两种腹腔镜手术方案治疗甲状腺良性肿瘤的对比分析

目的:探讨2D与3D腹腔镜手术对甲状腺良性肿瘤患者围手术期临床指标及安全性的影响。方法:选取2016年3月至2018年3月收治的138例甲状腺良性肿瘤患者,以随机数字表法分为2D组(n=69)与3D组(n=69),分别经胸乳入路行2D、3D腹腔镜手术;比较两组患者围手术期临床指标、术后VAS评分、外观满意度及术后并发症发生率。结果:3D组患者手术时间、术中出血量均少于2D组(P<0.05);两组患者术后引流量、总住院时间及住院费用差异无统计学意义(P>0.05);术后第1天、第3天,3D组VAS评分均低于2D组(P<0.05);两组患者术后外观满意度、并发症发生率差异无统计学意义(P>0.05)。结论:相较2D腹腔镜,3D腹腔镜手术用于经胸乳入路甲状腺良性肿瘤切除术能有效降低操作难度,减少医源性创伤,并有助于缓解术后疼痛。     

Clinical value of microRNA-135a and MMP-13 in colon cancer

The aim of the present study was to investigate the expression and prognostic value of microRNA-135a (miR-135a) and matrix metalloproteinase-13 (MMP-13) in serum of colon cancer (CC). A total of 117 cases of patients admitted to Sheng Li Oil Field Central Hospital from May 2015 to May 2017 were enrolled in the research group (RG), and 120 cases of subjects undergoing normal health examination were included in the control group (CG). The expression of miR-135 and MMP-13 in peripheral blood of the two groups were compared, and their values were analyzed. It was found that miR-135a was decreased and MMP-13 was increased in the RG (P<0.050), both of which were closely related to the pathological features and prognosis of CC (P<0.050), and was also significantly correlated with CEA (P<0.001). ROC curve analysis showed that both of them had great predictive value for the occurrence, prognosis and death of CC. In conclusion, miR-135a was low expressed in CC, while MMP-13 was increased in CC, suggesting that the combined detection of the two had a good diagnostic effect on the occurrence of CC, and was closely related to the prognosis of CCC patients, which might be an excellent potential indicator for the diagnosis and treatment of CC in the future.     

miR-188-5p promotes oxaliplatin resistance by targeting RASA1 in colon cancer cells

The efficacy of chemotherapy for colon cancer is limited due to the development of chemoresistance. MicroRNA (miR)-188-5p is downregulated in various types of cancer. The aim of the present study was to explore the molecular role of miR-188 in oxaliplatin (OXA) resistance. An OXA-resistant colon cancer cell line, SW480/OXA, was used to examine the effects of miR-188-5p on the sensitivity of colon cancer cells to OXA. The target of miR-188-5p was identified using a luciferase assay. Cell cycle distribution was also assessed using flow cytometry. The measurement of p21 protein expression, Hoechst 33342 staining and Annexin V/propidium iodide staining was used to evaluate apoptosis. The expression of miR-188-5p significantly increased in SW480/OXA compared with wild-type SW480 cells. The luciferase assay demonstrated that miR-188-5p inhibited Ras GTPase-activating protein 1 (RASA1; also known as p120/RasGAP) luciferase activity by binding to the 3′-untranslated region of RASA1 mRNA, suggesting that miR-188-5p could target RASA1. In addition, miR-188-5p downregulation or RASA1 overexpression promoted the chemosensitivity of SW480/OXA, as evidenced by increased apoptosis and G₁/S cell cycle arrest. Moreover, RASA1 silencing abrogated the increase in cell apoptosis induced by the miR-188-5p inhibitor. The findings of the present study suggested that miR-188-5p could enhance colon cancer cell chemosensitivity by promoting the expression of RASA1.     

早期宫颈癌术后中危因素定义及辅助治疗的研究进展

宫颈癌仍是中国常见的妇科肿瘤疾病。早期宫颈癌（FIGO分期ⅠB‐ⅡA期）的治疗常常首选根治性手术,术后病理往往存在不良预后因素影响患者的生存。根据NCCN指南推荐,存在中危因素（淋巴血管间隙受累、肿瘤大小或深层间质浸润）且符合Sedlis标准的宫颈癌患者,建议术后补充盆腔外照射±含顺铂同步化疗。但是目前早期宫颈癌术后中危因素的定义标准、辅助治疗的指征及方式仍存在争议,本文重点阐述早期宫颈癌根治术后中危因素的定义标准及辅助治疗的研究进展。     

嵌合抗原受体T细胞治疗安全性研究进展

嵌合抗原受体T细胞(CAR-T)治疗进展迅速,其安全性问题一直受到广泛关注。第62届美国血液学会年会上针对其主要不良反应的发生机制、预测指标及治疗策略进行了一系列报道,对全面提高CAR-T治疗的安全性具有一定的指导意义。     

Role of Neoadjuvant Chemotherapy in Squamous Variant Histology in Urothelial Bladder Cancer: Does Presence and Percentage Matter?

