Prognostic analysis of robotic and open pancreatoduodenectomy for pancreatic cancer / 中华消化外科杂志

Objective:To investigate the prognosis of robotic pancreatoduodenectomy after the learning curve and open pancreatoduodenectomy for pancreatic cancer.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 396 patients who underwent curative pancreatoduodenectomy for pancreatic duct adenocar-cinoma in Ruijin Hospital of Shanghai Jiaotong University School of Medicine from January 2017 to December 2018 were collected. There were 244 males and 152 females, aged 64(range, 36?92)years. Of 396 patients, 86 cases undergoing robotic pancreatoduodenectomy were divided into robotic group, 310 cases undergoing open pancreatoduodenectomy were divided into open group. Observa-tion indicators: (1) propensity score matching and comparison of general data between the two groups after matching; (2) follow-up and survival analysis. Follow-up was conducted by telephone interview or outpatient examinations including tumor markers and abdominal imaging examina-tions to detect survival of patients up to March 2022. Overall survival was defined as the time from the surgery date to death or the last follow-up. Disease-free survival was defined as the time from the surgery date to tumor recurrence or the last follow-up. The propensity score matching was conducted by 1∶1 matching using the nearest neighbor method. Normality of measurement data was examined using the Shapiro-Wilk test. Measurement data with skewed distribution were described as M(range), and comparison between groups was analyzed using the Mann-Whitney rank-sum test. Count data were represented as absolute numbers, and comparison between groups was analyzed using the chi-square test. Kaplan-Meier method was used to calculate survival rates and draw survival curves, and Log-Rank test was used for survival analysis. An intent-to-treat analysis was performed in this study, patients who were converted to laparotomy from robotic surgery were still divided into the robotic group. Results:(1) Propensity score matching and comparison of general data between the two groups after matching: 164 of 396 patients had successful matching, including 82 cases in robotic group and open group, respectively. Before propensity score matching, the body mass index, cases in stage T1, T2, T3, T4, cases in N0, N1, N2 were 23.4(range, 21.4?25.3)kg/m 2,24, 41, 10, 11, 52, 27, 7 for the robotic group, versus 22.4(range,20.3?23.9)kg/m 2,57, 144, 22, 87, 131, 132, 47 for the open group, showing significant differences in the above indicators between the two groups ( Z=3.01, 2.63, 3.03, P<0.05). After propensity score matching, cases of males, age, body mass index, cases with American Society of Anesthesiologists (ASA) score as 1, 2, 3, CA19-9, cases with preoperative biliary drainage, cases with portal vein resection, cases with pancreatic resection margin <1 mm, cases in stage T1, T2, T3, T4, cases in stage N0, N1, N2, cases with nerve invasion, cases with tumor differentiation as high-medium differentiation, medium-low differentiation, low differentiation, cases with adjuvant chemotherapy were 51, 65(range, 59?69)years, 23.0(range, 21.0?25.2)kg/m 2, 32, 41, 9, 160.4(range, 46.7?377.2)U/mL, 21, 9, 8, 21, 40, 10, 11, 48, 27, 7, 76, 26, 47, 9, 53 for the robotic group, versus 58, 65(range, 58?69)years, 23.3(range, 21.4?25.3)kg/m 2, 35, 39, 8, 172.0(range, 69.7?402.9)U/mL, 26, 9, 10, 24, 40, 7, 11, 49, 28, 5, 76, 22, 49, 11, 57 for the open group, showing no significant difference in the above indicators between the two groups ( χ2=1.34, Z=0.18, 0.34, 0.49, 0.51, χ2=0.75, 0.00,0.25, Z=0.59, 0.27, χ2=0.00, Z=0.76, χ2=0.44, P>0.05). (2) Follow-up and survival analysis: after propensity score matching, 164 patients were followed up for 54(range, 1?67)months. The follow-up time of patients was 55(range, 51?59)months for the robotic group, versus 54(range, 50?58)months for the open group, respectively, showing no significant difference between the two groups ( Z=0.48, P>0.05). During the follow-up, the 1-year overall survival rate, 3-year overall survival rate, the median survival time, 1-year disease-free survival rate, 3-year disease-free survival rate, the median disease-free survival time, tumor recurrence rate, cases with recurrence pattern as local recurrence, liver recurrence, other distant recurrence, local and distant recurrence were 81.7%, 39.0%, 27 months(95% confidence interval as 19?33 months), 61.0%, 34.2%, 15 months(95% confidence interval as 12?18 months), 54.9%(45/82), 12, 16, 9, 8 for the robotic group. The above indicators were 79.3%, 36.0%, 24 months(95% confidence interval as 19?31 months), 59.8%, 27.5%, 15 months(95% confidence interval as 10?20 months), 58.5% (48/82), 10, 22, 6, 10 for the open group. There was no significant difference in overall survival or disease-free survival between the two groups ( χ2=0.39, 0.47, P>0.05). There was no significant difference in tumor recurrence rate or tumor recurrence site between the two groups either ( χ2=0.22, 1.86, P>0.05). Conclusion:After the learning curve, robotic pancreato-duodenectomy has non-inferior prognosis compared with open pancreatoduodenectomy.

