喉癌微血管生成中P53 nm23蛋白和血管内皮生长因子的作用

目的　探讨P5 3、nm2 3蛋白和血管内皮生长因子 (vascularendothelialgrowthfacor,VEGF)在喉癌微血管生成及转移中的作用。方法　通过免疫组化SP法对 42例喉癌标本中P5 3、nm2 3蛋白、VEGF及微血管密度 (microvesseldensity,MVD)进行了检测。结果　喉癌中P5 3、nm2 3蛋白及VEGF的阳性表达率分别占 47 6 %、5 7 1%和 71 4%。P5 3基因和VEGF呈正相关 (P <0 0 5 ) ,在有淋巴结转移的喉癌标本中P5 3、VEGF阳性表达率及MVD明显高于非转移组 (P <0 0 5 )。而nm2 3基因和VEGF在喉癌标本中无直接相关性 ,在nm2 3蛋白表达阴性和VEGF阳性标本中MVD较高 ,这种现象多见于有淋巴结转移的喉癌中。结论　突变型P5 3基因通过调控VEGF的表达影响肿瘤内MVD ,促使喉癌发生转移 ;而nm2 3基因可能不是通过调控VEGF的表达 ,而是通过其它途径影响喉癌转移。     

Myc基因家族在喉癌中的异常扩增及其意义

目的探讨Ｍｙｃ基因家族在喉癌中的异常扩增及其临床意义。方法应用ＰＣＲ非变性聚丙稀酰胺凝胶电泳激光扫描技术检测了３２例喉癌组织、１２例癌旁组织和６例正常组织。结果正常组织细胞Ｍｙｃ基因无扩增，３２例喉癌中４７％（１５／３２）有Ｃｍｙｃ和Ｌｍｙｃ扩增，４１％（１３／３２）有Ｎｍｙｃ基因扩增。Ｍｙｃ基因扩增率与年龄、性别、喉癌临床分期及分化程度无关（Ｐ＞０．０５），但有淋巴结转移的患者的Ｎｍｙｃ扩增率明显高于无淋巴结转移者（Ｐ＜０．０１）。结论Ｍｙｃ基因３个成员异常扩增是喉癌发生的原因之一，Ｎｍｙｃ扩增在喉癌淋巴结转移过程中可能起正性调控作用。     

局部介入联合卡瑞利珠单抗与阿帕替尼治疗转移性软组织肉瘤的安全性和有效性

【摘要】 目的 探讨局部介入联合卡瑞利珠单抗与阿帕替尼治疗转移性软组织肉瘤的安全性与有效性。方法 选取2019年3月至2020年6月收治的15例转移性软组织肉瘤患者,于局部介入后行卡瑞利珠单抗联合阿帕替尼治疗,采用Kaplan- Meier法绘制生存曲线,统计患者中位总生存期（mOS）、中位无进展生存期（mPFS）。临床疗效评估根据改良实体瘤评价标准（mRECIST）,计算客观缓解率（ORR ）、临床受益率（CBR）、临床获益持续时间（DoCB）并随访观察安全性。结果 15例患者中1例CR、5例PR、7例SD、2例PD,mOS为14.9个月、mPFS为7.8个月、中位DoCB为8.4个月,ORR为40%,CBR为86.7%。Ⅲ级不良反应为贫血2例、高血压2例和白细胞减少1例,未观察到Ⅳ级不良反应。 结论 局部介入联合卡瑞利珠单抗与阿帕替尼能够显著延长转移性软组织肉瘤患者的生存期,且安全可控。     

姑息性放疗联合阿帕替尼治疗晚期肺癌的近期疗效与安全性

目的观察晚期肺癌患者接受姑息性放疗联合阿帕替尼治疗的临床近期疗效及安全性。方法回顾性分析40例晚期肺癌患者的临床资料,按照治疗方法的不同将患者分为对照组和观察组,每组20例。对照组患者单纯接受姑息性放疗,观察组患者在此基础上联用阿帕替尼治疗。比较治疗后2组的临床近期总有效率、临床症状评分和毒副反应发生率。结果观察组近期客观缓解率为70.00%、疾病控制率为90.00%,分别高于对照组的30.00%、60.00%,差异有统计学意义(P0.05);观察组疼痛评分、气喘评分和胸水评分均低于对照组,差异有统计学意义(P0.05);观察组高血压发生率高于对照组,差异有统计学意义(P0.05), 2组其他毒副反应发生率差异无统计学意义(P0.05)。结论相较于单纯姑息性放疗,姑息性放疗联合阿帕替尼治疗晚期肺癌的近期疗效更佳,可明显改善患者临床症状,且安全性较好。     

Public health insurance and cancer‐specific mortality risk among patients with breast cancer: A prospective cohort study in China

Little is known about how health insurance policies, particularly in developing countries, influence breast cancer prognosis. Here, we examined the association between individual health insurance and breast cancer‐specific mortality in China. We included 7436 women diagnosed with invasive breast cancer between 2009 and 2016, at West China Hospital, Sichuan University. The health insurance plan of patient was classified as either urban or rural schemes and was also categorized as reimbursement rate (ie, the covered/total charge) below or above the median. Breast cancer‐specific mortality was the primary outcome. Using Cox proportional hazards models, we calculated hazard ratios (HRs) for cancer‐specific mortality, contrasting rates among patients with a rural insurance scheme or low reimbursement rate to that of those with an urban insurance scheme or high reimbursement rate, respectively. During a median follow‐up of 3.1 years, we identified 326 deaths due to breast cancer. Compared to patients covered by urban insurance schemes, patients covered by rural insurance schemes had a 29% increased cancer‐specific mortality (95% CI 0%‐65%) after adjusting for demographics, tumor characteristics and treatment modes. Reimbursement rate below the median was associated with a 42% increased rate of cancer‐specific mortality (95% CI 11%‐82%). Every 10% increase in the reimbursement rate is associated with a 7% (95% CI 2%‐12%) reduction in cancer‐specific mortality risk, particularly in patients covered by rural insurance schemes (26%, 95% CI 9%‐39%). Our findings suggest that underinsured patients face a higher risk of breast cancer‐specific mortality in developing countries.     

The association of self-perception of body fat changes and quality of life in the Women's Interagency HIV Study

Body fat changes are of concern to HIV-seropositive adults on highly active antiretroviral therapy (HAART). Studies examining the association of body fat changes and quality of life (QOL) in the setting of HIV infection have been conducted predominately in men. We examined the relationship of self-perceived body fat change with QOL among 1671 HAART-using HIV-seropositive women (mean age 40±8 years; 54% African-American, 24% reporting <95% HAART adherence) from the Women's Interagency HIV Study. Self-perception of any fat loss was associated with lower overall QOL. Report of any peripheral fat loss was strongly associated with nearly all QOL domains (i.e., physical functioning, role functioning, energy/fatigue, social functioning, pain, emotional well-being, health perception, and perceived health index) except cognitive functioning, whereas report of any central fat loss was significantly associated with lower social and cognitive functioning. Report of any central fat gain was associated with lower overall QOL, but only physical functioning, energy/fatigue, and cognitive functioning were significantly affected. A significant association of report of any peripheral fat gain with overall QOL was not observed, however, peripheral fat gain was significantly associated with lower physical functioning and pain. We found that any report of fat loss, especially in peripheral body sites was associated with lower QOL, as was any report of central fat gain. Ultimately health providers and patients need to be informed of these associations so as to better support HIV-seropositive women who live with these effects.