Caracterización clínica, histológica y endoscópica del cáncer gástrico en el Hospital de Especialidades Dr. Abel Gilbert Pontón, Ecuador / Clinical, histological, and endoscopic characterization of gastric cancer at the Hospital de Especialidades Dr. Abel Gilbert Pontón, Ecuador

Resumen Introducción: El cáncer gástrico, a nivel mundial, tiene una incidencia variable y es una de las causas más frecuentes de muerte. En Ecuador ocupa el segundo lugar de muerte en los hombres y la cuarta en las mujeres por cáncer gástrico. Objetivos: Establecer las características sociodemográficas, clínicas, histológicas y endoscópicas, y determinar una correlación entre la localización e histología en una población de pacientes con cáncer gástrico en el Hospital de Especialidades de Guayaquil, Dr. Abel Gilbert Pontón. Materiales y métodos: Estudio de prevalencia analítico y prospectivo. Se incluyeron las endoscopias digestivas altas de consulta externa y emergencia con signos de sospecha de cáncer gástrico realizadas en el Hospital de Especialidades de Guayaquil, Dr. Abel Gilbert Pontón, Ecuador, entre enero de 2018 y diciembre de 2019. Resultados: En el estudio se incluyeron 62 pacientes con diagnóstico de adenocarcinoma gástrico, el sexo masculino representó el 72,6 % en relación con el sexo femenino, con el 27,4 %; el rango de edad fue entre los 27 y 95 años, el promedio de edad es de 60,96 ± 15,1 y la edad de mayor presentación fue de 60 a 70 años. El síntoma que predominó fue el dolor, en un 98,4 %, y la pérdida de peso, en un 64,5 %; su localización más frecuente fue el antro (50,0 %), su morfología de mayor presentación es el Borrmann tipo III y, con respecto al tipo histológico, se encontró el tipo intestinal (64,5 %) y el difuso (29,0 %). El tipo intestinal se presentó en edad más avanzada en un 60 %-69 %, fue más frecuente en el cuerpo (71,4 %) y su localización fue más proximal, en comparación con el tipo difuso, que se presentó más en edad temprana (27-39 años), fue más frecuente en el antro (32,3 %) y su localización fue más distal. Conclusiones: El cáncer gástrico se diagnostica en estadios avanzados, más en hombres que en mujeres y se puede afirmar que en nuestro hospital la localización del cáncer gástrico tipo intestinal se presentó en edades avanzadas, más frecuentemente a nivel proximal y en la clasificación del cáncer gástrico avanzado Borrmann tipo III, lo cual podría tener influencia en el tratamiento y pronóstico. Además, los resultados obtenidos justifican la implementación de programas de detección oportuna y tratamiento de esta grave enfermedad.

Abstract Introduction: Gastric cancer is one of the most common causes of death worldwide, with a varying incidence. In Ecuador, it is the second leading cause of death in men and the fourth in women. Objectives: To establish the socio-demographic, clinical, histological, and endoscopic characteristics of patients with gastric cancer and to determine the correlation between location and histology in this population treated at the Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón. Materials and methods: Analytical and prospective prevalence study. Outpatient and emergency upper gastrointestinal endoscopies with signs of suspected gastric cancer performed at the Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón - Ecuador between January 2018 through December 2019 were included. Results: The study included 62 patients diagnosed with gastric adenocarcinoma. 72.6% were male and 27.4% were female; the age range was between 27 and 95 years, with an average of 60.96 ± 15.1 years, the age of onset being between 60 and 70 years. Pain was the most frequent symptom in 98.4% of cases, followed by weight loss in 64.5%. The antrum was the most common site of cancer (50.0%), and Borrmann type III was the most common morphology. Intestinal cancer was found in 64.5% of cases, while diffuse gastric cancer was found in 29.0%. Intestinal cancer was more common in older ages (60-69%) and the most frequent site of presentation was the body of the stomach (71.4%) with a proximal location. In contrast, diffuse gastric cancer was more frequent in younger patients aged between 27-39 years, more often in the antrum (32.3%) at a more distal location. Conclusions: Gastric cancer is more often found in men and is usually diagnosed in advanced stages. Intestinal gastric cancer was most commonly seen at advanced ages in our hospital, most frequently at the proximal site and in the Borrmann type III according to the classification of advanced gastric cancer, affecting its treatment and prognosis. The results obtained support the implementation of programs to diagnose and treat this severe disease in a timely manner.

