胃癌淋巴结转移灶与原发灶P-糖蛋白的表达及意义

目的:探讨P-糖蛋白(P-glycoprotein,P—gp)在胃癌淋巴结转移灶与原发灶表达水平的差异及其与胃癌临床病理特征的关系.方法:应用免疫组化的方法检测19例伴有淋巴结转移的胃癌患者的淋巴结转移灶、胃癌原发灶和正常胃黏膜的P—gp表达.结果:淋巴结转移灶P-gp表达的阳性率高于原发灶(84.20％ vs 52.63％,P<0.05);淋巴结转移灶P-gp表达与患者性别、年龄、肿瘤分化程度和浸润深度无关;胃癌原发灶P-gp的表达与胃癌组织分化程度和浸润深度有关(P<0.05),与性别和年龄无关.P-gp表达阳性率在高、中分化者较低分化者高,肿瘤浸润未达浆膜者高于已穿越浆膜者.结论:胃癌淋巴结转移灶的P-gP表达高于原发灶,淋巴结转移灶与原发灶P-gp表达和胃癌临床病理特征的关系不同.     

Claudin-4 mRNA在胃癌组织中的表达及其临床意义

目的 研究chudin-4mRNA在胃癌组织中的表达,并探讨其与胃癌生物学行为的关系.方法 应用半定量逆转录聚合酶链反应(RT-PCR)检测10例正常胃黏膜组织和31例胃癌组织的claudin-4 mRNA的转录水平.结果 正常胃黏膜组织claudin-4 mRNA相对表达量低于胃癌组织(P<0.05),高中分化胃癌组织低于低分化组织(P<0.05),有淋巴结转移的胃癌组织高于无淋巴结转移组织(P<0.05),浸润深度达黏膜下层组织高于浸润深度未达到者(P<0.05).claudin-4 mRNA相对表达量与患者性别及肿瘤大小无显著相关性(P>0.05).结论 Claudin-4 mRNA在胃癌中表达上调可能在胃癌的发生发展中起着重要的作用,其表达上调可能促进胃癌的侵润和转移.     

VEGF与PTEN在胃癌组织中的表达及临床意义

应用免疫组化法检测87例胃癌组织和15例正常胃黏膜组织中的血管内皮生长因子(VEGF)与抑癌基因PTEN表达,分析二者与胃癌病理学指标的关系及其相关性.结果显示,VEGF、PTEN在胃癌组织中的表达均高于正常胃黏膜(P均<0.05),在有无侵及浆膜浸润、有无淋巴结转移者的表达均有统计学差异(P均<0.05);前者在高分化和低分化者的表达无统计学差异,后者有统计学差异(P均<0.05);两者表达呈负相关(r=-0.396,P<0.05).提示VEGF和PTEN在胃癌组织中的表达与浸润深度、淋巴结转移有关,两者表达呈负相关性.     

胃癌生物学行为及其临床意义的探讨

目的探讨胃癌生物学行为及其临床意义。方法统计分析195例胃癌术后的胃癌分化程度与年龄、胃癌部位、胃壁浸润深度、淋巴转移分站、淋巴转移度的关系。结果胃癌的组织分化程度与年龄、胃癌部位、胃壁浸润深度、淋巴转移分站、淋巴转移阳性率有一定规律，越是年轻胃癌患者，其纷化程度相对较差；分化程度较差者，胃壁浸润较深，其淋巴结转移个数越多，及淋巴转移阳性率也越高。结论根据胃癌组织分化程度的规律，选择合理的手术切除范围具有一定的临床指导意义。     

