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08 October 2019, Volume 46 Issue 10 Previous Issue    Next Issue

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New progression in the therapy of blastic plasmacytoid dendritic cell neoplasms Yang Jingshi, Zou Liqun 2019, 46 (10):  577-580.  doi: 10.3760/cma.j.issn.1673-422X.2019.10.001 Abstract ( 696 )   PDF (677KB) ( 308 )   Save Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a kind of rare and highly invasive hematological malignancy. Because of its low incidence, there is still no consensus on its standard treatment. For young patients, high intensity chemotherapy combined with hematopoietic stem cell transplantation is often used. Elderly patients who cannot accept hematopoietic stem cell transplantation receive low intensity chemotherapy. In December 2018, tagraxofusp, a new targeted drug, was approved by the U.S. Food and Drug Administration specially for treatment-naive and previously-treated BPDCN patients (age≥2 years old). Some targeted drugs, such as venetoclax and daratumumab, have certain effects on the treatment of BPDCN. The efficacies of PD-1/PDL-1 inhibitors and anti CD123 chimeric antigen receptor T cell immunotherapy need further researches. Related Articles | Metrics

Detection and clinical significance of EGFL7 and P185 protein in tissues and serum of patients with breast cancer Hu Xiaobo, Xia Mingzhi, He Yue, Liu Zhihua 2019, 46 (10):  581-584.  doi: 10.3760/cma.j.issn.1673-422X.2019.10.002 Abstract ( 357 )   PDF (790KB) ( 191 )   Save Objective  To detect the expressions of epidermal growth factor-like domain 7 (EGFL7) and P185 protein in breast cancer tissues and serum, and to analyze the correlation between the expression levels of EGFL7 and P185 in tissues and clinicopathological parameters of breast cancer patients. Methods  Sixty patients with breast cancer in Hunan Cancer Hospital from March 2016 to March 2018 were collected as observation group, and 60 patients with breast benign lesions in the hospital during the same period were selected as control group. The expressions of EGFL7 and P185 protein in tissues of patients in the two groups were detected by immunohistochemical two-step method, and the levels of EGFL7 and P185 protein in serum of patients in the two groups were detected by enzyme-linked immunosorbent assay (ELISA). The relationships between the expressions of EGFL7 and P185 protein and clinicopathological parameters of breast cancer patients were analyzed. Results  The positive rates of EGFL7 in tissues in the observation group and the control group were 65.00% (39/60) and 28.33% (17/60), and there was a significant difference between the two groups (χ2=16.205, P＜0.001). The positive rates of P185 in tissues in the two groups were 43.33% (26/60) and 15.00% (9/60), and there was a significant difference between the two groups (χ2=11.657,P=0.001). The serum levels of EGFL7 protein in the observation group and the control group were (3.39±0.38) μg/ml and (2.75±0.31) μg/ml respectively, with a significant difference (t=10.109, P<0.001). The serum levels of P185 protein in the two groups were (7.12±0.75) μg/ml and (6.08±0.62) μg/ml respectively, with a significant difference (t=8.279, P<0.001). The positive expression of EGFL7 protein was closely related to tumor size (χ2=6.128, P=0.013), TNM stage (χ2=7.781,P=0.005) and metastasis (χ2=5.444, P=0.020). The positive expression of P185 protein was closely related to tumor size (χ2=8.910, P=0.003) and TNM stage (χ2=8.024, P=0.005). Conclusion  The levels of EGFL7 and P185 protein are high in breast cancer tissues and serum, and their positive expressions are related to tumor size and TNM stage. EGFL7 and P185 proteins play important roles in the progression of breast cancer. Related Articles | Metrics

