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08 January 2016, Volume 43 Issue 1 Previous Issue    Next Issue

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Clinical study of onestage lymphatics-venous anastomosis to prevent upper extremity lymphedema of breast cancer after radical resection Shi Pengju, Zhao Gang, Cai Haifeng, Liu Huiren, Zhu Pengfei, Zhao Yanhui, Zhang Tieshan 2016, 43 (1):  1-4.  doi: 10.3760/cma.j.issn.1673-422X.2016.01.001 Abstract ( 455 )   PDF (776KB) ( 1528 )   Save Objective To investigate the value of onestage lymphaticsvenous anastomosis in radical mastectomy of breast cancer to prevent postmastectomy upper limb lymphedema. MethodsNinety patients requiring radical mastectomy of breast cancer in  Tangshan Tumor Hospital Affiliated to North China University of Science and Technology from March 2010 to May 2013 were collected as the objects. They were divided into the control group (45 cases) and the treatment group (45 cases) using block randomized grouping (concealment of allocation). Both groups underwent radical mastectomy of breast cancer, and the treatment group was treated with onestage lymphaticsvenous anastomosis on the basis of radical mastectomy. The operation times, amount of bleeding, hospitalization times, postoperative complications and the numbers of axillary lymph node dissection of the patients in the two groups were compared, and the postoperative upper limb lymphedema incidence rates of the patients in the two groups were compared. ResultsThe operative times of the patients in the treatment group and the control group were (152.82±18.76)min and (78.92±10.33)min respectively, and amount of bleeding were (416.64±94.65)ml and (250.84±63.17)ml, with statistical significances (t=-20.39, P=0.00; t=-4.48, P=0.00). The average hospitalization times of the patients in the treatment group and the control group were (14.91±5.44)d and (13.45±2.36)d respectively, the numbers of axillary lymph node dissection were 14.63±3.37 and 14.37±3.18, the numbers of postoperative complications occurred were 9 cases (20.00%) and 5 cases (11.11%), with no statistical significances (t=-0.47, P=0.64; t=0.75, P=0.46; χ2=1.35, P=0.38). Compared with the control group, the treatment group has lower incidence of upper extremity lymphedema (13.95% vs. 40.91%) and lower swelling degree, with statistical significance (χ2=8.48, P=0.03). ConclusionOnestage lymphaticsvenous anastomosis in radical mastectomy of breast cancer can effectively transfer lymph diversion to the venous circulation and reduce the incidence of limb lymphedema, which has significant preventive effect. References | Related Articles | Metrics

Expression and clinical significance of S100A11 in non-small cell lung cancer Chen Xiaoping, Pu Yong, Feng Jingjie, Hua Dong 2016, 43 (1):  5-7.  doi: 10.3760/cma.j.issn.1673-422X.2016.01.002 Abstract ( 418 )   PDF (972KB) ( 1234 )   Save Objective To investigate the expression of S100A11 protein in nonsmall cell lung cancer (NSCLC) and its association with clinical and pathological characteristics. MethodsThe expressions of S100A11 protein in 112 NSCLC tumor tissues (group A), tumoradjacent tissues (group B) and 10 normal lung tissues (group C) were detected by immunohistochemical SP method. The association of S100A11 expression with clinical pathological characteristics was analyzed. ResultsThe percentage of the cases with high expression cases of S100A11 protein was 78.6% (88/112), and the low expression rate was 21.4 % (24/112) in group A. The low expression rate of S100A11 protein was 100.0% (112/112) in group B. The negative expression rate of S100A11 protein was 100.0% (10/10) in group C. The difference of S100A11 expression among the three groups was statistically significant (χ2=153.634, P<0.001). The S100A11 expression was associated with pathological type (χ2=6.807, P=0.009), differentiated degree (χ2=5.029, P=0.025), regional lymph node metastasis (χ2=11.721, P=0.001) in NSCLC, but it was not associated with gender (χ2=0.020, P=0.888), age (χ2=0.816, P=0.366) and tumor size (χ2=0.406, P=0.524). ConclusionS100A11 is highly expressed in NSCLC, which is closely related with biological behavioral characteristics. S100A11 may participate in the occurrence and development of NSCLC, and it is expected to become the potential target of diagnosis and prognosis in patients with NSCLC. References | Related Articles | Metrics

