Renal cell carcinoma (RCC) accounts for approximately 2% of all malignancies. The incidence of RCC has increased by 2% per year for the past 65 years. Over the past two decades, with the widespread use of imaging methods, the frequency of incidental detection of RCC has increased. Surgery is an important therapeutic method for renal cell carcinoma. Originally, nephron-sparing surgery was indicated only for those treated with radical nephrectomy which would render the patients functionally anephric and requiring dialysis. These settings include RCC in a solitary kidney, RCC in one kidney with contralateral inadequate renal fuction, and bilateral synchronous RCC. However, nephron-sparing surgery has been used increasingly in patients with T_(1a) and T_(1b) renal tumors (i.e. up to 7 cm in the greatest dimension) and a normal contralateral kidney, with equivalent outcomes to radical nephrectomy. Compared with radical nephrectomy, nephron-sparing surgery can increase patient survival and reduce the risk of cardiovascular events. However, nephron-sparing surgery has not been widely used yet because most surgeons are confused of its safety, indication, resection range and complications.

Sentinel lymph node (SLN) detection in endometrial cancer is still in the exploration stage. But a good many studies have confirmed the feasibility of SLN detection in patients with early endometrial cancer. Higher detection rate of SLN can be achieved by the combination of blue dye and radiocolloid. Compared with intracervical injection, more injections at different sites of the uterine corpus and hysteroscopic injection may improve SLN detection rate and para-aortic SLN detection rate. SLN detection rates are also related to some other factors such as the amount of tracers, the interval between injection and detection, and the depth of myometrium invasion. Serial-step section of SLN combined with immunohistochemistry staining with anti-cyto-keratin may improve the detection of micrometastasis (MM) in SLN. SLN procedure can detect MM which cannot be found by traditional pathological techniques. The ultrastaging will allow better stratification of patients at intermediate risk and can provide valuable informaiton for the selection of adjuvant therapy, thus decreasing the recurrent rate.

Objective: To study the expressions of mitochondrial protein (MAB1273), Bcl-2, and Bax in renal cell carcinoma and to investigate their role in the tumorigenesis. Methods: The expressions of mitochondrial protein, Bcl-2 and Bax were detected by immunohistochemistry SP method in 9 tissue samples of renal on-cocytoma, 6 samples of chromophobe carcinoma, 23 samples of clear cell carcinoma and 12 samples of normal renal tissue. Results: The expression of MAB1273 in renal oncocytoma, chromophobe carcinoma and clear cell carcinoma was much higher than that in normal renal tissue (P=0.006). No significant difference was found in MAB1273 expression among the three types of renal carcinoma. The expression of Bcl-2 was higher in the renal carcinoma groups than in the normal renal tissue group, with a significant difference (P=0.008). The expression of Bax was not different among all of the groups (P=0.057). Rank correlation analysis showed a positive correlation between MAB1273 and Bcl-2 expression (r=0.341, P=0.015). The expression of Bcl-2 was negatively correlated with Bax expression (r= -0.287, P=0.043). Conclusion: Overexpression of mitochondrial protein and Bcl-2 and underexpression of Bax may play a part in the genesis of renal oncocytoma, chromophobe carcinoma and the clear cell carcinoma, indicating that overexpression of MAB1273 may be correlated with apoptosis of renal cell carcinoma cells.

Objective: To investigate the killing activity of cytokine-induced killer (CIK) cells after incubation with autologous tumor cell lysate-pulsed dendritic cells (Ag-DC) and to evaluate the immune functions of patients, the clinical efficacy and side effect of Ag-DC in combination with CIK on hepatocellular carcinoma. Methods: Peripheral blood mononuclear cells were isolated from 24 patients with hepatocellular carcinoma, and cultured with granulocyte-macrophage colony-stimulating factor and interleukin-4 to produce dendritic cells (DCs). The DCs were pulsed with autologous tumor cell lysate. T lymphocytes from PBMC were cultured with interferon-Y (IFN-γ), IL-2, CD3-moAb, and IL-1α to prepare CIK. The killing effect of CIK on SMMC-7721 was investigated after CIK was incubated with Ag-DC. After immunotherapy with Ag-DC and CIK, immunolog-ic and clinical responses of the 24 patients were evaluated. Results: The killing effect of CIK was remarkably improved after CIK was incubated with Ag-DC. The immunotherapy with DC and CIK alleviated symptoms and improved the immune functions of the patients. Except for transient fever and chill, no remarkable adverse events were observed. Conclusion: Ag-DC in combination with CIK shows short-term efficacy on hepatocellular carcinoma through inducing specific anti-tumor immunity and can be an effective adjuvant therapy for hepatocellular carcinoma.

