Objective： In this study,we aimed to estimate the updated incidence and mortality rate of stomach cancer based on the cancer registration data in 2014,collected by the National Central Cancer Registry of China（NCCRC...Objective： In this study,we aimed to estimate the updated incidence and mortality rate of stomach cancer based on the cancer registration data in 2014,collected by the National Central Cancer Registry of China（NCCRC）.Methods： In 2017,339 registries＇ data were qualified based on the criteria of data quality control of the NCCRC.Cases of stomach cancer were retrieved from the national database.We estimated numbers of stomach cancer cases and deaths in China using age-specific rates and corresponding national population stratified by area,sex,agegroup（0,1–4,5–9,10–14,…,85＋）.Chinese standard population in 2000 and Segi＇s world population were applied for age-standardized incidence and mortality rates.Results： In 2014,410,400 new stomach cancer cases and 293,800 cancer-associated deaths were estimated to have occurred in China.The crude incidence rate of stomach cancer was 30.00/100,000,age-standardized incidence rates by Chinese standard population（ASIRC） and by world standard population（ASIRW） were 19.62/100,000 and19.51/100,000,respectively.The crude mortality rate of stomach cancer was 21.48/100,000,age-standardized mortality rates by Chinese（ASMRC） and by world standard population（ASMRW） were 13.44/100,000 and13.30/100,000,respectively.Incidence and mortality rates in rural areas were both higher than that in urban areas.Stomach cancer has a strong relationship with gender and age.The disease has occurred more frequently among men than women with a male to female ratio of 2.4 for ASIRC.After age group of 40-44 years,incidence rates are substantially higher in men than in women,same pattern was seen for age-specific mortality rates.Conclusions： There is still a heavy burden of stomach cancer in China.The incidence and mortality patterns of stomach cancer show substantial gender and regional disparities.Great effort is needed to provide more accessible health services,sufficient financial resources,and adequate cancer-care infrastructure for the Chinese population,espec展开更多
INTRODUCTIONIn China ,the incidence and mortality of gastric cancer rank the second among all cancers. Recent development of cancer [1-20].The aim of this study was investigat the insight of apoptosis and bcl-2, p53 a...INTRODUCTIONIn China ,the incidence and mortality of gastric cancer rank the second among all cancers. Recent development of cancer [1-20].The aim of this study was investigat the insight of apoptosis and bcl-2, p53 and C-myc protein expression in the development of gastric cancer .展开更多
AIM To evaluate the effects of Helicobacterpylori infection and other environmental factorson the development of gastric cancer.METHODS A population-based case-controlstudy was conducted in Changle County,FujianProvin...AIM To evaluate the effects of Helicobacterpylori infection and other environmental factorson the development of gastric cancer.METHODS A population-based case-controlstudy was conducted in Changle County,FujianProvince.The primary gastric cancer cases werehistologically confirmed or diagnosed by surgerybetween,January 1996 and March 1998.Healthycontrols were randomly selected and matched byage,sex,and neighborhood of residence.Atotal of 101 pairs were included in the study.Specially trained interviewers conducted face-to-face interviews with the subjects according toa standardized questionnaire.Helicobacterpylori infections were measured by serum IgGantibody to Helicobacter pylori.ConditionalLogistic Regression analysis was used.RESULTS The presence of IgG antibody toHelicobacter pylori was 63.7% in studysubjects,56.0% in patients with cardiac cancer,and 60.5% in patients with non-cardiac gastriccancer.The risk factors of gastric cancer inChangle County were identified such as loweducational level[OR=3.864;95% confidenceinterval(95% CI)1.604-9.311],lowconsumption of fresh vegetables(OR=4.925;95%Cl 1.356-17.885),high intake of fish sauce(OR=10.587;95% Cl 2.821-39.738),unscheduled meals(OR=4.254;95%Cl 1.445- 12.552),and Helicobacter pylori infection(OR=3.453;95%Cl 0.901-13.224).CONCLUSION Helicobacter pylori infectionmay be important in the etiology of gastriccancer,but major risk factors other thanHelicobacter pylori are responsible for the highgastric morbidity in Changle County.展开更多
