老年胃癌患者组织不同密度脂蛋白表达与病理学特征相关性

目的 分析老年胃癌患者癌组织中不同密度脂蛋白的表达特性与病理学特征的相关性.方法 选择老年胃癌患者372例,根据病理切片分为乳头状腺癌等多种胃癌病理类型,并对癌组织总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)水平进行检测并比较,同时选取进行体检相同年龄段的胃部健康人群60例作为对照组,胃溃疡患者72...     

残胃癌的临床特征及预后分析

目的探讨残胃癌（GRC）胃镜所见、临床特征及预后影响因素。方法收集广东省台山市人民医院和中山大学附属第二医院1990年1月至2006年10月经胃镜及病理确诊为GRC的患者102例,分析其发生率、性别、年龄、临床表现、病程、手术病因、术式、幽门螺杆菌（Hp）感染率、残胃癌变部位、病理类型等特点及影响预后因素。结果本组患者GRC发生率为4.78%,男性患者明显多于女性,病程超过10年者占96.1%,平均病程为16.67年。胃溃疡术后致癌率（5.30%）与十二指肠球部溃疡术后致癌率（5.05%）相仿。行毕Ⅱ式患者GRC发生率（3.28%）明显高于行毕Ⅰ式者（1.50%）。GRC的Hp感染率（66.67%）明显高于同期一般残胃人群（29.68%）。GRC临床表现不典型,癌变部位多发生于吻合口,组织学分化较差,恶性程度高。根治性切除组1、3、5年生存率分别为100%、65.2%、33.8%;非根治切除组的1、3、5年生存率分别为26.3%、11.4%和0。结论残胃患者中,病程超过10年、行毕Ⅱ术式、Hp感染等均为GRC的高危因素;胃镜结合病理活检是目前确诊GRC的主要方法;残胃癌的预后与病理分期和能否行根治性切除密切相关。     

E-钙粘蛋白-连接素复合体表达与胃癌临床病理学及生存期的关系

目的　E 钙粘蛋白 连接素复合体介导细胞 细胞间粘附 ,在维持上皮组织结构和功能方面起重要作用。检测胃癌组织E 钙粘蛋白和α 连接素、β 连接素的表达情况 ,分析它们与临床病理特征及病人生存期之间的关系。方法　采用免疫组化方法检测 14 8例胃癌E 钙粘蛋白和α 连接素、β 连接素的表达水平。结果　E 钙粘蛋白、α 连接素和 β 连接素在胃癌异常表达率分别为 4 4 .6 % ,73.6 %和4 3.2 %。14 8例胃癌中E 钙粘蛋白 连接素复合体总的异常表达率为 91.9%。E 钙粘蛋白和α 连接素、β 连接素表达下调与胃癌分化程度显著相关 (P <0 .0 0 5 )。伴有淋巴结转移或远处转移胃癌 ,其 β 连接素异常表达率显著高于无淋巴结转移或无远处转移者 (P <0 .0 0 5 )。β 连接素正常表达具有显著的生存优势 (P <0 .0 0 5 ) ,且独立于胃癌分期、分级和分型。结论　胃癌广泛存在E 钙粘蛋白复合体表达异常。β 连接素异常表达可能是对胃癌生存期具有预测价值的重要指标     

胃癌的分子病理学预后因素

诊疗技术的发展进步使早期胃癌的长期生存得到很：赶改善，然而，进展期胃癌的预后仍不容乐观。进展期胃癌病人常常死于远处转移。既往的分子病理学研究揭示了胃癌浸润和转移的分子机制。转移过程由肿瘤细胞分离、局部浸润、血管发生、血管侵袭、循环中生长、黏附内皮细胞、外渗，然后在不同的器官中再生。上述每一阶段的相关介质分子都已被识别，包括细胞黏附分子，各种生长因子，基质降解酶和趋化因子等，所有这些均可认为是预后因素。基因组学的最新进展让我们揭示胃癌发生的详细分子机制和演进步骤。基因表达图谱分析和基因多态性研究都可以发现新的预后因素。本文着重阐述胃癌预后因素的基因和分子改变及其临床应用。     

E-cad基因表达与胃癌发生及预后的关系研究

为探讨上皮钙粘附蛋白（E-cad)基因表达与胃癌发生发展及预后的关系，应用免疫组织化学方法检测了65例胃癌，25例胃癌前病变患者及20例胃粘膜正常者标本中的E-cad表达。结果显示，胃癌E-cad异常表达率（53．85％）显著高于胃癌前病变（24．0％），E-cad表达异常与胃癌的临床分期，分化程度，浸润深度及淋巴结转移密切相关，E-cad表达正常胃癌患者的3年，5年生存率显著高于E-cad表达异常者（P＜0．05）。提示E-cad基因表达与胃癌发生发展密切相关，检测E-cad表达有助于胃癌的早期诊断及转移潜能与预后的判断。     

