Progress of poly (ADP-ribose) polymerase inhibitor in advanced ovarian cancer / 肿瘤研究与临床

At present, ovarian cancer is one of the main diseases threatening women's life and health. The mortality ranks first among female reproductive system malignant tumors. Due to the hidden onset, more than 75% of them are at advanced stage once diagnosed. Advanced ovarian cancer is characterized with the Federation International of Gynecology and Obstetrics (FIGO) stage Ⅲ-Ⅳ, very poor prognosis and the 5-year survival rate less than 50%. In recent years, the exploration of maintenance treatment of ovarian cancer is in full swing. A large number of studies show that poly (ADP-ribose) polymerase (PARP) inhibitors are effective in patients with advanced ovarian cancer. Therefore, PARP inhibitors have gradually become an important part for treatment of ovarian cancer, and the indications have also been concerned by clinicians. This paper reviews the application of PARP inhibitors in advanced ovarian cancer.

Uso do dispositivo Pegfilgrastim OBI para prevenção de neutropenia: revisão de escopo / Uso del dispositivo Pegfilgrastim OBI para prevenir la neutropenia: revisión de alcance / Pegfilgrastim OBI device use for neutropenia prevention: a scoping review

Resumo Objetivo Mapear os cuidados em saúde do dispositivo Pegfilgrastim on-body injector na prevenção de neutropenia em adultos com câncer em assistência domiciliar após quimioterapia ambulatorial. Métodos Revisão de escopo baseada na metodologia do Joanna Briggs Institute . Foram incluídos somente estudos com adultos com câncer submetidos à quimioterapia ambulatorial. A busca foi realizada nas bases de dados Cochrane, CINAHL, EMBASE, LILACS , PubMed, Scopus, LIVIVO e Web of Science, além da literatura cinzenta ProQuest, Scielo, Banco de Dados em Enfermagem, Google Scholar, Open Grey, bula do medicamento e websites . Foram esgotadas as buscas nas referências dos estudos elegidos. Todos os estudos identificados foram exportados para o gerenciador de referências EndNote para organização e remoção das duplicadas. Utilizou-se o aplicativo web Rayyan para seleção das evidências. Os estudos foram selecionados por pares e de forma independente, sendo os conflitos solucionados por um terceiro pesquisador. Resultados Foram incluídos 10 artigos cujos resultados foram subdivididos nas categorias: adesão do paciente, opinião da equipe de saúde, carga de trabalho do paciente em tratamento do câncer e uso do dispositivo na prática clínica. O dispositivo apresenta poucas falhas e foi aceito pelas equipes de saúde e pacientes na maioria dos estudos. Conclusão Os principais cuidados em saúde para o uso do dispositivo Pegfilgrastim on-body injector estão relacionados à técnica de preparo da pele onde o dispositivo será aplicado, o preparo e a administração do dispositivo. Além disso, salienta-se a importância da avaliação do conhecimento do paciente e seu familiar sobre o dispositivo, o fornecimento de todas as orientações necessárias, verbalmente e por escrito, de forma clara e objetiva, e a validação dessas informações, certificando-se que o paciente compreendeu todas elas e está seguro.

Resumen Objetivo Mapear los cuidados de la salud al utilizar el dispositivo Pegfilgrastim on-body injector para prevenir la neutropenia en adultos con cáncer en atención domiciliaria después de quimioterapia ambulatoria. Métodos Revisión de alcance basada en la metodología del Joanna Briggs Institute . Se incluyeron solamente estudios con adultos con cáncer sometidos a quimioterapia ambulatoria. La búsqueda se realizó en las bases de datos Cochrane, CINAHL, EMBASE, LILACS , PubMed, Scopus, LIVIVO y Web of Science, además de la literatura gris ProQuest, Scielo, Banco de Datos de Enfermería, Google Scholar, Open Grey, prospecto del medicamento y sitios web. Se concluyeron las búsquedas en las referencias de los estudios seleccionados. Todos los estudios identificados se exportaron al programa de gestión de referencias EndNote para organizarlas y remover las duplicadas. Se utilizó la aplicación web Rayyan para seleccionar las evidencias. Se seleccionaron los estudios por pares y de forma independiente, y los conflictos se solucionaron mediante un tercer investigador. Resultados Se incluyeron diez artículos cuyos resultados fueron subdivididos en las siguientes categorías: adhesión del paciente, opinión del equipo de salud, carga de trabajo del paciente en tratamiento de cáncer y uso del dispositivo en la práctica clínica. El dispositivo presenta pocas fallas y fue aceptado por los equipos de salud y por los pacientes en la mayoría de los estudios. Conclusión Los principales cuidados de la salud para el uso del dispositivo Pegfilgrastim on-body injector se relacionan con la técnica de preparación de la piel donde se aplicará el dispositivo, la preparación y la administración del dispositivo. Además, se destaca la importancia de la evaluación de conocimientos del paciente y su familiar sobre el dispositivo, la entrega de todas las instrucciones necesarias, verbalmente y por escrito, de forma clara y objetiva, la validación de la información y la verificación de que el paciente haya comprendido todo y esté seguro.

