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Patients with cancer-related fatigue are prone to symptoms and signs such as anorexia， weight loss， and abdominal distension， which seriously reduces the quality of life and becomes an independent risk factor affecting the survival rate of patients with malignant tumors. Therefore， it is urgent to find effective treatment strategies and drugs. In the past， the academic viewpoint of improving syndromes—a new strategy for tumor treatment was proposed based on the guidance of the Luobing theory. Based on this， this article proposes the pathogenesis of cancer-related fatigue is characterized by spleen and kidney deficiency， stasis and toxin internal obstruction， as well as the treatment method of strengthening the spleen and tonifying the kidney， resolving blood stasis and detoxification guided by the core theory of the Qiluo doctrine of Chengzhi Tiaoping. The representative drug Yangzheng Xiaoji capsules has been developed， not only has good therapeutic effect on solid tumors， but also shows good advantages in treating cancer-related fatigue， which can help to restore the homeostasis of tumor bearing survival in patients with malignant tumors and provide new drug choices for the clinical treatment of cancer-related fatigue.
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Antibody-drug conjugates (ADCs) are a class of targeted biological agents that link cytotoxic drugs to monoclonal antibodies through linkers. The monoclonal antibody targets tumor cells and transports small-molecule cytotoxic drugs for specific delivery and minimal off-target side effects. September 30, 2022, 14 anti-tumor ADC drugs have been approved for marketing in the world, and four ADCs have been approved in China. With the improvement of the clinical accessibility of ADC drugs, clinicians urgently need to understand the molecular characteristics and mechanisms of ADCs, and clarify the indications for rational use of drugs. Patients' survival mainly depends on the appropriate dose and course of treatment and also on proper management of adverse reactions. In view of this, on the basis of the "Expert Consensus on the Clinical Application of Antibody-drug Conjugates for the Treatment of Malignant Tumors (2020 edition)", Professional Committee on Clinical Research of Oncology Drugs, Chinese Anti-Cancer Association fully combines the existing clinical research evidence and the feasibility of current ADC drugs in China to update the consensus content. This consensus aims to provide a systematic overview of ADC drugs, so as to provide practical and effective suggestions and references for clinicians to apply and manage ADC drugs more accurately.
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Chemotherapy-induced neutropenia (CIN) is a common hematological adverse events and dose-limiting toxicities of chemotherapy. CIN may lead to dose reduction and delay of chemotherapeutic agents, febrile neutropenia and severe infection, which results in increased treatment cost, reduced efficacy of chemotherapy, and even life-threatening morbidities. Assessment of risk of CIN, early detection of FN and infection, and proper prevention and treatment play a crucial role in reducing the occurrence of CIN-related morbidities, improving patient treatment safety and anticancer efficacy. Based on evidence and expert opinion, the expert committee of Chinese Anti-Cancer Association issued "the consensus on diagnosis and treatment of chemotherapy-induced neutropenia in China (2023 edition)", which is an update version of the 2019 edition, aiming to provide reference for the diagnosis and treatment of CIN for Chinese oncologists.
Subject(s)
Humans , Granulocyte Colony-Stimulating Factor , Consensus , Neutropenia/prevention & control , Neoplasms/drug therapy , Antineoplastic Agents/adverse effects , Antineoplastic Combined Chemotherapy Protocols/adverse effectsABSTRACT
As a newly discovered posttranslational modification (PTM), crotonylation has been identified in histone and nonhistone proteins and has important roles in the regulation of various diseases and biological processes. With the development of high-resolution mass spectrometry approaches, an increasing number of endogenous crotonylation has been detected and identified. The discovery of crotonylation regulatory enzymes paved the way for the study of crotonylation mechanism. In this review, we summarize the biological functions and regulatory mechanism of crotonylation in eukaryotes and introduce the recent progress on crotonylation in malignant tumor.
