的临床前和临床研究,目前已有多个抗体偶联药物在临床上被广泛用于治疗多种类型的肿瘤。本文就应用于胃癌治疗的抗体偶联药物的研究进展进行综述。     

Allogenic dendritic cell and tumor cell fused vaccine for targeted imaging and enhanced immunotherapeutic efficacy of gastric cancer

Dendritic cells (DCs) have displayed the promising potential in cancer immunity. How to enhance DCs immunotherapeutic effect in cancer targeted immunotherapy and prevention is still a great challenge. Herein, we report for the first time the allogenic DCs and tumor cell fused vaccine combined with cytokine induced killing cells (CIKs) for targeted imaging and enhanced immunotherapeutic efficacy of gastric cancer (GC). The fused vaccine was prepared by PEG mediated fusion between mature DCs and inactive gastric cancer MGC803 cells. The immunotherapeutic and prophylactic potential of the fused cells (FCs) were evaluated in tumor-bearing, post-surgery and tumor free mice models. The migration and homing process of near infrared region quantum dots (NIR-QDs) labeled FCs were investigated by real-time animal imaging system. Results showed that the FCs and FC + CIKs could trigger the tumor-specific CTLs against GC cells, target the tumor tissue initiatively and enhance the prophylactic effects, suppress the tumor growth remarkably in vivo. The potential mechanism is also investigated. In conclusion, allogenic DCs and tumor cell fused vaccine can be used for targeted imaging and enhanced immunotherapeutic efficacy of GC, and the FC + CIKs strategy own great potential in clinical applications such as early therapy and prevention of tumor-metastasis and relapse in near future.     

Advanced gastric cancer and prognosis

Summary The morphological features of 158 gastric carcinomas were analyzed in an attempt to identify patterns best correlated with prognosis. To this end, the depth of infiltration, vascular invasion, intra- and perineoplastic lymphocytic infiltrate, lymph node metastases and number of metastatic lymph nodes were evaluated according to the several classifications for advanced gastric cancer. A good correlation between prognosis and histological features of malignancy were observed, as well as different five-year survival rates for Mulligan, Lauren and Ming histotypes However, when the influence of each single morphological criteria of malignancy was examined, these differences disappeared for Mulligan and Lauren histotypes. On the other hand, the better prognosis for Ming expanding type carcinomas appeared unrelated to any individual feature of malignancy.     

RhoC is essential for the metastasis of gastric cancer

Rho family members are known to regulate malignant transformation and motility of cancer cells, but the clinicopathological significance of RhoC remains unclear yet in the case of gastric cancer. In this study, we evaluated the protein expression level of RhoC in gastric cancer tissues and cell lines. Results showed that only weak staining of RhoC was detected in 3 of 33 non-tumorous cases by immunohistochemistry. The expression of RhoC was significantly higher in gastric cancer tissues (23/42, 54.8%) than in non-tumorous tissues (p < 0.01). Further analysis demonstrated that RhoC had high specificity (80.0%) in detecting gastric carcinomas with metastatic potential. RhoC was positively expressed in 18 out of 20 metastases (90.0%), even higher than that in primary gastric cancer tissues. Western blot showed that RhoC was up-regulated in five different gastric cancer cell lines but not expressed in SV40-transformed immortal gastric epithelial cell GES-1. Overexpression of RhoC GTPase in GES-1 cells could produce the motile and invasive phenotype but did not alter the monolayer growth rate. To further study the functions of RhoC, we took the powerful siRNA technology to knock down the expression of RhoC in SGC7901 cells. It was shown that down-regulation of RhoC did not affect the proliferation of SGC7901 cells. However, interference of RhoC expression could inhibit migration, invasion, and anchorage-independent growth of SGC7901 cells. In conclusion, RhoC may play a very important role in the metastasis of gastric carcinoma. Therapeutic strategies targeting RhoC and RhoC-mediated pathways may be a novel approach for treating metastasis of gastric cancer.     

