常规与后程超分割放疗治疗食管癌的疗效分析

[目的]对常规放疗和后程超分割放疗治疗食管癌的临床疗效进行分析。[方法]将72例食管癌患者分成两组,34例常规组患者采取常规放疗方案,38例观察组患者采取后程超分割放疗方案,治疗结束后随访3年,观察并比较两组的局部控制率、生存率和不良反应。[结果]观察并组治疗后1、2和3年的局部控制率分别为78.95%、65.79%和47.37%,优于常规组（P〈0.05）;观察组治疗后1、2和3年的生存率分别为73.68%、55.26%和39.47%,亦显著优于常规组（P〈0.05）;两组治疗后不良反应比较无显著性差异（P〉0.05）。[结论]后程超分割放疗治疗食管癌的临床疗效显著,提高了局部控制率和生存率,对食管黏膜和肺组织的损伤程度不大,值得临床推广应用。     

三维适形放疗联合同步化疗治疗直肠癌术后复发

[目的]探讨三维适形放疗同步化疗治疗直肠癌术后复发的疗效。[方法]78例术后复发直肠癌患者分为适形放疗加化疗组(适形组)39例,常规放疗加化疗组(常规组)39例。观察并比较两组的临床疗效和不良反应的发生。[结果]适形组和常规组1、2、3年生存率分别为89.7%、64.1%、46.2%和64.1%、35.9%、23.1%(P<0.05),中位生存期分别为35个月和20个月;3年肿瘤局部控制率分别为64.1%、41.0%(P<0.05);适形组放射性直肠炎、放射性膀胱炎和皮肤反应的发生率低于常规组(P<0.05)。[结论]三维适形放射治疗联合FOLFOX方案同步化疗是治疗直肠癌术后复发的安全有效的方法,能明显地提高患者的远期生存率,减少放疗反应。     

三维适形后程逐步递量加速放疗治疗局部晚期非小细胞肺癌的疗效观察

目的探讨三维适形(3D-CRT)后程逐步递量加速放疗治疗局部晚期非小细胞肺癌(NSCLC)的临床疗效。方法将108例局部晚期NSCLC患者随机分为观察组和对照组,每组54例。对照组患者采用常规3D-CRT放射治疗,观察组患者采用首程常规3D-CRT放射疗法,后程递量加速放射治疗。比较两组患者的总有效率(ORR)、疾病控制率(DCR)、局部复发和远处转移率、1年生存率以及放射反应。结果观察组患者的ORR和DCR分别为81.5%和94.4%,均显著高于对照组患者的61.1%和79.6%(P<0.05)。对照组患者肿瘤局部复发率、远处转移率及1年生存率分别为48.1%、29.6%和59.3%,观察组患者分别为20.4%、13.0%和79.6%,差异均有统计学意义(均P<0.05)。两组患者放射反应发生率的差异无统计学意义(P>0.05)。结论 3D-CRT后程逐步递量加速放疗可提高晚期NSCLC的局部控制率,延长患者生存时间,安全性及耐受性较好,是局部晚期NSCLC患者理想的放射治疗方案。     

腔内微波热疗联合放疗治疗中晚期宫颈癌临床观察

目的 观察腔内微波热疗加放疗治疗宫颈癌的临床疗效.方法 66例宫颈癌患者随机分为热疗加放疗组(热放组)33例,单纯放疗组(单放组)33例.两组放射治疗方法相同,均采用8 Mv-X线全盆腔外照射DT 30 Gy,盆腔4野DT 20 Gy,加192Ir高剂量率腔内后装治疗,A点DT 42 Gy.热疗采用915 MHz微波热疗仪,放疗后30 rain-1 h内进行,腔内加温43-45℃,每次45 min,每周1-2次,共7-10次.结果 热放组与单放组局部控制率、感染率分别为87.88%和63.63%、15.15%和36.36%,差异均有统计学意义(P<0.05),热放组治疗后CD4/CD8比值及自然杀伤细胞数较治疗前升高(P<0.05),与单放组比较差异有统计学意义(P<0.05).2年肿瘤无进展生存率及3年生存率热放组与单放组分别为93.94%和72.72%、84.85%和60.61%,差异均有统计学意义(P<0.05).骨髓抑制及放射性直肠炎发生率热放组均低于单放组.结论 腔内微波热疗联合放疗能提高宫颈癌的局部控制率及生存率.     

