PURPOSE: The purpose of our study was to compare the serum levels of CEA, CA19-9 and H.pylori antibody in patients with the Lewis (a+) blood group with that of the patients with the Lewis (a-) blood group. We also compared the outcome of the stomach cancer patients with the Lewis (b+) blood group with that of the stomach cancer patients with the Lewis (b-) blood group. METHODS: All of the 94 patients who underwent gastrectomy for stomach cancer at our hospital were retrospectively reviewed. The outcomes of the CEA, CA19-9 and H.pylori. antibody serum levels, the TNM stage, the ABO blood group and the Rh blood group were compared between the patients with the Lewis blood groups (a+) and (a-) and the patients with the Lewis blood groups (b+) and (b-), respectively. RESULTS: The mean serum level of CEA between the patients with the Lewis blood group (a+) and (a-) showed a statistical correlation (mean value: 5.51 ng/ml vs 3.25 ng/ml, respectively, P=0.016). But the mean serum level of CA19-9 and H.pylori. antibodies between the patients with the Lewis blood group (a+) and (a-) did not show a significant difference. The mean serum levels of CEA, CA19-9 and H.pylori antibodies between the patients with the Lewis blood group (b+) and (b-) did not show a significant difference. CONCLUSION: It was revealed that an elevated CEA level was related with the Lewis blood group (a), but this was not related with the Lewis blood group (b) in stomach cancer patients.
Antibodies ; Blood Group Antigens ; Gastrectomy ; Humans ; Retrospective Studies ; Stomach Neoplasms* ; Stomach*

OBJECTIVETo investigate the predictive value of serum CA125 in peritoneal metastasis, and to examine the association of CA125 with the prognosis.

METHODSClinical data of 1285 gastric cancer patients admitted to the Qilu Hospital from March 2003 to September 2008 were retrospectively reviewed. The sensitivity, specificity and accuracy of serum CA125 for peritoneal metastasis were analyzed. Clinicopathological characteristics and survival were compared between patients with normal serum CA125 level(≤35 μg/L) and patients with elevated serum CA125 level(>35 μg/L).

RESULTSThe specificity, sensitivity and accuracy of serum CA125 for peritoneal metastasis were 96.0%, 13.8% and 81.2%, respectively. A significantly higher incidence of peritoneal metastasis was observed in the patients with elevated serum CA125 level as compared to those with normal serum CA125 level(43.2% vs. 16.5%). CA125 was an independent predictor of peritoneal metastasis(RR=3.475, 95% CI:2.124-5.685). The 5-year overall survival rate in patients with elevated serum CA125 level was 13.5%, which was significantly lower than that of patients with normal serum CA125 level (49.8%, P<0.01). CA125 was an independent prognostic factor of gastric cancers(HR=2.049, 95%CI:1.355-2.873).

CONCLUSIONSerum CA125 is useful in predicting peritoneal metastasis and prognosis of gastric cancer, which should be used as a routine examination of gastric cancer patients.

CA-125 Antigen ; blood ; Humans ; Neoplasm Staging ; Peritoneal Neoplasms ; blood ; secondary ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; blood ; pathology ; Survival Rate

Considerable concentrations of circulating nucleic acids have been reported in peripheral blood from cancer patients. These circulating nucleic acids bear a variety of tumor-specific information and potentially represent a stable source of non-invasive tumor biomarkers. The assessable genetic and epigenetic changes of circulating nucleic acids include DNA mutations, copy number alterations, abnormal methylation and disruption of microRNA. Such alterations reflecting molecular characteristics of tumor tissues, provide a new clue for noninvasive, real-time and monitoring test. In the present article, the main findings of research status related to the utility of circulating nucleic acids for early diagnosis, prognosis and monitoring of gastric cancer are reviewed. In addition, the advantage, the examination technique and the application prospection of circulating nucleic acids as tumor markers are also reviewed.
Biomarkers, Tumor ; blood ; Humans ; Nucleic Acids ; blood ; Prognosis ; Stomach Neoplasms ; diagnosis

Early diagnosis is the key to improve the prognosis of gastric cancer. How to screen out high-risk subjects of gastric cancer in population is a hot spot. Serum-based early detection of gastric cancer is suitable for high-risk population screening, which is more convenient and safer. This article reviews the diagnostic value of serum biomarkers for gastric cancer, including serum DNA methylation, various RNAs, pepsinogen, gastrin, osteopontin, MG7-Ag and CA724. Until now, there is still lack of ideal biomarkers for gastric cancer, and searching for specific RNAs may be promising for early diagnosis and screening of gastric cancer.
Biomarkers, Tumor ; blood ; Early Detection of Cancer ; trends ; Humans ; Sensitivity and Specificity ; Stomach Neoplasms ; blood ; diagnosis

