ObjectiveTo evaluate the safety and efficacy of preoperation administration of enteral nutrition enriched ω-3 fatty acids for gastric cancer patients. MethodsA single center randomized controlled clinical trial was performed in 60 cases of gastric cancer in West China Hospital during January 2014 to June 2014, and cases were equally randomized divided into treatment group and control group. Cases of treatment group were given enteral nutrition enriched ω-3 fatty acids which was manufactured by Fresenius Kabi Deutschland GmbH for 5 consecutive days before operation, and cases of control group were given an isocaloric and isonitrogenous homogenized diet for 5 consecutive days before operation. The laboratory indexes of nutritional status and imflammatory factors were observed and compared between 2 groups on admission, preoperative day 1, postoperative day 3, and postoperative day 5. Liver and kidney function indexes which as the safety indexes were detected on admission and preoperative day 1. Vomiting, diarrhea, and infectious complications were recorded in addition. ResultsOn 3 days after operation, levels of interleukin-6 (IL-6) and α-acid glycoprotein (AAG) of treatment group were both lower than those of control group (P<0.05); on 5 days after operation, levels of C-reactive protein (CRP) of treatment group was lower than that of control group too (P<0.05); but at other time points, there were no significant differences in any index between the 2 groups (P>0.05). During the period of enteral nutrition, only 1 case suffered from bloating and 1 case suffered from diarrhea, both in treatment group, and the incidence of adverse reactions didn't differed between treatment group[6.7% (2/30)]and control group[0 (0/30)], P>0.05. Moreover, there were no significant differences between treatment group and control group in incidences of wound infection[3.3% (1/30) vs. 10.0% (3/30)], abdominal infection[0 (0/30) vs. 3.3% (1/30)], urinary infection[0 (0/30) vs. 3.3% (1/30)], and pulmonary infection[0 (0/30) vs. 6.7% (2/30)], but the total incidence of complication was lower in treatment group than that of control group[3.3% (1/30) vs. 23.3% (7/30)], P=0.026. ConclusionEnteral nutrition enriched ω-3 fatty acids can reduce the rate of infection-related complication for patients with gastric cancer, and has a sense of safety.
ObjectiveTo summarize the clinical effect of Da Vinci robot radical gastrectomy for gastric cancer.MethodsA retrospective analysis was performed on 200 patients undergoing radical surgery for Da Vinci robotic gastric cancer from the General Surgery of the 940th Hospital of the Chinese People's Liberation Army from December 2016 to January 2018.ResultsThere were 200 cases of robotic radical gastric cancer, 99 cases of radical distal gastrectomy, and 101 cases of radical total gastrectomy. The operative time was (241.0±33.3) min, intraoperative blood loss was (146.2±110.4) mL, and the number of lymph nodes cleaned was (42±14). The time of first anal exhaustion was (3.1±0.7) d, the time of first meal was (4.3±0.7) d, the postoperative extubation time was (5.3±0.5) d, and the postoperative hospitalization cost was (96 366.50±16 992.87) yuan. Tumor diameter was (4.5±2.0) cm. The degree of tumor differentiation was high differentiation in 7 cases, moderate differentiation in 61 cases and poor differentiation in 132 cases. TNM stage was 1 case in stage Ⅰ, 62 cases in stage Ⅱ and 137 cases in stage Ⅲ. Iauren was divided into intestinal type (78 cases), diffuse type (65 cases) and mixed type (57 cases). The tumor infiltrated into submucosa in 1 case, intrinsic muscularis in 3 cases, subserosal layer in 31 cases and serosal layer in 165 cases. The tumors were located in the upper part of the stomach in 45 cases, the lower part of the stomach in 106 cases, the body of the stomach in 46 cases, the whole stomach in 1 case, and the gastroesophageal junction in 2 cases. Postoperative complications occurred in 8 cases (4%), including anastomotic leakage in 4 cases, duodenal stump fistula in 1 case, tracheoesophageal fistula in 1 case, pulmonary infection in 1 case, and gastroparesis in 1 case.ConclusionThe DaVinci robotic surgical system has less surgical injuries, quicker postoperative recovery, and better clinical efficacy.