Study on the difference of sunitinib and sorafenib as firstline treatment in advanced renal carcinoma Dai Xing, Ba Nan, Yan Lin 2016, 43 (1):  8-11.  doi: 10.3760/cma.j.issn.1673-422X.2016.01.003 Abstract ( 575 )   PDF (873KB) ( 1294 )   Save Objective To evaluate the efficacy and safety of sunitinib versus sorafenib in the firstline treatment of advanced renal cell carcinoma. MethodsFortytwo patients with advanced renal cell carcinoma were divided into two groups according to the therapeutic method. Twenty patients were treated with sunitinib (50 mg, oral administration, once a day, for 4 weeks, drug withdrawal of 2 weeks, 6 weeks was a cycle) and 22 patients were treated with sorafenib (400 mg, oral administration, twice a day, until the disease progression, 6 weeks was a cycle). The efficacy and toxicity were evaluated every 2cycle treatment. ResultsAll 42 patients could be evaluated. The disease remission rate (RR), disease control rate (DCR) of sunitinib group and sorafenib group were 30.0% (6/20), 22.7% (5/22), 90.0% (18/20), 77.3% (17/22) respectively, the median progression free survival (PFS) were 10.8, 6.2 months, the median overall survival (OS) were 25.6, 18.6 months respectively. There were no statistical differences in the RR (χ2=0.287, P=0.592) and DCR (χ2=1.222, P=0.269) between the two groups. There were statistical difference in the PFS (χ2=6.041, P=0.014) and OS (χ2=11.245, P=0.001) between the two groups. The most common toxicities of the sunitinib group were diarrhea, fatigue, oral mucositis, nausea, vomiting, all these toxicities were mainly Ⅰ-Ⅱ degree, and could be well tolerated. The handfoot syndrome rate of the sorafenib group obviously exceeded the sunitinib group (59.1% vs. 25.0%, χ2=4.972, P=0.026). ConclusionSunitinib has good efficacy in the firstline treatment of advanced renal cell carcinoma with less toxicity than sorafenib, so it is worthy of popularization. References | Related Articles | Metrics

Effect of palonosetron in prevention of chemotherapy induced vomiting Wang Xu, Tong Zhongsheng, Chen Jianhua, Zhuang Zhixiang, Chen Deyu, Zhang Xizhi, Tong Jiandong, Wu Changping, Yu Hao, Li Shufen, Shi Yehui 2016, 43 (1):  12-16.  doi: 10.3760/cma.j.issn.1673-422X.2016.01.004 Abstract ( 478 )   PDF (708KB) ( 1332 )   Save Objective To evaluate the efficacy and safety of palonosetron in prevention of chemotherapyinduced vomiting. MethodsUsing multicenter, randomized, doubleblind, selfcrossover controlled clinical trial design, 149 cancer patients received 2 cycles chemotherapy including cisplatin or anthracycline continuously. All the patients were divided into moderately emetogenic group (cisplatin≤50 mg/m2 or doxorubicin≥40 mg/m2 or pirarubicin≥40 mg/m2 or epirubicin≥60 mg/m2) and highly emetogenic group (cisplatin≥60 mg/m2). All the patients received palonosetron or granisetron before chemotherapy respectively. If patients received palonosetron in the first cycles, the control drug granisetron would be used in the second cycles and vice versa. The complete control rates of acute vomiting and delayed vomiting， as well as the adverse effects of these antiemetic drugs in the experiment group and control group were observed. ResultsThe complete control rate of acute vomiting between palonosetron cycles and granisetron cycles had no significant difference in moderately emetogenic group (50.72% vs. 48.00%, χ2＝0.153, P＝0.695) and highly emetogenic group (45.76% vs. 52.24%, χ2＝0.924, P＝0.337). In moderately emetogenic group, the complete control rate of delayed vomiting in palonosetron cycles was significantly higher than that in granisetron cycles (59.42% vs. 41.33%, χ2＝4.673, P＝0.031), while it had no significant difference in highly emetogenic group (37.29% vs. 28.36%, χ2＝0.956, P＝0.328). And in moderately emetogenic group, the frequency of vomiting in palonosetron cycles was significantly less than that in granisetron cycles during 24 hours to 5 days(Median 0.0 vs. Median 1.0, χ2=7.765, P＝0.005). The adverse effects in the two cycles had a lower incidence and a lesser degree similarly. ConclusionPalonosetron has a definite effect in prevention of acute and delayed chemotherapyinduced vomiting. Especially it is superior to granisetron for delayed vomiting. And it has lower adverse effects, so it is worth spreading in clinic. References | Related Articles | Metrics

