新辅助化疗后腋窝阳性淋巴结病理完全缓解对乳腺癌预后的影响

目的 比较腋窝淋巴结病理完全缓解(pCR)与腋窝淋巴结癌残留乳腺癌患者的生存差异.方法 回顾性分析376例接受新辅助化疗的腋窝淋巴结阳性乳腺癌患者的临床与病理资料.结果 中位随访时间24个月(5～100个月),腋窝淋巴结pCR率30.9%(116/376).腋窝淋巴结pCR与残留患者的3年无远位转移生存(DDFS)率分别为91.7%与78.8%,生存曲线比较差异有统计学意义(Log-rank检验 P=0.016).多因素分析显示残留患者DDFS风险是pCR患者的2.14倍(P=0.047);两组无病生存(DFS)曲线比较差异无统计学意义(P>0.05).残留组中淋巴结转移数≤3枚与≥4枚患者的DDFS生存曲线比较差异有统计学意义(P=0.001).结论 腋窝淋巴结阳性乳腺癌新辅助化疗后的腋窝淋巴结状态与无远位转移生存相关.

Abstract：

Objective To compare the distant disease-free survival between breast cancer patients with nodal pathological complete response (pCR) and those with nodal residual disease (RD) after neoadjuvant chemotherapy.Methods The clinical and pathological data of 376 needle biopsy proved node positive breast cancer patients undergoing neoadjuvant chemotherapy were retrospectively analyzed. ResultsThe median follow-up time was 24 months(range: 5-100). The pCR rate of axillary lymph node was 30.9%. And the three-year distant disease-free survival (DDFS) rates were 91.7% and 78.8% in the patients with axillary lymph node pCR and RD respectively. According to the Log-rank test, there were significant differences in survival curves (P=0.016). Multivariate analysis showed that the relative risk of DDFS for patients with RD was 2.14 folds of than that of the pCR group (P=0.047). No significant difference existed between the disease-free survival (DFS) curve in two groups. DDFS had significant differences between the patients with the number of lymph node metastasis ≤ 3 and ≥ 4 in the RD group (P=0.001).Conclusion The distant disease-free survival of node positive breast cancer is associated with the status of axillary lymph node after neoadjuvant chemotherapy.     

HIWI expression profile in cancer cells and its prognostic value for colorectal cancer patients

Background: HIWI is a member of PIWI gene family and its expression was found in various tumors, indicating it may play a pivotal role in tumor development. This study was designated to examine HIWI expression profile in several cancer cell lines and its prognostic value for colon cancer patients. Patients and Methods: 270 patients who underwent surgical resection of primary colorectal cancer between January 1999 and December 2002 with a median follow-up time of 33 months were registered in the study. Formalin-fixed and paraffin-embedded specimens from these patients and 236 matched adjacent non-cancerous normal colorectal tissues were collected. Anti-HIWI monoclonal antibodies were generated and used for evaluating HIWI protein expression in tissues and 31 cell lines. χ2 tests were conducted to determine the association between HIWI expression and the other variables. Survival curves were estimated using the Kaplan–Meier method and compared by the log rank test. Multivariate analysis was performed by using the Cox regression model. Results: By generating antibodies specific for HIWI, we examined HIWI protein expression in several cancer cell lines and demonstrated positive expression of HIWI in 69 out of 270 (25.6%) colorectal cancer tissues. 15 of 236 (6.4%) matched adjacent non-cancerous tissues were also positive for HIWI. Patients with positive HIWI expression in adjacent non-cancerous tissue had statistically lower over survival (OS) and disease free survival (DFS) compared with negative patients (OS: 10.4% versus 55.5% P=0.009; DFS: 10.4% versus 55.1% P= 0.015). For early stage group (stage I and II), patients with positive HIWI expression had significantly lower OS and DFS (OS: 57.4% versus 79.5% P=0.014; DFS: 56.7% versus 80.5% P= 0.010). Patients with lymph node metastasis had statistically lower OS and DFS (OS: 53.0% versus 73.5% P=0.037; DFS: 52.2% versus 74.6% P= 0.025). Multivariate analysis revealed that HIWI over-expression was a significant prognostic factor for OS (95%CI：1.132-2.479,P=0.010). Conclusion: HIWI could be a potential biomarker for the prognosis of colorectal cancer patients, especially for those at early stages or without lymph node metastasis.     

