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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

Postal Subscription Code 80-967

2018 Impact Factor: 1.847

Front. Med.    2017, Vol. 11 Issue (1) : 20-31     DOI: 10.1007/s11684-016-0493-4
Detection of digestive malignancies and post-gastrectomy complications via gastrointestinal fluid examination
Lei Huang1,2(),Aman Xu1,3()
1. Department of Gastrointestinal Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
2. German Cancer Research Center (DKFZ), Heidelberg, Germany
3. Department of General Surgery, the Fourth Affiliated Hospital of Anhui Medical University, Hefei 230022, China
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To date, gastric carcinoma (GC) is one of the common and fatal digestive malignancies worldwide. The prognosis of GC is not always satisfactory because of late diagnosis. Scholars are keen on discovering novel accurate and economical biomarkers in body liquids for GC screening to detect and evaluate the lesion before the results of imaging techniques are obtained. While traditional serum assays have limited sensitivity and specificity, gastrointestinal juice may provide relevant specific biomarkers because of its close contact with the tumor. Herein, the current progress in the relationship between gastrointestinal fluid analyses and GC is systematically and comprehensively reviewed. The detection of gastric juice pH, fluorescence spectrum, cytology, Helicobacter pylori-associated markers, nitrosamines, conventional tumor markers, amino acids, proteomics, microRNAs, long noncoding RNAs, protein-coding genes, vitamin C, etc., and combination tests of different category markers could provide important diagnostic and prognostic clues for gastrointestinal diseases. Particularly, early GC may be efficiently screened using gastric juice. Gastrointestinal fluid examination could also predict the adverse effects of postgastrectomy, such as pancreatic leakage, fistula, and abscess. Gastric fluid markers should be further studied to reveal the early predicators of malignancy and complications. The methods for obtaining the samples of gastrointestinal juice with minimum incision should also be comprehensively investigated.

Keywords gastrointestinal fluid      gastric carcinoma      biomarker      diagnosis      prognosis      gastrectomy      adverse events     
Corresponding Authors: Lei Huang,Aman Xu   
Just Accepted Date: 28 December 2016   Online First Date: 20 February 2017    Issue Date: 20 March 2017
URL:     OR
Fig.1  The screening of digestive diseases via gastrointestinal fluid examination.
Fig.2  Gastrointestinal juice examination for predicting postgastrectomy adverse effects that might require reoperation.
Fig.3  Gastric juice detection for GC screening. P1 FI, fluorescence intensity of the first peak; FS, fluorescence spectroscopy; HPLC, high-performance liquid chromatography; IA, immunoassay; RT-qPCR, real-time quantitative polymerase chain reaction; miR, microRNA; RIA, radioimmunoassay; EGF, epithelial growth factor; TGF-a, tumor growth factor a.
Marker Disease/condition Sensitivity (%) Specificity (%) References
Pepsinogen I<40 ng/ml Gastric cancer 72.4 65.8 [10]
Pepsinogen I≤107.1 μg/ml Gastric cancer 73.5 71.4 [46]
Pepsinogen II≤78.4 μg/ml Gastric cancer 98.0 22.5 [46]
Pepsinogen I/II<2.2 Gastric cancer 78.2 61.0 [10]
