学科分类
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82 个结果
  • 简介:Dearcolleague,Astheeditor-in-chief,IwouldliketodeclarethegoodnewsthatCancerBiology&Medicine(CBM)hasbeenindexedinScienceCitationIndexExpanded(SCIE)andwillgetanimpactfactorsoon.AstheofficialjournaloftheChineseAnti-CancerAssociation(CACA)whichpossessesmorethan40,000members,CBMholdsalargeaudiencebothinChinaandabroad.Thejournalmainlyfocusesontranslationalcancerresearch,dedicatingtonarrowing

  • 标签: 微卫星不稳定性 稳定性检测 检测策略 敏感性 综合征 患者
  • 简介:客观试验性的证据建议胸的overexpression癌症特定的肿瘤suppressor蛋白质1(BRCA1)基因提高敏感到docetaxel和抵抗到cisplatin和ribonucleotidereductaseM1(RRM1)基因overexpression提高抵抗到gemcitabine。为了进一步检验BRCA1和RRM1mRNA的效果,在先进非小的房间肺癌症(NSCLC)在结果上铺平,我们执行了测试了那设定的治疗将授与的假设的这非使随机化的阶段II临床的审判在noncustomized上的改进结果治疗。

  • 标签: MRNA水平 非小细胞肺癌 BRCA1 化疗 患者 晚期
  • 简介:Objective:Thisstudyinvestigatedthecapabilityofdual-energyspectralcomputedtomography(CT)toquantitativelyevaluatelungperfusiondefectsthatareinducedbycentrallungcancer.Methods:Thirty-twopatientswithcentrallungcancerunderwentCTangiographyusingspectralimaging.Aunivariategenerallinearmodelwasconductedtoanalyzethevarianceofiodineconcentration/CTvaluewiththreefactorsoflungfields.Apairedt-testwasusedtocompareiodineconcentrationsandCTvaluesbetweenthedistalendoflungcancerandthecorrespondingareainthecontralateralnormallung.Results:Iodineconcentrationsincreasedprogressivelyinthefar,intermediateandneargroundsidesinthenormallungfieldsat0.60±0.28,0.93±0.27and1.25±0.38mg/mL,respectively(P<0.001).ThesametrendwasobservedfortheCTvalues[–(840.64±49.08),–(812.66±50.85)and–(760.83±89.17)HU,P<0.001].Theiodineconcentration(0.70±0.42mg/mL)ofthelungfieldinthedistalendoflungcancerwassignificantlylowerthanthecorrespondingareainthecontralateralnormallung(1.19±0.62mg/mL)(t=–7.23,P<0.001).However,theCTvalueoflungfieldinthedistalendoflungcancerwassignificantlyhigherthanthecorrespondingareainthecontralateralnormallung[–(765.29±93.34)HUvs.–(800.07±76.18)HU,t=3.564,P=0.001].Conclusions:SpectralCTimagingbasedonthespectraldifferentiationofiodineisfeasibleandcanquantitativelyevaluatepulmonaryperfusionandidentifyperfusiondefectsthatareinducedbycentrallungcancer.SpectralCTseemstobeapromisingtechniqueforthesimultaneousevaluationofbothmorphologicalandfunctionallunginformation.