HIWI expression profile in cancer cells and its prognostic value for patients with colorectal cancer

Background  HIWI is a member of PIWI gene family and its expression is found in various tumors, indicating that it may play a pivotal role in tumor development. This study was designated to examine HIWI protein expression profile in several cancer cell lines and its prognostic value for patients with colorectal cancer. 

Methods  Totally 270 patients who underwent surgical resection of primary colorectal cancer between January 1999 and December 2002 with a median follow-up time of 33 months were registered in the study. Formalin-fixed and paraffin-embedded specimens from these patients and 236 matched adjacent non-cancerous normal colorectal tissues were collected. Anti-HIWI monoclonal antibodies were generated and used for evaluating HIWI protein expression. χ² tests were conducted to determine the association between HIWI expression and the other variables. Survival curves were estimated using the Kaplan-Meier method and compared by the log-rank test. Multivariate analysis was performed by using the Cox regression model.

Results  By generating antibodies specific for HIWI, we examined HIWI protein expression in several cancer cell lines and demonstrated positive expression of HIWI in 69 out of 270 (25.6%) colorectal cancer tissues; 15 of 236 (6.4%) matched adjacent non-cancerous tissues were also positive for HIWI. Patients with positive HIWI expression in adjacent non-cancerous tissue had statistically lower overall survival (OS) and disease free survival (DFS) compared with negative patients (OS: 10.4% vs. 55.5%, P=0.009; DFS: 10.4% vs. 55.1%, P=0.015). For early stage group (stages I and II), patients with positive HIWI expression had significantly lower OS and DFS (OS: 57.4% vs. 79.5%, P=0.014; DFS: 56.7% vs. 80.5%, P=0.010). In lymph node negative group, patients with positive HIWI expression had statistically lower OS and DFS (OS: 53.0% vs. 73.5%, P=0.037; DFS: 52.2% vs. 74.6%, P=0.025). Multivariate analysis revealed that HIWI over-expression was a significant prognostic factor for OS (95% CI: 1.132–2.479, P=0.010).

Conclusion  HIWI could be a potential prognostic biomarker for the patients with colorectal cancer, especially for those at early stages or without lymph node metastasis. 

     

中国年轻乳腺癌的临床病理特征及预后分析

目的 分析中国年轻乳腺癌的临床病理特征,并探讨年轻乳腺癌患者的预后.方法 回顾分析北京肿瘤医院乳腺中心1994年12月至2003年12月收治的1538例Ⅰ～Ⅲ期可手术原发性乳腺癌患者的临床资料,其中年龄≤60岁且有完整随访资料者1075例.按年龄将1075例患者分为年轻组(≤40岁,208例)和对照组(41～60岁,867例),分析两组患者的预后及临床病理特征之间的差异.结果 与对照组相比,年轻组更倾向于淋巴结转移(P=0.016)、雌激素受体表达阴性(P=0.016)以及人表皮生长因子受体2表达阳性(P=0.001).年轻组和对照组5年无病生存率(DFS)分别为73.3%和84.1%(P<0.001),5年总生存率(OS)分别为83.5%和89.1%(P=0.004).进一步分层分析显示,在Ⅰ～Ⅱ期患者中年轻组预后不良,而在Ⅲ期患者中年轻组预后与对照组差异无统计学意义.在Ⅰ～Ⅱ期患者中,年龄≤40岁是影响DFS(HR=1.78,95%CI:1.19～2.66;P=0.005)和OS(HR=1.71,95%CI:1.01～2.90;P=0.046)的独立不良预后因素.结论 中国年轻乳腺癌患者预后不良,这种不良预后在临床Ⅰ～Ⅱ期乳腺癌患者中更为明显.

