Objective To investigate the differences in clinicopathological characteristics and prognostic survival of human epidermal growth factor receptor 2 (HER2) high expression, HER2 low expression and HER2 negative breast cancer. MethodWe retrospectively collected 1 560 female breast cancer patients who underwent surgical treatment at the Department of Breast and Thyroid Surgery in Renmin Hospital of Wuhan University between January 8, 2010 and December 31, 2015, and divided them into high expression group, low expression group and negative group according to HER2 expression, to compare the differences in clinicopathological characteristics among the three groups of breast cancer patients and to explore the factors influencing prognosis. Results The proportions of histological grade Ⅲ, tumor diameter >2 cm, lymph node metastasis, TNM stage Ⅲ, Ki67 high expression, and hormone receptor negative expression were higher in the high expression group than those in the low expression group and negative group (P<0.050); the proportions of histological grade Ⅲ, tumor diameter >2 cm, lymph node metastasis, and TNM stage Ⅲ were higher in the low expression group than those in the negative group (P<0.050). However, the proportions of Ki67 high expression and hormone receptor negative expression were lower than those of the negative group (P<0.050). The 5-year disease-free survival rate were 85.6%, 80.3% and 74.5% for the high expression, low expression and negative group, respectively, and the 5-year overall survival rate were 90.4%, 86.0% and 80.7%, respectively. The results of multivariate Cox proportional hazard model showed that patients with high histological grade, late TNM stage, Ki67 high expression and weaker HER2 expression intensity had worse 5-year disease-free survival (P<0.050); patients with older age, high histological grade, lymph node metastasis, late TNM stage, Ki67 high expression and weaker HER2 expression intensity had worse 5-year overall survival (P<0.050). Conclusions The intensity of HER2 expression affects the 5-year disease-free survival and overall survival of breast cancer patients, and the higher the intensity of HER2 expression, the better the 5-year disease-free survival and overall survival, while the weaker the HER2 expression, the worse the 5-year disease-free survival and overall survival.
摘要:目的： 检测大肠癌组织中Kras基因的突变情况以指导临床治疗。 方法 ：通过提取15例大肠癌石蜡组织中的DNA并进行PCR扩增,之后采用国际金标准方法直接测序法进行检测获得突变信息。 结果 ：15例大肠癌石蜡组织样本中Kras有4例发生突变,突变率为266%。值得注意的是发现一个新的突变位点密码子42,并且与密码子12突变共存。 结论 ：密码子42的突变进一步证明Kras突变不仅局限于密码子12,13,61,还有与密码子12共存的42位突变。Abstract: Objective: To detect the mutation status of Kras gene in colorectal cancers and to assist the clinical treatments Methods : DNA was extracted from fifteen formalinfixed, paraffinembedded tumor samples of colorectal cancers, and then the fragments containing codons 12,13 and codon 61 were amplified by PCR The sequences were indentified by direct sequencing which is gold standard for the detection of mutation Results : In the 15 samples of colorectal cancer patients, 4 mutations were observed, with 2 in codon 12 and 2 in codon 13 Suprisingly, a novel point mutation at codon 42 of Kras was found, and coexisted with mutation in codon 12 Conclusion : Except for codons 12,13,61 mutation, Kras has other mutation at codon 42 with coexisted with codon 12 point mutation
ObjectiveTo investigate the relationship between insulin-like growth factor binding protein (IGFBP) gene with pancreatic cancer. MethodsThe relevant literatures at home and abroad in recent years were reviewed. From the pancreatic cancer related genes, IGFBP related tumors and the correlation between IGFBP and pancreatic cancer research and other aspects of the previous research results were summaried. ResultsMost of the studies suggested that IGFBP could inhibit the function of tumor cells through the IGF dependent pathway, but the deletion or mutation of IGFBP gene and its regulation mechanism are still unclear. ConclusionIGFBP is closely related to the tumor, but its specific effects and mechanism of pancreatic cancer has not been settled. In order to affect the degree of cell differentiation, regulation of tumor growth and metastasis probability through the change of endogenous IGFBP gene level, the further studie is needed.
