Ai zheng = Aizheng = Chinese journal of cancer最新文献

Background and objective: Treatment planning for radiotherapy of upper thoracic esophageal carcinoma is challenging due to the anatomical features. The difficulty may be resolved by intensity-modulated radiotherapy (IMRT). This study was to compare the dosimetric advantages of IMRT to that of conformal radiotherapy (CRT) for upper thoracic esophageal carcinoma, and to explore the clinical application of IMRT.

Methods: Eleven patients with upper thoracic esophageal carcinoma were enrolled. In addition to the actually used CRT plan, a five-field IMRT plan was generated for each case. The parameters of dose volume histogram for targets and organs at risk were compared between two techniques.

Results: For the planning target volume (PTV) of tumor and para-tumor tissues, the mean dose, maximal dose, doses covering 99% and 95% volume were similar in IMRT and CRT plans (P>0.05). However, IMRT plan had a higher conformity index than CRT plan (0.68+/-0.04 vs. 0.46+/-0.11, P<0.01). For the PTV of supraclavicular region, IMRT plan showed a better dose heterogeneity index than CRT plan (1.17+/-0.05 vs. 1.33+/-0.15, P=0.01). IMRT plan had lower maximal dose to the planning risk volume of the spinal cord (44.4 Gy vs. 52.5 Gy, P<0.05) and lower lung volume received dose of 10 Gy or higher [(32+/-6)% vs. (35+/-9)%, P<0.05] than CRT plan.

Conclusion: For the upper thoracic esophageal carcinoma, IMRT has more conformal distribution of dose and better spinal cord sparing than CRT, and can reduce the volume of lung that received dose of 10 Gy or higher.

Circulating tumor cells (CTC) have been identified in peripheral blood from cancer patients especially those with metastatic lesions. Recently, the analysis of CTC has been developed rapidly and showed good prospects for individualized chemotherapy. The field of CTC research is very important since gene-expression profiling becomes feasible and real time when using CTC as the sample of evaluation. This review was to summarize present CTC detection, enrichment, or both methods and their contribution to individualized chemotherapy.

Background and objective: Helical tomotherapy (HT) has shown its dosimetric advantages in the radiotherapy for many cancers. To date, no published studies have performed a dosimetric evaluation of whole pelvic radiotherapy (WPRT) using HT for postoperative endometrial cancer. This study was to compare the dosimetric characteristics of HT and step-and-shoot intensity modulated radiation therapy (SaS-IMRT) for endometrial cancer patients undergoing postoperative WPRT, and to explore whether whole pelvic HT for postoperative endometrial cancer has the advantage of dosimetry.

Methods: Ten patients with endometrial cancer undergoing postoperative WPRT were enrolled in this study. SaS-IMRT and HT Plans were developed for each patient. The dose distributions of the targets, organs at risk and normal tissue were analyzed and compared.

Results: The mean PTV100 were 95.6% and 95.8% (P=0.72) for the SaS-IMRT and HT plans, respectively. The mean homogeneity indexes were 1.10 and 1. 07 (P=0.00). The mean conformity indexes were both 0.87. The mean doses to rectum and bladder for HT were decreased by 1.3 Gy and 3.0 Gy compared with SaS-IMRT, respectively, while the mean dose to pelvic bones was increased by 1.1 Gy. The volumes of small intestine and colon, pelvic bones receiving moderate and low dose also increased. The V5, V10 and V20 of normal tissue were increased by 13.0%, 18.0%, and 5.0% (P=0.00). The mean dose to normal tissue was increased by 2.5 Gy (P=0.00).

Conclusions: Compared with SaS-IMRT, HT resulted in more homogeneous PTV dose distribution, better sparing of rectum and bladder. The volumes of small intestine and colon, pelvic bones and normal tissue receiving moderate and low dose for HT increased. The clinical significance of the dosimetric differences needs further investigations.

Background and objective: Elevated expression of matrix metalloproteinases (MMPs) has been found in multiple carcinoma tissues. MMP-26 is highly expressed in prostate and breast cancer tissues, and promotes the invasion of human prostate cancer cells not only through the cleavage of fibronectin and type IV collagen but also by the activation of pro-MMP-9, a powerful gelatinase. This study was to present a comprehensive protein expression profile of MMP-26 in multiple human cancer tissues.

Methods: The protein expression pattern of MMP-26 was examined using immunohistochemistry and multiple-tissue microarray. MMP-26 mRNA expression in coronary artery smooth muscle cells was detected by reverse transcription-polymerase chain reaction (RT-PCR).

Results: The expression of MMP-26 in breast, colon, lung, brain, head and neck, prostate cancer, and melanoma tissues was significantly elevated when compared with parallel normal tissues (P<0.05), while not significantly elevated in kidney cancer, ovarian cancer, and non-Hodgkin's lymphoma (P>0.05). MMP-26 was also detected to express in gastric, rectal, thyroid, esophageal, and pancreatic cancers. MMP-26 protein was expressed in smooth muscle cells of the prostate and associated blood vessels. MMP-26 mRNA was also detected to express in human coronary artery smooth muscle cells.

