Plasma gastrin responses to bombesin and antral gastrin concentrations in patients with the intestinal type of gastric cancer

Mucosal atrophy of the gastric antrum (type B atrophic gastritis) is generally accepted as predisposing to the development of the intestinal type of gastric cancer. Since bombesin stimulates gastrin release selectively from the antral mucosa, the response can be used as a marker for antral mucosal atrophy. In this study we have investigated bombesin-stimulated plasma gastrin responses in 21 patients with the intestinal type of gastric cancer and we have compared the results with 12 patients with the diffuse type of gastric cancer, 17 patients with benign gastric ulcer, and 30 dyspeptic patients without endoscopical or histological abnormalities. Gastrin concentrations were also measured in extracts of antral biopsies. Basal plasma gastrin concentrations were not significantly different. In contrast, patients with the intestinal type of gastric cancer had a significantly lower plasma gastrin response to bombesin than did the normal subjects (P less than 0.01) and patients with the diffuse type of gastric cancer (P less than 0.05), but the result was not significantly different from that of the gastric ulcer patients. The antral gastrin content of the patients with the intestinal type of gastric cancer was significantly lower than in controls (P less than 0.005), the patients with the diffuse type of gastric cancer (P less than 0.05), and those with gastric ulcer (P less than 0.05). It is concluded that patients with the intestinal type of gastric cancer have, in contrast to those with the diffuse type of gastric cancer, an abnormally low plasma gastrin response to bombesin. This low response is due to a reduced gastrin content of the antral mucosa.     

胃癌癌区动—静脉血及其癌组织胃泌素变化的研究

目的：临床观察胃癌癌区动－静脉血及其癌区组织、癌旁区粘膜和外周区正常粘膜中胃泌素的变化,探讨病人体内胃泌素变化的原因和意义。方法：采用放射免疫法测定２６例胃癌患者癌区动－静脉血及其癌区组织、癌旁区粘膜和外周区正常粘膜中胃泌素水平。结果：胃癌癌区静脉血中胃泌素水平显著高于癌区动脉血（Ｐ＜０．０５）。胃窦部癌癌旁粘膜中胃泌素水平显著高于癌区组织和外周区正常粘膜（Ｐ＜０．０１）,也显著高于胃体部癌癌旁区粘膜（Ｐ＜０．０１）。胃体部癌癌旁区粘膜中胃泌素水平显著高于癌区组织（Ｐ＜０．０５）。结论：胃癌组织能分泌和释放胃泌素,可能是导致静脉血中胃泌素水平升高的主要原因。癌旁区粘膜中胃泌素的增多可能在胃癌的发生发展中起重要作用。     

胃癌癌区动－静脉血及其癌组织胃泌素变化的研究

目的：临床观察胃癌癌区动－静脉血及其癌区组织、癌旁区粘膜和外周区正常粘膜中胃泌素的变化，探讨病人体内胃泌素变化的原因和意义。方法：采用放射免疫法测定26例胃癌患者癌区动－静脉血及其癌区组织、癌旁区粘膜和外周区正常粘膜中胃泌素水平。结果：胃癌癌区静脉血中胃泌素水平显著高于癌区动脉血(P<0.05)。胃窦部癌癌旁粘膜中胃泌素水平显著高于癌区组织和外周区正常粘膜(P<0.01)，也显著高于胃体部癌癌旁区粘膜(P<0.01)。胃体部癌癌旁区粘膜中胃泌素水平显著高于癌区组织(P<0.05)。结论：胃癌组织能分泌和释放胃泌素，可能是导致静脉血中胃泌素水平升高的主要原因。癌旁区粘膜中胃泌素的增多可能在胃癌的发生发展中起重要作用。     

