最新刊期
卷 28 ， 期 6 ， 2018
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- 摘要：Background and purpose: Shanghai provides free colorectal cancer screening services to eligible residents. This study aimed to analyze immunochemical fecal occult blood test results in colorectal cancer screening to assess the effectiveness of twice fecal occult blood test, and to provide the evidence for community-based screening programs. Methods: Shanghai residents aged 50-74 years were target population. Twice immunochemical fecal occult blood test and risk assessment were used for initial screening, along with colonoscopy for individuals whose initial results were positive. Results: During the screening, 809 528 participants completed immunochemical fecal occult blood test twice, and 104 953 people’s test results were positive. There were 47 421 people whose initial results were positive, and the positive rate was 5.9%. There were 36 462 people who got positive results in the second test, and the positive rate was 4.5%. Another 21 070 people got positive results in both tests, and the positive rate was 2.6%. Among the individuals with positive immunochemical fecal occult blood test, 49 339 people underwent colonoscopy, and the overall colonoscopy compliance was 47.0%. The participation rate of colonoscopy was significantly higher in participants who had double positive results than in the participants with single positive result. One thousand two hundred cases (79.5%) of colorectal cancer were diagnosed and 3 777 cases (68.1%) of precancerous lesions were detected by only one fecal occult blood test. Three hundred and ten cases (20.5%) of colorectal cancer were diagnosed and 1 767 cases (31.9%) of precancerous lesions were detected by an additional fecal occult blood test. Conclusion: Compared with the only one immunochemical fecal occult blood test, the twice tests were more effective. The compliance of colonoscopy was improved among participants with double positive results, and the detective rates of colorectal cancer and precancerous lesions were increased. To improve the screening efficiency, twice or more immunochemical fecal occult blood test should be carried out in the community-based colorectal cancer screening.关键词：Colorectal cancer;Screening;Fecal occult blood test;Community residents2|2706|5更新时间：2026-01-27
- 摘要：Background and purpose: Ovarian cancer is one of the most lethal gynecologic cancers worldwide. This study aimed to analyze the incidence and mortality of ovarian cancer among local residents in the Former Luwan District in Shanghai from Jan. 2002 to Dec. 2011. Methods: Data of ovarian cancer in permanent residents of Shanghai Former Luwan District were extracted from the Shanghai cancer registration and management system. We calculated the incidence and mortality of ovarian cancer. The standardized rates were calculated based on the demographic composition developed in the Fifth Nationwide Census in the year 2000, and the Seig’s world standard. The temporal trend in the incidence and mortality of ovarian cancer was assessed using average annual percentage change (APC). Results: A total of 236 new cases were diagnosed from Jan. 2002 to Dec. 2011, accounting for 3.76% of the total female patients with malignant diseases. Ovarian cancer incidence stayed relatively stable between 2002 and 2011. A total of 111 cases died of ovarian cancer during this period, accounting for 3.05% of the total female patients died from malignant diseases. The mortality rates of ovarian cancer during these 10 years were also stable. Conclusion: The incidence and mortality rates of ovarian cancer were relatively stable during the period from 2002 to 2011. Older women are at the highest risk of ovarian cancer occurrence. Ovarian cancer is experiencing a trend of earlier occurrence and death in the younger age group. Morbidity and mortality can occur at all ages. Effective prevention and treatment strategies are urgently needed to improve women’s health.关键词：Ovarian cancer;Incidence;Mortality;Community2|1917|14更新时间：2026-01-27
- 摘要：Background and purpose: Solitary pulmonary nodule (SPN) detected by computed tomography (CT) in breast cancer patients may be primary lung cancer (PLC) or metastatic pulmonary breast cancer (MBC), and definitive diagnosis of nodule is very important for personalized medical care of patients. In this study, we retrospectively analyzed high resolution CT (HRCT) features of MBC and PLC shown as SPN in breast cancer patients and evaluated their diagnostic values. Methods: From Oct. 2007 to Jun. 2014 , data of 116 patients with 116 SPNs confirmed by pathology were assessed with respect to preoperative CT findings retrospectively. We reviewed CT signs of nodules to differentiate MBCs and PLCs by using multivariate logistic regression model and receiver operating characteristic (ROC) curve. Results: Of the 116 