Objective: To investigate the genetic risk factors and prognosis of 190 patients with myelodysplastic syndrome (MDS).
Methods: The clinical data of 190 patients with MDS admitted to the Department of Hematology, The First Affiliated Hospital of Chongqing Medical University from January 2015 to October 2020 were analyzed retrospectively, and the genetic background and survival curve of the patients were also analyzed.
Results: MDS patients with higher risk according to International Prognostic Score System (IPSS) stratification at the time of initial diagnosis had more frequent and complex types of gene mutation and chromosomal abnormalities, indicating poor prognosis. The choice of treatment is associated with the prognosis of MDS patients with intermediate risk (IPSS stratification), and the relative risk of the overall survival rate of patients treated with hypomethylating agents is higher than that of patients on concomitant medication.
Conclusion: MDS patients with higher-risk (IPSS stratification) have more complex genetic risk factors and lower survival rate than those with lower-risk (IPSS stratification). MDS patients with multiple genetic risk factors have a poor prognosis, and the type of gene mutation is a predictor of prognosis.
Objective: To provide scientific basis for prevention and control measures of island regions through analyzing the characteristics of malignant tumor incidence and mortality in eastern island areas of China and comparing the data with the national cancer mortality data in the same period.
Methods: Using the incidence and mortality data of malignant tumor in Daishan county, Zhoushan collected by the Daishan Center for Disease Control and Prevention (CDC) from 2014 to 2019, which was stratified by gender, the crude incidence rates (CIR) and crude mortality rates (CMR) were calculated, and the top 10 malignant tumors with the highest incidence or mortality rates were then ranked. The Segi’s world standard population was used to calculate the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR). The local data were compared with the national cancer mortality data from 2014 to 2019, and Chi-square test was used to analyze the differences between these two sets of data using the SPSS software. The difference was considered statistically significant when P < 0.05.
Results: There was a total of 7 305 incidence cases of malignant tumors in Daishan county, Zhoushan from 2014 to 2019. The CIR was 662.39/105 and the ASIR was 306.81/105. Notably, the CIR was the highest in the age group of 75-79 years old. The top 5 malignant tumors with the highest incidence rates were lung cancer (27.15%), gastric cancer (12.76%), liver cancer (10.95%), colorectal cancer (6.92%) and breast cancer (5.42%), whose ASIR were 75.09/105, 32.06/105, 31.01/105, 17.81/105 and 18.36/105, respectively. There was a total of 3 412 mortality cases of malignant tumors in Daishan county, Zhoushan from 2014 to 2019. The CMR was 309.39/105 and the ASMR was 122.73/105. Notably, the CMR was the highest in the age group of 80-84 years old. The top 5 malignant tumors with the highest mortality rates were lung cancer (24.94%), liver cancer (18.64%), gastric cancer (17.00%), colorectal cancer (7.56%) and esophageal cancer (5.72%), whose ASMR were 29.65/105, 24.97/105, 19.01/105, 8.75/105 and 6.60/105, respectively. The total ASMR of malignant tumors in Daishan county, Zhoushan was higher than national total ASMR from 2014 to 2019 (100.34/105) (P < 0.001). Specifically, the ASMR of gastric cancer, lung cancer and colorectal cancer in Daishan county were significantly higher than national levels (gastric cancer: 12.46/105; liver cancer: 16.45/105; colorectal cancer: 6.63/105) (P < 0.01), whereas no significant difference in the ASMR of lung cancer and esophageal cancer between Daishan county and the whole nation (lung cancer: 28.06/105; esophageal cancer: 7.61/105) was observed.
Conclusion: Lung cancer, gastric cancer, liver cancer and colorectal cancer were malignant tumors with higher incidence and mortality rates in Daishan county, Zhoushan from 2014 to 2019. Particularly, the ASMR of gastric cancer, liver cancer and colorectal cancer were significantly higher than the national levels, and these malignant tumors should be considered as the major focus of cancer prevention and control.
Objective: To establish a predictive model for preoperative diagnosis of benign and malignant phyllodes tumor of the breast (PTB). Methods: The clinicopathological data of 69 patients with benign PTB and 41 patients with malignant PTB (24 borderline and 17 malignant) who underwent multiple (≥2) preoperative ultrasound follow-ups in the Cancer Hospital of Harbin Medical University from January 2011 to December 2018 were retrospectively analyzed. The preoperative prediction models of benign and malignant PTB were constructed by using the influencing factors determined by multivariate logistic regression analysis. The receiver operating characteristic (ROC) curve was used to evaluate the efficiency of the prediction model. In addition, the clinicopathological data of 22 patients of benign PTB and 19 patients of malignant PTB (12 borderline and 7 malignant) admitted to the hospital from January 2019 to April 2022 were selected for external verification.
