Ⅳa期胃癌属于局部晚期胃癌(locally advanced gastric cancer,LAGC),中国临床肿瘤学会(Chinese Society of Clinical Oncology,CSCO)指南推荐行多学科联合会诊(multidisciplinary consultation,MDT)讨论制订个体化治疗方案。近年来,随...Ⅳa期胃癌属于局部晚期胃癌(locally advanced gastric cancer,LAGC),中国临床肿瘤学会(Chinese Society of Clinical Oncology,CSCO)指南推荐行多学科联合会诊(multidisciplinary consultation,MDT)讨论制订个体化治疗方案。近年来,随着精准医疗观念的不断加深,国内外越来越多的专家及学者逐渐重视新辅助治疗。新辅助治疗是指:对于初始评估手术指征存在但是病变局部已经处于晚期的恶性肿瘤患者,手术治疗难度大或需要联合脏器切除,可行新辅助治疗以减小肿瘤及转移灶、增加肿瘤完全切除(R0)率,同时进一步降低术后远处转移和肿瘤的复发率。本例患者临床分期为cT4bN3aM0、Ⅳa期,经过2周期新辅助治疗后,患者肿瘤病灶完全消失,现将其临床表现、影像学结果、病理学结果及治疗过程阐述如下,并结合相关文献分析,为该类疾病的诊治提供参考。展开更多
目的:对比研究FLOT方案与FOLFOX方案治疗中晚期胃癌(GC)的近远期疗效及对血清肿瘤标志物和NRP-2的影响。方法:选入我院2020年3月~2022年2月收治的82例中晚期GC患者,根据化疗方法不同分为FLOT组和FOLFOX组,各41例。比较两组的近远期疗效...目的:对比研究FLOT方案与FOLFOX方案治疗中晚期胃癌(GC)的近远期疗效及对血清肿瘤标志物和NRP-2的影响。方法:选入我院2020年3月~2022年2月收治的82例中晚期GC患者,根据化疗方法不同分为FLOT组和FOLFOX组,各41例。比较两组的近远期疗效、血清肿瘤标志物和NRP-2水平;随访至2023年11月,记录两组患者生存状态并绘制Kaplan-Meier生存曲线。结果:FLOT组客观有效率显著高于FOLFOX组(85.37%vs.65.85%,P<0.05)。FLOT组治疗后血清癌胚抗原[(12.77±1.85)ng/m L vs.(20.69±2.58)ng/mL]、糖类抗原19-9[(20.46±5.20)U/m L vs.(29.41±8.04)U/m L]、糖类抗原125[(14.90±5.61)U/m L vs.(20.72±6.23)ng/mL]和NRP-2[(13.01±2.11)ng/mL vs.(15.23±2.25)ng/mL]水平均显著低于FOLFOX组,PFS[12.900(95%CI:12.183~13.617)个月vs.9.600(95%CI:8.471~10.729)个月]和OS[28.103(95%CI:25.209~30.996)个月vs.20.799(95%CI:18.482~23.115)个月]显著长于FOLFOX组(P<0.05)。两组疾病控制率和毒副反应发生率无显著差异(P>0.05)。结论:FLOT方案和FOLFOX方案均是中晚期GC的有效化疗方案,安全性一致,但前者在提高客观有效率、降低血清肿瘤标志物和NRP-2水平、延长生存期方面更具优势。展开更多
To confirm the relationship between Circ_0003855 and EC,we purchased the Human esophageal carcinoma cell line Eca109 and normal human esophageal epithelial cells HEEC,and the expression levels of Circ_0003855,miR-622,...To confirm the relationship between Circ_0003855 and EC,we purchased the Human esophageal carcinoma cell line Eca109 and normal human esophageal epithelial cells HEEC,and the expression levels of Circ_0003855,miR-622,and FLOT1 were detected.The results show that Circ_0003855 and FLOT1 were highly expressed in Eca109 cells,while miR-622 was lowly expressed(p<0.05).Subsequently,Circ_0003855 small interfering RNA(si-Circ_0003855)and its negative control(si-NC)were used to detect changes in cellular biological behaviors.We found that the activity of Eca109 cells was reduced after interfering with the expression of Circ_0003855,and miR-622 expression was elevated,while FLOT1 was decreased(p<0.05).Additionally,si-Circ_0003855 and miR-622 inhibitor sequence(miR-622-inhibition)were co-transfected into cells with miR-622-inhibition alone,and untreated Eca109 cells were used as a control to detect the expression of FLOT1.Co-transfection of si-Circ_0003855 and miR-622-inhibition showed no significant difference in FLOT1 expression compared to the control cells(p>0.05).Synthesizing the results of these experiments above,we believe that interfering with the expression of Circ_0003855 can inhibit the activity of EC cells,and its mechanism is related to miR-622 and FLOT1.展开更多
