Linfoma no Hodgkin de células B primario de mama. Reporte de caso y revisión de la literatura / Primary breast B-cell non-Hodgkin's lymphoma of the breast. Case Report and review of the literature

Objetivos: Reportar un caso de linfoma no Hodgkin de células B primario de mama (LPM) y realizar una revisión de la literatura de su diagnóstico y tratamiento. Materiales y métodos: Se reporta el caso de una paciente de 80 años que acudió a una institución privada de referencia en México por un LPM. Además, se diagnosticó un melanoma primario de hígado, mediante biopsia dirigida y estudio de patología. La paciente recibió tratamiento con R-CHOP (rituximab, ciclofosfamida, doxorrubicina, vincristina y prednisona), cuadrantectomía, resección de cadenas ganglionares y radioterapia. La paciente presenta adecuada respuesta del LPM, sin embargo, el segundo tumor primario progresa llevando a la paciente a cuidados paliativos. Se realizó una búsqueda bibliográfica en Medline vía PubMed, LILACS y Google Scholar. Se incluyeron estudios de cohortes, reportes y series de casos en pacientes con LPM que abordaran el diagnóstico, tratamiento y pronóstico de esta patología, publicados en inglés y español entre los años 2000 a 2022. Resultados: Se identificaron 23 títulos, de los cuales 17 cumplieron con los criterios de inclusión, estos fueron reportes de caso y series de caso. La mayoría de las pacientes recibió un esquema quimioterapéutico R-CHOP, el cual se complementó con radioterapia. Cerca del 80 % presentó remisión completa. El sitio más frecuente de recaída fue el sistema nervioso central. La sobrevida a 5 años fue del 83,6 % en los estudios incluidos. Conclusiones: En la actualidad, el esquema CHOP -con o sin rituximab- es el más empleado y el único que ha mostrado tener un impacto positivo en la supervivencia, este suele acompañarse de radioterapia. Se requieren más estudios clínicos aleatorizados para establecer de manera más clara la efectividad y seguridad de estos tratamientos.

Objectives: To report a case of primary breast B-cell non-Hodgkin's lymphoma (PBL) and to conduct a literature review of its diagnosis and treatment. Material and methods: Case report of an 80-year-old female patient who presented to a private referral institution in Mexico, with PBL. She was also diagnosed with primary liver melanoma by means of targeted biopsy and pathology testing. The patient received treatment with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone), quadrantectomy, lymph node dissection and radiotherapy. The PBL showed good response but, because of progression of the second primary tumor, the patient went on to receive palliative care. A review of the literature was conducted in Medline via PubMed, LILACS and Google Scholar. Cohort studies, case reports and case series in patients with PBL that discussed diagnosis, treatment and prognosis of this disease, published in English and Spanish between 2000 and 2022, were included. Results: Overall, 23 titles were identified, of which 17 consisting of case reports and case series met the inclusion criteria. The majority of patients received R-CHOP as chemotherapy regimen, with irradiation as adjunct therapy. Close to 80 % went into complete remission. The most frequent site of recurrence was the central nervous system. Five-year survival was 83.6 % in the included studies. Conclusions: At present, the CHOP regimen, with or without rituximab and usually accompanied by radiotherapy, is the most widely used and the only one that has shown a positive impact on survival. Additional randomized clinical trials are needed in order to gain a clearer insight into the effectiveness and safety of these treatments.

Cáncer y COVID-19, un vínculo peligroso / Cancer and COVID-19, a dangerous association

Fundamento: La COVID-19 es una pandemia causada por el virus SARS-CoV-2 cuya asociación con el cáncer puede tener efectos adversos. Objetivo: Describir los principales vínculos entre el cáncer y la COVID-19. Metodología: Se realizó una búsqueda bibliográfica en Google Académico, SciELO y PubMed Central con los descriptores SARS-CoV-2, COVID-19 y cáncer, consultados en el DeCS. Se seleccionaron artículos a texto completo en español e inglés, principalmente de revistas arbitradas por pares. Resultados: La COVID-19 produce resultados más desfavorables en los pacientes con cáncer. Estos resultados se relacionan con altas tasas de hospitalización, complicaciones y mortalidad. La frecuente asociación de comorbilidades en pacientes con cáncer parece contribuir a este vínculo peligroso. Las vías de señalización comunes al cáncer y a la infección por el SARS-CoV-2 son citocinas proinflamatorias, interferón tipo I, receptor de andrógenos y puntos de control inmune. Este conocimiento tiene aplicación práctica en el empleo de medicamentos para combatir la COVID-19 en pacientes con cáncer. Conclusiones: El cáncer se relaciona con la COVID-19 grave, por lo que esos pacientes son más vulnerables a la infección viral.

