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| 1 | 中国晚期胃癌的诊疗现状显示文摘胃癌是中国较常见的恶性肿瘤之一,晚期胃癌严重威胁着人们的健康。目前晚期胃癌的定义按临床诊断和病理诊断进一步细分,过去的统计资料已无法充分反映国内晚期胃癌的状况。为此,本文从定义变化、分期迁移、流行病学、临床表现、病理类型、临床表型几个方面,重新整理及回顾了中国晚期胃癌的临床特征,并且总结了国内外治疗的研究进展。全身化疗仍然是中国晚期胃癌治疗的基石,但治疗模式早已开始向多学科综合治疗转变。转化治疗、手术治疗、放射治疗、靶向治疗、免疫治疗在晚期胃癌中有广阔前景。 | 郑潇豪 解亦斌 | 2019 | 癌症进展2019，17，1： | 73 |
| 2 | 进展期胃癌患者预后营养指数的临床意义显示文摘目的研究胃癌患者预后营养指数(PNI)与临床病理因素的关系以及PNI对于预测患者生存期的临床意义。方法回顾性分析2007年1月至2010年12月期间在哈尔滨医科大学附属肿瘤医院胃肠外科行胃癌根治术的1150例进展期胃癌患者的临床病理资料和随访资料。计算PNI值[PNI=淋巴细胞绝对值(109/L)× 5 +血清白蛋白(g/L)],根据PNI均值进行分组,分析PNI与患者性别、年龄、肿瘤大小、肿瘤浸润深度和分化程度、肿瘤分期、肿瘤位置、淋巴结转移情况以及肿瘤标记物检测水平的关系。同时对患者进行生存分析,采用log-rank法进行单因素分析,Cox法进行多因素分析。结果1150例患者男846例,女304例;平均年龄62(24~88)岁。肿瘤最大径平均为5.4(1.0~20.0)cm;肿瘤位于胃底159例,胃体221例,胃窦705例,全胃65例;分化型198例,分化不良型952例;肿瘤浸润深度,T2 165例,T3 343例,T4 642例;肿瘤TNM分期,Ⅰ期53例,Ⅱ期397例,Ⅲ期700例。淋巴结转移率平均25.0%,淋巴结转移N0 296例,N1 246例,N2 277例,N3 331例。血红蛋白≤ 130 g/L 544例,〉 130 g/L 606例;癌胚抗原(CEA)≤5 μg/L 903例,〉 5 μg/L 247例;糖类抗原(CA)19-9 ≤ 37 kU/L 927例,〉 37 kU/L 223例。全组患者PNI均值为51.81(24.5~80.4),PNI ≤ 51.81组有563例,PNI 〉 51.81组有587例。PNI≤51.81组与〉51.81组患者,年龄(χ2= 22.661,P = 0.000)、肿瘤位置(χ2 = 8.979,P = 0.030)、肿瘤大小(χ2 = 34.509,P = 0.000)、肿瘤分期(χ2 = 11.644,P = 0.003)、肿瘤浸润深度(χ2 = 21.681,P = 0.000)和周围血红蛋白(χ2 = 112.262,P = 0.000)的差异有统计学意义。全组患者平均随访45.1(4~108)月,PNI ≤ 51.81组5年生存率37.7%,PNI 〉 51.81组5年生存率47.0%,两组比较,差异有统计学意义(χ2 = 8.326,P = 0.004)。单因素预后分析显示,PNI ≤ 51.81(P = 0.004)、胃癌浸润程度深(P = 0.000)、淋巴结转移数目多(P = 0.000)、TNM分期晚(P = 0.000)、淋巴结转移率〉 25.02%(P = 0.000)、血红蛋白水平≤ 130 g/L(P = 0.011)、肿瘤最大径〉 5.4 cm(P = 0.000)、肿瘤分化差(P = 0.000)、癌胚抗原〉 5 μg/L(P = 0.000)、CA19-9 〉 37 kU/L(P = 0.000)和肿瘤位于全胃(P = 0.000)的进展期胃癌患者预后较差;多因素分析显示,患者年龄(HR = 1.195,95%CI:1.019~1.401,P = 0.028)、胃癌浸润深度(HR = 1.429,95%CI:1.231~1.658,P = 0.000)、淋巴结转移数目(HR = 1.536,95%CI:1.330~1.774,P = 0.000)、淋巴结转移率(HR = 1.376,95%CI:1.102~1.717,P = 0.005)、肿瘤TNM分期(HR = 1.387,95%CI:1.026~1.876,P = 0.033)和肿瘤最大径(HR = 1.182,95%CI:1.005~1.390,P = 0.043)是影响胃癌患者预后的独立危险因素,而PNI(HR = 0.913,95%CI:0.774~1.076,P = 0.278)并不是影响胃癌患者预后的独立危险因素。结论虽然PNI不是影响进展期胃癌患者总体生存率的独立危险因素,但PNI仍是一个与胃癌患者生存密切相关的指标,改善术前胃癌患者的营养状况或许有助于改善预后。 | 宋书彬 刘宏刚 薛英威 | 2018 | 中华胃肠外科杂志2018，21，2： | 23 |
| 3 | 卡培他滨联合洛铂对比联合奥沙利铂用于进展期胃癌D2术后辅助化疗显示文摘目的探讨洛铂联合卡培他滨针对进展期胃癌D2术后辅助化疗的效果与安全性以及与奥沙利铂联合卡培他滨方案的差异。方法行D2手术的进展期胃癌患者63例,术后病理分期均为Ⅱ期或Ⅲ期,其中28例接受洛铂联合卡培他滨的辅助化疗(XELLOBA组),35例接受奥沙利铂联合卡培他滨的辅助化疗(XELOX组),比较两组3年总生存率及安全性。结果 XELLOBA与XELOX两组3年总生存率分别为75.0%及62.9%(P=0.253);两组Ⅲ°以上化疗相关毒性反应发生率分别为21.42%及20.0%(P=0.889)。结论洛铂联合方案在疗效方面至少不低于奥沙利铂联合方案,且在安全性方面与后者相似,提示洛铂联合卡培他滨的方案在胃癌的辅助化疗中具有良好的临床应用前景。 | 李元方 周志伟 李威 陈映波 孙晓卫 关远祥 徐大志 王玮 袁庶强 詹友庆 | 2012 | 广东医学2012，33，9： | 20 |
