Magnetic resonance imaging in the diagnosis of gastric cancer: X-ray versus MRI anatomic findings

The paper assesses the present-day role of MRI in the diagnosis of gastric cancer. The authors consider the major prerequisites for the main aim of their study to be: 1) a dramatic incidence of diffuse (endophytic) gastric carcinoma, which requires significant correction of today's approaches to its diagnosis and 2) a rather biased and, in the authors' opinion, present-day mainly negative attitude towards MRI of the stomach as a diagnostic method for its tumor lesions. By applying the X-ray-MRI anatomic principle to the comparative study of MRI findings in 50 patients with predominantly gastric intramural carcinoma and in 25 patients without gastric tumors (controls), the authors present their methods for gastric MRI, the MRI semiotics of gastric cancer by concurrently touching upon a variety of problems that characterize the potentialities of MRI of the stomach in the diagnosis of its tumor lesions, including their differential diagnosis. As a result, the authors highly appreciate gastric MRI and consider this method to be included into the diagnostic algorithm of radiation techniques used in the diagnosis of gastric cancer, which should occupy its definite diagnostic place.     

Frequent amplification of the c-met gene in scirrhous type stomach cancer.

Amplification of the c-met gene, that encodes hepatocyte growth factor receptor, was examined on human esophageal, gastric and colorectal carcinomas. Six (55%) of the 11 gastric carcinoma cell lines and 15 (23%) of the 64 advanced gastric carcinomas showed the c-met gene amplification. Among them, c-met amplification was detected in 5 gastric cancer cell lines, derived from scirrhous gastric carcinoma and in 5 (38%) of 13 scirrhous gastric carcinoma tissues. Furthermore, patients of gastric carcinoma with c-met amplification showed significantly advanced tumor stage and poorer prognosis than those without the amplification. Conversely, no amplification was detected in any of the esophageal and colorectal carcinoma cell lines as well as carcinoma tissues except one colonic carcinoma. These results overall suggest that amplification of the c-met gene might participate in carcinogenesis and progression of stomach cancer, especially scirrhous type stomach carcinoma.     

Evaluation of the nucleolar organizer activity of tumor cells in patients with esophageal and stomach cancers

Silver impregnation findings of normal and cancer cell nucleoli are given for 30 cancer patients with esophageal (16) and gastric (14) carcinoma and 5 controls. It has been shown that the content of silver granules per cell (35.3 +/- 2.4) and per nucleolus (13.3 +/- 0.7) in tumor cells were significantly higher than in normal ones (11.4 +/- 1.9 and 5.3 +/- 0.5, respectively). The importance of these findings for clinical oncology is discussed.     

环氧合酶-2在胃癌中的研究进展

我国胃癌发病人数居全球首位,其发生机制及安全有效的治疗是研究重点。大量研究结果表明,环氧化酶-2(Cyclooxygenase-2,COX-2)过度表达促进肿瘤细胞增殖和抑制细胞凋亡,并与胃癌的发生发展、淋巴转移、分化程度、病理分期及预后密切相关。随着COX-2与胃癌关系的研究的深入,COX-2已逐渐成为胃癌治疗的新的靶点。近年来,针对细胞受体、信号传导、细胞周期和血管生成等靶点的抗肿瘤治疗已成为肿瘤治疗研究的新方向。因此,以COX-2为特异靶点的治疗策略有望为胃癌治疗提供新的思路。     

Interleukin-11 promotes the progress of gastric carcinoma via abnormally expressed versican

Versican, a ubiquitous component of the extracellular matrix (ECM), accumulates both in tumor stroma and cancer cells and is highly regulated by various cytokines. The aberrant expression of versican and its isoforms is known to modulate cell proliferation, differentiation, and migration, all of which are features of the invasion and metastasis of cancer; versican is also known to favour the homeostasis of the ECM. Interleukin-11 (IL-11) is an important cytokine that exhibits a wide variety of biological effects in gastric cancer development. Here, we analysed the expression of versican isoforms and found that the major isoforms expressed by both gastric carcinoma tissue and gastric cell lines were V0 and V1, and V1 was significantly higher in gastric carcinoma tissue. The treatment of the gastric cell lines AGS and MKN45 with rhIL-11 resulted in a significant increase in the expression of V0 and V1. Exogenous IL-11 increased migration in AGS and MKN45 cells, whereas these effects were reversed when the expression of V0 and V1 were abolished by siRNA targeting versican V0/V1. Collectively, these findings suggest that the abnormally expressed versican and its isoforms participate, at least in part, in the progress of gastric carcinoma triggered by IL-11.     

