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Systematic review of anorectal leiomyosarcoma: Current challenges and recent advances 预览
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作者 Mohammed O Nassif Razan A Habib +1 位作者 Luai Z Almarzouki Nora H Trabulsi 《世界胃肠外科杂志:英文版(电子版)》 2019年第8期334-341,共8页
BACKGROUND The anorectal leiomyosarcoma (LMS) is an aggressive malignant neoplasm. Owing to the rarity of LMSs, an optimal treatment modality has yet to be determined. AIM To collect all published data on anorectal LM... BACKGROUND The anorectal leiomyosarcoma (LMS) is an aggressive malignant neoplasm. Owing to the rarity of LMSs, an optimal treatment modality has yet to be determined. AIM To collect all published data on anorectal LMS characteristics, explore current treatment options, and review recent cases of postradiation LMS. METHODS A literature search of the PubMed electronic database was conducted using the MeSH terms "rectal neoplasms","anus neoplasms" and "gastrointestinal neoplasms" combined with "leiomyosarcoma". The search was limited to English language and human studies. All available case reports and case series of anal or rectal LMSs that were published from the beginning of January 1996 to May 2017 were included if the diagnosis of LMS had been confirmed by histopathologic examination. Data were analyzed using simple statistics (mean, median, and standard deviation). Independent sample t-test was used to compare means for continuous variables. RESULTS A total of 27 articles reporting on 51 cases of anorectal LMS were identified. Among these cases, 11.7% had undergone previous pelvic radiotherapy (developing LMS at 13-35 years afterwards). Anorectal LMS affected the rectum in 92.2% of the cases, and no sex-based predominance was observed. Surgical resection with negative margins remains the mainstay of treatment, which can be accomplished with wide local excision or radical resection. The local recurrence rate was higher among cases who received wide local excision (30%), as compared to radical resection (20%);however, the overall rate of metastasis was 51.61% regardless of the treatment approach. The use of neoadjuvant radiation lowers the risk of local recurrence compared to adjuvant radiotherapy, and facilitates R0 resection of the tumor. Cases treated with adjuvant chemotherapy showed better rates of distant recurrence and overall survival. Nonetheless, multidisciplinary team discussion is necessary to determine the optimal management plan whilst considering patient- and disease-related factors. CONCLUSION A 展开更多
关键词 LEIOMYOSARCOMA RECTAL NEOPLASMS ANAL NEOPLASMS GASTROINTESTINAL NEOPLASMS Soft tissue NEOPLASMS
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宫颈癌患者合并多原发恶性肿瘤一例并文献复习 预览
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作者 王欣 杨永秀 《国际妇产科学杂志》 CAS 2019年第4期478-480,共3页
多原发恶性肿瘤(MPMT)是指同一患者的不同器官或组织同时或先后发生2种或2种以上的原发性恶性肿瘤。现报道兰州大学第一医院妇产科收治的1例于2000—2019年间先后患多种良恶性肿瘤的宫颈癌患者,积极进行手术及相应辅助治疗后,经过5个月... 多原发恶性肿瘤(MPMT)是指同一患者的不同器官或组织同时或先后发生2种或2种以上的原发性恶性肿瘤。现报道兰州大学第一医院妇产科收治的1例于2000—2019年间先后患多种良恶性肿瘤的宫颈癌患者,积极进行手术及相应辅助治疗后,经过5个月随访,目前患者一般状态良好,无特殊不适,无复发或转移迹象。通过阐述对患者的准确诊断以及个体化治疗,探讨MPMT的发病机制、治疗方案和生存率,为广大医学研究者和临床工作者提供资料和参考。 展开更多
关键词 肿瘤 继发原发性 生殖器肿瘤 女(雌)性 宫颈肿瘤 肿瘤综合征 遗传性 病例报告
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Survival comparison between primary hepatic neuroendocrineneoplasms and primary pancreatic neuroendocrine neoplasms and theanalysis on prognosis-related factors 预览
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作者 Meng-Xia Li Qi-Yong Li +5 位作者 Min Xiao Da-Long Wan Xin-Hua Chen Lin Zhou Hai-Yang Xie Shu-Sen Zheng 《国际肝胆胰疾病杂志:英文版》 SCIE CAS CSCD 2019年第6期538-545,共8页
