【Abstract】Objective To investigate the recent studies on the biocharacters of keratin family (e.g. genetic mutations and abnormal expressions) and their relationships with the malignant tumors. Methods The literatures of recent years on the biocharacters of keratin family (e.g. genetic mutations and abnormal expressions) and their relationships with the malignant tumors were reviewed. Results Keratin family is a kind of structural proteins in cell which plays an important role in cytomechanics and regulates cell-cycle. The mutations of keratin genes (mRNA) or the overexpression of keratin proteins would interfere with the order of cell-cycle or the integrity of cytomechanics, and lead to some diseases and malignant tumors finally. Conclusion The studies on biocharaters of keratin family (e.g. genetic mutations and abnormal expressions) are helpful in the diagnosis, staging and the evaluation of prognosis of some diseases and cancers, e.g. liver cirrhosis, breast cancer, rectum carcinoma, etc.
Since November 1974 to December 1993, 110 cases with malignant tumors of the extremities were treated by en bloc resection and limb salvage procedure in our hopsital. There were 57 males and 53 females. Their ages ranged from 14 to 70 years. The diagnosis of all patients were confirmed by pathology. Among them, 68 cases were malignant bone tumor, 42 cases were malignant tumor of soft tissue. If the soft tissue was involved by the malignant tumors, the tumor was resected radically and myocutaneous or skin flap was transferred to covered the defect. Among the 42 cases, 5 were free vascularized and 37 were pediculated flaps. The maximal size of the flap was 15×25 cm and the minimal was 6×8 cm. For the malignant bone tumors, en bloc resection was performed and the bone defect was reconstructed with autogenous free vascularized fibular graft, autograft of massive bone with fusion or allograft of cryogenic massive bone. If the joint was involved, limited excision with replacement of prosthesis was recommended. When both soft tissue and bone were involved, segmental resection of tumor was indicated in 17 cases. The patients were followed up for 2 to 9 years, the results of 53 cases were still alive with a survival rate of 48.2%. We emphasized that the local extensive resection should be performed with a safety margin of 3 to 5 cm beyond the tumor. A djuvant chemotheapy and radiotherapy had definite value in the treatment of some malignant tumors, so that preoperative or postoperative chemotherapy or radiotherapy was necessary. Sometimes radical resection of regional lymph rodes was necessary. The indications and causes of recurrence were discussed.
ObjectiveTo summarize the research progress of constitutive photomorphogenesis 9 signalosome (CSN) in malignant tumor in recent years. MethodsLiteratures about the relationship between CSN and maglinant tumor which were published in recent years were collected to make a review. ResultsMany malignant tumors were found to have high expression level of CSN, and CSN could degrade various tumor suppressor genes, such as p53 gene, mainly through regulating the ubiquitin protein degradation pathway, which played an role in promoting tumor growth. CSN5 was the deneddylation active center of CSN, and the activity of CSN was based on the integrity of CSN, which meant CSN6 (CSN core scaffold structure) have to exist. Current study found that CSN6 could promote tumorigenesis and development through a variety of signaling pathways, and CSN5 was mainly involved in cell cycle regulation and DNA damage repair to promote tumor growth. ConclusionsThe research of CSN in malignant tumors has lay a foundation of targeted therapies for cancer. However, the specific function of each of its subunit still remains unclear, and its upstream regulatory factors also need to be further explored.
ObjectiveTo describe the cancer incidence and mortality in Henan cancer registries in 2014.MethodsRegistration data (including incidence, mortality and population data) were evaluated according to the criteria of quality control of cancer registry. The incidence, mortality, and cumulative rate (0 to 74 years old) were calculated and stratified by area (urban/rural), gender, and age. Chinese Population Census in 2000 and Segi’s Population were used for age-standardized incidence and mortality rates.ResultsThe total covered population of the 27 cancer registries in 2014 was 21 044 835, accounting for 19.73% of Henan's total population at the end of 2014. The crude incidence rate in Henan cancer registration areas was 252.79/100 000 (males 273.55/100 000, females 230.70/100 000). Age-standardized incidence rates by Chinese standard population and by world standard population were 205.27/100 000 and 203.78/100 000 with the cumulative incidence rate (0 to 74 years old) of 24.17%. The cancer mortality in Henan was 156.58/100 000 (188.10/100 000 in males and 123.02/100 000 in females). The age-standardized incidence rates by Chinese standard population and by world standard population were 123.94/100 000 and 123.80/100 000, and the cumulative incidence rate (0 to 74 years old) was 14.30%. Lung cancer, gastric cancer, esophageal cancer, liver cancer, breast cancer, colorectal cancer, cervical cancer, encephala, leukemia and thyroid cancer were the most common cancers, accounting for approximately 83% of all cancer cases in urban and rural areas. Lung cancer, gastric cancer, esophageal cancer, liver cancer, colorectal cancer, breast cancer, encephala, leukemia, pancreatic cancer and cervical cancer accounted for approximately 88% of all cancer deaths.ConclusionsThe age-standardized incidence and mortality in Henan are above the national level. The common cancers in Henan are lung cancer, female breast cancer and digestive system cancers. The strategy of cancer prevention and control in Henan should be implemented depending on pratical situations.
