Clinical trial of thalidomide combined with radiotherapy in patients with esophageal cancer

AIM:To investigate the short-term efficacy and tolerability of radiotherapy plus thalidomide in patients with esophageal cancer(EC).METHODS:Serum samples from 86 EC patients were collected before,during,and after radiotherapy,and the vascular endothelial growth factor(VEGF)level was examined by ELISA.According to the change in serum VEGF level during radiotherapy,the patients were divided into two groups:in the drug group,VEGF level was increased or remained unchanged,and thalidomide was administered up to the end of radiotherapy;in the non-drug group,VEGF level was decreased and radiotherapy was given alone.Thirty healthy volunteers served as controls.The efficacy and safety of radiotherapy plus thalidomide therapy were investigated.RESULTS:The 86 EC patients had a significantly higher level of VEGF compared with the 30 healthy controls before radiotherapy(P<0.01),and the VEGF level was significantly correlated with primary tumor size,lymph node metastasis,histopathologic type,and clinical stage(P<0.01).Of 83 evaluable cases,VEGF level was significantly decreased after radiotherapy in32 patients in the drug group(P<0.05),with an effective rate of 71.88%.The incidence of dizziness and/or burnout in the drug group and non-drug group was62.50%and 15.69%,respectively(P=0.000),and the incidence of somnolence was 12.50%and 0%,respectively(P=0.019).No significant differences were observed.CONCLUSION:Thalidomide can down-regulate serum VEGF level in EC patients,and combined with radiotherapy may improve treatment outcome.Thalidomide was well tolerated by EC patients.

Expression of Vascular Endothelial Growth Factor C and Its Clinical Significance in Human Esophageal Squamous Cell Carcinoma

OBJECTIVE To examine the expression of vascular endothelial growth factor C(VEGF-C)in human esophageal squamous cell carcinoma(ESCC), and to clarify its role in lymphatic metastasis in ESCC patients. METHODS Esophageal carcinoma EC9706 cel s and samples from 49 patients with primary ESCC were investigated by using S-P immunohisto- chemistry(IHC),the semi-quantitative reverse transcriptase-polymerase chain reaction(RT-PCR)and in situ hybridization(ISH)methods for VEGF-C expression. RESULTS VEGF-C positive expression was found in EC9706 cells through IHC,ISH and RT-PCR.Positive IHC for VEGF-C was observed in 36 of 49 cases of ESCC.There was a significant difference between the expres- sion of VEGF-C in a lymph-node-positive group compared to a node-nega- tive group(χ2=4.7,P<0.05).Positive ISH for VEGF-C mRNA was observed in 23 of 49 cases of ESCC.There was a significant difference between the expression of VEGF-C in the lymph-node-positive group and node-negative group(χ2=31.3,P<0.01).The expression of VEGF-C was significantly higher in the lymph-node-positive group compared to the node-negative group.Of 49 ESCC tissues,RT-PCR for VEGF-C mRNA was observed positively in 29 cases.There was a significant difference between the expression of VEGF-C in the lymph-node-positive group and node-negative group(χ2=23.3, P<0.01).The expression of VEGF-C was significantly higher in the lymph- node-positive group compared to the node-negative group.Expressions of VEGF-C were not significantly associated with age,gender,and pathological grade.There was a relationship between VEGF-C mRNA expressions by RT-PCR and ISH(χ2=18.5,P<0.01)in ESCC cases,but with no significant difference between the two methods. CONCLUSION VEGF-C expression may induce lymphangiogenesis in human ESCC.There was a close correlation between VEGF-C expression and lymph node metastasis.VEGF-C can serve as a useful prognostic factor for ESCC patients.

