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1.
Rev. colomb. gastroenterol ; 37(3): 289-295, jul.-set. 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1408038

ABSTRACT

Resumen Introducción: Helicobacter pylori juega un papel fundamental en la cascada de carcinogénesis del cáncer gástrico tipo intestinal; sin embargo, no existe claridad respecto a su prevalencia en condiciones preneoplásicas que generan cambio en el microambiente de la mucosa. Actualmente se recomienda la vigilancia endoscópica por protocolo de Sydney cada 2 a 3 años, pero no es clara la presencia de H. pylori en la región subcardial y el fondo gástrico. Objetivo: determinar la prevalencia y localización gástrica del H. pylori en pacientes con condiciones preneoplásicas. Materiales y métodos: estudio de corte transversal en adultos con diagnóstico previo de atrofia o metaplasia intestinal que ingresaron a endoscopia de control, a quienes se les tomaron biopsias del antro, cuerpo, incisura angularis, región subcardial y fondo gástrico. Se realizó un análisis descriptivo de los resultados por regiones gástricas. Resultados: se recolectó la información de 160 pacientes con una prevalencia de H. pylori del 37,5 %, la cual fue en aumento de proximal a distal iniciando con una prevalencia de 12,5 % en la región subcardial hasta una prevalencia de 30,6 % en el antro; hubo un patrón similar en la prevalencia de lesiones preneoplásicas. Se observó una mayor presencia de lesiones avanzadas (displasia, carcinoma) en la incisura. Conclusiones: la prevalencia de H. pylori en condiciones premalignas evidenció una mayor presencia en las regiones distales en comparación con las proximales, y es más frecuente en la región antral y menor en la región subcardial. En cuanto a la distribución gástrica de atrofia y metaplasia, se encontró mayor compromiso en el antro y la incisura, y es baja en la región subcardial y el fondo.


Abstract Introduction: Helicobacter pylori infection plays a critical role in the carcinogenesis cascade of intestinal gastric cancer. However, its prevalence in preneoplastic conditions generating changes in the gastric mucosa is unclear. Currently, endoscopic surveillance using the Sydney protocol is suggested every 2 to 3 years, but the presence of H. pylori infection in the subcardial region and gastric fundus is ill-defined. Objective: to determine the prevalence and gastric location of H. pylori infection in patients with preneoplastic conditions. Materials and methods: a cross-sectional study in adults with a previous diagnosis of atrophy or intestinal metaplasia who entered control endoscopy and were antrum, body, incisura angularis, subcardial region, and gastric fundus biopsied. A descriptive analysis of the results by gastric regions was performed. Results: data from 160 patients with a prevalence of H. pylori of 37.5% were collected. It increased from proximal to distal, starting with a 12.5% prevalence in the subcardial region to a 30.6% prevalence in the antrum. In addition, there was a similar pattern in the prevalence of preneoplastic lesions. Furthermore, advanced lesions (dysplasia, carcinoma) were observed in the incisura. Conclusions: the prevalence of H. pylori in precancerous conditions showed a high presence in the distal regions compared to the proximal ones, and it is more frequent in the antrum and lower in the subcardial region. As for the gastric distribution of atrophy and metaplasia, more involvement was found in the antrum and angular notch and lower in the subcardial region and fundus.

2.
Rev. cir. (Impr.) ; 74(4): 345-353, ago. 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1407936

ABSTRACT

Resumen Introducción: En los últimos años, la gastrectomía laparoscópica ha aparecido como una técnica quirúrgica con resultados oncológicos comparables a la técnica abierta, pero existe poca evidencia en cuanto a la calidad de vida posoperatoria de estos pacientes. Objetivo: Evaluar la calidad de vida posoperatoria de pacientes sometidos a gastrectomía total laparoscópica (GTL) en comparación a gastrectomia total abierta (GTA) en cáncer gástrico. Materiales y Método: Estudio retrospectivo, observacional en Hospital Militar de Santiago, entre enero de 2015 y junio de 2020. Se les aplicó 2 encuestas validadas para Chile: EORTC QLQ-30 y EORTC QLQ-OG25. Resultados: Se obtuvieron 60 pacientes; 30 sometidos a GTL y 30 a GTA. Promedio edad fue 66,3 ± 11 años para GTL y 68,2 ± 11 años en GTA (p = 0,5). Se obtuvo un score en GTL versus GTA: global 83,3 y 80,2 (p = 0,6), sintomático 17,1 y 25,5 (p = 0,2) y score funcional 87,9 y 70,9 (p = 0,03). Posterior a eso obtuvimos en funcionalidad GTL versus GTA; física 92,2 versus GTA 73,1 (p = 0,04), emocional 84,1 versus 78,5 (p = 0,6), cognitiva 84,9 versus 79,0 (p = 0,3) y social 80,9 versus 72,2 (p = 0,4). Al analizar síntomas destaco; fatiga 14,6 versus 33,1 (p = 0,04) y dolor 13,4 versus 24,3 (p = 0,05). Finalmente, en síntomas digestivos altos obtuvimos en disfagia 0,84 GTL versus 17,3 GTA (p = 0,04). Conclusión: La GTL logra resultados comparables a GTA en calidad de vida e incluso ofrece ventajas significativas en funcionalidad física como también en síntomas como dolor, fatiga y disfagia.


Introduction: In recent years, laparoscopic gastrectomy has appeared as a surgical technique with oncological results comparable to the open technique, but there is little evidence regarding the postoperative quality of life of these patients. Objective: To evaluate the postoperative quality of life of patients undergoing laparoscopic total gastrectomy (LTG) compared to open total gastrectomy (OTG) in gastric cancer. Materials and Method: Prospective, observational study at Hospital Militar of Santiago, between January 2015 and June 2020. Two surveys validated for Chile were applied: EORTC QLQ-30 and EORTC QLQ-OG25. Results: 60 patients were obtained; 30 subjected to LTG and 30 to OTG. Average age was 66.3 ± 11 years for LTG and 68.2 ± 11 years for OTG (p = 0.5). A score was obtained in LTG versus OTG: global 83.3 and 80.2 (p = 0.6), symptomatic 17.1 and 25.5 (p = 0.2) and functional score 87.9 and 70.9 (p = 0.03). After that we got LTG versus OTG functionality; physical 92.2 versus 73.1 (p = 0.04), emotional 84.1 versus 78.5 (p = 0.6), cognitive 84.9 versus 79.0 (p = 0.3) and social 80.9 versus 72.2 (p = 0.4). When analyzing symptoms I highlight; fatigue 14.6 versus 33.1 (p = 0.04) and pain 13.4 versus 24.3 (p = 0.05). Finally, in upper digestive symptoms, we obtained 0.84 LTG versus 17.3 OTG in dysphagia (p = 0.04). Conclusion: LTG achieves results comparable to OTG in quality of life and even offers significant advantages in physical functionality as well as symptoms such as pain, fatigue and dysphagia.


