EGFR expression as a predictive marker in esophageal squamous cell cancer:Review article

Esophageal cancer（ EC ） is a highly aggressive disease and 8＇h leading cause of death worldwide. Squamous cell cancer is the main histological type in China. Recent improvements in both surgical techniques and adju- vant/neoadjuvant radiotherapy and chemotherapy approaches have increased the survival of patients with the loco- regional disease. However, most of the patients with EC have advanced disease either at diagnosis or at follow-up. Despite recent advances in the treatment, these patients still do poorly. Over expression of the epidermal growth factor receptor in esophageal the role of epidermal growth cancer is associated with poor prognosis. However, very few researches have examined factor receptor（EGFR） in prediction and therapeutic sensitivity to esophageal squamous cell cancer（ESCC）. If pretherapeutic identification of esophageal squamous cell cancer which does not re- spond to chemoradiotherapy （CRT） can be done, it will help to improve the outcome of patients by selecting responders to treatment. In this review we describe the predictive significance of EGFR expression in ESCC.     

Prognosis of R1-resection at the bronchial stump in patients with non-small cell lung cancer

Background The prognosis of R1-resection at the bronchial stump in patients with non-small cell lung cancer （NSCLC） remains unclear.This study intends to identify the prognostic factors and to optimize treatments for these patients under update conditions.Methods The data of 124 NSCLC patients who underwent R1-resection at the bronchial stump was reviewed.There were 41 patients in the surgery group （S）,21 in the postoperative radiotherapy （PORT） group （S＋R）,30 in the postoperative chemotherapy （POCT） group （S＋C）,and 32 in the PORT plus POCT group （S＋R＋C）.The constitute proportion in different groups was tested using the X2 method,univariate analysis was performed using the Kaplan-Meier and log-rank method,and multivariate analysis was done using the Cox hazard regression with entry factors including age,sex,pathological type and stage,classification of the residual disease,and treatment procedure.The process was performed stepwise backward with a maximum iteration of 20 and an entry possibility of 0.05 as well as an excluded possibility of 0.10 at each step.Results In univariate analysis,survival was more favorable for patients with squamous cell carcinoma,early pathological T or N stage,and chemotherapy or radiotherapy.There was no significant difference in the survival for patients with different types of the residual disease,except for the difference between patients with carcinoma in situ and lymphangiosis carcinomatosa （P=0.030）.The survival for patients receiving chemoradiotherapy was superior to that for those undergoing surgery alone （P=0.016）.In multivariate analysis,the pathological type （HR 2.51,95% CI 1.59 to 3.96,P=0.000）,pathological T （HR 1.29,95% CI 1.04 to 1.60,P=-0.021） or N stage （HR 2.04,95% CI 1.40 to 2.98,P=0.000）,and chemotherapy （HR 0.24,95% CI 0.13 to 0.43,P=0.000） were independent prognostic factors.Conclusion Patients with squamous cell carcinoma,early pathological T or N stage,or receiving chemotherapy had a more favorable pro     

胆管细胞癌的影像学表现

胆管细胞癌临床上较少见,由于其影像表现缺乏特征性,容易误诊。现将我院经手术及病理证实的26例胆管细胞癌进行回顾性分析,探讨其影像学表现的特点,提高诊断水平。1材料与方法1.1临床资料本组26例中男性18例,女性8例,年龄45岁~72岁,平均年龄56岁。26例均出现黄疸,上腹痛、腹胀15例,低热8例,AFP均为阴性。1.2方法采用日立公司PRATICO全身螺旋CT机,常规平扫+强化,扫面层厚为5 mm,层距为5 mm,部分病例2 mm薄层扫描,强化常规行双期扫描及延时扫描。磁共振为日立0.3T 7000AD,常规SE序列及MRCP。2结果发生于肝内胆管者10例,其中肝右叶为4例,肝左叶为6例。10例肝内胆管细胞癌CT均表现为不规则低密度病灶,大小3 cm~7 cm,形态不规则,边界不清,其远侧肝内胆管均有扩张。强化扫描,动脉灶不强化者7例,轻微略强化者3例。静脉期逐渐强化,延时扫描呈线状或索条状强化者5例,表现为“枯藤征”者5例。合并肝叶萎缩者5例,肝内胆管结石1例,腹水4例,肝硬化及肝门区肿大淋巴结者各2例,3例行MR I检查,病变均表现为T1W I像呈不规则低信号,T2W I像呈略高混杂性信号灶,边界不清,...     

