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Circulating and tumor miR-21 could predict irinotecan sensitivity in gastric cancer

China Oncology.2013;(9):744-750. doi:10.3969/j.issn.1007-3969.2013.09.009

Background and purpose:Mir-21 has been demonstrated high expressed in many kinds of tumor tissues and cell lines. High expressed miR-21 leads to chemoresistance. Circulating miRNA is a novel biomarker for chemosensitivity prediction. The aim of our study was to investigate the role of plasma and tumor miR-21 levels as predictive biomarkers for irinotecan in gastric cancer. Methods: The histoculture drug response assay (HDRA) was used to determine irinotecan and cisplatin sensitivity on 35 freshly removed gastric tumor specimens. miR-21 expressions in tumor and plasma were determined by quantitative reverse transcription polymerase chain reaction. Results:Plasma miR-21 was closely correlated with corresponding miR-21 mRNA level in tumor tissues (rho=0.736, P<0.001) and was not correlated with sex, age, pathology type, differentiation, lymph node metastasis, TNM stage or tumor location. Patients with stage Ⅱ-Ⅲhad higher miR-21 levels. The tumor miR-21 expressions in cisplatin-sensitive group and resistant group were 1.32 (95%CI:0.73-1.90) and 4.06 (95%CI:1.71-6.41)(P=0.004), respectively. The plasma miR-21 expressions in cisplatin-sensitive group and resistant group were 5.25 (95%CI:0.14-10.64) and 5.82 (95%CI: 2.27-9.37)(P=0.19). The tumor miR-21 expressions in irinotecan-sensitive group and resistant group were 1.09 (95%CI:0.65-1.54) and 4.94 (95%CI:2.44-7.44)(P<0.001), respectively. The plasma miR-21 expressions in irinotecan-sensitive group and resistant group were 1.86 (95%CI:1.08-2.64) and 12.42 (95%CI:3.14-21.70)(P=0.001). Conclusion:A signiifcant correlation was observed between plasma and tumor miR-21 level. The low plasma miR-21 level could benefit from treatment with irinotecan. And low tumor miR-21 expression correlated with increased irinotecan and cisplatin response rate.

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Advances in breast cancer related nomograms

Ru YAO ; Bo PAN ; Qiang SUN ; Ying XU ; Changjun WANG ; Yidong ZHOU ; Feng MAO ; Yan LIN

China Oncology.2013;(9):765-771. doi:10.3969/j.issn.1007-3969.2013.09.012

Breast cancer is the leading cause of malignancy-related mortality in women worldwide. The more accurate prediction of lymph node metastasis and evaluation of personalized prognosis of breast cancer patients could provide evidence and reference for individualized comprehensive treatment and clinical decision-making. Nomogram is statistical calculation model developed to generate individualized prediction of a certain clinical event through the factors associated with it. Currently breast cancer related nomogram models is most commonly used in the prediction of non-sentinel lymph node status in patients with sentinel lymph node-positive breast cancer, sentinel lymph node metastasis in clinical node-negative breast cancer and prognosis evaluation of breast cancer. This article reviewed the recent advances in breast cancer related nomograms according to the above mentioned three aspects, and evaluated respectively the predictive factors, accuracy, characteristics and clinical application potential.

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Factors inlfuencing survival time of advanced cancer patients who received palliative care

Xiaoli GU ; Wenwu CHENG

China Oncology.2013;(9):759-764. doi:10.3969/j.issn.1007-3969.2013.09.011

Background and purpose:How to predict the survival length for terminally cancer patients is very important, it will help families and physicians to make decisions. This study aimed to reveal the factors related to the survival time of terminally ill cancer patients who received palliative care in our hospital. Methods:The clinical data of 271 dead patients treated in the Department of Palliative Care, Fudan University Shanghai Cancer Center from Mar. 2007 to Mar. 2012 were analyzed. The Kaplan-Meier method and the log-rank test were used to determine the corresponding factors with survival. Cox regression model was used to examine the independent prognostic factors. Different survival length of groups divided by different prognostic indexes was compared by log-rank test. Results:Seven factors were found to be related with the survival according to univariate analysis. The related factors were Karnofsky performance score (P<0.001), dyspnea (P=0.037), delirium (P=0.015), high white blood cell count (P=0.012), low lymphocyte percentage (P=0.030), high lactate dehydrogenase (P<0.001) and low serum albumin (P=0.001). The multivariate analysis selected four independent factors:Karnofsky performance score<30, high lactate dehydrogenase, low serum albumin and delirium.Conclusion:The study shows the clinical survival prognostics with Chinese characteristics. The combination of the seven factors may be useful but more studies in this area deserve further investigated.