摘要:目的: 探讨深部痛点阻滞在治疗顽固性癌痛患者中的作用。 方法 : 将156例顽固性癌痛患者,随机分为深部痛点阻滞组及对照组,每组78例。深部痛点阻滞组根据疼痛部位,应用软组织外科学理论找出相应压痛点,给予痛点深部阻滞治疗;对照组找出压痛点但仅按三阶梯用药原则给予口服药物治疗。 结果 : 深部痛点阻滞组及对照组两组患者经治疗后疼痛控制均较理想(深部痛点阻滞组VAS13, 对照组VAS17),但是深部痛点阻滞组吗啡用量明显少于对照组(吗啡日平用量深部痛点阻滞组为335mg, 对照组为15287 mg)。便秘的发生率深部痛点阻滞组为5384%,对照组为7692%。 结论 : 深部痛点阻滞能较好的控制顽固性癌痛,同时可明显减少吗啡的用量,副作用相对发生要少。Abstract: Objective: To investigate the effect of the deeppressed pain points injection on the refractory cancer pain and provide reference for relieving the cancer pain. Methods : One hundred and fiftysix patients with refractory cancer pain were diagnosed by the soft tissue surgery,finding the pain point by pressing deeply,the patients with deeppressed pain points were divided into deeppressed pain points injection group and control group randomly, The patients in deeppressed pain points injection group were treated with deeppressed pain points injection; the patients in control group were treated with drugs according with the WHO analgesic ladder. Results : The patients in deeppressed pain points injection group got the same pain relief as those in control group (VAS 13 in deeppressed pain points injection group, 17 in control group ),but the daily dose of morphine in deeppressed pain points injection group was less than that incontrol group (morphine 335mg/day in deeppressed pain points injection group,15287mg/day in control group ) significantly. There was 5384% patients with constipation in deeppressed pain points injection group, 7692% in control group. Conclusion : The refractory cancer pain can be controlled effectively by the deeppressed pain point injection and the daily dose of morphine to control the cancer pain is decreased significantly. The side effect in deeppressed pain points injection group was less than that in control group.
ObjectiveTo evaluate the effect on complication after esophagectomy by comparing the different methods of anastomosis (cervical versus thoracic anastomosis). MethodsWe searched the following databases including PubMed, EMbase, The Cochrane Library, Web of Science, CBM, CNKI, VIP and Wanfang database to identify randomized controlled trials (RCTs) of cervical versus thoracic anastomosis for esophagectomy patients from establishment of each database to October 30, 2014. Quality of the included RCT was evaluated. Meta-analysis was conducted by using RevMan 5.2 software. ResultsWe finally identified 4 RCTs involving 267 patients. In terms of the postoperative complication, the incidence of anastomotic leakage (RR=3.83, 95%CI 1.70 to 8.63, P=0.001) with cervical anastomosis was significantly higher than that of the patients with thoracic anastomosis. However, there was no statistical difference in incidence of anastomotic stricture (RR=1.04, 95%CI 0.62 to 1.76, P=0.87), pulmonary complication (RR=0.73, 95%CI 0.27 to 1.91, P=0.52), and mortality (RR=0.89, 95%CI 0.40 to 1.97, P=0.77) between cervical and thoracic anastomosis. ConclusionCompared with thoracic anastomosis, the method of cervical anastomosis is associated with a higher incidence of anastomotic leakage. But there are many unclear factors about anastomotic stricture, pulmonary complication and mortality, further measurement should be taken.
ObjectiveTo summarize value of preoperative inflammatory markers in diagnosis and prognosis of colorectal cancer.MethodThe literatures on the preoperative inflammatory markers in the diagnosis and prognosis prediction of colorectal cancer at home and abroad were searched and reviewed.ResultsThe chronic inflammation might promote the occurrence and development of tumor, the tumor related inflammatory markers could be used for the auxiliary diagnosis and assessment of prognosis, such as the neutrophil to lymphocyte ratio, tumor-associated neutrophils, platelet to lymphocyte ratio, Glasgow prognostic score, and C-reactive protein/albumin ratio were obviously correlated with the prognosis of patients with colorectal cancer. What’s more, the D-dimer and fibrinogen to albumin or prealbumin ratio were valuable in the diagnosis and prognosis of colorectal cancer.ConclusionsMore and more inflammatory factors are applied in diagnosis and prognosis prediction of tumors. However, in general, specificity and sensitivity of a single indicator for tumor diagnosis are poor. In future, while studying new inflammatory indicators, diagnosis can be conducted in combination with various indicators, which is expected to improve specificity and sensitivity. Similarly, prognostic efficacy of a single indicator is low, so it can be combined with various indicators to improve prognostic efficacy of patients with colorectal cancer, and Nomogram model can be established to achieve individualized prediction and guide clinical work.
