Optimal number of endoscopic biopsies in diagnosis of advanced gastric and colorectal cancer

Endoscopic biopsy is necessary to confirm a histopathologic diagnosis. Currently, 6 to 8 biopsies are recommended for diagnosis of a suspected malignant lesion. However, multiple biopsies may result in several problems, such as an increased risk of bleeding, procedure prolongation, and increased workload to pathologists. The aim of this study was to clarify the optimal number of endoscopic biopsy specimens required in diagnosis of advanced gastrointestinal cancer. Patients who were diagnosed with advanced gastrointestinal cancer during endoscopy were included. Five specimens were obtained sequentially from viable tissue of the cancer margin. Experienced pathologists evaluated each specimen and provided diagnoses. A total of 91 patients were enrolled. Fifty-nine subjects had advanced gastric cancer, and 32 had advanced colon cancer. Positive diagnosis rates of the first, second, and third advanced gastric cancer specimens were 81.3%, 94.9%, and 98.3%, respectively, while positive diagnosis rates of advanced colon cancer specimens were 78.1%, 87.5%, and 93.8%. Further biopsies did not increase positive diagnosis cumulative rates. This study demonstrated that three specimens were sufficient to make correct pathologic diagnoses in advanced gastrointestinal cancer. Therefore, we recommend 3 or 4 biopsies from viable tissue in advanced gastrointestinal cancer to make a pathologic diagnosis during endoscopy.     

Biweekly irinotecan and cisplatin as second-line chemotherapy in pretreated patients with advanced gastric cancer: a multicenter phase II study

The current phase II study was conducted to evaluate the response rate and safety of a combination regimen of biweekly irinotecan plus cisplatin in pretreated patients with advanced gastric cancer. Patients with previously treated metastatic or recurrent gastric cancer received intravenous irinotecan 70 mg/m2 and cisplatin 30 mg/m2 on day 1 and 15 every 4-week cycle. Thirty-two patients were enrolled in the current study. Of these, 31 patients were assessable for efficacy and all for toxicity. No complete response and 5 partial responses were confirmed, giving an overall response rate of 15.6% (95% CI; 2.3-28.9%). The median time to progression and median overall survival for all patients was 113 days and 184 days, respectively. Grade 3/4 neutropenia occurred in 6 patients (18.8%), yet no febrile neutropenia was observed. In addition, grade 3 anorexia was observed in 4 patients (12.5%) and grade 3 diarrhea occurred in 2 patients (6.2%). The combination chemotherapy of biweekly irinotecan and cisplatin was found to be moderately effective and well tolerated in pretreated patients with advanced gastric cancer. Accordingly, this regimen can be regarded as an important second-line treatment option for advanced gastric cancer.     

Phase II study of paclitaxel, cisplatin, and 5-fluorouracil combination chemotherapy in patients with advanced gastric cancer

This phase II study evaluated the efficacy and safety of combination chemotherapy with paclitaxel, cisplatin, and 5-fluorouracil (5-FU) in advanced gastric cancer. Patients with histologically confirmed gastric adenocarcinoma were eligible for the study. Paclitaxel (175 mg/m(2)) and cisplatin (75 mg/m(2)) were given as a 1-hr intravenous infusion on day 1, followed by 5-FU (750 mg/m(2)) as a 24-hr continuous infusion for 5 days. This cycle was repeated every 3 weeks. Forty-five eligible patients (median age, 56 yr) were treated in this way. Of the 41 patients in whom efficacy was evaluable, an objective response rate (ORR) was seen in 51.2% (95% CI, 0.35-0.67), a complete response in two, and a partial response in 19 patients. The median progression free survival was 6.9 months (95% CI, 5.86-7.94 months), and the median overall survival was 12.7 months (95% CI, 9.9-15.5). The main hematological toxicity was neutropenia and greater than grade 3 neutropenia was observed in twelve patients (54%). Febrile neutropenia developed in three patients (6.8%). The major non-hematological toxicities were asthenia and peripheral neuropathy, but most of patients showed grade 1 or 2. In conclusion, combination chemotherapy with paclitaxel, cisplatin, and 5-FU is a promising regimen, and was well tolerated in patients with advanced gastric cancer.     

