Breast cancer is one of the most common malignant tumors in women, and its treatment and management strategies are crucial for improving patients’ prognosis and quality of life. Early breast cancer refers to lesions confined to the breast and regional lymph nodes (N1 stage) without distant metastasis. Thanks to the improvement of screening techniques, the detection rate of early breast cancer has increased. The “early diagnosis and early treatment” model has led to a decrease in breast cancer mortality, especially among young women. The 2024 European Society for Medical Oncology (ESMO) clinical practice guideline for the diagnosis, treatment, and follow-up of early breast cancer aims to provide comprehensive and standardized recommendations for the diagnosis and treatment of early breast cancer, helping clinicians make optimal decisions. This article interprets the main content of the guideline in order to provide references and assistance for the current clinical diagnosis and treatment of early breast cancer in China.
ObjectiveTo quantitate expression of microRNA-21 (miRNA-21) in gastric cancer of different tumor stages and discuss its clinical value. Method The relative expressions of miRNA-21 were quantitated in the cancer tissues, corresponding normal gastric tissues adjacent to gastric cancer, and serums of 50 gastric cancer patients received opera-tion and confirmed gastric cancer by pathology and the serums of nongastric cancer patients in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine and its Chongming Branch from January 2015 to January 2016 by real time quantitative PCR. ResultsThe relative expression level of miRNA-21 in the gastric cancer tissues was significantly higher than that in the normal gastric tissues adjacent to gastric cancer. Among the TNM stageⅠ, Ⅱ, Ⅲ of gastric cancer patients, the relative expression levels of miRNA-21 in the cancer tissues were 2.17 (1.48-2.90), 4.08 (2.30-4.86), 8.64 (5.82-18.20), respectively and the differences among these three stages were statistically significant (P<0.05). The relative expression level of the serum miRNA-21 in the gastric cancer patients was significantly higher than that in the nongastric cancer patients, which in the serums for stageⅠ, Ⅱ, and Ⅲpatients were 31.00 (24.60-37.15), 39.10 (28.90-39.80), 44.15 (38.95-56.68), respectively and the differences among three stages were statistically significant (P<0.05). The relative expression level of miRNA-21 in the serums and cancer tissues had a positive correlation (r=0.86, P<0.05). ConclusionMiRNA-21 appears to have a potential association with TNM stage of gastric cancer, which cautiously suggests that it might be a potential indicator for prediction of preoperative TNM stage of gastric cancer.
ObjectiveTo detect the expression of Prox1 (prospero-related homeobox 1) gene in primary hepatocellular carcinoma (HCC), and to analyze the correlation of Prox1 gene expression with pathological grade and clinical stage of HCC. MethodsThe expressions of Prox1 gene in carcinoma tissues and adjacent cancerous tissues in HCC as well as normal liver tissues were detected by semi-quantitative RT-PCR, then the correlation of Prox1 gene expression with HCC pathological grade and clinical stage were analyzed. ResultsThe expression of Prox1 gene in carcinoma tissues (0.243±0.102) and adjacent cancerous liver tissues (0.537±0.235) was significantly lower than that in normal liver tissue (0.812±0.372), respectively （ Plt;0.01 or Plt;0.05）. Furthermore, the expression of Prox1 gene in carcinoma tissues was significantly lower than that adjacent cancerous liver tissues (Plt;0.05). The expressions of Prox1 gene in different pathological grade (F=97.950, Plt;0.001) and clinical stage were significantly different (F=228.300, Plt;0.001), and when compared with each other, the differences of pathological grade and clinical stage were also significant (Plt;0.001 or Plt;0.01). The expressions of Prox1 gene in HCC carcinoma tissue were negatively correlated with pathological grade (r=-0.930, Plt;0.01) and clinical stage (r=-0.980, Plt;0.01) of HCC. ConclusionsExpression of Prox1 gene may be related to the initiation and development of HCC, however, that whether Prox1 gene functions as tumor suppressor in HCC needs further investigation.
