The Relationship of PSA, PSAD and Clinicopathological Stage in Patients with Prostate Cancer

OBJECTIVE To investigate the relationship between the clinicopatho- logical stage and serum prostate specific antigen(PSA)concentration and PSAdensity(PSAD)in patients with prostate cancer. METHODS The clinicopathological stage was determined on the basis of a pathological examination and clinical data in 65 prostate cancer patients treated by radical prostatectomy.PSA and PSAD were measured before the operation.The Spearman rank correlation was applied to evaluate the relationship between the clinicopathological stage,serum PSAconcentration and PSAD. RESULTS Patients with higher PSA and PSAD were significantly more likely to have higher clinical stages,a higher Gleason score,positive surgical margins,capsular penetration,and seminal vesicle invasion(each P<0.05). But there was no significant association between PSA and lymph node metastasis(P=0.053).The levels of serum PSA concentration and PSAD were significantly correlated with the clinical stage(P<0.05)in the prostate cancer patients. CONCLUSION The level of both PSA and PSAD were significantly correlated with the clinical stage(P<0.05)in the prostate cancer patients.But PSAD may be a more powerful predictor of clinical stage and prognosis than PSA.     

Prognostic Value of P-gp and p27 in Patients with Esophageal Squamous Cell Carcinoma

Objective： To evaluate the prognostic value of P-gp and p27 expression in patients with esophageal squamous cell carcinoma （ESC）. Methods： The expressions of P-gp and p27 were detected by immunohistochemistry in 104 cases of ESC, and the clinicopathological characteristics were analyzed as well. Results： The positive rate of P-gp expression in 104 cases of ESCs was 32.7%. The positive rate of P-gp expression in the group that survived over 3 years （17.5%） was significantly lower than that in the group died within 3 years （53.3%） （x^2=14.227, P〈0.001）. The positive rate of p27 expression in 104 cases of ESCs was 67.3%. The positive rate of p27 expression in the group that survived over 3 years （75.8%） was significantly higher than that in the group died within 3 years （56.5%） （x^2=4.361, P〈0.05）. The patients with poorer differentiation whole wall invasion, lymph node metastasis and more advanced TNM stage had a shorter survival than did those with better differentiation, more superficial invasion, no lymph node involvement and earlier TNM stage; and it was statistically significant （P〈0.05）. However, tumor size, macropathologic type, age and gender had no prognostic impact on ESC patients （P〉0.05）. Conclusion： P-gp and p27 expression levels had a clinical prognostic significance in ESC. It could provide a reference basis for selecting the chemotherapy projection. The tumor differentiation degree, depth of invasion, lymph node involvement and TNM stages all were correlated to ESC patients＇ survival.     

Clinical Studies of Postoperative Arterial Infusion Chemotherapy in Patients with Pathologic T3 Esophageal Squamous Carcinoma

Multi-sample and multi-center studies have provided no evidence to indicate that preoperative chemo-radiation therapy can in- crease the 5 year survival rate of patients with esophageal squamous carcinoma, although some clinical studies have indicated tha…     

Influence of Autologous and Homologous Blood Transfusion on Interleukins and Tumor Necrosis Factor-α in Peri-operative Patients with Esophageal Cancer

Objective: To explore the influence of different ways of blood transfusion on the expression levels of interleukins(IL) and tumor necrosis factor-α (TNF-α) inperi-operative patients with esophageal cancer. Materials andMethods: A total of 80 patients with esophageal cancer who underwent radical operations were selected asstudy patients and randomly divided into an observation group (treated with autologous blood transfusion) andcontrol group (with homologous blood transfusion). Changes of intra-operative indexes and peri-operative bloodindexes, from hemoglobin (Hb) and hematocrit value (Hct), to levels of inflammatory factors like interleukins-6(IL-6), IL-8, IL-10 and tumor necrosis factor-α (TNF-α) were compared. Results: Operations for patients in bothgroups were successfully conducted, and no significant differences in mean surgical duration and intra-operativehemorrhage volume, fluid infusion volume and blood transfusion volume were detected (p>0.05). Compared withvalues before surgery, Hb and Hct levels decreased significantly while white blood cell count (WBC) increased1, 5 and 7 d after operation (p<0.05, p<0.01). In addition, WBC was apparently higher in observation groupthan in control group 5 and 7 d after operation (p<0.01). Compared with before surgery, in the observationgroup, levels of IL-6, IL-8 and IL-10 had no significant differences after operation (P>0.05), but TNF-α levelincreased y (p<0.01), whereas in control group, IL-6 level had no significant difference (p>0.05), IL-8 leveldecreased obviously (p<0.05), IL-10 level increased markedly first and then decreased gradually as time passedbut its level remained elevated (p<0.01), and TNF-α level increased first and then decreased, and there was nosignificant difference 7 d after operation (p>0.05). Conclusions: Decreased IL-8 and increased IL-10 levels aretwo important reasons forimmunosuppression after homologous blood transfusion, whereas autologous bloodtransfusion can alleviate this while increasing the TNF-α level, which also has potential to improve anti-tumorimmunity in the human body.     