宫颈癌术后放疗预后分析

目的:探讨宫颈癌术后放疗的价值。方法:回顾分析我院103例宫颈癌术后因盆腔淋巴结转移、局部肿瘤较大、术前误诊手术范围不足、术后残端复发等不同情况的病例,行60Co及近距离补充放疗。结果:全组103例5年生存率69.90%(72/103)。Ⅰ期、Ⅱ期5年生存率分别为75.86%(22/29)、63.24%(43/68)。复发及未控与术后即时辅助放疗5年生存率分别为38.10%(8/21)、79.27%(65/82),P<0.05。肿瘤直径>4cm与≤4cm病例5年生存率分别为55.56%(10/18)和69.41%(59/85)。盆腔淋巴结转移与无淋巴结病例5年生存率分别为50.00%(10/20)、71.08%(59/83),P<0.05。局部肿瘤侵犯深肌层与未侵犯深肌层患者5年生存率分别为67.61%(48/71)、71.88%(23/32)。结论:术前尽可能明确诊断,规范手术治疗;对有预后不良因素患者尽快行辅助放疗;对局部肿瘤稍晚的宫颈癌要有计划的综合治疗。     

放疗联合全身化疗治疗食管癌术后局部复发转移52例疗效分析

[目的]探讨放疗联合全身化疗对食管癌术后局部复发转移的疗效。[方法]52例纵隔和/或锁骨上复发及转移食管癌患者进行放射治疗,常规分割,DT48Gy～70Gy。22例放疗后予TP方案(紫杉醇+顺铂)化疗。[结果]全组总的中位生存期为12个月,1、2、3年生存率分别是48.1%、25.4%和14.0%。放化疗组1、2、3年生存率分别为77.3%、54.5%和31.8%,单纯放疗组1、2、3年生存率分别为50.0%、20.0%和6.7%(χ2=7.119,P=0.0076)。术后分期、放疗剂量、放疗后化疗及近期疗效与预后相关。[结论]放射治疗是食管癌术后局部复发和淋巴结转移的有效治疗方法,放疗结合化疗可能对患者有益。     

局部残留和复发鼻咽癌立体定向放疗的预后因素分析

目的分析局部残留和复发鼻咽癌分次立体定向放疗(FSRT)的预后因素。方法采用FSRT治疗鼻咽癌常规放疗后局部残留和复发患者共90例,除3例治疗前已发生远处转移外,余87例(34例残留,53例复发)纳入分析。其中肿瘤位于鼻咽腔内、外者分别为44、43例;中位肿瘤体积为5.7 cm3(0.8～24.7 cm3);残留和复发病灶FSRT的中位处方剂量分别为18 Gy分3次和48 Gy分6次。用Kaplan-Meier法计算无局部失败生存率(LFFS)和疾病相关生存率(DSS),用Logrank法和Cox模型分别进行单因素和多因素的预后分析。结果中位随访时间为24.9个月(3.3～86.3个月),1、2、3、4年LFFS和DSS分别为90%、83%、81%、75%和84%、77%、61%、56%。单因素分析显示肿瘤体积(≤或>5 cm3)对患者DSS有影响(P=0.015)。多因素分析显示肿瘤体积和病灶类型(残留或复发)是影响DSS的独立因素(P<0.05)。残留组和复发组晚期副反应发生率分别为9%和26%。结论FSRT治疗残留和复发鼻咽癌可得到较好局部控制率和生存率,复发病灶和较大肿瘤体积是预后不良的独立影响因素。     

放化疗同步治疗晚期或复发性宫颈癌76例临床分析

目的:探讨如何提高晚期宫颈癌的疗效和生存率。方法:将1996年1月～2000年7月我院放射治疗的晚期宫颈癌中阴道浸润呈团块、空洞状或宫旁浸润灶大于3cm的患者随机分成单纯放疗组和放疗同步化疗组,并将两组的治疗效果和不良反应相比较。结果:单纯放疗组CR为41.82%,PR为58.18%,5年生存率为29.09%;放疗同步化疗组CR为71.05%,PR为28.95%,5年生存率为56.58%;两组相比有显著性差异(χ2=9.7398,P<0.01),但两组不良反应无显著差异。结论:对阴道或宫旁浸润呈团块状的晚期宫颈癌患者,放疗同步化疗可明显提高肿瘤控制率和5年生存率,不良反应并无明显增加。     

