The extent and value of lymphadenectomy in the surgical treatment of gastroesophageal junction carcinoma

Objective： We studied the extent and value of the lymphadenectomy in surgical treatment of carcinoma of gastroesophageal junction （GEJ）. Methods： 217 patients with GEJ who underwent surgical resection were retrospectively analyzed. The extent of lymphadenectomy was divided into 5 types （DO to D4） and the curability of operation was graded as A, B and C. Results： The patients had been treated as follows： 186 with proximal gastrectomy, 31 with total gastrectomy, 97 with a combined-visceral resection. The patients who underwent D1, D2 and D3 lymphadenectomy were respectively 158, 58 and 1. The patients who were performed with resection of grade A, B and C were 53, 107 and 57 respectively. All patients were performed with a lymphadenectomy and well registered. The lymph node metastasis occurred in 157 cases （72.4%）. The lymph node metastasis rate in the group 1, 2, 3, 4, 7, 9, 12 and 110 as well as in the pulmonary ligament group were higher than other groups. 2868 lymph nodes were removed, in which 655 （22.8%） demonstrated the existence of metastasis. The total lymph node metastatic degree in these groups was higher compared to the other groups. Conclusion： The survival rate in the D1 lymphadenectomy and D2 is similar for all patients, and there may be some differences in the 2nd and 3rd years for the DI lymphadenectomy and D2 in the stage-Ⅲb patients. The survival rate of D2 lymphadenectomy in stage Ⅲb is better than D1 and that of D2 lymphadenectomy is superior to D1 in stage-Ⅳ patients. The survival rate of grade A and B operation is much better than grade C, and the survival rate of grade A is also higher than B.     

Changes in the clinicopathological characteristics of gastric cancer in Hehuang Valley of China -2379 cases of gastric cancer in recent 10 years

Objective： The aim of our studywas to discuss changes in the clinicopathological characteristics of gastric cancer in Hehuang Valley of China in recent 10 years. Methods： A retrospective case-control study was performed on 2379 newly-diagnosed gastric cancer patients. All of them came from Hehuang Valley. The patients were divided into two groups [recent 5 years （R5Y） and late 5 years （L5Y）] from February 2003 to February 2013, and the clinicopathological data were surveyed retrospectively. Results： The constituent ratio of upper 1/3 gastric cancer in R5Y and L5Y was 33.5% and 20.7%, respectively, and it showed a significant difference between the two groups （X2 = 21.28, P = 0.00）, The constituent ratio of squamous carcinoma/adenosquamous carcinoma was 2.7% and 1.6%, respectively, and it also showed a significant differ- ence between two groups （X2 = 50.91, P = 0.00）. The constituent ratio of moderately-poorly differentiated/poorly differentiated gastric carcinoma was 84.2% and 50.2%, respectively, and it showed statistically significant difference （X2 = 30.28, P = 0.00）. The detection rate of early gastric cancer （EGC） was 1.47% （35/2379）. The constituent ratio of the types of Borrmann II and Borrmann IV of advanced gastric cancer （AGC） among 2379 cases was 47.6% and 40.8%, respectively, and that still showed statistically significant difference （X2 = 18,80, P = 0.00）. The constituent ratio of diffuse-type of gastric cancer in R5Y and L5Y was 36.2% and 30.8%, respectively, even there was a significant difference （X2 = 7.49, P = 0.01）. Furthermore, there were also significant differences in regional lymph nodes metastasis, perineural infiltration and vascular invasion （P 〈 0.05）. The positive detection rate of HER2, ER and PR was 14.88%, 17.23% and 15.93%, respectively. The constituent ratio of HP in two groups was 43.8% and 36.2% respectively, and it also showed a significant difference （~2 = 13.51, P = 0.00）. Conclusion： The pathogenic sites in gastric cancer change to the upper stomach in Hehuang Valley in recent 10 years, and the detection rate of squamous carcinoma/adenosquamous carcinoma reveals a sharp rise. Borrmann III is still one of the main types of advanced gastric cancer, but the detection rates of Borrmann II and IV are increasing. The main type of gastric cancer is the intestinal- type, but the ratio of diffuse-type is also increasing in recent 10 years. The HP detection rate is 40.65% （967/2379）, and it has a slight rise in recent 10 years. The detection rate of poorly differentiated adenocarcinoma is increasing despite the fact that the moderately/moderately-poorly differentiated adenocarcinoma is the main histologic types. High detection rates of lymph nodes metastasis, perineural infiltration and vascular invasion indicate poor prognosis in patients with gastric cancer. There is no change in HER2 positive rate, on the contrary, there are a little increase in ER and PR expression in Hehuang Valley.     