MET 激酶在非小细胞肺癌中的活化

1文献来源 研究一：Qiao H,Hung W,Tremblay E,et al.Constitutive activation of met kinase in non-small-cell lung carcinomas correlates with anchorageindependent cell survival[J].J Cell Biochem,2002,86（4）：665-677.     

非小细胞肺癌患者MET表达水平是MET单抗的预后预测因素

1文献来源 Koeppen H,Yu W,Zha JP,et al.Biomarker analyses from a placebo-controlled phaseⅡstudy evaluating Erlotinib±Onartuzumab in advanced non-small-cell lung cancer：MET expression levels are predictive of patient benefit[J].Clin Cancer Res,2014,Mar 31[Epub ahead of print].DOI：10.1158/1078-0432.CCR-13-1836.     

Surgical treatment of 21 patients with spinal metastases of differentiated thyroid cancer

Background Differentiated thyroid cancer （DTC） is a common primary cancer for spinal metastases （SM）.The treatments for DTC spinal metastases （SM） have evolved from simple surgery and radiotherapy to a multidisciplinary comprehensive therapeutic strategy of combined spinal surgery,general surgery,radiotherapy,nuclear medicine and endocrinology.The purpose of this study was to discuss the efficacy and prognosis associated with different surgical treatments of SM patients with DTC.Methods A total of 21 consecutive patients with SM of DTC that were treated between 1999 and 2013 were studied.Biopsy was routinely performed to achieve the pathological diagnosis before treatment.Three patients underwent total spondylectomy intralesionally or piecemeally,and 18 had curettage.Postoperative recurrence and survival times were analyzed by the Kaplan-Meier methods.Results Nineteen patients （90％） had an average of 42.7 months （range,7-170 months） follow-up.The median visual analogue scale for pain reduced from 5 points to 1 point （P ＜0.01）,and the median Karnofsky performance score increased from 70 to 90 points after surgery （P ＜0.01）.Seventeen patients with neurological deficits attained improvements after surgeries,of at least one level according to the Frankel classification （P ＜0.01）.Eight patients with curettage had recurrence.Four patients died of DTC,12 patients lived with disease,and three patients were disease-free.No significant effects on postoperative recurrence or survival were observed between surgery combined with conservative treatment,total spondylectomy,the number of bone metastases and visceral metastasis.Conclusions DTC-SM have a relatively favorable prognosis,and curettage and stabilization can effectively relieve the pain and improve the quality of life and neurological status of the patients.For patients with Tomita scores of ＜3,total spondylectomy may have better clinical outcomes.Comprehensive therapeutic strategies including surgery,radioiodine,external beam     

肝动脉化疗栓塞术联合其他疗法在肝癌治疗中的应用概述

原发性肝癌（primary hepatic carcinoma．PHC）是威胁人类健康的重大疾病之一，其发病特点较隐匿，发现时多已失去手术机会。由于肝脏具有双重供血功能，肝脏肿瘤主要由肝动脉供血，而正常肝组织主要靠门静脉供血．因此肝动脉化疗栓塞术（transcatheter arterial chemoembolization，TACE）仍被公认为是肝癌非手术治疗的首选方法。为进一步提高疗效，在TACE术治疗基础上配合其他方法联合治疗PHC已成为近年来新的研究热点。     

Nursing of advanced colorectal cancer patients treated with Cetuximab combined with chemotherapy

Cetuximab is a new medication that has recently been approved for the treatment of advanced colorectal cancer. To date we have had little experience in using this targeted agent. Eleven patients in our hospital with advanced colorectal cancer were treated with cetuximab and chemotherapy. Based on the curative effect of this combination therapy, we have concluded that the following nursing practices make an important contribution to the patients＇ prognosis and wellbeing： to establish a good nurse-patient relationship, to increase patient understanding of the side effects, to standardize the medications, to observe and to deal with the side effects of the medications（for example skin reaction, neutropenia, and diarrhea）, and to provide continuous mental health care support and education.     