Subject(s)
Humans , Male , Female , Child , Middle Aged , Quality of Life , Stomach Neoplasms/surgery , Adenocarcinoma/surgery , Gastrectomy/adverse effects , Demography , Surveys and Questionnaires , Retrospective Studies
3.
Rev. Assoc. Med. Bras. (1992) ; 68(7): 888-892, July 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1394590

ABSTRACT

SUMMARY OBJECTIVE: Gastric cancer ranks the third among the cancer-related deaths. It is diagnosed at advanced stage in many patients due to malignant proliferation and has a poor prognosis. Currently, no instrument or biomarker has been proven to diagnose the disease before the advanced stages. This study aimed to measure the serum levels of galanin and obestatin, which were examined in various studies including cancer studies, and to discuss their diagnostic value in gastric cancers. METHODS: In this study, 30 adult patients with gastric cancer and 30 healthy adults in the control group were examined prospectively. The demographic characteristics and serum levels of galanin and obestatin in the patient and control groups were recorded. RESULTS: The mean serum level of galanin in the patient and control groups was 19.73±5.04 and 35.59±10.94 pg/mL, respectively. The mean serum level of obestatin in the patient and control groups was 40.21±5.82 and 15.15±3.32 ng/mL, respectively. A significant difference was found between the groups (p<0.001). CONCLUSION: Serum levels of galanin were lower and serum levels of obestatin were higher in patients with gastric cancer compared to the healthy individuals. Serum levels of obestatin and galanin can be used as potential biomarkers in the diagnosis of gastric cancer.

4.
Rev. cir. (Impr.) ; 74(3)jun. 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1407924

ABSTRACT

Resumen Introducción: El principal factor pronóstico del cáncer gástrico es la etapa al momento del diagnóstico, siendo indispensable evaluar la mejoría en la obtención de diagnósticos estadios precoces. En Chile no existen estudios focalizados en este punto. Objetivos: Comparar los casos de cáncer gástrico en los períodos 2006-2011 y 2012-2017, en el Hospital Base Osorno y evaluar si se logró una mejora en el estadio al momento del diagnóstico en el segundo período. Materiales y Método: Estudio de cohorte retrospectivo, sobre base de datos prospectiva del Hospital Base San José Osorno. El período de análisis fue enero 2006-diciembre 2017. Los casos recopilados se dividieron en 2 grupos según fecha de diagnóstico: período 2006-2011 (G1) y período 2012-2017(G2). Para realizar el análisis se aplicó test estadístico de Fisher y x2. Resultados: Se incluyeron en total 353 pacientes, 233 (66%) corresponden a sexo masculino, con edad promedio de 64,34 (24-87). 182 (51,55%) pacientes con etapificación patológica y 171 (49,45%) con etapificación clínica. Se evaluaron ambos períodos en cada grupo. No hubo diferencias significativas en las características demográficas. En los pacientes con etapificación patológica el G2 hubo mayor detección de cáncer incipiente pero no fue significativo p 0,201. En los pacientes con etapificación clínica hubo una disminución en la proporción de diagnósticos en etapa IV 59 (49,58%) p < 0,001. Conclusión: Existió un aumento estadísticamente significativo en la detección de adenocarcinoma gástrico en etapificación clínica, se requieren mayores estudios para evaluar nuevos factores.


Background: The main prognostic factor for gastric cancer is the stage at the time of diagnosis, and it is essential to evalúate improvements in obtaining early-stage diagnoses. In Chile there are no studies focused on this point. Aim: To compare the cases of gastric cancer in the periods 2006-2011 and 2012-2017 in the Hospital Base Osorno and to evalúate any improvement in the stage at diagnosis during the second period. Materials and Method: A retrospective cohort study was carried out based on a prospective database from the Hospital Base San Jose Osorno. The analysis period was between January 2006-December 2017.The collected cases were divided into 2 groups according to the date of diagnosis: period 2006-2011 (G1) and period 2012-2017 (G2). Fisher test and x2 were applied. Results: A total of 353 patients were included, 233 (66%) were male, mean age of 64,34 (24-87). 182 (51.55%) patients with pathological staging and 171 (49.45%) with clinical staging. Both periods were evaluated in each group. There were no significant differences in demographic characteristics. In patients with pathological staging, G2 had a higher detection of incipient cancer but it was not significant p 0.201. In patients with clinical staging, there was a decrease in the proportion of stage IV diagnoses 59 (49.58%) p < 0.001. Conclusión: There was a statistically significant increase in the detection of gastric adenocarcinoma in clinical staging. Further studies are required to evaluate new factors.

5.
Poblac. salud mesoam ; 19(2)jun. 2022.
Article in English | LILACS-Express | LILACS, SaludCR | ID: biblio-1386941

ABSTRACT

Abstract Introduction: Costa Rica has among the highest mortality rates from gastric cancer in the world, largely due to late detection. It is therefore important that economically and logistically sustainable screening is implemented in order to detect risk of developing cancer. We have previously shown that low pepsinogen (PG) values and infection with Helicobacter pylori-CagA+ are associated with risk of gastric atrophy and cancer in Costa Rican populations. OBJECTIVES: To determine how markers for gastric cancer risk are distributed in an elderly population representative of Costa Rica in order to design a screening strategy. METHODS: The population studied consists of 2,652 participants in a nationally representative survey of ageing. Information concerning epidemiologic, demographic, nutritional and life style factors is available. Serum PG concentrations as well as H. pylori and CagA status were determined by serology. Possible associations were determined by regression analyses. RESULTS: Antibodies to H. pylori were present in 72% of the population and of those, 58% were CagA positive. Infection with H. pylori was associated with higher PGI concentrations (p=0.000) and infection with H. pylori-CagA. with lower PGI concentrations (p=0.025). Both showed association with lower PGI/PGII (p=0.006 and p=0.000). Higher age was associated with lower prevalence of H. pylori infection (OR=0.98; p=0.000) and CagA. (OR=0.98; p=0.000) but not with PG values. Regions with high risk of gastric cancer showed lower PGI (p=0.004) and PGI/PGII values (p=0.021) as well as higher prevalence of H. pylori infection (OR=1.39; p=0.013) but not CagA.. Using cut-off values of PGI<100 µg/L and PGI/PGII<2.0, 2.5 and 3.0, 7-15% of the population would be considered at risk. CONCLUSIONS: H. pylorialone is not a useful marker for risk of gastric cancer. Screening using serum pepsinogen concentrations and infection with H. pylori-CagA. is feasible in the general elderly population of Costa Rica but appropriate cut-off values have to be determined based on more clinical data and follow up capacity.