The TNM staging of lung cancer which is now widely used in clinic was formally proposed in 1997. It has played quite an important role in directing the diagnosis and treatment of lung cancer as well as the clinical research in the past decade. However, at the same time, there are some insufficiencies which are emerging gradually. By collecting the clinical information from 100 869 patients, in 2007, International Association for the Study of Lung Cancer(IASLC) made a deep analysis on the relativity between TNM staging and prognosis, and put forward the suggestions to revise the Seventh Edition of the TNM staging of lung cancer: (1) According to the size of tumor, the primary T staging is divide into T1a (the maximum tumor diameter≤2 cm), T1b (3 cm≥the maximum tumor diameter＞2 cm), T2a (5 cm≥the maximum tumor diameter＞3 cm) and T2b (7 cm≥the maximum tumor diameter＞5 cm); (2) T 2c (the maximum tumor diameter gt;7 cm) and additional nodules in the same lobe are classified as T3, while nodules in the ipsilateral nonprimary lobe are classified as T4;(3) Cancerous hydrothorax, pericardial effusion and the additional nodules in the contralateral lung are classified as M1a, while the extrapulmonary metastases are classified as M1b. It is believed that the new revised edition will has higher international authority and identification degree, and it will play a more meticulous and accurate guiding role in the treatment of lung cancer and its predicting prognosis in the future. At the same time, it will provide a new starting point to the research of lung cancer.
ObjectiveTo explore the value of multi-slice spiral CT (MSCT) in ycT stage and ycN stage evaluation of patients with locally advanced gastric cancer (cT4bN0-3M0) who underwent surgery after transformation therapy.MethodsClinical data of 32 patients with locally advanced gastric cancer (cT4bN0-3M0) in Affiliated Yantai Yuhuangding Hospital of Qingdao University form January 2017 to April 2019 were retrospective analyzed. All the patients underwent surgery after SOX regimen transformation therapy. Preoperative MSCT plain and enhanced scan were used to evaluate clinical T stage (ycT) and clinical N stage (ycN). The accuracy of MSCT scanning was evaluated by comparing with the gold standard for postoperative pathological ypT stage and ypN stage.ResultsThe accuracy of preoperative MSCT examination on ycT stage after transformation therapy was 78.1% (25/32), and that of ycN was 56.3% (18/32).ConclusionThe accuracy of MSCT in preoperative ycT stage and ycN stage after successful transformation therapy for locally advanced gastric cancer (cT4bN0-3M0) is relatively high.
【Abstract】Objective To study the surgical therapy and staging investigation about stage Ⅳ breast carcinoma. Methods The clinical data of 38 patients with stage Ⅳ breast carcinoma were summarized, and the patients were followed up. Results The stage Ⅳ patients who had isolated metastasis and removable primary tumor were treated by radical surgery with good effect. On the other hand, the stage Ⅳ patients who had extensive metastasis and primary tumor unresectable were treated by palliative operation with the living quality of patients becoming better and chemotherapy load cutting down. Conclusion The stage Ⅳ patients should be divided into stage Ⅳa and stage Ⅳb. And the stage Ⅳa patients should be treated by radical operation, and the stage Ⅳb by palliative operation.
