Objective: The aim of this study was to assess the effectiveness and safety of transdermal fentanyl for the treatment of moderate or severe cancer-related pain. Materials and Methods: Electronic databases including PubMed, Embase, the Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure, the Chinese Biomedical Literature Database, and Chongqing Weipu and Wanfang Database were searched for relevant studies published prior to January 2015. Only randomized controlled trials on the use of the transdermal fentanyl patch for the treatment of cancer pain were selected. Two reviewers independently screened the studies and extracted data. The quality assessment of the studies included was based on the Cochrane Handbook for Systematic Reviews of Interventions (version 5.1.0). RevMan 5 (version 5.3) and Trial Sequential Analysis software (TSA, version 2.1, provided by Copenhagen Trial Unit, Denmark) were used for data analyses. Results: A total of 35 studies involving 3406 participants met the inclusion criteria for this meta-analysis. There was no statistically significant difference with regard to the effectiveness of management for cancer pain between the use of transdermal fentanyl patch and oral morphine (risk ratio = 1.00, 95% confidence interval, 0.97–1.03, P > 0.05). TSA results demonstrated that the cumulative Z-score crossed its monitoring boundaries, and therefore, reliable conclusions had been drawn. Moreover compared with oral morphine, the use of transdermal fentanyl patch resulted in statistically significantly decreased incidence of constipation, nausea and vomiting, drowsiness, and urinary retention. There was a significantly greater incidence of skin irritation in patients who used a transdermal fentanyl patch (P < 0.05). Conclusions: The findings from this study demonstrate that use of transdermal fentanyl for the management of moderate or severe cancer pain had more advantages compared to oral morphine.

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Purpose: We aimed, in the present study, to measure the risk related to the high-grade cervical intraepithelial neoplasia grade 3 (CIN3) or worse (CIN3+) or worse/high-grade squamous intraepithelial lesions with respect to changes in human papillomavirus (HPV) and smoking status. Materials and Methods: A structured interview underwent for 7129 women. Then, we obtained their cervical cells and subjected to HPV testing. High-risk HPV infected and “no prevalent” cervical disease infected women were followed for cervical lesions up to 12 years (at baseline; n = 1531). Hazard ratios (HRs) for diagnosis of CIN3 (or worse) or worse/high-grade intraepithelial lesions were calculated along with the corresponding 95% confidence intervals (CIs). Results: Among high-risk HPV-positive women, the conditions of long-term (more than 8 years) smokers and heavy (18 or more cigarettes/day) smokers are highly responsible for the increased risk for CIN3 or CIN3+. In the cases of persistent HPV-infected women, heavy smoking led to a higher risk for CIN3+ than those women who never smoked (HR, 2.31; 95% CI, 1.12–4.16). Conclusion: We concluded here that smoking leads to an enhanced risk of high-grade cervical lesions in persistent high-risk HPV-infected women. This makes a good understanding of smoking's role in cervical cancer.

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Side effects associated with conventional anticancer therapies have prompted the new idea of solid tumor treatment strategy. One of them is using bacteria explored as potential antitumor agents over more than one century. Notably, the ideal therapy is a specifical target to tumors with limited toxicity. Here, we take “Clostridium novyi” for the search keyword in the PubMed from 2000 to 2015 and describe that C. novyi-NT spores act as “Trojan horse” for bacteriolytic therapy. This therapy is based on the fact that the live and attenuated obligate anaerobic bacteria are capable of binary fission selectively in anoxic areas of solid tumors and direct tumoricidal effects. Our succinct review mainly concentrates on the potential mechanisms of combination bacteriolytic therapy, an effective and safe tumor therapy with the help of C. novyi-NT. Importantly, C. novyi-NT spores were shown to induce solid tumor regression and exhibit the property to initiate an immune response. Therefore, C. novyi-NT spores should be an effective and safe tumor therapy.

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Aim: This study attempted to compare the prognostic performance of short- and long-course preoperative treatments for neoadjuvant therapy of rectal cancer by meta-analysis. Methods: Electronic databases of PubMed and Embase were searched for eligible studies updated to February 29, 2016. Studies were included based on several predefined inclusion criteria. Quality assessment was carried out according to the Cochrane Collaboration recommendations in Cochrane handbook. Outcomes such as 1–5 survival rates, death rate, recurrence rate, complication rate, and distant metastasis were evaluated. Odds ratio (OR) with the corresponding 95% confidence interval (CI) was used to calculate the pooled results. Subgroup analysis stratified by radiotherapy (RT) and chemoradiotherapy (CRT) was performed. Publication bias was detected based on Egger's test. Sensitive analysis was also performed. Results: Eight studies were included, and they were randomized controlled trials or controlled clinical trials. The included studies involved a total of 1475 patients (short treatment: n = 665; long treatment: n = 810). No significant difference was detected in each outcome between the short- and long-course preoperative treatments. Subgroup analysis indicated that the outcome of distant metastasis was significantly higher in long-course RT, compared with the short-course RT (OR = 2.65, 95% CI: 1.05, 6.68). No significant publication bias was observed. Sensitive analysis did not show any reverse result. Conclusion: Short- and long-course preoperative treatments seem comparable for management of rectal cancer, in terms of outcomes such as survival, recurrence, and complications. However, long-course RT might increase risk of distance metastasis, compared to short-course RT.

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To probe into the reasons for misdiagnoses of pelvic tumor as deep venous thromboses as well as the diagnostic methods and effective treatments on pelvic tumor. Four case reports on misdiagnosing pelvic tumor as deep venous thromboses and further analysis on the causes of misdiagnosis, diagnosis, and treatment with the literature study. The four cases were misdiagnosed as pelvic tumor, which actually were fibroneuroma, myxo.fluidity liposarcoma, moderately differentiated squamous cell carcinoma, and synovial sarcoma, respectively. The tumor in first case was completely removed, and the tumor in other three cases, which were malignant tumors, were resected when the tumors shrank with clear boundary and less blood supply after applied with 3. cycles of intra.arterial chemotherapy via an implanted pumpies. Pelvic tumor usually show up or is misdiagnosed as deep venous thromboses for its untypical clinical manifestation, so it should be on the alert for pelvic tumor when deep venous thromboses occurs. Tumor resection is preferred for benign tumor, and intra.arterial intervention chemotherapy should be applied first for malignant tumor followed by surgery.

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Objective: The study aimed to evaluate the incidence of early and late radiation enteritis in cervical cancer patients receiving definitive or adjuvant radiotherapy (RT). Materials and Methods: Three hundred and twenty-four cervical cancer patients receiving definite or adjuvant RT in our hospital from January 2010 to December 2012 were divided into definitive (132 patients) or adjuvant RT (192 patients) and performed detailed analysis. Results: Early radiation enteritis was found in 54.3%, and late radiation enteritis was found in 17.9% of cervical patients. Early (P < 0.007) and late (P < 0.003) radiation enteritis appeared more frequently in patients treated with definitive RT than that with adjuvant RT. In the definitive RT group, incidence of both early and late radiation enteritis in the RT group was higher than in the radiochemotherapy (RCHT) group, and the difference was statistically significant (P < 0.004). Severe cases of late radiation enteritis (Grade 3 and 4) can be seen higher in the definitive radiation group (both the RT and RCHT group) than in the adjuvant radiation group, and the difference was statistically significant (P < 0.005). Conclusion: The incidence of both early and late radiation enteritis in the definitive RT group is higher than in the adjuvant RT group. The occurrence of side effects was associated with the prolongation of total irradiation time due to necessary interruptions of RT. Methods to decrease the interruptions in the RT and the irradiated volume of the small bowel will further lessen enteric morbidity.