  • 标签: CT成像 定量评估 光谱成像 肺癌 灌注 缺损
  • 简介:Objective:Toexploretheeffectsofpostmastectomyradiotherapy(PMRT)onthelocoregionalfailure-freesurvival(LRFFS)andoverallsurvival(OS)ofbreastcancerpatientsunderdifferenttumorstagesandwithonetothreepositiveaxillarylymphnodes(ALNs).Methods:Weconductedaretrospectivereviewof527patientswithonetothreepositivelymphnodeswhounderwentmodifiedradicalorpartialmastectomyandaxillarydissectionfromJanuary2000toDecember2002.ThepatientsweredividedintotheT1-T2N1andT3-T4N1groups.TheeffectsofPMRTontheLRFFSandOSofthesetwopatientgroupswereanalyzedusingSPSS19.0,Pearson’sχ2-test,Kaplan-Meiermethod,andCoxproportionalhazardmodel.Results:ForT1-T2N1patients,nostatisticalsignificancewasobservedintheeffectsofPMRTonLRFFS[hazardratio(HR)=0.726;95%confidenceinterval(CI):0.233-2.265;P=0.582]andOS(HR=0.914;95%CI:0.478-1.745;P=0.784)ofthegeneralpatients.Extracapsularextension(ECE)andhighhistologicalgradeweretheriskfactorsforLRFFSandOSwithstatisticalsignificanceinmultivariateanalysis.StratificationanalysisshowedthatPMRTstatisticallyimprovedtheclinicaloutcomesinhigh-riskpatients[ECE(+),LRFFS:P=0.026,OS:P=0.007;histologicalgradeIII,LRFFS:P<0.001,OS:P=0.007]butnotinlow-riskpatients[ECE(–),LRFFS:P=0.987,OS:P=0.502;histologicalgradeI-II,LRFFS:P=0.816,OS:P=0.296].ForT3-T4N1patients,PMRTeffectivelyimprovedthelocalcontrol(HR=0.089;95%CI:0.210-0.378;P=0.001)ofthegeneralpatients,whereasnostatisticaleffectwasobservedonOS(HR=1.251;95%CI:0.597-2.622;P=0.552).Absenceofestrogenreceptorsandprogesteronereceptors(ER/PR)(–)wasanindependentriskfactor.FurtherstratificationanalysisindicatedastatisticaldifferenceinLRFFSandOSbetweenthehigh-riskpatientswithER/PR(–)receivingPMRTandnotreceivingPMRT[ER/PR(–),LRFFS:P=0.046,OS:P=0.039].However,PMRThadabeneficialeffectonthereductionoflocoregionalr

  • 标签: 放射治疗 淋巴结 乳腺癌 患者 阳性 肿瘤
  • 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.

  • 标签: 非小细胞肺癌 预测 反应 晚期 治疗 酪氨酸激酶抑制剂
  • 简介:Objective:ThepurposesofthisstudyweretoidentifyriskfactorsforcervicallymphnodemetastasisandtoexaminetheassociationbetweenBRAFV600Estatusandclinicalfeaturesinpapillarythyroidmicrocarcinoma(PTMC).Methods:Atotalof1,587patientswithPTMC,treatedinTianjinMedicalUniversityCancerInstituteandHospitalfromJanuary2011toMarch2013,underwentretrospectiveanalysis.Wereviewedandanalyzedfactorsincludingclinicalresults,pathologyrecords,ultrasoundresults,andBRAFV600Estatus.Results:Multivariatelogisticregressionanalysesdemonstratedthatgender(male)[oddsratio(OR)=1.845,P=0.000],age(<45years)(OR=1.606,P=0.000),tumorsize(>6mm)(OR=2.137,P=0.000),bilateralism(OR=2.011,P=0.000)andextrathyroidalextension(OR=1.555,P=0.001)servedasindependentpredictorsofcentrallymphnodemetastasis(CLNM).Moreover,CLNM(OR=29.354,P=0.000)servedasanindependentpredictoroflaterallymphnodemetastasis(LLNM).Amongpatientswithasolitaryprimarytumor,thosewithtumorlocationinthelowerthirdofthethyroidlobeortheisthmusweremorelikelytoexperienceCLNM(P<0.05).UnivariateanalysesindicatedthatCLNM,LLNM,extrathyroidalextension,andmultifocalitywerenotsignificantlyassociatedwithBRAFV600Emutation.Conclusions:ThepresentstudysuggestedthatprophylacticneckdissectionofthecentralcompartmentshouldbeconsideredinpatientswithPTMC,particularlyinmenwithtumorsizegreaterthan6mm,agelessthan45years,extrathyroidalextension,andtumorbilaterality.AmongpatientswithPTMC,BRAFV600Emutationisnotsignificantlyassociatedwithprognosticfactors.ForabetterunderstandingofsurgicalmanagementofPTMCandtheriskfactors,werecommendmulticenterresearchandlong-termfollow-up.

  • 标签: PTMC RISK FACTORS CLNM LLNM B/MP 600E
  • 简介:EurJNuclMedMolImaging.2008Jun10.PURPOSE:ThepurposeofthisprospectivestudywastoclarifytheindividualandcombinedroleofL:-methyl-(11)C-methionine-positronemissiontomography(MET-PET)and3'-deoxy-3'-[(18)F]fluorothymidine(FLT)-PETintumordetection,noninvasivegrad-ing,andassessmentofthecellularproliferationrateinnewlydiagnosedhistologicallyverifiedgliomasofdifferentgrades.MATERI-

  • 标签: 蛋氨酸 神经胶质瘤 患者 诊断方法
  • 简介:DETECTIONOFOCCULTTUMORCELLSINRESECTEDLYMPHNODESOFPATIENTSWITHSTAGEICARCINOMAANDITSCLINICOPATHOLOGICALSIGNIFICANCEChenZhaolun...

