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Objective:To investigate the efficacy of different laparoscopic surgeries for gastrointestinal stromal tumors (GIST) of gastric cardia and fundus.Methods:The retrospective cohort study was conducted. The clinicopathological data of 251 patients with GIST of gastric cardia and fundus who underwent laparoscopic radical resection in 14 medical centers, including Guangdong Provincial People′s Hospital et al, from December 2007 to December 2021 were collected. There were 123 males and 128 females, aged 58(24,87)years. Observation indicators: (1) treatment; (2) clinicopathological data of patients undergoing different laparoscopic surgeries; (3) subgroup analysis for special laparoscopic techniques. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test or ANOVA. Measure-ment data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test or Kruskal-Wallis H test. Count data were described as absolute numbers or percentages. Comparison of ordinal data was conducted using the rank sum test. Results:(1) Treatment. Of the 251 patients,202 cases underwent gastric wedge resection, 26 cases underwent special laparoscopic techniques including 10 cases with serotomy and dissection and 16 cases with transluminal gastrectomy, 23 cases underwent structural gastrectomy including 6 cases with total gastrectomy and 17 cases with proximal partial gastrectomy. There were 24 patients had postoperative complications after surgery. (2) Clinicopathological data of patients undergoing different laparoscopic surgeries. The gender (male, female), age, tumor diameter, operation time, volume of intraoperative blood loss, length of incision, time to postoperative initial whole liquid food intake, time to postoperative initial semi-liquid food intake, duration of postoperative hospital stay, cases with perioperative complications, cases with mitotic count as ≤5/50 high power field, 6?10/50 high power field, >10/50 high power field, cases be classified as very low risk, low risk, medium risk, high risk according to the National Institutes of Health risk classification, cases with tumor located at fundus and gastric cardia were 93, 109, (59±11)years, 3.50(0.40,10.00)cm, 88.00(25.00,290.00)minutes,20.00(25.00,290.00)mL, 4.00(2.00,12.00)cm, 3.00(1.00,9.00)days, 4.00(1.00,16.00)days, 5.00(1.00,18.00)days, 14, 164, 31, 7, 47, 83, 50, 22, 30, 172 in patients undergoing gastric wedge resection, respectively. The above indicators were 19, 7, (49±14)years, 2.55(0.20,5.00)cm, 101.00(59.00,330.00)minutes, 27.50(2.00,300.00)mL, 4.50(0,6.00)cm, 2.50(1.00,10.00)days, 4.00(1.00,16.00)days, 6.00(1.00,18.00)days, 3, 20, 5, 1, 15, 5, 2, 4, 24, 2 in patients undergoing special laparos-copic techniques, and 11, 12, (52±10)years, 5.00(0.80,10.00)cm, 187.00(80.00,325.00)minutes, 50.00(10.00,300.00)mL, 6.00(4.00,12.00)cm, 4.00(2.00,8.00)days, 6.00(3.00,14.00)days, 8.00(2.00,18.00)days, 7, 11, 5, 7, 2, 6, 6, 9, 13, 10 in patients undergoing structural gastrectomy. There were significant differences in the above indicators among the three groups of patients ( χ2=6.75, F=10.19, H=17.71, 37.50, 35.54, 24.68, 16.09,20.20, 13.76, χ2=13.32, Z=28.98, 32.17, χ2=82.14, P<0.05). (3) Subgroup analysis for special laparoscopic techniques. The time to postoperative initial whole liquid food intake, time to postoperative initial semi-liquid food intake, classification of tumor location (endophytic type, exophytic type, parietal type) were 4.50(1.00,10.00)days, 8.00(3.00,12.00)days, 0, 8, 2 in patients undergoing serotomy and dissection, versus 2.00(1.00,4.00)days, 3.00(1.00,6.00)days, 16, 0, 0 in patients undergoing transluminal gastrectomy. There were significant differences in time to postoperative initial whole liquid food intake, time to postoperative initial semi-liquid food intake between them ( Z=-2.65, -3.16, P<0.05); and there was a significant difference in classification of tumor location between them ( P<0.05). Conclusions:Gastric wedge resection is the most commonly used laparoscopic technique for GIST of gastric cardia and fundus. The application of special laparoscopic techniques is focused on the GIST of cardia to preserve the function of the cardia.
