2005 - 2014年中国老年人肺癌发病的时间趋势分析

目的 分析2005 - 2014年我国老年人肺癌发病的时间趋势，为我国肺癌的防控工作提供依据。方法 根据2008 - 2017年《中国肿瘤登记年报》中肺癌的相关数据，分析2005 - 2014年我国老年人肺癌的发病情况，并通过年度变化百分比（annual percentage change，APC）分析其时间变化趋势。结果 2005 - 2014年我国老年人肺癌的发病率呈上升趋势（APC = 0.71%，P＜0.05），其中农村老年人肺癌的发病率从198.9/105上升至250.7/105，上升趋势更明显（APC = 2.81%，P＜0.05），尤以农村老年女性肺癌发病率的上升趋势最为明显（APC = 5.26%，P＜0.05）。2005 - 2014年中国老年人肺癌的发病在60～64岁和65～69岁组呈上升趋势（APC分别为2.83%和2.04%，均P＜0.05），而在农村地区，老年人所有年龄组的肺癌发病率都呈明显上升趋势（APC分别为3.49%，3.86%，1.66%，2.31%，3.49%及6.37%，均P＜0.05）。结论 2005 - 2014年我国老年人肺癌发病上升趋势明显，以农村老年女性最为突出，国家应针对高危人群及早开展筛查等工作，降低我国老年人肺癌的流行水平。     

Relationship between plasma cell-free DNA (cfDNA) and prognosis of TACE for primary hepatocellular carcinoma

BackgroundOur study aims to investigate changes in cell-free DNA (cfDNA) concentration and integrity in primary hepatocellular carcinoma (PHC) patients before and after transcatheter arterial chemoembolization (TACE) treatment and their influence on the evaluation of prognosis of the disease.MethodsA total of 84 PHC patients admitted to the Affiliated Hospital of Nanjing University of Chinese Medicine from December 2016 to December 2017 were included as the study group, while 55 healthy people served as the control group. Plasma cfDNA concentration and integrity were determined using qRT-PCR. The correlation between cfDNA concentration/integrity and clinical characteristics of PHC patients were analyzed. A ROC curve was used to investigate the sensitivity and specificity of cfDNA as detection indices. Univariate and multivariate analyses were used to analyze factors affecting recurrence in PHC patients and compare recurrence-free survival (RFS) of PHC patients with high cfDNA expression and low cfDNA expression.ResultsPlasma cfDNA concentration and integrity were significantly higher in PHC patients before TACE treatment than in healthy people and significantly lower after treatment than before (P<0.05). The cfDNA concentration was significantly correlated with tumor size, lymph node metastasis, TNM stage, and BCLC stage, while cfDNA integrity was significantly correlated with tumor size, TNM stage, and BCLC stage (P<0.05). ROC results showed that the area under the curve (AUC) value of cfDNA concentration was the largest, with an optimal cut-off of 10.51 ng/mL. Multivariate regression analysis for COX showed that the TNM stage, cfDNA concentration, and AFP were independent risk factors that affected PHC patients’ survival.ConclusionsPlasma cfDNA concentration in PHC patients is more sensitive and specific than any other tumor marker. It is an independent risk factor for PHC patients treated with TACE. Therefore, it is hypothesized cfDNA is a potential biomarker for prognostic evaluation of PHC patients treated with TACE.     

重症肌无力相关抗体的研究进展

作为一种累及神经肌肉接头的自身免疫性疾病,重症肌无力(myasthenia gravis,MG)的发病机制与自身免疫性抗体密切相关。关于MG相关抗体,研究最多且最为明确的是乙酰胆碱受体抗体(acetylcholine receptor antibody,AChR-Ab),由于存在AChR-Ab阴性的MG患者,近年来学者们开始热衷于研究AChR-Ab以外的其他抗体,如肌肉特异性酪氨酸激酶抗体、低密度脂蛋白4抗体等,并进行相应治疗方案的探索。该文对MG相关抗体的研究进展进行综述,为今后治疗该病提供临床依据和参考。