Secondary amyloidosis with concomitant gastric GIST and gastric adenocarcinoma - A case report

Secondary amyloidosis is a well-established entity and has been described in association with chronic inflammatory conditions such as rheumatoid arthritis, ankylosing spondylitis, bronchiectasis, tuberculosis, etc., It has also been reported in association with neoplasms such as Hodgkin's lymphoma, Waldenstrom's macroglobulinemia, renal cell carcinoma, lung carcinoma, etc. However, only a few case reports documenting the association of amyloidosis with gastrointestinal tumor (GIST) and gastric adenocarcinoma are available in the literature. Hereby, we report a case of a 74-year-old male who presented with colicky abdominal pain and vomiting. Ultrasonography revealed a common bile duct (CBD) stone and a small extra-luminal gastric mass. Endoscopic retrograde cholangiopancreatography (ERCP) was performed to remove the CBD stone which revealed an incidental finding of gastric ulcer. A biopsy was taken from the gastric ulcer which on histopathological examination was confirmed as adenocarcinoma leading onto total gastrectomy. During total gastrectomy, an inadvertent injury to the spleen led to simultaneous splenectomy. Multiple samples from the gastric ulcer, the extra-luminal gastric mass, and the spleen were subjected to histopathological examination. Gastric ulcer was confirmed as adenocarcinoma, gastric extra-luminal mass was confirmed as GIST, and splenic examination revealed widespread deposition of amyloid which on Congo-red stain imparted an apple-green birefringence on polarizing microscopy. To the best of our knowledge, this is the first-ever case of such an association where gastric adenocarcinoma occurred with concomitant gastric GIST and secondary amyloidosis of the spleen.

Clinical effects and pathological characteristics of gastric tumors of fundic gland type treated with endoscopic submucosal dissection / 中华消化内镜杂志

To evaluate the clinical effects and pathological characteristics of gastric tumors of fundic gland type treated with endoscopic submucosal dissection (ESD), data of 7 patients who treated by ESD and whose postoperative pathology indicated gastric adenocarcinoma of fundic gland type or gastric oxyntic gland adenoma in Endoscopic Center of Beijing Chao-Yang Hospital of Capital Medical University from August 2018 to June 2022 were collected. The clinical characteristics, surgical complications, preoperative and postoperative pathological data and follow-up data were evaluated. The lesions of the 7 patients were all located at gastric fundus, and were treated by ESD successfully. No bleeding, perforation or other complications occurred during and after the operation. Postoperative pathology showed that tumor cells originated from deep mucosa with an invasive growth pattern. Most of tumor surfaces were covered with normal concave epithelium. Tumors infiltrated into submucosa in 4 patients, and submucosa infiltration depth was more than 500 μm (550 μm) in 1 patient. Immunohistochemistry showed that MUC-6 was diffusely positive, indicating that the tumor originated from the main cell source. The expressions of MUC-2, MUC-5AC, CDX-2, CD10, and CgA were negative in all cases. With the mean follow-up time of 21 months, the ulcer healed well after the operation, with no recurrence. Gastric tumors of fundic gland type have relatively unique biological characteristics, and ESD is the preferred treatment. In addition, the histological characteristics can be used to differentiate from other gastric tumors by immunohistochemistry.

Estadiaje ganglionar en el adenocarcinoma gástrico / Lymph node stage in gastric adenocarcinoma