术前血清碱性磷酸酶及乳酸脱氢酶检测水平对结直肠癌患者病情评估的临床价值

[目的]探讨术前血清碱性磷酸酶(ALP)及乳酸脱氢酶(LDH)水平对结直肠癌患者病情评估的临床价值。[方法]选取2012年8月～2018年12月在本院确诊为结直肠癌并住院接受手术治疗的228例患者和81例健康对照组作为研究对象,收集健康对照组及结直肠癌患者术前血清ALP和LDH水平及结直肠癌组术后病理学资料。比较正常对照组与结直肠癌组患者术前血清ALP及LDH水平,并分析术前血清ALP水平LDH水平与临床病理特征之间的相关性。[结果]结直肠癌组术前血清ALP及LDH水平明显高于对照组(均P0.05);有淋巴结转移、有远处转移的结直肠癌患者术前血清ALP水平均比无淋巴结转移、无远处转移的患者更高(均P0.05)。肿瘤浸润较深的T3～T4期、有淋巴结转移、远处转移,CEA≥5μg/L的结直肠癌患者术前血清LDH水平均比肿瘤浸润深度较浅的T1～T2期、无淋巴结转移、远处转移、CEA5μg/L的患者更高(均P0.05)。不同TNM分期,不同分化程度的结直肠癌患者术前血清ALP和LDH水平不同,分期越高,分化程度越低,ALP及LDH水平越高,差异具有统计学意义(均P0.05)。[结论]术前结直肠癌患者血清ALP及LDH水平越高,提示肿瘤浸润程度越深,分期越高,越易出现淋巴结及远处转移。术前ALP及LDH水平可作为评价结直肠癌患者临床预后的辅助指标。     

胃癌及术后随访患者血清血管生成素-2含量的临床意义

目的 检测胃癌及术后随访患者血清血管生成素-2 (Ang-2)含量的变化,探讨其临床意义。方法采用ELISA法分别检测158例胃癌、31例慢性萎缩性胃炎、38例胃腺瘤息肉、28例慢性胃炎伴胃溃疡患者及30名健康对照者血清Ang-2与癌胚抗原(CEA)的含量,并检测131例行胃癌根治术患者术后2年血清Ang-2含量的变化,随访其预后。分析胃癌患者血清Ang-2含量与胃癌病理特征的关系。结果 胃癌组血清Ang-2和CEA含量分别为（331.8±64.3）μg/L和(42.6±37.3) μg/L,较正常对照组[（187.4±32.7）μg/L和（4.2±3.1）μg/L]及胃溃疡组[(197.3±35.4) μg/L和(4.5±3.2) μg/L]显著升高（P值均＜0.01）,慢性萎缩性胃炎组Ang-2含量亦明显升高(P＜0.05),而CEA含量无明显变化,胃腺瘤息肉组Ang-2与CEA含量均无明显变化。随访复发组及转移组术前血清Ang-2含量明显高于未复发组(P＜0.05)。未复发组术后1个月血清Ang-2含量降至正常范围,随访2年无明显升高。复发组术后1个月Ang-2含量亦降至正常范围,而术后6个月至2年显著高于未复发组及正常组(P＜0.01)。转移组术后2年Ang-2含量始终显著高于未复发组及正常组(P＜0.01)。未复发组2年存活率显著高于复发组和转移组。胃癌患者血清Ang-2含量变化与胃癌分化程度、TNM病理分期、有无淋巴结转移、有无远处组织转移、浸润深度和肿瘤大小均相关(P＜0.01),与组织学分型、肿瘤部位无相关性(P＞0.05)。结论血清Ang-2可作为一种新的具有一定临床价值的胃癌肿瘤标志物,有助于术后复发、转移的监测和预后评价。     

HIF-1α在中老年胃癌早期中的临床意义

目的探讨低氧诱导因子(HIF)-1α在胃癌组织及转移淋巴结中的表达情况及在中老年胃癌早期发生、发展、转移及预后中的作用及意义。方法对临床未进行化疗的60例胃癌患者切除的胃癌组织及转移淋巴结进行苏木素-伊红(HE)染色确定标本的组织分化程度,采用免疫组织化学方法检测HIF-1α在胃癌组织及转移淋巴结中的表达情况。结果 HIF-1α在胃癌组织中的阳性率为71.67%(43/60),转移淋巴结中的阳性率为86.7%(52/60),而正常胃组织仅有2列表达弱阳性,正常淋巴结中均未有阳性率表达,有显著差异(P<0.05),其中高分化阳性率为55%(11/20),中分化为65%(13/20),低分化为95.0%(19/20),差异有统计学意义(P<0.05)。结论 HIF-1α在胃癌中呈高表达,与胃癌新生血管形成、癌组织浸润、转移有密不可分的关系。     