Effects of different chemotherapies on prognosis and tumor markers in patients with small cell lung cancer Zhang Dongwei, Lan Bing 2019, 46 (10):  585-589.  doi: 10.3760/cma.j.issn.1673-422X.2019.10.003 Abstract ( 429 )   PDF (836KB) ( 302 )   Save Objective  To explore the effect and safety of two chemotherapy regimens in the treatment of small cell lung cancer. Methods  Ninety-eight patients with extensive small cell lung cancer admitted to Liuzhou People′s Hospital of Guangxi Zhuang Autonomous Region from March 2013 to March 2016 were randomly divided into two groups by random number table method, 49 of whom were treated with lobaplatin + etoposide (EL group), and another 49 cases were treated with cisplatin + etoposide (EP group). The short-term efficacy, 2-year survival rate and adverse reactions of the two groups were observed. The serum levels of gastrinreleasing peptide precursor (ProGRP), neuron-specific enolase (NSE), Ki-67, vascular endothelial growth factor (VEGF) were compared between the two groups before and after treatment. Results  The effective rates of the EL group and the EP group were 48.98% (24/49) and 40.82%(20/49) respectively, and the difference between the two groups was not statistically significant (χ2=0.660, P=0.417). The 2-year survival rates of patients in the EL group and the EP group were 17.07% and 11.11% respectively. The median survival time of the EL group was 17.00 months, and that of the EP group was 15.00 months. There was no significant difference between the two groups (χ2=1.094,  P=0.228). The serum level of ProGRP was (978.4±225.7) ng/L and (940.2±237.1) ng/L, NSE was (43.9±10.3) ng/ml and (41.7±11.6) ng/ml, Ki-67 was (287.5±55.3) pg/ml and (279.8±62.6) pg/ml, and VEGF was (566.8±109.4) pg/ml and (538.1±144.0) pg/ml in the EL and EP group before chemotherapy respectively, and there were no significant differences between the two groups (t=0.817,  P=0.416; t=0.993, P=0.323; t=0.645,  P=0.520; t=1.111,  P=0.269). The serum level of ProGRP was (167.3±68.5) ng/L and (180.6±62.1) ng/L, NSE was (17.5±4.8) ng/ml, (19.0±5.3) ng/ml, Ki-67 was (98.0±18.6) pg/ml and (101.4±20.8) pg/ml, VEGF was (430.4±95.8) pg/ml and (442.8±91.0) pg/ml in the EL and EP group after chemotherapy, and there was no significant difference between the two groups (t=-1.007,  P=0.316;t=-1.468,  P=0.145;t=-0.853,  P=0.396; t=-0.657,  P=0.513). The serum levels of ProGRP, NSE, Ki-67 and VEGF in EL group and EP group were significantly lower than those before chemotherapy （t=24.072,  P<0.001; t=21.694, P<0.001;t=16.263,  P<0.001; t=12.459,  P<0.001;t=22.736, P<0.001; t=18.931,  P<0.001; t=6.566,  P<0.001;t=3.916,  P<0.001）. During chemotherapy, the incidences of diarrhea and myelosuppression (≥grade 2) in the EL group ［26.53% (13/49) and 61.22% (30/49)］ were lower than those in the EP group ［48.98% (24/49) and 81.63% (40/49)］, and the differences were statistically significant (χ2=5.254, P=0.022; χ2=5.000,  P=0.025). Conclusion  Lobaplatin+etoposide is less toxic than cisplatin+etoposide in the treatment of small cell lung cancer, and adverse reactions of its is relatively slighter. Related Articles | Metrics