Pepsinogen I/II≤2.05 Gastric cancer 61.2 91.8 [46]
pH>5.5 Gastric cancer 76.0 67.9 [10]
Nitrite>20 μmol/L Gastric cancer 71.2 69.2 [10]
P1FI≥76.5 Gastric cancer 83.2 80.7 [12]
cag genes Gastric cancer 92.3 60.0 [15]
Mt 21-42 AGOM 96.3 85.7 [16]
Gastrin/pepsinogen AGOM 40.7 98.4 [16]
Intrinsic factor antibodies AGOM 3.7 100.0 [16]
Parietal cells antibodies AGOM 33.3 94.7 [16]
Vitamin B12 AGOM 22.2 99.5 [16]
Folate AGOM 11.1 99.5 [16]
Tyrosine>5.45 μg/ml Advanced gastric cancer 83.3 68.6 [28]
Phenylalanine>9.68 μg/ml Advanced gastric cancer 81.8 75.7 [28]
Tryptophan>1.94 μg/ml Advanced gastric cancer 84.8 68.6 [28]
Total protein>2.34 μg/ml Advanced gastric cancer 75.8 74.3 [28]
Tyrosine>5.88 μg/ml Early gastric cancer 75.5 71.4 [28]
Phenylalanine>11.74 μg/ml Early gastric cancer 75.5 81.4 [28]
Tryptophan>5.67 μg/ml Early gastric cancer 61.2 97.1 [28]
Total protein>2.66 μg/ml Early gastric cancer 59.2 81.4 [28]
α1-antitrypsin>717 μg/dl Gastric malignancy 96 92 [31]
α1-antitrypsin string test Gastric malignancy 74 88 [31]
Proteome Gastric cancer 88 93 [35]
miR-21 ΔCq >−2.73 Gastric cancer 85.7 97.8 [37]
miR-106a ΔCq >2.61 Gastric cancer 73.8 89.3 [37]
miR-129-1-3p ΔCq>10.17 Gastric cancer 45.2 83.8 [38]
miR-129-2-3p ΔCq>11.495 Gastric cancer 42.9 85.9 [38]
miR-421 ΔCq>5.21 Gastric cancer 71.4 71.7 [39]
lncRNA-AA174084 ΔCq>11.62 Gastric cancer 57 73 [40]
lncRNA-AA174084 ΔCq>0.88 Early gastric cancer 46 93 [40]
lncRNA-ABHD11-AS1 ΔCq>6.53 Gastric cancer 41.0 93.4 [41]
Telomerase expression Gastric cancer 80 84 [44]
Melanoma-associated gene Gastric cancer 53.1 95.9 [46]
Amylase>175 U/L Pancreatic leakage 76.0 74.5 [50]
Lipase>450 U/L Pancreatic leakage 72.0 69.8 [50]
Amylase>1190 IU/L Pancreas abscess 77.8 77.3 [53]
Amylase>1000 IU/L Grades B & C pancreatic fistula 94.1 72.4 [53]
Amylase>720 U/L Intra-abdominal abscess 85.7 62.8 [54]
Bacterial culture Intra-abdominal abscess 42.9 96.5 [54]
Tab.1  Sensitivity and specificity of gastrointestinal fluid markers for gastric diseases
1 Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin 2015; 65(2): 87–108
doi: 10.3322/caac.21262 pmid: 25651787
2 Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, Jemal A, Yu XQ, He J. Cancer statistics in China, 2015. CA Cancer J Clin 2016; 66(2): 115–132
doi: 10.3322/caac.21338 pmid: 26808342
3 Fuchs CS, Tomasek J, Yong CJ, Dumitru F, Passalacqua R, Goswami C, Safran H, dos Santos LV, Aprile G, Ferry DR, Melichar B, Tehfe M, Topuzov E, Zalcberg JR, Chau I, Campbell W, Sivanandan C, Pikiel J, Koshiji M, Hsu Y, Liepa AM, Gao L, Schwartz JD, Tabernero J; REGARD Trial Investigators. Ramucirumab monotherapy for previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (REGARD): an international, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet 2014; 383(9911): 31–39
doi: 10.1016/S0140-6736(13)61719-5 pmid: 24094768
4 Xu AM, Huang L, Liu W, Gao S, Han WX, Wei ZJ. Neoadjuvant chemotherapy followed by surgery versus surgery alone for gastric carcinoma: systematic review and meta-analysis of randomized controlled trials. PLoS ONE 2014; 9(1): e86941
doi: 10.1371/journal.pone.0086941 pmid: 24497999
5 Xu AM, Huang L, Zhu L, Wei ZJ. Significance of peripheral neutrophil-lymphocyte ratio among gastric cancer patients and construction of a treatment-predictive model: a study based on 1131 cases. Am J Cancer Res 2014; 4(2): 189–195
