Targeted treatment of cancer with radiofrequency electromagnetic fields amplitude-modulated at tumor-specific frequencies

In the past century, there have been many attempts to treat cancer with low levels of electric and magnetic fields. We have developed noninvasive biofeedback examination devices and techniques and discovered that patients with the same tumor type exhibit biofeedback responses to the same, precise frequencies. Intrabuccal administration of 27.12 MHz radiofrequency(RF) electromagnetic fields(EMF), which are amplitude-modulated at tumor-specific frequencies, results in long-term objective responses in patients with cancer and is not associated with any significant adverse effects. Intrabuccal administration allows for therapeutic delivery of very low and safe levels of EMF throughout the body as exemplified by responses observed in the femur, liver, adrenal glands, and lungs. In vitro studies have demonstrated that tumor-specific frequencies identified in patients with various forms of cancer are capable of blocking the growth of tumor cells in a tissue- and tumor-specific fashion. Current experimental evidence suggests that tumor-specific modulation frequencies regulate the expression of genes involved in migration and invasion and disrupt the mitotic spindle. This novel targeted treatment approach is emerging as an appealing therapeutic option for patients with advanced cancer given its excellent tolerability. Dissection of the molecular mechanisms accounting for the anti-cancer effects of tumor-specific modulation frequencies is likely to lead to the discovery of novel pathways in cancer.

Ovarian endometrioid carcinoma resembling sex cord-stromal tumor:A case report

BACKGROUND Ovarian endometrioid carcinoma resembling sex cord-stromal tumor(ECSCSs)is rare.CASE SUMMARY We present a rare case of primary ECSCSs in the left ovary.A 39-year-old female patient had persistent dull pain in the lower abdomen for more than 1 mo,and she was initially diagnosed with pelvic inflammatory disease at a hospital.The patient received transabdominal hysterectomy,bilateral salpingo-oophorectomy,and pelvic and para-aortic lymph node dissection at our hospital and finally diagnosed with ECSCSs.After the operation,the patient received eight courses of cisplatinum+etoposide+bleomycin chemotherapy treatment and no evidence of tumor recurrence or metastasis was found in a 2-year follow-up period.CONCLUSION Ovarian endometrioid carcinoma is similar to the ovary sex cord-stromal tumor,especially when the cord-like structure is obvious.The clinical diagnosis for this tumor is difficult before surgery and pathology examination.The necessary immunohistochemical markers are of positive significance for assisting diagnosis and differential diagnosis.

Ovarian Sex Cord-Stromal Tumors in Postmenopausal Women and Total Laparoscopical Management

BACKGROUND: Ovarian sex-cord stromal tumors (SCST) take up 5% of the ovarian neoplasm and may develop in?to?an ovarian mass or a haemoperitoneum. The surgical management of SCST in early-stage adult patients is not well?defined. CASE REPORT: A 69 year-old postmenopausal woman was admitted for metrorrhagia, a right ovary mass and?increasing pelvic pain. Preoperative clinical and instrumental examination suspected an ovarian tumor, and the?laparoscopic right ophorectomy and the frozen section suggested an ovarian SCST. To fast restore and preserve woman?integrity, total laparoscopic hysterectomy (TLH) plus left salpingo-ophorectomy (SO) were performed, without complications?in the short and long term follow-up. CONCLUSION: In the authors’ opinion, the minimally invasive management?of SCST by TLH plus bilateral SO followed by a prolonged surveillance and without intensive surgical staging,?could be an appropriate clinical and surgical choice in elder patient at early stage, since these tumors are slow at?growth, recurring locally and only a long time after initial treatment. We suggest, after a minimally invasive treatment,?a possible “wait and see” option, as in our case report.

Construction of Multi-Specific Antibody by Genetic Engineering and Its Progress in Tumor Therapy

Targeted treatment of cancer with monoclonal antibodies increases the benefit for patients. In order to improve the anti-tumor activity of monoclonal antibodies, multi-specific antibodies have entered the research field. The emergence of various techniques to produce multi-specific recombinant antibody molecules has led to the selection of target combinations in various forms. To date, only a few multi-specific constructs have entered phase III clinical trials, in contrast to classical monoclonal antibodies. Some of the format options are outlined from a technical point of view. We focus on the achievements and prospects of the underlying technologies for generating biand multispecific antibodies.

