Osteotomy in the vertical ramus outside the mandibular foramen for tumours in the parapharyngeal space

IntroductionAlthough several techniques have been described to access the parapharyngeal space, tumour surgery in this area remains a challenge. This study investigated a simple and safe technique to access parapharyngeal space tumours.Material and methodsEight primary parapharyngeal space tumours were treated with osteotomy of the vertical ramus outside the mandibular foramen. The primary tumours were pleomorphic adenoma, schwannoma, Warthin's tumour, lipoma, chordoma, and adenoid cystic carcinoma. Tumour size ranged from 4 × 4 cm to 6 × 7 cm. Patients with malignant tumours who underwent surgical resection also received adjuvant dose-fractionated stereotactic radiotherapy.ResultsAll tumours were removed completely without rupture. No patient exhibited any permanent postoperative complication, malocclusion, or other dental complications from this surgical approach. One patient had slight transient postoperative facial paresis, which resolved spontaneously within 4 weeks. The patients were followed for 7–26 months, during which no recurrence was encountered.ConclusionsOsteotomy of the vertical ramus outside the mandibular foramen achieved good exposure and satisfactory aesthetic and functional results. This simple and safe technique facilitates the removal of infratemporal fossa tumours while preserving the inferior alveolar nerve.     

Oncological outcome and prognostic factors in malignant parotid tumours

ObjectiveTo evaluate the oncological outcome of malignant parotid tumours and identify the prognostic factors for survival.Study designRetrospective study.MethodsOne hundred and forty-one patients with primary epithelial carcinoma of the parotid gland were examined. The overall survival (OS) and disease specific survival (DSS) rates were calculated. The DSS was evaluated according to different parameters.ResultsThe 5- and 10-year OS rates were 72.3% and 58.4%. The 5- and 10-year DSS rate was 75% and 71%, respectively. The univariate analysis showed that the pathological staging, clinical and pathological tumour and nodal status, surgical procedure and histological subtype significantly influenced the DSS (P ≤ 0.05). The 5- and 10-year loco-regional control rates were 82.1% and 78%. The multivariate analysis showed that the pathological nodal status and the pathological staging influenced the DSS. It further demonstrated that the clinical tumour status and the histological subtype were the most important preoperative prognostic factors.ConclusionThe pathological nodal status, the pathological staging, the clinical tumour status and the histological subtype are the most important factors influencing survival in malignant parotid tumours.     

F-FLT-PET for detection of rectal cancer

Purpose: This pilot study was undertaken to examine the ability of ¹⁸F-3′-fluoro-3′-deoxy-l-thymidine positron emission tomography (¹⁸F-FLT-PET)to detect rectal cancer, to identify pathologic lymph nodes and to determine the accuracy of tumour length estimation in comparison with computer tomography (CT). Methods: Nine patients with biopsy proven rectal cancer underwent CT and ¹⁸F-FLT-PET scanning prior to short-term pre-operative radiotherapy (5 × 5 Gy). Within 10 days after the start of radiotherapy a surgical resection was performed. Tumour lengths and regional lymph node visualisation on both imaging modalities were compared with pathology findings. Results: All tumours were visible on CT. ¹⁸F-FLT-PET visualised 7 out of 9 tumours (78%). The pathology-based tumours lengths correlated better with CT as compared to FLT-PET(r = 0.91, p < 0.01). ¹⁸F-FLT-PET was not able to visualise pathologic lymph nodes. However, CT identified all patients with pathologic lymph nodes. Conclusion: Primary rectal cancer can be visualised by ¹⁸F-FLT-PET in the majority of cases but not in all. However, ¹⁸F-FLT-PET was not able to identify pathologic lymph nodes. Therefore, we conclude that ¹⁸F-FLT-PET has limited value for the detection of pathologic lymph nodes and tumour delineation in rectal cancer.     

What factors determine patients’ preference for tumour necrosis factor inhibitors in ankylosing spondylitis?

Tumour necrosis factor inhibitor (TNFi) therapy, either intravenous (IV) or subcutaneous (SQ), demonstrates similar efficacy in ankylosing spondylitis (AS). The objective of this study was to examine factors influencing patient preference of TNFi. Fifty-nine (79.7%) participants were male with mean age 43.9 years and disease duration of 22.0 years. Fifty-nine patients (79.7%) agreed with the statement ‘My doctor gave me a choice and I made a decision based on my personal preference’. Patients commenced first on IV TNFi most commonly cited reduced frequency of injections (96.6%), administration by a trained professional (89.7%) and use of infusion time for leisure activities (86.2%). Patients commenced on SQ TNFi cited flexibility with timing of treatment (80%), shortened administration time (73.3%) and the convenience of home therapy (73.3%). Shared clinical decision-making between clinicians and patients may be desirable for AS patients commencing TNFi therapy.     

血清肿瘤特异性生长因子（TSGF）检测及其在恶性肿瘤诊断中的应用价值

目的：探讨恶性肿瘤特异生长因子检测在中瘤诊断及疗效观察中的价值。方法：利用化学法，对恶性肿瘤患血清TSGF含量进行测定。结果：恶性肿瘤患血清中TSGF含量明显升高，且治疗后含量和阳性率明显下降，其对恶性肿瘤诊断的敏感性为78.8%。特异性可达96.0%，准确性为83.5%。结论：对恶性肿瘤的筛查诊断、疗效观察、病情监测和预后有极为重要的意义。     

Identification of a subset of breast carcinomas characterized by expression of cytokeratin 15: Relationship between CK15+ progenitor/amplified cells and pre-malignant lesions and invasive disease

