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08 October 2022, Volume 49 Issue 10 Previous Issue    Next Issue

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All for People's Health—Our Pursuit in the Past Decade

Research progress of radiation recall pneumonitis caused by immune checkpoint inhibitors Zhang Jie, Wei Meizhuo, Zhao ling, Yi Shanyong 2022, 49 (10):  577-580.  doi: 10.3760/cma.j.cn371439-20220516-00114 Abstract ( 239 )   HTML ( 13 )   PDF (722KB) ( 70 )   Save At present， tumor therapy has entered the era of immunotherapy. However， in recent years， it has been found that the application of immune checkpoint inhibitors after chest radiotherapy can not only play a synergistic anti-tumor effect， but also cause radiation recall pneumonitis （RRP）. RRP is a rare immune-related adverse reaction， which even leads to death in severe cases. It is of great significance to study the mechanisms and influencing factors of RRP caused by immune checkpoint inhibitors for strengthening the cognitive management of RRP and reducing the risk of RRP. References | Related Articles | Metrics

Original Articles

Clinical study of venous phase CT value in predicting central group lymph node metastasis of papillary thyroid carcinoma Li Jinhao, Wang Guidong, Li Xuefei, Liu Zilin, Meng Kailong 2022, 49 (10):  581-585.  doi: 10.3760/cma.j.cn371439-20220414-00115 Abstract ( 290 )   HTML ( 8 )   PDF (833KB) ( 41 )   Save Objective To investigate the clinical value of imaging features of primary lesions combined with venous phase CT value in predicting central group lymph node （LN） metastasis in patients with papillary thyroid carcinoma （PTC）. Methods Clinical data of 170 PTC patients who underwent central group LN dissection in the First People's Hospital of Handan City of Hebei Province from January 2017 to June 2020 were retrospectively analyzed. All patients were divided into different groups according to whether central group LN metastasis or not， and there were 89 patients with central group LN metastasis and 81 patients without central group LN metastasis. The CT value and imaging features of primary lesions in different periods were analyzed， and the imaging features of primary lesions combined with venous phase CT values to predict the central group LN metastasis were evaluated by the receiver operating characteristic （ROC） curve. Results There were no statistically significant differences in CT value in plain scan phase and CT value， net increased CT value， standardized CT value in arterial phase between patients with and without central group LN metastasis （all P>0.05）. The CT value， net increased CT value and standardized CT value in venous phase of patients with central group LN metastasis were （113.84±22.95） HU， （59.05±12.10） HU and 0.72±0.14 respectively， which were significantly higher than those of patients without central group LN metastasis [（103.99±17.67） HU， （51.29±14.45） HU and 0.59±0.10]（t=3.26， P<0.001； t=3.81， P<0.001； t=3.67， P<0.001）. ROC curve analysis showed that the area under the curve for diagnosing central group LN metastasis of PTC patients was 0.75， 0.70 and 0.76 when the cut-off values of CT value， net increased CT value and standardized CT value in venous phase were 115.78 HU， 62.37 HU and 0.75 respectively. There were statistically significant differences in the diameter of primary focus and the contact area of thyroid capsule between patients with and without central group LN metastasis （Z=-2.34， P=0.019； Z=-2.08， P=0.037）. There were no statistically significant differences between calcification and primary lesion location （both P>0.05）. Lesion diameter >2 cm （87.73%） and capsule contact range ≥1/2 （92.17%） had the highest specificity in predicting central group LN metastasis. The imaging features of primary lesion combined with standardized CT value in venous phase was in good agreement with histopathological diagnosis results in predicting central group LN metastasis （Kappa=0.475）， and the sensitivity and specificity were 73.12% and 82.75% respectively. Conclusion The imaging features of the primary lesion combined with CT value in venous phase have a good clinical value in predicting central group LN metastasis in PTC patients. Patients with primary lesion diameter >2 cm， capsule contact range ≥1/2 and the standardized CT value in venous phase >0.75 are more likely to have central group LN metastasis. Figures and Tables | References | Related Articles | Metrics

