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08 September 2021, Volume 48 Issue 9 Previous Issue    Next Issue

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Prognostic differences of nasopharyngeal carcinoma patients treated with intensity-modulated radiothe-rapy with different T staging of the seventh and eighth edition of the UICC staging system Chen Fangming, Cai Yuanyuan, Li Han, Wang Xiaoli, Kan Hongxing, Li Yang, Hao Furong, Wang Mingchen 2021, 48 (9):  515-522.  doi: 10.3760/cma.j.cn371439-20201214-00100 Abstract ( 339 )   HTML ( 23 )   PDF (1395KB) ( 184 )   Save Objective To compare the differences in population distribution and prognosis of patients with nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT) in T staging of the Union for International Cancer Control (UICC) 7th edition and UICC 8th edition, and to analyze the prognostic factors in patients with NPC. Methods The clinicopathologic date of 184 patients with newly diagnosed NPC treated with IMRT at the Department of Radiation Oncology of Weifang People's Hospital of Shandong Province from June 1, 2005 to December 31, 2017 were retrospectively analyzed. All patients were restaged according to the 7th and 8th edition of the UICC staging system. The distribution of T staging of patients in the two staging systems was analyzed, and the consistency of the two staging systems was compared using the Kappa consistency test. Kaplan-Meier method was used for survival analysis, and log-rank test was used to compare the prognostic differences among T stages. Cox regression model was used to analyze the prognostic factors of patients with NPC. Results Of all 184 patients with NPC, stage T1, T2, T3 and T4 respectively accounted for 18.5% (34/184), 16.8% (31/184), 15.2% (28/184) and 49.5% (91/184) according to the 7th edition UICC staging system. However, stage T1, T2, T3 and T4 respectively accounted for 18.5% (34/184), 34.2% (63/184), 30.4% (56/184) and 16.8% (31/184) according to the 8th edition UICC staging system. The T staging population distribution of the two staging systems showed moderate consistency (Kappa=0.58). There was a statistically significant difference in overall survival (OS) among patients with stage T1, T2, T3, T4 according to the 7th edition UICC staging system (χ2=10.606, P=0.014). There were statistically significant differences in OS between stage T1 and stage T2, T3, T4 (χ 2=4.866, P=0.027; χ 2=11.965, P=0.001; χ 2=4.351, P=0.037). The OS curves of stage T2 and T4 could not be separated. Moreover, the OS curves of stage T3 and T4 were distributed in reverse order. There was a statistically significant difference in OS among patients with stage T1, T2, T3, T4 according to the 8th edition staging system (χ 2=8.663, P=0.034). There were statistically significant differences in OS between stage T1 and stage T3, T4(χ 2=8.746, P=0.003; χ 2=7.580, P=0.006). The OS curves of stage T1 to T4 were distributed in order, but the curves of stage T3 and T4 could not be separated. There was a statistically significant difference in progression-free survival (PFS) among patients with stage T1, T2, T3, T4 according to the 7th edition UICC staging system (χ 2=11.289, P=0.010). There were statistically significant differences in PFS between stage T1 and stage T2, T3, T4 (χ 2=8.209, P=0.004; χ 2=13.302, P<0.001; χ 2=6.550, P=0.010). The PFS curves of stage T2 and T4 could not be separated. Moreover, the PFS curves of stage T3 and T4 were distributed in reverse order. There was a statistically significant difference in PFS among patients with stage T1, T2, T3, T4 according to the 8th edition staging system (χ 2=12.074, P=0.007). There were statistically significant differences in PFS between stage T1 and stage T2, T3, T4(χ 2=5.182, P=0.023; χ 2=11.217, P=0.001; χ 2=10.174, P=0.001). The PFS curves of stage T1 to T4 were distributed in order, but the curves of stage T3 and T4 could not be separated. The results of Cox multivariate analysis showed that T staging of both staging systems were the independent prognostic factors of the OS (P=0.013; P=0.026) and PFS (P=0.031; P=0.012). However, T staging of the two editions were not the independent prognostic factors of the local recurrence-free survival (LRFS) (P=0.351; P=0.167) and distant metastasis-free survival (DMFS) (P=0.059; P=0.052). The age was the independent prognostic factor of the OS (HR=2.70, 95%CI: 1.53-4.76, P=0.001; HR=2.74, 95%CI: 1.55-4.84, P=0.001), PFS (HR=2.72, 95%CI: 1.46-5.08, P=0.002; HR=2.94, 95%CI: 1.57-5.52, P=0.001), LRFS (HR=5.87, 95%CI: 1.62-21.27, P=0.007; HR=6.02, 95%CI: 1.61-22.49, P=0.008) and DMFS (HR=2.40, 95%CI: 1.22-4.72, P=0.011; HR=2.63, 95%CI: 1.34-5.18, P=0.005). N staging was the independent prognostic factor of the OS (P=0.031; P=0.028). Conclusion The T staging population distribution of the 7th and 8th edition UICC staging system had moderate consistency, and the T staging of the 8th edition is more advantageous in predicting the prognosis of OS and PFS. In both editions, T staging is an independent prognostic factor for OS and PFS. Figures and Tables | References | Related Articles | Metrics