Correlativity of lymph node micrometastases detection in follicular carcinoma of thyroid in different risk groups

Objective： The aim of this study was to explore the relationship between follicular carcinoma of thyroid in different risk groups and lymph node micrometastases. Methods： The keratin-19 of negative neck lymph nodes in 83 cases in routine pathological examination, was detected by SP immunohistochemistry using keratin-19 monoclonal antibody to confirm lymph node micrometastases. All of cases are divided into high risk group, middle risk group and low risk group according to factors related prognosis, the relationship between lymph node micrometastases and different risk groups and follow-up visit documents were analyzed. Results： Fifty-eight neck lymph nodes in 16 cases of 83 cases （19.3%） showed positive lymph node micrometastases, and incidence of lymph node micrometastases was 4/39 in low risk group, 5/32 in middle risk group and 7/12 in high risk group, respectively, it showed remarkable difference during 3 groups （P 〈 0.001）. Nine patients in 16 cases with positive lymph node micrometastases showed local recurrence and distant metastases, 6 patients in 67 cases with negative lymph node micrometastases showed same result （P 〈 0.001）. Conclusion： Lymph node micrometastases in follicular thyroid carcinoma closely correlated to factors related to prognosis. The detection of lymph node micrometastases can directly assistant postoperative treatment and prognosis evaluation to some extent for follicular thyroid carcinoma.     

Clinical observation of capecitabine plus oxaliplatin in treatment of 68 cases with advanced clastric cancer

Objective： The aim of this study was to evaluate the response rate, time to progression （TTP）, overall survival, and safety of the combination of capecitabine plus oxaliplatin in treatment of advanced gastric cancer （AGC）. Methods： All the patients with advanced gastric cancer who were not received any prior chemotherapy or radiotherapy were treated with combination of capecitabine （1250 mg/m2 twice daily, days 1-14） plus oxaliplatin （130 mg/m2 as a 2-h intravenous infusion on day 1） every 3 weeks. Results： Two cases of complete response （CR） and 34 cases of partial response （PR） were confirmed, giving an overall response rate of 52.9%, of the 68 patients with advanced gastric cancer. The median TTP and overall survival for all patients were 7.3 and 11.9 months, respectively. Grade 3 leukopenia, thrombocytopenia, nausea/vomiting, and diarrhea were observed in 3, 5, 1, and 4 patients, respectively. Yet, no grade 4 toxicity was observed. Conclusion： Capecitabine/ oxaliplatin combination chemotherapy is active in patients with advanced gastric cancer.     

Expression of BI-1 protein and its significance in breast cancer

Objective： To investigate the correlations of expression of Bax inhibitor-1 （BI-1） gene and the receptors of estrogen and progestogen in breast cancer and its significance. Methods： Immunohistochemical methods had been used to detect the expressions of BI-1 gene and receptors of estrogen and progestogen in breast cancer. Results： The positive rates of expressions of BI-1 gene, estrogen receptor （ER） and progestogen receptor （PR） in breast cancer were 77.08%, 60.42% and 54.17%, respectively. The positive rate of expression of BI-1 gene was higher in the group with negative expression of ER than the positive group, their positive rates were 76.92% and 52.27%, respectively; but there was no statistical difference between the two groups with positive and negative expressions of PR. The positive rate of expression of BI-1 gene was also higher in the group with positive lymph node metastasis than the non-lymph node metastasis group, and their positive rates were 64.58% and 36.36%, respectively. The difference was statistically significant （P 〈 0.05）. Conclusion： BI-1 gene, in combination with ER, has guiding significance for patients with breast cancer to choose individual chemotherapy and radiotherapy after operation and can become an important indicator for judging the prognosis of breast cancer.     