COX-2与LRP在胃癌组织中的表达及其意义

目的: 观察环氧合酶-2(cyclooxygenase -2,COX-2)及肺耐药蛋白(lung resistance protein,LRP)在胃癌组织中的表达, 探讨COX-2介导胃癌耐药与LRP的关系.方法: 采用免疫组织化学法, 检测63例胃癌标本与30例非胃癌胃组织中COX-2和LRP的表达, 并分析其表达与胃癌的组织学类型、分化程度、淋巴结转移及与患者的年龄、性别的关系.结果: COX-2和LRP在胃癌组织中阳性表达率高于非胃癌胃组织(87.3% vs 53.3%, 66.7% vs43.3%, 均P<0.05). 胃癌组织中COX-2和LRP的表达与患者的年龄、性别及组织的分化程度、浸润深度等无明显关系; COX-2在淋巴结转移患者的阳性表达率明显高于无转移者(100% vs 69.2%, P<0.05), 而LRP的表达与淋巴结转移无明显关系. 在胃癌组织中COX-2与LRP的表达呈正相关( r = 0.033, P<0.05).结论: LRP可能是引起胃癌原发性耐药的耐药蛋白之一; COX-2可能通过影响LRP的表达介导胃癌耐药性的发生.     

血管内皮细胞生长因子及生长抑制因子4在大肠癌中的表达

目的探讨血管内皮细胞生长因子(VEGF)及生长抑制因子4(ING-4)在大肠癌中的表达及其与患者临床病理特征的关系。方法选择经手术病理证实的68例大肠癌、20例大肠腺瘤及20例正常的肠黏膜组织,采用免疫组化法检测并比较各组VEGF及ING-4表达情况,分析二者与大肠癌患者临床病理特征及生存期的关系。结果 VEGF蛋白在大肠癌组、大肠腺瘤组及正常组中的阳性表达率依次下降(P<0.05、P<0.01),ING-4蛋白在大肠癌组、大肠腺瘤组及正常组中的阳性表达率依次升高(P<0.05)。VEGF蛋白在浸润浆膜外层的大肠癌组阳性率显著高于浸润肌层及浆膜层者(P<0.05),在Dukes C、D期大肠癌患者中的阳性率高于A、B期者(P<0.05),在发生淋巴结转移的大肠癌组阳性率高于无淋巴结转移者(P<0.05);ING-4蛋白在高、中分化大肠癌组阳性率显著高于低分化组(P<0.05),在Dukes A、B期大肠癌患者中的阳性率高于C、D期(P<0.05),在发生淋巴结转移的大肠癌组阳性率高于无淋巴结转移者(P<0.05)。VEGF阳性大肠癌患者3年生存率及5年生存率均显著低于阴性患者(P<0.05),ING-4阳性大肠癌患者3年生存率及5年生存率较阴性患者无显著差异(P>0.05)。结论 VEGF高表达与大肠癌浸润程度、Dukes分期、淋巴结转移及预后有关,ING-4低表达与大肠癌分化程度、Dukes分期及淋巴结转移有关,可以作为大肠癌的术前诊断、制订手术方案的及预测转移的重要指标。     