Objective To explore the clinical epidemiologic characteristics and tendency of gastric cancer during recently ten years in northern Henan province. Methods The clinical data of 1 090 patients with gastric cancer in our department were collected from January 1998 to May 2008. The ten-year period was divided into two groups: previous 5 years group (n=433) and post 5 years group (n=657). The age, gender, pathologic characteristics and the relationship between age and pathologic features were analyzed retrospectively. Results ①The patient’s age was 15-83 years old 〔mean （57.60±10.84） years old〕 and men-momen ratio was 3.71∶1 in previous 5-year group. The patient’s age was 18-82 years old 〔mean （58.95±10.81）years old〕 and men-momen ratio was 2.84∶1 in post 5-year group. There was no significant difference in age or gender between two groups （Pgt;0.05）. ②Gastric cancer arised in cardia and gastric fundus more common and for the incidence of the site no change was found in two groups. The incidence of gastric antrum cancer descended but that of gastric body arised. ③The mean age of patients with gastrocardiac cancer was significantly different (Plt;0.05) between two groups. No significant difference occurred on the mean age of patients with gastric antrum (Pgt;0.05) or gastric body cancer (Pgt;0.05). The mean age of patients with highly malignant tumor (signet ring cell cancer, poorly differentiated adenocarcinoma and undifferentiated carcinoma) was significantly different compared with that of patients with lowly malignant tumor (well differentiated and moderately differentiated adenocarcinoma) (Plt;0.05). ④The proportion of patients with highly and lowly malignant tumor presented significantly different between the previous 5 years and the post 5 years (Plt;0.05). ⑤The proportion of early gastric cancer was very low and no correlation was found between infiltrating depth and age in all patients (Pgt;0.05). Conclusion Cardia and gastric fundus is the most common site of gastric cancer in northern Henan province. The patients with gastrocardiac cancer are often older but gastric antrum and gastric body cancer patients are younger. Highly malignant gastric cancer is often found in youths, however, lowly malignant gastric cancer occurred predominantly in elderly. The proportion of gastric cancer found early is very low in northern Henan province.
ObjectiveTo systematically review the efficacy and safety of crizotinib in the treatment of non-small cell lung cancer (NSCLC).MethodWe electronically searched databases including the Cochrane Library (Issue 5, 2017), PubMed, Embase, China Biology Medicine Database, China National Knowledge Internet Database, VIP Database and Wangfang Data from the establishment to May 2017. The randomized controlled trials (RCTs), non-RCTs, case series and case reports on crizotinib for NSCLC were included. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, assessed the methodological quality of included studies, then make Meta-analysis and descriptive analysis.ResultA total of 15 studies were included, including 4 RCTs, 1 non-RCT, 4 case series and 6 case reports. The results indicated that the progression-free survival time of crizotinib group was 8 months, which was better than chemotherapy group (4.6 months). The results of Meta-analysis showed that the response rate in the crizotinib group was higher than that in the chemotherapy group [RR=2.35, 95%CI (1.59, 3.46), P<0.000 1]. The one year survival rate in the crizotinib group was 74.5%-78.6%. The incidences of adverse reactions including dysopsia, dysgeusia, diarrhea, vomiting, constipation, transaminase lifts, upper respiratory tract infection, edema and dizziness in the crizotinib group were higher than those in the chemotherapy group (P<0.05), while the incidences of adverse reactions including leukopenia, thrombocytopenia, alopecia and fatigue in crizotinib group were lower than those in the chemotherapy group (P<0.05). Subgroup analysis under precision treatment showed the progression-free survival time of anaplastic lymphoma kinase (ALK)-positive group was 8 months, and it was longer than ALK-negative group of 4 months.ConclusionsBased on current evidence, crizotinib is better than chemotherapy for NSCLC. Due to limited quality of the included studies, the above conclusion needs to be verifed by more high quality studies.
Objective To evaluate the outcome of liver transplantation in patients with recurrent liver cancer after resection. Methods Data of 23 patients underwent liver transplantation for recurrent liver cancer from April 2001 to March 2008 were retrospectively collected and analyzed. Results Previous history of liver resection had little negative effect in subsequent liver transplantation in technical aspect. Liver function recovered uneventfully after transplantation in all cases. Alpha fetoprotein (AFP) recovered to normal value in 13 of 17 cases with elevated AFP before transplantation within one month after operation. Five cases (21.74%) had postoperative complications. Nineteen cases (82.61%) were followed up, average follow-up duration were 610 days. There were 5 cases (26.32%) of cancer recurrence and 6 deaths during follow-up, survival rate was 68.42%. Conclusion Liver transplantation is a reasonable treatment for recurrent liver cancer after resection.
Objective To systematically review the current situation of health economics evaluation of gastric cancer screening. Methods The PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, WanFang Data and VIP databases were electronically searched to collect the health economics evaluation studies on gastric cancer screening from January 1st, 1975 to September 30th, 2021. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Then, qualitative analysis was performed. Results A total of 44 studies were included. Most of the targeted populations of the study were high-risk groups in areas with a high incidence of gastric cancer. Screening methods such as endoscopy and Helicobacter pylori infection detection were mainly evaluated in those studies. According to the results, about 47% of the studies evaluated a single screening method. A total of 35 studies showed that they established models, however, only a few calibrated the models. Conclusion Most studies of gastric cancer screening reviews neither calibrate the results nor consider the effect of smoking on the progression of gastric cancer. Those evaluated screening programs are limited.