| 4 | 不同病理类型进展期胃癌的预后因素分析显示文摘目的探讨不同病理类型进展期胃癌患者的临床病理特征及预后因素。方法回顾性分析2011年间在南京大学医学院附属鼓楼医院集团宿迁市人民医院行胃癌根治术的98例进展期胃癌患者的临床病理资料,其中胃腺癌53例,胃黏液腺癌30例,胃印戒细胞癌15例,比较不同病理类型进展期胃癌患者的临床病理特征及预后的差异。结果 (1)3种不同病理类型进展期胃癌患者的性别、年龄、神经侵犯及分化程度比较差异无统计学意义(P>0.05),而其肿瘤直径、肿瘤位置、手术根治类型、区域淋巴结转移、淋巴管癌栓、侵犯深度及p TNM分期比较差异有统计学意义(P<0.05)。(2)单因素分析结果显示,胃腺癌患者的预后与肿瘤直径、肿瘤位置、手术根治类型、区域淋巴结转移、侵犯深度及p TNM分期有关(P<0.05),胃黏液腺癌患者的预后与手术根治类型、区域淋巴结转移及p TNM分期有关(P<0.05),胃印戒细胞癌患者的预后与区域淋巴结转移、侵犯深度及p TNM分期有关(P<0.05)。(3)将与3种不同病理类型进展期胃癌患者预后有关的因素进一步行Cox多因素分析,结果显示,肿瘤位置(P=0.016)、区域淋巴结转移(P=0.042)、侵犯深度(P=0.021)及p TNM分期(P=0.009)是影响胃腺癌患者预后的独立危险因素,区域淋巴结转移是影响胃黏液腺癌患者预后的独立危险因素(P=0.000),肿瘤侵犯深度(P=0.032)及区域淋巴结转移(P=0.002)是影响胃印戒细胞癌患者预后的独立危险因素。(4)随访时间60个月,胃腺癌患者的中位随访时间为32个月,胃黏液腺癌患者为43个月,胃印戒细胞癌患者为23个月,5年累积生存率胃腺癌患者为30.2%,胃黏液腺癌患者为23.3%,胃印戒细胞癌患者为26.7%。三者生存曲线比较差异无统计学(P=0.131)。结论不同病理类型进展期胃癌患者的临床病理特征有一定的差异,从而影响其预后的因素也不同,但是区域淋巴结转移是影响3种不同病理类型进展期胃癌患者的共同预后因素。 | 朱信强 张明 丁闯 孔令永 陈焰 管文贤 | 2017 | 中国普外基础与临床杂志2017，24，5： | 15 |
| 5 | Preoperative Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio Cannot Predict Lymph Node Metastasis and Prognosis in Patients with Early Gastric Cancer:a Single Institution Investigation in China显示文摘In the present study,we aimed at exploring the applied value of preoperative neutrophil lymphocyte ratio(NLR) and platelet lymphocyte ratio(PLR) in the prediction of lymph node metastasis(LNM) and prognosis in patients with early gastric cancer(EGC).We retrospectively analyzed a total of 248 consecutive patients who underwent curative gastrectomy to be identified T1 stage gastric adenocarcinoma between January 1,2010 and May 1,2016 in a single institution.According to median preoperative NLR and PLR value,we divided the patients into four groups:high NLR ≥1.73 and low NLR <1.73,high PLR ≥117.78 and low PLR <117.78.Furthermore,to evaluate the relationship between preoperative NLR and PLR values,we categorized patients according to cutoff preoperative NLR-PLR score of 2 [high NLR(≥1.73) and high PLR(≥117.78)],1 [either high NLR or high PLR],and 0 [neither high NLR nor high PLR].Statistical analyses were conducted using SPSS 20.0 software.The results showed that the preoperative NLR or PLR values,lower or higher,could not predict the LNM in patients with EGC(both P=0.544>0.05).The invasive depth of tumor was significantly correlated with LNM of EGC(P<0.001).Kaplan-Meier plots illustrated that preoperative NLR and PLR values were not associated with overall survival(OS) in patients with EGC.It was concluded that the preoperative NLR and PLR may be the predictors for LNM and prognosis in patients with advanced gastric cancer;nevertheless,they cannot predict LNM and prognosis in patients with EGC. | 朱光胜 田少博 王辉 麻懋光 刘亚 杜寒松 龙跃平 | 2018 | Journal of Huazhong University of Science and Technology(Medical Sciences)2018，38，1： | 13 |
| 6 | Factors predicting survival in patients with proximal gastric carcinoma involving the esophagus显示文摘AIM:To investigate the clinicopathologic features which predict surgical overall survival in patients with proximal gastric carcinoma involving the esophagus (PGCE).METHODS:Electronic pathology database established in the Department of Pathology of the Nanjing Drum Tower Hospital was searched for consecutive resection cases of proximal gastric carcinoma