儿童神经纤维瘤病1型颅内肿瘤性病变的治疗进展

神经纤维瘤病1型(neurofibromatosis 1,NF1)好发于儿童,是神经系统最常见的常染色体显性遗传病之一,是基因缺陷使神经嵴细胞发育异常导致的多系统损害。NF1的外显率几乎是100%,主要临床特征为皮肤牛奶咖啡斑和周围神经多发神经纤维瘤。NF1在颅内能引起肿瘤性病变,后者按照病理学依据可分为低级别肿瘤、高级别肿瘤和类似肿瘤病变。合并NF1的颅内肿瘤多为低级别肿瘤,视路胶质瘤最为多见,其次是脑干胶质瘤,其余部位和类型的肿瘤也有所发生;高级别肿瘤并不常见。而类似肿瘤病变即不明明亮物体虽不是肿瘤,但却是NF1儿童最常见的具有部分肿瘤性质的颅内异常病变。这些肿瘤性病变可通过观察、手术、化学治疗、放射治疗、靶向治疗等方式处理,不同病变的最佳处理方式不同,其预后也有所不同。目前针对儿童NF1颅内肿瘤性病变的治疗方式还有所争议。该文就此种病变的特点和治疗进展进行阐述,旨在提高大众对NF1肿瘤性病变的认知水平,提供针对性的诊疗方案,推进NF1患者完善神经外科治疗。

郭志强教授基于“虚毒络瘀”理论治疗外阴上皮内非瘤样病变的经验

文章总结了郭志强教授基于“虚毒络瘀”理论治疗外阴上皮内非瘤样病变(Non-neoplastic epithelial disorders of the vulva, NNEDV)的经验。郭志强教授认为NNEDV是由于阴阳两虚,湿热毒蕴,且久病夹瘀,客于络脉而发病。治疗应从“补虚、解毒、化瘀通络”辨证论治,谨察疾病病机,分清标本虚实。邪实为标,重在清热化湿解毒;内虚为本,重在滋补肝肾之阴,兼顾温补肾中之阳;久病成瘀,客于络脉,佐以活血化瘀通络之品。根据疾病正虚邪实之变化,灵活化裁,外治为主,辅以内调,同时重视生活余心理调护等因素。

贞芪扶正颗粒在不同疾病治疗中的作用研究进展

贞芪扶正颗粒主要由黄芪和女贞子组成,在临床中主要用于治疗肿瘤性疾病(如肺癌、胃癌、结直肠癌、肝癌等),能够提高患者细胞免疫功能,减轻放化疗不良反应,改善一般状况。黄芪有效活性成分[黄芪总黄酮(TFA)、黄芪甲苷(AS-Ⅳ)、黄芪多糖(APS)等]和女贞子有效活性成分[女贞子多糖(LVFP)、特女贞苷(SPN)、齐墩果酸(OA)等]在免疫调节、抗肿瘤、心血管保护、抗氧化、改善代谢及抗炎镇痛等方面具有一定疗效。近年来,较多研究发现贞芪扶正颗粒可用于其他疾病(如重症肺炎、肺结核、乙型病毒性肝炎、心力衰竭等)的辅助治疗。现将贞芪扶正颗粒在不同疾病治疗中的作用进行综述。