Histologic and serum risk markers for noncardia early gastric cancer

Corpus dominant gastritis and intestinal metaplasia (IM) are considered markers of increased risk of gastric carcinoma. The aim of our study was to determine serum and histologic risk markers of gastric cancer. Antral and corpus histology, pepsinogen and gastrin 17 levels were compared among patients with history of endoscopic mucosal resection (EMR) for early gastric cancer and controls. Serum pepsinogen (PG) and gastrin 17 levels were measured by RIA. There were 53 gastric cancer patients and 75 controls. The scores for IM in each region and atrophy at the lesser curvature of the corpus were significantly higher in the cancer group than in the H. pylori-positive control group. IM at the greater curvature of the corpus and atrophy at the lesser curvature of the corpus were associated with multiple malignant lesions. Although corpus gastritis was associated with an increased risk of gastric cancer (odds ratio [OR] = 3.4; 95% confidence interval [CI] 1.6-7.0) (p = 0.001), the most important marker was the presence of IM at the lesser curvature of the corpus (OR = 15.1; 95% CI 4.3-52.6) (p < 0.001)). The best cut-off points of serum markers for gastric cancer were a PG I concentration of 45 ng/mL or less and a gastrin 17 >60 pg/mL (sensitivity = 83%; specificity = 68%). IM at the lesser curvature of the corpus and the combination of serum gastrin 17 and PG I identified a group at high risk for development of gastric cancer. Annual endoscopic follow-up is warranted for patients with IM found at the greater curvature of the corpus.     

Overexpression of gastrin and c-met protein involved in human gastric carcinomas and intestinal metaplasia

Many studies have investigated the expression of c-met and c-erbB2 protein in human gastric adenocarcinomas, but the expression of gastrin protein in human gastric cancer and the relationship between gastrin and c-met are unknown. We have constructed a tissue microarray containing 408 formalin-fixed and paraffin-embedded human tissue blocks, including tissues containing intestinal metaplasia (IM, n=72) and primary tumors (n=232), as well as normal gastric mucosa (n=104) from patients with gastric cancer. Immunohistochemistry (IHC) was used for detecting gastrin, c-met and c-erbB2 proteins. Gastrin was detected in 13.5% (7/52) and c-met in 15.3% (11/72) of IM cases. In gastric carcinomas, 48.4% (103/213) of cases expressed gastrin, 68.8% (148/215) expressed c-met, and 5.5% (11/200) expressed c-erbB2. Gastrin and c-met protein expression were significantly higher in gastric tumor tissue than in IM (P<0.0001). Overexpression of c-erbB2 protein was detected in gastric carcinomas but not in normal gastric mucosa (P<0.05). Expression of gastrin and c-met protein was associated (P<0.01), but no significant difference was found on the changes of gastrin, c-met and c-erbB2 expression in gastric cancer with tumor stage, grade of differentiation or tumor type. These results indicate that gastrin and c-met play a role in the early process during malignant transformation of the gastric mucosa.     

Presentation, treatment, and outcome of type 1 gastric carcinoid tumors

BACKGROUND AND OBJECTIVES: The aim of this study was to review the presentation, treatment, and outcome of patients with Type 1 gastric carcinoid tumors. METHODS: A retrospective review of 1,600 carcinoid patients was analyzed to identify patients with gastric carcinoid tumors. RESULTS: Eighteen patients were found to have biopsy-confirmed Type 1 gastric carcinoid tumors on upper endoscopy. Reasons for endoscopy included abdominal pain (n = 4), gastrointestinal bleeding (n = 4), surveillance for pernicious anemia (n = 8), and other (n = 2). The mean pre-treatment serum gastrin and chromogranin A levels were 1,436 ng/ml (+/-771 ng/ml) and 91.6 ng/ml (+/-68.6 ng/ml), respectively. Imaging revealed evidence of gastric carcinoid in 4 of 10 patients undergoing CT scanning and 3 of 10 patients undergoing octreotide scintigraphy. Of the 18 patients, 8 were treated medically (acidification or octreotide) and 10 were treated with surgery (laparoscopic antrectomy or partial gastrectomy). Mean gastrin levels decreased by 37.2% in the medically treated group (median follow-up 6 months), versus 94.0% in the surgically treated patients (median follow-up 5 months). Mean chromogranin A levels decreased by 56.2% in patients undergoing surgery. CONCLUSIONS: Gastric antrectomy is the most efficacious treatment for Type 1 gastric carcinoid, leading to a significant reduction in serum gastrin levels and regression of carcinoid tumors.     

