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   2018|   | Volume 14 | Issue 1  
    Online since March 8, 2018

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Relationship between resilience, social support as well as anxiety/depression of lung cancer patients: A cross-sectional observation study
Tingjie Hu, Jian Xiao, Juan Peng, Xiao Kuang, Bixiu He
2018, 14(1):72-77
DOI:10.4103/jcrt.JCRT_849_17  PMID:29516963
Objective: The mood of patients with lung carcinoma would be greatly influenced by the diagnosing and treating processes. This study was aimed to explore the effects of resilience between social assistance and anxiety/depression of patients with lung cancer, which may assist in clinical intervention. Design and Methods: A cross-sectional pilot study was conducted on lung cancer patients at Xiangya Hospital of Central South University, China. A total of 289 patients aged 25–81 years were included in this study. Results: Correlational analyses revealed that anxiety/depression was negatively associated with psychological resilience and each dimension of social assistance, including subjective support, objective support along with the supports utilization (P < 0.01). Furthermore, psychological resilience was positively related to subjective support (P < 0.01), support utilization (P < 0.01) along with objective support (P < 0.05). Mediational analyses showed that, on the one hand, resilience could partially mediate the relation between anxiety and subjective support and totally mediate the relationship between support utilization and anxiety. On the other hand, resilience could totally mediate the relation between depression and subjective support and partially mediate the relation between support utilization and depression. However, resilience did not play an intermediary role between anxiety/depression and objective support. Conclusion: Lower psychological anxiety and depression would be experienced by lung cancer patients with higher resilience and social support. The level of anxiety and depression would be indirectly affected by social support through the mediation of resilience.
  7,989 418 -
Clinical significance of elevated antinuclear antibodies in patients with diffuse large B-cell lymphoma: A single center study
Junyuan Lang, Kai Ma, Jinxiu Guo, Jinhui Zhang, Qifeng Wang, Hui Sun
2018, 14(1):213-219
DOI:10.4103/0973-1482.183559  PMID:29516988
Objective: To investigate the potential diagnostic and prognostic values of antinuclear autoantibodies (ANAs) in diffuse large B-cell lymphoma (DLBCL). Materials and Methods: Eighty-two DLBCL patients and 120 healthy controls were selected from the Department of Hematology, Jincheng Dayi Hospital between 2005 and 2014. We examined the expression of ANA in the sera of the 82 DLBCL patients at different Ann-Arbor stages (15 at Stage I, 22 at Stage II, 27 at Stage III, and 18 at Stage IV). ANA detection was performed by immunofluorescence, and the results were confirmed by Western blotting analysis. Result: ANAs were more frequently detected in DLBCL patients than in controls (P < 0.001), with 25 (30.5%) DLBCL patients and 9 (7.5%) controls displaying elevated ANA levels. However, the majority of DLBCL patients in which ANA were detected did not develop autoimmune diseases, suggesting that ANA in DLBCL might not be correlated autoimmune diseases. Furthermore, no correlation was observed between the expression of ANA and the clinical stages of DLBCL. However, ANA-positive DLBCL patients had a better survival rate (P < 0.05). Conclusions: ANA in DLBCL may be a stage-independent prognostic factor rather than an indication for autoimmune diseases and may represent an effective immune response to the tumor.
  7,786 166 -
Medical expenditure for liver cancer in urban China: A 10-year multicenter retrospective survey (2002–2011)
Wu-Qi Qiu, Ju-Fang Shi, Lan-Wei Guo, A-Yan Mao, Hui-Yao Huang, Guang-Yu Hu, Pei Dong, Fang-Zhou Bai, Xiao-Ling Yan, Xian-Zhen Liao, Guo-Xiang Liu, Ya-Na Bai, Jian-Song Ren, Xiao-Jie Sun, Xin-Yu Zhu, Jin-Yi Zhou, Ji-Yong Gong, Lin Zhu, Ling Mai, Ling-Bing Du, Qi Zhou, Xiao-Jing Xing, Bing-Bing Song, Yu-Qin Liu, Pei-An Lou, Xiao-Hua Sun, Shou-Ling Wu, Rong Cao, Xiao Qi, Li Lan, Ying Ren, Kai Zhang, Jie He, Chunfeng Qu, Min Dai
2018, 14(1):163-170
DOI:10.4103/jcrt.JCRT_709_16  PMID:29516981
Objective: This study aims to understand the medical expenditure for liver cancer during 2002-2011 in urban areas of China. Materials and Methods: This is a retrospective study. Based on a stratified cluster sampling method, a medical expenditure survey collected basic personal information from related medical records. Two-tailed independent sample t-test, variance analysis, and Student–Newman–Keuls Tests were used in cost analysis for the corresponding data types. Results: A total of 12,342 liver cancer patients were included in the analysis. Overall average medical expenditure per case for liver cancer diagnosis and treatment in China has increased from ¥21, 950 to ¥40, 386 over the study period. For each liver cancer patient diagnosed between 2009 and 2011, the average expenditures were 29,332 CNY for stage I, 35,754 CNY for stage II, 34,288 CNY for stage III, and 30,275 CNY for stage IV diseases (P < 0.001). Pharmaceuticals accounted for the biggest part of the medical expenditure and it rose from 48.01% to 52.96% during these ten years, and the share of nursing fee expenses was the lowest (around 1%). Over the entire 10-year data period, the per capita expenditure of the east region (32,983 CNY) was higher than that of the west region (26,219 CNY) and slightly higher than the central region (31,018 CNY, P < 0.001). Discussion: As a major cancer in China, liver cancer accounts for a large portion of health economic burden and its medical expenditure is heavy for families. Early diagnosis and treatment for liver cancer will save medical expenditure. Conclusion: The economic burden of liver cancer is high in China and related medical expenditure has increased.
  4,012 80 -
Clinical analysis of electroacupuncture and multiple acupoint stimulation in relieving cancer pain in patients with advanced hepatocellular carcinoma
Lili Xu, Yongxian Wan, Juan Huang, Fangyuan Xu
2018, 14(1):99-102
DOI:10.4103/jcrt.JCRT_736_17  PMID:29516968
Objective: The objective of this study is to investigate the clinical efficacy and safety of electroacupuncture and multiple acupoint stimulation in relieving cancer pain in patients with advanced hepatocellular carcinoma. Methods: Sixty-five cases of advanced hepatocellular carcinoma with cancer pain were selected in our hospital and were divided into electroacupuncture multiple acupoint stimulation group (electroacupuncture group) (n = 32) and fentanyl transdermal patch analgesia group (control group) (n = 33) according to analgesic methods and intentions. In the electroacupuncture group, electric acupuncture treatment was administered at different acupoints, including Baihui, Quchi, Neiguan, Xuehai, Zusanli, and Sanyinjiao acupoint, once a day for 7 days. In the control group, a fentanyl transdermal patch was placed on the upper left arm every 3 days and replaced with a continuous external paste once for 7 days. Pain scores in the two groups before and during the treatment were evaluated with a visual analog scale (VAS), and adverse reactions during the treatment were recorded. Results: The VAS pain score of the electroacupuncture group was significantly decreased on day 3 (P < 0.05), but the pain scores were not significantly different (P > 0.05) between the two groups 4 days after treatment. For treatment-related side effects, there were 3 cases of subcutaneous hemorrhage in the electroacupuncture group; 1 case of skin rashes and 3 cases of nausea and vomiting in the control group. The incidences of adverse reactions in the two groups were 9.4% and 12.1%, respectively, without significant difference (P > 0.05). Conclusion: Cancer pain in patients with advanced hepatocellular carcinoma can be alleviated with electroacupuncture and multiple acupoint stimulation, but the onset pain relief was slow. To improve the analgesic effects of this technique, the combination of various analgesic methods should be necessary in early stage of the treatment.
  3,729 162 -
Programmed death 1 Ligand 1 expression in breast cancer and its association with patients' clinical parameters
Fei Li, Yi Ren, Zhandong Wang
2018, 14(1):150-154
DOI:10.4103/jcrt.JCRT_602_17  PMID:29516978
Objective: To evaluate the expression of programmed death 1 ligand 1 (PD-L1) in the cancer tissues and tumor-adjacent normal tissues of patients with invasive ductal carcinoma of the breast and to analyze the relationship between the expression of PD-L1 and the clinicopathological features of patients. Materials and Methods: This study included 112 cases of patients with invasive ductal carcinoma of breast who received surgical treatment from March 2012 to February 2016 in Xuzhou Cancer Hospital. The clinical materials of included patients were retrospectively analyzed. The immunohistochemical assay and real-time polymerase chain reaction (PCR) assay were applied to examine the expression of mRNA and protein of PD-L1 in breast cancer specimens of 112 cases and paired tumor-adjacent tissue specimens of 57 cases. The relationship between PD-L1 protein expression and clinicopathological features of patients was analyzed. Results: PD-L1 protein was mainly expressed in the cytoplasm. The positive rate of PD-L1 expression in invasive ductal carcinoma was 19.6% (22/112), and the positive rate of PD-L1 expression of tumor-adjacent normal tissues was 3.5% (2/57), indicating that the positive rate of PD-L1 expression of cancerous tissues was significantly higher than that of in tumor-adjacent normal tissues (P < 0.05); the positive expression of PD-L1 was not related with the patients' age, menopause history, family history of breast cancer, tumor size, and location of the tumor (P > 0.05) while it was related with lymph node metastasis, the clinic staging, and histopathological grading (P < 0.05). Real-time PCR was applied to detect the mRNA expression of PD-L1 in breast-invasive ductal carcinoma with the mean ΔCt value of 7.79 ± 2.25. However, the mRNA expression of PD-L1 in normal tumor-adjacent tissues was of low expression with the mean ΔCt value of 12.37 ± 3.33. The difference was statistically significant (P< 0.05). Conclusion: The expression of PD-L1 in breast-invasive ductal carcinoma was significantly increased, and it was related to histological grading, clinical staging, and lymph node metastasis of breast cancer. PD-L1 may be a significant marker for the prognosis of breast cancer patients.
