Objective To study the value of intraperitoneal chemotherapy in the treatment of gastrointestinal malignancies. Methods The current literature on intraperitoneal chemotherapy was reviewed. Results Following intraperitoneal injection, the concentration of drugs in the peritoneum and in the portal vein was high, lasting and sustained. Early postoperative chemotherapy showed better results. Port-A-Cath provides a safe and suitable drug delivery system. Complications were mild. Conclusion Intraperitoneal chemotherapy presents significant pharmacokinetic and clinical potentials in the treatment of gastrointestinal malignancies, as well as in the prevention and treatment of postoperative metastasis.
Objective To summarize the important role of sirtuin type 1 (SIRT1) in the development of gastrointestinal tumors. Methods Domestic and international publications related to biological functions of SIRT1 and its role in gastrointestinal tumors in recent years were collected and reviewed. Results SIRT1 had a significant high expression in esophageal cancer, gastric cancer, colorectal cancer, liver cancer, and pancreatic cancer tissues, by associating with long noncoding RNA (LncRNA), microRNA, and autophagy. It affected the occurrence and development of gastrointestinal tumors. Conclusions Abnormal expression of SIRT1 is closely related to the occurrence and development of gastrointestinal tumors.
【Abstract】Objective To introduce the current studies of the role of vascular endothelial growth factorC (VEGFC) and VEGFD in lymphangiogenesis and lymph node metastasis of gastrointestinal neoplasma. Methods The related literatures in recent 5 years were reviewed. Results The growth factors VEGFC and VEGFD enhance lymphangiogenic metastasis of gastrointestinal neoplasma with the property of angiogenesis and lymphangiogenesis. In gastric adenocarcinoma, VEGFC mRNA and tissue protein expression correlate with lymphatic invasion, lymph node metastasis, venous invasion and reduced 5year survival rates. The role of VEGFC in esophageal squamous cancer and colorectal cancer and VEGFD in colorectal cancer is not certain, with conflicting reports in the published literatures.Conclusion The VEGFC, VEGFD/VEGFR3 signal pathway may become the ideal target for inhibition of tumor proliferation and metastases, antilymphangiogenesis therapy may be a novel potential strategy in tumor biological therapy.
目的 探讨消化道类癌的诊断和治疗。方法 对我院1992年10月至2002年12月收治的23例消化道类癌患者的临床资料进行回顾性分析。结果 23例消化道类癌中3例胃类癌，1例十二指肠类癌，4例阑尾类癌，3例结肠类癌，12例直肠类癌。术前9例（39%）经活检确诊； 术后经病检23例中11例（47.8%）浸润程度超过肌层； 4例（17.4%）有区域淋巴结转移； 8例经神经元特异性烯醇酶（NSE）检查（此酶为神经内分泌肿瘤的重要标志物，具有诊断价值）有6例阳性表达，表达阳性率为75%。结论 病变部位、浸润深度、淋巴结转移是决定消化道类癌预后的关键因素，手术是有效的治疗方式。
Objective To review the advancement of heat shock protein 70 (HSP70) vaccine in alimentary canal cancer. Methods Related articles were reviewed. Results HSP70 can integrate with tumor special antigen to form HSP70 polypeptide compound. To activate the special and nonspecial immune response of body, HSP70 can participate in the process of tumor immunity as a “molecular partner”. Conclusion HSP70 has shown alluring perspective in the precaution and treatment of alimentary canal cancer.
Objective To evaluate the role of apparent diffusion coefficients (ADC) in assesment of response to chemotherapy in patients with gastrointestinal liver metastasis. MethodsTen patients with liver metastasis （8 from colorectal cancer， 1 from gastric cancer， 1 from esophageal cancer） at Peking University People’s Hospital from April 2006 to April 2007 were included. All of them received chemotherapy （FOLFOX6： 4 cases， XELOX： 3 cases, and FOLFIRI： 1 case in 8 cases of colorectal liver metastases; ECF: 1 case of gastric liver metastases; DCF: 1 case of esophageal liver metastasis）. ADC were calculated after MR duffusionweight imaging exmination (GE MEDICAL SYSTEMS HD EXCITE 1.5 T) 1 month pre-and post-chemotherapy, respectively. Tumour response to chemotherapy was assessed by RECIST criteria. ResultsTumors with low pretreatment ADC (lt;9.04×10－4 mm2/s) responded better to chemotherapy than that with high ADC (gt;9.04×10－4 mm2/s); pretreatment ADC of cases (6/10) were remarkable lower than those of cases (4/10)， P＝0.033. Increased ADC after onemonth chemotherapy in patients with liver metastasis predicted a better response. ConclusionsLow pretreatment ADC is predictive of better response to chemotherapy. An increased ADC after treatment predicts a better response to chemotherapy.
ObjectiveTo summarize the relationship between microRNAs (miRNAs) and the digestive tract cancer, and to investigate the applicative value of miRNAs in the diagnosis, treatment, and prognosis evaluation of the digestive tract cancer. MethodsDomestic and international papers focusing on the relationship between miRNAs and the digestive tract cancer were retrieved and reviewed. ResultsmiRNAs participated in cell proliferation, differentiation, and apoptosis through gene regulation. The patients with digestive tract cancer were often accompanied with some abnormal expression of miRNAs in circulation, that was closely related to the occurrence and development of tumor. These miRNAs in blood contributed to not only the diagnosis of tumor, but also identification of the primary tumor site, even the clinical and pathological staging. Thus, we could predict the progress, recurrence, and the metastasis of tumor, or perform the evaluation of therapeutic effects. ConclusionCirculating miRNAs can be used as molecular microsensors for the noninvasive early diagnosis, treatment, and prognosis of the digestive tract cancer.
ObjectiveTo summarize the application status of artificial intelligence (AI) in the diagnosis and treatment of gastrointestinal tumors using image deep learning, as well as its application prospect. MethodLiteratures on AI in the field of gastrointestinal tumors in recent years were reviewed and summarized.ResultsAI had developed rapidly in the medical field. The gastrointestinal endoscopy, imaging examination, and pathological diagnosis assisted by AI technology could assist doctors to make more accurate diagnosis opinions, and make the diagnosis and treatment of gastrointestinal tumors develop towards a more accurate and efficient direction. However, the application of AI in the medical field had just begun, and it still needed to be popularized for a long time.ConclusionThe gastrointestinal endoscopy system, imaging examination system, and pathological diagnosis assisted by AI technology all show high specificity and sensitivity, which obviously reflects its high efficiency and accuracy.
Objective To study the effects and mechanisms of major immune nutrients and to introduce the progresses of clinical applications about enteral immunonutrition. Methods The related literatures about the effects and clinical applications of enteral immunonutrition were reviewed. Results Infection rate can be reduced and the hospitalization can be shortened as a result of the improved nutritional status and immune competence of patients which can be enhanced by reasonable enteral immune nutrition. Most of the patients suffering from serious diseases can benefit from enteral immunonutrition, such as gastrointestinal cancers, post-transplantation complications, chronic liver disorders, acute pancreatitis and so on. However, as a new nutrition therapy, the clinical use of enteral immunonutrition in critically ill patients is still controversial. Conclusions Enteral immunonutrition plays an important role in the nutritional support of patients with serious diseases, such as gastrointestinal cancers, organ failures. However, much work remains to be done.