Prognostic values of serum LDH and β2-MG in patients with non-Hodgkin＇s lymphoma

Objective： To evaluate the clinical significance of quantitative determination of serum lactic dehydrogenase （LDH） and beta 2-microgtobulin （β2-MG） in patients with non-Hodgkin＇s lymphoma （NHL）. Methods： Date of the 65 patients from 2003 to 2004 were retrospectively analyzed, relationship between LDH and β2-MG activities and tumor phase, effect of treat- ment as well as prognosis were studied. Results： The levels of LDH and β2-MG in the advanced stage, B group and bone marrow involvement were obviously higher than their comparison counterpart and the difference was significant （P 〈 0.05）. There was no significant difference between the high LDH group and normal LDH group in the two-year survival rate. But the difference in the four-year survival rate was significance. Conclusion： The level of LDH and β2-MG are valuable for clinical stage, prognosis and evaluation of therapeutic response in patients with NHL.     

A clinical study of combination of radiotherapy and IP regimen in the treatment of patients with local advanced esophageal cancer

Objective： The aim of this study was to study the clinical efficacy and toxicity of combination of the radiotherapy and IP regimen for patients with local advanced esophageal cancer. Methods： Sixty-eight cases of local advanced esophageal cancer were randomized into two groups, simple irradiation group （control group, n = 33） receiving conventional radiotherepy to a total of 60 Gy, combined group （research group, n = 35） which received the same radiotherapy as simple irradiation group ptus chemotherapy with IP regimen, patients in research group were treated with infusion of Irinotecan 65 mg/m^2 and DDP 30 mg/m^2 on days 1 and 8. Twenty-one days was a cycle and 4 cycles were given. Results： The remission rate, one and two year disease-free survival rate in research group were significant higher than it in control group. But the incidence of nausea, vomiting, myelosuppression and diarrhea was higher in research group. Conclusion： The efficacy of concomitant radiotherapy and IP regimen for local advanced esophageal cancer is obviously and it can improve the survival rate of patients, which worthy of clinical application.     

Study of the Dextran-DTPA-Gd at rabbit popliteal fossa lymph node metastasis from thigh transplanted tumor with interstitial magnetic resonance lymDhoqraDhv

Objective： The aim of the study was to investigate the developing situation of the interstitial magnetic resonance （MR） lymphoid contrast agent Dextran-DTPA-Gd through the rabbit popliteal fossa lymph node metastasis from thigh VX2 transplanted tumor injection to show targeting enhanced metastatic lymph nodes and lymphatics. Methods： VX2 tumor was transplanted to the right hind limb quadriceps of 12 healthy New Zealand rabbits and the left side as a contrast. Eight rabbits had homonymy popliteal lymph node metastasis after 1 month through 3.0 GE MRI and they were later injected with lym phatic targeting contrast agent Dextran-DTPA-Gd 0.4 mL （3.96 x 10^-3 tool/L） through bilateral hindlimb toe web respectively. Enhanced MR images were obtained with interval 10 min, 15 min, 20 rain, 25 min, 30 rain, 35 min, 40 rain, 45 rain, 50 min, 55 min, 60 min, 2 h, 4 h, and 24 h. The signal intensities before and after enhancing were measured to calculate the enhanc- ing rates （E%） of popliteal lymph node and the popliteal lymph node signal intensity-time curves were drawn to observe the development of cancer metastasis lymph nodes and lymphatics and to compare the differences of interval sides. Results： Ten minutes after injected into the rabbit＇s bilateral hindlimb toe web, we could see hind lymphatic and popliteal lymph nodes were strengthened significantly and evenly without blood vessels developing. The signal reached a peak after 35 rain with E% to 315%, which decreased to 205% after 4 h and would be undifferentiated with the surrounding tissues after 24 h. Sta- tistical analysis was made to popliteal lymph node enhancement rate. It was considered statistically significant as long as P 〈 0.05. The tumor-side popliteal lymph node manifested as coarse and irregular shape, lymphatic vessels tortuous dilated and lymphatic chain incomplete as a result of tumor infection. Conclusion： Dextran-DTPA-Gd is specific to lymphoid tissue development. It can targeting display regional lymphatic drainage concretion and the morphology of normal and cancer cells metastasis lymph nodes rapidly.     