Trends in incidence and mortality of female breast cancer in China from 1990 to 2019 and age-period-cohort model analysis Duan Shuai, Guo Chenming, Li Huifang, Dilimulati · Aisimutula 2022, 49 (10):  586-591.  doi: 10.3760/cma.j.cn371439-20220726-00116 Abstract ( 373 )   HTML ( 16 )   PDF (1657KB) ( 62 )   Save Objective To analyze the incidence and mortality trends of female breast cancer in China from 1990 to 2019 and the impact of age-period-cohort （APC） on it. Methods The incidence and mortality of breast cancer of Chinese women aged 20-95 years from 1990 to 2019 were collected from the Global Burden of Disease （GBD） in 2019. Joinpoint software was used to estimate the average annual percentage change rate （AAPC） of age standardized incidence and mortality， and analyze the changing trend of disease burden of breast cancer in Chinese women from 1990 to 2019. The R language based APC model developed by the National Cancer Institute of the United States was used to analyze the impact of age， period and cohort on their changes. Results From 1990 to 2019， the age standardized incidence of female breast cancer in China showed an upward trend， from 17.07/100 000 in 1990 to 35.61/100 000 in 2019， with an average annual increase of 2.59% （95%CI： 2.45%-2.73%， P<0.001）， which was higher than the global level （AAPC=0.47%， 95%CI： 0.31%-0.63%， P<0.001）. The standardized mortality showed a slight downward trend， from 9.16/100 000 in 1990 to 9.01/100 000 in 2019， with a decrease of 0.05% （95%CI： -0.20%-0.09%， P=0.479）， but there was not a statistically significant difference. APC model results showed that the incidence and mortality of female breast cancer increased with age. With the passage of time， the incidence from 1990 to 2019 showed an upward trend， and the incidence risk rose to 1.49 in the 2015-2019 period （95%CI： 1.42-1.57， P<0.001）. The mortality showed a downward trend， and the death risk was the highest in the 1990-1994 period （RR=0.79， 95%CI： 0.74-0.83， P<0.001）. Cohort effect results showed that the later the women were born， the higher the risk of morbidity. The women born in the cohort from 1995 to 1999 had the highest risk （RR=3.12， 95%CI： 1.82-5.33， P<0.001）. The risk of death showed a unimodal distribution， showing a trend of first increasing and then decreasing， the later the women were born， the lower the risk of death. The birth cohort from 1950 to 1954 had the highest risk of death （RR=1.04， 95%CI： 0.98-1.09， P<0.001）， and then showed a downward trend， falling to 0.48 （95%CI： 0.19-1.24， P<0.001） in the birth cohort from 1995 to 1999. Conclusion From 1990 to 2019， the incidence of breast cancer in Chinese women shows an upward trend， which is significantly higher than the global increase， and the mortality tends to stabilize. APC model analysis finds that the incidence and mortality increase with age， and the period and cohort effects show that the incidence risk of breast cancer in Chinese women gradually increases with the passage of the period and cohort. The period effect of mortality shows a downward trend， and the cohort effect of mortality shows a unimodal distribution， showing a trend of first increasing and then decreasing. Figures and Tables | References | Related Articles | Metrics

Value of contrast-enhanced ultrasound combined with serum CXCL8 and CXCR2 in the evaluation of postoperative efficacy of transcatheter arterial chemoembolization for primary liver cancer Zhang Yumin, Zhao Xianwei, He Qianjin, Chen Jieneng 2022, 49 (10):  592-596.  doi: 10.3760/cma.j.cn371439-20220429-00117 Abstract ( 168 )   HTML ( 9 )   PDF (1450KB) ( 44 )   Save Objective To investigate the application value of contrast-enhanced ultrasound combined with serum CXC chemokine ligand 8 （CXCL8） and CXC chemokine receptor 2 （CXCR2） levels detection in the efficacy evaluation of patients with primary liver cancer after transcatheter arterial chemoembolization （TACE）. Methods A total of 80 patients with primary liver cancer who were diagnosed and treated in Huanggang Central Hospital of Hubei Province from June 2019 to January 2022 were selected as the research objects. The therapeutic efficacy was evaluated 2 months after TACE treatment. According to the pathological diagnosis， the patients were divided into complete inactivation group （n=30） and residual lesion group （n=50）. The levels of serum CXCL8 and CXCR2 were measured by enzyme linked immunosorbent assay （ELISA） double antibody sandwich method， and contrast-enhanced ultrasonography was performed on the patients. Receiver operating characteristic （ROC） curve was applied to analyze the value of serum CXCL8 and CXCR2 in evaluating the efficacy of TACE in patients with primary liver cancer. Kappa test was applied to test the consistency of contrast-enhanced ultrasound and contrast-enhanced ultrasound combined with serum CXCL8 and CXCR2 in evaluating the efficacy of TACE in patients with primary liver cancer and the results of pathological diagnosis. Results Compared with the complete inactivation group， the levels of serum CXCL8 [（7.12±1.68） ng/ml vs. （5.07±1.25） ng/ml] and CXCR2 [（3.62±0.79） ng/ml vs. （2.43±0.67） ng/ml] in the residual lesion group were obviously higher （t=5.79， P<0.001； t=6.89， P<0.001）. The areas under the curve of CXCL8 and CXCR2 in evaluating the efficacy of TACE in patients with primary liver cancer were 0.827 and 0.801 respectively， the specificities were 73.3% and 76.7%， and the sensitivities were 70.0% and 72.0% respectively. The concordance between contrast-enhanced ultrasound and pathological diagnosis was moderate， and the Kappa value was 0.49 （P<0.001）. The concordance between contrast-enhanced ultrasound combined with serum CXCL8 and CXCR2 and pathological diagnosis was high， and the Kappa value was 0.62 （P<0.001）. The sensitivity of contrast-enhanced ultrasound combined with serum CXCL8 and CXCR2 in evaluating the efficacy of TACE in patients with primary liver cancer was 90.0%， which was higher than the sensitivity of contrast-enhanced ultrasound （72.0%， χ2=5.26， P=0.022）， CXCL8 （70.0%， χ2=6.25， P=0.012） and CXCR2 （72.0%， χ2=5.26， P=0.022）. Conclusion Contrast-enhanced ultrasound can detect residual lesions after TACE in patients with primary liver cancer to a certain extent， and its combination with serum CXCL8 and CXCR2 can effectively improve the evaluation efficiency of the efficacy of TACE treatment in patients with primary liver cancer. Figures and Tables | References | Related Articles | Metrics