Tumor-Specific Histo-Blood Group Antigens: Apropos of Two Cases

Cancer cells with immunogenic properties having altered protein glycosylation, modified blood group substances have been widely studied. Due to the genetic instability occurring during carcinogenesis the glycosyltransferases may suffer from posttranslation sequence modification. The author describes 2 autopsy cases, where in the background of the unusual metastatic tumor presentation, incompatible blood group antigenic determinants have been demonstrated using blood group specific lectins and monoclonal antibodies (mAb). In the first case, reported here, a 10-year-old girl developed an acute myeloid leukemia and died in a septic endotoxin shock after successful cytostatic treatment of a juvenile signet ring cell cancer of her colon. At autopsy there were no signs of tumor except bilateral apple-sized mucinous ovarian (Krukenberg) metastases. While she had erythrocyte phenotype of blood group A, the signet ring adenocarcinoma cells expressed blood group B incompatible antigenic determinants with lectin/mAb. In the second case, the autopsy of a 78-year-old female resulted in no macroscopic tumor sign except a moderately enlarged, ham hard spleen. Light microscopy revealed adenocarcinomatous infiltration in the splenic sinusoids. The patient had blood group O, while the metastatic cells in the spleen reacted with Breast Carcinoma Antigen (BioGenex) and incompatible anti-B Banderiaeasimplicifolia agglutinin I and anti-B mAb. It proved to be a case of an occult, completely regressed breast cancer. Based on these observations the expression of tumor specific incompatible blood group antigens might occur from time to time, mostly in adenocarcinomas. Accordingly, blood group-based specific immuno-oncotherapy could be considered in some cancer cases.

The crystal structure of the non-liganded 14-3-3σ protein: insights into determinants of isoform specific ligand binding and dimerization

Seven different, but highly conserved 14-3-3 proteins are involved in diverse signaling pathways in human cells. It isunclear how the 14-3-3σ isoform, a transcriptional target of p53, exerts its inhibitory effect on the cell cycle in thepresence of other 14-3-3 isoforms, which are constitutively expressed at high levels. In order to identify structuraldifferences between the 14-3-3 isoforms, we solved the crystal structure of the human 14-3-3σ protein at a resolutionof 2.8 ? and compared it to the known structures of 14-3-3ζ and 14-3-3τ. The global architecture of the 14-3-3σ foldis similar to the previously determined structures of 14-3-3ζ and 14-3-3τ: two 14-3-3σ molecules form a cup-shapeddimer. Significant differences between these 14-3-3 isoforms were detected adjacent to the amphipathic groove, whichmediates the binding to phosphorylated consensus motifs in 14-3-3-ligands. Another specificity determining region islocalized between amino-acids 203 to 215. These differences presumably select for the interaction with specific ligands,which may explain the different biological functions of the respective 14-3-3 isoforms. Furthermore, the two 14-3-3σmolecules forming a dimer differ by the spatial position of the ninth helix, which is shifted to the inside of the ligandinteraction surface, thus indicating adaptability of this part of the molecule. In addition, 5 non-conserved residues arelocated at the interface between two 14-3-3σ proteins forming a dimer and represent candidate determinants of homo-and hetero-dimerization specificity. The structural differences among the 14-3-3 isoforms described here presumablycontribute to isoform-specific interactions and functions.

The diagnostic value of neuron specific enolase in patients with gliomas

Objective: In order ic look into the alterations and effects of neuron specific enolase (NSE) in cerebralspinal fluid (CSF ) and serum of foe paticnts with glioma and meningiomas. Methods: We studied CSF and serumlevels of NSE in 40 patients with gliomas and 10 with meningiomas;3 days before and after operation byradioimmunoassay. Results: Compared with the value of NSE: in CSF and serum from 10 control patients. samplesfrom patients with malignant gliomas contained abnormally high level of NSE before operation (P < 0. 05 ) butnormal level after operation (P >0. 05 ). However. samples from patients with low grade gliomas andmeningiomas were within normal range before and after operation (P >0. 05). Gliomas with totall refectionshowed normal NSE values but with sub lotal removal presented high levels of NSE after surgery (P < 0. 05).Conclusion: The increased value of NSE in patients with malignant gliomas may be associated with elevated rate of glucolysis. As one of the new tumor markers NSE Is postulated to play an important role in the diagnosi followup and monitoring of gliomas.

