Objective To compare the efficacies of total gastrectomy (TG) and proximal gastrectomy (PG) for patients with upper gastric cancer.Methods Databases including Medline,Cochrane Library,Web of Science,China National Knowledge Infrastructure,Wanfang database were searched to retrieve literatures on surgical treatment of upper gastric cancer which were published from January 1980 to October 2011.According to different surgical procedures,all the patients were divided into PG group and TG group.Meta analysis were performed by RevMan 5.1.Categorical variables were presented by odds ratio (OR) and 95％ confidence interval (95％CI).Results Thirteen literatures including 2622 patients with upper gastric cancer were retrieved.There were 1464 patients in the TG group and 1158 patients in the PG group.There was no significant difference in the 1-year survival rate between the 2 groups (OR =1.23,P ＞ 0.05).The 3-and 5-year survival rates of patients in the TG group were significantly higher than those of the PG group (OR =1.74,1.45,P ＜ 0.05).There were no significant difference in the 5-year survival rates of patients in TNM Ⅰ,Ⅱ,Ⅳ stages between the 2 groups (OR =0.94,1.31,2.03,P ＞ 0.05),while the 5-year survival rate of patients in TNM Ⅲ stage of TG group was significantly higher than PG group (OR =2.29,P ＜ 0.05) The overall recurrence rate of TG group was slightly lower than that of PG group,with no significant difference OR =0.44,P ＞ 0.05).The local recurrence rate of TG group was significantly lower than that of PG group (OR =0.29,P ＜ 0.05).There was no significant difference in the distal recurrence rate between the 2 groups (OR =0.60,P ＞ 0.05).Conclusions The medium and longterm efficacies of TG are superior than that of PG.The stage of cancer should be taken into account to determine the plan of individual treatment.

Objective:To explore the relationship between serum levels of thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (Tg-Ab) and the development of papillary thyroid carcinoma.Methods:The clinical data of 574 patients with thyroid nodules who received surgical treatment in Tengzhou Central People's Hospital from January to December 2021 were retrospectively analyzed. Using histopathological diagnosis as the gold standard, the patients were divided into papillary thyroid carcinoma group (malignant group, 267 cases) and benign thyroid nodules group (benign group, 307 cases). The clinical data and the preoperative serum TSH, TPO-Ab and Tg-Ab levels were compared between the two groups. The correlation between preoperative serum TSH, TPO-Ab and Tg-Ab levels and papillary thyroid cancer was analyzed by logistic regression.Results:There were no statistical differences in the age and gender of patients between the malignant group and the benign group (all P > 0.05). TSH [2.37 mIU/L (1.43 mIU/L, 5.09 mIU/L)], TPO-Ab [17.84 IU/ml (11.94 IU/ml, 40.68 IU/ml)] and Tg-Ab [15.69 IU/ml (10.57 IU/ml, 132.00 IU/ml)] in the malignant group were higher than those in the benign group [TSH 1.60 mIU/L (0.88 mIU/L, 2.57mIU/L), TPO-Ab 14.29 IU/ml (10.00 IU/ml, 21.17 IU/ml), Tg-Ab 12.23 IU/ml (10.00 IU/ml, 16.51 IU/ml)], and the differences were statistically significant ( Z values were -6.43, -4.60 and -6.15, all P < 0.05). Multivariate logistic regression analysis showed that positive TPO-Ab ( OR = 0.996, 95% CI 0.993-0.999, P = 0.013) and positive Tg-Ab ( OR = 0.996, 95% CI 0.994-0.998, P < 0.05) were independent risk factors for papillary thyroid cancer. Conclusions:Preoperative serum TSH, TPO-Ab and Tg-Ab levels are closely related to papillary thyroid cancer, among which positive serum TPO-Ab and positive Tg-Ab are independent risk factors for papillary thyroid cancer and have important values in the differential diagnosis of benign and malignant thyroid nodules.