Decreased expression of claudin-18.2 in alpha-fetoprotein-producing gastric cancer compared to conventional gastric cancer

BackgroundAlpha-fetoprotein-producing gastric cancer (AFPGC) is a subtype of gastric cancer (GC) with more aggressive biological behavior. As a highly specific tight junction component exclusively present in gastric mucosa and gastric adenocarcinomas, claudin-18.2 (CLDN18.2) has become an emerging target in GC. In this study, we aimed to provide insight into AFPGC and investigate the expression and the clinical implications of CLDN18.2 in AFPGC.MethodsWe retrospectively collected 98 cases of AFPGC and reviewed their clinical, morphological, and immunohistochemical features. Another 356 patients with stage-matched conventional GC (cGC) were enrolled as a control group. We further surveyed CLDN18.2 expression by immunohistochemistry (IHC) in 51 AFPGC tissues and explained its association with the clinicopathological parameters of AFPGC.ResultsOur results showed that AFPGC was a unique GC type with elevated serum alpha-fetoprotein (AFP), which was a predictor of a worse prognosis. AFPGC showed typical morphological features and positive staining of at least 1 hepatocytic or enteroblastic marker. The expression rate of CLDN18.2 was low, with a positivity rate of 21.6%, which was much lower than that observed in cGC tissues (38.5%). A significant correlation was found between CLDN18.2 expression and the differentiation of AFPGC. CLDN18.2 expression was negatively correlated with the serum AFP level of AFPGC. We also found that AFPGC with a hepatoid type (HPT) component showed a significantly lower CLDN18.2 expression than those without.ConclusionsThis study demonstrated that CLDN18.2 was significantly decreased in AFPGC and was negatively correlated with the patient’s preoperative serum AFP level. The negative correlation between AFP and CLDN18.2 could be explained by retro-differentiation of AFPGC. Special treatment strategies might be needed for this unique tumor type.     

Abrogation of ARF6 in promoting erastin-induced ferroptosis and mitigating capecitabine resistance in gastric cancer cells

BackgroundADP ribosylation factor 6 (ARF6) is a member of the Rat sarcoma virus (RAS) superfamily that is involved in the regulation of vesicular trafficking, membrane lipid remodeling, and signaling pathways. Our earlier work discovered that ARF6, as a downstream effector of the Kirsten rat sarcoma viral oncogene (Kras)/extracellular signal-regulated kinases (ERK) signaling pathway, may increase proliferation and induce the Warburg effect in gastric cancer (GC) cells. Additionally, ARF6 appears to be a potential biomarker for predicting the prognosis of GC. Ferroptosis has recently been described as a type of nonapoptotic iron-dependent cell death that is strongly associated with the Kras mutation. Therefore, it is critical to continue investigating the link between ARF6 and ferroptosis.MethodsWe first created ARF6 silenced cancer cell lines with lentivirus transfection. The knockdown efficiency was confirmed through quantitative polymerase chain reaction (qPCR) and western blotting. Subsequently, we used Cell Counting Kit-8 (CCK-8) and malondialdehyde (MDA) assay for lipid peroxidation measurement. Following this, qPCR and western blotting were conducted to clarify the mechanism involved. Finally, immunohistochemistry was used to stain human GC samples.ResultsOur findings established that, whereas ARF6 did not directly regulate lipid peroxidation, it did render GC cells susceptible to oxidative stress, particularly erastin-induced lipid peroxidation. Additionally, our research demonstrated that ARF6 may control capecitabine resistance via several routes.ConclusionsARF6 may play a critical role in the development of GC.     