  3,254 306 -
Clinical study on thalidomide combined with cinobufagin to treat lung cancer cachexia
Mingzhi Xie, Xiaoju Chen, Shouming Qin, Yongjian Bao, Kunpeng Bu, Yang Lu
2018, 14(1):226-232
DOI:10.4103/0973-1482.188436  PMID:29516990
Objective: To discuss and assess the clinical value of treating lung cancer cachexia with thalidomide combined with cinobufagin.s Methods: A cohort of 54 patients, who were diagnosed with lung carcinoma, was randomly divided into two groups, a trial group and a control group, respectively. The trial group was given 150 mg/day thalidomide and 2700 mg/day cinobufagin; the control group only received 2,700 mg/day cinobufagin. The therapy lasted for 12 weeks, and the nutritional status, quality of life, survival, and side effects in patients in the two groups were recorded. Results: The nutritional status, quality of life, and survival of patients with lung cancer cachexia in the trial group were significantly improved compared to the control group. The trial group received 150 mg thalidomide, which by contrast reduced the incidence of side effect and increased tolerance. Conclusion: Using thalidomide combined with cinobufagin to treat patients with lung cancer cachexia will significantly improve their nutritional status and quality of life. This therapy is better than that using cinobufagin alone and is well tolerated.
  3,193 110 -
Circulating microRNA-21 as a prognostic, biological marker in cholangiocarcinoma
Chen-Hai Liu, Qiang Huang, Zhi-Yuan Jin, Fang Xie, Cheng-Lin Zhu, Zhen Liu, Chao Wang
2018, 14(1):220-225
DOI:10.4103/0973-1482.193125  PMID:29516989
Aims: The prognosis of cholangiocarcinoma (CCA) is generally poor because there is a lack of effective diagnostic tools including laboratory assessments and imageological examination. Therefore, a novel biological marker (biomarker) to effectively diagnose cancer is highly desirable in clinical. Previously, serum microRNAs as biomarkers of cancers have been reported. However, it was still unclear about the clinical significance of serum microRNA-21 (miR-21) expression levels for CCA. Materials and Methods: The serum samples were separately collected from fifty patients of CCA, 15 patients of hepatolithiasis, and 15 healthy volunteers; quantitative real-time polymerase chain reaction was used for measuring miR-21 expression level in serum. The clinicopathological data were recorded before patients discharged. Results: In the CCA serum, the expression level of miR-21 significantly upregulated (P < 0.05). With the tumor, node, and metastasis stage developed (Stage I vs. III and IV, P < 0.05), the serum miR-21 expression level increased, but there was no statistical difference between Stage I patients and hepatolithiasis patients or healthy control (P > 0.05 for both). Furthermore, the miR-21 level was significant difference between pre- and post-operative serum (P < 0.05) for the high miR-21 expression group. The serum miR-21 expression levels were defective in discriminating patients with CCA from healthy control subjects by receiver-operator curve analysis because the area under the curve (AUC) value was 0.871 which was not better than the conventional CCA markers—carbohydrate antigen 19-9 (AUC value = 0.96). However, in serum, high expression level miR-21 was significantly related to clinical stage, invasion depth, lymph vessel infiltration, metastasis status, differentiation status, whether to resection, and poor survival of CCA patients (P < 0.05 for all). Conclusions: This study suggested that serum miR-21 was a promising biomarker for diagnosing the late stage CCA and would have potential to be a useful prognostic biomarker of CCA.
  3,135 148 -
Dynamic changes of T-cell subsets and their relation with tumor recurrence after microwave ablation in patients with hepatocellular carcinoma
Yan Zhou, Xiaolin Xu, Jianmin Ding, Xiang Jing, Fengmei Wang, Yandong Wang, Peng Wang
2018, 14(1):40-45
DOI:10.4103/jcrt.JCRT_775_17  PMID:29516957
Aims: Thermal ablation can evoke an immune response, which may have effects on the prognosis of patients with hepatocellular carcinoma (HCC). Our aim is to investigate the changes of circulating T-cell subsets after microwave ablation (MWA) and to explore the risk factors of tumor recurrence in patients with hepatitis B virus (HBV)-related HCC. Methods: Thirty patients with HBV-related HCC were enrolled in this study. The blood samples were collected both before and after MWA (24 h, 72 h, and 1 month after MWA). The distributions of Th17 cells, regulatory Treg-cells, CD4+ T-cells, CD8+ T-cells, and CD3+ T-cells were determined by flow cytometer. The potential-related factors of tumor recurrence were analyzed by logistic regression. Results: The levels of circulating T-cell subsets, except for Th17 cells, were relatively stable after MWA. The frequency of Th17 cells increased from 3.98% ± 2.40% before treatment to 5.53% ±3.27% 24 h after treatment. Eight of 30 patients had a tumor recurrence. The results of logistic regression suggested that among 11 candidates, only the level of Th17 cells was the risk factor of tumor recurrence. To remove the interference from other factors, seven patients with tumor(s) >3 cm or alpha-fetoprotein >400 ng/mL were excluded in another parallel logistic regression. The results of such regression clearly demonstrated that circulating Th17 cells is indeed a related factor of tumor recurrence. Conclusions: Thermal ablation may evoke a transitional immune response by increasing the frequency of Th17 cells. Patients with high levels of baseline circulating Th17 cells, instead of the transient elevation of Th17 cells induced by MWA, are at the risk of tumor recurrence.
  3,209 71 -
Fast recovery of platelet production in NOD/SCID mice after transplantation with ex vivo expansion of megakaryocyte from cord blood CD34+ cells
Hailian Wang, Wei Ge, Yong Zhuang, Jinqiu Fu, Dong Li, Xiuli Ju
2018, 14(1):233-239
DOI:10.4103/0973-1482.193893  PMID:29516991
Background: Cord blood transplantation (CBT) can be a life-saving procedure in the treatment of a broad variety of disorders, including hematologic, immune, and genetic diseases. However, delayed platelet recovery hinders the application of CBT. Purpose: The aim of this study was to determine the optimal combination of cytokines to amplify megakaryocyte (Mk). Methods: CB CD34+ cells were obtained by immunomagnetic isolation and amplified under four different cytokine combinations. CD34+ cells of the group with thrombopoietin (TPO), stem cell factor (SCF), Flt-3 ligand (FL), and interleukin-6 (IL-6) were collected on days 0, 3, 7, 10, and 14. Immunophenotype was analyzed by flow cytometry (FCM). Polyploidic Mk cultured cells were collected on days 7 and 14 for colony-forming unit-Mk assay. The NOD/SCID mice were injected with expanded CD34+ cells, and the peripheral blood (PB) and bone marrow (BM) were tested on 3, 7, and 14 days. Results: The group with TPO, SCF, FL, and IL-6 reached the maximal total expansion fold and Mk population at day 7, which was slightly reduced later. After transplantation into NOD/SCID mice with expanded CD34+ cells, the human CD41+ cells were detected in mice PB on day 3 and in BM on day 7, then disappeared after 14 days. The expressing of activated platelet CD 42b+/CD62P+ increased gradually after transplantation. Conclusion: Platelets can recover rapidly in vivo by means of expanded CD34+ cells with various cytokines. In our system, a group of TPO, SCF, FL, and IL-6 represents the best cytokine combination for expansion of Mk progenitor cells from CB CD34+ cells.
  3,095 103 -
Intra-arterial chemotherapy as second-line treatment for advanced retinoblastoma: A 2-year single-center study in China
Jiang Hua, Shen Gang, Jiang Yizhou, Zhang Jing
2018, 14(1):106-110
DOI:10.4103/jcrt.JCRT_722_17  PMID:29516970
Purpose: To evaluate the effectiveness and complications of intra-arterial chemotherapy (IAC) for treating advanced refractory retinoblastoma (RB) in a large single-center cohort. Patients and Methods: Eighty-four eyes of 62 consecutive patients with advanced refractory RB who received IAC were included in the study during January 2013 and April 2015. These patients failed to respond adequately to a standard systemic chemotherapy (i.e., carboplatin, vincristine, and etoposide) with or without local therapy. Clinical outcomes and complications of these patients were reviewed. Results: All of these patients received IAC of melphalan combined with topotecan. The mean follow-up period was 14.2 months after final IAC (ranged from 3 to 28 months). The rate of eye preservation was 41.67% in Group D and 20.83% in Group E of this study. Short-term ocular adverse events included eyelid edema (n = 12, 14.29%), bulbar conjunctiva congestion (n = 25, 29.76%), and excessive tearing (n = 10, 11.90%). Long-term complications included vitreous hemorrhage (n = 7, 8%), subretinal hemorrhage (n = 9, 11%), retinal vasculopathy (n = 6, 7%), and ophthalmic artery spasm with reperfusion (n = 11, 13%). Fever was observed after IAC in 14 patients; transient vomiting was observed in 17 patients; there were 8 cases of transient myelosuppression. Conclusion: IAC can be an optional treatment to save eyes of Group D RB that failed in systemic chemotherapy and were destined for enucleation. However, it should be cautioned for Group E. Both the ocular and systemic toxicities of IAC were within tolerance.
  2,726 190 -
Mechanisms correlated with chemotherapy resistance in tongue cancers
Guanghong Han, Chengbi Xu, Dan Yu
2018, 14(1):1-5
DOI:10.4103/jcrt.JCRT_763_17  PMID:29516950
Tongue cancer is one of the most common and deadly types of head and neck cancer. The incidence of tongue cancer has been particularly high and remained been increasing in some countries. A main reason for poor prognosis and clinical outcome for tongue cancer was its resistance to chemotherapies, behind which the mechanisms have been not clear. In this review, we summarized literatures published in recent years and listed the proteins, biomacromolecules, and signaling pathways related to this drug resistance. We hoped that this summary could provide reference for researchers to develop new treatment strategies for tongue cancer.
