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08 April 2018, Volume 45 Issue 4 Previous Issue    Next Issue

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Expression level and clinical significance of serum syndecan-1 in oral tongue squamous cell carcinoma patients Hao Rui, Liang Yan 2018, 45 (4):  193-196.  doi: 10.3760/cma.j.issn.1673-422X.2018.04.001 Abstract ( 463 )   PDF (1012KB) ( 881 )   Save ObjectiveTo detect the level of serum syndecan-1 in patients with oral tongue squamous cell carcinoma (OTSCC), and to investigate the effect of serum syndecan-1 in OTSCC diagnosis and disease progression assessment. MethodsThe serums of a total of 65 OTSCC patients (OTSCC group) and 74 healthy subjects (control group) were collected from March 2015 to June 2017 in the Fourth Hospital of Xi′an. Enzyme linked immunosorbent assay was used to detect the level of serum syndecan-1. Receiver operating characteristic (ROC) curve was conducted to evaluate the diagnostic value of serum syndecan-1 in OTSCC and its disease progression. ResultsThe level of serum syndecan1 in OTSCC group was significantly lower than that in the control group ［(91.87±33.18)ng/ml vs. (162.32±51.16)ng/ml, t=1.977, P=0.002］. The serum syndecan-1 levels of different TNM stage (F=3.536, P=0.025), tumor invasive depth (F=1.254, P=0.039) and lymph node metastasis (t=2.420, P=0.018) in OTSCC group had statistically significances. ROC curve analysis showed that 95.54 ng/ml serum syndecan-1 ［area under the curve (AUC)=0.944, P＜0.001, 95%CI: 0.915-0.974］ was the cutoff value of OTSCC diagnosis, and 74.54 ng/ml of lymph node metastasis in OTSCC diagnosis (AUC=0.783, P＜0.001, 95%CI: 0.697-0.867). ConclusionSerum syndecan-1 level is markedly decreased in patients with OTSCC, and is valuable to diagnose OTSCC or its lymph node metastasis, which is worthy of clinical application. Related Articles | Metrics

Application of pathological three-dimensional reconstruction in margins assessment and radiotherapy adjustment of breast-conserving surgery Qiu Heng, Zhang Aiping, Zhang Zhaopeng, Liu Yanbing, Wang Chunjian, Bi Zhao, Xu Chengjun, Wang Yongsheng. 2018, 45 (4):  197-201.  doi: 10.3760/cma.j.issn.1673-422X.2018.04.002 Abstract ( 627 )   PDF (942KB) ( 933 )   Save Objective To reconstruct the original three-dimensional conformation of tumor resection tissue through the study of breast-conserving surgery  excision specimens for part-mount sub-serial section  and pathological three-dimensional (3D) reconstruction, to establish a new margin assessment model, and to guide tumor bed delineation individually for radiotherapy. Methods From February 2016 to February 2017， thirty-three eligible breast cancer patients underwent breast-conserving surgery in Breast Cancer Center of Shandong Cancer Hospital were recruited. The excision specimens were prepared with part-mount sub-serial section, and residual tumors were microscopically outlined, scanned and registered by Photoshop software. The 3D model of residual tumors was reconstructed with 3DDOCTOR software to evaluate margin status and record pathological type, tumor length and 3D negative margin distance. The gross tumor volume (GTV) was delineated based on clips placed in the lumpectomy cavity. CTV1 and CTV2 were defined by adding uniform 1.00 cm and 1.50 cm margin based on GTV respectively. CTV3 and CTV4 were defined by adding 1.00 cm and 1.50 cm margin based on 3D boundary of excision tumor respectively, and compared the volume differences of CTV1 and CTV3, CTV2 and CTV4. Results Based on the marginal assessment results of 3D pathological reconstruction, the rates of false negatives during the intraoperative rapid pathological examination and postoperative routine pathological margin evaluation were 6.7% (2/30) and 3.4% (1/29) respectively. The pathological type of pathological large slice and routine pathological examination was consistent with rate of 93.9%（31/33). The M(QR) tumor lengths of routine pathological and pathological 3D reconstruction were 1.90 (1.502.40)cm and 2.00 (1.602.70)cm respectively, with statistical difference between the two groups (Z=-2.438,P=0.015). The M(QR) volumes for CTV1, CTV2, CTV3, CTV4 were 70.76 (49.8478.07)cm3, 110.11 (83.38126.17）cm3, 23.85 (16.4631.49）cm3 and 38.74 (30.4750.58）cm3 respectively. There were statistical differences between CTV1 and CTV3, CTV2 and CTV4 （Z=-4.372, P<0.001; Z=-4.372, P<0.001）. Conclusion The application of pathological 3D reconstruction technology can largely compensate for the shortcomings of the traditional margin assessment model, make the decisions of adjuvant treatment after breastconserving surgery  more accurate, and guide the tumor bed delineation individually for radiotherapy. Related Articles | Metrics