Abstract Objective To map the health care of Pegfilgrastim On-body Injector in neutropenia prevention in adults with cancer in home care after outpatient chemotherapy. Methods This is a scoping review based on the JBI methodology. Only studies with adults with cancer undergoing outpatient chemotherapy were included. The search was carried out in the Cochrane, CINAHL, EMBASE, LILACS, PubMed, Scopus, LIVIVO and Web of Science databases, in addition to gray literature ProQuest, SciELO, Database in Nursing, Google Scholar, Open Grey, drug leaflet and websites. The searches in the references of selected studies were exhausted. All identified studies were exported to the EndNote reference manager for organization and removal of duplicates. The Rayyan web application was used for evidence selection. The studies were selected by pairs independently, with conflicts resolved by a third researcher. Results A total of 10 articles were included, whose results were subdivided into categories: patient compliance, health team opinion, patient workload in cancer treatment and device use in clinical practice. The device has few flaws and was accepted by health care teams and patients in most studies. Conclusion The main health care for Pegfilgrastim On-body Injector use is related to the skin preparation technique where the device will be applied, in addition to device preparation and administration. Moreover, the importance of assessing the knowledge of patients and their family about the device is highlighted, providing all the necessary guidelines, verbally and in writing, clearly and objectively, and validating this information, making sure that patients have understood all of them and are safe.

Research progress in influences of epigenetic modifications on PD-L1 expression in tumors / 国际肿瘤学杂志

Tumor cells expression of programmed death ligand-1 (PD-L1) is a major mechanism of immune escape and a predictor of therapeutic efficacy of immune checkpoint inhibitors. The expression of PD-L1 is regulated by a variety of mechanisms, among which epigenetic modifications such as DNA methylation, histone modification and non-coding RNA can promote the occurrence, development and drug resistance of tumors by regulating the expression of PD-L1. To clarify its regulation mechanism can bring new ideas for clinical immunotherapy of tumors.

Comparative analysis of clinicopathological and mammographic findings between ductal carcinoma in situ with microinvasion and ductal carcinoma in situ / 中华放射学杂志

Objective:To comparative analyze mammographic and clinicopathological findings of ductal carcinoma in situ (DCIS) and DCIS with microinvasion (DCISM), and to investigate the predictive factors for DCISM.Methods:A total of 626 patients with DCISM and DCIS confirmed by surgery and pathology in the Affiliated Hospital of Qingdao University from January 2016 to July 2020 were collected and underwent preoperative mammography. The X-ray findings of DCISM and DCIS patients were classified and diagnosed according to the Breast Imaging Reporting and Data System (BI-RADS) criteria. The differences in clinicopathological and radiographic findings between DCISM and DCIS patients were analyzed using χ 2 test or Fisher exact test. The risk factors of DCISM were evaluated by using univariate and multivariate binary logistic regression analysis. Results:Among the 626 cases, 171 were diagnosed as DCISM, 455 were diagnosed as DCIS. Large diameter (≥2.7 cm), high nuclear grade, comedo type, axillary lymph node metastasis, high Ki67 proliferation index, negativity of estrogen receptor and progesterone receptor were found to be predictors of DCISM in the univariate analysis (all P<0.05). And large diameter (≥2.7 cm)(OR 2.229,95% CI 1.505-3.301, P<0.001), high nuclear grade(OR 1.711,95%CI 1.018-2.875, P=0.043) and axillary lymph node metastasis(OR 4.140,95% CI 1.342-12.773, P=0.013) were found to be independent predictors of DCISM in the multivariate analysis (all P<0.05). Mammographically, the lesion types, the presence and distribution of calcification were statistically significant between DCIS and DCISM patients (χ 2=17.42, 9.65, 9.10, P<0.05). Up to 17.6% (80/455) of DCIS were occult leisions, and DCISM showed more lesions with calcification in mass, asymmetry, and architectural distortion (49.1%, 84/171). Grouped calcifications were usually associated with DCIS (41.5%, 120/289), while regional calcification were commonly found in DCISM (35.9%, 47/131). Conclusions:Lesions with calcification and regional calcification were more likely associated with DCISM on mammography. Large diameter (≥2.7 cm), high nuclear grade and axillary lymph node metastasis were found to be independent predictors of DCISM.

Brazilin downregulates the expression of protein regulator of cytokinesis 1 in bladder cancer T24 cell and BIU87 cell and inhibits the cell proliferation / 肿瘤研究与临床

Objective:To investigate the inhibitory effect of brazilin on bladder cancer cells and its mechanism.Methods:Chemically synthesized brazilin was synthesized by chemical synthesis. Methyl thiazolyl tetrazolium (MTT) method was used to detect the inhibitory effect of synthetic brazilin on bladder cancer cells T24 and BIU87. Proteomic technique was used to detect the effect of brazilin on the level of protein in both cells. Real-time quantitative polymerase chain reaction (qRT-PCR) and Western blot methods were used to verify the effects of brazilin on the expression of protein regulator of cytokinesis 1 (PRC1) of both cells at gene and protein level.Results:MTT method showed that brazilin significantly inhibited the proliferation of bladder cancer cells T24 and BIU87, and its half inhibitory concentration ( IC50) of T24 cell and BIU87 cell was 9.9 μg/ml and 5.1 μg/ml,respectively. Proteomic results showed that brazilin could regulate the protein expression of PRC1 in both cells, which was verified by qRT-PCR and Western blot. Conclusion:Brazilin suppresses bladder cancer cell growth possibly by downregulating PRC1.

