2014 Vol.26(1)

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Case Report
Aberration of the Wnt signaling pathway in pulmonary fatal adenocarcinoma: a case report
Junzhe Li, Xinhua Bai, Yufeng Zou, Yanyong Hao, Xianhua Xu
2014, 26(1): E13-E16. doi: 10.3978/j.issn.1000-9604.2014.02.05
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We report a case of a 58-year-old woman showed a homogeneous well-defined perihilar mass in the right upper lobe and fully surrounded by aerated parenchyma at computed tomography (CT). A right upper lobectomy with mediastinal lymph node sampling was performed. A pathologic diagnosis of well-differentiated fetal adenocarcinoma of the lung was made and staged as T2bN0M0. For the expression of Wnt signaling pathway molecules, positive expressions of Wnt1, β-catenin, c-Myc, Cyclin D1and MMP7 were especially prominent in budding solid nests, but not in glandular structures. The nuclear/cytoplasmic localization of β-catenin accompanied upregulation of Wnt signaling pathway molecules in budding solid nests. These results demonstrated that elevated nuclear/cytoplasmic expression of β-catenin in fatal adenocarcinoma might be regulated by the Wnt signaling pathway.
A case of sudden hearing loss during treatment with decitabine for chronic myelomonocytic leukemia
Hee-Jun Kim, Eun-Kyung Park, In-Seok Moon
2014, 26(1): E1-E4. doi: 10.3978/j.issn.1000-9604.2014.01.05
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Chronic myelomonocytic leukemia (CMML) was initially classified in the category of myelodysplastic syndrome (MDS), but it is now categorized by the 2001 World Health Organization (WHO) classification in a separate nosological group of MDS. Unlike chronic myeloid leukemia (CML), the bone marrow morphology in CMML demonstrates prominent dysplastic changes in at least two of the three myeloid lineages. A 73-year-old male patient was brought to division of hematology for evaluation of leukocytosis. He was diagnosed with CMML and treated with decitabine. The hearing impairment had arisen during the third cycle of decitabine. To our knowledge, this is the first case that idiopathic sudden hearing loss (SHL) occured in CMML patients during treatment with decitabine.
Successful rechallenge of cetuximab following severe infusion-related reactions: a case report
Pei-Hung Chang, Jen-Seng Huang
2014, 26(1): E10-E12. doi: 10.3978/j.issn.1000-9604.2014.02.02
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Cetuximab, an anti-epidermal growth factor receptor (EGFR) monoclonal antibody, is associated with a risk of infusion reactions, similar to other infusional agents. Although avoiding a rechallenge with cetuximab following a severe infusion reaction is preferable, this may not be an option if few other reasonable alternatives exist. We report herein a successful case of cetuximab rechallenge, carried out by extending infusion times and using saline dilution in a patient who had severe infusion reactions twice and who required continuation of treatment. Cetuximab reintroduction with saline dilution and a slower infusion rate in an intensive care setting allowed safe continuation of therapy.
Steatocystoma multiplex as initial impression of non-small cell lung cancer with complete response to gefitinib
Ming-Hung Tsai, Yu-Ping Hsiao, Wea-Lung Lin, Szu-Wen Tseng
2014, 26(1): E5-E9. doi: 10.3978/j.issn.1000-9604.2014.01.02
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Cutaneous metastases are rare and seldom present at the time of first diagnosis of cancer. Data from various studies show that 1-12% of lung cancer patients experience tumor spread to the skin. The scalp, chest, and abdomen are favored sites of skin metastases from lung cancers, but metastases to multiple skin sites in a single patient are rarely reported. We describe a 56-year-old lung adenocarcinoma patient, initially diagnosed with steatocystoma multiplex who responded well to gefitinib treatment. The efficacy of conventional chemotherapy for cutaneous metastases has been limited because of the relatively poor blood supply to the skin. It has been demonstrated that tyrosine kinase inhibitor (TKI), gefitinib, has significant clinical benefit in lung cancer patients with epidermal growth factor receptor (EGFR) mutation even in metastases to the brain. However, the therapeutic response to gefitinib in patients with skin metastases is seldom mentioned in the literature. We report one case of lung adenocarcinoma with multiple skin metastases that were successfully treated with gefitinib.
