1.The prognosis of patients with stage Ⅰb-Ⅱb node-negative cervical carcinoma
Xi CHENG ; Shumo CAI ; Ziting LI
China Oncology 2000;0(06):-
Purpose:To investigate the survival and prognostic factors in patients with stage Ib~IIb node-negative cervical carcinoma.Methods:From Nov.1993 to Dec. 1997,236 patients who had radical hysterectomy and pelvic lymphadenectomy and pelvic lymph node found negative were reviewed retrospectively. Survival rates were calculated by Kaplan-Meier method with differences in survival estimated by Log-rank test. Independent prognostic factors were identified by the Cox's proportional-hazards regression model. Results:The overall 5-year survival of the patients was 82.0% and the median survival time was 100.0 months. The recurrence and/or metastatic rate was 19.5%. Of these patients the 5-year survival rate was 16.9% and median survival time was 15.0 months. Among the variables,clinical stage(Ⅱb),tumor size(≥4 cm),histological type (non-squamous carcinoma),poor differentiation,deep stromal invasion,parametrial extension,vaginal margin involved,and lymphvascular permeation were the poor prognostic factors in univariate survival analysis ( P
2.Detection of cytokeratin 19 (CK19) mRNA and human papillomavirus type 16 (HPV16) mRNA in peripheral blood of cervical cancer patients and its significance
Xi CHENG ; Shumo CAI ; Ziting LI
China Oncology 1998;0(04):-
Purpose:To detect the expression of cytokeratin 19 (CK19) mRNA and human papillomavirus type 16 (HPV16) mRNA in peripheral blood of cervical cancer patients. Methods:We used reverse transcription polymerase chain reaction (RT-PCR) to determine the expression of CK19 and HPV16 mRNA of 30 cervical cancer patients,8 patients with known distant metastases,16 patients with benign gynecological tumors and 9 healthy persons as control. Results:The presence of CK19 mRNA was observed in 3 peripheral blood samples among 30 cervical cancer patients (10%). The positive ratios for cervical patients with metastases,benign tumors and healthy control were 8/8,0/16 and 0/9. Only 10 cervical samples were proved to be HPV 16 positive by immunohistochemistry and/or hybridization in situ,whose expression of HPV16 mRNA in the peripheral blood were all negative (0/10). The positive ratios for cervical patients with metastasis,benign tumors and healthy control were 1/8,0/16 and 0/9,respectively. Conclusions:CK19 mRNA may be considered a powerful biomarker in the detection of peripheral blood of cervical cancer patients due to its high sensitivity and specificity. The detection of HPV16 mRNA was low and its clinical significance needs further evaluation.
3.Study on the optimal choice of therapeutic approaches for elderly women with advanced epithelial ovarian cancer
Rongyu ZANG ; Ziting LI ; Jie TANG ; Zhiyi ZHANG ; Shumo CAI
Chinese Journal of Geriatrics 2003;0(09):-
1cm, there was a significant statistical difference in median survival of 61 and 12 months, respectively (? 2 =16.60, P =0.0001). The median survival for patients with and without peritoneal chemotherapy were 27 and 12 months, respectively (? 2 =3.45, P =0.0633). Residual disease, FIGO stage, recurrent ascites, uterus muscle involvement were independent prognostic determinants of survival identified by Cox's stepwise regression analysis. Conclusions Aggressive surgical cytoreduction should be performed in elderly AEOC patients as well as in younger patients, but multi-course platinum-based chemotherapy should be used in accordance with the performance status of elder women.