ObjectiveTo analyze the relation between the literacy and prognosis in the patients with colorectal cancer (CRC) in the current version of the Database from Colorectal Cancer of West China (DACCA). MethodsThe version of DACCA selected for this data analysis was updated on September 12, 2022. The data items analyzed included age, gender, literacy, tumour site, nature of tumour, pathological TNM (pTNM) stage, survival status, and survival time. The overall survival and disease-specific survival of the CRC patients with different literacy (illiteracy, primary, secondary, and tertiary educations) after radical resection were compared, and then which were analyzed in the patients with different pTNM stages. ResultsA total of 3 692 data eligible for the study were screened, of which 202 were illiteracy, 1 054 were primary education, 1 809 were secondary education, and 627 were tertiary education; And there were 13 of stage 0, 406 of stage Ⅰ, 1 193 of stage Ⅱ, 1 139 of stage Ⅲ, and 941 of stage Ⅳ. The differences in the comparison of the pTNM stage and the nature of the tumour among the patients with the four levels of literacy were not statistically significant (P>0.05), while the differences in the comparison of the gender, age, and tumour site were statistically significant (P<0.001). The overall survival and disease-specific survival curves of the CRC patients with different literacy had no statistical differences (χ2=1.982, P=0.576; χ2=2.618, P=0.454), and the stratified overall survival curves had no statistical differences among the patients with pTNM stages Ⅰ to Ⅳ (stage Ⅰ: χ2=1.361, P=0.715; stage Ⅱ: χ2=3.507, P=0.320; stage Ⅲ: χ2=3.144, P=0.370; stage Ⅳ: χ2=4.993, P=0.172), and the stratified disease-specific survival curves had no statistical differences (stage Ⅰ: χ2=0.723, P=0.868; stage Ⅱ: χ2=3.295, P=0.348; stage Ⅲ: χ2=4.767, P=0.190; stage Ⅳ: χ2=6.177, P=0.103). ConclusionsThe results of this study based on real-world big data analysis suggests that the differences of overall survival and disease-specific survival of CRC patients with different literacy levels (illiterate, primary, secondary, and tertiary education) are not statistically significant, and the results of stratified analysis based on pTNM staging are consistent with this. In the future, limitations of this study can be excluded and further analysis can be conducted by combining treatment details or expanding sample data to seek more realistic results.
目的 评估非小细胞肺癌患者中癌症相关性乏力的发生情况及其与患者临床病理特征和生存期之间的相互关系。 方法 应用简明疲劳量表中文版评估2008年12月－2009年12月间收治的72例初治肺癌患者，入组患者均完成根治性手术及术后生存随访。 结果 72例早期非小细胞肺癌患者中，无乏力9例（12.5%），轻度乏力48例（66.7%），中度乏力15例（20.8%），重度乏力0例（0%），乏力总体发生率为87.5%。乏力指数与患者的年龄、性别、吸烟史均无相关性，与患者的体力状况评分（ECOG PS）、TNM分期呈正相关，与中位生存期呈负相关，均有统计学意义（P＜0.05）。 结论 癌症相关性乏力作为非小细胞肺癌患者中普遍存在的一种症状，不仅能够反映患者当时的主观感受和生活状况，还可能是判断患者术后病理分期及最终总生存期的预测因素。
Lung cancer management is complex and requires a multi-disciplinary approach to provide comprehensive care. Interventional pulmonology (IP) is an evolving field that utilizes minimally invasive modalities for the initial diagnosis and staging of suspected lung cancers. Endobronchial ultrasound guided sampling of mediastinal lymph nodes for staging and detection of driver mutations is instrumental for prognosis and treatment of early and later stage lung cancers. Advances in navigational bronchoscopy allow for histological sampling of suspicious peripheral lesions with minimal complication rates, as well as assisting with fiducial marker placements for stereotactic radiation therapy. Furthermore, IP can also offer palliation for inoperable cancers and those with late stage diseases. As the trend towards early lung cancer detection with low dose computed tomography is developing, it is paramount for the pulmonary physician with expertise in lung nodule management, minimally invasive sampling and staging to integrate into the paradigm of multi-specialty care.
In this report, 1175 cases of resected gastric cancer were staged, followed up and statistincally calculated by using the international unifying new TNM staging system for gastric cancer. The prognostic value of the TNM staging system was also tested with relevant statistics. The results showed that:(1)the 5-year survival rates of Ⅰa、Ⅰb、Ⅱ、Ⅲa、Ⅲb and Ⅳ were 100%,84%,65%,43%,25% and 13% respectively; (2)The 5-year survival rates of the subgroups withing same stage were quite; (3)the analysys of correlation and regression between the new staging and the prognosis provided that correlation coefficient r equals to -0.990(Ｐ＜0.005), and regression coefficient b equals to -0.1345(Ｐ＜0.005). These results indicate that there is statistical identity beween the new TNM staging for gastric cancer and the prognosis, and certify the rationality for the new staging in application and its accuracy to reflect the prognosis.