pmid: 24660108
6 Jung JJ, Noh S, Jeung HC, Jung M, Kim TS, Noh SH, Roh JK, Chung HC, Rha SY. Chemokine growth-regulated oncogene 1 as a putative biomarker for gastric cancer progression. Cancer Sci 2010; 101(10): 2200–2206
doi: 10.1111/j.1349-7006.2010.01666.x pmid: 20731665
7 Huang L, Xu AM, Li TJ, Han WX, Xu J. Should peri-gastrectomy gastric acidity be our focus among gastric cancer patients? World J Gastroenterol 2014; 20(22): 6981–6988
doi: 10.3748/wjg.v20.i22.6981 pmid: 24944492
8 Wu W, Chung MC. The gastric fluid proteome as a potential source of gastric cancer biomarkers. J Proteomics 2013; 90:3–13
doi: 10.1016/j.jprot.2013.04.035 pmid: 23665003
9 Lu PJ, Hsu PI, Chen CH, Hsiao M, Chang WC, Tseng HH, Lin KH, Chuah SK, Chen HC. Gastric juice acidity in upper gastrointestinal diseases. World J Gastroenterol 2010; 16(43): 5496–5501
doi: 10.3748/wjg.v16.i43.5496 pmid: 21086570
10 Shiotani A, Iishi H, Uedo N, Higashino K, Kumamoto M, Nakae Y, Tatsuta M. Hypoacidity combined with high gastric juice nitrite induced by Helicobacter pylori infection is associated with gastric cancer. Aliment Pharmacol Ther 2004; 20(Suppl 1):48–53
doi: 10.1111/j.1365-2036.2004.01978.x pmid: 15298605
11 Sanduleanu S, Jonkers D, De Bruine A, Hameeteman W, Stockbrügger RW. Non-Helicobacter pylori bacterial flora during acid-suppressive therapy: differential findings in gastric juice and gastric mucosa. Aliment Pharmacol Ther 2001; 15(3): 379–388
doi: 10.1046/j.1365-2036.2001.00888.x pmid: 11207513
12 Zhou LY, Lin SR, Li Y, Geng QM, Ding SG, Meng LM, Sun XN, Wang JT, Xu ZJ, Guo HL, Li CG, Cui RL. The intrinsic fluorescence spectrum of dilute gastric juice as a novel diagnostic tool for gastric cancer. J Dig Dis 2011; 12(4): 279–285
doi: 10.1111/j.1751-2980.2011.00507.x pmid: 21791022
13 Deng K, Zhou LY, Lin SR, Li Y, Chen M, Geng QM, Li YW. A novel approach for the detection of early gastric cancer: fluorescence spectroscopy of gastric juice. J Dig Dis 2013; 14(6): 299–304
doi: 10.1111/1751-2980.12040 pmid: 23356830
14 Levy MJ, Gleeson FC, Campion MB, Caudill JL, Clain JE, Halling K, Rajan E, Topazian MD, Wang KK, Wiersema MJ, Clayton A. Prospective cytological assessment of gastrointestinal luminal fluid acquired during EUS: a potential source of false-positive FNA and needle tract seeding. Am J Gastroenterol 2010; 105(6): 1311–1318
doi: 10.1038/ajg.2010.80 pmid: 20197762
15 Kawamura O, Murakami M, Araki O, Yamada T, Tomizawa S, Shimoyama Y, Minashi K, Maeda M, Kusano M, Mori M. Relationship between gastric disease and deletion of cag pathogenicity island genes of Helicobacter pylori in gastric juice. Dig Dis Sci 2003; 48(1): 47–53
doi: 10.1023/A:1021726213159 pmid: 12645789
16 Tucci A, Bisceglia M, Rugge M, Tucci P, Marchegiani A, Papadopoli G, Spada A, Villani A, Pennelli G, Fusaroli P, Caravelli G, Catalano T, Cennamo V, Cianci M, De Fanis C, Fabbri C, Feliciangeli G, Gizzi G, Spadaccini A, Caletti G. Clinical usefulness of gastric-juice analysis in 2007: the stone that the builders rejected has become the cornerstone. Gastrointest Endosc 2007; 66(5): 881–890
doi: 10.1016/j.gie.2007.03.1052 pmid: 17963873
17 Radziejewska I, Borzym-Kluczyk M, Kisiel DG, Namiot Z, Wosek J, Gindzieński A. The effect of Helicobacter pylori eradication treatment on the MUC 1 and Lewis antigens level in human gastric juice: a preliminary study. Dig Dis Sci 2008; 53(10): 2641–2645