Tumor de estroma gastrointestinal gigante de estómago / A Gigantic Gastrointestinal Stroma Tumor of the Stomach

RESUMEN Los tumores del estroma gastrointestinal son los tumores mesenquimales más frecuentes en el tracto gastrointestinal, entre el 20 y el 45 por ciento son malignos. Se originan de las células de Cajal o de sus precursores. La clínica más frecuente es la presencia de un tumor abdominal, la hemorragia digestiva por ulceración de la mucosa y el dolor o sensación de plenitud abdominal. Estos tumores pueden tener un largo período de crecimiento silente hasta que por su tamaño se manifiestan clínicamente, suelen tener un crecimiento expansivo desplazando las estructuras vecinas sin invadirlas. Se presenta a un paciente con un tumor del estroma gastrointestinal de estómago con proporciones inusualmente grandes, que fuera intervenido por nuestro grupo con una evolución satisfactoria(AU)

ABSTRACT Gastrointestinal stromal tumors are the most frequent mesenchymal tumors of the gastrointestinal tract, and are malignant in 20-45 percent. They originate from Cajal cells or their precursors. The most frequent clinical symptoms are the presence of an abdominal tumor, digestive hemorrhage due to mucosa ulceration, and pain or sensation of abdominal fullness. These tumors may have a long period of silent growth until, due to their size, they manifest clinically; they tend to have expansive growth, displacing neighboring structures without invading them. We present the case of a patient with a gastrointestinal stroma tumor of the stomach of unusually large proportions, who underwent surgery by our team and with a satisfactory evolution(AU)

Lipoma gástrico: lesión submucosa infrecuente: reporte de dos casos tratados / Unusual gastric submucosal lipoma lesion: report of two cases

El lipoma gástrico (LG), es un tumor benigno raro que representa el 5 % de los lipomas gastrointestinales y menos del 1 % de todos los tumores gástricos. Se localizan habitualmente a nivel de la submucosa y generalmente en la región antral. La endoscopia y la tomografía computarizada son las herramientas diagnósticas más utilizadas en el proceso diagnóstico. Dada su relativa rareza, quedan a menudo fuera del diagnóstico diferencial de las masas submucosas gastrointestinales superiores. El objetivo de este manuscrito, es reportar dos casos tratados de forma consecutiva y revisar la literatura existente en esta materia. Se trata de dos pacientes de sexo masculino, de 49 y 69 años de edad, a quienes se diagnosticó una lesión submucosa gástrica por endoscopia y fueron tratados quirúrgicamente y cuyos especímenes fueron estudiados histológicamente, concluyéndose en ambos casos la existencia de un LG. Ambos pacientes evolucionaron de forma correcta y permanecen en controles clínicos y endoscópicos hasta la actualidad, sin inconvenientes. El LG es una entidad poco común, que puede simular una enfermedad maligna. Presentamos dos casos tratados quirúrgicamente con resultados satisfactorios.

Gastric lipoma (GL), is a rare benign tumor that represents 5 % of gastrointestinal lipomas and less than 1 % of all gastric tumors. They are usually located at the level of the submucosa and usually in the antral region. Endoscopy and computed tomography are the diagnostic tools most used in the diagnostic process. Given their relative rarity, they are often left out of the differential diagnosis of the upper gastrointestinal submucosal masses. The aim of this manuscript was to report two cases treated consecutively and review the existing literature on this subject. Two male patients, 49 and 69 years of age, were diagnosed with a gastric submucosal lesion by endoscopy and were treated surgically. The specimens were studied histologically; concluding the existence of a GL in both cases. The two patients evolved adequately and have remained in clinical and endoscopic controls until now, without problems. GL is a rare entity, which can simulate a malignant disease. We present two cases treated surgically with satisfactory results.

