Retrospective analysis of results of treatment for nasopharyngeal carcinoma in Macao

Background： Nasopharyngeal carcinoma （NPC） is a common malignancy in Southeast Asia, however, a full consensus has not yet been reached as to the value of comprehensive treatment for NPC. This study was designed to evaluate the epidemiological characteristics of NPC and their prognostic value, as well as the long-term efficacy of NPC treatment. Patients and methods： A total of 248 patients, with different stages of NPC, were included in this study. Results： The 5-year overall survival （OS） rates for patients in stages I, II, lII and IV were 90.48%, 76.71%, 76.89% and 33.87%, respectively （P=0.000）, while the respective 5-year progression-free survival （PFS） rates were 85.15%, 72.36%, 63.88% and 26.26% （P=0.000）. The respective 5-year OS rates, according to stage, for the group that received radiotherapy combined with chemotherapy and for the group that received radiotherapy only were as follows： stages I and II, 81.67% and 79.59% （P=0.753）; stage III, 79.91% and 70.38% （P=0.143）; stage IV,, 35.22% and 0% （P=0.000）. The respective 5-year PFS rates in these groups were as follows： stages I and II, 75.83% and 74.98% （P=0.814）; stage III, 74.08% and 42.25% （P=0.027）; stage IV,, 27.31% and 0% （P=0.000）. Conclusions： Clinical staging appears to be the most important prognostic factor for NPC. As the stage number increases, both the 5-year OS and PFS significantly decrease. Adding chemotherapy to radiotherapy was not advantageous for patients with stage I or II NPC, however the addition of chemotherapy to radiotherapy significantly improved OS and PFS in patients with stage IV NPC. The addition of chemotherapy improved PFS, but not OS in patients with stage III NPC.     

Benefit of adjuvant chemoradiotherapy in patients with pathologically lymph node-positive and locally advanced gastric cancer

Objective This study aimed to compare the effectiveness of adjuvant chemoradiotherapy(CRT)and adjuvant chemotherapy(ChT)for T3–4/N+gastric cancer(GC)following D2/R0 dissection,and identify the specific subgroups that could benefit from adjuvant CRT.Methods All eligible patients were divided into the CRT group and ChT group.We assessed the survival outcomes and patterns of recurrence for each group,and determined the prognostic factors for survival by performing Cox proportional risk regression analyses.Results A total of 192 gastric cancer patients were included in the study.The estimated 3-year and 5-year disease-free survival(DFS)probabilities in the CRT and ChT groups were 52.9%vs.36.7%(P=0.024)and 41.2%vs.31.1%(P=0.148),respectively,and the estimated 3-year and 5-year overall survival(OS)probabilities were 82.4%vs.70.0%(P=0.044)and 52.0%vs.35.6%(P=0.022).Patients in the CRT group had a lower risk of locoregional recurrence than those in the ChT group(20.6%vs.34.4%;P=0.031).The subset analyses revealed that patients with stage N1–2 disease were more likely to benefit from adjuvant CRT than from adjuvant ChT(DFS:53.1%vs.36.4%;P=0.039;OS:53.1%vs.38.6%;P=0.036).Conclusion For locally advanced gastric cancer patients with LN+,adjuvant CRT showed superior survival benefits compared with adjuvant ChT alone.Patients with N1–2 achieved better survival from adjuvant CRT.     

Locoregional radiotherapy in patients with distant metastases of nasopharyngeal carcinoma at diagnosis

Systemic chemotherapy is the basic palliative treatment for metastatic nasopharyngeal carcinoma （NPC）; however, it is not known whether Iocoregional radiotherapy targeting the primary tumor and regional lymph nodes affects the survival of patients with metastatic NPC. Therefore, we aimed to retrospectively evaluate the benefits of Iocoregional radiotherapy. A total of 408 patients with metastatic NPC were included in this study. The mortality risks of the patients undergoing supportive treatment and those undergoing chemotherapy were compared with that of patients undergoing Iocoregional radiotherapy delivered alone or in combination with chemotherapy. Univariate and multivariate analyses were conducted. The contributions of independent factors were assessed after adjustment for covariates with significant prognostic associations （P 〈 0.05）. Both Iocoregional radiotherapy and systemic chemotherapy were identified as significant independent prognostic factors of overall survival （OS）. The mortality risk was similar in the group undergoing Iocoregional radiotherapy alone and the group undergoing systemic chemotherapy alone [multi-adjusted hazard ratio （HR） = 0.9, P = 0.529]; this risk was 60% lower than that of the group undergoing supportive treatment （HR = 0.4, P = 0.004） and 130% higher than that of the group undergoing both systemic chemotherapy and Iocoregional radiotherapy （HR = 2.3, P 〈 0.001）. In conclusion, Iocoregional radiotherapy, particularly when combined with systemic chemotherapy, is associated with improved survival of patients with metastatic NPC.     

