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Objective To explore the preoperative predictive factors influencing microscopic positive proximal margin in upper gastric cancer, and to establish a nomogram prediction model and to validate it internally. Methods Retrospective analysis of 187 patients with upper gastric cancer operated in the Department of Gastrointestinal Surgery of Hengshui People's Hospital from January 2018 to October 2022 were included in this study. Patients were divided into the microscopic positive proximal margin (the R0 group, n=15) and the negative microscopic proximal margin group (the R1 group, n=172) according to histopathological diagnosis. Preoperative factors that may influence positive upper margin of proximal gastric cancer were collected, including patient age, gender, tumor size, tumor location, Borrmann staging, tumor differentiation, Lauren staging, cT stage and cN stage. Receiver operating characteristic (ROC) curve was used to figure out the optimal cutoff value for predicting positive margin of proximal gastric cancer by tumor length. Multivariate Logistic regression was used to analyze the variables with statistical difference between the two groups, and independent risk factors were screened out, and prediction mode was constructed. The prediction accuracy of the model was verified internally using Bootstrap method. Results The best threshold for predicting positive margin of proximal gastric cancer by tumor length was 4.85 cm. Univariate analysis showed that there were significant differences in tumor length, tumor location, Borrmann staging, Lauren staging, cT staging and cN staging between the two groups (all P＜0.05). Multivariate Logistic regression analysis showed that tumor length >4.85 cm (OR=4.000, 95%CI: 1.039-15.399), tumor located in esophagogastric junction (OR=7.108, 95%CI: 1.604-31.494), Borrmann staging Ⅲ—Ⅳ(OR=6.991, 95%CI: 1.538-31.782), Lauren staging as diffuse or mixed (OR=7.583, 95%CI: 1.814-31.701) and cT staging as cT4 (OR=8.249, 95%CI: 1.890-36.007) were independent predictors of microscopic positive proximal margin of advanced upper gastric cancer before surgery, and a prediction model was established based on results of multivariate analysis. The area under ROC curve (AUC) value for subjects with the model was 0.862 after internal validation. The calibration curve showed that the model predicted the probability of microscopic positive proximal margin occurrence in good agreement with the probability of actual microscopic positive proximal margin occurrence （Hosmer-Lemeshow χ² =6.145，P=0.523）. Conclusion The established nomogram prediction model can predict the probability of positive upper incisal margin of proximal gastric cancer before operation, and provide clinical guidance for formulating surgical strategy. [ABSTRACT FROM AUTHOR]

Epithelial cell adhesion molecule (EpCAM) was first identified in colon cancer cells and is involved in the regulation of cell adhesion, proliferation, differentiation, migration, and signal transduction. Normally, EpCAM is only expressed in normal epithelial cells, but studies have shown that it is present and highly expressed in human epithelial cell-derived malignant tumors. EpCAM is involved in multiple links of tumor progression, and its unique expression pattern in tumor has also made it one of the most important tumor biomarkers. This article reviews the research advances in EpCAM as a tumor biomarker in recent years and its potential application in the treatment of lung cancer, breast cancer, and some digestive system tumors. These studies reveal the important role of EpCAM in tumor progression and provide a scientific basis for its potential as a therapeutic target.

Objective To explore the inhibitory effect of daphnetin (Dap) on gastric cancer cells and its mechanism. Methods Gastric cancer AGS cells were treated with Dap at concentrations of 0, 30, 60, 90, 120, and 150 μmol/L, and the effect on cell viability was evaluated after 48 h using the MTT assay. AGS cells were divided into groups A to E, and each group was treated with Dap at concentrations of 0, 30, 60, 90, 120, and 150 μmol/L, respectively, for 48 h. Each group was observed for changes in cell count and morphology using optical microscopy and crystal violet staining. DCF staining was used to evaluate the effect of Dap on intracellular reactive oxygen species (ROS) levels in AGS cells in groups A to D, while JC-1 staining was used to evaluate the effect of Dap on the level of mitochondrial membrane potential (MMP) in AGS cells in groups A to D. Western blot was conducted to measure the expression levels of LC3 and P62 proteins in AGS cells in groups A to D, and changes in autophagic flux in AGS cells were measured by Ad-mCherry-GFP-LC3B staining. Results Dap significantly inhibited AGS cell viability in a concentration-dependent manner (F=321.50,t=12.44-34.77,P

Background Gastrointestinal symptoms in gastric cancer patients treated with postoperative chemotherapy are diverse and interconnected, without effective intervention targets. In recent years, network analysis has emerged as a prominent approach to identify intervention targets. Objective To construct a network of gastrointestinal symptoms in gastric cancer patients treated with postoperative chemotherapy, identify core symptoms and analyze the factors influencing core symptoms, so as to provide a reference for precise symptom management. Methods Postoperative chemotherapy patients with gastric cancer were selected in the medical oncology and surgical oncology department of four tertiary A-level Chinese medicine hospitals (Jiangsu Provincial Hospital of Traditional Chinese Medicine, Suzhou Hospital of Traditional Chinese Medicine, Wuxi Hospital of Traditional Chinese Medicine, and Xuzhou Hospital of Traditional Chinese Medicine) in South, Central, and North of Jiangsu Province, from March to December 2022 via convenience sampling method, as the study subjects. The MD Anderson Symptom Inventory Gastrointestinal Cancer (MDASI-GI) was used for evaluating gastrointestinal symptoms and their severity among patients receiving postoperative chemotherapy for gastric cancer, as well as assessing the classification of traditional Chinese medicine constitution among patients. The network of gastrointestinal symptoms was constructed using an R package to identify the centrality indexes. The univariate analysis and multiple linear regression analysis were conducted to investigate factors influencing core gastrointestinal symptoms in patients undergoing postoperative chemotherapy for gastric cancer. Results A total of 362 electronic questionnaires were collected, 355 were valid, with a valid recovery rate of 98.1%. The highest incidence of gastrointestinal symptoms in patients with postoperative chemotherapy for gastric cancer was lack of appetite (83.1%), taste alteration (81.7%) and nausea (71.0%), and the top three in terms of severity were lack of appetite (2.77 points), taste alteration (2.50 points) and nausea (2.27 points). Network analysis showed that taste alteration had the highest intensity (rS=1.27) and the highest tight centrality (rC=1.50) ; vomiting had the highest betweenness centrality (rB=1.76). The results of multiple linear regression analysis showed that gender (B=0.809, 95%CI=0.319-1.298), smoking history (B=0.706, 95%CI=0.185-1.228) and phlegm-damp constitution (B=1.703, 95%CI=0.538-2.868) were the factors influencing the severity of taste alteration symptoms in patients with gastric cancer after chemotherapy (P

Background Locally advanced gastric cancer mainly includes stage Ⅲ gastric cancer, which is mainly treated with comprehensive therapy. Postoperative recurrence is a key factor affecting the prognosis of patients. Objective To explore the influencing factors of long-term prognosis in patients with stage Ⅲ gastric cancer undergoing D2 radical surgery and adjuvant chemotherapy. Methods Gastric cancer patients who underwent D2 radical surgery and adjuvant chemoradiotherapy were collected from the Department of Radiotherapy at Zhongshan Hospital affiliated to Fudan University from 2009 to 2014. They were pathologically diagnosed with stage Ⅲ gastric cancer according to the International Union of Cancer (UICC) and American Cancer Federation (AJCC) 8th edition TNM staging system for gastric cancer. All postoperative patients were followed up every 3 months in the first year, every 6 months for the following 2 years, and once a year thereafter. The deadline for follow-up is December 15, 2021. Survival rates of subgroups were compared using Log-rank tests.The influencing factors of overall survival (OS) and disease-free survival (DFS) were compared using Cox proportional hazards regression analysis, and the prediction of clinicopathological features were analyzed by Nomogram. Comparison of survival differences among patients with different pTNM stagings, age, metastatic lymph node radios (LNR), and gastrectomy methods using Kaplan-Meier method. Results A total of 135 qualified patients were included, with a median follow-up time of 10.48 years. Within 5 years, there were 70 cases of recurrence and 62 deaths. The 5-year DFS rate and OS rate were 48.1% (65/135) and 54.1% (73/135), respectively; Within 10 years, there were 74 cases of recurrence and 74 deaths. The 10-year DFS rate nd OS rate were both 45.2% (61/135). The Log-rank test results showed that there was a statistically significant difference in 5-year survival rates among patients with different pTNM stagings, pT stagings, LNRs, cancer nodules, tumor locations, and gastrectomy methods (P50%, OS: HR=1.74, 95%CI=1.03-2.94; DFS: HR=1.73, 95%CI=1.02-2.94), and gastrectomy method (total gastrectomy, OS: HR=2.07, 95%CI=1.22-3.50; DFS: HR=2.02, 95%CI=1.20-3.41) were independent influencing factors for OS and DFS in patients with stageⅢ gastric cancer undergoing D2 radical surgery with adjuvant chemotherapy (P

Gastric cancer (GC) is one of the most heterogeneous and aggressive malignant tumors of the digestive system. Traditional chemotherapy drugs and epidermal growth factor receptor 2 (HER2) targeted drugs such as Trastuzumab still have the disadvantages of high incidence of drug resistance, high toxic side effects and poor tolerance of patients. Therefore, it is imperative to develop more effective anti GC drugs. Novel targeted drugs against HER2 are currently available, but are ineffective or resistance in some cases, which is related to the low expression of HER2 (HER2 IHC1+ or IHC2+/ISH-) in certain GC cells, accounting for about 40%-60% of all types. However, in clinical practice, these patients are still reported as HER2-negative GC. Therefore, accurate detection of HER2 expression is crucial to identify patients who may benefit from trastuzumab therapy. The emergence of antibody drug conjugates (ADC) provides a new therapeutic option for HER2-positive GC and it is expected to replace traditional GC chemotherapy in the future by its precise and efficient anti-tumor effect. Recent studies have found that ADC may have potential anti-tumor activity in HER2 low-expression GC, and related clinical studies are evaluating its effectiveness and safety in HER2 low-expression GC treatment. This article reviews the application and the latest research progress of ADC in HER2 low-expression GC patients in the era of targeted therapy and discusses the challenges faced in the application and development of HER2-targeted ADCs.