老年胃癌患者血清miR-93-5p水平及其与临床特征和预后的关系

目的探讨老年胃癌患者血清miR-93-5p水平及其与临床特征和预后的关系。方法收集老年胃癌患者160例和同期老年健康体检者160例分别作为胃癌组和对照组。采用逆转录-聚合酶链反应(RT-PCR)测定血清miR-93-5p水平。结果胃癌组血清miR-93-5p水平明显高于对照组(P<0.05)。不同性别、年龄、肿瘤最大径、分化程度胃癌患者血清miR-93-5p水平比较差异无统计学意义(P>0.05);不同TNM分期、局部浸润深度、淋巴结转移胃癌患者血清miR-93-5p水平比较差异有统计学意义(P<0.05),TNM分期高、局部浸润深度深、有淋巴结转移胃癌患者血清miR-93-5p水平明显高于TNM分期低、局部浸润深度浅、无淋巴结转移者。血清miR-93-5p诊断胃癌的受试者工作特征(ROC)曲线下面积为0.871,95%CI为0.868~0.874,根据此截断值判断胃癌的灵敏度为71.25%,特异度为96.25%。血清miR-93-5p高表达组5年总生存率(51.09%)和无病生存率(39.13%)均明显低于低表达组(79.41%、70.59%,χ^2=13.477、15.516,P<0.001)。Cox比例风险模型结果显示:血清miR-93-5p水平、TNM分期、局部浸润深度、分化程度、淋巴结转移为胃癌预后的独立影响因素(P<0.05)。结论胃癌患者血清miR-93-5p水平升高,且与临床分期、浸润深度、淋巴结转移关系密切,在胃癌诊断和预后评估中具有重要价值。     

胃液中可溶性上皮型钙粘蛋白在几种胃疾病中的表达及其临床意义

目的探讨胃液中可溶性上皮钙粘蛋白(sE-cad)在检测几种胃部疾病中的诊断价值。方法113例因胃肠道症状接受胃镜检查配合活检确诊为慢性萎缩性胃炎16例,胃粘膜肠上皮化生20例,胃溃疡34例,胃癌22例,21例轻度浅表性胃炎(和无任何病理改变者作为正常对照组)。用双抗夹心酶联免疫吸附法检测胃液中sE-cad水平。结果胃癌组胃液sE-cad水平升高,与对照组比较差异有统计学意义(P<0.01);慢性萎缩性胃炎组及胃粘膜肠上皮化生组胃液sE-cad水平升高,与对照组比较差异有统计学意义(P<0.05)。结论胃液sE-cad水平升高可能对胃癌的诊断提供一定的佐证。     

The significance of serum transforming growth factor beta 1 in detecting of gastric and colon cancers

BACKGROUND/AIMS: TGF-beta1 is a growth factor with wide ranging effects on proliferation, differentiation, immune suppression, apoptosis and matrix remodeling. We aimed to clarify the clinical significance of circulating levels of TGF-beta1 as a tumor marker in gastrointestinal tract cancers by comparing it to CEA across a range of parameters such as cancer type and severity. METHODOLOGY: Sera collected from patients with gastrointestinal tract cancers (32 gastric, 36 colon) and from 25 healthy volunteers were analyzed for TGF-beta1 and CEA. Relations between serum TGF-beta1 levels and tumor stage and tumor grade were also evaluated. RESULTS: Mean serum TGF-beta1 levels were higher in patients with gastric or colon cancer compared to the control group (p = 0.001). In both types of cancer there were no differences in TGF-beta1 levels associated with serosal involvement, lymph node involvement, vascular invasion, distant metastasis or tumor size. Mean serum TGF-beta1 levels were also not statistically different across histopathological tumor grades in either type of cancer. The sensitivity of TGF-beta1 was higher in patients with gastric cancer than in patients with colon cancer. TGF-beta1 had greater sensitivity than CEA in gastric cancer patients. CONCLUSIONS: TGF-beta1 has higher sensitivity in gastric and colon cancers. Since it may be increased even in cancer without closed and distant metastasis, TGF-beta1 may be used as a tumor marker and combined with CEA particularly in gastric cancers.     

Evaluation of serum high-density lipoprotein cholesterol levels as a prognostic factor in gastric cancer patients

Background and Aim: Although there are some reports of an adverse effect of low serum high-density lipoprotein cholesterol (HDL-C) levels on gastrointestinal cancers, the specific correlation between serum HDL-C levels and gastric cancer remains unknown. Methods: Preoperative serum HDL-C levels were retrospectively examined in 184 patients who had undergone gastrectomy. The patients who had undergone gastrectomy were divided into two groups: the normal-HDL-C group and the low-HDL-C group. We examined the characteristics and outcomes of these two groups. Univariate and multivariate analyses were performed to investigate the association between serum HDL-C levels and gastric cancer. Results: There was no significant difference between the groups in terms of the progression of gastric cancer. In the low-HDL-C group, lymphatic and vascular invasion was significantly increased. The prognosis of the patients in the normal-HDL-C group was significantly better than those in the low-HDL-C group. Conclusions: In this study, a positive correlation between low preoperative serum HDL-C levels and prognosis for gastric cancer was demonstrated. Serum HDL-C level may be a clinical prognostic factor for gastric cancer patients.     

