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KML001,an arsenic compound,as salvage chemotherapy in refractory biliary tract cancers:A prospective study 预览
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作者 Jung Hyun Jo Huapyong Kang +5 位作者 Hee Seung Lee Moon Jae Chung Jeong Youp Park Seungmin Bang Seung Woo Park Si Young Song 《国际肝胆胰疾病杂志:英文版》 SCIE CAS CSCD 2019年第1期62-66,共5页
Background:Sodium meta-arsenite(NaAsO2,KML001)is a potential oral anticancer agent acting on telomerase and telomere length.This prospective study evaluated its safety,tolerability,and effectiveness as salvage chemoth... Background:Sodium meta-arsenite(NaAsO2,KML001)is a potential oral anticancer agent acting on telomerase and telomere length.This prospective study evaluated its safety,tolerability,and effectiveness as salvage chemotherapy in patients with advanced biliary tract cancer(BTC)resistant to gemcitabinebased chemotherapy.Methods:Forty-four patients(21 women and 23 men)with advanced BTC and failure history of gemcitabine-based chemotherapy,performance status(PS)0–2,normal cardiac,hepatic,and renal function were enrolled.Daily dose of KML001(7.5 mg.p.o.)was administered to eligible subjects for 24 weeks divided into six treatment cycles.Response was evaluated bimonthly using CT.Results:After an average of 1.5 months of treatment(range:0.5–10.0),3 patients(6.8%)obtained progression-free status,23 patients(52.3%)had disease progression,and 18 patients(40.9%)dropped out before evaluation.One patient(2.3%)completed six treatment cycles without progression.During the treatment,morphine dosage kept the same or decreased in 20 patients(47.6%).Nine patients(20.5%)experienced grade-3 adverse events(AEs),while no patient experienced grade-4 AEs.The most common AEs were liver enzyme elevation(11/44,25%)and anemia(10/44,22.7%).KML001 was discontinued in six patients(13.6%)due to AEs,including liver toxicity(n=3),QTc prolongation(n=2),and abdominal pain(n=1).Conclusions:KML001 did not have enough anticancer effect on patients with advanced BTC resistant to gemcitabine.However,KML001 was safe and well-tolerable in terms of AEs and pain control when used as salvage therapy.Further studies are needed to establish arsenic agents as a reliable treatment option in patients with BTC. 展开更多
关键词 BILIARY TRACT NEOPLASMS CHOLANGIOCARCINOMA GALLBLADDER NEOPLASMS KML001 Sodium meta-arsenite
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Endoscopic ultrasound-guided vs endoscopic retrograde cholangiopancreatography biliary drainage for obstructed distal malignant biliary strictures: A systematic review and meta-analysis 预览
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作者 Fernanda P Logiudice Wanderlei M Bernardo +9 位作者 Facundo Galetti Vitor M Sagae Carolina O Matsubayashi Antonio C Madruga Neto Vitor O Brunaldi Diogo T H de Moura Tomazo Franzini Spencer Cheng Sergio E Matuguma Eduardo G H de Moura 《世界胃肠内镜杂志:英文版(电子版)》 2019年第4期281-291,共11页
BACKGROUND For palliation of malignant biliary obstruction (MBO), the gold-standard method of biliary drainage is endoscopic retrograde cholangiopancreatography (ERCP) with the placement of metallic stents. Endoscopic... BACKGROUND For palliation of malignant biliary obstruction (MBO), the gold-standard method of biliary drainage is endoscopic retrograde cholangiopancreatography (ERCP) with the placement of metallic stents. Endoscopic ultrasound (EUS)-guided drainage is an alternative that is typically reserved for cases of ERCP failure. Recently, however, there have been robust randomized clinical trials (RCTs) comparing EUS-guided drainage and ERCP