Objective　To study the preventive effect of hepatic metastasis from colorectal cancer and the immune function influence on postoperative patients with colorectal cancer treated by TIL, rIL-2 and cyclophosphamide by portal vein infusion. Methods　One hundred and twenty-four patients with advanced colorectal cancer (Dukes B and Dukes C stage) were randomly divided into immunotherapy group and control group. The control group were treated with 5-Fu and MMC by intravenous injection after resection of colorectal cancer. The immunotherapy group were treated with TIL, rIL-2 and cyclophosphamide by portal vein infusion after resection of the tumor, then with chemotherapy as the control group. All cases were followed-up for 3 years. Results　Eight cases (12.3%) had hepatic metastases from colorectal cancer in the immunotherapy group, but nineteen cases (33.2%) in the control group. There was significant difference between the two groups (P>0.05). The NK, IL-2 activity and CD3, CD4, CD4/CD8 levels in peripheral blood of the immunotherapy group increased significantly after treatment (P<0.05). Conclusions　The TIL, rIL-2 and cyclophosphamide treatment after resection of colorectal cancer is effective in improving antitumorgenic immune function, and preventing hepatic metastases.

Objective　To evaluate the significance of combined therapy for advanced gastric carcinoma (AGC). Methods　To introduce the combined therapy for AGC based on home-and-abroad literalures review combiation with author's clinical experience.Results and Conclusions　 Most patients with gastric carcinoma are AGC in China, the 5-year survival rate after operation is 20% to 30%, and surgery along is not the satisfactory therapy of gastric carcinoma. Therefore, AGC must be treated with combined therapy which includes surgery, chemical therapy and biologic therapy, etc. The concept of radical operation AGC should be renewed: (1) Adequately resection of primary carcinoma and surounding tisusses; (2) resecting perigastric lymph nodes; (3) eliminating the cells falling away the tumor in abdominal cavity completely. The first two cases need standard operation, which should be introduced. Intraperitoneal chemotherapy should be carried out after operation in the third case. Palliative operation and surgery for perforated gastric carcinoma will prolong survival period of the patient with AGC.

Objective　To investigate the effect of total gastrectomy for gastric malignancy(GM). Methods　The clinical data of total gastrectomy in 113 patients with GM were analysed retrospectively. Results　Radical total gastrectomy was performed in 97 cases, palliative total gastrectomy in 16 cases, combined with resection of head or tail of pancreas, splenectomy, transverse colectomy or parital hepatectomy in 19 cases. Reconstruction of digestive tract : Roux-en-Y esophagojejunostomy in 26 cases, Braun esophagojejunostomy in 19 cases, Roux-en-Y jejunal p-type anastomosis in 68 cases, Postopterative complications occurred in15 cases,including pancreatic fistula in one cases,anastomostic leakage in 3; operative death was happened in 2 cases.　86 patients (76%)have been followed up, the postoperative 1-,3-,5-year survival rate in radical total gastrectomy, combined resection organs and palliative total gastrectomy was 77.9％,45.7％,37.2％;88.8％,55.5％,33.3％; and 80％,0％,0％ respectively. Conclusions　The effect of total gastrectomy for gastric malignancy can be successful, if the indications are stricted and combined with rational viscers resection.

Objective　To study the diagnosis and treatment of perforated gastric cancer(PGC). Methods　The clinical data of 43 patients with PGC proved pathologically were analysed retrospectively; Results　The diagnosis rate preoperatively was 30.2%(13 cases), misdiagonsis rate 69.8% (30 cases, including 2 misdiagonsed intraoperatively); 21 underwent simple suture closure of the perforation, among whom, 4 died (19.1%), 8 had hematemesis and melanorragia (38.1%), 3 reperforation (1.4%) after operation; mean survival period was 5 months. 9 cases had palliative gastrectomy, 1 died, while 1 had hematemesis after operation; mean survival period 18 months. 13 cases had radical gastrectomy, none of them had postoperative complication or death, mean survival period 27 months, 3 surrived for 5 years（23.1%）. 2 delyed diagnosis underwent simple suture closure at first, but had extensive metastasis at reoperation. Conclusions　Comprehensive analysis of clcnical data made before operation and attenton paid to the signs of PGC during operation can enhance the diagnosis rate of PGC. Simple suture closure of the perforation has more complications, and the survival time is shorter . Once PGC gastric cancer is diagnosed , radical or palliative gastrectomy should be performed.

Objective　To investigate the effect of intratumor injection of 131I-3H11 for gastric cancer (GC). Methods　16 patients with GC subjected to endoscopic intratumor injection of 131I-3H11 as a treatment group; 6 GC patients with FAM chemotherapy as a control group. Histological examination of the postoperative specimens of the two group were comparated. Results　In treatment group, 75.0%(12/16) of cases were found to have morphological changes with karyopyknosis, karyorrhexis, coagulation of cytoplasm, and invasion of lymphocyte in mesochyma. Most of these changes were medial; but in control group no obvious morphological change was found. Conclusions　The results suggest that GC subjected to endoscopic intratumor injection of 131I-3H11 preoperatively has promising application in the clinic.

