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Associations between physical exercise and quality of life in breast cancer patients.

Xiaohuan GONG ; Jiwei WANG ; Xuefen CHEN ; Changhong SHI ; Li SUN ; Qingyun ZHANG ; Zhengping YUAN ; Jinming YU

Chinese Journal of Oncology.2014;36(11):871-875.

OBJECTIVETo investigate the associations between physical exercise and quality of life in breast cancer patients.

METHODSA cross-sectional study was conducted among 3 344 community breast cancer patients between April and July 2013 in Shanghai, China. Data were collected using a questionnaire, including socio-demographic situation, cancer survival and health behaviors, and scores of EORTC QLQ-C30 Simplified Chinese version and FACT-G Simplified Chinese version.

RESULTSAmong a total of 3 344 breast cancer patients, the patients doing exercise reported significantly higher EORTC physical functioning scores, role functioning scores, emotional functioning scores, global health scores, and FACT-G physical well-being scores, social well-being scores, emotional well-being scores, functional well-being scores, and FACT-G total scores than the patients who didn't take exercise (P < 0.05, P(Adjusted)<0.05) . Breast cancer patients who did exercise more than or equal to 5 times/week reported significantly higher EORTC role functioning scores, cognitive functioning scores, emotional functioning scores, global health scores and FACT-G physical well-being scores, functional well-being scores, and FACT-G total scores than patients who did exercise less than 5 times/week (P < 0.05, P(Adjusted)<0.05 ).

CONCLUSIONSThere are active associations between physical exercise and quality of life in breast cancer patients. Engagement in physical exercise is beneficial to breast cancer patients with long-term survival.

Asian Continental Ancestry Group ; Breast Neoplasms ; epidemiology ; China ; epidemiology ; Cross-Sectional Studies ; Exercise ; Humans ; Quality of Life ; Surveys and Questionnaires

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Clinical analysis of 53 cases of retroperitoneal schwannoma.

Haitao ZHOU ; Zhixiang ZHOU ; Jianwei LIANG ; Zheng WANG ; Xingmao ZHANG ; Junjie HU ; Hong ZHAO ; Yi FANG ; Zhen HUANG ; Jian WANG ; Weigen ZENG

Chinese Journal of Oncology.2014;36(11):867-870.

OBJECTIVETo explore the clinical characteristics, diagnosis and treatment regimens for retroperitoneal schwannoma.

METHODSClinicopathological data of 53 retroperitoneal schwannoma patients treated from January 1999 to April 2013 in our hospital were collected and analyzed using SPSS 13.0 statistical software.

RESULTSSymptoms of the retroperitoneal schwannoma were vague and nonspecific. 12 patients had interrupted abdominal pain, 9 patients had abdominal discomfort, and only 6 patients presented with abdominal mass while 24 patients were detected by health checkup. There were some characteristics but not specific findings in imaging examination such as CT, ultrasonography and MRI, so preoperative diagnosis rate was low with only 9 patients diagnosed as retroperitoneal schwannoma and 21 patients diagnosed as neurogenic tumor. S-100 immunohistochemisty was very important in pathological diagnosis, and the patients with benign retroperitoneal schwannoma got 100% tumor specific 5-year survival after complete excision while the 5-year survival of malignant retroperitoneal schwannoma was only 50.0%.

CONCLUSIONSRetroperitoneal schwannoma is a rare disease. Most of them are benign tumors, and complete surgical excision is the effective treatment.

Abdominal Pain ; Diagnostic Imaging ; Humans ; Magnetic Resonance Imaging ; Neurilemmoma ; diagnosis ; pathology ; therapy ; Physical Examination ; Retroperitoneal Neoplasms ; diagnosis ; pathology ; therapy ; Retroperitoneal Space ; Treatment Outcome

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Comparison of perioperative outcomes and lymphadenectomy after thoracoscopic esophagectomy in semi prone position and open esophagectomy.

Xiang WANG ; Qiang LI ; Xiang ZHUANG ; Xiaojun YANG ; Tianpeng XIE ; Ping XIAO ; Ke MA ; Bin HU

Chinese Journal of Oncology.2014;36(11):863-866.

OBJECTIVEThoracoscopic esophagectomy has gained worldwide popularity. This study compared the perioperative outcomes and lymphadenectomy after thoracoscopic esophagectomy in semi prone position and open esophagectomy.

METHODSSixty-two consecutive patients after thoracoscopic esophagectomy were compared with 62 patients who underwent open esophagectomy. Outcomes included surgical time, blood loss, length of hospital stay, 30-day mortality, complications and gained lymph nodes.