as primary approaches to MBO. AIM To compare EUS guidance and ERCP in terms of their effectiveness and safety in palliative biliary drainage for MBO. METHODS This was a systematic review and meta-analysis, in which we searched the MEDLINE, Excerpta Medica, and Cochrane Central Register of Controlled Trials databases. Only RCTs comparing EUS and ERCP for primary drainage of MBO were eligible. All of the studies selected provided data regarding the rates of technical and clinical success, as well as the duration of the procedure, adverse events, and stent patency. We assessed the risk of biases using the Jadad score and the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation criteria. RESULTS The database searches yielded 5920 records, from which we selected 3 RCTs involving a total of 222 patients (112 submitted to EUS and 110 submitted to ERCP). In the EUS and ERCP groups, the rate of technical success was 91.96% and 91.81%, respectively, with a risk difference (RD) of 0.00%(95%CI:-0.07, 0.07;P = 0.97;I2 = 0%). The clinical success was 84.81% and 85.53% in the EUS and ERCP groups, respectively, with an RD of ?0.01%(95%CI:-0.12, 0.10;P = 0.90;I2 = 0%). The mean difference (MD) for the duration of the procedure was -0.12%(95%CI:-8.20, 7.97;P = 0.98;I2 = 84%). In the EUS and ERCP groups, there were 14 and 25 adverse events, respectively, with an RD of -0.06%(95%CI:-0.23, 0.12;P = 0.54;I2 = 77%). The MD for stent patency was 9.32%(95%CI:-4.53, 23.18;P = 0.19;I2 = 44%). The stent dysfunction rate was significantly lower in the EUS group (MD =-0. 展开更多
关键词 Common bile duct neoplasms ENDOSCOPIC retrograde cholangiopancreatography ENDOSONOGRAPHY Ultrasonography Interventional/methods ENDOSCOPIC ultrasound Systematic review META-ANALYSIS
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青年癌症患者标准化沟通系统的设置及应用
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作者 刘敏 谢建飞 +5 位作者 孙倩 王璐 周建大 曾赛男 樊小军 郑树基 《中国医师杂志》 CAS 2019年第4期507-512,共6页
目的探讨青年癌症患者标准化沟通系统的设置及应用,以改善青年癌症患者的心理痛苦等负性情绪,提升青年癌症患者的社会支持与生活质量。方法初步构建适合中国国情的青年癌症患者标准化沟通系统,并于2016年8月至9月从中南大学湘雅三医院... 目的探讨青年癌症患者标准化沟通系统的设置及应用,以改善青年癌症患者的心理痛苦等负性情绪,提升青年癌症患者的社会支持与生活质量。方法初步构建适合中国国情的青年癌症患者标准化沟通系统,并于2016年8月至9月从中南大学湘雅三医院和湖南省肿瘤医院就诊的486例青年癌症患者中逐步筛选,选取共171例受试者,运用随机数字表法将171例受试者随机分配至沟通组(n=57)、音乐组(n=57)和常规组(n=57),进行随机对照试验。分别以心理痛苦温度计(DT)、医院焦虑抑郁量表(HADS)、社会支持评定量表(SSRS)、简明健康状况问卷(SF-36)作为评价指标,观察三组受试者在干预前、干预后(立即)、干预后1个月和干预后3个月的心理痛苦、情绪、社会支持、生存质量等情况。结果干预后3个月随访时,共有38例失访,沟通组失访14例(最终n=43),音乐组失访11例(最终n=46)和常规组失访13例(最终n=44)。沟通组、音乐组及常规组三组在干预前的测评指标比较差异无统计学意义(P>0. 05);干预前与干预后立即、干预后1个月、3个月三组在心理痛苦、焦虑抑郁、社会支持的得分比较差异均有统计学意义(P<0. 05);沟通组干预后1个月的心理痛苦、焦虑抑郁、社会支持和生活质量得分与音乐组、常规组比较差异均有统计学意义(P<0.05)。结论标准化沟通系统对改善青年癌症患者的心理痛苦具有明显效果,该方法优于音乐疗法和常规照护,并能提升青年癌症患者的社会支持水平与生活质量。标准化沟通系统的临床验证,可为癌症患者的心理康复提供参考。 展开更多
关键词 青少年 肿瘤 心理疗法 心理测定学
Investigation of therapeutic modalities of G719X, an uncommon mutation in the EGFR gene in non-small cell lung cancer 预览
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作者 Hua Zheng Yuan Gao +7 位作者 Zan Liu Zhe Qian Tongmei Zhang Jie Li Hongmei Zhang Qunhui Wang Fanbin Hu Baolan Li 《肿瘤学与转化医学:英文版》 2019年第2期91-97,共7页
