2012 Vol.24(4)

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Expression of Gli1 in the hedgehog signaling pathway and breast cancer recurrence
Naoko Takebe, Sally Hunsberger, Sherry X. Yang
2012, 24(4): 257-258. doi: 10.3978/j.issn.1000-9604.2012.09.07
Abstract(721) FullText HTML (566) PDF 132KB(4)
Robotics - The answer to the Achilles’ heel of VATS pulmonary resection
Mark R. Dylewski, Richard S. Lazzaro
2012, 24(4): 259-260. doi: 10.3978/j.issn.1000-9604.2012.10.05
Abstract(754) FullText HTML (567) PDF 154KB(3)
The hedgehog pathway in breast cancer
Sheikh Asim Ali
2012, 24(4): 261-262. doi: 10.3978/j.issn.1000-9604.2012.10.02
Abstract(754) FullText HTML (572) PDF 148KB(3)
Original Article
Overexpression of Gli1 in cancer interstitial tissues predicts early relapse after radical operation of breast cancer
Ying-Hua Li, Hai-Feng Gao, Yan Wang, Fang Liu, Xiao-Feng Tian, Yang Zhang
2012, 24(4): 263-274. doi: 10.3978/j.issn.1000-9604.2012.10.04
Abstract(762) FullText HTML (590) PDF 2573KB(1)
ObjectiveTo investigate whether Gli1 expression is important in relapse after radical operation of breast cancer.MethodsUsing immunohistochemistry, Gli1 expression was analyzed in human primary breast cancer (n=284) and paracancerous tissues (n=20), and also in local lymph nodes (n=28) and metastatic lymph nodes (n=28).ResultsInitial analysis of Gli1 expression in a small cohort of 20 breast tumors and their paracancerous tissues showed a tendency towards Gli1 overexpression in breast cancer tissues (P<0.001). Further, Gli1 expression in 284 breast cancer tissue samples was analyzed and a significant correlation was found between increased expression of nuclear Gli1 and unfavorable recurrence-free survival (RFS) (P<0.05). The nuclear expression of Gli1 in metastatic lymph nodes following relapse after radical operation was much higher than that in the local lymph nodes of primary carcinoma (P<0.05). Most interestingly, the expression of Gli1 was much higher in the interstitial tissues of the relapsed group than of the non-relapsed group (P<0.001).ConclusionsBreast cancer shows a high prevalence of Gli1 expression, which is significantly correlated with aggressive features and unfavorable RFS. Nuclear Gli1 overexpression, especially in the interstitial tissues, signified early relapse after radical operation of breast cancer.
Anacardic acid (6-pentadecylsalicylic acid) induces apoptosis of prostate cancer cells through inhibition of androgen receptor and activation of p53 signaling
Jing Tan, Binghai Chen, Leye He, Yuxin Tang, Zhiqiang Jiang, Guangmin Yin, Jinrong Wang, Xianzhen Jiang
2012, 24(4): 275-283. doi: 10.3978/j.issn.1000-9604.2012.10.07
Abstract(725) FullText HTML (600) PDF 1902KB(2)
Anacardic acid (AA) is a mixture of 2-hydroxy-6-alkylbenzoic acid homologs. It is widely regarded as a non-specific histone acetyltransferase inhibitor of p300. The effects and the mechanisms of AA in LNCaP cells (prostate cancer cells) remain unknown. To investigate the effect of AA on LNCaP cells, we had carried out several experiments and found that AA inhibits LNCaP cell proliferation, induces G1/S cell cycle arrest and apoptosis of LNCaP cell. The mechanisms via which AA acts on LNCaP cells may be due to the following aspects. First, AA can regulate p300 transcription and protein level except for its mechanisms regulating function of p300 through post-translational modification in LNCaP cells. Second, AA can activate p53 through increasing the phosphorylation of p53 on Ser15 in LNCaP cells. AA can selectively activate p21 (target genes of p53). Third, AA can down-regulates androgen receptor (AR) through supressing p300. Our study suggests that AA has multiple anti-tumor activities in LNCaP cells and warrants further investigation.