Clinical significance of serum leptin level in patients with gastric cancer

Leptin may support the proliferation and hinder the apoptosis of tumor cells. Although leptin expression has been studied in several human tumors, its potential clinical significance remains uncertain in patients with gastric carcinoma. Furthermore, the majority of available findings have been determined from preclinical studies using stomach carcinoma tissue section and, to date, few studies have evaluated the clinical significance of leptin in the serum or plasma of gastric carcinoma patients. In the current study, the serum concentration of soluble leptin was assessed in gastric carcinoma patients, and its contributions to the clinical parameters and prognosis of patients were determined. A total of 63 pathologically confirmed gastric cancer patients and 30 healthy subjects were enrolled in the study and circulating leptin levels in the serum of all subjects were determined by ELISA. The serum leptin concentrations were significantly lower in the gastric cancer patients compared with the healthy control group (P = 0.009). In the gastric cancer patients, the clinical features of patient age, sex, lesion localization, histopathology, pathological grade, stage of disease, and serum tumor markers including lactate dehydrogenase, carcinoembryonic antigen, and carbohydrate antigen 19–9 were not correlated with serum leptin concentration. Furthermore, no association was observed between serum leptin concentration and responsiveness to chemotherapy (P = 0.51), and leptin level had no apparent prognostic role in clinical outcome (P = 0.57). In conclusion, although it was not predictive or prognostic, serum leptin level may be a valuable diagnostic indicator in patients with gastric carcinoma.     

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.     

Paranuclear blue inclusions of small cell carcinoma of the stomach: report of a case with cytologic presentation in peritoneal washings

BACKGROUND: Primary gastric small cell carcinoma is a rare but important entity. We describe a case that we diagnosed by peritoneal washing cytology. CASE: A 70-year-old male presented with upper abdominal discomfort and underwent endoscopic evaluation. Gastric endoscopy revealed a diffuse, infiltrating tumor from the body to the antrum. Total gastrectomy with lymph node dissection and intraoperative peritoneal washing cytology were carried out. Peritoneal washing cytology showed the presence of many undifferentiated malignant small cells with a necrotic background. The tumor cells were small and round, with naked, hyperchromatic nuclei and finely granular chromatin. Some tumor cells contained paranuclear blue inclusions (PBls) in the cytoplasm. The tumor cells were positive for neuron-specific enolase and synaptophysin on immunocyto-chemistry. Carcinoembryonic antigen, alpha-fetoprotein (AFP) and leukocyte common antigen were negative. Pathologic diagnosis after the operation was moderately to poorly differentiated adenocarcinoma and small cell carcinoma containing AFP-positive cells. CONCLUSION: The prognosis of primary gastric small cell carcinoma is usually poor. Our patient died of multiple liver metastases and peritonitis carcinomatosa 69 days after surgery. When a gastric small cell carcinoma is suspected in peritoneal washings, immunocytochemical demonstration of neuroendocrine differentiation is required to arrive at the final diagnosis.     