over the period from May 2004 through July 2009.Each retrieved pathology report was reviewed and the cases with tumors crossing the gastroesophageal junction line were selected as PGCE.Each tumor was re-staged,following the guidelines on esophageal adenocarcinoma,according to the 7th edition of the American Joint Commission on Cancer Staging Manual.All histology slides were studied along with the pathology report for a retrospective analysis of 13 clinicopathologic features,i.e.,age,gender,Helicobacter pylori (H.pylori ) infection,surgical modality,Siewert type,tumor Bormann's type,size,differentiation,histology type,surgical margin,lymphovascular and perineural invasion,and pathologic stage in relation to survival after surgical resection.Prognostic factors for overall survival were assessed with uniand multi-variate analyses.RESULTS:Patients' mean age was 65 years (range:47-90 years).The male:female ratio was 3.3.The 1-,3and 5-year overall survival rates were 87%,61% and 32%,respectively.By univariate analysis,age,male gender,H.pylori ,tumor Bormann's type,size,histology type,surgical modality,positive surgical margin,lymphovascular invasion,and pT stage were not predictive for overall survival;in contrast,perineural invasion (P = 0.003),poor differentiation (P = 0.0003),> 15 total lymph nodes retrieved (P = 0.008),positive lymph nodes (P = 0.001),and distant metastasis (P = 0.005) predicted poor post-operative overall survival.Celiac axis nodal metastasis was associated with significantly worse overall survival (P = 0.007).By multivariate analysis,≥ 16 positive nodes (P = 0.018),lymph node ratio > 0.2 (P = 0.003),and overall pathologic stage (P = 0.002) were independent predictors for poor overall survival after resection.CONCLUSION:Patients with PGCE showed worse overall survival in elderly,high nodal burden and advanced pathologic stage.This cancer may be more accurately staged as gastric,than esophageal,cancer. | Yi-Fen Zhang Jiong Shi Hui-Ping Yu An-Ning Feng Xiang-Shan Fan Gregory Y Lauwers Hiroshi Mashimo Jason S Gold Gang Chen Qin Huang | 2012 | World Journal of Gastroenterology2012，18，27： | 12 |
| 7 | 术前外周血中性粒细胞和淋巴细胞比值与血小板和淋巴细胞比值评估胃癌患者淋巴结转移的价值显示文摘胃癌是一种高度恶性的消化道肿瘤,是全球肿瘤第四常见类型及第三大肿瘤死亡原因。随着外科手术的发展和肿瘤多学科诊疗技术的进步,胃癌的临床预后已经较前大有改善。 | 夏挺松 刘兵团 王芳军 仲芹芹 徐洪明 黄建明 刘鹏飞 | 2017 | 中华消化杂志2017，37，11： | 12 |
| 8 | Normal carcinoembryonic antigen indicates benefit from perioperative chemotherapy to gastric carcinoma patients显示文摘AIM:To evaluate pretreatment serum carcinoembryonic antigen(CEA) as a predictor of survival for patients with locally advanced gastric cancer receiving perioperative chemotherapy.METHODS:We retrospectively studied a cohort of 228 gastric cancer patients who underwent D2 gastrectomy combined with chemotherapy at the Sun Yat-sen University Cancer Center between January 2005 and December 2009.Among them,168 patients received 6-12 cycles of