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Objective:To observe the clinical and imaging features of infiltrative optic neuropathy (ION) secondary to extraocular malignant tumors.Methods:A retrospective case study. From January 2017 to October 2022, 26 eyes of 20 patients with ION secondary to extraocular malignancies and 32 eyes of 16 patients with early papilloedema (EP) secondary to intracranial metastatic carcinoma were included in the study. All eyes underwent best corrected visual acuity (BCVA), fundus color photography, orbital and/or craniocerebral magnetic resonance imaging (MRI). A total of 54 eyes were examined by visual field examination, among which ION and EP were 22 and 32 eyes, respectively. Clinical and imaging features of the affected eye were retrospectively analyzed.Results:Among 26 eyes of 20 ION patients, there were 13 males and 7 females, with the mean age of (52.8±16.9) years. There were 10 patients of hematologic malignancy, 7 patients of periorbital malignancy, 2 patients of lung cancer, 1 patient of gastric cancer, 1 patient of breast cancer and 1 patient of prostate cancer. Two patients of nasal lymphoma were recorded as hematologic malignancies and periorbital malignancies. Sixteen patients had a history of systemic or periorbital malignancy, among which 4 patients reported that they had been "clinically cured". Optic neuritis was diagnosed in 15 patients. Among the 16 patients with EP, 5 were males and 11 were females, with the mean age of (47.9±12.3) years. The primary malignant tumors were lung cancer, breast cancer, leukemia, gastric cancer, ovarian cancer, colon cancer and rectal cancer in 7, 2, 2, 2, 1, 1, 1, respectively. In 26 eyes of ION, 20 eyes complained of blurred vision or peripheral vision occlusion and progressive aggravation; no obvious visual symptoms in 6 eyes. BCVA was light sensing to 1.0 with a median of 0.3, including light sensing and light sensing in 4 eyes. Optic disc edema was observed in 19 eyes; no obvious abnormality in 7 eyes. Visual field examination showed that in 22 eyes, normal or mild enlargement of blind spot in 3 eyes, arcuate scotoma in 4 eyes, annular scotoma in 6 eyes, tubular visual field or concentric contraction of visual field in 6 eyes, and diffuse depression in 3 eyes. MRI showed optic nerve enlargement with sheath enhancement in all ION eyes. Among 32 eyes of EP, 28 eyes showed recurrent transient amaurosis, and the other 4 eyes showed horizontal diplopia. BCVA ranged from 0.8 to 1.5, with a median of 1.0. All EP patients showed different degrees of optic disc hyperemia and edema by fundus examination. The visual field examination showed normal or mild enlargement of the physiological blind spot. MRI showed thickening of the optic nerve and widening of the intrathecal space, but no obvious enhancement of the optic nerve and its intrathecal membrane, and obviously enhanced space-occupying lesions in the brain parenchyma, accompanied by compression and edema of the surrounding brain tissue and midline displacement.Conclusions:ION secondary to extrocular malignant tumors mainly manifested as mild visual symptoms and obvious optic disc edema. MRI showed thickened optic nerve and strengthened sheath, and no obvious abnormality in optic nerve parenchyma.
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The phosphatase and tensin homolog deleted on chromosome ten (PTEN) is a common oncogene located in the 10q23.3 region on the long arm of human chromosome l0, which regulates a variety of biological processes such as proliferation, survival, cell structure, motility, energy metabolism and genomic stability. Inactivation of PTEN is prevalent in almost all malignancies and correlates with tumor progression. Thyroid malignancies are among the most common endocrine malignancies, and PTEN has been shown to be critically associated with their development. The aim of this review is to describe the structural function of PTEN, as well as to summarize and discuss the recent findings of PTEN in thyroid malignancies.
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OBJECTIVE@#To explore the clinical characteristics, treatment and prognosis of therapy-related hematological neoplasms patients secondary to malignant solid tumors.@*METHODS@#The clinical features, treatment and prognosis of 36 hematological neoplasms patients secondary to malignant solid tumors with radiotherapy and chemotherapy in the Second Hospital of Shanxi Medical University were retrospectively analyzed.@*RESULTS@#The 36 patients with therapy-related hematological neoplasms had a median age of 60 (47-81) years, 14 were male and 22 were female. Among them, 22 cases were acute myeloid leukemia, 5 cases were acute lymphoblastic leukemia, 4 cases were multiple myeloma, 3 cases were myelodysplastic syndrome, and 2 cases were non-hodgkin's lymphoma. The median latency of malignant tumor to hematological neoplasm was 42.5 (12-120) months. The median survival time of therapy-related hematological neoplasms was 10.5 (1-83) months, and the 3-year overall survival (OS) rate was 24.3%. The therapy-related acute myeloid leukemia patients had a very poor prognosis, with a median survival of 7 (1-83) months and a 3-year OS rate of 21.4%.@*CONCLUSION@#The prognosis of therapy-related hematological neoplasms secondary to malignant solid tumors with radiotherapy and chemotherapy is poor, and individualized treatment should be implemented according to the clinical situation of patients.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Prognosis , Retrospective Studies , Hematologic Neoplasms , Neoplasms, Second Primary , Leukemia, Myeloid, Acute , Antineoplastic Combined Chemotherapy Protocols/therapeutic useABSTRACT
In recent years, with the deepening of tumor biology research, people have a newer and more comprehensive understanding of complex tumor metabolism reprogramming. The glucose transport protein-1(GLUT-1) is a glucose transporter widely expressed in the cell membranes of various tissues and represents unusual overexpression in the plasma membrane of virous cancer cell. GLUT-1 can transport man-nose, galactose, glucosamine and ascorbic acid (AA). GLUT-1 is overexpressed in different degrees on the plasma membrane of different tumor cells. Overexpressed GLUT-1 will make tumor cells take in more glucose to reprogram the metabolic mode of cells, and at the same time, it influences the change of tumor microenvironment. And the regulation of GLUT-1 in tumors has been the focus of attention in recent years, and the upstream regulators that have been reported mainly include phosphatase and tension homolog deleted on chromosome ten (PTEN) and hypoxia inducible factor (HIF). GLUT-1 also plays an important role in tumorigenesis and development by influencing the p53 and cellular tumorigenic gene (c-Myc) pathways. The review introduces structure and function of GLUT-1, the effects of transporting different substrates in tumor metabolic reprogramming, the regulation of GLUT-1, and the current treatment of GLUT-1. Meanwhile, the review discusses mechanisms and development of the role of GLUT-1 in cancer metabolism reprogramming, and points out the existing problems to provide reference for the research of metabolism reprogramming and targeted therapy of malignant tumors.