Resumen Objetivos: El sistema linfático del estómago es complejo y multidireccional, siendo difícil predecir el patrón de diseminación linfática en el adenocarcinoma (ADC) gástrico. Los objetivos de este trabajo son determinar si el analizar los grupos ganglionares de la pieza quirúrgica por separado tiene implicaciones en el estadiaje, además estudiar la afectación de diferentes grupos ganglionares. Materials y Método: Estudio observacional retrospectivo de pacientes intervenidos de gastrectomía y linfadenectomía con intención curativa por ADC en un hospital de referencia (2017-2021).,_Se han comparado aquellos pacientes cuya pieza quirúrgica se estudió en su totalidad (grupo A) con aquellos en los que se separaron los grupos ganglionares para su análisis (grupo B). En el grupo B, se ha analizado la afectación ganglionar de diferentes grupos ganglionares en base a la localización tumoral y el estadio pT. Resultados: Se incluyeron 150 pacientes. La media de ganglios analizados fue significativamente mayor cuando se separaron los grupos ganglionares (grupo B) (24,01 respecto a 20,49). La afectación ganglionar fue del 45,8%, 58,3% y 55,5% en los tumores de tercio superior, medio e inferior respectivamente, y los grupos difirieron en base a la localización tumoral. El riesgo de afectación ganglionar fue significativamente mayor y hubo más grupos ganglionares perigástricos afectos cuanto mayor era el estadio pT. Conclusiones: Separar los grupos ganglionares previo a su análisis aumenta el número de ganglios analizados mejorando el estadiaje ganglionar. Existen diferentes rutas de drenaje linfático dependiendo de la localización tumoral y la afectación ganglionar aumenta de forma paralela al estadio pT.

Objectives: The lymphatic system of the stomach is complex and multidirectional, making it difficult to predict the pattern of lymphatic spread in gastric adenocarcinoma (GAC). The aim of this paper is to determine if analyzing the lymph node groups of the surgical specimen separately has implications in the pathological staging, as well as to study the involvement rate of different lymph node groups. Material and Method: Retrospective observational study of patients who underwent curative intent gastrectomy and lymphadenectomy for GAC in a reference hospital (2017-2021). Those patients whose surgical specimen was studied as a whole (group A) were compared with those in whom the lymph node groups were separated by surgeons before analysis (group B). In group B, the involvement of different lymph node groups was analyzed based on tumor location and pT stage. Results: 150 patients were included. The mean number of lymph nodes analyzed was significantly higher when the lymph node groups were separately analyzed (group B) (24.01 compared to 20.49). Lymph node involvement was 45.8%, 58.3%, and 55.5% in tumors of the upper, middle, and lower third, respectively, and the involved groups differed depending on the tumor location. The higher the pT stage was, the risk of lymph node involvement was significantly higher and there were more perigastric lymph node groups affected. Conclusions: Separating lymph node groups prior to their analysis increases the number of lymph nodes analyzed and therefore improves lymph node staging. There are different lymphatic drainage routes depending on the tumor location and lymph node involvement increases in parallel with the pT stage.

Expression of HER2/neu in gastric adenocarcinoma and its correlation with serum HER2/neu level and E-cadherin expression

Aim: To assess HER2/neu expressions and correlate with E-cadherin and Serum HER2 level in gastric carcinoma. Method: 31 gastric biopsies and 1 resected specimen were taken in the study with patient details and stained with H and E for histopathological details following Lauren's classification. Immunohistochemistry for HER2 and E-cadherin expression was conducted followed by serum HER2/neu ELISA. Result: Adenocarcinoma with 61% diffuse, 29% intestinal, and 10% other type were observed with predominant HER2 immunoexpression in intestinal-type than in diffuse-type adenocarcinoma. Other observations marked 44% as 3+/positive and 56% as 2+/equivocal in intestinal type while 26% cases as 3+/positive, 69% as 2+/equivocal, and 1% as 1+/negative were observed in diffuse type. The data presented 33% membranous positivity and 67% both membranous + cytoplasmic positivity in intestinal type while 2% showed membranous positivity, 47% both membranous + cytoplasmic, and 42% only cytoplasmic positivity in diffused type. On comparing the localization pattern of HER2 and E-cadherin, 25% of cases showed membranous staining while 50% of cases showed membranous with cytoplasmic staining for both. No cytoplasmic HER2 staining as well as no any staining for E-cadherin was shown by 6% cases. Conclusion: Thus, it can be concluded that cytoplasmic expression of HER2 in gastric adenocarcinoma (mainly diffuse type) may be due to shedding of its extracellular domain, leading to loss of membranous E-cadherin expression on immunohistochemistry. The loss of membranous expression of E-cadherin and increased serum HER2 ELISA were correlated well with these findings.

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.