Curative effects of icotinib combined with radiotherapy in non-small cell lung cancer with brain metastasis Hao Zhiqiang, Yu Dedong, Yang Haixiang, Zhang Runping, Zhu Wei 2018, 45 (4):  202-205.  doi: 10.3760/cma.j.issn.1673-422X.2018.04.003 Abstract ( 495 )   PDF (977KB) ( 779 )   Save Objective To study the clinical efficacy and safety of icotinib hydrochloride tablets combined with whole brain radiotherapy (WBRT) in non-small cell lung cancer (NSCLC) brain metastasis. Methods Fifty-three  patients with NSCLC brain metastasis who were unable to tolerate chemotherapy or che-motherapy failed were selected in Baotou Central Hospital from October 2010 to April 2015. The patients were divided into the observation group (n=27) and the control group (n=26) using random number table method. Two patients were dropped out, one in the control group and one in the observation group. The patients in the control group were given WBRT (30 Gy/15 Fx). On this basis, the patients in the observation group were given icotinib hydrochloride tablets 125 mg, 3 times a day. The patients were followed up for 18 months after the end of WBRT. The adverse reactions, clinical efficacy and the median survival times of the two groups were compared. Results The objective response rate of the observation group was 88.5%,  which was higher than that of the control group (64.0%), and the difference was statistically significant (χ2=4.238, P=0.040). The incidence rates of skin rash and liver function damage in the observation group were 76.9% and 15.4%, which were higher than those in the control group (0, χ2=31.638, P＜0.001; χ2=4.173, P=0.041). However, most of them were degree Ⅰ-Ⅱ, and they were tolerable. There were no significant differences in the incidence of myelosuppression and gastrointestinal reactions between the two groups (26.9% vs. 20.0%, χ2=0.339, P=0.560; 34.6% vs. 28.0%, χ2=0.259, P=0.611). The median survival time in the observation group (9.0 months) was longer than that in the control group (7.0 months). The one year survival rate of the observation group was 33.3%, which was higher than that of the control group (23.1%), but the difference was not significant (χ2=0.676, P=0.411). Conclusion Icotinib hydrochloride tablets combined with WBRT in the treatment of brain metastasis with NSCLC can significantly improve the curative effects of brain metastasis, and it has a survival advantage, with tolerable adverse reactions. Related Articles | Metrics

