Objective To use a meta-analysis method to establish quantitatively the association between the HER-2/neu gene amplification/enhanced protein expression status and the 5-year post-operative survival rate or median survival time in women with epithelial ovarian carcinoma. Methods We searched and screened Chinese and English literature published since 1989 to collect all retrospective cohort studies on the prognostic significance of HER-2/neu status in this population. The survival data were analyzed using Ludwig’s centered signed rank and the DerSimonian-Laird method. Results In total, 25 studies involving 3 251 patients were included. HER-2/neu was positive in 27.1% (95%CI 0 to 54.8%) of patients, which was not related to the pathological stage, type or grade of epithelial ovarian carcinoma. In HER-2/neu positive cases, the median survival time was shortened by 0.65 years, and the 5-year survival rate was lowered. The hazard ratio (HR) for mortality was 1.22 (95%C 1.09 to 1.36). By subgroup analysis, HER-2/neu protein expression was found to be most significant in prognostic assessment. Patients with a b positive value of HER-2/neu had an increased HR for the 5-year survival; and platinum-based chemotherapy was demonstrated to be less effective in HER-2/neu positive ovarian carcinoma. Conclusion In gynecological oncology, it is reasonable to measure HER-2/neu as a routine pathological marker to predict a patient’s prognosis and to determine the most appropriate adjuvant chemotherapy regimen.
目的 分析125I 放射性粒子组织间永久植入治疗胰腺癌的效果。 方法 回顾分析采用胆肠Roux-en-Y吻合旁路手术加125I 放射性粒子组织间永久植入治疗的10例进展期胰腺癌患者的临床资料。结果 术后4个月内CT观察9例胰腺肿瘤显著缩小，患者腹痛、腰背部疼痛症状均有不同程度地缓解或消失，平均生存期为(12.7±7.80)个月，超过进展期胰腺癌平均6～10个月的生存期。结论 该治疗方法可以显著提高进展期胰腺癌患者的生存和生活质量。
Objective To evaluate the predictive performance of the geometric characteristics, centerline (CL) of pulmonary nodules for prognosis in patients with surgically treatment in the National Lung Screening Trial (NLST). MethodsCT images of 178 patients who underwent surgical treatment and were diagnosed with non-small cell lung cancer (NSCLC) in the low-dose CT (LDCT) cohort from the NLST image database were selected, including 99 males and 79 females, with a median age of 64 (59, 68) years. CT images were processed using commercial software Mimics 21.0 to record the volume, surface area, CL and the area perpendicular to the centerline of pulmonary nodules. Receiver operating characteristic (ROC) curve was used to compare the predictive performance of LD, AD and CL on prognosis. Univariate Cox regression was used to explore the influencing factors for postoperative disease-free survival (DFS) and overall survival (OS), and meaningful independent variables were included in the multivariate Cox regression to construct the prediction model. ResultsThe area under the curve (AUC) of CL for postoperative recurrence and death were 0.650 and 0.719, better than LD (0.596, 0.623) and AD (0.600, 0.631). Multivariate Cox proportional risk regression analysis showed that pulmonary nodule volume (P=0.010), the maximum area perpendicular to the centerline (MApc) (P=0.028) and lymph node metastasis (P<0.001) were independent risk factors for DFS. Meanwhile, age (P=0.010), CL (P=0.043), lymph node metastasis (P<0.001), MApc (P=0.022) and the average area perpendicular to the centerline (AApc) (P=0.016) were independently associated with OS. ConclusionFor the postoperative outcomes of NSCLC patients in the LDCT cohort of the NLST, the CL of the pulmonary nodule prediction performance for prognosis is superior to the LD and AD, CL can effectively predict the risk stratification and prognosis of lung cancer, and spheroid tumors have a better prognosis.
