Hypopharyngeal squamous cell carcinoma (HPSCC) has a poor prognosis due, in large part, to distant metastasis (DM). Although induction therapy (IT) can reduce DM rates, its translation to an overall survival (OS) benefit remains unclear, highlighting the need for tools to identify patients who would benefit most from IT. This study developed a nomogram to predict the risk for DM in patients with HPSCC, and assessed the survival benefit of IT across risk groups. Data from patients obtained from the Surveillance, Epidemiology, and End Results (i.e., "SEER") database (2004-2015) were randomly assigned to 1 of 2 groups at a ratio of 7:3: training; and internal validation. The external validation set comprised patients from 2 medical centers in China. Risk factors were identified using multivariate logistic regression analysis. Male sex, T classification ≥ 2, N classification ≥ 1, and poorer histological grade were independent risk factors for DM. The nomogram demonstrated good discriminative ability, with areas under the receiver operating characteristic curve of 0.702 (95% confidence interval [CI]: 0.669-0.735) in the training set, 0.704 (95% CI: 0.648-0.759) in the internal validation set, and 0.863 (95% CI: 0.804-0.923) in the external validation set. Based on the optimal cut-off value, patients were stratified into high- and low-risk groups. In the high-risk group, patients who received IT exhibited significantly improved OS (hazard ratio [HR] 0.364; 95% CI: 0.165-0.805; P = 0.040) and progression-free survival (PFS; HR 0.420; 95% CI: 0.190-0.928; P = 0.042) compared with those who did not receive IT. There was no significant survival benefit from IT in the low-risk group (OS: HR 0.881; 95% CI: 0.414-1.875, P = 0.095; PFS: HR 0.544 95% CI: 0.182-1.626, P = 0.250). This study constructed and preliminarily validated a nomogram for predicting DM in patients with HPSCC, and may serve as an exploratory tool for screening high-risk patients who are likely to benefit from IT, thereby providing a reference for the design of future prospective intervention trials.

SLC16A3, belonging to the SLC16 gene family, is involved in the transportation of monocarboxylate. SLC16A family members play important roles in tumorigenesis, nonetheless, the specific involvement of SLC16A3 in tumor prognosis and diagnosis in human cancers remains unelucidated. This study dealt with the exploration of SLC16A3 expression in human pan-cancer and its significance regarding disease prognosis. For this investigation, the mRNA expression data of SLC16A3 were acquired from the TCGA and the GTEx datasets. The Kaplan-Meier plots, univariate Cox regression, and the ROC curve were employed for assessing the prognostic and diagnostic significance of SLC16A3 in pan-cancer. Furthermore, the cBioPortal database was used to analyze the SLC16A3 genomic alterations. Moreover, the association of the infiltration of immune cells and immune checkpoint genes with SLC16A3 was analyzed by the TIMER database. Gene Ontology and KEGG pathway analysis were employed to explore the function of SLC16A3 in pan-cancer. The resulting data demonstrated that SLC16A3 mRNA expression was overexpressed in most cancers and its protein expression was also high across diverse cancer types. Moreover, upregulated SLC16A3 expression was linked to poor OS and PFI of certain cancers. Cox regression analysis further indicated that SLC16A3 is a risk factor for patients with PAAD, CESC, LUSC, LUAD, CHOL, LGG, MESO, and OSCC. The ROC curve revealed that SLC16A3 exhibited a high accuracy (AUC > 0.9) in BRCA, CHOL, ESCA, GBM, and KIRC prediction. Moreover, the acquired data indicated that in pan-cancer, the SLC16A3 expression exhibited correlations with immune checkpoint genes and immune cells. These findings collectively suggest that SLC16A3 holds promise as a biomarker for diagnostic and prognostic purposes in pan-cancer.

