TACE 术前天冬氨酸氨基转移酶与淋巴细胞比值对原发性肝癌并门脉癌栓患者预后预测的价值

目的 探讨肝动脉化疗栓塞（transcatheter arterial chemoembolization，TACE）术前天冬氨酸氨基转移酶与淋巴细胞比值（aspartate aminotransferase to lymphocyte ratio index，ALRI）在原发性肝癌并门脉癌栓（primary liver cancer-portal vein tumor thrombosis，PLC-PVTT）患者预后预测中的价值。方法 选取2013年11月21日至2018年8月22日于广西医科大学附属肿瘤医院接受TACE治疗的175例PLC-PVTT患者为研究对象。采用时间依赖性ROC曲线确定ALRI的最佳临界值。采用Cox 回归模型分析总生存期（overall survival，OS）的独立预测因素，Kaplan-Meier法计算生存率。结果 ROC曲线显示，ALRI的最佳临界值为49.37，对应曲线下面积为0.71。Kaplan-Meier分析显示，ALRI>49.37的患者OS较ALRI≤49.37的患者短（P=0.003）。Cox 回归分析结果显示，ALRI>49.37、行1次以上TACE治疗、Child-Pugh分级B级、凝血酶原时间≥13 s是患者TACE术后OS的独立危险因素（均P＜0.05）。结论 TACE术前ALRI>49.37是PLC-PVTT患者OS的独立危险因素。     

Systemic treatment of patients with gastrointestinal stromal tumor: Current status and future opportunities

Imatinib mesylate is considered the standard first-line systemic treatment for patients with advanced gastrointestinal stromal tumor (GIST). Results from recent research have expanded the knowledge of tyrosine kinase inhibitors in management of GIST. In the setting of unresectable and metastatic GIST, long-term follow-up of the B2222 study showed that imatinib 400 and 600 mg/d produced objective responses in 68% of patients and clinical benefit in 84%; it also extended median survival from 19 months in historical controls to 57 months. The MetaGIST analysis in two large phase 3 trials consisting of more than 1600 patients with metastatic and/or unresectable GIST showed that imatinib 800 mg/d compared with the standard 400-mg/d dose conferred a progression-free survival advantage in patients with KIT exon 9 mutations but not in other subpopulations. The higher starting dose does not significantly improve overall survival. The BFR14 trial demonstrated that interrupting imatinib is associated with a high risk of rapid disease progression. For patients with imatinib-intolerant or imatinib-resistant GIST, sunitinib or a variety of investigational agents, including the next-generation kinase inhibitor nilotinib, may be viable options for achieving disease control. In the setting of primary localized GIST, function- sparing surgical resection is the standard treatment approach, but some patients may be at substantial risk of disease recurrence and metastasis depending on tumor size, mitotic count, and possibly other factors. Initial results from ACOSOG Z9001 indicate that adjuvant imatinib for 1 year prolongs recurrence-free survival following surgical resection of larger (at least 3 cm) KIT-expressing GIST. Other ongoing studies are further exploring the role of imatinib in both adjuvant and neoadjuvant therapy. Recent updates to clinical practice guidelines and recommendations now incorporate some of these new findings.     

中药神龙口服液配合放射治疗鼻咽癌的临床观察

目的：观察中药神龙口服液配合放射治疗鼻咽癌的效果。方法：应用中药制剂神龙口服液配合放射治疗鼻咽癌６０例（综合组），并与单纯放射治疗的６０例（单放组）进行急性毒副反应、细胞免疫细胞及临床疗效对比观察。结果：⑴综合组急性毒副反应明显轻于单放组（Ｐ〈０．０５）；⑵两组鼻咽部及颈部肿瘤消退率差异无显著性（Ｐ〉０．０５）；⑶综合组鼻咽癌及颈部肿瘤消退时的放射治疗剂量（简称肿瘤消退剂量明显低于单放组（Ｐ〈０．     

浆液性卵巢癌治疗后远期生存列线图预测模型的构建和验证

目的:构建并验证浆液性卵巢癌远期生存概率的列线图,为卵巢癌患者提供个性化的治疗建议和随访策略.方法:共有6957例来自SEER数据库的患者被纳入训练组;外部验证组数据来自于1244例患者的临床资料.基于Cox回归模型构建列线图,使用一致性指数、受试者操作特征曲线、校准图进行验证.绘制Kaplan-Meier曲线比较不同...     

脑胶质瘤术后常规放疗和三维适形放疗的同期对照研究

  目的   对比分析脑胶质瘤术后常规放疗和三维适形放疗的远期疗效, 以探索更好的术后放疗方法。   方法  对2001年1月至2010年12月在本院接受放疗的83例脑胶质瘤患者进行回顾性分析。采用Kaplan-Meier法计算无进展生存率和总生存率, 并应用Log-rank检验进行比较; 应用卡方检验比较两组的一般情况、不良反应发生情况等指标差异。   结果  所有83例患者3年总生存率和无进展生存率分别为76.3%和72.2%, 术后三维适形放射治疗组及常规放射治疗组3年总生存率、无进展生存率分别为82.5%、78.2%和66.9%、64.1% (P=0.015、0.018)。分层分析显示三维适形放射治疗主要提高了手术未完全切除肿瘤患者以及病理分级为Ⅲ~Ⅳ级患者的无进展生存率和总生存率。   结论  与术后常规放疗相比, 术后三维适形放疗提高了脑胶质瘤的无进展生存率和总生存率, 并可以减少放射性不良反应的发生。      