Background: COVID-19 is a pandemic caused by the SARS-CoV-2 virus which relation with cancer may have adverse effects. Objective: To describe the main associations between cancer and COVID-19. Methodology: A literature review was conducted in Google Scholar, SciELO and PubMed Central with the descriptors SARS-CoV-2, COVID-19 and cancer, consulted in DeCS. Full-text articles in Spanish and English were selected, mainly from peer-reviewed journals. Results: COVID-19 produces more non-favorable outcomes in patients with cancer. These outcomes are related to high hospitalization rates, complications and mortality. Frequent comorbidity relations in patients with cancer seem to contribute to this dangerous association. Signaling pathways common to cancer and SARS-CoV-2 infection are proinflammatory cytokines, type I interferon, androgen receptor, and immune checkpoints. This knowledge has a practical use with drugs against COVID-19 in patients with cancer. Conclusions: Cancer is associated with severe COVID-19, making such patients more vulnerable to viral infection.

Evaluation of oncological outcomes in patients with oral cavity cancer treated in a lowvolume hospital

Introduction: Oral cavity cancer (OCC) is one of the 10 most common types of tumors in the world. Surgical resection is the most indicated initial treatment, followed by adjuvant therapy, depending on tumor stage. A few studies have suggested that patients treated in high-volume hospitals present better oncologic outcomes; however, particularly in continental countries, some patients are treated in regional hospitals. Objective: To evaluate the results of OCC patients treated in low-volume regional hospitals. Methods: This is a retrospective longitudinal study conducted with patients diagnosed with OCC and operated on in a low-volume hospital between January 2003 and December 2018. Results: 174 patients with OCC were treated at the institution - an average of 11 patients/year. The most common tumor location was the tongue (48.2%), followed by the lip (18.2%). Squamous cell carcinomas were the most frequent (94.7% of patients). Adjuvant radiotherapy and chemotherapy were performed in 46.7 and 31.9% of patients, respectively. Almost 21% of patients had some postoperative complication. Specific survival of 62.6% and global survival of 58.2% after 3 years were similar to the results reported in high-volume centers. Disease-free survival was 45.8% in the same period. Conclusion: Low-volume hospitals qualified for oncological treatments can present outcomes similar to those of high-volume centers, and are thus a regional option for patients with OCC.

Dosimetric study of 125I seed implantation guided by 4D template for advanced malignant tumors / 中华放射肿瘤学杂志

Objective:To investigate the safety and dose of 4D template (real-time adjustable angle template) in the treatment of advanced malignant tumors with 125I seeds. Methods:98 patients with advanced malignant tumors admitted to Department of Thoracic Surgery of Shaanxi Provincial Tumor Hospital were treated with 4D template-navigated radioactive 125I seed implantation from June 2018 to December 2019. Preoperative TPS plan, intraoperative optimization, postoperative verification of immediate dose and postoperative evaluation of implantation dose were performed. The treatment results were observed. Results:All 98 patients completed the seed implantation. The implantation dose of GTV of implantation site receiving external irradiation was (12 489±414) cGy and the dose of no external irradiation was (15 036±514) cGy. V 100% was 84.7%-94.1%, and 88.2%-93.7%. The implantation dose of CTV was (7 450±621) cGy, and (9 080±761) cGy. The quality of dose implantation was evaluated as: excellent in 89 cases (91%, 89/98), good in 7 cases (7%, 7/98), fair in 2 cases (2%, 2/98), and poor in 0 case, respectively. The symptom relief rate of patients with pain was 92%(36/39). The 1-and 2-year local control rates were 61%, 36% and 82%, 54% in patients treated with and without external irradiation, respectively. The difference was statistically significant ( P=0.02). The incidence rates of pneumothorax and hemoptysis were 19%(9/48) and 10%(5/48). No corresponding complications were observed in other parts of the patients. Conclusion:4D template-assisted 125I seed therapy is safe and effective for malignant tumors, and intraoperative adjustment of needle angle and dose optimization can realize the precise control of implantation dose.

Basic research progress on the combination of heavy ion beam and immunotherapy in the treatment of malignant neoplasm / 中华放射肿瘤学杂志

In recent years, heavy ion beams have received great attention in the field of malignant tumor radiotherapy due to their radiation physics and biological characteristics. The high rate of local tumor control is one of its advantages, but the control rate of metastatic lesions is still crucial in the treatment of most malignant tumors. Clinical studies on the combined conventional radiotherapy and immunotherapy suggest that the combination of the two can not only control the primary lesions, but may also reduce or completely eliminate distant metastatic lesions. High linear energy transfer radiation, especially heavy ion beams, may have stronger potential in combined immunotherapy. Therefore, this article focuses on the basic research progress of heavy ion beams regulating anti-tumor immune effects and their combined application with immunotherapy.