oxaliplatin-based adjuvant(post-operative) chemotherapy,while 60 received perioperative chemotherapy(2 cycles of FOLFOX6 or XELOX before surgery and 4-10 cycles after surgery).Serum CEA was measured using an enzyme immunoassay.The followup lasted until December 2010.RESULTS:In the group that had elevated serum CEA,the difference in survival time between patients receiving perioperative chemotherapy and those receiving adjuvant chemotherapy had no statistical significance(P > 0.05).However,in the group that had normal serum CEA,patients receiving perioperative chemotherapy had a longer survival time.In multivariate analysis,T staging and lymph node metastatic rate were independent prognostic factors for the patients.Perioperative chemotherapy improved the overall survival of patients who had a normal pretreatment CEA level(P = 0.070).CONCLUSION:Normal pretreatment serum CEA is a predictor of survival for patients receiving perioperative chemotherapy. | Shi Chen Ying-Bo Chen Yuan-Fang Li Xing-Yu Feng Zhi-Wei Zhou Xiu-Hong Yuan Chao-Nan Qian | 2012 | World Journal of Gastroenterology2012，18，29： | 12 |
| 9 | 经动脉灌注化疗联合SOX全身化疗方案治疗进展期胃癌的临床效果研究显示文摘目的探讨经动脉灌注化疗(介入治疗)联合SOX全身化疗方案治疗进展期胃癌(AGC)的临床疗效和安全性。方法选取2008年1月—2009年12月青海大学附属医院肿瘤科收治的初诊为AGC的患者86例,按随机数字表法分为对照组和观察组各43例,对照组患者接受单纯SOX全身化疗方案,观察组患者接受介入治疗联合SOX全身化疗方案,21 d为1个周期,按照WHO实体瘤的疗效评价标准(RECIST)评价近期临床疗效,按照WHO抗肿瘤治疗毒副作用标准进行毒副作用评价。从术后第1个月开始每个月进行门诊随访或电话随访直至患者去世,比较两组患者的生存曲线,评价远期临床疗效。结果观察组和对照组患者的治疗有效率分别为76.7%(33/43)和53.5%(23/43),差异有统计学意义(χ2=5.119,P<0.05)。两组患者毒副作用发生率比较,差异均无统计学意义(P>0.05)。两组患者的中位总生存时间分别为300.0 d和377.5 d,两组生存曲线比较,差异有统计学意义(χ2=7.118,P=0.007)。结论介入治疗联合SOX全身化疗方案的近期临床疗效和远期临床疗效均优于单纯SOX全身化疗方案,并且安全性与之相当,值得临床推荐。 | 雷进元 | 2015 | 中国全科医学2015，18，5： | 11 |
| 10 | Ⅱ~Ⅲ期老年结肠癌患者行根治手术辅助化疗的预后分析显示文摘目的探讨结肠癌根治术辅助化疗对老年Ⅱ~Ⅲ期结肠癌患者的预后影响。方法将78例结肠癌患者按照是否化疗分为观察组38例和对照组40例。对照组患者只进行根治术,观察组患者在根治术后进行辅助化疗。观察2组患者的生命质量评价以及1年生存率、3年生存率和复发转移率。结果对照组患者的GLQI总分、生理功能状态及症状与体征评分均显著低于治疗前,且对照组患者治疗后的GLQI总分、生理功能状态及症状与体征评分也明显低于观察组患者,差异均具有统计学意义(P<0.05)。2组患者的1年生存率比较无明显差别(P>0.05),但是观察组患者的3年生存率明显高于对照组患者,且观察组患者的复发转移率显著低于对照组患者,差异均具有统计学意义(P<0.05)。结论在腹腔镜根治术后辅助化疗治疗,能提高患者的3年生存率,改善患者生命质量,并且能降低复发转移的风险。 | 陈建新 乔建国 | 2015 | 实用癌症杂志2015，30，6： | 11 |
| 11 | Carcinoma of the gastroesophageal junction in Chinese patients显示文摘Carcinoma of the gastroesophageal junction(GEJ) is defined as carcinoma that crosses the GEJ line,irrespective of where the tumor epicenter is located.This group of cancer is rare but controversial.Based on study results from the majority of epidemiologic and clinicopathologic investigations carried out in Western countries,this cancer is believed to arise from Barrett's esophagus(BE) and includes both distal esophageal and proximal gastric carcinomas because of similar characteristics in epidemiology,clinicopathology,and molecular pathobiology in relation to BE.As such,the most recent American Joint Committee on Cancer staging manual requires staging all GEJ carcinomas with the rule for esophageal adenocarcinoma(EA).This mandate has been challenged recently by the data from several studies carried out mainly in Chinese patients.The emerging evidence derivedfrom those studies suggests:(1) both BE and EA are uncommon in the Chinese population;(2) almost all GEJ cancers in Chinese arise in the proximal stomach and show the features of proximal gastric cancer,not those of EA;(3) application of the new cancer staging rule to GEJ cancer of Chinese patients cannot stratify patients' prognosis effectively;and(4) prognostic factors of GEJ cancer in Chinese are similar,but not identical,to those of EA.In conclusion,the recent evidence suggests that GEJ cancer in Chinese shows distinct clinicopathologic characteristics that are different from EA.Further investigations in molecular pathology may help illustrate the underlying pathogenesis mechanisms of this cancer in Chinese patients and better manage patients with this fatal disease. | Qin Huang | 2012 | World Journal of Gastroenterology2012，18，48： | 10 |
| 12 | 胃癌患者术前中性粒细胞与淋巴细胞比与临床病理特征及预后关系显示文摘目的:探讨胃癌患者术前中性粒细胞与淋巴细胞比(NLR)与临床病理特征及预后的关系。方法:回顾性分析2010年1月-2011年1月安徽医科大学第一附属医院收治的269例胃癌患者的临床病理及随访资料。根据受试者工作特征曲线,确定NLR的截断值为2.4(敏感性:53.3%,特异性:71.4%),将患者分为低NLR组(NLR〈2.4,153例)和高NLR组(NLR≥2.4,116例),比较两组患者临床病理特征及生存率的差异,并分析胃癌患者的预后因素。结果:比较结果显示,两组年龄、性别、淋巴结转移无明显差异(均P〉0.05),但高NLR组较低NLR组肿瘤直径大、肿瘤浸润深度深、TNM分期高(均P〈0.05);全组患者5年总生存率为44.3%,生存分析显示,高NLR组患者总生存率明显低于低NLR组(χ2=17.511,P〈0.01);单因素分析结果表明,术前NLR、肿瘤大小、肿瘤浸润深度和TNM分期与胃癌患者总生存率有关(均P〈0.05),多因素分析显示,NLR和肿瘤大小为影响胃癌患者预后的独立因素(均P〈0.05)。结论:术前NLR是影响胃癌患者预后的独立预测因素,高术前NLR值提示胃癌患者有较差的临床病理情况及生存预后。 | 韩文秀 徐阿曼 张理想 陈章明 | 2016 | 中国普通外科杂志2016，25，10： | 9 |
| 13 | A novel nomogram individually predicting disease-specific survival after D2 gastrectomy for advanced gastric cancer显示文摘Background:Few studies have shown nomograms that may predict disease-specific survival(DSS)probability after curative D2 gastrectomy for advanced gastric cancer(AGC),particularly among Chinese patients.This study sought to develop an elaborative nomogram that predicts long-term DSS for AGC in Chinese patients.Methods:A retrospective study was conducted on 6753 AGC patients undergoing D2 gastrectomy between January 1,2000 and December 31,2012 from three large medical hospitals in China.We assigned patients from Sun Yat-sen University Cancer Center to the training set,and patients from the First Affiliated Hospital of China Medical University and Tianjin Medical University Cancer Hospital to two separate external validation sets.A multivariate survival analysis was performed using Cox proportional hazards regression model in a training set,and a nomogram was constructed.Harrell’s C-index was used to evaluate discrimination and calibration plots were used to validate similarities between survival probabilities predicted by the nomogram model and actual survival rates in two validation sets.Results:The