从临床病理学角度看胃癌的预防

胃癌在病理学上是一种具有异质性且恶性程度极高的恶性肿瘤,是危及国人健康的元凶之一。目前关于胃癌的发生机制仍不清楚。通过越来越多的临床、病理、流行病学、基因学研究结果,可以将胃癌分为三大类：近端胃贲门癌、非近端胃癌、弥漫浸润型胃癌,其发病机制和致癌因子各不相同。在中国,大多数胃癌为非近端胃癌,主要发生在远端胃的胃窦、胃角等部位,多为幽门螺杆菌感染所致,其可以通过改变不良生活方式、全民戒烟、改善环境等措施加以预防。对高危人群,应进行年度胃镜检查和活检,按胃黏膜上皮病变程度和性质对患者进行适当的内镜监控和治疗,以期尽早检出早期胃癌并进行根治,防止其进展至晚期胃癌,从而大幅延长患者生存率,提高患者的生活质量。这是一个需要患者与医务人员相互配合、长期坚持的系统工程。     

幽门螺杆菌感染与C-myc基因和P53基因表达与胃癌的相关性研究

目的探讨幽门螺杆菌（Hp）感染情况与C-myc基因及P53基因的表达与胃癌的相关性。方法用w—s染色法观察不同胃病黏膜组织中Hp感染情况，采用免疫组化检测技术检测不同胃病组织的C-myc基因和P53基因表达产物。结果胃癌及癌前病变组Hp感染率明显高于慢性浅表性胃炎组（P〈0．01），C-myc基因和P53基因的表达也显著高于慢性浅表性胃炎组（P〈0．01）。Hp感染阳性组的C-myc基因和P53基因表达明显高于Hp感染阴性组（P〈0．01）。结论Hp感染可能通过激活C-myc基因，同时使P53基因失活从而诱发胃黏膜的癌变。     

研究合并2型糖尿病乳腺癌患者的临床病理学特征及其与预后的关系

目的探讨对合并2型糖尿病乳腺癌患者的临床病理学特征和预后效果之间关系。方法2015年2月-2016年2月在该院就诊的合并2型糖尿病乳腺癌患者中抽取46例作为实验组,在同时期抽取非糖尿病乳腺癌患者46例作为参照组,对两组患者的临床病理学特征和预后效果进行分析。结果与参照组进行比较,实验组50岁之上的例数较多,绝经后例数较多,组间差异有统计学意义(P<0.05);相比于参照组,实验组其T2期以及之上的例数、淋巴结阳性的例数、Ⅱ/Ⅲ期患者例数均较多,组间差异有统计学意义(P<0.05)。结论 2型糖尿病是乳腺癌发生、淋巴结转移等影响因素,乳腺癌伴有2型糖尿病患者的病理T分期与临床分期较晚,淋巴结转移较多,具有较高的复发转移率,伴有2型糖尿病乳腺癌患者的预后效果不佳,因此需重视术后复查和随访工作。     

Hhip和Lpar2基因表达与胃癌相关性的研究进展

胃癌(gastric cancer, GC)是源于胃粘膜上皮细胞的恶性肿瘤,近年来研究表明Hhip与Lpar2基因在GC的发生发展中分别发挥着抑制和促进的作用, Hhip基因通过参与Hh信号通路抑制GC细胞的增殖与侵袭,而Lpar2基因通过激活ATX-LPA信号通路促进GC的发生发展.本文就Hhip与Lpar2基因在GC患者中的表达水平变化、相关分子机制及未来在临床上的应用作一综述.     

