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Role of periostin and its antagonist PNDA-3 in gastric cancer metastasis

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World Journal of Gastroenterology 2015年第9期21卷 2605-2613页

作者： Guo-xiao Liu hong-qing xi xiao-Yan Sun Bo Wei Department of General Surgery Chinese People's Liberation Army General Hospital

The extracellular matrix component periostin is a secreted protein that functions as both a cell attachment protein and an autocrine or paracrine factor that signals through the cell adhesion molecule integrins αvβ3 and αvβ*** participates in normal physiological activities such as cardiac development,but is also involved in pathophysiological processes in vascular diseases,wound repair,bone formation,and tumor *** is of increasing interest in tumor biologybecause it is frequently overexpressed in a variety of epithelial carcinomas and is functionally involved in multiple steps of metastasis *** include the maintenance of stemness,niche formation,EMT,the survival of tumor cells,and angiogenesis,all of which are indispensable for gastric cancer *** has been reported to activate the PI-3K/AKT,Wnt,and FAK-mediated signaling pathways to promote ***,periostin represents a potentially promising candidate for the inhibition of *** this review article,we summarize recent advances in knowledge concerning periostin,its antagonist PNDA-3,and their influence on such key processes in cancer metastasis as maintenance of stemness,niche formation,epithelialto-mesenchymal transition,tumor cell survival,and *** particular,we focus our attention on the role of periostin in gastric cancer metastasis,speculate as to the usefulness of periostin as a therapeutic and diagnostic target for gastric cancer metastasis,and consider potential avenues for future research.

关键词： Periostin Cancer Tumorigenesis Extracellular matri

Establishment and validation of a nomogram to predict the risk of ovarian metastasis in gastric cancer: Based on a large cohort

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World Journal of Clinical Cases 2020年第19期8卷 4331-4341页

作者： Shao-qing Li Ke-Cheng Zhang Ji-Yang Li Wen-Quan Liang Yun-He Gao Zhi Qiao hong-qing xi Lin Che Department of General Surgery The First Medical CenterChinese PLA General HospitalBeijing 100853China Institute of General Surgery Chinese PLA General HospitalBeijing 100853China

BACKGROUND Ovarian metastasis is a special type of distant metastasis unique to female patients with gastric *** pathogenesis of ovarian metastasis is incompletely understood,and the treatment options are *** studies have predicted the risk of ovarian *** is not clear which type of gastric cancer is more likely to metastasize to the ovary.A prediction model based on risk factors is needed to improve the rate of detection and *** To analyze risk factors of ovarian metastasis in female patients with gastric cancer and establish a nomogram to predict the probability of occurrence based on different clinicopathological *** A retrospective cohort of 1696 female patients with gastric cancer between January 2006 and December 2017 were included in a single center,and patients with distant metastasis other than ovary and peritoneum metastasis were *** risk factors for ovarian metastasis were analyzed using univariate and multivariable logistic *** risk factors were chosen to construct a nomogram which received internal *** Ovarian metastasis occurred in 83 of 1696 female *** analysis showed that age,Lauren type,whether the primary lesion contained signet-ring cells,vascular tumor emboli,T stage,N stage,the expression of estrogen receptor,the expression of progesterone receptor,serum carbohydrate antigen 125 and the neutrophil-to-lymphocyte ratio were risk factors for ovarian metastasis of gastric cancer(all PN2,positive expression of estrogen receptor,serum carbohydrate antigen 125>35 U/mL,and a neutrophil-to-lymphocyte ratio>2.16 were independent risk factors(all P<0.05).The independent risk factors were constructed into a nomogram model using R language *** consistency index after continuous co

关键词： Stomach neoplasms Ovarian metastasis Risk factors Nomograms Krukenberg tumor

Comparison between laparoscopic and open surgery for large gastrointestinal stromal tumors:A meta-analysis

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World Journal of Gastrointestinal Oncology 2018年第1期10卷 48-55页

作者： Jian-xin Cui Yun-He Gao hong-qing xi Ai-Zhen Cai Ke-Cheng Zhang Ji-Yang Li Bo Wei Lin Chen Department of General Surgery Chinese PLA General Hospital