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Purpose: Numerous studies have confirmed that brain tumor patients and their family members frequently exhibit negative emotional reactions, such as anxiety and depression, during diagnosis and treatment of the disease. Family members experience increasing pressure as the year of survival of patient progress. The aim of this study was to investigate the effects of the continued psychological care (CPC) toward the brain tumor patients and their family members' emotions. Subjects and Methods: The asynchronous clinical control trial was performed, and 162 brain tumor patients and their family members were divided into the control group and the intervention group. The control group was only performed the telephone follow-up toward the patients. Beside this way, the intervention group was performed the CPC toward the patients and their family member. The self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) were used to measure the negative emotions of the patients and their family members, and the patients' treatment compliance and the incidence of seizures were compared. Results: The SAS and SDS scores of the intervention group on the 14 days, 28 days and 3 months of the CPC were significantly lower than the control group (P < 0.05); the SAS and SDS scores of the intervention group after the intervention were significantly lower than those at the discharging (P < 0.05), the treatment compliance of the intervention group was significantly higher than the control group (P < 0.05), and the seizure incidence of the intervention group was significantly lower than the control group (P < 0.05). Conclusion: The CPC could effectively reduce the anxiety and depression among the brain tumor patients and their family members.

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Objective: The aim of this study was to comparatively evaluate the efficacy of strontium-89 chloride (⁸⁹ SrCl₂) in treating bone metastasis-associated pain in patients with lung, breast, or prostate cancer. Materials and Methods: The 126 patients with lung cancer included 88, 16, 15, 4, and 3 patients with adenocarcinoma, squamous cell carcinoma, nonsmall cell carcinoma, mixed carcinoma, and small cell carcinoma, respectively, and the control group consisted of patients with breast (71 patients) or prostate cancer (49 patients) who underwent ⁸⁹ SrCl₂ treatment during the same period. The treatment dose of ⁸⁹ SrCl₂ was 2.22 MBq/kg. Results: The efficacy rate of treatment in the lung cancer group was 75.4%, compared to 95.0% in the control group. Approximately 67% of patients with lung cancer and bone metastases and 47% of control patients exhibited mild-to-moderate reductions of leukocyte and platelet counts 4 weeks after ⁸⁹ SrCl₂ treatment. Conclusions: ⁸⁹ SrCl₂ can safely and effectively relieve bone pain caused by bone metastasis from lung cancer. However, its efficacy was lower in patients with lung cancer with bone metastasis than in those with breast or prostate cancer with bone metastasis, and its effects on the peripheral hemogram were also significantly stronger in the lung cancer group.

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Background: Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph ⁺ ALL) is triggered by BCR/ABL tyrosine kinase which activates the downstream signaling pathways, such as Akt/mTOR, RAF/MEK/ERK, and STAT5 pathways. Curcumin has been shown to have inhibitory effects on cancers by inducing apoptosis and autophagy. We demonstrated that curcumin inhibited activation of Akt-mTOR, ABL/STAT5 pathways, inhibited cell proliferation, and induced apoptosis in Ph ⁺ ALL cells. Experiments here, were conducted to determine whether autophagy via MEK/ERK pathway involved in anti-leukemia effect of curcumin in Ph ⁺ ALL. Materials and Methods: Ph ⁺ ALL cell line SUP-B15 was treated with curcumin. Cytotoxic activity of curcumin was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide assay. Signaling protein and specific maker of autophagy and conversion of LC3-I to LC3-II were determined by Western blot analysis. Cell apoptosis was determined by flow cytometry. Results: Curcumin treatment up-regulated the activation of RAF/MEK/ERK at 4 h and 8 h after curcumin exposure in SUP-B15 cells, curcumin treatment induced autophagy at exactly 4 h and 8 h after curcumin exposure. Curcumin exerted cytotoxic activity against SUP-B15 cells at 4 h and 8 h, which was independent of apoptosis. MEK specific inhibitor U0126 inhibited the occurrence of autophagy, and then blocked curcumin-induced cytotoxicity at 4 h and 8 h. Conclusions: Curcumin induce autophagic cell death in SUP-B15 cells via activating RAF/MEK/ERK pathway. These findings suggest that autophagic mechanism contribute to the curcumin-induced early SUP-B15 cell death, and autophagy is another anti-leukemia mechanism of curcumin.

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Aims: Esophageal squamous cell carcinoma (ESCC) is the most common subtype of esophageal cancer in Iran. MicroRNAs (miRNAs) are a class of noncoding RNAs that are found to be involved in different processes and can play a role in tumorigenesis and result in cancer. MiR-371, miR-372, and miR-373 are a gene cluster that is located in the region of the human chromosome of 19q13.4. They are specifically expressed in human embryonic stem cells (ESCs) and involved in the maintenance of the stemness features through regulating the expression of certain key genes and signaling pathways. The present study investigated the potential expression of miR-371–373 cluster in tumor and nontumor tissues of ESCC. Materials and Methods: The expression level of miR-371–373 cluster was analyzed in paraffin-embedded tissues of tumor and tumor margin in 36 patients with ESCC. Total RNA was isolated and the miR-371–373 clusters were quantified with quantitative real-time-polymerase chain reaction expression analysis. Computed tomography analysis (2^–ΔΔCT) and t-test were used to determine the relationship between the characteristics of the tumor and nontumor tissues. Statistically, P value of <0.05 were considered significant. Data analysis was performed using SPSS 16. Results: We provided miR-371, miR-372, and miR-373 upregulation evidence significantly with 14.36, 26.9, and 21.1-fold in esophageal cancer cells compared with their adjacent normal cells (P < 0.05), respectively. In addition, evaluation of these genes expression in various grades didn't show a significant difference. Conclusion: Our findings support the hypothesis that these miRNAs might play a role in tumorigenesis in esophageal cancer.

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Context: Recently, increasing studies investigated the association between inflammation parameter such as neutrophil to lymphocyte ratio (NLR) and the prognosis of cancers. However, the clinical and prognostic significance of NLR in breast cancer remains controversial. Aim: This meta-analysis was conducted to establish the overall accuracy of the NLR test in the diagnosis of breast cancer. Materials and Methods: A comprehensive search of the literature was conducted using PubMed and Web of Science. Six studies dating up to July 2014 with 2267 patients were enrolled in the present study. STATA 11.0 software (STATA Corporation, College Station, TX, USA) was selected for data analysis. In order to evaluate the association between NLR and overall survival (OS), disease-free survival (DFS), recurrence-free survival or cancer-specific survival, the hazard ratios (HRs), and their 95% confidence intervals (CIs) were extracted. Results: Subgroup analyses showed that NLR was a strong prognostic factor for OS in multivariate analysis (HR = 2.81, 95% CI = 2.13–3.71, P_H = 0.992) and without metastasis (HR = 1.45, 95% CI = 0.37–5.66, P_H < 0.001). Elevated NLR was associated with a high risk for DFS in subgroups of multivariate analysis (HR = 2.16, 95% CI = 1.67–2.80, P_H = 0.977) and mixed metastasis (HR = 2.13, 95% CI = 1.38–3.30, P_H = 0.84). Conclusion: In summary, NLR may be considered as a predictive factor for patients with breast cancer.

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Synovial sarcomas (SSs) are very rare, poorly studied tumors that generally occurs around joint and muscle tendons. Primary SSs of the kidney are even rarer, accounting for <2% of all malignant renal tumors. We report the case of a 44-year-old man who was diagnosed with primary renal SS on the basis of imaging, histopathological, and immunohistochemical examination. We also present a comprehensive review of the literature, with a focus on the differential diagnosis and treatment of renal tumors.

