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| 1 | 我国早期胃癌的外科治疗现状和面临的若干问题显示文摘随着我国经济社会发展和人民健康意识的提升,我国胃癌的早期诊断率不断提升。外科手术治疗作为早期胃癌的有效治疗手段,在早期胃癌的治疗中发挥着越来越重要的作用。在确保早期胃癌R0切除的前提下,尽可能保存残胃功能、降低对胃癌病人术后生活质量的影响,是早期胃癌外科治疗的研究主线。随着越来越多临床研究的发表,早期胃癌的功能保留手术已逐渐被大家所接受。尽管如此,早期胃癌的外科治疗仍有一些问题亟待解决。此文结合北京大学肿瘤医院对于早期胃癌的临床诊疗经验,对我国早期胃癌外科治疗的现状和面临的若干问题进行评述。 | 杨雪松 季科 季加孚 | 2022 | 腹部外科2022，35，6： | 6 |
| 2 | 腹腔镜下保留幽门胃切除术与远端胃切除术治疗早期胃癌的疗效观察显示文摘目的 探讨腹腔镜下保留幽门胃切除术与远端胃切除术治疗早期胃癌的临床疗效。方法 前瞻性选取2018年7月至2020年12月间武警河南总队医院收治的72例早期胃癌患者,采用随机数字表法分为观察组和对照组,每组36例。对照组患者采用远端胃切除术治疗,观察组患者采用腹腔镜下保留幽门胃切除术治疗,比较两组患者的治疗效果、生存率及生存时间。结果 两组患者淋巴结清扫数目和术中出血量比较,差异无统计学意义;观察组患者术后排气时间和首次排便时间均短于对照组,术中耗时长于对照组,差异均有统计学意义(均P<0.05)。术后,观察组患者各时间段消化病生存质量指数评分均高于对照组,患者主观整体评估评分均低于对照组,差异均有统计学意义(均P<0.05)。术后1个月,观察组患者的白介素-6、肿瘤坏死因子-α和C反应蛋白水平均低于对照组,白蛋白和总蛋白均高于对照组,差异均有统计学意义(均P<0.05)。观察组患者1年后生存35例(97.2%),中位生存时间11个月;对照组患者生存30例(83.3%),中位生存时间10个月,两组比较,差异有统计学意义(P<0.05)。观察组患者并发症发生率为5.6%(2例),对照组为30.6%(11例),两组比较,差异有统计学意义(P<0.05)。结论 早期胃癌患者采用腹腔镜下保留幽门胃切除术治疗,能更好促使胃肠道功能恢复,提高手术安全性。 | 谢景军 王怀志 王亚利 孙杨 | 2022 | 中国肿瘤临床与康复2022，29，9： | 4 |
| 3 | Tertiary lymphoid structure patterns predicted anti-PD1 therapeutic responses in gastric cancer显示文摘Objective:Recent studies have highlighted the distinct value of tertiary lymphoid structure(TLS)for immunotherapeutic response prediction.However,it remains unclear whether TLS could play such roles in gastric cancer(GC).Methods:In this study,tumor tissue slices from 292 GC patients from Zhongshan Hospital were firstly reviewed to explore the correlation between TLS and clinical characteristics.Subsequently,we curated 38 reported genes that may function as triggers of TLS and performed consensus molecular subtyping in public RNA-seq datasets to determine TLS patterns in GC.Based on the differentially expressed genes acquired from two TLS patterns,we quantified TLS-related genes on the principal component analysis(PCA)algorithm to develop TLS score.A Zhongshan immunotherapy cohort including 13 patients who received programmed cell death 1(PD1)blockade therapy was established to conduct RNA sequencing analysis and multiplex immunohistochemistry(mIHC)tests using formalin-fixed and paraffin-embedded(FFPE)tissues.The corresponding TLS score and immune cell counts were further compared based on therapeutic response variations.Results:Mature TLS was revealed as an independent prognostic factor in 292 GC patients.Patients with higher TLS score was characterized by prolonged survival time and superior response to immunotherapy.TLS score was correlated with immunotherapy-related characters,such as microsatellite instability(MSI)and tumor mutation burden(TMB).In addition,RNA-seq data analysis in the Zhongshan immunotherapy cohort indicated that a higher TLS score was correlated with a superior response to PD1 blockade therapy.mIHC tests also revealed that PD1+CD8+T cell counts were significantly increased in the high-TLS score group.Conclusions:This study highlighted that TLS was significantly associated with immune landscape diversity and complexity.Quantitatively evaluating TLS patterns of individual tumor will strengthen our understanding of TME characteristics and promote more effective immunotherapy strategies. | Quan Jiang Chenyu Tian Hao Wu Lingqiang Min Hao Chen Lingli Chen Fenglin Liu Yihong Sun | 2022 | Chinese Journal of Cancer Research2022，34，4： | 1 |
| 4 | 三种手术方法治疗老年性股骨颈及股骨粗隆间骨折的临床效果比较显示文摘目的:研究适合老年性股骨颈及股骨粗隆间骨折治疗和减少并发症发生的方法。方法:采用回顾性分析的方法,选取我院2019年12月—2021年12月收治的246例老年股骨颈及股骨粗隆间骨折患者,按照骨折类型将其分成接受股骨颈动力交叉钉系统治疗组(FNS组,24例)、股骨近端防旋髓内钉治疗组(PFNA组,49例)及动力型加压髋螺钉组(DHS组,173例),比较三组临床治疗后的并发症发生率、手术时间、骨折愈合时间、术中出血量、生活质量评分及术后活动能力评分比较。结果:股骨颈动力交叉钉系统治疗组所造成的创伤比较小,手术时间、术中出血量、术后并发症发生率均显著低于股骨近端防旋髓内钉治疗组和动力型加压髋螺钉组(P<0.05),而股骨近端防旋髓内钉治疗组与动力型加压髋螺钉组比较,差异无统计学意义(P>0.05);股骨颈动力交叉钉系统治疗组的生活质量评分及活动能力评分高于其他两组(P<0.05)。结论:FNS适用于一型和二型股骨颈骨折的患者,DHS适用于大粗隆外侧皮质完整的患者,PFNA适用于骨折累及粗隆、大粗隆下骨质的患者。 | 刘欢 田鹏 康宇翔 邓中博 刘培佳 | 2022 | 中国中西医结合外科杂志2022，28，6： | 0 |