Detecção precoce do câncer de mama em Unidades Básicas de Saúde / Detección precoz de cáncer de mama en unidades básicas de salud / Early detection of breast cancer in primary care center

Resumo Objetivo: Analisar as ações para detecção precoce do câncer de mama realizadas por enfermeiros da atenção primária, de acordo com as diferentes configurações de unidades básicas de saúde. Métodos: Estudo de corte transversal, desenvolvido em 38 unidades básicas de saúde. As unidades foram selecionadas mediante cálculo de amostra aleatória simples; os critérios de inclusão foram os enfermeiros de ambos os sexos, com tempo mínimo de um ano de atuação na unidade. As diferentes hipóteses cogitadas foram avaliadas por meio de análise bivariada na tabela de contingência, utilizando o teste de qui-quadrado ou teste exato de Fischer; todos os testes realizados levaram em consideração um α bidirecional de 0,05 e intervalo de confiança (IC) de 95%. Resultados: Dos 133 enfermeiros do estudo, 46,6% atuavam em unidades básicas da Estratégia Saúde da Família, 31,6% em unidades mistas e 21,8% em unidades tradicionais. Houve melhor desempenho para o modelo Estratégia Saúde da Família, com resultados estatisticamente significativos para as seguintes ações: investigação dos fatores de risco (p=<0,001); orientação da idade ideal para exame clínico das mamas e a importância de sua realização (p=0,002 e p=<0,001 respectivamente); reunião educativa sobre câncer de mama (p=<0,001); busca ativa de mulheres com laudo suspeito (p=0,002) e encaminhamento à unidade de referência (p=<0,001). Conclusão: As ações para a detecção precoce do câncer de mama realizadas pelos enfermeiros diferenciam-se em relação à configuração da Unidade Básica de Saúde, sendo que as do modelo Estratégia Saúde da Família se aproximam mais das recomendações do Ministério da Saúde.

Resumen Objetivo: Analizar las acciones para la detección precoz de cáncer de mama realizadas por enfermeros de atención primaria, de acuerdo con las diferentes configuraciones de las unidades básicas de salud. Métodos: Estudio de corte transversal, llevado a cabo en 38 unidades básicas de salud. Las unidades fueron seleccionadas mediante cálculo de muestra aleatoria simple. Los criterios de inclusión fueron enfermeros de ambos sexos, con un tiempo mínimo de un año de actuación en la unidad. Las diferentes hipótesis consideradas fueron evaluadas mediante el análisis bivariado en la tabla de contingencia, utilizando la prueba χ² de Pearson o prueba exacta de Fisher. Todas las pruebas realizadas tuvieron en consideración un α bidireccional de 0,05 e intervalo de confianza (IC) de 95 %. Resultados: De los 133 enfermeros del estudio, el 46,6 % actuaba en unidades básicas de Estrategia Salud de la Familia, el 31,6 % en unidades mixtas y el 21,8 % en unidades tradicionales. Se observó un mejor desempeño en el modelo Estrategia Salud de la Familia, con resultados estadísticamente significativos en las siguientes acciones: investigación de los factores de riesgo (p=<0,001), orientación sobre la edad ideal para examen clínico de las mamas y la importancia de su realización (p=0,002 y p=<0,001 respectivamente), reunión educativa sobre cáncer de mama (p=<0,001), búsqueda activa de mujeres con resultados sospechosos (p=0,002) y derivación a la unidad de referencia (p=<0,001). Conclusión: Las acciones para la detección precoz de cáncer de mama realizadas por los enfermeros se diferencian según la configuración de la unidad básica de salud, entre las cuales el modelo Estrategia Salud de la Familia está más cerca de las recomendaciones del Ministerio de Salud.

Abstract Objective: To analyze the actions for early detection of breast cancer performed by primary care nurses, according to the different configurations of primary care center. Method: Cross-sectional study, carried out in a total of 38 primary care center. The centers were selected by calculating a simple random sample; the inclusion criteria were nurses of both genders, with at least one year working in the health center. The different hypotheses considered were evaluated by a bivariate analysis in the contingency table, using the chi-square test or Fisher's exact test; all tests performed considered a bidirectional α of 0.05 and a 95% confidence interval (CI). Result: Out of the 133 nurses in the study, 46.6% worked in primary care center of the Family Health Strategy, 31.6% in mixed centers and 21.8% in traditional ones. There was a better performance for the Family Health Strategy model, with statistically significant results for the following actions: investigation of risk factors (p=<0.001); orientation of the ideal age for clinical breast examination and the importance of its performance (p=0.002 and p=<0.001 respectively); educational meeting on breast cancer (p=<0.001); active search for women with suspicious medical reports (p=0.002) and referral to the health center (p=<0.001). Conclusion: The actions for early detection of breast cancer performed by nurses differ in relation to the configuration of the Primary care center, and those from the Family Health Strategy model are closer to the recommendations of the Ministry of Health.