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Antibody-drug conjugates (ADCs) are a class of targeted biological agents that link cytotoxic drugs to monoclonal antibodies through linkers. The monoclonal antibody targets tumor cells and transports small-molecule cytotoxic drugs for specific delivery and minimal off-target side effects. September 30, 2022, 14 anti-tumor ADC drugs have been approved for marketing in the world, and four ADCs have been approved in China. With the improvement of the clinical accessibility of ADC drugs, clinicians urgently need to understand the molecular characteristics and mechanisms of ADCs, and clarify the indications for rational use of drugs. Patients' survival mainly depends on the appropriate dose and course of treatment and also on proper management of adverse reactions. In view of this, on the basis of the "Expert Consensus on the Clinical Application of Antibody-drug Conjugates for the Treatment of Malignant Tumors (2020 edition)" , Professional Committee on Clinical Research of Oncology Drugs, Chinese Anti-Cancer Association fully combines the existing clinical research evidence and the feasibility of current ADC drugs in China to update the consensus content. This consensus aims to provide a systematic overview of ADC drugs, so as to provide practical and effective suggestions and references for clinicians to apply and manage ADC drugs more accurately.
Subject(s)
Humans , Immunoconjugates/therapeutic use , Consensus , Neoplasms/drug therapy , Antineoplastic Agents/adverse effects , Antibodies, Monoclonal/therapeutic useABSTRACT
@#Free tissue flap transplantation is the preferred option for repairing and reconstructing postoperative defects in oral and maxillofacial-head malignant tumors. However, challenges remain for oral and maxillofacial-head and neck oncology surgeons in terms of ischemia-reperfusion (I/R) injury, airway management, quality of life and prognosis. I/R injury is an inevitable complication of free-flap transplantation surgery. In addition to shortening the vascular anastomosis time as much as possible during the surgical process, many studies have attempted to further prevent and treat free-flap I/R injury using physical intervention therapy, antioxidant and reactive oxygen species (ROS) scavenger therapy, hyperbaric oxygen therapy, etc. However, there is a lack of large-scale clinical randomized controlled trial evidence to further support these methods. Postoperative tracheal management of patients receiving free tissue flap transplantation is very important. In recent years, delayed extubation has been proposed as an alternative to traditional tracheostomy. This method can facilitate wound care for patients, reduce infections, speed up patient recovery, and reduce the incidence of vascular crises. In the future, such management is expected to improve the practicality and safety of delayed extubation by formulating more appropriate patient selection criteria and intensive care plans. Preoperative selection of suitable free tissue flaps according to the defect for repair and reconstruction is beneficial for improving the quality of life and survival rate of patients. At the same time, for patients who require postoperative radiotherapy, reducing the complications of postoperative radiotherapy and improving the quality of life of patients can be achieved through intraoperative nerve anastomosis, preradiation oral hygiene maintenance, early speech training, and other methods.
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Los tumores malignos de cavidad nasal y cavidades paranasales son poco frecuentes y sus síntomas de presentación suelen ser unilaterales e inespecíficos; éstos incluyen: epistaxis, rinorrea y obstrucción nasal. Encontramos una amplia variedad histológica de tumores, entre ellos tenemos el angiosarcoma nasal, que es considerado una rareza y el diagnóstico definitivo lo da la confirmación anatomopatológica complementado con estudios inmunohistoquímicos. Su modalidad de tratamiento incluye múltiples opciones, pero la cirugía radical temprana con márgenes negativos asociado a radioterapia adyuvante, ofrece el mejor pronóstico. Se presenta a un paciente adulto masculino con un angiosarcoma nasal izquierdo que fue detectado de forma precoz y se manejó con cirugía radical y radioterapia.
Malignant tumors of the nasal cavity and paranasal cavities are rare, while presenting symptoms are usually unilateral and nonspecific like, epistaxis, rhinorrhea, and nasal obstruction. There are many histological varieties of tumors, among them we have nasal angiosarcoma, which is considered a rarity pathology. The definitive diagnosis is given by biopsy confirmation complemented with immunohistochemical studies. Its treatment modality includes multiple options, but early radical surgery with negative margins associated with adjuvant radiotherapy offers the best prognosis. We present a male adult patient with a left nasal angiosarcoma that was detected early and managed with radical surgery and radiotherapy.