Resumen Introducción: Costa Rica tiene una de las tasas de mortalidad por cáncer gástrico más altas del mundo, en gran parte debido a la detección tardía. Por lo tanto, es importante que se implemente un tamizaje económico y logísticamente sostenible para detectar el riesgo de desarrollar cáncer. En estudios anteriores demostramos, que valores bajos de pepsinógeno (PG) y la infección por Helicobacter pylori-CagA+ están asociados con el riesgo de atrofia gástrica y cáncer en poblaciones costarricenses. OBJETIVO: Determinar cómo se distribuyen los marcadores de riesgo de cáncer gástrico en una población representativa de adultos de Costa Rica para diseñar una estrategia de tamizaje. MÉTODOS: Se estudió una población representativa a nivel nacional de 2.652 adultos, que formaron parte de un estudio longitudinal sobre envejecimiento. Se dispone de información sobre factores epidemiológicos, demográficos, nutricionales y de estilo de vida. Las concentraciones séricas de PG, así como el estado de H. pylori y CagA se determinaron mediante serología. Las posibles asociaciones se determinaron mediante modelos de regresión (logística y lineal múltiple). RESULTADOS: El 72% de la población presenta anticuerpos contra H. pylori, de ellos, el 58% fueron positivos para CagA. La infección por H. pylori se asoció con altas concentraciones de PGI (p = 0,000) y la infección por H. pylori-CagA+ con bajas concentraciones de PGI (p = 0,025). Ambas pruebas mostraron asociación con una baja razón PGI/PGII (p = 0,006 y p = 0,000). El rango de mayor edad se asoció con una menor prevalencia de la infección por H. pylori (OR = 0,98; p = 0,000) y de CagA+ (OR = 0,98; p = 0,000) pero no se asoció con los valores de PG. Las regiones con alto riesgo de CG mostraron valores bajos de PGI (p = 0,004) y de PGI/PGII (p = 0,021) así como una alta prevalencia de la infección por H. pylori (OR = 1,39; p = 0,013), no así con CagA+. Utilizando valores de corte de PGI<100 µg/L y de PGI/PGII <2,0, 2,5 y 3,0, se consideraría en riesgo de cáncer entre 7-15% de la población. CONCLUSIONES: La infección por H. pylori, por sí sola, no es un marcador de riesgo de CG útil. Es factible realizar el tamizaje de adultos de la población general de Costa Rica, utilizando como marcadores las concentraciones séricas de pepsinógenos y la infección por H. pylori-CagA+, sin embargo, los valores de corte apropiados deben determinarse con base en una mayor cantidad de datos clínicos y la capacidad de seguimiento.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Stomach Neoplasms , Helicobacter pylori , Costa Rica , Gastritis, Atrophic
6.
Rev. colomb. cancerol ; 26(1): 39-96, ene.-mar. 2022. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1407971

ABSTRACT

Resumen Objetivo: Generar recomendaciones basadas en la evidencia, para la prevención primaria y secundaria, el tratamiento de las lesiones preneoplásicas y el diagnóstico temprano del cáncer gástrico en población adulta, con el propósito de reducir la carga de la enfermedad. Materiales y métodos: El grupo desarrollador estuvo integrado por profesionales de la salud y tomadores de decisiones. Se construyeron preguntas clínicas contestables y se realizó la graduación de los desenlaces. Se elaboró la búsqueda de la información en MEDLINE; EMBASE y CENTRAL, siendo actualizada el 18 de octubre de 2018. La pesquisa también abarcó otras fuentes de información como la Revista Colombiana de Gastroenterología y la lectura en "bola de nieve" de las referencias incluidas. Se contactó a expertos en la materia con el objetivo de identificar estudios relevantes no publicados. Para la construcción de las recomendaciones, se realizó un consenso acorde con los lineamientos propuestos por la metodología GRADE, sopesando los beneficios, los efectos adversos derivados de la intervención, las preferencias de los pacientes y el potencial impacto de las intervenciones sobre los costos. Resultados: Se presenta la versión corta de la "Guía de práctica clínica para la prevención primaria, secundaria y diagnóstico temprano de cáncer gástrico", junto con su evidencia de soporte y respectivas recomendaciones. Conclusiones: Como recomendación central para la implementación, se recomienda erradicar la infección por H. pylori en los pacientes con o sin factores de riesgo, como estrategia de prevención de las condiciones precursoras de cáncer gástrico. La Guía deberá actualizarse en tres años.


Abstract Objetive: Generate recommendations for primary and secondary prevention, treatment of gastric preneoplastic lesions, and early diagnosis of gastric cancer in the adult population, to increase the detection of gastric cancer in early stages. Material and methods: The developer group was made up of health professionals, decision-makers, and a representative of the patients. Answerable clinical questions were constructed and outcomes were graded. The search for information in MEDLINE was carried out; EMBASE and CENTRAL, being updated on October 18, 2018. The search also covered other sources of information such as the Colombian Journal of Gastroenterology and the "snowball" reading of the references included. Experts in the field were contacted to identify studies. For the construction of the recommendations, a consensus was made according to the guidelines proposed by the GRADE methodology, weighing the benefits, the adverse effects derived from the intervention, the preferences of the patients, and the potential impact of the interventions on costs. Results: The short version of the "Clinical practice guidelines for the primary, secondary, and early diagnosis of gastric cancer" is presented together with its supporting evidence and respective recommendations. Conclusions: As a central recommendation for implementation, it is recommended to eradicate H. pylori infection in patients with or without risk factors in whom it is detected to prevent gastric cancer precursor conditions. The Guide will need to be updated in three years.

7.
Acta méd. colomb ; 47(1): 41-43, ene.-mar. 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1374102

ABSTRACT

Resumen El síndrome de Li-Fraumeni (SLF) es un trastorno autosómico dominante hereditario con predisposición al cáncer, está asociado con anomalías en el gen de la proteína tumoral p53 (TP53), que se manifiesta por una amplia gama de neoplasias malignas que aparecen a una edad temprana. Se expone al caso de un adulto joven en quien hicimos este diagnóstico, y se describen las perspectivas terapéuticas en investigación. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2198).


Abstract Li-Fraumeni syndrome (LFS) is a hereditary autosomal dominant disorder with a predisposition to cancer. It is associated with abnormalities of the tumor protein p53 (TP53) gene, manifesting with a broad range of malignant neoplasms which appear at an early age. We discuss the case of a young adult in whom we did this diagnosis, and we describe the therapeutic perspectives being researched. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2198).

8.
Bol. latinoam. Caribe plantas med. aromát ; 21(1): 108-122, ene. 2022. ilus, tab
Article in English | LILACS | ID: biblio-1372494

ABSTRACT

Cota tinctoria is a medicinal plant which has been used for management of cancer in folk medicine of various regions. The aim of present study is to investigate cytotoxic activity of different concentrations of hydroalcoholic extract of C. tinctoria flowers on gastric (AGS) and liver (Hep-G2) cancer cell lines as well as Human Natural GUM fibroblast (HUGU) cells. Cell mortality rates were examined after 24, 48 and 72 h incubations using the MTT assay. IC50of extract on AGS cells after 24, 48 and 72h was 1.46, 1.29 and 1.14 µg/mL respectively. The extract demonstrated IC50 of 5.15, 3.92 and 2.89 µg/mL on Hep-G2 cells after 24, 48 and 72 h respectively. No cytotoxic effect was detected on HUGU (Human Natural GUM fibroblast) cells. C. tinctoria seems to have a promising potential to be considered as a source for anticancer drug discovery. However, more experimental and clinical studies are required.


Cota tinctoria es una planta medicinal que se ha utilizado para el tratamiento del cáncer en la medicina popular de varias regiones. El objetivo del presente estudio es investigar la actividad citotóxica de diferentes concentraciones de extracto hidroalcohólico de flores de C. tinctoria en líneas celulares de cáncer gástrico (AGS) e hígado (Hep-G2), así como en células de fibroblasto GUM humano natural (HUGU). Se examinaron las tasas de mortalidad celular después de incubaciones de 24, 48 y 72 h utilizando el ensayo MTT. La CI50 del extracto en células AGS después de 24, 48 y 72 h fue de 1,46; 1,29 y 1,14 µg respectivamente. El extracto demostró una CI50 de 5,15, 3,92 y 2,89 µg/mL en células Hep-G2 después de 24, 48 y 72 h, respectivamente. No se detectó ningún efecto citotóxico en las células HUGU (fibroblasto GUM humano natural). C. tinctoria parece tener un potencial prometedor para ser considerada como una fuente de descubrimiento de fármacos contra el cáncer. Sin embargo, se requieren más estudios experimentales y clínicos.