BackgroundThe purpose of this study was to evaluate the effect of neoadjuvant chemotherapy (NACT) on squamous variant (SV) bladder cancer by investigating patients presenting with SV histology at the time of transurethral resection (TUR), stratified by their receipt of NACT.Materials and MethodsThe records of 71 patients with muscle-invasive bladder cancer and SV in the TUR specimen who underwent cystectomy between 2008 and 2018 were reviewed. Our primary outcome was pathologic response at time of cystectomy. Secondary outcomes included recurrence-free survival and overall survival stratified by receipt of NACT. A subgroup analysis was then conducted on the patients with defined SV% on TUR stratified by % involvement (< 50% SV vs. ≥ 50% SV).ResultsThe median age of the NACT and no-NACT groups was 60.2 and 70 years, respectively (P = .003). The complete response rate at cystectomy was 60% versus 13.7% for the NACT and no-NACT groups, respectively (P < .001). The non-organ–confined disease rate at time of radical cystectomy was 35% for the NACT group and 68.6% for the no-NACT group (P = .01). The NACT group had fewer recurrences than the no-NACT group (10% vs 47.1%; P = .003). In the subgroup analysis, the lower rate of non-organ–confined disease persisted for the patients who underwent NACT at the lower SV percentage but failed to remain significant at greater percentage involvement. This was also true for overall survival.ConclusionsThe effect of NACT in variant histology bladder cancer is variable. In patients with SV, these results favor the recommendation in favor of NACT administration, particularly when the primary tumor has < 50% involvement by the variant histology.     

Clinical Significance of Receptor-Interacting Protein 3 and Parkin,Essential Molecules for Necroptosis,in Breast Cancer

PurposeReceptor-interacting protein 3 (RIP3) is the main initiator of necroptosis. Parkin prevents the formation of the RIP1–RIP3 complex by promoting polyubiquitination of RIP3. However, the mechanism by which necroptosis affects the clinical features of breast cancer and prognosis is not known. Here, we aimed to study the effect of necroptosis on the clinical features and prognosis of breast cancer by assessing the expression of RIP3 and Parkin.MethodsTissue microarrays (TMAs) were constructed from 257 cases of breast cancer. Immunohistochemistry was performed on 4-μm tissue sections from each TMA block. The χ² test, Kaplan-Meier survival analysis with log-rank test, and Cox regression proportional hazard model were used for statistical analysis.ResultsLow RIP3 expression resulted in a large tumor size and high nuclear grade. Low RIP3 expression was correlated with human epidermal growth factor receptor 2 positivity, short overall survival (OS), and short disease-free survival (DFS). The triple negative breast cancer group with low RIP3 expression and lymph node (LN) positive group with low RIP3 expression had the shortest OS. High Parkin expression was associated with high histological grade, estrogen and/or progesterone receptor negativity, and lymphatic emboli, but was not correlated with OS and DFS. OS was correlated with LN metastasis and RIP3 loss and DFS with large tumor size, LN metastasis, and RIP3 loss.ConclusionLow RIP3 and high Parkin expression are associated with aggressive clinical features in breast cancer. RIP3, a molecular marker of necroptosis, is an independent factor associated with survival in breast cancer. Further in-depth studies are needed to investigate the role of necroptosis in breast cancer development, metastasis, and treatment in the future.     

Standardized Pathology Report for Breast Cancer

Given the recent advances in management and understanding of breast cancer, a standardized pathology report reflecting these changes is critical. To meet this need, the Breast Pathology Study Group of the Korean Society of Pathologists has developed a standardized pathology reporting format for breast cancer, consisting of ‘standard data elements,’ ‘conditional data elements,’ and a biomarker report form. The ‘standard data elements’ consist of the basic pathologic features used for prognostication, while other factors related to prognosis or diagnosis are described in the ‘conditional data elements.’ In addition to standard data elements, all recommended issues are also presented. We expect that this standardized pathology report for breast cancer will improve diagnostic concordance and communication between pathologists and clinicians, as well as between pathologists inter-institutionally.     

肺癌脑转移中国治疗指南(2021年版)

肺癌患者脑转移发生率高、预后差、自然生存时间短。近年来,随着外科手术、放射治疗和内科治疗水平的不断提高,肺癌脑转移患者的治疗选择越来越多,生存时间得以延长。为了及时反映国内外肺癌脑转移治疗的新进展,进一步提高肺癌脑转移患者的规范化治疗水平,中国医师协会肿瘤医师分会和中国医疗保健国际交流促进会肿瘤内科分会组织专家编写了《肺癌脑转移中国治疗指南(2021年版)》,以供临床医师参考。