Serum pepsinogen levels in gastric cancer patients and their relationship with Helicobacter pylori infection: a prospective study.

BACKGROUND: Our aim was to study the serum pepsinogen levels in gastric cancer patients in our population in relation to histology and the presence of Helicobacter pylori. METHODS: Forty-six patients with gastric cancer and 70 controls were studied prospectively in a 1-year period. Serum levels of pepsinogen I (PG I), pepsinogen II (PG II), and gastrin were measured by radioimmunoassay. RESULTS: The mean PG I levels for cancer patients and controls were 83.5 microg/l and 60.9 microg/l, respectively (P = 0.03), the mean PG II levels were 27.2 microg/l and 12.1 microg/l respectively (P < 0.0001). The PG I/II ratio was significantly lower in cancer patients (P = 0.04) and in those with Helicobacter infection. Serum pepsinogen levels were not affected by any pathological characteristics. Histology showed that the prevalence of chronic gastritis, intestinal metaplasia, and gastric atrophy was 97%, 56%, and 15%, respectively. CONCLUSION: The prevalence of gastric atrophy is low in our population, and serum pepsinogen measurement is not useful as a screening tool for gastric cancer in this population.     

Levels of nitrite, nitrate, N-nitroso compounds, ascorbic acid and total bile acids in gastric juice of patients with and without precancerous conditions of the stomach

To determine the relevance of gastric juice factors to gastric carcinogenesis, 56 patients with unoperated stomachs undergoing endoscopy for dyspepsia had gastric juice aspirated and analysed for pH, ascorbic acid, total bile acids, nitrite, nitrate and total nitroso compounds (NOCs). Plasma was obtained for vitamin C estimation. Antral and body biopsies were assessed for gastritis, Helicobacter pylori, atrophy and intestinal metaplasia (IM). Patients with chronic atrophic gastritis (n = 17) had lower gastric juice ascorbic acid concentrations (P less than 0.001), higher pH (P less than 0.05) and higher incidence of H. pylori infection (P less than 0.001) than normal subjects (n = 12). Patients with reflux gastritis (n = 9) had higher total bile acids (P less than 0.01). Patients with chronic gastritis and IM (n = 11) had higher gastric juice pH (P less than 0.01) and total bile acid concentrations (P less than 0.05), and lower gastric ascorbic acid concentrations (P less than 0.01) than those with chronic gastritis and no IM (n = 24). In chronic gastritis, high nitrite concentrations were associated with high pH (P less than 0.01). However, there were no significant differences in plasma vitamin C or gastric nitrite, nitrate or total NOC concentrations in relation to gastric histology. We conclude that the premalignant condition IM is associated with H. pylori infection, low gastric ascorbic acid levels and elevated total bile acids, but not to elevation in nitrite or total NOCs in fasting gastric juice.     

Gastric acid secretions and serum gastrin levels in patients with mucosal and submucosal gastric cancers

Gastric acid secretions and serum gastrin levels have been examined in 128 patients with early gastric cancer and in 98 gastric ulcer patients. Gastric cancer patients were found to have lower acid secretions than did gastric ulcer patients, and those with elevated types of a differentiated adenocarcinoma had lower acid secretions than did those with depressed types of an undifferentiated adenocarcinoma. Gastric acid secretions in patients with both a gastric ulcer and cancer were found to decrease with aging. However, the serum gastrin levels were found to be decreased in patients with a gastric ulcer and to be increased in patients with a gastric cancer. Incidences of a differentiated adenocarcinoma increased with aging. From these observations, it has been speculated that the carcinogenesis of a differentiated adenocarcinoma may be related to increasing endogenous gastrin levels and decreasing gastric acid secretions. These results suggest that a continuous check of the serum gastrin levels might be a good marker for cancer detection and that gastrin antibodies might be useful for treatment.     

