Objective:To investigate the expressions of Yes-associated protein 1 (YAP1), YTH domain-containing family protein 2 (YTHDF2) and microRNA-888-3p (miR-888-3p) in patients undergoing radical resection for lung cancer, and their predictive value for short-term prognosis of patients.Methods:A total of 420 lung cancer patients who underwent radical resection for lung cancer in Shanxi Province Cancer Hospital from May 2015 to May 2022 were selected and divided into a modeling set (280 cases) and a validation set (140 cases) in a ratio of 2∶1 by using the computer-generated random number method. The paracancerous normal lung tissues removed by surgery (>5 cm from the edge of the cancer tissues) were used as the control. The relative expressions of YAP1 and YTHDF2 proteins in cancer tissues and paracancerous tissues of the modeling set was detected by Western blotting, and the relative expression of miR-888-3p was detected by real-time fluorescence quantitative polymerase chain reaction (qRT-PCR). The patients were followed up for 1 year to analyze the prognosis, and the patients in the modeling set who had recurrence, metastasis or cancer-caused death were considered as the poor prognosis group, and the rest of the patients were considered as the good prognosis group. The relative expressions of YAP1 protein, YTHDF2 protein, miR-888-3p and general information of the patients in the two groups were compared; the Cox proportional hazards model was used to analyze the influencing factors of the short-term prognosis of radical resection for lung cancer in the modeling set; a Nomogram prediction model was constructed for the short-term prognosis of radical resection for lung cancer, and its efficacy was verified.Results:The relative expression of miR-888-3p in the modeling set of cancer tissues and paracancerous tissues was 0.49±0.08 and 0.16±0.05, and the difference was statistically significant ( t = 58.53, P < 0.001); the relative expression of YAP1 protein was 0.48±0.06 and 0.12±0.03, and the difference was statistically significant ( t = 89.80, P < 0.001); the relative expression of YTHDF2 protein was 0.23±0.04 and 0.59±0.07, and the difference was statistically significant ( t = 74.72, P < 0.001). After 1 year of follow-up in the modeling set, 32 cases were lost, and 81 (32.66%) of the remaining 248 cases had a poor prognosis (poor prognosis group), while 167 cases (67.34%) were in the good prognosis group. Compared with the good prognosis group, the relative expressions of YAP1 protein and miR-888-3p in cancer tissues was elevated in the poor prognosis group (both P < 0.05), and the relative expression of YTHDF2 protein was decreased ( P < 0.05); the proportions of patients with smoking, coronary artery disease, TNM stage Ⅲ-Ⅳ, maximum tumor diameter ≥ 5 cm, and undifferentiated/lowly differentiated tissues were high in the poor prognosis group, the physical status (PS) score was elevated, and the proportion of patients with regular postoperative radiotherapy was reduced (all P < 0.05). The results of multivariate Cox regression analysis showed that the proportion of patients with smoking ( HR = 2.098, 95% CI 1.143-3.852, P = 0.009), TNM stage ( HR = 2.421, 95% CI 1.350-4.341, P = 0.002), maximum tumor diameter ( HR = 1.883, 95% CI 1.036-3.424, P = 0.011), degree of tissue differentiation ( HR = 3.133, 95% CI 1.590-6.173, P < 0.001), regular postoperative radiotherapy ( HR = 0.417, 95% CI 0.219-0.797, P = 0.003), YAP1 ( HR = 7.043, 95% CI 2.842-17.452, P < 0.001), YTHDF2 ( HR = 0.560, 95% CI 0.418-0.752, P < 0.001), and miR-888-3p ( HR = 4.100, 95% CI 1.789-9.394, P < 0.001) were the independent influencing factors for the short-term prognosis of radical resection for lung cancer. A Nomogram prediction model was constructed, and internal validation showed that the consistency index of the model was 0.822 (95% CI 0.774-0.870); the result of receiver operator characteristic curve showed that the sensitivity of the Nomogram prediction model for predicting the short-term prognosis of radical resection for lung cancer in the modeling set was 97.5% (95% CI 86.8%-99.9%), and the specificity was 82.4% (95% CI 73.0%-89.6%), and the area under the curve (AUC) was 0.943 (95% CI 0.889-0.976); the sensitivity of predicting the short-term prognosis of radical resection for lung cancer in the validation set was 91.53% (95% CI 81.3%-97.2%), and the specificity was 81.5% (95% CI 71.3%-89.2%), and the AUC was 0.922 (95% CI 0.865-0.961). Conclusions:YAP1, YTHDF2 and miR-888-3p are all influencing factors for short-term prognosis of radical resection for lung cancer, and the Nomogram prediction model constructed based on these factors has good predictive efficacy for the short-term prognosis of radical resection for lung cancer.