The Effect of Psychological Factors on Postoperative Pain in Gastric Tumor Patients after Endoscopic Submucosal Dissection / 정신신체의학

OBJECTIVES: Since pain in cancer patients is an important factor that greatly affects the quality of life and prognosis, many attempts have been actively made to reduce the pain. Despite continuous effort on reducing pain after Endoscopic submucosal dissection (ESD), research has not been done on psychological factors as much as on biological factors affecting pain. The objective of this study is to investigate the psychological factors affecting postoperative pain in gastric tumor patients who underwent gastric ESD. METHODS: 91 gastric tumor patients who visited National Health Service Ilsan Hospital in Korean between May 2015 and June 2016, and received ESD were evaluated. Baseline characteristics including sociodemographic factors, anxiety, depression, and resilience were evaluated before the procedure. Multivariate logistic regression was done to analyze factors affecting postoperative pain. RESULTS: The group with high postoperative pain showed lower alcohol consumption and higher depressive symptom scores than the group with low postoperative pain. Also, the group with high postoperative pain showed lower total resilience score with lower subtotal scores in self-control and positive item. Multivariate logistic regression analysis of the postoperative pain showed that patients with lower score in self-control of resilience [odd ratio (OR), 0.911 ; 95% CI, 0.854–0.971, p=0.004) reported more pain after ESD. CONCLUSIONS: This study showed that patients with lower self-control ability of resilience felt more pain after ESD. Among the psychological factors evaluated in this study, resilience of an individual seems to have effect on pain.

Characteristics of TCM Syndromes of Death in Patients with Malignant Gastric Tumor:A Real-world Study Based on Hospital Information System / 中国中医药信息杂志

Objective To analyze the characteristics of TCM syndromes of death in patients with gastric cancer;To provide some references for the clinical treatment and prognosis of gastric malignant tumor. Methods Based on hospital information system large integrated data warehouse electronic medical data, the descriptive analysis based on frequency and frequency was carried out on the general situation, sex, age, distribution of TCM syndromes and other data of the first diagnosis of gastric malignancy and treatment outcome of death. Results Totally 384 cases were included in the analysis, mainly as male, physical manual workers, and the middle-aged and elderly. TCM syndromes of the spleen and stomach deficiency was the most common, and the rest of the syndromes also included: blood stasis internal resistance, qi and yin deficiency, disharmony of liver and stomach, qi and blood deficiency, phlegm stagnation, stomach heat to weak yin. Spleen and stomach deficiency was common in the male, while qi and yin deficiency was common in the female. The number of patients aged between 18 and 44 was small; patients aged between 45 and 59 were maily spleen and stomach deficiency; patients aged between 60 and 74 were mainly qi and yin deficiency; patients aged between 75 and 89 were mainly blood stasis internal resistance. Conclusion Spleen and stomach deficiency may be one of the most central pathogens in patients with gastric cancer death, consistent with the traditional cognition of TCM "Wei Qi". In this study, the analysis of TCM syndromes in patients with death can provide a reference for real-world large data based on the early warning and risk prevention and control of death points in critically ill patients with severe gastric cancer.

Research progress on polysaccharide of Chinese materia medica against gastrointestinal tumors in vitro experiments / 药物评价研究

Tumor is a seriously disease that endanger human health.Gastrointestinal cancer is one of the most prevalent types of digestive system cancers among the Chinese population.While radiotherapy and chemotherapy kill cancer cells,their toxicity to normal cells cannot be ignored.Hence,polysaccharides from Chinese materia medica (CMM) have been the focus of anti-tumor research,as they can improve functions of the immune system and do not harm to normal cells.In this review,we have analyzed the recent advances in the study of the effects of polysaccharides from CMM on human gastric cancer cell lines (MGC-803 and SGC-7901) and intestinal tumor cell lines (LoVo,HCT-116,and HT-29) in vitro.The purpose of this study is to provide a material basis for clinical research of polysaccharides from CMM.