TAMs在贲门癌和非贲门癌组织中的表达及其临床意义冰

目的：观察不同部位胃癌（贲门癌与非贲门癌）组织中肿瘤相关巨噬细胞（tumor associated macrohags,TAMs）的表达及其与血管生成的关系,并进一步分析其与临床病理特征的相关性。方法：利用免疫组化方法标记TAMs（抗CD68抗体）和血管内皮细胞（抗CD34抗体）,检测90例胃癌中（包括18例贲门癌与72例非贲门癌）TAMs、微血管密度（microvesseldensity,MVD）的表达情况。结果：①TAMs与胃癌的部位、分化程度、浸润深度及临床分期呈显著正相关（P均〈0．05）;②MVD与胃癌的部位和分化程度呈显著正相关（P〈0．05）;结论：TAM可以促进胃癌的发展,这可能与TAM促进肿瘤的血管生成有关;TAM的表达可能是影响贲门癌与非贲门癌生物学行为差异的因素之一。     

Telomerase activity could be used as a marker for neoplastic transformation in gastric adenocarcinoma: but it does not have a prognostic significance

Telomerase activity is responsible for telomere maintenance and is believed to be crucial in most immortal cells and cancer cells; however, its clinicopathological significance in gastric cancer remains to be clarified. The aim of the present study was to assess whether malignant progression of gastric adenocarcinoma correlates with telomerase activity. We also investigated the correlation between telomerase activity and histopathological findings. We examined telomerase activity in tumor specimens and adjacent normal tissues from 43 patients with gastric adenocarcinoma. Telomerase activity was measured quantitatively by the TRAPEZE Gel Based Telomerase Detection Kit. Approximately 98% of the tumor tissues were telomerase positive, but telomerase activity was detected not only in tumor tissues but also in normal gastric mucosa. Although telomerase activity was found to be higher in tumor samples than normal tissue for each subject, we could not find a general cut-off level for telomerase activity in gastric adenocarcinoma. In addition, telomerase activity was not correlated with tumor invasion, lymph node involvement and histological stage. Our results support the idea that telomerase reactivation is a common event in gastric adenocarcinoma and it is not related to histopathological parameters. Since it is difficult to set a cut-off level for this type of cancer, we suggest that the prognostic utility of telomerase assay has not yet reached the clinic in terms of predicting outcome for patients with gastric adenocarcinoma. For the assessment of gastric carcinoma, telomerase activity should be evaluated in both tumor and normal tissues, because normal gastric mucosa samples show appreciable telomerase activity.     

COX-2 inhibitor, NS398, enhances Fas-mediated apoptosis via modulation of the PTEN-Akt pathway in human gastric carcinoma cell lines

A variety of human cancer cells are resistant to Fas ligand and anti-Fas antibody induced apoptosis. Previously, we reported that human gastric carcinoma cell lines were resistant to the anti-Fas antibody, CH-11, without interferon-gamma pretreatment in vitro. Cyclooxygenase (COX)-2 is known to be expressed in many human malignancies, and is correlated with tumor progression and resistance to apoptosis. This study examined whether NS398, a COX-2 inhibitor, inhibited cell proliferation and increased Fas-mediated apoptosis in human gastric carcinoma cell lines. Treatment of NS398 inhibited cell proliferation in MKN-45, which expressed the highest level of COX-2 among seven human gastric carcinoma cell lines, in a dose- and time-dependent manner, in contrast to less prominent effects in KATO-III, which expresses no COX-2. Although the treatment of CH-11 induced apoptosis in both cells, the simultaneous treatment of NS398 and CH-11 remarkably induced apoptosis, as confirmed by Hoechst 33258 staining and the terminal deoxynucleotidyl transferase- mediated dUTP-digoxigenin nick-end labeling (TUNEL) method in MKN-45. Flow cytometric analysis also revealed the increased pre-G1 fraction by the simultaneous treatment. The treatment of NS398 induced upregulation of Bad and PTEN, and downregulation of phosphorylated Akt (Thr308). These findings suggest that COX-2 might inhibit Fas-mediated apoptosis in human gastric carcinoma cell lines, especially MKN-45, by modulating PTEN and Akt.     