Serum tumor markers for detection of hepatocellular carcinoma

Hepatocellular carcinoma （HCC） is one of the most frequent malignant tumors and is the second most common cause of cancer death in China. Therefore, it is very important to detect this disease and the recurrence at its earlier period. Serum tumor markers, as the effective method for detecting hepatocellular carcinoma for a long time, could be divided into 4 categories： oncofetal antigens and glycoprotein antigens; enzymes and isoenzymes; genes; and cytokines. Serum alpha fetoprotein （AFP） is the most widely used tumor marker in detecting patients with hepatocellular carcinoma, and has been proven to have capability of prefiguring the prognosis. However, it has been indicated that AFP-L3 and DCP excel AFP in differentiating hepatocellular carcinoma from nonmalignant hepatopathy and detecting small hepatocellular carcinoma. Some tumor markers, such as human cervical cancer oncogene and human telomerase reverse transcriptase mRNA, have also been indicated to have higher accuracies than AFP. Furthermore, some other tumor markers, such as glypican-3, gamma-glutamyl transferase Ⅱ, alpha-Ifucosidase, transforming growth factor-beta1, tumorspecific growth factor, have been indicated to be available supplementaries to AFP in the detection. AFP mRNA has been shown to correlate with the metastasis and recurrence of HCC, and it may be the most useful marker to prefigure the prognosis. Some other markers, such as gamma-glutamyl transferase mRNA, vascular endothelial growth factor, and interleukin-8, could also be used as available prognostic indicators, and the simultaneous determination of AFP and these markers may detect the recurrence of HCC at its earlier period.

Diagnostic accuracy of endoscopic ultrasound in pancreatic neuroendocrine tumors: A systematic review and meta analysis

AIM: To detect pancreatic neuroendocrine tumors (PNETs) has been varied. This study is undertaken to evaluate the accuracy of endoscopic ultrasound (EUS) in detecting PNETs.METHODS: Only EUS studies confirmed by surgery or appropriate follow-up were selected. Articles were searched in Medline, Ovid journals, Medline nonindexed citations, and Cochrane Central Register of Controlled Trials and Database of Systematic Reviews. Pooling was conducted by both fixed and random effects model). RESULTS: Initial search identified 2610 reference articles, of these 140 relevant articles were selected and reviewed. Data was extracted from 13 studies (n = 456) which met the inclusion criteria. Pooled sensitivity of EUS in detecting a PNETs was 87.2% (95%CI: 82.2-91.2). EUS had a pooled specificity of 98.0% (95%CI: 94.3-99.6). The positive likelihood ratio of EUS was 11.1 (95%CI: 5.34-22.8) and negative likelihood ratio was 0.17 (95%CI: 0.13-0.24). The diagnostic odds ratio, the odds of having anatomic PNETs in positive as compared to negative EUS studies was 94.7 (95%CI: 37.9-236.1). Begg-Mazumdar bias indicator for publication bias gave a Kendall's tau value of 0.31 (P = 0.16), indication no publication bias. The P for χ2 heterogeneity for all the pooled accuracy estimates was > 0.10. CONCLUSION: EUS has excellent sensitivity and specificity to detect PNETs. EUS should be strongly considered for evaluation of PNETs.

Sclerosing stromal tumor of the ovary with masculinization,Meig’s syndrome and CA125 elevation in an adolescent girl:A case report

BACKGROUND Sclerosing stromal tumor (SST) is an extremely rare sex cord stromal tumor of theovary. It was first reported and named in 1973. These tumors typically presentwith pelvic/abdominal pain and tenderness, a mass, and/or abnormal menses,but rarely present with masculinity in children and adolescents. Only 2 cases ofthese tumors have been reported in premenarchal girls, who demonstratedhormonal activity, with a history of the development of a virilizing female due tohyperandrogenism. Here, we report a case of a giant SST with obviousmasculinity combined with Meig’s syndrome and CA125 elevation.CASE SUMMARY A 17-year-old female presented with a 7-year history of the development ofmasculinity and a 2-year history of amenorrhea. She had hirsutism, acne, obviouslaryngeal prominence, and voice deepening. Physical examination showed a malesuprapubic hair pattern and a 4.0 cm × 1.5 cm enlarged clitoris. Laboratory testsshowed that the testosterone level was > 15.00 ng/mL (normal range: 0.14-0.76ng/mL), and androstenedione level was > 10.00 ng/mL (normal range: 0.3-3.3ng/mL). A computed tomography scan of the abdomen and pelvis was carriedout and showed a large, solid and cystic, partly calcified pelvic mass in the rightovary measuring 27.1 cm × 20.0 cm × 11.0 cm, 15 cm above the umbilicus (to thelevel of the upper part of L1). Intraoperative findings at laparotomy revealed alarge tumor arising from the right ovary. Approximately, 500 mL of pale-yellow clear liquid was found in the pelvic cavity. A right salpingo-oophorectomy wasperformed. Microscopic examination and immunohistochemical staining of thesurgical specimen showed an SST of the ovary.CONCLUSION This report is remarkable as our patient was not only diagnosed with an SST ofthe ovary, which is extremely rare in this age group, but was the largest and mostobvious reported patient with this tumor who presented with virilization.Therefore, gynecologists should be aware of this potential complication inadolescent girls with a mass in the ovary.