RESULTSThe mean length of hospital stay of the thoracoscopic group was 12.4 ± 7.4 days, and 13.6 ± 6.7 days in the open esophagectomy group (P > 0.05). The median total operation time and median thoracic operation time were 270 and 130 min, the median total blood loss and median thoracic blood loss were 300 and 180 ml in the thoracoscopic group, while the results in open esophagectomy group were 290, 150 min and 300, 180 ml. The median total operation time and median thoracic operation time were of statistically significant difference (P < 0.01). But there were no significant differences between the two groups in total blood loss and thoracic blood loss (P > 0.05) . The numbers of obtained lymph nodes in the thoracoscopic group and open esophagectomy group were 20.5 and 16.9 (P < 0.01). Among them, the median numbers of mediastinal lymph nodes in the thoracoscopic group and open esophagectomy group were 12.4 and 8.8, the left recurrent laryngeal nerve lymph nodes were 1.8 and 1.0, and the right recurrent laryngeal nerve lymph nodes were 2.9 and 1.2 (P < 0.01 for all). There were 8 positive recurrent laryngeal nerve lymph nodes (12.9%) in the thoracoscopic group, while 5 in the open esophagectomy group (8.1%, P > 0.05). There were no peri-operative period death, heavy bleeding, or thoracic gastric fistula in both groups.

CONCLUSIONSThoracoscopic esophagectomy in semi prone position may achieve good surgical field exposure, therefore, to make esophagectomy, lymph node dissection and digestive tract reconstruction possible. These findings suggest that with further technical refinement, thoracoscopic esophagectomy may have the upper hand on reducing postoperative complications and performing mediastinal lymph node dissection.

Esophageal Neoplasms ; surgery ; Esophagectomy ; Humans ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; surgery ; Mediastinum ; Operative Time ; Postoperative Complications ; Prone Position ; Recurrent Laryngeal Nerve ; Thoracoscopy

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Clinicopathological features and prognostic analysis of 151 patients with primary extra-nodal non-Hodgkin's lymphoma.

Cong WANG ; Changji YUAN ; Hua HE ; Ou BAI

Chinese Journal of Oncology.2014;36(11):858-862.

OBJECTIVETo evaluate the epidermiology, clinicopathological features and prognosis of primary extra-nodal non-Hodgkin's lymphoma (PE-NHL).

METHODSThe clinicopathological data of 151 patients diagnosed as PE-NHL in the First Affiliated Hospital of Jilin University between January 2007 and December 2011 were reviewed and analyzed.

RESULTSThe proportion of PE-NHL patients was 58.8% among all the non-Hodgkin's lymphoma cases, with the average age of 52 years, and the male/female ratio was 1.16:1. The most frequently involved site was the stomach (30.5%) followed by nose and sinuses (19.9%) and Waldeyer's ring (17.2%). The most common subtype was diffuse large B-cell lymphoma (DLBCL) (55.0%), followed by NK/T (18.5%) and extra-nodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) ( 13.2%). The distribution of clinical stages was as follows: stage I 20.5%, II 29.8%, III 29.1%, and IV 20.5%. Most nasal PE-NHL is in early stages, with a proportion of 76.7% in stages I & II. The 3-year overall survival rate was 73.2% and 3-year progression free survival rate was 46.6% in the PE-DLBCL patients. The International Prognosis Index (IPI) could be used to estimate the prognosis of PE-DLBCL well. Multivariate analysis showed that ESR and curative effect of the first treatment were independent prognostic factors for PE-DLBCL patients.

CONCLUSIONSThe incidence of PE-NHL is quite high, and the most common primary extra-nodal site is the gastro-intestinal tract and the most common subtype is diffuse large B-cell lymphoma. Risk groups based on IPI can indicate the prognosis of PE-DLBCL to some extent, but only the ESR and curative effect of the first treatment are confirmed to be independent risk factors.

Adult ; Disease-Free Survival ; Female ; Humans ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Large B-Cell, Diffuse ; Lymphoma, Non-Hodgkin ; diagnosis ; pathology ; Male ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; Survival Rate

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Current trends of breast reconstruction after mastectomy for breast cancer patients in China: a survey report.

Ying CHEN ; Jiajian CHEN ; Jiaying CHEN ; Benlong YANG ; Lin LI ; Xiaoyan HUANG ; Zhimin SHAO ; Zhenzhou SHEN ; Peirong YU ; Jiong WU

Chinese Journal of Oncology.2014;36(11):851-857.

OBJECTIVETo explore the current trends of breast reconstruction (BR) for breast cancer patients in China.

