Search

Background: Although immune checkpoint inhibitors (ICIs) have demonstrated significant survival benefits in some patients diagnosed with gastric cancer (GC), existing prognostic markers are not universally applicable to all patients with advanced GC., Aim: To investigate biomarkers that predict prognosis in GC patients treated with ICIs and develop accurate predictive models., Methods: Data from 273 patients diagnosed with GC and distant metastasis, who un-derwent ≥ 1 cycle(s) of ICIs therapy were included in this study. Patients were randomly divided into training and test sets at a ratio of 7:3. Training set data were used to develop the machine learning models, and the test set was used to validate their predictive ability. Shapley additive explanations were used to provide insights into the best model., Results: Among the 273 patients with GC treated with ICIs in this study, 112 died within 1 year, and 129 progressed within the same timeframe. Five features related to overall survival and 4 related to progression-free survival were identified and used to construct eXtreme Gradient Boosting (XGBoost), logistic regression, and decision tree. After comprehensive evaluation, XGBoost demonstrated good accuracy in predicting overall survival and progression-free survival., Conclusion: The XGBoost model aided in identifying patients with GC who were more likely to benefit from ICIs therapy. Patient nutritional status may, to some extent, reflect prognosis., Competing Interests: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: The development and progression of gastric cancer (GC) are closely linked to the nutritional status of patients. Although immunotherapy has been demonstrated to be clinically effective, the relationships of sarcopenia and myosteatosis with the use of immune checkpoint inhibitors (ICIs) in patients with gastric cancer remain to be characterized., Aim: To assess the effects of sarcopenia and myosteatosis on the clinical outcomes of patients with GC undergoing treatment with an ICI., Methods: We performed a retrospective study of patients who were undergoing immunotherapy for GC. For the evaluation of sarcopenia, the optimal cut-off value for the skeletal muscle index was established using receiver operating characteristic analysis of data obtained from pre-treatment computed tomography images at the L3 vertebral level. Myosteatosis was defined using the mean skeletal muscle density (SMD), with a threshold value of < 41 Hounsfield units (HU) for patients with a body mass index (BMI) < 25 kg/m² and < 33 HU for those with a BMI ≥ 25 kg/m². The log-rank test was used to compare progression-free survival (PFS) and overall survival (OS), and a Cox proportional hazard model was used to identify prognostic factors. Nomograms were developed to predict the PFS and OS of patients on the basis of the results of multivariate analyses., Results: We studied 115 patients who were undergoing ICI therapy for GC, of whom 27.4% had sarcopenia and 29.8% had myosteatosis. Patients with sarcopenia or myosteatosis had significantly shorter PFS and OS than those without these conditions. Furthermore, both sarcopenia and myosteatosis were found to be independent predictors of PFS and OS in patients with GC administering an ICI. The prediction models created for PFS and OS were associated with C-indexes of 0.758 and 0.781, respectively., Conclusion: The presence of sarcopenia or myosteatosis is a reliable predictor of the clinical outcomes of patients with GC who are undergoing treatment with an ICI., Competing Interests: Conflict-of-interest statement: The authors declare no competing financial interests., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Aim: The study aimed to elucidate the value of multislice spiral computed tomography (MSCT) perfusion for the early prediction of gastric cancer (GC) recurrence., Methods: MSCT perfusion scans were performed to obtain values pertaining to blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface (PS). Logistic regression analysis was employed to evaluate the risk factors of postoperative recurrence in GC., Results: The maximum diameter of GC has a positive relationship with PS. The maximum enhancement of GC was positively correlated with BF, blood volume and PS. PS, BF, vascular thrombus and Tumor, Node, Metastasis staging were found to be significant risk factors in relation to the recurrence of GC (p = 0.006, p = 0.002, p < 0.001)., Conclusion: MSCT perfusion is strongly correlated with postoperative recurrence of GC, and PS and BF values, vascular thrombus and Tumor, Node, Metastasis staging were discovered as being prominent factors influencing the recurrence of GC.