Objective To review the research progress in relationship between hereditary diffuse gastric cancer (HDGC) and CDH1 gene. Methods Literatures on HDGC which were published in recent years were collected and analyzed. Results Aberrant CDH1 gene is significantly correlated with HDGC: mutations of CDH1 exons play the most important role in pathogenesis of HDGC. Screening CDH1 gene mutation is useful for diagnosis of HDGC as well as the treatments. Alterations of CDH1 other than exon mutation, such as intron mutation, gene promoter methylation and single nucleotide polymorphism may result in downregulation of the gene expression. Further study should be done to confirm the roles of these alterations. Conclusions Alterations of CDH1 gene are significantly associated with the pathogenesis of HDGC. Detecting alterations of CDH1 gene are important for diagnosis and management of HDGC as well as to get insights of the pathogenesis of the disease.
ObjectiveTo investigate the expression and clinical significance of octamer-binding transcription factor 4(Oct-4) in gastric cancer (GC) tissues with meta-analysis. MethodsPubMed, EMBASE, Web of Science, CBM, VIP, CNKI, and WanFang Database were searched from their establishment to Oct.2012 for related studies, to investigate the relationship between expression of Oct-4 and the clinicopathological characteristics of GC.After evaluating methodo-logical quality of studies that met the inclusion criteria, RevMan 5.1 software was used to data analysis. ResultsEight studies which enrolled 623 cases of GC were identified.The results of the meta-analysis showed that, as for the positive expression rate of Oct-4, there were significant differences between GC tissues and normal stomach tissues (OR=37.50, 95% CI: 4.76-295.51, P < 0.01), as well as the cell differentiation (OR=0.27, 95% CI: 0.16-0.45, P < 0.01), for that the positive expression rate of Oct-4 in low differentiation of gastric cancer tissues was higher than those of moderate-high differentation group.But there were no significant differences between GC tissues with lymph node metastasis and non-lymph node metastasis (OR=2.09, 95% CI: 0.63-6.94, P=0.23), as well as Ⅰ-Ⅱ stage and Ⅲ-Ⅳ stage (OR=0.62, 95% CI: 0.25-1.54, P=0.30) of GC tissues. ConclusionsOct-4 may participate in the whole course of carcinogenesis of GC, but the relationship between expression of Oct-4 and lymph node metastasis as well as the TNM stage of GC is unclear, which needs more high quality studies to explore the question clearly.
Objective To study relationship between integrins and carcinogenesis, development, treatment or prognosis of gastric cancer. Methods The literatures about integrins and gastric cancer in recent years were reviewed and analyzed. Results The current study found that the β1 subunit integrins and αν subline integrins are closely associated with the gastric cancer. The β1 subunit integrins are associated with the invasion and metastasis of the gastric cancer, the αν subline integrins are associated with the typing, grading, and staging of the gastric cancer, and the ανβ3, ανβ5 and ανβ6 are associated with the prognosis of the gastric cancer, further more, the ανβ6 could be used as an independent effective prognostic factor. Conclusions Integrins are associated with occurrence, development, treatment, and prognosis of gastric cancer. It′s mechanism such as signal transduction pathway is not completely clarified. With further in-depth research, it′s molecular mechanism would be gradually elucidated and provide new ideas and methods for diagnosis, treatment, and prognosis of gastric cancer.
T lymphocyte acid α-naphthl acetate esterase (Tc-ANAE) activity was measured in 23 pathologically proved gastric cancer patients before and after surgical intervention. The result showed that interventional treatment obviously decreased the Tc-ANAE activity in patients with gastric cancer (Ｐ＜0.01), especially decreased the immune function in late stage cases (stage Ⅳ) (Ｐ＜0.01), the more advanced the cancer was, the more impaired the immune function was. Interventional treatment had no influence on immune function in earlier stages (Ｐ＞0.05).
Objective To understand research progress on peritoneal metastasis from gastric cancer at present stage briefly. Methods The literatures about mechanism, diagnosis, prevention and treatment of the peritoneal metastasis from gastric cancer at home and aboard were collected to make a review. Results The peritoneal metastasis is the common site of the distant metastasis in the advanced gastric cancer. It’s occurrence mechanism is complex, the diagnostic measure is varied, the prevention way is difficulty, and it give priority to with the comprehensive treatment and the transformed therapy. Conclusion It has a certain necessity to study occurrence mechanism, prevention methods and treatment measures so that improve survival rate and prognosis for patients with peritoneal metastasis from advanced gastric cancer.