Screening for Prostate Cancer

In the United States, prostate cancer will affect 1 man in 6 during his lifetime. Since the mid‐1980s, screening with the prostate–specific antigen (PSA) blood test has more than doubled the risk of a prostate cancer diagnosis. A decrease in prostate cancer death rates has been observed since that time, but the relative contribution of PSA testing as opposed to other factors, such as improved treatment, has been uncertain. The recent release of 2 large randomized trials suggests that if there is a benefit of screening, it is, at best, small. Methods to assess a man's risk of prostate cancer, including those tools that integrate multiple risk factors, are now available and should be used in risk assessment. Men undergoing screening for prostate cancer may reduce their risk of prostate cancer with finasteride. CA Cancer J Clin 2009;59:264‐273. © 2009 American Cancer Society, Inc.     

Ethical Issues for Cancer Screening

In recent years medical ethics has become an undisputed part of medical studies. Many people believe that ‍modern advances in medical technology - such as the development of dialysis machines, respirators, magnetic ‍resonance imaging and genetic testing and types of cancer screenings - have created bioethical dilemmas that confront ‍physicians in the 21st century. Debates over research and screening ethics have until recently revolved around two ‍related questions: the voluntary, informed consent of subjects, and the appropriate relationship between risk and ‍benefit to subjects. ‍Every patient has a right to full and accurate information about his or her medical condition. This legal principle ‍arose primarily through court decisions concerning informed consent, but over time physicians recognized that ‍most patients prefer to learn the truth about their condition and use the information well. To screen is to search for ‍disease in the absence of symptoms or, in other words, to attempt to find disease in someone not thought to have a ‍disease. Examples of screening include routine mammography to detect breast cancer, routine pap smears to detect ‍cervical cancer, and routine Prostate Specific Antigen (PSA) testing to detect prostate cancer. Ethical principles to be ‍followed in cancer screening programmes are intended mainly to minimize unnecessary harm for the participating ‍individuals. Numerous ethical questions can be raised about the practice of screening for disease. ‍Here, we examine four leading cancer killers worldwide and we review the screening of protocols of these cancer ‍types and their possible ethics. ‍     

Screening for MiRNAs Related to Laryngeal Squamous Carcinoma Stem Cell Radiation

Objective: To use microarray chip technology for screening of stem cell radiation related miRNAs in laryngealsquamous cell carcinoma; study and explore the relationship of miRNAs with radiosensitivity of laryngealsquamous cells. Method: After conventional culture and amplification of the laryngeal squamous carcinoma cellline Hep-2, CD 133+ cells were screened out with combination of isolated culture of stem cell microspheres andFACS for preparation of laryngeal cancer stem cells. After radiation treatment, miRNAs of laryngeal squamouscarcinoma stem cells before and after radiation were enriched and purified. After microarray hybridizationwith mammalian miRNA and scanning of fluorescence signal, the miRNAs of laryngeal squamous carcinomastem cells before and after radiation was subject to differential screening and clustering analysis. Real-timequantitative RT-PCR was used to verify part of the differentially expressed miRNAs. Results: 70 miRNAs relatedto laryngeal cancer stem cell radiation with 2-fold difference in expression were screened out, in which 62 weredown-regulated and 8 were up-regulated. Fluorescent quantitative RT-PCR results were consistent with miRNAschip results. Conclusion: Some miRNAs may be involved in self-regulation with laryngeal squamous carcinomastem cell radiation.     

应用SELDI技术建立喉癌患者血清蛋白质指纹图谱筛选模型

背景与目的:建立喉癌患者血清蛋白质指纹图谱筛选模型.材料与方法:用表面加强激光解析/电离飞行时间质谱技术(SELDI-TOF-MS)及WCX2蛋白芯片对33例喉癌患者、30例声带息肉患者血清样本进行分析,将获得的血清蛋白质指纹图谱,用计算机软件进行比较分析,并建立喉癌的筛选模型.结果:喉癌组与声带息肉对照组共有27个蛋白质具有显著性差异;以其中3个蛋白质生物标志物(质/荷比分别为2 779、4 626和5 663)组建的筛选模型检测灵敏度为93.9%,特异性为100%.结论:建立的血清蛋白质指纹图谱模型能够区分喉癌与声带息肉患者,SELDI技术在喉癌的诊断及肿瘤特异性蛋白质生物标志分子的筛选等方面是一种快速而有效的工具.     