Objective G719 X is the most frequently seen uncommon mutation of the epidermal growth factor receptor(EGFR) gene, which is a point mutation at exon 18 with three common subtypes, G719 A/G719 C/G719 S. This study expl... Objective G719 X is the most frequently seen uncommon mutation of the epidermal growth factor receptor(EGFR) gene, which is a point mutation at exon 18 with three common subtypes, G719 A/G719 C/G719 S. This study explored the clinicopathological characteristics of the G719 X mutation and investigated the efficacy of EGFR-tyrosine kinase inhibitor(TKI) treatment and chemotherapy in patients with the G719 X mutation;the survival rate after these different treatment modalities were then analyzed in order to provide evidence for clinical treatment.Methods Clinical data of 41 patients with the G719 X mutation admitted in the Beijing Chest Hospital, Capital Medical University from September 2014 to July 2018, were collected and the EGFR mutations were detected by amplification refractory mutation system-polymerase chain reaction(ARMS-PCR). The clinicopathological characteristics of the G719 X mutation were analyzed, and the relationship among the G719 X mutation, the efficacy of different treatment modalities, and the progression-free survival(PFS) was analyzed. Results Of the 41 cases, 24(58.5%) were G719 X single mutations and 17(41.5%) were compound mutations, including G719 X/S768 I, G719 X/L861 Q, G719 X/19 del, and G719 X/c-Met compound mutation. The objective response rate(ORR) of first-line EGFR-TKI therapy was 50%(6/12), the disease control rate(DCR) was 83.3%(10/12), and the median PFS(mPFS) was 9 months. After resistance to EGFR-TKI in the previous treatment, the ORR(71.4%, 5/7) and DCR(100%, 7/7) were still high following EGFR-TKIs, by an mPFS of 8 months. The ORR of chemotherapy was 33.3%(2/6), the DCR was 100%(6/6), and the mPFS was 6 months. Conclusion G719 X is an uncommon mutation of the EGFR gene and is sensitive to many EGFR-TKIs. It can be treated with the second-or third-generation EGFR-TKIs after resistance to the first-generation EGFR-TKIs. G719 X mutation also showed favorable effect to chemotherapy. 展开更多
关键词 LUNG NEOPLASMS EGFR UNCOMMON MUTATION G719X TARGET therapy
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Tertiary stent-in-stent for obstructing colorectal cancer: A case report and literature review 预览
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作者 Giuseppe Vanella Chiara Coluccio +2 位作者 Emilio Di Giulio Daniela Assisi Rocco Lapenta 《世界胃肠内镜杂志:英文版(电子版)》 2019年第1期61-67,共7页
BACKGROUND Self-expandable metal stents(SEMSs) are frequently used in the setting of palliation for occluding, inoperable colorectal cancer(CRC). Among possible complications of SEMS positioning, re-obstruction is the... BACKGROUND Self-expandable metal stents(SEMSs) are frequently used in the setting of palliation for occluding, inoperable colorectal cancer(CRC). Among possible complications of SEMS positioning, re-obstruction is the most frequent. Its management is controversial, potentially involving secondary stent-in-stent placement, which has been poorly investigated. Moreover, the issue of secondary stent-in-stent re-obstruction and of more-than-two colonic stenting has never been assessed. We describe a case of tertiary SEMS-in-SEMS placement, and also discuss our practice based on available literature.CASE SUMMARY A 66-year-old male with occluding and metastatic CRC was initially treated by positioning of a SEMS, which had to be revised 6 mo later when a symptomatic intra-stent tumor ingrowth was treated by a SEMS-in-SEMS. We hereby describe an additional episode of intestinal occlusion due to recurrence of intra-stent tumor ingrowth. This patient, despite several negative prognostic factors(splenic flexure location of the tumor, carcinomatosis with ascites, subsequent chemotherapy that included bevacizumab and two previously positioned stents(1 SEMS and 1 SEMS-in-SEMS)) underwent successful management through the placement of a tertiary SEMS-in-SEMS, with immediate clinical benefit and no procedure-related adverse events after 150 d of post-procedural follow-up. This endoscopic management has permitted 27 mo of partial control of a metastatic disease without the need for chemotherapy discontinuation and, ultimately, a good quality of life until death.CONCLUSION Tertiary SEMS-in-SEMS is technically feasible, and appears to be a safe and effective option in the case of recurrent SEMS obstruction. 展开更多