Conclusions: MMP-26 expression may be associated with multiple human carcinomas, and it may serve as a molecular marker for the early diagnosis of these carcinomas. MMP-26 may also contribute to smooth muscle function in the human prostate and cardiovascular system.

Background and objective: Pelvic lymphocysts are the most common postoperative complications of pelvic lymphadenectomy. Prevention of this disease is more important than treatment. This randomized study was to evaluate the preventive effect of lymph vessel ligation during pelvic lymphadenectomy on pelvic lymphocyst formation.

Methods: A total of 39 patients with gynecologic malignancy, who had pelvic lymphadenectomy in the Second Affiliated Hospital of Sun Yat-sen University from July 2006 to January 2007, were randomized into the ligation group (19 patients) and the non-ligation group (20 patients). All patients had no heart disease, hepatopathy, nephronia, pneumonopathy, hypoproteinemia and no history of radiotherapy. All the patients were followed-up with sonographic evaluation and physical examination for lymphocysts and other postoperative complications at 1, 4, 12, and 24 weeks after operation.

Results: No significant differences were observed between the two groups in pathlogic type, age, height, weight, body surface area, body mass index (BMI), operation duration, estimated blood loss, time to the passage of flatus, total drainage volume, duration of drainage, and duration of hospital stay (P>0.05). The occurrence rate of lymphocysts was significantly lower in the ligation group than in the non-ligation group at one week after operation (26.3% vs. 60.0%, P<0.05). The rates were slightly lower in the ligation group than in the non-ligation group without significant differences after then (31.6% vs. 55.0% at the 4th week), (16.7% vs. 45.0% at the 12th week), (20.0% vs. 27.8% at the 24th week). No significant differences were observed in the occurrence of other postoperative complications between the two groups (P<0.05).

Conclusion: Ligations of the deep inguinal lymph vessels, obturator lymph vessels, common iliac lymph vessels, and the lymph vessels at the crossing of the external iliac and the inter iliac vein can decrease the occurrence of postoperative lymphocysts in short-term period, and will not increase the occurrence of postoperative complications.

Background and objective: Mutations in DNA repair system are related to carcinogenesis. This study was to evaluate the correlations of polymorphisms and haplotypes of XPD gene with individual susceptibility to gastric cancer.

Methods: Genomic DNA were extracted from peripheral blood leukocytes of 207 gastric cancer patients and 212 healthy controls. Genotypes at codon 312 and codon 751 polymorphic sites were identified by amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) or polymerase chain reaction-restriction fragment length polymorphism (PCR-PFLP), respectively.

Results: At codon 312, the frequency of GA or AA genotype was higher in the gastric cancer patients than in the healthy controls (P<0.01, OR=3.41, 95% CI: 2.06-4.79; P<0.01, OR=3.47, 95% CI: 1.39-8.68). No significant difference was found in the distribution of the polymorphism at codon 751 between the two groups (P>0.05). By the haplotype AA (codon 312A-codon 751A) analysis, the frequency of heterozygote (-/AA) or homozygote (AA/AA) was higher in the patients than in the controls (P<0.01,OR=2.81, 95% CI:1.82-4.34;P=0.02,OR=3.92, 95% CI:1.31-11.70, respectively). Whereas there were no significant differences of the other three haplotypes between the patients and the controls (P>0.05).

Conclusions: The polymorphism of XPD at codon 312 might contribute to the etiology of gastric cancer. The haplotype AA (codon 312A-codon 751A) would be a critical risk factor of the susceptibility to gastric cancer.

Background and objective: As an index of inflammation, neutrophil-to-lymphocyte ratio (NLR) is regarded as one of prognostic factors of hepatocellular carcinoma (HCC). This study was to evaluate the correlation of preoperative NLR to the prognosis of young HCC patients after radical resection.

Methods: Clinical data of 91 HCC patients with age of younger than 35 years who underwent radical resection from 2000 to 2005 were analyzed. According to preoperative NLR, the patients were divided into the low NLR group (NLR2). The overall and disease-free survival rates of the two groups were compared.

Results: The 1-and 3-year overall survival rates were 92.9% and 85.6% in the low NLR group, 89.8% and 57.1% in the high NLR group; the 1-and 3-year disease-free survival rates were 85.3% and 80.0% in the low NLR group, 69.1% and 43.5% in the high NLR group. The difference between the two groups was significant (P<0.05). Cox multivariate analysis showed that preoperative NLR and tumor size were independent prognostic factors of disease-free survival and overall survival for young HCC patients after radical resection.

Conclusion: Preoperative NLR>2 was a negative prognostic factor of disease-free and overall survival for young HCC patients after radical resection.