Objective:To explore the prognostic value of the maximum standardized uptake value reduction proportion (ΔSUVmax%) on 18F-fluorodeoxyglucose (FDG) positron emission tomography combined with computed tomography (PET/CT) imaging, Deauville scores and C-myc gene rearrangement for the prediction of diffuse large B-cell lymphoma (DLBCL) in early chemotherapy. Methods:A total of 83 primary patients with pathologically confirmed DLBCL admitted in Shanxi Provincial Cancer Hospital from September 2010 to December 2016 underwent 18F-FDG PET/CT 1 week before and after early chemotherapy. The patients underwent post-chemotherapy examinations between 17 to 21 days after one cycle ( n=34) or two cycles ( n=49). The region of interest (ROI) was drawn and the ΔSUVmax% was calculated. Deauville 5-point scale was used to score the PET/CT imaging in early chemotherapy. Fluorescence in situ hybridization (FISH) was used to detect C-myc gene rearrangement. The follow-up time was from 36 to 111 months. The primary end-point of the study was progression-free survival (PFS). Receiver operating characteristic (ROC) analysis, χ2 test, Spearman correlation analysis, Log rank test, and Cox regression analysis were used to analyze the data. Results:Of 83 DLBCL patients, 19 progressed during the follow-up period. The optimal cut-off value of ΔSUVmax% for predicting tumor progression in early chemotherapy was 62.59%, and the Deauville score was taken as 5. The differences in sensitivity, specificity, and accuracy between the two methods were not statistically significant ( P>0.05). The ΔSUVmax% were negatively correlated with C-myc gene rearrangement and the Deauville scores ( rs= -0.889, -0.862, P<0.001). However, the Deauville scores was positively correlated with the C-myc gene rearrangement ( rs=0.781, P<0.001). The median PFS were 59 months and 16 months in ΔSUVmax%≥62.59% ( n=57) and ΔSUVmax%<62.59% ( n=26), respectively, with significant difference ( P<0.001). The median PFS for the Deauville score <5 subgroup (61 cases) and =5 subgroup (22 cases) was 59.0 and 15.0 months, respectively, with statistically significant differences ( P<0.001). The median PFS for patients with C-myc rearrangement subgroup (62 cases) and without rearrangement subgroup (21 cases) was 59.0 and 15.0 months, respectively, with statistically significant differences ( P<0.001). The median PFS for ΔSUVmax%<62.59% and Deauville score=5 subgroup, ΔSUVmax%<62.59% and C-myc rearrangement subgroup, Deauville score=5 and C-myc rearrangement subgroup were 15.5 months, 15 months and 13.5 months, respectively, with statistically significant differences ( P<0.001). Conclusion:ΔSUVmax%, Deauville score and C-myc gene rearrangement in early chemotherapy are all associated with PFS in DLBCL patients, and the combination of the two has a good predictive value for the prognosis of DLBCL