关键词 BEVACIZUMAB Colorectal neoplasms Intestinal OBSTRUCTION PALLIATIVE care Self-expandable metallic STENTS Case report
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基于焦点小组访谈法构建以CICARE沟通模式为基础的癌症患者护患沟通流程的研究
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作者 柳鸿鹏 曹晶 +5 位作者 焦静 郭淑丽 陆相云 王志新 许宁 吴欣娟 《中华现代护理杂志》 2019年第12期1514-1517,共4页
目的基于美国CICARE沟通模式,建立针对我国癌症患者的护患沟通流程,为临床护士与癌症患者沟通交流过程中提供标准化、流程化的指导。方法2018年11—12月,采用目的抽样的方法于北京市某三级甲等医院选取5名临床护理专家,采用焦点小组访... 目的基于美国CICARE沟通模式,建立针对我国癌症患者的护患沟通流程,为临床护士与癌症患者沟通交流过程中提供标准化、流程化的指导。方法2018年11—12月,采用目的抽样的方法于北京市某三级甲等医院选取5名临床护理专家,采用焦点小组访谈法对其进行访谈。结果经过两轮焦点小组访谈,形成以CICARE沟通模式为基础的癌症患者护患沟通流程,6个环节包括:礼貌接触、全面介绍、专业解释、关心询问、耐心解答、适时离开;内容包括:护士角色转换、入院评估、协调住院间事宜、个案管理、提供关怀照顾及健康宣教等。结论借鉴国外护患沟通模式,结合临床护理实践经验,形成适用于我国癌症患者的护患沟通流程,利于为护患沟通交流提供参考,为深入开展优质护理服务示范工程及精细化管理奠定基础。 展开更多
关键词 肿瘤 护患沟通 CICARE沟通模式 优质护理服务 焦点小组访谈
酸性微环境在肿瘤中作用的研究进展 预览
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作者 杨建芬 《赣南医学院学报》 2019年第4期396-401,共6页
酸性微环境是实体肿瘤的主要特征之一,有氧糖酵解增强、磷酸戊糖途径增强以及缺氧是造成肿瘤酸性微环境的主要原因。近年来研究发现,肿瘤酸性微环境能够促进肿瘤细胞的增殖、侵袭、迁移等细胞恶性生物学行为,还使肿瘤细胞对某些化疗药... 酸性微环境是实体肿瘤的主要特征之一,有氧糖酵解增强、磷酸戊糖途径增强以及缺氧是造成肿瘤酸性微环境的主要原因。近年来研究发现,肿瘤酸性微环境能够促进肿瘤细胞的增殖、侵袭、迁移等细胞恶性生物学行为,还使肿瘤细胞对某些化疗药物产生耐药性以及逃避宿主免疫监视。此外,肿瘤的酸性微环境也为肿瘤的治疗提供了新的方向。本文就酸性微环境的成因、调节机制及其在肿瘤发生发展过程中的作用等进行综述,并阐述针对肿瘤酸性微环境的治疗策略。 展开更多
关键词 肿瘤 肿瘤微环境 肿瘤发生与发展
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Atypical chemokine receptor CCRL2 is overexpressed in prostate cancer cells 预览
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作者 Niradiz Reyes Ines Benedetti +2 位作者 Juan Rebollo Oscar Correa Jan Geliebter 《生物医学研究杂志:英文版》 CAS CSCD 2019年第1期17-23,共7页
Atypical chemokine receptors have recently emerged as important molecular players in health and diseases;they affect chemokine availability and function and impact a multitude of pathophysiological events,including th... Atypical chemokine receptors have recently emerged as important molecular players in health and diseases;they affect chemokine availability and function and impact a multitude of pathophysiological events,including the tumorigenesis process.This family of atypical receptors comprises five members:ACKR1/DARC,ACKR2/D6,ACKR3/CXCR7,ACKR4/CCRL1,and ACKR5/CCRL2.This work evaluated the differential expression of these receptors in prostate cancer using quantitative PCR.Further evaluation of CCRL2 at the protein level confirmed its overexpression in a metastatic cell line and in malignant prostatic tissues from patients.CCRL2,apresumed member of the atypical chemokine receptor family,plays akey role in lung dendritic cell trafficking to peripherally mphnodes.Recent studies have reported the expression of CCRL2 in different human cancer cell lines and tissues.However,its function and expression in prostate cancer has not been previously addressed. 展开更多
关键词 CHEMOKINE RECEPTOR PROSTATIC NEOPLASMS CCRL2 RECEPTOR real-time POLYMERASE chain reaction tissue array analysis
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2016年重庆市丰都县恶性肿瘤疾病负担研究 预览
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作者 江兵 崔小平 徐世强 《现代医药卫生》 2019年第10期1478-1481,共4页