Morbimortalidad por cáncer gástrico en un servicio de cirugía general / Morbidity and mortality from gastric cancer in a general surgery service

RESUMEN Introducción: El cáncer de estómago representa la segunda causa más frecuente de muerte relacionada con neoplasias en el mundo, es responsable del 8 al 10 por ciento de todas las muertes por cáncer. Objetivo: Determinar la morbilidad y la mortalidad por cáncer gástrico en el servicio de cirugía del Hospital Universitario "General Calixto García". Métodos: Se realizó un estudio observacional descriptivo, transversal. El universo estuvo conformado por 145 pacientes que cumplieron con los criterios de inclusión. Se utilizaron métodos estadísticos descriptivos y cálculos con valores porcentuales. Resultados: El 67,6 por ciento de los pacientes pertenecían al sexo masculino, mientras que 87 se ubicaron en los grupos de edades entre 60 y 79 años. El 37,2 por ciento de los pacientes presentaron lesión ulcerada infiltrante de acuerdo a la clasificación endoscópica de Borrmann. El adenocarcinoma gástrico fue el tipo histológico más encontrado. La técnica quirúrgica más empleada fue la gastrectomía subtotal, y la gastroyeyunostomía. La complicación postoperatoria más frecuente la constituyó la bronconeumonía con 35 pacientes. La mayoría de los pacientes egresaron vivos. Conclusiones: La investigación sugiere que el diagnóstico precoz y la cirugía en la actualidad es la única modalidad con potencial curativo y puede elevar la calidad de vida y mejorar los índices de morbimortalidad en la población(AU)

ABSTRACT Introduction: Stomach cancer is the second leading cause of death related to neoplasms worldwide. It is responsible for 8-10 percent of all cancer-related deaths. Objective: To determine the morbidity and mortality for gastric cancer in the surgery service of General Calixto García University Hospital. Methods: A descriptive, cross-sectional and observational study was carried out. The universe consisted of 145 patients who met the inclusion criteria. Descriptive statistical methods and calculations with percentage values were used. Results: 67.6 percent of the patients belonged to the male sex, while 87 were located in the age groups between 60 and 79 years. 37.2 percent of the patients presented an infiltrating ulcerated lesion according to Borrmann endoscopic classification. Gastric adenocarcinoma was the most common histological type. The most used surgical technique was subtotal gastrectomy, followed by gastrojejunostomy. The most frequent postoperative complication was bronchopneumonia, accounting for 35 patients. Most of the patients were discharged alive. Conclusions: Research suggests that early diagnosis and surgery are currently the only modality with curative potential and can raise the quality of life as well as improve morbidity and mortality rates among the population(AU)

Comportamiento clínico, endoscópico e histológico del cáncer gástrico diagnosticado en el Hospital "Dr. Mario Muñoz Monroy" / Histological, endoscopic and clinical behavior of gastric cancer diagnosed in the Hospital "Dr. Mario Muñoz Monroy"

RESUMEN Introducción: en los últimos años, se aprecia a nivel global un aumento del cáncer gástrico. La mayoría de los tumores gástricos primarios son malignos. En Matanzas, existe un incremento de esta patología. Objetivo: determinar el comportamiento clínico, endoscópico e histológico del cáncer gástrico diagnosticado. Materiales y métodos: se realizó un estudio observacional, descriptivo y prospectivo en el Departamento de Gastroenterología del Hospital "Dr. Mario Muñoz Monroy", de la ciudad de Matanzas, en el período de enero del 2017 a octubre del 2019. El universo fue 25 pacientes que presentaron cáncer gástrico por diagnóstico endoscópico e histológico. Resultados: el grupo de edad más afectado correspondió a los pacientes entre 61 y 70 años, (44 %). El sexo masculino predominó en un 68 %. Los factores de riesgo de mayor incidencia, fueron la dieta inadecuada y el hábito de fumar. Las manifestaciones clínicas más relevantes fueron: epigastralgia, plenitud gástrica y pérdida de peso. La variedad hística que predominó fue el adenocarcinoma difuso y la localización el antro. Conclusiones: el cáncer gástrico constituye un problema de salud que, al actuar sobre los factores de riesgo se puede disminuir su incidencia; con un diagnóstico precoz se logrará disminuir la mortalidad (AU).