Study on the correlation between thymidylate synthase expression level and postoperative chemotherapy in gastric cancer Liu Chuanchao, Zhao Yong. 2018, 45 (4):  206-209.  doi: 10.3760/cma.j.issn.1673-422X.2018.04.004 Abstract ( 464 )   PDF (1157KB) ( 698 )   Save Objective To investigate the expression of thymidylate synthase (TS), and the correlations with the clinicopathologcal factors and the prognosis of postoperative fluorouracil chemotherapy in gastric cancer. Methods 42 patients with gastric cancer who underwent radical gastrectomy were collected from April 2011 to April 2014 in Lu′an Hospital of Anhui Medical University, and the chemotherapy regimen was Cisplatin+Capecitabine or Cisplatin+Teggio. The levels of TS in tumor tissues of 42 patients with gastric cancer were detected by immunohistochemical method. The relationships between TS expression level, clinical features and the prognosis of patients treated with fluorouracil chemotherapy were analyzed. Results In 42 patients with gastric cancer, 19 patients (45.2%) have TS high expressions, 23 patients (54.8%) have TS low expressions. There were no significant correlations between the expression of TS and age, sex, clinical stage, differentiation degree, tumor location, depth of invasion, lymph node metastasis, vascular tumor thrombus and nerve bundle invasion (all P＞0.05). There were significant differences between low TS expression and high TS expression in median progression-free survival and 3-year survival rate of patients ［35 months vs. 17 months, 73.9% (17/23) vs. 42.1% (8/19)］, and the differences were statistically significant (χ2=4.788, P=0.029; χ2=4.369, P=0.037). In patients with stage Ⅲ gastric cancer, the median progressionfree survival of patients with low TS expression was significantly prolonged compared to that with high TS expression (33 months vs. 9 months), and the difference was statistically significant (χ2=4.731, P=0.030). Conclusion TS expression levels have no significant correlations with the clinicopathologcal factors, but closely relate to the prognosis of gastric cancer patients treatment with fluorouracil chemotherapy. The chemotherapy prognosis of TS high expression   is worse than that of TS low expression in gastric cancer. Related Articles | Metrics

Analysis of risk factors for postoperative duodenal stump fistula in elderly patients with gastric cancer Xiao Baoqiang, Zhou Yang, Sun Xinzeng 2018, 45 (4):  210-213.  doi: 10.3760/cma.j.issn.1673-422X.2018.04.005 Abstract ( 501 )   PDF (858KB) ( 920 )   Save Objective To investigate the risk factors for the occurrence of duodenal stump fistula in elderly patients with gastric cancer after radical resection. Methods From June 1996 to June 2016, the clinical data of 560 patients underwent radical operation for gastric cancer in elderly patients (age ≥60) in the Fifth People′s Hospital of Zhangjiagang of Jiangsu Province and 254 Hospital of PLA were collected. They were divided into occurred group (n=30) and without occurred group (n=530) according to whether duodenal stump fistula occurred or not. The effects of operative factors and nonoperative factors on duodenal fistula were analyzed. Nonoperative factors included gender, preoperative hemoglobin, preoperative serum albumin level, basic diseases (hypertension, diabetes, chronic obstructive pulmonary disease, heart disease, liver cirrhosis) and tumor staging; operative factors included operation time, intraoperative blood loss, surgical approach, reconstruction of digestive tract and duodenal stump embedding, etc. Results Single factor analysis showed that the preoperative serum albumin level (t=-5.035, P<0.001), preoperative hemoglobin (t=-0.567, P=0.048) and combined liver cirrhosis (χ2=14.093, P<0.001) of nonoperative factors were associated with the occurrence of duodenal stump fistula after surgery; reconstruction of digestive tract (χ2=5.427, P=0.019), and duodenal stump embedding (χ2=13.378, P<0.001) of operative factors were associated with the occurrence of duodenal stump fistula after surgery. Multivariate logstic analysis of regression showed that preoperative serum albumin level (OR=5.214, 95%CI: 2.23012.172, P=0.032), combined liver cirrhosis (OR=4.885, 95%CI: 3.8056.259, P=0.021), and reconstruction of digestive tract (OR=3.779, 95%CI: 2.1486.617, P<0.001) were independent risk factors affecting the occurrence of duodenal stump fistula after surgery. Conclusion Preoperative albumin level, combined liver cirrhosis and reconstruction of digestive tract are the main risk factors for postoperative duodenal stump fistula in elderly patients with gastric cancer. Related Articles | Metrics

