Objective:Clinicopathological features, treatment and prognosis of urinary and male reproductive system soft tissue sarcoma (STS) and sarcomatoid carcinoma in adults were compared.Methods:A retrospective analysis was performed on the clinical data of 73 patients with STS and 15 patients with sarcomatoid carcinoma in adult urinary and male reproductive system in the First Affiliated Hospital of Zhengzhou University. There were 59 males and 14 females in STS group, with a median age of 41 (18-78)years old. The maximum tumor diameter ranged from 0.5 to 19.0 cm. The primary tumors were located in testis and peritesticular (23 cases), kidney (23 cases), prostate (15 cases), bladder (8 cases), ureter(3 cases), other parts(1 case). There were 18 cases of lymph node metastasis and 8 cases of distant metastasis. Among 73 patients with STS, 66 patients underwent surgical resection, of which 31 patients underwent radical resection. Among the 66 patients who underwent surgery, 3 patients received neoadjuvant chemotherapy; 22 patients received adjuvant chemotherapy; 5 patients were treated with adjuvant radiotherapy. Among 7 patients with STS did not receive surgical treatment, 2 patients received radiotherapy combined with chemotherapy, 2 patients received chemotherapy alone, and 3 patients received symptomatic support treatment.There were 11 males and 4 females in sarcomatoid carcinoma group, with a median age of 65 (23 - 84)years old. The measurable tumor diameter ranged from 0.4 to 16.9 cm. The primary tumors were located in kidney (6 cases), bladder (5 cases), ureter(2 cases) and prostate(2 cases). There were 2 patients of lymph node metastasis and 4 patients of distant metastasis. Of the 15 patients with sarcomatoid carcinoma, 12 patients underwent surgical resection, of which 5 patients underwent radical resection. 2 patients were treated with adjuvant therapy after operation. Among the 12 patients who received surgical treatment, 2 patients had distant metastasis before operation, all of which originated from the kidney. Among the 3 patients without surgical treatment, 1 patients received systemic chemotherapy and 2 patients received symptomatic supportive treatment. There was no significant difference in gender, tumor maximum diameter, distant metastasis and operation, chemotherapy, radiotherapy and operation combined with chemotherapy ( P>0.05) and there were significant differences in age, tumor primary location and lymph node metastasis ( P<0.05) between STS and sarcomatoid carcinoma patients.The categorical variables of the two groups were compared by χ2.With Kaplan-Meier method for univariate survival analysis, the Cox was used for multivariate analysis. Results:The median follow-up time was 18.3(0.3-90.4) months.In STS group, there were 14 patients of synovial sarcoma, 11 patients of liposarcoma, 15 patients of rhabdomyosarcoma, 16 patients of leiomyosarcoma, 10 patients of other types, and 7 patients of spindle cell sarcoma without specific classification. Among 66 patients with STS, 8 patients recurred, 14 patients metastasized after operation, 4 patients recurred and metastasized after operation. The 7 patients without surgical treatment all progressed. Among the 10 patients of sarcomatoid carcinoma without distant metastasis before operation, 3 patients recurred and 3 patients metastasized after operation. Two patients of renal sarcomatoid carcinoma with distant metastasis were treated with nephrectomy and chemotherapy. One of them had overall survival (OS) up to 2 years, and one recurred 2 months after operation. The 3 patients without surgical treatment all progressed without remission. The median OS of STS patients were 59.3 (95% CI 24.1-94.5) months and that of sarcomatoid carcinoma patients were 8.7 (95% CI 6.1-11.2) months. The OS of STS patients were better than those of sarcomatoid carcinoma patients ( HR=2.874, 95% CI 1.118-7.386, P=0.022). Conclusions:The onset age of STS in adult urinary and male reproductive system was lower than that in sarcomatoid carcinoma. The primary lesions of STS were mainly in testis, peritesticular and kidney. The primary lesions of sarcomatoid carcinoma were mainly in kidney. Among STS, leiomyosarcoma was the most common type.STS and sarcomatoid carcinoma should be diagnosed and treated with surgery quickly, and systemic therapy should be performed for patients who cannot be treated with surgery.