multivariate Cox regression model identified age,tumor size,location,Lauren classification,lymphatic/venous invasion,depth of invasion,and metastatic lymph node ratio as covariates associated with survival.In the training set,the nomogram exhibited superior discrimination power compared with the 8th American Joint Com-mittee on Cancer TNM classification(Harrell’s C-index,0.82 vs.0.74;P<0.001).In two validation sets,the nomogram’s discrimination power was also excellent relative to TNM classification(C-index,0.83 vs.0.75 and 0.81 vs.0.74,respec-tively;P<0.001 for both).After calibration,the nomogram produced survival predictions that corresponded closely with actual survival rate.Conclusions:The established nomogram was able to predict 3-,5-,and 10-year DSS probabilities for AGC patients.Validation revealed that this nomogram exhibited excellent discrimination and calibration capacity,suggesting its clinical utility. | Wei Wang Zhe Sun Jing-Yu Deng Xiao-Long Qi Xing-Yu Feng Cheng Fang Xing-Hua Ma Zhen-Ning Wang Han Liang Hui-Mian Xu Zhi-Wei Zhou | 2018 | Cancer Communications2018，38，1： | 8 |
| 14 | 多种炎性反应指标在胃癌术后患者生存时间的评价及系统炎性标志物评分构建研究显示文摘目的:癌症患者的预后不仅取决于肿瘤相关因素,还取决于宿主相关因素,特别是全身炎性反应。基于中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)及淋巴细胞与单核细胞比值(LMR)构建预测胃癌(GC)根治性切除术后患者生存时间的系统炎性标志物评分(SIMS)。方法:选取青海省交通医院、青海省红十字医院2011年1月至2017年1月行根治性切除术治疗的205例GC患者。术前收集患者NLR、PLR及LMR。采用受试者工作特征(ROC)曲线获得NLR、PLR、LMR最佳截断值并构建SIMS。单因素及多因素Cox风险比例模型分析SIMS的临床价值。结果:所有患者均获得随访,随访时间20~65(63.47±10.36)个月,中位生存时间56个月。1年病死率6.3%,3年病死率26.2%,5年病死率34.6%。NLR、PLR、LMR的曲线下面积(AUC)分别为0.745、0.805、0.866,最佳截断值分别为3.11、144、3.34。NLR>3.11、PLR>144、LMR≤3.34患者的病死率高于NLR≤3.11、PLR≤114、LMR>3.34的患者(χ2=10.491、14.658、38.765,P<0.01);不同NLR、PLR、LMR分组间生存曲线比较差异均有统计学意义(P<0.05)。SIMS不同评分的生存曲线比较差异有统计学意义(P<0.05)。年龄(HR=1.358,95%CI 1.153~1.599)、T分期-T 3(HR=2.739,95%CI 1.200~6.248)、T分期-T 4(HR=3.013,95%CI 1.312~6.920)、N分期-N 2(HR=5.832,95%CI 2.974~11.455)、病理分期-Ⅲ期(HR=2.962,95%CI 1.835~4.646)、淋巴血管侵犯(HR=1.813,95%CI 1.274~3.642)、SIMS-1分(HR=7.065,95%CI 4.673~10.692)、SIMS-2分(HR=7.885,95%CI 4.991~12.435)、SIMS-3分(HR=8.365,95%CI 5.635~3.485)是GC患者死亡的独立危险因素(P<0.05)。结论:成功构建出SIMS且证实术前SIMS是GC患者一个较容易获得且价格低廉的预后指标,可以作为术前评估GC患者生存时间的方法。 | 马文良 白华千 李富秀 | 2020 | 中国医师进修杂志2020，43，11： | 7 |
| 15 | 转移相关基因2在胃癌中的表达及其与核转录因子Sp1的相关性显示文摘目的观察转移相关基因2(MTA2)在胃癌组织中的表达特征,明确MTA2表达与核转录因子Sp1表达的相关性。方法采用免疫组织化学染色技术(IHC)和逆转录-聚合酶链式反应(RT-PCR)法,检测83例手术切除的胃癌原发灶和对应癌旁胃黏膜组织中MTA2的表达情况。采用IHC方法检测上述标本中核转录因子Sp1的表达。结果MTA2在胃癌组织中的阳性表达率为31.3%,明显高于癌旁胃黏膜组织(12.0%),差异有统计学意义(P〈0.01)。MTA2阳性与胃癌的浸润深度相关(X^2=5.677,P〈0.05),但与患者的性别、年龄、分化程度、Lauren分型、淋巴结转移、远处转移和TNM分期无明显相关。MTA2的表达与胃癌组织中核转录因子Sp1的表达有关(r=0.320,P〈0.05),MTA2在Sp1阳性表达的胃癌组织中的表达率显著高于Sp1阴性表达者(X2:9.565,P〈0.01)。RT-PCR检测结果显示,在Sp1高表达的胃癌组织中,MTA2 mRNA表达水平升高。结论MTA2在胃癌组织中的表达率高于癌旁胃黏膜组织,并与胃癌的浸润深度相关。MTA2在核转录因子Sp1阳性胃癌组织中呈高度表达,可能与Sp1的转录调控有关。 | 周尘飞 计骏 袁菲 于颖彦 刘炳亚 张俊 朱正纲 | 2012 | 中华肿瘤杂志2012，34，8： | 7 |