Expression and clinical significance of immunoglobulin-like transcript 3 in colorectal cancer Lu Chunxiao, Liu Jie, Liu Chuanyong 2018, 45 (4):  214-219.  doi: 10.3760/cma.j.issn.1673-422X.2018.04.006 Abstract ( 557 )   PDF (1764KB) ( 778 )   Save Objective To investigate the expression of immunoglobulin-like transcript 3 (ILT3) in colorectal cancer tissues and colorectal cancer cell lines, and the correlations with the clinicopathological factors and prognosis, and to reveal the clinical significance of ILT3 abnormal expression in colorectal cancer. Methods The mRNA and protein expressions of ILT3 in colorectal cancer cell lines SW480, SW620, HT-29 and human normal intestinal epithelial cell line FHC were detected by real-time fluorescence quantitative PCR and Western blotting, and the differences were analyzed. Immunohistochemistry was used to detect the expressions of ILT3 in 85 colorectal cancer tissues and 30 adjacent normal tissues. The correlations between the expression of ILT3 and clinicopathological factors and prognosis were analyzed. Results The relative expressions of ILT3 mRNA in cancer cell lines SW480, SW620, HT-29 and the normal intestinal epithelial cells line FHC were 10.813±3.289, 4.391±0.622, 1.481±0.055 and 1.000±0.000 respectively, with a significant difference (F=21.846, P<0.001). Compared with the normal intestinal epithelial cell line FHC, the relative expressions of ILT3 mRNA in cancer cell lines SW480 and SW620 were significantly higher, with a statistically significant difference (P<0.001, P=0.038), and the relative expression of ILT3 mRNA in cancer cell HT-29 was higher, but the difference has no statistical significance (P=0.734). The relative expressions of ILT3 protein in cancer cell lines SW480, SW620, HT-29 and normal intestinal epithelial cells line FHC were 1.838±0.651, 1.763±0.222, 1.449±0.200 and 0.628±0.263 respectively, with a statistically significant difference (F=6.320, P=0.017). Compared with the normal intestinal epithelial cell line FHC, the relative expressions of ILT3 protein in cancer cell lines SW480, SW620, HT-29 were significantly higher, with a statistically significant difference(P=0.005, P=0.007, P=0.030). ILT3 was mainly expressed in the membrane and (or) cytoplasm. In 85 cases of colorectal cancer tissues, 55 cases (64.7%) have ILT3 high expressions, which were significantly higher than those in the adjacent normal tissues (16.7%, 5/30), with a significant difference (χ2=20.508, P<0.001). The high expression of ILT3 was related to lymph node metastasis (χ2=4.684, P=0.030) and TNM staging (χ2=4.684, P=0.030), but it was not related to age (χ2=0.927, P=0.336), gender (χ2=0.078, P=0.780), tumor location (χ2=0.249, P=0.618), tumor size (χ2=1.813, P=0.178) and tumor differentiation (χ2=0.807, P=0.369). The median overall survival of patients with high ILT3 expression was significantly shorter than that of patients with low ILT3 expression (45.0 months vs. 74.0 months), with a significant difference (χ2＝17.907, P<0.001). Conclusion The expressions of ILT3 in colorectal cancer cells are higher than those in the normal intestinal epithelial cell line, the expressions of ILT3 in colorectal tissues are higher than those in the adjacent normal tissues, which are correlated with lymph node metastasis and TNM staging. Patients with high expressions of ILT3 indicate poor clinical prognosis. The expression of ILT3 may serves as a new target for diagnosis, treatment and prognosis of colorectal cancer. Related Articles | Metrics

Mechanisms of long non-coding RNAs in tumors Li Zhi, Xu Jingkai, Zhang Bo 2018, 45 (4):  220-222.  doi: 10.3760/cma.j.issn.1673-422X.2018.04.007 Abstract ( 418 )   PDF (795KB) ( 856 )   Save Long noncoding RNAs (lncRNAs) can promote or inhibit the occurrence and development of pancreatic cancer, lung cancer, gastric cancer and breast cancer by regulating the expression of protein, signal pathway and cell cycle in different ways. Further studies of mechanisms of different lncRNAs in tumors may provide new methods for the diagnosis and treatment of cancers. Related Articles | Metrics

