Objective:To investigate the effect of low-dose ionizing radiation on blood cell parameters of radiation workers.Methods:A total of 124 staff members engaged in radiology were selected into the observation group, and they were divided into 4 subgroups of physicians, physicists, technicians, and maintainer according to their jobs. A total of 130 non-radiation-related staff members from the same hospital were selected into the control group. Blood cell parameters of peripheral blood of all subjects from 2016 to 2019 were collected, and the differences in blood cell parameters between the radiation group and the control group as well as 4 subgroups of the control group were analyzed and compared, and the correlation between the differences in blood cell parameters and the cumulative radiation dose was compared.Results:Compared with the control group, the white blood cell count, neutrophil count, red blood cell count and hemoglobin count in the observation group were lower than those in the control group (all P<0.05). There are no significant differences in cumulative radiation dose among different types of work (all P>0.05). Correlation analysis showed that the blood cell parameters of peripheral blood cells were not significantly correlated with the cumulative radiation dose. The blood cell count changes after 4-year low-dose ionizing radiation between the physicist group, the technician group and the maintainer sub-group were significantly different (all P<0.05), but the above differences were not related to the cumulative radiation dose (all P>0.05). Conclusions:Under the same exposure and protection conditions, the blood cell counts of different radiation-related workers are not significantly different, and the long-term cumulative radiation dose has no significant correlation with blood cell parameters. Therefore, peripheral blood cell parameters can no longer be used as a good indicator to reflect radiation damage, and it is urgent to find more convenient, intuitive and sensitive indicators of radiation damage.

Objective:To compare the dosimetry and efficacy of intracavitary brachytherapy (ICBT) and intracavitary/interstitial brachytherapy (IC+ ISBT) based on CT image guidance in the treatment of stage Ⅲ B cervical cancer. Methods:Clinical data of 93 patients with stage Ⅲ B cervical cancer treated in Department of Radiotherapy of Jilin Cancer Hospital from June 2014 to February 2017 were analyzed retrospectively. According to the results of Gynecological examination and pelvic MRI before brachytherapy, confirming the size of residual tumor and the degree of parauterine infiltration, all patients were divided into the ICBT and IC+ ISBT groups. The D 90%, D 100%, V 100% and D 2cm 3 of bladder and rectum were compared, and the short-term and long-term efficacy was observed between two groups. Results:The median follow-up time was 60 months. The 5-year local control rate, distant metastasis-free survival rate and overall survival rate of all patients were 83%, 71% and 68%, respectively. Compared with the ICBT group, HR-CTV D 90% in the IC+ ISBT group was all more than 85 Gy, while there was no significant difference between two groups ( P=0.188). The D 2cm 3 of bladder and rectum in the IC+ ISBT group was significantly decreased by 7 Gy and 8 Gy (both P<0.01), and the distant metastasis-free survival rate was significantly improved ( P=0.009). The 5-year local control rate in the HR-CTV volume>60 cm 3 in the IC+ ISBT group was significantly higher than that in the IC group ( P=0.029). Conclusion:For patients with Ⅲ B cervical cancer, IC+ ISBT can not only ensure target coverage, but also significantly reduce the incidence of distant metastasis and the dose of organs at risk, and significantly improve the local control rate of large tumors.

Breast cancer screening can significantly reduce the death rate of patients. Although the domestic screening programs have certain health economic value, the high-cost ones need to be weighed. The incidence rate of interval breast cancer is one of important indicators to measure the sensitivity of breast cancer screening program. This paper reviews the epidemiology, clinical features, pathological features and prognosis of interval breast cancer patients, with emphasis on the risk factors and prevention strategies of interval breast cancer.

Objective:Breast cancer is a kind of malignant tumor which seriously endangers women′s health. With the development of molecular biology technology and the further understanding of pathogenesis, the treatment of breast cancer has entered a new era of molecular targeted therapy, and has been making new progress. At present, molecular targeted drugs for the treatment of breast cancer keep emerging, mainly including endocrine therapy targeting estrogen and progesterone receptor (ER/PR), targeted drugs treatment for epidermal growth factor receptor-2 (HER-2); phosphatidylinositol 3 kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) pathway inhibitors, anti-angiogenic drugs, poly (ADP-ribose) polymerase (PARP) inhibitors for BRCA1/2 mutations, cyclin-dependent kinases (CDK) 4/6 inhibitors, etc. Because some signal pathway abnormalities may occur in different molecular types of breast cancer, the same targeted drugs are cross-used in different types.