Radiotherapy for Laryngeal Cancer in Patients under 50 Years Old

Fifty-nine cases of laryngeal cancer treated by radiotherapyat the National Cancer Center Hospital between 1962 and 1990were analyzed retrospectively. All the patients were less than50 years old. The median total dose of the radiation deliveredto the primary tumor site was 70 Gy. The overall 5-yr survivalrate and 5-yr local control rate were 88% and 72%, respectively.Five (8.5%) of the 59 patients developed late recurrence morethan five yr after initial treatment, but subsequent salvageoperations were successful for disease control; three patientshad T1 glottic cancer, one had T2-3 glottic cancer and one hadT3N1 supraglottic cancer. Since the local control rate and the5-yr survival rate after radiotherapy are satisfactory, radiotherapy,which allows both functional and esthetic conservation, hasan important role in the treatment of laryngeal cancer in adultsunder 50 yr of age.     

Screening for Distress in Breast Cancer

Distress is a common and clinically relevant complication of breast cancer which can occur at any time. Several organizations have recommended systematic screening for distress but, because there is still a debate about its effectiveness, uptake has been slow. Screening research can be divided into studies of diagnostic validity that test the accuracy of particular tools and studies involving screening implementation that test the clinical success of screening. Despite many cross-sectional validation studies, few have specifically studied breast cancer patients. Only one short tool, the distress thermometer (DT), and a longer tool, the hospital anxiety and depression scale (HADS) have been evaluated in both types of study in more than one centre. Multidomain tools, for example the Edmonton symptom assessment system (ESAS) and the Emotion Thermometer (ET), are promising, and are currently under evaluation. Current evidence suggests that for any mental disorder (including adjustment disorder) the DT has sensitivity of 84 % and specificity of 63 % and the HADS has sensitivity of 65 % and specificity of 77 %. Evidence to date suggests that the DT and HADS are moderately accurate when helping identify distress, performing best in screening (initial assessment), but only slightly increase referrals for psychosocial care. However, their effect can be magnified by combining screening with mandatory follow-up.     

Genetic Screening for Familial Gastric Cancer

Approximately 10% of gastric cancer cases show familial clustering but only 1-3% of gastric carcinomas arise as a result of inherited gastric cancer predisposition syndromes. Direct proof that Hereditary Gastric Cancer a genetic disease with a germline gene defect has come from the demonstration of co-segregation of germline E-cadherin (CDH1) mutations with early onset diffuse gastric cancer in families with an autosomal dominant pattern of inheritance (HDGC). E-cadherin is a transmembrane calcium-dependent cell-adhesion molecule involved in cell-junction formation and the maintenance of epithelial integrity. In this review, we describe frequency and type of CDH1 mutations in sporadic and familial gastric cancer. Further we demonstrate the functional significance of some CDH1 germline missense mutations found in HDGC. We also discuss the CDH1 polymorphisms that have been associated to gastric cancer. We report other types of malignancies associated to HDGC, besides diffuse gastric cancer. Moreover, we review the data available on putative alternative candidate genes screened in familial gastric cancer. Finally, we briefly discuss the role of low-penetrance genes and Helicobacter pylori in gastric cancer. This knowledge is a fundamental step towards accurate genetic counselling, in which a highly specialised pre-symptomatic therapeutic intervention should be offered.     

