[Integrin α5 promotes the proliferation, invasion and adhesion of gastric cancer by regulating the FAK/Src/Rac1 signaling pathway].

Objective: To elucidate the biological role and potential mechanism of integrin α5 (ITGA5) in gastric cancer (GC). Methods: From January 2019 to December 2020, 35 pairs of GC tissue [21 males and 14 females, aged (53.8±5.4) years] and matched adjacent tissue samples were collected from GC patients who underwent surgical resection in Zhejiang Provincial People's Hospital. GC and normal gastric mucosa cells were purchased from Beijing Biobw Biotech Company. Quantitative real-time PCR (qRT-PCR), immunohistochemistry, Western blotting were performed to detect the mRNA and protein expression levels of ITGA5, cell adhesion-related genes (pFAK, pSrc, aRac1) in GC cells. Cell Counting Kit-8 (CCK-8), Transwell invasion, wound healing and cell adhesion assays were conducted for GC cell phenotype detection. Results: ITGA5 was highly expressed in GC compared with normal gastric mucosa cells (relative expression increased from 1.00±0.26 to 1.23±0.27,P<0.05). In addition, ITGA5 overexpression promoted the cell proliferation [from (1.14±0.14) OD to (1.61±0.14) OD], migration ability [from (20.3±2.3)% to (56.4±6.1)%], invasion ability (from 144.0±4.6 to 216.7±6.6), and adhesion ability of matrix protein (from 99.0±8.5 to 152.0±12.3) through FAK/Src/Rac1 signaling pathway in GC.(all P<0.05) Conclusions: ITGA5 acts as a cancer-promoting factor in GC. The current study provides theoretical evidence for probing the novel molecular targets for the treatment of GC.

[Diagnosis and treatment of gastric cancer with immediate double primary carcinoma].

Objective: To investigate the clinical characteristics, treatment and prognosis of gastric cancer complicated with immediate double primary cancer. Methods: The clinical data of patients who met the diagnostic criteria of gastric cancer with immediate double primary cancer from January 2016 to June 2019 were analyzed retrospectively. Results: There were 29 cases of gastric cancer with immediate double primary carcinoma, accounting for 1.7% of the 1 741 patients with gastric cancer in the same period. Of these, 17 (58.6%) were more than 70 years of age. 25 cases (86.2%) were male. The postoperative pathological staging was mainly for early gastric cancer (63.2%). Colorectal cancer accounted for 8 cases (27.6%), followed by esophageal cancer in 7 cases (24.1%). The others included 6 cases of lung cancer (20.7%), 2 cases of pancreatic cancer (6.9%), 2 cases of prostate cancer (6.9%), 1 case of non-Hodgkin's lymphoma (3.4%), 1 case of ampullary tumor (3.4%), 1 case of bile duct carcinoma (3.4%) and 1 case of laryngeal carcinoma (3.4%). The prognosis of the surgical treatment group was significantly better than that of the non-surgical treatment group (median survival time: 21.0 months vs 13.0 months, P=0.014). Conclusion: Gastric cancer complicated with immediate double primary cancer mostly occurs in elderly men and early gastric cancer patients. In the complicated tumor, colorectal cancer is the main cause, so we should pay attention to the screening of digestive system. Radical surgery should be performed as far as possible for each primary tumor.

[Surgical treatment of port-site metastases after laparoscopic radical resection of gastric cancer].

Objective: To investigate the feasibility of surgical treatment of port-site metastasis after laparoscopic radical resection of gastric cancer. Methods: The clinical and follow-up data of five patients with port-site metastases after laparoscopic radical resection of gastric cancer at Zhejiang Provincial People's Hospital between January 2014 and January 2018 were retrospectively analyzed. Results: Port-site metastases occurred within 6 months after gastrointestinal tumor resection in three patients, 10 months after the operation in one patient, and 30 months after the operation in one patient, respectively. Metastasis to the abdominal cavity or distant metastasis was excluded before the surgical treatment of the port-site metastases, and all patients recovered well after the operation. No incisional infection or hernia occurred. By December 2018, two patients died (they survived for 13 and 24 months, respectively) and three patients survived. The follow-up duration ranged from 7 to 19 months. Conclusions: Surgical resection of port-site metastases is not difficult due to their superficial location. Surgical treatment can improve the prognosis of patients without abdominal or distant metastasis/recurrence.

[Dose effect relationship of the stilled water with the elimination of the exfoliated cancer cells in the peritoneal cavity during hepatocellular carcinoma resection].

Objective: The aim of the study was to investigate the dose effect relationship of warm distilled water to remove the exfoliated cancer cells (ECC) in peritoneal cavity in 116 cases of hepatocellular carcinoma. Methods: Positive rates of exfoliated cancer cells in 116 patients with hepatocellular carcinoma were detected before and after the removal of the tumor. The 43 to 45 ℃ distilled water was used by 1 500 ml/time before closing the abdomen, and then 37 ℃ sterile normal saline 200 ml was used for peritoneal lavage and collected for exfoliated cancer cell detection. Results: Positive rates of ECC had no significant difference before and after resection in groups with tumor diameter ≤10 cm (all P>0.05); positive rates of ECC were significantly increased after tumor resection in groups with tumor diameter>10 cm (≤15 cm, >10 cm, P=0.044; >15 cm, P=0.033). With the increase of tumor volume, ECC positive rates were significantly increased after resection (P<0.001), and the residual rate increased after washing; the residual rates was significantly decreased with the increasing of irrigation times in groups with tumor diameter>10 cm (≤15 cm, >10 cm, P=0.002; >15 cm, P=0.001), and undetectable after four times washing. With the increase of irrigation times, the residual rates were not significantly decreased (all P >0.05) in groups with tumor diameter ≤5 cm, but no residue was detected after three times of washing. Conclusion: The volume of irrigation needed to eliminate the ECC in the peritoneal cavity during the operation of hepatocellular carcinoma is significantly correlated with the tumor size.

AKR1B10, a good prognostic indicator in gastric cancer.

BACKGROUND AND OBJECTIVES: The aim of the study was to investigate the correlation between AKR1B10 expression and clinicopathological features of gastric cancer (GC). METHODS: Real-time polymerase chain reaction (RT-PCR) was performed to determine AKR1B10 mRNA expression. AKR1B10 protein levels were measured by immunohistochemistry. RESULTS: RT-PCR analysis confirmed that AKR1B10 was significantly down-regulated in gastric cancer compared with paired, normal mucosa. Immunohistochemistry revealed that the percentage of AKR1B10-positive specimens was lower in gastric carcinoma compared with normal specimens. The frequency of AKR1B10-positive GC specimens was higher in patients with tumor size <5 cm, no lymph node metastasis, no distant metastasis and lower tumor stages The mean survival time for patients in the AKR1B10-positive group was significantly higher compared with the AKR1B1-negative group. The 5-year survival rate for the AKR1B10-positive group was also significantly higher than for the AKR1B1-negative group. Cox regression analysis revealed that AKR1B10 expression is an independent prognostic factor of GC. CONCLUSIONS: Expression of AKR1B10 in gastric cancer was significantly associated with tumor size, lymph node metastasis, distance metastasis and TNM stage, and AKR1B10 may be a good prognostic indicator in gastric cancer.