Peritoneal metastasis of gastric cancer is the main cause of death in gastric cancer patients. Peritoneal metastasis of gastric cancer is difficult to diagnose in its early stage due to lack of obvious clinical signs and symptoms, and poor treatment outcomes and prognosis are often associated with late stage peritoneal metastasis. Therefore, it is crucial to utilize effective early diagnostic tools and to improve the long-term outcomes and the prognosis of patients with advanced gastric cancer. Recently, systemic chemotherapy and intraperitoneal chemotherapy are the first line therapy, and cytoreductive operation plus abdominal cavity thermochemotherapy may be the best method in the treatment of peritoneal metastasis. However, conversion therapy has been gradually incorporated into the treatment of peritoneal metastasis of gastric cancer because of the better efficacy and the higher survival.
Antineoplastic Agents ; therapeutic use ; Antineoplastic Protocols ; Combined Modality Therapy ; methods ; Cytoreduction Surgical Procedures ; Early Detection of Cancer ; methods ; Humans ; Hyperthermia, Induced ; Peritoneal Neoplasms ; diagnosis ; secondary ; Prognosis ; Stomach Neoplasms ; mortality ; pathology ; Treatment Outcome

The aim of the present study was to accurately evaluate the association of Sox2 expression with the survival of patients with digestive tract cancers. Relevant literatures were identified by comprehensively searching databases including the Pubmed, Embase, CBMdisc, and Wanfang (up to October 2014). A meta-analysis was performed to clarify the association between Sox2 expression and overall survival or clinicopathological parameters of patients with digestive tract cancers (esophageal, gastric, and colorectal cancers). The results showed a significant association between high Sox2 expression and poor overall survival in patients with digestive tract carcinomas (HR=1.55, 95% CI=1.04-2.31), especially for patients with esophageal cancer (HR=2.04, 95%CI=1.30-3.22), colorectal cancer (HR=1.40, 95% CI=1.04-1.89), and digestive tract adenocarcinoma (HR=1.80, 95% CI=1.12-2.89), for Europeans (HR=1.98, 95% CI=1.44-2.71) or patients who did not receive neoadjuvant treatment (HR=1.73, 95% CI=1.10-2.72). Furthermore, Sox2 over-expression was highly correlated with vascular invasion (OR=1.86, 95% CI=1.25-2.77) and poor differentiation (OR=1.88, 95% CI=1.14-3.08), especially in esophageal and colorectal cancers. In conclusion, Sox2 expression may serve as a novel prognostic factor for patients with digestive tract cancers. Over-expression of Sox2 that is correlated with vascular invasion and poor differentiation suggests poor outcomes of patients with digestive tract cancers.
Antineoplastic Agents ; therapeutic use ; Biomarkers, Tumor ; genetics ; metabolism ; Colorectal Neoplasms ; diagnosis ; drug therapy ; mortality ; pathology ; Esophageal Neoplasms ; diagnosis ; drug therapy ; mortality ; pathology ; Gastrointestinal Tract ; metabolism ; pathology ; Gene Expression ; Humans ; Neoadjuvant Therapy ; methods ; Neoplasm Grading ; Neoplasms, Vascular Tissue ; diagnosis ; drug therapy ; mortality ; secondary ; Prognosis ; SOXB1 Transcription Factors ; genetics ; metabolism ; Stomach Neoplasms ; diagnosis ; drug therapy ; mortality ; pathology ; Survival Analysis

The death of patients with gastric cancer is mainly due to its recurrence and metastasis, and circulating tumor cell (CTC) is the necessary condition of metastasis. As liquid biopsy, CTC detection has its certain clinical significance. The detection is required after enrichment because circulating tumor cells are rare. Many enrichment methods have been developed: methods based on physical characteristics of TCT, like density, size and dielectric properties and so on; immunogenicity, like Cell Search System; and microfluidic chip technology. The immunofluorescence is commonly used to identify CTC in gastric cancer and the isolated CTC can also be used for the following analysis on the level of nucleic acid, protein and gene regulation. Detection of CTC in gastric cancer is helpful to judge the prognosis, assess staging, monitor the curative effect and guide the development of drug. There are many challenges for clinical transformation of CTC: the lower enrichment efficiency, the less specific surface markers, the uncertain diagnostic efficiency and so on, but it also has the good research prospect because it is non-invasive, repeatable and can real-time monitor the condition and guide the clinical treatment compared with pathological biopsy. In this paper, the detection and identification methods, and clinical value of CTC in gastric cancer patients are reviewed.
Biomarkers, Tumor ; Biopsy ; Cell Separation ; methods ; Cytodiagnosis ; methods ; Flow Cytometry ; methods ; Fluorescent Antibody Technique ; methods ; Humans ; Microchip Analytical Procedures ; methods ; Neoplasm Recurrence, Local ; prevention & control ; Neoplasm Staging ; methods ; Neoplastic Cells, Circulating ; metabolism ; pathology ; Prognosis ; Secondary Prevention ; Stomach Neoplasms ; blood ; diagnosis ; genetics ; therapy ; Treatment Outcome

