Expression of HIF-1α in breast cancer and precancerous lesions and the relationship to clinicopathological features简

Objective： The aim of this study was to observe the expressions and clinical significance of HIF-1a in breast cancer and precancerous lesions, and analyze the relationship between the expressions and clinicopathological features in breast cancer. Methods： We analyzed the HIF-1a expression in 128 cases of invasive ductal carcinomas, 146 precancerous lesions patients including 89 cases of ductal carcinoma in situ and 57 cases of atypical ductal hyperplasia. 53 cases of usual ductal hyperplasia breast tissues were selected as a control group. The specimens were evaluated for HIF-1a, estrogen receptor （ER） ＆ progesterone receptor （PR）, epidermal growth factor receptor type 2 （HER2/neu） and Ki-67. Immunoreactivity was semi-quantitatively evaluated in at least 1000 cells examined under the microscope at 40 x magnification and recorded as the percentage of positive tumor cells over the total number of cells examined in the same area. The percentage scores were subsequently categorized. The express of HIF-1a and their relationship with multiple biological parameters including ER ＆ PR, HER2/neu and Ki-67, the biomarkers levels of CA153, CA125 TSGF, and CEA in blood serum and nipple discharge, histological grade, region lymph node metastasis, distant metastasis and recurrence on files were also assessed. Results： Compared with usual ductal hyperplasia, the positive expression rate of HIF-1a in atypical ductal hyperplasia, ductal carcinoma in situ and invasive ductal carcinomas group was significantly increased （P 〈 0.01）. The positive rates of HIF-1a in invasive ductal carcinomas were 68.75%, which were significantly higher than that in ductal carcinoma in situ （43.8%）, atypical ductal hyperplasia （31.6%）, usual ductal hyperplasia （9.4%; X2 = 13.44, 22.27, 52.79, respectively, P 〈 0.01）. Statistical analysis showed that difference of abnormal expression rate of HIF-1a between ductal carcinoma in situ and usual ductal hyperplasia （X2 = 18.37, P = 0.00）, atypical ductal hyperplasia and usual ductal hyperplasia （x2 = 8.14, P = 0.00） was significant （P = 0.00）. However, no significant difference in the positive expression rate of HIF-1a was found between atypical ductal hyperplasia and ductal carcinoma in situ tissue （X2 = 2.19, P = 0.14）. There was a significantly difference in the mean HIF-1a frequency between ER ＆ PR positive invasive ductal carcinomas group and negative group, epidermal growth factor receptor type 2 （HER2/neu） positive and negative groups, Ki-67 proliferation index 〈 14% and 〉 14% groups, histological grade （I ＋ II） and grade III invasive ductal carcinomas groups, with lymph node metastasis, distant metastasis and recurrence groups （P 〈 0.05） and without groups （P 〈 0.05）. However, there was not difference in the mean HIF-1a between age （〈 50 years vs 〉 50 years）, tumor diameter （〈 2 cm vs 〉 2 cm; P 〉 0.05）. The nipple discharge and serum levels of CA153, TSGF, CA125 and CEA in invasive ductal carcinomas HIF-1a positive patients were significantly higher than those in the negative patients （P 〈 0.05）. Conclusion： In breast cancer, HIF-1a expressibn was abnormally increased. The aberration of HIF-1a may play a key role during oncogenesis （atypical ductal hyperplasia or ductal carcinoma in situ） and promote breast cellular transformation into malignancy, a finding useful for further understanding of tumorigenesis. The abnormal expression of HIF-1a may be as an early event in the development of breast tumor. The over-expression of HIF-1a might be important biological markers for invasion, metastasis and recurrence of breast cancer.     