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Resumen OBJETIVO: Identificar las causas, curso clínico y el desenlace de las pacientes con estancia prolongada en la unidad de cuidados intensivos de un centro de atención ginecoobstétrica de tercer nivel. MATERIALES Y MÉTODOS: Estudio retrolectivo, transversal y descriptivo de serie de casos llevado a cabo en la unidad de cuidados intensivos de la Unidad Médica de Alta Especialidad Hospital de Ginecoobstetricia 3 del Centro Médico Nacional La Raza del Instituto Mexicano del Seguro Social, Ciudad de México, en pacientes admitidas entre enero de 2016 y diciembre de 2019. Solo se consultaron los expedientes de las pacientes con estancia prolongada definida: tiempo en días, con dos desviaciones estándar por encima de la media general. Se estudiaron los motivos de ingreso, causas que condicionaron la estancia prolongada y el desenlace. RESULTADOS: Se estudiaron 34 pacientes con estancia prolongada que representaron el 2.23% del total de casos de la unidad de cuidados intensivos. Motivos de ingreso: complicaciones del embarazo 20 de 34, complicaciones de la cirugía del aparato genitourinario 7 de 34 y también 7 de 34 con complicaciones quirúrgicas de tumores malignos pelvi-abdominales. La estancia prolongada en la unidad de cuidados intensivos, en promedio, fue de 11.99 ± 4.21 días, condicionada por reintervenciones por sangrado en 9 de 34 pacientes, lesión renal aguda 7 de 34, insuficiencia multiorgánica 5 de 34, descontrol hipertensivo 4 de 34, reintervenciones por infección 3 de 34, desempaquetamiento 3 de 34, ventilación mecánica 2 de 34 y cetoacidosis diabética 1 de 34. Dos pacientes fallecieron (hemorragia intraoperatoria urogenital n = 1 y sepsis de partida abdominal n = 1). CONCLUSIONES: Los casos con estancia prolongada representaron un pequeño porcentaje, las principales causas fueron multifactoriales y la frecuencia de mortalidad fue baja.
Abstract OBJECTIVE: To identify the causes, clinical course and outcome of patients with prolonged stay in the intensive care unit of a third level gyneco-obstetric care center. MATERIALS AND METHODS: Retrolective, cross-sectional, descriptive case series study conducted in the intensive care unit of the Unidad Médica de Alta Especialidad Hospital de Gineco-Obstetricia 3 del Centro Médico Nacional La Raza del Instituto Mexicano del Seguro Social, Mexico City, in patients admitted between January 2016 and December 2019. Only the records of patients with defined prolonged stay were consulted: time in days, with two standard deviations above the overall mean. We studied the reasons for admission, causes that conditioned the prolonged stay and the outcome. RESULTS: Thirty-four patients with prolonged stay were studied, representing 2.23% of the total number of cases in the intensive care unit. Reasons for admission: pregnancy complications 20 out of 34, complications of genitourinary system surgery 7 out of 34 and also 7 out of 34 with surgical complications of pelvi-abdominal malignant tumors. Prolonged stay in the intensive care unit, on average, was 11.99 ± 4.21 days, conditioned by reinterventions for bleeding 9 of 34, acute kidney injury 7 of 34, multiorgan failure 5 of 34, hypertensive decontrol 4 of 34, reinterventions for infection 3 of 34, unpacking 3 of 34, mechanical ventilation 2 of 34 and diabetic ketoacidosis 1 of 34. Mortality occurred in 2 cases (urogenital intraoperative bleeding n = 1 and abdominal game sepsis n = 1). CONCLUSIONS: Cases with prolonged length of stay represented a small percentage, the main causes were multifactorial, and the frequency of mortality was low.
