Objective To find an easy and proper way to differentiate metastatic breast cancer from second primary breast cancer by analyzing the histopathological characteristics of 40 patients with bilateral breast cancer.Methods According to the Chaudary histological criteria,the histopathological and biological characteristics of 16 cases of synchronous bilateral breast cancer and 24 cases of metachronous bilateral breast cancer were evaluated.The histopathological and biological characteristics included Nottingham histological grade,immunohistochemistry (IHC) results of the estrogen receptor,progesterone receptor and expression of Her-2.Results The average age of the 40 patients at first diagnosis was 41 years old (range,26-68 years old).The average time interval between first and second diagnosis of tumors was 34 months (range,7-209 months) in metachronous cancer.The concordant histopathological type was found in 93.8 ％ (15/16) of synchronous cancer patients and 58.3 ％ (14/24) of metachronous cancer patients (P =0.02).The concordance rates of tumor stage was 68.8 ％ (11/16) in synchronous cancer patients,while it was 25.0 ％ (6/24) in metachronous cancer patients (P =0.03).For progesterone receptor status,the concordance rates were 87.5 ％ (14/16) and 54.2 ％ (13/24) in synchronous and metachronous cancer patients respectively (P =0.03).There was no statistically significant difference in terms of estrogen receptor status and Her-2 expression (P ＞ 0.05).Conclusions Without considering the limitation of Chaudary criteria and the number of patients,it seems to be an easy and proper way to differentiate metastatic cancer from second primary cancer in the patients with bilateral breast cancer by combining the histopathological type,tumor stage and progesterone receptor status.The synchronous cancer is closer to same clonal lesion (metastatic lesion).

Background and purpose:Lung cancer is one of most common diseases,The number of new cases of lung cancer are more than 500 000 per year in the world and it has been ranked as number one in terms of incidence of malignant tumors in China.Unfortunately about 40 percent of the patients were diagnosed as locally advanced unresectable non-small cell lung cancer(NSCLC).Elderly patients with NSCLC also showed an increasing trend in the past years.The purpose of this study was to evaluate the efficacy and safety of gemcitabine(GEM) and carboplatin(CBP) used as induction regimen in the treatment of elderly patients with locally advanced unresectable NSCLC.Methods:42 cases of elderly patients have been cytologically and pathologically confirmed with locally advanced unresectable NSCLC,the age of the patients ranged from 65 to 75.The patients were treated with the combined regimen of gemcitabine and cisplatin.GEM 1 000 mg/m2 intravenously injected by drip on the 1st,8th day and the dosage of CBP was AUC 5 that was used on the 1st day,21 days apart to each cycle,most patients received 2-3 cycles.Treatment response was evaluated according to the criteria of RECIST(Response Evaluation Criteria in Solid Tumor),the side effect of the regimen was judged based on WHO criteria.Results:42 patients were evaluable and received a total of 89 cycles chemotherapy.There were no complete regression that could be observed,but 17 cases had partial regression(PR),22 cases with no change(NC) and 3 cases with progression disease(PD).The overall response rate was 40.5%.The main side effects were hematological toxicity.Conclusions:The GC regimen could be used as induction treatment for elderly patients with locally advanced unresectable NSCLC,and the regimen could be well tolerated and is safe in terms of side effects.

Surgical resection is the primary treatment for locally advanced rectal cancer,but the local recurrence rate of surgical resection is still at a high level. Preoperative and postoperative chemoradiotherapy not only decreases the local recurrence rate of surgical resection,but also elevates the survival rate and life quality. Recently,adjuvant chemoradiotherapy has been applied as the standard therapy for locally advanced rectal cancer. The application of targeted drugs,new chemotherapy drugs and rapid changing radiotherapy technology provide more approaches to the treatment of locally advanced rectal cancer.

Objective To observe and compare the curative effects of zoledronic acid (ZA) combined with radiotherapy and ZA combined with chemotherapy in the treatment of bone metastasis of non-small cell lung cancer (NSCLC). Methods Seventy-eight patients with NSCLC bone metastasis treated by radiotherapy or chemotherapy were taken in our hospital from January 2010 to June 2014, including 39 cases of ZA combined conventional fractionation radiotherapy (radiotherapy combined group), and 39 cases of ZA combined with chemotherapy (paclitaxel liposome + cisplatin) (chemotherapy combined group). Each group had 39 cases. WHO objective evaluation standard, efficacy evalulation of solid tumor metastasis and curative effect standard grading of pain, anticancer agent toxicity classification standard, Karnofsky standard were used for evaluating and analyzing the patients with primary lung tumor, bone metastasis, degree of pain, adverse reactions and functional status (once before and after the treatment). Results The efficiency rate of primary lung tumor, the efficiency rate of bone metastasis, the total effective rate of pain relief and the improvement rate of functional status (Karnofsky score increased by 10 points or more)in the radiotherapy combined group and chemotherapy combined group were 82.05 % (32/39) vs. 79.49 % (31/39), 48.72 % (19/39) vs. 51.28 %(20/39), 82.05 % (32/39) vs. 84.62 % (33/39), 66.67 % (26/39) vs. 71.79 % (28/39) respectively, and the differences were not statistically significant (the values of x2 were 0.224, 0.237, 0.195, 0.259 respectively, all P> 0.05); Although the two groups showed low-grade fever, bone marrow suppression, esophagitis, liver and kidney damage, gastrointestinal reactions and other adverse reactions, the adverse reactions of two groups were close to [28.21 % (11/39) vs. 30.77 % (12/39)] (x2 = 0.314, P> 0.05). Fortunately, these reactions were controlled well after symptomatic treatment. Conclusion ZA combined with radiotherapy or chemotherapy is a safe and effective way for bone metastasis of NSCLC, which should be taken based on the individual condition of the patients.