AIM: To evaluate the effects of sulindac in inducing growth inhibition and apoptosis of human gastric cancer cells in comparison with human hepatocellular carcinoma (HCC) cells. METHODS: The human gastric cancer cell ...AIM: To evaluate the effects of sulindac in inducing growth inhibition and apoptosis of human gastric cancer cells in comparison with human hepatocellular carcinoma (HCC) cells. METHODS: The human gastric cancer cell lines MKN45 and MKN28 and human hepatocellular carcinoma cell lines HepG(2) and SMMC7721 were used for the study. Anti-proliferative effect was measured by MTT assay, and apoptosis was determined by Hoechst-33258 staining, electronography and DNA fragmentation. The protein of cyclooxygenase-2 (COX-2) and Bcl-2 were detected by Western dot blotting. RESULTS: Sulindac could initiate growth inhibition and apoptosis of MKN45, MKN28, HepG(2) and SMMC7721 cells in a dose-and time-dependent manner. Growth inhibitory activity and apoptosis were more sensitive in HepG(2) cells than in SMMC7721 cells, MKN45 and MKN28 cells. After 24 hours incubation with sulindac at 2mmol x L(-1) and 4mmol x L(-1), the level of COX-2 and Bcl-2 protein were lowered in MKN45, SMMC7721 and HepG(2) cells but not in MKN28 cells. CONCLUSION: Sulindac could inhibit the growth of gastric cancer cells and HCC cells effectively in vitro by apoptosis induction, which was associated with regression of COX-2 and Bcl-2 expression. The growth inhibition and apoptosis of HCC cells were greater than that of human gastric cancer cells. The different effects of apoptosis in gastric cancer cells may be related to the differentiation of the cells.展开更多
AIM: To follow the principles of evidence based medicine to reach the integrated results of these studies. METHODS: Twenty-one papers of case-control studies were selected, including 11 on gastric cancer,7 on precance...AIM: To follow the principles of evidence based medicine to reach the integrated results of these studies. METHODS: Twenty-one papers of case-control studies were selected, including 11 on gastric cancer,7 on precancerous lesion of stomach and 3 on lymphoma of stomach. Meta analysis was used to sum up the odds ratios (OR) of these studies. RESULTS: H. pylori vs gastric cancer (intestinal and diffuse type): the odds ratio from the fixed effect model is 3.0016 (95% CI: 2.4197-3.7234, P【0.001). H. pylori vs precancerous lesion of stomach: a random effect model was used to calculate the summary odds ratio and its value is 2.5635 (95% CI: 1.8477-3.5566, P【0.01). H. pylori vs lymphoma of stomach: though the quantity of literature is too small to make Meta analysis, the data of these 3 studies show that lymphoma of stomach is highly associated with H. pylori infections. CONCLUSION: Since it had been revealed that H. pylori infection pre-exists in gastric carcinoma and precancerous lesions, the results of Meta analysis present a strong evidence to support the conclusion that H. pylori infection is a risk factor for gastric carcinoma.展开更多
AIM:The prognosis of early gastric carcinoma (EGC) is generally excellent after surgery. The presence or absence of lymph node metastasis in EGC is an important prognostic factor. The survival and recurrence rates of ...AIM:The prognosis of early gastric carcinoma (EGC) is generally excellent after surgery. The presence or absence of lymph node metastasis in EGC is an important prognostic factor. The survival and recurrence rates of node-negative EGC are much better than those of node-positive EGC. This study examined the factors related to lymph node metastasis in EGC to determine the appropriate treatment for EGC.METHODS: We investigated 748 patients with EGC who underwent surgery between January 1985 and December 1999 at the Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Hospital. Several clinicopathologic factors were investigated to analyze their relationship to lymph node metastasis: age, sex, tumor location, tumor size, gross type, histologic type, depth of invasion, extent of lymph node dissection, type of operation,and DNA ploidy.RESULTS:Lymph node metastases were found in 75 patients (10.0%). Univariate analysis showed that male sex, tumor size larger than 2.0cm, submucosal invasion of tumor, histologic differentiation, and DNA ploidy pattern were risk factors for regional lymph node metastasis in EGC patients. However, a multivariate analysis showed that three risk factors were associated with lymph node metastasis:large tumor size, undifferentiated histologic type and submucosal invasion. No statistical relationship was found for age, sex, tumor location, gross type, or DNA ploidy in multivariate analysis. The 5-year survival rate was 94.2% for those without lymph node metastasis and 87.3% for those with lymph node metastasis, and the difference was significant (P<0.05).CONCLUSION: In patients with EGC, the survival rate of patients with positive lymph nodes is significantly worse than that of patients with no lymph node metastasis. Therefore,a standard D2 lymphadenectomy should be performed in patients at high risk of lymph node metastasis: large tumor size, undifferentiated histologic type and submucosal invasion.展开更多