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Lymph nodes metastases in central compartment of laryngeal cancer:A 11-year review of surgical ;treatment cases

Ling ZHANG ; Kuan XU ; Qinghai JI ; Zhuoying WANG ; Yu WANG ; Duanshu LI ; Yi WU ; Yongxue ZHU

China Oncology.2013;(9):751-758. doi:10.3969/j.issn.1007-3969.2013.09.010

Background and purpose: The aim of this study was to determine the necessity of central compartment neck dissection in laryngeal cancer.Study Design: Retrospective study at a tertiary referral medical center. Methods:Patients with laryngeal squamous cell cancer who underwent neck dissection were evaluated, and a retrospective analysis of clinicopathologic factors and follow-up data were performed. Results: One hundred and eighteen patients from 1999 to 2009 were enrolled. There were 11.9% central compartment lymph node metastasis in all patients, including the 10 patients with central compartment lymph node metastasis in 34 patients underwent compartment neck dissection and 4 patients do not underwent compartment neck dissection but had central neck recurrence in the follow up time. Subglottic or pyriform extension were risk factors in central compartment lymph node metastasis and central neck recurrence (P=0.002). Central compartment lymph node metastasis had closed relationship with levelⅣmetastasis (P<0.001), extracapsular extension (P=0.001), vascular extension (P=0.015) and poor local control rates (P=0.035) respectively. Patients who were positive for lateral neck lymph node metastasis had poor disease-free survival rate (P=0.014) and poor local control rates (P=0.025), and supraglottic cancer had a trend to metastases to levelⅡ(P=0.044). Conclusion:Central compartment neck dissection might be considered a potential therapeutic approach for patients with laryngeal cancer.

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The effect of paclitaxel on the peripheral blood lymphocytes in early stage breast cancer

Anping GUI ; Feihai LING ; Shukai ZHENG

China Oncology.2013;(9):737-743. doi:10.3969/j.issn.1007-3969.2013.09.008

Background and purpose:Immunity function is one of the most profound factors in affecting the prognosis of breast cancer patients. Cytotoxic T lymphocytes counts in the peripheral blood and focal tumor tissue could indicate the overall survival time of these patients. On the other hand, adjuvant chemotherapy is also an important part in improving both the disease free survival and overall survival time of breast cancer patients. Selecting chemotherapy regime which is both able to kill all the tumor cells and reserve the immunity function to the greatest extent is of great importance in improving the survival rate of breast cancer patients. The aim of this study was to compare the effect of two chemotherapy regimens CEF (cyclophosphamide, epirubicin and lfuorouracil) and EC followed by P (paclitaxel) on the peripheral blood lymphocytes in early stage breast cancer. Methods:The clinicopathological characteristics and peripheral blood lymphocyte parameters before and after chemotherapy of CEF or EC-P regimen were retrospectively analyzed in post-operate patients with early stage breast cancer during the period from Nov. 2012 to May 2013. The lymphocyte parameters included: total blood lymphocytes count, percentages of T lymphocytes, cytotoxic T lymphocytes, helper T lymphocytes, active T lymphocytes and nature killer (NK) cells. Results: Patients undertook EC-P regimen were those at comparably high risk (signiifcant differences of clinical stage, tumor size, axillary lymph node status, estrogen/progestogen receptor and histological subtype were observed). There was no difference of lymphocyte parameters between these two groups before adjuvant chemotherapy. However, during the process of chemotherapy, peripheral blood lymphocytes counts decreased signiifcantly after 4 and 5 cycles of chemotherapy of CEF regime (1 077±359/μL;1 181±271/μL) compared with the level before chemotherapy (1 607±322/μL, P<0.05). On the contrary, there was no signiifcant difference of peripheral blood lymphocytes count before (1 746±576/μL) and after 4 and 5 cycles of chemotherapy (1 500±312/μL;1 623±468/μL) in EC-P group (P>0.05). Percentage of active T lymphocyte increased signiifcantly along with the chemotherapy in both groups (CEF group:11.8±7.1 vs 23±9.3, P<0.05;EC-P group:11.8±5.8 vs 17.6±8.2, P<0.05) (pre-chemotherapy vs after 5 cycles of chemotherapy). In EC-P group, the percentage of helper T lymphocyte (37.8±5.7) decreased significantly compared with the levels before chemotherapy (41.3±4.3) and before paclitaxel was undertaken (41.9±5.6, P<0.05) and the percentage of NK cells (21.5±5.2) increased significantly compared with the levels before chemotherapy (15.3±7.6) and before paclitaxel was undertaken (14.9±5.9, P<0.01) after one cycle of paclitaxel therapy. Conclusion:The effect of chemotherapy on peripheral blood lymphocyte is less profound in EC-P group compared to CEF group. Furthermore, paclitaxel can increase the NK cells without any effect to the levels of T lymphocytes and cytotoxic T lymphocyte. It is superior over other drug in conserving immune function in early stage breast cancer.