Background In recent years, screening, early diagnosis and early treatment of upper gastrointestinal cancer have been successively carried out in various provinces and cities in China. At present, there are few studies on the screening results of upper gastrointestinal cancer and influencing factors of gastric cancer in coastal area of northern Jiangsu. Objective To analyze the influencing factors of gastric cancer based on the results of opportunistic screening for upper gastrointestinal cancer in rural population in coastal areas of northern Jiangsu, so as to provide a reference for the development of relevant prevention and control strategies. Methods A total of 8 564 rural subjects at high risk for upper gastrointestinal cancer admitted to the outpatient department of gastroenterology of the Affiliated Lianyungang Hospital of Xuzhou Medical University and received gastroscopy screening from January 2021 to December 2022 were selected, and divided into the gastric cancer group (n=183) and benign gastric disease group (n=366) after matching according to age (±2 years) and gender (1∶2) based on the screening results. The baseline data of the subjects were collected, the cancer detection rate and cancer early diagnosis rate were calculated. Multivariate Logistic regression analysis was used to explore the influencing factors of gastric cancer in rural population in coastal area of northern Jiangsu. Results A total of 521 patients with upper gastrointestinal neoplastic lesions were detected, including 183 patients with gastric (including cardia) cancer, with a detection rate of 2.14% (183/8 564) ; and 46 patients with early gastric (including cardia) cancer, with the early diagnosis rate of 25.14% (46/183) . There was no significant difference in the distribution of different categories of gastric neoplastic lesions in different genders and ages (P>0.05) . The detection rate of gastric (including cardia) neoplastic lesions in males (5.14%, 195/3 795) was higher than females (2.05%, 98/4 769) , and the difference was statistically significant (χ2=60.807, P

Objective To investigate the value of preoperative CT evaluation of extramural vascular invasion in evaluating the prognosis of gastric cancer patients. Methods The patients who underwent gastrectomy in our hospital from January 2016 to December 2018 were enrolled as subjects, and preoperative CT examination was performed to evaluate extramural vascular invasion. The patients were followed up after surgery to observe overall survival (OS) and disease-free survival (DFS); the K-M curve and the log-rank test were used to analyze the association of extramural vascular invasion with OS and DFS, and the COX regression model was used to investigate the influencing factors for OS and DFS. Results The patients with a tumor diameter of ≥5 cm and TNM stage Ⅲ gastric cancer had a significantly higher incidence rate of extramural vascular invasion on preoperative CT evaluation than those with a tumor diameter of

ObjectivesTo analyze the status and temporal changes of disability-adjusted life year (DALY) for stomach and colorectal cancers among registered permanent residents in Changning District of Shanghai Municipality, and provide scientific basis for the prevention and treatment of stomach and colorectal cancers in this district. MethodsUsing the cancer registration data of stomach and colorectal cancers from 2002 to 2019, we estimated the indices such as the DALYs, the DALY crude rates, the age-standardized DALY rates, etc. Then we used the Joinpoint regression model to calculate the average annual percent change (AAPC) and annual percent change (APC) to explore the temporal variations in different periods. ResultsThe DALYs of stomach and colorectal cancers in Changning District from 2002 to 2019 were 55 931 person years and 65 252 person years, respectively. The crude rates of DALY were 512.16/10 5 and 597.51/10 5, respectively. We observed a higher disease burden in men than in women, and the peak rate of DALY in stomach cancer was in the 75-79 years age group, while in colorectal cancer the rate was in the 85-years-or-older age group. Joinpoint regression analysis showed that from 2002 to 2019, the age-standardized DALY rate of stomach cancer showed a downward trend (AAPC=-3.86%, P＜0.05), while the trend of colorectal cancer was not statistically significant(AAPC=-0.08%, P＞0.05). However, the trends in the age-standardized DALY rates of colorectal cancer were different between males and females, with males showing an upward trend (AAPC=1.24%, P＜0.05) and females showing a downward trend (AAPC=-1.67%, P＜0.05). ConclusionsThe DALY of stomach and colorectal cancers in Changning District of Shanghai showed a decreasing trend. Males and the middle-aged and elderly populations are still the key targets for disease prevention and control in this district. [ABSTRACT FROM AUTHOR]

Objective To explore the effect of individualized positive end expiratory pressure guided by driving pressure on lung protection after laparoscopic radical gastrectomy for elderly patients. Methods A total of 64 patients underwent elective laparoscopic radical gastrectomy for gastric cancer in the Second Affiliated Hospital of Anhui Medical University were selected. According to the random number table method, patients were divided into the driving the pressure guided individualized positive end-expiratory pressure (PEEP) group (experimental group) and the fixed PEEP group (control group), 32 cases in each group. In the control group, PEEP = 5 cmH2O. In the experimental group, PEEP titration was performed according to the increasing method, and the PEEP corresponding to the lowest driving pressure was selected until extubation. Peak airway pressure (Ppeak), plateau airway pressure (Pplat) and PEEP were recorded at 5 min after intubation (T1), immediately after PEEP titration (T2), 1 h after operation (T3), 2 h after operation (T4), and 10 min after pneumoperitoneum release (T5). Driving pressure (ΔP) and lung dynamic compliance (Cdyn) were calculated. Arterial blood was collected at T1-5 for blood gas analysis, arterial partial pressure of oxygen (PaO2) was recorded, and oxygenation index (OI) was calculated. The occurrence of pulmonary complications (PPCs) within 7 days after operation was recorded. Modified clinical pulmonary infection score (mCPIS) was recorded on the second day after operation. The pulmonary function was evaluated before operation, 1 day, 3 days and 5 days after operation. Results Compared with T1, Ppeak, Pplat and ΔP were increased and Cdyn was decreased at T2-5, while OI was decreased at T4 in control group (P＜0.05). Compared with the control group, Ppeak, Pplat and Cdyn in the experimental group were increased at T2-5, ΔP was decreased, and OI was increased at T3-5 (P＜0.05). Compared with the preoperative results, FVC at 1, 3 and 5 days after surgery was decreased, and FEV1 and maximum expiratory flow (PEF) were decreased 1 and 3 days after surgery in the experimental groups (P＜0.05). Compared with the control group, FVC, FEV1 and PEF were higher 1 day after operation in the experimental group (P＜ 0.05). Compared with the preoperative results, mCPIS scores of the two groups were higher on the second day after surgery (P＜0.05). Compared with the control group, the mCPIS score was lower on day 2 after surgery in the experimental group (P＜0.05). The incidence of PPCs within 7 days after surgery was lower in the experimental group than that in the control group (15.6% vs. 40.6%). Conclusion Individualized PEEP guided by drive pressure can improve lung compliance, reduce drive pressure, improve oxygenation function and early postoperative lung function, reduce the incidence of postoperative lung complications, and has a certain lung protection effect. [ABSTRACT FROM AUTHOR]

Objective To investigate the association of inflammatory and nutritional indicators with the efficacy of neoadjuvant chemotherapy (NACT) in patients with upper gastric cancer before and after NACT, and to establish a clinical predictive model. Methods A total of 117 patients with upper gastric cancer who underwent NACT in Department of Gastroenterology in our hospital from April 2013 to January 2022 were enrolled, and according to the efficacy of chemotherapy, they were divided into effective group and ineffective group. Related clinical data were collected, such as age, sex, smoking history, drinking history, initial symptoms, tumor location, degree of tumor differentiation, tumor stage, tumor pathological type, and routine blood test results within one week before NACT and within one week after NACT. Univariate and multivariate analyses were performed to identify the influencing factors for the efficacy of NACT, and then a nomogram model was established and validated. Results The multivariate analysis showed that the difference in plasma neutrophil-to-lymphocyte ratio before and after NACT (△NLR) (OR=2.043,95%CI=1.334-3.127,P

Objective To explore effects of Casticin (Cas) on the proliferation, invasion, migration and microRNA-378 (miR-378) /paired related homeobox 1 (PRRX1) axis of gastric cancer (GC) SGC-7901 cells. Methods SGC-7901 cells were treated with Cas at different concentrations (0, 5, 10, 20, 40 and 80 μmol/L) for 48 h, and the cell viability of SGC- 7901 was detected by tetrazole salt (MTT) method. SGC-7901 cells at logarithmic growth stage were divided into 7 groups: the control group, the Cas low concentration group (10 μmol/L), the Cas medium concentration group (20 μmol/L), the Cas high concentration group (40 μmol/L), the Cas high concentration+miR-378 small interfering RNA (siRNA) group (40 μmol/L Cas+miR-378 siRNA), the Cas high concentration+PRRX1 group (40 μmol/L Cas+PRRX1 overexpressed plasmid) and the Cas high concentration+miR-378 siRNA+PRRX1 group (40 μmol/L Cas+miR-378 siRNA+PRRX1 overexpression plasmid). Cell activity, colony formation number, apoptosis rate, invasion and migration ability of SGC-7901 cells were determined by MTT assay, colony formation assay, flow cytometry, Transwell chamber assay and scratch assay, respectively. Expression levels of miR-378 and PRRX1 protein in SGC-7901 cells were detected by fluorescence quantitative PCR and Western blot assay. Double luciferase assay verified the targeting relationship between miR-378 and PRRX1. Xenografted SGC-7901 cells were xenografted into nude mice to verify the anticancer activity of Cas and its effect on the expression of miR-378. Results The cell viability of SGC-7901 cells in Cas 10, 20, 40 and 80 μmol/L groups decreased in a concentration-dependent manner (P＜0.05), and 10, 20 and 40 μmol/L Cas were selected as the follow-up study concentration. Compared with the control group, the cell viability, colony formation number, invasion cell number, scratch healing rate and PRRX1 protein expression level of SGC-7901 cells in the Cas low, medium and high concentration groups were decreased successively (P＜0.05), while the apoptosis rate and the expression level of miR-378 were increased successively (P＜0.05). Compared with Cas high concentration group, the cell viability, colony formation number, invasion cell number, scratch healing rate and PRRX1 protein expression levels were increased in the Cas high concentration+miR- 378 siRNA group and the Cas high concentration+PRRX1 group, and the apoptosis rate was decreased (P＜0.05). The expression level of miR-378 in SGC-7901 cells was decreased in the Cas high concentration+miR-378 siRNA group (P＜ 0.05). Compared with the Cas high concentration+miR-378 siRNA group, the expression level of miR-378 in SGC-7901 cells was increased in the Cas high concentration+PRRX1 group (P＜0.05). Compared with the Cas high concentration+miR- 378 siRNA group and the Cas high concentration+PRRX1 group, the cell viability, colony formation number, invasion cell number, scratch healing rate and PRRX1 protein expression levels were increased in the Cas high concentration+miR-378 siRNA+PRRX1 group (P＜0.05), and the apoptosis rate was decreased (P＜0.05). In SGC-7901 cells, miR-378 could target the expression of PRRX1. Cas inhibited the growth of transplanted tumor and promoted the expression of miR-378 in nude mice (P＜0.05). Conclusion Cas may inhibit the proliferation, invasion and migration of SGC-7901 cells by regulating the miR-378/PRRX1 axis. [ABSTRACT FROM AUTHOR]