Gastric cancer frequently disseminates to the liver, lung, and bone via hematogeneous, lymphatic, or peritoneal routes. However, gastric adenocarcinoma that metastasize to the colon and that shows typical linea platisca pattern on colonofiberscopy has rarely been reported. Recently, the authors experience a case of advanced gastric cancer with colonic metastases in a 55-year-old female patient. Multiple colonic lymphoid hyperplasias were detected on colonofiberscopy and biopsy revealed metastatic gastric cancer to the colonic wall. She was treated with mFOLFOX (5-FU, oxaliplatin, leucovorin) and has achieved stable disease status without disease progression. Herein, we report a rare case of signet ring-cell gastric cancer which metastasized to the colon in the form of multiple colonic lymphoid hyperplasias.
Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Colonic Neoplasms/*diagnosis/secondary ; Colonoscopy ; Female ; Fluorouracil/administration & dosage ; Gastroscopy ; Humans ; Hyperplasia/diagnosis ; Leucovorin/administration & dosage ; Middle Aged ; Organoplatinum Compounds/administration & dosage ; Positron-Emission Tomography ; Stomach Neoplasms/*diagnosis/drug therapy ; Tomography, X-Ray Computed

Although hematogenous metastasis of cancer to the gastrointestinal track is rare, it sometime has been reported in patients with malignant melanoma and breast cancer. However, it is extremely rare for lung cancer to metastasize to the stomach, not to mention solitary gastric metastasis. Herein, the authors report a case of a 69-year-old man who was initially diagnosed with lung cancer with synchronous primary gastric cancer which proved to be lung cancer with solitary gastric metastasis after the operation.
Adenocarcinoma/*diagnosis/pathology ; Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Diagnosis, Differential ; Endoscopy, Digestive System ; Humans ; Lung Neoplasms/*diagnosis/drug therapy/pathology ; Male ; Stomach Neoplasms/*diagnosis/secondary/surgery ; Tomography, X-Ray Computed

Hepatoid adenocarcinoma (HAC) is a rare type of extrahepatic carcinoma whose morphology is similar to that of hepatocellular carcinoma (HCC). Metachronous HCC and HAC in the same patient is extremely rare. The case of a 68-year-old man with chronic hepatitis B infection who had both HCC and HAC of the stomach is reported herein. Nine years previously this patient had been diagnosed with HCC and received a right lobectomy. HCC that recurred at the caudate lobe at 6 months after the operation was successfully treated with transarterial chemoembolization. The patient was followed up regularly thereafter without evidence of tumor recurrence for 9 years. In July 2010 his serum alpha-fetoprotein (AFP) level elevated from 6.5 ng/mL to 625.4 ng/mL, and he developed a probable single metastatic lymph node around the hepatic artery without intrahepatic lesions. Subsequent evaluation with upper endoscopy revealed a 4-cm ulcerative lesion on the antrum of the stomach. Subtotal gastrectomy was performed with lymph-node dissection. Histologic examination revealed a special type of extrahepatic AFP-producing adenocarcinoma-HAC with lymph-node metastasis-which indicates that HAC can be a cause of elevated AFP even in patients with HCC. HAC should be considered if a patient with stable HCC exhibits unusual elevation of AFP.
Adenocarcinoma/*diagnosis/drug therapy/secondary ; Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Camptothecin/analogs & derivatives/therapeutic use ; Carcinoma, Hepatocellular/*diagnosis/drug therapy/pathology ; Chemoembolization, Therapeutic ; Chemotherapy, Adjuvant ; Fluorouracil/therapeutic use ; Gastroscopy ; Humans ; Leucovorin/therapeutic use ; Liver Neoplasms/*diagnosis/drug therapy/pathology ; Lymph Nodes/surgery ; Lymphatic Metastasis ; Male ; Recurrence ; Silicates/therapeutic use ; Stomach Neoplasms/*diagnosis/drug therapy/secondary ; Titanium/therapeutic use ; Tomography, X-Ray Computed ; alpha-Fetoproteins/*analysis