Effect of Kang’ai Injection (康艾注射液) on Serum Level of Soluble Interleukin-2 Receptor and Vascular Endothelial Growth Factor in Patients with Esophageal Carcinoma during Radiotherapy

Objective： To observe the effect of Kang＇ai Injection （康艾注射液, KAI） on serum level of soluble interleukin-2 receptor （sIL-2R） and vascular endothelial growth factor （VEGF） in patients with esophageal carcinoma （EC） during radiotherapy （RT）, and to investigate its synergistic effect with RT and its influence on immunological function of the body. Methods： One hundred and seventy patients with EC, who had missed the chance of surgical operational therapy, were assigned to the treated group （90 cases） and the RT group （80 cases）, and at the same time a control group consisting of 80 inpatients without tumors was set up. Patients in the RT group were treated with RT alone but KAI was given additionally to those in the treated group, with 50 ml given once per day via intravenous dripping, 15 days as one course, and 2 courses administered in total. The immediate therapeutic efficacy and changes of serum slL-2R and VEGF levels were observed, and the effect of KAI on patients＇ quality of life （QOF） was evaluated by Karnofsky scoring. Results： In 16 patients of the treated group it was completely remission （OR）, in 54 partially remission （PR）, in 18 it was stabilized disease （SD） and in 2 progressive disease （PD）, with the total effective rate （CR ＋ PR） as 77.8%, while in those of the control group it was 12, 46, 18, 4 and 72.5%, respectively, the immediate therapeutic efficacy in the treated group was somewhat better than that in the RT group, but showed no statistical significance （P〉0.05）. Serum levels of slL-2R and VEGF in all the patients before treatment were higher than those in the control group, which were decreased after treatment in both groups （P〈0.05）, but the improvement in the treated group was better than that in the RT group, showing significant difference （P〈0.05）, and patients＇ QOF improved more significantly in the former as well （62.2 % vs 40.0%, P〈 0.05）. Conclusion： KAI in combination with RT in treating patients with EC could enhance the immunological function of patients, improve their QOF and enhance their sensitivity to RT.

Cyclooxygenase-2 expression after preoperative chemoradiotherapy correlates with more frequent esophageal cancer recurrence

AIM: To investigate the relationship between cycloo- xygenase-2 (COX-2), and vascular endothelial growth factor (VEGF), and to determine the clinical significance of this relationship in esophageal cancer patients undergoing chemoradiotherapy (CRT). METHODS: Immunohistochemical staining was used to evaluate COX-2 and VEGF expression in 40 patients with histologically-confirmed esophageal squamous carcinoma (ESCC) who were undergoing preoperative CRT. RESULTS: Fourteen out of 40 ESCC patients showed a pathological complete response (CR) after CRT. COX-2 and VEGF protein expressions were observed in the cytoplasm of 17 and 13 tumors, respectively, with null expression in 9 and 13 tumors, respectively. COX-2 expression was strongly correlated with VEGF expression (P < 0.05). There were also significant associations between COX-2 expression, tumor recurrence, and lymph-node involvement (P = 0.0277 and P = 0.0095, respectively). COX-2 expression and VEGF expression had significant prognostic value for disease-free survival (log-rank test; P = 0.0073 and P = 0.0341, respectively), but not for overall survival, as assessed by univariate analysis. CONCLUSION: Our results suggest that COX-2 expression correlates with VEGF expression and might be a useful prognostic factor for more frequent tumor recurrence in ESCC patients undergoing neoadjuvant CRT. These findings support the use of anti-angiogenic COX-2 inhibitors in the treatment of ESCC.

The efficacy and safety of thalidomide for treating metastatic breast cancer:a systematic review

Objective This systematic review was conducted to investigate the efficacy and safety of thalidomide in metastatic breast cancer(MBC).Methods Based on pre-defined inclusion and exclusion criteria,data were independently collected from different databases by three investigators.Overall,three studies were included.Results The included studies indicated that no patient achieved a partial or complete response from different thalidomide dose levels.Thalidomide was well-tolerated at doses of 100 mg,200 mg,and 400 mg.In all three studies,common side effects included constipation,somnolence,fatigue,peripheral neuropathy,and dry mouth.Circulating angiogenic factors were not significantly correlated with disease progression.Conclusion The available evidence indicates that single-agent thalidomide has little or no activity in patients with MBC.