Synchronous double primary lung cancer: a report of three cases
Xue-Dong Liu, Yan Qu, Sen-Sen Lu
2014, 26(1): E17-E21. doi: 10.3978/j.issn.1000-9604.2014.01.03
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The incidence of synchronous multiple primary lung cancers is on the rise due to improvements in computed tomography (CT) scanning and increasing use of positron emission tomography scanning and other diagnostic modalities. We report three cases of synchronous double primary lung cancer (DPLC) diagnosed based on CT findings, results of bronchoscopy and histological study. All patients had a long-term history of heavy smoking. Squamous cell carcinoma and small cell carcinoma were the most common histological types in these cases. DPLC frequently involves the upper lobes of left or right lung. Future molecular biological studies on DPLC should be warranted to shed light on the mechanisms underlying the pathogenesis of DPLC and the role of targeted therapy in this condition.
Editorial
Intraperitoneal chemotherapy and its evolving role in management of gastric cancer with peritoneal metastases
Emel Canbay, Yutaka Yonemura, Bjorn Brucher, Seung Hyuk Baik, Paul H. Sugarbaker
2014, 26(1): 1-3. doi: 10.3978/j.issn.1000-9604.2014.02.06
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Advanced gastric cancer (GC) has been recognized as lethal disease when peritoneal metastases (PM) occurred. There is no standard treatment for advanced GC with PM. Until 1980s, the therapeutic arena for these patients had remained stagnant, with no therapeutic approach having shown a survival gain in GC with PM. However, cytoreductive surgery (CRS) with peritonectomy procedures and intraperitoneal chemotherapy (IPC) promising new combined therapeutic approach to achieve disease control for GC with PM. The recent publications changed the GC with PM treatment landscape by providing an evidence that CRS and IPC led to prolongation in overall survival (OS). This review will provide an overview of the evolving role of CRS and IPC in the management of advanced GC with PM in the current era.
Original Article
Prediction rule for estimating advanced colorectal neoplasm risk in average-risk populations in southern Jiangsu Province
Guochang Chen, Boneng Mao, Qi Pan, Qian Liu, Xinfang Xu, Yueji Ning
2014, 26(1): 4-11. doi: 10.3978/j.issn.1000-9604.2014.02.03
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ObjectiveThe aim of this study was to establish the risk scoring system towards the advanced colorectal neoplasm (CN) risk in the average-risk populations in the southern Jiangsu Province, and to evaluate the screening efficacy.MethodsTotally 905 cases of the average-risk populations who received the colonoscopy were selected as the objective. The multivariate logistic regression analysis method was used to establish the scoring system towards the occurrence risk of the advanced tumor, and its screening efficacy was evaluated through the prediction consistency, distinguishing ability and screening accuracy.ResultsThe scoring system consisted of five variables, namely age, gender, coronary heart disease, egg intake and stool frequency. The results revealed that it had good prediction consistency (P=0.205) and distinguishing ability [the area under the receiver operating characteristic (ROC) curve was 0.75, with 95% confidence interval (95% CI) of 0.69-0.82]. Thus, 2.5 points was set as the screening cutoff value, and its sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio were 93.8%, 47.6%, 50.1%, 9.1%, 99.3%, 1.79 and 0.13, respectively.ConclusionsThe established scoring system had good screening efficacy, and can be used as the screening tool applying to the CN screening within the average-risk populations in the southern Jiangsu Province.
Long-term fatigue state in postoperative patients with breast cancer
Xiao-Fang Tan, Fang Xia
2014, 26(1): 12-16. doi: 10.3978/j.issn.1000-9604.2014.01.12
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ObjectiveTo investigate the prevalence of long-term fatigue, anxiety, depression and social support, and the relationships among these symptoms in postoperative patients with breast cancer.MethodsA total of 180 postoperative patients with breast cancer meeting criterion were recruited in this cross-sectional study. The Brief Fatigue Inventory (BFI), Hospital Anxiety and Depression Scale (HADS) and The Social Support Survey-Chinese version were used to assessing the fatigue, anxiety and depression, Social support of participants. The magnitude of the relationship among the symptoms of fatigue and other variables was measured by Spearman Rho correlation.ResultsThe prevalence of long-term fatigue was 52.7%, and 18.3% occurred moderate/severe fatigue. Two-thirds of patients had a basal social support, only 12.8% of patients had better-perceived social support. Results of HADS showed that 16.7% and 21.1% of the participants have anxiety or depression disorder. Moderate/severe fatigue was negatively correlated with social support (r=–0.158, P=0.038) and positively correlated with age (r=0.132, P=0.042), chemotherapy (r=0.297, P=0.027), anxiety (r=0.324, P=0.018) and depression (r=0.211, P=0.034).ConclusionsLong-term fatigue was highly prevalent among over half of postoperative patients with breast cancer, and moderate/severe fatigue was associated with social and psychological factors such as social support, anxiety and depression. Our results suggest that overall nursing care may be a more effective manner in improving fatigue and quality of life.