Pathologic features and clinical outcome of central neurocytoma: analysis of 15 cases
Yu Li, Xiu-Feng Ye, Guo Qian, Yu Yin, Qian-Guan Pan
2012, 24(4): 284-290. doi: 10.3978/j.issn.1000-9604.2012.08.02
Abstract(723) FullText HTML (565) PDF 1273KB(0)
ObjectiveTo get better recognition of central neurocytoma and diminish misdiagnosis.MethodsA retrospective review identified 15 cases of central neurocytoma. All cases of central neurocytoma were analyzed for their clinical symptoms, pathologic changes, immunohistochemical staining, prognosis and differential diagnosis. Clinical follow up was performed.ResultsThere were 8 males and 7 females aged 10-64 years (median 32.93 years). The most common presenting symptoms were those related to increased intracranial pressure (ICP), including headache (100%), papilledema (93%) and vomiting (80%). All tumors were located in the ventricular system. The tumors were composed of uniform cells with round nuclei and a fine chromatin pattern, and in some areas, small cells with perinuclear halo could be seen. In particular, the anuclear areas may have a fine fibrillary matrix (neuropil). Nuclear atypia and vascular proliferation appeared in two cases, respectively. Focal necrosis could be seen in one case. Immunohistochemical findings included expression of synaptophysin (15/15), neuron specific enolase (12/15) and glial fibrillary acidic protein (GFAP) (3/15). MIB-1 proliferation index ranged from 0.8-12.5%, and was more than 2% in 3 of 15 cases assessed. Follow-up information of 11 patients was available.ConclusionsCentral neurocytoma has a favorable prognosis in general, but in some cases, the clinical course could be aggressive. Increase of GFAP positivity, proliferation index and vascular proliferation might suggest a more malignant process.
Combination chemotherapy with paclitaxel, cisplatin and fluorouracil for patients with advanced and metastatic gastric or esophagogastric junction adenocarcinoma: a multicenter prospective study
Xiao-Dong Zhang, Yong-Qian Shu, Jun Liang, Feng-Chun Zhang, Xue-Zhen Ma, Jian-Jin Huang, Li Chen, Gen-Ming Shi, Wei-Guo Cao, Cheng-Ye Guo, Lin Shen, Mao-Lin Jin
2012, 24(4): 291-298. doi: 10.3978/j.issn.1000-9604.2012.08.04
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ObjectiveTo evaluate the efficacy and toxicity of the combination regimen of paclitaxel, cisplatin and 5-FU (PCF) as first-line or second-line therapy in patients with advanced gastric and esophagogastric junction (EGJ) adenocarcinoma in China.MethodsThe patients were treated with paclitaxel 150 mg/m2 on d1; fractionated cisplatin 15 mg/m2 and continuous infusion 5-FU 600 mg/(m2·d) intravenously on d1-d5 of a 21-d cycle until disease progression or unacceptable toxicities.ResultsSeventy-five patients have been enrolled, among which, 41 received PCF regimen as the first-line therapy (group A) and 34 received the regimen as the second-line therapy (group B) with the median age of 59 years old and Karnofsky performance status (KPS) score ≥80. Toxicities were analyzed in all 75 patients. Seventy-one patients were evaluable for efficacy. The median overall survival (mOS) was 12.0 months (95% CI: 7.9-16.2 months) in group A and 7.3 months (95% CI: 4.3-10.3 months) in group B, respectively. The median progression-free survival (mPFS) was 5.7 months (95% CI: 4.1-7.2 months) and 5.0 months (95% CI: 3.1-6.9 months), respectively. The response rate (CR+PR) was 40% (16/40; 95% CI: 24.9-56.7%) in group A and 22.6% (7/31; 95% CI: 9.6-41.1%) in group B. Major grade 3 or 4 adverse events include neutropenia (41.3%), febrile neutropenia (9.3%), nausea/anorexia (10.7%), and vomiting (5.3%). There was no treatment-related death.ConclusionsThe combination chemotherapy with PCF is active and tolerable as first-line and second-line therapy in Chinese patients with advanced gastric and EGJ adenocarcinoma. The response and survival of PCF are same as those of DCF, but the tolerance is much better.
