Neuroendocrine tumor metastatic to the orbit treated with radiotherapy

Neuroendocrine tumors are rare neoplasms that infrequently metastasize to the orbit.Given that patients with these tumors may have prolonged survival despite dissemination,maintaining quality of life by providing early diagnosis and effective treatment to preserve vision and comfort is a fundamental issue.We report the case of a79-year old woman who presented with well-differentiated metastatic neuroendocrine tumor to the liver with no carcinoid syndrome and was started on intramuscular long-acting octreotide with disease stabilization.Two years later she developed right-sided diplopia associated with mild eye discomfort,proptosis and reddening.An magnetic resonance imaging showed a 2.1 cm mass in the right orbit and further biopsy confirmed a neuroendocrine tumor metastasis.The patient was treated with a four-week course of stereotactic radiotherapy to the right orbital metastasis(4000 cGy in 20 fractions)with minor conjunctivitis as the only side effect.Eighteen months later,she remains well with no visual loss.     

Malignant hemangioendothelioma of occipital bone

Epithelioid hemangioendothelioma is a rare vascular tumor of bone, and rarely these lesions can present as unique and extremely aggressive tumor. We report a case of highly aggressive epithelioid hemangioendothelioma and discuss the imaging findings. CT brain plain study revealed a poorly-defined, mixed density expansile and lytic lesion involving the occipital bone with extension to the left side with poorly defined trabecula formation. There was significant but irregular enhancement after intravenous administration of contrast material and also marked bone destruction. Microscopic examination of the fine needle aspiration cytology showed a tumor composed of vascular channels lined by plump endothelial cells, which had enlarged hyperchromatic nuclei. In view of the extensive infiltration the patient was submitted for the radiotherapy.     

Research advances of secretory proteins in malignant tumors

Secretory proteins in tumor tissues are important components of the tumor microenvironment.Secretory proteins act on tumor cells or stromal cells or mediate interactions between tumor cells and stromal cells,thereby affecting tumor progression and clinical treatment efficacy.In this paper,recent research advances in secretory proteins in malignant tumors are reviewed.     

Clinical application of multidisciplinary teams in tumor therapy

Multidisciplinary team (MDT) model is a diagnostic and treatment model characterized by interdisciplinarity,integration,centralism,individualization,and precision and is becoming more common in the management of complex malignancies.MDT emphasizes team spirit and a personalized treatment strategy according to the actual condition of each patient.A cooperative and effective mnltidisciplinary team is an important guarantee for delivering high-quality services to parents.Under the guidance of a medical humanistic concept,MDT provides reasonable,effective,convenient,and a full range of excellent quality medical service to patients.The MDT maximizes parent benefits,and it is the developmental direction for large-scale general hospitals.At the same time,the MDT is also an important measure to strengthen the core competitiveness of hospitals.Here,we introduce the clinical application of the model in tumor therapy as well as the current state and development in our hospital.     

Mechanisms ofvascularization inmurine models ofprimary andmetastatic tumor growth

Directed capillary ingrowth has long been considered synonymous with tumor vascularization. However, the vascu?lature of primary tumors and metastases is not necessarily formed by endothelial cell sprouting; instead, malignant tumors can acquire blood vessels via alternative vascularization mechanisms, such as intussusceptive microvascular growth, vessel co?option, and glomeruloid angiogenesis. Importantly, in response to anti?angiogenic therapies, malig?nant tumors can switch from one vascularization mechanism to another. In this article, we brielfy review the biological features of these mechanisms and discuss on their signiifcance in medical oncology.     

Radiotherapy for Lowly Malignant Cranial Inflammatory Myofibroblastic Tumor Accompanied with Intracranial Invasion: Case Report and Literature Review

Inflammatory myofibroblastic tumor(IMT) is rare in clinical practice.As its treatment mainly involves surgery,radiotherapy alone is seldom reported in literature.Here we report a case of lowly malignant cranial IMT with intracranial invasion in a female patient. As surgery was not suitable,intensity modulated radiation therapy(IMRT) was administered.After radiotherapy,the cranial lesions tended to show efficacy.     

Cell-free circulating tumor DNA in cancer

Cancer is a common cause of death worldwide. Despite significant advances in cancer treatments, the morbidity and mortality are still enormous. Tumor heterogeneity, especially intratumoral heterogeneity, is a significant reason under-lying difculties in tumor treatment and failure of a number of current therapeutic modalities, even of molecularly targeted therapies. The development of a virtually noninvasive“liquid biopsy”from the blood has been attempted to characterize tumor heterogeneity. This review focuses on cell-free circulating tumor DNA (ctDNA) in the bloodstream as a versatile biomarker. ctDNA analysis is an evolving field with many new methods being developed and optimized to be able to successfully extract and analyze ctDNA, which has vast clinical applications. ctDNA has the potential to accurately genotype the tumor and identify personalized genetic and epigenetic alterations of the entire tumor. In addition, ctDNA has the potential to accurately monitor tumor burden and treatment response, while also being able to monitor minimal residual disease, reducing the need for harmful adjuvant chemotherapy and allowing more rapid detection of relapse. There are still many challenges that need to be overcome prior to this biomarker getting wide adoption in the clinical world, including optimization, standardization, and large multicenter trials.     