Combination chemotherapy with 5-fluorouracil and heptaplatin as first-line treatment in patients with advanced gastric cancer

Heptaplatin is a recently developed platinum derivative. This agent has been reported to have a response rate of 17% as a single agent, and tolerable toxicity in the treatment of advanced gastric cancer. The aim of this study was to evaluate the efficacy and toxicity of a combination of 5-fluorouracil (5-FU) and heptaplatin in patients with advanced gastric cancer. Forty-seven chemotherapy-naive patients with advanced or recurred gastric cancer were recruited. 5-FU was administered over 120 hr by continuous intravenous infusion from day 1 to 5, at a daily dose of 1,000 mg/m2 and heptaplatin was administered over 1 hr by intravenous infusion on day 1 at 400 mg/m2, and this cycle was repeated every 4 weeks. The response rate was 21%, median progression-free survival was 1.9 months (95% CI, 1.6 to 2.2 months). Median overall survival was 6.2 months (95% CI, 4 to 8.4 months) and the 1-yr survival rate was 29% for all patients. The most frequent toxicity was proteinuria. Toxicities were generally mild and reversible. This study demonstrates that the combination of 5-FU/heptaplatin combination is less active but tolerated in patients with advance gastric cancer.     

Normal gallbladder visualization during post-ablative iodine-131 scan of thyroid cancer

Whole body iodine-131 scan is a well-established imaging method for the detection of metastatic or residual tumor sites in patients with well-differentiated thyroid cancer. Many false-positive iodine-131 scan findings mimicking metastatic thyroid cancer have long been reported. The authors describe a false positive uptake in normal gallbladder on post-ablative iodine-131 scan in a patient with papillary thyroid cancer. This finding should be considered to be another possible false-positive finding on iodine-131 whole body scan.     

骨髓间充质干细胞移植对胃癌模型大鼠肿瘤细胞的影响

BACKGROUND:Bone marrow mesenchymal stem cells can migrate into tumor tissues, as reported in recent studies. OBJECTIVE:To investigate the tropism and effect of transplantation of bone marrow mesenchymal stem cells on proliferation and differentiation of gastric cancer cell line SGC7901 in rats. METHODS:Gastric cancer models were established in Sprague-Dawley rats by subcutaneous injection of gastric cancer cell line SGC7901, and then, in cell transplantation group, each rat underwent an intraperitoneal injection of 1×107 bone marrow mesenchymal stem cells. After transplantation, the targeting ability of bone marrow mesenchymal stem cells was detected using fluorescent DiI labeling. Cyclin D2 mRNA and protein expressions were measured using real-time PCR and western blot assay, respectively. Apoptosis of gastric cancer cells was observed by in situ terminal labeling method. RESULTS AND METHODS: Bone marrow mesenchymal stem cells successfully migrated into the gastric cancer site in rats. The expression levels of cyclin D2 mRNA and protein in the cell transplantation group were significantly higher than those in the model group (P < 0.05). It was observed that the number of apoptotic cancer cells was significantly reduced in the cell transplantation group compared with the model group (P < 0.05). These findings indicate that bone marrow mesenchymal stem cells have the ability to migrate into the tumor sites, thereby promoting the proliferation of gastric cancer cells.     

5-氟尿嘧啶聚乳酸载药纳米微粒对胃癌细胞株的体外杀伤作用

背景：5-氟尿嘧啶在胃癌治疗中占据重要地位,但是长期服用容易出现骨髓抑制、白细胞减少等不良反应。聚乳酸及共聚物载药微粒材料生物相容性较高,分解物不会在机体内发生聚集。目的：探讨聚乳酸载药纳米微粒对胃癌细胞株的体外杀伤作用机制。方法：选取10只小鼠进行实验,利用超声乳化方法制备5-氟尿嘧啶聚乳酸载药纳米微粒,并采用噻唑蓝比色法配制1×10^-7,1×10^-6,1×10^-5,1×10^-4 mol/L的5-氟尿嘧啶聚乳酸载药纳米微粒,检测其对小鼠胃癌细胞的体外杀伤效应,并且计算出药物的抑制率浓度以及对胃癌细胞的生长抑制能力等以及凋亡的诱导作用。结果与结论：透射电镜下观察5-氟尿嘧啶聚乳酸载药纳米微粒：形态完好,分布相对均匀,不出现粘连等现象,用药24 h药物浓度可达到50%,72 h后能够达到62.9%;不同浓度下单一5-氟尿嘧啶和5-氟尿嘧啶聚乳酸载药纳米微粒和小鼠胃癌细胞联合培养48 h后,细胞的活性随着药物浓度的提高出现下降趋势,并且5-氟尿嘧啶聚乳酸载药纳米微粒细胞抑制能力显著高于5-氟尿嘧啶(P < 0.05);5-氟尿嘧啶聚乳酸载药纳米微粒的IC₅₀显著低于5-氟尿嘧啶(P < 0.05)。结果证实聚乳酸纳米微粒具有优良的药物载体作用,载药量较大,在机体内提高药物浓度,并且不降低5-氟尿嘧啶成分的生物学活性,可为胃癌治疗提供新思路。 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