Meta-analysis of the efficacies of laparoscopic intersphincteric resection and laparotomy for ultra low rectal cancer Zhen Ya′nan, Xiao Ruixue, Xu Huirong, Li Jianning, Shi Huiyong, Xu Zhongfa 2016, 43 (1):  17-22.  doi: 10.3760/cma.j.issn.1673-422X.2016.01.005 Abstract ( 354 )   PDF (2476KB) ( 1741 )   Save Objective  To compare the shortterm efficacies of laparoscopic intersphincteric resection (ISR) and laparotomy for ultralow rectal cancers by Meta-analysis. MethodsWe searched casecontrol trials that compared clinical outcomes of laparoscopic ISR and laparotomy from PubMed, EMBase, Ovid, CNKI and Wanfang database. Relevant published and unpublished data and conference papers were also retrieved. Two reviewers independently assessed the qualities of the included studies. Metaanalysis was performed by using of RevMan5.2 software. ResultsA total of 5 trials with 552 cases were included．The results of Metaanalysis showed that in terms of blood loss of the operation ［mean difference (MD)＝-65.42, 95%CI: -93.45-37.38, Z＝4.57, P<0.000 01］, flatus passage time (MD＝-0.96, 95%CI: -1.45-0.47, Z＝3.83, P＝0.000 1) and hospital stays (MD＝-1.69, 95%CI: -2.19-1.19, Z＝6.63, P<0.000 01), laparoscopic ISR were significantly superior than those of laparotomy, with significant differences. In terms of operation time (MD＝6.61, 95%CI: -21.2934.51, Z＝0.46, P＝0.64), the positive rate of circumferential resection margin (OR＝1.01, 95%CI: 0.372.80, Z＝0.02, P＝0.98) and postoperative morbidity (OR＝0.73, 95%CI: 0.451.20, Z＝1.23, P＝0.22), there were no significant differences in the two groups. However, laparotomy may clean more numbers of lymph nodes than those of laparoscopic ISR (MD＝-1.16, 95%CI: -2.14-0.18, Z＝2.31, P＝0.02), with significant difference. ConclusionThe shortterm efficacy of laparoscopic ISR is superior than that of laparotomy in the treatment of ultralow rectal cancer. References | Related Articles | Metrics

Ring finger protein 43 gene and cancer Wang Shixiong, Li Yaoping 2016, 43 (1):  23-25.  doi: 10.3760/cma.j.issn.1673-422X.2016.01.006 Abstract ( 408 )   PDF (692KB) ( 1359 )   Save Ring finger protein 43 (RNF43) gene is closely associated with the development of various types of human tumors. The mainly mechanisms of RNF43 gene are mutation and aberrant expression. Activated RNF43 protein participates in the proliferation, apoptosis, metastasis through some signal pathways and influences the tumorigenesis and development in colorectal cancer, hepatocellular carcinoma, which plays a role of oncogene. However, it is considered as a tumor suppressor gene in mucinous ovarian tumors and intraductal papillary mucinous neoplasms of the pancreas. References | Related Articles | Metrics

Roles of MTH1 gene in the occurrence and treatment of cancers Guan Xuwen, Huang Dingzhi 2016, 43 (1):  26-28.  doi: 10.3760/cma.j.issn.1673-422X.2016.01.007 Abstract ( 435 )   PDF (689KB) ( 1688 )   Save MTH1 protein can mitigate DNA damage which caused by reactive oxygen species through hydrolyzing oxidized deoxyribonucleoside triphosphate. MTH1 is highly expressed in various cancers, so as to maintain the viability of cancer cells. MTH1 is closely related to tumor associated genes such as microRNA, RAS gene and p53 gene. Moreover, MTH1 inhibitors can selectively suppress the proliferation of cancers, which is a potential new target in tumor therapy. References | Related Articles | Metrics