MiR-182 is up-regulated and targeting Cebpa in hepatocellular carcinoma
Chenggang Wang, Ren Ren, Haolin Hu, Changjun Tan, Miao Han, Xiaolin Wang, Yun Zheng
2014, 26(1): 17-29. doi: 10.3978/j.issn.1000-9604.2014.01.01
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MicroRNAs (miRNAs) are endogenous small non-coding RNAs that repress their targets at post transcriptional level. Existing studies have shown that miRNAs are important regulatory genes in hepatocellular carcinoma (HCC), as either tumor suppressors or oncogenes. MiR-122 is normally downregulated in HCC and regarded as a tumor suppressor. Recently miR-122 has been reported to be regulated by CEBPA, which is then involved in a novel pathway to influence proliferation of tumor cells. However it is unknown whether CEBPA is regulated by miRNAs in HCC. In this study, we find that miR-182 is upregulated in HCC model rat, and represses CEBPA in both rat and human. This further improves the current CEBPA/miR-122 pathway that controls the proliferation of tumor cells. These results suggest that miR-182 is a potential oncogene in HCC and could be used as a diagnostic marker and drug target of HCC.
Prognostic value of post-treatment 18F-FDG PET/CT for advanced head and neck cancer after combined intra-arterial chemotherapy and radiotherapy
Kimiteru Ito, Keigo Shimoji, Yoko Miyata, Kouhei Kamiya, Ryogo Minamimoto, Kazuo Kubota, Momoko Okasaki, Miyako Morooka, Jyunkichi Yokoyama
2014, 26(1): 30-37. doi: 10.3978/j.issn.1000-9604.2014.01.06
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ObjectiveTo clarify the prognostic value of post-treatment 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in patients with advanced head and neck squamous cell carcinoma (HNSCC) after combined intra-arterial chemotherapy and radiotherapy (IACR).MethodsThirty-six patients with HNSCC who underwent IACR were recruited. The period from the end of IACR to the last post-treatment 18F-FDG PET/CT examination was 8-12 weeks. Both patient-based and lesion-based analyses were used to evaluate the PET/CT images. For lesion-based analysis, 36 regions (12 lesions of recurrences and 24 scars at primary sites) were selected. The Kaplan-Meier method was used to assess the overall survival (OS) stratified by 18F-FDG uptake or visual interpretation results.ResultsTwelve patients with recurrence were identified by six months after IACR. The sensitivity and specificity in the patient-based analysis were 67% (8/12) and 88% (21/24), respectively. The mean OS was estimated to be 12.1 months (95% CI, 6.3-18.0 months) for the higher maximum standardized uptake value (SUVmax) group (n=7) and 44.6 months (95% CI, 39.9-49.3 months) for the lower SUVmax group (n=29). OS in the higher SUVmax group (cut-off point, 6.1) or positive visual interpretation group was significantly shorter than that in the lower SUVmax or negative visual interpretation group (P<0.001 and P<0.05, respectively).ConclusionsThe SUVmax and visual interpretation of HNSCC on post-IACR 18F-FDG PET/CT can provide prognostic survival estimates.
