Objective To investigate the clinical features and prognosis of recurrent gastric cancer. Methods The clinical data of 147 patients with recurrent gastric cancer was reviewed. Risk factors correlated with tumor recurrence and recurrent intervals were studied by logistic regression analysis. Survival analyses and comparisons were performed using Kaplan-Meier plots, the log rank test and the Cox proportional hazards model. Results Patients were divided into an early recurrence group consisting of 86 patients (recurred within one year after surgery) and a late recurrence group of 61 patients (recurred one year or more after surgery). There were significant difference in size of primary tumor, Borrmann stage, type of gastrectomy, T stage, N stage, TNM stage between the two groups(P ＜0.05). Multivariate analysis showed that the TNM stage and N stage independently influenced the recurrent time ( P ＜ 0. 05 ). In univariate survival analysis, post-gastrectomy chemotherapy(P ＜0. 05) , T stage (P ＜0. 05) , N stage(P ＜0.01) , TNM stage ( P ＜ 0. 01) , recurrence-free interval (P ＜ 0. 01) and reoperation (P ＜ 0.01) were significantly correlated with the prognosis. In multivariable analysis, TNM stage(P ＜0. 01) , recurrence-free interval ( P ＜ 0. 05 ) and reoperation ( P ＜ 0. 05 ) were independent factors predicting recurrence. Conclusions The TNM stage and N stage were the important factors predicting the time of recurrence after curative resection for gastric cancer. Patients with recurrent gastric cancer have poor prognosis and reoperation was associated with an improved survival in patients with recurrent gastric cancer.

Objective To investigate the clinicopathological characteristics,treatment,prognostic factors of primary small intestinal lymphoma (PSIL).Methods The clinical data of 68 patients with PSIL who were admitted to the Cancer Hospital of Tianjin Medical University from November 1999 to July 2009 were retrospectively analyzed.The diagnostic workup before operation included abdominal ultrasound,computed tomography (CT) scan of the abdomen,small intestinal barium radiography,endoscopy examination and laboratory examination.The patients with local PSIL underwent radical surgery,patients who were not eligible for radical surgery received palliative treatment,and then accurate staging was done according to Ann-Arbor system for gastrointestinal lymphoma,and chemotherapy was applied according to the condition of patients.The patients were followed up by letters,telephone and outpatient care till July 2012.Factors might have influence on the prognosis were analyzed by the Kaplan-Meier method and Log-rank test.COX regression model were used for univariate and multivariate analysis,respectively.Results The major symptoms of PSIL included abdominal pain (69.1％,47/68) and weight loss (29.4％,20/68).All of the 68 patients underwent small intestinal barium radiography and endoscopy examination,and 15 and 11 cases were definitely diagnosed as with PSIL.Abdominal mass were detected by abdominal ultrasound in 38 of 45 cases.Positive results were found in 30 cases by CT and 5 cases by positron emission tomography (PET)-CT.PSIL mainly involved ileum (73.5％,50/68),13 PSILs were located at the jejunum and 5 at the duodenum.Of all the 68 patients,64 were with B-cell subtype PSIL and 4 were with T-cell subtype PSIL.Most tumors belonged to stages Ⅰ and Ⅱ (66.2％,45/68).All of the 68 patients were treated with surgical procedure,including 51 patients received radical resection and 17 patients had palliative resection.After operation,4-8 cycles of chemotherapy were applied in 57 patients.Seven patients received COP regimen,50 received CHOP regimen (10 patients with positive expression of CD20 received R-CHOP regimen simutaneously),the remaining 11 patients did not receive chemotherapy.Sixty-four patients were followed up,and the follow-up rate was 94.1％ (64/68).The median follow-up time was 40 months (range,3-132 months).The median survival time was 40.5 months.The 1-,3-,and 5-year overall survival rates were 78.1％,62.2％ and 59.7％,respectively.The prognosis of patients with B-cell subtype PSIL,in stage Ⅰ-Ⅱ and received operation + chemotherapy was superior to those who were with T-cell subtype PSIL,in stage Ⅲ-Ⅳ and received operation (x2=22.459,45.535,15.782,P ＜ 0.05).The results of univariate analysis showed that level of LDH,pathological subtype,clinical stage,presence of systemic symptom,treatment modality,radical surgery and lymphatic metastasis were risk factors for prognosis (x2=7.245,22.459,45.535,5.796,15.782,45.926,9.214,P ＜ 0.05).The results of multivariate analysis revealed B cell phenotype,stage Ⅰ-Ⅱ and surgery + chemotherapy were independent prognostic factors for survival (RR =7.133,5.304,0.256,95％ CI:1.634-31.130,1.498-18.781,0.095-0.691,P ＜ 0.05).Conclusions The major symptoms of PISL include abdominal pain and weight loss.Definite diagnosis of PSIL depends on endoscopy and imaging examination.PSIL mainly involves ileum.Surgery based treatment is the preferred option,and the combined treatment of rituximab with chemotherapy may improve the survival.B-cell phenotype,early clinical stage (Ⅰ-Ⅱ) and surgical resection plus chemotherapy are independent prognostic factors for better survival.

