Survivin expression and its potential clinical significance in gastrointestinal stromal sarcoma

This study was designed to determine the level of survivin expression and its clinical significance as a prognostic factor in gastrointestinal stromal sarcoma (GIST). Twenty patients (12 males and 8 females) ranging in age from 25 to 72, with a median age of 53 were evaluated. Failure of TKI treatment was higher in the survivin-positive group (p = 0.06). The rate of metastasis was significantly higher in the survivin positive group vs. the negative group (80% vs. 30%, p = 0.18). The median overall survival (OS) time was 114 (range 29–199) months, and the median disease-free survival (DFS) time was 88 (range 40–135) months. The median progression-free survival (PFS) time was 40 (range 24–55) months. Further, a comparison of patients with survivin positive versus negative tumors, revealed no significant difference for OS, DFS, and PFS (p = 0.45, p = 0.19, p = 0.55, respectively), number of mitoses in 50 HPF (p = 0.14), and tumor size (p = 0.94).In conclusion, survivin was highly expressed in GISTs, although we found no correlation between survivin expression and PFS, DFS and OS, survivin may be a predictive marker in GISTs for disease progression. We believe that additional studies are warranted to determine the clinical significance of survivin expression as a prognostic or predictive marker in patients with GIST.     

Real-world use of osimertinib in non–small cell lung cancer: ASTRIS study Korean subgroup analysis

Abstract

Objective: ASTRIS is a large real-world, open-label, multinational clinical study of osimertinib in patients with epidermal growth factor receptor (EGFR) T790M mutation-positive advanced non-small cell lung cancer (NSCLC) who have previously received a tyrosine kinase inhibitor (TKI). We report data from the Korean ASTRIS subgroup.

Methods: Adult patients with locally advanced or metastatic NSCLC with a confirmed T790M mutation, WHO performance status of 0–2 and prior EGFR-TKI therapy, received osimertinib 80?mg once daily. Efficacy outcomes were overall survival (OS), investigator-assessed response rate (RR) and progression-free survival (PFS), and time to treatment discontinuation (TTD).

Results: At data cut-off (20 October 2017), 466 Korean patients were enrolled. Baseline EGFR molecular testing was mainly performed on biopsied tissue (75.1%). Baseline mutations co-occurring with T790M included exon 19 deletions (60.7%) and L858R (32.8%). 1-year OS was 82.7% (OS data not matured at data cut-off). Overall, RR was 71.0%, median PFS was 12.4?months and median TTD was 15.0?months. In patients with/without CNS metastases, RR was 68.0% and 79.6%, respectively; median PFS, 10.8 and 11.0?months, respectively; and median TTD, 11.2 and 14.7?months, respectively. Overall, 31.1% of patients experienced ≥1 adverse event (AE), leading to dose modification (12.0%), discontinuation (5.2%) or death (2.8%). Serious AEs (24.9%) included pulmonary embolism (1.7%), pleural effusion (1.7%), and pneumonia (1.5%).

Conclusion: In this real-world subgroup analysis of Korean patients in the ASTRIS study, osimertinib demonstrated comparable clinical efficacy to that attained in the global ASTRIS study and other clinical trials, with no new safety concerns.     

子宫颈神经内分泌癌16例临床病理特征及预后影响因素分析

目的　探讨影响子宫颈神经内分泌癌（NECC）预后的因素。方法　回顾性分析2012年7月至2021年8月广州医科大学附属第三医院收治的16例NECC患者的临床病理资料,进行单因素及多因素生存分析。生存率比较采用log-rank检验,用Cox比例风险模型进行多因素预后分析。结果　患者年龄23～63（42.94±1.2）岁,中位年龄44.5岁,肿瘤长径1.0～10.0（5.03±1.9）cm。单一型NECC 10例,鳞状细胞癌伴NECC 4例,腺癌伴NECC 2例。13例行广泛全子宫+双附件切除+盆腔淋巴结清扫术（其中5例接受新辅助化疗）,1例未手术者仅放疗1次放弃治疗,2例妊娠合并NECC均行剖宫产+全子宫切除术（1例接受化疗,1例放弃术后放化疗）。16例患者获得最终随访,随访时间2～97个月。15例手术患者中,6例无复发及转移,1例发生盆腔转移仍带瘤生存,8例死于多发转移所致的多器官功能衰竭（4例肺、肝、腰骶椎、骨盆转移,4例腹腔、膈角、纵隔、锁骨下多发淋巴结转移）;1例未手术ⅣB期患者随访3个月因多器官功能衰竭死亡。单因素分析显示,年龄（≥40岁）、术后化疗、盆腔淋巴结转移、国际妇产科联盟（FIGO）分期（>ⅡA期）是影响无进展生存期（PFS）及总生存期（OS）的因素（均P<0.05）。Cox回归模型多因素分析表明,FIGO分期>ⅡA期（HR=0.168,95%CI：0.038～0.743,P=0.019）是影响PFS的唯一独立因素,术后化疗（HR=5.034,95%CI：1.137～22.282,P=0.033）是影响OS的唯一独立因素。结论　NECC预后与肿瘤分期及术后化疗有关,提高肿瘤早诊早治率,可使患者生存受益,即使早期患者也建议术后辅助化疗,对于改善预后具有重要意义。     