顺铂在大鼠体内富集胃癌干细胞

背景：肿瘤干细胞具有自我更新、耐药和转移成瘤能力,对肿瘤的发生、发展以及肿瘤的转移等具有重要的功能。目前,确认肿瘤干细胞的方法主要有2种,即体外瘤球培养实验以及小鼠体内成瘤实验,但临床上通过化疗在大鼠体内富集胃癌细胞尚缺乏研究报道。 目的：观察顺铂在大鼠体内富集胃癌干细胞的情况,研究其表面标志蛋白的筛选方法。 方法：建立BGC-823胃癌模型大鼠,采用随机对照方法将大鼠分为2组,实验组大鼠分别尾静脉注射质量浓度0.1,0.2,0.25,0.3 g/L的顺铂,而对照组则尾静脉注射生理盐水。经过3期化疗,最后得到富集胃癌干细胞组织;采用高通量蛋白芯片对肿瘤表面蛋白进行提取,并采用Western blot对芯片进行验证,比较顺铂在大鼠体内富集胃癌干细胞及其表面标志蛋白的筛选方法。 结果与结论：顺铂剂量为0.3 g/L×200 μL时治疗效果最佳,且化疗药物浓度越高,耐受力越差,不良反应发生率越高。移植瘤经苏木精-伊红染色验证均为癌组织;Western blot检测结果与蛋白芯片结果显示,HLA-DQ,PMP22和Claudin7蛋白在胃癌组织中表达增强,HLA-DR,CD14,CD16和CD56蛋白表达减弱。结果证实,顺铂化疗能够在体内富集胃癌干细胞,能够成功筛选出相应的表面标志物蛋白。中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程     

Adenocarcinoma arising in gastric heterotopic pancreas: a case report

A heterotopic pancreas in the gastrointestinal tract is mostly found incidentally and its malignant transformation is extremely rare. We describe the second case of adenocarcinoma arising in a gastric heterotopic pancreas of an asymptomatic 35-yr-old man in Korea. Esophagogastroduodenoscopy revealed a submucosal tumor with an irregular central umbilication in the gastric antrum. A wedge resection specimen demonstrated a submucosal oligolocular cystic mass (1.7 x 1.4 x 1.2 cm) with a solid portion. Microscopically, the cystic portion was composed of dilated pancreaticobiliary type ducts with adjacent small foci of periductal glandular structures. The adenocarcinoma components in the solid area infiltrated the proper muscle and the overlying mucosa of the stomach. The transitional area between the benign ductal structures and the adenocarcinoma component was found. The follow-up course was uneventful 5 months postoperatively.     

胃癌患者胰腺CT影像解剖特点及其预测根治术后胰瘘的研究进展

目的 总结胃癌患者胰腺CT影像解剖特点及其预测根治术后胰瘘风险的研究进展。方法 在PubMed、中国知网、万方数据等数据库以“胃肿瘤”“胰瘘”“解剖学”“计算机断层扫描”和“stomach neoplasm”“pancreatic fistula”“anatomy”“computed tomography”为中英文关键词,检索2000年1月—2022年7月发表的与胃癌根治术后胰瘘相关的胰腺CT影像学的研究,共纳入文献620篇,排除重复文献、内容不符、无法获取全文及低质量文献,最终纳入24篇文献,进行总结分析。结果 通过胃癌患者术前CT检查,可了解胰瘘相关的胰腺的影像学解剖特点,如胰腺头部的形状、脂肪浸润程度,以及胰腺与胃左动脉、肝总动脉、腹主动脉及腹腔干的解剖位置关系。术前通过上述影像学解剖特点和参数可对胃癌患者的胰腺状态进行全面详细的评估,对患者术后发生胰瘘的风险有良好的预测作用。结论 对胃癌患者术前CT检查获得的胰腺头部的形状,脂肪浸润程度,以及胰腺与胃左动脉、肝总动脉、腹主动脉和腹腔干的解剖关系进行充分的评估,有助于预测胃癌根治术后发生胰瘘的风险。     