Diagnostic significance of soluble human leukocyte antigen-G for gastric cancer

Human leukocyte antigen-G (HLA-G) is a novel tumor marker. Increased level of soluble HLA-G (sHLA-G) in various tumor types has been reported. However, the potential diagnostic value of sHLA-G with other tumor markers in gastric cancer (GC) diagnosis is yet to be explored. In this study, plasma level of sHLA-G was measured in 81 GC patients, 53 benign gastric disease patients and 77 normal controls by ELISA. The serum levels of alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), cancer antigen 19-9 (CA19-9) and cancer antigen 72-4 (CA72-4) were also determined. Data showed that plasma level of sHLA-G in GC was dramatically increased compared with normal controls and benign gastric disease patients (both p < 0.001). The AUC for sHLA-G was 0.730 (p < 0.001), superior to serum AFP, CEA, CA125, CA19-9 and CA72-4. After evaluating three cut-offs of sHLA-G, we concluded sHLA-G (cut-off at 128 U/ml) plus CA125 in two-biomarker panel test and CA125 plus CA199 plus sHLA-G or CA125 plus CA724 plus sHLA-G in three-biomarker panel test were better choices for GC discrimination. Our findings indicated that sHLA-G was a potential biomarker for GC diagnosis and the combination of sHLA-G with CA125, CA19-9 and CA72-4 can improve the clinical screening and diagnosis for GC.     

CAR-T细胞免疫疗法在胃癌治疗的研究进展

胃癌(Gastric Cancer,GC)是世界上死亡率第三的恶性肿瘤,传统方法治疗效果欠佳。研究表明,嵌合抗原受体T细胞(Chimeric Antigen Receptor T-cell,CAR-T)免疫疗法是很有前景的治疗方法,利用基因工程方法改造T细胞靶向肿瘤抗原可以促进T细胞的抗肿瘤活性。因此,找寻在肿瘤细胞高表达、在正常细胞低表达或不表达的特异性抗原是提高CAR-T疗法的主要因素。本文介绍了在胃癌中比较重要的CAR-T治疗靶点,目前已经开展临床研究的靶点主要有:NKG2D,EpCAM,CLDN,MSLN,FOLR1,HER2,MUC1等,虽然这些靶点已经取得了一些研究成果,但远远不够,新的CAR-T治疗靶点是目前研究的热点。     

Elevated epiregulin expression predicts poor prognosis in gastric cancer

Epiregulin (EREG) is a novel family member of EGF-like ligands and have elevated expression in a variety of human cancers. EREG expression promotes tumor progression and metastasis and reduces patient survival. However, the expression of EREG and its prognostic value are not clear in gastric cancer (GC). We assessed EREG mRNA and protein expression in GC tissues from Chinese patients using quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemical staining of tissue microarray, and analyzed the correlation between the level of EREG expression and patient clinical characteristics and prognosis. We found that EREG expression was significantly higher in GC tissues than in matched adjacent noncancerous tissues. High EREG protein expression in GC was significantly associated with TNM stage including tumor size, lymph node metastases and distant metastases as well as poor overall survival. These finding demonstrate that EREG is an independent prognostic biomarker for GC.     

The use of lipid-coated nanodiamond to improve bioavailability and efficacy of sorafenib in resisting metastasis of gastric cancer

The metastasis is one of the greatest challenges for successful cancer therapy. Herein, we report a lipid-coated nanodiamond (ND) system loading water-insoluble sorafenib (SND) to improve the bioavailability and efficacy on suppression of cancer metastasis. SND was homogenous nanoassemblies with the mean diameter of 127.6 ± 12.9 nm. Compared with the drug suspension, the sorafenib concentration in gastrointestinal (GI) tract and major organs was significantly increased by SND. Moreover, the oral bioavailability of sorafenib was greatly improved 7.64-fold by SND. However, the ND in SND could not be absorbed into the mucus of GI tract or distributed into major organs after oral administration. Furthermore, the sorafenib concentration in tumor tissue was markedly improved 14.95 folds by SND, and SND demonstrated an efficient and impressive tumor growth inhibition effect in tumor xenograft models. In particular, the metastasis of gastric cancer to distant organs of liver and kidney was remarkably suppressed by SND, which was verified by the detection of macroscopic metastatic nodules, histological examination and immunofluorescence measurements. Thereby, the lipid-coated ND could be a promising drug delivery platform for improving the oral bioavailability of lipophilic drugs and treatment of cancer metastasis.     

