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   2016| October  | Volume 12 | Issue 5  
    Online since October 7, 2016

 
 
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ORIGINAL ARTICLES
Distribution and prognosis of mediastinal lymph node metastases of nonsmall cell lung cancer
Dawei Guo, Yiming Ni, Xiayi Lv, Zhihao Zhang, Peng Ye
October 2016, 12(5):120-125
DOI:10.4103/0973-1482.191613  PMID:27721268
Background and Objective: With the popularity of minimally invasive techniques, preoperatively determining whether mediastinal lymph node dissection (MLD) is necessary for patients with cN1/2 nonsmall cell lung cancer (NSCLC) has sparked controversy once again. This study aims to analyze whether different primary sites are associated with the distribution of mediastinal lymph node metastases and to investigate the necessity of lymph node dissection and the factors influencing prognosis. Materials and Methods: One hundred and thirteen patients with pathologically confirmed NSCLC with N2 lymph node metastases were included in the study and were grouped according to the lung lobes, in which primary lesions were located for statistically analyzing the metastatic rates of different mediastinal lymph node stations. Through a 3-year follow-up survey, risk factors influencing the 3-year postoperative survival were analyzed. Results: N2 stations with the highest metastasis rate for different pulmonary lobes were Station 2/4 of the right upper lobe (100%), Station 7 of the right middle/lower lobes (80.0%/88.9%), Station 5 of the left upper lobe (84.4%), and Station 7 of the left lower lobe (78.6%). Three-year survival rate of the cross-regional N2 group was lower than the total N2 group (47.8% vs. 75.3%), P = 0.009 (<0.01). Three-year survival rates for preoperative stages T1 and T2 were superior to stages T3 and T4, showing significant differences (P < 0.05). Conclusion: Station 7 is likely the most frequently metastases sites in all mediastinal lymph node stations. Cross-regional metastasis of N2 and staging of T3 and T4 were the risk factors for 3-year survival rate, whereas poor differentiation was not the risk factor. Due to the presence of micrometastases and skip metastases, MLD was first recommended for patients with preoperative stage cN1/2.
  1,729 107 -
Gemcitabine inhibits proliferation and induces apoptosis in human pancreatic cancer PANC-1 cells
Gui Yong-Xian, Li Xiao-Huan, Zhang Fan, Tian Guo-Fang
October 2016, 12(5):1-4
DOI:10.4103/0973-1482.191615  PMID:27721241
Aim: The aim of the study is to investigate the underlying molecular mechanisms by which gemcitabine (gem) inhibits proliferation and induces apoptosis in human pancreatic cancer PANC-1 cells in vitro. Materials and Methods: After PANC-1 cells had been treated by indicated concentration (0, 5, and 25 mg/L) of gem for 48 h, cell proliferation was evaluated by 3'-(4, 5 dimethyl-thiazol-2-yl)-2, 5-diphenyl tetrazolium bromide assay; cell morphology was observed by transmission electron microscopy; Expression of c-IAP2 and Bcl-2 proteins was analyzed by Western blot; the activity of caspase-3 and -9 was detected by spectrophotometry. Results: Gem significantly inhibited cell proliferation and could induce apoptosis of human pancreatic cancer PANC-1 cells, with a dose-dependent manner. Western blot analysis showed that gem significantly reduced c-IAP2 and Bcl-2 proteins expression level (P < 0.05). Spectrophotometric assay showed that gem significantly increased caspase-3 and -9 activity in PANC-1 cells. Conclusion: Gem could induce apoptosis of human pancreatic cancer PANC-1 cells, probably through downregulating c-IAP2 and Bcl-2 expression levels, and at the same time activating caspase-3 and -9.
  1,495 217 -
Helicobacter pylori infection and colorectal carcinoma risk: A meta-analysis
Yang Zhao, Xuli Wang, Yanrong Wang
October 2016, 12(5):15-18
DOI:10.4103/0973-1482.191621  PMID:27721244
Objective: Helicobacter pylori infection and colorectal cancer risk are not clear. We perform this meta-analysis to further evaluate the association between H. pylori infection and colorectal cancer susceptibility. Methods: The databases of CNKI, Wanfang, PubMed, Medline, EMBASE, and HighWire Press were electronic searched by two reviewers independently. The case–control study or cohort study about H. pylori infection and colorectal cancer risk were included in this meta-analysis. The association between H. pylori infection and colorectal cancer risk was evaluated by odds ratio (OR) and corresponding 95% confidence interval (95% CI). Results: Fourteen case–control studies related to H. pylori infection and colorectal cancer risk were eventually include in this meta-analysis. The pooled results showed that H. pylori infection slight increase the risk of developing colorectal carcinoma (OR = 1.33, 95% CI: 1.01–1.77, P = 0.05). Moreover, Begg's funnel plot demonstrated no significant publication bias. Conclusion: Colorectal carcinoma is associated with H. pylori infection. However, for significant heterogeneity across the studies, this results should be further confirmed by large sample size cohort study.
  1,214 152 -
Laparoscopic jejunoileal side-to-side anastomosis for the treatment of type 2 diabetes mellitus in Chinese patients with a body mass index of 24–32 kg/m2
Jin Li, Guangwei Xie, Qingzhong Tian, Yuanchao Hu, Qingliang Meng, Minkang Zhang
October 2016, 12(5):5-10
DOI:10.4103/0973-1482.191618  PMID:27721242
Objective: Laparoscopic jejunoileal side-to-side anastomosis (LJISSA) is an upcoming procedure that offers good metabolic improvement without causing significant malabsorption. The objective of this study was to evaluate the results of this novel procedure for the control of type 2 diabetes mellitus (T2DM) in patients with a body mass index (BMI) of 24–32 kg/m 2. Materials and Methods: Fifty-seven patients with T2DM who underwent LJISSA between February 2010 and May 2013 were recruited in this study. Data collected included fasting blood glucose (FBG), 2 h postprandial blood glucose (2 h PBG), 1 h postprandial C peptide (1 h C-P), and glycosylated hemoglobin (HbA1c). Results: Postoperatively, glycemic parameters (FBG and 2 h PBG, HbA1c and 1 h C-P) improved in all 57 patients. At 12 months, 34 patients had a remission of diabetes, and the remaining 23 patients showed a significantly decreased requirement for oral hypoglycemic agents. The patients with a BMI of 28–32 kg/m 2 had significant weight loss of between 7.8% and 20% (P < 0.05), whereas weight loss was not significant in those with a BMI of 24–28 kg/m 2. The group achieving remission had a higher BMI (28–32 kg/m 2), shorter duration of diabetes (<10 years), and higher stimulated C-P (>4 ng/mL). These three factors may be the predictors of diabetes resolution at 12 months. Conclusion: LJISSA seems to be a promising procedure for the control of T2DM. A multicenter study with a larger number of patients and a longer follow-up period is needed to substantiate our preliminary findings.