Abstract Temporal muscle thickness measured on 3D MRI has recently been linked to prognosis in glioblastoma patients and may serve as an independent prognostic indicator. This single-center study looked at temporal muscle thickness and prognosis in patients with primary glioblastoma. Overall survival was the major study outcome. For a retrospective analysis from 2010 to 2020, clinical data from 102 patients with glioblastoma at the Department of Oncology Radiotherapy of the First Affiliated Hospital of Dalian Medical University were gathered. Fifty-five cases from 2016 to 2020 contained glioblastoma molecular typing data, of which 45 were IDH wild-type glioblastomas and were analysed separately. TMT was measured on enhanced T1-weighted magnetic resonance images in patients with newly diagnosed glioblastoma.Overall patient survival (OS) was calculated by the Kaplan–Meier method and survival curves were plotted using the log-rank-sum test to determine differences between groups, and multifactorial analyses were performed using a Cox proportional-risk model.The median TMT for 102 patients was 6.775 mm (range: 4.95–10.45 mm). Patients were grouped according to median TMT, and the median overall survival (23.0 months) was significantly longer in the TMT > median group than in the TMT median group (P 0.001; Log-rank test). Analysing 45 patients with IDH wild type alone, the median overall survival (12 months) of patients in the TMT > median group was significantly longer than that of patients in the TMT ≤ median group (8 months) (P < 0.001; Log-rank test).TMT can serve as an independent prognostic factor for glioblastoma.

Abstract Purpose Malignant phyllodes tumor of the breast (MPTB) is a rare type of breast cancer, with an incidence of less than 1%. The value of adjuvant radiotherapy (RT) for MPTB has been controversial. The aim of the study was to explore the effect of radiotherapy on the long-term survival of female patients with MPTB at different ages. Methods Female MPTB patients were selected from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2020. A Kaplan–Meier survival analysis was conducted to investigate the value of RT for the long-term survival of MPTB patients in different age groups. Additionally, univariate and multivariate Cox regression analyses were performed for overall survival (OS) and breast cancer-specific survival (BCSS) of MPTB patients. Furthermore, propensity score matching (PSM) was also performed to balance the differences in baseline characteristics. Results 2261 MPTB patients were included in this study, including 455 patients (20.12%) with RT and 1806 patients (79.88%) without RT. These patients were divided into four cohorts based on their ages: 18–45, 46–55, 56–65, and 65–80. Before adjustment, there was a statistically significant difference in long-term survival between RT-treated and non-RT-treated patients in the younger age groups (age group of 18–45 years: OS P = 0.019, BCSS P = 0.016; age group of 46–55 years: OS P < 0.001, BCSS P < 0.001). After PSM, no difference was found in long-term survival of patients in both younger and older groups regardless of whether they received RT (age group of 18–45 years: OS P = 0.473, BCSS P = 0.750; age group of 46–55 years: OS P = 0.380, BCSS P = 0.816, age group of 56–65 years: OS P = 0.484, BCSS P = 0.290; age group of 66–80 years: OS P = 0.997, BCSS P = 0.763). In multivariate COX regression analysis, RT did not affect long-term survival in patients with MPTB. Conclusion There is no evidence that long-term survival of MPTB patients in specific age groups can benefit from RT.

Hepatocellular carcinoma (HCC) is a common malignant tumor that severely threatens human health. The poor prognosis of HCC is mainly attributed to intrahepatic and extrahepatic metastases. HOXD9 proteins belong to a superfamily that regulates the development and control of many cellular processes, including proliferation, apoptosis, cell shape, and cell migration. HOXD9 can also function as an oncogene in several cancer cells. However, its biological function in human HCC requires further investigation. In this study, HOXD9 exhibited high expression in invasive HCC cells. HOXD9 overexpression can significantly enhance HCC cell migration, invasion, and metastasis, whereas silencing HOXD9 inhibits these processes. HOXD9 also promotes the epithelial-mesenchymal transition (EMT) of HCC cells. Microarray analysis suggests that ZEB1 can function as a downstream factor of HOXD9. HOXD9 can interact with the promoter region of ZEB1 and promotes ZEB1 expression. ZEB1 knockdown inhibits HOXD9induced migration and invasion, as well as EMT in HCC cells. This study helps elucidates the oncogenic functions of HOXD9 in HCC.

