Publications by authors named "Pengliang Wang"

30 Publications

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Establishment and verification of prognostic model for gastric cancer based on autophagy-related genes.

Am J Cancer Res 2021 15;11(4):1335-1346. Epub 2021 Apr 15.

Department of Gastroenterology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer Tianjin 300060, P. R. China.

Autophagy played a significant role in the development of cancer. In this study, we explored the value of autophagy-associated genes in gastric cancer. RNA sequencing and clinical information containing 375 gastric cancer and 32 normal tissues were gathered from the TCGA portal. Then we stochastically allocated the autophagy-associated genes (AAGs) to training and testing groups. Next, we screened the discrepantly expressed AAGs and the prognostic AAGs by Cox regression analysis and Lasso regression analysis. Afterwards, we structured the model by using the prognostic AAGs and plotted Kaplan-Meier (KM) and receiver operating characteristic (ROC) curves to verify the performance of models in both groups. Besides, we utilized Gene Ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses to explore the molecular mechanisms of AAGs in gastric cancer. Finally, we demonstrated discrepant expression of AAGs within gastric cancer and non-tumor tissues at protein level with immunohistochemistry. 28 discrepantly expressed AAGs were screened from the TCGA database which contained 375 gastric cancer and 32 non-tumor samples. Cox and Lasso regression analyses were performed in training group and then we got 5 prognostic AAGs to establish the prognostic model. The patients who had high risk possessed worse overall survival (OS) both in training group (5-year OS, 47.6% vs 23.1%; P < 0.0001) and test group (5-year OS, 49.2% vs 0%, P=0.019). The proportion under ROC curves (AUC) were significant both in training group and test group (5-year AUC, 0.736 vs 0.809). Through this study, we constructed a model for gastric cancer patients which may provide individual treatment and superior prognosis.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8085875PMC
April 2021

DNMT3A-mediated silence in ADAMTS9 expression is restored by RNF180 to inhibit viability and motility in gastric cancer cells.

Cell Death Dis 2021 04 30;12(5):428. Epub 2021 Apr 30.

Department of Gastroenterology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy, Tianjin; Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China.

ADAMTS9 belongs to the ADAMTS (a disintegrin and metalloproteinase with thrombospondin motifs) protein family, and its expression is frequently silenced due to promoter hypermethylation in various human cancers. However, the underlying mechanisms remain largely unknown. In this study, we investigated the inhibitory effects of ADAMTS9 on gastric cancer (GC) cells. We initially examined ADAMTS9 protein level in 135 GC and adjacent normal tissue pairs, showing that ADAMTS9 was strikingly decreased in the malignant specimens and patients with low ADAMTS9 expression exhibited more malignant phenotypes and poorer outcome. ADAMTS9 expression was restored in AGS and BGC-823 cells, which then markedly suppressed cellular viability and motility in vitro and in vivo. As ADAMTS9 was enriched in the nuclei of gastric mucosal cells, RNA-sequencing experiment showed that ADAMTS9 significantly altered gene expression profile in BGC-823 cells. Additionally, DNA methyltransferase 3α (DNMT3A) was identified to be responsible for the hypermethylation of ADAMTS9 promoter, and this methyltransferase was ubiquitinated by ring finger protein 180 (RNF180) and then subject to proteasome-mediated degradation. In conclusion, we uncovered RNF180/DNMT3A/ADAMTS9 axis in GC cells and showed how the signaling pathway affected GC cells.
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http://dx.doi.org/10.1038/s41419-021-03628-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087691PMC
April 2021

Comparison of three lymph node staging methods for predicting outcome in breast cancer patients with mastectomy.

Ann Transl Med 2021 Feb;9(4):300

Department of Breast Surgery, the First Affiliated Hospital of China Medical University, Shenyang, China.

Background: Axillary lymph node (ALN) staging is essential in predicting the clinical outcome of breast cancer (BC) patients. Traditionally, it follows the tumor-node-metastasis (TNM) staging, but its accuracy needs further improvement.

Methods: A total of 9,616 BC patients from the Surveillance, Epidemiology, and End Results (SEER) database and 675 patients from the First Affiliated Hospital of China Medical University underwent mastectomy together with ALN dissection were reviewed. Univariate and multivariate logistic analyses were conducted to find the most meaningful factors relevant to prognosis.

Results: After univariate and multivariate analyses, age, race, primary site, radiation, chemotherapy, grade, T-stage, estrogen receptor (ER), progesterone receptor (PR), total number of positive lymph nodes (pN), positive lymph node ratio (LNR) and log odds of positive LNs (LODDS) were found to be significantly associated with overall survival (OS). Using these non-LN risk factors, we further compared the efficacy of three different ALN staging methods in prognosis via nomograms. Harrell's concordance index (C-index) and Akaike Information Criterion (AIC) were used to measure nomogram performance of the ALN staging methods: pN: C-index=0.687 (95% CI: 0.678-0.696), AIC =61,398.24; LNR: C-index =0.691 (95% CI: 0.683-0.701), AIC =61,313.56; and LODDS: C-index =0.691 (95% CI: 0.682-0.700), AIC =61,315.60. We found that the nomogram incorporating LODDS had better predictive ability compared with other two methods. Furthermore, an external validation revealed a C-index of 0.753 (95% CI: 0.690-0.816) for the Asian population, which indicates the nomogram based on LODDS may have universality for both Western and Asian populations.

Conclusions: Compared with pN and LNR, LODDS showed higher homeostasis in LN evaluation, and showed marked efficacy in evaluating survival differences among patients with negative LN staging. We constructed a BC prognosis model by incorporating highly relevant clinical pathological factors and a new method of LN staging, which may greatly aid in guiding postoperative treatment.
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http://dx.doi.org/10.21037/atm-20-4856DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7944312PMC
February 2021

Effects of a high body mass index on the short-term outcomes and prognosis after radical gastrectomy.

Surg Today 2021 Jul 10;51(7):1169-1178. Epub 2021 Mar 10.

Department of Gastric Cancer Surgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, West Huan-Hu Rd, Ti Yuan Bei, Hexi District, Tianjin, 300060, China.

Purpose: This study aimed to investigate the effects of a high body mass index (BMI) on the outcomes of radical gastrectomy for gastric cancer.

Methods: We conducted a retrospective cohort study of 1729 patients with stage I to III gastric cancer who received open radical gastrectomy from February 2003 to August 2011. The patients were divided into 3 groups according to their BMI: a low BMI group (BMI < 18.5 kg/m), normal BMI group (18.5 ≤ BMI < 25 kg/m), and high BMI group (BMI ≥ 25 kg/m).

