Primary testicular diffuse large B-cell lymphoma: a single center experience / 中华泌尿外科杂志

Objective To review the experience of the clinical diagnosis and treatment of primary testicular diffuse large B-cell lymphoma.Methods A review was made who were treated in the Tumor Hospital of Zhengzhou University from January 2011 to November 2018.The average age of the patients was 58 years old,with 4 cases in left side and 8 cases in right side.All patients were admitted to hospital with painless testicle mass.Solid mass of testis were detected by ultrasound with no abnormality in tumor markers.All patients underwent orchiectomy and followed by chemotherapy.Results Twelve primary testicular lymphoma (PTL) were identified by pathology,with 8 cases in phase Ⅰ,2 cases in phase Ⅱ,1 case in phase Ⅲ,and 1 case in phase Ⅳ.The mean follow-up was 31 months.Inguinal orchiectomy was recommended as a diagnositc and initial therapy.All patients underwent R-CHOP/CHOP chemotherapy consisting of cyclophosphamide,doxorubicin,vincristine and prednisone with or without rituximab,including 6 cases with R-CHOP and 6 cases with CHOP.Nine of 12 patients underwent intrathecal prophylatic chemotherapy and 6 of 12 patients underwent contralateral testicle radiotherapy.Relapse occured in 2 patient with CHOP in central nervous system and died of the disease.One case with CHOP relapsed in abdominal cavity.No contralateral testicle relapse was observed.Conclusions PTL is a rare extranodal lymphoma.Painless testicle tumor in men over 50 years old should suspect of this disease.Inguinal orchiectomy is an important part of the treatment,which combines systemic chemotherapy and prophylactic modalities such as radiotherapy of contralateral testis and/or central nervous system (CNS) prophylaxis.

Comparison of risk rating for chemical hazards in a petrochemical enterprise with two risk assessment methods / 中国职业医学

OBJECTIVE: To compare and analyze the risk rating for chemical hazards of aromatics complex in a petrochemical enterprise using two risk assessment methods. METHODS: Occupational hygiene investigation and chemical detection for workplaces of the construction project were made. The risk ratings were made in five workplaces including that of the aromatics extraction,disproportionation,isomerization,xylene fractionation and adsorptive fractionation. Two risk assessment methods were employed. They were the optimal indicator system of risk assessment on occupational chemical hazards( optimal indicator system) and the semi quantitative risk assessment model of Singapore. The results of risk rating generated by the two risk assessment methods were then compared and analyzed. RESULTS: Using the optimal indicator system,the risk rating of benzene was mild in the five workplaces; and the risk rating of methylbenzene and xylene was slight. However,using the semi quantitative risk assessment model of Singapore,the risk rating of benzene was extremely high in both the aromatics extraction and disproportionation workplaces; the risk rating was high in xylene fractionation,and was medium in the isomerization and adsorptive fractionation workplaces. The risk rating of methylbenzene was high in the aromatics extraction and disproportionation workplaces,and was low in the other three workplaces. The risk rating of xylene was low in the five workplaces. CONCLUSION: The optimal indicator system is more feasible,practical and objective for the assessment of chemical hazards. It is more suitable for risk assessment of occupational chemical hazards in our country.

Comparison and application of two risk assessment methods for occupational lead exposure risk classification in a lead-acid battery enterprise / 中华劳动卫生职业病杂志

Objective@#To apply and compare two risk assessment methods for occupational lead exposure risk classification in a lead-acid battery enterprise.@*Methods@#In April 2013, an occupational health survey was carried out in a lead-acid battery enterprise. Lead smoke and lead dust were tested in the workplace. The risk assessment index system for occupational chemical hazards that was established and optimized by the research group (referred to as "optimized index system" ) , as well as the Singapore semi-quantitative risk assessment model, was used for occupational lead exposure risk classification in the lead-acid battery enterprise. The two risk classification results were analyzed and compared.@*Results@#In the lead smoke risk classification results, the optimized index system classified the raw material group and foundry group workshops as Class I hazardous and the assembling group workshop as Class II hazardous. The Singapore semi-quantitative risk assessment model classified the raw material group workshop as high risk and foundry group and assembling group workshops as extremely high risk. In the lead dust risk classification results, the optimized index system classified the raw material group workshop as Class I hazardous, while the plate painting group, plate cutting group, and assembling group workshops were classified as Class II hazardous. The Singapore semi-quantitative risk assessment model classified the raw material group workshop as medium risk, the plate painting group and plate cutting group workshops as high risk, and the assembling group workshop as extremely high risk.@*Conclusion@#There are some differences in risk assessment of occupational lead exposure between the two risk assessment methods. The optimized index system is comparably more reasonable and feasible, and is highly operable.