Background Early diagnosis of gastric cancer is essential for patient prognosis. Currently, endoscopic forceps biopsy (EFB) is an important tool for the diagnosis of gastric cancer. However, it has been shown in relevant studies that there are some differences between EFB-based diagnosis and pathological diagnosis after endoscopic submucosal dissection (ESD), resulting in an underestimation of the patient's condition. No related research has been conducted in northern Shaanxi. Objective To calculate the rate of pathological upgrading in gastric mucosal lesions after ESD in five hospitals in northern Shaanxi, and to analyze the factors associated with pathological upgrading. Methods We recruited patients with gastric mucosal lesions who underwent ESD following EFB in five hospitals (Yan'an University Affiliated Hospital, Yan'an People's Hospital, the First Hospital of Yulin, Yan'an Traditional Chinese Medicine Hospital, Zichang People's Hospital) from 2016 to 2021. We classified the pathological results of gastric mucosal lesions into the following categories: chronic gastric inflammatory changes (CIC), low-grade gastric intraepithelial neoplasia (LGIN), high-grade gastric intraepithelial neoplasia (HGIN), early gastric cancer (EGC) and progressive gastric cancer. The difference between EFB-based diagnosis and pathological diagnosis of ESD specimens was analyzed. Pathological upgrading was defined as progression in pathological results. The pathological upgrading in patients with CIC, LGIN or HGIN was counted. The factors associated with pathological upgrading were analyzed. Results A total of 241 patients were included. The EFB-based diagnosis of CIC, LGIN, HGIN, and EGC were 84, 75, 65, 17 cases, respectively. Seventy-six (31.5%) were found with pathological upgrading after ESD compared with their EFB-based diagnoses. Binary logistic regression analysis showed that endoscopic classification〔OR=0.134, 95%CI (0.029, 0.617) 〕 and superficial ulceration〔OR=3.595, 95%CI (1.226, 10.536) 〕 were associated with pathological upgrading in CIC by EFB-based diagnosis (P

Objective To establish a nomogram risk predictive model by analyzing the risk factors for postoperative pulmonary complications (PPCs) after total gastrectomy for upper gastric cancer. Methods A retrospective analysis was performed for the clinical data of 197 patients who underwent total gastrectomy for upper gastric cancer in our hospital from June 1, 2020 to September 30, 2021. Univariate and multivariate Logistic regression analyses were used to investigate the risk factors for PPCs, and a nomogram predictive model for PPCs was established. Index of concordance, the receiver operating characteristic (ROC) curve, and the calibration curve were used to evaluate the performance of the predictive model, and the DCA curve was used to evaluate the clinical benefit of the model. Results Among the 197 patients included in the analysis, 71 experienced PPCs, with an incidence rate of 36%.The multivariate Logistic regression analysis showed that age, diabetes mellitus, smoking history, preoperative serum albumin 26 kg/m2 were independent risk factors for PPCs after total gastrectomy for upper gastric cancer. The nomogram prediction model established had an area under the ROC curve of 0.806, suggesting that the model had good prediction performance. The calibration curve showed that the predictive model showed good consistency with the actual incidence rate of complications, and the DCA curve showed obvious positive net benefits, indicating that the predictive model had good clinical benefits. Conclusion The nomogram prediction model established based on independent risk factors has good prediction performance and can provide a basis for predicting PPCs in patients undergoing total gastrectomy for upper gastric cancer.

Background and purpose: The response rate of gastric cancer patients to programmed death-1 (PD-1) inhibitor is relatively low. Establishing a useful efficacy prediction method to screen the superior gastric cancer patients receiving anti-PD-1 therapy could improve the prognosis of patients. This study aimed to explore the value of combined detection of lactate dehydrogenase (LDHA) and programmed death ligand-1 (PD-L1) expressions in predicting the efficacy and prognosis of gastric cancer patients treated with PD-1 inhibitor. Methods: The clinicopathological data of 50 advanced gastric cancer patients treated with PD-1 inhibitor in The First Affiliated Hospital of Wannan Medical College from January 2020 to March 2022 were retrospectively analyzed. The independent risk factors affecting the efficacy of PD-1 inhibitor were analyzed by multivariate logistic regression. The value of combined detection of LDHA and PD-L1 in predicting the efficacy of PD-1 inhibitors in gastric cancer was analyzed by receiver operating characteristic (ROC) curve analysis. Gastric cancer patient survival was analyzed by Kaplan-Meier method. Results: The objective response rate (ORR) of gastric cancer patients receiving PD-1 inhibitor therapy in LDHA low and high expression groups were 59% and 10%, respectively. The disease control rate (DCR) in LDHA low and high expression groups were 83% and 29%, respectively. The difference was statistically significant (P

Background Due to great differences in physiological reserve, psychological status and social functioning, frailty in elderly patients with gastric cancer may present various subtypes. The relationship between preoperative frailty and postoperative adverse outcomes in them still remains to be further explored. Objective To explore the relationship between preoperative frailty subtypes and postoperative adverse outcomes〔total complications, prolonged length of stay (PLOS), low quality of life (QOL), and disability〕among elderly patients with gastric cancer. Methods From March to October 2021, 404 elderly gastric cancer patients were selected from Department of Gastric Surgery, the First Affiliated Hospital with Nanjing Medical University by convenience sampling. The General Demographic Data Questionnaire and Tilburg Frailty Indicator were used to collect demographics and frailty status before surgery. Total complications and PLOS were collected from the electronic medical records, and the status of disability and QOL were obtained using a telephone follow-up at one month after discharge. Univariate Logistic regression was performed to explore the influencing factors of postoperative adverse outcomes. Multivariate Logistic regression analysis was performed to analyze the association of preoperative frailty subtypes with postoperative adverse outcomes, with potential confounders adjusted. Results Two hundred and eighty-five cases were found with preoperative frailty, and the frailty subtypes in them were classified into eight classes: exclusive physical frailty〔77 (19.1%) 〕, exclusive psychological frailty〔78 (19.3%) 〕, exclusive social frailty〔23 (5.7%) 〕, physical and psychological frailty〔63 (15.6%) 〕, physical and social frailty〔13 (3.2%) 〕, psychological and social frailty〔16 (4.0%) 〕, multidimensional frailty (physical, psychological, and social frailty) 〔15 (3.7%) 〕. The other 119 (29.5%) cases had no preoperative frailty. In the univariate Logistic regression, age was the factor influencing total complications〔OR=1.063, 95%CI (1.021, 1.106), P=0.003〕. History of pharmacological treatment〔OR=1.549, 95%CI (1.016, 2.362), P=0.042〕and surgical approach〔OR=2.103, 95%CI (1.191, 3.712), P=0.010〕were the factors influencing PLOS. Marital status〔OR=4.611, 95%CI (1.079, 19.706), P=0.039〕, living in an urban area〔OR=1.614, 95%CI (1.009, 2.582), P=0.046〕, having at least two comorbidities〔OR=1.694, 95%CI (1.038, 2.766), P=0.035〕were the factors influencing postoperative low QOL. Living in an urban area〔OR=0.601, 95%CI (0.390, 0.926), P=0.021〕, history of pharmacological treatment〔OR=1.663, 95%CI (1.082, 2.558), P=0.020〕, and advanced TNM stages〔OR=1.659, 95%CI (1.017, 2.706), P=0.043〕were the factors influencing postoperative disability. In the multivariate Logistic regression, the preoperative multidimensional frailty was independently associated with total complications, with age adjusted〔OR=5.344, 95%CI (1.715, 16.656), P=0.004〕. The preoperative physical frailty〔OR=2.048, 95%CI (1.078, 3.891), P=0.029〕, preoperative psychological frailty〔OR=2.077, 95%CI (1.103, 3.913), P=0.024〕and preoperative multidimensional frailty〔OR=8.321, 95%CI (2.400, 28.848), P

Background Preoperative frailty is a severely unhealthy status that reflects the reduction of overall physiological reserve, which is highly prevalent in elderly patients with gastric cancer. Understanding the perceived influencing factors of preoperative frailty can provide an important basis for developing individualized intervention plans. Objective To perform a qualitative descriptive study to identity the perceived influencing factors of preoperative frailty among elderly gastric cancer patients using the theory of health ecology. Methods A qualitative descriptive study was conducted based on health ecology theory. Purposive sampling method was used to select 29 frail elderly patients who would undergo gastric cancer surgery in the First Affiliated Hospital with Nanjing Medical University from February to June 2021 for semi-structured interview. Directed content analysis was used for data analysis. Results Five themes and thirteen sub-themes were extracted: physiological traits, including accumulated aging-related losses, obvious gastrointestinal symptoms, and successive attacks of multiple diseases; behavioral characteristics, including lack of exercise behavior and overexertion; interpersonal networks, including insufficient peer social interaction, lack of parent-child interaction, and lack of communication and self-disclosure between couples; living and working conditions, including heavy individual financial burden, heavy unplanned family care tasks, insufficient information resources for health and disease management; macro factors, including limited medical services and medical insurance support. Conclusion This study described the effects of different perceived factors on preoperative frailty among elderly gastric cancer patients from the perspective of health ecology. Medical workers should formulate and implement systematic prehabilitation programs based on the above factors to improve the patients' preoperative anti-stress capacity and postoperative outcomes.