Relationship between systematic immune-inflammation index and clinicopathological charac-teristics for colorectal cancer / 中华消化外科杂志

Objective:To investigate the relationship between systematic immune-inflamma-tion index(SII) and clinicopathological characteristics for colorectal cancer.Methods:The retrospec-tive cohort study was conducted. The clinicopathological data of 513 patients with colorectal cancer who were admitted to the Beijing Friendship Hospital of Capital Medical University from February 2019 to May 2021 were collected. There were 311 males and 202 females, aged (64±12)years. Observation indicators: (1) SII of colorectal cancer and relationship between SII and clinicopatholo-gical characteristics; (2) influencing factors for SII in colorectal cancer patients. According to the median of SII as the cutoff value, the patients were divided into high SII and low SII patients. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Count data were represented as absolute numbers or percen-tages, and comparison between groups was conducted using the chi-square test. Measurement data with skewed distribution were represented as M( P25, P75), and comparison between groups was analyzed using the non-parameter rank sum test. Comparison of ordinal data was analyzed using the Mann-Whitney U non-parameter test. Variables with statistically significant differences between groups were included for further analysis. Pearson correlation coefficient analysis was used for continuous data, and Wilcoxon or Kruskal-Willas analysis was used for categorical data and Bonferroni correction was performed. Univariate and multivariate linear regression analyses were conducted. Results:(1) SII of colorectal cancer and relationship between SII and clinicopathological charac-teristics: the SII of 513 patients was 355(253,507). Taking the median SII 355 as the cutoff value, 257 of 513 patients with SII>355 had high SII and 256 cases with SII≤355 had low SII. Of high SII patients, the Karnofsky performance status(KPS) score, preoperative albumin(Alb), CA125, cases with tumor located at left or right hemicolon, tumor diameter, cases with laparoscopic assisted surgery or laparotomy (surgical approach), cases in stage T0, T1, T2, T3, T4 (pathological T staging), cases in stage Ⅰ, Ⅱ, Ⅲ, Ⅳ (pathological TNM staging) were 87±17, (37±5)g/L, 8.80 U/mL(5.90 U/mL, 14.15 U/mL), 174, 83, (5.2±2.8)cm, 208, 44, 5, 19, 25, 131, 63, 34, 98, 94, 14. The above indicators of low SII patients were 91±13, (38±4)g/L, 7.20 U/mL(5.40 U/mL, 10.03 U/mL), 200, 56, (4.0±1.9)cm, 221, 24, 8, 39, 35, 118, 45, 61, 84, 79, 12. There were significant differences in above indicators between the two groups ( t=-2.770, -3.211, Z=-3.799, χ2=7.050, t=5.324, χ2=6.179, Z=-3.390, -2.227, P<0.05). Results of Pearson correlation coefficient analysis showed that SII was positively correlated with the tumor diameter ( r=0.390, P<0.05), and negatively correlated with preoperative Alb ( r=-0.200, P<0.05). Results of Wilcoxon analysis showed that SII was 447(311,720), 352(251,493) in patients with tumor located at right hemicolon and left hemicolon, 439(284,640), 345(243,481) in patients undergoing laparotomy and laparoscopic assisted surgery, respectively. There were signi-ficant differences in SII between patients with tumor located at right and left hemicolon,between patients undergoing laparotomy and laparoscopic assisted surgery ( P<0.05). Results of Kruskal-Willas analy-sis showed that SII was 289(201,463), 296(210,398), 329(252,446), 369(265,505), 434(274,631) in patients with pathological T staging as stage T0, stage T1, stage T2, stage T3, stage T4, respectively, and 307(226,400), 380(260,503), 381(272,563), 376(273,634) in patients with patho-logical TNM staging as stage Ⅰ, stage Ⅱ, stage Ⅲ, stage Ⅳ, respectively. There were significant differences in SII between patients with different pathological T staging and between patients with different pathological TNM staging ( P<0.05). (2) Influencing factors for SII in colorectal cancer patients: results of univariate analysis showed that KPS score, preoperative Alb, CA125, tumor location, tumor diameter, patholo-gical N staging, pathological TNM staging were related factors for SII in colorectal cancer patients ( Beta=-3.5, -15.8, 3.7, 106.3, 51.8, 115.1, 104.7, 141.2,95% confidence interval as -5.7 to -1.3, -22.6 to -9.1, 1.8 to 5.5,34.6 to 177.9, 38.5 to 65.2, 40.5 to 189.7, 11.2 to 198.2, 46.9 to 235.9, P<0.05). Multivariate analysis showed that tumor location and tumor diameter were independent influencing factors for SII in colorectal cancer patients ( Beta=79.5, 42.5, 95% confidence interval as 8.4 to 150.7, 26.6 to 58.4, P<0.05). Conclusions:The SII is correlated with tumor location, tumor diameter, preoperative Alb, pathological T staging, pathological TNM staging. Preoperative hypoproteinemia indicates a high SII score. The longer of tumor diameter, right hemicolon tumor and high TNM staging indicate the more serious immune-inflammatory imbalance. Tumor location and tumor diameter are independent influencing factors for SII in colorectal cancer patients.