4.Combined treatment and prognostic analysis of advanced epithelial ovarian carcinoma
Xiao HUANG ; Shumo CAI ; Jianxuan FAN ; Ziting LI
Chinese Journal of Obstetrics and Gynecology 2001;0(05):-
Objective To evaluate the effects of combined treatment for advanced epithelial ovarian carcinoma and to analyze its prognostic factors Methods Fifty three patients treated with a three step combined therapeutic regimen were defined as research arm The procedures of the three step combined treatment were as follows: induction of tumor remission, sequential chemotherapy and adjuvant immunotherapy Three hundred and eighteen patients with advanced epithelial ovarian carcinoma treated with cytoreductive surgery and systemic chemotherapy were retrospectively classified into control arm Results The rates of complete response and partial response in the research arm were significantly differed from those in the control arm (90 6%, 5 7% Vs 70 1%, 5 3%, P
5.Multidisciplinary treatment of recurrent epithelial ovarian carcinoma and prognostic analysis
Xiao HUANG ; Shumo CAI ; Jie TANG ; Ziting LI ; Rongyu ZANG
Chinese Journal of Obstetrics and Gynecology 2000;0(09):-
Objective To investigate individualized and multi-phase management of recurrent epithelial ovarian carcinoma in order to improve survival of the patients. Methods From 1998 to 2002, 70 patients with recurrent epithelial ovarian carcinoma were enrolled in the present study. The treatments were divided into: (1) Induction of tumor remission:platinum sensitive patients were treated with paclitaxol + cisplatin (TP) or carboplatin + cyclophosphamide(CP)regimen; platinum resistant patients used Taxol + mitomycin(TM)or etoposide+ mitomycin(VM)regimen. Resection of tumors was done in an attempt to reduce the residual tumor with a diameter less than 1cm. Local radiotherapy was performed for those with residual tumor and who achieved clinical response after chemotherapy or surgery. (2) Consolidation therapy: chemotherapy with lower doses was administrated after disease remission. Interferon was used as immunotherapy during chemotherapy and radiotherapy. Survial analysis was done. Results (1) The 1, 2, 3, 4, 5-year survival rates were 67%, 51%, 45%, 38%, 32% . Median survival was 38.57 months. (3)The 1,2,3-year progression-free survival rates of the research arm were 41%, 37%, 24%. Median progression-free survival was 12.00 months. (4) Multivariate analysis revealed that platinum-free interval (P
6.Technical and dosimetric study of three-dimensional conformal and intensity-modulated pelvic radiotherapy for post-hysterectomy cervical carcinoma
Yuan LIN ; Lijun ZHOU ; Zhiyong XU ; Shumo CAI ; Ziting LI ; Xiaolong FU ; Zhen ZHANG ; Xiaomao GUO ; Guoliang JIANG
Chinese Journal of Radiation Oncology 2008;17(5):372-376
Objective To establish the methods of three-dimensional eonformal(3DCRT) and intensity-modulated radiotherapy(IMRT) for whole pelvic irradiation in post-hysterectomy cervical carcinoma, And to optimize the methods for clinical practice. Methods Between 2004 and 2005,10 patients with cervical carcinoma who underwent hysterectomy with high risk of recurrence were selected for this study. The following observations and measurements were used for the study: Set-up errors with supine or prone position were measured to determine appropriate immobilization position. Influence of full and empty bladder on irradiated normal tissue volume was measured. Treatment errors were detected and CTV/PTV were then delineated. 3DCRT and IMRT planning and comparison were applied. Results The set-up error was within 5 mm of three dimensions in prone position and more than 5 mm in supine position, the difference of which was statistically significant. The percentage of irradiated volume of the bladder and bowel was smaller when the bladder was full comparing with empty bladder. In prone position and with full bladder,portal films showed the movement of isocenter in three directions. The total uncertainty was [7.4±1.6]mm. For 95% confidence interval,the margin from CTV to PTV was 1 cm. CIPTV for 3,4,5,and 6 fields 3DCRT was 0.46,O. 67, O. 68, and O. 68, respectively. When beyond 4 fields, the advantage of adding fields was not significant.Four fields planning was feasible for clinical practice. CI for 5,7,9,11 ,and 13 fidds IMRT was 0.75,0.83, 0.84,0.85 ,and 0.85 ,respectively. When beyond 9 fields,the advantage of adding fields was not significant. Nine fields planning was feasible for clinical practice. Conclusions For whole pelvic radiotherapy for post-hysterectomy cervical carcinoma,prone position was better than supine position for immobilization due to smaller set-up errors. The full bladder is recommended during radiotherapy, planning,For clinical practice,4 fields planning is feasible in 3DCRT while 9 fields planning is feasible in IMRT.