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Objective:To analyze the clinicopathological characteristics of differentiated early cardia cancer and to evaluate the short-term and long-term efficacy of endoscopic submucosal dissection (ESD).Methods:A total of 329 patients (331 lesions) who underwent ESD at Nanjing Drum Tower Hospital from October 2014 to December 2019 and were pathologically confirmed as differentiated early cardia cancer were included in the study and followed up. The endoscopic and pathological data of patients were reviewed to analyze the clinicopathological characteristics of differentiated early cardia cancer. The short-term (including en bloc resection rate, curative resection rate and incidence of short-term complications) and long-term efficacy (including incidence of metachronous cancer, recurrence and distant metastasis, and overall survival rate) of ESD was evaluated.Results:The ratio of male to female in 329 patients with differentiated early cardia cancer was 4∶1, and their age was 65.69±8.02 years. Tumor diameter of ≤2.0 cm accounted for 65.9% (218/331). Most lesions were located on the posterior wall (50.5%, 167/331), followed by the minor curve (36.3%, 120/331). The endoscopic morphology of 0-Ⅱc type accounted for 49.5% (164/331). There were 69.8% (231/331) lesions confined to the mucosal layer. The en bloc resection rate was 100.0% (329/329), and the curative resection rate was 83.3% (274/329). Short-term complications occurred in 28 patients (8.5%). With a median follow-up time of 39 months, 11 patients (3.3%) developed metachronous cancer, 2 (0.6%) developed distant metastasis, and no recurrence occurred. Seven patients died, and the overall survival rate during the follow-up period was 97.9% (322/329). The survival rate of patients with curative resection and additional surgery was 100.0% (3/3), while that without additional surgery was 99.3% (269/271). The survival rate of patients with non-curative resection and additional surgery was 96.0% (24/25), and that without additional surgery was 86.7% (26/30).Conclusion:Most differentiated early cardia cancers are well-differentiated adenocarcinomas, with less than 2 cm in diameter at the time of diagnosis with a low rate of ulcer and vascular invasion. ESD is safe and effective for the treatment of differentiated early cardia cancer with a high rate of curative resection, fewer intraoperative and postoperative complications, low incidences of metachronous cancer, distant metastasis and recurrence, and a high overall survival rate. However, additional surgical treatment is recommended for patients with non-curative resection.
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Objective:To investigate the incidence rate of upper digestive tract cancer in Cixian, China, a particular area with high inci-dence of esophageal cancer. Methods:Statistical analysis was performed on the 2003-2012 incidence data of upper digestive tract can-cer in Cixian. The annual incidence rate, Chinese population standardized incidence rate (the bid rate), and structure of world popula-tion standardized incidence rate (referred to as the world standard rate) were calculated. The incidence data were divided into two groups according to period (2003-2007 and 2008-2012), and different age groups were compared. Results:From 2003 to 2012, the in-cidence of upper gastrointestinal cancer was 165.36/10 million. The 2003-2007 crude incidence rate was 171.55/10 million), whereas 2008-2012 crude incidence rate was 151.41/10 million which has reduced over the last five years. Esophageal cancer incidence from 2003 to 2012 had a crude incidence rate of 108.05/10 million during the two periods (from 2003 to 2007, the incidence rate was 116.87/10 million;and from 2008 to 2012, 99.58/10 million), the crude incidence rate of the latter 5-year period has declined obvious-ly. From 2003 to 2012, the overall crude incidence rate of cardia cancer was 31.21/10 million, comparison of two peaiods (from 2003 to 2007 was 29.11/10 million, and 2008-2012, 33.23/10 million) indicated that the level of measurement of the latter period in-creased. At the same period, the overall incidence rate of gastric cancer was 26.10/10 million, comparison of the two periods (2003-2007 the crude incidence rate was 25.57/10 million, 2008-2012 was 26.60/10 million) indicated that the level of the parameter in the latter 5 years increased slightly. Conclusion:The incidence of esophageal cancer in Cixian decreased significantly, but the area remains to have the highest incidence rate of cardiac cancer morbidity. The incidence rate of distal gastric cancer increased significantly in males but decreased slightly in females, which suggests that early diagnosis and treatment of gastric cardia and distal stomach cancer is extremely important.