  1,182 128 -
A comparison of drug resistances of targeted drugs for advanced renal cell cancer approved by the Food and Drug Administration: A meta-analysis of randomized clinical trials
Ming Guo, Yunsong Cao, Jingzhe Yang, Jingfeng Zhang
October 2016, 12(5):109-115
DOI:10.4103/0973-1482.191617  PMID:27721266
Purpose: The purpose of this study was to conduct network meta-analysis to assess drug resistances of the Food and Drug Administration-approved drugs for advanced renal cell carcinoma. Materials and Methods: Database searches were conducted to identify randomized controlled trials reporting results for eligible treatments. After searching for PubMed, MEDLINE, EMBASE, and ISI Web of Science, 22 studies (n = 7854 patients) were included for the comparison of drug resistance in the present meta-analysis. Results: For overall present, the mean 6-month progression-free survival rates were 65.4%, 49.3%, 60.6%, 70.3%, 62.6%, 41.6%, 38.2%, 66.1%, 43.1%, and 17.9% for sunitinib, sorafenib, pazopanib, axitinib, bevacizumab plus interferon (IFN)-a, everolimus, temsirolimus, temsirolimus plus bevacizumab, IFN-a, and placebo, respectively. For indirect comparison, two combined therapies (bevacizumab plus IFN-a and temsirolimus plus bevacizumab) and sunitinib were of less ability of drug resistance. The risk ratio of sunitinib therapy was 3.64 (95% confidence interval [CI] [3.12, 4.25]), the risk ratio of temsirolimus plus bevacizumab therapy was 3.68 (95% CI [3.14, 4.33]), and the risk ratio of bevacizumab plus IFN-a therapy was 3.49 (95% CI [2.99, 4.06]). Conclusions: Our results support that combination of targeted therapies might be a novel strategy against advanced renal cell carcinomas.
  1,085 138 -
Adjuvant therapy with heparin in patients with lung cancer without indication for anticoagulants: A systematic review of the literature with meta-analysis
Yuman Yu, Qun Lv, Bin Zhang, Fen Lan, Yifan Dai
October 2016, 12(5):37-42
DOI:10.4103/0973-1482.191627  PMID:27721250
Background: The effect of heparin in improving cancer survival has gained increasing attention over the past decades. Several clinical trials have evaluated the role of heparin on survival outcome and its safety profile in lung cancer patients. Thus, we performed a systematic review and meta-analysis from the results of randomized controlled trials (RCTs) to assess the efficacy and safety of heparin in patients with lung cancer without indication for anticoagulants. Methods: We searched PubMed, Embase, and The Cochrane Central Register of Controlled Trials databases for relevant studies. The inclusion criteria used were patients with lung cancer without a concurrent diagnosis of venous thromboembolism (VTE) and were treated with low-molecular-weight heparin (LMWH) or unfractionated heparin (UFH). The outcomes included survival outcome, VTE, bleeding, major bleeding, and thrombocytopenia. The results were presented as hazard ratio (HR) and relative risk (RR), and the STATA 12.0 package was used for comprehensive quantitative analysis. Results: A total of 6 studies with 753 cases and 640 controls were included for the final analysis. The meta-analysis showed significant differences in survival with an HR of 0.71 (95% confidence interval [CI] 0.60–0.84), particularly in limited-stage small cell lung cancer (SCLC) with an HR of 0.57 (95% CI 0.43–0.77), and also in VTE (RR 0.46; 95% CI 0.27–0.80) when heparin was compared with placebo or no anticoagulant. There were no significant differences in risks for bleeding (RR 1.53; 95% CI 0.96–2.45), major bleeding (RR 1.43; 95% CI 0.59–3.45), and thrombocytopenia (RR 0.86; 95% CI 0.66–1.12). Conclusion: Administration of heparin (mainly LMWH) as primary thromboprophylaxis for lung cancer patients without indication for anticoagulants was associated with a significant survival benefit, particularly in limited-stage SCLC.
  1,047 134 -
CORRESPONDENCE
Prolonged overall survival of patients with leptomeningeal carcinomatosis from nonsmall cell lung cancer
Yanfang Ju, Shengjie Sun, Jinliang Wang, Shunchang Jiao
October 2016, 12(5):126-129
DOI:10.4103/0973-1482.191638  PMID:27721269
Leptomeningeal metastasis (LM) carries a devastating prognosis. Treatment selection is limited for patients with LM. We introduced to use nimotuzumab (also known as h-R3) for treating LM of nonsmall cell lung cancer. Here, we report two patients in our treatment who had prolonged overall survival over 1 year each. The pressure of cerebrospinal fluid of the patients decreased remarkably after intrathecal therapy. Symptoms of the patients had been improved quickly after one or two times of intrathecal therapy. Nimotuzumab was well tolerated used in intrathecal therapy.