Assessment of tumor markers CA 19-9,CEA,CA 125,and CA 242 for the early diagnosis and prognosis prediction of gallbladder cancer

BACKGROUND Gallbladder cancer(GBC)is one of the leading and aggressive cancers in this region of India.It is very difficult to diagnose in the early stage,as it lacks typical early signs and symptoms;thus,the diagnosis is often in the advanced stage,which ultimately leads to a poor 5-year survival outcome.Tumor markers including carbohydrate antigen 19-9(CA 19-9),carcinoembryonic antigen(CEA),CA 125,CA 242,and alpha fetoprotein are used as indicators in the diagnosis and prognosis of GBC.AIM To compare tumor marker levels between GBC and benign GB diseases(GBDs)and to assess the combined use of tumor markers to increase the diagnostic accuracy for GBC.METHODS Patients of either sex aged≥18 years,with suspected GBC(GB polyp,irregular thick GB wall,GB mass,porcelain GB)on the basis of radiological imaging were included in this study.GB wall thickness using ultrasonography and tumor markers CEA,CA 125,CA 19-9,and CA 242 in all patients were recorded.All cases after surgical intervention were divided into two groups,GBC and benign GBD,according to histopathological examination findings.The cases were followed up and clinical findings,radiological findings,and levels of tumor markers were assessed.RESULTS A total of 200 patients were included in this study,of whom 80 patients had GBC and 120 patients had benign GBD.The median(interquartile range)age was 52.0(41.0-60.0)years and the majority of patients(132,66.0%)were women.Tumor markers including CA 19-9,CA 125,CEA,and CA 242 were significantly elevated in patients with GBC(P<0.001).There was a significant reduction in tumor markers at 3 and 6 mo from baseline(P<0.001).The mean survival of patients with normal and elevated levels of tumor markers CA 125,CA 19-9,and CEA was comparable;however lymph node metastasis and CA 242 expression level were independent prognostic factors.CONCLUSION Serum levels of tumor markers including CA 19-9,CA 125,CEA,and CA 242 were significantly associated with GBC.However,no significant association was observed between the presence of elevated levels of any tumor marker with respect to survival.Tumor marker assessment during follow-up may represent a treatment response.

Colorectal cancer vaccines: Tumor-associated antigens vs neoantigens

Therapeutic options for the treatment of colorectal cancer(CRC) are diverse but still not always satisfying. Recent success of immune checkpoint inhibition treatment for the subgroup of CRC patients suffering from hypermutated tumors suggests a permanent role of immune therapy in the clinical management of CRC. Substantial improvement in treatment outcome could be achieved by development of efficient patient-individual CRC vaccination strategies. This mini-review summarizes the current knowledge on the two general classes of targets: tumor-associated antigens(TAAs) and tumorspecific antigens. TAAs like carcinoembryonic antigen and melanoma associated antigen are present in and shared by a subgroup of patients and a variety of clinical studies examined the efficacy of different TAA-derived peptide vaccines. Combinations of several TAAs as the next step and the development of personalized TAA-based peptide vaccines are discussed. Improvements of peptidebased vaccines achievable by adjuvants and immunestimulatory chemotherapeutics are highlighted. Finally, we sum up clinical studies using tumor-specific antigens-in CRC almost exclusively neoantigens-which revealed promising results; particularly no severe adverse events were reported so far. Critical progress for clinical outcomes can be expected by individualizing neoantigen-based peptide vaccines and combining them with immunestimulatory chemotherapeutics and immune checkpoint inhibitors. In light of these data and latest developments, truly personalized neoantigen-based peptide vaccines can be expected to fulfill modern precision medicine's requirements and will manifest as treatment pillar for routine clinical management of CRC.

