Clinical implications of metastatic lymph node ratio in gastric cancer

<p>Abstract</p> <p>Background</p> <p>The 5-year survival rate in patients with gastric cancer is still poor, and lymph node metastasis is considered one of the most important prognostic factors. However, there are controversies in the classification of lymph node metastasis in gastric cancer. This study was carried out to investigate whether the metastatic lymph node ratio is a reliable classification of lymph node metastasis in gastric cancer in Chinese.</p> <p>Methods</p> <p>224 cases with gastric cancer with more than D1 dissection were retrospectively reviewed. The association between the total number of resected lymph nodes and the number of metastatic lymph nodes was determined. The prognostic value of the metastastic node ratio, defined as the ratio of the number of metastatic lymph nodes over the total number of resected lymph nodes, and the pN classification was assessed.</p> <p>Results</p> <p>The number of metastatic lymph node increased with the number of total resected lymph nodes. A Cox regression revealed that the metastatic node ratio, the number of metastatic nodes, histological type, and histological growth pattern independently influenced prognosis. The 5-year survival rates were 78%, 61%, 25%, 0% in cases with a metastastic node ratio of 0%, > 0% but < 40%, 40–80%, > 80%, respectively (<it>P </it>< 0.001), and were 78%, 62%, 38%, 0% in cases with gastric cancer histologically classified as pN0, pN1, pN2, pN3, respectively (<it>P </it>< 0.001).</p> <p>Conclusion</p> <p>The metastatic lymph node ratio is a simple and useful independent prognostic factor. It may obviate possible confounding factors that are related to stage migration, and should be considered as an important component in the lymph node category.</p

Loss of imprinting of insulin-like growth factor 2 is associated with increased risk of lymph node metastasis and gastric corpus cancer

Abstract Background The aim of this study was to determine the clinicopathological features of gastric cancers with loss of imprinting (LOI) of LIT1. Insulin-like growth factor 2 (IGF2) and H19 in Chinese patients. Methods DNA and RNA from tumours were amplified and then digested with RsaI, ApaI and HinfI, and RsaI respectively to determine the LOI status. The demographic and clinicopathological characteristics in LOI positive and LOI negative patients were compared and tested with Statistical analysis. Results Of the 89 patients enrolled for analysis, 22, 40 and 35 were heterozygous and thus informative for LIT1, IGF2 and H19 LOI analyses respectively. The positive rate of LIT1, IGF2 and H19 LOI of gastric cancer tissues were 54.6% (12/22), 45% (18/40) and 8.6% (3/32) in Chinese patients. Gastric corpus cancer (8/10, 80%) were more likely to have LOI of IGF2 in tumours than antrum cancers (10/30, 33.3%){odds ratio (OR) = 8, 95% confidence intervals (CI) = 1.425-44.920, p = 0.018)}. LOI of IGF2 in tumours was also associated with the lymph node metastasis (LNM) (OR = 4.5, 95% CI = 1.084-18.689, p = 0.038). Conclusion IGF2 LOI is present in high frequency in Chinese gastric cancer patients, especially those with gastric corpus cancer.</p

Survival curve of cases with metastatic lymph node ratio 80%, in relation to pN category

<p><b>Copyright information:</b></p><p>Taken from "Clinical implications of metastatic lymph node ratio in gastric cancer"</p><p>http://www.biomedcentral.com/1471-2407/7/200</p><p>BMC Cancer 2007;7():200-200.</p><p>Published online 24 Oct 2007</p><p>PMCID:PMC2194781.</p><p></p> No significant difference was observed in cumulative survival rates after surgery between the two groups (pN2 and pN3) (P = 0.224; Kaplan-Meier and log-rank test)

Survival curve and comparison of cumulative survival rates after surgery according to according to pN categories (pN0: no metastatic lymph node, pN1: 1–6 metastatic lymph nodes, pN2: 7–15 metastatic lymph nodes, and pN: 15 metastatic lymph nodes)

<p><b>Copyright information:</b></p><p>Taken from "Clinical implications of metastatic lymph node ratio in gastric cancer"</p><p>http://www.biomedcentral.com/1471-2407/7/200</p><p>BMC Cancer 2007;7():200-200.</p><p>Published online 24 Oct 2007</p><p>PMCID:PMC2194781.</p><p></p> There were significant differences among the groups (P < 0.00; Kaplan-Meier and log-rank test)

Clinical implications of metastatic lymph node ratio in gastric cancer-7

<p><b>Copyright information:</b></p><p>Taken from "Clinical implications of metastatic lymph node ratio in gastric cancer"</p><p>http://www.biomedcentral.com/1471-2407/7/200</p><p>BMC Cancer 2007;7():200-200.</p><p>Published online 24 Oct 2007</p><p>PMCID:PMC2194781.</p><p></p>l number of dissected nodes increased, with the cuvre of pN category increased more significantly than metastatic node ratio, especially when the total number of the dissected nodes was more than 25

