Objective To investigate the expression of heat shock protein(HSP)70 and HSP90 in patients with atrophic gastritis(AG)or gastric cancer(GC)and its significance.Methods One hundred and forty-one patients including 35 with superficial gastritis(CSG),66 with AG(miner in 21,medium in 30 and severe in 15)and 40 with GC were enrolled with mean age of 47.8,56.1 or 59.4 years,respectively.H.pylori positive patients were 12 with CSG and 28 with AG.The quantity analysis of HSP90 and HSP70 were detected by immunohistochemistry,whereas their mRNA and protein expressions were measured by Western bolt and real-time PCR,respectively.Results The mRNA expression of HSP70 was significantly higher in CSG(1.31±0.80)and AG(1.41±0.80)than that in GC(1.18±0.70,P＜0.05),but was significantly lower in miner(1.32±0.70)and medium(1.34±0.60)AG than that in severe AG(2.20±0.80,P＜0.05).The mRNA expression of HSP90 was kept on increasing in order of CSG(1.27±0.60),AG(1.53±0.80)and GC(1.84±0.70); or in order of miner(1.33±0.60),medium(1.47±0.90)and severe(2.75±0.70)(P＜0.05).The patients infected with H.pylori had higher expression of HSP90 compared with those without H. pylori infection (P＜0.05). Conclusion The synchronous increase of HSP90 and HSP70 indicates the aggravation of AG. When HSP90 is up-regulated and HSP70 is down-regulatied, it may predict the occurrence of cancer.

Objective:To investigate the correlation of human epidermal growth receptor 2 (HER2) with clinicopathological characteristics and its postoperative prognostic value in patients with gastric cancer.Methods:The clinicopathological data of 543 patients with gastric cancer who underwent open radical gastrectomy were retrospectively analyzed in the Gastrointestinal Surgery Department of Jiangyin People′s Hospital Affiliated to Southeast University from June 2011 to December 2016, including 404 males and 139 females, aged from 26 to 84 years old. According to the results of HER2 immunohistochemical staining, gastric cancer patients were divided into HER2 0+ group ( n=427), HER2 1+ group ( n=56), HER2 2+ group ( n=29) and HER2 3+ group ( n=31), and the differences in clinicopathological indicators of the four groups were compared. Furthermore, HER2 0+ and 1+ gastric cancer patients were classified as HER2-negative group( n=26), and HER2 3+ as HER2-positive group( n=26). Propensity score matching method was used to balance the basic data variables related to prognosis of the two groups, and Kaplan-Meier method was used for survival analysis. Cox risk regression model was used to analyze the risk factors associated with postoperative survival in patients with HER2-positive gastric cancer. Results:The overexpression rate of HER2 in gastric cancer patients was 5.7% (31/543). The expression level of HER2 was significantly correlated with gender ( χ2=8.30, P=0.040), tumor longitudinal location ( χ2=22.86, P=0.029) and histological differentiation ( χ2=13.27, P=0.004). There was no significant correlation between median survival time and HER2 expression level( χ2=5.44, P=0.142). After propensity score matching, the median survival time of gastric cancer in the HER2-positive group was 23 months. Univariate and multivariate analysis showed that ABO blood group ( HR: 1.619, 95% CI: 1.081-2.423, P=0.019) was an independent risk factor for prognosis of HER2-positive gastric cancer. Conclusion:The expression of HER2 is higher in men, cardia fundus and high and medium differentiated gastric adenocarcinoma, but there is no significant correlation between the expression level of HER2 and the median survival time of gastric cancer. ABO blood group may be an independent risk factor for the survival of HER2-positive gastric cancer.

Objective:To analyze and discuss the clinical significance of preoperative planning and guidance based on three-dimensional reconstruction of perigastric vessels in precision surgery for gastric cancer.Methods:A prospective study was conducted to analyze the data of 50 patients with gastric cancer who received surgical treatment in Jiangyin People′s Hospital from December 2020 to December 2022, including 35 males and 15 females, aged from 38 to 79 years old, with an average age of 66.3 years old. All patients were divided into control group ( n=25) and experimental group ( n=25) according to random number table method. Both groups underwent enhanced multi-slice spiral CT scan of the chest, abdomen and pelvis before surgery. The experimental group underwent 3D reconstruction based on CT data for preoperative planning and guidance, while the control group did not undergo 3D reconstruction. Patients in both groups received radical surgery for gastric cancer. Operation time, intraoperative blood loss, total postoperative drainage volume, postoperative hospital stay, number of lymph node dissection and postoperative complications were compared between the two groups. The statistical software SPSS27.0 was used to obtain the relevant data analysis results. Results:The intraoperative blood loss, total drainage volume and postoperative hospital stay of the experimental group were lower than those of the control group( P<0.05). The operative time, number of lymph node dissection and postoperative complications of the experimental group were not significantly different from those of the control group( P>0.05). Conclusions:Preoperative three-dimensional reconstruction of gastric perivascular with CT data can provide better preoperative evaluation, surgical planning and intraoperative guidance, reduce intraoperative accidental vascular injury, blood loss, total postoperative drainage and postoperative hospital stay. It has positive clinical application value to complete accurate radical resection of gastric cancer.