Objective： To validate the necessity of increasing the examined lymph node （ELN） count for enhancing the accuracy of prognostic evaluation of gastric cancer （GC） patients after curative gastrectomy in multiple me...Objective： To validate the necessity of increasing the examined lymph node （ELN） count for enhancing the accuracy of prognostic evaluation of gastric cancer （GC） patients after curative gastrectomy in multiple medical centers of China.Methods： The clinicopathological data of 7,620 patients who underwent the curative resection for GC between 2001 and 2011 were included to demonstrate whether the ELN count is indispensable for enhancing the accuracy of prognostic evaluation of GC patients after surgery. After a meticulous stratification by using the cut-point survival analysis, all included 7,620 patients were allocated into three groups as： less than 16 （〈16）, between 16 and 30 （16-30）, and more than 30 （〉30） ELNs. Survival differences among various subgroups of GC patients were analyzed to assess the impact of the ELN count on the stage migration in accordance with the overall survival （OS） of GC patients.Results： Survival analyses revealed that the ELN count was positively correlated with the OS （P：0.001） and was an independent prognostic predictor （P〈0.01） of 7,620 GC patients. Stratum analysis showed that the accuracy of prognostic evaluation could be enhanced when the ELN count was no less than 16 （≥16） for node-negative patients and 〉30 for node-positive patients. Stage migrations were mainly detected in the various subgroups of patients with specific pN stages as follows： pN0 with 16-30 ELNs （pN016-30） and pN0 with 〉30 ELNs （pN0〉30）, pN0 with 〈16 ELNs （pN0〈16） and pNl〉30, pNl〈l6 and pN216_30, pNl：6_30 and pN2〉30, pN3a〈l6 and pN3b16-30, and pN3a〈16 and pN3 b〉30. These findings indicate that increasing the ELN count is a prerequisite to guarantee precisely prognostic evaluation of GC patients.Conclusions： The ELN count should be proposed to be 〉30 for acquiring the accurate prognostic evaluadort for GC patients, especially for node-positive patients.展开更多
Objective: The current surgical treatment guidelines for early proximal gastric cancer(PGC) still lack agreement. Lymphadenectomy of lymph nodes No. 5 and No. 6 is the major difference between total and proximal gastr...Objective: The current surgical treatment guidelines for early proximal gastric cancer(PGC) still lack agreement. Lymphadenectomy of lymph nodes No. 5 and No. 6 is the major difference between total and proximal gastrectomy. We elucidated the appropriate surgical procedure for PGC by investigating the pathological characteristics and prognostic significance of lymph nodes No. 5 and No. 6.Methods: In total, 333 PGC patients who underwent total gastrectomy were enrolled in this study. We investigated their clinicopathological characteristics and the metastatic patterns of the lymph nodes. Patients with metastasis in lymph nodes No. 5 and No. 6 were combined into one group and we compared the difference in survival between those with and without metastasis in lymph nodes No. 5, 6(lymph nodes No. 5 and No. 6 in any group of metastasis) for different subgroups.Results: The metastatic rates for lymph nodes No. 5 and No. 6 in PGC were 9.91% and 16.11%, respectively.The metastatic rate for both lymph nodes No. 5, 6 was 20.42%. Multivariate analysis showed that positive metastasis in lymph node No. 4, depth of invasion, and tumor size were independently correlated with the presence of metastasis in lymph nodes No. 5, 6.Conclusions: When lymph node No. 4 is positive(intraoperative pathology) or tumor size ≥5 cm or T4 stage,lymphadenectomy should be performed for lymph nodes No. 5 and No. 6, and total gastrectomy is recommended.展开更多
OBJECTIVE To screen metastatic-related genes in human gastric cancer by a low-density cDNA microarray technique. METHODS A total of 18 paired gastric cancer and adjacent normal mu-cosa were examined by a low-density c...OBJECTIVE To screen metastatic-related genes in human gastric cancer by a low-density cDNA microarray technique. METHODS A total of 18 paired gastric cancer and adjacent normal mu-cosa were examined by a low-density cDNA microarray containing 23 genes. RT-PCR was used for further verification. RESULTS The mRNA expression of MMP -7, heparanase, S100A4, hTERT, hRad17 in gastric cancers was higher than that in coupled normal mucosa (P=0.002, 0.00011, 0.000072, 0.002, 0.00016 respectively), whereas nm23H1, and CDH1 were lower (P=0.003, 0.012 respectively). The concordance was verified further by RT-PCR with a correlation coefficient of 0.774. In gastric primary lesions the mRNA expression of MMP-7, heparanase and S100A4 was higher in the serosa involved compared