No abstract available.
Adenocarcinoma/*diagnosis/radiography/secondary ; Adult ; Antineoplastic Agents/therapeutic use ; Breast Neoplasms/*diagnosis/drug therapy/pathology ; Carrier Proteins/metabolism ; Doxorubicin/therapeutic use ; Drug Therapy, Combination ; Endoscopy, Digestive System ; Female ; Glycoproteins/metabolism ; Humans ; Mastectomy, Modified Radical ; Positron-Emission Tomography and Computed Tomography ; Stomach Neoplasms/*diagnosis/radiography/secondary ; Taxoids/therapeutic use ; Tomography, X-Ray Computed

Spindle cell carcinoma (SpCC) is a rare tumor consisting of spindle cells which express cytokeratin. Despite recent advances in immunohistochemical and genetic studies, precise histogenesis of SpCC is still controversial and this tumor had been referred to with a wide range of names (in the past): carcinosarcoma, pseudosarcoma, sarcomatoid carcinoma, pseudosarcomatous carcinoma, and collision tumor. Recently, the authors experienced an extremely rare case of SpCC arising from the stomach. A 64-year-old male presented with unintended weight loss and hematochezia. Endoscopic examination revealed a fistulous tract between the stomach and the transverse colon which was made by direct invasion of SpCC of the stomach to the colon. Histologically, the tumor was positive for both vimentin and cytokeratin but negative for CD117, CD34, actin, and desmin. Herein, we report a case of SpCC arising from the stomach that formed a fistulous tract with the colon which was diagnosed during evaluation of hematochezia and weight loss.
Antineoplastic Agents/therapeutic use ; Brain Neoplasms/secondary ; Carcinoma/*diagnosis/drug therapy/pathology ; Colon, Transverse ; Endoscopy, Digestive System ; Fistula/pathology ; Gastrointestinal Hemorrhage/etiology ; Humans ; Keratins/metabolism ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Stomach Neoplasms/*diagnosis/drug therapy/pathology ; Tomography, X-Ray Computed ; Weight Loss

Gastric hepatoid adenocarcinoma is a special type of gastric carcinoma, which produces AFP. We report a case of an metastatic gastric hepatoid adenocarcinoma mistaken for primary hepatocellular carcinoma (HCC). A 72 year-old woman was transferred to our hospital for treatment of the hepatic mass. She underwent subtotal gastrectomy for gastric cancer 2 years ago. A year ago, she was diagnosed with hepatic mass and treated with transhepatic chemoembolization under the suspicion of primary HCC in other hospital. The hepatic mass looked like primary HCC on CT, and serum AFP was elevated to 18,735 IU/mL. We did the transhepatic mass biopsy and compared it to the histology of the previous gastric cancer. The results of immunohistochemical staining between them was coincident, and so it was diagnosed as a hepatic metastasis of gastric hepatoid adenocarcinoma.
Adenocarcinoma/*diagnosis/pathology/surgery ; Aged ; Carcinoma, Hepatocellular/*diagnosis/therapy ; Embolization, Therapeutic ; Endoscopy, Gastrointestinal ; Homeodomain Proteins/metabolism ; Humans ; Keratin-20/metabolism ; Keratin-7/metabolism ; Liver Neoplasms/diagnosis/*secondary/therapy ; Male ; Stomach Neoplasms/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed ; alpha-Fetoproteins/analysis

Gastric hepatoid adenocarcinoma is a special type of gastric carcinoma, which produces AFP. We report a case of an metastatic gastric hepatoid adenocarcinoma mistaken for primary hepatocellular carcinoma (HCC). A 72 year-old woman was transferred to our hospital for treatment of the hepatic mass. She underwent subtotal gastrectomy for gastric cancer 2 years ago. A year ago, she was diagnosed with hepatic mass and treated with transhepatic chemoembolization under the suspicion of primary HCC in other hospital. The hepatic mass looked like primary HCC on CT, and serum AFP was elevated to 18,735 IU/mL. We did the transhepatic mass biopsy and compared it to the histology of the previous gastric cancer. The results of immunohistochemical staining between them was coincident, and so it was diagnosed as a hepatic metastasis of gastric hepatoid adenocarcinoma.
Adenocarcinoma/*diagnosis/pathology/surgery ; Aged ; Carcinoma, Hepatocellular/*diagnosis/therapy ; Embolization, Therapeutic ; Endoscopy, Gastrointestinal ; Homeodomain Proteins/metabolism ; Humans ; Keratin-20/metabolism ; Keratin-7/metabolism ; Liver Neoplasms/diagnosis/*secondary/therapy ; Male ; Stomach Neoplasms/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed ; alpha-Fetoproteins/analysis