Background and purpose: The response rate of gastric cancer patients to programmed death-1 (PD-1) inhibitor is relatively low. Establishing a useful efficacy prediction method to screen the superior gastric cancer patients receiving anti-PD-1 therapy could improve the prognosis of patients. This study aimed to explore the value of combined detection of lactate dehydrogenase (LDHA) and programmed death ligand-1 (PD-L1) expressions in predicting the efficacy and prognosis of gastric cancer patients treated with PD-1 inhibitor. Methods: The clinicopathological data of 50 advanced gastric cancer patients treated with PD-1 inhibitor in The First Affiliated Hospital of Wannan Medical College from January 2020 to March 2022 were retrospectively analyzed. The independent risk factors affecting the efficacy of PD-1 inhibitor were analyzed by multivariate logistic regression. The value of combined detection of LDHA and PD-L1 in predicting the efficacy of PD-1 inhibitors in gastric cancer was analyzed by receiver operating characteristic (ROC) curve analysis. Gastric cancer patient survival was analyzed by Kaplan-Meier method. Results: The objective response rate (ORR) of gastric cancer patients receiving PD-1 inhibitor therapy in LDHA low and high expression groups were 59% and 10%, respectively. The disease control rate (DCR) in LDHA low and high expression groups were 83% and 29%, respectively. The difference was statistically significant (P＜0.001). Multivariate logistic regression analysis showed that PD-L1 combined positive score (CPS)＜5 and LDHA high expression were independent risk factors affecting the efficacy of PD-1 inhibitor in gastric cancer (P＜0.05). ROC curve analysis showed that combined detection of LDHA and PD-L1 had good predictive value for the efficacy of PD-1 inhibitor in gastric cancer ［area under curve (AUC) was 0.951］. Kaplan-Meier survival analysis showed that gastric cancer patients with low LDHA expression and PD-L1 CPS≥5 had longer overall survival (OS, P=0.003) and progression-free survival (PFS, P＜0.001) after receiving PD-1 inhibitor therapy. Conclusion: Low LDHA expression and PD-L1 CPS≥5 were positively correlated with the efficacy of PD-1 inhibitor in gastric cancer. Gastric cancer patients with low LDHA expression and PD-L1 CPS≥5 significantly had prolonged OS and PFS after receiving PD-1 therapy. Therefore, the combined detection of LDHA and PD-L1 expressions has good value in predicting the efficacy and evaluating prognosis of advanced gastric cancer patients treated with PD-1 inhibitor. [ABSTRACT FROM AUTHOR]

Objective: To systematically evaluate and compare the safety and effectiveness of esophagojejunostomy and traditional esophagojejunostomy in total laparoscopic total gastrectomy in the treatment of gastric cancer, providing evidence-based medical evidence for clinical practice. Methods: PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang and VIP databases were searched by computer, and the retrieval time was up to December 2021. Relevant literatures were obtained, and eligible studies were gradually screened and included. Cochrane ROB bias risk assessment tool and NOS scale were used to evaluate the quality of the articles, and required data were extracted from high-quality literatures. Finally, meta-analysis was performed using Review Manager 5.3 software. Results: Eleven studies were finally included, including 1 398 patients, including 566 patients receiving overlap anastomosis and 832 patients receiving traditional anastomosis. The results show that overlap anastomosis and traditional anastomosis had the advantages of operation time (MD=0.63, 95%CI =7.22, 8.48, P=0.88), postoperative first exhaust time (MD=-0.13, 95%CI =0.43, 0.18, P=0.42), postoperative first feeding time (MD=0.02, 95%CI=0.33, 0.37, P=0.91), anastomotic leakage (OR=1.38, 95%CI=0.73,2.63, P=0.32), and postoperative hospital stay (MD= -0.16, 95%CI =0.82, 0.51, P=0.64) had no significant differences (all P > 0.05) . Compared with traditional anastomosis, overlap anastomosis had longer anastomosis time (MD=5.60, 95%CI=0.59, 10.62, P=0.03), higher incidence of anastomotic bleeding (OR=2.48, 95%CI=1.08, 5.69, P=0.03), less intraoperative bleeding (MD=-6.42, MD=-6.42, OR=2.48, 95%CI=1.08, P=0.03) . 95%CI=10.28, -2.56, P=0.001) and anastomotic stenosis (OR=0.17, 95%CI=0.06, 0.46, P= 0.000 6) .Conclusion: Overlap esophagojejunostomy is a safe, effective and prognostic surgical method, and is expected to be- come the standard esophagojejunostomy in total laparoscopic total gastrectomy. [ABSTRACT FROM AUTHOR]

Background Along with the acceleration of population aging and the increase in average life expectancy, how to improve the quality of life of residents has become a social focus. Cancer is a major factor that seriously affects the health, causing increased medical burden. Therefore, it is of great significance to analyze cancer incidence in Cenxi City, Guangxi. Objective To perform a statistical analysis of cancer incidence in Cenxi from 2016 to 2020. Methods Data on cancer incidence in Cenxi from 2016 to 2020 were obtained from the Cancer Registry System of Cenxi Center for Disease Control and Prevention. Cancers were classified by the Guideline for Chinese Cancer Registration and International Classification of Disease for Oncology, Third Edition (ICD-O). Sex-specific and age-specific crude incidence rates, standardized incidence rates, and cumulative incidence rates (0-74 years), as well as truncated age-standardized incidence rate (35-64 years) were calculated. The standardized incidence rate was calculated by the 2000 Population Census of China and Segi's world population structure (Chinese age-standardized incidence rate was referred to as ASIRC, and world age-standardized incidence rate as ASIRW) . Results There were 4 205 registered new cases of cancer from 2016 to 2020 in Cenxi. The crude cancer incidence rate was 98.77/105. The ASIRC, ASIRW, cumulative incidence rate (0-74 years) and the truncated age-standardized incidence rate (35-64 years) were 85.48/105, 82.54/105, 9.08%, and 165.08/105, respectively. The male crude incidence rate was higher than that in female (χ2=161.703, P

Gastric cancer is a common cancer of the digestive system with a high mortality rate. Distant metastasis of tumor cells is one of main causes of treatment failure and patient death. Finding therapeutic targets for gastric cancer metastasis is of great significance for improving the survival rate of patients. A large number of recent studies have shown that long non-coding RNAs (LncRNAs) are closely related to the metastasis of gastric cancer, and they are involved in various biological processes of gastric cancer metastasis. Therefore, this article reviews the research progress in the regulation of gastric cancer metastasis by LncRNA, in order to provide a theoretical basis for understanding the mechanism of gastric cancer metastasis. [ABSTRACT FROM AUTHOR]

Background At present, whether the expression of programmed death ligand 1 (PD-L1) and the density of CD8+ tumor-infiltrating T lymphocytes (TILs) in gastric cancer tissue can be used as prognostic indicators for gastric cancer patients has been still unclear. Objective To analyze the expression of PD-L1 and density of CD8+ TILs in gastric cancer tissues and their relations with clinicopathological characteristics and prognosis of patients with gastric cancer. Methods A total of 125 gastric cancer patients underwent surgical treatment in Nanyang First People's Hospital from January 2016 to March 2018 were selected, and the expression level of PD-L1 mRNA in gastric cancer tissue was detected by real-time fluorescence quantitative polymerase chain reaction, the density of CD8+ TILs in gastric cancer tissue was detected by immunohistochemical methods. The relations of the relative expression quantity of PD-L1 mRNA and the density of CD8+ TILs in gastric cancer tissue with the clinicopathological characteristics of patients with gastric cancer was analyzed; the correlation between the relative expression quantity of PD-L1 mRNA and the density of CD8+ TILs in gastric cancer tissue was analyzed by Pearson correlation analysis; telephone follow-up was conduct till to 36 months after operation, taking death or loss to follow-up as outcome event, Kaplan-Meier survivorship curve was drawn to conduct survival analysis; univariate and multivariate Cox regression analysis was used to analyze the influencing factors of prognosis of gastric cancer patients. Results The average relative expression quantity of PD-L1 mRNA was 3.1 in gastric cancer tissue, the average number of CD8+ TILs was 36 in cancer nests, thus the 125 patients were divided into low-level group (with relative expression quantity of PD-L1 mRNA less than 3.1, n=73) , high-level group (with relative expression quantity of PD-L1 mRNA equal or over 3.1, n=52) , low-density group (with number of CD8+ TILs less than 31, n=55) and high-density group (with number of CD8+ TILs equal or over 31, n=70) . There were significant differences in lymph node metastasis, vascular invasion and peritoneal metastasis between the the low-level group and high-level group (P

Background It is very difficult to contain persistently high incidence and mortality rates of gastric cancer. Moreover, the age at onset of gastric cancer is becoming earlier. However, there are few studies on the prediction of the age at gastric cancer onset. Objective To investigate the relationship between single nucleotide polymorphisms (SNPs) in mitochondrial displacement loop (D-Loop) and age at gastric cancer onset. Methods A total of 150 patients with confirmed gastric cancer by pathologically examination of biopsy samples taken during gastroscopy were recruited from Department of Gastroenterology, the Fourth Hospital of Hebei Medical University between July 2007 and December 2008. PCR was used to amplify the targeted fragment of peripheral blood mitochondrial DNA, and the mitochondrial D-Loop region was sequenced. Survival curves for patients with different ages of onset of gastric cancer were plotted by the Kaplan-Meier method, and compared by the Log-rank test. Cox regression analysis was used to identify factors associated with age of onset of gastric cancer. Results The age of onset of patients with different degrees of education was statistically significant (P

Background and purpose: Gastric cancer is one of the most common malignant tumors of digestive system. Previous study demonstrated that circSMARCA5 was downregulated and could function as a tumor suppressor in gastric cancer. However, the molecular mechanism has not yet been documented. This study aimed to investigate the effects of circSMARCA5 on the proliferation and invasion of gastric cancer cells and their molecular mechanisms. Methods: Cell counting kit-8 (CCK-8) assays and transwell assays were performed to examine the cell proliferative and invasive abilities, respectively. The effect of circSMARCA5 on gastric cancer cell glycolysis was assessed by detecting the extracellular acidification rate, glucose uptake level and lactate production. Real-time fluorescent quantitative polymerase chain reaction (RTFQ-PCR) assay was performed to detect the expression levels of circSMARCA5, miR-4295 and PTEN. The levels of GLUT1 and LDHA were measured by Western blot assay. The transplanted xenograft model in nude mice was established, and the effects of circSMARCA5 on the tumor growth were observed. Immunohistochemistry assays were performed to examine the expression levels of GLUT1, LDHA and Ki-67 proliferation index in xenograft tumors. Dual luciferase reporter gene assays, Pearson's correlation analysis and RNA immunoprecipitation (RIP) assays were used to confirm the targeting relationship of circSMARCA5 and miR-4295 as well as miR-4295 and PTEN. Results: CircSMARCA5 overexpression inhibited the proliferation and invasion of gastric cancer cells. Compared to the control group, the glycolysis rate, glycolysis capacity, glucose uptake and lactate production in the circSMARCA5-overexpresing group were significantly decreased. In addition, nude mouse transplanted xenograft assays showed that the volume and the weight of the tumors in the circSMARCA5-overexpressing group were lower compared with the control group. Further studies indicated that circSMARCA5 acted as a molecular sponge to inhibit the expression of miR-4295. Besides, miR-4295 could inhibit the expression of PTEN by binding with the 3'-UTR of PTEN mRNA. Rescue experiments by upregulating miR-4295 or downregulating PTEN expression in the circSMARCA5-overexpressing gastric cancer cells were performed, and the results showed that upregulation of miR-4295 or PTEN knockdown could abolish the inhibitory effects of circSMARCA5 overexpression on cell proliferation, invasion and glycolysis. Conclusion: CircSMARCA5 suppresses the proliferation and invasion of gastric cancer cells by targeting miR-4295, increasing the expression level of PTEN and subsequently regulating glycolysis.

