Nodal metastasis is considered an important modality for the dissemination and staging of gastric cancer. Accurate staging of nodal metastasis improves prognostication and clinical treatment. However, clinical studies have failed to clarify a few issues regarding nodal metastasis from gastric cancer. In this review, we summarize and analyze new findings on the study of nodal metastasis from gastric cancer, and present the current opinions.

Objective To introduce the possible effect of endogenous angiogenesis inhibitive factors in the therapy of hepatocarcinoma.Methods Recent relevant literatures were reviewed. Results Endogenous angiogenesis inhibitive factors can suppress the growth of tumor blood vessels,which might head off the development and metastasis of hepatocarcinoma effectively.This might provide a new approach to the therapy of hepatocarcinoma.Conclusion Recent studies on endogenous angiogenesis inhibitive factors will be helpful in the prevention and treatment of hepatocarcinoma.

Objective To introduce the effect of estrogen on the vascular endothelial cells and on the development of Buerger's disease. Methods The relative papers were summarized with and made a literature reviewing. Results The physiological level estrogen in vivo has protective effects on the vascular endothelial cells; however, the high level of estrogen in vivo can hurt the vascular endothelial cells,which is an important factor in the development of Buerger's disease. Conclusion Investigation of the mechanism of high level of estrogen in Buerger's patients would have a favor effect on the prevention and treatment of Buerger's disease.

Autophagy is the process through which cells utilize lysosomal hydrolases to degrade cytoplasmic misfolded proteins and damaged organelles. This process allows cells to reuse degradation products and degrade harmful substances to maintain intracellu-lar stability. The autophagy level is low at the normal cell state. Cells under unfavorable conditions activate autophagy to eliminate ad-verse factors. An increasing number of studies have shown that autophagy plays important roles in tumorigenesis, tumor progression, metastasis, relapse, and drug resistance. However, the detailed mechanisms remain unclear. This review summarizes the expression of gastric cancer cell-related autophagy genes and the mechanism by which autophagy promotes gastric cancer cell death. Autophagy has an important application prospect in treating gastric cancer.

The lymphatic vessel is a crucial pathway for tumor metastasis. The discovery of more lymphatic growth factors and lymphatic vessel markers signifies the significant progress of studies on the role of vascular endothelial growth factor-C/D (VEGF-C/D) and one of its specific receptors in the mechanisms of tumor lymph-angiogenesis and lymph node metastasis. VEGF-C/D expression is related to the clinicopathologic features of gastric cancer, including lymph metastasis, micro-lymphatic vessel density in the paraneo-plastic tissues, survival rate, and prognosis. Experimental animal models and in vitro experiments show that suppression of VEGF-C/D expression is beneficial in gastric cancer treatment. This article provides an overview of the association between VEGF-C/D and lymph node metastasis in gastric cancer.

The mechanism of gastric cancer (GC) remains unclear. The diagnosis and treatment of GC undergo rapid development, but the prognosis of the patients remains dismal. The key procedure to improve overall survival is early detection and treatment. However, classic tumor markers have several limitations in clinical practice because of their low sensitivity and specificity. Given the expansion of high throughput technologies, investigators have attained considerable progress in obtaining the benefits of molecular biomarkers through genomics and proteomics analysis. These findings provide new directions for the diagnosis and treatment of early-stage GC. Markers from body fluids, which can be easily obtained , are increasingly gaining attention. This article summarizes the progress of the investigation of molecular biomarkers in early GC using body fluids.

Lymph node metastasis is one of the important factors influencing the prognosis of gastric cancer patients. Accurate and reasonable lymph node staging is greatly significant in evaluating the course of the disease, in estimating the prognosis, and in making a reasonable treatment plan. Local and international research institutions recently found that new staging methods for lymph nodes associated with the prognosis of gastric cancer (e.g., metastastic lymph nodes ratio, log odds of positive lymph nodes, negative lymph node count, and lymph node micrometastasis) can also predict the prognosis of gastric cancer patients. In this paper, the development history, current status of lymph node staging of gastric cancer, and research progress on the new staging methods for lymph nodes as-sociated with the prognosis of gastric cancer are reviewed.

10 000mL. Six cases developed ascites postoperatively. There was no mortality or bile duct injury. The average hospital stay was 15d.Conclusions Intraoperative bleeding and bile duct injuries are the major dangers of (cholecystectomy) in patients with liver cirrhosis, and packing of gallbladder bed with pedicle of greater omentum is a satisfactory method of hemostasis.