Clinical significance of pepsinogen A isozymogens, serum pepsinogen A and C levels, and serum gastrin levels

Gastric mucosal pepsinogen A phenotype, serum pepsinogen A level, serum pepsinogen C level, serum pepsinogen A/pepsinogen C ratio, and serum gastrin level were evaluated as potential markers for gastric cancer or its precursors in 19 healthy volunteers and 341 patients from the gastroscopy program. Gastric cancer, atrophic gastritis, and intestinal metaplasia of the stomach were associated with pepsinogen A phenotypes, characterized by an intense fraction 5, and with a low serum pepsinogen A level (less than 25 micrograms/l), a low serum pepsinogen A/pepsinogen C ratio (less than 1.5), and a high serum gastrin level (greater than 79 ng/l). The specificity of pepsinogen A phenotypes with an intense fraction 5 for gastric cancer or its precursors was 95.1% with a sensitivity of 20.4%. The sensitivity and specificity of the noninvasive tests were evaluated with the receiver operating characteristic. For clinical purposes, a serum pepsinogen A/pepsinogen C ratio less than 1.8 is the most suitable test, with a sensitivity of 74% and a specificity of 76% for gastric cancer or its precursors, with a reference population of patients with benign gastric disorders. However, the sensitivity and specificity of the single or combined tests are too low for population screening purposes.     

Thymidine kinase in breast cancer

The enzyme thymidine kinase is associated with DNA synthesis. Thymidine kinase serum levels were studied in normal controls (n = 20), patients with primary breast cancer (n = 60), patients with systemic breast cancer (n = 20) and as a non-cancer disease control group in patients with inflammatory gastrointestinal disorders (n = 20). Comparison of pretreatment values in the cancer patients with the normal controls showed a significant difference between the three groups in relation to stage of disease: mean values 4.22 (+/- 1.08), 6.22 (+/- 2.24) and 9.79 (+/- 7.56) pmol ml-1 h-1 for normal controls, operable breast cancer and systemic breast cancer respectively (P less than 0.005; analysis of variance). Patients with systemic breast cancer had a significantly elevated serum thymidine kinase level compared to controls (P less than 0.01) and patients with primary operable cancer (P less than 0.05). Patients with primary operable cancer had significantly higher serum thymidine kinase levels over normal controls (P less than 0.01). Mean serum TK in patients with inflammatory gastrointestinal diseases was similar to normal controls but significantly less than both patients with primary operable breast cancer and patients with systemic breast cancer. Twenty patients with operable breast cancer were followed up after primary surgery by serial 3-monthly thymidine kinase levels in the disease free interval. Four patients have developed systemic recurrence with a rise in the mean thymidine kinase value to 14.3 pmol ml-1 h-1. Ten patients with advanced breast cancer had serial thymidine kinase levels measured 2-monthly during the first 6 months of primary hormone therapy. The serum values fell in all five responders (mean 9.12-4.78 pmol ml-1 h-1) and rose in all five progressors (mean 8.62-38.5 pmol ml-1 h-1). Serum thymidine kinase reflects stage of disease in breast cancer. Serial thymidine kinase levels in patients with systemic breast cancer reflected response to systemic therapy.     

幽门螺杆菌感染与胃癌及癌前病变的环氧合酶-2表达的研究

目的：通过研究HP感染与胃癌及癌前病变中环氧合酶－2（cox-2)表达的关系,以探讨HP可能的致癌机制。方法：经胃镜和病理诊断明确的病例共120例,包括慢性浅表性胃炎（CSG）,肠上皮化生,不典型增生,胃癌各30例,以ABC免疫组化法检测上述标本的cox-2,以改良Giemsa法检测HP,结果：胃癌组肠型胃癌HP阳性率为83．3％（20／24）,弥漫型6型中HP阳性1例,胃癌HP阳性率为与CSG比较差异非常显著（P＜0．01）,肠型胃癌HP阳性率与胃癌阳性率比较有明显差异（P＜0．05）,各组HP阳性的cox-2与其HP阴性者作相应比较均有显著或非常显著性差异（P＜0．05或P＜0．01）,结论：HP感染可使胃粘膜中cox-2过度表达,导致细胞凋亡受抑制,从而可引起胃癌的发生。     