肝动脉灌注化疗（HAIC）在不可切除结直肠癌肝转移多线治疗耐药后的疗效分析

目的 探讨肝动脉灌注化疗（HAIC）在不可切除结直肠癌肝转移多线治疗耐药后的疗效和安全性。方法 收集本院2020年7月至2021年12月行HAIC治疗不可切除结直肠癌肝转移患者24例,其中既往经过二线治疗的患者14例,经过三线及以上治疗的患者10例,HAIC治疗每3~4周1次,追踪观察患者的客观缓解率（ORR）、疾病控制率（DCR）、无进展生存期（PFS）、总生存期（OS）和不良反应（AE）,并将影响预后的临床特征进行单因素和多因素分析。结果 24例患者共行56次HAIC治疗,其中2例行1次治疗,14例行2次治疗,6例行3次治疗,2例行4次治疗,ORR为16.7%（4/24）,DCR为62.5%（15/24）,3~4级AE发生率41.7%（10/24）,中位无进展生存期（mPFS）3.4个月,中位生存期（mOS）13.6个月。单因素分析显示,肿瘤数目、肿瘤最大直径、肝外转移及ECOG评分与预后相关（P<0.05）。多因素分析发现,肿瘤数目、肿瘤最大直径、ECOG评分为影响预后的独立危险因素（P<0.05）。结论 HAIC在不可切除结直肠癌肝转移多线治疗耐药后有一定的疗效,不良反应可接受。对于仅有肝内转移,且肿瘤数目较多、肿瘤直径较大、体力状况好的患者能从HAIC中获益;对于存在肝外转移的患者,还需要联合全身静脉化疗。     

基因检测指导Ⅱ、ⅢA期非小细胞肺癌术后辅助化疗的临床研究

目的 探讨以基因检测为指导的非小细胞肺癌 （NSCLC） 术后个体化治疗的效果。方法 将接受全胸腔镜肺癌根治术的Ⅱ、 ⅢA 期 NSCLC 患者 56 例随机分为个体化治疗组 26 例和非个体化治疗组 30 例, 取个体化治疗组患者新鲜肿瘤组织进行基因检测, 检测靶标包括切除修复交叉互补复合体 1(ERCC1)、 核苷酸还原酶亚单位 1 (RRM1)、 β微管蛋白Ⅲ、 胸苷酸合成酶(TS)、 表皮生长因子受体(EGFR)、 乳腺癌敏感蛋白 1 （BRCA1） 等。个体化治疗组根据检测结果制定化疗方案, 非个体化治疗组采用 “吉西他滨+顺铂” 方案, 比较 2 组 1 年、 2 年无疾病生存率 （DFS）、疾病无进展生存期(PFS)和总生存期(OS)。结果 个体化治疗组 2 年 DFS （57.69%）、 PFS （月： 22.1±5.0） 和 OS （月： 24.1±3.2） 均高于非个体化治疗组 （分别是 30.00%、 18.9±6.2、 21.9±4.3, 均 P < 0.05）; 2 组 1 年 DFS （88.46% vs 83.33%）差异无统计学意义。结论 基于基因检测的个体化治疗可以提高 NSCLC 术后的 2 年 DFS、 PFS 和 OS, 提高化疗的有效率。     

Long-term survival of high-risk melanoma patients immunized with a Hyper-IL-6-modified allogeneic whole-cell vaccine after complete resection

Objective: Two single arm, Phase II trials (3 and 5) were undertaken to determine the efficacy and toxicity of an adjuvant treatment using Hyper-IL-6 gene-modified whole-cell allogeneic melanoma vaccine in patients with stage IIIB–IV resected disease.