  2,599 183 -
Clinical efficacy of endoscopic submucosal dissection in the treatment of early esophageal cancer and precancerous lesions
Yue Wu, Haihui Zhang, Bingxi Zhou, Shuangyin Han, Yanrui Zhang
2018, 14(1):52-56
DOI:10.4103/jcrt.JCRT_805_17  PMID:29516959
Objective: The objective of this study was to evaluate the clinical value of endoscopic submucosal dissection (ESD) in the treatment of early esophageal cancer and precancerous lesions. Materials and Methods: We retrospectively analyzed 58 patients who suffered from early esophageal and precancerous lesions and received ESD in the First Affiliated Hospital of Zhengzhou University from February 2012 to January 2016. The clinical efficacy and safety of ESD in treating the early esophageal cancer and precancerous lesions was evaluated by analyzing the operation successful rate, postoperative pathology, complications, and follow-up data of patients who received ESD. Results: For the 58 patients, ESD was successfully completed in 56 cases with a success rate of 96.6%, whereas ESD was unsuccessful in 2 cases. Invasive lesions were observed in the esophageal muscular layer of 1 patient. Consequently, surgery was terminated and this patient was transferred to thoracotomy surgical intervention involving radical resection of esophageal cancer. Esophageal perforation was observed during the annular incision of the esophageal mucosa in another patient with early-stage cancer. This perforation was occluded with an endoscopic titanium clip and surgery was terminated. Intraoperative blood loss in 56 patients was ranged from 10 to 90 mL with an average of 28.3 ± 17.2 mL. The diameter of ESD resection lesion was varied from 2 to 6.0 cm with an average of 3.4 ± 1.1 cm. For the 56 patients, enbloc resection was performed in 50 patients, with an enbloc resection rate of 89.3%. Complete lesion resection was performed in 49 patients, with a complete resection rate of 87.5%. For all patients, 36 manifested with severe atypical hyperplasia confirmed by postoperative pathology, 11 showed moderate atypical hyperplasia, 2 showed carcinoma insitu, and 7 presented with esophageal squamous cell carcinoma. In these 7 patients, 6 patients whose lesions limited to their mucosa were in the early stage of cancer while 1 patient with esophageal cancer involving the incisal edge, and the submucosal layer was subjected to additional surgical treatment. In addition, 1 patient experienced postoperative delayed hemorrhage (1.79%), 6 patients suffered from fever (10.71%), 33 patients reported substernal burning pain (58.93%) that mostly lasted 1–2 days before spontaneous remission, 1 patient was observed intraoperative perforation (1.79%), and 3 patients showed postoperative esophageal stenosis (5.36%), received multiple balloon dilatations, and consumed fluids afterward. Follow-up visits were facilitated for 49 patients for more than 1 year, and their median follow-up time was 36 months. Of these patients, recurrence was observed in 3 patients, with a recurrence rate of 6.1% (3/49). Of these 3 patients, 2 received surgical treatment and 1 underwent another endoscopic lesion resection. No patient died of esophageal cancer during follow-up. Conclusion: ESD was safe and reliable for the treatment of early esophageal cancer and precancerous lesions, and its recurrence and complication rates were low. Complete pathological information could be obtained after operation, which could be applied to assess patients' condition accurately.
  2,618 85 -
Meta-analysis of adjuvant chemotherapy versus surgery alone in T2aN0 stage IB non-small cell lung cancer
Tianxiang Zhang, Qiang Guo, Ye Zhang, Zhidong Liu, Shijie Zhou, Shaofa Xu
2018, 14(1):139-144
DOI:10.4103/jcrt.JCRT_862_17  PMID:29516976
Background: Although there is a strong evidence that adjuvant chemotherapy after surgery was effective in Stages II and IIIA patients involved nonsmall cell lung cancer (NSCLC), its eligibility in Stage IB disease has been unknown. Therefore, this meta-analysis was aimed to compare the effects of adjuvant chemotherapy versus surgery alone in patients with Stage IB NSCLC. Materials and Methods: We systematically searched for articles from their inclusion to July 2016. An article search was performed in PubMed, Embase, Medline, and Cochrane Library. Irrelevant literature was excluded with the preferred reporting items for systematic reviews and meta-analysis standards. Overall survival (OS) was the primary end-point, which was defined as the time from randomization until death from any cause; our second end-point was disease-free survival (DFS). All analyses were based on intention-to-treat. Results: Six randomized controlled trials with total of 2007 patients were included in present meta-analysis. The results were expressed as risk ratios (RR) with 95% confidence intervals (CIs). Compared to surgery alone, patients can benefit from adjuvant chemotherapy after surgery in terms of 5-year OS (RR = 1.19; 95% CI, 1.03–1.37; P = 0.02) and 5-year DFS (RR = 1.36; 95% CI, 1.13–1.63; P = 0.001). There was no significant difference in terms of benefit according to certain patient characteristics, such as age, gender, tumor histology, smoking history, and resection type. Conclusion: Adjuvant chemotherapy after surgery was beneficial to the patients with Stage IB disease in terms of OS and progression-free survival. Therefore, we recommend clinicians to take this treatment strategy into account for the patients with Stage IB NSCLC.
  2,609 89 -
In silico identification of potent small molecule inhibitors targeting epidermal growth factor receptor 1
Zheng Shi, Jie Chen, Xiaolan Guo, Lijia Cheng, Xiaoheng Guo, Tian Yu
2018, 14(1):18-23
DOI:10.4103/jcrt.JCRT_365_17  PMID:29516953
Background: The receptor tyrosine kinase of the epidermal growth factor receptor (EGFR, ErbB) family played an important role in multisignaling pathways, which controlled numerous biological activities including proliferation, differentiation, apoptosis, etc. EGFR abnormalities have been associated with a variety of human tumors, which was a well-characterized target for cancer treatment. It was known to all that drug repositioning has been considered as a useful tool to accelerate the process of drug development. Materials and Methods: Herein, a total of 1408 small molecule drugs approved by the Food and Drug Administration (FDA) were employed to identify potential EGFR inhibitors by a series of bioinformatics approaches, including virtual screening and molecular dynamics (MD) simulations. Results: According to the docking score, five small molecules were chosed for further MD simulations. Following the 5 ns MD simulations, ZINC03830276 (Benzonatate) were finally recognized as “new use” of FDA-approved EGFR-targeting drug. Conclusions: Our findings suggested that the small molecule ZINC03830276 (Benzonatate) could be a promising EGFR inhibitor candidate and may also provide new ideas for designing more potent EGFR inhibitors for the future study.
  2,493 197 -
Combining differential expression and differential coexpression analysis identifies optimal gene and gene set in cervical cancer
Sheng-Quan Fang, Min Gao, Shi-Lu Xiong, Hai-Yan Chen, Shan-Shan Hu, Hong-Bing Cai
2018, 14(1):201-207
DOI:10.4103/0973-1482.199787  PMID:29516986
Objective: The objective of this study is to investigate the optimal gene and functional-related gene set in cervical cancer through combing the differential expression (DE) and differential coexpression (DC) analysis. Materials and Methods: To achieve this, we first measured expression data of cervical cancer by incorporating DE and DC effects utilizing absolute t-value in t-statistic and Z-test, respectively. Then, we selected the optimal threshold pair to determine both high DE and high DC (HDE_HDC) partition on the basis of Chi-square maximization, and the best threshold pair divided all genes into four parts, including HDE_HDC, high DE and low DC (HDE_LDC), low DE and high DC (LDE_HDC), and low DE and low DC (LDE_LDC). Using the known functional gene sets, functional relevance of partition genes was explored to determine the best-associated gene set based on the functional information (FI) conception. Results: Under the optimal threshold pair of 3.629 and 1.108 for DE and DC, respectively genes were divided into four partitions: HDE_HDC (311 genes), HDE_LDC (2072 genes), LDE_HDC (seventy genes), and LDE_LDC (1623 genes). Meanwhile, the gene set epidermis development was the best-associated gene set with the largest △G* = 10.496. Among the genes of epidermis development, zinc finger protein 135 (ZNF135) attained highest minimum FI gain of 41.226. Conclusion: The combination of DE and DC analysis showed higher mean FI relative to individual DE and DC analyses. We successfully exhibited the optimal gene set epidermis development and gene ZNF135, which might be crucial for the prevention and treatment of cervical cancer.
  2,466 94 -
Expert consensus statement on computed tomography-guided 125I radioactive seeds permanent interstitial brachytherapy
Junjie Wang, Shude Chai, Guangjun Zheng, Yuliang Jiang, Zhe Ji, Fuxin Guo, Hongqing Zhuang, Kaixian Zhang
2018, 14(1):12-17
DOI:10.4103/jcrt.JCRT_888_17  PMID:29516952
The aim of this study is to develop expert consensus statement for recommendations of patient selection criteria, prescription dose, and procedure of computed tomography (CT)-guided 125I radioactive seeds permanent interstitial brachytherapy. Members of Chinese medical association radiation oncology branch, Chinese medical association radiation therapy professional committee, Chinese cancer society minimally invasive surgery branch seed therapy group, Chinese geriatric cancer society minimally invasive surgery branch, Beijing medical association radiation oncology professional committee, China northern radioactive seeds brachytherapy group formed a committee, which consists of physician members who come from the department of radiation oncology, surgery, intervention, internal medicine, ultrasound, and nuclear medicine. The leader of the group organized experts to write the first draft based on clinical experience and literature review and then sent the draft to the commissioner for consultation, finally reached a consensus. Guidelines for patient selection criteria, prescription dose of 125I seed for different kinds of carcinomas, activity of per seed, and workflow of CT-guided permanent interstitial radioactive seed implantation (RSI) are presented in this study. The procedure of CT-guided RSI comprised eight steps: indication selection, preoperative preparation, preoperative CT simulation and position setup, preplan, intraoperative needle insertion, RSI, postoperative dosimetric evaluation, and follow-up. Patient selection criteria are developed. Guidelines for prescription dose of 125I seed for different kinds of carcinomas, activity of per seed, and workflow of CT-guided permanent interstitial RSI are provided.