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Objective：To investigate the expressions of circular RNA hsa_circ_0009735 in the gastric cancer tissue and cells, and to explore its effects on the epithelial mesenchymal transformation (EMT), migration, cell cycle, and autophagy of the gastric cancer cells. Methods：The GES-1 cells from normal gastric mucosa, gastric cancer MGC-803 cells, MKN-45 cells, and HGC-27 cells were collected. The hsa_ circ_ 0009735 small interfering RNA and negative control were transfected into the MGC-803 cells, and the gastric cancer MGC-803 cells were divided into si-hsa_ circ_ 0009735 group and negative control group; the control plasmid and hsa_circ_0009735 over-expression plasmid were transfected into the HGC-27 cells, and the gastric cancer HGC-27 cells were divided into OE-hsa_circ_0009735 group and control plasmid group, and the MGC-803 cells transfected with autophagic plasmid pcDNA-eGFP-LC3 were divided into blank group and different concentrations (0. 25, 0. 50, 1.00 and 2.00 mg·L－1 )of rapamycin groups. The expression levels of hsa _ circ_ 0009735 in the gastric cancer tissue and cells were detected by real-time fluorescence quantitative PCR (RT-qPCR)method; laser confocal microscope was used to observe the morphology of the MGC-803 cells and the number of autophagosomes in the MGC-803 cells in various groups; Transwell chamber experiment was used to detect the number of migration cells in various groups; flow cytometry was used to detect the percentages of the cells at different cell cycles in various groups; Western blotting method was used to detect the expression levels of microtuble-associated protein light chain 3 Ⅱ (LC3 Ⅱ), microtuble-associated protein light chain 3 Ⅰ (LC3 Ⅰ), E-cadherin, Cyclin D1, Vimentin, and N-cadherin proteins in the cells in various groups. Results：The PCR products were sequenced and showed cyclization sites, which was matched with the sequences of circ RNA hsa_circ_ 0009735. Compared with the sequences of adjacent tissue, the expression level of hsa_ circ_ 0009735 in gastric cancer tissue was increased (P<0.05); compared with GES-1 cells, the expression level of hsa_ circ_ 0009735 in the MGC-803 cells was increased (P<0.05). There was no significant change of the morphology of the MGC-803 cells among 0. 25 and 0. 50 mg·L－1 rapamycin groups. Compared with blank group, the number of granules in the MGC-803 cells in 1.00 mg·L－1 rapamycin group was increased and the boundary was unclear; in 2.00 mg·L－1 rapamycin group, more MGC-803 cells died. The laser confocal microscope observation results showed that the number of autophagosomes in the MGC-803 cells in 1.00 mg·L－1 rapamycin group had no significant difference compared with 2.00 mg·L－1 rapamycin group (P>0.05). Compared with blank group, the ratio of LC3 Ⅱ/LC3 Ⅰ in the MGC-803 cells in different concentrations of rapamycin groups were increased (P<0.05), the expression levels of hsa_circ_0009735 were decreased (P<0.01). Compared with negative control group, the expression level of hsa_circ_ 0009735 in the MGC-803 cells in si hsa_ circ_ 0009735 group was decreased (P<0.01), the ratio of LC3 Ⅱ/LC3 Ⅰ was increased (P<0.01), the number of migration cells was decreased (P<0.01), the percentage of cells at G1 phase was increased (P<0.05), the percentage of cells at S phase was decreased (P<0.01), the percentage of cells at G2 phase was decreased (P<0.05), and the expression levels of Cyclin D1, Vimentin, and N-cadherin proteins in the cells were decreased (P<0.05); compared with control plasmid group, the expression level of hsa _ circ -0009735 in the HGC-27 cells in OE-hsa_ circ_ 0009735 group was increased significantly (P<0.01), the ratio of LC3 Ⅱ/LC3 Ⅰ was decreased (P< 0.01), the number of migration cells was decreased (P<0.01), the percentage of the cells at G1 phase was decreased (P<0.01), the percentage of the cells at S phase was increased (P<0.05), the percentage of cells at G2 phase was increased (P<0.05), the expression level of E-cadherin protein in the cells was decreased (P<0.05), and the expression levels of Cyclin D1, Vimentin, and N-cadherin proteins in the cells were increased (P<0.05). Conclusion：High expression of hsa_circ_0009735 in the GC cells may promote the EMT process and affect the migration and the cell cycle, and inhibit the autophagy. [ABSTRACT FROM AUTHOR]

Objective To compare the treatment effects and complications of three reconstruction procedures in patients after radical gastrectomy. Methods A total of 194 patients with radical gastrectomy were selected and divided into the U-RY group (Uncut Roux-en-Y anastomosis, 69 cases), the B Ⅰ group (Billroth-Ⅰ modified delta-shaped anastomosis, 65 cases) and the B Ⅱ +Braun group (Billroth- Ⅱ +Braun anastomosis, 60 cases) according to the gastrointestinal reconstruction methods. The basic data of the three groups were matched by propensity score matching. The surgical status, postoperative recovery status, intestinal barrier function [diamine oxidase (DAO), D-lactic acid, endotoxin (ETX)], inflammatory stress indicators [interleukin-6 (IL-6), interleukin-10 (IL-10), 8-iso-prostaglandin F2α (8-iso-PGF2α), heme oxygenase-1 (HO-1)] and complications were compared between the three groups. Results Before propensity score matching, gender and age were not evenly distributed in the three groups (P＜0.05). After matching, 147 cases of 194 patients were successfully matched, with 49 cases in each group. There were no significant differences in general data between the three groups (P＞0.05). The surgical time increased successively in the B Ⅰ group, the B Ⅱ+Braun group and the U-RY group (P＜0.05). The intraoperative blood loss, postoperative bowel sound recovery time, first exhaust time, extubation time, eating time, first defecation time and hospital stay were less or shorter in the B Ⅰ group than those in the B Ⅱ+Braun group and the U-RY group (P＜0.05), but there were no significant differences in the above indicators between the B Ⅱ+Braun group and the U-RY group (P＞0.05). At 3 d after surgery, the levels of DAO, D-lactic acid and ETX were significantly lower in the B Ⅰ group than those of the U-RY group and the B Ⅱ+Braun group, while the levels of IL-6, IL10, 8-iso-PGF2α and HO-1 were higher compared with those in the U-RY group and the B Ⅱ+Braun group (P＜0.05). There were no significant differences in the above indicators between the U-RY group and the B Ⅱ+Braun group (P＞0.05). There were no significant differences in incidence rates of complications between the three groups (P＞0.05). Conclusion Billroth- Ⅰ modified delta-shaped anastomosis has the advantages of shorter surgical duration, less blood loss, faster recovery and smaller effect on the intestinal barrier compared to Billroth- Ⅱ+Braun anastomosis and Uncut Roux-en-Y anastomosis, but the latter two are more suitable for more indications and have milder inflammatory stimulation, and Uncut Roux-en-Y anastomosis can reduce postoperative reflux. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Clinical Healthcare is the property of Chinese Journal of Clinical Healthcare and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To investigate the effect of overexpression of Toll-like receptor 4(TLR4)gene by lentivirus on autophagy of the gastric cancer cells, and to clarify its mechanism. Methods: The gastric cancer cells BGC-823 and SGC-7901 at logarithmic growth phrase were divided into non-infection group negative control virus group and over-expression TLR4 group；they were infected with lentivirus-free, empty vector and lentivirus that overexpress TLR4, separately. Western blotting method was used to detect the expression levels of TLR4 protein in gastric epithelial cells GES-1 and gastric cancer cells BGC-823, SGC-7901, HGC-27 and MGC-803. CCK-8 assay was used to detect the proliferation activities of cells in various groups, real-time fluorescence quantitative PCR(RT-qPCR)method was performed to determine the expression levels of TLR4, Beclin1 and microtubule-associated protein light chain 3(LC3) mRNA, the expression levels of phosphatidylinositol-3 kinase/protein kinase B(PI3K/Akt), mammalian target of rapamycin (mTOR), phosphorylated PI3K/phosphorylated Akt (p-PI3K/p-Akt) and phosphorylated mTOR (p-mTOR) signaling pathway-related proteins and autophagy-related proteins (LC3, Beclin1 and p62) were detected by Western blotting method. Results: The expression levels of TLR4 protein in BGC-823 cells, HGC-27 cells and MGC-803 cells were higher than that in gastric epithelial cells GES-1. Compared with non-infection and negative control virus groups, the TLR4 protein expression levels in BGC-823 and SGC-7901 cells in over-expression TLR4 group were significantly increased (P<0. 05). Compared with non-infection control and negative control virus groups, the proliferation activities of BGC-823 cells and SGC-7901 cells in over-expression TLR4 group were significantly increased(P<0. 05 or P<0. 01). Compared with negative control group, the expression levels of TLR4 mRNA in the BGC-823 cells and SGC-7901 cells in over-expression TLR4 group were significantly increased(P<0. 01), the expression level of Beclin1 mRNA in BGC-823 cells was decreased (P<0. 05), and the expression levels of LC3 and Beclin1 mRNA in SGC-7901 cells were decreased(P< 0. 05). Compared with non-infection group and negative control group, the expression levels of LC3 and Beclin1 proteins in the BGC-823 cells and SGC-7901 cells in over-expression TLR4 group were significantly decreased(P<0. 05), while the expression levels of p62, p-PI3K、p-Akt and p-mTOR proteins were increaed(P<0. 05). Conclusion: The over-expression of TLR4 gene can significantly inhibit autophagy in gastric cancer cells via regulating the PI3K/Akt/mTOR signaling pathway. [ABSTRACT FROM AUTHOR]