Subject(s)
Plant Extracts/administration & dosage , Asteraceae/chemistry , Cell Line, Tumor/drug effects , Liver Neoplasms/drug therapy , Antineoplastic Agents, Phytogenic/administration & dosage , Stomach Neoplasms/drug therapy , Flavonoids/analysis , Plant Extracts/pharmacology , Plant Extracts/chemistry , Cell Culture Techniques , Anthemis/chemistry , Phenolic Compounds/analysis , Hep G2 Cells/drug effects , Antineoplastic Agents, Phytogenic/pharmacology , Antineoplastic Agents, Phytogenic/chemistry
9.
Acta Pharmaceutica Sinica ; (12): 2087-2100, 2022.
Article in Chinese | WPRIM | ID: wpr-936568

ABSTRACT

Based on the research system of computer-aided drug design combined with complex network analysis, the potential mechanism of Dunhuang Dabupi Decoction in preventing and treating gastric cancer (GC) is analyzed, and the scientific connotation of its prescription rules is explored through the efficacy grouping. To study the effect of Dabupi Decoction freeze-dried powder solution on the proliferation activity of gastric cancer cells through cell experiments; the TCMSP and TCMID databases were used to collect the compound components of Dabupi Decoction. Swiss Target Prediction is used to predict potential targets of compounds. DrugBank, GeneCards, TTD, and DisGeNET were used to collect potential targets for gastric cancer. Analyze protein interactions of potential targets through the STRING database. DAVID database was used for KEGG enrichment analysis; Dabupi Decoction was divided into Wenzhong group (dried ginger), Yiqi group (ginseng, licorice, Atractylodes macrocephala), nourishing Yin group (Ophiopogon japonicus, Schisandra) and Jiangni group according to its efficacy characteristics. The inverse group (inula) has 4 functional compatibility groups. Cytoscape was used to construct a network of "medicinal flavor-potential active ingredient-key target" respectively, and the network was used to analyze the scientific connotation of the compatibility of efficacy groups. The Schrödinger software was used to verify the molecular docking of the core components and the core targets. The material basis of the Dabupi Decoction to prevent and treat gastric cancer was discovered through the combination of pattern analysis and combined free energy calculation. The core drug was analyzed from the perspective of dynamics through molecular dynamics simulation. Potential targets and representative potential compounds interact with each other. Cell experiments confirmed that Dabupitang freeze-dried powder solution can down-regulate the mitochondrial membrane potential of AGS gastric cancer cells, block the cell cycle in the G0/G1 phase (P < 0.05), and inhibit its proliferation (P < 0.05). The pathways enriched by the four functional groups contained in Dabupi Decoction are mainly distributed in the body's energy metabolism, inflammation-immune system regulation, and cycle-apoptotic functions. Each module is connected by a common target gene and has its own focus. The results of molecular docking showed that the compounds liquiritigenin, quercetin, kaempferol, isorhamnetin, methylophiopogonanone A, etc. may be the effective multi-target components of Dabupi Decoction. Estrogen receptor 1, androgen receptor, ATP-binding cassette superfamily G member 2, epidermal growth factor receptor, glycogen synthase kinase-3 beta and other targets have good affinity with each potential active compound, which may be a potential target of Dabupi Decoction for preventing and treating gastric cancer. Among them, kaempferol and the drug target EGFR not only have good binding ability, but also have good binding stability. This study is based on computer-aided drug design combined with complex network analysis strategies to initially reveal the material basis and molecular mechanism of Dabupi Decoction in the prevention and treatment of gastric cancer. It also explores the scientific connotation of Dabupi Decoction in the prevention and treatment of gastric cancer with different efficacy groups, and its clinical application provide chemical bioinformatics basis.

10.
Article in Chinese | WPRIM | ID: wpr-936357

ABSTRACT

OBJECTIVE@#To investigate the expression of aldehyde dehydrogenase 3B1 (ALDH3B1) in gastric cancer and explore its correlation with the pathological parameters and long-term prognosis of the patients.@*METHODS@#We analyzed the clinical data of 101 patients who underwent radical gastrectomy for gastric cancer in our hospital between January, 2013 and November, 2016, and examined the expression of ALDH3B1 in paraffin-embedded samples of gastric cancer tissues and adjacent tissues from these cases by immunohistochemical staining. We evaluated the correlation between ALDH3B1 expressions and histopathological parameters and assessed the predictive value of ALDH3B1 expression for long-term survival of the patients. We also examined the effect of lentivirus-mediated interference and overexpression of ALDH3B1 on the malignant behaviors of MGC-803 gastric cancer cells.@*RESULTS@#The expressions of ALDH3B1 and Ki67 were significantly higher in gastric cancer tissues than in adjacent tissues (P < 0.05). In gastric cancer patients, ALDH3B1 expression was positively correlated with peripheral blood CEA and CA19-9 levels (P < 0.01). The proportion of patients with CEA ≥5 μg/L, CA19-9 ≥37 kU/L, T stage of 3- 4, and N stage of 2-3 was significantly greater in high ALDH3B1 expression group than in low expression group. Kaplan-Meier survival analysis showed that the 5-year survival rate was significantly lower in gastric cancer patients with high ALDH3B1 expressions (P < 0.01). Univariate and Cox multiple regression analyses identified a high expression of ALDH3B1 (P < 0.05, HR= 0.231, 95% CI: 0.064-0.826), CEA≥5 μg/L (P < 0.01, HR=4.478, 95% CI: 1.530-13.110), CA19-9≥37 kU/L (P < 0.01, HR=3.877, 95% CI: 1.625-9.247), T stage of 3-4 (P < 0.01, HR=4.953, 95% CI: 1.768-13.880), and N stage of 2-3 (P < 0.05, HR=2.152, 95% CI: 1.152-4.022) as independent risk factors affecting 5-year survival after radical gastrectomy. The relative ALDH3B1 expression level, at the cut-off point of 4.66, showed a sensitivity of 76.47% and a specificity of 76% for predicting 5-year postoperative death (P < 0.01). In the cell experiment, overexpression of ALDH3B1 obviously promoted the proliferation, migration and invasion of MGC-803 cells.@*CONCLUSION@#As an independent risk factor affecting 5-year survival after radical gastrectomy, ALDH3B1 is highly expressed in gastric cancer and correlated with pathological parameters of the tumor, and a high ALDH3B1 expression may promote proliferation, invasion and metastasis of gastric cancer cells.


