最新刊期
卷 31 ， 期 10 ， 2021
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- 摘要：Breast cancer is the most common malignant tumor in women, and its incidence is increasing year by year. Regional lymph node metastasis status is an important prognostic indicator of breast cancer. Sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection (ALND) as the standard method to identify regional lymph node metastasis in early-stage breast cancer patients. The current guidelines recommend blue dye and nuclear methods as the standard sentinel lymph node (SLN) tracing methods. The ideal SLN tracer should be visualized, targeted and reproducible, supported by evidence-based medical evidence, easy to use and inexpensive with minimal adverse effects. Currently, the tracers can be broadly divided into visual tracers and contrast tracers, with the former including cyanine dyes such as methylene blue, carbon nanomaterials such as carbon nanosuspensions, and mitoxantrone for tracing; the latter including nucleophiles, fluorescent tracers such as indocyanine green, magnetic tracers such as superparamagnetic iron oxide, and ultrasound contrast agents such as sulfur hexafluoride microbubbles. All these tracers have certain limitations, such as lack of targeting of methylene blue, low fluorescence penetration of indocyanine green, and radioactive contamination of nucleophiles. For this reason, many studies have been conducted on the development and improvement of new tracers for SLN of breast cancer. Photoacoustic imaging (PAI) is a new imaging technique utilizing photoacoustic effect, in which biological endogenous chromophores or exogenous contrast agents absorb pulsed light to cause local thermoelastic expansion and subsequently radiate ultrasonic waves outward, forming a biological tissue light energy absorption difference distribution map and imaging. The PAI technique can be used to evaluate the morphology and function of labeled tissues through photoacoustic contrast agents and their coupling groups. In this paper, we reviewed the progress of PAI and its contrast agent application in SLNB, focusing on the small molecule NIR dyes, metallic nanomaterials and carbon nanomaterials. At the same time, we discussed the research of new targeted fluorescent tracer formed after combining small molecule near-infrared dyes with molecular antibodies as a common ligand. At last, we presented the future perspectives in this field.关键词：Photoacoustic imaging;Sentinel lymph node biopsy;Photoacoustic contrast agent2|2749|0更新时间：2025-12-31
- 摘要：Background and purpose: The Shanghai Municipal Center for Disease Control and Prevention provides annual updates on cancer occurrence and trends in Shanghai. This study aimed to investigate the cancer incidence and mortality in 2016 and their trends from 2002 to 2016 in Shanghai. Methods: Data of new cancer diagnoses and deaths from 2002 to 2016 were obtained from the Shanghai Municipal Center for Disease Control and Prevention population-based cancer registry and Vital Statistics System. Cancer incidence and mortality stratified by year of diagnosis or death, gender and age group were analyzed. Number, proportion, crude rate, age-specific rate, age-standardized rate and others were calculated. The number, proportion and rates of common cancers in different groups were also calculated. Trends in age-standardized rate of incidence and death rates for all cancers combined and for the common cancer types by gender were estimated by joinpoint analysis and characterized by the annual percent change (APC). Segi’s 1960 world standard population was used for calculating age-standardized incidence and mortality. Results: The new cancer cases and deaths were 74 422 and 37 010 in Shanghai in 2016. The crude rate of incidence was 513.94/10 5 , and the age-standardized rate was 231.58/10 5 . The age-standardized rate of incidence was higher among females than among males. The crude rate of mortality was 255.58/10 5 , and the age-standardized rate was 90.01/10 5 . The age-standardized rate of mortality was higher among males than among females. The age-specific numbers and rates of incidence and mortality increased with age. The age-specific number and rate of incidence reached the peak at the age groups of 60-64 years and 80-84 years, and those of mortality reached the peak at the age groups of 80-84 years and more than 85 years, respectively. The sites of top 10 common cancer types sorted by the number of incidence cases were lung, colorectum, thyroid, stomach, breast, liver, prostate, pancreas, brain and central nervous system and bladder. The sites of those sorted by the number of mortality deaths were lung, colorectum, stomach, liver, pancreas, breast, gallbladder, esophagus, prostate and lymphoma. The top 10 common cancer types stratified by gender and the top 5 common cancer types stratified by common age groups merged of incidence