Objective To explore the relationship between expression of MDR1 gene in human esophageal and cardiac cancer and clinicopathological changes. Methods From Jan 2 000 to Dec 2001, a total of 161 patients with esophageal or cardiac carcinoma were recruited, and MDR1 were assayed by RT-PCR. Fresh tumor tissues were surgically resected without chemotherapy before operation. Results The positive rate of MDR1 was 34.78 % (56/161). Among them 5 cm 38.54 %, invasion to muscular layer 30.77 %, invasion to tunica serosa 35.14 %, squamous cell carcinoma 27.27 %, adenocarcinoma 41.67 %, lymphonode metastasis positive 35.19 %, negative 33.96 %, stage Ⅰ,Ⅱ 33.33 %, stage Ⅲ, Ⅳ 35.58 %. The correlation between MDR1 expression and the age and sex of patients, Tumor size depth of invasion histologic types lymph node involvement and TNM, was not significant. Conclusion Because of highly expressive level of MDR1 gene in untreated esophageal and cardiac carcinoma, we should choose appropriate chemotherapeutic regimen for esophageal and cardiac cancer. The expression of MDR1 gene in untreated cancer was independented of morphologic prognostic indexes without correlation between MDR1 gene expression and morphological indexes.

Objective To observe the short-term efficacy and adverse reactions of S-1 combined intrathoracic and intraperitoneal injection for the treatment of aged patients with gastric cancer and with malignant hydrothorax and ascites.Methods The patients were divided into treatment group (A group,22 cases) randomly and control group (B group,24 cases).The two groups underwent intrathoracic and intraperitoneal injection chemotherapy and biological therapy.Drainage tubes were placed in thoracic or abdominal cavity to discharge the effusion,cisplatin 40-60 mg,lentinan 4-6 mg,dexamethasone 10 mg were injected into the chest or abdomen,once per week,administered for 2-4 weeks.S-1 was added to the treatment group,S-1 capsules were administered orally on the first day of serous cavity drug injection,40-60 mg/m2,2 times per day,oral administration after morning and evening meal for 14 days,stop for 7 days,21 days were 1 cycle.The short-term curative effects,clinical quality of life and adverse reactions were compared between the two groups.Results Total effective rate of group A was 77.3 ％,50.0 ％ in B group,the difference of short-term effects of two groups was with statistical significance (P ＜ 0.05).The improvement rates of quality of life (QOL) of group A and group B were 86.4 ％ and 70.1％ respectively,with significant difference in the two groups (P ＜ 0.05).The major adverse reactions were gastrointestinal reaction and bone marrow suppression,nausea and vomiting rate in A group was 54.5 ％ (12/22),grade Ⅲ-Ⅳ neutropenia was 54.5 ％ (4/22),significantly higher than that in B group,there was significant difference in two groups (P ＜ 0.05).No treatment related death.Conclusion There is curative effect of S-1 combined with cisplatin and lentinan in treatment of the aged patients of gastric carcinoma and malignant hydrothorax and ascites.Gastrointestinal side efforts and bone marrow suppression in treatment group have been observed,but it is tolerable.This scheme can improve the QOL of patients and prolong the survival period.

Objective To detect the expressions of hTERT and MMP-7 mRNA in the peripheral blood of patients with colorectal cancer and their correlation,and discuss the clinical significance of peripheral blood micro-metastasis.Methods Total RNA was extracted from blood samples by TRIzol and was reverse transcribed into cDNA.The mRNA expressions of MMP-7 and hTERT were detected by real-time PCR.Results Positive mRNA expression of hTERT was found in 63 of 181 patients with colorectal cancer,while positive mRNA expression of MMP-7 was seen in 61 cases.The positive rates of hTERT and MMP-7 mRNA had no significant differences in the patients' sex and age (P ＞ 0.05).The positive rate of MMP-7 mRNA in the patients with poorly differentiated adenocarcinoma (43.9 ％) was higher than that in the patients with moderately and well differentiated adenocarcinoma (27.8 ％) (x2 =4.873,P ＜ 0.05).The positive rate of HTERT mRNA in the patients with stage Ⅲ-Ⅳ (42.5 ％) was higher than that in the patients with stage Ⅰ-Ⅱ (24.0 ％) (x2 =6.591,P ＜ 0.05).The positive rate of MMP-7 mRNA in the patients with stage Ⅲ-Ⅳ (39.6 ％) was higher than that in the patients with stage Ⅰ-1Ⅱ (25.3 ％) (x2 =4.014,P ＜ 0.05).The positive rate of hTERT mRNA in the patients with distant metastasis (53.3 ％) was higher than that in the patients without distant metastasis (28.7 ％) (x2 =9.059,P ＜ 0.05).The positive rate of MMP-7 mRNA in the patients with distant metastasis(46.7 ％) was higher than that in the patients without distant metastasis (29.4 ％) (x2 =4.506,P ＜ 0.05).The positive rate of hTERT mRNA in the patients with positive CEA expression (52.6 ％) was significantly higher than that in the patients with negative CEA expression (30.1％) (x2 =6.735,P ＜ 0.05).The positive rate of MMP-7mRNA in the patients with positive CEA expression (60.5 ％) was significantly higher than those in the patients with negative CEA expression (26.6 ％) (x2 =15.490,P ＜ 0.05).In the patients without distant metastasis,any of hTERT and MMP-7 mRNA expression was thought to be blood micro-metastasis.The recurrence and metastasis rates after 6 months in the patients with blood micrometastasis (36.58 ％) were higher than those in the patients without blood micro-metastasis (7.14 ％)(x2 =13.027,P ＜ 0.05).The recurrence and metastasis rates after 12-month follow-up in the patients with blood micro-metastasis (68.29 ％) were higher than those in the patients without blood micro-metastasis (12.5 ％) (x2 =31.948,P ＜ 0.01).The sensitivity of combined detection was 80.00 ％,and the specificity was 79.03 ％ after 12-month follow-up.Spearman correlation analysis revealed that significant positive correlation existed between hTERT and MMP-7mRNA expression (r =0.341,P =0.000).Conclusion Detection of hTERT and MMP-7 mRNA expression can be used as reliable markers to predict peripheral blood micrometastasis in colorectal cancer patients.