Spleen stiffness-spleen size-to-platelet ratio risk score as noninvasive predictors of esophageal varices in patients with hepatitis B virus-related cirrhosis

This study was conducted to evaluate the predictive value of spleen stiffness-spleen size-to-platelet ratio risk score (SSPS) as a noninvasive predictor of esophageal varices (EVs) and to compare it with others.In this retrospective study, from April 2017 to October 2018, a total of 65 patients with hepatitis B virus-related cirrhosis who underwent the liver and spleen stiffness (LS, and SS) measurements by 2 dimensional-shear wave elastography and endoscopic evaluation for EVs were enrolled. Liver stiffness-spleen size-to-platelet ratio risk score (LSPS) and SSPS were calculated. The prognostic values were assessed by the area under the receiver operating characteristic curve (AUC).Twenty-six patients had no EV on endoscopy. Among 39 patients who had EVs, 12 patients had high risk EVs. The AUCs of the LS value, SS value, LSPS, and SSPS for predicting EVs were 0.72, 0.77, 0.80, and 0.85, respectively. The AUCs of the LS value, SS value, LSPS, and SSPS for predicting high-risk EVs were 0.55, 0.78, 0.67, and 0.80, respectively. SSPS had the highest specificity, at 96.15%, for predicting EVs.SSPS may be beneficial to exclude from having EVs and it is expected that the frequency of performing endoscopies for screening EVs can be reduced.     

测定胃癌患者肿瘤组织与外周血中前列腺素E2的临床意义

目的 测定胃癌患者肿瘤组织及外周血中前列腺素E2(prostaglandin E2,PGE2)含量.方法 用PGE2酶联免疫试剂盒分别测定40例胃癌患者肿瘤组织、癌旁切缘组织及术前外周血中PGE2含量.结果 胃癌组织的PGE2含量明显高于癌旁切缘组织,分别为(8.225±2.425)、(1.669±0.287)ng/g,两者差异有统计学意义(P<0.01),低分化和高中分化胃癌组织PGE2含量分别为(9.02±2.28)、(5.38±0.35)ng/g,两者有显著性差异(P<0.05).外周血中PGE2含量与胃癌组织PGE2含量呈正相关(r=0.889,P<0.01).肿瘤直径≥5 cm和<5 cm的胃癌患者外周血中PGE2含量差异有统计学意义(P<0.05).低分化和高中分化胃癌患者外周血中PGE2含量差异也有统计学意义(P<0.05).胃癌组织及外周血中PGE2含量与患者年龄、性别无关,与肿瘤部位、浸润深度、临床病理分期及是否淋巴结转移也无关.结论 胃癌患者肿瘤组织中PGE2含量增高,其外周血PGE2含量也随之增高,表明外周血PGE:水平与胃癌组织释放的PGE2含量成正比.测定外周血中PGE2可以间接评估胃癌患者的肿瘤大小与分化程度.     

Hand-assisted laparoscopic versus laparoscopic-assisted radical gastrectomy in the treatment of advanced distal gastric cancer: final results of a single-center randomized study

ObjectiveTo compare the results and 5- and 8-year overall survival (OS) and disease-free survival (DFS) of hand-assisted laparoscopic surgery (HALS) and laparoscopic-assisted surgery (LAS) in radical gastrectomy for advanced distal gastric cancer.MethodsA total of 124 patients admitted to our institution from May 2009 to April 2013 were randomly divided into a HALS group (n = 62) and a LAS group (n = 62). Postoperatively, 110 patients were followed for 5 and 8 years, and 14 patients were lost to follow-up. The 5- and 8-year OS and DFS rates of the groups were compared and analyzed.ResultsThe 5- and 8-year OS rates, respectively, were 38.8% and 19.4% in the HALS group and 38.3% and 15.3% in the LAS group (log-rank test, χ² = 0.250). The 5- and 8-year DFS rates, respectively, were 23.1% and 10.6% in the HALS group and 19.3% and 11.6% in the LAS group (log-rank test, χ² = 0.109). No significant differences were found.ConclusionCompared with LAS, HALS radical gastrectomy for advanced distal gastric cancer had a lower conversion rate to open surgery, shorter surgical duration, and more thorough dissection of lymph nodes; 5- and 8-year OS and DFS rates were similar to those with LAS.     

腹腔镜辅助远端胃癌根治术中非离断式Roux-en-Y吻合的效果观察

目的:探讨非离断式Roux-en-Y吻合在腹腔镜辅助远端胃癌根治术中应用的疗效。方法:回顾性分析2016年5月至2019年10月唐山市协和医院53例经手术治疗的远端胃癌患者的临床资料,手术方式为腹腔镜辅助远端胃癌根治术,吻合方式为非离断式Roux-en-Y吻合29例(非离断组)和Roux-en-Y吻合24例(传统组),...     