Research progress of long non-coding RNA UCA1 in tumor Shi Youyang, Qian Yayun 2016, 43 (1):  29-31.  doi: 10.3760/cma.j.issn.1673-422X.2016.01.008 Abstract ( 337 )   PDF (690KB) ( 1536 )   Save As a proto-oncogene, urothelial carcinoma antigen 1 (UCA1) is highly expressed in many human tumors such as bladder cancer, gastric cancer, breast cancer, ovarian cancer and brain glioma, which shows important application value in the diagnosis, treatment and prognosis of tumor. Studies show that UCA1 can promote tumor cell proliferation through multiple signaling pathways and molecular mechanisms, which may become a new potential target for the diagnosis and treatment of tumor. References | Related Articles | Metrics

Metastasis-associated in colon cancer 1 and its role in cancer Guo Hongyan, He Lizhen, Zhang Yunfei, Zhang Hong, Jin Huiqin, An Wenwen 2016, 43 (1):  32-35.  doi: 10.3760/cma.j.issn.1673-422X.2016.01.009 Abstract ( 544 )   PDF (700KB) ( 1376 )   Save The protein product of metastasis-associated in colon cancer 1 (MACC1) gene induces the activation of hepatocyte growth factor/mesenchymalepithelial transition factor (HGF/c-Met) signaling pathway through transcriptionally activating cMet gene and upregulating its expression to further promote tumor invasion and metastasis. High level expression of MACC1 is associated with the occurrence and metastasis of a wide variety of human tumors, such as colon cancer, gastric cancer, liver cancer, lung cancer, ovarian cancer etc. In addition, the overexpression of MACC1 is also closely associated with clinical TNM stages and distant metastasis. Thus, MACC1 can serve as an independent indicator of tumor metastasis and prognosis, and become a new target for gene therapy. References | Related Articles | Metrics

Relationship between epithelial mesenchymal transition and tumor stem cells Chen Shaohua, Qian Jun 2016, 43 (1):  36-38.  doi: 10.3760/cma.j.issn.1673-422X.2016.01.010 Abstract ( 413 )   PDF (692KB) ( 1750 )   Save At present, more and more studies show that epithelialmesenchymal transition (EMT) is closely associated with cancer stem cell formation and tumor cell invasion, migration and metastasis. EMT not only enhances the capacity of cancer cell invasion and metastasis, but also makes the cell obtain self regeneration and other stem cell characteristics and promotes the production of cancer stem cells. As a result, the investigation of the relationship between EMT and common stem cells can be served as a new approach for searching for effective ways to control tumor invasion and metastasis. It also can provide new targets for the treatment of tumor. References | Related Articles | Metrics

Treatment of papillary thyroid microcarcinoma Sun Xiaoliang, Lu Yao, Yang Meng, Huang Linping 2016, 43 (1):  39-41.  doi: 10.3760/cma.j.issn.1673-422X.2016.01.011 Abstract ( 430 )   PDF (689KB) ( 2158 )   Save The recent development and wide application of ultrasonography and ultrasonographyguided fine needle aspiration biopsy have greatly facilitated the detection of papillary thyroid microcarcinoma (PTMC). Currently, the occurrence, development and pathological features of PTMC are not clearly understood. Therefore, no consensus on the diagnosis and treatment has been reached. Patients with PTMC are suggested to be closely observed and periodically examined with ultrasonography in some countries such as Japan, and these patients are to be operated when the tumor enlarged or new lymphatic metastasis are found. Operation is the first choice in the European and American countries, and the longterm survival rates of these patients are nearly 100%. For the PTMC patients with the risk factors such as thyroid capsule invasion, lymphatic metastasis, multifocal lesion, higher degree of malignancy, thyroid stimulating hormone suppression therapy was given after operation, which may reduce the local recurrence rate. In China, we should hold well the "limitation" and choose the best way for different patients according to the personalized principle in clinical practice. References | Related Articles | Metrics