NRS2002 assesses nutritional status of leukemia patients undergoing hematopoietic stem cell transplantation
Peng Liu, Zhao-Feng Zhang, Jing-Jing Cai, Bo-Shi Wang, Xia Yan
2012, 24(4): 299-303. doi: 10.3978/j.issn.1000-9604.2012.09.01
Abstract(724) FullText HTML (566) PDF 214KB(0)
ObjectiveTo discuss whether nutritional risk screening 2002 (NRS2002) is appropriate for nutritional risk screening for leukemia patients before and after hematopoietic stem cell transplantation (HSCT), and whether there are risk differences in other conditions, such as age, gender and matching degree; to find the methods and indicators of nutritional risk screening for these patients before and after HSCT, in order to give timely intervention to guarantee the successful completion of the entire transplantation process.MethodsNutritional risk of 99 leukemia patients was screened with NRS2002 before and after HSCT. The χ2 test was applied to compare the risk differences between groups such as age, gender and matching degree, while the differences of other enumeration data, such as recent (1-3 months) weight loss, reduced food intake within one week and BMI, were compared by continuity correction.ResultsOf the 99 leukemia patients, 22 cases (22.2%) had nutritional risk before HSCT, while all patients had nutritional risk after HSCT; there is no significant difference in nutritional risk between male and female, and patients of less than 30 years old, not-full matched, recent (1-3 months) weight loss, reduced food intake within a week or BMI <18.5 were more likely to have nutritional risk; and 77 cases (77.8%) had weight loss, among which 49 patients (63.6%) had more than 5% weight loss within one month.ConclusionsThis study showed that leukemia patients should receive the nutritional risk screening conventionally before and after HSCT, and NRS2002 was only appropriate for nutritional risk screening before HSCT. More attention should be paid to the patients less than 30 years old or not-full matched. Weight change was one of the important nutritional indicators for patients after HSCT.
Primary debulking surgery or neoadjuvant chemotherapy followed by interval debulking surgery for patients with advanced ovarian cancer
Hong Zheng, Yu-Nong Gao
2012, 24(4): 304-309. doi: 10.3978/j.issn.1000-9604.2012.09.02
Abstract(723) FullText HTML (572) PDF 252KB(0)
ObjectivesTo compare the survival and perioperative morbidity between primary debulking surgery (PDS) and neoadjuvant chemotherapy followed by interval debulking surgery (NAC/IDS) in treating patients with advanced epithelial ovarian cancer (EOC).MethodsWe retrospectively reviewed 67 patients with stage IIIC or IV EOC treated at Peking University Cancer Hospital from January 2006 to June 2009. Wherein, 37 and 30 patients underwent PDS and NAC/IDS, respectively.ResultsNo difference in overall survival (OS) or progression-free survival (PFS) was observed between NAC/IDS group and PDS group (OS: 41.2 vs. 39.1 months, P=0.23; PFS: 27.1 vs. 24.3 months, P=0.37). The optimal debulking rate was 60% in the NAC/IDS group, which was significantly higher than that in the PDS group (32.4%) (P=0.024). The NAC/IDS group had significantly less intraoperative estimated blood loss and transfusion, lower nasogastric intubation rate, and earlier ambulation and recovery of intestinal function than the PDS group (P<0.05).ConclusionsNAC/IDS is less invasive than PDS, and offers the advantages regarding optimal cytoreduction rate, intraoperative blood loss, and postoperative recovery, without significantly impairing the survival compared with PDS in treating patients with stage IIIC or IV EOC. Therefore, NAC/IDS may be a valuable treatment alternative for EOC patients.
Melatonin inhibits the expression of vascular endothelial growth factor in pancreatic cancer cells
Dong Lv, Pei-Lin Cui, Shi-Wei Yao, You-Qing Xu, Zhao-Xu Yang
2012, 24(4): 310-316. doi: 10.3978/j.issn.1000-9604.2012.09.03
Abstract(726) FullText HTML (561) PDF 1134KB(0)
ObjectiveTo investigate the effects of melatonin on cellular proliferation and endogenous vascular endothelial growth factor (VEGF) expression in pancreatic carcinoma cells (PANC-1).MethodsPANC-1 cells were cultured for this study. The secreted VEGF concentration in the culture medium was determined using ELISA method, VEGF production in the tumor cells was detected by immunocytochemistry, and VEGF mRNA expression was determined by RT-PCR.ResultsHigher melatonin concentrations significantly inhibited cellular proliferation, with 1 mmol/L concentration exhibiting the highest inhibitory effect (P<0.01). VEGF concentrations in the cell culture supernatants and intra-cellules were all significantly reduced after melatonin (1 mmol/L) incubation (P<0.05). VEGF mRNA expression decreased markedly in a time-dependent manner during the observation period (P<0.05).ConclusionsHigh melatonin concentrations markedly inhibited the proliferation of pancreatic carcinoma cells. The endogenous VEGF expression was also suppressed by melatonin incubation.