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Objective: To assess the association between long-term exposures to smoky coal, environmental tobacco smoke (ETS) and lung cancer incidence in China. Methods: A meta-analysis was performed on literature searched through Web of Science, Chinese National Knowledge Infrastructure, Weipu, and Wanfang databases. Odds ratio (OR) with 95% confidence intervals (CIs) was used to assess the strength of association between air pollution and lung cancer in China. Results: Twenty-eight studies were included in the meta-analysis. Stratification by ETS exposure source, amount, and gender found a variation in effect. The pooled OR (95% CI) for exposure to spousal, parents, and work ETS was 1.153 (1.000–1.329), 2.117 (1.626–2.755), and 1.454 (1.307–1.618), respectively. The OR (95% CI) values related to childhood exposure was 1.297 (1.142–1.473), adulthood exposure 1.102 (0.937–1.296), exposure lower than 20 cigarette/day 1.088 (0.809–1.464), higher than 20 cigarette/day 1.776 (1.392–2.267), male 1.555 (1.304–1.855), female 1.487 (1.265–1.748), and coal use 1.490 (1.330–1.669). Conclusion: The meta-analysis provided evidence that indoor coal use and ETS were significantly associated with lung cancer in China.

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Aim of Study: Hepatitis B virus (HBV) infection is a risk factor in diffuse large B-cell lymphoma (DLBCL); however, little is known other than the prevalence evidence. In addition, the impact of HBV infection to DLBCL remains controversial. The purpose of this study was to investigate the HBV infection status of 136 patients with DLBCL, analyze the clinical property of HBV-infected patients, and determine the effects of HBV infection to the outcomes of DLBCL patients. Materials and Methods: A retrospective analysis was performed in our center from January 2007 to December 2014. A total of 136 DLBCL patients accepting three or more cycles of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) or rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) regimen were analyzed. Results: Of the 136 patients, 55 were HBV-infected and their clinical features were different in several aspects such as young onset age (P = 0.027), frequent occurrence of B symptom (P = 0.009), and advanced disease stage (Stage III/IV, P = 0.037). Besides more HBV-infected patients exhibited lower levels of peripheral lymphocyte-to-monocyte ratio (≤2.0). In the survival assessment, HBV-infected patients were worse in both progression-free survival (PFS) (P = 0.001) and overall survival (OS) (P = 0.030) in MabThera treated group, but get a draw in CHOP regimen group (P = 0.658 in PFS and P = 0.798 in OS). Sort of surprisingly, HBV-infected patients treated with MabThera did not have a superior to the traditional regimen in both PFS (P = 0.969) and OS (P = 0.875). Conclusion: DLBCL patients with HBV infection are subset with unique clinical characters and have worse outcomes. The benefit of MabThera to HBV-infected DLBCL patients was uncertain thus have to be weighed against the costs before application.

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Objective: The objective of this study was to investigate the effect of Solanum nigrum polysaccharides (SNPs) on tumor growth in H22 hepatocarcinoma cells bearing mice and explore the mechanism by focusing on the regulation of the expression of caspase-3 and bcl-2. Materials and Methods: Totally, 50 mice bearing with H22 cells were randomly divided into five groups: Model group, cyclophosphamide group (CTX, 30 mg/kg), SNP groups with low, medium, and high doses of SNP (30, 60, and 120 mg/kg). Twenty-four hours after inoculation of H22 cells, CTX or SNP were given by gavage once a day for 10 days. The growth of tumor was observed. The tumor inhibition rate, indexes of the spleen and thymus were calculated. The immunohistochemical method was used for the determination of caspase-3 and bcl-2 expression in the tumor tissue. Results: SNP (30, 60, and 120 mg/kg) reduced the average tumor weight compared with that in model group in a dose-dependent manner, and the tumor inhibition rates were 37.73%, 38.24%, and 42.60%, respectively. In addition, SNP dose dependently increased the index of the thymus compared with that of the CTX group. Immunohistochemistry results showed that the protein expression of caspase-3 in SNP groups was higher, but the expression of bcl-2 was lower than that in model group in a dose-dependent manner. Conclusion: SNP inhibited the growth of tumor in H22-bearing mice and protected the immune organ. The mechanism underlying the inhibition of tumor might be related to the upregulation of caspase-3 and downregulation of bcl-2.

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Objective: The objective was to study the correlation between death-associated protein kinase (DAPK) promoter methylation and the clinicopathological and prognostic features in nonsmall cell lung cancer (NSCLC) patients. Materials and Methods: A total of 117 NSCLC patients were recruited into our study between December 2012 and December 2014. Methylation-specific polymerase chain reaction was employed to detect the methylation status of DAPK in cancer tissues, peficancerous tissues, and serum samples of 117 NSCLC patients. In addition, serum samples of 115 healthy subjects were analyzed as controls. A literature search of English and Chinese databases, based on predefined criteria, identified published studies closely related to this study. Data were extracted, and meta-analysis was performed using STATA 12.0 software (STATA Corporation, College Station, TX, USA). Results: Our study results showed that DAPK promoter methylation frequency was significantly higher in NSCLC tissues compared to peficancerous normal tissues (58.1% vs. 12.8%, χ² = 52.45, P < 0.001). When serum samples were compared, DAPK methylation frequency in NSCLC patients was higher than the control group (27.4% vs. 0, χ² = 37.07, P < 0.001). Our meta-analysis results demonstrated that DAPK methylation frequency was lower in tumor node metastasis (TNM) stage I-II compared to TNM stage III-IV (relative risk [RR] =0.87, 95% confidence interval [CI] =0.76–0.99, P = 0.041). DAPK promoter methylation frequency in NSCLC patients with lymph node metastasis was significantly higher compared to the patients with no metastases (RR = 1.26, 95% CI = 1.04–1.52, P = 0.020). Finally, the 5-year survival rate was lower in NSCLC patient group with high frequency of DAPK methylation, compared to the patient group with unmethylated DAPK (RR = 0.71, 95% CI = 0.56–0.89, P = 0.004). Conclusion: Our results showed that DAPK promoter methylation is tightly correlated with clinicopathological features of NSCLC and is associated with poor prognosis in patients.

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Objective: This study investigated the association between abnormal matrix metalloproteinase-9 (MMP-9) expression and bladder cancer (BC) development. Materials and Methods: In a retrospective analysis, this study used tissue samples derived from 92 patients pathologically diagnosed with BC (experimental group), who were hospitalized between September 2012 and June 2014 at the Urinary Surgery of Department of Urology, Lanzhou University Second Hospital. As controls (control group), 63 normal pericancerous bladder mucosal tissues (3 cm distant form edge of BC foci) with confirmed pathology were selected from the same time period. Immunohistochemistry was employed to detect MMP-9 protein expression in the tissues and enzyme-linked immunosorbent assay was performed to measure MMP-9 protein levels in tissue samples of patients and control subjects. Finally, a meta-analysis was conducted to understand the overall impact of MMP-9 on BC pathogenesis. STATA 12.0 software (Stata Corp, College Station, TX, USA) was used for all statistical analyses. Results: The MMP-9 positive expression rate in tissue samples and MMP-9 levels were significantly greater in the experimental group compared to the control group (both P < 0.001). The frequency of MMP-9 positive status showed statistically significant differences between G1 (low-grade) and G3 (high-grade) (P < 0.001), between G2 and G3 (P < 0.05), and between G1/G2 and G3 (P = 0.001). Our meta-analysis findings provided further evidence that MMP-9 positive expression status and MMP-9 levels in the experimental group were significantly higher than the control group (positive expressions: Odds ratio [OR] = 18.59, 95% confidence interval [95% CI] = 11.63–29.71, P < 0.001; expression levels: Standard mean difference = 1.51, 95%CI = 0.63–2.39, P = 0.001). The positive expression status of MMP-9 was notably lower in G1/G2 compared to G3 (OR = 0.24, 95%CI = 0.15–0.36, P < 0.001). Conclusion: Our study demonstrated that both positive expression status in tumor tissue and expression levels of MMP-9 are significantly elevated in BC patients and correlate with disease progression. Thus, MMP-9 can serve as a biomarker to determine the degree of BC malignancy.