Results: A total of 871 patients were included in the final analysis, of which the median BMI was 22.7 kg/m (range 13.6-44.9 kg/m). A high BMI increased the risk of postoperative intestinal fistula but not the risk of a reduced number of examined lymph nodes or hospital death. Furthermore, a high BMI did not negatively affect the overall survival (OS) of gastric cancer patients.

Conclusions: A high BMI increased the operative morbidity after radical gastrectomy for gastric cancer. However, a high BMI did not negatively affect the quality of lymphadenectomy or the OS of gastric cancer patients in experienced high-volume centers. A careful approach during operation and meticulous perioperative management are required for gastric cancer patients with a high BMI.
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http://dx.doi.org/10.1007/s00595-021-02259-9DOI Listing
July 2021

Cloning and expression of the ChGstα and ChGstκ genes in the gills of Crassostrea hongkongensis under nanoparticulate and ionic Zn stress.

Comp Biochem Physiol C Toxicol Pharmacol 2021 Jun 18;244:109007. Epub 2021 Feb 18.

Guangxi Key Laboratory of Beibu Gulf Marine Biodiversity Conservation, Beibu Gulf University, Guangxi 535011, PR China. Electronic address:

Nanoparticulate and ionic Zn have potential impacts on the detoxification systems of organisms, and Gst genes play key roles in the detoxification of xenobiotics. In this study, we cloned the ChGstα and ChGstκ genes of C. hongkongensis, and studied their expression in gills under nanoparticulate and ionic Zn stress. The results showed that the coding sequences of the ChGstα and ChGstκ genes were 684 and 675 bp, respectively, and had no signal peptide; ChGstα was cytoplasmic, while ChGstκ was mitochondrial. The two genes were expressed in all 8 tested samples, with the most abundant expression observed in hemocytes for ChGstα and digestive glands for ChGstκ. After ZnCl or ZnoNP challenge, the expression of ChGstα decreased significantly in the ZnCl groups, and its expression was higher in the ZnoNP groups than in the ZnCl groups. The expression of ChGstκ was significantly decreased in the ZnCl and ZnoNP groups, and its expression was higher in the ZnoNP groups than in the ZnCl groups except at 3 h post metal Zn stress, which suggested that ChGstα and ChGstκ were more sensitive to ZnoNP than ZnCl.
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http://dx.doi.org/10.1016/j.cbpc.2021.109007DOI Listing
June 2021

The complete mitochondrial genome of (Jordan & Snyder, 1901).

Mitochondrial DNA B Resour 2020 Aug 12;5(3):3154-3156. Epub 2020 Aug 12.

Guangxi Key Laboratory of Beibu Gulf Marine Biodiversity Conservation, Beibu Gulf University, Qinzhou, China.

is one of the species in the China-Vietnam Collective Fishery Zone, which has a few relevant studies. In this study, the mitochondrial genome of was determined for the first time using next-generation sequencing; the overall base components of mitogenome consisting of 17,784 bp was 32.45% for A, 25.76% for T, 15.72% for G, 26.08% for C, and its GC content was 41.8%. The mitochondrial circular genome was composed of 13 protein-coding genes, 22 transfer RNAs, 2D-loop, and 2 ribosomal RNAs. Polygenetic analysis showed that the was very close to . It can provide data reference for the analysis of genetic evolution of this species.
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http://dx.doi.org/10.1080/23802359.2020.1806130DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7782292PMC
August 2020

RNF180 mediates STAT3 activity by regulating the expression of RhoC via the proteasomal pathway in gastric cancer cells.

Cell Death Dis 2020 10 20;11(10):881. Epub 2020 Oct 20.

Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.

Ring finger protein 180 (RNF180) is an important member of the E3 ubiquitin ligase family. As a tumor suppressor gene, RNF180 is significantly associated with the prognosis of patients with gastric cancer (GC) and can inhibit the proliferation, invasion, and migration of GC cells. Signal transducer and activator of transcription 3 (STAT3) are considered one of the most common oncogenes in human cancers with a key role in GC progression. In this study, we explored the molecular signaling pathways by which RNF180 could potentially regulate STAT3 through transcriptomics and proteomics experiments. Here, we found RNF180 overexpression could suppress STAT3 phosphorylation in GC cells. Ubiquitin label-free experiments showed that the ubiquitination level of Ras homolog gene family member C (RhoC) is significantly increased in GC cells transfected with an RNF180 expression vector (RNF180-GFP vector) compared with cells transfected with an empty vector (vehicle vector). We subsequently demonstrated that RNF180 could directly combine with RhoC and promote the ubiquitination and degradation of RhoC protein in GC cells. The phosphorylation level of STAT3 significantly decreased in GC cells after RhoC knockdown using small hairpin RNA (shRNA). Together, these results reveal RNF180 could inhibit GC progression by reducing the phosphorylation of STAT3 via the ubiquitination and degradation of RhoC protein in GC cells. Thus, the protein may be considered a novel therapeutic target for patients with GC.
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http://dx.doi.org/10.1038/s41419-020-03096-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7575565PMC
October 2020

Proposal of a novel subclassification of pN3b for improvement the prognostic discrimination ability of gastric cancer patients.

Eur J Surg Oncol 2020 10 4;46(10 Pt B):e20-e26. Epub 2020 Jul 4.

Affiliated Cancer Hospital & Institution of Guangzhou Medical University, Guangzhou, 510060, China; Department of Gastroenterology, Tianjin Medical University Cancer Hospital, City Key Laboratory of Tianjin Cancer Center and National Clinical Research Center for Cancer, Tianjin, 300060, China. Electronic address:

Introduction: In the recent edition of TNM staging system, pN3b gastric cancer were separated into the staging system for better prognosis accuracy. The definition of pN3b contains a large range of metastasis lymph nodes (mLNs). However, few studies have evaluated the prognosis of pN3b patients and it remains unknown whether these patients were reasonably assigned into the same substage.

Materials And Methods: A total of 642 pN3b patients from a multi-institutional cohort in China were included. Disease-specific survival (DSS) was estimated using the Kaplan-Meier method and the Cox proportional hazards regression analysis was used to identify the independent prognostic factors. Restricted cubic spine model was used to specify the association between the continuous variables and the logarithm Hazard ratios (HRs). The optimal cut-off value of mLNs for DSS was identified using the X-tile software.

Results: The 5-year DSS rate of total pN3b cohort was 15.4%. The smooth curves showed a non-linear association between the mLNs and the logarithm HRs. All pN3b gastric cancer patients were divided into two subclassifications (pN3b1: 16-24 mLNs, pN3b2: ≥25 mLNs). Significant survival difference was observed between two subclassifications (P = 0.048). Additionally, more LNs examined could decrease the death risk of pN3b patients and bring survival benefit only in pN3b1 patients, but not in pN3b2 patients.

