Chronic pancreatitis as a driving factor for pancreatic cancer:An epidemiological understanding

The retrospective study by Lew et al(2022)examined the rising hospitalization rates for chronic pancreatitis(CP)and its association with pancreatic ductal adenocarcinoma(PDAC),revealing significant ethno-racial disparities and risk factors.Overweight black men aged 40-59 years and white men over 40 years with higher incomes showed an elevated risk of PDAC among CP patients.The study,which included 14.2 million admissions from 2016-2017,found that 2.6%of adult patients were diagnosed with CP,with white males being the majority.Multivariate regression analysis identified men,black individuals,those aged 40-59 years,and individuals with a body mass index(BMI)between 25 and 29.9 as having an increased risk for CP.Moreover,0.78%of CP patients also had PDAC,with older age and BMI being significant risk factors for developing PDAC in CP patients.The study also highlighted disparities in healthcare access and utilization among different socioeconomic and ethno-racial groups,which may impact the risk and outcomes of CP and PDAC.

Assessing the Effectiveness of a Cervical Cancer Screening Program in a Hospital-based Study

This study compared HPV testing and liquid-based cytology （LCT） as performance indicators for cervical cancer screening in a hospital-based study. A total of 61,193 outpatients were screened initially by LCT. Samples with screening results showing atypical squamous cells of undetermined significance （ASC-US） or worse were referred for colposcopy, and some samples were tested for high-risk HPV types with the Hybrid Capture II system （HC II）. Data on LCT （n=61,193） and HC II （n=1056） results were analysed. Overall test positivity for LCT was 2.53% using an ASC-US threshold, 3.11% using a low-grade squamous intraepithelial lesion （LSIL） threshold, and 0.67% using a high-grade squamous intraepithelial lesion （HSIL） threshold. A total of 1839 women （84% of the 3893 patients with abnormal cytology） underwent colposcopy-directed biopsy. HPV was positive in 80.3% of women with cervical intraepithelial neoplasia 1 （CIN1）, 88.3% of those with CIN2, 79.2% of women with CIN3 and 50% （2 of 4） of women with invasive cancer. There was a significant increase in the detection of CIN2 or worse with adjunct HPV testing of women with ASC-US and LSIL However, there were detection of CIN2＋ cases no differences in the with adjunct HPV testing of women with HSlI.. The results indicate that HPV testing for HSlL triage should not be recommended in cervical cancer screening.

Estimation Study of New Cancer Cases and Deaths in Wuwei, Hexi Corridor Region, China, 2018

Population-based cancer registration data were collected to estimate the cancer incidence and mortality in Wuwei, Hexi Corridor Region, China in 2018. We used the 2011-2013 data to predict the number of new cases and deaths in 2018 and the 2003-2013 data to analyze trends in cancer incidence and mortality. The goal is to enable cancer prevention and control directions. Our results indicated that stomach cancer is the most common cancer. For all cancers combined, the incidence and mortality rates showed significantly increasing trends（＋2.63% per year; P 〈 0.05 and ＋1.9% per year; P 〈 0.05）. This study revealed a significant cancer burden among the population of this area. Cancer screening and prevention should be performed after an epidemiological study of the cause of the cancer is completed.

External validation of the Prostate Cancer Prevention Trial and the European Randomized Study of Screening for Prostate Cancer risk calculators in a Chinese cohort

Several prediction models have been developed to estimate the outcomes of prostate biopsies. Most of these tools were designed for use with Western populations and have not been validated across different ethnic groups. Therefore, we evaluated the predictive value of the Prostate Cancer Prevention Trial （PCPT） and the European Randomized Study of Screening for Prostate Cancer （ERSPC） risk calculators in a Chinese cohort. Clinicopathological information was obtained from 495 Chinese men who had undergone extended prostate biopsies between January 2009 and March 2011. The estimated probabilities of prostate cancer and high-grade disease （Gleason 〉6） were calculated using the PCPT and ERSPC risk calculators. Overall measures, discrimination, calibration and clinical usefulness were assessed for the model evaluation. Of these patients, 28.7% were diagnosed with prostate cancer and 19.4% had high-grade disease. Compared to the PCPT model and the prostate-specific antigen （PSA） threshold of 4 ng m1-1, the ERSPC risk calculator exhibited better discriminative ability for predicting positive biopsies and high-grade disease （the area under the curve was 0.831 and 0.852, respectively, P〈O.01 for both）. Decision curve analysis also suggested the favourable clinical utility of the ERSPC calculator in the validation dataset. Both prediction models demonstrated miscalibration： the risk of prostate cancer and high-grade disease was overestimated by approximately 20% for a wide range of predicted probabilities. In conclusion, the ERSPC risk calculator outperformed both the PCPT model and the PSA threshold of 4 ng ml- z in predicting prostate cancer and high-grade disease in Chinese patients. However, the prediction tools derived from Western men significantly overestimated the probability of prostate cancer and high-grade disease compared to the outcomes of biopsies in a Chinese cohort.