胃癌干细胞在肿瘤侵袭转移及对血管形成的影响

BACKGROUND:Gastric cancer stem cells involved in the neoadjuvant chemotherapy and conventional treatment are closely associated with relapse of gastric cancer. However, this conclusion has not yet been confirmed. OBJECTIVE:To investigate the effects of gastric cancer stem cells in tumor invasion and metastasis and its effect on angiogenesis ability. METHODS:We prepared nude mouse models of gastric cancer to isolate and culture gastric cancer stem cells. Harvested gastric cancer stem cells were detected in cell scratch test, ring test, inhibition rate test, cell migration test and tumorigenicity test. RESULTS AND CONCLUSION:After 7 days of culture, the cells exhibited adherent growth but a lack of regularity that most cells were in a tadpole shape. In the cell scratch test, the scratch width was significantly different at 0 and 24 hours (P < 0.05). Under an inverted microscope, the cells were found to form a ring in the ring test. The 50% inhibiting concentration of gastric cancer stem cells induced by oxaliplatin was significantly lower than that induced by 5-fluorouracil (P < 0.05). The number of cells passing through the basilar membrane was significantly increased after cell migration (P < 0.05). After implantation of gastric cancer stem cells, the gastric tissue quality was significantly higher than that in normal nude mice of gastric cancer (P < 0.05). These findings indicate that gastric cancer stem cells responsible for tumor invasion and migration have stronger angiogenesis ability.     

胃癌干细胞表面标记物的研究与最新进展

背景:最近人们研究发现,肿瘤的复发与肿瘤干细胞密切相关。肿瘤干细胞理论为研究胃癌的发病机制以及诊治开辟了新的途径,确定的表型有利于锁定胃癌干细胞,这有助于探讨胃癌干细胞在自我更新和分化过程中的作用,并为治疗胃癌提供新思路,但其表型仍存在争议。目的:综述胃癌干细胞表面标志物的研究进展。方法:由第一作者分别以"Gastric Cancer Stem Cells"为英文关键词检索PubM ed英文数据库(http://www.ncbi.nlm.nih.gov/pubmed)中1965年1月至2015年10月的文献,共保留68篇文献进行综述。结果与结论:通过分析整理,传统上的肿瘤干细胞表型不适合于标记胃癌干细胞。研究发现CD90在胃癌原发性肿瘤中有表达,分离后经无血清肿瘤球培养法培养可获得肿瘤球。CD24的表达有助于提高胃癌细胞的黏附、侵袭、迁移能力。此外研究证实CD44及CD54共表达的细胞会大量出现在胃癌复发早期患者的体内而不是晚期,表达CD44及CD54的肿瘤细胞很可能是导致胃癌发生以及复发的重要原因。综上所述,CD44^+CD24^+CD90^+CD54^+很可能是胃癌干细胞的表型。     

胃癌干细胞在胃癌侵袭、转移中及血管形成中的作用和机制

BACKGROUND: Although tumor stem cells and their differentiated vascular cells, which are not sensitive to chemotherapy and molecular targeted therapy, reduce overall blood supply of the tumor, these cells facilitate the invasion and metastasis of the tumor, eventually resulting in treatment failure.     

The Value of SPECT/CT in Localizing Pain Site and Prediction of Treatment Response in Patients with Chronic Low Back Pain

In many circumstances, causing sites of low back pain (LBP) cannot be determined only by anatomical imaging. Combined functional and morphological imaging such as bone scan with single-photon emission computed tomography/computed tomography (SPECT/CT) may be helpful in identifying active lesions. The purpose of this study was to evaluate the usefulness of bone SPECT/CT in localizing the pain site and the treatment of chronic LBP. One hundred seventy-five patients suffering from chronic LBP who underwent SPECT/CT were included, retrospectively. All of the patients received multiple general treatments according to the symptoms, and some of them underwent additional target-specific treatment based on SPECT/CT. Numerical rating scale (NRS) pain score was used to assess the pain intensity. Of 175 patients, 127 showed good response to the given therapies, while the rest did not. Overall, 79.4% of patients with definite active lesions showed good response. Patients with mild active or no lesions on SPECT/CT had relatively lower response rate of 63.0%. Good response was observed by the treatment with the guidance of active lesions identified on SPECT/CT. SPECT/CT could be useful in identifying active lesions in patients with chronic LBP and guiding the clinicians to use adequate treatment.