STX 5对肝细胞癌转移的影响及其机制

目的探讨STX5对肝细胞癌(HCC)转移的影响及其机制。方法收集2015年1—12月我院确诊为HCC的36例患者的临床资料,分析肿瘤组织中STX5表达水平与HCC患者临床病理特征的相关性。将人肝癌细胞MHCC97H分为A、B组,分别转染阴性对照质粒、过表达STX5质粒,将人肝癌细胞Huh7分为C、D组,分别转染阴性对照慢病毒、STX5敲减慢病毒,采用Western blot实验检测A~D组细胞内STX5蛋白表达水平,采用划痕实验检测A~D组细胞的迁移能力,采用Transwell实验检测A~D组细胞的迁移能力。对A、B组细胞经转录组学测序分析获得的差异基因进行GO功能和KEGG信号通路富集分析,实时荧光定量聚合酶链反应(RT-qPCR)检测A、B组细胞最显著差异表达基因的水平。将MHCC97H细胞分为E~H组,分别转染阴性对照质粒、过表达STX5质粒、阴性对照质粒+Sarilumab、过表达STX5质粒+Sarilumab,采用划痕实验检测E~H组细胞的迁移能力,采用Transwell实验检测E~H组细胞的迁移能力。结果肿瘤组织中STX5表达水平与患者的BMI、有无乙型肝炎病毒感染、肿瘤数量有关(P<0.05)。Western blot检测结果显示,B组与A组、C组与D组比较,细胞中STX5的表达显著增高(t=48.86、31.09,P<0.05)。Transwell实验和划痕实验结果显示,B组与A组、C组与D组比较,细胞迁移能力和划痕愈合百分比显著升高(t=7.95~31.09,P<0.05)。GO和KEGG富集分析显示,A、B组细胞差异基因主要富集在细胞迁移、炎症等相关功能和通路上;RT-qPCR实验结果显示,B组细胞中IL-6 mRNA的表达水平显著高于A组细胞(t=23.69,P<0.05)。Transwell和划痕实验结果显示,G组和E组、H组和F组比较,细胞迁移能力和划痕愈合百分比均显著降低(t=2.94~24.39,P<0.05)。结论STX 5可能通过上调IL-6 mRNA表达来促进肝细胞癌细胞的转移。

肾血管平滑肌脂肪瘤合并肾静脉瘤栓行保肾手术治疗1例并文献复习

目的 探讨肾血管平滑肌脂肪瘤合并肾静脉瘤栓行肾部分切除术加瘤栓取出术的治疗效果。方法 总结合肥市滨湖医院2021年10月收治的1例肾血管平滑肌脂肪瘤合并肾静脉瘤栓病人的手术治疗方案。结果 病人术前行腹部增强磁共振加三维重建提示左肾占位(大小约51 mm×36 mm×55 mm)、左肾静脉瘤栓,考虑血管平滑肌脂肪瘤。于2021年10月21日行左肾部分切除术+肾静脉瘤栓取出术,病人术后第1天复查肾功能肌酐提示113μmol/L,术后4 d拔出肾周引流管,1周后拆线出院。病理结果:左肾肿瘤及肾静脉瘤栓均为血管平滑肌脂肪瘤。术后3个月复查肾功能提示69μmol/L。结论 合并静脉瘤栓的肾错构瘤病人通过个体化治疗,制定详细手术方案,可行保肾手术,病人受益更大。

2022年WHO头颈部肿瘤分类(第5版)的解读:口腔和舌体上皮性肿瘤

2022年3月,世界卫生组织(World Health Organization,WHO)发布了第5版《头颈部肿瘤分类》。第5版的口腔和舌体肿瘤部分中,上皮性肿瘤相较于2017年的第4版作出了一些修改,其中包括将口腔潜在恶性疾病(oral potentially malignant disorders,OPMD)和口腔上皮异常增生(oral epithelial dysplasia,OED)作了分开阐述,并详细讨论了黏膜下纤维性变(submucousfibrosis,SF)和人乳头瘤病毒(human papillomavirus,HPV)相关性口腔上皮异常增生(HPV-associated oral epithelial dysplasia,HPVOED);在鳞状细胞癌(squamous cell carcinoma,SCC)部分,介绍了穿掘性癌(carcinoma cuniculatum,CC)和疣状癌(verrucous carcinoma,VC),并阐述了其特有的临床和组织学特征。本文总结了自2017年来口腔和舌体的上皮性肿瘤相关内容在临床、组织学和分子学研究中的最新进展。