Level of circulating PD-L1 expression in patients with advanced gastric cancer and its clinical implications简

Objective：The programmed cell death-1 receptor/programmed cell death-1 ligand （PD-1/PD-L1） pathway plays a crucial role in tumor evasion from host immunity.This study was designed to evaluate the association between circulating PD-L1 expression and prognosis in patients with advanced gastric cancer.Methods：Totally 80 advanced gastric cancer patients and 40 health controls from Beijing Cancer Hospital were enrolled in the present study.Circulating PD-L1 expression was tested by enzymelinked immunosorbent assay （ELISA）.The associations between the expression level of PD-L1 and clinicopathological features and prognosis were analyzed statistically.Results：Expression of PD-L1 in advanced gastric cancer patients was significandy up-regulated compared with health people （P=0.006）.The expression of PD-L1 was significantly correlated with differentiation and lymph node metastasis （P=0.026 and P=0.041,respectively）.Although we didn＇t find significant difference in all advanced gastric cancer patients with different PD-L1 expression,the adenocarcinoma patients with higher up-regulated PD-L1 expression had much better prognosis than low expression patients （65.6％ vs.44.7％,P=0.028）.Conclusions：PD-L1 was elevated in advance gastric cancer patients and may play an important role in tumor immune evasion and patients prognosis.     

Long-term fatigue state in postoperative patients with breast cancer简

Objective：To investigate the prevalence of long-term fatigue,anxiety,depression and social support,and the relationships among these symptoms in postoperative patients with breast cancer.Methods：A total of 180 postoperative patients with breast cancer meeting criterion were recruited in this cross-sectional study.The Brief Fatigue Inventory （BFI）,Hospital Anxiety and Depression Scale （HADS） and The Social Support Survey-Chinese version were used to assessing the fatigue,anxiety and depression,Social support of participants.The magnitude of the relationship among the symptoms of fatigue and other variables was measured by Spearman Rho correlation.Results：The prevalence of long-term fatigue was 52.7％,and 18.3％ occurred moderate/severe fatigue.Two-thirds of patients had a basal social support,only 12.8％ of patients had better-perceived social support.Results of HADS showed that 16.7％ and 21.1 ％ of the participants have anxiety or depression disorder.Moderate/severe fatigue was negatively correlated with social support （r=-0.158,P=0.038） and positively correlated with age （r=0.132,P=0.042）,chemotherapy （r=0.297,P=0.027）,anxiety （r=0.324,P=0.018） and depression （r=0.211,P=0.034）.Conclusions：Long-term fatigue was highly prevalent among over half of postoperative patients with breast cancer,and moderate/severe fatigue was associated with social and psychological factors such as social support,anxiety and depression.Our results suggest that overall nursing care may be a more effective manner in improving fatigue and quality of life.     

Annual report on status of cancer in China,2010简

Objective：Population-based cancer registration data in 2010 were collected,evaluated and analyzed by the National Central Cancer Registry （NCCR） of China.Cancer incident new cases and cancer deaths were estimated.Methods：There wvere 219 cancer registries submitted cancer incidence and death data in 2010.All data were checked and evaluated on basis of the criteria of data quality from NCCR.Total 145 registries＇ data were qualified and accepted for cancer statistics in 2010.Pooled data were stratified by urban/rural,area,sex,age group and cancer site.Cancer incident cases and deaths were estimated using age-specific rates and national population.The top ten common cancers in different groups,proportion and cumulative rate were also calculated.Chinese census in 2000 and Segi＇s population were used for age-standardized incidence/ mortality rates.Results：All 145 cancer registries （63 in urban and 82 in rural） covered a total of 158,403,248 population （92,433,739 in urban and 65,969,509 in rural areas）.The estimates of new cancer incident cases and cancer deaths were 3,093,039 and 1,956,622 in 2010,respectively.The morphology verified cases （MV％） accounted for 67.11％ and 2.99％ of incident cases were identified through death certifications only （DCO％） with mortality to incidence ratio （M/I） of 0.61.The crude incidence rate was 235.23/100,000 （268.65/100,000 in males,200.21/100,000 in females）,age-standardized incidence rates by Chinese standard population （ASIRC,2000） and by world standard population （ASIRW） were 184.58/100,000 and 181.49/100,000 with the cumulative incidence rate （0-74 years old） of 21.l 1％.The cancer incidence and ASIRC were 256.41/100,000 and 187.53/100,000 in urban areas whereas in rural areas,they were 213.71/100,000 and 181.10/100,000,respectively.The crude cancer mortality in China was 148.81/100,000 （186.37/100,000 in males and 109.42/100,000 in females）,age-standardized incidence rates by Chinese standard population （ASMRC,2000） and by world standard population （ASMRW） were 113.92/100,000 and 112.86/100,000,and the cumulative incidence rate （0-74 years old） was 12.78％.The cancer mortality and ASMRC were 156.14/100,000 and 109.21/100,000 in urban areas,whereas in rural areas,they were 141.35/100,000 and 119.00/100,000 respectively.Lung cancer,gastric cancer,colorectal cancer,liver cancer,esophageal cancer,pancreas cancer,encephaloma,lymphoma,female breast cancer and cervical cancer,were the most common cancers,accounting for 75％ of all cancer cases in urban and rural areas.Lung cancer,gastric cancer,liver cancer,esophageal cancer,colorectal cancer,pancreatic cancer,breast cancer,encephaloma,leukemia and lymphoma accounted for 80％ of all cancer deaths.Conclusions：The coverage of cancer registration population had a rapid increase and could reflect cancer burden in each area and population.As the basis of cancer control program,cancer registry plays an irreplaceable role in cancer epidemic surveillance,evaluation of cancer control programs and making anticancer strategy.China is facing serious cancer burden and prevention and control should be enhanced.     

