肝癌组织LncRNA TINCR表达水平对术后长期生存的影响

目的 探讨肝癌组织中LncRNA TINCR 表达水平对术后长期生存的影响。方法 回顾性分析2013 年4 月～2016 年2 月间在本院接受手术治疗的157 例肝细胞肝癌患者的临床资料。RT-PCR 法检测肝癌标本内LncRNA TINCR 表达水平，采用ROC 曲线和Kaplan-Meier 法分析LncRNA TINCR 表达水平对肝癌术后长期生存的影响。结果 肝癌组织LncRNA TINCR 表达水平对术后长期生存预测的曲线下面积（AUC）为0.812，特异度为73.77%，灵敏度为79.17%，最佳判读值为1.89（P＜0.0001）。根据ROC 曲线分析结果，将肝癌组织LncRNA TINCR 相对表达水平大于1.89 的93 例（59.24%）患者纳入高表达组，而肝癌组织LncRNA TINCR 相对表达水平小于或等于1.89的64 例（40.76%）患者纳入低表达组。Kaplan－Meier 法生存分析发现高表达组术后3 年内有76 例患者死亡，3 年总生存率为18.28%（17/93）；低表达组术后3 年内有20 例患者死亡，3 年总生存率为68.75%（44/64），低表达组3 年总生存率明显优于高表达组（P＜0.0001，两组间死亡风险比为3.7534，95%可信区间为2.5158～5.6000）。结论 肝癌组织LncRNA TINCR 表达水平与肝癌术后长期生存显著相关，LncRNA TINCR 表达水平升高则预示着预后不佳。     

Comparison of microtransplantation,chemotherapy and allogeneic transplantation in post-remission therapy for Philadelphia chromosome-positive acute lymphoblastic leukemia

Patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph⁺ ALL) have poor prognosis, and the efficacy of chemotherapy plus tyrosine kinase inhibitors (TKIs) followed by mismatched donor stem cell infusion (microtransplantation, MST) has not been determined. We retrospectively summarized 45 patients including 11 undergoing MST with TKIs, 17 receiving allogeneic transplant and 17 undergoing chemotherapy with TKIs. Improved 4-year overall survival rate was observed in the MST group (91%) compared with either transplant group (31%, P = .005) or chemotherapy group (36%, P = .013). The MST group also had higher 2-year and 4-year leukemia-free survival rates (91% and 72%, respectively) compared with either transplant group (33%, P = .005 and 33%, P = .021, respectively) or chemotherapy group (41%, P = .017 and 31%, P = .023, respectively). 2-year and 4-year cumulative incidences of hematologic relapse were lower in the MST group (9% and 28%, respectively) compared with those in the chemotherapy group (56%, P = .025 and 67%, P = .034, respectively). In patients undergoing MST, donor microchimerism was detected (1.07 × 10^-5 to 6.6 × 10^-4 copies from 9 to 1499 days) in 7 patients, and donor/patient-derived HLA*0201/2402⁺WT1⁺CD8⁺ T cells were found from 0.05% to 0.67% in 6 patients. MST may provide a favorable treatment for patients with Ph⁺ ALL.     

Papillary thyroid carcinoma with a high tumor mutation burden has a poor prognosis

BackgroundTumor mutation burden (TMB) as a prognostic marker for immunotherapy has shown prognostic value in many cancers. However, there is no systematic investigation on TMB in papillary thyroid carcinoma (PTC).MethodsBased on the somatic mutation data of 487 PTC patients from The Cancer Genome Atlas (TCGA), TMB was calculated, and we classified the samples into high-TMB (H-TMB) and low-TMB (L-TMB) groups. Bioinformatics methods were used to explore the characteristics and potential mechanism of TMB in PTC.ResultsHigh TMB predicts shorter progression-free survival (PFS) (P < 0.001). TMB was positively correlated with age, stage, tumor size, metastasis, the male sex and tall cell PTC. Compared to the L-TMB group, the H-TMB group presented with lower immune cell infiltration, a higher proportion of tumor-promoting immune cells (M0 macrophages, activated dendritic cells and monocytes) and a lower proportion of antitumor immune cells (M1 macrophages, CD8⁺ T cells and B cells). Additionally, the characteristics displayed by different TMB groups were not driven by critical driver mutations such as BRAF and RAS.ConclusionsPTC patients with high TMB have a worse prognosis. By stratifying PTC patients according to their TMB, advanced PTC patients who are candidates for immunotherapy could be selected.     

VATS解剖性肺段切除术与肺叶切除术治疗Ⅰa期NSCLC患者的手术情 况及对肺功能影响的比较

目的:探讨电视胸腔镜（VATS）解剖性肺段切除术与肺叶切除术治疗Ia 期非小细胞肺癌（NSCLC）患者的手术情况及对患者肺功能的影响。方法:选取我院手术治疗的Ⅰa期NSCLC患者，收集时间2014年1月至2016年12月，根据术式不同分为两组，均采用VATS手术治疗，A组（54例）患者采用解剖性肺段切除术、B组（60例）采用肺叶切除术治疗，对比两组患者的手术效果及术后肺功能变化。结果:A组患者的手术时间、清扫淋巴结数目与B组比较差异无统计学意义（P>0.05）；A组患者的手术出血量、术后胸腔引流量、术后拔管时间、术后住院时间均显著的低于B组患者（P<0.05）；术前，A组和B组患者的FEV1%、FVC%、MVV%测定值差异无统计学意义（P>0.05），术后3个月复查，A组患者的FEV1%、FVC%、MVV%测定值均显著高于B组患者（P<0.05）；手术后，A组患者的并发症发生率（7.41%）低于B组患者（13.33%），但是差异无统计学意义（P>0.05）。结论:VATS解剖性肺段切除术治疗Ⅰa期NSCLC患者具有手术创伤小、术后恢复快、对患者肺功能影响更小的优势。     