Abstract：

Objective To analyze the clinicopathologic characteristics and evaluate the prognosis in young Chinese women with breast cancer. Methods A total of 1538 female patients with operable primary breast cancer (stage Ⅰ - Ⅲ) treated at our hospital from December 1994 to December 2003 were analyzed retrospectively. Among them, 1075 patients (≤60 yrs) with the complete follow-up data were divided into two groups according to age: young breast cancer group ( ≤40 yrs, n = 208) and control group (41-60 yrs, n = 867) to analyze the differences in their clinicopathologic characteristics and evaluate the prognosis of both groups. Results The patients with young breast cancer were more likely to have positive lymph nodes (P=0.016) , a negative expression of ER (estrogen receptor) (P = 0.016) and a positive expression of HER2 (P = 0. 001). The 5-year disease-free survival (DFS) rates of young breast cancer group and control group were 73. 3% and 84. 1% (P <0. 001) and the 5-year overall survival (OS) rates 83. 5% and 89. 1% (P = 0.004) respectively. Moreover, the patients with young breast cancer had a worse DFS than control group in patients with stage Ⅰ - Ⅱ disease but not in those with stage Ⅲ disease. And ≤40 years was an independent unfavorable prognostic factor of DFS (HR = 1. 78, 95% CI: 1. 19 - 2. 66, P = 0. 005) and OS (HR = 1. 71, 95%CI: 1.01 -2.90, P = 0.046) in the patients with stage Ⅰ - Ⅱ disease. Conclusion Chinese women with young breast cancer have a worse prognosis, particularly in those with stage Ⅰ - Ⅱ disease.     

Association between Chinese Medicine Therapy and Survival Outcomes in Postoperative Patients with NSCLC: A Multicenter, Prospective, Cohort Study

Objective: To evaluate the association between Chinese medicine(CM) therapy and disease-free survival(DFS) outcomes in postoperative patients with non-small cell lung cancer(NSCLC). Methods: This multiple-center prospective cohort study was conducted in 13 medical centers in China. Patients with stage Ⅰ,Ⅱ, or ⅢA NSCLC who had undergone radical resection and received conventional postoperative treatment according to the National Comprehensive Cancer Network(NCCN) guidelines were recruited. The recruited patients were divided into a CM treatment group and a control group according to their wishes. Patients in the CM treatment group received continuous CM therapy for more than 6 months or until disease progression. Patients in the control group received CM therapy for less than 1 month. Fol ow-up was conducted over 3 years. The primary outcome was DFS, with recurrence/metastasis rates as a secondary outcome. Results: Between May 2013 and August 2016, 503 patients were enrol ed into the cohort; 266 were classified in the CM treatment group and 237 in the control group. Adjusting for covariates, high exposure to CM was associated with better DFS [hazard ratio(HR) = 0.417, 95% confidential interval(CI): 0.307–0.567)]. A longer duration of CM therapy(6–12 months, 12–18 months, 24 months) was associated with lower recurrence and metastasis rates(HR = 0.225, 0.119 and 0.083, respectively). In a subgroup exploratory analysis, CM therapy was also a protective factor of cancer recurrence and metastasis in both stage Ⅱ–ⅢA(HR=0.50, 95% CI: 0.37–0.67) and stage ⅢA NSCLC postoperative patients(HR = 0.48, 95% CI: 0.33–0.71), DFS was even longer among CM treatment group patients.Conclusions: Longer duration of CM therapy could be considered a protective factor of cancer recurrence and metastasis. CM treatment is associated with improving survival outcomes of postoperative NSCLC patients in China.(Registration No. ChiC TR-OOC-14005398)     

Chemotherapy with or without gefitinib in patients with advanced non-small-cell lung cancer: a meta-analysis of 6844 patients

Background Gefitinib is widely used in patients with advanced non-small-cell lung cancer （NSCLC）, in whom chemotherapy had failed. Previous trials reported inconsistent findings regarding the efficacy of gefitinib on overall survival （OS） and progression free survival （PFS）. This study was to evaluate the effects of chemotherapy plus gefitinib versus chemotherapy alone on survival of patients with NSCLC. Methods We systematically searched Medline, EmBase, the Cochrane Central Register of Controlled Trials, reference lists of articles, and proceedings of major meetings for relevant literature. Randomized controlled trials （RCTs） comparing chemotherapy with and without gefitinib in the treatment of patients with advanced NSCLC were included in our analysis. The primary endpoints were OS and PFS. Results Of 182 relevant studies, 12 were included in the final analysis, which consisted of 6844 patients with NSCLC. Overall, we noted that gefitinib therapy had an 8% improvement in the OS as compared to the gefitinib-free therapy, but this difference was not statistically significant （HR, 0.92; 95% CI： 0.85-1.00; P=0.051）. Furthermore, gefitinib therapy had significantly longer PFS compared to gefitinib-free therapy （HR, 0.72; 95% CI 0.60-0.87, P=0.001）. Patients receiving gefitinib therapy also had a more frequent objective response rate （ORR） than the control arm （OR, 2.51; 95% CI, 1.67- 3.78, P 〈0.001）. Rashes, diarrhea, dry skin, pruritus, paronychia, and abnormal hepatic function were more frequent in the gefitinib therapy group. Conclusions Treatment with gefitinib had a clear effect on PFS and ORR, and it might contribute considerably to the OS. Furthermore, there was some evidence of benefit for gefitinib therapy among patients with adenocarcinoma.     

