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Objective:To evaluate the 3-year survival outcomes of postoperative patients after high exposure to traditional Chinese medicine （TCM） for triple negative breast cancer （TNBC）. Method:The complete 3-year follow-up data of 150 postoperative patients with stage I–III TNBC were retrospectively analyzed. All the patients received routine western medical treatments （surgery， chemotherapy， and/or radiotherapy） according to the National Comprehensive Cancer Network （NCCN） clinical practice guidelines in oncology as well as TCM. According to the degree of exposure to TCM， they were divided into the high- and low-exposure cohorts， with the oral administration of Chaihu Longmu Decoction with or without anti-cancer Chinese patent medicine for at least six months annually， or 18 months or more in the three years as the inclusion criterion for the former cohort. The metastatic sites of recurrent TNBC and the recurrent metastasis/death time were observed in both cohorts to compare the disease-free survival （DFS） and overall survival （OS）. The influences of onset age， pathological type， histopathological grade， vascular invasion， clinical stage， and exposure to TCM on survival were subjected to statistical analysis， followed by the observation of adverse effects. Result:There was no significant difference in the metastatic sites between the two cohorts （<italic>P</italic>>0.05）. The high-exposure cohort had a longer 3-year DFS than the low-exposure cohort， and the 3-year DFS rate in the high-exposure cohort was increased by 16.9% （χ<sup>2</sup>=6.995， <italic>P</italic>=0.008） as compared with that in the low-exposure cohort， exhibiting a significant difference （<italic>P</italic><0.05）. As revealed by the Cox proportional-hazards model， patients in the low-exposure cohort had a 3.724-fold as high risk of recurrent metastasis as that in the high-exposure cohort （95%CI 1.399~9.915）. There was no significant difference in the 3-year OS between the two cohorts （<italic>P</italic>>0.05）. The overall incidence of adverse effects in both groups was 7.3%， mainly manifested as gastrointestinal discomfort. Conclusion:High exposure to TCM contributes to reducing postoperative recurrence and metastasis and prolonging DFS.
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Objective: To detect the expression of SVEP1, PKHD1 and P53 in primary liver cancer tissues by immunohistochemistry for predicting the recurrence of liver cancer. Methods: The clinical data of 103 patients with primary liver cancer who underwent surgical resection at Tianjin Medical University Cancer Institute and Hospital were gathered from January 2013 to January 2014 and analyzed retrospectively. Expression values of three different proteins were used to develop separate immunohistochemical scores for the prog-nosis of recurrence in patients. The patients were classified into either a high-risk or a low-risk group based on their immunohisto-chemical scores through ROC curve analysis. The difference in recurrence ratio between the two groups was then compared using the common research index of disease-free survival (DFS). Results: The median age of the total patients was 55 years (range 21-88 years), the median AFP level was 70.6 (range 1.03-718840.0) μg/L, the median CA19-9 level was 22.89 (range 0.6-1000.0) kU/L, and the medi-an tumor size was 4.5 (1.0-27.0) cm. The expression levels of SVEP1, PKHD1, and P53 in primary liver tumors were detected by immu-nohistochemistry and assigned separate immunohistochemical scores. The areas under the ROC curves of the immunohistochemical scores of SVEP1, PKHD1, and P53 were 0.861, 0.829, and 0.716, respectively. The critical values of SVEP1, PKHD1, and P53 were 4, 4, and 1 point, respectively (P<0.001). The three-year DFS rates among the SVEP1 high-risk (expression≤4 points) and low-risk groups (expression>4 points) were 4.1% and 51.7%, respectively. Similarly, the three-year survival rates among the PKHD1 high-risk (expres-sion≤4 points) and low-risk groups (expression>4 points) were 5.3% and 51.9%, respectively. The three-year DFS rates among the P53 high-risk (expression>1 point) and the low-risk group (expression≤1 point) were 6.3% and 27.3%, respectively. The survival differenc-es between all the pairs were statistically significant (P<0.001,<0.001, and 0.003 respectively). When PKHD1 was used in combination with SVEP1, the ROC curve had an area of 0.897 (P<0.001) with a sensitivity of 76.5% and a specificity of 94.4%. Conclusions: The accu-racy of P53 data for predicting primary liver cancer recurrence is insufficient and therefore it is not recommended for use. SVEP1 and PKHD1 data achieve sufficient accuracy for predicting the recurrence of primary liver cancer. Since SVEP1 data impart a higher specifici-ty and PKHD1 data impart a higher sensitivity to the prognosis scores, the combined use of the two markers is better than being used individually.
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@#[Abstract] Objective: To investigate the relationship between expression of MICA/B (MHC class I chain-related proteinA/B) and disease-free survival (DFS) of patients with HER2+(human epidermal growth factor receptor 2) breast cancer tissue. Methods: Twenty six cases of corresponding para-cancerous tissue and 100 cases of HER2+ breast cancer tissue that preserved in wax at Zhengzhou People’ s Hospital Affiliated to Southern Medical University from January 2009 to June 2010 were collected for this study. Expression of MICA/ B in these tissue samples was detected by immunohistochemistry; and the relationship between MICA/B expression with clinicopathologic features as well as DFS was analyzed with Kaplan-Meier survival curve. Results: The expression of MICA/B in adjacent paracancerous tissues was negative (0/26), however, it was highly positive in cancer tissues (92/100), and the percentage with high expression was 65%(65/100), the difference was significant (P<0.05). High MICA/B expression rate in stage I was significantly higher than that in stage Ⅱ-Ⅲ (77.55% vs 52.94%， P<0.05), and the high expression rate in stage T1 was also significantly higher than that in stage T2-T4 (75.00% vs 52.27%， P<0.05). High MICA/B expression rate in ER+, PR+ group (with positive number≥1%) was significantly lower than that in ER- , PR-group (ER： 52.38% vs 74.14%，PR： 51.35% vs 73.02%， all P<0.05). MICA/B expression was correlated with clinical stages, the expression of ER, PR and tumor size (all P<0.05), but not associated with menopausal status, histological grade and lymph node metastasis (all P>0.05). Over-expression of MICA/B was closely associated with much better 6-year DFS rate in patients no matter with or without targeted therapy (the targeted group: 90.6% vs 72.2%; the untargeted group: 78.4% vs 58.8%, all P<0.05). Conclusion: Over-expression of MICA/B in HER2+ breast cancer tissue is closely related to DFS, which may be served as a potential prognosis indicator for patients with HER2+ breast cancer.
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Resumen El sarcoma de mediastino es un raro tumor que representa menos del 10% de los tumores del mediastino y alrededor del 1-2% de todas las neoplasias malignas en general. Debe abordarse en centros de referencia, donde se evalué multidisciplinariamente y se tengan opciones de manejo multimodal, infraestructura que permita la resección y reconstrucción quirúrgica mayor y estricto seguimiento, teniendo en cuenta la alta recurrencia local, cercana al 30%. Exponemos una serie de casos presentados a lo largo de 20 años de experiencia con la participación de varios departamentos, ajustándonos a la definición y manejo con la literatura actual.
Abstract Mediastinum sarcoma is a rare tumor that represents less than 10% of mediastinal tumors and about 1-2% of all malignancies in general. It should be approached in reference centers with multidisciplinary evaluation and multimodal management options, with an infrastructure that allows surgical resection and reconstruction and strict follow-up, taking into account the high local recurrence that is close to 30%. Therefore, we present a series of cases in 20 years of experience with the participation of several departments and adjusting the definition and management with the current literature.