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Objective:To explore the predictive value of thrombus markers for venous thromboembolism (VTE) in patients with malignant tumors after surgery.Methods:The clinical data of 150 patients with malignant tumors after surgery admitted to Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine in Hebei Province from July 2020 to February 2021 were retrospectively analyzed. All 150 patients followed-up for 4 weeks were treated as the observation group, including 30 cases with VTE (the thrombosis group) and 120 cases without VTE (the non-thrombosis group). Another 60 cases undergoing healthy physical examination during the same period were selected as the control group. The chemiluminescence immunoassay was used to detect thrombin-antithrombin complex (TAT), plasmin-α 2 plasmin inhibitor complex (PIC), thrombomodulin (TM), tissue-type plasminogen activator inhibitor-1 complex(tPAIC). The control group was tested once, and the observation group was tested on the 1 day before the operation and 1 day after the operation. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of thrombus markers for VTE in patients with malignant tumors after surgery. Results:The patients with lung cancer ( χ2 = 12.53, P = 0.014), ≥ 60 years old ( χ2 = 6.66, P = 0.036),body mass index>30 kg/m 2 ( χ2 = 40.53, P<0.001), tumor metastasis ( χ2 = 5.38, P = 0.031), Ⅲ-Ⅳ stage ( χ2 = 5.83, P = 0.023) had higher incidence of VTE after the operation, and the difference was statistically significant. The levels of TAT, PIC and TM in the observation group were higher than those in the control group (all P < 0.05).The levels of TAT and TM in the thrombosis group were higher than those in the non-thrombosis group before the operation, and the difference was statistically significant (all P < 0.05).The value of TM in predicting VTE was high [the best cut-off value was 10.70 TU/ml, area under the curve (AUC) was 0.786, the sensitivity was 73.30%, the specificity was 81.70%], the combination of TAT and TM could improve the predictive value (AUC was 0.796, the sensitivity was 80.00%, the specificity was 77.50%). The levels of TAT, PIC, TM and tPAIC in thrombosis group were all higher than those in the non-thrombosis group after the operation, and the difference was statistically significant (all P < 0.05). The value of TAT in predicting VTE was high (the best cut-off value was 16.50 ng/ml, AUC was 0.887, the sensitivity was 82.36%, the specificity was 71.65%), the combination of TAT, PIC, TM and tPAIC could improve the predictive value (AUC was 0.913, the sensitivity was 90.00%, the specificity was 88.60%). The level of PIC was positively correlated with TAT before and after the operation ( r = 0.66, P < 0.001; r = 0.64, P < 0.001). Conclusions:TM can be used as a sensitive indicator in the early prediction of VTE for the patients with malignant tumors and it aims at the prevention; TAT can be used as a specific indicator in predicting the development of VTE and it aims at the intervention in time. The combined detection of TAT, PIC, TM and tPAIC can improve the predictive value of VTE. At the same time, PIC can be used to evaluate the risk of bleeding.
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Objective@#To understand the incidence and influencing factors of postoperative constipation in patients with malignant tumors who undergo oral and maxillofacial surgery and construct a constipation risk prediction model to provide a reference for the prevention and treatment of postoperative constipation.@*Methods@#The data of 191 patients who underwent oral and maxillofacial malignant tumor surgery at the Affiliated Stomatological Hospital of Sun Yat sen University from June 2019 to June 2020 were analyzed retrospectively. The independent influencing factors were selected via univariate analysis and logistic multivariate regression analysis, a risk prediction nomogram was established, and the prediction model was evaluated by the area under the ROC curve. Both internal and external use the C index to verify the accuracy of the model. @*Results @#Among 191 patients, 52 (27.23%) had postoperative constipation. Univariate analysis showed that a preoperative secret history of defecation, total energy intake, tracheotomy, smoking, drinking, operation duration, bleeding volume, bed time, eating homogenate diet, sex, surgical repair method, use of probiotics, T-stage of cancer and food intake may be the influencing factors of postoperative constipation in patients with oral and maxillofacial malignant tumors (P<0.05). Multivariate analysis showed that repair method, bed time and sex were independent risk factors for postoperative constipation in patients with oral and maxillofacial malignant tumors (P<0.05). The repair method was a fibular myocutaneous flap with a long bed time, and male patients were prone to constipation after surgery. The c-index values in the training group and the verification group were 0.882 and 0.953, respectively. The area under the ROC curve of the training group was 0.909 (95%CI: 0.850-0.968), and the area under the ROC curve of the verification group was 0.893 (95%CI: 0.787-0.999). The nomogram showed good discrimination ability.@*Conclusion @#The repair method, bed time and sex are independent risk factors for postoperative constipation in patients with oral and maxillofacial malignant tumors. The risk prediction model has good discrimination ability.
ABSTRACT
Malignant tumors are currently seriously endangering human health and life， which has become one of the main causes of death in China. In modern Western medicine， they are mainly tackled by surgery， chemotherapy， and radiotherapy， but the death toll continues to rise year by year. At present， most of the anti-tumor chemotherapeutics used in clinical practice have toxic and side effects， affecting the anti-tumor efficacy and the conditions after treatment. Long-term medication will also induce drug resistance， making the good anti-tumor effect difficult to be achieved. With the vigorous development of traditional Chinese medicine （TCM）， it has played a crucial role in the fight against tumors. It is believed in TCM that "heat toxin" is one of the important causes of tumors. Therefore， the methods of clearing away heat and removing toxin are often emphasized in the treatment of tumors， and the resulting outcomes are satisfactory. There are many Chinese herbs and Chinese herbal compounds classified into the heat-clearing and toxin-removing type. Xihuangwan， a classic heat-clearing prescription， is composed of Calculus Bovis， Moschus， Olibanum， and Myrrh and has the effects of clearing away heat， removing toxin， eliminating edema， and dissipating mass， which is mainly used to treat carbuncle， pustule， scrofula， multiple abscess， and cancer caused by heat-toxin obstruction. In modern clinical practice， it has been employed in patients with lung cancer， breast cancer， gastric cancer， liver cancer， colorectal cancer， and other malignant tumors， especially during the advanced stage， as a routine or adjuvant treatment for alleviating their clinical symptoms and improving their quality of life. The main active components of Xihuangwan are pentacyclic triterpenoids （such as masticinic acids）， volatile oils， steroids （like porcine deoxycholic acid）， and bilirubin， which have been proved effective in anti-tumor. This paper reviewed the prescription source， pharmaceutical research， clinical anti-tumor research， and pharmacological mechanisms of Xihuangwan， which has provided reference for further expanding the anti-tumor applications of Xihuangwan and enhancing its secondary development.
