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Purpose@#Oligometastatic non–small cell lung cancer (NSCLC) patients have been increasingly regarded as a distinct group that could benefit from local treatment to achieve a better clinical outcome. However, current definitions of oligometastasis are solely numerical, which are imprecise because of ignoring the biological heterogeneity caused by genomic characteristics. Our study aimed to profile the molecular alterations of oligometastatic NSCLC and elucidate its potential difference from polymetastasis. @*Materials and Methods@#We performed next-generation sequencing to analyze tumors and paired peripheral blood from 77 oligometastatic and 21 polymetastatic NSCLC patients to reveal their genomic characteristics and assess the genetic heterogeneity. @*Results@#We found ERBB2, ALK, MLL4, PIK3CB, and TOP2A were mutated at a significantly lower frequency in oligometastasis compared with polymetastasis. EGFR and KEAP1 alterations were mutually exclusive in oligometastatic group. More importantly, oligometastasis has a unique significant enrichment of apoptosis signaling pathway. In contrast to polymetastasis, a highly enriched COSMIC signature 4 and a special mutational process, COSMIC signature 14, were observed in the oligometastatic cohort. According to OncoKB database, 74.03% of oligometastatic NSCLC patients harbored at least one actionable alteration. The median tumor mutation burden of oligometastasis was 5.00 mutations/Mb, which was significantly associated with smoking, DNA damage repair genes, TP53 mutation, SMARCA4 mutation, LRP1B mutation, ABL1 mutation. @*Conclusion@#Our results shall help redefine oligometastasis beyond simple lesion enumeration that will ultimately improve the selection of patients with real oligometastatic state and optimize personalized cancer therapy for oligometastatic NSCLC.
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Objective To explore the impact of breast conservation surgery and modified radical mastectomy combined with intensity modulated radiation therapy respectively on the living quality and sexual life for patients with early-stage breast cancer.Methods From January 2011 to December 2016, 89 patients with breast cancer were admitted and divided into two groups according to different surgical methods.Patients in the conservation group (n=24) received breast conservation surgery combined with intensity modulated radiation therapy, while patients in the modified radical group (n=65) received breast radical surgery combined with intensity modulated radiation therapy.The quality of life and sexual satisfaction of patients were measured by questionnaire investigation.And the data were calculated by SPSS 16.0.Results Different surgical methods combined with radiotherapy affectted the score of living quality a lot.The average score was (87.500±7.940) points in the conservation group, while it was (65.350±8.490) points in the modified radical group, the difference was statistically significant (P<0.01).At the same time,the degree of self acceptance and sexual satisfaction in the conservation group after surgery was better than that in the modified radical group,and the difference was statistically significant (P<0.01).Conclusion Breast conservation surgery combined with intensity modulated radiation therapy for breast cancer patients could receive better quality of life and sexual satisfaction compared with modified radical mastectomy combined with intensity modulated radiation therapy.
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Objective To investigate the short-term efficacy and the influencing factorof zoledroniacid combined with ra-diotherapy and single radiotherapy in the treatmenof bone metastasiin non-small cell lung cance(NSCL) .MethodTotally 117 NSCLpatientwith bone metastase(153 lesions) receiving the bone lesion radiotherapy in the TumoCenteof ouhospital from 2009 to 2013 were selected and treated by zoledroniacid combined with radiotherapy (combined therapy group ,n=54) and the single radiotherapy (single radiotherapy group ,n=63) .The bone pain relief and influence factorwere analyzed .ResultThe effective ratein the single radiotherapy group and the combined radiotherapy group were 69 .74% and 92 .21% respectively (χ2 =13 .75 ,P＜0 .01);the multivariate Logistiregression analysishowed thathe bone pain relief wacorrelated with the treatmenmode ,moreovethe bone pain relief rate in the combined therapy group wasignificantly highethan thain the single therapy group (OR=4 .60 ,95% CI:1 .23-17 .20 ,P=0 .02) .In the subgroup analysiof treatmenmode,the patientwith osteolytile-sions(OR=26 .59 ,95% CI:3 .29-215 .12 ,P=0 .00) had betteeffec.The combined therapy group had more superiority in the as-pecof non-skeletal related eventoccurrence (OR=4 .40 ,95% CI:1 .49 -12 .99 ,P=0 .01) .Conclusion Radiotherapy combined with zoledroniacid habettecurative effeccompared with single radiotherapy in the NSCLC patientwith bone metastasi.