Subject(s)
Aldehyde Oxidoreductases , CA-19-9 Antigen , Carcinoembryonic Antigen , Gastrectomy , Humans , Neoplasm Staging , Prognosis , Retrospective Studies , Stomach Neoplasms/pathology
11.
Article in Chinese | WPRIM | ID: wpr-936316

ABSTRACT

OBJECTIVE@#To explore the effects of ultrasound-guided stellate ganglion block (SGB) on perioperative stress response, gastrointestinal hormones and postoperative gastrointestinal function recovery in patients undergoing laparoscopic radical gastrectomy for gastric cancer.@*METHODS@#This study was conducted among 60 American Society of Anesthesiologists (ASA) class II-III patients with gastric cancer (regardless of gender, aged 35-75 years with BMI of 18.5-26 kg/m2) undergoing elective laparoscopic radical gastrectomy. The patients were randomized into experimental group (S group, n=30) and control group (NS group, n=30). In S group, SGB at the C6 level of the right cervical spine was performed under ultrasound guidance 15 min before induction of anesthesia by injection of 7 mL 0.5% ropivacaine; the patients in NS group received injections of normal saline in the same manner. Peripheral venous blood samples were collected before SGB (T1), after surgery (T2), and on the 2nd and 6th days after surgery (T3 and T4) for determination of the levels of motitin (MOT), vasoactive intestinal peptide (VIP), cortisol (COR), and blood glucose (GLU). Intraoperative usage of sufentanil, recovery rate of intestinal sounds at 36, 48, 60, 72, 84 and 96 h after operation and the time of first passage of flatus were recorded and compared between the two groups.@*RESULTS@#There was no significant difference in the total amount of sufentanil consumption between the two groups. Compared with those in NS group, the patients in S group had significant lower COR and VIP levels (P < 0.05) and higher MOT level (P < 0.05) at T2, T3 and T4. Glu level at T2 and T3 was also significantly lower in S group (P < 0.05). The recovery rates of intestinal sounds at 36, 48, 60, 72 and 84 h after surgery were significantly higher (P < 0.05) and the time of the first passage of flatus was earlier in S group than in NS group (P < 0.05).@*CONCLUSION@#In patients with gastric cancer undergoing laparoscopic radical gastrectomy, ultrasound-guided SGB can reduce postoperative stress level, promote the recovery of gastrointestinal hormone secretion, and accelerate postoperative recovery of gastrointestinal functions.


Subject(s)
Adult , Aged , Gastrectomy , Humans , Laparoscopy , Middle Aged , Recovery of Function , Stellate Ganglion , Stomach Neoplasms/surgery , Ultrasonography, Interventional
12.
Article in Chinese | WPRIM | ID: wpr-936304

ABSTRACT

OBJECTIVE@#To investigate the expression of profilin 2 (PFN2) in gastric cancer and assess its potential value as a novel prognostic indicator and a therapeutic target.@*METHODS@#We collected gastric cancer and paired adjacent tissues from 100 patients for immunohistochemical detection of PFN2 expression. According to the expression level of PFN2, the patients were divided into two groups with high (46 cases) and low (48 cases) PNF2 expression in cancer tissues, and also into two groups with high (26 cases) and low (49 cases) PNF2 expression in adjacent tissues. Chi-square test, Spearman correlation and KaplanMeier survival analysis were used to analyze the relationship between PFN2 protein expression level and the patients' clinical parameters. We also tested the effects of PFN2 knockdown and overexpression on the proliferation and migration of MKN-45 cells using Transwell assay and CCK-8 assay.@*RESULTS@#The expression of PFN2 protein was significantly higher in gastric cancer tissues than in adjacent tissues (P < 0.01). PFN2 expression was positively correlated with M-stage of gastric cancer and VEGFR expression in the tumor tissues (P < 0.01). A high expression of PFN2 protein was significantly correlated with a poor prognosis of gastric cancer patients (P < 0.01), and was an independent predictor of the prognosis of gastric cancer. In MKN-45 cells, the cells overexpressing PFN2 showed significantly stronger proliferation and migration abilities than those with PFN2 knockdown (P < 0.001).@*CONCLUSION@#PFN2 protein is highly expressed in gastric cancer tissues to promote the proliferation and migration of the tumor cells. PFN2 may serve as a potential diagnostic marker, a prognostic indicator and a therapeutic target for gastric cancer.


Subject(s)
Cell Proliferation , Humans , Profilins/metabolism , Prognosis , Stomach Neoplasms/pathology , Survival Analysis
13.
Article in Chinese | WPRIM | ID: wpr-936084

ABSTRACT

Objective: To establish a neural network model for predicting lymph node metastasis in patients with stage II-III gastric cancer. Methods: Case inclusion criteria: (1) gastric adenocarcinoma diagnosed by pathology as stage II-III (the 8th edition of AJCC staging); (2) no distant metastasis of liver, lung and abdominal cavity in preoperative chest film, abdominal ultrasound and upper abdominal CT; (3) undergoing R0 resection. Case exclusion criteria: (1) receiving preoperative neoadjuvant chemotherapy or radiotherapy; (2) incomplete clinical data; (3) gastric stump cancer.Clinicopathological data of 1231 patients with stage II-III gastric cancer who underwent radical surgery at the Fujian Medical University Union Hospital from January 2010 to August 2014 were retrospectively analyzed. A total of 1035 patients with lymph node metastasis were confirmed after operation, and 196 patients had no lymph node metastasis. According to the postoperative pathologic staging. 416 patients (33.8%) were stage Ⅱ and 815 patients (66.2%) were stage III. Patients were randomly divided into training group (861/1231, 69.9%) and validation group (370/1231, 30.1%) to establish an artificial neural network model (N+-ANN) for the prediction of lymph node metastasis. Firstly, the Logistic univariate analysis method was used to retrospectively analyze the case samples of the training group, screen the variables affecting lymph node metastasis, determine the variable items of the input point of the artificial neural network, and then the multi-layer perceptron (MLP) to train N+-ANN. The input layer of N+-ANN was composed of the variables screened by Logistic univariate analysis. Artificial intelligence analyzed the status of lymph node metastasis according to the input data and compared it with the real value. The accuracy of the model was evaluated by drawing the receiver operating characteristic (ROC) curve and obtaining the area under the curve (AUC). The ability of N+-ANN was evaluated by sensitivity, specificity, positive predictive values, negative predictive values, and AUC values. Results: There were no significant differences in baseline data between the training group and validation group (all P>0.05). Univariate analysis of the training group showed that preoperative platelet to lymphocyte ratio (PLR), preoperative systemic immune inflammation index (SII), tumor size, clinical N (cN) stage were closely related to postoperative lymph node metastasis. The N+-ANN was constructed based on the above variables as the input layer variables. In the training group, the accuracy of N+-ANN for predicting postoperative lymph node metastasis was 88.4% (761/861), the sensitivity was 98.9% (717/725), the specificity was 32.4% (44/136), the positive predictive value was 88.6% (717/809), the negative predictive value was 84.6% (44/52), and the AUC value was 0.748 (95%CI: 0.717-0.776). In the validation group, N+-ANN had a prediction accuracy of 88.4% (327/370) with a sensitivity of 99.7% (309/310), specificity of 30.0% (18/60), positive predictive value of 88.0% (309/351), negative predictive value of 94.7% (18/19), and an AUC of 0.717 (95%CI:0.668-0.763). According to the individualized lymph node metastasis probability output by N+-ANN, the cut-off values of 0-50%, >50%-75%, >75%-90% and >90%-100% were applied and patients were divided into N0 group, N1 group, N2 group and N3 group. The overall prediction accuracy of N+-ANN for pN staging in the training group and the validation group was 53.7% and 54.1% respectively, while the overall prediction accuracy of cN staging for pN staging in the training group and the validation group was 30.1% and 33.2% respectively, indicating that N+-ANN had a better prediction than cN stage. Conclusions: The N+-ANN constructed in this study can accurately predict postoperative lymph node metastasis in patients with stage Ⅱ-Ⅲ gastric cancer. The N+-ANN based on individualized lymph node metastasis probability has better accurate prediction for pN staging as compared to cN staging.