PURPOSE: The human CD24 antigen is a small heavily glycosylated cell surface protein, which is expressed in hematological malignancies, as well as in a large variety of solid tumors. Its expression is now known to be related to the prognosis of several kinds of tumors. This study is designed to examine the prognostic significance of CD24 in Korean gastric cancer patients. MATERIALS AND METHODS: In the present study, we examined CD24 expression in 300 consecutive cases of gastric carcinoma by immunohistochemical staining using the tissue-array method. We also investigated the clinicopathological profiles related to CD24 expression. RESULTS: One hundred and three cases out of 300 (34.3%) showed the positive expression of CD24. The altered expression of CD24 was significantly associated with differentiated cancer (p=0.003), the intestinal subtype according to the Lauren classification (p<0.001), the advanced stage cancer (p=0.027), with lymphatic invasion (p=0.038) and with vascular invasion (p=0.006). The survival analysis revealed that the patients with CD24 positive expression showed significantly poorer survival than those without CD24 expression. Moreover, a combined evaluation revealed that PTEN /CD24 cases showed the best survival compared to other groups (p=0.01). CONCLUSION: Positive CD24 expression occurs in a subset of gastric carcinomas and it correlates significantly with lymphatic invasion, blood vessel invasion and poor survival.
Antigens, CD24 ; Blood Vessels ; Classification ; Hematologic Neoplasms ; Humans ; Immunohistochemistry ; Prognosis ; Stomach Neoplasms ; Survival Analysis

OBJECTIVETo evaluate the fast serum pepsinogen level of the healthy adults among local population in areas with high incidence of gastric cancer and to study the suitable cut-off values of serum pepsinogen abnormality for the screen of chronic atrophic gastritis (CAG) and gastric carcinoma (GC) in China.

METHODSSerum PG I and PG II levels were detected with time resolved fluorescence immunoassay (TRFIA). The fast serum PG I and PG I level as well as PG I/PG II ratio of 606 healthy adult residents among local population in Zanhuang county, Hebei province were detected and the normal distribution ranges determined. The relationship between different cut-off values of serum PG I level, PG I/PG II ratio and corresponding pathological changes in gastric mucosae were comparatively analyzed with serum PG detection, endoscopic biopsy and pathological observation in 720 cases of local residents receiving endoscopic examination in the high incidence area of gastric cancer. The efficacy, sensitivity and specificity of different PG I, PG II abnormality cut-off values in the screen p rogram of CAG and GC were statistically analyzed.

RESULTSThe serum PG I, PG II and PG I/PG II ratio levels of healthy adults from a local natural population in the high incidence area of gastric cancer were all skewed from normal distribution. The median level of PG I, PG II and PG I/PG II were 161 microg/L, 14.8 microg/L and 10.5 respectively. Data from comparative studies on serum PG level and pathological changes of gastric mucosae showed that within the serum PG I range from 40 microg/L to 80 microg/L and PG I/PG II ratio range from 3 to 8, sensitivity of the screening program for CAG and GC increased while the specificity decreased along with the increase of cutoff values of serum PG I and PG I/PG II ratio. Results from statistical receiver operator characteristic curve (ROC) analysis suggested that the best cut-off value of PG I and PG I/PG II abnormality for the screening of CAG and GC being PG I < or =60 microg/L,PG I/PG II < or =6 respectively.

CONCLUSIONThe serum PC I, PG II and PG I/PG II ratio levels of healthy adults from a local natural population in the high incidence area of gastric cancer were all skewed from normal distribution. Serum PG I < or =60 microg/L and PG I/PG II ratio < or =6 as abnormal cut-off value for the screen of CAG and GC could result relatively good sensitivity and specificity.

China ; Chronic Disease ; Gastritis, Atrophic ; blood ; diagnosis ; Humans ; Mass Screening ; Pepsinogen A ; blood ; Reference Values ; Sensitivity and Specificity ; Stomach Neoplasms ; blood ; diagnosis

OBJECTIVETo screen and identify the serum specific protein markers of patients with gastric cancer by proteomics technology, and to provide more comprehensive serum protein fingerprint model for the early diagnosis of gastric cancer.

METHODSPreoperative and postoperative blood samples were collected from 60 gastric cancer patients. Mass spectrometry (SELDI-TOF-MS) technology was used to detect and screen serum specific proteins in gastric cancer patients(preoperative group, postoperative group, metastasis group), and the result was compared with normal control group. Gel electrophoresis(TRICINE SDS-OAGE) technology was applied in the separation and purification for those different protein. Matrix assisted laser desorption ionization tandem time-of-flight mass spectrometry (MALDI-TOF/TOF) technology was used in the identification for the proteins following separation and purification.

RESULTMass spectrometry data of preoperative group and normal group resulted in 15 specific m/z peak(P<0.01). SVM screened by a combination of the highest index model Youden get m/z peak at 6 449.1 protein markers. The protein expression of preoperative group was significantly higher than that of normal group(2 299.3±2 029.3 vs. 509.5±168.3, P<0.01). Mass spectrometry data of preoperative group and postoperative group resulted in 6 specific m/z peak(P<0.01). SVM screened by a combination of the highest Youden index model indentified get m/z peak at 6 449.2 protein markers. The protein expression of preoperative group was significantly higher than that of postoperative group(1 247.9±685.0 vs. 476.5±157.8, P<0.01). Mass spectrometry data of preoperative group and metastasis group resulted in 12 specific m/z peak (P<0.01). SVM screened by a combination of the highest Youden index model indentified get m/z peak at 6 448.9 protein markers. The protein expression of metastasis group was higher than that of preoperative group(1 506.9±1 036.5 vs. 649.7±621.0). MALDI-TOF/TOF identified that the protein with m/z peak at 6 449 was Apo CIII(.