Background: Primary hepatic neuroendocrine neoplasms (PHNENs) are extremely rare and few articles have compared the prognosis of PHNENs with other neuroendocrine neoplasms (NENs). This study aimed to investigate the d... Background: Primary hepatic neuroendocrine neoplasms (PHNENs) are extremely rare and few articles have compared the prognosis of PHNENs with other neuroendocrine neoplasms (NENs). This study aimed to investigate the different prognosis between PHNENs and pancreatic NEN (PanNENs) and evaluate the relevant prognosis-related factors. Methods: From January 2012 to October 2016, a total of 44 NENs patients were enrolled and divided into two groups according to the primary tumor location which were named group PHNENs (liver;n =12) and group PanNENs (pancreas;n =32). Demographic, clinical characteristics and survival data were compared between the two groups with Kaplan-Meier method and log-rank tests. Prognostic factors were analyzed using the Cox regression model. Results: The overall survival of group PHNENs and group PanNENs were 25.4 ±6.7 months and 39.8 ±3.7 months, respectively (P =0.037). The cumulative survival of group PanNENs was signi cantly higher than that of group PHNENs (P =0.029). Univariate analysis revealed that sex, albumin, total bilirubin, total bile acid, aspartate aminotransferase, alkaline phosphatase, α-fetoprotein and carbohydrate antigen 19-9, histological types, treatments and primary tumor site were the prognostic factors. Further multivariate analysis indicated that albumin (P =0.008), histological types NEC (P =0.035) and treatments (P =0.005) were the independent prognostic factors. Based on the histological types, the cumulative survival of pa- tients with well-differentiated neuroendocrine tumor was signi cant higher than that of patients with poorly differentiated neuroendocrine carcinoma in group PHNENs (P =0.022), but not in group PanNENs (P >0.05). According to the different treatments, patients who received surgery had signi cantly higher cumulative survival than those with conservative treatment in both groups (P <0.05). Conclusions: PHNENs have lower survival compared to PanNENs. Histological types and treatments affect the prognosis. Surgical resection still remains the rst 展开更多
关键词 NEUROENDOCRINE NEOPLASMS SURVIVAL PROGNOSIS HEPATIC NEUROENDOCRINE NEOPLASMS PANCREATIC NEUROENDOCRINE NEOPLASMS
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保留棘突行全椎板截骨回植在胸腰椎管内原发肿瘤手术治疗中的应用
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作者 吴玉仙 纪玉清 +5 位作者 李建民 李玉椿 王光辉 江雯 杨强 李振峰 《中华解剖与临床杂志》 2019年第3期227-231,共5页
目的 探讨保留棘突行全椎板截骨回植在胸腰椎管内原发肿瘤手术治疗中的临床应用价值.方法 采用回顾性队列研究方法.纳入2013年7月—2017年7月山东大学齐鲁医院(青岛)骨肿瘤科胸腰椎管内肿瘤患者92例,男48例、女44例,年龄41~79(53.9 ... 目的 探讨保留棘突行全椎板截骨回植在胸腰椎管内原发肿瘤手术治疗中的临床应用价值.方法 采用回顾性队列研究方法.纳入2013年7月—2017年7月山东大学齐鲁医院(青岛)骨肿瘤科胸腰椎管内肿瘤患者92例,男48例、女44例,年龄41~79(53.9 ± 10.2)岁.均采用全椎板截骨、肿瘤切除、截骨块回植、椎弓根内固定术治疗.按是否保留棘突行椎板截骨分为保留棘突截骨组(34例)及不保留棘突截骨组(58例).记录两组患者手术时间、出血量,随访观察肿瘤复发、回植骨块融合情况,术后功能以及并发症情况,比较两组患者术后3个月胸腰部疼痛视觉模拟评分(VAS)以及日本骨科协会(JOA)神经功能评分.结果 所有患者手术顺利,彻底切除病变.保留棘突截骨组手术时间(188 ± 17) min、术中出血量(386 ± 50) mL,不保留棘突截骨组手术时间(190 ± 16) min、术中出血量(380 ± 44) mL,两组比较差异均无统计学意义(t时间 = -0.564, t出血量 =0.604, P值均>0.05).术后3个月时,保留棘突截骨组VAS为(2.07 ± 0.28)分、JOA评分为(15.6 ± 1.8)分,不保留棘突截骨组VAS为(2.45 ± 0.30)分,JOA评分为(13.8 ± 2.0)分,两组比较差异均有统计学意义(tVAS = -5.881, tJOA =4.374, P值均<0.01);保留棘突截骨组术后骨性融合时间(4.0 ± 0.6)个月与不保留棘突截骨组(4.4 ± 0.7)个月比较,差异有统计学意义(t= -2.646, P<0.01).结论 保留棘突行全椎板截骨回植技术应用于胸腰椎管内原发肿瘤的手术治疗中,有利于脊柱的后方解剖结构恢复、促进功能康复及骨融合. 展开更多
关键词 肿瘤 椎管内肿瘤 椎板切除术 骨移植
不同部位口腔鳞癌的延迟诊断分析 预览
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作者 徐韬 王佃灿 +1 位作者 单小峰 蔡志刚 《北京大学学报:医学版》 CAS CSCD 北大核心 2019年第4期748-752,共5页
目的:通过科学设计的调查表,对口腔鳞状细胞癌(简称鳞癌)患者的延迟诊断情况进行临床调查,从而辨别影响口腔鳞癌患者患源性延迟的影响因素以及延迟特点。方法:共收集2014年1月至2016年4月就诊于北京大学口腔医院的原发口腔鳞癌患者514例... 目的:通过科学设计的调查表,对口腔鳞状细胞癌(简称鳞癌)患者的延迟诊断情况进行临床调查,从而辨别影响口腔鳞癌患者患源性延迟的影响因素以及延迟特点。方法:共收集2014年1月至2016年4月就诊于北京大学口腔医院的原发口腔鳞癌患者514例,包括334例男性和180例女性,男女构成比例为1.85 ∶ 1,年龄21~89岁,中位年龄57.6岁。发病部位按国际疾病分类(International Classification of Diseases,ICD)-10分为唇、颊、牙龈、磨牙后区、腭、口底、舌及口咽部共8个部位,年龄分组以10年为分隔,教育程度分为未受教育、初级教育水平(高中以下学历)和高级教育水平(高中及以上学历),体重指数(body mass index,BMI)以18 kg/m^2 和25 kg/m^2 为界分为3个等级,使用视觉模拟评分法(visual analogue score,VAS)评估患者术前的疼痛情况。对患者进行详细的问卷调查以了解其延迟诊断的可能因素和特点,并运用SPSS 18.0软件,采用方差分析和卡方检验来进行组间比较。结果:口腔鳞癌发生的部位按延迟时间长短排序依次为唇部(6.1个月)、颊部(4.1个月)、口底(3.9个月)、舌部(3.6个月)、口咽部(2.9个月)、磨牙后区(2.7个月)、腭部(2.4个月)、牙龈(2.4个月),不同部位间延迟诊断差异有统计学意义( P =0.048);不同性别、教育程度、疼痛、吸烟、饮酒、疼痛程度间延迟诊断差异无统计学意义。结论:肿瘤所在部位与延迟诊断具有相关性,唇部是最容易发生延迟诊断的口腔部位,对于唇明显变大的肿物,应建议患者及时就诊,同时接诊医师尽早采取合适的诊断方法。 展开更多
关键词 肿瘤 鳞状细胞 延迟诊断 口腔肿瘤
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同时性多原发肺腺癌表皮生长因子受体基因突变相关因素分析