The follow-up of 34 children with medulloblastoma who received 3-dimensional conformal radiation therapy

Objective： In our investigation, we studied the patients with medulloblastoma who received 3-dimensional conformal radiation therapy （3DCRT） and recorded their effects, side effects and failure reasons. Methods： From August 2001 to August 2007, 34 children with medulloblastoma were treated in our hospital. The age at diagnosis was 3-16 years old, and the mean age at diagnosis was 9.5 years old. Among all the patients, 16 cases were included in the high risk group and 18 cases were included in the low risk group. All the patients were performed total resection or subtotal resection and no patients received radiotherapy or chemotherapy before operation. All patients received 3DCRT within 3 weeks after resection. The dose of 30 Gy were given to the whole brain and whole spine, followed by 20-25 Gy boosted to the posterior brain fossa. The median fraction dose was 180 cGy. Every patient received the chemotherapy scheme of the Lomustine, Cisplatinum and Vincristine. Nobody received intrathecal chemotherapy. The tests of the complete blood count, blood biochemistry, hepatic and renal functions were required before every cycle of chemotherapy. Results： 5-year overall survival （OS） and 5-year disease free survival （DFS） were 71% and 62% respectively. The median follow-up time was 36.5 months. The 5-year OS of the high risk group was 71% compared to 62% of the low risk group. There were significant difference between the two groups （P = 0.01）. There were 13 failure cases in all the patients. Of these 13 patients, 10 were dead and the other 3 were alive with tumor. The complete remission （CR） rate was 70.5% and the partial remission （PR） rate was 14%. Among the failure patients, there were 3 patients （8.8%） with the recurrences located in the brain of cribriform region. The 5-year OS of the patients with preoperative metastases was 12.5% （1/8）, and which of the patients with residual tumor volume 〉 1.5 cm3 was 0% （0/5）. Through the statistic analysis, it was found that both wheth     

Synchronous primary cancers of the endometrium and ovary： review of 43 cases

Objective： To investigate the clinical and pathological characteristics, treatment methods, and prognosis of synchronous primary cancer of the endometrium and ovary. Methods： The clinical data of 43 patients with synchronous primary cancer of endometrium and ovary were retrospectively reviewed. The survival was calculated by Kaplan-Meier method and compared using the log-rank test. Results： The median age of the patients at diagnosis was 49 years （range, 28-73 years）. The most common symptoms were abnormal vaginal bleeding （69.8%） and abdominal or pelvic pain （44.2%）. Pelvic masses were found in 39.5% of the patients and enlarged corpus in 27.9% at physic examination, while pelvic masses were found in 67.4% of the 43 patients （29 cases） and thickening or abnormal endometrium in 23.3% （10 cases） during ultrasound examination. Of 25 patients examined by CT/MRI, pelvic masses were found in 13 cases and enlarged uterus in 11 cases. All 15 patients who underwent endometrial biopsies were proven to have endometrioid carcinomas. Serum CA125 level was found to be elevated in 22 of the 34 examined cases （64.7%） with median value 500 U/mL （range, 39-3439 U/mL）. FIGO stages of endometrial carcinomas： IA 18 cases, IB 20 cases, IC 2 cases, and ⅡA 3 cases; Stages of ovarian carcinomas： IA 19 case, IB 4 cases, IC 7 cases, Ⅱ 4 cases, and ⅢC 9 cases. Twenty-four patients （55.8%） were in stage I both endometrial and ovarian carcinomas. Thirty-one patients underwent total hysterectomy plus bilateral salpingo-oophorectomy with omentectomy and appendectomy, meanwhile, 12 patients had pelvic lymph nodes dissection. Thirty-eight of the 43 patients （88.4%） had a pathologically proven endometrial adenocarcinomas. The predominant ovarian histologies were endometrioid or mixed tumors with endometrioid components （30/43, 69.8%）. Postoperatively, 26 patients （60.5%） received adjuvant chemotherapy alone, 12 had chemotherapy plus radiotherapy, only one patients had radiation alone and     