  • 标签: NODAL OCCULT metastases NSCLC Breast CANCER
  • 简介:Objective:Theaimofthisprospective,single-armphaseIItrialwastoconfirmthesafetyandefficacyofneoadjuvantchemotherapy(NAC)usingoxaliplatinpluscapecitabine(CapOX)forpatientswithoperablelocallyadvancedcoloncancer(CC).Methods:Patientswithcomputedtomography-definedT4orlymphnode-positiveCCswereenrolled.Afterradiologicalstaging,patientsweretreatedwithatleast2cyclesofNACconsistingof130mg/m2oxaliplatinond1,plus1,000mg/m2capecitabinetwicedailyfor14devery3weeks,followedbysurgery,andthenwiththerestcyclesofadjuvantchemotherapy.Radiologicalresponsewasevaluatedafter2cyclesofNAC.Tumorresponse,treatmenttoxicity,andsurgicalcomplicationswererecorded.Thepathologicalresponsetotherapywasevaluatedaccordingtothetumorregressiongrade(TRG)score.Theprimaryendpointwaspathologictumorresponse.ThistrialisregisteredinClinicalTrials.gov(No:NCT02415829).Results:Forty-sevenpatientswereenrolledinthestudy.Forty-twopatientscompletedtheplannedtreatments.Thetotalradiologicalresponseratewas68%(32/47),includingcompleteandpartialresponseratesof2%(1/47)and66%(31/47),respectively.Stablediseasewasobservedin32%(15/47)andprogressivediseasewasobservedinnone.Completepathologicresponse,majorregression,andatleastmoderateregressionwereachievedin1(2%),2(4%),and29(62%)patients,respectively.Fourpatientsdevelopedgrade3treatmenttoxicities.Onepatientwithwoundinfectionoccurredafteroperation(1/47,2%).Therewasnotreatment-relateddeath.Conclusions:OurresultssuggestthatNACwithCapOXisaneffectiveandsafetreatmentoptionforpatientswithlocallyadvancedCCs.

  • 标签: 临床试验 结肠癌 患者 治疗 化疗 晚期
  • 简介:Objective:Tocreateanomogramtopredicttheincidenceoflymphnodemetastasis(LNM)inearlygastriccancer(EGC)patientsandtoexternallyvalidatethenomogram.Methods:Toconstructthenomogram,weretrospectivelyanalyzedaprimarycohortof272EGCpatients.Univariateanalysisandabinarylogisticregressionwereperformed.AnomogrampredictingtheincidenceofLNMinEGCpatientswascreated.Thediscriminationabilityofthenomogramwasmeasuredusingtheconcordanceindex(c-index),andthenomogramwasalsocalibrated.Then,anotherprospectivecohortof81patientswasanalyzedtovalidatethenomogram.Results:Intheprimarycohort,LNMwaspathologicallyconfirmedin37(13.6%)patients.Inmultivariateanalysis,thepresenceofanulcer,themaximumlesiondiameterobservedviagastroscopy,thethicknessofthelesionobservedviaendoscopicultrasonography,andthepresenceofenlargedlymphnodesoncomputedtomography(CT)wereindependentriskfactorsforLNM.Anomogramwasthencreatedbasedontheregressionmodelwiththec-indexof0.905,andthecalibrationcurveofthenomogramfellapproximatelyontheideal45-degreeline.Thecut-offscoreofthenomogramwas110,andthesensitivity,specificity,positivepredictiveandnegativepredictivevaluesofthenomogramintheprimarycohortwere81.1%,86.0%,47.6%and96.7%,respectively,andintheprospectivevalidationcohortwere75.0%,91.0%,60.0%and95.5%,respectively.Thecalibrationcurveoftheexternalvalidationcohortwasalmostonthe45-degreeline.Conclusions:WedevelopedaneffectivenomogrampredictingtheincidenceofLNMforEGCpatients.