SPNs, 77 (66.4%) were PLC and 39 were (33.6%) MBC. There were statistically significant differences in round or oval shape, sub-solid nodule, spiculation, lobulation, bubble lucency, air bronchogram, pleural tag, maximum diameter of nodule and portion of the solid volume component between MBCs and PLCs. Multivariate analysis showed that spiculation, presence of air bronchogram and portion of the solid volume component >24% were statistically significant independent predictors of PLCs, with the corresponding odds ratio (OR) being 0.219 (95%CI: 0.069-0.638), 0.061 (95%CI: 0.009-0.240) and 1.029 (95%CI: 1.010-1.052), respectively. This multivariate regression model had a good performance in differentiating PLC from MBC, with an area under the ROC curve (AUC) of 0.903 (95%CI: 0.838-0.969), an accuracy of 86.2%, a sensitivity of 88.3% and a specificity of 82.1%. Conclusion: In all SPNs of breast cancer patients, the probability of PLC is higher than that of MBC. Less solid component, absence of spiculation and air bronchogram are highly indicative of PLCs.关键词：Solitary pulmonary nodule;Metastatic pulmonary breast cancer;Primary lung adenocarcinoma;X-ray computed tomography;Differential diagnosis2|4611|4更新时间：2026-01-27
- 摘要：Background and purpose: Chronic lymphocytic thyroiditis (CLT) is a common autoimmune inflammation. The aim of this present study was to determine the relationship between CLT and the response of patients with differentiated thyroid carcinoma (DTC) who received surgery and radioactive iodine (131I) treatment for thyroid carcinoma. Methods: We retrospectively analyzed 128 patients who received initial treatment for thyroid disease at Peking Union Medical College Hospital from 2014 to 2016. Data of the participants with histologically confirmed DTC were analysed according to the presence (CLT1) or absence (CLT0) of concurrent CLT. One-way analysis, chi-square test and rank-sum test, Mann-Whitney test and multivariate analyses were used to evaluate the clinicopathological features. Correlation analysis was conducted between response to 131I and the presence or absence of concurrent CLT. The response was evaluated between two groups according to 2015 American Thyroid Association (ATA) response system. Results: Of the 128 patients, smaller tumor size and a greater female preponderance were noted in the patients with CLT compared with those without CLT (P=0.028, P=0.011, respectively). There was no significant difference in age, multifocality, stages of lymph nodes, capsular invasion and TNM classification system between the groups for DTC during 24-month mean follow-up period. There was no significant difference in response between two groups. The excellent response (ER) was 72.7%(40/55) and 68.5%(50/73), respectively. Indeterminate response (IR) was 14.5%(8/55) and 13.7%(10/73), respectively. Biochemical incomplete response (BIR) was 3.6%(2/55) and 6.8%(5/73), respectively. Structural incomplete response (SIR) was 9.1%(5/55) and 10.9%(8/73), respectively. Meanwhile, there was no correlation between response and the presence or absence of CTL (P=0.519). Conclusion: Our results do not support the hypothesis that CLT is associated with the response to 131I treatment for DTC patients.关键词：Differentiated thyroid carcinoma;Lymphocytic thyroiditis;Response;131I therapy2|2028|9更新时间：2026-01-27
- 摘要：Background and purpose: Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal malignancy which occurs primarily in children and adolescents. Complete surgical resection is the major treatment, and conventional chemotherapy and radiotherapy are usually invalid. In this study, we retrospectively analyzed the clinical and pathological features of eleven patients with adult IMT. Methods: A total of eleven patients with adult IMT were enrolled into this study between Feb. 2013 and Nov. 2017 in Fudan University Shanghai Cancer Center. The clinical and pathological data, treatment and prognosis were analyzed. Results: Among the eleven patients with adult IMT, five patients were male (45%), six patients were female (55%), and the median age was 39 years (24-74 years). The primary tumor located in the lung was found in two patients (18%), two cases (18%) in the retroperitoneum, and seven cases (64%) in the abdominopelvic region. Four cases were abdominal epithelioid inflammatory myofibroblastic sarcoma (EIMS). The positive rate of anaplastic lymphoma kinase (ALK) immunohistochemical expression was 82% (9/11), and the positive rate of ALK translocation was 86% (6/7). Seven patients with ALK-positive advanced disease received the treatment of crizotinib, the response rate was 86%, and the median progression-free survival (PFS) was 20.8 months (95% CI: 7.6 months-34.0 months). Conclusion: The treatment of crizotinib in adult patients with ALK-positive advanced IMT and EIMS resulted in very high response rate and long-term PFS, which suggested that ALK signaling pathway may play an important role in the development of adult IMT. It deserves further investigation.关键词：Inflammatory myofibroblastic tumor;Epithelioid inflammatory myofibroblastic sarcoma;Anaplastic lymphoma kinase;Crizotinib2|3169|2更新时间：2026-01-27