胃癌组织Cystatin SN mRNA表达及其临床意义的探讨

目的:研究半胱氨酸蛋白酶抑制剂1 (Cystatin SN)在胃癌组织中的表达及临床意义.方法:荧光定量PCR方法检测40例胃癌组织和40例癌旁组织中Cystatin SN的表达.结果:胃癌组织中Cystatin SN mRNA的表达水平为5.370 0±3.034 5,相应的癌旁组织为1.705 0±0.738 8,癌组织显著高于癌旁组织,t=8.297,P=0.000.Cystatin SN的表达与肿瘤大小(t=-0.646,P=0.001)、淋巴转移(t=3.393,P=0.002)、TNM分期(t=-3.798,P=0.001)和浸润程度(t=4.904,P=0.000)相关,与肿瘤的分化程度、患者年龄和性别无关,P＞0.05.结论:Cystatin SN在胃癌组织中的高表达与胃癌的发生发展密切相关.     

Growth effect of gastrin on gastric cancer and its clinical implications for gastric cancer surgery

This study was aimed at investigating the effect of gastrin on the growth of gastric cancer and evaluating postoperative hypergastrinemia in patients that had received various types of gastrectomy for gastric cancer. RT-PCR for gastrin/CCKB receptor mRNA was performed in human gastric cancer cell lines and tissue. The effect of gastrin or glycine-extended gastrin on the growth of gastric cancer cell lines was determined by MTT assay. Serum gastrin levels were compared with respect to the resection type of gastric cancer surgery. Gastrin/CCKB receptor mRNA expression was detected in all 9 gastric cancer cell lines, and in 19 of 29 (62%) gastric cancer tissue samples. Growth of gastric cancer cell lines containing the gastrin/CCKB receptor was significantly enhanced by gastrin and glycine-extended gastrin. The proximal gastrectomy group had a significantly higher mean serum gastrin level than the distal subtotal gastrectomy, total gastrectomy, or preoperative groups (p<0.05). Our study confirms that a high proportion of gastric cancer tissue samples express the gastrin/CCKB receptor, which can stimulate the growth of gastrin/CCKB receptor-positive gastric cancer cells. In addition, we confirm that hypergastrinemia can be induced in about half of patients after proximal gastrectomy. More studies are needed to clarify the relationship between hypergastrinemia and tumor recurrence after proximal gastrectomy.     

胃癌患者化疗前后血清胃泌素变化的临床研究

本文将胃癌患者55例接部位分为贲门、胃底癌组（1例），胃体癌组（1例），胃窦癌组（21例），以非胃癌组33例作为对照。对胃癌组及非胃癌组化疗前及化疗后1、3、5、7天进行血清胃泌素测定。结果表明：化疗前贲门、胃底癌组及胃体癌组血清胃泌素显著升高（P＜0．01），胃窦癌组及非胃癌组血清胃泌素基本在正常范围；化疗后胃癌各组血清胃泌素均有不同程度下降，以第3天后为著（P＜0.01）；非胃癌组化疗前后无明显变化（P＞0.05）。提示：化疗后血清胃泌素的下降为判断胃癌化疗疗效的血清学指标。     

Treatment of patients with metastatic pancreatic and gastrointestinal tumours with the somatostatin analogue Sandostatin: a phase II study including endocrine effects