Background: The present study aimed to illustrate the clinical value of contrast-enhanced computed tomography (CECT) in predicting gastric cancer (GC) recurrence and metastasis., Methods: From March 2012 to March 2014, 131 GC patients who underwent initial treatment at the Tumor Hospital of Harbin Medical University were enrolled in this study, and 64-slice spiral CT was used for CECT. CECT parameters were recorded, including CT values in the arterial and venous phases, as well as the enhancement patterns in the arterial phase. All GC patients were followed for one year. The receiver operating characteristic (ROC) curve was used to evaluate the clinical values of the CECT parameters in predicting GC recurrence and metastasis., Results: Significantly higher CT values in the arterial and venous phases were found in patients with higher tumor node metastasis (TNM) staging, lymph node metastasis (LNM), advanced Borrmann type and postoperative chemotherapy. TNM stage I-II patients showed less significant enhancement and significant heterogeneous enhancement than TNM stage III-IV patients. Compared with patients without recurrence and metastasis, patients with recurrence and metastasis demonstrated higher CT values in the arterial and venous phases, as well as a higher proportion of significant enhancement and significant heterogeneous enhancements. For the CT value in the arterial phase, the area under the ROC curve was 0.858, with 70.3% sensitivity and 95.7% specificity, and in the venous phase, it was 0.801, with 73.0% sensitivity and 83.0% specificity., Conclusion: Our study suggests that CECT has a high accuracy rate for predicting postoperative GC recurrence and metastasis.

Background/aims: This study gives insight into the effect of splenectomy in radical surgery for gastric cancer., Methodology: The study included 631 patients who underwent radical resection for gastric cancer. Of these 631 patients, 105 underwent splenectomy and 526 had splenic preservation. The clinicopathologic features of 105 patients underwent gastrectomy combined with resection of the spleen (splenectomy group) and 526 patients underwent gastrectomy (spleen-preservation group) were compared., Results: Gastric cancer with splenectomy was characterized by tumor located in gastric cardia (33.3%), positive lymph node metastasis (91.4%), and serosal invasion (94.3%). For age, gender, and tumor size, there was no significant difference between the patients with splenectomy and spleen-preservation. The 5-year survival of splenectomy group was 21.3% as compared with 38.6% for spleen-preservation group (P<0.001). With respect to patients with splenectomy, multivariate analysis showed that lymph node metastasis was significant factors affecting survival., Conclusions: Compared with spleen-preservation group, patients who underwent gastrectomy combined with splenectomy have a greater chance of tumor located in gastric cardia, positive lymph node metastasis, and serosal invasion and a significantly poor prognosis.

Purpose: The aim of this study was to identify proteins associated with gastric cancer lymph node metastasis and explore the clinicopathological significance of these proteins., Methods: Gastric cancer tissues were obtained from 24 patients with high or low lymph node metastatic potential. Total cellular proteins were separated by two-dimensional gel electrophoresis (2-DE), analyzed by MALDI/TOF-TOF MS, and identified by a database search. Expression of 14-3-3β and profilin-1 was then immunohistochemically verified in paraffin-embedded gastric cancer tissues from 128 patients and analyzed by multivariate logistic regression models, Kaplan-Meier curves, and Cox proportional hazard models., Results: A total of 26 differentially expressed proteins were identified, 20 of which were overexpressed and 6 of which were underexpressed. 14-3-3β and profilin-1 were upregulated in gastric cancer tissues with and without lymph node metastasis, respectively. Expression of 14-3-3β protein was associated, but profilin-1 expression was inversely associated with gastric cancer lymph node metastasis. Multivariate analysis showed that overexpression of 14-3-3β and reduced expression of profilin-1 were independent risk factors for gastric cancer lymph node metastasis, while 14-3-3β overexpression was an independent prognostic factor for gastric cancer patients., Conclusions: The current study identified 26 differentially expressed proteins. Further studies showed that both 14-3-3β and profilin-1 protein may be useful biomarkers for prediction of gastric cancer lymph node metastasis and that expression of 14-3-3β was a prognostic marker for gastric cancer patients.

