低氧诱导因子-1促进肿瘤血管生成的研究

低氧诱导因子-1（HIF-1）是调节血管内皮生长因子转录最重要的核转录因子之一,在肿瘤血管生长、转移中起重要的作用。HIF-1对肿瘤血管生成的转录调控作用与其本身的分子结构、生物学特性、分子机制及信号通路密切相关。     

Gallbladder carcinoma

Although it is the most common cancer of the biliary tree, gallbladder carcinoma remains an uncommon disease. As a result, many clinicians rarely encounter it and there is uncertainty regarding proper management. Resection is the most effective and only potentially curative treatment. Early stage tumors are often curable with a proper resection; however, many patients present late in the course of the disease when surgical intervention is no longer effective. While other treatment modalities are used in patients with advanced disease, there is limited data on efficacy. In many cases, the diagnosis is made after a cholecystectomy has been performed and an incidental tumor is identified in the specimen. In such cases, reoperation and definitive resection is appropriate and effective for patients with invasive lesions.     

恶性肿瘤患者化疗后心电图异常632例

目的对恶性肿瘤患者不同方案化疗后的心电图异常表现进行临床分析。方法回顾性分析恶性肿瘤患者采用不同方案化疗后出现心电图异常的632例临床资料。结果ST—T改变352例（55．70％）,心律失常197例（31．2％）,QRS低电压91例（14．4％）,心肌梗死2例（0．32％）。结论不同化疗方案患者均可发生心电图异常,尤其在方案含有蒽环类药物时更常出现。注意化疗药物的潜在心脏毒性,常规心电图定期检查十分重要。     

Toll样受体与癌症研究进展

Toll-like receptor (TLR) is an important pattern recognition receptor (PRR) which participates in innate immunity and regulates adaptive immunity. TLR can be expressed in immune cells and malignant tumors recognize conservative molecular structure, mediate response of inflammation, tissue injury and repair, which plays an important role in the process of tumor. Research results about some molecules and signal pathways of TLR demonstrate that it can act anti or pro-tumor dual functions, which has an extensive prospects in prevention and treatment of tumor.     

Paraaortic sentinel lymph node detection in intermediate and high-risk endometrial cancer by transvaginal ultrasound-guided myometrial injection of radiotracer (TUMIR)

ObjectiveWe aimed to evaluate the accuracy of sentinel lymph node (SLN) mapping with transvaginal ultrasound-guided myometrial injection of radiotracer (TUMIR) to detect lymph node (LN) metastases, in patients with intermediate and high-risk endometrial cancer (EC), focusing on its performance to detect paraaortic involvement.MethodsProspective study including women with preoperative intermediate or high-risk EC, according to ESMO-ESGO-ESTRO consensus, who underwent SLN mapping using the TUMIR approach. SLNs were preoperatively localized by planar and single photon emission computed tomography/computed tomography images, and intraoperatively by gamma-probe. Immediately after SLN excision, all women underwent systematic pelvic and paraaortic lymphadenectomy by laparoscopy.ResultsThe study included 102 patients. The intraoperative SLN detection rate was 79.4% (81/102). Pelvic and paraaortic drainage was observed in 92.6% (75/81) and 45.7% (37/81) women, respectively, being exclusively paraaortic in 7.4% (6/81). After systematic lymphadenectomy, LN metastases were identified in 19.6% (20/102) patients, with 45.0% (9/20) showing paraaortic involvement, which was exclusive in 15.0% (3/20). The overall sensitivity and negative predictive value (NPV) of SLNs by the TUMIR approach to detect lymphatic involvement were 87.5% and 97.0%, respectively; and 83.3% and 96.9%, for paraaortic metastases. After applying the MSKCC SLN mapping algorithm, the sensitivity and NPV were 93.8% and 98.5%, respectively.ConclusionThe TUMIR method provides valuable information of endometrial drainage in patients at higher risk of paraaortic LN involvement. The TUMIR approach showed a detection rate of paraaortic SLNs greater than 45% and a high sensitivity and NPV for paraaortic metastases in women with intermediate and high-risk EC.     

2018年NCCN指南更新版胆囊癌诊治进展述评

胆囊癌是胆道系统最常见的恶性肿瘤,美国NCCN指南2018年V1版胆囊癌更新内容主要包括：①AJCC分期T2期细化为T2a（腹腔侧）和T2b（肝脏侧）,N分期改为以阳性淋巴结数目（NMLN）作为分期标准。②术前检查评估更为全面。③手术方式和范围更为规范。④肯定了新辅助治疗的作用。⑤辅助治疗增加了放疗内容。⑥首次提出对无法切除肿瘤患者增加MSI检测,对MSI-H患者增加哌姆单抗治疗选择。本文就NCCN指南内容更新版胆囊癌诊治进展做一述评。     

前列腺根治性切除术治疗前列腺癌骨转移或淋巴结转移患者的生存预后分析

目的 探讨前列腺根治性切除术对前列腺癌骨转移或淋巴结转移患者生存预后的影响.方法 将美国SEER数据库2004年至2013年间收录的淋巴结转移或骨转移的647例前列腺癌患者纳入研究,其中单独骨转移非手术组129例,单独骨转移手术组129例,单独淋巴结转移非手术组131例以及单独淋巴结转移手术组131例,无转移非手术组1...     