Background:Neoadjuvant chemotherapy plays a vital role in the treatment of advanced gastric cancer(GC),however,optimizing its effectiveness remains an important research focus.Traditional Chinese medicine(TCM),a promi...Background:Neoadjuvant chemotherapy plays a vital role in the treatment of advanced gastric cancer(GC),however,optimizing its effectiveness remains an important research focus.Traditional Chinese medicine(TCM),a promising adjunctive therapy,has shown enhanced clinical outcomes when combined with postoperative adjuvant chemotherapy.Therefore,this study is designed to evaluate the clinical efficacy of Yiqi Huayu Jiedu decoction combined with neoadjuvant chemotherapy FLOT in the treatment of advanced GC.Methods:This study is a prospective,double-arm,randomized controlled trial.It involves a total of 260 patients diagnosed with advanced GC,who will be randomly assigned to two groups-a TCM treatment group and a control group,each comprising 130 patients.All patients will receive standard FLOT chemotherapy,and patients in the TCM treatment group will additionally receive TCM treatment with Yiqi Huayu Jiedu decoction.After four cycles of chemotherapy,GC D2 radical surgery will be performed.The primary objective is to evaluate the postoperative pathological response rate of the tumor.The secondary objectives include evaluating the perioperative nutritional status,the efficacy of TCM syndrome,and adverse events associated with both chemotherapy and surgery.Discussion:Currently,no trials have investigated the impact of TCM in combination with neoadjuvant chemotherapy on the preoperative treatment in patients with advanced GC.Accordingly,it is imperative to conduct this prospective study to evaluate the clinical efficacy and safety of this regimen,meanwhile providing high-level clinical evidence for TCM combined with neoadjuvant chemotherapy and introducing an innovative regimen for preoperative comprehensive treatment of GC.展开更多
文摘Ⅳa期胃癌属于局部晚期胃癌(locally advanced gastric cancer,LAGC),中国临床肿瘤学会(Chinese Society of Clinical Oncology,CSCO)指南推荐行多学科联合会诊(multidisciplinary consultation,MDT)讨论制订个体化治疗方案。近年来,随着精准医疗观念的不断加深,国内外越来越多的专家及学者逐渐重视新辅助治疗。新辅助治疗是指:对于初始评估手术指征存在但是病变局部已经处于晚期的恶性肿瘤患者,手术治疗难度大或需要联合脏器切除,可行新辅助治疗以减小肿瘤及转移灶、增加肿瘤完全切除(R0)率,同时进一步降低术后远处转移和肿瘤的复发率。本例患者临床分期为cT4bN3aM0、Ⅳa期,经过2周期新辅助治疗后,患者肿瘤病灶完全消失,现将其临床表现、影像学结果、病理学结果及治疗过程阐述如下,并结合相关文献分析,为该类疾病的诊治提供参考。
文摘目的:对比研究FLOT方案与FOLFOX方案治疗中晚期胃癌(GC)的近远期疗效及对血清肿瘤标志物和NRP-2的影响。方法:选入我院2020年3月~2022年2月收治的82例中晚期GC患者,根据化疗方法不同分为FLOT组和FOLFOX组,各41例。比较两组的近远期疗效、血清肿瘤标志物和NRP-2水平;随访至2023年11月,记录两组患者生存状态并绘制Kaplan-Meier生存曲线。结果:FLOT组客观有效率显著高于FOLFOX组(85.37%vs.65.85%,P<0.05)。FLOT组治疗后血清癌胚抗原[(12.77±1.85)ng/m L vs.(20.69±2.58)ng/mL]、糖类抗原19-9[(20.46±5.20)U/m L vs.(29.41±8.04)U/m L]、糖类抗原125[(14.90±5.61)U/m L vs.(20.72±6.23)ng/mL]和NRP-2[(13.01±2.11)ng/mL vs.(15.23±2.25)ng/mL]水平均显著低于FOLFOX组,PFS[12.900(95%CI:12.183~13.617)个月vs.9.600(95%CI:8.471~10.729)个月]和OS[28.103(95%CI:25.209~30.996)个月vs.20.799(95%CI:18.482~23.115)个月]显著长于FOLFOX组(P<0.05)。两组疾病控制率和毒副反应发生率无显著差异(P>0.05)。结论:FLOT方案和FOLFOX方案均是中晚期GC的有效化疗方案,安全性一致,但前者在提高客观有效率、降低血清肿瘤标志物和NRP-2水平、延长生存期方面更具优势。