Retroperitoneal liposarcoma in a nonagenarian

Retroperitoneal liposarcomas are rare tumors arising from the soft tissue of the retroperitoneum and are of mesenchymal cell origin. They can reach a large size prior to causing symptoms and generally have a poor prognosis. We present the case of a 93-year-old lady presenting with a large retroperitoneal liposarcoma at the site of a previous colonic anastomosis for the adenocarcinoma treatment. It caused minimal symptoms initially, but surgical resection was undertaken when the tumor was found to be growing significantly in size. However, due to the tumor's location and its invasion into surrounding structures, the resection was not feasible and subsequently abandoned. A retroperitoneal liposarcoma arising from the site of a previous colonic resection has not been previously described. A review of the diagnosis and current management of these lesions is also given.

Risk factor analysis on anastomotic leakage after laparoscopic surgery in rectal cancer patient with neoadjuvant therapy and establishment of a nomogram prediction model / 中华胃肠外科杂志

Objective@#To investigate the risk factors of anastomotic leakage (AL) after laparoscopic surgery in rectal cancer patient with neoadjuvant therapy and construct a nomogram prediction model.@*Methods@#This study was a retrospective case-control study that collected and reviewed the clinicopathological data of 359 patients who underwent laparoscopic surgery from January 2012 to January 2018, including 202 patients from the Department of General Surgery, Nanfang Hospital of Southern Medical University and 157 patients from the Department of Gastrointestinal Surgery of Fujian Provincial Cancer Hospital. Inclusion criteria: (1) age ≥ 18 years old; (2) diagnosis as rectal cancer by biopsy before treatment; (3) distance from tumor to anus within 12 cm; (4) locally advanced stage (T3-T4 or N+) diagnosed by imaging (CT, MRI, PET or ultrasound); (5) standardized neoadjuvant therapy followed by laparoscopic radical operation. Exclusion criteria: (1) previous history of colorectal cancer surgery; (2) short-term or incomplete standardized neoadjuvant therapy; (3) Miles, Hartmann, emergency surgery, palliative resection; (4) conversion to open surgery. Clinicopathological data, including age, gender, body mass index (BMI), preoperative albumin, distance from tumor to anus, operation hospital, American Society of Anesthesiologists score (ASA score), operation time, T stage, N stage, M stage, TNM stage, pathological complete response (pCR) were analyzed with univariate analysis to identify predictors for AL after laparoscopic surgery in rectal cancer patient with neoadjuvant therapy. Then, incorporated predictors of AL, which were screened by multivariate logistic regression, were plotted by the "rms" package in R software to establish a nomogram model. According to the scale of the nomogram of each risk factor, the total score could be obtained by adding each single score, then the corresponding probability of postoperative AL could be acquired. The area under ROC curve (AUC) was used to evaluate the predictive ability of each risk factor and nomogram on model. AUC > 0.75 indicated that the model had good predictive ability. The Bootstrap method (1000 bootstrapping resamples) was applied as internal verification to show the robustness of the model. The discrimination of the nomogram was determined by calculating the average consistency index (C-index) whose rage was 0.5 to 1.0. Higher C-index indicated better consistency with actual risk. The calibration curve was used to assess the calibration of prediction model. The Hosmer-Lemeshow test yielding a non-significant statistic (P>0.05) suggested no departure from the perfect fit.@*Results@#Of 359 cases, 224 were male, 135 were female, 189 were ≥ 55 years old, 98 had a BMI > 24 kg/m2, 176 had preoperative albumin ≤ 40 g/L, 128 had distance from tumor to anus ≤ 5 cm, 257 were TNM 0-II stage, 102 were TNM III-IV stage, and 84 achieved pCR after neoadjuvant therapy. The incidence of postoperative AL was 9.5% (34/359). Univariate analysis showed that gender, preoperative albumin and distance from tumor to the anus were associated with postoperative AL (All P<0.05). Multivariate logistic regression analysis revealed that male (OR=2.480, 95% CI: 1.012-6.077, P=0.047), preoperative albumin ≤40 g/L (OR=5.319, 95% CI: 2.106-13.433, P<0.001) and distance from tumor to anus ≤ 5 cm (OR=4.339, 95% CI: 1.990-9.458, P<0.001) were significant independent risk factors for postoperative AL. According to these results, a nomogram prediction model was constructed. The male was for 55 points, the preoperative albumin ≤ 40 g/L was for 100 points, and the distance from tumor to the anus ≤ 5 cm was for 88 points. Adding all the points of each risk factor, the corresponding probability of total score would indicated the morbidity of postoperative AL predicted by this nomogram modal. The AUC of the nomogram was 0.792 (95% CI: 0.729-0.856), and the C-index was 0.792 after internal verification. The calibration curve showed that the predictive results were well correlated with the actual results (P=0.562).@*Conclusions@#Male, preoperative albumin ≤ 40 g/L and distance from tumor to the anus ≤ 5 cm are independent risk factors for AL after laparoscopic surgery in rectal cancer patient with neoadjuvant therapy. The nomogram prediction model is helpful to predict the probability of AL after surgery.

