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Gao X, Li G, Deng J, Zhao L, Han W, Zhang N, Gao Y, Lu L, Wang S, Yu J, Yan J, Zhang G, Peng R, Zhang R, Fu Y, He F, Hu J, Wang W, Fan P, Si C, Gao P, Liang H, Chen H, Ji G, Shang L, Zhao Q, Zhang Z, Yang S, Wang Z, Xi H, Chen Y, Wu K, Nie Y. Association of survival with adjuvant chemotherapy in patients with stage IB gastric cancer: a multicentre, observational, cohort study. Lancet Reg Health West Pac 2024; 45:101031. [PMID: 38361774 PMCID: PMC10867760 DOI: 10.1016/j.lanwpc.2024.101031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/25/2023] [Accepted: 01/25/2024] [Indexed: 02/17/2024]
Abstract
Background Recurrence following radical resection in patients with stage IB gastric cancer (GC) is not uncommon. However, whether postoperative adjuvant chemotherapy could reduce the risk of recurrence in stage IB GC remains contentious. Methods We collected data on 2110 consecutive patients with pathologic stage IB (T1N1M0 or T2N0M0) GC who were admitted to 8 hospitals in China from 2009 to 2018. The survival of patients who received adjuvant chemotherapy was compared with that of postoperative observation patients using propensity score matching (PSM). Two survival prediction models were constructed to estimate the predicted net survival gain attributable to adjuvant chemotherapy. Findings Of the 2110 patients, 1344 received adjuvant chemotherapy and 766 received postoperative observation. Following the 1-to-1 matching, PSM yielded 637 matched pairs. Among matched pairs, adjuvant chemotherapy was not associated with improved survival compared with postoperative observation (OS: hazard ratio [HR], 0.72; 95% CI, 0.52-1.00; DFS: HR, 0.91; 95% CI, 0.64-1.29). Interestingly, in the subgroup analysis, reduced mortality after adjuvant chemotherapy was observed in the subgroups with elevated serum CA19-9 (HR, 0.22; 95% CI, 0.08-0.57; P = 0.001 for multiplicative interaction), positive lymphovascular invasion (HR, 0.32; 95% CI, 0.17-0.62; P < 0.001 for multiplicative interaction), or positive lymph nodes (HR, 0.17; 95% CI, 0.07-0.38; P < 0.001 for multiplicative interaction). The survival prediction models mainly based on variables associated with chemotherapy benefits in the subgroup analysis demonstrated good calibration and discrimination, with relatively high C-indexes. The C-indexes for OS were 0.74 for patients treated with adjuvant chemotherapy and 0.70 for patients treated with postoperative observation. Two nomograms were built from the models that can calculate individualized estimates of expected net survival gain attributable to adjuvant chemotherapy. Interpretation In this cohort study, pathologic stage IB alone was not associated with survival benefits from adjuvant chemotherapy compared with postoperative observation in patients with early-stage GC. High-risk clinicopathologic features should be considered simultaneously when evaluating patients with stage IB GC for adjuvant chemotherapy. Funding National Natural Science Foundation of China; the National Key R&D Program of China.
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Affiliation(s)
- Xianchun Gao
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 169 West Changle Road, Xi'an 710032, China
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, 169 West Changle Road, Xi'an 710032, China
| | - Gang Li
- Department of General Surgery, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & the Affiliated Cancer Hospital of Nanjing Medical University, 42 Baiziting, Nanjing 210009, China
| | - Jingyu Deng
- Department of Gastric Surgery, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Cancer for Cancer, West Huanhu Road, Tianjin 300060, China
| | - Lulu Zhao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Beijing 100021, China
| | - Weili Han
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 169 West Changle Road, Xi'an 710032, China
| | - Nannan Zhang
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 169 West Changle Road, Xi'an 710032, China
| | - Yunhe Gao
- Department of General Surgery, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing, Beijing 100853, China
| | - Linbin Lu
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 169 West Changle Road, Xi'an 710032, China
| | - Shibo Wang
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 169 West Changle Road, Xi'an 710032, China
| | - Jun Yu
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 169 West Changle Road, Xi'an 710032, China
| | - Junya Yan
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 169 West Changle Road, Xi'an 710032, China
| | - Gan Zhang
- Department of General Surgery, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing, Beijing 100853, China
| | - Rui Peng
- Department of General Surgery, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & the Affiliated Cancer Hospital of Nanjing Medical University, 42 Baiziting, Nanjing 210009, China
| | - Rupeng Zhang
- Department of Gastric Surgery, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Cancer for Cancer, West Huanhu Road, Tianjin 300060, China
| | - Yu Fu
- Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, China
- Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors (China Medical University), Ministry of Education, 155 North Nanjing Street, Shenyang, 110001, China
| | - Fang He
- Department of Gastroenterology, General Hospital of Ningxia Medical University, 804 Shengli, Yinchuan 750004, China
| | - Junguo Hu
- Gansu Wuwei Cancer Hospital, 16 Xuanwu, Wuwei 733000, China
| | - Wanqing Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Beijing 100021, China
| | - Ping Fan
- Gansu Wuwei Cancer Hospital, 16 Xuanwu, Wuwei 733000, China
| | - Cen Si
- Department of Gastroenterology, General Hospital of Ningxia Medical University, 804 Shengli, Yinchuan 750004, China
| | - Peng Gao
- Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, China
- Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors (China Medical University), Ministry of Education, 155 North Nanjing Street, Shenyang, 110001, China
| | - Han Liang
- Department of Gastric Surgery, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Cancer for Cancer, West Huanhu Road, Tianjin 300060, China
| | - Huanqiu Chen
- Department of General Surgery, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & the Affiliated Cancer Hospital of Nanjing Medical University, 42 Baiziting, Nanjing 210009, China
| | - Gang Ji
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 169 West Changle Road, Xi'an 710032, China
| | - Lei Shang
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, 169 West Changle Road, Xi'an 710032, China
| | - Qingchuan Zhao
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 169 West Changle Road, Xi'an 710032, China
| | - Zhiyi Zhang
- Gansu Wuwei Cancer Hospital, 16 Xuanwu, Wuwei 733000, China
| | - Shaoqi Yang
- Department of Gastroenterology, General Hospital of Ningxia Medical University, 804 Shengli, Yinchuan 750004, China
| | - Zhenning Wang
- Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, China
- Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors (China Medical University), Ministry of Education, 155 North Nanjing Street, Shenyang, 110001, China
| | - Hongqing Xi
- Department of General Surgery, The First Medical Center of Chinese PLA General Hospital, 28 Fuxing, Beijing 100853, China
| | - Yingtai Chen
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Beijing 100021, China
| | - Kaichun Wu
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 169 West Changle Road, Xi'an 710032, China
| | - Yongzhan Nie
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 169 West Changle Road, Xi'an 710032, China
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2
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Yang J, Deng L, Jing M, Xu M, Liu X, Li S, Zhang L, Xi H, Yuan L, Zhou J. Added value of spectral computed tomography quantitative parameters for differentiating tuberculosis-associated fibrosing mediastinitis from endobronchial lung cancer: initial results. Clin Radiol 2024:S0009-9260(24)00132-6. [PMID: 38658213 DOI: 10.1016/j.crad.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/09/2024] [Accepted: 02/14/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE The objective of this study was to explore the added value of spectral computed tomography (CT) parameters to conventional CT features for differentiating tuberculosis-associated fibrosing mediastinitis (TB-associated FM) from endobronchial lung cancer (EBLC). METHODS Chest spectral CT enhancement images from 109 patients with atelectasis were analyzed retrospectively. These patients were divided into two distinct categories: the TB-associated FM group (n = 77) and the EBLC group (n = 32), based on bronchoscopy and/or pathological findings. The selection of spectrum parameters was optimized with the least absolute shrinkage and selection operator regression analysis. The relationship between the spectrum parameters and conventional parameters was explored using Pearson's correlation. Multivariate logistic regression analysis was used to build spectrum model. The spectrum parameters in the spectrum model were replaced with their corresponding conventional parameters to build the conventional model. Diagnostic performances were evaluated using receiver operating characteristic curve analyses. RESULTS There was a moderate correlation between the parameters ㏒(L-AEFNIC) - ㏒(L-AEFC) (r= 0.419; p< 0.0001), ㏒(O-AEF40KeV) - ㏒(O-AEFC) (r= 0.475; p< 0.0001), [L-A-hydroxyapatite {HAP}(I)] - (L-U-CT) (r= 0.604; p< 0.0001), {arterial enhancement fraction (AEF) derived from normalized iodine concentration (NIC) of lymph node (L-AEFNIC), AEF derived from CT40KeV of bronchial obstruction (O-AEF40KeV), arterial-phase Hydroxyapatite (Iodine) concentration of lymph node [L-A-HAP(I)], AEF derived from conventional CT (AEFC), unenhanced CT value (U-CT)}. Spectrum model could improve diagnostic performances compared to conventional model (area under curve: 0.965 vs 0.916, p= 0.038). CONCLUSION There was a moderate correlation between spectrum parameters and conventional parameters. Integrating conventional CT features with spectrum parameters could further improve the ability in differentiating TB-associated FM from EBLC.
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Affiliation(s)
- J Yang
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, China.
| | - L Deng
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, China.
| | - M Jing
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, China.
| | - M Xu
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, China.
| | - X Liu
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, China.
| | - S Li
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, China.
| | - L Zhang
- Zhang Ye People's Hospital Affiliated to Hexi University, Zhangye, 73400, China.
| | - H Xi
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, China.
| | - L Yuan
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, China.
| | - J Zhou
- Department of Radiology, Lanzhou University Second Hospital, Cuiyingmen No.82, Chengguan District, Lanzhou, 730030, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, China.
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Gao Y, Xi H, Shang L, Tang Z, Wei B, Qiao Z, Tang Y, Wang X, Zhou J, Wang X, Huang C, Lu J, Li G, Yu J, Liang Y, Ji J, Li Z, Xue K, Liang H, Ke B, Zang L, He Z, Xie S, Huang H, Xu Z, Tian Y, Xiong J, Li J, Cui Q, Li L, Lu T, Song Q, Liu S, Sun Y, Li L, Chen L. Clinical landscape and prognosis of patients with gastric cancer liver metastases: A nation-wide multicenter cohort study in China (RECORD study). Sci Bull (Beijing) 2024; 69:303-307. [PMID: 38123430 DOI: 10.1016/j.scib.2023.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/07/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Yunhe Gao
- Section of Gastric Surgery, Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Hongqing Xi
- Section of Abdominal Trauma Surgery, Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Liang Shang
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Zhaoqing Tang
- Department of General Surgery, Fudan University Zhongshan Hospital, Shanghai 200032, China
| | - Bo Wei
- Section of Gastric Surgery, Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Zhi Qiao
- Section of Gastric Surgery, Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Yun Tang
- Section of Gastric Surgery, Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Xinxin Wang
- Section of Gastric Surgery, Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Jing Zhou
- Section of Gastric Surgery, Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Xuefei Wang
- Department of General Surgery, Fudan University Zhongshan Hospital, Shanghai 200032, China
| | - Changming Huang
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Jun Lu
- Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - Guoxin Li
- Department of General Surgery, Nanfang Hospital Affiliated to Southern Medical University, Guangzhou 510515, China
| | - Jiang Yu
- Department of General Surgery, Nanfang Hospital Affiliated to Southern Medical University, Guangzhou 510515, China
| | - Yanrui Liang
- Department of General Surgery, Nanfang Hospital Affiliated to Southern Medical University, Guangzhou 510515, China
| | - Jiafu Ji
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Ziyu Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Kan Xue
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Han Liang
- Department of Gastric Cancer Surgery, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
| | - Bin Ke
- Department of Gastric Cancer Surgery, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
| | - Lu Zang
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Zirui He
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Shaohua Xie
- Institute of Population Medicine and School of Public Health, Fujian Medical University, Fuzhou 350122, China
| | - Hua Huang
- Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Zekuan Xu
- Department of General Surgery, Jiangsu Province Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Yantao Tian
- Department of Pancreatic and Gastric Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100029, China
| | - Jianping Xiong
- Department of Pancreatic and Gastric Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100029, China
| | - Jiyang Li
- Section of Gastric Surgery, Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Qiuxia Cui
- Section of Gastric Surgery, Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Li Li
- Section of Gastric Surgery, Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Tingting Lu
- Section of Gastric Surgery, Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Qiying Song
- Section of Gastric Surgery, Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Shihe Liu
- Section of Gastric Surgery, Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Yihong Sun
- Department of General Surgery, Fudan University Zhongshan Hospital, Shanghai 200032, China.
| | - Leping Li
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China.
| | - Lin Chen
- Section of Gastric Surgery, Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China; Institute of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China.
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Liu Y, Gao Y, Chen Z, Cui J, Liang W, Wang Z, Sun L, Pang C, Lv Y, Liu G, Lu T, Zhang G, Dong X, Xu H, Yao S, Liang F, Liu G, Chen G, He J, Xu W, Wei B, Xi H, Chen L. Comparison of Clinical Characteristics, Therapy, and Short-Term Prognosis between Blunt and Penetrating Abdominal Trauma: A Multicentric Retrospective Cohort Study. Emerg Med Int 2024; 2024:5215977. [PMID: 38380077 PMCID: PMC10878762 DOI: 10.1155/2024/5215977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 12/31/2023] [Accepted: 01/28/2024] [Indexed: 02/22/2024] Open
Abstract
Objective Large-scale studies on the characteristics and management of abdominal trauma in megacities in China are lacking. The aim of this study was to analyze and present the clinical patterns and treatment status of abdominal trauma in regional medical centers. Methods Cases of abdominal trauma treated at seven medical centers in Beijing from 2010 to 2021 were collected. Clinical information about age, sex, injury cause, geographic distribution, abbreviated injury scale/injury severity score (AIS/ISS) value, injury-hospital time, preoperative time, surgically identified organ injuries, type of surgery, causes of reoperation and 90-day mortality was included in this study. Clinical characteristics, treatment methods, and short-term prognoses (90-days survival) were compared between blunt abdominal trauma (BAT) and penetrating abdominal trauma (PAT) cases. Non-normally distributed data are described as medians (IQR), and the Mann‒Whitney U test was performed; qualitative data were analyzed using the X2 test. Univariate and multivariate survival analyses were performed by the Cox proportional hazards model. Results A total of 553 patients (86.98% male) with a median age of 36.50 (27.00-48.00) years were included. The BAT group had a significantly higher proportion of serious injury (P=0.001), lower initial hemoglobin level (P=0.001), and a lower laparoscopy surgery rate (P=0.044) compared to the PAT group. Additionally, more BAT cases were from the area around Beijing (P=0.008) and a longer injury-regional hospital time (10.47 (5.18-22.51) hours vs. 7.00 (3.80-15.38) hours, P=0.001). In the hollow viscus injury subgroup, the BAT group had a significantly longer injury-regional hospital time and preoperative time compared to the PAT group (injury-regional hospital time: 10.23 (6.00-21.59) hours vs. 7.07 (3.99-13.85) hours, P=0.002; preoperative time: 3.02 (2.01-5.58) hours vs. 2.81 (1.85-3.63) hours, P=0.047). The overall 90-day mortality was 11.9%, and longer injury-regional hospital time (HR: 1.01, 95% CI: 1.00-1.02, P=0.008), receipt of ICU treatment (HR: 4.69, 95% CI: 2.54-8.65, P=0.001), and severe ISSs (ISS > 25 vs. ISS < 16, HR: 2.78, 95% CI: 1.38-5.601, P=0.004) had a worse impact on survival. Conclusion More patients with BAT were transferred to higher-level hospital, leading to significantly longer prehospital and preoperation time. In the subgroup of hemodynamically stable individuals, more patients with BAT experienced hollow viscus injuries. For those patients, aggressive diagnostic laparoscopic exploration may be beneficial. Patients with longer injury-regional hospital intervals, the need for ICU care, and higher injury severity scores (ISSs) suffered from worse prognoses.
