Objective To investigate the serum CEA,CA199,CA242,CA724,AFP levels as tumor markers for diagnosis and prognosis of gastric cancer.Methods The serum concentrations of CEA,CA199,CA724,AFP were detected in 108 patients with gastric cancer by ECLIA (electrochemiluminescence immunoassay) method.CA242 by ELISA method.The survival analysis was performed by the Kaplan-Meier method,Cox' s proportional hazards model was used for multivariate analysis of prognosis.Results Using healthy subjects group as control,the ROC-AUC of CEA,CA199,CA242,CA724 were 0.735,0.714,0.598,0.576.The sensitivity,specificity and Youden index were 40.2 ％,97.7 ％,0.379; 43.0 ％,91.3 ％,0.343;35.2 ％,94.8 ％,0.300 and 31.3 ％,95.3 ％,0.266,respectively.For combined detection of CEA,CA199,CA242,CA724,the sensitivity,specificity and Youden Index were 76.8 ％,82.3 ％,0.585.The levels of CEA,CA724 were closely related to lymph node status (both P ＜ 0.05).The concentrations of CEA,CA199,CA242 were significantly related to vascular embolization,distant metastases and ascites (all P ＜ 0.05).The patients of lump and catheter had significantly higher of AFP compared with patients of invasion and anabrosis (P ＜ 0.05).In gastric cancer patients,the size of the primary tumors was closely related to the preoperative serum levels of CEA,AFP,CA724 (P ＜ 0.05).During follow-up,there were 34 cases of death in 59 patients,and the median survival time were 18.1,10.9 months for the patients with CEA negative and positive (P ＜ 0.005).Conclusions Combing detection of CEA,CA199,CA242,CA72 can improve sensitivity of gastric cancer,and play an important role in forecasting the recurrence,metastasis,curing and prognosis evaluation.CEA is an important predictor of recurrence and prognosis of gastric cancer.

Objective:To explore the main factors of hypothyroidism after radiotherapy and to identify the optimal thyroid dosimetric parameters by analyzing the dosimetric parameters of the thyroid.Methods:The general clinical characteristics and dosimetric parameters of 206 patients with nasopharyngeal carcinoma treated in Cancer Hospital of University of Chinese Academy of Sciences were collected, and the correlation between them and the incidence of hypothyroidism was analyzed.Results:The incidence of hypothyroidism in patients with nasopharyngeal carcinoma after radiotherapy was 50.49%(104/206). Univariate analysis showed that gender, N-stage, volume, mean dose, V 20Gy, V 25Gy, V 30Gy, V 35Gy, V 40Gy, V 45Gy of thyroid were associated with the incidence of hypothyroidism. Multivariate analysis demonstrated that volume (≤12.82 cm 3) and mean dose of thyroid were the independent risk factors of hypothyroidism. Mean dose of thyroid combined with volume could significantly predict the incidence of hypothyroidism after radiotherapy. Conclusion:Mean dose of thyroid ≤ 47.21 Gy is the optimal dosimetric parameter for radiation-induced hypothyroidism, especially the patients with thyroid volume ≤ 12.82 cm 3 should pay more attention to the protection of thyroid gland during radiotherapy.

Hypothyroidism is a common complication in patients with nasopharyngeal carcinoma after radiotherapy, and its incidence is mainly associated with clinical factors, such as radiotherapy, chemotherapy, sex, age and clinical stage, etc. The normal tissue complication probability models of radiation-induced hypothyroidism can be established by using related factors, which can be employed to screen the high-risk patients. In this article, clinical factors related to radiation-induced hypothyroidism were summarized, aiming to prevent the early radiation-induced hypothyroidism, reduce the incidence of hypothyroidism and improve the quality of life of patients.

Objective:To preliminarily evaluate the efficacy and safety of stereotactic body radiotherapy (SBRT) for pulmonary oligometastatic tumors from head and neck carcinoma.Methods:Clinical data of 24 patients with pulmonary oligometastasis from head and neck carcinoma undergoing SBRT in Zhejiang Cancer Hospital from January 2014 to May 2019 were retrospectively analyzed. Survival analysis was performed by Kaplan- Meier method. Results:Among the 24 patients, 12 cases were diagnosed with nasopharyngeal origin and 12 cases of non-nasopharyngeal origin. A total of 34 pulmonary metastatic lesions were treated with SBRT. The median follow-up time was 19.5 months. Thirteen cases developed new lesions after SBRT, and 9 of them occurred within 1 year after SBRT treatment. The actual 1-year local control rate was 95%. The median progression-free survival was 15.2 months, and the 1-and 2-year progression-free survival were 59% and 46%, respectively. The 2-and 3-years overall survival rate at were 71% and 51% fter lung metastasis, respectively. Univariate analysis showed that the patients with primary lesions located in nasopharynx and disease-free interval of more than 1 year had survival advantage. No more than grade 3 radiation-induced injury was observed in the whole cohort after SBRT, and the incidence of mild radiation-induced injury was 13%.Conclusions:SBRT is safe and effective in the treatment of pulmonary oligometastatsis from head and neck carcinoma, and it may be more effective for patients with primary tumors located in nasopharynx.