Value of CD4/CD8 ratio and total B lymphocytes before radiotherapy in predicting radiation pneumonitis in patients with esophageal cancer and lung cancer Hu Ge, Su Jie, Li Qiangwei, Xu Peng, Xu Xiuli, Qian Xiaotao 2021, 48 (9):  523-526.  doi: 10.3760/cma.j.cn371439-20201209-00101 Abstract ( 383 )   HTML ( 25 )   PDF (870KB) ( 195 )   Save Objective To investigate the value of CD4/CD8 ratio and total B lymphocytes before radiotherapy in predicting the occurrence of radiation pneumonitis (RP) in patients with esophageal cancer and lung cancer. Methods The clinicopathological data of 28 patients with esophageal and 16 patients with lung cancer undergoing radiotherapy from April 2018 to March 2020 in Hefei Cancer Hospital, Chinese Academy of Sciences were retrospectively analyzed, and the patients were divided into RP group (n=16) and non-RP group (n=28) according to whether RP occurred during and after treatment. The CD4/CD8 ratio and total B lymphocytes before radiotherapy between the two groups, and the CD4/CD8 ratio and total B lymphocytes before and after radiotherapy in the RP group were compared. Receiver operating characteristic curve was used to analyze the value of CD4/CD8 ratio and total B lymphocytes before radiotherapy in predicting RP. Results The CD4/CD8 ratio before radiotherapy in the RP group was significantly lower than that in the non-RP group (0.993±0.179 vs. 1.708±0.170), with a statistically significant difference (t=2.706, P=0.009); the total B lymphocytes in the RP group was significantly lower than that in non-RP group [(4.409±0.823)% vs. (8.153±1.017)%], with a statistically significant difference (t=0.986, P=0.015). The CD4/CD8 ratio in the RP group was lower than that before radiotherapy when RP occurred (0.785±0.167 vs. 0.993±0.179), with no statistically significant difference (t=1.376, P=0.189). The total B lymphocytes in the RP group was lower than that before radiotherapy when RP occurred [(3.487±1.018)% vs. (4.409±0.823)%], with no statistically significant difference (t=0.804, P=0.433). The critical values of CD4/CD8 ratio and total B lymphocytes predicted RP were 0.580 and 0.357, respectively. The areas under the curve (AUC) of CD4/CD8 for predicting RP was 0.802 (95%CI: 0.653-0.932), the sensitivity was 89.29%, and the specificity was 68.75%. The AUC of total B lymphocytes for predicting RP was 0.694 (95%CI: 0.483-0.814), the sensitivity was 85.71%, and the specificity was 50.00%. The AUC of the two combined diagnostic method for RP was 0.834 (95%CI: 0.697-0.932), the sensitivity and specificity were 81.25% and 89.29%. AUC of the two combined tests was significantly higher than that of the single test, with statistically significant differences (Z=1.115, P=0.046; Z=1.992, P=0.026). Conclusion The CD4/CD8 ratio and total B lymphocytes in the RP group are lower than those in the non-RP group. The CD4/CD8 ratio and total B lymphocytes in the serum are of great significance in predicting the occurrence of RP in patients with malignant tumors receiving chest radiotherapy. Figures and Tables | References | Related Articles | Metrics