Clinical characteristics and prognosis of triple-negative breast cancer

Objective： We investigated the clinical characteristics, and the prognostic factors of triple-negative breast cancer. Methods： 130 triple-negative breast cancer patients were reviewed on clinical characteristics and prognosis. All cases were lack of expression of estrogen receptor, progesterone receptor, and HER2/neu determined by immunohistochemistry. Results： 17.1% of all breast cancer patients （774 cases） were triple-negative breast cancer, and 68.9% of triple-negative breast cancer patients （91 cases） were premenopausal. 53.8% of patients （71 cases） had the tumors with T2 size, and 39.4% of them （52 patients） had lymph node metastasis. The rate of relapse in patients with lymph node metastasis was obviously higher than that in patients without lymph node metastasis （P = 0.001）. The median time of follow-up was 63 months. 33 cases relapsed and 20 patients died. 23 patients had at least two organs metastasis. The 5-year disease-free and overall survival rates were 73.8% and 85.7%. Conclusion： Triple-negative breast cancer patients commonly have high rate of multiple distant metastasis in 2-3 years after treatment. The status of lymph node is the most important prognostic factor. The triple-negative breast caner patients with lymph node metastasis have poor prognosis.     

Efficacy and safety profiles of cetuximab in Chinese patients with colorectal cancer

Objective： The aim of this study was to investigate the efficacy and safety profiles of cetuximab, the commonly used monoclonal antibody of epidermal growth factor receptor, based on Chinese patients with colorectal cancer. Methods： All the papers studied on Chinese patients with gastrointestinal cancer treated by cetuximab and found in both databases of Chinese journal database for fulltext and PubMed were collected. The commonly used efficacy index such as disease control rate （CR ＋ PR ＋ SD） and response rate （CR ＋ PR） were analyzed, and the cetuximab related side effects such acne-like rash and nail change and hypersensitivity were analyzed too. Results： （1） There were 10 original papers contained total 152 patients with gastrointestinal cancer who were the candidates to analyze the safety profiles, and contained 130 patients with colorectal cancer who were candidates to analyze the efficacy. （2） The disease control rate and response rate in the whole group was 73.5% （95% CI： 65.5%-81.5%） and 29.1% （95% CI： 20.9%-37.3%）, respectively; In first-line setting group they were 70.0% （95% CI： 55%-85%） and 41.7% （95% CI： 25.6%-57.8%）, respectively; In non-first line setting group they were 71.6% （95% CI： 61.8%-81.4%） and 23.5% （95% CI： 14.3%-32.7%）, respectively. The disease control rate between the two line-setting groups was insignificant, but the response rate between the two line-setting groups was significant （P = 0.045）. （3） The incidence of acne-like rash was 72.0% （95% CI： 64.8%-79.2%）, the degree Ⅰ-Ⅱ and degree Ⅲ-Ⅳ account for 56.0% （95% CI： 48.1%-63.9%） and 16.0% （95% CI： 10.1%-21.9%）, respectively. No treatment related death, and the hypersensitivity was under control. Conclusion： This study is the first study to summarize the data of Chinese patients with colorectal cancer treated by cetuximab-contained regimen, it showed that the monoclonal antibody was effective and safe for Chinese patients as the West p     

The clinical significance of axillary sentinel lymph node biopsy in different clinical stages breast cancer patients after neoadjuvant chemotherapy

