In recent years a large number of studies have been conducted to investigate the role of vitamin D and its metabolites in cancer.However,the picture for lung cancer is not clear at the present time.There are three integral components of the vitamin D pathway:the vitamin D receptor(VDR),CYP27B1 and CYP24A1.Besides,vitamin D inhibits the carcinogenesis of lung by indirectly influencing IGF signaling,TGF-β signaling,and Wnt/β-catenin signaling pathway.Their differential expressions in normal lung tissue and lung cancer offer clues and lay the foundation for research of the inhibitory function in lung cancer pathogenesis.

Esophageal squamous cell carcinoma(ESCC) is a common malignancy in china,and TNM staging is the standard staging system for ESCC.However,in clinical practice,patients' prognosis is not always consistent with the staging.This phenomenon may be attributed from the fact that the current limitation and imperfect of the TNM staging system,and besides,another possible reason might be that some prognostic factors for ESCC other than TNM descriptors may exist.Among all the prognostic factors for ESCC,molecular biomarkers received widely concern.We searched the literatures and identified 12 molecular biomarkers that received the most concern and validated them in our single surgeon team.The results showed that only P21,COX-2 and E-cadherin were significant prognostic factors for ESCC in this series.Therefore,in the current study,we reviewed the literature regarding the prognostic significance of the above mentioned three biomarkers for clinical reference.

Breast cancer is one of the most common tumors in the world. HER2 and anti HER2 monoclonal antibody (Herceptin) has been a focus of breast cancer study in recent years. It is believed that HER2 and anti HER2 monoclonal antibody (Herceptin) may be a novel independent prognostic marker and therapeutic target for breast cancer. Herceptin, anti HER2 monoclonal antibody, has been proved to be an effective agent for breast cancer in late stage diseases, recurrent and metastatic lesion.

Lung Neoplasms ; Periodicals as Topic

Education, Medical ; Humans ; Neoplasms ; therapy ; Rare Diseases ; therapy

(1) Surgery is the first method to cure early stage non-small cell lung cancer (NSCLC). Ground glass nodule (GGO) like lung adenocarcinoma should be regarded as a new clinical issue to avoid over-treatment. The deep meaning of multidisciplinary pathological classification of lung adenocarcinoma should be fully understood to avoid over-diagnosis. The T staging of lung adenocarcinoma mixed with GGO components should be correctly understood to avoid over-staging. We should carefully understand the new data of relationship between sublobectomy and prognosis to avoid excessive resection. Attention should be paid to the research progress of minimal residual disease (MRD) to avoid insufficient treatment. (2) The treatment strategy of resectable stage Ⅲ NSCLC should be surgery with individualized systemic treatment. Locally advanced NSCLC dominated by Ⅲa-N2 NSCLC is a kind of disease with high multi-dimensional heterogeneity. In theory, preoperative treatment is superior to postoperative treatment, and molecular diagnosis should be made along with pretreatment staging, so as to select preoperative treatment. The patients with negative driver gene mutation obtained better pathological complete response/major pathological response (PCR/MPR) from immunotherapy compared to those from chemotherapy, and the better PCR/MPR is expected to be transformed into overall survival (OS). The data of preoperative treatment in patients with positive driver gene mutation are few, whereas the data of postoperative targeted treatment are much better than those of postoperative chemotherapy. (3) The effective systemic treatment strategy has "created" many long-term survivors with stage Ⅳ NSCLC, and has changed the original concept and population of "oligometastasis". Attention should be paid to the individual ineffective lesions in stage Ⅳ patients with long-term survival. It is also necessary to explore how to intervene in the resection of "oligometastasis" of stage Ⅳ NSCLC at an appropriate time and in an appropriate way, which may be one of the main tasks of lung cancer surgery in the future.

TNM system should be used in the staging of small cell lung cancer (SCLC), especially in the limited stages of SCLC. Preoperative staging should be strengthened to avoid invalid operation due to insufficient diagnosis. Retrospective studies showed that the efficacy of surgery (+ chemotherapy) in early SCLC is comparable to the outcome of resection for early stage non-small cell lung cancer, which shakes the concept of "chemotherapy/chemoradiotherapy as the main treatment of SCLC". The best operative procedure of SCLC is lobectomy. Sub-lobectomy and pneumonectomy are inferior to that of lobectomy, but still better than chemotherapy/chemo-radiotherapy in terms to long term survival. All these findings need to be confirmed by large sample prospective randomized studies.

Stomach is the first choice for esophageal reconstruction following esophagectomy. In the earlier days, however, whole stomach pulling-up was the major surgery, which had some shortcomings. Recently, gastric tube has gained wide acceptance for esophageal reconstruction. This paper summarized the anatomical and physiological advantage of stomach, the disadvantage of whole stomach, and benefits of gastric tube for esophageal reconstruction.
Esophageal Neoplasms ; surgery ; Esophagectomy ; Humans ; Reconstructive Surgical Procedures ; Stomach ; surgery

Esophageal squamous cell carcinoma is one of the malignant tumors with a high incidence in China. The main pathological anatomy is the obstruction of the diseased esophagus. Nutritional disorders and a series of relevant pathophysiological changes are the main factors affec-ting the safe implementation of treatment and the long-term survival of patients. Therefore, timely correction of nutritional disorders is the main component of treatment. The ideal treatment for locally advanced esophageal squamous cell carcinoma is induction systemic treatment followed by surgery. The outstanding problems in clinical management of esophageal carcinoma are that only short-term attention is paid to postoperative nutrition support, ignoring preoperative nutrition along with the major anticancer treatment, the rehabilitation of patients' swallowing function after surgery, as well as nutrition and weight management. The author reviews the unique role of tube feeding with element enteral nutrition during the whole course of treatment of esophageal cancer, in order to provide reference for its standardized management.

Esophagectomy is one of the most complicated procedures. Satisfactory anesthesia not only ensures the safety in terms of low morbidity and mortality postoperatively, but also one of the potential factors relevant to long-term survival. Most of physicians, however, ignore the significance of anesthesia. This article focuses on the recent advances of anesthesia for esophagectomy in preoperative preparation for induction, rapid-sequence induction, one-lung ventilation, fluid management during surgery and postoperative early extubation and analgesia.
Analgesia ; Anesthesia ; methods ; Esophagectomy ; methods ; Fluid Therapy ; Humans