Lymphocyte Proliferative Response to Autochthonous Tumor Extract in Patients with Various Types of Cancer

The lymphocyte proliferative response to autochthonous tumorextract of patients with various histological types of cancerwas examined. In 19 out of 53 patients, positive lymphocyteresponse was observed. Patients with neuro-blastoma had notonly the highest lymphocyte proliferation value (stimulationindex) but also the most frequent positive responses. Patientswith a primary tumor spreading to the regional lymph nodes tendedto have the highest lymphocyte proliferation index as well asthe most frequent positive responses, followed by patients witha primary tumor spreading beyond the regional lymph nodes andpatients with a primary tumor without any spread to the regionallymph nodes in that order. Sequential determinations of theresponse after tumor resection revealed that the proliferationvalues in certain selected patients fell to low levels sometimesafter surgery and thereafter remained low until metastasis,recurrence or tumor regrowth developed.     

中央型非小细胞肺癌肿瘤体积与位置对调强放射治疗靶区剂量的影响

摘 要： ［目的］ 评价中央型非小细胞肺癌（NSCLC）调强放疗中肿瘤体积、位置与靶区剂量的相关性。［方法］ 回顾性分析2017年1月至12月接受调强放疗的中央型NSCLC患者60例,计划靶区（PTV）处方剂量为60~66Gy,30次,2.0~2.2Gy/次。分析PTV体积与全肺组织的体积百分比(VPTV/VLung)、PTV的D95、PTV离脊髓的最小距离,利用回归模型进行曲线拟合分析肿瘤体积与位置对靶区剂量的相关性。［结果］ VPTV/VLung小于10%,PTV离脊髓的最小距离大于5mm时,PTV的D95大于60Gy。PTV离脊髓的最小距离大于20mm时,PTV的D95大于66Gy;VPTV/VLung大于30%,PTV离脊髓的最小距离小于10mm时,PTV的D95小于55Gy。［结论］ 中央型NSCLC患者调强放射治疗中,VPTV/VLung、PTV的D95、PTV离脊髓的最小距离三者之间存在相关性。肿瘤体积与位置是靶区能否达到处方剂量要求的重要影响因素。     

铁死亡与肿瘤放疗关系的研究进展

恶性肿瘤严重威胁人类生命健康,是目前全球性的重大公共卫生难题。放射治疗是恶性肿瘤的主要治疗方法之一,但仍存在放射抵抗、不良反应等问题。铁死亡是一种铁依赖性的以脂质过氧化代谢异常为特征的新型细胞程序性死亡方式,存在着多种调控方式,近年来被多次报道在肿瘤治疗与预后方面发挥重要作用,甚至与放疗所致正常组织损伤也存在密切联系。本文对铁死亡、铁死亡调控机制及其与肿瘤放疗之间关系的研究进展进行综述。     

Effect of Autochthonous Serum on Lymphocyte Response to Tumor Cells and Phytohemagglutinin in Patients With Various Types of Cancer

The serum-blocking effect on lymphocyte response to both authochthonoustumor cells and phytohemagglutinin (PHA) in sera of patientswith various types of cancer was evaluated. The blocking effecton lymphocyte respone to tumor cells correlated with the tumorburden and the subsequent clinical course of the disease. Theeffect on response to PHA, however, showed no significant relationshipwith either the tumor burden or the subsequent clinical course.Under the experimental conditions, no significant correlationof the serum-blocking effect on lymphocyte response to tumorcells with that on lymphocyte response to PHA was found.     

肿瘤微环境与肺癌相关性研究进展

肺癌是我国最常见的恶性肿瘤之一,发病率逐年增加并呈年轻化趋势.分子生物学的发展及靶向治疗应用成为肺癌治疗的里程碑,但仍有部分肺癌患者在治疗的早期就出现转移.近年大量研究发现肿瘤微环境在肺癌侵袭转移过程起着重要作用.全文就肿瘤微环境的概念、作用机制及其与肺癌复发转移及治疗的相互关系作一概述.     