CELLULAR IMMUNITY EFFECT OF LEUKEMIA VACCINE ON TUMOR BURDEN RAT

Objective To evaluate the effect of the active specific immunotherapy with leukemia vaccine in the malignant hematopoietic diseases. Methods We established the animal models by inoculating C 57 BL/6 rats with FBL 3 erythroleukemia cells and prepared three types of tumor vaccine, which were administered on the rats respectively. The MTT colorimetric assay was adopted 2 and 4 weeks later to test the cytotoxicity of macrophage( M Φ ) and that of cytotoxic T lymphocyte(CTL) derived from the rats injected with tumor vaccines, and compared the results with the control group. Results With the growth of erythroleulemia cells in the rats, the cellular immunity was seriously depressed, and the inhibition of specific cellular immunity was later than that of non specific cellular immunity. The tumor vaccine made from inactivated tumor cells, IFA and cytokines (rGM CSF, rIL 2 and rIL 6), promote the cellular immunity of tumor burden rats, especially the specific cellular immunity more efficiently than that of tumor vaccine made from inactivated tumor cells and IFA, but the third vaccine made from inactivated tumor cells alone has no effect. Conclusion The tumor vaccine made from inactivated tumor cells with addition of IFA and cytokines (rGM CSF, rIL 2 and rIL 6) provides a promising future in the active specific immunotherapy against hematopoietic tumor.

Retiform Sertoli-Leydig Cell Tumor of the Ovary

Sertoli-Leydig cell tumor of the ovary is a kind of sex cord-stromal tumor, which occurs between teens and twenties with symptoms including abdominal pain and swelling. The incidence rate is infinitely rare comprising less than 0.5% of all ovarian tumor. The average age of “retiform Sertoli-Leydig cell tumor” is 17 years as compared to 25 years for Sertoli-Leydig cell tumors as a group. We have experienced this rare case of retiform Sertoli-Leydig cell tumor in a 25-year-old foreign patient with the complaint of palpable mass on the right lower quadrant and an irregular menstrual period. The patient underwent right salpingo-oophorectomy and tumor stage was FIGO stage 1A. We report with a brief review of literature.

Demethylation of tumor necrosis factor-α converting enzyme promoter associated with high hepatitis B e antigen level in chronic hepatitis B

AIM: To evaluate tumor necrosis factor-α converting enzyme(TACE) methylation status in patients with chronic hepatitis B(CHB).METHODS: Eighty patients with hepatitis B e antigen(HBe Ag)-positive CHB, 80 with HBe Ag-negative CHB, and 40 healthy controls(HCs) were randomly enrolled in this study. Genomic DNA was extracted from peripheral blood mononuclear cells and methylation status of TACE promoter was determined by methylation-specific polymerase chain reaction. The clinical and laboratory parameters were collected.RESULTS: One hundred and thirty of 160 patients with CHB(81.25%) and 38 of 40 HCs(95%) displayed TACE promoter methylation. The difference was significant(χ2 = 4.501, P < 0.05). TACE promoter methylation frequency in HBe Ag-positive CHB(58/80, 72.5%) was significantly lower than that in HBe Ag-negative CHB(72/80, 90%; χ2 = 8.041, P < 0.01) and HCs(χ2 = 8.438, P < 0.01). However, no significant difference was observed in the methylation frequency between HBe Agnegative CHB and HCs(χ2 = 0.873, P > 0.05). In the HBe Ag-positive group, TACE methylation frequency was significantly negatively correlated with HBe Ag(r =-0.602, P < 0.01), alanine aminotransferase(r =-0.461, P < 0.01) and aspartate aminotransferase(r =-0.329, P < 0.01). CONCLUSION: Patients with HBe Ag-positive CHB have aberrant demethylation of the TACE promoter, which may potentially serve as a biomarker for HBe Ag seroconversion.