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Aim To investigate the selective inhibition of ethanol on muscarinic receptor-or 5-HT receptor-me-diated contractile responses in the circular smooth mus-cle strips isolated from the different regions of rat stom-ach. Methods Circular muscle strips isolated from the rat gastric fundus, body, cardia and pylorus were prepared, and the contractile responses to carbachol ( CCh ) or 5-HT were recorded. Results Ethanol (0. 000 05~0. 000 5, V/V) did not affect the contrac-tile response to CCh in circular muscle strips from the rat gastric fundus and cardia, and that to 5-HT in the strips from rat gastric fundus and body ( P >0. 05 ) . However, ethanol(0. 000 1 and 0. 000 5) significantly inhibited the Emax value of the contraction by CCh from (12. 18 ± 0. 33) g of control level to (10. 88 ± 0. 41) g and -lgEC50 value from ( 6. 33 ± 0. 05 ) of control level to (6. 12 ± 0. 06)(P <0. 05) in the strips from rat gastric body. Ethanol(0. 000 1 and 0. 000 5) also significantly inhibited the Emax value of the contraction by CCh from (2. 87 ± 0. 15) g of control level to (2. 2 ± 0. 13) g and -lgEC50 value from (6. 49 ± 0. 10) of control level to (6. 05 ± 0. 09)(P<0. 01) in the strips from rat gastric pylorus. Moreover, ethanol ( 0. 000 1 and 0. 000 5) significantly inhibited the Emax value of the contraction by 5-HT from (2. 93 ± 0. 35) g of con-trol level to ( 2. 1 ± 0. 30 ) g ( P<0. 05 ) , but did not affect the -lgEC50 value in the strips from rat gastric cardia. Conclusions Ethanol inhibits the contractile responses to 5-HT only in the circular muscle strips of rat gastric cardia, and it inhibits the contractile respon-ses to CCh more strongly in the circular muscle strips of gastric pylorus than gastric body. In those gastric circular muscle strips, ethanol decreases both the ac-tivity and affinity of CCh to muscarinic receptors, but decreases only the activity of 5-HT to its receptors.
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Objective To investigate the diagnostic value of combined examination of homocysteine (Hcy) and CEA for male patients with gastric cardia cancer.Methods Serum concentration of Hcy,CEA,CA199,CA724,CA242 and TPS in 54 male patients with gastric cardia cancer and in 30 healthy men were measured.The diagnostic efficacy was analyzed between the combination of Hcy,CEA and the combination of Hcy,CEA,CA199,CA724,CA242,TPS.Results Total Hcy,CEA levels were significantly increased in patients group compared with control group ((20.3±9.2) μmol/L vs (13.7±3.1) μmol/L,(7.8±3.5) μg/L vs (1.6±1.2) μg/L,P ＜ 0.05).The sensitivity,specificity and accuracy of the combination of CEA,CA199,CA724,CA242 and TPS were 73.6 ％,64.5 ％ and 70.2 ％ respectively,while those of the combination of Hcy,CEA were 92.5 ％,64.5 ％ and 82.1％,respectively.There was significant difference between the combination of Hcy,CEA and the combination of CEA,CA199,CA724,CA242 and TPS (P ＜ 0.05).Conclusion Combined detection of Hcy and CEA is helpful for diagnosis in male patients with gastric cardia cancer.