目的分析丰都县恶性肿瘤的疾病负担,为开展恶性肿瘤防治及制定相关政策提供依据。方法采用SPSS19.0统计软件分析2016年重庆市丰都县恶性肿瘤发病及死亡数据,统计分析发病率、死亡率、标化发病率与死亡率、伤残调整生命年(DALYs)、早死... 目的分析丰都县恶性肿瘤的疾病负担,为开展恶性肿瘤防治及制定相关政策提供依据。方法采用SPSS19.0统计软件分析2016年重庆市丰都县恶性肿瘤发病及死亡数据,统计分析发病率、死亡率、标化发病率与死亡率、伤残调整生命年(DALYs)、早死所致的寿命损失年(YLLs)、残疾所致寿命损失年(YLDs)等指标。结果2016年丰都县共计报告新发恶性肿瘤1395例,发病率为222.99/10万,标化发病率为162.16/10万,男性发病率(258.66/10万)高于女性(186.88/10万),差异有统计学意义(χ2=6.02,P=0.014)。报告恶性肿瘤死亡病例1069例,报告死亡率与标化死亡率分别为170.88/10万、99.74/10万,男性死亡率(219.89/10万)高于女性(121.26/10万),差异有统计学意义(χ2=9.44,P=0.002)。2016年丰都县恶性肿瘤YLLs、YLDs、DALYs分别为40.49、2.10、42.59年/千人,YLLs、YLDs和DALYs均是男性高于女性。结论丰都县恶性肿瘤发病率及死亡率均较低,但疾病负担重,尤其是YLLs高,应加强恶性肿瘤的预防和早诊早治工作。 展开更多
关键词 肿瘤 发病率 死亡率 患病代价 重庆
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以多发急性脑梗死为首发表现的Trousseau综合征12例临床分析
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作者 国丽茹 李彦青 +2 位作者 王澜涛 贾亚琼 周亚竹 《中华全科医师杂志》 2019年第5期479-482,共4页
回顾性分析2011年12月至2017年12月以急性动脉系统脑梗死入河北医科大学第四医院神经内科、治疗过程中发现恶性肿瘤,诊断为Trousseau综合征的12例患者临床资料。12例中,有脑梗死传统危险因素者4例,无传统危险因素者8例;影像学检查发现... 回顾性分析2011年12月至2017年12月以急性动脉系统脑梗死入河北医科大学第四医院神经内科、治疗过程中发现恶性肿瘤,诊断为Trousseau综合征的12例患者临床资料。12例中,有脑梗死传统危险因素者4例,无传统危险因素者8例;影像学检查发现单个梗死病灶者2例,≥2个病灶者10例;病灶分布在≥2个供血动脉分布区域者9例;其中,10例患者血D-二聚体水平升高,5例纤维蛋白原水平增高,7例外周血血小板计数增高,8例同型半胱氨酸水平升高,其恶性肿瘤经病理检查确诊10例,临床及影像学诊断2例。以急性脑梗死为主要表现的Trousseau综合征患者常为多发病灶,累及多支血管供血区,无传统脑梗死危险因素,可伴血D-二聚体和纤维蛋白原水平增高,血液高凝状态可能是肿瘤并发脑梗死的重要发病机制。 展开更多
关键词 肿瘤 脑梗死 体征和症状
Intraoperative intraperitoneal chemotherapy increases the incidence of anastomotic leakage after anterior resection of rectal tumors 预览
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作者 Zhi-Jie Wang Jin-Hua Tao +4 位作者 Jia-Nan Chen Shi-Wen Mei Hai-Yu Shen Fu-Qiang Zhao Qian Liu 《世界胃肠肿瘤学杂志:英文版(电子版)》 CAS 2019年第7期538-550,共13页
BACKGROUND Intraoperative intraperitoneal chemotherapy is an emerging treatment modality for locally advanced rectal neoplasms. However, its impacts on postoperative complications remain unknown. Anastomotic leakage (... BACKGROUND Intraoperative intraperitoneal chemotherapy is an emerging treatment modality for locally advanced rectal neoplasms. However, its impacts on postoperative complications remain unknown. Anastomotic leakage (AL) is one of the most common and serious complications associated with the anterior resection of rectal tumors. Therefore, we designed this study to determine the effects of intraoperative intraperitoneal chemotherapy on AL. AIM To investigate whether intraoperative intraperitoneal chemotherapy increases the incidence of AL after the anterior resection of rectal neoplasms. METHODS This retrospective cohort study collected information from 477 consecutive patients who underwent an anterior resection of rectal carcinoma using the double stapling technique at our institution from September 2016 to September 2017. Based on the administration of intraoperative intraperitoneal chemotherapy or not, the patients were divided into a chemotherapy group (171 cases with intraperitoneal implantation of chemotherapy agents during the operation) or a control group (306 cases without intraoperative intraperitoneal chemotherapy). Clinicopathologic features, intraoperative treatment, and postoperative complications were recorded and analyzed to determine the effects of intraoperative intraperitoneal chemotherapy on the incidence of AL. The clinical outcomes of the two groups were also compared through survival analysis. RESULTS The univariate analysis showed a significantly higher incidence of AL in the patients who received intraoperative intraperitoneal chemotherapy, with 13 (7.6%) cases in the chemotherapy group and 5 (1.6%) cases in the control group (P = 0.001). As for the severity of AL, the AL patients who underwent intraoperative intraperitoneal chemotherapy tended to be more severe cases, and 12 (92.3%) out of 13 AL patients in the chemotherapy group and 2 (40.0%) out of 5 AL patients in the control group required a secondary operation (P = 0.044). A multivariate analysis was subsequently performed to adjust 展开更多