Application of cystatin C and β2-microglobulin in the assessment of condition and short-term efficacy of multiple myeloma Zhang Yunyu, Peng Jing, Song Zhigang, Li Xingyuan 2019, 46 (10):  590-594.  doi: 10.3760/cma.j.issn.1673-422X.2019.10.004 Abstract ( 416 )   PDF (804KB) ( 221 )   Save Objective  To explore the application value of serum cystatin C (Cys-C) and β2-microglobulin (β2-MG) in the diagnosis and short-term efficacy evaluation of multiple myeloma (MM). Methods  A total of 450 patients with MM admitted to Anqing Hospital of Chinese People′s Liberation Army Navy and Jinhua Central Hospital of Zhejiang Province from October 2016 to October 2018 were selected as subjects (MM group), according to the Durie-Salmon staging criteria, including 150 patients in stage Ⅰ, Ⅱ and Ⅲ. A total of 150 healthy subjects were selected as the control group. The levels of Cys-C and β2-MG in the serum of the subjects were determined. The differences of Cys-C and β2-MG levels between the two groups and the MM patients with different Durie-Salmon stages were compared. The differences of Cys-C and β2-MG levels between the patients with different short-term efficacy were compared. The receiver operating characteristic (ROC) curve was used to analyze the value of the two indicators in the evaluation of MM efficacy, and the correlation between Cys-C and β2-GM was analyzed. Logistic regression analysis was used to analyze the multiple factors affecting the clinical efficacy of MM patients. Results  The levels of Cys-C and β2-MG in the serum of the patients with MM were (2.11±0.78) mg/L and (6.07±3.08) g/L respectively, and those in the control group were  (0.75±0.20) mg/L and (1.78±0.59) g/L, with significant differences (t=33.848, P<0.001; t=28.084, P<0.001). The Cys-C levels of Durie-Salmon stage Ⅰ, Ⅱ and Ⅲ patients were (0.99±0.21) mg/L, (1.36±0.17) mg/L and (3.07±1.02) mg/L respectively, and the difference was statistically significant (F=44.157, P<0.001). The β2-MG levels in the serum of patients with stage Ⅰ, Ⅱ and Ⅲ were (2.57±0.75) g/L, (4.66±1.43) g/L, (8.63±2.26) g/L respectively, and the difference was statistically significant (F=57.285, P<0.001). In all the patients, 338 patients were effective, accounting for 75.11%, and 112 patients were ineffective, accounting for 24.89%. The levels of Cys-C and β2-MG in the serum of the  effective MM patients were (1.28±0.23) mg/L and (2.82±0.78) g/L, and those of ineffective patients were (2.97±0.77) mg/L and (6.22±1.92) g/L, with statistically significant differences (t=35.874, P<0.001; t=26.633, P<0.001). The sensitivity of serum Cys-C for predicting short-term efficacy was 83.0%, the specificity was 76.6%, and those of serum β2-MG were 89.3% and 73.6%. The area under curve (AUC) of the serum Cys-C was 0.813 (95%CI: 0.764-0.862), and the AUC of serum β2-MG was 0.865 (95%CI: 0.825-0.906), with a statistically significant difference (Z=2.490, P=0.011). Spearman correlation analysis showed a positive correlation between serum Cys-C and β2-MG (r=0.539, P=0.041). Logistic regression analysis showed that both β2-MG (95%CI: 2.386-5.144, P＜0.001) and Cys-C (95%CI: 2.367-9.702, P＜0.001) were independent factors affecting the short-term efficacy of MM. Multivariate analysis showed that β2-MG (95%CI: 3.549-13.739, P=0.001) was an independent factor affecting the efficacy of MM. Conclusion  The levels of serum Cys-C and β2-M in MM patients are significantly higher than those in healthy people, and they show an increasing trend with the progression of MM disease, which can be used as markers for the pathological staging diagnosis of MM patients. The short-term efficacy of the patients can be evaluated by using the two indicators, and the clinical significance in efficacy evaluation of β2-MG is slightly better than that of Cys-C. Related Articles | Metrics