Research design and methods: Ninety-seven and 99 patients were enrolled into Trials 3 and 5, respectively. The primary endpoint was disease-free survival (DFS), and the secondary was overall survival (OS). Vaccine was administered eight times every 2 weeks (induction), every month (maintenance) until patient's death. At progression, maintenance was continued or induction was repeated followed by maintenance.

Results: Median follow-up was 10.5 and 6.2 years for Trials 3 and 5, respectively. No grade 3 or 4 toxicities were observed. An extension of DFS and OS was observed, when compared with historical non-treated controls. DFS probability at 5 years for Trials 3 and 5 was, respectively, 54.8% and 40.6% for stage IIIB, 25.0% and 24.0% for IIIC, and 8.5% and 17.7% for IV. OS probability at 5 years was, respectively, 66.7% and 56.3% for IIIB, 43.8% and 39.8% for IIIC, and 26.1% and 41.2% for IV.

Conclusions: Continuous vaccination, regardless of the disease progression, re-induction, and immunization of patients until death resulted in patients a long-term survival.     

吉非替尼治疗老年非小细胞肺癌化疗后脑转移的效果分析

目的 研究探讨吉非替尼治疗老年非小细胞肺癌化疗后脑转移的效果及安全性.方法 选择本院2009年6月至2012年6月收治的年龄≥60岁的非小细胞肺癌伴脑转移患者42例,均应用吉非替尼治疗,观察颅内外病灶的近期疗效及远期疗效(疾病进展时间TTP曲线及总生存时间OS曲线),并分析不同临床病理参数下中位TTP和中位OS,以评价吉非替尼治疗的控制效果.结果 42例患者颅内病灶RR率为33.3％,DCR率为97.6％;颅外病灶RR率为31.0％,DCR率为92.9％.42例患者中,有4例患者未进展,38例进展,平均中位TTP为245 d;截止到随访终止日或死亡日期,4例存活,38例死亡,平均中位OS为590 d,1年内生存率为76.2％(32/42),2年内生存率为11.9％(5/42).经统计,不同年龄段、性别、吸烟史、发生脑转移的时间、脑转移灶数目、吉非替尼治疗时机、放疗时间方面,均为影响TTP和OS的独立危险因素.结论 吉非替尼治疗老年非小细胞肺癌化疗后脑转移的效果值得肯定,安全性较好,其中以单发脑转移、一线治疗时机、同步放疗等患者应用吉非替尼治疗控制效果更好.     

同步整合加量调强联合选择性淋巴结照射根治性治疗食管鳞癌的长期预后分析

目的 探讨同步整合加量调强（SIB-IMRT）联合选择性淋巴结照射（ENI）加或不加化疗根治性治疗食管鳞 癌患者的长期预后。方法 对130例接受根治性放（化）疗的食管鳞癌患者进行回顾性分析，分析患者的长期生存情 况及其预后影响因素、治疗失败模式和不良反应情况。结果 所有患者1、3、5年总生存（OS）率和无进展生存（PFS） 率分别为81.5%、52.7%、39.8%和70.7%、40.6%、35.8%，中位OS期和PFS期分别为36.37个月和23.89个月。多因素 Cox分析显示，cT3期、cN1期、未接受化疗和GTV-V＞37.0 cm3为影响患者OS的独立危险因素，cT3期为影响患者PFS 的独立危险因素（P＜0.05）。所有患者出现局部区域复发39例（30.0%），远隔部位转移20例（15.4%），其中两者并存 4例；单纯局部区域复发的35例患者中原食管病变局部复发32例，区域淋巴结复发1例，食管局部联合区域淋巴结复 发2例。所有患者治疗期间及治疗后未出现≥4级相关不良反应。化疗组患者的≥2级不良反应发生率与未化疗组患 者差异无统计学意义。结论 SIB-IMRT联合ENI治疗食管鳞癌患者安全有效，对一般情况较好的患者可予以联合 化疗。     

A retrospective observational analysis to evaluate the off-label use of bevacizumab alone or with irinotecan in recurrent glioblastoma