Background/aims: This study gives insight into the effect of combined Billroth II with Braun anastomosis for patients with gastric cancer., Methodology: The clinical data of 720 patients with gastric cancer who underwent surgical treatment in our hospital from 1997 to 2011 were reviewed retrospectively. The results of different operative approaches were analyzed., Results: Combined Billroth II with Braun anastomosis was performed in 378 cases, and Billroth II in 342 cases. The Gastrointestinal Quality of Life Index (GIQLI) was used to evaluate postoperative quality of life., Conclusions: If the indications for combined Billroth II with Braun anastomosis are strictly controlled, and more attention is paid to perioperatively support, combined Billroth II with Braun anastomosis can prolong the life span of the patients with gastric cancer rather than increase the surgical complications and the mortality.

Enteral nutrition can provide adequate nutrients and enhance immunity. Because it is inexpensive, no significant side effects, and convenient, enteral nutrition has been used widely. However, enteral nutrition has its limitation, therefore some details should be noticed during the management. In this paper, we discuss the details about enteral nutrition based on the data of our gastric carcinoma patients.

Recently, the incidence of carcinoma at the esophagogastric junction (CEG), especially adenocarcinoma at esophagogastric junction (AEG) is increasing. AEG has obvious difference from other parts of stomach tumor in anatomy, physiology and pathology. The scholars have not made a consensus and standard about the treatment of AEG. It is necessary to improve the knowledge and cognition about AEG and find a feasible treatment strategy.

Objective: To compare the incidence of postoperative long-term complications and quality of life between two digestive tract reconstruction techniques after total gastrectomy in order to provide evidence for clinical practice., Methods: A systematic literature search was carried out to obtain studies of randomized controlled trials (RCTs) of reconstruction techniques including jejunal interposition and Roux-en-Y. Data extracted from RCTs for meta-analysis were independently assessed by two reviewers. A meta-analysis was performed by RevMan5.0 software., Results: A total of 1628 gastric cancer cases undergoing total gastrectomy from 10 RCTs were eligible for inclusion, among whom 728 received jejunal interposition reconstruction and 954 Roux-en-Y anastomosis. As compared with Roux-en-Y anastomosis, jejunal interposition reconstruction significantly decreased the incidence of dumping syndrome (OR=0.19, 95%CI:0.11-0.34, P<0.01), increased the prognostic nutritional index (WMD=6.02, 95%CI:1.82-10.22, P<0.01), and improved the body weight postoperatively (WMD=-2.45, 95%CI:-3.81--1.71, P<0.01). Meanwhile, jejunal interposition reconstruction did not prolong operative time and hospital stay (both P>0.05)., Conclusion: Jejunal interposition has better efficacy than Roux-en-Y in dumping syndrome and quality of life, and is a reasonable and effective digestive tract reconstruction for long-term survival of gastric cancer patients.

Objective: To evaluate the effect of nasogastric decompression tube after gastric cancer operation on the postoperative recovery., Methods: A total of 174 patients with gastric cancer were prospectively enrolled from December 2009 to March 2011 and randomly divided into non-nasogastric tube control group(n=88) and nasogastric tube group(n=86). Postoperative symptoms, complications, recovery time, and quality of life during hospital stay were compared between the two groups., Results: The incidences of nausea(14.8% vs. 47.7%, P<0.01), sore throat(6.8% vs. 38.4%, P<0.01), bucking and foreign body sensation(3.4% vs. 20.9%, P<0.01), expectoration obstruction(36.4% vs. 55.8%, P<0.05) were significantly lower in nasogastric tube group than those in the control group. The intervals to ambulation and flatus were(1.46±0.58) d and(3.11±0.77) d in the non-nasogastric tube group, significantly shorter those in nasogastric tube group[(1.68±0.61) d and(3.75±1.03) d]. There was no anastomotic leak or bowel obstruction. The difference in bleeding was not statistically significant[3.4%(3/88) vs. 5.8%(5/86), P>0.05] between the two groups. The quality of life differed between the two groups(mean score, 3.36 vs. 2.78, P<0.01)., Conclusion: Early removal of nasogastric decompression tube is safe and reasonable and can improve the quality of life during hospital stay.