  1,032 107 -
ORIGINAL ARTICLES
Clinical efficacy and safety of high-dose imatinib for chronic myeloid leukemia patients: An updated meta-analysis
Yonghua Liu, Bingmu Fang, Jinhong Jiang, Peng Wang
October 2016, 12(5):23-26
DOI:10.4103/0973-1482.191623  PMID:27721246
Objective: The aim of this study was to evaluate the clinical efficacy and safety of high-dose imatinib (IM) for chronic myeloid leukemia (CML) patients by pooled published studies. Methods: Through searching the databases of PubMed, EMBASE, ASCO, ESMO, CNKI, and Wanfang, we collected open published clinical controlled trials-related high-dose IM treatment of CML. The pooled complete cytogenetic response (CCyR) and hematologic toxicities were calculated by the statistical software. Results: Seven studies were included in this study with 1137 cases received high-dose IM treatment and 958 cases received regular-dose IM treatment. The pooled results showed that patients received high-dose IM had higher CCyR compared with regular-dose with the odds ratio (OR) of 1.75 (95% confidence interval [95% CI]: 1.44–2.1, P < 0.05) and 1.58 (95% CI: 1.38–1.81, P < 0.05) in 6 and 12 months. However, the hematologic toxicities risk of neutropenia (OR = 1.76, 95% CI: 1.22–2.54) and thrombopenia (OR = 1.88, 95% CI: 1.42–2.50) were much higher in the high-dose group. Conclusion: High-dose IM for CML treatment was superior to standard-dose IM in the aspects of CCyR, but the risk of developing neutropenia and thrombopenia was much higher.
  961 142 -
Serum carcinoembryonic antigen, neuron-specific enolase as biomarkers for diagnosis of nonsmall cell lung cancer
Yanjun Dong, Xianjie Zheng, Zhongxin Yang, Mingfei Sun, Guoyu Zhang, Xiaokang An, Lihong Pan, Shuanglin Zhang
October 2016, 12(5):34-36
DOI:10.4103/0973-1482.191626  PMID:27721249
Objective: To investigate the clinical efficacy of serum carcinoembryonic antigen (CEA) and neuron-specific enolase (NSE) as biomarkers for diagnosis of nonsmall cell lung cancer (NSCLC). Material and Methods: Forty-six cytology or pathology confirmed nonsmall cell lung patients and 33 cases of benign lung disease (BLD) were retrospective reviewed in our hospital from February 2013 to January 2016. The serum concentrations of CEA and NSE were measured by chemiluminescent assay. The sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve (area under the curve) of serum CEA and NSE as biomarkers for diagnosis of lung cancer were analyzed by SPSS version 17.0 software. Results: The serum CEA and NSE concentration were 30.69 ± 14.11 ng/mL, 52.36 ± 49.68 ng/mL for NSCLC patients and 12.69 ± 8.87 ng/mL, 5.32 ± 4.66 for BLD patients, respectively with statistical difference (P < 0.05); the diagnostic sensitivity and specificity were 58.66% and 76.48% for serum CEA at the cutoff value of 5.74 ng/mL and 66.67% and 78.69% for serum NSE at the cutoff value of 19.35 ng/mL; the diagnostic area under the ROC curve was 0.81 and 0.76 for CEA and NSE, respectively as biomarkers for diagnosis of NSCLC. Conclusion: Serum CEA and NSE are potential biomarker for NSCLC diagnosis.
  993 108 -
Oxycodone versus dezocine for postoperative analgesia in patients with cervical cancer treated with radical surgery
Zhonghua Li, Honglian Wu, Renhong He, Xiaowei Hu, Shaoxiao Liu
October 2016, 12(5):27-29
DOI:10.4103/0973-1482.191624  PMID:27721247
Objective: The aim of this study was to evaluate oxycodone versus dezocine for postoperative analgesia in patients with cervical cancer treated with radical surgery. Materials and Methods: Fifty-one cases of cervical cancer treated with radical surgery were included in the present study and divided into oxycodone group (n = 26) and dezocine group (n = 25). Patients in the oxycodone group were given with oxycodone 1 mg/kg plus tropisetron 0.1 mg/kg diluting to 100 ml by 0.9% saline for patient-controlled intravenous analgesia (PCIA) after surgery. Moreover, patients in the dezocine group were given with dezocine 0.6 mg/kg plus tropisetron 0.1 mg/kg diluting to 100 ml by 0.9% saline for PCIA after surgery. The visual analog scale (VAS) and Ramsay sedation score of the two groups were recorded in the time point of 4, 8, 12, 24, and 48 h after surgery. The adverse event-related drugs were recorded and compared between the two groups. Results: The VAS score was significantly lower in oxycodone group compared to dezocine group in the time point of 4, 8, 12, 24, and 48 h (Pall < 0.05). The Ramsay score at time point of 4, 8, 12, 24 h, and 48 h were obviously higher in oxycodone group than those in dezocine group (P < 0.05) which indicated that the sedative effect in oxycodone group was superior to dezocine. For oxycodone group, there were six cases (23.08%) with nausea and one case (3.85) with vomiting in the treatment procedure. Moreover, for dezocine group, there were one case (4.00%) with nausea, two cases (8.00%) with vomiting, and two cases (8.00%) with dizzy in the treatment procedure. There was no statistical difference of adverse event risk between the two groups (P > 0.05). Conclusion: Oxycodone postoperative analgesia is superior to dezocine for patients with cervical cancer treated with radical surgery.
  990 103 -
Aidi injection combined with CHOP chemotherapy regimen in the treatment of malignant lymphoma: A meta-analysis based on randomized controlled trials
Xiaoli Wang, Weimei Jin, Bingmu Fang, Jinhong Jiang, Min Liu, Yifen Lan, Zhigang Qu, Guangli Ma, Yu Jiang, Yonghua Liu, Yuxiao Zeng, Xiaoqiu Wang
October 2016, 12(5):11-14
DOI:10.4103/0973-1482.191619  PMID:27721243
Objective: The aim of this study was to evaluate the clinical efficacy of Aidi injection combined with CHOP chemotherapy regimen in the treatment of malignant lymphoma. Methods: We made an electronic search in the database of Wanfang, CNKI, and PubMed. All the clinical studies related to Aidi injection combined with CHOP chemotherapy regimen in the treatment of malignant lymphoma were screened and reviewed. The combined objective response rate (ORR), life quality improvement, and hematological toxicity were pooled by random- or fixed-effect model according to the heterogeneity across the included study. Moreover, the publication bias was evaluated by Begg's funnel plot and Egger's line regression test. Results: Eight prospective clinical trials with 513 subjects (273 in the Aidi injection plus CHOP group and 240 in the CHOP group) were included in this meta-analysis. The pooled results showed that Aidi injection combined with CHOP chemotherapy regimen can significantly improve the ORR (odds ratio [OR] =1.68, 95% confidence interval [CI]: 1.09–2.60, P < 0.05), improve the life quality (OR = 3.32, 95% CI: 1.97–5.58, P < 0.05), and decrease the risk of developing leukopenia (OR = 0.25, 95% CI: 0.17–0.39, P < 0.05) and thrombocytopenia (OR = 0.34, 95% CI: 0.22–0.53, P < 0.05). Conclusion: With the present evidence, Aidi injection combined with CHOP chemotherapy regimen can improve the treatment response and quality of life and decrease the risk of developing severe leukopenia or thrombocytopenia.
