简介：Objective:Theaimofthisstudywastoestablishtheriskscoringsystemtowardstheadvancedcolorectalneoplasm(CN)riskintheaverage-riskpopulationsinthesouthernJiangsuProvince,andtoevaluatethescreeningefficacy.Methods:Totally905casesoftheaverage-riskpopulationswhoreceivedthecolonoscopywereselectedastheobjective.Themultivariatelogisticregressionanalysismethodwasusedtoestablishthescoringsystemtowardstheoccurrenceriskoftheadvancedtumor,anditsscreeningefficacywasevaluatedthroughthepredictionconsistency,distinguishingabilityandscreeningaccuracy.Results:Thescoringsystemconsistedoffivevariables,namelyage,gender,coronaryheartdisease,eggintakeandstoolfrequency.Theresultsrevealedthatithadgoodpredictionconsistency(P=0.205)anddistinguishingability[theareaunderthereceiveroperatingcharacteristic(ROC)curvewas0.75,with95%confidenceinterval(95%CI)of0.69-0.82].Thus,2.5pointswassetasthescreeningcutoffvalue,anditssensitivity,specificity,accuracy,positivepredictivevalue,negativepredictivevalue,positivelikelihoodratioandnegativelikelihoodratiowere93.8%,47.6%,50.1%,9.1%,99.3%,1.79and0.13,respectively.Conclusions:Theestablishedscoringsystemhadgoodscreeningefficacy,andcanbeusedasthescreeningtoolapplyingtotheCNscreeningwithintheaverage-riskpopulationsinthesouthernJiangsuProvince.

简介：Purpose:Anumberofdifferentclinicalcharacteristicshavebeenreportedtosinglycorrelatewiththerapeuticactivityofepidermalgrowthfactorreceptor(EGFR)tyrosinekinaseinhibitors(TKIs)inadvancednon-small-celllungcancer(NSCLC).Thisstudyaimedtoidentifypredictivefactorsassociatedwithprognosticbenefitsofgefitinib.Patientsandmethods:EGFRgenetypingin33advancedNSCLCpatientsreceivedgefitinib(250mg/day)wereanalyzedwithmutant-enrichedPCRassay.Gefitinibresponsewasevaluatedwithpotentialpredictivefactorsretrospectively.Results:Theoverallobjectiveresponserate(ORR)andmedianprogression-freesurvival(PFS)inthe33patientstreatedbygefitinibwere45.5%and3.0(2.0-4.0)months.TheORRandmedianPFSinEGFRgenemutationpatientsweresignificantlyhigher/longerthanthoseinEGFRgenewild-typepatients(P<0.01).Similarly,theORRandmedianPFSinnon-smokerpatientsweresignificantlyhigher/longerthanthoseinsmokerpatients(P<0.05,P<0.01,respectively).However,nodifferenceforORRandmedianPFSoccurredbetweenmaleandfemalepatients.LogisticmultivariateanalysisshowedthatonlyEGFRmutatedgenewassignificantlyassociatedwiththeORR(P<0.01).BothEGFRmutatedgeneandnon-smokerwerethemajorfactorsthatcontributedtoPFS(P<0.05).Conclusions:EGFRmutatedgeneandnon-smokerstatusarepotentialpredictorsforgefitinibresponseinNSCLCpatients.

简介：Molecularsubtypingofbreastcancermayprovideadditionalprognosticinformationregardingpatientoutcome.Theepidermalgrowthfactorreceptor(HER2)overexpressingbreastcancersaredesignatedasHER2-postive(HER2+)breastcancerandcarryaparticularlyunfavorableprognosis.WepresenttwocasesofHER2-postivemetastaticbreastcancer(MBC)whoarefoundtobeachallengetotreat,especiallyduetotheoccurrenceofbrainmetastasis.Trastuzumab-basedtherapyimprovesclinicaloutcomes,evenifthepatienthasundergonemulti-linetreatment.ThesecasereportsalsoemphasizetheimportanceofretestingHER2statusbecauseitcanbediscordanceinreceptorstatusbetweenprimaryandrecurrentbreastcancer.

简介：Purpose:Wntpathwayscontrolkeybiologicalprocessesthatpotentiallyimpactontumorprogressionandpatientsurvival.Thepresentstudyanalyzedthepolymorphismoflipoprotein-relatedreceptor5(LRP5)(genewithkeyfunctionsinWntsignaling)anditsimpactontheresponsetochemotherapyandsurvivalofpatientswithadvancedgastriccancer(AGC).Methods:Atotalof107consecutivepatientswithAGCtreatedwithfirst-linechemotherapyofEOFregimenwereenrolledinthepresentretrospectivestudy.Theassociationbetweensinglenucleotidepolymorphism(SNP)ofrs3736228inLRP5andtheclinicaloutcomesofthepatientswasstudied.Results:TheCCgenotypeofrs3736228wassignificantlycorrelatedwithahigherdiseasecontrolratewhencomparedtotheCTandTTgenotypes(89.3%and61.8%,respectively,P<0.001).Aunivariatesurvivalanalysisalsoshowedthattheprogressionfreesurvival(PFS)andoverallsurvival(OS)forthepatientswiththeTCandTTgenotypesofrs3736228wereworsethanforthepatientswiththeCCgenotype(PFS:3.3and6.7months,respectively,HR=0.454,P<0.001;OS:8.1monthsand18.8months,respectively,HR=3.056,P<0.001).AmultivariateCoxmodelincorporatesrs3736228andclinicalfeatures,alsoidentifiedrs3736228wassignificantlyassociatedwiththePFSandOS.Conclusions:OurresultsfirstlyhighlighttheimportanceofLRP5geneofWntpathwayinthetreatmentofAGCandidentifypolymorphismofrs3736228asindependentpredictorofdiseasecontrolrate,PFSandOSinAGCpatientstreatedwithfirst-linechemotherapyofEOFregimenintheChineseHanpopulation.