Background and Objectives: Reports of clinicopathological features and prognosis in patients with mucinous gastric carcinoma (MGC) are conflicting. The aim was to describe the clinicopathological features and prognosis of patients with MGC in comparison with nonmucinous gastric carcinoma (NMGC)., Methods: We reviewed the records of 1,278 consecutive patients diagnosed with gastric carcinoma who were resected surgically from 1993 to 2003. Among them, 48 patients (3.8%) with MGC were compared to 1,230 patients with NMGC., Results: There were significant differences in tumor location, stage of disease, lymphatic invasion, and vascular invasion between the patients with MGC and NMGC. The overall 5-year survival of patients with MGC was 27.2% as compared with 42.8% for patients with NMGC (P = 0.031). For the patients with the same stage, there was no significant difference between MGC and NMGC. With respect to patients with MGC, multivariate analysis showed that lymph node metastasis and curative resection were significant factors affecting survival., Conclusions: MGC is rare and detected mostly in an advanced stage. Mucinous histology type itself is not an independent prognostic factor., ((c) 2010 Wiley-Liss, Inc.)

Background and Objective: The proportion of stage IV gastric cancer in the whole gastric cancer population in China is still high. This study was to investigate the surgery and pathologic characteristic and prognostic factors of stage IV (M0) gastric cancer., Methods: Clinical data of 630 patients with pathologically confirmed stage IV (M0) gastric cancer treated at the affiliated Tumor Hospital of Harbin Medical University between January 1993 and August 2004 were analyzed using Cox proportional hazard model. Of the 630 patients, 338 received radical excision and 292 received palliative resection., Results: The overall 1-, 3-, 5-year survival rates were 63.8%, 31.4% and 14.3%, respectively. Univariate analysis showed that Borrmann type, lymphatic metastasis, organ involvement, tumor location, tumor size, pathologic type, radical excision and other organ excision were significant prognostic factors affecting 1-year survival rate (P < 0.05); Borrmann type, lymphatic metastasis, organ involvement, pathologic type and radical excision affected 3-year survival rate (P < 0.05); only organ involvement and pathologic type affected 5-year survival rate (P < 0.05). Multivariate analysis showed that pathologic type was independent prognostic factor for poor survival., Conclusions: Radical resection and combined organ resection could prolong the survival of stage IV (M0) gastric cancer patients. Chemotherapy, radiotherapy and targeted therapy should be considered for individual therapeutic regimen.

Objective: To investigate the expression of transcription factor SP1, vascular endothelial growth factor(VEGF) and CD34 in serosa-infiltrating gastric cancer and their relationship with biological behavior and survival rate., Methods: Immunohistochemical technique was used to detect the expression of SP1, VEGF and CD34(described by microvessel density, MVD) in 68 specimens with serosa-infiltrating gastric cancer., Results: The positive expression rates of SP1 and VEGF in serosa-infiltrating gastric cancer were 50.0% and 52.9% respectively. In positive SP1 specimens, the positive rate of VEGF(73.5%) was significantly higher than that of negative SP1 specimens (32.4%, chi(2)=11.57, P=0.01). The mean tumor MVD was correlated with the expression levels of SP1 and VEGF(P<0.01). There was a significant correlation of the SP1 expression with tumor size and growth pattern(P =0.01). The expression levels of VEGF and MVD were correlated with Borrmann types, cell differentiation, metastatic lymph nodes and growth pattern(P<0.01). Univariate analysis revealed that SP1 and VEGF expression, MVD, Borrmann types, lymph node metastasis, tumor size and growth pattern were significant prognostic factors related to survival time. Multivariate analysis showed that SP1 expression, MVD and growth pattern were independently prognostic factors of poor survival., Conclusions: The activation of SP1 contributes to angiogenesis and metastasis in gastric cancer through the up-regulation of VEGF. SP1, VEGF and MVD may serve as valuable indicators of biological behavior of gastric cancer. SP1 protein expression is not related with the number of metastatic lymph nodes. SP1 expression and MVD may serve as valuable indicators of prognosis in gastric carcinoma.

