ObjectiveTo compare the current status of clinical studies regarding lung cancer between China and the United States in 2019, and to indicate the weakness, trend and future development direction of clinical studies drug treatment in China.MethodsThe data of lung cancer clinical studies from January 1st to November 30th, 2019 in China and the United States were retrieved and analyzed through Informa pharmaprojects database.ResultsThe United States was superior on the number of projects (128 vs. 156) and research institutions (743 vs. 2 250). Compared with the United State, there were more phase Ⅲ confirmatory researches (19.5% vs. 10.3%), bioequivalent drug researches (3.1% vs. 0%), and researches initiated by academic institutions (39.8% vs. 28.1%) in China. The United States exhibited advantages in phaseⅠ andⅠ/Ⅱstudies (25.8% vs. 60.3%), immunodrugs (49.2% vs. 60.3%), primary tested drug ratio (61.7% vs. 93.6%), targets abundance (32.9% vs. 69.6%), and chimeric antigen receptor-T (CAR-T, 0.7% vs. 7.1%).ConclusionCompared with the United States, China should pay more attention to innovative drug investigations in early phase of clinical studies, especially novel immune agents, vaccines, and CAR-T.
Objective To state operative details of lip-shaped hepatectomy (LSH) and evaluate its advantage in treatment of primary liver cancer (PLC).Methods LSH is one of the irregular hepatectomies. The key lies in the following five operative kinks: ①adequately mobilizing perihepatic ligaments; ②designing lip-shaped hepatic incision; ③laying sutures on both sides of the hepatic incision for traction; ④wedge-shapedly resecting the tumor and the surrounding liver; ⑤closely sewing up the hepatic cutting surface.Results Two hundreds and thirty three patients with PLC were treated by LSH between Oct. 1991 and Dec. 1997 in Zhongshan hospital, Shanghai medical university. Among them 8 cases underwent initial hepatectomy and resection for recurrence of the tumor. The operative mortality rate was 1.2%, 2 died of hepatic failure and 1 renal failure. In addition to bile leakage in 3 cases and hydropsy at the operative area in one case, no severe postoperative complications were found, such as intraperitoneal bleeding, subphrenic abscess and so on. The 1-,3-,5-year survival rates were 89.8%, 64.3% and 55.9% respectively, in 233 patients with 241 LSHs. 25 patients survived more than 5 years. The result indicated that the most advantage of LSH was to increase operative safety on the basis of guarantee of radical resection of PLC, especially to decrease some complications from hepatic cutting surface.Conclusion LSH is a relatively simple, safe, reasonable and recommendable hepatectomic modality.
Prostate cancer ranks second among the causes of death of malignant tumors in middle-aged and elderly men. A considerable number of patients are not easily detected in early-stage prostate cancer. Although traditional imaging examinations are of high value in the diagnosis and staging of prostate cancer, they also have certain limitations. With the development of nuclear medicine instruments and molecular probes, molecular imaging is playing an increasingly important role in the diagnosis and treatment of prostate cancer. Positron emission tomography and computed tomography (PET/CT) using prostate-specific membrane antigen (PSMA) as a probe has gained increasing recognition. This article will review the latest progress in the application of PET/CT using probes for targeting PSMA to imaging and treatment of prostate cancer, in order to provide a theoretical basis for the application of probes for targeting PSMA in the diagnosis and treatment of prostate cancer.
Objective To evaluate the clinical significance of submental island flap in repairing tongue defects.Methods Nine patients (6 men and 3 women)with tongue squamous cell carcinoma underwent subtotal or partial glossectomy, resection of mandible,radical neck dissection and immediate reconstruction of tongue defects with submental island flap. The age ranged from 48 years to 71 years, the lesion locations were right part of tongue (5 cases) and left part of tongue (4 cases). The defect sizes were 4.2 cm×3.2 cm to 5.5 cm×4.0 cm. The flap area rangedfrom 6.0 cm×3.0 cm to 7.0 cm×4.0 cm. The flap pedicle included submental artery in 8 cases and both submental artery and facial artery in 1 case. Results The submental island flap survived in 8 cases. Postoperative articulation and swallowing were investigated in all cases. The static shape of tongue after rec onstruction with submental island flap was acceptable. The dynamic speech, swallowing and food transport function were well preformed. No complication occurred.Three patients were given radiotherapy 3 weeks after operation. Conclusion It is simple and convenient to repair defects of tongue and oral floor with submental island flap.