Objective： We aimed to study the success and false negative rate of sentinel lymph node biopsy （SLNB） in dif- ferent clinical stages breast cancer patients being carried out with neoadjuvant chemotherapy （NAC）, and the clinical signifi- cance of SLNB, we conducting this trial. Methods： One hunderd and thirty-seven cases were enrolled in this clinical research from March 2003 to March 2007. All of the patients＇ sentinel lymph nodes were detected with 99mTc-Dx and methylene blue. There were 61 patients with stage TI_2NoMo carried SLNB without NAC （group A）, 76 cases were carried out NAC 3-4 cycles before SLNB, including 39 T2_4N0_IMo cases （group B） and 27 T2-4N2_3M0 cases （group C）. The success and false negative rate of SLNB were analysed with chi-square test. Results： In group A, the successful and false negative rate of SLNB were 92.31% （36/39）, 8.57% （3/35）, and in group B and C were 92.31% （36/39）, 8.57% （3/35） and 74.07 % （20/27）, 18.52 % （5/27）, respectively. The successful rate of group C decreased and false negative rate increased significantly compared with group A and B （P 〈 0.05）, but group A and B had no significant difference （P 〉 0.05）. Conclusion： The SLNB can accurately predict lymph node status of axillary lymph node in N0-1 stage patients with NAC, but in N2-3 stage patients the success rate decreased and false rate increased negative significantly.     

The value and association of CC chemokine receptor 7 expression in non-small cell lung cancer with lymph nodes metastasis

Objective： The aim of this study was to analyze the expression of CC chemokine receptor 7 （CCR7） in pulmonary tumor tissue and metastasized lymph nodes of non-small cell lung cancer （NSCLC）, explore the relationship between the expressions of CCR7 in pulmonary tumor tissue and metastasized lymph nodes, and discuss the significance. Methods： SABC immunohistochemical staining was used to investigate the expression of CCR7 by rabbit anti-human CCR7 monoclonal antibody, and the specimens were 17 cases of adenocarcinoma, 17 cases of squamous cell carcinoma, 12 cases of adenosquamous carcinoma, 4 cases of large cell carcinoma and 28 cases of metastasized lymph nodes of lung cancer. Negative control sections used 5 cases of inflammatory pseudotumor and 20 cases of normal lung tissue. Two independent pathologists observed all the specimens in the high power field （x 400） of microscope by double blind method. Results： （1） The expression of CCR7 in pulmonary tumor tissue was stronger than normal lung tissue （P 〈 0.005）; （2） The expressions of CCR7 in pulmonary tumor tissues and metastasized lymph nodes had no significant differences （P = 0.177）; （3） The expression of CCR7 had correlation with lymph nodes metastasis, and the expression in lymph nodes metastasis group was more than that of no lymph nodes metastasis group （P = 0.016）; （4） Along with the increment of clinical stage, the CCR7 expression had a tendency to increase （P = 0.003）. Conclusion： CCR7 has rich expression in carcinoma cell nests and lymph node metastasis. It demonstrates that CCR7 may be related to the development of lymph node metastasis in NSCLC.     

Clinical observation of platinum-based combined with concurrent three-dimensional conformal radiotherapy in patients with locally advanced non-small cell lung cancer

Objective： The aim of our study was to explore the shortterm efficacy of platinumbased combined with concur rent chemoradiotherapy for locally advanced nonsmallcell lung cancer （NSCLC）. Methods： Between 2006 to 2010, 78 cases of locally advanced NSCLC were enrolled into this trial. All patients were given platinumbased chemotherapy combined with concurrent threedimensional conformal radiotherapy （3DCRT）. Chest CT scans were obtained during endexpiratory and endinspiratory pauses when performing positioning. Image fusion was done after the image data was transferred to treat ment plan system （TPS）. The target volume was delineated on the fusion images. The chemotherapy was given on the first day of radiotherapy. Comprehensive examinations were conducted 46 weeks after concurrent chemoradiotherapy to assess shortterm efficacy. Results： Complete remission （CR） was achieved in 8 cases and partial remission （PR） in 54 cases. The efficiency rate reached 79.5%. Grade IllIV radiation esophagitis occurred in 11.5%. No exit and death cases during treat ment. Conclusion： Concurrent chemoradiotherapy could significantly improve the shortterm efficacy and prolong survival of stage III NSCLC, meanwhile the adverse reactions could be tolerated.     

