Clinicopathological features and prognosis of chronic gastric ulcer with early canceration / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinicopathological features and prognosis of chronic gastric ulcer with early canceration in order to provide useful information for diagnosis and treatment strategies.</p><p><b>METHODS</b>A retrospective review of clinical data and prognosis from 43 patients of chronic gastric ulcer with early canceration from 2003 to 2010 was conducted. These data were compared with those with primary intra-mucosa gastric cancer (type I and II 275 cases, type III 68 cases).</p><p><b>RESULTS</b>In 43 cases of chronic gastric ulcer with early canceration, 30 cases (69.8%) were male, 22 cases (51.2%) were younger than 60 years old. Lesions located in the body or antrum of the stomach in 39 cases (90.7%), were less than 2 cm in 26 cases (60.5%), were undifferentiated type in 23 cases (53.5%), and developed lymph node metastasis in 4 cases (9.3%). Lesions of 4 cases of chronic gastric ulcer with early canceration located in the upper third of the stomach, while those of type III primary intra-mucosal gastric cancer all located in the lower two thirds, and the difference was statistically significant (P<0.01). Compared to type III and type I and II primary intra-mucosal gastric cancer, chronic gastric ulcer with early canceration did not differ in clinicopathological characteristics such as histological type, vascular or lymphatic invasion, and lymph nodes metastasis (all P>0.05). The median follow-up time was 57 months (range 16 to 98 months). The 5-year overall survival was 95.3% in chronic gastric ulcer with early canceration group, similar to that of type I, II (97.4%) or type III (94.5%) primary intra-mucosal gastric cancer group (P>0.05).</p><p><b>CONCLUSIONS</b>The clinicopathological features of chronic gastric ulcer with early canceration are similar to those of primary intra-mucosal gastric cancer. The prognosis is promising for those patients undergoing surgical treatment.</p>

Association of T helper cell 1 cytokines expressions with prognosis of gastric cancer patients / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the association of the expressions of Th1 cytokines in gastric cancer tissue and the prognosis of patients with gastric cancer after radical resection.</p><p><b>METHODS</b>Fifty-eight patients with gastric cancer treated at the Zhongshan Hospital of Fudan University were retrospectively analyzed. The expressions of Th1 cytokines mRNA were detected in tumor tissues by real-time polymerase chain reaction(RT-PCR) method in Th1 cells including TRAV10, IRF1, TBX21, CD3Z, GZMB, GATA3, and IFNG. Association of Th1 cytokines mRNA expressions and prognosis was evaluated.</p><p><b>RESULTS</b>The median follow up was 42.5(1-64) months. The 1-year survival rate was 84.5% and the 3-year survival rate was 72.4%. Univariate Cox regression analysis showed that lymph node metastasis, distant metastasis, TNM staging, lymphovascular invasion, GNLY mRNA expression, and the overall expression level of the 8 types of Th1 cells were associated with the prognosis of patients with gastric cancer(all P<0.05). The 3-year survival was 86.2% in patients with increased expression of mRNA and 58.6% in those with decreased expression. The 3-year survival was 79.6% in patients with any increase in the 8 Th1 cytokines and 33.3% in those with consistent downregulation of the 8 cytokines. Multivariate Cox analysis showed that lymph node metastasis and the overall expression level of 8 Th1 cytokines were independent risk factors associated with the prognosis of patients with gastric cancer in this cohort(both P<0.05).</p><p><b>CONCLUSIONS</b>The mRNA expression of GNLY is associated with the prognosis of patients with gastric cancer but is not an independent risk factor. The combination of mRNA expressions of the eight cytokines is an independent prognostic factor.</p>

Clinicopathological features and prognosis of cystic gastrointestinal stromal tumor / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological and molecular genetic characteristics of gastrointestinal stromal tumor (GISTs) with significant cystic changes, and to assess their biological behavior.</p><p><b>METHODS</b>Clinicopathological features of 7 patients with cystic GISTs treated at the Zhongshan Hospital of Fudan University from February 2005 to January 2010 were summarized retrospectively. The mutations status of c-kit and PDGFR-α were analyzed.</p><p><b>RESULTS</b>There were 2 males and 5 females aged from 46 to 76 years old. Primary site of GISTs included stomach(n=4), duodenum(n=1), and small intestinal(n=2). Tumor size ranged from 6 to 16 cm with obviously cystic changes. Tumor cells were found in the solid components under microscope, of which epithelioid cell type were found in 4 case and spindle cell type in 3 cases. The mitotic figures were no more than 3/50 HPF in all the patients. According to the NIH criteria, 4 were high-risk and 3 were low-risk. Based on morphological characteristics, 3 cases were as borderline tumor, 3 moderate-risk, and 1 moderate-risk. Gene mutation of exon 11 of c-kit were identified in 3 cases. During the follow up ranging from 9 to 80 months, all the 7 patients had cancer-free survival.</p><p><b>CONCLUSION</b>The biological behavior of cystic GIST is indolent with a low risk of malignancy and favorable prognosis.</p>