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Objective:To investigate the clinical features and prognosis of patients with pancreatic metastasis from clear cell renal cell carcinoma(CCRCC).Methods:From Jan 2000 to May 2020, the clinical data of patients pathologically diagnosed as CCRCC with pancreatic metastasis and admitted in Cancer Institute and Hospital of Tianjin Medical University were analyzed retrospectively. The gender, age, metastasis time, relapse time, metastatic sites, numbers of metastatic lesions and whether metastatic pancreatic lesions should be surgerically removed were recorded and the influencing factors were analyzed.Results:Among the 20 patients, there were 12 males and 8 females. The median age of diagnosis was 50 years. There were 12 patients(60%) of left renal carcinoma and 8 patients(40%)of the other side. 12 cases(60%) had single pancreatic metastatic lesion and the other 8 cases(40%) had multiple metastatic lesions. Seven patients(35%) had other organs metastasis besides pancreatic metastasis. Two patients(10%) had simultaneous pancreatic metastasis and renal cancer, and the other eighteen patients(90%) had pancreatic metachronous metastasis after being diagnosed as renal cancer. The median time from the diagnosis of CCRCC to pancreatic metastasis was 102 months. Thirteen patients(65%)had recurrences within 10 years and the other seven patients(35%)had recurrences after 10 years. Pancreatectomy was performed in nine patients(45%) and targeted therapy was conducted in thirteen patients. The mean follow-up was 122.9 months (1-256 months). Three patients (15%) died and 17 patients (85%) survived. The median overall survival was 75.9 months, and the 5 year-survival rate was 66.7%. Simultaneous metastasis and extra-pancreatic metastasis were prognostic factors in patients with CCRCC with pancreatic metastasis.Conclusions:Pancreatic metastases from renal clear cell carcinoma were rare, but the prognosis was good, especially in patients with only pancreatic metastases several years after renal carcinoma was diagnosed.
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Immunotherapy plays an important role in tumor biology research, and there has been significant progress in target therapy for cancer. B7-H3(CD276) is an immune checkpoint from the B7 family of molecules, many of whom interact with known checkpoint markers including CTLA4, PD-1, and CD28. This molecule is over-expressed in many kinds of tumors, although the receptor of B7-H3 has not been characterized. Initially, B7-H3 was thought to co-stimulate the immune response, but recent studies have shown that it has a co-inhibitory role on T-cells, contributing to cancer cell immune evasion. Therefore, its over-expression has been linked to poor prognosis in human patients and to invasive and metastatic potential of tumors in in vitro models. Moreover, recent evidence has shown that B7-H3 influences cancer progression beyond the immune regulatory roles. In this review, we aim to characterize the roles of B7-H3 in different cancers, its relationship with other immune checkpoints, and its non-immunological function in cancer progression. Targeting B7-H3 in cancer treatment can reduce cell proliferation, progression, and metastasis, which may lead to improved therapeutic options and better clinical outcomes.
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Objective: To explore the expression of PTK7 in pancreatic ductal adenocarcinoma and its clinical significance. Methods: The clinical and follow-up data of 85 patients with pancreatic ductal adenocarcinoma who underwent radical surgery at Tianjin Medical University Cancer Institute and Hospital from May 2011 to January 2016 were analyzed. The expression of PTK7 in 85 pancreatic cancer tissues and the corresponding para-cancer tissues was detected by immunohistochemistry, and the relationship between PTK7 expression level and the clinical pathological features and prognosis was analyzed. Results: Positive expression of PTK7 was observed mainly in the cytoplasm, presenting as brownish yellow granules. It was noted that expression of PTK7 in pancreatic ductal adenocarcinoma tissues and para-carcinoma tissues was 70.6% (60/85) and 52.9% (45/85), respectively, and the positive rate in pancreatic ductal adenocarcinoma tissues was significantly higher than that in para-carcinoma tissues; the difference was statistically significant (P<0.05). The abnormal expression of PTK7 was correlated with the tumor stage, lymph node metastasis, and the vascular tumor embolus (P<0.05). The survival analysis suggested that the survival time or recurrence-free time of patients with PTK7 high expression in pancreatic duct adenocarcinoma was significantly shorter than in those with low expression (P<0.05, respectively). ShRNA interference of PTK7 was successfully established in the cell stabilizing system, verified by MTT and clone formation. Results indicated that cell survival was significantly lower in the shRNA experimental group compared to the control group (P<0.05), the number of colonies formed was significantly smaller in the shRNA experimental group compared to the control group (P<0.05), and the expression of proliferation-related proteins Ki-67 and PCNA was significantly lower in the shRNA experimental group compared to the control group (P<0.05, respectively). Conclusions: The up-regulation of PTK7 expression in pancreatic ductal ad-enocarcinoma tissues was associated with the tumor stage, lymph node metastasis, and the vascular tumor thrombus, suggesting poor prognosis. It was also found that in pancreatic cancer cell lines, PTK7 could promote the proliferation of pancreatic cancer cells by regulating the levels of proliferative factors Ki-67 and PCNA.