Objective:To investigate the correlation between KRAS, NRAS and BRAF V600E gene mutations and the clinicopathological characteristics of patients with colorectal cancer.Methods:Specimens from 217 patients with colorectal cancer who underwent surgical resection and were pathologically confirmed in Shanxi Province Cancer Hospital from January 2020 to December 2021 were selected, and the clinical data of the patients were retrospectively analyzed. The mutation status of KRAS, NRAS and BRAF V600E genes were detected in the paraffin specimens of surgically-resected tissues by direct sequencing. The mutation rates of KRAS, NRAS and BRAF V600E were compared among patients with different clinicopathological characteristics.Results:The mutation rates of KRAS, NRAS and BRAF V600E in 217 patients with colorectal cancer were 48.4% (105/217), 4.1% (9/217) and 3.7% (8/217), of which 1 patient (0.5%) had both KRAS and NRAS mutations. NRAS gene mutation was not correlated with gender, age, tumor size, tumor location, pathological type, degree of differentiation, depth of invasion, lymph node metastasis, distant metastasis, TNM stage, hemangioma thrombus/nerve invasion (all P>0.05); KRAS mutation rate in patients ≥ 60 year old was higher than that in patients < 60 year old [55.3% (63/114) vs. 40.8% (42/103), χ2 = 4.55, P = 0.033),and there was no correlation between KRAS gene mutation and other clinicopathological features (all P > 0.05); the mutation rate of BRAF V600E gene in colorectal cancerpatients with distant metastasis was higher than that in patients without distant metastasis [16.7% (4/24) vs. 2.1% (4/193), P = 0.006], and there was no correlation between BRAF V600E gene mutation and other clinicopathological features (all P > 0.05). Conclusions:Older colorectal cancer patients may be prone to KRAS gene mutation, and the BRAF V600E gene mutation rate is higher in patients with distant metastasis, and there is no correlation between NRAS gene mutation and clinicopathological characteristics.

目的 分析老年胃癌患者癌组织中不同密度脂蛋白的表达特性与病理学特征的相关性.方法 选择老年胃癌患者372例,根据病理切片分为乳头状腺癌等多种胃癌病理类型,并对癌组织总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)水平进行检测并比较,同时选取进行体检相同年龄段的胃部健康人群60例作为对照组,胃溃疡患者72例,比较3组胃组织TC、LDL、HDL水平.结果 胃癌组织恶性程度越高,分裂增殖能力越强,对TC的需求也越多,不同病理类型患者癌组织中TC、LDL、HDL水平差异显著(P<0.05),按照癌症分化程度将患者分为高、中、低3种分化程度,3种分化类型患者癌组织中TC、LDL、HDL水平差异显著(P<0.001),且分化程度越高,组织中TC、LDL、HDL水平越低,但与对照组及胃溃疡组相比,TC、LDL、HDL水平显著升高(P<0.05).结论 胃癌在分化进程中,患者癌组织中TC、LDL、HDL水平均会发生变化,其数值变化可以作为判断胃癌病理分期、治疗方案选择、患者预后预测的指标,可作为一种新的临床思路.

Objective:To observe the expression levels of serum Lemur tyrosine kinase-3(LMTK-3), amphiregulin and macrophage inhibitory cytokine-1(MIC-1)in patients with lung cancer and its prognostic value.Methods:A total of 125 patients with lung cancer who received treatment and retained pathological specimens in the department of Pathology of Shanxi Provincial Cancer Hospital from January to May 2015 were selected, including 83 males and 42 females, aged(49.67±10.28)years, ranging from 31 to 79 years.The general data of all patients were collected, and the expressions of LMTK-3, amphiregulin and MIC-1 were detected to analyze the relationship with the prognosis of patients.Results:Univariate analysis showed that there were significant differences in gender, family history, pathological type, clinical stage, vascular tumor thrombus, Kanofsky performance score(KPS)and treatment( P<0.05), but there were no significant differences in age, smoking history and respiratory symptoms( P>0.05). Cox multivariate analysis showed that clinical stage, vascular tumor thrombus and treatment were independent factors affecting the prognosis( P<0.05). The positive rates of LMTK-3 amphiregulin and MIC-1 were 41.6%(52/125), 26.4%(33/125)and 63.2%(79/125). The positive rates of LMTK-3 and amphiregulin in small cell lung cancer were the highest, while those in adenocarcinoma were the lowest( P<0.05). The expressions of LMTK-3, amphiregulin and MIC-1 were significantly correlated with the prognosis of patients( P<0.05). Conclusion:Clinical stage, vascular tumor thrombus and treatment are independent factors affecting the prognosis of patients with lung cancer.The survival time of patients with different pathological types of lung cancer is different, and the expression of LMTK-3 and bimodulin are also different.The positive expression is significantly correlated with the survival time.The detection of the expression of the three is of great value for judging the prognosis.