and mortality had wide variations. Overall, the age-standardized rates of incidence among males were stable from 2002 to 2009, and increased 1.16% on average per year from 2009 to 2016. Those among females were stable from 2002 to 2009, and increased 4.48% on average per year from 2009 to 2016. The age-standardized rates of mortality among males decreased 1.35% on average per year, and those among females decreased 1.31% on average per year from 2002 to 2016. The trends differed by gender and cancer type. Conclusion: Although the age-standardized rates of cancer incidence were increasing slightly among males and females, those of cancer mortality were decreasing. These current status and trends of overall and common cancer types stratified by gender or age reflect Shanghai permanent population changes in cancer risk factors, screening test use, diagnostic practices and treatment advances. Population-based cancer incidence and mortality data can be used to inform efforts to decrease the cancer burden.关键词：Cancer;Incidence;Mortality;Trends;Shanghai2|2699|0更新时间：2025-12-31
- 摘要：Background and purpose: Glioma is one of the most common intracranial malignant tumors with a poor prognosis. Choline kinase alpha (CHKα) is closely associated with the occurrence and development of gliomas. This study aimed to analyze the CHKα protein expression in glioma tissues and its relationship with prognosis. Methods: A total of 120 glioma patients treated in Department of Neurosurgery, Ningxia Medical University General Hospital from 2017 to 2019 were enrolled in this study. All patients were categorized by World Health Organization (WHO) grading Ⅰ-Ⅳ. Immunohistochemistry was used to detect the expression of CHKα. The relationship between the expression of CHKα and the clinicopathological features of patients was analyzed. Kaplan-Meier method was used to analyze the survival of patients. The relationship between CHKα and the survival of patients with glioma was further verified by using the relevant clinical data in the bioinformatics database. Results: Among the 120 glioma patients, 62 were male, and 58 were females. The pathological types included 32 pilocytic astrocytoma, 26 diffuse astrocytoma, 30 anaplastic astrocytoma and 32 glioblastoma multiforme. The positive expression rates of CHKα were 9.77%, 7.81%, 95.03% and 92.90%, respectively (P ＜ 0.01). Sixty patients died by June 30, 2021, and 10 patients were lost during follow-up. The follow-up rate was 91.67%. Kaplan-Meier method analysis showed that the overall survival time of patients with low CHKα expression was longer, the prognosis was better, and the side effect occurrence rate was lower, compared with patients with high CHKα expression (P ＜ 0.01). These results were consistent with the results of bioinformatics analysis (P ＜ 0.05). Conclusion: CHKα is differentially expressed in glioma tissues of different grades, and is correlated with poor prognosis in glioma patients. CHKα is a potential indicator of the prognosis in glioma patients.关键词：Glioma;Choline kinase alpha (CHKα);Immunohistochemistry;Prognosis4|1463|0更新时间：2025-12-31
- 摘要：Background and purpose: RNA helicase DEAD-box helicase 19A (DDX19A), a member of the DDX protein superfamily, is mainly involved in the RNA transport process. Many members of this family are involved in the genesis and progression of tumors, however, the role of DDX19A in gastric cancer has not been reported. Combined with bioinformatics analysis, the expression of DDX19A in gastric cancer tissues and its clinical significance were investigated. Methods: The UALCAN database was used to analyze the expression difference of DDX19A in gastric cancer tissues and adjacent gastric tissues at the transcriptional level, and the relationship between its expression in gastric cancer and clinical stage was further analyzed. Kaplan-Meier Plotter database was used to analyze the correlation between DDX19A expression level and overall survival (OS) and disease-free survival (DFS) of gastric cancer patients. Western blot assay was used to detect the expression of DDX19A protein in 16 pairs of frozen fresh gastric cancer tissues and adjacent gastric mucosa. A total of 109 paraffin specimens of gastric cancer and 30 paracancerous gastric mucosa specimens were collected from Department of Pathology, Affiliated Hospital of Chengde Medical College from 2011 to 2015, and clinicopathological data of all patients were complete. Immunohistochemical S-P four-step method was used to detect the expression of DDX19A protein in 109 cases of gastric cancer and 30 cases of adjacent gastric mucosa. The relationship between the overexpression of DDX19A protein and the clinicopathological characteristics and prognosis of gastric cancer was statistically analyzed. Results: UALCAN and Kaplan-Meier Plotter database search results showed that DDX19A mRNA expression was significantly higher in gastric