Global progress against cancer-challenges and opportunities

The last ten years have seen remarkable progress in cancer research. However, despite significant breakthroughs in the understanding, prevention, and treatment of cancer, the disease continues to affect millions of people worldwide. Cancer＇s complexity compounded with financial, policy and regulatory roadblocks has slowed the rate of progress being made against cancer. In this paper, we review a few of the most recent breakthroughs that are fueling medical advances and bringing new hope for patients affected by this devastating disease. We also address the challenges facing us and the opportunities to accelerate future progress against cancer. The efforts of the American Association for Cancer Research （AACK） to address the cancer burden already extend beyond the borders of the United States of America. The AACR is committed to increasing its efforts to stem the tide of cancer worldwide by promoting innovative programs, strategies, and initiatives for cancer researchers and all those engaged in cancer-related biomedical sciences around the world.     

腹腔镜手术治疗卵巢良性肿瘤的临床研究

卵巢肿瘤常规治疗方法为开腹手术，临床上有一定的治疗效果，但会给患者带来比较大的损伤。腹腔镜术式创伤小、并发症少而且恢复较快，已广泛应用于临床治疗上。为探讨腹腔镜手术治疗卵巢良性肿瘤的临床效果，我们回顾性分析2010年3月至2012年10月间248例卵巢良性肿瘤患者临床资料，现总结报告如下。     

pH-responsive mesoporous silica nanoparticles employed in controlled drug delivery systems for cancer treatment

In the fight against cancer, controlled drug delivery systems have emerged to enhance the therapeutic efficacy and safety of anti-cancer drugs. Among these systems, mesoporous silica nanoparticles （MSNs） with a functional surface possess obvious advantages and were thus rapidly developed for cancer treatment. Many stimuli-responsive materials, such as nanopartides, polymers, and inorganic materials, have been applied as caps and gatekeepers to control drug release from MSNs. This review presents an overview of the recent progress in the production of pH-responsive MSNs based on the pH gradient between normal tissues and the tumor microenvironment. Four main categories of gatekeepers can respond to acidic conditions. These categories will be described in detail.     

Analysis of 30 patients with persistent or recurrent squamous cell carcinoma of the cervix within one year after concurrent chemoradiotherapy

Objective： To investigate the recurrence sites, risk factors, and prognosis of＇patients with persistent or recurrent squamous cell carcinoma （SCC） of the cervix within one year after undergoing concurrent chemoradiotherapy （CCRT）. Methods： Clinical data of 30 patients with persistent or recurrent SCC of the cervix within one year after CCRT between July 2006 and July 2011 were analyzed retrospectively： These data were compared with those of 35 SCC cases with no signs of recurrence after complete remission. These 35 patients were treated during the same period （between 2,006 and Z011） and selected randomly. Results： Among these 30 patients, 25 exhibited distant metastases of which 14 were observed within 6 months after CCRT. Univariate analysis showed higher incidence of pelvic or para-aortic lymphadenectasis and SCC-ag 〉 10 ng/mL in the group with persistent or recurrent disease before treatment （P〈0.01）. Multivariate analysis by logistic regression revealed that the pre-therapeutic pelvic or para-aortic lymph node enlargement and SCC-ag 〉 10 ng/mL were the independent risk factors. Palliative chemotherapy was the main treatment option for patients with persistent or recurrent disease. The 2-year survival rate was 21.7%, and the median survival time was 17 months. Conclusion： Patients with persistent or recurrent SCC of the cervix after CCRT exhibited a high rate of distant metastasis with poor prognosis. The pre-therapeutic pelvic or para-aortic lymph node enlargement and SCC-ag 〉10 ng/mL were identified as the independent risk factors for persistent or recurrent SCC within i year after CCRT.     

Cancer metabolic reprogramming： importance,main features,and potentials for precise targeted anti-cancer therapies

Cancer cells are well documented to rewire their metabolism and energy production networks to support and enable rapid proliferation, continuous growth, survival in harsh conditions, invasion, metastasis, and resistance to cancer treatments. Since Dr. Otto Warhurg＇s discovery about altered cancer cell metabolism in 1930, thousands of studies have shed light on various aspects of cancer metabolism with a common goal to find new ways for effectively eliminating tumor cells by targeting their energy metabolism. This review highlights the importance of the main features of cancer metabolism, summarizes recent remarkable advances in this field, and points out the potentials to translate these scientific findings into life-saving diagnosis and therapies to help cancer patients.     