Activation of sonic hedgehog signaling pathway is an independent potential prognosis predictor in human hepatocellular carcinoma patients
Li Che, Yan-Hua Yuan, Jun Jia, Jun Ren
2012, 24(4): 323-331. doi: 10.3978/j.issn.1000-9604.2012.10.10
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ObjectiveThe activation of hedgehog (HH) pathway is implicated in the development of human malignancies including hepatocellular carcinoma (HCC). However, the clinical impact of HH activation in HCC patients is still unclear. This study was conducted to confirm whether the expression of HH pathway components was associated with HCC progression and clinical outcome.MethodsThis study was a sample-expanded and prolonged follow up of one of our previous studies. It included 46 HCC patients who underwent surgical treatment from 2002 to 2005. The expression of sonic HH (SHH), patched-1 (PTCH1), smoothened (SMOH) and glioma-associated oncogene-1 (GLI1) genes in tumor and adjacent normal tissues extracted from the patients were examined by reverse transcription-polymerase chain reaction (RT-PCR) to explore the relationship between these genes and the clinical prognosis of HCC.ResultsThe expression levels of SHH, PTCH1, SMOH and GLI1 in HCC tissues were 60.87%, 50.00%, 32.61% and 54.35%, respectively. The expression levels of SHH-related molecules were relatively intense in cancer tissue, but insignificantly correlated with any clinicopathological factors of tumor. Transcriptional factor GLI1 was the only molecule associated with poor prognosis among the HCC patients. The expression of GLI1 gene in tumor tissues was significantly related with disease-free survival (DFS) (P=0.042) and overall survival (OS) (P=0.030). The simultaneous expression of GLI1 in tumor and adjacent normal liver tissues correlated with DFS (P<0.029) and OS (P<0.025).ConclusionsHH signaling activation is an important event in the development of human HCC. The expression of GLI1 in SHH pathway is possibly involved in HCC progression, which may be a useful prognostic indicator of HCC.
High-risk endometrial cancer may be benefit from adjuvant radiotherapy plus chemotherapy
Jin-Wei Miao, Xiao-Hong Deng
2012, 24(4): 332-339. doi: 10.3978/j.issn.1000-9604.2012.10.03
Abstract(712) FullText HTML (567) PDF 610KB(1)
ObjectiveTo present patterns of practice and outcomes in the adjuvant treatment of intermediate- and high-risk endometrial cancer.MethodsRetrospective data on 224 women with intermediate-risk and high-risk endometrial cancer from 1999 to 2006 were reviewed. All patients underwent surgical staging. Patterns of adjuvant treatment, consisting of pelvic radiotherapy, chemotherapy, and radiotherapy plus chemotherapy, were assessed. The 3- and 5-year disease-specific survival (DSS) rates were calculated using the Kaplan-Meier method.ResultsThe difference in 5-year DSS rate was statistically significant between adjuvant group and non-adjuvant group (80.65% vs. 63.80%, P=0.040). In 110 high-risk patients who underwent adjuvant treatment, both 5-year DSS rate and recurrent rate were significantly different in combined radiotherapy and chemotherapy group compared with radiotherapy alone and chemotherapy alone groups (DSS rate, P=0.049; recurrent rate, P=0.047). In 83 intermediate-risk women who underwent adjuvant treatment, there was no significant difference in 5-year DSS rate and recurrence rate among the combined radiotherapy and chemotherapy, radiotherapy alone and chemotherapy alone groups (DSS rate, P=0.776; recurrent rate, P=0.937).ConclusionsAdjuvant radiotherapy plus chemotherapy is associated with a higher 5-year DSS rate and lower recurrence rate compared with radiotherapy alone and chemotherapy alone in high-risk endometrial cancer patients. Patients with intermediate-risk endometrial cancer may be not likely to benefit from adjuvant combined radiotherapy and chemotherapy.