  907 106 -
Combined nimotuzumab with chemoradiotherapy in patients with locally advanced or metastatic esophageal squamous cell carcinoma: A retrospective study
Xiaojing Lai, Qing Gu, Xiao Zheng, Guan Liu, Wei Feng, Xiao Lin, Weimin Mao
October 2016, 12(5):89-95
DOI:10.4103/0973-1482.191612  PMID:27721263
Aims: To observe the efficacy and toxicities of combined nimotuzumab with chemoradiotherapy as the first-line treatment to advanced esophageal squamous cell carcinoma (ESCC). Methods: The clinical data of 43 patients with local advanced or metastatic ESCC treated with nimotuzumab combined with chemoradiotherapy in our hospital were included in this retrospective study. The overall response, adverse events, overall survival (OS), and progressive-free survival (PFS) were analyzed. Results: At 1 month after the treatment, objective response rate (complete response [CR] + partial response [PR]) was 65.12%, and disease control rate (CR + PR + stable disease [SD]) was 86.05%, with one patient (2.33%) showing CR, 27 (62.79%) patients with PR, 9 (20.93%) with SD, and 6 (13.95%) with progressive disease, respectively. The median OS was 15.5 months, and the median PFS was 8.83 months. Multivariate analysis showed that the patients with more cycles (>6 times) of nimotuzumab treatment had better PFS and OS than those with fewer cycles (≤6 times). Patients received high-dose radiation (>55 Gy) had a better PFS than those patients received low-dose radiation (≤55 Gy). Three patients suffered severe esophageal fistula, and three patients showed superficial skin erosion. Conclusions: Chemoradiotherapy in combination with more than 6 weekly doses of nimotuzumab (>1400 mg) had a survival benefit to the patients with advanced ESCC. High-dose radiation therapy for primary tumor has been confirmed to improve PFS in these patients. Patients treated with nimotuzumab showed no increased risk of adverse events.
  915 92 -
Meta-analysis of therapeutic effects and the risks of hypertension and hyperglycemia in patients with renal cell carcinoma who were receiving antiangiogenic drugs
Lingling Chang, Ying An, Shuling Yang, Xiaosu Zhang
October 2016, 12(5):96-103
DOI:10.4103/0973-1482.191614  PMID:27721264
Purpose: A meta-analysis of published data was conducted to investigate the therapeutic effects in patients with renal cell carcinoma (RCC) who were receiving antiangiogenic drugs. Methods: A computerized search through electronic databases, including PubMed (until February 2016), was performed to obtain eligible randomized controlled trials that compared the effectiveness of antiangiogenic with control groups (everolimus, placebo, and interferon [IFN] alfa) in patients with RCC. The data of progressive disease, objective response rate (ORR), stable disease rate (SDR), progressive disease rate (PDR), progression-free survival (PFS), and overall survival (OS) were extracted to assess therapeutic effects, hypertension, and hyperglycemia. Relative risk and 95% confidence interval were calculated and pooled using a fixed effects model. Results: According to the meta-analysis, antiangiogenic agents have advantages in ORR (odds ratio [OR] =2.93, P < 0.00001), SDR (OR = 1.45, P < 0.00001), PDR (OR = 0.25, P < 0.00001, PFS (OR = 0.65, P < 0.00001), and median OS (OR = 0.88, P < 0.00001) compared with control group; in the subway group, sorafenib and pazopanib have advantages in median PFS compared with placebo (OR = 0.52, P < 0.00001); sunitinib and pazopanib have advantages in median OS compared with IFN (OR = 0.87, P = 0.03). Sunitinib, sorafenib, and pazopanib have greater risk of hypertension compared with control group (OR = 8.40, P < 0.00001); sunitinib and pazopanib did not have greater risk of hypertension compared with control group (OR = 1.26, P = 0.25). Conclusions: Sorafenib, sunitinib, and the combination of bevacizumab and IFN are more effective in stabilizing disease, but they have higher risk of hypertension.
  877 113 -
Outcomes of surgical treatments of pulmonary hamartoma
Tao Wang, Yang Liu
October 2016, 12(5):116-119
DOI:10.4103/0973-1482.191620  PMID:27721267
Objective: To retrospectively analyze the results of surgical resection in patients with pulmonary hamartoma (PH) in the Peoples Liberation Army (PLA) General Hospital during the past 30 years. Materials and Methods: We retrospectively enrolled 226 patients with PH who underwent surgical resection in the PLA General Hospital between January 1980 and January 2010, including tumors of pulmonary parenchyma (n = 216) and endobronchial tumors (n = 10). The type of operation include tumor enucleation (n = 103), wedge resection (n = 103), and lobectomy (n = 20). The postoperative follow-up time was 5–22 years. Results: Only one postoperative death occurred. The intraoperative blood loss and the drainage volume within 24 postoperative hours were significantly less in patients underwent lateral thoracotomy or video-assisted thoracic surgery (VATS) than those of patients underwent conventional incision. None of the patients experienced regional recurrence. Conclusion: We recommended lateral thoracotomy or VATS for the patients whose PH could not be confirmed preoperatively, and tumor enucleation or wedge resection was recommended.
