Primary malignant extragonadal germ cell tumors. An analysis of the effect of the effect of radiotherapy

A retrospective analysis was performed on all patients diagnosed with biopsy-proven extragonadal germ cell tumors at the University of Virginia (Charlottesville, VA), The Medical University of South Carolina (Charleston, SC), the Bethesda Naval Hospital (Bethesda, MD), and The Medical College of Virginia (Richmond, VA) for the time period of January 1965 to December 1984. A total of 54 patients were treated with the initial sites of presentation observed: mediastinum, 26; central nervous system, 14; retroperitoneum, eight; and sacrococcygeal region, six. Megavoltage irradiation was used in 44 patients with a dose range of 2400 to 5580 cGy (mean, 4213 cGy). With a minimum follow-up of 4.0 years and a mean follow-up of 10.8 years, the 5-year actuarial survival for the entire population was 57.8%. Local control was achieved in 26 of 44 (59%) of the irradiated population. Factors of prognostic significance included histologic type at presentation, site of presentation, and radiation doses greater than or equal to 4000 cGy. Radiotherapy appears to be an effective modality in patients with extragonadal seminomas; however, the nonseminomatous tumors do not appear to be as radioresponsive.     

Antitumor activity of the pineal gland: effect of unidentified substances versus the effect of melatonin.

There is growing evidence that the pineal gland has antineoplastic properties which, however, can only partially be attributed to its hormone melatonin. While the in vivo tumor-inhibiting activity of melatonin is established, observations on its in vitro effects have been contradictory. The effect of this substance was investigated on six human cancer cell lines and compared to the activity of a partially purified, melatonin-free low molecular weight pineal extract (UMO5R). Melatonin showed hardly any effect but UMO5R was capable of inhibiting the growth of all the six cell lines tested. It is therefore concluded that a direct inhibiting action on tumor cells is not a general physiological role of melatonin as opposed to UMO5R. It will be worthwhile to purify the yet unidentified pineal antitumor activity since it may have a considerable therapeutic potential.     

五行汤对黑色素瘤小鼠抑瘤作用及免疫功能的影响

背景与目的:民间验方"五行汤"由牛蒡、白萝卜、白萝卜叶、胡萝卜和香菇组成,有一定的抗肿瘤效果,值得深入研究.本研究通过动物体内实验观察五行汤对小鼠黑色素瘤的抑瘤作用和免疫功能的影响,同时检测比较单方和复方作用差异.方法:用不同成分汤剂处理小鼠黑色素瘤细胞B16,MTT法检测汤剂对细胞生长的影响;C57/BL6 小鼠接种B16建立小鼠黑色素瘤模型,随机分为阳性组、空白组和各汤剂处理组;接种后第2天给小鼠灌胃,每天1次, 25 d后处死小鼠取瘤称重;MTT法检测小鼠T淋巴细胞转化功能,乳酸脱氢酶(LDH)法检测NK细胞杀伤活性.结果:体外实验显示不同成分汤剂均可抑制B16细胞生长,以复方五行汤抑制作用最强,同时呈浓度依赖性;体内实验显示不同成分汤剂有不同程度的抑瘤作用;不同成分汤剂灌胃后小鼠淋巴细胞转化功能相应增强;同时NK细胞杀伤活性也有不同程度的增加;抑瘤作用和免疫功能的单、复方的比较中都是五行汤的作用最强.结论:五行汤对小鼠黑色素瘤有较明确的抑制作用同时可以增强荷瘤小鼠细胞免疫功能.     

The effect of tamoxifen on the endometrium

Summary Tamoxifen is one of the most important treatments for breast cancer, especially in postmenopausal patients. It acts primarily as an anti-estrogenic agent, due to its cytoplasmic estrogen receptor binding capacity. However, it also exerts a mild estrogenic effect. Since the prolonged use of estrogen has been reported to increase the rate of benign and malignant changes in the endometrium, we evaluated whether there is a correlation between tamoxifen therapy and endometrial benign and malignant conditions. The study group comprised 95 patients with breast cancer who were treated with tamoxifen. No control group was examined. Patients underwent vaginal ultrasonography and endometrial biopsy in order to evaluate any changes in the endometrium occurring during tamoxifen therapy. Pathological changes were observed in 14 patients, 13 of whom were treated with tamoxifen for more than 12 months. Of these women, 3 were diagnosed with endometrial cancer, 3 had mild dysplasia, 3 had endometrial hyperplasia, and 4 had a benign endometrial polyp. Our findings indicate a significant correlation between long-term tamoxifen administration and endometrial proliferation. We therefore recommend that women treated with tamoxifen for more than 12 months have an annual vaginal ultrasonography and endometrial biopsy.     

