Objective To analyze the prognostic characteristics of different invasion sites and the risk factors affecting overall prognosis, in patients with pT4b stage colorectal cancer who underwent radical resection and showed no lymph node metastasis （N0） by pathology. Methods The clinical and pathological data of colorectal cancer patients received surgical resection in China National Petroleum Corporation Central Hospital from 2017-01-01 to 2021-12-21 were calculated and followed up to 2022-12-31. The time of operation, the time of local recurrence or distant metastasis and the time of death were recorded. Risk factor analysis was grouped based on whether there was disease progression during follow-up. Prognosis of different groups was compared and logistic binary regression was used to screen for meaningful risk factors. Results Survival analysis showed that the disease-free survival (DFS) of patients with tumor invasion of abdominal wall or omentum was (22.2±3.2) months, DFS of tumor invasion of stomach or intestine was (28.3±5.6) months, DFS of tumor invasion of uterus or adnexal was (35.7±2.6) months, and DFS of tumor invasion of the bladder or ureteral was (30.1±3.4) months, Log-rank P=0.001 among groups. Multivariate analysis showed that the right colon (OR=6.829, 95%CI:1.603-29.093, P=0.009), tumor invasion of abdominal wall, omentum (OR=6.198, 95%CI:1.231-31.210, P=0.027), tumor maximum diameter (OR=0.565, 95%CI:0.365-0.874, P=0.010) were independent factors affecting the progression of colorectal cancer. Conclusion Among colorectal cancer patients with pathological staging pT4bN0M0, patients with tumor invasion of the uterus and appendix have the best prognosis, while patients with invasion of the abdominal wall and omentum have the worst prognosis. Patients with tumors located in the right colon and invading the abdominal wall, omentum, or smaller tumor lesions are more likely to experience regional recurrence or distant metastasis after surgery.

Colorectal cancer (CRC) has brought great healthy burden for patients. Neutrophil extracellular traps (NETs) have been explored in several tumors, while it remains largely unclear in CRC. CRC-related data were downloaded from Cancer Genome Atlas and Gene Expression Omnibus databases. Then, a NET risk score was built after univariate Cox and LASSO Cox regression analysis. Prognostic value was evaluated via survival analysis, stratification analysis, and ROC analysis. The functional enrichment analysis was conducted basing on bulk and scRNA-seq data. The immune landscape difference was analyzed using CIBERSORT, XCell, and MCPcounter portals. NET risk score was built for CRC patients, basing on G0S2, HIST1H2BC, CRISPLD2, and IL17A. In TCGA-CRC and validation datasets, regardless of age or gender, high-risk CRC patients had significantly worse prognosis, besides higher NET risk score was mainly found in samples with MSI-H and advanced T, N, and M stages. Employing multiple databases, we noticed that M0 and M2 Macrophages infiltrated the most in high-risk CRC patients, besides M2 Macrophages and neutrophils showed positive correlation with NET risk score. A novel reliable prognostic NET risk score was developed for CRC patients, and high-risk patients had unfavorable prognosis with advanced disease status.

目的:探讨副乳癌(ABC)和常规胸部乳腺癌(MC)转录因子发状分裂相关增强子1(HES1)、人类表皮生长因子受体2(HER2)表达差异及其与临床病理特征的关系.方法:回顾性分析30例ABC和30例MC病人的临床资料、病理资料和肿瘤组织HES1、HER2表达情况及随访资料,并进行统计分析.结果:ABC组HES1、HER2阳性表达率分别为30.00％、53.33％,MC组为40.00％、40.00％,2组HES1和HER2阳性率差异均无统计学意义(P>0.05).ABC组和MC组病人HES1阳性表达率在不同病理类型、组织学分级、临床分期和是否淋巴结转移、三阴乳腺癌间差异均有统计学意义(P<0.05～P<0.01),ABC组HES1阳性表达率在是否复发病人间差异亦有统计学意义(P<0.05).ABC病人HER2阳性表达率在不同病理类型、组织学分级、临床分期和是否三阴乳腺癌及复发间差异均有统计学意义(P<0.05～P<0.01);MC病人HER2阳性表达率在不同病理类型、临床分期和是否淋巴结转移、三阴乳腺癌间差异均有统计学意义(P<0.01).结论:术前HES1、HER2阳性表达率可一定程度上反映ABC、MC病人病理特征,为合理手术方案的选择提供参考.

