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Sample records for advanced gastric adenocarcinoma

  1. Relationship between clinicopathological features and mucin phenotypes of advanced gastric adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Fumiaki; Toki; Atsushi; Takahashi; Ryusuke; Aihara; Kyoichi; Ogata; Hiroyuki; Ando; Tetsuro; Ohno; Erito; Mochiki; Hiroyuki; Kuwano

    2010-01-01

    AIM: To investigate a relationship between the clinicopathological features and mucin phenotypes in advanced gastric adenocarcinoma (AGA). METHODS: Immunohistochemical staining was performed to determine the mucin phenotypes in 38 patients with differentiated adenocarcinomas (DACs), 9 with signet-ring cell carcinomas (SIGs), and 48 with other diffuse-type adenocarcinomas (non-SIGs) of AGA. The mucin phenotypes were classified into 4 types: gastric (G), gastrointestinal (GI), intestinal, and unclassified. RE...

  2. Synchronous advanced gastric adenocarcinoma and advanced esophageal squamous cell carcinoma

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    Fernando Augusto Mardiros Herbella

    2002-01-01

    Full Text Available CONTEXT: Synchronous associations of esophageal and gastric cancers are not a common finding, especially with differing histological types and both tumors in advanced forms. A case with such an association is presented, in which an unusual therapy was proposed: palliative gastrectomy and esophageal intubation. CASE REPORT: A 75-year-old white man was referred to our service complaining of malaise and weight loss for one year and dysphagia and vomiting for 2 months. The patient had sought out medical consultation as a result of the latter two complaints.

  3. Advanced Gastric Neuroendocrine Carcinoma with an Adenocarcinoma Component

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    Masashi Miguchi

    2012-01-01

    Full Text Available In the present study, we observed that the adenocarcinoma component in the mucosa was continuous with neuroendocrine carcinoma (NEC in the deeper layers; this suggests the normal course of NEC carcinogenesis at the histological level. A 72-year-old man was admitted to our hospital with a chief complaint of tarry stools. Endoscopic examination of the upper gastrointestinal tract revealed a 2-cm tumor, with a deep central depression, surrounded by a smooth elevated area, in the middle of the stomach body. A biopsy showed that the tumor was a moderately differentiated gastric adenocarcinoma. The patient underwent total gastrectomy and standard lymph node dissection. The resected tumor was a 3.5 × 2.5 cm type 2 lesion. It comprised two elements at the histological level: (i a moderately differentiated adenocarcinoma in the superficial portion of the mucous membrane layer, and (ii NEC-like cells with dark, round nuclei and scant cytoplasm, presenting a solid and trabecular pattern, in the submucosal and muscularis propria layers. Immunohistochemical findings showed that the NEC-like cells were diffusely positive for chromogranin A, synaptophysin, neural cell adhesion molecule, and neuron-specific enolase, but were negative for carcinoembryonic antigen. The Ki-67 labeling index was 95%. The final pathological diagnosis was gastric NEC with an adenocarcinoma component and a high cellular proliferative potential.

  4. Life expectancy with perioperative chemotherapy and chemoradiotherapy for locally advanced gastric adenocarcinoma

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    Sadighi S

    2008-12-01

    Full Text Available "nBackground: Although postoperative chemoradiotherapy should be considered for all patients at high risk for recurrence of adenocarcinoma of the stomach, curative surgery occurs in less than 50% of nonmetastatic gastric cancers. A regimen of docetaxel, cisplatin and infusional fluorouracil improves survival of patients with incurable locally-advanced gastric adenocarcinoma. So we assessed the perioperative regimen of docetaxel, cisplatin and infusions 5FU (TCF and postoperative chemoradiotherapy to improve outcomes in patients with potentially resectable gastric adenocarcinoma. "nMethods: Between March 2005 and March 2008, we 100 enrolled patients with stage II to IV (M0 adenocarcinoma of the stomach who had not been treated previously. Treatment consisted of three preoperative and one postoperative cycles of TCF followed by chemoradiotherapy. The primary end point was overall survival. The secondary end points were progression-free survival and toxicity of treatment. "nResults: A total of 100 patients participated, 83 of whom received neoadjuvant and 17 received adjuvant chemotherapy. Seventy-five patients underwent at least D0 gastrectomy. After chemotherapy, tumor stages were significantly lower than before beginning the protocol. Out of 100 patients, 44 had stage IV before chemotherapy versus 15 after the treatment. Three patients showed complete pathologic response. The median survival time was 25 months. "nConclusion: Docetaxel, cisplatin and 5FU combination chemotherapy is an active preoperative treatment in locally advanced gastric cancer. Perioperative chemoradio-therapy should be considered as an option to lengthen patient survival.

  5. Evaluation of two preoparative chemotherapy regimens for complete operability of advanced gastric adenocarcinoma: a clinical trial

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    S. Sedighi

    2006-08-01

    Full Text Available Background: This prospective phase III study was designed to compare the activity of two combinations chemotherapy drugs in advanced gastric adenocarcinoma Methods: In a double blinded clinical trial, From Jan. 2002 to Jan. 2005, ninety patients with advanced gastric adenocarcinoma were randomly assigned to 1 Cisplatin and continuous infusion of 5FU and Epirubicin (ECF, and 2 Cisplatin and continuous infusion of 5FU with Docetaxel (TCF. Reduction in tumor mass, overall survival (OS, time to progression (TTP, and safety were measured outcome. Results: About 90% of patients had stage III or IV disease and the most common sites of tumor spread were peritoneal surfaces, liver and Paraaortic lymph nodes in either group. The objective clinical response rate (more than 50% decreases in tumor mass was 38% and 43% in ECF and TCF group respectively. Global quality of life increased (p=0 002 and symptoms of pain and insomnia decreased after chemotherapy. Patients in TCF had more grade one or two skin reactions, neuropathy and diarrhea. Fourteen patients underwent surgery. Complete microscopic (R0 resection had done in two of ECF and six of TCF tumors (p=0.015. Two cases in TCF group showed complete pathologic response. Median TTP was nine months and 10 months in ECF and TCF group respectively. Median OS was 12 months in both groups. Conclusion: Although there wasn’t statistically significant difference regarded to clinical response or survival between two groups, TCF showed more complete pathologic response.

  6. Ifosfamide in advanced adenocarcinoma of the oesophagus or oesophageal-gastric junction area

    NARCIS (Netherlands)

    T.C. Kok (Tjebbe); A. van der Gaast (Ate); T.A.W. Splinter (Ted); H.W. Tilanus (Hugo)

    1991-01-01

    markdownabstractAbstract 25 previously untreated patients with inoperable or metastatic adenocarcinoma of the oesophagus or oesophageal-gastric junction area were treated with ifosfamide 6 g/m2 over 48 hours, combined with mesna 6 g/m2. 1 complete response and 1 partial response were seen among 23

  7. Gastric Adenocarcinoma Presenting with Gastric Outlet Obstruction in a Child

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    Abdulrahman Al-Hussaini

    2014-01-01

    Full Text Available Gastric carcinoma is extremely rare in children representing only 0.05% of all gastrointestinal malignancies. Here, we report the first pediatric case of gastric cancer presenting with gastric outlet obstruction. Upper endoscopy revealed a markedly thickened antral mucosa occluding the pylorus and a clean base ulcer 1.5 cm × 2 cm at the lesser curvature of the stomach. The narrowed antrum and pylorus underwent balloon dilation, and biopsy from the antrum showed evidence of Helicobacter pylori gastritis. The biopsy taken from the edge of the gastric ulcer demonstrated signet-ring-cell type infiltrate consistent with gastric adenocarcinoma. At laparotomy, there were metastases to the liver, head of pancreas, and mesenteric lymph nodes. Therefore, the gastric carcinoma was deemed unresectable. The patient died few months after initiation of chemotherapy due to advanced malignancy. In conclusion, this case report underscores the possibility of gastric adenocarcinoma occurring in children and presenting with gastric outlet obstruction.

  8. [Ocular metastasis heralding gastric adenocarcinoma].

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    Chekrine, T; Tawfiq, N; Bouchbika, Z; Benchakroun, N; Jouhadi, H; Sahraoui, S; Benider, A

    2010-10-01

    Ocular metastasis is a rare presenting feature of gastric adenocarcinoma. We report a 48-year-old woman who presented with a decrease in visual acuity of the right eye leading to the discovery of an ocular metastasis. Diagnostic work-up identified a gastric adenocarcinoma with pulmonary metastases. She received four cycles of chemotherapy combining epirubicin, cisplatin and fluorouracil. The patient died 6 months after the diagnosis of respiratory failure.

  9. Synchronous gastric adenocarcinoma and pancreatic ductal adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Mirko Muroni; Francesco D'Angelo; Massimo Pezzatini; Simone Sebastiani; Samantha Noto; Emanuela Pilozzi; Giovanni Ramacciato

    2010-01-01

    BACKGROUND: The association between gastric and pancreatic carcinoma is a relatively rare condition. In gastric carcinoma patients, the prevalence of second tumors varies 2.8% to 6.8% according to the reported statistics. Gastric cancer associated with pancreatic cancer is uncommon. METHODS: We report a case of a 73-year-old patient hospitalized for vomiting and weight loss. Esophagogastro-duodenoscopy demonstrated an ulcerative lesion of the gastric antrum. Computed tomography and magnetic resonance showed a gastric thickening in the antral and pyloric portion and a nodular mass (3×1.7 cm) in the uncinate portion of the pancreas. RESULTS: The patient underwent pancreaticoduoden-ectomy according to Whipple regional typeⅠFortner. Histological examination of the specimen demonstrated a moderately differentiated adenocarcinoma of the stomach and a poorly differentiated ductal adenocarcinoma of the pancreas. CONCLUSIONS: Long survival is rare in patients with associated gastric and pancreatic cancer. Surgical resection remains the only potentially curative treatment.

  10. Vesical metastasis of gastric adenocarcinoma

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    Alberto A. Antunes

    2004-10-01

    Full Text Available Metastatic vesical tumors are rare, and constitute approximately 1% of all neoplasias affecting this organ. The authors report the case of a 63-year old woman with vesical metastasis of gastric adenocarcinoma. Patient presented signs of cachexia and complained of left lumbar pain and dysuria unresponsive to antibiotic therapy for approximately 5 months. She reported a previous partial gastrectomy due to ulcerative undifferentiated gastric adenocarcinoma 1 year and 9 months before. Cystoscopy revealed an extensive vegetative lesion in bladder, occupying its entire mucosal surface. The biopsy revealed metastatic signet-ring cell adenocarcinoma.

  11. MYC and gastric adenocarcinoma carcinogenesis

    Institute of Scientific and Technical Information of China (English)

    Danielle Queiroz Calcagno; Mariana Ferreira Leal; Paulo Pimentel Assumpcao; Marilia de Arruda Cardoso Smith; Rommel Rodriguez Burbano

    2008-01-01

    MYC is an oncogene involved in cell cycle regulation, cell growth arrest, cell adhesion, metabolism, ribosome biogenesis, protein synthesis, and mitochondrial function. It has been described as a key element of several carcinogenesis processes in humans. Many studies have shown an association between MYC deregulation and gastric cancer. MYC deregulation is also seen in gastric preneoplastic lesions and thus it may have a role in early gastric carcinogenesis. Several studies have suggested that amplification is the main mechanism of MYC deregulation in gastric cancer. In the present review, we focus on the deregulation of the MYC oncogene in gastric adenocarcinoma carcinogenesis, including its association with Helicobacter pylori (H pylori) and clinical applications.

  12. A complete response to S-1 plus cis-diamminedichloroplatinum in advanced-stage esophageal and gastric adenocarcinoma: a case report

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    Matsuno Yoritaka

    2012-07-01

    Full Text Available Abstract Background Complete remission from advanced-stage synchronous double primary (SDP esophageal and gastric adenocarcinoma by chemotherapy alone is rare. We report a case of advanced-stage SDP esophageal and gastric adenocarcinoma in which a complete response to treatment was obtained with S-1 and cis-diamminedichloroplatinum (CDDP. Case presentation The patient was a 74-year-old man referred to our hospital complaining of dysphagia. Gastrointestinal endoscopy was performed and advanced-stage SDP esophageal and gastric adenocarcinoma diagnosed. Computed tomography revealed multiple regional lymph node metastases in the mediastinum. Neoadjuvant chemotherapy with S-1 and CDDP for advanced esophageal and gastric cancer was planned. An endoscopy following two courses of chemotherapy revealed that the esophageal cancer had been replaced with a normal mucosal lesion and the gastric tumor with a scar lesion; the results of biopsies of both were negative for cancer. Computed tomography revealed that the multiple lymph node metastases had disappeared. We diagnosed a complete response to S-1 and CDDP in advanced-stage SDP esophageal and gastric cancer. The patient is still alive with no signs of recurrence 22 months after the disappearance of the original tumor and metastatic lesions without surgical treatment. Conclusion These results suggest that complete remission from advanced-stage esophageal and gastric cancer can be obtained with chemotherapy with S-1 plus CDDP.

  13. An unusual presentation of tumor lysis syndrome in a patient with advanced gastric adenocarcinoma: case report and literature review.

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    Vodopivec, Danica Maria; Rubio, Jose Enrique; Fornoni, Alessia; Lenz, Oliver

    2012-01-01

    Tumor lysis syndrome (TLS) is characterized by hyperuricemia, hyperkalemia, hyperphosphatemia, and secondary hypocalcemia in patients with a malignancy. When these laboratory abnormalities develop rapidly, clinical complications such as cardiac arrhythmias, acute renal failure, seizures, or death may occur. TLS is caused by rapid release of intracellular contents by dying tumor cells, a condition that is expected to be common in hematologic malignancies. However, TLS rarely occurs with solid tumors, and here we present the second chemotherapy-induced TLS in a patient with advanced gastric adenocarcinoma to be reported in the literature. We also provide information regarding the total cases of TLS in solid tumors reported from 1977 to present day. Our methodology involved identifying key articles from existing reviews of the literature and then using search terms from these citations in MEDLINE to find additional publications. We relied on a literature review published in 2003 by Baeksgaard et al., where they gathered all total 45 cases reported from 1977 to 2003. Then, we looked for new reported cases from 2004 to present day. All reports (case reports, brief reports, letters to editor, correspondence, reviews, journals, and short communications) identified through these searches were reviewed and included.

  14. An Unusual Presentation of Tumor Lysis Syndrome in a Patient with Advanced Gastric Adenocarcinoma: Case Report and Literature Review

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    Danica Maria Vodopivec

    2012-01-01

    Full Text Available Tumor lysis syndrome (TLS is characterized by hyperuricemia, hyperkalemia, hyperphosphatemia, and secondary hypocalcemia in patients with a malignancy. When these laboratory abnormalities develop rapidly, clinical complications such as cardiac arrhythmias, acute renal failure, seizures, or death may occur. TLS is caused by rapid release of intracellular contents by dying tumor cells, a condition that is expected to be common in hematologic malignancies. However, TLS rarely occurs with solid tumors, and here we present the second chemotherapy-induced TLS in a patient with advanced gastric adenocarcinoma to be reported in the literature. We also provide information regarding the total cases of TLS in solid tumors reported from 1977 to present day. Our methodology involved identifying key articles from existing reviews of the literature and then using search terms from these citations in MEDLINE to find additional publications. We relied on a literature review published in 2003 by Baeksgaard et al., where they gathered all total 45 cases reported from 1977 to 2003. Then, we looked for new reported cases from 2004 to present day. All reports (case reports, brief reports, letters to editor, correspondence, reviews, journals, and short communications identified through these searches were reviewed and included.

  15. Mucin phenotype of gastric cancer and clinicopathology of gastric-type differentiated adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Tsutomu; Namikawa; Kazuhiro; Hanazaki

    2010-01-01

    Differentiated adenocarcinoma of the stomach is classified into gastric or intestinal phenotypes based on mucus expression. Recent advances in mucin histochemistry and immunohistochemistry have highlighted the importance of such a distinction, and it is important clinically to distinguish between gastricand intestinal-type differentiated adenocarcinoma. However, a clinical and pathological diagnosis of this type is often difficult in early gastric cancer because of histological similarities between a hyperp...

  16. S-1 plus cisplatin versus fluorouracil plus cisplatin in advanced gastric or gastro-esophageal junction adenocarcinoma patients: a pilot study.

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    Li, Yu Hong; Qiu, Miao Zhen; Xu, Jian Ming; Sun, Guo Ping; Lu, Hui Shan; Liu, Yun Peng; Zhong, Mei Zuo; Zhang, He Long; Yu, Shi Ying; Li, Wei; Hu, Xiao Hua; Wang, Jie Jun; Cheng, Ying; Zhou, Jun Tian; Guo, Zeng Qing; Guan, Zhon Gzhen; Xu, Rui Hua

    2015-10-27

    The safety and efficacy of S-1 plus cisplatin in Chinese advanced gastric cancer patients in first line setting is unknown. In this pilot study, patients with advanced gastric or gastro-esophageal junction adenocarcinoma were enrolled and randomly assigned in a 1:1 ratio to receive S-1 plus cisplatin (CS group) or 5-FU plus cisplatin (CF group). The primary endpoint was time to progression (TTP). Secondary end points included overall survival (OS) and safety. This study was registered on ClinicalTrials. Gov, number NCT01198392. A total of 236 patients were enrolled. Median TTP was 5.51 months in CS group compared with 4.62 months in CF group [hazard ratio (HR) 1.028, 95% confidential interval (CI) 0.758-1.394, p = 0.859]. Median OS was 10.00 months and 10.46 months in CS and CF groups (HR 1.046, 95%CI 0.709-1.543, p = 0.820), respectively. The most common adverse events in both groups were anemia, leukopenia, neutropenia, nausea, thrombocytopenia, vomiting, anorexia and diarrhea. We find that S-1 plus cisplatin is an effective and tolerable option for advanced gastric or gastro-esophageal junction adenocarcinoma patients in China.

  17. Clinicopathologial features of gastric hepatoid adenocarcinoma

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    Cheng-Yu Lin

    2015-02-01

    Full Text Available Background: Gastric hepatoid adenocarcinoma (GHA, a rare type of primary gastric cancer, is characterized by hepatocellular carcinoma-like histology. As details of this disease remain unknown, the aim of this study was to evaluate the clinicopathological features of GHA. Methods: From January 2001 to December 2010, 4563 patients were diagnosed with primary gastric cancer at Chang Gung Memorial Hospital, Linkou Medical Center. Ten (0.22% of these patients were diagnosed with GHA. The clinicopathological characteristics of these patients were collected retrospectively. Results: The median age at diagnosis was 65.5 years, and six patients (60% were male. Seven patients had lymph node metastasis and five had distant metastasis, with the liver as the most common site (four cases. Serum alpha-fetoprotein (AFP levels were elevated in seven of eight patients (median: 359.2 ng/ml; range: 4.3-6535.6 ng/ml. Endoscopically, six tumors were classified as Borrmann's type III cancer with the appearance of fungating mass lesion with a purple, berry-like surface. Of the five patients without distant metastasis, all received curative-intent surgery and four received adjuvant chemotherapy. Four patients with distant metastasis received either palliative operation or chemotherapy, and one patient received neither operation nor chemotherapy due to a poor performance status. The median survival time was 7.2 months (range: 0.7-131.8 months, and the 5-year survival rate was 20%. There was survival benefit in the chemotherapy groups. Conclusions: GHA is a rare subtype of gastric cancer which is prone to lymph node and liver metastasis. Most GHAs appear as Borrmann's type III fungating mass lesion with a purple, berry-like surface. Although the prognosis of advanced stage GHA is poor, chemotherapy might provide some benefit.

  18. HER2 testing in gastric and gastroesophageal adenocarcinomas.

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    Vakiani, Efsevia

    2015-05-01

    The human epidermal growth factor receptor 2 (HER2) is overexpressed in 10% to 35% of gastric and gastroesophageal junction (GEJ) adenocarcinomas. In 2010, the phase III Trastuzumab for Gastric Cancer (ToGA) trial showed that addition of the anti-HER2 monoclonal antibody trastuzumab to chemotherapy significantly improved survival of patients with advanced or metastatic tumors that were positive for HER2 overexpression. As a result, HER2 testing is now recommended for all patients with advanced or metastatic disease, although there is still some debate as to the optimal methods of assessment. HER2 expression in gastric and GEJ tumors shows several differences compared with breast tumors and, for this reason, the proposed criteria for scoring HER2 expression in biopsies and resections of gastric and GEJ carcinomas differ from those used in breast carcinomas. This review discusses what is currently known about the patterns of HER2 expression in gastric and GEJ adenocarcinomas, summarizes the findings of the ToGA trial and its clinical implications, and provides an overview of the recommended guidelines for the most accurate evaluation of HER2 status in gastric and GEJ cancer.

  19. Gastric adenocarcinoma inducing portal hypertension: A rare presentation

    Institute of Scientific and Technical Information of China (English)

    Pradipta Ghosh; Katsumi Miyai; Mario Chojkier

    2007-01-01

    Advanced gastric cancer usually presents with symptoms due to direct extension into adjacent viscera, distant metastases from lymphatic or hematogenic dissemination and peritoneal seeding. However, portal hypertension as a presentation of metastatic gastric cancer is rare and usually seen in association with other malignancies, e.g. hepatocellular and pancreatic carcinoma. We report a case of signet ring adenocarcinoma of the stomach that presented with esophageal and duodenal varices and bleeding due to portal hypertensive gastropathy. Pagetoid spread of cancer cells likely caused early metastasis and the unusual presentation. We also discussed the pathophysiology of development of portal hypertension in association with malignancies.

  20. Gastric neo-adenocarcinoma arising in a gastric tube after Ivor Lewis oesophagectomy for oesophageal adenocarcinoma.

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    Hanif, Faisal; Kerr, Joana; Going, James J; Fullarton, Grant

    2015-05-01

    A 69-year-old man, seven years post Ivor-Lewis oesophagectomy for oesophageal adenocarcinoma, was diagnosed to have a moderately differentiated 4 cm, malignant ulcer within the gastric tube remnant on an endoscopic biopsy. His original presentation was with a T1N0 oesophageal adenocarcinoma, histologically intestinal in type with inflammatory features. He presented with anaemia and melena due to a malignant ulcer in the mid body of his gastric tube on an endoscopy which was confirmed to be a gastric neo-adenocarcinoma on biopsy. He underwent right posterolateral thoracotomy and a wedge resection of the gastric tube including the tumour. Pathology confirmed a T3 N0 (0/7 lymph nodes) with clear margins moderately differentiated adenocarcinoma of intestinal phenotype with papillary features and was reported to be a histopathologically new tumour. Proposed surgical treatments in such patients are dependent on patient's fitness for major resection and may vary from Endoscopic Mucosal Resection to partial resection with preservation of right gastroepiploic vessels or total gastrectomy with intestinal interposition via a retromediastinal route. We suggest that regular endoscopic surveillance may be indicated in such post-oesophagectomy patients as the number of patients developing gastric tube cancers may increase with improve survival of those patients.

  1. Combination chemotherapy with paclitaxel, cisplatin and fluorouracil for patients with advanced and metastatic gastric or esophagogastric junction adenocarcinoma: a multicenter prospective study

    Institute of Scientific and Technical Information of China (English)

    Xiao-Dong Zhang; Cheng-Ye Guo; Lin Shen; Mao-Lin Jin; Yong-Qian Shu; Jun Liang; Feng-Chun Zhang; Xue-Zhen Ma; Jian-Jin Huang; Li Chen; Gen-Ming Shi; Wei-Guo Cao

    2012-01-01

    Objective:To evaluate the efficacy and toxicity of the combination regimen of paclitaxel,cisplatin and 5-FU (PCF) as first-line or second-line therapy in patients with advanced gastric and esophagogastric junction (EGJ) adenocarcinoma in China.Methods:The patients were treated with paclitaxel 150 mg/m2 on d1; fractionated cisplatin 15 mg/m2 and continuous infusion 5-FU 600 mg/(m2·d) intravenously on d1-d5 of a 21-d cycle until disease progression or unacceptable toxicities.Results:Seventy-five patients have been enrolled,among which,41 received PCF regimen as the first-line therapy (group A) and 34 received the regimen as the second-line therapy (group B) with the median age of 59 years old and Karnofsky performance status (KPS) score ≥80.Toxicities were analyzed in all 75 patients.Seventy-one patients were evaluable for efficacy.The median overall survival (mOS) was 12.0 months (95% CI:7.9-16.2 months) in group A and 7.3 months (95% CI:4.3-10.3 months) in group B,respectively.The median progression-free survival (mPFS) was 5.7 months (95% CI:4.1-7.2 months) and 5.0 months (95% CI:3.1-6.9 months),respectively.The response rate (CR+PR) was 40% (16/40; 95% CI:24.9-56.7%) in group A and 22.6% (7/31; 95% CI:9.6-41.1%) in group B.Major grade 3 or 4 adverse events include neutropenia (41.3%),febrile neutropenia (9.3%),nausea/anorexia (10.7%),and vomiting (5.3%).There was no treatment-related death.Conclusions:The combination chemotherapy with PCF is active and tolerable as first-line and second-line therapy in Chinese patients with advanced gastric and EGJ adenocarcinoma.The response and survival of PCF are same as those of DCF,but the tolerance is much better.

  2. Comprehensive molecular characterization of gastric adenocarcinoma

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    Bass, Adam J.; Thorsson, Vesteinn; Shmulevich, Ilya; Reynolds, Sheila M.; Miller, Michael; Bernard, Brady; Hinoue, Toshinori; Laird, Peter W.; Curtis, Christina; Shen, Hui; Weisenberger, Daniel J.; Schultz, Nikolaus; Shen, Ronglai; Weinhold, Nils; Kelsen, David P.; Bowlby, Reanne; Chu, Andy; Kasaian, Katayoon; Mungall, Andrew J.; Robertson, A. Gordon; Sipahimalani, Payal; Cherniack, Andrew; Getz, Gad; Liu, Yingchun; Noble, Michael S.; Pedamallu, Chandra; Sougnez, Carrie; Taylor-Weiner, Amaro; Akbani, Rehan; Lee, Ju-Seog; Liu, Wenbin; Mills, Gordon B.; Yang, Da; Zhang, Wei; Pantazi, Angeliki; Parfenov, Michael; Gulley, Margaret; Piazuelo, M. Blanca; Schneider, Barbara G.; Kim, Jihun; Boussioutas, Alex; Sheth, Margi; Demchok, John A.; Rabkin, Charles S.; Willis, Joseph E.; Ng, Sam; Garman, Katherine; Beer, David G.; Pennathur, Arjun; Raphael, Benjamin J.; Wu, Hsin-Ta; Odze, Robert; Kim, Hark K.; Bowen, Jay; Leraas, Kristen M.; Lichtenberg, Tara M.; Weaver, Stephanie; McLellan, Michael; Wiznerowicz, Maciej; Sakai, Ryo; Getz, Gad; Sougnez, Carrie; Lawrence, Michael S.; Cibulskis, Kristian; Lichtenstein, Lee; Fisher, Sheila; Gabriel, Stacey B.; Lander, Eric S.; Ding, Li; Niu, Beifang; Ally, Adrian; Balasundaram, Miruna; Birol, Inanc; Bowlby, Reanne; Brooks, Denise; Butterfield, Yaron S. N.; Carlsen, Rebecca; Chu, Andy; Chu, Justin; Chuah, Eric; Chun, Hye-Jung E.; Clarke, Amanda; Dhalla, Noreen; Guin, Ranabir; Holt, Robert A.; Jones, Steven J.M.; Kasaian, Katayoon; Lee, Darlene; Li, Haiyan A.; Lim, Emilia; Ma, Yussanne; Marra, Marco A.; Mayo, Michael; Moore, Richard A.; Mungall, Andrew J.; Mungall, Karen L.; Nip, Ka Ming; Robertson, A. Gordon; Schein, Jacqueline E.; Sipahimalani, Payal; Tam, Angela; Thiessen, Nina; Beroukhim, Rameen; Carter, Scott L.; Cherniack, Andrew D.; Cho, Juok; Cibulskis, Kristian; DiCara, Daniel; Frazer, Scott; Fisher, Sheila; Gabriel, Stacey B.; Gehlenborg, Nils; Heiman, David I.; Jung, Joonil; Kim, Jaegil; Lander, Eric S.; Lawrence, Michael S.; Lichtenstein, Lee; Lin, Pei; Meyerson, Matthew; Ojesina, Akinyemi I.; Pedamallu, Chandra Sekhar; Saksena, Gordon; Schumacher, Steven E.; Sougnez, Carrie; Stojanov, Petar; Tabak, Barbara; Taylor-Weiner, Amaro; Voet, Doug; Rosenberg, Mara; Zack, Travis I.; Zhang, Hailei; Zou, Lihua; Protopopov, Alexei; Santoso, Netty; Parfenov, Michael; Lee, Semin; Zhang, Jianhua; Mahadeshwar, Harshad S.; Tang, Jiabin; Ren, Xiaojia; Seth, Sahil; Yang, Lixing; Xu, Andrew W.; Song, Xingzhi; Pantazi, Angeliki; Xi, Ruibin; Bristow, Christopher A.; Hadjipanayis, Angela; Seidman, Jonathan; Chin, Lynda; Park, Peter J.; Kucherlapati, Raju; Akbani, Rehan; Ling, Shiyun; Liu, Wenbin; Rao, Arvind; Weinstein, John N.; Kim, Sang-Bae; Lee, Ju-Seog; Lu, Yiling; Mills, Gordon; Laird, Peter W.; Hinoue, Toshinori; Weisenberger, Daniel J.; Bootwalla, Moiz S.; Lai, Phillip H.; Shen, Hui; Triche, Timothy; Van Den Berg, David J.; Baylin, Stephen B.; Herman, James G.; Getz, Gad; Chin, Lynda; Liu, Yingchun; Murray, Bradley A.; Noble, Michael S.; Askoy, B. Arman; Ciriello, Giovanni; Dresdner, Gideon; Gao, Jianjiong; Gross, Benjamin; Jacobsen, Anders; Lee, William; Ramirez, Ricardo; Sander, Chris; Schultz, Nikolaus; Senbabaoglu, Yasin; Sinha, Rileen; Sumer, S. Onur; Sun, Yichao; Weinhold, Nils; Thorsson, Vésteinn; Bernard, Brady; Iype, Lisa; Kramer, Roger W.; Kreisberg, Richard; Miller, Michael; Reynolds, Sheila M.; Rovira, Hector; Tasman, Natalie; Shmulevich, Ilya; Ng, Santa Cruz Sam; Haussler, David; Stuart, Josh M.; Akbani, Rehan; Ling, Shiyun; Liu, Wenbin; Rao, Arvind; Weinstein, John N.; Verhaak, Roeland G.W.; Mills, Gordon B.; Leiserson, Mark D. M.; Raphael, Benjamin J.; Wu, Hsin-Ta; Taylor, Barry S.; Black, Aaron D.; Bowen, Jay; Carney, Julie Ann; Gastier-Foster, Julie M.; Helsel, Carmen; Leraas, Kristen M.; Lichtenberg, Tara M.; McAllister, Cynthia; Ramirez, Nilsa C.; Tabler, Teresa R.; Wise, Lisa; Zmuda, Erik; Penny, Robert; Crain, Daniel; Gardner, Johanna; Lau, Kevin; Curely, Erin; Mallery, David; Morris, Scott; Paulauskis, Joseph; Shelton, Troy; Shelton, Candace; Sherman, Mark; Benz, Christopher; Lee, Jae-Hyuk; Fedosenko, Konstantin; Manikhas, Georgy; Potapova, Olga; Voronina, Olga; Belyaev, Smitry; Dolzhansky, Oleg; Rathmell, W. Kimryn; Brzezinski, Jakub; Ibbs, Matthew; Korski, Konstanty; Kycler, Witold; ŁaŸniak, Radoslaw; Leporowska, Ewa; Mackiewicz, Andrzej; Murawa, Dawid; Murawa, Pawel; Spychała, Arkadiusz; Suchorska, Wiktoria M.; Tatka, Honorata; Teresiak, Marek; Wiznerowicz, Maciej; Abdel-Misih, Raafat; Bennett, Joseph; Brown, Jennifer; Iacocca, Mary; Rabeno, Brenda; Kwon, Sun-Young; Penny, Robert; Gardner, Johanna; Kemkes, Ariane; Mallery, David; Morris, Scott; Shelton, Troy; Shelton, Candace; Curley, Erin; Alexopoulou, Iakovina; Engel, Jay; Bartlett, John; Albert, Monique; Park, Do-Youn; Dhir, Rajiv; Luketich, James; Landreneau, Rodney; Janjigian, Yelena Y.; Kelsen, David P.; Cho, Eunjung; Ladanyi, Marc; Tang, Laura; McCall, Shannon J.; Park, Young S.; Cheong, Jae-Ho; Ajani, Jaffer; Camargo, M. Constanza; Alonso, Shelley; Ayala, Brenda; Jensen, Mark A.; Pihl, Todd; Raman, Rohini; Walton, Jessica; Wan, Yunhu; Demchok, John A.; Eley, Greg; Mills Shaw, Kenna R.; Sheth, Margi; Tarnuzzer, Roy; Wang, Zhining; Yang, Liming; Zenklusen, Jean Claude; Davidsen, Tanja; Hutter, Carolyn M.; Sofia, Heidi J.; Burton, Robert; Chudamani, Sudha; Liu, Jia

    2014-01-01

    Gastric cancer is a leading cause of cancer deaths, but analysis of its molecular and clinical characteristics has been complicated by histological and aetiological heterogeneity. Here we describe a comprehensive molecular evaluation of 295 primary gastric adenocarcinomas as part of The Cancer Genome Atlas (TCGA) project. We propose a molecular classification dividing gastric cancer into four subtypes: tumours positive for Epstein–Barr virus, which display recurrent PIK3CA mutations, extreme DNA hypermethylation, and amplification of JAK2, CD274 (also known as PD-L1) and PDCD1LG2 (also knownasPD-L2); microsatellite unstable tumours, which show elevated mutation rates, including mutations of genes encoding targetable oncogenic signalling proteins; genomically stable tumours, which are enriched for the diffuse histological variant and mutations of RHOA or fusions involving RHO-family GTPase-activating proteins; and tumours with chromosomal instability, which show marked aneuploidy and focal amplification of receptor tyrosine kinases. Identification of these subtypes provides a roadmap for patient stratification and trials of targeted therapies. PMID:25079317

  3. Expression profiling of CEACAM6 associated with the tumorigenesis and progression in gastric adenocarcinoma.

    Science.gov (United States)

    Deng, X; Liu, P; Zhao, Y; Wang, Q

    2014-09-26

    Carcinoembryonic antigen-related cellular adhesion molecule 6 (CEACAM6) is a member of the immunoglobulin superfamily and has been recently reported to affect the neoplastic, metastatic, and invasive ability of malignant cells by regulating intracellular signaling pathways during tumorigenesis and progression. We investigated the expression and amplification of CEACAM6 in relation to the clinicopathological and biological significance of gastric adenocarcinoma. Expression of CEACAM6 mRNA in 75 primary gastric adenocarcinom and 20 adjacent tissues compared to normal gastric mucosas were explored using real-time quantitative-polymerase chain reaction. Immunohistochemical assays were conducted to evaluate the expression and tissue distribution of CEACAM6 protein. Overexpression of CEACAM6 mRNA in both gastric adenocarcinoma (2.513 ± 0.869) and adjacent tissues (1.171 ± 0.428) was significantly higher than the relative expressions in non-neoplastic specimens (0.594 ± 0.513) (P < 0.01). CEACAM6 protein was present in 52 (69.33%) gastric adenocarcinomas, but not in normal gastric tissues. Adenocarcinomas with elevated CEACAM6 expression were significantly associated with lymph node metastases and advanced stages. There were no relationships between CEACAM6 expression and tumor size, histological differentiation, or different subtypes, respectively. Moreover, higher expression of CEACAM6 was found to be correlated with short postoperative survival time of patients with gastric cancer. Amplification and upregulation of CEACAM6 expression was observed in human gastric adenocarcinomas, which may be correlated with the generation or transformation of malignant cells, tumor aggressive progression, and clinical outcome. CEACAM6 may be a valuable biomarker screening for gastric tumor and novel predictor for patients in advanced stages of gastric cancer.

  4. [Gastric signet ring cell adenocarcinoma: A distinct entity].

    Science.gov (United States)

    Tabouret, Tessa; Dhooge, Marion; Rouquette, Alexandre; Brezault, Catherine; Beuvon, Frédéric; Chaussade, Stanislas; Coriat, Romain

    2014-04-01

    Gastric signet ring cell carcinoma (GSRC) is a distinct entity. Their incidence is increasing. The pathologist plays a central role in the identification of this entity. Diagnosis is based on an adenocarcinoma containing a majority of signet ring cells (above 50 %). The prognosis of GSRC is the same as gastric adenocarcinoma while GSRC appeared more aggressive. Signet ring cells present a low sensitivity to chemotherapy. This review aimed to discuss the histological, the prognostic and the therapeutic aspect of this entity.

  5. Tratamento paliativo do adenocarcinoma gástrico Palliative treatment of gastric adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Fernando de Oliveira Souza

    2011-03-01

    Full Text Available INTRODUÇÃO: Embora decrescendo nos países do chamado primeiro mundo, o adenocarcinoma gástrico mantém-se como terceiro tumor mais frequente no sexo masculino mundialmente. Sua mortalidade é muito elevada, fruto do diagnóstico tardio em lesões muito avançadas, o que frequentemente torna paliativo seu tratamento, motivos pelos quais se justificam estudos no sentido de melhorar estes resultados. MÉTODO: Revisão da literatura através do portal de periódicos da CAPES indicados por busca no sites da Bireme e PubMed. Além disso, foram consultados os sumários do 8º Congresso Internacional de Câncer Gástrico em 2009. Foi apresentada uma sugestão de algoritmo de atendimento destes pacientes. CONCLUSÕES: O surgimento de novas drogas anticancer, mais efetivas, está propiciando novas alternativas para a ressecção gástrica como tratamento paliativo. Novos protocolos estão surgindo mostrando boas perspectivas para melhorar os resultados desta doença.INTRODUCTION: Although decreasing in the well developed countries, gastric adenocarcinoma still represents the third most common cancer in males worldwide. Its mortality is very high because of the lateness of its diagnosis over advanced lesions, which turns palliative its treatment in the majority of the cases. METHOD: Literature review using CAPES, PubMed and Bireme sites as well as the abstracts of the 8 º International Gastric Cancer Congress which was held in Krakow in 2009. CONCLUSIONS: The release of new anticancer drugs against gastric cancer is providing a revival of gastrectomy as an effective palliative treatment of advanced gastric cancer. New protocols are being published, showing better results in the treatment of this disease.

  6. Positive nuclear expression of KLF8 might be correlated with shorter survival in gastric adenocarcinoma.

    Science.gov (United States)

    Hsu, Li-Sung; Wu, Pei-Ru; Yeh, Ken-Tu; Yeh, Chung-Min; Shen, Ko-Hung; Chen, Chih-Jun; Soon, Maw-Soan

    2014-04-01

    Krűppel-like factor 8 (KLF8) is important in cell proliferation, epithelial-to-mesenchymal transition, cell migration, and invasion. Gastric adenocarcinoma is among the leading causes of cancer-related death in the world. In this study, the clinicopathologic correlation of KLF8 expression with gastric adenocarcinoma in Taiwan was investigated. The nuclear localization of KLF8 was correlated with advanced stage (P = .008) and 3-year survival rate (P = .043). The nuclear expression of KLF8 was significantly higher in the diffused type of gastric adenocarcinoma compared with the intestinal type (P = .036). Kaplan-Meier analysis results showed that patients with positive nuclear KLF8 had significantly lower overall survival rate compared with those with negative nuclear KLF8 (P = .011). Univariate analysis results indicated that positive nuclear KLF8 expression, advanced stage, and lymph node metastasis are correlated with lower overall survival. Positive nuclear KLF8 might be correlated with lower survival in gastric adenocarcinoma patients and might be an oncogene property in gastric adenocarcinoma carcinogenesis.

  7. PIVKA-II-producing advanced gastric cancer.

    Science.gov (United States)

    Takano, Shigetsugu; Honda, Ichiro; Watanabe, Satoshi; Soda, Hiroaki; Nagata, Matsuo; Hoshino, Isamu; Takenouchi, Toshinao; Miyazaki, Masaru

    2004-08-01

    We describe the case of a 68-year-old man with primary advanced adenocarcinoma of the stomach, who displayed extremely high plasma levels of protein induced by vitamin K antagonist (PIVKA)-II (15 600 mAU/ml) and normal levels of alphafetoprotein (AFP) (4 ng/ml). Ultrasonography and dynamic computed tomography ruled out hepatocellular carcinoma (HCC) or liver metastasis. After preoperative chemotherapy, pancreatico-spleno total gastrectomy with D2 lymphadenectomy was performed. Postoperatively, plasma levels of PIVKA-II returned to within the normal range (29 mAU/ml). Microscopic examination revealed stomach adenocarcinoma showing various histological types, such as moderately to poorly differentiated mucinous adenocarcinoma, but hepatoid differentiation of gastric adenocarcinoma was not detected. Localization of PIVKA-II and AFP within tumor cells was demonstrated by immunohistochemical staining using monoclonal antibodies. These results indicate that tumor cells from gastric cancer may produce PIVKA-II. Some cases of PIVKA-II- and AFP-producing advanced gastric cancer with liver metastasis have been reported, but this is the first report of gastric cancer without liver metastasis producing PIVKA-II alone.

  8. Direct Liver Invasion from a Gastric Adenocarcinoma as an Initial Presentation of Extranodal Tumor Spread

    Directory of Open Access Journals (Sweden)

    Mitanshu Shah

    2012-01-01

    Full Text Available Gastric cancer often carries a poor prognosis, with an estimated 740,000 deaths from the malignancy occurring yearly worldwide (Dicken et al., 2005. The mortality of disease is largely dependent on the extent of tumor spread, as gastric cancer has a predilection to metastasize to other visceral secondaries via hematogenous and lymphatic dissemination. Direct invasion of a gastric adenocarcinoma to adjacent organs secondary to gastric wall perforation does occur; however, it is often present in the setting of advanced disease. Rarely does direct tumor invasion to adjacent organs from a gastric adenocarcinoma present as the initial manifestation of extranodal tumor spread. We present a case of a 40-year-old male with direct tumor extension to the liver as an initial presentation of extranodal tumor spread from a gastric adenocarcinoma. Clinicians should be aware of such an occurrence, as treatment modalities in direct liver extension from a gastric adenocarcinoma vary and may be directed towards palliation rather than curative intent.

  9. Primary Adenocarcinoma in an Oesophageal Gastric Graft – Case Report

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    Dranka-Bojarowska Daria

    2015-02-01

    Full Text Available Primary adenocarcinoma in the esophageal gastric graft is a rare complication diagnosed in patients with long-term survival. Most data concerning the diagnosis and treatment of patients with metachronic cancer in esophageal grafts is derived from Japan and South Korea. The diagnosis of cancer in esophageal gastric grafts in the European countries is rare.

  10. Gastric choriocarcinoma admixed with an α-fetoprotein-producing adenocarcinoma and separated adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Bang Wool Eom; So-Youn Jung; Hongman Yoon; Myeong-Cherl Kook; Keun Won Ryu; Jun Ho Lee; Young-Woo Kim

    2009-01-01

    We report a case of gastric choriocarcinoma admixed with an α-fetoprotein (AFP)-producing adenocarcinoma .A 70-year-old man was hospitalized for gastric cancer that was detected during screening by esophagogastroduodenoscopy (EGD). Initial laboratory data showed the increased serum level of AFP and EGD revealed a 5-cm ulcerofungating mass in the greater curvature of the gastric antrum.The patient underwent radical subtotal gastrectomy with D2 lymph node dissection and Billroth Ⅱ gastrojejunostomy. Histopathological evaluation confirmed double primary gastric cancer: gastric choriocarcinoma admixed with an AFP-producing adenocarcinoma and separated adenocarcinoma. At 2 wk postoperatively, his human chorionic gonadotropin and AFP levels had reduced and six cycles of adjuvant chemotherapy were initiated. No recurrence or distant metastasis was observed at 4 years postoperatively.

  11. Gastric Adenocarcinoma after Gastric Bypass for Morbid Obesity: A Case Report and Review of the Literature

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    Maxwel Capsy Boga Ribeiro

    2013-01-01

    Full Text Available Gastric adenocarcinoma after gastric bypass for morbid obesity is rare but has been described. The diet restriction, weight loss, and difficult assessment of the bypassed stomach, after this procedure, hinder and delay its diagnosis. We present a 52-year-old man who underwent Roux-en-Y gastric bypass 2 years ago and whose previous upper digestive endoscopy was considered normal. He presented with weight loss, attributed to the procedure, and progressive dysphagia. Upper digestive endoscopy revealed stenosing tumor in gastric pouch whose biopsy showed diffuse-type gastric adenocarcinoma. He underwent total gastrectomy, left lobectomy, distal pancreatectomy and splenectomy, segmental colectomy, and bowel resection with esophagojejunal anastomosis. The histopathological analysis confirmed the presence of gastric cancer. The pathogenesis of gastric pouch adenocarcinoma is discussed with a literature review.

  12. Genetic mutation analysis of human gastric adenocarcinomas using ion torrent sequencing platform.

    Directory of Open Access Journals (Sweden)

    Zhi Xu

    Full Text Available Gastric cancer is the one of the major causes of cancer-related death, especially in Asia. Gastric adenocarcinoma, the most common type of gastric cancer, is heterogeneous and its incidence and cause varies widely with geographical regions, gender, ethnicity, and diet. Since unique mutations have been observed in individual human cancer samples, identification and characterization of the molecular alterations underlying individual gastric adenocarcinomas is a critical step for developing more effective, personalized therapies. Until recently, identifying genetic mutations on an individual basis by DNA sequencing remained a daunting task. Recent advances in new next-generation DNA sequencing technologies, such as the semiconductor-based Ion Torrent sequencing platform, makes DNA sequencing cheaper, faster, and more reliable. In this study, we aim to identify genetic mutations in the genes which are targeted by drugs in clinical use or are under development in individual human gastric adenocarcinoma samples using Ion Torrent sequencing. We sequenced 737 loci from 45 cancer-related genes in 238 human gastric adenocarcinoma samples using the Ion Torrent Ampliseq Cancer Panel. The sequencing analysis revealed a high occurrence of mutations along the TP53 locus (9.7% in our sample set. Thus, this study indicates the utility of a cost and time efficient tool such as Ion Torrent sequencing to screen cancer mutations for the development of personalized cancer therapy.

  13. Expression of p53 protein in Barrett’s adenocarcinoma and adenocarcinoma of the gastric cardia and antrum

    Directory of Open Access Journals (Sweden)

    Jovanović Ivan

    2005-01-01

    Full Text Available Background/Aim. Most studies of esophageal and gastric adenocarcinomas have shown a very high rate of p53 gene mutation and/or protein overexpression, but the influence of the tumor site upon the frequency of p53 protein expression has not been evaluated (gastroesophageal junction, Barret's esophagus, and antrum. The aim of our study was to analyze the correlation between the selected clinico-pthological parameters, and p53 protein overexpression in regards to the particular tumor location. Methods. The material comprised 66 surgical specimens; 10 were Barrett’s carcinomas, 25 adenocarcinomas of the gastric cardia (type II adenocarcinoma of the esophagogastric junction - EGJ, and 31 adenocarcinomas of the antrum. Immunostaining for p53 protein was performed on formalin-fixed, paraffin-embedded tissue sections, using the alkaline phosphatase - antialkaline phosphatase (APAAP method. The cases were considered positive for p53 if at least 5% of the tumor cells expressed this protein by immunostaining. Results. There was no significant difference observed between the studied groups in regards to age, sex, Lauren’s classification and tumor differentiation. There was, however, a significant difference observed in the depth of tumor invasion between Barrrett’s adenocarcinoma and adenocarcinoma of the cardia compared with the adenocarcinoma of the antrum. Namely, at the time of surgery, both Barrett’s adenocarcinomas and adenocarcinomas of the cardia, were significantly more advanced comparing with the adenocarcinomas of the antrum. Overexpression of p53 was found in 40% (4/10 of Barrett’s adenocarcinomas, 72% (18/25 of adenocarcinoma of the cardia and 65% (20/31 of adenocarcinoma of the antrum. No significant differences in p53 expression in relation to sex, type (Lauren of tumor, depth of invasion, lymph node involvement, or tumor differentiation were observed in any of the analyzed groups of tumors. Patients with more advanced Barrett

  14. Phenotypic Classification of Well-Differentiated Gastric Adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Ying Wu; Zhong-wu Li; Ji-you Li

    2009-01-01

    Objective: To investigate the genotypes of well-differentiated non-cardiac gastric adenocarcinoma and their clinicopathological significance.Methods: Sixty-four cases of well-differentiated non-cardiac gastric adenocarcinoma were included in this study. The expressions of intestinal phenotypic markers including CDX2, MUC2, Li-cadherin, CD10, Hepatocyte(Hep) and Villin, and gastric phenotypic markers including MUC5AC and pS2 were detected immunohistochemically. Based on the expressions of phenotypic markers, 64 cases can be divided into four phenotypes. Cases only expressing intestinal phenotypic markers were classified as intestinal phenotype; cases only expressing gastric phenotypic markers as gastric phenotype; cases expressing both intestinal and gastric phenotypic markers as gastrointestinal phenotype; and cases expressing neither intestinal nor gastric phenotypic marker as null phenotype. The association of phenotype and clinic-pathological parameters was analyzed. We also detected the expressions of markers related to the development and progression of cancer, including Rb, P53, c-Met, MIF, TGF-β-RII, β-catenin, CD44v6 and E-cadherin.Results: Of 64 cases, 33(51.6%) were intestinal type, 3(4.7%) were gastric type, 25(39.1%) were gastrointestinal type and 3(4.7%) were null type. Fifty-eight cases were either intestinal or gastrointestinal type, which accounted for 90.6% of all the cases. In addition, there was an association between phenotype and biological behaviors (invasion or metastasis). The biological behaviors of intestinal and gastrointestinal type were better than gastric type. Compared with intestinal, gastric and gastrointestinal types, the biological behaviors of null type were the most aggressive. The biological behaviors of gastric carcinoma tended to be better as the number of expression of intestinal markers increased. Expression of markers related to the development and progression of cancer was not significantly correlated with phenotypes

  15. Advanced gastric adenocarcinoma. Influence of preoperative radiation therapy on toxicity and long-term survival rates; Adenocarcinoma gastrico avancado. Analise da toxicidade e da influencia da radioterapia pre-operatoria nos indices de sobrevivencia a longo prazo

    Energy Technology Data Exchange (ETDEWEB)

    Malzoni, Carlos Eduardo

    1996-12-31

    The surgical treatment of gastric cancer has better long-term survival rates when performed in patients with early gastric cancer. Worse results are obtained in treatment of advanced gastric cancer. Most patients in west centers are treated in advanced stages. A great number of them go through a surgical treatment unable by itself to cure them. the frequent local recurrence caused by failure of the surgical treatment has been keeping poor survival rates in patients with advanced gastric cancer for decades. The desire of improving survival is the reason of the use of adjuvant therapies. This paper achieved the retrospective study of the influence of preoperative radiation therapy (2000 cGy) in long-term survival rates (120 months) of patients with advanced gastric cancer on stages IIIa, IIIb and IV. The possible injuries caused in the liver and kidney were observed also as well as first group was treated by surgical and radiation therapies and the second received surgical treatment only. There was no statistical difference between the two groups when sex, age, race, occurrence of other diseases, nutritional assessment, TNM stage, occurrence of obstruction or bleeding caused by tumor, surgical procedure and hepatic and renal function were considered. Survival rates and changes on hepatic and renal function were statistically compared. The results showed a statistic improvement on the long-term survival rates of stage IIIa patients treated by preoperative radiation therapy. No statistic difference was observed on hepatic or renal function between the groups. No adverse influence of radiation therapy method was detected by the used parameters. There was no statistical difference between the two groups when immediate surgical complications were considered. (author) 112 refs., 34 tabs.

  16. Synchronous and metachronous occurrence of gastric adenocarcinoma and gastric lymphoma: A review of the literature

    Institute of Scientific and Technical Information of China (English)

    Erhan Hamaloglu; Serdar Topaloglu; Arif Ozdemir; Ahmet Ozenc

    2006-01-01

    The occurrence of both primary gastric lymphoma and gastric adenocarcinoma in the same patient is a rare entity. The possible causative factors of synchronous or metachronous occurrence of both malignancies and varieties in the treatment modalities are reviewed according to published cases in English language medical literature.

  17. Gastric adenocarcinoma of fundic gland type: Endoscopicand clinicopathological features

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Gastric adenocarcinoma of fundic gland type (GA-FG)with chief cell differentiation was recently proposed asan extremely rare type of gastric adenocarcinoma. Here,we report 4 cases of GA-FG with chief cell differentiation.Endoscopic features included a submucosal tumor shapeor a flat shape, whitish discolorationand dilated vesselson the surface. The tumors were located in the upper ormiddle third of the stomach. All cases were preoperativelydiagnosed as GA-FG by biopsy, and endoscopic submucosaldissection was performed. Resected specimensrevealed well-differentiated adenocarcinomas resemblingchief cells. Tumor cells were diffusely positive for pepsinogen-Ⅰ,but partially positive for H+/K+-ATPase inscattered locations around the tumor margin. Despitethe presence of minimal invasion of the carcinoma intothe submucosal layer, which was observed in two cases,neither lymphatic nor venous invasion was detected inany of the cases. Finally, all cases showed less aggressiveclinical behavior with low grade malignancy.

  18. Activating GNAS and KRAS mutations in gastric foveolar metaplasia, gastric heterotopia, and adenocarcinoma of the duodenum

    OpenAIRE

    Matsubara, A.; Ogawa, R; Suzuki, H; Oda, I.; Taniguchi, H; Kanai, Y.; Kushima, R; Sekine, S

    2015-01-01

    Background: Heterotopic gastric-type epithelium, including gastric foveolar metaplasia (GFM) and gastric heterotopia (GH), is a common finding in duodenal biopsy specimens; however, there is still controversy regarding their histogenetic backgrounds. Methods: We analysed a total of 177 duodenal lesions, including 66 GFM lesions, 81 GH lesions, and 30 adenocarcinomas, for the presence of GNAS, KRAS, and BRAF mutations. Results: Activating GNAS mutations were identified in 27 GFM lesions (41%) ...

  19. Chylothorax in gastric adenocarcinoma: A case report and systematic review of the English literature

    OpenAIRE

    2014-01-01

    Background: Chylothorax is a rare complication of gastric adenocarcinoma and data on its identification, prevalence and outcomes are scant. Objectives: To enable identification of gastric carcinoma as a cause of chylothorax. Methods: A case report and a systematic review were conducted of all reported cases of gastric adenocarcinoma with chylothorax as the presenting complaint in the English literature. Results: Chylothorax is a rare presenting complaint of gastric adenocarcinoma. There are o...

  20. Widespread hematogenous metastases and Trousseau's syndrome in gastric adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Santos Vitorino Modesto dos

    2001-01-01

    Full Text Available A case of widespread hematogenous metastases and Trousseau's syndrome is reported in a 40 year-old white housewife with gastric cancer, presenting subdural hematoma, ecchymoses, epistaxis, stomach and uterine bleeding. After undergoing hematoma drainage, she was unsuccessfully treated with platelets, red blood cells, plasma cryoprecipitate transfusions, and antibiotics. Necropsy disclosed gastric ring-signet adenocarcinoma invading the serous layer, with massive disseminated intravascular coagulation and systemic neoplastic embolism. Multiple old and recent hyaline (rich in fibrin and platelets microthrombi, and tumor emboli were observed in the bone marrow, meninges, liver, lungs, kidneys, lymph nodes, adrenals, thyroid, heart, pancreas, and ovaries (Krukenberg tumor.

  1. Gastric signet-ring adenocarcinoma presenting with breast metastasis

    Institute of Scientific and Technical Information of China (English)

    Anastasios L Boutis; Charalambos Andreadis; Frideriki Patakiouta; Despina Mouratidou

    2006-01-01

    Breast metastases from gastric cancer are extremely rare. A case report of a 37-year-old female with breast inflammatory invasion and ascites is described. Breast biopsy revealed carcinomatous invasion of the lymphatics from adenocarcinoma cells with signet-ring features.Estrogen (ER) and progesterone receptors (PR) and c-erb-B2 were negative. Upper gastrointestinal endoscopy revealed a prepyloric ulcerative mass. Histopathologic examination of the lesion showed infiltration from a highgrade adenocarcinoma, identical with that of the breast.Immunostaining was positive for cytokeratins CK-7 and CK-20 and CEA and negative for ER and PR. Ascitic fluid cytology was positive for adenocarcinoma cells. Mammography was not diagnostic. Abdominal CT scanning revealed large ovarian masses suggestive of metastases (Krukenberg's tumor). A cisplatin-based regimen was given but no objective response was observed. The patient died six months after initial diagnosis. A review of the literature is performed.

  2. Prognostic significance of erythropoietin and erythropoietin receptor in gastric adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Lin Wang; Hai-Gang Li; Zhong-Sheng Xia; Jian-Ming Wen; Jun Lv

    2011-01-01

    AIM: To investigate the expression of Erythropoietin (Epo) and its receptor (EpoR) in gastric adenocarcinoma (GAC) and the correlation with angiogenesis and clinicopathological features. METHODS: The expressions of Epo, EpoR and vascular endothelial growth factor (VEGF), as well as microvessel density were evaluated in 172 GAC biopsies by immunohistochemical staining. The correlations between these parameters and patient's clinicopathological features were analyzed statistically. RESULTS: The proportion of Epo and EpoR alterations in GAC was higher than that in adjacent normal mucosa (P = 0.035 and 0.030). Epo high-expression was associated with EpoR high-expression, Lauren type, extensive lymph node metastasis and advanced stage of GAC (P = 0.018, 0.018, 0.004 and 0), while EpoR expression was linked with older age, World Health Organization type, extensive lymph node metastasis and advanced stage (P = 0.001, 0.013, 0.008 and 0.001). VEGF high expression was significantly correlated with EpoR low-expression, Lauren type, extensive lymph node metastasis and advanced stage (P = 0.001, 0.001, 0.001 and 0.007). The expression of Epo or EpoR was associated with microvessel density (P = 0.004 and 0.046). On multivariate analysis, only lymph node metastasis, abnormal Epo expression and tumor nodes metastases stage were independently associated with survival. In addition, a strong association with the immunohistochemical expression of EpoR and the angiogenic protein, VEGF, was noted. CONCLUSION: Increased expression of Epo and EpoR may play a significant role in the carcinogenesis, angiogenesis and progression of GAC. Epo may be an independent prognostic factor.

  3. Possible involvement of leptin and leptin receptor in developing gastric adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Liang Zhao; Zhi-Xiang Shen; He-Sheng Luo; Lei Shen

    2005-01-01

    AIM: To investigate the expression of leptin and leptin receptor (ob-R) in intestinal-type gastric cancer and precancerous lesions, and to explore the possible mechanism and role of the leptin system in developing intestinal-type gastric adenocarcinoma.METHODS: Immunohistochemistry was performed to examine the expression of leptin and leptin receptor in archival samples of gastric adenocarcinoma and preneoplastic lesions, including intestinal metaplasia and mild to severe gastric epithelial dysplasia. Positive staining was identified and percentage of positive staining was graded.RESULTS: Dual expression of leptin and leptin receptor were detected in 80% (16/20) intestinal metaplasia,86.3% (25/30) mild gastric epithelial dysplasia, 86.7%(26/30) moderate gastric epithelial dysplasia, 93.3%(28/30) severe gastric epithelial dysplasia, 91.3% (55/60)intestinal-type gastric adenocarcinoma and 30.0% (9/30)difffuse-type gastric carcinoma. The percentage of dual expression of leptin and leptin receptor in intestinal-type gastric adenocarcinoma was significantly higher than that in diffuse-type gastric adenocarcinoma (x2 = 37.022,P<0.01).CONCLUSION: Our results indicate the presence of an autocrine loop of leptin system in the development of intestinal-type gastric adenocarcinoma.

  4. A case of gastric adenocarcinoma in a Shih Tzu dog: successful treatment of early gastric cancer.

    Science.gov (United States)

    Lee, Hee-Chun; Kim, Ji-Hyun; Jee, Cho-Hee; Lee, Jae-Hoon; Moon, Jong-Hyun; Kim, Na-Hyun; Sur, Jung-Hyang; Cho, Kyu-Woan; Kang, Byeong-Teck; Ha, Jeongim; Jung, Dong-In

    2014-07-01

    A 9-year-old castrated male Shih Tzu dog was referred to us, because of chronic vomiting. The patient's hematological, radiographic, ultrasonographic, endoscopic and histological examinations were evaluated for diagnosis. Hematologic analysis indicated moderate anemia and azotemia. Based on the imaging studies, an oval-shaped mass was identified in the gastric pylorus area. A proliferative mass was found on endoscopic examination, and we performed biopsy using grasping forceps. The histopathological findings of the biopsy specimens indicated hypertrophic gastritis, and Y-U pyloroplasty was performed. However, histopathological examination of the surgically resected mass revealed tubular adenocarcinoma of the stomach. Then, carboplatin chemotherapy was performed 4 times for 13 weeks. Clinical signs, such as vomiting, were resolved gradually after surgery and chemotherapy, and the patient's condition was managed favorably until recently (30 months after surgery). This case report describes clinical features, imaging studies, endoscopic characteristics and histopathological and immunohistochemical features of gastric tubular adenocarcinoma as early gastric cancer in a dog.

  5. Multidetector computed tomography in the preoperative staging of gastric adenocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Barros, Ricardo Hoelz de Oliveira; Penachim, Thiago Jose; Martins, Daniel Lahan; Andreollo, Nelson Adami; Caserta, Nelson Marcio Gomes, E-mail: rhobarros@hotmail.com [Universidade Estadual de Campinas (UNICAMP), Campinas, SP (Brazil)

    2015-03-15

    Objective: To evaluate the role of multidetector computed tomography in the preoperative investigation of tumor invasion depth and lymph node and metastatic involvement according to the TNM classification, in patients with gastric adenocarcinoma. Materials and Methods: Fifty-four patients with biopsy-confirmed gastric cancer underwent preoperative staging with 64-channel multidetector computed tomography. Two independent radiologists analyzed the images and classified the findings. Sensitivity, specificity, accuracy and overall accuracy were calculated for each observer. The interobserver agreement was also evaluated. Results: The accuracy in the classification of categories T ranged from 74% to 96% for observer 1 and from 80% to 92% for observer 2. The overall accuracy was 70% for both observers. The weighted kappa index was 0.75, consistent with a significant interobserver agreement. The accuracy in the classification of lymph node involvement (category N) ranged from 55% to 79% for observer 1 and from 73% to 82% for observer 2. The evaluation of metastatic involvement showed an overall accuracy of 89.6% for both observers. Conclusion: 64-channel multidetector computed tomography demonstrated clinically relevant accuracy in the preoperative staging of gastric adenocarcinoma as regards invasion depth (T category) and metastatic involvement (M category). (author)

  6. Her2+ and b-HCG Producing Undifferentiated Gastric Adenocarcinoma.

    Science.gov (United States)

    Eivaz-Mohammadi, Sahar; Gonzalez-Ibarra, Fernando; Abdul, Waheed; Tarar, Omer; Malik, Khurram; Syed, Amer K

    2014-01-01

    A 25-year-old Hispanic female with a history of anemia, schizoaffective disorder, and psychosis was admitted for anemia associated with fatigue, weakness, shortness of breath, night sweats, weight loss, and abdominal and lower back pain for the past two months. On routine management, she was found to have a positive serum b-HCG of 80.4 (0-5 mIU/mL) but the patient denied any sexual activity in her life. During her admission, U/S of the pelvis was noncontributory. CT angiogram of the chest was significant for prominent mediastinal and hilar lymph nodes, diffusely thickened stomach suggesting gastric malignancy with multiple hypoenhancing lesions in the liver and diffuse lytic lesions in the spine and sacrum suspicious for metastatic disease. The MRI of the abdomen confirmed the CT angiogram findings. After these findings, EGD was performed which showed lesions in the antrum, body of the stomach, fundus, and cardia on the lesser curvature of the stomach body correlating with carcinoma. The biopsy was positive for Her2, b-HCG producing poorly differentiated gastric adenocarcinoma. Patient underwent one successful round of chemotherapy with Taxotene, Cisplatin, and 5-FU for Stage IV gastric adenocarcinoma.

  7. Hearing loss as an unusual consequence of metastatic gastric adenocarcinoma

    Directory of Open Access Journals (Sweden)

    CE Owers

    2010-10-01

    Full Text Available A sixty-one year old man was referred with a history of progressive dysphagia, vomiting and weight loss with some back pain. Upper gastrointestinal endoscopy and biopsies revealed a gastro-oesophageal junction adenocarcinoma. Despite the absence of metastatic disease on computed tomography, positron emission tomography demonstrated multiple vertebral and sternal deposits. He was reviewed in an ENT clinic with a sudden onset of hearing loss accompanied by dizziness, but no focal neurology. Magnetic resonance imaging identified bilateral 2cm lesions at the internal auditory meatus, consistent with a diagnosis of bilateral acoustic neuromas. The patient subsequently died of carcinomatosis and, because of the potential familial significance of bilateral acoustic neuromas, a limited post-mortem examination was carried out. Unexpectedly, this revealed bilateral adenocarcinoma metastases infiltrating the internal auditory meatus affecting the acoustic nerves. The authors believe this a very rare presentation of metastatic gastric disease.

  8. Identification of distinct phenotypes of locally advanced pancreatic adenocarcinoma.

    LENUS (Irish Health Repository)

    Teo, Minyuen

    2013-03-01

    A significant number of pancreatic ductal adenocarcinoma present as locally advanced disease. Optimal treatment remains controversial. We sought to analyze the clinical course of locally advanced pancreatic adenocarcinoma (LAPC) in order to identify potential distinct clinical phenotypes.

  9. Novel Method for Differentiating Histological Types of Gastric Adenocarcinoma by Using Confocal Raman Microspectroscopy.

    Science.gov (United States)

    Hsu, Chih-Wei; Huang, Chia-Chi; Sheu, Jeng-Horng; Lin, Chia-Wen; Lin, Lien-Fu; Jin, Jong-Shiaw; Chau, Lai-Kwan; Chen, Wenlung

    2016-01-01

    Gastric adenocarcinoma, a single heterogeneous disease with multiple epidemiological and histopathological characteristics, accounts for approximately 10% of cancers worldwide. It is categorized into four histological types: papillary adenocarcinoma (PAC), tubular adenocarcinoma (TAC), mucinous adenocarcinoma (MAC), and signet ring cell adenocarcinoma (SRC). Effective differentiation of the four types of adenocarcinoma will greatly improve the treatment of gastric adenocarcinoma to increase its five-year survival rate. We reported here the differentiation of the four histological types of gastric adenocarcinoma from the molecularly structural viewpoint of confocal Raman microspectroscopy. In total, 79 patients underwent laparoscopic or open radical gastrectomy during 2008-2011: 21 for signet ring cell carcinoma, 21 for tubular adenocarcinoma, 14 for papillary adenocarcinoma, 6 for mucinous carcinoma, and 17 for normal gastric mucosas obtained from patients underwent operation for other benign lesions. Clinical data were retrospectively reviewed from medical charts, and Raman data were processed and analyzed by using principal component analysis (PCA) and linear discriminant analysis (LDA). Two-dimensional plots of PCA and LDA clearly demonstrated that the four histological types of gastric adenocarcinoma could be differentiated, and confocal Raman microspectroscopy provides potentially a rapid and effective method for differentiating SRC and MAC from TAC or PAC.

  10. Preoperative chemoradiotherapy for locally advanced gastric cancer

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    Pepek Joseph M

    2013-01-01

    Full Text Available Abstract Background To examine toxicity and outcomes for patients treated with preoperative chemoradiotherapy (CRT for gastric cancer. Methods Patients with gastroesophageal (GE junction (Siewert type II and III or gastric adenocarcinoma who underwent neoadjuvant CRT followed by planned surgical resection at Duke University between 1987 and 2009 were reviewed. Overall survival (OS, local control (LC and disease-free survival (DFS were estimated using the Kaplan-Meier method. Toxicity was graded according to the Common Toxicity Criteria for Adverse Events version 4.0. Results Forty-eight patients were included. Most (73% had proximal (GE junction, cardia and fundus tumors. Median radiation therapy dose was 45 Gy. All patients received concurrent chemotherapy. Thirty-six patients (75% underwent surgery. Pathologic complete response and R0 resection rates were 19% and 86%, respectively. Thirty-day surgical mortality was 6%. At 42 months median follow-up, 3-year actuarial OS was 40%. For patients undergoing surgery, 3-year OS, LC and DFS were 50%, 73% and 41%, respectively. Conclusions Preoperative CRT for gastric cancer is well tolerated with acceptable rates of perioperative morbidity and mortality. In this patient cohort with primarily advanced disease, OS, LC and DFS rates in resected patients are comparable to similarly staged, adjuvantly treated patients in randomized trials. Further study comparing neoadjuvant CRT to standard treatment approaches for gastric cancer is indicated.

  11. Gastric adenocarcinoma with features of endodermal sinus tumor

    Institute of Scientific and Technical Information of China (English)

    Malvinderjit Singh; Mukul Arya; Sury Anand; Nan Sandar

    2007-01-01

    Extragonadal germ cell tumors are rare. The most common sites for EGGCTs are in midline locations such as the mediastinum, retroperitoneum and pineal gland.These tumors rarely present in the stomach. We describe here a case where a middle aged man presented with typical symptoms of gastric cancer. After extensive workup, which included blood work, CT abdomen scan,upper endoscopy, and endoscopic ultrasound, the patient was diagnosed with gastric cancer. However,due to very high blood levels of alpha-fetoprotein, the specimen was sent for special histochemical staining,which demonstrated that the tumor had features of both adenocarcinoma and endodermal sinus tumor. This is a very aggressive tumor with a very poor prognosis.

  12. Influence of a microscopic positive proximal margin in the treatment of gastric adenocarcinoma of the cardia

    Institute of Scientific and Technical Information of China (English)

    Jian-Guo Shen; Jae-Ho Cheong; Woo-Jin Hyung; Junuk Kim; Seung-Ho Choi; Sung-Hoon Noh

    2006-01-01

    AIM: To investigate the influence of a positive proximal margin in total gastrectomy patients with gastric adenocarcinoma of the cardia.METHODS: Medical records of 191 patients with total gastrectomies for adenocarcinoma of the cardia between 1995 and 2000 were reviewed. The clinicopathologic features associated with a positive margin were determined, and the predictors for survival were analyzed.RESULTS: The incidence of positive proximal margin was 8.4% (16/191). The positive margins were associated with advanced diseases. The tumor size and the depth of tumor invasion were independent risk factors for a positive margin. The mean survival in the positive margin group was 33.9 mo as compared with 62.4 mo in the negative group (P < 0.001). However, the difference in survival lost significance in subgroup analysis according to stage. Multivariate analysis identified that a positive margin was not an independent prognostic factor for survival.CONCLUSION: A positive margin is more of an indication of advanced disease in patients with gastric adenocarcinoma of the cardia rather than an independent prognostic factor for survival.

  13. Elevated risk for gastric adenocarcinoma can be predicted from histomorphology

    Institute of Scientific and Technical Information of China (English)

    Michael Vieth; Mandred Stolte

    2006-01-01

    The number of patients with gastric cancer has more than doubled since 1985 in developing countries.Thus, the questions of whether it can be predicted from gastritis morphology, who is at risk and who has a lower risk of developing gastric carcinoma are raised. H pylori-infection leads to erosions, ulcerations,carcinoma, rnucosa associated lymphoid tissue (MALT)-lymphoma and extragastric diseases only in some individuals. The frequency of ulcerations among H pylori-infected individuals is estimated to be 13%,gastric cancer about 1% and MALT lymphoma around 0.1%. In the literature a multistep model from chronic active H pylori-infection through multifocal atrophy,intestinal metaplasia, dysplasia (intraepithelial neoplasia)and carcinoma has been described. But this model cannot be applied to all routine cases. Since risk factors such as metaplasia and atrophy are paracancerous rather than precancerous conditions, this raises the question whether there is a better morphological marker. Differences in topography, grade and activity of Helicobacter gastritis in the antrum and corpus might be good markers for identifying those who are at risk of developing gastric cancer. It is known that the so-called corpus dominant H pylori gastritis is found more frequently among individuals with early and advanced gastric cancer and within high risk populations. This is valid both for firstdegree relatives of gastric cancer patients and for patients with gastric adenoma and hyperplastic polyps.In conclusion, corpus-dominant H pylori gestritis is significantly more common in patients with advanced and early gastric cancer, first-degree relatives of patients with gastric cancer, patients with gastric adenoma and gastric hyperplastic polyps. Therefore, all these patients are at risk of developing gastric cancer. Next, the question of who is at risk of developing corpus-dominant gastritis is raised. It appears that patients with a low acid output more frequently develop gastric cancer

  14. An Asian population-based survival analysis of patients with distal esophageal and gastric cardia adenocarcinomas

    Institute of Scientific and Technical Information of China (English)

    ZHENG Bin; ZHENG Wei; ZHU Yong,; WU Wei-dong; CHEN Chun

    2012-01-01

    Background Gastroesophageal junction adenocarcinomas include adenocarcinomas of the distal esophagus(DE)and gastric cardia(GC).It is controversial whether these tumors are the same entity and whether they have the same survival rates.Patients with DE and GC adenocarcinomas have a similar survival rate in the US;however,data are lacking in Asian countries.Therefore,we conducted a retrospective study to understand the implications of the tumor location in the survival of Asian patients.Methods A total of 209 patients with pathologically confirmed DE and GC adenocarcinomas,from 2005 to 2007,were included in the study.We identified patients with adenocarcinomas of the DE(DE group,n=91)and GC(GC group)(n=118).We performed an unadjusted survival analysis using the Kaplan-Meier method,and used a Cox proportional hazards regression model to adjust for potential confounding covariates.Results We found no significant difference between the overall survival of the DE and GC groups.The 3-year survival rates were 44.8% and 53.0%,respectively,and the 5-year survival rates were 27.9% and 30.2%,respectively(P=0.162).We found no significant difference in early staging,advanced staging,different T staging,and different N staging,between the groups.Both advanced post-operative N staging and advanced AJCC staging had a significant adverse effect on survival.Conclusions Patients with DE and GC adenocarcinomas have similar survival rates in the Asian population.Both post-operative N staging and AJCC staging are prognostic factors.

  15. The effect of low concentrations of ethanol on gastric adenocarcinoma cell lines

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    Wu Lingjiao

    2013-01-01

    Full Text Available Chronic alcohol consumption was identified as a significant risk factor for cancer in humans. The aim of the study was to analyze the influence of low concentrations of ethanol on gastric adenocarcinoma cell viability, apoptosis, and changes in the expression of alcohol dehydrogenase with ethanol treatment. Gastric adenocarcinoma cell lines (MGC803, MGC823 and SGC7901 were treated with different concentrations of ethanol (0.03125%, 0.0625%, 0.125%, 0.25%, 0.5%, 1%, 2%, and 4%. The MTT (3-(4,5-dimethylthiazol-2-yl-2,5-diphenyltetrazolium bromide assay and flow cytometry were used to analyze the effect of ethanol treatment on cell viability and apoptosis. Western blotting was used to analyze the expression of alcohol dehydrogenase in gastric carcinoma cells. Ethanol treatment inhibited cell proliferation in gastric adenocarcinoma cell lines in a significant dose-dependent manner. Ethanol induced apoptosis of gastric adenocarcinoma cells in a dose-dependent manner. The alcohol dehydrogenase activity of gastric adenocarcinoma cells increased with the increase in the concentration of ethanol. Ethanol inhibited cell viability and the growth of gastric adenocarcinoma cell lines. Low concentrations of ethanol also induced apoptosis and increased the expression of alcohol dehydrogenase of the gastric adenocarcinoma cell lines.

  16. The effect of low concentrations of ethanol on gastric adenocarcinoma cell lines

    Directory of Open Access Journals (Sweden)

    Wu Lingjiao

    2014-01-01

    Full Text Available Chronic alcohol consumption has been identified as a significant risk factor for cancer in humans. The aim of the study was to analyze the influence of low concentrations of ethanol on gastric adenocarcinoma cell viability, apoptosis, and changes in the expression of alcohol dehydrogenase with ethanol treatment. Gastric adenocarcinoma cell lines (MGC803, MGC823 and SGC7901 were treated with different concentrations of ethanol (0.03125%, 0.0625%, 0.125%, 0.25%, 0.5%, 1%, 2%, and 4%. An MTT (3-(4,5-dimethylthiazol-2-yl-2,5-diphenyltetrazolium bromide assay and flow cytometry were used to analyze the effect of ethanol treatment on cell viability and apoptosis. Western blotting was used to analyze the expression of alcohol dehydrogenase in gastric carcinoma cells. Ethanol treatment inhibited cell proliferation in gastric adenocarcinoma cell lines in a significant dose-dependent manner. Ethanol was also able to induce the apoptosis of gastric adenocarcinoma cells in a dose-dependent manner. Alcohol dehydrogenase activity of gastric adenocarcinoma cells increased with the increase in the concentration of ethanol. Ethanol inhibited cell viability and growth of gastric adenocarcinoma cell lines. Low concentrations of ethanol also induced apoptosis and increased the expression of alcohol dehydrogenase of the gastric adenocarcinoma cell lines.

  17. Comorbid gastric adenocarcinoma and gastric and duodenal Strongyloides stercoralis infection: a case report.

    Science.gov (United States)

    Seo, An Na; Goo, Youn-Kyoung; Chung, Dong-Il; Hong, Yeonchul; Kwon, Ohkyoung; Bae, Han-Ik

    2015-02-01

    Strongyloides stercoralis can cause systemic infection, termed strongyloidiasis, and gastrointestinal ulcer disease in immunocompromised patients. However, to our knowledge, there are no reported cases of comorbid gastric adenocarcinoma and S. stercoralis infection. Here, we report a case of an 81-year-old Korean man who presented with S. stercoralis infection coexisting with early gastric adenocarcinoma (T1aN0M0). S. stercoralis eggs, rhabditiform larvae, and adult females were observed in normal gastric and duodenal crypts. They were also observed in atypical glands representative of adenocarcinoma and adenoma. Preliminary laboratory tests revealed mild neutrophilic and eosinophilic leukocytosis. A routine stool test failed to detect rhabditiform larvae in the patient's fecal sample; however, S. stercoralis was identified by PCR amplification and 18S rRNA sequencing using genomic DNA extracted from formalin-fixed paraffin-embedded tissues. Postoperatively, the patient had a persistent fever and was treated with albendazole for 7 days, which alleviated the fever. The patient was followed-up by monitoring and laboratory testing for 4 months postoperatively, and no abnormalities were observed thus far. The fact that S. stercoralis infection may be fatal in immunocompromised patients should be kept in mind when assessing high-risk patients.

  18. Adenocarcinoma of the GEJ: gastric or oesophageal cancer?

    Science.gov (United States)

    Rüschoff, J

    2012-01-01

    According to WHO (2010) adenocarcinomas of the esophagogastric junction (GEJ) are defined as tumors that cross the most proximal extent of the gastric folds regardless of where the bulk of the tumor lies. In addition, these neoplasms are now classified as esophageal cancers by UICC (2010). Recent studies, however, revealed two types of carcinogenesis in the distal oesophagus and at the GEJ, one of intestinal type (about 80 %) and the other of gastric type (about 20 %). These are characterized by marked differences in morphology, tumor stage at diagnosis, and prognosis. Furthermore, both cancer types show different targetable biomarker expression profiles such as Her2 in the intestinal and EGFR in the non-intestinal pathway indicating new therapy options. Due to the fact that carcinomas of the intestinal pathway were typically associated with Barrett's mucosa which was not the case in the non-intestinal-type tumors, this challenges the paradigm "no goblets no Barrett's". Moreover, even the cancer risk of intestinal-type metaplasia has seriously been questioned by a Danish population-based study where Barrett's mucosa turned out to be only a weak indicator of esophageal and GEJ cancer (1 case in 860 patients years). Thus, two biologically different types of cancer arise at the GEJ-esophageal and gastric type that open distinctive targeted treatment options and also question our current concept about the diagnostics of potential precursor lesions as well as the associated screening and surveillance strategy.