- 摘要：Background and purpose: Occult breast cancer is a difficult and hot spot in the field of breast cancer because of its occult onset, diagnostic difficulties, and unclear therapeutic strategies. In this study, we discussed the clinical pathological characteristics and the diagnosis and treatment strategy of occult breast cancer. Methods: Fiftysix cases of occult breast cancer received the preoperative examinations of ultrasonography, mammography, magnetic resonance imaging (MRI) and PET/CT. The different detection rates and pathological coincidence rates in suspicious primary lesions of occult breast cancer were compared. Treatment options included the neoadjuvant chemotherapy, modified radical mastectomy, breast-conserving surgery with axillary lymph node dissection and axillary lymph node dissection. All patients received postoperative chemotherapy with radiotherapy. Results: The detection rates of ultrasonography, mammography, MRI and PET/CT for the suspicious breast primary tumors were 7.14% (4/56), 29.41% (15/51), 37.50% (18/48) and 16.28% (7/43). Combined with the postoperative pathological examination, we found that the pathological coincidence rates were 66.67%, 50.00%, 50.00% and 50.00%. Twenty-six cases examined with ultrasonography, mammography and MRI did not have suspicious primary tumors, 21 patients underwent breast pathology examination with a positive rate of 14.29% (3/21). Thirty-nine patients received pathology examination, and the breast primary tumors were detected in 15 patients. The detection rate by pathology examination was 38.46%. According to the St.Gallen molecular classification standards, the ratio of Luminal A, Luminal B, HER-2 positive and triple-negative breast cancer was 7.14%, 46.43%, 12.50% and 33.93%, respectively. There were 52 cases with postoperative follow-up, the median follow-up period was 35 months (10-104 months), recurrence or metastasis occurred in 4 cases, and there was no death. Among the 15 patients with primary tumors, 2 cases eventually had recurrence or metastasis; 24 patients without the primary tumors did not have recurrence or metastasis; 17 patients received neoadjuvant chemotherapy, of whom 2 patients achieved pathologic complete response (PCR) and 2 patients had recurrence or metastasis. Modified radical mastectomy was performed on 39 cases, and recurrence or metastasis occurred in 2 cases. Breast-conserving surgery with axillary lymph node dissection was performed on 8 cases, and recurrence or metastasis occurred in 2 cases. Axillary lymph node dissection with radiotherapy was performed on 9 cases, and there was no recurrence or metastasis. Conclusion: MRI examination has important value in excluding the occult breast cancer. Breast pathology of primary tumors has lower detection rate in the patients without suspicious primary tumors on ultrasonography, mammography and MRI. The treatment options for occult breast cancer include the neoadjuvant chemotherapy, modified radical mastectomy, breast-conserving surgery with axillary lymph node dissection and axillary lymph node dissection. Patients who did not have primary tumors examined by breast pathology had a lower recurrence or metastasis rate than patients with the primary tumors.关键词：Occult breast cancer;Axillary lymph node metastasis;Magnetic resonance imaging;Neoadjuvant chemotherapy2|2458|12更新时间：2026-01-27
- 摘要：Intensity-modulated radiation therapy (IMRT) considered as the sophisticated treatment technique is widely used to deliver the desired dose to the tumor volume while limiting the dose to the adjacent healthy tissue. The conflict between increasing the target coverage and sparing of organs at risk (OARs) can be partially balanced when many rounds of IMRT optimization are performed. However, this optimization procedure is a trial-and-error process that is greatly dependent on the experience of the treatment planner and the amount of time they spend. Consequently, a prediction of the clinically acceptable plan before the long optimization, would be an effective and efficient way to improve the quality and consistency of treatment plans. This study summarized the up-to-date studies on the automatic planning technique.关键词：Intensity-modulated radiation therapy;Planning prediction;Automatic planning2|3154|6更新时间：2026-01-27
- 摘要：<正>1序言（P440）1.1目的1.2工作组的构成和共识编撰1.3肿瘤整形和乳房重建的决策制定1.3.1术前影像学和病理评估1.3.2决策制定1.3.3技术选择1.4共识的证据级别2肿瘤整形手术（P442）2.1共识要点2.2文献数据解读2.2.1肿瘤整形手术的安全性2.2.2肿瘤整形手术的适应证2.2.3肿瘤保乳整形技术的选择和应用2.2.4肿瘤整形手术切缘的病理学检查关键词：乳腺肿瘤;肿瘤整形;乳房重建;专家共识2|16187|53更新时间：2026-01-27
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