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Affiliation(s)
- Yi Liu
- Department of Abdominal Trauma Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Yunhe Gao
- Department of Gastric Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Zhida Chen
- Research Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Jianxin Cui
- Department of Abdominal Trauma Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Wenquan Liang
- Department of Gastric Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Ze Wang
- Department of Abdominal Trauma Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Linde Sun
- Department of Abdominal Trauma Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Chuan Pang
- Department of General Surgery, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
| | - Yuan Lv
- Department of General Surgery, The Seventh Medical Center of Chinese PLA General Hospital, Beijing 100007, China
| | - Guoxiao Liu
- Department of Abdominal Trauma Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Tingting Lu
- Research Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Gan Zhang
- Research Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Xiaoyu Dong
- Research Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Hong Xu
- Department of General Surgery, The Third Medical Center of Chinese PLA General Hospital, Beijing 100039, China
| | - Sheng Yao
- Department of General Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Feng Liang
- Department of General Surgery, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
| | - Gang Liu
- Department of General Surgery, The Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Gang Chen
- Department of General Surgery, The Seventh Medical Center of Chinese PLA General Hospital, Beijing 100007, China
| | - Jianmiao He
- Department of General Surgery, The Eighth Medical Center of Chinese PLA General Hospital, Beijing 100091, China
| | - Wentong Xu
- Department of Abdominal Trauma Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Bo Wei
- Department of Abdominal Trauma Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Hongqing Xi
- Department of Abdominal Trauma Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Lin Chen
- Department of Abdominal Trauma Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
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Pang C, Li J, Dou J, Li Z, Li L, Li K, Chen Q, An C, Zhou Z, He G, Lou K, Liang F, Xi H, Wang X, Zuo M, Cheng Z, Han Z, Liu F, Yu X, Yu J, Jiang X, Yang M, Liang P. Microwave ablation versus liver resection for primary intrahepatic cholangiocarcinoma within Milan criteria: a long-term multicenter cohort study. EClinicalMedicine 2024; 67:102336. [PMID: 38261915 PMCID: PMC10796969 DOI: 10.1016/j.eclinm.2023.102336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/09/2023] [Accepted: 11/09/2023] [Indexed: 01/25/2024] Open
Abstract
Background Ablation has been recommended by worldwide guidelines as first-line treatment for hepatocellular carcinoma (HCC), while evidence regarding its efficacy for primary intrahepatic cholangiocarcinoma (iCCA) is lacking. We aimed to study the efficacy of ablation in treating iCCA by comparing its prognosis with surgery. Methods In this real-world multicenter cohort study from January 2009 to June 2022, 10,441 iCCA patients from ten tertiary hospitals were identified. Patients who underwent curative-intent microwave ablation (MWA) or liver resection (LR) for tumors within Milan criteria were included. One-to-many propensity score matching (PSM) at variable ratios (1:n ≤4) was used to balance baseline characteristics. Mediation analysis was applied to identify potential mediators of the survival difference. Findings 944 patients were finally enrolled in this study, with 221 undergoing MWA and 723 undergoing LR. After PSM, 203 patients in the MWA group were matched with 588 patients in the LR group. The median follow-up time was 4.7 years. Compared with LR, MWA demonstrated similar overall survival (5-year 44.8% versus 40.4%; HR 0.96, 95% CI 0.71-1.29, P = .761). There was an improvement in the 5-year disease-free survival rate for MWA from 17.1% during the period of 2009-2016 to 37.3% during 2017-2022, becoming comparable to the 40.8% of LR (P = .129). The proportion of ablative margins ≥5 mm increased from 25% to 61% over the two periods, while this proportion of surgical margins was 62% and 77%, respectively. 34.5% of DFS disparity can be explained by the mediation effect of margins (P < .0001). Similar DFS was observed when both ablative and surgical margins exceeded 5 mm (HR 0.83, 95% CI 0.52-1.32, P = .41). Interpretation MWA may be considered as a viable alternative to LR for iCCA within Milan criteria when an adequate margin can be obtained. Funding National Natural Science Foundation of China.
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Affiliation(s)
- Chuan Pang
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
- Department of General Surgery, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jianming Li
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jianping Dou
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhishuai Li
- Biliary Tract Surgery Department I, Eastern Hepatobiliary Surgery Hospital, Secondary Military Medical University, Shanghai, China
| | - Lu Li
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Kai Li
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qi Chen
- Department of Health Statistics, Naval Medical University, Shanghai, China
| | - Chao An
- Department of Minimal Invasive Intervention, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Zhongsong Zhou
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Guangbin He
- Department of Ultrasound, Xijing Hospital, The Fourth Military Medical University, Xian, China
| | - Kexin Lou
- Department of Medical Ultrasound, Xuzhou Central Hospital, Xuzhou, China
| | - Feng Liang
- Department of General Surgery, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Hongqing Xi
- Department of General Surgery, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiaohui Wang
- Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Mengxuan Zuo
- Department of Minimal Invasive Intervention, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Zhigang Cheng
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhiyu Han
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Fangyi Liu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiaoling Yu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiaoqing Jiang
- Biliary Tract Surgery Department I, Eastern Hepatobiliary Surgery Hospital, Secondary Military Medical University, Shanghai, China
| | - Minghui Yang
- Senior Department of Traditional Chinese Medicine, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
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Qiu X, Wang J, Zhang N, Du T, Chen L, Xi H. Estradiol cypionate inhibits proliferation and promotes apoptosis of gastric cancer by regulating AKT ubiquitination. Biomed Pharmacother 2023; 165:115073. [PMID: 37392652 DOI: 10.1016/j.biopha.2023.115073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/14/2023] [Accepted: 06/23/2023] [Indexed: 07/03/2023] Open
Abstract
Gastric cancer is a common gastrointestinal malignancy worldwide, with a high mortality rate and poor prognosis. Multidrug resistance remains a major obstacle to successful treatment for patients. Hence, it is of great significance to develop novel therapies to potentiate the anti-tumor effect. In this study, we have investigated the effect of estradiol cypionate (ECP) on gastric cancer in vitro and vivo. Our data show that ECP inhibited the proliferation, promoted apoptosis, and caused G1/S phase arrest of gastric cancer cells. The mechanism by which ECP promoted apoptosis of gastric cancer cells was related to the downregulation of AKT protein expression caused by the increased ubiquitination modification levels of AKT, which finally inhibited the over-activation of the PI3K-AKT-mTOR signaling pathway. In vivo tumorigenesis experiments showed that ECP significantly inhibited the growth of gastric cancer cells, showing promise for clinical application. The above findings indicate that ECP inhibited the growth of gastric cancer and induced apoptosis through the PI3K /Akt/mTOR pathway. In summary, the efficacy showed in our data suggests that ECP is a promising anti-tumor compound for gastric cancer.
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Affiliation(s)
- Xiaochen Qiu
- Department of General Surgery, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Medical School of Chinese PLA, Beijing, China
| | - Juan Wang
- Department of Oncology, Dushu Lake Hospital Affiliated to Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake Hospital, Suzhou, Jiangsu, 215123, China
| | - Nan Zhang
- Medical School of Chinese PLA, Beijing, China; Department of Gastrointestinal Surgery, Shanghai Fourth People's Hospital, School of Medicine, Tongi Uni-versuty, Shanghai 200434, China
| | - Tongde Du
- Suzhou Institute of Systems Medicine, No. 100 Chongwen Road, Suzhou City, Suzhou 215000, China.
| | - Lin Chen
- Department of General Surgery, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Medical School of Chinese PLA, Beijing, China.
| | - Hongqing Xi
- Department of General Surgery, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Medical School of Chinese PLA, Beijing, China.
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Jing M, Xi H, Zhu H, Zhang B, Deng L, Han T, Zhang Y, Zhou J. Correlation of pericoronary adipose tissue CT attenuation values of plaques and periplaques with plaque characteristics. Clin Radiol 2023:S0009-9260(23)00172-1. [PMID: 37225572 DOI: 10.1016/j.crad.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 04/19/2023] [Accepted: 04/22/2023] [Indexed: 05/26/2023]
Abstract
AIM To investigate the relationship between different plaque characteristics and pericoronary adipose tissue (PCAT) computed tomography (CT) attenuation values for plaques and periplaques. MATERIALS AND METHODS The data from 188 eligible patients with stable coronary heart disease (280 lesions) who underwent coronary CT angiography between March 2021 and November 2021 were collected retrospectively. All PCAT CT attenuation values of plaques and periplaques (the area within 5 and 10 mm proximal and distal to the plaque) were calculated, and multiple linear regression was used to assess their correlation with different plaque characteristics. RESULTS PCAT CT attenuation of plaques and periplaques was higher in non-calcified plaques (-73.38 ± 10.41 HU, -76.77 ± 10.86 HU, 79.33 ± 11.13 HU, -75.67 ± 11.24 HU, -78.63 ± 12.09 HU) and mixed plaques (-76.83 ± 8.11 HU, -79 [-85, -68.5] HU, -78.55 ± 11 HU, -78.76 ± 9.9 HU, -78.79 ± 11.06 HU) than in calcified plaques (-86.96 ± 10 HU, -84 [-92, -76] HU, -84.14 ± 11.08 HU, -84.91 ± 11.41 HU, -84.59 ± 11.69 HU; all p<0.05) and higher in distal segment plaques than in proximal segment plaques (all p<0.05). Plaque PCAT CT attenuation was lower in plaques with minimal stenosis than in plaques with mild or moderate stenosis (p<0.05). The significant determinants of PCAT CT attenuation values of plaques and periplaques were non-calcified plaques, mixed plaques, and plaques located in the distal segment (all p<0.05). CONCLUSIONS PCAT CT attenuation values in both plaques and periplaques were related to plaque type and location.
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Affiliation(s)
- M Jing
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China
| | - H Xi
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China
| | - H Zhu
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China
| | - B Zhang
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China
| | - L Deng
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China
| | - T Han
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China
| | - Y Zhang
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China
| | - J Zhou
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China; Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China; Gansu International Scientific and Technological Cooperation Base of Medical Imaging Artificial Intelligence, Lanzhou, China.
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Gao Y, Xi H, Mattsson F, Liang W, Xie SH, Chen L, Lagergren J. Surgical starting time of the day and survival in gastric cancer. Sci Rep 2023; 13:6955. [PMID: 37117226 PMCID: PMC10147916 DOI: 10.1038/s41598-023-33692-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 04/17/2023] [Indexed: 04/30/2023] Open
Abstract
Previous studies indicate differences in short-term postoperative outcomes depending on the surgical starting time of the day, but long-term data are lacking. The aim of this study was to clarify if surgical starting time of the day influences long-term survival in gastric cancer patients. This cohort study consecutively included 2728 patients who underwent curatively intended gastrectomy for gastric cancer in 2011-2015 at a high-volume hospital in China, with follow-up until June 2019. Cox regression provided hazard ratios (HRs) with 95% confidence intervals (CIs) for 3-year all-cause mortality, adjusted for age, sex, health insurance, pathological tumor stage, surgical approach, neoadjuvant therapy, and weekday of surgery. Compared with patients with early starting time of gastrectomy (08:00-09:29), the point estimates for 3-year all-cause mortality were modestly increased in patients with a starting time in the middle of day (09:30-13:29; HR 1.15, 95% CI 0.97 to 1.37) and later (13:30-21:25; HR 1.10, 0.91 to 1.32). The corresponding HRs were increased particularly in patients who underwent laparoscopic gastrectomy (HR 1.54, 1.10 to 2.14 and HR 1.59, 1.12 to 2.25, respectively) and in those with stage II tumors (HR 1.74, 1.11 to 2.73 and HR 1.60, 1.00 to 2.58, respectively). Our study indicated that in patients who underwent laparoscopic gastrectomy and in those who with stage II tumors, starting surgery in the early morning might be associated with better long-term survival.
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Affiliation(s)
- Yunhe Gao
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing, People's Republic of China
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Retzius väg 13 a, 171 77, Stockholm, Sweden
| | - Hongqing Xi
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing, People's Republic of China
| | - Fredrik Mattsson
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Retzius väg 13 a, 171 77, Stockholm, Sweden
| | - Wenquan Liang
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing, People's Republic of China
| | - Shao-Hua Xie
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Retzius väg 13 a, 171 77, Stockholm, Sweden.
- Institute of Population Medicine and School of Public Health, Fujian Medical University, Fuzhou, People's Republic of China.
- Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, People's Republic of China.
| | - Lin Chen
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing, People's Republic of China.
| | - Jesper Lagergren
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Retzius väg 13 a, 171 77, Stockholm, Sweden
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
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Zhang B, Lu Y, Li L, Gao Y, Liang W, Xi H, Wang X, Zhang K, Chen L. [Establishment and validation of a nomogram for predicting prognosis of gastric neuroendocrine neoplasms based on data from 490 cases in a single center]. Nan Fang Yi Ke Da Xue Xue Bao 2023; 43:183-190. [PMID: 36946036 PMCID: PMC10034550 DOI: 10.12122/j.issn.1673-4254.2023.02.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVE To develop and validate a nomogram for predicting outcomes of patients with gastric neuroendocrine neoplasms (G-NENs). METHODS We retrospectively collected the clinical data from 490 patients with the diagnosis of G-NEN at our medical center from 2000 to 2021. Log-rank test was used to analyze the overall survival (OS) of the patients. The independent risk factors affecting the prognosis of G-NEN were identified by Cox regression analysis to construct the prognostic nomogram, whose performance was evaluated using the C-index, receiver-operating characteristic (ROC) curve, area under the ROC curve (AUC), calibration curve, DCA, and AUDC. RESULTS Among the 490 G-NEN patients (mean age of 58.6±10.92 years, including 346 male and 144 female patients), 130 (26.5%) had NET G1, 54 (11.0%) had NET G2, 206 (42.0%) had NEC, and 100 (20.5%) had MiNEN. None of the patients had NET G3. The numbers of patients in stage Ⅰ-Ⅳ were 222 (45.3%), 75 (15.3%), 130 (26.5%), and 63 (12.9%), respectively. Univariate and multivariate analyses identified age, pathological grade, tumor location, depth of invasion, lymph node metastasis, distant metastasis, and F-NLR as independent risk factors affecting the survival of the patients (P < 0.05). The C-index of the prognostic nomogram was 0.829 (95% CI: 0.800-0.858), and its AUC for predicting 1-, 3- and 5-year OS were 0.883, 0.895 and 0.944, respectively. The calibration curve confirmed a good consistency between the model prediction results and the actual observations. For predicting 1-year, 3-year and 5-year OS, the TNM staging system and the nomogram had AUC of 0.033 vs 0.0218, 0.191 vs 0.148, and 0.248 vs 0.197, respectively, suggesting higher net benefit and better clinical utility of the nomogram. CONCLUSION The prognostic nomogram established in this study has good predictive performance and clinical value to facilitate prognostic evaluation of individual patients with G-NEN.
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Affiliation(s)
- B Zhang
- Department of General Surgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Y Lu
- Department of General Surgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - L Li
- Department of General Surgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Y Gao
- Department of General Surgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - W Liang
- Department of General Surgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - H Xi
- Department of General Surgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - X Wang
- Department of General Surgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - K Zhang
- Department of General Surgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - L Chen
- Department of General Surgery, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
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Xu X, Li Y, Liu G, Li K, Chen P, Gao Y, Liang W, Xi H, Wang X, Wei B, Li H, Chen L. MiR-378a-3p acts as a tumor suppressor in gastric cancer via directly targeting RAB31 and inhibiting the Hedgehog pathway proteins GLI1/2. Cancer Biol Med 2022; 19:j.issn.2095-3941.2022.0337. [PMID: 36245214 PMCID: PMC9755959 DOI: 10.20892/j.issn.2095-3941.2022.0337] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE To improve the prognosis of patients with gastric cancer (GC), more effective therapeutic targets are urgently needed. Increasing evidence indicates that miRNAs are involved in the progression of various tumors, and RAS-associated protein in the brain 31 (RAB31) is upregulated and promotes the progression of multiple malignant tumors. Here, we focused on identifying RAB31-targeted miRNAs and elucidating their potential mechanism in the progression of GC. METHODS RAB31 and miR-378a-3p expression levels were detected in paired fresh GC tissues and GC cell lines. Bioinformatics analysis was used to predict the miRNAs targeting RAB31 and the relationships between RAB31 and other genes. Dual-luciferase reporter assays were applied to verify the targeted interaction relationship. CCK-8, colony formation, flow cytometry, wound healing, and Transwell assays were performed to assess the proliferation, apoptosis, migration, and invasion of GC cells. Tumorsphere formation assays were performed to assess the stemness of gastric cancer stem cells. Related proteins were detected by Western blot. Xenograft assays in nude mice were performed to explore the effect of miR-378a-3p in vivo. RESULTS We report the first evidence that miR-378a-3p is downregulated in GC, whereas its overexpression inhibits proliferation, invasion, and migration as well as promotes apoptosis in GC cells. Mechanistically, miR-378a-3p inhibits the progression of GC by directly targeting RAB31. Restoring RAB31 expression partially offsets the inhibitory effect of miR-378a-3p. Further research revealed that miR-378a-3p inhibits GLI1/2 in the Hedgehog signaling pathway and attenuates the stemness of gastric cancer stem cells. Finally, xenograft assays showed that miR-378a-3p inhibits GC tumorigenesis in vivo. CONCLUSIONS MiR-378a-3p inhibits GC progression by directly targeting RAB31 and inhibiting the Hedgehog signaling pathway proteins GLI1/2.