MicroRNAs与胃癌关系研究进展

MicroRNAs是一类内源性非编码RNA,近年来研究发现,若干microRNAs参与基因调控,直接参与胃癌的发生和分化,microRNAs表达谱与胃癌的进展和预后等密切相关.因此,microRNAs的研究对于阐明胃癌相关基因的功能和胃癌癌变的分子机制具有重要的意义.     

胃癌临床研究进展

胃癌是我国的高发癌种,外科治疗是胃癌治疗的基石,腔镜手术和淋巴结清扫范围仍然是外科研究的重点。同时,随着免疫及分子靶向药物的不断推陈出新,围术期治疗及晚期治疗的模式都有了长足的改变和进步,也增加了患者生存的机率。此外,随着分子生物学及二代测序的飞速发展,精准的筛选人群及基于亚人群的精准用药,都为胃癌患者打开了生存之门。     

Molecular analysis of primary gastric cancer, corresponding xenografts, and 2 novel gastric carcinoma cell lines reveals novel alterations in gastric carcinogenesis

We report the molecular characterization of 8 primary gastric carcinomas, corresponding xenografts, and 2 novel gastric carcinoma cell lines. We compared the tumors and cell lines, with respect to histology, immunohistochemistry, copy number, and hypermethylation of up to 38 genes using methylation-specific multiplex ligation-dependent probe amplification, and TP53 and CDH1 mutation analysis where relevant. The primary tumors and xenografts were histologically comparable and shared expression of 11 of 14 immunohistochemical markers (E-cadherin, beta-catenin, COX-2, p53, p16, TFF1, cyclin E, MLH1, SMAD4, p27, KLK3, CASR, CHFR, and DAPK1). Gains of CASR, DAPK1, and KLK3--not yet described in gastric cancer--were present in the primary tumors, xenografts, and cell lines. The most prominent losses occurred at CDKN2A (p16), CDKN2B (p15), CDKN1B (p27/KIP1), and ATM. Except for ATM, these losses were found only in the cell line or xenograft, suggesting an association with tumor progression. However, examination of p16 and p27 in 174 gastric cancers using tissue microarrays revealed no significant correlation with tumor stage or lymph node status. Further losses and hypermethylation were detected for MLH1, CHFR, RASSF1, and ESR, and were also seen in primary tumors. Loss of CHFR expression correlated significantly with the diffuse phenotype. Interestingly, we found the highest rate of methylation in primary tumors which gave rise to cell lines. In addition, both cell lines harbored mutations in CDH1, encoding E-cadherin. Xenografts and gastric cancer cell lines remain an invaluable research tool in the uncovering of the multistep progression of cancer. The frequent gains, losses, and hypermethylation reported in this study indicate that the involved genes or chromosomal regions may be relevant to gastric carcinogenesis.     

Elevation of HLA-G-expressing DC-10 cells in patients with gastric cancer

DC-10 is a distinct subset of human tolerogenic dendritic cells (DCs) which express high levels of human leukocyte antigen-G (HLA-G). DC-10 could induce adaptive type 1 regulatory T cells through the IL-10 dependent ILT4/HLA-G signaling pathway. However, the significance of DC-10 in malignancies remains unclear. In this study, the frequency and mean fluorescence intensity (MFI) of HLA-G+ DC-10 in the peripheral blood of 124 patients with gastric cancer (GC) and 130 normal controls was analyzed with flow cytometry. Plasma sHLA-G was analyzed with ELISA. Results showed both the percentages of peripheral HLA-G+ DC-10 (median: 0.13% vs 0.01%; p < 0.01) and MFI of HLA-G on these cells (median: 310.0 vs 91.5; p < 0.01) were dramatically increased in GC patients than in normal controls. The frequency of HLA-G+ DC-10 in GC patients was strongly relative to the tumor grade (p = 0.021). sHLA-G levels in GC patients were significantly higher than in healthy controls (median: 85.80 U/ml vs 61.20 U/ml; p < 0.01). There was no significant correlation between the percentage of DC-10 and plasma sHLA-G (p > 0.05). However, the increased HLA-G+ DC-10, HLA-G MFI and plasma sHLA-G in patients with gastric cancer could be a diagnostic factor with the area under the ROC curve with 0.947 (p < 0.01), 0.882 (p < 0.01) and 0.700 (p < 0.01) respectively. Given the immune tolerant function of DC-10 could play, the increased DC-10 might play an important role in immune suppression for patients with gastric cancer, while more studies are necessary to illustrate the clinical relevance of DC-10 in cancer patients.     