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Metastasis is the main cause of poor prognosis of malignant tumors， and intervention with metastasis is the key measure in the treatment of malignant tumors. Hematogenous metastasis， the most common tumor metastasis， falls into the category of "Chuanshe" in traditional Chinese medicine （TCM）， with Qi deficiency and blood stasis as the critical pathogenesis. In the fight against malignant tumors， TCM emphasizes the reinforcement of healthy Qi and the elimination of pathogenic factors， exhibiting its action advantages of multiple targets， multiple mechanisms， and multiple levels. Extensive clinical evidence has shown the exact efficacy of Chinese herbal compounds designed for invigorating Qi and activating blood in delaying the progression of tumor disease and prolonging the survival period of patients. In view of the important role of hematogenous metastasis in the prognosis of tumors， more and more studies have explored the effects and mechanisms of Chinese herbal compounds capable of invigorating Qi and activating blood in intervening in hematogenous metastasis. This paper summarized the relevant literature reports in China and abroad on the intervention of Chinese herbal compounds capable of invigorating Qi and activating blood in the hematogenous metastasis of malignant tumors， in order to provide a theoretical basis for the clinical application of Qi-invigorating and blood-activating therapy in the treatment of malignant tumors. It has been found that Chinese herbal compounds formulated for invigorating qi and activating blood are effective in hindering several key steps in hematogenous metastasis through various mechanisms， including regulating the expression of cell adhesion molecules， inhibiting extracellular matrix degradation and angiogenesis， enhancing the killing effect of immunity， and improving blood hypercoagulability and hyperviscosity. Furthermore， the combination of invigorating Qi and activating blood targets the pathogenesis essence （Qi deficiency and blood stasis， characterized by sthenia in origin and asthenia in superficiality） of malignant tumor much better. Some comparative studies have demonstrated that the anti-metastasis effect of Qi-invigorating and blood-activating therapy is significantly stronger than that of the Qi-invigorating or blood-activating therapy alone， and such combination avoids the possible risk of the metastasis of malignant tumors triggered by the use of either of them. This study has provided some reference for the current clinical application of TCM for improving the prognosis of malignant tumors.
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RESUMEN Introducción: la mortalidad por tumores malignos se caracteriza por un incremento sostenido en el tiempo. En casi la totalidad de la provincia de Matanzas se ha observado esta tendencia en los últimos 30 años, con mayor o menor intensidad. Objetivo : describir algunas características de la mortalidad por cáncer en la provincia de Matanzas. Materiales y métodos: estudio observacional descriptivo retrospectivo de la mortalidad por tumores malignos durante 30 años (1990-2019). Se estimaron tasas crudas y ajustadas de mortalidad, globalmente, por períodos y por sexo. Se obtuvieron porcentajes y se determinó la significación estadística mediante el estadígrafo X2 y el valor de p < 0,05. Resultados: se detectaron diferencias estadísticas significativas entre sexos en cada uno de los períodos. Las tasas crudas y específicas de mortalidad experimentaron una tendencia sostenida al incremento. Cada 0,3 días (aproximadamente cada 8 horas) ocurrió una defunción por cáncer, con diferencias entre las localizaciones. Conclusiones: la tendencia al incremento sostenido de las tasas de mortalidad cruda y ajustada por edad se debe al aumento de las defunciones, pudiendo ser consecuencia, en parte, del envejecimiento poblacional y de un posible incremento de la morbilidad. El sexo masculino apareció como el más expuesto. La frecuencia de la mortalidad por cáncer fue diferente según localizaciones (AU).