Subject(s)
Artificial Intelligence , Humans , Lymph Nodes/pathology , Lymphatic Metastasis , Neoplasm Staging , Neural Networks, Computer , Prognosis , Retrospective Studies , Stomach Neoplasms/surgery
14.
Article in English | WPRIM | ID: wpr-929036

ABSTRACT

With the recent upsurge of studies in the field of microbiology, we have learned more about the complexity of the gastrointestinal microecosystem. More than 30 genera and 1000 species of gastrointestinal microflora have been found. The structure of the normal microflora is relatively stable, and is in an interdependent and restricted dynamic equilibrium with the body. In recent years, studies have shown that there is a potential relationship between gastrointestinal microflora imbalance and gastric cancer (GC) and precancerous lesions. So, restoring the balance of gastrointestinal microflora is of great significance. Moreover, intervention in gastric premalignant condition (GPC), also known as precancerous lesion of gastric cancer (PLGC), has been the focus of current clinical studies. The holistic view of traditional Chinese medicine (TCM) is consistent with the microecology concept, and oral TCM can play a two-way regulatory role directly with the microflora in the digestive tract, restoring the homeostasis of gastrointestinal microflora to prevent canceration. However, large gaps in knowledge remain to be addressed. This review aims to provide new ideas and a reference for clinical practice.


Subject(s)
Drugs, Chinese Herbal/therapeutic use , Gastrointestinal Microbiome , Humans , Medicine, Chinese Traditional , Precancerous Conditions/pathology , Stomach Neoplasms/pathology
15.
Acta Pharmaceutica Sinica ; (12): 233-241, 2022.
Article in Chinese | WPRIM | ID: wpr-913175

ABSTRACT

This paper aims to develop folic acid-modified paclitaxel nanocrystals (PTX NC@FA) with good stability, high drug loading and tumor cell targeting for endoscopic injection for preoperative local chemotherapy of gastric cancer. PTX NC@FA was prepared by the "bottom-up" followed by ultrasonic to study its morphology, particle size, ζ-potential, drug loading, folic acid-modified phospholipid (FA-DSPE-PEG2000) content, crystalline characteristics, stability, in vitro release, cytotoxicity against human gastric cancer cell line SGC-7901, and anti-tumor effect in two different tumor sizes (tumor volume 100 mm3 or 300 mm3) after single peri-tumor injection in a murine subcutaneous SGC-7901 tumor model. Animal experiments were approved by the Experimental Animal Ethics Committee of the School of Pharmacy, Fudan University. The resulting PTX NC@FA was of short rod-like shape, average particle size 175.3 ± 2.5 nm (PDI 0.17 ± 0.02), ζ- potential -2.5 ± 0.2 mV, PTX loading (28.23 ± 0.74) % (w/w) and FA-DSPE-PEG2000 content (4.40 ± 0.60) % (w/w). The size of the PTX NC@FA remained unchanged for 4 days in phosphate buffer with or without serum. Cellular growth inhibition effect on SGC-7901 showed the superiority of PTX NC@FA over nanocrystals without FA modification. PTX NC@FA inhibited tumor growth more efficiently than both nanocrystals without FA modification and commercially available paclitaxel injection (Taxol) 12 days after peri-tumor injection. For model tumor with the volume of 100 mm3, tumors of all animals in the PTX NC@FA group disappeared completely. For model tumor with the volume of 300 mm3, tumors of 3 animals in the PTX NC@FA group completely disappeared and tumors of the rest 4 animals also became significantly smaller with a tumor volume inhibition rate of 90%. PTX NC@FA showed good potential for preoperative chemotherapy of increase the chances of function preserving gastrectomy and improve the quality of life of patients.

16.
Article in Chinese | WPRIM | ID: wpr-936048

ABSTRACT

Objective: It is not yet to be clarified whether proximal gastrectomy with double tract anastomosis reconstruction (PG-DT) for gastric cancer increases postoperative complications. This meta-analysis aims to evaluate the safety and efficacy of PG-DT for upper gastric cancer. Methods: The Chinese and English literatures about PG-DT and total gastrectomy with Roun-en-Y digestive tract reconstruction (TG-RY) for upper gastric cancer were searched from PubMed, Embase, Cochrane Library, Wiley Online Library, Web of Science, CNKI net, Wanfang database and VIP database. Literature inclusion criteria: (1) prospective or retrospective cohort study of PG-DT and TG-RY for upper gastric cancer published publicly; (2) patients with upper gastric cancer; (3) the enrolled literatures included at least one of the following outcome indicators: operation time, intraoperative blood loss, postoperative exhaust time, postoperative feeding time, hospitalization time, number of harvested lymph nodes, postoperative complications, postoperative 1-year albumin, postoperative 1-year hemoglobin and 1-, 3-, 5-year survival after surgery. Literature exclusion criteria: (1) reviews, case reports, conference summaries and other non-control studies; (2) studies published repeatedly, studies with incomplete or unextractable information. The search time ended in February 2021. The basic information and evaluation indicators included in the article were extracted. The retrospective study was evaluated using Newcastle-Ottawa literature quality evaluation scale. The prospective randomized controlled study was evaluated using Jadad modified scale. Meta-analysis was performed using Review Manager 5.3. Publication bias was assessed using funnel map. Publication bias was tested using Egger tools. Results: A total of 385 literatures were searched, finally 2 randomized controlled trials and 16 retrospective cohort study were included. There were 1521 patients, including 692 in the PG-DT group and 829 in the TG-RY group. The meta-analysis of the enrolled indicators showed that as compared to TG-RYT group, PG-DT group had less intraoperative blood loss (OR=-54.58, 95%CI: -57.77 to -51.38, P<0.001), shorter postoperative exhaust time (OR=-0.21, 95%CI: -0.29 to -0.13, P<0.001), shorter hospitalization time (OR=-0.98, 95%CI: -1.31 to -0.64, P<0.001), less harvested lymph nodes (OR=-6.07, 95%CI: -7.14 to -4.99, P<0.001), lower morbidity of postoperative complication (OR=0.32, 95%CI: 0.24 to 0.43,P<0.001), higher level of postoperative 1-year albumin (OR=1.90, 95%CI: 1.08 to 2.77, P<0.001) and postoperative 1 year hemoglobin (OR=5.07, 95%CI: 2.83 to 7.31, P<0.001). While there were no significant differences in operation time (OR=0.08, 95%CI: -4.24 to 4.39, P=0.97), postoperative feeding time (OR=-0.05, 95%CI: -0.15 to 0.06, P=0.39), 1-year survival after surgery (OR=1.61, 95%CI: 0.69 to 3.75, P=0.27), 3-year survival after surgery (OR=1.31, 95%CI: 0.81 to 2.10, P=0.27) and 5-year survival after surgery (OR=1.50, 95%CI: 0.86 to 2.63, P=0.15) between two groups. Conclusions: PG-DT treatment for upper gastric cancer is safe and feasible. Compared with TG-RY, PG-DT has advantages in intraoperative bleeding, postoperative exhaust time, hospitalization time, morbidity of postoperative complication and postoperative nutritional indicators.