Analysis of factors influencing skip lymphatic metastasis in pN2 non-small cell lung cancer
Gui-Long Li, Yong Zhu, Wei Zheng, Chao-Hui Guo, Chun Chen
2012, 24(4): 340-345. doi: 10.3978/j.issn.1000-9604.2012.10.06
Abstract(733) FullText HTML (580) PDF 203KB(0)
ObjectiveAlthough many clinical studies on skip lymphatic metastasis in non-small cell lung cancer have been reported, the risk factors for skip lymphatic metastasis are still controversy and debatable. This study investigated, by multivariate logistic regression analysis, the clinical features of skip metastasis to mediastinal lymph nodes (N2) in non-small cell lung cancer (NSCLC) patients.MethodsWe collected the clinicopathological data of 256 pN2-NSCLC patients who underwent lobectomy plus systemic lymph node dissection in Fujian Medical University Union Hospital. The cases in the present study were divided into two groups: skip metastasis (N2 skip+) and non- skip metastasis (N2 skip-). A retrospective analysis of clinical pathological features of two groups was performed. To determine an independent factor, multivariate logistic regression analysis was used to identify possible risk factors.ResultsA total of 256 pN2-NSCLC patients were recruited. The analysis results showed that gender, pathologic types, surgery, pleural involvement, smoking history, age, tumor stages, and differentiation were not statistical significant factors impacting on skip metastasis in pN2-NSCLC (P>0.05), whereas tumor size was an independent factor for skip metastasis (P=0.02).ConclusionsThe rate of skip lymphatic metastasis increases in pN2-NSCLC patients, in accompany with an increased tumor size.
The efficacy of the inhalation of an aerosolized Group A streptococcal preparation in the treatment of lung cancer
Jun Liu, Xiang Liu, Fei Cui, Guoqin Chen, Yubao Guan, Jianxing He
2012, 24(4): 346-352. doi: 10.3978/j.issn.1000-9604.2012.10.08
Abstract(736) FullText HTML (567) PDF 774KB(0)
ObjectiveTo observe the efficacy of the inhalation of an aerosolized group A streptococcal (GAS) preparation in treating orthotopic lung cancer in mouse models and assess the feasibility, safety, and effectiveness of this administration mode for lung cancer.MethodsLewis lung carcinoma (LLC) cell strains were administered via intrathoracic injection to establish orthotopic lung cancer mouse models. After the tumor-bearing models were successfully established, as confirmed by computed tomography, the mice were administered by inhalation with an aerosolized GAS preparation (GAS group) or aerosolized normal saline (control group). The anti-tumor effect of the aerosolized GAS preparation was evaluated histologically; meanwhile, the survival and quality of life were compared between these two groups.ResultsThe aerosolized GAS preparation showed remarkably anti-tumor effect, causing the necrosis of the orthotopic lung cancer cells in tumor-bearing mice. Furthermore, mice in the GAS group had significantly better quality of life and longer survival than those in control group.ConclusionsThe inhalation of aerosolized GAS preparation may be a feasible, safe and effective solution for lung cancer.
Evolution of viral RNA in a Chinese patient to interferon/ribavirin therapy for hepatitis C
Xian-Zi Wen, Zhi-Hai Chen, Ya-Zhi Wei, Jia-Fu Ji
2012, 24(4): 353-360. doi: 10.3978/j.issn.1000-9604.2012.10.01
Abstract(772) FullText HTML (564) PDF 2758KB(4)
ObjectiveThe combination of interferon (IFN) and ribavirin (RBV) is the standard therapy for hepatitis C virus (HCV) infection. HCV genotype 2a has proved more amenable to the therapy, but its efficacy is yet limited. This study aimed to investigate the mechanism of the poor response in a case of HCV genotype 2a infection.MethodsWe analyzed dynamic change of HCV RNA from a patient, infected with HCV genotype 2a, showing a poor virological response to IFN/RBV as judged 12 weeks after initiation of the therapy by HCV clone sequencing. Then we constructed subgenomic Japanese fulminant hepatitis-1 (JFH1) replicon and different chimeric replicons with humanized Gaussia luciferase gene. The chimeric replicons were derived from subgenomic JFH1 replicon, in which the NS5A region was replaced by the patient’s sequence from the pre/post-treatment, and the chimeric replicons’ susceptibility to IFN were evaluated by relative Gausia Luciferase activity.ResultsThe pretreatment HCV sequences appeared almost uniform, and the quasispecies variation was further more simplified after 12 weeks of therapy. Besides, the quasispecies variation seemed to be more diversified in the NS5A, relatively, a region crucial for IFN response, and each of chimeric replicons exhibited distinct response to IFN.ConclusionsDuring the course of the chronic infection, HCV population seems to be adapted to the patient’s immunological system, and further to be selected by combination of IFN/RBV therapy, indicating quasispecies may completely eliminated by addition of other drugs with targets different from those of IFN. In addition, each different response of chimeric replicon to IFN is most likely related to amino acid changes in or near the IFN-sensitivity determining region (ISDR) of NS5A during chronic infection and IFN/RBV therapy.