Background The American Society of Colon and Rectal Surgeons is suggesting laparoscopic surgeries for colorectal cancer. Conventional perioperative procedures like long preoperative fasting and bowel procedures are not useful and harmful to patients undergoing surgeries for colorectal cancer. The objectives of the study were to compare surgery outcomes, hospital stays, and survival of patients who received fast-track (laparoscopy/open) surgical procedure followed by chemotherapy against those who received conventional (laparoscopy/open) surgical procedure followed by chemotherapy for colorectal cancer. Methods The study analyzes the outcomes of a total of 542 colorectal cancer (preoperative biopsies stage II or III) patients submitted to surgery and adjuvant chemotherapy. The study cohort is retrospectively subdivided in 4 groups submitted to open or laparoscopic resection with or without fast-track protocol appliance and two different chemotherapy regimens. Patients who ended up being TNM stage I have not received the adjuvant chemotherapy. Results The fast-track surgical procedure had shorter total hospital stays and postoperative hospital stays than the conventional surgical procedures. Flatus resumption time, the time until first defecation, and intraoperative blood loss were shorter for the fast-track surgical procedures than the conventional surgical procedures. Those surgery outcomes were also shorter for the fast-track laparoscopy than the open fast-track. Resumption of a fluid diet and ambulation onset time were shorter for the fast-track surgical procedures than the conventional surgical procedures. The surgical checkpoints that were compliance by patient of fast-track surgeries were significantly fewer than those of the conventional surgeries. Clinically significant difference for QLQ-C30/CR38 score after chemotherapy was reported between patients who received open conventional surgeries and those patients who received fast-track laparoscopy (59.63 ± 2.26 score/patient vs. 71.67 ± 5.19 score/patient). There were no significant differences for the number of patients with any grade adverse effects ( p = 0.431) or with grade 3–4 adverse effects ( p = 0.858), and the disease-free and overall survival among cohorts. Conclusions The fast-track surgical procedure is effective and safe even in a multidisciplinary scenario as colorectal cancer treatment in which surgery is only a part of management. Level of evidence: III Technical efficacy stage: 4.

目的 探讨乳腺癌原发肿瘤组织发状分裂相关增强子1(HES1)、人类表皮生长因子受体2(Her2)、趋化因子受体4(CXCR4)及生存素(Survivin)的表达情况及与术后复发、生存的关系.方法 选取河北中石油中心医院收治的原发性乳腺癌患者90例,均行乳腺癌改良根治术,将术中所取原发肿瘤病理组织及癌旁组织送检,检测并比较肿瘤组织与癌旁组织HES1、Her2、CXCR4及Survivin表达水平.根据患者术后复发情况将其分为复发组和未复发组,比较二组HES1、Her2、CXCR4及Survivin表达情况,并分析上述指标与患者术后生存的关系.结果 原发肿瘤组织HES1、Her2、CXCR4及Survivin表达阳性率分别为53.33％、56.67％、46.67％、51.11％,均显著高于癌旁组织的11.11％、14.44％、10.00％、13.33％ (P＜0.05);肿瘤＞3 cm、腋窝淋巴结阳性、淋巴结转移个数＞3个、临床分期为Ⅲ期的乳腺癌患者HES1、Her2、CXCR4及Sur-vivin表达阳性率高于肿瘤≤2 cm、腋窝淋巴结阴性、淋巴结转移个数≤3个、临床分期为Ⅰ～Ⅱ期的患者(P＜0.05);复发组HES1、Her2、CXCR4及Survivin表达阳性率分别为73.17％、74.07％、63.41％、68.29％,均显著高于未复发组的36.73％、42.42％、32.65％、36.73％ (P＜0.05);HES1、Her2、CXCR4及Survivin阳性乳腺癌患者术后3年无瘤生存率较HES1、Her2、CXCR4及Survivin阴性患者呈明显下降趋势(P＜0.05).结论 原发肿瘤病理组织中HES1、Her2、CXCR4及Survivin均呈高表达,且与患者肿瘤大小、腋窝淋巴结性质、淋巴结转移情况、临床分期及术后复发和无瘤生存存在相关性.