Value of MRI in diagnosis of benign and malignant breast lesions with cluster ring enhancement Zhang Bei, Zhao Bofeng, Wang Ying, Yu Jun, Chen Ping, Chen Baoying 2021, 48 (9):  527-531.  doi: 10.3760/cma.j.cn371439-20200921-00102 Abstract ( 314 )   HTML ( 21 )   PDF (1652KB) ( 239 )   Save Objective To investigate the diagnostic value of MRI in benign and malignant breast lesions with cluster ring enhancement. Methods The imaging signs of 68 patients with clustered ring enhancement who underwent MRI examination due to clinical palpation, ultrasound or X-ray examination for suspected malignant lesions in Tangdu Hospital of Air Force Military Medical University from October 2017 to July 2019 were retrospectively analyzed. The differences between benign and malignant lesions in the distribution pattern, T2 lipid suppression signal intensity, time-signal intensity curve (TIC), ductal dilatation, peripheral gland edema, pectoralis major edema were compared using χ 2 test or Mann-Whitney U test, and the risk factors of MRI imaging signs of malignant breast lesions were analyzed using binomial logistic regression model. Results There were 68 cluster ring enhancement lesions in 68 patients, all of which were single lesions, among which 18 cases (26.5%) were benign, and the common lesions were plasma cell mastitis (9 cases). Fifty cases (73.5%) were malignant, and the most common type was invasive breast cancer (40 cases). Imaging features of plasma cell mastitis showed cluster ring enhancement, regional distribution, slightly high signal on fat suppression T2 image, type Ⅲ TIC, with ductal dilatation, edema of peripheral glands and pectoralis major. Imaging features of invasive breast cancer showed cluster ring enhancement, regional distribution, iso-signal on fat suppression T2 image, type Ⅲ TIC, no ductal dilatation, and edema of peripheral gland and pectoralis major. There were statistically significant differences in the intensity of fat-suppression T2 signal (Z=3.003, P=0.003) and duct dilatation (χ 2=7.174, P=0.007) between benign and malignant lesions. There were no significant differences in distribution (χ 2=5.510, P=0.313), TIC type (χ 2=3.538, P=0.133), peripheral gland edema (χ 2=0.164, P=0.686) and pectoralis major edema (χ 2<0.001, P>0.999). The analysis of binomial logistic regression model showed that fat-suppression T2 iso-signal (OR=0.182, 95%CI: 0.036-0.914, P=0.039) and no ductal dilatation (OR=0.198, 95%CI: 0.047-0.846, P=0.029) were the risk factors for breast malignant lesions. Conclusion Breast cancer MRI findings of cluster ring enhancement, fat-suppression T2 iso-signal and no ductal dilatation are related risk factors for malignant breast lesions. MRI is helpful for early detection and diagnosis of breast lesions. Figures and Tables | References | Related Articles | Metrics