MiR-181c-5p对卵巢癌干细胞样细胞肿瘤血管生成拟态的作用及其机制

目的探讨miR-181c-5p对卵巢癌干细胞样细胞(OCS-LCs)肿瘤血管生成拟态(VM)的作用及其机制。方法采用无血清悬浮培养法将人卵巢癌细胞系OVCAR3细胞诱导形成OCS-LCs。将OVCAR3细胞分为A~C组,各组分别转染NC-miR-181c-5p、siRNA-miR-181c-5p和pRNA-miR-181c-5p。通过成球实验评估A~C组细胞成球能力。采用实时荧光定量PCR(RT-qPCR)方法检测A~C组细胞miR-181c-5p的相对表达量,采用Western blot实验检测A~C组细胞Oct-4、Nanog、HIF-1α和VEGF蛋白相对表达量。采用CCK-8实验检测A~C组细胞的活性,采用三维立体培养实验检测A~C组的血管形成率。结果OVCAR3细胞成功被诱导形成OCS-LCs。RT-qPCR实验结果显示,B组细胞的miR-181c-5p相对表达量显著低于A组,C组高于A组(t=2.25、8.68,P<0.05)。成球实验结果显示,B组与A组、A组与C组相比,细胞的成球周期显著缩短,最大的细胞球直径显著增大,成球率显著增加(t=5.56~33.66,P<0.05)。Western blot实验结果表明,B组与A组、A组与C组相比,Oct-4、Nanog、HIF-1α和VEGF蛋白相对表达量显著升高(t=4.51~56.15,P<0.05)。CCK-8实验结果显示,B组的细胞活性高于A组,C组低于A组(F=97.70~281.80,P<0.05)。三维立体培养实验结果显示,B组与A组、A组与C组相比较,血管形成率显著性提高(t=3.70、18.67,P<0.05)。结论miR-181c-5p可能通过降低细胞中HIF-1α和VEGF蛋白的表达,从而抑制OCS-LCs的VM形成。

游离DNA甲基化在非肿瘤性疾病中的应用研究进展

游离DNA已成为新兴的、非侵入性的重要临床样本类型,游离DNA甲基化具有组织特异性,可以反映来源细胞的DNA甲基化状态,在临床疾病诊疗中可能成为重要的潜在标志物。该文旨在综述近年常用的游离DNA甲基化检测技术,以及游离DNA甲基化在神经退行性疾病、精神性疾病、心血管疾病、糖尿病和出生缺陷等非肿瘤疾病中的应用研究进展。

磁共振动态增强结合血循环肿瘤细胞、循环游离DNA对乳腺癌的临床诊断研究

目的探讨磁共振动态增强(DCE-MRI)结合血循环肿瘤细胞(CTCs)、循环游离DNA(cfDNA)对乳腺癌的诊断价值。方法选取沧州市人民医院2020年6月至2021年11月符合纳入标准的乳腺癌病人82例(乳腺癌组)。另选同期65例乳腺良性病变且未合并其他疾病者作为良性组。比较两组DCE-MRI定量参数、CTCs、cfDNA水平,对比MRI特征,分析DCE-MRI结合CTCs、cfDNA诊断乳腺癌的价值。结果乳腺癌组DCE-MRI定量参数速度常数(K^(trans))值、速率常数(K_(ep))值、Alu247/115水平及CTCs计数分别为(0.18±0.04)min、(1.32±0.27)min、(12.97±2.14)个/毫升、0.97±0.32,比良性组高(0.05±0.01)min、(0.51±0.11)min、(10.15±1.45)个/毫升、0.55±0.12(P<0.05)。良性组边缘多光滑,形状规则,内部强化以均匀为主,时间-信号强度曲线(TIC)以Ⅰ型多见,早期增强率<60%;乳腺癌组边缘毛刺征、形状不规则,内部不均匀强化为主,以TIC分型Ⅲ型多见,早期增强率<60%占比高。两组MRI形态表现比较差异有统计学意义(P<0.05)。淋巴结转移、Ⅲ~Ⅳ期者CTCs数量、Alu247/115水平明显高于无淋巴结转移、Ⅰ~Ⅱ期者(P<0.05)。受试者操作特征(ROC)曲线分析结果显示,三者联合(DCE-MRI+CTCs+cfDNA)诊断乳腺癌的曲线下面积(AUC)、灵敏度、特异度分别为0.86、0.93、0.84,诊断效果优于单一检测CTCs、cfDNA检测(P<0.05)。结论乳腺癌病人CTCs、cfDNA存在异常表达,可能与病人临床分期、淋巴结转移有关,相对单一实验室检测,DCE-MRI结合CTCs、cfDNA检测能获取更多可靠信息。