文摘To confirm the relationship between Circ_0003855 and EC,we purchased the Human esophageal carcinoma cell line Eca109 and normal human esophageal epithelial cells HEEC,and the expression levels of Circ_0003855,miR-622,and FLOT1 were detected.The results show that Circ_0003855 and FLOT1 were highly expressed in Eca109 cells,while miR-622 was lowly expressed(p<0.05).Subsequently,Circ_0003855 small interfering RNA(si-Circ_0003855)and its negative control(si-NC)were used to detect changes in cellular biological behaviors.We found that the activity of Eca109 cells was reduced after interfering with the expression of Circ_0003855,and miR-622 expression was elevated,while FLOT1 was decreased(p<0.05).Additionally,si-Circ_0003855 and miR-622 inhibitor sequence(miR-622-inhibition)were co-transfected into cells with miR-622-inhibition alone,and untreated Eca109 cells were used as a control to detect the expression of FLOT1.Co-transfection of si-Circ_0003855 and miR-622-inhibition showed no significant difference in FLOT1 expression compared to the control cells(p>0.05).Synthesizing the results of these experiments above,we believe that interfering with the expression of Circ_0003855 can inhibit the activity of EC cells,and its mechanism is related to miR-622 and FLOT1.
基金This study has been approved by the Ethics Committee of Jiangsu Provincial Hospital of Traditional Chinese Medicine(Ethical approval number:2023NL-046-02)registered with the Chinese Clinical Trial Registry(Registration number:ChiCTR2300072742).
文摘Background:Neoadjuvant chemotherapy plays a vital role in the treatment of advanced gastric cancer(GC),however,optimizing its effectiveness remains an important research focus.Traditional Chinese medicine(TCM),a promising adjunctive therapy,has shown enhanced clinical outcomes when combined with postoperative adjuvant chemotherapy.Therefore,this study is designed to evaluate the clinical efficacy of Yiqi Huayu Jiedu decoction combined with neoadjuvant chemotherapy FLOT in the treatment of advanced GC.Methods:This study is a prospective,double-arm,randomized controlled trial.It involves a total of 260 patients diagnosed with advanced GC,who will be randomly assigned to two groups-a TCM treatment group and a control group,each comprising 130 patients.All patients will receive standard FLOT chemotherapy,and patients in the TCM treatment group will additionally receive TCM treatment with Yiqi Huayu Jiedu decoction.After four cycles of chemotherapy,GC D2 radical surgery will be performed.The primary objective is to evaluate the postoperative pathological response rate of the tumor.The secondary objectives include evaluating the perioperative nutritional status,the efficacy of TCM syndrome,and adverse events associated with both chemotherapy and surgery.Discussion:Currently,no trials have investigated the impact of TCM in combination with neoadjuvant chemotherapy on the preoperative treatment in patients with advanced GC.Accordingly,it is imperative to conduct this prospective study to evaluate the clinical efficacy and safety of this regimen,meanwhile providing high-level clinical evidence for TCM combined with neoadjuvant chemotherapy and introducing an innovative regimen for preoperative comprehensive treatment of GC.