关键词 Anastomotic leakage RECTAL neoplasms LOBAPLATIN Fluorouracil implants POSTOPERATIVE complications INTRAOPERATIVE INTRAPERITONEAL chemotherapy
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TYMS/KRAS/BRAF molecular profiling predicts survival following adjuvant chemotherapy in colorectal cancer 预览
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作者 Anastasios Ntavatzikos Aris Spathis +6 位作者 Paul Patapis Nikolaos Machairas Georgia Vourli George Peros Iordanis Papadopoulos Ioannis Panayiotides Anna Koumarianou 《世界胃肠肿瘤学杂志:英文版(电子版)》 CAS 2019年第7期551-566,共16页
BACKGROUND Patients with stage II-III colorectal cancer (CRC) treated with adjuvant chemotherapy, gain a 25% survival benefit. In the context of personalized medicine, there is a need to identify patients with CRC who... BACKGROUND Patients with stage II-III colorectal cancer (CRC) treated with adjuvant chemotherapy, gain a 25% survival benefit. In the context of personalized medicine, there is a need to identify patients with CRC who may benefit from adjuvant chemotherapy. Molecular profiling could guide treatment decisions in these patients. Thymidylate synthase (TYMS) gene polymorphisms, KRAS and BRAF could be included in the molecular profile under consideration. AIM To investigate the association of TYMS gene polymorphisms, KRAS and BRAF mutations with survival of CRC patients treated with chemotherapy.METHODS A retrospective study studied formalin-fixed paraffin-embedded tissues (FFPEs) of consecutive patients treated with adjuvant chemotherapy during January/2005-January/2007. FFPEs were analysed with PCR for the detection of TYMS polymorphisms, mutated KRAS (mKRAS) and BRAF (mBRAF). Patients were classified into three groups (high, medium and low risk) according to 5’UTR TYMS polymorphisms Similarly, based on 3’UTR polymorphism ins/loss of heterozygosity (LOH) patients were allocated into two groups (high and low risk of relapse, respectively). Cox regression models examined the associated 5- year survival outcomes. RESULTS One hundred and thirty patients with early stage CRC (stage I-II: 55 patients;stage III 75 patients;colon: 70 patients;rectal: 60 patients) were treated with surgery and chemotherapy. The 5-year disease free survival and overall survival rate was 61.6% and 73.9% respectively. 5’UTR polymorphisms of intermediate TYMS polymorphisms (2RG/3RG, 2RG/LOH, 3RC/LOH) were associated with lower risk for relapse [hazard ratio (HR) 0.320, P = 0.02 and HR 0.343, P = 0.013 respectively] and death (HR 0.368, P = 0.031 and HR 0.394, P = 0.029 respectively). The 3’UTR polymorphism ins/LOH was independently associated with increased risk for disease recurrence (P = 0.001) and death (P = 0.005). mBRAF (3.8% of patients) was associated with increased risk of death (HR 4.500, P = 0.022) whereas mKRAS (39% of patient 展开更多
关键词 Colorectal neoplasms Thymidylate SYNTHASE Untranslated REGIONS Fluorouracil KRAS BRAF Prognosis
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四川省肿瘤疾病治疗总费用研究 预览
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作者 刘臻 谭玲 +4 位作者 杨练 田兴军 孙群 钟志刚 魏涵 《重庆医学》 CAS 2019年第12期2090-2094,共5页
目的分析四川省肿瘤疾病治疗费用的规模、服务功能、筹资方案和提供机构,为合理配置卫生资源提供依据。方法采用多阶段分层整群随机抽样的方法,在四川省抽取1652家相关医疗、卫生机构,利用《四川省卫生财务年报》和《四川卫生和计划生... 目的分析四川省肿瘤疾病治疗费用的规模、服务功能、筹资方案和提供机构,为合理配置卫生资源提供依据。方法采用多阶段分层整群随机抽样的方法,在四川省抽取1652家相关医疗、卫生机构,利用《四川省卫生财务年报》和《四川卫生和计划生育统计年鉴》等官方资料的总量数据,以"卫生费用核算体系2011版(SHA2011)"为方法学框架,对四川省肿瘤治疗费用进行核算及统计学描述。结果四川省肿瘤的治疗费用为148.75亿元,女性肿瘤治疗费用为71.36亿元,男性肿瘤治疗费用为77.39亿元,肿瘤治疗费用的中有71.67%发生在综合医院,肿瘤治疗费用以公共筹资方案(52.45%)和个人家庭卫生支出(43.58%)为主。结论四川省人群的肿瘤治疗费用已经造成严重的社会负担,除对重点人群和重点肿瘤疾病的干预力度有待加强外,分级诊疗在肿瘤防治中的作用也需要提高,进一步降低居民的自付比例。 展开更多
