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Objective To investigate the clinical significance of lymphatic mapping and sentinel lymph nodes (SLNs) biopsy in the diagnosis and treatment of gastric cancer. Methods A retrospective analysis was carried out based on the data of 46 patients who had received D2 gastrectomy from January 2003 to June 2006. The SLNs stained by methylene blue were resected for biopsy. Results The success rate of SLNs biopsy was 83% (38/46). The sensitivity, false-negative rate, accuracy, specificity, negative predictive value and positive predic-tive value of SLNs were 69% (18/26), 31% (8/26), 79% (30/38), 100% (12/12), 60% (12/20) and 100% (12/12). The sensitivity, accuracy and negative predictive value were 100% in patients with tumor in pT1 stage or TNM I stage, or with the diameters of the tumors under 4 era. The tumor site, and the degree of lymph node metastasis affected the success rate of biopsy, and the invasion depth, clinical stage and the degree of lymph node metastasis affected the sensitivity, accuracy and negative predictive value of biopsy. Conclusions The application of sentinel lymph node biopsy using methylene blue in gastrie cancer is feasible. The sensitivity, accuracy and reliability are high in patients at early stage of gastric cancer.
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Objective To summarize the current value of neoadjuvant chemotherapy(NAC) for potentially resectable gastric cancer.Methods The recent 5-year literatures searched through the PubMed with the key words:stomach neoplasm,gastric cancer/carcinoma,neoadjuvant therapy/chemotherapy and preoperative therapy/chemotherapy as well as the relevant reports presented in the ASCO Annual Meeting in 2007 and 2008 were analyzed.The present status of NAC for advanced gastric cancer was summarized,the necessity and feasibility were evaluated,and the patients features for selecting,the predictors for response,the mainly existing problems and development trend of NAC were analyzed.Results At present,there were 7 randomized control trails(RCT) published,and among them 3 were phase Ⅲ.It was safe,effective and feasible to most of trails in NAC for gastric cancer.However,it was still little to obtain survival benefit for NAC RCT,and short of randomized trial comparing strict preoperative chemotherapy to surgery alone or perioperative chemotherapy to surgery plus adjuvant chemotherapy.It remained lots of problems such as how to select the appropriate patients,the effective induced regimes and the predicted factors,the evaluated indices for response.Conclusion NAC is a safe,feasible and efficient method to potentially resectable gastric cancer,but strict phase Ⅲ randomized trials are needed.In the future,substantial improvements of treatment outcome will likely depend on the novel drugs and molecular biological targeted therapies.
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To explore the molecular mechanisms underlying the immunomodulatory effects of hypertonic sodium chloride and hetastarch 40 injection (HSH) resuscition on the development of lung inflammation in a hemorrhagic shock model, Sprague Dawley rats were subjected to hemorrhagic shock and intratracheal LPS,the so called two hit rodent model.The animals resuscitated by transfusion of either Ringer's lactate(RL) or a 6ml/kg volume of HSH were sacrificed at 1,2,4 hour after resuscitation,respectively. Surface expression of adhesion molecule CD11b on circulating polymorphonuclear (PMN) was measured by flow cytometry. Bronchoalveolar lavage fluid(BALF) neutrophil counts were determined.Lung tissue myeloperoxidase(MPO) activity reflecting total lung neutrophil infiltration was assessed by modified Bradly′ method. The results showed that resuscitation with HSH significantly reduced BALF neutrophil counts( P