Gut microbiota in colorectal cancer: Evidence from observational studies

ABSTRACT This study proposes to update knowledge about the relationship between microbiota and Colorectal Cancer (CRC). This is a review carried out using the methodology of the Preferred Report Item for Systematic Analysis and Meta-Analysis (PRISMA) and search for original articles, indexed in the Pubmed, Cochrane and Science Direct databases, published between 2011 and 2019, in English. Ten articles showed changes in bacterial composition and its influence on the development and progression of CRC, and only two addressed changes in the composition of fungi and their relationship with CRC. Most studies have shown that the increase in Fusobacterium nucleatum and bacteroides fragilis is strongly associated with the occurrence of CRC due to inflammatory mechanisms; and that Faecalibacterium prausnitzii is a protective factor through the production of butyrate. Additional research is recommended to assess the relationship of microorganisms with the development of CRC, with an emphasis on fungi.

RESUMEN Este estudio propone actualizar el conocimiento sobre la relación entre la microbiota y el Cancer Colorectal (CCR). Esta es una revisión realizada utilizando la metodología del Elemento de Informe Preferido para el Análisis Sistemático y el Meta-análises (PRISMA) y la búsqueda de artículos originales, indexados en las bases de datos Pubmed, Cochrane y Science Direct, publicados entre 2011 y 2019, en inglés. Diez artículos mostraron cambios en la composición bacteriana y su influencia en el desarrollo y la progresión del CCR, y solo dos abordaron los cambios en la composición de los hongos y su relación con el CCR. La mayoría de los estudios han demostrado que el aumento de Fusobacterium nucleatum y bacteroides fragilis está fuertemente asociado con la aparición de CCR debido a mecanismos inflamatorios; y que Faecalibacterium prausnitzii es un factor protector a través de la producción de butirato. Se recomienda investigación adicional para evaluar la relación de los microorganismos con el desarrollo de CCR, con énfasis en los hongos.

Double synchronous primary gastric and thyroid cancer

Second or multiple primary malignancies is very rare and the number of patients diagnosed with multiple primary cancers has recently been increasing due to the improved diagnostic techniques. Herein we report a very rare case of synchronous double primary cancer of the stomach and thyroid gland for the 39 years old lady who presented with a short period of abdominal pain were diagnosed to have an invasive adenocarcinoma with signet ring differentiation of the stomach by gastroscopy and biopsy. Computed tomography and positron emission tomography scan showed high fludeoxyglucose uptake of the thyroid gland were biopsied to confirm the malignancy. underwent initially for radical distal gastrectomy followed by adjuvant chemotherapy and interval total thyroidectomy. Although Synchronous tumors are defined as ≥2 primary tumors occurring within 6 months of diagnosis of the first primary tumor, our case was discovered concomitantly at the first presentation of the patient. The prognosis of patients with multiple primary cancers can be determined independently by the stage of each cancer.

Asociación entre características de las calcificaciones mamográficas y neoplasia maligna en un hospital nacional, 2017 / Association Between Characteristics Of Mammographic Calcifications And Malignie Neoplasia In A National Hospital ­ 2017

Introducción: La presencia de calcificaciones puede ser útil para el diagnóstico de neoplasia de mama. Objetivo: Determinar la asociación entre las características de las calcificaciones mamográficas y neoplasia maligna. Métodos: Estudio observacional, analítico, retrospectivo de casos y controles. Desarrollado en la Unidad de Patología Mamaria de ginecología. Se incluyeron como casos a pacientes mujeres con mamografía sugerente de neoplasia maligna con biopsia positiva a malignidad y como controles a 67 pacientes sin evidencia histológica de neoplasia. Resultados: La edad media de los casos fue de 54,12 años, en los controles 50,34. El 50,9%(59) son mayores o iguales a 50 años, OR 2,399 IC 95% (1,125 ­ 5,114) p=0,022, de estos el 52,5% (31) tenían cáncer de mama. El 9,5%(11) presentaron calcificaciones sospechosas de malignidad, las más frecuentes, la amorfa y la fina pleomórfica. El 37,1% (43) de los casos totales correspondieron a la categoría BI-RADS 0, el 6,9% (8) a BI-RADS 1, el 8,6% (10) a BI-RADS 2, el 7,8% (9) a BI-RADS 3, el 28,4% (33)a BI-RADS 4, el 8,6% (10) a BI-RADS 5 y el 2,6% (3) a BI-RADS 6. El 72,7% (8) de pacientes con calcificaciones sospechosas de malignidad presentó cáncer de mama. En el análisis bivariado se obtuvo un OR de 4,163. IC 95% (1,043 ­ 16,606) p = 0,031. En el análisis multivariado la asociación permaneció inalterada independientemente de la edad y BI-RADS. Conclusión: La edad mayor o igual de 50 años y las calcificaciones mamográficas sospechosas de malignidad son factores asociados para el cáncer de mama.