Expression of miR-490 in malignant tumors and its molecular mechanism / 国际肿瘤学杂志

MicroRNA-490 (miR-490)is an important member of the miRNA family and is closely related to the occurrence and development of tumors. Studies have shown that miR-490 is abnormally expressed in various tumors such as gastric cancer,colorectal cancer,breast cancer,etc. ,which plays an oncogene or tumor suppressor gene role in the biological behaviors such as proliferation,apoptosis,invasion and metastasis of different tumor cells. MiR-490 is expected to be an indicator of tumor diagnosis and clinical prognosis,and in-depth study of its mechanism is expected to provide a new direction for the diagnosis and treatment of cancer.

Progress of the relationship between aberrant p53 protein and tumorigenesis / 肿瘤研究与临床

TP53 gene has been found to have the highest correlation with human tumors, and its mutations occurr in about 50% malignant tumors. Its encoded p53 protein is a well-known tumor-suppressor factor in vivo, which is closely related to tumorigenesis. It is found that tumorigenesis has a close relationship with various abnormal biological processes, including cell cycle regulation, apoptosis, DNA damage repair, cell senescence, autophagy, metabolic regulation. This paper reviews the complex network relationship between p53 protein and tumorigenesis from biological processes affecting the tumorigenesis.

Silencing PXDN gene expression inhibits proliferation and migration of ovarian cancer SKOV3 and OV15 cells and its possible mechanism / 肿瘤

Objective: To investigate the role of peroxidase (PXDN) in ovarian cancer and its potential mechanisms. Methods: The expression of PXDN in ovarian cancer tissues and its relationship with the prognosis of patients was analyzed by The Cancer Genome Atlas (TCGA) database and Kapplan- Meier Plotter database, respectively. The expression of PXDN in 79 cases of serous ovarian cancer and 137 cases of benign ovarian cyst was detected by immunohistochemistry, and its clinical significance was analyzed. The expression of PXDN gene in ovarian cancer SKOV3 and OV15 cells was knocked down by using siRNA-PXDN, then the effects of PXDN gene silencing on the proliferation and migration of ovarian cancer cells were detected by CCK-8, colony formation, Transwell chamber assay and scratch healing test, respectively. The PXDN gene silenced ovarian cancer SKOV3 cells transfected with shRNA-PXDN were treated with transforming growth factor-β (TGF-β) (10 ng/mL). Then the expressions of epithelial-mesenchymal transition-related protein E-cadherin and fibronectin (FN) and TGF-β pathway-related protein Snail1, Smad2, Smad3, Smad4, phosphorylated Smad2 (p-Smad2) and p-Smad3 were detected by Western blotting. Results: The expression of PXDN in ovarian cancer tissues was significantly higher than that in benign ovarian tissues (P < 0.001), and the high expression of PXDN was associated with the poor prognosis of ovarian cancer patients (P < 0.001). Silencing PXDN gene expression inhibited the proliferation and migration of ovarian cancer SKOV3 and OV15 cells (all P < 0.001). After the PXDN gene silenced SKOV3 cells were treated with TGF-β, the expression level of E-cadherin was significantly increased (P < 0.01), the expression level of FN was significantly decreased (P < 0.01), but the expressions of Smad2 and Smad3 were not changed, while the expression levels of Snail1, Smad4, p-Smad2 and p-Smad3 were significantly decreased (all P < 0.01). Conclusion: PXDN can regulate the epithelial-mesenchymal transformation in ovarian cancer through TGF-β/Smad pathway.

Expression of miR-490 in malignant tumors and its molecular mechanism / 国际肿瘤学杂志

MicroRNA-490 (miR-490) is an important member of the miRNA family and is closely related to the occurrence and development of tumors. Studies have shown that miR-490 is abnormally expressed in various tumors such as gastric cancer, colorectal cancer, breast cancer, etc., which plays an oncogene or tumor suppressor gene role in the biological behaviors such as proliferation, apoptosis, invasion and metastasis of different tumor cells. MiR-490 is expected to be an indicator of tumor diagnosis and clinical prognosis, and in-depth study of its mechanism is expected to provide a new direction for the diagnosis and treatment of cancer.