METHODSA questionnaire was designed for this study, and it included questions on surgeon demographics, number of mastectomy and BR, type and timing of BR, reconstructive choices in the setting of preoperative or postoperative radiotherapy or chemotherapy, etc. All data were collected until December 2012. Questionnaires were sent to 52 members of the Committee of Breast Cancer Society by e-mail or mail.

RESULTSBy July 2013, 41 questionnaires had been returned. Among all, 5 were excluded for not performing BR. These 36 hospitals covered 22 provinces and municipalities in China. A total of 538 surgeons working in the general surgery or oncological surgery department, but only 123 (22.9%) were qualified to perform BR. In 2012, except for 4 missing data, 24, 763 mastectomies were performed in 32 hospitals; among them, 1120 (4.5%) received BR. According to these 36 respondents, 32 (88.9%) performed prosthetic (1, 843 cases in all) while 4 (11.1%) performed prosthetic BR with acellular dermal matrix (17 cases in all) from the time of their first BR operation to the end of 2012. During the same period, 965 latissimus dorsi myocutaneous flaps with implant were performed in 23 (63.9%) hospitals while 738 latissimus dorsi myocutaneous flaps without implant were performed in 32 (88.9%) hospitals. At the same time, 366 pedicled transverse rectus abdominis myocutaneous flap BRs were performed in 28 (77.8%) hospitals, while 155 abdominal free flap BRs were carried out in 9 (25.0%) hospitals. The overall complication rate was 18.2%. Postoperative radiotherapy had some effect on influencing the esthetic outcomes of BR, so the autologous BR was recommended, but the timing remained controversial. Regarding chemotherapy, most respondents concluded that it had no effect or only a mild effect. The overall cosmetic outcomes of the reconstructed breasts satisfied the majority of physicians and patients.

CONCLUSIONSWith more attention paid to the quality of life after mastectomy, more and more BRs are needed, but the ratio is still low in China. To improve this situation, more efforts are needed, including the improvement of the intrahospital framework of multi-disciplinary service, the training for doctors and the educational program for patients, etc.

Breast Neoplasms ; epidemiology ; surgery ; China ; epidemiology ; Humans ; Mammaplasty ; Mastectomy ; trends ; Postoperative Complications ; Postoperative Period ; Quality of Life ; Reconstructive Surgical Procedures ; Surgical Flaps ; Surveys and Questionnaires

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Prevalence and viral load of human papillomavirus in squamous cell carcinomas of the head and neck in different nationalities in Xingjiang area.

Yang ZHANG ; Niyazi HUERXIDAN ; Huarong ZHAO ; Pan LIU ; Lei ZHANG ; Songan ZHANG ; Jingru BA ; Yongxing BAO

Chinese Journal of Oncology.2014;36(11):849-850.

Carcinoma, Squamous Cell ; epidemiology ; virology ; China ; epidemiology ; Ethnic Groups ; Head and Neck Neoplasms ; epidemiology ; virology ; Humans ; Papillomaviridae ; isolation & purification ; Prevalence ; Viral Load

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Correlations between DNA mismatch repair (MMR) and prognosis and prediction of treatment efficacy in stage II/II colon cancer.

Qiong QIN ; Jianming YING ; Ning LYU ; Lei GUO ; Wenxue ZHI ; Aiping ZHOU ; Jinwan WANG

Chinese Journal of Oncology.2014;36(11):844-848.

OBJECTIVETo investigate the role of DNA mismatch repair (MMR) as a prognostic indicator of radical resection and a predictor of fluorouracil-based adjuvant therapy benefit in patients with stage II/III colon cancer.

METHODSThe clinicopathological characteristics of 172 patients with stage II/III colon cancer who underwent radical resection were retrospectively analyzed. Immunohistochemical staining was used to detect the expression of DNA mismatch repair (MLH1/MSH2/MSH6/PMS2) in the tumor tissues.

RESULTSAmong a total of 172 patients, there were 38 (22.1%) cases with defective DNA mismatch repair (dMMR) and 134 (77.9%) cases with proficient DNA mismatch repair (pMMR). Among the 115 patients who did not receive adjuvant chemotherapy, those with tumor displaying dMMR had a better 5-year overall survival (OS) rate and disease-free survival (DFS) rate than the patients with proficient DNA mismatch repair (pMMR) (88.0% vs. 66.7%, P = 0.040; 84.0% vs. 60.0%, P = 0.034). The benefit of adjuvant chemotherapy differed significantly according to the MMR status. Adjuvant 5-Fu chemotherapy improved the 5-year overall survival rate among 134 patients with pMMR (86.4%) than that in patients treated by surgery alone (66.7%, P = 0.012). By contrast, there was no benefit of adjuvant 5-Fu chemotherapy in the patients with dMMR (61.5% vs. 86.4%, P = 0.062), which was even more clear the 5-year disease-free survival rate (53.8% vs. 84.0%, P = 0.038).