  852 96 -
Meta-analysis of gemcitabine and cisplatin combination chemotherapy versus gemcitabine alone for pancreatic cancer
Diyu Huang, Jie Fang, Gaojian Luo
October 2016, 12(5):104-108
DOI:10.4103/0973-1482.191616  PMID:27721265
Purpose: The aim of this study is to assess the efficacy and safety of combination chemotherapy with gemcitabine (GEM) and cisplatin (CIS) compared with GEM alone in patients with pancreatic cancer. Methods: A computerized search through electronic databases, including PubMed (until February 2016), was performed to obtain eligible randomized controlled trials that compared effectiveness of GEM and CIS combination chemotherapy with GEM alone in patients with pancreatic cancer. The indicators we used were overall response rate, stable disease rate, progressive disease rate, and 1-year overall survival. Relative risk and 95% confidence interval were calculated and pooled using a fixed effects model. Results: Compared with GEM alone, combination chemotherapy has significant advantage in the overall response rate (odds ratio [OR] =0.52, P = 0.004), stable disease (OR = 0.68, P = 0.05), and progressive disease (OR = 2.11, P = 0.0002). However, the control group and experimental group have no significant difference in 1-year survival (OR = 1.07, P = 0.75). The combination chemotherapy with GEM and CIS group had higher hematological toxicities including neutropenia (OR = 0.39, P = 0.0003), thrombocytopenia (OR = 0.3, P < 0.0001), and anemia (OR = 0.41, P = 0.004). Conclusions: Overall response rate, stable disease, and progressive disease, as well as 1-year survival rate in patients who received GEM + CIS, were superior to those treated with GEM alone. Combination chemotherapy with GEM and CIS may offer greater benefits in the treatment of pancreatic cancer than that of GEM alone although the combination group had higher hematological toxicities.
  844 103 -
Positive correlation of cysteine-rich 61 and target genes of Wnt/β-catenin pathway in esophageal squamous cell carcinoma
Peng Wang, Li Li, Ting Li
October 2016, 12(5):19-22
DOI:10.4103/0973-1482.191622  PMID:27721245
Objectives: To analyze the relationship between cysteine-rich 61 (Cyr61) and target genes of Wnt/β-catenin pathway (CCND1 and MYC) in 40 esophageal squamous cell carcinoma (ESCC) tissue specimens. Another aim of this study was to verify whether Cyr61 could be regulated by Wnt/β-catenin signaling. Materials and Methods: Forty ESCC tissue specimens with paired adjacent normal epithelial tissues were obtained. The expression of Cyr61, CCND1, and MYC was examined by quantitative real-time polymerase chain reaction. Regression analysis was further performed to evaluate the correlation between expression levels of Cyr61 and CCND1, MYC. Finally, the mRNA expression of Cyr61 was determined in ESCC cells after lithium chloride (LiCl) treatment, which activated intrinsic Wnt/β-catenin signaling. Results: Cyr61, CCND1, and MYC were obviously increased in ESCC tissue specimens than the matched normal epithelial tissues. Positive correlation of Cyr61 expression with CCND1 and/or MYC was validated by regression analysis. In addition, the expression of Cyr61 could be modulated by LiCl, an activator of Wnt/β-catenin signaling. Conclusion: Our data characterized that Cyr61 was aberrantly upregulated in ESCC tissues and was positively correlated to the targets of Wnt/β-catenin pathway. We also speculated that Cyr61 might be a direct target of this pathway and play a crucial role in ESCC progression.
  773 82 -
The efficacy and safety of simultaneous integrated boost intensity-modulated radiation therapy for esophageal squamous cell carcinoma in Chinese population: A single institution experience
Yujin Xu, Zhun Wang, Guan Liu, Xiao Zheng, Yuezhen Wang, Wei Feng, Xiaojing Lai, Xia Zhou, Pu Li, Honglian Ma, Jin Wang, Xiao Hu, Ming Chen
October 2016, 12(5):82-88
DOI:10.4103/0973-1482.191640  PMID:27721262
Purpose: To evaluate the clinical efficacy and toxicity of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) in patients with esophageal squamous cell carcinoma (ESCC) in Chinese population. Patients and Methods: Patients with ESCC, who received SIB-IMRT from September 2011 to January 2013 were retrospectively analyzed. The SIB-IMRT plans were designed to deliver primary gross tumor volume at 60–64.4 Gy in 28–30 fractions, and planning target volume at 50.4–56 Gy in 28–30 fractions. Treatment-related toxicities were estimated based on Common Terminology Criteria for Adverse Events version 4.0, and tumor response after the treatment was estimated according to Response Evaluation Criteria in Solid Tumors version 1.0. Overall survival (OS), locoregional progression-free survival (LPFS), and progression-free survival (PFS) were estimated with Kaplan–Meier. Results: All patients completed definitive radiotherapy, 54 (78.3%) received combined chemotherapy, of which 31 (44.9%) were concurrent chemoradiotherapy and 23 (33.3%) were sequential chemotherapy. The objective response rate is 82.6% (56/69), with complete response 11 (15.9%), partial response 45 (65.2%), stable disease 8 (11.6%), and progressive disease 5 (7.2%). The 1-, 2- and 3-year LPFS was 74.4%, 57.8%, and 55.6%, respectively. The 1-, 2- and 3-year PFS was 62.3%, 41.0%, and 34.2%, respectively, and the 1-, 2-, and 3-year OS was 73.8%, 57.4%, and 41.0%, respectively, with a median OS of 27.1 months (4.5–54.9 m). For those who received concurrent chemotherapy, the 1-, 2-, and 3-year OS was 75.9%, 69.0%, and 55.2%, respectively, better than those who had sequential chemotherapy or radiotherapy alone (χ2 = 3.115, P = 0.078). Radiation esophagitis occurred in 63.8% and 14.5% with Grade 2 and 3, respectively. No patients occurred ≥ Grade 3 radiation pneumonia. Conclusions: It is safe and effective using SIB-IMRT technology to treat patients with ESCC. More prospective clinical studies should be needed.