干扰素在恶性淋巴瘤自体移植后早期干预的应用

目的:观察非霍奇金淋巴瘤（non-Hodgkin's lymphoma，NHL）患者自体造血干细胞移植（autologous hematopoietic stem cell transplantation，ASCT）术后应用重组人α-2b干扰素（α-2b IFN）进行早期干预治疗的临床疗效。方法:选取18例行ASCT的NHL患者为研究对象，移植前疾病评估均未达到完全缓解（complete remission，CR），试验组血象恢复后给予IFN 3 000 000 U次/隔日干预治疗，3个月后停用；对照组未行干扰素干预治疗，分析总体疗效及两组对比的生存情况。结果:随访中位时间为34（10~50）个月，患者中位生存时间为37（31~45）个月，3年总体无进展生存（progressive free survival，PFS）、总生存（overall survivial，OS）分别为54.7%、66.8%。ASCT后试验组1年内无疾病复发，2年内复发率为12.5%；对照组1年内复发率为20%，2年内复发率为30%。结论:NHL患者在ASCT后给予重组人α-2b IFN早期干预治疗，患者耐受性好，可能降低移植后早期复发率。     

接受选择性淋巴结照射的食管鳞癌患者预后和失败模式的分析

目的探讨接受选择性淋巴结照射(ENI)的食管鳞癌患者预后和失败模式。方法回顾性分析2005年1月至2012年12月河北医科大学第四医院收治的179例符合入组条件的食管鳞癌患者,分析肿瘤局部相关因素预测患者预后的价值,分析影响患者近期疗效、预后的影响因素,并对影响患者总生存率(OS)、无进展生存率(PFS)和复发的指标分别进行单因素和多因素分析。结果全组患者1、3、5年OS和PFS分别为77.1%、40.1%、26.0%和62.6%、30.6%、20.3%。多因素分析结果显示声音嘶哑、cN分期、cTNM分期、GTV-横径(GTV-D)和GTV-体积/长度(GTV-V/L)为影响患者OS的独立性影响因素(P<0.05);声音嘶哑、cTNM分期和近期疗效为影响患者PFS的独立性影响因素(P<0.05)。全组有75例(41.9%)患者出现复发,61例(34.1%)远处转移,其中19例(10.6%)为合并复发和远处转移。75例复发患者中64例(85.3%)患者为单纯食管复发,4例(5.3%)为单纯淋巴结复发,另7例(9.3%)患者为食管合并淋巴结复发。治疗后达完全缓解(CR)的63例患者中有18例患者出现复发,其中仅有2例患者出现淋巴结复发;logistic多因素分析结果显示患者周边组织/器官受侵、GTV-D和近期疗效为影响患者复发的独立性影响因素(P<0.05)。结论食管鳞癌患者接受ENI确实可行,其失败主要模式仍为食管复发;治疗前声音嘶哑、GTV-D和GTV-V/L较大、临床分期较晚和近期疗效不佳为患者预后较差的指标;肿瘤周边组织受侵、GTV-D和近期疗效是影响患者失败的独立性因素。     

Outcomes after neoadjuvant or adjuvant chemotherapy for cT2-4N0-1 non–small cell lung cancer: A propensity-matched analysis

Objective

Comparative survival between neoadjuvant chemotherapy and adjuvant chemotherapy for patients with cT2-4N0-1M0 non–small cell lung cancer has not been extensively studied.

Study of skin neoplasms in a university hospital: integration of anatomopathological records and its interface with the literature

BackgroundSkin cancer is a highly prevalent condition with a multifactorial etiology resulting from genetic alterations, environmental and lifestyle factors. In Brazil, among all malignant tumors, skin cancers have the highest incidences.ObjectiveTo retrospectively evaluate the incidence, prevalence and profile of basal cell carcinoma, squamous cell carcinoma and cutaneous melanoma in Campos dos Goytacazes and region.Methods:In total, 2,207 histopathological reports of a local reference hospital were analyzed between January 2013 and December 2015, of which 306 corresponded to the neoplasms studied.Results:Of the 306 reports evaluated, 232 basal cell carcinomas (75.9%), 55 squamous cell carcinomas (18%) and 19 cutaneous melanomas (6.5%) were identified. The face was the most involved anatomical site (58.8%) and women (51%) were the most affected gender. The temporal analysis revealed a decrease in the overall incidence of 3.4% from 2013 to 2014 and 5.4% from 2014 to 2015. There was a 10.1% increase in basal cell carcinomas and 38% in melanomas in this period; however, there was a decrease in the number of squamous cell carcinomas of 14.8% during the studied years.Study limitations:Some samples of cutaneous fragments had no identification of the anatomical site of origin.Conclusion:Research that generates statistical data on cutaneous tumors produces epidemiological tools useful in the identification of risk groups and allows the adoption of more targeted and efficient future prevention measures.