Introduction: The presence of calcifications may be useful for the diagnosis of breast neoplasia. Objective: To determine the association between the characteristics of mammographic calcifications and malignant neoplasia. Methods: Observational, analytical, retrospective of cases and controls. Developed in the Gynecology Breast Pathology Unit. Female patients with mammogram suggestive of malignant neoplasm with a positive malignancy biopsy were included as cases, and 67 patients without histological evidence of malignancy as controls. Results: The average age of the cases was 54.12 years, in the controls 50.34. 50,.9% (59) are older than or equal to 50 years, OR 2,399 95% CI (1,125-5,114) p = 0.022, of these 52.5% (31) had breast cancer. 9.5% (11) had calcifications suspicious of malignancy, the most frequent, the amorphous and the pleomorphic fine. 37.1% (43) of the total cases have the BI-RADS 0 category, 6.9% (8) BI-RADS 1, 8.6% (10) BI-RADS 2, 7.8 % (9) BI-RADS 3, 28.4% (33) BI-RADS 4, 8.6% (10) BI-RADS 5 and 2.6% (3) BI-RADS 6. 72, 7% (8) of patients with calcifications suspected of malignancy presented breast cancer. In the bivariate analysis, an OR of 4,163 was obtained. 95% CI (1,043-16,606) p = 0,031. In the multivariate analysis the association remained unchanged regardless of age and BI-RADS. Conclusion: Age 50 years or older and mammographic calcifications suspected of malignancy are associated factors for breast cancer.

Common risk factors of cardiovascular diseases and malignant tumors and the effect of drugs / 药学学报

Cardiovascular diseases (CVDs) and malignant tumors are the main causes of death worldwide. The etiology study of CVDs and malignant tumors has found a series of widely recognized risk factors. Medical practice and medical theory usually focus on one of the diseases, but more and more evidence reveals that malignant tumors usually involve the cardiovascular system, thus leading to thromboembolism, heart failure, etc. Anti-cancer treatment proves to induce CVDs, while CVDs seem to increase the risk of malignant tumors. This situation requires researchers to conduct further combined crossover study on both CVDs and malignant tumors. In this review, we discuss the potential common risk factors of cardiovascular diseases and malignant tumors, the pathological and physical mechanism of the two kinds of diseases, the cardiac toxicity induced by tumor therapy and the impact of cardiovascular drugs on cancer from the perspective of cardio-oncology, and in the endput forward the prospect of prevention and treatment.

Caracterización clínica, patológica y epidemiológica de pacientes con carcinoma diferenciado de tiroides / Clinical, pathological and epidemiological characterization of patients with thyroid differentiated carcinoma

Introducción: El diagnóstico y tratamiento de pacientes con nódulo de tiroides son un desafío clínico, instrumental, imagenológico y patológico, y a pesar de que no representan un problema de salud en Cuba, afecta a un grupo importante de la población, fundamentalmente en edad laboral. Objetivo: Determinar las características clínicas, patológicas y epidemiológicas de pacientes con carcinoma bien diferenciado de tiroides. Métodos: Se realizó un estudio descriptivo y transversal de 30 pacientes con cáncer bien diferenciado de tiroides, operados en el Hospital Oncológico Conrado Benítez García de Santiago de Cuba, desde enero de 2014 hasta julio de 2017 y que recibieron tratamiento oncoespecífico, para lo cual se revisaron las historias clínicas y los informes de biopsia de cada uno. Resultados: En la serie predominaron las mujeres de 40-49 años de edad, los afectados de piel mestiza y negra, el aumento de volumen de la glándula, los nódulos hipoecogénicos, el tumor papilar, además de la infiltración capsular y la permeabilización vascular entre los factores pronósticos histológicos más comunes. Conclusiones: Existen elementos clínicos, epidemiológicos e imagenológicos para diagnosticar un presunto carcinoma bien diferenciado de tiroides.

Introduction: The diagnosis and treatment of patients with thyroid node are a clinical, instrumental, imagenological and pathological challenge, and although they does not represent a health problem in Cuba, they affect an important populational group, fundamentally in working periods. Objective: To determine the clinical, pathological and epidemiological characteristics of patients with well differentiated carcinoma of thyroid. Method: A descriptive and cross-sectional study of 30 patients with well differentiated cancer of thyroid, operated in Conrado Benítez García Oncological Hospital belonging to Santiago de Cuba was carried out from January, 2014 to July, 2017 and who received onchospecific treatment , for which the medical records and the biopsy reports were reviewed from each patient. Results: In the series the 40-49 year-old women , those patients affected of mestizo and black skin, the increase of the gland volume, the hypoechogenic nodules and the papillary tumor prevailed, besides the capsular infiltration and the vascular permeabilization among the most common histological prognosis factors. Conclusions: Clinical, epidemiological and imagenological elements exist to diagnose a presumed well differentiated carcinoma of thyroid.

