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腹膜转移胃癌腹腔化疗药物的应用现状
根据 Globocan 统计[1],2008年,中国胃癌发病人数为46.3万,胃癌死亡人数为35.2万,居癌症死亡率第3位。约10%的胃癌患者在确诊时已经存在腹膜转移;腹膜转移癌也是胃癌术后的常见复发症,占复发病例的33%~50%[2-3]。腹膜转移胃癌是肿瘤的终末期,治疗效果不佳,预后极差。 Saito等[4]报告,经手术及全身化疗治疗后,90例腹腔游离癌细胞检测阳性的胃癌患者5年生存率为15.3%,64例腹膜转移胃癌患者5年生存率为0。对于腹膜转移胃癌的治疗,以往常采用全身静脉化疗或联合肿瘤细胞减灭术(cytoreductive surgery , CRS)。近的临床研究[5]显示,腹腔和(或)静脉化疗联合 CRS 可以延长腹膜转移胃癌患者的总生存期。
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温热低渗性顺铂溶液腹腔灌注化疗防治胃癌腹膜播种的临床研究
在胃癌手术治疗已进入近于合理化、规范化阶段的今天,彻底杀灭腹腔脱落癌细胞是提高胃癌生存率和生活质量的主要措施之一.我们自1999年4月起选择顺铂作为化疗药,配成低渗液作腹腔内灌注,并利用温热效应与化疗药的协同抗癌作用来防治胃癌的腹膜播种,取得了满意的疗效,现报告如下.
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Objective:To establish a positive feedback circuit triggered by Reg4 and investigates its signiifcance in peritoneal metastasis of gastric cancer.Methods: Reg4 expression was detected in gastric cancer samples by immunohistochemistry staining. Reg4 overexpressed and knocked down cells were used to investigate its biological function. Activation of EGFR pathway and promotion of Reg4 were evaluated upon EGFR ligand stimulation. Mass spectrometry was performed to identify Reg4 receptor. ADAM phosphorylation and EGFR ligand shedding was detected after upstream manipulation. Possible downstream effectors were investigated by PCR array.Results:Expression of Reg4 was higher in gastric cancer tissues. Reg4 enhanced prometastatic abilities of gastric cancer cells. EGFR ligand was able to induce Reg4 expression through sequential EGFR pathway activation. Reg4 receptor was identified by mass spectrometry. ADAM phosphorylation and EGFR ligand shedding were enhanced after Reg4 overexpression. PCR array showed several promising downstream effectors.Conclusion:Reg4 is able to trigger a positive feedback regulatory circuit that promotes peritoneal metastasis of gastric cancer.