1030例早期乳腺癌术后放疗不同年龄组的预后分析

Objective To analyze the prognostic value of age in patients with early stage breast cancer. Methods The clinical characteristics of 1030 patients with early stage breast cancer (the number of positive axillary lymph nodes was less than 3) were retrospectively reviewed. Of all the patients, 468(stage Ⅰ, n = 227; and stage Ⅱ , n = 241) received breast conserving surgery (BCS) and 562 (stage Ⅰ, n =184; and stage Ⅱ, n= 378) received modified mastectomy. Patients were divided into young-age group (≤35,136 patients), middle-age group (> 35-≤60,738 patients) and old-age group (> 60,156 patients).The number of patients without postoperative radiation therapy after BCS is 16, 60 and 39 in the three groups, respectively. Two-dimensional conventional fractionated radiotherapy was administered. The prognostic value of the tumor size, status of axillary lymph nodes or hormonal receptors, postoperative radiation therapy were analyzed. Results The follow-up rate was 97.86%. Of 795 patients followed up more than 5 years, 110,569 and 116 patients were devided into the three groups, respectively. There were 40, 202 and 87 patients without radiation therapy in the three groups. The 5-year recurrence rates of the three groups were 6. 2%, 8. 7% and 10. 4% (χ2 = 1.14, P= 0.567). The 5-year distant metastasis rates were4.3% , 9.5 % and2. 5% (χ2 = 5.31 , P = 0. 070) . The5 - year survival rates were9l. 2% , 92. 6%and 82. 1% (χ2 = 6. 83, P = 0.033). The young-age group had more tumors smaller than 2. 0 cm (65.4%), less positive axillary lymph nodes (13.2%), poorer differential tumor and less positive hormone acceptors (48.0%). Of patients with tumor larger than 2. 0 cm who had no radiotherapy after BCS, the 5-year survival rates were 94%, 87% and 71% (χ2= 20.69, P= 0.000) in the three groups. The corresponding recurrence rates were 23%, 18% ,7%, (χ2 = 9. 97, P = 0. 007), and distant metastasis rates were23%, 25% and 10% (χ2 =8.51, P=0. 014). Conclusions The age is an important prognostic factor in patients with early stage breast cancer undergoing BCS, but not in those undergoing modified mastectomy.     

1030例早期乳腺癌术后放疗不同年龄组的预后分析

Objective To analyze the prognostic value of age in patients with early stage breast cancer. Methods The clinical characteristics of 1030 patients with early stage breast cancer (the number of positive axillary lymph nodes was less than 3) were retrospectively reviewed. Of all the patients, 468(stage Ⅰ, n = 227; and stage Ⅱ , n = 241) received breast conserving surgery (BCS) and 562 (stage Ⅰ, n =184; and stage Ⅱ, n= 378) received modified mastectomy. Patients were divided into young-age group (≤35,136 patients), middle-age group (> 35-≤60,738 patients) and old-age group (> 60,156 patients).The number of patients without postoperative radiation therapy after BCS is 16, 60 and 39 in the three groups, respectively. Two-dimensional conventional fractionated radiotherapy was administered. The prognostic value of the tumor size, status of axillary lymph nodes or hormonal receptors, postoperative radiation therapy were analyzed. Results The follow-up rate was 97.86%. Of 795 patients followed up more than 5 years, 110,569 and 116 patients were devided into the three groups, respectively. There were 40, 202 and 87 patients without radiation therapy in the three groups. The 5-year recurrence rates of the three groups were 6. 2%, 8. 7% and 10. 4% (χ2 = 1.14, P= 0.567). The 5-year distant metastasis rates were4.3% , 9.5 % and2. 5% (χ2 = 5.31 , P = 0. 070) . The5 - year survival rates were9l. 2% , 92. 6%and 82. 1% (χ2 = 6. 83, P = 0.033). The young-age group had more tumors smaller than 2. 0 cm (65.4%), less positive axillary lymph nodes (13.2%), poorer differential tumor and less positive hormone acceptors (48.0%). Of patients with tumor larger than 2. 0 cm who had no radiotherapy after BCS, the 5-year survival rates were 94%, 87% and 71% (χ2= 20.69, P= 0.000) in the three groups. The corresponding recurrence rates were 23%, 18% ,7%, (χ2 = 9. 97, P = 0. 007), and distant metastasis rates were23%, 25% and 10% (χ2 =8.51, P=0. 014). Conclusions The age is an important prognostic factor in patients with early stage breast cancer undergoing BCS, but not in those undergoing modified mastectomy.     