Background Recurrent glioblastoma is nearly always fatal, with median survival rates of approximately 12–14 months. Previous phase II clinical trials showed promising results with bevacizumab, alone or in combination with irinotecan, in patients with recurrent glioblastoma. Objective To assess whether the survival of patients with recurrent glioblastoma receiving bevacizumab alone or with irinotecan in everyday practice is comparable to that reported in clinical trials. Setting This was a retrospective observational study conducted at a single hospital in Italy. Method Patients with recurrent glioblastoma who had received bevacizumab alone or with irinotecan from January 2009 to September 2011 were included in our study. Main outcome measure Progression-free survival (PFS) and overall survival (OS), and rates of PFS and OS at 6 months. Results Median PFS was 5.1 months in the bevacizumab group (n = 9) and 15.4 months in the bevacizumab + irinotecan group (n = 10), with 6-month PFS rates of 45 and 69 %, respectively. Median OS was 6.8 months for bevacizumab alone and 11.1 months for bevacizumab + irinotecan, with 6-month OS rates of 100 and 90 %, respectively. Conclusion Although the number of patients included is not sufficient to allow a conclusive statement about the place of bevacizumab in the treatment of recurrent glioblastoma, the data appear promising, and are consistent with the results of clinical trials.     

调强放射治疗局部晚期鼻咽癌489例远期预后影响因素及晚期安全性研究

目的 探讨行调强放射治疗（IMRT）初治局部晚期鼻咽癌远期预后影响因素及晚期安全性。方法 回顾性纳入2012年1月至2017年12月于梅州市人民医院行IMRT一线治疗的局部晚期鼻咽癌病人共489例，分析随访生存情况、复发转移及晚期损伤情况，采用单因素和多因素评价局部区域控制率、总生存（OS）率及无复发生存（DFS）率独立影响因素。结果 489例病人随访5年局部区域控制率为92.64%(453/489),5年DFS率为84.05%(411/489),5年OS率为91.00%(445/489)。随访过程中死亡65例，其中因局部区域复发死亡25例，因远处转移死亡35例，因其他事件死亡5例。随访3～4级晚期损伤发生率为2.04%(10/489)；单因素分析结果显示，临床分期与IMRT一线治疗局部晚期鼻咽癌病人5年局部区域控制率有关（P<0.05）；性别、EB DNA拷贝数、临床分期及N分期均与IMRT一线治疗局部晚期鼻咽癌病人5年DFS率有关（P<0.05）；年龄、EB DNA拷贝数、临床分期及N分期均与IMRT一线治疗局部晚期鼻咽癌病人5年OS率有关（P<0.05）。Cox...     

50例套细胞淋巴瘤临床特征与预后的回顾性分析

目的 分析和探讨套细胞淋巴瘤(MCL)的临床特点、免疫表型与预后的影响因素.方法 回顾性分析50例MCL病人的临床资料、临床特征、生物学指标及治疗方案对总有效率(ORR)、无进展生存时间(PFS)、总生存期(OS)的影响.结果 50例MCL病人中位发病年龄62岁,男女比例3.5∶1,Ann-Arbor 分期Ⅲ~Ⅳ期病人为41例(82.0%).骨髓累及者19例(38.0%),消化道侵犯者11例(22.0%).50例病人中位生存期为61.0个月,中位无进展生存期为33.0个月.46例病人接受化疗,其中有18例病人使用化疗加利妥昔单抗;接受含与不含利妥昔单抗化疗的预期总生存期分别为74.0个月及46.5个月,差异无统计学意义(P=0.456).全组2、3、5年生存率分别为81.3%、72.0%、54.5%,2、3年无进展生存率分别为57.8%、46.7%.白细胞计数(WBC)与乳酸脱氢酶(LDH)水平高于正常、Ki-67≥30%、CD5(+)、MUM-1(-)均提示预后不良.多因素生存分析结果仅显示LDH水平(P=0.039),Ki-67≥30%(P=0.001)对MCL的预后差异有统计学意义,为MCL病人长期生存的独立影响因素.结论 MCL多发于老年男性,临床生物学行为具有侵袭性,常结外侵犯.治疗完全缓解率低,无疾病进展时间短,预后不佳.WBC与LDH高于正常、Ki-67≥30%、CD5(+)、MUM-1(-)是预后不良因素.LDH水平、Ki-67≥30%为MCL病人长期生存的独立影响因素.     

