肺癌重度(3~4级)免疫检查点抑制剂相关肺炎CT特征

目的观察肺癌患者重度免疫检查点抑制剂相关肺炎(CIP)的临床及CT特点。资料与方法回顾性收集2019年9月1日—2022年3月31日在西安国际医学中心医院接受免疫检查点抑制剂(PD-1/PD-L1抑制剂)治疗的174例肺癌患者,分析重度CIP患者的临床及影像特点。结果共23例患者符合重度CIP诊断。其中,22例男性,15例发病年龄<65岁,17例有基础肺病史,16例有放化疗和其他治疗史,21例有联合放化疗史;免疫检查点抑制剂用药开始至发生CIP的中位时间为128(74,348)d;19例为非小细胞癌;16例CIP发生于右肺癌,15例出现肿瘤中央气道侵犯,14例影像学特征为弥漫性肺泡损伤/急性间质性肺炎模式,20例于随访期间死亡。结论重度CIP可能好发于男性、有基础病史、放化疗治疗史的肺癌患者,其临床表现多样,主要影像学特征为弥漫性肺泡损伤/急性间质性肺炎模式,预后较差。

三阴性乳腺癌中COX-2表达及其与临床病理特征关系的Meta分析

目的:分析比较COX-2基因在三阴性乳腺癌患者与非三阴性乳腺癌患者中的表达情况,评价COX-2基因是否能够成为三阴性乳腺癌的一个有效标志物。方法:计算机检索PubMed、Medline、Cochrane Collaboration Library、CNKI、万方、VIP数据库,收集国内外1989年至2018年公开发表的所有相关病例对照研究进行Meta分析。结果:共纳入9个病例对照研究,其中三阴性乳腺癌384例,非三阴性乳腺癌1 390例。Meta分析结果显示,COX-2在三阴性乳腺癌患者与非三阴性乳腺癌患者中的表达差异具有统计学意义[OR=1.41,95%CI(1.10,1.81)];COX-2在三阴性乳腺癌中的表达与淋巴结转移及组织大小相关[OR=5.89,95%CI(2.72,12.78);OR=2.39,95%CI(1.01,5.68)],而与患者年龄无关[OR=1.12,95%CI (0.55,2.30)]。结论:我们的研究显示,COX-2的表达与乳腺癌的分子分型有关,且在三阴性乳腺癌中表达更高。在三阴性乳腺癌中,COX-2阳性者更易发生淋巴结转移,且肿瘤组织更大。

THE CHANGES OF PERIPHERAL BLOOD T LYMPHOCYTE SUBSETS IN PATIENTS WITH PRIMARY HEPATIC CARCINOMA BOTH PRE-TACE AND POST-TACE

Objective To observe the variations of the cellular immunological function in patients with primary hepatic carcinoma both pre-TACE(transcatheter arterial chemoembolization,TACE).Methods T lymphocyte subset CD4,CD8 and CD4/CD7 ratio in 45 patients with primary hepatic carcinoma both pre-TACE and post-TACE were measured by flow Cytometer,and compared with the result of T lymphocyte subset in 19 healthy people as normal control samples.Results The CD4 and CD4/CD8 ratio in patients with primary hepatic carcinoma were significantly lower than those in normal control(P<0.05),while CD8 higher(P<0.05);The CD4 and CD4/CD8 ratio in patients with primary hepatic carcinoma were much more lower after TACE than those before TACE(P<0.05),while CD8 was higher but had no significant difference(P>0.05).Conclusion The cellular immunological function in patients with primary hepatic carcinoma decreased and is much more lower after TACE.

Scalp metastasis from gallbladder cancer： an unusual case

Gallbladder cancer is the most common malignant tumor of the biliary tract and the fifth most common malignancy of the gastrointestinal tract, In general, metastases of gallbladder carcinoma tends to occur in the regional lymph nodes and liver, while extra-abdominal and blood-borne metastases are relatively infrequent. Here we present an unusual case presenting with scalp metastasis from gallbladder cancer. To the best of our knowledge, only two similar cases have been documented in published literatures.