To investigate the relationship between clinicopathological features and lymph node metastasis in the primary gastric cancer and affer the basis for deciding appropriate extent of lymph node dissection, a total of 192 patients who underwent curative gastrectomy and lymph node dissection for gastric cancer were analyzed retrospectively. Result: The total rate of lymph node metastasis was 60.4%, with 28.9% of the resected lymph nodes involved. The lymph node metastasis of C, M, A region and the whole stomach were 64.6%, 57.7%, 59.1% and 90.9% respectively. The rates of the lymph node metastasis increased successively in carcinoma of early, middle and late stages (Ｐ＜0.05), the rate of the infiltrative tumor (Borr Ⅲ，Ⅳ) being 76.5% which was significantly higher than that of the circumscribed tumor (Borr Ⅰ，Ⅱ) (43.2%)。 Relating with the tumor size ＜4cm in diameter showed lesser rate, while 4-8 cm and ＞8cm in diameter showed increasingly higher metastaticrate (Ｐ＜0.01). As a result, we should decide the appropriate extent of lymph node dissection during the operation on the basis of clinicopathological stages, type of Borrmann’s, site and maximum diameter of gastric cancer along with the state of lymph node metastasis in carcinoma of different region of the stomach.
Objective To investigate the expression of syndecan-1 protein in gastric carcinoma and normal gastric mucosa tissues, and find out the correlation between the expression of syndecan-1 protein and the clinicopathologic characteristics of gastric carcinoma. Methods The expression of syndecan-1 protein was detected by immunohistochemistry (ABC) in 60 cases of gastric carcinoma, including gastric carcinoma tissues and normal gastric mucosa tissues. Results Syndecan-1 protein expressed in all of the 60 normal gastric mucosa tissues, however, only 10 of 60 gastric carcinoma tissues (16.67%) showed positive expression. The positive rate of syndecan-1 expression in normal gastric mucosa tissues was higher than that in gastric carcinoma tissues, and this difference was statistically significant (χ2=65.88, P＜0.05). The expression level of syndecan-1 protein in gastric carcinoma tissues with lymph node metastasis was lower than that without lymph node metastasis, and this difference was also statistically significant (χ2 =18.62, P＜0.05). In addition, syndecan-1 expression was not correlated with patients’ age and position of tumor (Pgt;0.05), but correlated with the diameter， invasion depth and TNM stage of tumor (Plt;0.05). Conclusion The positive expression of syndecan-1 protein is low in gastric carcinoma tissue and has b correlation with tumor stage and lymph node metastasis.
Objective To investigate the correlation among lymph node metastasis and clinical features, postoperative survival rate in rectal cancer. Methods Seventy-nine patients who had accepted total mesorectal excision (TME) were collected, and the correlation among their clinical features (including gender, age, tumor size, gross type, depth of infiltration, histology type, differentiated degree and the level of blood serum CEA), lymph node metastasis, and postoperative survival rate were analyzed. Results There was significant correlation between six factors (namely the tumor size, gross type, depth of infiltration, histology type, differentiated degree and the level of blood serum CEA) and lymph node metastasis in single factor analysis. However， multivariate analysis showed that only gross type of tumor and depth of tumor infiltration were related to lymph node metastasis. The postoperative survival time of 43 non-metastasis cases was remarkably longer than that of 33 cases with lymph node metastasis (χ2=18.806， P=0.000), and it was longer in 22 cases with ＜4 lymph nodes metastasis than that of 11 cases with ≥4 lymph nodes metastasis (χ2=4.659， P=0.031). Conclusion In rectal cancer patients the clinical features can reflect the condition of lymph node metastasis in a certain extent, and it can help doctors to evaluate the lymph node metastasis and prognosis.
Abstract：Pulmonary metastasectomy is an important curative option for patients with osteogenic and softtissue sarcoma spread to the lungs. Complete surgical removal of pulmonary metastases can improve survival and is recommended under certain criteria. Specific issues that require consideration when planning pulmonary metastasectomy include: preoperative assessment of the operation index and contraindications, choice of surgical strategies, pulmonary parenchymal preservation, and the role of lymphadenectomy. With the development of iconography and chemotherapy, the emergence of targeted drugs, and the innovation of radiotherapy, the concept of the diagnosis and treatment for pulmonary metastases from osteogenic and softtissue sarcoma is also undergoing great changes.