金龙胶囊联合肝动脉栓塞化疗治疗胃癌伴肝转移

金龙胶囊是以鲜活药用动物为原料。运用低温冷冻及现代生化技术分离提取工艺制备而成的现代中药，具有抗肿瘤及免疫调节双重作用。上海市东方肝胆外科医院中西医结合科2004年12月～2006年12月应用金龙胶囊联合肝动脉栓塞化疗（transarterial chemoembolization，TACE）治疗胃癌伴肝转移取得满意疗效。     

Polymorphism of methylenetetrahydrofolate reductase gene is associated with response to fluorouracil-based chemotherapy in Chinese patients with gastric cancer

Background The importance of polymorphisms in the methylenetetrahydrofolate reductase （MTHFR） gene for the prediction of the response to fluorouracil-based adjuvant chemotherapy in gastric cancer patients remains unclear. The aim of this study is to assess the predictive value of several polymorphisms of the MTHFR gene for clinical outcomes of gastric cancer patients treated with fluorouracil-based adjuvant chemotherapy in Chinese population. Methods Three hundred and sixty-two Chinese patients with gastric cancer were treated with fluorouracil-based adjuvant chemotherapy. DNA samples were isolated from peripheral blood collected before treatment. The three single nucleotide polymorphisms （SNPs） （rs1801131, rs1801133, rs2274976） genotypes of the MTHFR gene were determined by matrix- assisted laser desorption/ionization time-of-flight mass spectrometry （MALDI-TOF MS）. Results The average response rate for chemotherapy was 46.7%. Homozygous genotypes rs2274976G/G （X2=22.7, P 〈0.01） and rs1801131A/A （X2=14.3, P=0.008） were over-represented in responsive patients. Carriers of the rs2274976A allele genotypes （G/A and A/A） and of the rs1801131C allele genotypes （A/C and C/C）were prevalent in nonresponsive patients. In the haplotype association analysis, there was a significant difference in global haplotype distribution between the groups （X2=20.69, P=0.000 124）. Conclusions These results suggest that polymorphisms of the MTHFR gene may be used as predictors of the response to fluorouracil-based chemotherapy for gastric cancer patients in Chinese population. Well-designed, comprehensive, and prospective studies on determining these polymorphisms of MTHFR gene as clinical markers for predicting the response to fluorouracil-based therapy in gastric cancer patients is warranted.     

超声在胆囊癌诊断中的应用价值

胆囊癌是一种恶性程度较高的肿瘤。临床相对少见,约占全身恶性肿瘤的0.5%～5%。术前诊断符合率仅为23%,预后较差。因病情发展迅速,常较早发生扩散和转移,失去手术机会。早期胆囊癌手术则预后较好,五年生存率可达100%。     

Epidemiological characteristics of thyroid nodules and risk factors for malignant nodules: a retrospective study from 6 304 surgical cases