Epidemiological Profile of Malignant Brain Neoplasms in the Northern Region of Brazil: data from the Cancer Hospital Registry of the Instituto Nacional de Câncer

Objective Tumors of the central nervous system (CNS) are considered rare, with an incidence of 3.4 cases per 100,000 individuals worldwide. Although uncommon, CNS tumors have been gaining epidemiological importance due to their increased incidence and mortality. In Brazil, there is a lack of population research regarding CNS cancer, especially in the Northern region. Thus, the authors aim to trace an epidemiological profile of malignant brain neoplasms in the Northern region from 2001 to 2013. Methods Data were collected from the Cancer Hospital Registry of the Instituto Nacional de Câncer (RHC-INCA, in the Portuguese acronym) and stratified according to origin, gender, age, detailed primary location, and histological type. A total of 742 cases were analyzed. Most of the cases came from inland areas, with a male predominance. Results The most affected age groups were between 0 and 9 years old and between 30 and 49 years old, with an accentuated decrease in incidence starting at the age of 70 years old. The frontal lobe was themost affected area, followed by the temporal and parietal lobes. Astrocytic tumors accounted for 64.3% of cases, followed by embryonal tumors (18.2%), and ependymal tumors (7.4%). Among the astrocytic tumors, astrocytoma, not otherwise specified (NOS), and glioblastoma, NOS corresponded to 82.2% of the cases. Among embryonal tumors, medulloblastoma accounted for 71.9% of the cases. Conclusion More epidemiological studies in this area, especially in the Northern region, are required to identify risk factors and allow prevention and early diagnosis.

Analysis of the poor prognostic factors affecting 48 cases of cervical stump carcinoma / 中华放射肿瘤学杂志

Objective@#To explore the poor prognostic factors of patients with cervical stump carcinoma, aiming to provide certain reference for the clinical diagnosis and treatment.@*Methods@#Clinical data of 48 patients with cervical stump carcinoma admitted to the Affiliated Tumor Hospital of Xinjiang Medical University from January 1, 2005 to December 1, 2016 were retrospectively analyzed. A total of 19 patients (40%) withⅠA-ⅡA stage cervical stump carcinoma were treated with surgery+ adjuvant therapy and 29 patients (60%) in ⅡB-Ⅳ stage received radiotherapy combined with chemotherapy. The median age of onset was 51 years old. Uterine fibroids were the main cause of subtotal hysterectomy. The average time interval from subtotal hysterectomy to definite diagnosis was 10.76 years.@*Results@#The 1-, 3-, 5-year survival rate was 98%, 83% and 74%, respectively. Univariate analysis demonstrated the time interval from subtotal hysterectomy (P=0.016), tumor diameter (P=0.016), clinical stage (P=0.036), histological grade (P=0.009), lymph node metastasis (P=0.044), parametrial invasion (P=0.046), myelosuppression (P=0.013) and radical surgery (P=0.019) were the poor prognostic factors of cervical stump carcinoma.@*Conclusions@#Poor prognosis of patients with cervical stump carcinoma is correlated with tumor diameter, clinical stage, histological grade, lymph node metastasis, parametrial invasion and myelosuppression. Histological grade is an independent risk factor.

Preliminary study of efficacy and safety of Pembrolizumab and Nivolumab in treatment of advanced malignant tumors / 中华放射肿瘤学杂志

Objective@#To preliminarily compare the efficacy and safety of Pembrolizumab and Nivolumab in the treatment of advanced malignant tumors.@*Methods@#Clinical data of 50 patients diagnosed with advanced malignant tumors treated with Pembrolizumab and Nivolumab from January 2017 to August 2018 in our hospital were retrospectively analyzed. All patients were divided into the Pembrolizumab (n=26) and Nivolumab groups (n=24). The incidence of adverse reactions was statistically compared between two groups by using χ2 test. The survival analysis was performed by using Kaplan-Meier method.@*Results@#The median progression-free survival in the Pembrolizumab group was 213 d, and 146 d in the Nivolumab group (P>0.05). The incidence of aminotransferase elevation and hypothyroidism in the Nivolumab group was significantly higher than that in the Pembrolizumab group (63% vs. 23%, 12% vs. 0%, both P<0.05), whereas the incidence of oral mucositis in the Nivolumab group was 0%, significantly lower than 15% in the Pembrolizumab group (P<0.05). The median overall survival time in the Pembrolizumab group was 579 d, and 238 d in the Nivolumab group (P>0.05).@*Conclusion@#Clinical efficacy does not significantly differ, whereas the incidence of adverse reactions slightly differs between the Pembrolizumab and Nivolumab groups.

Correlation between family history of malignant neoplasms and clinicopathological features of non-small cell lung cancer / 肿瘤研究与临床