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Clinicopathologic features of collecting duct carcinoma of the kidney-report of 5 case and review ;of literature

Yingjie HUANG ; Changshui LI ; Rong GE ; Chuangfeng LIU ; Deshang WANG

China Oncology.2013;(9):733-736. doi:10.3969/j.issn.1007-3969.2013.09.007

Background and purpose: Collecting duct carcinomas of the kidney are a rare malignant tumor accounting for<1%of renal malignancies. It is associated with aggressive nature and more than 50%of patients have metastatic disease at the time of initial diagnosis. The diagnosis of collecting duct carcinoma is often dififcult and to some extent is one of exclusion. This study aimed to study the clinicopathologic features of collecting duct carcinoma of the kidney. Methods:We retrieved the data of ifve cases of collecting duct carcinomas of the kidney from pathology ifles, and determined the expressions of CK19, CAM5.2, CK7, Vimentin, CD10, P63 and PaX-8 by pathohistological observation and immunohistochemical examination. Results: The most common symptoms were blood urine, bellyache and abdomen mass. The tumor originated from the medulla of the kidney central zone. Histologically, the tumors demonstrated irregular tubular or papillary architecture with the stroma of inflammatory cells and fibrous tissue proliferation. Immunohistochemically, the tumor cells were positive for CK19(5/5), CAM5.2(5/5), PaX-8(5/5), Vimentin(2/5), CK7(1/5), and negative for P63, CD10. Conclusion: The correct diagnosis in collecting duct carcinomas of the kidney is based on characteristic morphological features and immunophenotype labeling.

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Relationship between aflatoxin and primary liver cancer

Dongdong LU

China Oncology.2001;11(2):184-185.

This paper summarizes the relationship between aflatoxin and primary liver cancer. The results show that the exposure to aflatoxin is consistent with p53 gene mutation. The variation of AFB1 detoxicate enzyme,AFB1 adduct and p53 gene mutation are conelated with occurrence of primary liver cancer.

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Advances in the study of tumor suppressor genes in gliomas

Xiaoyun CAO ; Xiancheng CHEN

China Oncology.2001;11(2):181-183.

Glioma is the most malignant tumor in CNS， the effect of present therapy is poor. A important discovery in tumor molecular biology is that the activation of oncogene and inactivation of tumor suppressor gene play an important role in the mechanism of tumorgenesis. The advances in the study of tumor suppressor genes in gliomas were reviewed.

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Research advances of middle ear effusion due to radiotherapy of head and neck carcinoma

Shengzi WANG ; Qinfang CHENG

China Oncology.2001;11(2):178-180.

The incidence of middle ear effusion due to radiotherapy of head and neck carcinoma is as high as 16—26 percent.Irradiation causes tissue reactions such as congestion,edema, mucositis and fibrosis, which is responsible for the postirradiation tubal dysfunction. The tubal function is worst 6 months after radiotherapy . The cancer disappears after radiotherapy, but the tubal dysfunction still would happen if inflammation and local radiotherapy-induced oedema exist. The tubal function improved at 5 years after radiotherapy if the irradiation dosage is below 70 Gy in patients with nasopharyngeal carcinoma. The mean radiation dosage in the ears with patulous tubes compared for tubals with normal opening has no significant difference. The incidence of otorrhea is very high 2 years after radiotherapy in patients treated by myringotomy and ventilation tube insertion. The tubal function may become normal without treatment and patulous tubes may develope 5 to 10 years after radiotherapy.

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Relations between gastric cancer and the expression of PS2 protein

Shengyi WANG ; Yi LIU

China Oncology.2001;11(2):175-177.

Oestrogen(E), oestrogen receptor (ER) and oestrogen induced proteins form a cellular signal transduction pathway. As a member of this pathway, PS2 protein has close relations with gastric cancer. To elucidate its role in the course of tumourigenesis and advancing may contribute to the insight into the tumourigenic mechanisms and signal-transduction therapy of the gastric cancer.

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