AIM To evaluate the clinical and prognostic significance of preoperative and postoperative cytokeratin 19(CK19) and carcinoembryonic antigen(CEA) m RNA levels in peripheral blood of patients with gastric cardia cancer...AIM To evaluate the clinical and prognostic significance of preoperative and postoperative cytokeratin 19(CK19) and carcinoembryonic antigen(CEA) m RNA levels in peripheral blood of patients with gastric cardia cancer(GCC).METHODS We detected the preoperative and postoperative mR NA levels of CK19 and CEA in peripheral blood of 129 GCC patients by using reverse transcription-polymerase chain reaction and evaluated their clinical and prognostic significance by univariate Kaplan-Meier survival analysis and multivariate Cox proportional hazard analysis. A new prognostic model which stratified patients into three different risk groups was established based on the independent prognostic factors.RESULTS Elevated preoperative and postoperative CK19 and CEA mR NA levels in peripheral blood of GCC patients were associated with lymph node metastasis. Univariate analysis showed that tumor size, histological grade, depth of tumor invasion, lymph node metastasis, preoperative CK19 m RNA, and preoperative and postoperative CEA m RNA levels were correlated with the prognosis of GCC patients. The multivariate analysis showed that lymph node status(P = 0.018), preoperative CK19(P = 0.035) and CEA(P = 0.011) m RNA levels were independent prognostic factors for overall survival(OS). The 5-year OS rates for the low-, intermediate-, and high-risk groups were 48.3%, 22.6%, and 4.6%, respectively(P < 0.001).CONCLUSION Elevated preoperative CK19 and CEA mR NA levels may be regarded as promising biomarkers for predicting lymph node metastasis and poor prognosis in patients with GCC. This new prognostic model may help us identify the subpopulations of GCC patients with the highest risk.展开更多
AIM: Genetic polymorphisms of drug-metabolizing enzymes have recently been shown to affect susceptibility to chemical carcinogenesis. Cytochrome P450 2E1 (CYP2E1)enzyme catalyzes the metabolism of many procarcinogens,...AIM: Genetic polymorphisms of drug-metabolizing enzymes have recently been shown to affect susceptibility to chemical carcinogenesis. Cytochrome P450 2E1 (CYP2E1)enzyme catalyzes the metabolism of many procarcinogens,such as N-nitrosamines and related compounds. The gene coding for this enzyme is polymorphic and thus may play a role in gastric cardia cancer (GCC) etiology. In this hospital-based case-control study, we evaluate the relationship between genetic polymorphisms of CYP2E1and the risk of GCC.METHODS: The study subjects comprised 159 histologically confirmed GCC cases identified via hospital cancer registry and surgical records at five hospitals in Fuzhou, Fujian Province, China, between April and November 2001.Controls were 192 patients admitted to the same hospitals for nonmalignant conditions. The genotypes of CYP2E1were detected by a PCR-based RFLP assay. The odds ratios were estimated by logistic regression analyses and were adjusted for potential confounding factors.RESULTS: The distribution of three genotypes of CYP2E1in GCC cases and controls was significantly different (X2 = 16.04, P＜0.01). The frequency of the CYP2E1 (c1/c1)genotype in GCC cases and controls was 60.4% and 40.1%,respectively. The CYP2E1 (c1/c1) genotype was associated with an increased risk for GCC (the adjusted (OR) was 2.37, 95% confidence interval (CI): 1.52-3.70). Subjects who carried the CYP2E 1 (c1/c1) genotype and were habitual smokers were at a significantly higher risk of developing GCC (OR = 4.68, 95%CI: 2.19-10.04) compared with those who had the CYP2E1 (c1/c2or c2/c2') genotype and did not smoke.CONCLUSION: These results suggest that the CYP2E 1genotype may influence individual susceptibility to development of GCC, and that the risk increases significantly in smokers.展开更多