Objective To study the necessity and feasibility of No.12b lymph node dissection in D2 lymphadenectomy for advanced distal gastric cancer, and the relation between No.12b lymph node metastasis and clinicopathologic factors. Methods Clinical data of sixty cases of advanced distal gastric cancer receiving D2 or D2+ radical correction were collected retrospectively, both of which were all plus No.12b lymph node dissections. The relationships between No.12b lymph node metastasis and clinicopathologic factors were analyzed. Results No death attributed to operation or severe operative complications were found. There were 12 cases (20.00%) with No.12b lymph node metastasis. The rates of No.12b lymph node metastasis in Borrmann Ⅲ-Ⅳ types, N2-3 of lymph node metastasis and T3-4 of tumor infiltration were 31.25% (10/32), 30.30% (10/33) and 29.73% (11/37), which were significantly higher than those in Borrmann Ⅰ-Ⅱ types 〔7.14% （2/28）〕, N0-1 〔7.41% （2/27）〕 and T1-2 〔4.35% （1/23）〕 respectively (Plt;0.05). There was no relationship between tumor size and No.12b lymph node metastasis. Conclusions No.12b lymph node dissection is safe and feasible for advanced distal gastric cancer. Further perspective studies on No.12b lymph node dissection influence on prognosis in more cases are required.
Objective To summarize and analyze the different views on the lymph node metastasis and the extent of lymphadenectomy in gastric cancer.Methods The current domestic and foreign reports on lymph node metastasis and lymphadenectomy in gastric cancer were reviewed.Results Lymph node dissection of gastric cancer is based on clinical stage and the location of the tumor. Laparoscopic-assisted gastrectomy in treatment of gastric cancer is a safe， feasible， effective， and minimally invasive technique with good outcomes for patients. Sentinel lymph node（SLN） in the clinical assessment of early gastric cancer is feasible，besides with high accuracy and sensitivity. Lymphatic mapping is an effective， easy， and safe method to guide lymphadenectomy in gastric cancer. Evidence-based lymphadenectomy in gastric cancer provide a new perspective to the extent. Conclusions It is difficult to evaluate those methods exactly. Researchers over the world should learn from each other and explore further in order to develop guiding principles in the end.
Objective To study the expression of CD133 mRNA in peripheral blood mononuclear cells （PBMCs） of patients with gastric adenocarcinoma （GC） before operation or after operation and its clinical significance. To learn the relationship of CD133 expressions in PBMCs to primary lesion of GC. Methods Fifty patients with GC，10 patients with gastric ulcer （GU）， and 10 healthy volunteers were registered in this research. Expressions of CD133 mRNA in PBMCs and in primary lesion of GC by semi-quantitative RT-PCR and expression of CD133 protein in primary lesion of GC by immunohistochemical staining were detected. Correlations of CD133 mRNA expression with clinicopathologic parameters and postoperative survival rate were analyzed. Relation between CD133 mRNA level and CD133 protein expression or lymphatic metastasis were assessed too. Results The brightness scale value （ABSV） of CD133 mRNA in PBMCs of the patients with GC before operation （0.270±0.163） was higher than that in the healthy volunteers （0.029±0.060） or in the patients with GU （0.059±0.099） （P=0.000）. The ABSV of CD133 mRNA in the PBMCs of patients with GC before operation was related to poor cell differentiation （P=0.002）， lymph vessel invasion （P=0.028），deeper tumor invasion （P=0.041），later lymph node metastasis stage （P=0.010），later TNM stage （P=0.006），and positive expression of CD133 protein in the primary lesion （P=0.011）. Relative analysis revealed that the ABSV of CD133 mRNA in the PBMCs of patients with GC before operation was related positively to metastatic lymphatic nodes ratio （rs=0.422，P=0.002），metastatic lymph node number （rs=0.398，P=0.004），and ABSV of CD133 mRNA in the primary lesion of GC （rs=0.337，P=0.017）. The ABSV of CD133 mRNA in the PBMCs of patients with GC after operation obtained from blood sample at 1 week after curative resection was higher than that in the patients before operation （P=0.021）. Patients suffered from deeper invasion inclined to have a higher ABSV of CD133 mRNA after surgery （P=0.039）. Higher expression of CD133 mRNA in patients after operation demonstrated a much poorer survival rate （P=0.013）. Conclusions Higher expressive level of CD133 mRNA in GC before operation is associated to poor cell differentiation，lymph vessel invasion，deeper invasion，higher lymph node metastasis，later TNM stage，and positive expression of CD133 protein. It is also related positively to metastatic lymphatic nodes ratio，metastatic lymph node number，and ABSV of CD133 mRNA in primary lesion of GC. The level of CD133 mRNA in PBMCs of patients with GC is higher after operation as compared with before operation，which demonstrates deeper invasion and poorer survival.