Conclusions: We proposed a novel subclassification of pN3b patients, which assigned patients into two subclassifications with significant survival difference. Future study should explore the prognosis value based on this novel subclassification in TNM staging system.
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http://dx.doi.org/10.1016/j.ejso.2020.06.033DOI Listing
October 2020

Reconstruction Methods and Complications of Esophagogastrostomy and Jejunal Interposition in Proximal Gastrectomy for Gastric Cancer: A Meta-Analysis.

Gastroenterol Res Pract 2020 16;2020:8179254. Epub 2020 Jan 16.

Department of Surgical Oncology, Department of General Surgery, First Affiliated Hospital, China Medical University, Shenyang, China.

Background: Proximal gastrectomy is used for the treatment of primary gastric cancer by open or laparoscopic surgery in the upper third of the stomach. Esophagogastrostomy (EG) or jejunal interposition (JI) is widely used in various reconstruction methods after proximal gastrectomy. We conducted a meta-analysis of EG and JI for treatment of gastric cancer.

Materials And Methods: A search of PubMed, Embase, MEDLINE, J-STAGE, and Cochrane Library identified retrospective series on EG and JI. Weight mean differences (WMDs), odds ratios (ORs), and 95% confidence intervals (CIs) were used to analyze the operation-related data and postoperative complications. Heterogeneity was evaluated by the test, and potential publication bias was assessed with Egger regression tests and sensitivity analysis.

Results: Eight studies were selected, and 496 patients were included. EG group benefits were 44.81 min shorter operating time ( < 0.001), 56.58 mL less blood loss ( = 0.03), and 7.4 days shorter hospital stay time ( < 0.001) than the JI group. Between the two groups, there was no significant difference in anastomotic leakage; otherwise, the EG group had a lower risk of anastomotic stenosis (OR = 0.44, 95%CI = 0.20 to 0.97, = 0.04), lower risk of intestinal obstruction (OR = 0.07, 95%CI = 0.01 to 0.43, = 0.004), and higher risk of reflux esophagitis (OR = 2.47, 95%CI = 1.07 to 5.72, = 0.03).

Conclusion: The results of our study indicated that EG has significant advantages during the perioperative period and in short-term outcomes compared to JI.
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http://dx.doi.org/10.1155/2020/8179254DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201443PMC
January 2020

Prognostic impact of D2-plus lymphadenectomy and optimal extent of lymphadenectomy in advanced gastric antral carcinoma: Propensity score matching analysis.

Chin J Cancer Res 2020 Feb;32(1):51-61

Department of Gastrointestinal Cancer, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center of Cancer; Key Laboratory of Cancer Prevention and Therapy; Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.

Objective: To investigate the prognostic impact of D2-plus lymphadenectomy including the posterior (No. 8p, No. 12b/p, No. 13, and No. 14v), and para-aortic (No. 16a2, and No. 16b1) lymph nodes (LNs) in subtotal gastrectomy for advanced gastric antral carcinoma.

Methods: A total of 203 patients with advanced gastric cancer (GC) located in the antrum, who underwent R0 gastrectomy with D2 or D2-plus lymphadenectomy between January 2003 and December 2011 were enrolled. Propensity score matching was used to reduce the strength of the confounding factors to accurately evaluate prognoses. The therapeutic value index (TVI) was calculate to evaluate the survival benefit of dissecting each LN station.

Results: Of 102 patients with D2-plus lymphadenectomy, 21 (20.59%) were pathologically identified as having LN metastases beyond the extent of D2 lymphadenectomy. After matching, the overall survival (OS) was significantly better in the D2-plus than the D2 group (P=0.030). In the multivariate survival analysis, D2-plus lymphadenectomy (hazard ratio, 0.516; P=0.006) was confirmed to significantly improve the survival rate. In the logistic regression analysis, pN stage [odds ratio (OR), 2.533; 95% confidence interval (95% CI), 1.368-4.691; P=0.003] and extent of LNs metastasis (OR, 5.965; 95% CI, 1.335-26.650; P=0.019) were identified as independent risk factors for LN metastases beyond the extent of D2 lymphadenectomy. The TVI of patient with metastasis to LNs station was 7.1 (No. 8p), 5.7 (No. 12p), 5.1 (No. 13), and 7.1 (both No. 16a2 and No. 16b1), respectively.

Conclusions: D2-plus lymphadenectomy may improve the prognoses of some patients with advanced GC located in the antrum, especially for No. 8p, No. 12b, No. 13, and No. 16.
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http://dx.doi.org/10.21147/j.issn.1000-9604.2020.01.07DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7072021PMC
February 2020

Patient Selection for Adjuvant Chemotherapy in High-Risk Stage II Colon Cancer: A Systematic Review and Meta-Analysis.

Am J Clin Oncol 2020 04;43(4):279-287

Department of Surgical Oncology, First Affiliated Hospital of China Medical University.

Objectives: Patients with high-risk stage II colon cancer (CC) are recommended to undergo adjuvant chemotherapy (ACT). However, whether such patients can benefit from ACT remains unclear. This meta-analysis aimed to investigate the clinicopathologic parameters that are important for selecting patients for ACT in high-risk stage II CC.

Methods: We systematically retrieved articles from PubMed, the Cochrane Library, and Embase that were published up to September 13, 2018. We analyzed overall survival (OS) and disease-free survival (DFS) based on hazard ratios (HRs) and 95% confidence intervals (CIs).

Results: A total of 23 cohort studies and 1 randomized controlled trial were included in our study. Overall analyses showed that ACT improved OS (HR=0.64, 95% CI=0.51-0.80, P<0.001) and DFS (HR=0.46, 95% CI=0.28-0.76, P=0.002) in patients with high-risk stage II CC. Subgroup analyses showed that ACT improved OS in patients with localized intestinal perforation and obstruction and pT4 lesions and improved OS and DFS in patients with <12 sampled lymph nodes. However, ACT had no significant effect on OS in patients with lymphovascular invasion, perineural invasion, or poorly differentiated histology.

Conclusions: Our study suggests that not all high-risk factors (lymphovascular invasion, perineural invasion, poorly differentiated histology) show a benefit from ACT. Randomized controlled trials selectively targeting high-risk patients will need to be conducted in the future.
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http://dx.doi.org/10.1097/COC.0000000000000663DOI Listing
April 2020

Clinicopathological Characteristics and Prognosis of Upper Gastric Cancer Patients in China: A 32-Year Single-Center Retrospective Clinical Study.

Gastroenterol Res Pract 2019 1;2019:9248394. Epub 2019 Dec 1.

Department of Surgical Oncology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, China.