Tumor-specific expression of sh VEGF and suicide gene as a novel strategy for esophageal cancer therapy

AIM: To develop a potent and safe gene therapy for esophageal cancer.METHODS: An expression vector carrying fusion suicide gene(y CDgly TK) and sh RNA against vascular endothelial growth factor(VEGF) was constructed and delivered into EC9706 esophageal cancer cells by calcium phosphate nanoparticles(CPNP). To achieve tumor selectivity, expression of the fusion suicide gene was driven by a tumor-specific human telomerase reverse transcriptase(h TERT) promoter. The biologic properties and therapeutic efficiency of the vector, in the presence of prodrug 5-fluorocytosine(5-FC), were evaluated in vitro and in vivo.RESULTS: Both in vitro and in vivo testing showed that the expression vector was efficiently introduced by CPNP into tumor cells, leading to cellular expression of y CDgly TK and decreased VEGF level. With exposure to 5-FC, it exhibited strong anti-tumor effects against esophageal cancer. Combination of VEGF sh RNA with the fusion suicide gene demonstrated strong anti-tumor activity.CONCLUSION: The sh VEGF-h TERT-y CDgly TK/5-FC system provided a novel approach for esophageal cancer-targeted gene therapy.

Effect of kanglaite injection and docetaxel in treating advanced stage esophageal cancer on tumor markers, angiogenesis and immune function in elderly patients

Objective:To investigate the effect of Kanglaite injection combined with docetaxel in advanced esophageal cancer on tumor markers, angiogenesis and immune function in elderly patients.Method:A total of 130 patients with advanced esophageal cancer admitted in our hospital from October 2014 to July 2017were selected and divided into two groups according to the time of admission, 65 cases in each group, set as observation group and control group, all patients were treated with conventional radiotherapy (cisplatin combined with 5-fluorouracil), the observation group was given Kanglaite injection combined with docetaxel on the basis of this, while the control group only was given docetaxel treatment, the treatment period was 6 weeks, tumor markers, VEGF and immune function of both group after treatment were compared.Result: After treatment, the levels of carbohydrate antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9) and carcino-embryonic antigen (CEA) in the observation group were lower than those in the control group, the difference was statistically significant;VEGF level in the observation group after treatment was lower than the control group, the difference was statistically significant;After treatment, the levels of CD3+, CD4+ and CD4+/CD8+ in the observation group were higher than those in the control group, while the levels of CD8+ in the observation group was lower than those in the control group, the difference was statistically significant.Conclusion: Kanglaite injection combined with docetaxel in the treatment of elderly patients with advanced esophageal cancer is better, effectively reducing the level of tumor markers and vascular endothelial growth factor, improve immune function, it isworthy of clinical application.

Advances in targeted therapy and immunotherapy for esophageal cancer

Esophageal cancer(EC)is one of the most common aggressive malignant tumors in the digestive system with a severe epidemiological situation and poor prognosis.The early diagnostic rate of EC is low,and most EC patients are diagnosed at an advanced stage.Multiple multimodality treatments have gradually evolved into the main treatment for advanced EC,including surgery,chemotherapy,radiotherapy,targeted therapy,and immunotherapy.And the emergence of targeted therapy and immunotherapy has greatly improved the survival of EC patients.This review highlights the latest advances in targeted therapy and immunotherapy for EC,discusses the efficacy and safety of relevant drugs,summarizes related important clinical trials,and tries to provide references for therapeutic strategy of EC.