Survivin expression and its potential clinical significance in gastrointestinal stromal sarcoma

This study was designed to determine the level of survivin expression and its clinical significance as a prognostic factor in gastrointestinal stromal sarcoma (GIST). Twenty patients (12 males and 8 females) ranging in age from 25 to 72, with a median age of 53 were evaluated. Failure of TKI treatment was higher in the survivin-positive group (p = 0.06). The rate of metastasis was significantly higher in the survivin positive group vs. the negative group (80% vs. 30%, p = 0.18). The median overall survival (OS) time was 114 (range 29–199) months, and the median disease-free survival (DFS) time was 88 (range 40–135) months. The median progression-free survival (PFS) time was 40 (range 24–55) months. Further, a comparison of patients with survivin positive versus negative tumors, revealed no significant difference for OS, DFS, and PFS (p = 0.45, p = 0.19, p = 0.55, respectively), number of mitoses in 50 HPF (p = 0.14), and tumor size (p = 0.94).In conclusion, survivin was highly expressed in GISTs, although we found no correlation between survivin expression and PFS, DFS and OS, survivin may be a predictive marker in GISTs for disease progression. We believe that additional studies are warranted to determine the clinical significance of survivin expression as a prognostic or predictive marker in patients with GIST.     

Treatment outcome of docetaxel,capecitabine and cisplatin regimen for patients with refractory and relapsed nasopharyngeal carcinoma who failed previous platinum-based chemotherapy

Objective: Although cisplatin combined with 5-fluorouracil is a common first-line regimen for advanced nasopharyngeal carcinoma (NPC), there are no standard regimens for refractory or relapsed patients. A study of DXD regimen [cisplatin (D), capecitabine (X) and docetaxel (D)] was conducted to evaluate the efficacy and toxicity for patients with refractory or relapsed NPC.

Methods: The regimen was administered as follows: 50 mg/m² docetaxel and 50 mg/m² cisplatin on day 1 and 800 mg/m² capecitabine on days 1 – 14, repeated every 3 – 4 weeks.

Results: Thirty patients were enrolled. The overall response and complete remission rate was 46.4 and 21.4%. Median follow-up was 24 months; median overall survival (OS) and progression-free survival (PFS) were 14.0 and 8.0 months. Five-year OS and PFS rates were 14.8 and 13.3%, respectively. Four patients achieved long-term tumor-free survival (range, 53.8 – 125.3 months). Multivariate analysis demonstrated that Epstein–Barr virus DNA status (p = 0.003) and therapeutic effect (p < 0.001) were significant independent factors for OS and PFS. The main grade 3/4 toxicities included neutropenia (26.6%), anemia (13.3%) and thrombocytopenia (10.0%). There were no chemotherapy-related deaths.

Conclusion: The DXD regimen appeared to be effective and well tolerated by patients with refractory or relapsed NPC. Further investigation is warranted.     

Pixantrone,etoposide, bendamustine,rituximab (P[R]EBEN) as an effective salvage regimen for relapsed/refractory aggressive non-Hodgkin lymphoma—Polish Lymphoma Research Group real-life analysis

BackgroundDespite a significant improvement in treatment outcomes, 30–40% of aggressive non-Hodgkin lymphomas (NHL) patients are refractory or relapse after the first line therapy. Half of them are not eligible to autologous stem cell transplantation (ASCT) due to failure of platinum-based salvage regimens. Pixantrone is conditionally approved in Europe in patients with R/R aggressive NHL failing at least 2 previous lines of therapy. Polish Lymphoma Research Group (PLRG) evaluated the efficacy and tolerability of P[R]EBEN combining pixantrone, etoposide, bendamustine with or without rituximab), a new regimen developed recently by Francesco d’Amore, in real-life experience.MethodsIn this retrospective audit, we analyzed the data of consecutive 25 R/R NHL cases, treated with P[R]EBEN regimen in 9 PLRG centers. Safety and efficacy data, including adverse reactions (AE), response rates, progression-free and overall survival (PFS and OS) were collected.ResultsOverall response rate (ORR) to P[R]EBEN regimen was 68% (40% CR and 28% PR). Most patients responded, relatively early, by second cycle of therapy. P[R]EBEN was effective in 8 out of 15 patients (53%) refractory to previous platinum-based salvage regimens. In 4 patients (16%) stabilization of disease (SD) during therapy was observed and further 4 patients (16%) progressed during the treatment (PD). Response rates were higher in patients, chemosensitive to their prior regimen (ORR – 87.5%, including 50% CR). At the median follow-up of 7.5 months (range 1–16) the median PFS and OS were not reached. Projected PFS and OS at 12 months are 68% and 78% respectively. The P[R]EBEN regimen was well tolerated and most of patients received it as out-patients. AEs grade ≥3 occurred in 17 patients (68%). Most common grade 3–4 AEs were due to hematological toxicity with febrile neutropenia observed in 5 patients (20%). There were no episodes of septic deaths. Six patients (24%) died during treatment and follow-up period, all of them due to lymphoma progression.ConclusionOur data suggest good efficiency and tolerability of P[R]EBEN regimen as a rescue therapy in patients with R/R aggressive NHL.     