Purpose: Upper or proximal gastric cancer occurs in the upper third of the stomach between the cardia and a line connecting the greater and lesser curvatures. As it differs from other gastric cancers in pathology and prognosis, we evaluated patient and disease characteristics that might guide improved treatment and survival of upper gastric cancer.

Methods: We conducted a retrospective analysis of 649 patients with upper gastric cancer and 1551 patients with lower gastric cancer and R0 radical surgery at our institution between January 1980 and December 2012.

Results: Survival after radical surgery for upper gastric cancer was 77.8% at 1 year, 49.6% at 3 years, and 41.1% at 5 years. The corresponding rates for lower gastric cancer were 85.9%, 60.0%, and 57.2% ( < 0.001). Upper gastric cancer had a poor prognosis. Sex ( = 0.036), tumor diameter ( = 0.001), macroscopic type ( < 0.001), pTM stage ( < 0.001), tissue differentiation type ( = 0.003), and serosal invasion ( = 0.034) were independently associated with lymph node metastasis. The macroscopic type ( = 0.045), lymphovascular tumor emboli ( = 0.021), and pTNM stage were independently associated with recurrence and metastasis. Survival of 333 patients with D2 total gastrectomy was 81.3% at 1 year, 54.4% at 3 years, and 45.2% at 5 years. The corresponding rates for 316 proximal gastrectomy patients were 75.4%, 44.9%, and 36.7%. Radical total gastrectomy had better survival than radical proximal resection.

Conclusions: Upper gastric cancers were more aggressive, had a worse prognosis, and were more prone to recurrence and metastasis compared with lower gastric cancers. Survival was better after total gastrectomy than after proximal resection.
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http://dx.doi.org/10.1155/2019/9248394DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6914896PMC
December 2019

Retrieved lymph nodes from different anatomic groups in gastric cancer: a proposed optimal number, comparison with other nodal classification strategies and its impact on prognosis.

Cancer Commun (Lond) 2019 09 13;39(1):49. Epub 2019 Sep 13.

Department of Surgical Oncology, The First Affiliated Hospital of China Medical University, North Nanjing Street 155, Shenyang, 110001, Liaoning, P. R. China.

Background: The optimal number of retrieved lymph nodes (LNs) in gastric cancer (GC) is still debatable and previous studies proposing new classification alternatives mostly focused on the number of retrieved LNs without proper consideration on the anatomic nodal groups' location. Here, we assessed the impact of retrieved LNs from different nodal location groups on the survival of GC patients.

Methods: Stage I-III gastric cancer patients who had radical gastrectomy were investigated. LN grouping was determined according to the 13th edition of the JCGC. The optimal cut-off values of retrieved LNs in different LN groups (Group 1 and 2) were calculated, based on which a proposed nodal classification (rN) simultaneously accounting the optimal number and location of retrieved LNs was proposed. The performance of rN was then compared to that of LN ratio, log-odds of metastatic LNs (LODDs) and the 8th edition of the Union for International Cancer Control/American Joint Committee on Cancer (UICC/AJCC) N classification.

Results: The optimal cut-off values for Group 1 and 2 were 13 and 9, respectively. The 5-year overall survival (OS) was higher for patients in retrieved Group 1 LNs > 13 (vs. Group 1 LNs ≤ 13, 63.2% vs. 57.9%, P = 0.005) and retrieved Group 2 LNs > 9 (vs. Group 2 LNs ≤ 9, 72.5% vs. 60.7%, P = 0.009). Patients staged as pN0-3b were sub classified using this Group 1 and 2 nodal analogy. The OS of pN0-N2 patients in retrieved Group 1 LNs > 13 or Group 2 LNs > 9 were superior to those in retrieved Group 1 LNs ≤ 13 and Group 2 LNs ≤ 9 (All P < 0.05); except for pN3 patients. The rN classification was formulated and demonstrated better 5-year OS prognostication performance as compared to the LNR, LODDs, and the 8th UICC/AJCC N staging system.

Conclusions: The retrieval of > 13 and > 9 LNs for Group 1 and Group 2, respectively, could represent an alternative lymph node retrieval approach in radical gastrectomy for more precise survival prognostication and minimizing staging migration, especially if > 16 LNs is found to be difficult.
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http://dx.doi.org/10.1186/s40880-019-0394-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6743096PMC
September 2019

The complete mitochondrial genome of .

Mitochondrial DNA B Resour 2019 Sep 11;4(2):2942-2943. Epub 2019 Sep 11.

Guangxi Key Laboratory of Beibu Gulf Marine Biodiversity Conservation, Beibu Gulf University, Qinzhou, China.

is a common and important component of mangrove ecosystem. In this study, the mitogenome of was determined for the first time using next-generation sequencing; the overall base components of mitogenome consisting of 15,710 bp was 31.37% for A, 34.91% for T, 19.47% for G, 14.25% for C, and its GC content was 33.72%. The mitogenome was composed of 13 protein-coding genes, 22 tranfer RNAs, and 2 ribosomal RNAs. Polygenetic analysis showed that the was more close to and . We speculated that the was evolved from freshwater species.
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http://dx.doi.org/10.1080/23802359.2019.1662744DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7707012PMC
September 2019

The complete mitochondrial genome of (Stimpson, 1860).

Mitochondrial DNA B Resour 2019 Sep 6;4(2):2834-2835. Epub 2019 Sep 6.

Guangxi Key Laboratory of Beibu Gulf Marine Biodiversity Conservation, Beibu Gulf University, Qinzhou, Guangxi Autonomous Regions, China.

is a common and important shrimp species in the shallow waters of Indo-West Pacific. In this study, the mitochondrial genome of was determined for the first time using next-generation sequencing; the overall base components of mitogenome consisting of 15968 bp was 35.16% (5614 bp) for A, 33.51% (5351 bp) for T, 11.54% (1842 bp) for G, 19.80% (3161 bp) for C, and its GC content was 31.34%. The mitochondrial circular genome was composed of 13 protein-coding genes, 22 transfer RNAs, 1 D-loop and 2 ribosomal RNAs. Polygenetic analysis showed that the was more closed to .
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http://dx.doi.org/10.1080/23802359.2019.1660279DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7706880PMC
September 2019

Benefits of Surgery After Neoadjuvant Intraperitoneal and Systemic Chemotherapy for Gastric Cancer Patients With Peritoneal Metastasis: A Meta-Analysis.

J Surg Res 2020 01 14;245:234-243. Epub 2019 Aug 14.

