Objective To observe the biological activity of the recombinant immunotoxin hIL-2-LuffinP1 derived by gene engineering in vitro.Methods To observe the inhibitory effect on lymphocytes in vitro,the splenocytes isolated from C57 and BALB/c mice were used for mixed mouse lymphocyte response(MLR),and the lymphocyte proliferation was observed in vitro with BALB/c mice splenocytes stimulated by concanavalin A(ConA).Different concentrations of hIL-2-LuffinP1 was added into the reaction system,with LuffinP1 adopted as control.3H-TdR incorporation assay was used to detect the effects of hIL-2-LuffinP1 on lymphocyte proliferation,and its effects on CTLL-2 cells(IL-2 dependent cells) were also observed.The experiments consisted of six groups(PBS,IL-2,LuffinP1,LuffinP1+IL-2,hIL-2-LuffinP1 and hIL-2-LuffinP1+IL-2).CTLL-2 cells were cultured for 12h after being treated with different agents,and then the cells were stained by trypan blue to estimate the dead cells in every 100 cells.Results It was showed that CPM declined correspondingly to the gradually increased concentration of hIL-2-LuffinP1,and cell proliferation was inhibited obviously.The inhibition rate was up to 97% at the concentration of 10-6mmol/L of hIL-2-LuffinP1.The activity of inhibiting lymphocyte proliferation was proportional to the dosage.On the contrary,no obvious inhibition to lymphocyte proliferation was found in the control group treated with LuffinP1,the inhibition ratio only reached to 14% with the same concentration of hIL-2-LuffinP1.It was also found that,when hIL-2-LuffinP1 and LuffinP1 in different concentrations added to spleen cells stimulated by ConA,hIL-2-LuffinP1 still exhibited strong ability of inhibition on the splenocyte proliferation,while LuffinP1 has no obvious inhibiting effect on the lymphocyte proliferation in the two reaction systems mentioned above.MLR showed the same results.Furthermore,in the experiment of cytotoxic effects of IL-2-LuffinP1 on CTLL-2 cells,the inhibition rates of hIL-2-LuffinP1+IL-2 group and hIL-2-LuffinP1 group were 29.6% and 47.4% respectively,the difference was significant compared with IL-2 group(P

Objective To investigate the correlation between thrombocytosis and the progress of gastric cancer. Methods The clinical data of 276 gastric cancer patients who had been admitted to Tianjin Cancer Hospital from August 2002 to January 2004 were retrospectively analyzed. Of all patients, 75 were with thrombocy-tosis and 201 were with normal level of platelet. Data were analyzed by chi-square test, and the prognostie factors for gastric cancer were analyzed by Cox regression model. The accumulative survival was determined by Kaplan-Meier method, and the difference in survival between patients with and without thrombocytosis was analyzed by Log-rank test. Results The 1-, 3-, 5-year survival rates of gastric cancer patients with normal level of platelet were 82.4%, 50.5% and 41.9%, and the 1-, 3-, 5-year survival rates of gastric cancer patients with thrombocy-tosis were 74.7%, 37.3% and 25.3%. There was a significant difference in 5-year survival rates between patients with or without thrombocytosis (χ~2= 7.358, P<0.05). Thrombocytosis was correlated with the depth of invasion, distal metastasis, TNM staging and the tumor size (χ~2=6.946, 5.625, 14. 925, 4.028, P<0.05). The result of multivariate analysis indicated that the content of platelet was not the independent factor of good prog-nosis in gastric cancer. Conclusions There is a close relationship between thromboeytosis and clinieopathological factors of gastric cancer. Thrombocytosis may be used as a reference indicator for the prognosis of gastric cancer.