Effects of nutrition guidance on energy intake and body weight of patients with gastric cancer for the first time chemotherapy / 中国实用护理杂志

Objective To investigate the effect of nutritional guidance on the energy intake and body weight of patients with gastric cancer chemotherapy. Methods The experimental study was used to study the 144 cases with gastric cancer for the first time of chemotherapy. They were randomly divided into the experimental group and the control group, 72 cases in each group. Routine healthy guidance was used in the control group, while the patients in the experimental group were treated by the nutrition prescription, the nutrition guidance, the purpose and the significance of the chemotherapy, and the follow-up of the patients after discharge. The body weight of patients was collected before chemotherapy, and the dietary questionnaire was used for second days after first days of dietary intake, and the changes of energy consumption and body weight were compared between the two groups. Results The mean values of energy intake within 24 hours in the first 3 days after the chemotherapy in the experimental group was 5 068.92 kJ, which was 51%of the RNI. The mean values of energy intake within 24 hours in the first 3 days after the chemotherapy in the control group was 3 439.25 kJ, which was 38%of the RNI. The difference between the two groups was significant (P<0.01). The weight of patients in the experimental group at the time point of before the 5th and 6th time of chemotherapy were significant higher than those in the control group (P<0.05). Energy intake had influenced the patients′weight, high energy intake with low decrease of body weight. Conclusions Nutritional guidance can effectively improve the energy intake of patients with gastric cancer when chemotherapy, so that the weight remained stable during chemotherapy.

Endoscopic Submucosal Dissection for Early Gastric Neoplasia Occurring in the Remnant Stomach after Distal Gastrectomy

BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) for tumors occurring in the remnant stomach is technically difficult to perform because of limited working space and severe fibrosis and staples present around the suture line. We aimed to elucidate the feasibility and clinical outcomes of performing ESD for tumors in the remnant stomach. METHODS: Between December 2007 and January 2013, 18 patients underwent ESD for tumors (six adenomas and 12 differentiated-type early gastric cancers [EGCs]) occurring in the remnant stomach after distal gastrectomy. Clinicopathologic features and clinical outcomes after ESD were retrospectively analyzed. RESULTS: Two-thirds of the lesions were located on the body, and half were located on the suture line. En bloc resection, R0 resection, and en bloc with R0 resection rates were 88.9%, 100%, and 88.9%, respectively. Curative resection rate for EGC was 91.7%. Perforation occurred in one patient (5.6%) and was successfully managed by endoscopic closure with metallic clips and conservative management. There was no significant bleeding after ESD. During a median follow-up of 47.5 months, no local, metachronous, or extragastric recurrence was seen for either EGC or adenoma lesions. CONCLUSIONS: ESD is a feasible and effective treatment modality and can be considered a primary intervention for early gastric neoplasia occurring in the remnant stomach.

Tricobezoar, a proposito de un caso / Tricobezoar, a case report

El tricobezoar es una masa de cabello no digerido que se encuentra en las vías gastrointestinal. Se alojan frecuentemente en el estómago pero se pueden ubicar a todo lo largo del tracto gastrointestinal. Se observan en sexo femenino en el 90% de los casos, y con una mayor frecuencia entre los 10 y 19 años. Se presenta el caso de una adolescente femenina de 11 años de edad quien cursa con enfermedad actual de 1 mes de evolución caracterizada por dolor abdominal, vómitos alimenticios pospandriales y pérdida de peso. Al examen se palpa una masa que ocupa el hemiabdomen superior. Se realiza tomografía computarizada de abdomen donde se evidencia imagen hipodensa y heterogénea que ocupaba la totalidad del estómago, compatible con cuerpo extraño. Se realiza laparotomía exploradora donde se evidencia tricobezoar gástrico.