Department of Surgical Oncology, the First Hospital of China Medical University, Shenyang, PR China; Key Laboratory of Gastric Cancer Molecular Pathology of Liaoning Province, Shenyang, PR China. Electronic address:

Background: Conversion therapy is intended to allow achieving R0 resection after chemotherapy for tumors initially considered unresectable or partially resectable. Neoadjuvant intraperitoneal and systemic chemotherapy (NIPS) is the current conversion therapy for gastric cancer (GC) patients with peritoneal metastasis. This meta-analysis evaluated the effectiveness and safety of NIPS-combined surgery for GC patients with peritoneal metastasis.

Methods: Standard methods were used to select and analyze studies that included GC patients with peritoneal metastasis assigned to two groups, either NIPS-combined surgery or a NIPS-only control. Publications were retrieved from PubMed, EMBASE, Medline, and the Cochrane Central Register. Overall survival, conversion therapy success and R0 resection rates, and adverse events were analyzed using Stata 11.0.

Results: Eight of the 14 studies that were evaluated after screening the titles and abstracts of 327 retrieved publications met the selection criteria. The eight retrospective studies included 373 patients with GC and peritoneal metastasis included 265 with NIPS-combined surgery and 109 with NIPS only. Survival was significantly better with NIPS-combined surgery than with NIPS only (hazard ratio = 0.440, 95% confidence interval [CI]: 0.274-0.704; P = 0.0001; odds ratio = 1.960; 95% CI: 1.247-3.083; P = 0.004). Subgroup analysis revealed significantly better survival with S-1 Joint intravenous paclitaxel and intraperitoneal paclitaxel compared with other NIPS regimens. NIPS regimens had a higher conversion rate (effect size [ES] = 0.656; 95% CI: 0.495-0.817; P < 0.05), higher percentage of patients with R0 surgery (ES = 0.633; 95% CI: 0.568-0.699; P < 0.05), less severe adverse reactions to chemotherapy (ES = 0.030; 95% CI: 0.020-0.040; P < 0.05), and fewer postoperative complications (ES = 0.040; 95% CI: 0.020-0.050; P < 0.05).

Conclusions: NIPS-combined surgical treatment was effective and safe for treating GC with peritoneal metastasis. Higher quality trials, better patient selection, and multicenter randomized controlled trials are needed to support standard treatment guidelines.
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http://dx.doi.org/10.1016/j.jss.2019.07.044DOI Listing
January 2020

The complete mitochondrial genome of (Philippi, 1848).

Mitochondrial DNA B Resour 2019 Jul 24;4(2):2742-2743. Epub 2019 Jul 24.

Guangxi Key Laboratory of Beibu Gulf Marine Biodiversity Conservation, Beibu Gulf University, Qinzhou, Guangxi Autonomous Regions, China.

is a common and important component of mangrove ecosystem. In this study, the mitochondrial genome of was determined for the first time using next-generation sequencing; the overall base components of mitogenome consisting of 15633 bp was 31.14% for A, 35.70% for T, 16.65% for G, 16.51% for C, and its GC content was 33.16%. The mitochondrial circular genome was composed of 13 protein-coding genes, 22 tranfer RNAs, and 2 ribosomal RNAs. Polygenetic analysis showed that the was more closed to than and . We may speculate that the is evolved from freshwater species.
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http://dx.doi.org/10.1080/23802359.2019.1644549DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7706624PMC
July 2019

The optimal strategy of multimodality therapies for resectable gastric cancer: evidence from a network meta-analysis.

J Cancer 2019 2;10(14):3094-3101. Epub 2019 Jun 2.

Department of Surgical Oncology, First Affiliated Hospital of China Medical University, Shenyang, China.

: Controversy continues regarding the optimal strategy of multimodality therapies for resectable gastric cancer. The aim of this network meta-analysis was to determine the efficacy of surgery combined with neoadjuvant or adjuvant chemotherapy (CT), radiotherapy (RT), and chemoradiotherapy (CRT) by integrating the direct and indirect method. : A systematic search for randomized controlled trials (RCTs) was performed through Medline, Embase, CENTRAL, and PMC databases. Overall survival (OS) was the primary outcome of interest. A Bayesian network meta-analysis was conducted and treatments were ranked based on their effectiveness for improving survival. : Fifty-six RCTs involving 12,435 patients were included. Overall analysis showed that neoadjuvant CRT resulted in a statistically significantly better OS compared with adjuvant CT, adjuvant RT, adjuvant CRT, neoadjuvant CT, neoadjuvant RT, and surgery alone. Moreover, subgroup analysis of D2 lymphadenectomy revealed that neoadjuvant CRT was not significant superior to neoadjuvant CT (HR = 0.67, 95% CrI 0.41-1.08), adjuvant CRT (HR = 0.67, 95% CrI 0.37-1.21), and adjuvant CT (HR = 0.60, 95% CrI 0.35-1.04). With a tendency to survival benefit, neoadjuvant CRT had an 89% probability of being the best selection. : Our study showed no significant survival advantage for neoadjuvant CRT, though the highest probability of being the best treatment was observed. Further clinical trials are essential to determine the value of neoadjuvant CRT, especially in D2 lymphadenectomy subgroup.
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http://dx.doi.org/10.7150/jca.30456DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6603377PMC
June 2019

Effects of metastasectomy and other factors on survival of patients with ovarian metastases from gastric cancer: a systematic review and meta-analysis.

J Cell Biochem 2019 09 3;120(9):14486-14498. Epub 2019 May 3.

Department of Surgical Oncology, First Affiliated Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, China.

Ovarian metastasis from gastric cancer (Krukenberg tumor [KT]) has no consensus treatment and the role of surgical treatment is still controversial. Identifying prognostic factors for KT could help guide the management of this tumor. We used a meta-analysis to evaluate the prognostic value of metastasectomy and other factors in patients with KT to develop a treatment plan. We searched literature in PubMed, Cochrane library and EMBASE. We analyzed hazard ratios (HR) and 95% confidence intervals (CI) with respect to overall survival (OS). The meta-analysis included 12 cohort studies with 1,031 patients associated with longer OS following metastasectomy (HR = 0.41; 95% CI = 0.32-0.53; P < 0.001), R0 resection (HR = 0.37; 95% CI = 0.26-0.53; P < 0.001), metachronous ovarian metastasis (HR = 0.74; 95% CI = 0.58-0.93; P = 0.012), size of KT (<5 cm) (HR = 0.74; 95% CI = 0.58-0.95; P = 0.019), ECOG PS (Eastern Cooperative Oncology Group performance status) 0 to 1 (HR = 0.48; 95% CI = 0.29-0.80; P  = 0.004), tumor confined to ovary (HR = 0.40; 95% CI = 0.16-0.99; P  = 0.047), and tumor confined to pelvic cavity (HR = 0.36; 95% CI = 0.14-0.92; P  = 0.033). Shorter OS was associated with peritoneal carcinomatosis (HR = 2.00; 95% CI = 1.25-3.21; P  = 0.004), ascites (HR = 1.66; 95% CI = 1.19-2.31; P  = 0.003) and positive CEA (HR = 1.41; 95% CI = 1.10-1.82; P  = 0.007). Gastrectomy led to a slight improvement in OS, but without statistical significance (HR = 0.69; 95% CI = 0.47-1.02; P  = 0.061). No significant difference in OS was observed in patients with signet-ring cells (HR = 1.17; 95% CI = 0.91-1.51; P  = 0.226), bilateral ovarian metastasis (HR = 0.87; 95% CI = 0.70-1.08; P  = 0.212), age ≥ 50 years (HR = 0.93; 95% CI = 0.71-1.22; P  = 0.619), positive CA19-9 (HR = 1.01; 95% CI = 0.75-1.35; P  = 0.960), and positive CA-125 (HR = 0.98; 95% CI = 0.73-1.33; P  = 0.915). Various factors affect OS in patients with KT.
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http://dx.doi.org/10.1002/jcb.28708DOI Listing
September 2019