CONCLUSIONSMMR status is a predictor of the benefit of adjuvant chemotherapy with fluorouracil in stage II/III colon cancer. Patients with stage II/III colon cancer displaying dMMR have a better prognosis than those with pMMR.

Antineoplastic Combined Chemotherapy Protocols ; Chemotherapy, Adjuvant ; Colonic Neoplasms ; diagnosis ; therapy ; Combined Modality Therapy ; DNA Mismatch Repair ; Disease-Free Survival ; Fluorouracil ; Humans ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Survival Rate ; Treatment Outcome

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Expression of leptin and adiponectin in esophageal squamous cell carcinoma and their clinical significance.

Xiaofeng DUAN ; Peng TANG ; Hongdian ZHANG ; Zhentao YU

Chinese Journal of Oncology.2014;36(11):839-843.

OBJECTIVETo preliminarily investigate the expression and clinical significance of leptin and adiponectin in esophageal squamous cell carcinoma (ESCC).

METHODSThe expression of leptin and adiponectin in ESCC and normal esophageal mucosal tissue was detected by immunohistochemical staining with tissue microarray. The correlation between leptin, adiponectin and clinicalpathological features was statistically analyzed.

RESULTSThe expression of leptin was significantly upregulated in the ESCC than in the normal esophageal mucosa tissue [65.6% (80/122) versus 27.5% (11/40), P < 0.001]. Expression of leptin was significantly correlated with lymph node involvement and advanced tumor stage (P = 0.009 and P = 0.043, respectively). Expression of adiponectin was significantly down-regulated in ESCC compared with that in normal esophageal mucosal tissue [22.1% (27/122) versus 47.5% (19/40), P = 0.002]. Expression of adiponectin was significantly correlated with lymph node involvement (P = 0.020). Correlation analysis showed a positive correlation between the expression of leptin and lymph node metastasis and TNM stage (r = 0.235 and r = 0.183, respectively), and a negative correlation between the expression of adiponectin and lymph node metastasis (r = -0.229). There was no significant correlation between the expressions of leptin and adiponectin (P > 0.05), and between the body mass index and the expression of leptin and adiponectin, and lymph node metastasis (P > 0.05 for all).

CONCLUSIONSAn imbalanced expression of adipocytokines exits in ESCC. The expression of leptin and adiponectin is correlated with lymph node metastasis and/or tumor stage. Therefore, imbalanced expression of leptin and adiponectin may have a potential role in the carcinogenesis and disease progression of ESCC.

Adiponectin ; metabolism ; Carcinoma, Squamous Cell ; metabolism ; Down-Regulation ; Esophageal Neoplasms ; metabolism ; Leptin ; metabolism ; Lymphatic Metastasis ; Neoplasm Staging ; Up-Regulation

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Changes of fibroblast immunophenotype and their clinical significance in stromal remodeling of breast tumors.

Xing HUA ; Xiaoxiao HUANG ; Zexiao LIAO ; Qi XIAN ; Lina YU

Chinese Journal of Oncology.2014;36(11):834-838.

OBJECTIVETo evaluate the immunophenotype conversion of fibroblasts and its clinical significance in the process of breast tumor stromal remodeling.

METHODSCD34, FAP-α, p63 and a-SMA were detected by immunohistochemistry in 273 breast biopsies, including 60 normal breast tissues, 46 atypical ductal hyperplasia (ADH), 60 ductal carcinoma in situ (DCIS), 47 DCIS microinvasive carcinoma (DCIS-MI) and 60 invasive ductal carcinoma (IDC).

RESULTSThe positive expression rates of CD34, FAP-α and α-SMA in the stromal fibroblasts of normal breast tissues were 93.3%, 6.7% and 18.3%, respectively. Those in the stromal fibroblasts of ADH tissues were 95.7%, 4.3% and 10.9%, respectively. Those in the stromal fibroblasts of DCIS tissues were 95.0%, 8.3% and 15.0%, respectively. Those in the IDC tissues were 35.0%, 85.0% and 93.3%, respectively. The expressions of CD34, α-SMA and FAP-α in the stromal fibroblasts of normal, ASH and DCIS breast tissues did not show significant differences (χ(2) = 1.142, P = 0.896). The main immunophenotype of stromal fibroblasts in the tumor-host interface at the invasive front of ADH and DCIS lesions was CD34(+)α-SMA(+)FAP-α(+). There were statistically significant differences in the expression of CD34, α-SMA and FAP-α between IDC and ADH, DCIS and normal breast tissues (χ(2) = 8.351, P < 0.001). The immunophenotype of stromal fibroblasts in the IDC and DCIS-MI breast tissues was CD34(-) α-SMA(+) FAP-α(+).