Somatostatin analogues can suppress the secretion of some gastrointestinal hormones and growth factors involved in the growth regulation of gastrointestinal cancers and can inhibit the growth of experimental pancreatic tumours. Therefore, in a phase II study 34 patients with metastatic pancreatic (n = 14), colorectal (n = 16) and gastric cancer (n = 4) were treated with three daily subcutaneous injections of 100-200 micrograms of the somatostatin analogue Sandostatin (SMS 201-995). All patients had an extensive tumour load and 13 were pretreated with chemotherapy. Before Sandostatin treatment the patients with pancreatic cancer showed a higher mean plasma concentration of GH (P less than 0.05) and a lower concentration of 'total' somatomedin-C (P less than 0.005) compared with patients with colorectal cancer; there was no significant difference between these two groups in plasma levels of directly assayable somatomedin-C, EGF/TGF-alpha, insulin and prolactin. Within 3 days after start of treatment, somatomedin-C levels initially decreased (without a change in basal plasma GH levels), but returned to pretreatment levels within 4-13 weeks. Plasma insulin levels also were suppressed but only during the first 3-5 days of treatment. Plasma EGF-TGF-alpha levels increased significantly at day 5 of treatment only in the pancreatic cancer patients. Twenty-seven per cent of the patients showed stable disease for 3-9 months, but most patients experienced subjective improvement in the absence of serious side-effects. However, the overall survival remained disappointing, emphasising the need for better treatment regimens.     

Plasma matrix metalloproteinase-9 level is better than serum matrix metalloproteinase-9 level to predict gastric cancer evolution.

PURPOSE: Matrix metalloproteinase-9 (MMP-9) in blood is a promising new tumor marker. The aims of the present study are to compare the usefulness of plasma and serum MMP-9 levels for predicting gastric cancer development, invasion, and survival. EXPERIMENTAL DESIGN: In this nested case-control study, 114 gastric cancer patients and 87 healthy controls were enrolled. MMP-9 levels and activities were quantitatively measured by ELISA assay and zymography. The results were compared with the occurrence, clinicopathologic features, and outcomes of gastric cancer patients. The follow-up time for all patients was at least 5 years. RESULTS: Serum MMP-9 levels were significantly higher than plasma MMP-9 levels. Both plasma and serum MMP-9 levels correlated significantly with active MMP-9 identified by zymography (P = 0.002 and P = 0.048, respectively). Plasma MMP-9 level was significantly elevated in gastric cancer patients when compared with control subjects (P < 0.001). Serum MMP-9 levels did not differ between the groups. Receiver-operator characteristics analysis showed the values of sensitivity (82.5%) and specificity (65.5%) at the maximum accuracy for plasma MMP-9 at >or=60 ng/mL (P < 0.001). Elevated plasma MMP-9 correlated significantly with lymph node metastasis [odds ratio (OR), 3.43; P = 0.019], lymphatic invasion (OR, 7.58; P = 0.009), and venous invasion (OR, 4.14; P = 0.033). Patients with elevated plasma MMP-9 levels had poorer survival rates than those with normal plasma MMP-9 levels (P = 0.038). Serum MMP-9 level did not correlate well with gastric cancer-invasive phenotypes or survival. CONCLUSION: Our results suggest plasma MMP-9 level is a better marker than serum MMP-9 level for predicting gastric cancer development and progression.     

Humoral immune response to MUC1 and to the Thomsen-Friedenreich (TF) glycotope in patients with gastric cancer: relation to survival

Humoral immune responses to the MUC1 peptide and to MUC1-related Thomsen-Friedenreich (TF) glycotope was investigated in patients with gastric cancer (n = 247), chronic gastroduodenal diseases (n = 199) and in healthy blood donors (n = 100). Data were correlated with disease type, stage of cancer, tumor morphology and survival. MUC1 IgG antibody levels were higher in patients with gastric cancer (p < 0.0001) than in healthy controls. Higher levels of anti-MUC1 IgG were also detected in patients with ulcer of the stomach (p = 0.015) and in atrophic gastritis (p = 0.027). Compared to blood donors, significantly lower levels of anti-TF IgG were found both in the cancer (p = 0.002) and in the benign group (p < 0.0001). At early stages of cancer a positive correlation (p < 0.0001) was found between MUC1 IgG and TF IgG antibody levels. High levels of TF IgG antibodies were significantly associated with a benefit in survival of gastric cancer patients (p = 0.003). A similar though weaker association was observed for patients with high levels of MUC1 IgG antibodies and locoregional disease (stage I-III) (p = 0.037). Thus IgG immune responses to MUC1 are increased in patients with gastric cancer. High levels of either TF IgG or MUC1 IgG antibodies may predict better outcome in surgically treated patients with gastric cancer.     

