Molecular mechanisms of cetuximab resistance in metastatic colorectal cancer / 国际肿瘤学杂志

Cetuximab has become an important molecular targeted drug for the treatment of metastatic colorectal cancer (mCRC), which increases the curative effect of chemotherapy and prolongs the survival time. However, some patients develop insensitiveness or resistance to cetuximab, while the complicated molecular mechanisms are not quite clear. With the deep research in epidermal growth factor receptor (EGFR) signaling pathway, the genetic alteration of KRAS, BRAF, PTEN and PIK3CA and polymorphism of microRNA (miRNA) have been proved to associated with cetuximab resistance. Wnt signaling pathway with its negative regulator RNF43 is also considered to be related with cetuximab resistance in recent studies. The review of the progress on molecular mechanisms of cetuximab resistance in mCRC can establish theoretical basis for finding out reasonable drugs to overcome the resistance.

Clinical application of fusion indocyanine green fluorescence imaging in total laparoscopic radical resection for right colon cancer / 中华肿瘤杂志

Objective@#This study aims to explore the clinical value of fusion indocyanine green fluorescence imaging (FIGFI) in total laparoscopic radical resection for right colon cancer.@*Methods@#From October, 2018 to December, 2018, 15 patients who underwent total laparoscopic radical resection for right colon cancer using FIGFI in Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College were retrospectively enrolled in this study. Data regarding surgical outcomes, postoperative recovery, pathological outcomes and complications were collected and analyzed.@*Results@#All patients successfully underwent total laparoscopic radical resection for right colon cancer using FIGFI. 1 patients (6.7%) received extended resection of bowel due to poor blood supply after mesentery excision. The average operation time was 133.7 minutes and intraoperative blood loss was 26.7 ml. The average time to ground activities, fluid diet intake, first flatus and postoperative hospitalization were 19.1 h, 11.7 h, 32.5 h and 5.0 d, respectively. The average length of tumor was 4.5 cm. The average proximal and distal resection margins were 14.9 cm and 12.1 cm, respectively. The average number of lymph nodes retrieved was 29.3 per patient. Only one patient suffered from incisional fat liquefaction after surgery and was managed effectively by regular dressing change. No severe complications such as indocyanine green allergy, anastomotic stenosis, anastomotic leakage, abdominal bleeding, bowel obstruction, pulmonary infection, and abdominal infection occurred in any patients.@*Conclusions@#FIGFI is helpful to judge the blood supply of intestinal segments and anastomotic stoma in total laparoscopic radical resection for right colon cancer quickly. It is a safe and feasible technique with satisfactory short-term effect.

Application of recurrent laryngeal nerve detector in the neck anastomosis of upper or middle-thoracic esophageal carcinoma / 肿瘤研究与临床

Objective To evaluate the effect of recurrent laryngeal nerve detector on the operation of upper or middle-thoracic esophageal carcinoma. Methods A total of 60 patients with resectable esophageal carcinoma in Beijing Tsinghua Changgung Hospital from January 2015 to December 2017 were recruited. These patients were randomly divided into experimental group and control group by using random number table method.The experimental group used recurrent laryngeal nerve detector to assist in the nerve exploration and separation. The control group was treated by routine operation method, and the operation effect of the two groups was compared. Results In the experimental group, the time spent on the confirmation of recurrent laryngeal nerve was significantly shorter than that in the control group [right side: 1.50 min (1.00, 1.63 min) vs. 5.50 min(4.88, 6.50 min), Z= -6.715, P < 0.05; left side: 1.75 min (1.50, 2.00 min) vs. 7.85 min (6.50, 9.00 min), Z= -6.726, P< 0.05]. The rate of recurrent laryngeal nerve injury in the experimental group was significantly lower than that in the control group [3.3 % (1/30) vs. 20.0 % (6/30), χ 2= 4.043, P < 0.05]. Conclusion The use of recurrent laryngeal nerve detector in the neck anastomosis of upper or middle-thoracic esophageal carcinoma can significantly shorten the time spent on confirming of the recurrent laryngeal nerve and reduce the rate of recurrent laryngeal nerve injury.

Advance of surgery for non-small-cell lung cancer with limited liver metastases / 中华胸心血管外科杂志

Objective Lung cancer has been the most common cause of cancer death worldwide.More than three quarters is diagnosed at advanced stage.Nearly one half has distant metastases outside the chest cavity.It has been recognized that oligometastatic state exists in natural history of malignant tumors,which has significantly better prognosis than those with polymetastases.The eighth edition of TNM staging system defined NSCLC with a single metastasis as a new separated stage(M1 b).Long-term survival of oligometastatic NSCLC patients treated with local control methods has been reported in literatures.But whether surgical resection of liver metastasis has benefit or not remains unknown.We performed a systematic review of surgical therapy for NSCLC with limited liver metastases.