Bax mediates the apoptosis-sensitizing effect of maspin

Maspin, a serine protease inhibitor (serpin), can suppress tumor growth and metastasis in vivo and tumor cell motility and invasion in vitro. This may occur through maspin-mediated inhibition of pericellular proteolysis. In a recent report, we provided evidence that maspin may also suppress tumor progression by enhancing cellular sensitivity to apoptotic stimuli. To our knowledge, maspin is the only proapoptotic serpin among all of the serpins implicated thus far in apoptosis regulation. The goal of the present study is to identify the specific target molecule(s), the modification of which by maspin renders tumor cells sensitive to chemotherapeutic agents. Our cellular, molecular, and biochemical studies demonstrate an essential role of Bax in the proapoptotic effect of maspin. First, Bax was up-regulated in maspin-transfected prostate and breast tumor cells, whereas the levels of other Bcl-2 family members including Bcl-2, Bcl-xl, and Bak remained unchanged. Second, on apoptosis induction, a greater amount of Bax was translocated from cytosol to mitochondria in maspin-transfected cells. After treatment with a Bax-silencing small interfering RNA, maspin-transfected cells became significantly more resistant to drug-induced apoptosis. Consistently, the release of cytochrome c and Smac/DIABLO from mitochondria was more responsive to apoptosis stimuli in maspin-transfected cells than in the mock-transfected cells. Third, the apoptosis induction of maspin-transfected cells was associated with increased activation of both caspase-8 and caspase-9. However, a caspase-9-specific inhibitor blocked the sensitization effect of maspin in a dose-dependent and time-dependent manner, demonstrating a rate-limiting role for caspase-9. In line with the central role of the Bax-mediated mitochondrial apoptotic pathway, maspin sensitized the apoptotic response of breast and prostate carcinoma cells to various drugs, ranging from death ligands to endoplasmic reticulum stress. The link between maspin and Bax up-regulation explains the loss of maspin-expressing tumor cells in invasive breast and prostate carcinomas. Our data reveal a novel mechanism for tumor suppressive maspin and suggest that maspin may be used as a modifier for apoptosis-based cancer therapy.     

白藜芦醇抗肿瘤作用的研究进展

白藜芦醇(Res)是一种天然的植物补体,近年来,其抗癌作用的研究倍受关注,白藜芦醇可通过抑制肿瘤细胞合成、细胞周期阻滞、诱导肿瘤细胞凋亡、抑制酶类、干扰相关信号传导通路等发挥抑瘤作用,体内研究表明没有明显的毒副作用,作为理想的天然化疗药物,很有希望用于肿瘤的临床治疗.     

改良小切口手术治疗微小甲状腺癌的近期疗效及对生活质量的影响

目的:研究改良小切口手术治疗微小甲状腺癌的近期疗效及对生活质量的影响。方法:研究对象选取我院2014年10月到2016年2月间收治的微小甲状腺癌患者82例，采用随机数字法将其分为对照组和观察组，每组各41例。对照组患者采用传统甲状腺切除术治疗，观察组患者采用改良小切口手术治疗。比较两组患者的治疗疗效、手术时间、术中出血量、住院时间、切口长度、并发症发生率及术后随访12个月，比较两组患者的SF-36生活质量评分。结果:观察组的手术总有效率(92.68%)明显高于对照组(75.61%)(χ2=4.47,P=0.03)，观察组的手术时间、术中出血量、住院时间、切口长度均明显低于对照组(P＜0.01)，观察组的总并发症发生率(14.64%)明显低于对照组(43.92%)(χ2=8.48,P=0.00)；术后12个月，观察组的SF-36评分明显高于对照组(P＞0.05)。结论:改良小切口手术能提高微小甲状腺癌手术效果，减少手术创伤和并发症，加快术后恢复速度，并能改善患者的生活质量，值得在临床推广。