目的 探讨手辅助腹腔镜技术在直肠癌根治术中的疗效.方法 对90例直肠癌患者资料进行回顾性分析,根据手术选择分为研究组(手辅助腹腔镜治疗,n=40)和对照组(传统开腹手术治疗,n=50).比较两组患者临床特征、手术时间、失血量、术后并发症、住院费用、住院时间、R0切除率、淋巴结检出个数、保肛率、3年局部复发率、3年无复发生存率和3年生存率.结果 研究组术中失血量和住院时间均低于对照组,手术时间和住院费用均高于对照组,差异均具有统计学意义(均P<0.01).研究组和对照组在淋巴结检出个数、R0切除率、保肛率、3年局部复发率、3年无复发生存率、3年总生存率、术后排便异常发生率和术后并发症发生率方面比较,差异均无统计学意义(均P>0.05).结论 与传统开腹手术比较,采用手辅助腹腔镜切除手术治疗直肠癌患者,具有创伤小、出血少和住院时间短等优点,且能够获得与传统开腹手术相同的预后,是可选择的外科技术.

分析副乳腺癌(ABC)和常规乳腺癌的临床特点及肿瘤组织中人类表皮生长因子受体2(HER2)表达差异.2012年1月-2016年1月,确诊的30例ABC和30例常规胸部乳腺癌患者的临床资料、病理资料、肿瘤组织HER2表达情况及至少5年的随访资料,并进行统计分析.结果 显示,ABC与常规乳腺癌患者性别、年龄、绝经情况、病理类型、临床分期及三阴乳腺癌,新辅助化疗、术后化疗、内分泌治疗情况均无统计学差异(P＞0.05),ABC接受放疗者显著高于常规乳腺癌(P＜0.05),术后淋巴结转移者显著高于常规乳腺癌(P＜0.05).ABC组织中HER2表达程度明显高于常规乳腺癌组织(P＜0.05).随访期间ABC患者复发转移率显著高于常规乳腺癌,无病累积生存函数显著低于常规乳腺癌组(P＜0.05);两种乳癌病死率无统计学差异(P＞0.05),但ABC患者累积生存函数显著低于常规乳腺癌患者(P＜0.05).结果 表明,ABC与常规乳腺癌多种临床特点类似,但ABC组织中HER2表达程度更高,且更易发生淋巴结转移及复发,预后更差.

目的 观察重组人血管内皮抑制素(恩度)联合化疗药物治疗恶性胸腔积液的疗效.方法 选取乳腺癌所致恶性胸腔积液患者90例,根据其不同的治疗方式将其分为观察组以及对照组,每组45例.观察组应用恩度联合化疗药物治疗,对照组单独应用化疗药物治疗,治疗前均先排尽胸腔积液.治疗组在胸腹腔内注入顺铂60 mg、恩度45～60 mg;对照组除不加入恩度外,其余同治疗组.比较2组治疗效果.结果 观察组的总有效率为77.78％(35/45),对照组为44.44％,组间差异有统计学意义(x2=5.372,P＜0.05).观察组生活质量改善率为55.26％;对照组为33.33％,组间差异有统计学意义(x2 =4.500,P＜0.05).2组的不良反应发生率分别达到了35.56％和33.33％,差异无统计学意义(P＞0.05).治疗前,2组红细胞数无统计学差异(P＞0.05);治疗后,观察组较对照组红细胞数显著减少(P＜0.05).结论 对于乳腺癌所致的恶性胸腔积液采用胸腔内灌注顺铂序贯恩度治疗安全、有效,值得临床推广应用.