  19. Resveratrol engages selective apoptotic signals in gastric adenocarcinoma cells

    Institute of Scientific and Technical Information of China (English)

    William L Riles; Jason Erickson; Sanjay Nayyar; Mary Jo Atten; Bashar M Attar; Oksana Holian

    2006-01-01

    AIM: To investigate the intracellular apoptotic signals engaged by resveratrol in three gastric adenocarcinoma cancer cell lines, two of which (AGS and SNU-1) express p53 and one (KATO-Ⅲ) with deleted p53.METHODS: Nuclear fragmentation was used to quantitate apoptotic cells; caspase activity was determined by photometric detection of cleaved substrates; formation of oxidized cytochrome C was used to measure cytochrome C activity, and Western blot analysis was used to determine protein expression.RESULTS: Gastric cancer cells, irrespective of their p53 status, responded to resveratrol with fragmentation of DNA and cleavage of nuclear lamins A and B and PARP, Resveratrol, however, has no effect on mitochondria-associated apoptotic proteins Bcl-2, Bclxl, Bax, Bid or Smac/Diablo, and did not promote subcellular redistribution of cytochrome C, indicating that resveratrol-induced apoptosis of gastric carcinoma cells does not require breakdown of mitochondrial membrane integrity. Resveratrol up-regulated p53 protein in SNU-1 and AGS cells but there was a difference in response of intracellular apoptotic signals between these cell lines.SNU-1 cells responded to resveratrol treatment with down-regulation of survivin, whereas in AGS and KATO-Ⅲ cells resveratrol stimulated caspase 3 and cytochrome C oxidase activities.CONCLUSION: These findings indicate that even within a specific cancer the intracellular apoptotic signals engaged by resveratrol are cell type dependent and suggest that such differences may be related to differentiation or lack of differentiation of these cells.

  20. Chylothorax in gastric adenocarcinoma: A case report and systematic review of the English literature

    Directory of Open Access Journals (Sweden)

    Uma Devaraj

    2014-01-01

    Full Text Available Background: Chylothorax is a rare complication of gastric adenocarcinoma and data on its identification, prevalence and outcomes are scant. Objectives: To enable identification of gastric carcinoma as a cause of chylothorax. Methods: A case report and a systematic review were conducted of all reported cases of gastric adenocarcinoma with chylothorax as the presenting complaint in the English literature. Results: Chylothorax is a rare presenting complaint of gastric adenocarcinoma. There are only 18 case reports in the world literature, of which six are in English. Chylothorax occurred variably in gastric adenocarcinoma, either as a presenting feature or as a complication of therapy. Here, we analyze the index case and six patients in whom gastric carcinoma presented with chylothorax as the initial symptom. Respiratory features of cough and dyspnea preempted any abdominal complaint. Bilateral chylothorax (66% with associated chylous ascites (50% was common. Four of the six patients had skin lymphedema also as a prominent feature. The chylothoraces have been treated by therapeutic pleurocentesis, intercoastal tube drainage and restriction of oral intake. Gastric adenocarcinoma was associated with high mortality (50% and morbidity. Conclusions: Chylothorax can be the presenting feature of gastric adenocarcinoma. A thorough search for this life-threatening disease should be done before labeling the chylothorax as idiopathic.

  1. Detection of microsatellite instability but not truncating APC mutations in gastric adenocarcinomas in Brazilian patients

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    Bevilacqua Roberta A.U.

    2000-01-01

    Full Text Available A crucial role for the adenomatous polyposis colonic (APC gene in colorectal carcinogenesis has been conclusively established, but, the role of APC in gastric tumors remains controversial. APC mutations have been detected at a relatively high frequency in gastric tumors of Japanese patients, yet such mutations have been reported to be extremely rare in British patients and patients from north-central-Italy. We here report the analysis of 40 primary sporadic gastric adenocarcinomas and 35 primary sporadic colon adenocarcinomas (from patients resident in São Paulo, Brazil, for mutations in the APC gene between codons 686 and 1693 using the protein truncation test. Although 19 truncating mutations were detected in 35 colon adenocarcinomas (54.2% none were found in any of the gastric adenocarcinomas. As an internal control the tumor samples were also evaluated for microsatellite alterations, which are also common features of both tumor types. Microsatellite instability was present in 1 colon and 7 gastric tumor samples. This suggests that in relation to APC mutations gastric adenocarcinomas from Brazilian patients are similar to those that occur in Europe, and support a fundamental difference both between gastric carcinomas that occur in different geographical regions and between the molecular etiology of gastric and colorectal adenocarcinomas occurring in São Paulo, Brazil.

  2. Cardiac tamponade as the first clinical sign of gastric adenocarcinoma: a rare condition.

    Science.gov (United States)

    Arısoy, Arif; Memiç, Kadriye; Karavelioğlu, Yusuf; Sen, Fatma

    2014-06-01

    Cardiac tamponade originating from a primary gastric cancer (GC) is a rare condition. Patients are generally asymptomatic until the disease is advanced. We report a rare patient with cardiac tamponade as the first manifestation of primary GC. A 46-year-old male was admitted with progressive dyspnea. Cardiac tamponade was diagnosed on two-dimensional ultrasonographic echocardiography. Pericardiocentesis yielded 1500 ml of bloody fluid. Pericardial cytologic examination was positive for malignant cells. The patient underwent abdominal computed tomography scan, which showed thickening of the gastric wall and several mesenteric lymph nodes. Endoscopic examination of the stomach disclosed malignant ulcer along the lesser curvature, and the biopsy showed diffuse type adenocarcinoma. Chemotherapy was initiated by the Oncology Department, and he had no pericardial effusion after six courses of systemic chemotherapy. In conclusion, this is a rare condition and difficult to diagnosis early. Thus, physicians should be aware of malignancy of the stomach when patients present with unexplained cardiac manifestations.

  3. Prevalence of gastric precancerous lesions in Ardabil, a high incidence province for gastric adenocarcinoma in the northwest of Iran

    NARCIS (Netherlands)

    Malekzadeh, R; Sotoudeh, M; Derakhshan, MH; Mikaeli, J; Yazdanbod, A; Merat, S; Yoonessi, A; Tavangar, M; Ardakani, BA; Sotoudehmanesh, R; Pourshams, A; Asgari, AA; Doulatshahi, S; Alizadeh, BZ; Arshi, S; Madjidpoor, A; Moomen, SM; Fleischer, DE

    2004-01-01

    Background/Aims: Ardabil Province, in northwestern Iran, has the highest rate of gastric ( predominantly cardia) adenocarcinoma in Iran. This study aimed to investigate the feasibility of endoscopic screening and to look for associated Helicobacter pylori infection and gastric precancerous lesions.

  4. Prevalence of gastric precancerous lesions in Ardabil, a high incidence province for gastric adenocarcinoma in the northwest of Iran

    NARCIS (Netherlands)

    Malekzadeh, R; Sotoudeh, M; Derakhshan, M H; Mikaeli, J; Yazdanbod, A; Merat, S; Yoonessi, A; Tavangar, M; Abedi, B Ardakani; Sotoudehmanesh, R; Pourshams, A; Asgari, A Ali; Doulatshahi, S; Alizadeh, B Ziad; Arshi, S; Madjidpoor, A; Mir Moomen, S; Fleischer, D E

    2004-01-01

    BACKGROUND/AIMS: Ardabil Province, in northwestern Iran, has the highest rate of gastric (predominantly cardia) adenocarcinoma in Iran. This study aimed to investigate the feasibility of endoscopic screening and to look for associated Helicobacter pylori infection and gastric precancerous lesions. M

  5. Gastric adenocarcinoma with choriocarcinomatous differentiation in the remnant stomach, 54 years after Billroth II partial gastrectomy

    Directory of Open Access Journals (Sweden)

    Mehmet Yildirim

    2016-07-01

    Full Text Available The gastric remnant cancer is defined as a cancer that has developed 5 or more years after distal gastric resection for benign diseases of the stomach. The choriocarcinomatous differentiation of adenocarcinoma in the stomach is a very rare tumor. A 75-year-old woman underwent resection of remnant stomach which she had operated for benign gastric pathology 54 years ago. Pathologic examination of the resection revealed areas of choriocarcinomatous differentiation in addition to classical adenocarcinoma. In the literature on English language, this report presents the first case of adenocarcinoma associated with choriocarcinomatous differentiation in the gastric remnant. The treatment of these patients depends on the clinical setting, and early diagnosis is an important factor for the treatment strategies. Therefore, due to the probability of arising adenocarcinoma in the remnant stomach, the patient should be investigated with endoscopic examination periodically, despite the long postoperative period.

  6. The effect of low concentrations of ethanol on gastric adenocarcinoma cell lines

    OpenAIRE

    Wu Lingjiao; Chen Shaohua; Zhang Yu; Pan Hongming

    2014-01-01

    Chronic alcohol consumption has been identified as a significant risk factor for cancer in humans. The aim of the study was to analyze the influence of low concentrations of ethanol on gastric adenocarcinoma cell viability, apoptosis, and changes in the expression of alcohol dehydrogenase with ethanol treatment. Gastric adenocarcinoma cell lines (MGC803, MGC823 and SGC7901) were treated with different concentrations of ethanol (0.03125%, 0.0625%, 0.125%, 0....

  7. Gastric extremely well differentiated adenocarcinoma of gastric phenotype: as a gastric counterpart of adenoma malignum of the uterine cervix

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    Ae Lee Won

    2005-05-01

    Full Text Available Abstract Background Most of gastric adenocarcinoma can be simply diagnosed by microscopic examination of biopsy specimen. Rarely the structural and cellular atypia of tumor cells is too insignificant to discriminate from benign foveolar epithelium. Case presentation A 67-year-old male presented with a gastric mass incidentally found on the abdominal computed tomography (CT for routine medical examination. Gastric endoscopic examination revealed a huge fungating mass at the cardia and mucosal biopsy was performed. Microscopically the biopsy specimen showed proliferation of bland looking foveolar epithelia in the inflammatory background and diagnosed as foveolar epithelial hyperplasia. Because the clinical and endoscopic features of this patient were strongly suggestive of malignancy, the patient underwent radical total gastrectomy. The resected stomach revealed a huge fungating tumor at the cardia. The cut surface of the tumor was whitish gelatinous. Microscopically the tumor was sharply demarcated from surrounding mucosa and composed of very well formed glandular structures without significant cellular atypia, which invaded into the whole layer of the gastric wall. Tumor glands were occasionally complicated or dilated, and glandular lumina were filled with abundant mucin. Immunohistochemically the tumor cells revealed no overexpression of p53 protein but high Ki-67 labeling index. The tumor cells and intraluminal mucin were diffusely expressed MUC1 and MUC5AC and only focally expressed MUC2. On abdominal CT taken after 12 months demonstrated peritoneal carcinomatosis and multiple metastatic foci in the lung. Conclusion The clinicopathologic profiles of gastric extremely well differentiated adenocarcinoma of gastric phenotype include cardiac location, fungating gross type, very similar histology to foveolar epithelial hyperplasia, foveolar mucin phenotype, lack of p53 overexpressoin and high proliferative index.

  8. Sequential FDG-PET and induction chemotherapy in locally advanced adenocarcinoma of the Oesophago-gastric junction (AEG: The Heidelberg Imaging program in Cancer of the oesophago-gastric junction during Neoadjuvant treatment: HICON trial

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    Weichert Wilko

    2011-06-01

    Full Text Available Abstract Background 18-Fluorodeoxyglucose-PET (18F-FDG-PET can be used for early response assessment in patients with locally advanced adenocarcinomas of the oesophagogastric junction (AEG undergoing neoadjuvant chemotherapy. It has been recently shown in the MUNICON trials that response-guided treatment algorithms based on early changes of the FDG tumor uptake detected by PET are feasible and that they can be implemented into clinical practice. Only 40%-50% of the patients respond metabolically to therapy. As metabolic non-response is known to be associated with a dismal prognosis, metabolic non-responders are increasingly treated with alternative neoadjuvant chemotherapies or chemoradiation in order to improve their clinical outcome. We plan to investigate whether PET can be used as response assessment during radiochemotherapy given as salvage treatment in early metabolic non-responders to standard chemotherapy. Methods/Design The HICON trial is a prospective, non-randomized, explorative imaging study evaluating the value of PET as a predictor of histopathological response in metabolic non-responders. Patients with resectable AEG type I and II according to Siewerts classification, staged cT3/4 and/or cN+ and cM0 by endoscopic ultrasound, spiral CT or MRI and FDG-PET are eligible. Tumors must be potentially R0 resectable and must have a sufficient FDG-baseline uptake. Only metabolic non-responders, showing a 18FDG-PET scans will be performed before ( = Baseline and after 14 days of standard neoadjuvant therapy as well as after the first cycle of salvage docetaxel/cisplatin chemotherapy (PET 1 and at the end of radiochemotherapy (PET2. Tracer uptake will be assessed semiquantitatively using standardized uptake values (SUV. The percentage difference ΔSUV = 100 (SUVBaseline - SUV PET1/SUVBaseline will be calculated and assessed as an early predictor of histopathological response. In a secondary analysis, the association between the difference

  9. Cereal fiber intake may reduce risk of gastric adenocarcinomas : The EPIC-EURGAST study

    NARCIS (Netherlands)

    Mendez, M. A.; Pera, Guillem; Aguclo, Antonio; Bueno-de-Mesquita, H. Bas; Palli, Domenico; Boeing, Heiner; Carneiro, Ftima; Berrino, Franco; Sacerdote, Carlotta; Tumino, Rosario; Panico, Salvatore; Berglund, Goeran; Manjer, Jonas; Johansson, Ingegerd; Stenling, Roger; Martinez, Carmen; Dorronsoro, Miren; Barricarte, Aurelio; Tormo, Maria J.; Quiros, Jose R.; Allen, Naomi; Key, Timothy J.; Bingham, Sheila; Linseisen, Jakob; Kaaks, Rudolf; Overvad, Kim; Jensen, Majken; Olsen, Anja; Tjonneland, Anne; Peeters, Petra H. M.; Numans, Mattijs E.; Ocke, Marga C.; Clavel-Chapelon, Francoise; Boutron-Ruault, Marie-Christine; Trichopoulou, Antonia; Lund, Eiliv; Slimani, Nadia; Jenab, Mazda; Ferrari, Pietro; Riboli, Elio; Gonzalez, Carlos A.

    2007-01-01

    Numerous case-control studies suggest dietary fiber may reduce risk of gastric cancer, but this has not been confirmed prospectively. A previous case-control study reported reduced risk of gastric cardia adenocarcinomas associated with cereal fiber, but not with fruit or vegetable fiber. To date, di

  10. Differences in oxidative stress dependence between gastric adenocarcinoma subtypes

    Institute of Scientific and Technical Information of China (English)

    Brigitte Bancel; Jacques Estève; Jean-Christophe Souquet; Shinya Toyokuni; Hiroshi Ohshima; Brigitte Pignatelli

    2006-01-01

    AIM: To investigate the extent of oxidative stress in preneoplastic and neoplastic gastric mucosa in relation to their pathological criteria and histological subtypes.METHODS: A total of 104 gastric adenocarcinomas from 98 patients (88 infiltrative and 16 intraepithelial tumors)were assessed immunohistochemically for expression of iNOS and occurrence of nitrotyrosine (NTYR)-containing proteins and 8-hydroxy-2'-deoxyguanosine (8-OHdG)-containing DNA, as markers of NO production and damages to protein and DNA.RESULTS: Tumor cells staining for iNOS, NTYR and 8-OH-dG were detected in 41%, 62% and 50% of infiltrative carcinoma, respectively. The three markers were shown for the first time in intraepithelial carcinoma.The expression of iNOS was significantly more frequent in tubular carcinoma (TC) compared to diffuse carcinoma (DC) (54% vs 18%; P=0.008) or in polymorphous carcinoma (PolyC) (54% vs 21%; P=0.04). NTYR staining was obviously more often found in TC than that in PolyC (72% vs 30%; P=0.03). There was a tendency towards a higher rate of iNOS staining when distant metastasis (pM) was present. In infiltrative TC, the presence of oxidative stress markers was not significantly correlated with histological grade, density of inflammation, the depth of infiltration (pT), lymph nodes dissemination (pN) and pathological stages (pTNM).CONCLUSION: The iNOS-oxidative pathway may play an important role in TC, but moderately in PolyC and DC.DNA oxidation and protein nitration occur in the three subtypes. Based on the significant differences of NTYR levels, TC and PolyC appear as two distinct subtypes.

  11. Expression and clinical significance of fibroblast growth factor 1 in gastric adenocarcinoma

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    Liu NQ

    2015-03-01

    Full Text Available Naiqing Liu,1,2,* Jingyu Zhang,2,* Shuxiang Sun,2 Liguang Yang,2 Zhongjin Zhou,2 Qinli Sun,2 Jun Niu11Department of General Surgery, Qilu Hospital Affiliated to Shandong University, Jinan, People’s Republic of China; 2Department of General Surgery, Yishui Central Hospital, Linyi, People’s Republic of China*These authors contributed equally to this workBackground: The clinical significance of fibroblast growth factor 1 (FGF1 has been revealed in several cancers, including ovarian cancer, breast cancer, and bladder cancer. However, the clinical significance of FGF1 in gastric adenocarcinoma has not been explored.Patients and methods: In our experiments, we systematically evaluated FGF1 expression in 178 cases of gastric adenocarcinoma with immunohistochemistry, and subsequently analyzed the correlation between FGF1 expression and clinicopathologic features. Moreover, FGF1 expression in tumor tissue and corresponding adjacent tissue was detected and compared by real-time polymerase chain reaction. The Kaplan–Meier method and the Cox-regression model were used with univariate and multivariate analysis, respectively, to evaluate the prognostic value of FGF1 in gastric adenocarcinoma.Results: Higher FGF1 expression rate is 56.7% (101/178 in gastric adenocarcinoma. FGF1 expression in gastric adenocarcinoma was significantly higher than adjacent tissue (P<0.0001. Expression of FGF1 is significantly associated with lymph node invasion (P<0.001, distant metastasis (P=0.013, and differentiation (P=0.015. Moreover, FGF1 overexpression was closely related to unfavorable overall survival rate (P=0.021, and can be identified to be an independent unfavorable prognostic factor (P=0.004.Conclusion: FGF1 is an independent prognostic factor, indicating that FGF1 could be a potential molecular drug target in gastric adenocarcinoma.Keywords: fibroblast growth factor 1, gastric adenocarcinoma, prognosis, biomarker, lymph node, gene fusion

  12. Preoperative docetaxel/cisplatin/5-fluorouracil chemotherapy in patients with locally advanced gastro-esophageal adenocarcinoma.

    Science.gov (United States)

    Bayraktar, Ulas Darda; Bayraktar, Soley; Hosein, Peter; Chen, Emerson; Koniaris, Leonidas G; Rocha-Lima, Caio Max S; Montero, Alberto J

    2012-09-01

    Perioperative chemotherapy plus surgery improves survival compared to surgery alone in GE junctional (GEJ) and gastric adenocarcinomas. The docetaxel/cisplatin/5-fluorouracil (DCF) combination is superior to CF in patients with metastatic gastric cancer. We retrospectively evaluated the safety and efficacy of preoperative DCF chemotherapy in patients with locally advanced gastric and GEJ cancer. Twenty-one gastric and 10 gastroesophageal junctional (GEJ) cancer patients received 2-3 cycles of preoperative docetaxel 75 mg/m(2) and cisplatin 75 mg/m(2) on day 1, 5-FU 750 mg/m(2) (continuous infusion) on days 1-5 every 3 weeks. Clinical response was evaluated by comparing pre- and postchemotherapy CT scans. Overall survival (OS) and progression-free survival (PFS) were calculated from the initiation of chemotherapy. None of the patients achieved complete clinical remission while 11 (35%) patients achieved partial clinical remission. Ten patients with GEJ cancer (100%) and 13 with gastric cancer (62%) underwent curative surgery (P = 0.023). Seventeen (55%) patients experienced grade 3-4 chemotherapy-related adverse events. The most common adverse events were anemia, nausea/vomiting, diarrhea, and febrile neutropenia. At a median follow-up of 17.0 months, median OS and PFS were 26.1 months (95% CI: 22.7-29.5) and 18.8 months (95% CI: 9.9-27.7), respectively. The DCF regimen is active in patients with gastric and GEJ adenocarcinoma in the preoperative setting.

  13. Body mass index, height and risk of adenocarcinoma of the oesophagus and gastric cardia: A prospective cohort study

    NARCIS (Netherlands)

    Merry, A.H.H.; Schouten, L.J.; Goldbohm, R.A.; Brandt, P.A. van den

    2007-01-01

    Background: In the last decades, the incidence of oesophageal and gastric cardia adenocarcinoma has increased rapidly in the Western world. We investigated the association between body mass index (BMI), height and risk of oesophageal and gastric cardia adenocarcinoma. Methods: The Netherlands Cohort

  14. Treatment for isolated loco-regional recurrence of gastric adenocarcinoma: Does surgery play a role?

    Institute of Scientific and Technical Information of China (English)

    Fabio Carboni; Pasquale Lepiane; Roberto Santoro; Riccardo Lorusso; Pietro Mancini; Massimo Carlini; Eugenio Santoro

    2005-01-01

    AIM: To evaluate the role of surgical treatment for isolated loco-regional recurrences of operated gastric adenocarcinoma.METHODS: Among the 837 patients operated for gastric adenocarcinoma between December 1979and April 2004, 713 (85%) underwent resection with curative intent. A retrospective review of a prospectively collected gastric cancer database was carried out.Overall recurrence rate was 44% (315 cases), with 75%occurring within the first 2 years from the operation.Isolated L-R recurrences were observed in 38 (12%)patients. Symptomatic lesions were observed in 27(71%).RESULTS: Six (16%) patients were macroscopically resected with curative intent. The recurrence was located in the gastric stump after a STG in three patients, in theesophagojejunal anastomosis after a TG in two patients and in the gastric bed after a TG in one patient.Surgical procedures consisted of three secondary TG, two esophagojejunal resection and one excision of an extraluminal recurrence. Postoperative complications occurred in two patients (33%), including one anastomotic leakage and one hemorrhage. The latter patient died of sepsis 35 d after the surgery (mortality rate 17%). All patients died of recurrent gastric cancer:2 within 1 year from surgery (8 and 11 mo, respectively),2 after 16 and 17 mo respectively and 1 after 28 mo from the second operation.CONCLUSION: Surgery plays a very limited role in the treatment for isolated loco-regional recurrence of gastric adenocarcinoma.

  15. The effect of low concentrations of ethanol on gastric adenocarcinoma cell lines

    OpenAIRE

    Wu Lingjiao; Chen Shaohua; Zhang Yu; Pan Hongming

    2013-01-01

    Chronic alcohol consumption was identified as a significant risk factor for cancer in humans. The aim of the study was to analyze the influence of low concentrations of ethanol on gastric adenocarcinoma cell viability, apoptosis, and changes in the expression of alcohol dehydrogenase with ethanol treatment. Gastric adenocarcinoma cell lines (MGC803, MGC823 and SGC7901) were treated with different concentrations of ethanol (0.03125%, 0.0625%, 0.125%, 0.25%, 0.5%, 1%, 2%, and 4%). The MTT...

  16. Prognostic significance of tumor budding and single cell invasion in gastric adenocarcinoma

    Science.gov (United States)

    Che, Keying; Zhao, Yang; Qu, Xiao; Pang, Zhaofei; Ni, Yang; Zhang, Tiehong; Du, Jiajun; Shen, Hongchang

    2017-01-01

    Purpose Gastric carcinoma (GC) is a highly aggressive cancer and one of the leading causes of cancer-related deaths worldwide. Histopathological evaluation pertaining to invasiveness is likely to provide additional information in relation to patient outcome. In this study, we aimed to evaluate the prognostic significance of tumor budding and single cell invasion in gastric adenocarcinoma. Materials and methods Hematoxylin and eosin-stained slides generated from 296 gastric adenocarcinoma patients with full clinical and pathological and follow-up information were systematically reviewed. The patients were grouped on the basis of tumor budding, single cell invasion, large cell invasion, mitotic count, and fibrosis. The association between histopathological parameters, different classification systems, and overall survival (OS) was statistically analyzed. Results Among the 296 cases that were analyzed, high-grade tumor budding was observed in 49.0% (145) of them. Single cell invasion and large cell invasion were observed in 62.8% (186) and 16.9% (50) of the cases, respectively. Following univariate analysis, patients with high-grade tumor budding had shorter OS than those with low-grade tumor budding (hazard ratio [HR]: 2.260, Ptumor budding and single cell invasion were observed to be independent risk factors for gastric adenocarcinoma (PTumor budding and single cell invasion in gastric adenocarcinoma are associated with an unfavorable prognosis.

  17. Network pharmacology dissection of multiscale mechanisms of herbal medicines in stage IV gastric adenocarcinoma treatment

    Science.gov (United States)

    Gao, Li; Hao, Jian; Niu, Yang-Yang; Tian, Miao; Yang, Xue; Zhu, Cui-Hong; Ding, Xiu-Li; Liu, Xiao-Hui; Zhang, Hao-Ran; Liu, Chang; Qin, Xue-Mei; Wu, Xiong-Zhi

    2016-01-01

    Abstract Increasing evidence has shown that Chinese Herbal Medicine (CHM) has efficient therapeutic effects for advanced gastric adenocarcinoma, while the therapeutic mechanisms underlying this treatment remain unclear. In this study, the Kaplan–Meier method and Cox regression analysis were used to evaluate the survival benefit of CHM treatment, and correlation analysis was applied to identify the most effective components in the formulas. A network pharmacological approach was developed to decipher the potential therapeutic mechanisms of CHM. CHM treatment was an independent protective factor. The hazard ratio was 0.364 (95% CI 0.245–0.540; P < 0.001). The median survival time was 18 months for patients who received CHM treatment, while for patients without CHM treatment was decreased to 9 months (P < 0.001). Thirteen out of the total 204 herbs were significantly correlated with favorable survival outcomes (P < 0.05), likely representing the most effective components in these formulas. Bioinformatics analyses suggested that the simultaneous manipulation of multiple targets in proliferation pathways (such as epidermal growth factor receptor, fibroblast growth factor receptor 2, human epidermal growth factor receptor 2, proliferating cell nuclear antigen, and insulin like growth factor 2) and the process of cancer metastasis (collagen families, fibronectin 1 and matrix metalloproteinases families) might largely account for the mechanisms of the 13 herbs against gastric adenocarcinoma. A network pharmacology method was introduced to decipher the underlying mechanisms of CHM, which provides a good foundation for herbal research based on clinical data. PMID:27583849

  18. Coexistence of Gastric Adenocarcinoma and Choriocarcinoma: Complete Response to Trastuzumab and Chemotherapy

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    Seyda Gunduz

    2012-07-01

    Full Text Available Gastric choriocarcinoma is a rare neoplasm and usually accompanies gastric adenocarcinoma. The prognosis is poor due to the aggressive course of the disease. A 57-year-old female patient with weight loss and abdominal pain was examined. The patient was operated following the examination, and pathological analysis revealed the presence of a gastric adenocarcinoma associated with choriocarcinoma. Immunohistochemical analysis showed a positive reaction with antibodies to beta-human chorionic gonadotropin and overexpression of the cErbB2 proto-oncogene. Staging revealed multiple metastases in the liver. A complete response was obtained with a combination of trastuzumab and chemotherapy. The diagnosis of gastric choriocarcinomas without pathological examination is difficult due to their rare occurrence. A complete response can be obtained with trastuzumab in the treatment of cases with overexpression of the cErbB2 protein.

  19. Coexistence of Gastric Adenocarcinoma and Choriocarcinoma: Complete Response to Trastuzumab and Chemotherapy

    Science.gov (United States)

    Gunduz, Seyda; Elpek, Gulsum Ozlem; Uysal, Mukremin; Goksu, Sema Sezgin; Tatli, Murat; Arslan, Deniz; Coskun, Hasan Senol; Bozcuk, Hakan; Savas, Burhan; Ozdogan, Mustafa

    2012-01-01

    Gastric choriocarcinoma is a rare neoplasm and usually accompanies gastric adenocarcinoma. The prognosis is poor due to the aggressive course of the disease. A 57-year-old female patient with weight loss and abdominal pain was examined. The patient was operated following the examination, and pathological analysis revealed the presence of a gastric adenocarcinoma associated with choriocarcinoma. Immunohistochemical analysis showed a positive reaction with antibodies to beta-human chorionic gonadotropin and overexpression of the cErbB2 proto-oncogene. Staging revealed multiple metastases in the liver. A complete response was obtained with a combination of trastuzumab and chemotherapy. The diagnosis of gastric choriocarcinomas without pathological examination is difficult due to their rare occurrence. A complete response can be obtained with trastuzumab in the treatment of cases with overexpression of the cErbB2 protein. PMID:23525369

  20. Ectopic expression of RASSF2 and its prognostic role for gastric adenocarcinoma patients.

    Science.gov (United States)

    Luo, Deng; Ye, Ting; Li, Tian-Qian; Tang, Peng; Min, Sha-Dong; Zhao, Gong-Fang; Huang, Hua; Chang, Jiang; Wang, Yan; Lv, Lin; Lu, Ming-Liang; Zheng, Meng-Yao

    2012-03-01

    RASSF2 has recently been identified as a potential tumor suppressor that serves as a Ras effector in various types of human cancers. However, there have been few reports detailing this in gastric cancer. Samples of gastric adenocarcinoma from 276 Chinese patients with follow-up were analyzed for RASSF2 protein expression by immunohistochemistry. RASSF2 was expressed in up to 31.2% (86/276) of this group of gastric carcinoma. The expression of RASSF2 was significantly lower in carcinomas than in normal mucosas (P50.9% reduction in 3-year survival compared to that of patients with RASSF2-positive expression. In late stages, the difference was also significant (χ(2)=6.246, P=0.019), with a 35.5% reduction in 3-year survival. It is suggested that RASSF2 plays an important role in the evolution of gastric adenocarcinoma and should be considered as a potential marker for its prognosis.

  1. Epigenetic regulation of GATA4 expression by histone modification in AFP-producing gastric adenocarcinoma.

    Science.gov (United States)

    Yamamura, Nobuhisa; Kishimoto, Takashi

    2012-08-01

    AFP-producing adenocarcinoma is a variant of adenocarcinoma with high malignancy. Production of AFP suggests enteroblastic or hepatoid differentiation of cancer cells. GATA4 is a key molecule involved in the prenatal development of the stomach and liver. GATA4 is epigenetically silenced by hypermethylation of primer region in many types of cancers including gastric cancer. The aim of this study is to investigate the expression and epigenetic regulation of GATA4 in AFP-producing adenocarcinoma. Immunohistochemical analysis revealed that GATA4 was positive in 3/8 cases of AFP-producing gastric adenocarcinomas and in 28/30 cases of common type adenocarcinomas. Epigenetic modification of GATA4 promoter region was investigated with 3 AFP-producing and 4 common-type gastric cancer cell lines. GATA4 mRNA was detected in 1/3 of AFP-producing and 2/4 of common-type gastric cancer cell lines by RT-PCR. Methylation-specific PCR revealed no GATA4 methylation in any of the AFP-producing gastric cancers, whereas methylation was consistent with GATA4 expression in the common-type gastric cancers. Chromatin immunoprecipitation assay for AFP-producing gastric cancers revealed that histones H3 and H4 were hypoacetylated in the GATA4-negative cells, while they were hyperacetylated in the GATA4-positive cells. Treatment with trichostain A, an inhibitor for histone deacetylase, induced acetylation of histones H3 and H4, and tri-methylation of lysine 4 of histone H3, which was associated with the active transcription of GATA4 in GATA4-negative AFP-producing cells. These results indicated that histone deacetylation is a silencing mechanism for GATA4 expression in AFP-producing gastric cancer cells. Differences between AFP-producing gastric cancer and common-type gastric cancer in terms of the mechanism of GATA4 regulation may be reflected in the phenotypic deviation of AFP-producing gastric cancer from common-type gastric cancer.

  2. [Esophageal adenoma-carcinoma and Barrett's esophagus. Gastric adenocarcinoma and Helicobacter pylori].

    Science.gov (United States)

    Andreu Garcia, Montserrat

    2008-10-01

    In the last two decades, the incidence of esophageal cancer has progressively increased, especially that of adenocarcinomas localized in the esophagogastric junction. The incidence of gastric cancer has decreased in the last few decades, although this decrease shows wide geographical variations. Thus, the prevalence of gastric cancer continues to be high in countries such as Chile, Colombia and Ireland and this disease remains the most frequent neoplasm in both sexes in China and Japan. In the meeting of the American Gastroenterological Association, notable among all the studies presented on the prevention and treatment of esophageal and gastric cancer were the following contributions: the use of clinical practice guidelines for the prevention and surveillance of Barrett's esophagus (BE) should be improved; treatment with proton pump inhibitors does not seem to reduce the risk of esophageal cancer; endoscopic therapy of intramucosal cancer through complete mucosal resection is effective; Helicobacter pylori eradication prevents the development of metachronous gastric cancer in patients treated for a first intramucosal adenocarcinoma through endoscopic resection; the risk of developing gastric cancer is 6 times higher in patients with mucosa-associated lymphoid tissue (MALT) lymphoma than in the general population; and photodynamic therapy may be an alternative for the treatment of "invisible" gastric adenocarcinoma, which should be followed-up endoscopically.

  3. Etiologic factors of gastric cardiac adenocarcinoma among men in Taiwan

    Institute of Scientific and Technical Information of China (English)

    Mei-Ju Chen; Deng-Chyang Wu; Jia-Ming Lin; Ming-Tsang Wu; Fung-Chang Sung

    2009-01-01

    AIM: To elucidate etiologic associations between Helicobacter pylori ( H pylori), lifestyle, environmental factors and gastric cardiac adenocarcinoma (GCA) among men.METHODS: A hospital-based case-control study was conducted in Taiwan from 2000 to 2009.All cases were newly confirmed as primary GCA.Five controls were selected matching with age, sex, and admission date to each case.Participants were informed of potential risk factors with a structured questionnaire by trained interviewers during hospitalization and provided a blood sample for the determination of H pylori infection.Odds ratio (OR) and 95% confidence interval (95% CI) were used to evaluate risk, and a multivariate conditional logistic regression model was performed.RESULTS: All participants recruited for this study were men, consisting of 41 cases and 205 controls.Results of the univariate analysis showed that significant factors associated with the etiology of GCA included H pylori (OR = 2.69, 95% CI = 1.30-5.53), cigarette smoking (OR = 2.28, 95% CI = 1.05-4.96), working or exercising after meals (OR = 3.26, 95% CI = 1.31-8.11), salted food (OR = 2.51, 95%CI = 1.08-6.11), fresh vegetables (OR = 0.28, 95% CI = 0.09-0.80), fruits (OR = 0.19, 95% CI = 0.04-0.89), and rice as principal food (OR = 0.53, 95% CI = 0.30-0.85).Multivariate conditional logistic regression models indicated that a significantly elevated risk of contracting GCA was associated with working or exercising after meals (OR = 3.18, 95% CI = 1.23-9.36) and H pylori infection (OR = 2.93, 95% CI = 1.42-6.01).In contrast, the consumption of fresh vegetables (OR = 0.22, 95% CI = 0.06-0.83), fruits (OR = 0.28, 95% CI = 0.09-0.79) and rice as principal food (OR = 0.48, 95% CI = 0.24-0.93) remained as significant beneficial factor associated with GCA.CONCLUSION: Working or exercising after meals and H pylori infection increase the risk of GCA, but higher intakes of rice, fresh vegetables and fruits reduce the risk.

  4. Effect of body mass index on adenocarcinoma of gastric cardia

    Institute of Scientific and Technical Information of China (English)

    Ji Zhang; Xiang-Qian Su; Xiao-Jiang Wu; Ya-Hang Liu; Hua Wang; Xiang-Nong Zong; Yi Wang; Jia-Fu Ji

    2003-01-01

    AIM: Obesity has been proved as one of the main risk factors for gastric cardia adenocarcinoma (GCA) in the West.The objective of our research was to evaluate the relationship between obesity and the risk of GCA in people from North China.METHODS: A total of 300 patients who had been diagnosed as GCA and had accepted surgical operation at Beijing Cancer Hospital from 1995 to 2002 were enrolled. Data were collected from pathology materials and hospital records. Two hundred and fifty-eight healthy people who had accepted health examination at the same hospital during the same period were enrolled as controls. Height, weight and gender of them at the time of examination were also collected.Obesity was estimated by body mass index (BMI), computed as weight in kilograms per square surface area (Kg/m2).The degree of obesity was determined by using BMI≤ 18.5,24-27.9 and ≥28 (Kg/m2) as the cut-off points for underweight/normal, overweight and obesity, respectively.Associations with obesity were estimated by odds ratios (ORs) and 95 % confidence intervals (CIs). All ORs were adjusted for age and sex.RESULTS: The mean level of BMI was significantly lower in the patient group than that in the control group. The ORs for obesity in age groups 30-59 and 60-79 were 1.15 (95 %CI=0.37-3.65) and 0.16 (95 % CI=0.05-0.44) for males and 0.78 (95 % CI=0.26-2.36) and 0.28 (95 % CI=0.04-2.05)for females, respectively. The ORs for underweight were 2.42 (95 % CI=0.56-10.53) and 4.68 (95 % CI=1.13-19.40)for males in age subgroups 30-59 and 60-79 and 40.7 (95 %CI=9.32-177.92) for females older than 60 yrs. BMI was significantly associated with GCA (P<0.01). Underweight people were at high risk for GCA.CONCLUSION: BMI is an independent risk factor for GCA.Underweight is positively associated with GCA.

  5. Intratumoral Expression of IL-17 and Its Prognostic Role in Gastric Adenocarcinoma Patients

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    Ju-gao Chen, Jian-chuan Xia, Xiao-ting Liang, Ke Pan, Wei Wang, Lin Lv, Jing-jing Zhao, Qi-jing Wang, Yong-qiang Li, Shi-ping Chen, Jia He, Li-xi Huang, Miao-la Ke, Yi-bing Chen, Hai-qing Ma, Zhen-wu Zeng, Zhi-wei Zhou, Alfred E Chang, Qiao Li

    2011-01-01

    Full Text Available In this study, we characterized the intratumoral expression of IL-17 and CD8+ TILs in gastric adenocarcinoma patients after resection and determined the correlation between the survival probability of gastric adenocarcinoma patients and the expression of IL-17 in tumor. Expression of IL-17 and CD8 was assessed by immunohistochemistry, and the prognostic effects of intratumoral IL-17 expression and CD8+ TILs were evaluated by Cox regression and Kaplan-Meier analysis. Immunohistochemical detection revealed the presence of IL-17 and CD8+ cells in gastric adenocarcinoma tissue samples (90.6%, 174 out of 192 patients and 96.9%, 186 out of 192 patients, respectively. We have also found that intratumoral IL-17 expression was significantly correlated with age (p=0.004 and that the number of CD8+ TILs was significantly correlated with UICC staging (p=0.012 and the depth of tumor invasion (p=0.022. The five-year overall survival probability among patients intratumorally expressing higher levels of IL-17 was significantly better than those expressing lower levels of IL-17 (p=0.036. Multivariate Cox proportional hazard analyses revealed that intratumoral IL-17 expression (HR: 0.521; 95% CI: 0.329-0.823; p=0.005 was an independent factor affecting the five-year overall survival probability. We conclude that low levels of intratumoral IL-17 expression may indicate poor prognosis in gastric adenocarcinoma patients.

  6. Differentiating gastrointestinal stromal tumors from gastric adenocarcinomas and normal mucosae using confocal Raman microspectroscopy

    Science.gov (United States)

    Hsu, Chih-Wei; Huang, Chia-Chi; Sheu, Jeng-Horng; Lin, Chia-Wen; Lin, Lien-Fu; Jin, Jong-Shiaw; Chen, Wenlung

    2016-07-01

    Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract, and gastric adenocarcinomas are a common cancer worldwide. To differentiate GISTs from adenocarcinomas is important because the surgical processes for both are different; the former excises the tumor with negative margins, while the latter requires radical gastrectomy with lymph node dissection. Endoscopy with biopsy is used to distinguish GISTs from adenocarcinomas; however, it may cause tumor bleeding in GISTs. We reported here the confocal Raman microspectroscopy as an effective tool to differentiate GISTs, adenocarcinomas, and normal mucosae. Of 119 patients enrolled in this study, 102 patients underwent gastrectomy (40 GISTs and 62 adenocarcinomas), and 17 patients with benign lesions were obtained as normal mucosae. Raman signals were integrated for 100 s for each spot on the specimen, and 5 to 10 spots, depending on the sample size, were chosen for each specimen. There were significant differences among those tissues as evidenced by different Raman signal responding to phospholipids and protein structures. The spectral data were further processed and analyzed by using principal component analysis. A two-dimensional plot demonstrated that GISTs, adenocarcinomas, and normal gastric mucosae could be effectively differentiated from each other.

  7. CT differentiation of poorly-differentiated gastric neuroendocrine tumours from well-differentiated neuroendocrine tumours and gastric adenocarcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seong Ho; Kim, Se Hyung; Shin, Cheong-il; Han, Joon Koo; Choi, Byung Ihn [Seoul National University Hospital, Department of Radiology, Jongno-gu, Seoul (Korea, Republic of); Seoul National University Hospital, Institute of Radiation Medicine, Jongno-gu, Seoul (Korea, Republic of); Kim, Min-A [Seoul National University Hospital, Department of Pathology, Jongno-gu, Seoul (Korea, Republic of)

    2015-07-15

    To evaluate the differential CT features of gastric poorly-differentiated neuroendocrine tumours (PD-NETs) from well-differentiated NETs (WD-NETs) and gastric adenocarcinomas (ADCs) and to suggest differential features of hepatic metastases from gastric NETs and ADCs. Our study population was comprised of 36 patients with gastric NETs (18 WD-NETs, 18 PD-NETs) and 38 patients with gastric ADCs who served as our control group. Multiple CT features were assessed to identify significant differential CT findings of PD-NETs from WD-NETs and ADCs. In addition, CT features of hepatic metastases including the metastasis-to-liver ratio were analyzed to differentiate metastatic NETs from ADCs. The presence of metastatic lymph nodes was the sole differentiator of PD-NETs from WD-NETs (P =.001, odds ratio = 56.67), while the presence of intact overlying mucosa with mucosal tenting was the sole significant CT feature differentiating PD-NETs from ADCs (P =.047, odds ratio = 15.3) For hepatic metastases, metastases from NETs were more hyper-attenuated than those from ADCs. The presence of metastatic LNs and intact overlying mucosa with mucosal tenting are useful CT discriminators of PD-NETs from WD-NETs and ADCs, respectively. In addition, a higher metastasis-to-liver ratio may help differentiate hepatic metastases of gastric NETs from those of gastric ADCs with high accuracy. (orig.)

  8. Prognostic significance of tumor budding and single cell invasion in gastric adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Che K

    2017-02-01

    Full Text Available Keying Che,1,* Yang Zhao,2,3,* Xiao Qu,1 Zhaofei Pang,1 Yang Ni,4 Tiehong Zhang,4 Jiajun Du,1,5 Hongchang Shen4 1Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 2Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Collaborative Innovation Center of Cancer Medicine, Fudan University Shanghai Cancer Center, 3Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 4Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 5Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, People’s Republic of China *These authors contributed equally to this work Purpose: Gastric carcinoma (GC is a highly aggressive cancer and one of the leading causes of cancer-related deaths worldwide. Histopathological evaluation pertaining to invasiveness is likely to provide additional information in relation to patient outcome. In this study, we aimed to evaluate the prognostic significance of tumor budding and single cell invasion in gastric adenocarcinoma.Materials and methods: Hematoxylin and eosin-stained slides generated from 296 gastric adenocarcinoma patients with full clinical and pathological and follow-up information were systematically reviewed. The patients were grouped on the basis of tumor budding, single cell invasion, large cell invasion, mitotic count, and fibrosis. The association between histopathological parameters, different classification systems, and overall survival (OS was statistically analyzed.Results: Among the 296 cases that were analyzed, high-grade tumor budding was observed in 49.0% (145 of them. Single cell invasion and large cell invasion were observed in 62.8% (186 and 16.9% (50 of the cases, respectively. Following univariate analysis, patients with high-grade tumor budding had shorter OS than those with low-grade tumor budding (hazard ratio [HR]: 2.260, P<0

  9. Association of tooth loss and oral hygiene with risk of gastric adenocarcinoma.

    Science.gov (United States)

    Shakeri, Ramin; Malekzadeh, Reza; Etemadi, Arash; Nasrollahzadeh, Dariush; Abedi-Ardekani, Behnoush; Khoshnia, Masoud; Islami, Farhad; Pourshams, Akram; Pawlita, Michael; Boffetta, Paolo; Dawsey, Sanford M; Kamangar, Farin; Abnet, Christian C

    2013-05-01

    Poor oral health and tooth loss have been proposed as possible risk factors for some chronic diseases, including gastric cancer. However, a small number of studies have tested these associations. We conducted a case-control study in Golestan Province, Iran, that enrolled 309 cases diagnosed with gastric adenocarcinoma (118 noncardia, 161 cardia, and 30 mixed-locations) and 613 sex, age, and neighborhood matched controls. Data on oral health were obtained through physical examination and questionnaire including tooth loss, the number of decayed, missing, and filled teeth, and frequency of tooth brushing. ORs and 95% confidence intervals (95% CI) were obtained using conditional logistic regression models adjusted for potential confounders. Standard one degree-of-freedom linear trend test and a multiple degree-of-freedom global test of the effect of adding oral hygiene variables to the model were also calculated. Our results showed apparent associations between tooth loss and decayed, missing, filled teeth (DMFT) score with risk of gastric cancer, overall and at each anatomic subsite. However, these associations were not monotonic and were strongly confounded by age. The results also showed that subjects who brushed their teeth less than daily were at significantly higher risk for gastric cardia adenocarcinoma ORs (95% CI) of 5.6 (1.6-19.3). We found evidence for an association between oral health and gastric cancer, but the nonmonotonic association, the relatively strong effect of confounder adjustment, and inconsistent results across studies must temper the strength of any conclusions.

  10. Concomitant gastric adenocarcinoma and stromal tumor in a woman with polymyalgia rheumatica

    Institute of Scientific and Technical Information of China (English)

    Panteleimon Kountourakis; Niki Arnogiannaki; Ilias Stavrinides; Nikiforos Apostolikas; Gerasimos Rigatos

    2008-01-01

    Gastrointestinal stromal tumors (GISTs) are rare neoplasms (1%) of the gastrointestinal tract and to our knowledge only rare cases of synchronous presentation of gastric carcinomas and GISTs are reported in the literature.A 72-year-old female with a simultaneous presentation of gastric adenocarcinoma and GIST is presented.Moreover,due to polymyalgia rheumatica the patient received corticosteroids as treatment for the last 3 years.The concomitant occurrence of these neoplasms may involve common carcinogenic factors and there could be an association with polymyalgia rheumatica either as a paraneoplastic presentation or due to its treatment with corticosteroids.

  11. NR4A2 is regulated by gastrin and influences cellular responses of gastric adenocarcinoma cells.

    Directory of Open Access Journals (Sweden)

    Kristine Misund

    Full Text Available The peptide hormone gastrin is known to play a role in differentiation, growth and apoptosis of cells in the gastric mucosa. In this study we demonstrate that gastrin induces Nuclear Receptor 4A2 (NR4A2 expression in the adenocarcinoma cell lines AR42J and AGS-GR, which both possess the gastrin/CCK2 receptor. In vivo, NR4A2 is strongly expressed in the gastrin responsive neuroendocrine ECL cells in normal mucosa, whereas gastric adenocarcinoma tissue reveals a more diffuse and variable expression in tumor cells. We show that NR4A2 is a primary early transient gastrin induced gene in adenocarcinoma cell lines, and that NR4A2 expression is negatively regulated by inducible cAMP early repressor (ICER and zinc finger protein 36, C3H1 type-like 1 (Zfp36l1, suggesting that these gastrin regulated proteins exert a negative feedback control of NR4A2 activated responses. FRAP analyses indicate that gastrin also modifies the nucleus-cytosol shuttling of NR4A2, with more NR4A2 localized to cytoplasm upon gastrin treatment. Knock-down experiments with siRNA targeting NR4A2 increase migration of gastrin treated adenocarcinoma AGS-GR cells, while ectopically expressed NR4A2 increases apoptosis and hampers gastrin induced invasion, indicating a tumor suppressor function of NR4A2. Collectively, our results uncover a role of NR4A2 in gastric adenocarcinoma cells, and suggest that both the level and the localization of NR4A2 protein are of importance regarding the cellular responses of these cells.

  12. Esophagogastric junction and gastric adenocarcinoma: neoadjuvant and adjuvant therapy, and future directions.

    Science.gov (United States)

    Sandler, Steven

    2014-06-01

    In North America, gastric cancer is the third most common gastrointestinal malignancy and the third most lethal neoplasm overall. In Asia, gastric cancer represents an even more serious problem: in Japan, it is the most common cancer in men. The standard primary therapy for gastric cancer is surgical resection; in esophagogastric-junction (EGJ) adenocarcinoma, which is often included in studies of gastric cancer, surgery is also typically the initial management strategy. However, the rates of locoregional and distant recurrence following surgery with curative intent have remained high. Investigators have explored a variety of ways of reducing these rates and improving survival in patients with gastric and EGJ cancers. These strategies have included explorations of the optimal extent of regional lymphadenectomy at the time of gastric resection; investigation of different neoadjuvant, perioperative, and adjuvant chemotherapy regimens; use of preoperative and postoperative radiation therapy; and the use of pre- and postoperative chemoradiotherapy (CRT).To date, benefit has been seen in gastric cancer patients with the use of what is called a"D2 resection"(which includes lymph nodes of stations 7 through 12) and with adjuvant CRT (in the West) or adjuvant chemotherapy with S-1 (in Japan); and neoadjuvant CRT has been shown to have a survival benefit in patients with EGJ cancers.

  13. Cryptolepine, isolated from Sida acuta, sensitizes human gastric adenocarcinoma cells to TRAIL-induced apoptosis.

    Science.gov (United States)

    Ahmed, Firoj; Toume, Kazufumi; Ohtsuki, Takashi; Rahman, Mahmudur; Sadhu, Samir Kumar; Ishibashi, Masami

    2011-01-01

    Bioassay guided separation of Sida acuta whole plants led to the isolation of an alkaloid, cryptolepine (1), along with two kaempferol glycosides (2-3). Compound 1 showed strong activity in overcoming TRAIL-resistance in human gastric adenocarcinoma (AGS) cells at 1.25, 2.5 and 5 μm. Combined treatment of 1 and TRAIL sensitized AGS cells to TRAIL-induced apoptosis at the aforementioned concentrations.

  14. Depression and oxidative damage in TNM stage Ⅲ patients with poorly differentiated gastric adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Objective To investigate the association between psychological stress and oxidative damage in TNM stage Ⅲ patients with poorly differentiated gastric adenocarcinoma (GA). Methods One hundred and six patients with newly diagnosed poorly differentiated GA were assessed using the Hamilton Depression Rating Scale (HAMD), Zung Self-rating Depression Scale (SDS), Zung Self-rating Anxiety Scale (SAS), Symptom Checklist 90 (SCL-90), activities of daily living (ADL) and other multiple-item questionnaires. Oxidative-...

  15. "Big IGF-II"-induced hypoglycemia secondary to gastric adenocarcinoma.

    Science.gov (United States)

    Morbois-Trabut, L; Maillot, F; De Widerspach-Thor, A; Lamisse, F; Couet, C

    2004-06-01

    Non-islet cell tumor-related hypoglycemia is a rare phenomenon. We report the case of a 63 Year-old man admitted for hemiparesia and a capillary blood glucose of 20 mg/dL. The presence of an immature form of IGF-II that can mimic the effect of insulin, namely "big IGF-II", explained this patient's hypoglycaemia. A moderately differentiated adenocarcinoma of the cardia with metastatic extension to the stomach and the liver was demonstrated. Octreotide failed to control the hypoglycaemia, therefore prednisolone (2 mg/kg per day) and enteral feeding prevented new episodes of severe hypoglycaemia.

  16. Expression of Anion Exchanger 1 Sequestrates p16 in the Cytoplasm in Gastric, Colonic Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Wei-Wei Shen

    2007-10-01

    Full Text Available p16INK4A (p16 binds to cyclin-dependent kinase 4/6, negatively regulates cell growth. Recent studies have led to an understanding of additional biologic functions for p16; however, the detailed mechanisms involved are still elusive. In this article, we show an unexpected expression of anion exchanger 1 (AEi in the cytoplasm in poorly, moderately differentiated gastric, colonic adenocarcinoma cells, in its interaction with p16, thereby sequestrating the protein in the cytoplasm. Genetic alterations of p16, AEi were not detectable. Forced expression of AEi in these cells sequestrated more p16 in the cytoplasm, whereas small interfering RNA-mediated silencing of AEi in the cells induced the release of p16 from the cytoplasm to the nucleus, leading to cell death, growth inhibition of tumor cells. By analyzing tissue samples obtained from patients with gastric, colonic cancers, we found that 83.33% of gastric cancers, 56.52% of colonic cancers coexpressed AEi, p16 in the cytoplasm. We conclude that AEi plays a crucial role in the pathogenesis of gastric, colonic adenocarcinoma, that p16 dysfunction is a novel pathway of carcinogenesis.

  17. Association of tumor necrosis factor genetic polymorphism with chronic atrophic gastritis and gastric adenocarcinoma in Chinese Han population

    Institute of Scientific and Technical Information of China (English)

    Bao-Ying Fei; Bing Xia; Chang-Sheng Deng; Xiao-Qing Xia; Min Xie; J Bart A Crusius; A Salvador Pena

    2004-01-01

    AIM: To investigate the association of TNF polymorphisms with chronic atrophic gastritis (CAG) and gastric adenocarcinoma in Chinese Han patients.METHODS: The TNFa-e 5 microsatellites and 3 RFLP sites were typed using PCR technique, followed by high-voltage denaturing PAGE with silver staining and restriction enzyme digestion respectively in specimens from 53 patients with CAG and 56 patients with gastric adenocarcinoma and 164 healthy controls. The PCR products were cloned and sequenced.RESULTS: The frequency of TNF-β Ncol*1/2 genotype was higher in patients with chronic atrophic gastritis than in healthy controls, but no significant difference was observed (60.38% vs 46.34%, P=0.076). The frequency of TNa10 allele was significantly higher in patients with chronic atrophic gastritis than in healthy controls (19.81% vs 11.89%,P=0.04). However, it did not relate to age, gender, atrophic degree or intestinal metaplasia in patients with chronic atrophic gastritis. The frequency of TNF-β Ncol*1/2 and d2/d6 genotypes were significantly higher in patients with gastric adenocarcinoma than in healthy individuals(P>0.05).However, TNF-β Ncol*1/2 and d2/d6 genotypes did not relate to age, gender, grade of differentiation and clinicopathologic stage in patients with gastric adenocarcinoma. The frequency of TNFa6b5c1 haplotype homozygote was significantly lower in patients with gastric adenocarcinoma than in healthy controls (1.79% vs15.85%, P=0.006).CONCLUSION: TNFa10 allele may be a risk factor for chronic atrophic gastritis. TNF-β Ncol*1/2 and d2/d6 genotypes are associated with the susceptibility to gastric adenocarcinoma,whereas TNFa6b5c1 haplotype homozygote may contribute to the resistance against gastric adenocarcinoma.

  18. CLONING AND IDENTIFICATION OF A GENE RELATED TO THE DIFFERENTIATION OF HUMAN GASTRIC ADENOCARCINOMA CELLS

    Institute of Scientific and Technical Information of China (English)

    王建华; 陈诗书

    2002-01-01

    Objective: To compare the differential expression of mRNA between MKN-28 (highly differentiated) and MKN-45 (poorly differentiated) gastric adenocarcinoma cells and identify genes involved in human gastric adenocarcinoma differentiation. Methods: Differential expression of mRNA between MKN-28 and MKN-45 adenocarcinoma cells was investigated by fluorescent differential display (FDD). Differentially expressed cDNA was analyzed by bio-informatics and confirmed by RT-PCR and Northern-blot. Results: 45 differential fragments were finally attained. One of them (No. 10) was an approximate 750 bp cDNA and highly up-regulated in MKN-45 cells as compared with MKN-28 cells. By using Blastn and UniGene database analysis, we found the fragment was mapped to chromosome 14q11.2(q12 and showed a significant homology to Bcl-2 binding protein gene (BNip3), which was recently identified encoding pro-apoptosis protein located in mitochondrial. Conclusion: The BNip3 induced apoptosis could be suppressed by interacting with bcl-2. The BNip3 gene in tumor cells might be up-regulated by the hypoxia response element through the HIF1a transcription factor, causing death of the hypoxic cells at the center of the tumor where vascularization is usually poor in the process of tumor development.

  19. High prevalence of osteoporosis in patients with gastric adenocarcinoma following gastrectomy

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To evaluate the prevalence and predictive factors of osteoporosis in patients with gastric adenocarcinoma after gastrectomy.METHODS: The study included 133 patients diagnosed with gastric adenocarcinoma but who did not undergo prior diagnostic work-up for osteoporosis. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA) and vertebral deformity was assessed by plain X-rays. We evaluated the effects of age, sex, body mass index (BMI), anemia, back pain,vertebral deformity, tumor staging, reconstruction type,and past medical history to determine predictive factors of osteoporosis in these patients.RESULTS: The prevalence of osteoporosis in the lumbar spine was 38.3% (male, 28.9%; female, 54.0%), and 15.0% in the femoral neck (male, 10.8%; female,22.0%). The vertebral deformity rate was 46.6% (male,43.4%; female, 52.0%). Age, BMI and hemoglobin correlated with BMD (P < 0.01). In males, anemia and age > 64 years were independent predictive factors of osteoporosis in multivariate analysis. In females, back pain was an independent factor for osteoporosis.CONCLUSION: The results of this study revealed that prevalence of osteoporosis and vertebral bone deformity rate were high in gastric cancer patients, regardless of post-gastrectomy duration and operation type. Early diagnosis and a proper management plan must be established in these patients.

  20. Adjuvant chemo-radiation for gastric adenocarcinoma: an institutional experience

    Directory of Open Access Journals (Sweden)

    Ghosn Marwan G

    2010-06-01

    Full Text Available Abstract Background Studies have shown that surgery alone is less than satisfactory in the management of early gastric cancer, with cure rates approaching 40%. The role of adjuvant therapy was indefinite until three large, randomized controlled trials showed the survival benefit of adjuvant therapy over surgery alone. Chemoradiation therapy has been criticized for its high toxicity. Methods 24 patients diagnosed between September 2001 and July 2007 were treated with adjuvant chemoradiation. 18 patients had the classical MacDonald regimen of 4500 cGy of XRT and chemotherapy with 5-fluorouracil (5FU and leucovorin, while chemotherapy consisted of 5FU/Cisplatin for 6 patients. Results This series consisted of non-metastatic patients, 17 females and 7 males with a median age of 62.5 years. 23 patients (96% had a performance status of 0 or 1. The full course of radiation therapy (4500 cGy was completed by 22 patients (91.7%. Only 7 patients (36.8% completed the total planned courses of chemotherapy. 2 local relapses (10%, 2 regional relapses (10% and 2 distant relapses (10% were recorded. Time to progression has not been reached. 9 patients (37.5% died during follow-up with a median overall survival of 75 months. Patients lost a mean of 4 Kgs during radiation therapy. We recorded 6 episodes of febrile neutropenia and the most frequent toxicity was gastro-intestinal in 17 patients (70.8% with 9 (36% patients suffering grade 3 or 4 toxicity and 5 patients (20% suffering from grade 3 or 4 neutropenia. 4 (17% patients required total parenteral nutrition for a mean duration of 20 days. 4 patients suffered septic shock (17% and 1 patient developed a deep venous thrombosis and a pulmonary embolus. Conclusions Adjuvant chemo-radiation for gastric cancer is a standard at our institution and has resulted in few relapses and an interesting median survival. Toxicity rates were serious and this remains a harsh regimen with only 36.8% of patients completing the

  1. Intensity-Modulated Radiation Therapy With Concurrent Chemotherapy as Preoperative Treatment for Localized Gastric Adenocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Chakravarty, Twisha; Crane, Christopher H. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Ajani, Jaffer A. [Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Mansfield, Paul F. [Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Briere, Tina M.; Beddar, A. Sam [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Mok, Henry; Reed, Valerie K.; Krishnan, Sunil; Delclos, Marc E. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Das, Prajnan, E-mail: PrajDas@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States)

    2012-06-01

    Purpose: The goal of this study was to evaluate dosimetric parameters, acute toxicity, pathologic response, and local control in patients treated with preoperative intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy for localized gastric adenocarcinoma. Methods: Between November 2007 and April 2010, 25 patients with localized gastric adenocarcinoma were treated with induction chemotherapy, followed by preoperative IMRT and concurrent chemotherapy and, finally, surgical resection. The median radiation therapy dose was 45 Gy. Concurrent chemotherapy was 5-fluorouracil and oxaliplatin in 18 patients, capecitabine in 3, and other regimens in 4. Subsequently, resection was performed with total gastrectomy in 13 patients, subtotal gastrectomy in 7, and other surgeries in 5. Results: Target coverage, expressed as the ratio of the minimum dose received by 99% of the planning target volume to the prescribed dose, was a median of 0.97 (range, 0.92-1.01). The median V{sub 30} (percentage of volume receiving at least 30 Gy) for the liver was 26%; the median V{sub 20} (percentage of volume receiving at least 20 Gy) for the right and left kidneys was 14% and 24%, respectively; and the median V{sub 40} (percentage of volume receiving at least 40 Gy) for the heart was 18%. Grade 3 acute toxicity developed in 14 patients (56%), including dehydration in 10, nausea in 8, and anorexia in 5. Grade 4 acute toxicity did not develop in any patient. There were no significant differences in the rates of acute toxicity, hospitalization, or feeding tube use in comparison to those in a group of 50 patients treated with preoperative three-dimensional conformal radiation therapy with concurrent chemotherapy. R0 resection was obtained in 20 patients (80%), and pathologic complete response occurred in 5 (20%). Conclusions: Preoperative IMRT for gastric adenocarcinoma was well tolerated, accomplished excellent target coverage and normal structure sparing, and led to appropriate

  2. Gastric adenocarcinoma in common variable immunodeficiency: features of cancer and associated gastritis may be characteristic of the condition.

    Science.gov (United States)

    De Petris, Giovanni; Dhungel, Bal M; Chen, Longwen; Chang, Yu-Hui H

    2014-10-01

    Common variable immunodeficiency (CVID) is associated with an increased risk of gastric cancer. The aim of the study was to determine the morphological features of CVID-associated gastric adenocarcinoma (CAGA) and of the background gastritis. The population of gastric cancer patients with CVID of Mayo Clinic in the period 2000-2010 was studied; 6 cases of CVID (2 males, 4 females, average age 47 years, age range 26-71 years) were found in 5793 patients with gastric cancer in the study period. Each patient underwent gastric resection for which histology slides were reviewed. Chronic gastritis variables, CVID-related findings, and features of the adenocarcinoma were recorded. CAGA was of intestinal type, with high number of intratumoral lymphocytes (ITLs). Cancer was diagnosed in younger patients than in the overall population of gastric cancer. Severe atrophic metaplastic pangastritis with extensive dysplasia was present in the background in 4 cases, with features of lymphocytic gastritis in 2 cases. Features of CVID (plasma cells paucity in 4 of 6 cases, lymphoid nodules prominent in four cases) could be detected. In summary, gastric adenocarcinoma at young age with ITLs, accompanied by atrophic metaplastic pangastritis, should alert the pathologist of the possibility of CAGA. It follows that, in presence of those characteristics, the search of CVID-associated abnormalities should be undertaken in the nonneoplastic tissues.

  3. Breast metastasis from gastric adenocarcinoma mimicking normal breast parenchyma on ultrasound: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Hyun; Lee, Jin Hwa; Park, Min Kyung; Kim, Dae Cheol; Lee, Mi Ri; Cho, Se Heon [Dong A University Hospital, Busan (Korea, Republic of); Park, Young Mi [Dept. of Radiology, Inje University Busan Paik Hospital, Busan (Korea, Republic of)

    2015-12-15

    Breast metastases from extramammary malignancies are uncommon. Although metastatic lesions show variable radiologic features, there have been few reports of metastatic breast cancer with negative sonographic findings. Furthermore, the results of several studies have indicated a high negative predictive value when ultrasonographic and mammographic findings were normal in the setting of a palpable lump, and follow-up is recommended when the physical examination is not highly suspicious. Herein, we report a case of a 26-year-old woman with breast metastasis from a known gastric adenocarcinoma, which had negative findings without any evidence of suspicious features for malignancy on the initial mammogram and ultrasound.

  4. THE PRESENCE OF METASTASES IN REGIONAL LYMPH NODES IS ASSOCIATED WITH TUMOR SIZE AND DEPTH OF INVASION IN SPORADIC GASTRIC ADENOCARCINOMA

    Science.gov (United States)

    CAMBRUZZI, Eduardo; de AZEREDO, Andreza Mariane; KRONHART, Ardala; FOLTZ, Katia Martins; ZETTLER, Cláudio Galeano; PÊGAS, Karla Lais

    2014-01-01

    Background Gastric adenocarcinoma is more often found in men over 50 years in the form of an antral lesion. The tumor has heterogeneous histopathologic features and a poor prognosis (median survival of 15% in five years). Aim To estimate the relationship between the presence of nodal metastasis and other prognostic factors in sporadic gastric adenocarcinoma. Method Were evaluated 164 consecutive cases of gastric adenocarcinoma previously undergone gastrectomy (partial or total), without clinical evidence of distant metastasis, and determined the following variables: topography of the lesion, tumor size, Borrmann macroscopic configuration, histological grade, early or advanced lesions, Lauren histological subtype, presence of signet ring cell, degree of invasion, perigastric lymph node status, angiolymphatic/perineural invasion, and staging. Results Were found 21 early lesions (12.8%) and 143 advanced lesions (87.2%), with a predominance of lesions classified as T3 (n=99/60, 4%) and N1 (n=62/37, 8%). The nodal status was associated with depth of invasion (p<0.001) and tumor size (p<0.001). The staging was related to age (p=0.048), histological grade (p=0.003), and presence of signet ring cells (p = 0.007), angiolymphatic invasion (p = 0.001), and perineural invasion (p=0.003). Conclusion In gastric cancer, lymph node involvement, tumor size and depth of invasion are histopathological data associated with the pattern of growth/tumor spread, suggesting that a wide dissection of perigastric lymph nodes is a fundamental step in the surgical treatment of these patients. PMID:24676292

  5. Characterization of gastrins and their receptor in solid human gastric adenocarcinomas

    DEFF Research Database (Denmark)

    Goetze, Jens Peter; Eiland, Signe; Svendsen, Lars Bo;

    2013-01-01

    OBJECTIVE: The gastrin and the gastrin/CCK-B receptor genes are co-expressed in several carcinomas. The primary translational product, progastrin, however, is processed to several peptides of which only those that are α-amidated at their C-terminus are receptor ligands. So far, characterization...... of the progastrin-derived peptides in gastric cancer has not been reported. The authors therefore examined the molecular nature of gastrin and its receptor in human gastric carcinomas. MATERIALS AND METHODS: Twenty patients with adenocarcinoma underwent partial or total gastrectomy. In samples from each carcinoma...... blotting. RESULTS: α-Amidated gastrins were detectable in 16 of 20 carcinomas (median concentration 2.1 pmol/g tissue; range 0-386 pmol/g tissue). The tissue concentrations correlated closely to the gastrin mRNA contents (r = 0.75, p amidated processing intermediates...

  6. Carcinomatous meningitis due to gastric adenocarcinoma:A rare presentation of relapse

    Institute of Scientific and Technical Information of China (English)

    Nibal; Saad; Ahmad; Alsibai; Tarik; H; Hadid

    2014-01-01

    While solid tumors are less commonly associated with meningeal involvement; lung, breast and melanoma are the ones most often reported. A few case reports have included gastric carcinoma but these are rare and most often associated with systemic disease at the time of diagnosis. Here we report a unique presentation of gastric carcinoma relapse with leptomeningeal carcinomatosis. An 81-year-old female was diagnosed with gastric cancer approximately one year before presentation. Following neoadjuvant chemotherapy, she had gastrectomy. Her periodic surveillance was stable. Thereafter she presented with a one week history of progressive fatigue lightheadedness, syncope. During hospitalization her mental status deteriorated. A repeat computed axial tomography scan of the head showed no changes to suggest an etiology. A lumbar puncture was performed and cerebral spinal fluid(CSF) cytopathology confirmed gastric signet cell adenocarcinoma. Encephalopathy was likely caused by increased intracranial pressure from communicating hydrocephalus.Leptomeningeal carcinomatosis is associated with short life expectancy. Therapeutic lumbar punctures and best supportive care or systemic therapy can be applied with guarded prognosis. Survival, however, may improve with cytologic negative conversion of the CSF if patient performance status allows treatment.

  7. Gastric Composite Tumor of Alpha Fetoprotein-Producing Carcinoma/Hepatoid Adenocarcinoma and Endocrine Carcinoma with Reference to Cellular Phenotypes

    Directory of Open Access Journals (Sweden)

    Akira Suzuki

    2012-01-01

    Full Text Available Alpha-fetoprotein-producing carcinoma (AFPC/hepatoid adenocarcinoma (HAC and neuroendocrine carcinoma (NEC are uncommon in the stomach. Composite tumors consisting of these carcinomas and their histologic phenotypes are not well known. Between 2002 and 2007, to estimate the prevalence of composite tumors consisting of tubular adenocarcinoma, AFPC/HAC and NEC, we reviewed specimens obtained from 294 consecutive patients treated surgically for gastric cancer. We examined histological phenotype of tumors of AFPC or NEC containing the composite tumor by evaluating immunohistochemical expressions of MUC2, MUC5AC, MUC6, CDX2, and SOX2. Immunohistochemically, AFPC/HAC dominantly showed the intestinal or mixed phenotype, and NEC frequently showed the gastric phenotype. In the composite tumor, the tubular and hepatoid components showed the gastric phenotype, and the neuroendocrine component showed the mixed type. The unique composite tumor predominantly showed the gastric phenotype, and the hepatoid and neuroendocrine components were considered to be differentiated from the tubular component.

  8. Adenocarcinoma of the cervical esophagus arising in heterotopic gastric mucosa: exclusive chemoradiotherapy following a mucosal resection

    Energy Technology Data Exchange (ETDEWEB)

    Jestin-Letallec, V.; Muller, M.; Metges, J.P.; Bouchekoua, M.; Albarghach, N.; Pradier, O. [Departement de Cancerologie, 29 - Brest (France)

    2007-11-15

    Esophagus adenocarcinomas developing within heterotopic gastric mucosa are very rare and described to be found endoscopically in a prevalence of .29%. We report a case of cervical adenocarcinoma arising in ectopic gastric mucosa in a fifty-four year old man. The patient underwent a mucosal resection followed with exclusive chemoradiotherapy because of infiltration of the sub mucosa layer. A radiotherapy dose of 60 Gy ( 2 Gy/Fr, 30 Fr) was realized with a reduction of the fields at 50 Gy associated with a continuous 5FU-cisplatin combination after eliminating known mutation in the dihydro-pyrimidine of the dehydrogenase gene. for this tumor, surgery is the main treatment, (oesophagectomy associated with laryngo-pharyngectomy) and has an important repercussion on the quality of life. Because of the refusal of our patient, after a mucosal resection attempt, we proposed our patient a chemoradiotherapy. For the first time in the literature, we report the results of radio chemotherapy for this rare tumor. Eighteen months after the treatment, the patient is alive without sign of recurrence. The radio chemotherapy could be a safety treatment for this rare tumor associated with a good quality of life. A review of the literature since 1950 will be shown. (authors)

  9. Cancer of the esophagus and gastric cardia: recent advances

    NARCIS (Netherlands)

    Tytgat, G.N.; Bartelink, H.; Bernards, R.A.; Giacone, G.; Lanschot, J.J. van; Offerhaus, G.J.; Peters, G.J.

    2004-01-01

    Esophageal cancer and cancer of the gastric cardia, in particular adenocarcinomas, have shown a rapid and largely unexplained increase in incidence in many developed countries around the world. These diseases have a poor prognosis and current therapies have a modest impact on survival. This review p

  10. Cancer of the esophagus and gastric cardia: recent advances.

    NARCIS (Netherlands)

    Tytgat, GN; Bartelink, H.; Bernards, R; Giaccone, G.; Lanschot, van JJ; Offerhaus, GJ; Peters, G.J.

    2004-01-01

    Esophageal cancer and cancer of the gastric cardia, in particular adenocarcinomas, have shown a rapid and largely unexplained increase in incidence in many developed countries around the world. These diseases have a poor prognosis and current therapies have a modest impact on survival. This review p

  11. Primary adenocarcinomas of lower esophagus, esophagogastric junction and gastric cardia: in special reference to China

    Institute of Scientific and Technical Information of China (English)

    Li-Dong Wang; Shu Zheng; Zuo-Yu Zheng; Alan G. Casson

    2003-01-01

    Gastric cardia adenocarcinoma (GCA) is an under-studied subject. The pathogenesis, molecular changes in the early stage of carcinogenesis and related risk factors have not been well characterized. There is evidence, however, that GCA differs from cancer of the rest of the stomach in terms of natural history and histopathogenesis. Adenocarcinomas of the lower esophagus, esophagogastric junction (EGJ)and gastric cardia have been given much attention because of their increasing incidences in the past decades, which is in striking contrast with the steady decrease in distal stomach adenocarcinoma. In China, epidemiologically, GCA shares very similar geographic distribution with esophageal squamous cell carcinoma (SCC), especially in Linzhou (formerly Linxian County), Henan Province, North China,the highest incidence area of esophageal SCC in the world.Historically, both GCA and SCC in these areas were referred to as esophageal cancer (EC) by the public because of the common syndrome of dysphagia. In Western countries,Barrett's esophagus is very common and has been considered as an important precancerous lesion of adenocarcinoma at EGJ. Because of the low incidence of Barrett's esophagus in China, it is unlikely to be an important factor in early stage of EGJ adenocarcinoma development.However, Z line up-growth into lower esophagus may be one of the characteristic changes in these areas in early stage of GCA development. Whether intestinal metaplasia (IM) is a premalignant lesion for GCA is still not clear. Higher frequency of IM observed at adjacent GCA tissues in Henan suggests the possibility of IM as a precancerous lesion for GCA in these areas. Molecular information on GCA,especially in early stage, is very limited. The accumulated data about the changes of tumor suppressor gene, such as p53 mutation, and ontogeny, such as C-erbB2, especially the similar alterations in GCA and SCC in the same patient,indicated that there might be some similar risk factors,such as

  12. Effects of mifepristone on proliferation of human gastric adenocarcinoma cell line SGC-7901 in vitro

    Institute of Scientific and Technical Information of China (English)

    Da-Qiang Li; Zhi-Biao Wang; Jin Bai; Jie Zhao; Yuan Wang; Kai Hu; Yong-Hong Du

    2004-01-01

    AIM: To explore the effects of mifepristone, a progesterone receptor (PR) antagonist, on the proliferation of human gastric adenocarcinoma cell line SGC-7 901 in vitro and the possible mechanisms involved.METHODS: In situ hybridization was used to detect theexpression of PR mRNA in SGC-7 901 cells. After treatment with various concentrations of mifepristone (2.5, 5, 10,20 μmol/L) at various time intervals, the ultrastructural changes, cell proliferation, cell-cycle phase distribution, and the expression of caspase-3 and Bcl-XL were analyzed using transmission electron microscopy (TEM), tetrazolium blue(MTT) assay, 3H-TdR incorporation, flow cytometry, and reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: Mifepristone markedly induced apoptosis and inhibited cell proliferation of PR- positive SGC-7 901 cells revealed by TEM, MTT assay and 3H-TdR incorporation, in a dose- and time-dependent manner. The inhibitory rate was increased from 8.98% to 51.29%. Flow cytometric analysis showed mifepristone dose-dependently decreased cells in S and G2/M phases, increased cells in Go/G1 phase,reduced the proliferative index from 57.75% to 22.83%. In addition, mifepristone up-regulated the expression of caspase-3, and down- regulated the Bcl-XL expression, dose-dependently.CONCLUSION: Mifepristone effectively inhibited the proliferation of PR-positive human gastric adenocarcinoma cell line SGC-7 901 in vitro through multiple mechanisms, and may be a beneficial agent against human adenocarcinoma.

  13. Preoperative growth inhibition of human gastric adenocarcinoma treated with a combination of celecoxib and octreotide

    Institute of Scientific and Technical Information of China (English)

    Mao-tao HUANG; Zhi-xin CHEN; Bing WEI; Bo ZHANG; Chun-hui WANG; Ming-hui HUANG; Rui LIU; Cheng-wei TANG

    2007-01-01

    Aim:To gain insight into the histopathological responses and molecular targets in the inhibition of growth of human gastric cancer treated with celecoxib (a cyclooxygenase [COX]-2 inhibitor) combined with octreotide. Methods:Seventy five patients with gastric cancer undergoing curative gastrectomy or extended resection were randomly divided into 3 groups. The apoptosis of tumor cells was measured by terminal deoxynucleotide transferase-mediated dUTP nick endlabeling (TUNEL) assay. Gastric cancer microvessel density (MVD) and the expression of COX-2 were evaluated by immunohistochemlcal staining. The expression of somatostatin receptor (SSTR)-2 was detected with the biomolecular interaction analysis system. The transcription of non-steroidal anti-inflammatory drugactivated gene (NAG)-I was measured by RT-PCR. Results:Compared with the control and celecoxib groups,more necrosis in the combination group was observed. The apoptotic rate in the combination group (7.06%±0.67%) was sig nificantly higher than that in the control group (6.23%±1.29%,P<0.05). The MVD decreased considerably in the combination group. The upregulation of NAG-1 was displayed both in the celecoxib and combination groups. The positive rate of SSTR-2 in gastric cancers treated with celecoxib (48%) was significantly higher than that of control group (12%) after surgery (P<0.05). Conclusion:Celecoxib combined with octreotide significantly promoted necrosis in gastric adenocarcinoma through the induction of apoptosis and the reduction of MVD. NAG-1 and SSTR-2 might be the molecular targets for celecoxib or octreotide.

  14. Cutaneous metastasis from signet-ring gastric adenocarcinoma in a carcinoma en cuirasse pattern: An unusual clinical-diagnostic sequence

    Directory of Open Access Journals (Sweden)

    Sarabjit Kaur

    2015-01-01

    Full Text Available Cutaneous metastasis (CM of gastric adenocarcinoma (ADC is rare and usually presents late in the course of the disease. We report a rare case of carcinoma en cuirasse (CEC pattern of CM secondary to gastric malignancy in a 55-year-old male patient-the interesting part being that CM was the first-presenting sign, which on further histopathological and immunohistochemical evaluation led to the diagnosis of hidden gastric carcinoma. The finding of signet ring cells (SRCs on cutaneous biopsy further added a differential of the rare possibility of primary cutaneous tumors.

  15. HER2 Testing in Gastric/Gastroesophageal Junction Adenocarcinomas: Unique Features of a Familiar Test.

    Science.gov (United States)

    Ross, Jeffrey S; Mulcahy, Mary

    2011-03-01

    Using the standard slide-based techniques of immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH), it has been firmly established that human epidermal growth factor receptor 2 (HER2) is overexpressed in adenocarcinoma of the upper gastrointestinal tract. In the ToGA trial, the addition of the monoclonal antibody trastuzumab to a standard regimen of cisplatin and fluoropyrimidine resulted in a clinically and statistically significant benefit in terms of response rate, median progression-free survival, and median overall survival in HER2-positive patients. Major differences exist, however, between HER2 testing in gastric/gastroesophageal junction (GEJ) cancer versus breast cancer, and the ToGA trial employed a significant modification of the breast cancer scoring criteria. As trastuzumab approaches regulatory approval in the United States for gastric/GEJ cancer, it is critical that pathologists and diagnostic laboratories learn and apply the unique criteria for assessing gastric/GEJ tumors for their HER2 status defined by the ToGA investigators, as they ready themselves for the approximately 50,000 new specimens that will be tested for HER2 status by both IHC and FISH each year.

  16. Retinol-binding protein, acute phase reactants and Helicobacter pylori infection in patients with gastric adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Nicolas Tsavaris; Christos Koufos; Athanasios Archimandritis; Christos Kosmas; Petros Kopterides; Dimitrios Tsikalakis; Hlias Skopelitis; Fotini Sakelaridi; Nikitas Papadoniou; Michalis Tzivras; Vasilios Balatsos

    2005-01-01

    AIM: To determine the serum levels of c-reactive protein (CRP), transferrin (TRF), a2-macroglobulin (A2M),ceruloplasmin (CER), a1-acid glycoprotein (AAG), prealbumin (P-ALB) and retinol-binding protein (RBP) in gastric carcinoma patients and to explore their possible correlation with underlying Helicobacter pylori (H pylon)infection.METHODS: We measured the serum levels of CRP, TRF,A2M, CER, AAG, P-ALB, and RBP in 153 preoperative patients (93 males; mean age: 63.1±11.3 years) with non-cardia gastric adenocarcinoma and 19 healthy subjects.RESULTS: The levels of CRP, CER, RBP, andAAG in cancer patients were significantly higher than those in healthy controls (P<0.0001), while no difference was found regarding the TRF, P-ALB, and A2M levels. Cancer patients with H pylori infection had significantly lower RBP values compared to non-infected ones (P<0.0001)and also higher values of CRP and AAG (P = 0.09 and P = 0.08, respectively).CONCLUSION: High serum levels of CRP, CER and AAG in cancer patients do not seem to be related to H pylori infection. Retinol-binding protein seems to discriminate between infected and non-infected patients with gastric carcinoma. Further studies are needed to explore if it is directly involved in the pathogenesis of the disease or is merely an epiphenomenon.

