Research progress of translational medicine for gastric cancer / 中华消化外科杂志

Gastric cancer is one of the most common malignant digestive tumors globally.The comprehensive treatment based on surgery of gastric cancer can not satisfy the purpose to reduce morbidity and mortality.In recent years,translational medicine has emerged with the rapid development of basic medical research,such as molecular biology,and the change of medical patterns.The core of translational medicine is to establish a fast conversion channel between basic research and clinical applications which could translate basic research results into theories,technologies and products for clinical practice.In the present paper,the research progress of translational medicine in the diagnosis and treatment of gastric cancer will be summarized,and the role of translational medicine for precise treatment of gastric cancer will be discussed.

Gastrointestinal Microecology and Postoperative Diarrhea after Gastrointestinal Tumor Surgery / 沈阳医学院学报

As a common postoperative complication after gastrointestinal tumor surgery, the diarrhea adversely affects the recovery and the life quality of the patients. The occurrence of diarrhea is closely related to the operations and the perioperative treatments. Meanwhile,the gastrointestinal microecological disorders are found to be involved. In this article,the author will make a systemic review on the related factors and their treatments of the postoperative diarrhea after gastrointestinal tumor surgery, and mainly discuss the microecological issues involved in these processes.

Integration and analysis of associated data in surgical treatment of gastric cancer based on multicenter, high volume databases / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To elucidate the current diagnosis and treatment status of gastric cancer in the Chinese population based on three high volume databases.</p><p><b>METHODS</b>Clinical and pathological data of patients who underwent gastric cancer resection with complete follow-up information between January 2000 and December 2012 from Sun Yat-sen University Cancer Center, The First Affiliated Hospital of China Medical University and Tianjin Medical University Cancer Hospital were retrospectively analyzed. The overall survival rate was calculated by Kaplan-Meier method. The prognostic risk factors were analyzed by using Cox proportional hazards model.</p><p><b>RESULTS</b>A total of 8 338 cases were enrolled into the study, including 2 977 cases (35.7%) from Sun Yat-sen University Cancer Center, 3 043 cases (36.5%) from The First Affiliated Hospital of China Medical University and 2 318 cases (27.8%) from Tianjin Medical University Cancer Hospital. There were 5 852 male cases and 2 486 female cases with a ratio of 2.4 to 1.0. The age of patients was from 15 to 89 years old (median 59 years old). The ratio of early gastric cancer (T1NanyM0) was 11.5% (956/8 338). There were 2 226 gastric cancer cases (26.7%) originating from the fundus and cardiac region, 1 637 cases (19.6%) from the body, 3739 (44.9%) cases from the antrum, and 736 cases (8.8%) from the whole stomach. The median maximal tumor diameter was (4.5 ± 2.8) cm. Based on the Lauren classification, 3 448 cases (41.4%) were intestinal type and 4 890 cases (58.6%) diffuse type. A total of 1 975 cases (23.7%) and 6 363 cases (76.3%) underwent complete and subtotal gastrectomy respectively. The majority of patients (7 707 cases, 92.4%) underwent radical gastric resection, while 631 cases (7.6%) palliative resection. According to AJCC/UICC seventh edition of gastric cancer TNM staging system, 802 patients (9.6%) were stage I(A, 735 patients (8.8%) stage I(B, 695 patients (8.3%) stage II(A, 1 507 patients (18.1%) stage II(B, 1 247 patients (15.0%) stage III(A, 1 342 patients (16.1%) stage III(B, 1 583 patients (19.0%) stage III (C and 427 patients (5.1%) stage IIII(. The average number of retrieved lymph node was 21.0 ± 13.1, in which 5 761 patients (69.1%) had more than 15 retrieved lymph nodes. The overall 1-, 3-, 5- and 10-year survival rates were 83.0%, 56.8%, 49.1% and 43.0% respectively. For patients receiving radical resection, the 1-, 3-, 5- and 10-year survival rates were 84.9%, 59.5%, 51.7% and 45.3% respectively. The overall 5-year survival rates for different stages were as follows: stage I(A 93.8%, stage I(B 80.8%, stage II(A 70.8%, stage II(B 59.6%, stage III(A 44.4%, stage III(B 32.9%, stage III(C 18.9% and stage IIII( 10.2%. Cox regression model showed that age, tumor site, tumor size, Lauren type, T staging, N staging, M staging and number of retrieved lymph nodes were independent factors affecting the prognosis of gastric cancer patients (P=0.000).</p><p><b>CONCLUSION</b>Retrospective study on these domestic three high volume databases demonstrates the clinical and pathological characteristics of gastric cancer based on Chinese population, which is expected to stand as a ground of basic data for future clinical research.</p>