Objective To analyze the initial response rate of radiotherapy and chemotherapy,and the influence of different treatment modalities on pmgnnsis of primary non-Hodgkin lymphoma(NHL)of the nascl cavity.Methods From January 1993 to December 2002,70 patients were confirmed by histopathology as NHL,including 52 T cell origin,2 B cell and 16 NK cell.The main radiotherapy portal was set in front of the nose with a spade like protrusion,supplement with a portal next to the ear on one side or both sides.Combined portal in facial cervical area was first used when there was invasion of the oropharynx.The median dose to the nasal cavity wag 54.0 Gy with a range of 336 to 66 Gy,given before or during after radiotherapy or alone,consisted of 2-6 cycles chemotherapy of COP,CHOP or COBDP.Prognostic factors were analyzed with Cox model. Results The local control rates was 12.5%, 66.7% and 74.0% in chemotherapy alone,radiotherapy alone,and chemotherapy plus radiotherapy.The 5-year survival rate Wag 12.5%,50.0% and 62.0%,respectively(P＜0.05).Multifaetor analysis showed that tumor extension and treatment methods were the most important prognostic factors besides Ann-Arbor stage,but gender,pathology,age and symptoms had little effect on prognosis.Conclusion Chemotherapy plus radiotherapy group achieved a better survival rate than radiotherapy alone.For some NHL patients with good financial condition,APBSCT is a good choice.

Objective To analyze the long-term results of rituximab combined with whole brain radiotherapy and 3-dimentional conformal radiotherapy (3D-CRT) in treatment of patients with primary central nervous system lymphoma (PCNSL). Methods 23 postoperative patients younger than 60 years old were treated. Whole brain radiotherapy with dose of 32.4 Gy were performed and lesions were followed by 3D-CRT with dose of 18 Gy.A dose of rituximab (375 mg/m2) was infused on day 1 (once a week for six weeks).The overall survival was analyzed by using Kaplan-Meier.Results 19 patients(82.6 ％) was complete remission 3 patients (13.0 ％) was part remission,14 patients (60.9 ％) was progression-free survival was 26 months (17-34 months). The overall survival was 40 months (29-55 months). Toxicity was moderate without grade 3-4 neurotoxicity toxic events. Conclusions Radiotherapy (whole brain radiotherapy with sequential 3D-CRT)combined with rituximab seems to yield substantial long-term survival with moderate toxicity for the treatment of the younger patients with PCNSL.

Objective To investigate relationships between serum levels of anti?tyrosinase IgG antibody(TYR IgG)as well as anti?tyrosinase?related protein?1 IgG antibody(TRP?1 IgG)and vitiligo. Methods Enzyme linked immunosorbent assay(ELISA)was performed to detect serum levels of TYR IgG and TRP?1 IgG in 260 patients with vitiligo and 50 health controls. The threshold for defining a positive test result was set at 3 standard deviations above the mean serum level of TYR IgG or TRP?1 IgG in the healthy controls. Results The positive rate of TYR IgG and/or TRP?1 IgG in the vitiligo group was 57.31%(149/260). The positive rates of TYR IgG and TRP?1 IgG were both significantly higher in the vitiligo group than in the control group(TYR IgG:37.3%[97/260]vs. 0,χ2=25.441, P<0.01;TRP?1 IgG:33.5%[87/260]vs. 0,χ2=21.630, P<0.01). The positive rate of TYR IgG was not associated with that of TRP?1 IgG in the vitiligo group(r=-0.032, P>0.05). Among patients with vitiligo, the positive rate of TRP?1 IgG was significantly higher in females than in males(χ2=5.811, P<0.05), as well as in patients aged≤20 years than in those aged>20 years(χ2=6.498, P<0.05), while the positive rate of TYR IgG didn′t differ between females and males, or between patients aged ≤ 20 years and those aged > 20 years (both P >0.05). Conclusion Detection of TYR IgG and TRP?1 IgG may provide some evidence for the diagnosis and treatment of vitiligo.

BACKGROUNDChemotherapy is very important in the treatment of advanced non-small cell lung cancer (NSCLC). The aim of this study is to evaluate the efficacy, clinical benefit and toxicity of combined chemotherapy with domestic gemcitabine (ZEFEI) plus carboplatin in the treatment of advanced NSCLC.

METHODSThirty-four previously untreated patients with advanced NSCLC (stage III-IV) received domestic gemcitabine of 1000mg/m² on days 1, 8, and carboplatin of AUC 5 on day 1, with 21 days as a cycle. Each patient received at least three cycles.

RESULTSThe total clinical response rate (complete and partial response) was 44% (15/34). Overall clinical benefit rate was 53% (18/34). The main toxicities were hematological toxicities. The rate of grade III-IV leukopenia and thrombocytopenia was 47% and 24% respectively.

CONCLUSIONSCombined chemotherapy with domestic gemcitabine plus carboplatin is an effective and feasible regimen for advanced NSCLC.