High risk factors related to central lymph node metastasis in papillary thyroid microcarcinoma Li Yao, Wang Shengying 2016, 43 (1):  42-44.  doi: 10.3760/cma.j.issn.1673-422X.2016.01.012 Abstract ( 623 )   PDF (691KB) ( 1320 )   Save In recent years, a large number of studies have found that central lymph node metastasis of the papillary thyroid microcarcinoma (PTMC) is significantly related with some risk factors. These high risk factors include age below 45 years old, BRAF gene mutation, vascular epithelial growth factorC high expression, tumor diameter≥5 mm, multifocal and bilateral tumor, thyroid capsule invasion and so on. These high risk factors involve in disease process, and interact with each other. The studies of the high risk factors can help us to predict the risk of central lymph node metastasis in the patients with PTMC, thus to effectively guide the patients′ treatment. References | Related Articles | Metrics

Molecular targeted therapy for non-small cell lung cancer and drug resistance Zhang Yu, Zhou Jianguo, Ma Hu 2016, 43 (1):  45-48.  doi: 10.3760/cma.j.issn.1673-422X.2016.01.013 Abstract ( 286 )   PDF (699KB) ( 2028 )   Save Gefitinib and erlotinib play important roles, which as the representative of the epidermal growth factor receptor tyrosine kinase inhibitors for non-small cell lung cancer (NSCLC). However, preclinical and clinical studies find that many patients exist primary or acquired drug resistance to this drug, which limits the use of molecular targeted therapy drugs. At present, there are many studies focus on delaying or reversing drug resistance and developing new targets, which provide more potential for the molecular targeted therapy of NSCLC. References | Related Articles | Metrics

Radical concurrent chemoradiotherapy for esophageal carcinoma Liu Yongxuan, Feng Xiaoshan 2016, 43 (1):  49-52.  doi: 10.3760/cma.j.issn.1673-422X.2016.01.014 Abstract ( 1150 )   PDF (700KB) ( 1584 )   Save In National Comprehensive Cancer Network guideline, patients with the clinical stages of ⅠBⅢA esophageal neoplasms should be given radical PF regimen (cisplatin + 5fluorouracil) concurrent chemoradiotherapy. The majorization PF and radiation dosage are studied by some scholars in China and abroad, and the local control rate and survival rate are improved, adverse reaction is within a controllable range. In recent years, some new drugs such as capecitabine, paclitaxel, docetaxel, pemetrexed and carboplatin also show their advantages in radical concurrent chemoradiotherapy. References | Related Articles | Metrics

Research progress of neoadjuvant therapy in adenocarcinoma of the esophagogastric junction Fan Sunfu, Wang Xinbao 2016, 43 (1):  53-55.  doi: 10.3760/cma.j.issn.1673,422X.2016.01.015 Abstract ( 366 )   PDF (693KB) ( 1257 )   Save Surgery alone for the adenocarcinoma of the esophagogastric junction (AEG) often gives unsatisfactory results, with a poor prognosis. At present, there is no unified therapeutic regimen specifically for AEG. Neoadjuvant therapy includes neoadjuvant radiotherapy, chemotherapy and chemoradiotherapy, but the applications and effects of them for AEG are still controversial. References | Related Articles | Metrics

Ring finger protein 43 gene and its function in digestive system cancer Qiu Wangwang, Yang Zhili, Zheng Qi 2016, 43 (1):  56-59.  doi: 10.3760/cma.j.issn.1673-422X.2016.01.016 Abstract ( 344 )   PDF (698KB) ( 1649 )   Save Ring finger protein 43 (RNF43) is a ringtype E3 ubiquitin ligase. As a negative regulater of Wnt signaling pathway, RNF43 has an important antitumor effect. The mutation of RNF43 may cause abnormal activation of Wnt signaling pathway, and then promote invasion, metastasis and proliferation of tumor cell. In addition, the act of RNF43 protein in the Wnt signal pathway is expected to be a molecular target in the therapy of cancer. In recent years, with the gradual deepening of related research, the molecular structure of RNF43 protein and its mechanism of action with the Wnt pathwayrelated proteins have been gradually clear. In clinical, RNF43 protein analogs and related vaccine also show the important position in the therapy of cancer. References | Related Articles | Metrics