关键词 四川 肿瘤 卫生保健费用 SHA2011
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纳米拉曼影像在肿瘤诊疗中的应用
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作者 李鑫 李杨杨 +2 位作者 刘凤永 周民 王茂强 《中华核医学与分子影像杂志》 CAS 北大核心 2019年第4期241-243,共3页
拉曼光谱可被具有表面增强拉曼散射效应的纳米粒子(SERS-NPs)放大,通过SERS-NPs可实现对拉曼信号的增强,实现肿瘤的高分辨率成像。SERS-NPs具有高度分子特异性和灵敏度等特点,在肿瘤诊疗中展现出良好的应用前景。该文从SERS-NPs的优势... 拉曼光谱可被具有表面增强拉曼散射效应的纳米粒子(SERS-NPs)放大,通过SERS-NPs可实现对拉曼信号的增强,实现肿瘤的高分辨率成像。SERS-NPs具有高度分子特异性和灵敏度等特点,在肿瘤诊疗中展现出良好的应用前景。该文从SERS-NPs的优势、肿瘤诊疗应用及相关研究等方面进行综述。 展开更多
关键词 光谱分析 拉曼 诊疗纳米医学 肿瘤 发展趋势
居家口服化疗癌症患者自我管理评估指标的构建
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作者 彭琦 吴婉英 +1 位作者 梁冠冕 吴怡 《中华现代护理杂志》 2019年第10期1233-1237,共5页
目的构建客观、科学和可行的居家口服化疗癌症患者自我管理评估指标,为医务人员有针对性地开展患者自我管理的教育工作提供依据,更好地保障口服化疗药患者安全。方法基于自我管理理论,2017年7月—2018年6月通过文献分析、半结构式访谈... 目的构建客观、科学和可行的居家口服化疗癌症患者自我管理评估指标,为医务人员有针对性地开展患者自我管理的教育工作提供依据,更好地保障口服化疗药患者安全。方法基于自我管理理论,2017年7月—2018年6月通过文献分析、半结构式访谈方法和专家小组讨论的方法初步拟定评估指标,采用德尔菲法,经过2轮对18名专家的函询确定居家口服化疗癌症患者自我管理评估指标。结果2轮问卷收回率均为100%,专家的积极性较高,专家权威系数为0.83,专家协调系数0.192(P<0.05),最终确定5个一级指标,38个二级指标。结论居家口服化疗癌症患者自我管理评估指标科学、可靠,便于医务人员了解患者的自我管理情况,为居家口服化疗癌症患者提供更加优质的护理。 展开更多
关键词 肿瘤 居家护理 口服化疗 自我管理 德尔菲法 指标构建
放射性粒子植入术的布源方式及放射剂量学研究进展 预览
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作者 苏伟力 于晓玲 《解放军医学院学报》 CAS 2019年第4期388-390,共3页
放射性粒子植入技术的核心是精准性,包括粒子布源精准性和放射剂量学精准性两方面。目前临床应用的主要布源方式为个体化3D打印模板布源及扇形布源,在放射剂量学控制方面主要是通过蒙特卡洛算法及持续低剂量照射BED公式。本文对上述内... 放射性粒子植入技术的核心是精准性,包括粒子布源精准性和放射剂量学精准性两方面。目前临床应用的主要布源方式为个体化3D打印模板布源及扇形布源,在放射剂量学控制方面主要是通过蒙特卡洛算法及持续低剂量照射BED公式。本文对上述内容进行综述,为进一步提高放射性粒子植入术的规范化治疗提供参考。 展开更多
关键词 近距离治疗 布源方式 放射剂量学 肿瘤
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Synchronous resection of esophageal cancer and other organ malignancies:A systematic review 预览
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作者 Dimitrios Papaconstantinou Diamantis I Tsilimigras +7 位作者 Dimitrios Moris Adamantios Michalinos Aikaterini Mastoraki Efstratia Mpaili Natasha Hasemaki Anargyros Bakopoulos Dimitrios Filippou Dimitrios Schizas 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第26期3438-3449,共12页
BACKGROUND Neoplasms arising in the esophagus may coexist with other solid organ or gastrointestinal tract neoplasms in 6%to 15%of patients.Resection of both tumors synchronously or in a staged procedure provides the ... BACKGROUND Neoplasms arising in the esophagus may coexist with other solid organ or gastrointestinal tract neoplasms in 6%to 15%of patients.Resection of both tumors synchronously or in a staged procedure provides the best chances for long-term survival.Synchronous resection of both esophageal and second primary malignancy may be feasible in a subset of patients;however,literature on this topic remains rather scarce.AIM To analyze the operative techniques employed in esophageal resections combined with gastric,pancreatic,lung,colorectal,kidney and liver resections and define postoperative outcomes in each case.METHODS We conducted a systematic review according to PRISMA guidelines.We searched the Medline database for cases of patients with esophageal tumors coexisting with a second primary tumor located in another organ that underwent synchronous resection of both neoplasms.All English language articles deemed eligible for inclusion were accessed in full text.Exclusion criteria included:(1)Hematological malignancies;(2)Head/neck/pharyngeal neoplasms;(3)Second primary neoplasms in the esophagus or the gastroesophageal junction;(4)Second primary neoplasms not surgically excised;and(5)Preclinical studies.Data