Experience in the use of gastrofluorography in the Byelorussian SSR

The paper discusses the major stages of long-term studies of the effectiveness of application of gastrofluorography for detection of cancer and precancerous lesions in the stomach conducted during mass screenings in the Byelorussian SSR. The test results for the first Soviet-made on-site gastrofluorographic installation are presented. Successful applications of the installation for both screening and primary detection of the lesions are discussed.     

长链非编码RNA在结直肠癌中的研究进展

长链非编码RNAs(Long non-coding RNAS,lncRNAs)是一类不编码蛋白质,长度大于200个核苷酸的RNA。结直肠癌的发生发展与lncRNA的异常表达密切相关。本文结合近年来国内外的文献报道,对lncRNA在结直肠癌中的表达情况及作用机制做一综述,以期为临床诊断和靶向治疗提供可能的依据。     

男性肺癌血中内分泌激素的测定

 从1991年10月-1993年6月对45岁以上男性，44例正常人和87例肺癌患者血中8种内分泌激素进行测定，肺癌病人治疗前Cort、β-HC、Gluc和PRL明显高于正常人群。87例肺癌治疗前按不同病理比较，腺癌β-HCG明显高于其它病理类型，鳞癌PRL高于其它，小细胞未分化Gast高于其它。43例肺癌治疗后，TSH、PRL、Cort和Glue都明显降低，而GH则升高，11例治疗后肿瘤复又增大或远处转移的肺癌患者，再次测定激素水平表明，PRL、Cort和Glue复又升高。这些结果说明部分内分泌激素，可用于男性肺癌的早期诊断或鉴别诊断，有些激素可作为肺癌病理分类的参考。     

Practice pearls in the management of lung cancer in the elderly

Lung cancer is a disease that afflicts the elderly. It is a leading cause of cancer mortality worldwide. Treatment of lung cancer which was predominantly combination chemotherapy was initially thought to be too toxic for older patients with cancer due to their frail state. However a number of recent studies have shown that this is not necessarily true and many elderly can actually tolerate combination chemotherapy and derive just as much benefit from it as younger patients with lung cancer do. More recently it has been found that a significant proportion of lung cancer patients have tumors that harbor mutations that are targetable by molecularly targeted therapy (MTT). These targeted therapies have a much better tolerated side effect profile, hence have been used in elderly patient with lung cancer with great success. A new generation of drugs called immune checkpoint inhibitors have now come into the fray with exciting results in the second line treatment of lung cancer with a low side effect profile. A key element in deciding whether an elderly patient with lung cancer can tolerate treatment involves a detailed assessment using the comprehensive geriatric assessment (CGA). A number of CGA and clinical factors have also been found to be able to predict chemotherapy associated toxicity. This review of lung cancer in the elderly was part of a lecture on “Practice pearls in the management of lung cancer in the elderly” presented at the SIOG Annual Meeting in Prague in November 2015.     

Challenges in the treatment of gastric cancer in the older patient

Gastric cancer is considered an age-related disease, with the majority of new cases in the UK diagnosed in individuals over the age of 75. At present most guidance related to the management of gastric cancer is based on trials undertaken in the fit, younger patient. Historically the elderly have been underrepresented in clinical trials, which frequently have a restricted inclusion to an upper age limit of 75. The European Society for Medical Oncology (ESMO) recommends use of a geriatric assessment to determine functional age when initiating treatment in elderly patients with gastric cancer, which has been shown to be a better predictor of treatment response than chronological age. The physiological changes that occur with age, including reduced organ function and pharmacokinetic and pharmacodynamic variability, together with impaired functional status, necessitate a more individualised approach to treatment decisions in the older patient to provide them with the same advantages from radical treatment and palliative chemotherapy as younger patients. This review summarises the current evidence extrapolated from trial data on how best to optimise treatment for elderly patients with gastric cancer.     

Oral urea in the treatment of secondary tumours in the liver

Twenty patients with secondary liver tumours, predominantly from colorectal carcinoma, were treated with oral urea at a daily dose of 8 gm-2. Treatment was well tolerated without side-effects. No objective responses were seen. It is concluded that oral urea is ineffective in the treatment of liver metastases from colorectal cancer.     