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Affiliation(s)
- Xinxin Xu
- Medical School of Chinese PLA, Beijing 100853, China,Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Yang Li
- Medical School of Chinese PLA, Beijing 100853, China,Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Guoxiao Liu
- Medical School of Chinese PLA, Beijing 100853, China,Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Kai Li
- Medical School of Chinese PLA, Beijing 100853, China,Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Peng Chen
- Department of General Surgery, The 940th Hospital of Joint Logistics Support Force of People’s Liberation Army, Lanzhou 730050, China
| | - Yunhe Gao
- Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Wenquan Liang
- Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Hongqing Xi
- Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Xinxin Wang
- Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Bo Wei
- Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Hongtao Li
- Department of General Surgery, The 940th Hospital of Joint Logistics Support Force of People’s Liberation Army, Lanzhou 730050, China,Correspondence to: Hongtao Li and Lin Chen, E-mail: and
| | - Lin Chen
- Senior Department of General Surgery, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China,Correspondence to: Hongtao Li and Lin Chen, E-mail: and
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Liang W, Xu X, Liu Y, Cui J, Gao Y, Wang C, Zhuang Z, Zhang K, Xi H, Cai A, Wei B, Chen L. Defining the impact of platelet-to-lymphocyte ratio on patient survival with gastric neuroendocrine neoplasm: a retrospective cohort analysis. World J Surg Oncol 2022; 20:356. [DOI: 10.1186/s12957-022-02822-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/29/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Gastric neuroendocrine neoplasm (g-NEN) is a rare but heterogeneous neoplasm, with an increasing incidence yearly. Conventional prognostic markers of g-NEN remain limited which could only be detected after surgery. There is an urgent need to explore new prognostic markers for g-NEN patients. This study aimed to investigate the prognostic value of platelet-to-lymphocyte, ratio (PLR) and the association between PLR and body mass index (BMI) in patients with gastric neuroendocrine neoplasms (g-NEN).
Methods
A retrospective cohort of patients with g-NEN from January 2001 through June 2016 was examined. The prognostic significance of PLR was determined by multiple regression analysis in different models. Stratified analysis was performed to examine the prognostic value of PLR at different BMI levels.
Results
In total, 238 patients were enrolled. Those with higher PLRs tended to undergo open surgery, had larger tumor sizes, were diagnosed more frequently with neuroendocrine carcinoma, and had higher tumor grades. PLR was significantly associated with the survival of patients with g-NEN. With PLR increased per standard deviation, the all-cause mortality risk of patients with g-NEN increased by 67%, 63%, and 54% in the crude (HR = 1.67, 95% CI 1.32–2.12, P < 0.001), minimally adjusted (HR = 1.63, 95% CI 1.28–2.08, P < 0.001), and fully adjusted (HR = 1.54, 95% CI 1.202–1.98, P = 0.001) models, respectively. Patients with higher PLR (quartile 4, ≥ 187) had a 1.8-fold increase in all-cause mortality risk compared with those with lower PLR (quartile 1–3, < 187). Furthermore, there was a significant interaction effect between BMI subgroups and PLR in predicting the survival of patients with g-NEN (PLR regarded as a continuous variable: all P for interaction < 0.05 in the crude, minimally adjusted, and fully adjusted models; PLR regarded as a categorical variable: P for interaction < 0.05 in the fully adjusted model). Patients with g-NEN with the characteristics of higher PLR (quartile 4, ≥ 187) and non-obesity (BMI < 25 kg/m2) had worse survival than others (P < 0.05).
Conclusion
The inflammation marker PLR has an independent prognostic value for patients with g-NENs, and high PLR combined with non-obesity increases the mortality risk of these patients.
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Wang C, Gao Y, Liang W, Lu Y, Zhang K, Wu D, Zhuang Z, Li K, Qiao Z, Xi H, Chen L. Rspondin-1 contributes to the progression and stemness of gastric cancer by LGR5. Biochem Biophys Res Commun 2022; 627:91-96. [DOI: 10.1016/j.bbrc.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/01/2022] [Indexed: 11/30/2022]
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Lu Y, Zhang B, Wang B, Wu D, Wang C, Gao Y, Liang W, Xi H, Wang X, Chen L. MiR-144-3p inhibits gastric cancer progression and stemness via directly targeting GLI2 involved in hedgehog pathway. J Transl Med 2021; 19:432. [PMID: 34657624 PMCID: PMC8521984 DOI: 10.1186/s12967-021-03093-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/26/2021] [Indexed: 12/14/2022] Open
Abstract
Background Gastric cancer (GC) is the fifth most commonly diagnosed cancer worldwide. Due to the dismal prognosis, identifying novel therapeutic targets in GC is urgently needed. Evidences have shown that miRNAs played critical roles in the regulation of tumor initiation and progression. GLI family zinc finger 2 (GLI2) has been reported to be up-regulated and facilitate cancer progression in multiple malignancies. In this study, we focused on identifying GLI2-targeted miRNAs and clarifying the underlying mechanism in GC. Methods Paired fresh gastric cancer tissues were collected from gastrectomy patients. GLI2 and miRNAs expression were detected in gastric cancer tissues and cell lines. Bioinformatics analysis was used to predict GLI2-targeted miRNAs and dual-luciferase reporter assay was applied for target verification. CCK-8, clone formation, transwell and flow cytometry were carried out to determine the proliferation, migration, invasion and cell cycle of gastric cancer cells. Tumorsphere formation assay and flow cytometry were performed to detail the stemness of gastric cancer stem cells (GCSCs). Xenograft models in nude mice were established to investigate the role of the miR-144-3p in vivo. Results GLI2 was frequently upregulated in GC and indicated a poor survival. Meanwhile, miR-144-3p was downregulated and negatively correlated with GLI2 in GC. GLI2 was a direct target gene of miR-144-3p. MiR-144-3p overexpression inhibited proliferation, migration and invasion of gastric cancer cells. Enhanced miR-144-3p expression inhibited tumorsphere formation and CD44 expression of GCSCs. Restoration of GLI2 expression partly reversed the suppressive effect of miR-144-3p. Xenograft assay showed that miR-144-3p could inhibit the tumorigenesis of GC in vivo. Conclusions MiR-144-3p was downregulated and served as an essential tumor suppressor in GC. Mechanistically, miR-144-3p inhibited gastric cancer progression and stemness by, at least in part, regulating GLI2 expression. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-021-03093-w.
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Affiliation(s)
- Yixun Lu
- Medical School of Chinese PLA, Beijing, 100853, China.,Department of General Surgery & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Benlong Zhang
- Medical School of Chinese PLA, Beijing, 100853, China.,Department of General Surgery & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Baohua Wang
- Medical School of Chinese PLA, Beijing, 100853, China.,Department of General Surgery & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Di Wu
- Medical School of Chinese PLA, Beijing, 100853, China.,Department of General Surgery & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Chuang Wang
- Medical School of Chinese PLA, Beijing, 100853, China.,Department of General Surgery & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Yunhe Gao
- Department of General Surgery & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Wenquan Liang
- Department of General Surgery & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Hongqing Xi
- Department of General Surgery & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Xinxin Wang
- Department of General Surgery & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Lin Chen
- Department of General Surgery & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China.
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Hammond E, Liu Y, Xu F, Liu G, Xi H, Xue L, Bai X, Liao H, Xue S, Zhao S, Zhang A, Kemper J, Afnan M, Mol B, Morbeck D. P–138 When is low quality really low? Should we transfer low-grade blastocysts? Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What is the live birth rate after single, low-grade blastocyst (LGB) transfer?
Summary answer
The live birth rate for LGBs is 28%, ranging between 15–31% for the different inner cell mass (ICM) and trophectoderm (TE) subgroups of LGBs.
What is known already
Live birth rates following LGB transfer are varied and have been reported to be in the range of 5–39%. However, these estimates are inaccurate as studies investigating live birth rates following LGB transfer are inherently limited by sample size (n = 10–440 for LGB transfers) due to LGBs being ranked last for transfer. Further, these studies are heterogenous with varied LGB definitions and design. Collating LGB live birth data from multiple clinics is warranted to obtain sufficient numbers of LGB transfers to establish reliable live birth rates, and to allow for delineation of different LGB subgroups, including blastocyst age and female age.
Study design, size, duration
We performed a multicentre, multinational retrospective cohort study in 9 IVF centres in China and New Zealand from 2012 to 2019. We studied the outcome of 6966 single blastocyst transfer cycles on days 5–7 (fresh and frozen) according to blastocyst grade, including 875 transfers from LGBs (<3bb, this being the threshold typically applied to LGB studies). Blastocysts with expansion stage 1 or 2 (early blastocysts) were excluded.
Participants/materials, setting, methods
The main outcome measured was live birth rate. Blastocysts were grouped according to quality grade: good-grade blastocysts (GGBs; n = 3849, aa, ab and ba), moderate-grade blastocysts (MGBs; n = 2242, bb) and LGBs (n = 875, ac, ca, bc, cb and cc) and live birth rates compared using the Pearson Chi-squared test. A logistic regression analysis explored the relationship between blastocyst grade and live birth after adjustment for the confounders: clinic, female age, expansion stage, and blastocyst age.
Main results and the role of chance
The live birth rates for GGBs, MGBs and LGBs were 45%, 36% and 28% respectively (p < 0.0001). Within the LGB group, the highest live birth rates were for grade c TE (30%) and the lowest were for grade c ICM (19%). The lowest combined grade (cc) maintained a 15% live birth rate (n = 7/48). After accounting for confounding factors, including female age and blastocyst characteristics, the odds of live birth were 2.33 (95% CI = 1.88–2.89) for GGBs compared to LGBs and 1.56 (95% CI = 1.28–1.92) for MGBs compared to LGBs following fresh and frozen blastocyst transfers (p < 0.0001, odds ratios confirmed in exclusively frozen blastocyst transfer cycles). When stratified by individual ICM and TE grade, the odds of live birth according to ICM grade were 1.31 (a versus b; 95% CI = 1.15–1.48), 2.82 (a versus c; 95% CI = 1.91–4.18) and 2.16 (b versus c; 95% CI = 1.48–3.16; all p < 0.0001). The odds of live birth according to TE grade were 1.33 (a versus b; 95% CI = 1.17–1.50, p < 0.0001), 1.85 (a versus c; 95% CI = 1.45–2.34, p < 0.0001) and 1.39 (b versus c; 95% CI = 1.12–1.73, p = 0.0024).
Limitations, reasons for caution
Despite the large multicentre design of the study, analyses of transfers occurring within the smallest subsets of the LGB group were limited by sample size. The study was not randomised and had a retrospective character.
Wider implications of the findings: LGBs maintain satisfactory live birth rates (averaging 28%) in the general IVF population. Even those in the lowest grading tier maintain modest live birth rates (15%; cc). It is recommended that LGBs not be universally discarded, and instead considered for subsequent frozen embryo transfer to maximize cumulative live birth rates.
Trial registration number
Not applicable
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Affiliation(s)
- E Hammond
- Fertility Associates, Embryology, Auckland, New Zealand
| | - Y Liu
- Monash IVF Group- Southport- Australia, Embryology, Queensland, Australia
| | - F Xu
- Tianjin First Central Hospital, Reproductive Medicine Center, Tianjin, China
| | - G Liu
- Tianjin Aiwei Hospital, Reproductive Center, Tianjin, China
| | - H Xi
- The second affiliated hospital of WenZhou Medical University, Department of Obstetrics and Gynecology, Wenzhou, China
| | - L Xue
- People’s Hospital of Guangxi Zhuang Autonomous Region, Reproductive Medical and Genetic Center, Nanning, China
| | - X Bai
- General Hospital of Tianjin Medical University, Department of Obstetrics and Gynecology, Tianjin, China
| | - H Liao
- The second affiliated hospital of South China University, Reproductive Medicine Center, Hengyang, China
| | - S Xue
- Shanghai East Hospital, Department of Assisted Reproduction, Shanghai, China
| | - S Zhao
- Zaozhuang Maternal and Child Health Care, Reproductive Center, Zaozhuang, China
| | - A Zhang
- Reproductive Medical Center of Ruijin Hospital- School of Medicine- Shanghai Jiao Tong University, Reproductive Medical Center, Shanghai, China
| | - J Kemper
- Monash Women’s- Monash Health- Clayton- Australia, Department of obstetrics and gynaecology, Melbourne, Australia
| | - M Afnan
- Qingdao United Family Hospital- Qingdao- China, Obstetrics and Gynecology, Qingdao, China
| | - B Mol
- Monash Women’s- Monash Health- Clayton- Australia, Obstetrics & Gynaecology Monash Health, Melbourne, Australia
| | - D Morbeck
- Fertility Associates, Embryology, Auckland, New Zealand
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15
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Xi H, Li LJ, Sun LY. [Holistic view of surgery based on membrane anatomy for gastrointestinal tumor]. Zhonghua Wei Chang Wai Ke Za Zhi 2021; 24:560-566. [PMID: 34289537 DOI: 10.3760/cma.j.cn.441530-20210413-00161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The mesentery is a continuous unity and the operation of digestive carcinoma is the process of mesenteric resection. This paper attempts to simplify the formation process of all kinds of fusion fascia in the process of digestive tract embryogenesis, and to illuminate the continuity of fusion fascia with a holistic concept. This is helpful for beginners to reversely dissect the fusion fascia and maintain the correct surgical plane during operation, and to achieve the purpose of complete mesenteric resection.
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Affiliation(s)
- H Xi
- Department of Oncology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin 150000, China
| | - L J Li
- Department of Oncology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin 150000, China
| | - L Y Sun
- Department of Oncology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin 150000, China
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16
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Gao Y, Xi H, Chen L. Does Endoscopic Screening Really Not Alter the Incidence of Gastric Cancer? Gastroenterology 2021; 161:374-375. [PMID: 33745947 DOI: 10.1053/j.gastro.2018.07.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 07/03/2018] [Indexed: 12/02/2022]
Affiliation(s)
- Yunhe Gao
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Hongqing Xi
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Lin Chen
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China
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17
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Wang B, Wang L, Lu Y, Liang W, Gao Y, Xi H, Chen L. GRSF1 promotes tumorigenesis and EMT-mediated metastasis through PI3K/AKT pathway in gastric cancer. Biochem Biophys Res Commun 2021; 555:61-66. [PMID: 33813277 DOI: 10.1016/j.bbrc.2021.03.121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 03/22/2021] [Indexed: 12/29/2022]
Abstract
It is vital to identify effective therapeutic targets and explore the underlying mechanisms to curb the progression of Gastric cancer (GC) and improve the prognosis of GC patients. Guanine-rich RNA sequence binding factor 1 (GRSF1) is a member of the RNA-binding protein family. The present study showed that GRSF1 knockdown suppressed GC cells proliferation, migration and invasion in vitro, while GRSF1 overexpression enhanced the proliferation, migration and invasion of GC cells. Meanwhile, knockdown of GRSF1 inhibited tumor growth and tumor metastasis in vivo. Furthermore, we demonstrated that GRSF1 induced epithelial-mesenchymal transition (EMT) and activated PI3K/AKT pathway in vitro and in vivo through gain and loss of function. In conclusion, we demonstrated that GRSF1 promotes tumorigenesis and EMT-mediated metastasis through PI3K/AKT pathway in GC. Our study for the first time identified the functions of GRSF1 serving as an oncogene in GC, which may be a potential effective therapeutic target and malignant indicator in GC.
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Affiliation(s)
- Baohua Wang
- Medical School of Chinese PLA, Beijing, China; Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Lili Wang
- Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Yixun Lu
- Medical School of Chinese PLA, Beijing, China; Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Wenquan Liang
- Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Yunhe Gao
- Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Hongqing Xi
- Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Lin Chen
- Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China.