Clinical Safety and Efficacy of Kanglaite® (Coix Seed Oil) Injection Combined with Chemotherapy in Treating Patients with Gastric Cancer

Objective: To observe efficacy and side effects, as well as the impact on quality of life, of Kanglaite® (CoixSeed Oil) injections combined with chemotherapy in the treatment of advanced gastric cancer patients. Method:A consecutive cohort of 60 patients were divided into two groups: the experimental group receiving Kanglaite®Injection combined with chemotherapy and the control group with chemotherapy alone. After more than twocourses of treatment, efficacy, quality of life and side effects were evaluated. Results: The response rate andKPS score of experimental group were significantly improved as compared with those of the control group(P<0.05). In addition, gastrointestinal reactions and bone marrow suppression were significantly lower than inthe control group (P<0.05). Conclusions: Kanglaite® Injection enhanced efficacy and reduced the side effects ofchemotherapy, improving quality of life of gastric cancer patients; use of Kanglaite® injections deserves to befurther investigated in randomized control clinical trails.     

Profile and Survival of Tongue Cancer Patients in “Dharmais” Cancer Hospital,Jakarta

Background: Tongue cancer is still a major health problem in most developing countries around the world.Statistics shown the number of tongue cancers, especially in early age, to be increasing, with poor survival.Objective: To analyze the characteristic profile of tongue cancer patients in Indonesia as well as the survivalrate. Materials and Methods: A cross sectional study was conducted in Dharmais National Cancer Hospitalby collecting general, clinical, and survival data of tongue cancer patients from medical records for January2009 to April 2012. Results: Tongue cancer incidence increased year by year. The average age of tongue cancerpatients was 47.5 years, and males predominated, accounting for 64.5% of cases. Most patients presented at anadvanced stage (69.6%). The histopathology type was squamous cell carcinoma in the vast majoriy (96.8%).The therapies applied were surgery (45.6%), radiation (63.6%) and chemotherapy (57.6%). The survival rateafter one year is 60.6% and after two years was 12.1%. In addition, median survival of tongue cancer patientswas 20 months (95% confidence interval 9.07-30.9). The significant factor affecting survival was size of tumorwith a hazard ratio of 3.18 (95% CI, 1.02-9.93; p 0.046) for largest versus smallest categories. Conclusions: Ineach year, the number of tongue cancer incidents in Indonesia is increasing. The age of tongue cancer patientsin Indonesia is younger compared to other countries. Moreover, the survival rates are not high.     

Clinical Study on Safety and Efficacy of Qinin® (Cantharidin Sodium) Injection Combined with Chemotherapy in Treating Patients with Gastric Cancer

Objectives: To assess the efficacy, side effects, and the impact on quality of life with Qinin® (Cantharidinsodium) injection combined with chemotherapy for gastric cancer patients. Method: A consecutive cohort of 70patients were divided into two groups: experimental group with cantharidin sodium injection combined withchemotherapy, while the control group received chemotherapy alone. After more than two courses of treatment,efficacy, quality of life and side effects were evaluated. Results: The response rate of experimental group wasnot significantly different from that of the control group (P>0.05), but differences were significant in clinicalbenefit response and KPS score. In addition, gastrointestinal reactions and the incidence of leukopenia werelower than in the control group (P<0.05). Conclusions: Qinin® (Cantharidin sodium) injection combined withchemotherapy enhances clinical benefit response, improving quality of life of gastric cancer patients and reducingside effects of chemotherapy. Thus Qinin® (Cantharidin sodium) injection deserves to be further investigatedin randomized control clinical trails.     

Cost-Utility of “Doxorubicin and Cyclophosphamide” versus “Gemcitabine and Paclitaxel” for Treatment of Patients with Breast Cancer in Iran

Purpose: A cost-utility analysis was performed to assess the cost-utility of neoadjuvant chemotherapy regimens containing doxorubicin and cyclophosphamide (AC) versus paclitaxel and gemcitabine (PG) for locally advanced breast cancer patients in Iran. Materials and Methods: This cross-sectional study in Namazi hospital in Shiraz, in the south of Iran covered 64 breast cancer patients. According to the random numbers, the patients were divided into two groups, 32 receiving AC and 32 PG. Costs were identified and measured from a community perspective. These items included medical and non-medical direct and indirect costs. In this study, a data collection form was used. To assess the utility of the two regimens, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core30 (EORTC QLQ-C30) was applied. Using a decision tree, we calculated the expected costs and quality adjusted life years (QALYs) for both methods; also, the incremental cost-effectiveness ratio was assessed. Results: The results of the decision tree showed that in the AC arm, the expected cost was 39,170 US$ and the expected QALY was 3.39 and in the PG arm, the expected cost was 43,336 dollars and the expected QALY was 2.64. Sensitivity analysis showed the cost effectiveness of the AC and ICER=-5535 US$. Conclusions: Overall, the results showed that AC to be superior to PG in treatment of patients with breast cancer, being less costly and more effective.     