Metastatic patterns and surgical methods for lymph nodes No. 5 and No. 6 in proximal gastric cancer.

Chin J Cancer Res 2019 Feb;31(1):171-177

Department of Surgical Oncology, the First Hospital of China Medical University, Shenyang 110001, China.

Objective: The current surgical treatment guidelines for early proximal gastric cancer (PGC) still lack agreement. Lymphadenectomy of lymph nodes No. 5 and No. 6 is the major difference between total and proximal gastrectomy. We elucidated the appropriate surgical procedure for PGC by investigating the pathological characteristics and prognostic significance of lymph nodes No. 5 and No. 6.

Methods: In total, 333 PGC patients who underwent total gastrectomy were enrolled in this study. We investigated their clinicopathological characteristics and the metastatic patterns of the lymph nodes. Patients with metastasis in lymph nodes No. 5 and No. 6 were combined into one group and we compared the difference in survival between those with and without metastasis in lymph nodes No. 5, 6 (lymph nodes No. 5 and No. 6 in any group of metastasis) for different subgroups.

Results: The metastatic rates for lymph nodes No. 5 and No. 6 in PGC were 9.91% and 16.11%, respectively. The metastatic rate for both lymph nodes No. 5, 6 was 20.42%. Multivariate analysis showed that positive metastasis in lymph node No. 4, depth of invasion, and tumor size were independently correlated with the presence of metastasis in lymph nodes No. 5, 6.

Conclusions: When lymph node No. 4 is positive (intraoperative pathology) or tumor size ≥5 cm or T4 stage, lymphadenectomy should be performed for lymph nodes No. 5 and No. 6, and total gastrectomy is recommended.
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http://dx.doi.org/10.21147/j.issn.1000-9604.2019.01.12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6433591PMC
February 2019

Novel immune-risk score of gastric cancer: A molecular prediction model combining the value of immune-risk status and chemosensitivity.

Cancer Med 2019 05 3;8(5):2675-2685. Epub 2019 Apr 3.

Department of Surgical Oncology, The First Affiliated Hospital of China Medical University, Shenyang, China.

Gastric cancer is still one of the most common and deadly malignancies in the world. Not all patients could benefit from chemotherapy or chemoradiotherapy due to tumor heterogeneity. Therefore, identifying different subgroups of patients is an important trend for obtaining more effective responses. However, few molecular classifications associated with chemosensitivity are based on immune-risk status. In this study, we obtained six key immune-related genes. Using these genes, we constructed a molecular model related to immune-risk status and calculated an individual immune-risk score. The score showed great efficiency and stability in predicting prognosis and identifying different subgroups where persons could benefit from postoperative adjuvant therapy. The patients could be divided into different risk groups based on the immune-related score. For patients in the low-risk group, both postoperative chemoradiotherapy and chemotherapy could significantly improve prognosis on overall survival (OS) and disease-free survival (DFS) (DFS, P < 0.001 and P = 0.041, respectively; OS, P < 0.001, P = 0.006, respectively) and chemoradiotherapy was significantly superior than simple chemotherapy (DFS, P = 0.031; OS, P = 0.027). For patients with an intermediate-risk score, postoperative chemoradiotherapy showed a statistically significant survival advantage over no anticancer treatment (P = 0.004 and P = 0.002, respectively), while chemotherapy did not. Compared with no adjuvant treatment, neither postoperative chemoradiotherapy nor chemotherapy made significant difference for patients in the high-risk group. Combining the value of immune-risk status and chemosensitivity, the immune-risk score could not only offer us prognostic evaluation and adjuvant treatment guidance, but also improve our understanding about the binding point between chemotherapy or chemoradiotherapy and the immune system, which may be helpful for further expanding the application of immunotherapy.
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http://dx.doi.org/10.1002/cam4.2077DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537086PMC
May 2019

SPHK1-induced autophagy in peritoneal mesothelial cell enhances gastric cancer peritoneal dissemination.

Cancer Med 2019 04 21;8(4):1731-1743. Epub 2019 Feb 21.

Department of Surgical Oncology, First Affiliated Hospital of China Medical University, Shenyang, China.

Gastric cancer peritoneal dissemination (GCPD) has been recognized as the most common form of metastasis in advanced gastric cancer (GC), and the survival is pessimistic. The injury of mesothelial cells plays an important role in GCPD. However, its molecular mechanism is not entirely clear. Here, we focused on the sphingosine kinase 1 (SPHK1) in human peritoneal mesothelial cells (HPMCs) which regulates HPMCs autophagy in GCPD progression. Initially, we analyzed SPHK1 expression immunohistochemically in 120 GC peritoneal tissues, and found high SPHK1 expression to be significantly associated with LC3B expression and peritoneal recurrence, leading to poor prognosis. Using a coculture system, we observed that GC cells promoted HPMCs autophagy and this process was inhibited by blocking TGF-β1 secreted from GC cells. Autophagic HPMCs induced adhesion and invasion of GC cells. We also confirmed that knockdown of SPHK1 expression in HPMCs inhibited TGF-β1-induced autophagy. In addition, SPHK1-driven autophagy of HPMCs accelerated GC cells occurrence of GCPD in vitro and in vivo. Moreover, we explored the relationship between autophagy and fibrosis in HPMCs, observing that overexpression of SPHK1 induced HPMCs fibrosis, while the inhibition of autophagy weakened HPMCs fibrosis. Taken together, our results provided new insights for understanding the mechanisms of GCPD and established SPHK1 as a novel target for GCPD.
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http://dx.doi.org/10.1002/cam4.2041DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6488120PMC
April 2019

miR-29 promotes osteosarcoma cell proliferation and migration by targeting PTEN.