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Aims: MicroRNA-186 (miR-186) has been shown to be involved in various types of cancer. The purpose of this study was to investigate the expression level and functional role of miR-186 in human cutaneous malignant melanoma cells. Subjects and Methods: Expression of miR-186 was analyzed in human cutaneous malignant melanoma (CMM) cell lines SK-MEL-1, G-361, A375 and A875, and human normal epidermal melanocytes cell line HEMn-LP by quantitative reverse transcription polymerase chain reaction (qRT-PCR). Additionally, the functional role of miR-186 on melanoma cells was investigated by transfection of miR-186 mimic followed by analyses of cell proliferation, apoptosis, and metastasis. Results: We found that the expression levels of miR-186 were decreased in CMM cell lines compared with normal epidermal melanocytes cell line. Moreover, overexpression of miR-186 inhibited cells proliferation through abrogating the G₁–S transition, and reduced cells migration and invasion. Conclusions: Our findings suggested that miR-186 exhibit an inhibitory effect on CMM cell proliferation, migration, and invasion; thus, may serve as a potential therapeutic target for human CMM intervention.

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Aim: The purpose of this study was to identify predictive biomarkers used for clinical therapy and prognostic evaluation of high-risk gastrointestinal stromal tumors (GISTs). Materials and Methods: In this study, microarray data GSE31802 were used to identify differentially expressed genes (DEGs) between high-risk GISTs and low-risk GISTs. Then, enrichment analysis of DEGs was conducted based on the gene ontology and kyoto encyclopedia of genes and genomes pathway database. In addition, the transcription factors and cancer-related genes in DEGs were screened according to the TRANSFAC, TSGene, and TAG database. Finally, protein–protein interaction (PPI) network was constructed and analyzed to look for critical genes involved in high-risk GISTs. Results: A total of forty DEGs were obtained and these genes were mainly involved in four pathways, including melanogenesis, neuroactive ligand-receptor interaction, malaria, and hematopoietic cell lineage. The enriched biological processes were related to the regulation of insulin secretion, integrin activation, and neuropeptide signaling pathway. Transcription factor analysis of DEGs indicated that POU domain, class 2, associating factor 1 (POU2AF1) was significantly downregulated in high-risk GISTs. By constructing the PPI network of DEGs, ten genes with high degrees formed local networks, such as PNOC, P2RY14, and SELP. Conclusions: Four genes as POU2AF1, PNOC, P2RY14, and SELP might be used as biomarkers for prognosis of high-risk GISTs.

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Purpose: Papillary thyroid carcinoma (PTC) has a strong propensity to metastasize to regional lymph nodes which increases the risk of local-regional relapse and affects the course of the disease. Molecular pathogenesis of lymph node metastasis (LNM) is not yet fully understood. Survivin, a multifunctionale molecule involved in apoptosis, proliferation and angiogenesis, and vascular endothelial growth factor-C (VEGF-C) are suggested to be implicated in lymphatic metastases of human malignancies. Materials and Methods: Expression of survivin and VEGF-C was examined by immunohistochemistry and Western blot in 75 cases of PTCs in relation to their LNM status. Additionally, survivin and VEGF-C were immunohistochemically analyzed in 15 primary PTCs paired with their metastatic tissue in lymph nodes. Results: High expression of survivin and VEGF-C was found in 62.7% and 64.0% cases, respectively, with a positive correlation to each other (Spearman's correlation co-efficient = 0.878, P < 0.001). Expression levels of both proteins were significantly higher in patients with LNM than in those without LNM (P < 0.001). The rate of concomitant high expression of survivin and VEGF-C in patients with LNM involvement was 88.9% (P < 0.01). Metastatic tissue in lymph nodes expressed survivin and VEGF-C at the same high extent as their primary tumors. Conclusion: Concomitant high expression of survivin and VEGF-C is closely associated with LNM status of PTC patients, which suggests their cooperation in the metastatic process. Evaluation of survivin and VEGF-C expression could be clinically significant in predicting the metastatic potential of PTC and subsequent treatment and follow-up of these patients.

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Aim: Patients aged 65 years and older are often underrepresented in clinical trials of metastatic colorectal cancer (mCRC) and probably undertreated in clinical practice. We performed a meta-analysis of randomized controlled trials (RCTs) to assess the efficacy of molecular targeted agents (MTAs) in this population. Materials and Methods: A comprehensive literature search for studies published up to December 2014 was performed. The endpoints were overall survival (OS) and progression-free survival (PFS). The pooled hazard ratio (HR) and 95% confidence intervals (CIs) were calculated employing fixed- or random-effects models depending on the heterogeneity of the included trials. Results: Eleven RCTs involving 8,488 patients were ultimately identified. The pooled analysis demonstrated that the use of MTAs in elderly patients with mCRC significantly improve OS (HR 0.84, 95% CI: 0.76–0.92, P < 0.001) and PFS (HR 0.78, 95% CI: 0.64–0.96, P = 0.017) when compared to MTAs-free therapies. Similar results of OS were observed in subgroup analysis according to treatment line, therapy regimes, and approval status of MTAs. No publication bias was detected by Begg's and Egger's tests. Conclusions: The introduction of MTAs to therapies offered a survival benefit in elderly patients with mCRC. Further studies aimed at this specific patient population were still needed to watchfully monitor potential treatment-related toxicities to optimize the use of these drugs.

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Background: Tyrosine kinase growth factor receptors (TKGFRs) play an important role in the progression of cancer. A variety of studies have investigated the clinicopathologic correlation of these receptors and their influences on patient survival in different types of cancer. As the members of TKGFRs, the biomarkers c-MET, epidermal growth factor receptor (EGFR), and human epidermal growth factor receptor 2 (HER-2) have been extensively investigated in biliary tract cancer (BTC). However, their prognostic value is still controversial. Our study aimed to evaluate the prognostic significance of the three markers in BTC patients based on the published studies. The correlation between high expression of these markers and clinical parameters or overall survival (OS) has been assumed in this paper. Materials and Methods: Including PubMed, EMBASE, China National Knowledge Infrastructure, and Springer, a comprehensive search for the related literature published in Chinese and English has been done. Finally, 31 studies were selected in our research. Results: Surprisingly, the meta-analysis indicated that HER-2 high expression was not correlated with age, gender, primary tumor, tumor node metastasis (TNM) stage, lymph node status, and differentiation. We also found that EGFR high expression was not associated with the parameters, such as age, gender, TNM stage, differentiation, or lymph node status. c-MET high-expression was not associated with age, differentiation, gender, TNM stage, or lymph node status. In addition, our study showed that HER-2, EGFR, and c-MET high expression had an adverse influence on OS in BTC, the pooled hazard ratio for HER-2, EGFR, and c-MET was statistically significant. Conclusion: The present meta-analysis indicated that EGFR and HER-2 high expression have little impact on OS in patients with BTC while c-MET high expression influenced OS in patients with BTC to a large extent. However, c-MET, EGFR, and HER-2 expression did not show any correlation with those clinical parameters. c-MET may be a potential therapeutic target for BTC.