Mutational Analysis of Triple-Negative Breast Cancer Using Targeted Kinome Sequencing

PurposeTriple-negative breast cancer (TNBC) does not have defined therapeutic targets and is currently treated with chemotherapy only. Kinase dysregulation triggers cancer cell proliferation and metastasis and is a crucial therapeutic target for cancer. In this study, targeted kinome sequencing of TNBC tumors was performed to assess the association between kinome gene alterations and disease outcomes in TNBC.MethodsA kinome gene panel consisting of 612 genes was used for the targeted sequencing of 166 TNBC samples and matched normal tissues. Analyses of the significantly mutated genes were performed. Genomic differences between Asian and non-Asian patients with TNBC were evaluated using two Asian TNBC datasets (from Seoul National University Hospital [SNUH] and Fudan University Shanghai Cancer Center [FUSCC]) and three non-Asian TNBC datasets (The Cancer Genome Atlas [TCGA], METABRIC, and Gustave Roussy). The prognostic value of kinome gene mutations was evaluated using tumor mutational burden (TMB) and oncogenic pathway analyses. Mutational profiles from the TCGA were used for validation.ResultsThe significantly mutated genes included TP53 (60% of patients), PIK3CA (21%), BRCA2 (8%), and ATM (8%). Compared with data from non-Asian public databases, the mutation rates of PIK3CA p.H1047R/Q were significantly higher in the SNUH cohort (p = 0.003, 0.048, and 0.032, respectively). This was verified using the FUSCC dataset (p = 0.003, 0.078, and 0.05, respectively). The TMB-high group showed a trend toward longer progression-free survival in our cohort and the TCGA TNBC cohort (p = 0.041 and 0.195, respectively). Kinome gene alterations in the Wnt pathway in patients with TNBC were associated with poor survival in both datasets (p = 0.002 and 0.003, respectively).ConclusionComprehensive analyses of kinome gene alterations in TNBC revealed genomic alterations that offer therapeutic targets and should help identify high-risk patients more precisely in future studies.     

血清胸苷激酶1检测对恶性肿瘤诊断及疗效评估的意义

目的探讨血清胸苷激酶1（TK1）作为肿瘤细胞增殖标志物对恶性肿瘤诊断及疗效评估的意义。方法应用免疫印迹-增强化学发光法检测恶性肿瘤组（53例）治疗前后、体格检查组（49例）以及健康对照组（18名）的血清TK1水平。治疗前与治疗后比较用配对t检验,治疗前和后分别与健康对照组、体格检查组比较采用两独立样本均数比较t检验。结果恶性肿瘤组治疗前STK1为0．3—11．3（2．4±2．0）pmol／L;恶性肿瘤组治疗后STK1为0．3～5．0（0．9±0．8）pmol／L;体格检查组STK1为0．1～2．1（0．8±0．3）pmol／L;健康对照组STK1为0．5～1．2（0．7±0．2）pmol／L。恶性肿瘤组治疗前与治疗后之间STK1水平差异有统计学意义（t=5．257,P〈0．0001）。恶性肿瘤组治疗前与健康对照组和体格检查组STK1水平比较,差异均有统计学意义（t=3．568和5．460,P=0．001和〈0．0001）,而恶性肿瘤组治疗后与健康对照组和体格检查组STK1水平比较,差异均无统计学意义（t=1．056和0．715,P均〉0．05）。结论血清TK1检测细胞增殖有较高的特异性和灵敏度,对临床监测恶性肿瘤疗效和在体格检查中进行恶性肿瘤风险筛查具有重要意义。     

青石棉污染区恶性肿瘤的影像学调查

目的通过影像学调查以了解1998年以来青石棉污染造成的恶性肿瘤患病情况.方法搜集云南省大姚县人民医院1998年6月1日至2001年12月31日间来我院就诊做CT及X线检查的病例与非污染区同省禄丰县人民医院同期同样病例资料进行对比,重点探讨胸膜间皮瘤及肺癌.结果观察组就诊病人CT检查6 615例,检出恶性肿瘤258例,检出率为3.9%;对照组就诊病人CT检查4 854例,检出恶性肿瘤132例,检出率为2.72%.观察组肺癌66例,检出率为1.00%,胸膜间皮瘤51例,检出率为0.77%;对照组肺癌50例,检出率为1.03%,胸膜间皮瘤1例,检出率为0.02%.观察组就诊病人X线检查14 044例,检出恶性肿瘤57例,检出率为0.41%;对照组就诊病人X线检查16 024例,检查出恶性肿瘤35例,检出率为0.22%.观察组肺癌42例,检出率为0.3%,胸膜间皮瘤6例,检出率为0.04%;对照组肺癌25例,检出率为0.16%,胸膜间皮瘤1例,检出率为0.01%.结论在X线及CT检查中,青石棉污染区恶性肿瘤患病率以肺癌、胸膜间皮瘤最高.