Objective:Breast cancer is a kind of malignant tumor which seriously endangers women′s health. With the development of molecular biology technology and the further understanding of pathogenesis, the treatment of breast cancer has entered a new era of molecular targeted therapy, and has been making new progress. At present, molecular targeted drugs for the treatment of breast cancer keep emerging, mainly including endocrine therapy targeting estrogen and progesterone receptor (ER/PR), targeted drugs treatment for epidermal growth factor receptor-2 (HER-2); phosphatidylinositol 3 kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) pathway inhibitors, anti-angiogenic drugs, poly (ADP-ribose) polymerase (PARP) inhibitors for BRCA1/2 mutations, cyclin-dependent kinases (CDK) 4/6 inhibitors, etc. Because some signal pathway abnormalities may occur in different molecular types of breast cancer, the same targeted drugs are cross-used in different types.

Objective: In order to investigate the clinical features and influence factors for incidence in patients with radiation-induced external auditory canal carcinoma (RIEACC). Methods: The nasopharyngeal carcinoma (NPC) 16 patients who were diagnosised RIEACC after radiotherapy in the Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University from January 1990 to December 2017 were retrospectively analysis. The influence factors analysis were used Logistic regression analysis. Results: Univariate analysis showed that age, somking history, family history of cancer and NPC stage were the influencing factors. Multi-factor logistic regression analysis showed that age, family history of cancer and NPC stage were independent risk factors. Conclusions RIEACC is rare complication of NPC patients received radiotherapy, which is also a multifactorial outcome. Age, family history of cancer and NPC stage is preliminary the main influencing factor. Although RIEACC has a low incidence, its malignancy should be highly vigilant.

Objective To explore the clinicopathological characteristics,diagnosis,treatment and prognosis of accessory breast cancer.Methods Clinical and pathological data of 37 accessory breast cancer patients from Dec 2005 to Aug 2017 were reviewed.Results 12 patients underwent breast-conserving local wide excision plus axillary lymph node dissection.5 cases were treated by segmental resection and 19 patients by Auchincloss or Halsted mastectomy;One patient abandoned surgery.The most common histological type of accessory breast cancer was infiltrating ductal carcinoma (26 cases,70.3％) followed by adenocarcinoma (4 cases) and miscellaneous type (7 cases).The most common AJCC pathological stages were stage Ⅱ (n =24,65 ％),Ⅰ (n =8),Ⅲ(n =3) and Ⅳ (n =2).The median follow-up time was 6 (1-12) years,the followup rate was 100％.Until Dec 2017,7 patients died from metastasis and the others were alive.Conclusions Accessory breast cancer is rare and with poor prognosis.The diagnosis depends on clinical manifestations,imaging and pathology.Surgery is the mainstay therapy,adjuvant chemo therapy is recommanded.

Tumor suppressor genes breast cancer gene 1/2 ( BRCA1/2) play key roles in DNA damage repair pathways and are essential for maintaining genome integrity. The earliest studies found that BRCA1/2 are the main pathogenic factors of hereditary breast/ovari-an cancer syndrome, and the risk of breast cancer and ovarian cancer is greatly increased in BRCA1/2 mutation carriers. Recent studies have demonstrated that BRCA1/2 mutations also increased the risk of developing colon cancer, pancreatic cancer, skin cancer, and male prostate cancer. BRCA1/2 mutation patients have common molecular pathological basis, which may be independent of pathologi-cal tissue diagnosis in the future. Furthermore, it can serve as an important basis for clinical drug therapy, including chemotherapy drugs represented by platinum, PARP inhibitors, PD-1 antibodies, ALDH2 inhibitors, and mTOR inhibitors.

Breast cancer is the most common cancer for Chinese women. Early screening is the best way to improve the rates of early diagnosis and early treatment of breast cancer. The peak ages of breast cancer in Chinese women are obviously different from those in the European and American countries. It is imperative to develop a guideline for breast cancer screening that is suitable for Chinese women. Based on the analysis and summary of breast cancer screening data in China, and the latest guidelines and consensus on breast cancer screening in Europe, the United States and East Asia, China Anti-Cancer Association and National Clinical Research Center for Cancer (Tianjin Medical University Cancer Institute and Hospital) has developed a population-based guideline for breast cancer screening in Chinese women. This guideline has provided detailed recommendations on the screening starting age, screening modalities, and screening interval in Chinese women with average risk and high risk of breast cancer, respectively. This article aims to interpret the above guideline, providing references for professionals in breast cancer screening.

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.