Objective To analyze the risk factors of liver metastasis from gastric cancer. Methods The clinical data of 225 patients with liver metastasis from gastric cancer who had been admitted to our hospital from January 1996 to December 2001 were retrospectively analyzed. Synchronous liver metastasis was observed in 123 patients and metachronous liver metastasis in 102 patients. The risk factors of liver metastasis from gastric cancer were evaluated. Results The gender of patients, location and size of gastric cancer foci, differentiation and invasion depth of gastric cancer, Lanren classification, lymph node metastasis and lymph node metastasis in region Ⅷ, vascular invasion, extrahepatic metastasis, ascites and peritoneal metastasis were the significant factors associated with liver metastasis from gastric cancer (X2 = 43.560-263. 907, P<0.05). All the factors except the size of gastric cancer foci, extrahepatic metastasis and ascites were found to be the significant factors associated with different types of liver metastasis from gastric cancer (X2 = 6.673-26. 555, P < 0.05 ). Logistic regression analysis demonstrated that the gender of patients, lymph node metastasis and peritoneal metastasis were the factors that determined the types of liver metastasis from gastric cancer. Conclusion The gender of patients, lymph node metastasis and peritoneal metastasis are the important factors to evaluate the occurrence of different types of liver metastasis from gastric cancer.

Objective To investigate the clinicopathological characteristics,treatment,prognostic factors of primary small intestinal lymphoma (PSIL).Methods The clinical data of 68 patients with PSIL who were admitted to the Cancer Hospital of Tianjin Medical University from November 1999 to July 2009 were retrospectively analyzed.The diagnostic workup before operation included abdominal ultrasound,computed tomography (CT) scan of the abdomen,small intestinal barium radiography,endoscopy examination and laboratory examination.The patients with local PSIL underwent radical surgery,patients who were not eligible for radical surgery received palliative treatment,and then accurate staging was done according to Ann-Arbor system for gastrointestinal lymphoma,and chemotherapy was applied according to the condition of patients.The patients were followed up by letters,telephone and outpatient care till July 2012.Factors might have influence on the prognosis were analyzed by the Kaplan-Meier method and Log-rank test.COX regression model were used for univariate and multivariate analysis,respectively.Results The major symptoms of PSIL included abdominal pain (69.1％,47/68) and weight loss (29.4％,20/68).All of the 68 patients underwent small intestinal barium radiography and endoscopy examination,and 15 and 11 cases were definitely diagnosed as with PSIL.Abdominal mass were detected by abdominal ultrasound in 38 of 45 cases.Positive results were found in 30 cases by CT and 5 cases by positron emission tomography (PET)-CT.PSIL mainly involved ileum (73.5％,50/68),13 PSILs were located at the jejunum and 5 at the duodenum.Of all the 68 patients,64 were with B-cell subtype PSIL and 4 were with T-cell subtype PSIL.Most tumors belonged to stages Ⅰ and Ⅱ (66.2％,45/68).All of the 68 patients were treated with surgical procedure,including 51 patients received radical resection and 17 patients had palliative resection.After operation,4-8 cycles of chemotherapy were applied in 57 patients.Seven patients received COP regimen,50 received CHOP regimen (10 patients with positive expression of CD20 received R-CHOP regimen simutaneously),the remaining 11 patients did not receive chemotherapy.Sixty-four patients were followed up,and the follow-up rate was 94.1％ (64/68).The median follow-up time was 40 months (range,3-132 months).The median survival time was 40.5 months.The 1-,3-,and 5-year overall survival rates were 78.1％,62.2％ and 59.7％,respectively.The prognosis of patients with B-cell subtype PSIL,in stage Ⅰ-Ⅱ and received operation + chemotherapy was superior to those who were with T-cell subtype PSIL,in stage Ⅲ-Ⅳ and received operation (x2=22.459,45.535,15.782,P ＜ 0.05).The results of univariate analysis showed that level of LDH,pathological subtype,clinical stage,presence of systemic symptom,treatment modality,radical surgery and lymphatic metastasis were risk factors for prognosis (x2=7.245,22.459,45.535,5.796,15.782,45.926,9.214,P ＜ 0.05).The results of multivariate analysis revealed B cell phenotype,stage Ⅰ-Ⅱ and surgery + chemotherapy were independent prognostic factors for survival (RR =7.133,5.304,0.256,95％ CI:1.634-31.130,1.498-18.781,0.095-0.691,P ＜ 0.05).Conclusions The major symptoms of PISL include abdominal pain and weight loss.Definite diagnosis of PSIL depends on endoscopy and imaging examination.PSIL mainly involves ileum.Surgery based treatment is the preferred option,and the combined treatment of rituximab with chemotherapy may improve the survival.B-cell phenotype,early clinical stage (Ⅰ-Ⅱ) and surgical resection plus chemotherapy are independent prognostic factors for better survival.