Radiation-induced cognitive dysfunction is a common complication in patients with nasopharyngeal carcinoma after undergoing radiotherapy, which has been proven to be associated with neurogenesis dysfunction, oligodendrocyte loss, vascular damage and abnormal cytokine expression. With the development of medicine, functional magnetic resonance image (fMRI) can detect the early lesions of cognitive dysfunction. Hippocampus-sparing technology and drug therapy (memantine, donepezil and bevacizumab) can mitigate radiation-induced cognitive dysfunction. In this article, the pathogenesis, neuroimaging, radiodosimetry and therapies of radiotherapy-induced cognitive dysfunction in nasopharynal carcinoma patients were reviewed.

OBJECTIVE: To explore the characteristics of Shwachman-Diamond syndrome (SDS) in Chinese children in order to provide a reference for early diagnosis. METHODS: With Shwachman-Diamond syndrome, SDS, SBDS gene and inherited bone marrow failure as the keywords, the search period was set from January 2002 to October 2022. Relevant literature was retrieved from the Wanfang Database and China National Knowledge Infrastructure (CNKI) database. In addition, by using Shwachman-diamond syndrome as a keyword, the search period was also retrieved from the Web of Science, PubMed, and MEDLINE databases from January 2002 to October 2022. A child with SDS treated at the Tongji Hospital was also included. A total of 44 cases with complete clinical data were analyzed with reference to the International Standard for SDS Diagnosis. Chi-square test and t test were used for statistical analysis. Evidence-based research was carried out in the form of systematic review. The epidemiology, clinical characteristics and key points of early diagnosis of the Chinese SDS children were summarized and compared with the international data. RESULTS: The main characteristics of SDS in Chinese children were summarized as follows: The ratio of males to females was about 1.3 : 1, the median age of onset was 3 months, and the median age of diagnosis was 14 months. The first symptoms were often exocrine pancreatic insufficiency (31.8%) and granulocytopenia with infection (31.8%). According to the international consensus, the incidence rates of the three major diseases of SDS were hemocytopenia (95.4%), pancreatic disease (72.7%), and bone abnormality (40.9%). The common factors underlying SDS disease were variants of the SBDS gene (c.258+2T>C and c.183_184TA>CT), albeit there was no significant correlation between genotype and phenotype (P > 0.05). Compared with international reports, the clinical manifestations and genotypes of Chinese SDS children are different (P < 0.05). CONCLUSION The SDS children have an early age of onset and significant individual difference. It is necessary to analyze the case-related data to facilitate early recognition, diagnosis and clinical intervention.
Female ; Humans ; Male ; Bone Marrow Diseases/therapy* ; China ; East Asian People ; Exocrine Pancreatic Insufficiency/therapy* ; Shwachman-Diamond Syndrome/therapy*

Objective:To analyze the relationship between hematological examination combined with clinical factors and radiation-induced hypothyroidism (HT) in patients with nasopharyngeal carcinoma (NPC).Methods:Clinical data of 206 patients with NPC who received radiotherapy in Cancer Hospital of University of Chinese Academy of Sciences between January 2015 to August 2018 were retrospectively analyzed. The correlation between general clinical data, hematological examination and HT was analyzed to establish a hematological prediction model.Results:Univariate analysis showed that sex, N-stage, thyroid volume, average dose, V 20Gy, V 25Gy, V 30Gy, V 35Gy, V 40Gy, V 45Gy, fibrinogen content, cholinesterase and neutrophil count were closely associated with the incidence of HT. Multivariate analysis showed that thyroid volume, fibrinogen content and cholinesterase were the independent predictors of HT. Conclusion:The combination of sex, N-stage, thyroid volume, dose parameters, fibrinogen content, cholinesterase, neutrophil percentage and neutrophil count can predict the incidence of HT (AUC=0.777).