Symptom load assessment of Ph chromosome/BCR-ABL fusion gene negative myeloproliferative tumor patients at different efficacy evaluation periods Zhang Zhifu, Tang Libin, Sun Hongbo, Liu Junmin, Luo Wei 2019, 46 (10):  595-600.  doi: 10.3760/cma.j.issn.1673-422X.2019.10.005 Abstract ( 273 )   PDF (658KB) ( 194 )   Save Objective  To observe the disease type and the changes of symptom load during treatment of patients with Ph chromosome/BCR-ABL fusion gene negative myeloproliferative neoplasm (MPN). Methods  A total of 84 patients with MPN diagnosed from May 2017 to January 2019 in People′s Hospital of Longhua District of Shenzhen were selected, and were divided into polycythemia vera (PV) group, essential thrombocyhemia (ET) group, and myelofibrosis (PMF) group according to their subtypes, with 28 cases in each group. The scores of MPN-SAF-TSS were compared among the three groups. Besides, the scores of the scale (myeloproliferative neoplasm symptom assessment form total symptom score, MPN-SAF-TSS) in different treatment periods (at the time of the visit, when the disease progressed, when the disease was stable, when the clinical improvement was made, when the partial remission was completed, at the time of remission and recurrence) were also compared. Results  At the time of initial diagnosis, there were significant differences in the incidences of symptom burdens among the three groups of MPN patients with abdominal fullness (χ2=6.095, P=0.047), abdominal discomfort (χ2=7.342, P=0.025), poor mobility (χ2=13.029,P=0.001), inattention (χ2=6.099, P=0.047), pruritus (χ2=6.956,P=0.031), bone pain (χ2=7.807, P=0.020), fever (χ2=8.000, P=0.018) and weight loss (χ2=27.340, P＜0.001). The incidences of poor mobility (85.71%, 24/28), inattention (67.86%, 19/28) and weight loss (82.14%, 23/28) in PMF group were significantly higher than those in PV group ［42.86% (12/28), 39.29% (11/28), 35.71% (10/28)］  and ET group ［46.43% (13/28), 39.29% (11/28), 14.29% (4/28)］ (all P＜0.05). The incidences of abdominal discomfort (75.00%, 21/28) and bone pain (60.71%, 17/28) in PMF group were higher than those in PV group ［39.29% (11/28), 25.00% (7/28)］ (both P＜0.05). The incidences of   abdominal fullness (89.29%, 25/28)  and fever (42.86%, 12/28)  in PMF group were higher than those in ET group ［60.71% (17/28), 10.71% (3/28)］ (both P＜0.05). The incidence of pruritus in PV group (71.43%, 20/28) was higher than that in ET group (42.86%, 12/28) and PMF group (39.29%, 11/28) (both P＜0.05). Symptom load scores of patients with fatigue (χ2=368.594, P<0.001), abdominal fullness (χ2=261.312, P<0.001), abdominal discomfort (χ2=195.629, P<0.001), poor mobility (χ2=217.862, P<0.001), lack of concentration (χ2=280.664, P<0.001), night sweats (χ2=239.650, P<0.001), pruritus (χ2=254.418, P<0.001), bone pain (χ2=180.291, P<0.001), fever (χ2=231.613, P<0.001) and weight loss (χ2=227.831, P<0.001) were significantly different during different therapeutic periods. The fatigue symptom load score was higher when the disease progressed than that at the time of the visit (P<0.05), and the symptom score of abdominal fullness was lower than that at the time of visit (P<0.05). Symptom load scores of weakness and pruritus when the condition was stable was lower than those when the disease progressed (both P<0.05). When the clinical improvement was made, symptom load scores of weakness, abdominal discomfort, inattention, night sweats, weight loss were lower than those when the disease was stable (all P<0.05). Symptom load scores of abdominal fullness, poor mobility, inattention, night sweats and pruritus in partial remission period decreased compared to temporary improvement period (all P<0.05). Compared to the partial remission period, the symptom load scores of weakness, abdominal fullness, night sweats, pruritus, bone pain and weight loss in complete remission period were lower (all P<0.05). At last, symptom load scores of weakness, abdominal fullness, abdominal discomfort, poor mobility, inattention, night sweats, pruritus, bone pain, fever and weight loss in recurrence period were higher than those in complete remission period (all P<0.05). Conclusion  There are several differences in the main clinical symptoms among patients with different MPN subtypes, and there are significant changes in the main clinical symptoms as the disease progresses or turns around. Related Articles | Metrics

Expression of miR-490 in malignant tumors and its molecular mechanism Deng Siyuan, He De 2019, 46 (10):  601-604.  doi: 10.3760/cma.j.issn.1673-422X.2019.10.006 Abstract ( 535 )   PDF (643KB) ( 241 )   Save 微小RNA-490 (miR-490)是miRNA家族中重要的一员，其与肿瘤的发生、发展密切相关。研究表明miR490在胃癌、结直肠癌、乳腺癌等多种肿瘤中异常表达，并在不同肿瘤细胞的增殖、凋亡、侵袭、转移等生物学行为中扮演着癌基因或抑癌基因的角色。miR-490有望作为肿瘤诊断和临床预后的指标，对其机制的深入研究有望为肿瘤诊治提供新的方向。 Related Articles | Metrics