doi: 10.1007/s10620-008-0224-z pmid: 18409003
18 Radziejewska I, Borzym-Kluczyk M, Kisiel DG, Namiot Z, Gindzieński A. The influence of Helicobacter pylori patients’ treatment on MUC 1 content in gastric juice. Hepatogastroenterology 2008; 55(86-87): 1887–1889
pmid: 19102415
19 Hayakawa T, Kaneko H, Konagaya T, Shinozaki K, Kasahara A, Funaki Y, Mori S, Yokoi T, Hirooka Y, Kusugami K, Kakumu S. Enhanced somatostatin secretion into the gastric juice with recovery of basal acid output after Helicobacter pylori eradication in gastric ulcers. J Gastroenterol Hepatol 2003; 18(5): 505–511
doi: 10.1046/j.1440-1746.2003.03008.x pmid: 12702041
20 Nishibayashi H, Kanayama S, Kiyohara T, Yamamoto K, Miyazaki Y, Yasunaga Y, Shinomura Y, Takeshita T, Takeuchi T, Morimoto K, Matsuzawa Y. Helicobacter pylori-induced enlarged-fold gastritis is associated with increased mutagenicity of gastric juice, increased oxidative DNA damage, and an increased risk of gastric carcinoma. J Gastroenterol Hepatol 2003; 18(12): 1384–1391
doi: 10.1046/j.1440-1746.2003.03192.x pmid: 14675267
21 Akyuz M, Ata S and Dinc E.A chemometric optimization of method for determination of nitrosamines in gastric juices by GC-MS. J Pharm Biomed Anal 2016; 117:26–36
doi: 10.1016/j.jpba.2015.08.021 pmid: 26342445
22 Duraker N, Naci Celik A, Gençler N. The prognostic significance of gastric juice CA 19-9 and CEA levels in gastric carcinoma patients. Eur J Surg Oncol 2002; 28(8): 844–849
doi: 10.1053/ejso.2002.1295 pmid: 12477476
23 Bazuro GE, Ferrario F, Dezi A, Ciaco A, Koch M, Capurso L. CEA in gastric juice and chronic atrophic gastritis: a prospective evaluation. J Clin Gastroenterol 1993; 16(2): 179–180
doi: 10.1097/00004836-199303000-00025 pmid: 8463627
24 Muretto P, Graziano F, Staccioli MP, Barbanti I, Bartolucci A, Paolini G, Giordano D, Testa E, De Gaetano A. An endogastric capsule for measuring tumor markers in gastric juice: an evaluation of the safety and efficacy of a new diagnostic tool. Ann Oncol 2003; 14(1): 105–109
doi: 10.1093/annonc/mdg027 pmid: 12488301
25 Xu AM, Huang L, Han WX, Wei ZJ. Monitoring of peri-distal gastrectomy carbohydrate antigen 19-9 level in gastric juice and its significance. Int J Clin Exp Med 2014; 7(1): 230–238
pmid: 24482710
26 Huang L, Xu A, Li T, Han W, Wu S, Wang Y. Detection of perioperative cancer antigen 72-4 in gastric juice pre- and post-distal gastrectomy and its significances. Med Oncol 2013; 30(3): 651
doi: 10.1007/s12032-013-0651-3 pmid: 23820956
27 Nagata Y, Sato T, Enomoto N, Ishii Y, Sasaki K, Yamada T. High concentrations of D-amino acids in human gastric juice. Amino Acids 2007; 32(1): 137–140
doi: 10.1007/s00726-006-0262-9 pmid: 16583309
28 Deng K, Lin S, Zhou L, Li Y, Chen M, Wang Y, Li Y. High levels of aromatic amino acids in gastric juice during the early stages of gastric cancer progression. PLoS ONE 2012; 7(11): e49434
doi: 10.1371/journal.pone.0049434 pmid: 23152906
29 Lian W, Ma DJ, Xu X, Chen Y, Wu YL. Rapid high-performance liquid chromatography method for determination of tryptophan in gastric juice. J Dig Dis 2012; 13(2): 100–106
doi: 10.1111/j.1751-2980.2011.00559.x pmid: 22257478
30 Hsu PI, Chen CH, Hsieh CS, Chang WC, Lai KH, Lo GH, Hsu PN, Tsay FW, Chen YS, Hsiao M, Chen HC, Lu PJ. α1-Antitrypsin precursor in gastric juice is a novel biomarker for gastric cancer and ulcer. Clin Cancer Res 2007; 13(3): 876–883