Resveratrol is a non-flavonoid polyphenolic compound which presents in plants such as grapes.It has a variety of physiological effects such as antioxidant ,anti-inflammatory ,anti-cancer , cardiovascular and neurological protection. In cardiovascular disease ,through the anti-inflammatory , anti-oxidation and regulating a variety of factors ,resveratrol involves in atherosclerosis ,hypertension , ischemic heart disease ,heart failure and other cardiovascular disease process ,thus plays a protective function for heart. Related clinical researches are also widely carried out ,and resveratrol may be one of the candidate interventions for prevention and treatment of cardiovascular disease.

OBJECTIVETo evaluate the impact of primary site, NIH risk and imatinib treatment on the prognosis of patients with gastrointestinal stromal tumors(GIST).

METHODSClinicopathological data of 156 adult patients with GIST treated by imatinib in the Cancer Institute and Hospital of Tianjin Medical University from January 2006 to December 2010 were retrospectively analyzed. According to NIH risk classification, 30 patients were at moderate risk and 126 at high risk. Sixty-seven patients had advanced GIST. Prognosis of patients with different primary tumor site, different NIH risk and different treatment was compared respectively.

RESULTSImatinib therapy was well tolerated in all the patients. Eighty-nine cases received radical operation and adjuvant imatinib treatment. Among 67 advanced GIST cases, 26 received radical operation and adjuvant imatinib treatment, 27 received palliative operation and adjuvant imatinib treatment, and 14 received simple adjuvant imatinib treatment without operation. All the patients had routine follow-up, ranging from 9 to 56(median 27) months. The overall survival (OS) rate was 96% in 1-year, 86% in 2-year, and 71% in 3-year. The OS rate was 95% in 1-year, 77% in 2-year, and 65% in 3-year for patients at high risk, and all 100% in 1-, 2-, 3-year for patients at moderate risk, the differences was statistically significant (P=0.001). The OS rate was 97% in 1-year, 90% in 2-year, and 84% in 3-year for patients with gastric GIST, and 95% in 1-year, 69% in 2-year, and 52% in 3-year for patients with non-gastric GIST, the difference was significant(P=0.000). The OS rate was 98% in 1-year, 95% in 2-year, and 90% in 3-year for patients undergoing radical resection and adjuvant imatinib therapy. For 67 advanced GIST patients with imatinib therapy, none had complete remission, 41 had part remission, 15 had stable disease, indicating 56 advanced GIST cases(83.6%) obtaining clinical benefit. The OS rate was 91% in 1-year, 58% in 2-year, and 43% in 3-year.

CONCLUSIONSThe prognosis of high, and non-gastric and advanced GIST patients is poor. Radical resection combined with early imatinib treatment can improve the prognosis of GIST patients.

Antineoplastic Agents ; therapeutic use ; Benzamides ; therapeutic use ; Combined Modality Therapy ; Follow-Up Studies ; Gastrointestinal Neoplasms ; drug therapy ; pathology ; Gastrointestinal Stromal Tumors ; drug therapy ; Humans ; Imatinib Mesylate ; Piperazines ; therapeutic use ; Prognosis ; Pyrimidines ; therapeutic use ; Retrospective Studies ; Survival Rate

OBJECTIVETo investigate the lymph node metastasis pattern in pN1 stage gastric cancer patients and to analyze its risk factors.

METHODSClinicopathological data of 219 patients who underwent radical gastrectomy and were confirmed as pN1 stage gastric cancer between January 2013 and March 2016 were reviewed. All the patients underwent D2 or extended D2(D2+) lymphadenectomy. The overall metastatic rate was calculated. The risk factors associated with lymph node metastasis were analyzed. The pattern of skip lymph node metastasis and clinicopathological factors related to skip metastasis were analyzed.