Treatment of non-small cell lung cancer with EGFR-TKI / 国际肿瘤学杂志

Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are the key to the treatment of advanced non-small cell lung cancer (NSCLC),but there are various drug-resistant mutations in the latter stage.The first and second generation of EGFR-TKIs significantly prolong the survival of patients with EGFR-activated mutant tumors.The third generation of EGFR-TKIs effectively inhibit the progress of T790M mutant tumors.The fourth generation of EGFR-TKIs inhibit both L858R,T790M and L858R,T790M,C797S mutant tumors.Using circulating tumor DNA and exogenous RNA can effectively detect the mutation types of EGFR,and choose EGFR-TKIs therapy or combined chemotherapy according to the mutation types.

Present situation and prospect of Da Vinci robot-assisted pancreatic surgery / 中华消化外科杂志

With the continuous improvement of the diagnosis rate of benign pancreatic disease and the younger age of disease onset,the demand for minimally invasive pancreatic surgery is increasing,meanwhile,how to keep the normal pancreatic tissue as much as possible to reduce the impact on the patients' life has gained surgeons' thinking.The Da Vinci robotic surgical system,providing a clearer 3D vision and more accurate operation,makes some difficult minimally invasive pancreatic surgery such as pancreaticoduodenectomy can be carried out extensively.Based on clinical experiences and related literatures,this paper will analyze the present situation of Da Vinci robot-assisted pancreatic surgery and give prospects.

Aptamers as molecular probes in tumor molecular imaging / 国际肿瘤学杂志

The ideal molecular imaging probe should have characteristics of specificity,sensitivity and safety.Aptamers are sing-strand DNA or RNA oligonucleotides which can bind their targets with high specificity and high affinity.Aptamers are new types of molecular imaging probe because they have many advantages,such as their large sum of possible targets,small molecule weights,easily production and modification,low immuno-genicity,high tissue penetration and so on.Now more and more aptamers research on tumor molecular imaging provides a new technology and tool for tumor diagnosis and therapy.

Association of MnSOD single nucleotide polymorphism with the occurrence and clinical outcome of nasopharyngeal carcinoma in Cantonese / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the association of MnSOD single nucleotide polymorphisms (SNPs) with the susceptibility to nasopharyngeal carcinoma (NPC) in Cantonese.</p><p><b>METHODS</b>A total of 105 Cantonese NPC patients and 136 age-matched healthy controls were enrolled in this study. Genotyping of the SNP Ala-9Val of MnSOD gene was performed by PCR and direct sequencing of the PCR products.</p><p><b>RESULTS</b>The allele frequency of Ala in Cantonese was 19.1%. The frequencies of Val/Val, Val/Ala, and Ala/Ala genotypes were 83.8%, 14.3%, and 1.9% in NPC patients and 80.9%, 16.9%, and 2.2% in healthy individuals, respectively. No significant differences were found in the allele or genotype frequencies between NPC patients and controls. Ala/Val genotype was shown to be significantly less frequent in patients with a positive lymph node status, but the allele Ala was not correlated to lymph node involvement. No significant differences were found in the allele and genotype frequencies in patients with different tumor sizes, metastatic statuses, clinical statuses and histological types.</p><p><b>CONCLUSION</b>MnSOD Ala-9Val polymorphism can be region- and race-related, and it is not correlated to the genetic susceptibility of NPC in Cantonese.</p>

Teaching of Radiation and Oncology / 中华医学教育探索杂志

There are many difficulties in studying Radiation & Oncology.We improve the teaching effect by selecting the proper teaching content,optimizing the teaching mode,cultivating idea of multidisciplinary tumor management and clinical teaching.