Trichobezoar is a mass of undigested hair found within the gastrointestinal tract. They are often found in the stomach but may be found along the entire gastrointestinal tract. 90% of the cases occur in females between the age of 10 and 19 years. We present the case of an 11 years old girl who suffered abdominal pain, vomiting and weight loss for a month, with a palpable mass located in the upper abdomen quadrant. Abdomen computed tomography reported a hypodense heterogeneous image which occupied the whole of the stomach, compatible with foreign body. At laparotomy a gastric tricobezoar was found.

Tumor glómico gástrico. Reporte de un caso / Gastric glomic tumor. Report of a case

El tumor glómico es un tumor mesenquimatoso tipo vascular benigno. Se origina de la modificación de las células de músculo liso del cuerpo gnómico, que son comúnmente observados en el dermis o en tejido células subcutáneo. Su aparición es rara en el tracto gastrointestinal. Se presentó el caso de un paciente masculino de 62 años de edad que acude por acidez y dolor en epigastrio al que se le realiza endoscopia con hallazgo de masa tumoral de 3 cm cubierto por mucosa sana localizado en cara posterior de cuerpo gástrico. Fue realizado estudio de rayos X contrastado, biopsia por ponchamiento y, posteriormente, gastrectomía subtotal. El estudio histopatológico demostró un tumor glómico gástrico, se le concluyó su estudio con la aplicación de inmunohistoquimica. Por las dificultades para su diagnóstico preoperatorio y constituir el estudio histopatológico la única forma de determinar la naturaleza de esta lesión submucosa gástrica con sus características típicas, se decidió presentar este caso, posiblemente el primero diagnosticado en Cuba.

The glomic tumor is mesenchymal tumor of benign vascular type. It arises from the modification of the cells of the plain muscles of the gnomic body, commonly observed in the dermis or in subcutaneous cellular tissues. It is rarely found in the gastrointestinal tract. We presented the case of a male patient, aged 62 years, who assisted the consultation because of sourness and epigastrium pain. As a result of an endoscopy we found a 3 cm tumoral mass covered by healthy mucous located on the back side of the gastric body. A contrasted X-rays study, a biopsy by puncture, and a subtotal gastrectomy were carried out. The histopathologic study showed a glomic gastric tumor, and its study was ended with the application of immunohistochemistry. Because of the difficulties for its pre surgical diagnosis, and because the histopathologic study is the unique form of determining the nature of this gastric submucous lesion with its typical characteristics, we decided to present this case, probably the first one diagnosed in Cuba.

Prevention of surgery-related complications of radical lymphade-nectomy for gastric cancer / 中国肿瘤临床

D2 radical lymphadenectomy is currently the worldwide standard operation for locally advanced gastric cancer. The most common organs affected by intraoperative injuries include perigastric blood vessels, the spleen, the common bile duct, the pancre-as, and lymphatic vessels. Postoperative complications usually include bleeding, lymphatic leakage, anastomotic leakage, and delayed gastric emptying. Annual volume is an important factor in the mortality and morbidity of the operation. The learning curve for the proce-dure involves approximately 50 operations. Adequate living anatomical knowledge and skilled surgical techniques are prerequisites for D2 lymphadenectomy.

Small Submucosal Tumors of the Stomach: Differentiation of Gastric Schwannoma from Gastrointestinal Stromal Tumor with CT

OBJECTIVE: To identify the CT features that help differentiate gastric schwannomas (GS) from small (5 cm or smaller) gastrointestinal stromal tumors (GIST) and to assess the growth rates of both tumors. MATERIALS AND METHODS: We included 16 small GSs and 56 GISTs located in the stomach. We evaluated the CT features including size, contour, surface pattern, margins, growth pattern, pattern and degree of contrast enhancement, and the presence of intralesional low attenuation area, hemorrhage, calcification, surface dimpling, fistula, perilesional lymph nodes (LNs), invasion to other organs, metastasis, ascites, and peritoneal seeding. We also estimated the tumor volume doubling time. RESULTS: Compared with GISTs, GSs more frequently demonstrated a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs (each p < 0.05). The intralesional low attenuation area was more common in GISTs than GSs (p < 0.05). Multivariate analyses indicated that a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs were statistically significant (p < 0.05). Tumor volume doubling times for GSs (mean, 1685.4 days) were significantly longer than that of GISTs (mean, 377.6 days) (p = 0.004). CONCLUSION: Although small GSs and GISTs show similar imaging findings, GSs more frequently show an exophytic or mixed growth pattern, homogeneous enhancement pattern, perilesional LNs and grow slower than GISTs.