| 16 | 胃癌新辅助化疗的研究进展显示文摘我国是胃癌高发病率的国家之一,全球40%以上的胃癌新发病例发生在我国.据我国2015年癌症统计数据显示,胃癌发生率仅次于肺癌,也是恶性肿瘤死亡的第二大病因.在过去的几十年里,我国胃癌患者的生存率有明显提高,在大型医院,胃癌的5年生存率从40.1%提高到57.6%.近年来,人们对胃癌的研究逐渐深入,胃癌的治疗模式从单一的手术治疗进入多学科团队的新治疗模式.新辅助化疗具有降低肿瘤分期.提高R0切除率等优势,成为近几年研究的热点.本文就胃癌新辅助化疗的研究进展做一综述. | 彭良群 张斌 杨巍 张占东 刘洪兴 花亚伟 | 2017 | 河南医学研究2017，26，5： | 6 |
| 17 | 785例胃癌根治术后预后的多因素分析显示文摘目的探讨影响胃癌根治术后预后的相关因素。方法应用Cox模型单因素及多因素分析实施根治性胃癌切除术患者785例临床资料。结果单因素及多因素分析表明患者的淋巴结转移、大体分型、pTNM分期、中性粒细胞-淋巴细胞比率(NLR)及分化程度是胃癌预后的独立因素,肿瘤大小、胃切除量及浸润深度是胃癌预后的影响因素。结论 NLR是胃癌预后的独立因素,有潜在应用前景。 | 鲁明典 李永翔 | 2014 | 安徽医科大学学报2014，49，11： | 6 |
| 18 | Ⅲ期胃癌患者根治术后复发转移特征及预后影响因素显示文摘目的探讨Ⅲ期胃癌(GC)患者行GC根治术后复发转移的特征及预后影响因素。方法选取行GC根治术的Ⅲ期GC患者181例为研究对象,收集患者临床资料[性别、年龄、Tumor-Node-Metastasis(TNM)分期、N分期,肿瘤部位];分别于术前1周及术后转移时采集所有患者空腹静脉血,采用迈瑞6800血球分析仪检测患者常规血液指标及血小板(PLT),用罗氏Cobas c702全自动生化分析仪和罗氏Cobas e602电化学发光免疫分析仪检测患者血清总蛋白(TP)、白蛋白(ALB)和甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原199(CA199)、糖类抗原153(CA153)、糖类抗原242(CA242);术后随访2~80个月,记录患者发生复发转移部位和时间;根据术后是否发生复发转移,将患者分为复发转移组(n=30)与无复发转移组(n=151),比较2组患者术前上述血液生化指标,比较复发转移组Ⅲ期GC患者转移前、后血清CEA、CA125、CA199水平;运用Cox单因素及多因素分析影响Ⅲ期GC患者预后的危险因素,采用Kaplan-Meier(K-M)法分析Ⅲ期GC患者术后1、2及3年的总体生存率。结果约90%的复发转移Ⅲ期GC患者于术后0~24个月内出现复发转移者,这些患者术前血清TP、ALB低于无复发转移组(P<0.05),且发生复发转移后血清CEA、CA125、CA199水平较转移前升高(P<0.05);术前血清CA125含量≥35 kU/L(HR=3.508,95%CI为1.548~7.950)、术后复发转移(HR=2.613,95%CI为1.576~4.333)是Ⅲ期GC术后患者预后的独立危险因素(P<0.05),且复发转移组Ⅲ期GC患者的中位生存时间低于无复发转移组(P<0.001)。结论术前低水平血清TP、ALB是Ⅲ期GC患者术后出现复发转移的危险因素;术前高水平血清CA125(CA125含量≥35 kU/L)、术后复发转移是Ⅲ期GC术后患者预后的不良因素。 | 李红羽 夏英 韦四喜 杜洪 袁婷 金泳 黄海 | 2021 | 贵州医科大学学报2021，46，12： | 4 |
| 19 | 参附注射液联合卡培他滨、奥沙利铂治疗胃癌的疗效观察显示文摘目的观察参附注射液在晚期胃癌联合卡培他滨和奥沙利铂(XELOX)化疗方案中的作用。方法将135例胃癌患者随机分为观察组和对照组,观察组67例患者同时予参附注射液加XELOX方案化疗;对照组68例予单纯XELOX方案化疗。每3周重复1次,化疗3个疗程后评价不良反应和生活质量。结果观察组有效率44.8%(30/67),对照组有效率47.1%(32/68),两组比较差异无显著性(P=0.790);不良反应(包括贫血和恶心呕吐)观察组明显少于对照组(P<0.05);KPS评分改善率分别是49.3%和32.3%(P=0.046)。结论参附注射液联合XELOX方案治疗晚期胃癌,可明显减轻化疗药物所产生的贫血和恶心呕吐不良反应,提高患者生活质量。 | 李丕宏 卢明东 孙维建 俞耀军 王飞海 郑志强 陈力 | 2012 | 中国现代医生2012，50，36： | 4 |
| 20 | High mobility group-box 3 overexpression is associated with poor prognosis of resected gastric adenocarcinoma显示文摘AIM:To elucidate high mobility group-box 3(HMGB3) protein expression in gastric adenocarcinoma,its potential prognostic relevance,and possible mechanism of action.METHODS:Ninety-two patients with gastric adenocarcinomas surgically removed entered the study.HMGB3 expression was determined by immunohistochemistry through a tissue microarray procedure.The clinicopathologic characteristics of all patients were recorded,and regular follow-up was made for all patients.The inter-relationship of HMGB3 expression with histological and clinical factors was analyzed using nonparametric tests.Survival analysis was carried out by Kaplan-Meier(log-rank) and multivariate Cox(Forward LR) analyses between the group with overexpression of HMGB3 and the group with low or no HMGB3 ex-pression to determine the prognosis value of HMGB3 expression on overall survival.Further,HMGB3 expression was