Oncol Lett 2019 Jan 31;17(1):883-890. Epub 2018 Oct 31.

Department of Pediatric Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China.

Osteosarcoma (OS) is an aggressive malignant neoplasm that arises from primitively transformed cells of mesenchymal origin, and that exhibits osteoblastic differentiation and produces malignant osteoid. MicroRNAs (miRNAs) have been widely reported to have important regulatory roles in various human tumors, including OS. However, the potential mechanism of miR-29 in OS remains largely unknown. miR-29 was highly expressed in OS and overexpression of miR-29 promoted OS cell proliferation, as well as proliferating cell nuclear antigen (PCNA) expression and migration, whereas lower expression of miR-29 inhibited OS cell proliferation, PCNA expression and migration. In the present study, a dual-luciferase reporter system supporting phosphatase and tensin homolog (PTEN) was a target of miR-29 and its expression was inhibited by miR-29 mimic, but increased by miR-29 inhibitor. Overexpression of PTEN inhibited OS cell proliferation and migration and it could attenuate miR-29 promotion effect on OS progression. Overall, the results revealed that miR-29, as a tumor promoter, is involved in OS progression and metastasis by targeting PTEN, indicating that the miR-29/PTEN pathway is a potential therapeutic target for the treatment of OS.
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http://dx.doi.org/10.3892/ol.2018.9646DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313002PMC
January 2019

Palliative gastrectomy plus chemotherapy versus chemotherapy alone for incurable advanced gastric cancer: a meta-analysis.

Cancer Manag Res 2018 26;10:4759-4771. Epub 2018 Oct 26.

Department of Surgical Oncology, First Affiliated Hospital of China Medical University, Shenyang 110001, China,

Background: Whether palliative gastrectomy combined with chemotherapy can improve the survival of patients with advanced gastric cancer remains controversial. We performed a meta-analysis to clarify whether palliative gastrectomy plus chemotherapy can benefit patients with incurable advanced gastric cancer and to explore the best candidates in this patient population.

Methods: We searched the literature systematically using electronic databases including PubMed, EMBASE, and the Cochrane Library. And HRs and their 95% CIs were used to express the results for overall survival (OS) and progression-free survival (PFS).

Results: One randomized controlled trial with 175 patients and 12 cohort studies with 2,193 patients were analyzed. The pooled HR for OS (HR=0.43, 95% CI=0.29-0.65, <0.001), subgroup analysis of stage M1 (HR=0.53, 95% CI=0.40-0.72, <0.001), peritoneal dissemination (HR=0.46, 95% CI=0.28-0.73, =0.001), and liver metastasis (HR=0.46, 95% CI=0.33-0.65, <0.001) all indicated the superiority of palliative gastrectomy plus chemotherapy. However, the pooled HR for PFS (HR=0.61, 95% CI=0.33-1.13, =0.110) got separate outcome.

Conclusion: The results of this meta-analysis indicated that palliative gastrectomy plus chemotherapy can improve OS for incurable advanced gastric cancer. In addition, analyses based on liver metastasis and peritoneal dissemination demonstrated the advantages of palliative gastrectomy plus chemotherapy. However, the PFS of incurable advanced gastric cancer with palliative gastrectomy plus chemotherapy was no better than that under chemotherapy alone.
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http://dx.doi.org/10.2147/CMAR.S179368DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6208494PMC
October 2018

Novel prognostic biomarkers of gastric cancer based on gene expression microarray: COL12A1, GSTA3, FGA and FGG.

Mol Med Rep 2018 Oct 9;18(4):3727-3736. Epub 2018 Aug 9.

Department of Surgical Oncology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China.

Gastric cancer (GC) is the fifth most common malignancy and the third leading cause of cancer‑associated mortality in the world. However, its mechanisms of occurrence and development have not been clearly elucidated. Furthermore, there is no effective tumor marker for GC. Using DNA microarray analysis, the present study revealed genetic alterations, screened out core genes as novel markers and discovered pathways for potential therapeutic targets. Differentially expressed genes (DEGs) between GC and adjacent normal tissues were identified, followed by pathway enrichment analysis of DEGs. Next, the protein‑protein interaction (PPI) network of DEGs was built and visualized. Analyses of modules in the PPI network were then performed to identify the functional core genes. Finally, survival analysis of core genes was conducted. A total of 256 genes were identified as DEGs between the GC samples and normal samples, including 169 downregulated and 87 upregulated genes. Through Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis, the present study identified a total of 143 GO terms and 21 pathways. Six clusters of functional modules were identified, and the genes associated with these modules were screened out as the functional core genes. Certain core genes, including collagen type 12 α1 chain (COL12A1), glutathione S‑transferase α3 (GSTA3), fibrinogen α chain (FGA) and fibrinogen γ chain (FGG), were the first reported to be associated with GC. Survival analysis suggested that these four genes, COL12A1 (P=0.002), GSTA3 (P=3.4x10‑6), FGA (P=0.00075) and FGG (P=1.4x10‑5), were significant poor prognostic factors and therefore, potential targets to improve diagnosis, optimize chemotherapy and predict prognostic outcomes.
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http://dx.doi.org/10.3892/mmr.2018.9368DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6131538PMC
October 2018

MicroRNA-28-5p inhibits the migration and invasion of gastric cancer cells by suppressing AKT phosphorylation.

Oncol Lett 2018 Jun 27;15(6):9777-9785. Epub 2018 Apr 27.

Department of Surgical Oncology and General Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China.

Gastric cancer is a polygenic disease with a high mortality rate worldwide. Although a number of dysregulated genes have been confirmed to be involved in development and progression of gastric cancer, the molecular mechanisms by which this occurs remain unclear. The present study identified that microRNA (miR-28-5p) was involved in the migration and invasion of gastric cancer cells, and was able to affect the prognosis of patients with gastric cancer. Reverse transcription-quantitative polymerase chain reaction analysis indicated that the expression of miR-28-5p was significantly downregulated in gastric cancer tissues, and that patients with higher expression had a good prognosis. miR-28-5p expression was significantly associated with depth of invasion, lymph node metastasis and pathological stage. Gastric cancer cells overexpressing miR-28-5p exhibited a marked reduction of migration and invasion by Transwell and wound scratch assay. The phosphorylation of RAC serine/threonine-protein kinase (AKT), which affected cellular invasion and metastasis, was significantly inhibited by overexpression of miR-28-5p. In conclusion, miR-28-5p is a tumor suppressor that inhibits gastric cancer cell migration and invasion through repressing AKT phosphorylation. miR-28-5p may therefore represent a potential biomarker for the prognosis of gastric cancer and a novel therapeutic target in advanced gastric cancer.
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http://dx.doi.org/10.3892/ol.2018.8603DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6004724PMC
June 2018

Tranexamic acid versus aminocaproic acid for blood management after total knee and total hip arthroplasty: A systematic review and meta-analysis.