ABSTRACT Introduction: an increase of gastric cancer is appreciated in the world in the last years. Most of the primary gastric tumors are malignant. There is an increase of this disease also in Matanzas. Objective: to determine the histological, endoscopic and clinical behavior of the diagnosed gastric cancer. Materials and methods: a prospective, descriptive and observational study was carried out in the Department of Gastroenterology of the Hospital "Mario Munoz Monroy, of Matanzas, in the period from January 2017 to October 2019. The universe were 25 patients presenting gastric cancer by histologic and endoscopic diagnosis. Results: The most affected age group was the one of patients among 61 and 70 years old (44 %). Male sex predominated in 68 %. The risk factors having higher incidence were an inadequate diet and smoking. The more relevant clinical manifestation were epigastralgia, gastric fullness and weight loss. The predominating tissue variety was the diffuse adenocarcinoma and antrum location. Conclusions: gastric cancer is a health problem the incidence of which could be reduced when acting on its risk factors; with a precocious diagnosis mortality will be reduced (AU).

Synchronous malignancy of stomach and kidney: an unusual combination: a case report

Synchronous occurrence of primary gastric cancer with primary renal cell carcinoma (RCC) is exceedingly rare. We report a case of a 70 years old gentleman who presented with a history of epigastric fullness and tarry stools from 1 month, along with significant weight loss which he was unable to quantify. Esophagogastroduodenoscopy showed ulceroproliferative growth in the antropyloric region of stomach causing complete outlet obstruction. Histopathology revealed poorly differentiated mucinous adenocarcinoma. Contrast enhanced computed tomography (CECT) abdomen showed an asymmetrical circumferential growth in the antropyloric region leading to obstruction. A heterogeneously enhancing hypervascular mass was also visualized over the lower pole of left kidney with an initial impression of metastasis. A concomitant radical subtotal gastrectomy and radical left nephrectomy was performed. Pathological examination confirmed gastric adenocarcinoma (T4a) and renal cell carcinoma-RCC (T3a). Most of the operable synchronously occurring second primary malignancy (SPM) can be resected in a single stage.

Double synchronous primary gastric and thyroid cancer

Second or multiple primary malignancies is very rare and the number of patients diagnosed with multiple primary cancers has recently been increasing due to the improved diagnostic techniques. Herein we report a very rare case of synchronous double primary cancer of the stomach and thyroid gland for the 39 years old lady who presented with a short period of abdominal pain were diagnosed to have an invasive adenocarcinoma with signet ring differentiation of the stomach by gastroscopy and biopsy. Computed tomography and positron emission tomography scan showed high fludeoxyglucose uptake of the thyroid gland were biopsied to confirm the malignancy. underwent initially for radical distal gastrectomy followed by adjuvant chemotherapy and interval total thyroidectomy. Although Synchronous tumors are defined as ≥2 primary tumors occurring within 6 months of diagnosis of the first primary tumor, our case was discovered concomitantly at the first presentation of the patient. The prognosis of patients with multiple primary cancers can be determined independently by the stage of each cancer.

Resectable locally advanced gastric adenocarcinoma: interim analysis

Background: The MAGIC and ACCORD 07 trials have established the role of perioperative chemotherapy in locally advanced gastric adenocarcinoma. A more recent study has demonstrated the superiority of the FLOT perioperative regimen. The best strategy to improve outcomes has yet to be determined. Aims of the study were to evaluate perioperative chemotherapy in terms of morbidity and tolerance of FLOT regimen with modification and histopathological responseMethods: This prospective study was started after ethical committee approval in February 2019 at a tertiary cancer center in South India for a period of 1 year up till February 2020. Patients fulfilling inclusion criteria were enrolled. Perioperative chemotherapy was given as scheduled regimen and adverse effects and response to preoperative chemotherapy were recorded. Radical D2 gastrectomy and histopathology assessed analysed by using IBM SPSS statistics ver. 21 and descriptive statistics used.Results: From February 2019 till February 2020, a total of 24 patients of newly diagnosed adenocarcinoma of the stomach of which 18 patients were nonmetastatic on workup. Moderately different (38.8%), well-differentiated in 11.2%, poorly differentiated in 50%. Total 66.7% were diagnosed as metastatic on staging laparoscopy, peritoneal wash cytology in 50% was negative. The cardiopulmonary resuscitation was seen in two patients.Conclusions: Even though it is an interim analysis with less number of patients enrolled, so far it can be concluded that all patients where surgery is planned should undergo peritoneal lavage cytology and FLOT regimen can be practised with acceptable morbidity. Long term results after completion of study will definitely throw more light.