Objective:To investigate the progression-free survival (PFS) and safety of apatinib combined with docetaxel treated patients with advanced gastric cancer after failure of first-line chemotherapy.Methods:From March 2017 to May 2018, 23 patients with advanced gastric cancer who had received a failure of first-line chemotherapy (either fedocetaxel or paclitaxel) were treated with apatinib combined with docetaxel. The short-term efficacy and safety of the patients were observed.Results:The therapeutic effects of 20 patients were evaluated. Among them, 4 cases were partial response (PR), 13 patients were stable disease (SD), 3 patients were progressive disease (PD). The objective remission rate (ORR) was 20.0%, the disease control rate (DCR) was 85.0%, the median PFS (mPFS) was 4.5 months. The main adverse reactions were hypertension, vomiting and weakness.Conclusion:Apatinib combined with docetaxel applied in the second-line treatment of gastric cancer is safe and effective.

Objective:To investigate the progression-free survival (PFS) and safety of apatinib combined with docetaxel treated patients with advanced gastric cancer after failure of first-line chemotherapy.Methods:From March 2017 to May 2018, 23 patients with advanced gastric cancer who had received a failure of first-line chemotherapy (either fedocetaxel or paclitaxel) were treated with apatinib combined with docetaxel. The short-term efficacy and safety of the patients were observed.Results:The therapeutic effects of 20 patients were evaluated. Among them, 4 cases were partial response (PR), 13 patients were stable disease (SD), 3 patients were progressive disease (PD). The objective remission rate (ORR) was 20.0%, the disease control rate (DCR) was 85.0%, the median PFS (mPFS) was 4.5 months. The main adverse reactions were hypertension, vomiting and weakness.Conclusion:Apatinib combined with docetaxel applied in the second-line treatment of gastric cancer is safe and effective.

OBJECTIVETo analyze the clinicopathologic features and prognosis of α-fetoprotein (AFP)-producing gastric cancers (AFPGC).

METHODSFifty-one serum AFP-positive patients with positive immunohistochemical staining of AFP in the primary lesions (study group) and sixty-five gastric cancer cases with normal AFP level (control group) treated in our department from January 2005 to December 2007 were included in this study. Their clinicopathologic features and follow-up data were statistically analyzed.

RESULTSCompared with the control group, the study group had a higher incidence of poorly differentiated adenocarcinoma (P=0.021) and liver metastasis (P=0.001) than that in the control group.The TNM stages in the study group were significantly higher than those in the control group (P=0.001). The 1-, 2-, and 5-year survival rates of the study group were 62.7%, 27.5% and 4.7%, respectively, and the median survival was 16 months, significantly lower than the 84.6%, 55.4%, 16.5%, and 30 months of the control group (P<0.001 for all). The serum AFP levels in the study group ranged from 58.63 µg/L to 12 100.00 µg/L, and could be classified into two groups:27 cases <500 µg/L, and 24 cases ≥500 µg/L. There was no significant difference of the immunohistochemical staining results between the two subgroups (P=0.912).

CONCLUSIONSAFPGC is a special type of gastric cancer with high degree of malignancy and poor prognosis. Monitoring of serum AFP level can earlier detect the progression of disease and give corresponding treatment.