Diffusion-weighted images (DWI) without ADC values in assessment of small focal nodules in cirrhotic liver
Mai-Lin Chen, Xiao-Yan Zhang, Li-Ping Qi, Qing-Lei Shi, Bin Chen, Ying-Shi Sun
2014, 26(1): 38-47. doi: 10.3978/j.issn.1000-9604.2014.01.07
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ObjectiveTo assess if diffusion-weighted magnetic resonance (MR) imaging without apparent diffusion coefficient (ADC) values provides added diagnostic value in combination with conventional MR imaging in the detection and characterization of small nodules in cirrhotic liver.MethodsTwo observers retrospectively and independently analyzed 86 nodules (≤3 cm) certified pathologically in 33 patients with liver cirrhosis, including 48 hepatocellular carcinoma (HCC) nodules, 13 high-grade dysplastic nodules (HDN), 10 low-grade dysplastic nodules (LDNs) and 15 other benign nodules. All these focal nodules were evaluated with conventional MR images (T1-weighted, T2-weighted and dynamic gadolinium-enhanced images) and breath-hold diffusion-weighted images (DWI) (b=500 s/mm2). The nodules were classified by using a scale of 1-3 (1, not seen; 3, well seen) on DWI for qualitative assessment. These small nodules were characterized by two radiologists. ADC values weren’t measured. The diagnostic performance of the combined DWI-conventional images and the conventional images alone was evaluated using receiver operating characteristic (ROC) curves. The area under the curves (Az), sensitivity and specificity values for characterizing different small nodules were also calculated.ResultsAmong 48 HCC nodules, 33 (68.8%) were graded as 3 (well seen), 6 (12.5%) were graded as 2 (partially obscured), and 9 weren’t seen on DWI. Among 13 HDNs, there were 3 (23.1%) and 4 (30.8%) graded as 3 and 2 respectively. Five (50%) of 10 benign nodules were partially obscured and slightly hyperintense. For 86 nodules, the average diagnostic accuracy of combined DWI-conventional images was 82.56%, which was increased significantly compared with conventional MR images with 76.17%. For HCC and HDN, the diagnostic accuracy of combined DWI-conventional images increased from 78.69% to 86.07%.ConclusionsDiffusion-weighted MR imaging does provide added diagnostic value in the detection and characterization of HDN and HCC, and it may not be helpful for LDN and regenerative nodule (RN) in cirrhotic liver.
Annual report on status of cancer in China, 2010
Wanqing Chen, Rongshou Zheng, Siwei Zhang, Ping Zhao, Hongmei Zeng, Xiaonong Zou, Jie He
2014, 26(1): 48-58. doi: 10.3978/j.issn.1000-9604.2014.01.08
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ObjectivePopulation-based cancer registration data in 2010 were collected, evaluated and analyzed by the National Central Cancer Registry (NCCR) of China. Cancer incident new cases and cancer deaths were estimated.MethodsThere were 219 cancer registries submitted cancer incidence and death data in 2010. All data were checked and evaluated on basis of the criteria of data quality from NCCR. Total 145 registries’ data were qualified and accepted for cancer statistics in 2010. Pooled data were stratified by urban/rural, area, sex, age group and cancer site. Cancer incident cases and deaths were estimated using age-specific rates and national population. The top ten common cancers in different groups, proportion and cumulative rate were also calculated. Chinese census in 2000 and Segi’s population were used for age-standardized incidence/mortality rates.ResultsAll 145 cancer registries (63 in urban and 82 in rural) covered a total of 158,403,248 population (92,433,739 in urban and 65,969,509 in rural areas). The estimates of new cancer incident cases and cancer deaths were 3,093,039 and 1,956,622 in 2010, respectively. The morphology verified cases (MV%) accounted for 67.11% and 2.99% of incident cases were identified through death certifications only (DCO%) with mortality to incidence ratio (M/I) of 0.61. The crude incidence rate was 235.23/100,000 (268.65/100,000 in males, 200.21/100,000 in females), age-standardized incidence rates by Chinese standard population (ASIRC, 2000) and by world standard population (ASIRW) were 184.58/100,000 and 181.49/100,000 with the cumulative incidence rate (0-74 years old) of 21.11%. The cancer incidence and ASIRC were 256.41/100,000 and 187.53/100,000 in urban areas whereas in rural areas, they were 213.71/100,000 and 181.10/100,000, respectively. The crude cancer mortality in China was 148.81/100,000 (186.37/100,000 in males and 109.42/100,000 in females), age-standardized incidence rates by Chinese standard population (ASMRC, 2000) and by world standard population (ASMRW) were 113.92/100,000 and 112.86/100,000, and the cumulative incidence rate (0-74 years old) was 12.78%. The cancer mortality and ASMRC were 156.14/100,000 and 109.21/100,000 in urban areas, whereas in rural areas, they were 141.35/100,000 and 119.00/100,000 respectively. Lung cancer, gastric cancer, colorectal cancer, liver cancer, esophageal cancer, pancreas cancer, encephaloma, lymphoma, female breast cancer and cervical cancer, were the most common cancers, accounting for 75% of all cancer cases in urban and rural areas. Lung cancer, gastric cancer, liver cancer, esophageal cancer, colorectal cancer, pancreatic cancer, breast cancer, encephaloma, leukemia and lymphoma accounted for 80% of all cancer deaths.ConclusionsThe coverage of cancer registration population had a rapid increase and could reflect cancer burden in each area and population. As the basis of cancer control program, cancer registry plays an irreplaceable role in cancer epidemic surveillance, evaluation of cancer control programs and making anti-cancer strategy. China is facing serious cancer burden and prevention and control should be enhanced.