  17. A rare cause of Emergency Department visit for melena: Gastric Mucormycoma mimicking Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Ivan Comelli

    2012-07-01

    Full Text Available “Mucormycosis” is an extremely rare infection typically occuring in individuals with impaired immunity. Gastrointestinal Mucormycosis is the rarest form, and shows the highest mortality rate (50-85%. The diagnosis mostly depends on histological examination. Although culture can identify the fungal species, it is positive in only 52% of autopsy cases and 30% of surgical specimens. No reliable serologic or skin tests are available as yet. We describe a rare case of gastric mucormycoma, presenting to the Emergency Department (ED for melena, and the potential pitfalls encountered during its evaluation and treatment. In our patient gastroscopy showed a large infiltrative and ulcerated mass located in gastric fundus and extended up to the gastro-esophageal junction. Hystology of bioptic specimens showed findings suggestive of gastric adenocarcinoma, leading the patient to surgery, consisting of total gastrectomy with esophagodigiunal and enteroenteric anastomosis. Our patient had no typical risk factor for Mucormycosis, and we suppose that the feeding by nasogastric tube, possibly through contamination by paranasal sinuses, could have caused the disseminated fungal strains, supported by a transient immunity derangement occurred during the ICU staying.

  18. Significance of TFF3 protein and Her-2/neu status in patients with gastric adenocarcinoma.

    Science.gov (United States)

    Xu, Cong-cong; Yue, Lu; Wei, Hong-jun; Zhao, Wen-wen; Sui, Ai-hua; Wang, Xiu-mei; Qiu, Wen-sheng

    2013-08-01

    Increased knowledge of molecular alterations involved in gastric carcinogenesis has provided useful information for diagnosis and prediction. In this study, we investigated the clinicopathological significance of TFF3 expression and Her-2/neu status in gastric adenocarcinoma and explored the correlation between TFF3 expression and Her-2/neu status. A hundred and twenty-six (126) patients having undergone curative gastrectomy were enrolled. Immunohistochemistry for TFF3 was performed on tumor tissues and non-neoplastic resection margins. Her-2/neu status was assessed by immunohistochemical staining and fluorescence in situ hybridization (FISH) on tumor tissues. As a result, TFF3 expression and Her-2/neu positivity were detected in 46.8% and 11.9% of the cases, respectively. Patients with negative TFF3 exhibited longer survival than the positive group (P=0.0142), while patients with positive Her-2/neu only showed a tendency toward longer overall survival (P>0.05). However, Her-2/neu was significantly associated with improved disease-free survival (P=0.0234). Multivariate analysis demonstrated Her-2/neu and TFF3 to be independent prognostic indicators of recurrence, and a significantly poor prognosis for expression of TFF3 in patients with Her-2/neu negative tumors. TFF3 is an independent indicator for overall survival in gastric cancer, while Her-2/neu, as a marker of long time survival prediction, seems to be limited.

  19. MicroRNA-181b targets cAMP responsive element binding protein 1 in gastric adenocarcinomas.

    Science.gov (United States)

    Chen, Lin; Yang, Qian; Kong, Wei-Qing; Liu, Tao; Liu, Min; Li, Xin; Tang, Hua

    2012-07-01

    MicroRNAs are a class of small endogenous non-coding RNAs that function as post-transcriptional regulators. In our previous study, we found that miR-181b was significantly downregulated in human gastric adenocarcinoma tissue samples compared to the adjacent normal gastric tissues. In this study, we confirm the down-regulation of miR-181b in human gastric cancer cell lines versus the gastric epithelial cells. Overexpression of miR-181b suppressed the proliferation and colony formation rate of gastric cancer cells. miR-181b downregulated the expression of cAMP responsive element binding protein 1 (CREB1) by binding its 3' untranslated region. Overexpression of CREB1 counteracted the suppression of growth in gastric cancer cells caused by ectopic expression of miR-181b. These results indicate that miR-181b may function as a tumor suppressor in gastric adenocarcinoma cells through negative regulation of CREB1.

  20. Expression of Fas ligand by human gastric adenocarcinomas: a potential mechanism of immune escape in stomach cancer.

    LENUS (Irish Health Repository)

    Bennett, M W

    2012-02-03

    BACKGROUND: Despite being immunogenic, gastric cancers overcome antitumour immune responses by mechanisms that have yet to be fully elucidated. Fas ligand (FasL) is a molecule that induces Fas receptor mediated apoptosis of activated immunocytes, thereby mediating normal immune downregulatory roles including immune response termination, tolerance acquisition, and immune privilege. Colon cancer cell lines have previously been shown to express FasL and kill lymphoid cells by Fas mediated apoptosis in vitro. Many diverse tumours have since been found to express FasL suggesting that a "Fas counterattack" against antitumour immune effector cells may contribute to tumour immune escape. AIM: To ascertain if human gastric tumours express FasL in vivo, as a potential mediator of immune escape in stomach cancer. SPECIMENS: Thirty paraffin wax embedded human gastric adenocarcinomas. METHODS: FasL protein was detected in gastric tumours using immunohistochemistry; FasL mRNA was detected in the tumours using in situ hybridisation. Cell death was detected in situ in tumour infiltrating lymphocytes using terminal deoxynucleotidyl transferase mediated dUTP nick end labelling (TUNEL). RESULTS: Prevalent expression of FasL was detected in all 30 resected gastric adenocarcinomas examined. In the tumours, FasL protein and mRNA were co-localised to neoplastic gastric epithelial cells, confirming expression by the tumour cells. FasL expression was independent of tumour stage, suggesting that it may be expressed throughout gastric cancer progression. TUNEL staining disclosed a high level of cell death among lymphocytes infiltrating FasL positive areas of tumour. CONCLUSIONS: Human gastric adenocarcinomas express the immune downregulatory molecule, FasL. The results suggest that FasL is a prevalent mediator of immune privilege in stomach cancer.

  1. Promoter hypermethylation of CDH1, FHIT, MTAP and PLAGL1 in gastric adenocarcinoma in individuals from Northern Brazil

    Institute of Scientific and Technical Information of China (English)

    Mariana Ferreira Leal; Eleonidas Moura Lima; Patrícia Natália Oliveira Silva; Paulo Pimentel Assumpc(a)o; Danielle Queiroz Calcagno; Spencer Luiz Marques Pay(a)o; Rommel Rodríguez Burbano; Marília de Arruda Cardoso Smith

    2007-01-01

    AIM: To evaluate the methylation status of CDH1, FHIT,MTAP and PLAGL1 promoters and the association of these findings with clinico-pathological characteristics.METHODS: Methylation-specific PCR (MSP) assay was performed in 13 nonneoplastic gastric adenocarcinoma,30 intestinal-type gastric adenocarcinoma and 35 diffusetype gastric adenocarcinoma samples from individuals in Northern Brazil. Statistical analyses were performed using the chi-square or Fisher's exact test to assess associations between methylation status and clinicopathological characteristics.RESULTS: Hypermethylation frequencies of CDH1, FHIT,MTAP and PLAGL1 promoter were 98.7%, 53.9%, 23.1% and 29.5%, respectively. Hypermethylation of three or four genes revealed a significant association with diffuse-type gastric cancer compared with nonneoplastic cancer. A higher hypermethylation frequency was significantly associated with H pylori infection in gastric cancers, especially with diffuse-type. Cancer samples without lymph node metastasis showed a higher FHIT hypermethylation frequency. MTAP hypermethylation was associated with H pylori in gastric cancer samples, as well as with diffuse-type compared with intestinal-type.In diffuse-type, MTAP hypermethylation was associated with female gender.CONCLUSION: Our findings show differential gene methylation in tumoral tissue, which allows us to conclude that hypermethylation is associated with gastric carcinogenesis. MTAP promoter hypermethylation can be characterized as a marker of diffuse-type gastric cancer, especially in women and may help in diagnosis,prognosis and therapies. The H pylori infectious agent was present in 44.9% of the samples. This infection may be correlated with the carcinogenic process through the gene promoter hypermethylation, especially the MTAP promoter in diffuse-type. A higher H pylori infection in diffuse-type may be due to greater genetic predisposition.

  2. Sensitivity of gastric adenocarcinoma and normal cell lines against combined or conjugated antimetabolites.

    Science.gov (United States)

    Weinreich, Jürgen; Struller, Florian; Küper, Markus; Hack, Anita; Königsrainer, Alfred; Schott, Timm C

    2013-04-01

    The in-vitro growth inhibition of cancer and normal cell lines caused by mixed or covalently linked antimetabolites should clarify whether the conjugation of antimetabolites influences cell sensitivity and growth inhibition in a manner that differs from an equimolar mixture of the same antimetabolites or not. Growth inhibition of the human gastric adenocarcinoma cell lines 23132/87 and MKN-45 in comparison with normal gastric intestinal CCL-241 and the dermal fibroblast cell line NHDF was evaluated using CASY technology. The cell lines were incubated with an equimolar mixture of 5-fluoro-2'-deoxyuridine (5FdU)+3'-C-ethynylcytidine (ECyd) or the covalently linked duplex drug 5FdU(5'→5')ECyd. The drug and metabolites of the assays and medium were determined semiquantitatively using high-performance liquid chromatography. The sensitivity of cancer and nonmalignant cell lines was clearly different against the duplex drug. A measure of 0.65 µmol/l 5FdU(5'→5')ECyd, for example, reduced the growth of MKN-45 or 23132/87 gastric cancer cells from 100% on day 0 to about 50 or 20% on day 10, respectively. However, under the same conditions, the growth of the nonmalignant NHDF and CCL-241 cell lines was not markedly inhibited. The cytostatic activity of the duplex drug is based on the active metabolites in and outside the cell formed by the degradation of 5FdU(5'→5')ECyd. The sensitivity of cell lines against the duplex drug depended on its ability to metabolize the duplex drug. 5FdU(5'→5')ECyd should be more advantageous for specific and efficient polychemotherapy of gastric cancer than the corresponding equimolar mixture of 5FdU+ECyd or a standard combination regime of single drugs.

  3. Claudin-1, but not claudin-4, exhibits differential expression patterns between well- to moderately-differentiated and poorly-differentiated gastric adenocarcinoma

    Science.gov (United States)

    TOKUHARA, YASUNORI; MORINISHI, TATSUYA; MATSUNAGA, TORU; OHSAKI, HIROYUKI; KUSHIDA, YOSHIO; HABA, REIJI; HIRAKAWA, EIICHIRO

    2015-01-01

    Claudins are members of a large family of transmembrane proteins, which are essential in the formation of tight junctions and have previously been associated with the process of tumor progression. Studies have reported the aberrant expression of claudin-1 and claudin-4 in numerous types of cancer. The present study aimed to investigate the expression of claudin-1 and claudin-4 in gastric adenocarcinoma tissue. Surgically resected gastric adenocarcinoma tissue specimens were obtained from 94 patients. Protein expression levels of claudin-1 and claudin-4 were determined using immunohistochemical staining; the association between claudin-1 or claudin-4 expression and various clinicopathological parameters were then analyzed. In gastric adenocarcinoma specimens, the expression rates of claudin-1 and claudin-4 were 43.6 and 87.2%, respectively. Claudin-1 expression demonstrated a significant correlation with histological type (P<0.01) and was significantly higher in well- to moderately-differentiated gastric adenocarcinomas compared with poorly-differentiated tumors. However, no correlation was observed between claudin-4 expression in adenocarcinoma and clinicopathological parameters. In conclusion, downregulation of claudin-1 expression in poorly-differentiated gastric adenocarcinoma may be involved in the biological transformation of tumors. The present findings suggested that claudin-1 may be an important protein associated with histological type and therefore may have potential for use as a prognostic marker for gastric adenocarcinoma. Further studies are required to elucidate the precise mechanism of claudin expression and its involvement in tumor progression. PMID:26170982

  4. Novel therapy for advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Yue; Zhang; Shenhong; Wu

    2015-01-01

    Gastric cancer(GC) is a common lethal malignancy.Gastroesophageal junction and gastric cardia tumors are the fastest rising malignancies due to increasing prevalence of obesity and acid reflex in the United States.Traditional chemotherapy remains the main treatment with trastuzumab targeting human epidermal growth factor receptor 2 positive disease.The median overall survival(OS) is less than one year for advanced GC patients; thus,there is an urgent unmet need to develop novel therapy for GC.Although multiple targeted agents were studied,only the vascular endothelial growth factor receptor inhibitor ramucirumab was approved recently by the United States Food and Drug Administration because of its 1.4 mo OS benefit(5.2 mo vs 3.8 mo,P = 0.047) as a single agent; 2.2 mo improvement of survival(9.6 mo vs 7.4 mo,P = 0.017) when combined with paclitaxel in previously treated advanced GC patients.It is the first single agent approved for previously treated GC and the second biologic agent after trastuzumab.Even with limited success,targeted therapy may be improved by developing new biomarkers.Immune therapy is changing the paradigm of cancer treatment and is presently under active investigation for GC in clinical trials.More evidence supports GC stem cells existence and early stage studies are looking for its potential therapeutic possibilities.

  5. Expression and Prognostic Significance of Human Epidermal Growth Factor Receptors 1 and 3 in Gastric and Esophageal Adenocarcinoma.

    Directory of Open Access Journals (Sweden)

    Charlotta Hedner

    Full Text Available Gastric and esophageal adenocarcinomas are major global cancer burdens. These cancer forms are characterized by a poor prognosis and a modest response to chemo- radio- and targeted treatment. Hence there is an obvious need for further enhanced diagnostic and treatment strategies. The aim of this study was to examine the expression and prognostic impact of human epidermal growth factor receptor 1 (HER1/EGFR and 3 (HER3, as well as the occurrence of EGFR and KRAS mutations in gastric and esophageal adenocarcinoma.Immunohistochemical expression of EGFR and HER3 was analysed in all primary tumours and a subset of lymph node metastases in a consecutive cohort of 174 patients with adenocarcinoma of the stomach, cardia and esophagus. The anti-HER3 antibody used was validated by siRNA-mediated knockdown, immunohistochemistry and quantitative real-time PCR. EGFR and KRAS mutation status was analysed by pyrosequencing tecchnology.High EGFR expression was an independent risk factor for shorter overall survival (OS, whereas high HER3 expression was associated with a borderline significant trend towards a longer OS. KRAS mutations were present in only 4% of the tumours and had no prognostic impact. All tumours were EGFR wild-type. These findings contribute to the ongoing efforts to decide on the potential clinical value of different HERs and druggable mutations in gastric and esophageal adenocarcinomas, and attention is drawn to the need for more standardised investigational methods.

  6. Hepatic Artery Chemotherapy for Advanced Adenocarcinoma of the Pancreas

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    Robert Levin

    2016-08-01

    Full Text Available Context Seventy patients with adenocarcinoma of the pancreas with liver metastases, received chemotherapy every four weeks and their outcomes are reported in this retrospective series. Objective Advanced adenocarcinoma of the pancreas has a poor prognosis with only 2% 5-year survival reported by SEER (Surveillance, Epidemiology and End Results of the NCI. Chemotherapy given as intra-arterial perfusions is more intense than intravenous chemotherapy. Responses in perfused tumor is expected to be better than that obtained with only intravenous chemotherapy. Design Hepatic artery therapy is given monthly as a 5 hour perfusion of the hepatic artery using DDP and MIC. Also given is monthy Intravenous (IV therapy with four hours of Leucovorin (LV, with an injection of FUDR during the last hour of LV, daily x 5 days. Setting all therapy was given at Midwestern Regional Medical Center. Patients Thirty seven patients had no prior chemotherapy, while 33 patients had progressed after prior IV chemotherapy. Intervention Hepatic artery therapy with IV LV-FUDR was given for up to six months depending upon marrow tolerance and response. At that point, if response was ongoing or improving, therapy was continued monthly with only IV LV-FUDR; all therapy was stopped whenever progressive disease was evident. Results of those without prior chemotherapy, the mean overall survival (OS was 17.3 ± 30.2 months (mean±SD, ranging up to 13 years. Six patients survived more than three years with four are living in continuing complete remission for more than five years. Conclusion This therapy offers the opportunity for long term survival in a subset of patients with metastatic adenocarcinoma of the pancreas who have liver metastases, and some patients can be cured.

  7. Intrathoracic esophagojejunostomy using OrVilTM for gastric adenocarcinoma involving the esophagus

    Institute of Scientific and Technical Information of China (English)

    Kazuhito; Yajima; Tatsuo; Ka; Shin-ichi; Kosugi; Yosuke; Kano; Takashi; Ishikawa; Hiroshi; Ichikawa; Takaaki; Hanyu; Toshifumi; Wakai

    2014-01-01

    AIM: To demonstrate a new surgical technique of lower mediastinal lymphadenectomy and intrathoracic anastomosis of esophagojejunostomy using OrV ilTM. METHODS: After a total median phrenotomy, the supradiaphragmatic and lower thoracic paraesophageal lymph nodes were transhiatally dissected. The esophagus was cut off using a liner stapler and OrV ilTMwas inserted. Finally, end-to-side esophagojejunostomy was created by using a circular stapler. From July 2009,we adopted this surgical technique for five patients with gastric cancer involving the lower esophagus. RESULTS: The median operation time was 314 min(range; 210-367 min), and median blood loss was 210 mL(range; 100-838 mL). The median numbers of dissected lower mediastinal nodes were 3(range; 1-10). None of the patients had postoperative complications including anastomotic leakage and stenosis. Themedian hospital stay was 16 d(range: 15-20 d). The median length of esophageal involvement was 14 mm(range: 6-48 mm) and that of the resected esophagus was 40 mm(range: 35-55 mm); all resected specimens had tumor-free margins.CONCLUSION: This surgical technique is easy and safe intrathoracic anastomosis for the patients with gastric adenocarcinoma involving the lower esophagus.

  8. Enhancement of Radiation Effects by Ursolic Acid in BGC-823 Human Adenocarcinoma Gastric Cancer Cell Line.

    Directory of Open Access Journals (Sweden)

    Yang Yang

    Full Text Available Recent research has suggested that certain plant-derived polyphenols, i.e., ursolic acid (UA, which are reported to have antitumor activities, might be used to sensitize tumor cells to radiation therapy by inhibiting pathways leading to radiation therapy resistance. This experiment was designed to investigate the effects and possible mechanism of radiosensitization by UA in BGC-823 cell line from human adenocarcinoma gastric cancer in vitro. UA caused cytotoxicity in a dose-dependent manner, and we used a sub-cytotoxicity concentration of UA to test radioenhancement efficacy with UA in gastric cancer. Radiosensitivity was determined by clonogenic survival assay. Surviving fraction of the combined group with irradiation and sub-cytotoxicity UA significantly decreased compared with the irradiation group. The improved radiosensitization efficacy was associated with enhanced G2/M arrest, increased reactive oxygen species (ROS, down-regulated Ki-67 level and improved apoptosis. In conclusion, as UA demonstrated potent antiproliferation effect and synergistic effect, it could be used as a potential drug sensitizer for the application of radiotherapy.

  9. Synchronous Gastric Gastrointestinal Stromal Tumor and Colon Adenocarcinoma: A Case Report

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    Thivi Vasilakaki

    2014-01-01

    Full Text Available Gastrointestinal stromal tumors (GISTs represent the majority of primary mesenchymal tumors of the gastrointestinal tract. They are generally considered to be solitary tumors and therefore the synchronous occurrence with other primary malignancies of gastrointestinal track is considered a rare event. Here we present the case of a 75-year-old man admitted to our hospital with a 10-day history of gastrointestinal bleeding. Colonoscopy revealed an ulcerative mass of 4 cm in diameter in the ascending colon. Gastroscopy revealed a bulge in the gastric body measuring 1 cm in diameter with normal overlying mucosa. Surgical intervention was suggested and ileohemicolectomy with regional lymph node resection along with gastric wedge resection was performed. Pathologic examination of the ascending colon mass showed an invasive moderately differentiated adenocarcinoma stage III B (T3N1M0. Grossly resected wedge of stomach showed a well circumscribed intramural tumor which microscopically was consistent with essentially benign gastrointestinal stromal tumor (according to Miettinen criteria. The patient did not receive additional treatment. Two years later the patient showed no evidence of recurrence or metastasis.

  10. Capsaicin-induced cell death in a human gastric adenocarcinoma cell line

    Institute of Scientific and Technical Information of China (English)

    Yi-Ching Lo; Yuan-Chen Yang; I-Chieh Wu; Fu-Chen Kuo; Chi-Ming Liu; Hao-Wei Wang; Chao-Hung Kuo; Jeng-Yi Wu; Deng-Chyang Wu

    2005-01-01

    AIM: Capsaicin, a pungent ingredient found in red pepper,has long been used in spices, food additives, and drugs.Cell death induced by the binding of capsaicin was examined in a human gastric adenocarcinoma cell line (AGS cells).METHODS: By using XTT-based cytotoxicityassay, flow cytometry using the TUNEL method, and quantitation of DNA fragmentation, both cell death and DNA fragmentation were detected in AGS cells treated with capsaicin. By using Western blotting methods, capsaicin reduced the expression of Bcl-2, the antiapoptotic protein, in AGS cells in a concentration-dependent manner.RESULTS: After incubation of AGS cells with capsaicin for 24 h, cell viability decreased significantly in a dose-dependent manner. After incubation of AGS cells with capsaicin for 24 h, apoptotic bodies also significantly increased, and were again correlated with the dose of capsaicin. When the concentration of capsaicin was 1 mmol/L, the amount of DNA fragments also increased. Similar results werealso in the lower traces.CONCLUSION: These results suggest that capsaicininduced cell death might be via a Bcl-2 sensitive apoptotic pathway. Therefore, capsaicin might induce protection from gastric cancer.

  11. Proteome analysis of human gastric cardia adenocarcinoma by laser capture microdissection

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    Wang Yan

    2007-10-01

    Full Text Available Abstract Background The incidence of gastric cardiac adenocarcinoma (GCA has been increasing in the past two decades in China, but the molecular changes relating to carcinogenesis have not been well characterised. Methods In this study, we used a comparative proteomic approach to analyse the malignant and nonmalignant gastric cardia epithelial cells isolated by navigated laser capture microdissection (LCM from paired surgical specimens of human GCA. Results Twenty-seven spots corresponding to 23 proteins were consistently differentially regulated. Fifteen proteins were shown to be up-regulated, while eight proteins were shown to be down-regulated in malignant cells compared with nonmalignant columnar epithelial cells. The identified proteins appeared to be involved in metabolism, chaperone, antioxidation, signal transduction, apoptosis, cell proliferation, and differentiation. In addition, expressions of HSP27, 60, and Prx-2 in GCA specimens were further confirmed by immunohistochemical and western blot analyses. Conclusion These data indicate that the combination of navigated LCM with 2-DE provides an effective strategy for discovering proteins that are differentially expressed in GCA. Such proteins may contribute in elucidating the molecular mechanisms of GCA carcinogenesis. Furthermore, the combination provides potential clinical biomarkers that aid in early detection and provide potential therapeutic targets.

  12. Advanced endoscopic imaging in gastric neoplasia and preneoplasia

    Science.gov (United States)

    Lee, Jonathan W J; Lim, Lee Guan; Yeoh, Khay Guan

    2017-01-01

    Conventional white light endoscopy remains the current standard in routine clinical practice for early detection of gastric cancer. However, it may not accurately diagnose preneoplastic gastric lesions. The technological advancements in the field of endoscopic imaging for gastric lesions are fast growing. This article reviews currently available advanced endoscopic imaging modalities, in particular chromoendoscopy, narrow band imaging and confocal laser endomicroscopy, and their corresponding evidence shown to improve diagnosis of preneoplastic gastric lesions. Raman spectrometry and polarimetry are also introduced as promising emerging technologies. PMID:28176895

  13. Astragalus saponins induce apoptosis in human gastric adenocarcinoma cells via a caspase 3-dependent pathway

    Institute of Scientific and Technical Information of China (English)

    JOSHUA K S Ko; Kathy K W Auyeung

    2008-01-01

    Objective Many Asian countriea including China, Japan and Korea have very high incidence of gastric cancer, in which about 42 % cases occur in mainland China. The precise targets and underlying mechanisms are not well understood. Our previous study revealed that Astragalus saponins (AST) showed promising effects on the suppression of the growth of HT-29 human colon cancer cells and tumor xenograft by inhibiting cell proliferation and promoting apoptosis. In the present study, we investigated the anti-carcinogenic effects of AST in AGS human gastric adenocarcinoma cells and attempted to elucidate the underlying mechanisms. Methods Growth inhibition of AGS cells was determined by using the MTT viability test. Involvement of different members of the apoptotic cascade and other growth-related factors was explored by assessment of their protein expression using Western blot analysis. Distribution of cells in different phases of the cell cycle was assessed by flow eytometry. Results Our data indicate that AST induced growth-inhibition and apoptosis in AGS cells by activating caspase 3 with subsequent poly (ADP-ribose) polymerase (PARP) cleavage. Cell cycle arrest at the G2/M phase had been observed in AST-treated AGS cells. The anti-proliferative effect of AST was associated with modulation of eydin B1 and p21. We then demonstrate that AST could downregulate the expression of VEGF, of which interaction with its receptors is important for angiogenesis during tumor formation. Conclusions Our findings suggest that AST is an effective agent in gastric cancer treatment by inducing cell cycle arrest and apoptosis, of which anti-angiogenesis could be an alternative mode of action.

  14. The extrinsic apoptotic signaling pathway in gastric adenocarcinomas assessed by tissue microarray.

    Science.gov (United States)

    Gomes, Thiago S; Oshima, Celina T F; Segreto, Helena R C; Barrazueta, Luis M; Costa, Henrique O; Lima, Flavio O; Forones, Nora M; Ribeiro, Daniel A

    2011-10-15

    The purpose of this investigation was to analyze the immunoexpression of FasL, Fas, FADD, cleaved caspase 8, and cleaved caspase 3 in gastric cancer. Formalin-fixed and paraffin-embedded gastric adenocarcinoma tissues from 87 patients, including adjacent normal tissues, were included on tissue microarray by immunohistochemistry. The tumor and the adjacent normal tissues were positive for FasL in 66.7% and 90.6%, for Fas in 52.8% and 52.4%, for FADD in 67.4% and 82.3%, for cleaved caspase 8 in 27.9% and 37.7%, and for cleaved caspase 3 in 33.7% and 8.3%, respectively. FasL and the FADD from tumor were statistically different in relation to the histological type. Cleaved caspase 8 was statistically different in relation to clinical stage (p=0.031). The FADD from normal tissue was statistically different in relation to age (p=0.039), sex (p=0.055), clinical stage (p=0.019), and Fas was different in relation to tumor size (p=0.012). In the tumor, we observed a correlation between FasL and Fas, FasL and FADD, and FasL and cleaved caspase 3. In the adjacent normal tissue, a correlation was observed between FasL and Fas, FasL and FADD. There was no association of another marker with sex, age, clinical stage, and survival. Our results suggest that these proteins mediate the early extrinsic apoptotic pathway in gastric cancer and adjacent normal mucosa. FasL protein binds to Fas protein and subsequently binds to death receptor FADD signaling activation of the extrinsic apoptotic pathway. In this phase, there was inhibition of caspase 8 and, consequently, decreased apoptosis.

  15. Correlation of primary tumor FDG uptake with histopathologic features of advanced gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hae Won; Won, Kyoung Sook; Song, Bong Il; Kang, Yu Na [Keimyung University Dongsan Medical Center, Daegu (Korea, Republic of)

    2015-06-15

    Histopathologic features could affect the FDG uptake of primary gastric cancer and detection rate on FDG PET/CT. The aim of this study was to evaluate the FDG uptake of primary gastric cancer by correlating it with the histopathologic features of the tumors. Fifty patients with locally advanced gastric adenocarcinoma who were referred for preoperative FDG-PET/CT scans were enrolled in this study. The detection rate of PET/CT and maximum standardized uptake values (SUV{sub max}) of the primary tumor were compared using the WHO, Lauren, Ming and Borrmann classifications and tumor size and location. In 45 of the 50 patients (90 %), the primary gastric tumors were detected by FDG PET/CT. On comparison using the WHO classification, the detection rate and SUV{sub max} of the tubular type were significantly higher than those of the poorly cohesive type. On comparison using the Lauren and Ming classifications, the SUV{sub maxs} of the intestinal type and expanding type were significantly higher than those of the diffuse and infiltrative type, respectively. On comparison using the Borrmann classification and tumor size and location, there was no significant difference in the detection rate and SUV{sub max} of primary gastric tumors. This study demonstrates that the poorly cohesive type according to the WHO classification, diffuse type according to the Lauren classification and infiltrative type according to the Ming classification have low FDG uptake in patients with locally advanced gastric carcinoma. Understanding the relationship between primary tumor FDG uptake and histopathologic features would be helpful in detecting the primary tumor by FDG PET/CT in patients with gastric cancer.

  16. Gastric adenocarcinoma in the context of X-linked agammaglobulinemia: case report and review of the literature.

    Science.gov (United States)

    Staines Boone, Aidé Tamara; Torres Martínez, María Guadalupe; López Herrera, Gabriela; de Leija Portilla, Julia O; Espinosa Padilla, Sara Elva; Espinosa Rosales, Francisco J; Lugo Reyes, Saúl Oswaldo

    2014-02-01

    The hallmarks of X-linked Agammaglobulinemia (XLA) are panhypogammaglobulinemia, absent B-cells, and recurrent sinopulmonary and gastrointestinal infections starting at an early age, as well as other infections like cellulitis, meningitis, arthritis and sepsis. A number of non-infectious complications have been reported in these patients, including autoimmune diseases and malignancy, especially lymphomas. Here, we report the case of a 30-year old man who developed gastric adenocarcinoma in the context of XLA. Previous reports of, and hypotheses addressing the development of cancer in patients with XLA, are also summarized. Solid cancer in XLA affects mainly the gastrointestinal tract and seems to be related to chronic infection. A natural evolution can be traced back from gastric adenocarcinoma to megaloblastic anemia due to achlorhydria in the context of chronic infection; periodic endoscopy thus seems justified to detect and treat carcinoma in early stages.

  17. Coexpression of receptor-tyrosine-kinases in gastric adenocarcinoma-a rationale for a molecular targeting strategy?

    Institute of Scientific and Technical Information of China (English)

    Daniel Drescher; Thomas Wehler; Andreas Teufel; Kerstin Herzer; Thomas Fischer; Martin R Berger; Theodor Junginger; Peter R Galle; Carl C Schimanski; Markus Moehler; Ines Gockel; Kirsten Frerichs; Annett Müller; Friedrich Dünschede; Thomas Borschitz; Stefan Biesterfeld; Martin Holtmann

    2007-01-01

    AIM: To define the (co-)expression pattern of target receptor-tyrosine-kinases (RTK) in human gastric adenocarcinoma.METHODS: The (co-)expression pattern of VEGFR1-3,PDGFRα/β and EGFR1 was analyzed by RT-PCR in 51 human gastric adenocarcinomas. In addition, IHC staining was applied for confirmation of expression and analysis of RTK Iocalisation.RESULTS: The majority of samples revealed a VEGFR1(98%), VEGFR2 (80%), VEGFR3 (67%), PDGFRα(82%) and PDGFRβ (82%) expression, whereas only 62% exhibited an EGFR1 expression. 78% of cancers expressed at least four out of six RTKs. While VEGFR1-3and PDGFRα revealed a predominantly cytoplasmatic staining in tumor cells, accompanied by an additional nuclear staining for VEGFR3, EGFR1 was almost exclusively detected on the membrane of tumor cells.PDGFRβ was restricted to stromal pericytes, which also depicted a PDGFRα expression.CONCLUSION: Our results reveal a high rate of receptor-tyrosine-kinases coexpression in gastric adenocarcinoma and might therefore encourage an application of multiple-target RTK-inhibitors within a combination therapy.

  18. Adenocarcinoma of gastric cardia in the elderly:Surgical problems and prognostic factors

    Institute of Scientific and Technical Information of China (English)

    Natale Di Martino; Giuseppe Izzo; Angelo Cosenza; Guido Cerullo; Francesco Torelli; Antonio Brillantino; Alberto del Genio

    2005-01-01

    AIM: To analyze retrospectively, our results about patients who underwent surgical treatment for adenocarcinoma of the cardia in relation to age, in order to evaluate surgical problems and prognostic factors.METHODS: From January 1987 to March 2003, 140 patients with adenocarcinoma of the cardia underwent resection in the authors' institution. They were divided into three groups with regard to age. Patients 60 year old (31) were excluded; we also excluded 18 out of 109 patients with poor general status or systemic metastases. So, we compared 51 elderly (≥ 70 year old)and 58 younger patients (≤ 60 year old). The treatment was esophagectomy for type Ⅰ tumors, and extended gastrectomy and distal esophagectomy for type Ⅱ and Ⅲ lesions.RESULTS: Laparotomy was carried out in 91 patients (83.4%), 38 in the elderly (74.5%) and 53 in younger patients (91.3%, P<0.05). Primary resection was performed in 811 cases (89%) without significant differences between the two groups. Postoperative death was higher in the elderly (12.1%) than the other group (4.1%, P<0.05), while morbidity was similar in both groups. A curative resection (R0) was performed in 59 patients (72.8%), 69.6% in the elderly and 75% in the younger group (P>0.05). The overall 3- and 5-year survival rates were 26.7% and 117.8% respectively for the elderly and 40.7% and 35.1% respectively for younger patients (P = 0.1544). Survival rates were significantly associated with R0 resection,pathological node-positive category and tumor differentiation in both groups.CONCLUSION: As the age of the general population increases, more elderly patients with gastric cardia cancer will be candidates for surgical resection. Age alone should not preclude surgical treatment in elderly patients with gastric cardia cancer and a tumor resection can be carried out safely. Certainly, we should take care in defining the surgical treatment in elderly patients, particularly as regarding the surgical approach; although the

  19. -765G>C COX-2 polymorphism may be a susceptibility marker for gastric adenocarcinoma in patients with atrophy or intestinal metaplasia

    Institute of Scientific and Technical Information of China (English)

    Carina Pereira; Hugo Sousa; Paula Ferreira; Maria Fragoso; Luís Moreira-Dias; Carlos Lopes; Rui Medeiros; Mário Dinis-Ribeiro

    2006-01-01

    AIM: To investigate the relationship between the -765G> C COX-2 polymorphism and the development of different gastric lesions: atrophy or intestinal metaplasia and gastric adenocarcinoma.METHODS: A cross-sectional study was performed involving 320 Portuguese individuals (210 without evidence of neoplastic disease, 73 patients with gastric adenocarcinomas and 37 with atrophy or intestinal metaplasia) using a PCR-RFLP method. RESULTS: -765C allele was overrepresented in the patients with gastric adenocarcinoma (51%) when compared either with the control group (38%) or patients with atrophy or intestinal metaplasia (27%).Callele was found to be very common in our population (0.22), and a multivariate logistic regression analysis revealed nearly 3-fold increased risk for the progression to gastric adenocarcinoma in patients with atrophy or intestinal metaplasia carrying the -765C allele (OR = 2.67, 95% CI = 1.03-6.93; P = 0.04).CONCLUSION: -765C carrier status should be considered as another susceptibility marker for gastric adenocarcinoma development in patients with atrophy or intestinal metaplasia.

  20. Interrelationship between chromosome 8 aneuploidy, C-MYC amplification and increased expression in individuals from northern Brazil with gastric adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Danielle Queiroz Calcagno; Márcia Valéria Pitombeira Ferreira; Marília de Arruda Cardoso Smith; Rommel Rodríguez Burbano; Mariana Ferreira Leal; Aline Damaceno Seabra; André Salim Khayat; Elizabeth Suchi Chen; Samia Demachki; Paulo Pimentel Assump(c)(a)o; Mario Henrique Gir(a)o Faria; Silvia Helena Barem Rabenhorst

    2006-01-01

    AIM: To investigate chromosome 8 numerical aberrations, C-MYC oncogene alterations and its expression in gastric cancer and to correlate these findings with histopathological characteristics of gastric tumors.METHODS: Specimens were collected surgically from seven patients with gastric adenocarcinomas. Immunostaining for C-MYC and dual-color fluorescence in situ hybridization (FISH) for C-MYC gene and chromosome 8centromere were performed.RESULTS: All the cases showed chromosome 8 aneuploidy and C-MYC amplification, in both the diffuse and intestinal histopathological types of Lauren. No significant difference (P < 0.05) was observed between the level of chromosome 8 ploidy and the site, stage or histological type of the adenocarcinomas. C-MYC high amplification,like homogeneously stained regions (HSRs) and double minutes (DMs), was observed only in the intestinal-type.Structural rearrangement of C-MYC, like translocation,was observed only in the diffuse type. Regarding C-MYC gene, a significant difference (P < 0.05) was observed between the two histological types. The C-MYC protein was expressed in all the studied cases. In the intestinaltype the C-MYC immunoreactivity was localized only in the nucleus and in the diffuse type in the nucleus and cytoplasm.CONCLUSION: Distinct patterns of alterations between intestinal and diffuse types of gastric tumors support the hypothesis that these types follow different genetic pathways.

  1. Establishment and characterization of a cisplatin-resistant cell line (IGSK-1) from a poorly differentiated gastric adenocarcinoma.

    Science.gov (United States)

    Ohi, Satoshi; Takahashi, Naoto; Ninomiya, Kouzou; Nakajima, Masako; Hashimoto, Hisashi; Tachibana, Toshiaki; Yanaga, Katsuhiko; Ishikawa, Hiroshi

    2007-02-01

    We successfully established a spontaneously cisplatin-resistant tumor cell line (designated as IGSK-1) derived from original gastric carcinoma. The patient was a 75-year-old Japanese woman. The histopathological diagnosis was gastric poorly differentiated adenocarcinoma accompanied with metastatic foci in lymph nodes, pT3, N2 M0, stage IIIB. The IGSK-1 cells grew as adhesive and monolayered cultures on the bottom of dishes. The susceptibility of the IGSK-1 cells to anti-cancer drugs was examined using oxygen electrode apparatus (Daikin, Tsukuba, JPN), and the results suggested TXL was effective, and CDDP, CPT-11 and 5-FU were not effective. Gastrin and somatostatin secretions were confirmed by immunohistochemical staining and also radioimmunoassay. Immunohistochemistry and radioimmunoassay for serotonin suggested the IGSK-1 cells might incorporate serotonin from the growth media. Spontaneously cisplatin-resistant gastric carcinoma cell line secreted gastrin and somatostatin is very important material for chemotherapy.

  2. Identification and expansion of cancer stem cells in tumor tissues and peripheral blood derived from gastric adenocarcinoma patients

    Institute of Scientific and Technical Information of China (English)

    Tie Chen; Xinzu Chen; Fang Wang; Fan Zeng; Hong Xu; Jiankun Hu; Xianming Mo; Kun Yang; Jianhua Yu; Wentong Meng; Dandan Yuan; Feng Bi; Fang Liu; Jie Liu; Bing Dai

    2012-01-01

    Gastric cancer is the fourth most common cancer worldwide,with a high rate of death and low 5-year survival rate.To date,there is a lack of efficient therapeutic protocols for gastric cancer.Recent studies suggest that cancer stem cells (CSCs) are responsible for tumor initiation,invasion,metastasis,and resistance to anticancer therapies.Thus,therapies that target gastric CSCs are attractive.However,CSCs in human gastric adenocarcinoma (GAC)have not been described.Here,we identify CSCs in tumor tissues and peripheral blood from GAC patients.CSCs of human GAC (GCSCs) that are isolated from tumor tissues and peripheral blood of patients carried CD44 and CD54 surface markers,generated tumors that highly resemble the original human tumors when injected into immunodeficient mice,differentiated into gastric epithelial cells in vitro,and self-renewed in vivo and in vitro.Our findings suggest that effective therapeutic protocols must target GCSCs.The capture of GCSCs from the circulation of GAC patients also shows great potential for identification of a critical cell population potentially responsible for tumor metastasis,and provides an effective protocol for early diagnosis and longitudinal monitoring of gastric cancer.

  3. Effects of Spinach Powder Fat-Soluble Extract on Proliferation of Human Gastric Adenocarcinoma Cells

    Institute of Scientific and Technical Information of China (English)

    HE TAo; HUANG CHENG-YU; CHEN HAl; HOU YUN-HUA

    1999-01-01

    Four kinds of assays were used to study the effect of a fat-soluble extract of spinach powder(SPFE) on the proliferation of human gastric adenocarcinoma cell line (SGC-7901) in vitro.These studies included: ( i ) cell growth assay, ( ii ) colony forming assay, ( iii ) MTT colorimetric assay, and ( iv ) 3H-TdR incorporation assay. The concentrations of SPFE expressed as the level of β-carotene in the medium were 2 × 10-s, 2 × 10-7 and 2 × 10-6 mol/L β-carotene in assays ( i ) ~ ( iii ), but 4 × 10-8, 4 × 10-7 and 4 × 10-6 mol/L β-carotene in assay ( iV ) respectively. The results indicated that SPFE inhibited the proliferation and colony forming ability of SGC-7901 cells. And in MTT assay, SPFE inhibited the viability of SGC-7901 cells, but no inhibitory effect of SPFE was observed on the viability of lymphocytes in peripheral blood of healthy people. Finally, in the 3H-TdR incorporation test, both SPFE and β-carotene showed significant inhibitory effects on DNA synthesis in SGC-7901 cells, but SPFE was more effective than 3-carotene.

  4. Loss of fragile histidine triad and amplification of 1p36.22 and 11p15.5 in primary gastric adenocarcinomas

    Institute of Scientific and Technical Information of China (English)

    Yuan-Yuan Liu; Hai-Ying Chen; Man-Li Zhang; Dan Tian; Shibo Li; Ji-Yun Lee

    2012-01-01

    AIM:To investigate the genomic copy number alterations that may harbor key driver genes in gastric tumorigenesis.METHODS:Using high-resolution array comparative genomic hybridization (CGH),we investigated the genomic alterations of 20 advanced primary gastric adenocarcinomas (seventeen tubular and three mucinous)of Chinese patients from the Jilin province.Ten matching adjacent normal regions from the same patients were also studied.RESULTS:The most frequent imbalances detected in these cancer samples were gains of 3q26.31-q27.2,5p,8q,11p,18p,19q and 20q and losses of 3p,4p,18q and 21q.The use of high-resolution array CGH increased the resolution and sensitivity of the observed genomic changes and identified focal genetic imbalances,which included 54 gains and 16 losses that were smaller than 1 Mb in size.The most interesting focal imbalances were the intergenic loss/homozygous deletion of the fragile histidine triad gene and the amplicons 11q13,18q11.2 and 19q12,as well as the novel amplicons 1p36.22 and 11p15.5.CONCLUSION:These regions,especially the focal amplicons,may harbor key driver genes that will serve as biomarkers for either the diagnosis or the prognosis of gastric cancer,and therefore,a large-scale investigation is recommended.

  5. Effect of leptin on cell proliferation and apoptosis of gastric adenocarcinoma cell line-SGC7901 and colon cancer cell line-HT-29

    Institute of Scientific and Technical Information of China (English)

    Chang-Wen Yu; Bi-Sheng Zhu

    2016-01-01

    Objective:To explore effect of leptin on cell proliferation and apoptosis of gastric adenocarcinoma cell line-SGC7901 and colon cancer cell line-HT-29.Methods: MTT and flow cytometry were adopted for detecting the effect of exogenous leptin on cell cycle of gastric adenocarcinoma cell line-SGC7901 and colon cancer cell line-HT-29.Results: Leptin with mass concentration (0 ng/mL, 5 ng/mL, 50 ng/mL, 100 ng/mL, 200 ng/mL) could stimulate the growth of gastric adenocarcinoma cell line-SGC7901 and colon cancer cell line-HT-29; exogenous leptin with mass concentration (5 ng/mL, 50 ng/mL, 100 ng/mL, 200 ng/mL) could inhibit cell growth of gastric adenocarcinoma cell line-SGC7901 and colon cancer cell line-HT-29 after 72 h; among which, inhibiting effects of cell line-SGC7901 and cell line-HT-29 were the most significant under the effect of exogenous leptin with mass concentration-200 ng/mL.Conclusion:Within a certain concentration and action time, exogenous leptin can stimulate the growth of gastric adenocarcinoma cell line and colon cancer cell line, and then promot the tumor cell proliferation and/or inhibit the tumor cell apoptosis.

  6. HER2 in situ hybridization in gastric and gastroesophageal adenocarcinoma: comparison of automated dual ISH to FISH.

    Science.gov (United States)

    Grin, Andrea; Brezden-Masley, Christine; Bauer, Sharon; Streutker, Catherine J

    2013-12-01

    Patients with gastric and gastroesophageal junction (GEJ) adenocarcinomas that are HER2 positive by immunohistochemistry (IHC) or in situ hybridization show a significant survival benefit with trastuzumab therapy. In situ hybridization is traditionally done by fluorescence in situ hybridization (FISH), despite some limitations. An alternative is the dual in situ hybridization (Dual ISH) technique that is fully automated and uses differentially labeled CEP17 and HER2 probes that can be read by light microscopy on 1 slide. The aim of this study was to assess the utility of Dual ISH in gastric/GEJ cancer and to compare the results with those obtained by IHC and FISH. Cases of gastric/GEJ adenocarcinoma were analyzed by IHC, FISH, and Dual ISH and the correlation between methods calculated. Results for 50 patients were available. There was a 98% (49/50) concordance rate between Dual ISH and FISH. One discrepant case was nonamplified by FISH but showed focal amplification by Dual ISH. Discrepancy was attributed to tumor heterogeneity, which was a frequent finding (78% of HER2-positive cases). There was excellent correlation between Dual ISH and FISH for assessment of HER2 amplification. Dual ISH was rapid, easy to interpret, and maintained cell morphology, which was valuable in identifying tumor heterogeneity.

  7. Borrmann Type 4 Advanced Gastric Cancer: Focus on the Development of Scirrhous Gastric Cancer

    OpenAIRE

    Jung, Kyoungwon; Park, Moo In; Kim, Sung Eun; Park, Seun Ja

    2016-01-01

    Early diagnosis of Borrmann type 4 advanced gastric cancer (AGC) is very important for improving the prognosis of AGC patients. Because there is no definite mass in most cases of Borrmann type 4 AGC, its accurate diagnosis via endoscopy requires an understanding of its pathogenesis and developmental process. Moreover, many people confuse linitis plastica (LP) type gastric cancer (GC), scirrhous GC, and Borrmann type 4 AGC. To distinguish each of these cancers, knowledge of their endoscopic an...

  8. New Perspectives in the Treatment of Advanced Gastric Cancer

    DEFF Research Database (Denmark)

    Mahlberg, Rolf; Lorenzen, Sylvie; Thuss-Patience, Peter

    2017-01-01

    available in non-Asia countries until recently. In Japan, S-1 in combination with cisplatin is the recommended first-line treatment in patients with gastric cancer. In Europe, the first trials with S-1 were disappointing due to high unacceptable incidences of adverse events. Pharmacokinetic studies showed...... differences in Asian and Caucasian patients; therefore, a new non-Asian study program was initiated, which led to the pivotal phase 3 trial First-Line Advanced Gastric Cancer Study (FLAGS). In FLAGS, 1,053 patients with advanced gastric cancer from 24 non-Asian countries were enrolled. S-1 plus cisplatin...... safety profile. This led to the approval of S-1 in combination with cisplatin in gastric cancer in Europe in 2011. This article reviews the mode of action of S-1, pivotal study results from an EU point of view, and future perspectives....

  9. Lineage analysis of early and advanced tubular adenocarcinomas of the stomach: continuous or discontinuous?

    Directory of Open Access Journals (Sweden)

    Mukaisho Ken-ichi

    2010-06-01

    Full Text Available Abstract Background Eradication of early gastric carcinoma (GC is thought to contribute to reduction in the mortality of GC, given that most of the early GCs progress to the advanced GCs. However, early GC is alternatively considered a dormant variant of GC, and it infrequently progresses to advanced GC. The aim of this study was to clarify the extent of overlap of genetic lineages between early and advanced tubular adenocarcinomas (TUBs of the stomach. Methods Immunohistochemical staining for p53 was performed using 28 surgically resected stomachs with 13 intramucosal and 15 invasive TUBs. By chromosome- and array-based comparative genomic hybridization (CGH, genomic copy number constitution was compared between the mucosal and invasive parts of the invasive TUBs and between the mucosal parts of the invasive and intramucosal TUBs, using 25 and 22 TUBs, respectively. TP53 mutation in exons 5-8 was examined in 20 TUBs. Results Chromosomal CGH revealed that 4q+ and 11q+ were more common in advanced and early TUBs, respectively, whereas copy number changes in 8q and 17p showed no significant differences between early and advanced TUBs. However, array CGH revealed that, of the 13 intramucosal TUBs examined, loss of MYC (MYC- and gain of TP53 (TP53+ was detected in 9 TUBs and MYC+ and/or TP53- was detected in 3 TUBs. Of the mucosal samples of 9 invasive TUBs, 7 showed MYC-/TP53+ and none showed MYC+ and/or TP53-. Of the 9 samples from the invasive parts, 1 (from submucosal cancers showed MYC-/TP53+ and 6 (1 from submucosal and 5 from advanced cancers showed MYC+ and/or TP53-. The latter 6 tumours commonly showed a mutant pattern (diffuse or null in p53 immunohistochemistry, and 4 of the 6 tumours assessable for TP53 sequence analysis revealed mutations. The overall array CGH pattern indicated that, between the mucosal and invasive parts, genetic lineage was found discontinuous in 5 advanced cancers and continuous in 3 submucosal cancers. Conclusions

  10. XRCC7 rs#7003908 Polymorphism and Helicobacter pylori Infection-Related Gastric Antrum Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Chao Wang

    2013-01-01

    Full Text Available The X-ray repair cross-complementing group 7 (XRCC7 plays a key role in DNA repair that protects against genetic instability and carcinogenesis. To determine whether XRCC7 rs#7003908 polymorphism (XRCC7P is associated with Helicobacter pylori (H. pylori infection-related gastric antrum adenocarcinoma (GAA risk, we conducted a hospital-based case-control study, including 642 patients with pathologically confirmed GAA and 927 individually matched controls without any evidence of tumours or precancerous lesions, among Guangxi population. Increased risks of GAA were observed for individuals with cagA positive (odds ratio (OR 6.38; 95% confidence interval (CI 5.03–8.09. We also found that these individuals with the genotypes of XRCC7 rs#7003908 G alleles (XRCC7-TG or -GG featured increasing risk of GAA (ORs 2.80 and 5.13, resp., compared with the homozygote of XRCC7 rs#7003908 T alleles (XRCC7-TT. GAA risk, moreover, did appear to differ more significantly among individuals featuring cagA-positive status, whose adjusted ORs (95% CIs were 15.74 (10.89–22.77 for XRCC7-TG and 38.49 (22.82–64.93 for XRCC7-GG, respectively. Additionally, this polymorphism multiplicatively interacted with XRCC3 codon 241 polymorphism with respect to HCC risk (ORinteraction=1.49. These results suggest that XRCC7P may be associated with the risk of Guangxiese GAA related to cagA.

  11. Evaluation of Outcome and Tolerability of Combination Chemotherapy with Capecitabine and Oxaliplatin as First Line Therapy in Advanced Gastric Cancer

    Science.gov (United States)

    Mashhadi, Mohammad Ali; Sepehri, Zahra; Bakhshipour, Ali Reza; Zivari, Ali; Danesh, Hossein Ali; Metanat, Hasan Ali; Karimkoshteh, Azra; Hashemi, Seyed Mehdi; Rahimi, Hossein; Kiani, Zohre

    2016-01-01

    Background: Combination chemotherapy is accepted as a high efficacy treatment for gastric cancer, whereas choice of standard treatment is unclear. Multiple chemotherapeutic regimens have been used to achieve higher efficacy and lower toxicity. This study was designed to evaluate the treatment results of advanced gastric cancer with Capecitabine and Oxaliplatin regimen. Subjects and Methods : All cases with documented gastric adenocarcinoma and advanced disease were candidates for receiving Xelox regimen (Capecitabine – 750 mg/m2/twice daily/ 1-14 days and Oxaliplatin 125 mg/m2 in 1st day). Results: Twenty five cases with advanced gastric cancer entered in study while 24 cases continued treatment protocol and were evaluated. Mean age was 59.5 ± 12.1 years (range: 20-75), male and female cases were 66.7% and 33.3%, respectively. All cases received at least four cycles of Xelox regimen. Overall response rate was 74.99% with 29.16% complete response. Overall survival rate was 13 ± 0.53 months and DFS (disease-free survival) was 6 ± 1.09 months. Extremities neuropathy (62.5%), headache (45.8%) and muscle cramps (29.2%) were the most common complains. Haematological changes were rare and 16.7% of cases had mild cytopenia. Treatment related death was not observed. Conclusion: Xelox regimen is a safe and highly effective first line treatment for gastric cancer; however, considering it as first line therapy needs larger studies. PMID:27928475

  12. Gastric adenocarcinoma in a patient with X-linked agammaglobulinemia and HIV: Case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Joud Hajjar

    2016-09-01

    Full Text Available X-linked agammaglobulinemia (XLA is an X-linked inherited disease usually caused by a germline mutation in the BTK gene leading to Bruton’s tyrosine kinase deficiency, which results in the impaired development of B-lymphocytes and a subsequent lack of immunoglobulin production. Patients with XLA have an increased susceptibility to bacterial and viral infections, and multiple case reports have been published regarding an association between XLA and gastrointestinal (GI malignancy. Here, we describe a case of a 25-year-old man with XLA and HIV, who developed gastric adenocarcinoma. Previously reported cases of XLA and GI malignancy are also reviewed and summarized.

  13. Is there any advantage to combined trastuzumab and chemotherapy in perioperative setting her 2neu positive localized gastric adenocarcinoma?

    Directory of Open Access Journals (Sweden)

    Albouzidi Abderrahmane

    2011-09-01

    Full Text Available Abstract We report here a 44-year-old Moroccan man with resectable gastric adenocarcinoma with overexpression of human epidermal growth factor receptor 2 (HER2 by immunohistochemistry who was treated with trastuzumab in combination with chemotherapy in perioperative setting. He received 3 cycles of neoadjuvant chemotherapy consisting of trastuzumab, oxaliplatin, and capecitabine. Afterwards, he received total gastrectomy with extended D2 lymphadenectomy without spleno-pancreatectomy. A pathologic complete response was obtained with a combination of trastuzumab and oxaliplatin and capecitabine. He received 3 more cycles of trastuzumab containing regimen postoperatively. We conclude that resectable gastric carcinoma with overexpression of the c-erbB-2 protein should ideally be managed with perioperative combination of trastuzumab with chemotherapy. Further research to evaluate trastuzumab in combination with chemotherapy regimens in the perioperative and adjuvant setting is urgently needed.

  14. Point Mutations in Exon 1B of APC Reveal Gastric Adenocarcinoma and Proximal Polyposis of the Stomach as a Familial Adenomatous Polyposis Variant

    OpenAIRE

    LI, Jun; Woods, Susan L.; Healey, Sue; Beesley, Jonathan; Chen,Xiaoqing; Lee, Jason S.; Sivakumaran, Haran; Wayte, Nicci; Nones, Katia; Waterfall, Joshua J.; Pearson, John; Patch, Anne-Marie; Senz, Janine; Ferreira, Manuel A.; Kaurah, Pardeep

    2016-01-01

    Gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS) is an autosomal-dominant cancer-predisposition syndrome with a significant risk of gastric, but not colorectal, adenocarcinoma. We mapped the gene to 5q22 and found loss of the wild-type allele on 5q in fundic gland polyps from affected individuals. Whole-exome and -genome sequencing failed to find causal mutations but, through Sanger sequencing, we identified point mutations in APC promoter 1B that co-segregated with diseas...

  15. The development of a mini-array for estimating the disease state of gastric adenocarcinoma by array CGH

    Directory of Open Access Journals (Sweden)

    Oga Atsunori

    2008-12-01

    Full Text Available Abstract Background The treatment strategy usually depends on the disease state in the individual patient. However, it is difficult to estimate the disease state before treatment in many patients. The purpose of this study was to develop a BAC (bacterial artificial chromosome mini-array allowing for the estimation of node metastasis, liver metastasis, peritoneal dissemination and the depth of tumor invasion in gastric cancers. Methods Initially, the DNA copy number aberrations (DCNAs were analyzed by array-based comparative genomic hybridization (aCGH in 83 gastric adenocarcinomas as a training-sample set. Next, two independent analytical methods were applied to the aCGH data to identify the BAC clones with DNA copy number aberrations that were linked with the disease states. One of the methods, a decision-tree model classifier, identified 6, 4, 4, 4, and 7 clones for estimating lymph node metastasis, liver metastasis, peritoneal dissemination, depth of tumor invasion, and histological type, respectively. In the other method, a clone-by-clone comparison of the frequency of the DNA copy number aberrations selected 26 clones to estimate the disease states. Results By spotting these 50 clones together with 26 frequently or rarely involved clones and 62 reference clones, a mini-array was made to estimate the above parameters, and the diagnostic performance of the mini-array was evaluated for an independent set of 30 gastric cancers (blinded – sample set. In comparison to the clinicopathological features, the overall accuracy was 66.7% for node metastasis, 86.7% for liver metastasis, 86.7% for peritoneal dissemination, and 96.7% for depth of tumor invasion. The intratumoral heterogeneity barely affected the diagnostic performance of the mini-array. Conclusion These results suggest that the mini-array makes it possible to determine an optimal treatment for each of the patients with gastric adenocarcinoma.

  16. Duodenal adenocarcinoma: Advances in diagnosis and surgical management

    Institute of Scientific and Technical Information of China (English)

    Jordan M Cloyd; Elizabeth George; Brendan C Visser

    2016-01-01

    Duodenal adenocarcinoma is a rare but aggressive malignancy. Given its rarity, previous studies have traditionally combined duodenal adenocarcinoma(DA) with either other periampullary cancers or small bowel adenocarcinomas, limiting the available data to guide treatment decisions. Nevertheless, management primarily involves complete surgical resection when technically feasible. Surgery may require pancreaticoduodenectomy or segmental duodenal resection; either are acceptable options as long as negative margins are achievable and an adequate lymphadenectomy can be performed. Adjuvant chemotherapy and radiation are important components of multi-modality treatment for patients at high risk of recurrence. Further research would benefit from multiinstitutional trials that do not combine DA with other periampullary or small bowel malignancies. The purpose of this article is to perform a comprehensive review of DA with special focus on the surgical management and principles.

  17. Combination Chemotherapy With or Without Vismodegib in Treating Patients With Advanced Stomach Cancer or Gastroesophageal Junction Cancer

    Science.gov (United States)

    2015-12-16

    Adenocarcinoma of the Gastroesophageal Junction; Adenocarcinoma of the Stomach; Recurrent Gastric Cancer; Stage IIIA Gastric Cancer; Stage IIIB Gastric Cancer; Stage IIIC Gastric Cancer; Stage IV Gastric Cancer

  18. A p53 genetic polymorphism of gastric cancer: Difference between early gastric cancer and advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Sun Young Yi; Woon Jung Lee

    2006-01-01

    AIM: To investigate the role of the polymorphism of p53 codon 72 in early gastric cancer (EGC) and advanced gastric cancer (AGC) in Korean patients.METHODS:DNA was extracted from blood samples of gastric cancer patients (n = 291) and controls (n=216).tn the p53 codon 72 genotypes were determined by PCR-RFLP.RESULTS: Patients with gastric cancer had a significantly higher frequency of the homozygous proline (Pro) allele than the control (P=0.032). Patients with AGC had a significantly higher frequency of the Arg/Arg (arginine)allele (P=0.038) than EGC and a similar Pro/Pro allele.The signet ring cell type had a higher frequency of the Pro/Pro allele than other types (P=0.031). The Pro/Pro genotype carries a 3.9-fold increased risk of developing gastric cancer (95% CI,1.3-15.4,P=0.039)when compared to Arg/Arg and Arg/Pro genotypes and to develop EGC is a 5.25 fold increased risk (95% CI,1.8-19.6,P=0.021).CONCLUSION: The Pro/Pro genotype of the p53 codon 72 polymorphism carries a higher risk for gastric cancer in general and is also associated with a much higher risk for EGC than AGC.

  19. Germ Cell Tumor Targeting Chemotherapy in Gastric Adenocarcinoma with an Endodermal Sinus Tumor Component: A Case Report.

    Science.gov (United States)

    Choi, Jung Eun; Choe, A Reum; Yoon, Sang Eun; Nam, Eun Mi; Park, Heejung; Lee, Kyoung Eun

    2017-01-01

    The most common sites for extragonadal germ cell tumors are the midline mediastinum, retroperitoneum and, much less frequently, the stomach. The stomach-originated primary germ cell tumor carries a poor prognosis, especially when metastasis occurs to the liver, with a mean survival time of 1 month. We describe the case of a 77-year-old male who presented with usual symptoms of gastric malignancy. Gastrectomy was performed. Histopathology of surgically resected tissue revealed a mixture of adenocarcinoma and endodermal sinus tumor components with α-fetoprotein production. After liver metastasis was identified, oxaliplatin and capecitabine were administered as palliative chemotherapy. The response was poor. For the second-line therapy, bleomycin, etoposide, and cisplatin (BEP) therapy was initiated. The overall response to these drugs was a partial response and the residual liver lesion was considered to be resectable. The patient died of pneumonia 11 months following the BEP session, representing an overall survival time of 22 months. Gastric adenocarcinoma with a germ cell tumor component is uncommon and an effective combination of chemotherapeutic agents is not yet clear. In this case, the patient received germ cell tumor-targeting chemotherapy and showed a durable response. Hence, germ cell-targeting cytotoxic agents have potential as the 'front-line regimen'.

  20. Evaluation of the Pattern of EPIYA Motifs in the Helicobacter pylori cagA Gene of Patients with Gastritis and Gastric Adenocarcinoma from the Brazilian Amazon Region

    Directory of Open Access Journals (Sweden)

    Adenielson Vilar e Silva

    2014-01-01

    Full Text Available The Helicobacter pylori is associated with the development of different diseases. The clinical outcome of infection may be associated with the cagA bacterial genotype. The aim of this study was to determine the EPIYA patterns of strains isolated from patients with gastritis and gastric adenocarcinoma and correlate these patterns with the histopathological features. Gastric biopsy samples were selected from 384 patients infected with H. pylori, including 194 with chronic gastritis and 190 with gastric adenocarcinoma. The presence of the cagA gene and the EPIYA motif was determined by PCR. The cagA gene was more prevalent in patients with gastric cancer and was associated with a higher degree of inflammation, neutrophil activity, and development of intestinal metaplasia. The number of EPIYA-C repeats showed a significant association with an increased risk of gastric carcinoma (OR = 3.79, 95% CI = 1.92–7.46, and P=0.002. A larger number of EPIYA-C motifs were also associated with intestinal metaplasia. In the present study, infection with H. pylori strains harboring more than one EPIYA-C motif in the cagA gene was associated with the development of intestinal metaplasia and gastric adenocarcinoma but not with neutrophil activity or degree of inflammation.

  1. Evaluation of the Pattern of EPIYA Motifs in the Helicobacter pylori cagA Gene of Patients with Gastritis and Gastric Adenocarcinoma from the Brazilian Amazon Region.

    Science.gov (United States)

    Vilar E Silva, Adenielson; Junior, Mario Ribeiro da Silva; Vinagre, Ruth Maria Dias Ferreira; Santos, Kemper Nunes; da Costa, Renata Aparecida Andrade; Fecury, Amanda Alves; Quaresma, Juarez Antônio Simões; Martins, Luisa Caricio

    2014-01-01

    The Helicobacter pylori is associated with the development of different diseases. The clinical outcome of infection may be associated with the cagA bacterial genotype. The aim of this study was to determine the EPIYA patterns of strains isolated from patients with gastritis and gastric adenocarcinoma and correlate these patterns with the histopathological features. Gastric biopsy samples were selected from 384 patients infected with H. pylori, including 194 with chronic gastritis and 190 with gastric adenocarcinoma. The presence of the cagA gene and the EPIYA motif was determined by PCR. The cagA gene was more prevalent in patients with gastric cancer and was associated with a higher degree of inflammation, neutrophil activity, and development of intestinal metaplasia. The number of EPIYA-C repeats showed a significant association with an increased risk of gastric carcinoma (OR = 3.79, 95% CI = 1.92-7.46, and P = 0.002). A larger number of EPIYA-C motifs were also associated with intestinal metaplasia. In the present study, infection with H. pylori strains harboring more than one EPIYA-C motif in the cagA gene was associated with the development of intestinal metaplasia and gastric adenocarcinoma but not with neutrophil activity or degree of inflammation.

  2. 多西他赛联合奥沙利铂及卡培他滨治疗进展期胃癌的疗效及安全性评估——单中心非对照Ⅱ期临床研究%Efficacy and safety evaluation of docetaxel plus oxaliplatin and capecitabine in the treatment of advanced gastric adenocarcinoma: a single center non-controlled phase Ⅱ clinical trial

    Institute of Scientific and Technical Information of China (English)

    刘瑾; 马韬; 叶正宝; 张俊; 朱正纲

    2010-01-01

    目的 评价多西他赛联合奥沙利铂及卡培他滨方案(DOX方案)治疗进展期胃癌的临床疗效和不良反应.方法 采用单中心非对照Ⅱ期临床研究,进展期胃癌患者30例入组.DOX方案为:多西他赛75 mg/m~2,第1天,静脉滴注2 h;奥沙利铂130 mg/m~2,第1天,静脉滴注2 h:卡培他滨1000 mg/m~2,2次/d,口服,1~14 d;每21 d为1周期.至少2周期后评价疗效及不良反应.结果 入组30例患者均根据RECIST标准评估疗效,完全缓解1例,部分缓解2例,稳定25例,进展2例;有效率为10.0%(3/30),疾病控制率为93.3%(28/30).中位随访时间261 d,全组患者中位无进展生存期197 d,中位总生存期466 d.不良反应:18例(60.0%)发生Ⅲ~Ⅳ度白细胞减少,13例(43.3%)发生Ⅲ~Ⅳ度中性粒细胞减少,9例(30.0%)出现粒细胞减少性发热,8例(26.7%)发生Ⅲ~Ⅳ度乏力.结论 DOX方案治疗进展期胃癌疗效较好,有一定的耐受性,值得进一步扩大样本量开展后续研究.%Objective To assess the efficacy and safety of docetaxel plus oxaliplatin and capecitabine (DOX) in the treatment of advanced gastric adenocarcinoma. Methods A total of 30 patients were recruited to receive DOX regimen (docetaxel 75 mg/m~2 day 1, oxaliplatin 130 mg/m~2 day 1, and capecitabine 1000 mg/m~2 bid d1-14, repeated every 3 weeks). Only those who completed at least 2 cycles were assessed. Results The number of patients with complete response, partial response, stable disease and progressive disease were 1, 2, 25 and 2, respectively. The objective response rate was 10.0%(3/30) and the disease control rate was 93.3%(28/30). After a median follow-up of 261 days, the median progression free survival and overall survival time were 197 days and 466 days, respectively. The most common grade Ⅲ to Ⅵ toxicity was hematologic toxicity. The percentage of patients with grade Ⅲ to Ⅵ leucopenia, neutropenia and febrile neutropenia were 60.0%, 43.3% and 30.0%, respectively. The most common

  3. In vitro and in vivo studies on antitumor effects of gossypol on human stomach adenocarcinoma (AGS) cell line and MNNG induced experimental gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gunassekaran, G.R., E-mail: gunassekaran@yahoo.co.in [Department of Medical Biochemistry, Dr. ALM Post Graduate Institute of Basic Medical Sciences, University of Madras, Taramani Campus, Chennai 600 113, Tamil Nadu (India); Kalpana Deepa Priya, D.; Gayathri, R.; Sakthisekaran, D. [Department of Medical Biochemistry, Dr. ALM Post Graduate Institute of Basic Medical Sciences, University of Madras, Taramani Campus, Chennai 600 113, Tamil Nadu (India)

    2011-08-12

    Highlights: {yields} Gossypol is a well known polyphenolic compound used for anticancer studies but we are the first to report that gossypol has antitumor effect on MNNG induced gastric cancer in experimental animal models. {yields} Our study shows that gossypol inhibits the proliferation of AGS (human gastric adenocarcinoma) cell line. {yields} In animal models, gossypol extends the survival of cancer bearing animals and also protects the cells from carcinogenic effect. {yields} So we suggest that gossypol would be a potential chemotherapeutic and chemopreventive agent for gastric cancer. -- Abstract: The present study has evaluated the chemopreventive effects of gossypol on N-methyl-N'-nitro-N-nitrosoguanidine (MNNG)-induced gastric carcinogenesis and on human gastric adenocarcinoma (AGS) cell line. Gossypol, C{sub 30}H{sub 30}O{sub 8}, is a polyphenolic compound that has anti proliferative effect and induces apoptosis in various cancer cells. The aim of this work was to delineate in vivo and in vitro anti-initiating mechanisms of orally administered gossypol in target (stomach) tissues and in human gastric adenocarcinoma (AGS) cell line. In vitro results prove that gossypol has potent cytotoxic effect and inhibit the proliferation of adenocarcinoma (AGS) cell line. In vivo results prove gossypol to be successful in prolonging the survival of MNNG induced cancer bearing animals and in delaying the onset of tumor in animals administrated with gossypol and MNNG simultaneously. Examination of the target (stomach) tissues in sacrificed experimental animals shows that administration of gossypol significantly reduces the level of tumor marker enzyme (carcino embryonic antigen) and pepsin. The level of Nucleic acid contents (DNA and RNA) significantly reduces, and the membrane damage of glycoprotein subsides, in the target tissues of cancer bearing animals, with the administration of gossypol. These data suggest that gossypol may create a beneficial effect in

  4. Synchronous Double Malignant Tumors Consisting of Stomach and Hodgkin’s Lymphoma with Collision between Gastric Adenocarcinoma and Hodgkin’s Lymphoma in the Stomach

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    Naoki Yanagawa

    2012-12-01

    Full Text Available We report the rare case of a 72-year-old man with double cancers (gastric adenocarcinoma and Hodgkin’s lymphoma with collision between gastric adenocarcinoma and Hodgkin’s lymphoma. Abdominal computed tomography showed increased wall thickness in the fundus region of the stomach and multiple lymph node swellings in the lesser curvature, periceliac and left cardial regions. Upper gastrointestinal endoscopy showed an ulcer approximately 5 cm in diameter with a malignant appearance in the fundus region of the stomach. On histopathologic examination, two completely different tumors were recognized in the stomach. One tumor was a poorly differentiated adenocarcinoma characterized by poorly developed tubular structures associated with prominent lymphoid infiltration of the stroma. The other tumor was found to have proliferated in the wall of the stomach, with diffuse granulomatous lesions and bordering the adenocarcinoma. Large atypical lymphoid cells with prominent nucleoli and enlarged mononuclei or multinuclei were seen in the latter tumor. Hodgkin’s lymphoma was also found in the swollen lesser curvature lymph nodes. As a result, gastric adenocarcinoma and metastasis of Hodgkin’s lymphoma were collided in the stomach. In conclusion, this case might be helpful in exploring the occurrence mechanism of tumor collision between lymphoma and carcinoma.

  5. Resectable adenocarcinoma of the oesophago-gastric junction care: Which perioperative treatment?; Prise en charge des adenocarcinomes de la jonction oesogastrique resecables: quel traitement perioperatoire?

    Energy Technology Data Exchange (ETDEWEB)

    Crehangea, G.; Maingon, P. [Centre de Lutte Contre le Cancer Georges-Francois-Leclerc, Dept. de Radiotherapie, 21 - Dijon (France); Bonnetain, F. [Centre de Lutte Contre le Cancer Georges-Francois-Leclerc, Dept. de Biostatistiques, 21 - Dijon (France); Chauffert, B. [Centre de Lutte Contre le Cancer Georges-Francois-Leclerc, Dept. d' Oncologie Medicale, 21 - Dijon (France); Rat, P. [Centre Hospitalier Universitaire le Bocage, Service de Chirurgie Digestive, 21 - Dijon (France); Bedenne, L. [Centre Hospitalier Universitaire le Bocage, Service d' Hepatogastroenterologie, 21 - Dijon (France)

    2008-09-15

    Adenocarcinoma of the oesophago-gastric junction has an ominous prognosis. Until now, oesophageal adenocarcinoma care was close to the squamous cell cancer one whereas adenocarcinoma of the cardia was mixed with gastric cancers. Results from randomized studies mixed them without making distinctions. Nevertheless, context, natural history and clinical outcome differ. Five-year survival rate is around 40 %, all stages included. Results from several phase-III studies or meta-analysis allowed to define three therapeutic strategies applicable to adenocarcinoma of the oesophagus and the oesophago-gastric junction. In Europe, in the case of a resectable tumour, preoperative chemotherapy became a standard treatment since results from the Magic trial. In the United States, post-operative radio chemotherapy according to the 'Macdonald' scheme is used in case of a resected tumour with a R0 surgery. Actually, modern techniques of irradiation could reduce the rate of gastro-intestinal toxicities. The survival benefit from preoperative radio chemotherapy is still very controversial with high rates of postoperative morbidity and mortality. We have performed a review of the literature with a methodological analysis of data with a high level of evidence in order to advise perioperative treatment guidelines for patients with a resectable adenocarcinoma of the lower oesophagus or gastro-oesophageal junction. Results from pre- or postoperative strategies and the role of radiotherapy will need to be analysed in the future through a randomized study. (authors)

  6. Preoperative treatment with radiochemotherapy for locally advanced gastroesophageal junction cancer and unresectable locally advanced gastric cancer

    Directory of Open Access Journals (Sweden)

    Ratosa Ivica

    2015-06-01

    Full Text Available Background. To purpose of the study was to analyze the results of preoperative radiochemotherapy in patients with unresectable gastric or locoregionally advanced gastroesophageal junction (GEJ cancer treated at a single institution.

  7. Metástasis mandibular de adenocarcinoma gástrico: Presentación de un caso Mandibular metastases of gastric adenocarcinoma: A case report

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    J. Ferreras Granado

    2007-10-01

    Full Text Available Los tumores malignos de la cavidad oral y mandíbula representan aproximadamente un 5% de todas las neoplasias malignas del cuerpo, y sólo entre el 1 y el 4% son consideradas como metástasis. Tienen su localización más frecuente a nivel de la mandíbula (80%, fundamentalmente en la región molar. Las metástasis mandibulares, cuando aparecen, suelen tener su origen en tumores primarios que asientan en la mama, pulmón, riñón, tiroides, intestinos y próstata; y con menor frecuencia en el estómago, testículos y vesícula biliar. Suelen afectar a pacientes de edad avanzada (4ª-7ª décadas de la vida sin predilección por el sexo. El tratamiento en general es paliativo y pasa por el uso de la radioterapia, quimioterapia y hormonoterapia, reservando la cirugía para casos aislados. Describimos un caso de metástasis mandibular en un paciente adulto como primera manifestación clínica de un adenocarcinoma gástrico.Malignant tumors of the mouth and jaws represents approximately 5% of all malignant neoplasms in the body, and only 1-4% are considered to be metastatic. They are most frequently located in the mandible (80%, fundamentally in the molar region. Metastases to the jaws are usually from breast, lung, kidney, thyroid gland, intestines, and prostate gland; and less frequently from stomach, testes, and bladder. They are more frequent in elderly patients (between 4th and 7th decades with no gender differences. Treatment is usually palliative and based on the use of radiotherapy, chemotherapy andhormonal therapy. Surgery is only used in selected cases. A case of mandibular metastases as first sign of malignant disease of gastric adenocarcinoma is reported.

  8. S-1 Joint Cisplatin Cannot Improve Survival Advanced Gastric Carcinoma%S-1联合顺铂不能提高晚期胃癌的生存率

    Institute of Scientific and Technical Information of China (English)

    巴一; 马冬

    2011-01-01

    @@ 1 文献来源 Ajani JA,Rodriguez W,Bodoky G ,et al.Multicenter phase Ⅲ comparison of Cisplatin/S-1with Cisplatin/Infusional Fluorouracil in advanced gastric or gastroesophageal adenocarcinoma study:The FLAGS trial [J].J Clin Oncol,2010,28(9):1547-1553.

  9. MUC4 and MUC1 expression in adenocarcinoma of the stomach correlates with vessel invasion and lymph node metastasis: an immunohistochemical study of early gastric cancer.

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    Yukihiro Tamura

    Full Text Available We have previously reported that MUC4 expression is a poor prognostic factor in various carcinomas. Our previous study also showed that MUC1 expression in gastric cancers, including the early and advanced stages is a poor prognostic factor. In the present study, the expression profiles of MUC4 and MUC1 were examined by immunohistochemistry (IHC using two anti-MUC4 monoclonal antibodies (MAbs, 8G7 and 1G8, and anti-MUC1 MAb DF3 in 104 gastrectomy specimens of early gastric adenocarcinoma with submucosal invasion (pT1b2, including 197 histological subtype lesions. Before the IHC study of the human specimens, we evaluated the specificity of the two MAbs by Western blotting and IHC of two MUC4 mRNA expressing gastric cancer cell lines. MAb 8G7 reacted clearly, whereas MAb 1G8 did not show any reactivity, in either Western blotting or IHC. In the IHC of the gastric cancers, the expression rates of MUC4/8G7 detected by MAb 8G7, MUC4/1G8 detected by MAb 1G8 and MUC1/DF3 detected by MAb DF3 in well differentiated types (70%, 38/54; 67%, 36/54; 52%, 28/54 were significantly higher than those in poorly differentiated types (18%, 10/55; 36%, 20/55; 13%, 7/55 (P<0.0001; P = 0.0021; P<0.0001, respectively. The MUC4/8G7 expression was related with lymphatic invasion (r = 0.304, P = 0.033. On the other hand, the MUC4/1G8 expression was related with lymphatic invasion (r = 0.395, P = 0.001 and lymph node metastasis (r = 0.296, P = 0.045. The MUC1/DF3 expression was related with lymphatic invasion (r = 0.357, P = 0.032 and venous invasion (r = 0.377, P = 0.024. In conclusion, the expression of MUC4 as well as MUC1 in early gastric cancers is a useful marker to predict poor prognostic factors related with vessel invasion.

  10. Contribution of H. pylori and smoking trends to US incidence of intestinal-type noncardia gastric adenocarcinoma: a microsimulation model.

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    Jennifer M Yeh

    Full Text Available BACKGROUND: Although gastric cancer has declined dramatically in the US, the disease remains the second leading cause of cancer mortality worldwide. A better understanding of reasons for the decline can provide important insights into effective preventive strategies. We sought to estimate the contribution of risk factor trends on past and future intestinal-type noncardia gastric adenocarcinoma (NCGA incidence. METHODS AND FINDINGS: We developed a population-based microsimulation model of intestinal-type NCGA and calibrated it to US epidemiologic data on precancerous lesions and cancer. The model explicitly incorporated the impact of Helicobacter pylori and smoking on disease natural history, for which birth cohort-specific trends were derived from the National Health and Nutrition Examination Survey (NHANES and National Health Interview Survey (NHIS. Between 1978 and 2008, the model estimated that intestinal-type NCGA incidence declined 60% from 11.0 to 4.4 per 100,000 men, <3% discrepancy from national statistics. H. pylori and smoking trends combined accounted for 47% (range = 30%-58% of the observed decline. With no tobacco control, incidence would have declined only 56%, suggesting that lower smoking initiation and higher cessation rates observed after the 1960s accelerated the relative decline in cancer incidence by 7% (range = 0%-21%. With continued risk factor trends, incidence is projected to decline an additional 47% between 2008 and 2040, the majority of which will be attributable to H. pylori and smoking (81%; range = 61%-100%. Limitations include assuming all other risk factors influenced gastric carcinogenesis as one factor and restricting the analysis to men. CONCLUSIONS: Trends in modifiable risk factors explain a significant proportion of the decline of intestinal-type NCGA incidence in the US, and are projected to continue. Although past tobacco control efforts have hastened the decline, full benefits will take decades to be

  11. S-1 in combination with docetaxel and oxaliplatin in patients with advanced gastro-esophageal adenocarcinoma

    DEFF Research Database (Denmark)

    Pfeiffer, Per; Qvortrup, Camilla; Krogh, Merete

    2017-01-01

    BACKGROUND: Docetaxel in combination with cisplatin and 5-fluorouracil (5-FU) is one of several standard chemotherapy regimens for patients with advanced gastro-esophageal adenocarcinoma (aGEA) in Europe. To enable outpatient treatment, we evaluated the maximum tolerated dose (MTD), recommended...

