OBJECTIVE: To observe the effect of grain-moxibustion at Zusanli (ST 36) and Weishu (BL 21) on neutrophil to lymphocyte ratio (NLR) and quality of life (QOL) in patients with advanced gastric cancer. METHODS: Sixty patients with advanced gastric cancer were randomly divided into an observation group and a control group, 30 cases in each one. In the control group, conventional chemotherapy regimen combined with symptomatic treatment，such as antiemetic, acid-suppressive, liver-protecting drugs. On the basis of the treatment in the control group, grain-moxibustion was applied at Zusanli (ST 36) and Weishu (BL 21) in the observation group, 9 cones for each acupoint, once a day for a total of 90 days. The levels of NLR were observed before and after treatment, and the clinical efficacy and quality of life were evaluated in the two groups. RESULTS: After treatment, the value of NLR in the observation group was significantly lower than before treatment (<0.05), there was no significant difference before and after treatment in the control group (>0.05), and the descend range of observation group was larger than the control group (<0.05). The effective rates (RR) were 33.3% (10/30) in the observation group and 36.7% (11/30) in the control group, there was no significant difference between the two groups (>0.05). After treatment, the QOL in the observation group was improved in diarrhea, loss of appetite, fatigue, nausea and vomiting, general health states (<0.05), there was no significant difference in the control group before and after treatment in varions scores (>0.05), and the observation group was superior to the control group in fatigue, sleep disorder, loss of appetite, diarrhea and general health states after treatment (<0.05). CONCLUSION Grain-moxibustion at Zusanli (ST 36) and Weishu (BL 21) can decrease NLR and improve QOL of patients with advanced gastric cancer.
Acupuncture Points ; Humans ; Lymphocytes ; immunology ; Moxibustion ; methods ; Neutrophils ; immunology ; Quality of Life ; Stomach Neoplasms ; immunology ; psychology ; therapy

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

Human epidermal growth factor receptor 2 (HER2) proteins are overexpressed in a high proportion of gastric cancer (GC) cases and affect the maintenance of cancer stem cell (CSC) subpopulations, which are used as targets for the clinical treatment of patients with HER2-positive GC. Despite improvements in survival, numerous HER2-positive patients fail treatment with trastuzumab, highlighting the need for more effective therapies. In this study, we generated a novel type of genetically modified human T cells, expressing a chimeric antigen receptor (CAR), and targeting the GC cell antigen HER2, which harbors the CD137 and CD3ζ moieties. Our findings show that the expanded CAR-T cells, expressing an increased central memory phenotype, were activated by the specific recognition of HER2 antigens in an MHC-independent manner, and effectively killed patient-derived HER2-positive GC cells. In HER2-positive xenograft tumors, CAR-T cells exhibited considerably enhanced tumor inhibition ability, long-term survival, and homing to targets, compared with those of non-transduced T cells. The sphere-forming ability and in vivo tumorigenicity of patient-derived gastric cancer stem-like cells, expressing HER2 and the CD44 protein, were also inhibited. Our results support the future development and clinical application of this adoptive immunotherapy in patients with HER2-positive advanced GC.
Animals ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasms, Experimental ; immunology ; pathology ; therapy ; Receptor, ErbB-2 ; immunology ; Receptors, Antigen, T-Cell ; immunology ; Stomach Neoplasms ; immunology ; pathology ; therapy ; Tumor Cells, Cultured

Gastric cancer (GC) is one of the most common tumor in the world, and remains a major public health problem and one of the leading causes of death. Recently many researches have demonstrated that systemic inflammatory response is associated with prognosis and response to therapy in gastric cancer, and the peripheral blood count test can partly reflect the systemic inflammatory response. Based on the peripheral blood count test, there are a lot of research regarding the relation between the platelet count (PLT), neutrophil, lymphocyte, white blood cell (WBC), neutrophil to lymphocyte ratio(NLR), platelet to lymphocyte ratio (PLR) with their prognostic role in gastric cancer. A high PLT and preoperative lymphocytopenia are both associated with increased lymph node metastasis, stage (III(+IIII(), serosal invasion (T3+T4) risk and poorer overall survival. Besides above, platelet monitoring following surgery can be applied to predict the recurrence for patients with GC that suffer preoperative high PLT but have restored PLT levels following resection. Moreover systemic inflammatory factors based on blood parameters, such as PLR, NLR and so on, have relation with the poor prognosis of patients with GC. Among them, high NLR is a negative predictor of prognosis in GC patients. However PLR remains inconsistent, while most researches demonstrated high PLR may be useful prognostic factor rather than independent prognostic factor. There are still some limitations which include various cut-off values, little of clinician attention, the uncertain mechanism, etc. Here we review the research progress in the prognostic role of the blood count test in gastric cancer.
Blood Cell Count ; methods ; statistics & numerical data ; Blood Platelets ; physiology ; Humans ; Inflammation ; blood ; diagnosis ; immunology ; Leukocyte Count ; statistics & numerical data ; Lymphatic Metastasis ; diagnosis ; immunology ; Lymphocyte Count ; statistics & numerical data ; Lymphopenia ; blood ; physiopathology ; Neoplasm Invasiveness ; immunology ; Neoplasm Recurrence, Local ; blood ; diagnosis ; Neoplasm Staging ; statistics & numerical data ; Neutrophils ; immunology ; Platelet Count ; statistics & numerical data ; Prognosis ; Stomach Neoplasms ; blood ; diagnosis ; immunology ; mortality ; Treatment Outcome