RNF180在胃癌中的研究进展

RNF180是具有泛素连接酶活性的一类环指蛋白,可通过参与泛素-蛋白酶体系统影响细胞增殖、分化及凋亡等多种生理过程。研究表明,RNF180在肿瘤中多呈低表达,可抑制胃癌细胞的增殖侵袭,影响胃癌淋巴结转移及预后。RNF180的启动子甲基化引起的基因表达沉默是导致RNF180蛋白在肿瘤中低表达的主要原因,重要甲基化位点与癌前病变、胃癌淋巴结转移及患者预后相关。故RNF180具有成为胃癌肿瘤生物标志物的潜力。     

Early gastric cancer: a morphological study of 144 cases.

Within 144 early gastric cancers (EGC), the ulcerated type was most frequent (54.2%), followed by the superfical (29.9%) and protruded types (16%). 10.4% of EGC originated from adenomatous polyps of gastric mucosa. No positive correlation between hyperplastic polyps and occurrence of EGC could be stated. Antrum and corpus regions were preferred localization of EGC, harboring about 90% of the tumors. Histologic classification according to Laurén (1965) proved to be very reliable, revealing an intestinal type of EGC in 53.1% and a diffuse type in 32.4%. Primary anaplastic tumors seem to be very rare. Intestinal types were predominant in males, especially in the elderly patient. In about 50% the tumor was still limited to the mucosa with the exception of Type I, since those tumors originating from polyp infiltrated submucosa above and those without evidence of a preceding polyp, below average. Regional metastases were found in 4.2% with one primary tumor still limited to the mucosa. In the pure intestinal type of EGC metastases did not occur at all. Multicentricity of EGC was, with 2.8%, remarkably low, compared with the findings of others. Excluding malignancies, the only other noteworthy concurrent lesions were ulcer scars or chronic ulcers with 6.9% and B II resection for benign disease with 2.8%.     

Circular RNAs as diagnostic biomarkers in gastric cancer: A meta-analysis review

PurposeGastric cancer is a malignant tumor in the world and circRNA has a close connection with it. However, the effects of circRNA on gastric cancer is still not clear.MethodsA comprehensive search of PubMed, Web of Science and Embase for published experimental studies about circRNA from 2013 to June 2018 was conducted with two investigators. Diagnostic OR (DOR) was calculated to evaluate the diagnostic efficacy by STATA 12.0.ResultsTotal 11 studies were found, including 12 kinds of circRNAs, 11 in tissues, 5 in plasma, and all down regulated. The combined DOR and AUC (Area Under the Curve of Receiver Operating Characteristic) with their 95%CI were 8.778 [6.108, 12.614] and 0.81 [0.78, 0.84] respectively, indicating that circRNAs can reflect gastric cancer as well. Subgroup analysis revealed that circRNAs in plasma were higher than tissues as well as in subgroup with different sample sizes. We speculated that the heterogeneity of the literatures was mainly due to the different backgrounds of gastric cancer and the differences in experimental design and operation process. And the Deeks’ funnel map revealed there was no obvious public biasness in the literature.ConclusionCircRNAs have high sensitivity and specificity in the diagnosis of gastric cancer, and it may become an auxiliary diagnostic biomarker of gastric cancer.