Relationship between glutathione peroxidases family and survival prognosis in patients with colorectal cancer Hao Haiya, Li Shulin, Zhang Rongqiang, Zuo Zehua 2022, 49 (10):  597-603.  doi: 10.3760/cma.j.cn371439-20220330-00118 Abstract ( 175 )   HTML ( 28 )   PDF (3137KB) ( 59 )   Save Objective To investigate the relationship between glutathione peroxidases （GPXs） gene expression in colorectal cancer tissues and survival prognosis， and to construct and evaluate a nomogram prediction model of GPXs for survival prognosis of colorectal cancer patients. Methods The GPXs gene expresion data and other clinical data of 620 patients with colorectal cancer （455 cases of colon cancer and 165 cases of rectal cancer） were downloaded from The Cancer Genome Atlas （TCGA） database， and the GPXs gene expression data of 820 normal people were downloaded as controls， preprocessed by R language， and the gene expression data were analyzed for differential expression. Spearman rank correlation was used to analyze the correlation between GPXs gene expression and tumor mutation burden （TMB） in colorectal cancer tissues. Cox risk regression model was used to analyze the influencing factors of survival and prognosis of colorectal cancer patients. Nomogram models were constructed to predict overall survival （OS） of colon cancer and rectal cancer patients， and its predictive performance was evaluated by calibration curve. Results In the GPXs family， there were statistically significant differences in the mRNA expressions of GPX1， GPX2， GPX3， GPX4， GPX5， GPX7 and GPX8 between colon cancer patients and normal population， and the mRNA expressions of GPX1， GPX2， GPX4 and GPX8 in colon cancer patients were higher than those in normal population （all P<0.05）. There were statistically significant differences in the mRNA expressions of GPX1， GPX2， GPX3， GPX4， GPX7 and GPX8 between rectal cancer patients and normal population， and the mRNA expressions of GPX1， GPX2， GPX4， GPX7 and GPX8 in rectal cancer patients were higher than those in normal population （all P<0.05）. Spearman rank correlation analysis showed that GPX2 （rs=-0.27， P<0.001） and GPX7 （rs=-0.11， P=0.043） expressions were negatively correlated with TMB in colon cancer. There were no significant correlations between GPXs genes expressions and TMB in rectal cancer tissues （all P>0.05）. In colon cancer， univariate analysis showed that GPX3 （HR=1.22， 95%CI： 1.05-1.43， P=0.012）， GPX4 （HR=1.39， 95%CI： 1.01-1.92， P=0.045）， age （HR=1.02， 95%CI： 1.01-1.04， P=0.010） and pTNM-stage （HR=1.78， 95%CI： 1.43-2.21， P<0.001） were the influencing factors of OS. Multivariate analysis showed that GPX4 （HR=1.96， 95%CI： 1.09-3.51， P=0.024）， age （HR=1.02， 95%CI： 1.00-1.04， P=0.042） and pTNM-stage （HR=1.61， 95%CI： 1.21-2.15， P=0.001） were the independent risk factors of OS. In rectal cancer， univariate analysis showed that age （HR=1.08， 95%CI： 1.04-1.13， P<0.001） was the influencing factor of OS. Multivariate analysis showed that GPX7 （HR=0.44， 95%CI： 0.22-0.88， P=0.020）， GPX8 （HR=3.17， 95%CI： 1.63-6.17， P=0.001） and age （HR=1.10， 95%CI： 1.04-1.16， P=0.001） were the independent influencing factors of OS. The consistency index （C-index） of the nomogram model for predicting OS in patients with colon cancer and rectal cancer were 0.71 （95%CI： 0.63-0.79） and 0.88 （95%CI： 0.82-0.94） respectively. The calibration curve showed that the prediction curve of the two models had a good fit with the real curve. Conclusion GPX4 is an independent risk factor affecting the prognosis of colon cancer patients. Patients with high GPX4 expression have a poor prognosis. GPX7 and GPX8 are independent prognostic factors for rectal cancer patients， and the rectal cancer patients with low GPX7 expression and high GPX8 expression have poor prognosis. The nomogram constructed based on the above factors can better predict the prognosis of patients with colon cancer and rectal cancer. Figures and Tables | References | Related Articles | Metrics