Objective: To observe the therapeutic efficacy of astragalus polysaccharide (APS) in combination with three-dimensional conformal radiotherapy (3D-CRT) for elderly patients with non-small cell lung cancer (NSCLC). Methods: A total of 80 elderly patients with I～IV stage NSCLC were randomly divided into two groups. The 40 patients in the therapeutic group received radiotherapy in combination with APS. The 40 patients in the control group received radiotherapy alone. Both groups received 3D-CRT with a total dose of 50～ 70Gy, 2.0Gy/fraction, once a day, 5 times per week. The patients in the therapeutic group were treated with radiotherapy combined with injection of APS (250mg in 5% glucose) or normal saline (500 mL) intravenously once a day until the end of radiotherapy. The short-term efficacy and patients' quality of life were evaluated. The T-lymphocyte subpopulation and peripheral blood leukocyte count were also measured after treatment. Results: The short-term effective rates of the therapeutic group and the control group were 87.5% and 72.5%, respectively, without significant difference between the two groups (P＞0.05). The decrease of peripheral blood leukocyte count after treatment in the control group was significant (P＜0.05). In the therapeutic group, the T-lymphocyte subsets CD8 and CD4/CD8 were improved after treatment, with a significant difference (P＜ 0.05). But in the control group, no significant changes in T-lymphocyte subsets CD8 and CD4/CD8 were observed after treatment (P＞0.05). Patients' quality of life in the therapeutic group was superior to that in the control group, with a significant difference (P＜0.05). Conclusion: APS in combination with 3D-CRT can reduce the side effects of radiation and improve the quality of life of elderly patients with NSCLC.

Objective: To evaluate the therapeutic effects of Rituximab combined with CHOP on B cell non-Hodgkin's lymphoma. Methods: A prospective study with concurrent control group was carried out. A total of 60 cases of B cell non-Hodgkin's lympoma were divided into 2 groups. The 30 cases in the research group received Rituximab combined with CHOP regimen. The 30 cases in the control group were treated with CHOP regimen alone. CHOP regimen (Cyclophospham 600mg/m~2 IV, Vincristine 1.4mg/m~2 Ⅳ, and Adriamy-cin piarubicin 50mg/m~2 IV) was administered on the first day of chemotherapy course. Prednisone 100mg/m~2 was administered orally from the first day to the fifth day. The cycle was repeated every 21 days and the patients received at least 3-6 cycles of chemotherapy. The therapeutic effect was assessed. Results: The complete remission (CR) rate and total response rate were 66.7% (20/30) and 90.0% (27/30) in the research group and 39.97% (12/30) and 56.7% (17/30) in the control group. The therapeutic differences between the two groups showed a statistical significance (P＜0.05). Conclusion: Compared with CHOP regimen chemotherapy, Rituximab combined with CHOP regimen shows better therapeutic effect. The side effects in the research group are similar to those in the control group. Rituximab combined with CHOP regimen can be the first choice in the treatment for B cell non-Hodgkin's lymphoma.

Objective: To study the influence of clinicopathologic factors on the recurrent pattern of colorectal cancer after radical treatment. Methods: There were 464 consecutive patients with colorectal cancer treated with radical surgery between January 1998 and December 2002 in our hospital. The clinicopathologic features of 90 patients with relapse of colorectal cancer after radical surgery were analyzed. According to the interval between radical surgery and recurrence, these 90 patients were divided into subgroups, the early recurrent group (within 30 months after surgery) and the late recurrent group (more than 30 months after surgery). Chi-square test was used for univariate analysis, and the Logistic regression model was performed for multivariate analysis. Result: There were 78 (86%) patients in the early recurrent group and 12 (14%) patients in the late recurrent group. The median time of recurrence was 17.4 months. The median recurrent time in stage I patients was 35.1 months, 13.6 months in stage II patients, and 12.9 months in stage III patients, respectively. Univariate analysis showed that the depth of penetration, the number of positive lymph nodes, and the gross appearance of tumor were predictors for early recurrence. Multivariate analysis revealed that the depth of penetration (T category) of the primary tumor significantly predicted for early recurrence (P= 0.049). Conclusion: A great proportion of recurrence in patients with colorectal cancer occurred within 30 months after radical treatment, but the late recurrence which occurs at more than 30 months after radical surgery should not be neglected. Patients with different patterns of recurrence had different intervals between radical surgery and recurrence. DM (distant metastasis) occurs earlier than LR (local recurrence). The depth of penetration of the primary tumor is an independent predictor for early recurrence of colorectal cancer patients after radical surgery.