Serum levels of interleukin-2 and tumor necrosis factor-alpha correlate to tumor progression in gastric cancer

BACKGROUND/AIMS: The aim of this study was to assess serum levels of Interleukin-2 and tumor necrosis factor-alpha with disease progression and correlate these levels with CEA and CA19-9 serum levels. METHODOLOGY: Serum levels of interleukin-2 and tumor necrosis factor-alpha were measured in 23 patients with gastric cancer (being 9 stage I or II and 14 stage III or IV) and 10 patients without cancer by ELISA using Predicta Genzyme Diagnostica. The patients were followed for at least 2 years or until death. CEA and CA19-9 were also measured in both groups by ELISA (Abbott Diagnostic). RESULTS: Patients with gastric cancer stage III or IV had elevated levels of these cytokines (P = 0.002 for IL-2 and P = 0.003 for tumor necrosis factor-alpha). There was no difference between the serum levels of tumor necrosis factor-alpha and interleukin-2 in patients with gastric cancer stage I or II and the control group (P > 0.05). We also found no difference among the groups for CEA and CA19-9 (P = 0.17 and 0.72, respectively). Only one gastric cancer patient stage I or II had elevated level of IL-2 and none had elevated levels of tumor necrosis factor-alpha. In the group of patients with gastric cancer stage III or IV, 87.5% of them with elevated levels of tumor necrosis factor-alpha and 75% of them with elevated levels of interleukin-2 died during the follow-up. CONCLUSIONS: We conclude that serum interleukin-2 and tumor necrosis factor-alpha are associated with advanced gastric cancer and that these cytokines might be a useful tumor marker for gastric cancer, being associated with poor prognosis.     

Association of VCAM-1 overexpression with oncogenesis,tumor angiogenesis and metastasis of gastric carcinoma

AIM: To investigate the relationship between the expression of vascular cell adhesion molecule-1 (VCAM-1) and oncogenesis,tumor angiogenesis and metastasis in gastric carcinoma,and to evaluate the clinical significance of serum VCAM-1levels in gastric cancer.METHODS: Specimens from 41 patients with gastric cancer, 8 patients with benign gastric ulcer, and 10 healthy subjects were detected for the expression of VCAM-1 by immunohistochemistry. Microvessel density (MVD) was measured by counting the endothelial cells immunostained with the monoclonal antibody CD34 at x200 magnification.Serum VCAM-1 concentrations were measured by an enzyme linked immunosorbent assay in the 41 gastric cancer patients before surgery, and at 7 days after surgery as well as in 25 healthy controls. The association between preoperative serum VCAM-1 levels and clinicopathological features, and their changes following surgery was evaluated. Tn addition, serum carcinoembryonic antigen (CEA) was also examined.RESULTS: Of the 41 gastric cancer tissues, 31 (75.6 %)were VCAM-1 positive. The VCAM-1 positive gastric cancers were more invasive and classified in the more advanced stage than the VCAM-1 negative ones. The VCAM-1 positive cancers were associated with more lymph node metastases than VCAM-1-negative ones (P＜0.05). The expression of VCAM-1 was detected in tissues of two of the eight patients with gastric ulcer and two of the 10 healthy controls. The expression of VCAM-1 in gastric cancer patients was significantly more frequent than that in the healthy controls and ulcer group (both P＜0.05). MVD in VCAM-1 expressing tissues was higher than that in VCAM-1 negative tissues (t=2.13,P＜0.05). Serum VCAM-1 levels in gastric cancer patients were significantly higher than those in controls (t=3.4, P＜0.05). There was a significant association between serum VCAM-1 levels and disease stage, as well as invasion depth of the tumor and the presence of distant metastases.The concentrations of serum CEA in gastric cancer were higher than normal controls. Both serum VCAM-1 and CEA levels decreased significantly after radical resection of the primary tumor (P＜0.05). Furthermore, the serum levels of VCAM-1 were positively correlated with the expression of VCAM-1 in the tumor tissue (r=-0.85, P＜0.05).CONCLUSION: The expression of VCAM-1 is closely related to oncogenesis, tumor angiogenesis and metastasis in gastric carcinoma. Serum VCAM-1 level in gastric cancer patients is significantly increased compared with normal controls, which decreases significantly after radical resection of the primary tumor. The serum concentration of VCAM-1 may be considered as an effective marker of tumor burden of gastric cancer. Moreover, overexpression of VCAM-1 in gastric cancer tissue is likely a major source of serum VCAM-1.     