Objective To analyze risk factors of malignancy in patients with small pulmonary nodules （diameter ≤2 cm） using univariate analysis and multivariate logistic regression，and establish a mathematical prediction model to estimatethe probability of malignancy. Methods Clinical data of 147 patients with small pulmonary nodules who underwentsurgical resection with definite postoperative pathological diagnosis from January 2005 to September 2012 in the 161st Central Hospital of PLA were retrospectively analyzed. There were 84 male and 63 female patients with their age of 31-78（56.2±10.1） years. Univariate analysis using Chi-square test or t test was performed to analyze risk factors including patientage，gender，symptoms，history and quantity of smoking，history of heavy drinking，history of tumor，tumor site，diameter，lobulation，spiculation，pleural indentation，ground-glass opacity，cavity，enlarged hilar and mediastinal lymph nodes.Independent predictors of malignancy were screened with multivariate logistic regression analysis. A mathematical predictionmodel was built to estimate the probability of malignancy and then examined. Results Univariate analysis showed that there was statistical difference in patient age（t=7.146，P＜0.001），heavy smoking history（χ2=6.169，P=0.013），nodule diameter（t=3.375，P=0.001），spiculation（χ2=5.609，P=0.018），lobulation（χ2=5.675，P=0.017），and pleural indentation（χ2=12.994，P＜0.001）between benign and malignant small pulmonary nodule groups. Multivariate logistic regression analysis showed that patient age （OR=1.110，P=0.000），nodule diameter （OR=2.050，P=0.029），lobulation （OR=1.672，P=0.045），spiculation（OR=2.054，P=0.032） and pleural indentation（OR=4.090，P=0.024）were independent predictors of malignancy in patients with small pulmonary nodules （P＜0.05） . The mathematical prediction model to estimate the probability of malignancy was：Logit （P） =ez/ （1 ＋ ez），Z=-6.657 ＋ （0.104×age） ＋ （0.718×diameter） ＋ （0.720×spiculation） ＋（0.514×lobulation） ＋ （1.409×pleural indentation），and e was natural logarithm. Both Hosmer-Lemeshow test （χ2=1.802，P=0.986） and maximum likelihood ratio test （Cox-Snell R2=0.310，Nagelkerke R2=0.443） showed satisfactory goodness of fit. The diagnostic accuracy was 85.71%，sensitivity was 87.50%，specificity was 81.40%，positive predictive value was 91.92%，and negative predictive value was 72.92% when the cut-off value was 0.58. Conclusions Patient age，nodule diameter，spiculation，lobulation and pleural indentation are independent predictors of malignancy in patients with small pulmonary nodules. The mathematical prediction model can accurately estimate the probability of malignancy for patients with small pulmonary nodules.
After freatment of prosthesis replacement for 12 malignant tumer of the proximal humoral werereported. The operation were performed after the indications and methods of treatment had beendefined. All of the 12 cases were followed-up, in the average of 8 yeare. On functional evaluation , 8cases had satisfactory result , but per in 1 cases and 3 cases died from recurrence or metastasis withinfive years. The indieation of the procthetic replantation, the complications, and revision weredisecused.