中性粒细胞明胶酶相关蛋白及基质金属蛋白酶10在非小细胞肺癌中的表达及临床意义

目的 观察中性粒细胞明胶酶相关蛋白(NGAL)和基质金属蛋白酶10(MMP-10)在非小细胞肺癌(NSCLC)中的表达,探讨其与NSCLC浸润、转移的关系.方法 采用免疫组织化学SP法检测70例非小细胞肺癌组织及30例癌旁肺组织标本中NGAL和MMP-10的表达,并分析它们的表达与相关临床参数的关系.结果 NSCLC组织中NGAL和MMP-10的表达分别为67.1%、70.0%,并与肿瘤直径、TNM分期、淋巴结转移明显相关(P<0.05),而与患者性别、年龄无关.NGAL和MMP-10的表达呈正相关(r=0.376,P=0.001).结论 NSCLC组织中NGAL和MMP-10表达明显增加.NGAL和MMP-10可能在NSCLC的发生、发展中起一定作用. Abstract： Objective To observe the expression of neutrophil gelatinase associated lipocalin (NGAL) and matrix metalloproteinase 10(MMP10) in human non-small cell lung cancer(NSCLC) and to investigate their correlations with the infiltration and metastasis of NSCLC.Methods Immunohistochemistry method was applied to investigate the expression of NGAL and MMP-10 in specimens of 70 NSCLC tissues and 30 paracancerous tissues.The relationship between the expression of NGAL and MMP-10 in the NSCLC tissue and related clinical parameters were analyzed. Results The positive expression rates of NGAL and MMP-10 in NSCLC tissues were 67.1% and 70.0%,respectively. The expression of NGAL and MMP-10 in NSCLC tissues was correlated with the diameter of the mass, the pathological grading, the lymph node metastasis, but not correlated with sex, age and smoking. There was a positive correlation between NGAL and MMP-10 expression in lung squamous cell cancer tissues (r=0.376, P=0.001).Conclusions Higher expression of NGAL and MMP-10 may play an important role in carcinogenesis and development of NSCLC.     

Effect of radiotherpy techniques (IMRT versus 3D-CRT) on clinical outcomes in patients with glioblastoma multiforme

Objective This study aimed to determine whether intensity-modulated radiotherapy (IMRT) improves clinical outcomes compared with three-dimensional conformal radiotherapy (3D-CRT) for patients with glioblastoma multiforme (GBM). Methods and Materials The records of 54 patients with newly-diagnosed GBM from July 2009 to December 2010 were reviewed. The patients underwent postoperative IMRT or 3D-CRT with concurrent and adjuvant temozolomide. Kaplan-Meier method and log rank test were used to estimate differences of patients’ survival. Results The median follow-up was 13 months. Of the 54 patients, fifty (92.6%) completed the combined modality treatment. The 1-year overall survival rate (OS) was 79.6%. The pattern of failure was predominantly local. A comparative analysis revealed that no statistical difference was observed between the IMRT group (n=21) and the 3D-CRT group (n=33) for 1-year OS (89.6% vs. 75.8%, P=0.795), or 1-year progression-free survival (PFS) (61.0% vs. 45.5%, P=0.867). In dosimetric comparison, IMRT seemed to allow better sparing of organs at risk than 3D-CRT did (P=0.05, P=0.055). However, there was no significant difference for toxicities of irradiation between the IMRT group and the 3D-CRT group. Conclusions Our preliminary results demonstrated that delivering standard radiation doses by IMRT is unlikely to improve local control or overall survival for GBM compared with 3D-CRT. Given this lack of survival benefit and increased costs of IMRT, the utilization of IMRT treatment for GBM needs to be carefully rationalized. Future prospective randomized trials are warrant to validate our results.     