7.V-Y latissimus dorsi musculocutaneous flap for reconstruction of chest wall defects after local advanced breast cancer surgery: Report of 14 cases
Yuan DONG ; Shumo LI ; Liang CHEN ; Fei GE ; Ting ZHOU ; Qing MAO ; Zhe SUN ; Cheng CHEN ; Feili LI
Chinese Journal of Microsurgery 2022;45(6):634-638
Objective:To demonstrate the clinical effect of latissimus dorsi musculocutaneous flap with primary closure in V-Y suture in the repair of major lesions in the anterior chest wall that was left after mastectomies with locally advanced breast cancer (LABC) surgery.Methods:From September 2018 to February 2021, the technique was employed on 14 female cancer patients who had LABC surgery in the Department of Breast Surgery of the First Affiliated Hospital of Kunming Medical University. The patients received radical mastectomies with major resection of cutaneous tegument. The defect areas in chest wall were 15.0 cm×15.0 cm-22.0 cm×35.0 cm. The sizes of flap were 12.0 cm×28.0 cm-18.0 cm×35.0 cm. The sizes of musculocutaneous flap were 12.0 cm×28.0 cm×2.0 cm~18.0 cm×35.0 cm×3.5 cm. All patients were entered the postoperative follow-up through out-patient clinic and telephone interviews.Results:The flap provided an efficient coverage in closing the defects among all 14 patients. Three patients presented small areas (1.0-3.0 cm) of superficial necrosis in Y-cross area of the flap. None of the patient had back swelling. The average operation time was 6.3 hours. Postoperative follow-up varied from 4 to 41 months(18 months in average). The colour, texture, elasticity of the flaps were acceptable, with good shapes. Function of upper limbs was normal in 13 cases without lymphedema, except 1 who had lymphedema of affected limb at 3 years after surgery. Eleven cases had radiotherapy after surgery with good tolerance. None of the cases had local recurrence of breast cancer. Five cases had metastasis, 3 cases died of metastasis.Conclusion:The latissimus dorsi musculocutaneous flap with primary closure in V-Y suture is easy to perform and an reliable and efficient technique in repairing large defects in the anterior chest wall left after a LABC surgery.
8.Establishment of cisplatin-resistant breast cancer cell line and role of FANCF gene in cisplatin resistance
MA Yun ; LI Shumo ; JIANG Aimei ; DONG Jian
Chinese Journal of Cancer Biotherapy 2018;25(6):607-612
Objective: To investigate the expression profile and function of FANCF gene (a key gene in FA/BRCA pathway) in both cisplatin (DDP)-resistant and DDP-sensitive human triple-negative breast cancer cell lines and to analyze its correlation with DDP-resistance in breast cancer. Methods: The DDP-resistant breast cancer MDA-MB-231 cell line (MDA-MB-231/DDP) was established by induction of gradient DDP. The expression of FANCF gene in both sensitive and resistant cell lines was knocked-down by RNAi interference technology and the knockdown efficiency was validated at both RNA and protein level. The cell viability of MDA-MB-231 cells and MDA-MB-231/DDP cells was determined by the CCK8 assay; Flow cytometry was used to examine the cell cycle distribution and apoptosis; the mRNAand protein expressions of FANCF gene were examined by using qRT-PCR and western blotting, respectively. Results: The resistance index of MDA-MB-231/DDP cells was 13.5 after 3-month induction. The mRNA and protein expressions of FANCF were significantly increased in MDA-MB-231/DDP cells (all P<0.01). Cell cycle analysis indicated that the DDP treatment significantly induced G0/G1 arrest and decreased the cell proportion in phase S and G2/M. siRNA-mediated knockdown of FANCF could not only be able to increase sensitivity of MDA-MB-231 to DDP but also promote the cell apoptosis (all P<0.01). Conclusion: FANCF attributes to the occurrence of DDP-resistance through anti-apoptosis effect, which might be served as a potential treatment target for drug-resistant human breast cancer.
9.The effects of FANCFon paclitaxel-resistant triple negative breast cancercell
MA Yun ; CHAI Wenying ; LI Shumo ; DONG Jian
Chinese Journal of Cancer Biotherapy 2018;25(3):240-245
[Abstract] Objective: To establish paclitaxel(PTX)-resistant human triple negative breast cancer cell line and to examine the expression profile of FA-related genes and FANCF, the correlation between the expression of FA-related genes, FANCF and PTX-resistance in breast cancer were further analyzed. Methods: PTX-resistant MDA-MB-231 cell line was established by means of long-term PTX-exposed culture. The sensitivity of the cells to paclitaxel was determined by the CCK8 assay. The cell cycle distribution was examined by flow cytometry after exposure to the paclitaxel. The expression of FA-related gene mRNA and FANCF protein were examined by using real time quantitative PCR and Western blotting. The expression of FANCF in the cells was reduced by RNAi interference technology and the effect of the RNAi was verified. Results: MDA-MB-231/PTX cell showed a 9.9-fold resistance to paclitaxel, indicating that the cell had acquired resistance to PTX. PTX treatment significantly induced G0/G1 arrest and the number of cells in phase S markedly decreased after exposure to PTX. The mRNA and protein expression of FANCF was significantly higher in PTX-resistant cell than that in PTX-sensitve parental cell,Knockdown of FANCF induced apoptosis in MDA-MB-231/PTX cell as well as in parental cell. FANCF knockdown increased the sensitivity of paclitaxel to both MDA-MB-231 and MDA-MB-231/PTX cells (P<0.05 or P<0.01). Conclusion: FANCF played an important role in PTX resistance of the breast cancer cells and FANCF might be a target for therapy aimed at reversing chemoresistance.