Chinese consensus guidelines for diagnosis and management of gastrointestinal stromal tumor

In order to further promote the standardization of diagnosis and treatment of gastrointestinal stromal tumor (GIST) in China,the members of Chinese Society of Clinical Oncology (CSCO) Expert Committee on GIST thoroughly discussed the key contents of the consensus guidelines,and voted on the controversial issue.In final,the Chinese consensus guidelines for the diagnosis and management of GIST (2017 edition) was formed on the basis of 2013 edition consensus guidelines,which is hereby announced.The consensus included the pathological diagnosis,recurrence risk classification evaluation,targeted agent therapy,surgery and principles of surveillance of GIST.     

江苏省海安县2010年居民恶性肿瘤发病率及死亡率分析(英文)

Objective: The aim of the study was to analyze the incidence, mortality and their impact factors and changing trends of malignant tumors in 2010 in the residents of Hai’an county, Jiangsu Province, China. Methods: Using the information of incidence, death registration information database and population data of malignant tumors in 2010 in the residents of Hai’an county, the incidence, mortality, accumulation incidence rates, and truncated incidence rate of malignant tumors were statistically analyzed. Results: The crude incidence, China standardized and world standardized incidence rates of malignant tumors in 2010 in Hai’an county were 281.53 per 100000 persons, 174.96 per 100 000 persons, and 175.14 per 100000 persons, respectively. The cumulative incidence rate from aged 0 to 64 years, the cumulative incidence rate from aged 0 to 74 years and the truncated incidence rate from aged 35 to 64 years were 6.85%, 15.39%, and 193.26 per 100000 persons, respectively. The rough mortality rate, China standardized and world standardized incidence rates were 234.11 per 100000 persons, 145.30 per 100000 persons, and 144.77 per 100000 persons, respectively. The top five cancers in the spectrum of cancer incidence were respectively esophageal cancer, lung cancer, stomach cancer, liver cancer, and colorectal cancer. The top four cancers in the spectrum of cancer death were consistent with the spectrum of cancer incidence. The 5th cancer in the spectrum of cancer death was pancreatic cancer. The incidence and mortality of various age groups were at a low level before 35-year-old age group. The incidence of female was slightly higher than that of male. But the incidence and mortality from the age group of 50 showed "suddenly" upward trend with age. The incidence and mortality of male were significantly higher than those of female. The ratios of male to female of incidence and mortality were 1.52:1 and 1.67:1, respectively. Conclusion: Residents over the age of 50, especially males, are high-risk groups who are exposed to certain risk factors. They should be the key objects of prevention and treatment of malignant tumors.     

Endoscopic diagnosis of postoperative stomach cancer]

The authors examined endoscopically the esophagus and stomach in 309 patients, previously operated upon for gastric cancer (258), ulcer of the stomach or duodenum (36) and benign gastric tumors (15). They estimated the value of this method for establishing diagnosis of the operated stomach cancer and also the importance of histological and cytological methods in the complex diagnosis of this pathology. Moreover, roentgeno-endoscopic correlations were made. Cancer of the operated stomach was detected in 59 patients, it was suspected in 8, other lesions were found in 194. no changes in the operated stomach were found in 48. It is stated that endoscopy is more advantageous than roentgenological examination in establishing the diagnosis of tumor pathology of the operated stomach. Histological and cytological findings are of considerable value in making the correct diagnosis. These methods are mostly informative in an exophytic form of the tumor growth.     

胃癌肿瘤标志的研究进展

目的:总结国内外胃癌肿瘤标志的研究进展.方法:应用检索Medline及CHKD期刊全文数据库检索系统,以"胃肿瘤/诊断、肿瘤标记和生物学/分析"为关键词,检索1991-01-2003-12相关肿瘤标志在胃癌组织中的表达及其临床意义方面的文献.精选40篇文献,最后纳入分析15篇.结果:肿瘤标志是细胞癌变过程中产生的反映疾病发展程度的抗原或生物活性物质,在胃癌中的表达分为基因表型标志、基因标志2类.结论:胃癌标志的研究发展很快,但缺乏高度特异性和敏感性,尤其是对于胃癌的早期诊断和筛选不够理想,需要进一步研究其进展.     