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作者 王玉婕 冯昊 +4 位作者 马山蕊 王一超 刘蕴瑶 白慧君 赵亮 《中华医学杂志》 CAS CSCD 北大核心 2019年第29期2297-2301,共5页
目的探讨多原发肺腺癌表皮生长因子受体(EGFR)基因突变的临床、病理及CT表现相关因素,为多原发肺腺癌患者术后行EGFR基因检测提供参考。方法选取2017年8至12月在中国医学科学院肿瘤医院经手术治疗的232例多原发肺癌患者的558个结节,其中... 目的探讨多原发肺腺癌表皮生长因子受体(EGFR)基因突变的临床、病理及CT表现相关因素,为多原发肺腺癌患者术后行EGFR基因检测提供参考。方法选取2017年8至12月在中国医学科学院肿瘤医院经手术治疗的232例多原发肺癌患者的558个结节,其中216个结节通过DNA直接测序法完成EGFR基因突变状态检测。采用χ2检验、Mann-Whitney U检验分析比较216个结节的临床、病理学及CT特征在EGFR有效突变组与非有效突变组中的差异;采用Logistic回归分析探寻EGFR突变的独立危险因素;相关因素的界值采用受试者工作特征(ROC)曲线确定。结果232例多原发肺癌患者男58例、女174例,男女比例为1∶3。年龄≥59岁117例,<59岁115例。非吸烟者192例(占82.8%)。其中,216个结节行EGFR基因检测,有效突变136个,非有效突变(包括野生型、无效突变)80个。EGFR有效突变组与非有效突变组在不同性别、年龄、是否有吸烟史、组织学类型、分化程度的肺腺癌患者中差异均有统计学意义(P=0.006、0.002、0.002、0.015、0.025)。其中,有效突变组,女性107个,年龄≥59岁85个,无吸烟史117个,腺泡为主型68个,中分化89个。计数资料中,127个结节边缘分叶,仅有9个结节边缘光滑。计量资料中,平扫磨玻璃结节(GGO)CT值EGFR突变组为(-459±147)HU,与非有效突变组比较差异有统计学意义(P=0.037)。GGO直径为(11±9)mm,P=0.279。多因素Logistic回归分析显示GGO直径(OR=0.873,95%CI:0.780~0.997,P=0.018)及边缘光滑(OR=0.183,95%CI:0.041~0.824,P=0.027)均为EGFR有效突变的独立保护性因素。结论多原发肺癌好发于中老年女性,EGFR突变率高,且女性、年龄≥59岁、无吸烟、结节GGO平扫CT值<-548 HU、中分化及病理亚型为乳头为主型的早期肺腺癌患者的EGFR有效突变率较高,术后可考虑推荐行EGFR基因检测。 展开更多
关键词 肿瘤 多原发性 肺肿瘤 受体 表皮生长因子 突变 体层摄影术 X 线计算机
外泌体在卵巢癌化疗耐药中的研究进展 预览
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作者 袁梦琴 王艳清 +4 位作者 鲜舒 张莉 杨冬咏 刘诗意 程艳香 《国际生殖健康/计划生育杂志》 CAS 2019年第5期430-433,共4页
卵巢癌是死亡率最高的女性生殖系统恶性肿瘤,目前卵巢癌主要的治疗方法为肿瘤细胞减灭术和手术后辅助紫杉醇联合铂类药物化疗,虽然多数卵巢癌患者对初始化疗反应较为敏感,但一般预后较差,其中化疗耐药是一个亟待解决的难题。近年来,外... 卵巢癌是死亡率最高的女性生殖系统恶性肿瘤,目前卵巢癌主要的治疗方法为肿瘤细胞减灭术和手术后辅助紫杉醇联合铂类药物化疗,虽然多数卵巢癌患者对初始化疗反应较为敏感,但一般预后较差,其中化疗耐药是一个亟待解决的难题。近年来,外泌体作为细胞间物质和信息交流的途径而备受关注,其来源广泛,分布于各种体液中,内含多种生物活性物质,参与抗原提呈、免疫应答、组织损伤修复等多种生理活动过程,并可通过多种方式影响肿瘤微环境,从而促进肿瘤的发生、发展。此外,国内外已有多项研究表明,外泌体在卵巢癌化疗耐药方面也起着重要的调控作用。随着研究的不断深入,外泌体的临床应用可能为化疗耐药的靶向阻断治疗、改善卵巢癌预后带来新的希望。 展开更多
关键词 外泌体 肿瘤 卵巢肿瘤 化疗耐药 抗药性 肿瘤 微RNAS
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Left armpit subcutaneous metastasis of gastric cancer:A case report 预览
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作者 Feng-Jun He Peng Zhang +2 位作者 Mo-Jin Wang Yi Chen Wen Zhuang 《世界临床病例杂志》 2019年第23期4137-4143,共7页
BACKGROUND Gastric cancer is the third most lethal malignant tumor worldwide.Metastasis has always been a major cause of poor prognosis.Epidemiological evidence shows that the most common sites for metastasis of gastr... BACKGROUND Gastric cancer is the third most lethal malignant tumor worldwide.Metastasis has always been a major cause of poor prognosis.Epidemiological evidence shows that the most common sites for metastasis of gastric carcinoma are the liver(48%),peritoneum(32%),lung(15%),and bone(12%);however,subcutaneous metastasis is are and occurs in approximately 0.8%of cases.We report a rare case of armpit subcutaneous metastasis of gastric cancer.The best surgical window was missed,as a result of lacking attention of the mass.CASE SUMMARY A 69-year-old man who had previously undergone radical gastrectomy and received eight cycles of oral chemotherapy for gastric cancer showed a rapidly growing mass in his the left armpit;within just 3 mo,the mass grew to a size of 6.9 cm×4.4 cm×5.7 cm.Color Doppler ultrasonography and Positron emission tomography/computed tomography prompted the possibility of metastasis of the malignancy.Fine needle aspiration biopsy guided by color Doppler ultrasound showed the presence of cancer cells in the mass.Immunohistochemical examination showed CDX-2(+),PCK(+),CK20(+),CK7(-),and TTF(-),which supported the metastasis of gastric cancer.Considering the risk of resection,the patient did not undergo surgical treatment.CONCLUSION The case indicates that unidentified subcutaneous masses in patients with a history of gastric cancer should be carefully evaluated. 展开更多
关键词 Stomach neoplasms Neoplasm metastasis SUBCUTANEOUS Case report Cancer therapy Skin neoplasms
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KML001,an arsenic compound,as salvage chemotherapy in refractory biliary tract cancers:A prospective study 预览
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作者 Jung Hyun Jo Huapyong Kang +5 位作者 Hee Seung Lee Moon Jae Chung Jeong Youp Park Seungmin Bang Seung Woo Park Si Young Song 《国际肝胆胰疾病杂志:英文版》 SCIE CAS CSCD 2019年第1期62-66,共5页