Epidemiologic Study of Cancer Mortality among Chloroprene Workers

Both case-control and cohort studies were undertaken from July 1,1969 to June 30,1983 to ascertain whether exposure to chloroprene increases the risk of cancer.Fifty-five cases of cancer deaths were verified,16 of which had histories of exposure to chloroprene ranging from 3 to 23 years(median 11 years)with a latent period of 8-27 years,except for one case of 3 years(median 12.5 years).Fifty-four pairs were obtained by matching the cancer deaths to noncaneer deaths in accordance with strict requirements.The odds ratio for the paired data was 13,x^2=8.64,P <0.005.The average age at death from cancer of workers exposed to chloroprene was 12.7 years younger than that of unexposed workers,t'=2.98,P<0.001.The total cohort consisted of 1213 persons,among whom 149(11.6%)had histories of exposure for over 25 years,381(31.5%) for over 20 years,and 852(70.2%) for over 15 years.The SMR for the total cohort was 2.38(P <0.01),and all SMRs for the high-exposure occupations were of significance(P<0.05or P<0.01),in contrast to those of the low-exposure groups whose SMRs were low or zero.Thus, a dose-response relationship existed.Among the high-exposure occupations,maintenance me- chanics seem to have the highest risk of cancers,and SMRs for liver,lung,and lymphatic cancers were significant in this group.These results suggested that chloroprene exposure increases the risk of developing cancer.1989 Academic Press,Inc.

A Genetic Susceptibility Study of Lung Cancer Risk Potentially Associated with Polycyclic Aromatic Hydrocarbon Inhalation Exposure

For lifetime non-smokers, lung cancer risk is mainly associated with inhalation exposure to air pollution. For the Chinese population, indoor air pollution due to solid fuel combustion has been the primary source of inhalation exposure for decades. Polycyclic aromatic hydrocarbons （PAHs） are the by-products of incomplete combustion.

A STUDY OF LECTINS IN HUMAN BREAST CANCER AND PRECANCEROUS LESIONS

This paper report the binding pattern of 12 different kinds of lectin in human breast lesions. Of the 12 kinds of lectins, WGA showed the highest binding activity to the cells of the breast tissue derived; the binding of BSL, SBA and DBA were localized to membrane or cytoplasm of cancer cells and to the lumina membrane border of the normal and benign lesions; PNA receptor is related with the differentiation of the breast; cancer; we didn't find any relationship between the lectin receptor and the tendency of metastasis of breast cancer.

THE ALTERNATIVE PATHWAY OF HUMAN T CELL ACTIVATION BY MONOCLONAL ANTIBODIES(A COMPARATIVE STUDY BETWEEN NORMAL INDIVIDUALS AND CANCER PATIENTS)

This paper described T cell proliferative response by an alternative pathway in normal subjects and In patients with malignant diseases. Two McAbs, Anti-CCTl and Lo-CD2-act recognizing two distinct epitopes on E-receptor (CD2) were used to costimulate PBMC. Proliferative responsiveness was measured by 3H-thymidine incorporation. It was found that 82% of 72 nonnal subjects gave proliferative response whereas only 23% of the 93 patients did. The average cpm±SD in patients with bladder cancer (118±2314), kidney cancer (1619±2719) or lymphoma (2518±4057) was significantly lower than that in normal subjects (4935±2314), (P<0.001). These results indicate that T cell proliferation through the alternative pathway was significantly depressed in patients with cancer, and this can be used as a new parameter to monitor the immune status of cancer patients.

A PRELIMINARY STUDY OF SERUM GLYCOCONIUGATES IN PATIENTS WITH CANCER USING THE ENZYME-LINKED LECTIN ASSAY

After primary analyses on the serum glycocon-jugates of lung cancer and normal individul using the enzyme-linked lectin assay (ELLA) with 12 kinds of lectins, PHA and LCA were selected to further study in the sera of 8 kinds of cancers, 4 kinds of non-malignant disease and 1 kind of postoperative cancer. It was found that the test values of 7 kinds of cancers with PHA or LCA were significantly higher than that of the normal (P<0.01); the values of 4 kinds of non-malignant diseases with PHA were not higher (P>0.05); the values of the postoperative cancer with PHA were obviously lower than that of the preoperative (P<0.05). The results showed that the serum glycoconjugates which can bind to PHA seemed related to the cancerous existence in human bodies. The significance of the findings was discussed.