降钙素原在恶性血液病发热中的诊断价值

目的：探讨血清降钙素原（Procalcitonin,PCT）在恶性血液病发热中对于感染的诊断价值。方法：分析我科自2006年5月-2007年5月收治的85例恶性血液病患者105次发热病程中的PCT和C反应蛋白（C—reactive protein,CRP）浓度特征,根据患者临床特征将其分为败血症组、病原学证明肺炎组、临床证明肺炎组、病原学证明感染组、临床证明感染组、非感染性发热组和不明原因发热组,将各组PCT和CRP平均浓度进行比较,并进行ROC曲线检验;对伴并发症和不伴并发症热程以及死亡和存活的热程中患者的PCT和CRP浓度进行比较,并行ROC曲线检验。结果：105例次热程中感染组84例次（80．0％）,其中败血症组8例次（12．4％）。发热组PCT和CRP浓度显著高于不发热组（P〈0．001）。感染组PCT浓度显著高于非感染组和不明原因发热组（P〈0．001）,PCT对于感染的最佳鉴别界值为0．157ug／L;感染组CRP浓度与非感染组有显著差异（P=0．047）,但对于感染与非感染发热鉴别价值不大。败血症热程中患者的PCT和CRP浓度显著高于非败血症热程（P〈0．001）,PCT和CRP对于败血症热程均有较好的鉴别价值,最佳鉴别界值分别为1．009ug／L和85．5mg／L。结论：PCT血清浓度与恶性血液病发热患者的感染严重程度相关,尤其对于败血症特异性高。对于该群患者感染性发热和非感染性发热、败血症发热和非败血症发热有很好鉴别价值。CRP血清浓度对于该群患者感染性发热与非感染发热无鉴别意义,但对于败血症发热与非败血症发热有较好的鉴别价值。     

Reversibility of the malignant phenotype in monoclonal tumours in the mouse

Longterm goitrogen administration to rodents is well known to result in multiple proliferative lesions of the thyroid. The regression of these lesions on withdrawal of goitrogen has led to their neoplastic nature being questioned, and they have been regarded as 'nodules' rather than as true tumours. We have induced multiple thyroid lesions by the combined use of high dose radiation as a mutagen, together with goitrogen administration to induce prolonged TSH growth stimulation. G6PD histochemistry was used in heterozygous G6PD deficient female mice to show that all the thyroid lesions induced by this regime were monophenotypic, and therefore monoclonal in origin. The great majority of induced tumours were adenomas, a minority were carcinomas. The number of carcinomas observed was significantly lower in a group of animals from which goitrogen was withdrawn for 4 weeks prior to killing, when compared to animals killed while on goitrogen treatment. Both adenomas and carcinomas, including areas of intravascular tumour, showed morphological features of regression on withdrawal of the goitrogen. There are three key cellular changes which must occur in spontaneous thyroid carcinogenesis--escape from a growth limiting mechanism, acquisition of TSH independent growth and acquisition of invasiveness. In the natural selection of mutations or epimutations during carcinogenesis, prolonged high levels of TSH are likely to remove any selective advantage from mutations that lead to TSH independent growth. Tumours induced by a regime including prolonged goitrogen treatment may therefore develop following two rather than three key stages. They will occur with an increased frequency relative to lesions observed in spontaneous carcinogenesis, but will retain TSH dependency. We speculate that several mechanisms may lead to loss of the growth limiting mechanism, including translocation of an oncogene to the region of a TSH induced promoter. Other carcinogenic regimes may also increase the yield of tumours by creating conditions which reduce the number of essential steps required for carcinogenesis, and may involve translocation to a carcinogen inducible promoter.     

Trends in the use of cytoreductive nephrectomy in the United States

BackgroundTwo randomized trials published in 2001 established CyNx for patients with metastatic renal carcinoma (mRCC) as a treatment standard in the cytokine era. However, first-line systemic therapy for mRCC changed in 2005 with FDA approval of VEGFR TKIs. We evaluated the patterns of use of CyNx from 2000 to 2008.Materials and MethodsThe National Cancer Database was queried for patients diagnosed with mRCC. Patients who underwent CyNx were identified and were further categorized by pre-VEGFR versus VEGFR TKI era, race, insurance status, and hospital. For these subcategories, prevalence ratios (PRs) were generated using the proportion of patients with mRCC undergoing CyNx versus those not undergoing CyNx.ResultsOf the 47,417 patients (pts) identified with mRCC, the prevalence of cytoreductive nephrectomy increased 3% each year from 2000 to 2005 (P < .0001), then decreased 3% each year from 2005 to 2008 (P = .0048), with a significant difference between the eras (0.97 vs. 1.025; P < .0001). Black and Hispanic pts were less likely than Caucasian pts to undergo CyNx. Pts with Medicaid, Medicare, and no insurance were less likely than pts with private insurance to undergo CyNx. Pts diagnosed at community hospitals were significantly less likely than pts at teaching hospitals to undergo CyNx.ConclusionThe use of CyNx has declined in the VEGFR-TKI era. In addition, racial and socioeconomic disparities exist in the use of CyNx. The results of pending randomized trials evaluating the role of CyNx in the VEGFR-TKI era are awaited to optimize use of this modality and address potential disparities.