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Objective To describe the time trend of esophageal and gastric cardia adenocarcinomas in Chongqing of China in the past 30 years .Methods The medical records of all patients who underwent gastroscopy from Janaury 1983 to December 2012 at the Southwest hospital were reviewed .The rate of endoscopic detection and proportion of adenocarcinoma in all upper gastrointestinal tumors (esophageal adenocarcinoma ,esophageal squamous cell carcinoma ,gastric cardia adenocarcinoma and gastric non-cardiac ad-enocarcinoma) were compiled and serial comparisons were made .Results 435 829 patients who underwent gastroscopy were re-viewed .Totally ,there were 352 patients with esophageal adenocarcinomas(0 .08% ) ,10 301 with esophageal squamous cell carcino-mas(2 .40% ) ,3 058 with gastric cardia adenocarcinomas(0 .70% ) and 5 543 with gastric non-cardiac adenocarcinomas(1 .30% ) .O-ver the 30-year period ,the rate of endoscopic detection of esophageal adenocarcinomas did not show a statistically significant .How-ever ,the proportion of esophageal adenocarcinomas increased from 1 .90% to 3 .20% ,suggesting an increased proportions .The rate of endoscopic detection of gastric cardia adenocarcinomas increased from 0 .70% to 0 .81% and the proportions of gastric cardia ade-nocarcinomas increased from 25 .30% to 38 .30% .Conclusion Over the 30-year period ,it seems that the incidence of esophageal adenocarcinoma had increased .An increasing trend of gastric cardia adenocarcinoma is also observed in this study ,especially in male patients .
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Background and purpose:RASSF10 acts as a kind of tumor suppressor in various tumor tissues, but researches in cardiac adenocarcinoma has not been reported. This study aimed to detect the methylation status and expression ofRas-association domain family 10 (RASSF10) in gastric cardia adenocarcinoma (GCA), and explore its role in occurrence and development of GCA.Methods:Methylation speciifc polymerase chain reaction (MSP), reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry method were respectively used to detect methylation status, mRNA expression and protein expression ofRASSF10 in 81 GCA tissues and corresponding normal tissues.Results:The promoter methylation frequency ofRASSF10 in GCA tissues (64.20%, 52/81) was signiifcantly higher than that in corresponding normal tissues (20.99%, 17/81,P<0.05), and was closely correlated with TNM stages, differential degree and lymph node metastasis (P<0.05). RASSF10 mRNA expression in GCA tissues (0.57±0.05) was significantly lower than that in corresponding normal tissues (0.78±0.02,P<0.05), and was closely correlated with TNM stages and lymph node metastasis (P<0.05). Protein expression of RASSF10 in GCA tissues (31.10%, 26/81) was signiifcantly lower than that in corresponding normal tissues (71.60%, 58/81,P<0.05), and was closely correlated with TNM stages, differential degree and lymph node metastasis (P<0.05). The promoter methylation frequency ofRASSF10 in GCA tissues was inversely related to its protein expression.Conclusion:Inactivation of RASSF10 caused by aberrantmethylation in the promoter region may be closely correlated with the GCA tumorgenesis.