Expression and significance of cyclooxygenase-2 n human lung cancer

Objective： We aimed to examine the expression of cyclooxygenase-2 and the relationship with the pathological types, TNM stage, lymph node metastasis, the degree of differentiation, smoking and the survival. Methods： Immunohisto chemical staining method was used to examine the expression of cyclooxygenase-2 of 121 cases of lung cancer and three control groups. The data were statistically analyzed. Results： Compared with the health group, cyclooxygenase-2 was over expressed in the inflammatory tissue （P = 0.036）, lung adenocarcinoma （P = 0.005） and squamous carcinoma （P = 0.047）. Compared with patients without lymph node metastasis, cyclooxygenase-2 was over expressed （P = 0.033） in patients with lymph node metastasis. Compared with high differentiation group, cyclooxygenase-2 was over expressed （P = 0.004） in low differentiation group. Compared with non-smokers, the expression of cyclooxygenase-2 increased in smokers （P = 0.000）. The median survival time of patients that the expression of cyclooxygenase-2 were negative was 9 months （95% CI, 5.6-12.4 months）. The median survival time of patients that the expression of cyclooxygenase-2 were positive was 5 months （95% CI, 3-7 months）. They was statistical difference （P = 0.001）. Conclusion： Overexpression of cyclooxygenase-2 is associated with pathological types, TNM stage, lymph node metastasis, degrees of differentiation, smoking and prognosis in lung cancer.     

Improvements of quality of life in patients with advanced non-small cell lung cancer treated with gefitinib

Objective： The aim of this study was to evaluate the effect of gefitinib on improvement of quality of life （QoL） of patients with advanced non-small cell lung cancer （NSCLC）. Methods： There were 70 patients with advanced NSCLC. One oral gefitinib tablet （250 mg） was administered every day without interruption unless disease progression or unacceptable toxicity occurred. The impact of treatment on disease-related symptoms and QoL was evaluated with the Chinese versions of European Organization for Research and Treatment of Cancer Quality of Life Questionnaires （EORTC QLQ-C30 and QLQ- LC13）. Results： Fifty-eight patients had finished the questionnaires. The mean scores of five functioning scales （physical, role, emotional, cognitional and social） were 62.64, 56.03, 68.41, 64.67, 60.63 respectively after eight weeks of treatment, which were 52.30, 49.43, 64.39, 59.79, 52.30 respectively before treatment, and the mean score of global QoL after and before treatment was 60.17 and 52.70 respectively. There was statistical difference in five functioning scales and global QoL （P 〈 0.05）. Mean scores of main general symptoms （fatigue and appetite loss） were 57.66 and 48.08 respectively after eight weeks of treatment, which were 61.11 and 51.72 respectively before treatment, and mean scores of disease-related symptoms （dyspnoea, coughing, empsyxis, pain in chest）were 48.66, 47.13, 26.82, 24.71 respectively after eight weeks of treatment, which were 54.98, 53.64, 27.78, 28.54 respectively before treatment. There was statistical difference in fatigue, dyspnoea, cough and pain in chest （P 〈 0.05）. Response rate of five functioning and global QoL were all more than 50% after gefitinib treatment. Response rate of main general symptoms and disease-related symptoms were all more than 40%. QoL and symptom response correlated with disease control. The patients with better QoL had longer survival. Conclusion： gefitinib treatment can improve the QoL and symptoms of advanced NSCLC patient     

Gefitinib in the treatment of 41 cases with refractory non-small cell lung cancer