doi: 10.1158/1078-0432.CCR-06-1404 pmid: 17289880
31 Hsu PI, Chen CH, Hsiao M, Wu DC, Lin CY, Lai KH, Lu PJ. Diagnosis of gastric malignancy using gastric juice α1-antitrypsin. Cancer Epidemiol Biomarkers Prev 2010; 19(2): 405–411
doi: 10.1158/1055-9965.EPI-09-0609 pmid: 20086110
32 Lee K, Kye M, Jang JS, Lee OJ, Kim T, Lim D. Proteomic analysis revealed a strong association of a high level of α1-antitrypsin in gastric juice with gastric cancer. Proteomics 2004; 4(11): 3343–3352
doi: 10.1002/pmic.200400960 pmid: 15378737
33 Kam SY, Hennessy T, Chua SC, Gan CS, Philp R, Hon KK, Lai L, Chan WH, Ong HS, Wong WK, Lim KH, Ling KL, Tan HS, Tan MM, Ho M, Kon OL. Characterization of the human gastric fluid proteome reveals distinct pH-dependent protein profiles: implications for biomarker studies. J Proteome Res 2011; 10(10): 4535–4546
doi: 10.1021/pr200349z pmid: 21842849
34 Paulo JA, Lee LS, Wu B, Repas K, Banks PA, Conwell DL, Steen H. Proteomic analysis of endoscopically (endoscopic pancreatic function test) collected gastroduodenal fluid using in-gel tryptic digestion followed by LC-MS/MS. Proteomics Clin Appl 2010; 4(8-9): 715–725
doi: 10.1002/prca.201000018 pmid: 21137089
35 Kon OL, Yip TT, Ho MF, Chan WH, Wong WK, Tan SY, Ng WH, Kam SY, Eng A, Ho P, Viner R, Ong HS, Kumarasinghe MP. The distinctive gastric fluid proteome in gastric cancer reveals a multi-biomarker diagnostic profile. BMC Med Genomics 2008; 1:54 PMID: 18950519
doi: 10.1186/1755-8794-1-54
36 Chang WC, Hsu PI, Chen YY, Hsiao M, Lu PJ, Chen CH. Observation of peptide differences between cancer and control in gastric juice. Proteomics Clin Appl 2008; 2(1): 55–62
doi: 10.1002/prca.200780066 pmid: 21136779
37 Cui L, Zhang X, Ye G, Zheng T, Song H, Deng H, Xiao B, Xia T, Yu X, Le Y, Guo J. Gastric juice microRNAs as potential biomarkers for the screening of gastric cancer. Cancer 2013; 119(9): 1618–1626
doi: 10.1002/cncr.27903 pmid: 23335180
38 Yu X, Luo L, Wu Y, Yu X, Liu Y, Yu X, Zhao X, Zhang X, Cui L, Ye G, Le Y, Guo J. Gastric juice miR-129 as a potential biomarker for screening gastric cancer. Med Oncol 2013; 30(1): 365
doi: 10.1007/s12032-012-0365-y pmid: 23307240
39 Zhang X, Cui L, Ye G, Zheng T, Song H, Xia T, Yu X, Xiao B, Le Y, Guo J. Gastric juice microRNA-421 is a new biomarker for screening gastric cancer. Tumour Biol 2012; 33(6): 2349–2355
doi: 10.1007/s13277-012-0497-x pmid: 22926798
40 Shao Y, Ye M, Jiang X, Sun W, Ding X, Liu Z, Ye G, Zhang X, Xiao B, Guo J. Gastric juice long noncoding RNA used as a tumor marker for screening gastric cancer. Cancer 2014; 120(21): 3320–3328
doi: 10.1002/cncr.28882 pmid: 24986041
41 Yang Y, Shao Y, Zhu M, Li Q, Yang F, Lu X, Xu C, Xiao B, Sun Y, Guo J. Using gastric juice lncRNA-ABHD11-AS1 as a novel type of biomarker in the screening of gastric cancer. Tumour Biol 2016; 37(1): 1183–1188
pmid: 26280398
42 Dabrowska-Ufniarz E, Dzieniszewski J, Jarosz M, Wartanowicz M. Vitamin C concentration in gastric juice in patients with precancerous lesions of the stomach and gastric cancer. Med Sci Monit 2002; 8(2): CR96–CR103
pmid: 11859281
43 Kodama K, Sumii K, Kawano M, Kido T, Nojima K, Sumii M, Haruma K, Yoshihara M, Chayama K. Gastric juice nitrite and vitamin C in patients with gastric cancer and atrophic gastritis: is low acidity solely responsible for cancer risk? Eur J Gastroenterol Hepatol 2003; 15(9): 987–993