to non-involved (P=0.003, 0.009, 0.012 respectively), whereas nm23H1, CDH1, KAI1 were lower (P=0.001, 0.001, 0.006 respectively). With respect to the area of serosa involvement, MMP-7 and heparanase expressions were higher in an area of more than 20 cm2 compared to an area of less than 20 cm2 (P=0.001, 0.02 respectively), whereas nm23H1, CDH1 and KAI1 were lower (P=0.030, 0.041, 0.031 respectively). MMP-7 and hTERT expressions were higher in the heavier lymph node metastatic cases (no less than 7) than in the lighter lymph node metastatic cases (no more than 6, P=0.001, 0.005 respectively). CONCLUSION Expression of MMP -7, S100A4, heparanase, hTERT, KAI1, CDH1 and nm23H1 correlated closely with invasion and metastasis in gastric carcinomas. The low-density cDNA microarrays can be used to examine the expression of many genes simultaneously, parallely and quickly.展开更多
Introduction Gastric tumors represent a significant subset of gastrointestinal pathologies.Among these,gastric cancer is the most common malignancy,ranking fifth in global incidence and third in cancer-related mortali...Introduction Gastric tumors represent a significant subset of gastrointestinal pathologies.Among these,gastric cancer is the most common malignancy,ranking fifth in global incidence and third in cancer-related mortality within China.[1]The increasing adoption of endoscopic procedures has contributed to an increasing annual rate of early gastric cancer(EGC).[2–3]Additionally,gastric submucosal tumors(SMTs),which are primarily composed of stromal tumors and leiomyomas,originate from protruding lesions in the nonmucosal layer and are being detected with increasing frequency.展开更多
Dear Editor,Early diagnosis is critical for successful treatment of gastric adenocarcinoma(GA).However,the sensitivities of tumor markers carcinoembryonic antigen(CEA),cancer antigen 19-9(CA19-9)and CA72-4 for GA dete...Dear Editor,Early diagnosis is critical for successful treatment of gastric adenocarcinoma(GA).However,the sensitivities of tumor markers carcinoembryonic antigen(CEA),cancer antigen 19-9(CA19-9)and CA72-4 for GA detection are approximately 20%[1],and the sensitivities of all markers combined for early gastric cancer detection is still very low[2].DNA methylation plays a major role in tumorigenesis and therefore has obvious potential as a non-invasive biomarker for cancer detection[3].Through genome-wide methylation analysis and histological verification,we previously identified ring finger protein 180(RNF180)as a novel preferentially methylated gene in GA[4,5].展开更多
Lymphatic vessels,comprising the secondary circulatory system in human body,play a multifaceted role in maintaining homeostasis among various tissues and organs.They are tasked with a serious of responsibilities,inclu...Lymphatic vessels,comprising the secondary circulatory system in human body,play a multifaceted role in maintaining homeostasis among various tissues and organs.They are tasked with a serious of responsibilities,including the regulation of lymph absorption and transport,the orchestration of immune surveillance and responses.Lymphatic vessel development undergoes a series of sophisticated regulatory signaling pathways governing heterogeneous-origin cell populations stepwise to assemble into the highly specialized lymphatic vessel networks.Lymphangiogenesis,as defined by new lymphatic vessels sprouting from preexisting lymphatic vessels/embryonic veins,is the main developmental mechanism underlying the formation and expansion of lymphatic vessel networks in an embryo.However,abnormal lymphangiogenesis could be observed in many pathological conditions and has a close relationship with the development and progression of various diseases.Mechanistic studies have revealed a set of lymphangiogenic factors and cascades that may serve as the potential targets for regulating abnormal lymphangiogenesis,to further modulate the progression of diseases.Actually,an increasing number of clinical trials have demonstrated the promising interventions and showed the feasibility of currently available treatments for future clinical translation.Targeting lymphangiogenic promoters or inhibitors not only directly regulates abnormal lymphangiogenesis,but improves the efficacy of diverse treatments.In conclusion,we present a comprehensive overview of lymphatic vessel development and physiological functions,and describe the critical involvement of abnormal lymphangiogenesis in multiple diseases.Moreover,we summarize the targeting therapeutic values of abnormal lymphangiogenesis,providing novel perspectives for treatment strategy of multiple human diseases.展开更多