AIM: To identify whether JTE-522 can induce apoptosis in AGS cells and ROS also involved in the process, and to investigate the changes in NF-kB, p53, bcl-2 and caspase in the apoptosis process. METHODS: Cell culture,...AIM: To identify whether JTE-522 can induce apoptosis in AGS cells and ROS also involved in the process, and to investigate the changes in NF-kB, p53, bcl-2 and caspase in the apoptosis process. METHODS: Cell culture, MTT, Electromicroscopy, agarose gel electrophoresis, lucigenin, Western blot and electrophoretic mobility shift assay (EMSA) analysis were employed to investigate the effect of JTE-522 on cell proliferation and apoptosis in AGS cells and related molecular mechanisms. RESULTS: JTE-522 inhibited the growth of AGS cells and induced the apoptosis. Lucigenin assay showed the generation of ROS in cells under incubation with JTE-522. The increased ROS generation might contribute to the induction of AGS cells to apoptosis. EMSA and Western blot revealed that NF-kB activity was almost completely inhibited by preventing the degradation of IkBalpha. Additionally, by using Western blot we confirmed that the level of bcl-2 was decreased, whereas p53 showed a great increase following JTE-522 treatment. Their changes were in a dose-dependent manner. CONCLUSION: These findings suggest that reactive oxygen species, NF-kB, p53, bcl-2 and caspase-3 may play an important role in the induction of apoptosis in AGS cells after treatment with JTE-522.展开更多
Pro-inflammatory cytokines are produced in the gastric mucosa by inflammatory cells activated by chronic Helicobacter pylori (H. pylori) infection. Polymorphisms of these cytokine genes are associated with individual ...Pro-inflammatory cytokines are produced in the gastric mucosa by inflammatory cells activated by chronic Helicobacter pylori (H. pylori) infection. Polymorphisms of these cytokine genes are associated with individual differences in gastric mucosal cytokine mRNA level, which result in differences in gastric mucosal inflammation, acid inhibition and gastroduodenal disease risk in response to H. pylori infection. Although polymorphisms of interleukin (IL)-1B, IL-1RN and TNF-A have been reported to relate well with gastric cancer and peptic ulcer risk, those of IL-2, IL-4, IL-6 and IL-8 genes are unclear. In combined analyses using data from previous studies, we found that the risk of gastric non-cardia cancer development was significantly associated with IL-4-168 C allele (OR: 0.81, 95% CI: 0.69-1.00) and IL-4-590 T allele carrier status (0.61, 0.53-0.73), and IL-6-174 G/G genotype (2<Abstract>Pro-inflammatory cytokines are produced in the gastric mucosa by inflammatory cells activated by chronic Helicobacter pylori (H. pylori) infection. Polymorphisms of these cytokine genes are associated with individual differences in gastric mucosal cytokine mRNA level, which result in differences in gastric mucosal inflammation, acid inhibition and gastroduodenal disease risk in response to H. pylori infection. Although polymorphisms of interleukin (IL)-1B, IL-1RN and TNF-A have been reported to relate well with gastric cancer and peptic ulcer risk, those of IL-2, IL-4, IL-6 and IL-8 genes are unclear. In combined analyses using data from previous stud- ies, we found that the risk of gastric non-cardia cancer development was significantly associated with IL-4-168 C allele (OR: 0.81, 95% CI: 0.69-1.00) and IL-4-590 T allele carrier status (0.61, 0.53-0.73), and IL-6-174 G/G genotype (2.02, 1.31-3.10). In peptic ulcer development, IL-2-330 G and IL-4-590 T allele carriers had a significantly decreased risk (0.37, 0.27-0.50 and 0.58, 0.34-0.99, respectively). Moreover, IL-2, IL-4, IL-6 and IL-8 gene genotypes prevalence differs am展开更多
Objective：Gastroscopy combined with gastric mucosa biopsies is currently regarded as a gold standard for diagnosis of gastric cancer.However,its application is restricted in clinical practice due to its invasive prop...Objective：Gastroscopy combined with gastric mucosa biopsies is currently regarded as a gold standard for diagnosis of gastric cancer.However,its application is restricted in clinical practice due to its invasive property.A new noninvasive population screening process combining the assay ofanti-Helicobacterpylori antibody and serum pepsinogen （PG） （ABC method） is adopted to recognize the high-risk patients for further endoscopy examination,avoiding the unnecessary gastroscopy for most population and saving the cost consumption for mass screening annually.Nevertheless,controversies exist for the grouping of ABC method and the intervals of gastroscopy surveillance for each group.In this review,we summarized these popular concerned topics for providing useful references to the healthcare practitioner in clinical practice.Data Sources：The PubMed databases were systematically searched from the inception dates to November 22,2017,using the keywords ＂Helicobacterpylori,＂ ＂Pepsinogens,＂ and ＂Stomach Neoplasms.＂Study Selection：Original articles and reviews on the topics were selected.Results：Anti-H.pylori antibody and serum PG concentration showed significant changes under the different status ofH.pylori infection and the progression of atrophic gastritis,which can be used for risk stratification of gastric cancer in clinic.In addition,anti-H,pylori antibody titer can be used for further risk stratification of gastric cancer contributing to determine better endoscopy surveillance interval.Conclusions：The early detection and diagnosis of gastric cancer benefit from the risk stratification,but the cutoff values for H.pylori antibody and serum PG concentration require further modification.展开更多