  770 70 -
S-1 combined with cisplatin chemotherapy for advanced gastric cancer
Chen Weidong, Xia Lijun
October 2016, 12(5):54-56
DOI:10.4103/0973-1482.191631  PMID:27721254
Objective: To observe the short-term efficacy and safety of S-1 combined with cisplatin (DDP) chemotherapy for advanced gastric cancer (AGC). Materials and Methods: Sixty-six patients were diagnosed with AGC and were admitted to our department from February 2012 to January 2015 and retrospectively analyzed. Of these patients, 31 (experimental group) underwent S-1 combined with DDP chemotherapy and 35 received oxaliplatin combined with tegafur and calcium folinate chemotherapy regimen (control group). The chemotherapy regimen for the experimental group included S-1, 60 mg bid on d1–d14 and 60 mg/m 2 DDP by intravenous dripping on d1–d3, with 4 weeks in a cycle. The chemotherapy regimen for the control group consisted of 130 mg/m 2 oxaliplatin by intravenous dripping, d1; 600 mg/m 2 tegafur by intravenous dripping on d1–d5; and 120 mg/m 2 calcium folinate by intravenous dripping on d1–d5, with 3 weeks in a cycle. The efficacies and adverse effects of the two regimens were assessed after three cycles. Results: After three cycles, the objective response rates of the experimental and control groups were 41.94% and 42.86%, without significantly difference (P > 0.05), respectively. However, the incidence rate of adverse drug reactions in Grades 3–4 in the experimental group was significantly lower than that of control group (P < 0.05). Conclusion: The short-term efficacy of primary S-1 with DDP chemotherapy for AGC is relatively satisfactory with less adverse effects.
  735 81 -
Diagnostic value of secreted frizzled-related protein 2 gene promoter hypermethylation in stool for colorectal cancer: A meta-analysis
Zhiran Zhou, Huitian Zhang, Yunxia Lei
October 2016, 12(5):30-33
DOI:10.4103/0973-1482.191625  PMID:27721248
Objective: To evaluate the diagnostic value of secreted frizzled-related protein 2 (SFRP2) gene promoter hypermethylation in stool for colorectal cancer (CRC). Materials and Methods: Open published diagnostic study of SFRP2 gene promoter hypermethylation in stool for CRC detection was electronic searched in the databases of PubMed, EMBASE, Cochrane Library, Web of Science, and China National Knowledge Infrastructure. The data of true positive, false positive false negative, and true negative identified by stool SFRP2 gene hypermethylation was extracted and pooled for diagnostic sensitivity, specificity, and summary receiver operating characteristic (SROC) curve. Results: According to the inclusion and exclusion criteria, we finally included nine publications with 792 cases in the meta-analysis. Thus, the diagnostic sensitivity was aggregated through random effect model. The pooled sensitivity was 0.82 with the corresponding 95% confidence interval (95% CI) of 0.79–0.85; the pooled specificity and its corresponding 95% CI were 0.47 and 0.40–0.53 by the random effect model; we pooled the SROC curve by sensitivity versus specificity according to data published in the nine studies. The area under the SROC curve was 0.70 (95% CI: 0.65–0.73). Conclusion: SFRP2 gene promoter hypermethylation in stool can was a potential biomarker for CRC diagnosis with relative high sensitivity.
  755 58 -
Does hospital-based transitional care reduce the postoperative complication in patients with enterostomy? A meta-analysis
Yi Chen, Jinyan Jiang, Yuehong Wu, Jingjing Yan, Huali Chen, Xuemei Zhu
October 2016, 12(5):76-78
DOI:10.4103/0973-1482.191637  PMID:27721260
Objective: The objective of the study is to investigate whether hospital-based transitional care can reduce the postoperative complication in patients who received enterostomy or not by pooling the published prospective clinical studies. Materials and Methods: Prospective clinical studies related to hospital-based transitional care for reducing the postoperative complication in patients with enterostomy were searched in the electronic databases of PubMed, Medline, EMBASE, CNKI, and Wanfang. The postoperative complications in the experiment and control groups were extracted from the original studies and pooled by fixed effects model. The publication bias was evaluated by Begg's funnel plot and Egger's line regression test. Results: After searching through the electronic databases of PubMed, Medline, EMBASE, CNKI, and Wanfang, we finally included in eight studies with 600 cases related to hospital-based transitional care and postoperative complication in patients with enterostomy. The pooled result showed that hospital-based transitional care could significantly reduce the postoperative complication in patients with enterostomy (risk ratio = 0.42, 95% confidence interval: 1.0.32, ~0.55, P = 0.005) by fixed effects model. The Begg's funnel plot demonstrated a litter left-right asymmetry, which indicated potential publication bias. Moreover, Egger's line regression test showed that there were significant publications (t = −3.04, P = 0.023). Conclusion: Hospital-based transitional care can significantly reduce the postoperative complication in patients with enterostomy.
  739 70 -
Inhibitory roles of miR-320 in osteosarcoma via regulating E2F1
Haojie Wu, Weihua Li, Minghui Zhang, Shutao Zhu, Dengfeng Zhang, Xiao Wang
October 2016, 12(5):68-71
DOI:10.4103/0973-1482.191635  PMID:27721258
Objectives: Osteosarcoma (OsC) is the most common primary bone malignant tumor with lower incidence and high degree of malignancy, but the exact mechanism remains unknown. More evidence demonstrated microRNAs (miRNAs) could contribute to tumor progression. In this study, we investigated the expression and functions of miR-320 in OsC cells. Materials and Methods: miR-320 expression levels in several human OsC cell lines and human normal osteoblastic cell line were tested by quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR). U2OS cells were transfected with miR-320 mimics or negative control oligos. MTT assay and cell flow cytometry assay by PI staining were performed to access the cell growth rate. Bioinformatic prediction and luciferase assays were used to identify the predicted target E2F1. qRT-PCR and Western blot were performed to access the molecular alteration of E2F1. Results: miR-320 was decreased in human OsC cell lines. Heterogeneous expression of miR-320 inhibited cell proliferation and induced cell cycle arrest. Besides, we proved that miR-320 could directly regulate the expression of E2F1 in U2OS cells. Conclusion: These data suggested that miR-320 regulates the proliferation and cell cycle by targeting E2F1 in human OsC progression.