EGFR gene copy number as a predictive biomarker for resistance to anti-EGFR monoclonal antibodies in metastatic colorectal cancer treatment: a meta-analysis
Wei-Dong Shen, Hong-Lin Chen, Peng-Fei Liu
2014, 26(1): 59-71. doi: 10.3978/j.issn.1000-9604.2014.01.10
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ObjectiveThe epidermal growth factor receptor (EGFR) inhibitors monoclonal antibodies (MoAbs) have already shown the therapeutic effectiveness in patients with metastatic colorectal cancer (mCRC). But many patients resist to the treatment. The aim of this meta-analysis was to assess EGFR gene copy number (GCN) as a candidate predictive biomarker for resistance to anti-EGFR MoAbs in mCRC treatment.MethodsSystematic computerized searches of the PubMed, EMBase and Cochrane Library were performed. The primary endpoint was objective response rate (ORR). The second endpoints included progression-free survival (PFS), and overall survival (OS). The pooled odd ratio (OR) and pooled sensitivity, specificity, and summary receiver operator characteristic (SROC) for ORR were estimated. The pooled hazard ratios (HR) for PFS and OS were also calculated.ResultsFourteen studies with 1,021 patients were included. Increased EGFR GCN was associated with increased ORR (OR=6.905; 95% CI: 4.489-10.620). It was also found in wild-type KRAS mCRC patients, with the pooled OR of 8.133 (95% CI: 4.316-15.326). GCN has medium value for predicting ORR, with the pooled sensitivity of 0.79 (95% CI: 0.73-0.84), the pooled specificity of 0.59 (95% CI: 0.55-0.62). In wild-type KRAS mCRC patients, the sensitivity and the specificity were 0.80 (95% CI: 0.70-0.87) and 0.60 (95% CI: 0.53-0.66), respectively. Increased EGFR GCN was associated with increased PFS (HR=0.557; 95% CI: 0.382-0.732) and OS (HR=0.579; 95% CI: 0.422-0.737).ConclusionsThis meta-analysis suggests that EGFR GCN represents a predictive biomarker for tumor response in mCRC patients treated with MoAbs regardless of KRAS mutation. mCRC patients with increased EGFR GCN are more likely to have a better response, PFS, and OS when treated with cetuximab or panitumumab.
Overexpression of HOXB9 promotes metastasis and indicates poor prognosis in colon cancer
Kai Huang, Rongfa Yuan, Kai Wang, Junwen Hu, Zixi Huang, Chen Yan, Wei Shen, Jianghua Shao
2014, 26(1): 72-80. doi: 10.3978/j.issn.1000-9604.2014.01.11
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ObjectiveHomeobox B9 (HOXB9) is proposed to be involved in tumor angiogenesis and metastasis. We investigated the role of HOXB9 in the progression of colon cancer.MethodsHOXB9 expression was investigated by immunohistochemically and Western blotting in 128 colon cancer patients and the results were analyzed statistically associated with clinicopathological data and survival of the patients. The effect of HOXB9 on cell invasion and metastases abilities were analyzed in vitro and in vivo.ResultsHOXB9 is overexpressed in colon cancer tissues and significantly correlated with metastasis and poor survival of patients (P<0.05, respectively). Additionally, high levels of expression of HOXB9 were observed in metastatic lymph nodes. The down-regulation of HOXB9 expression can inhibit the migration and invasive ability of colon cancer cells, while exogenous expression of HOXB9 in colon cancer cells enhanced cell migration and invasiveness. Moreover, stable knockdown of HOXB9 reduced the liver and lung metastasis of colon cancer in vivo.ConclusionsHOXB9 may play an important role in the invasion and metastasis of colon cancer cells and may be a useful biomarker for metastasis and prognostic of colon cancer.