Clinical implications of metastatic lymph node ratio in gastric cancer-0

<p><b>Copyright information:</b></p><p>Taken from "Clinical implications of metastatic lymph node ratio in gastric cancer"</p><p>http://www.biomedcentral.com/1471-2407/7/200</p><p>BMC Cancer 2007;7():200-200.</p><p>Published online 24 Oct 2007</p><p>PMCID:PMC2194781.</p><p></p>l number of dissected nodes increased, with the cuvre of pN category increased more significantly than metastatic node ratio, especially when the total number of the dissected nodes was more than 25

Survival curve of cases with metastatic lymph node ratio 40–79%, in relation to pN category

<p><b>Copyright information:</b></p><p>Taken from "Clinical implications of metastatic lymph node ratio in gastric cancer"</p><p>http://www.biomedcentral.com/1471-2407/7/200</p><p>BMC Cancer 2007;7():200-200.</p><p>Published online 24 Oct 2007</p><p>PMCID:PMC2194781.</p><p></p> No significant difference was observed in cumulative survival rates after surgery among the groups (pN1, pN2 and pN3) (P = 0.367; Kaplan-Meier and log-rank test)

Molecular Typing of Pathogenic <i>Leptospira</i> Serogroup Icterohaemorrhagiae Strains Circulating in China during the Past 50 Years

<div><p>Background</p><p>Leptospirosis is one of the most important neglected tropical infectious diseases worldwide. Icterohaemorrhagiae has been throughout recent history, and still is, the predominant serogroup of this pathogen in China. However, very little in detail is known about the serovars or genotypes of this serogroup.</p><p>Methodology/Principal Findings</p><p>In this study, 120 epidemic strains from five geographically diverse regions in China collected over a 50 year period (1958~2008), and 8 international reference strains characterized by 16S rRNA sequencing and MLST analysis. 115, 11 and 2 strains were identified as <i>L</i>. <i>interrogans</i>, <i>L</i>. <i>borgpetersenii</i>, and <i>L</i>. <i>kirschneri</i>, respectively. 17 different STs were identified including 69 ST1 strains, 18 ST17, 18 ST128, 9 ST143 and 2 ST209. The remaining 12 strains belonged to 12 different STs. eBURST analysis demonstrated that, among the clonal complexes isolated (CCs), CC1 accounted for 73.3% (88/120) strains representing three STs: ST1, ST128 and ST98. ST1 was the most likely ancestral strain of this CC, followed by singleton CC17 (17/120) and CC143 (11/120). Further analysis of adding 116 serogroup Icterohaemorrhagiae strains in the MLST database and studies previously described using global eBURST analysis and MST dendrogram revealed relatively similar ST clustering patterns with five main CCs and 8 singletons among these 244 strains. CC17 was found to be the most prevalent clone of pathogenic <i>Leptospira</i> circulating worldwide. This is the first time, to our knowledge, that ST1 and ST17 strains were distributed among 4 distinct serovars, indicating a highly complicated relationship between serovars and STs.</p><p>Conclusions/Significance</p><p>Our studies demonstrated a high level of genetic diversity in the serogroup Icterohaemorrhagiae strains. Distinct from ST17 or ST37 circulating elsewhere, ST1 included in CC1, has over the past 50 years or so, proven to be the most prevalent ST of pathogenic leptospires isolated in China. Moreover, the complicated relationship between STs and serovars indicates an urgent need to develop an improved scheme for <i>Leptospira</i> serotyping.</p></div

Molecular phylogenetic analysis between 17 sequence types (STs) of 128 pathogenic <i>Leptospira</i> strains based on neighbor-joining (N-J) tree method.

<p>Phylogenetic relationships based on concatenated sequences of 7-locus MLST scheme (3,102 bp) for the 128 pathogenic strains were inferred using N-J method and 1000 bootstrap replications as implemented in MEGA5. Each bacterial strain is labeled as follows: abbreviation of species name (L.int: <i>L</i>. <i>interrogans</i>, L.kir: <i>L</i>. <i>kirschneri</i> and L. bor: <i>L</i>. <i>borgpetersenii</i>), strain name, isolated time, isolated region and (for the 7-locus MLST scheme) sequence type (ST). The dendrogram displays three major clusters corresponding to 3 <i>Leptospira</i> species analyzed in different colors: Red: <i>L</i>. <i>int</i>; Yellow: <i>L</i>. <i>kri</i>; Blue: <i>L</i>. <i>bor</i>.</p