cancer tissues than in adjacent gastric tissues (P<0.01), and its high expression was positively correlated with clinical stage and poor prognosis of gastric cancer patients (P<0.05). Western blot results showed that DDX19A protein was significantly overexpressed in gastric cancer tissues (P<0.01). Immunohistochemical experiments showed that the positive expression rate of DDX19A in gastric cancer tissues was 68.8% (75/109), which was significantly higher than that in paracancerous gastric mucosa (33.3%, 10/30) (P<0.01). The high expression of DDX19A was closely related to the differentiation degree, infiltration depth and TNM stage of gastric cancer (P<0.05), but not to gender, age, tumor size or lymph node metastasis (P>0.05). In 69 cases with complete follow-up data, the OS of patients with high DDX19A expression was significantly lower compared with those with low DDX19A expression (P<0.05). Conclusion: DDX19A is highly expressed in gastric cancer tissues, and is associated with clinical staging, invasiveness and poor prognosis of patients. It is expected to be a potential biomarker and a new therapeutic target related to the prognosis of gastric cancer.关键词：Gastric cancer;DDX19A;Prognosis;UALCAN;Kaplan-Meier plotter2|1787|0更新时间：2025-12-31
- 摘要：Background and purpose: IIn the past, the prognosis of glioma was mainly predicted by biochemical indicators. In clinical practice, it is difficult to predict the prognosis of glioma due to the contamination of various factors, which leads to relatively poor prediction efficiency. This study aimed to investigate the value of circulating tumor cells (CTCs) by microfluidic core in the diagnosis and prognosis of gliomas. Methods: A total of 96 patients with brain glioma admitted to the Department of Neurosurgery in People's Hospital of Inner Mongolia Autonomous Region from March 2016 to March 2020 were studied. CTCs were enriched in peripheral blood by microfluidic core technology, and identified by immunofluorescence method. The regression model was used to analyze the relationship between the detection of CTCs in peripheral blood of glioma patients and the clinical characteristics of glioma patients. The receiver operating characteristic (ROC) curve was established, and the survival curve was made to analyze CTCs test results and the postoperative survival time of glioma patients. Results: CTCs enrichment by microfluidic core technology combined with immunofluorescence showed CTCs with a positive detection rate of 42.71%, and the number of CTCs detected in peripheral blood was (66.27±6.36)/mL. Univariate analysis showed that CTC in peripheral blood was closely correlated to tumor stage, histological type, cystic lymph node metastasis and neuron-specific enolase (NSE) (P<0.05), but had no correlation with age, gender, smoking status Cartesian functional status score, glial fibrillary acidic protein (GFAP) content and other clinical characteristics. Multivariate analysis showed that tumor stage, histological type, NSE expression and CTCs were closely related. The area under the curve (AUC) of tumor stage, histological type and NSE were 0.645, 0.687 and 0.720, respectively, and the predictive probability AUC was 0.814 (P<0.05). The CTCs test results and the postoperative survival curve of glioma patients were analyzed. Conclusion: The microfluidic core technology established in this study can quantitatively detect peripheral blood CTCs in patients with glioma, whose CTCs level is closely related to tumor stage, histological type and NSE, and directly affects the long-term survival rate of patients with glioma. Therefore, peripheral blood CTCs can be used as an important indicator for the diagnosis and prognosis of glioma patients, providing a new idea for clinical research.关键词：Microfluidic core technology;Circulating tumor cells;Glioma;Prognosis2|2080|0更新时间：2025-12-31
- 摘要：Background and purpose: The use of full-field digital mammography (FFDM) can significantly reduce the mortality rate of breast cancer. However, it is a two-dimensional imaging method, the sensitivity and specificity of diagnosis are significantly reduced in patients with dense breast. This study compared the detectability of FFDM alone versus FFDM plus digital breast tomosynthesis (DBT), and the detectability of scan angle of 40° (HR-mode) DBT versus scan angle of 15° (ST-mode) DBT for the diagnostic evaluation of breast lesion. Methods: The prospective study enrolled 175 women with clinically suspected breast lesion from July 2016 to September 2016 in Fudan University Shanghai Cancer Center. One hundred and seventy-five patients confirmed by biopsy or surgery were included. All the patients underwent full-field digital mammography (FFDM) and DBT examinations, and patients were randomly allocated into DBT-ST group or DBT-HR group. The images of FFDM and FFDM plus DBT were analyzed. According to Breast Imaging Reporting and Data