  2,414 65 -
Increasing rates of Acinetobacter baumannii infection and resistance in an oncology department
Li Fan, Zhe Wang, Qiang Wang, Zhijian Xiong, Ying Xu, Dandan Li, Shiwen Zhou
2018, 14(1):68-71
DOI:10.4103/jcrt.JCRT_737_17  PMID:29516962
Objective: Acinetobacter baumannii is an opportunistic pathogen found in immunocompromised patients, especially cancer patients. This study was to investigate the clinical characteristics of cancer patients and the antimicrobial resistance of A.baumannii isolates. Materials and Methods: Clinical isolates were collected from the oncology department of a general teaching hospital, and the clinical and demographic information of patients was obtained from the hospital's information system. Antimicrobial susceptibility was examined using the agar dilution method. Carbapenemase-encoding genes were amplified by polymerase chain reaction, and sequence types were determined by multilocus sequence typing. Results: The isolation rate of A.baumannii increased annually in the oncology department. Multivariate analysis showed that only prior antibiotic use was an independent risk factor for A.baumannii infection. The use of antibiotics in A.baumannii-infected patients was significantly more frequent than in non-A.baumannii-infected patients. A.baumannii isolates were highly resistant to most tested antibiotics. The IMP-4 and VIM-2 genes were present in 6 and 2 isolates, respectively. Sixty isolates had 12 genotypes, and ST208 was the most common genotype. Conclusion: Our results suggest that the use of antibiotics and hospital environmental pollution may be the main causes of A. baumannii infection.
  2,277 188 -
Apatinib for advanced nonsmall-cell lung cancer: A retrospective case series analysis
Chengxi Yang, Wen Feng, Di Wu
2018, 14(1):159-162
DOI:10.4103/jcrt.JCRT_258_17  PMID:29516980
Objectives: Apatinib, a tyrosine kinase inhibitor which selectively inhibits vascular endothelial growth factor receptor-2, has been shown to be beneficial to patients with a variety of cancers, including advanced nonsmall-cell lung cancer (NSCLC). Thus, this study was aimed to retrospectively assess the efficacy and safety of apatinib in patients with advanced/metastatic NSCLC who failed more than two lines of treatment. Methods: Twenty-three NSCLC patients were involved in this study, who received oral apatinib at a daily dose of 250/500/750 mg, with the progression after the failure of second-line therapy. Treatment was continued until disease progression. The tumor assessments were determined according to the Response Evaluation Criteria in Solid Tumors (version 1.1). Safety was evaluated with adverse reactions and toxicities based on the Common Terminology Criteria for Adverse Events (version 4.0). Response and safety for the included patients were evaluated every 8 weeks. Results: In this study, 23 NSCLC patients were followed from January 2015 to December 2016. Available image efficacy was obtained in 22 patients, including 4 identified as partial responses, 17 stable disease, and 1 progressive disease; no complete responses was observed. The objective response rate was 18.2%, and the disease control rate was 95.5%. Median progression free survival and overall survival for apatinib were 203 days (95% CI, 120–269) and 227 days (95% CI, 146–294), respectively. The most frequent treatment-related adverse events were hypertension, gastrointestinal reactions, and hand-foot skin reaction. Conclusion: Apatinib exhibited modest activity and acceptable toxicity for advanced NSCLC after the failure of chemotherapy or other targeted therapy.
  2,371 66 -
Efficacy and safety of epirubicin applied in transcatheter arterial chemoembolization for hepatocellular carcinoma: A meta-analysis
Zhibin Bai, Yonglin Qin, Guangyu Zhu, Guofeng Zhao, Gang Deng, Jinhe Guo, Shicheng He
2018, 14(1):133-138
DOI:10.4103/jcrt.JCRT_1261_16  PMID:29516975
Objectives: This study was aimed to evaluate the efficacy and safety of epirubicin applied in transcatheter arterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC). Materials and Methods: Studies were searched in Embase, PubMed, and Springer until August 10, 2016. All the studies were screened with inclusion and exclusion criteria. The quality assessment of the eligible studies was performed with the Newcastle-Ottawa Scale and the Jadad Scale. Response rate, recurrence, mortality, and thrombocytopenia were evaluated with risk ratios (RRs) with 95% confidence intervals (CIs). The heterogeneity and publication bias were assessed. Results: Ten eligible studies were included with a total of 993 objects. The data were extracted and summarized. The overall results were calculated including response rate (RR = 0.98, 95% CI: 0.83–1.15), recurrence (RR = 0.75, 95% CI: 0.58–0.96), mortality (RR = 0.71, 95% CI: 0.39–1.28), and thrombocytopenia (RR = 0.42, 95% CI: 0.09–1.93), without significant heterogeneity. There was a significant heterogeneity for mortality; thus, the random effects model was used. No publication bias was observed in this study. Conclusions: The results of meta-analysis indicated that epirubicin applied in TACE has an obvious efficacy for the treatment of HCC, with significantly decreased recurrence while without superiority of safety.
  2,335 79 -
The application value of capsule endoscopy in diagnosing small intestinal carcinoma
Xiaohuan Li, Yongxian Gui, Feifei Shen, Chun Ling Zhao, Yi Yang, Wenliang Han
2018, 14(1):57-60
DOI:10.4103/jcrt.JCRT_584_17  PMID:29516960
Objective: The aim of this study was to explore the clinical value of capsule endoscopy in the diagnosis of small intestine neoplastic lesions. Materials and Methods: A retrospective analysis was conducted on the clinical data of 108 patients who underwent capsule endoscopic examination in the Endoscopy Center of Xinxiang Central Hospital from February 2010 to January 2014. The characteristics of different small bowel diseases were observed, and the prevalence rates of different small bowel lesions were calculated. Results: Of the included 108 patients who received capsule endoscopic examination, 74 cases showed lesions, with a detection rate of 68.52%. Of these 74 patients, 56 cases (51.85%) suffered from small bowel diseases and 18 cases (16.67%) were manifested with other gastrointestinal lesions. Moreover, obvious lesion was not observed in 34 cases (31.48%). Among the patients with lesions, we observed seven cases of submucosal tumor in small intestines, five cases of small intestinal carcinoma, two cases of small intestinal polyps, two cases of small intestinal roundworm, eight cases of small intestine ulcer, one case of Crohn's disease, 18 cases of enteritis, two cases of small intestine diverticula, four cases of small intestine hemangioma, one case of small intestine vascular malformation, one case of intestinal lymphangiectasia, one case of small intestine compression, two cases of small intestine hemorrhage, and two cases of small intestinal lipoma. Among the patients who showed other gastrointestinal lesions, we observed one case of esophageal diverticula, three cases of gastric erosion, six cases of superficial gastritis, four cases of gastric ulcer, one case of pyloric ulcer, one case of colonic polyps, and two cases of colon tumor. Conclusion: Capsule endoscopy demonstrated a high diagnostic value for various small bowel diseases, including both tumor and inflammatory lesions. Given its simplicity, safety, and reliability, capsule endoscopy was an important examination tool for the diagnosis of small bowel diseases.
  2,315 86 -
Effectiveness and the strategy to treat the side effects of sorafenib administration after transarterial chemoembolization in advanced hepatocellular carcinoma patients
Kai Zhang, Xiangyang Sun, Fubo Xie, Wencheng Jian, Caixia Li
2018, 14(1):196-200
DOI:10.4103/jcrt.JCRT_1175_16  PMID:29516985
Objective: The aim is to study the effectiveness and side effects of sorafenib administration after transarterial chemoembolization (TACE) in advanced hepatocellular carcinoma (HCC) patients. To evaluate the safety of the combination of sorafenib and TACE to treat HCC. Materials and Methods: A total of 36 unresectable HCC patients were enrolled. After TACE, administration of sorafenib was carried out. Follow-up was taken for every 4 weeks. Liver and renal function and alpha-fetoprotein were tested. Modified response evaluation criteria in solid tumors (mRECIST) was used to evaluate the clinical effect. The side effects were recorded. Results: The median overall survival (mOS) and the median time to progress were 12.5 and 8 months with the range from 6 to 32 and 4–30 months, respectively. The mOS of patients with single tumor was 18 months while that of multiple tumors in liver was 10 months (χ2 = 4.1639, P = 0.0413). According to mRECIST, there were no complete response patients, 2 partial response patients, 10 stable disease patients, and 24 progressive disease patients. Response rate was 5.5% (2/36). Disease control rate (DCR) was 33% (12/36). The main adverse events were hand-foot skin reaction and diarrhea. The frequency of Grade II, III hand-foot-skin reaction was 39%. After treatment, it decreased to 5.6%. Forty-four percentage patients suffered from diarrhea of Grades I and II. After treatment, it decreased to 28%. The mean interval of TACE was 45 days before combination therapy and 120 days after combination therapy. Conclusion: Administration of sorafenib after TACE could prolong overall survival of advanced HCC patients, keep the stable status longer and extend the interval between TACEs. The side effects are usually treatable, which proves the safety of this combination.