Role of leukemia inhibitory factor in tumorigenesis and development Si Sainyu, Wang Huaying, Yu Wanjun, Li Jipeng 2019, 46 (10):  605-608.  doi: 10.3760/cma.j.issn.1673-422X.2019.10.007 Abstract ( 481 )   PDF (702KB) ( 254 )   Save Leukemia inhibitory factor (LIF) is a multifunctional secretory cytokine that plays a role in different tumor tissues and cells through janus kinase/signal transducer and activator of transcription 3, phosphatidylinositol 3kinase, mitogen-activated protein kinase signaling pathways. LIF is highly expressed in colorectal cancer, breast cancer, malignant melanoma, nasopharyngeal carcinoma and other malignant tumors. High expression of LIF can promote the development of cancer, increase the ability of tumor invasion and migration, reduce the sensitivity of radiotherapy and chemotherapy, and lead to poor prognosis. Blocking the LIF signaling pathway can inhibit tumor progression, and LIF is expected to become a new target for tumor therapy. Related Articles | Metrics

Advantages of carbon ion radiotherapy and its application in tumor therapy Li Qian, Zhou Jin 2019, 46 (10):  609-612.  doi: 10.3760/cma.j.issn.1673-422X.2019.10.008 Abstract ( 547 )   PDF (644KB) ( 322 )   Save Compared with proton and photon, heavy ion radiotherapy has unique physical and biological advantages, which enables it to kill tumor tissues to the greatest degree and protect surrounding normal tissues as much as possible. Carbon ion is recognized as the most suitable heavy ion for radiotherapy at present. Carbon ion radiotherapy in chordoma, head and neck cancer, non-small cell lung cancer, prostate cancer, cervical cancer and other malignant tumor treatment advantages have been preliminarily reflected. Therefore, understanding the characteristics of carbon ion radiotherapy and its application in tumor therapy will help clinicians make better clinical decisions in the future. Related Articles | Metrics

MYC inhibition associated mechanism research of Group3 medulloblastoma Yang Xilin, Chen Xiaopin 2019, 46 (10):  613-616.  doi: 10.3760/cma.j.issn.1673-422X.2019.10.009 Abstract ( 467 )   PDF (645KB) ( 295 )   Save Medulloblastoma (MB) is the most prevalent pediatric brain tumor. Group3 MB is the most malignant subgroup, quiet a part of which are MYC-amplified. Blocking the upstream gene sites of MYC is mainly achieved through the blockade of miR-494, DDX3, NOTCH1 pathway; BETi or ATR/Chk1 double-inhibition realizes the inhibition of duplication or transcription of MYC; as to the blockade of downstream genes of MYC, researchers mainly focus on LDHA, SETD8 and EZH2. All of these researches which target on MYC-amplified associated anti-tumor treatment mechanism present the theoretical basis for anti-MYC-associated medulloblastoma clinically. Related Articles | Metrics

Application of CDK4/6 inhibitors in the treatment of hormone receptorpositive breast cancer  Mo Qiuping, Chen Yiding, Wang Xiaochen, 2019, 46 (10):  617-619.  doi: 10.3760/cma.j.issn.1673-422X.2019.10.010 Abstract ( 313 )   PDF (636KB) ( 281 )   Save With roles of blocking cell proliferation, cyclindependent protein kinase (CDK) 4/6 inhibitors are  effective and safe complementary therapies for hormone receptorpositive breast cancer. CDK4/6 inhibitors combined with endocrine therapy significantly improve the prognosis of patients with advanced or metastatic breast cancer, especially those with endocrine resistance. Indications for CDK4/6 inhibitors are also expected to broaden into earlystage breast cancer. However, mechanisms of resistance of CDK4/6 inhibitors remain elusive. Related Articles | Metrics

lncRNA and small cell lung cancer Ming Chao, He Rui, Sun Yuan, Tian Linghan, Zhao Guangqiang 2019, 46 (10):  620-623.  doi: 10.3760/cma.j.issn.1673-422X.2019.10.011 Abstract ( 414 )   PDF (643KB) ( 331 )   Save The incidence and mortality of lung cancer rank first, and small cell lung cancer (SCLC) accounts for about 15% of lung cancer cases. In recent years, it has been found that long non-coding RNA (lncRNA) (TUG1, CCAT2, PVT1, HOTTIP and HOTAIR) plays a significant role in the development of SCLC. lncRNA can regulate the expression of related genes at the transcriptional, posttranscriptional and epigenetic levels, and it can infulence proliferation, invasion, metastasis and chemotherapy resistance of SCLC.  Related Articles | Metrics