THE STUDY ON RISK FACTORS ASSOCIATED WITH BREAST CANCER AMONG WOMEN IN TIANJIN, CHINA AND ADELAIDE, AUSTRALIA

To explore the possible explanation of the marked difference in the incidence of breast cancer between Chinese and Australian women, the authors have compared and analysed the results of two case-control studies completed recently in Tianjin, China and Adelaide, Australia. Of 10 known risk factors for breast cancer 9 were significantly higher in level in Adelaide women than in Tianjin women, i.e., women in Adelaide were much taller, heavier, more obese, earlier at menarche, later at first full-term pregnancy, more nulliparous, less parity, more in history of breast cancer in first degree relatives, more educated. From the 7 risk factors analysed by use of logistic regression model 5 factors, i.e., earlier age at menarche, later age at first full-term pregnancy, less parity, history of benign disease, and history of breast cancer in first degree relatives, were associated significantly with the increased risk for breast cancer in the Tianjin study, but not in Adelaide study. These factors being not associated with breast cancer in Adelaide women were unexpected. The explanation of the indefinite findings in Adelaide study was due to the fact that the level of the risk factor is universally high, relatively uniform and lack of categories. The difference in the risk factor distribution between cases and controle would not be seen in case-control studies, and significance of the risk factor therefore may not be found. According to data on diet survey in these two cities, the calories from fat was significantly higher in Adelaide women than in Tianjin women. The marked difference in incidence in women in the two cities resulted from the summing-up effect of a number of factors. The important role of fat intake in geographical incidence difference and in the development of breast cancer was also discussed.

A STUDY OF DECREASING DRUG-RESISTANCE OF HUMAN OVARIAN CANCER CELLS IN VITRO

A chemosensitivity test for ovarian cancer using tritiated thymidine incorporation assay was carried out. A dose-response relationship for cisplatin and potentiation of verapamil in increasing vincristine inhibition to ovarian cancer were investigated. A 5- fold increase of cisplatin density converted the tumors which were initially resistance to standard-dose cisplatin Into drug-sensitive ones. Vera-pamil was found to be able to overcome vincristine-resistance of some tumors in vitro. These results suggest that using high dose cisplatin therapy or increasing local drug concentration by using other administration way, we could expect some ovarian cancers that had failed to standard dose cisplatin therapy to be effective. Combination of vincristine with verapamll may be helpful in treating some vincristineresistant cases.

IMMUNOELECTRON MICROSCOPIC STUDY ON THE LOCALIZATION OF MONOCLONAL ANTIBODIES ON GASTRIC CANCER CELLS

The localization of three monoclonal antibodies (MAb) against gastric cancer was studied on two human gastric cancer cell lines by immunoelectron microscopic technique. It has shown that the corresponding antigens of MAb 3G9 and 3H11 were distributed on the microvilli (M) and non-microvillus (NM) plasma membrane of target cells, with various M to NM ratios depending on the MAbs and target cells used. However, the corresponding antigens of MAb PD4 was only localized on the surface of round or finger-like bulges of target cells and never on the microvilli and non-microvillous plasma membrane. Since the nature and function of these tumor antigens have not been identified yet, the implication of the different distributions of these antigens remians to be clarifated.

A FIVE-YEAR PROSPECTIVE STUDY ON THE RELATIONSHIP BETWEEN GARLIC AND GASTRIC CANCER

A prospective study on the relationship between garlic and gastric cancer of 4552 subjects was made from Oct., 1980 through 1985. The volunteers, aged 50-59, were healthy males and came from different incidence areas of gastric cancer where they lived for long periods. The result of this study showed that the death rates of gastric cancer in < 2500 g and >500 g groups of annual garlic intake were 10.40/ 10000 and 0, respectively. The relative risk of gastric cancer was significantly much higher in the former than in the latter, and showed a dose-response relationship. Protective effect of garlic for the population equal annual garlic intake was roughly the same in different districts. It was further confirmed that garlic played important role in preventing gastric cancer and had no regional differences.

Prudent application of single-cell RNA sequencing in understanding cellular features and functional phenotypes in cancer studies

This decade has seen remarkable advances in the field of high-throughput single cell techniques.Single-cell RNA sequencing(sc RNA-seq)has proven to be a powerful strategy to study the heterogeneity in clinical samples,providing an unbiased approach to uncover the characteristics in different cell subsets.To ensure the reproducibility and robustness of biological discoveries,researchers need to be aware of hidden caveats in tissue dissociation,cell capturing and transcripts measurement which may affect cell composition assessment and cellular function annotation.With measured interpretation of data and innovations in experimental and technical approaches,sc RNA-seq can greatly unravel the heterogeneity in complex system and improve our understandings in tissue homeostasis and cancer biology.