Objective: To observe the expression of hepatocyte growth factor (HGF), transcription factor SP1, vascular endothelial growth factor (VEGF) and CD34 (demonstrating by microvessel density, MVD) in serosa-infiltrative gastric cancer (T3) and their relations with the pathobiological behavior of the tumor, and to investigate the molecular basis of the defluxion of gastric cancer cells in abdominal cavity and its influence on prognosis., Methods: Selective collection of peritoneal lavage was obtained from 80 patients with serosa-infiltrative gastric cancer received operation from April to December in 2007. The cancer cells were detected by using peritoneal lavage cytology (PLC) and immunochemistry of cytokeratin 18 (CK18). Immunohistochemistry was applied to detect the HGF, SP1, VEGF and CD34 in serosa-infiltrative gastric cancer tissues. The rigorous follow-up was carried out for the patients., Results: The positive rate of PLC was 63.8% (51/80), and the positive rate of immunochemistry of CK18 was 75.0% (60/80). The positive cases in PLC were positive in immunochemistry of CK18 also, while 9 negative cases in PLC were positive with CK18, and of them 6 cases were determined positive with exfoliated cancer cells through pathological consulting. So the positive rate of exfoliated cells of this group was 71.3% (57/80). The positive rates of HGF, SP1 and VEGF in gastric cancer tissues were 57.5%, 52.5% and 55.0%, respectively, and were all significantly correlated with the MVD (P < 0.05). HGF, SP1, VEGF and MVD were correlated with the positive rate of exfoliated cells (P < 0.05). HGF, SP1, VEGF and MVD were found significantly related to prognosis on univariate analysis (P < 0.05), and it was demonstrated that HGF, SP1 and VEGF were independent prognostic influential factors on Logistic regression analysis (P < 0.05)., Conclusions: The expression of HGF, SP1, VEGF and MVD are related with the biological behaviour of serosa-infiltrative gastric cancer. The detection of these factors might be helpful in predicting the defluxion of gastric cancer cells and postoperative recurrence.

The purpose of this study is to investigate the reversal effect and its mechanism of arsenic trioxide (As2O3) on multidrug resistance of gastric carcinoma cells. The concentration of vincristine (VCR) increased gradually to induce the drug resistance of gastric carcinoma cell SGC7901. MTT assay was used to determine the lethal effect of anticarcinogens on tumor cells and Western blotting assay was applied to determine the expression of P-glucoprotein (P-gp) and glutathione S-transferase (GST-s) in tumor cells. As a result, the resistance of SGC7901/VCR cells to VCR, fluorouracil and epirubicin was 16.56, 2.69 and 13.05 times, respectively, more than that of SGC7901 cells. After 24 h precondition with As2O3, RI of vincristine, fluorouracil and epirubicin decreased significantly (P < 0.05). Expression of P-gp and GST-s in resting SGC7901/VCR cells was significantly higher than that in carcinogen-sensitive SGC7901 cells. As2O3 decreased the expression of P-gp and GST-s in SGC7901/VCR cells significantly, while it showed no significant effect on carcinogen-sensitive SGC7901 cells. The result suggested that As2O3 could partly reverse drug resistance of SGC7901/VCR cells by probably the mechanism of decreasing the expression of P-gp and GST-s.