AIM To investigate whether laparoscopic surgery is as safe and feasible as open resection for patients with larger gastrointestinal stromal tumors(GISTs)(≥ 5 cm).METHODS A systematic search of Pub Med, EMBASE, Web of Science and the Cochrane Library database was performed. Relevant studies of laparoscopic and open surgery for GISTs of > 5 cm published before December 2016 were identified from these databases. The quality of the studies was assessed by the Newcastle-Ottawa Quality Assessment Scale. The tumor size, operation time, blood loss, postoperative hospital stay, complication rate, and disease-free survival rate were assessed. The software Stata(version 12.0) was used for the *** Five clinical trials comprising 209 patients with GISTs of similar larger sizes were evaluated. The pooled analysis of 100 patients in the laparoscopic resection group and 109 patients in the open resection group demonstrated that laparoscopic surgery was significantly associated with a shorter postoperative hospital stay(P < 0.001)and less blood loss(P = 0.002). Moreover, there were no statistically significant differences in the operation time(P = 0.38), postoperative complication rate(P = 0.88), or disease-free survival rate(P = 0.20) between two groups. CONCLUSION Our findings revealed that for patients with large GISTs of comparable sizes, laparoscopic surgery did not significantly influence the operation factors or clinical outcomes compared with open surgery. This suggests that laparoscopic resection is as acceptable as open surgery for treatment of large gastric GISTs.

关键词： Laparoscopic resection Open resection Gastrointestinal stromal tumor Meta-analysis Clinical outcome

Timing of surgery after neoadjuvant chemotherapy for gastric cancer: Impact on outcomes

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World Journal of Gastroenterology 2018年第2期24卷 257-265页

作者： Yi Liu Ke-cheng Zhang xiao-hui huang hong-qing xi Yun-he Gao Wen-quan Liang xin-xin Wang Lin chen Department of General Surgery & Institute of General Surgery Chinese People's Liberation Army General Hospital

AIM To evaluate whether the neoadjuvant chemotherapy(NAc T)-surgery interval time significantly impacts the pathological complete response(pc R) rate and longterm *** One hundred and seventy-six patients with gastric cancer undergoing NAc T and a planned gastrectomy at the chinese p LA General hospital were selected from January 2011 to January 2017. Univariate and multivariable analyses were used to investigate the impact of NAc T-surgery interval time( 6 wk) on pc R rate and overall survival(OS).RESULTS The NAc T-surgery interval time and clinician T stage were independent predictors of pc R. The interval time > 6 wk was associated with a 74% higher odds of pc R as compared with an interval time of 4-6 wk(p = 0.044), while the odds ratio(OR) of clinical T3 vs clinical T4 stage for pc R was 2.90(95%c I: 1.04-8.01, p = 0.041). In cox regression analysis of long-term survival, postneoadjuvant therapy pathological N(yp N) stage significantly impacted OS(N0 vs N3: h R = 0.16, 95%c I: 0.37-0.70, p = 0.015; N1 vs N3: h R = 0.14, 95%c I: 0.02-0.81, p = 0.029) and disease-free survival(DFS)(N0 vs N3: h R = 0.11, 95%c I: 0.24-0.52, p = 0.005; N1 vs N3: h R = 0.17, 95%c I: 0.02-0.71, p = 0.020). The surgical procedure also had a positive impact on OS and DFS. The hazard ratio of distal gastrectomy vs total gastrectomy was 0.12(95%c I: 0.33-0.42, p = 0.001) for OS, and 0.13(95%c I: 0.36-0.44, p = 0.001) for *** The NAc T-surgery interval time is associated with pc R but has no impact on survival, and an interval time > 6 wk has a relatively high odds of pc R.

关键词： Gastric cancer Timing of surgery Neoadjuvant chemotherapy

Serum HER2 as a predictive biomarker for tissue HER2 status and prognosis in patients with gastric cancer

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World Journal of Gastroenterology 2017年第10期23卷 1836-1842页

作者： hong-Zhi Shi Yu-Ning Wang xiao-Hui Huang Ke-Cheng Zhang hong-qing xi Jian-xin Cui Guo-xiao Liu Wen-Tao Liang Bo Wei Lin Chen Department of General Surgery Chinese PLA General Hospital Department of General Surgery General Hospital of Armed Police Force Department of Surgery Chinese PLA General Hospital Institute of General Surgery Chinese PLA General Hospital

AIM To investigate the association between serum human epidermal growth factor receptor 2(HER2) extracellular domain(ECD) and tissue HER2 status, and the prognostic value of serum HER2 ECD in patients with gastric *** A total of 239 patients with gastric cancer were enrolled from December 2012 to June 2013. Serum HER2 ECD was determined by chemiluminescent assay, and tissue HER2 status was evaluated by immunohistochemistry and fluorescence in situ hybridization assay. A receiver operating characteristic(ROC) curve was plotted to identify the optimal cut-off value for serum HER2 ECD assay for predicting survival in gastric cancer *** Serum HER2 ECD was significantly correlated with tissue HER2 status(P < 0.001), tumor size(P < 0.001), and intestinal type of gastric cancer(P =0.021). Serum HER2 ECD levels differed significantly between patients with HER2-positive tissue expression and those with HER2-negative tissue expression. ROC analysis yielded an area under the curve value of 0.79(95%CI: 0.71-0.87, P < 0.001), with a sensitivity and specificity of 0.54(95%CI: 0.37-0.70) and 0.93(95%CI: 0.88-0.96), respectively. With a cut-off value of 24.75 ng/m L, high serum HER2 ECD had a negative impact on overall survival of the patients(HR: 1.93, 95%CI: 1.32-4.38, P = 0.006). CONCLUSION Serum HER2 ECD could be a highly specific surrogate biomarker for tissue HER2 status in gastric cancer. Optimal cut-off criteria for predicting survival should be established.