Objective:To investigate the value of 18F-prostate specific membrane antigen (PSMA)-1007 PET/CT in the detection of prostate cancer recurrence at low serum prostate specific antigen (PSA) level. Methods:From July 2018 to June 2019, 45 patients (age: 59-74 years) with suspected biochemical recurrence of prostate cancer with low PSA level (<2.0 μg/L) who underwent 18F-PSMA-1007 PET/CT examinations in Shanxi Tumor Hospital were retrospectively analyzed. Four patients with PSA<0.2 μg/L were not included in the statistical analysis due to the small sample. Among the remaining 41 patients with 0.2 μg/L≤PSA<2.0 μg/L, 10 were with 0.2 μg/L≤PSA<0.5 μg/L, 14 were with 0.5 μg/L≤PSA<1.0 μg/L, 17 were with 1.0 μg/L≤PSA<2.0 μg/L. PET/CT imaging were performed within 2 weeks after the examination of serum PSA. All patients were divided into low-moderate-risk group ( n=12) and high-risk group ( n=29) according to the National Comprehensive Cancer Network (NCCN) guidelines. χ2 test, Fisher′s exact test and Spearman rank correlation were used to analyze the data. Results:Patients were followed up for 7 (4-15) months, and all 45 patients were confirmed by pathology or follow-up. There were 31 patients with recurrence and 14 patients without recurrence. The sensitivity, specificity and accuracy were 100%(31/31), 13/14, 97.78%(44/45)respectively. One patient with PSA<0.2 μg/L presented retroperitoneal lymph node metastasis. Among 41 patients with 0.2 μg/L≤PSA<2.0 μg/L, 31(75.61%) were with at least one recurrent lesion by 18F-PSMA-1007 PET/CT. There were 20 cases of local recurrence, 13 cases of lymph node metastasis, 14 cases of bone metastasis. The detection efficacies of 18F-PSMA-1007 PET/CT were 5/10 for patients with 0.2 μg/L≤PSA<0.5 μg/L, 11/14 for those with 0.5 μg/L≤PSA<1.0 μg/L, and 15/17 for those with 1.0 μg/L≤PSA<2.0 μg/L ( χ2=4.641, P>0.05). The positive results of 18F-PSMA-1007 PET/CT were positively correlated with serum PSA value and risk group ( r values: 0.394, 0.384, both P<0.05). Conclusion:18F-PSMA-1007 PET/CT is a valuable tool for detecting biochemical recurrence of prostate cancer with low PSA level.

Objective To investigate the expressions of Twist transcription factor and E-cadherin in anaplastic thyroid carcinoma and their correlation with the prognosis. Methods The clinicopathological data of 20 patients with anaplastic thyroid carcinoma in Shanxi Provincial Cancer Hospital from May 2016 to April 2018 were retrospectively analyzed. The expressions of Twist protein and E-cadherin protein in anaplastic thyroid carcinoma tissues and corresponding paracancerous tissues were detected by using immunohistochemistry. The relationship between the expressions of the two proteins and the clinicopathological features of the patients was analyzed, and the correlation among the expressions of the two proteins as well as the clinicopathological factors and the prognosis of the patients was analyzed. Results The positive expression rate of Twist protein in anaplastic thyroid carcinoma tissues was 65％ (13/20), while it was 20％ (4/20) in paracancerous tissues, and the difference was statistically significant (P= 0.004). The positive expression rate of E-cadherin in anaplastic thyroid carcinoma tissues was 60％(12/20), while it was 100％(20/20) in paracancerous tissues, and the difference was statistically significant (P = 0.001). There was a negative correlation between the expression of Twist protein and E-cadherin protein in anaplastic thyroid carcinoma (r=-0.685, P=0.001). The expression of Twist protein in anaplastic thyroid carcinoma was correlated with lymph node metastasis and TNM stage (both P< 0.05), while it had no correlation with gender, age and tumor diameter (all P> 0.05). The expression of E-cadherin protein in anaplastic thyroid carcinoma had no correlation with clinicopathological factors (all P> 0.05). The results of Kaplan-Meier survival analysis showed that lymphnode metastasis (P< 0.01), TNM stage (P = 0.002) and the expression of Twist protein (P = 0.017) were prognostic factors in patients with anaplastic thyroid carcinoma. Conclusions The expression of Twist transcription factor is upregulated in anaplastic thyroid carcinoma, and the expression of E-cadherin is downregulated. The expression of Twist protein is correlated with the prognosis of the patients. The epithelial-mesenchymal transition may be involved in the progress of anaplastic thyroid carcinoma.