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18
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Cui H, Cao B, Liu G, Xi H, Chen Z, Liang W, Zhang K, Cui J, Xie T, Deng H, Tang Y, Chen L, Wei B. Comparison of short-term outcomes and quality of life in totally laparoscopic distal gastrectomy and totally robotic distal gastrectomy for clinical stage I-III gastric cancer: study protocol for a multi-institutional randomised clinical trial. BMJ Open 2021; 11:e043535. [PMID: 34035091 PMCID: PMC8154927 DOI: 10.1136/bmjopen-2020-043535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 04/07/2021] [Accepted: 04/15/2021] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Laparoscopic distal gastrectomy (LDG) is regarded as a standard treatment for patients with clinical stage I-III gastric cancer. With the popularisation of the Da Vinci robotic system in the 21st century, robotic distal gastrectomy has been increasingly applied, and its potential advantages over LDG have been proved by several studies. Intraperitoneal anastomosis is a hot topic in research as it highlights the superiority of minimally invasive surgery and is safe and feasible. We intend to conduct this randomised clinical trial to focus on short-term outcomes and quality of life (QOL) in totally laparoscopic distal gastrectomy (TLDG) and totally robotic distal gastrectomy (TRDG) for patients with clinical stage I-III gastric cancer. METHODS AND ANALYSIS This study is a prospective, multi-institutional, open-label randomised clinical trial that will recruit 722 patients with a 1:1 ratio (361 patients in the TLDG group and 361 patients in the TRDG group) from eight large-scale gastrointestinal medical centres in China. The primary endpoint is 30-day postoperative morbidity. The secondary endpoints include QOL, 30-day severe postoperative morbidity and mortality, anastomotic-related complication rate, conversion to open surgery rate, intraoperative and postoperative indicators, operative and total costs during hospitalisation, 1-year overall survival and disease-free survival. QOL is determined by the The European Organization for Reasearch and Treatment of Cancer Quality of Life Questionnare-Core 30 and Stomach22 (EORTC QLQ-C30 and STO22) questionnaires which are completed before surgery and 1, 3, 6 months, and 1 year after surgery. χ2 test will be used for the primary endpoint, while analysis of covariance will be used to compare the overall changes of QOL between the two groups. ETHICS AND DISSEMINATION This trial was approved by the Ethics Committee of the Chinese PLA General Hospital. The trial's results will be disseminated via peer-reviewed scientific journals and conference presentations. TRIAL REGISTRATION NUMBER ChiCTR2000032670.
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Affiliation(s)
- Hao Cui
- Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China
- School of Medicine, Nankai University, Tianjin, China
| | - Bo Cao
- Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Guoxiao Liu
- Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Hongqing Xi
- Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Zhida Chen
- Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Wenquan Liang
- Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Kecheng Zhang
- Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Jianxin Cui
- Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Tianyu Xie
- Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China
- School of Medicine, Nankai University, Tianjin, China
| | - Huan Deng
- Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Yun Tang
- Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Lin Chen
- Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Bo Wei
- Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China
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19
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Harn H, Wang S, Lai Y, Van Handel B, Liang Y, Tsai S, Schiessl IM, Sarkar A, Xi H, Hughes M, Kaemmer S, Tang M, Peti-Peterdi J, Pyle A, Woolley T, Evseenko D, Jiang T, Chuong C. 609 Symmetry breaking of tissue mechanics in wound induced hair follicle regeneration. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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20
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Guo X, Lv X, Ru Y, Zhou F, Wang N, Xi H, Zhang K, Li J, Chang R, Xie T, Wang X, Li B, Chen Y, Yang Y, Chen L, Chen L. Circulating Exosomal Gastric Cancer-Associated Long Noncoding RNA1 as a Biomarker for Early Detection and Monitoring Progression of Gastric Cancer: A Multiphase Study. JAMA Surg 2021; 155:572-579. [PMID: 32520332 PMCID: PMC7287948 DOI: 10.1001/jamasurg.2020.1133] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Questions What role does circulating exosomal long noncoding RNA-GC1 (lncRNA-GC1) play in gastric cancer (GC), and does lncRNA-GC1 exhibit sufficient diagnostic performance for detecting early-stage GC and for monitoring disease progression? Findings In this multiphase study involving 826 participants, including patients with GC, patients with gastric precancerous lesions, and healthy donor individuals, circulating exosomal lncRNA-GC1 served as a noninvasive biomarker for detecting early-stage GC and for monitoring disease progression. Meaning For patients with gastric cancer, detection of circulating exosomal lncRNA-GC1 may improve the early diagnostic rate and monitor disease progression. Importance The gastric cancer (GC)–associated long noncoding RNA1 (lncRNA-GC1) plays an important role in gastric carcinogenesis. However, exosomal lncRNA-GC1 and its potential role in GC are poorly understood. Objective To evaluate the diagnostic value of circulating exosomal lncRNA-GC1 for early detection and monitoring progression of GC. Design, Setting, and Participants We performed a multiphase investigation of circulating exosomal lncRNA-GC1 for early detection of GC involving consecutive patients with GC (n = 522), patients with gastric precancerous lesions (n = 85), and healthy donor individuals (HDs; n = 219) from December 2016 to February 2019 at Chinese People’s Liberation Army General Hospital, China. LncRNA-GC1 was measured by reverse transcription–polymerase chain reaction by independent researchers who had no access to patients’ information. Receiver operating characteristic curves were used to calculate diagnostic efficiency in comparison between lncRNA-GC1 and 3 traditional biomarkers (carcinoembryonic antigen [CEA], cancer antigen 72-4 [CA72-4], and CA19-9). Main Outcomes and Measures Assessment of diagnostic efficiency on the basis of area under curve (AUC), specificity, and sensitivity. Results Of the 826 patients included in the study, 508 were men (61.5%), and the median age of all patients was 60 years (range, 28-82 years). In the test phase, lncRNA-GC1 achieved better diagnostic performance than the standard biomarkers CEA, CA72-4, and CA19-9 (AUC = 0.9033) for distinguishing between the patients with GC and HDs. Additionally, exosomal lncRNA-GC1 levels were significantly higher in culture media from GC cells compared with those of normal gastric epithelial cells (t = 5.310; P = .002). In the verification phase, lncRNA-GC1 retained its diagnostic efficiency in discriminating patients with GC from those with gastric precancerous lesions as well from HDs. Moreover, lncRNA-GC1 exhibited a higher AUC compared with those of CEA, CA72-4, and CA19-9 for early detection of GC with sufficient specificity and sensitivity, especially for patients with GC with negative standard biomarkers. Moreover, the levels of circulating exosomal lncRNA-GC1 were significantly associated with GC from early to advanced stages (HD vs stage I, t = 20.98; P < .001; stage I vs stage II, t = 2.787; P = .006; stage II vs stage III, t = 4.471; P < .001; stage III vs stage IV, t = 1.023; P = .30), independent of pathological grading and Lauren classification (pathological grading: HD vs G1, t = 21.09; P < .001; G1 vs G2, t = 0.3718; P = .71; G2 vs G3, t = 0.3598; P = .72; Lauren classification: t = 24.81; P <.001). In the supplemental phase, the levels of circulating exosomal lncRNA-GC1 were consistent with those in GC tissues and cells and were higher compared with those in normal tissues and cells. Furthermore, the levels of circulating lncRNA-GC1 were unchanged after exosomes were treated with RNase and remained constant after prolonged exposure to room temperature or after repeated freezing and thawing (t = 1.443; P = .39). Total circulating lncRNA-GC1 was nearly all packaged within exosomes rather than a free form in plasma. Conclusions and Relevence Circulating exosomal lncRNA-GC1 may serve as a noninvasive biomarker for detecting early-stage GC and for monitoring disease progression. Combining circulating exosomal lncRNA-GC1 detection with endoscopy could improve the early diagnostic rate of GC.
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Affiliation(s)
- Xin Guo
- Department of Endoscopic Surgery, Chinese People's Liberation Army 986th Hospital, Fourth Military Medical University, Shaanxi, China.,Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Xiaohui Lv
- Department of Gynecology and Obstetrics, Xijing Hospital, Fourth Military Medical University, Shaanxi, China
| | - Yi Ru
- Department of Biochemistry and Molecular Biology, Fourth Military Medical University, Shaanxi, China
| | - Fuxing Zhou
- Department of Gynecology and Obstetrics, Xijing Hospital, Fourth Military Medical University, Shaanxi, China
| | - Ning Wang
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Hongqing Xi
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Kecheng Zhang
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jiyang Li
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Rongyan Chang
- Department of Endoscopic Surgery, Chinese People's Liberation Army 986th Hospital, Fourth Military Medical University, Shaanxi, China
| | - Tianyu Xie
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Xinxin Wang
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Baohai Li
- Department of Ophthalmology, Chinese People's Liberation Army 305th Hospital, Nanjing, China
| | - Yong Chen
- Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Shaanxi, China
| | - Yanling Yang
- Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Shaanxi, China
| | - Lubin Chen
- Department of Endoscopic Surgery, Chinese People's Liberation Army 986th Hospital, Fourth Military Medical University, Shaanxi, China
| | - Lin Chen
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
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21
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Li J, Li S, Xi H, Liu P, Liang W, Gao Y, Wang C, Wei B, Chen L, Tang Y, Qiao Z. Effect of preoperative nutrition therapy type and duration on short-time outcomes in gastric cancer patient with gastric outlet obstruction. Chin J Cancer Res 2021; 33:232-242. [PMID: 34158742 PMCID: PMC8181873 DOI: 10.21147/j.issn.1000-9604.2021.02.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective To avoid perioperative complications caused malnutrition, nutrition therapy is necessary in gastric outlet obstruction (GOO) patients. Compared to parenteral nutrition (PN), enteral nutrition (EN) is associated with many advantages. This study aimed to investigate whether preoperative EN has beneficial clinical effects compared to preoperative PN in gastric cancer patients with GOO undergoing surgery. Methods According to the methods of preoperative nutrition therapy, 143 patients were divided into EN group (n=42) and PN group (n=101) between January 2013 and December 2017 at the Chinese People’s Liberation Army General Hospital. Multiple logistic regression models were used to assess the association between the methods of preoperative nutrition therapy and postoperative day of flatus passage. The generalized additive model and two-piecewise linear regression model were used to calculate the inflection point of the preoperative nutritional therapy time on the postoperative day of flatus passage in the PN group. Results EN shortened the postoperative day of flatus passage in gastric cancer patients with GOO, which is a protective factor, especially in patients who underwent non-radical operations and the postoperative day of flatus passage reduced when the preoperative PN therapy was up to 3 d and a longer PN therapy (>3 d) did not accelerate the postoperative recovery of gastrointestinal functions. Conclusions Preoperative EN therapy would benefit gastric cancer patients with GOO by accelerating postoperative recovery. For patients with absolute obstruction, no more than 3-day PN therapy is recommended if patients can tolerate general anesthesia and surgery.
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Affiliation(s)
- Jiyang Li
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China.,Liposuction Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100144, China
| | - Shaoqing Li
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Hongqing Xi
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Peifa Liu
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Wenquan Liang
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Yunhe Gao
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Chuang Wang
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Bo Wei
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Lin Chen
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Yun Tang
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Zhi Qiao
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
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22
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Li J, Li S, Liu C, Xi H, Liu P, Chen Z, Wei B, Chen L, Qiao Z. Advantages of intraoperative nerve monitoring in endoscopic thyroidectomy for papillary thyroid carcinoma. Minerva Surg 2020. [PMID: 32975382 DOI: 10.23736/s0026-4733.20.08317-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND This study aimed to evaluate the feasibility and effectiveness of intraoperative nerve monitoring (IONM) for reducing the recurrent laryngeal nerve (RLN) injury risk during central compartment lymph node dissection in endoscopic thyroidectomy of papillary thyroid carcinoma (PTC). METHODS The prospective cohort consisted of 69 patients diagnosed with PTC undergoing endoscopic thyroidectomy via the areola approach with (N.=42) or without IONM (N.=27). Multiple logistic regression models were used to assess the association between IONM and postoperative temporary vocal cord palsy or number of retrieved lymph nodes. RESULTS IONM was a protective factor against temporary RLN injury. IONM use was positively correlated with number of retrieved lymph nodes (β=1.563, P=0.003). After adjustment for operation type, the result remained significant (β=1.581, P<0.001). CONCLUSIONS IONM use reduced the risk of temporary vocal cord palsy and increased the number of retrieved lymph nodes in endoscopic thyroidectomy via the areola approach for patients with PTC.
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Affiliation(s)
- Jiyang Li
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China.,General Surgery Institute, Chinese PLA General Hospital, Beijing, China
| | - Shaoqing Li
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China.,General Surgery Institute, Chinese PLA General Hospital, Beijing, China
| | - Chen Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
| | - Hongqing Xi
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Peifa Liu
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Zhida Chen
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Bo Wei
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China.,General Surgery Institute, Chinese PLA General Hospital, Beijing, China
| | - Lin Chen
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China.,General Surgery Institute, Chinese PLA General Hospital, Beijing, China
| | - Zhi Qiao
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China -
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23
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Li J, Li S, Liu C, Xi H, Liu P, Chen Z, Wei B, Chen L, Qiao Z. Advantages of intraoperative nerve monitoring in endoscopic thyroidectomy for papillary thyroid carcinoma. Minerva Surg 2020; 76:165-172. [PMID: 32975382 DOI: 10.23736/s2724-5691.20.08317-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND This study aimed to evaluate the feasibility and effectiveness of intraoperative nerve monitoring (IONM) for reducing the recurrent laryngeal nerve (RLN) injury risk during central compartment lymph node dissection in endoscopic thyroidectomy of papillary thyroid carcinoma (PTC). METHODS The prospective cohort consisted of 69 patients diagnosed with PTC undergoing endoscopic thyroidectomy via the areola approach with (N.=42) or without IONM (N.=27). Multiple logistic regression models were used to assess the association between IONM and postoperative temporary vocal cord palsy or number of retrieved lymph nodes. RESULTS IONM was a protective factor against temporary RLN injury. IONM use was positively correlated with number of retrieved lymph nodes (β=1.563, P=0.003). After adjustment for operation type, the result remained significant (β=1.581, P<0.001). CONCLUSIONS IONM use reduced the risk of temporary vocal cord palsy and increased the number of retrieved lymph nodes in endoscopic thyroidectomy via the areola approach for patients with PTC.
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Affiliation(s)
- Jiyang Li
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China.,General Surgery Institute, Chinese PLA General Hospital, Beijing, China
| | - Shaoqing Li
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China.,General Surgery Institute, Chinese PLA General Hospital, Beijing, China
| | - Chen Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
| | - Hongqing Xi
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Peifa Liu
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Zhida Chen
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Bo Wei
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China.,General Surgery Institute, Chinese PLA General Hospital, Beijing, China
| | - Lin Chen
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China.,General Surgery Institute, Chinese PLA General Hospital, Beijing, China
| | - Zhi Qiao
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China -
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24
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Wang Q, Mu L, Xi H, Zhang C, Yuan J, Zhu M, Li M. Upregulated miRNA-543 promotes the proliferation and migration of gastric carcinoma by downregulating KLF6. Am J Transl Res 2020; 12:5789-5796. [PMID: 33042458 PMCID: PMC7540122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 07/22/2020] [Indexed: 06/11/2023]
Abstract
This study aims to uncover the potential function of MicroRNA-543 (miRNA-543) in the pathogenesis of gastric carcinoma and the possible mechanism. MiRNA-543 levels in gastric carcinoma tissues and cell lines were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Regulatory effects of miRNA-543 on proliferative and migratory abilities of AGS and MKN45 cells were assessed. The downstream target of miRNA-543 was predicted by online bioinformatics and verified by dual-luciferase reporter gene assay. At last, rescue experiments were carried out to uncover the interaction between miRNA-543 and Krüppel-like factor 6 (KLF6) in the progression of gastric carcinoma. MiRNA-543 was upregulated in gastric carcinoma tissues and cell lines. Particularly, gastric carcinoma patients with advanced stage or positive metastasis expressed higher abundance of miRNA-543. Overexpression of miRNA-543 promoted proliferative ability in gastric carcinoma, manifesting as increased viability, EdU-positive ratio and migratory cell number in AGS and MKN45 cells. KLF6 was proved to be the downstream target of miRNA-543. Both mRNA and protein levels of KLF6 were negatively regulated by miRNA-543 in gastric carcinoma cells. Silence of KLF6 was able to reverse the regulatory effects of miRNA-543 inhibitor on proliferative and migratory abilities in gastric carcinoma. MiRNA-543 is highly expressed in gastric carcinoma. It accelerates gastric carcinoma cells to proliferate and migrate by negatively regulating KLF6 level.