Background:Sodium meta-arsenite(NaAsO2,KML001)is a potential oral anticancer agent acting on telomerase and telomere length.This prospective study evaluated its safety,tolerability,and effectiveness as salvage chemoth... Background:Sodium meta-arsenite(NaAsO2,KML001)is a potential oral anticancer agent acting on telomerase and telomere length.This prospective study evaluated its safety,tolerability,and effectiveness as salvage chemotherapy in patients with advanced biliary tract cancer(BTC)resistant to gemcitabinebased chemotherapy.Methods:Forty-four patients(21 women and 23 men)with advanced BTC and failure history of gemcitabine-based chemotherapy,performance status(PS)0–2,normal cardiac,hepatic,and renal function were enrolled.Daily dose of KML001(7.5 mg.p.o.)was administered to eligible subjects for 24 weeks divided into six treatment cycles.Response was evaluated bimonthly using CT.Results:After an average of 1.5 months of treatment(range:0.5–10.0),3 patients(6.8%)obtained progression-free status,23 patients(52.3%)had disease progression,and 18 patients(40.9%)dropped out before evaluation.One patient(2.3%)completed six treatment cycles without progression.During the treatment,morphine dosage kept the same or decreased in 20 patients(47.6%).Nine patients(20.5%)experienced grade-3 adverse events(AEs),while no patient experienced grade-4 AEs.The most common AEs were liver enzyme elevation(11/44,25%)and anemia(10/44,22.7%).KML001 was discontinued in six patients(13.6%)due to AEs,including liver toxicity(n=3),QTc prolongation(n=2),and abdominal pain(n=1).Conclusions:KML001 did not have enough anticancer effect on patients with advanced BTC resistant to gemcitabine.However,KML001 was safe and well-tolerable in terms of AEs and pain control when used as salvage therapy.Further studies are needed to establish arsenic agents as a reliable treatment option in patients with BTC. 展开更多
关键词 BILIARY TRACT NEOPLASMS CHOLANGIOCARCINOMA GALLBLADDER NEOPLASMS KML001 Sodium meta-arsenite
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肿瘤病人141例支持性照顾需求与社会支持的调查 预览
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作者 崔蕾 李玉红 +1 位作者 李艳平 王倩云 《安徽医药》 CAS 2019年第8期1559-1562,共4页
目的调查住院肿瘤病人社会支持、支持性照顾需求的现状及对策。方法运用支持性照顾需求量表、领悟社会支持量表对2015年12月至2016年12月来自3所三级甲等医院(安徽医科大学第一附属医院、江苏省苏北人民医院、上海市第十人民医院)接受... 目的调查住院肿瘤病人社会支持、支持性照顾需求的现状及对策。方法运用支持性照顾需求量表、领悟社会支持量表对2015年12月至2016年12月来自3所三级甲等医院(安徽医科大学第一附属医院、江苏省苏北人民医院、上海市第十人民医院)接受治疗的145例住院肿瘤病人进行问卷调查。结果回收141份有效问卷。住院肿瘤病人社会支持总得分为(69.65±10.45)分、支持性照顾需求总得分为(93.38±27.89)分。社会支持分别与支持性照顾需求、心理需求、性需求呈负相关(均r=-0.22,P<0.01)。结论住院肿瘤病人社会支持总体处于高支持状态,支持性照顾需求存在未被满足的情况。临床医护人员应重视肿瘤病人的需求,给予专业支持性照顾,尤其是满足病人的健康信息需求和心理需求,鼓励家庭及社会力量关注肿瘤病人,以提高肿瘤病人支持性照顾需求满足度。 展开更多
关键词 住院病人 肿瘤 社会支持 问卷调查 支持性照顾需求
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Endoscopic ultrasound-guided vs endoscopic retrograde cholangiopancreatography biliary drainage for obstructed distal malignant biliary strictures: A systematic review and meta-analysis 预览
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作者 Fernanda P Logiudice Wanderlei M Bernardo +9 位作者 Facundo Galetti Vitor M Sagae Carolina O Matsubayashi Antonio C Madruga Neto Vitor O Brunaldi Diogo T H de Moura Tomazo Franzini Spencer Cheng Sergio E Matuguma Eduardo G H de Moura 《世界胃肠内镜杂志:英文版(电子版)》 2019年第4期281-291,共11页
BACKGROUND For palliation of malignant biliary obstruction (MBO), the gold-standard method of biliary drainage is endoscopic retrograde cholangiopancreatography (ERCP) with the placement of metallic stents. Endoscopic... BACKGROUND For palliation of malignant biliary obstruction (MBO), the gold-standard method of biliary drainage is endoscopic retrograde cholangiopancreatography (ERCP) with the placement of metallic stents. Endoscopic ultrasound (EUS)-guided drainage is an alternative that is typically reserved for cases of ERCP failure. Recently, however, there have been robust randomized clinical trials (RCTs) comparing EUS-guided drainage and ERCP as primary approaches to MBO. AIM To compare EUS guidance and ERCP in terms of their effectiveness