Objective: To discuss the epidemic strength of cardia and distant stomach cancers in the high risk region of esophageal cancer along the south Taihang mountain such as in Shexian, Linxian, and Cixian Counties, and to ...Objective: To discuss the epidemic strength of cardia and distant stomach cancers in the high risk region of esophageal cancer along the south Taihang mountain such as in Shexian, Linxian, and Cixian Counties, and to clarify the tasks for the control of upper gastrointestinal tract cancer as a whole in the region. Methods: Comparisons of incidence and mortality rates of esophageal, cardia and stomach cancers were made between Cixian, Linxian and Shexian Counties with reference to detection rates of cancer in situ and precancerous lesions of the three upper gastrointestinal cancers by endoscopic screening. The screening was performed from 1999 through 2004 in the three adjacent counties including a total of 6233 local residents aged 40 to 69 years old. Results: The incidence rates for cardia cancer for the male and female from 2000 through 2004 were 69.9 and 41.5, and the mortality rates were 54.3 and 33.2 respectively in Shexian County. Esophageal, cardia, and stomach cancers constitute about 70～80 percent of all malignant disease by incidence or mortality rates. Endoscopic survey with iodine staining can effectively detect squamous cell precancerous lesions in the esophagus, but the method is inadequate for the detection of adeno precancerous lesions of the cardia and stomach. Conclusion: The south Taihang mountain region is a high risk area not only for esophagus cancer, but also for cardia and stomach cancers. To control upper gastrointestinal tract cancers as a whole in the region, special attention should be paid to the control of cardia and stomach cancers. Presently, to find effective screening methods for detecting cardia and stomach precancerous lesions is especially important.展开更多
AIM: To examine the interactions between cytotoxinassociated gene (CagA) positive Helicobacter pylori infection and smoking in non-cardiac gastric cancer.METHODS: A case-control study (257 cases and 514 frequency-matc...AIM: To examine the interactions between cytotoxinassociated gene (CagA) positive Helicobacter pylori infection and smoking in non-cardiac gastric cancer.METHODS: A case-control study (257 cases and 514 frequency-matched controls) was conducted from September 2008 to July 2010 in Xi’an,China.Cases were newly diagnosed,histologically confirmed non-cardiac cancer.Controls were randomly selected from similar communities to the cases and were further matched by sex and age (± 5 years).A face-to-face interview was performed by the investigators for each participant.Data were obtained using a standardized questionnaire that included questions regarding known or suspected lifestyle and environmental risk factors of gastric cancer.A 5 mL sample of fasting venous blood was taken.CagA infection was serologically detected by enzymelinked immunosorbent assays.RESULTS: Smoking and CagA infection were statistically significant risk factors of non-cardiac cancer.CagA was categorized in tertiles,and the odds ratio (OR) was 12.4 (95% CI: 6.1-20.3,P = 0.003) for CagA after being adjusted for confounding factors when the highexposure category was compared with the low-exposure category.Smokers had an OR of 5.4 compared with subjects who never smoked (95% CI: 2.3-9.0,P = 0.002).The OR of non-cardiac cancer was 3.5 (95% CI: 1.8-5.3) for non-smokers with CagA infection,3.5 (95% CI: 1.9-5.1) for smokers without CagA infection,and 8.7 (95% CI: 5.1-11.9) for smokers with CagA infection compared with subjects without these risk factors.After adjusting for confounding factors,the corresponding ORs of non-cardiac cancer were 3.2 (95% CI: 1.5-6.8),2.7 (95% CI: 1.3-4.9) and 19.5 (95% CI: 10.3-42.2),respectively.There was a multiplicative interaction between smoking and CagA,with a synergistic factor of 2.257 (Z = 2.315,P = 0.021).CONCLUSION: These findings support a meaningful interaction between CagA and smoking for the risk of gastric cancer which may have implications for its early detection.展开更多