  12. Postoperative chemoradiotherapy in high risk locally advanced gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Song, Sang Hyuk; Chie, Eui Kyu; Kim, Kyu Bo; Lee, Hyuk Joon; Yang, Han Kwang; Han, Sae Won; Oh, Do Youn; Im, Seok Ah; Bang, Yung Jue; Ha, Sung W. [Seoul National University College of Medicine, Seoul(Korea, Republic of)

    2012-12-15

    To evaluate treatment outcome of patients with high risk locally advanced gastric cancer after postoperative chemoradiotherapy. Between May 2003 and May 2012, thirteen patients who underwent postoperative chemoradiotherapy for gastric cancer with resection margin involvement or adjacent structure invasion were retrospectively analyzed. Concurrent chemotherapy was administered in 10 patients. Median dose of radiation was 50.4 Gy (range, 45 to 55.8 Gy). The median follow-up duration for surviving patients was 48 months (range, 5 to 108 months). The 5-year overall survival rate was 42% and the 5-year disease-free survival rate was 28%. Major pattern of failure was peritoneal seeding with 46%. Loco-regional recurrence was reported in only one patient. Grade 2 or higher gastrointestinal toxicity occurred in 54% of the patients. However, there was only one patient with higher than grade 3 toxicity. Despite reported suggested role of adjuvant radiotherapy with combination chemotherapy in gastric cancer, only very small portion of the patients underwent the treatment. Results from this study show that postoperative chemoradiotherapy provided excellent locoregional control with acceptable and manageable treatment related toxicity in patients with high risk locally advanced gastric cancer. Thus, postoperative chemoradiotherapy may improve treatment result in terms of locoregional control in these high risk patients. However, as these findings are based on small series, validation with larger cohort is suggested.

  13. Requirement for a standardised definition of advanced gastric cancer.

    Science.gov (United States)

    DE Sol, Angelo; Trastulli, Stefano; Grassi, Veronica; Corsi, Alessia; Barillaro, Ivan; Boccolini, Andrea; DI Patrizi, Micol Sole; DI Rocco, Giorgio; Santoro, Alberto; Cirocchi, Roberto; Boselli, Carlo; Redler, Adriano; Noya, Giuseppe; Kong, Seong-Ho

    2014-01-01

    Each year, ~988,000 new cases of stomach cancer are reported worldwide. Uniformity for the definition of advanced gastric cancer (AGC) is required to ensure the improved management of patients. Various classifications do actually exist for gastric cancer, but the classification determined by lesion depth is extremely important, as it has been shown to correlate with patient prognosis; for example, early gastric cancer (EGC) has a favourable prognosis when compared with AGC. In the literature, the definition of EGC is clear, however, there is heterogeneity in the definition of AGC. In the current study, all parameters of the TNM classification for AGC reported in each previous study were individually analysed. It was necessary to perform a comprehensive systematic literature search of all previous studies that have reported a definition of ACG to guarantee homogeneity in the assessment of surgical outcome. It must be understood that the term 'advanced gastric cancer' may implicate a number of stages of disease, and studies must highlight the exact clinical TNM stages used for evaluation of the study.

  14. Down-regulation of miR-302b, an ESC-specific microRNA, in Gastric Adenocarcinoma

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    Seyed Javad Mowla

    2012-01-01

    Full Text Available Objective: microRNAs (miRNAs are a new class of non-coding RNAs involved in regulatingvarious biological processes including proliferation, differentiation, and apoptosis,among others. Alterations in miRNA expression are reported in several human cancers,which suggests their potential roles in tumor initiation and progression. Members of themiR-302 cluster are highly expressed in embryonic stem cells (ESC, where they regulatecell self-renewal and pluripotency. Based on the cancer stem cell (CSC hypothesis,mis-expression of such genes might contribute to tumorigenicity. This study aims to find apotential link between the expression level of human/homo sapiens miR-302b (has-miR-302b and tumor/grade state of gastric tissues.Materials and Methods: A matched based case-control study was conducted that includedtumor and matched marginal non-tumor surgical specimens from 34 patients diagnosedwith gastric adenocarcinoma. Randomly selected samples were obtained fromthe Iran National Tumor Bank. cDNA synthesis was carried out on total RNA, by usingthe miRCURY LNA™ Universal RT microRNA PCR Kit. Real-time reverse transcriptionpolymerasechain reaction (RT-PCR assays were performed with specific LNA™ primersand SYBR Green master mix. The human embryonic carcinoma cell line, NTERA2 (NT2and a human gastric adenocarcinoma cell line, AGS, were used to optimize the PCR reactions.A comparative evaluation of miR-302b expression in tumor and non-tumor gastricsamples was performed by either paired t test or Wilcoxon non-parametric test. The abilityof miR-302b to discriminate tumor from non-tumor gastric samples was evaluated usingthe area under the receiver operating characteristic (ROC curve.Results: According to our data, miR-302b expression (normalized to that of the U6 snRNAhousekeeping gene in the pluripotent cell line NT2 was more than 500 times greater thanthat of the AGS cell line. The level of expression was even lower in tumor and non

  15. Urokinase plasminogen activator receptor on invasive cancer cells: A prognostic factor in distal gastric adenocarcinoma

    DEFF Research Database (Denmark)

    Alpizar, Warner Enrique Alpizar; Christensen, Ib Jarle; Santoni-Rugiu, Eric

    2012-01-01

    Gastric cancer is the second cancer causing death worldwide. The five-year survival for this malignancy is below 25% and few parameters have shown an impact on the prognosis of the disease. The receptor for urokinase plasminogen activator (uPAR) is involved in extracellular matrix degradation...... by mediating cell surface associated plasminogen activation, and its presence on gastric cancer cells is linked to micrometastasis and poor prognosis. Using immunohistochemistry, the prognostic significance of uPAR was evaluated in tissue samples from a retrospective series of 95 gastric cancer patients. u...... association between the expression of uPAR on tumor cells in the peripheral invasion zone and overall survival of gastric cancer patients (HR = 2.16; 95% CI: 1.13-4.14; p = 0.02). Multivariate analysis showed that uPAR immunoreactivity in cancer cells at the invasive front is an independent prognostic factor...

  16. De novo gastric adenocarcinoma 1 year after sleeve gastrectomy in a transplant patient

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    M. Masrur

    2016-01-01

    Conclusions: No direct relation has been established between sleeve gastrectomy and the development of gastric cancer. Robotic procedures allow for complex multiorgan resections, while preserving the benefits of minimally invasive surgery.

  17. Postoperative chemoradiation in patients with localized gastric adenocarcinoma: Single center experience

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    A Yoney

    2011-01-01

    Full Text Available Background : 5-Flourouracil (FU-based chemotherapy (CT and concurrent 45 Gy radiotherapy (RT is one of the standard postoperative approaches currently used in gastric carcinoma. The high toxicity rates of this treatment leads to interruption of treatment in the majority of patients. In our study, we investigated the rates of toxicity and treatment discontinuation observed during postoperative FU-based chemoradiotherapy (CRT; retrospectively evaluated the effect of CRT and the other prognostic factors on local and distant control and survival. Patients and Methods: A total of 160 patients consisting of 97 total and 63 subtotal gastrectomy receiving postoperative CRT, have been studied retrospectively. Results : Patients who had to discontinue the treatment for a median of 6 (range, 3-13 days experienced toxicity during treatment at a rate of 43%. During the 21 (range, 4-68 months of follow-up local recurrences were observed in 8 (5% patients and distant recurrences were observed in 41 (25.6% patients. While the 1-3 year overall survival (OS rates were 75% and 42%, 13-year disease-free survival (DFS rates were 63% and 42%, respectively. In the univariate analysis for OS and DFS demonstrated statistical significance for below those 60 years of age, D1-D2 dissection type, negative surgical margin, early treatment beginning, the absence of invasion, and early stage disease. D1D2 dissection type, early treatment begining, age below 60 years and early stage disease significantly improve OS and DFS in multivarite analysis. Conclusions: Survival is worse in patients older than 60 years, had late treatment begining, advanced stage and D0 dissection.

  18. Antisense bcl-2 retrovirus vector increases the sensitivity of a human gastric adenocarcinoma cell line to photodynamic therapy.

    Science.gov (United States)

    Zhang, W G; Ma, L P; Wang, S W; Zhang, Z Y; Cao, G D

    1999-05-01

    The bcl-2 oncoprotein directly prolongs cellular survival by blocking apoptosis and its overexpression is associated with cellular resistance to killing by chemotherapeutic drugs and gamma-irradiation. Meanwhile, it has been shown that bcl-2 antisense oligonucleotide can induce apoptosis or increase toxicity of the treatment in tumors in vivo and in vitro. However, it is difficult to obtain stable transfection by this approach and there are no reports about the effect of an antisense bcl-2 on the sensitivity to oxidative stress induced by photodynamic therapy (PDT). Here we investigated the effect of an antisense bcl-2 RNA retrovirus vector transfer on the sensitivity of 2-butylamino-2-demethoxy-hypocrellin A (2-BA-2-DMHA) photosensitization in a human gastric adenocarcinoma MGC803 cell line. The results indicate that antisense bcl-2-infected MGC803 cells expressed exogenous antisense bcl-2 mRNA measured by reverse transcription polymerase chain reaction and significantly reduced bcl-2 protein determined by western blotting analysis. The decreased expression of bcl-2 protein was accompanied by increased phototoxicity and susceptibility to apoptosis induced by 2-BA-2-DMHA PDT. Our finding suggests that reduction of bcl-2 protein in gastric cancers, and possibly also in a variety of other tumors, may be a novel and rational approach to improve photosensitivity and the treatment outcome.

  19. Long non-coding RNA HOTAIR promotes carcinogenesis and invasion of gastric adenocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Na Keum; Lee, Jung Hwa; Park, Chan Hyuk; Yu, Dayeon; Lee, Yong Chan [Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Cheong, Jae-Ho; Noh, Sung Hoon [Department of Surgery, Yonsei University College of Medicine (Korea, Republic of); Lee, Sang Kil, E-mail: sklee@yuhs.ac [Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-08-22

    Highlights: • HOTAIR expression was tested in fifty patients with gastric cancer. • Cell proliferation was measured after HOTAIR silencing in gastric cancer cell line. • siRNA–HOTAIR suppresses cell invasiveness and capacity of migration. • Knock down of HOTAR leads to decreased expression of EMT markers. • Inhibition of HOTAIR induces apoptosis and cell cycle arrest. - Abstract: Gastric cancer is one of the major causes of cancer death worldwide; however, the mechanism of carcinogenesis is complex and poorly understood. Long non-coding RNA HOTAIR (HOX transcript antisense RNA) recently emerged as a promoter of metastasis in various cancers including gastric cancer. Here we investigated the impact of HOTAIR on apoptosis, cell proliferation and cell cycle to dissect the carcinogenesis of gastric cancer. We examined the mechanism of invasion and metastasis and analyzed the clinical significance of HOTAIR. Downregulation of HOTAIR was confirmed by two different siRNAs. The expression of HOTAIR was significantly elevated in various gastric cancer cell lines and tissues compared to normal control. si-HOTAIR significantly reduced viability in MKN 28, MKN 74, and KATO III cells but not in AGS cells. si-HOTAIR induced apoptosis in KATO III cells. Lymphovascular invasion and lymph node metastasis were more common in the high level of HOTAIR group. si-HOTAIR significantly decreased invasiveness and migration. si-HOTAIR led to differential expression of epithelial to mesenchymal transition markers. We found that HOTAIR was involved in inhibition of apoptosis and promoted invasiveness, supporting a role for HOTAIR in carcinogenesis and progression of gastric cancer.

  20. Targeting chemotherapy via arterial infusion for advanced gastric cancer

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    Zhi-yu CAO

    2011-10-01

    Full Text Available Objective To evaluate the clinical effects of chemotherapy via arterial infusion in treatment of advanced gastric cancer.Methods Forty-seven patients with advanced gastric cancer were given chemotherapy via arterial infusion.Chemotherapy plan was as follows: 5-Fluorouracil(Fu 500mg/m2,cyclophosphamide(MMX 10mg/m2,Hydroxycamptothecin(HPT 20mg/m2,once per week,2 weeks as a course,a total of 2-3 courses.Results After chemotherapy via arterial infusion,complete remission(CR was achieved in 1 case,partial remission(PR in 28 cases,stabilization of disease(SD in 16 cases,progression of disease(PD was found in 2 cases,and rate with response(CR+PR was 61.7%.Four of 28 PR patients underwent tumorectomy,the pathology revealed the presence of cancer cells around the vascular vessels,manifesting karyopyknosis,karyorrhexis,coagulation and necrosis of cytoplasm,intercellular edema,hyperplasia of fibroblasts,inflammatory cell infiltration,thickening of endothelium,and thrombosis.One,two and three-year survival rates were 70.2%,14.9% and 2.1%,respectively.The average survival period was 17.2 months.Conclusion Targeting chemotherapy via arterial infusion,as a part of the combined treatment,is beneficial to the patients with unresectable advanced gastric cancer.

  1. Control study of arterial interventional chemotherapy before radical gastrectomy for gastric cancer and simple radical gastrectomy for gastric cancer in treatment of advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Bin Liu

    2016-01-01

    Objective: To analyze the differences in effect of arterial interventional chemotherapy before radical gastrectomy for gastric cancer and simple radical gastrectomy for gastric cancer in treatment of advanced gastric cancer.Methods:A total of 86 cases of patients with advanced gastric cancer treated in our hospital were selected as research subjects and randomly divided into two groups, observation group received arterial interventional chemotherapy combined with radical gastrectomy for gastric cancer, control group received simple radical gastrectomy for gastric cancer, and then differences in prognosis-associated factors, MMP and Leptin contents as well as tumor marker and telomerase activity levels of two groups were compared.Results:Serum HER-2/neu ECD level of observation group was lower than that of control group, and serum DKK-1, TS and TP levels were higher than those of control group; at each point in time after treatment, serum CA72-4 and CA50 contents of observation group were lower than those of control group; intraoperative MMP-2, MMP-7, MMP-9 and Leptin levels in gastric cancer tissue of observation group were lower than those of control group; telomerase activity value in gastric cancer tissue of observation group after treatment was lower than that of control group, and both PGⅠ positive expression rate and PGⅠ/ PGⅡ ratio were higher than those of control group.Conclusion: Arterial interventional chemotherapy before radical gastrectomy for gastric cancer can lower tumor malignancy, promote the curative effect of radical gastrectomy for gastric cancer and improve long-term prognosis.

  2. Prevalence of Helicobacter pylori infection and intestinal metaplasia in subjects who had undergone surgery for gastric adenocarcinoma in Northwest Italy

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    Giorgio Palestro; Donata Campra; Miguel Angel Cutufia; Elena Margaria; Giancarlo Spinzi; Aldo Ferrara; Giorgio Marenco; Mario Rizzetto; Antonio Ponzetto; Rinaldo Pellicano; Gian Ruggero Fronda; Guido Valente; Marco De Giuli; Tito Soldati; Agostino Pugliese; Stefano Taraglio; Mauro Garino

    2005-01-01

    AIM: To investigate the seroprevalence of Helicobacter pylori(H pylorri) infection and its more virulent strains as well as the correlation with the histologic features among patients who had undergone surgery for gastric cancer (GC).METHODS: Samples from 317 (184 males, 133females, mean age 69±3.4 years) consecutive patients who had undergone surgery for gastric non-cardia adenocarcinoma were included in the study. Five hundred and fifty-five (294 males, 261 females, mean age 57.3±4.1 years) patients consecutively admitted to the Emergency Care Unit served as control. Histological examination of tumor, lymph nodes and other tissues obtained at the time of surgery represented the diagnostic "gold standard". An enzyme immunosorbent assay was used to detect serum anti-H pylori(IgG)antibodies and Western blotting technique was utilized to search for anti-CagA protein (IgG).RESULTS: Two hundred and sixty-one of three hundred and seventeen (82.3%) GC patients and 314/555 (56.5%)controls were seropositive for anti-H pylori (P<0.0001;OR, 3.58; 95%CI, 2.53-5.07). Out of the 317 cases, 267(84.2%) were seropositive for anti-CagA antibody vs 100 out of 555 (18%) controls (P<0.0001; OR, 24.30;95%CI, 16.5-35.9). There was no difference between the frequency of H pyloriin intestinal type carcinoma (76.2%) and diffuse type cancer (78.8%). Intestinal metaplasia (IM) was more frequent but not significant in the intestinal type cancer (83.4% vs 75.2% in diffuse type and 72.5% in mixed type). Among the patients examined for IM, 39.8% had IM type Ⅰ, 8.3% type Ⅱ and 51.9% type Ⅲ (type Ⅲ vs others, P = 0.4).CONCLUSION; This study confirms a high seroprevalence of H pyloriinfection in patients suffering from gastric adenocarcinoma and provides further evidence that searching for CagA status over H pylori infection might confer additional benefit in identifying populations at greater risk for this tumor.

  3. SUVmax/THKmax as a biomarker for distinguishing advanced gastric carcinoma from primary gastric lymphoma.

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    Liping Fu

    Full Text Available BACKGROUND: Gastric carcinoma and primary gastric lymphoma (PGL are the two most common malignancies in stomach. The purpose of this study was to screen and validate a biomarker of (18F-fluorodeoxyglucose positron emission tomography/computed tomography ((18F-FDG PET/CT for distinguishing advanced gastric carcinoma (AGC from PGL for clinical applications. METHODOLOGY/PRINCIPAL FINDINGS: We reviewed PET/CT scans collected from January 2008 to April 2012 of 69 AGC and 38 PGL (14 low-grade mucosa-associated lymphoid tissue [MALT], 24 non-MALT aggressive non-Hodgkin lymphoma [ANHL] with a focus on FDG intensity (maximum standardized uptake value [SUVmax] of primary lesions and its CT-detected abnormalities, including maximal gastrointestinal wall thickness (THKmax and mucosal ulcerations. Gastric FDG uptake was found in 69 (100% patients with AGC and 36 (95%, 12 MALT vs. 24 ANHLwith PGL. The presence of CT-detected abnormalities of AGC and PGL were 97% (67/69 and 89% (12 MALT vs. 22 ANHL, respectively. After controlling for THKmax, SUVmax was higher with ANHL than AGC (17.10 ± 8.08 vs. 9.65 ± 5.24, p0.05. Cross-validation analysis showed that for distinguishing ANHL from AGC, the classifier with SUVmax as a feature achieved a correct classification rate of 81% with thresholds 13.40 ± 1.12 and the classifier with SUVmax/THKmax as a feature achieved a correct classification rate of 83% with thresholds 7.51 ± 0.63. CONCLUSIONS/SIGNIFICANCE: SUVmax/THKmax may be as a promising biomarker of FDG-PET/CT for distinguishing ANHL from AGC. Structural CT abnormalities alone may not be reliable but can help with PET assessment of gastric malignancies. (18F-FDG PET/CT have potential for distinguishing AGC from PGL at the individual level.

  4. Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study

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    Buckland, G.; Travier, N.; Huerta, J.M.; Bueno-de-Mesquita, H.B.; Siersema, P.D.; Skeie, G.; Weiderpass, E.; Engeset, D.; Ericson, U.; Ohlsson, B.; Agudo, A.; Romieu, I.; Ferrari, P.; Freisling, H.; Colorado-Yohar, S.; Li, K.; Kaaks, R.; Pala, V.; Cross, A.J.; Riboli, E.; Trichopoulou, A.; Lagiou, P.; Bamia, C.; Boutron-Ruault, M.C.; Fagherazzi, G.; Dartois, L.; May, A.M.; Peeters, P.H.M.; Panico, S.; Johansson, M.; Wallner, B.; Palli, D.; Key, T.J.; Khaw, K.T.; Ardanaz, E.; Overvad, K.; Tjonneland, A.; Dorronsoro, M.; Sanchez, M.J.; Quiros, J.R.; Naccarati, A.; Tumino, R.; Boeing, H.; Gonzalez, C.A.

    2015-01-01

    Several modifiable lifestyle factors, including smoking, alcohol, certain dietary factors and weight are independently associated with gastric cancer (GC); however, their combined impact on GC risk is unknown. We constructed a healthy lifestyle index to investigate the joint influence of these behav

  5. Interleukin-4 receptor −3223C→T Polymorphism is Associated with Increased Gastric Adenocarcinoma Risk

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    Florin Burada

    2012-01-01

    Full Text Available BACKGROUND: Gastric cancer remains one of the most common types of cancer worldwide, with a large geographical variation in incidence and mortality rates. Cytokine polymorphisms are the most studied host polymorphisms and are associated with an increased risk of stomach cancer in many regions, but have not been studied extensively in Eastern European populations.

  6. Expression of the hedgehog pathway components in gastric adenocarcinomas%胃腺癌中hedgehog通路分子的表达

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    杨凌; 崔宏伟; 师迎旭

    2015-01-01

    目的:检测胃腺癌中hedgehog通路分子的表达情况。方法应用原位杂交方法在20例胃腺癌和2例胃炎中检测hedgehog通路分子的表达。结果在20例胃癌组织中,我们检测到11例(15%)有Gli1基因的表达,8例(40%)有Hip基因表达,只在3例(15%)中检测到PDGFRaúà„h¾在11例(55%)胃癌组织中检测到SMO转录水平。在10例(50%)胃癌组织中检测到了Su(Fu)基因的转录。2例胃炎中未见上述基因表达。结论 hedgehog分子在胃腺癌中呈高表达。%Aim We aimed to examine expression of the hedgehog pathway components in gastric adenocarcinomas. Methods We examine expression of the hedgehog pathway components in 20 gastric adenocarcinomas and 2 gastritis using in situ hybridization. Results In 20 gastric adenocarcinomas we detected 11 tissues had Gli1 expression (55%), 8 had Hip (40%), 3 had PDGFRα (15%), 11 had SMO (55%) and 10 had Su(Fu) (50%). There was no expression of these gene detected in 2 gastritis. Conclusion The hedgehog pathway components highly expressed in gastric adenocarcinomas.

  7. Mucin phenotypic expression and p53 gene abnormality of gastric super-minute well-differentiated adenocarcinoma: Re-evaluation with relationship between histogenesis of well-differentiated adenocarcinoma and intestinal metaplasia in distal stomach

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    Yamaguchi Toshikazu

    2005-01-01

    Full Text Available Abstract Background Although the gastric well-differentiated adenocarcinoma in the distal stomach has been thought to develop via a intestinal metaplasia-carcinoma sequence, there are some disproofs from new mucin examinations for minute-size lesions in same type carcinoma. The current study was performed and pointed out the new findings for the solution to the problem according to the point described above. Methods 12 super-minute lesions (less than 1 mm in maximum diameter of well-differentiated adenocarcinoma in distal stomach (SMCa, which were detected from the pathological examinations of 210 surgically resected stomach specimens, and the mucosa adjacent to these carcinoma lesions, were examined by immunohistochemical mucin stainings (MUC2 and CD-10: intestinal phenotype, 45M1 and MUC6: gastric phenotype and p53-overexpression. And the analyses of the replication error of the microsatellites in chromosome 17 related p53 gene (TP53 and D17S786 (RER-p53MS were performed in SMCa lesions, adjacent mucosa to each lesion and other gastric mucosa with intestinal metaplasia, because all SMCa lesions showed p53-overexpression immunohistochemically, decribed below. Results 1. The carcinoma cells in all SMCa lesions were positive for 45M1 and p53. On the other hand, no positive carcinoma cells for MUC6 were seen although the pyloric glands and the remnant pyloric gland in the SMCa lesions in the same slides were positive for MUC6. Ten lesions (83% had intestinal phenotypic mucin (10 lesions: MUC2 (+, 4 lesions: CD10 (+. Two lesions (17% were positive for only 45M1 (gastric phenotypic mucin. 2. All of the mucosa adjacent to SMCa showed intestinal metaplasia (complete type: 7 regions, incomplete type: 5 regions. 3. RER-p53MS was confirmed in 42% (5/12 regions of SMCa, in 42% (5/12 regions of the mucosa adjacent to SMCa and 14% (6/42 regions of the other intestinal metaplasia mucosa. Conclusion Most of the super-minute well-differentiated adenocarcinoma

  8. [Intestinal linitis plastica: late metastasis from gastric signet ring cell adenocarcinoma].

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    Rodríguez Ortega, María; Carabias Hernández, Alberto; Rodríguez Barbero, José María; Garaulet González, Paloma; Limones Esteban, Manuel

    2006-09-01

    Linitis plastica is a malignant disease that usually occurs in the stomach, although it can affect any segment of the alimentary tract. Typically, this entity shows slow progression and insidious clinical course. We present the case of a patient with a previous diagnosis of signet ring cell cancer of the stomach that had been treated with curative intent 12 years before the clinical onset of small and large bowel linitis plastica. The diagnosis was obtained as an incidental pathological finding after urgent surgery for intestinal obstruction. No gastric mass was found. Linitis plastica should be considered in the differential diagnosis of patients with symptoms of obstruction after resection of a gastric carcinoma, especially if there are macroscopic surgical findings of circumferential narrowing. A long interval after diagnosis and treatment of the primary disease does not allow malignancy to be ruled out.

  9. Ductal Adenocarcinoma of the Prostate With a Rare Clinical Presentation; Late Gastric Metastasis

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    Hasan Huseyin Tavukcu; Omer Aytac; Fatma Aktepe; Fatih Atug; Levent Erdem; Coskun Tecimer

    2016-01-01

    A 67 year male had robotic prostatectomy whose pathology revealed mixed type prostate cancer composed of 55% ductal and 45% acinar components. The patient was then admitted to hospital with sudden health problems including ascites and serious vomiting attacks in the 46th month after prostatectomy and the PSA test was 4565 ng/mL. Gastroscopic biopsy was reported and proved immunhistochemically undifferentiated ductal prostate cancer metastasis. This is the first report of late gastric metastas...

  10. Toxicity and survival results of a phase II study investigating the role of postoperative chemoradioimmunotherapy for gastric adenocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Bese, N.S.; Yildirim, A.; Oeber, A. [Dept. of Radiation Oncology, Istanbul Univ., Cerrahpasa Medical School, Istanbul (Turkey); Bueyuekuenal, E.; Oezgueroglu, M.; Demir, G.; Mandel, N.M.; Demirelli, F.; Serdengecti, S. [Dept. of Internal Medicine, Medical Oncology Section, Istanbul Univ., Cerrahpasa Medical School, Istanbul (Turkey)

    2005-10-01

    Background and purpose: to investigate the role of postoperative concomitant chemoradioimmunotherapy in gastric adenocarcinoma patients. Patients and methods: 59 pateints, who underwent total or subtotal gastrectomy, with lymph node involvement, positive microscopic surgical margins or serosal involvement were included in the study. Radiotherapy started concomitantly with chemotherapy and levamisole. Extended-field radiotherapy was given to gastric bed and regional lymphatics via two anterior-posterior/posterior-anterior fields. A total dose of 45 Gy in 25 fractions with a fraction size of 1.8 Gy was planned. In 28 patients (48%) with positive surgical margins a 10-Gy boost dose was given to the anastomosis site. An adjuvant i.v. bolus of 450 mg/m{sup 2}/day 5-fluorouracil (5-FU) was administered concomitantly during the first 3 days and at the 20th day of irradiation. After completion of radiotherapy, i.v. boluses of 450 mg/m{sup 2}/day 5-FU and 25 mg/m{sup 2}/day rescuvorin were continued for 6 months once a week. Levamisole 40 mg/day orally was started at the 1st day of radiotherapy and also continued for 6 months. Median follow-up was 37 months (7-112 months). Results: median survival was 23 months. Overall 3- and 5-year survival rates amounted to 35% and 14%, respectively. Median survival of the patients with positive surgical margins was 22 months. The 3- and 5-year locoregional control rates were 59% and 55%, respectively. The most common toxicity was upper gastrointestinal system toxicity, which was observed in 42 patients (71%). Four patients (7%) died on account of early toxic effects, and six (10%) could not complete treatment. Conclusion: although 48% of the study population involved patients with microscopic residual disease, the survival results as a whole were satisfactory. However, due to high toxicity, radiotherapy must be delivered with the most proper techniques along with adequate nutrition and supportive care. (orig.)

  11. Prevalence of Helicobacter pylori infection in advanced gastric carcinoma

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    Irami Araújo-Filho

    2006-12-01

    Full Text Available BACKGROUD: There is substantial evidence that infection with Helicobacter pylori plays a role in the development of gastric cancer and that it is rarely found in gastric biopsy of atrophic gastritis and gastric cancer. On advanced gastric tumors, the bacteria can be lost from the stomach. AIMS: To analyze the hypothesis that the prevalence of H.pylori in operated advanced gastric carcinomas and adjacent non-tumor tissues is high, comparing intestinal and diffuse tumors according to Lauren's classification METHODS: A prospective controlled study enrolled 56 patients from "Hospital Universitário", Federal University of Rio Grande do Norte, Natal, RN, Brazil, with advanced gastric cancer, treated from February 2000 to March 2003. Immediately after partial gastrectomy, the resected stomach was opened and several mucosal biopsy samples were taken from the gastric tumor and from the adjacent mucosa within 4 cm distance from the tumor margin. Tissue sections were stained with hematoxylin and eosin. Lauren's classification for gastric cancer was used, to analyse the prevalence of H. pylori in intestinal or diffuse carcinomas assessed by the urease rapid test, IgG by ELISA and Giemsa staining. H. pylori infected patients were treated with omeprazole, clarithromycin and amoxicillin for 7 days. Follow-up endoscopy and serology were performed 6 months after treatment to determine successful eradication of H. pylori in non-tumor tissue. Thereafter, follow-up endoscopies were scheduled annually. Chi-square and MacNemar tests with 0.05 significance were used. RESULTS: Thirty-four tumors (60.7% were intestinal-type and 22 (39.3% diffuse type carcinomas. In adjacent non-tumor gastric mucosa, chronic gastritis were found in 53 cases (94.6% and atrophic mucosa in 36 patients (64.3%. All the patients with atrophic mucosa were H. pylori positive. When examined by Giemsa and urease test, H. pylori positive rate in tumor tissue of intestinal type carcinomas was

  12. Localization of thymidine phosphorylase in advanced gastric and colorectal cancer.

    Science.gov (United States)

    Kobayashi, Michiya; Okamoto, Ken; Akimori, Toyokazu; Tochika, Naoshige; Yoshimoto, Tadashi; Okabayashi, Takehiro; Sugimoto, Takeki; Araki, Keijiro

    2004-01-01

    Thymidine phosphorylase (TP) is known to be more concentrated in human cancer tissues than in adjacent normal tissue based on findings using enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry. However, the ultrastructural localization of TP in cancer tissues has not previously been demonstrated. We investigated the localization of TP in gastric cancer and colorectal cancer tissue by ELISA, immunohistochemistry, and immunoelectron microscopy. Between April 1997 and May 2000, we obtained surgically resected specimens from 42, 46, and 36 cases of advanced gastric, colon, and rectal cancer, respectively. ELISA demonstrated that the TP level was higher in cancer tissues than in adjacent normal tissue. Immunohistochemically, cancer cells were positive for the enzyme in some cases. However, in a number of cases immunopositive inflammatory cells were also present in cancerous tissues. At the electron microscope level, TP was diffusely distributed in the cytoplasm of cancer cells and in the mitochondria of the neutrophil in gastric cancer tissue. In rectal cancer tissues, cytoplasmic granules in macrophages in cancer tissues were immunoreactive for the TP. These findings suggest that TP is produced by macrophages and exists in neutrophils and cancer cells.

  13. Cellular responses to chlorin-based photosensitizer DH-II-24 under darkness in human gastric adenocarcinoma AGS cells.

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    Lim, Young-Cheol; Yoo, Je-Ok; Kang, Seong-Sik; Kim, Young-Myeong; Ha, Kwon-Soo

    2011-03-01

    We investigated cellular responses to chlorin-based photosensitizer DH-II-24 under darkness in human gastric adenocarcinoma AGS cells. Cells were loaded with 0.5-10 μg/mL DH-II-24 for 12 h, and intracellular reactive oxygen species (ROS) and intracellular Ca(2+) levels, in situ tissue transglutaminase (tTGase) activity, cell viability, cell morphology and cell cycle were examined. DH-II-24 treatment had no effect on intracellular ROS production or cell morphology, and did not induce cell detachment at any concentrations tested. In addition, cell viability and cell cycle progression were not altered by the photosensitizer. However, DH-II-24 treatment elevated the basal level of intracellular Ca(2+) in a dose-dependent manner and inhibited tTGase activity without affecting tTGase expression levels. Furthermore, DH-II-24 inhibited lysophosphatidic acid-induced activation of tTGase in a dose-dependent manner. In contrast, photodynamic therapy (PDT) with 1 μg/mL DH-II-24 significantly elevated intracellular ROS and in situ tTGase activity in parallel with a rapid and large increase in intracellular Ca(2+) levels. DH-II-24-mediated PDT decreased cell viability and induced cell detachment. These results demonstrate that DH-II-24 treatment alone under darkness induced different cellular responses to DH-II-24-mediated PDT.

  14. Ductal Adenocarcinoma of the Prostate With a Rare Clinical Presentation; Late Gastric Metastasis

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    Hasan Huseyin Tavukcu

    2016-07-01

    Full Text Available A 67 year male had robotic prostatectomy whose pathology revealed mixed type prostate cancer composed of 55% ductal and 45% acinar components. The patient was then admitted to hospital with sudden health problems including ascites and serious vomiting attacks in the 46th month after prostatectomy and the PSA test was 4565 ng/mL. Gastroscopic biopsy was reported and proved immunhistochemically undifferentiated ductal prostate cancer metastasis. This is the first report of late gastric metastasis of ductal prostate cancer.

  15. Pancreaticoduodenectomy for advanced gastric cancer with pancreaticoduodenal region involvement

    Institute of Scientific and Technical Information of China (English)

    Xin-Bao Wang; Li-Tao Yang; Ze-Wei Zhang; Jian-Min Guo; Xiang-Dong Cheng

    2008-01-01

    AIM:To characterize the factors of the improved survival following combined pancreaticoduodenectomy (PD) and gastrectomy for the treatment of advanced gastric cancer with pancreaticoduodenal region involvement. METHODS:From 1995 to 2004,53 patients with primary gastric cancer were diagnosed with synchronous (n=44) or metachronous (n=9) pancreaticoduodenal region involvement.Of these,17 patients (32%) underwent total gastrectomy (TG) or distal subtotal gastrectomy (SG) combined with PD simultaneously.The preoperative demographic,clinical information,clinicopathologic features and the surgical results of these 17 patients were considered as factors influencing survival and were analyzed by the Kaplan-Meier method with log-rank comparison. RESULTS:The actual 1-and 3-year survival rates of these 17 patients after resection were 77% and 34%, respectively,and three patients survived for more than 5 years after surgery.The tumor-free resection margin (P=0.0174) and a well-differentiated histologic type (P=0.0011) were significant prognostic factors on univariate analysis.No mortality occurred within one mo after operation,postoperative weight loss of different degree was present in all the patients with TG and 12 cases had other complications.There were 9(53%) cases of recurrence in 5-48 mo after operation.The survival rate in the palliative and explorative group was significantly (P=0.0064) lower than in the combined PD group. CONCLUSION:Judicious use of en bloc PD and gastrectomy and strictly preventing postoperative complications may improve the long-term survival for advanced gastric cancer patients with pancreaticoduodenal region involvement.Well-differentiated histology and negative resection margin are the most important predictors of long survival.

  16. Clinical role of ramucirumab alone or in combination with paclitaxel for gastric and gastro-oesophageal junction adenocarcinoma

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    Davidson M

    2016-07-01

    Full Text Available Michael Davidson, Elizabeth C Smyth, David Cunningham Department of Gastrointestinal Cancer Research, The Royal Marsden Hospital NHS Foundation Trust, London, UK Abstract: Cancers of the stomach and gastro-esophageal junction represent a significant challenge in oncology. Despite some recent advances in genetic categorization and the development of novel agents, outcomes remain poor. The vascular endothelial growth factor receptor 2 monoclonal antibody ramucirumab is the first targeted therapy to improve survival in a molecularly unselected population, and represents a valuable new treatment option. This review describes the current treatment landscape for advanced disease, evaluates existing and ongoing research into ramucirumab, and discusses its current and potential future therapeutic role. Keywords: advanced gastric cancer, ramucirumab, paclitaxel, angiogenesis inhibitors

  17. Prevalence and importance of nodal micrometastasis in patients with gastric adenocarcinoma

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    Bjelović Miloš

    2004-01-01

    Full Text Available Micrometastasis is a microscopic (less than 2 mm deposit of malignant cells separated from the primary tumor. The incidence and importance of occult perigastric lymph node involvement were analyzed in 26 pNO patients using the prospective method. The occult lymph node involvement was detected by immunohistochemical method using the anticyto-keratin 8/18 antibody. Prevalence of clinically significant occult lymph node involvement (Mi+ was statistically significant, and found in 38.5% of pNO patients. Out of tumor characteristics analyzed as possible predictors of occult lymph node involvement, the histological grade (GH and the involvement of lymphatic vessels within gastric wall (pLl had significant effect on the respective evaluation. The patients with histological grade 3 and 4 had occult lymph node involvement more often than those with grade 1 and 2 (p<0.05. More than 60% of pL1 patients had occult lymph node involvement LN (Mi+. Due to high prevalence of micrometastatic lymph node involvement, detection with specific immunohistochemical or molecular biology techniques should be a part of routine specimen examination in patients with pNO gastric cancer.

  18. Fatores prognósticos nas gastrectomias com linfadenectomia D2 por adenocarcinoma gástrico Prognostic factors in D2 gastrectomy for gastric adenocarcinoma

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    Osvaldo Antonio Prado Castro

    2009-09-01

    comprometimento tumoral na câmara gástrica, o estádio da doença, a ocorrência de metástases a distância e principalmente a presença de metástases linfonodais, constituíram-se em variáveis com valor prognóstico independente.BACKGROUND: Lymphatic spread is more common in gastric cancer than the hematogenic one. Thus, the locoregional dissection type D2 seems to be important. AIM: To evaluate the overall survival after D2 gastrectomy for gastric adenocarcinoma and to determine the most important prognostic factors, including those with independent statistical value. METHODS: Prospective study with 125 patients operated between August 1997 and October 2005. The technique employed followed strictly the protocol of the National Cancer Center - Tokyo. RESULTS: There were 73 men and 52 women with ages ranging 28 to 84 years (mean of 58.96 ± 14.01. Seventy per cent of the lesions were located at the distal portion of the stomach, 20% were proximal and 10% comprised the whole organ. The stage distributions were: I - 37 cases (29.6%, II - 20 cases (16%, III - 37 cases (29.6%, and IV - 31 cases (24.8%. It was performed the amount of 73 subtotal gastrectomies and 52 totals. The morbidity rate was 26.4%, mainly, due to leakage and pulmonary complications. The overall mortality rate was 9.6%. After a mean follow-up of 48 months, 68 (54.4% patients were dead, representing an overall survival rate of 45.6%. Univariate and multivariate statistical analysis revealed that: tumors comprising the whole stomach, beyond the serosal layer (T3 or T4, with more than seven metastatic lymph nodes (N2 or N3, with distant metastasis (M1, and belonging to the stage III or IV of the disease, were related to a poor prognosis. CONCLUSIONS: Less than a half of the patients were alive after a mean follow-up of almost four years; the TNM stage system was the main prognostic factor, ergo, the extension of the lesions, the stage of the disease, metastatic occurrence and mainly the lymph node involvement

  19. MRI for advanced gastric cancer; Especially for scirrhous cancer of the stomach

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    Homma, Hisato; Masuko, Eiichi; Saito, Tadanori; Ikeda, Shigeyuki (National Sapporo Hospital (Japan)); Mezawa, Synichi; Betsuyaku, Takashi; Niitsu, Yoshiro

    1993-01-01

    We conducted MRI examinations in 92 patients with advanced gastric cancer and evaluated the clinical potential of MRI for diagnosis of scirrhous cancer of the stomach. The feature of scirrhous cancer of stomach by MRI are: (1) thickened gastric wall, (2) shortening of T1 and T2 values; and (3) clear contrast between the gastric mucosae and cancer areas found in the T1 and T2 weighted images (preservation of the mucosae). MRI for scirrhous cancer of the stomach is thought a useful image diagnosis as an adjunct method to gastric X-ray and gastric endoscopy. (author).

  20. The gastric cancer

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    Pelayo Correa

    2013-09-01

    Full Text Available Gastric cancer ranks fourth in incidence and second in mortality among all cancers worldwide. Despite the decrease in incidencein some regions of the world, gastric cancer continues to present a major clinical challenge due to most cases beingdiagnosed in advanced stages with poor prognosis and limited treatment options. The development of gastric cancer is acomplex and multi-factored process involving a number of etiological factors and multiple genetic and epigenetic alterations.Among the predisposing factors are: Helicobacter pylori infection, high salt intake, smoking, and, in a small percentage ofpatients, a family genetic component. More than 90% of stomach cancers are adenocarcinomas, which are classified intotwo major histological groups: intestinal and diffuse. Intestinal adenocarcinoma is preceded by a sequence of gastric lesionsknown as Correa´s cascade. According to the anatomical position, adenocarcinomas are classified as proximal (originatingin the cardia and distal (originating in the body and antrum. This is a classification that recognizes two different clinicalentities. In general, the only possible cure for the disease is resection of the tumor in an early stage for which the identificationand monitoring of at-risk patients play a significant role. With the exception of Japan, no effective early detection programsexist. Anti-H. pylori has been shown to be an effective measure in the prevention of gastric cancer.

  1. Chemotherapy versus support cancer treatment in advanced gastric cancer: a meta-analysis

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    L. Casaretto

    2006-04-01

    Full Text Available The aim of the present study was to compare the efficacy of chemotherapy and support treatment in patients with advanced non-resectable gastric cancer in a systematic review and meta-analysis of randomized clinical trials that included a comparison of chemotherapy and support care treatment in patients diagnosed with gastric adenocarcinoma, regardless of their age, gender or place of treatment. The search strategy was based on the criteria of the Cochrane Base, using the following key words: 1 randomized clinical trials and antineoplastic combined therapy or gastrointestinal neoplasm, 2 stomach neoplasm and drug therapy, 3 clinical trial and multi-modality therapy, 4 stomach neoplasm and drug therapy or quality of life, 5 double-blind method or clinical trial. The search was carried out using the Cochrane, Medline and Lilacs databases. Five studies fulfilled the inclusion criteria, for a total of 390 participants, 208 (53% receiving chemotherapy, 182 (47% receiving support care treatment and 6 losses (1.6%. The 1-year survival rate was 8% for support care and 20% for chemotherapy (RR = 2.14, 95% CI = 1.00-4.57, P = 0.05; 30% of the patients in the chemotherapy group and 12% in the support care group attained a 6-month symptom-free period (RR = 2.33, 95% CI = 1.41-3.87, P < 0.01. Quality of life evaluated after 4 months was significantly better for the chemotherapy patients (34%; RR = 2.07, 95% CI = 1.31-3.28, P < 0.01 with tumor mass reduction (RR = 3.32, 95% CI = 0.77-14.24, P = 0.1. Chemotherapy increased the 1-year survival rate of the patients and provided a longer symptom-free period of 6 months and an improvement in quality of life.

  2. The Future Prospects of Immune Therapy in Gastric and Esophageal Adenocarcinoma

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    Walid L. Shaib

    2016-11-01

    Full Text Available The prognosis of esophageal cancers is poor and novel approaches are urgently needed. Despite improvements in outcomes with transtuzumab and ramucirumab, these improvements added an average of only 2 to 3 months with a median overall survival reported to be around 1 year. Comprehensive genomic sequencing has defined some molecular alterations with potential targets, but the majority of patients still do not benefit from druggable targets. Breakthroughs in immune checkpoint blockade have provided new therapeutic options in many cancers. Programmed death ligand 1 (PDL1 overexpression, a possible biomarker predicting response to immune checkpoint inhibitors, approaches forty percent in esophageal and gastric cancers. Translational and molecular studies have shown that esophageal cancers are possible candidate malignancies for immune checkpoint inhibition. In this review, we plan to highlight the mechanisms, preclinical, and early clinical data that provide insight on the role of immune therapeutics in esophageal cancers.

  3. A STUDY OF ENDOSCOPIC TREATMENT OF ADVANCED ESOPHAGEAL AND GASTRIC CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    Zhang Jichang; Zhang Lijian; Wang Yanmeng; Li Wei

    1998-01-01

    Objective: To investigate the effect of endoscopic treatment on advanced esophageal and gastric carcinoma.Methods: Twenty advanced gastric cancer patients and 25advanced esophageal cancer patients, who had recurrence after operation and radiotherapy were managed by endoscopic treatment. Results: 10 cases were treated to stop bleeding only, 35 cases were treated by microwave,dilation and local chemotherapy. The successful rate of hemostasis was about 67%, the remission rate of digestive obstruction was about 100% after dilation, 83% of the recurrence lesions were relieved by endoscopic chemotherapy. Conclusion: Endoscope treatment has certain therapeutic efficiency for the recurrence of advanced esophageal and gastric cancer.

  4. Single nucleotide polymorphism in DNA methyltransferase 3B promoter and its association with gastric cardiac adenocarcinoma in North China

    Institute of Scientific and Technical Information of China (English)

    Yi-Min Wang; Xiu-Feng Zhang; Jian-Hui Zhang; Rui Wang; Deng-Gui Wen; Yan Li; Wei Guo; Na Wang; Li-Zhen Wei; Yu-Tong He; Zhi-Feng Chen

    2005-01-01

    AIM: To investigate the association between single nucleotide polymorphism (SNP)in promoter of the DNA methyltransferase 3B (DNNT3B) gene and risk for development and lymphatic metastasis of gastric cardiac adenocarcinoma (GCA).METHODS: The hospital based case-control study included 212 GCA patients and 294 control subjects without overt cancer. The DNMT3B SNP was genotyped by PCR and restriction fragment length polymorphism (RFLP) analysis. RESULTS: The C/C genotype was not detected in both GCA patients and controls. In control subjects, the frequency of T/T and C/T genotypes was 94.9% and 5.1% respectively,and that of T and C alleles was 97.4% and 2.6%, respectively.The genotype and allelotype distribution in the GCA patients was not significantly different from that in controls (P = 0.34 and 0.33, respectively). When stratified by smoking status and family history of upper gastrointestinal cancer, significant difference in the genotype distribution was not observed between GCA patients and controls. The distribution of DNMT3Bgenotypes in GCA patients with or without lymphatic metastasis did not show significant difference (P = 0.42). CONCLUSION: The distribution of DNMT3BSNP in North China is distinct from that in Caucasians. Although this SNP has been associated with susceptibility to lung, head, neck and breast cancer, it may not be used as a stratification marker to predict susceptibility and lymphatic metastasis of GCA, at least in the population of North China.

  5. Chemoprevention by celecoxib in reflux-induced gastric adenocarcinoma in Wistar rats that underwent gastrojejunostomy Quimioprevenção pelo celecoxibe no adenocarcinoma gástrico induzido por refluxo em ratos Wistar submetidos à gastrojejunostomia

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    Valéria Costa

    2009-06-01

    Full Text Available PURPOSE: To evaluate chemoprevention by celecoxib in cases of reflux-induced gastric adenocarcinoma, in Wistar rats that underwent gastrojejunostomy. METHODS: Sixty male Wistar rats of average age three months underwent surgery and were distributed into three groups: group 1, exploratory laparotomy; group 2, gastrojejunostomy; and group 3, gastrojejunostomy and daily celecoxib administration. After 53 weeks, the animals were sacrificed. Changes in the mucosa of the gastric body of group 1 and in the gastrojejunal anastomosis of groups 2 and 3, observed in histopathological and immunohistochemical examinations, were compared. All statistical analyses were performed using Epi-Info®, version 3.4.3. RESULTS: Comparison between groups 2 and 3 relative to the presence of adenocarcinoma showed a statistically significant difference (p=0.0023. Analysis of the association between groups 2 and 3 relative to COX-2 expression also showed a statistically significant difference (p=0.0018. CONCLUSION: Celecoxib had an inhibiting effect on gastric carcinogenesis induced by enterogastric reflux in an animal model.OBJETIVO: Avaliar a quimioprevenção pelo celecoxibe no adenocarcinoma gástrico induzido por refluxo, em ratos Wistar, submetidos a gastrojejunostomia. MÉTODOS: Sessenta ratos machos Wistar, com média de idade de três meses foram operados e distribuídos em 03 grupos: Grupo 1 - Os animais foram submetidos a laparotomia exploradora. Grupo 2 - Os animais foram submetidos a gastrojejunostomia. Grupo 3 - Os animais foram submetidos a gastrojejunostomia e tomaram celecoxib, diariamente. Após um período de 53 semanas, os animais foram sacrificados. As alterações da mucosa do corpo gástrico dos animais do grupo 1 e da anastomose gastrojejunal dos animais dos grupos 2 e 3 foram analisadas no exame histopatológico e imuno-histoquímica e foram comparadas. Todas as análises estatísticas foram realizadas pelo programa Epi Info®, versão 3

  6. Depression and oxidative damage in TNM stage Ⅲ patients with poorly differentiated gastric adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Wei Yongchang; He Dalin; Bai Jirong; Wang Xinyang; Nan Kejun

    2008-01-01

    Objective To investigate the association between psychological stress and oxidative damage in TNM stage Ⅲ patients with poorly differentiated gastric adenecarcinoma (GA). Methods One hundred and six patients with newly diagnosed poorly differentiated GA were assessed using the Hamilton Depression Rating Scale (HAMD), Zung Self-rating Depression Scale (SDS), Zung Self-rating Anxiety Scale (SAS), Symptom Checklist 90 (SCL-90), activities of daily living (ADL) and other multiple-item qnestionnaires. Oxidative-stress-related parameters in serum and the expression of DNA repair genes were monitored during a pretreatment period. Results The patients were divided into depression and nondepression groups (Groups A and B, respectively) based on a HAMD score cutoff of 20. The mean SDS, SAS, SCL-90, ADL and passive coping scores were higher in Group A, whereas social support and quality of life were lower. Serum total antioxidant capacity, eatalase, superoxide dismutuse concentrations and anti-superoxide anion capacity (A-ASC) were significantly decreased in Group A, whereas serum malondialdehyde (MDA) and 8-hydroxy-deoxyguanosine (8-OHdG) levels were significantly increased. Pearson correlation analysis revealed that depression was pesitively correlated with MDA, SAS, SCL-90 and ADL, but negatively correlated with A-ASC. Furthermore, real-time PCR revealed that the expression levels of hOGG1 and APEX1 were increased in Group A. Conclusion Psychological stress might be related to impaired antioxidant system in patients with GA, and it presents the first evidence of the involvement of oxidative DNA damage in the pathogenesis of depression.

  7. Surgical palliation of gastric outlet obstruction in advanced malignancy

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    Potz, Brittany A; Miner, Thomas J

    2016-01-01

    Gastric outlet obstruction (GOO) is a common problem associated with advanced malignancies of the upper gastrointestinal tract. Palliative treatment of patients’ symptoms who present with GOO is an important aspect of their care. Surgical palliation of malignancy is defined as a procedure performed with the intention of relieving symptoms caused by an advanced malignancy or improving quality of life. Palliative treatment for GOO includes operative (open and laparoscopic gastrojejunostomy) and non-operative (endoscopic stenting) options. The performance status and medical condition of the patient, the extent of the cancer, the patients prognosis, the availability of a curative procedure, the natural history of symptoms of the disease (primary and secondary), the durability of the procedure, and the quality of life and life expectancy of the patient should always be considered when choosing treatment for any patient with advanced malignancy. Gastrojejunostomy appears to be associated with better long term symptom relief while stenting appears to be associated with lower immediate procedure related morbidity. PMID:27648158

  8. Vandetanib Treatment in Refractory Advanced Lung Adenocarcinoma Patients: 
Five Cases and Review of Literature

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    Lili GUO

    2012-02-01

    Full Text Available Background and objective Vandetanib is a once-daily oral multi-target inhibitor of vascular endothelial growth factor receptor, epidermal growth factor receptor, and rearranged during transfection (RET tyrosine kinases. The current study aimed to evaluate the effect and safety of vandetanib administered in refractory advanced lung adenocarcinoma patients. Methods Five patients who accepted chemotherapy and Tarceva therapy as first- and second-line treatments received vandetanib (300 mg, oral, once daily. Results The effects are stable disease on two patients (40% and progressive disease on three patients (60%. With a median follow-up of 36 months, one patient remained on follow-up. The median progression free survival (PFS is 2 months, and the mean overall survival is 22.6 months. The adverse events include rash (n=2, skin change (n=2, paronychia (n=2, asymptomatic QTc prolongation (n=2, ST-T change (n=1, diarrhea (n=1, and increased transaminase (n=1. Conclusion There were lower incidences of severe side effects with vandetanib therapy in refractory advanced lung adenocarcinoma patients. The results of effect and safety of vandetanib are similar with the related reviewed articles.

  9. The prognostic significance of whole blood global and specific DNA methylation levels in gastric adenocarcinoma.

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    Mansour S Al-Moundhri

    Full Text Available BACKGROUND: Epigenetics, particularly DNA methylation, has recently been elucidated as important in gastric cancer (GC initiation and progression. We investigated the clinical and prognostic importance of whole blood global and site-specific DNA methylation in GC. METHODS: Genomic DNA was extracted from the peripheral blood of 105 Omani GC patients at diagnosis. DNA methylation was quantified by pyrosequencing of global DNA and specific gene promoter regions at 5 CpG sites for CDH1, 7 CpG sites for p16, 4 CpG sites for p53, and 3 CpG sites for RUNX3. DNA methylation levels in patients were categorized into low, medium, and high tertiles. Associations between methylation level category and clinicopathological features were evaluated using χ(2 tests. Survival analyses were carried out using the Kaplan-Meier method and log rank test. A backward conditional Cox proportional hazards regression model was used to identify independent predictors of survival. RESULTS: Older GC patients had increased methylation levels at specific CpG sites within the CDH1, p53, and RUNX-3 promoters. Male gender was significantly associated with reduced global and increased site-specific DNA methylation levels in CDH1, p16, and p53 promoters. Global DNA low methylation level was associated with better survival on univariate analysis. Patients with high and medium methylation vs. low methylation levels across p16 promoter CpG sites, site 2 in particular, had better survival. Multivariate analysis showed that global DNA hypermethylation was a significant independent predictor of worse survival (hazard ratio (HR = 2.0, 95% CI: 1.1-3.8; p = 0.02 and high methylation mean values across p16 promoter sites 1-7 were associated with better survival with HR of 0.3 (95% CI, 0.1-0.8; p = 0.02 respectively. CONCLUSIONS: Analysis of global and site-specific DNA methylation in peripheral blood by pyrosequencing provides quantitative DNA methylation values that may serve as important

  10. Topography Of Helicobacter Pylori Gastritis In Different Biopsy Sites Of Gastric Mucosa Of Residents Of A High Risk Area For Gastric Adenocarcinoma

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    Mikaeili J

    2004-08-01

    Full Text Available Background: Many recent studies have examined potential risk factors of H. pylori gastritis to improve our understanding of the early events in gastric carcinogenesis. We evaluated the extent and topography of chronic gastritis in a high risk area for gastric cardia cancer and investigated the critical role of H.pylori, risk index and age in its pathogenesis. Materials and Methods: During a national population-based endoscopic survey, we enrolled 508 participants aged ≥40 from urban and rural areas of Meshkin-Shahr, Ardebil province of Iran. After informed consent, all underwent complete upper GI endoscopy. At least one mucosal biopsy was obtained from 6 standard sites: three of antrum (sites 1, 2, 3, two of corpus (sites 4, 5 and one of cardia (site 6. Severity, activity and combined inflammatory scores (CIS of chronic gastritis and H.pylori infection status were assessed according to modified Sydney Classification of Gastritis. Statistical effects of H.pylori, age, gender, and residency place on mean gastritis severity, activity and CIS were separately calculated in each site. Results: Total of 508 participants with mean age (±SD of 54.6(±SD were enrolled. 234(46.1% were male and 274(53.9% were female. Histologically 80.5% of cases were H.pylori positive. Mean activity scores of all sites except for site 5 are significantly (P<0.01 higher in H.pylori + cases. Mean CIS of all sites was significantly (P<0.01 higher in H.pylori + patients. In 44% of infected subjects, CIS of the corpus was at least equally as severe as that in antrum. Also in 54% of H.pylori + cases, cardia’s CIS was ≥ than antral CIS. Age had a significant (P<0.01 negative relationship with CIS of antral site, but this relationship in cardia was positive and more potent. Conclusion: H.pylori is the main cause of gastritis activity in all sites of stomach; this causality is more potent in antrum and cardia. Continuous cardia inflammation in advanced age may contribute to

  11. Recent advances in molecular biology of gastric carcinogenesis

    Institute of Scientific and Technical Information of China (English)

    萧树东; 冉志华

    2003-01-01

    Gastric cancer is a major health care problem and the second most common fatal cancer worldwide. In the last decade, better insight has been gained into the molecular basis underlying the neoplasitc transformation of stomach. The dramatic variation in the incidence of gastric cancer in different geographical areas and from one generation to the next have led to the hypothesis that the incidence of gastric cancer is determined largely by environmental rather than genetic factors.

  12. Neoadjuvant chemotherapy for advanced gastric cancer:A meta-analysis

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM:To study the value of neoadjuvant chemotherapy (NAC) for advanced gastric cancer by performing a meta-analysis of the published studies.METHODS:All published controlled trials of NAC for advanced gastric cancer vs no therapy before surgery were searched.Studies that included patients with metastases at enrollment were excluded.Databases included Cochrane Library of Clinical Comparative Trials,MEDLINE,Embase,and American Society of Clinical Oncology meeting abstracts from 1978 to 2010.The censor date was...

  13. [Utility of the WallFlexTM duodenal stent for unresectable advanced gastric cancer related to gastric outlet obstruction].

    Science.gov (United States)

    Aoki, Taro; Hyuga, Satoshi; Kato, Aya; Chono, Teruhiro; Watanabe, Risa; Komori, Takamichi; Matsumoto, Takashi; Takachi, Kou; Nishioka, Kiyonori; Uemura, Yoshio; Kobayashi, Kenji

    2012-11-01

    Duodenal stenting for malignant disease related to gastric outlet obstruction(GOO) has been covered by health insurance in Japan since April 2010. We inserted WallFlexTM duodenal stents(WDS) in 4 patients with GOO caused by unresectable gastric cancer. WDS insertion was successful in all 4 cases. Duodenal perforation occurred in 1 case. One case each of stent obstruction and stent migration occurred. All patients could eat a soft-food diet for 3-6 months (median, 5.3 months). Survival time ranged between 5 and 14 months (median, 6 months). Three patients underwent S-1 combination chemotherapy. Duodenal stenting is expected to be effective for advanced gastric cancer related to GOO.

  14. miR-107 and miR-25 simultaneously target LATS2 and regulate proliferation and invasion of gastric adenocarcinoma (GAC) cells

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Mingjun; Wang, Xiaolei [Cancer Center, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601 (China); Li, Wanhu [MRI Room of Shandong Cancer Hospital & Institute, Jinan 250117 (China); Cui, Yongchun, E-mail: yongchuncui1@126.com [Drug Clinical Trial Institution of Shandong Cancer Hospital & Institute, #440, Jiyan Road, Jinan 250117 (China)

    2015-05-08

    Although a series of oncogenes and tumor suppressors were identified in the pathological development of gastric adenocarcinoma (GAC), the underlying molecule mechanism were still not fully understood. The current study explored the expression profile of miR-107 and miR-25 in GAC patients and their downstream regulative network. qRT-PCR analysis was performed to quantify the expression of these two miRNAs in serum samples from both patients and healthy controls. Dual luciferase assay was conducted to verify their putative bindings with LATS2. MTT assay, cell cycle assay and transwell assay were performed to explore how miR-107 and miR-25 regulate proliferation and invasion of gastric cancer cells. Findings of this study demonstrated that total miR-107 or miR-25 expression might be overexpressed in gastric cancer patients and they can simultaneously and synchronically regulate LATS2 expression, thereby affecting gastric cancer cell growth and invasion. Therefore, the miR-25/miR-107-LATS2 axis might play an important role in proliferation and invasion of the gastric cancer cells. - Highlights: • Total miR-107 and miR-25 expression is significantly increased in GAC patients. • Both miR-107 and miR-25 can promote proliferation and invasion of GAC cells. • Both miR-107 and miR-25 can target LATS2 and regulate its expression. • miR-107 and miR-25 regulate proliferation and invasion of GAC cells though LATS2.

  15. Helicobacter pylori in gastric carcinogenesis

    Institute of Scientific and Technical Information of China (English)

    Hyo; Jun; Ahn; Dong; Soo; Lee

    2015-01-01

    Gastric cancer still is a major concern as the third most common cancer worldwide, despite declining rates of incidence in many Western countries. Helicobacter pylori(H. pylori) is the major cause of gastric carcinogenesis, and its infection insults gastric mucosa leading to theoccurrence of atrophic gastritis which progress to intestinal metaplasia, dysplasia, early gastric cancer, and advanced gastric cancer consequently. This review focuses on multiple factors including microbial virulence factors, host genetic factors, and environmental factors, which can heighten the chance of occurrence of gastric adenocarcinoma due to H. pylori infection. Bacterial virulence factors are key components in controlling the immune response associated with the induction of carcinogenesis, and cag A and vac A are the most well-known pathogenic factors. Host genetic polymorphisms contribute to regulating the inflammatory response to H. pylori and will become increasingly important with advancing techniques. Environmental factors such as high salt and smoking may also play a role in gastric carcinogenesis. It is important to understand the virulence factors, host genetic factors, and environmental factors interacting in the multistep process of gastric carcinogenesis. To conclude, prevention via H. pylori eradication and controlling environmental factors such as diet, smoking, and alcohol is an important strategy to avoid H. pylori-associated gastric carcinogenesis.

  16. Advanced endoscopic imaging for gastric cancer assessment: new insights with new optics?

    Science.gov (United States)

    Serrano, M; Kikuste, I; Dinis-Ribeiro, M

    2014-12-01

    The most immediate strategy for improving survival of gastric cancer patients is secondary prevention through diagnosis of early gastric cancer either through screening or follow-up of individuals at high risk. Endoscopy examination is therefore of paramount importance and two general steps are to be known in assessing gastric mucosa - detection and characterization. Over the past decade, the advent of advanced endoscopic imaging technology led to diverse descriptions of these modalities reporting them to be useful in this setting. In this review, we aim at summarizing the current evidence on the use of advance imaging in individuals at high-risk (i.e., advance stages of gastric atrophy/intestinal metaplasia) and in those harbouring neoplastic lesions, and address its potential usefulness providing the readers a framework to use in daily practice. Further research is also suggested.

  17. Polymorphism of-765G>C COX-2 is a risk factor for gastric adenocarcinoma and peptic ulcer disease in addition to H pylori infection:A study from northern India

    Institute of Scientific and Technical Information of China (English)

    Ashish Saxena; Kashi Nath Prasad; Uday Chand Ghoshal; Monty Roshan Bhagat; Narendra Krishnani; Nuzhat Husain

    2008-01-01

    AIM:To investigate-765G>C COX-2 polymorphism and H pylori infection in patients with gastric adenocarcinoma,peptic ulcer disease(PUD)and nonulcer dyspepsia(NUD).METHODS:We enrolled 348 adult patients(62 gastric adenocarcinoma,45 PUD and 241 NUD)undergoing upper gastrointestinal endoscopy at two referral centers between September,2002 and May,2007.H pylori infection was diagnosed when any of the four tests (RUT,culture,histopathology and PCR)were positive.Genotyping for-765G>C polymorphism of COX-2 was performed by PCR-RFLP analysis.RESULTS:Frequency of C carrier had significant association with gastric adenocarcinoma as compared to NUD[77.4%vs 29%,P<0.001,odds ratio(0R)8.20;95% confidence interval(95%CI),4.08-16.47]and PUD(77.4%vs 31.1%,P<0.001;OR 8.04;95%CI,3.25-19.90).Risk of gastric adenocarcinoma was significantly higher in patients having C carrier with (OR 7.83;95% CI 3.09-19.85)and without H pylori infection(OR 7.06;95% CI,2.61-19.09).Patients with C carrier and H pylori infection had significant risk for the development of PUD(P<0.001;OR 5.65;95% CI,2.07-15.34).CONCLUSION:-765G>C COX-2 polymorphism with or without H pylori could be a marker for genetic susceptibility to gastric adenocarcinoma.COX-2 polymorphism in presence of Hpylori infection might be useful in predictinq the risk of PUD.

  18. Clinical application of trastuzumab plus chemotherapy in the treatment of HER2-positive gastric or gastro-oesophageal junction adenocarcinoma: a retrospective analysis of 75 cases

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    Xiao-tian ZHANG

    2014-03-01

    Full Text Available Objective  To evaluate the effcacy and safety of trastuzumab combined with chemotherapy for the treatment of human epidermal growth factor 2 (HER2-positive chemo-refractory gastric or gastro-oesophageal junction adenocarcinoma in China. Methods  The clinical data of seventy-five cases of HER2-positive and chemo-refractory gastric or gastro-oesophageal junction adenocarcinoma were collected in Peking University Cancer Hospital from May 2006 to Nov. 2013. Patients with historically confirmed adenocarcinoma were eligible if their tumors showed overexpression of HER2 protein by immunohistochemistry  or ISH positive, and if they were treated with trastuzumab combined with chemotherapy. Response and toxicity were evaluated with RECIST 1.0 and CTC AE 3.0 criteria. Results  All the 75 patients received trastuzumab plus chemotherapy. In 52 patients of first line therapy, combination regimens consisted of 44 cisplatin or oxaliplatin with fluorouracil (as adjuvant therapy in 3 patients with prolonged follow up, 5 with paclitaxel with fluorouracil, and 3 with gimeracil and oteracil potassium monotherapy. Evaluation of curative effects was performed in 49 cases, in whom 32 with PR (61.5%, 13 with SD, and 4 with PD. The disease control rate (DCR was 86.5%. Median PFS and median OS were 10.9 months (95%CI 6.8-15.0 and 18.7 months (95%CI 6.3-31.1 respectively. Three patients received radical operation followed by oxaliplatin + capecitabine. In 20 cases with second-line or delayed therapy, combination cisplatin or oxaliplatin with fluorouracil were given in 9 patients, paclitaxel with fluorouracil in 5, fluorouracil monotherapy in 3, irinotecan monotherapy in 2, and docetaxel monotherapy in 1 patient. In 20 cases, PR (35.0% was achieved in 7, SD was achieved in 6, and PD was achieved in 7. The DCR was 65%. Median PFS and median OS were 6.2 months (95%CI 5.1-7.3 and 12.3 months (95%CI 9.0-15.6 respectively. The median time of Trastuzumab administration

  19. Relationship between trefoil factor 1 expression and gastric rnucosa injuries and gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Jian-Lin Ren; Jin-Yan Luo; Ya-Pi Lu; Lin Wang; Hua-Xiu Shi

    2005-01-01

    AIM: To determine whether trefoil factor 1 (TFF1) is associated with mucosa healing and carcinoma suppression, we assess the expression of trefoil factor 1 in normal and pathologic gastric mucosa.METHODS: TFF1 in normal and pathologic gastric mucosa was assessed by immunohistochemical method, and the average positive A was estimated by Motic Images Advanced 3.0 software.RESULTS: Increased TFF1 was detected in gastritis, gastric ulcer and duodenal ulcer compared with normal mucosa. The same result could be seen in multiple and compound ulcer compared with simple ulcer. There was no significant difference between gastric ulcer and duodenal ulcer, gastritis and simple ulcer respectively. Increased TFF1 was detected in the peripheral mucosa of the gastric adenocarcinoma compared with normalmucosa. The expression of TFF1 in gastric adenocarcinoma was related to the differentiation of adenocarcinoma. The lower the differentiation of adenocarcinoma, the weaker the expression of TFF1. There was no TFF1 expressed in low-differentiated adenocarcinoma. The expression of TFF1 in middle and highly differentiated adenocarcinoma was a little lower than that in normal mucosa. But there was no significant difference. No TFF1 was assessed in esophageal squamous carcinoma and peripheral tissue. There was no significant difference between male and female.CONCLUSION: The expression of TFF1 was higher in gastritis and peptic ulcer than that in normal mucosa, and was also higher in multiple and compound ulcer than in simple ulcer. It seems that TFF1 plays a role in gastric mucosa protection and epithelial restitution. Increased expression of TFF1 in peripheral tissue suggests that TFFLis associated with mechanism of carcinoma suppression and differentiation. Decreased expression of TFF1 in carcinoma and its relativity to the differentiation suggests that TFF1 is related to gland and cell destruction of carcinoma.

  20. Role of Helicobacter pylori in gastric cancer: advances and controversies.

    Science.gov (United States)

    Meng, Wenbo; Bai, Bing; Sheng, Liang; Li, Yan; Yue, Ping; Li, Xun; Qiao, Liang

    2015-11-01

    Gastric cancer is one of the most common cancers of digestive system globally and Helicobacter pylori (HP) infection is believed to be a major risk factor. HP can be classified into different types based on the presence and expression level of CagA and VacA, and, when exposed to adverse environment, HP changes its phenotype from helical type to coccoid type, with each having different pathogenicity. The mechanisms of HP-induced gastric carcinogenesis and progression are complicated, including DNA nitration and oxidation induced by mutagenic factors, HP-induced epigenetic modifications, HP-induced disruption of the balance between cell proliferation and apoptosis, and HP-induced cancer cell invasion and metastasis. HP may also affect the biological function of cancer stem cells and induction of cell autophagy. The lipopolysaccharide produced by HP can act through toll-like receptor-4 (TLR-4) to induce gastric mucosal inflammation and is thereby linked to the development of gastric cancer.

  1. Enterococcus faecalis Infection and Reactive Oxygen Species Down-Regulates the miR-17-92 Cluster in Gastric Adenocarcinoma Cell Culture

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    Jesper A. B. Strickertsson

    2014-08-01

    Full Text Available Chronic inflammation due to bacterial overgrowth of the stomach predisposes to the development of gastric cancer and is also associated with high levels of reactive oxygen species (ROS. In recent years increasing attention has been drawn to microRNAs (miRNAs due to their role in the pathogenesis of many human diseases including gastric cancer. Here we studied the impact of infection by the gram-positive bacteria Enterococcus faecalis (E. faecalis on global miRNA expression as well as the effect of ROS on selected miRNAs. Human gastric adenocarcinoma cell line MKN74 was infected with living E. faecalis for 24 h or for 5 days or with E. faecalis lysate for 5 days. The miRNA expression was examined by microarray analysis using Affymetrix GeneChip miRNA Arrays. To test the effect of ROS, MKN74 cells were treated with 100 mM tert-Butyl hydroperoxide (TBHP. Following 5 days of E. faecalis infection we found 91 differentially expressed miRNAs in response to living bacteria and 2 miRNAs responded to E. faecalis lysate. We verified the down-regulation of the miR-17-92 and miR-106-363 clusters and of other miRNAs involved in the oxidative stress-response by qRT-PCR. We conclude that only infection by living E. faecalis bacteria caused a significant global response in miRNA expression in the MKN74 cell culture. E. faecalis infection as well as ROS stimulation down-regulated the expression of the miR-17-92 cluster. We believe that these changes could reflect a general response of gastric epithelial cells to bacterial infections.

  2. Recent advances in mass spectrometry-based proteomics of gastric cancer

    Science.gov (United States)

    Kang, Changwon; Lee, Yejin; Lee, J Eugene

    2016-01-01

    The last decade has witnessed remarkable technological advances in mass spectrometry-based proteomics. The development of proteomics techniques has enabled the reliable analysis of complex proteomes, leading to the identification and quantification of thousands of proteins in gastric cancer cells, tissues, and sera. This quantitative information has been used to profile the anomalies in gastric cancer and provide insights into the pathogenic mechanism of the disease. In this review, we mainly focus on the advances in mass spectrometry and quantitative proteomics that were achieved in the last five years and how these up-and-coming technologies are employed to track biochemical changes in gastric cancer cells. We conclude by presenting a perspective on quantitative proteomics and its future applications in the clinic and translational gastric cancer research. PMID:27729735

  3. Expression of nuclear factor-kappa B and target genes in gastric precancerous lesions and adenocarcinoma:Association with Helicobactor pylori cagA (+) infection

    Institute of Scientific and Technical Information of China (English)

    Gui-Fang Yang; Chang-Sheng Deng; Yong-Yan Xiong; Ling-Ling Gong; Bi-Cheng Wang; Jun Luo

    2004-01-01

    AIM: To examine the expression of nuclear factor kappaB (NF-κB) and its target genes in intestinal metaplasia (IN),dysplasia (DYS) and gastric carcinoma (GC) infected with Helicobacter pylori(H pylori) and to investigate the mechanism underlying H pylori cytotoxin associated gene A (cag A) infection leading to gastric adenocarcinoma.METHODS: Expressions of NF-κB/p65 and its target genes:c-myc, cyclinD1 and bcl-xl were immunohistochemically examined in 289 cases of gastric biopsy and resection specimens from patients with IM, DYS and GC infected with H pylori. H pylori in the above mentioned tissues was detected by Warthin-Starry stain and rapid urease tests.IgG antibody to cagA in sera of the patients was measured by ELISA.RESULTS: The positive rates of NF-κB/p65 were significantly higher in groups with cagA of IMI-Ⅱ(28/33), IM Ⅲ(48/52),DYSI(27/31), DYS Ⅱ-Ⅲ(28/32), GC(35/40) than in groups without cagA of IMI-Ⅱ(4/17), IMIII(3/20), DYSI(3/20),DYSII-Ⅲ(6/21), GC(10/23). The expressions of c-myc,cyclinD1, and bcl-xl were significantly higher in groups with cagA of IM Ⅲ(47/52, 49/52, 46/52), DYSII-Ⅲ(29/32, 26/32,25/32) than in groups without cagA of IM Ⅲ(8/20, 7/20,5/20), DYSII-Ⅲ(10/21, 8/21,3/21), which were in conformity with the expression of NF-κB in IM Ⅲ, and DYSII-Ⅲ. A significantly higher expression level of NF-κB/p65, c-myc,cyclinD1 and bcl-xl was detected in intestinal type GC(27/28,18/28, 22/28, 24/28) than in diffuse type GC(8/12, 3/12,3/12, 6/12), respectively.CONCLUSION: There may be two different molecular mechanisms in the occurrence of intestinal and diffuse type gastric carcinomas. Intestinal type gastric carcinoma is strongly associated with high expression of c-myc, cyclinD1 and bcl-xl through NF-κB/p65 activated by H pylori cagA.Inhibiting the activity of NF-κB is an effective and promising way to prevent intestinal type gastric carcinoma.

  4. Late-onset peritoneal recurrence of advanced gastric cancer 20 years after primary resection

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    Mohri Yasuhiko

    2010-11-01

    Full Text Available Abstract Late onset of peritoneal recurrence of gastric cancer more than 10 years after surgery is extremely rare, and only three cases have been reported. We present the case of a 61-year-old man who was diagnosed finally with peritoneal recurrence of gastric cancer 20 years after primary curative resection. As a result of small-bowel obstruction caused by peritoneal recurrence, diverting ileostomy with partial ileal resection was performed. The resected specimen revealed tubular adenocarcinoma that resembled the primary gastric cancer. The clinical course after the second operation was unfavorable and systemic chemotherapy had no effect. He died at 62 years of age, 21 years and 7 months after initial gastrectomy. Immunohistochemical analysis using antibodies against proliferating cell nuclear antigen (PCNA, Ki-67, and p53 was performed to investigate the phenotype of primary and recurrence cancer. Protein expression of proliferation markers such as PCNA and Ki-67 was down-regulated, but p53 was overexpressed at the site of recurrence. These data suggest that late peritoneal recurrence has a low proliferation rate and is resistant to chemoradiotherapy. In conclusion, we present late onset of peritoneal recurrence of gastric cancer more than 20 years after primary surgery, and speculate on the mechanism of late-onset recurrence in our case.

  5. Correlação da infiltração das células Natural Killer (NK CD 57+ no prognóstico do adenocarcinoma gástrico Gástrico correlation of Natural Killer cell with the prognosis of gastric adenocarcinoma

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    Déborah Rosso

    2012-06-01

    Full Text Available OBJETIVO: Avaliar a concentração da célula Natural Killer (NK no adenocarcinoma gástrico operado, e sua correlação com fatores prognósticos e sobrevida MÉTODOS: Foram estudados 72 doentes portadores de adenocarcinoma gástrico e que foram submetidos à gastrectomia com linfadenectomia D2. A concentração de célula NK foi avaliada por técnica de imunoistoquímica pelo reagente CD57. Os doentes foram divididos em dois grupos: alta concentração de células (n=32 (>15 células /10 campos de grande aumento e baixa concentração (≤ 15 células/10 campos de grande aumento. Esses dois grupos foram comparados com seguintes fatores prognósticos: gênero, idade, localização do tumor, grau de diferenciação celular, classificação de Lauren, estádio, disseminação linfática, metástases e sobrevida. A curva de Kaplan-Meier foi empregada para avaliação de sobrevida e a análise multivariada para avaliação dos fatores prognósticos. RESULTADOS: Não houve relação das células NK com as diversas variáveis estudadas, a não ser com o estádio, onde houve significância (pAIM: To evaluate the concentration of Natural Killer cells (NK cells in adenocarcinoma of the stomach, and its correlation with prognostic factors and survival. METHODS: Seventy-two patients with gastric adenocarcinoma who underwent gastric resection surgery and D2 lymphadenectomy in the period 1997-2007 were analyzed. The concentration of NK cells was evaluated by immunohistochemistry technique with the reagent CD57. Patients were divided into two groups: high concentration (n = 32 (more than 15 cells per 10 high power field and low concentration (less or equal than 15 cells per 10 high power field. These two groups were compared with several prognostic factors such as: gender, age, tumor location, tumor differentiation, Lauren classification, stage, lymph nodes involvement, distant metastases and survival. The Kaplan-Meier curve was applied to evaluate survival

  6. Clinical significance of preoperative regional intra-arterial infusion chemotherapy for advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Cheng-Wu Zhang; Shou-Chun Zou; Dun Shi; Da-Jian Zhao

    2004-01-01

    AIM: Preoperative intra-arterial infusion chemotherapy could increase the radical resection rate of advanced gastric cancer, but its effect on the long-term survival has not been assessed. This study was designed to evaluate the clinical significance of preoperative intra-arterial infusion chemotherapy for advanced gastric cancer.METHODS: Clinicopathological data of 91 patients who underwent curative resection for advanced gastric cancer were collected. Among them, 37 patients undertaken preoperative intra-arterial infusion chemotherapy were used as the interventional chemotherapy group, and the remaining 54 patients as the control group. Eleven factors including clinicopathological variables, treatment procedures and molecular biological makers that might contribute to the long-term survival rate were analyzed using Cox multivariate regression analysis.RESULTS: The 5-year survival rate was 52.5% and 39.8%,respectively, for the interventional group and the control group (P<0.05). Cox multivariate regression analysis revealed that the TNM stage (P<0.001), preoperative intraarterial infusion chemotherapy (P = 0.029) and growth pattern (P = 0.042) were the independent factors for the long-term survival of patients with advanced gastric cancer.CONCLUSION: Preoperative intra-arterial infusion chemotherapy plays an important role in improving the prognosis of advanced gastric cancer.

  7. Advances in Understanding How Heavy Metal Pollution Triggers Gastric Cancer

    Science.gov (United States)

    Yuan, Wenzhen; Yang, Ning

    2016-01-01

    With the development of industrialization and urbanization, heavy metals contamination has become a major environmental problem. Numerous investigations have revealed an association between heavy metal exposure and the incidence and mortality of gastric cancer. The mechanisms of heavy metals (lead, cadmium, mercury, chromium, and arsenic) contamination leading to gastric cancer are concluded in this review. There are four main potential mechanisms: (1) Heavy metals disrupt the gastric mucosal barrier by decreasing mucosal thickness, mucus content, and basal acid output, thereby affecting the function of E-cadherin and inducing reactive oxygen species (ROS) damage. (2) Heavy metals directly or indirectly induce ROS generation and cause gastric mucosal and DNA lesions, which subsequently alter gene regulation, signal transduction, and cell growth, ultimately leading to carcinogenesis. Exposure to heavy metals also enhances gastric cancer cell invasion and metastasis. (3) Heavy metals inhibit DNA damage repair or cause inefficient lesion repair. (4) Heavy metals may induce other gene abnormalities. In addition, heavy metals can induce the expression of proinflammatory chemokine interleukin-8 (IL-8) and microRNAs, which promotes tumorigenesis. The present review is an effort to underline the human health problem caused by heavy metal with recent development in order to garner a broader perspective.

  8. Advances in Understanding How Heavy Metal Pollution Triggers Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Wenzhen Yuan

    2016-01-01

    Full Text Available With the development of industrialization and urbanization, heavy metals contamination has become a major environmental problem. Numerous investigations have revealed an association between heavy metal exposure and the incidence and mortality of gastric cancer. The mechanisms of heavy metals (lead, cadmium, mercury, chromium, and arsenic contamination leading to gastric cancer are concluded in this review. There are four main potential mechanisms: (1 Heavy metals disrupt the gastric mucosal barrier by decreasing mucosal thickness, mucus content, and basal acid output, thereby affecting the function of E-cadherin and inducing reactive oxygen species (ROS damage. (2 Heavy metals directly or indirectly induce ROS generation and cause gastric mucosal and DNA lesions, which subsequently alter gene regulation, signal transduction, and cell growth, ultimately leading to carcinogenesis. Exposure to heavy metals also enhances gastric cancer cell invasion and metastasis. (3 Heavy metals inhibit DNA damage repair or cause inefficient lesion repair. (4 Heavy metals may induce other gene abnormalities. In addition, heavy metals can induce the expression of proinflammatory chemokine interleukin-8 (IL-8 and microRNAs, which promotes tumorigenesis. The present review is an effort to underline the human health problem caused by heavy metal with recent development in order to garner a broader perspective.