circVANGL1/miR-134-5p/CDCA3轴调控乳腺癌干细胞增殖、迁移、侵袭的机制研究

目的探讨circVANGL1/miR-134-5p/细胞分裂周期相关因子3(CDCA3)轴调控乳腺癌干细胞增殖、迁移、侵袭的机制。方法收集2021年2月至2023年11月治疗乳腺癌患者的乳腺癌组织及相对应癌旁组织。体外培养乳腺癌MCF-7细胞干细胞亚群,根据不同处理方法将其分为Con组、si-NC组、si-circVANGL1组、pcDNA组、pcDNA-circVANGL1组、miR-NC组、miR-134-5p组、anti-miR-NC组、anti-miR-134-5p组、si-circVANGL1+anti-miR-134-5p组、si-circVANGL1+pcDNA-CDCA3组。采用qRT-PCR检测circVANGL1、miR-134-5p和CDCA3 mRNA在乳腺癌组织、癌旁组织及各组乳腺癌干细胞中的表达水平;Western blot检测CDCA3、基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)蛋白表达水平。双荧光素酶报告实验验证circVANGL1与miR-134-5p、miR-134-5p与CDCA3靶向关系;CCK-8实验检测乳腺癌干细胞增殖活性,划痕实验检测细胞迁移能力,克隆形成实验检测细胞克隆形成能力,Transwell小室实验检测细胞侵袭能力。结果与癌旁组织比较,乳腺癌组织中circVANGL1、CDCA3 mRNA、CDCA3蛋白表达水平较高,miR-134-5p表达水平较低(P<0.05)。circVANGL1可靶向调控miR-134-5p的表达,miR-134-5p可靶向调控CDCA3蛋白的表达。干扰circVANGL1表达后,乳腺癌干细胞增殖活性、划痕愈合率、细胞克隆形成数、侵袭细胞数以及MMP-2、MMP-9蛋白表达水平均明显降低(P<0.05)。下调miR-134-5p表达或过表达CDCA3可部分逆转干扰circVANGL1对乳腺癌干细胞增殖、迁移、侵袭的作用(P<0.05)。结论circVANGL1可能通过miR-134-5p/CDCA3轴调控乳腺癌干细胞的增殖、迁移、侵袭。

Neoplastic pericardial disease: Old and current strategies for diagnosis and management

The prevalence of neoplastic pericardial diseases has changed over time and varies according to diagnostic methods. The diagnostic factor is usually the detection of neoplastic cells within the pericardial fluid or in specimens of pericardium, but the diagnosis may be difficult. Accurate sampling and cytopreparatory techniques, together with ancillary studies, including immunohistochemical tests and neoplastic marker dosage, are essential to obtain a reliable diagnosis. The goals of treatment may be simply to relieve symptoms (cardiac tamponade or dyspnea), to prevent recurrent effusion for a long-term symptomatic benefit, or to treat the local neoplastic disease with the aim of prolonging survival. Immediate relief of symptoms may be obtained with percutaneous drainage or with a surgical approach. For long term prevention of recurrences, various approaches have been proposed: extended drainage, pericardial window (surgical or percutaneous balloon pericardiostomy), sclerosing local therapy, local and/or systemic chemotherapy or radiation therapy (RT) (external or with intrapericardial radionuclides). The outcomes of various therapeutic approaches vary for different tumor types. Lymphoma and leukemias can be successfully treated with systemic chemotherapy; for solid tumors, percutaneous drainage and the use of systemic and/or localsclerosing and antineoplastic therapy seems to offer the best chance of success. The use of "pure" sclerosing agents has been replaced by agents with both sclerosing and antineoplastic activity (bleomycin or thiotepa), which seems to be quite effective in breast cancer, at least when associated with systemic chemotherapy. Local chemotherapy with platinum, mitoxantrone and other agents may lead to good local control of the disease, but the addition of systemic chemotherapy is probably relevant in order to prolong survival. The surgical approach (creation of a pericardial window, even with the mini-invasive method of balloon pericardiostomy) and RT may be useful in recurring effusions or in cases that are refractory to other therapeutic approaches.

Comparative study of mutations in SNP loci of K-RAS, hMLH1 and h MSH2 genes in neoplastic intestinal polyps and colorectal cancer