Expression of PD-1/PD-L1 in lung adenocarcinoma and its clinical significance

Objective This study aimed to investigate PD-1/PD-L1 expression in lung adenocarcinoma and its relationship with EGFR/KRAS mutation.Methods The expression levels of PD-1 and PD-L1 in lung adenocarcinoma were detected.Clinicopathological parameters were collected and followed up.The effects of PD-1 and PD-L1 expression on clinicopathological parameters and prognosis of patients with lung adenocarcinoma were statistically analyzed.Results PD-L1 and PD-1 were mainly located in the membrane and cytoplasm of tumor cells.The positive expression rates of PD-1 and PD-L1 were 53%and 40%,respectively.Positive PD-1 expression had a significant effect on the incidence of KRAS mutation(P<0.05),while PD-L1 expression significantly affected the incidence of EGFR mutation(P<0.05).Overexpression of PD-1 and PD-L1 had a significant negative effect on disease-free survival(DFS)in patients with lung adenocarcinoma(P<0.05)but had no significant effect on overall survival(P>0.05).EGFR gene mutation,high PD-1 expression,high PD-L1 expression,N stage,and AJCC stage were independent risk factors of DFS(P<0.05).Conclusion High PD-1/PD-L1 expression is closely related to the occurrence of lung adenocarcinoma and can be used as an independent factor to assess the prognosis of patients with lung adenocarcinoma.There were negative correlations between PD-L1 expression and EGFR mutation and between PD-1 expression and KRAS mutation.     

腋淋巴结阴性乳腺癌血管生成与预后相关性研究

】 ObjectiveTo determine the relation of microvessel density (MVD) and the expression of vascular endothelial growth factor (VEGF) with the prognosis of axillary-node-negative breast carcinoma (ANNBC) for searching for new prognostic factors. MethodsEighty specimens resected from patients with ANNBC were investigated by staining with a monoclonal antibody against FVⅢ-RA and polyclonal antibody against VEGF. Correlations between the expression of VEGF,MVD and several of clinicopathologic factors were studied. ResultsThe mean of MVD was 35.99± 20.27 in all patients.The positive rate of VEGF was 36.25％ . Both of them were not correlated with the clinicopathological factors. MVD was significantly higher in VEGF-positive tumors or relapsed or metastatic group than in VEGF-negative tumors or disease-free survival group. Moreover, patients with higher MVD or VEGF positive tumors had lower disease-free survival (DFS) or overall survival (OS) than those with lower MVD or VEGF-negative tumors. When those (45 cases) without adjuvant therapies after surgery were analyzed, the results were the same.But OS of them (35 cases) with adjuvant therapies had no significiant difference between high and low MVD group,and between VEGF positive and negative group. DFS was the same among VEGF positive and negative group. Multivariate analysis indicated that MVD,the expression of VEGF and tumor size were independent prognostic factors in patients with ANNBC. ConclusionsMVD,the expression of VEGF may be good prognostic indicators for patients with ANNBC and adjuvant therapies after surgery or antiangiogenic therapy may be useful to improve the prognosis of patients with high MVD or VEGF-positive tumors.     