胃肠道间质瘤的血管造影诊断

目的探讨胃肠道间质瘤（GIST）的血管造影表现,评价血管造影对该肿瘤的诊断价值。方法采用PUCK和DSA方法,对12例GIST患者术前1周行血管造影检查,分析病灶的部位、大小、形态及血管造影表现。结果肿瘤发生于胃区2例,空肠8例,回肠2例。良性者7例,恶性者5例。肿瘤供血动脉明显增粗者8例,静脉提前显影者3例。GIST的血管造影改变主要有两种类型：（1）肿瘤血管紊乱呈卷发状,部分血管边缘毛糙、模糊。（2）肿瘤血管呈抱球状,肿瘤染色均匀一致。结论血管造影检查对于GIST的定位、定性诊断有很大的帮助,可以明确肿瘤的大小、范围及部位,尤其是对于不明原因的黑便患者更有价值。     

胃肿瘤CT灌注成像的临床研究

Objection: The purpose of this study is preliminarily to discuss stomach perfusion imaging technique with Multi-slice CT and its clinical application value in stomach neoplasm. Methods: Fifteen patients with known stomach neoplasm performed perfusion imaging with 4 or 16 slice CT. Performing peffusion imaging in central slice of neoplasm, using CT cine scan, slice thick 10 mm/2i; with high pressure syringe, injecting quickly from right elbow-front vein, dosage 45-50 mL, injec-tion rate 3.5-4.0 mL/s, scanning delay time 5 s, scanning total time 45 s. We performed perfusion CT post-processing using pancreatic mode of perfusion CT software. Blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS) of gastric wall and tumor were computed for every case. Results: BF, BV, MTT and PS of gastric tumor were 116.68±90.09 mL/(min .100 g), 9.57±8.12 mL/100 g, 10.07± 7.74 s, 20.78±19.68 mL/ (min .100 g), respectively. The P values for each CT perfusion parameters between gastdc tumor and normal gastric wall were 0.001,0.021, 0.155 and 0.031,respectively. Conclusion: Perfusion CT can provide hemodynamics of gastdc tumors and play a key role in the diagnosis of gastric tumors. It's clinical application prospect will be fully broad.     

Survival of Patients with Stomach Cancer and its Determinants in Kurdistan

Background: Stomach cancer is the fourth most common cancer and the second leading cause of death from cancer in the world. In Iran, this type of cancer has high rates of incidence and mortality. This study aimed to assess the survival rate of patients with stomach cancer and its determinants in Kurdistan, a province with one of the highest incidence rates of stomach cancer in the country. Materials and Methods: We studied a total of 202 patients with stomach cancer who were admitted to Tohid Hospital in Sanandaj from 2009 to 2013. Using KaplanMeier nonparametric methods the survival rate of patients was calculated in terms of different levels of age at diagnosis, gender, education, residential area, occupation, underweight, and clinical variables including tumor histology, site of tumor, disease stage, and type of treatment. In addition, we compared the survival rates using the logrank test. Finally, Cox proportional hazards regression was applied using Stata 12 and R 3.1.0 software. The significance level was set at 0.05. Results: The mean age at diagnosis was 64.7 12.0 years. The survival rate of patients with stomach cancer was 43.9% and 7% at the first and the fifth year after diagnosis, respectively. The results of logrank test showed significant relationships between survival and age at diagnosis, education, disease stage, type of treatment, and degree of being underweight (P<0.05). Moreover, according to the results of Cox proportional hazards regression model, the variables of education, disease stage, and type of treatment were associated with patient survival (P<0.05). Conclusions: The survival rate of patients with stomach cancer is low and the prognosis is very poor. Given the poor prognosis of the patients, it is critical to find ways for early diagnosis and facilitating timely access to effective treatment methods.     

胃平滑肌肉瘤17例临床分析

[目的]探讨胃平滑肌肉瘤的诊断和治疗。[方法]对1988年－1998年手术治疗的17例胃平滑肌肉瘤进行回顾性分析。[结果]术后5年生存率58.3%（7／12），手术切除率94.12%（16／17）。[结论]病变大小不影响胃平滑肌肉瘤的切除率。有邻近脏器侵犯和孤立肝转移者，手术仍有较大临床价值。     

Comparative Study of Carcinoembryonic Antigen Tumor Marker in Stomach and Colon Cancer Patients in Khyber Pakhtunkhwa