Objective　To study the effect of regional arterial chemotherapy (RACT) on unresectable gastric carcinoma (URGC). Methods　The clinical data of 100 patients with URGC treated by RACT were retrospectively analysed. Results　In addition to different degree of symptoms improvement, the size of gastric cancer became smaller in 81.2% of the cases, and the survival time of patients had been prolonged (mean 29.5 months). Conclusions　RACT is more effective for treating URGC and worthly of further clinical study.

Objective　To evalute long-term effect of combined therapy (radical or palliative resection of carcer and intraperitoneal hyperthermic perfusion (IPHP) chemotherapy) for advenced garstric cancer (GC) from October 1987 to October 1997 in our haspital. The cases were randomly divided into two groups: IPHP group (37 cases) and control group (34 cases). In IPHP group, before suture the abdomine, heated 5-Fu solution in abdominal cavity should be maintained at 42～43℃ for 60 minutes. Results　After IPHP chemotherapy, 12 patients with cancer cells widespreading in abdominal carity, refractable ascites were disappeared. All the patients were dischargd after IPHP. The 5-year survival rate in IPHP group (51.6%) was significanfly highter than that in control group (32.3%) (P<0.05).

Objective　To study the experience in surgical treatment of gastric mucosa-associated lymphoid tissue lymphoma (GMALTL). Methods　The clinical data of 69 cases of GMALTL from 1984 to 1996 were reviewed. Results　In this series, there were 26 cases in stage Ⅰ, 21 in stageⅡ, 13 in stage Ⅲ and 9 in stage Ⅳ. Diagnosis was proved by both surgery and pathology in all the cases. 61 cases underwent curative resection, 4 incomplete resect and 4 unresectable. Among them, 5 cases were treated by surgery only, surgery plus postoperative radiotherapy used in 25 cases, 19 received surgery plus postoperative chemotherapy, and 20 cases received surgery plus chemotherapy and radiotherapy. 57 cases (82.6%) were following up for 1 to 12 years.The 5,10-year survival rate was 71%(49/69)and 31.9%(22/69) respectively. Conclusions　Clinical stage and therapeutic modality adopted do the major prognostic foctors ,while age and gender do not count much to the recovery. Surgery remains to be the most important treatment model.

Objective　To evaluate the correlation between vascular endothelial growth factor(VEGF) expression and microvessel density(MVD) in gastric carcinoma (GC) and the relationship of VEGF and MVD with clinicopathologic characteristics and prognosis of GC. Methods　The expression of VEGF and intratumoral microvessel density (MVD) in one hundred and sixteen resected specimens of the patients with GC were observed and counted, and the relationship of VEGF and MVD with clinicopathologic factors and prognosis of GC were analysed. Results　The expression of VEGF was found in 60.34% of the specimens. The MVD value was much higher in VEGF(+) group than that in VEGF(-) group (26.16±8.50 and 19.22±8.20, respectively, P<0.01). Expression of VEGF was significantly higher in patients with lymph node metastasis than that in patients without lymph node metastasis (p<0.05).Expression of VEGF was highly correlated with the stage of tumor (P<0.05). MVD correlated with lymph node metastasis (P<0.01) and abdomen metastasis (P<0.01) and increased with the TNM stage (P<0.01). The total five-year survival rate in VEGF(-) group and low MVD group were significantly higher than that in VEGF(+) group and high MVD group respectively(both P<0.01). Multivariate analysis indicated that the expression of VEGF and MVD were independent prognostic factors of GC. Conclusions　The expression of VEGF and MVD can reflect the malignant degree of GC. They may serve as the prognostic factors and guide the decisions on the therapy.

Objective　To study the relationship between the biologic behaviours of gastric carcinoma (GC) and the immune reaction cells of GC tissue. Methods　One hundred and seven radical gastrectomy specimens and 3 to 8 years follow-up data were quantitatively assessed on the reactive degree of lymph-plasma cells and eosinophils with CMIAS image analysis system. Mast cell reaction was accounted in the low power microscopy. Each indicator was divided into two groups, high reaction group and low reaction group, according to the intensity of reactions. Both high reaction and low reaction group were analysed on the base of clinicopathologic parameters. Results　There was a significant difference in the survival time, depth of tumour invasion and lymph node metastasis in GC tissue between high reaction group and low reaction group (P<0.05). Conclusions　Local immune reaction cells plays an important role in the defense mechanism of GC host against the tumour cells invising and spreading.