BCNU/PLGA microspheres: a promising strategy for the treatment of gliomas in mice
Tongming Zhu, Yiwen Shen, Qisheng Tang, Luping Chen, Huasong Gao, Jianhong Zhu
2014, 26(1): 81-88. doi: 10.3978/j.issn.1000-9604.2014.02.01
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ObjectiveTo investigate the effects of BCNU/PLGA microspheres on tumor growth, apoptosis and chemotherapy resistance in a C57BL/6 mice orthotopic brain glioma model using GL261 cell line.MethodsBCNU/PLGA sustained-release microspheres were prepared by the water-in-oil-in-water emulsion technique. GL261 cells were intracranially injected into C57BL/6 mouse by using the stereotactic technology. A total of 60 tumor-bearing mice were randomly and equally divided into three groups: untreated control, PLGA treated, BCNU/PLGA treated. Magnetic resonance imaging (MRI) was taken to evaluate tumor volume. BCNU/PLGA sustained-release wafers were implanted in the treatment group two weeks after inoculation. Survival time and quality were observed. Specimens were harvested, and immunohistochemical staining was used to check the expression of Bax, Bcl-2, and O6-methylguanine-DNA methyltransferase (MGMT). Statistical methods was used for analysis of relevant data.ResultsBCNU/PLGA sustained-release wafers were fabricated and implanted successfully. There is statistical difference of survival time between the BCNU/PLGA treated group and control groups (P<0.05). MRI scan showed inhibitory effect of BCNU/PLGA on tumor growth. Compared to the group A and B, BCNU/PLGA decreased the expression of apoptosis related gene Bcl-2 (P<0.05), but did not elevate the expression level of Bax (P>0.05), with the ratio of Bax/Bcl-2 increased. For MGMT protein expression, no statistically significant change was found in treated group (P>0.05).ConclusionsLocal implantation of BCNU/PLGA microspheres improved the survival quality and time of GL261 glioma-bearing mice significantly, inhibited the tumor proliferation, induced more cell apoptosis, and did not increase the chemotherapy resistance.
Significance of combined detection of LunX mRNA and tumor markers in diagnosis of lung carcinoma
Hui Yu, Xiuying Huang, Zhihua Zhu, Yi Hu, Wei Ou, Lanjun Zhang, Ningning Zhou
2014, 26(1): 89-94. doi: 10.3978/j.issn.1000-9604.2014.02.04
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ObjectiveTo evaluate the significance of combined detection of LunX mRNA, carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), and cytokeratin 21-1 fragment (CYFRA21-1) in clinical diagnosis of lung carcinoma.MethodsBased on the quantitative RT-PCR and chemiluminescence immunoassay, the expression levels of LunX mRNA, CEA, NSE, and CYFRA21-1 in 113 patients with lung carcinoma (case group) and 30 healthy participants (control group) were detected. Meantime, the sensitivity, specificity, and accuracy of the combination detection were also explored.ResultsThe positive rates of LunX mRNA in peripheral blood and CEA, NSE, and CYFRA21-1 in serum were significantly higher in case group than those in control group (χ2=17.295, 16.825, 19.148, and 17.450; P<0.05). There was no statistical significance when positive rate of LunX mRNA was evaluated among different pathological types (χ2=0.047, P>0.05). The positive rate of LunX mRNA in stage I + II, III, and IV had a significantly increasing tendency (χ2=10.565, 32.462, P<0.05). The positive rate of CYFRA21-1 was highest in squamous carcinoma (78.5%), the positive rate of NSE was highest in small cell carcinoma (86.7%), and the positive rate of CEA wag highest in lung adenocarcinoma (80.4%). The sensitivity and accuracy of the combination detection were 91.1% and 88.1%, respectively.ConclusionsThe combined detection of LunX mRNA and tumor markers (TMs) including CEA, NSE, and CYFRA21-1 in peripheral blood is helpful to increase the diagnostic accuracy of lung cancer. Also, it can inform the pathological typing of lung carcinoma.