The incidence of complications after radical resection of esophageal carcinoma is high up to about 20%-50%. The incidence of pneumonia, pleural effusion, tracheal intubation, anastomotic fistula and cardiac events is relatively high. Among them, pulmonary complications are the most common complications after esophageal cancer operation and cause the most perioperative deaths. Among the factors that influence the occurrence of postoperative complications of esophageal cancer, the amount of fluid infusion during and after the operation is closely related to the occurrence of postoperative complications. Moreover, in the environment of enhanced recovery after surgery (ERAS), it is more important to optimize the postoperative fluid management of esophageal cancer. Restricted fluid therapy plays a more and more important role in patients undergoing esophagectomy. This review integrated the relevant research results and discussed the advantages of the restricted fluid therapy compared with other fluid therapy, how to control the restricted infusion volume and infusion speed and how to monitor and evaluate the infusion process and the selection of infusion types, so as to provide reference for clinical practice test.
Objective To study the expression and significance of CCR chemokine receptor-7 (CCR7) protein and vascular endothelial growth factor-D (VEGF-D) protein in the progression of breast cancer, including normal breast tissue, slight and moderate atypical hyperplasia, severe atypical hyperplasia and intraductal carcinoma in situ, as well as invasive ductal carcinoma. Methods Immunohistochemistry was used to detect the expression of CCR7 and VEGF-D protein in the nomal breast tissue (n=20), slight and moderate ductal atypical hyperplasia tissue (n=20), severe atypical hyperplasia and intraductal carcinoma in situ tissue, as well as invasive ductal breast carcinoma tissue (n=73). In addition, the D2-40 staining was also used to determine lymphatic microvessel density (LMVD). Meanwhile, the relationship between the expression of the two kinds of protein and clinicopathological factors/LMVD was analyzed by statistical analysis in breast cancer, and the correlation between expression of CCR7 protein and expression of VEGF-D protein was analyzed too. Results ①The positive rates of CCR7 protein (χ 2 =23.905，P<0.050) and VEGF-D protein (χ 2 =22.349，P<0.050) were gradually increased in the normal breast tissue group 〔CCR7 protein: 0 (0/20), VEGF-D protein: 5.0% (1/20)〕, slight and moderate atypical hyperplasia group 〔CCR7 protein: 5.0% (1/20), VEGF-D protein: 20.0% (4/20)〕, severe atypical hyperplasia and intraductal carcinoma in situ group 〔CCR7 protein: 30.0% (6/20), VEGF-D protein: 40.0% (8/20)〕, and invasive ductal carcinoma group 〔CCR7 protein: 47.9% (35/73), VEGF-D protein: 57.5% (42/73)〕. ②The LMVD value gradually increased in normal breast tissue group (2.00±1.02), slight and moderate atypical hyperplasia group (6.70± 3.48), severe atypical hyperplasia and intraductal carcinoma in situ group (9.01±2.13), as well as invasive ductal carcinoma group (16.32±4.07), there was significant difference between any 2 groups (P<0.050). ③The expressions of CCR7 protein and VEGF-D protein were correlated with clinical staging, histological grading, lymph node metastasis, and expression of human epidermal growth factor receptor-2 (HER-2) protein in patients with breast cancer (P<0.050), the higher positive rates of CCR7 and VEGF-D protein occurred in patients with higher histological grading, later clinical staging of Ⅲ+Ⅳ (compared with staging of Ⅰ+Ⅱ), lymph node metastasis (compared with no lymph node metastasis), and positive expression of HER-2 protein (compared with negative expression of HER-2 protein). The result indicated that LMVD value was related with expression of VEGF-D protein (r=0.623, P<0.010) in patients with breast cancer, but there was no correlation with expression of CCR7 protein (r=-0.303, P>0.050). Furthermore, there was weak positive correlation between expression of CCR7 protein and expression of VEGF-D protein in breast cancer (r=0.112, P<0.050). Conclusion The results strongly suggest that the expression levels of the VEGF-D protein and CCR7 protein indicate the potential of translation some extent, and they play an important role in the progression of breast cancer.