Astrocytoma is a common brain tumor that can occur in any part of the central nervous system. This tumor is extremely harmful to patients, and there are no clear studies on the risk factors for astrocytoma of the brain. This study was conducted based on the SEER database to determine the risk factors affecting the survival of patients with astrocytoma of the brain. Patients diagnosed with brain astrocytoma in the SEER database from 2004 to 2015 were screened by inclusion exclusion criteria. Final screened brain astrocytoma patients were classified into low grade and high grade according to WHO classification. The risk factors affecting the survival of patients with low-grade and high-grade brain astrocytoma were analyzed by univariate Kaplan–Meier curves and log-rank tests, individually. Secondly, the data were randomly divided into training set and validation set according to the ratio of 7:3, and the training set data were analyzed by univariate and multivariate Cox regression, and the risk factors affecting the survival of patients were screened and nomogram was established to predict the survival rates of patients at 3 years and 5 years. The area under the ROC curve (AUC value), C-index, and Calibration curve are used to evaluate the sensitivity and calibration of the model. Univariate Kaplan–Meier survival curve and log-rank test showed that the risk factors affecting the prognosis of patients with low-grade astrocytoma included Age, Primary site, Tumor histological type, Grade, Tumor size, Extension, Surgery, Radiation, Chemotherapy and Tumor number; risk factors affecting the prognosis of patients with high-grade astrocytoma include Age, Primary site, Tumor histological type, Tumor size, Extension, Laterality, Surgery, Radiation, Chemotherapy and Tumor number. Through Cox regression, independent risk factors of patients with two grades were screened separately, and nomograms of risk factors for low-grade and high-grade astrocytoma were successfully established to predict the survival rate of patients at 3 and 5 years. The AUC values of low-grade astrocytoma training set patients were 0.829 and 0.801, and the C-index was 0.818 (95% CI 0.779, 0.857). The AUC values of patients in the validation set were 0.902, 0.829, and the C-index was 0.774 (95% CI 0.758, 0.790), respectively. The AUC values of high-grade astrocytoma training set patients were 0.814 and 0.806, the C-index was 0.774 (95% CI 0.758, 0.790), the AUC values of patients in the validation set were 0.802 and 0.823, and the C-index was 0.766 (95% CI 0.752, 0.780), respectively, and the calibration curves of the two levels of training set and validation set were well fitted. This study used data from the SEER database to identify risk factors affecting the survival prognosis of patients with brain astrocytoma, which can provide some guidance for clinicians.

目的 分析ERα36 表达与乳腺癌患者临床病理特征之间的关系,以及ERα36 和HER2 不同表达水平患者的预后情况.方法 收集 2008 年 1 月至 2018 年 12 月大连医科大学附属第二医院经病理确诊的 61 例乳腺癌患者的癌及癌旁组织标本及临床病例资料,采用qPCR检测标本中ERα36 mRNA的表达量,采用免疫组化及FISH方法检测标本HER2 表达.分析ERα36 表达量与临床病理特征之间的关系、ERα36 和HER2 不同表达水平与患者预后的关系.结果 乳腺癌组织与癌旁组织比较,ERα36 mRNA的表达量增高(P＜0.05).根据ERα36 mRNA表达量值,将61 例乳腺癌患者分为ERα36 高表达组42 例(表达量值≥1)和ERα36 低表达组19 例(表达量值＜1).ERα36 高表达组中已绝经者占 83.33％,高于ERα36 低表达组的 16.67％;ERα36 高表达组淋巴结转移(N1～3)者占 81.82％,高于ERα36 低表达组的 18.18％,差异均有统计学意义(P＜0.05).而年龄、生育史、家族史、临床分期、组织学分级、乳头大导管浸润、T分期、M分期在ERα36 高表达组与低表达组之间差异无统计学意义.ERα36 高表达组无进展生存期(progression free survival,PFS)较ERα36 低表达组短,同时ERa36 高表达HER2 阳性组PFS较 ERa36 低表达HER2 阴性组短,P均＜0.05.各组间总生存期(overall survival,OS)未见明显差异.结论 ERα36 mRNA在乳腺癌组织内表达增加,可能促进乳腺癌淋巴结转移;ERα36 高表达HER2阳性患者预后不良.