Gastric cancer(GC)is known as a top malignant type of tumors worldwide.Despite the recent decrease in mortality rates,the prognosis remains poor.Therefore,it is necessary to find novel biomarkers with early diagnostic...Gastric cancer(GC)is known as a top malignant type of tumors worldwide.Despite the recent decrease in mortality rates,the prognosis remains poor.Therefore,it is necessary to find novel biomarkers with early diagnostic value for GC.In this study,we present a large-scale proteomic analysis of 30 GC tissues and 30 matched healthy tissues using label-free global proteome profiling.Our results identified 537 differentially expressed proteins,including 280 upregulated and 257 downregulated proteins.The ingenuity pathway analysis(IPA)results indicated that the sirtuin signaling pathway was the most activated pathway in GC tissues whereas oxidative phosphorylation was the most inhibited.Moreover,the most activated molecular function was cellular movement,including tissue invasion by tumor cell lines.Based on IPA results,15 hub proteins were screened.Using the receiver operating characteristic curve,most of hub proteins showed a high diagnostic power in distinguishing between tumors and healthy controls.A four-protein(ATP5B-ATP5O-NDUFB4-NDUFB8)diagnostic signature was built using a random forest model.The area under the curve(AUC)values of this model were 0.996 and 0.886 for the training and testing sets,respectively,suggesting that the four-protein signature has a high diagnostic power.This signature was further tested with independent datasets using plasma enzyme-linked immune sorbent assays,resulting in an AUC value of 0.778 for distinguishing GC tissues from healthy controls,and using immunohistochemical tissue microarray analysis,resulting in an AUC value of 0.805.In conclusion,this study identifies potential biomarkers and improves our understanding of the pathogenesis,providing novel therapeutic targets for GC.展开更多
Background:The optimal number of retrieved lymph nodes(LNs)in gastric cancer(GC)is still debatable and previ-ous studies proposing new classification alternatives mostly focused on the number of retrieved LNs without ...Background:The optimal number of retrieved lymph nodes(LNs)in gastric cancer(GC)is still debatable and previ-ous studies proposing new classification alternatives mostly focused on the number of retrieved LNs without proper consideration on the anatomic nodal groups’location.Here,we assessed the impact of retrieved LNs from different nodal location groups on the survival of GC patients.Methods:Stage I-III gastric cancer patients who had radical gastrectomy were investigated.LN grouping was deter-mined according to the 13th edition of the JCGC.The optimal cut-off values of retrieved LNs in different LN groups(Group 1 and 2)were calculated,based on which a proposed nodal classification(rN)simultaneously accounting the optimal number and location of retrieved LNs was proposed.The performance of rN was then compared to that of LN ratio,log-odds of metastatic LNs(LODDs)and the 8th edition of the Union for International Cancer Control/American Joint Committee on Cancer(UICC/AJCC)N classification.Results:The optimal cut-off values for Group 1 and 2 were 13 and 9,respectively.The 5-year overall survival(OS)was higher for patients in retrieved Group 1 LNs>13(vs.Group 1 LNs≤13,63.2%vs.57.9%,P=0.005)and retrieved Group 2 LNs>9(vs.Group 2 LNs≤9,72.5%vs.60.7%,P=0.009).Patients staged as pN0-3b were sub classified using this Group 1 and 2 nodal analogy.The OS of pN0-N2 patients in retrieved Group 1 LNs>13 or Group 2 LNs>9 were superior to those in retrieved Group 1 LNs≤13 and Group 2 LNs≤9(All P<0.05);except for pN3 patients.The rN clas-sification was formulated and demonstrated better 5-year OS prognostication performance as compared to the LNR,LODDs,and the 8th UICC/AJCC N staging system.Conclusions:The retrieval of>13 and>9 LNs for Group 1 and Group 2,respectively,could represent an alternative lymph node retrieval approach in radical gastrectomy for more precise survival prognostication and minimizing staging migration,especially if>16 LNs is found to be difficult.展开更多
Purpose In recent years,natural orifice specimen extraction surgery(NOSES)has gained widespread attention as an alternative approach.Although the safety and feasibility of NOSES have been well documented,many question...Purpose In recent years,natural orifice specimen extraction surgery(NOSES)has gained widespread attention as an alternative approach.Although the safety and feasibility of NOSES have been well documented,many questions remain open for discussion.The aim of this guideline is to provide more evidence for the promotion of NOSES.Methods This guideline has been prepared by the CACA Committee of Colorectal Cancer Society and the International NOSES Alliance,based on the latest evidence.Results The guideline on NOSES for colorectal cancer include the definition,classification,technology requirement,indications,technical difficulties and clinical research.Conclusion The guideline provides a full introduction of the theoretical and technical aspects of NOSES for colorectal cancer which will beneficial to development of NOSES.展开更多