Objective:To investigate the association between indoleamine 2,3-dioxygenase(IDO)expression in tumor tissue,its periph-eral blood activity, and the efficacy of neoadjuvant chemotherapyin patients with breast cancer. Methods: Immunohistochemistry (IHC)and high-performance liquid chromatography(HPLC)were used to measure IDO protein expression in tumor tissue,and kynuren-ine(Kyn),tryptophan(Trp),and IDO activity(Kyn/Trp)in peripheral blood before neoadjuvant chemotherapy in 53 patients with breast cancer from Tianjin Medical University Cancer Institute and Hospital between September 2015 and December 2016.The correlations between the expression and activity of IDO and the efficacy of chemotherapy were analyzed.Results:In tumor tissue,IDO expression-before neoadjuvant chemotherapy was related to clinical tumor stages(P=0.006),node stages(P=0.020),clinical stages(P=0.045),and estrogen receptor(ER)status(P=0.014).High IDO activity before neoadjuvant chemotherapy in peripheral blood was associated with high IDO expression in tumor tissue(P=0.004),and was also correlated with clinical tumor stages(P=0.019)and node stages(P=0.047). Univariate analysis showed that the clinical efficacy of neoadjuvant chemotherapy was associated with pre-chemotherapeutic clinical tumor stages(P=0.049),ER status(P=0.025),and molecular subtype(P=0.014),while pathologic complete response(pCR)was related to pre-chemotherapeutic clinical tumor stages(P=0.014).Importantly,the clinical efficacy of neoadjuvant chemotherapy and pCR were both related to IDO expression and activity before chemotherapy(all P<0.05).Multivariate analysis showed that pre-chemotherapeu-tic IDO activity in peripheral blood was the only independent factor that affected pCR(P=0.032).Conclusions:Tumor tissue IDO expres-sion and peripheral blood IDO activity before chemotherapy were associated with chemotherapy efficacy,and could provide promising information for the clinical prediction of chemotherapy sensitivity.

Objective: To explore clinicopathological and ultrasound characteristics of extranodal extension in metastatic papillary thyroid carcinoma patients. Methods: 176 patients with papillary thyroid carcinoma who were diagnosed in Tianjin Medical University Cancer Institute and Hospital between March 2011 and March 2016 were identified and recruited in the study. Among the 176 patients, 59 patients were diagnosed with regional lymph nodes metastasis accompanied with extranodal extension (extranodal extension positive group), 117 patients were regional lymph nodes metastasis without extranodal extension (extranodal extension negative group). The clinicopathological and ultrasound characteristics between extranodal extension positive group and extranodal extension negative group were also discussed in this article. Results: 59 patients were diagnosed with regional lymph nodes metastasis accompanied with extranodal extension (extranodal extension positive group). Single lymph node region of extranodal extension was identified in 40 patients, while 19 patients were confirmed with more than 2 regions of extranodal extension. The most frequent extranodal extension were detected in region Ⅵ lymph nodes(32 cases), following by Ⅲ(25 cases), Ⅳ(16 cases), Ⅱ(11 cases). In the aspect of ultrasound characteristics, metastatic papillary thyroid carcinoma with extranodal extension showed a higher incidence of node matting[13.6%(8/59) vs 3.4%(4/117), P=0.022], micro-calcification[66.1%(39/59) vs 46.2%(54/117), P=0.016], cystic[28.8%(17/59) vs 12.8%(15/117), P=0.013], aspect ratio(L/S)<2[88.1%(52/59) vs 75.2%(88/117), P=0.032] and larger diameter(1.95±1.01 cm vs 1.63±0.94 cm, P=0.028). Logistic multivariate analysis demonstrated that node matting (P=0.025) and cystic (P=0.026) were independent risk factors for extranodal extension. Conclusion Node matting, micro-calcification, cystic, aspect(L/T)>2 and larger diameter were associated with extranodal extension in metastatic papillary thyroid carcinoma patients, especially node matting and cystic, which might help topre-operative ultrasound diagnosis of extranodal extension.

OBJECTIVETo introduce the recent developments in cancer immunoinformatics with an emphasis on the latest trends and future direction.

DATA SOURCESAll related articles in this review were searched from PubMed published in English from 1992 to 2013. The search terms were cancer, immunoinformatics, immunological databases, and computational vaccinology.

STUDY SELECTIONOriginal articles and reviews those were related to application of cancer immunoinformatics about tumor basic and clinical research were selected.

RESULTSCancer immunoinformatics has been widely researched and applied in a series of fields of cancer research, including computational tools for cancer, cancer immunological databases, computational vaccinology, and cancer diagnostic workflows. Furthermore, the improvement of its theory and technology brings an enlightening insight into understanding and researching cancer and helps expound more deep and complete mechanisms of tumorigenesis and progression.

CONCLUSIONCancer immunoinformatics provides promising methods and novel strategies for the discovery and development of tumor basic and clinical research.

Cancer Vaccines ; therapeutic use ; Computational Biology ; methods ; Humans ; Neoplasms ; diagnosis ; immunology ; prevention & control