Dosimetric study of helical tomotherapy and volumetric modulated arc therapy simultaneous integrated boost for patients receiving breast-conserving surgery of left breast Ji Wei, Liu Menglan, Wen Xiaobo, Yuan Meifang, Zhao Biao, Yang Yi 2021, 48 (9):  532-536.  doi: 10.3760/cma.j.cn371439-20210520-00103 Abstract ( 247 )   HTML ( 30 )   PDF (676KB) ( 164 )   Save Objective To compare the dosimetric characteristics of helical tomotherapy (HT) and volumetric modulated arc therapy (VMAT) after left breast conserving surgery. Methods Twenty-four patients with left breast cancer after breast-conserving surgery who were admitted to the Department of Radiation Oncology of Tumor Hospital of Yunnan Province from May 2016 to May 2019 were selected. The HT plan and the VMAT plan were designed for the same patient. The target dose and the dose volume parameters of organs at risk were compared and analyzed in the two radiotherapy plans. Results There were significant differences in the D2% [(59.68±0.46) Gy vs. (60.06±0.20) Gy, t=-4.229, P<0.001], D98% [(57.46±0.44) Gy vs. (57.20±0.07) Gy, t=2.912, P<0.001], conformity index (CI) (0.80±0.05 vs. 0.76±0.04, t=4.079, P<0.001) and homogeneity index (HI) (0.04±0.01 vs. 0.05±0.00, t=-5.505, P<0.001) of the planning gross tumor volume (PGTV) between the HT and VMAT plans. However, there was no significant difference in the D50% [(58.77±0.46) Gy vs. (58.75±0.11) Gy, t=0.179, P=0.859]. There were significant differences in the D50% [(51.99±0.39) Gy vs. (52.39±0.36) Gy, t=-5.278, P<0.001], D98% [(49.46±0.29) Gy vs. (48.35±0.46) Gy, t=9.538, P<0.001] and HI (0.19±0.01 vs. 0.21±0.01, t=-7.538, P<0.001) of the planned target volume (PTV) between the two plans. However, there were no significant differences in the D2% [(59.13±0.64) Gy vs. (59.09±0.46) Gy, t=0.511, P=0.614] and CI (0.83±0.04 vs. 0.82±0.04, t=1.637, P=0.115). In terms of organs at risk, there were significant differences in the V5 [(57.90±1.42)% vs. (52.40±5.74)%, t=4.812, P<0.001], V20 [(22.40±2.17)% vs. (18.40±3.16)%, t=5.573, P<0.001] and Dmean [(12.71±0.55) Gy vs. (11.46±1.26) Gy, t=4.963, P<0.001] of left lung, Dmean of right lung [(3.42±0.27) Gy vs. (2.49±0.24) Gy, t=13.310, P<0.001], Dmean of right breast [(4.41±0.50) Gy vs. (3.12±0.65) Gy, t=10.326, P<0.001], V30 [(0.55±0.37)% vs. (1.24±1.11)%, t=-4.020, P=0.001] and Dmean of heart [(4.68±0.62) Gy vs. (3.83±0.88) Gy, t=7.335, P<0.001], Dmean of left atrium [(2.53±0.31) Gy vs. (2.16±0.28) Gy, t=5.488, P<0.001], Dmean of right atrium [(2.77±0.43) Gy vs. (2.20±0.30) Gy, t=7.103, P<0.001], Dmean of right ventricle [(5.10±0.72) Gy vs. (3.72±0.94) Gy, t=9.802, P<0.001] and D2% of spinal cord [(14.79±2.73) Gy vs. (5.42±2.23) Gy, t=14.788, P<0.001] between HT and VMAT plans. There was no significant difference in the Dmean of left ventricle [(5.10±1.19) Gy vs. (4.80±1.54) Gy, t=1.250, P=0.224]. Conclusion Both the HT plan and the VMAT plan can meet the treatment requirements. The HT plan can provide better target area conformity and dose uniformity. The VMAT plan has more advantages in terms of organs at risk. The HT plan shows an advantage only in exposure to high-dose area. Figures and Tables | References | Related Articles | Metrics

