Primary bronchopulmonary carcinoma occurs in the bronchial mucosa epithelium, also called lung cancer (LC), and has currently become the first cause of death of malignant tumors in China. With constant efforts of Chinese physicians, the diagnosis and management of LC has made certain progress, but standardized surgery for LC still varies to a great extent due to difference regions, nature of medical centers, and technical levels. Complete and standardized surgical resection can provide good long-term survival for patients with stageⅠ, Ⅱand partly ⅢA LC, and cannot be a substitute for other treatment, which shows the importance of standardized surgery. As the most solid member, surgery plays a decisive role in comprehensive multidisciplinary treatment of LC. Today's medical development requires thoracic surgeons to provide most standardized and individualized treatment with principles of evidence-based medicine. This review focuses on progress of standardized surgery for stage Ⅰto ⅢA LC.
Objective To understand breast cancer 1 (BRCA1) gene and relationship between BRCA1 gene and breast cancer, and analyze its effect on clinical comprehensive therapy of breast cancer. Method The domestic and international studies relevant BRCA1 and breast cancer in recent years were reviewed and summarized. Results BRCA1, a tumor suppressor gene, its mutations caused structural changes and functional abnormalities, which were closely related to breast cancer. And the expression situation and mutation of BRCA1 were associated with the therapeutic effect. Conclusions Mutation of BRCA1 is closely related to occurrence and development of breast cancer in female. Comprehensive therapy ideas should be found in clinical therapy according to expression or mutation of BRCA1. Further research on BTCA1 is beneficial to explore gold standard for treatment of breast cancer.
Cytogenetic study of 18 colorectal carcinomas confirmed the extensive heterogeneity and the complexity of the karyotypic picture in this tumor.Karyotypic analysis showed that chromosomes 7 and 3 were of the highest chromosomal gaining frequencies(72%,66%) and chromosomal losses were shown in chromosome 17(50%),chromosome5(44%) and chromosome 18(33%).The structual rearrangements frequently involved were 17p(78%),5q(61%),6q,7q,8p,12q,2p,etc.A great number of marker chromosomes and polyploid chromosomes had bad prognosis relatively.According to these results,we conclude that chromosomes 17,5,and 18 may play an important role in the evolution of colorectal cancer.
Objective To evaluate the feasibility of laparoscopic rectal resection (LR) in elderly and younger patients with rectal cancer. Methods From January 2008 to March 2009, 76 patients with rectal cancer undergoing elective rectal resection were included in this study. Older than 70 years named elderly group, in which LR was given to 16 cases, and open resection (OR) to 18 cases. Younger than 70 years named younger group, in which LR was performed in 23 cases, and OR in 19 cases. The results after LR and OR in rectal cancer between 2 groups of patients were compared. Results No surgery-assisted death occurred in either group. In 2 groups, ventilation time, intake food time and hospitalization after operation in LR were shorter than those of OR (P＜0.05， P＜0.01); intraoperative blood loss and the proportion of postoperative analgesia in LR were less than those of OR in 2 groups (P＜0.01); there were no significant differences between LR and OR (Pgt;0.05) in mean operation time or number of lymph node resected. In addition to the incision infection rate, the other complications rates and the postoperative life self-care rate between LR and OR were no significantly different in younger group (Pgt;0.05). In the elderly group, every complication rates of LR were lower than those of OR (P＜0.05), oppositely, the postoperative life self-care rate was higher (P＜0.01). Conclusions LR of rectal cancer can be applied to both elderly and younger patients. It is suggested that advanced age should not be the contraindication for LR, and by contrary elderly patients may be particularly indicated for lower postoperative complications rate compared to open surgeries.
ObjectiveTo compare the current status of clinical studies regarding lung cancer between China and the United States in 2019, and to indicate the weakness, trend and future development direction of clinical studies drug treatment in China.MethodsThe data of lung cancer clinical studies from January 1st to November 30th, 2019 in China and the United States were retrieved and analyzed through Informa pharmaprojects database.ResultsThe United States was superior on the number of projects (128 vs. 156) and research institutions (743 vs. 2 250). Compared with the United State, there were more phase Ⅲ confirmatory researches (19.5% vs. 10.3%), bioequivalent drug researches (3.1% vs. 0%), and researches initiated by academic institutions (39.8% vs. 28.1%) in China. The United States exhibited advantages in phaseⅠ andⅠ/Ⅱstudies (25.8% vs. 60.3%), immunodrugs (49.2% vs. 60.3%), primary tested drug ratio (61.7% vs. 93.6%), targets abundance (32.9% vs. 69.6%), and chimeric antigen receptor-T (CAR-T, 0.7% vs. 7.1%).ConclusionCompared with the United States, China should pay more attention to innovative drug investigations in early phase of clinical studies, especially novel immune agents, vaccines, and CAR-T.