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Objective To evaluate the changes and clinical significance ot the serum levels of homocysteine (Hcy) in gastric cardia cancer patients before and after surgery.Methods Serum Hcy concentrations of 102 patients with gastric cardia cancer (including 69 case of males) and 50 healthy human were measured by enzymatic cycling assay.Results Total Hcy levels were significantly increased in male patient group compared with the levels in control group (t =5.143,P =0.001).Hcy levels were significantly lower in postoperative group compared with preoperative group [(17.08±5.31) μmol/L vs (20.34±9.26) μmol/L,(14.07±4.87) μmol/L vs (20.34±9.26) μmol/L,P ＜ 0.05].Compared with Ⅳ stage group and other TNM stage groups,significantly lower levels of Hcy were detected in patients with gastric cardia cancer (t =2.306,3.285,P =0.030,0.002).Hcy levels in patients with gastric cardia cancer were also significantly higher than those in the tumor length ＜ 3 cm,3-5 cm and ＞ 5 cm groups (t =2.461,2.147,P =0.017,0.038).Multiple logistic regression analysis indicated a statistically significant association between serum Hcy concentration and gastric cardia cancer incidence (OR =1.136,95 ％ CI 1.010-1.278,P =0.033).Increasing serum Hcy levels were significantly associated with a decreasing risk of metastatic lymph node (OR =0.865,P =0.010).Conclusion Serum Hcy levels are directly associated with risk of male patients with gastric cardia cancer,and play important roles in the development of gastric cardia cancer.
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Objective To investigate the effect of different operative approaches on perioperative respiratory and cardiac function of patients with gastric cardia carcinoma. Methods The perioperative changes of SpO2 ,Breath Rate (BR) and Heart Rate(HR) of patients with gastric cardia carcinoma underwent surgical therapies through transthoracic ( n = 30 ), transabdominal ( n = 37 ) or trans-thoracoabdominal ( n = 10 )approaches were compared respectively. Results On the postoperative 1st,2nd,4th and 7th day,the changes of BR in transthoracic (5. 20 ± 0. 96,5. 17 ± 1. 58,3.93 ± 1.53,2. 63 ± 1.25 )/min and trans-thoracoabdominal (5.80 ±0. 79,6. 10 ± 1.20,4. 80 ± 1.32,3.00 ± 1.49)/min approach groups were significantly greater than that of transabdominal group (4. 35 ± 1.06,3.89 ±0. 99,2. 24 ± 1.30,1.16 ±0. 65)/min (Ps ＜0. 05). At the meanwhile, the changes of SpO2 at 2nd, 4th postoperative day of transthoracic ( [ 8. 30 ± 1.95 ] %, [ 7.23 ±2. 01 ] % ) and trans-thoracoabdominal ( [ 8.60 ± 1.43 ] %, [ 7. 70 ± 2. 11 ] % ) approach groups were significantly greater than that of transabdominal group ( [ 7. 08 ± 1.82 ] %, [ 6.24 ± 1.88 ] % ) ( Ps ＜ 0. 05 ), but there were no significant differences observed among three groups on the postoperative 1st,7th day. On the postoperative 1 st,2nd and 4th day, the changes of HR of transthoracic ( 18.00 ± 3.79,13.47 ± 4. 42,8. 60 ±4. 13 )/min and trans-thoracoabdominal ( 19. 80 ± 4. 96,14. 80 ± 3.33,8.70 ± 3.47)/min approach groups were significantly greater than that of transabdominal group ( 13.62 ± 4. 00,10. 84 ± 4. 16,6. 32 ± 2. 53 )/min, too (Ps ＜0. 05) ,but no differences were observed among three groups on the postoperative 7th day (Ps ＞0. 05).Coniclusion Transthoracic,transabdominal and trans-thoracoabdominal approachs resulted in different effects on respiratory and cardiac function in patients with gastric cardia carcinoma.
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Objective: To observe the therapeutic action of earth enteral nutrition after jejunum interposition in patients with carcinoma of gastric cardia.Methods: Sixty-two patients after jejunum interposition were divided into early enteral nutrition group(n=33) and parenteral alimentation group(n=29).The clinical observation index and nutrition index were compared between the two groups.Results: The enteral nutrition group had more advantages than the parenteral alimentation group in the aspects of clinical observation index postoperative complication and nutrition index.Conclusion: Early enteral nutrition could improve gastrointestinal function and nutritional state and decrease the incidence rate of postoperative complication.