术前配合放化疗治疗宫颈癌100例临床分析

目的:观察术前腔内后装配合VBP化疗方案治疗宫颈癌的疗效及毒副反应。方法:1996年~1998年1月住院宫颈癌患者100例,随机分为放化疗组50例(术前腔内放疗配合化疗),对照组50例(术前单纯腔内放疗),分析两组近期有效率、毒副反应及3、5、7年生存率。结果:放化疗组的近期有效率86%,对照组76%,(P<0.05)有显著性差异。放化疗组3、5、7年生存率分别为98%、94%、86%,对照组为94%、76%、58%。两组比较3年生存率无明显差异(P>0.05),5、7年生存率有显著差异(P<0.05)。研究组3、5、7年复发率分别为0%、5%、11%,对照组3、5、7年复发率分别为16%、24%、40%。两组比较3、5、7年复发转移率均有显著差异(P<0.05)。结论:宫颈癌术前放疗配合化疗、明显提高有效率及生存率,降低局部复发与转移。     

紫杉醇联合铂类与放疗同步治疗局部晚期食管癌的临床研究

目的探讨常规剂量紫杉醇联合铂类与放疗同步治疗食管癌的疗效,以及扩大照射野对同步放化疗疗效的影响。方法89例局部晚期食管癌初治患者,采用根治性同步放化疗,扩大野组51例,常规野组38例。放疗总剂量60 Gy(分两阶段进行),放疗的第1周和第4周给予常规剂量的紫杉醇和铂类化疗。结果87.6%的患者完成了治疗计划,扩大野组和常规野组的治疗有效率分别为75.5%和66.7%(P=0.37)。两组的Ⅲ级以上急性毒副反应主要为白细胞、血小板下降和放射性食管炎,主要远期放射损伤为肺纤维化,两组间各种毒副反应发生率差异均无统计学意义。患者总的3年生存率为32.8%,3年无复发转移生存率为34.5%,3年局部控制率为44.0%;扩大野组和常规野组的3年生存率、3年无复发转移生存率、3年局部控制率之间差异均无统计学意义。完成治疗计划的Ⅱ、Ⅲ期患者中,扩大野组3年生存率、3年无复发转移生存率及3年局部控制率较常规野组显著提高。结论常规剂量紫杉醇联合铂类化疗同步扩大野放疗对食管癌患者是安全的,可增加Ⅱ、Ⅲ期食管癌患者的局部控制率,提高3年生存率。     

The medically important dematiaceous fungi and their identification

Dematiaceous fungi include a large group of organisms that are darkly pigmented (dark brown, olivaceous, or black). In most cases the pigment is melanin, and specifically, dihydroxynaphthalene melanin. The diseases produced include chromoblastomycosis, eumycotic mycetoma, and phaeohyphomycosis. Phaeohyphomycosis is a new classification for a diverse group of previously known entities grouped together on the basis of finding dematiaceous hyphal and/or yeast-like forms in tissue; tissue involvement may be superficial, cutaneous and corneal, subcutaneous, or systemic. Identification of these fungi is based mostly upon morphology. Important structures include annellides (Phaeoannellomyces, Exophiala), phialides (Phialophora, Wangiella), adelophialides (Phialemonium without collarettes, Lecythophora with collarettes), differentiation of conidiophores (Xylohypha versus Cladosporium) and conidial hilum, septation and germination (Bipolaris, Drechslera, Exserohilum). Useful laboratory tests include the 12% gelatin test (controversial), nitrate assimilation (W. dermatitidis is negative, most other species are positive), and determination of temperature maxima (especially 37 degrees C for E. jeanselmei, 40 degrees C for W. dermatitidis and B. spicifera, 42 degrees C for X. bantiana, and 45 degrees C for Dactylaria constricta var. gallopava and Scedosporium inflatum).     