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The effect of the treatment of 112I particle therapy in solid tumor is remarkable and with less side effect.This study retrospectively analyzed the clinical data of 125I particles implantation combined systemic chemotherapy in the treatment of locally advanced pancreatic cancer patients.Main observation indexes included:the overall median survival,1 year survival rate,pain relief rate,the postoperative complications.Intraoperative 125I particles implantation combined with postoperative chemotherapy in treatment of locally advanced pancreatic cancer patient was safety,which can effectively prolong patient survival and relieve patients' pain.
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Objective:This study explored the clinical characteristics, imaging features, biological characteristics, treatment, and prog-nosis of solid-pseudopapillary tumor of the pancreas (SPT). Methods:We collected clinical data of 50 cases of SPT in Tianjin Medical University Cancer Istitute and Hospital from January 2011 to October 2016. We then retrospectively reviewed and analyzed clinical and pathological features of these patients. We conducted follow-up consultations and summarized data on patient characteristics, pathological features, diagnosis, treatment, and prognosis. Results:Among 50 SPT patients, mean age was 33.0±12.00 years, and male-to-female ratio was 1:5.25. Clinical presentation was mostly an abdominal placeholder diagnosed by physical examination, and tumor was usually located in the head or body and tail of the pancreas. All patients received surgery;procedures included pancreaticoduode-nectomy, and distal pancreatectomy plus spleen resection. SPT was clearly diagnosed with postoperative histopathological examina-tion. Hospital stay lasted for 13.9±5.16 days. All 50 cases were followed up, with consultation period lasting for 3-70 months. No recur-rence or metastasis appeared in 49 cases, and perioperative death was not noted in our patients. Conclusion:SPT is a rare, potential low-grade malignant tumor, which mostly affects young females. There is no obvious specificity in the clinical manifestation and labora-tory examination. Tumor marker levels are almost within normal range. Surgery for SPT provides good prognosis and long survival dura-tion.
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Objective To investigate the clinical efficacy of modified FOLFIRINOX as neoadjuvant chemotherapy for borderline resectable pancreatic cancer.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 28 patients diagnosed as borderline resectable pancreatic cancer who were admitted to the Tianjin Medical University Cancer Institute and Hospital between April 2013 and October 2015 were collected.Twenty-eight patients were treated with modified FOLFIRINOX (irinotecan 135 mg/m2,oxaliplatin 64 mg/m2,leucovorin 400 mg/m2,5-FU 2 400 mg/m2,repeat the regimen every 2 weeks) as neoadjuvant chemotherapy.After the completion of neoadjuvant chemotherapy,patients were evaluated operation feasibility and developed surgical planning in 3 weeks.Observation indicators:(1) Efficacy of neoadjuvant chemotherapy;(2) adverse events of neoadjuvant chemotherapy;(3) surgical and postoperative situations;(4)follow-up situations.Follow-up using outpatient examination,telephone interview and we-chat was performed to detect survival of patients up to January 2017.Measurement data with skewed distribution were described as median (range).The survival curve was drawn by Kaplan-Meier method and the survival analysis was done by Log-rank test.Results (1) Efficacy of neoadjuvant chemotherapy:28 patients received chemotherapy with a median cycle of 6 cycles (range,3-12 cycles).Chemotherapy reaction of 28 patients:14 had partial remission,10 had stable disease and 4 had progressive disease.(2) Adverse events of neoadjuvant chemotherapy:there were 22 adverse events of 28 patients during chemotherapy,including 15 with grade1-2 and 7 with grade 3-4.(3)Surgical and postoperative situations:of 28 patients,18 received radical resection for pancreatic cancer including 11 receiving pancreaticoduodenectomy,7 receiving distal pancreatectomy with splenectomy.Surgeries included 6 with portal vein and superior mesenteric vein resection and reconstruction,1 with coeliac trunk resection.Ten patients received R0 resection and 8 received R1 resection.Of 18 patients,8 with postoperative complications were improved by conservative treatment,including 2 with pancreatic fistula,1 with biliary fistula,3 with delayed gastric empty,1 with anastomotic hemorrhage,1 with lympha fistula.No patient received re-operation or died within 30 days postoperatively.Pathological TNM staging:2 patients were detected in stage Ⅰ-Ⅱ,14 in stage Ⅲ and 2 in stage Ⅳ.All the 18 patients received chemotherapy after operation.Ten patients without operation continued chemotherapy.(4) Following up:28 patients were followed up for 5-21 months with a median time of 13 months.Of the 15 died patients,5 received operation and 10 received no operation.The median progressionfree survival time and median overall survival time were 14 months and 19 months in the 18 operative patients,7 months and 11 months in the 10 non-operative patients,respectively,with statistically significant differences (x2=7.335,9.950,P＜0.05).Conclusions Modified FOLFIRINOX as neoadjuvant chemotherapy for borderline resectable pancreatic cancer is safe and effective,and patients can tolerate mild adverse reactions.Operable patients undergo surgeries after chemotherapy have relatively good outcome.