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PURPOSE: The aim of this study was to determine proportions of upper third gastric cancer (UTG) among all gastric cancers and analyze clinicopathological features of the disease. MATERIALS AND METHODS: The medical records of 12,300 patients who underwent gastric surgery between 1986 and 2006 at Seoul National University Hospital (SNUH) were retrospectively reviewed. Clinicopathological features of 1,260 patients with UTG and 9,929 patients with middle or lower third gastric cancer (MLG) were compared, and annual proportions of UTG were evaluated. RESULTS: The proportion of patients with UTG rapidly increased from 2.6% in 1986 to 12.5% in 1992. However, linear regression analysis showed that the rate of increase was reduced (0.21%/year) after 1992 (12.5% to 14.2% from 1992 to 2006). Compared with the MLG group, the UTG group had a lower proportion of (22.3% vs. 39.7%, P<0.001) and a greater proportion of stage III/IV disease (39.4% vs. 31.7%, P<0.001). The UTG group also had larger tumors than the MLG group in stages I/II and III (3.5 cm/5.3 cm/6.5 cm vs. 3.2 cm/5.0 cm/5.8 cm, P=0.020/0.028 /<0.001), a higher proportion of undifferentiated cancer (63.1% vs. 53.7%, P<0.001), and less intestinal Lauren's type (38.8% vs. 47.4%, P<0.001). The 5-year survival rate of the UTG group was significantly lower than that of the MLG group in stages I/II and III (85.6%/63.1%/34.2% vs. 91.6%/ 69.2%/44.7%, P<0.001/0.028/0.006). CONCLUSIONS: The proportion of UTGs has increased over the last two decades at SNUH, but the rate of increase has been greatly reduced since 1992. The UTG group showed a poorer prognosis compared with the MLG group in stages I/II and III.
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Humans , Gastric Fundus , Incidence , Linear Models , Medical Records , Prognosis , Retrospective Studies , Stomach Neoplasms , Survival RateABSTRACT
PURPOSE: The aim of this study was to determine proportions of upper third gastric cancer (UTG) among all gastric cancers and analyze clinicopathological features of the disease. MATERIALS AND METHODS: The medical records of 12,300 patients who underwent gastric surgery between 1986 and 2006 at Seoul National University Hospital (SNUH) were retrospectively reviewed. Clinicopathological features of 1,260 patients with UTG and 9,929 patients with middle or lower third gastric cancer (MLG) were compared, and annual proportions of UTG were evaluated. RESULTS: The proportion of patients with UTG rapidly increased from 2.6% in 1986 to 12.5% in 1992. However, linear regression analysis showed that the rate of increase was reduced (0.21%/year) after 1992 (12.5% to 14.2% from 1992 to 2006). Compared with the MLG group, the UTG group had a lower proportion of (22.3% vs. 39.7%, P<0.001) and a greater proportion of stage III/IV disease (39.4% vs. 31.7%, P<0.001). The UTG group also had larger tumors than the MLG group in stages I/II and III (3.5 cm/5.3 cm/6.5 cm vs. 3.2 cm/5.0 cm/5.8 cm, P=0.020/0.028 /<0.001), a higher proportion of undifferentiated cancer (63.1% vs. 53.7%, P<0.001), and less intestinal Lauren's type (38.8% vs. 47.4%, P<0.001). The 5-year survival rate of the UTG group was significantly lower than that of the MLG group in stages I/II and III (85.6%/63.1%/34.2% vs. 91.6%/ 69.2%/44.7%, P<0.001/0.028/0.006). CONCLUSIONS: The proportion of UTGs has increased over the last two decades at SNUH, but the rate of increase has been greatly reduced since 1992. The UTG group showed a poorer prognosis compared with the MLG group in stages I/II and III.