| 5 | Double-tract reconstruction is superior to esophagogastrostomy in controlling reflux esophagitis and enhancing quality of life after proximal gastrectomy:Results from a prospective randomized controlled clinical trial in China显示文摘Objective:The aim of this study was to prospectively compare double-tract reconstruction(DTR)and esophagogastrostomy(EG)after proximal gastrectomy(PG)regarding the incidence of reflux esophagitis,quality of life(QOL),nutritional status and surgical safety.Methods:This study was a randomized controlled trial.Patients eligible for PG were enrolled and randomly assigned to the EG group and DTR group.The characteristics of patients,parameters for surgical safety,incidence of reflux esophagitis,nutrition status and QOL were collected and compared between the two groups.Univariate analysis and multivariate analysis were performed to determine the significant factors affecting the incidence of reflux esophagitis after PG.Results:Thirty-seven patients of the EG group and 36 patients of the DTR group were enrolled.The incidence of reflux esophagitis was significantly lower in the DTR group than in the EG group(8.3%vs.32.4%,P=0.019).The DTR group demonstrated a more favorable QOL than the EG group after PG.The nutritional status was balanced within the EG group and the DTR group.The operation time was longer in the DTR group than in the EG group(191 min vs.221 min,P=0.001),while surgical safety was similar in the two groups.Conclusions:Our research demonstrated that DTR is superior to EG after PG in terms of the incidence of reflux esophagitis and provides a more satisfactory QOL without increasing surgical complications or sacrificing nutritional status. | Yinan Zhang Hongtao Zhang Yan Yan Ke Ji Ziyu Jia Heli Yang Biao Fan Anqiang Wang Xiaojiang Wu Ji Zhang Jiafu Ji Xin Ji Zhaode Bu | 2023 | Chinese Journal of Cancer Research2023，35，6： | 0 |
| 6 | Characteristics of lymph node stations/basins metastasis and construction and validation of a preoperative combination prediction model that accurately excludes lymph node metastasis in early gastric cancer显示文摘Objective:To explore the candidate indications for function-preserving curative gastrectomy and sentinel lymph node navigation surgery in early gastric cancer(EGC).Methods:The clinicopathological data of 561 patients with EGC who underwent radical gastrectomy for gastric cancer at Peking University Cancer Hospital from November 2010 to November 2020 with postoperative pathological stage pT1 and complete examination data,were collected.Pearson’s Chi-square test was used and binary logistic regression was employed for univariate and multivariate analyses.Combined analysis of multiple risk and protective factors for lymph node metastasis(LNM)of EGC was performed.A negative predictive value(NPV)combination model was built and validated.Results:LNM occurred in 85 of 561 patients with EGC,and the LNM rate was 15.15%.NPV for LNM reached 100%based on three characteristics,including ulcer-free,moderately well differentiation and patient<65years old or tumor located at the proximal 1/3 of the stomach.Regarding lymphatic basin metastasis,multivariate analysis showed that the metastatic proportion of the left gastric artery lymphatic basin was significantly higher in male patients compared with female patients(65.96%vs.38.89%,P<0.05).The proportion of right gastroepiploic artery lymphatic basin metastasis in patients with a maximum tumor diameter>2 cm was significantly greater than that noted in patients with a maximum tumor diameter≤2 cm(60.78%vs.28.13%,P<0.05).Conclusions:Characteristics of lymph node stations/basins metastasis will facilitate precise lymph node resection.The NPV for LNM reaches 100%based on the following two conditions:young and middle-aged EGC patients,well-differentiated tumors,and without ulcers;or well-differentiated tumors,without ulcers,and tumors located in the proximal stomach.These findings can be used as the recommended indications for functionpreserving curative gastrectomy and sentinel lymph node navigation surgery. | Mengyu Feng Jingtao Wei Ke Ji Yinan Zhang Heli Yang Xiaojiang Wu Ji Zhang Zhaode Bu Jiafu Ji | 2022 | Chinese Journal of Cancer Research2022，34，5： | 0 |
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