Clinical Significance of VEGF-C and VEGFR-3 Expression in Non-small Cell Lung Cancer

The relationship between vascular endothelial growth factor-C (VEGF-C)/vascular en-dothelial growth factor receptor 3 (VEGFR-3) expression and clinicopathologic features of the patients with non-small cell lung cancer (NSCLC) was investigated. The expression of VEGF-C and VEGFR-3 was assessed in 65 patients with NSCLC by immunohistochemistry. The significance of VEGF-C and VEGFR-3 expression was analyzed statistically. The results showed that VEGF-C and VEGFR-3 were highly expressed in cytoplasm and membrane in lung cancer tissues with the positive rate being 55.4 % and 52.3 % respectively, while there was no expression in the normal lung tissues. The expression of VEGF-C was significantly increased in adenocacinoma as compared to other types of NSCLC (P<0.05). The VEGFR-3 expression was closely related with lymph node metastasis (P<0.01) and TNM stage (P<0.05). There was a positive correlation between the VEGF-C and VEGFR-3 expression in NSCLC patients (r=0.658, P<0.01). It is suggested that VEGFR-3 plays an important role in the lymphatic metastasis of NSCLC. The interaction between VEGF-C and VEGFR-3 may be deeply involved in the mechanism of lung cancer metastasis.     

Ⅲa(N_2)期非小细胞肺癌术后放疗疗效分析

目的:回顾性分析Ⅲa(N_2)期非细胞肺癌术后放疗的治疗结果,同时探讨其治疗策略.方法:1987～2004年本院收治的Ⅲa(N_2)期非小细胞肺癌92例,所有病人都接受根治性手术,术后放疗46例(S+R组),单纯手术46例(S组),39例接受化疗;放疗中位剂量56Gy(40～64Gy).用Kaplan-Meier及Log-rank法计算和比较两组病人的生存率.结果:(1)全组病人5年及10年总生存率(Overall survival,OS)分别为44.5%和30.4%.(2)术后放疗组与单纯手术组相比,5年及10年总生存率分别为49.1%、36.5%,36.3%、25.4%;两组间差异无统计学意义(χ~2=0.83,P=0.65).(3)纵隔单站转移N2病人,术后放疗组有提高无病生存率(Diseaes-free survival,DFS)的趋势;而多站转移N2病人,术后放疗组与单纯手术组相比,5年及10年无病生存率明显提高,分别为:40.6%、4.5%,21.2%、4.1%,差异有显著性(χ~2=4.35,P=0.03),且有提高总生存率的趋势.(4)1996～2004年术后放疗病人的生存率优于1987～1995年.(χ~2=4.28,P=0.04).(5)治疗失败率63.0%,术后放疗组总复发率及局部区域复发率低于单纯手术组,差异具显著性,分别为50.0%、76.1%,(χ~2=6.72,P=0.001);及8.7%、32.6%,(χ~2=8.03.P=0.001).两组失败的首位原因均为远处转移.(6)多变量分析结果显示,年龄和纵隔淋巴结受累的站数影响Ⅲa(N_2)期非小细胞肺癌的生存.结论:(1)Ⅲa(N_2)期非小细胞肺癌术后放疗有延长生存期的趋势.纵隔多站转移N2病人术后放疗可提高无病生存期.纵隔单站转移N2病人术后放疗价值不确切,有待于进一步的随机临床研究加以证实.(2)年龄和纵隔淋巴结受累的站数影响病人的生存期.(3)治疗设备和治疗技术可以影响术后放疗的价值.(4)无论是否放疗,失败的首位原因均为远处转移,提示这类病人可能从化疗获益,建议Ⅲa(N_2)期非小细胞肺癌术后常规辅以化疗.     

淋巴结比例对有腋窝淋巴结转移的三阴性乳腺癌患者预后的价值

目的评价三阴性乳腺癌改良根治术后腋窝淋巴结阳性个数与切除淋巴结总数比例（LNR）对患者的预后价值。方法纳入三阴性乳腺癌改良根治术后患者75例,应用Kaplan—Meier生存曲线分析患者总生存（OS）和无病生存（DFS）,并应用Log—rank检验LNR对患者预后的价值。结果本组病例LNR平均值为0．31＋0．18。LNR和淋巴结阳性总数呈正相关。LNR低分组中位OS和中位DFS均比LNR高分组长,差异有统计学意义。结论LNR是影响有腋窝淋巴结转移的三阴性乳腺癌的预后因素。     