关键词： Gastric cancer Serum HER2 extracellular domain Tissue HER2 status Prognosis

Palliative Therapy for Gastric Outlet Obstruction Caused by Unresectable Gastric Cancer： A Meta-analysis Comparison of Gastrojejunostomy with Endoscopic Stenting

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Chinese Medical Journal 2016年第9期129卷 1113-1121页

作者： Shi-Bo Bian Wei-Song Shen hong-qing xi Bo Wei Lin Chen Department of General Surgery Chinese People's Liberation Army General Hospital Beijing 100853 China

Background： Gastrojejunostomy （G J J） and endoscopic stenting （ES） are palliative treatments for gastric outlet obstruction （GO0） caused by gastric cancer. We compared the outcomes of GJJ with ES by performing a meta-analysis. Methods： Clinical trials that compared GJJ with ES for the treatment of GOO in gastric cancer were included in the meta-analysis. Procedure time, time to resumption of oral intake, duration of hospital stay, patency duration, and overall survival days were compared using weighted mean differences （WMDs）. Technical success, clinical success, procedure-related mortality, complications, the rate of re-obstruction, postoperative chemotherapy, and reintervention were compared using odds ratios （ORs）.Results： Nine studies were included in the analysis. Technical success and clinical success were not significantly different between the ES and GJJ groups. The ES group had a shorter procedure time （WMD = -80.89 min, 95% confidence interval [CI] = -93.99 to -67.78, P 〈 0.001）, faster resumption of oral intake （WMD = -3.45 days, 95% CI = -5.25 to -1.65, P 〈 0.001）, and shorter duration of hospital stay （WMD = -7.67 days, 95% CI = -11.02 to -4.33, P 〈 0.001）. The rate of minor complications was significantly higher in the GJJ group （OR = 0.13, 95% CI = 0.04-0.40, P 〈 0.001）. However, the rates of major complications （OR = 6.91, 95% CI = 3.90-12.25, P 〈 0.001）, re-obstruction （OR = 7.75, 95% CI = 4.06-14.78, P 〈 0.001）, and reintervention （OR = 6.27, 95% CI = 3.36-11.68, P 〈 0.001） were significantly lower in the GJJ group than that in the E S group. Moreover, GJJ was significantly associated with a longer patency duration （WMD = -167.16 days, 95% CI = -254.01 to -89.31, P 〈 0.001） and overall survival （WMD = -103.20 days, 95% CI = -161.49 to -44.91, P = 0.001）. Conclusions： Both GJJ and ES are effective procedures for the treatment of GOO caused by gastric cancer. ES is associated with better short-term outcomes. GJJ is preferable to ES in terms of its lo

关键词： Endoscopic Stenting Gastric Cancer Gastric Outlet Obstruction Gastrojejunostomy

Expression of epithelial cellular adhesion molecule in gastric cancer:A meta-analysis

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World Journal of Meta-Analysis 2016年第1期4卷 1-9页

作者： Yi-Bin xiao hong-qing xi Ji-Yang Li Lin Chen Department of General Surgery Chinese People's Liberation Army General Hospital

AIM： To obtain an accurate evaluation of the association between high expression of epithelial cellular adhesion molecule （EpCAM） and gastric cancer （GC） ***： Studies that had examined the association between high expression of EpCAM and GC risk were identified by searching electronic databases PubMed, EMBASE, Cochrane library and Chinese Biomedical Literature database. Risk ratios （RRs） together with their 95%CIs were used to assess the association between high expression of EpCAM and GC risk. We selected eligible studies based on inclusion criteria. RevMan 5.3 software was used to calculate the pooled ***： A total of 14 studies were included in this meta-analysis. EpCAM-positive cases were signifcantly associated with tumor size （RR： 1.68, 95%CI： 1.47-1.91, P 〈 0.00001 fxed-effect）, depth of invasion （RR： 1.37, 95%CI： 1.11-1.68, P = 0.003 random-effect）, TNM stage （RR： 2.02, 95%CI： 1.35-3.02, P = 0.0007 random-effect）, tumor location （RR： 0.80, 95%CI： 0.71-0.91, P = 0.0007 fxed-effect）, histologic differentiation （RR： 1.23, 95%CI： 1.13-1.33, P 〈 0.00001 fxed-effect） and lymph node metastasis （RR： 1.89, 95%CI： 1.28-2.80, P = 0.001 random-effect）. However, we did not observe any significant association between the presence of EpCAM with age, gender, distant metastasis, Borrmann type or Lauren classification. Additionally, EpCAM expression was not associated with the overall survival rate. The pooled HR of the overall effect was 1.39（95%CI： 0.30-6.48, P = 0.67 random-effect）.CONCLUSION： Our meta-analysis indicates that EpCAM contributes to GC risk, which acts as a prognostic factor and a marker of poor outcome.