索拉菲尼对COC1DDP细胞增殖凋亡及血管形成影响的研究

卵巢癌是女性生殖器管发病率仅次于子宫颈癌和子宫体癌的常见肿瘤之一,但是其死亡率却占女性各类生殖器官疾病之首。目前的综合治疗手段有化疗、手术、放疗、靶向治疗等。手术及化疗对进展期的卵巢癌治疗效果并不理想,而目前靶向治疗正逐渐成为抗肿瘤药物治疗的重点和热点。索拉菲尼是一种新型的多靶点的生物靶向药物,临床前研究和临床试验的结果都提示索拉菲尼具有抗肿瘤的作用。我们观察索拉菲尼对人体卵巢癌细胞株COC1／DDP的抑制作用,以期为使用索拉菲尼等靶向型药物治疗女性卵巢癌提供试验依据。     

2009国际小细胞肺癌热点问题解析

小细胞肺癌（small cell lungcancer,SCLC）占肺癌总数的15％～25％。由于其增殖快、高度侵袭性的特点,易早期转移。SCLC对化疗药物敏感,但容易产生耐药性而复发,预后较差。通常中位生存期9～11个月,1年生存率10％左右。目前,SCLC的治疗策略是综合治疗,包括化疗、放疗、手术等的综合治疗模式,特别是近年来的SCLC化疗联合同步放疗可显著提高患者的生存率,其中位生存期提高到16～24个月,5年生存率提高到12％～30％。     

宫颈癌放化疗前后的影像学特征变化分析

<正>我国宫颈癌发病率为1400/10万左右,每年新发病例约为14万人[1-2]。手术、放疗及化疗为主的综合治疗是宫颈癌治疗的主要方法,其中手术切除适应于临床分期Ⅰa-Ⅱa期患者,放疗适用于不能耐受手术者及Ⅱb、Ⅲ、Ⅳ期患者[3-4],化疗作为手术或放疗的辅助治疗,用于治疗宫颈癌[5]。而随着影像学技术的快速发展,MRI与CT检查已广泛地应用于临床中,其中多层螺旋CT灌注成像与增强MRI使得诊断的空间分辨率增加,从而使诊断更准确[6-7]。我们探讨了宫颈     

居家癌痛患者家属的心理状态及相关因素的分析

疼痛是癌症患者最常见的、最难以忍受的症状之一,是患者及家属极大的应激源。研究发现,患者和家属的心理状态是相互影响的[1]。本研究旨在了解居家癌痛患者家属心理状态及相关因素,更好地为居家癌痛患者提供家庭及社会支持,提高其生活质量。     

Inhalation treatment of lung cancer： the influence of composition,size and shape of nanocarriers on their lung accumulation and retention

Objective： Various nanoparticles have been designed and tested in order to select optimal carriers for the inhalation delivery ofanticancer drugs to the lungs. Methods： q-he following nanocarriers were studied： micelles, liposomes, mesoporous silica nanoparticles （MSNs）, poly propyleneimine （PPI） dendrimer-siRNA complexes nanoparticles, quantum dots （QDs）, and poly （ethylene glycol） polymers. All particles were characterized using the following methods： dynamic light scattering, zeta potential, atomic force microscopy, in vitro cyto- and genotoxicity. In vivo organ distribution of all nanopartides, retention in the lungs, and anticancer effects of liposomes loaded with doxorubicin were examined in nude mice after the pulmonary or intravenous delivery. Results： Significant differences in lung uptake were found after the inhalation delivery of lipid-based and non-lipid-based nanoparticles. The accumulation ofliposomes and miceUes in lungs remained relatively high even 24 h after inhalation when compared with MSNs, Q Ds, and PPI dendrimers. There were notable differences between nanoparticle accumulation in the lungs and other organs 1 and 3 h after inhalation or intravenous administrations, but 24 h after intravenous injection all nanoparticles were mainly accumulated in the liver, kidneys, and spleen. Inhalation delivery of doxorubicin by liposomes significantly enhanced its anticancer effect and prevented severe adverse side effects of the treatment in mice bearing the orthotopic model of lung cancer. Conclusion： The results of the study demonstrate that lipid-based nanocarriers had considerably higher accumulation and longer retention time in the lungs when compared with non-lipid-based carriers after the inhalation delivery. These particles are most suitable for effective inhalation treatment of lung cancer.     

An analysis of vascularity and neovascularization in surgical pathology materials of breast carcinoma and its clinical significance

<正>Breast cancer is one of the most common malignancies among women and its morbidity has recently increased in many parts of the world[1].Numerous factors have been reported to be associated with development of breast cancer including angiogenesis.Angiogenesis or the formation of new blood vessel networks,not only plays a pivotal role in human normal development,but also in pathophysiological conditions such as inflammatory diseases and neoplasms[2]     

卡培他滨联合三维适形放射治疗食管癌的临床观察

目前欧美等国对于中晚期食管癌多采用同期放化疗,我国还存在一些争议[1]。考虑到食管癌患者年老体质较差,强烈的化疗可能增加其不良反应。卡培他滨因其毒性低,对消化道肿瘤的疗效确切,我们自2007年6月至2009年8月,对50例食管鳞癌患者采用卡培他滨联合三维适形放射治疗与单纯三维适形放射治疗对比,现将结果报道如下。     