AIM:To explore the role of Helicobacter pylori(H pylori) infection on the risk of digestive tract cancers. METHODS:In total,199 oral squamous-cell carcinoma(SCC),317 esophageal SCC,196 gastric cardia and non-cardia ad...AIM:To explore the role of Helicobacter pylori(H pylori) infection on the risk of digestive tract cancers. METHODS:In total,199 oral squamous-cell carcinoma(SCC),317 esophageal SCC,196 gastric cardia and non-cardia adenocarcinoma and 240 colon adenocarcinoma patients were recruited for serum tests of H pylori infection.Two hospital-and one community-based control groups were used for the comparisons.H pyloriseropositivity was determined by an enzyme linked immunosorbent assay method against H pylori IgG. RESULTS:Presence of H pylori infection was significantly inversely associated with esophageal SCC[adjusted odds ratio(AOR):0.315-0.472,all P-value< 0.05]but positively associated with gastric adenocarcinoma(both cardia and non-cardia)(AOR:1.636-3.060, all P-value<0.05)in comparison to the three control groups.Similar results were not found in cancers of the oral cavity and colon. CONCLUSION:Our findings support the finding that H pylori seropositivity is inversely associated with esophageal SCC risk,but increases the risk of gastric cardia adenocarcinoma.展开更多
The factors associated with an increase in gastric cardia adenocarcinoma are poorly understood.Environmental factors such as Helicobacter pylori(H.pylori) infection and diet have been hypothesized to play a role in th...The factors associated with an increase in gastric cardia adenocarcinoma are poorly understood.Environmental factors such as Helicobacter pylori(H.pylori) infection and diet have been hypothesized to play a role in the recently increased risk of this disease,but additional studies are needed.In conducting studies to establish the relationship between potential risk factors and gastric cardia adenocarcinoma,it is necessary to carefully consider the role of bias.In a recently published study,the reported associations between H.pylori as well as post-meal physical exertion and gastric cardia adenocarcinoma may have been greatly influenced by selection bias.展开更多
背景与目的:食管胃结合部腺癌(adenocarcinoma of gastroesophageal junction,AGEJ)的发病率逐步升高,且由于其解剖部位特殊,预后相对较差。本研究旨在总结复旦大学附属肿瘤医院外科治疗的AGEJ的临床资料,以探讨影响AGEJ术后生存的相关...背景与目的:食管胃结合部腺癌(adenocarcinoma of gastroesophageal junction,AGEJ)的发病率逐步升高,且由于其解剖部位特殊,预后相对较差。本研究旨在总结复旦大学附属肿瘤医院外科治疗的AGEJ的临床资料,以探讨影响AGEJ术后生存的相关预后因素。方法:回顾性分析1996年1月1日-2005年9月31日间复旦大学附属肿瘤医院腹部外科收治的749例可切除的AGEJ病例的临床和病例资料,并对其进行随访。AJCC分期:Ⅰ期90例(12.0%),Ⅱ期165例(22.0%),Ⅲ期379例(50.6%),Ⅳ期115例(15.4%)。手术根治率89.5%,R0根治切除率87.4%。生存率计算及生存曲线绘制采用Kaplan-Meier法,单因素预后分析采用Log-rank检验,多因素预后分析采用Cox比例风险模型。结果:本组病例的总体5年生存率为38.5%,中位生存期为38个月。手术性质、淋巴结清扫范围、胃体切除范围、联合胰脾切除、大体标本类型、肿瘤累及贲门、肿瘤部位、肿瘤最大径、分化程度、脉管侵犯、淋巴结阳性比、阳性切缘、肿瘤残留分级以及TNM分期在单因素分析中显示对预后有显著影响。胸腹联合手术与单纯进腹手术预后差异无统计学意义(38.3%vs40.1,P=0.850)。多因素分析结果显示肿瘤残留分级、脉管累及、淋巴结阳性比及TNM分期是独立的预后因素。结论:AGEJ的外科治疗中,手术入路的选择不影响患者的预后。手术应行标准D2淋巴清扫,并达到R0根治切除。联合胰脾切除疗效有待临床验证。病理检查中,应尽可能检出16枚以上的淋巴结,以保证分期的准确性。展开更多
基金Supported by the National Key Clinical Specialist Construction Programs of China,No.2013-544Science and Technology Development Fund of Tianjin Education Commission for Higher Education,No.20130121Science Foundation of Tianjin Medical University,No.2016KYZM03
文摘AIM To evaluate the clinical and prognostic significance of preoperative and postoperative cytokeratin 19(CK19) and carcinoembryonic antigen(CEA) m RNA levels in peripheral blood of patients with gastric cardia cancer(GCC).METHODS We detected the preoperative and postoperative mR NA levels of CK19 and CEA in peripheral blood of 129 GCC patients by using reverse transcription-polymerase chain reaction and evaluated their clinical and prognostic significance by univariate Kaplan-Meier survival analysis and multivariate Cox proportional hazard analysis. A new prognostic model which stratified patients into three different risk groups was established based on the independent prognostic factors.RESULTS Elevated preoperative and postoperative CK19 and CEA mR NA levels in peripheral blood of GCC patients were associated with lymph node metastasis. Univariate analysis showed that tumor size, histological grade, depth of tumor invasion, lymph node metastasis, preoperative CK19 m RNA, and preoperative and postoperative CEA m RNA levels were correlated with the prognosis of GCC patients. The multivariate analysis showed that lymph node status(P = 0.018), preoperative CK19(P = 0.035) and CEA(P = 0.011) m RNA levels were independent prognostic factors for overall survival(OS). The 5-year OS rates for the low-, intermediate-, and high-risk groups were 48.3%, 22.6%, and 4.6%, respectively(P < 0.001).CONCLUSION Elevated preoperative CK19 and CEA mR NA levels may be regarded as promising biomarkers for predicting lymph node metastasis and poor prognosis in patients with GCC. This new prognostic model may help us identify the subpopulations of GCC patients with the highest risk.