AIM To investigate the expression of multiplegenes and the behavior of cellular biology ingastric cancer（GC）and other gastric mucosallesions and their relations to Helicobacter pylori（H.pylori）infection,tumor stag...AIM To investigate the expression of multiplegenes and the behavior of cellular biology ingastric cancer（GC）and other gastric mucosallesions and their relations to Helicobacter pylori（H.pylori）infection,tumor staging andhistological subtypes.METHODS Three hundred and twenty-sevenspecimens of gastric mucosa obtained viaendoscopy or surgical resection,and ABCimmunohistochemical staining were used todetect the expression of p53,p16,Bcl-2 andCOX-2 proteins.H.pylori was determined byrapid urea test combined with pathologicalstaining or<sup>14</sup>C urea breath test.Cellular image analysis was performed in 66 patients withintestinal metaplasia（IM）and/or dysplasia（Dys）.In 30 of them,both cancer and theparacancerous tissues were obtained at the timeof surgery.Histological pattern,tumor staging,lymph node metastasis,grading ofdifferentiation and other clinical data werestudied in the medical records.RESULTS p16 expression of IM or Dys wassignificantly lower in positive H.pylori chronicatrophic gastritis（CAG）than those withnegative H.pylori（CAG:54.8% vs 88.0%,IM:34.4% vs 69.6%,Dys:23.8% vs 53.6%,allP【0.05）,Bcl-2 or COX-2 expression of IM orDys in positive H.pylori cases was significantlyhigher than that without H.pylori（Bcl-2:68.8%vs23.9%,90.5% vs 60.7%;COX-2:50.0% vs10.8%,61.8% vs 17.8%;all P【0.05）.Themean number of most parameters of cellularimage analysis in positive H.pylori group wassignificantly higher than that in negative H.pylori group（Ellipser:53±14,40±12μm,Area<sub>1</sub>:748±572,302±202 μm<sup>2</sup>,Area<sub>2</sub>:3050±1661,1681±1990 μm<sup>2</sup>,all P【0.05;Ellipseb:79±23,58±15 μm,Ratio<sub>1</sub>:22%±5%,13%±4%,Ratio<sub>2</sub>:79%±17%,53%±20%,all P【0.01）.There was significant correlation between Bcl-2and histologic pattern of gastric carcinoma,andbetween COX-2 and tumor staging or lymph nodemetastasis（Bcl-2:75.0% vs 16.7%;COX-2:76.0% vs 20.0%,79.2% vs 16.7%;allP【0.05）.CONCLUSION p1l6, Bcl-2, and COX-2 but not p53 gene may play a role 展开更多
Due to the complexity of the splenic hilar vessels, their anatomical variation and the narrow and deep space, as well as the bleeding-prone splenic parenchyma and the difficulty to manage splenic or vascular bleeding ...Due to the complexity of the splenic hilar vessels, their anatomical variation and the narrow and deep space, as well as the bleeding-prone splenic parenchyma and the difficulty to manage splenic or vascular bleeding at the splenic hilum,the procedure remains challenging and technically demanding procedure for the performance of laparoscopic pancreas- and spleen-preserving splenic hilar lymph nodes dissection. Based on our experiences, we gradually explored a set of procednral operation steps called ＂Huang＇s three-step maneuver＂. In this paper, we not only provide the concrete operation steps for the surgeon, but we also provide our recommended technique of pulling and exposure for assistants. This new maneuver simplifies the complicated procedure and improves the efficiency of laparoscopic spleen-preserving splenic hilar lymphadenectomy, making it easier to master and allowing for its widespread adoption.展开更多
AIM: To study the relationship between Helicobacter pylori (H. pylori) and gastric carcinoma and its possible pathogenesis by H. pylori. METHODS: DNEL technique and immunohistochemical technique were used to study the...AIM: To study the relationship between Helicobacter pylori (H. pylori) and gastric carcinoma and its possible pathogenesis by H. pylori. METHODS: DNEL technique and immunohistochemical technique were used to study the state of apoptosis, proliferation and p53 gene expression. A total of 100 gastric mucosal biopsy specimens, including 20 normal mucosa, 30 H. pylori-negative and 30 H. pylori-positive gastric precancerous lesions along with 20 gastric carcinomas were studied. RESULTS: There were several apoptotic cells in the superficial epithelium and a few proliferative cells within the neck of gastric glands, and no p53 protein expression in normal mucosa. In gastric carcinoma, there were few apoptotic cells, while there were a large number of proliferative cells, and expression of p53 protein significantly was increased. In the phase of metaplasia, the apoptotic index (AI, 4.36%+/-1.95%), proliferative index (PI, 19.11%+/-6.79%) and positivity of p53 expression (46.7%) in H. pylori-positive group were higher than those in normal mucosa (P【0.01). AI in H. pylori-positive group was higher than that in H. pylori-negative group (3.81%+/-1.76%), PI in H. pylori-positive