Objective To understand role of chemokines and their receptors in pathogenesis, progression, and metastasis of gastric cancer, and to provide a better approach for diagnosis and treatment of gastric cancer. Method The literatures about the relationship between chemokines and their receptors and gastric cancer were reviewed. Results There were about 50 various chemokines and their receptors abnormally expressed in the tumor microenvironment. The main types related gastric cancer were the CXC, CC and CX3C chemokines and their receptors, which could promote the proliferation, invasion, and metastasis of the gastric cancer through several pathways like mTOR pathway, JAK2-STAT3 pathway, etc.. Conclusions Chemokines and their receptors play an important role in occurrence and development of gastric cancer. Further studies on chemokines and their receptors will not only assist in early diagnosis of gastric cancer, as well as estimation of clinical prognosis, but also provide an intervention target for gastric cancer.
Objective To study the necessity and feasibility of No.12b lymph node dissection in D2 lymphadenectomy for advanced distal gastric cancer, and the relation between No.12b lymph node metastasis and clinicopathologic factors. Methods Clinical data of sixty cases of advanced distal gastric cancer receiving D2 or D2+ radical correction were collected retrospectively, both of which were all plus No.12b lymph node dissections. The relationships between No.12b lymph node metastasis and clinicopathologic factors were analyzed. Results No death attributed to operation or severe operative complications were found. There were 12 cases (20.00%) with No.12b lymph node metastasis. The rates of No.12b lymph node metastasis in Borrmann Ⅲ-Ⅳ types, N2-3 of lymph node metastasis and T3-4 of tumor infiltration were 31.25% (10/32), 30.30% (10/33) and 29.73% (11/37), which were significantly higher than those in Borrmann Ⅰ-Ⅱ types 〔7.14% （2/28）〕, N0-1 〔7.41% （2/27）〕 and T1-2 〔4.35% （1/23）〕 respectively (Plt;0.05). There was no relationship between tumor size and No.12b lymph node metastasis. Conclusions No.12b lymph node dissection is safe and feasible for advanced distal gastric cancer. Further perspective studies on No.12b lymph node dissection influence on prognosis in more cases are required.
With the upgrading of minimally invasive surgical concepts and laparoscopic equipment for gastric cancer, single-incision laparoscopic surgery (SILS) had emerged as a new focus of research in gastric cancer surgery. SILS offered advantages such as reduced damage, superior cosmetic outcomes, decreased postoperative pain, and faster recovery as compared with traditional laparoscopic gastrectomy. However, its level of difficulty limited its further promotion and application. Although numerous studies supported the safety and feasibility of SILS, more high-level evidence-based medical research was required to endorse its widespread use. The author reviewed the development history, current status, and prospects of SILS laparoscopic gastric cancer surgery.
In perioperation period, the dynamic changes of solubla interleulcin-2 receptor (sIL-2R) in serum were determined by ELISA in 60 patients with gastric cancer (GC), and then was compared with those of 30 normal individuals and 40 selective patients who necieved common abdominal surgery. Results: At the day before and ten days after operation, the sIL-2R of patients with GC was higher than that of normal individual. But twenty days after operation, the sIL-2R reduced to as normal level. Conclusion: As a immunodepressive index, the sIL-2R of patients with GC was increased obviously, and after radical gastrectomy, it decreased gradually. So by determining sIL-2R, we can evaluate the immunologic function of patientswith GC.
ObjectiveTo discuss the current status and progress of delayed gastric emptying (DGE) after pancreaticoduodenectomy (PD).MethodThe related researches about DGE after PD in recent year were searched and reviewed.ResultsThe etiology and pathogenesis of DGE had not yet been fully elucidated. There were various risk factors, such as the surgical trauma, advanced age, diabetes, and with other abdominal complications. The pylorus preserving PD didn’t increase the risk of DGE. The pylorus ring resection, anterior colon, Braun anastomosis, and minimally invasive surgery were beneficial for reducing DGE. Although there was no obvious progress in the treatment of DGE at home and abroad, the majority of patients could be cured by the symptomatic conservative treatment.ConclusionsPrevention is a main strategy for DGE after PD. Application of enhanced recovery after surgery might be a key to solve problem in clinical, but further research is needed.
ObjectiveTo summarise the application research progress of clinical prediction models in postoperative complications of gastric cancer, in order to reduce the risk of complications after gastric cancer surgery. MethodThe literature on the study of postoperative complications of gastric cancer at home and abroad was read and reviewed. ResultsAt present, the main way of treating gastric cancer was still radical resection, and the occurrence of complications after surgical treatment seriously affected the recovery and survival quality of patients. With the deepening of research, the prediction models of postoperative complications in gastric cancer were constantly constructed, and these models provided strong evidence for the early judgement of postoperative complications in gastric cancer, and provided a scientific basis for the improvement of patients’ life quality. ConclusionClinical predictive models are expected to become risk screening tools for predicting the risk of postoperative complications of gastric cancer with clinical utility.
With the swift evolution of bariatric and metabolic surgery, additional procedures building upon sleeve gastrectomy have consistently surfaced. Recent studies suggest that sleeve gastrectomy with jejunojejunal bypass (SG-JJB) yields superior short-term weight reduction outcomes compared to sleeve gastrectomy alone, with weight loss and glycemic control effects akin to Roux-en-Y gastric bypass, and without significant complications. As a result, SG-JJB is regarded as a safe and efficacious bariatric procedure, noted for its technical simplicity and reversibility, presenting substantial clinical utility. Nonetheless, high-quality, multicenter, large-sample, long-term follow-up randomized controlled trials are essential to further ascertain its long-term efficacy and safety, and to facilitate its standardized implementation. This article seeks to review the advancements in SG-JJB research, evaluate its effectiveness and safety in managing obesity and associated comorbidities, and explore its future developmental trajectory.
