The intestinal microbiota plays a crucial role in the innate and acquired immune responses. It regulates cancer initiation, progression, and response to therapies. This article focuses on the effect of intestinal microbiota on chemotherapy and immunotherapy. Intestinal microorganisms can activate the peripheral immune system, induce anti-tumor immune surveillance. Specific bacteria significantly affects anti-tumor immunity and the response to chemotherapy and immunotherapy. Proliferation, metastasis of specific bacteria or using of antibiotics induced intestinal microbiota disorders can change the efficacy of chemotherapy and immunotherapy. In the future, precision medicine can predict the patients’ response to drugs through the composition of intestinal microbes, regulate the initiation and development of tumors and the response to treatment by changing the composition of intestinal microbiome.

OBJECTIVETo evaluate the staging criteria and surgical treatment strategy of traumatic intrathoracic esophageal perforations by foreign bone.

METHODSFifty-seven patients with intrathoracic esophageal perforations caused by foreign bone in our department from January 1980 to June 2006 were studied. Patients were divided into 4 grades: grade I was esophageal perforation without mediastinitis (n=17), grade II was esophageal perforation with severe mediastinitis (n=13), grade III was esophageal perforation with severe empyema (n=21), grade IV was esophageal perforation with tracheal or aorto-esophageal fistula (n=6). Based on the stage of esophageal perforation, operative procedures were selected including esophagotomy, esophageal repair, esophagectomy, mediastinal drainage, and esophagus reconstruction with colon.

RESULTSIn grade I, II and III, all but one patient experienced satisfactory healing of the esophagus. One patient died of multi-organ failure from septic complication. No leakage was observed. Normal swallowing function and improved weight gain was achieved in all the patients. There were 2 deaths in grade IV (2/6).

CONCLUSIONSGrading of esophageal perforation caused by foreign bone is helpful to the decision of surgical treatment strategy.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Esophageal Perforation ; classification ; surgery ; Esophagus ; pathology ; surgery ; Female ; Foreign Bodies ; classification ; surgery ; Humans ; Infant ; Male ; Middle Aged ; Young Adult

Objective:To investigate the clinicopathological features, immunohistochemical phenotypes and molecular characteristics of adenosquamous carcinoma of the lung(ASC)in elderly patients.Methods:Clinical data of 72 ASC patients in the Department of Pathology, The Second Affiliated Hospital of Soochow University from January 2009 to December 2020 were retrospectively analyzed, and 48 patients aged ≥60 years were selected.Clinical manifestations, imaging findings, histopathological and immunohistochemical characteristics were collected, and gene mutations were detected by the amplification refractory mutation system(ARMS-PCR).Results:There were 48 patients including 32 males and 16 females with a mean age of 70 years(range: 60-84 years). The maximum diameters of the tumors ranged from 0.3 to 9.0 cm(mean: 2.8 cm). Microscopically, the tumors contained two components, squamous cell carcinoma and adenocarcinoma, with the squamous cell carcinoma tissue showing intercellular bridges and the adenocarcinoma tissue showing papillary, acinar or tubular structures.Immunohistochemistry assays detected varying expression levels of CK7(30/31), CK5/6(20/28), TTF1(12/31), P40(15/17), and P63(12/13). Molecular testing showed that the EGFR mutation rate was 58.8%(10/17)and the ALK fusion mutation rate was 5.9%(1/17), while ROS1 and MET mutations were not detected.All 48 patients underwent surgical resection.Conclusions:ASC cases are relatively rare and prone to misdiagnosis.The diagnosis requires the combination of HE morphology, immunohistochemistry and imaging examination, and surgery is the main treatment option.The mutation rate of the EGFR gene is relatively high in ASC patients.

Objective : To investigate the expression and clinical significance of erbb2 interacting protein (ERBIN) and PDZ domain containing 2 protein (PDZD2) in colorectal cancer tissues，as well as the effects of ERBIN and PDZD2 on the progression of colorectal cancer and the corresponding mechanisms． Methods : Western blot was used to detect the expression of ERBIN and PDZD2 proteins in tumor tissues and corresponding adjacent tissues from 86 colorectal cancer patients，as well as normal human colon fibroblasts ( CCD-18Co) and human colorectal cancer cell lines ( SW480 ，HCT116 ，SW620 and HT29 ) ; SW620 and HCT116 cells were transfected with ERBIN or PDZD2 overexpression vector，and then cell proliferation，cell invasion and apoptosis were detected．The expres- sion of ERBIN or PDZD2 protein in SW620 cell was observed by immunofluorescence chemistry．Co-immunoprecip- itation assay was used to detect the interaction between ERBIN and PDZD2 proteins. Results : The expression levels of ERBIN and PDZD2 proteins in colorectal cancer tissues were lower than those in adjacent tissues (P＜0．01) ， and the expression levels of ERBIN and PDZD2 in colorectal cancer cells were lower than those in CCD-18Co cells (P＜0. 01) ．The expression levels of ERBIN and PDZD2 proteins were correlated with the depth of invasion，dif- ferentiation，TNM staging and lymph node metastasis of colorectal cancer (P＜0. 001) ; ERBIN or PDZD2 overex- pression reduced the proliferation and invasion of SW620 and HCT116 cells (P＜0. 01) ，increased cell apoptosis (P ＜0. 01 ) ; ERBIN directly bound to PDZD2 ，and overexpression of ERBIN increased the expression level of PDZD2 protein． Conclusion ERBIN can inhibit the proliferation and invasion of colorectal cancer cells and pro- mote apoptosis by promoting the expression of PDZD2 protein.