Objective To explore the clinical efficacy of transcatheter hepatic arterial embolization(TACE) in treatment of patients with liver metastasis from colon-rectal cancer. Methods 90 patients with liver metastasis from colon-rectal cancer in our hospital between November 2013 and November 2014 were recruited,and they were randomly divided into observation group and control group. The patients in both groups were treated with TACE,and the only difference was arterial infusion of raltitrexed in the observation group. Clinical efficacy,serum CA19-9 and CEA levels,adverse events and long-term survival rates were observed and recorded in the two groups. Results The total effective rate in the observation group was 51.1%,significantly higher than 22.2% in the control group(P<0.05);before treatment,there were no significant differences as respect to serum CA19-9 and CEA levels between the two groups(P>0.05),while three months after treatment,serum CA19-9 and CEA levels in the observation group were(18.46±7.59)U/ml and(3.52±2.58)ng/ml,significantly lower than [(27.65±11.85) U/ml and(9.86 ±3.47)ng/ml,respectively,in the control group,P<0.05];the incidence of adverse reactions was 22.2% in the observation group,significantly lower than 46.7% in the control group(P<0.05);the 1 a,2 a and 3 a survival rates in the observation group was 88.9%,73.3% and 57.8%,respectively,obviously higher than 66.7%, 42.2% and 33.3% in the control group(P<0.05). Conclusion The application of raltitrexed in TACE treatment of patients with liver metastasis from colon-rectal cancer can effectively improve patients' clinical efficacy,prolong the long-term survivals.

临床药师积极参与1例中晚期肺腺癌并颈部淋巴结转移高龄患者的治疗.根据患者病理诊断结果、功能状态评分及心、肝、肾功能评估,参与制订的化疗方案为培美曲塞(第1天,500 mg/m2)+顺铂(第1～3天,25 mg/m2).患者于化疗第3天出现腹泻以及白细胞报危急值伴发热,第7天出现急性肾功能衰竭,第8～10天血小板报危急值.临床药师协助医师在抗菌药物选择、不良反应应对上提供药物治疗措施,将不良反应的危害降到最低.本文首次报道该化疗方案在治疗短时间内发生急性肾衰竭合并Ⅳ度骨髓抑制的严重不良反应.临床药师应在工作中参与制订肿瘤患者的治疗方案,并规范临床医师对化疗药物及其辅助用药的使用,减少因用药不规范产生的不良反应.

ObjectiveTo investigate the efficacy of raltitrexed combined with transcatheter arterial chemoembolization (TACE) in the treatment of advanced colorectal cancer with liver metastasis. MethodsA total of 80 patients with liver metastasis of advanced colorectal cancer who were admitted to Central Hospital of China National Petroleum Corporation and underwent surgery from January 2012 to June 2015 were enrolled and randomly divided into study group and control group, with 40 patients in each group. The patients in the study group underwent hepatic arterial infusion chemotherapy with raltitrexed combined with TACE, and those in the control group were treated with intravenous infusion of raltitrexed alone. The above treatment was performed once every 4 weeks for 3-6 cycles. The response rate (RR), disease control rate (DCR), median time to disease progression, survival rate, and reductions in carcinoembryonic antigen (CEA), CA19-9, aminotransferases, and bilirubin were observed in the two groups. The chi-square test was used for comparison of categorical data between groups. ResultsRR, DCR, and the median time to disease progression showed significant differences between the study group and the control group (45.0% vs 22.5%, χ2=4.528, P=0.033; 70.0% vs 47.5%, χ2=4.178, P=0.041; 17.9 months vs 10.5 months, χ2=2408, P＜0.001). The study group had significantly higher 1- and 2-year survival rates than the control group (80.0% vs 57.5%, χ2=4.713, P=0.030; 55.0% vs 32.5%, χ2=4.114, P=0.043). The study group had a significantly higher number of patients with more than 50% reductions in CA19-9, CEA, aminotransferases, and bilirubin at 2 months after TACE than the control group (χ2=5.333, 4.528, 5.051, and 5.013, P=0.021, 0.033, 0.025, and 0.025). ConclusionRaltitrexed combined with TACE is of good value in the treatment of advanced colorectal cancer with liver metastasis and holds promise for clinical application.