and safety in palliative biliary drainage for MBO. METHODS This was a systematic review and meta-analysis, in which we searched the MEDLINE, Excerpta Medica, and Cochrane Central Register of Controlled Trials databases. Only RCTs comparing EUS and ERCP for primary drainage of MBO were eligible. All of the studies selected provided data regarding the rates of technical and clinical success, as well as the duration of the procedure, adverse events, and stent patency. We assessed the risk of biases using the Jadad score and the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation criteria. RESULTS The database searches yielded 5920 records, from which we selected 3 RCTs involving a total of 222 patients (112 submitted to EUS and 110 submitted to ERCP). In the EUS and ERCP groups, the rate of technical success was 91.96% and 91.81%, respectively, with a risk difference (RD) of 0.00%(95%CI:-0.07, 0.07;P = 0.97;I2 = 0%). The clinical success was 84.81% and 85.53% in the EUS and ERCP groups, respectively, with an RD of ?0.01%(95%CI:-0.12, 0.10;P = 0.90;I2 = 0%). The mean difference (MD) for the duration of the procedure was -0.12%(95%CI:-8.20, 7.97;P = 0.98;I2 = 84%). In the EUS and ERCP groups, there were 14 and 25 adverse events, respectively, with an RD of -0.06%(95%CI:-0.23, 0.12;P = 0.54;I2 = 77%). The MD for stent patency was 9.32%(95%CI:-4.53, 23.18;P = 0.19;I2 = 44%). The stent dysfunction rate was significantly lower in the EUS group (MD =-0. 展开更多
关键词 Common bile duct neoplasms ENDOSCOPIC retrograde CHOLANGIOPANCREATOGRAPHY ENDOSONOGRAPHY Ultrasonography Interventional/methods ENDOSCOPIC ultrasound Systematic review META-ANALYSIS
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CD13靶向分子探针在肿瘤新生血管显像与治疗中的研究进展
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作者 武明豪 张燕燕 +2 位作者 曹琳 张雪宁 叶兆祥 《中华核医学与分子影像杂志》 CAS 北大核心 2019年第11期688-693,共6页
肿瘤新生血管生成在癌症发生、发展和转移过程中起着重要作用。非侵入性定量和检测新生血管生成对于癌症的早期诊断以及预后评估十分重要。基于新生血管生成的分子特征,靶向分子显像在肿瘤新生血管显像与精准治疗中发挥关键作用。氨基肽... 肿瘤新生血管生成在癌症发生、发展和转移过程中起着重要作用。非侵入性定量和检测新生血管生成对于癌症的早期诊断以及预后评估十分重要。基于新生血管生成的分子特征,靶向分子显像在肿瘤新生血管显像与精准治疗中发挥关键作用。氨基肽酶N(APN,又称CD13)是一种在新生血管内皮细胞和部分肿瘤细胞中过量表达,而在正常组织血管中鲜有表达的多功能的膜结合外显肽酶,是新生血管显像和抗血管生成治疗的潜在靶点。通过系统分析近年来有关CD13分子靶向技术的研究,该文总结了基于CD13分子靶向显像及精准治疗的应用进展及发展趋势。 展开更多
关键词 肿瘤 新生血管化 病理性 血管生成抑制剂 抗原 CD13 发展趋势
青年癌症患者标准化沟通系统的设置及应用
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作者 刘敏 谢建飞 +5 位作者 孙倩 王璐 周建大 曾赛男 樊小军 郑树基 《中国医师杂志》 CAS 2019年第4期507-512,共6页
目的探讨青年癌症患者标准化沟通系统的设置及应用,以改善青年癌症患者的心理痛苦等负性情绪,提升青年癌症患者的社会支持与生活质量。方法初步构建适合中国国情的青年癌症患者标准化沟通系统,并于2016年8月至9月从中南大学湘雅三医院... 目的探讨青年癌症患者标准化沟通系统的设置及应用,以改善青年癌症患者的心理痛苦等负性情绪,提升青年癌症患者的社会支持与生活质量。方法初步构建适合中国国情的青年癌症患者标准化沟通系统,并于2016年8月至9月从中南大学湘雅三医院和湖南省肿瘤医院就诊的486例青年癌症患者中逐步筛选,选取共171例受试者,运用随机数字表法将171例受试者随机分配至沟通组(n=57)、音乐组(n=57)和常规组(n=57),进行随机对照试验。分别以心理痛苦温度计(DT)、医院焦虑抑郁量表(HADS)、社会支持评定量表(SSRS)、简明健康状况问卷(SF-36)作为评价指标,观察三组受试者在干预前、干预后(立即)、干预后1个月和干预后3个月的心理痛苦、情绪、社会支持、生存质量等情况。结果干预后3个月随访时,共有38例失访,沟通组失访14例(最终n=43),音乐组失访11例(最终n=46)和常规组失访13例(最终n=44)。沟通组、音乐组及常规组三组在干预前的测评指标比较差异无统计学意义(P>0. 05);干预前与干预后立即、干预后1个月、3个月三组在心理痛苦、焦虑抑郁、社会支持的得分比较差异均有统计学意义(P<0. 05);沟通组干预后1个月的心理痛苦、焦虑抑郁、社会支持和生活质量得分与音乐组、常规组比较差异均有统计学意义(P<0.05)。结论标准化沟通系统对改善青年癌症患者的心理痛苦具有明显效果,该方法优于音乐疗法和常规照护,并能提升青年癌症患者的社会支持水平与生活质量。标准化沟通系统的临床验证,可为癌症患者的心理康复提供参考。 展开更多
关键词 青少年 肿瘤 心理疗法 心理测定学
单细胞测序在肿瘤诊治中的应用 预览
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作者 何毅刚 张百红 《现代肿瘤医学》 CAS 2019年第16期2965-2968,共4页
单细胞测序提供了全方位理解肿瘤的方法。单细胞测序因不同的原理分为多种类型,它能够检测到单细胞的精细差异,甚至发现新的细胞类型,用于分析肿瘤的细胞谱系、基因图谱、克隆进化、免疫进化、肿瘤亚型和药物反应。单细胞测序正在改变... 单细胞测序提供了全方位理解肿瘤的方法。单细胞测序因不同的原理分为多种类型,它能够检测到单细胞的精细差异,甚至发现新的细胞类型,用于分析肿瘤的细胞谱系、基因图谱、克隆进化、免疫进化、肿瘤亚型和药物反应。单细胞测序正在改变我们对肿瘤的理解。 展开更多
关键词 肿瘤 治疗 单细胞测序
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Investigation of therapeutic modalities of G719X, an uncommon mutation in the EGFR gene in non-small cell lung cancer 预览
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作者 Hua Zheng Yuan Gao +7 位作者 Zan Liu Zhe Qian Tongmei Zhang Jie Li Hongmei Zhang Qunhui Wang Fanbin Hu Baolan Li 《肿瘤学与转化医学:英文版》 2019年第2期91-97,共7页