Orale Langzeitbehandlung von Onychomykosen mit Ketoconazol

Zusammenfassung: An der Studie zur Wirksamkeit und Anwendungssicherheit von Ketoconazol nahmen 27 Männer im Alter von 20 bis 80 (Median: 57) Jahre, davon 18 mit Onychomykosen und 9 als KontroUen bei den Laborwertbestimmungen, teil. Während des ersten Behandlungsmonats erhielten je 9 Patienten 200 mg und 400 mg Ketoconazol täglich. Danach wurden beide Gruppen 6 Monate mit 200 mg/d weiterbehandelt. Die klinische Beurteilung sowie hämatologische, biochemische und Plasmaspiegeluntersu-chungen erfolgten mindestens monafich, mykologische Untersuchungen wurden vor Aufnahme und bei Beendigung der Therapie vorgenommen. Erne letzte klinische Unter-suchung erfolgte 1 Jahr nach Beginn der Studie. Nach 7 Monaten Behandlung wurden 23 von 30 Nägeln mit “gebessert” bis “stark gebessert” beurteilt, nach dem behandlungsfreien Intervall galt dies für 28 von 30 Nägeln. Die Plasmaspiegel waren mit 200 mg/d ausreichend und uber den Behandlungszeit-raum konstant. Dies spricht für gute orale Resorption und Abwesenheit von Enzyminduktion. Die Laborwerte zeigten im Vergleich zu den Kontrollen und den Werten vor Behandlung keine signifikanten Abweichungen, so daß myelo-, nephro- und hepatotoxische Wirkungen von 400 bzw. 200 mg/d ausgeschlossen werden können. Der Lipidhaushalt wurde nicht beeinfluat und es trat unter Therapie als Folge der Ketoconazolwirkung lediglich Lanosterin im Serum auf. Nach Beendigung der Therapie ging der Lanosteringehalt schnell zurück. Damit erweist sich Ketoconazol in den angewandten Dosen als ein gut verträgliches und zur Langzeitbehandlung von Onychomykosen geeignetes Antimykotikum. Summary: Twenty-seven males with a median age of 57 (range: 20 to 80) years took part in this study on the efficacy and safety of ketoconazole. Eighteen men suffered from onychomycosis; nine served as controls in the safety evaluation. During the first month of treatment, nine patients received 200 mg and the nine other 400 mg ketoconazole daily. Then the treatment was uniformly continued with 200 mg/d for 6 months. Clinical evaluation and haematological, biochemical and plasma level investigations were carried out at least at monthly intervals; mycological controls were performed at the start and end of therapy. A final clinical evaluation was carried out one year after the start of the study. After 7 months of treatment, moderate or definite clinical improvement was obtained in 23 out of 30 nails. After 5 more months without antimycotic treatment this was the case in 28 of 30 nails. Plasma levels obtained with 200 mg ketoconazole daily were adequate and constant during the entire treatment period. This indicates a good oral resorption as well as the absence of induction of hepatic enzymes. The laboratory values did not show significant deviations as compared with the controls or with the pretreatment values. This excludes myelo-, nephro- and hepatotoxic effects of 400 and 200 mg ketoconazole daily. The lipid metabolism was not influenced, the only difference was the occurrence of lanosterol in the serum, which is a result of the mechanism of action of ketoconazole. After the medication period the lanosterol levels subsided rapidly. In the applied doses ketoconazole is a well-tolerated and effective drug for the systemic long-term treatment of onychomycosis.     

Laboratory Techniques Alternative to In Vivo Experiments for Studying the Liberation, Penetration and Fungicidal Action of Topical Antimycotic Agents in the Skin, Including Ciclopiroxolamine