group was higher than that in H. pylori-negative group (12.25%+/-5.63%, P【0.01). In the phase of dysplasia, AI (2.31%+/-1.10%) in H. pylori-positive group was lower (3.05%+/-1.29%) than that in H. pylori-negative group, but PI (33.89%+/-11.65%) was significantly higher (22.09+/-8018%, P【0.01). In phases of metaplasia, dysplasia and gastric cancer in the H. pylori-positive group, AIs had an evidently graduall decreasing trend (P【0.01), while PIs had an evidently gradual increasing trend (P【0.05 or P【0.01), and there was also a trend of gradual increase in the expression of p53 gene. CONCLUSION: In the course of the formation of gastric carcinoma, proliferation of gastric mucosa can be greatly increased by H. pylori, and H. pylori can induce apoptosis in the phase of metaplasia, but in the phase of dysplasia H. pylori can inhibit cellu展开更多
基金supported by grants from the Beijing Young Talent Program (No.2016000021469 G189)Special Fund for Health Research in the Public Interest (No.201502001)CAMS Innovation Fund for Medical Sciences (CIFMS) (No.2016-12M-2-004)
文摘Objective： In this study,we aimed to estimate the updated incidence and mortality rate of stomach cancer based on the cancer registration data in 2014,collected by the National Central Cancer Registry of China（NCCRC）.Methods： In 2017,339 registries＇ data were qualified based on the criteria of data quality control of the NCCRC.Cases of stomach cancer were retrieved from the national database.We estimated numbers of stomach cancer cases and deaths in China using age-specific rates and corresponding national population stratified by area,sex,agegroup（0,1–4,5–9,10–14,…,85＋）.Chinese standard population in 2000 and Segi＇s world population were applied for age-standardized incidence and mortality rates.Results： In 2014,410,400 new stomach cancer cases and 293,800 cancer-associated deaths were estimated to have occurred in China.The crude incidence rate of stomach cancer was 30.00/100,000,age-standardized incidence rates by Chinese standard population（ASIRC） and by world standard population（ASIRW） were 19.62/100,000 and19.51/100,000,respectively.The crude mortality rate of stomach cancer was 21.48/100,000,age-standardized mortality rates by Chinese（ASMRC） and by world standard population（ASMRW） were 13.44/100,000 and13.30/100,000,respectively.Incidence and mortality rates in rural areas were both higher than that in urban areas.Stomach cancer has a strong relationship with gender and age.The disease has occurred more frequently among men than women with a male to female ratio of 2.4 for ASIRC.After age group of 40-44 years,incidence rates are substantially higher in men than in women,same pattern was seen for age-specific mortality rates.Conclusions： There is still a heavy burden of stomach cancer in China.The incidence and mortality patterns of stomach cancer show substantial gender and regional disparities.Great effort is needed to provide more accessible health services,sufficient financial resources,and adequate cancer-care infrastructure for the Chinese population,espec
基金Supported by the Medical Research Foundation of Guangdong Province,No.1997423
文摘INTRODUCTIONIn China ,the incidence and mortality of gastric cancer rank the second among all cancers. Recent development of cancer [1-20].The aim of this study was investigat the insight of apoptosis and bcl-2, p53 and C-myc protein expression in the development of gastric cancer .
基金the Natural Science Foundation of Fujian Province,China,No.K98031
文摘AIM To evaluate the effects of Helicobacterpylori infection and other environmental factorson the development of gastric cancer.METHODS A population-based case-controlstudy was conducted in Changle County,FujianProvince.The primary gastric cancer cases werehistologically confirmed or diagnosed by surgerybetween,January 1996 and March 1998.Healthycontrols were randomly selected and matched byage,sex,and neighborhood of residence.Atotal of 101 pairs were included in the study.Specially trained interviewers conducted face-to-face interviews with the subjects according toa standardized questionnaire.Helicobacterpylori infections were measured by serum IgGantibody to Helicobacter pylori.ConditionalLogistic Regression analysis was used.RESULTS The presence of IgG antibody toHelicobacter pylori was 63.7% in studysubjects,56.0% in patients with cardiac cancer,and 60.5% in patients with non-cardiac gastriccancer.The risk factors of gastric cancer inChangle County were identified such as loweducational level[OR=3.864;95% confidenceinterval(95% CI)1.604-9.311],lowconsumption of fresh vegetables(OR=4.925;95%Cl 1.356-17.885),high intake of fish sauce(OR=10.587;95% Cl 2.821-39.738),unscheduled meals(OR=4.254;95%Cl 1.445- 12.552),and Helicobacter pylori infection(OR=3.453;95%Cl 0.901-13.224).CONCLUSION Helicobacter pylori infectionmay be important in the etiology of gastriccancer,but major risk factors other thanHelicobacter pylori are responsible for the highgastric morbidity in Changle County.
