Significance of multidrug resistance gene-associated proteins in the postoperative adjuvant chemotherapy for gastric carcinoma and the prognosis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the expression of multidrug resistance (MDR) gene-associated proteins (MRP) in gastric carcinoma, and their effects on the postoperative adjuvant chemotherapy and the prognosis of patients.</p><p><b>METHODS</b>The expressions of ToPo II, MRP, GST-pi in 99 patients with gastric carcinoma were detected by immunohistochemistry. The expression and its relationship to the pathological data were analyzed. The positive expression of MRP and GST-pi, and the negative expression of ToPo II were considered as risk factors. Patients were divided into two groups: a high risk drug-resistant group (2-3 risk factors) and the low risk drug-resistant group (0-1 risk factors). Postoperative recurrence, survival rate, and efficacy of adjuvant chemotherapy were compared between two groups.</p><p><b>RESULTS</b>The positive rate of ToPo II was 74.7%, and the expression was associated with types and differentiation of the tumor. The positive rate of GST-pi was 49.5%, and the expression was related to the gender and the differentiation. The positive rate of MRP was 40.4%, and there was no relationship between the MRP expression and the pathological finding. There were no significant differences in the recurrence, time to recurrence, and the 5-year survival rate between the positive and negative group of the three proteins (P>0.05). Recurrence was found in 25 cases(55.6%) in the high risk drug-resistant group and the mean time to recurrence was (15.2+/-8.1) months. The time to recurrence was shorter in the low risk drug-resistant group [(21.3+/-11.1) months, P<0.05] , but there was no significant difference in the recurrence rate between two groups (P>0.05). The 5-year survival rate of the high risk drug-resistant group and the low risk drug-resistant group was 44.4% and 55.6% (P>0.05). The 5-year survival rates of patients with or without chemotherapy in the high risk drug-resistant group were 45.8% and 42.9% (P>0.05). The 5-year survival rates of patients with or without chemotherapy in the low risk drug-resistant group were 70.4% and 40.7%. The survival rate of patients with chemotherapy was higher than that of the patients without chemotherapy (P<0.05).</p><p><b>CONCLUSIONS</b>The expression of ToPo II, MRP and GST-pi is associated with the efficacy of postoperative adjuvant chemotherapy. Chemotherapy appears to be more beneficial to patients with low risk drug-resistance.</p>

Relationship between the protein expression of P53, c-erbB-2, vascular endothelial growth factor and CD44 and the survival rates of stage II( colorectal cancer patients without radiochemotherapy after radical resection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the relation between protein expression of 4 genes [P53,c-erbB-2,vascular endothelial factors(VEGF) and CD44]and survival rate in stage II( colorectal cancer(CRC) patients without radiochemotherapy after radical resection.</p><p><b>METHODS</b>One hundred and fifty-nine cases of stage II(CRC without radiochemotherapy were enrolled in this study. The clinicopathological date and 5-year follow-up data were reviewed. Streptavidin-peroxidase immunohistochemical technique was used to detect the expression of P53, c-erbB-2, VEGF and CD44 in formalin-fixed, paraffin embedded sections of CRC tissues from above 159 patients.</p><p><b>RESULTS</b>The 5-year survival rate was 82.4%. The rates of positive expression of P53, c-erbB-2, VEGF and CD44 were 58.5%(93/159), 26.4%(42/159), 57.9%(92/159) and 40.0%(54/159) respectively. The 5-year survival rates of positive expression patients were not significantly different with those of negative expression. chi(2) analysis showed that the positive expressions of 4 genes had no relationships with the prognosis.</p><p><b>CONCLUSION</b>The expression of 4 gene proteins has no relationship with the prognosis of stage II( CRC patients without radiochemotherapy after radical resection.</p>

Effect of Supportan on nutritional status and immune function of late-staged gastric cancer patients undergoing chemotherapy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of Supportan, an enteral nutrition (EN) specific for tumor patients, on the nutritional status and immune function of late-staged gastric cancer patients undergoing chemotherapy.</p><p><b>METHODS</b>Sixty-six late-staged gastric cancer patients undergoing chemotherapy were randomly divided into EN group (n=33) and control group (n=33). During chemotherapy, the patients in EN group received Supportan and the patients in the control group received basic diet. On the 14th day before chemotherapy and after chemotherapy, nutritional status and cell immune indicators were evaluated.</p><p><b>RESULTS</b>As for nutrition indicators, there were no significant differences in EN group before and after chemotherapy (P > 0.05). Total protein, hemoglobin, prealbumin and transferrin significantly decreased after chemotherapy compared with those before chemotherapy in the control group (P< 0.01). The levels of CD4(+), CD8(+) T cells and CD4/CD8 were significantly increased, and NK cells, serum levels of IL-1, IL-6 were significantly decreased after chemotherapy in EN group (P< 0.01). The levels of IL-6 and TNF-alpha were significantly higher after chemotherapy than those before chemotherapy in the control group(P< 0.01). Curative effects of immune nutrition in EN group were superior to that in the control group, however, the differences were not statistically significant. The incidences of nausea, vomiting and marrow inhibition in Supportan group was lower compared with those in the control group, but with no significant difference.</p><p><b>CONCLUSION</b>Supportan can prevent malnutrition of the late-staged gastric cancer patients undergoing chemotherapy, and improve immune function and alleviate adverse effects of chemotherapy.</p>