  2,262 93 -
Role of inferior phrenic artery in the interventional treatment of lung metastases tumor: A report of 11 cases
Lin-Zhong Zhu, Ren-Jie Yang, Xu Zhu
2018, 14(1):61-67
DOI:10.4103/jcrt.JCRT_742_17  PMID:29516961
Background: Lung metastases have been very common in advanced cancer, which were observed in 30%–40% of cancer cases. Transarterial chemoembolization (TACE) is one of the choice for treating lung cancer. In our center, 119 cases of lung metastases were treated with TACE, and we found that inferior phrenic artery (IPA) played an important role in this procedure. Materials and Methods: From June 2011 to June 2015, 119 cases with malignant lung metastases received TACE procedure in our center. The TACE procedure was performed through bronchial artery (BA) and collateral arteries. In these 11 cases, we found that part of metastatic lesions was supplied by the IPA. Angiography and embolization technique, successful rate, safety and clinical adverse events, and survival were retrospectively studies. Results: The lung metastases were mainly supplied by BA, thoracic artery, and intercostal artery. In 11 cases, the IPA was involved in the blood supply of lung metastases (9.2%). Right IPA (RIPA), left IPA (LIPA), and both LIPA and RIPA were involved in blood supply of 6, 3, and 2 cases of lung metastases, respectively, especially for the lesions located in the lower lobe of the lung. All lesions of the 11 cases were successfully embolized; no diaphragmatic dysfunction and spinal cord injury or other serious complications were observed. The average survival time was 14.7 months since the diagnosis of lung metastases. Conclusion: The IPA was an important feeding artery for lung metastases, especially for lesions in the lower lung lobe. It should be searched as much as possible for achieving complete embolization of metastases.
  2,251 95 -
Research progress on the regulation of tumor initiation and development by the forkhead box Q1 gene
Hui Tang, Jinjin Zhang, Qiang Guo
2018, 14(1):6-11
DOI:10.4103/jcrt.JCRT_701_17  PMID:29516951
Transcription factor forkhead box Q1 (FOXQ1), a member of the forkhead box superfamily, has been involved in various biological processes and plays important roles in tumor initiation and progression. The FOXQ1 protein activated transcription of target genes directly by binding to the promoters of target genes or indirectly by interacting with other transcription factors. FOXQ1 affected the initiation, progression, invasion, and metastasis of many kinds of tumor by promoting the epithelial–mesenchymal transition, regulating cell cycle, promoting cell proliferation, regulating senescence-associated inflammation, and activating many cellular signal pathways. In this review, we have focused on the possible molecular mechanisms for FOXQ1 gene in tumor initiation and progression. Medline literature review related to this subject was performed by the electronically retrieval with the keywords “forkhead box Q1” and “tumor” on PubMed for including previous publications, and then, it further reviewed reference articles on the biological function of FOXQ1 gene and target genes transcription directly regulated by FOXQ1.
  2,277 60 -
Clinical efficacy of endovascular radiofrequency ablation in the treatment of portal vein tumor thrombus of primary hepatocellular carcinoma
Zhong-Wu Chen, Zheng-Yu Lin, Yi-Ping Chen, Jian Chen, Jin Chen
2018, 14(1):145-149
DOI:10.4103/jcrt.JCRT_784_17  PMID:29516977
Objective: The objective of this study is to investigate the clinical efficacy and safety of Habib™ VesOpen, a new intravascular radiofrequency ablation (RFA) catheter in percutaneous puncture of portal vein tumor thrombus (PVTT) in patients with primary hepatocellular carcinoma. Materials and Methods: Collected data of patients with primary hepatocellular carcinoma with portal vein trunk or main branch who were treated by the RFA of portal vein tumor ablation with Habib™ VesOpen, a new intravascular RFA catheter. The postoperative success rate, complications, liver and kidney function, alpha-fetoprotein (AFP), portal vein patency, and tumor thrombus were analyzed, and the survival status of patients was analyzed by Kaplan–Meier survival analysis, and the COX proportional hazards regression model was used to analyze the factors influencing the clinical prognosis of patients. Results: All the 44 patients were operated successfully without complications such as vascular perforation, infection, liver abscess, and intraperitoneal hemorrhage. The liver function index, alanine aminotransferase, aspartate aminotransferase, and serum albumin (ALB) were significantly different before and after surgery at 2 weeks and 4 weeks after operation (P < 0.05); AFP before and after surgery, the difference was statistically significant (P < 0.05). Doppler ultrasonography showed blood flow through the original portal vein after 4 weeks of surgery; enhanced computed tomography examination or magnetic resonance examination on the abdomen suggested patients with varying degrees of tumor thrombosis or disappearance after 8 weeks of surgery. The overall survival time was 284.72 ± 27.20 days (95% confidence interval: 231.42–338.02 days). The cumulative survival rates of 90, 180, and 360 days were 97.7%, 72.7%, and 17.2%, respectively. Cox multivariate regression analysis showed that tumor size and the size of ALB before RFA treatment was an independent factor in the prognosis of hepatocellular carcinoma with PVTT ablation (P < 0.05). Conclusions: The use of Habib™ VesOpen intravascular RFA catheter percutaneous puncture of the portal vein tumor RFA has positive clinical effect which is safe and reliable, expected to become one of the effective means in treatment of primary hepatocellular carcinoma with PVTT.
  2,231 80 -
Correlation between epidermal growth factor receptor mutation and histologic subtypes or characteristics of computed tomography findings in patients with resected pulmonary adenocarcinoma
Danyun Wang, Ning Yan, Xudong Yang, Yuan Ge, Dedong Xu, Guangyuan Shao, Zhongmin Peng
2018, 14(1):240-244
DOI:10.4103/0973-1482.183178  PMID:29516992
Objective: To investigate the correlation between epidermal growth factor receptor (EGFR) mutation and the histologic subtypes features or computed tomography (CT) findings in patients with resected pulmonary adenocarcinoma. Materials and Methods: We retrospectively reviewed 153 patients underwent surgical resected pulmonary adenocarcinoma. EGFR mutations were detected using the amplification refractory mutation system. Histologic subtype was classified according to the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society pulmonary adenocarcinoma classification. Characteristics of CT in the tumor were retrospectively analyzed, and compared to mutation-negative cohort. Results: EGFR mutations were found in 67 (43.79%) cases. The prevalent histologic subtypes of invasive adenocarcinoma were acinar predominant adenocarcinoma (33.99%), papillary predominant adenocarcinoma (24.18%), micropapillary predominant adenocarcinoma (MPA; 18.95%), solid predominant adenocarcinoma (11.76%), and lepidic predominant adenocarcinoma (LPA; 11.11%). EGFR mutations were correlated with the MPA and LPA subtypes (P = 0.009 and P = 0.018) and was correlated with the air bronchograms (P = 0.008). EGFR mutations were independently associated with other CT characteristics including ground-glass opacity/tumor ratio (P = 0.054). Conclusions: Correlation exists between EGFR mutations and histologic subtypes of invasive adenocarcinoma or air bronchograms on CT images, which could use to predict EGFR mutation status in patients with pulmonary adenocarcinoma.
  2,201 105 -
Enhanced antitumor effects of radiotherapy combined local nimustine delivery rendezvousing with oral temozolomide chemotherapy in glioblastoma patients
Dong-Yi Yang, Xing-Yao Bu, Zhi-Long Zhou, Zhao-Yue Yan, Chun-Xiao Ma, Ming-Qi Qu, Yue-Wu Zhao, Ling-Fei Kong, Yao-Wei Wang, Jian-Chao Luo
2018, 14(1):78-83
DOI:10.4103/jcrt.JCRT_844_17  PMID:29516964
Background: Glioblastoma (GBM) is one of the worst cancers with bad prognosis despite systemic chemotherapy and radiotherapy after surgery. Methods: In this study, 71 patients with GBM were enrolled and randomly assigned to two groups: Receiving radiotherapy with concomitant and adjuvant temozolomide (TMZ) (TMZ, standard therapy) after surgery, or receiving radiotherapy with concomitant and adjuvant local delivery of nimustine (ACNU) rendezvousing with oral TMZ (rendezvous therapy). In the follow-up of all patients and the progression-free survival (PFS), overall survival (OS), Karnofsky performance score (KPS) and toxicities were recorded. Results: For the whole cohort, the median OS was 18.0 months, and the median PFS was 7.8 months. A significantly longer OS was observed in patients received rendezvous therapy than those who receiving standard therapy (18.5 months vs. 16.0 months; P = 0.014), as well as PFS (8.8 months vs. 7.0 months; P = 0.008). The KPS ≥70 rates were 81.8%, 40.9%, 20.5% in 1, 2, and 3 years for the rendezvous therapy group, significantly superior to standard therapy group. The most common toxicities were tolerable gastrointestinal reaction, liver dysfunction, and hematological toxicities, which were relieved with symptomatic treatment. Grade 3 or 4 toxicity was documented in 8 (18.3%) patients in rendezvous therapy group, while it was observed in 6 (22.2%) patients in standard therapy group during whole treatment process. Conclusions: Compared to standard therapy, the antitumor effects of rendezvous therapy were more effective in GBM patients without increasing the toxicities.
  1,995 66 -
Three-dimensional-printed individual template-guided 125I seed implantation for the cervical lymph node metastasis: A dosimetric and security study
Yansong Liang, Zeyang Wang, Hongtao Zhang, Zhen Gao, Jinxin Zhao, Aixia Sui, Jing Zhao, Zezhou Liu, Juan Wang
2018, 14(1):30-35
DOI:10.4103/jcrt.JCRT_619_17  PMID:29516955
Objective: The objective of this study is to evaluate the dosimetric accuracy and pathway safety of the three-dimensional (3D)-printed individual template-guided 125I seed implantation for the treatment of cervical lymph node metastasis. Materials and Methods: A total of 15 consecutive patients with cervical lymph node metastasis were enrolled during September 2015–July 2017 (12 patients had a history of external beam radiotherapy, with the mean dose of 63 Gy), who undergone radioactive seed implantation guided by the 3D-printed individual template. The preplan was completed based on contrast-enhanced computed tomography images, and then, the 3D-printed individual template was printed according to the preplan. After the operation, the real-time dose verification was completed: the D90 was ranged from 60 to 113 Gy with median of 93 Gy and the number of seeds was ranged from 21 to 76 with median of 53. To observe the intraoperative complications and postoperative complications in 3 days, we collected and compared the deviation of the number of seeds, target volume, and dosimetric parameters (D90, V90, V100, and V150) between preplan and postoperative plan. Result: Intraoperatively, each template was observed to exactly fit and lock on the lamina, and the operation was successfully completed. No intraoperative complications and postoperative complications were observed in 3 days. There was no significant difference in P values between the two groups for all the parameters (P > 0.05). Conclusion: The 3D-printed individual template-guided 125I seed implantation for the cervical lymph node metastasis has not only reduced the dosimetric differences between pre- and postplan but also lowered the difficulty of puncture, indicating that it was a safe and accurate guidance approach.