Gastrointestinal cancers are difficult to be cured with a high recurrence rate accounting for more than 50%of global cancer-related morbidity and mortality.1 Many patients with gastrointestinal cancer are diagnosed at...Gastrointestinal cancers are difficult to be cured with a high recurrence rate accounting for more than 50%of global cancer-related morbidity and mortality.1 Many patients with gastrointestinal cancer are diagnosed at a late stage.Over the past few decades,basic and clinical research with new technologies have made significant progress in the diagnosis and treatment of gastrointestinal cancers,which significantly improved the quality of life and prolonged the survival of patients.Here,we briefly highlight several advances in diagnosing and treating gastrointestinal tumors,mainly gastric cancer and colorectal cancer from multiple perspectives.展开更多
The incidence and mortality of colon cancer in China are increasing each year.At present,treatment selection for colon cancer patients mainly depends on imaging results,which require a large number of radiologists to ...The incidence and mortality of colon cancer in China are increasing each year.At present,treatment selection for colon cancer patients mainly depends on imaging results,which require a large number of radiologists to interpret.In China,there is a shortage and uneven distribution of experienced radiologists,which leads to delays and bias in the evaluation of imaging data.Based on these considerations,the Colorectal Surgery Group of the Surgery Branch of the Chinese Medical Association in collaboration with experts at Beihang University has independently developed an artificial intelligence(AI)-based recognition system for the preoperative determination of colon cancer stage to partially replace the work of and relieve the pressure on radiologists.These guidelines aim to standardize the use of AI-based recognition systems in the preoperative staging of colon cancer and guide their clinical application.展开更多
基金supported in part by grants from the Programs of National Natural Science Foundation of China(No.81572372,No.81172080,No.81201773,No.81572372)National Key Research and Development Program(MOST-2016YFC1303202)+2 种基金National Precision Medicine Research Program(2017YFC0908300)the Application Foundation and Advanced Technology Program of Tianjin Municipal Science and Technology Commission(15JCYBJC24800)the National Key Clinical Specialist Construction Programs of China(2013-544)
文摘Objective： To validate the necessity of increasing the examined lymph node （ELN） count for enhancing the accuracy of prognostic evaluation of gastric cancer （GC） patients after curative gastrectomy in multiple medical centers of China.Methods： The clinicopathological data of 7,620 patients who underwent the curative resection for GC between 2001 and 2011 were included to demonstrate whether the ELN count is indispensable for enhancing the accuracy of prognostic evaluation of GC patients after surgery. After a meticulous stratification by using the cut-point survival analysis, all included 7,620 patients were allocated into three groups as： less than 16 （〈16）, between 16 and 30 （16-30）, and more than 30 （〉30） ELNs. Survival differences among various subgroups of GC patients were analyzed to assess the impact of the ELN count on the stage migration in accordance with the overall survival （OS） of GC patients.Results： Survival analyses revealed that the ELN count was positively correlated with the OS （P：0.001） and was an independent prognostic predictor （P〈0.01） of 7,620 GC patients. Stratum analysis showed that the accuracy of prognostic evaluation could be enhanced when the ELN count was no less than 16 （≥16） for node-negative patients and 〉30 for node-positive patients. Stage migrations were mainly detected in the various subgroups of patients with specific pN stages as follows： pN0 with 16-30 ELNs （pN016-30） and pN0 with 〉30 ELNs （pN0〉30）, pN0 with 〈16 ELNs （pN0〈16） and pNl〉30, pNl〈l6 and pN216_30, pNl：6_30 and pN2〉30, pN3a〈l6 and pN3b16-30, and pN3a〈16 and pN3 b〉30. These findings indicate that increasing the ELN count is a prerequisite to guarantee precisely prognostic evaluation of GC patients.Conclusions： The ELN count should be proposed to be 〉30 for acquiring the accurate prognostic evaluadort for GC patients, especially for node-positive patients.