Background: Due to the increase in morbidity and mortality rate, cancer has become an alarming threat tothe human population worldwide. Since cancer is a progressive disorder, timely diagnosis would be helpful toprevent/stop cancer from progressing to severe stage. In Khyber Pakhtunkhwa, Pakistan, most of the time, tumorsare diagnosed with endoscopy and biopsy; therefore rare studies exist regarding the diagnosis of gastrointestinal(GIT) carcinomas based on tumor markers, especially CEA. Objectives: This study made a comparative analysisof CEA in admitted hospitalized stomach and colon cancer patients diagnosed as GIT with biopsy. Materials andMethods: In this study, a total of 66 cases were included. The level of CEA was determined in the blood of thesepatients using ELISA technique. Results: Out of 66 patients, the level of CEA was high in 59.1% of the total,60.7% in colon cancer patients and 57.9 % in stomach cancer patients. Moreover, the incidence of colorectaland stomach cancer was greater in males as compared to females. Patients were more of the age group of 40-60 and the level of CEA was comparatively higher in patients (51.5%) with histology which was moderatelydifferentiated, than patients with well differentiated and poorly differentiated tumor histology. Conclusions:CEA level was high in more than 50% of the total patients. Moreover, CEA exhibited higher sensitivity for colonthan stomach cancer.     

多肿瘤标志物蛋白芯片对泌尿系肿瘤和男性生殖系肿瘤诊断的临床价值

目的：探讨多肿瘤标志物蛋白质芯片在泌尿系肿瘤和男性生殖系肿瘤诊断中的临床应用价值,并建立12项肿瘤标志物联合诊断泌尿系和男性生殖系肿瘤的函数。方法：采用C-12多肿瘤标志物蛋白质芯片检测57例泌尿系肿瘤患者、38例男性生殖系肿瘤患者、11例泌尿系良性病变患者、25例男性生殖系良性病变患者,以及1203例正常体检者。所有患者均经病理学、影像学或临床确诊。结果：用C-12芯片检测泌尿系肿瘤的灵敏度是49.12%,特异度是81.81%,阳性预测值是93.33%,阴性预测值是23.68%;男性生殖系肿瘤的灵敏度是62.16%,特异度是48.00%,阳性预测值是64.86%,阴性预测值是46.15%。除前列腺癌外,C-12芯片联合检测的阳性率在泌尿系肿瘤和其他男性生殖系肿瘤中显著高于单项肿瘤标志物的检测（P〈0.05）。建立的诊断判别函数对肾癌、膀胱输尿管肿瘤、前列腺癌、睾丸癌的诊断准确率分别为81.3%、94.5%、94.0%、91.0%,显著高于单项标志物检测（P〈0.01）。结论：除前列腺癌外,用多肿瘤标志物蛋白质芯片检测泌尿系和男性生殖系肿瘤可提高诊断的灵敏度,优于单项肿瘤标志物;诊断判别函数可明显提高泌尿系及男性生殖系肿瘤诊断的准确率,具有一定的临床参考价值。     

胃神经鞘瘤CT表现及误诊分析（附12例）

目的:分析12例胃神经鞘瘤（gastric schwannoma,GS）的CT表现,提高对该肿瘤的认识。方法:回顾性分析本院2012年1月至2019年5月经手术及免疫组化证实的GS患者共12例,搜集临床及影像学资料,所有患者术前均行CT检查,其中5例仅行CT增强检查,7例行CT平扫及增强检查。结果:12例肿瘤最大径1.0~6.4 cm,12例均表现为单发的类圆形、类椭圆形肿块或结节,生长于胃体8例,胃底2例,胃窦2例。4例有溃疡形成,2例存在钙化。12例中3例腔内生长,3例腔外生长,6例为跨壁生长。CT增强扫描均呈渐近性强化,静脉期CT值平均增加14.58 HU。结论:GS好发于中老年女性,在CT上常表现为孤立性、界限清楚的肿块,多位于胃体,一般很少出现坏死囊变,CT增强扫描呈渐近性强化。但这些特点尚缺乏特异性,GS与其他胃部肿瘤,尤其是胃黏膜下肿瘤易相混淆,术前诊断较为困难。最终确诊需要病理及免疫组化检查。     

河南省林州市人群胃癌的现时生存分析

目的:分析1988-2004年河南省林州市人群胃癌的生存率及不同时期的变化,评估当地胃癌二级预防及临床诊治的水平.方法:从林州市肿瘤登记处提取1988-2004年全部的胃癌发病和死亡个案记录,剔除重复和仅有死亡证明书(death certificate only, DCO)的病例.计算该地区的去肿瘤死因寿命表,并与胃癌发病死亡数据相链接.采用现时生存分析(period survival analysis)方法计算1990-1994年、1995-1999年和2000-2004年这3个时期的胃癌5年观察生存率和相对生存率,并绘制相对生存曲线.结果:林州市3个时期的胃癌5年相对生存率分别为26.66%、32.01%和40.43%,呈逐年上升趋势.男性患者的生存率要高于女性.前2个时期的贲门癌生存率要高于非贲门胃癌,而在2000-2004年则低于非贲门胃癌.结论:林州市人群胃癌生存率自20世纪90年代起逐渐提高,反映了当地胃癌二级预防及临床诊疗水平的不断提高.