Clinic diagnostic value of MSCT imaging features in nodular lung adenocarcinoma subtype Wang Jun, Zhao Xia, Li Haifei, Zhang Cheng 2021, 48 (9):  537-543.  doi: 10.3760/cma.j.cn371439-20201217-00104 Abstract ( 248 )   HTML ( 19 )   PDF (1113KB) ( 155 )   Save Objective To investigate the clinic diagnostic value of multi-slice CT (MSCT) imaging features in various subtypes of nodular lung adenocarcinoma. Methods The imaging information and general clinical data of 160 patients with nodular lung adenocarcinoma who were admitted to Yantai Affiliated Hospital of Binzhou Medical University and received surgical treatment from January 2017 to May 2019 were retrospectively analyzed. Univariate analysis was used to screen statistically significant imaging features of each pathological subtype, and binary logistic regression analysis was performed. The diagnostic value was analyzed using the receiver operating characteristic (ROC) curve, the area under the curve (AUC) was calculated, and the diagnostic efficacy was compared. Results The age of patients with atypical adenomatous hyperplasia and adenocarcinoma in situ (AAH+AIS), minimally invasive ademocarcinoma (MIA), invasive adenocarcinoma cancer (IAC) and variant of invasive adenocarcinoma cancer (VIAC) were (57.07±7.92), (59.37±6.96), (60.68±8.83), (63.33±6.89) years old, with no statistically significant difference (F=1.221, P=0.304). The age of patients with VIAC, IAC, MIA and AAH+AIS decreased in turn. The imaging features of AAH+AIS, MIA, IAC and VIAC that exhibited statistically significant differences were as following in turn: the maximum diameter of lesion [6.85 (3.73) mm vs. 8.00 (5.00) mm vs. 16.00 (11.90) mm vs. 17.20 (9.08) mm, H=55.107, P<0.001], CT value [-563.50 (176.63) HU vs. -536.00 (293.50) HU vs. -235.50 (346.50) HU vs. -23.00 (30.50) HU, H=47.499, P<0.001], solid ratio [0 (0) vs. 0 (0) vs. 49.00% (100.00%) vs. 100.00% (0), H=44.242, P<0.001], vacuolar sign [14 (87.50%) vs. 35 (100.00%) vs. 84 (81.55%) vs. 3 (50.00%), χ 2=13.925, P=0.002], inflatable bronchus sign [1 (6.25%) vs. 2 (5.71%) vs. 36 (34.95%) vs. 2 (33.33%), χ 2=16.578, P=0.001], intratumoral vascular sign [13 (81.25%) vs. 28 (80.00%) vs. 64 (62.14%) vs. 1 (16.67%), χ 2=11.168, P=0.009], vessel convergence sign [1 (6.25%) vs. 3 (8.57%) vs. 66 (64.08%) vs. 6 (100.00%), χ 2=54.232, P<0.001], short burr sign [3 (18.75%) vs. 11 (31.43%) vs. 77 (74.76%) vs. 6 (100.00%), χ 2=36.218, P<0.001], lobulation sign [4 (25.00%) vs. 18 (51.43%) vs. 93 (90.29%) vs. 6 (100.00%), χ 2=43.302, P<0.001], pleural traction sign [0 (0) vs. 6 (17.14%) vs. 70 (67.96%) vs. 5 (83.33%), χ 2=50.794, P<0.001]. The maximum diameter of lesion (OR=0.858, 95%CI: 0.754-0.977, P=0.021) and pleural traction sign (OR=0.288, 95%CI: 0.084-0.993, P=0.049) were independent influencing factors of MIA. The maximum diameter of lesion (OR=1.131, 95%CI: 1.030-1.241, P=0.010) and pleural traction sign (OR=3.441, 95%CI: 1.279-9.254, P=0.014) were independent influencing factors of IAC. The optimum threshold of the maximum diameter of lesion in diagnosis of MIA was 11.05 mm, AUC was 0.798 (95%CI: 0.724-0.872) sensitivity was 68.00%, and specificity was 85.70%. The AUC of pleural traction sign in diagnosis of MIA was 0.714 (95%CI: 0.623-0.806). The diagnostic efficacy exhibited no statistically significant difference between the maximum diameter of lesion and pleural traction sign in diagnosis of MIA (Z=1.838, P=0.066). The optimum threshold of the maximum diameter of lesion in diagnosis of IAC was 11.05 mm, AUC was 0.827 (95%CI: 0.759-0.895), sensitivity was 75.70%, and specificity was 78.90%. The AUC of pleural traction sign in diagnosis of IAC was 0.743 (95%CI: 0.663-0.823). The diagnostic efficacy exhibited statistically significant difference between the maximum diameter of lesion and pleural traction sign in diagnosis of IAC (Z=2.114, P=0.035), and the maximum diameter of lesion > 11.05 mm was better for the diagnosis of IAC. Conclusion The maximum diameter of lesion and pleural traction sign are independent influence factors in diagnosis of MIA and IAC, and the maximum diameter of lesion > 11.05 mm is better for the diagnosis of IAC. Figures and Tables | References | Related Articles | Metrics

