Risk factors of cholecystitis after radical gastrectomy for gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the risk factor of cholecystitis after radical gastrectomy for gastric cancer.</p><p><b>METHODS</b>Clinicpathological data of 553 gastric cancer patients with normal gallbladders undergoing radical gastrectomy in Tianjin Medical University Cancer Institute and Hospital between March 2013 and March 2015 were analyzed retrospectively. Univariate and multivariate analysis were applied to evaluate factors influencing the cholecystitis after radical gastrectomy using log-rank and logistic regression model.</p><p><b>RESULTS</b>There were 360 males and 193 females with a median age of 60 years. All patients were followed up from 6 months to 2 years. The incidence of cholecystitis after radical gastrectomy for gastric cancer was 33.1%(183/553), while incidence of cholecystolithiasis was 4.9%(27/553). In addition, the cholecystitis incidence of patients with No.12 lymph node cleaning was 39.6%(89/225), while with No.8a lymph node cleaning was 38.0%(151/397), with No.5 lymph node cleaning was 38.0%(68/179), with No.7 lymph node cleaning was 34.4%(138/402), with No.9 lymph node cleaning was 34.7%(136/392). Univariate log-rank test indicated that the lymphadenectomy of No.8a(χ(2)=15.530, P=0.000), No.12 group(χ(2)=7.157, P=0.007) and surgical methods (χ(2)=7.427, P=0.024) were significantly associated with cholecystitis after radical gastrectomy. Multivariate analysis showed that the lymphadenectomy of No.8a was independent factor of cholecystitis after radical gastrectomy (OR=2.016, 95% CI:1.244 to 3.267, P=0.004).</p><p><b>CONCLUSIONS</b>Vagal nerve trunk and sympathetic ganglion should be protected carefully during No.8a lymphadenectomy in radical gastrectomy for gastric cancer, in order to reduce the incidence of postoperative cholecystitis.</p>

Regularity of lymph node metastasis in distal gastric cancer and its clinical significance / 中国肿瘤临床

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.

Effect of perioperative blood transfusion on the prognosis of gastric cancer / 中华肿瘤杂志

<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>

Application of gene mutation detection in gastrointestinal stromal tumors / 中华胃肠外科杂志

Gastrointestinal stromal tumors(GISTs) are the most common gastrointestinal mesenchymal tumors of the gastrointestinal tract. Most of GISTs are characterized by mutation in the c-kit or PDGFR-α genes. In recent years, detection of gene mutation in GISTs has been widely used. In addition to the contribution to the diagnosis of difficult cases, such detection also has important value in predicting the efficacy of therapeutic drugs targeting, guiding clinical treatment and evaluating the prognosis of patients. In a word, gene mutation detection should be considered as the important standard for exact diagnosis and treatment of GISTs.

Correlation studies of VEGF-C/D and its receptor with lymph node metastasis in gastric cancer / 中国肿瘤临床

The lymphatic vessel is a crucial pathway for tumor metastasis. The discovery of more lymphatic growth factors and lymphatic vessel markers signifies the significant progress of studies on the role of vascular endothelial growth factor-C/D (VEGF-C/D) and one of its specific receptors in the mechanisms of tumor lymph-angiogenesis and lymph node metastasis. VEGF-C/D expression is related to the clinicopathologic features of gastric cancer, including lymph metastasis, micro-lymphatic vessel density in the paraneo-plastic tissues, survival rate, and prognosis. Experimental animal models and in vitro experiments show that suppression of VEGF-C/D expression is beneficial in gastric cancer treatment. This article provides an overview of the association between VEGF-C/D and lymph node metastasis in gastric cancer.