文摘Objective: The current surgical treatment guidelines for early proximal gastric cancer(PGC) still lack agreement. Lymphadenectomy of lymph nodes No. 5 and No. 6 is the major difference between total and proximal gastrectomy. We elucidated the appropriate surgical procedure for PGC by investigating the pathological characteristics and prognostic significance of lymph nodes No. 5 and No. 6.Methods: In total, 333 PGC patients who underwent total gastrectomy were enrolled in this study. We investigated their clinicopathological characteristics and the metastatic patterns of the lymph nodes. Patients with metastasis in lymph nodes No. 5 and No. 6 were combined into one group and we compared the difference in survival between those with and without metastasis in lymph nodes No. 5, 6(lymph nodes No. 5 and No. 6 in any group of metastasis) for different subgroups.Results: The metastatic rates for lymph nodes No. 5 and No. 6 in PGC were 9.91% and 16.11%, respectively.The metastatic rate for both lymph nodes No. 5, 6 was 20.42%. Multivariate analysis showed that positive metastasis in lymph node No. 4, depth of invasion, and tumor size were independently correlated with the presence of metastasis in lymph nodes No. 5, 6.Conclusions: When lymph node No. 4 is positive(intraoperative pathology) or tumor size ≥5 cm or T4 stage,lymphadenectomy should be performed for lymph nodes No. 5 and No. 6, and total gastrectomy is recommended.
基金This work was supported by the Natural Science Foundation of Liaoning Province (No. 20022069).
文摘OBJECTIVE To screen metastatic-related genes in human gastric cancer by a low-density cDNA microarray technique. METHODS A total of 18 paired gastric cancer and adjacent normal mu-cosa were examined by a low-density cDNA microarray containing 23 genes. RT-PCR was used for further verification. RESULTS The mRNA expression of MMP -7, heparanase, S100A4, hTERT, hRad17 in gastric cancers was higher than that in coupled normal mucosa (P=0.002, 0.00011, 0.000072, 0.002, 0.00016 respectively), whereas nm23H1, and CDH1 were lower (P=0.003, 0.012 respectively). The concordance was verified further by RT-PCR with a correlation coefficient of 0.774. In gastric primary lesions the mRNA expression of MMP-7, heparanase and S100A4 was higher in the serosa involved compared to non-involved (P=0.003, 0.009, 0.012 respectively), whereas nm23H1, CDH1, KAI1 were lower (P=0.001, 0.001, 0.006 respectively). With respect to the area of serosa involvement, MMP-7 and heparanase expressions were higher in an area of more than 20 cm2 compared to an area of less than 20 cm2 (P=0.001, 0.02 respectively), whereas nm23H1, CDH1 and KAI1 were lower (P=0.030, 0.041, 0.031 respectively). MMP-7 and hTERT expressions were higher in the heavier lymph node metastatic cases (no less than 7) than in the lighter lymph node metastatic cases (no more than 6, P=0.001, 0.005 respectively). CONCLUSION Expression of MMP -7, S100A4, heparanase, hTERT, KAI1, CDH1 and nm23H1 correlated closely with invasion and metastasis in gastric carcinomas. The low-density cDNA microarrays can be used to examine the expression of many genes simultaneously, parallely and quickly.
基金supported by grants from the National Natural Science Foundation of China(Nos.82203854 and 82372772)the Key Research and Development Program of Shandong Province(No.2021CXGC011104)the Special Foundation for Taishan Scholars Program of Shandong Province(Nos.ts20190978 and tsqn202408363).
文摘Introduction Gastric tumors represent a significant subset of gastrointestinal pathologies.Among these,gastric cancer is the most common malignancy,ranking fifth in global incidence and third in cancer-related mortality within China.[1]The increasing adoption of endoscopic procedures has contributed to an increasing annual rate of early gastric cancer(EGC).[2–3]Additionally,gastric submucosal tumors(SMTs),which are primarily composed of stromal tumors and leiomyomas,originate from protruding lesions in the nonmucosal layer and are being detected with increasing frequency.