Objective G719 X is the most frequently seen uncommon mutation of the epidermal growth factor receptor(EGFR) gene, which is a point mutation at exon 18 with three common subtypes, G719 A/G719 C/G719 S. This study expl... Objective G719 X is the most frequently seen uncommon mutation of the epidermal growth factor receptor(EGFR) gene, which is a point mutation at exon 18 with three common subtypes, G719 A/G719 C/G719 S. This study explored the clinicopathological characteristics of the G719 X mutation and investigated the efficacy of EGFR-tyrosine kinase inhibitor(TKI) treatment and chemotherapy in patients with the G719 X mutation;the survival rate after these different treatment modalities were then analyzed in order to provide evidence for clinical treatment.Methods Clinical data of 41 patients with the G719 X mutation admitted in the Beijing Chest Hospital, Capital Medical University from September 2014 to July 2018, were collected and the EGFR mutations were detected by amplification refractory mutation system-polymerase chain reaction(ARMS-PCR). The clinicopathological characteristics of the G719 X mutation were analyzed, and the relationship among the G719 X mutation, the efficacy of different treatment modalities, and the progression-free survival(PFS) was analyzed. Results Of the 41 cases, 24(58.5%) were G719 X single mutations and 17(41.5%) were compound mutations, including G719 X/S768 I, G719 X/L861 Q, G719 X/19 del, and G719 X/c-Met compound mutation. The objective response rate(ORR) of first-line EGFR-TKI therapy was 50%(6/12), the disease control rate(DCR) was 83.3%(10/12), and the median PFS(mPFS) was 9 months. After resistance to EGFR-TKI in the previous treatment, the ORR(71.4%, 5/7) and DCR(100%, 7/7) were still high following EGFR-TKIs, by an mPFS of 8 months. The ORR of chemotherapy was 33.3%(2/6), the DCR was 100%(6/6), and the mPFS was 6 months. Conclusion G719 X is an uncommon mutation of the EGFR gene and is sensitive to many EGFR-TKIs. It can be treated with the second-or third-generation EGFR-TKIs after resistance to the first-generation EGFR-TKIs. G719 X mutation also showed favorable effect to chemotherapy. 展开更多
关键词 LUNG NEOPLASMS EGFR UNCOMMON MUTATION G719X TARGET therapy
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标准化心理干预对中晚期癌症患者生活质量的影响
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作者 叶菁 闵振兴 +4 位作者 徐桂银 崔巧娜 李福华 褚明洋 张勇 《中华现代护理杂志》 2019年第15期1959-1962,共4页
目的探讨标准化心理干预对中晚期癌症患者生活质量的影响.方法采用方便抽样法,选取2016年10月—2018年11月北京市宣武中医医院外科收治的中晚期癌症住院患者60例为研究对象,根据入院先后顺序将患者进行编号,采用随机数字表法将其随机分... 目的探讨标准化心理干预对中晚期癌症患者生活质量的影响.方法采用方便抽样法,选取2016年10月—2018年11月北京市宣武中医医院外科收治的中晚期癌症住院患者60例为研究对象,根据入院先后顺序将患者进行编号,采用随机数字表法将其随机分为试验组30例和对照组30例.试验组接受标准化心理干预,对照组接受支持性心理护理措施.干预前后,采用癌症患者生活质量核心调查问卷对两组患者生活质量进行评估.在研究过程中,试验组流失9例,最终纳入21例;对照组流失10例,最终20例.结果干预前,试验组认知功能和整体生活质量得分差异有统计学意义(P<0.05),其余维度两组差异无统计学意义(P>0.05).干预后,试验组与对照组在情绪功能维度、认知功能维度、整体生活质量维度、疼痛症状维度、失眠症状维度和食欲丧失症状维度得分差异均有统计学意义(P<0.05),试验组情绪功能和整体生活质量得分高于对照组,认知功能、疼痛症状、失眠症状和食欲丧失症状得分低于对照组.干预前后差值比较,试验组与对照组在情绪功能维度、疼痛症状维度、恶心与呕吐症状维度、失眠症状维度、食欲丧失症状维度、便秘症状维度和腹泻症状维度的变化上差异有统计学意义(P<0.05).试验组情绪功能、疼痛、恶心与呕吐、失眠和食欲丧失症状在干预后得到改善.结论对于中晚期癌症患者采取标准化心理干预,可以改善患者的负性情绪,增强治疗的信心,提高患者生活质量. 展开更多
关键词 肿瘤 生活质量 标准化心理干预
Tertiary stent-in-stent for obstructing colorectal cancer: A case report and literature review 预览
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作者 Giuseppe Vanella Chiara Coluccio +2 位作者 Emilio Di Giulio Daniela Assisi Rocco Lapenta 《世界胃肠内镜杂志:英文版(电子版)》 2019年第1期61-67,共7页
BACKGROUND Self-expandable metal stents(SEMSs) are frequently used in the setting of palliation for occluding, inoperable colorectal cancer(CRC). Among possible complications of SEMS positioning, re-obstruction is the... BACKGROUND Self-expandable metal stents(SEMSs) are frequently used in the setting of palliation for occluding, inoperable colorectal cancer(CRC). Among possible complications of SEMS positioning, re-obstruction is the most frequent. Its management is controversial, potentially involving secondary stent-in-stent placement, which has been poorly investigated. Moreover, the issue of secondary stent-in-stent re-obstruction and of more-than-two colonic stenting has never been assessed. We describe a case of tertiary SEMS-in-SEMS placement, and also discuss our practice based on available