[目的]评价雷替曲塞在治疗晚期结直肠癌肝转移中的疗效和不良反应.[方法]对120例结直肠癌术后肝转移的患者进行化疗,将其随机分为研究组和对照组,每组60例.研究组采用介入下肝动脉灌注雷替曲塞化疗联合栓塞治疗,对照组采用雷替曲塞单药静脉滴注治疗.以上治疗每3周1次.共进行3～6个周期.比较两组的治疗有效率(RR)、疾病控制率(DCR)、中位疾病进展时间、生存率及不良反应情况.[结果]治疗有效率(RR)研究组为38.3％,对照组为20.0％,差异有统计学意义(P=0.027);疾病控制率(DCR)研究组为66.7％,对照组为45.0％,差异有统计学意义(P=0.017).中位疾病进展时间研究组为15.4个月,对照组为10.5个月,差异有统计学意义(P=0.000).研究组1、2年生存率分别为71.7％、56.7％,对照组分别为51.7％、38.3％,差异均有统计学意义(P值分别为0.024、0.044).[结论]介入下肝动脉灌注雷替曲塞化疗联合栓塞治疗结直肠癌肝转移疗效肯定,不良反应能耐受,值得临床推广.

Objective To evaluate the therapeutic effect of intervention of raltitrexed combined with epirubicin in hepatic arterial infusion and embolization in the treatment of advanced primary liver cancer.Methods A total of 80 patients with advanced primary liver cancer who were admitted to the Central Hospital of China National Petroleum Corporation from January 2011 to May 2013 and not suitable for surgical treatment were selected and randomly divided into study group (n =40)and control group (n =40).The study group was treated with inter-vention of raltitrexed combined with epirubicin in hepatic arterial infusion and embolization,while the control group was treated with inter-vention of fluorouracil (5 -FU)combined with epirubicin in hepatic arterial infusion and embolization.The treatment was given once every four weeks for a total of three to six circles.The response rate (RR),disease control rate (DCR),median time to progression,survival rate,and the decreases in alpha fetoprotein (AFP),carcinoembryonic antigen (CEA),transaminase,and bilirubin of the two groups were observed.Comparison of categorical data between the two groups was made by chi -square test,and comparison of continuous data was made by t test.Results The RRs of the study group and control group were 52.5% and 22.5%,respectively,and the difference was significant (χ2 =7.680,P =0.006);the DCRs of the study group and control group were 87.5% and 60.0%,respectively,and the difference was significant (χ2 =7.813,P =0.005);the median time to progression of the study group and control group was 12.2 and 8.0 months,re-spectively,and the difference was significant (t =5.118,P =0.00);the 1 -and 2 -year survival rates of the study group were 85.0%and 60.0%,respectively,with the control group being 65.0% and 37.5%,and the difference was significant (χ2 =4.267,P =0.039;χ2=4.053,P =0.044).One month after chemoembolization,the number of patients whose AFP,transaminase,and bilirubin levels de-creased more than 50% in the study group was significantly larger than that of the control group (χ2 =4.381,4.114,and 5.000,P =0.036, 0.043,and 0.025).Conclusion The intervention of raltitrexed combined with epirubicin in hepatic arterial infusion and embolization is of good value in the treatment of advanced primary liver cancer,and should be applied clinically.

[目的] 研究增殖抑制基因(HSG)和表皮生长因子(EGF)蛋白在乳腺癌组织中的表达及其相关性.[方法] 应用免疫组织化学的方法来检测 HSG、EGF 蛋白在乳腺癌组织中的表达,并以正常乳腺组织和乳腺纤维腺瘤组织作为对照.[结果] HSG 主要在细胞浆中表达,在乳腺癌组织中 HSG 的表达率明显低于乳腺纤维腺瘤组织和正常乳腺组织(P＜0.05),而在乳腺纤维腺瘤组织和正常乳腺组织中的表达率无明显差异(P＞0.05).EGF 主要在胞浆中表达,其在乳腺癌组织中的表达率明显高于乳腺纤维腺瘤组织和正常乳腺组织(P＜0.05),在乳腺纤维腺瘤组织和正常乳腺组织中的表达无明显差异(P＞0.05).乳腺癌组织中 HSG 和 EGF 的表达与淋巴结转移和病理组织学分级相关.其中在有淋巴结转移组和分化差的乳腺癌中 HSG 的表达明显下降(P＜0.05),而 EGF 却表达明显升高(P＜0.05).[结论] HSG 可能具有抑制乳腺癌的发生和淋巴转移的功能,而 EGF 可能有促进作用,两者表达呈现负相关性.

