Computer-guided surgery for gastric carcinoma

Lymphadenectomy offers the only hope for cure when lymph nodes are involved. In gastric cancer, three approaches have been pursued to preoperatively predict node status in individual patients, modern radiological imaging techniques, sentinel node and technique that uses a computerized database of information to convert a large amount of information and experience to a treatment decision for an individual patient. The aim of this study was to evaluate accuracy in preoperative prediction of lymph node status in selected patients with the help of computer analysis for stage-appropriate surgery. With the help of computer programs Win Estimate and Microsoft Access, we constructed an artificial neural network that calculated a statistical prediction of nodal status in an observed patient with preoperatively gathered data. In 110 patients who have undergone R0 resection with D2 lymphadenectomy, the differences between the individual results generated by artificial neural network calculation and the actual data were compared. The accuracy of computerized predictions of N0 stage for study group is 91%, sensitivity 94% and specificity 87%. The results of accuracy of computerized preoperative prediction of N2 stage are 88%, with sensitivity 94% and specificity 88%. Preoperative analyses of patient data and tumour characteristics offers a rational approach to individualizing tumour therapy where the extent of lymph node dissection is tailored to the type, site, and stage of the tumour, thereby minimizing the disadvantages associated with the extensive operative procedure.     

Polyarthritis associated with gastric carcinoma.

In a 68-year-old man who had polyarthritis associated with gastric carcinoma surgical resection of the tumour was accompanied by prompt resolution of the arthritic syndrome. In 11 years of follow-up the arthritis has remained in complete remission and there has been no recurrence of the carcinoma. An awareness that polyarthritis may be a presenting manifestation of an underlying carcinoma may, especially in an elderly person, lead to early recognition and treatment of the malignant disease.     

胃癌发生中的独特肿瘤标记物-LI-cadherin

LI-cadherin,也被称为cadherin-17,是肠上皮细胞中一种贯穿细胞膜的、钙依赖性的、介导细胞间连接的糖蛋白.与经典钙黏蛋白相比,LI-cadherin是一种具备独特结构和功能的新型钙黏蛋白.LI-cadherin由7个胞外重复序列和一个只包含20个氨基酸残基的较短的胞质尾区组成.在人体中,LI-cadherin特异性的位于肝细胞和肠细胞中的底外侧区.而LI-cadherin介导细胞连接时,既不与链蛋白结合,也不导致β-catenin的上调.一些研究发现,在胃癌中LI-cadherin的过度表达与CDX-2显著相关,而且在肠化生中CDX-2的表达总是与LI-cadherin呈现很强的成对性.最新的研究认为LI-cadherin的表达与胃癌的发生、发展、转移及预后均有关系.在针对胃癌的临床处理方面,LI-cadherin将会是有用的肿瘤标记物.     

胃癌肝转移治疗方法的探讨

目的:探讨胃癌肝转移的外科治疗效果.方法:对本院1998年1月～2008年1月收治的原发性胃癌269例中伴肝转移的53例的临床资料进行回顾性分析.对其中施行同时性胃癌肝转移灶切除术(切除组)的18例和仅行胃癌切除术而未行肝转移灶切除术(未切除组)的35例的术后生存时间进行对比.结果:全组有50例获得随访.胃癌肝转移灶切除术后1年、3年和5年生存率分别为58.8%、17.6%和0;未切除组术后1年、3年和5年生存率分别为为57.6%、15.2%和0.两组术后生存时间差异无统计学意义(P>0.05).结论:胃癌肝转移施行同时胃癌肝转移病灶切除术并不能有效改善病人的预后.     

Expression of viral microRNAs in Epstein-Barr virus-associated gastric carcinoma

Epstein-Barr virus (EBV) is associated with about 6 to 16% of gastric carcinoma cases worldwide. Expression of the EBV microRNAs (miRNAs) was observed in B cells and nasopharyngeal carcinoma cells infected with EBV. However, it is not clear if the EBV miRNAs are expressed in EBV-associated gastric carcinomas (EBVaGCs). We found that BART miRNAs but not BHRF1 miRNAs were expressed in EBV-infected gastric carcinoma cell lines and the tumor tissues from patients as well as the animal model. The expression of viral miRNAs in EBVaGCs suggests that these EBV miRNAs may play important roles in the tumorigenesis of EBVaGCs.     

Mitochondrial alterations in human gastric carcinoma cell line

We compared mitochondrial function, morphology, and proteome in the rat normal gastric cell line RGM-1 and the human gastric cancer cell line AGS. Total numbers and cross-sectional sizes of mitochondria were smaller in AGS cells. Mitochondria in AGS cells were deformed and consumed less oxygen. Confocal microscopy indicated that the mitochondrial inner membrane potential was hyperpolarized and the mitochondrial Ca²⁺ concentration was elevated in AGS cells. Interestingly, two-dimensional electrophoresis proteomics on the mitochondria-enriched fraction revealed high expression of four mitochondrial proteins in AGS cells: ubiquinol-cytochrome c reductase, mitochondrial short-chain enoyl-coenzyme A hydratase-1, heat shock protein 60, and mitochondria elongation factor Tu. The results provide clues as to the mechanism of the mitochondrial changes in cancer at the protein level and may serve as potential cancer biomarkers in mitochondria. two-dimensional gel electrophoresis proteomics; biomarker; cancer     

The mucin profiles of normal gastric mucosa, intestinal metaplasia and its variants and gastric carcinoma

Summary Human gastrectomy specimens, including 48 carcinomas and 25 selected benign cases showing extensive intestinal metaplasia (IM), were examined in detail histologically and histochemically. IM was classified into complete (type I), incomplete without sulphomucins (type IIA) and incomplete with sulphomucins (type IIB). Type IIB was associated with intestinal but not diffuse cancers (P<0.01) or benign lesions (P<0.01). The mucin profiles of IIB IM were similar to intestinal cancers with sulphomucins predominating overN-acetylsialomucins.O-acetylsialomucins were not seen in IIB IM or tumours but were observed in complete or type IIM. These findings suggest a histogenic link between incomplete IM secreting sulphomucins (or colonic metaplasia) and intestinal cancers of the human stomach.     