Background The prevalence of thyroid nodules （TN） is increasing rapidly.This study analyzed the epidemiological and clinical characteristics of TN in surgically treated patients and identified the risk factors for malignant nodules （MN） to provide more understanding of the differential diagnosis of TN.Methods A total of 6 304 TN cases who underwent thyroid surgery were included in this retrospective study.The clinical data were collected to evaluate the clinical and epidemiological characteristics and related risk factors for MN.The nature of TN （benign nodules （BN） or MN）,medical records,laboratory data,and imaging data were analyzed.The risk factors for MN were screened using Spearman＇s rank correlation analysis and nonconditional binary Logistic regression analysis.Results The number of surgically treated TN cases increased yearly.A total of 34.33％ of cases were MN and 65.67％ were BN.Up to 56.74％ of these cases underwent unnecessary surgery.Among the MN cases,papillary thyroid carcinoma accounted for 94％,in which 46.71％ coexisted with benign thyroid disease and 32.28％ with multiple foci.Single-related factor analysis showed that age,employment,disease duration,history of breast nodules and/or hypertension,the levels of serum thyroid-stimulating hormone （TSH）,thyroglobulin antibody （TgAb）,and thyroid peroxidase antibody （TPoAb）,and ultrasound features of TN were related to MN.Stepwise nonconditional binary Logistic regression analysis showed that 13 factors may be the independent risk factors for MN,including ＜40 years old,previous history of breast nodules and/or hypertension,disease duration ＜1 month,employment,hypoechoic nodule,irregular nodules,nodule calcification,solid echo nodule,fuzzy boundary,rich blood flow within nodules,abnormal lymph nodes around the neck,nodule diameter ＜1 cm,and abnormally high TgAb.Conclusions Our results demonstrate a rapid increase in surgically treated TN cases and ratio of MN and indicate unnecessary surgeries in some cases.Thi     

生存质量量表在胃癌疗效评价中的应用进展

胃癌是常见的恶性肿瘤之一。虽然，目前医疗技术的发展和医学整体水平的提高已经明显延长了胃癌患者的生存期，但其带来的各种心理和社会问题越来越受到人们的关注。在胃癌临床疗效评价和预后评估中，除了传统的终点事件，生存质量（quality of life，QOL）的评估已为越来越多的学者所认同。并已经逐步应用于临床。生存质量测定的核心是研制适宜的测评量表，目前在胃癌研究方面，还没肓一个国际公认的测评量表标准。     

MET 基因扩增的肺癌细胞系依赖MET生长和生存

1文献来源 Lutterbach B,Zeng Q,Davis LJ,et al.Lung cancer cell lines harboring MET gene amplification are dependent on MET for growth and survival[J].Cancer Res,2007,67（5）：2081-2088.     

肺癌的客观检测指标与辨证分型相关性研究概述

肺癌,即原发性支气管肺癌,是最常见的肺部原发性肿瘤。临床上,中医药在肺癌的综合治疗中发挥独到的作用。辨证分型是中医辨证论治的基础,但由于对本病病因病机的认识不同,且无客观指标可依,使肺癌辨证分型难以统一标准且不利于中医治法的推广。     

Risk factors for non-sentinel lymph node metastases in breast cancer patients with positive sentinel lymph nodes

The presence or absence of metastases in the axillary lymph nodes has remained the most powerful prognostic factor in breast carcinoma. Axillary lymph node dissection （ALND） is the standard procedure for obtaining this information. However, postoperative complications are common. Sentinel lymph node （SLN） biopsy has been proposed as a potential alternative to ALND for staging breast carcinoma. This technique has been shown to be sensitive and specific for predicting the status of the axillary lymph nodes. Furthermore, it has the potential advantage of decreasing the morbidity associated with ALND.     

Aberrant expression of Wnt antagonist SFRP1 in pancreatic cancer

Pancreatic cancer is one of the malignant tumor with a very poor prognosis. Both genetic and epigenetic alterations are involved in the pathogenetic mechanisms of pancreatic cancer. Hypermethylation and subsequent loss of expression of some tumor suppressor genes and tumor-related genes occur frequently in pancreatic cancer, such as loss of expression of p16, ^1RASSF1A,^2 SOCS-1,^3 and hMLH1^4 genes were repoted.     