A Very Rare Case of Pancreatic Acinar Variant of Gastric Adenocarcinoma with Review of the Literature

A pancreatic acinar variant of gastric adenocarcinoma is a very rare presentation, and only six cases have been reported worldwide.A 55-year-old male came with complaints of vomiting and weight loss. By PET-CT, a growth was found in the gastric antrum.Distal gastrectomy was done and a histopathology report of a pancreatic acinar variant of gastric adenocarcinoma was done.

Cellular mesenchymal epithelial transition (C-MET) gene copy number variation in gastric adenocarcinoma: A pilot search for new marker for targeted therapy in HER-2/neu resistance

Increasing HER-2/neu resistance in gastric carcinoma has encouraged search for new biomarkers for targeted therapy. Cellular mesenchymal epithelial transition (C-MET) is one such tyrosine kinase inhibitor proposed for personalized salvage treatment. We determined frequency of C-MET gene copy number variation (CNV) by Fluorescent in-situ hybridization (FISH) in gastric adenocarcinoma (GAC) and sought its correlation with conventional clinicopathologic parameters. Dual-coloured FISH was done on 32 GAC cases. C-MET gene and centromere 7 signals were counted under fluorescent microscope and ratio was calculated for each case. Correlation between C-MET CNV and conventional clinic-pathologic parameters was done by Fischer exact test. CNV was identified in the form of amplification and polysomy (3.1% each) and associated with poorer prognostic parameters. Our pilot study highlights limited subset of patients that may benefit from anti-C-MET-targeted therapy and thus could be a novel biomarker for targeted intervention in GAC.

HER2/neu immunohistochemical expression in gastric carcinoma

Background: Gastric carcinoma is a deadly disease with high mortality. A better understanding of the molecular basis of gastric cancer has contributed to the development of rationally designed molecular targeted therapies which will improve the survival rate. A genetic alteration that could help in targeted therapy and prognostication includes Human Epidermal Growth Factor Receptor 2 (HER2/neu) overexpression in gastric carcinoma. The objective of the present study was to identify and evaluate the HER2/neu protein immunohistochemical expression in gastric cancer from biopsies and surgical resection specimens and to evaluate their correlation with histopathological features.Methods: Total/subtotal gastrectomy specimens and gastric biopsies from a tertiary care center in South India were included in the study and assessed by light microscopy and Immunohistochemistry (IHC).Results: HER2/neu overexpression was seen in 28.6% of gastric adenocarcinoma. HER2/neu overexpression was seen in 44.2% of intestinal-type and 20% of mixed type with none of the diffuse type exhibited HER2/neu positivity and this was statistically highly significant with p value of <0.01. HER2/neu positivity was found in 50% well-differentiated and 36.4% moderately differentiated tumors with none of the poorly differentiated tumors exhibiting HER2/neu positivity and this was statistically highly significant with p value of <0.01.Conclusions: This study highlights the importance of the identification of HER2/neu overexpression in gastric adenocarcinoma. This will help in prognostication and identifying patients suitable for novel therapeutic interventions which will help in prolongation of survival of patients with this deadly disease.

Diagnostic value of combined detection of multiple serum cytokines for gastric adenocarcinoma / 中国肿瘤生物治疗杂志