doi: 10.1097/00042737-200309000-00008 pmid: 12923371
44 Wong SC, Yu H, So JB. Detection of telomerase activity in gastric lavage fluid: a novel method to detect gastric cancer. J Surg Res 2006; 131(2): 252–255
doi: 10.1016/j.jss.2005.11.567 pmid: 16427084
45 Muretto P, Ruzzo A, Pizzagalli F, Graziano F, Maltese P, Zingaretti C, Berselli E, Donnarumma N, Magnani M. Endogastric capsule for E-cadherin gene (CDH1) promoter hypermethylation assessment in DNA from gastric juice of diffuse gastric cancer patients. Ann Oncol 2008; 19(3): 516–519
doi: 10.1093/annonc/mdm493 pmid: 17986624
46 Chae HD, Kim IH, Lee GH, Shin IH, Suh HS, Jeon CH. Gastric cancer detection using gastric juice pepsinogen and melanoma-associated gene RNA. Am J Clin Pathol 2013; 140(2): 209–214
doi: 10.1309/AJCPOHXRM5IYXVOC pmid: 23897256
47 Ruan HL, Hong RT, Xie HJ, Hu NZ, Xu JM, Zhang W. Significance of elevated levels of collagen type IV and hyaluronic acid in gastric juice and serum in gastric cancer and precancerous lesion. Dig Dis Sci 2011; 56(7): 2001–2008
doi: 10.1007/s10620-011-1571-8 pmid: 21264511
48 Dias A, Garcia C, Majewski M, Wallner G, McCallum RW, Poplawski C, Sarosiek J. Gastric juice prostaglandins and peptide growth factors as potential markers of chronic atrophic gastritis, intestinal metaplasia and gastric cancer: their potential clinical implications based on this pilot study. Dig Dis Sci 2011; 56(11): 3220–3225
doi: 10.1007/s10620-011-1758-z pmid: 21695403
49 Mehmet N, Refik M, Harputluoglu M, Ersoy Y, Aydin NE, Yildirim B. Serum and gastric fluid levels of cytokines and nitrates in gastric diseases infected with Helicobacter pylori. New Microbiol 2004; 27(2): 139–148
pmid: 15164624
50 Seo KW, Yoon KY, Lee SH, Shin YM, Choi KH, Hwang HY. Amylase, lipase, and volume of drainage fluid in gastrectomy for the early detection of complications caused by pancreatic leakage. J Korean Surg Soc 2011; 81(6): 402–407
doi: 10.4174/jkss.2011.81.6.402 pmid: 22200041
51 De Sol A, Cirocchi R, Di Patrizi MS, Boccolini A, Barillaro I, Cacurri A, Grassi V, Corsi A, Renzi C, Giuliani D, Coccetta M, Avenia N. The measurement of amylase in drain fluid for the detection of pancreatic fistula after gastric cancer surgery: an interim analysis. World J Surg Oncol 2015; 13:65
doi: 10.1186/s12957-014-0428-y pmid: 25849316
52 Tomimaru Y, Miyashiro I, Kishi K, Motoori M, Yano M, Shingai T, Noura S, Ohue M, Ohigashi H, Ishikawa O. Is routine measurement of amylase concentration in drainage fluid necessary after total gastrectomy for gastric cancer? J Surg Oncol 2011; 104(3): 274–277
doi: 10.1002/jso.21938 pmid: 21495031
53 Iwata N, Kodera Y, Eguchi T, Ohashi N, Nakayama G, Koike M, Fujiwara M, Nakao A. Amylase concentration of the drainage fluid as a risk factor for intra-abdominal abscess following gastrectomy for gastric cancer. World J Surg 2010; 34(7): 1534–1539
doi: 10.1007/s00268-010-0516-2 pmid: 20198371
54 Migita K, Takayama T, Matsumoto S, Wakatsuki K, Tanaka T, Ito M, Nakajima Y. Impact of bacterial culture positivity of the drainage fluid during the early postoperative period on the development of intra-abdominal abscesses after gastrectomy. Surg Today 2014; 44(11): 2138–2145
doi: 10.1007/s00595-014-0881-9 pmid: 24633956
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