Role of long non-coding RNA in tumor drug resistance development Zhou Tong, Jia Yanhong, Bi Ye, Zhang Zebing 2018, 45 (4):  223-225.  doi: 10.3760/cma.j.issn.1673-422X.2018.04.008 Abstract ( 374 )   PDF (788KB) ( 887 )   Save With the continuous research and elucidation of the role and species of long noncoding RNAs (lncRNAs), the relationship between lncRNAs and cancer resistance has been paid more and more attention by researchers. Studies find that lncRNAs are involved in tumor drug resistance by altering DNA repair and cell cycle, drug delivery system, drug metabolism, cell apoptosis and epithelial interstitial transformation. lncRNAs are expected to be a new biological marker, which provids a new way to diagnose, treat and evaluate the prognosis of cancer. Related Articles | Metrics

Relationship between microRNA-335 expression and prognosis in tumor tissue Xu Xiaoyan, Wu Yinjie, Yin Ling, Xu Fei, Yu Zhuang 2018, 45 (4):  226-228.  doi: 10.3760/cma.j.issn.1673-422X.2018.04.009 Abstract ( 369 )   PDF (792KB) ( 800 )   Save The low expression of microRNA-335 (miR-335) indicates poor prognosis in many types of cancer, such as gastric cancer, breast cancer, lung cancer and other solid tumors. The low expression of miR-335 can promote tumor metastasis and progression, and is associated with histological grading, lymph node metastasis and tumor staging, which  provids a new way of thinking for the diagnosis and treatment of tumors. Related Articles | Metrics

Roles of Fibulin family members in the genesis and development of tumors Luo Xu, Sun Yunchen, Zhu Liang, Hu Jiangfeng 2018, 45 (4):  229-233.  doi: 10.3760/cma.j.issn.1673-422X.2018.04.010 Abstract ( 426 )   PDF (1013KB) ( 824 )   Save The Fibulin family is a kind of secreted glycoprotein, belonging to the extracellular matrix protein. A total of 7 family members are widely distributed in basement membrane, elastic fiber and loose connective tissue. The Fibulin family is widely involved in the regulation of cell morphology, growth and adhesion. When Fibulin is disturbed, it can cause a range of diseases, such as skin laxity, tooth hypoplasia and various tumors. The researches show that Fibulin-1 is expressed abnormally in fibrosarcoma, gastric cancer and liver cancer, and the expression of Fibulin-2 is downregulated in breast cancer and upregulated in lung cancer. The other members of the family also show abnormal expression in various tumor tissues, which indicates the members of the Fibulin family play important roles in the genesis and development of tumors. Related Articles | Metrics

Research progress of acetylCoA carboxylase in cancer metabolism Deng Leihong, Peng Lifen, Zeng Tao, Chao Haichao 2018, 45 (4):  234-237.  doi: 10.3760/cma.j.issn.1673-422X.2018.04.011 Abstract ( 823 )   PDF (873KB) ( 1496 )   Save Abnormal fatty acid metabolism is one of the unique metabolic ways in which malignant cells maintain their growth needs and plays a crucial role in tumor progression. AcetylCoA carboxylase (ACC) is the ratelimiting enzyme in fatty acid synthesis and oxidative metabolism. More and more researches confirm that ACC is highly expressed in many tumors, and is closely related to tumor progression and prognosis of patients, which makes ACC as a potential marker for clinical diagnosis and prognosis. Tumor cell fatty acid synthesis can be blocked and fatty acid β oxidation can be stimulated by inhibiting the activity of ACC, resulting in serious lipid consumption of tumor, and then inhibit tumor growth and proliferation. Investigating the effect and molecular mechanisms of ACC in the genesis and development of tumors can provide a new insight into cancer targeted molecular therapy. Related Articles | Metrics