脏层胸膜浸润对术后早期非小细胞肺癌患者预后的影响

目的：研究术后早期非小细胞肺癌（NSCLC）患者的脏层胸膜浸润（VPI）情况,阐明VPI对NSCLC患者预后的影响。方法：门诊随访2007-2011年本院经外科根治性术后病理分期为Ⅰ～Ⅱ期NSCLC患者261例,中位随访时间36个月,将患者分为VPI组(130例)和无VPI组(131例),采用χ2检验或Fisher精确概率法进行分类变量分析;Kaplan-Meier法估算患者无疾病生存率和总生存率,采用COX比例风险模型分析患者临床特征与预后的关系。结果：VPI组患者1年总生存率为90.77%,无VPI组患者1年总生存率为93.13%,组间比较差异无统计学意义（P>0.05）。VPI组患者3和5年总生存率（69.23%和63.85%）低于无VPI组（80.15%和74.05%）（P<0.05）。COX单因素及多因素分析,年龄、肿瘤大小和VPI是影响NSCLC患者无疾病生存期(DFS)和总生存期(OS)的独立预后因素（P<0.05）。 结论：VPI是术后早期NSCLC患者不良预后因素之一,对肿瘤临床病理分期标准有影响。     

乳腺癌临床病理特征对预后判断的价值

目的:分析乳腺癌患者术后临床病理学特征、治疗以及预后,探讨其预后的影响因素。方法:收集338例可手术的经病理证实的乳腺癌患者的临床及病理学资料,回顾性分析其临床及病理学特征、复发转移及生存情况,通过生存分析研究预后相关因素。结果:患者的随访时间为4～115个月,中位随访时间42个月,患者术后5年无病生存（DFS）率为77.46%,5年总生存（OS）率为81.69%。单因素分析结果显示,影响患者DFS及OS的因素包括:肿瘤大小、淋巴结转移数目以及放疗（P<0.01）,多因素分析结果显示肿瘤大小以及淋巴结转移数目是乳腺癌患DFS和OS的独立影响因素（P<0.01）。结论:肿瘤大小和淋巴结转移数目是影响乳腺癌患者预后的独立危险因素。     

肝豆状核变性蛋白在乳腺癌组织中的表达及其与预后的关系

目的研究肝豆状核变性蛋白(W ilson d isease prote in),也称P型铜转运ATP酶(Copper-trans-porting P-type adenosine triphosphatese,ATP7B),在乳腺癌组织中的表达,评估其对预测乳腺癌预后的意义。方法采用免疫组织化学方法(immunoh istochem istry,IHC)检测60例乳腺癌患者手术切除的乳腺癌组织中ATP7B的表达,并分析其与临床、病理特征的关系及对预后的影响。结果(1)ATP7B在乳腺癌组织中的阳性表达率为36.7%(22/60);(2)组织学低分化者ATP7B表达水平明显高于中高分化患者(P<0.01),ATP7B表达与月经状况、肿瘤大小、腋淋巴结转移和激素受体状况均无关(P>0.05);(3)Kap lan-M e ier生存分析结果表明ATP7B和无病生存期和总生存期均密切相关(P<0.05);(4)在COX多因素分析中ATP7B表达、肿瘤大小、腋淋巴结转移、组织学分级和雌激素受体状况与无病生存期和总生存期均明显相关(P<0.01)。结论ATP7B在乳腺癌组织中具有一定的表达水平,可能是预测乳腺癌患者预后的独立因素。     

真核生物胞质伴侣素6A在非小细胞肺癌中的异常表达及临床意义

目的：本研究旨在评估真核生物胞质伴侣素6A(chaperonin containing TCP1 subunit 6A,CCT6A)在非小细胞肺癌(non-small cell lung cancer,NSCLC)癌组织中的异常表达,以及其与NSCLC患者临床病理特征和预后的关联。方法：本研究回顾性纳入160例经手术切除的NSCLC患者,采用免疫组化(immunohistochemistry,IHC)检测癌组织和癌旁组织CCT6A表达水平。 结果：CCT6A主要表达在细胞质和细胞膜上,其表达水平在癌组织中显著高于癌旁组织(P<0.001)。癌组织CCT6A表达水平与高的东部肿瘤协作组体力状态(Eastern Cooperative Oncology Group Performance Status,ECOG PS)评分(P=0.038)、差的肿瘤分化(P=0.014)、以及淋巴结转移相关(P=0.018),而与患者其他临床病理特征不相关,例如：年龄、性别、吸烟、饮酒、慢性合并症、肿瘤细分类型、肿瘤大小等(均P>0.050)。此外,无病生存期(disease-free survival,DFS)(P<0.001)和总体生存期(overall survival,OS)(P=0.036)在癌组织CCT6A高表达患者中均显著短于癌组织CCT6A低表达患者。进一步采用多因素Cox回归分析患者的独立预后因素,发现癌组织CCT6A高表达可以独立预测患者差的DFS(P=0.001),然而不可以独立预测患者OS。结论：CCT6A在NSCLC组织中高表达,其高表达与NSCLC患者差肿瘤分化、淋巴结转移、ECOG PS评分及不良预后相关,表明CCT6A有作为NSCLC标记物的潜能。     