AIM:To clarify the molecular mechanism involved in pathogenesis of colorectal cancer as well as clinical significance of genetic analysis of histological samples.METHODS:A total of 480 blood and tissue specimens were collected in our hospital from January 2011 to October 2012.In the observation group,there were120 blood specimens and 120 intestinal tract tissue specimens collected from patients with neoplastic intestinal polyps.In the control groupⅠthere were80 blood specimens and 80 intestinal tract tissue specimens collected from patients with colorectal cancer.In the control groupⅡthere were 40 blood specimens and 40 intestinal tract tissue specimens collected from healthy individuals.The gene segments were amplified using PCR and DNA gel electrophoresis along with DNA sequence analysis were employed for the detection of the following single nucleotide polymorphisms(SNPs):K-RAS codons 12 and 13;h MLH1(human mut S homolog 1)gene missense mutation at Va1384Asp;h MSH2(human mut S homolog2)gene missense mutation at 2783C/A.RESULTS:The mutation rate of the SNP at Va1384Asp locus of the h MLH1 gene from blood and tissue specimens in the observation group showed no statistical difference from those in the control groupⅠ.The mutation rates of SNPs in codons 12 and 13 of K-RAS and at 2783C/A locus of the h MSH2 gene were significantly lower in the observation group than in the control groupⅠ(χ2=15.476,29.670,10.811,16.618,33.538,7.898,P<0.05).The mutation rate of SNP at Va1384Asp locus of the h MLH1 gene was significantly higher in the observation group when compared to the control groupⅡ(χ2=10.486,4.876,P<0.05).The mutation rates of SNPs in codons 12 and 13 of K-RAS and at 2783C/A locus of the h MSH2 gene did not show any statistical difference from those in the control groupⅡ.CONCLUSION:There may be important clinical significance and relevance between neoplastic intestinal polyps and colorectal cancer in terms of the mechanisms involved in the

NEOPLASTIC TRANSFORMATION OF HUMAN EMBRYONIC NASOPHARYNGEAL EPITHELIAL CELLS INDUCED BY N,N'-DINITROSOPIPERAZINE (DNP) IN VITRO

This experiment is the first report on N, N'-dini-trosopiperazine (DNF)-induced neoplastic transformation of human embryonic nasopharyngeal (HENPE) cells. The transformed cells showed a prolonged life span, anchorage independent growth, chromosome aberration, tumorigenicity and an altered cell morphological appearance. The results demonstrated that DNP was able to induce not only nasopharyngeal carcinoma (NPC) of rats in vivo, but also neoplastic transformation of HENPE cells in vitro.

Pre-operative factors that can predict neoplastic polypoid lesions of the gallbladder

AIM:To investigate the preoperative factors that can predict neoplastic polypoid lesions of the gallbladder(PLGs) as well as malignant PLGs.METHODS:A retrospective analysis was conducted on the 210 consecutively enrolled patients who underwent cholecystectomy due to a PLG larger than 10 mm,as was determined by preoperative trans-abdominal ultrasonography or endoscopic ultrasonography.We ana-lyzed the medical,laboratory,radiologic data and the pathologic results.RESULTS:In 210 cases,146 had non-neoplastic polyps(69.5%) and 64 cases were neoplastic polyps(30.5%).An older age(≥ 65 years),the presence of diabetes mellitus(DM) and the size of polyp(≥ 15 mm) were revealed to be independent predictive variables for neoplastic polyps with odd ratios(OR) of 2.27(P = 0.044),2.64(P = 0.021) and 4.94(P < 0.01),respectively.Among the neoplastic PLGs,an older age(≥ 65 years),the presence of DM and polyp size(≥ 15 mm) were associated with malignancy with ORs of 4.97(P = 0.005),6.13(P = 0.001) and 20.55(P < 0.001),respectively.CONCLUSION:Among patients with PLGs larger than 10 mm in size,higher risk groups such as elderly patients more than 65 years old,those with DM or a large polyp size(≥ 15 mm) should be managed by cholecystectomy.

THE ROLE OF PSYCHOSOCIAL STRESSORS,PERSONALITY AND COPING IN THE MULTIFACTORIAL ORIGIN,INITIATION AND CLINICAL COURSE OF NEOPLASTIC DISEASE AND IN HOST-DEFENSE

Summary: Retrospective and prospective bio-behavioral cancer studies have revealed that psycho social stressors may play a pivotal role in the initiation and progression of malignant neoplasia. In recent research, a pattern has emerged, which in analogy to the coronary prone pattern (type A) has been labelled type C, encompassing suppression of emotional responses, such as anger and hostility, rationality and antiemotionality, as well as high social conformity and a lack of self-assertiveness. There is growing evidence in both infrahuman and human research that specific coping styles (repressive coping) with stress may be associated with specific biologic responses, including neuroendocrine, immunologic and other bodily functions. The application of this model appears to be of importance for further research, as well as for the detection of high risk individuals, but also in regard to therapy, rehabilitation, early detection and possibly also prevention of malignant disease. This concept suggests also new directions and modifications of stress research, as stressors are to be viewed not necessarily as pathological, but in some instances as quite possibly salutary, depending on the nature of the stres-sor, the psychophysiologic state of the individual and his or her ability to cope with adverse life situations. Quite naturally, the development of this concept is still in its initial stages, there remain anumber of open questions, and it needs hardly to be pointed out in this connection that further and painstaking clinical and laboratory work is warranted in order to clarify the role of stressors, life and coping styles and its biological concomitants in neo-plastic disease.