Objective To investigate the correlation between the maximum standardized uptake value(SUVm,) of colorectal cancer primary lesions and clinical pathological features,such as TNM staging and clinical staging.Methods Eighty-three patients diagnosed with colorectal cancer and without any previous treatment were retrospectively analyzed and underwent 18F-fluorodeoxyglucose PET/CT examinations within one week,in which the SUVmax of the primary lesions was measured.Data were compared using one-way ANOVA and two-sample t test.Spearman correlation analysis was used to evaluate the correlation of the SUVmax of colorectal cancer primary lesions with TNM staging and clinical staging.Results The SUVmax of colorectal cancer primary lesions correlated with the tumor diameter(t=2.497,P＜0.05),pathological type and differentiation degree(F=3.727,P＜0.05).Statistically significant differences were found in the SUVmax of different N stages,M stages,and clinical stages(t=2.081,t=2.168,F=2.839,all P＜0.05) but not in the SUVmax of different T stages.The SUVmax of colorectal cancer primary lesions positively correlated with N,M,and clinical stages(r=-0.248,0.273,0.324,all P＜0.05) but not with T stages (r=0.004,P＞0.05).Conclusions The SUVmax of colorectal cancer primary lesions correlated with the tumor diameter,pathological type,differentiation degree,N stages,M stages,and clinical stages.Hence,SUVmax can reflect the invasion and proliferation abilities of colorectal cancer.

Objective To discuss the BRAF V600E mutation rate in papillary thyroid carcinoma (PTC) and its relationship with the clinicopathological features. Methods Two hundred and sixty-five PTC patients(including 226 cases of classical type,29 cases of follicular type, 3 cases of high cell type, 2 cases of diffuse sclerosis type, 2 cases of eosinophilic type, 3 cases of cystic type) from August 2014 to October in Shanxi Provincial Cancer Hospital, were collected with completely clinical and pathological information. The BRAF V600E mutation was detected by real-time polymerase chain reaction (RT-PCR) method. Pearson χ 2 test and the exact probability method were used to analysis the relationship between gene mutations and clinicopathological data. Results BRAF V600E mutation rate in PTC patients was 73.21 %(194/265). There was no significant difference in the mutation rate of BRAF V600E among patients with different age, gender, tumor location,tumor number and extravaginal invasion(all P>0.05),but the mutation rates of BRAF V600E gene in patients with different tumor size, histopathological subtypes, lymph node metastasis and clinical stage were significantly different(all P<0.05).Conclusion The PTC patients with positive BRAF V600E mutation have poor clinicopathological features,and BRAF V600E mutation may be a predictor of advanced PTC.

Purpose To discuss the diagnostic value and the optimal diagnostic threshold of preoperative 18F-FDG PET/CT imaging on regional lymph node metastasis in colorectal cancer.Materials and Methods Seventy-six patients with newly diagnosed colorectal cancer underwent radical resection of colorectal cancer within one week after PET/CT examination.All lymph nodes matching PET/CT were divided into proximal and distal lymph nodes on the basis of their location relative to the primary tumor.Meanwhile,the receiver operating characteristic (ROC) curves of the lymph node short diameter and maximum standardized uptake value (SUVmax) were created according to the pathological findings which were considered as the gold standard,and the diagnostic efficacies were analyzed.Results The proximal and distal lymph node ROC curves showed that the optimum thresholds of lymph node short diameter,SUVmax were 6.5 mm,1.9 and 5.5 mm,1.81.The sensitivity,specificity and accuracy of the diagnosis of proximal lymph node metastasis under the optimum threshold of lymph node short diameter were 84.85％,73.02％ and 77.52％,respectively;and those of distal lymph node metastasis were 97.62％,65.45％ and 79.38％,respectively.The sensitivity,specificity and accuracy of the diagnosis of proximal lymph node metastasis under the optimum threshold of SUVmax were 84.85％,95.81％ and 91.64％,respectively;those of distal lymph node metastasis were 92.86％,94.55％ and 93.81％,respectively.The specificity and accuracy of the optimum threshold of SUVmax were higher than those of the optimum threshold of lymph node short diameter (P＜0.01).The homogeneity of optimum threshold of SUVmax was excellent in comparison with the pathological results (Kappa=0.813 and 0.874,P＜0.01).Conclusion Optimum threshold method improves the diagnostic efficacy of 18F-FDG PET/CT in regional lymph node metastasis of colorectal cancer.Moreover,the SUVmax standard is superior to lymph node short diameter standard.