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Affiliation(s)
- Qiong Wang
- Department of Pathology, The First Medical Centre, Chinese PLA General HospitalBeijing, China
| | - Lihua Mu
- Department of Clinical Pharmacology, The First Medical Centre, Chinese PLA General HospitalBeijing, China
| | - Hongqing Xi
- Department of General Surgery, The First Medical Centre, Chinese PLA General HospitalBeijing, China
| | - Chunyan Zhang
- Birth Defects Prevention and Control Technology Research Center, Chinese PLA General HospitalBeijing, China
| | - Jing Yuan
- Department of Pathology, The First Medical Centre, Chinese PLA General HospitalBeijing, China
| | - Min Zhu
- Department of Oncology, The Fifth Medical Centre, Chinese PLA General HospitalBeijing, China
| | - Mingyang Li
- Department of Gastrointestinal, The First Medical Centre, Chinese PLA General HospitalBeijing, China
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25
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Gao Y, Xi H, Wei B, Cui J, Zhang K, Li H, Cai A, Shen W, Li J, Rosell R, Chao J, Chen T, Klempner S, Qiao Z, Chen L. Association Between Liquid Biopsy and Prognosis of Gastric Cancer Patients: A Systematic Review and Meta-Analysis. Front Oncol 2019; 9:1222. [PMID: 31850190 PMCID: PMC6901923 DOI: 10.3389/fonc.2019.01222] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 10/25/2019] [Indexed: 12/24/2022] Open
Abstract
Background: Reports regarding liquid biopsy and gastric cancer (GC) have emerged rapidly in recent decades, yet their prognostic value still remains controversial. This study was aimed to assess the impact of liquid biopsy, including circulating tumor cells (CTCs) and cell-free nucleic acids, on GC patients' prognosis. Methods: PubMed, Medline, EMBASE, and ClinicalTrial.gov databases were searched for studies that report GC patient survival data stratified by CTC/circulating tumor DNA (ctDNA)/circulating miRNAs' status. The hazard ratios (HRs) and their 95% confidence intervals (CIs) for patients' overall survival (OS) and disease-free survival (DFS)/progression-free survival (PFS) were recorded or calculated depending on circulating target status. Results: We initially identified 4,221 studies, from which 43 were eligible for further analysis, comprising 3,814 GC patients. Pooled analyses showed that detection of certain CTCs, ctDNA, and circulating miRNA was associated with poorer OS (CTCs: HR = 1.84, 95%CI 1.50–2.26, p < 0.001; ctDNA: HR = 1.78, 95%CI 1.36–2.34, p < 0.001; circulating miRNA: HR = 1.74, 95%CI 1.13–2.69, p < 0.001) and DFS/PFS (CTCs: HR = 3.39, 95%CI 2.21–5.20, p < 0.001; ctDNA: HR = 2.38, 95%CI 1.31–4.32, p = 0.004; circulating miRNA: HR = 3.30, 95%CI 2.39–4.55, p < 0.001) of GC patients, regardless of disease stage and time point at which sample is taken (at baseline or post-treatment). Conclusions: The presence of CTCs and/or cellular components identifies a group of GC with poorer prognosis. Among circulating markers, CTCs demonstrated a stronger and more stable predictive value for late-stage disease and among Mongolian populations with GC. Less data are available for ctDNA and miRNA; however, their presence may also reflect aggressive biology and warrants further prospective study.
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Affiliation(s)
- Yunhe Gao
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China.,General Surgery Institute, Chinese PLA General Hospital, Beijing, China
| | - Hongqing Xi
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Bo Wei
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China.,General Surgery Institute, Chinese PLA General Hospital, Beijing, China
| | - Jianxin Cui
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Kecheng Zhang
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Hua Li
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Aizhen Cai
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China.,General Surgery Institute, Chinese PLA General Hospital, Beijing, China
| | - Weishen Shen
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China.,Nanjing General Hospital of Nanjing Military Command, Nanjing, China
| | - Jiyang Li
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China.,General Surgery Institute, Chinese PLA General Hospital, Beijing, China
| | - Rafael Rosell
- Catalan Institute of Oncology, Germans Trias i Pujol Health Science Institute and Hospital, Barcelona, Spain
| | - Joseph Chao
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Tianhui Chen
- Department of Cancer Prevention, Institute of Cancer and Basic Medicine (ICBM), Zhejiang Provincial Office for Cancer Prevention and Control, Cancer Hospital of the University of CAS, Chinese Academy of Sciences (CAS), Hangzhou, China
| | - Samuel Klempner
- The Angeles Clinic and Research Institute, Los Angeles, CA, United States.,Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Zhi Qiao
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Lin Chen
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China.,General Surgery Institute, Chinese PLA General Hospital, Beijing, China
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26
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Wang P, Zhang K, Xi H, Liang W, Xie T, Gao Y, Wei B, Chen L. Lymph Node Yield Following Packet Submission After Isolation By Surgeon During Gastrectomy. Cancer Manag Res 2019; 11:9871-9881. [PMID: 31819624 PMCID: PMC6875238 DOI: 10.2147/cmar.s211218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 10/20/2019] [Indexed: 12/24/2022] Open
Abstract
Purpose To compare the lymph node yields of lymph node packet submission (PS), packet submission after isolation by surgeons (PSI), and en bloc lymph node submission (EBS) after gastrectomy. Methods We conducted a prospective study including 118 gastric cancer patients who underwent gastrectomy between June 2016 and August 2016. We also retrospectively reviewed 607 patients who underwent gastrectomy from May 2015 to May 2016. Following gastrectomy, lymph node specimens were either submitted en bloc (EBS group), divided into packets with accompanying adipose tissue according to the lymph node stations (PS group), or isolated individually based on the surgeon’s visualization and palpation before submission to the Pathology Department (PSI group). Results The average lymph node yield was significantly higher in the PSI compared with the PS group in the prospective study (46.5±19.4 vs 31.8±11.1), and significantly higher in the PS compared with the EBS group in the retrospective study (31.5±12.6 vs 23.9±8.9) (both P<0.001). There was no significant difference in positive lymph node yields in either of these comparisons (prospective study, P=0.581; retrospective study, P=0.489). The survival curve indicated no significant difference between the PS and PSI groups (log rank P=0.957); however, these three groups share different lymph node ratio (LNR). Conclusion PSI could yield more lymph nodes than PS or EBS with a lower LNR at pathological examination. However, the difference in lymph nodes harvested had no impact on survival, which may need further investigation.
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Affiliation(s)
- Pengpeng Wang
- School of Medicine, Nankai University, Tianjin 300071, People's Republic of China.,Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China
| | - Kecheng Zhang
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China
| | - Hongqing Xi
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China
| | - Wenquan Liang
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China
| | - Tianyu Xie
- School of Medicine, Nankai University, Tianjin 300071, People's Republic of China.,Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China
| | - Yunhe Gao
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China
| | - Bo Wei
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China
| | - Lin Chen
- School of Medicine, Nankai University, Tianjin 300071, People's Republic of China.,Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, People's Republic of China
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27
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Su Y, Lv JL, Yu M, Ma ZH, Xi H, Kou CL, He ZC, Shen AL. Long-term decomposed straw return positively affects the soil microbial community. J Appl Microbiol 2019; 128:138-150. [PMID: 31495045 DOI: 10.1111/jam.14435] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 07/24/2019] [Accepted: 08/21/2019] [Indexed: 01/12/2023]
Abstract
AIMS In order to understand the response of soil microbial communities to the long-term of decomposed straw return, the modifications of soil microbial community structure and composition induced by more than 10 years of fresh and decomposed straw return was investigated and the key environmental factors were analysed. METHODS AND RESULTS Phospholipid fatty acid analysis and high-through sequencing technique were applied to analyse the structure and composition of the soil microbial communities. Compared with fresh straw, returning decomposed straw increased the relative abundance of bacteria and fungi by 1·9 and 7·7% at a rate of ~3750 kg ha-1 , and increased by 23·1 and 5·7%, at a rate of ~7500 kg ha-1 respectively. The relative abundance of the bacteria related to soil nitrification increased, but the ones related to soil denitrification decreased with decomposed straw return, which led to higher total nitrogen contents in soils. Moreover, returning decomposed straw reduced pathogenic fungal populations (genus of Alternara), which had significantly positive correlation with soil electric conductivity. It indicated that the long-term of decomposed straw return might have lower risk of soil-borne disease mainly for the reasonable soil salinity. CONCLUSIONS Long-term of decomposed straw return could provide suitable nutrient and salinity for healthier development of soil microbial community, both in abundance and structure, compared with fresh straw return. SIGNIFICANCE AND IMPACT OF THE STUDY The results of the study helps to better understand how the microbial community modifications induced by decomposed straw return benefit on soil health. The obtained key factors impacting soil microbial community variations is meaningful in soil health management under conditions of straw return.
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Affiliation(s)
- Y Su
- Institute of Environment, Resource, Soil and Fertilizer, Zhejiang Academy of Agricultural Sciences, Hangzhou, 310021, China
| | - J L Lv
- Institute of Plant Nutrient, Environment and Resource, Henan Academy of Agricultural Sciences, Zhengzhou, 450002, China
| | - M Yu
- Institute of Environment, Resource, Soil and Fertilizer, Zhejiang Academy of Agricultural Sciences, Hangzhou, 310021, China
| | - Z H Ma
- Institute of Plant Nutrient, Environment and Resource, Henan Academy of Agricultural Sciences, Zhengzhou, 450002, China
| | - H Xi
- Institute of Environment, Resource, Soil and Fertilizer, Zhejiang Academy of Agricultural Sciences, Hangzhou, 310021, China
| | - C L Kou
- Institute of Plant Nutrient, Environment and Resource, Henan Academy of Agricultural Sciences, Zhengzhou, 450002, China
| | - Z C He
- Institute of Environment, Resource, Soil and Fertilizer, Zhejiang Academy of Agricultural Sciences, Hangzhou, 310021, China
| | - A L Shen
- Institute of Environment, Resource, Soil and Fertilizer, Zhejiang Academy of Agricultural Sciences, Hangzhou, 310021, China
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28
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Liang W, Li J, Zhang W, Liu J, Li M, Gao Y, Wang N, Cui J, Zhang K, Xi H, Wei B, Chen L. Prolonged postoperative ileus in gastric surgery: Is there any difference between laparoscopic and open surgery? Cancer Med 2019; 8:5515-5523. [PMID: 31385451 PMCID: PMC6745839 DOI: 10.1002/cam4.2459] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 06/28/2019] [Accepted: 07/18/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Prolonged postoperative ileus (PPOI) is a common complication after abdominal surgery, but data about risk factors of PPOI for patients with gastric cancer are rare. We sought to investigate the impact of laparoscopic versus open surgery for PPOI after gastric cancer surgery. METHODS A retrospective cohort study was conducted using a registry database consecutively collected from June 2016 to March 2017. PPOI was defined as no bowel function persisting for more than 4 days. Univariate analysis and multiple logistic regression models were performed to investigate risk factors, and stratified analysis was carried out to examine the primary association at different levels of a potential confounding factor. RESULTS A total of 162 patients composed of 63 patients undergoing laparotomy and 99 patients undergoing laparoscopy were enrolled and PPOI was observed in 32 (19.75%) patients. Risk factors significantly correlated with PPOI were as follows: open surgery, older age, late surgical pathologic staging, postoperative use of opioid analgesic, low level of postoperative albumin and serum potassium. Compared to open surgery, the laparoscopic surgery was a strong protective factor for PPOI after adjusting related variables (OR = 0.17, CI: 0.05-0.52, P = .002). There was an interaction between surgical methods and the postoperative WBC level (P for interaction = .007). In the two group stratified analysis of WBC, laparoscopic surgery had a significant lower risk of PPOI than open group for the patients with WBC counts above the middle level in crude or adjusted models. This result remained significantly in the three group stratified analysis for the patients with WBC counts in the middle and or high tertile groups. CONCLUSIONS PPOI is a common postoperative complication of patients after gastrectomy. Laparoscopic surgery is associated with decreased risk of PPOI in gastric surgery. Patients who underwent open surgery and presented with high level of WBC should be cautious with PPOI.
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Affiliation(s)
- Wenquan Liang
- Department of General Surgery, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.,General Surgery Institute, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Jiyang Li
- Department of General Surgery, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.,General Surgery Institute, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Wang Zhang
- Department of General Surgery, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.,General Surgery Institute, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Jie Liu
- Department of Vascular and Endovascular Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Mingsen Li
- Anorectal Desease Diagnosis and Treatment Center, Tianjin Union Medical Center Nankai University Affiliated Hospital, Tianjin, China
| | - Yunhe Gao
- Department of General Surgery, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.,General Surgery Institute, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Ning Wang
- Department of General Surgery, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Jianxin Cui
- Department of General Surgery, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.,General Surgery Institute, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Kecheng Zhang
- Department of General Surgery, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.,General Surgery Institute, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Hongqing Xi
- Department of General Surgery, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.,General Surgery Institute, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Bo Wei
- Department of General Surgery, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.,General Surgery Institute, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
| | - Lin Chen
- Department of General Surgery, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.,General Surgery Institute, The First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China
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Li J, Xi H, Guo X, Gao Y, Xie T, Qiao Z, Chen L. Surgical outcomes and learning curve analysis of robotic gastrectomy for gastric cancer: Multidimensional analysis compared with three‑dimensional high‑definition laparoscopic gastrectomy. Int J Oncol 2019; 55:733-744. [PMID: 31364736 DOI: 10.3892/ijo.2019.4851] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 06/04/2019] [Indexed: 11/06/2022] Open
Abstract
The present ambispective cohort study was performed to compare the short‑term surgical outcomes, including financial cost and surgeons' acceptance, of robotic versus three‑dimensional high‑definition (3D‑HD) laparoscopic gastrectomy for patients with gastric cancer (GC). Between 2011 and 2017, 517 patients with GC were enrolled for treatment with either robotic gastrectomy [408 patients, including 73 treated by one of the authors (LC)] or 3D‑HD laparoscopic gastrectomy (109 patients, including 71 treated by LC). The cumulative summation method was developed to analyze the learning curves of robotic and 3D‑HD laparoscopic gastrectomy performed by LC. In the analysis of all 517 patients, there were no significant differences in the clinicopathological characteristics between the two treatment groups, with the exception of smoking status (P<0.001). The robotic group had a shorter operative time (OT; 209 vs. 228 min, P=0.004), fewer postoperative days (PODs) to first flatus (3 vs. 4 days, P=0.025), more PODs to removal of the drainage and nasogastric tubes (12 vs. 9 days, P=0.001; 6 vs. 4 days, P=0.001, respectively), and more postoperative complications (21.3 vs. 9.2%, P=0.003). Comparison of these short‑term outcomes of robotic and 3D‑HD laparoscopic gastrectomy performed by LC (144 patients) revealed that only the number of retrieved lymph nodes (27 in the robotic group vs. 33 in the 3D‑HD group; P=0.038) and PODs to removal of the nasogastric tube (5 days in the robotic group vs. 3 days in the 3D‑HD group; P<0.001) were significantly different. The OT stabilized after around 21 robotic gastrectomy procedures and 19 3D‑HD laparoscopic gastrectomy procedures. The cost‑effectiveness analysis revealed that robotic gastrectomy had a significantly higher total cost than 3D‑HD laparoscopic gastrectomy (124,907 vs. 94,395 RMB, P<0.001). With comparable surgical outcomes, lower financial cost and higher surgeons' acceptance, 3D‑HD laparoscopic gastrectomy is highly recommended as a minimally invasive surgical method for patients with GC prior to the popularization of robotic surgery.
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Affiliation(s)
- Jiyang Li
- Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Hongqing Xi
- Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Xin Guo
- Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Yunhe Gao
- Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Tianyu Xie
- Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Zhi Qiao
- Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Lin Chen
- Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, P.R. China
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30
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Shen W, Xi H, Li C, Bian S, Cheng H, Cui J, Wang N, Wei B, Huang X, Chen L. Endothelin-A receptor in gastric cancer and enhanced antitumor activity of trastuzumab in combination with the endothelin-A receptor antagonist ZD4054. Ann N Y Acad Sci 2019; 1448:30-41. [PMID: 30937921 DOI: 10.1111/nyas.14053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 11/30/2018] [Accepted: 02/21/2019] [Indexed: 12/25/2022]
Abstract
Endothelin-A receptor (ETAR) is overexpressed in cancers and can function through transactivation of the epidermal growth factor receptor. We explored ETAR in gastric cancer and investigated the antitumor effect of trastuzumab in combination with the ETAR antagonist ZD4054. The expression of ETAR was significantly correlated with the expression of vascular endothelial growth factor. Univariate and multivariate analyses further showed that ETAR expression correlated with reduced survival in gastric cancer patients. In vitro, ZD4054 increased the antiproliferative effect of trastuzumab in gastric cancer cell lines. Moreover, the addition of ZD4054 to trastuzumab significantly increased apoptosis in gastric cancer cell lines. In vivo, tumor growth was considerably inhibited by treatment with ZD4054 and trastuzumab, and the tumor volume in the trastuzumab and ZD4054 combination group was smaller than in the other groups. The detection of ETAR could help predict the prognosis of gastric cancer patients. Additionally, this study provides support for the therapeutic use of the combination of ZD4054 and trastuzumab as an anticancer treatment, especially for gastric cancer.