基金supported by the National Key R&D Program of China(Grant no.2016YFC1303200,2022YFC2505100,2017YFC0908300,and 2018YFC1313101)Tianjin Key Medical Discipline(Specialty)Construction Project(Grant no.TJYXZDXK-009A)Beijing Munic-ipal Science&Technology Commission,Administrative Commission of Zhongguancun Science Park(Grant no.Z201100005420007).
文摘Dear Editor,Early diagnosis is critical for successful treatment of gastric adenocarcinoma(GA).However,the sensitivities of tumor markers carcinoembryonic antigen(CEA),cancer antigen 19-9(CA19-9)and CA72-4 for GA detection are approximately 20%[1],and the sensitivities of all markers combined for early gastric cancer detection is still very low[2].DNA methylation plays a major role in tumorigenesis and therefore has obvious potential as a non-invasive biomarker for cancer detection[3].Through genome-wide methylation analysis and histological verification,we previously identified ring finger protein 180(RNF180)as a novel preferentially methylated gene in GA[4,5].
基金supported by the National Natural Science Foundation of China(U22A20324,82202927)Excellent Youth Foundation of Liaoning Province(2022-YQ-15).
文摘Lymphatic vessels,comprising the secondary circulatory system in human body,play a multifaceted role in maintaining homeostasis among various tissues and organs.They are tasked with a serious of responsibilities,including the regulation of lymph absorption and transport,the orchestration of immune surveillance and responses.Lymphatic vessel development undergoes a series of sophisticated regulatory signaling pathways governing heterogeneous-origin cell populations stepwise to assemble into the highly specialized lymphatic vessel networks.Lymphangiogenesis,as defined by new lymphatic vessels sprouting from preexisting lymphatic vessels/embryonic veins,is the main developmental mechanism underlying the formation and expansion of lymphatic vessel networks in an embryo.However,abnormal lymphangiogenesis could be observed in many pathological conditions and has a close relationship with the development and progression of various diseases.Mechanistic studies have revealed a set of lymphangiogenic factors and cascades that may serve as the potential targets for regulating abnormal lymphangiogenesis,to further modulate the progression of diseases.Actually,an increasing number of clinical trials have demonstrated the promising interventions and showed the feasibility of currently available treatments for future clinical translation.Targeting lymphangiogenic promoters or inhibitors not only directly regulates abnormal lymphangiogenesis,but improves the efficacy of diverse treatments.In conclusion,we present a comprehensive overview of lymphatic vessel development and physiological functions,and describe the critical involvement of abnormal lymphangiogenesis in multiple diseases.Moreover,we summarize the targeting therapeutic values of abnormal lymphangiogenesis,providing novel perspectives for treatment strategy of multiple human diseases.
基金This work was supported by the National Key R&D Program of China(Grant Nos.MOST-2017YFC0908300 and MOST2017YFC0908305)the National Science Foundation of China(Grant No.81872031)+1 种基金the Natural Science Foundation of Liaoning Province,China(Grant No.20180550582)the Song Y et al/Diagnostic Biomarkers in Gastric Cancer 693 Project of Science and Technology of Shenyang,China(Grant No.18-014-4-07).
文摘Gastric cancer(GC)is known as a top malignant type of tumors worldwide.Despite the recent decrease in mortality rates,the prognosis remains poor.Therefore,it is necessary to find novel biomarkers with early diagnostic value for GC.In this study,we present a large-scale proteomic analysis of 30 GC tissues and 30 matched healthy tissues using label-free global proteome profiling.Our results identified 537 differentially expressed proteins,including 280 upregulated and 257 downregulated proteins.The ingenuity pathway analysis(IPA)results indicated that the sirtuin signaling pathway was the most activated pathway in GC tissues whereas oxidative phosphorylation was the most inhibited.Moreover,the most activated molecular function was cellular movement,including tissue invasion by tumor cell lines.Based on IPA results,15 hub proteins were screened.Using the receiver operating characteristic curve,most of hub proteins showed a high diagnostic power in distinguishing between tumors and healthy controls.A four-protein(ATP5B-ATP5O-NDUFB4-NDUFB8)diagnostic signature was built using a random forest model.The area under the curve(AUC)values of this model were 0.996 and 0.886 for the training and testing sets,respectively,suggesting that the four-protein signature has a high diagnostic power.This signature was further tested with independent datasets using plasma enzyme-linked immune sorbent assays,resulting in an AUC value of 0.778 for distinguishing GC tissues from healthy controls,and using immunohistochemical tissue microarray analysis,resulting in an AUC value of 0.805.In conclusion,this study identifies potential biomarkers and improves our understanding of the pathogenesis,providing novel therapeutic targets for GC.
