Proximal gastric cancer: lymph node metastatic patterns according to different T stages dictate surgical approach / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>As a common form of gastric cancer migration, lymph node metastasis largely affects the surgical treatment and prognosis of gastric cancer. Surgery is the fundamental curative option for gastric cancer that varies depending on different stages. The study aimed to compare the clinicopathological characteristics and lymph node metastatic patterns in patients of proximal gastric cancer with different T stages and investigate a reasonable radical gastrectomy approach in terms of the range of lymphadenectomy for proximal gastric cancer.</p><p><b>METHODS</b>In our retrospective study, the data of 328 patients of proximal gastric cancer with different T stages were analyzed. By comparing the differences of lymph node metastatic rate and ratio, we investigated the clinicopathological characteristics and metastatic patterns of lymph nodes. Also, we were especially interested in the differences in survival rates between patients with and without No. 5 and 6 group metastasis with the same TNM stage.</p><p><b>RESULTS</b>The overall lymph node metastatic rate and ratio of advanced proximal gastric cancer were 73.4% and 23.3%, respectively. The tumors of different T stages were statistically significant in size and differentiation degree (P < 0.05), multivariate analysis showed that the depth of tumor invasion was an independent risk factor for lymph node metastasis in proximal gastric cancer (RR, 12.025; 95% CI, 2.326 to 62.157; P = 0.003). The overall survival rate of patients with No. 5, 6 group lymph node metastasis and those without was significantly different, but the differences in survival rates between patients with and without No. 5 and 6 group metastasis with the same TNM stage were not statistically significant.</p><p><b>CONCLUSIONS</b>Different T stages in proximal gastric cancer showed different patterns and characteristics of lymph node metastasis. D2 lymphadenectomy in patients with early gastric cancer had little survival benefit because metastasis to level 2 nodes was rare. Therefore the range of the lymph node dissection in radical gastrectomy for early gastric cancer was considered reasonable. Moreover, to meet the requirements of the lymph node dissection, total gastrectomy plus D2 lymphadenectomy or more are supposed to be applied for the advanced proximal gastric cancer patients. Precise T staging largely determines the range of gastrectomy and lymphadenectomy.</p>

Expression and significance of miR-125a and Mcl-1 in intestinal tissue after massive small bowel resection in rat / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the expression and significance of miR-125a and anti-apoptotic protein Mcl-1 in intestinal tissue after massive small bowel resection in intestinal adaptation.</p><p><b>METHODS</b>Sprague-Dawley rats (54 male rats, 8-week old) were divided into 3 groups randomly, including two control groups. Rats in the experiment group were subjected to 70% massive small bowel resection. Rats in the resection group underwent simple intestinal resection and anastomosis. Rats in the control group underwent laparotomy alone. A 5 cm intestine approximately 1 cm distal to the anastomosis was harvested a week after operation. Expression of Mcl-1 was assessed by immunohistochemistry and real-time PCR was used to detect the expression of miR-125a in intestinal tissue.</p><p><b>RESULTS</b>The positive expression of Mcl-1 in the experiment group was 18.8%(3/16), significantly lower than that in the control group(76.5%, 13/17) and the resection group (83.33%, 15/18)(both P<0.01). The expression of miR-125a in the experiment group was 1.92, significantly higher than that in the control group (1.01) and the resection group (1.05)(both P<0.01).</p><p><b>CONCLUSION</b>miR-125a and anti-apoptotic protein Mcl-1 may play an important role in intestinal adaptation process and they may regulate each other through a certain pathway.</p>

Assessment of psychological characteristics of EORTC QLQ-H&N35 scale in nasopharyngeal carcinoma patients / 肿瘤研究与临床

Objective To assess the psychological characteristics of EORTC QLQ-H&N35 scale,and to explore whether QLQ-H&N35 scale is suitable to measure the qulity of life (QOL) in nasopharyngeal carcinoma (NPC) patients.Methods The data of 391 NPC patients from Cancer Hospital of Sun Yat-Sen University was collected.Split-half reliability,Cronbach's α coefficient,content validity,construct validity,discriminant validity,and feasibility of QLQ-H&N35 were performed.Person separation index (PSI),the order of item threshold,and differential item functioning were analyzed.Results Cronbach'sα coefficient and split-half reliability of QLQ-H&N35 were higher than 0.7,except for sense parameter.All Test-retest coefficients of QLQ-H&N35 were higher than 0.7.The result of factor analysis showed that the data was consistent with the theoretical model.Most of the domain scores and dimension scores of patients with different radiotherapy stages were significantly different (P ＜ 0.05).PSI of the model was 0.90.Most of the order of item threshold were normal.All the items had no uniform or non-uniform DIF among different genders and age groups.Conclusion QLQ-H&N35 scale is a reliable,operable,and valid disease-specific scale for the evaluation QOL in NPC patients.

Quality of life analysis of nasopharyngeal carcinoma tumor-free survivors / 肿瘤研究与临床

Objective To evaluate the quality of life (QOL) of nasopharyngeal carcinoma (NPC) tumorfree survivors,and analyze the factors affecting the QOL of NPC patients.Methods The QOL and demographic variables (gender,age,education,marital status,income,dialects,concomitant chronic disease,clinical stage,treatment method,radiation course,and radiotherapy stages) were collected.ANOVA and t test were used to compare the QOL of NPC patients among different demographic variables. Multivariate ANOVA was used to select the influencing factors. Results The influencing factors of psychological QOL included radiotherapy stage, radiation course and concomitant chronic disease. NPC patients had higher psychological domain QOL whose survival greater than five years, had a completed course of radiation, and without other diseases (P ＜0.05).The influencing factors of social QOL included radiotherapy stage and treatment method (P＜ 0.05). The influencing factors of side-effect QOL included radiotherapy stage(P ＜ 0.05).Conclusion The NPC tumor-free survivors who survival longer, have more course of radiation and with chronic diseases should be pay more attention.Prevention interventions should be preformed to reduce radiation injury to patients; side effects,and improve QOL of NPC tumor-free patients.