Graphical Abstract

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肿瘤干细胞表面标记物CD44在胃癌浸润和淋巴结转移中的作用

背景：肿瘤干细胞不仅能启动肿瘤发生,还参与肿瘤细胞的侵袭和转移。对肿瘤干细胞来说,识别其特异性细胞表面标志物已成为研究热点。 目的：探讨肿瘤干细胞表面标记物CD44在胃癌浸润和淋巴结转移中的临床意义。 方法：采用免疫组化 SABC法检测胃癌组织标本CD44蛋白表达,应用Pearsonχ2检验和Cox回归多因素分析,确定CD44表达与胃癌生物学特性及其预后的相关性。 结果与结论：100例胃癌标本中,59例(59.0%)标本CD44蛋白呈阳性表达。CD44蛋白在距胃癌原发灶边缘5 cm以上的正常胃黏膜组织中呈阴性表达。胃癌组织中CD44蛋白广泛表达,主要表达于细胞膜,少量表达于细胞浆。胃癌组织中 CD44蛋白的表达和患者性别、年龄无关(P > 0.05),但与肿瘤分期和淋巴管浸润、组织学分级、肿瘤大小等有关(P < 0.05),其中,肿瘤浸润越深、组织学分级越高、肿瘤直径越大、有淋巴结转移,则CD44蛋白表达阳性率越高,CD44阳性表达是影响患者术后生存的独立预后因素(P < 0.05)。以上结果表明肿瘤干细胞表面标记物CD44在胃癌组织中的表达与胃癌的浸润和淋巴结转移密切相关,表达越高患者预后越差。 中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程     

Chronic advanced gastric cancer: clinicopathologic analysis of survival data

Patients with advanced gastric cancer who survived 5 years or more were studied. They were divided into 2 groups: 31 who later died of their disease (chronic patients) and 33 who were apparently cured (cured patients). Each survivor was matched with a patient who died within 5 years (control patients). The clinical and pathologic features of each group were compared. The 5-year survivors were easily distinguished from the controls by histologic stage, size of neoplasm, intratumoral eosinophil counts, extent of fibrosis; and by most histologic classifications. Chronic patients resembled cured patients in mean age (56 years), stage, size, site, percentage with lymphatic and neural invasion, eosinophil counts, extent of fibrosis, and characteristics in most histologic classifications. Chronic cancers differed from cured cancers by having less venous invasion, fewer solid tumors, more mucinous carcinomas, a lesser proportion of intestinal to diffuse cancers (World Health Organization), and more intracellular mucin production (Goseki). Chronic cancers were lower stage and smaller with less lymphatic, venous, and neural invasion than controls. Their superior overall survival time was largely because of longer progression-free survival. We conclude that chronic advanced gastric cancer patients differ both from cured patients and control patients. The use of pathologic features in addition to the standard Lauren classification better separated the chronic cancers from the cured cancers and showed differences in behavior between histologic types.     

胃癌干细胞对氟尿嘧啶敏感性及化疗药物耐受细胞的生物学机制

背景：氟尿嘧啶是胃癌化疗的基础药物,临床上耐药现象较为常见。肿瘤干细胞对化疗药敏感性较低,可能是导致化疗后肿瘤复发进展的重要原因。 目的：探讨胃癌干细胞对氟尿嘧啶敏感性,从细胞生物学角度分析胃癌的化疗耐药机制。 方法：利用免疫组织化学染色法检测69例胃癌组织内干细胞标志物CD44和耐药蛋白胸苷酸合成酶表达情况;基于克隆形态的分选策略,从AGS胃癌细胞系内分离胃癌干细胞克隆,检测CD44和胸苷酸合成酶的表达和自我更新能力;利用CCK-8法检测不同AGS细胞克隆的5-氟尿嘧啶半数抑制浓度(IC50)。 结果与结论：69例胃癌组织标本中,胸苷酸合成酶和CD44的表达阳性率分别为57%(39/69)和61%(42/69),CD44与胸苷酸合成酶的表达之间呈正相关关系(Kappa=0.41,χ²=11.59,P < 0.05)。AGS细胞系的克隆形成率为39%(29/69),其中,副克隆、次克隆、全克隆所占比例分别为 17%(5/29)、69%(20/29)、14%(4/29)。二代克隆形成后,采用胰酶消化克隆并再次低密度接种传代,副克隆均无法传代,次克隆仅少数可连续传代,全克隆均可连续传代。不同浓度5-氟尿嘧啶作用之后,全克隆的生长抑制率均显著低于次克隆和AGS细胞,经比较差异均有显著性意义(P < 0.05)。以上结果表明胃癌干细胞对5-氟尿嘧啶敏感性较低,其对化疗药物耐受,可能是临床胃癌化疗耐药的产生机制之一。     