Adenocarcinoma ; Humans ; Incidence ; Liver Neoplasms ; Prognosis ; Stomach Neoplasms ; diagnosis ; metabolism ; pathology ; Survival Rate ; alpha-Fetoproteins ; metabolism

Objective We propose an image-based key frames gating method for intravascular ultrasound (IVUS) sequence based on manifold learning to reduce motion artifacts in IVUS longitudinal cuts. Methods We achieved the gating with Laplacian eigenmaps, a manifold learning technique, to determine the low-dimensional manifold embedded in the high-dimensional image space. A distance function was constructed by the low-dimensional feature vectors to reflect the heart movement. The IVUS images were classified as end-diastolic and non-end-diastolic based on the distance function, and the IVUS images collected in end-diastolic stage constitutes the key frames gating sequences. Result We tested the algorithm on 13 in vivo clinical IVUS sequences (images 915 ± 142 frames, coronary segments length 15.24 ± 2.37 mm) to calculate the vessel volume, lumen volume, and the mean plaque burden of the original and gated sequences. Statistical results showed that both the vessel volume and lumen volume measured from the gated sequences were significantly smaller than the original ones, indicating that the gated sequences were more stable;the mean plaque burden was comparable between the original and gated sequences to meet the need in clinical diagnosis and treatment. In the longitudinal views, the gated sequences had less saw tooth shape than the original ones with a similar trend and a good continuity. We also compared our method with an existing gating method. Conclusion The proposed algorithm is simple and robust, and the gating sequences can effectively reduce motion artifacts in IVUS longitudinal cuts.

Objective To analyze the clinicopathologic features and prognosis of α-fetoprotein ( AFP)-producing gastric cancers ( AFPGC) .Methods Fifty-one serum AFP-positive patients with positive immunohistochemical staining of AFP in the primary lesions ( study group) and sixty-five gastric cancer cases with normal AFP level ( control group) treated in our department from January 2005 to December 2007 were included in this study.Their clinicopathologic features and follow-up data were statistically analyzed. Results Compared with the control group, the study group had a higher incidence of poorly differentiated adenocarcinoma (P=0.021) and liver metastasis (P=0.001) than that in the control group.The TNM stages in the study group were significantly higher than those in the control group (P=0.001).The 1-, 2-, and 5-year survival rates of the study group were 62.7%, 27.5%and 4.7%, respectively, and the median survival was 16 months, significantly lower than the 84.6%, 55.4%, 16.5%, and 30 months of the control group (P<0.001 for all).The serum AFP levels in the study group ranged from 58.63μg/L to 12 100.00μg/L, and could be classified into two groups:27 cases <500μg/L, and 24 cases≥500μg/L.There was no significant difference of the immunohistochemical staining results between the two subgroups ( P =0.912) .Conclusions AFPGC is a special type of gastric cancer with high degree of malignancy and poor prognosis.Monitoring of serum AFP level can earlier detect the progression of disease and give corresponding treatment.

Objective We propose an image-based key frames gating method for intravascular ultrasound (IVUS) sequence based on manifold learning to reduce motion artifacts in IVUS longitudinal cuts. Methods We achieved the gating with Laplacian eigenmaps, a manifold learning technique, to determine the low-dimensional manifold embedded in the high-dimensional image space. A distance function was constructed by the low-dimensional feature vectors to reflect the heart movement. The IVUS images were classified as end-diastolic and non-end-diastolic based on the distance function, and the IVUS images collected in end-diastolic stage constitutes the key frames gating sequences. Result We tested the algorithm on 13 in vivo clinical IVUS sequences (images 915 ± 142 frames, coronary segments length 15.24 ± 2.37 mm) to calculate the vessel volume, lumen volume, and the mean plaque burden of the original and gated sequences. Statistical results showed that both the vessel volume and lumen volume measured from the gated sequences were significantly smaller than the original ones, indicating that the gated sequences were more stable;the mean plaque burden was comparable between the original and gated sequences to meet the need in clinical diagnosis and treatment. In the longitudinal views, the gated sequences had less saw tooth shape than the original ones with a similar trend and a good continuity. We also compared our method with an existing gating method. Conclusion The proposed algorithm is simple and robust, and the gating sequences can effectively reduce motion artifacts in IVUS longitudinal cuts.

Objective To analyze the clinicopathologic features and prognosis of α-fetoprotein ( AFP)-producing gastric cancers ( AFPGC) .Methods Fifty-one serum AFP-positive patients with positive immunohistochemical staining of AFP in the primary lesions ( study group) and sixty-five gastric cancer cases with normal AFP level ( control group) treated in our department from January 2005 to December 2007 were included in this study.Their clinicopathologic features and follow-up data were statistically analyzed. Results Compared with the control group, the study group had a higher incidence of poorly differentiated adenocarcinoma (P=0.021) and liver metastasis (P=0.001) than that in the control group.The TNM stages in the study group were significantly higher than those in the control group (P=0.001).The 1-, 2-, and 5-year survival rates of the study group were 62.7%, 27.5%and 4.7%, respectively, and the median survival was 16 months, significantly lower than the 84.6%, 55.4%, 16.5%, and 30 months of the control group (P<0.001 for all).The serum AFP levels in the study group ranged from 58.63μg/L to 12 100.00μg/L, and could be classified into two groups:27 cases <500μg/L, and 24 cases≥500μg/L.There was no significant difference of the immunohistochemical staining results between the two subgroups ( P =0.912) .Conclusions AFPGC is a special type of gastric cancer with high degree of malignancy and poor prognosis.Monitoring of serum AFP level can earlier detect the progression of disease and give corresponding treatment.