目的 探讨血管内皮生长因子（VEGF）及受体Flt-1蛋白表达与卵巢恶性肿瘤临床病理和预后的关系。 方法 2000年1月-2004年6月，以SABC免疫组织化学方法检测48例卵巢恶性肿瘤组织中VEGF及其受体Flt-1蛋白的表达。 结果 VEGF和Flt-1蛋白表达与卵巢恶性肿瘤的病理学类型、分化级别及临床分期无明显相关性（P＞0.05）。有淋巴结转移者VEGF和Flt-1蛋白的表达阳性率均明显高于无淋巴结转移者（P＜0.05）。 VEGF 和Flt-1共同表达者平均总生存期为27.88个月，明显短于没有共同表达者的36.04个月（95%CI 为33.42～38.65，P=0.022 3）。 结论 VEGF和Flt-1蛋白表达与卵巢恶性肿瘤的淋巴结转移相关，可作为预测肿瘤转移及预后的指标。
ObjectiveTo compare the long-term survival of elderly patients with esophageal squamous cell carcinoma (ESCC) treated with surgical versus non-surgical treatment. MethodsA retrospective analysis was conducted on the clinical data of elderly patients aged ≥70 years with ESCC who underwent esophagectomy or radiotherapy/chemotherapy at Sichuan Cancer Hospital from January 2009 to September 2017. Patients were divided into a surgical group (S group) and a non-surgical group (NS group) according to the treatment method. The propensity score matching method was used to match the two groups of patients at a ratio of 1∶1, and the survival of the two groups before and after matching was analyzed. ResultsA total of 726 elderly patients with ESCC were included, including 552 males and 174 females, with 651 patients aged ≥70-80 years and 75 patients aged ≥80-90 years. There were 515 patients in the S group and 211 patients in the NS group. The median follow-up time was 60.8 months, and the median overall survival of the S group was 41.9 months [95%CI (35.2, 48.5)], while that of the NS group was only 24.0 months [95%CI (19.8, 28.3)]. The 1-, 3-, and 5-year overall survival rates of the S group were 84%, 54%, and 40%, respectively, while those of the NS group were 72%, 40%, and 30%, respectively [HR=0.689, 95%CI (0.559, 0.849), P<0.001]. After matching, 138 patients were included in each group, and there was no statistical difference in the overall survival between the two groups [HR=0.871, 95%CI (0.649, 1.167), P=0.352]. ConclusionCompared with conservative treatment, there is no significant difference in the long-term survival of elderly patients aged ≥70 years who undergo esophagectomy for ESCC. Neoadjuvant therapy combined with surgery is still an important choice to potentially improve the survival of elderly patients with ESCC.
目的 评估非小细胞肺癌患者中癌症相关性乏力的发生情况及其与患者临床病理特征和生存期之间的相互关系。 方法 应用简明疲劳量表中文版评估2008年12月－2009年12月间收治的72例初治肺癌患者，入组患者均完成根治性手术及术后生存随访。 结果 72例早期非小细胞肺癌患者中，无乏力9例（12.5%），轻度乏力48例（66.7%），中度乏力15例（20.8%），重度乏力0例（0%），乏力总体发生率为87.5%。乏力指数与患者的年龄、性别、吸烟史均无相关性，与患者的体力状况评分（ECOG PS）、TNM分期呈正相关，与中位生存期呈负相关，均有统计学意义（P＜0.05）。 结论 癌症相关性乏力作为非小细胞肺癌患者中普遍存在的一种症状，不仅能够反映患者当时的主观感受和生活状况，还可能是判断患者术后病理分期及最终总生存期的预测因素。
目的 探讨结肠癌患者术后3年生存情况的影响因素。方法 回顾2006年1月至2007年12月期间笔者所在科室收治的确诊为结肠癌且随访资料完整的169例患者临床资料，从术前CEA水平、肿瘤病理分型、分化程度和体质指数（BMI）方面分析影响结肠癌预后的因素。结果 术前CEA水平、肿瘤分化程度及BMI对术后3年生存期的差异有统计学意义（P＜0.05），术前CEA水平对术后3年生存率的差异均有统计学意义（P＜0.05）；术前CEA水平、病理分型、分化程度对术后发生转移的差异有统计学意义（P＜0.05）。结论 术前CEA水平是结肠癌预后的高危因素。
ObjectiveTo detect level of circulating tumor cells (CTCs) in peripheral venous blood of fasting patients with gastric cancer (GC) and to analyze relationships between CTCs and clinicopathologic features and prognosis of patients with GC.MethodsOne hundred patients with GC were selected (GC group), who underwent the surgery and confirmed by the histopathology in the 940 Hospital of Joint Service of PLA, from August 2015 to December 2016. Thirty-eight patients with gastric benign lesions who were treated in this hospital at the same time were selected as the control group. The 7 mL peripheral venous blood of the elbow in the morning was taken from the fasting patients and the CTCs were detected by the immunomagnetic microparticle negative enrichment combined with immunofluorescence in situ hybridization within 24 h. The positive rate of CTCs was calculated and its relationships with the clinicopathologic features (tumor location, tumor invasion depth, degree of differentiation, TNM stage, lymph node metastasis, and vascular tumor thrombus) and the progression-free survival of the patients with GC were analyzed.ResultsThe positive rate of peripheral venous blood CTCs in the GC group was 89.0% (89/100), which was higher than that in the control group (10.5%, 4/38), and the difference was statistically significant (P<0.001). The levels of CTCs in the patients with GC were significantly correlated with the tumor invasion depth (P=0.017), lymph node metastasis (P=0.038), and TNM stage (P=0.016), which were not associated with the age, gender, tumor location, degree of differentiation, and vascular tumor thrombus (P>0.050). The predictive value of CTCs for the diagnosis of GC was significantly superior to that of the tumor markers CEA, CA19-9, or CA125. The progression-free survival of patients with low CTCs expression was significantly longer than that in the patients with high CTCs expression (χ2=5.172, P=0.023).ConclusionsDetecting CTCs of patients with GC by immunomagnetic particle negative enrichment combined with immunofluorescence in situ hybridization has a high sensitivity. And it can improve early diagnosis of patients with GC. Preoperative CTCs detection has a certain value in guiding staging of GC and predicting prognosis of patients with GC.