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Aims: Some studies suggested that TOX high mobility group box family member 3 (TOX3) rs3803662 polymorphism was associated with the risk of breast cancer. However, the results were controversy. Therefore, in order to derive a more comprehensive estimation of the association between TOX3 rs3803662 polymorphism and breast cancer risk, we conducted a meta-analysis to investigate this relationship. Materials and Methods: An electronic literature search was conducted using the following database: PubMed, EMBASE, and China National Knowledge Infrastructure till to March 31, 2015. The strength of the associations between the TOX3 rs3803662 polymorphism and breast cancer risk in per alle model was measured by odds ratios (ORs) and 95% confidence intervals (CIs). Results: A statistically significant association between TOX3 rs3803662 polymorphism and breast cancer risk was fond. The data showed that TOX3 rs3803662 polymorphism could increase the risk of breast cancer (OR = 1.20; 95% CI: 1.16–1.25; P < 0.00001). In the subgroup analysis of race, Caucasians, Asians, and Hispanics also showed increased breast cancer risk (OR = 1.21; 95% CI: 1.17–1.25; P < 0.00001; OR = 1.20; 95% CI: 1.08–1.33; P = 0.0004; OR = 1.32; 95% CI: 1.12–1.57; P = 0.001). However, African-Americans with TOX3 rs3803662 polymorphism showed decreased breast cancer risk (OR = 0.95; 95% CI: 0.86–1.04; P = 0.28), although the result was not significant. When considered estrogen receptor (ER) status, we found that ER ⁺ subjects and ER ⁻ subjects all had increased breast cancer risk, if they carried this polymorphism (OR = 1.27; 95% CI: 1.19–1.35; P < 0.00001; OR = 1.12; 95%CI: 1.08–1.17; P < 0.00001). Similarly, both progesterone receptor–positive (PR ⁺) subjects and PR ⁻ subjects all showed increased breast cancer risk, if they carried this polymorphism (OR = 1.32; 95% CI: 1.17–1.49; P < 0.00001; OR = 1.15; 95% CI: 1.09–1.23; P < 0.00001). Conclusions: This meta-analysis suggested that TOX3 rs3803662 polymorphism was associated with increased breast cancer risk.

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Gallbladder adenomyomatosis (GAM) is an acquired, reactive, tumor-like condition. Malignant transformation is extremely rare, and imaging features during contrast-enhanced ultrasound (CEUS) have not been described before. Herein, we describe a 73-year-old Asian man who had been diagnosed with gallbladder carcinoma by conventional ultrasonography (US). Based on additional radiological findings, we believed that it was a localized adenomyomatosis. However, the histopathological diagnosis was adenocarcinoma originate from adenomyomatosis with serosal invasion. We believe this is the first case of adenocarcinoma derived from GAM with characteristics of CEUS findings. This case is presented to indicate a clinical awareness of malignant transformation of GAM and discuss the radiology significance with an emphasis on CEUS.

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Aim of Study: To examine the function of lenalidomide (LEN) on the human multidrug resistance (MDR)-type gastric cancer line SGC7901/vincristine (VCR) via regulating Notch signaling. Materials and Methods: Quantitative polymerase chain reaction was used for checking the genes of Notch, DNA methyltransferase (DNMT), RBP-J, Hes1/5, Deltex1, MDR/multidrug resistant protein (MRP); the cell proliferation and cell death were detected by cell counting kit-8 (CCK8) staining, Ki-67 expression, and propidium-iodide staining, and methylated DNA immunoprecipitation assay (MeDIP) was used for checking the 5 mC enrichment, indicating the DNA methylation of the Notch2 gene loci. Results: LEN reduced the mRNA expression of Notch2 (P < 0.01) and increased the expression of the DNMT3A (P < 0.001) in SGC7901/VCR cell, suggesting the involvement of epigenetic regulation by DNMT3A on Notch2 gene expression. Consistently, Notch2 gene expression showed no obvious change between the LEN treatment and the control when the DNMT3A was knockdown using the interference of shRNA. The modulation of DNA methylation process on gene expression was then confirmed by 5 mC enrichment on Notch2 gene loci after LEN treatment. Furthermore, LEN could suppress the downstream genes in Notch2 signaling including RBP-J (P < 0.05), Hes1 (P < 0.001), and Deltex1 (P < 0.01). Due to the changes of gene expression pattern in Notch pathway, LEN showed a phenotype of cell proliferation suppression using CCK8 staining. Meanwhile, the expression of the genes associated with MDR and MRP was also significantly decreased (MDR, P < 0.01; MRP, P < 0.001) after LEN treatment. Therefore, inhibition of cell proliferation by LEN via Notch2 signaling combined with the MDR/MRP expression modulation contributes to the efficacy of LEN on the gastric cancer cell line SGC7901/VCR. Conclusion: The data implicate that LEN would be an effective chemical for the therapy of drug-resistant human gastric cancer cell and the gastric cancer patients.

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Objective: To observe changes in the growth of fluorescence-labelled tumour cells in nude mice using small animal in vivo imaging technology and to compare the anti-tumour effects of the administration of bevacizumab monoclonal antibodies combined with chemotherapy at different time sequences. Materials and Methods: Different time sequences of administration of bevacizumab monoclonal antibodies combined with the 5-fluorouracil and cisplatin (FP) chemotherapy regimen were used for intervention treatment of tumour growth in a subcutaneous xenograft model of human gastric cancer in nude mice. Tumour growth, that is, tumour volume, was evaluated with the changes in fluorescence signal strength and the inhibition rate. Results: Compared with the control group (normal saline), experimental groups had a certain inhibition rate, while the tumour inhibition rate in the group with a bevacizumab treatment for 24 h followed by the FP chemotherapy regimen was the highest (68.42%). Moreover, the fluorescence signal strength changed significantly in all of the experimental groups. At the 3^rd week of bevacizumab administration, the fluorescence signal value in the group with a bevacizumab treatment for 24 h followed by the FP chemotherapy regimen was the lowest, indicating this is the best treatment out of five groups. Conclusion: Bevacizumab monoclonal antibodies combined with chemotherapy had synergistic effects. The small animal in vivo imaging system could dynamically obtain long and short diameters of tumours and their fluorescence signal values; compared with traditional methods that calculate tumour inhibition rates by weighing tumours, this method was more sensitive and more objective for drug evaluation.

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Objective: The objective of this paper was to investigate key genes in retinoblastoma using a novel method which is mainly based on five kinds of genes, differentially expressed genes (DEGs), differential pathway genes (DPGs), seed genes (common genes between DEGs and DPGs), hub genes and informative genes (common genes of hub genes and DEGs), and support vector machines (SVM) model. Materials and Methods: In the proposed method, the first step was to identify five types of significant genes. DEGs were identified using linear models for microarray data (Limma) package (The Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia). DPGs were originated from differential pathways based on attract method. Hub genes of mutual information network which is constructed by the context likelihood of relatedness algorithm were obtained according to topological degree centrality analysis. For the second step, SVM model was implemented to assess the classification performance of DEGs, DPGs, seed genes, hub genes, and informative genes, depending on its induces the area under the receiver operating characteristics curve (AUC), true negative rate (TNR), true positive rate (TPR) and the Matthews coefficient correlation classification (MCC). Results: We detected 479 DEGs, 747 DPGs, 29 seed genes, 34 hub genes, and 7 informative genes in total for retinoblastoma. The classification performance of informative genes was the best of all with AUC = 1.00, TNR = 1.00, TPR = 1.00, and MCC = 1.00, hence they were considered to key genes which included EPARS1, FN1, HLA-DPA1, HLA-DPB1, HLA-DRA, CFI, and transforming growth factor, beta receptor II. Conclusions: We have successfully identified seven key genes, which might be potential biomarkers for detection and therapy of retinoblastoma for current and future study.

