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 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.

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: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.

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.

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.

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.

Objective: To evaluate the efficacy of intraoperative hyperthermic peritoneal perfusion (CHPP) on advanced gastric carcinoma. Methods: Sixty patients with advanced gastric carcinoma were divided into the control group and the treatment group. All patients underwent radical gastrectomy and D2 node dissection. Patients in the treatment group received CHPP when surgical resection was completed. Patients in the control group underwent resection of gastric carcinoma without CHPP. Chemotherapy was administered with FOLFOX4 regimen intravenously for 12 cycles in both groups at 4 weeks after surgery. The serum Carcinoembryonic antigen (CEA) and CA19-9 were measured in patients with advanced gastric cancer before and after resection of tumor. Survival and recurrence in both groups were analyzed and compared. Results: The mean levels of the expression of CEA and CA19-9 in the peripheral blood of the 60 patients were significantly higher than the upper limits of normal (55.89±22.25μg/L vs 0～5μg/L; 125.35±61.78 U/mL vs 0～39U/mL P< 0.01). There were no significant differences in the mean levels of the expression of CEA and CA19-9 in the peripheral blood between the treatment group and the control group (54.67±22.95μg/L vs 56.09±22.15μg/L; 126.16±62.45 U/mL vs 123.35±60.88 U/mL,P>0.05). The serum CEA and CA19-9 levels were significantly decreased at 7 days after treatment in the treatment group (7.58±3.21 μg/L, 31.35±13.47 U/mL, P<0.01). The levels of these two tumor markers were decreased unremarkably at 7 days after treatment in the control group (37. 68±20.59μg/L, 98.23±36.28 U/mL, P>0.05). The serum CEA and CA19-9 levels were decreased significantly in both groups at 30 days after surgery (P<0.05). One-year survival and recurrence rates were 83.3% and 10% in the treatment group and 80% and 13.3% in the control group, with no significant differences between the two groups (P>0.05). Three-year survival and recurrence rates were 63.3% and 20% in the treatment group and 40% and 40% in the control group, with a significant difference between the two groups (P<0.05). Conclusion: Surgical resection combined with CHPP can significantly decrease the serum CEA and CA19-9 levels. Intraoperative CHPP for patients with advanced gastric carcinoma is helpful for preventing peritoneal metastasis and recurrence and can prolong survival time.