  1,998 58 -
Multislice spiral computed tomography in the differential diagnosis of ground-glass opacity
Jianqiang Yu, Shiqiang Zhu, Zufeng Ge, Beilei Shen, Yazhi Shen, Chaojun Wang, Xiong Fang, Jian Dai
2018, 14(1):128-132
DOI:10.4103/jcrt.JCRT_660_17  PMID:29516974
Objective: This study aimed to evaluate the value of multislice spiral computed tomography (CT) in differential diagnosis of benign or malignant pulmonary ground-glass opacity (GGO). Materials and Methods: A total of 68 patients with pulmonary GGO who received surgical treatment in our hospital from January 2014 to January 2017 were retrospectively analyzed. Postoperative pathology showed that there were 22 cases of benign GGO and 47 cases of malignant GGO (adenocarcinoma). The diameter, maximum CT value, and mean CT value of benign and malignant GGOs were determined and compared. The clinical value of identifying benign or malignant GGOs with these indices was analyzed through receiver operating characteristic (ROC) curve. Results: The mean GGO diameter, maximum CT value, and mean CT value in the benign group were significantly lower than those of in the malignant group, and the difference was statistically significant (P < 0.05). The diameter, maximum CT value, and mean CT value of GGO were applied to identify benign or malignant GGO: sensitivity was 60.87%, 69.57%, and 63.04%; and the specificity was 63.64%, 63.64%, and 81.82%; the cutoff values were 13.89 (mm), 26.18 (Hu), and 24.61 (Hu); and areas under the ROC curves were 0.66, 0.71, and 0.69, respectively. Conclusion: The possibility of malignancy has been significantly increased for GGOs with a large diameter, high mean CT value and maximum CT value. Surgical treatment should be performed for this type of GGOs.
  1,963 77 -
Risk analysis on infection caused by peripherally inserted central catheter for bone tumor patients
Kui He, Yongxian Wan, Shengping Xian
2018, 14(1):90-93
DOI:10.4103/jcrt.JCRT_777_17  PMID:29516966
Objective: The aim of this study is to explore the related factors affecting infection risk caused by peripherally inserted central catheter (PICC) for bone tumor patients. Method: A retrospective analysis was performed for 223 bone tumor patients who received PICC and were admitted to our hospital from 2004 to 2017. A total of 18 cases (infection group) with PICC catheter-related infections and 205 cases without infection (noninfection group) were studied. First, factor analysis of variance or Chi-square test was applied to compare independent risk factors for PICC catheter-related infections, between bone tumor patients with catheter-related infections and those without catheter-related infections. Results: This retrospective analysis involved a total of 18 patients with PICC infections and 205 patients without infections. The infection rate was 8.07%. Factor analysis of variance showed that many factors were related to PICC catheter-related infections, including experience of operator (χ2 = 3.48, P < 0.05), catheter retention time (χ2 = 7.478, P < 0.05), receiving chemotherapy or not (χ2 = 2.43, P < 0.05), Karnofsky Performance Scale scores (χ2 = 2.19, P < 0.05) and the frequency of replacing pad pasting on the point of puncture (χ2 = 2.23). Logistic regression analysis showed that PICC catheter retention time (odds ratio [OR] = 4.21, P < 0.05) and operator experience (OR = 2.80, P < 0.05) were independent factors affected PICC catheter-related infections. Conclusion: Catheter-related infections were related to experience of PICC operatorand length of catheter retention time.
  1,955 81 -
Preablation neutrophil-to-lymphocyte ratio as an independent prognostic factor in locally advanced hepatocellular carcinoma patients following radiofrequency ablation
Wei Tan, Wenkui Sun, Xia Li, Lei Zhao, Chun Wang, Aihua Zang, Xiangchong Kong
2018, 14(1):84-89
DOI:10.4103/jcrt.JCRT_835_17  PMID:29516965
Background and Aims: Neutrophil-to-lymphocyte ratio (NLR), as an inflammation-based marker, plays critical roles in hepatocellular carcinoma (HCC). This study was aimed to investigate the prognostic value of preablation NLR in locally advanced HCC patients following radiofrequency ablation (RFA) and to determine an optimal cutoff value for NLR. Materials and Methods: From September 2008 to May 2017, 402 locally advanced HCC patients treated with RFA were retrospectively evaluated. Several prognostic factors including NLR was assessed with univariate and multivariate analysis. The optimal cutoff value of NLR was determined with a maximally selected log-rank test. Other prognostic factors influenced the overall survival (OS) were also evaluated. Results: Based on the univariate analysis of 16 prognostic factors for OS, the type of hepatitis, a-fetoprotein (AFP), NLR, alanine aminotransferase, aspartate aminotransferase, and serum albumin were identified as independent prognostic factors; and based on multivariate analysis of 6 prognostic factors for OS, AFP, and NLR were identified (P < 0.05). A NLR of 2.2 was determined to be the optimal cutoff value (area under the curve = 0.855, P < 0.001). In a comparison between the high NLR group and the low NLR group, there was a difference of 7 months in the median OS (24 vs. 31 months, P < 0.001). Conclusions: Preablation NLR was a valuable predictor in locally advanced HCC patients treated with RFA. NLR ≥2.2 indicated a poor prognosis. These findings suggested that preablation NLR may be a convenient, easily-obtained, low cost, and reliable biomarker with prognostic potential for HCC patients.
  1,950 73 -
Heparan sulfate D-glucosamine 3-O-sulfotransferase 3B1 is a novel regulator of transforming growth factor-beta-mediated epithelial-to-mesenchymal transition and regulated by miR-218 in nonsmall cell lung cancer
Zengli Zhang, Hanyi Jiang, Yongsheng Wang, Minhua Shi
2018, 14(1):24-29
DOI:10.4103/jcrt.JCRT_659_17  PMID:29516954
Background: Due to high metastasis and recurrence rate. Recent studies indicated that epithelial-to-mesenchymal transition (EMT) was involved in the progression and metastasis in cancer. Some reports also indicate that HS3ST3B1 played a role in angiogenesis and the proliferation of cancer cells. In this study, we aim to investigate its role in non-small cell lung cancer (NSCLC) . Materials and Methods: All cell lines were purchased from ATCC and cultured in our central lab. RT-PCR was performed to study the expession of HS3ST3B1 in tumors and matched normal tissues. Western-blot was used to investigate the expession of HS3ST3B1 in cell lines. We also used luciferase report system to confirm the regulation of HS3ST3B1 by miR-218 in cells. Results: In this study, we found that HS3ST3B1 was significantly upregulated in NSCLC tissues compared with matched normal tissues (P = 0.02). Its expression was also up-regulated in mesenchymal phenotype of NSCLC cell lines compared with epithelial phenotype (P < 0.05). When TGF-β was applied to induce the epithelial phenotype to mesenchymal phenotype, it was upregulated compared with previous epithelial cell lines. When HS3ST3B1 was knocked down by specific small interfering RNA in the mesenchymal phenotype, mesenchymal phenotype was transformed to epithelial phenotype. Moreover, we also found that it could be targeted by miR-218 in NSCLC. Conclusion: These findings indicate that HS3ST3B1 is a novel regulator of TGF-beta-mediated EMT and is regulated by miR-218 in NSCLC.
  1,954 56 -
miR-150 contributes to the radioresistance in nasopharyngeal carcinoma cells by targeting glycogen synthase kinase-3β
Yuanjian Huang, Duxun Tan, Juan Xiao, Qiaoyun Li, Xianfeng Zhang, Zhiqiang Luo
2018, 14(1):111-118
DOI:10.4103/jcrt.JCRT_682_17  PMID:29516971
Introduction: Radiotherapy has been the primary treatment for nasopharyngeal carcinoma (NPC), but the NPC radiocurability was severely limited with the radioresistance. The research suggested the important role of miRNAs in cancer therapeutic response. Materials and Methods: A radioresistant NPC cell line CNE-2R, we exposed CNE-2 cells to a range of radiation doses. Levels of miR-150 were measured by quantitative reverse-transcriptase polymerase chain reaction in CNE-2R and CNE-2 cells. Results: In this study, a cell line CNE-2R derived from parental CNE-2 was established via being exposed to stepwise escalated radiation dose. The expression of miR-150 was upregulated in CNE-2R cells. The radioresistance of CNE-2R cells was reversed after inhibiting miR-150 with specific inhibitor, while the radioresistance of CNE-2 cells was enhanced after the overexpression of miR-150. MiR-150b elicited these responses by directly targeting GSK3β. Moreover, GSK3β protein expression was downregulated in CNE-2R cells and restored GSK3β expression increased radiosensitivity of CNE-2R cells. Importantly, the negative correlation between miR-150 expression and GSK3β protein level was confirmed in the NPC tissues. High miR-150 expression and low GSK3β protein level were associated with poor prognosis in NPC patients. Conclusion: Our findings suggested that miR-150-GSK3β axis may be a novel candidate for developing rational therapeutic strategies for NPC treatment.