CONCLUSIONSImmunophenotype conversion from CD34(+) α-SMA(-) FAP-α(-) to CD34(-) α-SMA(+)FAP-α(+) may be a sensitive indicator to judge whether DCIS has microinvasion. Detection of the immunophenotype conversion of stromal fibroblasts may be helpful to determine the presence of microinvasion, and to improve the diagnostic accuracy rate of DCIS.

Breast ; Breast Neoplasms ; immunology ; pathology ; Carcinoma in Situ ; Carcinoma, Ductal, Breast ; Carcinoma, Intraductal, Noninfiltrating ; Fibroblasts ; immunology ; Gelatinases ; metabolism ; Humans ; Hyperplasia ; Immunohistochemistry ; Immunophenotyping ; Membrane Proteins ; metabolism ; Serine Endopeptidases ; metabolism

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Expression and clinical significance of CCL5 in patients with esophageal carcinoma.

Jinyan LIU ; Feng LI ; Xinfeng CHEN ; Liping WANG ; Dongli YUE ; Song ZHAO ; Wei HU ; Pawel KALINSKI ; Stephen THORNE ; Jingzhou HOU ; Yi ZHANG

Chinese Journal of Oncology.2014;36(11):828-833.

OBJECTIVETo investigate the expression and significance of CCL5 in patients with esophageal carcinoma.

METHODSUsing reverse transcriptase polymerase chain reaction (RT-PCR), the expressions of CCL5/CD8/granzyme B/perforin in tumor and corresponding adjacent tissues from esophageal carcinoma patients were examined. Flow cytometry (FACS) was used to detect the percentages of CD8(+) T cells and CCR5(+)CD8(+) T cells in TIL and PBMC from the patients. Transwell assay was performed to study the effect of CCL5 on the migration of T cells in vitro. T test and Spearman correlation analysis were performed.

RESULTSThe mRNA expressions of CCL5 and perforin were 0.348 2 ± 0.300 1 and 0.181 9 ± 0.118 6, respectively, in the tumor samples, while their expressions in adjacent samples were 0.279 6 ± 0.138 0 and 0.118 0 ± 0.109 8, respectively, with no statistically significant differences between them (P > 0.05 for both). The mRNA expressions of CD8 and granzyme B were significantly higher in the tumor tissues than in adjacent tissues (0.464 9 ± 0.300 8 vs. 0.279 0 ± 0.173 4, 0.648 7 ± 0.516 0 vs. 0.469 7 ± 0.259 1; P < 0.05 for both). The relative expression of CCL5 was positively correlated with that of CD8, perforin and granzyme B (r(CD8) = 0.272, P = 0.034; r(perforin) = 0.305, P = 0.026; r(granzymeB) = 0.108, P = 0.012) in the tumor sites. FACS data revealed that the proportions of CD8(+) T cells in TIL and PBMC were (45.86 ± 16.09)% and (34.05 ± 15.07)%, respectively, showing a significant difference (P = 0.022). Similarly, CCR5(+)CD8(+) T cells fraction in TIL (48.12 ± 26.75)% was much higher than that in PBMC (19.53 ± 13.67) % (P < 0.001). Transwell assay showed that CCL5 protein enhanced the migration of T cells, supporting that CCL5 is crucial for CD8(+) T cells recruitment in vivo. Intriguingly, CCL5 expression was down-regulated in advanced patients (stage IIb-IV). The accumulation of CD8(+) T cells and CCR5(+)CD8(+) T cells was strongly reduced in advanced patients, suggesting that CCL5 expression may be involved in the local control of the disease and its reduction may be involved in disease progression.

CONCLUSIONSThe current data indicate the involvement of CCL5 in the regulation of CD8(+) T cell entry into tumor lesions in esophageal carcinoma patients. This process may affect the disease status and potentially as a prognostic factor for cancer patients. Enhancing local CCL5 expression in tumor lesions may represent a novel strategy in esophageal cancer therapy.

CD8-Positive T-Lymphocytes ; Chemokine CCL5 ; metabolism ; Disease Progression ; Esophageal Neoplasms ; metabolism ; Flow Cytometry ; Humans ; Leukocytes, Mononuclear ; Lymphocytes, Tumor-Infiltrating

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