基金Supported by Asahi Medical Foundation,No.00-2000-03
文摘AIM: To evaluate the effects of sulindac in inducing growth inhibition and apoptosis of human gastric cancer cells in comparison with human hepatocellular carcinoma (HCC) cells. METHODS: The human gastric cancer cell lines MKN45 and MKN28 and human hepatocellular carcinoma cell lines HepG(2) and SMMC7721 were used for the study. Anti-proliferative effect was measured by MTT assay, and apoptosis was determined by Hoechst-33258 staining, electronography and DNA fragmentation. The protein of cyclooxygenase-2 (COX-2) and Bcl-2 were detected by Western dot blotting. RESULTS: Sulindac could initiate growth inhibition and apoptosis of MKN45, MKN28, HepG(2) and SMMC7721 cells in a dose-and time-dependent manner. Growth inhibitory activity and apoptosis were more sensitive in HepG(2) cells than in SMMC7721 cells, MKN45 and MKN28 cells. After 24 hours incubation with sulindac at 2mmol x L(-1) and 4mmol x L(-1), the level of COX-2 and Bcl-2 protein were lowered in MKN45, SMMC7721 and HepG(2) cells but not in MKN28 cells. CONCLUSION: Sulindac could inhibit the growth of gastric cancer cells and HCC cells effectively in vitro by apoptosis induction, which was associated with regression of COX-2 and Bcl-2 expression. The growth inhibition and apoptosis of HCC cells were greater than that of human gastric cancer cells. The different effects of apoptosis in gastric cancer cells may be related to the differentiation of the cells.
基金Supported by Funds for University Key Teachers by the Ministry of Education,No.2000-65
文摘AIM: To follow the principles of evidence based medicine to reach the integrated results of these studies. METHODS: Twenty-one papers of case-control studies were selected, including 11 on gastric cancer,7 on precancerous lesion of stomach and 3 on lymphoma of stomach. Meta analysis was used to sum up the odds ratios (OR) of these studies. RESULTS: H. pylori vs gastric cancer (intestinal and diffuse type): the odds ratio from the fixed effect model is 3.0016 (95% CI: 2.4197-3.7234, P【0.001). H. pylori vs precancerous lesion of stomach: a random effect model was used to calculate the summary odds ratio and its value is 2.5635 (95% CI: 1.8477-3.5566, P【0.01). H. pylori vs lymphoma of stomach: though the quantity of literature is too small to make Meta analysis, the data of these 3 studies show that lymphoma of stomach is highly associated with H. pylori infections. CONCLUSION: Since it had been revealed that H. pylori infection pre-exists in gastric carcinoma and precancerous lesions, the results of Meta analysis present a strong evidence to support the conclusion that H. pylori infection is a risk factor for gastric carcinoma.
文摘AIM:The prognosis of early gastric carcinoma (EGC) is generally excellent after surgery. The presence or absence of lymph node metastasis in EGC is an important prognostic factor. The survival and recurrence rates of node-negative EGC are much better than those of node-positive EGC. This study examined the factors related to lymph node metastasis in EGC to determine the appropriate treatment for EGC.METHODS: We investigated 748 patients with EGC who underwent surgery between January 1985 and December 1999 at the Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Hospital. Several clinicopathologic factors were investigated to analyze their relationship to lymph node metastasis: age, sex, tumor location, tumor size, gross type, histologic type, depth of invasion, extent of lymph node dissection, type of operation,and DNA ploidy.RESULTS:Lymph node metastases were found in 75 patients (10.0%). Univariate analysis showed that male sex, tumor size larger than 2.0cm, submucosal invasion of tumor, histologic differentiation, and DNA ploidy pattern were risk factors for regional lymph node metastasis in EGC patients. However, a multivariate analysis showed that three risk factors were associated with lymph node metastasis:large tumor size, undifferentiated histologic type and submucosal invasion. No statistical relationship was found for age, sex, tumor location, gross type, or DNA ploidy in multivariate analysis. The 5-year survival rate was 94.2% for those without lymph node metastasis and 87.3% for those with lymph node metastasis, and the difference was significant (P<0.05).CONCLUSION: In patients with EGC, the survival rate of patients with positive lymph nodes is significantly worse than that of patients with no lymph node metastasis. Therefore,a standard D2 lymphadenectomy should be performed in patients at high risk of lymph node metastasis: large tumor size, undifferentiated histologic type and submucosal invasion.
基金National Natural Science Foundation of China,No.39770300,30070873the Overseas Chinese Affairs Office of the State Council Foundation,No.98-33
文摘AIM: To identify whether JTE-522 can induce apoptosis in AGS cells and ROS also involved in the process, and to investigate the changes in NF-kB, p53, bcl-2 and caspase in the apoptosis process. METHODS: Cell culture, MTT, Electromicroscopy, agarose gel electrophoresis, lucigenin, Western blot and electrophoretic mobility shift assay (EMSA) analysis were employed to investigate the effect of JTE-522 on cell proliferation and apoptosis in AGS cells and related molecular mechanisms. RESULTS: JTE-522 inhibited the growth of AGS cells and induced the apoptosis. Lucigenin assay showed the generation of ROS in cells under incubation with JTE-522. The increased ROS generation might contribute to the induction of AGS cells to apoptosis. EMSA and Western blot revealed that NF-kB activity was almost completely inhibited by preventing the degradation of IkBalpha. Additionally, by using Western blot we confirmed that the level of bcl-2 was decreased, whereas p53 showed a great increase following JTE-522 treatment. Their changes were in a dose-dependent manner. CONCLUSION: These findings suggest that reactive oxygen species, NF-kB, p53, bcl-2 and caspase-3 may play an important role in the induction of apoptosis in AGS cells after treatment with JTE-522.