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Objective To investigate the clinical efficacy of modified FOLFIRINOX as neoadjuvant chemotherapy for borderline resectable pancreatic cancer.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 28 patients diagnosed as borderline resectable pancreatic cancer who were admitted to the Tianjin Medical University Cancer Institute and Hospital between April 2013 and October 2015 were collected.Twenty-eight patients were treated with modified FOLFIRINOX (irinotecan 135 mg/m2,oxaliplatin 64 mg/m2,leucovorin 400 mg/m2,5-FU 2 400 mg/m2,repeat the regimen every 2 weeks) as neoadjuvant chemotherapy.After the completion of neoadjuvant chemotherapy,patients were evaluated operation feasibility and developed surgical planning in 3 weeks.Observation indicators:(1) Efficacy of neoadjuvant chemotherapy;(2) adverse events of neoadjuvant chemotherapy;(3) surgical and postoperative situations;(4)follow-up situations.Follow-up using outpatient examination,telephone interview and we-chat was performed to detect survival of patients up to January 2017.Measurement data with skewed distribution were described as median (range).The survival curve was drawn by Kaplan-Meier method and the survival analysis was done by Log-rank test.Results (1) Efficacy of neoadjuvant chemotherapy:28 patients received chemotherapy with a median cycle of 6 cycles (range,3-12 cycles).Chemotherapy reaction of 28 patients:14 had partial remission,10 had stable disease and 4 had progressive disease.(2) Adverse events of neoadjuvant chemotherapy:there were 22 adverse events of 28 patients during chemotherapy,including 15 with grade1-2 and 7 with grade 3-4.(3)Surgical and postoperative situations:of 28 patients,18 received radical resection for pancreatic cancer including 11 receiving pancreaticoduodenectomy,7 receiving distal pancreatectomy with splenectomy.Surgeries included 6 with portal vein and superior mesenteric vein resection and reconstruction,1 with coeliac trunk resection.Ten patients received R0 resection and 8 received R1 resection.Of 18 patients,8 with postoperative complications were improved by conservative treatment,including 2 with pancreatic fistula,1 with biliary fistula,3 with delayed gastric empty,1 with anastomotic hemorrhage,1 with lympha fistula.No patient received re-operation or died within 30 days postoperatively.Pathological TNM staging:2 patients were detected in stage Ⅰ-Ⅱ,14 in stage Ⅲ and 2 in stage Ⅳ.All the 18 patients received chemotherapy after operation.Ten patients without operation continued chemotherapy.(4) Following up:28 patients were followed up for 5-21 months with a median time of 13 months.Of the 15 died patients,5 received operation and 10 received no operation.The median progressionfree survival time and median overall survival time were 14 months and 19 months in the 18 operative patients,7 months and 11 months in the 10 non-operative patients,respectively,with statistically significant differences (x2=7.335,9.950,P＜0.05).Conclusions Modified FOLFIRINOX as neoadjuvant chemotherapy for borderline resectable pancreatic cancer is safe and effective,and patients can tolerate mild adverse reactions.Operable patients undergo surgeries after chemotherapy have relatively good outcome.
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Objective To explore the effect and molecular mechanism of proteasome inhibitor in TNF-related apoptosis-inducing ligand (TRAIL)-induced apoptosis resistance on malignant lymphoma cells.Methods Raji cells were treated with TRAIL and proteasome inhibitor (PS-341) in vitro and the cell growth index was evaluated by MTT assay; cell cycle was analysed by flow cytometry; the protein and mRNA level of Bax were measured by Western blotting and real time RT-PCR. Results TRAIL inhibited proliferation of Raji cells at the concentration of 500 μg/L, but the inhibition rate was lower than that of the control cell:Hmy2.ciR.TRAIL arrested cell in G0/G1 phase. The Bax protein in Raji is degraded, but the Bax mRNA expression level does not change significantly .The effects of TRAIL was enhanced significantly 10 nmol/L PS-341 was added. Conclusion Raji cells are resistant in TRAIL-induced apoptosis. This effect may be related to the decrease of Bax protein. The Ubiquitin-proteasome pathway is involved in the degradation of Bax in TRAIL-treated Raji cells.
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Objective To investigate the clinical characteristics of gastrointestinal stromal tumor (GIST) of the stomach and to analyze the corresponding prognostic factors. Methods We retrospectively reviewed the clinical data of 121 patients in our hospital from March 1996 to March 2008. Gender、age、tumor size and histological type were analyzed. Results For these 121 cases the median survival time is 73.2 months. The overall 1-、3-、and 5-year survival rates were 82%, 59% and 50% respectively. The tumor-free survival rates for 1-、3-、and 5-yeas were 65%, 46% and 33% respectively. Cox univariale analysis revealed that gender、tumor size、organ involvement and recurrence were factors impacting prognosis. Cox multivariate analysis revealed that gender、tumor size、organ involvement、recurrence were prognostic factors for gastric GIST. Conclusions Male sex、tumor size (> 10 cm) and involvement of organ were independent indicators for a poor prognosis in patients with primary malignant gastric GIST.