Reviews

SLC7A11 and glioma Kong Chunyu, Sun Pengfei 2022, 49 (10):  604-607.  doi: 10.3760/cma.j.cn371439-20220516-00119 Abstract ( 131 )   HTML ( 7 )   PDF (730KB) ( 67 )   Save Glioma is the most common primary brain tumor in adults and is essentially a polygenic abnormal disease. Solute carrier family 7 member 11（SLC7A11） is a core component of the cystine/glutamate transporter and its expression is regulated at the transcriptional and translational levels. SLC7A11 mediates glioma cells proliferation， invasion and chemoradiotherapy resistance through regulation of oxidative stress and ferroptosis. Deep study of SLC7A11 will provide new theoretical basis and therapeutic targets for the treatment of gliomas. References | Related Articles | Metrics

Research progress on the malignant transformation of oral submucosal fibrosis Zhou Changqun, Guan Xiaoyan, Liu Jianguo, Yue Chaoyi, Liao Chengcheng 2022, 49 (10):  608-611.  doi: 10.3760/cma.j.cn371439-20220609-00120 Abstract ( 307 )   HTML ( 5 )   PDF (729KB) ( 50 )   Save Oral submucous fibrosis （OSF） can cause various oral dysfunctions in patients and can turn into oral cancer. The causes and processes of OSF malignant transformation involve betel nut chewing， vascular atrophy， tissue hypoxia， cell cycle changes， aging， autophagy， and changes in cancer/cancer suppressor genes and microRNAs. It is of great significance to study the causes and process of OSF malignant transformation for the treatment and prevention of OSF malignant transformation. References | Related Articles | Metrics

Research progress of FOXO1 in oral squamous cell carcinoma Yang Fan, Guan Xiaoyan, Liu Jianguo, Xiao Linlin, Yue Chaoyi, Long Qian, Liao Chengcheng 2022, 49 (10):  612-614.  doi: 10.3760/cma.j.cn371439-20220414-00121 Abstract ( 163 )   HTML ( 4 )   PDF (709KB) ( 51 )   Save Forkhead box protein O1（FOXO1） has been extensively studied as a tumor suppressor. In oral squamous cell carcinoma， studies have demonstrated that FOXO1 can inhibit tumor cell oxidative stress， stemness and epithelial-mesenchymal transition， and promote tumor cell autophagy and apoptosis. FOXO1 may serve as a potential target for the treatment of oral squamous cell carcinoma. References | Related Articles | Metrics

Role of cancer-associated fibroblasts in the development and progression of breast cancer Wang Wenhao, Sun Xirui, Liu Jin, Sun Xiumei 2022, 49 (10):  615-618.  doi: 10.3760/cma.j.cn371439-20220614-00122 Abstract ( 199 )   HTML ( 10 )   PDF (752KB) ( 44 )   Save Recent studies have shown that tumor microenvironment （TME） is significantly different from normal tissues， such as the change of abnormal enzyme expression， hypoxia， pH and so on. TME is closely related to the induced proliferation of tumor cells， angiogenesis， immune escape and the production of multidrug resistance. Cancer associated fibroblasts （CAFs） are the main stromal cell types in the TME. A variety of cytokines secreted by CAFs play an important role in tumor growth， invasion and metastasis. Understanding the role and mechanism of CAFs in the development of breast cancer is expected to provide a new target for improving the prognosis of breast cancer patients. References | Related Articles | Metrics