Community-Based Screening Interventions for Colorectal Cancer

Abstract

This review examines issues related to population-based colorectal cancer screening and strategies to increase screening levels for all clients, particularly the elderly. Because cancer survival is inversely related to the stage of cancer at the time of detection and the costs of screening are less than the costs of treatment, screening levels are used increasingly as a measure of high-quality health care. Patients in acute and primary care settings underestimate their risk and overestimate their screening; providers also overestimate the level of screening in their patients. Strategies to increase patients' completion of screening include speaking directly with patients in the office, making follow-up telephone calls, and using behavioral health education strategies. Provider issues that may act as barriers to the completion of screenings also are discussed. Special concerns related to diverse populations (including immigrants) include issues regarding language and dialect, the appropriate use of interpreters, and the reading level of educational materials.     

喉 癌 治 疗 进 展

随着手术技术的进展,诱导化疗、术前或术后放化疗及生物治疗的开展,喉癌的治疗进入了一个新的时期.全文主要对此作一综述.     

焦亡相关lncRNA对喉癌预后的预测价值

目的 基于焦亡相关lncRNA构建喉癌的预后模型.方法 从TCGA数据库下载喉癌转录组表达数据和患者的临床资料.利用Wilcox秩和检验和Spearman相关性分析筛选出差异表达的焦亡相关lncRNA.进一步利用单因素Cox分析筛选出与患者预后相关的lncRNA(P<0.05),并使用多因素Cox回归建立预后模型.RO...     

Prostate Cancer Screening

Prostate cancer is the most common cancer and the second leading cause of cancer-related deaths in American men. Although the use of the prostate-specific antigen (PSA) test for prostate cancer screening since the 1990s has led to increased early diagnoses, the most recent studies are in conflict about the risks and benefits of routine prostate cancer screening. Recently, evidence has emerged to support the use of the PSA test to lower mortality, but there is still concern that over-diagnosis may lead to over-treatment of cancers that would not significantly affect patients’ health for several years. This article describes the results of important recent prostate cancer screening trials, the National Comprehensive Cancer Network and American Cancer Society screening guidelines, and discusses the implications for clinical practice.     

Clinical Predictors of Laryngeal Preservation Rate in Stage III-IV Laryngeal Cancer and Hypopharyngeal Cancer Patients Treated with Organ Preservation

Purpose: To determine factors affecting laryngeal preservation rate in laryngeal and hypopharyngeal cancer patientstreated with organ preservation. Material and Methods: Retrospective study examining stage III to IV laryngeal andhypopharyngeal cancer patients who have been treated with organ preservation. Conventional radiation must be appliedin all patients with minimum dose of 45 Gray. Weekly or triweekly chemotherapy can be adding during radiation. Salvagesurgery should be considered in residual disease or local recurrence. Kaplan-Meier was used for survival analysis and,Log rank test and Cox proportional hazard test were used for uni and multivariate analysis. Results: From January2010 to October 2014, there were 69 patients treated with laryngeal preservation and 53 patients received radiationdose 61-70 Gray. After completing radiation, we found that 44 patients have no residual tumor within 6 months and33 patients can preserve their functional larynx later with complete response (median follow up 6 mo, range 0-46.3mo). The 1-year, 2-year and 3-year laryngeal preservation rate was 49%, 36 % and 32 % respectively. On univariateanalysis, lower nodal stage (p = 0.008), stage III disease (p = 0.046), tumor volume cord involvement (p = 0.016), dose 61-70 Gray (p < 0.001) and no interruption of treatment (p = 0.017) have betterlaryngeal preservation rates. ECOG performance status 2, higher nodal stage, stage IV, presence of true vocal cordinvolvement, upper airway obstruction before/during radiation and radiation dose below 61-70 Gray had an effect onworse overall survival when evaluated with univariate analysis statistical significance. Conclusion: For factors thataffected laryngeal preservation in our study were nodal stage, group stage, tumor volume, true vocal cord involvement,radiation dose and treatment break time more than one week with statistical significance.     

癌症筛查中的一些基本问题

癌症筛查就是在"健康"人群中发现可疑者或癌症病人,通过早期发现、早期诊断和早期治疗,以期得到较好的预后.文章从伦理学、社会经济效益以及筛查方法评价等诸多方面进行探讨,分析癌症筛查的利与弊.目前,对于多数肿瘤来说,筛查被认为是研究实验性的,尚不能推荐为公共卫生政策.