术后妊娠对年轻乳腺癌患者预后的影响

目的 评估术后妊娠对中国年轻女性乳腺癌患者预后的影响.方法 对1989年3月至2007年7月于我院治疗的432例年轻(≤35岁)单侧乳腺癌患者进行回顾性研究,分析术后妊娠对预后的影响,用Kaplan-Meier法进行生存分析,Log Rank法比较不同患者的生存差异,用Cox回归分析对患者进行多因素回归分析.结果 432例年轻乳腺癌患者中共有18例术后妊娠,其中5例足月产,13例流产,最早妊娠的时间为术后17个月.中位随访62个月(6～237个月),432例患者的无病生存率(DFS)为72.5%(313/432),总体生存率(OS)为88.7%(383/432).Cox回归多因素分析发现术后妊娠、临床分期及病理腋窝淋巴结转移数对患者的DFS有显著影响,只有淋巴结转移数对患者的OS有显著影响.由于术后妊娠的患者中并未出现死亡,Cox回归分析中术后妊娠对预后并无显著影响.结论 年轻乳腺癌患者手术后妊娠对预后无不良影响.     

髓样分化因子88及Toll样受体4对新疆地区乳腺癌预后的影响

目的 目前乳腺癌仍然是全球女性死亡的主要原因之一,肿瘤的远处转移是乳腺癌患者规范化治疗后的首要致死原因。本研究通过分析乳腺癌患者的预后与固有免疫应答物髓样分化因子88(myeloid differentiation primary response 88,MyD88)和Toll样受体4(toll-like receptor 4,TLR4)的关系以确定对乳腺癌预后的影响。 方法 本研究分析了2005—2007年新疆医科大学第一附属医院乳腺外科200例乳腺浸润性导管癌患者的临床、病理资料,并且对总生存期(overall survival,OS)以及无病生存期(disease free survival,DFS)进行了分析。 结果 153名(76.50%)患者是无复发转移的,47名(23.50%)为复发或者转移的患者。MyD88和TLR4之间是有着显著的相关性(P<0.001)。高表达MyD88和TLR4的患者更容易发生死亡及复发/转移事件(P<0.05)。低表达MyD88及TLR4较二者均高表达的患者表现出更长时间的DFS及OS (log-rank test,P<0.05)。低表达MyD88及TLR4的较二者任一高表达的患者表现出更长时间的DFS及OS (log-rank test,P<0.001)。在多因素分析中,MyD88的高表达是DFS的独立不良预后因素(adjusted HR为3.322;95%CI:1.663～6.631;P=0.001),同样预示着较低的OS (adjusted HR为4.500;95%CI:1.544～13.098;P=0.005)。 结论 TLR4-MyD88信号通路的活化或者MyD88的活化将会预示着乳腺癌患者不良的预后,二者将会成为乳腺癌新的生物调节治疗的新靶点。      

超声造影定量灌注参数对子宫内膜癌的预后价值

目的 子宫内膜癌的发展和侵袭性与肿瘤血液灌注显著相关,本研究旨在评估子宫内膜癌术前超声造影（CEUS）定量灌注参数的预后价值。 方法 本研究纳入2016年1月至2021年1月期间112名术前行超声造影的子宫内膜癌患者。根据CEUS的时间-强度曲线（TIC）计算平均增强率ER（增强强度EI/上升时间RT）。平均随访34.6±9.7个月后,采用单因素和多因素COX回归分析ER值与术后总生存率（OS）和无病生存率（DFS）的相关性。结果 根据ROC曲线预测生存率的ER值最佳截断点值为1.8 dB/s。Kaplan-Meier生存曲线表明,ER值水平高的患者的DFS和OS比ER值水平低的患者更差（DFS：P<0.001;OS：P<0.05）。在多因素分析中,ER值被认为是子宫内膜癌患者复发（HR：1.68）和OS（HR：1.98）的独立预测因子（均P<0.05）。 结论 CEUS测量的定量灌注参数是子宫内膜癌术后生存率的重要预测因素。