Following the publication of this paper, it was drawn to the Editors' attention by a concerned reader that various panels showing the western blotting data in Figs. 1D, 3A, 6A and C, 9B and 10A, the Transwell migration and invasion assays in Fig. 10C, and the H&E staining images from the lung portrayed in Fig. 5B were strikingly similar to data largely appearing in different form in other articles by different authors from different research institutions. Moreover, the data panels showing the Transwell migration and assay experiments in Figs. 3C and D and 4C and D showed several overlapping sections, such that the data appeared to have been selected from a small number of original sources to represent differently performed experiments. Owing to the fact that the contentious data in the above article had already been published prior to its submission to International Journal of Oncology, the Editor has decided that this paper should be retracted from the Journal. The authors were asked for an explanation to account for these concerns, but the Editorial Office did not receive a reply. The Editor apologizes to the readership for any inconvenience caused. [International Journal of Oncology 48: 1639‑1649, 2016; DOI: 10.3892/ijo.2016.3398].

Abstract Background Hematological parameters have been associated with prognosis in patients with nasopharyngeal carcinoma (NPC). The present meta‐analysis investigated the utility of neutrophil‐lymphocyte ratio (NLR) in the prognosis of patients with NPC. Methods Multiple electronic databases, including PubMed, Embase, the Cochrane Library, and the Web of Science, were systematically searched for studies assessing the association between NLR and NPC from 2011 to 2021. The primary outcomes were overall survival (OS) and progression‐free survival (PFS). Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were utilized to estimate effect size. Use of a fixed effect or random effect model was based on heterogeneity stability was tested by sensitivity analysis, and the risk of bias was assessed by funnel plots. Random effects models were used based on the actual results. Because the NLR grouping criteria for the included studies differed, subgroup analyses were performed. Results A search of the electronic databases identified 14 studies, encompassing 6693 patients, that met the selection criteria. NLR higher than the cutoff value was significantly associated with poorer OS [HR 1.760, 95% CI 1.470–2.120, p <0.00001] and PFS [HR 1.850, 95% CI 1.430–2.390, p = .006]. Sensitivity analysis showed that the results of the meta‐analysis were relatively stable, and funnel plots were used to exclude the risk of bias. Conclusions Elevated pretreatment NLR in peripheral blood is predictive of poorer OS and PFS in patients with NPC. NLR is an easily measured and important prognostic factor in patients with NPC.

目的 基于静息态功能磁共振成像(rs-fMRI)探讨鼻咽癌(NPC)患者放疗后远期全脑功能连接(FC)变化.方法 选取NPC患者(NPC组)和健康志愿者(对照组)各30例,NPC患者均接受常规放疗,且放疗结束6个月以上.对所有受试者行rs-fMRI检查,使用北京版蒙特利尔认知评估量表(MoCA)进行认知能力评估,统计患者双侧颞叶辐射剂量.结果 NPC组的MoCA评分较对照组降低,视空间与执行能力及延迟回忆差异有统计学意义.与对照组相比,NPC组网络内出现3个节点FC降低,分别为右侧岛叶、左侧小脑脚Ⅱ区及右侧楔叶,且右侧岛叶变化具有剂量依赖性;NPC组网络间有4对脑区FC异常,增强及减弱各2对,其中左侧执行控制网络与岛叶网络间FC变化与辐射剂量相关.结论 NPC患者放疗后远期出现认知功能降低,rs-fMRI能够显示特定脑区网络内/间FC异常.