The enigma of Helicobacter pylori infection and gastric cancer.

Abstract Although H. pylori has been recognized as a class I carcinogen, incongruence between infection prevalence and cancer incidence has been reported. Holcombe called attention to the high prevalence of infection in the face of low cancer rates, which he called “The African Enigma”. Similar observations have now been made in other geographic areas. Gastric carcinoma should be considered an infectious disease, for which the classical epidemiologic model of causality applies. The model proposes that tissue injury inflicted by the infectious agent is modulated by its interactions with host and environmental factors. Although approximately half of the world’s population is infected, only a small proportion of people develop cancer. The African enigma is a striking example of the major contrasts in cancer risk among populations with similarly high prevalence of infection. The mechanisms involved in reducing the risk of cancer in infected individuals are explored in this article, which may lead to the design of effective prevention strategies.

Coexistent gastric primary choriocarcinoma and adenocarcinoma.

Choriocarcinomas are commonly gestational and intrauterine or gonadal in origin. Nongestational and extragonadal disease, especially in the stomach is extremely rare with a poorer prognosis and early metastasis. We herein describe a case of primary gastric choriocarcinoma with liver metastasis in a 69-year-old male. The patient presented with abdominal pain and irregular bowel habits of one month duration. Both endoscopic and radiographic imaging revealed an ulcerated and necrotic circumferential tumor in the pyloric antrum of the stomach. The histopathologic findings of the resected tumor were that of an extensively necrotic and hemorrhagic neoplasm with combined choriocarcinomatous and adenocarcinomatous element. A strongly positive immunohistochemical staining for β- subunit of human chorionic gonadotropin (β-HCG) in the choriocarcinomatous component and a proper correlation with elevated serum β-HCG levels confirmed the diagnosis.

Morphology and mechanism research of gastric cancer vasculogenic mimicry / 重庆医科大学学报

Objective:Vasculogenic mimicry(VM) is a new microcirculation form of tumor cells which found resent years. This research observed whether gastric cancer SGC-7901 cells can form vasculogenic mimicry in 3-dimentional culture and had a primer examination on its mechanism. Methods:Put SGC-7901 cells in 3-dimentinal culture and observed if it could form vasculogenic mimicry. Immunohischemistry tested the MMP-2 and MT1-MMP level of 3-dimentional cultured SGC-7901 cells. Observe the effect of PI3K way inhibitor on MMP-2、MT1-MMP level and VM formation of gastric cancer cells. Results:Gastric cancer SGC-7901 cells can form VM in 3-demintional culture. MMP-2 and MT1-MMP highly expressed in gastric cancer cells that took part in the tube structure. PI3K way inhibitor decreased MT1-MMPmRNA and MMP-2 protein level and inhibited VM formation of SGC-7901cells. Conclusion:Gastric cancer SGC-7901 cells had the ability to form vasculogenic mimicry in vitro 3-dimentional culture.One of its mechanism was probably through decreasing MT1-MMP and MMP-2 level.