Subject(s)
Anastomosis, Surgical , Gastrectomy , Humans , Postoperative Complications , Prospective Studies , Randomized Controlled Trials as Topic , Retrospective Studies , Stomach Neoplasms/surgery , Treatment Outcome
17.
Article in Chinese | WPRIM | ID: wpr-936045

ABSTRACT

Objective: Patients with advanced gastric cancer have a poor prognosis and a possibility of peritoneal metastasis even if receiving gastrectomy. Hyperthermic intraperitoneal chemotherapy (HIPEC) can effectively kill free cancer cells or small lesions in the abdominal cavity. At present, preventive HIPEC still lacks safety evaluation in patients with locally advanced gastric cancer. This study aims to explore the safety of radical resection combined with HIPEC in patients with locally advanced gastric cancer. Methods: A descriptive case series study was carried out. Clinicopathological data of 130 patients with locally advanced gastric cancer who underwent radical resection + HIPEC at the Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2020 to February 2021 were retrospectively analyzed. Inclusion criteria: (1) locally advanced gastric adenocarcinoma confirmed by postoperative pathology; (2) no distant metastasis was found before surgery; (3) radical resection; (4) at least one HIPEC treatment was performed. Exclusion criteria: (1) incomplete clinicopathological data; (2) tumor metastasis was found during operation; (3) concomitant with other tumors. HIPEC method: all the patients received the first HIPEC immediately after D2 radical resection, and returned to the ward after waking up from anesthesia; the second and the third HIPEC were carried out according to the patient's postoperative recovery and tolerance; interval between two HIPEC treatments was 48 h. Observation indicators: (1) basic information, including gender, age, body mass index, etc.; (2) treatment status; (3) perioperative adverse events: based on the standard of common adverse events published by the US Department of Health and Public Health (CTCAE 5.0), the adverse events of grade 2 and above during the treatment period were recorded, including hypoalbuminemia, bone marrow cell reduction, wound complications, abdominal infection, lung infection, gastroparesis, anemia, postoperative bleeding, anastomotic leakage, intestinal obstruction, pleural effusion, abdominal distension, impaired liver function, and finally a senior professional title chief physician reviewed the above adverse events and made a safety evaluation of the patient; (4) association between times of HIPEC treatment and adverse events in perioperative period; (5) analysis of risk factors for adverse events in perioperative period. Results: Among the 130 patients, 79 were males and 51 were females with a median age of 59 (54, 66) years and an average body mass index of (23.9±7.4) kg/m(2). The tumor size was (5.4±3.0) cm and 100 patients (76.9%) had nerve invasion. All the 130 patients received radical resection + HIPEC and 125 (96.2%) patients underwent laparoscopic surgery. The mean operative time was (345.6±52.3) min and intraoperative blood loss was (82.0±36.5) ml. One HIPEC treatment was performed in 54 patients (41.5%), 2 HIPEC treatments were in 57 (43.8%), and 3 HIPEC treatments were in 19 (14.6%). The average postoperative hospital stay was (13.1±7.5) d. A total of 57 patients (43.8%) had 71 cases of postoperative complications of different degrees. Among them, the incidence of hypoalbuminemia was 22.3% (29/130), and the grade 2 and above anemia was 15.4% (20/130), lung infection was 3.8% (5/130), bone marrow cell suppression was 3.7% (4/130), abdominal cavity infection was 2.3% (3/130), and liver damage was 2.3% (3/130), wound complications was 1.5% (2/130), abdominal distension was 1.5% (2/130), anastomotic leakage was 0.8% (1/130), gastroparesis was 0.8% (1/130) and intestinal obstruction was 0.8% (1/130), etc. These adverse events were all improved by conservative treatments. There were no statistically significant differences in the incidence of adverse events during the perioperative period among patients undergoing 1, 2, and 3 times of HIPEC treatments (all P>0.05). Univariate and multivariate logistic analyses showed that age > 60 years (OR: 2.346, 95%CI: 1.069-5.150, P=0.034) and neurological invasion (OR: 2.992, 95%CI: 1.050-8.523, P=0.040) were independent risk factors for adverse events in locally advanced gastric cancer patients undergoing radical resection+HIPEC (both P<0.05). Conclusions: Radical surgery + HIPEC does not significantly increase the incidence of perioperative complications in patients with advanced gastric cancer. The age >60 years and nerve invasion are independent risk factors for adverse events in these patients.


Subject(s)
Female , Gastrectomy , Humans , Hyperthermic Intraperitoneal Chemotherapy , Male , Middle Aged , Peritoneal Neoplasms/therapy , Retrospective Studies , Stomach Neoplasms/surgery
18.
Article in Chinese | WPRIM | ID: wpr-936040

ABSTRACT

The incidence and mortality rates of gastric cancer are among the top three cancers in China, which poses great threat to people's lives and health. So far, surgery remains to be the cornerstone of treatment for gastric cancer. With the development of laparoscopic surgery, minimally invasive treatment techniques, together with the deepening of clinical researches, as we review the research progress in 2021, the core controversial issues of gastric cancer surgery have been basically addressed. The series of "minimal-innovation" concepts and technologies represented by single-incision/reduced-port laparoscopic surgeries have been further developed; radiomics and artificial intelligence aided prediction have been applied into the forefront of surgical accurate decision-making; targeted and immune-therapy is about to break through the bottleneck of surgical efficacy of gastric cancer. Currently, molecular imaging and targeted tracer guided precision cancer surgery are being explored, which is expected to revolutionize in key links such as real-time in-vivo determination of tumor margin, tracing of metastatic lymph nodes and visualization of nerves. Looking forward into the future, gastric cancer surgery will break through the century-old ceiling of "gross appearance by naked eye" and "traditional extensive experience", and set off a new round of technological revolutions in molecular visualization intelligent precision minimally invasive surgery.


Subject(s)
Artificial Intelligence , Digestive System Surgical Procedures , Gastrectomy , Humans , Laparoscopy , Lymph Node Excision , Minimally Invasive Surgical Procedures , Stomach Neoplasms/surgery
19.
Article in Chinese | WPRIM | ID: wpr-934362

ABSTRACT

Objective:This study aimed to investigate the expression of plasma exosomal hsa_circ_0064910 in gastric cancer (GC) patients, explore its correlation with the clinical pathological characteristics and evaluate its diagnostic efficacy in GC.Methods:Sixty patients with GC and 30 patients with Chronic Gastritis (disease control group) admitted to The First Affiliated Hospital of Henan University from October 2019 to December 2020 were selected. Meanwhile, 30 healthy subjects (healthy control group) who underwent physical examination were also enrolled. General data of GC patients were collected, including tumor size, degree of differentiation, TNM stage, lymph node metastasis, etc. Blood samples were collected before treatment and the expression levels of plasma exosomal hsa_circ_0064910 were detected via quantitative reverse transcription PCR (qRT-PCR). The serum concentrations of traditional biomarker (CEA and CA19-9) were measured via a chemiluminescent detection system. The receiver operating characteristic (ROC) curve and area under curve (AUC) were used to estimate the diagnostic capacity of different index in GC. Then, the expression difference of plasma exosomal hsa_circ_0064910 in GC patients before and after operation was analyzed, and its relationship with clinicopathological features of GC patients was also investigated.Results:RT-PCR results revealed that compared with Chronic gastritis patients and healthy control, the expression of plasma exosomal hsa_circ_0064910 was upregulated in the gastric cancer group(0.47±0.06, 0.43±0.05, 0.97±0.12, all P<0.001). The area under the ROC curve was 0.778, and AUC of the combination of CEA and CA19-9 for the diagnosis of gastric cancer was 0.841. which was higher than the diagnostic accuracies of CEA (AUC=0.673)and CA 19-9(AUC=0.653). The expression level of exosomal hsa_circ_0064910 was also significantly correlated with tumor size( χ2=7.545, P<0.01), TNM stage( χ2=4.571, P<0.05)and lymph node metastasis( χ2=6.907, P<0.01). The postoperative expression levels of exosomal hsa_circ_0064910 were lower compared with those of preoperative levels(1.21±0.21 vs 0.62±0.11, P<0.01). Conclusion:Our data demonstrated that exosomal hsa_circ_0064910 is highly expressed in GC patients and might be a potential noninvasive biomarker for the auxiliary diagnosis of GC.