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Affiliation(s)
- Weisong Shen
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Hongqing Xi
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Chenyang Li
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shibo Bian
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Haidong Cheng
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jianxin Cui
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Ning Wang
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Bo Wei
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Xiaohui Huang
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Lin Chen
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
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Lu Y, Xi H, Xie T, Qiu Z, Wang X, Wei B, Chen L. [Comparison of the superiority of different TNM staging systems in Siewert III adenocarcinoma of esophagogastric junction]. Zhonghua Wei Chang Wai Ke Za Zhi 2019; 22:143-148. [PMID: 30799536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To compare the prognostic value of TNM staging systems in the 7th edition and the 8th edition AJCC in Siewert III adenocarcinoma of esophagogastric junction (AEG). METHODS Data of 160 patients with Siewert III AEG who underwent radical surgery (R0) from January 2009 to January 2013 in PLA General Hospital were collected retrospectively. Exclusion standards:(1)preoperative neoadjuvant chemoradiotherapy;(2)with distant metastasis before or during operation;(3)palliative operation or R1/R2 resection;(4)pathological type as non-adenocarcinoma;(5)number of retrieved lymph nodes less than 16;(6)diagnosed with other malignant tumors concurrently or within 5 years after operation;(7)incomplete clinical or follow-up data. According to the above criteria, 160 patients were included in this study finally. All the patients underwent radical total or proximal gastrectomy by abdominal approach. D1 or D1+ lymph node dissection was performed in early patients and D2 in advanced patients. All the patients were re-staged by the gastric cancer TNM7 (G7), the gastric cancer TNM8 (G8) and the esophageal cancer TNM7(E7). Univariate analysis and Cox regression analysis were performed. Kappa value and Akaike's information criterion (AIC, the less AIC, the better prognosis) value were compared between different staging systems in agreement and predicting prognosis. RESULTS There were 128 males and 32 females(sex ratio 4:1), and the average age was (60.2±11.6) years and 17 patients with basic disease. Of all the patients, 133 cases (83.1%) underwent radical total gastrectomy and 27 cases (16.9%) underwent proximal gastrectomy. The median number of dissected lymph nodes were 31 and the median number of positive lymph nodes were 4. Multivariate analysis showed that the G7, G8, E7 staging systems were independent prognostic factors (HR=1.374, 1.407 and 1.305 respectively,all P<0.001). Stage migration between G7 and G8 were only observed in IIIA, IIIB and IIIC, and stage migration rate was 8.1% (13/160), and the agreement was very good (weighted Kappa 0.904, P<0.001). However, the difference between G8 and E7 was quite obvious, stage migration rate was 40.6%(65/160), and the agreement between G8 and E7 was not satisfied (weighted Kappa 0.536, P<0.001). AIC value was 811.4 in G8, 812.8 in G7 and 815.9 in E7, respectively. CONCLUSION Compared with G7 and E7 staging systems, the G8 staging system is superior in predicting the prognosis of patients with Siewert III AEG.
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Affiliation(s)
- Yixun Lu
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Hongqing Xi
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Tianyu Xie
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Zhaoyan Qiu
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Xinxin Wang
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Bo Wei
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
| | - Lin Chen
- Department of General Surgery, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China,
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Affiliation(s)
- H. Xi
- Key Laboratory of System Bio-medicine of Jiangxi Province, Jiujiang University, Jiujiang, PR China
- College of Animal Science and Technology, Shanxi Agricultural University, Shanxi, PR China
| | - L. Lei
- Key Laboratory of System Bio-medicine of Jiangxi Province, Jiujiang University, Jiujiang, PR China
| | - W. Fu
- Key Laboratory of System Bio-medicine of Jiangxi Province, Jiujiang University, Jiujiang, PR China
- Department of human anatomy, Jiujiang University, Jiujiang, PR China
| | - L. Li
- Key Laboratory of System Bio-medicine of Jiangxi Province, Jiujiang University, Jiujiang, PR China
- Department of human anatomy, Jiujiang University, Jiujiang, PR China
| | - X. Cao
- Key Laboratory of System Bio-medicine of Jiangxi Province, Jiujiang University, Jiujiang, PR China
| | - L. Yang
- Key Laboratory of System Bio-medicine of Jiangxi Province, Jiujiang University, Jiujiang, PR China
- Department of human anatomy, Jiujiang University, Jiujiang, PR China
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Zhao X, Cai A, Peng Z, Liang W, Xi H, Li P, Chen G, Yu J, Chen L. JS-K induces reactive oxygen species-dependent anti-cancer effects by targeting mitochondria respiratory chain complexes in gastric cancer. J Cell Mol Med 2019; 23:2489-2504. [PMID: 30672108 PMCID: PMC6433691 DOI: 10.1111/jcmm.14122] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 11/08/2018] [Accepted: 12/06/2018] [Indexed: 12/12/2022] Open
Abstract
As a nitric oxide (NO) donor prodrug, JS‐K inhibits cancer cell proliferation, induces the differentiation of human leukaemia cells, and triggers apoptotic cell death in various cancer models. However, the anti‐cancer effect of JS‐K in gastric cancer has not been reported. In this study, we found that JS‐K inhibited the proliferation of gastric cancer cells in vitro and in vivo and triggered mitochondrial apoptosis. Moreover, JS‐K induced a significant accumulation of reactive oxygen species (ROS), and the clearance of ROS by antioxidant reagents reversed JS‐K‐induced toxicity in gastric cancer cells and subcutaneous xenografts. Although JS‐K triggered significant NO release, NO scavenging had no effect on JS‐K‐induced toxicity in vivo and in vitro. Therefore, ROS, but not NO, mediated the anti‐cancer effects of JS‐K in gastric cancer. We also explored the potential mechanism of JS‐K‐induced ROS accumulation and found that JS‐K significantly down‐regulated the core proteins of mitochondria respiratory chain (MRC) complex I and IV, resulting in the reduction of MRC complex I and IV activity and the subsequent ROS production. Moreover, JS‐K inhibited the expression of antioxidant enzymes, including copper‐zinc‐containing superoxide dismutase (SOD1) and catalase, which contributed to the decrease of antioxidant enzymes activity and the subsequent inhibition of ROS clearance. Therefore, JS‐K may target MRC complex I and IV and antioxidant enzymes to exert ROS‐dependent anti‐cancer function, leading to the potential usage of JS‐K in the prevention and treatment of gastric cancer.
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Affiliation(s)
- Xudong Zhao
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Aizhen Cai
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zheng Peng
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Wenquan Liang
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Hongqing Xi
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Peiyu Li
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Guozhu Chen
- Institute of Military Cognitive and Brain Sciences, Academy of Military Medical Sciences, Beijing, China
| | - Jiyun Yu
- Institute of Military Cognitive and Brain Sciences, Academy of Military Medical Sciences, Beijing, China
| | - Lin Chen
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
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Zhang K, Huang X, Gao Y, Liang W, Xi H, Cui J, Li J, Zhu M, Liu G, Zhao H, Hu C, Liu Y, Qiao Z, Wei B, Chen L. Robot-Assisted Versus Laparoscopy-Assisted Proximal Gastrectomy for Early Gastric Cancer in the Upper Location: Comparison of Oncological Outcomes, Surgical Stress, and Nutritional Status. Cancer Control 2018; 25:1073274818765999. [PMID: 29582668 PMCID: PMC6852367 DOI: 10.1177/1073274818765999] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: An increasing amount of attention has been paid to minimally invasive function-preserving gastrectomy, with an increase in incidence of early gastric cancer in the upper stomach. This study aimed to compare oncological outcomes, surgical stress, and nutritional status between robot-assisted proximal gastrectomy (RAPG) and laparoscopy-assisted proximal gastrectomy (LAPG). Methods: Eighty-nine patients were enrolled in this retrospective study between November 2011 and December 2013. Among them, 27 patients underwent RAPG and 62 underwent LAPG. Perioperative parameters, surgical stress, nutritional status, disease-free survival, and overall survival were compared between the 2 groups. Results: Sex, age, and comorbidity were similar in the RAPG and LAPG groups. There were also similar perioperative outcomes regarding operation time, complications, and length of hospital stay between the groups. The reflux esophagitis rates following RAPG and LAPG were 18.5% and 14.5%, respectively (P = .842). However, patients in the RAPG group had less blood loss (P = .024), more harvested lymph nodes (P = .021), and higher costs than those in the LAPG group (P < .001). With regard to surgical stress, no significant differences were observed in C-reactive protein concentrations and white blood cell count on postoperative days 1, 3, and 7 between the groups (Ps > .05). There appeared to be higher hemoglobin levels at 6 months (P = .053) and a higher body mass index at 12 months (P = .056) postoperatively in patients in the RAPG group compared with those in the LAPG group, but this difference was not significant. Similar disease-free survival and overall survival rates were observed between the groups. Conclusions: RAPG could be an alternative to LAPG for patients with early gastric cancer in the upper stomach with comparable oncological safety and nutritional status. Further well-designed, prospective, large-scale studies are needed to validate these results.
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Affiliation(s)
- Kecheng Zhang
- 1 Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China.,Kecheng Zhang, Xiaohui Huang, Yunhe Gao and Wenquan Liang contributed equally to this work
| | - Xiaohui Huang
- 1 Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China.,Kecheng Zhang, Xiaohui Huang, Yunhe Gao and Wenquan Liang contributed equally to this work
| | - Yunhe Gao
- 1 Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China.,Kecheng Zhang, Xiaohui Huang, Yunhe Gao and Wenquan Liang contributed equally to this work
| | - Wenquan Liang
- 1 Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China.,Kecheng Zhang, Xiaohui Huang, Yunhe Gao and Wenquan Liang contributed equally to this work
| | - Hongqing Xi
- 1 Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Jianxin Cui
- 1 Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Jiyang Li
- 1 Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Minghua Zhu
- 1 Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Guoxiao Liu
- 1 Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Huazhou Zhao
- 1 Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Chong Hu
- 1 Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Yi Liu
- 1 Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Zhi Qiao
- 1 Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Bo Wei
- 1 Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Lin Chen
- 1 Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China
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Xi H, Li J, Li S, Qiao Z, Wei B, Chen L. [Comparison of clinicopathological features and prognosis analysis between gastric stump cancer and recurrence of gastric cancer after radical gastrectomy]. Zhonghua Wei Chang Wai Ke Za Zhi 2018; 21:507-513. [PMID: 29774931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To investigate and compare the clinicopathological characteristics of gastric stump cancer(GSC) and the recurrent of gastric cancer (RGC) following radical gastrectomy, and to evaluate survival prognosis. METHODS A retrospective cohort study was performed on clinicopathological and survival data of patients with GSC (n=31) and with RGC (n=105) following radical gastrectomy at the Chinese People's Liberation Army General Hospital between January 1992 and August 2017. GSC was defined as cancer occured in remnant stomach ≥10 years after radical gastrectomy, while RGC was defined as <10 years. Patients of both groups received radical resection or palliative operation with tumor resection and had complete clinicopathological data regarding the first operation and gastric stump operation. T-test was used to compare quantitative data between the two groups, and Pearson χ2 test was used to compare qualitative data between the two groups. Kaplan-Meier method was applied to draw survival curves and log-rank test to assess survival differences. RESULTS Of the 136 enrolled patients, 113 were male and 23 were female. In the first operation, compared with RGC group, in GSC group, the Borrmann type and histological differentiation were more better [Borrmann I(: 11/31 (35.5%) vs. 5/105 (4.8%), χ2=23.003, P=0.001; the high differentiation: 15/31 (48.4%) vs. 1/105 (1.0%), χ2=57.137, P=0.001]; the tumor diameter was smaller [<4 cm: 28/31(90.3%) vs. 56/105(53.3%), χ2=14.045, P=0.001]; the pT stage [pT1: 12/31 (38.7%) vs. 3/105 (2.9%), χ2=50.373, P=0.001], pN stage [pN0: 28/31 (90.3%) vs. 19/105 (18.1%), χ2=55.722, P=0.001] and pTNM staging [I(: 26/31 (83.9%) vs. 11/105 (10.5%), χ2=66.688, P=0.001] were earlier. Most of the GSC occurred at non-anastomotic sites, while the recurrence mostly occurred at anastomotic sites [51.6%(16/31) vs. 61.9%(65/105), χ2=7.520, P=0.023]. Compared with RGC group, GSC group had better histological differentiation [high differentiation: 5/31 (16.1%) vs. 2/105(1.9%), χ2=10.029, P=0.007]. There was more histological type change between the first and the second operation in GSC group than that in RGC group[48.4%(15/31) vs. 26.7%(28/105), χ2=5.222, P=0.022]. The overall survival time of GSC group was significantly longer than that of RGC group [mean: (161.0±18.6) months vs. (50.8±27.6) months, respectively, Log-rank: 76.818, P=0.001]. The survival time after the second surgery of GSC group was longer than that of RGC group [mean: (30.7±18.4) months vs. (20.5±15.0) months, P=0.003]. In the subgroup analysis of all the 136 patients according to histological type change between the two surgeries (unchanged 93 patients, changed 43 patients), compared with unchanged group, the overall survival time of changed group was longer [mean: (99.6±56.5) months vs. (72.1±58.1) months, P=0.008]. CONCLUSIONS GSC patients have better histological differentiation and earlier clinical stage of primary gastric cancer, and longer survival time compared with RGC patients. The histological type change between two operations may be used as a new factor to define GSC.
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Affiliation(s)
- Hongqing Xi
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853,China.
| | | | | | | | | | - Lin Chen
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853,China.
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Zhao H, Zhang K, Wang T, Cui J, Xi H, Wang Y, Song Y, Zhao X, Wei B, Chen L. Long non-coding RNA AFAP1-antisense RNA 1 promotes the proliferation, migration and invasion of gastric cancer cells and is associated with poor patient survival. Oncol Lett 2018; 15:8620-8626. [PMID: 29805596 DOI: 10.3892/ol.2018.8389] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 11/21/2017] [Indexed: 12/19/2022] Open
Abstract
Gastric cancer (GC) is the second-leading cause of cancer-associated mortality worldwide. AFAP1-antisense RNA 1 (AFAP1-AS1), a long non-coding RNA (lncRNA), is believed to promote the aggressive progression of cancer; however, its role in GC remains largely unknown. In the present study, the expression of AFAP1-AS1 in GC tissues and cell lines was measured using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Knockdown of AFAP1-AS1 was performed using a lentiviral vector containing a short hairpin RNA. The proliferation of GC cells was measured using Cell Counting kit-8. The migration and invasion of GC cells were analyzed using a QCM Laminin Migration Assay kit and a Cell Invasion Assay kit. The levels of epithelial-mesenchymal transition (EMT)-associated proteins were detected by western blot analysis. The cut-off value of the expression of AFAP1-AS1 was evaluated using receiver operating characteristic (ROC) curves and patient survival rate was analyzed using Kaplan-Meier. The expression of AFAP1-AS1 was significantly increased in the primary tumor tissues of GC patients with lymph node metastasis or tumor node metastasis stage (stage III or IV; P<0.01). ROC curve analysis revealed that the expression of AFAP-AS1, at a cut-off value of 0.5040, could distinguish GC tissues from the matched normal tissues, with an AUC of 0.8802, sensitivity of 81.25% and specificity of 83.75%. The overexpression of AFAP1-AS1 was positively associated with the poor survival rates of GC patients. Furthermore, the downregulation of AFAP1-AS1 significantly inhibited the proliferation, migration and invasion of GC cells in vitro (P<0.01). The decrease in AFAP1-AS1 expression significantly suppressed the expression level of N-cadherin protein in GC cells and increased that of E-cadherin. The present study demonstrated that the expression signature of AFAP1-AS1 may serve as a biomarker for the diagnosis and prognosis of GC, and its downregulation may repress the aggressive progression of GC, partially through inhibiting the EMT progress.
