摘要:目的： 檢測大腸癌組織中Kras基因的突變情況以指導臨床治療。 方法 ：通過提取15例大腸癌石蠟組織中的DNA并進行PCR擴增,之后采用國際金標準方法直接測序法進行檢測獲得突變信息。 結果 ：15例大腸癌石蠟組織樣本中Kras有4例發生突變,突變率為266%。值得注意的是發現一個新的突變位點密碼子42,并且與密碼子12突變共存。 結論 ：密碼子42的突變進一步證明Kras突變不僅局限于密碼子12,13,61,還有與密碼子12共存的42位突變。Abstract: Objective: To detect the mutation status of Kras gene in colorectal cancers and to assist the clinical treatments Methods : DNA was extracted from fifteen formalinfixed, paraffinembedded tumor samples of colorectal cancers, and then the fragments containing codons 12,13 and codon 61 were amplified by PCR The sequences were indentified by direct sequencing which is gold standard for the detection of mutation Results : In the 15 samples of colorectal cancer patients, 4 mutations were observed, with 2 in codon 12 and 2 in codon 13 Suprisingly, a novel point mutation at codon 42 of Kras was found, and coexisted with mutation in codon 12 Conclusion : Except for codons 12,13,61 mutation, Kras has other mutation at codon 42 with coexisted with codon 12 point mutation
Objective To explore the comprehensive treatment of synchronous double cancers of the esophagus and stomach. Methods The treatment procedures of 8 patients with synchronous double cancers of the esophagus andstomach admitted in the Department of Digestive Tumor Surgery of The Hospital of Traditional Chinese Medicine of Jiangsu Province between Oct. 2006 to Feb. 2013 were analyzed. Some experience of comprehensive treatment of synch-ronous double cancers of the esophagus and stomach was explored. Results Eight cases of synchronous double cancers of the esophagus and stomach were all diagnosed by endoscopic biopsy. According to the results of CT and endoscopic ultrasonography assessment， lesions which were staged earlier than T1a were cured by endoscopic mucosal resection（6 cases， including 4 cases of esophagus cancer and 2 cases of gastric cancer）， and resection operation （1 cases of esop-hagus cancer）. The lesions staged later than T2 were treated by preoperative neoadjuvant chemoradiation， surgery， and adjuvant chemoradiation after operation （8 cases， including 2 cases of esophagus cancer and 6 cases of gastric cancer）， and simple operation （1 case）. Eight patients had been followed-up for 10-76 months （averaged 41.3 months）. Six patients survived without recurrence and metastasis during the followed-up， 1 patient died in 7 months after operation， and 1 patient relapsed in 20 months after operation. Conclusions Individually designed comprehensive treatment using neo-chemotherapy， intervention chemotherapy， radio-chemotherapy， radical resction surgery， adjuvant chemotherapy， and endoscopic mucosal resection can treat synchronous double cancers of the esophagus and stomach effectively. Impr-actical pursuit for radical surgery will not result in good prognosis
Skin cancers are the most common cancers, and are usually the most curable cancers as well. Recent evidence from Cochrane systematic review and randomized controlled trial (RCT) showed that protecting from over-exposure to radiation from the sun is the main way that can lower the risk of skin cancer. Surgery and radiotherapy are the standard treatments for basic cell cancer (BCC), but cosmetic results are better from surgery. Imiquimod cream may be effective for superficial and low-risk BCCs and causes little or no scarring, but more research is needed on this and other drug alternatives. Cryotherapy (freezing) is an alternative to surgery, but surgery is better for preventing recurrence of BCCs. Photodynamic (light) therapy and lasers might be able to remove some BCCs with less scarring, but may not be as effective as surgery to prevent recurrence.