Comparative effectiveness of everolimus and axitinib as second targeted therapies for metastatic renal cell carcinoma in the US: a retrospective chart review

Background Second targeted therapies for metastatic renal cell carcinoma (mRCC) include mammalian target of rapamycin inhibitors (mTORis) and tyrosine kinase inhibitors (TKIs). This observational study compares overall survival (OS) and progression-free survival (PFS) of patients treated with everolimus (an mTORi) and axitinib (a TKI) following first TKI, and assesses the impact of type and duration of first TKI on the relative effectiveness of these second targeted therapies.

Methods Retrospective reviews of medical records were conducted by medical oncologists or hematologists/oncologists recruited from a nationwide panel. Included patients with mRCC were required to have discontinued a first TKI (sunitinib, sorafenib, or pazopanib) for medical reasons, and to have initiated everolimus or axitinib as second targeted therapy between February 2012 and January 2013. OS and PFS were compared between patients treated with everolimus vs. axitinib using multivariable Cox proportional hazards regression models. Comparative results were also stratified by type and duration of first TKI.

Results Included patients (n?=?325 for everolimus and n?=?127 for axitinib) had a mean age of 61 years and 31% were female. Sunitinib was the most commonly used first TKI (73%). After adjusting for patient characteristics, no statistically significant differences were observed in OS or PFS between everolimus and axitinib. When stratifying by type and duration of first TKI, there was no statistically significant difference in OS between everolimus and axitinib in all subgroups except for patients with?<6 months on sunitinib or sorafenib as first TKI. No significant difference in PFS was observed in any subgroup.

Limitations Important limitations include potential missing or inaccurate data in medical charts, and confounding due to unobserved factors.

Conclusions In this retrospective chart review, no significant differences were detected in OS or PFS between axitinib and everolimus as second targeted therapy. Longer duration of first TKI was not associated with increased effectiveness of subsequent axitinib compared to everolimus.     

Impact of intraoperative MRI-guided resection on resection and survival in patient with gliomas: a meta-analysis

Objective: This study addressed the benefit of intraoperative magnetic resonance imaging (iMRI) compared with conventional neuronavigation-guided resection in patients with gliomas.

Research design and methods: The Medline, PubMed, Cochrane, and Google Scholar databases were searched up to 26 September 2015. Randomized controlled trials (RCTs), two-arm prospective studies, and retrospective studies in patients with glioblastoma/glioma who had received surgical treatment were included.

Main outcome measures: The primary outcome measures were the extent of tumor resection and tumor size reduction for using iMRI-guided or conventional neuronavigation-guided neurosurgery. Secondary outcomes included impact of surgery on 6 month progression-free survival (PFS), 12 month overall survival (OS) rates and surgical duration.

Results: We found that iMRI was associated with greater rate of gross total resection (rGTR) compared with conventional neuronavigation procedures (3.16, 95% confidence interval [CI] 2.07–4.83, P?P values ≥.065). Intraoperative MRI was associated with a higher rate of progression-free survival (PFS) compared with conventional neuronavigation (odds ratio, 1.84; 95% CI 1.15–2.95; P?=?.012), but the rate of overall survival (OS) between groups was similar (P?=?.799). Limitations of the study included the fact that data from non-RCTs was used, the small study population, and heterogeneity of outcomes across studies.

Conclusions: Our findings indicate that iMRI more frequently resulted in more complete resections leading to improved PFS in patients with malignant gliomas.     