Background and objective: Intensity-modulated radiotherapy (IMRT) for esophageal carcinoma has seldom been reported; its clinical efficacy and toxicity are still uncertain. This study was to evaluate the short-term efficacy of IMRT on esophageal carcinoma, and to observe adverse events.

Methods: From June 2006 to March 2008, 37 patients with cervical and thoracic esophageal carcinoma were treated with IMRT. The treatment response, local control and survival were evaluated and the adverse events were observed.

Results: The minimal prescription dose of 100% of gross tumor volume (GTV D100) 95% of clinical target volume (CTV D95), and 95% of planning target volume (PTV D95) were (6 456+/-172)cGy, (6 293+/-145)cGy, and (5 988+/-53)cGy, respectively. The volumes of lung receiving irradiation of >or= 5 Gy, >or=10 Gy, >or=20 Gy and >or=30 Gy were (59.6+/-12.8)%, (39.5+/-8.7)%, (22.0+/-5.4)%, and (12.0+/-4.3)%, respectively. The mean lung dose (MLD) was (1 178+/-248)cGy. The overall response rate was 97.3% (36/37). The patients were followed-up for 8-29 months (median,13 months). The occurrence rates of grades 3-4 acute and late esophagitis, grades 2-4 acute and late pneumonitis were 16.2% and 7.2%, 10.8% and 8.1%. The 1-and 2-year local control rates were 72.9% and 72.9%. The 1-and 2-year overall survival rates were 80.9% and 67.4%. The 1-and 2-year disease-free survival rates were 73.5% and 51.4%. Local recurrence (69.2%) was the main reason of treatment failure.

Conclusion: IMRT is an effective treatment for esophageal carcinoma with low occurrence of acute and late radiation-related pneumonitis, but local failure is still a main problem for treatment of patients with esophageal carcinoma.

Background and objective: Studies on survivin over the past 5 years have shown that survivin participates in the genesis of several human cancers, including bladder cancer. Recent studies have indicated that survivin splice variants appeared to have unique subcellular localizations and functions as well. This study was to explore the roles of survivin and its two splice variants survivin-2B and survivin-DeltaEx3 in transitional cell carcinoma of bladder (BTCC).

Methods: The relative amount of survivin, survivin-2B, and survivin-DeltaEx3 mRNA of fresh carcinoma tissues from 60 patients with BTCC and 12 non-cancerous bladder tissues were detected by real-time quantitative reverse transcription polymerase chain reaction (RT-PCR), and the relationships of their expression levels in different pathologic grades to clinical stages of bladder cancer were analyzed. The time of follow-up was 4-24 months.

Results: Survivin, survivin-2B, and survivin-DeltaEx3 mRNA were detected in all BTCC tissues, and their relative expressions were 0.333+/-0.163, 0.056+/-0.017, and 0.124+/-0.096, respectively. In the control group,three and four samples expressed survivin and survivin-DeltaEx3 mRNA respectively, and all samples expressed survivin-2B mRNA. The expressions of survivin and survivin-DeltaEx3 mRNA were positively correlated with the pathologic grades and clinical stages (0 < r 's < 1,P < 0.05), however, survivin-2B mRNA was negatively correlated with those (-1 < r 's < 0, P < 0.05).

Conclusion: Detecting the expression levels of survivin and its two splice variants survivin-2B and survivin-DeltaEx3 mRNA in BTCC by real-time PCR could have potential values to evaluate tumor progression and recurrence rate.

Background and objective: E2F transcription factor 1 (E2F-1) is an important transcription factor in cell cycle. This study was to investigate the effects of E2F-1 overexpression on apoptosis of gastric cancer MGC-803 cells and expressions of the downstream genes.

Methods: The apoptotic rates were measured by flow cytometry in MGC-803/E2F-1 cells, MGC-803/EV cells or untransfected MGC-803 cells. The total RNA was extracted from MGC-803/E2F-1 cells or MGC-803 cells, and cDNA was obtained by RT-PCR. Fluorescent (fluorescence exchange clip) probes marked by Cy5 and Cy3 were hybridized with gene chips containing 21522 human genes. Subsequently, the two signal images were scanned by Lux Scan 10K/A dual pathways laser scanner and analyzed by LuxScan3.0 image analysis software. RT-PCR was used to verify the target genes.

Results: The apoptotic rate of MGC-803/E2F-1 cells [(8.40+/-0.91)%] was higher than that of MGC-803/EV [(4.53+/-0.61)%] and MGC-803 cells [(4.97+/-0.47)%]. Fifteen differentially expressed apoptosis-related genes were detected, 4 of which were up-expressed and 11 were down-expressed genes, and the same results were verified by RT-PCR.

Conclusion: Overexpression of E2F-1 accelerates apoptosis of gastric carcinoma MGC-803 cells, which may be related to the 15 differentially expressed genes.