Objective: To analyze the association between hepatitis B virus (HBV) infection and pancreatic cancer. Methods: Retrospective analysis was performed to explore the positive rate of serum hepatitis B virus surface antigen (HBsAg) in patients with pancreatic cancer, lung cancer, diabetes mellitus and general population. Z test was used to compare the rate of HBV infection between the samples and general population. The rates among the samples were compared by Chi-square test. Results: A total of 3,701 registered patients seen in our hospital between January 1st 2003 and March 31st 2009 were collected. There were 230 pancreatic cancer patients with a positive rate of serum HBsAg of 16.1%, 1,188 lung cancer patients with a positive rate of serum HBsAg of 10.7%, and 2,283 patients with diabetes mellitus with a positive rate of serum HBsAg of 11.6%. There was no statistical significance in Z-test results between lung cancer patients and general population (Z=1.104, P=0.163), but the Z-test results between patients with diabetes mellitus and general population showed a statistical significance (Z=2.98, P=0.002). The positive rate of HBsAg was higher in pancreatic cancer patients than that in lung cancer patients (OR=1.60, 95% Cl: 1.077-2.382, r=5.487, P=0.019). Similar results were found between pancreatic cancer patients and diabetic patients (OR=1.46, 95% CI: 1.004-2.123, r=3.965, P=0.046). Conclusion: The positive rate of HBsAg is high in pancreatic cancer patients. There might be an association between HBV infection and pancreatic cancer.

Objective: To investigate the long-term effect of submandibular salivary gland transfer on xerostomia induced by radiation in patients with nasopharyngeal carcinoma (NPC). Methods: A total of 70 eligible patients with NPC were divided into the test group (36 cases) and the control group (34 cases). In the test group, the submandibular salivary glands were transferred to the submental space before conventional radiotherapy (XRT) and shielded during XRT. Submandibular gland function and salivary fluid before and after radiotherapy, questionnaire of xerostomia at 60 months after XRT, and 5-year survival rate were compared between the two groups. Results: At 5 years after XRT, the trapping and excretion function of submandibular glands were significantly better in the test group (P=0.000 and P=0.000, respectively). The mean weight of saliva after XRT was greater in the test group than in the control group (1.65gvs.0.73g, P=0.000). Incidence of moderate to severe degree of xerostomia was significantly lower in the test group than in the control group (12.9%vs.78.6%, P=0.000). No significant difference was found in 5 year survival rate between the two groups (86.1%vs.82.4%, P＞0.05). Conclusion: Submandibular gland transfer procedure is safe for NPC patients. It can prevent XRT induced xerostomia and improve the quality of life of NPC patients.

Objective To explore the relationship of serum level of Cystatin C and suPAR with tumor infiltration, metastasis, and treatment of patients with malignant tumor. Methods: The serum levels of Cystatin C was detected by particle enhanced nephelometic immunoassay (PENIA) by 7600-010 full-automatic biochemical analyzer made in Japan. The level of suPAR was detected by ELISA. The serum levels of Cystatin C and suPARof 82 normal adults and 172 patients with malignant tumor were measured and compared. Results: The serum level of Cystatin C and suPAR in patients with malignant tumor was significantly increased compared with that of normal adults (P＜0.01 and P＜0.01). The level of Cystatin C and suPAR in terminally ill patients or patients with metastasis was significantly higher than that in the control group. The levels of the two indices in postoperative patients were lower than those in preoperative patients. No significant difference was found in the levels of the two indicies before chemotherapy or radiotherapy and after therapy. Conclusion: The serum levels of Cystatin C and suPARin patients with malignant tumor are correlated with tumor invasion, metastasis and surgical intervention. Detection of Cystatin C and suPAR levels in patients with malignant tumor is valuable for disease monitoring and treatment evaluation.