ABSTRACT
<p><b>OBJECTIVE</b>To explore the association of perioperative blood transfusion (PBT) with survival of gastric cancer after surgery.</p><p><b>METHODS</b>We retrospectively reviewed the medical records of 1 000 gastric cancer patients, including 738 non-transfused (73.8%) and 262 transfused (26.2%) cases. A one to one match was created using propensity score analysis, except preoperative hemoglobin level and operative blood loss. The survival was analyzed by Kaplan-Meier survival model.</p><p><b>RESULTS</b>The 5-year survival rate of the 1 000 cases of gastric cancer patients was 39.9%. Before matching, there was a significant difference between transfused group (33.6%) and non-transfused group (49.1%, P<0.005). Univariate analysis showed that age, tumor size, hemoglobin level, albumin level, depth of invasion, lymph node metastasis, lymph node dissection, surgery mode, adjuvant chemotherapy, blood loss and blood transfusion during perioperative period were associated with prognosis in the gastric cancer patients (all P<0.05). Multivariate analysis showed that tumor invasion, lymph node metastasis, lymph node dissection, chemotherapy and perioperative blood transfusion were independent prognostic factors in gastric cancer (all P<0.05). After matching, the 5-year survival rate of the 262 non-transfused patients was 37.7%, while that of the 262 transfused patients was 33.6% (P>0.05).</p><p><b>CONCLUSIONS</b>Perioperative blood transfusion has no significant effect on the prognosis of gastric cancer patients.</p>
Subject(s)
Humans , Analysis of Variance , Blood Transfusion , Mortality , Kaplan-Meier Estimate , Lymph Node Excision , Lymphatic Metastasis , Perioperative Period , Prognosis , Retrospective Studies , Stomach Neoplasms , Mortality , Pathology , General Surgery , Survival RateABSTRACT
Objective:The characteristics of lymph node metastasis were investigated to guide the range of lymph node dissection during the radical operation of distal gastric cancer. Methods:The clinical data of 773 patients with distal gastric cancer who under-went radical distal subtotal gastrectomy at the Tianjin Medical University Cancer Institute and Hospital between February 2010 and September 2014 were reviewed and analyzed to infer the potential clinical mechanisms of lymph node metastasis. Results:Among the included patients, 423 (54.72%) had lymph node metastasis. The proportion of metastasis in the patients from the highest to the lowest rate was observed in group NO. 6, 3, 4sb, and 5 lymph nodes. The metastasis rates of the N1 lymph nodes from the highest to the low-est were observed in group NO. 3, 6, 5, and 4d lymph nodes, whereas those of the N2 lymph nodes occurred in group NO. 8a, 7, and 1 lymph nodes. Group NO. 8a lymph node with skipped metastasis was observed in 50.68%of the patients. Conclusion:During radical distal gastric cancer surgery, attention should be given to the possibility of metastasis in group NO. 8a lymph node. Appropriate exten-sion of the lymph node dissection should be conducted when necessary.
ABSTRACT
Autophagy is the process through which cells utilize lysosomal hydrolases to degrade cytoplasmic misfolded proteins and damaged organelles. This process allows cells to reuse degradation products and degrade harmful substances to maintain intracellu-lar stability. The autophagy level is low at the normal cell state. Cells under unfavorable conditions activate autophagy to eliminate ad-verse factors. An increasing number of studies have shown that autophagy plays important roles in tumorigenesis, tumor progression, metastasis, relapse, and drug resistance. However, the detailed mechanisms remain unclear. This review summarizes the expression of gastric cancer cell-related autophagy genes and the mechanism by which autophagy promotes gastric cancer cell death. Autophagy has an important application prospect in treating gastric cancer.