基金Supported by the Natural Science Foundation of Fujian Province, China, No. C0410016 the Foundation for the Author of National Excellent Doctoral Dissertation of PR China, No. 200157
文摘AIM: Genetic polymorphisms of drug-metabolizing enzymes have recently been shown to affect susceptibility to chemical carcinogenesis. Cytochrome P450 2E1 (CYP2E1)enzyme catalyzes the metabolism of many procarcinogens,such as N-nitrosamines and related compounds. The gene coding for this enzyme is polymorphic and thus may play a role in gastric cardia cancer (GCC) etiology. In this hospital-based case-control study, we evaluate the relationship between genetic polymorphisms of CYP2E1and the risk of GCC.METHODS: The study subjects comprised 159 histologically confirmed GCC cases identified via hospital cancer registry and surgical records at five hospitals in Fuzhou, Fujian Province, China, between April and November 2001.Controls were 192 patients admitted to the same hospitals for nonmalignant conditions. The genotypes of CYP2E1were detected by a PCR-based RFLP assay. The odds ratios were estimated by logistic regression analyses and were adjusted for potential confounding factors.RESULTS: The distribution of three genotypes of CYP2E1in GCC cases and controls was significantly different (X2 = 16.04, P＜0.01). The frequency of the CYP2E1 (c1/c1)genotype in GCC cases and controls was 60.4% and 40.1%,respectively. The CYP2E1 (c1/c1) genotype was associated with an increased risk for GCC (the adjusted (OR) was 2.37, 95% confidence interval (CI): 1.52-3.70). Subjects who carried the CYP2E 1 (c1/c1) genotype and were habitual smokers were at a significantly higher risk of developing GCC (OR = 4.68, 95%CI: 2.19-10.04) compared with those who had the CYP2E1 (c1/c2or c2/c2') genotype and did not smoke.CONCLUSION: These results suggest that the CYP2E 1genotype may influence individual susceptibility to development of GCC, and that the risk increases significantly in smokers.
基金This work was supported by the grants from The Natural Scientific Foundation of Hebei Province (No. C 2005000797 Hebei Significant Topic of Tackle Key Programs (No. 03276198D) Hebei Technology Program Item (No. 032761100D-1)
文摘Objective: To discuss the epidemic strength of cardia and distant stomach cancers in the high risk region of esophageal cancer along the south Taihang mountain such as in Shexian, Linxian, and Cixian Counties, and to clarify the tasks for the control of upper gastrointestinal tract cancer as a whole in the region. Methods: Comparisons of incidence and mortality rates of esophageal, cardia and stomach cancers were made between Cixian, Linxian and Shexian Counties with reference to detection rates of cancer in situ and precancerous lesions of the three upper gastrointestinal cancers by endoscopic screening. The screening was performed from 1999 through 2004 in the three adjacent counties including a total of 6233 local residents aged 40 to 69 years old. Results: The incidence rates for cardia cancer for the male and female from 2000 through 2004 were 69.9 and 41.5, and the mortality rates were 54.3 and 33.2 respectively in Shexian County. Esophageal, cardia, and stomach cancers constitute about 70～80 percent of all malignant disease by incidence or mortality rates. Endoscopic survey with iodine staining can effectively detect squamous cell precancerous lesions in the esophagus, but the method is inadequate for the detection of adeno precancerous lesions of the cardia and stomach. Conclusion: The south Taihang mountain region is a high risk area not only for esophagus cancer, but also for cardia and stomach cancers. To control upper gastrointestinal tract cancers as a whole in the region, special attention should be paid to the control of cardia and stomach cancers. Presently, to find effective screening methods for detecting cardia and stomach precancerous lesions is especially important.
基金Supported by Health department of Shaanxi Province,China,No.2009K12-022
文摘AIM: To examine the interactions between cytotoxinassociated gene (CagA) positive Helicobacter pylori infection and smoking in non-cardiac gastric cancer.METHODS: A case-control study (257 cases and 514 frequency-matched controls) was conducted from September 2008 to July 2010 in Xi’an,China.Cases were newly diagnosed,histologically confirmed non-cardiac cancer.Controls were randomly selected from similar communities to the cases and were further matched by sex and age (± 5 years).A face-to-face interview was performed by the investigators for each participant.Data were obtained using a standardized questionnaire that included questions regarding known or suspected lifestyle and environmental risk factors of gastric cancer.A 5 mL sample of fasting venous blood was taken.CagA infection was serologically detected by enzymelinked immunosorbent assays.RESULTS: Smoking and CagA infection were statistically significant risk factors of non-cardiac cancer.CagA was categorized in tertiles,and the odds ratio (OR) was 12.4 (95% CI: 6.1-20.3,P = 0.003) for CagA after being adjusted for confounding factors when the highexposure category was compared with the low-exposure category.Smokers had an OR of 5.4 compared with subjects who never smoked (95% CI: 2.3-9.0,P = 0.002).The OR of non-cardiac cancer was 3.5 (95% CI: 1.8-5.3) for non-smokers with CagA infection,3.5 (95% CI: 1.9-5.1) for smokers without CagA infection,and 8.7 (95% CI: 5.1-11.9) for smokers with CagA infection compared with subjects without these risk factors.After adjusting for confounding factors,the corresponding ORs of non-cardiac cancer were 3.2 (95% CI: 1.5-6.8),2.7 (95% CI: 1.3-4.9) and 19.5 (95% CI: 10.3-42.2),respectively.There was a multiplicative interaction between smoking and CagA,with a synergistic factor of 2.257 (Z = 2.315,P = 0.021).CONCLUSION: These findings support a meaningful interaction between CagA and smoking for the risk of gastric cancer which may have implications for its early detection.