The epithelial cytokine response, associated with reactive oxygen species (ROS), is important in Helicobacter pylori (H. pylori)-induced inflammation. H. pylori induces the production of ROS, which may be involved in the activation of mitogen-activated protein kinases (MAPK), janus kinase/signal transducers and activators of transcription (Jak/Stat), and oxidant-sensitive transcription factor, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kappaB), and thus, expression of interleukin-8 (IL-8) in gastric epithelial cells. alpha-lipoic acid, a naturally occurring thiol compound, is a potential antioxidant. It shows beneficial effects in treatment of oxidant-associated diseases including diabetes. The present study is purposed to investigate whether alpha-lipoic acid inhibits expression of inflammatory cytokine IL-8 by suppressing activation of MAPK, Jak/Stat, and NF-kappaB in H. pylori-infected gastric epithelial cells. Gastric epithelial AGS cells were pretreated with or without alpha-lipoic acid for 2 h and infected with H. pylori in a Korean isolate (HP99) at a ratio of 300:1. IL-8 mRNA expression was analyzed by RT-PCR analysis. IL-8 levels in the medium were determined by enzyme-linked immunosorbent assay. NF-kappaB-DNA binding activity was determined by electrophoretic mobility shift assay. Phospho-specific and total forms of MAPK and Jak/Stat were assessed by Western blot analysis. ROS levels were determined using dichlorofluorescein fluorescence. As a result, H. pylori induced increases in ROS levels, mRNA, and protein levels of IL-8, as well as the activation of MAPK [extracellular signal-regulated kinase 1/2 (ERK1/2), c-Jun NH2-terminal kinase 1/2 (JNK1/2), p38], Jak/Stat (Jak1/2, Stat3), and NF-kappaB in AGS cells, which was inhibited by alpha-lipoic acid. In conclusion, alpha-lipoic acid may be beneficial for prevention and/or treatment of H. pylori infection-associated gastric inflammation.
Enzyme-Linked Immunosorbent Assay ; Epithelial Cells/metabolism ; Gastric Mucosa/*drug effects/metabolism/microbiology ; Gene Expression Regulation, Bacterial ; Helicobacter Infections/immunology/*metabolism ; Helicobacter pylori/drug effects/*pathogenicity ; Humans ; Interleukin-8/genetics/*metabolism ; JNK Mitogen-Activated Protein Kinases ; Janus Kinase 1 ; Mitogen-Activated Protein Kinases/*biosynthesis ; NF-kappa B/*metabolism ; RNA, Messenger/isolation & purification/metabolism ; Reactive Oxygen Species/metabolism ; STAT3 Transcription Factor ; Stomach/metabolism/*microbiology ; Thioctic Acid/*pharmacology

No abstract available.
Antibodies, Bacterial ; Helicobacter ; Helicobacter Infections ; Helicobacter pylori/*immunology ; Humans ; *Stomach Neoplasms

No abstract available.
Aged ; Antigens, CD38/analysis ; Biomarkers, Tumor/analysis ; Biopsy ; Gastrointestinal Hemorrhage/diagnosis/*etiology/therapy ; Gastroscopy ; Hematemesis/etiology ; Humans ; Immunohistochemistry ; Male ; Melena/etiology ; Membrane Glycoproteins/analysis ; Multiple Myeloma/*complications/immunology/pathology/therapy ; Recurrence ; Stomach Neoplasms/*complications/immunology/pathology/therapy