  9. Esophagoenteral stents in patients with recurrent gastric adenocarcinoma Prótesis esofagoenterales en pacientes con recidiva de adenocarcinoma gástrico

    Directory of Open Access Journals (Sweden)

    F. Pérez-Roldán

    2006-05-01

    Full Text Available One of the problems that can appear in patients with total gastrectomy for adenocarcinoma with esophagoenteral anastomosis is the appearance of a stenosis of the anastomosis. These stenosis are frequently malignant due to relapse of neoplasia. The therapeutic possibilities available are the surgical bypass or palliative treatment. There is very little experience described in the literature (21 cases on the placing of self-expandable metal stents as a palliative treatment for the symptoms of stenosis. We present our experience of 3 patients, in whom 4 esophageal stents were fitted (1 covered and 3 uncovered with good results. The dysphagia disappeared or improved, it allowed the ingestion of a soft diet and meant an improvement in the quality of life and at the same time stopped the weight loss. It seems an effective palliative treatment as a treatment for dysphagia in patients with tumoral relapse in the anastomosis of total gastrectomies.Uno de los problemas que puede aparecer en los pacientes con gastrectomía total por adenocarcinoma con anastomosis esofagoenteral es la aparición de estenosis de la anastomosis o próxima a ella. Estas estenosis con frecuencia son malignas debido a la aparición de recidiva en la neoplasia. Las posibilidades terapéuticas de las que disponemos son el bypass quirúrgico o bien el tratamiento paliativo. Existe muy poca experiencia descrita en la literatura (21 casos sobre la colocación de prótesis metálicas autoexpandibles como tratamiento paliativo de los síntomas de la estenosis. Presentamos nuestra experiencia en 3 pacientes, en los que se colocaron 4 prótesis esofágicas (1 recubierta y 3 no recubiertas con buenos resultados. Desapareció o mejoró la disfagia, permitió la ingesta de dieta blanda y supuso una mejora en la calidad de vida a la vez que impide la pérdida ponderal. Parece un tratamiento paliativo eficaz como tratamiento de la disfagia en pacientes con recidiva tumoral en la anastomosis

  10. Fulminant amoebic colitis during chemotherapy for advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Noboru Hanaoka; Katsuhiko Higuchi; Satoshi Tanabe; Tohru Sasaki; Kenji Ishido; Takako Ae; Wasaburo Koizumi; Katsunori Saigenji

    2009-01-01

    A 52-year-old man had bloody stools during chemotherapy for gastric cancer. A colonoscopy revealed necrotizing ulcer-like changes. A biopsy confirmed the presence of amoebic trophozoites. Subsequently,peritonitis with intestinal perforation developed, and emergency peritoneal lavage and colostomy were performed. After surgery, endotoxin adsorption therapy was performed and metronidazole was given. Symptoms of peritonitis and colonitis resolved.with the progression of gastric cancer. The patient died 50 d after surgery. Fulminant amoebic colitis is very rarely associated with chemotherapy. Amoebic colitis should be considered in the differential diagnosis of patients who have bloody stools during chemotherapy.

  11. Histochemical studies on intestinal metaplasia adjacent to gastric cardia adenocarcinoma in subjects at high-incidence area in Henan, north China

    Institute of Scientific and Technical Information of China (English)

    She-Gan Gao; Hua-Qin Guo; Jun-Kuan Wang; Xiao-Shan Feng; Bao-Gen Ma; Li-Dong Wang; Zong-Min Fan; Ji-Lin Li; Xin He; Rui-Feng Guo; Dong-Ling Xie; Xin-Wei He; Shan-Shan Gao

    2005-01-01

    AIM: To characterize the histochemical type and pattern of intestinal metaplasia (IM) adjacent to gastric cardia adenocarcinoma (GCA) and distal gastric cancer (GC) in Linzhou, Henan Province, China.METHODS: Alcian-blue-periodic acid Schiff and high iron diamine-Alcian blue histochemical methods were performed on 142 cases of IM, including 49 cases of GCA and 93 cases of GC. All the patients were from Linzhou, Henan Province, China, the highest incidence area for both GCA and squamous cell carcinoma. Radio- or chemotherapy was not applied to these patients before surgery.RESULTS: The detection rate of IM in tissues adjacent to GCA tissues was 44.9%, which was significantly lower than that in GC tissues (80.64%, P<0.01). The rates of both incomplete small intestinal and colonic IM types identified by histochemistry in GCA tissues (31.82% and 63.64%, respectively) were significantly higher than those in GC (5.33% and 21.33%, respectively, P<0.01).CONCLUSION: IM in GCA and GC should be considered as a separate entity. Further research is needed to evaluate whether neoplastic progression of IM is related to its mucin profile in GCA.

  12. A Pilot Study to Investigate the Role of Thymidylate Synthase as a Marker of Prognosis for Neoadjuvant Chemotherapy in Gastric and Gastro-Oesophageal Junction Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    A. Mirza

    2013-01-01

    Full Text Available Aims and Background. Patients in the United Kingdom with operable gastric and gastro-oesophageal junction (GOJ tumours receive neoadjuvant chemotherapy. Our aim was to study the expression of thymidylate synthase (TS enzyme in pre-treatment diagnostic biopsy specimens and investigate its clinical usefulness. Methods. A single-centre study was carried out in 45 patients with gastric and GOJ adenocarcinoma treated with neo-adjuvant chemotherapy according to the MAGIC protocol. TS expression was determined using immunohistochemistry. >10% tumour nuclei expression of TS was used as cut-off for positivity. Results. Forty-one (91% of the 45 tumours expressed TS. There was no association between TS expression and lymph node status (P = 0.80, histological response (P = 0.30, and recurrence (P = 0.55. On univariate analysis, only N-stage (P = 0.02 and vascular invasion (P = 0.04 were associated with a poor prognosis. Patients with negative tumour TS expression had better outcome than those with positive expression. The overall 5-year survival rate was 100% in the TS negative versus 56% in TS positive group, but the difference was not statistically significant (P = 0.17. Conclusion. TS expression should be studied in a larger series of gastro-oesophageal cancers as a potential prognostic marker of prognosis to neo-adjuvant chemotherapy.

  13. CD147在胃腺癌中的表达意义%The Expression and Significance of CD147 in Gastric Adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    张颖; 张古林; 胡建功

    2012-01-01

    目的:探讨CD147 在胃腺癌中的表达意义.方法:采用免疫组化S-P 法检测10 例正常胃粘膜上皮、20 例癌旁组织、60 例胃腺癌组织中CD147 的表达,并分析其与胃癌临床病理特征的关系.结果:CD147 的表达阳性率在胃腺癌组织中显著高于正常胃粘膜上皮及癌旁组织中(P<0.01),在癌旁组织中显著高于正常组织中(P<0.05);在低分化癌组织中显著高于中分化癌组织中(P<0.05),在浸润肌层及浸润浆膜层组织中显著高于浸润粘膜下层组织中(P>0.05),在浸润肌层及浸润浆膜层组织中差异无显著性(P<0.05);在淋巴结转移组显著高于无淋巴结转移组(P<0.05).CD147 的表达阳性率与患者性别、年龄、肿瘤体积等无关(P>0.05).结论:CD147 的表达增强可能与胃癌的侵袭转移有关.CD147 可能促进了胃癌的发生发展.%Objective:To investigate the expression of leucocyte differentiation antigen 147 ( CD147 ) and significance in gastric adenocarcinoma. Method: Immunohistochemistry was used to detect the expression of CD147 in 10 specimens of normal gastric mucosas, 20 specimens of juxtacancerous tissues and 60 specimens of adenocarcinoma tissues, and analyzed significances with clinical pathological factors. Result: The expression positive rate of CD147 was much higher in carcinoma tissues than in normal gastric mucosas and juxtacancerous tissues (P<0.01) , in juxtacancerous tissues than in normal gastric mucosas (P<0. 05). The expression positive rate of CD147 were also much higher in poorly differentiated tissues than in moderately differentiated tissues, was higher in tissues with muscular layer and placenta percreta infiltration than those with submucosa infiltration, was higher in tissues with lymph nodes metastasis than those without lymph nodes metastasis. No significant difference was found between tissues with muscular layer infiltration and placenta percreta infiltration, and no correlation was found

  14. Potential Therapeutic Benefit of Combining Gefitinib and Tamoxifen for Treating Advanced Lung Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Chien-Ming Liu

    2015-01-01

    Full Text Available Introduction. Epidermal growth factor receptor (EGFR mutations are known as oncogene driver mutations and with EGFR mutations exhibit good response to the EGFR tyrosine kinase inhibitor Gefitinib. Some studies have shown that activation of estrogen and estrogen receptor α or β (ERα/β promote adenocarcinoma. We evaluated the relationship between the two receptors and the potential therapeutic benefit with Gefitinib and Tamoxifen. Methods. We assessed the association between EGFR mutations as well as ERα/β expression/location and overall survival in a cohort of 55 patients with LAC from a single hospital. PC9 (EGFR exon 19 deletion mutant; Gefitinib-vulnerable cells and A549 (EGFR wild type; Gefitinib-resistant cells cancer cells were used to evaluate the in vitro therapeutic benefits of combining Gefitinib and Tamoxifen. Results. We found that the cytosolic but not the nuclear expression of ERβ was associated with better OS in LAC tumors but not associated with EGFR mutation. The in vitro study showed that combined Gefitinib and Tamoxifen resulted in increased apoptosis and cytosolic expression of ERβ. In addition, combining both medications resulted in reduced cell growth and increased the cytotoxic effect of Gefitinib. Conclusion. Tamoxifen enhanced advanced LAC cytotoxic effect induced by Gefitinib by arresting ERβ in cytosol.

  15. Efficacy of Gefitinib for Young Patients with Unknown EGFR Gene Mutation 
in Advanced Lung Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Yutao LIU

    2014-05-01

    Full Text Available Background and objective Lung cancer in young patients (less or equal to 45 years is relatively rare. We explored the efficacy and survival of Gefitinib for young patients with unknown epidermal growth factor receptor (EGFR gene mutation of advanced lung adenocarcinoma. Methods The clinical data of 55 young patients with unknown EGFR gene mutation in advanced lung adenocarcinoma referred to the Cancer Hospital & Institute, Chinese Academy of Medical Sciences from Jan 2006 through Dec 2010 were analyzed retrospectively. Results Of 55 young patients enrolled, the median age was 41 years. The objective response rate and disease control rate were 43.6% and 90.9%, respectively.. The median progression-free survival (PFS was 9.0 months. Among the factors analyzed, brain metastasis had significant effect on PFS (P=0.017. The median overall survival (OS was 24.0 months. The independent prognostic factors to significantly improve OS included non-smoking history (P=0.028 and receiving other anti-cancer treatment after Gefitinib therapy (P<0.001. Conclusion The median PFS and OS of the young patients with Unknown EGFR gene mutation in advanced lung adenocarcinoma were similar with general population.

  16. Correlation of the expression of gonadotropin releasing hormone and its receptor in human gastric adenocarcinoma cell proliferation and differentiation%GnRH及其受体的表达与胃腺癌细胞增殖和分化的相关性研究

    Institute of Scientific and Technical Information of China (English)

    孙绪德; 柴伟; 高昌俊; 张贵和; 陈蕾; 黄威权

    2003-01-01

    AIM:To investigate the possible correlation of the expression of gonadotropin releasing hormone(GnRH) and its receptor with of proliferating cell nuclear antigen(PCNA) in human gastric adenocarcinoma cell proliferation and differentiation.METHODS:GnRH and its receptor and PCNA were detected in 30 gastric adenocarcinoma by immunohistochemical ABC technique. RESULTS:GnRH and its receptor had the same distribution pattern in gastric adenocarcinoma cells.The positive signal was found mainly in cytoplasm.The content of GnRH and its receptor immunoreative product in high differentiatied adenocarcinoma was significantly higher than those of the other two groups and the low differentiatied adenocarcinoma was the lowest(P< 0.05).PCNA positive signal which was found mainly in nucleus was gradually abated along with the raising of the extent of the differentiation.The differences were significant among the three groups(P< 0.05). In human gastric adenocarcinoma,the expression of GnRH and its receptor was negative correlation with the expression of PCNA(r=0.9).CONCLUSION:GnRH might be involved in the regulation of human gastric adenocarcinoma cell proliferation and differentiation.

  17. Polymorphisms of interleukin-10 promoter are not associated with prognosis of advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Jie Liu; Bao Song; Jia-Lin Wang; Zeng-Jun Li; Wan-Hu Li; Zhe-Hai Wang

    2011-01-01

    AIM: To evaluate the association between of the interleukin- 10 (IL-10) promoter polymorphisms and survival of advanced gastric cancer (GC) patients. METHODS: The IL-10 (-1082, rs1800896; -819, rs1800871; and-592, rs1800896) genotypes in 234 patients with advanced gastric cancer and in 243 healthy controls were determined by polymerase chain reactionrestriction fragment length polymorphism assay. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by unconditional logistic regression for the associations between IL-10 genotypes and the risk of GC. The Kaplan-Meier method with log-rank testing was used to evaluate the association between genotype and survival of the patients. RESULTS: The IL-10 -1082 G allele and GCC (-1082, -819 and -592) haplotype were associated with increased gastric cancer risks (OR 1.2, 95% CI 0.6-3.2, P = 0.007, for -1082 G allele, OR = 2.3, 95% CI, 1.2-4.1, P = 0.005, for GCC haplotype, respectively). However, none of the three IL-10 gene polymorphisms (-1082, -819 and -592) was correlated with gastric cancer survival (P > 0.05), and none of the genotypes of the three IL-10 sites was found as independent prognostic risk factors in the multivariate test. CONCLUSION: IL-10 gene promoter polymorphisms may not be associated with the prognosis of advanced gastric cancer.

  18. Diagnostic value of 18 FDG-PET/CT for poorly differentiated gastric adenocarcinoma%18 F-脱氧葡萄糖 PET/CT 对低分化胃腺癌的诊断价值

    Institute of Scientific and Technical Information of China (English)

    刘凯; 邹丹丹; 李琼; 贺琦; 刘士远

    2015-01-01

    Objective The sensitivity and specificity of 18 FDG PET/CT are poor in the diagnosis of gastric cancer .Gastric signet ring cell carcinoma and Mucinous gastric carcinoma is known to have low fluorodeoxyglucose (18FDG) uptake,but not known for poorly differentiated gastric adenocarcinoma .This study was to investigate the value of 18 FDG PET/CT in the diagnosis of poorly differ-entiated gastric adenocarcinoma . Methods We retrospectively analyzed the results of 18 FDG PET/CT of 34 cases of histologically confirmed poorly differentiated gastric adenocarcinoma .We recorded the volume , location , and gastric wall invasion depth , and maxi-mum standardized uptake value ( SUVmax) of the tumors and analyzed the relationship of 18 FDG uptake with the clinicopathologic pa-rameters. Results By 18 FDG-PET/CT, poorly differentiated gastric adenocarcinoma was diagnosed in only 67.6% of the patients (23/34).SUVmax was found to be significantly correlated with age , gastric wall invasion, and tumor size (P0 .05 ) .Logistic regression a-nalysis showed the tumor size to be the sole factor influencing the 18 FDG uptake of poorly differentiated gastric adenocarcinoma ( OR=0.37, 95%CI 0.154-0.920, P=0.03). Conclusion The di-agnostic value of 18 FDG-PET/CT is but limited for poorly differentia-ted gastric adenocarcinoma , and attention should be paid to its false-negative results .%目的:18 F-脱氧葡萄糖(18 F fluorodeoxyglucose ,18 FDG) PET/CT对胃癌的诊断敏感性及特异性不佳。文中旨在探讨18 F PET/CT对低分化胃腺癌的诊断价值。方法回顾性分析第二军医大学附属长征医院2012年4月至2014年7月经手术或胃镜病理证实为低分化胃腺癌的34例患者18 FDG PET/CT征象,记录肿瘤大小、位置、胃壁浸润深度及最大标准摄取值( maximum standardized uptake values , SUVmax)。分析18 FDG摄取阳性与各个临床病理参数关系。结果34例患者低分化胃腺癌诊断阳性率仅为67

  19. [Atrophy in the mucosa neighboring an intestinal-type gastric adenocarcinoma by comparing the Sydney vs. OLGA systems].

    Science.gov (United States)

    Ramírez-Mendoza, Pablo; Hernández-Briseño, Liliana; Casarrubias-Ramírez, Moisés; Alvarado-Cabrero, Isabel; Ángeles-Garay, Ulises

    2015-01-01

    Introducción: el carcinoma gástrico ocasiona al año unas 700 000 muertes en el mundo. El objetivo de este artículo es evaluar la atrofia en la mucosa vecina al adenocarcinoma gástrico tipo intestinal comparando los sistemas Sídney y OLGA. Diferencias en el rendimiento diagnóstico impulsarían el empleo de alguno. Métodos: estudiamos 28 sujetos con adenocarcinoma gástrico tipo intestinal (Lauren), que comparamos con 32 casos sin neoplasia, ambos grupos con gastrectomía total. Dos patólogos evaluaron la atrofia en el epitelio de cuerpo y antro no neoplásico con los sistemas Sídney y OLGA. Se obtuvieron la media, mediana y distribución de frecuencias por escala de medición, así como la distribución de las variables del estudio. Se calculó la sensibilidad, especificidad y los valores predictivos para cáncer gástrico gracias a dicotomizar las escalas con resultado positivo y negativo para atrofia avanzada. Resultados: veinticuatro de 28 casos con adenocarcinoma gástrico tipo intestinal mostraron atrofia avanzada con OLGA con una sensibilidad y especificidad de 77 y 85 % respectivamente. Con el sistema Sídney, 4 de 28 mostraron atrofia avanzada con una sensibilidad y especificidad de 14 y 100 % respectivamente. Conclusiones: el sistema OLGA tiene elevada sensibilidad y especificidad (77 y 85 % respectivamente) para reconocer cambios preneoplásicos en la mucosa vecina al cáncer gástrico. Empero, OLGA no mostró atrofia avanzada en adenomas foveolares con displasia de alto grado, ni en adenocarcinomas en las porciones proximales del estómago.

  20. Detecção do vírus Epstein-Barr (EBV em adenocarcinomas gástricos procedentes dos estados do Ceará e de São Paulo Epstein-Barr virus (EBV detection in gastric carcinomas from Ceará and São Paulo states, in Brazil

    Directory of Open Access Journals (Sweden)

    Marcos Antonio Pereira de Lima

    2011-04-01

    remain contentious. OBJECTIVE: The objective of this study was to analyze clinical-pathological features of gastric adenocarcinomas from two Brazilian states, São Paulo and Ceará, by correlating them with EBV detection. MATERIALS AND METHODS: One hundred ninety-two gastric adenocarcinoma cases were selected from hospitals in São Paulo and Ceará, of which 160 were submitted to RNA in situ hybridization for EBV detection. RESULTS: Eleven (6.9% out of 160 cases were EBV-positive with intense nuclear staining in tumor cells. Among these, two cases also showed stained infiltrating lymphocytes. There was no staining in normal or preneoplastic tissue. São Paulo and Ceará yielded the respective results: 3/60 (5% and 8/100 (8%. In both states, EBV was more prevalent among elder male patients with little to moderately differentiated intestinal tumors in advanced stage. Ceará cases substantiated a relative increase in EBV(+ tumors located in the cardia, whereas São Paulo cases presented an increase in the gastric corpus. CONCLUSION: The frequency of EBV(+ tumors is similarly described in the literature. Among our findings, the elevated percentage of EBV(+ tumors in the gastric corpus, which was observed in São Paulo cases, is unprecedented in the literature.

  1. Alcohol consumption, cigarette smoking and risk of subtypes of oesophageal and gastric cancer: A prospective cohort study

    NARCIS (Netherlands)

    Steevens, J.; Schouten, L.J.; Goldbohm, R.A.; Brandt, P.A. van den

    2010-01-01

    Objective: Alcohol consumption and cigarette smoking may be differentially associated with oesophageal squamous cell carcinoma (OSCC), oesophageal adenocarcinoma (OAC), gastric cardia adenocarcinoma (GCA) and gastric non-cardia adenocarcinoma (GNCA). However, because this was based on retrospective

  2. Effects of mifepristone on invasive and metastatic potential of human gastric adenocarcinoma cell line MKN-45 in vitro and in vivo

    Institute of Scientific and Technical Information of China (English)

    Da-Qiang Li; Zhi-Biao Wang; Jin Bai; Jie Zhao; Yuan Wang; Kai Hu; Yong-Hong Du

    2004-01-01

    AIM: To investigate the effects of mifepristone on the invasive and metastatic potential of human gastric adenocarcinoma cell line MKN-45 and its mechanisms.METHODS: After incubation with various concentrations of mifepristone (5, 10, 20 μmol/L), the adhesion to artificial basement membrane, Matrigel, and the migration of MKN-45cells were assayed using MTT assay and lranswell cell culture chambers, respectively. Enzyme- linked immunoabsorbent assay (ELISA) and flow cytometry were used to determine the expression of vascular endothelial growth factor (VEGF)and integrin β3 in the cells. After subcutaneous transplantation of MKN-45 cells in nude mice, mifepristone (50 mg/kg.d)was administrated subcutaneously for 8 wk to assess its effects on tumor metastasis. Immunohistochemical analysis was used to detect the expression of VEGF and microvascular density (MVD) in xenografted tumors.RESULTS: Mifepristone dose-dependently inhibited the heterotypic adhesion to Matrigel of MKN-45 cells. The inhibition was accompanied by a significant down-regulation of integrin β3 expression in the cells. After incubation with 5, 10, 20 μmol/L mifepristone, the number of migrated MKN-45 cells was 72±8, 50±6, 41±5 in experiment group, and 94±16 in control group (P<0.01). Meanwhile, secreted VEGF protein of MKN-45 cells in mifepristone-treated group (14.2±2.9, 8.9±3.1, 5.4±2.1 ng/g per liter) was significantly lower than that in control group (22.7±4.3 ng/g per liter,P<0.01). In vivo, mifepristone decreased the number of metastatic foci in lungs of nude mice and down-regulated the expression of VEGF and MlVD in the xenograted tumors.CONCLUSION: Mifepristone can effectively inhibit the invasive and metastatic potential of human gastric adenocarcinoma cell line MKN-45in vitro and in vivo through inhibition of heterotypic adhesion to basement membrane,cell migration and angiogenesis.

  3. Targeted therapy for advanced gastric cancer: A review of current status and future prospects

    Institute of Scientific and Technical Information of China (English)

    Ozkan; Kanat; Bert; O’Neil; Safi; Shahda

    2015-01-01

    In the West in particular, the vast majority of gastric cancer(GC) patients present with advanced-stage disease. Although combination chemotherapy is stillthe most important component of treatment for these patients, it confers a modest survival advantage. Recently, increased knowledge of the key molecular signaling pathways involved in gastric carcinogenesis has led to the discovery of specific molecular-targeted therapeutic agents. Some of these agents such as trastuzumab and ramucirumab have changed the treatment paradigm for this disease. In this paper, we will summarize the current clinical status of targeted drug therapy in the management of GC.

  4. Prognostic impact of splenectomy on advanced proximal gastric cancer with No.10 lymph node metastasis

    Institute of Scientific and Technical Information of China (English)

    HUANG Chang-ming; WANG Jia-bin; LU Hui-shan; ZHENG Chao-hui; LI Ping; XIE Jian-wei; ZHANG Xiang-fu

    2009-01-01

    Background This study evaluated the prognostic impact of D2 lymphadenectomy combined with splenectomy in patients with advanced proximal gastric cancer and lymph node metastasis at the splenic hilum (No. 10 lymph nodes).Methods The clinical records of 216 patients with advanced proximal gastric cancer and No.10 lymph node metastasis who underwent D2 curative resection were retrospectively analyzed. Seventy-three patients underwent simultaneous splenectomy (splenectomy group), while 143 patients did not (spleen-preserving group). Five-year survival rates, mean numbers of dissected No.10 lymph nodes and metastatic No.10 lymph nodes, and operative morbidity and mortality were calculated and compared between the two groups. Potential prognostic factors were evaluated by univariate and multivariate analysis.Results The 5-year survival rate was 30.0% for the splenectomy group and 19.7% for the spleen-preserving group (X~2=14.73, P 0.05).Conclusions Splenectomy is beneficial for No.10 lymph node dissection in patients with advanced proximal gastric cancer. To improve patient prognosis, total gastrectomy with splenectomy is recommended for patients with T3 proximal gastric cancer who have No. 10 lymph node metastasis.

  5. Fatal pulmonary thromboembolism in gastrectomy intraoperative procedures by gastric adenocarcinoma: case report Tromboembolismo pulmonar fatal no intra-operatório de gastrectomia por adenocarcinoma gástrico: relato de caso

    Directory of Open Access Journals (Sweden)

    Cláudio Bresciani

    1999-08-01

    Full Text Available The case of a patient with gastric adenocarcinoma with indication for gastrectomy is reported. The surgery took place without complications. A palliative, subtotal gastrectomy was performed after para-aortic lymph nodes compromised by neoplasm were found, which was confirmed by pathological exam of frozen sections carried out during the intervention. At the end of the gastroenteroanastomosis procedure, the patient began to show intense bradycardia: 38 beats per minute (bpm, arterial hypotension, changes in the electrocardiogram's waveform (upper unlevelling of segment ST, and cardiac arrest. Resuscitation maneuvers were performed with temporary success. Subsequently, the patient had another circulatory breakdown and again was recovered. Finally, the third cardiac arrest proved to be irreversible, and the intra-operative death occurred. Necropsy showed massive pulmonary embolism. The medical literature has recommended heparinization of patients, in an attempt to avoid pulmonary thromboembolism following major surgical interventions. However, in the present case, heparinization would have been insufficient to prevent death. This case indicates that it is necessary to develop preoperative propedeutics for diagnosing the presence of venous thrombi with potential to migrate, causing pulmonary thromboembolism (PTE. If such thrombi could be detected, preventative measures, such as filter installation in the Cava vein could be undertaken.Relata-se um caso de paciente com adenocarcinoma gástrico com indicação de gastrectomia. O ato operatório transcorreu sem anormalidades. Foi realizada gastrectomia subtotal paliativa, pois encontrou-se linfonodos para-aórticos comprometidos pela neoplasia, confirmado por exame anátomo-patológico de congelação realizado no decorrer da intervenção. Ao fim da confecção da gastroêntero-anastomose o paciente passou a apresentar bradicardia intensa: 38 batimentos por minuto (bpm, hipotensão arterial, altera

  6. Achievement of Cure with Gefitinib in Advanced Lung Adenocarcinoma Harboring an Activating EGFR Mutation: A Case Report

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    Taiji Kuwata

    2016-10-01

    Full Text Available Tyrosine kinase inhibitors (TKIs of the epidermal growth factor receptor (EGFR may achieve long-term survival in selected cases with advanced non-small cell lung cancer harboring activating mutations in the EGFR gene, but a cured case has not been reported yet. Here, we present the first case of EGFR-mutated lung adenocarcinoma cured with an EGFR-TKI, as the 75-year-old Japanese man has achieved complete response with gefitinib treatment and has survived without tumor 10 years after termination of gefitinib treatment.

  7. Cytostatic activity of the duplex drug linking 2'-deoxy-5-fluorouridine (5FdU) with 3'-C-ethynylcytidine (ECyd) against gastric adenocarcinoma cell lines.

    Science.gov (United States)

    Weinreich, Jürgen; Schott, Sarah; Königsrainer, Ingmar; Zieker, Derek; Königsrainer, Alfred; Schott, Herbert

    2011-12-01

    The cytostatic potential of the new duplex drug 2'-deoxy-5-fluorouridylyl-(5'5')-3'-C-ethynylcytidine (5FdU(5'-5')ECyd) was evaluated in comparison to those of 5-fluorouracil (5FU), 2'-deoxy-5-fluorourindine (5FdU), 3'-C-ethynylycytidine (ECyd), cisplatin, an equimolar mixture of 5FdU + ECyd and a three component-mixture of 0.75 μM epirubicin/0.90 μM cisplatin/3.0 μM 5FU (ECF) by incubation of the two human gastric adenocarcinoma cell lines 23132/87 and MKN-45. The molar composition of ECF was taken from data of a triple combination chemotherapy for human gastric cancer. Time and dose depending inhibition of cell growth was determinated using the CASY technology. A growth decrease of both cell lines from 100% to about 20% was observed by treatment with ECF over a course of 14 days. This result provided basis to estimate the cytostatic potential of all tested drugs and combinations thereof. Corresponding high activities in respect to ECF were achieved by incubation of 23132/87 cells with single drugs 49 μM 5FU, 10 μM cisplatin, 3.4 μM 5FdU, 0.65 μM ECyd, the mixture 0.32 μM 5FdU + 0.32 μM ECyd and 0.32 μM 5FdU(5'-5')ECyd. The less sensitive MKN-45 cells require a 1.5-4 fold higher dose of the standard chemotherapeutics in order to achieve an equivalent cytostatic effect, in respect to the 23132/87 cell line,. However, the effect of the duplex drugs on MKN-45 cells was gained with a 5-fold lower dose than ECF. Due to its high cytostatic potential the duplex drug, which covalently links two active anticancer compounds, could be a new therapeutic alternative for chemotherapy in gastric cancer, currently treated with different combinations.

  8. Comparison of EGFR Mutation Status in Paired Pre- and Post-chemotherapy Serum for Advanced Pulmonary Adenocarcinoma

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    Rubing HAN

    2011-02-01

    Full Text Available Background and objective Non-small cell lung cancer (NSCLC with mutations in the epidermal growth factor receptor (EGFR is a distinct subgroup of NSCLC, which is particularly responsive to EGFR tyrosine kinase inhibitors (TKIs. The aim of this study is to detect EGFR mutations in paired serum of pre- and post-chemotherapy from advanced pulmonary adenocarcinoma patients to evaluate impact of chemotherapy on EGFR mutation status. Methods Magnetic beads were used for DNA extraction from paired serum of pre- and post-chemotherapy of 33 advanced pulmonary adenocarcinoma patients. The EGFR exon 19 and 21 were amplified by mutant-enriched nested PCR and analyzed by direct sequencing. Results EGFR mutations were detected in 39.4% (13/33 and 54.5% (18/33 serum samples of pre- and postchemotherapy, respectively. The EGFR mutation status was consistent in 54.5% (18/33 patients. Among 15 discordant cases, 10 changed from pre-chemo wild-type to post-chemo mutant-type status, while 5 from pre-chemo mutant-type to post-chemo wild-type status. Conclusion Chemotherapy may have influence on serum EGFR mutation status in advanced adenocacinoma patients.

  9. Dealcoholized Korean Rice Wine (Makgeolli) Exerts Potent Anti-Tumor Effect in AGS Human Gastric Adenocarcinoma Cells and Tumor Xenograft Mice.

    Science.gov (United States)

    Shin, Eun Ju; Kim, Sung Hee; Kim, Jae Ho; Ha, Jaeho; Hwang, Jin-Taek

    2015-09-01

    Makgeolli is a traditional wine in Korea and has been traditionally believed to exhibit health benefits. However, the inhibitory effect of dealcoholized makgeolli (MK) on cancer has never been investigated scientifically. In this study, MK exhibited an anti-angiogenic effect by inhibiting tube formation in human umbilical vein endothelial cells, without cytotoxicity. Treatment with MK reduced the proliferation of AGS human gastric adenocarcinoma cells in a dose-dependent manner and increased the sub-G1 population. Next, we evaluated whether MK could induce apoptosis in AGS cells by using the terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay or Annexin V method. Treatment with MK at 500 and 1,000 μg/ml increased the number of TUNEL-positive AGS cells. Under the same conditions, MK-treated (500 and 1,000 μg/ml) cells showed significant induction of early or late apoptosis, compared with untreated cells (no induction). In addition, MK also induced phosphatase and tensin homolog (PTEN) expression in AGS cells. However, p53 expression in AGS cells was not changed by MK treatment. Furthermore, MK at 500 mg/kg·d reduced the tumor size and volume in AGS tumor xenografts. Taken together, MK may be useful for the prevention of cancer cell growth.

  10. Coexpression of vascular endothelial growth factor and its receptor KDR on gastric adenocarcinoma MGC803 cell line and stimulation of exogenous VEGF165 to MGC803 cells

    Institute of Scientific and Technical Information of China (English)

    田学军; 孟麟; 寿成超; 董志伟

    2000-01-01

    Vascular endothelial growth factor (VEGF), also known as vascular permeability factor (VPF), is an angiogenic factor playing an important role in tumor growth. VEGF/VPF interacts with endothelial cells by way of two high-affinity receptor tyrosine kinases: flt-1 and KDR. The vast majority of published studies have described expression of the VPF/VEGF receptors specifically in endothelial cells. To elucidate the further function of VEGF in solid tumor development, the coex-pression of VEGF and KDR in gastric adenocarcinoma MGC803 cell lines was shown by reverse transcription polymerase chain reaction (RT-PCR). The MGC803 tumor cells could also be strongly immunostained for KDR by immunocytochemistry. It was further demonstrated that exogenous VEGF-165 can stimulate the MGC803 cell growth in both dose-dependent and time-dependent manners by 3H-thymidine incorporation. Furthermore, anti-VEGF165 monoclonal antibody and anti-KDR monoclonal antibody could dose-dependently block the VEGF166-induced cell growth

  11. Tissue Inhibitor of Metalloproteinase-1 Is Confined to Tumor-Associated Myofibroblasts and Is Increased With Progression in Gastric Adenocarcinoma

    DEFF Research Database (Denmark)

    Alpízar-Alpízar, Warner; Laerum, Ole Didrik; Christensen, Ib J;

    2016-01-01

    The tissue inhibitor of metalloproteinase-1 (TIMP-1) inhibits the extracellular matrix-degrading activity of several matrix metalloproteinases, thereby regulating cancer cell invasion and metastasis. Studies describing the expression pattern and cellular localization of TIMP-1 in gastric cancer are......-associated myofibroblasts. In the normal-appearing mucosa, scattered TIMP-1 protein was only found in chromogranin A positive cells. TIMP-1-positive myofibroblasts at the invasive front of the tumors were more frequently seen in intestinal than in diffuse histological subtype cases (p=0.009). A significant trend...

  12. Differentiation of early gastric cancer with ulceration and resectable advanced gastric cancer using multiphasic dynamic multidetector CT

    Energy Technology Data Exchange (ETDEWEB)

    Tsurumaru, Daisuke; Miyasaka, Mitsutoshi; Nishimuta, Yusuke; Asayama, Yoshiki; Nishie, Akihiro; Honda, Hiroshi [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences, Fukuoka (Japan); Kawanami, Satoshi [Kyushu University, Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Fukuoka (Japan); Oki, Eiji [Kyushu University, Department of Surgery and Sciences, Graduate School of Medical Sciences, Fukuoka (Japan); Hirahashi, Minako [Kyushu University, Department of Anatomic Pathology and Pathological Sciences, Graduate School of Medical Sciences, Fukuoka (Japan)

    2016-05-15

    Early gastric cancer with ulceration (EGC-U) mimics advanced gastric cancer (AGC), as EGC-Us and ACGs often have similar endoscopic appearance to ulceration. The purpose of this retrospective study was to determine whether multiphasic dynamic multidetector CT (MDCT) can help differentiate EGC-Us from AGCs. Patients with EGC-Us with ulcer stages Ul-III or IV and AGCs with tumour stages T2 to T4a were enrolled. MDCT images were obtained 40 s (arterial phase), 70 s (portal phase) and 240 s (delayed phase) after injection of non-ionic contrast material. Two readers independently measured the attenuation values of the lesions by placing regions of interest. We compared the EGC-Us and AGCs using the mean attenuation values in each phase and peak enhancement phase. We analysed the diagnostic performance of CT for differentiating EGC-Us from AGCs. Forty cases (16 EGC-Us and 24 AGCs) were analysed. The mean attenuation values of the EGC-Us were significantly lower than those of the AGCs in both the arterial and portal phases (all p < 0.0001 for each reader). The peak enhancement was significantly different between the EGC-Us and AGCs for both readers (Reader 1, p = 0.0131; Reader 2, p = 0.0006). Multiphasic dynamic contrast-enhanced MDCT can help differentiate EGC-Us from AGCs. (orig.)

  13. Serum HER 2 extracellular domain level is correlated with tissue HER 2 status in metastatic gastric or gastro-oesophageal junction adenocarcinoma.

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    Shu-Qin Dai

    Full Text Available BACKGROUND: To explore the association between serum human epidermal growth factor receptor 2 (HER 2 extracellular domain (ECD levels and tissue HER 2 status in metastatic gastric cancer. PATIENTS AND METHODS: HER 2 status was retrospectively analyzed in 219 advanced gastric or gastroesophageal junction (GEJ patients. Serum HER 2 ECD was measured by chemiluminescent assay and tissue HER 2 was assessed by fluorescent in situ hybridisation (FISH and immunohistochemistry (IHC assay. RESULTS: Significant associations were found between serum HER 2 ECD levels and tissue HER 2 status. Twenty-four patients had HER 2 ECD levels >16.35 ng/mL, which has a sensitivity of 51.4% and a specificity of 97.3% to predict tissue HER 2 status. When the cut-off value was increased to 22 ng/mL, then all 12 patients with serum HER 2 ECD levels>22 ng/mL were tissue HER 2 positive, corresponding to a specificity of 100% and a sensitivity of 32.4%. High serum HER 2 ECD levels were strongly associated with the intestinal histological type (Lauren's classification, liver metastasis, multiple metastasis (>2 and increased LDH levels, but not with overall survival. CONCLUSIONS: The high specificity of the serum HER 2 ECD assay in predicting tissue HER 2 status suggests its potential as a surrogate marker of the HER 2 status in gastric cancer.

  14. Molecular forms of trefoil factor 1 in normal gastric mucosa and its expression in normal and abnormal gastric tissues

    Institute of Scientific and Technical Information of China (English)

    Jian-Lin Ren; Jin-Yan Luo; Ya-Pi Lu; Lin Wang; Hua-Xiu Shi

    2006-01-01

    AIM: To study the molecular forms of trefoil factor 1 (TFF1) in normal gastric mucosa and its expression in normal and abnormal gastric tissues (gastric carcinoma, atypical hyperplasia and intestinalized gastric mucosa) and the role of TFF1 in the carcinogenesis and progression of gastric carcinoma and its molecular biological mechanism underlying gastric mucosa protection.METHODS: The molecular forms of TFF1 in normal gastric mucosa were observed by Western blot. The expression of TFF1 in normal and abnormal gastric tissues (gastric carcinoma, atypical hyperplasia and intestinalized gastric mucosa) was also assayed by immunohistochemical method. The average positive AO was estimated by Motic Images Advanced 3.0 software.RESULTS: Three patterns of TFF1 were found in normal gastric mucosa: monomer, dimmer, and TFF1 compound whose molecular weight is about 21 kDa.The concentration of TFF1 compound was the highest among these three patterns. TFF1 was expressed mainly in epithelial cytoplasm of the mucosa in gastric body and antrum, especially around the nuclei. The closer the TFF1 to the lumen, the higher the expression of TFF1.The expression of TFF1 in peripheral tissue of gastric carcinoma (0.51 ± 0.07) was higher than that in normal gastric mucosa (0.44 ± 0.06, P < 0.001). The expression of TFF1 in gastric adenocarcinoma was positively related to the differentiation of adenocarcinoma. The lower the differentiation of adenocarcinoma was, the weaker the expression of TFF1. No TFF1 was expressed in poorly-differentiated adenocarcinoma. The expression of TFF1 in moderately-well differentiated adenocarcinoma (0.45± 0.07) was a little lower than that in normal mucosa (P > 0.05). The expression of TFF1 in gastric mucosa with atypical hyperplasia (0.57 ± 0.03) was significantly higher than that in normal gastric mucosa (P < 0.001).No TFF1 was expressed in intestinalized gastric mucosa.There was no statistically significant difference between the expressions of

  15. Synchronous lung and gastric cancers successfully treated with carboplatin and pemetrexed: a case report

    Directory of Open Access Journals (Sweden)

    Sato Takashi

    2012-08-01

    Full Text Available Abstract Introduction Lung and gastric cancers are the first and second leading causes of death from cancer worldwide, and are especially prevalent in Eastern Asia. Relatively few reports are available in relation to the treatment and outcome of synchronous lung and gastric cancers, although there are increasing numbers of patients with these cancers. Efforts to develop more effective drugs for the treatment of synchronous cancers, without serious adverse effects, have been intensifying. Pemetrexed, a multi-targeted antifolate enzyme inhibitor, was approved by the United States Food and Drug Administration as a first-line chemotherapy for advanced non-squamous non-small cell lung cancer in 2007. Although clinical activity against several tumor types of adenocarcinoma, including gastric cancer, has been demonstrated, the efficacy of pemetrexed for gastric cancer remains to be fully evaluated. Case presentation We report a case involving a 62-year-old Japanese woman with synchronous locally-advanced poorly-differentiated lung adenocarcinoma and poorly-differentiated gastric adenocarcinoma, containing signet-ring cells distinguished by immunohistochemical profiles. She had been treated with carboplatin and pemetrexed as a first-line chemotherapy for lung cancer, and had achieved partial responses for both lung and gastric cancers. These responses led to a favorable 12-month progression-free survival after the initiation of chemotherapy, and the patient is still alive more than 33 months after diagnosis. Conclusions This case suggests a new chemotherapeutic regimen for patients with synchronous multiple primary cancers that have an adenocarcinoma background.

  16. OUR EXPERIENCE OF HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY FOR PATIENTS WITH ADVANCED GASTRIC CANCER

    Directory of Open Access Journals (Sweden)

    A. D. Kaprin

    2015-01-01

    Full Text Available Purpose. Improvement of the results of treatment of patients with locally advanced and metastatic gastric cancer. Material and methods. From the 2010–2014 we performed 30 surgeries using techniques HICT. Among patients there were 17 men and 13 women. The median of age was 50 years. Locally advanced gastric cancer (T4a-T4b was observed in 22 cases, including 4 patients in the emergency immunocytochemical study with peritoneal lavage detected cancer-free (Cyt + cells in the abdominal cavity. The group of patients with metastatic gastric cancer accounted for 8 patients. Narrow carcinomatosis (P1 was 4 cases, carcinomatosis (P2-P3 — 4. Adjuvant systemic chemotherapy in the study group was not carried out. In the control group No 1 (n = 51 performed surgery alone, without additional anticancer therapy. In the control group No 2 (n = 66, a combined treatment (surgery + chemotherapy. Results. Follow-up median was 25 months. Overall 1-year survival rate for all three groups was 55%, 39% and 52%, respectively. Median survival in the intervention group versus 21.4 months in the 8 and 12 months, respectively. The most effective HICT is shown for patients with locally advanced gastric cancer. In the study group, median overall survival was 29 months. The survival rate of 1-, 2-, 3-year-old was equal to 68%, 61% and 42%. In the first control group, 1-year survival of 45%. None of the patients did not survive 2 years. In the second control group, one-year survival rate was 60%, 2-year survival is not. Results of treatment of metastatic gastric cancer proved to be more modest. In the main group the median survival was 10 months, compared with 6 and 7 months of the two control groups. There were no statistically significant differences. Conclusions. 1. Availability of limited dissemination, free cancer cells in the abdominal cavity, as well as a massive defeat of serous membrane of the stomach can be seen as indications for HICT in gastric cancer. 2. In

  17. A Prognostic Model Using Inflammation- and Nutrition-Based Scores in Patients With Metastatic Gastric Adenocarcinoma Treated With Chemotherapy.

    Science.gov (United States)

    Hsieh, Meng-Che; Wang, Shih-Hor; Chuah, Seng-Kee; Lin, Yu-Hung; Lan, Jui; Rau, Kun-Ming

    2016-04-01

    The outcomes of patients with metastatic gastric cancer (mGC) are poor. Recent studies have identified the prognostic impact of inflammatory response and nutritional status on survival for patients with gastric cancer. This study aims to create a prognostic model using inflammatory- and nutrition-based scores to predict survival in patients with mGC treated with chemotherapy.After institutional review board approval, patients who had mGC and were treated with chemotherapy from 2007 to 2012 at Kaohsiung Chang Gung Memorial Hospital were retrospectively reviewed. Significantly predictive factors were identified by multivariate Cox regression analyses. Based on these variables, a prognostic model using inflammatory- and nutrition-based scores was constructed to predict survival. Kaplan-Meier curves were plotted to estimate overall survival. The c-statistic values with 95% confidence interval (CI) were also calculated to access their predicting performances.Our study consisted of 256 patients with a median age of 60 years and a median follow-up visit of 18.5 months. Multivariate analyses showed that neutrophil to lymphocyte ratio (NLR), modified Glasgow prognostic score (mGPS), and Patient-Generated Subjective Global Assessment (PG-SGA) were independently related to survival. After computing these scores, patients were classified into favorable-, intermediate-, and poor-risk groups. The median overall survival were 27.6 versus 13.2 versus 8.2 months in favorable, intermediate, and poor-risk groups, respectively. The 2-year survival rate was 52% versus 16% versus 3% in favorable-, intermediate-, and poor-risk groups, respectively. (P nutrition-based scores could provide prognostic information to patients and physicians.

  18. Catheterization-associated complications of intraperitoneal chemotherapy in advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Meng Ye; Hong-Ming Pan; Hai-Yun Wang; Fang Lou; Wei Jin; Yu Zheng; Jin-Ming Wu

    2004-01-01

    AIM: To assess the catheterization-associated complications during intraperitoneal chemotherapy (IPCT) for advanced gastric cancer.METHODS: From 1998 to 2002, 80 patients with advanced gastric cancer received a total of 320 courses of IPCT using a large bore central venous catheter and associated complications were analyzed.RESULTS: Catheterization-associated complications occurred in 11 of the 80 patients (13.8%), including abdominal pain caused by catheter in 2 cases (0.63%), insertion failure in 2 cases (0.63%), bowel perforation in 1 case (0.31%)and abdominal pain during chernotherapy in 6 cases (1.88%).No serious complications required surgical intervention.CONCLUSION: IPCT using central venous catheters can be performed safely and simply without severe associated complications.

  19. Radiologic presentation of chronic granulomatous prostatitis mimicking locally advanced prostate adenocarcinoma.

    Science.gov (United States)

    Lee, Su-Min; Joshi, Jay; Wolfe, Konrad; Acher, Peter; Liyanage, Sidath H

    2016-06-01

    We present a case of nonspecific granulomatous prostatitis (GP), a clinical mimic of prostate adenocarcinoma. A 54-year-old man presented with lower urinary tract symptoms and raised prostate-specific antigen. Magnetic resonance imaging showed features consistent with prostate cancer, including low T2-signal intensity in the peripheral and transition zones with signs of extracapsular extension. Diffusion-weighted imaging showed high-signal intensity, with low apparent diffusion coefficient values, whereas dynamic contrast enhancement demonstrated a type 3 washout curve, similar to that found in prostate cancer. Transperineal sector-guided prostate biopsy confirmed nonspecific GP, and the patient was treated conservatively. We discuss and compare nonspecific, chronic GP as a radiologic mimic of prostate adenocarcinoma patient.

  20. Radiologic presentation of chronic granulomatous prostatitis mimicking locally advanced prostate adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Su-Min Lee

    2016-06-01

    Full Text Available We present a case of nonspecific granulomatous prostatitis (GP, a clinical mimic of prostate adenocarcinoma. A 54-year-old man presented with lower urinary tract symptoms and raised prostate-specific antigen. Magnetic resonance imaging showed features consistent with prostate cancer, including low T2-signal intensity in the peripheral and transition zones with signs of extracapsular extension. Diffusion-weighted imaging showed high-signal intensity, with low apparent diffusion coefficient values, whereas dynamic contrast enhancement demonstrated a type 3 washout curve, similar to that found in prostate cancer. Transperineal sector-guided prostate biopsy confirmed nonspecific GP, and the patient was treated conservatively. We discuss and compare nonspecific, chronic GP as a radiologic mimic of prostate adenocarcinoma patient.

  1. Krukenberg tumors diagnosed during pregnancy simultaneously with advanced gastric cancer; A case report

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    You, Myung Won; Jung, Yoon Young; Shin, Jung Hwan; Hong, Young Ok [Eulji Hospital, Eulji University School of Medicine, Seoul (Korea, Republic of)

    2015-06-15

    Krukenberg tumors recognized during pregnancy are rarely reported. The preoperative diagnosis can be challenging because of the confusing morphological features and symptoms during pregnancy. Here, we report a case of a 29-year-old pregnant woman at 29 weeks gestation presenting with bilateral solid ovarian masses, which were later diagnosed as metastatic ovarian cancer originating from advanced gastric cancer. This case suggests that Krukenberg tumors should be considered when bilateral ovarian solid masses are encountered regardless of pregnancy.

  2. Eight-year survival after advanced gastric cancer treated with S-1 followed by surgery

    Institute of Scientific and Technical Information of China (English)

    Susumu; Hijioka; Keisho; Chin; Yasuyuki; Seto; Noriko; Yamamoto; Kiyohiko; Hatake

    2010-01-01

    We report a case of advanced gastric cancer, with cervical, axillary, and abdominal paraaortic lymph node metastases, that was successfully treated with chemotherapy and surgery. The disease was initially considered unresectable, and the patient was treated with orally administered S-1. Chemotherapy was effective, and all lymph node metastases disappeared after 6 courses. After 27 mo of chemotherapy, the patient underwent curative surgery, with subtotal gastrectomy and lymph node dissection. Histopathologic...

  3. A Case of Advanced Gastric Cancer with Poor Performance Status Which Improved by Chemotherapy

    Directory of Open Access Journals (Sweden)

    Kohei Shitara

    2010-07-01

    Full Text Available Introduction: The prognosis of advanced gastric cancer patients, especially those with poor performance status (PS, is generally dismally poor. Patients with PS 3–4 are usually ineligible for participation in clinical studies and are managed with only best supportive care. Case Report: A 63-year-old male with advanced gastric cancer was admitted to our hospital. His PS was markedly impaired (Eastern Cooperative Oncology Group PS 4, with dyspnea secondary to lymphangitis, pleuritis and pericarditis. He also had bilateral leg paralysis due to multiple bone metastases. He was treated with chemotherapy using 5-fluorouracil and leucovorin for 14 days with pericardial drainage followed by intrapericardial infusion of cisplatin. He was also treated with radiotherapy for bone metastasis. The patient required 5 l/min oxygen therapy at the start of chemotherapy, but his dyspnea was improved by day 14 and he no longer required supplemental oxygen therapy. His leg paralysis also improved with the radiation therapy. His PS was significantly improved with this multimodal treatment modality, and he was ultimately discharged with chemotherapy with oral fluoropyrimidine. Conclusion: This case suggests that multimodal therapy including chemotherapy may be beneficial in advanced gastric cancer patients even in the setting of poor PS. Further study might be required to confirm the benefit of chemotherapy in this patient population.

  4. Effect of lymphadenectomy extent on advanced gastric cancer located in the cardia and fundus

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    AIM: To analyze the prognostic impact of lymphade- nectomy extent in advanced gastric cancer located in the cardia and fundus. METHODS: Two hundred and thirty-six patients with advanced gastric cancer located in the cardia and fundus who underwent D2 curative resection were analyzed retrospectively. Relationships between the numbers of lymph nodes (iNs) dissected and survival was analyzed among different clinical stage subgroups. RESULTS: The 5-year overall survival rate of the entire cohort was 37.5%. Multivariate prognostic variables were total LNs dissected (P<0.0001; or number of negative LNs examined, P<0.0001), number of positive INs (P < 0.0001), T category (P < 0.0001) and tumor size (P=0.015). The greatest survival differences were observed at cutoff values of 20 INs resected for stage II (P = 0.0136), 25 for stage III (P < 0.0001), 30 for stage IV (P = 0.0002), and 15 for all patients (P = 0.0024). Based on the statistically assumed linearity as best fit, linear regression showed a significant survival enhancement based on increasing negative INs for patients of stages III (P = 0.013) and IV (P = 0.035). CONCLUSION: To improve the long-term survival of patients with advanced gastric cancer located in the cardia and fundus, removing at least 20 INs for stage II, 25 INs for stage III, and 30 INs for stage 1V patients during D2 radical dissection is recommended.

  5. Comparison of histological and molecular diagnosis of Helicobacter pylori in benign lesions and gastric adenocarcinoma Comparação dos diagnósticos histológico e molecular do Helicobacter pylori em lesões benignas e adenocarcinomas gástricos

    Directory of Open Access Journals (Sweden)

    Ana Cristina Gobbo César

    2005-03-01

    Full Text Available Helicobacter pylori colonization is associated with chronic gastritis, peptic ulcers, intestinal metaplasia, adenocarcinoma and lymphoma of the stomach. The objective of this study was to compare the results of the routinely used histology with molecular diagnosis for the detection of H. pylori. Eighty samples from gastric lesions (chronic gastritis, atrophic gastritis, gastric ulcer, and intestinal metaplasia, 18 gastric adenocarcinoma and 10 normal mucosa H. pylori-negative (control samples were obtained. All samples were examined histologically (hematoxylin-eosin and Giemsa staining, and PCR amplifications of the species-specific antigen gene (H3H4 and urease A gene segment (H5H6 of H. pylori were made, using the human gene CYP1A1 for DNA quality control. In the benign lesion and adenocarcinoma the infection was detected in 43% (42/98 and 71% (70/98 by histological and molecular diagnosis (p = 0.0001, respectively. The PCR test detected H. pylori in 27.5% (22/80 of the benign gastric lesions and in 50% (9/18 of the gastric adenocarcinoma cases, the histological diagnosis being negative for this bacterium. About 2.5% of the samples, exclusively from benign lesions and with a positive histological diagnosis, showed negative molecular results for both primers. Statistically significant differences were found between the histological and the molecular method in intestinal metaplasia (p = 0.0461 and gastric adenocarcinoma (p = 0.0011, due to underdetection of H. pylori by the histological method, which is probably due to the low density of the bacterium as a consequence of the severe atrophy of the gastric mucosa. Our findings suggest that PCR is the more efficient method for the assessment of H. pylori infection, especially in metaplasia and gastric adenocarcinoma.A colonização do Helicobacter pylori está associada com gastrite crônica, úlcera péptica, metaplasia intestinal, adenocarcinoma e linfoma gástrico. O objetivo desse estudo foi

  6. [A case of early gastric cancer completely responding to adjuvant chemotherapy for advanced colon cancer].

    Science.gov (United States)

    Tanaka, Ryo; Kameyama, Hitoshi; Nakano, Mae; Ichikawa, Hiroshi; Hanyu, Takaaki; Nakano, Masato; Ishikawa, Takashi; Shimada, Yoshifumi; Sakata, Jun; Kobayashi, Takashi; Kosugi, Shinichi; Minagawa, Masahiro; Koyama, Yu; Wakai, Toshifumi

    2014-11-01

    A 70-year-old man was referred to our hospital with ascending colon cancer (cT3N1M0, Stage IIIa), which was found during examinations following a positive fecal occult blood test. The patient was also diagnosed with early gastric cancer (cT1a, N0, M0, Stage IA)during a preoperative gastroscopy examination. A laparoscopically assisted right colectomy and D3 lymphadenectomy was performed for the ascending colon cancer. The postoperative pathological diagnosis was Stage IIIb (pT3N2), he was administered in combination with capecitabine plus oxaliplatin (CapeOX) as adjuvant chemotherapy before the treatment for the colon cancer. After 6 months of adjuvant chemotherapy, we were unable to detect any gastric lesions at the same location using gastroscopy, and so diagnosed a clinical complete response. A follow-up gastroscopy 6 months later showed the same findings. The patient has had no recurrence of gastric cancer for 18 months after the initial operation. He will continue to be followed up closely using gastroscopy. In this case, CapeOX as adjuvant chemotherapy for advanced colon cancer was also effective for early gastric cancer.

  7. Literature Analysis of TCM Syndrome Types of Gastric Cancer and Advanced Gastric Cancer%进展期胃癌中医证型的文献分析

    Institute of Scientific and Technical Information of China (English)

    王晓妍; 曹志群; 相宏杰; 王慧娟

    2013-01-01

    Objective: Study of gastric cancer and advanced gastric cancer syndromes distribution was made to determine the main TCM syndrome types. Methods: The domestic public reports of gastric cancer and advanced gastric cancer syndrome differentiation of TCM in nearly 30 years were analyzed, in order to summarize and analyze the syndrome type of traditional Chinese medicine constitution ratio. Results: Common syndrome types of traditional Chinese medicine about gastric cancer are deficiency of the spleen and stomach type,stasis toxin resistance type,liver stomach disharmony,Qi and blood deficiency type,phlegm coagulation type,stomach yin deficiency type,Common syndrome types of traditional Chinese medicine about advanced gastric cancer are deficiency of the spleen and stomach type, stasis toxin resistance type, Qi and blood deficiency type, liver stomach disharmony, stomach yin deficiency type, Deficiency of the spleen and stomach is the most basic pathogenesis of gastric carcinoma. Conclusion: The statistical results of TCM syndrome type of gastric cancer and advanced gastric cancer have important guiding significance on the establishment of the clinical syndrome differentiation standard.%目的:运用循证医学方法,探讨进展期胃癌的证型分布规律,明确其主要证型.方法:统计近30余年国内公开报道的进展期胃癌辨证分型文献,总结、分析其中中医证型的构成比.结果:进展期胃癌常见中医证型是:脾胃虚损型、瘀毒内阻型、气血两亏型、肝胃不和型、胃热伤阴型.脾胃虚损是胃癌的最基本病机.结论:进展期胃癌证型统计结果对确立临床辨证分型标准具有重要指导意义.

  8. Antitumor effects of the flavone chalcone: inhibition of invasion and migration through the FAK/JNK signaling pathway in human gastric adenocarcinoma AGS cells.

    Science.gov (United States)

    Lin, Su-Hsuan; Shih, Yuan-Wei

    2014-06-01

    Chalcones (benzylideneacetophenone) are cancer-preventive food components found in a human diet rich in fruits and vegetables. In this study, we first report the chemopreventive effect of chalcone in human gastric adenocarcinoma cell lines: AGS. The results showed that chalcone could inhibit the abilities of the adhesion, invasion, and migration by cell-matrix adhesion assay, Boyden chamber invasion/migration assay, and wound-healing assay. Molecular data showed that the effect of chalcone in AGS cells might be mediated via sustained inactivation of the phosphorylation of focal adhesion kinase (FAK) and c-Jun N-terminal kinase 1 and 2 (JNK1/2) signal involved in the downregulation of the expressions of matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9). Next, chalcone-treated AGS cells showed tremendous decrease in the phosphorylation and degradation of inhibitor of kappaBα (IκBα), the nuclear level of NF-κB, and the binding ability of NF-κB to NF-κB response element. Furthermore, treating FAK small interfering RNA (FAK siRNA) and specific inhibitor for JNK (SP600125) to AGS cells could reduce the phosphorylation of JNK1/2 and the activity of MMP-2 and MMP-9. Our results revealed that chalcone significantly inhibited the metastatic ability of AGS cells by reducing MMP-2 and MMP-9 expressions concomitantly with a marked reduction on cell invasion and migration through suppressing and JNK signaling pathways. We suggest that chalcone may offer the application in clinical medicine.

  9. Current Molecular Targeted Therapy in Advanced Gastric Cancer: A Comprehensive Review of Therapeutic Mechanism, Clinical Trials, and Practical Application

    Directory of Open Access Journals (Sweden)

    Kaichun Li

    2016-01-01

    Full Text Available Despite the great progress in the treatment of gastric cancer, it is still the third leading cause of cancer death worldwide. Patients often miss the opportunity for a surgical cure, because the cancer has already developed into advanced cancer when identified. Compared to best supportive care, chemotherapy can improve quality of life and prolong survival time, but the overall survival is often short. Due to the molecular study of gastric cancer, new molecular targeted drugs have entered the clinical use. Trastuzumab, an antibody targeting human epidermal growth factor receptor 2 (HER2, can significantly improve survival in advanced gastric cancer patients with HER2 overexpression. Second-line treatment of advanced gastric cancer with ramucirumab, an antibody targeting VEGFR-2, alone or in combination with paclitaxel, has been proved to provide a beneficial effect. The VEGFR-2 tyrosine kinase inhibitor, apatinib, can improve the survival of advanced gastric cancer patients after second-line chemotherapy failure. Unfortunately, none of the EGFR targeting antibodies (cetuximab or panitumumab, VEGF targeting monoclonal antibodies (bevacizumab, mTOR inhibitor (everolimus, or HGF/MET pathway targeting drugs has a significant survival benefit. Many other clinical trials based on molecular markers are underway. This review will summarize targeted therapies for advanced gastric cancer.

  10. Complete Response after Treatment with Neoadjuvant Chemoradiation with Prolonged Chemotherapy for Locally Advanced, Unresectable Adenocarcinoma of the Pancreas

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    Tiffany A. Pompa

    2017-01-01

    Full Text Available Surgery is the only chance for cure in pancreatic ductal adenocarcinoma. In unresectable, locally advanced pancreatic cancer (LAPC, the National Comprehensive Cancer Network (NCCN suggests chemotherapy and consideration for radiation in cases of unresectable LAPC. Here we present a rare case of unresectable LAPC with a complete histopathological response after chemoradiation followed by surgical resection. A 54-year-old female presented to our clinic in December 2013 with complaints of abdominal pain and 30-pound weight loss. An MRI demonstrated a mass in the pancreatic body measuring 6.2×3.2 cm; biopsy revealed proven ductal adenocarcinoma. Due to splenic vein/artery and contiguous celiac artery encasement, she was deemed surgically unresectable. She was started on FOLFIRINOX therapy (three cycles, intensity modulated radiation to a dose of 54 Gy in 30 fractions concurrent with capecitabine, followed by FOLFIRI, and finally XELIRI. After 8 cycles of ongoing XELIRI completed in March 2015, restaging showed a remarkable decrease in tumor size, along with PET-CT revealing no FDG-avid uptake. She was reevaluated by surgery and taken for definitive resection. Histopathological evaluation demonstrated a complete R0 resection and no residual tumor. Based on this patient and literature review, this strategy demonstrates potential efficacy of neoadjuvant chemoradiation with prolonged chemotherapy, followed by surgery, which may improve outcomes in patients deemed previously unresectable.

  11. Intraperitoneal Paclitaxel Is Useful as Adjuvant Chemotherapy for Advanced Gastric Cancer with Serosal Exposure

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    Joji Kitayama

    2014-01-01

    Full Text Available Background: Intraperitoneal administration of paclitaxel (PTX can elicit a marked clinical response in peritoneal metastases of gastric cancer. Methods: In this study, we retrospectively analyzed the clinical outcome of 17 patients who underwent R0 resection with D2 dissection for advanced gastric cancer with macroscopic serosal exposure and received intraperitoneal PTX as adjuvant therapy. Results: A pathological study revealed that the depth of invasion of the primary tumor was pT4a or pT4b in 10 cases, and that the pN stage was more than pN2 in 8 cases. Genetic analysis of peritoneal lavage fluid was performed in 14 cases, all of which were positive for carcinoembryonic antigen mRNA. In these patients, PTX was intraperitoneally administered at 20-60 mg/m2 with oral S-1 for 3-36 months after surgery. In a median follow-up period of 66 months, recurrence occurred in the liver and peritoneum in 2 (11.7% and 1 (5.9% patients, respectively, and no nodal recurrence was observed. Five-year overall survival and disease-free survival were 88.2 and 82.3%, respectively. Conclusion: Since these patients are considered to be a high-risk group for peritoneal recurrence, this result strongly suggests that adjuvant chemotherapy including intraperitoneal PTX is a promising protocol to improve the outcome of patients with advanced gastric cancer with serosal exposure.

  12. Pharmacokinetics of paclitaxel in a hemodialysis patient with advanced gastric cancer: A case report

    Institute of Scientific and Technical Information of China (English)

    Susumu Kawate; Izumi Takeyoshi; Yasuo Morishita

    2006-01-01

    We report for the first time the possibility of weekly paclitaxel chemotherapy for a patient with advanced,nonresectable gastric cancer undergoing hemodialysis. A 50-year-old man with chronic renal failure due to bilateral polycystic kidneys, who had undergone hemodialysis three times a week for 5 years, presented with hematemesis in December 2004. Based on the diagnosis of gastric cancer with lymph node metastases, surgery was performed. On the 15th postoperative day, the patient was treated with chemotherapy using paclitaxel. Paclitaxel was administered at a dose of 60 mg/m2 as a 1 h iv infusion in 250 mL of saline. Hemodialysis was started 1 h after the completion of the paclitaxel infusion and was performed for 3 h. Paclitaxel was administered weekly on d 1, 8, and 15 on a 28-d cycle. The maximum plasma concentration of paclitaxel was 1390 μg/L. The Grade 2 leukopenia was encountered during the first cycle. The plasma concentrations of paclitaxel from 6to over 24 h after the infusion were 0.01 to 0.1 μmol/L in our patient, and these concentrations have been shown to be effective on inhibiting the growth of gastric cancer cells without producing adverse side effects in the patient. The plasma concentration of paclitaxel was not influenced by hemodialysis. We conclude that the pharmacokinetics of paclitaxel is not altered in a patient with renal failure, and that weekly paclitaxel is a suitable treatment regimen for hemodialysis patients with advanced gastric cancer.

  13. Advanced Gastric Cancer and Perfusion Imaging Using a Multidetector Row Computed Tomography: Correlation with Prognostic Determinants

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    Zhang, Huan; Pan, Zilai; Du, Lianjun; Yan, Chao; Ding, Bei; Song, Qi; Ling, Huawei; Chen, Kemin [Jiaotong University, Jiaotong (China)

    2008-04-15

    Objective : To investigate the relationship between the perfusion CT features and the clinicopathologically determined prognostic factors in advanced gastric cancer cases. Materials and Methods : A perfusion CT was performed on 31 patients with gastric cancer one week before surgery using a 16-channel multi-detector CT (MDCT) instrument. The data were analyzed with commercially available software to calculate tumor blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS). The microvessel density (MVD), was evaluated by immunohistochemical staining of the surgical specimens with anti-CD34. All of the findings were analyzed prospectively and correlated with the clinicopathological findings, which included histological grading, presence of lymph node metastasis, serosal involvement, distant metastasis, tumor, node, metastasis (TNM) staging, and MVD. The statistical analyses used included the Student's t-test and the Spearman rank correlation were performed in SPSS 11.5. Result : The mean perfusion values and MVD for tumors were as follows: BF (48.14+/-16.46 ml/100 g/min), BV (6.70+/-2.95 ml/100 g), MTT (11.75+/-4.02 s), PS (14.17+/-5.23 ml/100 g/min) and MVD (41.7+/-11.53). Moreover, a significant difference in the PS values was found between patients with or without lymphatic involvement (p = 0.038), as well as with different histological grades (p 0.04) and TNM stagings (p = 0.026). However, BF, BV, MTT, and MVD of gastric cancer revealed no significant relationship with the clinicopathological findings described above (p > 0.05). Conclusion : The perfusion CT values of the permeable surface could serve as a useful prognostic indicator in patients with advanced gastric cancer.

  14. Association between vascular-poor area of primary tumors and epidermal growth factor receptor gene status in advanced lung adenocarcinoma.

    Science.gov (United States)

    Togashi, Yosuke; Masago, Katsuhiro; Kubo, Takeshi; Fujimoto, Daichi; Sakamori, Yuichi; Nagai, Hiroki; Kim, Young Hak; Togashi, Kaori; Mishima, Michiaki

    2012-12-01

    Mutation of the epidermal growth factor receptor gene (EGFR mutation) is a very important marker in the treatment for non-small cell lung cancer. Since signaling from this receptor induces tumor-associated angiogenesis, we hypothesized that lung cancers with EGFR mutations tend to develop locally with increased angiogenesis. Thus, the association between vascular-poor area of primary tumors and EGFR status was retrospectively investigated in advanced lung adenocarcinomas. To assess vascular-poor area, contrast-enhanced computed tomography scans taken before initial treatment for lung cancer were analyzed, together with primary tumor location (peripheral or central) and size. We analyzed 178 patients with advanced lung adenocarcinoma. EGFR mutations were detected in 95 of the 178 patients (53.4 %). EGFR mutation was found to be significantly related to women (P = 0.0070), never-smokers (P area (P area (P = 0.0001), and tumor size >30 mm (P = 0.0080). EGFR mutations were found in 41 of 51 never-smokers without vascular-poor area (80.4 %), 19 of 36 never-smokers with vascular-poor area (52.8 %), 19 of 37 current or former-smokers without vascular-poor area (51.4 %), and 16 of 54 current or former-smokers with vascular-poor area (29.6 %). This study showed an association between vascular-poor area of primary tumors and EGFR status. As a consequence, evaluation using a combination of smoking status and vascular-poor area allows us to predict presence of EGFR mutations at a high frequency.

  15. [A case report-highly advanced gastric cancer leading to perforation during neoadjuvant chemotherapy with docetaxel, cisplatin and S-1].

    Science.gov (United States)

    Mihara, Koki; Egawa, Tomohisa; Kemmochi, Takeshi; Irino, Tomoyuki; Okamura, Akihiko; Inaba, Yusaku; Eto, Eiichi; Segami, Kenki; Ito, Yasuhiro; Hayashi, Shinobu; Nagashima, Atsushi

    2011-11-01

    A 70-year-old man was found to have advanced gastric cancer with a deep ulcer and multiple lymph-node metastases. Although the tumor was resectable, we predicted that the patient would have a poor outcome. We therefore administered neoadjuvant chemotherapy with docetaxel, cisplatin, and S-1 to improve the prognosis before curative resection. On day 15 of chemotherapy, sudden abdominal pain occurred, and we performed an emergency surgery for a diagnosis of panperitonitis due to gastric cancer perforation. The defect in the gastric wall was about 2 cm in diameter and was located in the anterior wall of the antrum, consistent with the center of the tumor. The operative findings suggested that the perforation was caused by chemotherapy-induced necrosis of gastric cancer cells. We saved the patient's life, but intensive care with high-dose catecholamine therapy was needed for several days after the surgery. Gastric cancer perforation induced by neoadjuvant chemotherapy appeared to be more severe than perforation caused by other factors. The adverse effects of chemotherapy apparently increased the severity. Our findings suggest that the risk of gastric cancer perforation should be borne in mind when we administer neoadjuvant chemotherapy to patients who have advanced gastric cancer with a deep ulcer.

  16. Endoscopic Ultrasound-Guided Drainage of Intra-Abdominal Abscess after Gastric Perforation in a Patient Receiving Ramucirumab and Paclitaxel for Advanced Gastric Cancer

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    Koichiro Mandai

    2017-01-01

    Full Text Available Gastrointestinal perforation is a serious adverse event that occurs in approximately 1% of patients receiving ramucirumab and paclitaxel. A 67-year-old man with unresectable advanced gastric cancer was admitted to our hospital and treated with ramucirumab and paclitaxel. Gastric perforation occurred during the second cycle of chemotherapy. Although the patient’s condition improved without surgery, an abscess developed in the intra-abdominal fluid collection resulting from the perforation. We performed endoscopic ultrasound-guided abscess drainage. The patient improved and was discharged in satisfactory condition. Endoscopic ultrasound-guided drainage is a treatment option for patients with intra-abdominal abscess following gastric perforation due to ramucirumab.

  17. [The third report from Sapporo Tsukisamu Hospital--chemotherapy for patients with advanced gastric cancer (peritoneal dissemination, peritonitis carcinomatosa)].

    Science.gov (United States)

    Yamamitsu, Susumu; Kimura, Hiromichi; Yamada, Yoshiyuki; Inui, Noriaki; Hiyama, Shigemi; Hirata, Koichi; Kimura, Yasutoshi; Yamaguchi, Kouji; Shirasaka, Tetsuhiko

    2007-09-01

    Recently, it became possible to reduce the size of tumors in patients with advanced or relapsed gastric cancer by chemotherapy with the combination of several kinds of anti-cancer drugs which are all effective and allowed for use with gastric cancer patients. However, chemotherapy alone can not cure patients with advanced gastric cancer that was shown to improve median survival time (MST), compared with patients provided with the best supportive care (BSC). According to reports from Europe, US and Japan,the MST of patients with advanced gastric cancer and those with peritoneal expansion treated by chemotherapy is almost 7-12 months and 5-6 months,respectively, both of which are short and unsatisfactory. From March 2002, we started to treat patients with advanced gastric cancer (stage IV) with a new regimen; intermittent dosage of 5-FU (-->S-1), CDDP and paclitaxel utilizing the difference of cell cycle between normal and cancer cells (intermittent FP . weekly PTX). In the present study, therefore, we analyzed advanced gastric cancer patients with peritoneal expansion (9 cases, 4 with cancerous peritonitis) treated with this regimen. The results were as follows. The one-and 2-year survival rate was 55.6% and 27.8%, respectively, and the MST was 14 months. Four patients (44.4%) had hematological toxicities over grade 3. All of them had anemia (3 cases) and neutropenia (3 cases). Toxicities of thrombocytopenia were all under grade 1 and nonhematological toxicities were all under grade 2, which were clinically manageable. These results, although the sample was small, suggested that this may contribute to the extension of survival time of patients with stage IV advanced gastric cancer with peritoneal expansion.

  18. Critical evaluation of ramucirumab in the treatment of advanced gastric and gastroesophageal cancers.

    Science.gov (United States)

    ElHalawani, Hesham; Abdel-Rahman, Omar

    2015-01-01

    Gastric (GC) and gastroesophageal junction (GEJ) cancers are two global health problems with a relatively high mortality, particularly in the advanced stage. Inhibition of angiogenesis is now contemplated as a classic treatment preference for myriad tumor types encompassing renal cell carcinoma, non-small cell lung cancer, colorectal cancer, glioblastoma, and ovarian cancer, among others. Bevacizumab and ramucirumab have been widely investigated in GC and GEJ cancer, with some controversy about their therapeutic role. Ramucirumab is a monoclonal antibody for vascular endothelial growth factor receptor-2, with demonstrated activity both as a monotherapy and as a part of combination strategy in the management of advanced GC/GEJ cancer. In this review article, we present a critical evaluation of the preclinical and clinical data underlying the use of this drug in this indication. Moreover, we provide a spotlight on the future perspectives in systemic therapy for advanced GC/GEJ cancer.

  19. Advanced gastric cancer: Is there enough evidence to call second-line therapy standard?

    Institute of Scientific and Technical Information of China (English)

    Hendrik-Tobias Arkenau; Matilde Saggese; Charlotte Lemech

    2012-01-01

    Gastric cancer and cancer of the gastro-oesophageal junction (GOJ) are the 4th most common cancer diagnoses worldwide with regional differences in incidence rates.The treatment of gastric and GOJ cancers is complex and requires multimodality treatment including chemotherapy treatment,surgery,and radiotherapy.During the past decade considerable improvements were achieved by advanced surgical techniques,tailored chemotherapies/radiotherapy and technical innovations in clinical diagnostics.In patients with advanced or metastatic gastric/GOJ cancer systemic chemotherapy with fluoropyrimidine/platinum-based regimens (+/-human epidermal growth factor receptor-2 antibody) is the mainstay of treatment.Despite these improvements,the clinical outcome for patients with advanced or metastatic disease is generally poor with 5-year survival rates ranging between 5%-15%.These poor survival rates may to some extent be related that standard therapies beyond first-line therapies have never been defined.Considering that this patient population is often not fit enough to receive further treatments there is an increasing body of evidence from phase-2 studies that in fact second-line therapies may have a positive impact in terms of overall survival.Moreover two recently published phase-3 studies support the use of second-line chemotherapy.A South Korean study compared either,irinotecan or docetaxel with best supportive care and a German study compared irinotecan with best supportive care-both studies met their primary endpoint overall survival.In this "Field of Vision" article,we review these recently published phase-3 studies and put them into the context of clinical prognostic factors helping to guide treatment decisions in patients who most likely benefit.

  20. Critical evaluation of ramucirumab in the treatment of advanced gastric and gastroesophageal cancers

    Directory of Open Access Journals (Sweden)

    ElHalawani H

    2015-07-01

    Full Text Available Hesham ElHalawani, Omar Abdel-Rahman Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt Abstract: Gastric (GC and gastroesophageal junction (GEJ cancers are two global health problems with a relatively high mortality, particularly in the advanced stage. Inhibition of angiogenesis is now contemplated as a classic treatment preference for myriad tumor types encompassing renal cell carcinoma, non-small cell lung cancer, colorectal cancer, glioblastoma, and ovarian cancer, among others. Bevacizumab and ramucirumab have been widely investigated in GC and GEJ cancer, with some controversy about their therapeutic role. Ramucirumab is a monoclonal antibody for vascular endothelial growth factor receptor-2, with demonstrated activity both as a monotherapy and as a part of combination strategy in the management of advanced GC/GEJ cancer. In this review article, we present a critical evaluation of the preclinical and clinical data underlying the use of this drug in this indication. Moreover, we provide a spotlight on the future perspectives in systemic therapy for advanced GC/GEJ cancer. Keywords: ramucirumab, gastric cancer, gastroesophageal cancer

  1. Effects of tachyplesin and n-sodium butyrate on proliferation and gene expression of human gastric adenocarcinoma cell line BGC-823

    Institute of Scientific and Technical Information of China (English)

    Song-Lin Shi; Yong-Ye Wang; Ying Liang; Qi-Fu Li

    2006-01-01

    AIM: To investigate the effects of tachyplesin and n-sodium butyrate on proliferation and gene expression of human gastric adenocarcinoma cell line BGC-823.METHODS: Effects of tachyplesin and n-sodium butyrate on proliferation of BGC-823 cells were determined with trypan blue dye exclusion test and HE staining. Effects of tachyplesin and n-sodium butyrate on cell cycle were detected by flow cytometry. Protein levels of c-erbB-2, c-myc, p53 and p16 were examined by immunocytochemistry.RESULTS: The inhibiting effects were similar after 2.0 mg/L tachyplesin and 2.0 mmol/L n-sodium butyrate treatment, the inhibitory rate of cellular growth was 62.66% and 60.19% respectively, and the respective maximum mitotic index was decreased by 49.35% and 51.69% respectively. Tachyplesin and n-sodium butyrate treatment could markedly increase the proportion of cells at G0/G1 phase and decrease the proportion at S phase.The expression levels of oncogene c-erbB-2, c-myc, and mtp53 proteins were down-regulated while the expression level of tumor suppressor gene p16 protein was up-regulated after the treatment with tachyplesin or n-sodium butyrate. The effects of 1.0 mg/L tachyplesin in combination with 1.0 mmol/L n-sodium butyrate were obviously superior to their individual treatment in changing cell cycle distribution and expression of c-erbB-2,c-myc, mtp53 and p16 protein. The inhibitory rate of cellular growth of BGC-823 cells after combination treatment was 62.29% and the maximum mitotic index was decreased by 51.95%.CONCLUSION: Tachyplesin as a differentiation inducer of tumor cells has similar effects as n-sodium butyrate on proliferation of tumor cells, expression of correlative oncogene and tumor suppressor gene. It also has a synergistic effect on differentiation of tumor cells.

  2. Polymorphisms in tumor necrosis factor genes and susceptibility to esophageal squamous cell carcinoma and gastric cardiac adenocarcinoma in a population of high incidence region of North China

    Institute of Scientific and Technical Information of China (English)

    GUO Wei; WANG Na; LI Yan; ZHANG Jian-hui

    2005-01-01

    Background We investigated the possible association of the functional polymorphisms in the tumor necrosis factor (TNF) genes with susceptibility to esophageal squamous cell carcinoma (ESCC) and gastric cardiac adenocarcinoma (GCA). Methods The TNF-α-308G/A and TNF-β+252G/A single nucleotide polymorphisms (SNPs) were genotyped using polymerase-chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis, in 555 cancer patients (291 ESCC and 264 GCA) and 437 healthy controls in a high incidence region of North China. Results Among healthy controls, frequencies of the TNF-α 1/1, 1/2 and 2/2 genotypes were 89.4%,9.2% and 1.4% respectively, while frequencies of the TNF-β B1/B1, B1/B2 and B2/B2 genotypes were 12.6%,32.3% and 55.1%, respectively. No significant difference was found in the overall genotype and allelotype distribution of the TNF-α-308G/A and TNF-β+252G/A SNPs among cancer patients and controls. However, both the B1/B1 genotype and B1/B2 genotype significantly increased the risk of developing ESCC [the age and gender adjusted odds ratio (OR)=2.04 and 1.91, 95% confidence interval (CI)=1.04-4.43 and 1.14-2.60, respectively] and GCA (the age and gender adjusted OR=2.68 and 2.64, 95% CI=1.14-6.29 and 1.47-4.72, respectively) in individuals with negative family history of UGIC, in comparison with the B2/B2 genotype. When the two TNF polymorphisms were combined and analyzed, individuals with the TNF-β B1/B2 and TNF-α1/2 or 2/2 genotypes significantly reduced the risk of developing ESCC and GCA, in comparison with those harboring the TNF-β B2/B2 and TNF-α 1/1 genotypes (the age and gender adjusted OR=0.37 and 0.34, 95% CI=0.15-0.92 and 0.13-0.90, respectively).Conclusions Therefore, the TNF-α-308G/A and TNF-β+252G/A genotyping may be used as a stratification markers to predicate the risk of ESCC and GCA development in North China.

