PurposeOxidative stress was significantly associated with the development of malignancies. The purpose of this study was to evaluate the significance of serum total oxidant/antioxidant status in operable advanced gastric cancer patients.Materials and methodsA total of 284 patients who underwent curative resection for primary stage III gastric cancer were enrolled. Total oxidant status, total antioxidant status, and oxidative stress index (OSI) were evaluated within 24 hours before surgery, and compared with 120 healthy donors. The correlation between the OSI and survival outcome was analyzed by the Kaplan–Meier method with log-rank test and Cox’s regression methods, respectively.ResultsMean OSI of gastric cancer patients was higher than healthy controls (1.41±0.96 vs 0.78±0.42, P<0.001). All patients were stratified into two groups using the optimal cutoff value (1.42) of OSI using a sensitivity of 94.1% and a specificity of 64.0% as optimal conditions from receiver operating curve analysis. Patients with an OSI ≥1.42 had poorer mean overall survival (45.6 vs 29.8 months, P=0.022) and mean recurrence-free survival (43.3 vs 28.1 months, P=0.011) than patients with an OSI <1.42 in univariate analysis, and OSI was also confirmed as an independent predictor for survival for gastric cancer in multivariate analysis (hazard ratio, 0.541; 95% CI: 0.127–1.102; P=0.01).ConclusionPreoperative OSI can be considered as an independent prognostic factor for operable and advanced gastric cancer.

AIM:To compare the efficacy of a combined chemotherapy regimen of 5-fluouracil (5-FU) and adriamycin (ADM) with nimustine hydrochloride (ACNU; brand name Nidran), a new nitrosourea agent, or with methyl-CCNU for advanced gastric cancer. METHODS:One-hundred-and-three cases of advanced gastric cancer were randomly allocated into Group A (Me-CCNU, 5-FU and ADM combination) and Group B (ACNU, 5-FU and ADM combination). The quality of life (QOL) questionnaire, composed of 11 ordinal categorical items, was used to collect data from these patients. Xiao SD, Li DH, Zhang DZ, Shen MJ, Zhu XT, He GF, Zhao TP, Xi LP, Deng XC, Wang M, Wang XL, Chen Q, Zhang YP, Yao CL, Bao JG, Tong GW, Zhu LF, Jiang H, Minoru K. A multicenter randomized study on Me-CCNU, 5-FU and ADM versus ACNU, 5-FU and ADM for treatment of advanced gastric cancer.

AIM:To observe the nitric oxide synthase (NOS) distribution in the esophageal mucosa and hemodynamic changes in cirrhotic rats.METHODS:NOS distribution in the lower esophagus of rats with carbon tetrachloride-induced cirrhosis was assessed by using NADPH-diaphorase (NADPH-d) histochemical method.Concentration of NO in serum were measured by fluorometric assay. Mean arterial pressure (MAP), cardiac output (CO), cardiac index (CI), splanchnic vascular resistance (SVR), and splanchnic blood flow (SBF) were also determined using (57)Co-labled microsphere technique.RESULTS:Intensity of NOS staining in the esophageal epithelium of cirrhotic rats was significantly stronger than that in controls. There was a NOS-positive staining area in the endothelia of esophageal submucosal vessels of cirrhotic rats, but the NOS staining was negative in normal rats. NO concentration of serum in cirrhotic rats were significantly higher in comparison with that of controls. Cirrhotic rats had significantly lower MAP, SVR and higher SBF than those of the controls.CONCLUSION:Splanchnic hyperdynamic circulatory state was observed in rats with cirrhosis. The endogenous NO may play an important role in development of esophageal varices and in changes of hemodynamics in cirrhosis.