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Affiliation(s)
- Huazhou Zhao
- Department of General Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, P.R. China.,Department of General Surgery, 309th Hospital of Chinese People's Liberation Army, Beijing 100091, P.R. China
| | - Kecheng Zhang
- Department of General Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, P.R. China
| | - Ting Wang
- Medical Administration Division of Beijing Chaoyang Hospital, Beijing 100020, P.R. China
| | - Jianxin Cui
- Department of General Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, P.R. China
| | - Hongqing Xi
- Department of General Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, P.R. China
| | - Yi Wang
- Department of General Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, P.R. China
| | - Yanjing Song
- Department of General Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, P.R. China
| | - Xudong Zhao
- Department of General Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, P.R. China
| | - Bo Wei
- Department of General Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, P.R. China
| | - Lin Chen
- Department of General Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, P.R. China
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Huang X, Shen W, Xi H, Zhang K, Cui J, Wei B, Chen L. Prognostic role of extracellular matrix metalloproteinase inducer/CD147 in gastrointestinal cancer: a meta-analysis of related studies. Oncotarget 2018; 7:81003-81011. [PMID: 27768590 PMCID: PMC5348372 DOI: 10.18632/oncotarget.12745] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 10/03/2016] [Indexed: 11/29/2022] Open
Abstract
The prognostic role of Extracellular matrix metalloproteinase inducer (EMMPRIN/ CD147) in gastrointestinal cancer remains controversial. We systematically reviewed the evidence of assessment of CD147 expression in gastrointestinal cancer to help clarify this issue. Pubmed, Embase, Cochrane Library and Web of Science databases were searched to identify eligible studies to evaluate the association of CD147 expression and disease-free and overall survival of gastrointestinal cancer. Hazard ratios (HRs) were pooled to estimate the effect. CD147 overexpression was significantly correlated with poor disease-free survival (HR 2.38, 95% CI 1.43–3.97) and overall survival (HR 1.64, 95% CI 1.25–2.14) of cancer patients. Furthermore, CD147 overexpression was significantly association with TNM stage (TIII/TIV vs TI/TII: OR 3.60, 95% CI 1.85–7.01), the depth of invasion (T3/T4 vs T1/T2: OR 2.04, 95% CI 1.25–3.33), lymph node metastasis (positive vs negative: 2.35, 95% CI 1.14–4.86), distant metastasis (positive vs negative: OR 4.78, 95% CI 1.43–16.00). Our analyses demonstrate that CD147 was effectively predictive of worse prognosis in gastrointestinal cancer. Moreover, Identifying CD147 may help identify new drug targets for cancer therapy.
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Affiliation(s)
- Xiaohui Huang
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Weisong Shen
- Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, China
| | - Hongqing Xi
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Kecheng Zhang
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Jianxin Cui
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Bo Wei
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Lin Chen
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
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Chen L, Li J, Xi H, Gao Y, Cui J, Qiao Z, Zhang K, Xie T, Liang W, Wei B. Safety, effectiveness, and rapid adaptation of robotic gastrectomy for advanced gastric cancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
161 Background: As robotic surgery techniques advances, robotic gastrectomy has emerged as an alternative modality for advanced gastric cancer (AGC). However, there is a lack of supporting evidence regarding the safety, effectiveness and surgeon acceptance of robotic gastrectomy for AGC patients. Methods: An ambispective cohort study was conducted. We compared surgical and oncological outcomes between robotic and traditional laparoscopic gastrectomy for AGC patients. The Cumulative Sum (CUSUM) method was developed and used to analyze the learning curves of robotic gastrectomy for AGC by two surgeons who had different surgical experience. Results: From August 2011 to June 2017, a total of 134 AGC patients were performed robotic gastrectomy by surgeon A (n = 42) and surgeon B (n = 147). And there were 238 AGC patients received traditional laparoscopic gastrectomy which performed by the same two surgeons over the same period. There were no significant differences between the two operation methods regarding the clinicopathologic characteristics and long-term outcomes (p=0.737). However, robotic gastrectomy group had less operative blood loss (229 ml vs. 240 ml, p=0.031) and less Clavien-Dindo Grade II to IV complications (p=0.006) than laparoscopic group. Clinicopathologic characteristics, short-term and long-term outcomes of the patients treated by surgeon A and surgeon B are similarity. CUSUM analysis showed that operative time reached a stable state after around 12 cases in surgeon A who had more open gastrectomy experience than laparoscopic gastrectomy experience, and 21 cases in surgeon B who had more laparoscopic gastrectomy experience than open gastrectomy experience. The stable operation time was 242 min for surgeon A and 236 min for surgeon B. The number of lymph node dissections was 38 for surgeon A and 28 for surgeon B during their capacity-increasing phase. Conclusions: Robotic gastrectomy achieved superior short-term outcomes and comparable long-term outcomes compared with traditional laparoscopic gastrectomy for AGC patients. Surgeons with sufficient experience in either open or laparoscopic gastrectomy can rapidly overcome the learning curve and performed gastrectomy for AGC patients safely.
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Affiliation(s)
- Lin Chen
- Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Jiyang Li
- Chinese People's Liberation Army General Hospital, Beijing, China
| | - Hongqing Xi
- Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yunhe Gao
- People's Liberation Army General Hospital, Beijing, China
| | - Jianxin Cui
- Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhi Qiao
- Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Kecheng Zhang
- People's Liberation Army General Hospital, Beijing, China
| | - Tianyu Xie
- Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Wenquan Liang
- Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Bo Wei
- People's Liberation Army General Hospital, Beijing, China
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Chen L, Zhang K, Wei B, Guo X, Xi H, Li J, Cui J, Gao Y, Liang W, Lu Y. Phase II trial of conversion surgery after apatinib in combination with S-1/oxaliplatin (SOX) for patients with unresectable gastric cancer (Ahead-BG301 trial). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.tps203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS203 Background: Recent study has showed that selected patients with unresectable gastric cancer could benefit from surgical resection after achieving response following induction chemotherapy. We speculated that apatinib, an inhibitor of VEGFR-2, in combination with chemotherapy could increase response rate and resection rate following systemic therapy. This trial is designed to investigate the efficacy and safety of conversion surgery after apatinib plus S-1/oxaliplatin (SOX) for patients with unresectable gastric cancer (NCT03007446). Methods: This is a prospective, single-arm and open-label Phase II clinical trial. The primary outcome is resection rate after induction chemotherapy for patients with unresectable gastric cancer. The secondary outcomes include objective response rate and overall survival. Main eligibility criteria include patients with at least single non-curative factor confirmed by CT, MRI, PET-CT or staging laparoscopy: unresectable diseases with locally advanced gastric cancer (T4b); hepatic metastasis (H1; less than five lesions, total diameter ≤ 8 cm); peritoneal metastasis (CY1, P1). An estimated enrollment of 20 patients was planned. After receiving two cycles of apatinib (500 mg, oral, qd) plus SOX (S-1: 40mg bid, d1-14 q3W; oxaliplatin: 130 mg/m2, d1 q3W), patients will be subject to multidisciplinary team evaluation for surgery. First patients were enrolled in Dec 2016. Data analysis was planned in Nov 2018. Clinical trial information: NCT03007446.
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Affiliation(s)
- Lin Chen
- Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Kecheng Zhang
- People's Liberation Army General Hospital, Beijing, China
| | - Bo Wei
- People's Liberation Army General Hospital, Beijing, China
| | - Xin Guo
- Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Hongqing Xi
- Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jiyang Li
- Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jianxin Cui
- Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yunhe Gao
- People's Liberation Army General Hospital, Beijing, China
| | - Wenquan Liang
- Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Yixun Lu
- Chinese People’s Liberation Army General Hospital, Beijing, China
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Chen L, Gao Y, Xi H, Cui J, Cai A, Shen W, Zhang K, Li J, Peng Z, Wei B. Association of liquid biopsy and gastric cancer patients' prognosis: Comprehensive synopsis and a meta-analysis. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
25 Background: Liquid biopsy including circulating tumor cells (CTCs) and cell-free nucleic acids (cfNAs) has offered a minimally invasive approach for detection and measurement of gastric cancer (GC). Reports regarding associations between liquid biopsy and gastric cancer have been emerging rapidly in recent decades, yet their prognostic value still remains paradoxical. Methods: We searched Medline, Embase, Cochrane Central Register of Controlled Trials database for relevant studies that assessed the prognosis significance of CTCs and cfNAs in gastric cancer from peripheral blood(PB). Newcastle-Ottawa Scale (NOS) was used to assess the quality of evidence. Stata 12.0 was used for pooled analysis and subgroup analysis was performed to determine the association of CTCs or cfNAs’ presence and major clinical characteristics. Pooled results were displayed as hazard ratios (HRs) with their 95% confidence intervals (95% CI) with random effect models. Results: We identified 1258 studies, and then 43 were finally eligible for analysis. A total of 3792 patients were included for final evaluation. Pooled analysis showed that detection of certain CTCs, ctDNA or circulating miRNA was associated with poorer overall survival (OS) (CTCs, HR=2.05, 95%CI 1.65-2.55, p < 0.001; circulating miRNA HR=1.74, 95%CI 1.13-2.69, p=0.013; ctDNA, HR=1.77, 95%CI 1.28-2.44, p=0.001) and disease-free survival(DFS) (CTCs, HR=2.92, 95%CI 1.93-4.40, p < 0.001; circulating miRNA, HR=3.30, 95%CI 2.39-4.55, p < 0.001; ctDNA, HR=4.69, 95%CI 2.23-9.86, p < 0.001) of gastric cancer patients, regardless of the disease’s early or late stage. Conclusions: Several high-quality circulating biomarkers or detection methods for gastric cancer prognosis prediction were identified by subgroup analysis, including the Cellsearch system, cytokeratins, miR-20a, miR-200c, etc. Detection of these certain dysregulation circulating markers in patients’ PB indicates poor prognosis with advanced GC patients.
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Affiliation(s)
- Lin Chen
- Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Yunhe Gao
- People's Liberation Army General Hospital, Beijing, China
| | - Hongqing Xi
- Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jianxin Cui
- Chinese People's Liberation Army General Hospital, Beijing, China
| | - Aizhen Cai
- People's Liberation Army General Hospital, Beijing, China
| | - Weisong Shen
- Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Kecheng Zhang
- People's Liberation Army General Hospital, Beijing, China
| | - Jiyang Li
- Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zheng Peng
- People's Liberation Army General Hospital, Beijing, China
| | - Bo Wei
- People's Liberation Army General Hospital, Beijing, China
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Chen L, Li J, Guo X, Xi H, Gao Y, Cui J, Qiao Z, Zhang K, Liang W, Wei B, Xie T. Surgical outcomes and learning curve analysis of robotic gastrectomy for gastric cancer: multidimensional analysis in a comparison with 3D laparoscopic gastrectomy. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
162 Background: There is a lack of supporting evidence regarding the safety, efficacy and surgeon acceptance of robotic versus three-dimensional (3D) laparoscopic surgery for patients with gastric cancer (GC). Methods: An ambispective cohort study was conducted. We compared short-term surgical outcomes including financial cost between robotic and 3D laparoscopic gastrectomy for all GC patients and the GC patients treated by Prof. Chen’s team. The Cumulative Sum (CUSUM) method was developed and used to analyze the learning curves of robotic and 3D laparoscopic gastrectomy performed by Prof. Chen. Results: From August 2011 to June 2017, a total of 517 patients were enrolled for treatment with either robotic (n=408 including n=73 performed by Prof. Chen) or 3D laparoscopic (n=109 including n=71 performed by Prof. Chen) gastrectomy. There were no significant differences between the two operation methods regarding the clinical pathological characteristics, except for smoking habit (p < 0.001). In analysis of all the 517 patients, robotic group had shorter operative time (208 min vs 228 min, p=0.004), less time to first flatus (3 days vs 4 days, p=0.025), longer time to remove drainage and nasogastric tube (12 days vs 9 days, p=0.001, 6 days vs. 4 days, p=0.001, respectively), and more postoperative complications (21.3% vs. 9.2%, p=0.003). While we compared these short-term outcomes of robotic and 3D laparoscopic gastrectomy performed by Prof. Chen, only number of lymph node dissections (robotic 27 vs. 3D 33, p=0.038) and time to remove nasogastric tube (robotic 5 days vs. 3D 3 days, p < 0.001) were significantly different. CUSUM analysis showed that operative time reached a stable state after around 21 cases in robotic gastrectomy and 19 cases in 3D laparoscopic gastrectomy. The cost-effectiveness analysis showed that robotic gastrectomy had significantly higher total cost than 3D laparoscopic gastrectomy (robotic = RMB 124907 vs. 3D-laparoscopic = RMB 94395; p < 0.001). Conclusions: With comparable surgical outcomes, higher surgeon acceptance and less financial cost, 3D laparoscope is a highly recommended minimal invasive surgical method for GC patients.
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Affiliation(s)
- Lin Chen
- Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Jiyang Li
- Chinese People's Liberation Army General Hospital, Beijing, China
| | - Xin Guo
- Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Hongqing Xi
- Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yunhe Gao
- People's Liberation Army General Hospital, Beijing, China
| | - Jianxin Cui
- Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhi Qiao
- Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Kecheng Zhang
- People's Liberation Army General Hospital, Beijing, China
| | - Wenquan Liang
- Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Bo Wei
- People's Liberation Army General Hospital, Beijing, China
| | - Tianyu Xie
- Chinese People’s Liberation Army General Hospital, Beijing, China
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Zhang Z, Fan X, Xi H, Ji R, Shen H, Shi A, He J. Effect of local scrotal heating on the expression of tight junction-associated molecule Occludin in boar testes. Reprod Domest Anim 2018; 53:458-462. [PMID: 29330895 DOI: 10.1111/rda.13131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 11/23/2017] [Indexed: 11/30/2022]
Abstract
The aim of this study was to determine whether local scrotal heating (42°C, for 1 hr) had an effect on the expression of tight junction (TJ)-associated molecule Occludin in boar testes. Adult boars (Landrace, n = 6) were used and randomly divided into two groups (n = 3 each). Three boars were given local scrotal exposure to 42°C for approximately 1 h with a home-made electric blanket of controlled temperature as local scrotal heating group, the other three boars received no heat treatment and were left at standard room temperature as control group. After 6 hr, all boars were castrated and the testes were harvested. qRT-PCR, Western blotting and immunohistochemistry were used to explore the expression and localization of Occludin. qRT-PCR and Western blotting showed that the protein and mRNA levels of Occludin significantly decreased in local scrotal heating group as compared to the control. Furthermore, immunoreactivity staining of Occludin was localized at the sites of the blood-testis barrier (BTB) and formed an almost consecutive and strong immunoreactivity strand in the control, while Occludin was limited to Sertoli cells (SCs) and no obvious immunoreactivity strand was present in local scrotal heating group. These data indicated that local scrotal heating decreased the expression of TJ-associated molecule Occludin, which may be involved in heat-induced spermatogenesis damage.
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Affiliation(s)
- Z Zhang
- Institute of Animal Biotechnology, College of Animal Science and Veterinary Medicine, Shanxi Agricultural University, Taigu, China
| | - X Fan
- Institute of Animal Biotechnology, College of Animal Science and Veterinary Medicine, Shanxi Agricultural University, Taigu, China
| | - H Xi
- Institute of Animal Biotechnology, College of Animal Science and Veterinary Medicine, Shanxi Agricultural University, Taigu, China
| | - R Ji
- Institute of Animal Biotechnology, College of Animal Science and Veterinary Medicine, Shanxi Agricultural University, Taigu, China
| | - H Shen
- Institute of Animal Biotechnology, College of Animal Science and Veterinary Medicine, Shanxi Agricultural University, Taigu, China
| | - A Shi
- Landscape Administration, Yangquan, China
| | - J He
- Institute of Animal Biotechnology, College of Animal Science and Veterinary Medicine, Shanxi Agricultural University, Taigu, China
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Wang Y, Zhao X, Song Y, Cai A, Xi H, Chen L. A systematic review and meta-analysis of robot-assisted versus laparoscopically assisted gastrectomy for gastric cancer. Medicine (Baltimore) 2017; 96:e8797. [PMID: 29310358 PMCID: PMC5728759 DOI: 10.1097/md.0000000000008797] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Robotic-assisted gastrectomy (RAG) has been used for gastric cancer since 2002. This meta-analysis was carried out to evaluate whether RAG is safer and more effective than conventional laparoscopically assisted gastrectomy (LAG) for gastric cancer. METHODS We performed a manual search for these 2 types of operations (RAG and LAG) in the PubMed, Embase, and the Cochrane Library databases up to April 30, 2016. Twelve nonrandomized controlled trials that reported on RAG and LAG for gastric cancer were included. Outcomes evaluated included operation time, number of retrieved lymph nodes, blood loss, length of the resection margin, complications, and postoperative hospital stay. RESULTS A total of 3744 patients in 12 studies were included (1134 patients in the RAG group and 2610 patients in the LAG group). The operation time was significantly shorter in the LAG group [weighted mean difference (WMD) 42.0 (95% confidence interval, 95% CI 28.11-55.89) minutes; P < .00001], while the loss of blood volume was lower in the RAG group (P = .01). The number of retrieved lymph nodes, duration of postoperative stay, length of the proximal resection margin, length of the distal resection margin, and postoperative complications were similar between groups. CONCLUSION We conclude that RAG is a safe and appropriate treatment for gastric cancer patients in comparison to LAG. Nevertheless, RAG is not superior to LAG. Future research on RAG should focus on comparing the differences in retrieved lymph nodes in different tiers, evaluating the postoperative recovery and reducing the cost of the treatment.