20.
Chinese Journal of Digestion ; (12): 163-170, 2022.
Article in Chinese | WPRIM | ID: wpr-934141

ABSTRACT

Objective:To explore the association of platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) with early gastric cancer (EGC), and to assess the predictive value of PLR and NLR in EGC diagnosis.Methods:From January 1, 2017 to December 31, 2020, 178 patients with EGC, 129 patients with chronic gastritis (CG), 122 patients with gastric intraepithelial neoplasia (GIN) admitted and treated at Taizhou Hospital of Zhejiang Province were enrolled. According to Rand random function and with the ratio of 7 to 3, the patients were divided into training group ( n=301, 125 cases of EGC, 90 cases of CG, 86 cases of GIN) and validation group ( n=128, 53 cases of EGC, 39 cases of CG, 36 cases of GIN). The age, gender, routine blood test, carcinoembryonic antigen (CEA) level, Helicobacter pylori ( H. pylori) infection status and other data of the patients were collected. The routine blood test and clinical characteristics of EGC, CG and GIN patients of the training group, and the routine blood test of EGC patients and CG+ GIN patients (hereinafter referred to as non-EGC group) of training group were compared to analyzed the independent risk factors of EGC. Receiver operator characteristic curve (ROC) was drawn. The optimal cut-off value, area under the curve (AUC), OR, 95% confidence interval (95% CI) of independent risk factors were analyzed for EGC diagnosis and prediction. A diagnostic prediction model was established, and the model was apply to the validation group for validation. Hosmer-Lemeshow test was used to test the fitting degree of the model. Compared the AUC of the model applied to training group with validation group to evaluate the discrimination of model. Kruskal-Wallis H test, Mann-Whitney U test or Wilcoxon rank sum test, chi square test, and univariate and multivariate logistic regression analysis were used for statistical analysis. Results:In the training group, the proportions of males and females in CG, GIN and EGC patients were 50.0% (45/90) and 50.0% (45/90), 61.6% (53/86) and 38.4% (33/86), 69.6% (87/125) and 30.4% (38/125), respectively, and the difference was statistically significant ( χ2=8.49, P=0.014). The proportion of males in EGC patients was higher than that in CG patients, and the difference was statistically significant ( χ2 =8.48, P=0.004). The H. pylori infection rate, age, PLR, NLR, lymphocyte count, neutrophil count, and CEA level of CG, GIN and EGC patients in the training group were 18.9% (17/90), 18.6% (16/86) and 43.2% (54/125); 54.0 years old (45.5 years old, 64.0 years old), 63.0 years old (58.0 years old, 66.3 years old) and 66.0 years old (58.5 years old, 71.0 years old); 113.70 (84.48, 136.09), 120.00 (97.94, 138.37) and 124.29 (101.97, 173.57), 1.55 (1.17, 2.23), 1.71 (1.44, 2.02) and 2.04 (1.57, 2.62), 2.00×10 9/L (1.50×10 9/L, 2.40×10 9/L), 1.75×10 9/L (1.50×10 9/L, 2.40×10 9/L) and 1.60×10 9/L (1.30×10 9/L, 2.05×10 9/L), 3.00×10 9/L (2.38×10 9/L, 3.90×10 9/L), 3.00×10 9/L (2.48×10 9/L, 3.40×10 9/L) and 3.30×10 9/L (2.60×10 9/L, 4.30×10 9/L), 1.70 g/L (1.10 g/L, 2.50 g/L), 2.05 g/L (1.48 g/L, 2.90 g/L) and 2.50 g/L (1.55 g/L, 3.40 g/L), respectively, and the differences were statistically significant ( χ2=21.26, H=41.00, 11.79, 21.13, 10.82, 8.54 and 14.42; all P<0.05). The H. pylori infection rate of EGC patients was higher than that of CG and GIN patients, the ages of EGC and GIN patients were older than that of CG patients, the NLR and PLR levels of EGC patients were higher than those of CG patients, the NLR level of EGC patients was higher than that of GIN patients, the level of lymphocyte count of EGC patients was lower than that of CG patients, and the levels of neutrophil count and CEA were higher than those of CG patients, and the differences were statistically significant( χ2=13.98 and 13.90, Z=-6.13, -4.15, -4.07, -3.25, -3.40, -3.18, -2.62 and -3.74; all P<0.017). The levels of PLR, NLR, neutrophil count and CEA of EGC patients were all higher than those of non-EGC patients(124.29 (101.97, 173.57) vs. 117.97 (101.57, 137.32); 2.04(1.57, 2.62) vs.1.66(1.25, 2.17); 3.30×10 9/L (2.60×10 9/L, 4.30×10 9/L) vs.3.00×10 9/L(2.40×10 9/L, 3.60×10 9/L); 2.50 g/L (1.55 g/L, 3.40 g/L) vs. 1.90 g/L(1.23 g/L, 2.70 g/L)), and the lymphocyte count level was lower than that of non-EGC patients (1.60×10 9/L(1.30×10 9/L, 2.05×10 9/L) vs. 1.80×10 9/L(1.50×10 9/L, 2.20×10 9/L)), and the differences were statistically significant ( Z=-3.23, -4.45, -2.91, -3.30 and -2.35; all P<0.05). The results of ROC analysis showed that the optimal cut-off value of PLR, NLR, CEA, neutrophil count and lymphocyte count was 138.18, 1.76, 2.70 g/L, 3.40×10 9/L, 1.80×10 9/L, respectively. The results of univariate analysis indicated that the gender, age, H. pylori infection, neutrophil count, PLR, NLR, lymphocyte count and CEA were all related to EGC ( χ2=5.98, 27.73, 21.26, 8.26, 10.26, 22.80, 4.81 and 25.91; all P<0.05). The results of multivariate analysis demonstrated that age≥70 years old( OR=9.267, 95% CI 3.239 to 26.514), H. pylori infection ( OR=3.353, 95% CI 1.862 to 6.037), NLR >1.76 ( OR=2.084, 95% CI 1.190 to 3.648), PLR>138.18 ( OR=2.452, 95% CI 1.325 to 4.539), CEA >2.70 g/L ( OR=2.637, 95% CI 1.490 to 4.667) were independent risk factors for EGC (all P<0.05). The Hosmer-Lemeshow test showed that there was no statistically significant difference between the predicted value of the model and the actual observed value ( P>0.05), which indicated that the fitting degree of the model was good. In the training group, the AUC of the diagnostic prediction model was 0.787 (95% CI 0.737 to 0.832, P<0.001). The model was applied to the validation group for validation, and the result showed that the AUC of the model was 0.664 (95% CI 0.576 to 0.745, P<0.001), which indicated that the discrimination of the model was good. Conclusions:PLR and NLR are independent risk factors of EGC, and may help to identify EGC. In this study the established diagnostic model has good discrimination and fitting degree, which can provide important reference information for early clinical diagnosis of EGC, which may facilitate early treatment and improve prognosis of patients.

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