三阴性乳腺癌治疗进展简

三阴性乳腺癌（TNBC）是ER、PR、HER2受体均阴性的乳腺癌,是具有独特的生物学及临床特征的乳腺癌亚型,与基底细胞样乳腺癌有较高的一致性。众所周知ER、PR、HER2的表达是目前临床乳腺癌治疗的靶点,但TNBC患者因为缺少这些靶点,不能从内分泌治疗及靶向治疗中获益,导致了其预后差、复发转移率高、死亡率高,也因此成为近几年乳腺癌研究和关注的焦点。本文旨在对TNBC治疗相关的国内外研究现状做一综述。     

Long non-coding RNAs in cancer简

Long non-coding RNAs （IncRNAs）, gradually being paid attention to, have been found playing a critical role in regulation of cellular processes such as cell growth and apoptosis, what is more, accumulating evidence indicates that IncRNAs also play a critical role in regulation of carcinogenesis and cancer progression. Here, we will summarize the recent researches about some IncRNAs in the development of cancers, hoping to give a new view about the study in the mechanisms involved in carcinogenesis and tumor progression.     

Image-guided radiation therapy: basic concepts and clinical potentials简

The adaptation and integration of imaging into the process of cancer detection, diagnosis, and intervention is an area of medicine that is undergoing extremely rapid development. Radiation therapy is a prime example of this change. While the objectives of these developments are clear, they raise numerous issues regarding the skil s and resources that assure these technologies are appropriately integrated and applied. We wil explore the basic concepts related to image guidance in various radiotherapy-related procedures with special emphasis on the clinical potentials of this impressive technology.     

Intraperitoneal chemotherapy and its evolving role in management of gastric cancer with peritoneal metastases简

Advanced gastric cancer （GC） has been recognized as lethal disease when peritoneal metastases （PM） occurred.There is no standard treatment for advanced GC with PM.Until 1980s,the therapeutic arena for these patients had remained stagnant,with no therapeutic approach having shown a survival gain in GC with PM.However,cytoreductive surgery （CRS） with peritonectomy procedures and intraperitoneal chemotherapy （IPC） promising new combined therapeutic approach to achieve disease control for GC with PM.The recent publications changed the GC with PM treatment landscape by providing an evidence that CRS and IPC led to prolongation in overall survival （OS）.This review will provide an overview of the evolving role of CRS and IPC in the management of advanced GC with PM in the current era.     