100例肺癌临床及放射治疗分析

我院1977年～1987年收治的肺癌~(60)Co外放射总量在4000cGy以上者100例,男90例、女10例,50岁～59岁为高峰年龄组、占41％。治疗采用胸前垂直,背部成角照射方式,总剂量4000～8500cGy/4～8周,随访结果经统计学处理,1、3、5年生存率分别为18.31％、13.53％和11.07％,其中以6000cGy～6900cGy剂量组的5年生存率最高。经检查多数患者细胞免疫值偏低,以扶正治疗增强免疫力提高了疗效。本组患者吸烟率85％,每天5支～40支,同样显示出吸烟与肺癌的密切关系。     

癌基因K-ras、C-myc、erbB-2的激活与非小细胞肺癌组织学类型相关性研究

为探讨癌基因突变、扩增与非小细胞肺癌发生及类型间的关系，应用核酸杂交的方法检测了63伤1肺手术标本中（腺癌19例，鳞癌23例，腺鳞癌3例，大细胞癌3例，小细胞癌3例，其它12例）三种癌基因（c－myc、K－ras、erbB－2）的扩增及突变。实验结果显示：50％（24／48）的非小细胞癌分别出现三种癌基因的激活；31．6％（6／19）的腺癌出现K－ras12密码子突变及K－ras扩增；30．4％（7／23）的鳞癌有erbB－2扩增；10．4％（5／48）的非小细胞癌存在c－myc扩增。提示K－ras突变可能为肺腺癌所特有，而erbB－2扩增是肺鳞癌发生的重要因素。     

肺癌放疗中肿瘤组织内有无建成效应的研究

目的验证射线在肺部肿瘤组织中有无再次建成效应存在。方法对加速器输出的15 MV和6 MV X线在经由不同材料组成的体模后在水模中进行测量。结果15 MV X线出现明显的建成效应。6 MV X线因测量水箱结构的原因,未能完整的显现出建成效应。结论对肺癌的治疗,不但要考虑组织密度修正,还应考虑肿瘤体积的大小,选择合适的能量。     

Disease Behavior and Treatment Response of Special Histological Types of Triple-Negative Breast Cancer

Background: Special histological types (SHT) of triple-negative breast cancer (TNBC) are a heterogeneous group of rare poorly understood diseases. We aimed to evaluate the clinical features, treatment, and outcomes of patients with SHT of TNBC.Methods: We evaluated patients with a SHT of TNBC treated in a cancer center between 2009 and 2020. The endpoints were characterization of clinical and pathological features, pathologic complete response (PCR) rate after neoadjuvant chemotherapy, disease-free survival (DFS), progression-free survival, and overall survival (OS).Results: The 132 patients included had the following histologies: metaplastic (n=71), medullary pattern (n=14), lobular (n=12), adenoid cystic (n=12), apocrine (n=10), and others (n=13). Metaplastic, lobular, and medullary pattern tumors had higher grade (66.6–85.7% grade 3); adenoid cystic and apocrine had mainly grade 1-2 (70–83.3%). Metaplastic and lobular carcinomas had higher disease stages (47.8% and 58.2% stages III-IV). PCR rates were 10.3% for metaplastic and 33.3% for lobular carcinomas, with 5-year DFS rates of 56% and 51.4%. Medullary pattern carcinomas had a great response to treatment, with PCR rate of 100%, and 5-year DFS rate of 92.8%. Apocrine carcinomas also had favorable prognosis, with no recurrence after early disease treatment, and 5-year DFS rate of 83.3%. Adenoid cystic carcinomas had intermediate prognosis, with 5-year DFS rate of 66.6%.Conclusion: SHT of TNBC encompasses heterogeneous malignancies with distinct behaviors. Lobular and metaplastic carcinomas showed high aggressiveness and poor treatment response, while medullary pattern and apocrine carcinomas had favorable outcomes. Treatment strategies focus on molecular features of each of these diseases are warranted.     

肺癌放疗GTV勾画差异的研究

[目的]确定大体肿瘤体积（GTV）是三维适形放疗的重要环节。本研究观察同一医生本身和一组医生之间勾画肺癌GTV的差异，分析产生差异的原因。[方法]5位医生分别勾画8个肺癌GTV两次，两次间隔≥1周。比较GTV和三维方向波动范围。[结果]①勾画GTV后的临床分期与诊断分期相比。2例分期升级，1例降期。②不同医生勾画的GTV-t＋n（t：原发灶，n：淋巴结）体积之比为1.24～5．7，CTV-t为1．5-68．39。GTV-t＋n在三维方向波动范围为左右4．97±2．44cm、上下3．00±1．25cm、前后2．43±1．37cm；GTV-t为左右3．32±2．47cm、上下3．26±1．67cm、前后3．92±2．69cm。③勾画GTV-n的假阴性率13％，假阳性率17．5％。④同一医生勾画的前后两次GTV没有明显差异。[结论]肺癌CTV勾画是放疗质量保证的难题之一，不同医生之间存在明显差异。