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Objective: The aim of this study is to investigate the clinical effect of goal-directed fluid therapy in elderly patients with radical resection of bladder cancer. Materials and Methods: Seventy-six elderly patients with radical resection of bladder cancer were selected from October 2012 to October 2014 and randomly divided into two groups, in which 38 patients received routine treatment as the control group and 38 patients received goal-directed fluid therapy based on routine treatment as the observation group. The treatment effect was compared between two groups. Results: The cardiac index, stroke volume variability, mean arterial pressure, central venous pressure, central venous oxygen saturation, oxygen supply index, oxygen consumption index, and oxygen uptake rate in observation group were distinctly higher than those in control group at T₁, T₂, T₃, and T₄ while the artery serum lactate and S100-β were apparently lower than those in control group at T₁, T₂, T₃, and T₄. The urine volume and colloidal infusion were obviously elevated when compared with those in control group at T₁, T₂, T₃, and T₄ while the crystalloid infusion volume, total liquid infusion volume, hospitalization time, and expenses were significantly less than those in control group; further, similar tendency was also found regarding the complication incidences of nausea, vomiting, or hypotension in observation group. The postoperative flatus and postoperative food-taking times were visibly earlier than those in control group (both P < 0.05). Conclusion: The goal-directed fluid therapy is beneficial for stabilization of hemodynamic status and maintenance of oxygen balance of supply and demand, and it is worthy of clinical expansion for good microcirculation perfusion, reduction in therapeutic time and expenses of patients, and less complications and superior security.

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Objectives: Studies have suggested that the crosstalk between estrogen receptor and ErbB receptor is involved in endocrine therapy (ET) resistance, which might be overcome by drugs-targeting ErbB receptor. However, the results of clinical studies remain controversial. The aim of this meta-analysis was to evaluate the efficacy and safety of ErbB (mainly epidermal growth factor receptor and human epidermal growth factor receptor 2 [HER2]) inhibitors added to ET for hormone receptor-positive breast cancer patients. Materials and Methods: Eligible randomized clinical trials on ET with or without ErbB receptor-targeting inhibitors (ERTI) for hormone receptor-positive breast cancer were identified by searching the main electronic databases (up to July 2015). Revman 5.3 was used to analyze the outcomes extracted from the included trials. Results: In the overall population, ERTI failed to show any significant differences on overall response rate (ORR), clinical benefit rate (CBR), and overall survival (OS). However, improvement on progression-free survival (PFS) (hazard ratio [HR] 0.84, 95% confidence interval [CI] = 0.76–0.93, P = 0.0005) was observed. For the HER2+ subgroup, ERTI could significantly improve ORR, CBR, PFS, OS, and time to progression compared to endocrine monotherapy. This improvement cannot be found in the HER2− subgroup. The risk of serious adverse events (SAEs) increased significantly when ERTI was present (RR = 2.09, 95% CI = 1.44–3.02, P < 0.0001). Conclusions: For HR+/HER2+ breast cancer, ERTI added to ET can significantly improve the clinical efficacy with the cost of increasing SAE.

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Aim: Accumulated evidence has suggested a relationship between S100A4 protein expression and the development and progression of pancreatic cancer (PC) while its role in diagnosis and prognosis of PC still keeps inconsistent. To obtain definitive associations between S100A4 and PC, a meta-analysis was conducted. Materials and Methods: The PubMed and Chinese National Knowledge Infrastructure databases were electronically searched to identify studies reporting an association between S100A4 protein and PC. Statistical analyses were undergone with the utilization of STATA version 12.0 software. Results: Nine clinical studies with a total of 545 tumor samples were included in the meta-analysis. Results revealed that increased S100A4 expression were associated with the tumor-node-metastasis stages of PC (III-IV vs. I-II: odds ratio [OR] =5.50, 95% confidence interval [95% CI] =3.13–9.67, P < 0.001). Also, compared with 1–2 histologic grade of PC samples, S100A4 protein was expressed more frequently in samples with 3–4 histologic grade (grades 1–2 vs. grades 3–4: OR = 2.57, 95% CI = 1.05–6.24, P = 0.038). Conclusion: This meta-analysis showed that overexpression of S100A4 seems to be associated with tumor progression and poor prognosis of PC patients.

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Objective: We used a meta-analysis framework to examine the correlation between HIF-1α gene polymorphisms and the susceptibility to digestive cancers. Methods: Cochrane Library Database, EMBASE, MEDLINE, Pubmed, CINAHL, Chinese Biomedical Database and Web of Science were searched without language restrictions to identify relevant case-control studies reporting data on HIF-1α gene polymorphisms in digestive cancers. Data was extracted from the selected studies and meta-analysis was carried out using STATA 12.0 and Comprehensive Meta-analysis 2.0 softwares. Relative risk (RR) and its 95% confidence interval (95%CI) were calculated. A total of 8 eligible case-control studies were included. These 8 studies contained a combined total of 1,276 patients diagnosed with various digestive cancers and 3,392 healthy controls. Two functional HIF-1α polymorphisms (rs11549465 C>T and rs11549467 G>A) were examined in these 8 studies. Results: Our findings demonstrated that both rs11549465 C>T and rs11549467 G>A HIF-1α polymorphisms conferred significantly increased risk of digestive cancers. However, ethnicity-stratified analysis revealed that HIF-1α rs11549465 C>T and rs11549467 G>A polymorphisms were associated with an elevated risk of digestive cancer in Asians, but not in Caucasians. These two polymorphisms also conferred different degrees of susceptibility to various digestive cancer types. Conclusion: Our meta-analysis suggests that HIF-1α rs11549465 C>T and rs11549467 G>A polymorphisms influence the pathogenesis of digestive cancers in Asians.

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Aim of Study: Association of toll-like receptors (TLRs) with the risk of oral squamous cell carcinoma (OSCC) from the published reports is still conflicting. This study was conducted to evaluate the relationship between TLRs and the risk of OSCC using meta-analysis method. Materials and Methods: The association studies were identified from PubMed and Cochrane Library on April 01 2015, and eligible investigations were included and synthesized using meta-analysis method. Result: Three reports were recruited into this meta-analysis for the association of TLRs with OSCC susceptibility. In this meta-analysis, we found that TLRs were not associated with OSCC susceptibility. However, in the sub-group analysis, we found that TLR-7 was associated with OSCC risk. Conclusion: TLR-7 was associated with OSCC risk. TLR-7 might be an indicator to predict the OSCC risk. However, more studies should be conducted to confirm it.

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Objective: The aim of the study was to investigate the application of nerve stimulator-guided thoracic paravertebral nerve block (TPVB) plus general anesthesia (GA) in small-incision lung cancer surgery. Methods: Forty patients scheduled for small-incision lung cancer surgery, the American Society of Anesthesiologists Grade I-II, were randomized into a TPVB-GA group (Group P) and a GA group (Group G), with 20 cases in each group. The dosage of general anesthetic, mean arterial pressure (MAP) at each time point, and heart rate (HR) of the two groups were recorded. The postoperative respiration recovery time, extubation time, incidence of adverse reactions, and postoperative visual analog scale (VAS) scores of the two groups were also observed. Results: Group P showed stable hemodynamics, and lower MAP and HR at each time point than Group G (P < 0.05). The intraoperative dosage of general anesthetic in Group P was lower than that in Group G (P < 0.05). The respiration recovery time and extubation time in Group P were significantly shorter than those in Group G (P < 0.05); the incidence of agitation was significantly lower than that in Group G (P < 0.05). The VAS scores of Group P under quiet and cough status were also better than Group G (P < 0.05). Conclusions: Nerve stimulator-guided TPVB-GA is suitable for small-incision lung cancer surgery.