Effect of recombinant human endostatin onradiotherapy for esophagus cancer

Objective:To investigate the effect of radiotherapy plus recombinant human endostatin（RHendostatin） on esophageal cancer and its mechanism.Methods:A total of SO nudemice were equally randomized into control group,radiotherapy group,and combined therapy group Ⅰ,Ⅱ,and Ⅲ after inoculating with Ecal09 cell suspension（1×107 cells/mL）.On the day of grouping,control group and radiotherapy group were injected normal saline,while radiotherapy group and 3 combined therapy groups received radiotherapy;besides,combined therapy group Ⅰ,Ⅱ,and Ⅲ was injected RH-endostatin of 2.5,5,10 mg/kg respectively.After 3-week therapy,the tumors of each group were collected and microvessel density and VEGF expression in tumors were determined.In vitro,Eca109 cells were divided into control group,radiotherapy group,and combined therapy group.Forty-eight hours after treatment cell cycle distribution and apoptosis rate were detected,and the activity of VEGF signal paths was semiquantitatively analyzed.Results:Since the 6th day of treatment,the relative tumor proliferation rate of combined therapy group Ⅱ was lower than radiotherapy group（P<0.05） and 40%since the 15 th day.Average microvessel density and EGFR expression in combined therapy group Ⅱ were lower than radiotherapy group（P<0.05）.In vitro,the cell percentage in S and G2/M phase of combined therapy group cells was lower than that in radiotherapy group cells,while the apoptosis rate and the expression of VEGF,AKT,p-AKT,ERK1/2 and p-ERKl/2 in combined group were higher than that in radiotherapy group（P<0.05）.Conclusions:RH-endostatin promotes the efficacy of radiotherapy on esophageal cancer,which may be partly realized by inhibiting the activity of VEGF related signal paths.

VEGF、P53表达与食管癌淋巴结转移及其预后的相关性分析

目的分析血管内皮生长因子(VEGF)、P53表达与食管癌淋巴结转移与预后的关系。方法选取120例食管癌患者,采集其癌组织(观察组)与癌旁正常组织(对照组)标本,应用免疫组织化学法测定两组VEGF、P53表达差异;并收集患者资料,分析VEGF、P53阳性表达与食管癌临床病理特征的关系;另外随访3年,分析VEGF、P53阳性表达与食管癌患者预后的关系。结果观察组VEGF阳性率为69.17%(83/120)、P53阳性率为75.00%(90/120),均高于对照组的33.33%(40/120)、31.67%(38/120),差异有统计学意义(P<0.05);VEGF、P53阳性表达与淋巴结转移、TNM分期、分化程度、肿瘤最大径相关(P<0.05);VEGF、P53阳性表达患者的生存率低于阴性表达患者,差异有统计学意义(P<0.05)。结论VEGF、P53在食管癌组织内呈高表达,表达水平与患者的淋巴结转移、TNM分期、分化程度、肿瘤最大径等临床病理特征相关,且阳性表达患者预后更差。

血清血管内皮生长因子、胰岛素样生长因子-1水平与胸腔镜食管癌根治术后食管胃吻合口漏的相关性研究

目的 探讨血清血管内皮生长因子(VEGF)、胰岛素样生长因子(IGF)-1水平与胸腔镜食管癌根治术后食管胃吻合口漏的关系。方法 2015年9月~2022年9月我院收治的食管癌病人425例,根据术后发生食管胃吻合口漏情况分为吻合口漏组(31例)和无吻合口漏组(394例)。检测血清VEGF、IGF-1水平,分析影响胸腔镜食管癌根治术后食管胃吻合口漏发生的危险因素以及VEGF、IGF-1预测术后食管胃吻合口漏发生的价值。结果 吻合口漏组术后血清VEGF、IGF-1水平降低,无吻合口漏组血清VEGF、IGF-1水平增高,吻合口漏组术前、术后1天、术后2天、术后3天血清VEGF、IGF-1水平均低于无吻合口漏组,差异有统计学意义(P<0.05)。术后肺部感染、低白蛋白、术后3天VEGF、术后3天IGF-1与术后食管胃吻合口漏有关(P<0.05)。术后3天VEGF、术后3天IGF-1水平预测术后食管胃吻合口漏的曲线下面积为0.675、0.655,联合两项指标曲线下面积为0.841,高于单独指标(Delong z=3.752、3.218,P<0.05)。结论 胸腔镜食管癌根治术后吻合口漏病人血清VEGF、IGF-1水平降低,且与吻合口漏的发生密切相关。