Objective To systematically review the association between menstrual condition and the risk of breast cancer. Methods We searched The Cochrane Library (Issue 4, 2016), PubMed, EMbase, CNKI, WanFang Data, VIP and ScienceDirect databases from inception to June 1st 2016 to collect case-control studies about the association between menstrual condition and breast cancer. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using Stata12.0 software. Results Eighty-three studies involving 48 811 breast cancer patients and 57 268 controls were finally included. The results of meta-analysis showed that breast cancer was associated with age at menarche≤13 years old (OR=1.17, 95%CI 1.12 to 1.24) and irregular menstruation (OR=1.98, 95%CI 1.62 to 2.41), but was not associated with history of dysmenorrhea, cycle time≥30 days and period of time>7 days. Further subgroup analysis showed that the sample size was one of the main source of heterogeneity for history of dysmenorrheal analysis, and breast cancer was associated with the history of dysmenorrhea after removing small-sampled studies (OR=1.47, 95%CI 1.36 to 1.59). The association between breast cancer and age at menarche≤13 years old, irregular menstruation was statistically significant in community control, but not in hospital control. The association between breast cancer and age at menarche≤13 years old, irregular menstruation were statistically significant both in Chinese and foreign population. Conclusion Early age at menarche, irregular menstruation and history of dysmenorrhea may be risk factors of breast cancer. Due to the limitation of quality and quanity of included studies, the above conclusions need more researches to verify.
Objective To assess the feasibility and adequacy of Harmonic Scalpel in a totally laparoscopic total mesorectal excision (TME) and low,ultralow,colo-anal anastomoses for rectal cancer. Methods Excision of the mesorectum and low，ultralow site anastomoses were performed laparoscopically on 30 patients with low rectal cancer based on the concept of TME. Results All 30 TME were successfully completed by laparoscopic approach, and no one was converted to open procedures. A cholecystectomy and/or an ovariotomy were meanwhile performed laparoscopically for 3 patients with rectal cancer,and 1 patient with chronic cholesyctitis, gallstone,ovarian cyst and torsion of the ovary. The operation time was 155 min (115-320 min). Operative blood loss was 20 ml (5-80 ml).The time of bowel function returned and the time to resume postoperative diet was 1-2 days after the operation. Fourteen patients had postoperative analgesic requirement. Average hospital stay was 8 days (5-14 days) and there were no intraoperative and postoperative complications in all 30 patients.Conclusion Laparoscopic excision of the mesorectum and low,ultralow,coloanal anastomoses with Harmonic Scalpel for low rectal cancer is a perspective minimally invasive technique, which is feasible, safe, effective and has dramatic high rates of sphincter preservation with decreased postoperative pain, rapid recovery.
ObjectiveThe study was aimed to further explore risk factors of axillary lymph node metastasis in Luminal A breast cancer and revealed high-risk clinicopathological features.MethodsFrom January 2017 to December 2019, the clinical and pathological data of 237 Luminal A breast cancer patients diagnosed in our hospital were retrospectively analyzed. For the identification of related risk factors of axillary lymph node metastasis in Luminal A breast cancer, χ2 test for univariate analysis and logistic regression model for multivariate analysis were conducted.ResultsAmong the 237 patients with Luminal A breast cancer, 115 patients were associated with lymph node metastasis (48.5%). The univariate analysis indicated that multifocal tumor (P=0.001), p53 mutation (P=0.012), and lymphovascular invasion (P=0.022) were correlated with axillary lymph node metastasis in the Luminal A breast cancer. The multivariate analysis identically showed that multifocal tumor (P=0.009), p53 mutation (P=0.019), and lymphovascular invasion (P=0.021) were independent risk factors of axillary lymph node metastasis.ConclusionMultifocal breast cancer, p53 mutation, and lymphovascular invasion are risk factors of axillary lymph node metastasis in Luminal A breast cancer.
ObjectiveTo summarize the functional outcomes of transanal total mesorectal excision (TaTME).MethodThe literatures about functional outcomes and existing problems secondary to TaTME in China and abroad were collected to make a review.ResultsNeither the TaTME or the laparoscopic TME (LTME) had few serious impact on the quality of life of patients. At present, only a few studies were involved in the postoperative sexual function, and no definite conclusion could be drawn. From the current data only, the TaTME had few serious impact on the sexual function and it didn’t show some advantages as compared with the LTME. The urinary and defecation functions showed no obvious differences between the TaTME and the LTME, which of the patients after the TaTME might be impaired to some extent. The defecation disorders mainly occurred in 1—6 months after the TaTME, but it would recover to a certain extent as time went on.ConclusionsAlthough TaTME has more advantages in protecting pelvic autonomic nerves, there is no obvious difference in postoperative organ function as compared with LTME surgery at present. Multi-center, large sample size, and long-term follow-up studies are still needed to validate long-term results.
Esophageal cancer is one of the common malignant tumors with high incidence and poor prognosis. Angiogenesis-related pathways play an important role in the occurrence and development of esophageal cancer. Vascular endothelial growth factor (VEGF) is the main mediator of angiogenesis. In addition to promoting angiogenesis and maintaining the survival of neovascularization, VEGF can also directly act on esophageal cancer cells and promote the occurrence and development of tumors. This article reviews the biology of VEGF and its effect on blood vessels, the expression of VEGF in esophageal cancer cells and its influencing factors, the role of VEGF in esophageal cancer cells, the immunomodulatory activity of VEGF and the clinical study of VEGF inhibitors. The purpose of this study is to provide a basis for more rational use of VEGF inhibitors in the treatment of esophageal cancer.