  • 标签: Early GASTRIC cancer LYMPH NODE METASTASIS
  • 简介:Objective:Toexploretheeffectofearlyenteralnutrition(EN)onpostoperativenutritionalstatus,intestinalpermeability,andimmunefunctioninelderlypatientswithesophagealcancerorcardiaccancer.Methods:Atotalof96patientswithesophagealcancerorcardiaccancerwhounderwentsurgicaltreatmentinourhospitalfromJune2007toDecember2010wereenrolledinthisstudy.TheyweredividedintoENgroup(n=50)andparenteralnutrition(PN)group(n=46)basedonthenutritionsupportmodes.Thebodyweight,timetofirstflatus/defecation,averagehospitalstay,complicationsandmortalityafterthesurgeryaswellastheliverfunctionindicatorswererecordedandanalyzed.Peripheralbloodsampleswerecollectedonthedays1,4and7aftersurgery.Theplasmadiamineoxidase(DAO)activityandD-lactatelevelweredeterminedtoassesstheintestinalpermeability.TheplasmaendotoxinlevelsweredeterminedusingdynamicturbidimetricassaytoassesstheprotectiveeffectofENonintestinalmucosalbarrier.Thepostoperativebloodlevelsofinflammatorycytokinesandimmunoglobulinsweredeterminedusingenzyme-linkedimmunosorbentassay(ELISA).Results:Afterthesurgery,thetimetofirstflatus/defecation,averagehospitalstay,andcomplicationsweresignificantlylessintheENgroupthanthoseinthePNgroup(P<0.05),whereastheENgrouphadsignificantlyhigheralbuminlevelsthanthePNgroup(P<0.05).Onthe7thpostoperativeday,theDAOactivity,D-lactatelevelandendotoxincontentsweresignificantlylowerintheENgroupthanthoseinthePNgroup(allP<0.05).Inaddition,theENgrouphadsignificantlyhigherIgA,IgG,IgM,andCD4levelsthanthePNgroup(P<0.05)butsignificantlylowerIL-2,IL-6,andTNF-αlevels(P<0.05).Conclusions:Inelderlypatientswithesophagealcancerorcardiaccancer,earlyENaftersurgerycaneffectivelyimprovethenutritionalstatus,protectintestinalmucosalbarrier(byreducingplasmaendoxins),andenhancetheimmunefunction

  • 标签: 增强免疫功能 肠内营养 营养状况 贲门癌 食管癌 老年
  • 简介:Objective:MemorystemTcells(Tscm)haveattractedattentionbecauseoftheirenhancedself-renewal,multipotentcapacity,andanti-tumorcapacities.However,littleisknownaboutTscminpatientswithrenalclearcellcarcinoma(RCC)andtheroleofWntsignalinginthesecells.WeevaluatedTscmfromRCCpatientsconcerningtheiractivationofWntsignalinginvitroandexploredthemechanismofpreferentialsurvival.Methods:FlowcytometryidentifiedsurfacemarkersandcytokinesproducedfromaccumulatedTscminthepresenceoftheglycogensynthasekinasebetainhibitorTWS119.Apoptosiswasevaluatedafterinductionusingtumornecrosisfactor-alpha.ImmunofluorescenceandWesternblotanalyseswereusedtoinvestigatetheactivationofthenuclearfactor-kappaB(NF-КB)pathway.Results:RCCpatientshadasimilarpercentageofCD4~+andCD8~+Tscmashealthydonors.ActivationofWntsignalingbyTWS119resultedintheaccumulationofTscminactivatedTcells,butreversalofdifferentiatedTcellstoTscmwasnotachieved.PreferentialsurvivalofTscmwasassociatedwithincreasedanti-apoptoticabilitymediateddownstreamoftheNF-КBactivationpathway.Conclusions:ThefindingthatTscmcanaccumulatebyWntsignalinginvitroinbloodfromRCCpatientswillhelpindevisingnewcancertherapystrategiesofTscm-basedadoptiveimmunotherapy,suchasdendriticcell-stimulatedTscm,andTcellreceptororchimericantigenreceptor-engineeredTscm.