Objective To discuss the value of preoperative 18F-FDG PET-CT imaging in the staging of colorectal cancer. Methods Eighty-three patients with colorectal cancer were studied who underwent 18F-FDG PET-CT examinations without any previous treatment and subsequent operations within one week. The results of PET-CT and pathology were analyzed with chi-square test and Kappa consistency test. Results The diagnostic accuracy of primary colorectal lesions was 100 %, the average of maximum standardized uptake value(SUVmax) was 14.54±8.10(4.43-48.19). The diagnostic accuracy of local infiltration depth, lymph node metastasis, distant metastasis and TNM staging before operation were 73.49 %(61/83), 90.36 %(75/83), 97.59 % (81/83) and 85.54 % (71/83), respectively, and the Kappa values were 0.481, 0.797, 0.950, 0.788 (P <0.05).The diagnostic sensibility of staging with T1-2,T3and T4were 30.00 %(3/10),68.42 %(13/19) and 83.33 % (45/54), respectively, the diagnostic accuracy of staging with T1-2, T3and T4were 91.57 % (76/83), 74.70 % (62/83) and 80.72 % (67/83). Conclusion Preoperative 18F-FDG PET-CT imaging is an effective staging method for colorectal cancer, and has high accuracy in the detection of primary colorectal lesions, lymph node metastasis, distant metastasis and T4stage lesions, but it is difficult for diagnosing of the T1-2and T3lesions.

胃癌是常见的消化道恶性肿瘤之一,在我国的发病率和病死率均居所有恶性肿瘤前列,由于多数胃癌患者在确诊时已为进展期,且中晚期胃癌患者无有效的治疗方案,即使采用围手术期化疗或辅助化疗,5年生存率仍不足7%[1].近年来随着靶向治疗的兴起,为晚期胃癌患者的治疗带来了新的希望,一项国际多中心随机对照三期临床研究(ToGA试验)的结果显示,化疗联合针对人类表皮生长因子受体2(human epidermal growth factor receptor-2,HER2)的曲妥珠单抗治疗可延长HER2阳性进展期胃癌患者的生存期[2],因此准确分析HER2状态是进展期胃癌HER2靶向治疗的关键.

患者男,55岁,2010年10月无诱因出现左膝关节疼痛、肿胀,外院就诊,X线检查未见明显异常,临床考虑韧带撕裂,给予抗炎对症治疗,患者自觉疼痛减轻后出院.2010年12月患者因左膝关节疼痛加重于本院就诊,X线检查示髌骨骨密度减低(未予重视);MRI示髌骨信号减低且不均匀,关节腔见少量液体信号影(图1a),考虑滑膜炎,经休息、热敷、频谱治疗后好转.2011年5月患者扭伤后左膝关节疼痛再次加剧,局部软组织肿胀,行走困难,封闭治疗效果差,X线检查示髌骨局限性骨质破坏(图1b),遂再次于本院就诊.

Objective To investigate the association of Her-2 protein expression and gene expression in gastric cancer by different methods,and to explore the effective approaches of Her-2 in gastric cancer detection.Methods Immunohistochemistry (IHC) was used to mark Her-2 protein in 68 cases of gastric cancer,and fluorescence in situ hybridization(FISH)wasused to detect the Her-2 gene amplification.Results Among 68 cases,IHC Her-2 protein in 12 cases(17.65 ％)was positive expression,including ++ 3 cases ++ 9 cases,+ 7 cases and-49 cases.By FISH,Her-2 gene in 11 cases(16.17 ％)was overexpression.Corresponding to the IHC results,FISH results was 3 cases(100 ％),8 cases(88.89 ％),0 cases,0 cases,respectively.Conclusion Her-2 protein expression and gene overexpression occur in gastric cancer.Her-2 protein expression in gastric cancer shows significant heterogeneity.Her-2 gene overexpression and Her-2 protein expression is correlated (P＜0.05).The differences of Her-2 expression in gastric cancer by IHC and FISH mostly occur in IHC++ groupe.Suggestion of Her-2 gene test should be given for patients with IHC++ who will be undertaken Her-2 gene therapy.