Prognostic significance of ERCC1 expression in postoperative patients with gastric cancer

Aim： This study explored the correlation between the expression of excision repair cross-complementation group 1 （ERCC1） and the prognosis of gastric cancer patients. Methods： From January 2005 to December 2008, 605 patients who underwent radical surgery in The First Affiliated Hospital of Nanjing Medical University were enrolled. We conducted the follow-up every 6 months and its contents included a comprehensive medical history, tumor markers and abdominal ultrasound or CT and other imaging findings. Deadline was April 30, 2013 and follow-up time between 51 to 91 months. Survival time is calculated from the date of diagnosis to death or last follow-up date. Immunohistochemistry （IHC） was used to assess the expression of ERCCI in resected samples. The relationship between ERCCI expression and survival of patients was investigated. The comparison of count data were analyzed by Chi-square test. Median survival time （MST） and the 5-year survival rate were calculated by life table analysis. The Kaplan-Meier curves were used for survival analysis. Results： ERCC1 expression was positive in 412 patients （68.1%）. There is no significant difference between ERCCl-positive group and ERCCl-negative group in terms of the MST and 5-year survival rate （P=0.455）. The MST and 5-year survival rate have no significant difference （P=0.162） between group with chemotherapy and group with no chemotherapy in patients with ERCCl-positive expression. However, the MST and 5-year survival rate in patients with ERCCl-negative expression benefited more from with chemotherapy （P=0.019）. The ERCCl-positive patients survived longer than those ERCCl-negative patients （P=0.183） in subgroup with no adjuvant chemotherapy. In the subgroup analysis, ERCC 1 expression had no significant relationship with overall survival in patients with stage II or llI gastric cancer （P〉0.05）. Conclusions： ERCC1 might be a good prognostic factor for the patients of gastric cancer after radical resection. Patients with ERCC     

Adjuvant chemotherapy with paclitaxel and cisplatin in lymph node-positive thoracic esophageal squamous cell carcinoma

Objective:No standard postoperative adjuvant chemotherapy has ever been established in node-positive esophageal squamous cell carcinoma (ESCC).This is a study to explore the effect of postoperative paclitaxel (PTX) and cisplatin (DDP) in lymph node-positive,completely resected thoracic ESCC patients.Methods:We conducted a prospective phase Ⅱ trial.Patents had pathologically node-positive thoracic ESCC with negative margins.Outcomes of disease-free survival (DFS) and overall survival (OS) were compared with a matched historical control cohort.The postoperative chemotherapy regimen consisted of 4 to 6 cycles of PTX 150 mg/m2 administered intravenously on d 1 followed by DDP 50 mg/m2 on d 2 every 14 d.Results:Forty-three patients were accrued from December 2007 to May 2012 at Cancer Hospital of Chinese Academy of Medical Sciences for adjuvant chemotherapy.The historical control group consisted of 80 patients who received complete resection but no adjuvant chemotherapy during the same period of time.Of the 43 patients with adjuvant chemotherapy,37 (86.0％) patients completed 4 to 6 cycles of chemotherapy.The 3-year DFS rates were 56.3％ in the adjuvant group and 34.6％ in the control group (P=0.006).The 3-year OS rates were 55.0％ in the adjuvant group and 37.5％ in the control group (P=0.013).Multivariate analysis revealed that postoperative chemotherapy was the significant predictor for improved OS (P=0.005).Conclusions:Biweekly adjuvant PTX and DDP might improve 3-year DFS and OS in lymph node-positive,curatively resected thoracic ESCC patients.These conclusions warrant further study in randomized phase Ⅲ clinical trials.     

The cardiotoxicity and long-term efficacy of different doses of epirubicin in the adjuvant treatment of breast cancer patients：A case control study

Abstract Objective： The aim of the study was to observe the cardiac toxicity caused by different doses of epirubicin in the adjuvant treatment of breast cancer and to evaluate the long-term efficacy. Methods： The 180 cases of breast cancer patients received epirubicin based adjuvant chemotherapy. The patients were randomly assigned to high-dosage group （90 rag/m^2）, medium-dosage group （70 mg/m^2） and low-dosage group （50 rag/m^2）, the primary endpoint was cardiac toxicity. The secondary outcomes were the 5-year overall survival （OS） and 5-year disease-free survival （DFS）. Results： During chemo- therapy, the clinical symptoms such as palpitation, dyspnea and paroxysmal nocturnal dyspnea occurred in 6 patients with the high-dosage group, 4 patients with the medium-dosage group and 3 patients with the low-dosage group. The number of patients who had changed in electrocardiogram （ECG） was 7, 5 and 4 in three groups, respectively. The echocardiographic showed each group had only one case with LVEF 〈 50%, there was no significantly difference （P 〉 0.05）. In the three groups, the 5-year DFS rates were 73.3% （44/60） in high-dose group, 53.3% （32/60） in medium-dose group and 41.6% （25/60） in low dose group. The 5-year OS rates were 85.0% （51/60）, 68.3% （41/60） and 58.3% （35/60） in three groups, respectively. The differences were statistically significant （P 〈 0.05）. Conclusion： The high-dose epirubicin in adjuvant chemotherapy with CEF （cyclophosphamide, epirubicin and fluorouracil） regimen could improve the 5-year OS rate and 5-year DFS rate on patients of breast cancer. The cardiotoxicity was mild-moderate and well tolerated.     