Neoadjuvant chemotherapy for triple-negative breast cancer: a meta-analysis with 7168 cases简

Objective:The pathological complete response (pCR) rates of neoadjuvant chemotherapy (NAC) in triple-nega-tive breast cancer (TNBC) was reported higher than that in non-TNBC but ranged from 12%to 48%. pCR was reported to be a predictor of long overal survival and exact pCR rate of NAC in TNBC would give us some hints on how to improve outcomes of TNBC patients. The meta-analysis was conducted to estimate the pCR rate of NAC for TNBC through contrasting the pCR rates of TNBC and non-TNBC tumors in NAC. Methods:Studies were selected from the PubMed database and Cochrane Col aboration Library. pCR rates were col ected in groups of TNBC and non-TNBC tumors. Review Manager 4.2 was used to perform forest plots and funnel plots. Results:The analysis included 22 studies with 7168 patients, the aggregate pCR rate was 29.5%in TNBC group, which was 17.7%higher than non-TNBC. The summary relative risk (RR) for pCR rate of TNBC group with that of non-TNBC group was 2.55. No obvious statistical heterogeneity and publication bias was detected. Conclu-sion:This meta-analysis demonstrated that NAC showed a higher pCR rate in TNBC than non-TNBC.     

眼睑 Merkel 细胞癌临床病理分析简

目的：探讨眼睑Merkel细胞癌（Merkel cell carcinoma,MCC）的临床病理特征、诊断与鉴别诊断。方法：观察1例眼睑MCC的组织病理特点和免疫组化染色结果,并复习相关文献。结果：患者男性,78岁。以“发现右眼下睑无痛性结节样包块6月增大1月”入院。基于冷冻切片（Mohs显微外科）评估安全切缘的肿瘤扩大切除术被实施。巨检肿瘤切面呈灰白色,边界清楚。镜下病变主要位于眼睑真皮层,无表皮浸润。肿瘤呈弥漫片层状或巢索状排列,主要由小圆细胞构成,形态单调一致,胞质较少,嗜酸性,核大,圆形或卵圆形,轮廓清晰,细胞呈裸核状,染色质呈空泡状或细颗粒状,核分裂明显。免疫组化显示除了经典神经内分泌抗体如Syn、CgA外,肿瘤细胞还表达CK及CK20（一种关键的MCC诊断标记物）,而HMB45、LCA和TTF-1等阴性。结论：Merkel细胞癌是一种罕见的伴有神经内分泌分化的致死性皮肤恶性肿瘤,预后差。需与“小圆蓝细胞肿瘤”成员如恶性淋巴瘤、小细胞无色素性黑色素瘤和转移性肺小细胞癌等鉴别。     

Retrospective analysis of clinical characteristics and prognostic factors for pathologic fracture in 44 patients with extremity osteosarcoma简

Objective： The aim of this study was to identify the clinical features and prognostic factors associated with ex- tremity osteosarcoma with pathologic fracture. Methods： The clinical records of 271 patients with extremity osteosarcomas were retrospectively reviewed. The data obtained covered the period from October 2003 to May 2012, and included sex, age, tumor site etc. The mean follow-up time was 25.2 months （ranged from 1 to 117）. Chi-square method and Kaplan-Meier method were used to compare clinical differences and overall survival between patients with or without pathologic fracture, respectively. The univariate analysis was used to determine the prognostic factors related with survival rate by log-rank test. The multivariate analysis of prognosis was performed by COX proportional hazards regression model. Results： The proportions of patients having a tumor＇s diameter of 10 cm or more （P = 0.038）, locating upper limbs （P = 0.004） and receiving amputation surgery （P = 0.02） were significantly higher with pathological fracture group than without pathological fracture group. The local recurrence rate （P = 0.000） was also significantly higher in the pathological fracture group. The median survival time of patients with or without pathological fracture was 16 （95% confidence interval： 14.6-17.4） months and 22 （95% confidence interval： 19.8-24.1） months （P = 0.002）. The Log-rank univariate analysis indicated that the tumor size, Enneking＇s surgical staging, Karnofsky performance status （KPS） score, cycles of adjuvant chemotherapy, local recurrence and metastasis were significantly related to overall survival. Multivariate Cox regression analysis revealed KPS score, cycles of adjuvant chemotherapy and metastasis were independent prognostic factors （P 〈 0.05）. Conclusion： Compared with the patients without pathological fracture, a higher proportion of patients receiving amputation surgery or having larger tumor size, humeral osteosarcoma or local recurrence was observed in patients with pathological fracture, and the prognosis of these patients was poor. The independent prognostic factors of extremity osteosarcoma with pathologic fracture were the KPS score, cycles of adjuvant chemotherapy and metastasis.     