胃癌HME表达的临床病理学意义

目的:探讨人类巨噬细胞金属弹力酶(human macrophage metalloelastase,HME)在人胃癌中的表达对肿瘤进展及预后的影响.方法:选取完整随访资料的胃癌存档蜡块65例(男57例,女8例,患者年龄30-74岁,分期T1-T4)进行免疫组化和原位杂交分析,评价HME表达与人胃癌临床病理学因素的相关性及其对疾病预后的意义.结果: HME蛋白及mRNA高表达率在分化类型较高的胃癌组织中较高(67.74% vs 41.18%,77.42% vs 52.94%,均P<0.05),血管浸润的胃癌组织低于无血管浸润者(31.25% vs 75.76%,40.63% vs 87.88%,均P<0.01),术后复发者低于无术后复发者(37.50% vs 63.41%,P<0.05;41.67% vs 78.05%,P<0.01).HME蛋白及mRNA高表达率与性别、年龄、肿瘤位置、大小、组织浸润深度及远处转移均无明显相关性,胃癌术后5年内复发死亡患者HME蛋白及mRNA高表达率明显低于术后生存5年以上者(37.04% vs 74.29%,P<0.01;48.15% vs 77.14%,P<0.05).HME表达为胃癌预后的独立影响因素,HME蛋白及mRNA高表达者预后较好(OR=0.323,OR=0.377;均P<0.05).结论:HME高表达与预后较好的密切相关,可能成为反映胃癌生物学行为及预测预后的有效指标.     

Endoscopic, clinicopathological features and prognosis of very young patients with gastric cancer

Background and Aim: The number of clinical reports of very young (< 35 years) patients with gastric cancer are limited. We aimed to investigate the endoscopic and clinicopathological features and long‐term prognosis of this unique group of patients. Methods: A prospective endoscopy database review of all consecutive very young patients with gastric cancer was performed. The gender, age, clinical features, endoscopic and pathologic findings, and long‐term survival of these very young patients were analyzed and compared with those of elderly patients. Results: A total of 210 patients were included with a median age of 31 year, 60.0% was female, and 34.3% presented with alarm features, 19.0% reported family history of gastric cancer. 58.1% of these cancers were located in gastric body, 33.8% were located in the antrum. 63.8% of these cancers were found to be diffuse type; 18.1% of patients underwent curative surgical treatment, and the 5‐year survival rate was 42.1%. Conclusions: The study describes that very young patients with gastric cancer were mainly females, who were less likely to present with alarm features, but had a high frequency of family history of gastric cancer; and the majority of these cancers were located in gastric body, and they had similar long‐term prognosis compared with elderly counterparts if curative surgical resection was performed.     

Correlation between expression of leptin and clinicopathological features and prognosis in patients with gastric cancer

BACKGROUND: The relationship between the expression of leptin in the tissue of gastric cancer and the clinicopathological features as well as patients' outcome were investigated. METHODS: Sixty-one gastric cancer specimens were investigated by immunohistochemical studies with anti-leptin and anti-vascular endothelial growth factor (VEGF) antibodies and by monitoring patients for at least 3 years after surgery. RESULTS: A positive rate of leptin expression was significantly associated with Borrmann classification (Borrmann type 1 and type 2 68.2% vs Borrmann type 3 and type 4 or unclassified 35.3%), tumor histology (well differentiated tumors 87.5% vs poorly differentiated tumors 48.9%), lymph node metastasis (with 69.0% vs without 36.8%) and stage (stage III + IV 69.0% vs stage I + II 36.8%).There was a significant association between leptin expression and VEGF expression. In the poorly differentiated group, the overall survival rate for patients with a weak expression of leptin (histochemistry score <0.5) was significantly higher than that in patients with a strong expression (histochemistry score =0.5). The Cox proportional hazards model identified serosal involvement, tumor size, metastasis, tumor histology, leptin expression, lymph node metastasis, age and postoperative chemotherapy as significant prognostic factors. CONCLUSIONS: The expression of leptin in the tissue of gastric cancer was significantly associated with tumor histology, Borrmann classification, lymph node metastasis and stage of gastric cancer. In patients with poorly differentiated gastric cancer, a poor prognosis was found in those with a strong expression of leptin.     

Comparison of clinicopathological characteristics and prognosis among patients with pure invasive ductal carcinoma,invasive ductal carcinoma coexisted with invasive micropapillary carcinoma,and invasive ductal carcinoma coexisted with ductal carcinoma in situ: A retrospective cohort study