胃癌患者血清miR-515-3p水平与临床病理特征及预后的关系

目的 探讨胃癌患者血清miR-515-3 p水平与临床病理特征及预后的关系.方法 选择2013年1月至2015年1月在成都医学院第一附属医院接受胃癌手术治疗的130例原发性胃癌患者作为原发性胃癌组,另选择同期在该院进行体检的100名健康志愿者作为正常对照组.分析两组的血清miR-515-3 p水平差异,以及原发性胃癌患...     

Circulating level of hepatocyte growth factor as a useful tumor marker in patients with early-stage gastric carcinoma

BACKGROUND: Although conventional tumor markers including carcinoembryonic antigen (CEA) and carbohydrate antigen (CA19-9) have been used in gastric cancer patients, clinically useful markers of early gastric cancer have not been identified. The present study was designed to clarify the clinical significance of the circulating level of hepatocyte growth factor (HGF) as a tumor marker, especially in early-stage gastric cancer patients. METHODS: Preoperative serum HGF levels were measured with an enzyme-linked immunosorbent assay in 30 early-stage and 42 advanced-stage gastric cancer patients. RESULTS: The mean value of serum HGF in 72 patients was significantly higher than that in the normal subjects. There was a significant increase in serum HGF levels in both advanced-stage and early-stage patients compared with normal subjects. The positivity rates of HGF in early disease cases were higher than those of CEA and CA19-9. The serum HGF level was significantly higher in patients with vessel invasion than in those without invasion. In smaller early gastric cancers, serum HGF elevation was associated with lymphatic invasion. CONCLUSIONS: The serum HGF level may be a clinically significant tumor marker in patients with early-stage, as well as advanced-stage, gastric cancer. HGF elevation in early-stage patients may help us to predict the risk of lymph node metastasis of early gastric tumors, even of smaller tumor size. HGF may be a useful indicator for appropriate lymphadenectomy in early gastric cancer.     

血清CEA、AFP、CA72-4联合检测评价胃癌分化程度的效能

目的探讨血清癌胚抗原(CEA)、甲胎蛋白(AFP)、糖类抗原(CA72-4)联合检测对胃癌分化程度的评价效能。方法选取2019年2月至2020年9月合肥市第三人民医院收治的92例胃癌患者,并招募92例健康志愿者,分别记为胃癌组和健康组,开展前瞻性研究。两组均采用酶联免疫吸附试验检测血清CEA、AFP和CA72-4水平并进行比较;比较胃癌组不同分化程度患者血清CEA、AFP和CA72-4水平,分析三者联合对胃癌分化程度的评价效能。结果胃癌组血清CEA、AFP和CA72-4水平均高于健康组(P<0.05)。胃癌组未/低分化患者血清CEA、AFP和CA72-4水平均高于中/高分化患者(P<0.05)。血清CEA、AFP和CA72-4水平联合对胃癌组未/低分化评价的灵敏度和AUC分别为100.00%和0.917,均高于单独评价,差异均有统计学意义(P<0.05),特异度与单独评价对比差异均无统计学意义(P>0.05)。结论胃癌患者血清CEA、AFP和CA72-4水平均较高,且未/低分化患者水平更高。三者联合对胃癌分化程度评估效能理想。     