@#[Abstract] Objective:To explore the clinical significance of multiple serumcytokines in early diagnosis and progression assessment of gastric adenocarcinoma. Methods: Peripheral blood samples of 85 healthy subjects (healthy control group) and 81 patients with pathologically confirmed gastric adenocarcinoma (gastric cancer group) were collected from November 2017 to February 2018 at Shanxi Cancer Hospital. Serum levels of 17 cytokines (including IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-15, IL-17A, TNF-α, TNF-β, GM-CSF, G-CSF, IFN-γ, IP-10, MCP-1 andVEGF-A) were measured byAimPlex multiplex assay technology.Their diagnostic values were analyzed by receiver operating characteristic (ROC) curve. Results: Serum levels of IL-10, IL-8, IL-6, IP-10, MCP-1, VEGF-Aand IL-12p70 were significantly higher in gastric cancer patients than those in healthy controls (all P<0.01). There were significantly increasedlevelsofIL-8,IL-6and VEGF-Ain advanced-stage gastriccancer(stageI/II)groupoverearly-stage gastric cancer (stage III/IV) group (all P<0.01).AUC (areas under the curve) of IL-8, IL-6, IL-10, IP-10, MCP-1, IL-12p70 and VEGF-Afor distinguishing early-stage gastric cancer patientsfromhealthy controls was0.98,0.92,0.89,0.84,0.76,0.74 and 0.58, respectively. The diagnostic sensitivity of IL-8, IL-6 and IL-10 was 97.4%, 89.5% and 97.4%, respectively, and the specificity was 87.1%, 85.9%and 77.6%, respectively.TheAUCof IL-8, IL-6 andVEGF-Afor distinguishing advanced-stage gastric cancer patients from early-stage gastric cancer patients was 0.82, 0.72 and 0.69, respectively. Thediagnosticsensitivity of IL-8, IL-6 and VEGF-A was 83.7%, 60.5% and 41.9%, respectively, and the specificity was71.1%,76.3%and 92.1%, respectively. Conclusion: ThecombineddetectionofserumIL-8,IL-6andIL-10 may be a potential approach for early screening of gastric adenocarcinoma, which canalsobeusedtoassessthe progression of gastric adenocarcinoma.

Caracterización de los pacientes operados por adenocarcinoma gástrico en el Hospital "Dr. Carlos J Finlay". 2009-2016 / Characterization of patients operated on for gastric adenocarcinoma at "Dr. Carlos J. Finlay" Hospital from 2009 to 2016

RESUMEN Introducción: El cáncer gástrico ocupa hoy el cuarto lugar de incidencia mundial de cáncer y es la segunda causa de muerte por cáncer en el mundo. Objetivo: Caracterizar a los pacientes operados con adenocarcinoma gástrico en el Hospital "Dr. Carlos J. Finlay". 2009-2016. Material y Métodos: Se realizó un estudio descriptivo retrospectivo a los pacientes operados con adenocarcinoma gástrico en un periodo de 8 años. Resultados: Prevalecieron los pacientes geriátricos del sexo masculino. La forma más frecuente de presentación fue la úlcera gástrica en 54,7%. Predominaron los tumores del antro en 72,0%, moderadamente diferenciados en 61,3% de pacientes. La mayoría de los tumores se encontraban en estadio IIIA. De los procedimientos quirúrgicos predominó la gastrectomía distal en 56,0% y los procederes exeréticos en 68,0% de pacientes. La mortalidad operatoria fue de 6,0%, con prevalencia del shock hipovolémico. Conclusiones: Predominaron los pacientes geriátricos del sexo masculino cuya técnica quirúrgica fue la gastrectomía distal. Como forma clínica sobresalió la úlcera gástrica, así como los tumores del antro en estadio IIIA, moderadamente diferenciados. El estadio avanzado y los procedimientos paliativos se relacionaron de manera significativa con la mortalidad.

ABSTRACT Introduction: Gastric cancer is the fourth most common cancer at present and the second leading cause of cancer-related mortality worldwide. Objective: The aim of this study is to characterize the patients with gastric adenocarcinoma operated on at "Dr. Carlos J. Finlay" Hospital during the period between 2009 and 2016. Material and Methods: A descriptive retrospective study was conducted in patients operated on for gastric adenocarcinoma in an eight-year period. Results: Male geriatric patients prevailed in the study. Gastric ulcer was the most frequent form of presentation in 54,7 %. Tumors of the antrum predominated in 72,0 %, with moderate degree of differentiation in 61,3 % of patients. The majority of tumors were in stage IIIA. The most used surgical methods were distal gastrectomy which was performed in 56,0 % of patients and exeretic procedures that were carried out in 68,0 % of patients. Operative mortality was 6,0 % with prevalence of hypovolemic shock. Conclusion: There was a predominance of male geriatric patients who underwent the surgical technique of distal gastrectomy. Gastric ulceration was the most common clinical form of presentation as well as tumors of the antrum in stage IIIA, in which there was a moderate degree of differentiation. Advanced stage tumors and palliative procedures were significantly related to mortality.