鼻咽癌组织中EGFR和nm23基因表达与预后关系研究

目的 探讨表皮生长因子受体(EGFR)和转移抑制基因(nm23)表达与鼻咽癌(NPC)患者预后的相关性.方法 回顾分析本院2003-2006年放疗前行鼻咽活检且资料完整的127例经病理证实的鼻咽癌患者,所有患者均采用6 MV X线调强放疗联合顺铂+氟尿嘧啶方案化疗.采用免疫组化链霉素抗生物素蛋白-过氧化物酶法(SP)检...     

nm23、GST-π在85例胃癌中的表达

[目的]探讨nm23和GST-π在胃癌组织中的表达及其临床意义。[方法]应用免疫组化SP法对85例胃癌中nm23和GST-π的表达进行检测。[结果]肿瘤组织中nm23和GST-π阳性表达率分别为48.2%和81.2%。nm23表达与淋巴结转移、肿瘤的浸润深度及TNM分期呈负相关。GST-π在不同分化程度的胃癌中的阳性率有明显差异,未分化癌者为92.3%,低分化腺癌者为89.4%,黏液癌者为65.0%,高—中分化腺癌者为57.1%,前两者明显高于后两者（P〈0.05）。[结论]胃癌组织中nm23和GST-π的检测可用于胃癌淋巴结转移、肿瘤浸润深度、TNM分期的预测。     

乳腺癌中ERK2、nm23、MMP9基因蛋白的表达及意义

目的探讨乳腺癌中ERK2基因蛋白表达与淋巴结转移相关基因nm23、MMP9蛋白表达的关系。方法采用HE染色光镜观察96例乳腺癌,用免疫组织化学技术检测病灶中ERK2、nm23、MMP9蛋白表达情况。结果ERK2蛋白表达在乳腺浸润性癌中有高于原位癌的趋势（χ^2=3.783,P=0.052）;nm23蛋白表达在淋巴结转移组中显著低于无淋巴结转移组（χ^2=9.222,P=0.010）,与ERK2蛋白表达呈显著负相关（χ^2=4.085,P=0.043）;MMP9蛋白表达在淋巴结转移组中显著性高于无淋巴结转移组（χ^2=4.153,P=0.043）,与ERK2蛋白表达无明显相关性（P〉0.05）。结论ERK2信号蛋白可能通过与nm23基因蛋白的作用影响乳腺癌的进展、淋巴结转移。     

nm23、上皮型钙粘素和β-连环素在非小细胞肺癌中的表达及其与转移和预后的关系

背景与目的:近年来关于nm23、上皮型钙粘素(E-cadherin)和连环素(Catenins)与肿瘤关系的研究比较多,但不同研究得到的结果差异较大。而且近年来的研究显示,nm23、E-cadherin和Catenins还参与细胞信号转导,使它们在肿瘤转移过程中的作用可能具有多面性。本实验检测nm23、E-cadherin和β-Catenin在一组非小细胞肺癌(non-sm allcelllang cancer,NSCLC)中的表达水平,试图了解它们与非小细胞肺癌转移和预后的关系,以及它们之间的相互关系。方法:采用免疫组化(SP法)检测112例NSCLC和30例肺良性病变组织中nm23、E-cadherin和β-Catenin的表达水平。结果:(1)nm23、E-cadherin和β-Catenin在肺癌组织中表达水平(分别为53.0%,53.1%和47.2%)显著低于癌旁肺组织中的表达水平(分别为64.8%,79.7%和80.6%)和肺良性病变组织中的表达水平(分别为76.9%,83.5%和85.6%);(2)nm23、E-cadherin和β-Catenin在有淋巴结转移的肺癌组织中的表达水平(分别为48.0%,47.3%和41.2%)显著低于无淋巴结转移者(分别为65.0%,60.5%和60.3%),在Ⅲ期和Ⅳ期NSCLC的表达水平(分别为44.8%,46.6%和38.1%)均显著低于Ⅰ期、Ⅱ期NSCLC(分别为67.2%,64.3%和63.1%);(3)nm23、E-cadherin和β-Catenin高表达组5年生存率(分别为39.29%,35.85%和37.29%)均显著     

