Experience in the use of gastrofluorography in the Byelorussian SSR

The paper discusses the major stages of long-term studies of the effectiveness of application of gastrofluorography for detection of cancer and precancerous lesions in the stomach conducted during mass screenings in the Byelorussian SSR. The test results for the first Soviet-made on-site gastrofluorographic installation are presented. Successful applications of the installation for both screening and primary detection of the lesions are discussed.     

长链非编码RNA在结直肠癌中的研究进展

长链非编码RNAs(Long non-coding RNAS,lncRNAs)是一类不编码蛋白质,长度大于200个核苷酸的RNA。结直肠癌的发生发展与lncRNA的异常表达密切相关。本文结合近年来国内外的文献报道,对lncRNA在结直肠癌中的表达情况及作用机制做一综述,以期为临床诊断和靶向治疗提供可能的依据。     

男性肺癌血中内分泌激素的测定

 从1991年10月-1993年6月对45岁以上男性，44例正常人和87例肺癌患者血中8种内分泌激素进行测定，肺癌病人治疗前Cort、β-HC、Gluc和PRL明显高于正常人群。87例肺癌治疗前按不同病理比较，腺癌β-HCG明显高于其它病理类型，鳞癌PRL高于其它，小细胞未分化Gast高于其它。43例肺癌治疗后，TSH、PRL、Cort和Glue都明显降低，而GH则升高，11例治疗后肿瘤复又增大或远处转移的肺癌患者，再次测定激素水平表明，PRL、Cort和Glue复又升高。这些结果说明部分内分泌激素，可用于男性肺癌的早期诊断或鉴别诊断，有些激素可作为肺癌病理分类的参考。     

Practice pearls in the management of lung cancer in the elderly

Lung cancer is a disease that afflicts the elderly. It is a leading cause of cancer mortality worldwide. Treatment of lung cancer which was predominantly combination chemotherapy was initially thought to be too toxic for older patients with cancer due to their frail state. However a number of recent studies have shown that this is not necessarily true and many elderly can actually tolerate combination chemotherapy and derive just as much benefit from it as younger patients with lung cancer do. More recently it has been found that a significant proportion of lung cancer patients have tumors that harbor mutations that are targetable by molecularly targeted therapy (MTT). These targeted therapies have a much better tolerated side effect profile, hence have been used in elderly patient with lung cancer with great success. A new generation of drugs called immune checkpoint inhibitors have now come into the fray with exciting results in the second line treatment of lung cancer with a low side effect profile. A key element in deciding whether an elderly patient with lung cancer can tolerate treatment involves a detailed assessment using the comprehensive geriatric assessment (CGA). A number of CGA and clinical factors have also been found to be able to predict chemotherapy associated toxicity. This review of lung cancer in the elderly was part of a lecture on “Practice pearls in the management of lung cancer in the elderly” presented at the SIOG Annual Meeting in Prague in November 2015.     

Challenges in the treatment of gastric cancer in the older patient

Gastric cancer is considered an age-related disease, with the majority of new cases in the UK diagnosed in individuals over the age of 75. At present most guidance related to the management of gastric cancer is based on trials undertaken in the fit, younger patient. Historically the elderly have been underrepresented in clinical trials, which frequently have a restricted inclusion to an upper age limit of 75. The European Society for Medical Oncology (ESMO) recommends use of a geriatric assessment to determine functional age when initiating treatment in elderly patients with gastric cancer, which has been shown to be a better predictor of treatment response than chronological age. The physiological changes that occur with age, including reduced organ function and pharmacokinetic and pharmacodynamic variability, together with impaired functional status, necessitate a more individualised approach to treatment decisions in the older patient to provide them with the same advantages from radical treatment and palliative chemotherapy as younger patients. This review summarises the current evidence extrapolated from trial data on how best to optimise treatment for elderly patients with gastric cancer.     

Oral urea in the treatment of secondary tumours in the liver

Twenty patients with secondary liver tumours, predominantly from colorectal carcinoma, were treated with oral urea at a daily dose of 8 gm-2. Treatment was well tolerated without side-effects. No objective responses were seen. It is concluded that oral urea is ineffective in the treatment of liver metastases from colorectal cancer.     