Objective To discuss the correlation between family history of malignant neoplasms (MN-FH) and the clinicopathological features of patients with non-small cell lung cancer (NSCLC). Methods The clinicopathological data of 326 patients with NSCLC in Yangzhou University Affiliated Hospital from June 2016 to June 2018 were analyzed retrospectively. The patients were divided into two groups based on with or without MN-FH, and the clinicopathological features of the two groups were analyzed by χ 2 test. Results Of the 326 patients with NSCLC, 41 (12.6％) were in the MN-FH group and 285 (87.4％) in the MN-FH group. There were no significant differences in sex, age, smoking, location of tumors and histological classification between patients with or without MN-FH (χ 2 values were 0.031, 0.769, 0.546, 0.117, and 0.945, all P > 0.05), but in patients with MN-FH, the proportion of tumor diameter < 5 cm [65.9％ (27/41) vs. 42.5％(121/285), χ 2 = 14.173, P < 0.05], undifferentiation and low differentiation [70.7％ (29/41) vs. 53.7％(153/285), χ 2 = 4.224, P < 0.05], TNM stage Ⅲ+Ⅳ [65.9％ (27/41) vs. 46.7％ (133/285), χ 2 = 5.280, P <0.05], lymph node metastasis [78.0％ (32/41) vs. 60.0％ (171/285), χ 2 = 4.970, P < 0.05], distant metastasis [75.6％ (31/41) vs. 53.3％ (152/285), χ 2 = 7.224, P < 0.05], high degree of malignancy [70.7％ (29/41) vs. 51.6％ (147/285), χ 2 = 5.293, P < 0.05] and combination of other tumors [29.3％ (12/41) vs. 7.7％ (22/285),χ 2 = 17.817, P < 0.05] were significantly higher than those in patients without MN-FH. Conclusions NSCLC patients with MN-FH have a higher degree of malignancy. For people with MN-FH, physical examination is very important.

Preliminary study of efficacy and safety of Pembrolizumab and Nivolumab in treatment of advanced malignant tumors / 中华放射肿瘤学杂志

Objective To preliminarily compare the efficacy and safety of Pembrolizumab and Nivolumab in the treatment of advanced malignant tumors.Methods Clinical data of 50 patients diagnosed with advanced malignant tumors treated with Pembrolizumab and Nivolumab from January 2017 to August 2018 in our hospital were retrospectively analyzed.All patients were divided into the Pembrolizumab (n =26) and Nivolumab groups (n =24).The incidence of adverse reactions was statistically compared between two groups by using x2 test.The survival analysis was performed by using Kaplan-Meier method.Results The median progression-free survival in the Pembrolizumab group was 213 d,and 146 d in the Nivolumab group (P＞0.05).The incidence of aminotransferase elevation and hypothyroidism in the Nivolumab group was significantly higher than that in the Pembrolizumab group (63％ vs.23％,12％ vs.0％,both P＜0.05),whereas the incidence of oral mucositis in the Nivolumab group was 0％,significantly lower than 15％ in the Pembrolizumab group (P＜0.05).The median overall survival time in the Pembrolizumab group was 579 d,and 238 d in the Nivolumab group (P＞0.05).Conclusion Clinical efficacy does not significantly differ,whereas the incidence of adverse reactions slightly differs between the Pembrolizumab and Nivolumab groups.

Mechanism and research progress on radiotherapy combined with immunotherapy / 中华放射肿瘤学杂志

In recent years, the incidence rate of malignant tumors has been ever increased. As the persistent advancement of various therapeutic techniques, the therapeutic plans of cancer have been improved. Radiotherapy takes effect mainly by killing the topical tumor cells by radiation. During radiotherapy, the anti-tumor immune response can be induced or enhanced. Appropriate radiotherapy dose and segmentation model combined with certain immunotherapy plays a more and more significant role in the treatment of tumors. In this article, the underlying mechanisms of radiation-enhanced anti-tumor immune response and the current status and research prospects of radiotherapy combined with immunotherapy were reviewed.

Safety analysis of anti-radiation-induced injury drug of Andorin capsule——based on real-world big data research / 中华放射肿瘤学杂志

Objective To retrospectively analyze the safety of anti-radiation injury drug of Andorin using real-world big data.Methods A total of 87 053 hospitalized cancer patients receiving radiotherapy from 2015 to 2017 were analyzed.Ten medical institutions with the largest number of patients treated with Andorin capsules were screened.Patients with 5 types of cancer including lung cancer,cervical cancer,nasopharyngeal carcinoma,breast cancer and colorectal cancer with/without use of Andorin capsule were subject to propensity score matching (PSM).The safety of Andorin capsule as an adjuvant drug in the radiotherapy for cancer patients was evaluated by the results of blood biochemical detection and liver and kidney function test.Results In the relevant indexes of liver function,the AST and TBIL levels in the lung cancer patients with use of Andorin capsule were significantly lower than those in their counterparts without use of Andorin capsule (22.1 U/L vs.24.7 U/L,P =0.04 and 9.8 mmol/L vs.11.4 μmol/L,P =0.01),but all the results were within the normal range.In patients with cervical cancer,the ALT level in patients treated with Andorin capsule was considerably higher than that in those without use of Andorin capsule (24.7 U/L vs.21.1 U/L,P=0.01) and both the results were within the normal range.In terms of the renal function-related indexes,CRE and UREA were similar between patients with and without use of Andorin capsule in 5 types of tumors (P=0.09-0.86).In patients with cervical and colorectal cancer,the LDH in patients with Andorin capsule was significantly lower compared with that in those without use of Andorin capsule (P=0.04,0.00),but both the resuhs were within the normal range.Regarding the nutrition-related indexes,the TB level in breast cancer patients with use of Andorin capsule was significantly higher than that in those without use of Andorin capsule (69.4 g/L vs.67.1 g/L,P=0.030),but both the results were within the normal range.Conclusion As the first anti-radiation traditional Chinese medicine in China,Andorin capsule is utilized as an adjuvant drug for radiotherapy,which yields no significant liver and kidney toxicity and possesses high safety.