Objective To systematically review the cost-effectiveness of gefitinib for advanced non-small cell lung cancer (NSCLC), in order to provide the economics values of gefitinib for clinical application. Method We electronically searched databases including PubMed, Ovid, Embase, Cochrane Library, Medline, China National Knowledge Internet, VIP, and Wanfang database for articles about the cost-effectiveness of gefitinib for advanced NSCLC patients from January 1946 to October 2017, and then performed a systematic literature review of economic evaluations of geftinib. Results A total of 20 independent studies were included in the present systematic review, in which 8 were the first-line treatment, 9 were the second-line treatment, 1 was the third-line treatment, and 2 were maintenance treatment. The most common comparison was gefitinib vs. chemotherapy (n=7), and other comparisons were gefitinib vs. erlotinib (n=4), gefitinib vs. docetaxel (n=3), gefitinib vs. placebo (n=2), gefitinib vs. icotinib (n=2), gefitinib vs. afatinib (n=1), and gefitinib vs. other treatments (n=1). For the advanced NSCLC patients, the first- or second-line treatment with gefitinib compared to chemotherapy was considered to be more cost-effective, especially in patients with mutated epidermal growth factor receptor gene. As the second-line treatment, gefitinib was considered to be more economical than erlotinib and docetaxel. Conclusion Gefitinib is considered to be a cost-effective strategy for the advanced NSCLC patients as the first- or second-line therapy.
Objective To summary the incidence rate and trends of cancers in China. MethodsBy compiling and analyzing the Chinese Cancer Registry Annual Report from 2008 to 2021, we summarized the regional and population distribution characteristics of overall and high-incidence rate cancers in China and analyzed influencing factors. ResultsFrom 2005 to 2018, the overall crude incidence of cancers in China showed a continuous upward trend. The incidence rate in the eastern region (incidence rate was 353.26/100 000 in 2018, the following data were crude incidence rate in 2018) was significantly higher than those in the central (269.47/100 000) and western regions (253.71/100 000), while the incidence rates in the central and western regions were closer. 2005–2018, the incidence rates of male was higher than that of female, and the population aged 80 years old or older (2 741.02/100 000) had the highest incidence rate of cancers, and the incidence rate of people aged 0–14 years old (41.38/100 000) was the lowest. From 2005–2018 (except for 2009), lung cancer (65.05/100 000), gastric cancer (27.03/100 000), liver cancer (27.42/100 000), colorectal cancer (30.51/100 000), and breast cancer (43.02/100 000) were the top 5 highest incidence rates of China’s cancers, of which lung cancer ranked the first in different regions, and the ranking of other cancers varied in different regions. The top 5 cancers in males’ incidence rates from 2005 to 2018 were lung cancer (83.45/100 000), gastric cancer (37.12/100 000), liver cancer (40.02/100 000), colorectal cancer (35.32/100 000) and esophageal cancer (26.30/100 000); the top 5 cancers in females’incidence rates had changed a lot in different years, breast cancer, lung cancer, colorectal cancer, gastric cancer, liver cancer, thyroid cancer and cervical cancer had all been in the top 5, for example, in 2018, the top 5 cancers in female were lung cancer (46.10/100 000), breast cancer (43.02/100 000), colorectal cancer (25.56/100 000), thyroid cancer (24.60/100 000) and cervical cancer (18.10/100 000).ConclusionsThe crude incidence rate of cancers in China continues to rise, with the cancer spectrum showing new characteristics that combine high-incidence rate cancers in developed countries (e.g., breast cancer, colorectal cancer) with common cancers in developing countries (e.g., gastric cancer, liver cancer). The situation of cancer prevention and control remains challenging.
In recent years, the detection rate of multiple primary lung cancers has been increasing year by year. However, there existed discrepance in cognition and treatment modalities for multiple primary early lung cancers among different physicians, which affects the standardized treatment for early-stage multiple primary lung cancers. Therefore, based on a thorough review of domestic and foreign literature, our team proposes this expert consensus focusing on the treatment of early-stage multiple primary lung cancers in China, aiming at providing reference for physicians in early-stage multiple primary lung cancers' treatment and further improving the level of standardized diagnosis and therapy of lung cancer in China.