Background and purpose: Gastric cancer is one of the most common malignant tumors of digestive system. Previous study demonstrated that circSMARCA5 was downregulated and could function as a tumor suppressor in gastric cancer. However, the molecular mechanism has not yet been documented. This study aimed to investigate the effects of circSMARCA5 on the proliferation and invasion of gastric cancer cells and their molecular mechanisms. Methods: Cell counting kit-8 (CCK-8) assays and transwell assays were performed to examine the cell proliferative and invasive abilities, respectively. The effect of circSMARCA5 on gastric cancer cell glycolysis was assessed by detecting the extracellular acidification rate, glucose uptake level and lactate production. Real-time fluorescent quantitative polymerase chain reaction (RTFQ-PCR) assay was performed to detect the expression levels of circSMARCA5, miR-4295 and PTEN. The levels of GLUT1 and LDHA were measured by Western blot assay. The transplanted xenograft model in nude mice was established, and the effects of circSMARCA5 on the tumor growth were observed. Immunohistochemistry assays were performed to examine the expression levels of GLUT1, LDHA and Ki-67 proliferation index in xenograft tumors. Dual luciferase reporter gene assays, Pearson's correlation analysis and RNA immunoprecipitation (RIP) assays were used to confirm the targeting relationship of circSMARCA5 and miR-4295 as well as miR-4295 and PTEN. Results: CircSMARCA5 overexpression inhibited the proliferation and invasion of gastric cancer cells. Compared to the control group, the glycolysis rate, glycolysis capacity, glucose uptake and lactate production in the circSMARCA5-overexpresing group were significantly decreased. In addition, nude mouse transplanted xenograft assays showed that the volume and the weight of the tumors in the circSMARCA5-overexpressing group were lower compared with the control group. Further studies indicated that circSMARCA5 acted as a molecular sponge to inhibit the expression of miR-4295. Besides, miR-4295 could inhibit the expression of PTEN by binding with the 3'-UTR of PTEN mRNA. Rescue experiments by upregulating miR-4295 or downregulating PTEN expression in the circSMARCA5-overexpressing gastric cancer cells were performed, and the results showed that upregulation of miR-4295 or PTEN knockdown could abolish the inhibitory effects of circSMARCA5 overexpression on cell proliferation, invasion and glycolysis. Conclusion: CircSMARCA5 suppresses the proliferation and invasion of gastric cancer cells by targeting miR-4295, increasing the expression level of PTEN and subsequently regulating glycolysis. [ABSTRACT FROM AUTHOR]

Objective To investigate the the expression level of tumor necrosis factor-α induced protein 6 (TNFαIP6) in gastric cancer and its correlation to clinicopathological features and survival outcome of gastric cancer patients. Methods The clinicopathological and follow-up data of 133 gastric cancer patients who underwent surgical resection in our hospital were retrospectively collected. Immunohistochemical staining was used to evaluate the expression of TNFαIP6 in gastric cancer tissues, and the correlation between TNFαIP6 expression and clinicopathological characteristics of gastric cancer patients was analyzed. Kaplan-Meier survival curves were plotted to compare the survival difference between patients with high TNFαIP6 expression and patients with low TNFαIP6 expression. The independent prognostic value of TNFαIP6 expression for gastric cancer patients was determined by Cox multivariate regression analysis. Results Among 133 patients, TNFαIP6 expression levels were high in 52 patients and low expression levels in 81 patients. The proportion of TNFαIP6 expression increased significantly in patients with poorly differentiated adenocarcinoma, Borrmann type Ⅳ, T3-T4 tumors, M1 stage and lymphatic vascular invasion. Kaplan-meier survival curve showed that the 5-year overall survival rate of patients with high TNFαIP6 expression was significantly lower than that of patients with low TNFαIP6 expression (56.5% vs. 82.9%, Log-rank χ2 =12.404, P<0.01). Cox multivariate analysis confirmed that T3-T4 tumor (HR=2.291, 95%CI: 1.028- 5.103), M1 stage (HR=3.628, 95%CI: 1.421-9.260) and high expression of TNFαIP6 (HR=2.742, 95%CI: 1.265-5.945) were independent risk factors affecting prognosis of gastric cancer patients. Conclusion The high expression of TNFαIP6 in gastric cancer tissues is associated with the invasive characteristics of tumor, and which is an independent marker affecting the prognosis of gastric cancer patients. [ABSTRACT FROM AUTHOR]

Objective To describe the epidemic characteristics of stomach cancer mortality in Qidong between 1972 and 2016. Methods The cancer registry data of stomach cancer death and population during 1972—2016 in Qidong was collected. The mortality of crude rate (CR), China age-standardized rate (CASR), world age-standardized rate (WASR), 35-64 years truncated rate, 0-74 years cumulative rate, cumulative risk, percentage change (PC), annual percent change (APC) were calculated. Results During 1972—2016, a total of 15 863 (male: 10 114, female: 5 749) deaths occurred attributed to stomach cancer, accounting for 16.04% of all cancers, with CR of 31.37/100 000 (CASR: 12.97/100 000, WASR: 21.39/100 000). The truncated rate of 35-64, cumulative rate of 0-74, and cumulative risk were 28.86/100 000, 2.54%, and 2.51%, respectively. For male, the CR, CASR, WASR were 40.53/100 000, 17.98/100 000, 30.13/100 000, respectively, and for female, the CR, CASR, WASR were 22.45/100 000, 8.52/100 000, 13.92/100 000, respectively. Age-specific mortality analysis showed that the mortality of each age group under 25-year-old group was less than 1/100 000. The CR increased with age. The 50-year-old group reached and exceeded the average mortality of the population, and more than 80-year-old group reached the peak of death. During 1972—2016 in Qidong, The PCs in CR, CASR, and WASR of stomach cancer were 55.43%, -52.02%, -43.60%. The APC were 0.54%, -2.30%, -2.08%, respectively. Period mortality analysis showed that except for the 75-year-old group, the mortality of stomach cancer decreased significantly. Conclusions The crude mortality of stomach cancer increases slightly in Qidong, while the CASR and WASR decrease significantly. However, stomach cancer is still one of the malignant tumors that most affect health and seriously threat lives. [ABSTRACT FROM AUTHOR]

Objective To estimate stomach cancer incidence and mortality in Henan, 2016 and analyze the trend of stomach cancer incidence and mortality from 2010 to 2016. Methods Stomach cancer related data in 2016 was extracted from Henan cancer registration and follow-up system. All data were qualified in validity, reliability and completeness according to the Guideline on Cancer Registration in China and International Agency for Research on Cancer (IARC/IACR). The incidence and mortality of stomach cancer were estimated by areas, gender and age based on the quality data and the registered population data of Henan province in 2016. The epidemic trend of stomach cancer was also been evaluated based on the age-standardized incidence and mortality by Chinese population (ASR China) from 2010 to 2016. Results In 2016, the estimated incident cases of stomach cancer were 44 311. The incidence was 41.07/100 000, ASR China was 30.17/100 000, ASR by world population (ASR world) was 30.36/100 000, and the cumulative incidence rate was 3.84%. The incidences of male and female were 55.65/100 000 and 25.35/100 000, respectively. Meanwhile, 32 927 people died of stomach cancer in Henan. The mortality was 30.52/100 000, ASR China was 21.45/100 000, ASR world was 21.54/100 000, and the cumulative mortality was 2.53%. From 2010 to 2016, both the ASR China for incidence and mortality of stomach cancer in Henan showed a steady downward trend. In rural, the ASR China for incidence and mortality decreased rapidly, while the stable trend was observed in urban. Nevertheless, the incidence and mortality of stomach cancer in rural were still higher than those in urban. Conclusions The incidence and mortality of stomach cancer in Henan province showed steadily declining trend from 2010 to 2016, and the geographical distribution difference between rural and urban areas was gradually narrowing. However, the disease burden was still high in 2016. [ABSTRACT FROM AUTHOR]

To explore the effect of quercetin (QE) on gastric cancer-related p53/AMPK/mTOR signaling pathway. Methods Gastric cancer cells were divided into the QE group and the solvent group. DMSO was used as the solvent. QE was formulated into 0.02 (QEA group), 0.04 (QEB group), 0.06 (QEC group), and 0.08 mmol/L (QED group) solutions. The solvent group was added the same amount of solvent without QE. MTT test was used to detect the effect of quercetin on gastric cancer cell proliferation. MDC staining method was used to detect the effect of quercetin on gastric cancer cell autophagy. Double staining method was used to detect the effect of quercetin on gastric cancer cell apoptosis. Real-time polymerase chain reaction test was used to detect the relative expression levels of p53, AMPK and mTOR mRNA in cells. Western blot assay was used to detect the differences in the expression levels of LC3Ⅱ/LC3Ⅰ, P53, AMPK and mTOR in cells. Results Compared with the solvent group, the autophagy and apoptosis rate of gastric cancer cells were significantly increased in the different QE dose groups (P＜0.05). The expression of LC3Ⅱ/LC3Ⅰ protein in cells was upregulated in the QE groups, and p53, AMPK mRNA and protein levels were also up-regulated, and the mRNA and protein expression of mTOR were down-regulated (P＜0.05) with a dose-dependent pattern. Conclusion Quercetin can inhibit the proliferation of gastric cancer cells, induce autophagy and promote apoptosis, which may be related to the p53/AMPK/mTOR signaling pathway. [ABSTRACT FROM AUTHOR]