Advances in TCM Treatment of Gastric Cancer and Studies on the Apoptosis

The significance of apoptosis in gastric cancer is now widely recognized, and the induction of apoptosis as a new approach to treat gastric cancer has aroused great interest. In recent years, studies on certain TCM drugs for treating gastric cancer and for inducing apoptosis have brought about great attention both at home and abroad. The following is a summary made in this aspect.

Progression-free survival as surrogate endpoint in advanced pancreatic cancer: meta-analysis of 30 randomized first-line trials

BACKGROUND：Progression-free survival（PFS）has not been extensively investigated as a surrogate for survival in the firstline treatments of pancreatic cancer.The aim of this review was to evaluate PFS as a potential surrogate endpoint for overall survival（OS）in advanced pancreatic cancer in trials comparing poly-chemotherapy to gemcitabine alone.DATA SOURCES： A systematic literature search in PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials was conducted. The key words included randomized trial, first-line chemotherapy, pancreatic cancer, gemcitabine and poly-chemotherapy. Adjusted weighted linear regression was used to calculate Rs （Spearman＇s rank-order correlation coefficient） between PFS and post-progression survival （PPS） with OS （Rs） and between treatment effects on PFS and OS （RHR）. RESUEFS： A total of 30 trials including 8467 patients met the inclusion criteria. Correlation between the treatment effects on PFS and OS （RHR=0.78） and between the endpoint PFS and OS was high across all studies （Rs=0.75）. The slope of the re- gression line was 0.76±0.26, indicating that an agent produc- ing a 10% risk reduction for PFS will provide a 7.6%±2.6% risk reduction for OS. Correlation between PPS and OS was very strong （Rs=0.71） and accounted for more than 50% of the whole OS variability （R2=0.57）. CONCLUSION： Because of the robust correlation with OS and the potential influence of PPS caused by the second line therapies, it may be justified to consider PFS as a surrogate endpoint in trials evaluating new cytotoxic agents when gemcitabine is the control arm.

Cardiovascular risk management in cancer survivors:Are we doing it right?

Although under-recognized,cancer survivors continue to be at an increased risk of death from cardiovascular complications post-remission or cure.This increased burden of cardiovascular disease results from the interplay of various factors.Adequate cardiovascular risk assessment and timely intervention through a multi-disciplinary approach in these patients plays a pivotal role in the prevention of cardiovascular morbidity and mortality.We discuss the shortcomings of using current risk prediction scores in cancer survivors and provide some insights into cardiovascular risk management relevant for primary care physicians,oncologists,and cardiologists alike.

EXPERIMENTAL STUDIES OF TARGETING THERAPY OF GASTRIC CANCER WITH ^(131)-I LABELED McAbs

To investigate the radioimmunotherapeutic efficacy, radio-immunoconjugate 131-I-3G9, 811-I-3H11 and 131-I-NMIgG (irre levant antibody) were i.p. injected into nude mice bearing human gastric cancer xenograftes. Each animal received a single doses of 555MBq. Over 14 days the accumulative absorbed doses in tumors were 13.7 Gy for 131-I-3H11 and 12.17 Gy for 131-I-3G9. Both were significantly higher than that for 131-I-NMIgG (3.23 Gy). Thera peutic efficacy appeared most sharply from 2 to 3 weeks after injection. The inhibition ratio of tumor were 86% and 70% for 131-I-3H11 and 131-I-3G9 respectively. Histopathological evidance indicated that in tumor tissues radioactive damage was showed as karyopyknosis, karyorrhexis and necrosis or partial disappearance of tumor cells, while in the other tissues no radioactive damage was observed. WBC counts of all animals did not show significant difference before and after treatment, which indicated that the haemopoietic function of bone marrow was not affected.

Molecular Diagnosis of Thyroid Nodules and Its Future Implications for the Management of Thyroid Cancer

Molecular testing in thyroid nodules and thyroid cancer is rapidly evolving;care must be used when incorporating molecular testing for thyroid nodules into clinical practice. A clear appreciation of the goals and restraints of molecular testing must be integrated into how physicians use and explain molecular testing to patients. Molecular tests can help rule in cancer for indeterminate thyroid nodules with very specific mutations for thyroid cancer, such as BRAF and RET/PTC, and can help reduce the rates of completion thyroidectomies in this era of de-escalation of the management of thyroid disease. The positive predictive value (PPV) of malignant cytology (Bethesda VI) is 98%;and even though molecular testing improves specificity and PPV, it falls short of this ideal for other mutations. We present a detailed evaluation of the current state of molecular testing and their clinical relevance in the setting of diagnostic utility and their impact on surgical decision-making. By recapitulating the clinical impact of these tests and some of the related drawbacks, we hope to provide adequate up to date information of the appropriate utilization of these tools in the management of indeterminate or suspicious thyroid nodules and highlight future directions on their utilization for the management of thyroid cancer.