Reviews

Mechanism study of CeRNA regulatory network mediating malignant tumor phenotype Zhang Jing, Huang Shouguo, Xia Ying 2021, 48 (9):  544-548.  doi: 10.3760/cma.j.cn371439-20201122-00105 Abstract ( 214 )   HTML ( 25 )   PDF (673KB) ( 183 )   Save Competing endogenous RNAs (CeRNAs) are crisscrossing regulatory networks. CeRNAs networks can mediate malignant tumor cell phenotypes, including proliferation and inhibition, autophagy, infinite growth, induction of angiogenesis and angiogenic mimicosis, immune escape, etc.. It is expected to provide new diagnostic markers and therapeutic targets for malignant tumors to master the regulation and function of CeRNAs mediated phenotype in malignant tumors. References | Related Articles | Metrics

Clinical significance of exosomal-circRNA in tumor diagnosis and treatment Zhang Wanchen, Xu Jiajie, Zhang Lizhuo, Ge Minghua 2021, 48 (9):  549-552.  doi: 10.3760/cma.j.cn371439-20210206-00106 Abstract ( 278 )   HTML ( 24 )   PDF (665KB) ( 174 )   Save There are abundant and stable circular RNAs in tumor-derived exosomes, which play an important role in the occurrences and developments of tumors. Exosome-circRNAs can be used as the marker of tumors diagnosis and prognosis, and have different roles in regulating tumors immune responses, regulating tumors progressions and mediating tumors drug resistances in different tumors. Exploring and applying the potential value of exosome-circRNAs will provide a new choice for the diagnosis and treatment of tumors. References | Related Articles | Metrics

Role of tumor microenvironment in tumor drug resistance Fu Weida, Chen Mengjiao, Guo Guilong, Zheng Shurong 2021, 48 (9):  553-556.  doi: 10.3760/cma.j.cn371439-20210517-00107 Abstract ( 460 )   HTML ( 71 )   PDF (667KB) ( 461 )   Save Tumor microenvironments (TMEs) are closely related to tumor resistance. TMEs are divided into cellular components and acellular components. The cellular components include tumor-associated macrophages, tumor-associated fibroblasts, mesenchymal stem cells, etc., which can enhance tumor resistance through recruitment and secretion of a variety of protective cytokines; acellular components such as extracellular matrix, hypoxia and acidification, etc., can mediate drug resistance by constructing physical barriers, affecting tumor cell growth and metabolism. Studying the mechanisms of TME-mediated drug resistance and reshaping TMEs can provide new strategies for anti-tumor therapy. References | Related Articles | Metrics

Role of substrate stiffness in the treatment of malignant tumor Deng Bo'er, Kong Weimin 2021, 48 (9):  557-559.  doi: 10.3760/cma.j.cn371439-20201122-00108 Abstract ( 226 )   HTML ( 18 )   PDF (657KB) ( 172 )   Save Substrate stiffness is one of the important mechanical parameters of extracellular matrix. Different substrate stiffness will affect the proliferation, movement and phenotype of tumor cells. It is found that the change of substrate stiffness is also related to the chemotherapy and radiotherapy sensitivity of tumor cells. Substrate stiffness can cause changes in the characteristics of tumor stem cells, which are related to the activation or inactivation of some signaling pathways, mainly involving ABCG2 protein and Akt/mTOR/Sox2 signaling pathway. Further study on the role of substrate stiffness in radiotherapy, chemotherapy and targeted therapy of malignant tumor is expected to provide basis for the clinical treatment of malignant tumor. References | Related Articles | Metrics