Abstract: Objective To screen out the ferroptosis-related prognostic genes of gastric cancer and to construct a ferroptosis genes-related prognostic model through bioinformatics method. Methods â‘ To screen out ferroptosis-related genes associated with prognosis of gastric cancer: ：The gene microarray and related clinical data of gastric cancer were download from The Cancer Genome Atlas(TCGA) database. R software was used to screen out ferroptosis-related differentially expressed genes between cancer and paracancer tissues, as well as prognostic genes related to overall survival. The intersectional genes were obtained and their biological functions were analyzed. The Gene Set Enrichment Analysis (GSEA) software (https//www. gsea-msigdb.org/gsea/index.jsp) was utilized to analyze the enrichment pathways of ferroptosis genes related to the prognosis of gastric cancer of high expression. â‘¡ To construct and verify prognostic model of gastric cancer: A gene-related prognostic model of gastric cancer was constructed and validated by Lasso Cox regression analysis. Results Compared with paracancer tissues, the expression of 29 ferroptosis-related genes increased and the expression of 12 ferroptosis-related genes decreased in the gastric cancer tissues. Among them，NFE2L2 and SLC1A5 were related to the prognosis of gastric cancer. NFE2L2 mainly participated in the biological functions such as detection of chemical stimulus and regulation of membrane potential, while SLC1A5 mainly participated in the biological functions such as metal ion transport and regulation of protein serine and threonine kinase activity. The prognostic model of these genes was e(-0.315×NFE2L2)+(-0.161×SLC1A5). The area under ROC curve predicted by this model was 0. 561, 0. 587 and 0. 615 in the Abstract: Objective To screen out the ferroptosis-related prognostic genes of gastric cancer and to construct a ferroptosis genes-related prognostic model through bioinformatics method. Methods ①To screen out ferroptosis-related genes associated with prognosis of gastric cancer: ：The gene microarray and related clinical data of gastric cancer were download from The Cancer Genome Atlas(TCGA) database. R software was used to screen out ferroptosis-related differentially expressed genes between cancer and paracancer tissues, as well as prognostic genes related to overall survival. The intersectional genes were obtained and their biological functions were analyzed. The Gene Set Enrichment Analysis (GSEA) software (https//www. gsea-msigdb.org/gsea/index.jsp) was utilized to analyze the enrichment pathways of ferroptosis genes related to the prognosis of gastric cancer of high expression. ② To construct and verify prognostic model of gastric cancer: A gene-related prognostic model of gastric cancer was constructed and validated by Lasso Cox regression analysis. Results Compared with paracancer tissues, the expression of 29 ferroptosis-related genes increased and the expression of 12 ferroptosis-related genes decreased in the gastric cancer tissues. Among them，NFE2L2 and SLC1A5 were related to the prognosis of gastric cancer. NFE2L2 mainly participated in the biological functions such as detection of chemical stimulus and regulation of membrane potential, while SLC1A5 mainly participated in the biological functions such as metal ion transport and regulation of protein serine and threonine kinase activity. The prognostic model of these genes was e(-0.315×NFE2L2)+(-0.161×SLC1A5). The area under ROC curve predicted by this model was 0. 561, 0. 587 and 0. 615 in the [ABSTRACT FROM AUTHOR]

Objective To compare the short-term efficacy between laparoscopic and open total gastrectomy on stage Ⅰ gastric cancer. Methods A total of 89 patients with clinical stage Ⅰ gastric cancer who underwent total gastrectomy were divided into two groups: Laparoscopic total gastrectomy group (n=47) and open total gastrectomy group (n=42). The short-term curative effect of two groups was compared. Results The preoperative data of the two groups were comparable. Compared with open total gastrectomy group, the operative time in the laparoscopic total gastrectomy group was longer, but the intraoperative blood loss, the time for bowel function recovery, the length of hospital stay and the incidence of postoperative complications were all significantly reduced (P < 0.05). Conclusion Compared with the open total gastrectomy, laparoscopic total gastrectomy is safe and feasible for stage Ⅰ gastric cancer patients. It could reduce the bleeding volume, the time for bowel function recovery, the length of hospital stay and the incidence of postoperative complications.

Early onset gastric cancer (EOGC), defined as gastric cancer occurring at a younger age. Early-onset gastric cancer tends to be poorly differentiated and highly malignant. Genetic material and environmental exposure factors may be the main causes of early occurrence of gastric cancer. Prolonging the survival and improving the quality of life of patients with early-onset gastric cancer is our main research goal in the future. This article aims to elaborate on the current research status and progress of EOGC in terms of its clinicopathological characteristics, molecular genetics, microecological environment, prediction methods, treatment plans, and prognosis, while also exploring potential avenues for future research.

Objective To investigate the expression of Wnt1 induced signaling pathway protein-1 (WISP1) in gastric adenocarcinoma and its relationship with prognosis. Methods Immunohistochemical staining was used to analyze the expression and correlation of WISP1, vascular endothelial growth factor (VEGF), Twist1 and matrix metalloproteinase (MMP) -2 in 200 cases of gastric adenocarcinoma, and the relationship between WISP1 and prognosis of stomach adenocarcinoma. Meanwhile, the expression differences of WISP1 in gastric adenocarcinoma and adjacent tissues, the correlation between WISP1 and clinical prognosis were analyzed in the Cancer Genome Atlas database by the GEPIA (Gene Expression profiling interactive analysis) and UALCAN online tools. R package was used to analyze the expression of WISP1 in GSE13861 gastric adenocarcinoma data set and the correlation between WISP1 and Twist 1 in TCGA database. In addition, based on TCGA database and GSE13861 gastric adenocarcinoma data set, WISP1 gene was selected for Gene Ontology, Kyoto Encyclopedia of Genes and Genomes by R package and Gene Set Enrichment Analysis by Gene Set Enrichment software. Results Immunohistochemical staining showed that 116 cases (58%) were positive and 84 cases (42%) were negative in 200 cases of gastric adenocarcinoma. The positive rates of WISP1 expression were higher in TNM Ⅲ- Ⅳ stage, lymph node metastasis, distant metastasis and/or recurrence patients (P＜0.05), and the survival time of patients with WISP1 positive expression was shorter than that of patients with negative expression (24 months vs. 52 months, Logrank χ²=5.368, P＜0.05). TCGA database and GSE13861 gastric adenocarcinoma data set showed that the expression level of WISP1 was significantly higher in gastric adenocarcinoma tissue than that in adjacent tissue and normal gastric tissue (P＜ 0.05). The survival time of patients with high WISP1 expression was short analyzed by online tools. In addition, immunohistochemical results showed that VEGF, Twist1 and MMP-2 protein were highly expressed in WISP1 positive group (P＜0.05). WISP1 was positively correlated with the expressions of VEGF, CDH5, MMP-2, MMP-9, Snail, Twist1 and Vimentin, but negatively correlated with the expression of CDH1 (P＜0.05). GO analysis showed that WISP1 gene was involved in the biological processes of single cell migration, extracellular matrix structure and intercellular adhesion. WISP1 gene showed the molecular function of binding integrin and collagen, and molecular function of activating cytokines. KEGG pathway enrichment analysis showed that WISP1 was involved in the signal transduction pathway of extracellular matrix binding and cell adhesion. GSEA enrichment results showed that when WISP1 was over-expressed, the genes related to angiogenesis and EMT were up-regulated. Conclusion WISP1 is highly expressed at gene and protein levels in gastric adenocarcinoma, which may be involved in the metastasis and/or recurrence of gastric adenocarcinoma by promoting angiogenesis or EMT. [ABSTRACT FROM AUTHOR]

Objective To investigate the pathological features of gastric tumor originated from the fundic gland, including oxyntic gland adenoma ( OGA) and gastric adenocarcinoma of the fumlic gland (GA- FG). Methods A retrospective analysis of 2 cases of OGA mid 2 cases of GA-FG admitted to our hospital from February 2019 to September 2019 was performed. The histological features were analyzed by immunohistochemical staining combined with endoscopic observation. Results The four cases arose from the deep layer of the lamina propria mucosae and well differentiated. Two cases of OGA confined to the mucosa, including I case of irregular tubules showing low-degree dysplasia and another case of irregular branching and anastomosing tubules showing high-degree dysplasia. Two cases of GA-FG combined with suhmucosal invasion, showed irregular branching and anastomosing tubules and formed a so-called " endless glands" pattern. Atypia, hdicobacter pylori (HP) infection, chronic gastritis, intestinal metaplasia, or gastric atrophy were not observed in the superficial epithelium covering the tumor extent. Two cases of OGA and 2 cases of GA -FG showed the same result of immunohistochemical staining: pepsinogen- 1 was diffusely positive in the tumor tissues and indicated chief cell differentiation, while positive ATPase and PDGFTIA-α indicated parietal cells differentiation. The expression of Syn were positive in all cases, while CD JO, MUC2 and CD -X2 were negative. The upregulation of p53 protein or nuclear positivity of β-catenin was not observed. The Ki -67 labeling index in the hot area was approximately 1-5%. Conclusions GA-FG is a well-differentiated, low-grade malignant novel subtype of gastric cancer. The immunohistochemical markers and narrowband imaging combined with magnifying endoscopy ( NBI-ME) enhance the diagnostic sensitivity. Whether Syn positive expression can be one of the diagnostic item needs to be further investigate. The process of tumorigenesis of GA-FG might he the transition from low-grade dysplasia to high-grade dysplasia of OGA mid farther to submucosal infiltration. However, the mechm1ism of GAFG was still unclear. Disregulation of the Shh and Wnt/β-catenin signaling pathway might he associated with tumorigenesis of GA-FG. Endoscopic submucosal dissection ( ESD) is often the preferred and curative treatment. [ABSTRACT FROM AUTHOR]