Recently, we presented evidence – based on the analysis of benign hyperproliferative lesions of the breast – for the presence of cells that express the stem cell marker cytokeratin (CK) 15 in combination with CK19, a protein widely expressed by mammary epithelial cells. Here we report the finding of a subset of breast carcinomas characterized by expression of CK15. CK15 expressing tumors constituted 5% (6 out of 120; 4 of ductal type and 2 of lobular type) of the high-risk breast carcinomas examined by gel-based proteomics and immunohistochemistry. Five out of the six CK15+ carcinomas were CK15+/CK19−. The remaining tumor was mainly composed of cells expressing both CK15 and CK19 (CK15+/CK19+), but it also contained invasive areas with cells expressing only one of these makers (CK15+/CK19− and CK15−/CK19+ cells). To address the relationship between putative luminal progenitor/amplified CK15+ cells and malignant disease, and to determine whether cells/lesions lose expression of CK15 as a result of tumour initiation and/or progression, we searched among our sample set for carcinomas in which invasive tumor areas co-existed with non-malignant cells and hyperproliferative and known pre-malignant lesions. Only one such tumour was found (T71), a CK15−/CK19+/p53+ carcinoma that contained p53 negative non-malignant epithelial cells exhibiting a variety of, CK15/CK19 cellular phenotypes (CK15+/CK19+; CK15+/CK19−; CK15−/CK19+; CK15−/CK19−), often associated with simple columnar cells. Single layers of epithelial cells exhibiting all four CK15/CK19 phenotypes were observed contiguous to areas of atypical ductal hyperplasia that contained p53 positive cells that lost CK15 expression (CK15−/CK19+) and had a very similar phenotype to those of the neighboring ductal carcinoma in situ (DCIS) and invasive cells. The undifferentiated CK15+/CK19+ cells, which had the phenotype CK15+/CK19+/CK14+/CK8+ and −/ER−/PgR−/AR−/CD44+ (weak)/CK17−/p63−/vimentin+/Ki67−/Bcl-2+ (weak)/GATA-3−/p53−, most likely correspond to lineage-restricted luminal progenitor cells able to generate the other more differentiated CK15/CK19 cellular phenotypes, thus giving rise to the daunting intratumour heterogeneity displayed by carcinoma T71. Cells with a very similar phenotype to the CK15+/CK19+ progenitor cells were observed in a juvenile fibroadenoma as well as in the large collecting ducts of the breast. The latter, however, expressed in addition CK14 and had a phenotype (CK15+/CK19+/CK14+/CK8+ (weak)/ER−/PgR−/AR−/CD44+ (weak)/CK17−/p63−/vimentin−/Ki67−/Bcl-2+/GATA-3−/p53−) that resembled that of the putative normal adult breast stem cells as inferred from published data. Further molecular characterization of these progenitor cells as well as unraveling of the signaling pathways that regulate their growth and differentiation may prove invaluable for developing novel therapeutic strategies that target cancer at an early stage.     

自身抗体与肿瘤

肿瘤患者体内可以检测到针对肿瘤抗原的自身抗体,其产生是多种复杂机制共同作用的结果。其中,肿瘤自身抗原诱导机体产生肿瘤自身抗体是重要机制之一。目前研究发现肿瘤自身抗体与肿瘤的发生发展密切相关。肿瘤自身抗体检测有着重要的临床意义。     

Angiopoietins in malignancy.

BACKGROUND: Tumour growth is dependant upon the development of an adequate blood supply. This, in turn, is thought to depend upon a switch by the tumour, from a dormant to angiogenic state. Recent data suggest that this switch may occur when the balance of pro- and anti-angiogenic agents alters to promote angiogenesis. Angiopoietins may be involved in this balance. METHODS: An electronic literature search was performed with respect to angiopoietins from 1996 to the present. Published data from in-vitro and in-vivo studies were critically analysed. A specific focus was made of studies relating to tumour growth and vasculature. RESULTS: Since angiopoietin-1 was first described in 1996, three more angiopoietins have been described. All family members bind to the Tie-2 receptor. There is now a considerable accumulation of data that suggests they play a pivotal role in the development and stabilisation of tumour vasculature. angiopoietin-2 appears to be pro-angiogenic whilst angiopoietin-1 appears to be a stabilising factor. CONCLUSIONS: Recent trials of anti-angiogenic agents show promise in the treatment of solid human cancers. The angiopoietins are a new family of proteins that appear to be influential in the development of the tumour vasculature. Manipulation of the angiopoietin balance may provide a potential therapeutic target in human cancer.     

莪术醇生物构建自体瘤苗治疗晚期胃癌患者近期疗效研究

目的:探讨自体瘤苗治疗胃腺癌对患者免疫功能的影响及临床效应.方法:9例瘤苗组实体瘤术后患者应用自体瘤苗,并与对照组8例进行比较,对其疗效进行判断评价,检测治疗前后其NKC活性及CD3 、CD4 、CD8 水平.结果:实验组使用自体瘤苗治疗后,其NKC细胞的活性及CD3 、CD4 水平明显高于对照组及自身治疗前,其CD8 阱水平低于其他组;近期随诊其生存质量及疗效也明显优于治疗前及对照组.结论:莪术醇生物构建的自体瘤苗能增强胃癌患者的治疗效果,明显提高自身细胞免疫功能,副反应较小,是一种安全、有效、实用的辅助治疗方法.     

护理干预对肿瘤化疗患者静脉血管的影响

[目的]通过对肿瘤患者的护理干预,病人有较好的血管条件接受化疗,保证了治疗计划的顺利实施。[方法]对60例肿瘤患者采用心理干预、合理选择血管、提高穿刺技术、减轻化疗药物对血管的刺激、恢复血管弹性等措施。[结果]静脉炎的发生率和严重程度明显降低。[结论]护理干预可使肿瘤化疗患者有较好的血管条件。