Results: Logistic regression analysis showed that growth rate of tumor >2 mm/month and ultrasound BI-RADS category ≥4b were independent predictors for the diagnosis of malignant PTB (OR: 4.476, 95% CI: 1.673~11.975; OR: 9.448, 95% CI: 3.149~28.345; P < 0.01). The logistic regression equation: Logit(P) = -1.868+1.499×growth rate of tumor+2.246×ultrasound BI-RADS category. The AUC for the training cohort was 0.795 (95% CI: 0.699~0.890), the best cut-off value was 0.421, the corresponding sensitivity was 0.732, the specificity was 0.826, and the Jorden index was 0.558, P < 0.001. The AUC for the the validation cohort was 0.772 (95% CI: 0.624~0.919), with the sensitivity of 0.526 and the specificity of 0.773, positive predictive value was 0.667 and negative predictive value was 0.654, P = 0.003. The AUC of the training cohort and the validation cohort were both >0.75, indicating that the model has certain predictive ability.
Conclusion: The predictive model constructed by clinicopathological parameters can be used for preoperative diagnosis of benign PTB and malignant PTB, and provide a certain reference value for clinicians to select the appropriate surgical resection scope.
Biliary tract tumors are a class of highly malignant digestive system tumors. Although surgical treatment, chemotherapy, and targeted therapy have achieved good therapeutic effects. However, due to its complex biological characteristics, it is easy to develop drug resistance, and recurrence is still inevitable. More than 99.9% of the species that had ever appeared on earth have become extinct, and these species possess resistance to external selection pressures similar to tumor cells. The comprehensive treatment of biliary tract tumors should be designed from the perspective of natural evolution and species extinction. We compared the causes of species extinction with existing cancer treatments, which are expected to provide new ideas for fundamental and clinical research.
In 2011, the International Association for the Study of Lung Cancer (IASLC), American Thoracic Society (ATS) and European Respiratory Society (ERS) simultaneously defined micropapillary pattern (MPP)-based lung adenocarcinoma as an independent pathological type: micropapillary-predominant adenocarcinoma (MPA). Its histological and clinical specificities have attracted broad attention from researchers. Lung adenocarcinoma with a micropapillary pattern (MPPAC) often shows biological behaviors indicative of poor prognosis, including strong invasion, high metastasis rate and easy recurrence after surgical treatment. At present, the clinical diagnosis of MPPAC depends on postoperative pathological examination, but systematic studies on its pathological heterogeneity, molecular biological characteristics, clinical features and prognosis remains scarce. This review aims to focus on the research progress of the pathological and clinical features of MPPAC.
Triple-negative breast cancer (TNBC) is characterized by strong aggressiveness, high metastatic potential, easy recurrence and poor prognosis. Due to lack of expression for estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor (HER2) in TNBC patients, there is a lack of specific therapeutic targets and effective treatment plans for TNBC. At present, immunotherapy has been widely used in solid tumors. Immune checkpoint inhibitors (ICIs) have shown some preliminary clinical effects in the treatment of TNBC, but there were still some patients who do not respond to ICIs therapy or develop resistance, and multiple clinical studies cannot obtain consistent results on the efficacy of ICIs. Therefore, we reviewed the potential biological factors that influence the efficacy of ICIs in TNBC, aiming to explore the mechanisms affecting the efficacy of ICIs and analyze its potential clinical value.
Objective: To explore the clinical characteristics, diagnosis and thearpy of Fanconi syndrome secondary to multiple myeloma. We described the case to provide clinical experience for the treatment of such rare disease.
Methods: The clinical data, diagnosis and the treatment process of one case of Fanconi syndrome secondary to multiple myeloma were retrospectively analyzed and the related literatures were reviewed.
Results: A 63-year-old female was admitted to hospital because of foam urine. She was diagnosed with multiple myeloma, stage R-ISS I, complicated with secondary Fanconi syndrome after immunofixation electrophoresis, bone marrow examination and related urine tests. She received VCD (bortezomib, cyclophosphamide and dexamethasone)chemotherapy after diagnosis. The current follow-up is 13 months, and the disease is in continuous stable (VGPR).
Conclusion: The incidence of Fanconi syndrome secondary to multiple myeloma is rare. Significant reduction in serum free light chain (FLC) is closely related to the improvement of renal function. Aggressive therapy in time is commanded to avoid further degradation of renal function. Favorable effect could be achieved by chemotherapy combined with agents with few renal function side effects.
Although immune checkpoint inhibitors (ICIs) are widely used in cancer therapy, showing great advantages and development potential, it is accompanied by a series of immune-related adverse reactions, of which myositis is a potentially fatal adverse event, which has attracted great attention. Herein, we reported a case of advanced esophageal cancer with myositis after treatment with camrelizumab, which was characterized by myasthenia gravis (MG) with myasthenic crisis, and recovered after active rescue by multidisciplinary cooperation.