Lower serum folate is associated with development and invasiveness of gastric cancer

AIM: To evaluate the associations of serum folate level with development, invasiveness and patient survival of gastric cancer.METHODS: In this nested case-control study, patients with newly diagnosed gastric cancer undergoing gastrectomy were enrolled, and patients receiving chemotherapy prior to surgery, with other concurrent malignancy, or of the aboriginal and alien populations were excluded. In total, 155 gastric cancer patients and 149 healthy controls were enrolled for determination of serum folate levels and their correlation with gastric cancer. Using the median value of serum folate computed among the overall population as the cutoff value, the associations between serum folate and gastric cancer in all cases and different age and gender subgroups were analyzed by multivariate logistic regression analysis. In the patient cohort of gastric cancer, receiver-operating characteristic analyses were performed to calculate the best cutoff values of serum folate, and the associations between serum folate levels and clinicopathological features were further analyzed by multivariate regression analysis. Survival analyses were conducted using the Cox proportional hazards model.RESULTS: The mean serum folate level was significantly lower in gastric cancer patients than that in controls (3.71 ± 0.30 ng/mL vs 8.00 ± 0.54 ng/mL, P < 0.01), and folate levels were consistently lower in gastric cancer patients regardless of age and gender (all P < 0.01). Using the median serum folate value as the cutoff value, low serum folate was significantly associated with gastric cancer risk in the whole population (OR = 19.77, 95%CI: 10.54-37.06, P < 0.001) and all strata (age < 60 years OR = 17.39, 95%CI: 7.28-41.54, age ≥ 60 years (OR = 21.67, 95%CI: 8.27-56.80), males (OR = 17.95, 95%CI: 7.93-40.62), and females (OR = 20.95, 95%CI: 7.66-57.31); all P < 0.001. In the patient cohort of gastric cancer, the respective cutoff values showed that low serum folate levels were significantly associated with serosal invasion (OR = 2.54, 95%CI: 1.23-5.23), lymphatic invasion (OR = 2.23, 95%CI: 1.17-4.26), and liver metastasis (OR = 6.67, 95%CI: 1.28-34.91) of gastric cancer (all P < 0.05). Serum folate level below 1.90 ng/mL was associated with poor patient survival (HR = 1.84, 95%CI: 1.04-3.27, P < 0.05) in univariate analysis.CONCLUSION: Lower serum folate levels were significantly associated with gastric cancer development and invasive phenotypes. The role of folate depletion in gastric cancer invasion warrants further study.     

C-reactive protein, procalcitonin, interleukin-6, vascular endothelial growth factor and oxidative metabolites in diagnosis of infection and staging in patients with gastric cancer

AIM: The current study was to determine the serum/plasma levels of VEGF, IL-6, malondialdehyde (MDA), nitric oxide (NO), PCT and CRP in gastric carcinoma and correlation with the stages of the disease and accompanying infection. METHODS: We examined the levels of serum VEGF, IL-6, PCT, CRP and plasma MDA, NO in 42 preoperative gastric cancer patients and 23 healthy subjects. There were infection anamneses that had no definite origin in 19 cancer patients. RESULTS: The VEGF levels (mean+/-SD; pg/mL) were 478.05+/-178.29 and 473.85+/-131.24 in gastric cancer patients with and without infection, respectively, and these values were not significantly different (P>0.05). The levels of VEGF, CRP, PCT, IL-6, MDA and NO in cancer patients were significantly higher than those in healthy controls and the levels of CRP, PCT, IL-6, MDA and NO were statistically increased in infection group when compared with non-infection group (P<0.001). CONCLUSION: Although serum VEGF concentrations were increased in gastric cancer, this increase might not be related to infection. CRP, PCT, IL-6, MDA and NO have obvious drawbacks in the diagnosis of infections in cancer patients. These markers may not help to identify infections in the primary evaluation of cancer patients and hence to avoid unnecessary antibiotic treatments as well as hospitalization. According to the results of this study, IL-6, MDA, NO and especially VEGF can be used as useful parameters to diagnose and grade gastric cancer.