Advances of next-generation immune checkpoint blockade Zhang Baihong, Yue Hongyun 2018, 45 (4):  238-240.  doi: 10.3760/cma.j.issn.1673-422X.2018.04.012 Abstract ( 360 )   PDF (793KB) ( 1387 )   Save Immune checkpoint blockades can induce long lasting responses but only in a fraction of patients owing to deficient of antibody as well as the neglect of immune suppressive cells. Nextgeneration immune checkpoint blockades, including FcγR-binding anti-programmed cell death-1 (PD-1）/PD ligand 1 (PD-L1) antibodies, coinhibitors of immune checkpoint, small-molecule modulators and antibody-drugs conjugated with PD-1/PD-L1, will overcome the deficiencies of current antiPD-1/PD-L1 antibodies and will become the direction of immunotherapy in the future. Related Articles | Metrics

Clinicopathological characteristics and susceptibility genes of early-onset breast cancer Li Lixi, Ma Fei 2018, 45 (4):  241-244.  doi: 10.3760/cma.j.issn.1673-422X.2018.04.013 Abstract ( 471 )   PDF (864KB) ( 1006 )   Save Early-onset breast cancer has aggressive clinicopathological characteristics and worse prognosis. However, there are few studies about it at home and abroad, which restricts the improvement of diagnosis and treatment level of breast cancer. Compared with older breast cancer, early-onset breast cancer has high mutation frequency and wide mutation spectrum. The study of unique susceptibility genes of early-onset breast cancer not only helps elucidate the difference of germline mutation spectrum between early-onset breast cancer and older breast cancer, but also will be helpful to study the diagnostic and prognostic marker for breast cancer, which provides evidence for screening and precision therapy. Related Articles | Metrics

Tracers′  clinical application status in the sentinel lymph node biopsy of breast cancer Shi Manman, Chen Chuang, Li Zhiyu, Sun Shengrong 2018, 45 (4):  245-249.  doi: 10.3760/cma.j.issn.1673-422X.2018.04.014 Abstract ( 563 )   PDF (947KB) ( 1331 )   Save The treatment of breast cancer is becoming more individualized and minimally invasive, which makes sentinel lymph node biopsy becoming the standard treatment for axillary in patients with early-stage breast cancer who are negative in clinical axillary lymph nodes. Tracers image sentinel lymph nodes or lymphatic vessels for the successful detection of sentinel lymph node biopsy. Tracers selection is also more diverse, such as nano carbon mixed suspension, methylene blue, radioisotope, indocyanine green, etc. Different tracers and combined applications have their advantages and limitations. As for the selection of tracing methods, many factors need to be weighed. References | Related Articles | Metrics

Notch signaling pathway in lung cancer and lung cancer stem cells and its inhibitors Liu Hengyao, Zhao Guoli, Wang Fuwen, Cai Haibo, Zhang Yueying. 2018, 45 (4):  250-252.  doi: 10.3760/cma.j.issn.1673-422X.2018.04.015 Abstract ( 500 )   PDF (789KB) ( 910 )   Save Notch signaling pathway is involved in the abnormal differentiation and selfrenewal of lung cancer stem cells. The further studies for the roles of Notch signaling pathway in the regulation of lung cancer stem cells are expected to find new targets in the diagnosis and treatment of lung cancer. Inhibitors of the Notch signaling pathway may be effective in the treatment of lung cancer. Lung cancer stem cells are thought to be a major cause of recurrence of lung cancer, therefore, targeted therapy for lung cancer stem cells may be more effective than treatment for the entire tumor. Related Articles | Metrics

Application of nanotechnology in the treatment of ovarian cancer Li Dan, Zhao Hongwei 2018, 45 (4):  253-256.  doi: 10.3760/cma.j.issn.1673-422X.2018.04.016 Abstract ( 570 )   PDF (631KB) ( 868 )   Save In recent years, the application of nanotechnology in the treatment of ovarian cancer has become a hot topic. Nanomedicine has characteristics of small diameter, good biocompatibility, surface modification and targeting ability, which has been shown to improve the biocompatibility of drugs remarkably. Nanotechnology has potential application value in chemotherapy, antiangiogenesis therapy, gene therapy, immune therapy, thermotherapy, and photodynamic therapy of ovarian cancer. Related Articles | Metrics