The most dangerous variety of glioma, glioblastoma, has a high incidence and fatality rate. The prognosis for patients is still bleak despite numerous improvements in treatment approaches. We urgently need to develop clinical parameters that can evaluate patients' conditions and predict their prognosis. Various parameters are available to assess the patient's preoperative performance status and degree of frailty, but most of these parameters are subjective and therefore subject to interobserver variability. Sarcopenia can be used as an objective metric to measure a patient's physical status because studies have shown that it is linked to a bad prognosis in those with cancers. For the purpose of identifying sarcopenia, temporal muscle thickness has demonstrated to be a reliable alternative for a marker of skeletal muscle content. As a result, patients with glioblastoma may use temporal muscle thickness as a potential marker to correlate with the course and fate of their disease. This narrative review highlights and defines the viability of using temporal muscle thickness as an independent predictor of survival in glioblastoma patients, and it evaluates recent research findings on the association between temporal muscle thickness and prognosis of glioblastoma patients.

PurposeTo evaluate the feasibility of using a simplified non-coplanar volumetric modulated arc therapy (NC-VMAT) and investigate its dosimetric advantages compared with intensity modulated radiation therapy (IMRT) and coplanar volumetric modulated arc therapy (C-VMAT) for hippocampal-avoidance whole brain radiation therapy (HA-WBRT).MethodsTen patients with brain metastase (BM) were included for HA-WBRT. Three treatment plans were generated for each case using IMRT, C-VMAT, and NC-VMAT, respectively.ResultsThe dosimetric results of the three techniques complied roughly with the RTOG 0933 criteria. After dose normalization, the V30Gy of whole brain planned target volume (WB-PTV) in all the plans was controlled at 95%. Homogeneity index (HI) of WB-PTV was significantly reduced in NC-VMAT (0.249 ± 0.017) over IMRT (0.265 ± 0.020, p=0.005) and C-VMAT (0.261 ± 0.014, p=0.020). In terms of conformity index (CI), NC-VMAT could provide a value of 0.821 ± 0.010, which was significantly superior to IMRT (0.788 ± 0.019, p<0.001). According to D2% of WB-PTV, NC-VMAT could provide a value of 35.62 ± 0.37Gy, significantly superior to IMRT (36.43 ± 0.65Gy, p<0.001). According to D50% of WB-PTV, NC-VMAT can achieve the lowest value of 33.18 ± 0.29Gy, significantly different from IMRT (33.47 ± 0.43, p=0.034) and C-VMAT (33.58 ± 0.37, p=0.006). Regarding D2%, D98%, and Dmean of hippocampus, NC-VMAT could control them at 15.57 ± 0.18Gy, 8.37 ± 0.26Gy and 11.71 ± 0.48Gy, respectively. D2% and Dmean of hippocampus for NC-VMAT was significantly lower than IMRT (D2%: 16.07 ± 0.29Gy, p=0.001 Dmean: 12.18 ± 0.33Gy, p<0.001) and C-VMAT (D2%: 15.92 ± 0.37Gy, p=0.009 Dmean: 12.21 ± 0.54Gy, p<0.001). For other organs-at-risk (OARs), according to D2% of the right optic nerves and the right lenses, NC-VMAT had the lowest values of 31.86 ± 1.11Gy and 7.15 ± 0.31Gy, respectively, which were statistically different from the other two techniques. For other organs including eyes and optic chiasm, NC-VMAT could achieve the lowest doses, different from IMRT statistically.ConclusionThe dosimetry of the three techniques for HA-WBRT could roughly comply with the proposals from RTOG 0933. After dose normalization (D95%=30Gy), NC-VMAT could significantly improve dose homogeneity and reduce the D50% in the brain. Besides, it can reduce the D2% of the hippocampus, optic nerves, and lens. With this approach, an efficient and straightforward plan was accomplished.