CONCLUSIONApo CIII( may be the specific serum protein marker of gastric cancer, which may provide a more comprehensive serum protein fingerprint model for the early diagnosis of gastric cancer and a new way for further research.

Biomarkers, Tumor ; blood ; Blood Proteins ; analysis ; Humans ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Stomach Neoplasms ; blood ; diagnosis

ObjectiveGastroscopy combined with gastric mucosa biopsies is currently regarded as a gold standard for diagnosis of gastric cancer. However, its application is restricted in clinical practice due to its invasive property. A new noninvasive population screening process combining the assay of anti-Helicobacter pylori antibody and serum pepsinogen (PG) (ABC method) is adopted to recognize the high-risk patients for further endoscopy examination, avoiding the unnecessary gastroscopy for most population and saving the cost consumption for mass screening annually. Nevertheless, controversies exist for the grouping of ABC method and the intervals of gastroscopy surveillance for each group. In this review, we summarized these popular concerned topics for providing useful references to the healthcare practitioner in clinical practice.

Data SourcesThe PubMed databases were systematically searched from the inception dates to November 22, 2017, using the keywords "Helicobacter pylori," "Pepsinogens," and "Stomach Neoplasms."

Study SelectionOriginal articles and reviews on the topics were selected.

ResultsAnti-H. pylori antibody and serum PG concentration showed significant changes under the different status of H. pylori infection and the progression of atrophic gastritis, which can be used for risk stratification of gastric cancer in clinic. In addition, anti-H. pylori antibody titer can be used for further risk stratification of gastric cancer contributing to determine better endoscopy surveillance interval.

ConclusionsThe early detection and diagnosis of gastric cancer benefit from the risk stratification, but the cutoff values for H. pylori antibody and serum PG concentration require further modification.

Antibodies, Bacterial ; blood ; immunology ; Gastroscopy ; Helicobacter Infections ; blood ; immunology ; Helicobacter pylori ; immunology ; Humans ; Mass Screening ; methods ; Stomach Neoplasms ; blood ; microbiology

Common methods of suicide are hanging, toxic substance ingestion, descent from height, and drowning. However, suicide by cutting the tongue is very rare and there are almost no reported cases in the literature. A 76-year-old man who had terminal gastric cancer with multiple liver metastases was found dead in his home. Upon autopsy, it was noted that his tongue was cut by a pair of scissors four times and copious blood was identified in the stomach and intestine. The total loss of blood volume was approximately 750 mL. He had also cut his finger-tip and stabbed his abdomen with a pair of scissors. We concluded that lingual artery injury by scissors was the cause of death.
Abdomen ; Aged ; Arteries ; Autopsy ; Blood Volume ; Cause of Death ; Drowning ; Eating ; Humans ; Intestines ; Liver ; Neoplasm Metastasis ; Stomach ; Stomach Neoplasms ; Suicide* ; Tongue*

PURPOSE: Perioperative blood transfusion and its influence on the immune system in cancer surgery is a subject of controversy. We made a retrospective study to comprehend the prognostic effects of perioperative blood transfusion in gastric cancer surgery. METHODS: A total 284 patients who underwent gastrectomy for gastric cancer from 1991 to 1998 were retrospectively reviewed. Uni- and multi-variated analyses of the incidence and amount of perioperative blood transfusion were performed, along with a comparison of the clinicopathologic features. RESULTS: Of the 284, 119 (42%) required no blood transfusion and 165 (58%) required blood transfusion within the perioperative period. The transfused group included patients with larger tumors (more than 4 cm, 67.1% vs 47.5%, P=0.001), with longer operation time (260.8 vs 229.2 min, P=0.001), with total gastrectomy (29.7% vs 14.4%, P=0.001), with advanced T-stages (P=0.001), and with more advanced nodal metastasis (P=0.005) than the nontransfused group. Overall comparison of transfused patients versus nontransfused patients by log rank analysis revealed a statistically significant adverse influence of blood transfusion on survival rate (58.7% vs 80.3%, P=0.001). However, after stratifying patients into stages and applying Cox-regression analyses, blood transfusion did not appear to have any effect on prognosis except stage III. CONCLUSION: We could not find any direct causal relationship between perioperative transfusion and long term prognosis in patients receiving gastric cancer surgery. However, in cases with advanced gastric cancer, it is better to refrain from unnecessary blood transfusion in the perioperative periods.
Blood Transfusion* ; Gastrectomy ; Humans ; Immune System ; Incidence ; Neoplasm Metastasis ; Perioperative Period ; Prognosis* ; Retrospective Studies ; Stomach Neoplasms* ; Stomach* ; Survival Rate