Surgical excision of polymorphous adenocarcinoma in the left maxilla with mucocutaneous flap reconstruction / Exérese de adenocarcinoma polimorfo em maxila esquerda com reconstrução a base de retalho mucocutâneo

ABSTRACT Low-grade polymorphous adenocarcinoma is a malignant neoplasm of salivary glands with uncommon occurrence in the head and neck region, almost exclusively affecting minor salivary glands. While this condition has typical clinical pathological signs, it commonly presents low biological damage potential. The lesions occur more frequently among elderly females between the sixth and eighth decades of life, with a higher prevalence for the hard palate, soft palate and, most regularly, the upper lip and jugal mucosa. The clinical and histological differential diagnosis of this condition is between pleomorphic adenoma and adenoid cystic carcinoma. The most indicated surgical treatment is extensive surgical excision, eventually including resection of the underlying bone. Although infrequent, there may be metastasis for regional lymph nodes. Radical dissection of the neck is not indicated unless there is clinical evidence of cervical metastasis. The present study reports the case of surgical excision of polymorphous adenocarcinoma in the left maxillary tuberosity region. A 63-year-old white male patient sought the Maxillofacial Surgery and Traumatology Service at the Federal University of Pernambuco Clinics Hospital, complaining of a tumor-like lesion in his left maxilla, which gradually increased in volume. The patient further reported a history of surgery ten years before for removal of a tooth in the same region, upper left arch. Given the extent and complexity of the lesion, the surgical treatment in this case consisted of hemimaxillectomy.

RESUMO O adenocarcinoma polimorfo de baixo grau é uma neoplasia maligna das glândulas salivares incomum em região de cabeça e pescoço, ocorre quase exclusivamente em glândulas salivares menores. Entretanto essa patologia apresenta sinais clínico patológicos próprios e baixo potencial biológico. A lesão ocorre com maior frequência em indivíduos idosos do gênero feminino, entre a sexta e oitava década de vida, com maior prevalência para as regiões do palato duro, palato mole, sendo o lábio superior e a mucosa jugal as outras localizações mais comuns. O diagnóstico diferencial tanto clínico quanto histológico é feito com o adenoma pleomórfico e o carcinoma adenoide cístico. O tratamento cirúrgico mais indicado é a excisão cirúrgica ampla, incluindo algumas vezes a ressecção do osso subjacente. Podem ocorrer metástases para os linfonodos regionais, porém são incomuns. A dissecção radical do pescoço não está indicada a menos que haja uma evidência clínica de metástase cervical. O presente estudo objetiva relatar um caso clínico de exérese de adenocarcinoma polimorfo em região de tuberosidade maxilar esquerda. Paciente do gênero masculino, com 63 anos de idade, leucoderma, procurou o Serviço de Cirurgia e Traumatologia Buco Maxilo Facial do Hospital das Clínicas da Universidade Federal de Pernambuco, relatando que aproximadamente 10 anos, havia realizado uma exodontia na arcada superior esquerda e a partir desse procedimento cirúrgico, surgiu uma tumoração a nível de maxilar esquerdo, que foi aumentando de volume gradativamente. Diante da extensão e complexidade da lesão se fez necessário realizar a hemimaxilectomia.

Tumor maligno da bainha perineural retrobulbar e intracraniano em cão: relato de caso / Malignant neoplasm of the perineural sheath retrobulbar and intracranial in dog: case report

Os tumores da bainha perineural são pouco frequentes em animais domésticos. Relata-se o caso de um cão, sem raça definida, de cinco anos, fêmea, com histórico de aumento de volume em região retrobulbar do globo ocular direito (GOD) havia três semanas. Ao exame clínico, constatou-se a presença de uma neoformação retrobulbar direita com deslocamento do globo ocular cranialmente. Aos exames realizados durante o internamento, não foi possível localizar a origem e a extensão da neoformação. O animal veio a óbito por parada cardiorrespiratória e foi encaminhado para a necropsia. À avaliação macroscópica, observou-se neoformação esbranquiçada fixada à base do crânio em região selar, com possível origem no terceiro (III) par de nervos cranianos, a qual se infiltrava no encéfalo na altura do hipotálamo, estendia-se caudalmente em direção ao tronco encefálico e cranialmente à órbita direita, comprimindo, assim, o GOD. Microscopicamente consistia de feixes curtos entrelaçados ou enovelados de células fusiformes com pleomorfismo discreto a moderado, alternando-se a áreas de necrose multifocalmente, compatível com tumor da bainha perineural. Ao exame imuno-histoquímico, apresentou marcação fraca para S100 e GFAP e marcação positiva para vimentina, o que indica caráter maligno.(AU)