Expression of Mina53 and its significance in gastric carcinoma

AIM: To study the expression of Mina53 and its relationships with clinicopathological characteristics, antioncogene inactivation and tumor proliferation in human gastric carcinoma, and to explore the role of Mina53 in carcinogenesis and tumor progression. METHODS: Expression of Mina53 and proliferating cell nuclear antigen (PCNA) was determined in gastric carcinoma (n=79), gastric dysplasia (n=21) and normal gastric tissues (n=20), while p53 was measured in gastric carcinoma tissues by immunohistochemistry. RESULTS: Mina53 was negatively expressed in all normal mucosa tissues. Dysplasia specimens showed weakly positive staining for Mina53 in 3 of 21 cases. Elevated expression of Mina53 was observed in 72 (91.1%) of the gastric carcinomas. No significant associations were found between Mina53 and clinicopathological characteristics such as sex, age, histological differentiation, distant metastasis and lymph node metastasis (p>0.05). There was a significant association with depth of invasion (X2=5.385, p<0.05) and TMN stage (X2=6.255, p<0.05). In gastric carcinoma, positive staining for p53 was detected in 53 of 79 cases (67.1%), showing a significant association with Mina53 (X2=5.161, p<0.05). The mean (+/- SD) PCNA labeling index for gastric carcinoma was 39.47+/-16.92%. Mina53 expression was positively associated with PCNA level (r=0.756, p<0.01). CONCLUSION: Mina53 was overexpressed in gastric carcinoma and associated with tumor proliferation and antioncogene inactivation. Mina53 could therefore play an important role in the carcinogenesis and progression of gastric carcinoma.     

A case of metastatic leptomeningeal carcinomatosis from early gastric carcinoma

Intramuscular myxoma is a rare benign soft tissue tumor which may be mistaken for other benign and low-grade malignant myxoid neoplasms. We present the case of a 63-year-old woman with an asymptomatic intramuscular myxoma discovered incidentally on a whole-body F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography. PET images showed a mild FDG uptake (maximum standardized uptake value, 1.78) in the left gluteus maximus. Subsequent magnetic resonance (MR) imaging revealed a well-defined ovoid mass with homogenous low signal intensity on T1-weighted sequences and markedly high signal intensity on T2-weighted sequences. Contrast-enhanced MR images showed heterogeneous enhancement throughout the mass. The diagnosis of intramuscular myxoma was confirmed on histopathology after surgical excision of the tumor. The patient had no local recurrence at one year follow-up. Our case suggests that intramuscular myxoma should be considered in the differential diagnosis of an oval-shaped intramuscular soft tissue mass with a mild FDG uptake.     

Pancreatic metastasis from gastric carcinoma: a case report

Background  

The pancreas is a rare but occasionally favored target for metastasis. Metastatic lesions in the pancreas have been described for various primary cancers, such as carcinomas of the lung, the breast, renal cell carcinoma and sarcomas.     

Expression of UDP-N-acetyl-D-galactosamine: polypeptide N-acetylgalactosaminyltransferase-6 in gastric mucosa, intestinal metaplasia, and gastric carcinoma

Aberrant mucin O-glycosylation is often observed in cancer and is characterized by the expression of immature simple mucin-type carbohydrate antigens. UDP-N-acetyl-d-galactosamine:polypeptide N-acetylgalactosaminyltransferase-6 (ppGalNAc-T6) is one of the enzymes responsible for the initial step in O-glycosylation. This study evaluated the expression of ppGalNAc-T6 in human gastric mucosa, intestinal metaplasia, and gastric carcinomas. Our results showed that ppGalNAc-T6 is expressed in normal gastric mucosa and in intestinal metaplasia. A heterogeneous expression and staining pattern for this enzyme was observed in gastric carcinomas. ppGalNAc-T6 was expressed in 79% of the cases, and its expression level was associated with the presence of venous invasion. Our results provide evidence that ppGalNAc-T6 is an IHC marker associated with venous invasion in gastric carcinoma and may contribute to the understanding of the molecular mechanisms that underlie aberrant glycosylation in gastric carcinogenesis and in gastric carcinoma.     

Ghrelin immunohistochemistry of gastric adenocarcinoma and mucoepidermoid carcinoma of salivary gland

Ghrelin (G-HH) synthesized in several tissues including salivary and stomach glands stimulates appetite in humans by modulating neuropeptide Y neurons in the hypothalamic arcuate nucleus. Loss of appetite is one of the most important symptoms of stomach cancer. We conducted a study using immunohistochemistry to determine whether salivary glands and stomach cancer tissues produce ghrelin. We determined that negative ghrelin immunohistochemistry discriminates tumors from normal tissues and may therefore further our understanding of the clinically important problem of reduced food intake and anorexia in cancer patients. Radioimmunoassay analyses confirmed that cancer cells do not produce a G-HH peptide, whereas normal cells yield this peptide.