Mechanism of PD-L1 in thyroid carcinoma and its application in diagnosis and treatment Wu Yuping, Zhang Xiaoyu, Lu Keyi 2021, 48 (9):  560-563.  doi: 10.3760/cma.j.cn371439-20201208-00109 Abstract ( 639 )   HTML ( 31 )   PDF (664KB) ( 265 )   Save Programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) participate in the regulation of immune checkpoint and are closely related to the occurrence and development of thyroid carcinoma. PD-L1 is expressed differently in different types of thyroid cancer and can be used as a biomarker for the diagnosis of some tumors. The expression of PD-L1 in thyroid cancersis associated with higher tumor invasiveness and higher risk of recurrence. PD-1/PD-L1 immune checkpoint is a promising target for the treatment of some thyroid cancers. Further discussion of the mechanism of PD-1/PD-L1 pathway and its role in the diagnosis and treatment of thyroid cancer and the biomarkers related to the therapeutic effect can provide new ideas for the diagnosis and treatment of thyroid cancer. References | Related Articles | Metrics

Research on the anti-lung cancer effects of targeted Neddylation modifying pathway and its inhibitor MLN4924 and its mechanism Zhu Feng, Wang Shiwen, Xian Jingrong, Liu Yue, Zhao Hu, Zhang Yanmei 2021, 48 (9):  564-567.  doi: 10.3760/cma.j.cn371439-20210517-00110 Abstract ( 314 )   HTML ( 16 )   PDF (665KB) ( 163 )   Save Neddylation is overactivated in lung cancer, which promotes the development of lung cancer by activating its downstream CRL ubiquitin ligase and promoting the CRL tumor-suppressor protein substrate degradation. MLN4924, a small molecule inhibitor of Neddylation, plays an anti-lung cancer role by inducing cell cycle arrest, apoptosis and senescence. Furthermore, targeting the key enzymes of Neddylation and their substrates, Cullin family proteins, can inhibit the development of lung cancer. References | Related Articles | Metrics

Research progress of brain injuries in patients with small cell lung cancer caused by prophylactic cranial irradiation Zhang Hong'e, Zhou Qinghua, Liu Jiewei, Dai Shuang, Zhou Jie 2021, 48 (9):  568-571.  doi: 10.3760/cma.j.cn371439-20201207-00111 Abstract ( 285 )   HTML ( 24 )   PDF (667KB) ( 166 )   Save Small cell lung cancer (SCLC), as a pathological type with high malignancy, presents a high risk of early brain metastasis. Prophylactic cranial irradiation (PCI) can reduce the risk of brain metastasis in patients with SCLC, however, the incidence of brain structural and functional damage caused by PCI is high, and their clinical symptoms are not typical. The existing treatment methods can relieve some clinical symptoms, but can not effectively reverse the process of brain injury, which reduces the survival benefit of patients. In-depth understanding the mechanisms of PCI neurotoxicity and exploring effective strategies for ptevention and treatment are of great value in improving prognosis of SCLC. References | Related Articles | Metrics

Research progress of arsenic trioxide in anti-liver cancer mechanism and treatment of hepatocellular carcinoma Du Jiahang, Chen Dong, Chen Yaoting 2021, 48 (9):  572.  doi: 10.3760/cma.j.cn371439-20201201-00112 Abstract ( 225 )   HTML ( 21 )   PDF (658KB) ( 178 )   Save Arsenic trioxide (ATO) is involved in a variety of biological processes of hepatocellular carcinoma (HCC) cells, including apoptosis induction, proliferation inhibition, invasion and metastasis inhibition, and tumor stem cell inhibition. ATO has a variety of therapeutic approaches in the treatment of HCC, mainly including single drug therapy, combined local therapy, combined systemic therapy, and so on. Further research on the anti-cancer mechanism and clinical application of ATO is expected to provide new ideas for the treatment of liver cancer. References | Related Articles | Metrics