knocked down by small hairpin RNAs(shRNAs) in the human gastric cancer cell line BGC823 to observe its influence on cell biological characteristics.The MTT method was utilized to detect gastric cancer cell proliferation changes,and cell cycle distribution was analyzed by flow cytometry.RESULTS:Among 92 patients with gastric adenocarcinomas surgically removed in this study,high HMGB3 protein expression was detected in the gastric adenocarcinoma tissues vs peritumoral tissues(P < 0.001).Further correlation analysis with patients' clinical and histology variables revealed that HMGB3 overexpression was obviously associated with extensive wall penetration(P = 0.005),a positive nodal status(P = 0.004),and advanced tumor-node-metastasis(TNM) stage(P = 0.001).But there was no correlation between HMGB3 overexpression and the age and gender of the patient,tumor localization or histologic grade.Statistical Kaplan-Meier survival analysis disclosed significant differences in overall survival between the HMGB3 overexpression group and the HMGB3 no or low expression group(P = 0.006).The expected overall survival time was 31.00 ± 3.773 mo(95%CI = 23.605-38.395) for patients with HMGB3 overexpression and 49.074 ± 3.648 mo(95%CI = 41.925-57.311) for patients with HMGB3 no and low-level expression.Additionally,older age(P = 0.040),extensive wall penetration(P = 0.008),positive lymph node metastasis(P = 0.005),and advanced TNM tumor stage(P = 0.007) showed negative correlation with overall survival.Multivariate Cox regression analysis indicated that HMGB3 overexpression was an independent variable with respect to age,gender,histologic grade,extent of wall penetration,lymph nodal metastasis,and TNM stage for patients with resectable gastric adenocarcinomas with poor prognosis(hazard ratio = 2.791,95%CI = 1.233-6.319,P = 0.019).In the gene function study,after HMGB3 was knocked down in the gastric cell line BGC823 by shRNA,the cell proliferation rate was reduced at 24 h,48 h and 72 h.Compared to BGC823 shRNA-negative control(NC) cells,the cell proliferation rate in cells that had HMGB3 shRNA transfected was significantly decreased(P < 0.01).Finally,cell cycle analysis by FACS showed that BGC823 cells that had HMGB3 knocked down were blocked in G1/G0 phase.The percentage of cells in G1/G0 phase in BGC823 cells with shRNA-NC and with shRNA-HMGB3 was 46.84% ± 1.7%,and 73.03% ± 3.51% respectively(P = 0.001),whereas G2/M cells percentage decreased from 26.51% ± 0.83% to 17.8% ± 2.26%.CONCLUSION:HMGB3 is likely to be a useful prognostic marker involved in gastric cancer disease onset and progression by regulating the cell cycle. | Hua-Rong Tang Xian-Qin Luo Gang Xu Yan Wang ZhiJun Feng Hui Xu Ya-Wei Shi Qin Zhang Li-Guang Wu Chun-Quan Xue Cheng-Wei Wang Chao-Yang Wu | 2012 | World Journal of Gastroenterology2012，18，48： | 2 |
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