Tumors of the perineural sheath are uncommon in domestic animals. We report the case of a 5-year-old female dog with a history of increased volume in the retrobulbar region of the right eye (RE) three weeks ago. The clinical examination revealed a presence of a right retrobulbar neoformation with cranial ocular globe displacement. In the examinations carried out during hospitalization, it was not possible to locate a source and an extension of the neoformation. The animal died of cardiorespiratory arrest and was referred to an autopsy. The macroscopic evaluation revealed a whitish neoformation fixated to the base of the skull in a seal region, with a possible non-III origin of cranial nerves, infiltrating non-encephalon at the height of the hypothalamus, extending caudally towards the brainstem and cranially to the orbit right, compressing RE. Microscopically it consisted of short bundles intertwined or enovelados of spindle cells with discrete to moderate pleomorphism, alternating to areas of multifocal necrosis, compatible with tumor of the perineural sheath. Immunohistochemical examination showed weak marking for S100 and GFAP and positive marking for vimentin, indicating malignancy.(AU)

Comparación de tres índices ecográficos para evaluación del riesgo de malignidad de los tumores anexiales / Comparison of three ultrasound index in evaluating the risk of malignancy of adnexal tumors

Resumen Objetivo: Determinar y comparar el rendimiento diagnóstico de las Reglas Ecográficas Simples (RES), Índice Morfológico Ecográfico (IME) e Índice de Riesgo de Malignidad de Jacobs (IRM) en el diagnóstico de benignidad o malignidad de un tumor anexial. Material y método: Estudio retrospectivo, transversal y analítico efectuado en el Hospital Militar de Especialidades de la Mujer y Neonatología de la Ciudad de México. Se incluyeron pacientes con diagnóstico ecográfico de tumor anexial intervenidas quirúrgicamente. Se estudió el rendimiento diagnóstico de los índices comparado con el diagnóstico histopatológico mediante tablas de contingencia. Resultados: Se analizaron 141 pacientes y 166 tumores; 22 casos fueron bilaterales. De la muestra analizada, 79 eran pacientes premenopáusicas y 62 posmenopáusicas. Los casos de neoplasia maligna fueron 43 (26%) y benigna 123 (74%). El Índice Morfológico Ecográfico tuvo sensibilidad de 98.8%, especificidad de 33.3%, valor predictivo positivo de 33.9% y valor predictivo negativo de 97.6%. Las Reglas Ecográficas Simples reportaron una sensibilidad de 97.2%, especificidad de 71.1%, valor predictivo positivo de 55.6% y valor predictivo positivo de 98.6%; y el Índice de Riesgo de Malignidad de Jacobs una sensibilidad de 72.7%, especificidad de 79.3%, valor predictivo positivo de 55.8% y valor predictivo positivo de 89.4%. Conclusiones: Las Reglas Ecográficas Simples son un modelo prequirúrgico que en 82% de los casos permitieron clasificar los tumores anexiales en benignos o malignos. Los casos indeterminados deben ser reevaluados por un ecografista experto. El método es reproducible por evaluadores de mediana experiencia y susceptible de aplicarse en instituciones hospitalarias de segundo y tercer nivel de atención.

Abstract Objective: To determine and compare the diagnostic performance of the Simple Ultrasound-Based Rules (SUR), Sonographic Morphology Index (SMI) and the Jacob´s Risk Malignancy Index (RMI) in the diagnosis of benignity or malignancy to an adnexal tumor. Materials and methods: Retrospective, cross-sectional and analytical study at the at the Hospital Militar de Especialidades de la Mujer y Neonatología of Mexico City. Patients with ultrasound diagnosis of adnexal tumor who underwent surgery were included. The diagnostic performance of the indices compared to histopathological diagnosis was studied using contingency tables. Results: 141 women and 166 tumors were included for analysis, 22 cases were bilateral. Of the sample analyzed, 79 were premenopausal and 62 postmenopausal. Cases of malignant neoplasm were 43 (25.9%) and benign 123 (74.1%). The SMI had a sensitivity of 98.8%, specificity of 33.3%, positive predictive value (PPV) of 33.9%, and negative predictive value (NPV) of 97.6%. SUR showed a sensitivity of 97.2%, specificity of 71.1%, PPV of 55.6% and NPV of 98.6%; And RMI had a sensitivity of 72.7%, specificity of 79.3%, PPV of 55.8% and NPV of 89.4%. Conclusions: The simple ultrasonographic rules are a presurgical model that in 82% of the cases allowed to classify the adnexal tumors in benign or malignant. Indeterminate cases should be reevaluated by an expert sonographer. The method is reproducible by evaluators of medium experience and susceptible of being applied in hospital institutions of the second and third level of care.