免疫炎症指数、血管表皮生长因子和胰岛素生长因子-1联合预测接受根治性放疗食管癌患者预后的价值

目的:探讨免疫炎症指数(SⅡ)、血管表皮生长因子(VEGF)和胰岛素生长因子-1(IGF-1)联合预测接受根治性放疗的食管癌患者预后的价值。方法:选取接受根治性放疗的食管癌患者128例,随访患者术后1年生存情况,分为存活组(n=98)和病死组(n=30),比较两组临床资料、SⅡ、VEGF和IGF-1差异,分析SⅡ、VEGF和IGF-1与临床病理、预后的关系。结果:病死组患者年龄、病灶位于胸下段比例、病灶长度>6 cm比例、TNM分期Ⅲ比例、低分化比例、非同步化疗比例、处方剂量<61.2 Gy比例明显高于存活组患者(均P<0.05)。病死组患者SⅡ、VEGF和IGF-1水平明显高于存活组患者(均P<0.05)。TNM分期Ⅲ期、低分化患者SⅡ明显高于TNM分期Ⅰ-Ⅱ期、中高分化患者(均P<0.05);病灶长度≥6 cm、TNM分期Ⅲ期、低分化患者VEGF水平明显高于病灶长度<6 cm、TNM分期Ⅰ-Ⅱ期、中高分化患者(均P<0.05);TNM分期Ⅲ期患者IGF-1水平明显高于TNM分期Ⅰ-Ⅱ期患者(均P<0.05)。Logistic回归分析显示:TNM分期、分化程度、SⅡ、VEGF和IGF-1是患者术后1年病死的影响因素(均P<0.05)。该方程预测患者术后1年病死的ROC曲线下面积为0.843,灵敏性和特异性分别为63.00%和91.00%。结论:SⅡ、VEGF和IGF-1水平与食管癌患者TNM分期、分化程度等临床病理有关,同时在预测食管癌患者根治性放疗预后方面有一定应用价值。

沙利度胺联合化疗对EGFR野生型晚期非小细胞肺癌的影响

目的 观察沙利度胺联合化疗治疗表皮生长因子受体(epidermal growth factor receptor, EGFR)野生型晚期非小细胞肺癌(non-small cell lung cancer, NSCLC)患者的生活质量评分、不良反应发生率以及对血清血管内皮生长因子(vascular endothelial growth factor, VEGF)水平的影响。方法 纳入2021年1月至2022年12月在蚌埠医学院第一附属医院肿瘤内科接受治疗的EGFR野生型晚期NSCLC患者,共纳入100例。观察组为采用沙利度胺联合含铂两药化疗治疗患者;对照组为单用含铂两药化疗治疗的患者。观察组共纳入58例患者,给予含铂两药化疗方案治疗;同时口服沙利度胺片100 mg,每日一次,睡前服用;对照组共纳入42例患者,给予化疗方案剂量同上,两组化疗前常规给予止吐药物预防性治疗。比较用药后第7~14天两组患者生活质量各领域评分;比较两组患者治疗期间不良反应发生率;比较两组患者治疗后血清VEGF水平差异。结果 观察组患者第7~14天的躯体(79.18±8.59 vs 64.94±8.60)、角色(71.82±14.05 vs 59.00±12.10)、情绪功能(81.94±15.95 vs 69.71±11.38)、认知(74.53±11.74 vs 59.56±8.75)、社会功能(82.24±13.70 vs 66.82±10.11)和总体健康状况评分(70.81±9.67 vs 60.11±8.77)较对照组患者均明显提高,差异有统计学意义(P<0.05);疲倦(28.08±13.09 vs 38.53±14.23)、疼痛(27.44±8.17 vs 39.19±10.13)、失眠(38.07±12.12 vs 45.23±16.61)和食欲丧失症状评分(40.46±13.70 vs 47.61±17.15)则显著低于对照组,差异有统计学意义(P<0.05);两组间恶心呕吐、气促、便秘、腹泻和经济困难差异无统计学意义(P>0.05);观察组患者化疗期间白细胞及血小板下降不良反应发生率低于对照组(20/58 vs 27/42;P<0.05);两组患者血清VEGF水平比较,观察组水平低于对照组,且差异有统计学意义(127.35±126.03 vs 183.86±120.55;P<0.05)。结论 沙利度胺对EGFR野生型晚期非小细胞肺癌化疗期间的生活质量起到改善作用,且降低不良反应发生率及VEGF水平。