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Objective: The association between cyclooxygenase-2 (COX-2) gene polymorphisms and hepatocellular carcinoma (HCC) has been widely reported, but the results are still controversial. To clarify the effect of COX-2 −1195G/A (rs689466), −765G/C (rs20417), and +8473T/C (rs5275) polymorphisms on HCC risk, a meta-analysis was performed. Materials and Methods: The PubMed, Embase, Cochrane Library, Web of Science, Chinese BioMedical Literature, Wanfang, and Chinese National Knowledge Infrastructure databases were systematically searched to identify potential studies published up to October 10, 2014. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the strength of association. A total of eight studies with 2060 HCC cases and 2610 controls for −1195G/A, six studies with 1295 cases and 2193 controls for −765G/C, and four studies with 1477 cases and 1747 controls for +8473T/C were included in this meta-analysis. Results: Overall, the COX-2 −1195G/A, and +8473T/C polymorphisms were both significantly associated with an increased risk of HCC (rs689466 GA + AA vs. GG: OR = 1.390, P = 0.006, 95% CI: 1.099–1.759, I² = 50.7%, P_{heterogeneity} = 0.048; rs5275 CC vs. TT + TC: OR = 1.484, P = 0.041, 95% CI: 1.017–2.165, I² = 0.0%, P_{heterogeneity} = 0.416). In the subgroup analyses stratified by ethnicity, the COX-2 −1195G/A, −765G/C, and +8473T/C were all associated with an increased HCC risk in Asian populations (rs689466 A vs. G: OR = 1.346, P = 0.001, 95% CI: 1.137–1.595, I² = 0.0%, P_{heterogeneity} = 0.869; rs20417 CC vs. GG + GC: OR = 3.069, P = 0.013, 95% CI: 1.265–7.447; rs5275 CC vs. TT + TC: OR = 1.626, P = 0.020, 95% CI: 1.079–2.452, I² = 0.0%, P_{heterogeneity} = 0.495). Conclusions: Our meta-analysis suggests that −1195G/A, −765G/C, and +8473T/C in COX-2 may contribute significantly to HCC risk.

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Background: This study aims to investigate the correlations of positive rate of phosphatase and tensin homolog (PTEN) protein with lymph node metastasis (LNM) and tumor node metastasis (TNM) staging of nonsmall cell lung cancer (NSCLC) patients by conducted a meta-analysis. Materials and Methods: Covering several electronic databases (Embase, Cochrane Library, China BioMedicine, China National Knowledge Infrastructure, PubMed, and Web of Science), published papers eligible for enrollment in the current meta-analysis had to fulfill our predefined selection criteria. Odds ratios (ORs) with their 95% confidence interval (95%CI) were aggregated utilizing comprehensive meta-analysis 2.0 software (Biostatic Inc., Englewood, New Jersey, USA). Results: Twelve cohort studies with a total of 419 NSCLC patients were incorporated into the current meta-analysis. A decreased positive rate of PTEN protein was detected in NSCLC patients with TNM stage III-IV rather than those patients with TNM stage I-II (OR = 0.454, 95%CI = 0.338–0.610, P < 0.001). PTEN in NSCLC patients without LNM expressed higher than that in the patients with LNM (OR = 0.532, 95%CI: 0.299–0.948, P = 0.032). Ethnicity-stratified analysis demonstrated a negative relationship between positive rate of PTEN protein and TNM staging of NSCLC among both Asians and Caucasians (both P < 0.05). However, we found no significant association between positive rate of PTEN protein and LNM among Asians and Caucasians (both P > 0.05). Conclusion: Our findings indicate that decreased positive rate of PTEN protein may be linked to TNM staging and LNM in NSCLC, and it could be an important diagnostic biomarker of NSCLC.

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Objective: MicroRNAs-associated single nucleotide polymorphisms are thought to play an important role in cancer development. We investigated the association of miR-146a rs2910164 polymorphism with the risk of colorectal cancer (CRC) in Chinese population. Materials and Methods: In this hospital-based case-control study of 560 cases and 780 age- and gender-matched healthy controls, the miR-146a rs2910164 polymorphism was genotyped by polymerase chain reaction-restriction fragment length polymorphism. Results: We found that miR-146a rs2910164 polymorphism was not associated with CRC risk. However, the subgroup analysis by gender showed significant associations in male subjects (GG vs. CC: Odds ratios [OR] = 1.54, 95% confidence intervals [CI] = 1.04–2.29, P = 0.03; G vs. C: OR = 1.21, 95% CI = 1.01–1.45, P = 0.04). Conclusion: Our study provides evidence that miR-146a rs2910164 polymorphism may play an important role in susceptibility to CRC in Chinese male population.

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Background: Nonsmall cell lung cancer (NSCLC) mainly contains adenocarcinoma (AC) and squamous cell carcinoma (SqCC). This study investigated single nucleotide polymorphism (SNP) of topoisomerase II alpha (TOP2A) and dual-specificity phosphatase 6 (DUSP6) in a hospital-based case and control cohort of individuals for association with risk of different histological subtypes of NSCLC. Materials and Methods: A total of 454 (237 SqCC and 217 AC) NSCLC patients, and 454 healthy controls were recruited for analysis of TOP2A rs471692 and DUSP6 rs2279574 genotypes using the TaqMan polymerase chain reaction technique. Results: TOP2A rs471692 and DUSP6 rs2279574 SNPs were in complete linkage disequilibrium; however, frequency of DUSP6 rs2279574 genotype was significantly different between the case and control, that is, DUSP6 rs2279574a/A and A/C genotypes might contribute to an increased risk of lung squamous carcinoma compared with the C/C genotype. Moreover, DUSP6 rs2279574 AA genotype was also significantly associated with advanced stages of lung cancer. In contrast, frequency of the TOP2A rs471692 genotype had no association between cases and controls (P = 0.906). Genotype frequency of DUSP6 rs2279574 was 11.9% for C/C, 43.6% for C/A, and 44.5% for A/A in the case versus 16.7% C/C, 43.4% C/A, and 39.9% A/A in the control population (χ² = 3.136, P= 0.077 by Hardy–Weinberg equilibrium test [HWE]). The genotype frequency of TOP2A rs471692 was 50.0% for C/C, 41.6% for C/T, and 8.4% for T/T in the case versus 50.2% C/C, 43.0% C/T, and 6.8% T/T in the control populations (χ² = 0.023, P= 0.879 by HWE test). Conclusion: Individuals are carrying DUSP6 rs2279574 AA and AC genotypes associated with an increased risk in developing lung squamous carcinoma in Han Chinese and with advanced NSCLC stages.

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Objective: Thoracoscopic esophagectomy (TSE), as a minimally invasive technique, has obtained wide acceptance for treating esophageal cancer. In this study, we report our experience of the transfer from open sweet esophagectomy (OSE) to TSE and compare cost associated with the two approaches for esophageal cancer. Patients and Methods: Data were taken through a retrospective review of operative outcomes, complications and cost of 91 patients who underwent OSE or TSE for esophageal cancer from January 2012 to June 2014. Results: Among 91 patients, 48 patients underwent TSE, and 43 patients underwent OSE. Patients dealt with TSE had significantly less blood loss (152 ml vs. 204 ml, P = 0.004), shorter chest drainage time (3.3 days vs. 4.5 days, P < 0.001), less patients admitted to the Intensive Care Unit after surgery (6.3% vs. 30.2%, P = 0.003), and lower incidence of respiratory complications (16.7% vs. 37.2%, P = 0.026). However, the operative time was statistically longer in TSE group (276.0 min vs. 207.4 min, P < 0.001). The total cost (¥61,817 vs. ¥48,712, P < 0.001) and the day of surgery cost (¥29,701 vs. ¥19,446, P < 0.001) were significantly higher in the TSE group. Conclusion: This study shows that TSE is a safe and acceptable alternative to OSE. TSE will be more competitive if its cost can be reduced.