目的 探讨Septin7蛋白在胶质瘤中的表达情况及其临床意义.方法 通过免疫组织化学方法检测188例胶质瘤患者石蜡标本中Septin7蛋白表达情况,分析与患者临床病理参数(WHO分级、性别、年龄、KPS、术中切除情况、肿瘤大小、肿瘤部位、肿瘤局限于单叶或多叶)的关系,并结合是否行放疗,是否口服替莫唑胺及生存情况进行预后分析.结果 随着胶质瘤WHO分级的升高,Septin7蛋白表达降低(P<0.05).女性胶质瘤患者中Septin7蛋白表达水平较男性患者高(P<0.05),Septin7表达在不同年龄、KPS评分、切除情况、肿瘤部位、肿瘤是否局限于单叶情况间比较,差异均无统计学意义(P>0.05).不同Septin7蛋白表达组之间生存时间差异有统计学意义(P<0.05).单因素Cox分析显示,性别(P=0.003)、年龄(P=0.002)、WHO分级(P=0.001)、是否行放疗(P=0.005)及Septin7蛋白表达程度(P=0.020)是胶质瘤预后的影响因素.将单因素Cox分析中具备统计学意义的因素纳入多因素Cox逐步回归分析,结果提示性别(HR=0.618,95％CI 0.429～0.889,P=0.009)、年龄(HR=1.707,95％CI 1.099～2.651,P=0.017)、WHO分级(HR=2.683,95％CI 1.452～4.959,P=0.002)及是否行放疗(HR=2.090,95％CI 1.499～2.914,P<0.001)为预后的独立影响因素.结论 Septin7蛋白在女性胶质瘤患者中表达水平更高.随着脑胶质瘤WHO分级提高,Septin7蛋白表达程度降低,与胶质瘤患者预后不良相关,但暂无法作为独立预后因子.

目的 探讨帕博利珠单抗联合卡培他滨、奥沙利铂治疗进展期胃癌的临床疗效及安全性.方法 以大连大学附属新华医院肿瘤内科收治的92例进展期胃癌患者为研究对象,按照随机数字法,将其分为对照组(卡培他滨+奥沙利铂,XELOX化疗,45例)和观察组(帕博利珠单抗联合XELOX化疗,47例),比较两组的临床疗效、毒副反应及生存率.结果 与对照组相比,观察组患者的治疗有效率(ORR)显著升高,差异具有统计学意义(80.95％vs.67.50％);观察组患者的化疗毒副作用如白细胞减少(7.14％vs.22.50％)、血小板减少(19.04％vs.40.00％)、贫血(14.28％vs.35.00％)和甲状腺功能减退(23.81％vs.45.00％)的发生率显著低于对照组;与对照组相比,观察组无进展生存率及总生存率明显提高.结论 帕博利珠单抗联合卡培他滨、奥沙利铂能够明显提高进展期胃癌患者的临床疗效,降低化疗期间的毒副反应,提升患者的生存率.

Immunotherapy has revolutionized the established therapeutics against tumors. As the major immunotherapy approach, immune checkpoint inhibitors (ICIs) achieved remarkable success in the treatment of malignancies. However, the clinical gains are far from universal and durable, because of the primary and secondary resistance of tumors to the therapy, or side effects induced by ICIs. There is an urgent need to find safe combinatorial strategies that enhance the response of ICIs for tumor treatment. Diets have an excellent safety profile and have been shown to play pleiotropic roles in tumor prevention, growth, invasion, and metastasis. Accumulating evidence suggests that dietary regimens bolster not only the tolerability but also the efficacy of tumor immunotherapy. In this review, we discussed the mechanisms by which tumor cells evade immune surveillance, focusing on describing the intrinsic and extrinsic mechanisms of resistance to ICIs. We also summarized the impacts of different diets and/or nutrients on the response to ICIs therapy. Combinatory treatments of ICIs therapy with optimized diet regimens own great potential to enhance the efficacy and durable response of ICIs against tumors, which should be routinely considered in clinical settings.