ObjectiveTo systematically evaluate the potential value of C-reactive protein to albumin ratio (CAR) as an indicator of prognosis and survival in patients with pancreatic cancer. MethodsThe literatures were searched comprehensively in the PubMed, Embase, Web of Science, Cochrane Library, CBM, Wanfang, CNKI, and CQVIP databases from the establishment of the databases to May 20, 2021. The combined hazard ratio (HR) and 95% confidence interval (95%CI) were used to evaluate the correlation between the CAR and the overall survival (OS), progression-free survival (PFS), or disease-free survival (DFS) in the patients with pancreatic cancer. The Newcastle-Ottawa scale (NOS) was used to evaluate the quality of the non-randomized controlled studies, and the Stata SE 15.0 software was used for meta-analysis. ResultsA total of 2 985 patients with pancreatic cancer were included in this meta-analysis of 15 studies. The results of meta-analysis showed that the higher CAR value, the shorter OS [effect size (ES)=0.60, 95%CI (0.50, 0.69), Z=12.04, P<0.001], DFS [ES=0.63, 95%CI (0.47, 0.78), Z=3.61, P<0.001], and PFS [ES=0.41, 95%CI (0.19, 0.63), Z=7.91, P<0.001] in the patients with pancreatic cancer. The results of subgroup analysis of OS according to different countries, sample size, mean age, follow-up time, CAR cut-off value, and NOS score showed that the higher CAR value was related to the shorter OS (P<0.05). The result of linear regression analysis showed that there was no correlation between the CAR cut-off value and lnHR of OS (r2=0.947, P=0.455). Conclusion From results of this study, CAR is closely related to OS of patients, and it is expected to be used as a new reference index for monitoring and judging prognosis of patients with pancreatic cancer.
Objective To analyze the Podoplanin expression in patients with esophageal squamous cell carcinoma and to find out the relationship between Podoplanin expression and tumor embolus, lymph node metastasis, tumor differentiation as well as prognosis, and to provide clinical evidence for reducing the recurrence of esophageal squamous cell carcinoma and prolonging the disease-free survival and overall survival. Methods A retrospective analysis of 70 patients with esophageal squamous cell carcinoma in our hospital from June 2010 to June 2012 was conducted, including 39 males and 31 females, with a mean age of 63.6 years. Positive diagnosis of tumor thrombus was achieved in 35 patients and negative in 35 patients. Postoperative pathological specimens were examined and normal esophageal tissues (esophageal tissue more than 5 cm from the edge of the tumor) of patients were excised as a control group. Results The positive rate of Podoplanin was 34.2% in normal esophageal tissues and 62.8% in tumor tissues. The positive rate of Podoplanin expression was 77.1% and 48.6% in esophageal squamous cell carcinoma patients with or without tumor embolus, respectively. The positive rate of Podoplanin expression in tumor cells of patients with positive and negative lymph node metastasis was 71.9% and 23.1%, respectively (P<0.05). The mean disease-free survival of patients with Podoplanin expression-negative esophageal squamous cell carcinoma was 15.2 months, which was significantly longer than that of patients with Podoplanin expression-positive esophageal squamous cell carcinoma (P<0.05). Conclusion Podoplanin expression in the tumor cells and vessels can be an important reference index to the prognosis of patients with esophageal squamous cell carcinoma.