甲磺酸阿帕替尼对裸鼠食管癌的抗肿瘤作用及机制研究

目的:探究甲磺酸阿帕替尼对裸鼠食管癌的抗肿瘤作用,并分析可能的机制。方法:建立食管癌NEC细胞裸鼠皮下移植瘤模型40只,随机分为荷瘤组、实验A组、实验B组及5-氟尿嘧啶(5-Fu)组,每组10只。其中,实验A、B组分别给予8.3、16.6 mg/kg甲磺酸阿帕替尼灌胃处理,连续4周;荷瘤组同时间给予等量0.9%氯化钠溶液灌胃;5-Fu组腹腔注射130 mg/kg 5-Fu溶液。统计各组瘤体质量并计算肿瘤抑制率。采用原位末端转移酶标记(TUNEL)法检测各组肿瘤组织中细胞凋亡情况。采用实时荧光定量PCR(RT-qPCR)和免疫印迹法检测瘤体组织血管内皮生长因子受体2(VEGFR2)、p-VEGFR2、信号转导和转录激活因子3(STAT3)、p-STAT3、半胱天冬氨酸蛋白酶-3(Caspase-3)mRNA及蛋白表达水平。结果:荷瘤组、实验A组、实验B组及5-Fu组成瘤率为100%,模型均构建成功。分组后处理第12天时,实验A组、实验B组及5-Fu组裸鼠瘤体体积小于荷瘤组(均P<0.05)。随处理时间延长,实验B组及5-Fu组各时间点裸鼠瘤体体积小于实验A组(均P<0.05)。与荷瘤组比较,实验A组、实验B组及5-Fu组移植瘤瘤体质量减少,p-VEGFR2/VEGFR2、p-STAT3/STAT3蛋白表达降低,抑瘤率、细胞凋亡率、Caspase-3 mRNA及蛋白表达升高(均P<0.05),且实验B组、5-Fu组瘤体质量及p-VEGFR2/VEGFR2、p-STAT3/STAT3蛋白表达低于实验A组,抑瘤率、细胞凋亡率、Caspase-3蛋白表达高于实验A组(均P<0.05)。结论:甲磺酸阿帕替尼可抑制裸鼠食管癌移植瘤生长并促进细胞凋亡,其机制可能与抑制VEGFR2/STAT3通路有关。

食管鳞癌组织中VEGFR-2基因扩增情况观察及与患者预后关系分析

目的观察食管鳞癌组织中血管内皮生长因子受体-2(VEGFR-2)基因扩增情况,并分析VEGFR-2基因扩增与食管鳞癌患者预后的关系。方法食管鳞癌患者120例,术中留取食管癌组织,采用荧光原位杂交(FISH)法观察食管鳞癌组织中VEGFR-2基因扩增情况,并分析VEGFR-2基因扩增与食管鳞癌患者临床病理参数的关系。根据有无VEGFR-2基因扩增,将120例食管鳞癌患者分为阳性组(VEGFR-2基因扩增阳性)和阴性组(VEGFR-2基因扩增阴性),采用Kaplan-Meier生存分析法及多因素COX回归模型分析VEGFR-2基因扩增与食管鳞癌患者预后的关系。结果120例食管鳞癌患者中,49例患者存在VEGFR-2基因扩增,VEGFR-2基因扩增率为40.8%。VEGFR-2基因扩增与食管鳞癌患者肿瘤分化程度、有无淋巴结转移、有无脉管浸润有关(P均<0.05)。阴性组的食管鳞癌患者生存时间为16(11.15~20.84)个月,阳性组为13(8.27~17.72)个月,两组相比,P<0.05。多因素COX回归分析结果显示,VEGFR-2基因扩增是食管鳞癌患者不良预后的独立危险因素(HR=0.562,95%CI:0.374~0.844,P=0.006)。结论部分食管鳞癌患者存在VEGFR-2基因扩增。VEGFR-2基因扩增与食管鳞癌肿瘤分化程度、有无淋巴结转移、有无脉管浸润有关,是食管鳞癌患者不良预后的独立危险因素。