Review Article
Proton therapy for hepatocellular carcinoma
Ted C. Ling, Joseph I. Kang, David A. Bush, Jerry D. Slater, Gary Y. Yang
2012, 24(4): 361-367. doi: 10.3978/j.issn.1000-9604.2012.10.09
Abstract(714) FullText HTML (567) PDF 183KB(0)
Proton radiotherapy has seen an increasing role in the treatment of hepatocellular carcinoma (HCC). Historically, external beam radiotherapy has played a very limited role in HCC due to a high incidence of toxicity to surrounding normal structures. The ability to deliver a high dose of radiation to the tumor is a key factor in improving outcomes in HCC. Advances in photon radiotherapy have improved dose conformity and allowed dose escalation to the tumor. However, despite these advances there is still a large volume of normal liver that receives a considerable radiation dose during treatment. Proton beams do not have an exit dose along the beam path once they enter the body. The inherent physical attributes of proton radiotherapy offer a way to maximize tumor control via dose escalation while avoiding excessive radiation to the remaining liver, thus increasing biological effectiveness. In this review we discuss the physical attributes and rationale for proton radiotherapy in HCC. We also review recent literature regarding clinical outcomes of using proton radiotherapy for the treatment of HCC.
The induction of the apoptosis of cancer cell by sonodynamic therapy: a review
Wen-Kun Bai, E Shen, Bing Hu
2012, 24(4): 368-373. doi: 10.3978/j.issn.1000-9604.2012.08.03
Abstract(707) FullText HTML (561) PDF 220KB(1)
Ultrasound can be used not only in the examination, but also in the therapy, especially in the therapy of cancer, which has got effect in the treatment. Sonodynamic therapy is an experimental cancer therapy which uses ultrasound to enhance the cytotoxic effects of drugs known as sonosensitizers. It has been tested in vitro and in vivo. The ultrasound could penetrate the tissue and cell under some of conditions which directly changes the cell membranes permeability, thereby allowing the delivery of exogenous molecules into the cells in some degree. Ultrasound could inhibit the proliferation or induce the apoptosis of the cancer cell in vitro or in vivo. Recent research indicated low frequency and low intensity ultrasound could induce cells apoptosis, and which could be strengthened by sonodynamic sensitivities, microbubbles, chemotherapeutic drugs and so on. Most kinds of ultrasound suppressed the proliferation of cancer cell through inducing the apoptosis of cancer cell. The mechanism of apoptosis is not clear. In this review, we will focus on and discuss the mechanisms of the induction of the apoptosis of cancer cell by ultrasound.
Potential effects of CRM1 inhibition in mantle cell lymphoma
Ke-Jie Zhang, Michael Wang
2012, 24(4): 374-387. doi: 10.3978/j.issn.1000-9604.2012.09.05
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Mantle cell lymphoma (MCL) is an aggressive histotype of B-cell non-Hodgkin lymphoma. The disease has no known cure, which prompts the urgent need for novel therapeutic agents. Chromosomal region maintenance 1 (CRM1) may play a role in human neoplasia and serve as a novel target of cancer treatment. This study summarizes MCL pathogenesis and determines the involvement of CRM1 in the regulation of several vital signaling pathways contributing to MCL pathogenesis, including the pathways of cell cycle progression, DNA damage response, phosphoinositide kinase-3, nuclear factor-κB activation, and chromosomal stability. A preclinical study is also presented to compare the CRM1 status in MCL cell lines and primary MCL cells with normal B cells, as well as the therapeutic efficiency of CRM1 inhibition in MCL in vitro and in vivo, which make these agents potential targets of novel MCL treatments.