Effects of HLEC on the secreted proteins of epithelial ovarian cancer cells prone to metastasize to lymph nodes

Objective： To study explores the effect of HLEC on the secreted proteins of epithelial ovarian cancer （EOC） cells （SKOV3-PM4） with directional highly lymphatic metastasis. Methods： Supernatants of four groups of cultured cells, namely, SKOV3 （A）, SKOV3＋HLEC （B）, SKOV3-PM4 （C）, SKOV3-PM4＋HLEC （D）, were collected, and their proteins were detected by antibody arrays and iTRAOcZD-LC-MALDI- TOF/TOF/MS. Significantly differential proteins were further analyzed via bioinformatics and validated in human serums and cell media via ELISA. Results： Results of antibody arrays and mass spectrometry demonstrated that GRN and VEGFA were upregulated in group C （compared with group A）, whereas IGFBP7 and SPARC were downregulated in group D （compared with group C）. Comprehensive bioinformatics analysis results showed that IGFBP7 and VEGFA were closely linked to each other. Further validation with serums showed statistical significance in VEGFA and IGFBP7 levels among groups of patients with ovarian cancers, benign tumors, and control groups. Two proteins were upegulated in the first group. VEGFA in the control group was downregulated. For IGFBP, upregulation in the control group and down-regulation in the first group were also observed. Conclusion： The HLEC microenvironment is closely associated with directional metastasis to lymph nodes and with differential proteins including cell stromal proteins and adhesion factors. The upregulation of VEGFA and GRN and the downregulation of SPARC and IGFBP7 are closely associated with directional metastasis to lymph nodes in EOC cells.     

氟尿嘧啶衍生物维持治疗对晚期胃癌无进展生存期的影响

胃癌是我国最常见的恶性肿瘤之一,其死亡率仅次于肺癌、肝癌。大量临床实践与实验证明,一线化学药物,如紫杉醇、多西紫杉醇、顺铂、卡铂、奥沙利铂、氟尿嘧啶、依立替康等联合化学治疗可以延长胃癌患者的生存期。目前,对于晚期胃癌姑息化疗常选用氟尿嘧啶类、紫杉类和铂类、蒽环类或依立替     

中晚期贲门癌根治术中联合化疗的疗效观察

贲门癌早期检出率低,大多数患者发现时已属中晚期,尽管近年来手术技巧不断提高,但远期生存时间仍不理想。我们自1999年7月开始在贲门癌根治术中应用联合化疗,效果满意,现报告如下。     

消化道肿瘤患者应用奥沙利铂引起周围神经毒性的护理进展

奥沙利铂(L-HOP、草酸铂、奥铂、艾克博康、艾恒)是第3代铂类广谱化疗药物,其疗效好,胃肠、血液、肾、耳毒性较顺铂低,对消化道肿瘤有显著疗效,已成为消化道辅助化疗的标准方案和复发转移性大肠癌的一线化疗方案[1]。周际昌[2]报告,奥沙利铂神经毒性发生率为82%。周围神经毒性在临床治疗中广泛存在,严重的神经毒性反应可以影响患     

HBV／HCV相关性肝细胞癌抗病毒治疗专家共识

肝炎病毒／乙型;肝炎病毒／丙型;癌／肝细胞;治疗     

紫杉醇联合顺铂对中晚期食管癌新辅助化疗的疗效观察

食管癌是全球性、常见的、难治的恶性肿瘤之一,手术治疗是早中期患者获得根治的有效方法,但局部晚期患者不能完全切除局部病灶,且70％～80％切除标本在区域淋巴结出现转移,通常术后2～5年出现肿瘤复发,所以单纯依靠手术治疗难以达到理想效果。新辅助化疗能够增加患者手术的可能性和彻底性,提高术后生存时间,是近年来新提出来的化疗概念。我们术前应用紫衫醇＋顺铂（TP方案）新辅助化疗食管癌,并与术后辅助化疗进行比较,探讨TP方案新辅助化疗在Ⅲ期食管癌患者的临床应用价值。     

小切口胸段食管癌根治术与标准开胸手术治疗食管癌的临床疗效分析

食管癌是我国常见的恶性肿瘤之一,虽然有学者认为放射治疗与外科手术治疗食管癌效果相当,但目前食管癌仍然以外科手术治疗为主,而且术式逐渐向微创化发展。     

小儿白血病患者骨髓和腰椎穿刺疼痛控制及循证护理干预

小儿白血病的治疗在5年无病生存率和长期存活率方面取得了较大程度的突破,然而由于长期化疗带来的严重不良反应,给患儿及家庭带来沉重的经济与心理压力,从而影响患者的临床治疗效果。同时,本病治疗过程中骨髓穿刺和腰椎穿刺出现的疼痛及带来的不良反应给患儿身心带来较大痛苦,因此,