关键词： Epithelial cellular adhesion molecule Gastric cancer Prognosis Progression Meta-analysis

Preoperative albumin levels predict prolonged postoperative ileus in gastrointestinal surgery

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World Journal of Gastroenterology 2020年第11期26卷 1185-1196页

作者： Wen-Quan Liang Ke-Cheng Zhang Hua Li Jian-xin Cui hong-qing xi Ji-Yang Li Ai-Zhen Cai Yu-Hua Liu Wang Zhang Lan Zhang Bo Wei Lin Chen Department of General Surgery&Institute of General Surgery Chinese People’s Liberation Army General HospitalBeijing 100853China Department of Surgical Oncology Xing Tai People's HospitalXingtai 054001Hebei Province China Institute of Army Hospital Management Chinese People’s Liberation Army General HospitalBeijing 100853China

BACKGROUND Prolonged postoperative ileus(PPOI) is a prolonged state of "pathological"gastrointestinal(GI) tract dysmotility. There are relatively few studies examining the influence of preoperative nutritional status on the development of PPOI in patients who underwent GI surgery. The association between preoperative albumin and PPOI has not been fully studied. We hypothesized that preoperative albumin may be an independent indicator of *** To analyze the role of preoperative albumin in predicting PPOI and to establish a nomogram for clinical risk *** Patients were drawn from a prospective hospital registry database of GI surgery.A total of 311 patients diagnosed with gastric or colorectal cancer between June 2016 and March 2017 were included. Potential predictors of PPOI were analyzed by univariate and multivariable logistic regression analyses, and a nomogram for quantifying the presence of PPOI was developed and internally *** The overall PPOI rate was 21.54%. Advanced tumor stage and postoperative opioid analgesic administration were associated with PPOI. Preoperative albumin was an independent predictor of PPOI, and an optimal cutoff value of 39.15 was statistically calculated. After adjusting multiple variables, per unit or per SD increase in albumin resulted in a significant decrease in the incidence of PPOI of 8%(OR = 0.92, 95%CI: 0.85-1.00, P = 0.046) or 27%(OR = 0.73, 95%CI:0.54-0.99, P = 0.046), respectively. Patients with a high level of preoperative albumin(≥ 39.15) tended to experience PPOI compared to those with low levels(< 39.15)(OR = 0.43, 95%CI: 0.24-0.78, P = 0.006). A nomogram for predicting PPOI was developed [area under the curve(AUC) = 0.741] and internally validated by bootstrap resampling(AUC = 0.725, 95%CI: 0.663-0.799).CONCLUSION Preoperative albumin is an independent predictive factor of PPOI in patients who underwent GI surgery. The nomogram provided a model to screen for early indications in the clinic

关键词： Albumin Prolonged postoperative ileus Gastrointestinal surgery Nomogram Complications

Military training-related abdominal injuries and diseases:Common types,prevention and treatment

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Chinese Journal of Traumatology 2022年第4期25卷 187-192页

作者： Chuan Pang Zhi-Da Chen Bo Wei Wen-Tong Xu hong-qing xi Division of Abdominal Trauma Surgery Department of General SurgeryFirst Medical Center of Chinese PLA General HospitalBeijing226010China

Military training is intense,difficult and often dangerous,so all kinds of injuries or diseases frequently occur during *** of the previous studies and reviews on military training-related injuries focused on musculoskeletal system,whereas there are no reviews of abdominal injuries and *** the incidence of military training-related abdominal injuries and diseases is relatively low,the patients’condition is often critical especially in the presence of abdominal organ injury,leading to multiorgan dysfunction syndrome and even *** paper elaborates on common types of military training-related abdominal injuries and diseases as well as the prevention and treatment measures,which provides some basis for scientific and reasonable training and improvement of medical security.

关键词： Military training Injuries Abdomen Prevention Treatment