Caveolin - 1 在消化系统肿瘤中的研究进展简

细胞窖蛋白-1（Caveolin—1）为分子量21—24kD的膜蛋白,是Caveolae的主要结构成分,参与胆固醇运输、囊泡转运,细胞信号转导等过程,同时与肿瘤的发生、发展和转移密切相关。本文介绍Caveolin-1的结构和功能以及在肿瘤中的作用,重点综述Caveolin-1在消化系统肿瘤的表达及其临床意义,并展望Caveolin-1在消化系统肿瘤中的应用前景。     

Dosimetric evaluation of a beam matching procedure简

Objective:The dosimetric characteristics for linear accelerators with the same model, and nominal energy are known to be very similar, as long as the machines are unaltered from the manufacturer’s original specifications. In this pre-liminary study, a quantitative investigation of the similarity in the basic photon and electron dosimetry data from the Siemens Oncor linear accelerators at our hospital (Children’s Cancer Hospital, Cairo, Egypt) was reported. Methods:The output factor (OF), wedge factors (WF), percentage depth dose (PDD), and beam profile for the 6 and 10 MV photon beams were measured. Results:The measured output factors varied by less than about 1%for each field size. The dif erence between the maximum and minimum PDD values at each depth was less than about 1%. The dif erence between the beam flattnes and symetry was no more than 1%at al of-axis distances. For electron the results showed that the PDD, OF, and the beam profiles were matched within 1%dif erences. Conclusion:These results strongly suggest that it is feasible to establish one reference photon and electron dosimetry data set for the two machines and nominal energies.     

Significance of combined detection of LunX mRNA and tumor markers in diagnosis of lung carcinoma简

Objective：To evaluate the significance of combined detection of LunX mRNA,carcinoembryonic antigen （CEA）,neuron-specific enolase （NSE）,and cytokeratin 21-1 fragment （CYFRA21-1） in clinical diagnosis of lung carcinoma.Methods：Based on the quantitative RT-PCR and chemiluminescence immunoassay,the expression levels of LunX mRNA,CEA,NSE,and CYFRA21-1 in 113 patients with lung carcinoma （case group） and 30 healthy participants （control group） were detected.Meantime,the sensitivity,specificity,and accuracy of the combination detection were also explored.Results：The positive rates of LunX mRNA in peripheral blood and CEA,NSE,and CYFRA21-1 in serum were significandy higher in case group than those in control group （x2=17.295,16.825,19.148,and 17.450; P＜0.05）.There was no statistical significance when positive rate of LunX mRNA was evaluated among different pathological types （x2=0.047,P＞0.05）.The positive rate of LunX mRNA in stage Ⅰ ＋ Ⅱ,Ⅲ,and Ⅳ had a significandy increasing tendency （x2=10.565,32.462,P＜0.05）.The positive rate of CYFRA21-1 was highest in squamous carcinoma （78.5％）,the positive rate of NSE was highest in small cell carcinoma （86.7％）,and the positive rate of CEA wag highest in lung adenocarcinoma （80.4％）.The sensitivity and accuracy of the combination detection were 91.1％ and 88.1％,respectively.Conclusions：The combined detection of LunX mRNA and tumor markers （TMs） including CEA,NSE,and CYFRA21-1 in peripheral blood is helpful to increase the diagnostic accuracy of lmg cancer.Also,it can inform the pathological typing of lung carcinoma.     