Application of laparoscopic local resection for gastric tumors / 上海第二医科大学学报

Objective To evaluate the clinical application of laparoscopic local resection for gastric tumors.Methods Twenty-three patients with gastric tumors who were performed laparoscopic gastric local resection were retrospectively analyzed with the size of tumor,location of tumor,operative time,blood loss during the operation,time for passage of flatus,post-operative hospital stay,operative complications,post-operative pathological findings and result of follow-up.Results Twenty-three patients were successfully performed laparoscopic local resection,including 8 laparoscopic wedge resection(LWR)and 15 intragastric mucosal resections(IGMR),with no conversion to open surgery.The mean size of gastric tumor was(2.8?1.3)cm,the mean operative time was(82.2?35.5)min,the mean blood loss was(26.5?15.3)mL,the length of incision was(3.1?1.1)cm,the time for passage of flatus was(2.1?0.9)d,and the mean post-operative hospital stay was(7.8?2.0)d.Two patients(8.7%)were found with postoperative gastric mucosal blee-ding and were recovered well through non-operative treatment.The median time of follow-up was 12 months(2-45 months),and no recurrent tumor was observed.Conclusion Laparoscopic local resection is a feasible,safe,effective and less invasive procedure for gastric tumors.

Expression of endocrine glands-derived-vascular endothelial growth factor in human gastric cancer tissue / 中国癌症杂志

0.05).The expression of EG-VEGF in the gastric cancer tissue was 41.6?13.3,which significantly higher than that in tissue near gastric cancer and normal gastric tissue(P

Anti-tumor Effect and Mechanism of SEA-Fab' Coupled Protein on Gastric Tumor / 华中科技大学学报（医学）（英德文版）

The anti-tumor effect and mechanism of SEA-Fab' coupled protein on gastric tumor was studied. The target cell Walker-256 was treated with SEA-Fab' synthesized chemically or SEA respectively for 24 h, 36 h or 72 h. PBMC+Walke-256 cells served as controls. The apoptotic index of SEA-Fab' against effector cells was detected. In the mouse gastric cancer models (n=60), SEAFab', SEA and normal saline was injected in experimental group, SEA group and control group respectively. The occurrence and weight of tumor was observed. The results showed that the apoptotic index was significantly higher in the SEA-Fab' (34.6 %-68.9 %) and SEA group (15.5 %-31.9 %) than in PBMC+Walker-256 group (5.5 %-12.8 %) with the difference being significant (P＜0.01). And there was significant difference between SEA-Fab' group and SEA group (P ＜0. 01). The tumor weight in SEA-Fab', SEA and control groups was 3. 64±0. 53 g, 0. 78±0.26 g and 0.49 ±0.17 g respectively with the difference being statistically significant between the SEAFab' group, SEA group and the control group (P＜0.01). In the SEA-Fab's and SEA groups,there were CD4+ T and CD8+ T cell infiltrates, but in the cotnrol group, no or few T lymphocytes were seen in the mouse tumor tissue. It was concluded that SEA-Fab' was more effective to activate T lymphocytes to kill the tumor cells than SEA used alone. It was feasibility by using the monoclonal antibody as carrier to perform the targeted immunotherapy of gatric tumor.

Clinical Analysis of Post-operative Complications in Gastric Tumors

PURPOSE: The incidence of complications after gastric tumor surgery has been decreasing, because of properly chosen and improved surgical techniques and procedures. But the incidence of several complications that result in relatively high mortality remains stubbornly high. To predict and prevent postoperative complications in gastric tumor treatment, we retrospectively analyzed gastric tumor patients who underwent elective gastrectomy. METHODS: This is a retrospectively study of 1,028 patients with gastric tumor who underwent elective surgery at the Department of Surgery, Ulsan University College of Medicine and Asan Medical Center between January 1999 and December 1999. Non-curative surgery was defined in cases of peritoneal seeding, distant lymph node metastasis and residual tumor in the resection margin. RESULTS: There were no significant differences in age, hemoglobin, albumin, operation time, extent of lymph node dissection, surgical procedure or stage (P>0.05). The complication rate after non-curative resection was higher (11.7%) than that for curative resection (5.9%) (P<0.05). The complication rate was higher (12.3%) in patients who had combined diseases than in those who did not (4.9%) (P<0.05), and was higher (13.2%) in patients who underwent combined resection than in those who did not (5.0%) (P<0.05). CONCLUSION: In patients who had combined diseases and underwent combined resection, the complication rate was significantly higher. But, if more attentive preoperative evaluation and intraoperative caution are exercised in patients who exhibit preoperative risk factors, the incidence of post operative complication is expected to diminish.