放大内镜结合VEGF、CD34及CD105等血管生成分子检测在早期食管癌诊断中的价值

目的探索放大内镜结合血管内皮生长因子(VEGF)、CD34及CD105等血管生成分子检测在早期食管癌诊断中的价值。方法选取2022年1月—2022年12月海南省人民医院内镜诊疗中心检出可疑早期食管癌或癌前病变患者152例,进行放大内镜下日本食管学会(JES)分型,并检测患者血清VEGF、CD34及CD105水平。利用R软件构建列线图模型,并利用受试者工作特征曲线(ROC)评估列线图和各血清学指标的诊断效能。结果152例可疑早期食管癌或癌前病变患者中放大内镜JES分型为A型80例(早癌11例)、B1型51例(早癌36例)、B2型14例(早癌10例)、B3型7例(早癌6例),利用放大内镜JES分型诊断食管早癌的敏感度为0.730,特异度为0.663;血清VEGF、CD34及CD105水平在炎性反应、轻度不典型增生、重度不典型增生、食管早癌患者中依次逐渐升高(F/P=1536.000/<0.001、1133.000/<0.001、3156.000/<0.001),其诊断食管早癌的曲线下面积(AUC)分别为0.821、0.772和0.687;放大内镜JES分型联合血清标志物列线图诊断模型的AUC为0.922。结论放大内镜JES分型联合VEGF、CD34及CD105等血清标志物可用于食管早癌诊断,其诊断准确度显著高于单一指标。

宫颈癌中miRNA-409-3p、VEGF、Gab2表达与调强适形放疗同步化疗疗效及患者治疗后3年生存情况的关系

目的 探讨宫颈癌中微小RNA-409-3p(miRNA-409-3p)、血管内皮生长因子(VEGF)、Grb2协同结合蛋白2(Gab2)表达与调强适形放疗同步化疗疗效及治疗后3年生存情况的关系。方法 采用回顾性研究方法,选取2019年1月至2020年2月在新疆医科大学附属肿瘤医院治疗的宫颈癌患者138例,均给予调强适形放疗同步化疗。同时随访所有患者疗效及治疗后3年生存情况,分为化疗有效组(n=92)和治疗无效组(n=56)、死亡组(n=26)和存活组(n=112)。观察不同临床特征、疗效、预后患者宫颈癌组织miRNA-409-3p、VEGF、Gab2表达水平。结果 低分化宫颈癌组织miRNA-409-3p相对表达量明显低于中高分化宫颈癌组织,而VEGF mRNA和Gab2 mRNA相对表达量明显高于中高分化宫颈癌组织,差异均有统计学意义(P<0.05)。FIGO分期Ⅲ期宫颈癌组织miRNA-409-3p相对表达量明显低于Ⅱ期宫颈癌组织,而VEGF mRNA和Gab2 mRNA相对表达量明显高于Ⅱ期宫颈癌组织,差异均有统计学意义(P<0.05)。治疗有效组患者miRNA-409-3p相对表达量明显高于治疗无效组,而VEGF mRNA和Gab2 mRNA相对表达量明显高于治疗无效组,差异均有统计学意义(P<0.05)。死亡组患者miRNA-409-3p相对表达量明显高于存活组患者,而VEGF mRNA和Gab2 mRNA相对表达量明显高于存活组患者,差异均有统计学意义(P<0.05)。miRNA-409-3p、VEGF、Gab2表达预测疗效有效的ROC曲线下面积分别为0.647、0.779和0.616,预测价值较好(P<0.05)。miRNA-409-3p、VEGF、Gab2表达预测死亡的ROC曲线下面积分别为0.715、0.653和0.785,预测价值较好(P<0.05)。结论 宫颈癌组织miRNA-409-3p表达下调,而VEGF、Gab2表达上调,与调强适形放疗同步化疗疗效及预后有关,其中VEGF预测疗效有一定价值,而Gab2预测预后有一定价值。