System (BI-RADS, version 2013), the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficiency of FFDM and FFDM plus DBT, referring to the pathology as the gold standard. The sensitivities and specificities of DBT-HR and DBT-ST were analyzed according to different breast compositions. Results: A total of 181 lesions were detected in 145 patients, including 50 benign lesions and 131 malignant lesions. The sensitivities of FFDM and FFDM plus DBT were 81.92% and 91.15%, and the specificities were 77.45% and 87.25%, respectively. There was significant difference in the area under curve (AUC) between the two methods (0.88 vs 0.94, Z value was 5.37, P<0.01). There were 86 lesions randomly allocated into DBT-HR group and 95 lesions into DBT-ST group. For DBT-HR group, the consistency rate of finding between FFDM and DBT was 83.14%, and the only DBT detected rate was 3.49%. For DBT-ST group, the consistency rate of finding between FFDM and DBT was 92.63%, and the only DBT detected rate was 0.53%. Compared with the non-dense breast after combining the DBT, the improvement in sensitivity and specificity was more obvious in dense breast, especially the improvement in sensitivity of dense breast in DBT-HR (18.72%) and specificity of dense breast in DBT-ST (14.28%). Conclusion: The diagnostic efficiency of FFDM plus DBT is superior to that of FFDM, and the DBT-HR better than DBT-ST, especially in dense breast.关键词：Breast cancer;Digital breast tomosynthesis;High-resolution-mode;Standard-mode2|2177|0更新时间：2025-12-31
- 摘要：Background and purpose: For off-center patients, split arcs are used for radiotherapy plan to increase the tumor control rate, as the traditional linear accelerator (linac) gantry cannot span 180°. This method increases the idling time and the risk of collision between the gantry and the patient. The purpose of this study was to compare and analyze the potential advantages in volumetric-modulated arc therapy (VMAT) plans between the United Imaging Healthcare (UIH) linac 540° gantry and the traditional 360° gantry. Methods: In this study, 100 arc plans were randomly generated according to different arc lengths and arbitrary starting points, and they were divided into two groups. Group A included arcs that could span 180°, and group B plan consisted of two arcs on both sides of 180° with total arc length equal to group A. By using the trajectory simulation software, the double S velocity model was used to describe the rotational trajectory, and the execution efficiency simulation was carried out considering the reset time. In addition, the efficiency advantages of group A and B were also analyzed based on 10 actual clinical cases. Results: Comparing the execution time of group A and B, the difference mainly came from the idling time of gantry without considering the reset time. For clinical routine, the idling time was proportional to the proportion of the double arc plan. The maximum saving time was the full double arc plan, saving about 32 minutes. The maximum execution time of full arc plan could be reduced by about 85 minutes in clinical situation. Conclusion: For VMAT plan in which tumors are deviated from the center of patient, the UIH machine can save the idling time of the gantry and improve efficiency while meet the clinical dose distribution. In addition, it can effectively avoid the risk of collision between the gantry and the patient.关键词：UIH 540°;Gantry angle;Angle optimization2|1371|0更新时间：2025-12-31
- 摘要：Background and purpose: Nonrecurrent laryngeal nerve (NRLN) is rare but important for thyroid surgery. This study aimed to explore the anatomical characteristics of NRLN and the clinical significance of intraoperative neuromonitoring (IONM), so that surgeons could better protect the function of NRLN during surgery and reduce the risk of nerve injury. Methods: A total of 1 600 patients with recurrent laryngeal nerve (RLN) exposure in thyroid surgery who were treated at Department of General Surgery in First People's Hospital of Anqing, from January 2015 to September 2020, were selected as the study subjects. The exposure and injury of NRLNs were analyzed retrospectively. IONM of vagus nerve and RLN was used for detecting the function of nerves. Results: The total number of RLNs exposed during the operation was 2 312 in 1 600 patients, of which 5 patients with NRLNs (0.31%) were found. All NRLNs were found on the right side, including 2 cases of type Ⅰ, 1 case of type ⅡA and 2 cases of type ⅡB. The exposure time of NRLN was (11.38±1.59) minutes. All the 5 patients had aberrant subclavian artery that arose directly from the aortic arch detected by preoperative CT scanning. No related postoperative complication occurred. Conclusion: The incidence of NRLN is low, and most of them exist on the right side. If preoperative examination indicates the variation of subclavian artery, the existence of NRLN should be considered. With the help of IONM, NRLN can be found in time, and complications can be effectively avoided.关键词：Thyroid surgery;Nonrecurrent laryngeal nerve;Nerve monitoring2|2694|0更新时间：2025-12-31