Primary pulmonary peripheral T-cell lymphoma, not otherwise specified：two cases report and literature review / 白血病·淋巴瘤

Objective To study the clinical characteristics, diagnosis, treatment and prognosis of primary pulmonary peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS). Methods Two cases of primary pulmonary PTCL-NOS were studied and relevant literature were reviewed. Results Case 1 diagnosed as primary pulmonary PTCL-NOS was a 44 years old woman and disease progressed after GLD (Gem+L-OHP+DXM) chemotherapy regimen. At last, the patient died of respiratory failure after one month. Case 2 diagnosed as primary pulmonary PTCL-NOS was a 46 years old man and reach partial response after CHOP regimen, and still alive now.Conclusion Primary pulmonary PTCL-NOS is very rare. It is easy to be misdiagnosed due to non-specific clinical and imaging manifestations. Acquiring enough tissue specimens for pathologic examination is the key to a definitive diagnosis. At present, there is no standard chemotherapy regimen for these patients, the prognosis is relatively poor.

Clinical study on sequential platinum regimen as primary therapy for young patients with diffuse large B-cell lymphoma / 中国肿瘤临床

Objective:To evaluate the efficacy and safety of sequential platinum regimen in young patients with diffuse large B-cell lym-phoma (DLBCL). Methods:Newly diagnosed young patients with DLBCL, who were hospitalized from January 2005 to June 2012 in the Affiliated Cancer Hospital of Zhengzhou University, were selected according to the requirements. The patients were divided into stan-dard and sequential platinum regimen groups. The remission rates were compared usingχ2 test, whereas the five-year survival rates between the two groups were compared using the Kaplan–Meier method. Multivariate survival analysis was performed using the Cox proportional regression. Subgroup analysis was conducted to select candidate patients for the sequential platinum regimen. Results:A total of 331 patients were enrolled in the study, in which 129 were provided with sequential platinum regimen and 202 were provided with the standard regimen. Sequential regimen yielded higher rates of complete remission (80%vs. 63%, P=0.001), five-year progres-sion-free survival (PFS;60%vs. 50%, P=0.014), and overall survival (OS;70%vs. 58%, P=0.016) than the standard regimen. Multivariate analysis revealed that sequential regimen was an independent prognostic factor for PFS (hazard ratio HR=0.635, P=0.012) and OS (HR=0.625, P=0.021). Subgroup analysis showed that patients with good prognosis and patients who did not receive rituximab benefited more from the sequential platinum regimen. Sequential platinum regimen did not increase the occurrence of adverse effects com-pared with the standard regimen. Conclusion:Sequential platinum regimen is a safe treatment that can improve the survival of young patients with DLBCL. Patients with good prognosis and patients who did not receive rituximab can benefit more from the treatment with sequential platinum regimen.

Efficacy and safety of fixed dose rate gemcitabine infusion in combination with docetaxel in patients with relapsed/refractory soft tissue sarcoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of fixed dose rate (FDR) gemcitabine infusion in combination with docetaxel in patients with relapsed/refractory soft tissue sarcoma.</p><p><b>METHODS</b>Clinicopathological data of 28 patients with relapsed/refractory soft tissue sarcoma treated in our hospital from April 2008 to August 2013 were reviewed in this study. The patients received 900 mg/m² gemcitabine with a FDR infusion (10 mg/m²/min) in a total dose of 900 mg/m² on days 1 and 8, and 75 mg/m² docetaxel intravenously over 60 min on day 8 of a 21-day cycle. When irradiation was conducted before drug therapy, the dose of gemcitabine was reduced to 675 mg/m² on days 1 and 8. The clinicopathological characteristics, short-term response, long-term survival status and toxicity were analyzed retrospectively.</p><p><b>RESULTS</b>The 28 patients received a total of 118 cycles of therapy (range 1-8 cycles, median 4 cycles per patient). No patient achieved complete response (CR), 4 partial responses (PR) and 11 stable diseases (SD), with an overall response rate (ORR) of 14.3% and clinical benefit rate (CBR) of 53.6%. The median progression-free survival (PFS) was 3.2 months and the median overall survival (OS) was 8.5 months. PFS and OS were correlated with the response to this treatment regimen (P < 0.0001). Patients with clinical benefit had significantly better PFS and OS than the patients with progressive disease (P < 0.05 for all). The ORR, CBR, PFS and OS were better in patients with leiomyosarcoma than in patients with other histological subtypes in this study, but the differences were not significant (P > 0.05 for all). Grade 3-4 neutropenia, anemia and thrombocytopenia were 50.0%, 17.9% and 14.3%, respectively. Only one patient (3.6%) had febrile neutropenia. Grade 3 non-hematologic toxicities were nausea/vomiting (3.6%) and mucositis (3.6%). No grade 4 non-hematologic toxicities were observed. Almost all non-hematologic toxicities were grade 1-2 and manageable.</p><p><b>CONCLUSIONS</b>The fixed dose rate (FDR) gemcitabine infusion in combination with docetaxel is an effective treatment regimen for patients with relapsed/refractory soft tissue sarcoma, and with tolerable adverse reactions.</p>