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Aim of Study: To investigate the anti.tumor effect of spleen tyrosine kinase. (Syk) on the human nonsmall cell lung cancer cells in vitro and its mechanism. Materials and Methods: In this study, we constructed a eukaryotic expression vector pcDNA3.1D/V5-His-TOPO/Syk and transfected it into human nonsmall cell lung cancer cells A549. Then, we not only analyzed the expression of Syk in transfected cells and its invasion but also the expression of matrix metalloproteinase-9 (MMP-9). Results: The results showed that overexpressed Syk significantly inhibited A549 cell invasive ability by decreasing the expression of MMP-9. Conclusion: The overexpressed Syk plays an important role in tumor invasion and metastasis, and a negative role in human nonsmall cell lung cancer cells.

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For localized the incidence of renal cell carcinoma (RCC), nephrectomy is the standard treatment. As RCC is generally regarded as a radiation-resistant tumor, the value of postoperative adjuvant radiotherapy is controversial. However, with new advance in radiotherapy (i.e., three-dimensional conformal radiation therapy [3DCRT] and intensity-modulated radiation therapy [IMRT]), target volume delineation, intensity modulation in treatment planning, and treatment delivery are more accurate with fewer adverse effect. A right renal tumor was identified in a 50-year-old man during a routine examination. T1N0M0 RCC was clinically diagnosed as the tumor was 3 cm × 3.5 cm and well-enhanced with intravenously infused contrast material in the arterial phase on computed tomography (CT). No metastases to regional lymph nodes or distant sites were evident. 3DCRT after the operation was carried out. A total dose of 50 Gy in 20 fractions over 28 days was delivered using a 15-MV X-ray. No clinical acute or chronic side effects were recorded during or after treatment, which was well tolerated. After radiotherapy, the patient came back to the hospital for a check regularly, with no evidence of recurrence and metastasis more than 11 years, and the CT for abdominal showed partial function of the right renal remained. The present case showed a good response with recovery after CRT of 50 Gy in 20 fractions for postoperative RCC. Although further experiences and longer follow-up are mandatory to conclude the optimal treatment schedule and efficacy of CRT for RCC, postoperative radiotherapy definitely reduces locoregional recurrences and with acceptable gastrointestinal toxicity if modern techniques (CRT and IMRT) are utilized.

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Context: Hyperthermia has now been used to treat many kinds of solid malignancies. However, the applied thermal parameters about heat temperature and time varied all over the world, and no consensus about the optimal formula had been reached. Microwave ablation, as one of thermal ablation methods, is usually applied based on the fixed parameters of power and duration. As a result, too high temperature or overheating might not be avoided and excessive heating might cause some additional side effects to normal tissues. Aims: To explore the optimal parameters of power and duration for the HELA and MG-63 cells in vitro. Settings and Design: With a temperature-controlled microwave workstation, a microwave thermal ablation experiment was performed in vitro. Subjects and Methods: The HELA and MG-63 cells were heated with 40°C, 45°C, 50°C, 55°C, and 60°C lasting for 5–30 min, respectively. Then, the cell viability was detected using four methods: Flow cytometer assay, nicotinamide adenine dinucleotide-diaphorase staining, Calcein-acetoxymethyl ester staining immediately after treatment, and CCK-8 assay 24 h later. Results: The temperature-controlled microwave has an excellent ablation effect on both cell lines. Furthermore, when the thermal stimulation reached 55°C 25 min and 55°C 20 min for the HELA and MG-63 cells, respectively, or 60°C 5 min for both, all the viability indexes indicated immediately devitalization. Conclusion: It presented a preliminary minimum lethal dose of heat was validated on the cellular level in vitro, which should be verified and corrected further in vivo.

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Pulmonary inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal tumor, and is considered an inflammatory pseudotumor. Here, we report of a 37-year-old woman with severe cough and stridor who was diagnosed with primary IMT of the lungs, with adenocarcinoma in situ based on the pathology in December 2012. A year later, transabdominal ultrasonography demonstrated a solid mass in the uterine wall that was initially diagnosed as a leiomyoma. However, postoperative histological examination and immunohistochemical staining revealed it as a uterine metastasis of the lung IMT. One year thereafter, the patient died of the lung tumor.

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Purpose: To explore the influence of intermediate-conductance-Ca²⁺-activated K⁺ channels. (IKCal) on HeLa cell proliferation. Materials and Methods: An IKCal blocking agent (clotrimazole (CLT)) and small hairpin ribonucleic acid interference (RNAi) was used to block IKCal in HeLa cells; subsequently, cell growth was observed. Furthermore, the messenger ribonucleic acid (mRNA) expression of IKCal was detected by reverse transcriptase polymerase chain reaction (RT-PCR) after IKCal-blocking. Results: The obvious morphological changes in HeLa cells were observed 48 h after CLT-blocking. The PCR results indicated that CLT reduced the mRNA expression of IKCal in HeLa cells. HeLa cells were transfected with pGenesil via RNAi; the HeLa cells transfected with pGenesil-IK displayed obvious morphological changes 48 h after transfection. In addition, RT-PCR further demonstrated the reduced mRNA expression of IKCal in the pGenesil group. Conclusion: CLT and blocking of IKCal gene expression effectively inhibits HeLa cell proliferation; therefore, the use of a blocking agent and RNAi both effectively downregulated the mRNA expression of IKCal, which in turn mediated the proliferation of HeLa cells, producing an antitumor effect.

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Objective: This study aims to investigate the application values of preoperative multislice spiral computed tomography angiography (MSCTA) in laparoscopic radical resection of gastric carcinoma (GC). Materials and Methods: A total of 108 GC patients were divided into Groups I (i.e., where preoperative MSCTA was performed; n = 60) and II (i.e., where preoperative MSCTA was not performed; n = 48). Surgery was performed by the same group of surgeons. Results: Seven cases of blood vascular variation were detected in Group I during surgery, whereas four cases were detected in Group II. The operation time for Group I ([207 ± 24] min) was shorter than that for Group II ([260 ± 31] min) (95% confidence interval [95% CI]: −21.543–−0.920, P = 0.044). The operation time of patients with gastric vascular anatomic variation in Group I ([189 ± 49] min) was shorter than that of patients in Group II ([257 ± 61] min) (95% CI: −99.68–−3.201, P = 0.048). The differences in the number of lymph node dissection, average blood loss, eating time, complication rate, and postoperative hospital stay between the two groups was not statistically significant (P > 0.05). Conclusions: MSCTA before endoscopic radical resection exhibits guiding values in assessing blood vascular variations and shortening operation times.

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Purpose: To investigate whether the serum levels of matrix metalloproteinases (MMPs) are predictive on treatment response and survival in locally advanced rectal cancer (LARC) patients undergoing preoperative chemoradiotherapy. Patients and Methods: Serum MMP-2 and MMP-9 was analyzed by enzyme-linked immunosorbent assay and obtained before, midway, and 1-month after the end of preoperative radiotherapy treatment. The prognostic significance of serum MMP-2 and MMP-9 levels and their association with other pathological findings for LARC patients were evaluated. Results: Serum levels of MMP-2 or MMP-9 were found to decrease with increasing clinical stage and negative correlation was statistically significant (P < 0.05). There was no statistically significant difference in tumor response and survival between the low and high MMP-2 and MMP-9 groups. MMP-2 and MMP-9 were not correlated with local-regional recurrence. Conclusions: We propose that serum levels of MMP-2 and MMP-9 are not predictive on treatment response and survival in LARC patients.

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