  1,937 70 -
Effects of the Akt inhibitor Src-homology 5 on proliferation and apoptosis of the laryngeal squamous cell carcinoma
Tao Jia, Qing-Qing Cao, Xue-Mei Chen, Feng-Lei Xu
2018, 14(1):208-212
DOI:10.4103/0973-1482.199454  PMID:29516987
Objective: The aim of this study was to investigate the effect of the Akt inhibitor Src-homology 5 (SH-5) on the proliferation and apoptosis of laryngeal squamous cell carcinoma cells (LSCC; Hep-2 cells) and to elucidate the possible mechanisms of such effects. Materials and Methods: Hep-2 cells were treated with different concentrations of the Akt inhibitor SH-5. The inhibitory effect of SH-5 on cell proliferation was examined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, whereas apoptosis was detected by flow cytometric based on Annexin V/propidium iodide (PI) staining. In addition, the expression level of Akt protein was evaluated by Western blot analysis. Results: MTT assay results revealed that SH-5 inhibited the proliferation of Hep-2 cells, with its greatest effect being observed at 2 μM. Apoptosis of Hep-2 cells increased following treatment with SH-5. Treatment of Hep-2 cells with SH-5 decreased the expression of Akt, and this effect was statistically significantly when compared with that in controls (P < 0.05). Conclusion: SH-5 inhibited proliferation and induced apoptosis in the LSCC cell line Hep-2. These effects may be caused by inhibition of the phosphoinositide 3-kinase-Akt signaling pathway. We believe that our data will provide useful insights into LSCC target treatment and future research.
  1,802 72 -
The role of NRAGE subcellular location and epithelial–mesenchymal transition on radiation resistance of esophageal carcinoma cell
Xiaojing Chang, Xiaoying Xue, Yafang Zhang, Ge Zhang, Huandi Zhou, Yanling Yang, Yuge Ran, Zhiqing Xiao, Xiaohui Ge, Huizhi Liu
2018, 14(1):46-51
DOI:10.4103/jcrt.JCRT_687_17  PMID:29516958
Background: Neurotrophin receptor-interacting MAGE homolog (NRAGE) has been considered as a tumor suppressor. In the previous study, we established human esophageal carcinoma resistance cell line TE13R120 and found the difference of NRAGE expression between TE13 and TE13R120 cells by gene microarray. Herein, we further discuss the possible molecular mechanism of NRAGE on participating the radiation sensitivity of esophageal carcinoma cells. Materials and Methods: We used colony formation assay to measure the surviving fraction and relevant radiobiological parameters. NRAGE expression was estimated by immunofluorescence and Western blot. Tumor growth factor-β (TGF-β) was used for inducing epithelial–mesenchymal transition (EMT) in TE13 cells to detect the relationship between NRAGE and EMT; the capacity of cell migration was also assessed by wound healing assay. Results: TE13R120 cells were showed significantly radioresistance compared with TE13. The D0, Dq, and N value of TE13R120 were all higher than those of TE13 (2.499, 1.991, and 2.219 vs. 2.242, 0.854, and 1.645), as well as SF2 (0.734 vs. 0.538). Results of immunofluorescences showed that NRAGE was mainly expressed in the nucleus of TE13R120 cells, but in TE13 cells, it was mainly in cytoplasm. In addition, EMT phenotype was observed in TE13R120 cells and TGF-β-induced EMT in TE13 cells, E-cadherin expression was decreased, but vimentin was upregulated. Furthermore, TE13 cells have a rising tendency in NRAGE nucleus expression after treatment with TGF-β. Results of wound healing assay showed that the cell migration of TE13R120 and TGF-β-induced EMT in TE13 cells were remarkably enhanced. Conclusions: Our results indicate that NRAGE subcellular localization is related to radiation resistance of esophageal carcinoma cell and EMT may be involved in NRAGE subcellular location.
  1,804 49 -
Occludin protein expression in human cervical cancer and its association with patient's clinical characteristics
Bin Zhang, Xiuhui Chen, Yao Lin, Shaoyu Wang, Qiufang Bao
2018, 14(1):124-127
DOI:10.4103/jcrt.JCRT_664_17  PMID:29516973
Objective: The objective of the study was to investigate the expression of the tight junction protein occludin (encoded by OCLN gene) in human cervical cancer and its association with clinical features of patients. Materials and Methods: Sixty-one patients with cervical cancer were included in this study from June 30, 2015 to April 30, 2017. Immuno-histochemical assay was applied to examine the expression of occludin protein in 61 cervical cancer tissues and matched adjacent cancer normal tissues. The association of occludin protein expression with clinical pathology characteristics was analyzed. Results: Occludin protein was mainly expressed in cell membranes and cytoplasm of both the cervical cancer cell and the normal cells. The protein was manifested with brownish-yellow granules. In cervical cancer tissues, the positive rate of occludin protein was 77.05% (47/61), whereas, in adjacent normal tissues of the cancer, the positive rate was 96.72% (59/61). Therefore, the positive rate of occludin in cervical cancer tissues was significantly lower than that of the adjacent cancer tissues (P < 0.05). Occludin protein expression level was not significantly correlated with the age (P > 0.05), tumor size (P > 0.05), International Federation of Gynecology and Obstetrics staging (P > 0.05), pathological grades (P > 0.05), and lymph node metastasis (P > 0.05) of the patients. Conclusion: Occludin protein may contribute to the development of cervical cancer. However, it was not correlated with the clinical features.
  1,715 93 -
Use of simultaneous radiation boost achieves high treatment response rate in patients with metastatic gastric cancer
Ju Yang, Juan Liu, Shanbao Gao, Yang Yang, Weiwei Kong, Wei Ren, Lijing Zhu, Mi Yang, Jia Wei, Zhengyun Zou, Xiaoping Qian, Baorui Liu, Jing Yan
2018, 14(1):36-39
DOI:10.4103/jcrt.JCRT_387_17  PMID:29516956
Objective: Intensity-modulated radiation therapy (IMRT) with a simultaneous integrated boost (SIB) could improve local control rates at different anatomic sites. However, little is known for its use in metastatic gastric cancer. Our study aimed to compare the treatment response rates of IMRI-SIB and conformal radiotherapy (CRT) in patients with metastatic gastric cancer. Materials and Methods: We retrospectively identified twenty patients with metastatic gastric cancer from 2013 to 2015, 12 given IMRT-SIB, and eight given CRT. Treatment response and toxicities were evaluated for all patients. The radiation target included peritoneal lymph nodes. RECIST criteria were used to assess the treatment response. Three patients of eight in the CRT group died before the end of treatment due to the progression of diseases in the field. Results: For the IMRT-SIB group, the median dose of high dose field was 60.8 Gy (50–64.4 Gy), and the median dose of low-dose field was 45 Gy (36–50.4 Gy). For the CRT group, the median dose of the total dose was 50 Gy (41.4–60 Gy). IMRT-SIB could elevate local dose significantly, compared to the CRT group. One patient of 12 in the IMRT-SIB group achieved complete response, and nine patients achieved partial response (PR), whereas no patient achieved CR in the CRT group. Two of five patients achieved PR (40%) in the CRT group. IMRT-SIB improved the treatment response rate significantly (odds ratio 8.33, 95% confidence interval: 1.03–67.14, P = 0.046). Two patients of 12 in the IMRT-SIB group developed enteritis, whereas two patients of five developed enteritis in the CRT group. Conclusions: IMRT-SIB could escalate the local dose and improve the treatment response rates in patients with metastatic gastric cancer and with acceptable toxicities. Further study with a larger population to validate our data is underway.
  1,740 63 -
Value of magnetic resonance images in preoperative staging and resectability assessment of pancreatic cancer
Shufang Yang, Jie Liu, Haiying Jin, Xiang He, Peng Nie, Changfu Wang
2018, 14(1):155-158
DOI:10.4103/jcrt.JCRT_590_17  PMID:29516979
Objective: The objective of this study is to evaluate the clinical value of magnetic resonance images (MRI) in preoperative staging and resectability evaluation of pancreatic cancer. Materials and Methods: Thirty-one pancreatic cancer patients who received operation from January 2012 to May 2017 were included in this study. The upper abdominal MRI of 31 cases were analyzed retrospectively. The results of operation and pathology were compared to evaluate the correlation between MRI staging and postoperative pathological staging of pancreatic cancer. Results: According to pathological staging, there were 12 cases of Stage I, 13 cases of Stage II, 4 cases of Stage III, and 2 case of Stage IV. However, for preoperative MRI stage, there were 13 cases of Stage I, 14 cases of Stage II, 4 cases of Stage III. In addition, there was no significant difference in the distribution frequency of pathological staging and MRI staging (P > 0.05). This finding indicated that the results of MRI staging were consistent with that of postoperative pathological staging. The pathology I/II or III/IV stage of pancreatic cancer patients could be predicted with preoperative abdominal MRI detection, with the sensitivity of 1.00 and the specificity of 0.67. Conclusion: MRI was clinically significant in preoperative staging and resectability assessment of pancreatic carcinoma.