RESULTSAmong 219 patients, 119 patients had only one metastatic lymph node, and 100 patients had two metastatic lymph nodes. The relatively higher sites of lymph node metastasis were station No.3[29.2%(64/219)], No.6[18.3%(40/219)] and No.4[11.4%(25/219)]. Compared to patients with tumor diameter ≤5 cm, metastatic rates of station No.3[39.4% (39/99) vs. 20.8%(25/120), P=0.003], No.4[16.2%(16/99) vs. 7.5%(9/120), P=0.045] and No.8[16.2%(16/99) vs. 6.7%(8/120), P=0.025] were significantly higher in those with tumor diameter >5 cm. Skip lymph node metastasis was detected in 56 cases(25.6%) and skip lymph node metastatic rate was significantly higher in patients with tumor diameter >5 cm [34.3%(34/99) vs. 18.3%(22/120), P=0.007]. Logistic regression analysis showed that the tumor size was an independent risk factor for the skip lymph node metastasis in pN1 stage gastric cancer (OR=1.982, 95%CI: 0.978 to 3.921, P=0.033).

CONCLUSIONSThe perigastric station No1 lymph node is the main site of early lymph node metastasis of pN1 stage gastric cancer. General pattern of lymph node metastasis is from proximus to distance, while quite a lot of skip lymph node metastases are observed. Tumor size is an important factor affecting the lymph node metastasis and bigger tumor may result in skip lymph node metastasis easily.

Objective: To evaluate the potential clinical value of standardized procedures of fine lymph node sorting from gastric can-cer samples after curative resection. Methods: Between January 2016 and December 2017, 727 gastric cancer patients who under- went R0 resection in the Tianjin Medical University Cancer Institute and Hospital were retrospectively included and assigned to either the fine lymph node sorting group or regional lymph node sorting group in accordance with the lymph node sorting methods from the tumor samples of all patients. Both the numbers of examined lymph nodes and metastatic lymph nodes were compared between the two groups. Additionally, correlation analyses were performed between the numbers of examined lymph nodes and metastatic lymph nodes in the two groups. Results: There was no significant difference in sex, age, or tumor size between the two groups (P>0.05), indi-cating that there was comparability between the two groups. The number of examined lymph nodes in the fine lymph node sorting group was significantly higher than that in the regional lymph node sorting group (P<0.001). Furthermore, the number of examined lymph nodes in the fine lymph node sorting group was much higher than that in the regional lymph node sorting group with the same pT, pN, or pTNM stage (P<0.001). The number of metastatic lymph nodes in the fine lymph node sorting group was significantly higher than that in the regional lymph node sorting group (P<0.001). There was a significant positive correlation between the numbers of ex-amined lymph nodes and metastatic lymph nodes in both groups (fine lymph node sorting group r=0.181, P=0.023; regional lymph node sorting group r=0.227, P<0.001). Additionally, the correlation coefficient between the numbers of examined lymph nodes and metastatic lymph nodes in the fine lymph node sorting group was weaker than that in the regional lymph node sorting group. Conclu-sions: The standard procedures of fine lymph node sorting from tumor samples of gastric cancer may increase the number of exam-ined lymph nodes, accurately provide the postoperative pN stage, reduce the stage migration, and should be applied in clinical stan-dardization.