Epidemiological review and clinicopathological study of gastric adenocarcinoma cases in a tertiary care center in North Chennai, India

Background: Gastric carcinoma is the third most common cause of cancer-related mortality worldwide. The Incidence of gastric carcinoma shows wide geographic and regional variation as well. The clinical presentation varies with the individual and hence histopathological evaluation plays a major role in the diagnosis and management of the patients. This study aims to evaluate the epidemiological and clinicopathological profile of gastric adenocarcinoma cases encountered in a tertiary care center in North Chennai where only limited statistical data available in literature.Methods: All the gastric adenocarcinoma cases diagnosed by histopathology who underwent total/subtotal gastrectomy were retrospectively collected for clinical as well as histopathological details for a year. Descriptive statistics were used for analysis.Results: The mean age of the study population is 59.3±11.3 with male: female sex ratio of 2.1:1. Higher prevalence noted in lower socioeconomic status (80%) and alcoholics (65%) with a history of high salted diet (62%). Most common presenting symptom was dyspepsia (94%). Upper GI endoscopy revealed antrum (42%) as the commonest site of tumor and majority were more than 5 cm size (75%). 62% of tumors were of moderately differentiated, predominantly intestinal type (86%) and mostly found to be in stage 3 (50%).Conclusions: Gastric adenocarcinoma was more common in elderly males and majority presented in advanced stage at the time of diagnosis. The General public needs to be creating awareness about variable nonspecific symptoms of an early stage of gastric carcinoma as well as the risk of poor dietary habits (high salted diet) and can enforce screening of high-risk category people.

Expression and significance of OR2W3 in gastric adenocarcinoma / 中国综合临床

Objective To detect and analyze the expression and significance of olfactory receptor family 2 subfamily W member 3 (OR2W3) in gastric adenocarcinoma,and to explore its correlation with cell proliferation and apoptosis. Methods From January 2013 to June 2014, 61 patients with gastric adenocarcinoma diagnosed in the Affiliated Hospital of North China University of Technology and undergoing radical operation were selected as the study subjects. Neoplasm tissue were selected as the observation group, normal gastric mucosa ( 61 cases) were selected as the control group. Immunohistochemistry was used to detect the expression of or2w3 and HER-2 in the two groups. Fish was used to detect the amplification of HER-2 gene in some of the patients with uncertain expression of HER-2. Western blot was used to detect the expression of PCNA and BAX in the observation group. Results Positive rate of OR2W3 was higher in the observation group ( 50. 8%, 31／61) than that in the control group ( 8. 2%( 5／61 )), and the difference between the two groups was statistically significant(χ2＝26. 63,P＜0. 05). The difference of the positive rate of OR2W3 in the maximum diameter(≥6 cm was 68. 8%(22／32),＜6 cm was 31. 0%( 9／29)),depth of invasion(seroas and beyond was 63. 4%(26／41),less serosa was 25. 0%(5／20)),vascular and lymphatic vessel involvement ( involvement was 78. 6%( 11／14),no involvement was 42. 6%( 20／47)), lymph node metastasis(metastasis was 82. 1%(23／28),no metastasis was 24. 2%(3／33)) and TNM staging(Ⅲ+Ⅳwas 78. 1%(25／32),Ⅰ+Ⅱ was 20. 7%( 6／29)) in observation group was statistically significant ( χ2 was 8. 423,7. 937,5. 559,20. 318,20. 080,respectively,all P＜0. 05). Expression of OR2W3 was correlated with survival time(X2＝5. 31,P＜0. 05). Positive correlation was found between OR2W3 and PCNA expression(r＝0. 54,P＜0. 05) . Negative correlation were found between OR2W3 and BAX expression ( r＝－0. 59, P＜0. 05). There were 8 cases of HER-2 positive and 53 cases of HER-2 negative. The difference of OR2W3 expression in tumors with different HER-2 expression was statistically significant ( χ2＝4. 957,P＜0. 05) . Conclusion The expression of OR2W3 in gastric adenocarcinoma tissue is significantly increased,which can promote the proliferation of cancer cells and inhibit apoptosis. OR2W3 is related to HER-2 expression. Detection of OR2W3 expression may be of some value in judging prognosis.