基金This study was supported by a grant from the National Natural Science Foundation of China(Grant No.81772549)
文摘Background:The optimal number of retrieved lymph nodes(LNs)in gastric cancer(GC)is still debatable and previ-ous studies proposing new classification alternatives mostly focused on the number of retrieved LNs without proper consideration on the anatomic nodal groups’location.Here,we assessed the impact of retrieved LNs from different nodal location groups on the survival of GC patients.Methods:Stage I-III gastric cancer patients who had radical gastrectomy were investigated.LN grouping was deter-mined according to the 13th edition of the JCGC.The optimal cut-off values of retrieved LNs in different LN groups(Group 1 and 2)were calculated,based on which a proposed nodal classification(rN)simultaneously accounting the optimal number and location of retrieved LNs was proposed.The performance of rN was then compared to that of LN ratio,log-odds of metastatic LNs(LODDs)and the 8th edition of the Union for International Cancer Control/American Joint Committee on Cancer(UICC/AJCC)N classification.Results:The optimal cut-off values for Group 1 and 2 were 13 and 9,respectively.The 5-year overall survival(OS)was higher for patients in retrieved Group 1 LNs>13(vs.Group 1 LNs≤13,63.2%vs.57.9%,P=0.005)and retrieved Group 2 LNs>9(vs.Group 2 LNs≤9,72.5%vs.60.7%,P=0.009).Patients staged as pN0-3b were sub classified using this Group 1 and 2 nodal analogy.The OS of pN0-N2 patients in retrieved Group 1 LNs>13 or Group 2 LNs>9 were superior to those in retrieved Group 1 LNs≤13 and Group 2 LNs≤9(All P<0.05);except for pN3 patients.The rN clas-sification was formulated and demonstrated better 5-year OS prognostication performance as compared to the LNR,LODDs,and the 8th UICC/AJCC N staging system.Conclusions:The retrieval of>13 and>9 LNs for Group 1 and Group 2,respectively,could represent an alternative lymph node retrieval approach in radical gastrectomy for more precise survival prognostication and minimizing staging migration,especially if>16 LNs is found to be difficult.
基金supported by National Key R&D Program for Young Scientists(Grant Number:2022YFC2505700)the Sanming Project of Medicine in Shenzhen(Grant Number:No.SZSM201911012).
文摘Purpose In recent years,natural orifice specimen extraction surgery(NOSES)has gained widespread attention as an alternative approach.Although the safety and feasibility of NOSES have been well documented,many questions remain open for discussion.The aim of this guideline is to provide more evidence for the promotion of NOSES.Methods This guideline has been prepared by the CACA Committee of Colorectal Cancer Society and the International NOSES Alliance,based on the latest evidence.Results The guideline on NOSES for colorectal cancer include the definition,classification,technology requirement,indications,technical difficulties and clinical research.Conclusion The guideline provides a full introduction of the theoretical and technical aspects of NOSES for colorectal cancer which will beneficial to development of NOSES.
文摘Gastrointestinal cancers are difficult to be cured with a high recurrence rate accounting for more than 50%of global cancer-related morbidity and mortality.1 Many patients with gastrointestinal cancer are diagnosed at a late stage.Over the past few decades,basic and clinical research with new technologies have made significant progress in the diagnosis and treatment of gastrointestinal cancers,which significantly improved the quality of life and prolonged the survival of patients.Here,we briefly highlight several advances in diagnosing and treating gastrointestinal tumors,mainly gastric cancer and colorectal cancer from multiple perspectives.
文摘The incidence and mortality of colon cancer in China are increasing each year.At present,treatment selection for colon cancer patients mainly depends on imaging results,which require a large number of radiologists to interpret.In China,there is a shortage and uneven distribution of experienced radiologists,which leads to delays and bias in the evaluation of imaging data.Based on these considerations,the Colorectal Surgery Group of the Surgery Branch of the Chinese Medical Association in collaboration with experts at Beihang University has independently developed an artificial intelligence(AI)-based recognition system for the preoperative determination of colon cancer stage to partially replace the work of and relieve the pressure on radiologists.These guidelines aim to standardize the use of AI-based recognition systems in the preoperative staging of colon cancer and guide their clinical application.