Objective:To investigate the clinical efficacy of radical proximal gastrectomy with esophagogastrostomy and double-tract anastomosis for upper gastric cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 172 patients who underwent radical proximal gastrectomy for upper gastric cancer in Tianjin Medical University Cancer Institute and Hospital from January 2018 to December 2020 were collected. There were 147 males and 25 females, aged from 25 to 81 years, with a median age of 62 years. All the 172 patients underwent digestive reconstruction. Of the 172 patients, 83 cases undergoing esophagogastrostomy were allocated into esophagogastrostomy group, 89 cases undergoing double-tract anastomosis were allocated into double-tract anastomosis group. Patients were performed radical proximal gastrectomy combined with D 1+ lymph node dissection by attending surgeons from department of gastric cancer. The operator decided to adopt esophagogastrostomy or double-tract anastomosis for digestive reconstruction. Observation indicators: (1) surgical situations; (2) follow-up. Follow-up using outpatient examination, telephone interview, and online APP was conducted at postoperative 1 month, once three months within postoperative 2 years, and once six months within postoperative 2-5 years. The questionnaires of reflux esophagitis, gastroscopy and upper gastrointestinal angio-graphy were conducted to evaluate gastroesophageal reflux and anastomotic stenosis up to February 1, 2021. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M (range), and comparison between groups was analyzed using the Mann-Whitney U test. Comparison of ordinal data was analyzed using the non-parameter rank sum test. Count data were represented as absolute numbers, and comparison between groups was analyzed using the chi-square test. Results:(1) Surgical situations: cases with open, laparoscopic or Da Vinci robotic surgery (surgical method), the number of metastatic lymph node, duration of postoperative hospital stay were 74, 9, 0, 2(range, 0-15), (12±4)days for the esophagogastrostomy group, versus 65, 15, 9, 3(range, 0-28), (11±3)days for the double-tract anastomosis group, respectively, showing significant differences in the above indicators between the two groups ( χ2=10.887, Z=-1.058, t=3.284, P<0.05). (2) Follow-up: 172 patients were followed up for 2-38 months, with a median follow-up time of 13 months. Cases with gastroesophageal reflux and anastomotic stenosis were 58 and 10 for the esophagogastrostomy group, versus 14 and 1 for the double-tract anastomosis group, respectively, showing significant differences in the above indicators between the two groups ( χ2=51.743, 7.219, P<0.05). Conclusions:For upper gastric cancer patients undergoing proximal radical gastrectomy, double-tract anastomosis is more suitable for Siewert type Ⅱ adenocarcinoma of esophagogastric junction in large curvature or lower located tumor. Compared with esophago-gastrostomy, double-tract anastomosis has lower incidence of postoperative gastroesophageal reflux and anastomotic stenosis, without increasing complications.

Objective To evaluate the impact of primary site, NIH risk and imatinib treatment on the prognosis of patients with gastrointestinal stromal tumors (GIST). Methods Clinicopathological data of 156 adult patients with GIST treated by imatinib in the Cancer Institute and Hospital of Tianjin Medical University from January 2006 to December 2010 were retrospectively analyzed. According to NIH risk classification, 30 patients were at moderate risk and 126 at high risk. Sixty-seven patients had advanced GIST. Prognosis of patients with different primary tumor site , different NIH risk and different treatment was compared respectively. Results Imatinib therapy was well tolerated in all the patients. Eighty-nine cases received radical operation and adjuvant imatinib treatment. Among 67 advanced GIST cases, 26 received radical operation and adjuvant imatinib treatment, 27 received palliative operation and adjuvant imatinib treatment, and 14 received simple adjuvant imatinib treatment without operation. All the patients had routine follow-up, ranging from 9 to 56 (median 27) months. The overall survival (OS) rate was 96% in 1-year, 86% in 2-year, and 71% in 3-year. The OS rate was 95% in 1-year, 77% in 2-year, and 65% in 3-year for patients at high risk, and all 100% in 1-, 2-, 3-year for patients at moderate risk, the differences was statistically significant (P=0.001). The OS rate was 97%in 1-year, 90% in 2-year, and 84% in 3-year for patients with gastric GIST, and 95% in 1-year, 69%in 2-year, and 52%in 3-year for patients with non-gastric GIST, the difference was significant(P=0.000). The OS rate was 98% in 1-year, 95% in 2-year, and 90% in 3-year for patients undergoing radical resection and adjuvant imatinib therapy. For 67 advanced GIST patients with imatinib therapy , none had complete remission, 41 had part remission, 15 had stable disease, indicating 56 advanced GIST cases (83.6%) obtaining clinical benefit. The OS rate was 91% in 1-year, 58% in 2-year, and 43% in 3-year. Conclusions The prognosis of high, and non-gastric and advanced GIST patients is poor. Radical resection combined with early imatinib treatment can improve the prognosis of GIST patients.