Background & Objective: Cellular FLICE inhibitory protein (cFLIP) plays an important role in cell apoptosis, researches of antisense oligonucleotides (ASODN) of cFLIP gene may provide a new method or protocol for treatment of human gastric cancer. This study was to explore effect of cFLIP ASODN on apoptosis of human gastric cancer cell line BGC823., Methods: Human cervical cancer cell line HeLa was used as control, cFLIP ASODN was introduced into BGC823 cells and HeLa cells, reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blot were used to detect cFLIP(L/S) (cellular FLIP(Short) and cellular FLIP(long)) mRNA and protein. The 5'FAM-conjugated ASODN was created complementary to a sequence that included the start site of FLIP open reading frame. After introducing, MTT was used to detect cell inhibition rate,TUNEL and flow cytometry (FCM) were used to detect cell apoptosis, and Western blot was used to detect protein level of cFLIP., Results: The encoding mRNA and protein of cFLIP(L) and cFLIP(S) can be detected in both HeLa and BGC823 cells. MTT revealed that cFLIP ASODN significantly inhibited proliferation of BGC823 cells (P< 0.05) in a concentration-dependent manner. TUNEL staining detected positive FLIP expression, specific apoptotic peak can be detected before G1 peak by FCM, and Western blot revealed that protein level of cFLIP(L) and cFLIP(S) decreased significantly (P< 0.05)., Conclusion: The cFLIP(L/S) mRNA and encoded proteins expressed in both HeLa and BGC823 cells. ASODN may down-regulate cFLIP(L/S) protein level, and initiate apoptosis of BGC823 cells.

Background: Peptide nucleic acid (PNA) has many characteristics useful in molecular biology. This paper described an effective way to raise the cell ingestion rate of PNA so as to kill gastric cancer cells., Methods: Heteroduplexes of PNAs and oligonucleotides, wrapped by Lipofectamine 2000, were used to infect SGC7901 cells. The inhibitive effect of heteroduplexes was evaluated by analyzing cell clone forming and cell growth rate. Telomerase activity of SGC7901 cells was detected by polymerase chain reaction enzyme-linked immunosorbent assay (PCR-ELISA) and silver staining assay., Results: PNAs showed a dose-dependent inhibition of cell proliferation. The percentage of proliferation inhibition was 99.4% after 7 days; the rate of cloning inhibition was 98.2% after 8 days; whereas for oligonucleotide groups, at the same concentration, the percentages were 50.1% and 67.5% respectively. Antisense PNA-DNA-Lipofectamine 2000 group (AP-D-L group) exhibited significantly different percentages from the control groups (P < 0.05). The test result indicated that telomerase activity of the AP-D-L group was inhibited (P < 0.05). At the same time, the impact on cell morphology was observed., Conclusions: The results showed that PNAs are potent antisense reagents. The telomerase-associated therapies are very promising for the treatment of malignant tumours.

Aim: To study the expression of cyclooxygenase-2 (COX-2) gene in gastric cancer and the relationship between COX-2 expression and clinicopathologic features of gastric cancer., Methods: With reference to the expression of beta-actin gene, COX-2 mRNA level was examined in cancerous tissues and adjacent noncancerous mucosa from 33 patients by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR). Quantitation of relative band Adj volume counts was performed using molecular Analyst for windows software. The COX-2 index was determined from the band Adj volume counts ratio of COX-2 to constitutively expressed actin., Results: The COX-2 index in gastric carcinoma was significantly higher than that in normal mucosa (0.5966+/-0.2659 vs 0.2979+/-0.171, u=5.4309, P<0.01). Significantly higher expression of COX-2 mRNA was also observed in patients with lymph node involvement than that in those without (0.6775+/-0.2486 vs 0.4105+/-0.2182, t=2.9341, P<0.01). Furthermore, the staging in the UICC TNM classification significantly correlated with COX-2 overexpression (F=3.656, P<0.05), the COX-2 index in stage III and IV was significantly higher than those in stage I and II (q=3.2728 and q=3.4906, P<0.05). The COX-2 index showed no correlation with patient's age, sex, blood group, tumor location, gross typing, depth of invasion, differentiation, and the greatest tumor dimension (P>0.05)., Conclusion: Expression of COX-2 mRNA in gastric carcinoma was significantly higher, which may enhance lymphatic metastasis in patients with gastric carcinoma. The staging in the UICC TNM classification was significantly correlated with COX-2 over-expression. COX-2 may contribute to progression of tumor in human gastric adenocarcinoma.