ObjectiveTo explore the differences and similarities of the featurs of lymph node metatasis of abdominal esophageal carcinoma and cardiac cancer. MethodsPreoperative CT images of abdominal esophageal carcinomas and cardiac cancers were reviewed and analysed on lymph node size and preponderant distribution. ResultsShort diameter ≥10 mm of lymph node at CT was adopted as metastasis criterion. The detection rates of abdominal esophageal carcinomas and cardiac cancers were 73.5%（144/196） and 83.7% （170/203）, respectively. Thoracic lymph node metastasis rate of abdominal esophageal carcinomas was 11.1% （4/36） in 7 area, 27.8% （10/36） in 8 area, 8.3% （3/36） in 9 area, while celiac lymph node metastasis rate was 36.1% (13/36 ） in No.7 group, 19.4% （7/36） in No.1 group, and 11.1% （4/36） in No.2 group primarily. Lymph node metastasis rate of cardiac cancers was 17.9% （5/28） in No.1 group, 28.6% （8/28） in No.2 group, 39.3% （11/28 ） in No.3 group, and 25.0% （7/28） in No.4 group for the first stop lymph nodes, and 35.7% （10/28 ） in No.7 group for the second stop primarily. ConclusionAs metastasis criterion, short diameter ≥10 mm of lymph node at CT is feasible, but there exist certain falsepositive rate. Thoracic lymph node metastasis of abdominal esophageal carcinomas is mainly in the 7, 8, and 9 area, while celiac metastasis is mainly in No.7, No.1, and No.2 groups. Lymph node metastasis of cardiac cancers is in No.1, No.2, No.3, No.4, and No.7 group primarily.
Objective To study the relationship between early gastric cancer and MiB-1 expression. Methods Resected early gastric cancer from 99 cases were studied by immunohistochemical method. Results MiB-1 proliferation index (MiB-1 PI) was related to patient ’s age, tumor size, location and depth of invasion. MiB-1 PI was higher in differentiated adenocarcinomas than in undifferentiated adenocarcinomas(P＜0.01). Cancers with lymphatic vessel invasion or lymph node metastasis had higher MiB-1 PI (P＜0.05). The postoperative survival was related to MiB-1 proliferation grade (MiB-1 PG), being higher in MiB-1 PG 1,2 grade than that in MiB-1 PG 3,4 grade. Conclusion Even in the early stage of gastric cancer, tumor proliferation activity was related to patients’ prognosis.
ObjectiveTo investigate the expression of CD133 protein in primary lesions of gastric cancer and its clinical significance. MethodsThe expressions of CD133 protein in the primary lesion of tumor and normal gastric mucosa tissues confirmed by using histopathologic examination of 99 patients were detected by immunohistochemical staining. The correlation of CD133 protein expression with the clinicopathologic parameters and features after operation were analyzed. ResultsPositive cells of CD133 protein were localized in the gland parietal and cell membrane surface. The expression of CD133 protein in the cancer and normal gastric mucosa tissues were 29.29% (29/99) and zero, respectively (P=0.000). Expression of CD133 protein in tumor with diameter gt;5 cm was significantly higher than that in the tumor with diameter ≤5 cm (P=0.041). The expression of CD133 protein was correlated with TNM stage (P=0.044), lymph node metastasis (P=0.017), lymphatic vessel invasion (P=0.000), and vascular invasion (P=0.000). Logistic regression analysis revealed that invasion depth of tumor (P=0.011), lymph node metastasis (P=0.043), and TNM stage (P＝0.049) were independent risk factors for CD133 protein expression. Survival time of patients with positive expression of CD133 protein was significantly shorter than that negative expression of CD133 protein (P＝0.046). Cox proportial hazard regression model analysis demonstrated that lymph node metastasis (P=0.042), TNM stage (P=0.046), and positive expression of CD133 protein (P=0.046) were independent risk factors for patients survival. ConclusionThe CD133 protein expression in primary lesions is closely related with development, metastasis, and prognosis of gastric cancer.