Prognostic significance of p53 mutation protein in patients with diffuse large B-cell lymphoma / 白血病·淋巴瘤

Objective To explore the prognostic significance of p53 mutation protein in patients with diffuse large B-cell lymphoma for the purpose of individualized therapy. Methods Newly diagnosed 62 cases were randomly chosen from our hospital, p53 mutation protein and CD10, bcl-6, MUM1 were tested by immunohistochemistry. Correlation of p53 mutation protein with patients ' characteristics, genotype and survival were analysed in the study. Results p53 mutation protein was found in 48.4 % (30/62) of patients.Its expression was only related to initial treatment response (x2 =20.365, P =0.040), including complete remission rate of 33.3 % (10/30) in positive group and 59.4 % (19/32) in negative group, and non-germinal center genotype (x2=31.023, P =0.021) with 83.3 % in positive group and 56.2 % in negative group. No other correlation was not verified with clinical features. Multivariate survival analysis showed that p53 mutation protein was an independent predictor for shorter progress-free and overall survival in positive group (x2 =30.784, P =0.005 and x2 =35.276, P =0.006). Conclusion p53 mutation protein should be an independent predictor with poor prognosis and to direct personalized therapy.

Survival predictive factors in completely resected high-risk Ⅱ/Ⅲ stage colorectal cancer after adjuvant chemotherapy / 肿瘤研究与临床

Objective To analyze predictive factors on survival in patients with completely resected high-risk Ⅱ/Ⅲ stage colorectal cancer after adjuvant chemotherapy.Methods According to random number table, 76 cases with completely resected high-risk Ⅱ/Ⅲ stage colorectal cancer after adjuvant chemotherapy were selected, who newly diagnosed and hospitalized in 2004. Their disease-free and overall survivals were followed up.Thymidylate synthase gene polymorphism and microsatellite instability were tested in these cases with microdissection combined with polymerase chain reaction and capillary electrophoresis. Correlation of these factors including clinical characteristics, thymidylate synthase gene polymorphism and microsatellite instability to survival was analyzed with SPSS13.0 software. Results Histologic grades and evaluated lymph node number had significantly difference between two groups of distinct prognosis (χ2 = 7.827, P =0.003 and χ2 = 9.265, P =0.018, respectively), which were also independent predictors on survival proved by COX regression analysis (χ2 = 40.472, P =0.000 and χ2 = 39.528, P =0.000, respectively).Kaplan-Meier survival analysis showed that the median disease-free and overall survival of poor-differentiated adenocarcinoma patients were significantly shorter than those of high and intermediate-differentiated ones (27.67 vs 61.13months, χ2 = 45.015, P =0.000 and 43.13 vs 64.21 months, χ2 = 35.514, P =0.000, respectively), as well, the median disease-free and overall survival of patients with the evaluated lymph node number less than 11 were poorer than those of more than 11 ( 45.65 vs 68.47 months, χ2 = 23.134, P =0.011 and 53.10 vs 70.18months, χ2 = 22.896, P =0.013, respectively).Conclusion Poor-differentiated adenocarcinoma and evaluated lymph node number less than 11 may be predictors on poor survival in patients with completely resected highrisk Ⅱ/Ⅲ stage colorectal cancer after adjuvant chemotherapy.

Expression of PTEN protein and clinical significance in diffuse large B lymphomas / 白血病·淋巴瘤

Objective To study PTEN protein expression and clinical significance in patients with diffuse large B cell lymphoma. Methods Immunohistochemical staining was used to determine the PTEN protein expression in 40 cases of primary diffuse large B lymphoma tissuse. The results were analyzed by Kaplan-Merie survival analysis, Log-Rank test and Logistic regression analysis. Results PTEN protein was positive in 16 cases and negative in 24 cases. There was no significant difference between two groups in twoyear overall survival rate(62.5 % vs 66.7 %, P >0.05). Survival analysis showed that patient' s survival time gradually were reduced with extended time between PTEN protein-positive group and negative group, lower in PTEN-positive group than the negative group, but there was no significant difference in survival curve (P >0.05) in the two groups. We compared characteristics of patients between PTEN protein positive and negative groups,including molecular type, patient' s age, stage, LDH, physical score and extranodular invasion, there was no significant difference among them. PTEN protein was not correlated with prognosis, while International Prognosis Index(IPI) was still a risk factor (OR >1). Conclusion PTEN protein expression may not predict the outcome in diffuse large B cell lymphoma, but IPI still is a predictor.