Iron-deficiency anemia: a predictor of diminished disease-free survival of T3N0M0 stage colon cancer.

PURPOSE: The aim of this study was to determine whether iron-deficiency anemia (IDA) predicts long-term oncologic outcomes in patients with TNM stage II colon cancer. METHODS: Clinical and follow-up data were extracted from a prospective colon cancer database. Univariate and multivariate analyses were performed to identify IDA and other predictors of long-term oncologic outcomes. RESULTS: Among 644 patients, 147 (22.8%) patients presented with IDA. The data were stratified by T3N0M0 and T4N0M0. The distribution difference of IDA between the two subsets was not significant (P = 0.340). But in the T4N0M0 subset, the incidence of IDA increased with the depth of tumor penetration (75.9% and 18.2% for the patients with and without adjacent organ involvement, respectively, P = 0.011). IDA predicted a worse disease-free survival among patients with T3N0M0 cancer (472 patients; log-rank test, P = 0.016; Cox regression, P = 0.009), but it was not a predictor in T4N0M0 cancer patients (172 patients; log-rank test, P = 0.016; Cox regression, P > 0.05). CONCLUSIONS: IDA was an independent predictor of long-term outcome in T3N0M0 stage, but not in T4N0M0 colon cancer. T3N0M0 stage colon cancer patients with IDA could be included in future trials of adjuvant therapies.

Role of heparanase-1 in gastric carcinoma invasion.

PURPOSE: The heparan sulfate-degrading endoglycosidase may mediate tumor invasion and metastasis. It is known that heparanase-1 (HPA-1) plays an important role in cleaving heparan sulfate. In this study we investigated its potential role in gastric carcinoma malignant behaviour. METHODS: To assess the role of HPA-1, we suppressed its expression using small interfering RNA (siRNA). The human heparanase-1 specific siRNA was transfected to the human gastric carcinoma cell line SGC7901. The effect of gene silencing was assessed by Real-Time PCR and Western Blot. The invasion potential of the cells was evaluated using an in vitro cell invasion model system. RESULTS: The HPA-1 specific siRNA significantly suppressed expression of heparanase-1 in SGC7901 cells. Invasion after RNAi treatment through membranes in a model system was significantly decreased. CONCLUSION: HPA-1 facilitates gastric carcinoma invasion by up-regulating endoglycosidase activity in tumor cells.

Paget's disease is associated with eleven cancerous regions: a case report and therapeutic strategy / 华中科技大学学报（医学）（英德文版）

Paget's disease of the breast is an uncommon disorder that accounts for 1% to 3% of all mammary tumors. The incidence of underlying carcinoma associated with Paget's disease has been reported in 82% to 100% of cases. The finding of underlying carcinoma reaches almost 100% when a palpable lump is also present. In this rare case, we described a patient presenting with Paget's disease but no palpable lump. However, we found 11 independent regions which were all invasive ductal carcinoma after the operation. Considering this patient, we should pay more attention to a multifocal and multicentric breast carcinoma associated with Paget's disease. Furthermore, we believe the mammography examination and a modified radical mastectomy are the most appropriate treatments for this population in clinical practice.