  707 81 -
A meta-analysis of association between glutathione S-transferase gene polymorphism and osteosarcoma chemosensitivity in Chinese population
Jun Lan, Qi Yang, Mingping Zhou, Rongcheng Xu, Chongbin Zhou, Jiwei Wang, Haiya Zheng
October 2016, 12(5):64-67
DOI:10.4103/0973-1482.191634  PMID:27721257
Objective: In this study, a meta-analysis was performed to investigate whether there is an association between glutathione S-transferase (GST) gene polymorphism and chemosensitivity in patients with osteosarcoma. Methods: A comprehensive electronic database search was performed between January 1, 2016, and May 21, 2016. All eligible studies related to GST gene polymorphism and chemosensitivity in patients with osteosarcoma were screened and included in the current meta-analysis. The association between GSTT1, GSTM1 and osteosarcoma chemosensitivity was demonstrated by odds ratio (OR) and corresponding 95% confidence interval (CI). The publication bias was assessed by Begg's funnel plot. Results: A total of four studies with 681 osteosarcoma patients were included in the present study. The data were pooled by fixed effect model for lack of statistical heterogeneity. The results showed there was no significant association between GSTT1 OR = 1.04, 95% CI: 0.77–1.41, P > 0.05), GSTM1 (OR = 1.08, 95% CI: 0.80–1.46, P > 0.05) gene polymorphism and chemosensitivity in patients with osteosarcoma was found by pooled the published data. Begg's funnel plot indicated no significant publication bias in meta-analysis. Conclusion: Glutathione S-transferase gene polymorphism had no association with chemosensitivity in patients with osteosarcoma.
  690 79 -
Application value of endoscopic submucosal dissection and endoscopic mucosal resection for treatment of rectal carcinoids
Xiaohuan Li, Yongxian Gui, Wenliang Han, Hongjian Jiang, Daihua Qi, Yi Yang
October 2016, 12(5):43-46
DOI:10.4103/0973-1482.191628  PMID:27721251
Objective: The objective of this study is to explore the clinical effect and safety of endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) for treatment of rectal carcinoids. Methods: A retrospective analysis was conducted on 42 patients with rectal carcinoids who were hospitalized and subjected to surgical treatment in our hospital from January 2010 to November 2015. The patients were categorized into two groups based on treatment received: ESD (n = 22) and EMR (n = 20). The patients were analyzed and compared to determine differences in lesion size, operation time, histopathologically curative resection rate, intraoperative complications, complete lesion resection rate, and postoperative recurrence rate between the two groups. Results: Operation time (25.2 ± 20.1 min) and wound surface diameter (36.2 ± 10.1 mm) were significantly higher in the ESD group than those in the EMR group (12.6 ± 8.4 min and 18.6 ± 5.9 mm, respectively) (P < 0.05). The differences in complete lesion and histopathologically curative resection rates between the two groups were not statistically significant (P > 0.05). Delayed hemorrhage was the primary postoperative complication in both groups. Postoperative follow-up was performed for 3–71 months, and the median follow-up time was 45 months. Recurrence was noted 32 months after surgery in one patient in the EMR group (4.5%), whereas recurrence was not detected in the ESD group. Conclusion: ESD and EMR are safe and effective methods for treatment of rectal carcinoids. Moreover, ESD had less risk of recurrence, more complete resection rate which could provide more information for postoperative treatment.
  664 87 -
The Rho GTPase RhoE exerts tumor-suppressing effects in human esophageal squamous cell carcinoma via negatively regulating epidermal growth factor receptor
Haojie Wang, Yi Wang, Bing Liang, Fei He, Yong Li, Jianbo Che, Xiaohui Li, Hui Zhao, Gongning Shi
October 2016, 12(5):60-63
DOI:10.4103/0973-1482.191633  PMID:27721256
Objectives: The objective of this study was to investigate the expression pattern, functions, and possible mechanisms of RhoE/Rnd3, a novel member of the Rho GTPases family, in human esophageal squamous cell carcinoma (ESCC) cells by using molecular and cell-based experiments. Materials and Methods: Quantitative polymerase chain reaction and Western blotting were carried out to determine the mRNA and protein expression of RhoE in ESCC cell lines, respectively. Both 3-(4,5-dimethylthiazol-2-yl)-2,5diphenyltetrazoliumbromide (MTT) and flow cytometry were applied to evaluate the effects of RhoE overexpression on ESCC cell growth and apoptosis. Furthermore, Western blotting was used to test the expression of epidermal growth factor receptor (EGFR) and phosphorylated-extracellular signal-regulated kinase (p-ERK) in ESCC cells after RhoE was forced and expressed. Results: RhoE was downregulated in human ESCC tissues. Overexpression of RhoE inhibited cell growth as assessed by MTT assay and induced apoptosis. Importantly, we proved that RhoE could negatively regulate the protein expression of EGFR and p-ERK, suggesting that RhoE might inhibit ESCC progression through the EGFR/ERK pathway. Conclusion: Our data supported that RhoE could inhibit cell proliferation and promote apoptosis. Moreover, these tumor-suppressing effects might be acted through the negative regulation of EGFR/ERK signaling.
  682 59 -
Application value of sentinel lymph node biopsy in the radical operation for Stage II advanced gastric cancer
Yongzheng Xie, Fangjun Li, Xuequn Ren
October 2016, 12(5):57-59
DOI:10.4103/0973-1482.191632  PMID:27721255
Objective: This study aims to explore the application value of sentinel lymph node (SLN) biopsy in patients with Stage II advanced gastric cancer and its effects on prognosis. Materials and Methods: A total of 43 patients with Stage II gastric cancer (experimental group) admitted to our department from March 2011 to February 2013 underwent radical operation using SLN biopsy, and 51 patients with gastric cancer D2 (the control group) received conventional radical operation. The operation time, intraoperative blood loss, number of lymph nodes dissected, postoperative complications, and length of hospital stay between the two groups of patients were recorded. Their clinical data were retrospectively analyzed. Results: The operation times of the experimental group and that of the control group patients were, respectively, 199.6 ± 38.7 and 143.8 ± 33.6 min, with statistical difference (P < 0.05). The number of lymph nodes dissected in the experimental group (18.2 ± 0.8) was significantly greater than that of the control group (13.8 ± 0.7) (P < 0.05). No difference in statistical significance in the intraoperative blood loss (150.2 ± 33.6 vs. 143.8 ± 39.4 mL) or length of stay (12.3 ± 2.6 vs. 11.8 ± 3.1 days) was found between the two groups (P > 0.05). The 2-year survival rates of the experimental group after surgery and that of the control group were 83.7% and 72.5%, respectively, with statistical difference (P < 0.05). Conclusions: Compared with conventional radical gastrectomy, Stage II SLN biopsy on the premise that neither the intraoperative blood loss nor the length of hospital stay increases can improve the 2-year survival.