  1,650 64 -
Investigation of the dose perturbation effect for therapeutic beams with the presence of a 1.5 T transverse magnetic field in magnetic resonance imaging-guided radiotherapy
Wencheng Shao, Xiaobin Tang, Yanling Bai, Diyun Shu, Changran Geng, Chunhui Gong, Fada Guan
2018, 14(1):184-195
DOI:10.4103/jcrt.JCRT_1349_16  PMID:29516984
Background: Magnetic resonance imaging (MRI)-guided radiotherapy is a promising image-guided cancer radiotherapy method. For MRI-guided radiotherapy, the proper energy of a therapeutic beam is important for beam-designing processes, and the magnetic-induced dose perturbation would be mainly influenced, especially the perturbation surrounding the tissue–air or air–tissue interfaces. Thus, it was necessary to investigate the impact of beam energy from photon, proton, and carbon ion beams on the magnetic-induced dose perturbations. Materials and Methods: Using a phantom of a water-air-water structure, the dose distributions were calculated with or without the presence of a 1.5 T uniform magnetic field through GEANT4. Based on the calculated doses, magnetic-induced dose perturbations were then obtained. For investigating the effects of beam energies on magnetic-induced dose perturbations, low-, middle-, and high-beam energies were adopted for each beam type. Results and Discussion: For photon beams, the dose perturbations were increased as the beam energies increased. At the up water–air interface, the maximum perturbations exceeded 50%. Near the edge of the radiation field, perturbations of 5%–20% were achieved. For proton and carbon ion beams, their Bragg peaks were shifted from original positions, and the shifting distances were increased with the increased beam energies. However, no evident magnetic-induced dose perturbations were noted at the up water–air interface and bottom air–water interface for all the beam energies. To some extent, this study provided references for assessing the effects of beam energies on magnetic-induced dose perturbations, especially the perturbations around the air cavities inside cancer patients. Conclusion: In MRI-guided cancer radiotherapy, the dose perturbation effects for therapeutic beams are relatively obvious, and the beam energies of therapeutic beams have large impacts on the magnetic-induced dose perturbations with the presence of a 1.5 T transverse magnetic field.
  1,529 58 -
Expression and clinical significance of centrosomal protein 55 in T-cell lymphoma
Yangyang Xu, Xiangxiang Zhou, Ying Li, Ya Zhang, Xin Wang
2018, 14(1):94-98
DOI:10.4103/jcrt.JCRT_758_17  PMID:29516967
Context: T-cell lymphomas (TCLs) have been heterogeneous lymphoid malignancies with aggressive clinical phenotype and poor prognosis. Centrosomal protein 55 (CEP55) played a critical role in cytokinesis and served as a centrosome- and midbody-associated protein. Previous studies have reported the overexpression and clinical significance of CEP55 in various human malignancies, but the exact biological roles of CEP55 in TCLs remained unclear. Aims: In this study, we aimed to evaluate the CEP55 expression in patients with TCL and reactive hyperplasia of lymph nodes. The correlation between CEP55 levels and clinical characteristics was also explored for TCL patients. For further investigation, the cell viability of TCL cell lines after CEP55 inhibition was also assessed. Subjects and Methods: Immunohistochemistry was applied to assess the elevated level of CEP55 in TCLs. After siRNA treatment, cell viability and apoptotic rate of TCL cell lines were observed with CCK-8 assay and flow cytometry, respectively. Statistical Analysis: The Pearson's Chi-square test or Fisher's exact test was applied to analyze the correlations between CEP55 overexpression and clinical characteristics. All statistical tests were two-sided, and P < 0.05 was considered to be statistically significant. Results: CEP55 was upregulated in TCL patients and significantly correlated with Ki-67 label index. Consistently, cell viability was decreased, and apoptosis was increased after the suppression of CEP55 in TCL cell lines. Conclusions: These results suggested that target CEP55 would be a novel therapeutic strategy for the TCL.
  1,528 49 -
Association of glutathione S-transferase M1 polymorphisms in the colorectal cancer risk: A meta-analysis
Min Huang, Yan Zeng, Fen Zhao, Ying Huang
2018, 14(1):176-183
DOI:10.4103/jcrt.JCRT_446_16  PMID:29516983
Purpose: The glutathione S-transferase M1 (GSTM1) as a member of phase II detoxification enzymes is expressed in many tissues and plays a critical role in preventing the occurrence of cancer. Published data regarding the associations between the GSTM1 polymorphism and colorectal cancer (CRC) risk are inconclusive. Materials and Methods: A meta-analysis of 55 case–control studies involving 17,498 cases and 26,441 controls were performed to assess the strength of association using odds ratio (OR) with 95% confidence interval (CI). Results: The meta-analysis of those studies suggested that GSTM1 null genotype was significantly associated with CRC risk (OR = 1.13, 95% CI = 1.06–1.20, P < 0.0001). In the subgroup analysis by ethnicity, significant risks were associated with GSTM1 null genotype in Caucasians (OR = 1.18, 95% CI = 1.07–1.29, P = 0.001), Asians (OR = 1.11, 95% CI = 1.02–1.22, P = 0.02), and mixed group (OR = 1.01, 95% CI = 0.90–1.14, P = 0.85). In the subgroup analysis by study design, significant elevated risks were associated with GSTM1 null genotype in hospital-based case–control study group (OR = 1.20, 95% CI = 1.10–1.31, and P < 0.0001) but not in population-based case–control study group (OR = 1.03, 95% CI = 0.96–1.10, P = 0.43). Conclusions: Based on our meta-analysis, the GSTM1 null genotype is a risk factor for CRC.
  1,482 81 -
Lipopolysaccharide promoted the growth rate of MG-63 cells via the extracellular regulated kinase pathway
Xiaobo Niu, Hao Peng
2018, 14(1):119-123
DOI:10.4103/jcrt.JCRT_673_17  PMID:29516972
Objective: The objective of this study is to investigate the effects of lipopolysaccharide (LPS) on the growth rate of MG-63 cells. Materials and Methods: MG-63 cells were exposed to various concentrations of LPS, and the growth rate was determined with the 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. In addition, variations in the phosphorylation state of extracellular regulated kinase (ERK1/2), Jun N-terminal kinase, and p38 were determined by western blotting. Results: There was a correlation between the increased phosphorylation of ERK1/2 and the growth of LPS-treated MG-63 cells. The increased phosphorylation was mediated by the LPS receptor toll-like receptor-4. Conclusions: LPS promoted the growth of MG-63 cells through the ERK pathway.
  1,472 44 -
Detection of epidermal growth factor receptor mutation in the peripheral blood of patients with esophageal carcinoma to guide epidermal growth factor receptor-tyrosine kinase inhibitor treatment
Yingjun Xu, Zhihui Xie, Hong Lu
2018, 14(1):103-105
DOI:10.4103/jcrt.JCRT_735_17  PMID:29516969
Objective: This study aimed to explore the epidermal growth factor receptor (EGFR) mutation in the peripheral blood of patients with esophageal carcinoma and analyze the relationship between EGFR–tyrosine kinase inhibitor (EGFR–TKI) therapeutic effect and EGFR mutation in peripheral blood. Methods: A retrospective analysis was performed on 66 patients with esophageal carcinoma treated with EGFR–TKI (Gefitinib) from February 2014 to March 2017 in our hospital. Real-time polymerase chain reaction was applied to detect the mutation of the EGFR gene in peripheral blood specimens before patients were treated with EGFR–TKI. The relationship between EGFR mutation in the peripheral blood and clinical features of patients were analyzed. The correlation between EGFR mutation in peripheral blood and EGFR–TKI treatment response was also demonstrated. Results: Among the 66 patients, 18 cases were determined as EGFR mutation in peripheral blood. The mutation rate was 27.3%. Among these patients, it observed 1 case of exon 18 2155G>A mutation, 3 cases of exon 19 2235–2249Del mutation, 5 cases of 2236–2250Del mutation, 1 case of 2254–2277Del mutation, 1 case of L747–A750Del mutation, 3 cases of exon 21 2576T>G mutation, 3 cases of 2497T>G mutation, and 1 case of 2504A>T mutation. EGFR mutation in the peripheral blood of patients with esophageal carcinoma was unrelated to the gender, age, and the location of the tumor (P < 0.05). By contrast, EGFR mutation was related to the pathological types of the patients (P < 0.05). The mutation rate of the EGFR of squamous cell carcinoma patients was significantly higher than that of adenocarcinoma patients (P < 0.05). Among EGFR wild-type patients, 8 cases were stable disease (SD), and 40 cases were progressive disease (PD), after EGFR-TIK treatment. No complete response (CR) and partial response (PR) patients were reported. The overall response rate (ORR) was 0.0%. Among the EGFR mutation group, 5 were SD cases, 5 were PD cases, and 8 were PR cases. No CR case was reported. The ORR was 44.4%. The ORR of the EGFR group was significantly higher than that of the wild-type group (P < 0.05). Conclusion: The detection of EGFR mutation in peripheral blood can be applied as an effective index for EGFR-TKI (Gefitinib) treatment in patients with esophageal carcinoma.
  1,455 55 -
Preliminary clinical study on brass compensator-based intensity-modulated radiation therapy
Jie Li, Guohai Qi, Yuan Qin, Pei Wang
2018, 14(1):171-175
DOI:10.4103/jcrt.JCRT_453_16  PMID:29516982
Objective: The objective of this study is to preliminarily evaluate the feasibility of brass compensator-based intensity-modulated radiation therapy (CB-IMRT). Materials and Methods: Ten patients (three cases of nasopharyngeal cancer, four of esophageal cancer, and three of rectal cancer) who underwent an IMRT treatment planning were selected for this study. The transmission coefficient of brass plates with different thicknesses was measured under a 6 MV photon beam used in the treatment planning system, and the equation for thickness computation was fitted out. The plan file RTPLAN file of each patient was exported from the planning system and transformed to a compensator thickness matrix; therefore, it was input into a numerical control machine for the manufacturing and cutting of the compensators. The CB-IMRT plans obtained were verified on a homogeneous phantom with commercial software. Planar doses were measured by films, and the computed ones were compared using gamma evaluation with 3-mm distance to agreement and 3% dose difference criteria adopting a pass rate of Pγ >90%. The monitor units (MUs) of the multileaf collimator IMRT plan (MLC-IMRT) and the CB-IMRT plans were compared. Depth of cut was computed through the equation fitted from real measurements. The planned RTPLAN files were used to transform the cutting files needed by the numerical control machine. Results: Plan validations show that the minimum and maximum of gamma pass rate among the 10 patients are 90.2% and 98.2%, respectively, which both satisfy the requirements of clinical planning. The MUs of CB-IMRT are significantly smaller compared with MLC-IMRT. Conclusion: CB-IMRT satisfies the requirements of clinical therapy and can be used in a radiotherapy routine.
  1,389 49 -