ABSCRACT Introduction: Steady increase in time characterized the mortality by malignant tumors in the world as in Cuba. It was observed similar trend in the province of Matanzas in the last 30 years, almost in all body sites, showing higher or less intensity. Objective: To describe some characteristics of mortality by malignant tumors in the province of Matanzas Materials and methods: It is a descriptive observational and retrospective study of the mortality by malignant tumors for 30 years: 1990-2019. Crude and adjusted mortality rates were estimated, globally, by periods and sex. Percentages were estimated and statistical significance was determined through X2 test and p value < 0,05. Results: Statistical significant differences were detected among sexes in all periods. Crude and specific mortality rates showed an increasing steady trend. Every 0.3 days (around 8 hours) one decease took place due to malignant tumors, with differences among sites of the disease. Conclusions: The increasing steady trend of the crude & adjusted mortality rates by age could be, partly, results of the population ageing. Male sex appeared to be the most exposed. Mortality frequency by malignant tumors was different according to sites of the tumor (AU).
Subject(s)
Humans , Male , Female , Patient Acuity , Neoplasms/mortality , Terminal Care , Catastrophic Illness/mortality , Neoplasms/complications , Neoplasms/diagnosis , Neoplasms/pathologyABSTRACT
Introducción: Los tumores de la cavidad nasal y senos paranasales son neoplasias poco frecuentes. La histopatología y características clínicas son diferentes al resto de las neoplasias de cabeza y cuello. Objetivo: Caracterizar desde el punto de vista clínico-epidemiológico, radiológico y anatomopatológico a los pacientes mayores de 18 años con tumores nasosinusales malignos atendidos en un hospital hondureño. Métodos: Estudio observacional, descriptivo y transversal, mediante una técnica de muestreo no probabilístico por conveniencia se tomó una muestra de 30 pacientes que estaban hospitalizados en sala de otorrinolaringología del Hospital Escuela de la Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras, en el periodo enero del 2017-diciembre del 2019. Los pacientes estudiados habían sido diagnosticados con cáncer de nariz y senos paranasales. Resultados: El estudio incluyó 30 pacientes, de los cuales el 47 por ciento eran mayores de 50 años, de sexo femenino un 53 por ciento, amas de casa el 40 por ciento y agricultores el 20 por ciento. Los principales síntomas y signos fueron obstrucción nasal (50 por ciento), rinorrea (30 por ciento) y masa (20 por ciento), con localización principalmente en cavidades nasales (67 por ciento). Las características radiológicas más importantes fueron su vascularidad (43 por ciento) y unilateralidad (33 por ciento), la estirpe histológica que predominó fue el linfoma (30 por ciento). Conclusiones: Los tumores nasales predominaron en el sexo femenino, siendo la obstrucción nasal, rinorrea y masa sus síntomas y signos principales. El aumento de la vascularidad en la imagen por tomografía computarizada orienta a sospechar malignidad. Se evidenció que el factor económico y el desconocimiento de la enfermedad demoró la asistencia del paciente a un centro hospitalario(AU)
Introduction: Tumors of the nasal cavity and paranasal sinuses are infrequent neoplasms. Their histopathology and clinical characteristics are different from those of other head and neck neoplasms. Objective: Carry out a clinical-epidemiological, radiological and anatomopathological characterization of patients aged over 18 years with malignant sinonasal tumors attending a Honduran hospital. Methods: A cross-sectional observational descriptive study was conducted. Nonprobability convenience sampling technique was applied to select a sample of 30 patients staying at the otolaryngology ward of the Medical Sciences Hospital School at the National Autonomous University of Honduras from January 2017 to December 2019. These patients had been diagnosed with nose and paranasal sinus cancer. Results: The study included 30 patients, of whom 47 percent were aged over 50 years, 53 percent were female, 40 percent were housewives and 20 percent were farmers. The main signs and symptoms were nasal obstruction (50 percent), rhinorrhea (30 percent) and mass (20 percent), with most common location in the nasal cavity (67 percent). The most important radiological characteristics were their vascularity (43 percent) and one-sidedness (33 percent), with lymphoma as the prevailing histological type (30 percent). Conclusions: Nasal tumors prevailed in the female sex, with nasal obstruction, rhinorrhea and mass as their main signs and symptoms. Increase in vascularity in computed tomography images leads to suspecting malignancy. Evidence was found that the economic factor and poor knowledge about the disease delayed patient attendance to a hospital institution(AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged, 80 and over , Paranasal Sinus Neoplasms/pathology , Paranasal Sinus Neoplasms/epidemiology , Paranasal Sinus Neoplasms/diagnostic imaging , Epidemiology, Descriptive , Cross-Sectional Studies , Observational Studies as Topic , Nasal Cavity/anatomy & histologyABSTRACT
Los tumores malignos vienen incrementándose en los últimos años, por lo que se viene determinando el grupo más frecuente y su impacto para mejorar las estrategias de acuerdo a los escenarios locales. Determinar los aspectos epidemiológicos de los tumores malignos atendidos en el hospital de la Sociedad de Lucha Contra el Cáncer en el Ecuador (SOLCA) Guayaquil. Se realizó un estudio observacional de diseño de investigación tipo corte transversal descriptivo, en los pacientes diagnosticados con tumor maligno; tomando una población de 19871 pacientes, diagnosticados en el hospital de SOLCA Guayaquil, período 2015 2019. Los sujetos fueron los pacientes con tumor maligno. Aplicando estadísticas descriptivas y comparación entre variables. Los tumores malignos en ambos sexos presentan al de Mama con 16,39% como el más frecuente. La mayor proporción de los tumores en hombres fue el de órganos genitales con 25,73%; mientras que en mujeres fuera Mama con 27,05%- La población más afectada fueron las mujeres con el 60,35%. El grupo etario más afectado en hombres fue de 65 69 años con 12,56%, y en mujeres de 50 54 años con 11,44%. Conclusiones. El comportamiento epidemiológico en este quinquenio, evidenció que el Tumor de Mama en la mujer y de órganos genitales masculinos en el hombre son los más frecuentes; siendo las mujeres más afectadas; y en ambos sexos en los grupos etarios de 50 a 69 años; constituyendo una herramienta para destacar el papel del registro de cáncer hospitalario y su uso en los programas de prevención y control.