基金Supported by Grants From Kaohsiung Medical University Hospital,97-ND-006,the National Science Council,NSC97-2314-B-037-018,NSC 98-2314-B-037-004,and the Department of Health,Taiwan
文摘AIM:To explore the role of Helicobacter pylori(H pylori) infection on the risk of digestive tract cancers. METHODS:In total,199 oral squamous-cell carcinoma(SCC),317 esophageal SCC,196 gastric cardia and non-cardia adenocarcinoma and 240 colon adenocarcinoma patients were recruited for serum tests of H pylori infection.Two hospital-and one community-based control groups were used for the comparisons.H pyloriseropositivity was determined by an enzyme linked immunosorbent assay method against H pylori IgG. RESULTS:Presence of H pylori infection was significantly inversely associated with esophageal SCC[adjusted odds ratio(AOR):0.315-0.472,all P-value< 0.05]but positively associated with gastric adenocarcinoma(both cardia and non-cardia)(AOR:1.636-3.060, all P-value<0.05)in comparison to the three control groups.Similar results were not found in cancers of the oral cavity and colon. CONCLUSION:Our findings support the finding that H pylori seropositivity is inversely associated with esophageal SCC risk,but increases the risk of gastric cardia adenocarcinoma.
文摘The factors associated with an increase in gastric cardia adenocarcinoma are poorly understood.Environmental factors such as Helicobacter pylori(H.pylori) infection and diet have been hypothesized to play a role in the recently increased risk of this disease,but additional studies are needed.In conducting studies to establish the relationship between potential risk factors and gastric cardia adenocarcinoma,it is necessary to carefully consider the role of bias.In a recently published study,the reported associations between H.pylori as well as post-meal physical exertion and gastric cardia adenocarcinoma may have been greatly influenced by selection bias.
文摘背景与目的:食管胃结合部腺癌(adenocarcinoma of gastroesophageal junction,AGEJ)的发病率逐步升高,且由于其解剖部位特殊,预后相对较差。本研究旨在总结复旦大学附属肿瘤医院外科治疗的AGEJ的临床资料,以探讨影响AGEJ术后生存的相关预后因素。方法:回顾性分析1996年1月1日-2005年9月31日间复旦大学附属肿瘤医院腹部外科收治的749例可切除的AGEJ病例的临床和病例资料,并对其进行随访。AJCC分期:Ⅰ期90例(12.0%),Ⅱ期165例(22.0%),Ⅲ期379例(50.6%),Ⅳ期115例(15.4%)。手术根治率89.5%,R0根治切除率87.4%。生存率计算及生存曲线绘制采用Kaplan-Meier法,单因素预后分析采用Log-rank检验,多因素预后分析采用Cox比例风险模型。结果:本组病例的总体5年生存率为38.5%,中位生存期为38个月。手术性质、淋巴结清扫范围、胃体切除范围、联合胰脾切除、大体标本类型、肿瘤累及贲门、肿瘤部位、肿瘤最大径、分化程度、脉管侵犯、淋巴结阳性比、阳性切缘、肿瘤残留分级以及TNM分期在单因素分析中显示对预后有显著影响。胸腹联合手术与单纯进腹手术预后差异无统计学意义(38.3%vs40.1,P=0.850)。多因素分析结果显示肿瘤残留分级、脉管累及、淋巴结阳性比及TNM分期是独立的预后因素。结论:AGEJ的外科治疗中,手术入路的选择不影响患者的预后。手术应行标准D2淋巴清扫,并达到R0根治切除。联合胰脾切除疗效有待临床验证。病理检查中,应尽可能检出16枚以上的淋巴结,以保证分期的准确性。