Overexpression of ZEB1 associated with metastasis and invasion in patients with gastric carcinoma

The aim of this study was to investigate the expression of ZEB1 in gastric carcinoma, its correlation with the clinicopathology of gastric carcinoma, and the role of ZEB1 in invasion and metastasis in gastric carcinoma. ZEB1 expression was analyzed by immunohistochemistry and Western blot in 45 gastric carcinoma tissue samples that contained the adjacent gastric mucosa. The correlation between ZEB1 expression, the occurrence and development of gastric cancer, and clinical pathology was investigated. ZEB1 expression in the human gastric carcinoma cell line AGS was downregulated by RNA interference, and changes in ZEB1 expression corresponded with changes in the invasive and metastatic ability of AGS cells. Immunohistochemistry revealed that ZEB1 protein expression in gastric carcinoma tissues was significantly higher than in normal gastric mucosa tissues (p < 0.001). A lower degree of differentiation of gastric cancer (p = 0.009), a higher TNM (tumor, node, and metastasis) stage (p = 0.010), and a larger scope of invasion were correlated with higher expression of ZEB1 (p = 0.041, 0.002). However, the expression of ZEB1 in gastric carcinoma tissue was independent of gender, age, and tumor size (p > 0.05). Western blot results also showed that ZEB1 protein expression was significantly higher in gastric carcinoma tissue than in the adjacent normal gastric mucosa tissue (p = 0.008). A lower degree of differentiation of the gastric carcinoma correlated with a higher TNM stage, and a larger scope of invasion correlated with increased ZEB1 expression (p = 0.023). Transfection of ZEB1 siRNA in AGS cells significantly decreased the expression level of ZEB1 protein (p = 0.035). Furthermore, the number of cells that could pass through the Transwell chamber was significantly lower in the transfected group than in the non-transfected control group (p = 0.039), indicating that the suppression of ZEB1 expression could significantly reduce the invasive and metastatic ability of AGS cells (p = 0.005). Concluding, in gastric carcinoma tissue, overexpression of ZEB1 may be related to the occurrence and development as well as invasion and metastasis of gastric carcinoma.     

胃癌中TAMs与血管生成及转移相关性的分析

目的：研究胃癌中肿瘤相关巨噬细胞（tumor associated macrophages,TAMs）的表达及其与肿瘤血管生成的关系,进而分析其与转移的相关性。方法：利用免疫组化双染方法同时标记TAMs（抗CD68抗体）和内皮细胞（抗CD34抗体）,检测90例胃癌中TAMs、微血管密度（microvessel density,MVD）。结果：①TAMs与胃癌的大小、淋巴结转移、远处转移呈显著正相关（P均〈0.05）;②MVD与胃癌的远处转移呈显著正相关（P均〈0.05）;③在胃癌组织中TAMs与MVD的表达呈显著的正相关（r=0.325,P=0.002）。结论：TAMs可能通过促进胃癌血管的生成,进而促进胃癌细胞发生血管内渗,最终实现胃癌细胞的转移。     

CD44v6、MMP-9、VEGF在胃癌的表达及临床意义

目的:检测胃癌组织中CD44v6、MMP-9、VEGF表达情况及其与胃癌临床病理因素的关系,并探讨其表达与胃裸区侵犯的临床意义。方法:采用免疫组化方法测定60例胃癌组织CD44v6、MMP-9、VEGF表达情况,并结合患者的临床病理资料进行分析。结果:CD44v6、MMP-9、VEGF的表达与胃癌的TNM分期、浸润深度、淋巴结转移有关。胃裸区受侵组与未受侵组胃癌组织的CD44v6、MMP-9、VEGF的表达无明显差异。结论:CD44v6、MMP-9、VEGF的表达与胃癌的浸润转移密切相关,胃裸区是否受侵与胃癌组织的CD44v6、MMP-9、VEGF的表达无关,胃裸区这一解剖结构可能是胃癌预后较差的原因。     

EGFR在胃癌中的研究进展

表皮生长因子受体（EGFR）通过下游的信号传导途径参与肿瘤细胞增殖、血管生成、侵袭、转移及凋亡抑制等的基因调控,在多种肿瘤组织中有高表达。近几年在胃癌的研究中显示：EGFR在胃癌中有高表达,与胃癌的发生、发展及生物学行为密切相关,被认为是胃癌等肿瘤治疗的理想靶点。当前以EGFR为靶点的生物治疗成为胃癌新的研究热点,本文就其近几年EGFR在胃癌的表达、预后及靶向治疗等研究现状作一综述。     