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Objective To explore the risk factors of skeletal related events (SREs) in non small cell lung cancer with bone metastases and its effect on the prognosis .Methods Totally 223 cases of NSCLC patients with bone metastasis were retrospective studied from January 2010 to December 2012 in our hospital .The clinical features ,predictive factors for SREs were analysed by sin‐gle factor and multifactor analysis .Results Among 223 cases of NSCLC patients with bone metastasis ,119 cases occured with SREs(53 .4% ) .Univariate analysis showed that the occurrence of SREs in female ,no smoker ,adenocarcinoma ,solitary bone metas‐tasis lesions were less than the male ,smoker non‐adenocarcinoma ,and multiple bone metastases (P0 .05) .The multivariate analysis revealed only multiple bone metastases was an independent risk factor for SREs .The median survival time of the NSCLC patients with bone metastasis was 15 .3 months .Moreover ,survival analysis showed that SREs had no statistical significance on the prognosis of bone metastasis in NSCLC patients (P>0 .05) .Conclusion The female ,adenocarcinoma ,smoking history ,solitary bone metastasis lesions occurred in patients with lower risk SREs .Multiple bone metastasis is an independent risk factor for SREs ,attention should be paid to monitoring and prevention .
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Objective To explore skeletal‐related events (SREs) clinical factors and analysis prognosis factors on patients with non‐small cell lung cancer(NSCLC) with bone metastases .Methods We collected clinical data of pathology confirmed 383 patients with non‐small cell lung cancer between April 2007 and January 2007 in the third affiliated hospital of the third military medical uni‐versity .It was used to screening for Emission Computed Tomography (ECT ) for bone metastases .And then it was need to con‐firmed for CT ,MRI or PET‐CT or pathology .Statistics in patients between clinical features and the SREs prediction factor with Univariate and Multivariate .And Kaplan‐Meier method analysis of survival in the non‐small cell lung cancer patients with bone me‐tastases .Results Out of 383 patients with bone metastases ,178 patients with SREs .The incidence was 46 .5% .Univariate analysis showed that women ,adenocarcinoma ,never smoking history ,single bone metastases ,bisphosphonate therapy ,targeted therapy in patients with bone metastases are less likely to have SREs ,it was considered statistically significant (P<0 .05) .Multivariate analy‐sis showed multiple bone metastases and no bisphosphonate therapy is independent risk factors for SREs .Median survival time was 14 .5 months in non‐small cell lung cancer patients with bone metastases ,1 year survival rate was 46 .5% ,2 years survival rate was 15 .9% .The survival analysis shows that more bisphosphonate treatment and bisphosphonate with EGFR‐TKI therapy on the prog‐nosis of patients with statistically significance (P<0 .05) .Conclusion It was likely to occur SREs in NSCLC patients with bone metastases .No bisphosphonate and multiple bone metastases are independent risk factors for SREs .Bisphosphonate treatment may prevent or reduce occur SREs for NSCLC patients with bone metastases ,and it may prolong survival ,it speculated that bisphospho‐nate may have resistant NSCLC cell activity .
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Objective The palliation of dysphagia in metastatic esophageal cancer remains a challenge ,and the optimal approach for this difficult clinical scenario is not clear .We therefore sought to define and determine the efficacy of various treatment options used at our institution for this condition .Methods Methods We reviewed a prospective database for all patients managed in an e-sophageal cancer referral centre over a 5-year period .All patients receiving palliation of malignant dysphagia were reviewed for de-mographics ,palliative treatment modalities ,complications ,and dysphagia scores (0= none to 4= complete) .The Wilcoxon signed rank test was used to determine significance (P<0 .05) .Results During 2005~2010 ,80 patients with inoperable esophageal cancer were treated for palliation of dysphagia .The primary treatment was radiotherapy in 66% ,metal stenting in 21% and radiotherapy combined with stent in 13% .Mean duration of treatment was 1 day in he stent group and 40 days in the radiotherapy group(P=0 . 001) .In patients treated initially by stenting ,dysphagia improved within 2 weeks of treatment in 82% of patients(dysphagia score of 0 or 1) .However ,18% of patients presented with recurrence of dysphagia at 10 weeks of treatment .In the radiotherapy group , the onset of palliation was slower ,with only 50% of patients palliated at 2 weeks(dysphagia score of 0 or 1) .However ,long-term palliation was more satisfactory ,with 90% of patients remaining palliated after 10 weeks of treatment .Conclusion In inoperable e-sophageal cancer at our centre ,radiation treatment provided durable long-term relief ,but came at a high price of a long wait time for initiation of treatment and a long lag time between initiation of treatment and relief of symptoms .On the other hand ,stenting pro-vided more rapid and effective early relief from symptoms ,but was affected by recurrence of dysphagia in the long-term .
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Despite the progress in the comprehensive management of colorectal cancer,locally advanced (T3 and T4 stages) and metastatic colorectal cancer is still a challenging problem.Although researches on neoadjuvant therapy and targeted therapy have obtained many encouraging results,many unanswered questions still remain.These include the indication of multivisceral resection for locally advanced colorectal cancer,the optimal management of patients with hepatic and (or) pulmonary metastasis.R0 resection was the first choice for the treatment of metastatic colorectal cancer,but it is only suitable for selected patients.Chemotherapy and targeted therapy are effective in converting some unresectable liver metastasis into resectable disease.This review focuses on recent improvements in the management of locally advanced colorectal cancer,as well as the management of hepatic and (or) pulmonary metastasis.