This paper aimed to analyze the clinicopathological characteristics of invasive ductal carcinoma with an invasive micropapillary carcinoma component (IDC + IMPC), invasive ductal carcinoma with a ductal carcinoma in situ component (IDC + DCIS), and compare the clinicopathological characteristics and prognosis to those of IDC.A total of 1713 patients (130 IDC + IMPC cases, 352 IDC + DCIS cases, and 1231 pure IDC cases) who underwent appropriate surgery from June 2011 to September 2017 were retrospectively selected.Compared to the pure IDC and IDC + DCIS patients, the IDC + IMPC patients presented with more aggressive characteristics, such as a higher proportion of vascular invasion (P < .001), fewer progesterone receptor (PR)-positive patients (P < .001), a lower proportion of cases in American Joint Committee on Cancer stage I (P < .001), a higher recurrence risk (P < .001), more deaths (P < .001), and more metastatic cases (P < .001). Compared to the pure IDC and IDC + IMPC patients, the IDC+DCIS patients presented with less aggressive characteristics, such as a higher proportion of estrogen receptor-positive patients (P < .001) and PR-positive patients (P < .001), a lower proportion of cases with nerve invasion (P < .001) and vascular invasion (P < .001), a higher proportion of cases in American Joint Committee on Cancer stage I (P < .001), fewer deaths (P < .001), and fewer metastatic cases (P < .001). The patients with IDC + DCIS had significantly better disease-free survival (DFS) and overall survival (OS) compared to those with pure IDC and IDC + IMPC (P < .001). The patients with IDC + IMPC had significantly worse DFS and OS compared to those with pure IDC and IDC + DCIS (P < .001). In univariate analysis, the presence of an IMPC component in IDC (P = .007), estrogen receptor status (P = .05), and PR status (P = .003) were factors associated with OS. In multivariate analysis, coexisting IMPC (P = .04) was the only independent prognostic factor associated with OS.Compared to IDC and IDC + DCIS, IDC + IMPC had more aggressive characteristics and significantly worse DFS and OS. Compared to IDC and IDC + IMPC, IDC + DCIS had less aggressive characteristics and significantly better DFS and OS.     

Differences in the clinicopathological features of pancreatic head carcinoma in dorsal and ventral pancreas: A single institution retrospective review

The embryonic development of the pancreas originates from dorsal and ventral anlagen, and the pancreatic cancer arising from dorsal or ventral pancreas may have different clinical pathology features. This study aims to explore whether there are differences in clinicopathological features and prognosis of pancreatic head carcinoma arising from dorsal or ventral pancreas.Between January 2014 and February 2018, 101 patients with resectable pancreatic head cancer who underwent pancreaticoduodenectomy in our institution were retrospectively reviewed. The patients were assigned into 2 groups according to tumor location on preoperative imaging materials (computed tomography/magnetic resonance imaging [CT/MRI]), and the clinicopathological features and prognosis were retrospectively analyzed in view of the embryonic development of the pancreas.Among these patients with pancreatic head cancer, 42 patients had tumors arising from dorsal pancreas (D group) and 59 patients had tumors arising from ventral pancreas (V group). The frequency of lymph node (LN) metastasis around the common hepatic artery (CHA) and hepatoduodenal ligament lymph nodes in the D group was higher than that in the V group (45.2% vs 10.2%, P = .001). And the rate of LN metastasis in the superior mesenteric artery (SMA) region in the V group is higher than that in the D group (32.2% vs 4.8%, P = .002). The D group was more likely to invade the common bile duct (78.6% vs 59.3%, P = .042) and duodenum (71.4% vs 44.1%, P = .006) than the V group. In addition, the survival outcome of V group was better than D group (median overall survival [OS], 15.37 months vs 10.53 months, P = .048, median DFS 9.73 months vs 5.93 months, P = .046).The clinicopathological features of pancreatic head carcinoma arising from dorsal or ventral pancreas are different, and the pancreatic head carcinoma arising from ventral pancreas has a better survival outcome.     

Meta-analysis of the relationship between lymphovascular invasion and prognosis of patients with stage I gastric cancer

Lymphovascular invasion is considered to be a high-risk pathological feature after radical resection of gastric cancer, but the relationship between lymphovascular invasion and the prognosis of stage I gastric cancer is still controversial. Therefore, we used meta-analysis to systematically evaluate the relationship between lymphovascular invasion and the prognosis of stage I gastric cancer. Up to September 2, 2021, the databases of PubMed, EMBASE, Cochrane Library, CNKI, and Wanfang were searched. According to the inclusion and exclusion criteria, 2 researchers independently completed the screening of literature, extraction of data, and quality evaluation. Meta-analysis was performed using RevMan 5.4 software merged with HR and 95%CI. A total of 7508 patients with stage I gastric cancer were included in 9 studies, and the positive rate of lymphovascular invasion was 17%. Lymphovascular invasion was significantly associated with shorter overall survival (OS) (univariate: HR = 4.05, 95%CI: 1.91–8.58; multivariate: HR = 2.10, 95%CI: 1.37–3.22) and relapse-free survival (RFS) (univariate: HR = 4.79, 95%CI: 2.30–9.99; multiple: HR = 2.17, 95%CI: 1.56–3.00). This study indicates that lymphovascular invasion is an independent risk factor affecting the prognosis of patients with stage I gastric cancer, and can be used as a reference index for postoperative adjuvant therapy.