An open-label, multinational, multicenter study of G17DT vaccination combined with cisplatin and 5-fluorouracil in patients with untreated, advanced gastric or gastroesophageal cancer: the GC4 study

BACKGROUND: Gastrin hormone is trophic to in vitro gastric cancer, and the antigastrin antibodies (AGAs) are antiproliferative and antimetastatic. Human gastric cancers overexpress gastrin genes and receptors that react to gastrin's trophic effects. Immunogen G17DT elicits a specific and high-affinity AGA. The authors evaluated G17DT vaccination given with cisplatin plus 5-fluorouracil for the treatment gastric adenocarcinoma. METHODS: In this multicenter, Phase II study, patients received G17DT vaccination intramuscularly on Weeks 1, 5, 9 and 25 and cisplatin plus 5-fluorouracil every 28 days. Eligible patients had untreated, metastatic, or unresectable gastric or gastroesophageal adenocarcinoma with near-normal organ function. The primary endpoint of the study was the over response rate (ORR), and secondary endpoints included overall survival (OS), safety, and the impact of successful vaccination on patient outcome. RESULTS: In total, 103 patients were enrolled in 5 countries. Seven patients who were overdosed inadvertently with 5-fluorouracil (a major protocol violation) were removed from the analysis. The confirmed ORR was 30% in 79 patients who were evaluated for response. The median time-to-progression (TTP) was 5.4 months, and the median survival (MS) was 9.0 months (n = 96 patients). Sixty-five of 94 patients who were vaccinated (69%) had 2 consecutive AGA titers of > or =1 units (successfully vaccinated patients or immune-responders). The TTP was longer in immune-responders than in immune-nonresponders (P = .0005). Similarly, the MS was longer in immune-responders than in immune-nonresponders (10.3 months vs. 3.8 months; P < or =.0001). In a multivariate analysis, successful vaccination was an independent OS prognosticator (P = .0001). G17DT did not have an adverse effect on safety. CONCLUSIONS: The results demonstrated that successful G17DT vaccination was correlated with longer TTP and MS. AGA response was an independent OS prognosticator. A Phase III evaluation of G17DT in gastric cancer is warranted.     

Ca2+依赖的膜结合蛋白7在胃癌中的表达及临床意义

目的：探讨Ca²⁺依赖的膜结合蛋7(CPNE7)在胃癌中的表达水平及其与肿瘤发生发展的关系。方法：首先通过生物信息学分析CPNE7在胃癌及癌旁中的表达差异及其与预后的关系。收集2020年1月至2021年5月在兰州大学附属第二医院行手术治疗的102例胃癌患者的癌组织及其癌旁组织,制作成组织芯片(TMA),采用免疫组织化学染色法检测CPNE7的表达水平,Spearman相关分析CPNE7表达与胃癌患者临床病理特征的关系。采用RT-PCR和Western blot检测CPNE7在胃癌细胞(MKN45/AGS/HGC-27)和人正常胃黏膜细胞(GES-1)中mRNA和蛋白的表达水平。结果：CPNE7蛋白及其mRNA水平在胃癌中高于癌旁组织(P<0.05),CPNE7的表达与患者的临床分期(P<0.001)、T分期(P=0.012)、N分期(P=0.01)以及有无淋巴结浸润(P=0.005)和Lauren’s分型(P=0.007)显著相关,与年龄(P=0.37)、性别(P=0.121)、分化程度(P=0.15)、有无转移(P=0.835)、血管浸润(P=0.27...