临床肿瘤学涵盖内容广泛、更新迅速,给肿瘤学硕士研究生教学带来了较大的挑战.“翻转课堂”是一种新兴的教学形式,其已被建议作为医学教育中有效教学的一种方法.但是,该方法在中国临床肿瘤学研究生的教育环境中的可行性和有效性尚不明确.本研究介绍了翻转课堂的内涵以及联合目前研究生教学模式应用最广泛的的可行性,并以局部晚期食管鳞癌教学单元为例,详细介绍了其实施过程,分析师生对翻转课堂教学的效果评价.结果 表明,翻转课堂的教学模式在肿瘤学硕士研究生教学中是可行的,和目前常用的案例为基础的教学模式相结合,对于培养研究生的自学兴趣和能力、尽快建立临床思维,有其独特的优势.

临床肿瘤学是一门极为复杂的交叉学科,专业的细分、治疗手段的更新迫使其治疗模式由单学科转化为综合多个学科的治疗理念和方法,即多学科综合治疗模式(MDT).我国的医学研究生教育体系形式较为单一,有很多不合理之处.探索建立与肿瘤专业MDT相匹配的研究生教育模式是一个非常重要的课题.本文概述了MDT的涵义、在硕士研究生肿瘤学教学中应用的可行性及教学效果.结果 表明,MDT应用于肿瘤学研究生的教学,对其开拓视野,培养MDT观念,提高团队协作能力,培养临床思辨能力较传统教学具有明显优势.

目的 探讨趋化因子受体CXCR4(CXC chemokine receptor 4,CXCR4)在食管癌上皮间质转化(epithelial-mesenchymal transition,EMT)发生中的作用及其参与食管癌侵袭转移的可能机制.方法 化学合成靶向CXCR4的siRNA,脂质体作用下转染食管癌EC9706细胞,同时以转染阴性对照siRNA、单纯转染脂质体和空白细胞作为对照.RT-PCR和Western blot检测CXCR4 siRNA对CXCR4 mRNA和蛋白表达的抑制作用;侵袭小室、划痕实验和MTT检测CXCR4 siRNA对EC9706细胞侵袭转移和增殖能力的影响;RT-PCR和Western blot检测CXCR4 siRNA对E-cadherin和vimentin mRNA和蛋白表达的影响.结果 靶向CXCR4 siRNA可以有效抑制食管癌EC9706细胞中CXCR4 mRNA和蛋白的表达,与对照组相比,差异有统计学意义(P＜0.01),且有时间依赖性(P＜0.05);转染CXCR4 siRNA的EC9706细胞侵袭转移和增殖能力较对照组显著下降(P＜0.05);转染CXCR4 siRNA的EC9706细胞随着CXCR4表达下降,E-cadherin表达随之升高,而vimentin表达则相应下降,差异有统计学意义(P＜0.05).结论 CXCR4可通过促进食管癌EMT的发生,参与其侵袭转移过程.

Objective To observe the clinical efficacy and toxicities of chemotherapy of NP regimen combined with compound matrine injection and bozhi glycopeptide in treating the elderly patients with advanced non-small cell cancer(NSCLC).Methods Seventy-five patients with elderly NSCLC were randomly divided into two groups,38cases in the treatment group received NP regimen chemotherapy combined with compound matrine injection and bozhi glycopeptide,37 cases in the control group were treated with NP regimen alone,the curative effect and improvement of clinical symptoms were observed,serum tumor marker was detected and KPS score was calculated.Results The effective rate of the treatment group and the control group was respectively 44.7% and 35.1%,but the difference was not statistically significant(P>0.05);but the clinical benefit response in the treatment group was higher than that in the control group(68.4% vs 37.8%,P<0.05).The differences of the incidence of toxicities,serum carcinoembryonic antigen levels,immune function change in the treatment group were also better than those in the control group(P<0.05).Conclusion NP regimen chemotherapy combined with compound matrine injection and bozhi glycopeptide in treating the elderly patients with NSCLC can relieve toxicities and increase efficiency.