^(18)F-FDG PET/CT显像和血清学指标对前列腺肿瘤的诊断价值

目的 研究^(18)F-氟代脱氧葡萄糖(^(18)F-fluorodexyglucose,^(18)F-FDG)PET/CT显像和前列腺血清学指标诊断前列腺肿瘤的价值。方法 回顾性分析2013年8月至2021年12月在浙江大学医学院附属第二医院经病理证实的95例疑似前列腺肿瘤患者的^(18)F-FDG PET/CT图像与前列腺血清学指标。根据病理检查结果分为恶性组(n=77)和良性组(n=18)。采用受试者工作特征(receiver operating characteristic,ROC)曲线分析前列腺病灶的最大标准摄取值(maximum standardized uptake value,SUV_(max))与血清总前列腺特异性抗原(total prostate specific antigen,tPSA)、游离前列腺特异性抗原(free prostate specific antigen,fPSA)及游离/总前列腺特异性抗原比值(free/total prostate specific antigen,f/t-PSA)诊断前列腺良恶性病灶的最佳截断界值。结果 ROC曲线显示,SUV_(max)、tPSA、fPSA和f/t-PSA诊断前列腺良恶性病灶的最佳截断值分别为4.47、46.67 ng/mL、11.11 ng/mL和0.10。SUV_(max)、tPSA、fPSA和f/t-PSA的ROC曲线下面积(area under the curve,AUC)分别为0.658、0.897、0.842和0.836。^(18)F-FDG PET/CT显像、tPSA、f PSA和f/t-PSA对前列腺肿瘤的诊断敏感度分别是81.8%、97.4%、92.2%和83.1%,特异度分别是61.1%、27.8%、50.0%和50.0%,准确度分别是77.9%、84.2%、84.2%和76.8%。恶性组SUV_(max)、tPSA和fPSA均高于良性组,f/t-PSA低于良性组(均P<0.05)。^(18)F-FDG PET/CT检查显示,72例有远处转移病灶。结论 SUV_(max)、tPSA、fPSA和f/t-PSA均能鉴别前列腺良恶性病灶。^(18)F-FDG PET/CT显像在探测远处病灶方面更具有优势,能够为临床决策提供更好的帮助。

针刺配合翁沥通胶囊治疗良性前列腺增生的疗效观察

目的观察针刺配合翁沥通胶囊治疗良性前列腺增生的临床疗效及其对血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、前列腺特异性抗原(prostate specific antigen,PSA)水平的影响。方法将119例良性前列腺增生患者随机分为A组40例、B组38例及C组41例。A组采用针刺治疗,B组采用口服翁沥通胶囊治疗,C组采用针刺配合口服翁沥通胶囊治疗。观察3组治疗前后尿动力学各项指标[排尿后残余尿量(postvoid residual urine,PVR)、最大尿流率(maximum urine flow,Qmax)、最大逼尿肌压力]、国际前列腺症状评分(international prostate symptom score,IPSS)、生活质量(quality of life,QOL)评分、中医证候(排尿困难、夜尿频数、腰膝酸软、小腹胀满)积分及实验室指标[血清TNF-α、PSA、白细胞介素-6(interleukin-6,IL-6)、表皮细胞生长因子(epidermal growth factor,EGF)水平]的变化情况,比较3组临床疗效。结果3组治疗后PVR、最大逼尿肌压力、I-PSS、QOL评分、各项实验室指标及中医证候积分均较同组治疗前显著降低,Qmax均显著升高,差异均具有统计学意义(P<0.05)。C组治疗后PVR、最大逼尿肌压力、I-PSS、QOL评分、各项实验室指标及中医证候积分均明显低于A组和B组,Qmax均明显高于A组和B组,差异均具有统计学意义(P<0.05)。A组治疗后各项指标与B组比较,差异均无统计学意义(P>0.05)。C组总有效率为92.7%,明显高于A组的70.0%和B组的73.7%,差异均具有统计学意义(P<0.05)。结论针刺配合翁沥通胶囊治疗良性前列腺增生疗效确切,能降低患者TNF-α、PSA水平,改善其临床症状。