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Humans , Gastric Fundus , Incidence , Linear Models , Medical Records , Prognosis , Retrospective Studies , Stomach Neoplasms , Survival RateABSTRACT
Objective To investigate forte and technique in radical correction of gastric eardia carcinoma (esophagojejunostomy and gastric stump esophago anastomosis). Methods 753 Patients with gastric cardia carcinoma admitted to our hospital from 1998 to 2007 treated with radical correction by jejuno-osophagus an-astomosis and esophagogastric anastomosis to digestive tract reconstruction, circular staplers were used in all cases. Results There was no death (no leakage、bleeding and stricture of anastornotic entrance stenosis)in these cases by thoracoabdominal approach 6 cases, anastomotic leakage 0 case, pero-eutting 2 cases, steno-sis 4 cases, infection of abdominal cavity 1 case, diaphragmatic hernia 1 case, pathologic diagnosis of exam-ple after operation , the upper cut positive 1 case, the lower cut negative in all cases. Conclusions in rad-ical correction gastric cardia carcinoma, the application of circular stapler makes this procedure simple, reli-ability, safety and time saving, descends the ratio of radical correction of gastric cardia carcinoma by thora-coabdominal approach, decreases surgical trauma, decurtate the period of recovery following an illness, pre-vent the complications of post-operation such as the leakage and stricture of anastomotic entrance. But the applieation of circular stapler is not absolutely trustworthy, there are also any ratio of leakage ,haemorrhage and stricture of anastomotic entrance, the technique worth summarizing and investgating in the future.
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Objective To characterise the alterations of serum autoantibodies for cyclinB1,p62,Koc-IMP1 and survivin in the subjects with esophgeal and gastric cardia carcinoma and precancerous lesion and their expres-sions in the esophageal and gastric cardia cancer tissue.Methods Enzyme-linked immunoassay and tumor-associated antigen mini-array (consisting of five full-length recombinant proteins,including eyefinB1-p62-Koc,IMP1 and Survivin)were applied to determine the serum level of the autoantibodies of these antigens on 376 subjects with e-sephageal and gastric cardia carcinoma and precancerous lesions.At the same time,the expression of these antigens was detected by immunohistochemical method(ABC)on 13 patients with esophageal cancer and 16 with gastric car-dia cancer.Results All of the 5 antigens determined,the linear correlation Was observed for the detection frequency of cyclinB1,IMPI and p62 in esophageal carcinogenesis,and for p62 in gastric cardia multi-stage progression from normal to precancerous and cancerous lesions(P<0.05).The detection rale with single positive antoantibody im-munoreactivity for both esophageal and gastric cardia cancers were low.However.the positive detection mte for both esophageal and gastric cardia cancer increased apparently when the multiple positive markers were combined together for analysis,which increased tO 3～5 and 3～4 folds respectively.Furthermore,the difference in autoantibody immu-noreactive rate was significant with the lesion progressed from mild tO severe precancerous lesions and to cancer both in esophageal and gastric cardia cancers(P<0.05).The positive immunoreactions of the 5 antigens were detected in cancer tissues.The positive immunostaining rates for cyclinB1,Koc,IMP1 and Survivin both in esophageal and gastric cardia cancers were higher compared to their serllin positive rate of autoantibodies I P<0.05).Of the pa-tients with positive immunostaining in the two cancer tissues,the autoantibodies in the serum for the corresponding antigens could be detected in the same patient.Conclusion The production of the tumor-associated autoantibodies is related tO antigens.The screening rate through serum tumor-associated antigen mini-array for the patients with e-sophageal and gastric cardia carcinoma and precancerous lesions has been increased apparently with combined analy-sis of multiple autoantibodies than with single one.
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First described in 1926 by Abrikossoff, a granular cell tumor is a benign lesion and commonly involves the skin, connective tissue, and breast, but rarely the esophagus. The origin of granular cell tumors is controversial. The tumor is thought to arise from a Schwann cell origin, based on characteristics such as the positive expression of S-100 protein determined by immunohistochemical staining. A 29-year-old female was referred from the local clinic because of a polypoid lesion in the gastric cardia. After performing endoscopy and endoscopic ultrasonography, a 1.5 cm submucosal tumor covered with normal mucosa was found in the gastric cardia. Endoscopic mucosal resection revealed a tumor that initiated in the esophagus, and grew into the cardia. Immunohistochemical analysis revealed strong positive staining for S-100 protein, confirming the presence of a granular cell tumor.