简介：Objective:Non-smallcelllungcancer(NSCLC)patientswithepidermalgrowthfactorreceptor(EGFR)-activatingmutationshavehigherresponserateandmoreprolongedsurvivalfollowingtreatmentwithsingle-agentEGFRtyrosinekinaseinhibitor(EGFR-TKI)comparedwithpatientswithwild-typeEGFR.However,allpatientstreatedwithreversibleinhibitorsdevelopacquiredresistanceovertime.Themechanismsofresistancearecomplicated.ThelackofestablishedtherapeuticoptionsforpatientsafterafailedEGFR-TKItreatmentposesagreatchallengetophysiciansinmanagingthisgroupoflungcancerpatients.ThisstudyevaluatestheinfluenceofEGFR-TKIretreatmentfollowingchemotherapyafterfailureofinitialEGFR-TKIwithinatleast6monthsonNSCLCpatients.Methods:Thedataof27patientswhoexperiencedtreatmentfailurefromtheirinitialuseofEGFR-TKIwithinatleast6monthswereanalyzed.Afterchemotherapy,thepatientswereretreatedwithEGFR-TKI(gefitinib250mgqdorerlotinib150mgqd),andthetumorprogressionwasobserved.Thepatientswereassessedforadverseeventsandresponsetotherapy.TargetedtumorlesionswereassessedwithCTscan.Results:Ofthe27patientswhoreceivedEGFR-TKIretreatment,1(3.7%)patientwasobservedincompleteresponse(CR),8(29.6%)patientsinpartialresponse(PR),14(51.9%)patientsinstabledisease(SD),and4(14.8%)patientsinprogressivedisease(PD).Thediseasecontrolrate(DCR)was85.2%(95%CI:62%-94%).Themedianprogression-freesurvival(mPFS)was6months(95%CI:1-29).Ofthe13patientswhoreceivedthesameEGFR-TKI,1patientinCR,3patientsinPR,8patientsinSD,and2patientsinPDwereobserved.TheDCRwas84.6%,andthemPFSwas5months.Ofthe14patientswhoreceivedanotherEGFR-TKI,nopatientinCR,6patientsinPR,6patientsinSD,and2patientsinPDwereobserved.TheDCRwas85.7%,andthemPFSwas9.5months.SignificantdifferencewasfoundbetweenthetwogroupsinPFSbutnotinresponserateorDCR.Conclusion:RetreatmentofEGFR-TKIscanbeconsideredano

简介：Objective:Toclarifytheprognosticvalueofpost-treatment18F-fluorodeoxyglucose(FDG)positronemissiontomography(PET)/computedtomography(CT)inpatientswithadvancedheadandnecksquamouscellcarcinoma(HNSCC)aftercombinedintra-arterialchemotherapyandradiotherapy(IACR).Methods:Thirty-sixpatientswithHNSCCwhounderwentIACRwererecruited.TheperiodfromtheendofIACRtothelastpost-treatment18F-FDGPET/CTexaminationwas8-12weeks.Bothpatient-basedandlesion-basedanalyseswereusedtoevaluatethePET/CTimages.Forlesion-basedanalysis,36regions(12lesionsofrecurrencesand24scarsatprimarysites)wereselected.TheKaplan-Meiermethodwasusedtoassesstheoverallsurvival(OS)stratifiedby18F-FDGuptakeorvisualinterpretationresults.Results:TwelvepatientswithrecurrencewereidentifiedbysixmonthsafterIACR.Thesensitivityandspecificityinthepatient-basedanalysiswere67%(8/12)and88%(21/24),respectively.ThemeanOSwasestimatedtobe12.1months(95%CI,6.3-18.0months)forthehighermaximumstandardizeduptakevalue(SUVmax)group(n=7)and44.6months(95%CI,39.9-49.3months)forthelowerSUVmaxgroup(n=29).OSinthehigherSUVmaxgroup(cut-offpoint,6.1)orpositivevisualinterpretationgroupwassignificantlyshorterthanthatinthelowerSUVmaxornegativevisualinterpretationgroup(P<0.001andP<0.05,respectively).Conclusions:TheSUVmaxandvisualinterpretationofHNSCConpost-IACR18F-FDGPET/CTcanprovideprognosticsurvivalestimates.