Objective:The influences of detection of the preoperative level of serum CA19-9 were analyzed on the prognosis of gastric cancer patients. Methods:A total of 513 gastric patients with preoperative CA19-9 detection were enrolled and underwent radical gastrectomy in Tianjin Medical University Cancer Institute and Hospital from January 2003 to October 2008. Clinico-pathological variables associated with the CA19-9 level were analyzed, and the prognostic value of CA19-9 was evaluated. Results:Eighty-six (16.8%) patients manifested an increased CA19-9 level, which was associated with ageing, Borrmann typesⅢandⅣ, undifferentiated type, and advanced T stage. The five-year survival rates were 45.7%and 25.6%for patients with normal (<39 U/mL) and significantly high CA 19-9 levels (≥39 U/mL), respectively. Differences in survival rates between the patient groups were statistically significant (P<0.001). Tumor-node-metastasis (TNM)-stratified analysis revealed a difference in overall survival for patients with stageⅢtumors. The significantly increased CA19-9 level was an independent prognostic factor for gastric cancer patients after radical surgery based on multivariate analysis. Conclusion:Detection of preoperative level of serum CA19-9 could provide important information for prognostic evaluation of gastric cancer patients. CA19-9 was a potential independent prognostic factor for gastric cancer patients after surgery.

Objective To investigate the prognostic factors of low-and undifferentiated gastric cancer with negative metastasis of lymph nodes.Methods The clinicopathological data of 270 patients with low-and undifferentiated gastric cancer and negative metastasis of lymph nodes who were admitted to the Tianjin Cancer Hospital from January 2002 to December 2007 were retrospectively analyzed.All the patients received radical gastrectomy.One hundred and sixty-one patients had the number of lymph nodes dissected under 15,53 patients had 15-20 lymph nodes dissected,33 had 21-30 lymph nodes dissected and 23 patients with the number of lymph nodes dissected more than 30.Patients were followed up via out-patient examination,phone call and mail till October 2013.The prognosis analysis was done by COX step-wise regression.The survival curve was drawn by KaplanMeier method,and the survival was analyzed using the Log-rank test.Results All the patients were followed up for a median time of 63 months (range,2-103 months).The median survival time was 63 months (range,2-103 months),and the 1-,3-,5-year overall survival rates were 93.0％,69.5％ and 58.5％,respectively.The median survival time of the 161 patients with the number of lymph nodes dissected under 15 was 58 months (range,2-103 months),and the 1-,3-,5-year survival rates were 91.4％,59.3％ and 48.8％,respectively.The median survival time of the 53 patients with the number of lymph nodes dissected between 15 and 20 was 68 months (range,4-95 months),and the 1-,3-,5-year survival rates were 94.3％,84.9％ and 71.7％,respectively.The median survival time of the 33 patients with the number of lymph nodes dissected between 21 and 30 was 68 months (range,34-94 months),and the 1-,3-,5-year survival rates were 100.0％,97.0％ and 87.9％,respectively.The median survival time of the 23 patients with the number of lymph nodes dissected more than 30 was 60 months (range,2-84 months),and the 1-,3-,5-year survival rates were 87.5％,62.5％ and 54.2％,respectively.There was significant difference in the prognosis between the 4 groups (x2 =25.077,P ＜ 0.05).There was significant difference in the prognosis between patients who had 21-30 lymph nodes resected and those had 15-20 lymph nodes resected (x2=3.924,P ＜0.05).Significant difference was also observed in the prognosis between patients who had 15-20 lymph nodes resected and those had more than 30 lymph nodes resected (x2=4.454,P ＜ 0.05),while no significant difference was observed in the prognosis between patients who had lymph nodes resected more than 30 and those had lymph nodes resected less than 15 (x2=0.450,P ＞0.05).The results of univariate analysis showed that gender,age,location and diameter of the tumor,serosal invasion,Borrmann classification,range of gastric resection and the number of lymph nodes dissected were factors influencing the prognosis of patients with low-and undifferentiated gastric cancer and with negative metastasis of lymph nodes (x2 =4.143,12.607,23.665,11.549,26.350,8.059,5.222,25.077,P ＜0.05).The results of multivariate analysis showed that the tumor diameter longer than 5 cm and serosal invasion were the independent factors influencing the prognosis of patients with low-and undifferentiated gastric cancer and with negative metastasis of lymph nodes (HR =1.842,3.084,95％ confidence interval:1.286-2.638,1.956-4.861,P ＜ 0.05).Lymph nodes dissected for 21-30 was the protective factor of prognosis (HR =1.533,95％ confidence interval:1.229-2.248,P ＜ 0.05).Conclusions Lymph nodes dissected for 21-30 during radical gastrectomy may improve the long-term survival of patients.The tumor diameter longer than 5 cm,serosal invasion and the number of lymph nodes dissected (less than 15,15-20 and more than 30) were the independent factors influencing the prognosis of patients with low-and undifferentiated gastric cancer and with negative metastasis of lymph nodes.