Progress of the relationship between aberrant p53 protein and tumorigenesis / 肿瘤研究与临床

TP53 gene has been found to have the highest correlation with human tumors, and its mutations occurr in about 50％ malignant tumors. Its encoded p53 protein is a well-known tumor-suppressor factor in vivo, which is closely related to tumorigenesis. It is found that tumorigenesis has a close relationship with various abnormal biological processes, including cell cycle regulation, apoptosis, DNA damage repair, cell senescence, autophagy, metabolic regulation. This paper reviews the complex network relationship between p53 protein and tumorigenesis from biological processes affecting the tumorigenesis.

Efficacy of percutaneous transhepatic biliary drainage combined with transarterial chemoembolization in treatment of malignant obstructive jaundice / 肿瘤研究与临床

Objective To observe the efficacy of percutaneous transhepatic biliary drainage (PTBD) combined with transarterial chemoembolization (TACE) in treatment of malignant obstructive jaundice, and to evaluate its application value in clinic. Methods A total of 82 patients with malignant obstructive jaundice who received PTBD from January 2017 to January 2019 in Taiyuan Central Hospital were collected. The patients were divided into the experimental group who received TACE (41 cases) and the control group who could not receive TACE (41 cases) after PTBD. Clinical symptoms, liver function, tumor markers, drainage tube patency rate and survival time of the two groups were compared before and after the treatment. T-test and chi-square test were used for statistical analysis, and Kaplan-Meier method was used for survival analysis. Results A total of 93 drainage tubes were placed in 82 patients, and 109 TACE treatments were performed in the experimental group. PTBD and TACE both had successful results. After PTBD, 72 patients felt jaundiceand obvious alleviation of other clinical symptoms. There were no serious complications after PTBD and TACE. Postoperative follow-up results showed that compared with the total bilirubin (TBIL) [(269±113)μmol/L], the direct bilirubin (DBIL) [(159 ±74) μmol/L], alanine transaminase (ALT) [(118 ±40) U/L] and aspartate aminotransferase (AST) [(111±55) U/L] before the operation, the TBIL [(46±11)μmol/L], DBIL [(28±10)μmol/L], ALT [(35±12) U/L] and AST [(33±12) U/L] in the experimental group were decreased significantly 3 months after the operation, and the differences were statistically significant (all P<0.05). TBIL [(48±9)μmol/L], DBIL [(25±10) μmol/L], ALT [(32±9) U/L] and AST [(30±12) U/L] in the control group were decreased significantly compared with TBIL [(291±114)μmol/L, DBIL [(171±66)μmol/L], ALT [(129±54) U/L] and AST [(114±43) U/L] before the operation, and the differences were statistically significant (all P< 0.05). There was no significant difference in liver function between the two groups before the operation and 3 months after the operation (both P>0.05). The level of carbohydrate antigen-199 in the experimental group at 6 months after PTBD was lower than that in the control group [(426 ±136) U/ml vs. (569 ±204) U/ml; t = 19.457, P < 0.05]. There were statistical differences in the patency rate of the both groups at 6, 9 and 12 months after PTBD (all P< 0.05). The median survival time in the experimental group was longer than that in the control group (310.4 d vs. 234.5 d; χ2= 12.678, P< 0.05). Conclusion The effect of PTBD in patients with malignant obstructive jaundice is obvious. The combination with TACE after PTBD can prolong the survival of patients and it is worthy of clinical application.

Plasmocitoma intraconal e infiltração uveal em paciente portadora de mieloma múltiplo / Intraconal plasmocytoma and uveal infiltration in a patient with multiple myeloma

Resumo Mieloma múltiplo (MM) é uma neoplasia que cursa com a proliferação desordenada de clones de plasmócitos, produzindo imunoglobulina monoclonal e normalmente se apresenta como lesões osteolíticas. Em alguns casos, porém, esta doença apresenta-se como massas, chamadas de plasmocitomas. O acometimento ocular e orbitário é incomum nesta patologia. Neste trabalho, descrevemos o caso de uma paciente de 63 anos com diagnóstico prévio de MM que evoluiu com um plasmocitoma intraconal em olho direito, bem como uma massa vascularizada câmara anterior proveniente de infiltração uveal. Essas lesões foram correlacionadas MM e culminaram com a perda visual no olho acometido. Não foi encontrado na literatura relatos de plasmocitoma intraconal.

Abstract Multiple myeloma (MM) leads to disorderly proliferation of plasma cells clones, producing monoclonal immunoglobulin and commonly presents osteolytic lesions. In some cases, however, masses called plasmocytomas are found. Ocular and orbital involvement is unusual in this pathology. In this paper, we describe a case of a 63 year-old patient with previous diagnostic of MM that evolved an intraconal plasmocytoma in the right eye, as well as a vascularized mass in the anterior chamber from uveal infiltration. These lesions were correlated to MM e lead to visual loss in the affected eye. Reports of intraconal plasmocytoma have not been found in literature.