文摘Pro-inflammatory cytokines are produced in the gastric mucosa by inflammatory cells activated by chronic Helicobacter pylori (H. pylori) infection. Polymorphisms of these cytokine genes are associated with individual differences in gastric mucosal cytokine mRNA level, which result in differences in gastric mucosal inflammation, acid inhibition and gastroduodenal disease risk in response to H. pylori infection. Although polymorphisms of interleukin (IL)-1B, IL-1RN and TNF-A have been reported to relate well with gastric cancer and peptic ulcer risk, those of IL-2, IL-4, IL-6 and IL-8 genes are unclear. In combined analyses using data from previous studies, we found that the risk of gastric non-cardia cancer development was significantly associated with IL-4-168 C allele (OR: 0.81, 95% CI: 0.69-1.00) and IL-4-590 T allele carrier status (0.61, 0.53-0.73), and IL-6-174 G/G genotype (2<Abstract>Pro-inflammatory cytokines are produced in the gastric mucosa by inflammatory cells activated by chronic Helicobacter pylori (H. pylori) infection. Polymorphisms of these cytokine genes are associated with individual differences in gastric mucosal cytokine mRNA level, which result in differences in gastric mucosal inflammation, acid inhibition and gastroduodenal disease risk in response to H. pylori infection. Although polymorphisms of interleukin (IL)-1B, IL-1RN and TNF-A have been reported to relate well with gastric cancer and peptic ulcer risk, those of IL-2, IL-4, IL-6 and IL-8 genes are unclear. In combined analyses using data from previous stud- ies, we found that the risk of gastric non-cardia cancer development was significantly associated with IL-4-168 C allele (OR: 0.81, 95% CI: 0.69-1.00) and IL-4-590 T allele carrier status (0.61, 0.53-0.73), and IL-6-174 G/G genotype (2.02, 1.31-3.10). In peptic ulcer development, IL-2-330 G and IL-4-590 T allele carriers had a significantly decreased risk (0.37, 0.27-0.50 and 0.58, 0.34-0.99, respectively). Moreover, IL-2, IL-4, IL-6 and IL-8 gene genotypes prevalence differs am
基金This work was supported by grants from the Natural Science Foundation of Guangdong Province, China （No. $2011010001430）, the Science and Technology Planning Project of Guangdong Province, China （No. 2017A030223006, 2016A020215128, 2014A020212636, and 2013B021800161）, the Science and Technology Planning Project of Guangzhou, China （No. 201704020077）, the Research Fund of Guangdong General Hospital （No. y012015338）, the Yuexiu Science and Information Center of Guangzhou Scientific Foundation （No. 2012-GX-046）.
文摘Objective：Gastroscopy combined with gastric mucosa biopsies is currently regarded as a gold standard for diagnosis of gastric cancer.However,its application is restricted in clinical practice due to its invasive property.A new noninvasive population screening process combining the assay ofanti-Helicobacterpylori antibody and serum pepsinogen （PG） （ABC method） is adopted to recognize the high-risk patients for further endoscopy examination,avoiding the unnecessary gastroscopy for most population and saving the cost consumption for mass screening annually.Nevertheless,controversies exist for the grouping of ABC method and the intervals of gastroscopy surveillance for each group.In this review,we summarized these popular concerned topics for providing useful references to the healthcare practitioner in clinical practice.Data Sources：The PubMed databases were systematically searched from the inception dates to November 22,2017,using the keywords ＂Helicobacterpylori,＂ ＂Pepsinogens,＂ and ＂Stomach Neoplasms.＂Study Selection：Original articles and reviews on the topics were selected.Results：Anti-H.pylori antibody and serum PG concentration showed significant changes under the different status ofH.pylori infection and the progression of atrophic gastritis,which can be used for risk stratification of gastric cancer in clinic.In addition,anti-H,pylori antibody titer can be used for further risk stratification of gastric cancer contributing to determine better endoscopy surveillance interval.Conclusions：The early detection and diagnosis of gastric cancer benefit from the risk stratification,but the cutoff values for H.pylori antibody and serum PG concentration require further modification.
基金the Natural Science Foundation of the Educational Committee of Jiangsu Province,No.125FA9608.