- 摘要：Background and purpose: The purpose of this study was to explore a simple, safe, accurate and noninvasive method for intraoperative localization of pulmonary nodules, so as to provide reference for more surgeons and benefit more patients with pulmonary nodules. Methods: Data of 100 patients with pulmonary nodules who underwent sublobectomy were collected. Combined with computed tomography (CT) images before operation, the localization point of pulmonary nodule on the pleural layer of the medial wall of chest wall was determined. The electric hook was left on this point, and the anesthesiologist was instructed to hold his breath after full drum and lung. The electric coagulation hook left burning point on the lung surface, which was the location point of the small pulmonary nodule on the pleura surface. After resection of the specimen, the distance between the burn point and the nodule and the distance between the nodule and the cut edge were measured to evaluate the accuracy of the localization. Results: The accuracy rate of localization was 99.1%. Only one patient had a significant deviation (>1.5 cm) between the small pulmonary nodule and the localization point. The pulmonary nodule was found after the second resection. The other patients had single resection successfully. The success rate of operation was 100.0%. No complication occurred. Conclusion: Intraoperative chest wall localization method is non-invasive, simple and safe without complication. Especially for pulmonary nodules at special location, it can achieve more accurate positioning and has obvious advantages, which is worth promoting.关键词：Lung tubercle;Intraoperative localization;Thoracoscope2|2672|0更新时间：2025-12-31
- 摘要：The cure rate of gastric cancer, a highly aggressive digestive tract malignancy, can reach more than 90%, if it can be treated by surgery at the early stage. However, due to the lack of obvious symptoms and sensitive tumor markers in the early stage of gastric cancer, nearly 80% of gastric cancer patients in China are in advanced stage when first diagnosed. As an emerging molecular detection technology, liquid biopsy is noninvasive, quick, economic and reproducible, and has better sensitivity and specificity than serological tumor markers. It can also detect tumor in advance of pathological biopsy, which brings a bright light for early detection and risk assessment of gastric cancer. Yet, liquid biopsy has not been widely used in clinic due to many factors. One of the main reasons is that most samples of traditional liquid biopsies are from patient’s blood (including plasma and serum), and the low concentration of cancer-derived components in the blood samples limits the ability of liquid biopsy to detect and warn occurrence or recurrence of early cancer. Recent research has further expanded the concept of liquid biopsies, finding that biopsies derived from fluids other than blood, called non-blood derived liquid biopsy, can better screen, diagnose and monitor tumors, promising to advance the use of liquid biopsies for the early diagnosis of gastric cancer. Therefore, by searching the relevant literature in recent years, we analyzed the advantages and challenges of non-blood derived liquid biopsy compared with traditional liquid biopsy, and reviewed the research advances of liquid biopsy derived from saliva, gastric juice, gastric wash and urine in gastric cancer.关键词：liquid biopsy;Gastric cancer;Early diagnosis;Body fluids2|2991|0更新时间：2025-12-31
- 摘要：Sentinel lymph node (SLN) mapping has been proposed as a more “targeted” alternative for accurate lymph node resection in endometrial cancer (EC). However, there are still some problems and disputes to be resolved. For example, the standard clinical application of SLN mapping in high-risk patients, the optimal SLN algorithm, the optimal approach to evaluate SLN and the clinical significance of low volume metastasis (LVM) are worth exploring. At present, the cervical indocyanine green injection is the most commonly used tracer method, and the detection rate of LVM can be improved by ultrastaging. However, the procedures and indications of ultrastaging and clinical management of LVM need to be further standardized. In addition, high-risk EC is not an absolute contraindication for SLN mapping, however, the standard clinical application of SLN mapping in such patients needs further clinical study. This article reviewed the research status and progress of SLN mapping in EC in recent years.关键词：Endometrial cancer;Sentinel lymph node;Micrometastasis;Ultrastaging2|3532|0更新时间：2025-12-31
- 关键词：Fallopian tube carcinoma;Endometrial carcinoma;Prognosis;Treatment2|1720|0更新时间：2025-12-31
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