  • 标签: MEMORY STEM T cell TWS119 WNT
  • 简介:PURPOSE:Todeterminethesafetyandefficacyofgefitinib,anepidermalgrowthfactorreceptor(EGFR)tyrosinekinaseinhibitor,incombinationwithradiationfornewlydiagnosedglioblastoma(GBM)patients.METHODSANDMATERIALS:BetweenMarch21,2002,andMay3,2004,RadiationTherapyOncologyGroup(RTOG)0211enrolled31and147GBMpatientsinthephase1and2arms,respectively.Treatmentconsistedofdailyoralgefinitnibstartedatthetimeofconventionalcranialradiationtherapy(RT)andcontinuedpostRTfor18monthsoruntilprogression.Tissuemicroarraysfrom68caseswereanalyzedforEGFRexpression.RESULTS:Themaximumtolerateddose(MTD)ofgefitinibwasdeterminedtobe500mginpatientsonnon-enzyme-inducinganticonvulsantdrugs(non-EIAEDs).Allpatientsinthephase2componentweretreatedatagefitinibdoseof500mg;patientsreceivingEIADSscouldbeescalatedto750mg.Themostcommonsideeffectsofgefitinibincombinationwithradiationweredermatologicandgastrointestinal.Mediansurvivalwas11.5monthsforpatientstreatedperprotocol.Therewasnooverallsurvivalbenefitforpatientstreatedwithgefitinib+RTwhencomparedwithahistoricalcohortofpatientstreatedwithRTalone,matchedbyRTOGrecursivepartitioninganalysis(RPA)classdistribution.Youngeragewassignificantlyassociatedwithbetteroutcome.Perprotocolstratification,EGFRexpressionwasnotfoundtobeofprognosticvalueforgefitinib+RT-treatedpatients.CONCLUSIONS:TheadditionofgefitinibtoRTiswelltolerated.MediansurvivalofRTOG0211patientstreatedwithRTwithconcurrentandadjuvantgefitinibwassimilartothatinahistoricalcontrolcohorttreatedwithradiationalone.

  • 标签: 放射治疗 母细胞 患者 表皮生长因子受体 并发 胶质
  • 简介:在病人作为首要或第二线的治疗评估paclitaxel,cisplatin和5-FU(PCF)的联合政体的功效和毒性与的目的进展胃并且在中国的esophagogastric连接(EGJ)腺癌。病人与paclitaxel被对待的方法d1上的150mg/m2;fractionatedcisplatin15mg/m2和连续注入5-FU600mg/(m2朠楬污映扩楲汬牡????????????М

  • 标签: 治疗方案 紫杉醇 患者 胃癌 腺癌 食管
  • 简介:Objective:Toinvestigatetherecurrencesites,riskfactors,andprognosisofpatientswithpersistentorrecurrentsquamouscellcarcinoma(SCC)ofthecervixwithinoneyearafterundergoingconcurrentchemoradiotherapy(CCRT).Methods:Clinicaldataof30patientswithpersistentorrecurrentSCCofthecervixwithinoneyearafterCCRTbetweenJuly2006andJuly2011wereanalyzedretrospectively.Thesedatawerecomparedwiththoseof35SCCcaseswithnosignsofrecurrenceaftercompleteremission.These35patientsweretreatedduringthesameperiod(between2006and2011)andselectedrandomly.Results:Amongthese30patients,25exhibiteddistantmetastasesofwhich14wereobservedwithin6monthsafterCCRT.Univariateanalysisshowedhigherincidenceofpelvicorpara-aorticlymphadenectasisandSCC-ag>10ng/mLinthegroupwithpersistentorrecurrentdiseasebeforetreatment(P<0.01).Multivariateanalysisbylogisticregressionrevealedthatthepre-therapeuticpelvicorpara-aorticlymphnodeenlargementandSCC-ag>10ng/mLweretheindependentriskfactors.Palliativechemotherapywasthemaintreatmentoptionforpatientswithpersistentorrecurrentdisease.The2-yearsurvivalratewas21.7%,andthemediansurvivaltimewas17months.Conclusion:PatientswithpersistentorrecurrentSCCofthecervixafterCCRTexhibitedahighrateofdistantmetastasiswithpoorprognosis.Thepre-therapeuticpelvicorpara-aorticlymphnodeenlargementandSCC-ag>10ng/mLwereidentifiedastheindependentriskfactorsforpersistentorrecurrentSCCwithin1yearafterCCRT.