Summary: Short-term experiments on excised skin (human, pig) gave the following results: 1. In the tissue activity test with direct inoculation (D-TAT) commercial preparations of the non-azole antimycotics ciclopiroxolamine, tolnaftate and naftifine, produced higher inhibitory activity against Trichophyton mentagrophytes (standard strain) in various levels of the horny layer than were produced by the azole antimycotics econazole, miconazole, clotrimazole, oxiconazole and bifonazole. Fast drying solutions of antimycotics invariably gave higher inhibitory activities than creams. In the ultrafiltration tissue activity test (UFT- TAT) against Candida albicans (2 strains), antimycotic agents ranked in order of effectiveness as follows: ciclopiroxolamine – most of the azole antimycotics – bifonazole and naftifine. 2. In tests of fungicidal activity against T. mentagrophytes (2 strains) and Microsporum gypseum (1 strain) the first step was to inoculate the skin surface. After the horny layer had been penetrated by fungal mycelia, antimycotic agents of documented fungicidal potency, chiefly in the form of creams, were applied to the skin surface and left to act for up to 18 hours. The horny layer and epidermis were then scraped off and the concentration of viable fungi was determined. Ciclopiroxolamine cream and lotion produced by far the greatest diminution in viable fungi; creams containing oxiconazole and naftifine were moderately effective and those containing tioconazole and bifonazole produced a relatively small decrease in viable fungi. To avoid erroneous results it is important to homogenize and dilute the skin scrapings; if this is not done certain antimycotics will give misleadingly high fungal killing rates. At this early stage the scatter of results is still wide and minor differences in efficacy cannot as yet be detected with certainty. 3. From the results of various comparative tests it is evident that pig skin can be used as a substitute for human skin in the tests listed under 1. and 2. above. This discovery may make a valuable contribution towards limiting the need for experiments on living animals and trials on human beings. Zusammenfassung: In Kurzzeitversuchen an exzidierter Haut (Mensch, Schwein) wurde gefunden: 1. Im Gewebeaktivitätstest mit direkter Inokulation (D-GAT) wurde mit Handelspräparaten der Nichtazol-Antimykotika Ciclopiroxolamin, Tolnaftat und Naftifin in verschiedenen Hornschichtniveaus eine höhere Hemmaktivität gegenüber Trichophyton mentagrophytes (Standard-Stamm) erzielt als mit solchen der Azol-Antimykotika Econazol, Miconazol, Clotrimazol, Oxiconazol und Bifonazol. Rasch trocknende Lösungen von Antimykotika ergaben durchweg höhere Hemmaktivitäten als Cremes. Im Ultrafiltrations-Gewebeaktivitätstest (UFT-GAT) gegenüber Candida albicans (2 Stämme) ergab sich nach erzielter Wirksamkeit die Rangfolge Ciclopiroxolamine – Mehrzahl der Azolantimykotika – Bifonazol und Naftifin. 2. In Fungizidie-Testen gegenüber T. mentagrophytes (2 Stämme) und Microsporum gypseum (1 Stamm) wurde zunächst die Hautoberfläche inokuliert. Nach Durchdringung der Hornschicht mit Pilzmyzelien wirkten auf die Hautoberfläche bis zu 18 Stunden lang überwiegend Cremes von als fungizid publizierten Antimykotika ein. Während sich in abgeschabter Hornschicht und Epidermis der so bearbeiteten Hautoberflächen mit Ciclopiroxolamin-Creme und -Lotion die weitaus höchste Verminderung lebensfähiger Keime ergab, bewirkten Cremes mit Oxiconazol und Naftifin eine mittlere und solche mit Tioconazol und Bifonazol eine relativ niedrige Keimeliminierung. Zur Vermeidung von fehlerhaften Ergebuissen mußten Homogenisierung und Verdünnung der Hautschabsel erfolgen, anderenfalls bei mehreren Antimykotika eine zu hohe Keimabtötung vorgetäuscht worden wäre. Wegen der vorerst noch hohen Streuung der Ergebnisse können kleinere Wirksamkeitsunterschiede noch nicht sicher erfaßt werden. 3. Nach dem Ergebnis verschiedener Vergleichstests kann in den Testen zu 1. und 2. Schweinehaut als Ersatz für Haut vom Menschen dienen und dürfte damit wesentlich zur Einschränkung von Versuchen am lebenden Tier und von Prüfungen am Menschen beitragen.     

Efficiency of crude and purified fungal antigens in serodiagnosis to discriminate mycotic from other respiratory diseases

Mycotic immunodiagnosis was performed in 186 hospitalized patients with different respiratory diseases, mostly considered as tuberculosis and others with a doubtful diagnosis. Crude histoplasmin, coccidioidin, paracoccidioidin, blastomycin, candidin, aspergillin, and sporotrichin, as well as purified polysaccharide-protein complexes (PPC) of Histoplasma capsulatum, Coccidioides immitis, and Paracoccidioides brasiliensis were used as antigens. Immune tests used included skin test (ST), gel immunodiffusion (ID), counterimmunoelectrophoresis (CIE), complement fixation (CF), and ELISA. A possible association with candidosis was observed in 17% of patients with tuberculosis and diabetes; one presumptive paracoccidioidomycosis, one confirmed aspergillosis, and six cases of active histoplasmosis were determined. Candidin ST showed 29% of positive reactions with an increased frequency in patients between 31 and 55 years of age. CF test showed the highest positivity percentages with crude antigens, specially for Candida antigen (26.3%) and histoplasmin (18.2%). Cross reactions were evident with crude antigens but decreased when PPC's were used in ELISA.     