Overexpression of HOXB9 promotes metastasis and indicates poor prognosis in colon cancer简

Objective：Homeobox B9 （HOXB9） is proposed to be involved in tumor angiogenesis and metastasis.We investigated the role of HOXB9 in the progression of colon cancer.Methods：HOXB9 expression was investigated by immunohistochemically and Western blotting in 128 colon cancer patients and the results were analyzed statistically associated with clinicopathological data and survival of the patients.The effect of HOXB9 on cell invasion and metastases abilities were analyzed in vitro and in vivo.Results：HOXB9 is overexpressed in colon cancer tissues and significandy correlated with metastasis and poor survival of patients （P＜0.05,respectively）.Additionally,high levels of expression of HOXB9 were observed in metastatic lymph nodes.The down-regulation of HOXB9 expression can inhibit the migration and invasive ability of colon cancer cells,while exogenous expression of HOXB9 in colon cancer cells enhanced cell migration and invasiveness.Moreover,stable knockdown of HOXB9 reduced the liver and lung metastasis of colon cancer in vivo.Conclusions：HOXB9 may play an important role in the invasion and metastasis of colon cancer cells and may be a useful biomarker for metastasis and prognostic of colon cancer.     

热休克蛋白27与恶性肿瘤的研究进展简

热休克蛋白是细胞在受到刺激时产生的一类特殊蛋白质,热休克蛋白27（heat shock protein 27,HSP27）是该家族中的重要成员之一,现已证实HSP27在多种肿瘤细胞中异常高表达,HSP27在肿瘤的发生、发展中的作用及其机制是近年来研究的热点,本文就HSP27与肿瘤的研究进展作一综述.     

BCNU/PLGA microspheres:a promising strategy for the treatment of gliomas in mice简

Objective：To investigate the effects of BCNU/PLGA microspheres on tumor growth,apoptosis and chemotherapy resistance in a C57BL/6 mice orthotopic brain glioma model using GL261 cell line.Methods：BCNU/PLGA sustained-release microspheres were prepared by the water-in-oil-in-water emulsion technique.GL261 cells were intracranially injected into C57BL/6 mouse by using the stereotactic technology.A total of 60 tumor-bearing mice were randomly and equally divided into three groups：untreated control,PLGA treated,BCNU/PLGA treated.Magnetic resonance imaging （MRI） was taken to evaluate tumor volume.BCNU/PLGA sustained-release wafers were implanted in the treatment group two weeks after inoculation.Survival time and quality were observed.Specimens were harvested,and immunohistochemical staining was used to check the expression of Bax,Bcl-2,and O6-methylguanine-DNA methyltransferase （MGMT）.Statistical methods was used for analysis of relevant data.Results：BCNU/PLGA sustained-release wafers were fabricated and implanted successfully.There is statistical difference of survival time between the BCNU/PLGA treated group and control groups （P＜0.05）.MRIscan showed inhibitory effect of BCNU/PLGA on tumor growth.Compared to the group A and B,BCNU/PLGA decreased the expression of apoptosis related gene Bcl-2 （P＜0.05）,but did not elevate the expression level of Bax （P＞0.05）,with the ratio of Bax/Bcl-2 increased.For MGMT protein expression,no statistically significant change was found in treated group （P＞0.05）.Conclusions：Local implantation of BCNU/PLGA microspheres improved the survival quality and time of GL261 glioma-bearing mice significandy,inhibited the tumor proliferation,induced more cell apoptosis,and did not increase the chemotherapy resistance.     

Antidepressant fluoxetine and its potential against colon tumors简

Colon cancer is one of the most common tumors worldwide, with increasing incidence in developing countries. Patients treated with fluoxetine (FLX) have a reduced incidence of colon cancer, although there still remains great controversy about the nature of its effects. Here we explore the latest achievements related to FLX treatment and colon cancer. Moreover, we discuss new ideas about the mechanisms of the effects of FLX treatment in colon cancer. This leads to the hypothesis of FLX arresting colon tumor cells at the at G₁ cell-cycle phase through a control of the tumor-related energy generation machinery. We believe that the potential of FLX to act against tumor metabolism warrants further investigation.