Treatment progress of intrahepatic cholangiocarcinoma Luo Mengchao, Ding Chaofeng, Wu Jian, Zheng Shusen 2016, 43 (1):  60-63.  doi: 10.3760/cma.j.issn.1673,422X.2016.01.017 Abstract ( 468 )   PDF (698KB) ( 2338 )   Save Surgical resection is still the mainstay for treatment of intrahepatic cholangiocarcinoma (ICC). Gemcitabine and cisplatin is a systemic therapy practice standard for patients with nonresectable ICC. Neoadjuvant therapy with liver transplantation may be a new therapeutic option for patients with ICC. In addition, radiotherapy, hepatic intraarterial therapy, ablation therapy and molecular targeted therapy are important components of comprehensive therapy for ICC. References | Related Articles | Metrics

The role of Hedgehog pathway in colorectal cancer Bi Yanzhen, Kong Lingbin 2016, 43 (1):  64-66.  doi: 10.3760/cma.j.issn.1673,422X.2016.01.018 Abstract ( 327 )   PDF (695KB) ( 1267 )   Save Hedgehog (Hh) signaling pathway is closely associated with the development of various types of human tumors. Recent studies have reported that Hh pathway plays an important role in oncogenesis, metastasis and therapy of colorectal neoplasms. Currently, Hh signals have been detected highly expressed in colorectal cancer tissues and cells. Inhibition of this pathway can deeply restrain the invasion and metastasis of colorectal cancer cells. And it has become a hot topic that Hh pathway is used as a target in the treatment of colorectal cancer. References | Related Articles | Metrics

Research progress of resveratrol on the prevention and treatment of colorectal cancer Xu Jiahui, Liu Deying, Xu Zhijun, Ma Wenxia, Zhang Qingling 2016, 43 (1):  67-70.  doi: 10.3760/cma.j.issn.1673-422X.2016.01.019 Abstract ( 688 )   PDF (702KB) ( 1437 )   Save Recent studies show that resveratrol is characterized with its antioxidative and antiinflammatory effects, and plays an important role in the prevention and treatment of colorectal cancer through modulating intracellular carbohydrate and ceramide metabolism, activating tumor suppressors such as activator of transcription 3 and peroxisome proliferatorsactivated receptor γ, downregulating the expression of kirsten rat sarcoma viral oncogene and inhibiting the epithelialtomesenchymal transition process of cancer cells. In addition, resveratrol exhibits its broad application prospects in combination therapy. References | Related Articles | Metrics

Treatment of primary central nervous system lymphoma Li Xiaoyou, Feng Jifeng 2016, 43 (1):  71-74.  doi: 10.3760/cma.j.issn.1673-422X.2016.01.020 Abstract ( 479 )   PDF (702KB) ( 1296 )   Save As a kind of rare central nervous system malignant tumor, primary central nervous system lymphoma (PCNSL) has poor prognosis, and the main treatment include surgery, radiotherapy and chemotherapy. Stereotactic biopsy has become a routine diagnostic method of PCNSL, because of which has the advantage of minimally invasive and convenient. Whole brain radiotherapy is a standardized treatment method for the multifocal PCNSL, which can delay the progress of tumor in a short term. The therapeutic regimen based on high dose methotrexate leads to significant changes in the PCNSL treatment and it has become an effective treatment measure. Effective comprehensive treatment is the key to extending survival time and improving the quality of life for the patients with PCNSL. References | Related Articles | Metrics

Application of big medical data in cancer diagnosis and treatment Zhou Yinjie, Xiang Mingfei, Li Tao 2016, 43 (1):  75-78.  doi: 10.3760/cma.j.issn.1673-422X.2016.01.021 Abstract ( 362 )   PDF (697KB) ( 2361 )   Save With the extensive use of information technology and the development of big data technology, the traditional treatment methods for cancer are not meeting our needs. The application of medical large data has now changed our tumor treatment model profoundly, but also brings a deeply cognition to the nature of malignant tumor. Development of medical big data analysis and management technologies are driving malignancy treatment model from "individual treatment" era into the "precision medicine" era, which allows us to change the prediction, diagnosis, treatment and monitor of malignancy. There are also a variety of challenges to resolve. References | Related Articles | Metrics