Objective： We observe the curative effect, median survival time, time to progression, quality of life and adverse effect of patients with advanced refractory non-small cell lung cancer （NSCLC） after gefitinib （Iressa） treatment. Methods： Forty-one patients with grade Ⅲb to Ⅳ NSCLC previously treated with two chemotherapy including 85.4% of patients after second line therapy were chosen. The regimen was oral intake of gefitinib 250 mg once daily until the disease progression or toxic reaction has become intolerable. The patients were required to receive tumor evaluation before the treatment, one month, two month and every three months after Iressa administration. Results： All of 41 patients were evaluable for therapeutic effect. Without complete regression being observed, partial response rate （PR）, stable disease （SD） and progression of disease （PD） were 43.9% （18/41）, 34.1% （14/41） and 22.1% （9/41）, respectively. The overall response rate was 43.9% （18141） and disease control rate （PR ＋ SD） was 78% （32/41）. The response rate in male was 42.1%, while it in female was 45.5% （P 〉 0.05）. Twenty-two of them （53.7%, 22/41） were still alive with 10.1 months of MST when the follow-up ended in November 2006. TTP and MST of patients who died was 2.7 and 5.0 months, respectively. The rate of symptom improvement was 78% of all patients with 13 months of MST of PR patients. The Karnofsky enhanced 20 ＋ 5 after 28 days treatment without 3-4 degree of reactive toxicity. Conclusion： Iressa has significant antitumor activity in advanced NSCLC patients who have previously failed in second or third line chemotherapy. Iressa is effective and safe for patients with poor performance status.     

Expression and significance of ER and PR in differentiated thyroid carcinoma

Objective： The aim of the study was to investigate the relationship between expressions of estrogen receptor （ER）, progesterone receptor （PR） and gender, age, tumor size, lymph node metastasis, capsular invasion and histological type of differentiated thyroid carcinoma （DTC）. Methods： Seventy cases of DTC who received surgery in our hospital （No. 401 Hospital of People＇s Liberation Army, Qingdao, China） between January 2008 and December 2011 were selected. Among them, 61 cases were papillary carcinoma and 9 cases were follicular carcinoma. Twenty cases were normal thyroid tissue adjacent to the tumor which was used as control. Immunohistochemical SP method was employed to detect the expression of ER and PR. Results： The positive rates of ER and PR in tumor tissues of DTC patients were 21.4% （15/70） and 31.4% （22/70）, respectively, and no expression of ER or PR were founded in normal thyroid tissue （P 〈 0.01）. The expressions of ER and PR were related to the lymph node metastasis and capsular invasion （X2 = 16.913 and 6.327, P 〈 0.05; x2 = 7.516 and 12.727, P 〈 0.05）. No relationship was observed between the expressions of EPJPR and gender, age, and histological type （P 〉 0.05） of DTC patients. Conclusion： The expression levels of ER and PR in the tumor tissue of DTC patients were higher than those in the normal thyroid tissue nearby the tumor. Therefore, ER and PR expression might be clinical markers for DTC and its prognosis.     

TACE combined with liver resection versus liver resection alone in the treatment of resectable HCC： a meta-analysis

Objective： The efficacy of preoperative transarterial chemoembolization （TACE） for hepatectomy on hepatocel- luar carcinoma （HCC） is still controversial. This study aims to evaluate the efficacy of preoperative TACE on resectable HCC. Methods： Pubmed, SCI, Medline, EMBASE, Cochrane Datebase, CNKI were searched. The articles that focused on pre- operative TACE for resectable HCC, published from 1990 to 2012, were collected by computerized search of literatures and manual search of bibliographies. The relevant clinical trials＇ data were reviewed by meta-analysis using the random effects model or fixed effect model by heterogeneity. The outcomes were expressed as odds ratio （OR） with 95% confidence intervals （CIs）. Results： A total of 1347 patients were included in these 7 studies, the cases were divided into the preoperative TACE group and the non-preoperative TACE group, and there was no difference between the two groups in the 3-year disease-free survival rate, with an odds ratio of 1.14 （95% CI = 0.90-1.45, P = 0.27）; the 5-year disease-free survival rate in the preopera- tive TACE group was better than that in the non-TACE group with an odds ratio of 1.35 （95% CI = 1.07-1.74, P = 0.02）; the 5-year overall survival rate in the preoperative TACE group was higher than that in the non-TACE group with an odds ratio of 0.59 （95% CI = 0.46-0.77, P 〈 0.0001）. Conclusion： The present data suggests that preoperative TACE has no different in improving the 3-year disease-free survival rate with non-TACE group for resectable HCC, while it can improve the 5-year disease-free survival rate and the 5-year overall survival rate. More randomized controlled trials using large sample size are needed to provide sufficient evidence to confirm current conclusion.