literature.CASE SUMMARY A 66-year-old male with occluding and metastatic CRC was initially treated by positioning of a SEMS, which had to be revised 6 mo later when a symptomatic intra-stent tumor ingrowth was treated by a SEMS-in-SEMS. We hereby describe an additional episode of intestinal occlusion due to recurrence of intra-stent tumor ingrowth. This patient, despite several negative prognostic factors(splenic flexure location of the tumor, carcinomatosis with ascites, subsequent chemotherapy that included bevacizumab and two previously positioned stents(1 SEMS and 1 SEMS-in-SEMS)) underwent successful management through the placement of a tertiary SEMS-in-SEMS, with immediate clinical benefit and no procedure-related adverse events after 150 d of post-procedural follow-up. This endoscopic management has permitted 27 mo of partial control of a metastatic disease without the need for chemotherapy discontinuation and, ultimately, a good quality of life until death.CONCLUSION Tertiary SEMS-in-SEMS is technically feasible, and appears to be a safe and effective option in the case of recurrent SEMS obstruction. 展开更多
关键词 BEVACIZUMAB Colorectal neoplasms Intestinal OBSTRUCTION PALLIATIVE care Self-expandable metallic STENTS Case report
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Intraoperative intraperitoneal chemotherapy increases the incidence of anastomotic leakage after anterior resection of rectal tumors 预览
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作者 Zhi-Jie Wang Jin-Hua Tao +4 位作者 Jia-Nan Chen Shi-Wen Mei Hai-Yu Shen Fu-Qiang Zhao Qian Liu 《世界胃肠肿瘤学杂志:英文版(电子版)》 CAS 2019年第7期538-550,共13页
BACKGROUND Intraoperative intraperitoneal chemotherapy is an emerging treatment modality for locally advanced rectal neoplasms. However, its impacts on postoperative complications remain unknown. Anastomotic leakage (... BACKGROUND Intraoperative intraperitoneal chemotherapy is an emerging treatment modality for locally advanced rectal neoplasms. However, its impacts on postoperative complications remain unknown. Anastomotic leakage (AL) is one of the most common and serious complications associated with the anterior resection of rectal tumors. Therefore, we designed this study to determine the effects of intraoperative intraperitoneal chemotherapy on AL. AIM To investigate whether intraoperative intraperitoneal chemotherapy increases the incidence of AL after the anterior resection of rectal neoplasms. METHODS This retrospective cohort study collected information from 477 consecutive patients who underwent an anterior resection of rectal carcinoma using the double stapling technique at our institution from September 2016 to September 2017. Based on the administration of intraoperative intraperitoneal chemotherapy or not, the patients were divided into a chemotherapy group (171 cases with intraperitoneal implantation of chemotherapy agents during the operation) or a control group (306 cases without intraoperative intraperitoneal chemotherapy). Clinicopathologic features, intraoperative treatment, and postoperative complications were recorded and analyzed to determine the effects of intraoperative intraperitoneal chemotherapy on the incidence of AL. The clinical outcomes of the two groups were also compared through survival analysis. RESULTS The univariate analysis showed a significantly higher incidence of AL in the patients who received intraoperative intraperitoneal chemotherapy, with 13 (7.6%) cases in the chemotherapy group and 5 (1.6%) cases in the control group (P = 0.001). As for the severity of AL, the AL patients who underwent intraoperative intraperitoneal chemotherapy tended to be more severe cases, and 12 (92.3%) out of 13 AL patients in the chemotherapy group and 2 (40.0%) out of 5 AL patients in the control group required a secondary operation (P = 0.044). A multivariate analysis was subsequently performed to adjust 展开更多
关键词 Anastomotic LEAKAGE RECTAL neoplasms LOBAPLATIN Fluorouracil implants POSTOPERATIVE complications INTRAOPERATIVE INTRAPERITONEAL chemotherapy