Medical Resource Utilizations and Economic Burden in Chinese Cancer Patients with Chemotherapy-induced Anemia： A Populational Database Study

Objective  Most of published studies emphasized the medical cost of treating chemotherapy-induced anemia (CIA) by using specific agents, for example, epoetin α, epoetin β, darbepoetin α or combined with red blood cell transfusions, however, the investigation of the overall medical resources utilizations and economic burden of CIA is still limited. Besides, such studies which emphasized Chinese population still lack. The aim of this study is to investigate the medical resource utilization and the economic burden of Chinese cancer patients with CIA by using a populational representative claim database. Methods  The data for this study are from the 2000-2003 Population Health Insurance Research Database (PHIRD) in Taiwan. On the basis of issuing catastrophic illness cards in the enrollment data files, a total of 26,053 beneficiaries were identified from the PHIRD, who were newly diagnosed with these four cancers in 2001 and 2002 (2001: n=12,954; 2002: n=13099). A generalized linear model (GLM) was employed for analyzing the differences of medical resource utilization and economic burden between the anemic and non-anemic groups. Results  Analyses showed that the anemic patients were significantly more likely to have longer length of hospital stay than non-anemic patients (P<0.05) across all these four cancers and in two study periods (except women breast cancer in 2002/03). As regards the health care expenditures, the average one-year total medical cost was USD$8,982 (2001/02) and USD$8,990 (2002/03) for anemic patients among these four cancers, and USD$7,769 (2001/02) and USD$7713 (2002/03) for non-anemic patients (P<0.0001). As for ambulatory costs, anemic patients’ was significantly higher than non-anemic patients’ for lung cancer (in 2001/02), women breast cancer (in 2001/02 and 2002/03) and the summarized data (in 2001/02). As for inpatient costs, anemic patients’ was significantly higher than non-anemic patients’ for gastric cancer (in 2002/03), colon and rectal cancer (in 2001/02 and 2002/03), lung cancer (in 2001/02 and 2002/03), women breast cancer (in 2001/02) and the summarized data (in 2001/02 and 2002/03). Conclusion  This study is the first study to demonstrate that cancer patients who receive chemotherapy and with anemia utilize more medical resources and have heavier economic burden among Chinese cancer patients. Although the Population Health Insurance Program in Taiwan was established to provide more low-burdened medical care for all cancer patients, further effort is still needed to reduce the economic burden for cancer patients who have specific complications. This work was supported by a grant from Roche Co., Taiwan.     

The Effects of Microwave Ablation and Surgical Resection on Hematogenous Dissemination of Cancer Cells in Treating Patients with Small Primary Hepatocellular Carcinoma

OBJECTIVE To conduct a comparative study of the effects of treatment using microwave ablation versus surgical resection on hematogenous dissemination of cancer cells, and on the level of immune cells of the peripheral blood in patients with small primary hepatocellular carcinoma (PHC,≤5 cm). METHODS Forty patients with small PHC (maximal diameter≤5 cm) were divided into a microwave group (19 cases) and a surgical operation group (21 cases). A real-time (RT) quantitative nested RT-PCR examination was performed for peripheral blood alpha-fetoprotein (AFP) mRNA. Studies were conducted to determine the level of CD3, CD4, CD8 and CD4/CD8 cells and for liver function at 30 min before, and 30 min,1 day and 3 days after the treatment. RESULTS Compared to the value before ablation, no obvious changes of CD3, CD4, CD8 and CD4/CD8 cells were found in patients of the microwave group within 7 days after ablation, but CD3, CD4 and CD4/CD8 cells in the operation group were lower compared to that before operation. The copy number of AFP mRNA in the peripheral blood samples of the patients of the 2 groups before operation was determined in 67.5% of the patients (27/40). There was an rise in the expression after treatment but no statistical difference was found in comparing the 2 groups. Follow-up of the patients was conducted for 1 to 16 months. For patients with continuous expression of peripheral blood AFP mRNA, the possibility of relapse and metastasis was increased. CONCLUSION Surgical resection or microwave ablation can cause more exfoliation of hepatoma carcinoma cells in the peripheral blood of patients with small PHC. The immune function of peripheral blood cells decreased in the patients after surgical resection, however, the immune function was better protected following microwave ablation. Microwave ablation causes minor reduction in liver function, and the treatment method presents a definite value for PHC therapy.     

Effects and Permanency of the Training Program “Communication with Cancer Patients” on the Opinions of Students

Learning to develop the doctor-patient relationship is very important in the treatment of patients with cancer. We aim to train our students in the early years of study about this subject with a course on the patient-doctor communication, prepared for third year students. One hundred fifty-four third year students participated in our study during the 2006-2007 academic years. The same questionnaire was given to the students in the 2009-2010 academic year; their sixth year of study. The rate of return for the questionnaire is 88.7%. Based on this study, we have the opinion that the training given in the third year is beneficial; however, the efficacy of the training diminishes with the advancing years, and therefore, the length of this training should be increased in the upper classes and additional hours should be added.