  3. The expression of LI-cadherin and Nucleophosmin in gastric adenocarcinoma%肝肠钙黏连蛋白与核磷蛋白在胃腺癌中的表达及其相关性分析

    Institute of Scientific and Technical Information of China (English)

    张建新; 雷晓斐; 董卫国

    2012-01-01

    Objective To investigate the expression and association of the liver-intestine cadher-in(LI-cadherin) and Nucleophosmin( NPM) in gastric adenocarcinoma. Methods The expression of LI-cadherin and NPM were examined by S-P immunohistochemistry in 60 gastric adenocarcinoma tissues,the association between clinical manifestation and pathological data was analyzed. Results The positive rates of Ll-cadherin and NPM were 51. 67% ,76. 67% respectively in gastric adenocarcinoma tissues. There were positive correlation between LI-cadherin and NPM(r =0. 798,P<0.05) ;The expression of LI-cad-herin was correlated with the differentiation degree of the tumor and lymph node metastasis ( P < 0. 05), and the expression of NPM was correlated with the differentiation degree of the tumor and TNM staging (P <0.05). Conclusion The high expression of LJ-cadherin and NPM is correlated with the development of gastric adenocarcinoma, and the consistent expression of Ll-cadherin and NPM indicates that NPM may be a reliable molecule marker for the diagnosis of gastric adenocarcinoma.%目的 探讨肝肠钙黏连蛋白( LI-cadherin)及核磷蛋白(NPM)在胃腺癌组织中的表达、与胃腺癌生物学行为的关系以及2种蛋白的相关性.方法 采用免疫组化S-P法,检测肝肠钙黏连蛋白及核磷蛋白在60例胃腺癌组织中的表达,并分析其与肿瘤生物学行为的关系.结果 肝肠钙黏连蛋白与核磷蛋白在胃腺癌组织中的阳性率分别为51.67%和76.67%,两种蛋白表达呈正相关(r =0.798,P<0.05);肝肠钙黏连蛋白的表达与胃腺癌的分化程度及淋巴结转移有关(P<0.05),而核磷蛋白的表达与胃腺癌的分化程度及TNM分期有关(P<0.05),二者均与性别、年龄无关(P>0.05).结论 胃腺癌的发生与肝肠钙黏连蛋白和核磷蛋白的高表达有关,二者在胃腺癌中表达的一致性,提示核磷蛋白可能为1种较为可靠的检测胃腺癌发生及发展的分子标记物.

  4. Despite shared susceptibility loci, esophageal squamous cell carcinoma embraces more familial cancer than gastric cardia adenocarcinoma in the Taihang Mountains high-risk region of northern central China

    Institute of Scientific and Technical Information of China (English)

    WEN Deng-gui; YANG Yi; WEN Xiao-duo; SHAN Bao-en

    2013-01-01

    Background In China,esophageal squamous cell carcinoma (ESCC) and gastric cardia adenocarcinoma (GCA) share susceptibility loci,but different rates of multiple primary cancer and male/female ratio suggest the proportion of familial cancer is not equal.Methods The percent of cases with a positive family history,median onset age,rate of multiple primary cancer,and male/female ratio associated with upper,middle,lower third ESCC and GCA were compared to reveal the proportion of familial cancer.The 7267 subjects analyzed constituted all ESCC and GCA cases in whom the cancer was resected with cure intention between 1970 and 1994 at the 4th Hospital of Hebei Medical University.Results A positive family history for cancer was most often associated with the multiple primary ESCC and/or GCA cases,e.g.with 42% of the males and 59% of the females.For upper,middle,lower third ESCC and GCA,the percent of cases with a positive family history decreased by 38.5%,26.3%,26.5%,and 11.2% in males (P <0.000) and 25.0%,22.3%,23.9%,and 9.8% in females (P <0.0001).Median onset age increased from 49,52,55,to 56 years old in males and from 50,53,55,to 56 years old in females (both P <0.0001) for upper,middle,lower third ESCC and GCA.Male/female ratio increased from 2.2,2.1,2.2,to 6.2:1 for upper,middle,lower third ESCC and GCA (P<0.0001).For upper,middle,lower third ESCC and GCA,the percent of multiple primary cancers decreased from 21.2%,2.3%,2.2%,to 1.5% in males and from 14.3%,2.4%,3.4%,to 3.1% in females.The preponderance of males,smoking,drinking,or onset-age ≥50 years was significantly higher in GCA than in ESCC,and the difference in the rates of multiple primary cancers between the preponderant and the non-preponderant cases was significant in GCA,but not in ESCC,suggesting non-equal requirement for genetic susceptibility when environmental hazards did not exist.Conclusions The proportion of familial cancer in upper gastrointestinal

  5. Pathology and Genetics of Syndromic Gastric Polyps

    NARCIS (Netherlands)

    Brosens, Lodewijk A A; Wood, Laura D; Offerhaus, G Johan; Arnold, Christina A; Lam-Himlin, Dora; Giardiello, Francis M; Montgomery, Elizabeth A

    2016-01-01

    Gastric polyps are found in 1% to 4% of patients undergoing gastroscopy. The vast majority are sporadic, but some gastric polyps indicate an underlying syndrome. Gastric polyps can manifest in each of the gastrointestinal polyposis syndromes, including the recently described gastric adenocarcinoma a

  6. Safety and efficacy of laparoscopy-assisted gastrectomy for advanced gastric cancer in the elderly.

    Science.gov (United States)

    Qiu, Jiang-Feng; Yang, Bing; Fang, Lei; Li, Yi-Ping; Shi, Yi-Jiu; Yu, Xiu-Chong; Zhang, Mou-Cheng

    2014-01-01

    To evaluate safety and efficacy of laparoscopy-assisted radical gastrectomy (LARG) for advanced gastric cancer patients aged 70 years or older. Clinical data were retrospectively collected from patients with IIA-IIIC gastric cancer who underwent LARG (n = 30) and open radical gastrectomy (ORG, n = 34) in Department of Gastrointestinal Surgery in the Ningbo First Hospital from January 2012 to December 2013. The mean operative time was longer in the LARG group than in the ORG group but there was no statistical difference between the two groups. The intraoperative blood loss (120 ± 52.7 ml vs 227.3 ± 146.9 ml), incidence of postoperative complication (23.0% vs 47%) were lower in the LARG group than those in the ORG group. In addition, the time to first flatus (2.9 ± 0.8 d vs 4.6 ± 1.2 d), time to first ambulation (1.2 ± 0.4 vs 4.1 ± 1.0 d), time of nasogastric intubation (2.5 ± 1.0 d vs 3.5 ± 1.4 d), and postoperative hospital stay (13.0 ± 4.2 d vs 16.9 ± 4.1 d) were significantly shorter in the LARG group than in the ORG group, respectively. No statistical difference in the number of harvested lymph nodes was noted between the two groups (30.2 ± 12.0 vs 28.1 ± 11.8, P > 0.05). LARG is safer, more effective and less invasive for the elderly patients with advanced gastric cancer.

  7. Locally advanced pancreatic adenocarcinoma. Chemoradiotherapy, reevaluation and secondary resection; Adenocarcinomes pancreatiques localement evolues. Chimioradiotherapie, reevaluation et resection secondaire?

    Energy Technology Data Exchange (ETDEWEB)

    Delpero, J.R.; Turrini, O. [Institut Paoli-Calmettes, Dept. de chirurgie, 13 - Marseille (France)

    2006-11-15

    Induction chemoradiotherapy (CRT) may down-stage locally advanced pancreatic tumors but secondary resections are unfrequent. However some responders' patients may benefit of a RO resection. Patients and methods. We report 18 resections among 29 locally advanced pancreatic cancers; 15 patients were treated with neo-adjuvant 5-FU-cisplatin based (13) or taxotere based (2 patients) chemoradiotherapy (45 Gy), and 3 patients without histologically proven adenocarcinoma were resected without any preoperative treatment. Results. The morbidity rate was 28% and the mortality rate was 7%; one patient died after resection (5.5%) and one died after exploration (9%). The RO resection rate was 50%. The median survival for the resected patients was not reached and the actuarial survival at 3 years was 59%. Two specimens showed no residual tumor and the two patients were alive at 15 and 46 months without recurrence; one specimen showed less than 10% viable tumoral cells and the patient was alive at 36 months without recurrence. A mesenteric infarction was the cause of a late death at 3 years in a disease free patient (radiation induced injury of the superior mesenteric artery). The median survival of the 11 non-resected patients was 21 months and the actuarial survival at 2 years was 0%. When the number of the resected patients (18) was reported to the entire cohort of the patients with locally advanced pancreatic cancer treated during the same period in our institution, the secondary resectability rate was 9%. Conclusion. Preoperative chemoradiotherapy identifies poor surgical candidates through observation and may enhance the margin status of patients undergoing secondary resection for locally advanced tumors. However it remains difficult to evaluate the results in the literature because of the variations in the definitions of resectability. The best therapeutic strategy remains to be defined, because the majority of patients ultimately succumb with distant metastatic

  8. Role of salvage radiotherapy for regional lymph node recurrence after radical surgery in advanced gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Byoung Hyuck; Eom, Keun Yong; Kim, Jae Sung; Kim, Hyung Ho; Park, Do Jong [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2013-09-15

    To evaluate the role of salvage radiotherapy (RT) for the treatment of regional lymph node recurrence (RLNR) after radical surgery in advanced gastric cancer. We retrospectively analyzed medical records of 26 patients who underwent salvage treatment after diagnosis of RLNR between 2006 and 2011. Patients with peritoneal seeding or distant metastasis were excluded. Eighteen patients received RT with or without chemotherapy and the other 8 did chemotherapy only without RT. A three-dimensional conformal RT was performed with median dose of 56 Gy (range, 44 to 60 Gy). Sixteen patients had fluoropyrimidine-based chemotherapy, 5 did taxane-based chemotherapy, and irinotecan was applied in 4. With a median follow-up of 20 months (range, 5 to 57 months), median overall survival (OS) and progression-free survival (PFS) after diagnosis of RLNR were 29 months and 12 months in the entire patients, respectively. Radiotherapy (p = 0.007) and disease-free interval (p = 0.033) were statistically significant factors for OS in multivariate analysis. Median OS was 36 months in patients who received RT and 16 months in those who did not. Furthermore, delivery of RT (p < 0.001), complete remission after salvage treatment (p = 0.040) and performance status (p 0.023) were associated with a significantly better PFS. Gastrointestinal toxicities from RT were mild in most patients. Salvage RT combined with systemic chemotherapy may be an effective treatment managing RLNR from advanced gastric cancer.

  9. Genetic variation in PSCA and risk of gastric advanced preneoplastic lesions and cancer in relation to Helicobacter pylori infection.

    Directory of Open Access Journals (Sweden)

    Cosmeri Rizzato

    Full Text Available SNPs in the Prostate Stem Cell Antigen (PSCA gene have been found associated with gastric cancer (GC risk in a genome-wide association study. This association has been replicated in several populations. In this study we assessed the impact of PSCA genotype on the risk of advanced gastric precancerous lesions and GC. We used baseline gastric histopathology data and DNA from frozen gastric biopsies of 2045 subjects enrolled in a chemoprevention trial for gastric precancerous lesions in Venezuela, and 180 cases of GC from the same area. We analyzed 3 SNPs in the PSCA gene (rs2294008, rs9297976 and rs12155758 which were previously found to be associated with GC risk in Europeans. The T allele of rs2294008 was found to be associated with a higher prevalence of atrophic gastritis (OR = 1.44; 95% CI 1.03-2.01 for the dominant model and intestinal metaplasia (OR = 1.50; 95% CI 1.13-1.98 for the dominant model. We also confirmed the association with higher risk of gastric cancer (OR = 2.34; 95% CI 1.36-4.01 for the allele carriers. SNP rs12155758 was not associated with risk of gastric preneoplastic lesions, but we confirmed its association with higher GC risk (OR 1.95; 95% CI 1.29-2.97 for dominant model. We tested the relevance of the presence of the Helicobacter pylori cagA gene, which is known to increase the risk of more severe gastric lesions, but we did not find any clearcut interaction with PSCA SNPs in defining risk of gastric precancerous lesions or cancer.

  10. Primary gastric adenosquamous carcinoma in a Caucasian woman: a case report

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    Sousa-Rodrigues Joaquim

    2010-10-01

    Full Text Available Abstract Introduction Most gastric tumors are adenocarcinomas. Primary gastric adenosquamous carcinoma is a rare malignancy, mostly associated with Asian populations. It constitutes less than one percent of all gastric carcinomas and its clinical presentation is the same as adenocarcinoma. It occurs more frequently in the proximal stomach, usually presents with muscular layer invasion and tends to be found in advanced stages at diagnosis, with a worse prognosis than adenocarcinoma. Case presentation We report the case of an 84-year-old Caucasian woman with an adenosquamous carcinoma extending to her serosa with lymphatic and venous invasion (T3N1M1. Nodal and hepatic metastasis presented with both cellular types, with dominance of the squamous component. Conclusions Adenosquamous gastric cancer is a rare diagnosis in western populations. We present the case of a woman with a very aggressive adenosquamous carcinoma with a preponderance of squamous cell component in the metastasis. Several origins have been proposed for this kind of carcinoma; either evolution from adenocarcinoma de-differentiation or stem cell origin might be possible. The hypothesis that a particular histological type of gastric cancer may arise from stem cells might be a field of research in oncological disease of the stomach.

  11. Prognostic Value of Baseline 18F-FDG PET/CT Functional Parameters in Patients with Advanced Lung Adenocarcinoma Stratified by EGFR Mutation Status.

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    Dalong Wang

    Full Text Available The study objective was to retrospectively analyze the metabolic variables derived from 18 F-fluorodeoxyglucose (18F-FDG positron emission tomography/computed tomography (PET/CT as predictors of progression-free survival (PFS and overall survival (OS in advanced lung adenocarcinoma stratified by epidermal growth factor receptor (EGFR mutation status. A total of 176 patients (91, EGFR mutation; 85, wild-type EGFR who underwent 18F-FDG PET/CT before treatment were enrolled. The main 18F-FDG PET/CT-derived variables: primary tumor maximum standardized uptake value (SUVmaxT, primary tumor total lesion glycolysis (TLGT, the maximum SUVmax of all selected lesions in whole body determined using the Response Evaluation Criteria In Solid Tumors (RECIST 1.1 criteria (SUVmaxWBR, and whole-body total TLG determined using the RECIST 1.1 criteria (TLGWBR were measured. Survival analysis regarding TLGWBR, and other factors in advanced lung adenocarcinoma patients stratified using EGFR mutation status, were evaluated. The results indicated that high TLGWBR (≥259.85, EGFR wild-type, and high serum LDH were independent predictors of worse PFS and OS in all patients with advanced lung adenocarcinoma. Among patients with wild-type EGFR, only TLGWBR retained significance as an independent predictor of both PFS and OS. Among patients with the EGFR mutation, high serum LDH level was an independent predictor of worse PFS and OS, and high TLGWBR (≥259.85 was an independent predictor of worse PFS but not worse OS. In conclusion, TLGWBR is a promising parameter for prognostic stratification of patients with advanced lung adenocarcinoma and EGFR status; however, it cannot be used to further stratify the risk of worse OS for patients with the EGFR mutation. Further prospective studies are needed to validate our findings.

  12. Synchronous papillary urothelial carcinoma of urinary bladder and adenocarcinoma of stomach in a middle-aged man: An extremely rare association with therapeutic dilemma

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    Dodul Mondal

    2013-01-01

    Full Text Available Synchronous occurrence of urinary bladder carcinoma and gastric carcinoma is very rare. A middle-aged Asian man presented with complaints of hematuria which was diagnosed due to muscle invasive papillary urothelial carcinoma of urinary bladder. Metastatic work-up revealed simultaneous presence of locally advanced gastric adenocarcinoma. He was treated with TURBT for the bladder cancer and was planned for radical gastric resection followed by radiation to urinary bladder and stomach with concurrent chemotherapy. However, due to very advanced nature of the gastric tumor patient was treated only with palliative gastric resection followed by palliative radiation to both urinary bladder and stomach due to his poor performance status. Lack of published English literature and evidence related to such clinical entity made this an extremely rare clinical entity and treatment decision difficult.

  13. Updates on surgical management of advanced gastric cancer: new evidence and trends. Insights from the First International Course on Upper Gastrointestinal Surgery--Varese (Italy), December 2, 2011.

    Science.gov (United States)

    Rausei, Stefano; Dionigi, Gianlorenzo; Sano, Takeshi; Sasako, Mitsuru; Biondi, Alberto; Morgagni, Paolo; Garofalo, Alfredo; Boni, Luigi; Frattini, Francesco; D'Ugo, Domenico; Preston, Shaun; Marrelli, Daniele; Degiuli, Maurizio; Capella, Carlo; Sacco, Rosario; Ruspi, Laura; De Manzoni, Giovanni; Roviello, Franco; Pinotti, Graziella; Rovera, Francesca; Noh, Sung Hoon; Coit, Daniel; Dionigi, Renzo

    2013-11-01

    Between the Ninth International Gastric Cancer Congress (IGCC) in South-Korea (Seoul, 2011) and the Tenth IGCC in Italy (Verona, 2013), the Insubria University organized the First International Course on Upper Gastrointestinal Surgery (Varese, December 2, 2011), with the patronage of Italian Research Group for Gastric Cancer (IRGGC) and the International Gastric Cancer Association (IGCA). The Course was intended to be a comprehensive update and review on advanced gastric cancer (GC) staging and treatment from well-known international experts. Clinical, research, and educational aspects of the surgeon's role in the era of stage-adapted therapy were discussed. As highlighted in the meeting, in this final document we summarize and thoroughly analyze (with references only for well-acquired randomized control trials) the new and old open problems in surgical management of advanced GC. Between the Ninth (Seoul, 2011) and the Tenth (Verona,2013) International Gastric Cancer Congress, the First International Course on Upper Gastrointestinal Surgery (Varese, December 2, 2011) was organized by the University of Insubria. This congress received the patronage of the International Gastric Cancer Association and the Italian Research Group for Gastric Cancer. The aim was to discuss open issues in surgical management of advanced gastric malignancies. We considered the opinions of several recognized experts in the field from both the Eastern and Western world, focused on definition problems and oncological and technical issues to define the current principles of advanced gastric cancer (GC) surgery.

  14. Noxa在胃腺癌细胞耐受内质网应激诱导凋亡中的作用%The role of Noxa in endoplasmic reticulum stress-induced apoptosis in gastric adenocarcinoma cell

    Institute of Scientific and Technical Information of China (English)

    王家钰; 张丽; 吴萍; 朱孝峰; 张旭东; 张林杰

    2013-01-01

    Objective To investigate the role and mechanism of Noxa in resistance of gastric adenocarcinoma cells to endoplasmic reticulum ( ER ) stress-induced apoptosis. Methods Apoptosis was measured by flow cytometry u-sing propidium iodide staining. The activation of Caspase-3 , Caspase-9 and protein levels of GRP78 , Noxa, Mcl-1 were detected by Western blot. The expression of Noxa mRNA was monitored by quantitative RT-PCR. Silencing of gene Mcl-1 , Noxa expression was accomplished by small interfering RNA ( siRNA ) techniques. Results Gastric adenocarcinoma cells were generally resistant to apoptosis induced by the ER-stress inducer tunicymicin( TM ). Exposure of TM resulted in less activation of Caspase-3 and Caspase-9 in gastric adenocarcinoma cells. The expression of Noxa and Mcl-1 were increased in protein level. Inhibiting Mcl-1 expression by siRNA in SGC-7901 cells increased the cell apoptosis. In contrast, inhibition of Noxa and Mcl-1 partially blocked tunicamycin-induced apoptosis in SGC-7901 cells. Conclusion Pro-apoptotic Bcl-2 family member Noxa is critical in gastric adenocarcinoma cells and the role of pro-apoptotic of Noxa is neutralized by the anti-apoptotic protein Mcl-1 , which is also increased by ER stress.%目的 研究胃腺癌细胞对内质网应激诱导细胞凋亡耐受中BH3-only家族蛋白Noxa的表达、作用以及相关机制.方法 衣霉素(TM)处理SGC-7901中分化胃腺癌细胞株及BGC-823低分化胃腺癌细胞株;采用PI单染法测定细胞凋亡率;Western blot法检测葡萄糖调节蛋白78(GRP78)、半胱天冬氨酸蛋白酶3(Caspase-3)、半胱天冬氨酸蛋白酶9(Caspase-9)、成人T细胞白血病诱导的PMA反应蛋白(Noxa)和髓样细胞白血病-1(Mcl-1)蛋白变化;小干扰RNA(siRNA)技术特异“沉默”Mcl-1和Noxa基因;实时荧光定量PCR检测Noxa mRNA水平变化.结果 TM处理胃腺癌细胞后,GRP78表达升高;胃腺癌细胞对TM诱导的内质网应激性凋亡耐受,Caspase-3和Caspase-9活

  15. COMBINATION OF 5-FU AND EPIRUBICIN IN THE TREATMENT OF ADVANCED GASTRIC CANCER

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    Ardeshir Ghavamzadeh

    1993-06-01

    Full Text Available This study was undertaken to assess the effectiveness of 5-FU plus epirubicin in the treatment of the advanced gastric cancer. For this purpose, 22 patients with no previous treatment were studied. All of the patients were unoperable or metastatic. Follow up checking continued for 24 months. Our selected therapeutic regimen consisted of a combination of 500 mg/m2 5-FU dialy for five days, and 75 mg/m2 epirubicin for one day. The response rate in this study was 47.4% and the mean survival rate was 9.7 months. By far, the most common complication was gastrointestinal disturbances and no carditoxicity was seen. Having presented the results of this study and comparing it with the other therapeutic regimens like FAM combination, this selected two drug combination seems to be a useful therapeutic protocol.

  16. Collagen-based biological glue after Appleby operation for advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Gianluca Baiocchi; Nazario Portolani; Federico Gheza; Stefano M Giulini

    2011-01-01

    Pancreatic fistula is a common complication of distal pancreatectomy; although various surgical procedures have been proposed, no clear advantage is evident for a single technique. We herein report the case of a 38-year-old patient affected by an advanced gastric carcinoma infiltrating the pancreas body, with extensive nodal metastases involving the celiac trunk, who underwent total gastrectomy with lymphadenectomy, distal pancreatectomy and resection en bloc of the celiac trunk (Appleby operation). At the end of the demolitive phase, thepancreaticstumpandtheaortahe pancreatic stump and the aorta at the level of the celiac ligature were covered with a layer of Tachosil(R), ahorsecollagenspongemadewitha horse collagen sponge made with human coagulation factors (fibrinogen and thrombin). Presenting this case, we wish to highlight the possible sealing effect of this product and hypothesize a role in preventing pancreatic fistula and postoperative lymphorrhagia from extensive nodal dissection.

  17. Síndrome de Fournier secundária a adenocarcinoma de próstata avançado: relato de caso Fournier's syndrome secondary to advanced prostatic adenocarcinoma: case report

    Directory of Open Access Journals (Sweden)

    Rodrigo Rocha Batista

    2010-06-01

    Full Text Available A Síndrome de Fournier é uma fasciite necrotizante rapidamente progressiva que acomete a genitália e região perineal. Mesmo com os avanços na terapêutica, a morbidade e a mortalidade desta afecção permanecem elevadas. É relatado caso de paciente masculino, 70 anos, com diagnóstico de adenocarcinoma de próstata avançado. Há um dia com dor e aumento de volume escrotal associado a febre. Ao exame físico, paciente séptico com gangrena gasosa do pênis e escroto; ao toque retal, lesão ulcero-vegetante em parede anterior do reto estendendo-se de 3 a 7 cm da borda anal. Realizado desbridamento cirúrgico, com identificação de fístula reto-escrotal transtumoral. Estudo histo-patológico da lesão retal confirmou infiltração por adenocarcinoma de próstata. Recebeu alta hospitalar no vigésimo dia de internação, atualmente em acompanhamento oncológico ambulatorial.Fournier's syndrome is a rapidly progressive necrotizing fasciitis affecting the genitalia and perineal region. Even with the advances in therapy, morbidity and mortality of this disease remain high. We report the case of male patient, 70 years old, diagnosed with advanced adenocarcinoma of the prostate. A day with pain and swelling near scrotum associated with fever. The physical examination revealed septic patient with gas gangrene of the penis and scrotum; on digital rectal examination, a vegetative and ulcerated lesion on the anterior wall of the rectum extending from 3 to 7 cm from the anal edge. Performed surgical debridement, with identification of scrotal-rectal fistula transtumoral. Histo-pathological study of the lesion confirmed rectal infiltration by adenocarcinoma of prostate. Was discharged from the hospital on the twentieth day of hospitalization, outpatient cancer currently monitoring.

  18. Sequence-dependence of cisplatin and 5-fluorouracil in advanced and recurrent gastric cancer.

    Science.gov (United States)

    Koizumi, Wasaburo; Kurihara, Minoru; Hasegawa, Koichi; Chonan, Akimichi; Kubo, Yasuhiko; Maekawa, Ryuichiro; Iwasaki, Ryozo; Sasai, Tadashi; Fukuyama, Yoshio; Ishikawa, Kunitsugu; Miyoshi, Kazuo; Yasutake, Koichi; Hayakawa, Makoto

    2004-09-01

    This randomized controlled clinical trial was designed to compare the safety and effectiveness of different sequences of treatment with cisplatin (CDDP) and 5-fluorouracil (5-FU) in patients with unresectable advanced and post-operative recurrent gastric cancer. Patients with unresectable advanced or post-operative recurrent gastric cancer were randomly assigned by a registration center to group A or B. Group A received CDDP (80 mg/m(2)) as a continuous 2-h intravenous infusion on day 1 and 5-FU (700 mg/m(2)) as a continuous intravenous infusion on days 2-5. Group B was given 5-FU (700 mg/m(2)) as a continuous intravenous infusion on days 1-4, followed by CDDP (80 mg/m(2)) as a continuous 2-h intravenous infusion on day 5. Each course of chemotherapy was repeated every 28 days. A total of 74 patients were enrolled. One patient died accidentally, and 5 could not be evaluated. Response was assessable in 68 patients. The response rate was 31.3% (10/32) in group A as compared with 13.9% (5/36) in group B. Although the response rate was higher in Group A, the difference was not significant (p=0.085). The response rate in patients with diffuse type tumors was significantly lower in group B. There was no difference between the groups in response among patients with intestinal type tumors. The median overall survival was 239 and 174 days and time to progression was 175 and 140 days in group A and group B, respectively. Although there were trends toward longer survival and time to progression in group A, the differences between the groups were not statistically significant. There was also no difference in the type or incidence of adverse reactions. The results of this controlled study indicate that the overall response rate was slightly but not significantly higher in patients who received CDDP before 5-FU. Among patients with diffuse type tumors, the response rate was significantly lower when 5-FU was administered before CDDP. Our results suggest that CDDP should be given

  19. Prognostic impact of metastatic lymph node ratio in advanced gastric cancer from cardia and fundus

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    AIM: To investigate the prognostic impact of the metastatic lymph node ratio (MLR) in advanced gastric cancer from the cardia and fundus. METHODS: Two hundred and thirty-six patients with gastric cancer from the cardia and fundus who underwent D2 curative resection were analyzed ret- rospectively. The correlations between MLR and the total lymph nodes, positive nodes and the total lymph nodes were analyzed respectively. The influence of MLR on the survival time of patients was determined with univariate Kaplan-Meier survival analysis and mul- tivariate Cox proportional hazard model analysis. And the multiple linear regression was used to identify the relation between MLR and the 5-year survival rate of the patients. RESULTS: The MLR did not correlate with the total lymph nodes resected (r = -0.093, P = 0.057). The 5-year overall survival rate of the whole cohort was 37.5%. Kaplan-Meier survival analysis identified that the following eight factors influenced the survival time of the patients postoperatively: gender (X2 = 4.26, P = 0.0389), tumor size (X2 = 18.48, P < 0.001), Borrmann type (X2 = 7.41, P = 0.0065), histological grade (X2 =5.07, P = 0.0243), pT category (X2 = 49.42, P < 0.001), pN category (X2 = 87.7, P < 0.001), total number of re- trieved lymph nodes (X2 = 8.22, P = 0.0042) and MLR (X2 = 34.3, P < 0.001). Cox proportional hazard model showed that tumor size (X2 = 7.985, P = 0.018), pT category (X2 = 30.82, P < 0.001) and MLR (X2 = 69.39, P < 0.001) independently influenced the prognosis. A linear correlation between MLR and the 5-year survival was statistically significant based on the multiple lin- ear regression (β = -0.63, P < 0.001). Hypothetically, the 5-year survival would surpass 50% when MLR was lower than 10%. CONCLUSION: The MLR is an independent prognostic factor for patients with advanced gastric cancer from the cardia and fundus. The decrease of MLR due to adequate number of total resected lymph nodes can improve the survival.

  20. Advances in TCM Treatment of Gastric Cancer and Studies on the Apoptosis

    Institute of Scientific and Technical Information of China (English)

    吴敏; 姚保泰

    2002-01-01

    @@ The significance of apoptosis in gastric cancer is now widely recognized, and the induction of apoptosis as a new approach to treat gastric cancer has aroused great interest. In recent years, studies on certain TCM drugs for treating gastric cancer and for inducing apoptosis have brought about great attention both at home and abroad. The following is a summary made in this aspect.

  1. Dietary flavonoid and lignan intake and gastric adenocarcinoma risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study123

    DEFF Research Database (Denmark)

    Zamora-Ros, Raul; Agudo, Antonio; Luján-Barroso, Leila

    2012-01-01

    Background: Several experimental studies have suggested potential anticarcinogenic effects of flavonoids, although epidemiologic evidence for the impact of dietary flavonoids on risk of gastric cancer (GC) is limited.Objective: We investigated the association between intake of dietary flavonoids...

  2. Association between SNPs at 3'-UTR of apoptosis genes CASP3, CASP7 and risk of gastric adenocarcinoma in a North-eastern Chinese population

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Objective:To explore the association of SNPs at the 3'-UTR of apoptosis genes CASP3 and CASP7 with the risk of gastric cancer among Han Chinese in the northeastern region of China.Methods: In a case-control study of 1,000 patients with gastric cancer and 1,036 cancer-free controls with frequency matching on age and sex. We genotyped 4 potentially functional SNPs (rs1049253 T/C and rs1049216 T/C in CASP3, rs4353229 T/C and rs12247479 G/A in CASP7) by using Taqman assays and evaluated their associations with risk of gastric cancer by using logistic regression analyses.Results:Compared with the GG/AG genotypes, the CASP7 rs12247479 AA genotype was associated with 0.560-fold decreased risk (P=0.036, 95% CI, 0.325~0.964) of gastric cancer, but no associations were found for the other 3 SNPs. After gastric cancer cases were stratified according to sex, age, smoking and drinking data, this risk was more evident in subgroups of nonsmokers, OR =0.506 (P<0.01, 95% CI, 0.407~0.629).Conclusion:Potentially functional SNP in the microRNA binding sites at the 3'-UTR of apoptosis genes CASP7 rs12247479 variants may contribute to risk of gastric cancer.

  3. DAG/PKCδ and IP3/Ca²⁺/CaMK IIβ Operate in Parallel to Each Other in PLCγ1-Driven Cell Proliferation and Migration of Human Gastric Adenocarcinoma Cells, through Akt/mTOR/S6 Pathway.

    Science.gov (United States)

    Dai, Lianzhi; Zhuang, Luhua; Zhang, Bingchang; Wang, Fen; Chen, Xiaolei; Xia, Chun; Zhang, Bing

    2015-12-01

    Phosphoinositide specific phospholipase Cγ (PLCγ) activates diacylglycerol (DAG)/protein kinase C (PKC) and inositol 1,4,5-trisphosphate (IP3)/Ca(2+)/calmodulin-dependent protein kinase II (CaMK II) axes to regulate import events in some cancer cells, including gastric adenocarcinoma cells. However, whether DAG/PKCδ and IP3/Ca(2+)/CaMK IIβ axes are simultaneously involved in PLCγ1-driven cell proliferation and migration of human gastric adenocarcinoma cells and the underlying mechanism are not elucidated. Here, we investigated the role of DAG/PKCδ or CaMK IIβ in PLCγ1-driven cell proliferation and migration of human gastric adenocarcinoma cells, using the BGC-823 cell line. The results indicated that the inhibition of PKCδ and CaMK IIβ could block cell proliferation and migration of BGC-823 cells as well as the effect of inhibiting PLCγ1, including the decrease of cell viability, the increase of apoptotic index, the down-regulation of matrix metalloproteinase (MMP) 9 expression level, and the decrease of cell migration rate. Both DAG/PKCδ and CaMK IIβ triggered protein kinase B (Akt)/mammalian target of rapamycin (mTOR)/S6 pathway to regulate protein synthesis. The data indicate that DAG/PKCδ and IP3/Ca(2+)/CaMK IIβ operate in parallel to each other in PLCγ1-driven cell proliferation and migration of human gastric adenocarcinoma cells through Akt/mTOR/S6 pathway, with important implication for validating PLCγ1 as a molecular biomarker in early gastric cancer diagnosis and disease surveillance.

  4. Ressecção alargada para o adenocarcinoma colorretal localmente invasivo: relato de caso e revisão da literatura Enlarged resection for locally advanced colorectal adenocarcinoma: case report and literature review

    Directory of Open Access Journals (Sweden)

    Sergio Henrique Couto Horta

    2009-03-01

    Full Text Available O câncer colorretal localmente invasivo, que acomete por contiguidade estruturas adjacentes e sem metástases à distância, ocorre de 5 a 18% dos casos. São adequadamente tratados com ressecção do tumor e órgãos comprometidos em monobloco e margens livres. É relatado o caso de paciente de 27 anos, masculino, portador de adenocarcinoma de retossigmóide com extensa invasão para bexiga e ceco. Tratado com colectomia total, cistectomia radical em monobloco e ileostomia. O trânsito urinário foi reconstituído com reservatório ileal e anastomose com a uretra prostática. O estudo anátomo-patológico da peça cirúrgica revelou adenocarcinoma moderadamente diferenciado, invasão perineural e invasão da parede da bexiga (T4, N0. Realizou no pós-operatório quimioterapia adjuvante, 6 ciclos, com 5-Fluorouracil e ácido folínico. Após 36 meses de seguimento, o paciente encontra-se livre de doença neoplásica, função urinária preservada, porém com ejaculação retrógrada.The locally advanced colorectal cancer compromises adjacent structures and do not disseminate distant metastasis, occur in 5 to 18% of patients. It is properly treated with tumour resection as well as other compromised organs in an "en bloc" resection with free margins. We report a 27 year old, male patient with colorectal adenocarcinoma invading the urinary bladder and cecum. He was treated with total colectomy associated with radical cistectomy and ileostomy. The urinary transit was established building an ileal reservatory anastomosed to the urethra. The tumour histopathologic study showed adenocarcinoma moderate differentiated, invading urinary bladder (T4N0. Postoperative treatment was 5-fluorouracil and folinic acid chemotherapy. After 36 months of outcome, patient is improving and preserves urinary function but has ejaculatory dysfunction.

  5. Resultados da esplenectomia no tratamento do câncer gástrico avançado Results of esplenectomy in the treatment of advanced gastric cancer

    Directory of Open Access Journals (Sweden)

    Bruno da Costa Martins

    2007-06-01

    results associated with total D2 gastrectomy and splenectomy, correlating these with the average results obtained from patients without this procedure. METHODS: Retrospective analysis from a prospective database of the patients with gastric adenocarcinoma submitted to total gastrectomy and D2 lymphadenectopmy plus splenectomy between 1985 and 2005 in the Gastrointestinal Surgery Division of the Medical School of São Paulo University. RESULTS: A total of 109 patients were enrolled in this study. Resection of other organs was performed in 43 patients (41 pancreatectomies, 5 transverse colectomies and 3 hepatectomies. The incidence of post-operative complications was 39%, higher than the expected from our overall morbidity (24%. Intra cavitary abscesses were found on 10 patients (9.1%. Ten patients died (9.1%, all due to septic complications significantly different of the overall mortality of 3.7%, registered in our Division. Metastasis to station 10 and 11d were observed on 13 patients (11.9%, with higher risk related to T4 lesions (20% and tumors of the upper third (19.5%. CONCLUSION: Splenectomy in the treatment of gastric cancer is related to a higher morbidity and mortality rates, and should be reserved to advanced tumors in the upper part of the stomach.

  6. Epstein-Barr virus in gastric carcinomas and gastric stump carcinomas: a late event in gastric carcinogenesis.

    NARCIS (Netherlands)

    Hausen, A zur; Rees, van B.P.; Beek, van J.; Craanen, M.E.; Bloemena, E.; Offerhaus, GJ; Meijer, C.J.L.M.; Brule, van den AJ

    2004-01-01

    BACKGROUND: To determine at what stage during gastric carcinogenesis Epstein-Barr virus (EBV) enters the gastric epithelial cells, the presence of EBV was investigated in two pathogenetically related but distinct forms of adenocarcinoma of the stomach-gastric carcinoma of the intact stomach (GCIS) a

  7. Gastric cancer: a primer on the epidemiology and biology of the disease and an overview of the medical management of advanced disease.

    Science.gov (United States)

    Shah, Manish A; Kelsen, David P

    2010-04-01

    Gastric cancer is a cause of significant morbidity and cancer-related mortality worldwide. Despite recent advances in targeted therapy and understanding of the biology and development of the malignancy, progress in the treatment of gastric cancer has been limited. Most newly diagnosed patients will present with incurable disease, and have a median survival of less than 1 year. Although the disease has widespread ethnic and epidemiologic differences, medical management of gastric cancer does not distinguish among the various disease subtypes. The recent report of the ToGA phase III study has validated Her2 as a molecular target in this disease, supporting the concept that a greater understanding of the biology of gastric cancer subsets may improve treatment selection and overall outcome of individual patients. This article summarizes the epidemiology and ethnic variation of this disease to crystalize subtypes of gastric cancer in the context of current and future medical management of advanced disease.

  8. Association of visceral adiposity with oesophageal and junctional adenocarcinomas.

    LENUS (Irish Health Repository)

    Beddy, P

    2012-02-01

    BACKGROUND: Obesity is associated with an increased incidence of oesophageal and oesophagogastric junction adenocarcinoma, in particular Siewert types I and II. This study compared abdominal fat composition in patients with oesophageal\\/junctional adenocarcinoma with that in patients with oesophageal squamous cell carcinoma and gastric adenocarcinoma, and in controls. METHOD: In total, 194 patients (110 with oesophageal\\/junctional adenocarcinoma, 38 with gastric adenocarcinoma and 46 with oesophageal squamous cell carcinoma) and 90 matched control subjects were recruited. The abdominal fat area was assessed using computed tomography (CT), and the total fat area (TFA), visceral fat area (VFA) and subcutaneous fat area (SFA) were calculated. RESULTS: Patients with oesophageal\\/junctional adenocarcinoma had significantly higher TFA and VFA values compared with controls (both P < 0.001), patients with gastric adenocarcinoma (P = 0.013 and P = 0.006 respectively) and patients with oesophageal squamous cell carcinoma (both P < 0.001). For junctional tumours, the highest TFA and VFA values were seen in patients with Siewert type I tumours (respectively P = 0.041 and P = 0.033 versus type III; P = 0.332 and P = 0.152 versus type II). CONCLUSION: Patients with oesophageal\\/junctional adenocarcinoma, in particular oesophageal and Siewert type I junctional tumours, have greater CT-defined visceral adiposity than patients with gastric adenocarcinoma or oesophageal squamous cell carcinoma, or controls.

  9. Expression of altered retinoblastoma protein inversely correlates with tumor invasion in gastric carcinoma

    Institute of Scientific and Technical Information of China (English)

    Nan-Hua Chou; Hui-Chun Chen; Nan-Song Chou; Ping-I Hsu; Hui-Hwa Tseng

    2006-01-01

    AIM: To investigate the clinical and pathological significance of altered retinoblastoma (Rb) encoding protein (pRb) in gastric carcinoma.METHODS: Expression of altered pRb was analyzed in 91 patients with gastric adenocarcinoma by immunohistochemistry.RESULTS: Sixty-five percent (59/91) of the tumors were positively stained and the staining in tumor nuclei of gastric carcinoma ranged 0%-90%. Moreover, strong expression of altered pRb was found in 35% (6/17),24% (5/21), 17% (8/46) and 0% (0/7) of T1, T2, T3 and T4 gastric carcinomas, respectively. Altered pRb expression was inversely correlated with the depth of tumor invasion (P = 0.047). Degree of immunoreactivity had no significant correlation with tumor grade, node metastasis and distant metastasis. In terms of prognostic significance, univariate analysis showed that poor differentiation [41 (66.1%) vs 34 (42.5%) P = 0.051],advanced tumor stage (P < 0.001) and weakly altered pRb expression [17 (80.5%) vs 58 (49.6%) P = 0.044]were associated with worse prognosis in these patients.However, multivariate analysis revealed that advanced tumor stage was the only independent poor prognostic factor (P < 0.001).CONCLUSION: The mutation of Rb gene is frequent in gastric carcinoma. The expression of altered pRb inversely correlates with tumor invasion and is not an independent prognostic marker in gastric adenocarcinoma

  10. [A case of advanced gastric cancer showing high serum CYFRA21-1 level responding to chemotherapy with S-1].

    Science.gov (United States)

    Hara, Akihito; Watanabe, Hiroaki

    2008-12-01

    The patient was a 75-year-old man whose complaint was back pain and appetite loss. He was diagnosed with unresectable advanced gastric cancer due to multiple liver metastases and direct invasion of pancreas and spleen. He underwent gastrostomy because of esophageal stenosis, and we administered S-1 80 mg/body(4 weeks administration and 2 weeks rest)to the patient through a gastrostogavage tube. On blood examination, the serum level of CYFRA21- 1 was significantly high, while those of CEA and CA19-9 were within normal ranges. After the first course of this chemotherapy, the serum CYFRA21-1 level significantly decreased with reduction of the cancer. After the second course, it sensitively increased before image views detected the progression of the cancer. This case shows that CYFRA21- 1 could be a useful tumor marker of advanced gastric cancer.

  11. Plasma and dietary carotenoid, retinol and tocopherol levels and the risk of gastric adenocarcinomas in the European prospective investigation into cancer and nutrition.

    NARCIS (Netherlands)

    Jenab, M.; Riboli, E.; Ferrari, P.; Friesen, M.; Sabate, J.; Norat, T.; Slimani, N.; Tjonneland, A.; Olsen, A.; Overvad, K.; Boutron-Ruault, M.C.; Clavel-Chapelon, F.; Boeing, H.; Schulz, M.; Linseisen, J.; Nagel, G.; Trichopoulou, A.; Naska, A.; Oikonomou, E.; Berrino, F.; Panico, S.; Palli, D.; Sacerdote, C.; Tumino, R.; Peeters, P.H.; Numans, M.E.; Bueno-De-Mesquita, H.B.; Buchner, F.L.; Lund, E.; Pera, G.; Chirlaque, M.D.; Sanchez, M.J.; Arriola, L.; Barricarte, A.; Quiros, J.R.; Johansson, I.; Johansson, A.; Berglund, G.; Bingham, S.; Khaw, K.T.; Allen, N.; Key, T.J.; Carneiro, F.; Save, V.; Giudice, G. Del; Plebani, M.; Kaaks, R.; Gonzalez, C.A.

    2006-01-01

    Despite declining incidence rates, gastric cancer (GC) is a major cause of death worldwide. Its aetiology may involve dietary antioxidant micronutrients such as carotenoids and tocopherols. The objective of this study was to determine the association of plasma levels of seven common carotenoids, the

  12. Enterococcus faecalis Infection and Reactive Oxygen Species Down-Regulates the miR-17-92 Cluster in Gastric Adenocarcinoma Cell Culture

    DEFF Research Database (Denmark)

    Strickertsson, Jesper A B; Rasmussen, Lene Juel; Friis-Hansen, Lennart

    2014-01-01

    Chronic inflammation due to bacterial overgrowth of the stomach predisposes to the development of gastric cancer and is also associated with high levels of reactive oxygen species (ROS). In recent years increasing attention has been drawn to microRNAs (miRNAs) due to their role in the pathogenesis...

  13. Self-expanding metal stents versus antrectomy for the palliative treatment of obstructive adenocarcinoma of the gastric antrum Prótesis metálicas autoexpandibles versus antrectomía en el tratamiento paliativo del adenocarcinoma obstructivo del antro gástrico

    Directory of Open Access Journals (Sweden)

    Juan Octavio Alonso-Larraga

    2012-04-01

    Full Text Available Background: gastric cancer patients are first diagnosed with an unresectable tumor in up to 40% of cases. Gastric outlet obstruction causes nausea, vomiting, dehydration and malnutrition. The aim of the study was to compare self-expanding metal stents to antrectomy and Roux-en Y gastrojejunostomy for palliation of obstructive adenocarcinoma of the gastric antrum. Methods: retrospective study in patients with obstructing cancer of the gastric antrum. Patients were divided into two groups: group A, underwent endoscopic placement of self-expanding metal stents and group B underwent surgical treatment with antrectomy and Roux-en Y gastrojejunostomy. Collected Data included: age, gender, performance status (Karnofsky's score, body mass index, histopathology, clinical stage (TNM classification, technical and clinical success of the procedure, time to oral intake, in-hospital stay, re-intervention rate, and complications related to the treatment and survival. Results: a total of 39 patients with gastric adenocarcinoma were included, 21 male and 18 female. Nineteen patients were assigned to group A and 20 patients to group B. There were no statistically significant differences between groups in regards to age, body mass index, Karnofsky's score and clinical stage. The technical and clinical success was similar for both groups. There was a statistically significant difference between groups favoring Self-expanding metal stent in time to oral intake (1 ± 0 vs. 4.9 ± 0.6 days, p = 0.0001 and in-hospital stay (0.94 ± 1.18 vs. 7.8 ± 7.7 days, p = 0.0005. We did not find statistically significant differences with regards to long-term survival. Conclusions: in patients with malignant gastric outlet obstruction due to gastric cancer, endoscopic palliation with self-expanding metal stents provide a shorter interval to oral intake, shorter in-hospital stay and lower rate of complications.Introducción: los pacientes con cáncer gástrico tienen un tumor

  14. [A successful resected case of advanced esophageal cancer with early gastric cancer responding to neoadjuvant chemotherapy of docetaxel, CDDP and 5-FU].

    Science.gov (United States)

    Matsutani, Takeshi; Yoshida, Hiroshi; Sasajima, Koji; Maruyama, Hiroshi; Yokoyama, Tadashi; Matsushita, Akira; Hirakata, Atsushi; Takao, Yoshimune; Umakoshi, Michinobu; Hayakawa, Tomohiro; Katayama, Hironori; Hosone, Masaru; Uchida, Eiji

    2012-04-01

    A 72-year-old male with a chief complaint of dysphagia was admitted to our hospital. Upper gastrointestinal endoscopic examination showed double cancers with thoracic esophageal cancer in the middle esophagus and gastric cancer in the antrum. Pathological examinations of the double cancer revealed the first one to be moderately-differentiated squamous cell carcinoma and the second to be well-differentiated adenocarcinoma. Computed tomography (CT) of the chest and abdomen showed no distant or lymph node metastases. Clinical stagings of the double cancer were stage II (T2N0M0)in esophageal cancer and stage I A (T1N0M0) in gastric cancer. The patient received neoadjuvant chemotherapy using docetaxel, CDDP and 5-FU. After 2 courses of chemotherapy, the adverse event was grade 2 in leucopenia and grade 2 in alopecia. Repeated macroscopic and histological examinations after chemotherapy revealed that the esophageal cancer had significant reductions in the size of tumors, leading to a partial response, and the gastric cancer had disappeared, leading to a complete response. He underwent thoracoscopy-assisted esophagectomy in the prone position, and laparoscopy-assisted gastric tube reconstruction. This neoadjuvant chemotherapy of docetaxel, CDDP and 5-FU might be effective and tolerable as with patients with double cancer of esophageal and gastric cancers.

  15. Multidetector CT of Locally Invasive Advanced Gastric Cancer: Value of Oblique Coronal Reconstructed Images for the Assessment of Local Invasion

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Jin Hee; Kim, Ah Yong; Kim, Hye Jin; Yook, Jeong Hwan; Yu, Eun Sil; Jang, Yoon Jin; Park, Seong Ho; Shin, Yong Moon; Ha, Hyun Kwon [Asan Medical Center, Seoul (Korea, Republic of)

    2010-01-15

    To evaluate the diagnostic value of oblique coronal reconstructed CT images to determine the local invasion of advanced gastric cancer (AGC). Thirty-four consecutive patients, who were suspected to have locally invasive advanced gastric cancer (more than T3 stage) on a preoperative MDCT scan and underwent a diagnostic or curative laparotomy, were enrolled in this study. Two reviewers performed an independent blind review of three series of MDCT images in random order; axial (AXI), conventional coronal (CCI), and oblique coronal (OCI) (parallel to long axis of gastric body and pancreas) images. In assessing the local invasion, the reader's confidence for the local invasion of AGC was graded using a five point scale (1 = definitely negative, 5 = definitely positive: T4). With surgical findings and histopathological proofs as reference standards, the diagnostic performance of the three different plans of CT images was employed for the verification of local invasion of AGC on a preoperative CT scan using the receiver operating characteristic (ROC) method. Agreements between the two reviewers were analyzed using weighted kappa statistics. Results: In 19 out of 34 patients, local invasion was confirmed surgically or histopathologically (13 pancreas invasion, 6 liver invasion, 4 major vascular invasion, 3 colon and mesocolon invasion, and 2 spleen invasion). The diagnostic performance of OCI was superior to AXI or CCI in the local invasion of AGC. The differences in the area under the curve of AXI (0.770 {+-} 0.087, 0.700 {+-} 0.094), CCI (0.884 {+-} 0.058, 0.958 {+-} 0.038), and OCI (0.954 {+-} 0.050, 0.956 {+-} 0.049), were statistically significant for both reviewers. Inter-observer agreement was excellent for OCI ({kappa}= .973), which was greater than CCI (({kappa}= .839), and AXI (({kappa}= .763). On a CT scan, OCI might be a useful imaging technique in evaluating locally invasive advanced gastric cancer.

  16. Prognostic potential of initial CT changes for progression-free survival in gefitinib-treated patients with advanced adenocarcinoma of the lung: a preliminary analysis

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Yu-Cheng; Hsu, Hsian-He; Chang, Wei-Chou; Ko, Kai-Hsiung; Hsu, Yi-Chih [Tri-Service General Hospital, National Defense Medical Center, Department of Radiology, Taipei (China); Tung, Ho-Jui [Asia University, Department of Healthcare Administration, Taichung (China); Huang, Tsai-Wang; Chang, Hung [Tri-Service General Hospital, National Defense Medical Center, Division of Thoracic Surgery, Department of Surgery, Taipei (China); Ho, Ching-Liang [Tri-Service General Hospital, National Defense Medical Center, Division of hematology-oncology, Department of internal Medicine, Taipei (China)

    2015-06-01

    We aimed to determine whether initial tumour responses measured during short-term follow-up computed tomography (CT) examinations after baseline examinations would correlate with clinical outcomes in patients with non-small cell lung cancer (NSCLC) who received epidermal growth factor receptor (EGFR)-targeted therapy. A total of 86 gefitinib-treated patients with advanced adenocarcinoma of the lung were retrospectively reviewed. All patients underwent baseline and short-term follow-up CT examinations. The new response criteria (NRC) by Lee et al. were used for the response evaluations. A Cox proportional hazards multiple regression model and Kaplan-Meier survival analyses were used to evaluate correlations between the initial tumour changes and progression-free and overall survival (PFS, OS). Better separation and smaller p values were observed for both PFS and OS when good and poor disease responses (as defined by NRC) were compared after excluding tumours with characteristic morphologies. Early tumour changes correlated with PFS in a size-dependent manner. Moreover, a stronger association was observed between size changes and PFS when characteristic morphology was also considered. Initial changes in tumour size during short-term post-treatment CT examinations could act as a potential prognostic imaging surrogate for PFS in gefitinib-treated patients with advanced adenocarcinoma of the lung. (orig.)

  17. Dosimetric comparison of intensity modulated radiotherapy, volumetric-modulated arc therapy and tomotherapy in patients with gastric adenocarcinoma after curative surgery

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Objective:To compare the dosimetric differences between IMRT, VMAT and TOMO planning for gastric cancer patients.Methods: A total of 14 patients with gastric cancer after curative surgery were prospectively enrolled. In each case, IMRT, VMAT and TOMO plans were created (45Gy/25f). Dose distributions and dose–volume histograms for PTV and normal tissue were compared. A paired t test or signed-rank test was applied to compare the averages between techniques.Results:Comparison of the PTV revealed satisfactory coverage by the 95% isodose envelope in three plans. However, significantly higher conformity index (CI) and lower V20 of bone marrow were observed in TOMO plan. Moreover, IMRT and TOMO techniques both showed signiifcant reduced mean dose of the bilateral lungs compared to the VMAT. Not much difference was found in parameters of the kidney, intestine, spine, liver and heart.Conclusion:The IMRT, VMAT and TOMO plans all achieved favorable target coverage and dose sparing of the critical organs in adjuvant radiotherapy for gastric cancer. However, the TOMO technique displayed the best target dose conformity and superior sparing of the bone marrow and lungs.

  18. A case of gastric adenocarcinoma of fundic gland type resected by combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique (CLEAN-NET).

    Science.gov (United States)

    Kato, Motohiko; Uraoka, Toshio; Isobe, Yoh; Abe, Keiichiro; Hirata, Tetsu; Takada, Yoshiaki; Wada, Michiko; Takatori, Yusaku; Takabayashi, Kaoru; Fujiyama, Yoichi; Sekiya, Kousuke; Kawaguchi, Yoshiki; Sukeda, Aoi; Shiraishi, Junichi

    2015-12-01

    A male in his eighties attended our hospital for further evaluation of gastric cancer. A gastroscopy revealed a whitish flat elevated lesion (Paris, 0-IIa) of 15 mm in diameter on the greater curvature of the proximal fornix. The preoperative diagnosis was intra-mucosal differentiated gastric cancer, and a novel therapeutic approach, combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique (CLEAN-NET) was applied and the lesion was resected in a single piece without any complications. Histopathological findings revealed atypical glandular epithelium proliferated in the mucosa and shallow layer (300 μm) of submucosa. These cells stained positive for pepsinogen-I and the final diagnosis was gastric cancer of fundic gland type (GAFT). There was no lymph-vascular involvement and free horizontal and vertical margins were confirmed. CLEAN-NET could be a therapeutic option for GAFT at low risk of lymph node metastasis because it prevents excess wall defect and exposure of cancer cells into the peritoneal cavity.

  19. Fruit and vegetable intake and the risk of gastric adenocarcinoma: a reanalysis of the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST) study after a longer follow-up.

    Science.gov (United States)

    Gonzalez, Carlos A; Lujan-Barroso, Leila; Bueno-de-Mesquita, H B; Jenab, Mazda; Duell, Eric J; Agudo, Antonio; Tjønneland, Anne; Boutron-Ruault, Marie Christine; Clavel-Chapelon, Françoise; Touillaud, Marina; Teucher, Birgit; Kaaks, Rudolf; Boeing, Heiner; Steffen, Annika; Trichopoulou, Antonia; Roukos, Dimitrios; Karapetyan, Tina; Palli, Domenico; Tagliabue, Giovanna; Mattiello, Amalia; Tumino, Rosario; Ricceri, Fulvio; Siersema, Peter D; Numans, Mattijs E; Peeters, Petra P H; Parr, Christine L; Skeie, Guri; Lund, Eiliv; Quirós, J Ramón; Sánchez-Cantalejo, Emilio; Navarro, Carmen; Barricarte, Aurelio; Dorronsoro, Miren; Ehrnström, Roy; Regner, Sara; Khaw, Kay-Tee; Wareham, Nick; Key, Timothy J; Crowe, Francesca L; Blaker, Hendrik; Romieu, Isabelle; Riboli, Elio

    2012-12-15

    In a previous European prospective investigation into cancer and nutrition (EPIC) analysis, we found an inverse association between total intake of vegetables, onion and garlic, and risk of intestinal gastric cancer (GC) and between citrus fruit and risk of cardia GC. The aim of this study is to reanalyze the effect of fruit and vegetables (F&V), based on a longer follow-up and twice the number of GC cases. Subjects are 477,312 men and women mostly aged 35 to 70 years participating in the EPIC cohort, including 683 gastric adenocarcinomas with 11 years of follow-up. Information on diet and lifestyle was collected at baseline. A calibration study in a subsample was used to correct for dietary measurement errors. When comparing the highest vs. lowest quintile of intake, we found an inverse association between total intake of V&F and GC risk [hazard ratio (HR) 0.77; 95% confidence interval (CI) 0.57-1.04; p for trend 0.02], between fresh fruit and risk of the diffuse type (HR 0.59; 95% CI 0.36-0.97; p for trend 0.03) and an inverse association between citrus fruit and risk of cardia cancer (HR 0.61; 95% CI 0.38-1.00, p for trend 0.01). Although calibration revealed somewhat stronger inverse associations, none of the risks reached statistical significance. There was no association between total or specific vegetables intake and GC risk. The inverse association between fresh fruit and citrus fruits and risk of GC seems to be restricted to smokers and the Northern European countries. Fresh fruit and citrus fruit consumption may protect against diffuse and cardia GC, respectively.

  20. Effect of preoperative S-1 combined with regional transcatheter arterial chemoembolization on malignant degree of locally advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Ru-Juan Xu

    2016-01-01

    Objective:To study the effect of preoperative S-1 combined with regional transcatheter arterial chemoembolization on malignant degree of locally advanced gastric cancer. Methods:A total of 134 patients who were diagnosed with advanced gastric cancer in our hospital from May 2012 to December 2014 were selected for study, received surgical resection after chemotherapy, and were divided into intravenous chemotherapy group and combined treatment group according to different chemotherapy regimens. After chemotherapy and before operation, serum tumor marker levels were detected;after operation, recurrence and metastasis-related molecule levels in tumor tissue were detected. Results:After chemotherapy and before operation, serum CEA, CA199, CA72-4, TSGF, ESM-1 and DKK-1 levels of combined treatment group were significantly lower than those of intravenous chemotherapy group;TET1, TET2, LATS1 and RUNX3 levels in tumor tissue of combined treatment group were higher than those of intravenous chemotherapy group while Sipa1, GOLPH3, AEP, MT2-MMP, OPN, Galectin-1, Galectin-3 and Galectin-9 levels were lower than those of intravenous chemotherapy group. Conclusions:Compared with systemic intravenous chemotherapy, preoperative S-1 combined with regional transcatheter arterial chemoembolization can more effectively kill gastric cancer cells and prevent tumor recurrence and metastasis at molecular level.

  1. Efficacy and safety assessment of short EOF program regional arterial infusion chemotherapy and conventional chemotherapy for advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Ming-Cai Shui; Lin Xiong

    2016-01-01

    Objective:To study the efficacy and safety of short EOF program regional arterial infusion chemotherapy and conventional chemotherapy for advanced gastric cancer.Methods: 66 cases of patients diagnosed of advanced gastric cancer in our hospital were enrolled for study, given preoperative short EOF program chemotherapy and randomly divided into two groups. Observation group received short EOF program regional arterial infusion chemotherapy and control group received short EOF program intravenous chemotherapy. Then number of apoptosis cells and contents of apoptosis genes in the tumor tissue, serum liver and kidney function indicators as well as cfDNA methylation degree of two groups were detected. Results:(1) indicators of efficacy: the number of apoptosis cells in gastric cancer tissue of observation group was more than that of control group, mRNA levels of Caspase-3, Caspase-9, Fas and FasL were higher than those of control group, and serum p16, RNF180, SFRP2, SOX17 and RUNX methylation ratios were lower than those of control group; (2) indicators of safety: serum RBP, CysC, ALT and AST contents of observation group were lower than those of control group.Conclusions:Short EOF program regional arterial infusion chemotherapy can more effectively kill cancer cells, reduce methylation degree of tumor-associated genes and decrease liver function and kidney function damage; both efficacy and safety of it are better than conventional chemotherapy.

  2. Gastric carcinogenesis

    Institute of Scientific and Technical Information of China (English)

    Ismail Gomceli; Baris Demiriz; Mesut Tez

    2012-01-01

    Gastric cancer is the second most common cancer worldwide and the second most common cause of cancer-related deaths.Despite complete resection of gastric cancer and lymph node dissection,as well as improvements in chemotherapy and radiotherapy,there are still 700 000 gastric cancer-related deaths per year worldwide and more than 80% of patients with advanced gastric cancer die of the disease or recurrent disease within 1 year after diagnosis.None of the treatment modalities we have been applying today can influence the overall survival rates:at present,the overall 5-year relative survival rate for gastric cancer is about 28%.Cellular metaplasia due to chronic inflammation,injury and repair are the most documented processes for neoplasia.It appears that chronic inflammation stimulates tumor development and plays a critical role in initiating,sustaining and advancing tumor growth.It is also evident that not all inflammation is tumorigenic.Additional mutations can be acquired,and this leads to the cancer cell gaining a further growth advantage and acquiring a more malignant phenotype.Intestinalization of gastric units,which is called "intestinal metaplasia";phenotypic antralization of fundic units,which is called "spasmolytic polypeptide-expressing metaplasia"; and the development directly from the stem/progenitor cell zone are three pathways that have been described for gastric carcinogenesis.Also,an important factor for the development of gastrointestinal cancers is peritumoral stroma.However,the initiating cellular event in gastric metaplasia is still controversial.Understanding gastric carcinogenesis and its precursor lesions has been under intense investigation,and our paper attempts to high-light recent progress in this field of cancer research.

  3. Laparoscopy-assisted gastrectomy with D2 lymph node dissection for advanced gastric cancer without serosa invasion: a matched cohort study from South China

    Directory of Open Access Journals (Sweden)

    Lin Jian-Xian

    2013-01-01

    Full Text Available Abstract Background Gastric cancer is a common malignancy worldwide and a common cause of death from cancer. Despite recent advances in multimodality treatment and targeted therapy, complete resection remains the only treatment that can lead to cure. This study was devised to investigate the technical feasibility, safety and oncologic efficacy of laparoscopy-assisted gastrectomy for advanced gastric cancer without serosa invasion. Methods A retrospective matched cohort study was performed in south China comparing laparoscopy-assisted gastrectomy and open gastrectomy for advanced gastric cancer without serosa invasion. Eighty-three patients with advanced gastric cancer undergoing laparoscopy-assisted gastrectomy between January 2008 and December 2010 were enrolled. These patients were compared with 83 patients with advanced gastric cancer undergoing open gastrectomy during the same period. Results There was no significant difference in clinicopathologic characteristics between the two groups. Regarding perioperative characteristics, the operation time and time to ground activities did not differ between the two groups, whereas the blood loss, transfused patient number, time to first flatus, time to resumption of diet, and postoperative hospital stay were significantly less in laparoscopy-assisted gastrectomy than in open gastrectomy (P Conclusion Laparoscopy-assisted gastrectomy with D2 lymphadenectomy is a safe and feasible procedure for advanced gastric cancer without serosa invasion. To be accepted as a choice treatment for advanced gastric cancer, well-designed randomized controlled trials comparing short-term and long-term outcomes between laparoscopy-assisted gastrectomy and open gastrectomy in a larger number of patients are necessary.

  4. Optimal indications for second-line chemotherapy in advanced gastric cancer.

    Science.gov (United States)

    Hasegawa, Hiroko; Fujitani, Kazumasa; Nakazuru, Shoichi; Hirao, Motohiro; Mita, Eiji; Tsujinaka, Toshimasa

    2012-04-01

    As it remains uncertain whether patients with advanced gastric cancer who progress after first-line chemotherapy should receive second-line chemotherapy, we attempted to identify the optimal indications for second-line chemotherapy. In this retrospective study, 101 patients were included in univariate and multivariate analyses to identify clinicopathological variables independently associated with longer survival postprogression (SPP), defined as the time from recognition of disease progression on first-line chemotherapy to death from any cause or last follow-up. The median SPP was 340 days. On multivariate analysis, performance status 2 [hazard ratio (HR), 14.234; 95% confidence interval (CI), 2.766-73.258], serum albumin level less than 3.5 g/dl (HR, 2.088; 95% CI, 1.047-4.060) at initiation of second-line chemotherapy, and time to progression less than 170 days on first-line chemotherapy (HR, 2.497; 95% CI, 1.227-5.083) were identified as independent prognostic factors associated with shorter SPP. The median SPP was 496, 375, and 232 days in patients with 0, 1, and 2 of these 3 negative prognostic factors, respectively (P=0.0002). The present study suggests that second-line chemotherapy would not be beneficial in patients with two or more of the following three negative prognostic factors: performance status 2, serum albumin less than 3.5 g/dl at initiation of second-line chemotherapy and time to progression less than 170 days on first-line chemotherapy.

  5. Clinical study on the D4 lymph nodes excision in advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Bo Jian Jiang; Hong Qiang Wang; Rong Xun Sun; You Fu Gao; Hao Shen

    2000-01-01

    AIM To study the safety and the traumatic degree of D4 approach by retrospective analysis of the para-operative data from the para-aortic lymph nodes excision in comparison with those from standard radicalresection in advanced gastric cancer (AGC).METHODS Several para-operative data including the resectability, the mortality, the complicatedmorbidity, the amount of transfused blood, and the hospitalized days relating to the operation were analyzedstatistically between D4(n = 30) and D2 lymph nodes excision (n = 34) groups. The data expressed as means±SD was analyzed statistically by Student t test. Percentage of the data was analyzed by x2 test statistically.It was taken as significant difference if P value was less than 0.05.RESULTS The percentage of palliated resection in D4 group was significantly lower than that in D2 group(16.67% vs 47.06%, P<0.05). This D4 radical resection would indeed prolong the drainage time (7.35±0.98 days vs 14.78±2.16 days, P < 0.01). The amount of transfused blood during operation (774.32±112.09mL) and the operative consuming time in D4 group (7.14±0.39h) increased significantly toocompared with those in D2 group (538.67±59.87mL, P < 0.05; 4.12±0.18h, P < 0.05), suggesting that thedraumatic degree of D4 operation was severer than that of D2 operation. But the mortality, the morbidity ofcomplication and the hospitalized time after D4 operation did not increase significantly, indicating that D4lymph nodes excision as a choice of the surgical treatment of AGC was safe and feasible.CONCLUSION D4 lymph nodes excision for AGC is safe, reasonable and feasible.

  6. 应用二代测序技术助解胃癌术后睾丸转移性腺癌诊治研究%Next-generation sequencing assistants in diagnosis of testicular metastatic adenocarcinoma after gastric cancer surgery

    Institute of Scientific and Technical Information of China (English)

    曹彦硕; 孙利; 沈琳

    2015-01-01

    目的 探讨二代测序技术在肿瘤疑难病例诊治中的作用.方法 北京大学肿瘤医院于2014-11-18应用传统病理组织学检查手段及二代测序和分子进化遗传分析(MEGA)对1例胃癌术后7年发现睾丸转移性腺癌病人的病理组织及外周血进行检测及诊断.结果 病理学专家一致认为睾丸转移性腺癌来源于胃癌,而基因检测结果提示病人睾丸肿瘤可能并非7年前切除的胃癌转移.结论 新的基因检测技术对传统的病理组织学诊断提出了挑战,有必要在临床研究中积累更多数据以将其更好地应用于临床实践.%Objective To investigate the role of next-generation sequencing technique in the diagnosis and treatment of cancer. Methods Using traditional pathologic diagnosis and next-generation sequencing and molecular evolutionary genetics analysis (MEGA) in a patient who was diagnosed of testicular metastatic adenocarcinoma 7 years after the radical surgery of gastric cancer. Results Pathologists make the conclusion that testicular tumor is the metastasis from gastric cancer, while the results of sequencing indicates that there may be other potential original tumor instead of gastric cancer from 7 years ago. Conclusion New gene detection technique has challenged the conclusion of traditional histopathology, and there is necessity to accumulate more data in future research to better apply this technique in clinical practice.

  7. A case of gastric cancer with heterogeneous components of EB virus (+)/TP53 (+) and EB virus (-)/TP53 (-).

    Science.gov (United States)

    Matsuda, Ikuo; Kan, Kazuomi; Doi, Sadayuki; Motoki, Yoshiyuki; Onodera, Masayuki; Hirota, Seiichi

    2015-01-01

    Epstein-Barr virus (EBV)-associated gastric adenocarcinoma is a histological subtype of gastric adenocarcinoma, in which all of the carcinoma cells are basically positive for EBV-encoded small RNA (EBER) by in situ hybridization. Although its typical histology has some overlap with gastric carcinoma with lymphoid stroma, absence of massive lymphoid infiltrate is sometimes observed either in whole or in part. EBV-associated adenocarcinoma is one of the four representative molecular pathological subtypes recently identified by comprehensive genomic analysis of gastric adenocarcinomas. According to the analysis, typical EBV-associated gastric adenocarcinoma constitutes an independent molecular pathological subgroup, which is mutually exclusive to TP53-mutated adenocarcinoma with chromosomal instability, another molecular pathological subtype in gastric adenocarcinomas. Here, we report a rare case of gastric cancer heterogeneously composed of EBER (+)/TP53 (+) and EBER (-)/TP53 (-) portions. The EBER (+)/TP53 (+) component with massive lymphoid infiltrate surrounded the EBER (-)/TP53 (-) component showing well to moderately differentiated tubular adenocarcinoma. Although collision of two independent gastric cancers could be the simplest and most possible explanation for this situation, we discussed another possibility. In the case of gastric collision tumors, concurrent development of EBER (+) gastric adenocarcinomas and EBER (-) gastric adenocarcinomas in a single stomach is a rare incident. Since presence of the EBER (+)/TP53 (+) tumor component is atypical in itself, we also discussed the mechanism of development of the clone.

  8. Perforated early gastric cancer: uncommon and easily missed a case report and review of literature.

    Science.gov (United States)

    Lim, Raymond Hon Giat; Tay, Clifton Ming; Wong, Benjamin; Chong, Choon Seng; Kono, Koji; So, Jimmy Bok Yan; Shabbir, Asim

    2013-03-01

    Gastric carcinoma rarely presents as a perforation, but when it does, is perceived as advanced disease. The majority of such perforations are Stage III/IV disease. A T1 gastric carcinoma has never been reported to perforate spontaneously in English literature. We present a 56 year-old Chinese male who presented with a perforated gastric ulcer. Intra-operatively, there was no suspicion of malignancy. At operation, an open omental patch repair was performed. Post-operative endoscopy revealed a macroscopic Type 0~III tumour and from the ulcer edge biopsy was reported as adenocarcinoma. Subsequently, the patient underwent open subtotal gastrectomy and formal D2 lymphadenectomy. The final histopathology report confirms T1b N0 disease. The occurrence of a perforated early gastric cancer re-emphasises the need for vigilance, including intra-operative frozen section and/or biopsy, as well as routine post-operative endoscopy for all patients.

  9. Expression of Inflammation-Related Genes Is Altered in Gastric Tissue of Patients with Advanced Stages of NAFLD

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    Rohini Mehta

    2013-01-01

    Full Text Available Obesity is associated with chronic low-grade inflammation perpetuated by visceral adipose. Other organs, particularly stomach and intestine, may also overproduce proinflammatory molecules. We examined the gene expression patterns in gastric tissue of morbidly obese patients with nonalcoholic fatty liver disease (NAFLD and compared the changes in gene expression in different histological forms of NAFLD. Stomach tissue samples from 20 morbidly obese NAFLD patients who were undergoing sleeve gastrectomy were profiled using qPCR for 84 genes encoding inflammatory cytokines, chemokines, their receptors, and other components of inflammatory cascades. Interleukin 8 receptor-beta (IL8RB gene overexpression in gastric tissue was correlated with the presence of hepatic steatosis, hepatic fibrosis, and histologic diagnosis of nonalcoholic steatohepatitis (NASH. Expression levels of soluble interleukin 1 receptor antagonist (IL1RN were correlated with the presence of NASH and hepatic fibrosis. mRNA levels of interleukin 8 (IL8, chemokine (C-C motif ligand 4 (CCL4, and its receptor chemokine (C-C motif receptor type 5 (CCR5 showed a significant increase in patients with advanced hepatic inflammation and were correlated with the severity of the hepatic inflammation. The results of our study suggest that changes in expression patterns for inflammatory molecule encoding genes within gastric tissue may contribute to the pathogenesis of obesity-related NAFLD.

  10. Molecular targeted therapy of advanced gastric cancer%进展期胃癌分子靶向治疗

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    王润洁; 石晓燕; 黄薇; 刘超英

    2012-01-01

    Efficacy of chemotherapy for advanced gastric cancer is unsatisfactory. Molecular targeted therapies have emerged as a novel approach to the treatment of advanced gastric cancer in recent years.These therapeutic strategies include targeting EGFR signal transduction pathway,anti-angiogenesis therapy,multi-target molecular targeted drugs. Targeted drugs such as trastuzumab,cetuximab,bevacizumab,apatinib,sorafenib sunitinib,lapatinib and everolimus which are targeting HER2,EGFR,VEGF and mTOR pathway,are applied in the comprehensive treatment of advanced gastric cancer,and their therapeutic effects are encouraging.%进展期胃癌化疗效果不佳.分子靶向治疗是近年来进展期胃癌综合治疗的新手段.目前这些策略主要包括针对表皮生长因子受体(EGFR)通道的靶向治疗、针对血管内皮生长因子通道的靶向治疗、口服小分子靶向药物等.近期有关HER2、EGFR、VEGF、mTOR信号通路的靶向药物曲妥珠单抗、西妥昔单抗、贝伐单抗、阿帕替尼、索拉非尼、舒尼替尼、拉帕替尼、RAD001 (everolimus)等综合治疗进展期胃癌的报道结果令人鼓舞.

  11. [A case of S-1/CDDP chemotherapy for inoperable advanced gastric cancer which led to gastrectomy with histological complete response].

    Science.gov (United States)

    Kobayashi, Kenji; Tanizaki, Keiko; Aoki, Taro; Takachi, Kou; Nishioka, Kiyonori; Matsumoto, Takashi; Komori, Takamichi; Chono, Teruhiro; Kato, Aya; Hyuga, Satoshi; Watanabe, Risa; Uemura, Yoshio

    2011-11-01

    As the treatment for inoperable advanced gastric cancer, S-1/CDDP combination therapy (SP chemotherapy) has become a standard treatment. In our hospital, a second course of chemotherapy was performed on an outpatient basis in order to improve a traditional QOL. In this case, it showed remarkable effects in 15 months after starting chemotherapy. Then gastrectomy was performed. Histological findings of the resected specimens confirmed pCR in all tumors. We report on progress of this case and explain about the ingenuity of SP chemotherapy.

  12. The Role of E3 Ubiquitin Ligase Cbl Proteins in β-Elemene Reversing Multi-Drug Resistance of Human Gastric Adenocarcinoma Cells

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    Xue-Jun Hu

    2013-05-01

    Full Text Available Recent studies indicate that β-elemene, a compound isolated from the Chinese herbal medicine Curcuma wenyujin, is capable of reversing tumor MDR, although the mechanism remains elusive. In this study, β-Elemene treatment markedly increased the intracellular accumulation of doxorubicin (DOX and rhodamine 123 in both K562/DNR and SGC7901/ADR cells and significantly inhibited the expression of P-gp. Treatment of SGC7901/ADR cells with β-elemene led to downregulation of Akt phosphorylation and significant upregulation of the E3 ubiquitin ligases, c-Cbl and Cbl-b. Importantly, β-elemene significantly enhanced the anti-tumor activity of DOX in nude mice bearing SGC7901/ADR xenografts. Taken together, our results suggest that β-elemene may target P-gp-overexpressing leukemia and gastric cancer cells to enhance the efficacy of DOX treatment.

  13. Impact of histological subtype on survival in patients with locally advanced cervical cancer that were treated with definitive radiotherapy: adenocarcinoma/adenosquamous carcinoma versus squamous cell carcinoma

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    Kuroda, Hiromasa; Kimura, Tadashi

    2017-01-01

    Objective To compare the survival outcomes of patients with cervical squamous cell carcinoma (SCC) and adenocarcinoma/adenosquamous carcinoma (AC/ASC) among patients with locally advanced cervical cancer that were treated with definitive radiotherapy. Methods The baseline characteristics and outcome data of patients with locally advanced cervical cancer who were treated with definitive radiotherapy between November 1993 and February 2014 were collected and retrospectively reviewed. A Cox proportional hazards regression model was used to investigate the prognostic significance of AC/ASC histology. Results The patients with AC/ASC of the cervix exhibited significantly shorter overall survival (OS) (p=0.004) and progression-free survival (PFS) (p=0.002) than the patients with SCC of the cervix. Multivariate analysis showed that AC/ASC histology was an independent negative prognostic factor for PFS. Among the patients who displayed AC/ASC histology, larger tumor size, older age, and incomplete response to radiotherapy were found to be independent prognostic factors. PFS was inversely associated with the number of poor prognostic factors the patients exhibited (the estimated 1-year PFS rates; 100.0%, 77.8%, 42.8%, 0.0% for 0, 1, 2, 3 factors, respectively). Conclusion Locally advanced cervical cancer patients with AC/ASC histology experience significantly worse survival outcomes than those with SCC. Further clinical studies are warranted to develop a concurrent chemoradiotherapy (CCRT) protocol that is specifically tailored to locally advanced cervical AC/ASC. PMID:28028992

  14. Study of Sonic hedgehog signaling pathway related molecules in gastric carcinoma

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    Xiao-Li Ma; Hai-Ji Sun; Yun-Shan Wang; Shu-Hong Huang; Jing-Wu Xie; Hong-Wei Zhang

    2006-01-01

    AIM: To study the expression of Sonic hedgehog pathway-related molecules, Sonic hedgehog (Shh) and Gli1 in gastric carcinoma.METHODS: Expression of Shh in 56 gastric specimens including non-cancerous gastric tissues, gastric adenocarcinoma, gastric squamous cell carcinoma was detected by RT-PCR, in situ hybridization and immunohistochemistry. Expression of Gli1 was observed by in situ hybridization.RESULTS: The positive rate of Shh and Gli1 expression was 0.0%, 0.0% in non-cancerous gastric tissues while it was 66.7%, 57.8% respectively in gastric adenocarcinoma, and 100%, 100% respectively in gastric squamous cell carcinoma. There was a significant difference between the non-cancerous gastric tissues and gastric carcinoma (P < 0.05). Elevated expression of Shh and Gli1 in gastric tubular adenocarcinoma was associated with poorly differentiated tumors while the expression was absent in gastric mucinous adenocarcinoma.CONCLUSION: The elevated expression of Shh and Gli1 in gastric adenocarcinoma and gastric squamous cell carcinoma shows the involvement of activated Shh signaling in the cellular proliferation of gastric carcinogenesis. It suggests Shh signaling gene may be a new and good target gene for gastric tumor diagnosis and therapy.

  15. Locally advanced adenocarcinoma of the rectum presenting with necrotising fasciitis of the perineum: successful management with early aggressive surgery and multimodal therapy.

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    Ferreira, Luís; Alexandrino, Henrique; Soares Leite, Júlio; Castro Sousa, Francisco

    2015-12-16

    Colorectal cancer is a common malignant neoplasm and its treatment usually involves surgery associated, in some cases, depending on the staging, with chemoradiotherapy. Necrotising fasciitis of the perineum is a highly lethal infection of the perineum, perirectal tissues and genitals, requiring emergency surgical debridement, broad-spectrum antibiotics and control of sepsis. We present the case of a 59-year-old man with necrotising fasciitis of the perineum as the first clinical manifestation of locally advanced adenocarcinoma of the rectum, in which successful management consisted of early and aggressive surgical debridement, followed by multimodal therapy with curative intent. 2 years and 6 months after surgery the patient is well, with no evidence of local or systemic relapse.