Isoconazole nitrate in the treatment of tropical dermatomycoses

Summary. A total of 54 patients with culturally proven tropical dermatomycoses, comprising 23 with various types of dermatophytoses, one with foot infection due to Trichosporon beigelii and one with foot infection due to Geotrichum candidum , two with candidoses of the groin and 27 with pityriasis versicolor, were included in a clinical trial of efficacy of 1% isoconazole cream (Travogen^R, Schering, Berlin, Germany). Five patients were not evaluable. A clinical and mycological cure was achieved in 29 cases in 3–4 weeks. In 15 (31%) of the remaining patients treatment was required for 5–6 weeks, while another three patients required treatment for 8 weeks. In two patients the disease proved to be resistant to treatment with the drug.
Zusammenfassung. Insgesamt 54 Patienten mit kulturell gesicherter Dermatomykose, (23 unterschiedliche Dermatophytosen, eine Trichosporon beigelii - und eine Geotrichum candidum -Fußinfektion, 2 Candidosen der Leistengegend und 27 Pityriasis versicolor) wurden in einer klinischen Wirksamkeits-studie mit 1% iger Isoconazol-Creme (Travogen^R, Schering, Berlin, Deutschland) behandelt. Fünf Patienten waren nicht auswertbar. Eine klinische und mykologische Heilung wurde bei 47 von 49 Patienten (96%) erreicht. Bei 29 patienten (59%) wurde die Heilung bereits nach 3–4 Wochen Behandlung erreicht. Weitere 15 Patienten (31%) benötigten 5–6 Wochen und drei Patienten 8 Wochen Behandlungsdauer. Zwei Mykosesituationen erwiesen sich als therapieresistent.     

Large-scale molecular characterization and analysis of gastric cancer

The recent effort by The Cancer Genome Atlas （TCGA） Network has revealed that gastric cancer, which is a leading cause of cancerrelated deaths worldwide with a 5-year survival rate less than 25%, is a much more heterogeneous disease than previously thought. And yet, conventional treatment approaches and clinical trials have assumed it is a single disease. Although it is well known that under the microscope, gastric cancer cells appear quite different, the current classification scheme recognizes two main categories of gastric cancer： diffuse and intestinal.     

A conceptually new treatment approach for relapsed glioblastoma: Coordinated undermining of survival paths with nine repurposed drugs (CUSP9) by the International Initiative for Accelerated Improvement of Glioblastoma Care

To improve prognosis in recurrent glioblastoma we developed a treatment protocol based on a combination of drugs not traditionally thought of as cytotoxic chemotherapy agents but that have a robust history of being well-tolerated and are already marketed and used for other non-cancer indications. Focus was on adding drugs which met these criteria: a) were pharmacologically well characterized, b) had low likelihood of adding to patient side effect burden, c) had evidence for interfering with a recognized, well-characterized growth promoting element of glioblastoma, and d) were coordinated, as an ensemble had reasonable likelihood of concerted activity against key biological features of glioblastoma growth. We found nine drugs meeting these criteria and propose adding them to continuous low dose temozolomide, a currently accepted treatment for relapsed glioblastoma, in patients with recurrent disease after primary treatment with the Stupp Protocol. The nine adjuvant drug regimen, Coordinated Undermining of Survival Paths, CUSP9, then are aprepitant, artesunate, auranofin, captopril, copper gluconate, disulfiram, ketoconazole, nelfinavir, sertraline, to be added to continuous low dose temozolomide. We discuss each drug in turn and the specific rationale for use- how each drug is expected to retard glioblastoma growth and undermine glioblastoma''s compensatory mechanisms engaged during temozolomide treatment. The risks of pharmacological interactions and why we believe this drug mix will increase both quality of life and overall survival are reviewed.     

Endometrial cancers and predisposition

As nearly 5% of all endometrial cancers occur because of a predisposition, this possibility has systematically to be explored. The hallmarks of predisposition, a young age at diagnosis, a personal or a familial history of cancer, have to be searched systematically. The identification of a predisposition in a family has a major impact on the management of the proband or his relatives. The endometrial cancer main predisposition is Lynch's syndrome. In this review, we will focus on this condition and describe its clinical manifestations, the underlying molecular mechanisms, the cancer risks and the management guidelines. We will also get onto some far less frequent other predispositions.