A Retrospective Study of Mean Computed Tomography Value to Predict the Tumor Invasiveness in AAH and Clinical Stage Ia Lung Cancer / 中国肺癌杂志

BACKGROUND@#Recently, the detectable rate of ground-glass opacity (GGO ) was significantly increased, a appropriate diagnosis before clinic treatment tends to be important for patients with GGO lesions. The aim of this study is to validate the ability of the mean computed tomography (m-CT) value to predict tumor invasiveness, and compared with other measurements such as Max CT value, GGO size, solid size of GGO and C/T ratio (consolid/tumor ratio, C/T) to find out the best measurement to predict tumor invasiveness.@*METHODS@#A retrospective study was conducted of 129 patients who recieved lobectomy and were pathological confirmed as atypical adenomatous pyperplasia (AAH) or clinical stage Ia lung cance in our center between January 2012 and December 2013. Of those 129 patients, the number of patients of AAH, AIS, AIS and invasive adenocarcinoma were 43, 26, 17 and 43, respectively. We defined AAH and AIS as noninvasive cancer (NC), MIA and invasive adenocarcinoma were categorized as invasive cancer(IC). We used receiver operating characteristic (ROC) curve analysis to compare the ability to predict tumor invasiveness between m-CT value, consolidation/tumor ratio, tumor size and solid size of tumor. Multiple logistic regression analyses were performed to determine the independent variables for prediction of pathologic more invasive lung cancer.@*RESULTS@#129 patients were enrolled in our study (59 male and 70 female), the patients were a median age of (62.0±8.6) years (range, 44 to 82 years). The two groups were similar in terms of age, sex, differentiation (P>0.05). ROC curve analysis was performed to determine the appropriate cutoff value and area under the cure (AUC). The cutoff value of solid tumor size, tumor size, C/T ratio, m-CT value and Max CT value were 9.4 mm, 15.3 mm, 47.5%, -469.0 HU and -35.0 HU, respectively. The AUC of those variate were 0.89, 0.79, 0.82, 0.90, 0.85, respectively. When compared the clinical and radiologic data between two groups, we found the IC group was strongly associated with a high m-CT value, high Max CT value, high C/T ratio and large tumor size. Gender, solid tumor size, tumor size, C/T ratio, m-CT value and MaxCT value were selected factor for multivariate analysis, when using the preoperatively determined variables to predict the tumor invasiveness, revealed that tumor size, C/T ratio, m-CT value and Max CT value were independent predictive factors of IC.@*CONCLUSIONS@#The musurements of Max CT value, GGO size, solid size of GGO and C/T ratio were significantly correlated with tumor invasiveness, and the evaluation of m-CT value is most useful musurement in predicting more invasive lung cancer.

Definition and diagnostic criteria of anastomotic leakage after sphincter-preserving surgery for rectal cancer / 中华胃肠外科杂志

Anastomotic leakage is a common and severe postoperative complication foollowing sphincter-preserving surgery of rectal cancer. Many useful studies on anastomotic leakage were conducted both in our country and abroad. However, the lack of standardized and influential definition and diagnostic criteria is responsible for confusion in the literature. In this paper, the history of studies on the definition and diagnostic criteria of anastomotic leakage is reviewed, and the name evolution process of anastomotic leakage in domestic and foreign studies is introduced. We briefly describe the current situation of the coexistence of "leakage" and "fistula" in China. Based on the general definition and the word meaning of the interruption of anastomotic continuity, using "anastomotic leakage" instead of "anastomotic fistula" is necessary. The common diagnostic criteria are the Clavien-Dindo classification in 2004 and the ISREC definition and grading proposed by the International Study Group of Rectal Cancer in 2010. Both criteria have their own advantages and disadvantages. The standardized use of the definition and diagnostic criteria of postoperative anastomotic leakage of rectal cancer will help improve surgical safety assessment and facilitate academic communication. In view of the current situation of China, we still need to promote standardized definition and diagnostic criteria of anastomotic leakage.

Advances in the relationship between microRNA-483 and digestive system tumors / 中华消化外科杂志

MicroRNA (miRNA) is a kind of small non-coding RNA that regulates gene expression at the posttranscriptional level through inhibition of translation or degradation of messenger RNA.MiRNA is involved in the regulation of many cellular biological processes,and its abnormal expression closely relates to development of tumors.MiR-483 plays an important role in the tumorgenesis or development,meanwhile,its role in digestive system tumors has aroused widespread attention.

Diagnosis and treatment of intraductal papillary neoplasm of the bile duct / 中华消化外科杂志

Intraductal papillary neoplasm of the bile duct (IPNB) is a rare tumor arising from epithelia of bile duct,with a better prognosis compared with common cholangiocarcinoma.IPNB can occur anywhere along the biliary tree,and cause the dilation of the bile duct and acute cholangitis.Recent large case series of this peculiar disease in the far eastern countries showed greater incidences of hepatolithiasis and clonorchiasis compared with Western series.According to the immunochemistry features,IPNB can be classified into four subtypes,pancreaticobiliary,intestinal,gastric and oncocytic types.The pancreaticobiliary type is the most common and is usually associated with invasive lesions.Patients without distant metastasis can undergo surgical resection,surgical procedures include pancreaticoduodenectomy,hemihepatectomy,segmental liver resection and liver transplantation,and regional lymphectomy is necessary.