  16. Side Effects during Treatment of Advanced Gastric Carcinoma by Chemotherapy Combined with CIK-cell Transfusion in Elderly People

    Institute of Scientific and Technical Information of China (English)

    Jingting Jiang; Changping Wu; Liangrong Shi; Ning Xu; Haifeng Deng; Mingyang Lu; Mei Ji; Yibei Zhu; Xueguang Zhang

    2008-01-01

    OBJECTIVE To study the side effects and therapeutic results of autologous cytokine-induced killer (CIK) cell treatment in elderly patients with advanced gastric cancer.METHODS CIK cells were induced and cultured using biotechnics in vitro, and then the ceils were infused back into the patients. Sixty elderly gastric cancer patients treated by chemotherapy (FOLFOX4 protocol) were followed-up. Among them, 29 patients were treated with CIK cells during application of chemotherapy. Short-term curative effects and adverse events from the CIK transfusion and chemotherapy were observed.RESULTS Eight cases developed partial remission (PR), 9 cases moderate remission (MR), 7 cases stable disease(SD) and 5 cases progressive disease (PD). Out of a total of 29 patients who received chemotherapy combined with autologous CIK therapy,the total remission rate (PR + MR) was 58.6%. The total remission rate following chemotherapy alone was 45.2%, including 5 PR cases, 9 MR cases, 7 SD cases, and 10 PD cases. There was a relatively lower rate of severe chemotherapic toxicities in the CIK-cell transfusion group. Side effects of autologous CIK transfusion included chilis (13 cases), fever (9 cases), nausea and vomiting(1 case) and general malaise (3 cases). Side effects were treated with conventional therapy resulting in their amelioration. No patients developed shock, blood capillary leakage syndrome, or abnormalities in routine blood, urine, liver and renal function tests.CONCLUSION Adoptive immunotherapy with autologous CIK cells may decrease the clinical signs and symptoms of elderly patients who suffer from advanced gastric cancer. Adverse reactions of patients can be alleviated by conventional therapy.Autologous CIK-cell transfusion may improve endurance to chemotherapy.

  17. Effect of laparoscope and open radical resection on immunological and stress levels in patients with advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Xia-Fei Sun; Zi-Rui He

    2016-01-01

    Objective:To explore the effect of laparoscope and open radical resection of gastric cancer on the immunological and stress levels in patients with advanced gastric cancer.Methods:A total of 80 patients with advanced gastric cancer who were admitted in our hospital from May, 2015 to May, 2016 were included in the study and divided into the laparoscope group and open group according to different treatment protocols. The morning fasting venous blood 1 d before operation, and 1 d, 3 d, and 5 d after operation in the two groups was collected, and centrifuged for the serum. The scatter turbidimetry was used to detect CRP. ELISA was used to detect IL-6. FCM was used to detect CD4+ and CD8+. CD4+/CD8+ were calculated.Results:The comparison of CRP and IL-6 levels before operation between the two groups was not statistically significant (P>0.05). CRP and IL-6 levels 1 d after operation were significantly elevated, and were gradually reduced 3 d and 5 d after operation. CRP and IL-6 levels 3 d and 5d after operation in the laparoscope group were significantly lower than those in the open group (P0.05). CD4+ 1 d after operation reached the peak, while CD8+ and CD4+/CD8+ were reduced to the lowest. CD4+, CD8+, and CD4+/CD8+ 3 d and 5 d after operation were gradually recovered, and the recovered degree of the above indicators in the laparoscope group were significantly superior to that in the open group (P<0.05).Conclusions:Due to the significant advantage of small effect on the stress reaction and immunosuppression, the laparoscopic radical gastrectomy should be preferred.

  18. Chemotherapy with or without irinotecan in patients with advanced or recurrent gastric cancer: a meta-analysis of randomized controlled trials

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    Zeng Chao; Zhou Hang; Wei Yang; Wang Liyang; Xie Hua; Yao Wenxiu

    2014-01-01

    Background Studies have shown that irinotecan can improve survival in patients with advanced or recurrent gastric cancer,but the overall benefit of irinotecan in the treatment of advanced or recurrent gastric cancer remains controversial.The aim of this study was to evaluate the benefits and risks of irinotecan for survival in patients with advanced or recurrent gastric cancer.Method We searched PubMed,EmBase,the Cochrane Central Register of Controlled Trials,reference lists of articles,and proceedings of major conferences for relevant clinical trials.We included randomized controlled trials that reported on the efficacy and safety of irinotecan in patients with advanced or recurrent gastric cancer.Outcomes were analyzed by survival rate,objective response rate (ORR),and toxicity.Furthermore,the analysis was further stratified by factors that could affect the treatment effects.Results Eight trials recruiting 1 546 patients with advanced or recurrent gastric cancer were included in the analysis.Overall,irinotecan therapy was associated with a 6% improvement in survival rate,but this difference was not statistically significant (odds ratio (OR) 0.94; 95% confidence interval (95% CI) 0.70-1.27; P=-0.69).However,irinotecan therapy had more frequent ORR than irinotecan-free arm (OR 1.70; 95% CI 1.34-2.17; P <0.001).Furthermore,irinotecan therapy was associated with a clinically and statistically significant increase in the risk for declined hemoglobin,hyponatremia,and diarrhea,but it also protected against thrombocytopenia risk when compared with irinotecan-free therapy.Conclusions There is no evidence to support the use of irinotecan therapy in patients with advanced or recurrent gastric cancer; however,given the significant advantage in ORR irinotecan therapy using combination regimens may be considered for further evaluation in subsets of patients who may benefit from this treatment.

  19. Neo-adjuvant chemo(radio)therapy in gastric cancer: Current status and future perspectives

    Institute of Scientific and Technical Information of China (English)

    Alberto; Biondi; Maria; C; Lirosi; Domenico; D’Ugo; Valeria; Fico; Riccardo; Ricci; Francesco; Santullo; Antonia; Rizzuto; Ferdinando; CM; Cananzi; Roberto; Persiani

    2015-01-01

    In the last 20 years, several clinical trials on neoadjuvant chemotherapy and chemo-radiotherapy as a therapeutic approach for locally advanced gastric cancer have been performed. Even if more data are necessary to define the roles of these approaches, the results of preoperative treatments in the combined treatment of gastric adenocarcinoma are encouraging because this approach has led to a higher rate of curative surgical resection. Owing to the results of most recent randomized phase III studies, neoadjuvant chemotherapy for locally advanced resectable gastric cancer has satisfied the determination of level I evidence. Remaining concerns pertain to the choice of the optimal therapy regimen, strict patient selection by accurate pre-operative staging, standardization of surgical procedures, and valid criteria for response evaluation. New well-designed trials will be necessary to find the best therapeutic approach in pre-operative settings and the best way to combine old-generation chemotherapeutic drugs with new-generation molecules.

  20. Advanced gastric cancer (GC) and cancer of the gastro-oesophageal junction (GEJ): focus on targeted therapies.

    Science.gov (United States)

    Cappetta, Alessandro; Lonardi, Sara; Pastorelli, Davide; Bergamo, Francesca; Lombardi, Giuseppe; Zagonel, Vittorina

    2012-01-01

    Despite recent improvements in surgical techniques and chemotherapy treatments, locally advanced/metastatic gastroesophageal junction (GEJ) and gastric cancer (GC) are still associated with poor clinical outcome. However, increased understanding of molecular mechanisms underlying carcinogenesis and its implementation in the treatment of breast, colon, lung, and other cancers in recent years have spurred focus on the development and incorporation of targeted agents in current therapeutic options for this difficult-to-treat disease. Such agents have the ability to target a variety of cancer relevant targets, including epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) and its receptor. In this review, we describe the current status of targeted therapies in the treatment of advanced GC and GEJ cancer, focusing on pre-clinical and clinical data available on monoclonal antibodies and tyrosine kinase inhibitors acting in these pathways, including completed and ongoing phase III studies.

  1. Synchronous Appearance of Adenocarcinoma and Gastrointestinal Stromal Tumour (GIST) of the Stomach: A Case Report.

    Science.gov (United States)

    Telugu, Ramesh Babu; Pushparaj, Magesh; Masih, Dipti; Pulimood, Anna

    2016-02-01

    Adenocarcinoma is the most common histological type of gastric tumour, accounting for approximately 95% of all gastric carcinomas. Gastrointestinal stromal tumours (GISTs) are rare mesenchymal neoplasms of the digestive tract. Synchronous adenocarcinoma and gastrointestinal stromal tumour (GIST) occurring in the stomach is rare and very few cases have been reported in literature. Synchronous tumours in the stomach are rarely diagnosed preoperatively. A 63-year-old gentleman was diagnosed with a gastric adenocarcinoma on endoscopic biopsy and underwent surgery. Postoperative histopathologic examination revealed 2 synchronous tumours with both adenocarcinoma and GIST. The adenocarcinoma was determined to be the aggressive tumour based on histologic features. GIST was categorized as a very low risk of malignancy, based on its size and mitosis. The patient underwent chemotherapy for adenocarcinoma. He is under follow up and is currently disease free. Careful histopathologic evaluation is required to detect co-existing rare synchronous tumours. Presence of the second tumour may require additional procedures or protocols.

  2. Imaging Characteristics of Driver Mutations in EGFR, KRAS, and ALK among Treatment-Naïve Patients with Advanced Lung Adenocarcinoma

    Science.gov (United States)

    Park, Jangchul; Kobayashi, Yoshihisa; Urayama, Kevin Y.; Yamaura, Hidekazu; Yatabe, Yasushi; Hida, Toyoaki

    2016-01-01

    This study aimed to identify the computed tomography characteristics of treatment-naïve patients with lung adenocarcinoma and known driver mutations in EGFR, KRAS, or ALK. Patients with advanced lung adenocarcinoma (stage IIIB–IV) and known mutations in EGFR, KRAS, or ALK were assessed. The radiological findings for the main tumor and intra-thoracic status were retrospectively analyzed in each group, and the groups’ characteristics were compared. We identified 265 treatment-naïve patients with non-small-cell carcinoma, who had EGFR mutations (n = 159), KRAS mutations (n = 55), or ALK rearrangements (n = 51). Among the three groups, we evaluated only patients with stage IIIB–IV lung adenocarcinoma who had EGFR mutations (n = 126), KRAS mutations (n = 35), or ALK rearrangements (n = 47). We found that ground-glass opacity at the main tumor was significantly more common among EGFR-positive patients, compared to ALK-positive patients (p = 0.009). Lymphadenopathy was significantly more common among ALK-positive patients, compared to EGFR-positive patients (p = 0.003). Extranodal invasion was significantly more common among ALK-positive patients, compared to EGFR-positive patients and KRAS-positive patients (p = 0.001 and p = 0.049, respectively). Lymphangitis was significantly more common among ALK-positive patients, compared to EGFR-positive patients (p = 0.049). Pleural effusion was significantly less common among KRAS-positive patients, compared to EGFR-positive patients and ALK-positive patients (p = 0.046 and p = 0.026, respectively). Lung metastases were significantly more common among EGFR-positive patients, compared to KRAS-positive patients and ALK-positive patients (p = 0.007 and p = 0.04, respectively). In conclusion, EGFR mutations were associated with ground-glass opacity, KRAS-positive tumors were generally solid and less likely to metastasize to the lung and pleura, and ALK-positive tumors tended to present with lymphadenopathy, extranodal

  3. Epidemiology of gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Katherine D Crew; Alfred I Neugut

    2006-01-01

    The incidence and mortality of gastric cancer have fallen dramatically in US and elsewhere over the past several decades. Nonetheless, gastric cancer remains a major public health issue as the fourth most common cancer and the second leading cause of cancer death worldwide. Demographic trends differ by tumor location and histology. While there has been a marked decline in distal, intestinal type gastric cancers, the incidence of proximal, diffuse type adenocarcinomas of the gastric cardia has been increasing, particularly in the Western countries. Incidence by tumor sub-site also varies widely based on geographic location, race, and socioeconomic status. Distal gastric cancer predominates in developing countries, among blacks, and in lower socioeconomic groups, whereas proximal tumors are more common in developed countries, among whites, and in higher socio-economic classes. Diverging trends in the incidence of gastric cancer by tumor location suggest that they may represent two diseases with different etiologies. The main risk factors for distal gastric cancer include Helicobacter pylori (H pylori) infection and dietary factors, whereas gastroesophageal reflux disease and obesity play important roles in the development of proximal stomach cancer. The purpose of this review is to examine the epidemiology and risk factors of gastric cancer, and to discuss strategies for primary prevention.

  4. Clinical profile of gastric cancer in Khuzestan, southwest of Iran

    Institute of Scientific and Technical Information of China (English)

    Hajiani Eskandar; Sarmast Shoshtari Mohammad Hossein; Masjedizadeh Rahim; Hashemi Jalal; Azmi Mehrdad; Tahereh Rajabi

    2006-01-01

    AIM: To analyze the characteristics of epidemiological, clinical and survival patterns among patients with carcinoma of the stomach. METHODS: We retrospectively studied the characteristics of 186 gastric adenocarcinoma patients at Ahwaz Jundishapur University Hospitals (AJSUH) from September 1, 1996 to September 1, 2002. All the patients had histopathologicallyconfirmed malignancy. Demographic variables, family history of gastric cancer (GC), clinicopathologic characteristics and treatment-related variables were analyzed. Univariate analysis was performed with the log-rank test and multivariate analysis with Cox regression. P < 0.05 was considered statistically significant. RESULTS: Male to female ratio was 2.6:1. The meanage was 60.6 years and 14% of the patients were younger than 40 years. Adenocarcinoma, gastric lymphoma, and gastric metastasis were found in 94.5%,2.3%, and 3% patients, respectively. There was an average of 6-mo delay between the initial symptoms and the diagnosis. Among adenocarcinoma groups, intestinal type was the commonest (55.9%) and the distal third was the most common localization (88.4%). One hundred and thirty-four patients (72.1%) were males. Thirty-one patients (17%) had a family history of GC. Surgery was performed in 90% of patients (non-curative).CONCLUSION: The epidemiological features of GC in south Iran mimic those in high-risk areas. There is a higher frequency of GC in young patients at our institution. Patients are detected and treated after a relatively long delay. Most patients present in advanced stages, which favors a poor overall survival. Family history of GC has a significant problem in our area. Studying the etiology of this cancer in south Iran and earlier diagnosis and subsequent better cares are recommended.

  5. Trajectory of chemotherapy for patients with EGFR wild-type advanced pulmonary adenocarcinoma: a single-institution retrospective study

    Science.gov (United States)

    Minami, Seigo; Ogata, Yoshitaka; Ihara, Shouichi; Yamamoto, Suguru; Komuta, Kiyoshi

    2017-01-01

    Background Pulmonary adenocarcinoma, recently benefited by new cytotoxic and molecularly targeted drugs, has been classified by driver mutations, such as EGFR mutations. The aim of this study was to research the proportions of patients treated with first- to third-line chemotherapy and to find influential factors for the introduction of chemotherapy and survival benefit from chemotherapy. Materials and methods Data were collected retrospectively on patients who met the following criteria: adenocarcinoma, diagnosed between June 2007 and March 2015 at our hospital, stage IIIB or IV, and EGFR wild type. A nonchemotherapy group of patients who did not receive chemotherapy was compared with a chemotherapy group of patients who received it. The patients who had received first- to third-line chemotherapy between June 2007 and November 2015 at our hospital were also analyzed. Results During the study period, 46 patients did not receive chemotherapy, while 148, 89, and 48 received first-, second- and third-line chemotherapy, respectively. As predictive factors for unlikely chemotherapy, multivariate logistic analysis detected Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥2, hemoglobin <13.2 g/dL, creatinine clearance (Ccr) <50.4 mL/min, and CRP ≥0.53 mg/dL. As factors predicting shorter survival after chemotherapy, multivariate Cox proportional-hazard analyses detected age ≥75 years, ECOG PS ≥2, lower lymphocyte counts, and higher CRP for the first line; female, higher neutrophil counts, lower lymphocyte counts, reduced Ccr, hyponatremia, and shorter interval between first- and second-line chemotherapy for the second line; and age ≥75 years, body mass index <18.5 kg/m2, higher neutrophil counts, lower lymphocyte counts, hyponatremia, higher lactate dehydrogenase, and higher CRP for the third line. Conclusion Approximately 76% of patients were treated with first-line chemotherapy. Of those patients, 61% and 34% proceeded to second- and third

  6. Comparison of efficacy of different route of administration of chemotherapy on unresectable, advanced gastric cancer

    Directory of Open Access Journals (Sweden)

    Zhang Caihua

    2012-08-01

    Full Text Available Abstract Background The aim of this study was to compare the efficacy of two neoadjuvant chemotherapies (FLEEOX and XELOX with different routes of administration for unresectable gastric cancer. Methods A total of 85 patients with unresectable gastric cancer hospitalized from January 2007 to December 2009 received neoadjuvant chemotherapy. The FLEEOX group (48 patients received the FLEEOX regimen(fluorouracil, leucovorin, http://epirubicin, epotoside, and oxaliplatin, which combined arterial with venous administration for one or two cycles, while the XELOX group (37 patients received XELOX (capecitabine plus oxaliplatin via venous administration for two to four cycles. The clinical response and overall survival of the two groups were compared. Results In the FLEEOX group, the clinical response rate (RR of chemotherapy was 85.4% (41 of 48 patients and the median survival time was 25 months. The 1-year and 2-year disease-free survival (DFS rates were 85.4% and 45.8%, respectively. In the XELOX group, the clinical RR was 59.5% and the median survival time was 9 months, while the 1-year and 2-year survival rates were 35.2% and 8.3%, respectively. The clinical RR, the R0 resection rate, the median survival time, and the 1-year and 2-year DFS rates were significantly better (P 0.05 in the FLEEOX group than in the XELOX group. In addition, there were no significant differences in the rates of toxic and adverse reactions or post-operative complications between the two groups. Conclusions For patients with a preoperative diagnosis of unresectable gastric cancer, the efficacy of the FLEEOX regimen, which combines arterial with venous administration, was better than that of the XELOX regimen, using venous administration only. This combination of arterial and venous administration could be useful for improving the efficacy of neoadjuvant chemotherapy for gastric cancer.

  7. Recent advances in photodynamic diagnosis of gastric cancer using 5-aminolevulinic acid.

    Science.gov (United States)

    Koizumi, Noriaki; Harada, Yoshinori; Minamikawa, Takeo; Tanaka, Hideo; Otsuji, Eigo; Takamatsu, Tetsuro

    2016-01-21

    Photodynamic diagnosis based on 5-aminolevulinic acid-induced protoporphyrin IX has been clinically applied in many fields based upon its evidenced efficacy and adequate safety. In order to establish a personalized medicine approach for treating gastric cancer patients, rapid intraoperative detection of malignant lesions has become important. Feasibility of photodynamic diagnosis using 5-aminolevulinic acid for gastric cancer patients has been investigated, especially for the detection of peritoneal dissemination and lymph node metastasis. This method enables intraoperative real-time fluorescence detection of peritoneal dissemination, exhibiting higher sensitivity than white light observation without histopathological examination. The method also enables detection of metastatic foci within excised lymph nodes, exhibiting a diagnostic accuracy comparable to that of a current molecular diagnostics technique. Although several complicating issues still need to be resolved, such as the effect of tissue autofluorescence and the insufficient depth penetration of excitation light, this simple and rapid method has the potential to become a useful diagnostic tool for gastric cancer, as well as urinary bladder cancer and glioma.

  8. Robotic surgery of locally advanced gastric cancer: a single-surgeon experience of 41 cases.

    Science.gov (United States)

    Vasilescu, C; Procopiuc, L

    2012-01-01

    The mainstay of curative gastric cancer treatment is open gastric resection with regional lymph node dissection. Minimally invasive surgery is yet to become an established technique with a well defined role. Robotic surgery has by-passed some of the limitations of conventional laparoscopy and has proven both safe and feasible. We present our initial experience with robotic surgery based on 41 gastric cancer patients. We especially wish to underline the advantages of the robotic system when performing the digestive tract anastomoses. We present the techniques of end-to-side eso-jejunoanastomoses (using a circular stapler or manual suture) and side-to-side eso-jejunoanastomoses. In our hands, the results with circular stapled anastomoses were good and we advocate against manual suturing when performing anastomoses in robotic surgery. Moreover, we recommend performing totally intracorporeal anastomoses which have a better post-operative outcome, especially in obese patients. We present three methods of realising the total intracorporeal eso-jejuno-anastomosis with a circular stapler: manual purse-string suture, using the OrVil and the double stapling technique. The eso-jejunoanastomosis is one of the most difficult steps in performing the total gastrectomy, but these techniques allow the surgeon to choose the best option for each case. We consider that surgeons who undertake total gastrectomies must have a special training in performing these anastomoses.

  9. Intermittent Chemotherapy and Erlotinib for Nonsmokers or Light Smokers with Advanced Adenocarcinoma of the Lung: A Phase II Clinical Trial

    Directory of Open Access Journals (Sweden)

    Matjaz Zwitter

    2011-01-01

    Full Text Available Background. Intermittent application of chemotherapy and tyrosine kinase inhibitors may avoid antagonism between the two classes of drugs. This hypothesis was tested in a Phase II clinical trial. Patients and Methods. Eligible patients were nonsmokers or light smokers, chemo-naïve, with metastatic adenocarcinoma of the lung. Treatment: 4 to 6 cycles of gemcitabine 1250 mg/m2 on days 1 and 4, cisplatin 75 mg/m2 on day 2, and erlotnib 150 mg daily on days 5–15, followed by erlotinib as maintenance. Results. 24 patients entered the trial. Four pts had grade 3 toxicity. Complete remission (CR and partial remission (PR were seen in 5 pts and 9 pts, respectively (response rate 58%. Median time to progression (TTP was 13.4 months and median overall survival (OS was 23 months. When compared to patients with negative or unknown status of EGFR mutations, 8 patients with EGFR gene activating mutations had significantly superior experience: 4 CR and 4 PR, with median TTP 21.5 months and OS 24.2 months (P  <  .05. Conclusions. Intermittent schedule with gemcitabine, cisplatin and erlotinib has mild toxicity. For patients who are positive for EGFR gene activating mutations, this treatment offers excellent response rate, time to progression and survival.

  10. Gastric metastasis from primary lung adenocarcinomamimicking primary gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Min Ji Kim; Ji Hyung Hong; Eun Su Park; Jae Ho Byun

    2015-01-01

    Gastric metastases from lung adenocarcinoma arerare. Because gastric metastasis grossly resemblesadvanced gastric cancer, it is difficult to diagnose gastricmetastasis especially when the histology of the primarylung cancer is adenocarcinoma. We describe a case ofgastric metastasis from primary lung adenocarcinomamimicking Borrmann type Ⅳ primary gastric cancer.A 68-year-old man with known lung adenocarcinomawith multiple bone metastases had been experiencingprogressive epigastric pain and dyspepsia over one year.Esophagogastroduodenoscopy revealed linitis plasticalikelesions in the fundus of the stomach. Pathologicexamination revealed a moderately differentiatedadenocarcinoma with submucosal infiltration. Positiveimmunohistochemical staining for thyroid transcriptionfactor-1 (TTF-1) and napsin A (Nap-A) confirmed thatthe metastasis was pulmonary in origin. The patienthad been treated with palliative chemotherapy for thelung cancer and had lived for over fifteen months afterthe diagnosis of gastric metastasis. Clinicians should beaware of the possibility of gastric metastasis in patientswith primary lung adenocarcinoma, and additionalimmunohistochemical staining for Nap-A as well as TTF-1may help in differentiating its origin.

  11. Effect of Yunpi Huoxue soup combined chemotherapy on T lymphocyte subsets and nutritional status in patients with advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Yi-Jiao Huang; Pei Xiang; Wei-Min Zhu

    2016-01-01

    Objective:To observe the effect of Yunpi Huoxue soup combined with chemotherapy on T lymphocyte subsets and nutritional status in patients with advanced gastric cancer.Methods:A total of 94 cases patients with advanced gastric cancer were randomly divided into the treatment group (49 cases) and the control group (45 cases) according to the results of the draw. The control group was given chemotherapy, the treatment group was given Yunpi Huoxue soup on the basis of the control group. Treated for 6 weeks, observed the changes of T cell subsets (CD3, CD4, CD8 and CD4/CD8) and nutrition indexes: total protein (TP), albumin (ALB), prealbumin (PA) and transferrin (TRF) in the two groups.Results:After treatment, CD3, CD4, CD8 and CD4/CD8 in the treatment group were (57.38±4.03), (31.63±4.26), (30.82±3.52) and (1.16±0.20 ) respectively, there were no significant differences compared with before treatment; After treatment, the levels of CD3, CD4, CD8 and CD4/CD8 in the control group were significantly lower than those before treatment, and the differences were statistically significant; After treatment, the levels of CD3, CD4, CD8 and CD4/CD8 in the treatment group were significant higher than those in the control group after treatment, and the differences were statistically significant. After treatment, TP, ALB, PA and TRF in the treatment group were(54.22±5.93) g/L, (32.47±4.97) g/L, (2.52±0.43) g/L and (1.66±0.40) g/L respectively, there were no significant differences compared with before treatment; After treatment, the levels of TP, ALB, PA and TRF in the control group were significantly lower than those before treatment; After treatment, the levels of TP, ALB, PA and TRF in the treatment group were significant higher than those in the control group after treatment, and the differences were statistically significant.Conclusion:When chemotherapy for patients with advanced gastric cancer, Yunpi Huoxue soup is helpful to maintain the immune function and

  12. The Clinical Research in Advanced Stage Gastric Cancer Accompanying Hemorrhage with EHLF Chemotherapy and Thrombin to Take Orally

    Institute of Scientific and Technical Information of China (English)

    Chen Huoguo

    2003-01-01

    Purpose:Study therapeutic effectiveness about EHLF chemotherapy and thrombin to take orally in advanced stage gastriccancer accompanying hemorrhage.Methods:76 cases were divided into two groups at random,that were diagnosed by pathology andclinical. Research group included medicine:(etoposide)VP-16,100 mg intravenous drip,d1~3;(hydroxycamptothecin)HCPT, 10mg,ivtravenous drip,d1~5;(calciumfolinate)CF, 100 mg,intravenous drip,d1~5;(fluorouracil)5-Fu,0.5,intravenous drip,d1~5;thrombin,5oou,oral administration,three times in a day, d1~7.Matched control:normal regulation to medicine in gastric hemorrhye.Results:Effective rate in research group was 78.4%,obvious better than one in matched control 28.2%(P<0.01),bad reaction wasslight, life quantity was obvious exaltation.Conclusion:EHLF chemotherapy and thrombin to take orally was used as treatment project inadranced stage gastric cancer accompanying hemorrhage,good result in research group. It is worthy to deserve further reseach.

  13. [Effectiveness of chemoradiotherapy for a patient with local recurrence of advanced gastric cancer followed by curable gastrectomy].

    Science.gov (United States)

    Natsume, Soichiro; Iwasaki, Yoshiaki; Yajima, Kazuhito; Yuu, Ken; Oohinata, Ryouki; Ishiyama, Satoshi; Takahashi, Keiichi; Maeda, Yoshiharu

    2014-11-01

    We report here the effectiveness of chemoradiotherapy for a patient with local recurrence followed by curable gastrectomy. A 57-year-old man presented with a history of total gastrectomy with distal pancreatectomy and splenectomy, D2 lymphadenectomy, and Roux-en-Y reconstruction for advanced gastric cancer arising from the cardia. Esophageal intramural metastasis and lymph node metastasis around the right recurrent nerve were detected by chest-abdominal computed tomography and gastrointestinal endoscopy 27 months after the initial gastrectomy. Stable disease was achieved following 7 courses of chemotherapy using S-1 plus CDDP. Concurrent chemoradiotherapy including administration of S-1 and radiation of total 50 Gy (2 Gy/25 Fr) was selected for local tumor control. The patient was not able to eat solid food because of esophageal stenosis from regrowth of intramural metastasis of the esophagus 60 months after the chemotherapy. A WallFlex™ Duodenal Stent was placed to improve the dysphagia 67 months after chemotherapy. The patient died from recurrence of gastric cancer 69 months after completion of the initial chemotherapy and 2 months after the stent insertion.

  14. The efficacy and safety of S-1-based regimens in the first-line treatment of advanced gastric cancer : a systematic review and meta-analysis

    NARCIS (Netherlands)

    Ter Veer, Emil; Mohammad, Nadia Haj; Lodder, Paul; Ngai, Lok Lam; Samaan, Mary; van Oijen, Martijn G H; van Laarhoven, Hanneke W M

    2016-01-01

    BACKGROUND: S-1 is first-line therapy for advanced gastric cancer in Asia and is used with increased frequency in Western counties. We conducted a meta-analysis to investigate the efficacy and toxicity of S-1-based therapy compared with 5-fluorouracil (5-FU)/capecitabine-based therapy and S-1-based

  15. Benefits of intra-operative systemic chemotherapy during curative surgery in patients with locally advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    MENG Qing-bin; YU Jian-chun; MA Zhi-qiang; KANG Wei-ming; ZHOU Li; YE Xin

    2013-01-01

    Background There is little information on the impact of intra-operative systemic chemotherapy on gastric cancer.The aim of this study was to identify prognostic factors in patients with locally advanced gastric cancer and undergoing curative resection,with a focus on evaluating survival benefits and tolerance of intra-operative systemic chemotherapy.Methods We retrospectively analyzed clinicopathological data for 264 consecutive patients who underwent curative resection for gastric cancer at Peking Union Medical College Hospital from January 2002 to January 2007.Survival curves were plotted using the Kaplan-Meier method and compared using log-rank tests.Univariate and multivariate analyses were performed with the Cox proportional hazard model.Results Patients who received intra-operative systemic chemotherapy had higher 5-year overall survival and 5-year disease-free survival rates (P=0.019 and 0.010,respectively) than patients who did not receive intra-operative systemic chemotherapy.In the subgroup analysis,systemic intra-operative chemotherapy benefited the 5-year overall survival and disease-free survival rates for patients with cancer of stage pTNM ⅠB-ⅢB,but not stage pTNM ⅢC.Patients who received intra-operative systemic chemotherapy in combination with post-operative chemotherapy had higher 5-year overall survival and 5-year disease-free survival rates (P=0.046 and 0.021,respectively) than patients who only received postoperative chemotherapy.However,the difference in these rates between patients who received only intra-operative systemic chemotherapy and patients who only received curative surgery was not statistically significant (P=0.150 and 0.170,respectively).Multivariate analyses showed that intra-operative systemic chemotherapy was a favorable prognostic factor for the overall survival and disease-free survival rates (P =0.048 and 0.023,respectively).No grade 4 toxicities related to intra-operative systemic chemotherapy were recorded within the

  16. Helicobacter pylori-associated malignancies: Genetics, Epidemiology and Gastric Cancer Risk

    NARCIS (Netherlands)

    L.G. Capelle (Lisette)

    2010-01-01

    textabstractHelicobacter pylori infection affects at least 50% of the world population. The chronic inflammation caused by H. pylori can progress to pre-malignant gastric lesions, gastric adenocarcinoma and gastric MALT lymphoma. The widespread high prevalence of H. pylori explains that gastric canc

  17. Molecular heterogeneity assessment by next-generation sequencing and response to gefitinib of EGFR mutant advanced lung adenocarcinoma.

    Science.gov (United States)

    Bria, Emilio; Pilotto, Sara; Amato, Eliana; Fassan, Matteo; Novello, Silvia; Peretti, Umberto; Vavalà, Tiziana; Kinspergher, Stefania; Righi, Luisella; Santo, Antonio; Brunelli, Matteo; Corbo, Vincenzo; Giglioli, Eliana; Sperduti, Isabella; Milella, Michele; Chilosi, Marco; Scarpa, Aldo; Tortora, Giampaolo

    2015-05-20

    Cancer molecular heterogeneity might explain the variable response of EGFR mutant lung adenocarcinomas to tyrosine kinase inhibitors (TKIs). We assessed the mutational status of 22 cancer genes by next-generation sequencing (NGS) in poor, intermediate or good responders to first-line gefitinib. Clinical outcome was correlated with Additional Coexisting Mutations (ACMs) and the EGFR Proportion of Mutated Alleles (PMA). Thirteen ACMs were found in 10/17 patients: TP53 (n=6), KRAS (n=2), CTNNB1 (n=2), PIK3CA, SMAD4 and MET (n=1 each). TP53 mutations were exclusive of poor/intermediate responders (66.7% versus 0, p=0.009). Presence of ACMs significantly affected both PFS (median 3.0 versus 12.3 months, p=0.03) and survival (3.6 months versus not reached, p=0.03). TP53 mutation was the strongest negative modifier (median PFS 4.0 versus 14.0 months). Higher EGFR PMA was present in good versus poor/intermediate responders. Median PFS and survival were longer in patients with EGFR PMA ≥0.36 (12.0 versus 4.0 months, p=0.31; not reached versus 18.0 months, p=0.59). Patients with an EGFR PMA ≥0.36 and no ACMs fared significantly better (p=0.03), with a trend towards increased survival (p=0.06). Our exploratory data suggest that a quantitative (PMA) and qualitative (ACMs) molecular heterogeneity assessment using NGS might be useful for a better selection of patients.

  18. Class III β-tubulin in advanced NSCLC of adenocarcinoma subtype predicts superior outcome in a randomized trial

    DEFF Research Database (Denmark)

    Vilmar, Adam Christian; Santoni-Rugiu, Eric; Sørensen, Jens Benn

    2011-01-01

    Platinum-based doublets are the cornerstone of treatment in advanced non-small-cell lung cancer (NSCLC) and often include vinorelbine or taxanes. A predictive biomarker is greatly needed to select chemotherapy-sensitive patients for these microtubule-interfering agents. Class III β-tubulin (TUBB3......) has been shown of value in NSCLC, but evidence is not uniform. Accordingly, we explored the predictive role of TUBB3 in advanced NSCLC....

  19. IQGAP1 in rectal adenocarcinomas

    DEFF Research Database (Denmark)

    Holck, Susanne; Nielsen, Hans Jørgen; Hammer, Emilie;

    2015-01-01

    Treatment of rectal adenocarcinoma includes total mesorectal excision, which is preceded by radiochemotherapy (RCT) in cases of advanced disease. The response to RCT varies from total tumor regression to no effect but this heterogeneous response is unexplained. However, both radiation and treatme...

  20. Evaluation of the efficacy and toxicity of protocol cisplatin, 5-fluorouracil, leucovorin compared to protocol fluorouracil, doxorubicin and mitomycin C in locally advanced and metastatic gastric cancer

    Directory of Open Access Journals (Sweden)

    Andrić Zoran

    2012-01-01

    Full Text Available Introduction. Still there is no consensus on the choice of the most efficient and the least toxic chemotherapy regimen in the treatment of advanced gastric cancer. Nowadays few therapy protocols are available for treating this disease. Objective. Study was conducted to compare the efficacy and toxicity of FAM (flurouracil, doxorubicin, mitomycin C with CDDP and FU/FA (cisplatin, 5-fluorouracil, leucovorin protocols in patients with locally advanced and metastatic gastric cancer. Methods. This randomized study involved a group of 50 patients with locally advanced or metastatic gastric cancer, who had not previously undergone chemotherapy treatment. Progression free survival, overall survival and drug toxicity were evaluated. For statistical analysis chi-square test, Kaplan-Meier curve and the log rank test were used. Results. The overall response rate was 20% in the group treated with FAM and 24% in the group treated with CDDP, FU/FA (4% of patients from each group had complete response, but without significant statistical difference. Median survival was 10.9 months in the FAM group and 11.8 months in CDDP, FU/FA group, with no statistically significant difference. Non-haematological and haematological toxicities of CDDP, FU/FA were considerably less frequent than of FAM, and there was no treatment related deaths in any of the groups. Conclusion. Both investigated regimens demonstrated moderate efficacy. The study shows in favour of justified application of both protocols, while in regard to toxicity CDDP and FU/FA can be recommended as preferable treatment for locally advanced and metastatic gastric cancer. New strategies should be considered for better efficacy in the treatment of advanced gastric cancer. New strategies are necessary with the goal to achieve a better therapeutic effect.

  1. Pathological Features of Gastric Cancer in Zhuanghe High-risk Area in China during 1992-2005

    Institute of Scientific and Technical Information of China (English)

    GONG Yue-hua; SUN Li-ping; LIU Yan-hou; HUANG he; SUN Guo-peng; WANG Quan-gang; YIN Yuan-jun; YUAN Yuan

    2008-01-01

    Objective:To investigate the pathological features and chronological changes of 1003 cases with gastric cancer in Zhuanghe high-risk area during 1992-2005 and the relationship between the changes and etiology factors in order tO make a clue for gastric cancer prevention. Methods:A total of 1003 gastric cancer specimens resected surgically between 1992-2005 in Zhuanghe Center Hospital were studied.The specimens were fixed in formalin and diagnosed by routine pathology. Results:The incidence of patients with gastric cancer was highest at age of 60-69,the next high was at age of 50-59 and it was significantly higher in male than in female(P<0.001),the ratio was 3.0∶1.During the past 14 years,there were 159(15.9%)EGC,195(19.4%)moderate and 649(64.7%)advanced gastric cancer detected.In macroscopical features,type Ⅲ remained dominant in EGC,the next was mixed type in EGC.In advanced gastric cancer the Borrmann's type Ⅲ remained the dominant,the next was type Ⅱ.For nodal metastasis,positive cases were decreasing and negative were increasing in EGC,moreover negative cases were higher than positive ones each year.There was no obvious trend in advanced cancer but positive cases were higher than negative ones each year.In histological features,papillary,moderately and poorly differentiated tubular adenocarcinoma remained downtrend,mucus adenocarcinoma and undifferentiation cancer remained uptrend year after year.The radio of intestinal to diffuse type decreased from 0.78 to 0.62 during the past 14 years. Conclusion:There were significant chorological trends of pathological characteristic of gastric cancer in Zhuanghe high-risk area during the past 14 years.

  2. Expression of ATP7B in human gastric cardiac carcinomas in comparison with distal gastric carcinomas

    Institute of Scientific and Technical Information of China (English)

    Da-Long Wu; Hui-Xing Yi; Feng-Ying Sui; Xiao-Hong Jiang; Xiao-Ming Jiang; Ying-Ying Zhao

    2006-01-01

    AIM: To analyze expression of ATP7B in gastric cardiac adenocarcinomas, its clinicopathologic significance, in comparison with distal gastric adenocarcinomas.METHODS: Immunohistochemical avidin-biotin peroxidase complex method was applied to detect the expression of ATP7B in 49 cases of cardiac carcinomas,the corresponding adjacent non-neoplastic epithelium and 55 cases of distal gastric carcinomas.RESULTS: The proportion of ATP7B positive samples in gastric cardiac carcinomas (51.0%, 25 of 49) was significantly higher than that in the corresponding adjacent non-neoplastic epithelium (22.4%, 11 of 49)(P = 0.003). ATP7B expression in poorly differentiated gastric cardiac carcinomas was significantly higher than that in well/moderately differentiated gastric cardiac carcinomas (P = 0.030). ATP7B expression in gastric cardiac carcinomas was independent of age, tumor size, nodal stage and metastasis status. ATP7B protein was detected in 30.9% (17/55 cases) of distal gastric carcinomas, markedly lower than that in gastric cardiac carcinomas (P = 0.037).CONCLUSION: ATP7B protein is frequently overexpressed in gastric cardiac carcinomas, and correlated with the differentiation of cardiac carcinoma. ATP7B expression in gastric cardiac carcinomas is significantly higher than that in distal gastric carcinomas, which might partially explain the difference of chemotherapy response and prognosis between these two gastric carcinomas.

  3. HER-2/neu Testing and Therapy in Gastroesophageal Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Cathy B. Moelans

    2011-01-01

    Full Text Available Despite ongoing advances in the treatment of gastroesophageal cancer, prognosis remains poor. The best promise to improve this poor survival is provided by new targeted agents. Of these, human epidermal growth factor receptor 2 (HER2 is currently in the spotlight. In this review, we provide an overview of recent developments in HER2 testing and results of clinical trials targeting HER2 in gastroesophageal adenocarcinoma. Based on the encouraging ToGA trial findings it is now expected that routine HER2 testing will be included in the diagnostic work-up of patients with advanced gastric cancer. With regard to this testing, overexpression of the HER2 protein seems to possess the best predictive properties. However, HER2 immunohistochemistry (IHC is subject to assay and interobserver variability, so standardization and internal and external proficiency testing is an absolute prerequisite, especially as the IHC scoring system in gastric cancer is different from that of breast cancer. Further study is needed to investigate the clinical meaning of the significant heterogeneity observed in both gene amplification and protein overexpression in gastroesophageal cancer. Highly effective therapies for gastroesophageal cancer can only be accomplished by a multi-targeted approach, considering crosstalk between pathways and continuing to optimize chemotherapy.

  4. Efficacy and safety of neoadjuvant chemotherapy with modified FOLFOX7 regimen on the treatment of advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jun; CHEN Ren-xiong; ZHANG Jing; CAI Jun; MENG Hua; WU Guo-cong; ZHANG Zhong-tao; WANG Yu; WANG Kang-li

    2012-01-01

    Background Gastric cancer is one of the most common types of malignant tumors in China and East Asia and has the highest mortality rate of the malignant gastrointestinal tumors.Neoadjuvant chemotherapy is a systemic or local chemotherapy that is given prior to the local treatment of malignant tumors.Neoadjuvant therapy is currently showing some positive prospects; however,its clinical effects remain controversial.In this study,we used the modified FOLFO×7 (mFOLFO×7) regimen as a neoadjuvant chemotherapy regimen.Perioperative clinical and pathological efficacy,toxicity,effects of surgery,postoperative observation,and prognosis were studied to investigate its clinical efficacy and safety.Methods Eighty patients with advanced gastric cancer were treated in our surgery department from 2005 to 2009; 38 of these patients received mFOLFO×7 neoadjuvant chemotherapy,the other 42 patients assigned to the control group.The perioperative effects of mFOLFO×7 chemotherapy,including clinical effects and toxicity,were observed in each patient.Results After mFOLFO×7 chemotherapy,clinical and pathologic stages decreased in 21.1% and 36.8% of the patients,respectively,but the results were not statistically significant (P=0.129).The clinical response rate was 50% (19/38).Toxicity was mild; most adverse events were grade I or ll and involved no severe infections or deaths.Compared with the control group,the radical resection rate increased (92.1% vs.85.7%; P=0.437); surgical effects were completed without an increased incidence of perioperative complications.The 1-,2-,and 3-year survival rates were 78.70%,57.40%,and 51.66%,respectively,in the neoadjuvant chemotherapy group and 78.57%,56.87%,and 43.16%,respectively,in the control group.Conclusions The mFOLFO×7 regimen was very effective and well-tolerated as a neoadjuvant chemotherapy for advanced gastric cancer.However,the 1-,2-,and 3-year survival rates in the mFOLFO×7 group were not significantly

  5. The influence of advanced age on the morbi-mortality of gastric cancer after curative surgery

    Directory of Open Access Journals (Sweden)

    Araceli Mayol-Oltra

    2013-04-01

    Full Text Available Introduction: gastric cancer (GC is the fourth leading cause of cancer death in Spain after lung, colorectal, breast and prostate tumours. Surgery remains the only potentially curative treatment in localized gastric cancer. Objective: the aim of our study is to evaluate and compare the clinical and surgical aspects, development of postoperative complications and outcomes of patients over 75 years old compared with younger patients in our centre. Material and methods: comparative retrospective study, from March 2003 to June 2011. We diagnosed 166 cases of GC, 109 (65 % underwent curative surgery. Two groups were settled: group M: ≥ 75 years (41 patients and group m: < 75 years (68 patients. We analyzed age, sex, comorbidities, tumour location, clinical stage, perioperative chemotherapy, surgical technique, postoperative complications, recurrence and mortality from cancer. Results: a more frequent presence of cardiovascular comorbidities and a greater postoperative mortality by medical causes were the only significant differences between both groups. Also, a lower proportion of patients in group M received preoperative chemotherapy and underwent D1 lymphadenectomy. However, the rate of local and systemic recurrence and overall survival were similar in both groups. Conclusions: age should not be considered a contraindication for curative surgery on GC. The general condition and comorbidities are more important to contraindicate surgical treatment.

  6. Phenotyping of peripheral blood mononuclear cells of patients with advanced heavily pre-treated adenocarcinoma of the stomach and gastro-esophageal junction.

    Science.gov (United States)

    Kuehnle, Marie-Cristine; Attig, Sebastian; Britten, Cedrik M; Schulze-Bergkamen, Henning; Lordick, Florian; von Wichert, Goetz; Thuss-Patience, Peter; Stein, Alexander; Schuler, Martin; Bassermann, Florian; Sahin, Ugur; Türeci, Ozlem

    2014-12-01

    Immunotherapeutic approaches are emerging as promising new treatment options for patients with solid cancers. The host immune system in cancer patients is dysfunctional due to a number of reasons. The level of immunosuppression is variable at the time of diagnosis and depends on the particular cancer entity, stage, and prior anti-cancer therapies. For many cancer entities, the immune alterations of the respective patient population have not been further characterized even though a patient's immunophenotype may be prognostic for the course of the disease or predictive for clinical/biological response to immunotherapy. In this study, we used flow cytometry to determine the phenotype of peripheral blood mononuclear cells (PBMCs) from 30 patients with heavily pre-treated, advanced adenocarcinoma of the stomach and gastro-esophageal junction. The frequencies and activation status of relevant immune effector populations were determined in PBMCs and compared to those of healthy individuals. This report provides comprehensive immune phenotyping data of a patient population with a high medical need.

  7. Class III β-tubulin in advanced NSCLC of adenocarcinoma subtype predicts superior outcome in a randomized trial

    DEFF Research Database (Denmark)

    Vilmar, Adam Christian; Santoni-Rugiu, Eric; Sørensen, Jens Benn

    2011-01-01

    Platinum-based doublets are the cornerstone of treatment in advanced non-small-cell lung cancer (NSCLC) and often include vinorelbine or taxanes. A predictive biomarker is greatly needed to select chemotherapy-sensitive patients for these microtubule-interfering agents. Class III ß-tubulin (TUBB3...

  8. Clinicopathological characteristics of Barrett's carcinoma, cardia carcinoma type II and distal gastric carcinoma: Influence of observed parameters on the five-year postoperative survival of patients

    Directory of Open Access Journals (Sweden)

    Jovanović Ivan

    2009-01-01

    Full Text Available Introduction. In the past two decades, the increased frequency of distal esophageal adenocarcinoma, esophagogastric junction and proximal gastric adenocarcinoma has been observed. The vast majority of these tumours are diagnosed in advanced stages, when the prognosis is poorer than in other gastric cancers. Objective. The aim of our study was to analyze the demographic and clinicopathological characteristics of patients operated on for Barrett's, cardia and distal gastric adenocarcinomas, as well as to study the influence of manifestations of each cancerogenetic indication on the studied clinicopathological parameters and to analyze the 5-year survival rate of patients surgically treated for cardia adenocarcinoma in relation to the patients operated on for distal gastric adenocarcinoma. Methods. We analyzed gender and age, tumour type, depth of tumour invasion, involvement of blood and lymph vessels in 66 patients surgically treated at the Centre for Oesophageal Surgery of the Institute for Digestive Diseases of the Belgrade Clinical Centre. Results. Except for significant differences in the depth of tumour invasion during surgery, there were no other statistically significant differences between the studied groups of patients. In the patients operated on for Barrett's and cardia cancers, the tumours invaded more deeply the wall layers, i.e. they were significantly more invasive than the distal gastric tumour. The lymph node involvement was present in 87.5% of patients with Barrett's cancer, in 80% with cardia cancer and in 87% with distal gastric cancer. The 3-year survival rate of patients operated on for cardia cancer was 47.4% and the 5-year survival rate was 31.6%, while the 3-year survival rate of patients operated on for distal gastric cancer was 46.2% and the 5-year survival rate was 34.6%. These differences were not statistically significant (Wilcoxon 0,036; p=0,85. Singly, the patients' gender, cancer type and the degree of tumour

  9. [Treatment of S-1 plus weekly CDDP for advanced gastric cancer].

    Science.gov (United States)

    Kemmochi, Takeshi; Egawa, Tomohisa; Mihara, Yasunori; Irino, Tomoyuki; Ito, Yasuhiro; Nagashima, Atsushi; Makino, Hiroyuki; Yamamuro, Wataru

    2011-11-01

    We analyzed the clinical efficacy and safety of chemotherapy using S-1 plus weekly CDDP( w-CS therapy) for unresectable gastric cancer. Twenty one patients were treated with this treatment. S-1 80 mg/m²/day was administered for 2 weeks followed by a 1-week rest. CDDP 20 mg/m² was injected intravenously on day 1 and 8. The overall response rate was 52. 3%. The disease control rate was 85.7%. Grade 3 or 4 major toxicity comprised neutropenia (14.2%), thrombocytopenia (4.7%) and plasma creatinine elevation (4.7%). w-CS therapy is satisfied resulting with efficacy and safety. Thus, future clinical trials and accumulation of futher cases are warranted.

  10. Expression of macrophage migration inhibitory factor is associated with enhanced angiogenesis and advanced stage in gastric carcinomas

    Institute of Scientific and Technical Information of China (English)

    Chia-Tung Shun; Jaw-Town Lin; Shih-Pei Huang; Min-Tsan Lin; Ming-Shiang Wu

    2005-01-01

    AIM: Macrophage migration inhibitory factor (MIF) was reported to inactivate p53 and play an essential role in the growth and angiogenesis of tumors that arise at sites of chronic inflammation. Gastric inflammation is a prerequisite for the development of gastric carcinoma (GC), which has recently been linked to Helicobacter pylori(H pylori)infection. This study aimed to investigate dinicopathologicalsignificance of MIF expression in GCs.METHODS: We selected 90 consecutive patients with GCs for investigation of the relation among MIF status, clinicopathological parameters, p53 expression and angiogenesis. MIF and p53 expression was assessed by immunohistochemistry as positive and negative groups. Tumor vascularity was evaluated by counting microvessel density on anti-CD34 stained sections. Expression status of MIF was correlated with determined clinicopathological data, p53 immunoreactivity and microvessel counts.RESULTS: Strong immunostainings of MIF were observed in the cytoplasm of cancerous cells in 40% (36/90) of cases but not in normal or metaplastic epithelia. There was no statistically significant correlation between MIFexpression and age, gender, H pylori infection, tumor location, histological subtypes, lymph node metastasis or p53 expression. Early GC less frequently overexpressed MIFas compared to advanced GCs (4/20 vs 32/70, P = 0.04).A remarkably increased microvessel count was noted inGCs with MIF expression than those without MIF expression (55.1±30.1 vs 31.3±28.8, P= 0.0001).CONCLUSION: Our results suggest that expression of MIF may contribute to the progression and enhanced angiogenesis in a substantial portion of GCs.

  11. Pilot study of postoperative adjuvant chemoradiation for advanced gastric cancer: Adjuvant 5-FU/cisplatin and chemoradiation with capecitabine

    Institute of Scientific and Technical Information of China (English)

    Hyung-Sik Lee; Min-Chan Kim; Youngmin Choi; Won-Joo Hur; Hyo-Jin Kim; Hyuk-Chan Kwon; Sung-Hyun Kim; Jae-Seok Kim; Jong-Hoon Lee; Ghap-Joong Jung

    2006-01-01

    AIM: To evaluate the efficacy and toxicity of postoperative chemoradiation using FP chemotherapy and oral capecitabine during radiation for advanced gastric cancer following curative resection.METHODS: Thirty-one patients who had underwent a potentially curative resection for Stage Ⅲ and Ⅳ (MO) gastric cancer were enrolled. Therapy consists of one cycle of FP (continuous infusion of 5-FU 1000 mg/m2 on d 1 to 5 and cisplatin 60 mg/m2 on d 1) followed by 4500 cGy (180 cGy/d) with capecitabine (1650 mg/m2 daily throughout radiotherapy). Four wk after completion of the radiotherapy, patients received three additional cycles of FP every three wk. The median follow-up duration was 22.2 mo.RESULTS: The 3-year disease free and overall survival in this study were 82.7% and 83.4%, respectively. Four patients (12.9%) showed relapse during follow-up. Eight patients did not complete all planned adjuvant therapy.Grade 3/4 toxicities included neutropenia in 50.2%, anemia in 12.9%, thrombocytopenia in 3.2% and nausea/vomiting in 3.2%. Neither grade 3/4 hand foot syndrome nor treatment related febrile neutropenia or death were observed.CONCLUSION: These preliminary results suggest that this postoperative adjuvant chemoradiation regimen of FP before and after capecitabine and concurrent radiotherapy appears well tolerated and offers a comparable toxicity profile to the chemoradiation regimen utilized in INT-0116. This treatment modality allowed successful loco-regional control rate and 3-year overall survival.

  12. Identification of novel genes involved in gastric carcinogenesis by suppression subtractive hybridization.

    Science.gov (United States)

    Mottaghi-Dastjerdi, N; Soltany-Rezaee-Rad, M; Sepehrizadeh, Z; Roshandel, G; Ebrahimifard, F; Setayesh, N

    2015-01-01

    Gastric cancer (GC) is one of the most common and life-threatening types of malignancies. Identification of the differentially expressed genes in GC is one of the best approaches for establishing new diagnostic and therapeutic targets. Furthermore, these investigations could advance our knowledge about molecular biology and the carcinogenesis of this cancer. To screen for the overexpressed genes in gastric adenocarcinoma, we performed suppression subtractive hybridization (SSH) on gastric adenocarcinoma tissue and the corresponding normal gastric tissue, and eight genes were found to be overexpressed in the tumor compared with those of the normal tissue. The genes were ribosomal protein L18A, RNase H2 subunit B, SEC13, eukaryotic translation initiation factor 4A1, tetraspanin 8, cytochrome c oxidase subunit 2, NADH dehydrogenase subunit 4, and mitochondrially encoded ATP synthase 6. The common functions among the identified genes include involvement in protein synthesis, involvement in genomic stability maintenance, metastasis, metabolic improvement, cell signaling pathways, and chemoresistance. Our results provide new insights into the molecular biology of GC and drug discovery: each of the identified genes could be further investigated as targets for prognosis evaluation, diagnosis, treatment, evaluation of the response to new anticancer drugs, and determination of the molecular pathogenesis of GC.

  13. Three Weekly Irinotecan and Bolus 5-Fluorouracil Combination in the First Line Treatment of Advanced Gastric Cancer - A Single Institution Experience

    Directory of Open Access Journals (Sweden)

    Mohamed Mesmoudi

    2016-06-01

    Full Text Available Background: The goal of this study is to determine the efficacy and toxicity of a non-platinum based chemotherapy combination using irinotecan associated to bolus 5-FU as first line treatment in advanced gastric cancer. Materiel and methods: Retrospective analysis of a population of patients treated for metastatic and locally advanced gastric cancer with irinotecan and 5-FU as upfront chemotherapy. Results: Thirteen patients were enrolled. The median age was 56 years. Seven patients were males and six were of females. Ten patients had a metastatic disease and three patients had a locally advanced disease. Patients received a total number of 43 cycles of chemotherapy. Overall response rate was 38,4%, median time to progression (TTP was 3 months, and median overall survival was 4 months. Three patients (23,1% presented grade 3 /4 neutropenia complicated with an infectious episode with fever in two cases, three patients (23,1% required blood transfusion for a grade 4 anemia, and one patient (7,6% was hospitalized for a severe episode of diarrhea. Conclusion: Three weekly irinotecan and bolus 5-FU is an interesting combination as first line treatment of advanced gastric cancer; designed clinical trials are needed to confirm the activity of this combination.

  14. The expression and clinical significance of GRP78 and pERK in gastric adenocarcinoma, chronic atrophic gastritis and superifcial gastritis%GRP78和pERK在胃癌及非胃癌组织中的表达及临床意义

    Institute of Scientific and Technical Information of China (English)

    彭春雷; 杨书云; 季进锋; 徐薇薇; 季从飞; 王建红; 谭清和; 杨磊

    2013-01-01

    Background and purpose:In the process of gastric cancer development, cytothesis and apoptosis, and endoplasmic reticulum stress (ERS) are very important pathological processes. Glucose regulated protein 78 (GRP78) and phosphorylated form of extracellular signal-regulated protein kinase (pERK) play important roles in it. This study aimed to investigate the expression of GRP78 and pERK in gastric adenocarcinoma, chronic atrophic gastritis and superficial gastritis, and the role of GRP78 and pERK in the development of gastric adenocarcinoma. Methods:Gastric adenocarcinoma, chronic atrophic gastritis and superifcial gastritis tissues in 60 cases respectively were employed in the study. We chose 25 fresh tissue samples from each group, and the level of GRP78 and pERK mRNA in different tissues were detected by RT-PCR assay. The expressions of GRP78 and pERK in different parafifn samples were detected using immunohistochemistry assay. In addition, the relationships between GRP78 and pERK expression and age, gender, differentiation, invasion, disease stage, and lymphoid node metastasis were analyzed. Results: The expression level of GRP78 and pERK mRNA in gastric adenocarcinoma(1.26±0.18, 2.35±0.36) were significantly higher than chronic atrophic gastritis (0.89±0.25, 1.18±0.25) and superficial gastritis (0.29±0.09, 0.68±0.10, P<0.01). The positive ratio of GRP78 expression in gastric adenocarcinoma, chronic atrophic gastritis and superficial gastritis were 78.3%, 46.6%, 6.7%. The positive ratios of pERK expression were 88.3%, 43.3%, 5.0%, respectively. The GRP78 and pERK expression in different tissues were signiifcantly different (P<0.01). GRP78 and pERK expression were positively correlated with differentiation, disease stage and lymph node metastasis. There was a positive correlation between the gene and protein expression of GRP78 and pERK with a Pearson correlation value of 0.307 and 0.368, respectively. Both univariate and multivariate analysis revealed that

  15. Survival after adjuvant chemoradiotherapy or surgery alone in resectable adenocarcinoma at the gastro-esophageal junction

    DEFF Research Database (Denmark)

    Kofoed, Steen Christian; Muhic, A; Jensen, Lene Bæksgaard;

    2012-01-01

    Longterm survival after curative resection for adenocarcinoma at the gastro-esophageal junction (GEJ) range between 18% and 50%. In the pivotal Intergroup-0116 Phase III trial by Macdonald et all, adjuvant chemoradiotherapy improved both disease-free and overall survival in curatively resected...... patients with mainly gastric adenocarcinoma. We compared survival data for curatively resected patients with adeno-carcinoma solely at the gastro-esophageal junction (GEJ), treated with surgery alone or surgery and adjuvant chemoradio-therapy....

  16. Pre-adjuvant chemotherapy leukocyte count may predict the outcome for advanced gastric cancer after radical resection.

    Science.gov (United States)

    Pei, Dong; Zhu, Fang; Chen, Xiaofeng; Qian, Jing; He, Shaohua; Qian, Yingying; Shen, Hua; Liu, Yiqian; Xu, Jiali; Shu, Yongqian

    2014-03-01

    Gastric cancer (GC) has a high morbidity worldwide each year especially in China and advanced GC is well known with poor prognosis, for which surgical resection combine adjuvant chemotherapy is the optimal choice for therapy. Leukocyte is an important index during the treatment for its influence on drugs' dosage and tolerance. Therefore, peripheral blood leukocyte and its subsets during adjuvant chemotherapy may have great clinical value for predicting prognostic. In this retrospective study, we showed the distribution of white blood cell and its subsets in the baseline period before adjuvant chemotherapy in 399 patients who underwent radical resection for advanced GC from January 1, 2008 to August 31, 2012. We investigated the relationship between leukocyte count and overall survival (OS) as well as disease-free survival (DFS). In these patients, females were more likely to have less white blood cells after operation (P=0.016). Patients with pre-chemotherapy leukocyte count less than 4×10(9)/L got worse DFS (P=0.028) and OS (P=0.016). In multivariate analysis, tumor size ≥ 6cm (P=0.033), TNM stage IV (P=0.024), vascular or nerval invasion (P=0.005) and leukocyte count less than 4.0×10(9)/L (P=0.019) was associated with poor DFS. TNM stage IV (P=0.008), vascular or nerval invasion (P=0.001) and lower leukocyte count (P=0.045) were independent risk factors for poor OS. Taken together, our findings suggest that pre-adjuvant chemotherapy peripheral blood leukocyte count correlates with clinical outcome of patients with advanced GC after radical resection.

  17. FEP regimen (epidoxorubicin, etoposide and cisplatin) in advanced gastric cancer, with or without low-dose GM-CSF: an Italian Trial in Medical Oncology (ITMO) study.

    OpenAIRE

    Bajetta, E; Di Bartolomeo, M.; Carnaghi, C; Buzzoni, R.; Mariani, L; Gebbia, V.; Comella, G.; Pinotti, G; Ianniello, G.; Schieppati, G.; Bochicchio, A. M.; Maiorino, L.

    1998-01-01

    The new regimens developed over the last few years have led to an improvement in the treatment of advanced gastric cancer, and our previous experience confirmed the fact that the combination of etoposide, doxorubicin and cisplatin (EAP regimen) is an active treatment that leads to interesting complete remission rates. The primary end point of the present multicentre, randomized, parallel-group phase II study was to determine the activity of the simplified 2-day EAP schedule in patients with l...

  18. Gastric inverted hyperplastic polyp: A rare cause of iron deficiency anemia

    Science.gov (United States)

    Yun, Jin Tak; Lee, Seung Woo; Kim, Dong Pil; Choi, Seung Hwa; Kim, Seok-Hwan; Park, Jun Kyu; Jang, Sun Hee; Park, Yun Jung; Sung, Ye Gyu; Sul, Hae Jung

    2016-01-01

    Gastric inverted hyperplastic polyp (IHP) is a rare gastric polyp characterized by the downward growth of hyperplastic mucosal components into the submucosal layer. Macroscopically, a gastric IHP resembles a subepithelial tumor (SET); as a result, accurately diagnosing gastric IHP is difficult. This issue has clinical significance because gastric IHP can be misdiagnosed as SET or as malignant neoplasm In addition, adenocarcinoma can accompany benign gastric IHP. Although in most cases, gastric IHPs are asymptomatic and are found incidentally, these polyps may cause anemia secondary to chronic bleeding. Here, we report one case involving gastric IHP accompanied by chronic iron deficiency anemia that was successfully managed using endoscopic submucosal dissection. PMID:27099452

  19. Cross-sectional imaging of gastric neoplasia

    Energy Technology Data Exchange (ETDEWEB)

    Hargunani, R. [Royal Free Hampstead NHS Trust (United Kingdom)], E-mail: rikin@doctors.org.uk; Maclachlan, J. [Royal Free Hampstead NHS Trust (United Kingdom); Kaniyur, S. [Lister Hospital, East and North Hertfordshire NHS Trust (United Kingdom); Power, N. [Barts and The London NHS Trust (United Kingdom); Pereira, S.P. [University College London Hospitals NHS Foundation Trust (United Kingdom); Malhotra, A. [Royal Free Hampstead NHS Trust (United Kingdom)

    2009-04-15

    The detection of gastric neoplasia has traditionally been limited to barium examination and direct visualization at endoscopy. The rapid development of techniques such as multidetector computed tomography (MDCT) and endoscopic ultrasound (EUS) has resulted in more accurate diagnosis and staging of gastric neoplasia. In this review we describe the normal anatomy of the stomach with multi-modality illustrations and review the imaging manifestations of gastric neoplasia, including adenocarcinoma, lymphoma, neuroendocrine and gastro-intestinal stromal tumours. We also describe the optimal techniques for up-to-date and accurate gastric imaging, outlining the role of MDCT and EUS.

  20. Neoadjuvant therapy in advanced gastric cancer:a case report%1例中晚期胃癌新辅助治疗探讨

    Institute of Scientific and Technical Information of China (English)

    刘勇; 张汝鹏; 黄鼎智; 潘源; 梁寒; 肖建宇; 战忠利; 韩如冰; 朱莉; 王宝贵; 巴一

    2013-01-01

      无远处转移的局部进展期胃癌,虽然有手术切除的机会,但与早期胃癌相比预后较差。局部晚期肿瘤不可切除率较高,且根治术后复发率较高。新辅助化疗对胃癌的治疗具有以下优点:减少肿瘤负荷,提高R0切除率,控制微转移,评价肿瘤对细胞毒药物的化疗敏感性。现介绍1例经天津医科大学附属肿瘤医院胃部肿瘤科治疗的进展期胃癌新辅助治疗病例,该患者经多学科协作诊疗后效果较好。通过报道该病例诊治以促进胃癌新辅助治疗经验交流,推动多学科间的合作。%Nearly 41%of the global gastric cancer cases occur in China, and the vast majority of cases in China present as ad-vanced gastric cancer. Advanced gastric cancer without distant metastasis remains a potentially curable disease, but the prognosis is poorer than the early-stage disease. The prognosis of locally advanced tumors is poor because of a high unresectability rate at presenta-tion and a much higher relapse rate after radical surgery. The administration of neoadjuvant chemotherapy has several potential benefits for gastric cancer. It can reduce tumor volume, improve R0 resection rate, act on micrometastases, and evaluate tumor chemosensitivity to cytotoxic medications. The current study presents an advanced gastric cancer patient who underwent neoadjuvant chemotherapy in our hospital. The multimodal treatment achieved a favorable curative effect for the patient. Mechanical diagnosis and therapy promotes comprehensive integration of gastric cancer diagnosis and treatment strategies. Moreover, it can enhance interdisciplinary communica-tion and cooperation among medical colleagues in the same fields.

  1. Treatment of Advanced Gastric Carcinoma Patients with Calcium Folinate, a 5-Fluorouracil Bolus and Continous Infusion with 5-Infusion with 5-Fluorouracil Combined with Oxaliplatin

    Institute of Scientific and Technical Information of China (English)

    Qilian Liang; Saihong Chen; Dachao Pan; Jierong Xie; Liangzhen Cai; Shujun Li

    2008-01-01

    OBJECTIVE To examine the therapeutic effects and toxicity of high-dose-folinic acid plus a 5-fluorouracil (5-FU) bolus and continuous infusion with 5-FU combined with locally produced oxaliplatin (L-HOP)in treating advanced gastric carcinoma patients.METHODS Sixty-five patients with advanced gastric carcinoma were treated with high-dose-folinic acid plus a 5-FU bolus and a 48-h continuous infusion of 5-FU combined with oxaliplatin. The effects of treatment and toxicity were observed.RESULTS There were 4 complete responses, 26 partial responses,30 with no change and 5 with progressive disease. The overall effective response rate was 46.2% (30/65). The median duration was 7 months, with the main side effects including nausea and vomiting, peripheral phlebitis, alopecia, leukopenia, dental ulcers,peripheral neuritis and diarrhea. All the side effects were tolerated and minimal.CONCLUSION The results showed that high-dose folinic acid plus a 5-FU bolus and continuous infusion of 5-FU combined with oxaliplatin appears to be a safe and effective therapy for patients with advanced gastric carcinoma. This therapeutic regimen is of value for these patients.

  2. [P53 protein in adenocarcinoma of the large intestine].

    Science.gov (United States)

    Paluszkiewicz, P; Pawłowska-Wakowicz, B; Cybulski, M; Berbeć, H

    1997-01-01

    P53 gen mutations play significant role in neoplastic transformation of colorectal mucosa. We investigated p53 immunostaining in 80 cases of spontaneous human colorectal adenocarcinomas (with monoclonal DO7 antibody and LSAB+ kit). We found positive, nuclear p53 immunostaining in 64% of nonmucinous adenocarcinoma tissues and in 19% of mucinous adenocarcinomas tissues. P53 protein deposits were most often found in colorectal adenocarcinomas localised in rectum (66.67%) and in advanced (Dukes C, D) colorectal adenocarcinomas (59.38%) as well. There was no statistical significance between the p53 positive immunostaining and the histological differentiation of the colorectal adenocarcinomas. The overall survival of patients with tumours positive for p53 protein was significantly shorter than that of patients with colorectal cancers negative for p53 protein. We conclude that p53 immunohistochemical analysis may be treated as a supplementary prognostic marker for patients with colorectal adenocarcinoma, especially it may be useful for adjuvant therapy selection.

  3. 胃癌干细胞研究概况%Advanced in Gastric Cancer Stem Cells

    Institute of Scientific and Technical Information of China (English)

    武慧军; 欧阳晓晖; 苏秀兰

    2014-01-01

    Gastric cancer stem cells in gastric cancer tissues, the stomach may originate from adult stem cells, bone marrow cells or by other stem cells transformed. At present, gastric cancer stem cell identification, separation methods mainly depend on gastric cancer stem cell markers, side group cells (side population cells, sP cells). Greater omentum milk spot and epithelial interstitial transformation helps to gastric cancer cell identification separation. Gastric cancer stem cells and gastric cancer treatment and prognosis were significantly related. in this paper the origin of gastric cancer stem cells, the identification of separation and the treatment of gastric cancer were summarized in this review.%胃癌干细胞(gastric cancer stem cell)存在于胃癌组织中,可能来源于胃成体干细胞、骨髓细胞或由其他干细胞转化而来。目前胃癌干细胞的鉴定、分离方法主要依靠胃癌干细胞标志物,侧群细胞(side population cells,sP)细胞。大网膜乳斑及上皮间质转化有助于胃癌细胞的鉴定分离。胃癌干细胞与胃癌的治疗和预后明显相关。本文就胃癌干细胞的起源、鉴定分离与胃癌的治疗作一综述。

  4. Adjuvant IMRT/XELOX radiochemotherapy improves long-term overall- and disease-free survival in advanced gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Boda-Heggemann, J.; Schneider, V. [Heidelberg Univ., Universitaetsmedizin Mannheim (Germany). Dept. of Radiation Oncology; Weiss, C. [Heidelberg Univ., Universitaetsmedizin Mannheim (Germany). Dept. of Biomathematics and Medical Statistics] [and others

    2013-05-15

    Purpose: In a retrospective analysis, adjuvant intensity-modulated radiation therapy (IMRT) combined with modern chemotherapy improved advanced gastric cancer survival rates compared to a combination of three-dimensional conformal radiation therapy (3D-CRT) and conventional chemotherapy. We report on the long-term outcomes of two consecutive patient cohorts that were treated with either IMRT and intensive chemotherapy, or 3D-CRT and conventional chemotherapy. Patients and methods: Between 2001 and 2008, 65 consecutive gastric cancer patients received either 3D-CRT (n = 27) or IMRT (n = 38) following tumor resection. Chemotherapy comprised predominantly 5-fluorouracil/folinic acid (5-FU/FA) in the earlier cohort and capecitabine plus oxaliplatin (XELOX) in the latter. The primary endpoints were overall survival (OS) and disease-free survival (DFS). Results: Median OS times were 18 and 43 months in the 3D-CRT and IMRT groups, respectively (p = 0.0602). Actuarial 5-year OS rates were 26 and 47 %, respectively. Within the IMRT group, XELOX gave better results than 5-FU/FA in terms of OS, but this difference was not statistically significant. The primary cause of death in both groups was distant metastasis. Median DFS times were 14 and 35 months in the 3D-CRT and IMRT groups, respectively (p = 0.0693). Actuarial 5-year DFS rates were 22 and 44 %, respectively. Among patients receiving 5-FU/FA, DFS tended to be better in the IMRT group, but this was not statistically significant. A similar analysis for the XELOX group was not possible as 3D-CRT was almost never used to treat these patients. No late toxicity exceeding grade 3 or secondary tumors were observed. Conclusion: After a median follow-up period of over 5 years, OS and DFS were improved in the IMRT/XELOX treated patients compared to the 3D-CRT/5-FU/FA group. Long-term observation revealed no clinical indications of therapy-induced secondary tumors or renal toxicity. (orig.)

  5. -------------Gastric malignancy : Clinicopathologic spectrum and relationship to helicobacter pylori infection

    Directory of Open Access Journals (Sweden)

    Satti Mohamed

    2005-01-01

    Full Text Available Background: Upper gastrointestinal cancer particularly of stomach is a relatively frequent form of cancer. Gastric H pylori infection has been implicated in the pathogenesis of both gastric carcinoma and gastric lymphoma. Gastric carcinoma has been addressed by many articles in the Kingdom of Saudi Arabia (KSA and the Middle East, while only a few addressed gastric lymphoma. Aim of the study: To investigate the relative frequency of gastric carcinoma and gastric lymphoma and their association with H pylori infection in endoscoped patients. Patients and methods: A retrospective study of patients endoscoped at King Fahad Hospital of the University, Al-Khobar, KSA during the period 1983-1999 was performed. Endoscopy and pathology records were retrieved and reviewed. The histopathology slides were re-examined, applying immunohistochemical techniques on corresponding paraffin sections to classify the various tumors. H pylori were identified on routine histology and by utilizing Giemsa stain. Results: During the study period of 17 years (1983-1999, a total of 94 endoscopically-diagnosed, histologically-confirmed cases of gastric malignancy were identified. Of these, there were 55 gastric adenocarcinoma and 39 gastric lymphoma. H pylori was identified in the adjacent gastric mucosa in 18 of all cases of gastric adenocarcinoma and in 27 of the 39 cases of lymphoma. Conclusion: The study demonstrates the comparatively high frequency of gastric lymphoma in this population and confirms the intimate association of H-pylori infection to both gastric adenocarcinoma and MALT-lymphoma. Gastric lymphoma should always be considered in the differential diagnosis of gastric malignancy and the use of immunohistochemistry is essential for the differential diagnosis of some of these tumors

  6. Quality of life of palliative chemotherapy naive patients with advanced adenocarcinoma of the stomach or esophagogastric junction treated with irinotecan combined with 5-fluorouracil and folinic acid: results of a randomised phase III trial.

    LENUS (Irish Health Repository)

    Curran, Desmond

    2009-09-01

    PURPOSE: The quality of life (QL) of advanced gastric cancer patients receiving irinotecan, folinic acid and 5-fluorouracil (5-FU) (IF arm) or cisplatin with 5-FU (CF arm) is presented. METHODS: Patients with measurable or evaluable advanced gastric cancer received IF weekly for 6\\/7 weeks or CF q4 weeks. QL was assessed using the EORTC QLQ-C30 at baseline, subsequently every 8 weeks until progression and thereafter every 3 months until death. The QL data were analysed using several statistical methods including summary measures and pattern-mixture modelling. RESULTS: A total of 333 patients were randomised and treated (IF 170, CF 163). The time-to-progression for IF and CF was 5.0 and 4.2 months (P = 0.088), respectively. The overall compliance rates for QL questionnaire completion were 60 and 56% in the IF and CF arms, respectively. Significant treatment differences were observed for the physical functioning scale (P = 0.024), nausea\\\\vomiting (P = 0.001) and EQ-5D thermometer (P = 0.020) in favour of the IF treatment arm. CONCLUSION: There was a trend in favour of IF over CF in time-to-progression. The IF group also demonstrated a better safety profile than CF and a better QL on a number of multi-item scales, suggesting that IF offers an alternative first-line platinum-free treatment option for advanced gastric cancer.

  7. Laparoscopic spleen-preserving splenic hilar lymphadenectomy performed by following the perigastric fascias and the intrafascial space for advanced upper-third gastric cancer.

    Directory of Open Access Journals (Sweden)

    Chang-Ming Huang

    Full Text Available BACKGROUND: Laparoscopic spleen-preserving Splenic hilar lymphadenectomy (LSPL is required in laparoscopy-assisted total gastrectomy for advanced proximal gastric cancer. However, it is considerably difficult and risk in clinical practice. Thus, we explore the application of LSPL performed by following the perigastric fascias and the intrafascial space in D2 radical gastrectomy for advanced upper-third gastric cancer. METHODS: From July 2010 to December 2012, 109 patients with T2-3 upper-third gastric cancer underwent LSPL. Of these patients, 55 underwent classic LSPL (classic group, and the remaining 54 patients underwent LSPL performed by following the fascias and intrafascial space (fascia group. Clinicopathologic characteristics and intraoperative and postoperative variables were compared between the two groups. RESULTS: There were no significant differences in clinicopathological characteristics between the two groups (P>0.05. All of the operations were successful without conversion to laparotomy. The operation time, mean splenic hilar lymph node (LN dissection time, mean total blood loss and mean blood loss from splenic hilar LN dissection were significantly lower in the fascia group than in the classic group (P0.05. At a median follow-up of 12 months(range 5 to 35 months, none of the patients had died or experienced recurrent or metastatic disease. CONCLUSION: LSPL performed by following the fascias and intrafascial space is an optimal and safe technique based on anatomical logic, and it reduces the difficulties associated with LSPL, making it easier to master and allowing its widespread adoption.

  8. MYCOPLASMA HYORHINIS IN GASTRIC CANCER

    Institute of Scientific and Technical Information of China (English)

    季加孚; 张霁; 寿成超; 王怡; 徐光炜

    2002-01-01

    Objective: To determine the prevalence of Mycoplasma hyorhinis in archived paraffin-embedded gastric cancer tissue. Methods: The antigen recognized by anti-tumor monoclonal antibody PD4 was identified as P40 (a specific Mycoplasma hyorhinis protein). We constructed a tissue-microarray of high density containing 105 gastric cancer samples, 101 non-tumor margin samples and 62 benign gastric disease samples for detecting Mycoplasma hyorhinis using Immunohistochemistry. Results: The infection rate of M. hyorhinis was 54.1%(53/98) in gastric cancer samples, 51.7%(45/87) in non-tumor margin samples and 15.8%(9/57) in benign disease samples. The difference in infection rate between gastric cancer and benign gastric disease has statistical significance (P=0.001). Highly differentiated adenocarcinomas have a greater chance (84.6%) to be infected with M. hyorhinis than poorly differentiated ones (45.5%)(P<0.05. Conclusion: The infection rate of M. yorhinis was higher in gastric cancer than in other tastric diseases, which suggests the association between Mycoplasma infection and gastric cancer. Whether M. hyorhinis has oncogenic potential needs to be elucidated.

  9. Dose-Volume Analysis of Predictors for Gastrointestinal Toxicity After Concurrent Full-Dose Gemcitabine and Radiotherapy for Locally Advanced Pancreatic Adenocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Huang Jiayi [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Robertson, John M., E-mail: jrobertson@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Ye Hong [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Margolis, Jeffrey; Nadeau, Laura [Division of Medical Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Yan Di [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2012-07-15

    Purpose: To identify dosimetric predictors for the development of gastrointestinal (GI) toxicity in patients with locally advanced pancreatic adenocarcinoma (LAPC) treated with concurrent full-dose gemcitabine and radiotherapy (GemRT). Methods and Materials: From June 2002 to June 2009, 46 LAPC patients treated with definitive GemRT were retrospectively analyzed. The stomach and duodenum were retrospectively contoured separately to determine their dose-volume histogram (DVH) parameters. GI toxicity was defined as Grade 3 or higher GI toxicity. The follow-up time was calculated from the start of RT to the date of death or last contact. Univariate analysis (UVA) and multivariate analysis (MVA) using Kaplan-Meier and Cox regression models were performed to identify risk factors associated with GI toxicity. The receiver operating characteristic curve and the area under the receiver operating characteristic curve (AUC) were used to determine the best DVH parameter to predict for GI toxicity. Results: Of the patients, 28 (61%) received concurrent gemcitabine alone, and 18 (39%) had concurrent gemcitabine with daily erlotinib. On UVA, only the V{sub 20Gy} to V{sub 35Gy} of duodenum were significantly associated with GI toxicity (all p {<=} 0.05). On MVA, the V{sub 25Gy} of duodenum and the use of erlotinib were independent risk factors for GI toxicity (p = 0.006 and 0.02, respectively). For the entire cohort, the V{sub 25Gy} of duodenum is the best predictor for GI toxicity (AUC = 0.717), and the 12-month GI toxicity rate was 8% vs. 48% for V{sub 25Gy} {<=} 45% and V{sub 25Gy} > 45%, respectively (p = 0.03). However, excluding the erlotinib group, the V{sub 35Gy} is the best predictor (AUC = 0.725), and the 12-month GI toxicity rate was 0% vs. 41% for V{sub 35Gy} {<=} 20% and V{sub 35Gy} > 20%, respectively (p = 0.04). Conclusions: DVH parameters of duodenum may predict Grade 3 GI toxicity after GemRT for LAPC. Concurrent use of erlotinib during GemRT may increase GI

  10. 进展期胃癌的分子靶向治疗%Molecular targeted therapy for advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    汪兵; 张义胜

    2014-01-01

    过去的二十年里,进展期胃癌患者通过治疗后可以改善生活质量及延长生存期,但是其治疗方法并没有获得显著进展。虽然胃癌的中位生存期大约在7~11个月,且存活超过2年的已经>10%,但是,对于进展期胃癌患者来说,其最合适的一线化疗方案一直存在争议,且大多数人对化疗仍持有偏见。最近,肿瘤生物学的显著进展促进了靶向致癌关键途径的新药物研究。在国际随机研究中,对进展期胃癌来说,多数分子靶向因子被证实有效,一种抗HER-2单克隆抗体(曲妥珠单抗)显示在抗HER-2阳性的进展期胃癌方面有抗肿瘤活性。然而,只有20%的HER-2阳性的进展期胃癌患者在此获益。因此,发展更有效的因子和鉴别预测及预后的标记物因子来选择哪些患者能从特定的化疗方案和靶向治疗中获益显得至关重要。本文就进展期胃癌的靶向治疗作一综述。%Although medical treatment has been shown to improve quality of life and prolong survival, no significant progress has been made in the treatment of advanced gastric cancer (AGC) within the last two decades. Thus the optimum standard first-line chemotherapy regimen for AGC remains debatable: and most responses to chemotherapy are partial and of short duration; the median survival is approximately 7 to 11 months, and survival rate at 2 years is exceptionally>10%. Recently, remarkable progress in tumor biology has led to the development of new agents that target critical aspects of oncogenic pathways. For AGC, many molecular targeting agents have been evaluated in international randomized studies, and trastuzumab (an anti-HER-2 monoclonal antibody) has shown antitumor activity against HER-2-positive AGC. However, this benefit is limited to only 20% patients with AGC (patients with HER-2-positive AGC). Therefore, there remains a critical need for both the development of more effective agents and

  11. Fluoropyrimidine-Based Chemotherapy as First-Line Treatment for Advanced Gastric Cancer: a Bayesian Network Meta-Analysis.