【Abstract】ObjectiveTo discuss the value of thyroglobulin (TG) in diagnosis and treatment of differentiated thyroid cancer (DTC) patients. MethodsLiteratures on measurement and clinical application of serum TG were reviewed. ResultsImmunometric assay (IMA) was adopted by most clinical lab.TG antibody （TGAb） should be measured in the same sample of DTC patient.TG detection before operation is of less value in confirming diagnosis of DTC, but is helpful in differential diagnosis of histopathological type of DTC.TG detection after operation is very important in patients who had undergone total thyroidectomy.Monitoring TG after thyroid hormone withdrawal or recombinant human TSH stimulation is more sensitive to identify tumor recurrence. ConclusionMonitoring TG after total thyroidectomy has great value in followup of DTC patients.
Objective To explore the factors associated with clinic follow-up of old patients with colorectal cancer and provide more evidence to improve the efficiency and quality of clinic follow-up after sugery. Methods The data of 253 patients who were underwent sugery because of old colorectal cancer in our hospital from January 2009 to May 2010 were reviewed. Data about the rate and times of clinic follow-up within 6 months after operation were collected via Hospital Information Systerm, then the follow-up rate was calculated, and to analyse the possible factors associated with follow-up times and rate. Results The total follow-up rate was 84.2%（213/253）, and the total times of follow-up was between 0 to 24 times per one, （4.08±0.03）times on average. On the times of follow-up, patients inside the city was higher than that outside, patients with medical or postoperative complications were higher than those without, and patients with a stoma was lower than that without, and the differences were statistically significant （P＜0.05）.While on the follow-up rate, patients underwent a radical sugery or with a stoma were lower than those not or without, and the differences were statistically significant （P＜0.05）. Conclusions The clinic follow-up of old colorectal cancer patients is not satisfactory, and the possible factors associated with follow-up times or rate are the distance between residence and hospital, have medical complications or not, have postoperative complications or not, radical sugery or not, and with a stoma or without.
ObjectiveTo understand the single-cell RNA sequencing (scRNA-seq) and its research progress in the tumor microenvironment (TME) of breast cancer, in order to provide new ideas and directions for the research and treatment of breast cancer. MethodThe development of scRNA-seq technology and its related research literature in breast cancer TME at home and abroad in recent years was reviewed. ResultsThe scRNA-seq was a quantum technology in high-throughput sequencing of mRNA at the cellular level, and had become a powerful tool for studying cellular heterogeneity when tissue samples were fewer. While capturing rare cell types, it was expected to accurately describe the complex structure of the TME of breast cancer. ConclusionsAfter decades of development, scRNA-seq has been widely used in tumor research. Breast cancer is a malignant tumor with high heterogeneity. The application of scRNA-seq in breast cancer research can better understand its tumor heterogeneity and TME, and then promote development of personalized diagnosis and treatment.
The effects of preoperative selective arterial perfusion chemotherapy (PSAPC) in the treatment of 20 cases of histologically confirmed gastric cancers is reported in which 12 patients were operated on, and a comparison with that of general chemotherapy in 10 cases of gastric cancers (as controls) was made. In the PSAPC group, besides the improvement of clinical symptoms and singns, the cancer cells of lesions in situ and metastatic lymph nodes have different degrees of degeneration and necrosis. This result show significant differences in two group comparison (Plt;O.01). We conclude that the PSAPC has good short-term effect and little side-effect. It can improve the resection rate and radical resection rate, and prevent the iatrogenic metastasis and implantation during operation, and decrease the postoperative recurrence of the patients with gastric cancer.