Malignant tumors have been increasing in recent years, so the most frequent group and its impact have been determined to improve strategies according to local scenarios. Determine the epidemiological aspects of malignant tumors treated at the hospital of the Society for the Fight Against Cancer in Ecuador (SOLCA) Guayaquil. Observational study of a descriptive crosssectional research design was carried out in patients diagnosed with a malignant tumor; taking a population of 19871 patients, diagnosed in the SOLCA hospital Guayaquil, period 2015 2019. The subjects were patients with malignant tumor. Applying descriptive statistics and comparison between variables. Malignant tumors in both sexes present the breast tumor with 16,39% as the most frequent. The highest proportion of tumors in men was the genital organs with 25,73%; while in women it was Mama with 27,05% The most affected population was women with 60,35%. The age group most affected in men was 65-69 years with 12,56%, and in women 50-54 years with 11,44%. Conclusions. The epidemiological behavior in this five-year period showed that the Breast Tumor in women and of the male genital organs in men are the most frequent; being the women most affected; and in both sexes in the age groups from 50 to 69 years; constituting a tool to highlight the role of the hospital cancer registry and its use in prevention and control programs.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Breast Neoplasms , Urogenital Neoplasms , Neoplasms/epidemiology , Incidence , Secondary Prevention , Neoplasms/prevention & controlABSTRACT
Resumen Los carcinomas neuroendocrinos son tumores poco frecuentes en nariz y senos paranasales. Se consideran tumores primitivos y son los menos diferenciados del sistema neuroendocrino difuso. Se discute el caso de una paciente femenina de 49 años quien acude al servicio de otorrinolaringología en el Hospital Central Militar refiriendo masa en cavidad nasal izquierda de crecimiento progresivo en un periodo de 9 meses, así como epistaxis y obstrucción nasal izquierda. Mediante resonancia magnética y tomografía computada se observó tumoración de la cavidad nasal izquierda en su totalidad hasta nasofaringe, con captación heterogénea del medio de contraste. Se decide resección de tumoración mediante abordaje endoscópico (sinusotomía maxilar tipo III, etmoidectomía anterior y posterior izquierda, Draf esfenoidal tipo II izquierdo, Draf IIa del seno frontal izquierdo, así como septectomía posterior). El estudio histopatológico reportó un carcinoma neuroendocrino moderadamente diferenciado, por lo que se trató de forma conjunta con servicio de oncología médica. Este tipo de tumores son un reto diagnostico por la complejidad para diferenciarlos en un estudio histopatológico. La diferenciación efectiva de los mismos puede tener un impacto clínico, por lo que los avances en la intervención terapéutica podrían prolongar la supervivencia del paciente, mejorar la calidad de vida e incluso la cura.
Abstract Neuroendocrine carcinomas are rare tumors of the nose and sinuses. They are considered primitive tumors and are the least differentiated from the diffuse neuroendocrine system. We report a 49-year-old female patient who attends the otolaryngology service at the Central Military Hospital referring mass in the left nasal cavity with a progressive growth over a period of 9 months, including epistaxis, as well as left nasal obstruction. Magnetic Resonance Imaging and Computed Tomography imaging studies showed a tumor occupying the entirety of the left nasal cavity to the nasopharynx, with heterogeneous uptake of the contrast medium. Tumor resection is decided by endoscopic approach (maxillary sinusotomy type III, left anterior and posterior ethmoidectomy, left sphenoid Draf type II, left frontal Draf IIa as well as posterior septectomy). The pathology service reported a moderately differentiated neuroendocrine carcinoma. The treatment was decided joint session with the medical oncology service. These types of tumors are a diagnostic challenge because of the complexity to differentiate them in a histopathological study. Their effective differentiation can have a clinical impact, that's why the advances in therapeutic intervention could prolong patient survival, improve quality of life and even find a cure.