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<p><b>BACKGROUND</b>According to the report of the 11th World Conference on Lung Cancer, lung cancer is the leading cause of cancer related death. So there is important clinical significance to monitor the patients with lung cancer through different ways. The aim of this study is to investigate the clinical significance of multiple tumor marker protein chip in monitoring the recurrence, progression and metastasis of lung cancer.</p><p><b>METHODS</b>Forty-four patients were selected, who were detected at least 4 times with tumor mar-ker protein chip. Based on efficacy and status, patients were classified as six grades. Correlation of expression level of each tumor marker with grade of efficacy and status was analyzed. And the discriminant functions for recurrence, progression and metastasis of lung cancer were established.</p><p><b>RESULTS</b>Grade of efficacy and status was closely related to CA199, CEA, CA242, AFP and CA125 in adenocarcinoma (AC), to CA125 in squamous cell carcinoma (SqCa), and to CA199 and CA125 in small cell lung cancer (SCLC). Based on the discriminant functions, accuracy rate of efficacy and status judgement was 89.4%, 80.4%, 78.3% and 66.7% for female AC, male AC, SqCa and SCLC respectively.</p><p><b>CONCLUSIONS</b>There is important clinical significance of multiple tumor marker protein chip in monitoring the recurrence, progression and metastasis of lung cancer (especially adenocarcinoma).</p>
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Objective To investigate the effects and mechanisms of all-trans retinoic acid(ATRA)on the proliferation and cell cycle of lung carcinoma cell line A549.Methods The A549 cells were treated with ATRA at the dosages of 5,10,50 ?mol/L for 1-7 d.The proliferation of A549 was assessed by MTT method and cell cycle was analyzed by flow cytometry.The expressions of CDK4,Rb and p-ERK1/2 were assessed by Western blotting.CyclinD1 mRNA was analyzed by SYBR-PCR amplification.Results ATRA obviously inhibited the proliferation of A549 cells,and the cell cycle was arrested in G0/G1 phase.The expression of p-ERK1/2 protein and CyclinD1 mRNA on A549 cells were decreased.Conclusion ATRA might inhibit the proliferation of A549 cells through down-regulating p-ERK1/2 protein and CyclinD1 mRNA.
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Objective To investigate the expression of TGF-β and TGF-β receptor in human breast cancer cell Bcap-37 inhibited by soybean isoflavones. Methods mRNA and protein of TGF-β1、TGF-βRⅠ in Bcap-37 cells were examined with reverse transcription ploymerase chain reaction(RT-PCR) and immunohistochemistry after cells were treated with daidein or genistein for 1-4 d.The expression of TGF-β1 and TGF-β2 was determined with TGF-β resistance test. Results The TGF-β1, TGF-β2 and TGF-β recepor increased in Bcap-37 cells at a concentration of 3×10-5 mol/L of genistein. No changes was found when treated with daidzein. Conclusion Genistein may inhibit the proliferation of Bcap-37 cells and accompany with increasing expression of TGF-β1, TGF-β2 and TGF-β receptor.
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Objective To explore the relation between changes in apurinic/apyrimidinic endonuclease (APE1) gene expression and effects of melphalan on multiple myeloma (MM) cells. Methods Expression of APE1 protein was detected in MM cell line KM3 using immunocytochemical staining and Western blot assay after 0~15?mol/L melphalan treatment for 1~2d. Integral optical density was determined by means of image analysis system. Results There was positive relationship between levels of APE1 protein in KM3 cells and the treatment time and dose of melphalan. Conclusion Expression of APE1 protein could be induced by melphalan treatment. The result suggests that a high expression of APE1 protein may play a certain role in the resistance of multiple myeloma to melphalan.
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Objective To explore the robe of interleukin-6 in the apoptosis of multiple myeloma (MM) cell lines KM_3 induced by melphalan and its molecular mechanism. Methods Apoptosis was confirmed by flow cytometry, DNA fragmentation rate and TUNEL. The expression of caspase-3, caspase-8 proteins in KM_3 cell, which was assessed by Western blot analysis, after melphalan treatment and cultured with or without interleukin-6. Results KM3 cells in the presence of interleukin-6 showed lower rate of apoptosis compared with that in the absence of interleukin-6 (P
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Objective To observe and evaluate clinical therapeutic effect of photodynamic therapy (PDT) on malignant tumor. Methods 20 patients of malignant tumors of different nature and different stages were subjected to PDT or PDT-predominant comprehensive therapy. All the patients were followed-up, and the clinical results were analyzed. Results Among these patients, 3 tumors at early stage showed complete remission (CR), and no relapse was found in the follow-up period. Among the 17 cases with tumors in advanced stage, CR was seen in 9 cases, PR in 8, and 3 patients died of causes other than PDT after 1-6 months of follow-up. Conclusion PDT shows a curative effect on malignant tumors in early stage, and fairly good therapeutic effect on those in advanced stage. It is one of the optional treatments for malignant tumors.