降钙素原在恶性血液病发热中的诊断价值

目的：探讨血清降钙素原（Procalcitonin，PCT）在恶性血液病发热中对于感染的诊断价值。方法：分析我科自2006年5月-2007年5月收治的85例恶性血液病患者105次发热病程中的PCT和C反应蛋白（C—reactive protein，CRP）浓度特征，根据患者临床特征将其分为败血症组、病原学证明肺炎组、临床证明肺炎组、病原学证明感染组、临床证明感染组、非感染性发热组和不明原因发热组，将各组PCT和CRP平均浓度进行比较，并进行ROC曲线检验；对伴并发症和不伴并发症热程以及死亡和存活的热程中患者的PCT和CRP浓度进行比较，并行ROC曲线检验。结果：105例次热程中感染组84例次（80．0％），其中败血症组8例次（12．4％）。发热组PCT和CRP浓度显著高于不发热组（P〈0．001）。感染组PCT浓度显著高于非感染组和不明原因发热组（P〈0．001），PCT对于感染的最佳鉴别界值为0．157ug／L；感染组CRP浓度与非感染组有显著差异（P=0．047），但对于感染与非感染发热鉴别价值不大。败血症热程中患者的PCT和CRP浓度显著高于非败血症热程（P〈0．001），PCT和CRP对于败血症热程均有较好的鉴别价值，最佳鉴别界值分别为1．009ug／L和85．5mg／L。结论：PCT血清浓度与恶性血液病发热患者的感染严重程度相关，尤其对于败血症特异性高。对于该群患者感染性发热和非感染性发热、败血症发热和非败血症发热有很好鉴别价值。CRP血清浓度对于该群患者感染性发热与非感染发热无鉴别意义，但对于败血症发热与非败血症发热有较好的鉴别价值。     

Choices in the management of asymptomatic lung nodules in the elderly

More than half of all lung cancer cases are diagnosed in patients older than 65 years of age. Risk of death after thoracotomy also increases over the age of 65. As a result, surgical intervention for lung cancer is often considered too risky in elderly patients, leaving the caregiver with a treatment dilemma when confronted with an abnormal radiographic finding. Advances in preoperative risk assessment, surgical and anesthetic techniques, radiation oncology, and locally ablative techniques have resulted in improved survival with a significant decrease in post-procedure mortality and morbidity for the aged population. On this basis, we believe treatment options for incidental pulmonary nodules found on chest roentgenograms should be discussed with patients and interventional work up pursued. It is no longer reasonable to deny elderly patients the benefits of surgical intervention simply on the basis of age. Every effort should be made to assess risk and optimize treatment for this large and growing segment of the population.     

Cardiovascular medications in angiogenesis--how to avoid the sting in the tail

Cancer and cardiovascular disease are the leading causes of death worldwide. Cardiovascular medications have recently been found to have favorable effects also for the treatment of noncardiovascular diseases, including cancer. In this review, we use a reverse bedside-to-bench approach to investigate the effects of common cardiovascular medications on tumor angiogenesis and vascular angiogenesis. Aspirin seems to reduce the risk of developing cancer, particularly colon cancer. However, whether the protective influence of aspirin is due to antiangiogenesis effect is still unclear. β-Blockers, which are normally used to reduce heart rate and prolong diastole, trigger an increase in stretch-associated release of proangiogenic growth factors thereby inducing angiogenesis. However, according to other studies β-blockers are able to inhibit angiogenesis via multiplicate mechanisms. Similarly, angiotensin converting enzyme inhibitor and angiotensin II type 1 receptor blocker have controversial effects for the regulation of cell proliferation and angiogenesis. Statins can augment collateral vascular growth in ischemic tissues and restrict the development of cancer. So this topical anti-inflammatory drug seems to be of high value for further therapy. Finally, suggestions on how this pilot experience may guide the conduct of future preclinical investigations, and clinical trials are discussed.