VEGF的表达及其微血管密度在胃癌组织中的意义

Effect of hyperthermic perfusion chemotherapy on vascular endothelial growth factor receptor 1 and matrix metalloproteinase-9 in patients with gastric cancer

AIM: To explore the effect of hyperthermic perfusion chemotherapy on vascular endothelial growth factor receptor 1 (VEGFR-1) and matrix metalloproteinase 9 (MMP-9) in patients with gastric cancer.

METHODS: Eighty-six gastric cancer patients treated at our hospital from March 2010 to April 2013 were randomly divided into either a treatment group or a control group, with 43 cases in each group. The control group was given conventional chemotherapy, and the treatment group was given hyperthermic perfusion chemotherapy. Carbohydrate antigen 72-4 (CA72-4), VEGFR-1 and MMP-9, changes in clinical symptoms and adverse reactions were compared between before and after treatment.

RESULTS: There were no significant differences in CA72-4 value, the percentages of VEGFR-1 or MMP-9 positive cases, or the number of cases with ascites between the two groups before treatment (P > 0.05). CA72-4 value, the percentages of VEGFR-1 and MMP-9 positive cases, and the number of cases with ascites were significantly lower in the treatment group than in the control group (5.43 kU/L ± 2.07 kU/L vs 7.08 kU/L ± 3.19 kU/L, 18.60% vs 41.86%, 23.26% vs 41.86%, 7 vs 15, P < 0.05). The recurrence rates at 6 mo and 1 yr were significantly lower in the treatment group than in the control group (2.33% vs 18.6%, 13.95% vs 32.56%, P < 0.05), while the survival rates at 6 mo and 1 yr were significantly higher in the treatment group (88.37% vs 69.77%, 44.19% vs 67.44%, P < 0.05). The numbers of cases with gastrointestinal bleeding, abdominal pain, leukopenia and diarrhea were significantly less in the treatment group than in the control group (2 vs 9, 5 vs 13, 1 vs 9, 2 vs 9, P < 0.05).

CONCLUSION: Hyperthermic perfusion chemotherapy can achieve better effects than conventional chemotherapy in patients with gastric cancer, and it can reduce the levels of VEGFR-1and MMP-9, relieve clinical symptoms and decrease the relapse rate.

Clinical significance of oxidative stress evaluation in gastrointestinal cancer diagnosis

AIM: To analyze oxidative stress in patients with gastrointestinal tumors.

METHODS: Two hundred patients with gastrointestinal cancer treated from September 2011 to September 2013 at our hospital were randomly selected and divided into a gastric cancer group (n = 100) and a colorectal cancer group (n = 100). Fifty healthy volunteers receiving physical examination during the same period at our hospital were used as controls. All study subjects were subjected to measurement of serum oxidative damage products, antioxidants and antioxidant enzymes.

RESULTS: The concentrations of protein carbonyl (PC), advanced oxidation protein products (AOPP), malondialdehyde (MDA), and 8-hydroxy-2'-deoxyguanosine (8-OHdG) in patients with gastric cancer and colorectal cancer were significantly different from those in healthy controls (4.12 nmol/L ± 1.34 nmol/L, 4.24 nmol/L ± 1.29 nmol/L vs 2.83 nmol/L ± 0.71 nmol/L; 31.93 μmol/L ± 12.34 μmol/L, 32.14 μmol/L ± 11.69 μmol/L vs 25.91 μmol/L ± 9.10 μmol/L; 2.98 nmol/L ± 1.13 nmol/L, 3.02 nmol/L ± 1.24 nmol/L vs 6.13 nmol/L ± 1.82 nmol/L; 125.91 mg/L ± 5.00 mg/L, 124.13 mg/L ± 5.00 mg/L vs 96.16 mg/L ± 68.29 mg/L, P < 0.05), although there were no significant differences between the gastric cancer and colorectal cancer groups (P > 0.05). The concentrations of glutathione, glutathione (GSH), vitamin C and vitamin E in patients with gastric cancer and colorectal cancer were significantly different from those in healthy controls (P < 0.05), although there were no significant differences between the gastric cancer and colorectal cancer groups (P > 0.05). Superoxide dismutase (SOD), glutathione peroxide matter enzyme (GSH-Px) and catalane (CAT) activity in patients with gastric cancer and colorectal cancer were significantly different from those in healthy controls (P < 0.05), although there were no significant differences between the gastric cancer and colorectal cancer groups (P > 0.05).

CONCLUSION: Patients with gastrointestinal tumors undergo oxidative stress, and evaluation of oxidative stress in patients with gastrointestinal cancer has important clinical significance in determining the occurrence of gastrointestinal cancer.

Correlation between Epstein-Barr virus infection and tumor angiogenesis in patients with gastric carcinoma

AIM: To evaluate the characteristics of Epstein-Barr virus (EBV)-associated gastric cancer and to explore the correlation between EBV infection and tumor angiogenesis in patients with gastric carcinoma.

METHODS: EBV infection was examined by localizing EBV-encoded small RNAs (EBERs) using in situ hybridization. Tumor angiogenesis was evaluated by examining the expression of VEGF protein using immunohistochemistry and tissue microarray technique. The association of EBV infection with clinicopathological parameters, including age, gender, tumor type, lymph node metastasis, and tumor stage, was analyzed. The correlation of VEGF expression with lymph node metastasis and Lauren's classification was also analyzed.

RESULTS: Among 486 patients, 18 showed nuclear expression of EBV. EBV staining was seen only in tumor cells. 14 of 18 patients with EBV-associated gastric cancer had regional lymph node metastasis. Of note, metastatic tumor cells in all of the involved lymph nodes contained EBV. EBER-positive gastric carcinomas tended to have lymphoid stroma (17/18) and were mostly poorly differentiated type (P<0.05). There was no significant difference in TNM stage between EBV-positive and -negative carcinomas (P>0.05). The positive rate of VEGF protein expression was 28.2% (137/486). Angiogenesis was significantly associated with lymph node metastasis and TNM stage (both P<0.05). EBV infection was closely correlated with angiogenesis (r = 0.119, P = 0.009).

CONCLUSION: EBV is present exclusively in gastric cancer cells and tumor cells in all of the lymph nodes involved. EBV-positive gastric cancer has distinct clinicopathological features. Angiogenesis may be a good predictor of metastasis and prognosis of gastric carcinoma in patients with EBV-associated gastric cancer.

Roles of mast cells in gastric carcinogenesis

There is a growing acceptance that mast cells play an active role in tumor growth. However, little is known about the role of mast cells in gastric carcinogenesis. Accumulated evidence suggests that mast cells play critical roles in gastric carcinogenesis in terms of promoting angiogenesis, modulating immune responses and participating in tissue remodeling. All these roles are closely related to tumor growth and metastasis. In this paper, we review recent advances in research on the roles of mast cells in gastric carcinogenesis. We also discuss the clinical application of drugs regulating mast cell function in tumors.