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TYMS/KRAS/BRAF molecular profiling predicts survival following adjuvant chemotherapy in colorectal cancer 预览
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作者 Anastasios Ntavatzikos Aris Spathis +6 位作者 Paul Patapis Nikolaos Machairas Georgia Vourli George Peros Iordanis Papadopoulos Ioannis Panayiotides Anna Koumarianou 《世界胃肠肿瘤学杂志:英文版(电子版)》 CAS 2019年第7期551-566,共16页
BACKGROUND Patients with stage II-III colorectal cancer (CRC) treated with adjuvant chemotherapy, gain a 25% survival benefit. In the context of personalized medicine, there is a need to identify patients with CRC who... BACKGROUND Patients with stage II-III colorectal cancer (CRC) treated with adjuvant chemotherapy, gain a 25% survival benefit. In the context of personalized medicine, there is a need to identify patients with CRC who may benefit from adjuvant chemotherapy. Molecular profiling could guide treatment decisions in these patients. Thymidylate synthase (TYMS) gene polymorphisms, KRAS and BRAF could be included in the molecular profile under consideration. AIM To investigate the association of TYMS gene polymorphisms, KRAS and BRAF mutations with survival of CRC patients treated with chemotherapy.METHODS A retrospective study studied formalin-fixed paraffin-embedded tissues (FFPEs) of consecutive patients treated with adjuvant chemotherapy during January/2005-January/2007. FFPEs were analysed with PCR for the detection of TYMS polymorphisms, mutated KRAS (mKRAS) and BRAF (mBRAF). Patients were classified into three groups (high, medium and low risk) according to 5’UTR TYMS polymorphisms Similarly, based on 3’UTR polymorphism ins/loss of heterozygosity (LOH) patients were allocated into two groups (high and low risk of relapse, respectively). Cox regression models examined the associated 5- year survival outcomes. RESULTS One hundred and thirty patients with early stage CRC (stage I-II: 55 patients;stage III 75 patients;colon: 70 patients;rectal: 60 patients) were treated with surgery and chemotherapy. The 5-year disease free survival and overall survival rate was 61.6% and 73.9% respectively. 5’UTR polymorphisms of intermediate TYMS polymorphisms (2RG/3RG, 2RG/LOH, 3RC/LOH) were associated with lower risk for relapse [hazard ratio (HR) 0.320, P = 0.02 and HR 0.343, P = 0.013 respectively] and death (HR 0.368, P = 0.031 and HR 0.394, P = 0.029 respectively). The 3’UTR polymorphism ins/LOH was independently associated with increased risk for disease recurrence (P = 0.001) and death (P = 0.005). mBRAF (3.8% of patients) was associated with increased risk of death (HR 4.500, P = 0.022) whereas mKRAS (39% of patient 展开更多
关键词 Colorectal NEOPLASMS Thymidylate SYNTHASE Untranslated regions Fluorouracil KRAS BRAF Prognosis
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2型糖尿病患者的恶性肿瘤发病风险:基于浙江省嘉兴市糖尿病管理数据的回顾性队列研究
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作者 王蕾 吴益康 +3 位作者 马骏 李雪琴 陈中文 徐望红 《肿瘤》 CAS CSCD 北大核心 2019年第7期548-557,共10页
目的:分析2型糖尿病(type 2 diabetes mellitus,T2DM)患者发生恶性肿瘤的风险以及使用降糖药物对恶性肿瘤发病风险的影响。方法:基于浙江省嘉兴市糖尿病管理数据,采用回顾性队列研究的方法,以嘉兴市南湖区、秀洲区和海宁市2009年1月1日... 目的:分析2型糖尿病(type 2 diabetes mellitus,T2DM)患者发生恶性肿瘤的风险以及使用降糖药物对恶性肿瘤发病风险的影响。方法:基于浙江省嘉兴市糖尿病管理数据,采用回顾性队列研究的方法,以嘉兴市南湖区、秀洲区和海宁市2009年1月1日—2016年12月31日确诊的T2DM患者为研究对象,通过身份证号与嘉兴市肿瘤登记和死因登记系统进行记录联动,获得肿瘤发病和全死因死亡信息。按性别分别计算T2DM患者中恶性肿瘤的发病率和标化发病率比(standardized incidence ratio,SIR)。采用COX风险回归模型,估计双胍类、磺脲类和胰岛素等主要降糖药物使用与恶性肿瘤发病的风险比(hazard ratio,HR)及95%可信区间(condence interval,CI)。结果:52 911例T2DM患者在确诊1年内恶性肿瘤的发病呈现一个小高峰,提示检出偏倚的可能性。剔除确诊1年内的信息,发现男性患者全癌种(SIR=0.89,95%CI:0.83~0.95)、食管癌(SIR=0.56,95%CI:0.37~0.81)、胃癌(SIR=0.60,95%CI:0.44~0.79)及肺癌(SIR=0.73,95%CI:0.62~0.84)的发病率显著低于同一地区一般人群,而肾癌(SIR=1.67,95%CI:1.02~2.57)和胰腺癌(SIR=1.36,95%CI:1.02~1.78)的发病率高于同一地区一般人群;女性全癌种发病率与一般人群无异,但胃癌(SIR=0.56,95%CI:0.34~0.87)低于一般人群,胰腺癌(SIR=1.77,95%CI:1.34~2.31)高于一般人群。单纯使用口服降糖药的患者全癌种发病率显著低于一般人群(男性SIR=0.78,95%CI:0.69~0.88;女性SIR=0.79,95%CI:0.69~0.91)。采用COX风险回归模型调整可能的混杂因素后,未发现使用降糖药物与恶性肿瘤发病风险有显著关联。结论:嘉兴市男性T2DM患者全癌种、食管癌、胃癌和肺癌的发病率低于一般人群,而肾癌、胰腺癌高于一般人群;女性患者的胃癌发病率低于一般人群,但胰腺癌的发病率高于一般人群。降糖药物尤其是二甲双胍和磺脲类药物可能降低T2DM患者中恶性肿瘤的发生风险。 展开更多
关键词 肿瘤 队列研究 糖尿病 2型 二甲双胍 胰岛素 磺脲类
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