Progress in the treatment of triple negative breast cancer with sacituzumab govitecan Wang Mengchao, Chen Liwei, Kong Fanming 2022, 49 (10):  619-622.  doi: 10.3760/cma.j.cn371439-20220715-00123 Abstract ( 281 )   HTML ( 6 )   PDF (729KB) ( 64 )   Save Triple-negative breast cancer is a subtype of invasive breast cancer， accounting for about 15% of all breast cancers. Its clinical treatment is relatively difficult， prone to recurrence and metastasis， with a short median survival and poor prognosis. Sacituzumab govitecan is the first approved antigen-coupled drug targeting trophoblast surface antigen 2 in the world. It has significant clinical efficacy， high safety and less adverse reactions， which brings new hope to the treatment of triple-negative breast cancer. References | Related Articles | Metrics

Progress in detection and technology applications of minimal residual disease detection in postoperative early stage non-small cell lung cancers Niu Ruiqi, Liu Pingping, Du Yingying 2022, 49 (10):  623-626.  doi: 10.3760/cma.j.cn371439-20220330-00124 Abstract ( 122 )   HTML ( 2 )   PDF (756KB) ( 45 )   Save Surgery is the mainstay of treatment for early lung cancers， but there is still a risk of recurrence and metastasis after surgery. With the advancement of molecular biology and detection methods， detecting the level of postoperative peripheral blood minimal residual disease （MRD） in patients can dynamically monitor recurrence and determine prognosis. Due to the wide variety of MRD detection methods， uneven detection power， lack of uniform standards and prospective study validation， clinical application is still controversial. The further development of MRD detection for early stage cell lung cancer still needs technical progress， standardized detection criteria and credible clinical data. References | Related Articles | Metrics

Research progress on the prognostic value of the ratio of lymphocytes to C-reactive protein in digestive system neoplasms Xu Kai, Wen Gang, Li Rui, Tian Yuan 2022, 49 (10):  627-629.  doi: 10.3760/cma.j.cn371439-20220531-00125 Abstract ( 92 )   HTML ( 5 )   PDF (737KB) ( 40 )   Save Tumor-associated inflammation is closely related to the development of tumors. The ratio of lymphocytes to C-reactive protein （LCR） is a new marker reflecting the inflammatory state of the body， which plays an important role in predicting the prognosis of digestive system neoplasms. Compared with the detection of lymphocytes or C-reactive protein alone， this marker has higher sensitivity and accuracy， and can provide a new direction for clinical diagnosis and treatment of digestive system neoplasms. References | Related Articles | Metrics

Research progress on the background of inflammation， immunity and cholesterol metabolism in colorectal cancer Yang Chi, Luo Changjiang 2022, 49 (10):  630-634.  doi: 10.3760/cma.j.cn371439-20220715-00126 Abstract ( 150 )   HTML ( 7 )   PDF (748KB) ( 65 )   Save At present， many treatment options for colorectal cancer， including chemotherapy， targeted therapy and immunotherapy， have poor efficacy due to resistance variation and patient individualization. It is urgent to find new precise and effective treatment measures at this stage. Studies have shown that the pathogenesis and progression of colorectal cancer involve multiple processes such as inflammation， immunity，and cholesterol metabolism， and there are many types of potential interactive reactions. Clarifying the regulatory mechanism of various factors is helpful to provide new ideas for colorectal cancer treatment. References | Related Articles | Metrics

Research progress on the relationship between DNA damage repair genes and liver cancer Di Weihua, Zhao Xuemei 2022, 49 (10):  635-638.  doi: 10.3760/cma.j.cn371439-20220520-00127 Abstract ( 166 )   HTML ( 3 )   PDF (721KB) ( 68 )   Save DNA damage repair （DDR） genes are overexpressed in liver cancer. Studies have found that DDR is closely related to the occurrence and development of liver cancer. There is a synergistic effect between DDR inhibitors and chemotherapy and targeted drugs for liver cancer. DDR inhibitors can enhance the sensitivity of radiotherapy. Some DDR genes can be used as biomarkers for the prognosis of liver cancer. References | Related Articles | Metrics