Clinicopathological Features and Surgical Safety of Gastric Cancer in Elderly Patients

Gastric cancer is one of the most common cancers, especially among the elderly. However little is known about gastric cancer in elderly patients. This study was designed to evaluate the specific features of gastric cancer in elderly patients. Medical records of 1,107 patients who had radical gastrectomy for gastric cancer between June 2005 and December 2009 were reviewed. They were divided into young (<65 yr, n=676), young-old (65-74 yr, n=332), and old-old age group (≥75 yr, n=99). Increased CA 19-9 (5.6%, 13.4%, 14.6%, P=0.001), advanced diseases (42.5%, 47.0%, and 57.6, P=0.014), and node metastasis (37.6%, 38.9%, 51.5%, P=0.029) were more common in the young-old and old-old age groups. There were no significant differences in Helicobacter pylori status (63.6%, 56.7%, 61.2%, P=0.324) between the three groups. Surgery-related complication rates were similar in the three groups (5.3%, 5.1%, 8.1%, P=0.497). Microsatellite instability (P<0.001) and p53 overexpression (P<0.001) were more common among the elderly. The elderly group had more synchronous tumors (7.5%, 10.2%, 17.2%; P=0.006). Surgery can be applied to elderly gastric cancer without significant risk of complications. However, considering the more advanced disease and synchronous tumors among the elderly, care should be taken while deciding the extent of surgery for elderly gastric cancer.

Graphical Abstract

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Sentinel lymph node radiolocalization with 99mTc filtered tin colloid in clinically node-negative squamous cell carcinomas of the oral cavity

The objective of this study was to evaluate the feasibility of sentinel lymph node biopsy by using a radiotracer lymphatic mapping technique in patients with squamous cell carcinoma of the oral cavity, and the diagnostic value of this technique. We studied twenty patients with previously untreated squamous cell carcinomas of the oral cavity and N0 necks. After the peritumoral injection of 99mTc filtered tin colloid preoperatively, lymphoscintigraphy and intraoperative mapping using a gamma detector were performed to localize sentinel nodes. An open biopsy of the sentinel node was followed by complete neck dissection. We identified the sentinel nodes in 19 of 20 patients (95.0%) by lymphoscintigraphy and in all (100%) by intraoperative gamma detector. In all cases, the status of the sentinel node accurately predicted the pathologic status of the neck with the false negative rate being 0%. The negative predictive value for the absence of cervical metastases was 100%. In conclusion, our radiolocalization technique of sentinel nodes using 99mTc filtered tin colloid in N0 squamous cell carcinomas of the oral cavity is technically feasible and appears to accurately predict the presence of the occult metastatic disease.     

人原代胃癌细胞中肿瘤干细胞的分化培养

BACKGROUND:There is a close relationship between tumor stem cells and tumor occurrence and recurrence, but there are still some disputes in the presence of tumor stem cells in all tumors. OBJECTIVE:To investigate the differentiation and culture of tumor stem cells in human primary gastric cancer cells. METHODS:Primary gastric cancer cells isolated from fresh gastric cancer tissues were stained with hematoxylin-eosin and identified by immunohistochemical detection of carcinoembryonic antigen. The CD44 expression of the cells was detected using immunofluorescence method. Magnetic activated cell sorting was used to isolate CD44⁺ gastric cancer cells that were then seeded subcutaneously behind the armpit of mice. Growth of implanted tumor cells was observed. RESULTS AND CONCLUSION:Human primary gastric cancer cells were isolated in serum-free medium. Compared with the routine culture group, the number of CD44⁺ cells (P < 0.05) and the tumor volume were significantly increased in the spheroid culture group. Furthermore, at 90 days after transplantation, the tumor volume of mice in spheroid culture group was significantly higher than that in the routine culture group. These experimental findings indicate that gastric cancer cells with certain tumorigenicity can be successfully isolated from gastric cancer cells using serum-free culture method and magnetic activated cell sorting method.