ObjectiveTo compare the effect of ileal transposition (IT) and Roux-en-Y gastric bypass (RYGBP) on blood glucose and expression of glucagon-like peptide-1 (GLP-1) in Goto-Kakizaki (GK) rats with non-obese type 2 diabetes mellitus (T2DM). MethodsThirty male GK rats were randomized divided into three groups:IT group (n=10), RYGBP group (n=10), and Sham group (n=10). The mortality and complication were observed after surgery. The levels of fasting blood glucose (FBG), fasting insulin (FINS), glycosylated hemoglobin (HbA1c), and GLP-1 were determined before operation, and 1 week, 2 weeks, 1 month, 2 months, 3 months, 6 months after operation in the GK rats of 3 groups. Results① Mortality and morbility. There was no death and complication occurred in IT group and Sham group, only 5 rats of RYGBP group suffered from complication, and 2 of them died. The mortality and morbility were higher in RYGBP group than those of IT group and Sham group (P < 0.05). ② FBG. Compared with before operation in the same group, the FBG levels of IT group and RYGBP group in 1 week, 2 weeks, 1 month, 2 months, 3 months, and 6 months after operation were all lower (P < 0.05). In 1 week, 2 weeks, 1 month, 2 months, 3 months, and 6 months after operation, FBG levels of IT group and RYGBP group were all lower than those of Sham group at the same time point (P < 0.05), but there was no significant difference between IT group and RYGBP group at the 6 time points (P > 0.05). ③ FINS and HbA1c. Compared with before operation in the same group, the FINS levels of IT group and RYGBP group in 3 months and 6 months after operation were higher than those of Sham group (P < 0.05), HbA1c levels of IT group and RYGBP group were both lower at the 2 time points (P < 0.05). In 3 months and 6 months after operation, FINS levels of IT group and RYGBP group were both higher, and HbA1c levels were both lower than corresponding indexes of Sham group at the same time point (P < 0.05), but there was no significant difference between IT group and RYGBP group at the 2 time points (P > 0.05). ④ GLP-1. Compared with before operation in the same group, the GLP-1 levels of IT group and RYGBP group in 1 week, 2 weeks, 1 month, 2 months, 3 months, and 6 months after operation were all higher (P < 0.05). In 1 week, 2 weeks, 1 month, 2 months, 3 months, and 6 months after operation, GLP-1 levels of IT group and RYGBP group were both higher than those of Sham group at the same time point (P < 0.05), but there was no significant difference between IT group and RYGBP group at the 6 time points (P > 0.05). ConclusionIT and RYGBP have a significant hypoglycemic effect on non-obese T2DM GK rats, but IT has lower mortality and morbility, which is more effective and safer, comparing with RYGBP.
ObjectiveTo evaluate the weight loss outcomes, metabolic disease remission, and complications profiles of laparoscopic sleeve gastrectomy (LSG) based on a large single-center cohort experience. MethodsA retrospective observational study was conducted. Clinical data of patients who underwent LSG at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from June 2021 to June 2024 were collected based on predefined inclusion and exclusion criteria. The outcomes including percentage of total weight loss (%TWL), metabolic disease remission, and the incidence of postoperative complications were assessed. ResultsA total of 1 568 patients met the inclusion and exclusion criteria were finally included, including 304 males and 1 264 females. The age at surgery was (31.51±8.01）years old, and the body mass index was (37.26±4.18) kg/m2. At 1 year after surgery, the %TWL was (32.84±6.38)%, and the complete remission rate of diabetes was 96.2% (304/316). Complications within 1 year after surgery: 1 (0.06%) case of postoperative bleeding, 2 (0.13%) cases of gastric leakage, 1 (0.06%) case of vitamin B1 deficiency, and 1 (0.06%) case of unilateral common peroneal nerve entrapment injury. The total complications rate was 0.32% (5/1 568). No mortality was observed. ConclusionsLSG has significant short-term efficacy and higher safety in treatment of obesity and related metabolic diseases. In particular, experiences in aspects such as complications prevention and multidisciplinary follow-up management could provide references for centers in the early stage of development.
Objective To investigate the role of vascular endothelial growth factor-C (VEGF-C) and its receptors in the formation of lymphatic vessels and lymphatic metastasis in gastric cancer. Methods By the domestic and overseas literatures review, the expressions of VEGF-C and its receptors in gastric cancer, their role in tumor lymphatic metastasis and prospect in treatment of gastric cancer were summarized.Results There was a significant correlation between VEGF-C and its receptors and the formation of lymphatic vessels and lymphatic metastasis in gastric cancer. VEGF-C high expression might be an early event in lymphatic metastasis and could be considered as an independent predictive factor of lymphaticmicrometastasis. By inhibition of gastric cancer cell from secrete VEGF-C or blockage of the interaction of VEGF-C with VEGFR3, it was possible to inhibit tumor angiogenesis and the invasion and distant spread of cancer cells, thereby decreased mortality and improve survival. ConclusionVEGF-C and its receptors may promote the formation of lymphatic vessels and lymphatic metastasis in gastric cancer. It may be an effective way to gastric cancer for the treatments against VEGF-C and its receptors.