Pathfinders in oncology from the first clinical use of single-agent chemotherapy to the introduction of mammography

During the period from 1942 to 1962, treatment attempts with single-agent chemotherapy such as nitrogen mustard and urethan gained limited application. However, the groundbreaking success with aminopterin in the treatment of patients with pediatric acute leukemia and methotrexate in the treatment of gestational choriocarcinoma established single-agent chemotherapy as a pioneering contribution to oncology. The landmark discovery that early-stage Hodgkin disease is curable with radiation made radiotherapy into an essential specialty of oncology. Although radical surgical treatment dominated the field of surgery, the excision of localized cancers with or without adjuvant radiation emerged as new modality in therapy. Cytopathology and surgical pathology became new fields in medicine and pathologists became an integral part of the preoperative, intraoperative, and postoperative care of patients with cancer. The discovery of multiple new drugs demonstrated promising results and widened the field of oncology from the laboratory to the clinic. In the etiology of cancer, precancerous conditions were named and carcinoma of the lung was definitively linked to cigarette smoking. All things considered, the progress made between 1942 and 1962 came about through the dedicated work of many individuals. However, there were 7 distinguished pathfinders (2 pathologists, 1 pediatric pathologist–oncologist, 1 radiation therapist, 1 physician-actuary, 1 gynecologist-oncologist, and 1 chemist) who, despite their different backgrounds, interests, and sex, made groundbreaking contributions to oncology.     

Combination Treatment of the Oral CHK1 Inhibitor,SRA737, and Low-Dose Gemcitabine Enhances the Effect of Programmed Death Ligand 1 Blockade by Modulating the Immune Microenvironment in SCLC

IntroductionDespite the enthusiasm surrounding cancer immunotherapy, most SCLC patients show very modest response to immune checkpoint inhibitor monotherapy treatment. Therefore, there is growing interest in combining immune checkpoint blockade with chemotherapy and other treatments to enhance immune checkpoint blockade efficacy. Based on favorable clinical trial results, chemotherapy and immunotherapy combinations have been recently approved by the U.S. Food and Drug Administration for frontline treatment for SCLC.Methods and ResultsHere, we show that combined treatment of SRA737, an oral CHK1 inhibitor, and anti–programmed death ligand 1 (PD-L1) leads to an antitumor response in multiple cancer models, including SCLC. We further show that combining low, non-cytotoxic doses of gemcitabine with SRA737 + anti–PD-L1/anti–PD-1 significantly increased antitumorigenic CD8+ cytotoxic T cells, dendritic cells, and M1 macrophage populations in an SCLC model. This regimen also led to a significant decrease in immunosuppressive M2 macrophage and myeloid-derived suppressor cell populations, as well as an increase in the expression of the type I interferon beta 1 gene, IFNβ, and chemokines, CCL5 and CXCL10.ConclusionsGiven that anti–PD-L1/anti–PD-1 drugs have recently been approved as monotherapy and in combination with chemotherapy for the treatment of SCLC, and that the SRA737 + low dose gemcitabine regimen is currently in clinical trials for SCLC and other malignancies, our preclinical data provide a strong rational for combining this regimen with inhibitors of the PD-L1/PD-1 pathway.     

影响 Lauren分型胃癌患者行根治术治疗后早期复发的因素分析

目的:探讨不同 Lauren分型胃癌患者的临床病理特征及患者行根治术后早期复发的独立影响因素。方法:选择 2016年 1月—2019年 4月于我院行根治性切除术的胃癌患者 236例,收集患者临床资料,对比不同 Lauren分型胃癌患者的临床特征。术后随访两年,根据随访期间患者复发情况将其分为复发组( 80例)和无复发组( 156例),采用多因素 Logistic回归分析患者胃癌根治术后早期复发的影响因素,构建列线图预测模型并验证。结果:肠型胃癌多发于男性,患者组织学分级较高,术后辅助化疗周期更长,癌组织中 Ki-67、HER-2高表达比例更高;弥漫型胃癌多发于女性,患者更易出现脉管瘤栓和周围神经浸润,肿瘤直径≥ 50 mm比例更高,淋巴结阳性率较肠型患者显著增加,差异有统计学意义( P<0.05)。肿瘤大小、Lauren分型、T分期、淋巴结阳性率及术后辅助化疗周期均为胃癌患者行根治术后早期复发的影响因素(P<0.05),依据独立影响因素构建列线图模型,其一致性指数为 0.745(95%CI:0.702~0.788),ROC曲线的 AUC为 0.726(95%CI:     

Lauren分类法在胃癌CT分期及术前评估中的价值

目的：通过对本组胃癌患者的螺旋CT（SCT）扫描图像应用Lauren组织临床分类法进行分期及术前评估,旨在提高胃癌CT分期和术前评估的准确性。方法：通过对48例胃癌患者SCT的轴位图像和重建的MPR及SSD图像的观察分析,以Lauren组织临床分类法为基础按TNM对各病例进行分期及术前评估。结果;所有患者的肿瘤诊断符合率为100％,I期肿瘤2例,Ⅱ期肿瘤18例,Ⅲ期肿瘤15例,Ⅳ期肿瘤13例,CT分期的准确性为85．4％,术前评估的准确性为95．0％。结论：以Lauren组织临床分类法为基础,SCT可以比较准确地对胃癌进行TNM分期及术前评估,为临床治疗提供具有价值的信息。     

十二指肠胃黏膜异位的内镜表现与病理分析

目的探讨十二指肠球部胃黏膜异位的内镜下表现,病理特征和分型。方法选择我院从2005年7月至2012年7月经内镜及病理检查确诊为十二指肠胃黏膜异位的30例患者进行内镜下分型并行病理检查及幽门螺杆菌快速酶试验（RUT）。结果 10例为多发小结节样隆起。4例平坦隆起。11例为大结节样隆起。5例为散在颗粒样隆起。30例患者中,光镜下可见在所有十二指肠球部黏膜标本的固有层均可见胃底腺。且快速尿素酶试验证实幽门螺杆菌均为阴性。结论十二指肠球部胃黏膜异位在内镜下肉眼观察可分为3型：结节型,平坦隆起型,散在颗粒型。其中以结节型最为常见,且异位的胃黏膜多不合并HP感染,但十二指肠球部溃疡会发生,一般不会发生癌变。