Objective To establish a new clinical T staging model for patients with gastric cancer (GC) and to evaluate its predictive effect, so as to provide the basis for improving the predictive value of clinical T staging. Methods A total of 227 GC patients underwent radical surgery in our hospital were enrolled in this study. Among them, 102 cases were pT1-pT2 gastric cancer, 125 cases were pT3-pT4 gastric cancer. All patients underwent endoscopic ultrasonography (EUS) and multislice spiral computed tomography (CT) examination before operation. Univariate analysis was used to compare the clinical and pathological data, including gender, age, tumor location, Borrmann classification, CT based T staging, the layers of tumor invading the gastric wall under EUS and the maximum short diameter of longitudinal section of tumor under EUS, between pT1-pT2 and pT3-pT4 patients. According to the clinical experience, CT-based T staging and the layers of tumor invading the gastric wall under EUS were included to establish the traditional conventional clinical T staging model (CCTSM). Multivariate Logistic regression analysis was used to further evaluate the risk factors of pT3-pT4 after univariate analysis, and the significant variables were included in the revised clinical T staging model (RCTSM). The receiver operating characteristic (ROC) curve was constructed to assess the performance of two prediction models. Results The corresponding Logistic regression equation was Logit (P)= -2.599+2.409× CT based T staging + 2.553× the layers of tumor invading the gastric wall under EUS. The results of univariate analysis and multivariate Logistic regression analysis showed that CT based T3-T4 staging (OR=12.528, 95%CI: 4.347-36.109), the 5th layer of tumor invading the gastric wall under EUS (OR=7.533, 95%CI: 2.539-22.353), the longer maximum of the short diameter of tumor longitudinal section under EUS (OR=31.084, 95%CI: 8.681-111.307) were independent risk factors of pT3-pT4 stage in the GC patients. The Logistic regression equation of the revised clinical T staging model was established with these three variables: Logit (P)= -7.884+2.528× CT based T staging + 2.019× the layers of tumor invading the gastric wall under EUS + 3.437×the maximum short diameter of longitudinal section of tumor under EUS. The clinical value of the RCTSM in predicting pT3~pT4 was better than that of the CCTSM (AUC: 0.952 vs. 0.891, Z=3.870, P＜0.01). In the lymph node positive subgroup, the predictive value of the RCTSM was also better than that of the CCTSM (AUC: 0.916 vs. 0.864, Z=2.058，P＜0.05). Conclusion The RCTSM can better predict the pathological T staging in patients with gastric cancer and provide reliable basis for individualized treatment of GC patients. [ABSTRACT FROM AUTHOR]

To investigate the expression and clinical significance of miR-184, autophagy-related protein Beclin 1 and microtubule-associated protein 1 light chain 3 (LC3B) in the gastric cancer tissues. Methods Clinical and pathological data of 103 patients with gastric cancer were collected. The expression levels of miR-184, Beclin1, and LC3B were measured by real-time quantitative fluorescence PCR (qRT-PCR) and their clinical characteristics were analyzed. Pearson correlation analysis was used to examine the correlation of miR-184, Beclin1 and LC3B. Results The expression levels of miR-184, Beclin1, and LC3B in the gastric cancer tissues were lower than those in the paracancer tissues (all P<0. 05). The expression of miR-184, Beclin1, and LC3B decreased in patients with lymph node metastasis and TNM stage Ⅲ-Ⅳ (all P<0. 05). There were significantly positive correlations between the expression levels of miR-184 and Beclin1, between miR-184 and LC3B, and between Beclin1 and LC3B (r=0. 845, P<0. 05；r=0. 787, P<0. 05；r= 0. 793, P<0. 05). Conclusion The expression levels of miR-184, Beclin1, and LC3B in the gastric cancer tissues all decrease, and are closely related to lymph node metastasis and TNM stage, which can evaluate the patients' condition to a certain extent. [ABSTRACT FROM AUTHOR]

Objective To study the effect of uridine triphosphate (UTP) on the proliferation of gastric cancer cells and explore the underlying molecular mechanisms. Methods The effects of UTP and BAPTA-AM (an intracellular calcium chelator) on the proliferation of gastric cancer cell lines SGC-7901 and AGS were tested using CCK-8 assay. Colony formation assay was used to assess the effect of UTP on the colony-forming ability of gastric cancer cells. The effect of UTP on cyt in the cells was explored with digital Ca2+ imaging. Western blotting was performed to observe the effect of UTP and BAPTA-AM on the protein expression of LC3Ⅱ/LC3Ⅰ in the cells. Results UTP significantly inhibited the proliferation and the colony-forming ability of SGC-7901 and AGS cells(P < 0.05), and these inhibitory effects were reversed by BAPTA-AM. Digital Ca2+ imaging showed that UTP obviously increased cyt in the gastric cancer cells. The results of Western blotting showed that UTP significantly up-regulated the protein expression of LC3Ⅱ/LC3Ⅰ in the cells, and the application of BAPTA-AM obviously blocked the effect of UTP(P < 0.05). Conclusion UTP inhibits the proliferation of gastric cancer cells probably through increasing calcium signaling and up-regulating LC3Ⅱ/LC3Ⅰ, and thus causing autophagy.

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Hepatoid adenocarcinoma of the stomach is a rare type of gastric cancer. Compared to the common gastric adenocarcinoma, the tumor markers, imaging manifestation, histopathological features, immunophenotype, treatment and prognosis of HAS are distinct. It has characteristics of gastric adenocarcinoma and hepatocellular carcinoma at the same time, which leads to the misdiagnosis and missed diagnosis. The purpose of this paper is to analysis the characteristics of HAS from the above aspects, improve the diagnosis rate, reduce mortality rate and prolong the survival period of HAS patients. [ABSTRACT FROM AUTHOR]

Objective: To investigate the endoscopic and histopathological features, diagnosis and differential diagnosis of gastric hamartomatous inverted polyp (GHIP). Methods: Five cases of GHIP were collected at the University Town Hospital of Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China, from May 2021 to May 2023. The endoscopic, pathological and immunohistochemical features of the 5 GHIP cases were analyzed. The relevant literature was reviewed. Results: There were 3 males and 2 females, aged from 49 to 60 years, with a mean age of 56 years. The lesions were located in the fundus and body of the stomach, and presented as polyps or masses under endoscopy. Microscopically, the lesions were mainly in the submucosa and consisted of lobulated or clustered gastric glandular epithelium surrounded by hyperplastic smooth muscle. In some areas, there were differentiated glandular elements mimicking the normal gastric mucosa. The irregularly dilated glandular elements in the center were lined by hyperplastic foveolar epithelium, while the glands in the periphery were fundic or pyloric glands. In addition, in some areas, the glands showed cystic expansion, disordered arrangement and lack of differentiation. The hyperplastic glandular epithelium included foveolar epithelium, fundic gland and pyloric gland. There were scattered neuroendocrine cells and smooth muscle bundles in the stroma. Immunohistochemically, the tumor cells were positive for MUC5AC, MUC6, Pepsinogen Ⅰ and H + /K + ATPase β, but negative for MUC2. The scattered neuroendocrine cells were positive for synaptophysin, and the desmin stain highlighted hyperplastic smooth muscle bundles. One case was classified as type 2 gastric inverted polyp, and 4 cases were classified as type 3. Conclusions: GHIP is a rare gastric polyp with unique histological features. It should be distinguished from inverted hyperplastic polyp, gastritis cystica profunda, adenomyoma, hyperplastic polyps and well-differentiated gastric tubular adenocarcinoma, etc. Improving the understanding of its pathogenesis and diagnostic features can help avoid misdiagnoses.

Gastric cancer is a common tumor of the gastrointestinal tract, and the global trend in morbidity and mortality are not encouraging. Especially in advanced gastric cancer, patient survival outcome is an essential clinical concern and a vital outcome indicator in clinical outcome assessment. This article reviews the definition of clinical outcome assessment and the measurement tools that can be applied in gastric cancer patients, describes the detailed classification of clinical outcome assessment tools, and reviews the current status of the application of clinical outcome assessment in gastric cancer, analyzing the effects and shortcomings of its application, to provide a reference for the clinical staff in choosing the appropriate tools, and assisting in the comprehensive and holistic assessment of clinical outcomes for the promotion of the development of precision medicine.

Gastrointestinal (GI) cancers are the most common tumors of the digestive system, and their high morbidity and cancer-related mortality dramatically threaten the health of the population. With the researching progress of immunotherapy, its use in the treatment of GI cancers in the perioperative and advanced stages is becoming more and more important. Currently, immunotherapy has become the standard first-line treatment for MSI-H late-stage colorectal cancer, while in the first-line treatment of late-stage gastric cancer, immunotherapy combined with chemotherapy and HER2-targeted drugs (in HER2-positive patients) has also achieved significant efficacy and long-term survival benefits. Advances in immunotherapy in the neoadjuvant and adjuvant treatment and in the second- and later-line treatment of late-stage GI cancers have demonstrated its promising therapeutic potential. However, there is still an urgent need for future studies to explore more immunotherapy combination strategies for patients with GI cancers, especially with MSS colorectal cancers.

Objective: Gastric adenocarcinoma of the fundic gland type (GA-FG) is rare and often occurs in patients who are not infected with Helicobacter pylori . The current study analyzed and summarized the clinical, endoscopic, and pathological features of GA-FG, in an effort to improve its diagnosis. Methods: Patients who were diagnosed with GA-FG and treated with endoscopic submucosal dissection (ESD) resection at the Department of Gastroenterology, First Affiliated Hospital of Zhejiang Chinese Medical University from January 1st 2020 to October 1st 2022 were included in the study. Their clinical manifestations, endoscopic features, pathological immunohistochemistry, and other characteristics were analyzed. Results: A total of 14 patients with GA-FG were included in the study, 5 males and 9 females, with a mean age of 59 years. Most had no substantial clinical manifestations. Twelve patients were H. pylori -negative, all patients underwent ESD resection, and all patients survived during the follow-up period of 13±9 months. Eleven patients had postoperative endoscopic follow-up records, and no recurrence was detected. Fifteen lesions were detected (2 were present in 1 patient). Twelve were located in the upper 1/3 of the stomach, 10 were ≤ 1 cm in diameter, 12 had a morphology of type 0-Ⅱa, 8 had visible discoloration changes, and 12 had visible vasodilation on the surface. Magnified endoscopy and narrow-band imaging indicated that 12 of the lesions had enlarged marginal crypt epithelium, without any obvious microvascular pattern abnormalities and no obvious borderline. After resection the pathological specimens were all without vascular infiltration, and there was no atrophy of the mucosa at the edge of the lesion. In immunohistochemistry analyses MUC-2 was negative in all cases. MUC5AC was negative in 11 cases, MUC-6 was positive in all cases, and Ki-67 was ≤ 5% in 12 cases. Conclusions: GA-FG is a newly identified type of gastric cancer with low malignancy and a good prognosis. Characteristic discoloration and surface dilated vessels are often evident endoscopically. Enlarged marginal crypt epithelium and no visible boundary lines are often apparent in magnification endoscopy and narrow band imaging.