A clinical study of paraffin-embedded sediments section combined with routine smear in diagnosis of malignant tumor from hydrothorax and hydroperitoneum / 肿瘤研究与临床

Objective To evaluate the value of paraffin-embedded sediments section combined with routine smear in diagnosis of malignant tumor from hydrothorax and hydroperitoneum.Methods 150 cases of hydrothorax and hydroperitoneum were analyzed by using the methods of paraffin-embedded section and routine smear respectively.Results Among 150 cases with hydrothorax and hydroperitoneum,120 cases were certified malignancy by clinical source and other methods.The positive rate was 62.5% (75/120) by routine smear and 84.2% (101/120) by paraffin-embedded sediments section respectively,while the positive rate was 94.2% (113/120) by the combined examination of the two and the difference was significant compared with routine smear and paraffin-embedded sediments section respectively. At the same time, It is easier for us to distinguish adenocarcinoma cell from mesothelial cell by means of detecting the expression of CEA,CK,CAL and VIM immunohistochemically.Conclusion The combined examination of the two methods along with immunohistochemistry can increase diagnosis rate significantly and worth of being generalized.

Analysis of clinical data and prognosis for 24 patients with primary parotid malignant lymphoma / 白血病·淋巴瘤

Objective To discuss the clinical and pathological characteristics, treatment results and prognosis of primary parotid malignant lymphoma. Methods Pathological subtypes, clinical stages and treatment of the 24 patients with primary parotid malignant lymphoma were retrospectively analysed. Kaplan-Meier method was used in the survival analysis and Log-Rank method was used in the statistic study. Results The 5-year progression free survival (PFS) and overall survival (OS) were 79.2 % and 83.3 %, respectively. The 5-year PFS and OS were 89.5 % and 94.7 % for 19 patients with low-grade malignant lymphoma (including MALTL and Ⅰ/Ⅱ grade FL). The differences of the 5-year PFS and OS of 9 patients received chemotherapy and of 10 patients with on chemotherapy had no statistical significance. Conclusion The incidence of primary parotid malignant lymphoma is low, at earlier clinical stage, and most of its pathological subtype were B-cell low-grade malignant non-Hodgkin lymphoma. Surgery and/or radiotherapy should be the first choice for patients with early stage low-grade malignant lymphoma, whereas combined modality therapy was probably the best choice for patients with DLBCL.

Clinical observation of four-weekly pirarubicin combined with COP regimen in aggressive non-Hodgkin lymphoma patients with bone marrow involvement / 白血病·淋巴瘤

Objective To evaluate the clinic efficacy and adverse effects of four-weekly pirarubicin combined with COP (CTOP-28) regimen in aggressive non-Hodgkin lymphoma patients with bone marrow involvement. Methods 65 aggressive non-Hodgkin lymphoma cases with bone marrow involvement (BMI)from January 2002 to January 2007 were chosen, who were newly diagnosed according to 2001 World Health Organisition (WHO) classification. The response rate and adverse effects of CTOP-28 regimen were retrospectively compared with standard CHOP-21 regimen in these patients. CHOP-21 regimen:eyclophosphamide 750 mg/m2(day 1), vincristine 1.4 mg/m2 (maximum 2 rag, day 1), adrimycin 50 mg/m2 (day1), prednisene 100 nag (day 1 to 5). CTOP-28 regimen: cyclopbosphamide 750 mg/m2 (day 1, 15), vincristine 1.4 mg/m2 (maximum 2 rag, day 1,8,15,22), pirarubicin 25 mg/m2 (day 1,2 and 15,16), prednisone 40 mg/m2(day 1 to 28). Results The complete remission rate (CRR) in CHOP-21 group was less than in CTOP-28group (40 % vs 80 %, P＜0.05). The incidence of 3 and 4 degree blood toxicity in CTOP-28 was more than in CHOP-21 (100.0 % vs 50.0 %, P ＜0.05), but incidence of 1 and 2 degree cardic toxicity was similar as CHOP-21 (8.57 % vs 10.0 %, P＞0.05) and 3 and 4 degree cardic toxicity did not occurred in both groups.The gastrointestinal, hepatobiliary and renal toxicities at only 1 and 2 degree took place and no difference wasfound between two groups. No therapy-related mortality occurred in these patients. Conclusion CTOP-28regimen is more effective, safer for aggressive non-Hodgkin lymphoma patients with BMI as induction treatment.