regarding the operative strategy employed,perioperative outcomes and longterm outcomes were extracted and analyzed using descriptive statistics.RESULTS The systematic literature search yielded 23 eligible studies incorporating a total of 117 patients.Of these patients,71%had a second primary neoplasm in the stomach.Those who underwent total gastrectomy had a reconstruction using either a colonic(n=23)or a jejunal(n=3)conduit while for those who underwent gastric preserving resections(i.e.,non-anatomic/wedge/distal gastrectomies)a conventional gastric pull-up was employed.Likewise,in cases of patients who underwent esophagectomy combined with pancreaticoduodenectomy(15%of the cohort),the decision to preserve part of the stomach or not dictated the reconstruction method(whether by a gastric pullup or a colonic/jej 展开更多
关键词 ESOPHAGECTOMY Esophageal neoplasm Second PRIMARY Multiple PRIMARY CONCURRENT neoplasms Management
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胚胎发育不良性神经上皮肿瘤的MRI分型及影像表现
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作者 张旭妃 朱明旺 +3 位作者 杜铁桥 王丽宁 高洁 胡建新 《中华放射学杂志》 CAS CSCD 北大核心 2019年第5期341-344,共4页
目的探讨胚胎发育不良性神经上皮肿瘤(DNET)的MRI分型及影像表现。方法回顾性搜集首都医科大学三博脑科医院2009年5月至2018年5月,34例经手术病理证实的DNET患者的影像资料,所有患者均进行MR平扫和增强检查,根据囊性病变数量、内部结构... 目的探讨胚胎发育不良性神经上皮肿瘤(DNET)的MRI分型及影像表现。方法回顾性搜集首都医科大学三博脑科医院2009年5月至2018年5月,34例经手术病理证实的DNET患者的影像资料,所有患者均进行MR平扫和增强检查,根据囊性病变数量、内部结构、累及范围、形态及部位等对DNET进行分型。结果DNET的MRI表现可分为单囊型、多囊型及弥漫型。单囊型12例,额叶5例、颞叶5例、顶叶2例。12例均局限于皮层,9例为圆形、类圆形,3例为不规则形。12例在T1WI上均表现为稍低信号影,T2WI上均表现为高信号影,与脑脊液信号相当,FLAIR较脑脊液信号稍高,边缘见高信号"环征"。5例颅骨变薄。1例可见强化。8例误诊。多囊型20例,额叶7例、颞叶7例、顶叶5例、枕叶1例。15例表现为楔形或三角形,5例脑回形。所有病变均在T1WI上表现为稍低信号影,T2WI上均表现为高信号影,FLAIR像上病变内见多分隔影及高信号"环征",4例颅骨变薄。2例可见少许强化。2例误诊。弥漫型2例,双侧1例、单侧1例。表现为多发囊性病变弥漫累及多个部位。2例均可见少许出血信号。1例误诊。结论DNET的影像表现多样,可分为单囊型、多囊型及弥漫型3种类型,DNET的MRI分型有助于提高其诊断和认识,减少误诊率。 展开更多
关键词 肿瘤 神经上皮 磁共振成像 诊断
参麦注射液对肿瘤放射性口腔黏膜炎临床疗效 预览
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作者 张圣林 李文鑫 +4 位作者 刘春丽 徐繁 张冠男 刘承一 李青山 《临床荟萃》 CAS 2019年第4期339-342,共4页
目的探讨参麦注射液对肿瘤放射性口腔黏膜炎治疗作用的研究。方法120例均明确临床诊断为头颈部肿瘤,全部接受放射治疗。将患者随机分为2组:对照组60例,予以常规对症治疗;观察组60例,在对症治疗的基础上加入参麦注射液治疗。两组的给予... 目的探讨参麦注射液对肿瘤放射性口腔黏膜炎治疗作用的研究。方法120例均明确临床诊断为头颈部肿瘤,全部接受放射治疗。将患者随机分为2组:对照组60例,予以常规对症治疗;观察组60例,在对症治疗的基础上加入参麦注射液治疗。两组的给予调强放射治疗,1.82~2.18Gy/次,1次/d,5次/周,放疗总剂量60~71.96Gy。结果观察组较对照组放射性口腔黏膜炎出现时间较迟、复原时间较快(P<0.05);两组中重度放射性口腔黏膜炎发生率分别为观察组20%、对照组80%(P<0.01);观察组患者平均放疗时间明显低于对照组(P<0.05)。结论 参麦注射液能明显减轻患者出现放射性口腔黏膜炎的症状,保证放疗按时完成,提高了生活质量,具有较好的临床推广价值。 展开更多
关键词 肿瘤 放射治疗剂量 口炎 植物药疗法
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恶性肿瘤手术后静脉血栓栓塞症患者临床特点及预后分析
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作者 金金 谭政 +6 位作者 乔力松 杨鹤 张丽 王艳 杨菁菁 方保民 许小毛 《国际呼吸杂志》 2019年第3期201-206,共6页
目的分析恶性肿瘤手术后静脉血栓栓塞症(VTE)患者的发病情况、临床特点及预后。方法选择北京医院2003年1月至2013年4月间,因恶性肿瘤接受开放性手术,并于手术后90d内并发VTE,且具有完整临床资料的68例患者进行回顾性分析。结果北京医院1... 目的分析恶性肿瘤手术后静脉血栓栓塞症(VTE)患者的发病情况、临床特点及预后。方法选择北京医院2003年1月至2013年4月间,因恶性肿瘤接受开放性手术,并于手术后90d内并发VTE,且具有完整临床资料的68例患者进行回顾性分析。结果北京医院10年间共收治恶性肿瘤手术患者10967例,术后90d内发生VTE68例,发病率为0.62%,主要发生于妇科肿瘤、肺癌、泌尿系统肿瘤、消化道肿瘤、乳腺癌和血液系统肿瘤患者中,其中妇科肿瘤和肺癌术后VTE发病率最高(分别为1.03%和0.95%),明显高于其他类型肿瘤(P值均<0.05)。68例患者中男31例,女37例,年龄(63.94±10.50)岁,合并心血管疾病者29例(42.65%);术后卧床制动>3d共34例(50.00%),VTE发病距离手术时间为(33±30)d,手术麻醉时间为(172.75±104.71)min,术后病理提示中低分化癌者40例(58.82%),Caprini评分≥5分者51例(75.00%)。老年组36例(52.94%),非老年组32例(47.06%)。老年组体质量指数较非老年组低(t=-2.052,P=0.044);老年组Caprini评分明显高于非老年组(t=2.613,P=0.011);老年组D-二聚体明显高于非老年组(Z=-1.976,P=0.048)。老年组晚发VTE(术后5~12周内发病)发病率明显高于非老年组(χ^2=8.438,P=0.004)。3例致死性肺血栓栓塞症均发生在老年组,均为晚发VTE,均未给予预防措施。结论北京医院10年间恶性肿瘤手术后VTE的发病率为0.62%,各种肿瘤中以妇科肿瘤和肺癌术后VTE发病率最高。老年人恶性肿瘤手术后VTE应延长观察时间至12周,老年致死性肺栓塞可发生于术后5~12周。 展开更多
关键词 肿瘤 手术 静脉血栓栓塞 静脉血栓形成
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