健脾消胀片对大鼠胃酸含量、胃蛋白酶活力及胃肠电活动影响

目的探讨健脾消胀片对大鼠胃酸含量、胃蛋白酶活力及胃肠电活动的影响。方法结扎大鼠幽门与十二指肠结合部造模,测大鼠胃酸含量和胃蛋白酶活力;用EGEG-8D胃肠电图仪记录5 min大鼠胃电图,测量频率和幅值,以观察健脾消胀片对大鼠胃窦电活动、小肠电活动的影响。结果大、中剂量健脾消胀片组可使大鼠胃酸含量显著升高,大剂量健脾消胀片组可使大鼠胃蛋白酶活性显著升高,中剂量健脾消胀片组可使大鼠胃蛋白酶活性明显升高;大、中剂量健脾消胀片组可使大鼠胃窦电活动频率显著升高,小剂量健脾消胀片组可使大鼠胃窦电活动频率明显升高,大、中、小剂量健脾消胀片组可使大鼠胃窦电活动幅值显著升高;大、中、小剂量健脾消胀片组可使大鼠小肠电活动频率和幅值均显著升高。结论健脾消胀片具有消食和胃的临床意义。     

腹腔镜对比传统开腹手术对于早期远端胃癌的手术疗效的Meta分析

目的本研究对比分析和评价早期远端胃癌患者行腹腔镜大部切除与传统开腹手术治疗的临床疗效与安全性。方法从Pub-med、EMBASE、中国生物医学数据库(CBM)、以及Cochrane实验注册中心检索2002年7月—2012年7月发表的有关对比腹腔镜手术和开腹手术治疗早期远端胃癌患者的关于近期疗效的文献,由2位胃肠外科医生独立地对入选研究的实验对象特征及实验设计和研究结果等内容进行摘录,并用RevMan 5.0软件进行系统分析。结果经过筛选有7个随机对照试验(ran-domized controlled trials,RCT)共计382例早期胃癌患者纳入系统评价。Meta分析结果指出:与传统开腹手术相比,腹腔镜组术后肠道恢复排气时间短[WMD:-0.70,95%CI:(-81.00,-58.00),P0.001],术后使用镇痛药物次数较少[WMD:-4.77,95%CI:(-6.77,-2.77),P0.000 1],住院时间短[WMD:-1.54,95%CI:(-2.02,-1.06),P0.001],术中清扫淋巴结数目比较开腹手术略少[WMD:-4.19,95%CI:(-6.08,2.29),P0.001],术后并发症腹腔镜组与开腹组之间较低[OR:0.57,95%CI:(0.31,1.03)]。结论腹腔镜早期远端胃手术比较传统开腹手术,在术后有效性及安全性上具有明显优势。     

金龙胶囊联合FOLFOX4方案治疗晚期胃癌28例

目的 观察金龙胶囊联合FOLFOX 4方案治疗晚期胃癌的客观疗效、免疫功能改善和不良反应.方法 将57例晚期胃癌患者随机分成治疗组(28例)和对照组(29例),治疗组采用金龙胶囊联合FOLFOX 4方案治疗,对照组仅采用FOLFOX 4方案治疗.结果 对晚期胃癌的控制,治疗组的有效率为39.29%,明显高于对照组的34.48%.治疗组应用金龙胶囊后NK细胞活性及T细胞亚群CD3+,CD4+百分率及CD4+/CD8+的比值均呈不同程度的升高,而CD8+呈下降趋势,治疗前后差异明显(P<0,05).治疗组的骨髓抑制、恶心、呕吐及腹泻等毒副反应发生率低于对照组,两组比较有统计学意义(P<0.05).结论 金龙胶囊联合FOLFOX 4方案治疗晚期胃癌,提高了化学治疗有效率,改善患者免疫功能,减小化学治疗相关不良反应的发生,可作为晚期胃癌的一种辅助治疗方法.