Genomic profile concordance between pancreatic cyst fluid and neoplastic tissue

BACKGROUND DNA mutational analysis of pancreatic cystic fluid (CF) is a useful adjunct to the evaluation of pancreatic cysts. KRAS/GNAS or RAF/PTPRD/CTNNB1/RNF43 mutations are highly specific to precancerous or advanced neoplasia. Several studies recently demonstrated the ability of next-generation sequencing (NGS)analysis to detect DNA mutations in pancreatic CF, but few studies have performed a systematic comparative analysis between pancreatic CF and neoplastic surgical tissue (NT). The value of CF-NGS analysis indicators for determining surgical resection necessitates evaluation. AIM To confirm whether CF genomic profiles are a reliable malignancy predictor by comparing NGS mutational analyses of CF and NT. METHODS Patients requiring surgery for high-risk pancreatic cysts were included in a multicenter prospective pilot study. DNA from CF (collected by endoscopic ultrasound-guided fine needle aspiration (known as EUS-FNA)) and NT (collected by surgery) were analyzed by NGS. The primary objective was to compare the mutation profiles of paired DNA samples. The secondary objective was to correlate the presence of specific mutations (KRAS/GNAS, RAF/ PTPRD/CTNNB1/RNF43/POLD1/TP53) with a final cancer diagnosis. Sensitivity and specificity were also evaluated. RESULTS Between December 2016 and October 2017, 20 patients were included in this pilot study. Surgery was delayed for 3 patients. Concordant CF-NT genotypes were found in 15/17 paired DNA, with a higher proportion of mutated alleles in CF than in NT. NGS was possible for all pancreatic CF collected by EUS-FNA. In 2 cases, the presence of a KRAS/GNAS mutation was discordant between CF and NT. No mutations were found in 3 patients with NT or pancreatic cysts with high-grade dysplasia. The sensitivity and specificity of KRAS/GNAS mutations in CF to predict an appropriate indication for surgical resection were 0.78 and 0.62, respectively. The sensitivity and specificity of RAF/PTPRD/CTNNB1 /RNF43/POLD1/TP53 mutations in CF were 0.55 and 1.0, respectively. CONCLUSION Mutational analyses of CF and NT were highly concordant, confirming the value of NGS analysis of CF in the preoperative malignancy assessment. However, these results need to be confirmed on a larger scale.

Fruquintinib beneficial in elderly patient with neoplastic pericardial effusion from rectal cancer:A case report

BACKGROUND Neoplastic pericardial effusion(NPE)is a rare consequence of rectal cancer and carries a poor prognosis.Optimal management has yet to be determined.Fruquintinib is an oral anti-vascular endothelial growth factor receptor tyrosine kinase inhibitor approved by the China Food and Drug Administration in September 2018 as third-line treatment of metastatic colorectal cancer.CASE SUMMARY Herein,we report an elderly patient with NPE from rectal cancer who responded to the use of fruquintinib.In March 2015,a 65-year-old Chinese woman diagnosed with KRAS-mutated adenocarcinoma of the rectum was subjected to proctectomy,adjuvant concurrent chemoradiotherapy,and adjuvant chemotherapy.By October 2018,a mediastinal mass was detected via computed tomography.The growth had invaded parietal pericardium and left hilum,displaying features of rectal adenocarcinoma in a bronchial biopsy.FOLFIRI and FOLFOX chemotherapeutic regimens were administered as first-and second-line treatments.After two cycles of second-line agents,a sizeable pericardial effusion resulting in tamponade was drained by pericardial puncture.Fluid cytology showed cells consistent with rectal adenocarcinoma.Single-agent fruquintinib was initiated on January 3,2019,as a third-line therapeutic.Ten cycles were delivered before the NPE recurred and other lesions progressed.The recurrence-free interval for NPE was 9.2 mo,attesting to the efficacy of fruquintinib.Ultimately,the patient entered a palliative care unit for best supportive care.CONCLUSION Fruquintinib may confer good survival benefit in elderly patients with NPEs due to rectal cancer.