肌肉质量减少对不同部位肿瘤病人的预后分析

目的:分析肌肉质量减少对肿瘤病人预后的影响,并观察肌肉质量减少在不同肿瘤病人预后中的差异。方法:选用NHANES数据库中1999~2006年及2011~2018年可获得肌肉质量的肿瘤病人作为研究对象,将其根据DXA测量的肌肉质量差异分成肌肉质量减少组和非肌肉质量减少组。通过Cox回归多因素分析肌肉质量减少对肿瘤病人预后的影响,并将病人不同肿瘤部位进行亚组分析,分析肌肉质量减少对其总生存率(OS)及癌症特异性生存率(CSS)产生的差异。结果:本研究共纳入肿瘤病人1 663人,其中头颈部肿瘤病人64例,皮肤肿瘤病人478例,乳腺肿瘤病人237例,肺部肿瘤病人39例,消化系统肿瘤病人138例,泌尿系统肿瘤病人253例,妇科肿瘤病人264例,血液系统肿瘤病人64例,其他部位肿瘤病人103例。共分为肌肉质量降低组517例,非肌肉质量降低1 146例。肌肉质量降低的肿瘤组病人OS以及CSS显著低于非肌肉质量降低组(OS,HR=1.358;CSS,HR=2.109)。其中肌肉质量降低与头颈部肿瘤病人的OS显著相关(HR=4.060),在泌尿系统肿瘤病人中,肌肉质量降低组OS及CSS都明显更差(OS,HR=1.625;CSS,HR=2.311),而其余肿瘤病人在未表现出明显差异性。结论:肌肉质量降低的肿瘤病人较正常肿瘤病人的OS以及CSS明显更差,且对不同部位的肿瘤病人表现出不同的预后影响性,尤其需关注头颈部肿瘤及泌尿系统肿瘤的肌肉质量状况并及时干预。

Effects on the Tumor Specific Growth Factor and Tumor Necrosis Factorαin Rats'Precancerous Lesion of Primary Hepatocellular Carcinoma by Direct Moxibustion at Ganshu(BL 18)Acupoint

Objective： To investigate the effect of direct moxibustion at Ganshu （BL18） on the serum concentrations of tumor specific growth factor （TSGF） and tumor necrosis factor a （TNF-a） in a rat model with precancerous lesion of primary hepatocellular carcinoma （HCC）, so as to explore the mechanism of moxibustion underlying improvement of HCC. Methods： Sixty male Wistar rats were randomly divided into control group （n=10）, model group （n=20）, prevention group 1 （n=15） and prevention group 2 （n=15）. The normal rats were injected with physiological saline as blank control. At the same time, the rats of other three groups were injected with diethylnitrosamine to establish the HCC model. Direct moxibusUon with grain-sized moxa was applied to bilateral Ganshu acupoint of the rats in the prevention group 1 （1 treatment course, 20 days） and prevention group 2 （2 treatment courses, 40 days）, 5 doses for each acupoint, 0.5 mg/dose, once every other day. At each time point （before model establishment, the end of 1st course prevention, the end of 2rid course prevention and the end of model establishment）, serum levels of TSGF and TNF-eL were detected using enzyme-linked immunosorbent assay. Results： Compared with the control group, there was a remarkably increase of serum TSGF and TNF-eL contents in the model group at the end of the experiment （P〈0.05）. At the end of the 1st course of direct moxibustion, the contents of serum TSGF and TNF- a of rats in the prevention group 1 were significantly increased compared with that of the model group （P〈0.05）. At the end of the 2nd course of direct moxibustion, serum TSGF and TNF-a levels of rats in the model group were higher than the normal group with significantly difference （P〈0.05）, and the levels of TSGF and TNF-a in the prevention group 2 were significantly reduced in comparison with the model group （P〈0.05）. Conclusion： It was possible that direct moxibustion could inhibit precancerous lesion and postpone hepatocarcinogenesis, and the therapeutic effect of two courses were better than one course.

细针吸取活检在下颌下腺肿物诊断中的价值及误诊原因分析

目的探讨细针吸取活检(FNA)对下颌下腺肿物的诊断价值。方法回顾2013-2022年就诊于首都医科大学附属北京友谊医院口腔科,行FNA并获得最终病理的下颌下腺肿物患者,以最终病理为金标准,计算FNA诊断各型下颌下腺肿物的准确性、灵敏度、特异性、安全性,分析误诊原因。结果共纳入114例患者。非肿瘤性疾病多为IgG4-RD,FNA诊断准确度为91.2%,灵敏度97.4%,特异性88.2%。FNA诊断下颌下腺良性肿瘤准确度:86.8%,灵敏度:81.7%,特异度:92.6%。FNA诊断下颌下腺恶性肿瘤准确度为93.0%,灵敏度62.5%,特异性98.0%。误诊原因包括10例取样误差及8例病理类型误判。结论FNA在诊断IgG4相关性下颌下腺炎中极具价值,在诊断下颌下腺恶性肿瘤灵敏度较低,有误诊可能,需结合患者资料进行综合考虑。