文摘AIM To investigate the expression of multiplegenes and the behavior of cellular biology ingastric cancer（GC）and other gastric mucosallesions and their relations to Helicobacter pylori（H.pylori）infection,tumor staging andhistological subtypes.METHODS Three hundred and twenty-sevenspecimens of gastric mucosa obtained viaendoscopy or surgical resection,and ABCimmunohistochemical staining were used todetect the expression of p53,p16,Bcl-2 andCOX-2 proteins.H.pylori was determined byrapid urea test combined with pathologicalstaining or<sup>14</sup>C urea breath test.Cellular image analysis was performed in 66 patients withintestinal metaplasia（IM）and/or dysplasia（Dys）.In 30 of them,both cancer and theparacancerous tissues were obtained at the timeof surgery.Histological pattern,tumor staging,lymph node metastasis,grading ofdifferentiation and other clinical data werestudied in the medical records.RESULTS p16 expression of IM or Dys wassignificantly lower in positive H.pylori chronicatrophic gastritis（CAG）than those withnegative H.pylori（CAG:54.8% vs 88.0%,IM:34.4% vs 69.6%,Dys:23.8% vs 53.6%,allP【0.05）,Bcl-2 or COX-2 expression of IM orDys in positive H.pylori cases was significantlyhigher than that without H.pylori（Bcl-2:68.8%vs23.9%,90.5% vs 60.7%;COX-2:50.0% vs10.8%,61.8% vs 17.8%;all P【0.05）.Themean number of most parameters of cellularimage analysis in positive H.pylori group wassignificantly higher than that in negative H.pylori group（Ellipser:53±14,40±12μm,Area<sub>1</sub>:748±572,302±202 μm<sup>2</sup>,Area<sub>2</sub>:3050±1661,1681±1990 μm<sup>2</sup>,all P【0.05;Ellipseb:79±23,58±15 μm,Ratio<sub>1</sub>:22%±5%,13%±4%,Ratio<sub>2</sub>:79%±17%,53%±20%,all P【0.01）.There was significant correlation between Bcl-2and histologic pattern of gastric carcinoma,andbetween COX-2 and tumor staging or lymph nodemetastasis（Bcl-2:75.0% vs 16.7%;COX-2:76.0% vs 20.0%,79.2% vs 16.7%;allP【0.05）.CONCLUSION p1l6, Bcl-2, and COX-2 but not p53 gene may play a role
基金National Key Clinical Specialty Discipline Construction program of China (No. [2012] 649)
文摘Due to the complexity of the splenic hilar vessels, their anatomical variation and the narrow and deep space, as well as the bleeding-prone splenic parenchyma and the difficulty to manage splenic or vascular bleeding at the splenic hilum,the procedure remains challenging and technically demanding procedure for the performance of laparoscopic pancreas- and spleen-preserving splenic hilar lymph nodes dissection. Based on our experiences, we gradually explored a set of procednral operation steps called ＂Huang＇s three-step maneuver＂. In this paper, we not only provide the concrete operation steps for the surgeon, but we also provide our recommended technique of pulling and exposure for assistants. This new maneuver simplifies the complicated procedure and improves the efficiency of laparoscopic spleen-preserving splenic hilar lymphadenectomy, making it easier to master and allowing for its widespread adoption.
基金Supported by National Ninth Five-Year Study Program for Tacking Key Scientific Problems.No.96-906-01-04
文摘AIM: To study the relationship between Helicobacter pylori (H. pylori) and gastric carcinoma and its possible pathogenesis by H. pylori. METHODS: DNEL technique and immunohistochemical technique were used to study the state of apoptosis, proliferation and p53 gene expression. A total of 100 gastric mucosal biopsy specimens, including 20 normal mucosa, 30 H. pylori-negative and 30 H. pylori-positive gastric precancerous lesions along with 20 gastric carcinomas were studied. RESULTS: There were several apoptotic cells in the superficial epithelium and a few proliferative cells within the neck of gastric glands, and no p53 protein expression in normal mucosa. In gastric carcinoma, there were few apoptotic cells, while there were a large number of proliferative cells, and expression of p53 protein significantly was increased. In the phase of metaplasia, the apoptotic index (AI, 4.36%+/-1.95%), proliferative index (PI, 19.11%+/-6.79%) and positivity of p53 expression (46.7%) in H. pylori-positive group were higher than those in normal mucosa (P【0.01). AI in H. pylori-positive group was higher than that in H. pylori-negative group (3.81%+/-1.76%), PI in H. pylori-positive group was higher than that in H. pylori-negative group (12.25%+/-5.63%, P【0.01). In the phase of dysplasia, AI (2.31%+/-1.10%) in H. pylori-positive group was lower (3.05%+/-1.29%) than that in H. pylori-negative group, but PI (33.89%+/-11.65%) was significantly higher (22.09+/-8018%, P【0.01). In phases of metaplasia, dysplasia and gastric cancer in the H. pylori-positive group, AIs had an evidently graduall decreasing trend (P【0.01), while PIs had an evidently gradual increasing trend (P【0.05 or P【0.01), and there was also a trend of gradual increase in the expression of p53 gene. CONCLUSION: In the course of the formation of gastric carcinoma, proliferation of gastric mucosa can be greatly increased by H. pylori, and H. pylori can induce apoptosis in the phase of metaplasia, but in the phase of dysplasia H. pylori can inhibit cellu