Regulation of mTOR singnaling pathway by microRNA in hepatocellular carcinoma Niu Yaqian, Chang Yuling, Liu Fang, Chu Huiyuan, Chen Che 2019, 46 (10):  624-626.  doi: 10.3760/cma.j.issn.1673-422X.2019.10.012 Abstract ( 337 )   PDF (636KB) ( 253 )   Save MicroRNA (miRNA) is a non-coding small molecule RNA, which is involved in the occurrence and development of tumor as an oncogene or tumor suppressor gene. The abnormal expression of many kinds of miRNAs in hepatocellular carcinoma (HCC) can directly or indirectly act on PI3K, Akt, mTOR, IGF-1R, TGF-β and other signal molecules in mTOR signal pathway, they are crucial in the appreciation, invasion and metastasis of HCC cells. Related Articles | Metrics

Application of stereotactic body radiation therapy in advanced renal cell carcinoma Cai Liang, Shen Yali 2019, 46 (10):  627-630.  doi: 10.3760/cma.j.issn.1673-422X.2019.10.013 Abstract ( 424 )   PDF (645KB) ( 262 )   Save Stereotactic body radiation therapy (SBRT) can effectively kill renal cancer cells by biological molecules such as hypoxia-inducible factor-1α and acid sphingomyelinase. SBRT regimen with higher biological dose and single irradiation can achieve more effective local control of primary and metastatic lesion of advanced renal cancer, and adverse reactions can be tolerated. Combination of SBRT and targeted drugs can increase the sensitivity of renal cancer to radiotherapy, and the combination of SBRT and immune drugs can enhance the immune response through the abscopal effect. The efficacy of SBRT in the treatment of advanced renal cancer remains to be explored. Related Articles | Metrics

New progress of cabozantinib in the treatment of metastatic renal cell carcinoma Mei Yanxia, Zhao Yizhou 2019, 46 (10):  631-633.  doi: 10.3760/cma.j.issn.1673-422X.2019.10.014 Abstract ( 515 )   PDF (636KB) ( 262 )   Save Renal cell carcinoma (RCC), the most common form of kidney cancer, is characteristic by difficult in diagnosis at an early stage, insensitivity to chemoradiotherapy, poor prognosis, etc.. Localized RCC is treated by surgery while advanced RCC is mainly treated by immunotherapy and targeted therapy. With the ongoing in-depth researches on targeted therapy in recent years, plenty of targeted drugs come into the market in succession. Cabozantinib has been approved for the treatment of advanced RCC in the first/second line setting. It′s safety profile and efficiency have been demonstrated in Ⅱ-Ⅲ clinical trials. Related Articles | Metrics

Human telomerase reverse transcriptase and cutaneous malignant tumor Zhao Juan, Kang Xiaojing 2019, 46 (10):  634-637.  doi: 10.3760/cma.j.issn.1673-422X.2019.10.015 Abstract ( 272 )   PDF (642KB) ( 173 )   Save Human telomerase reverse transcriptase (hTERT) is a catalytic subunit of telomerase and is closely related to immortalization of cells, tumorigenesis and senescence of cells. hTERT has a great relationship with the occurrence and development of skin malignant tumors (melanoma, squamous cell carcinoma, basal cell carcinoma, cutaneous lymphoma, etc.). Abnormal expression of hTERT has important clinical application value in early diagnosis, individualized comprehensive treatment and prognosis evaluation of cutaneous malignant tumors. Related Articles | Metrics

#br# 2019, 46 (10):  638-640.  doi: 10.3760/cma.j.issn.1673-422X.2019.10.016 Abstract ( 207 )   PDF (1061KB) ( 313 )   Save Related Articles | Metrics