ObjectiveTo explore the effect of full nutritional management pattern on perioperative nutritional status in patients with head and neck malignancies. MethodsSixty-four patients with head and neck cancer treated in our department between March 2012 and June 2013 were randomly divided into control group and study group with 32 in each. The control group received conventional dietary guidance, while patients in the study group were given full nutritional management. Nutritional Risk Screening Scale 2002 (NRS-2002) was used for nutrition screening and assessment before surgery (after admission) and after surgery (3 days after surgery). The study group received full nutritional support, along with nutrition-related physical examination and biochemical tests, and observation of postoperative complications, and hospital stay and costs were also observed. ResultsNutritional risk existed in 29.7%-48.4% of the head and neck cancer patients during various stages of the perioperative period. Through the full nutritional support, patients in the study group had a significantly lower risk than those in the control group (P<0.01). Body mass index, triceps skinfold thickness, mid-arm muscle circumference, prealbumin, and creatinine in the study group were significantly more improved compared with the control group (P<0.01). No significant difference was detected in blood urea and serum albumin between the two groups. Postoperative complications in the study group was significantly lower (P<0.05), and hospital stay and costs were significantly lower than the control group (P<0.001). ConclusionFull nutritional management pattern can significantly improve the perioperative nutritional status in head and neck cancer patients. Early detection of nutritional risk and malnutrition (foot) in the patients and carrying out normal and scientific nutrition intervention are helpful in the rehabilitation of these patients. We suggest that qualified hospitals should carry out the full nutritional management model managed by a Nutrition Support Team for patients with malignancies.
OBJECTIVE: To investigate the styles and affecting factors of bone union after massive frozen allografting for skeletal reconstruction owing to excision of bone tumor. METHODS: From 1992 to 1999, 85 patients suffering from bone malignant tumor were given the excision of large bone segment and treated with allografting in different methods of operation: large bone allografts with condylar articular surface in 16 cases, osteoarticular allografts in 57 cases, bone allografts in combination with prosthetic replacement of hip in 9 cases, and prosthetic replacement of knee in 3 cases. The average follow-up was 2 years and 9 months. The union time and styles of host-donor junction were determined by X-ray characters, and the results of operations were assessed according to Enneking’s functional evaluation system of reconstructive procedures after surgical treatment of tumors for the musculoskeletal system. RESULTS: There were 4 kinds of basic bone union styles by the X-ray characters, there were no significant difference in the time span of bone union after fixation with different methods. Of the 85 fresh-frozen allografting procedures, more than 80% of the patients were treated with interlocked intramedullary nail and allograft-prosthesis combination, and the overall result was excellent and good. Sufficient blood supply was important for host-donor junction healing, but the function of immune response was uncertain. CONCLUSION: There were different styles of bone union after massive allografting. The recommended operative methods for massive allografts are stable internal fixation, sufficient blood supply, soft tissue repair and periosteal flap coverage.
ObjectiveTo explore the relationship between nuclear factor κB (NFκB) and the occurrence, metastasis, and treatment of colon cancer. MethodsThe literature on the structure and the property of molecular biology of NFκB, the relationship between NFκB and apopotosis, malignant tumor and colon cancer were reviewed.ResultsNFκB had action of antiapopotosis. The occurrence of malignant tumor had close relation with the oncogene by NFκB, the metastasis of malignant tumor was that cell of cancer escaped the killing and supervising of immunity by NFκB. NFκB affected the occurrence and metastasis of colon cancer by regulating cmyc, Cox2, ICAM1.Conclusion NFκB has important action in the occurrence and metastasis of colon cancer. It will become a new target of treatment.
Objective To investigate the diagnosis and treatment methods of primary cardiac malignant tumors，so as to improve its’ level of diagnosis and treatment. Methods From April 2004 to June 2008, 19 patients with primary cardiac malignant tumors were diagnosed and treated in the department of cardiac surgery in this hospital. Male 11, Female 8.Age of the patients was 40.7±12.1 years(17-64 years). Preoperative diagnosis were occupying lesion in cardiac, malignant tumors were possible. Complete resections of malignant tumors were achieved by cardiopulmonary bypass (CPB) in 3 cases, and partially resected in 1 case, heart transplantation was performed in 1 case, only biopsies were performed in 5 cases. 9 cases (47.4%) lost the chances of operative treatments. Results There were no operative and hospitalstay deaths. Hospital stay was 10±7 d（9-15 d）, all patients were safely discharged from hospital. Two cases suffered from postoperative pericardial effusions，and high temperature happened in 1 patient, these 3 cases recovered by puncture and symptomatic treatment. The pathological diagnosis: leiomyosarcoma in 1case, malignant mesothelioma in 1 case and hemangioendothelial sarcoma in 8 cases. 14 cases (73.7%) were followed up from 1 to 38 months, 14 cases died of tumor recurrence or metastasis, the mortality was 73.7%, 5 cases (26.3%) were failed to be followed up. Conclusion The prognosis of patient with primary cardiac malignant tumor is still poor. Earlier diagnosis and complete surgical removal of the tumor as soon as possible may improve the patients’qualities of lives.