Risk factors for neoplastic progression in Barrett's esophagus

Barrett's esophagus (BE) confers a significant increased risk for development of esophageal adenocarcinoma (EAC), with the pathogenesis appearing to progress through a "metaplasia-dysplasia-carcinoma" (MDC) sequence. Many of the genetic insults driving this MDC sequence have recently been characterized, providing targets for candidate biomarkers with potential clinical utility to stratify risk in individual patients. Many clinical risk factors have been investigated, and associations with a variety of genetic, specific gastrointestinal and other modifiable factors have been proposed in the literature. This review summarizes the current understanding of the mechanisms involved in neoplastic progression of BE to EAC and critically appraises the relative roles and contributions of these putative risk factors from the published evidence currently available.

Study on medication regularity of traditional Chinese medicine cases in treatment of neoplastic fever based on data mining

Objective:To analyze the medication regularity of traditional Chinese medicine cases in treatment of neoplastic fever in order to guide clinical medication.Methods:The database of China National Knowledge Infrastructure,Vip database and WanFang medical network were searched.The cases involving traditional Chinese medicine prescription in the treatment of neoplastic fever were screened.After extracting the prescriptions and Chinese medicines,make statistics according to frequency analysis,cluster analysis and association analysis.Results:79 literatures were included which involving 123 decoctions.221 traditionalChinese medicines were included in the statistics,the most frequently used traditional Chinese medicines were Gancao,Chaihu,Huangqi and Shengdihuang.The proportion of heat-clearing drugs in Chinese medicines was the largest(23.98%).The most common property of the Chinese medicines is cold property,accounting for 51.13%.The higher frequencies of flavors of the Chinese medicines are bitter,sweet and acrid,the sum of which is 84.66%.The most common meridian of Chinese medicines is liver meridian,accounting for 19.82%.The cluster analysis and association analysis of high frequency Chinese medicines showed that high frequency Chinese medicines could form three clustering formulas,and could get 18 pairs of high frequency drug combinations.Conclusion:Traditional Chinese medicines for heat-clearing,deficiencytonifying,phlegm-resolving,blood stasis-dispeling are mostly used to the treatment of neoplastic fever.The results of cluster analysis and association analysis of high frequency traditional Chinese medicines can provide certain reference and guidance for clinical medication.

血清CTC联合临床特征对乳腺癌新辅助治疗效果的预测价值

目的探讨血清循环肿瘤细胞(CTC)联合临床特征对乳腺癌新辅助治疗效果的影响因素分析。方法回顾性分析2019年4月—2022年4月甘肃省妇幼保健院收治的80例乳腺癌患者的临床资料,根据患者治疗效果分为pCR获得组30例和p CR未获得组50例。比较两组的年龄、体质量指数(BMI)、绝经状态、哺乳史、糖尿病史、高血压史、乳腺疾病史、家族史、肿瘤大小、T分期、N分期、临床分期、组织学分级、腋窝淋巴结状态、雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER-2)、细胞增殖指数Ki-67、分子分型、CTC等临床资料。采用非条件Logistic逐步回归分析乳腺癌患者新辅助治疗效果的影响因素,分析血清CTC联合临床特征预测乳腺癌患者新辅助治疗效果的价值。结果pCR获得组ER阴性、PR阴性、HER-2阳性、Ki-67高表达、HER-2过表达型、CTC阴性患者的占比高于pCR未获得组(P<0.05)。非条件Logistic逐步回归分析结果显示,ER阴性[OR=3.113(95%CI:1.524,6.359)]、PR阴性[OR=3.242(95%CI:1.431,7.345)]、HER-2阳性[OR=2.756(95%CI:1.135,6.692)]、Ki-67高表达[OR=2.895(95%CI:1.074,7.804)]、HER-2过表达型[OR=2.957(95%CI:1.247,7.012)]及CTC阴性[OR=3.688(95%CI:1.752,7.763)]是乳腺癌患者新辅助治疗效果良好的影响因素(P<0.05)。血清CTC联合临床特征预测乳腺癌患者新辅助治疗效果的敏感性为93.3%(28/30)(95%CI:1.611,8.047)、特异性为94.0%(47/50)(95%CI:1.336,7.823),准确性为93.8%(75/80)(95%CI:1.288,8.112)。结论血清CTC联合临床特征对乳腺癌新辅助治疗效果有较好的预测价值。