OBJECTIVE:To study the expression of hyperplasic suppress gene(HSG),epidermal growth factor receptor(EGFR) and their correlation in breast cancer tissues.METHODS:The method of real-time Fluorescene quantitative polymerase chain reaction(RT-PCR) were applied to detect the proliferation of HSG.EGFR mRNA and the protein expression of HSG,EGFR were detected by using SP immunohistochemistry in normal breast tissue,breast carcinoma,breast fibroadenoma tissues and their relevance in breast cancer tissues.RESULTS:The expression of HSG mRNA was significantly lower in breast cancer than those in breast fibroadenoma and normal breast tissue(P0.05);The expression of EGFR mRNA was significantly higher in breast cancer than those in breast fibroadenoma and normal breast tissue(P0.05);The expression of HSG mRNA and EGFR mRNA in breast fibroadenoma and normal breast tissues showed no statistically significant difference(P0.05).The expression of HSG and EGFR mRNA was correlated with lymph node metastasis,different pathological grades of breast cancer,ER and HER-2 and that was incorrelated with the age of the patient,tumor type,tumor size and clinical stage(P0.05).The expressions of HSG and EGFR were negative correlation in breast cancer tissues(r=-0.456,P=0.002).CONCLUSIONS:With the decline in the degree of differentiation or lymph node metastasis and the negative expression of ER and HER-2,the expression of HSG mRNA decreased significantly in breast cancer tissues.The expression level of EGFR is significantly increased in low pathological grades and the positive expression of ER and HER-2 of breast cancer.The expression of HSG is negatively correlated with EGFR in breast cancer tissues.The expression of HSG is positively correlated with inhibitting the occurrence of cancer tissue and the metastasis of lymph node.

Objective To investigate the expressions of hyperplasic suppress gene(HSG) and epidermal growth factor receptor(EGFR) in normal breast tissues,breast carcinoma and breast fibroadenoma issues,and their relationship with clinicopathological and other molecular features.Methods The protein expression of HSG,EGFR in normal breast tissues,breast carcinoma,breast fibroadenoma issues were detected by using SP immunohistochemistry.Results HSG protein was mainly expressed in the cytoplasm.The positive rate of HSG protein in breast cancer tissues was significantly lower than that in breast fibroadenoma and normal breast tissues,the difference was statistically significant(P0.05);while the positive rate in breast fibroadenoma and normal breast tissues showed no statistically significant difference(P0.05).The expression rate of EGFR protein was significantly higher in breast cancer than those in breast fibroadenoma and normal breast tissues(P0.05);while the positive rate in breast fibroadenoma and normal breast tissues showed no significant statistical difference(P0.05).The expression of HSG and EGF protein was correlated with lymph node metastasis and different pathological grades of breast cancer.That was also correlated with ER and H-erb-2.The expression rates of EGFR and HSG protein had no correlation with the age of the patients,tumor type,tumor size and clinical stage(P0.05).The expression of HSG is negatively correlated with EGFR in breast cancer tissues;is positively correlated with ER and H-erb-2;and is not correlated with PR.Conclusion Joint detection of the expressions of HSG and EGFR is important for the biological behaviors,prognosis and instruction of breast cancer.

<正>陈光惠等研究表明,高血压模型中细胞增殖抑制基因(hyperplasic suppress gene,HSG)在增生活跃的血管平滑肌中呈低水平表达,而外源性给予HSG可明显地抑制血管平滑肌细胞的生长,同时证实HSG对多种肿瘤传代细胞系同样有明显的生长抑制和诱导凋亡的作用,提示HSG有可能成为新的抑癌基因。下面就HSG的结构、功能及其与高血压、肿瘤等疾病的关系作一综述。