PURPOSE:Nasopharyngeal carcinoma (NPC), an epithelial-originated malignant tumor, has a special geographic distribution. However, the etiology of NPC has not been examined in detail. Increasing pieces of evidence indicate that the microbiome may contribute to head and neck squamous cell carcinoma. Until now, there is limited information on the role of the microbiome in NPC, so we assessed variations in the nasopharynx microbiota of patients with NPC relative to the bacterial in health controls.METHODS:Nasopharynx lavage fluid (NLF) samples were collected from 11 NPC patients and 5 volunteer controls. 16S rRNA sequencing and comparative analyses of NLF bacterial microbiome between NPC patients and controls were performed.RESULTS:NLF microbial alpha-diversity by the Shannon index and Simpson index decreased significantly in the NPC patients when compared with the controls. Beta-diversity by principal component analysis exhibited separated patterns of the NPC patients and healthy controls. Thirty-one genera differed significantly between the NPC patient group and healthy control group. The abundance of 17 bacteria was correlated with primary tumor size and invaded lymph node size. Functional gene prediction analysis showed that 9 gene function pathways were significantly different between the two groups.CONCLUSION:Our results demonstrated that the nasopharynx microbiota in NPC patients was different from that of the healthy controls, suggesting that the nasopharynx microenvironment might be related to NPC.

肿瘤心脏病学是关注肿瘤患者心血管疾病发生发展、诊断治疗以及预后随访的新兴交叉学科,2018年肿瘤心脏病学已写入我国第九版内科学教材,放射性心脏损伤是肿瘤心脏病学所关注的重点内容之一,学科间交叉知识的掌握对该类患者的治疗十分重要,这也促使放疗专科医生掌握疾病相关跨学科知识.然而,以学科为基础的传统的教学模式,不能适应新兴交叉学科人才培养的需求,文章总结了大连医科大学附属第一医院应用多学科团队教学模式,在放疗相关肿瘤心脏病教学中的应用效果,分析了其在培养放疗医生过程中起到的作用,探讨了目前放疗相关肿瘤心脏病教学中存在的问题及解决方案.

目的 分析单纯脑寡转移的初治非小细胞肺癌患者临床特征及治疗模式,探讨影响患者预后的相关因素.方法 收集2005年1月至2014年12月大连医科大学附属第一医院治疗的晚期非小细胞肺癌患者,均为初诊单纯脑寡转移病例41例.对年龄、性别、KPS评分、GPA评分、原发病灶病理类型、脑转移病灶数量、脑转移病灶最大径、脑转移灶局部治疗模式、肺内病灶控制情况、全身治疗模式等因素应用Log-rank检验进行单因素分析,多因素分析采用Cox回归模型,Kaplan-Meier法分析生存情况.结果 全组患者中位生存时间8.9个月,1年、2年生存率分别为41.5％、14.6％.单因素分析提示:脑转移病灶数量、脑转移治疗模式、全身治疗模式与预后相关,多因素分析结果提示靶向治疗是唯一独立预后相关因素.结论 对于初诊即存在脑寡转移的非小细胞肺癌患者,寡转移病灶的数量、脑转移治疗模式、全身治疗模式为预后相关因素,其中全身治疗模式即是否应用靶向治疗为唯一独立预后相关因素.

Objective To explore the role of microbiota abnormality in pathogenesis of nasopharyngeal carcinoma.Methods With 5 healthy individuals as the controls and 7 patients diagnosed as nasopharyngeal squamous carcinoma who had not received any treatment as the subjects,polymerase chain reaction-modified gradient gel electrophoresis (PCR-DGGE) gene fingerprint technology was used to observe the differences in the microbiota in nasopharyngeal lavage fluid between the patients and healthy individuals.The total DNA was extracted from the nasopharyngeal lavage fluid.The similarity and diversity of microbiota between the two groups were analysed.Results There were significant differences in the distribution of the microbiota in nasopharyngeal lavage fluid between patients and healthy controls.Compared with the controls,the relative abundances of Streptococcus anginosus and Acinetobacters were significantly higher while that of Streptococcus thermophilus was lower in the patients.Conclusion There is significant difference in the distribution of microbiota in the nasopharyngeal lavage fluid between the patients and healthy controls.This study can provide experimental evidence for the prevention and treatment of nasopharyngeal carcinoma.