Korea and Japan show the highest incidence of gastric cancer and Helicobacter pylori infection. New 2013 guidelines on H. pylori infection differ between the two countries with regard to the indications for H. pylori eradication, diagnostic methods, and treatment regimens. Indications for eradication in Korean guideline focus on specific diseases such as peptic ulcer disease, low-grade gastric mucosa-associated lymphoid tissue lymphoma, and after resection of early gastric cancer, while Japanese guideline includes all H. pylori-associated gastritis for the prevention of dissemination. With regard to the diagnosis, either noninvasive or invasive method (except for bacterial culture) is recommended in Korea, while two noninvasive tests including serum anti-H. pylori IgG antibody level are preferred in Japan. As for the treatment regimens, second-line treatment (quadruple bismuth-containing regimen) is recommended without first-line triple therapy in areas of high clarithromycin resistance in Korea. However, there is no bismuth-based second-line treatment in Japan, and the Japanese regimen consists of a lower dose of antibiotics for a shorter duration (7 days). Such discrepancies between the two countries are based not only on the differences in the literature search and interpretation, but also on the different approvals granted by the national health insurance system, manufacturing process of the antibiotics, and diagnostic techniques in each country. Collaborations are required to minimize the discrepancies between the two countries based on cost-effectiveness.
Anti-Bacterial Agents/pharmacology/*therapeutic use ; Antibodies/blood ; Bismuth/pharmacology/therapeutic use ; Disease Eradication/trends ; Drug Administration Schedule ; Guidelines as Topic ; Helicobacter Infections/complications/diagnosis/*drug therapy ; *Helicobacter pylori/drug effects/immunology ; Humans ; Japan ; Lymphoma, B-Cell, Marginal Zone/complications/surgery ; Republic of Korea ; Stomach Neoplasms/complications/surgery

OBJECTIVETo evaluate the efficacy and safety of autologous cytokine-induced killer (CIK) cell t combined with XELOX regimen in treatment of senile advanced gastric cancer.

METHODSForty-six cases of senile advanced gastric cancer patients with a mean age of 70 years were prospectively divided into two groups according to individual acceptance of CIK cells: 25 patients receiving autologous CIK cell treatment combined with XELOX regimen (trial group) and 21 patients receiving simple chemotherapy (control group). Patients in CIK group were matched to those in control group by sex, ages, KPS ranking scores, histological type, pathological grade, and clinical stage. Immune reaction, adverse reaction, time to progression (TTP) and overall survival (OS) were evaluated.

RESULTSHost immune function was increased (P<0.05) and the adverse reaction was decreased in patients of trial group as compared to control group. There were no significant differences in response rate (RR)(33.3% vs. 23.1%, P>0.05), disease control rate (DCR)(86.7% vs. 80.8%, P>0.05) between the two groups. TTP (4.8 months vs. 3.1 months, P<0.05) and OS (7.1 months vs. 5.9 months, P<0.05) in trial group were significantly improved as compared to control group.

CONCLUSIONAutologous CIK cells combined with XELOX regimen can increase immune function, improve clinical efficacy, decrease adverse reaction and prolong OS for senile patients with advanced gastric cancers.

Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cytokine-Induced Killer Cells ; immunology ; Deoxycytidine ; analogs & derivatives ; Fluorouracil ; analogs & derivatives ; Humans ; Immunotherapy, Adoptive ; Prospective Studies ; Stomach Neoplasms ; immunology ; therapy

Gastric cancer is the second most common cause of cancer-related death in the world. A growing body of evidence indicates that inflammation is closely associated with the initiation, progression, and metastasis of many tumors, including those of gastric cancer. In addition, approximately 60% of the world's population is colonized by Helicobacter pylori, which accounts for more than 50% of gastric cancers. While the role of inflammation in intestinal and colonic cancers is relatively well defined, its role in stomach neoplasia is still unclear because of the limited access of pathogens to the acidic environment and the technical difficulties isolating and characterizing immune cells in the stomach, especially in animal models. In this review, we will provide recent updates addressing how inflammation is involved in gastric malignancies, and what immune characteristics regulate the pathogenesis of stomach cancer. Also, we will discuss potential therapeutics that target the immune system for the efficient treatment of gastric cancer.
Adaptive Immunity/*immunology ; B-Lymphocytes/immunology ; Cytokines/immunology ; Gastritis/immunology ; Helicobacter Infections/immunology ; Helicobacter pylori/immunology ; Humans ; Immunity, Innate/*immunology ; Immunotherapy/methods ; Receptors, Cytokine/immunology ; Stomach Neoplasms/diagnosis/*immunology/therapy ; T-Lymphocytes/immunology ; Tumor Microenvironment/*immunology