  • 标签: 鳞状细胞癌 持续性 子宫颈 复发 化疗 同步
  • 简介:Objective:Upto40%ofwomenover70yearswithprimaryoperablebreastcancerintheUKaretreatedwithprimaryendocrinetherapy(PET)asanalternativetosurgery.Avarietyoffactorsareimportantindeterminingtreatmentforolderbreastcancerpatients.Thisstudyaimedtoidentifythepatientandtumorfactorsassociatedwithtreatmentallocationinthispopulation.Methods:Prospectivelycollecteddataontreatmentreceived(surgeryvs.PET)wereanalysedwithmultivariablelogisticregressionusingthevariablesage,modifiedCharlsonComorbidityIndex(CCI),activitiesofdailyliving(ADL)score,Mini-MentalStateExamination(MMSE)score,HER2status,tumoursize,gradeandnodalstatus.Results:Datawereavailablefor1,122cancersin1,098patientsrecruitedbetweenFebruary2013andJune2015from51UKhospitals.About78%ofthepopulationweretreatedsurgically,withtheremainderbeingtreatedwithPET.Increasingpatientageatdiagnosis,increasingCCIscore,largetumorsize(5cmormore)anddependenceinoneormoreADLcategorieswereallstronglyassociatedwithnon-surgicaltreatment(P<0.05).Conclusion:Increasingcomorbidity,largetumorsizeandreducedfunctionalabilityareassociatedwithreducedlikelihoodofsurgicaltreatmentofbreastcancerinolderpatients.However,ageitselfremainsasignificantfactorfornon-surgicaltreatment;reinforcingtheneedforevidence-basedguidelines.

  • 标签: 手术治疗 癌症患者 乳腺癌 可操作性 决策过程 老年
  • 简介:Molecularsubtypingofbreastcancermayprovideadditionalprognosticinformationregardingpatientoutcome.Theepidermalgrowthfactorreceptor(HER2)overexpressingbreastcancersaredesignatedasHER2-postive(HER2+)breastcancerandcarryaparticularlyunfavorableprognosis.WepresenttwocasesofHER2-postivemetastaticbreastcancer(MBC)whoarefoundtobeachallengetotreat,especiallyduetotheoccurrenceofbrainmetastasis.Trastuzumab-basedtherapyimprovesclinicaloutcomes,evenifthepatienthasundergonemulti-linetreatment.ThesecasereportsalsoemphasizetheimportanceofretestingHER2statusbecauseitcanbediscordanceinreceptorstatusbetweenprimaryandrecurrentbreastcancer.

  • 标签: 乳腺癌 治疗 文献综述 单抗 表皮生长因子受体 晚期
  • 简介:Objective:Epidermalgrowthfactorreceptor(EGFR)activationwasreportedtoupregulateprogrammeddeath-ligand1(PD-L1)expressioninlungcancercellsandsubsequentlycontributetoimmuneescape,indicatingitscriticalroleinEGFR-drivenlungtumors.ThisstudycharacterizedPD-L1expressioninpatientswithsurgicallyresectedEGFR-mutantnon-smallcelllungcancer(NSCLC).TheeffectofPD-L1expressiononclinicaloutcomeswasalsoinvestigatedinadvancedEGFR-mutantNSCLCtreatedwithEGFR-tyrosinekinaseinhibitors(TKIs).Methods:Intotal,73patientswithsurgicallyresectedNSCLCandEGFRmutationswereidentified.PD-L1expressionandCD8+tumor-infiltratinglymphocyte(TIL)densitywereassessedbyimmunohistochemistry.AliteraturereviewofpublicationsthatassessedthepredictiveandprognosticvalueofPD-L1expressioninadvancedEGFR-mutantNSCLCpatientstreatedwithEGFRTKIswasperformed.Results:Nineteen(26.0%)patientswerepositiveforPD-L1expression,whichwassignificantlyassociatedwithconcomitantKRASmutation(P=0.020)andmarginallyassociatedwithhigherCD8+TILsdensity(P=0.056).PositivePD-L1expressionwasassociatedwithmarkedlyinferioroverallsurvival(OS)inmultivariateanalysis(P=0.032).ThecombinationofPD-L1andCD8+TILsexpressioncouldbeusedtostratifythepopulationintothreegroupswithdistinctprognoses.Ameta-analysisofsixpublicationsshowedthatpositivePD-L1expressionwasnotassociatedwithOS[hazardratio(HR)=0.90;95%confidenceinterval(CI),0.42–1.38]orprogression-freesurvival(HR=1.03;95CI,0.73–1.33)inadvancedEGFR-mutantNSCLCpatientsreceivingEGFR-TKIs.Conclusions:PD-L1expressiontendedtocorrelatewithCD8+TILexpression,concomitantKRASmutation,andpoorsurvivalinsurgicallyresectedEGFR-mutantNSCLC.PD-L1expressionwasneitherthepredictivenortheprognosticfactorinadvancedEGFR-mutantNSCLCpatientstreatedwithEGFR-TKIs.

  • 标签: NON-SMALL cell LUNG cancer EGFR MUTATION