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Liang W, Cui J, Zhang K, Xi H, Cai A, Li J, Gao Y, Hu C, Liu Y, Lu Y, Wang N, Wu X, Wei B, Chen L. Shikonin induces ROS-based mitochondria-mediated apoptosis in colon cancer. Oncotarget 2017; 8:109094-109106. [PMID: 29312593 PMCID: PMC5752506 DOI: 10.18632/oncotarget.22618] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 08/26/2017] [Indexed: 12/21/2022] Open
Abstract
Colon cancer is the third most common malignancy worldwide, and chemotherapy is a widely used strategy in clinical therapy. Chemotherapy-resistant of colon cancer is the main cause of recurrence and progression. Novel drugs with efficacy and safety in treating colon cancer are urgently needed. Shikonin, a naphthoquinone derived from the roots of the herbal plant Lithospermum erythrorhizon, has been determined to be a potent anti-tumor agent. The aim of the present study was to detect the underlying anti-tumor mechanism of shikonin in colon cancer. We found that shikonin suppressed the growth of colon cancer cells in a dose-dependent manner in vitro and in vivo. Shikonin induced mitochondria-mediated apoptosis, which was regulated by Bcl-2 family proteins. Shikonin increased the generation of intracellular ROS, which played an upstream role in shikonin-induced apoptosis. Our data indicated that generation of ROS, down-regulated expression of Bcl-2 and Bcl-xL, depolarization of the mitochondrial membrane potential and activation of the caspase cascade were components of the programmed event of shikonin-induced apoptosis in colon cancer cells. In addition, shikonin presented minimal toxicity to non-neoplastic colon cells and no liver injury in xenograft models, showing safety in the control of colon cancer cell growth in vitro and in vivo. Taken together, our findings suggest that shikonin might serve as a potential novel therapeutic drug in the treatment of human colon cancer.
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Affiliation(s)
- Wenquan Liang
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.,Institute of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Jianxin Cui
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.,Institute of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Kecheng Zhang
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.,Institute of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Hongqing Xi
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.,Institute of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Aizhen Cai
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Jiyang Li
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.,Institute of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Yunhe Gao
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.,Institute of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Chong Hu
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.,Institute of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Yi Liu
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.,Institute of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Yixun Lu
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.,Institute of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Ning Wang
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Xiaosong Wu
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Bo Wei
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.,Institute of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Lin Chen
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.,Institute of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
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Zhao X, Cai A, Xi H, Song Y, Wang Y, Li H, Li P, Chen L. Predictive factors for lymph node metastasis in early gastric cancer with signet ring cell histology: a meta-analysis. ANZ J Surg 2017; 87:981-986. [PMID: 28681963 DOI: 10.1111/ans.14089] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/02/2017] [Accepted: 05/03/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Less invasive surgery is widely used in the treatment of early gastric cancer; however, no definite guidelines exist regarding indications for less invasive surgery to treat early gastric cancer with signet ring cell histology. The aim of this study was to identify risk factors for lymph node metastasis (LNM) in early signet ring cell carcinoma (SRC). An extensive search of PubMed, Embase and the Cochrane library was performed for pertinent articles involving early SRC and LNM. METHODS Eligible data (gender, depth of invasion, lymphovascular invasion, size, ulceration, macroscopic type and location) were extracted from the included studies and systematically reviewed via a meta-analysis. Review Manager version 5.3 was used to perform the data processing. The Newcastle-Ottawa Scale was utilized to evaluate the quality of the included articles. RESULTS Fourteen studies were included in the final analysis. After meta-analysis, female gender, submucosal invasion, lymphovascular invasion and size >20 mm were associated with LNM in early SRC. CONCLUSION Four variables were identified as risk factors for LNM in early SRC. The significance of the results of the present study should be further confirmed in more early SRC patients for future clinical use.
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Affiliation(s)
- Xudong Zhao
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Aizhen Cai
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Hongqing Xi
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yanjing Song
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yi Wang
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Hua Li
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China.,Department of Surgical Oncology, Affiliated Xing Tai People Hospital of Hebei Medical University, Xingtai, Hebei, China
| | - Peiyu Li
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Lin Chen
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing, China
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Zhang K, Peng Z, Huang X, Qiao Z, Wang X, Wang N, Xi H, Cui J, Gao Y, Huang X, Gao H, Wei B, Chen L. Phase II Trial of Adjuvant Immunotherapy with Autologous Tumor-derived Gp96 Vaccination in Patients with Gastric Cancer. J Cancer 2017; 8:1826-1832. [PMID: 28819380 PMCID: PMC5556646 DOI: 10.7150/jca.18946] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 03/05/2017] [Indexed: 02/07/2023] Open
Abstract
Background/Aims: Autologous, tumor-derived, heat shock protein gp96 peptide complexes have antitumor potential. We conducted the first Phase II trial to evaluate the safety and efficacy of gp96 vaccination in adjuvant settings for patients with gastric cancer. Methods: We enrolled 73 consecutive patients from October 2012 to December 2015. Thirty-eight patients received gp96 vaccination plus chemotherapy and 35 received chemotherapy alone. The primary endpoints were disease-free survival (DFS) and toxicity. The secondary endpoints were overall survival (OS) and tumor-specific immune responses. Results: There were comparable baseline characteristics between the two groups. Tumor-specific immune responses increased significantly after gp96 vaccination. gp96 vaccination plus chemotherapy was well tolerated and there were no gp96-related serious adverse events. Patients who received gp96 vaccination had improved DFS compared with those who did not [p = 0.045; hazard ratio (HR): 0.47; 95% confidence interval (CI): 0.23-0.96]. The 2-year OS rates were 81.9% and 67.9% for the gp96 vaccination and chemotherapy alone group, respectively (p = 0.123; HR: 0.42; 95% CI: 0.15-1.24). Conclusion: gp96 vaccination elicits tumor-specific immune responses and can be safely used in adjuvant settings combined with chemotherapy. Patients with less-aggressive diseases might benefit from gp96 therapy.
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Affiliation(s)
- Kecheng Zhang
- Department of General Surgery & Institute of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing 100853, China
| | - Zheng Peng
- Department of General Surgery & Institute of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing 100853, China
| | - Xiaohui Huang
- Department of General Surgery & Institute of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing 100853, China
| | - Zhi Qiao
- Department of General Surgery & Institute of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing 100853, China
| | - Xinxin Wang
- Department of General Surgery & Institute of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing 100853, China
| | - Ning Wang
- Department of General Surgery & Institute of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing 100853, China
| | - Hongqing Xi
- Department of General Surgery & Institute of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing 100853, China
| | - Jianxin Cui
- Department of General Surgery & Institute of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing 100853, China
| | - Yunhe Gao
- Department of General Surgery & Institute of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing 100853, China
| | - Xijian Huang
- Cure&Sure Biotech Co., LTD, Hi-tech Industrial Park, Shenzhen 518057, P.R. China
| | - Hua Gao
- Cure&Sure Biotech Co., LTD, Hi-tech Industrial Park, Shenzhen 518057, P.R. China
| | - Bo Wei
- Department of General Surgery & Institute of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing 100853, China
| | - Lin Chen
- Department of General Surgery & Institute of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing 100853, China
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Li J, Zhang K, Gao Y, Xi H, Cui J, Liang W, Cai A, Wei B, Chen L. Evaluation of hepatectomy and palliative local treatments for gastric cancer patients with liver metastases: a propensity score matching analysis. Oncotarget 2017; 8:61861-61875. [PMID: 28977910 PMCID: PMC5617470 DOI: 10.18632/oncotarget.18709] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 05/23/2017] [Indexed: 12/14/2022] Open
Abstract
Background The optimal treatments for gastric cancer with liver metastases (GCLM) remain controversial. This study aimed to evaluate the efficacy of hepatectomy, RFA and TACE as local treatments for GCLM. Methods From 2001 to 2015, 119 consecutive patients who received multidisciplinary treatments based on curative gastrectomy and local treatments (hepatectomy, RFA and TACE) for liver metastases were enrolled in this retrospective cohort study. Patients were divided into Group A (46, hepatectomy) and Group B (73, either or both RFA and TACE). Propensity score matching analysis was employed. Results The propensity model revealed that hepatectomy was associated with significantly longer OS compared with either or both RFA and TACE (P=0.021). The 1-, 3- and 5-year OS rates were 80.5%, 41.5% and 24.4%, respectively in Group A; and 85.4%, 21.9% and 12.2%, respectively in Group B. Subgroup analyses indicated that hepatectomy was associated with significantly longer long-term survival compared with TACE (P=0.033) and RFA (P=0.010). TACE had a similar efficacy as RFA (P=0.518), but with significantly lower costs (P=0.014) in for patients with metachronous GCLM. Conclusion Hepatectomy is the optimal local treatment for GCLM when surgical R0 resection is intended. TACE attained a similar prognosis as RFA with relatively high cost-effectiveness, particularly for patients with metachronous GCLM.
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Affiliation(s)
- Jiyang Li
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Kecheng Zhang
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Yunhe Gao
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Hongqing Xi
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Jianxin Cui
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Wenquan Liang
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Aizhen Cai
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Bo Wei
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - Lin Chen
- Department of General Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
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Gao Y, Cai A, Xi H, Li J, Xu W, Zhang Y, Zhang K, Cui J, Wu X, Wei B, Chen L. Ring finger protein 43 associates with gastric cancer progression and attenuates the stemness of gastric cancer stem-like cells via the Wnt-β/catenin signaling pathway. Stem Cell Res Ther 2017; 8:98. [PMID: 28446252 PMCID: PMC5406878 DOI: 10.1186/s13287-017-0548-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 02/23/2017] [Accepted: 03/31/2017] [Indexed: 01/10/2023] Open
Abstract
Background Ring finger protein 43 (RNF43) is a member of the transmembrane E3 ubiquitin ligase family that was originally found in stem cells and plays important roles in tumor formation and progression. Our previous study indicated that RNF43 might be a tumor suppressor protein in gastric cancer. Given its antagonistic relationship with leucine-rich repeat-containing G-protein-coupled receptor 5 (Lgr5), one of the gastric cancer stem cell markers, investigation of the potential role of RNF43 in gastric stem cancer cells is necessary. Methods Immunohistochemistry staining, western blot analysis, and quantitative reverse transcription polymerase chain reaction were used to determine the mRNA and protein expression level of RNF43 and other Wnt pathway factors. Gastric cancer stem-like cells were obtained from gastric cancer tumor and cell lines by tumorsphere culture. The adeno-associated virus system was used to upregulate RNF43 expression in cancer cells. Functional experiments including tumorsphere formation, chemotherapy resistance, surface marker detection, and tumor xenograft assay were performed to measure stem-like properties in gastric cancer stem-like cells after RNF43 overexpression. Results RNF43 loss was significantly associated with TNM stage, distant metastasis, and Lauren classification, and predicted worse prognosis in gastric cancer patients. RNF43 expression was even lower in tumorspheres derived from tumor tissues or cell lines compared with adherent cancer cells and normal gastric cells. Overexpression of RNF43 in gastric cancer cells impaired their stem-like properties, including sphere formation ability, chemoresistance in vitro, and tumorigenicity in vivo. Moreover, Wnt pathway-related proteins were decreased in RNF43-overexpressing cells, while Wnt pathway activators could reverse the trend to some extent. Conclusions Our findings indicated that RNF43 might not only participate in gastric cancer progression, but also attenuate the stemness of gastric cancer stem-like cells through the Wnt/β-catenin pathway. Electronic supplementary material The online version of this article (doi:10.1186/s13287-017-0548-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yunhe Gao
- Department of General Surgery, Chinese PLA General Hospital, Beijing, 100853, China
| | - Aizhen Cai
- Department of General Surgery, Chinese PLA General Hospital, Beijing, 100853, China
| | - Hongqing Xi
- Department of General Surgery, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jiyang Li
- Department of General Surgery, Chinese PLA General Hospital, Beijing, 100853, China
| | - Wei Xu
- School of Medicine, Tsinghua University, Beijing, 10084, China
| | - Yanmei Zhang
- School of Medicine, Tsinghua University, Beijing, 10084, China
| | - Kecheng Zhang
- Department of General Surgery, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jianxin Cui
- Department of General Surgery, Chinese PLA General Hospital, Beijing, 100853, China
| | - Xiaosong Wu
- Department of General Surgery, Chinese PLA General Hospital, Beijing, 100853, China
| | - Bo Wei
- Department of General Surgery, Chinese PLA General Hospital, Beijing, 100853, China
| | - Lin Chen
- Department of General Surgery, Chinese PLA General Hospital, Beijing, 100853, China.
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Song Y, Wang Y, Tong C, Xi H, Zhao X, Wang Y, Chen L. A unified model of the hierarchical and stochastic theories of gastric cancer. Br J Cancer 2017; 116:973-989. [PMID: 28301871 PMCID: PMC5396111 DOI: 10.1038/bjc.2017.54] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 01/16/2017] [Accepted: 01/26/2017] [Indexed: 02/06/2023] Open
Abstract
Gastric cancer (GC) is a life-threatening disease worldwide. Despite remarkable advances in treatments for GC, it is still fatal to many patients due to cancer progression, recurrence and metastasis. Regarding the development of novel therapeutic techniques, many studies have focused on the biological mechanisms that initiate tumours and cause treatment resistance. Tumours have traditionally been considered to result from somatic mutations, either via clonal evolution or through a stochastic model. However, emerging evidence has characterised tumours using a hierarchical organisational structure, with cancer stem cells (CSCs) at the apex. Both stochastic and hierarchical models are reasonable systems that have been hypothesised to describe tumour heterogeneity. Although each model alone inadequately explains tumour diversity, the two models can be integrated to provide a more comprehensive explanation. In this review, we discuss existing evidence supporting a unified model of gastric CSCs, including the regulatory mechanisms of this unified model in addition to the current status of stemness-related targeted therapy in GC patients.
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Affiliation(s)
- Yanjing Song
- Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Yao Wang
- Department of Immunology, Institute of Basic Medicine, School of Life Sciences, Chinese PLA General Hospital, Beijing 100853, China
| | - Chuan Tong
- Department of Immunology, Institute of Basic Medicine, School of Life Sciences, Chinese PLA General Hospital, Beijing 100853, China
| | - Hongqing Xi
- Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Xudong Zhao
- Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Yi Wang
- Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China
| | - Lin Chen
- Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China
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Zhao X, Cai A, Xi H, Chen L, Peng Z, Li P, Liu N, Cui J, Li H. Predictive Factors for Lymph Node Metastasis in Undifferentiated Early Gastric Cancer: a Systematic Review and Meta-analysis. J Gastrointest Surg 2017; 21:700-711. [PMID: 28120275 DOI: 10.1007/s11605-017-3364-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 01/04/2017] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Less invasive surgery is gaining popularity for the treatment of early gastric cancer (EGC), but there are no definitive guidelines for the use of less invasive surgery for the treatment of undifferentiated EGC. The aims of this meta-analysis were to identify potential predictive factors for lymph node metastasis (LNM) in undifferentiated EGC and to guide the personalized therapeutic modality for patients with undifferentiated EGC. METHODS An extensive search of the PubMed, Embase, and Cochrane Library databases was performed to identify relevant articles involving undifferentiated EGC and LNM. Eligible data were systematically reviewed through a meta-analysis using Review Manager 5.3. RESULTS In total, 23 studies were included in this analysis. The meta-analysis found that the variables sex (female), age (greater than 60 years), tumor size (greater than 20 mm), depth of invasion (submucosal invasion), presence of lymphovascular involvement, presence of ulcer findings, histology type (non-signet ring carcinoma), and tumor location (not in the middle part of the stomach) were significantly associated with LNM. CONCLUSIONS Eight variables were identified as predictive factors for LNM in undifferentiated EGC. The significance of these variables should be further confirmed during the process of LNM in undifferentiated EGC patients for future clinical application.
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Affiliation(s)
- Xudong Zhao
- Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Aizhen Cai
- Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Hongqing Xi
- Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Lin Chen
- Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
| | - Zheng Peng
- Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.
| | - Peiyu Li
- Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Na Liu
- Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Jianxin Cui
- Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China
| | - Hua Li
- Department of General Surgery, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.,Department of Surgical Oncology, Affiliated Xing Tai People Hospital of Hebei Medial University, Xingtai, 054001, Hebei Province, China
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