    Science.gov (United States)

    Zhu, Lucheng; Liu, Jihong; Ma, Shenglin

    2016-10-01

    Fluoropyrimidine-based regimens are the most common treatments in advanced gastric cancer. We used a Bayesian network meta-analysis to identify the optimal fluoropyrimidine-based chemotherapy by comparing their relative efficacy and safety. We systematically searched databases and extracted data from randomized controlled trials, which compared fluoropyrimidine-based regimens as first-line treatment in AGC. The main outcomes were overall survival (OS), progression-free survival (PFS), overall response rate (ORR), and grade 3 or 4 adverse events (AEs). A total of 12 RCTs of 4026 patients were included in our network meta-analysis. Pooled analysis showed S-1 and capecitabine had a significant OS benefit over 5-Fu, with hazard ratios of 0.90 (95%CI = 0.81-0.99) and 0.88 (95%CI = 0.80-0.96), respectively. The result also exhibited a trend that S-1 and capecitabine prolonged PFS in contrast to 5-Fu, with hazard ratios of 0.84 (95%CI = 0.66-1.02) and 0.84 (95%CI = 0.65-1.03), respectively. Additionally, all the three fluoropyrimidine-based regimens were similar in terms of ORR and grade 3 or 4 AEs. Compared with regimens based on 5-Fu, regimens based on S-1 or capecitabine demonstrated a significant OS improvement without compromise of AEs as first-line treatment in AGC in Asian population. S-1 and capecitabine can be interchangeable according their different emphasis on AEs.

  12. A matched cohort study of laparoscopy-assisted and open total gastrectomy for advanced proximal gastric cancer without serosa invasion

    Institute of Scientific and Technical Information of China (English)

    Lin Jianxian; Huang Changming; Zheng Chaohui; Li Ping; Xie Jianwei; Wang Jiabin; Lu Jun

    2014-01-01

    Background Little is known about the feasibility and safety of laparoscopy-assisted total gastrectomy (LATG) with extended lymphadenectomy in patients with advanced gastric cancer (AGC).This study compared the technical feasibility,safety,and oncologic efficacy of LATG with open total gastrectomy (OTG) for AGC without serosa invasion.Methods From January 2009 to December 2011,235 patients underwent LATG and 153 patients underwent OTG for AGC without serosa invasion.Age,gender,and depth of invasion (pT2 and pT3) were matched by propensity scoring,and 116 patients (58 LATG and 58 OTG) were selected for analysis.Their clinicopathologic characteristics,postoperative outcomes,and survival were compared.Results There was no significant difference in clinicopathologic characteristics between the two propensity-matched groups.Median number of lymph nodes per patient was 29,and the mean number of retrieved lymph nodes was similar in the LATG and OTG groups (30.8±10.2 vs.29.0±8.3).Peri-operative characteristics,operation time,number of transfused units per patient,and time to resumption of activities were similar in the two groups; while blood loss,times to first flatus and resumption of soft diet,and post-operative stay were significantly lower in the LATG group (P <0.05,respectively).Rates of post-operative complications (12.1% vs.15.5%) and postoperative mortality (0% vs.1.7%),as well as cumulative survival rates,were similar.Conclusions LATG with D2 lymphadenectomy is a safe and feasible procedure for AGC patients without serosa invasion.ProsPective.multicenter,randomized trials are needed to confirm the efficacy of LATG in this patient population.

  13. Inhibitory effect of adenovirus-mediated short hairpin RNA targeting P85 and Akt1 on growth of human gastric adenocarcinoma cell%腺病毒介导的靶向P85和Akt1短发夹RNA对人胃腺癌细胞生长抑制作用的研究

    Institute of Scientific and Technical Information of China (English)

    张靖; 付彦超; 康春生; 张庆瑜; 王涛; 张洁

    2009-01-01

    expression was identified with real-time PCR and Western blot. The proliferative activity of tumor cells was evaluated with MTr assay and flow cytometry in vitro, rAd5-HK and rAd5-P + A mediated by adenovirus were injected into the established subcutancous SGC-7901 gastric adenocarcinoma in nude mice. During the observation period of 21 days, tumor volume was measured every 3 days to further testify the anti-tumor effect of rAd5-P + A on the SGC-7901 gastric adenocarcinoma cells and cell in situ apoptosis was detected with TUNEL assay. Results The adenovirus vector rAd5-P + A was successfully constructed and it dramatically downregulated P85 and Akt1 mRNA expression in SGC-7901 gastric adenocarcinoma cells. Compared with a control group of SGC-7901 cells and cells transfected with general adenovirus rAd5-HK as control, P85 and Akt1 protein expression 48 h and 72 h after rAd5-P + A transfection was decreased by 57.5% and 63. 7%, 67. 8% and 75.6% with statistical significance(P = 0. 005, P = 0. 003). Cell proliferative activity in rAd5-P + A transfected cells was suppressed from the second day (P <0. 001) and the decreased P85 and Akt1 expression was accompanied by 5.9% -7. 1% decrease of S phase fraction and 12. 1% - 13.7% increase of G0/G1 phase. The tumor volume of rAd5-P + A treated group was smaller than that of the control and rAd.5-HK group with statistical significance (F = 9. 871, P = 0. 025) . Moreover, rAd5-P + A could induce cell in situ apoptosis. Conclusions Adenovirus-mediated targeting P85 and Akt1 shRNA can inhibit the growth of SGC-7901 human gastric adenocarcinoma cells and this may provide a new strategy of combination gene therapy in gastric adenocarcinoma.

  14. Diet, microbial virulence, and Helicobacter pylori-induced gastric cancer

    OpenAIRE

    Cover, Timothy L.; Peek, Jr, Richard M

    2013-01-01

    Gastric adenocarcinoma is a leading cause of cancer-related death worldwide, and Helicobacter pylori infection is one of the strongest known risk factors for this malignancy. H. pylori strains exhibit a high level of genetic diversity, and the risk of gastric cancer is higher in persons carrying certain strain types (for example, those that contain a cag pathogenicity island or type s1 vacA alleles) than in persons carrying other strain types. Additional risk factors for gastric cancer includ...

  15. Coexistence of gastrointestinal stromal tumor, esophageal and gastric cardia carcinomas

    OpenAIRE

    Zhou, Yong; Wu, Xu-Dong; Shi, Quan; Jia, Jing

    2013-01-01

    Gastric gastrointestinal stromal tumor (GIST), esophageal squamous cell carcinoma and gastric cardia adenocarcinoma are distinct neoplasms originating from different cell layers; therefore, simultaneous development of such carcinomas is relatively rare. Auxiliary examinations revealed coexistence of esophageal and gastric cardia carcinoma with lymph node metastasis in a 77-year-old man. Intraoperatively, an extraluminal tumor (about 6.0 cm × 5.0 cm × 6.0 cm) at the posterior wall of the gastr...

  16. EBV感染与胃癌关系的研究进展%Advances in understanding the relationship between EpsteinBarr virus infection and gastric carcinoma

    Institute of Scientific and Technical Information of China (English)

    陈江; 朱冠保

    2011-01-01

    EB病毒(Epstein-Barr virus,EBV)是引起胃癌的重要生物学因素之一,其感染与胃癌的发生和发展密切相关.随着分子生物学技术的发展和应用,研究者对与EBV感染相关胃癌(EBVaGC)的特征和发生机制进行了深入研究,发现EBV潜伏感染和细胞恶性转化是EBV致EBVaGC的重要基础,为EBVaGC的诊断、治疗和预防提供了理论基础.%Epstein-Barr virus (EBV) plays an important role in gastric carcinogenesis and EBV infection is closely related to the development and progression of gastric cancer. Advances in molecular biology techniques have deepened our understanding of the characteristics of EBV-associated gastric cancer (EBVaGC). It has been found that latent EBV infection and EBV-induced malignant transformation are an important basis for the pathogenesis of EBVaGC. Understanding the pathogenesis of EBVaGC provides a theoretical basis for the diagnosis, treatment and prevention of this disease.

  17. Weekly oxaliplatin, 5-fluorouracil and folinic acid (OXALF as first-line chemotherapy for elderly patients with advanced gastric cancer: results of a phase II trial

    Directory of Open Access Journals (Sweden)

    Vincenzi B

    2006-05-01

    Full Text Available Abstract Background Elderly patients have been often excluded from or underrepresented in the study populations of combination chemotherapy trials. The primary end point of this study was to determine the response rate and the toxicity of the weekly oxaliplatin, 5-fluorouracil and folinic acid (OXALF regimen in elderly patients with advanced gastric cancer. The secondary objective was to measure the time to disease progression and the survival time. Methods Chemotherapy-naive patients with advanced gastric cancer aged 70 or older were considered eligible for study entry. Patients received weekly oxaliplatin 40 mg/m2, fluorouracil 500 mg/m2 and folinic acid 250 mg/m2. All drugs were given intravenously on a day-1 schedule. Results A total of 42 elderly patients were enrolled. Median age was 73 years and all patients had metastatic disease. The response rate according to RECIST criteria was 45.2% (95% CIs: 30%–56% with two complete responses, 17 partial responses, 13 stable diseases and 10 progressions, for an overall tumor rate control of 76.2% (32 patients. Toxicity was generally mild and only three patients discontinued treatment because of treatment related adverse events. The most common treatment-related grade 3/4 adverse events were fatigue (7.1%, diarrhoea (4.8%, mucositis (2.4%, neurotoxicity (2.4% and neutropenia (4.8%. The median response duration was 5.3 months (95% CIs: 2.13 – 7.34, the median time to disease progression was 5.0 months (95% CIs: 3.75 – 6.25 and the median survival time was 9.0 months (95% CIs: 6.18 – 11.82. Conclusion OXALF represents an active and well-tolerated treatment modality for elderly patients with locally advanced and metastatic gastric cancer.

  18. Comparative effectiveness and safety between oxaliplatin-based and cisplatin-based therapy in advanced gastric cancer: A meta-analysis of randomized controlled trials

    Science.gov (United States)

    Zhu, Yanjie; Huang, Jiale; Liu, Yanna; Zhao, Liying; Li, Zhijia; Liu, Hao; Wang, Qi-long; Qi, Xiaolong

    2016-01-01

    Background & Aims Platinum-based drugs are the most significant chemotherapy for advanced gastric cancer. The study aims to compare the efficacy and safety of oxaliplatin-based therapy versus cisplatin-based therapy in patients with advanced gastric cancer. Materials and Methods An adequate literature search in EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, American Society of Clinical Oncology (ASCO) and European Society of Medical Oncology (ESMO) was conducted. Phase II or III randomized controlled trials (RCTs) that compared effectiveness and safety between oxaliplatin-based and cisplatin-based therapy in patients with advanced gastric cancer were eligible. The primary endpoint was overall response rate (ORR), progression free survival (PFS) and overall survival (OS). The second endpoint was the adverse events. Results Five phase II or III RCTs involving a total of 2,046 patients were identified. The results showed that there were no significant difference in ORR (OR = 1.17, 95% CI = 0.98–1.40, p = 0.08, I2 = 0%), PFS (HR = 0.92, 95% CI = 0.84–1.01, p = 0.09, I2 = 0%) and OS (HR = 0.91, 95% CI = 0.82–1.01, p = 0.07, I2 = 0%) between oxaliplatin-based therapy and cisplatin-based therapy. In addition, oxaliplatin-based therapy had lower risk of neutropenia, anemia, nausea, alopecia, thromboembolism, stomatitis and creatinine increased at all grades, and neutropenia, anemia, leukopenia and alopecia at 3–4 grades than cisplatin-based therapy. However, oxaliplatin-based therapy was associated with increased risk of neurosensory toxicity and thrombocytopenia. Conclusions Our meta-analysis showed that there were no significant difference in ORR, PFS and OS between oxaliplatin-based therapy and cisplatin-based therapy. The oxaliplatin-based therapy could generally decrease the risk of adverse effects except neurosensory toxicity and thrombocytopenia. PMID:27166187

  19. High-mobility group box 1 inhibits gastric ulcer healing through Toll-like receptor 4 and receptor for advanced glycation end products.

    Science.gov (United States)

    Nadatani, Yuji; Watanabe, Toshio; Tanigawa, Tetsuya; Ohkawa, Fumikazu; Takeda, Shogo; Higashimori, Akira; Sogawa, Mitsue; Yamagami, Hirokazu; Shiba, Masatsugu; Watanabe, Kenji; Tominaga, Kazunari; Fujiwara, Yasuhiro; Takeuchi, Koji; Arakawa, Tetsuo

    2013-01-01

    High-mobility group box 1 (HMGB1) was initially discovered as a nuclear protein that interacts with DNA as a chromatin-associated non-histone protein to stabilize nucleosomes and to regulate the transcription of many genes in the nucleus. Once leaked or actively secreted into the extracellular environment, HMGB1 activates inflammatory pathways by stimulating multiple receptors, including Toll-like receptor (TLR) 2, TLR4, and receptor for advanced glycation end products (RAGE), leading to tissue injury. Although HMGB1's ability to induce inflammation has been well documented, no studies have examined the role of HMGB1 in wound healing in the gastrointestinal field. The aim of this study was to evaluate the role of HMGB1 and its receptors in the healing of gastric ulcers. We also investigated which receptor among TLR2, TLR4, or RAGE mediates HMGB1's effects on ulcer healing. Gastric ulcers were induced by serosal application of acetic acid in mice, and gastric tissues were processed for further evaluation. The induction of ulcer increased the immunohistochemical staining of cytoplasmic HMGB1 and elevated serum HMGB1 levels. Ulcer size, myeloperoxidase (MPO) activity, and the expression of tumor necrosis factor α (TNFα) mRNA peaked on day 4. Intraperitoneal administration of HMGB1 delayed ulcer healing and elevated MPO activity and TNFα expression. In contrast, administration of anti-HMGB1 antibody promoted ulcer healing and reduced MPO activity and TNFα expression. TLR4 and RAGE deficiency enhanced ulcer healing and reduced the level of TNFα, whereas ulcer healing in TLR2 knockout (KO) mice was similar to that in wild-type mice. In TLR4 KO and RAGE KO mice, exogenous HMGB1 did not affect ulcer healing and TNFα expression. Thus, we showed that HMGB1 is a complicating factor in the gastric ulcer healing process, which acts through TLR4 and RAGE to induce excessive inflammatory responses.

  20. High-mobility group box 1 inhibits gastric ulcer healing through Toll-like receptor 4 and receptor for advanced glycation end products.

    Directory of Open Access Journals (Sweden)

    Yuji Nadatani

    Full Text Available High-mobility group box 1 (HMGB1 was initially discovered as a nuclear protein that interacts with DNA as a chromatin-associated non-histone protein to stabilize nucleosomes and to regulate the transcription of many genes in the nucleus. Once leaked or actively secreted into the extracellular environment, HMGB1 activates inflammatory pathways by stimulating multiple receptors, including Toll-like receptor (TLR 2, TLR4, and receptor for advanced glycation end products (RAGE, leading to tissue injury. Although HMGB1's ability to induce inflammation has been well documented, no studies have examined the role of HMGB1 in wound healing in the gastrointestinal field. The aim of this study was to evaluate the role of HMGB1 and its receptors in the healing of gastric ulcers. We also investigated which receptor among TLR2, TLR4, or RAGE mediates HMGB1's effects on ulcer healing. Gastric ulcers were induced by serosal application of acetic acid in mice, and gastric tissues were processed for further evaluation. The induction of ulcer increased the immunohistochemical staining of cytoplasmic HMGB1 and elevated serum HMGB1 levels. Ulcer size, myeloperoxidase (MPO activity, and the expression of tumor necrosis factor α (TNFα mRNA peaked on day 4. Intraperitoneal administration of HMGB1 delayed ulcer healing and elevated MPO activity and TNFα expression. In contrast, administration of anti-HMGB1 antibody promoted ulcer healing and reduced MPO activity and TNFα expression. TLR4 and RAGE deficiency enhanced ulcer healing and reduced the level of TNFα, whereas ulcer healing in TLR2 knockout (KO mice was similar to that in wild-type mice. In TLR4 KO and RAGE KO mice, exogenous HMGB1 did not affect ulcer healing and TNFα expression. Thus, we showed that HMGB1 is a complicating factor in the gastric ulcer healing process, which acts through TLR4 and RAGE to induce excessive inflammatory responses.

  1. Comparative study of laparoscopic vs open gastrectomy in gastric cancer management

    Institute of Scientific and Technical Information of China (English)

    Giuseppe S Sica; Edoardo Iaculli; Livia Biancone; Sara Di Carlo; Rosa Scaramuzzo; Cristina Fiorani; Paolo Gentileschi; Achille L Gaspari

    2011-01-01

    AIM: To compare long-term results of gastric cancer patients undergoing laparoscopic and open gastrectomy in a single unit.METHODS: From February 2000 to September 2004, all patients with adenocarcinoma of the stomach were assessed to entry in this longitudinal prospective non-randomized trial. Primary endpoint was cancer-related survival and secondary endpoints were overall survival, evaluation of surgical complications and mortality.RESULTS: Fifty-eight patients were enrolled. Forty-seven patients were followed-up (range 11-103, median 38 mo). Four patients were lost at follow up. Twenty-two patients underwent a laparoscopic gastric surgery (LGS) and 25 had a standard open procedure (OGS). No statistical difference was found between the two groups in terms of 5 years cancer-related mortality rate (50% vs 52%, P = 1), and 5 years overall mortality rate (54.5% vs 56%, P = 1). Accordingly, cancer-related and overall survival probability by Kaplan-Meier method showed comparable results (P = 0.81 and P = 0.83, respectively). We found no differences in surgical complications in the 2 groups. There was no conversion to open surgery in this series.CONCLUSION: LGS is as effective as OGS in the management of advanced gastric cancer. However LGS cannot be recommended routinely over OGS for the treatment of advanced gastric cancer.

  2. Effect of Proton Pump Inhibitors on Cancer Cachexia in Nude Mice Bearing SGC-7901 Gastric Adenocarcinoma%质子泵抑制剂对SGC-7901胃腺癌裸小鼠癌性恶病质的作用

    Institute of Scientific and Technical Information of China (English)

    沈永华; 陈敏; 沈卫东; 黄淑玲; 张丽莉; 邹晓平

    2011-01-01

    背景:癌性恶病质是癌症晚期最重要的并发症之一.质子泵抑制剂(PPIs)目前广泛用于治疗酸相关疾病,有研究显示其对恶性肿瘤细胞具有化疗增敏和诱导凋亡作用.目的:探讨PPIs对裸小鼠癌性恶病质的改善作用及其可能机制.方法:予BALB/c nu/nu裸小鼠皮下注射人胃腺癌细胞株SGC-901建立癌性恶病质模型并予PPIs干预(奥美拉唑治疗组和泮托拉唑治疗组),同时设立不予干预的癌性恶病质组和非荷瘤空白对照组,每组11只裸小鼠.观察各组裸小鼠的一般情况、肿瘤体积以及与癌性恶病质的发生、发展密切相关的血清细胞因子肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平.结果:两组PPI治疗组裸小鼠体质量下降受抑,摄食、饮水量明显高于癌性恶病质组,血清TNF-α、IL-6水平明显低于癌性恶病质组,差异均有统计学意义(P<0.05),肿瘤体积则与癌性恶病质组无明显差异.结论:PPIs对裸小鼠的癌性恶病质有明显改善作用,其机制可能与改变体内细胞因子水平有关.%Background: Cancer cachexia is one of the most important complications of advanced cancer. It has been reported that proton pump inhibitors (PPIs), currently used in the treatment of acid-related diseases, can increase the sensitivity of cancer cells to cytotoxic agents and induce cancer cell apoptosis. Aims: To investigate the improvement effect of PPIs on cancer cachexia in nude mice and its possible mechanism. Methods: Thirty-three BALB/c nu/nu nude mice were injected with human gastric adenocarcinoma cell line SGC-7901 subcutaneously to induce cancer cachexia, and then randomized to receive omeprazole, pantoprazole or normal saline treatment (Ome-treated group, Pan-treated group, and cancer cachexia group), respectively; 11 nude mice without any intervention served as blank controls. The general condition, tumor volume and the serum levels of two cachexia-associated cytokines, tumor

  3. Current Status on Stem Cells and Cancers of the Gastric Epithelium

    Directory of Open Access Journals (Sweden)

    Werner Hoffmann

    2015-08-01

    Full Text Available Gastric cancer is still a leading cause of cancer-related mortality worldwide in spite of declining incidence. Gastric cancers are, essentially, adenocarcinomas and one of the strongest risk factors is still infection with Helicobacter pylori. Within the last years, it became clear that gastric self-renewal and carcinogenesis are intimately linked, particularly during chronic inflammatory conditions. Generally, gastric cancer is now regarded as a disease resulting from dysregulated differentiation of stem and progenitor cells, mainly due to an inflammatory environment. However, the situation in the stomach is rather complex, consisting of two types of gastric units which show bidirectional self-renewal from an unexpectedly large variety of progenitor/stem cell populations. As in many other tumors, cancer stem cells have also been characterized for gastric cancer. This review focuses on the various gastric epithelial stem cells, how they contribute to self-renewal and which routes are known to gastric adenocarcinomas, including their stem cells.

  4. Multimodality management of resectable gastric cancer: A review

    Institute of Scientific and Technical Information of China (English)

    Helen; Shum; Lakshmi; Rajdev

    2014-01-01

    Adenocarcinoma of the stomach carries a poor prognosis and is the second most common cause of cancer death worldwide. It is recommended that surgical resection with a D1 or a modified D2 gastrectomy(with at least 15 lymph nodes removed for examination), be performed in the United States, though D2 lymphadenectomies should be performed at experienced centers. A D2 lymphadenectomy is the recommended procedure in Asia. Although surgical resection is considered the definitive treatment, rates of recurrences are high, necessitating the need for neoadjuvant or adjuvant therapy. This review article aims to outline and summarize some of the pivotal trials that have defined optimal treatment options for non-metastatic non-cardia gastric cancer. Some of the most notable trials include the INT-0116 trial, which established a benefit in concurrent chemoradiation and adjuvant chemotherapy. This was again confirmed in the ARTIST trial, especially in patients with nodal involvement. Later, the Medical Research Council Adjuvant Gastric Infusional Chemotherapy trial provided evidence for the use of perioperative chemotherapy. Targeted agents such as ramucirumab and trastuzumab are also being investigated for use in locally advanced gastric cancers after demonstrating a benefit in the metastatic setting. Given the poor response rate of this difficult disease to various treatment modalities, numerous studies are currently ongoing in an attempt to define a more effective therapy, some of which are briefly introduced in this review as well.

  5. Vitamins B2 and B6 and Genetic Polymorphisms Related to One-Carbon Metabolism as Risk Factors for Gastric Adenocarcinoma in the European Prospective Investigation into Cancer and Nutrition

    NARCIS (Netherlands)

    Eussen, Simone J. P. M.; Vollset, Stein Emil; Hustad, Steinar; Midttun, Oivind; Meyer, Klaus; Fredriksen, Ase; Ueland, Per Magne; Jenab, Mazda; Slimani, Nadia; Ferrari, Pietro; Agudo, Antonio; Sala, Nuria; Capella, Gabriel; Del Giudice, Giuseppe; Palli, Domenico; Boeing, Heiner; Weikert, Cornelia; Bueno-de-Mesquita, H. Bas; Buechner, Frederike L.; Carneiro, Fatima; Berrino, Franco; Vineis, Paolo; Tumino, Rosario; Panico, Salvatore; Berglund, Goran; Manjer, Jonas; Stenling, Roger; Hallmans, Goeran; Martinez, Carmen; Arrizola, Larraitz; Barricarte, Aurelio; Navarro, Carmen; Rodriguez, Laudina; Bingham, Sheila; Linseisen, Jakob; Kaaks, Rudolf; Overvad, Kim; Tjonneland, Anne; Peeters, Petra H. M.; Numans, Mattijs E.; Clavel-Chapelon, Francoise; Boutron-Ruault, Marie-Christine; Morois, Sophie; Trichopoulou, Antonia; Lund, Eiliv; Plebani, Mario; Riboli, Elio; Gonzalez, Carlos A.

    2010-01-01

    B vitamins and polymorphisms in genes coding for enzymes involved in one-carbon metabolism may affect DNA synthesis and methylation and thereby be implicated in carcinogenesis. Previous data on vitamins B2 and B6 and genetic polymorphisms other than those involving MTHFR as risk factors for gastric

  6. Vitamins B2 and B6 and genetic polymorphisms related to one-carbon metabolism as risk factors for gastric adenocarcinoma in the European prospective investigation into cancer and nutrition.

    NARCIS (Netherlands)

    Eussen, S.J.; Vollset, S.E.; Hustad, S.; Midttun, O.; Meyer, K.; Fredriksen, A.; Ueland, P.M.; Jenab, M.; Slimani, N.; Ferrari, P.; Agudo, A.; Sala, N.; Capella, G.; Giudice, G. Del; Palli, D.; Boeing, H.; Weikert, C.; Bueno-De-Mesquita, H.B.; Buchner, F.L.; Carneiro, F.; Berrino, F.; Vineis, P.; Tumino, R.; Panico, S.; Berglund, G.; Manjer, J.; Stenling, R.; Hallmans, G.; Martinez, C.; Arrizola, L.; Barricarte, A.; Navarro, C.; Rodriguez, L.; Bingham, S.; Linseisen, J.; Kaaks, R.; Overvad, K.; Tjonneland, A.; Peeters, P.H.M.; Numans, M.E.; Clavel-Chapelon, F.; Boutron-Ruault, M.C.; Morois, S.; Trichopoulou, A.; Lund, E.; Plebani, M.; Riboli, E.; Gonzalez, C.A.

    2010-01-01

    B vitamins and polymorphisms in genes coding for enzymes involved in one-carbon metabolism may affect DNA synthesis and methylation and thereby be implicated in carcinogenesis. Previous data on vitamins B2 and B6 and genetic polymorphisms other than those involving MTHFR as risk factors for gastric

  7. Synchronous rectal adenocarcinoma and anal canal adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    GU Jin; LI Jiyou; YAO Yunfeng; LU Aiping; WANG Hongyi

    2007-01-01

    It is difficult to distinguish a tectal carcinoma with anal metastases from coexistent synchronous anorectal carcinomas.The therapeutic strategy for rectal and anal carcinoma is so different that it should be clearly identified.Here,we report on the case of a 63-year-old man who presented with an upper-third rectal adenocarcinoma.Five months after resection,he developed an adenocarcinoma in the anal canal.The histological slides of both tumors were reviewed and immunohistochemical studies for cytokeratins(CKs)7 and 20 were performed.The index tumor demonstrated CK 7-/CK 20+and the second showed CK7+/CK20+.For this reason,we believe the present case had synchronous adenocarcinomas arising from anal canal and the rectum separately.It is very important to difierentiate the anorectal lesions pathologically because of the impact on the therapeutic options available,especially for the lesion arising in the anal canal.

  8. A phase Ⅱ trial of oxaliplatin plus S-1 as a first-line chemotherapy for patients with advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    YANG Lin; SONG Yan; ZHOU Ai-ping; QIN Qiong; CHI Yihebali; HUANG Jing; WANG Jin-wan

    2013-01-01

    Background Palliative chemotherapy has been shown to have a survival benefit for patients with recurrent or metastatic gastric cancer.We conducted a Phase Ⅱ trial to determine the efficacy and safety of S-1 plus oxaliplatin (SOX regimen) as first-line chemotherapy for patients with unresectable locally advanced or metastatic gastric cancer.Methods Eligible patients had measurable lesions and no previous history of chemotherapy (except adjuvant chemotherapy).Oxaliplatin was administered intravenously at a dose of 130 mg/m2 on day 1.S-1 was administered orally in doses of 80,100,or 120 mg/d according to body surface areas of <1.25 m2,1.25-1.5 m2,or >1.5 m2 respectively;the total dose was divided into two daily doses on days 1-14.Treatments were repeated every 3 weeks until disease progression or intolerable toxicity occurred.Results Forty-three patients were enrolled in the study.All were assessable for efficacy and adverse events.The objective response and disease control rates were 55.8% and 76.7% respectively.The median follow-up time was 16.5 months.The median progression-free survival time was 7 months (95% Cl,5.8-8.2 months) and the median overall survival time was 16.5 months (95% Cl,9.7-23.3 months).The one-year survival rate was 54.2%.Major adverse reactions were grade 3/4 neutropenia (9.3%) and thrombocytopenia (20.9%).Conclusion The SOX regimen with oxaliplatin at a dose of 130 mg/m2 was found to be effective and safe as a first-line chemotherapy in Chinese patients with advanced gastric cancer.

  9. Krukenberg tumor after gastric bypass for morbid obesity: Bariatric surgery and gastric cancer

    Directory of Open Access Journals (Sweden)

    Pablo Menéndez

    2013-06-01

    Full Text Available Gastric by-pass is one of the most performed surgical procedure in bariatric surgery. Neoplasm within gastric remnant is a slightly frequent complication (only six cases have been described but with important survival consequences. We present a case of a patient who developed an adenocarcinoma in excluded stomach, after three years of bariatric surgery; the tumor was incidentally discovered after a gynecological surgery for uterine myomas. Different diagnostic modalities for the excluded stomach were analyzed.

  10. Esophageal Adenocarcinoma Developing after Eradication of Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    Yasuhiko Abe

    2011-07-01

    Full Text Available A 75-year-old man underwent endoscopic hemostatic therapy for hemorrhagic gastric ulcer in September 2002. After healing of the gastric ulcer, he underwent Helicobacter pylori eradication therapy in February 2003. In August 2007, an irregular tumor was detected in the lower esophagus at annual checkup for gastric cancer screening using X-ray. Endoscopic examination showed that the lower margin of the tumor almost coincided with the esophagogastric junction and that a short segment of Barrett’s epithelium existed near the tumor. Biopsies of the tumor showed moderately to poorly differentiated adenocarcinoma. Mild reflux esophagitis and minor hiatal hernia was also observed, and the previously treated gastric ulcer was not recurrent. Absence of H. pylori was confirmed by serum antibody and urea breath test. Surgical resection of the lower esophagus and proximal stomach was performed. The tumor invaded into the muscularis propria of the esophageal wall but had no evidence of lymph node metastasis. Based on macroscopic and pathological findings, the tumor was recognized as esophageal adenocarcinoma. Previous endoscopic examination did not detect any apparent signs of tumor in the esophagogastric junction. As far as we know, this is the first report documenting a newly developed esophageal adenocarcinoma after the successful eradication of H. pylori.

  11. Gastric carcinoma originating from the heterotopicsubmucosal gastric gland treated by laparoscopy andendoscopy cooperative surgery

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Gastric carcinoma is derived from epithelial cells inthe gastric mucosa. We reported an extremely rarecase of submucosal gastric carcinoma originating fromthe heterotopic submucosal gastric gland (HSG) thatwas safely diagnosed by laparoscopy and endoscopycooperative surgery (LECS). A 66-year-old manunderwent gastrointestinal endoscopy, which detected asubmucosal tumor (SMT) of 1.5 cm in diameter on thelesser-anterior wall of the upper gastric body. The tumorcould not be diagnosed histologically, even by endoscopicultrasound-guided fine-needle aspiration biopsy. Localresection by LECS was performed to confirm a diagnosis.Pathologically, the tumor was an intra-submucosal welldifferentiated adenocarcinoma invading 5000 μm into the submucosal layer. The resected tumor had negativelateral and vertical margins. Based on the Japanesetreatment guidelines, additional laparoscopic proximalgastrectomy was curatively performed. LECS is a lessinvasive and safer approach for the diagnosis of SMT,even in submucosal gastric carcinoma originating fromthe HSG.

  12. 胃腺癌与淋巴瘤形成的碰撞瘤伴胃肠道间质瘤临床及病理观察%A Clinicopathological Analysis of Collision Tumor of Gastric Adenocarcinoma and Lymphoma Accompanied by Gastrointestinal Stromal Tumor

    Institute of Scientific and Technical Information of China (English)

    邹宗楷; 苏海燕; 沈洪武; 郑舒静; 黄智勇

    2014-01-01

    Objective To introduce the histopathological and clinical features of collision tumor of the stomach,and to improve the understanding of this disease. Methods Clinical manifestations and histological and immunohistochemical findings of collision tumor of gastric adenocarcinoma, lymphoma and gastrointestinal stromal tumor(GIST)were analyzed and literature review was performed in 1 patient. Results The patient mainly showed dysphagia. In the total gastrectomy specimen, moderately differentiated tubular adenocarcinoma and diffuse large B-cell lymphoma were intermingled within the same tumor with an infiltrative growth pattern. The two elements were adjacent to one another with clear boundaries and integration. However, GIST was an isolated focus in the stomach wall. The three types of tumors formed the collision tumor. The adenocarcinoma expressed epithelial markers ,lymphoma showed anti-B-cell antibodies,and GIST expressed CD34,CD117 and DOG-1.Conclusion The gastric coll-ision tumor composed of adenocarcinoma, lymphoma and GIST is very rare and represents the collision of three separate components. In addition, clinical awareness should be improved to identify the collision tumor and appropriate treatment plan should be developed according different components.%目的:介绍胃碰撞瘤的组织学特点和临床表现,以提高对本病的认识。方法分析1例胃腺癌与淋巴瘤伴胃肠道间质瘤碰撞瘤的临床表现,且进行组织学及免疫组织化学标记研究,并复习相关文献。结果患者主要表现为吞咽困难。在全胃切除标本中,同一肿瘤内可见中分化管状腺癌和弥漫性大B 细胞性淋巴瘤呈浸润性生长,两种成分界限清楚、彼此靠近、互相融合,胃肠道间质瘤孤立胃壁病灶,三者形成碰撞瘤。腺癌表达上皮性标记物,而淋巴瘤表达B 细胞抗体,胃肠道间质瘤CD34、CD117、DOG-1(+)。结论胃碰撞瘤十分罕见。胃腺癌与淋巴瘤伴

  13. Clinical Research on Use of Oxaliplcrtin in Combination with HCPT, LV and 5FU in a Regimen for Advanced Gastric Cancer

    Institute of Scientific and Technical Information of China (English)

    GuoqingHu; QiangFu; MaolinJin; JieLi; LiangxiPan; YuxianBai; HuaijinWang; JianweiZhang; DingYu

    2004-01-01

    OBJECTIVE To observe the effects and adverse reactions of a OXA-HCPT LV/5FU 3 regimen for patients with advanced gastric cancer.METHODS OHLF3 regimen: OXA 130 mg/m2iv d 1, HCPT6 mg/m2, iv d 1-5, LV 200 mg/m2iv 2 h followed by a 5FU 400 mg/m2 iv bolus and 5FU 600mg/m2 iv d 1-3, were given, every 21 days as 1 cycle. Assessment of the tumor was conducted after 3 cycles and the effective cases were confirmed after 4 weeks.RESULTS Among 39 patients, 36 were actually evaluable. Overall response rates (CR + PR} were 50%' the major adverse reactions were mild hematological toxicity, nausea and vomiting and peripheral nerve abnormalities.CONCLUSION The OHLF 3 regimen using OXA and HCPT is effective and results in mild toxicity when used in combined chemotherapy for advanced gastric cancer.

  14. A systematic review and meta-analysis of randomized trials on the role of targeted therapy in the management of advanced gastric cancer: Evidence does not translate?

    Science.gov (United States)

    Ciliberto, Domenico; Staropoli, Nicoletta; Caglioti, Francesca; Gualtieri, Simona; Fiorillo, Lucia; Chiellino, Silvia; De Angelis, Antonina Maria; Mendicino, Francesco; Botta, Cirino; Caraglia, Michele; Tassone, Pierfrancesco; Tagliaferri, Pierosandro

    2015-01-01

    Summary It is still uncertain if targeted therapy-based regimens in advanced gastric cancer actually produce survival benefit. To shed light on this important question, we performed a systematic review and meta-analyses on each relevant targeted-pathway. By searching literature databases and proceedings of major cancer meetings in the time-frame 2005–2014, 22 randomized clinical trials exploring targeted therapy for a total of 7022 advanced gastric cancer patients were selected and included in the final analysis. Benefit was demonstrated for antiangiogenic agents in terms of overall survival (HR 0.759; 95%CI 0.655–0.880; p < 0.001). Conversely no benefit was found for EGFR pathway (HR 1.077; 95%CI 0.847–1.370; p = 0.543). Meta-analysis of HER-2 pathway confirmed improvement in terms of survival outcome, already known for this class of drugs (HR 0.823; 95%CI 0.722–0.939; p = 0.004). Pooled analysis demonstrated a significant survival benefit (OS: HR 0.823; PFS: HR 0.762) with acceptable tolerability profile for targeted-based therapies as compared to conventional treatments. This finding conflicts with the outcome of most individual studies, probably due to poor trial design or patients selection. In conclusion, our findings demonstrate a significant survival benefit for targeted therapy in its whole, which can be ascribed to anti-angiogenic and anti-HER2 agents. PMID:26061272

  15. CLINICAL OBSERVATION OF GEFITINIB IN TREATMENT OF PATIENTS WITH ADVANCED ADENOCARCINOMA OF LUNG CANCER%吉非替尼治疗晚期肺腺癌的临床观察

    Institute of Scientific and Technical Information of China (English)

    江波; 赵金奇; 何文杰

    2011-01-01

    [Objective] To analyze the efficacy, median survival time, media progression-free survival and control of the related symptoms of SO advanced lung adenocarcinoma caaes treated with Gefitinib. [Methods] A total of 50 patients with advanced lung adenocarcinoma of stage IE B or IV confirmed by pathology or cytology took Gefitinib 2S0mg orally once a day, until death or tumor progression or withdrawal by intolerable reaction. CT scan was performed before treatment and after treatment once a month. [Results] Objective response rate was 24%, disease control rate was 76%, and symptom improving rate was 70%. Significant difference was found in the efficacy of gender and smoking history (P 0.05). Median progression-free survival time was 7.5 months. Median survival time was 16.8 months. Skin rash and diarrha were the most common complication. [Conclusion] Gefitinib is better choice for the patients with advanced lung adenocarcinoma.%[目的]分析吉非替尼治疗50例晚期肺腺癌的疗效、中位生存期、中位无进展生存期及对相关症状的控制.[方法]50例经病理学或细胞学证实的ⅢB期或Ⅳ期肺腺癌患者,口服吉非替尼250 mg/d,直至患者死亡或肿瘤进展或发生不可耐受的不良反应,服药前或服药后每月复查CT进行疗效评价.[结果]客观缓解率为24%,疾病控制率为76%,症状改善率为70%,性别及吸烟两亚组之间疗效对比有统计学差异(P<0.05);年龄、分期、PS评分及既往治疗等各亚组之间疗效对比均无统计学差异(P>0.05).中位无进展生存期7.5个月,中位生存期16.8个月,最常见的不良反应为皮疹和腹泻.[结论]吉非替尼是晚期肺腺癌治疗较好的选择.

  16. Mandibular metastasis of adenocarcinoma from prostate cancer: case report according to epidemiology and current therapeutical trends of the advanced prostate cancer

    Directory of Open Access Journals (Sweden)

    Juliana Dreyer da Silva de Menezes

    2013-09-01

    Full Text Available Prostate cancer represents the most frequent non-cutaneous neoplasia in males. This type of neoplasia can develop peculiar patterns of evolution, presenting, in many cases, precocious relapses and metastasis. Bone metastasis in the mouth is extremely rare, and represents 1% of all malignant mouth neoplasias. The aim of the present study is to report a clinical case of bone metastasis in the mandibular region associated with a tumoral prostate adenocarcinoma, as well as to discuss connected aspects about diagnosis, prognosis and integrated treatment of this condition.

  17. Angiogenesis in advanced colorectal adenocarcinoma with special reference to tumoral invasion Angiogênese no adenocarcinoma colorretal avançado com especial referência à invasão tumoral

    Directory of Open Access Journals (Sweden)

    Cláudio TARTA

    2002-03-01

    Full Text Available Background - Angiogenesis is a crucial step in tumor growth and progression. Its quantification by microvessel counting has a prognostic value in several types of malignancies and recently has been appraised in gastrointestinal tumors. Aim - To assess the prognostisc significance of microvessel quantification in colorectal carcinomas, studying its association with hematogenous metastases, survival and clinicopathological variables such as size, histologic differentiation and depth of tumoral invasion. Patients/Methods - Forty eight patients with colorectal adenocarcinoma were included in this study. Histologic sections of invasion tumoral margin (4 µm were analyzed and endothellined microvessels were immunostained with monoclonal mouse Von Willebrand Factor (anti-FVIII. The microvessel count was performed from the identification of the area with increased microvessel density - hot spots - and results of the mean in five of these fields. Results- The cut-off microvessel count was 14 microvessels/0,785 mm² , which divided the sample into hypovascular and hypervascular groups. While 2/8 (25% tumors with muscularis propria invasion were classified as hypervascular, 11/15 (73% tumors with serosa or perivisceral fat were classified as hypervascular. However, a non-significant statistical association was found between the angiogenesis quantification, hematogenous metastases, survival and clinicopathological variables such as size and histologic differentiation of the tumor. Conclusions - The findings of significantly increase of microvessel count in conformity with tumoral invasion depth supports the hypothesis that tumor progression might be related to angiogenesis. Although angiogenesis is an important step in the tumoral growth and during the metastatization process, other factors can be implicated.Racional- A angiogênse é uma etapa fundamental no crescimento e progressão tumoral. Sua quantificação, através da contagem microvascular

  18. Meat intake and risk of stomach and esophageal adenocarcinoma within the European Prospective Investigation Into Cancer and Nutrition (EPIC).

    NARCIS (Netherlands)

    González, Carlos Alberto; Jakszyn, Paula; Pera, Guillem; Agudo, Antonio; Bingham, Sheila A; Palli, Domenico; Ferrari, Pietro; Boeing, Heiner; Giudice, Giuseppe del; Plebani, Mario; Carneiro, Fátima; Nesi, Gabriella; Berrino, Franco; Sacerdote, Carlotta; Tumino, Rosario; Panico, Salvatore; Berglund, Göran; Simán, Henrik; Nyrén, Olof; Hallmans, Göran; Martinez, Carmen; Dorronsoro Iraeta, Miren; Barricarte, Aurelio; Navarro, Carmen A; Quirós, José Ramón; Allen, Naomi E; Key, Timothy J; Day, Nicholas E; Linseisen, Jakob; Nagel, Gabriele; Bergmann, Manuela M; Overvad, Kim; Jensen, Majken K; Tjønneland, Anne; Olsen, Anja; Bueno-de-Mesquita, H Bas; Ocké, Marga C; Peeters, Petra H M; Numans, Mattijs E; Clavel-Chapelon, Françoise; Boutron-Ruault, Marie-Christine; Trichopoulou, Antonia; Psaltopoulou, Theodora; Roukos, Dimitrios; Lund, Eiliv; Hemon, Bertrand; Kaaks, Rudolf; Norat, Teresa; Riboli, Elio

    2006-01-01

    BACKGROUND: Dietary factors are thought to have an important role in gastric and esophageal carcinogenesis, but evidence from cohort studies for such a role is lacking. We examined the risks of gastric cancer and esophageal adenocarcinoma associated with meat consumption within the European Prospect

  19. Helicobacter pylori, Cancer, and the Gastric Microbiota.

    Science.gov (United States)

    Wroblewski, Lydia E; Peek, Richard M

    Gastric adenocarcinoma is one of the leading causes of cancer-related death worldwide and Helicobacter pylori infection is the strongest known risk factor for this disease. Although the stomach was once thought to be a sterile environment, it is now known to house many bacterial species leading to a complex interplay between H. pylori and other residents of the gastric microbiota. In addition to the role of H. pylori virulence factors, host genetic polymorphisms, and diet, it is now becoming clear that components of the gastrointestinal microbiota may also influence H. pylori-induced pathogenesis. In this chapter, we discuss emerging data regarding the gastric microbiota in humans and animal models and alterations that occur to the composition of the gastric microbiota in the presence of H. pylori infection that may augment the risk of developing gastric cancer.

  20. Unresectable gastric cancer with gastric outlet obstruction and distant metastasis responding to intraperitoneal and folfox chemotherapy after palliative laparoscopic gastrojejunostomy: report of a case

    Directory of Open Access Journals (Sweden)

    Park Joong-Min

    2010-12-01

    Full Text Available Abstract Background Gastric outlet obstruction (GOO caused by unresectable gastric cancer is a challenging aspect of patient care. There have been no reports involving patients with obstructing gastric cancer and several incurable factors curatively treated by multimodal treatments. Case presentation We report a case of 55-year-old man who was diagnosed with a poorly differentiated adenocarcinoma in the pre-pyloric antrum with GOO by gastroscopy. An abdominal computed tomography (CT scan revealed thickening of the gastric wall and adjacent fat infiltration, and a large amount of food in the stomach suggesting a passage disturbance, enlarged lymph nodes along the common hepatic and left gastric arteries, and multiple hepatic metastases. The serum carcinoembryonic antigen (CEA level was 343 ng/ml and the carbohydrate antigen (CA 19-9 level was within normal limits. The patient underwent a laparoscopic gastrojejunostomy for palliation of the GOO. On the 3rd and 12th days after surgery, he received intraperitoneal chemotherapy with 40 mg of docetaxel and 150 mg of carboplatin. Simultaneously, combined chemotherapy with 85 mg/m2 of oxaliplatin for the 1st day and 600 mg/m2 of 5-FU for 2 days (FOLFOX regimen was administered from the 8th post-operative day. After completion of nine courses of FOLFOX, the patient achieved a complete response (CR with complete disappearance of the primary tumor and the metastatic foci. He underwent a radical subtotal gastrectomy with D3 lymph node dissection 4 months after the initial palliative surgery. The pathologic results revealed no residual primary tumor and no lymph node metastasis in 43 dissected lymph nodes. He has maintained a CR for 18 months since the last operation. Conclusion Combination chemotherapy with systemic and intraperitoneal chemotherapy following laparoscopic bypass surgery showed marked efficacy in the treatment for unresectable advanced gastric cancer with GOO.

  1. 胃癌基因治疗研究进展%Advancement on gene therapy for gastric cancer

    Institute of Scientific and Technical Information of China (English)

    孙栋; 王西涛; 王新涛; 刘凤军

    2009-01-01

    胃癌的传统治疗措施效果不理想,近来随着分子生物学及基因工程技术的发展,基因治疗作为肿瘤治疗的新方法逐渐受到人们的重视,胃癌基因治疗研究主要包括以下几个方面:抑癌基因的替代治疗、反义基因治疗、"自杀"基因治疗、免疫基因治疗等.%Gastric cancer is one of the most common tumors. The outcome of conventional therapies is inefficient. In recent years,with development of molecular biology and genetic engineering technology,people pay more attention to gene therapy. The gene therapy for gastric cancer approaches include the following aspects: tumor suppressor gene replacement therapy, antisense gene therapy," suicide" gene therapy,immune gene thera-py,and so on. This review provides an update of the new developments in cancer gene therapy,new principles, techniques, strategies and vector systems, and shows how they may be applied in the treatment of gastric cancer.

  2. Anti-EGFR-Targeted Therapy for Esophageal and Gastric Cancers: An Evolving Concept

    Directory of Open Access Journals (Sweden)

    Tomislav Dragovich

    2009-01-01

    Full Text Available Cancers of the esophagus and stomach present a major health burden worldwide. In the past 30 years we have witnessed some interesting shifts in terms of epidemiology of esophago gastric cancers. Regardless of a world region, the majority of patients diagnosed with esophageal or gastric cancers die from progression or recurrence of their disease. While there are many active cytotoxic agents for esophageal and stomach cancers, their impact on the disease course has been modest at best. Median survival for patients with advanced gastroesophageal cancer is still less than a year. Therefore, novel strategies, based on our understanding of biology and genetics, are desperately needed. Epidermal growth factor receptor (EGFR pathway has been implicated in pathophysiology of many epithelial malignancies, including esophageal and stomach cancers. EGFR inhibitors, small molecule tyrosine kinase inhibitors and monoclonal antibodies, have been explored in patients with esophageal and gastric cancers. It appears that tumors of the distal esophagus and gastroesophageal junction (GEJ may be more sensitive to EGFR blockade than distal gastric adenocarcinomas. Investigations looking into potential molecular predictors of sensitivity to EGFR inhibitors for patients with esophageal and GEJ cancers are ongoing. While we are still searching for those predictors, it is clear that they will be different from ones identified in lung and colorectal cancers. Further development of EGFR inhibitors for esophageal and GEJ cancers should be driven by better understanding of EGFR pathway disregulation that drives cancer progression in a sensitive patient population.

  3. FEP regimen (epidoxorubicin, etoposide and cisplatin) in advanced gastric cancer, with or without low-dose GM-CSF: an Italian Trial in Medical Oncology (ITMO) study.

    Science.gov (United States)

    Bajetta, E.; Di Bartolomeo, M.; Carnaghi, C.; Buzzoni, R.; Mariani, L.; Gebbia, V.; Comella, G.; Pinotti, G.; Ianniello, G.; Schieppati, G.; Bochicchio, A. M.; Maiorino, L.

    1998-01-01

    The new regimens developed over the last few years have led to an improvement in the treatment of advanced gastric cancer, and our previous experience confirmed the fact that the combination of etoposide, doxorubicin and cisplatin (EAP regimen) is an active treatment that leads to interesting complete remission rates. The primary end point of the present multicentre, randomized, parallel-group phase II study was to determine the activity of the simplified 2-day EAP schedule in patients with locally advanced or metastatic gastric cancer, and to verify whether the addition of low doses of granulocyte-macrophage colony-stimulating factor (GM-CSF) made it possible to increase dose intensity. Of the 62 enrolled patients, 30 were randomized to receive epirubicin 35 mg m(-2), etoposide 120 mg m(-2) and cisplatin 45 mg m(-2) (FEP) on days 1 and 2 every 28 days and 32 to receive the same schedule plus subcutaneous GM-CSF (molgramostin) 150 microg day(-1) on days 5-14 every 21 days. The patients were stratified by age and the number of disease sites. The characteristics of the patients were well balanced between the two groups. The objective response rate of the patients as a whole was 34% (21 out of 62; 95% confidence interval 22-46), with only one complete remission. The median response duration was 4.5 months (range 1-24 months). The median time to treatment failure was 5 months (range 1-14 months), without any difference between the two groups. The median survival of the patients as a whole was 9 months. Full doses were administered in 92% and 94% of the cycles in the control and GM-CSF arms respectively. The average dose intensity calculated for all drugs was 0.96% in the control and 1.27% in the GM-CSF group. CTC-NCI grade 3-4 neutropenia was reported in 39% vs 45% of patients, thrombocytopenia in 11% vs 35% (P = 0.020) and anaemia in 7% vs 35% (P = 0.014). The FEP combination is as active (OR: 34%) in the treatment of patients with advanced gastric cancer as the EAP

  4. Clinical Study of S-1 Plus Oxaliplatin Versus S-1 Plus Cisplatin as First-Line Treatment for Elderly Patients with Advanced Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Deng-feng BO

    2015-12-01

    Full Text Available Abstract Objective: To explore the efficacy and safety of S-1 plus oxaliplatin versus S-1 plus cisplatin as the first-line treatment for elderly patients with advanced gastric cancer. Methods: A total of 60 patients with advanced gastric cancer admitted in Xi’an Yanliang Railway Hospital from Jan., 2011 to Oct., 2013 were selected as study objects and randomly divided into 2 groups: S1 plus oxaliplatin group (SOX group, 30 cases and S1 plus cisplatin group (SP group, 30 cases. SOX group were given intravenous drip of 130 mg/m2 oxaliplatin for 2 h on d1. And S-1 was also given according to body surface area: body surface area <1.25 m2, 40 mg once; 1.25-1.5 m2, 60 mg once; >1.5, 28 d as 1 cycle. SP group was administered with intravenous drip of 25 mg/m2 cisplatin during d1-d3. Treatment was discontinued until the occurrence of disease progression or patients’ intolerance to chemotherapy. Results: SOX group was non-inferior to SP group in overall response rate (ORR (53.3% vs. 43.3%, disease control rate (DCR (83.3% vs. 80.0%, median progression-free survival (PFS (7.0 vs. 6.0 months and median overall survival (OS (11.0 vs. 10.5 months. However, the difference was statistical significant in the rate of increased KPS score (86.7% vs. 46.7%, χ2=10.800, P=0.001 and the rate of increased FACT-G score (73.3% vs. 36.7%, χ2=8.148, P=0.004. The main toxic and side effects of two groups was hematological toxicity. There was no degree III-IV toxic and side effects occurring in non hematological toxicity in two groups. The main toxic effect was peripheral neuritis in SOX group, and nausea and vomiting and renal dysfunction in SP group, and there were statistical differences in the above toxic and side effects between two groups (P<0.05. Conclusion: SOX regimen is as safe and effective as SP regimen for elderly patients with advanced gastric cancer, with better quality of life and less toxic and side effects.

  5. Trial of the correlation between cytochrome oxidase CYP3A4 with the susceptibility of paclitaxel-based regimen for advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Jianwei Yang; Yan Meng; Ying Su; Zeng Chen; Wei Gao; Jinyuan Lin; Jing Jia; Huamei Lin

    2014-01-01

    Objective: The aim of the study was to investigate the relationship between susceptibility of paclitaxel-based regimen and gene polymorphisms of cytochrome oxidase CYP3A4 for advanced gastric cancer.Methods: Peripheral venous blood sample of 53 advanced gastric cancer patients were enroled to test the mutation of CYP3A4 gene by denaturing high performance liquid chromatography (DHPLC) and DNA sequencing. The relation between the eficacy of paclitaxel-based regimen and CYP3A4 gene polymorphisms was further analyzed.Results: DHPLC indicated that among the 53 patients, 21 cases showed biomodal type (mutation) and 32 cases were of unimodal type (wild-type). Sequencing results showed that the deletion mutation was found at the 27th basic group of C in exon 10 of CYP3A4 gene. The response rate (RR) and disease control rate (DCR) of wild-type group were 40.6% and 84.4%, while in mutation group they were 33.3% and 85.7%, respective-ly, with no significances between the two groups (P > 0.05). Of al 53 cases, the median progression-free survival (PFS) was 6.5 months (95% CI: 3.576-9.424 months), and the median overal survival (OS) was 11.0 months (95% CI: 6.955-15.045 months). The median PFS and OS in wild-type group had no diferences compared with those in mutation group (7.0 months vs. 7.0 months,P > 0.05; 10.0 months vs. 14.0 months,P > 0.05). Between wild-type and mutation groups, the median PFS of patients applied with oxaliplatin containing regimen and the median OS in patients applied with/without oxaliplatin had no significant diferences (P > 0.05), while the median PFS in patients received non-oxaliplatin regime had statistical diferences (P = 0.024). The median PFS and OS in patients receiving 3-drug or 2-drug regimes had no correlation with CYP3A4 gene polymorphisms. The adverse efects in the two groups were mild, mainly in grades 1-2. The common adverse efects were anorexia, nausea/vomiting and leucopenia.Conclusion: Deletion mutation was located in the 27th

  6. Advances of Epstein-Barr virus-associated gastric carcinoma%EB病毒相关胃癌研究进展

    Institute of Scientific and Technical Information of China (English)

    王长亮; 崔凯; 李胜

    2009-01-01

    Epstien-Barr病毒(EBV)在EBV阳性胃癌的演进中有重要作用.最近的研究集中在本病的流行病学和生物学发病机制.复习近年来针对EBV相关胃癌有关的基础、临床和流行病学研究,讨论EBV在胃癌发生发展中的作用,介绍此领域最新的研究成果.%Epstein-Barr virus(EBV) plays an important role in the development of EBV positive gas- tric carcinomas. Recent studies focus on epidemiological evidence and biological role of EBV infection in patho-genesis of gastric cancer. This article reviews mainly biological, epidemiological and clinicopathological stud-ies , discusses the roles of EBV in carcinogenesis and development of gastric cancer and introduce the latest ad-vancement in this area.

  7. 卡培他滨联合奥沙利铂治疗进展期胃癌68例%Clinical observation of capecitabine plus oxaliplatin in treatment of 68 cases with advanced gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Chaoying Liu; Jiang Li; Runjie Wang; Hong Hu; Juanying Xu

    2009-01-01

    Objective: The aim of this study was to evaluate the response rate, time to progression (TTP), overall survival, and safety of the combination of capecitabine plus oxaliplatin in treatment of advanced gastric cancer (AGC). Methods: All the patients with advanced gastric cancer who were not received any prior chemotherapy or radiotherapy were treated with combination of capecitabine (1250 mg/m2 twice daily, days 1-14) plus oxaliplatin (130 mg/m2 as a 2-h intravenous infusion on day 1) every 3 weeks. Results: Two cases of complete response (CR) and 34 cases of partial response (PR) were confirmed, giving an overall response rate of 52.9%, of the 68 patients with advanced gastric cancer. The median TTP and overall survival for all patients were 7.3 and 11.9 months, respectively. Grade 3 leukopenia, thrembocytopenia, nausealvomiting, and diarrhea were observed in 3, 5, 1, and 4 patients, respectively. Yet, no grade 4 toxicity was observed. Conclusion: Capecitabine/ oxaliplatin combination chemotherapy is active in patients with advanced gastric cancer.

  8. Divergent expression of MUC5AC, MUC6, MUC2, CD10, and CDX-2 in dysplasia and intramucosal adenocarcinomas with intestinal and foveolar morphology: is this evidence of distinct gastric and intestinal pathways to carcinogenesis in Barrett Esophagus?

    Science.gov (United States)

    Khor, Tze Sheng; Alfaro, Eduardo E; Ooi, Esther M M; Li, Yuan; Srivastava, Amitabh; Fujita, Hiroshi; Park, Youn; Kumarasinghe, Marian Priyanthi; Lauwers, Gregory Yves

    2012-03-01

    Dysplasia in Barrett esophagus has been recognized to be morphologically heterogenous, featuring adenomatous, foveolar, and hybrid phenotypes. Recent studies have suggested a tumor suppressor role for CDX-2 in the metaplasia-dysplasia-carcinoma sequence. The phenotypic stability and role of CDX-2 in the neoplastic progression of different types of dysplasias have not been evaluated. Thirty-eight endoscopic mucosal resections with dysplasia and/or intramucosal carcinoma (IMC) arising in Barrett esophagus were evaluated for the expression of MUC5AC, MUC6, MUC2, CD10, and CDX-2. The background mucosa was also evaluated. The results were correlated with morphologic classification and clinicopathologic parameters. Of 38 endoscopic mucosal resections, 23 had IMC and dysplasia, 8 had IMC only, and 7 had dysplasia only. Among dysplastic lesions, 73% were foveolar, 17% were adenomatous, and 10% were hybrid. Twenty of 23 cases with dysplasia and adjacent IMC showed an identical immunophenotype of dysplasia and IMC comprising 16 gastric, 3 intestinal, and 1 mixed immunophenotype. Three cases showed discordance of dysplasia and IMC immunophenotype. These findings suggest that most Barrett-related IMC cases are either gastric or intestinal, with phenotypic stability during progression supporting separate gastric and intestinal pathways of carcinogenesis. CDX-2 showed gradual downregulation of expression during progression in adenomatous dysplasia but not in foveolar or hybrid dysplasia, supporting a tumor suppressor role, at least in the intestinal pathway. CDX-2 was also found to be expressed to a greater degree in intestinal metaplasia compared with nonintestinalized columnar metaplasia. Consistent with CDX-2 as a tumor suppressor, this suggests that nonintestinalized columnar metaplasia may be an unstable intermediate state at risk for neoplastic progression.

  9. Importance of gastrin in the pathogenesis and treatment of gastric tumors

    Institute of Scientific and Technical Information of China (English)

    Michael D Burkitt; Andrea Varro; D Mark Pritchard

    2009-01-01

    In addition to regulating acid secretion, the gastric antral hormone gastrin regulates several important cellular processes in the gastric epithelium including proliferation, apoptosis, migration, invasion, tissue remodelling and angiogenesis. Elevated serum concentrations of this hormone are caused by many conditions, particularly hypochlorhydria (as a result of autoimmune or Helicobacter pylori ( H pylori)-induced chronic atrophic gastritis or acid suppressing drugs) and gastrin producing tumors (gastrinomas). There is now accumulating evidence that altered local and plasma concentrations of gastrin may play a role during the development of various gastric tumors. In the absence of H pylori infection, marked hypergastrinemia frequently results in the development of gastric enterochromaffin cell-like neuroendocrine tumors and surgery to remove the cause of hypergastrinemia may lead to tumor resolution in this condition. In animal models such as transgenic INS-GAS mice,hypergastrinemia has also been shown to act as a cofactor with Helicobacter infection during gastric adenocarcinoma development. However, it is currently unclear as to what extent gastrin also modulates human gast r ic adenocarcinoma development .Therapeutic approaches targeting hypergastrinemia,such as immunizat ion wi th G17DT, have been evaluated for the treatment of gastric adenocarcinoma,with some promising results. Although the mild hypergastrinemia associated with proton pump inhibitor drug use has been shown to cause ECL-cell hyperplasia and to increase H pylori-induced gastric atrophy, there is currently no convincing evidence that this class of agents contributes towards the development of gastric neuroendocrine tumors or gastric adenocarcinomas in human subjects.

  10. Solitary AFP- and PIVKA-II-producing hepatoid gastric cancer with giant lymph node metastasis.

    Science.gov (United States)

    Iso, Yukihiro; Sawada, Tokihiko; Shimoda, Mitsugi; Rokkaku, Kyu; Ohkura, Yasuo; Kubota, Keiichi

    2005-01-01

    A 61-year-old man was admitted to our hospital because of abdominal pain and an abdominal mass. The patient had anemia and elevated serum alpha-fetoprotein (AFP) (9630ng/mL) and PIVKA-II (91mAU/mL) levels. Roentgenographic examination revealed an extra-gastric tumor in the upper abdomen, and gastroscopy revealed Bormann type 2 gastric cancer in the lower portion of the stomach. The preoperative diagnosis was synchronous gastric cancer and hepatocellular carcinoma (HCC), and surgery was performed. The extra-gastric tumor appeared to be an extra-hepatically growing HCC because the tumor was fed by vessels ramifying from the umbilical portion of the liver. Distal gastrectomy with resection of the extra-gastric tumor was performed, and histological examination of the resected specimen revealed that the gastric cancer was an AFP-producing hepatoid gastric adenocarcinoma and that the extra-gastric tumor was a lymph node metastasis. AFP-producing hepatoid gastric adenocarcinoma tends to metastasize to the regional lymph nodes and form a giant tumor. A giant tumor in the upper abdomen associated with gastric cancer may therefore be a clinical manifestation of AFP-producing hepatoid gastric adenocarcinoma.

  11. Related factors for mediastinal lymph node metastasis in gastric cardia adenocarcinoma:A report of 118 cases%贲门腺癌纵隔淋巴结转移相关因素分析(附118例报告)

    Institute of Scientific and Technical Information of China (English)

    汪金钱; 解明然; 魏大中

    2014-01-01

    Objective:To investigate the related factors affecting the mediastinal lymph node metastasis in patients with gastric cardial adenocarcinoma for indications of necessary lymph node dissection .Methods:The clinical data were retrospectively analyzed in 118 cases of gastric cardial adenocarcinoma undergone surgical treatment in our department between Jan.2011 and May 2013.The outcomes of mediastinal lymph node metastasis were determined on the pathological finding basis of the patients.Results:Totally,362 pieces of mediastinal lymph nodes were dissected,mean(3.1 ±0.4)pieces,and the rate and ratio of mediastinal lymph node metastasis were 25.4%(30/118) and 11.6%(42/362),respectively.The metastasis to the mediastinal lymph nodes was associated with tumor size,pathological tumor depth,differentiation and presence or absence of involvement of the lower esophagus .The results were statistically significant (P≤0.05).Conclusion:Metastasis status of the mediastinal lymph nodes for cardial adenocarcinoma is associated with pathological factors,and occurs more common in cases with poorly differentiated and larger sized tumor ( >3 cm in diameter) ,deeper invasion and involvement of lower esophagus.Thus,conventional dissection of the mediastinal lymph nodes,especially the lymph nodes at the inferior mediastinum,is necessary for those types of patients.%目的:探讨贲门腺癌纵隔淋巴结转移相关因素,以明确纵隔淋巴结清扫指征。方法:回顾性分析2011年1月~2013年5月118例左胸入路手术治疗贲门腺癌患者临床资料,分析患者临床病理资料与纵隔淋巴结转移的关系。结果:全组病例共清扫纵隔淋巴结362枚,平均清扫每例淋巴结数(3.1±0.4)枚。纵隔淋巴结转移率为25.4%(30/118),转移度为11.6%(42/362)。肿瘤长度、浸润深度、分化程度、肿瘤是否累及食管下段与纵隔淋巴结转移有关,结果有统计学意义(P≤0.05)。结论

  12. Selenium Status and the Risk of Esophageal and Gastric Cancer Subtypes: The Netherlands Cohort Study

    NARCIS (Netherlands)

    Steevens, J.; Brandt, P.A. van den; Goldbohm, R.A.; Schouten, L.J.

    2010-01-01

    Background & Aims: Selenium may protect against the development of esophageal squamous cell carcinoma (ESCC), esophageal adenocarcinoma (EAC), and gastric cardia adenocarcinoma (GCA). Only in very few studies have the associations with ESCC and GCA been investigated, and no epidemiologic studies exi

  13. Preoperative evaluation of oesophageal adenocarcinoma.

    Science.gov (United States)

    Khanna, Lauren G; Gress, Frank G

    2015-02-01

    The preoperative evaluation of oesophageal adenocarcinoma involves endoscopic ultrasound (EUS), computed tomography (CT), and positron emission tomography (PET). With routine Barrett's oesophagus surveillance, superficial cancers are often identified. EUS, CT and PET have a limited role in the staging of superficial tumours. Standard EUS has limited accuracy, but high frequency ultrasound miniprobes are valuable for assessing tumour stage in superficial tumours. However, the best method for determining depth of invasion, and thereby stage of disease, is endoscopic mucosal resection. In contrast, in advanced oesophageal cancers, a multi-modality approach is crucial. Accurate tumour staging is very important since the treatment of advanced cancers involves a combination of chemotherapy, radiation, and surgery. EUS is very useful for staging of the tumour and nodes. High frequency ultrasound miniprobes provide the ability to perform staging when the lesion is obstructing the oesophageal lumen. CT and PET provide valuable information regarding node and metastasis staging.

  14. Towards Fluorescence In Vivo Hybridization (FIVH) Detection of H. pylori in Gastric Mucosa Using Advanced LNA Probes

    DEFF Research Database (Denmark)

    Fontenete, Sílvia; Leite, Marina; Guimarães, Nuno

    2015-01-01

    acid (LNA)/ 2' O-methyl RNA (2'OMe) probe using standard phosphoramidite chemistry and FISH hybridization was then successfully performed both on adhered and suspended bacteria at 37°C. In this work we simplified, shortened and adapted FISH to work at gastric pH values, meaning that the hybridization......In recent years, there have been several attempts to improve the diagnosis of infection caused by Helicobacter pylori. Fluorescence in situ hybridization (FISH) is a commonly used technique to detect H. pylori infection but it requires biopsies from the stomach. Thus, the development of an in vivo...

  15. Analysis of Traditional Chinese Medicine in the Treatment of Advanced Gastric Cancer%中医药治疗晚期胃癌的思路与方法

    Institute of Scientific and Technical Information of China (English)

    王长志; 孙绪勇

    2013-01-01

    目的:探析中医药治疗晚期胃癌的理论依据.方法:根据中医“有胃气则生,无胃气则死”和“脾胃为后天之本,气血生化之源”的理论,一方面急则对症治标,另一方面缓则饮食调配,中医药健脾和胃,益气止血,消癥散结,兼以抗癌治本.结果:中医药治疗患者的生存时间均超过手术治疗和化疗患者的生存时间,患者的生活质量也明显改善.结论:中医药治疗晚期胃癌有较好疗效.%Objective:To improve the life quality and survival time of patients with advanced gastric cancer.Methods:On the one hand,alleviate the symptoms of a problem.On the other hand keep diet order combined with traditional Chinese medicine strengthening the spleen and stomach,benefiting vital energy so as to radical therapy.Results:The survival time of patients treated by traditional Chinese medicine was longer than patients treated by palliative surgery and chemotherapy.The life quality is much better than patients treated by western medicine.Conclusion:Chinese medicine has good curative effect in treating advanced gastric cancer.

  16. Multiple early gastric cancer with duodenal invasion

    Directory of Open Access Journals (Sweden)

    Okino Tetsuya

    2007-10-01

    Full Text Available Abstract Background Early gastric cancers with duodenal invasion are rare, and no previous case of multiple early gastric cancer, one invading the duodenal bulb, has been reported. Case presentation A 79-year-old woman was investigated for upper abdominal discomfort. Endoscopic examination revealed an irregular nodulated lesion in the antrum area, and a reddish aggregated-type semi-circumferential nodulated lesion extending from the prepyloric area to the duodenal bulb through the normal mucosa with the antrum lesion. Biopsy revealed a tubular adenoma for the antrum lesion and a well-differentiated tubular adenocarcinoma for the prepyloric lesion. Distal gastrectomy with sufficient duodenal resection was performed. Microscopically, the antrum lesion appeared as a papillary adenocarcinoma, and the prepyloric lesion as a mainly papillary adenocarcinoma which partially invaded the submucosa without any sequential elongation for endoscopic findings. The lesion extended into the duodenal bulb, and was 12 mm in length from the oral end of Brunner's gland's area and limited within the duodenal mucosa. Conclusion Here, we present an unusual case of multiple early gastric cancer, one of which invaded the duodenum with relative wide mucosal spreading. This case illustrates that even early stage cancers located in the gastric antrum, particularly in the prepyloric area can invade the duodenum directly.

  17. [A Case of Synchronous Multiple Esophageal Cancers Composed of Squamous Cell Carcinoma and Barrett's Adenocarcinoma].

    Science.gov (United States)

    Kobayashi, Toshiyuki; Shiozaki, Atsushi; Fujiwara, Hitoshi; Konishi, Hirotaka; Arita, Tomohiro; Kosuga, Toshiyuki; Morimura, Ryo; Murayama, Yasutoshi; Komatsu, Shuhei; Kuriu, Yoshiaki; Ikoma, Hisashi; Nakanishi, Masayoshi; Ichikawa, Daisuke; Okamoto, Kazuma; Otsuji, Eigo

    2015-11-01

    A 67-year-old man was admitted to our hospital for treatment for multiple superficial esophageal cancers. Screening upper gastrointestinal endoscopy examination revealed a superficial squamous cell carcinoma (SCC) at the middle thoracic esophagus and Barrett's epithelium and a superficial adenocarcinoma at the abdominal esophagus. We performed a subtotal esophagectomy with gastric tube reconstruction via the retrosternal route. Pathological examination revealed a Barrett's adenocarcinoma at the abdominal esophagus. Esophageal cancer is thought to be a multicentric disease, and we sometimes find multiple esophageal cancers. In Japan, most cases of multiple esophageal cancers are composed of SCCs, and the occurrence of multiple esophageal cancers composed of SCC and Barrett's adenocarcinoma is rare. In contrast, the number of the patients with Barrett's esophagus is increasing, and the number of the patients with Barrett's adenocarcinoma also seems to be on the rise. Therefore, it is important be aware of the possibility of multiple esophageal cancers composed of SCC and Barrett's adenocarcinoma while making diagnoses.

  18. Increased oxidative DNA damage, inducible nitric oxide synthase,nuclear factor κB expression and enhanced antiapoptosis-related proteins in Helicobacter pylori-infected non-cardiac gastric adenocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Chi-Sen Chang; Wei-Na Chen; Hui-Hsuan Lin; Cheng-Chung Wu; Chau-Jong Wang

    2004-01-01

    AIM: Several epidemiological studies have demonstrated a close association between Helicobacter pylori (H Pylori)infection and non-cardiac carcinoma of the stomach. H pylori infection induces active inflammation with neutrophilic infiltrations as well as production of oxygen free radicals that can cause DNA damage. The DNA damage induced by oxygen free radicals could have very harmful consequences,leading to gene modifications that are potentially mutagenic and/or carcinogenic. The aims of the present study were to assess the effect of Hpyloriinfection on the expression of inducible nitric oxidative synthase (iNOS) and the production of 8-hydroxy-deoxyguanosine (8-OHdG), a sensitive marker of oxidative DNA injury in human gastric mucosa with and without tumor lesions, and to assess the possible factors affecting cell death signaling due to oxidative DNA damage.METHODS: In this study, 40 gastric carcinoma specimens and adjacent specimens were obtained from surgical resection. We determined the level of 8-OHdG formation by HPLC-ECD, and the expression of iNOS and mechanism of cell death signaling [including nuclear factor-κB(NFκB),MEKK-1, Caspase 3, B Cell lymphomal leukemia-2 (Bcl-2),inhibitor of apoptosis protein (IAP) and myeloid cell leukemia-1 (Mcl-1)] by Western-blot assay.RESULTS: The concentrations of 8-OHdG, iNOS, NFκB, Mcl-1 and IAP were significantly higher in cancer tissues than in adjacent non-cancer tissues. In addition, significantly higher concentrations of 8-OHdG, iNOS, NFκB, Mcl-1 and IAP were detected in patients infected with H pylori compared with patients who were not infected with H pylori. Furthermore,8-OHdG, iNOS, NFκB, Mcl-1 and IAP concentrations were significantly higher in stage 3 and 4 patients than in stage 1 and 2 patients.CONCLUSION: Chronic H pylori infection induces iNOS expression and subsequent DNA damage as well as enhances anti-apoptosis signal transduction. This sequence of events supports the hypothesis that oxygen

  19. Expression of mucins and E-cadherin in gastric carcinoma and their clinical significance

    Institute of Scientific and Technical Information of China (English)

    Hong-Kai Zhang; Qiu-Min Zhang; Tie-Hua Zhao; Yuan-Yuan Li; Yong-Fen Yi

    2004-01-01

    AIM: To investigate the expression of three types of mucin (MUC1, MUC2, MUCSAC) and E-cadherin in human gastric carcinomas and their clinical significance.METHODS: Ninety-four gastric cancer specimens were classified according to WHO criteria and detected by immunohistochemical assay of expression of mucins and E-cadherin.RESULTS: The positive expression rates of MUC1, MUC2,MUC5AC and E-cadherin were 82% (77/94), 84% (79/94),40% (38/94) and 56% (53/94) respectively. MUC1 expression was significantly correlated with the types of cancer (the positive rates of MUC1 in well and moderately differentiated tubular adenocarcinoma, poorly differentiated adenocarcinoma,signet-ring cell carcinoma and mucinous carcinoma were 91%, 87%, 71%, 71%, respectively, P<0.05), age of patients (the positive rates of it among the people who are younger than 40 years, between 40-60 years and over 60 year were 74%, 81%, 89%, P<0.05), lymph nodes involvement (the positive rates in the non-interfered group and the interfered group were 78%, 85%, P<0.05) and tumor size (the positive rates in the tumors with the size less than 3 cm, 3-6 cm and larger than 6 cm were 69%, 92%, 69%, P<0.05); MUC2expression was significantly associated with types of cancers and had the strongest expression in mucinous carcinomas (the positive rates of MUC2 in well and moderately differentiated tubular adenocarcinoma, poorly differentiated adenocarcinoma,signet-ring cell carcinoma and mucinous carcinoma were 94%, 70%, 81%, 100%, P<0.05), but it had no obvious relation to age, gender, tumor location, lymph nodes involvement,depth of invasion and metastasis to extra-gastric organs (P>0.05); MUC5AC expression was not related to any of the characteristics investigated except that it had relation to gender, whereas MUC5AC showed the tendency to higher expression in less invasive lesions and lower expression in advanced stage cancers (P>0.05); No significant difference was found for E-cadherin expression

  20. Correlation of p53 over-expression and alteration in p53 gene detected by polymerase chain reaction-single strand conformation polymorphism in adenocarcinoma of gastric cancer patients from India

    Institute of Scientific and Technical Information of China (English)

    Sajjad Karim; Arif Ali

    2009-01-01

    AIM: To study the alterations in p53 gene among Indian gastric cancer patients and to correlate them with the various clinicopathological parameters.METHODS: A total of 103 gastric cancer patients were included in this study. The p53 alterations were studied by both immunohistochemical method as well as polymerase chain reaction (PCR)-single strand conformation polymorphism (SSCP) analysis. We only studied four (exon 5, 6, 7, and 8) of the 11 p53 exons. The alterations in p53 were also correlated with respect to various clinicopathological parameters.RESULTS: Among 103 cases, p53 over-expression and alteration were detected in 37 (35.92%) and 19 (18.44%) cases, respectively. Most of the p53 alterations were found at exon 5 (31.54%), followed by exon 6 (26.31%), exon 7 (21.04%) and exon 8 (21.04%). A significant correlation of p53 overexpression was found with p53 alteration ( P = 0.000).Concordance between p53 alteration (as detected by SSCP) and over-expression [as detected by immunohistochemistry (IHC)] was found in 75% cases.We found that IHC-positive/SSCP-negative cases accounted for 21% of cases and IHC-negative/SSCPpositive cases accounted for remaining 4% cases.CONCLUSION: Our results show that p53 gene mutations are significantly correlated with p53 protein over-expression, with 75% concordance in overexpression and alteration in the p53 gene, but 25% disconcordance also cautions against the assumption that p53 over-expression is always associated with a gene mutation. There may be other mechanisms responsible for stabilization and accumulation of p53 protein with no evidence of gene mutation that reflect an accumulation of a non-mutated protein, or a false negative SSCP result.

  1. Primary adenocarcinoma of lung: A pictorial review of recent updates

    Energy Technology Data Exchange (ETDEWEB)

    Gaikwad, Anand, E-mail: anandgaik@yahoo.co.in [Department of Diagnostic Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON (Canada); Gupta, Ashish, E-mail: ashgupta@toh.on.ca [Department of Diagnostic Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON (Canada); Hare, Sam, E-mail: samanjeet@btinternet.com [Department of Diagnostic Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON (Canada); Gomes, Marcio, E-mail: mgomes@toh.on.ca [Department of Pathology and Laboratory Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON (Canada); Sekhon, Harman, E-mail: hsekhon@toh.on.ca [Department of Pathology and Laboratory Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON (Canada); Souza, Carolina, E-mail: csouza@ottawahospital.on.ca [Department of Diagnostic Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON (Canada); Inacio, Joao, E-mail: joao.r.inacio@gmail.com [Department of Diagnostic Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON (Canada); Lad, Shilpa, E-mail: slad@toh.on.ca [Department of Diagnostic Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON (Canada); Seely, Jean, E-mail: jeseely@ottawahospital.on.ca [Department of Diagnostic Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON (Canada)

    2012-12-15

    Primary adenocarcinoma of lung has replaced squamous cell carcinoma as the commonest histological subtype of lung cancer and the incidence of primary lung adenocarcinoma appears to be rising. Although the main factors behind this ‘epidemic-like’ situation are largely undiscovered, filter cigarettes appear to significantly contribute to this shift in the histopathological spectrum. The new multidisciplinary classification of adenocarcinoma of lung was introduced to address advances in clinical, pathological, radiological and molecular sciences. The purpose of this essay is to discuss various classes of lung adenocarcinoma in the new classification with their classical imaging features on computed tomography and summarise the recent advances in the field of radiology and review radiology recommendations.

  2. Immunotherapy for gastric premalignant lesions and cancer.

    Science.gov (United States)

    Zorzetto, Valerio; Maddalo, Gemma; Basso, Daniela; Farinati, Fabio

    2012-06-01

    Chronic atrophic gastritis, a precancerous change for gastric cancer, shows a loss of appropriate glands, Helicobacter pylori infection and autoimmune gastritis being the two main etiologic factors. While H. pylori eradication is the mandatory treatment for the former, no etiologic treatment is available for the latter, in which a Th1-type response, modulated by Tregs and Th17 cells, is involved. H. pylori-related atrophic gastritis is a risk factor for gastric adenocarcinoma, while autoimmune atrophic gastritis is also linked to a substantial risk of gastric type I carcinoid, related to the chronic stimulus exerted by hypergastrinemia on enterochromaffin-like cells. Several studies have been published on gastric cancer treatment through an active specific immunotherapy, aimed at improving the immunoregulatory response and increasing the circulating tumor-specific T cells. No study on immunotherapy of carcinoids is available but, in our experience, the administration of an antigastrin 17 vaccine induced carcinoid regression in two out of three patients treated.

  3. Paclitaxel plus valproic acid versus paclitaxel alone as s