人胃癌组织中乙酰肝素酶和S-100蛋白的表达及其意义

目的:探讨乙酰肝素酶和S-100蛋白在人胃癌组织中的表达及其意义。方法:根据胃癌的病理大体分型将40例胃癌组织分为早期组和晚期组。其中,早期组同时未伴有淋巴结转移,晚期组伴有淋巴结转移。采用光镜、透射电镜、原位杂交和免疫组化方法对这两组胃癌组织的超微结构,乙酰肝素酶和S-100蛋白表达进行检测。结果:早期组乙酰肝素酶阳性表达细胞较少,晚期组阳性细胞较多,二者数密度和面密度比较。具有统计学意义(P<0.01);早期组S-100蛋白阳性表达细胞较晚期组多,二者比较,具有统计学意义(P<0.01);电镜观察可见:在胃癌早期,淋巴细胞和树突状细胞浸润较多,树突状细胞突起与淋巴细胞相接触,基底膜基本完整。晚期,基底膜几乎消失。淋巴细胞和树突状细胞浸润较少,癌细胞穿基膜明显。结论:乙酰肝素酶和S-100蛋白的表达程度可作为判定胃癌的侵袭和转移的指标,对其预后的判断具有参考价值。     

Up-regulated expression of Ezrin and c-Met proteins are related to the metastasis and prognosis of gastric carcinomas

Recent publications demonstrated that abnormal expression of Ezrin and c-Met proteins were related to carcinogenesis, metastasis and prognosis of various sorts of tumors. In this study we detected the expressions of Ezrin and c-Met proteins in normal gastric mucosa, chronic atrophic gastritis, intestinal metaplasia, dysplasia and gastric carcinoma and analyzed the correlations with metastasis and prognosis of gastric carcinomas. The results demonstrated that both Ezrin and c-Met overexpression were related to the occurrence and progression of gastric carcinoma. Our findings also demonstrated that combined detection of these two tumor-specific biomarkers in gastric carcinomas can provide additional efficacy in predicting the patients' outcomes.     

胃癌组织中Bmi-1基因表达的研究

目的：多梳基因家族的Bmi．1被认为是一种癌基因,在多种肿瘤组织中均有表达。本研究主要是检测Bmi-1基因在胃癌组织中的表达及探讨其临床意义。方法：应用RT—PCR和Westernblotting方法检测45例胃癌中Bmi-1基因的表达情况,并结合患者的临床病理资料分析与其相关性。结果：Bmi-1基因阳性表达率在胃癌中为88．9％（40／45）,癌旁组织为17．7％（8／45）,差异有显著性（P〈0．05）;Bmi-1基因阳性表达率与患者年龄、性别、肿瘤大小及有无淋巴结转移无关,与肿瘤分化程度及TNM分期有关（P〈0．05）。结论：Bmi-1基因在胃癌中高表达,与胃癌的疾病进展密切相关,检测Bmi-1的表达可作为胃癌生物学行为的一项评估指标。     

EBV阳性胃癌细胞系与阴性胃癌细胞系全基因组表达谱差异比较

目的：探讨EB病毒阳性胃癌细胞系与EB 病毒阴性胃癌细胞系全基因组表达谱的差异。方法：利用Agilent 人类全基因组 表达谱芯片技术在3 种EB病毒阳性胃癌细胞系和3 种EB 病毒阴性胃癌细胞系中筛选EB病毒相关胃癌肿瘤相关基因。选取6 条差异表达基因,应用实时荧光定量PCR验证芯片结果的可靠性。结果：聚类热图及矩阵图分析显示,EB病毒阳性胃癌细胞系与 阴性胃癌细胞系之间表达谱存在明显差异。差异表达基因涉及多种生物学过程。选取的6 条差异基因进行验证,其表达趋势与芯 片结果一致。结论：感染EB病毒可能会改变肿瘤相关基因的表达,进而在EB病毒相关胃癌的发生、发展及预后中发挥作用。筛 选出的肿瘤相关基因涉及多种生物学过程,提示多基因及相关基因的变异参与了EB病毒相关胃癌的形成。