Differential expression of serum miR-126, miR-141 and miR-21 as novel biomarkers for early detection of liver metastasis in colorectal cancer
Jie Yin, Zhigang Bai, Jianning Song, Yun Yang, Jin Wang, Wei Han, Jun Zhang, Hua Meng, Xuemei Ma, Yao Yang, Tingting Wang, Weirong Li, Zhongtao Zhang
2014, 26(1): 95-103. doi: 10.3978/j.issn.1000-9604.2014.02.07
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ObjectiveMicroRNAs (miRNAs) have potential as diagnostic biomarkers in cancer. Evaluation of the association between miRNA expression patterns and early detection of liver metastasis in colorectal cancer (CRC) has not been reported.MethodsWe investigated the expression of metastasis-associated miRs-31, 335, 206, 141, 126, 200b, 200c, 21, Let7a, Let7b and Let7c in localized, liver-metastatic and other organ-metastatic CRC (OM-CRC). Expressions of target miRNAs in serum were evaluated in 116 consecutive localized CRC (L-CRC), 72 synchronous liver-metastatic CRC (SLM-CRC) and 36 other OM-CRC by quantitative real-time PCR.ResultsSeven of 11 tested miRNAs could be detected from serum. Four miRNAs, miR-126, Let-7a, miR-141 and miR-21 were identified as metastasis-associated miRNAs. Compared with L-CRC, significant up-regulated expression was observed for miR-141 and miR-21 in SLM-CRC and OM-CRC, down-regulated expression was observed for miR-126 in SLM-CRC and OM-CRC, and up-regulated expression of Let-7a in OM-CRC. The receiver operating characteristic (ROC) curve showed serum miR-126 had a cut-off [log10 relative quantity (log10RQ)=–0.2005] with 77.78% sensitivity and 68.97% specificity with an area under curve (AUC) of 0.7564, miR-141 had a cut-off (log10RQ=–0.2285) with 86.11% sensitivity and 76.11% specificity with an AUC of 0.8279, and miR-21 had a cut-off (log10RQ=–0.1310) with 73.61% sensitivity and 66.38% specificity with an AUC of 0.7479.ConclusionsWe identified liver metastasis-associated miRNAs, suggesting serum miR-126, miR-141 and miR-21 may be novel biomarkers for clinical diagnosis of early stage liver-metastatic CRC.
Level of circulating PD-L1 expression in patients with advanced gastric cancer and its clinical implications
Zhixue Zheng, Zhaode Bu, Xijuan Liu, Lianhai Zhang, Ziyu Li, Aiwen Wu, Xiaojiang Wu, Xiaojing Cheng, Xiaofang Xing, Hong Du, Xiaohong Wang, Ying Hu, Jiafu Ji
2014, 26(1): 104-111. doi: 10.3978/j.issn.1000-9604.2014.02.08
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ObjectiveThe programmed cell death-1 receptor/programmed cell death-1 ligand (PD-1/PD-L1) pathway plays a crucial role in tumor evasion from host immunity. This study was designed to evaluate the association between circulating PD-L1 expression and prognosis in patients with advanced gastric cancer.MethodsTotally 80 advanced gastric cancer patients and 40 health controls from Beijing Cancer Hospital were enrolled in the present study. Circulating PD-L1 expression was tested by enzyme-linked immunosorbent assay (ELISA). The associations between the expression level of PD-L1 and clinicopathological features and prognosis were analyzed statistically.ResultsExpression of PD-L1 in advanced gastric cancer patients was significantly up-regulated compared with health people (P=0.006). The expression of PD-L1 was significantly correlated with differentiation and lymph node metastasis (P=0.026 and P=0.041, respectively). Although we didn’t find significant difference in all advanced gastric cancer patients with different PD-L1 expression, the adenocarcinoma patients with higher up-regulated PD-L1 expression had much better prognosis than low expression patients (65.6% vs. 44.7%, P=0.028).ConclusionsPD-L1 was elevated in advance gastric cancer patients and may play an important role in tumor immune evasion and patients prognosis.
Radiofrequency ablation or microwave ablation combined with transcatheter arterial chemoembolization in treatment of hepatocellular carcinoma by comparing with radiofrequency ablation alone
Yongxiang Yi, Yufeng Zhang, Qiang Wei, Liang Zhao, Jianbo Han, Yan Song, Ying Ding, Guilan Lu, Junmao Liu, Huaiying Ding, Feng Dai, Xiaojun Tang
2014, 26(1): 112-118. doi: 10.3978/j.issn.1000-9604.2014.02.09
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Abstract:
ObjectiveTo compare radiofrequency ablation (RFA) or microwave ablation (MWA) and transcatheter arterial chemoembolization (TACE) with RFA or MWA monotherapy in hepatocellular carcinoma (HCC).MethodsA prospective, randomized, controlled trial was conducted on 94 patients with HCC ≤7 cm at a single tertiary referral center from June 2008 to June 2010 at the Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Southeast University. The patients were randomly assigned into the TACE-RFA or TACE-MWA (combined treatment group) and the RFA-alone or MWA-alone groups (control group). The primary end point was overall survival. The secondary end point was recurrence-free survival, and the tertiary end point was adverse effects.ResultsUntil the time of censor, 17 patients in the TACE-RFA or TACE-MWA group had died. The median follow-up time of the patients who were still alive for the TACE-RFA or TACE-MWA group was 47.5±11.3 months (range, 29 to 62 months). The 1-, 3- and 5-year overall survival for the TACE-RFA or TACE-MWA group was 93.6%, 68.1% and 61.7%, respectively. Twenty-five patients in the RFA or MWA group had died. The median follow-up time of the patients who were still alive for the RFA or MWA group was 47.0±12.9 months (range, 28 to 62 months). The 1-, 3- and 5-year overall survival for the RFA or MWA group was 85.1%, 59.6% and 44.7%, respectively. The patients in the TACE-RFA or TACE-MWA group had better overall survival than the RFA or MWA group [hazard ratio (HR), 0.526; 95% confidence interval (95% CI), 0.334-0.823; P=0.002], and showed better recurrence-free survival than the RFA or MWA group (HR, 0.582; 95% CI, 0.368-0.895; P=0.008).ConclusionsRFA or MWA combined with TACE in the treatment of HCC ≤7 cm was superior to RFA or MWA alone in improving survival by reducing arterial and portal blood flow due to TACE with iodized oil before RFA.