Int J Surg 2018 Jun 1;54(Pt A):105-112. Epub 2018 May 1.

Department of Pediatric Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China.

Objective: To compare the efficacy and safety of tranexamic acid and aminocaproic acid for reducing blood loss and transfusion requirements after total knee and total hip arthroplasty.

Methods: We conduct electronic searches of Medline (1966-2017.11), PubMed (1966-2017.11), Embase (1980-2017.11), ScienceDirect (1985-2017.11) and the Cochrane Library (1900-2017.11). The primary outcomes, including total blood loss, hemoglobin decline and transfusion requirements. Secondary outcomes include length of hospital stay and postoperative complications such as the incidence of deep vein thrombosis and pulmonary embolism. Each outcome is combined and calculated using the statistical software STATA 12.0. Fixed/random effect model is adopted based on the heterogeneity tested by I statistic.

Results: A total of 1714 patients are analyzed across three randomized controlled trials (RCTs) and one non-RCT. The present meta-analysis reveals that TXA is associated with a significantly reduction of total blood loss and postoperative hemoglobin drop compared with EACA. No significant differences are identified in terms of transfusion rates, length of hospital stay, and the incidence of postoperative complications.

Conclusion: Although total blood loss and postoperative hemoglobin drop are significant greater in EACA groups, there is no significant difference between TXA and EACA groups in terms of transfusion rates. Based on the current evidence available, higher quality RCTs are still required for further research.
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http://dx.doi.org/10.1016/j.ijsu.2018.04.042DOI Listing
June 2018

Conditional survival of patients with gastric cancer who undergo curative resection: A multi-institutional analysis in China.

Cancer 2018 03 4;124(5):916-924. Epub 2017 Dec 4.

Department of Surgical Oncology, First Affiliated Hospital of China Medical University, Shenyang, China.

Background: Conditional survival estimates, which take into consideration the changing risk with increasing survival time, provide a dynamic survival probability and more accurate survival information for clinician decision making. The objective of the current study was to evaluate the conditional disease-specific survival (DSS) for patients with gastric cancer who underwent curative surgery in China.

Methods: In total, 7658 patients with gastric cancer from a multi-institutional cohort in China were included in the analyses. Actuarial DSS was estimated using the Kaplan-Meier method. Three-year conditional DSS (CDS ) of patients who had already survived for x years was estimated as CDS = DSS(x + 3)/DSS(x). Cox proportional hazards regression analyses were used to identify the factors related to DSS.

Results: The 1-year, 3-year, and 5-year actuarial DSS rates were 88.2%, 64.5%, and 54.6%, respectively. By using CDS estimates, the probabilities that patients would remain alive for an additional 3 years given that they had already survived for 1, 3, and 5 years were 66.6%, 80.2%, and 88.3%, respectively. Patients who had unfavorable tumor characteristics diagnosed initially at surgery had the greatest improvement in CDS and the largest survival gap between actuarial DSS and CDS.

Conclusions: The current results indicate that CDS estimates for Chinese patients with gastric cancer who underwent surgery were dynamic and increased with time elapsed. Patients who had unfavorable tumor characteristics had the greatest improvement in CDS. This valuable information could provide more a precise evaluation of long-term prognosis and may serve as an important prognostic index in clinical practice. Cancer 2018;124:916-24. © 2017 American Cancer Society.
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http://dx.doi.org/10.1002/cncr.31160DOI Listing
March 2018

CD163 as a novel target gene of STAT3 is a potential therapeutic target for gastric cancer.

Oncotarget 2017 Oct 14;8(50):87244-87262. Epub 2017 Aug 14.

Department of Surgical Oncology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China.

CD163 is a member of the scavenger receptor cysteine-rich superfamily, and has been widely used to identify M2 type macrophage. However, the expression of CD163 in gastric cancer and its regulatory mechanism are still unclear. Here we show that CD163 is elevated in gastric cancer tissues. High expression of CD163 is a potential indicator to evaluate the status of tumor associated macrophages (TAMs), regulatory T cells (Tregs), myeloid-derived suppressor cells (MDSCs) and cancer associated fibroblasts (Cafs). Besides, more CD163 positive macrophages and CD163 expressing gastric cancer cells are associated with tumor invasion and poor prognosis. Knocking-down CD163 in cancer cells could inhibit tumor growth . We also find various immune molecules which are correlated with CD163 in gastric cancer tissues and cell lines have positive staining in the cancer cells of clinical sample. Finally, we confirm CD163 is a novel target gene of STAT3 (signal transducer and activator of transcription 3) in gastric cancer. Our data indicate that CD163 may be a potential poor prognostic marker and therapeutic target for gastric cancer.
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http://dx.doi.org/10.18632/oncotarget.20244DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5675630PMC
October 2017

GRIK3: A novel oncogenic protein related to tumor TNM stage, lymph node metastasis, and poor prognosis of GC.

Tumour Biol 2017 Jun;39(6):1010428317704364

1 Department of Surgical Oncology, The First Affiliated Hospital of China Medical University, Shenyang, China.

Glutamate receptor, ionotropic, kainate 3 (GRIK3), as a member of the glutamate kainate receptor family, mainly participated in neuroactive ligand receptor interaction pathway. Other members of GRIK family were previously reported to regulate cellular migration, transformation, and proliferation in tumor. However, the mechanism of GRIK3 in tumor is still unclear. Therefore, the purpose of our study was to reveal the expression and clinical significance of GRIK3 in gastric cancer (GC). First, we performed the expression analysis and survival analysis of GRIK3 using The Cancer Genome Atlas (TCGA) database, and the results showed that the GRIK3 expressed differentially between gastric cancer tissues and the adjacent normal tissues and that higher expression of GRIK3 was associated with poor survival outcomes. And the gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis suggested that GRIK3 mainly took part in cancer-related process. Subsequently, the validated immunohistochemistry showed that GRIK3 expressed higher in the GC tissues than in the matched normal tissues and the patients with overexpressed GRIK3 had worse survival outcomes. The univariate and multivariate analyses suggested that the expression of GRIK3 was an independent prognostic factor to predict GC prognosis. Furthermore, additional experiment showed that the lymph node metastasis tissues had higher GRIK3 expression than their matched primary GC tissues. These findings suggested that elevated GRIK3 expression could serve as an independent prognostic biomarker and a novel potential treatment target for patients with GC.
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http://dx.doi.org/10.1177/1010428317704364DOI Listing
June 2017
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