乳腺癌保乳手术MRI影像学证据的多中心前瞻性研究

Background This multicenter prospective study aimed to assess the utility of dynamic enhanced magnetic resonance imaging （MRI） prior to breast-conserving surgery for breast cancer.Methods The research subjects were drawn from patients with primary early resectable breast cancer treated in the breast disease centers of six three-level hospitals in Beijing from 1 January 2010 to 31 December 2012.The participants were allocated to a breast-conserving surgery group （breast-conserving group） or a total mastectomy group （total mastectomy group）.Enhanced MRI was used to measure breast volume,longest diameter of tumor and tumor volume.The correlations between these measurements and those derived from histopathologic findings were assessed.The relationships between the success rate of breast-conserving surgery and MRI-and pathology-based measurement results were statistically analyzed in the breast-conserving group.Results The study included 461 cases in the total mastectomy group and 195 in the breast-conserving group.Allocation to these groups was based on clinical indications and patient preferences.The cut-off for concurrence between MRI-and pathology-based measurements of the longest diameter of tumor was set at 0.3 cm.In the total mastectomy group,the confidence interval for 95％ concurrence of these measurements was 35.41％-44.63％.Correlation coefficients for MRI and histopathology-based measurements of breast volume,tumor volume and tumor volume/breast volume ratio were r=0.861,0.569,and 0.600,respectively （all P ＜0.001）.In the breast-conserving group,with 0.30 cm taken as the cut-off for concurrence,the 95％ confidence interval for MRI and pathology-based measurements of the longest diameter of tumor was 29.98％-44.01％.The subjective and objective success rates for breast-conserving surgery were 100％ and 88.54％,respectively.Conclusions There were significant correlations between dynamic enhanced MRI-and histopathology-based measurements of the longest diameter of breast lesions,breas     

Xihuang Pill (西黄丸) Induces Mesenchymal-Epithelial Transition and Inhibits Loss of Apical-Basal Polarity in Colorectal Cancer Cell through Regulating ZEB1-SCRIB Loop

Objective：To investigate the antiproliferative and anti-metastasis effect of Xihuang Pill（西黄丸,XP） on human colorectal cancer cell and to explore the molecular mechanism by which it produces the effects.Methods：Highly metastatic human colorectal cancer cell line LoVo was treated with low-,medium-,and highdose XP-containing serum（XP-L,XP-M,XP-H） groups for 48 h,cells intervened with no drug rat serum and PD98059[extracellular signal-regulated kinase（ERK） inhibitor]as negative and positive controls（NC and PC）groups.Cell proliferation assay was made using cell counting kit-8（CCK8）.The 8 μm pore-size transwell chamber and 4＇,6-diamidino-2-phenylindole（DAPI） staining were applied to examine the ability of invasion and migration of the cells.The protein expression of ERK1/2,zinc finger E-box-binding homeobox 1（ZEB1）,Scrib and lethal giant larvae homolog 2（Lgl2） was detected by Western blotting while the relative mRNA quantity of E-cadherin,N-cadherin,Occludin and junctional adhesion molecule-1（JAM1） was measured by realtime fluorescent quantitative polymerase chain reaction（RT-qPCR）.Results：XP induced a dose-dependent suppression on the proliferation of LoVo cells（P〈0.05 or P〈0.01）,with the inhibition rates varied from 27.30%to31.08%.Transwell assay showed that when preprocessed with PD98059 and XP-containing serum,the number of cells that passed the filter decreased significantly compared with that of NC group（P〈0.05 or P〈0.01）.Moreover,XP inhibited the protein expression of ERK1/2 and ZEB1（P〈0.05）;and up-regulated the protein expression of Scrib and Lgl2（P〈0.05）.The mRNA levels of E-cadherin,Occludin and JAM1 of the XP intervened groups and PC group markedly ascended（P〈0.05） while that of N-cadherin showed a descending tendency（P〉0.05）.Conclusion：XP intervention suppressed the ability of proliferation,invasion and migration of the LoVo cells.Regulating ZEB1-SCRIB Loop so as to recover epithelial phenotype and apical juncti