Expressions and its prognostic value research of MMP-11 and cathepsin-D in gastric adenocarcinoma / 中国综合临床

Objective To detect the expressions of Matrix Metalloprotein-11 ( MMP-11 ) and Cathepsin-D(Cath-D),and investigate their relationship and prognostic significance. Methods The study included 95 cases′ clinical date and postoperative specimens of gastric adenocarcinoma ( North China University of Science and Technology Affiliated Hospital,2010. 01-2013. 12) as observation group,70 cases of normal gastric tissue(from observation group) as control group. Expressions of MMP-11 and Cath-D were detected by IHC methods in two groups. Results The positive rate of MMP-11 was 51. 6%( 49/95) in observation group,5. 7%(4/70)in control group(χ2＝38. 884,P＜0. 05). The positive rate of Cath-D was 73. 7%(70/95) in observation group,28. 6%(20/70) in control group(χ2＝33. 082,P＜0. 05). The positive rate of MMP-11 was correlated with metastasis and vascular invasion(χ2＝7. 193、15. 566,P＜0. 05). The positive rate of Cath-D was correlated with maximal diameter,lymph node metastasis,vascular invasion and proliferation index(χ2＝7.431、5.654、6.569、6.801,P＜0.05).There was positive relationship between MMP-11 and Cath-D in observation group(r＝0. 46,P＜0. 05). The expressions of MMP-11 and Cath-D were correlated with prognosis in gastric adenocarcinoma ( P＜0. 05) . Conclusion The higher expressions and synergistic effect of MMP-11 and Cath-D may promote the occurrence and development in gastric adenocarcinoma. The joint detection of MMP-11 and Cath-D may be helpful to predict the prognosis of gastric adenocarcinoma.

Various Classification of Gastric Adenocarcinoma / 대한소화기암학회지

Despite its declining incidence, gastric cancer is globally, still, the third most common cause of cancer-related mortality. Gastric cancer is a heterogeneous disease with diverse pathogenesis and molecular backgrounds. Therefore several systems have been proposed to aid in the classification of gastric adenocarcinoma based on the macroscopic, microscopic and anatomical features of the tumor. However, these classifications did not reflect the pathogenesis of the disease. Recently, genomic analysis has identified several subtypes of gastric adenocarcinoma and a detailed understanding of the molecular biology behind the neoplastic phenotype is possible to develop of more effective therapies. We will describe the existing various classification of gastric cancer and the recently introduced molecular biology and immunological classification.

The significance of Hp antigen combined with serum total sialic acid and gastric mucosal Survivin detection in the diagnosis of gastric adenocarcinoma / 国际检验医学杂志

Objective To explore the significance of Hp antigen combined with serum total sialic acid and gastric mucosal Survivin detection in the diagnosis of gastric adenocarcinoma.Methods Selected a hospital 90cases of patients with gastric adenocarcinoma (malignant group) and 90cases of the digestive system benign disease (benign disease group) and hospital check-up of 60cases of healthy people (healthy control group) as the research object.Comparing the three groups of patients with Hp antigen, serum total sialic acid positive detection rate and the positive rate of Survivin in the gastric mucosa, and to assess individual detection of Hp antigen, serum total sialic acid and the two combined diagnostic sensitivity and specificity of gastric adenocarcinomas.Results Hp antigen, serum total sialic acid positive test results showed that the malignant tumor group were significantly higher than that of benign disease group and healthy control group, benign disease group obviously higher than that of healthy control group, difference between three groups of participants were statistically significant (P<0.05) .The sensitivity of Hp antigen and serum total sialic acid combined in the diagnosis of digestive system was 80.1％, which was significantly higher than that of single test, but the specificity was reduced.Linear correlation analysis showed that there was a positive correlation between Hp antigen and serum total sialic acid and Survivin detection in gastric mucosa, and the correlation was high (r=0.94, P<0.05) .Conclusion The combined detection of Hp antigen and total serum sialic acid is positively correlated with the results of Survivin detection in gastric mucosa, and has a high correlation.It can replace Survivin detection in gastric mucosa as a sensitive index for the diagnosis of gastric adenocarcinoma.