Build infrastructure in publishing scientific journals to benefit medical scientists
Ni Dai, Dingyao Xu, Xiyao Zhong, Li Li, Qibo Ling, Zhaode Bu
2014, 26(1): 119-123. doi: 10.3978/j.issn.1000-9604.2014.02.10
Abstract(287) FullText HTML (254) PDF 112KB(3)
Abstract:
There is urgent need for medical journals to optimize their publishing processes and strategies to satisfy the huge need for medical scientists to publish their articles, and then obtain better prestige and impact in scientific and research community. These strategies include optimizing the process of peer-review, utilizing open-access publishing models actively, finding ways of saving costs and getting revenue, smartly dealing with research fraud or misconduct, maintaining sound relationship with pharmaceutical companies, and managing to provide relevant and useful information for clinical practitioners and researchers. Scientists, publishers, societies and organizations need to work together to publish internationally renowned medical journals.
A comparative study between Embosphere® and conventional transcatheter arterial chemoembolization for treatment of unresectable liver metastasis from GIST
Guang Cao, Xu Zhu, Jian Li, Lin Shen, Renjie Yang, Hui Chen, Xiaodong Wang, Song Gao, Haifeng Xu, Linzhong Zhu, Peng Liu, Jianhai Guo
2014, 26(1): 124-131. doi: 10.3978/j.issn.1000-9604.2014.02.11
Abstract(265) FullText HTML (229) PDF 2147KB(3)
Abstract:
ObjectiveTranscatheter arterial chemoembolization (TACE) is a standard treatment for hepatocellular carcinoma (HCC) and/or some unresectable liver metastasis tumors. Hypervascular liver metastatic lesions such as metastasis from gastrointestinal stromal tumor (GIST) are an indication for transcatheter arterial embolization (TAE). The purpose of this study was to evaluate the efficacy and safety of Embosphere®-TAE (Embo-TAE) in comparison with conventional TACE (cTACE) for the treatment of liver metastasis from GIST.MethodsA total of 45 patients who underwent TACE between Aug 2008 and Feb 2013 were enrolled. Patients with GIST who underwent TAE with Embosphere® (n=19) were compared with controls who received cTACE (n=26). The primary end points were treatment response and treatment-related adverse events. The secondary end points were progression-free survival (PFS) and overall survival (OS).ResultsThe treatment response of Embo-TAE group was significantly higher than that of the cTACE group (P<0.001). The PFS was significantly better in the Embosphere®-group than in the cTACE group (56.6 and 42.1 weeks, respectively; P=0.003). However, there was no statistically significant difference in liver toxicity between the two groups (P>0.05). The median OS in the Embo-TAE group was longer than that in the cTACE group (74.0 weeks, 95% CI: 68.2-79.8 vs. 61.7 weeks, 95% CI: 56.2-67.2 weeks) (unadjusted P=0.045). The use of Embo-TAE significantly reduced the risk of death in patients with GIST with liver metastases according to the Cox proportional hazards regression model [hazard ratio (HR): 0.149; 95% CI: 0.064-0.475].ConclusionsTAE with Embosphere® showed better treatment response and delayed tumor progression compared with cTACE. There was no significant difference in treatment-related hepatic toxicities. Embo-TAE thus appears to be a feasible and promising approach in the treatment of liver metastasis from GIST.