西妥昔单抗联合放疗治疗结直肠癌

目的探讨西妥昔单抗联合放疗对结直肠癌的治疗效果及对血清基质金属蛋白酶-9(MMP-9)、血管内皮生长因子(VEGF)水平的影响。方法选择100例结直肠癌患者纳入研究,随机数表法分为放疗组与联合组,各50例。2组均手术治疗,放疗组采用放疗治疗,联合组在放疗组基础上使用西妥昔单抗治疗,统计2组临床症状恢复时间,对2组CEA、CA199、VEGF、MMP-9水平进行检测,评估治疗效果,记录不良反应发生情况。结果联合组临床症状恢复时间短于放疗组(P<0.05);治疗后联合组CEA、CA199、VEGF、MMP-9水平均低于放疗组(P<0.05);联合组治疗总有效率(92%,46/50)高于放疗组(72%,36/50)(P<0.05);2组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论西妥昔单抗联合放疗治疗结直肠癌,能够减轻患者炎性因子释放,降低MMP-9、VEGF水平,效果显著。

阿帕替尼治疗晚期肺癌的研究进展

血管生成贯穿肺癌发生发展的整个过程,临床将治疗新靶点逐渐放在此方面。阿帕替尼可以对肿瘤新生血管生成给予抑制,属于一种小分子抗血管生成抑制剂,其临床抗肿瘤功效相对较为理想。既往临床在晚期胃癌中一直使用阿帕替尼,其耐受性相对良好,抗肿瘤效应也比较理想。现阶段,在诸多恶性肿瘤抗血管生成方面,阿帕替尼的效应、作用不断呈现,在晚期肺癌治疗中,也开始使用阿帕替尼,其临床疗效也越来越明显,逐渐成为晚期肺癌的治疗新选择。

奥沙利铂联合替吉奥治疗对进展期食管癌患者生存时间的影响

目的研究奥沙利铂联合替吉奥治疗进展期食管癌的效果及对患者生存时间的影响。方法84例进展期食管癌患者随机均分为观察组和对照组,对照组采用替吉奥联合顺铂干预,观察组采用替吉奥联合奥沙利铂干预,连续治疗4个周期;于治疗第1、第2及第4个周期时抽取患者肘静脉血5 mL,使用ELISA法检测血清糖类抗原199(CA199)、癌胚抗原(CEA)、血管内皮生长因子(VEGF)及糖类抗原125(CA125)水平,比较两组患者外周神经毒性反应、肝肾功能损害、胃肠道反应、血小板减少、白细胞减少等不良反应;比较两组患者的治疗效果;随访6个月后,比较两组患者总生存时间。结果观察组干预第1个周期、第2个周期及第4个周期时的CA125、CEA、CA199及VEGF改善情况均优于对照组,差异有统计学意义(P<0.05);观察组患者干预第1个周期、第2个周期及第4个周期后疾病改善率高于对照组,不良反应低于对照组,差异有统计学意义(P<0.05);6个月随访结果显示,观察组生存率高于对照组,差异有统计学意义(P<0.05)。结论奥沙利铂联合替吉奥治疗进展期食管癌患者可改善肿瘤标志物水平,提高用药安全性,延长生存时间。