p15、bcl-2及PCNA在不同放射敏感性的鼻咽癌组织中的表达及其相关性研究

 目的　探讨p15、bcl 2及PCNA的表达与鼻咽癌放射敏感性的关系及它们之间的相关性。方法根据放疗结束时肿瘤消退与否将 5 6例鼻咽癌病人分为肿瘤消退组 (2 9例 )及肿瘤残存组 (2 7例 ) ,采用免疫组织化学S P法测定癌组织中p15、bcl 2及PCNA的表达。结果　p15、bcl 2及PCNA蛋白阳性表达率在肿瘤残存组、消退组中差别无显著性意义 (P >0 .0 5 )。肿瘤残存组中各指标间存在显著相关性(P <0 .0 1) ,而肿瘤消退组中除bcl 2与PCNA蛋白表达显著相关 (P <0 .0 1)外 ,其余指标间无明显的相关性 (P >0 .0 5 )。结论　鼻咽癌组织中p15、bcl 2及PCNA的表达水平不能作为判断鼻咽癌放射敏感性的指标 ,但通过检测 p15与bcl 2、PCNA的相关性可能是预测鼻咽癌放射敏感性的重要手段。     

鼻咽癌不同设野或不同分割放疗方式放射反应比较

 目的　比较不同照射野或不同剂量分割放疗鼻咽癌的急性放射反应及后遗症。方法　耳前野不同分割方法两组各 30例 ,面颈联合野不同分割方法两组各 5 0例进行比较。结果　 (1)面颈联合野照射者消化道及咽粘膜反应均重于耳前野者 (P <0 .0 5或 0 .0 1) ,后遗症无显著性差别 (P >0 .0 5 ) ;(2 )后程加速超分割与常规分割放疗的急性放射反应及后遗症无显著性差异 (P >0 .0 5 )。结论　后程加速超分割放疗不明显增加急性放射反应及后遗症 ,面颈联合野急性放射反应加重。     

鼻咽癌常规分割与后程加速超分割放疗远期结果分析

目的 对比分析常规分割（CF）与后程加速超分割（LCAHF）放疗鼻咽癌的远期疗效，以探索更好的鼻咽癌放疗方案。方法 回顾性分析符合人组条件的鼻咽癌患者496例，其中cF组269例，LCAHF组227例。两组均采用双侧面颈联合野对穿照射，200cGy／次，5次／周，鼻咽部剂量达36～40Gy后改为双侧耳前野或小面颈野对穿避开脊髓继续照射；CF组继续用原分割方案照射至鼻咽部总剂量68—76Gy，LCAHF组改用150cGy／次，2次／d，两次间隔至少6h，总剂量达69～72Gv。采用Kaplan-Meier法进行生存分析。结果 LCAHF组及cF组5年鼻咽原发灶控制率、无瘤生存率、总生存率分别为65．4％、61．5％、68．1％和52．8％、49．4％、57．5％（P=0．006、0．006、0．031），而鼻咽部复发率明显低于cF组（P〈0．05）。进一步按T分期进行分析显示LCAHF主要提高了1、2、13期患者5年鼻咽原发灶控制率、无瘤生存率及总生存率（P〈0．05）。两组急性毒副反应及放射后遗症相似（P〉0．05）。颈部淋巴结复发率及远处转移率两组相似（P〉0．05）结论 与常规分割放疗相比，后程加速超分割放疗提高了鼻咽癌局部控制率、无瘤生存率及总生存率，降低了鼻咽部复发率，并能被鼻咽癌患者耐受，但未减少颈部淋巴结复发率及远处转移率。     

Analysis of serum proteome profiles in nasopharyngeal carcinoma with different radiosensitivity

Purpose

The research is endeavored to establish a serum protein fingerprint model for predicting radiosensitivity of nasopharyngeal carcinoma through the analysis of the serum expressed proteins of the pre- and post-treatment nasopharyngeal carcinoma patients treated with radiotherapy.

Methods

Surface-enhanced laser desorption ionization-time of flight-mass spectrometry and CM-10 protein chip were used to detect the serum proteomic patterns of 50 nasopharyngeal carcinoma patients with different radiosensitivity. Thirty-eight of the 50 patients after the treatment were also studied. Biomarker Wizard 3.01 and Biomarker Pattern 5.01 were used in combination to analyze the data and to develop predicting models.

Results

At the molecular weight range of 2,000–20,000, the software identified an average of 83 mass peaks between radiation sensitive group and radiation resistant group. 11 protein peaks were significantly different. Of the 83 mass peaks, 4 mass peaks (mass/charge ratio [m/z] 2,575, 3,942, 6,117 and 6,778) were chosen automatically to construct a classification tree. The diagnostic accuracy was 78.0 %. M/z 6,117 and 6,778 of the radiation sensitive group after the treatment trended to those of the radiation resistant group.

Conclusions

The technology of surface-enhanced laser desorption ionization-time of flight-mass spectrometry can be used to screen and identify differentially expressed proteins associated with different radiosensitivity in nasopharyngeal cancer. It should be a very useful tool for predicting radiosensitivity of nasopharyngeal carcinoma.