可溶性耐药相关钙结合蛋白在乳腺癌组织中的表达及预后

目的：研究可溶性耐药相关钙结合蛋白（Soluble resistiince-related caLcittmbinding protein，Sorcin）在乳腺癌组织中的表达，评估其在乳腺癌预后中的作用。方法：采用免疫组织化学方法（IHC）检测47例手术切除的乳腺癌组织中Sorcin的表达．并分析其与临床、病理特征的关系及对预后的影响。结果：（1）Sorcin在乳腺癌组织中的阳性表达率为85．1％（40／47例），其中高表达27例（57．4％）；（2）Sorcin与月经状况、肿瘤大小、淋巴结转移、组织分级和雌激素受体状况差异均无显著性（P〉0．05），但与孕激素受体状况似有一定关系（P〈0．05）；（3）Kaplan-Meier生存分析结果表明Sorcin表达与无瘤生存期和总生存期差异均无显著性（P〉0．05）；（4）COX多因素分析显示肿瘤大小、淋巴结转移与无瘤生存期及总生存期明显相关（P〈0．05），组织分级也与无瘤生存期明显相关（P〈0．05）。结论：Sorein在乳腺癌组织中具有高表达。但与乳腺癌患者无瘤生存期和总生存期均无关。     

Adenocarcinoma histology is a poor prognostic factor in locally advanced cervical cancer

Objective: This retrospective study aimed to compare prognostic factors and survival between adenocarcinoma (AC) and squamous cell carcinoma (SCC) in locally advanced cervical cancer treated at a single center.

Methods: All medical records of cervical cancer patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIB or IIIA,B, treated between 2004 and 2012, were reviewed. We treated patients with chemoradiotherapy (CRT) followed by brachytherapy (BT). Multivariate logistic regression and Cox proportional hazard models were used to analyze clinicopathological characteristics, patterns of care and outcomes.

Results: We included in the analysis 161 patients (52 AC; 109 SCC). Patients with AC were younger (age 50 vs. 55?years), more likely to die from the disease (HR: 1.60; 95% CI: 1.26–2.58; p?=?.001) and to have disease recurrence (HR: 1.69; 95% C.I: 1.21–2.12; p?=?.004) than those with SCC. The other significant prognostic factors for overall survival (OS) and recurrence-free survival (RFS) in AC were FIGO stage (p?=?.001; p?=?.002), WHO status (0 vs. 1–3; p?=?.003; p?=?.04), and hemoglobin level (<12?g/dl>; p?=?.04; p?=?.02). The 5?year overall survival for stage II of AC and SCC was 63% and 82% (p?=?.03), and for IIIA,B it was 33.6% and 73% (p?=?.0005). The 5?year RFS for AC and SCC stage FIGO IIIA,B was 24% and 57% (p?=?.001).

Conclusions: Adenocarcinoma histology negatively impacts OS and RFS for advanced cervical cancer. Histology-specific therapy may be an opportunity for survival improvement in these women.     

Prognostic value of the MicroRNA‐29 family in multiple human cancers: A meta‐analysis and systematic review

MicroRNAs (miRNAs) in cancer development have attracted much attention in recent years. miR‐29 is known to critically affect cancer progression by functioning as a tumor suppressor. However, it may also act as an oncogene under certain situations. The prognostic value of the miR‐29 family in cancer progression is still under debate and reported results are inconsistent. Therefore, we reported here a meta‐analysis and systematic review to analyze the prognostic role of the miR‐29 family in cancer. We screened 20 published studies and calculated pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for overall survival (OS) or disease‐free survival/recurrence‐free survival (DFS/RFS). Our results showed that a low or absent expression of miR‐29 family was significantly associated with poor OS (HR, 1.57; 95%CI, 1.18‐2.08), and inferior to 5‐year DFS/RFS (HR, 1.89; 95%CI, 1.47‐2.44). Analysis of individual miR‐29 subtypes indicated that the low expression of miR‐29a/b/c subtypes correlated with poor 5‐year OS (miR‐29a: HR, 1.99; 95%CI, 1.41‐2.80; miR‐29b: HR, 1.60; 95%CI, 1.18‐2.17; miR‐29c: HR, 1.69; 95%CI, 1.00‐2.86), as well as poor 5‐year DFS/RFS (miR‐29b: HR, 1.70; 95%CI, 1.27‐2.27). Ethnicity analysis demonstrated Asian patients with low expression of miR‐29 were significantly correlated with poor OS (HR, 1.61; 95%CI, 1.16‐2.23) and 5‐year DFS/RFS (HR, 2.03; 95%CI, 1.50‐2.74). Taken together, our analysis indicates that the low expression of miR‐29 is associated with aggressiveness and poor prognosis of malignant neoplasms. More importantly, miR‐29 might serve as a key biomarker for predicting the recurrence and progression of human cancers.