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Adult , Female , Humans , Breast , Cardia , Connective Tissue , Endoscopy , Endosonography , Esophagus , Granular Cell Tumor , Mucous Membrane , S100 Proteins , SkinABSTRACT
Objective To explore the relationship between the amount of CD3+ T cells in gastric cardia carcinoma(GCC)samples and the clinical pathological index of GCC.Methods Immunohistochemical Elivision method was used to detect CD3+T cells in 42 cases of GCC samples,18 cases of paraneoplastic tissue and 12 cases of normal cardiac mucosa tissue.The relationship between CD3+ T cell and the clinical pathological index was analysed.Results(1)The order of the mean number of CD3+ T cells from high to low was paraneoplastic tissue,GCC and normal mucosa(P0.05).(3)The mean number of CD3+ T cells was negatively correlated with the depth of carcinoma invasion and the lymphatic metastisis(P
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Purpose:To evaluate the effects of intraoperative radiotherapy for adenocarcinoma gastric cardia.Meth- ods:From Jan.1992 to Dec.2000 a trial on intraoperative radiotherapy for AGC was carried out in 38 patients.Whose age was younger than 75 years,at least on semiliquid diet and no contraindication of surgery.6MV or 9MV-E photon was used for the intraoperative radiation therapy to the cardia,lower segment of the esophagus,fundus,lesser curvature and hepato- gastric ligament.Results:Average follow up 65 months.The 5 year survival rates were 39.4%.Conclusions:Intraoperative radiation therapy is able to improve the results of surgery for adenocarcinoma of the gastric cardia.
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Objective To reseach the way of rising resectable rate,reducing operative mortality,enhancing long-term effect and higher life quality in postoperation for cancers of esophagus and gastric cardia.Method Operation outcome of 2837 cases for cancers of esophagus and gastric cardia and followed-up were analysed.Results Overall resectability was 98.7%,and postoperative mortality was 0 92% in the group.Survival rates of 3 and 5 years were 48.9% and 33.7%,respectively.Factors affecting long-term survival were those of depth of tumor invasion and lymph nodes metastasis and oncologic staging.It was higher for cervical lymph nodes metastasis within 3 years after operation.Conclusions Early discovery and timely treatment,an appropriate enlarging resectable field and comprehensive therapies are the key to improve the long-term survival.
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OBJECTIVE:To evaluate the application value of water-soluble vitamin for injection in the treatment of pe-rioperative esophagus cancer and carcinoma of gastric cardia.METHODS:80patients with esophagus cancer or carcinoma of gastric cardia were randomly divided into control group and treatment group,the control group were treated with total par-enteral nutrition(TPN)therapy only while the treatment group were treated with one bottle of water-soluble vitamin for in-jection,q.d.for7days besides the TPN therapy.RESULTS:The volume ejections of Vit B 1 ,Vit B 2 and Vit Vit C in the treatment group showed significantly higher than those of the control group from the urine loading tests after receiving drugs for4hours(P
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Background and Purpose:dPET/CT is very expensive,so although the accuracy of hPET/CT is less than dPET/CT,it is better than CT,and is useful for guiding the tumor staging before operation.This paper is evaluate the role of ~(18)F-fluorodeoxyglucose(FDG) hPET/CT in primary carcinoma of gastric cardia detection.Methods:26 patients with histologically proven primary carcinoma of gastric cardia underwent whole body hPET/CT imaging.Visual and semiquantitative analysis and standardized uptake value(SUV) were used to analyze the images.The results of hPET/CT study were compared with those of CT.Results:1.The sensitivity of hPET/CT in primary carcinoma of gastric cardia detection was 92.3%(24/26);two cases of signet ring cell carcinoma gave false negative results,and the primary lesions were small(