Circulating tumor cells (CTCs) in breast cancer: a diagnostic tool for prognosis and molecular analysis
Xiaoshen Dong, Katherine R. Alpaugh, Massimo Cristofanilli
2012, 24(4): 388-398. doi: 10.3978/j.issn.1000-9604.2012.11.03
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Metastatic breast cancer (MBC) is characterized by a combination of tumor growth, proliferation and metastatic progression and is typically managed with palliative intent. The benefit of standard systemic therapies is relatively limited and the disease is considered incurable suggesting the need to investigate the biological drivers of the various phases of the metastatic process in order to improve the selection of molecularly driven therapies. The detection, enumeration and molecular analysis of circulating tumor cells (CTCs) provide an intriguing opportunity to advance this knowledge. CTCs enumerated by the Food and Drugs Administration-cleared CellSearch® system are an independent prognostic factor of progression-free survival (PFS) and overall survival (OS) in MBC patients. Several published papers demonstrated the poor prognosis for MBC patients that presented basal CTC count ≥5 in 7.5 mL of blood. Therefore, the enumeration of CTCs during treatment for MBC provides a tool with the ability to predict progression of disease earlier than standard timing of anatomical assessment using conventional radiological tests. During the metastatic process cancer cells exhibit morphological and phenotypic plasticity undergoing epithelial-mesenchymal transition (EMT). This important phenomenon is associated with down regulation of epithelial marker (e.g., EpCAM) with potential limitations in the applicability of current CTCs enrichment methods. Such observations translated in a number of investigations aimed at improving our capabilities to enumerate and perform molecular characterization of CTCs. Theoretically, the phenotypic analysis of CTCs can represent a “liquid” biopsy of breast tumor that is able to identify a new potential target against the metastatic disease and advanced the development and monitoring of personalized therapies.
Case Report
Perivascular epithelioid cell tumor of male pelvic cavity: a case report and literature review
Feng Sun, Chun-Lin Chen, Rong-Jian Chen, Ling Ding, Shi-Tao Xing, Xiao-Zhe Cao
2012, 24(4): 399-402. doi: 10.3978/j.issn.1000-9604.2012.09.06
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Perivascular epithelioid cell tumors (PEComas) are a family of rare mesenchymal neoplasms. The PEComas, composed of epithelioid and spindle cells, have the same cellular and immunohistochemical features but are found in different visceral and soft tissue sites. Here, we report the histological and immunohistochemical features of one case of PEComa restricted in the pelvic visceral peritoneum of a male patient. The patient was treated with radical surgery, and was well and on follow-up visits without tumor recurrence.
Evaluation of treatment response for breast cancer: are we entering the era of “biological complete remission”?
Li Bian, Tao Wang, Yi Liu, Hui-Qiang Zhang, Jin-Jie Song, Shao-Hua Zhang, Shi-Kai Wu, San-Tai Song, Ze-Fei Jiang
2012, 24(4): 403-407. doi: 10.3978/j.issn.1000-9604.2012.11.01
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Breast cancer is one of the most common malignancies in women. The post-operative recurrence and metastasis are the leading causes of breast cancer-related mortality. In this study, we tried to explore the role of circulating tumor cell (CTC) detection combination PET/CT technology evaluating the prognosis and treatment response of patients with breast cancer; meanwhile, we attempted to assess the concept of “biological complete remission” (bCR) in this regard. A 56-year-old patient with breast cancer (T2N1M1, stage IV left breast cancer, with metastasis to axillary lymph nodes and lungs) received 6 cycles of salvage treatment with albumin-bound paclitaxel plus capecitabine and trastuzumab. Then, she underwent CTC detection and PET/CT for efficacy evaluation. CTC detection combination PET/CT is useful for the evaluation of the biological efficacy of therapies for breast cancer. The bCR of the patient appeared earlier than the conventional clinical imaging complete remission and promised the histological (pathological) complete remission. The integrated application of the concepts including bCR, imageological CR, and histological CR can achieve the early and accurate assessment of biological therapeutic reponse and prognosis of breast cancer.
Meeting Report
The 7th National Gastric Cancer Academic Conference: focus on translational research in gastric cancer
Aiwen Wu, Jiafu Ji
2012, 24(4): 408-414. doi: 10.3978/j.issn.1000-9604.2012.09.08
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