非霍奇金淋巴瘤患者nm23蛋白检测的预后价值

目的：探讨nm23基因蛋白在非霍奇金淋巴瘤中表达的临床预后价值。方法：应用免疫组化EnVision法。结果：nm23在非霍奇金淋巴瘤组织中的表达强度与其恶性程度有关，呈正相关（P＜0．001）。nm23低水平表达组患者完全缓解率和1、3、5年生存率均明显高于高表达组（P＜0．01）。结论：nm23表达水平反映了非霍奇金淋巴瘤的恶性程度，可作为判定非霍奇金淋巴瘤的预后因子。     

大肠癌nm23H1基因表达及其临床意义

目的：研究大肠恶性肿瘤nm23H1基因表达及其临床意义。方法：应用免疫组化SP法检测1990年8月－1996年2月间收治的60例大肠恶性肿瘤。Dusk‘s分期为A期10例,B期25例,C期16例,D期9例。结果：大肠恶性肿瘤nm23H1强阳性23例,中度阳性18例,阴性19例,表达阳性率随分期的进展逐渐下降,有淋巴结转移的表达阳性率明显低于无转移者。结论：抑癌基因nm23H1表达,在大肠癌病期、淋巴结转移和预后研究中可作为判断指标。     

Regulation of CD23 expression by Notch2 in B-cell chronic lymphocytic leukemia

The original observation that sera from patients with chronic B-cell lymphocytic leukemia (B-CLL) contain high amounts of soluble CD23 (sCD23), which reflect disease activity and tumor load has been confirmed by numerous reports and serial determinations of sCD23 are now recognized as important indicators of disease progression. The reason why the leukemic cells over express CD23 and subsequently release large quantities of sCD23 as compared to healthy persons or patients with other lymphoproliferative disorders is still not clear. However, progress has been made in understanding the mechanism leading to the upregulation of CD23 in the leukemic cells. Following is an update on clinical data and a short review on the potential functions of CD23 as well as its regulation by Notch2 in B-CLL.     

nm23基因在肿瘤预后监测中的应用

nm23基因是1988年由Steeg首次从小鼠黑色素瘤细胞中分离出来的-种与肿瘤转移表型抑制相关的基因。人类nm23基因家族有8个，即nm23-H1、nm23-H2、DR—nm23、nm23-H4、nm23-H5、nm23-H6、nm23-H7和nm23-H8，其中研究最多的是主要与肿瘤转移相关的nm23-H1及调控c—mye和PDGF基因转录的nm23-H2。nm23-H1和nm23-H2所编码的蛋白与核苷二磷酸激酶（NDPK）的A、B亚基分别相对应，编码蛋白的氨基酸序列与NDPK的同源性分别为89％和97％，二者之间的同源性为88％。DR—nm23基因又称nm23-H3，其结构与nm23-H1和nm23-H2具有65％～70％的同源性，DR—nm23靶蛋白位于细胞质和线粒体膜上，其表达调控不在转录水平，可能出现在转录后或翻译水平。nm23-H4基因产物是线粒体NDPK，其氨基酸序列与NDPKA和NDPKB有58％～59％的同源性，nm23-H5至nm23-H8基因产物均被证实具有NDPK活性或NDPK样区域。     

nm23因子在大肠癌组织中的表达及其临床意义

肿瘤转移是一个复杂的、多步骤的、肿瘤细胞和宿主细胞相互作用的过程,是恶性肿瘤的重要生物学行为,往往是导致病人死亡的直接原因.随着分子生物学的发展,对肿瘤转移抑制的研究已进入分子水平,nm23基因即是近年来发现并被证实与多种肿瘤的转移有关的较新的肿瘤抑制基因,该基因可能通过影响细胞内微管的聚合/解聚和G蛋白介导的信号传导,而参与肿瘤的发生和发展.