  653 80 -
The association between runt-related transcription factor 3 gene promoter methylation and gastric cancer: A meta-analysis
Xu Liu, Lina Wang, Yongtie Guo
October 2016, 12(5):50-53
DOI:10.4103/0973-1482.191630  PMID:27721253
Objective: To systematically evaluate the relationship of the methylation of the human-runt-related transcription factor 3 (RUNX3) promoter region and gastric cancer risk through meta-analysis. Materials and Methods: The studies published in PubMed, EMBASE, Ovid, and CNKI were retrieved. The association between RUNX3 gene promoter methylation and gastric cancer was analyzed using Stata 11.0 (http://www.stata.com; Stata Corporation, College Station, TX, USA) and Review Man 5.0 software (http://ims.cochrane.org/revman/download). Results: Seventeen studies are included in the analysis. Meta-analysis reveals that the odds ratio of the methylation of the RUNX3 promoter region in gastric was 7.32 (95% confidence interval: 5.12–10.47), which was significant higher than the normal gastric tissues (P < 0.05). Conclusions: The RUNX3 gene promoter methylation rate was much higher in tumor tissue than that in normal gastric tissue in patient with gastric cancer, which indicates a close association between gastric cancer and RUNX3 gene promoter methylation.
  606 77 -
Expression of excision repair cross-complementation group 1 in locoregionally advanced nasopharyngeal carcinoma treated with cisplatin-based induction chemotherapy
Chuan Shen, Lingling Chen, Jiangtao Fu, Hongbin Lin
October 2016, 12(5):72-75
DOI:10.4103/0973-1482.191636  PMID:27721259
Objective: The purpose of this study was to evaluate the expression of excision repair cross-complementation group 1 (ERCC1) in locoregionally advanced nasopharyngeal carcinoma (NPC) treated with cisplatin-based induction chemotherapy. Methods: Eighty-five patients with locoregionally advanced NPC treated with cisplatin-based induction chemotherapy were included in this study. The expression level of ERCC1 protein in cancer tissues was detected by immunohistochemistry, and the expression level was divided into the high- and low-expression groups according to their expression level. The objective response rate (ORR) and the long-term disease control rate of two groups were compared between the two groups. Results: The expression level of ERCC1 in NPC tissues was detected by immunohistochemistry. Forty-one cases had the high ERCC1 expression, and 44 cases had the low ERCC1 expression. The cases for complete response, partial response, stable disease, and progression disease were 1, 19, 21 in the ERCC1 high expression group and 3, 29, 12 for the ERCC1 low-expression group which indicated that the ORR in ERCC1 low group were significant higher than that of ERCC1 high expression group (P < 0.05). The 5-year overall survival, 5-year disease-free survival (DFS), and 5-year local recurrence-DFS were not statistical different between two group (P < 0.05); but the 5-year distant-DFS for ERCC1 low group were significant higher than ERCC1 high group (P < 0.05). Conclusion: Cisplatin-induced short-term ORR was decreased in nasopharyngeal carcinoma patients with high ERCC1 expression, which increased the risk of metastasis.
  588 78 -
A meta-analysis of contrast-enhanced computer tomography in the diagnosis of colorectal cancer
Shuqian Man, Jianxun Zou, Mingjie Wang, Feng Liang, Shuyan Chen, Xueyong Zhang, Xudan Li
October 2016, 12(5):79-81
DOI:10.4103/0973-1482.191639  PMID:27721261
Objective: To investigate the diagnostic value of contrast-enhanced computer tomography in diagnosis of colorectal cancer. Methods: All the diagnostic studies about contrast-enhanced computer tomography in diagnosis of colorectal cancer were searched in the PubMed, Medline, EMBASE, CNKI, and Wanfang databases and included in this meta-analysis. The diagnostic sensitivity and specificity were pooled. The data were analyzed by statistic software Meta-DiSc1.4. Results: After searching the databases, eight studies with 4764 cases were finally included in this meta-analysis. The combined results showed the pooled diagnostic sensitivity and specificity were 0.73 (95% confidence interval [CI] of 0.69–0.76) and 0.86 (95% CI of 0.85–0.87). Moreover, the area under the receiver operating characteristic was 0.896. Conclusion: Contrast-enhanced computer tomography was a good method for detection colorectal cancer.
  596 67 -
Evaluating the efficacy and safety of continuous arterial infusion chemotherapy with cisplatin and 5-fluorouracil in treating oral cancer
Min Ye, Xudan Li, Weidong Liu, Haibiao Tao, Junjie Yan
October 2016, 12(5):47-49
DOI:10.4103/0973-1482.191629  PMID:27721252
Objective: To investigate the clinical effects and safety for cisplatin combined with 5-fluorouracil (5-FU) intra-arterial chemotherapy in the treatment of oral cancer. Materials and Methods: A total of ninety cases with oral cancer were recruited in this study. Forty-three subjects received the pingyangmycin (PYM) (control group) with PYM 8 mg, intramuscular injection, QD for 21 days per cycle. Moreover, other 47 cases received cisplatin 100 mg/m 2 24 h perfusion chemotherapy, day 1 with 21 days per cycle, and 5-FU 1000 mg/m 2 perfusion chemotherapy 72 h with 21 days per cycle. All the patients received three cycles treatment. After three cycles chemotherapy, the objective response rate (ORR) and chemotherapy-related toxicities were evaluated between the two groups. Results: The ORR were 53.49% and 72.34%, respectively in the control and observation group which indicated observation group significant higher (P < 0.05). The chemotherapy-related toxicities incidence was much higher in control group compared with observation group (36.17% vs. 11.63%, P < 0.05). Conclusion: Cisplatin combined with 5-FU intra-arterial chemotherapy was effective in the treatment of oral cancer with less toxicties.
  573 81 -