carcinoma

摘要： Clear cell carcinoma of the thyroid is rare. We report a case observed in a 17-year-old woman with a nodule in the left lobe of the thyroid. Cervical ultrasound showed a single nodule of the left lobe of the thyroid, measuring 28 × 14 × 21 mm with microcalcifications, classified TIRADS 4. Pathological and immunohistochemical examination of the excisional specimen concluded with clear cell carcinoma. The epidemiological and histological aspects were discussed.

摘要： BACKGROUND Ovarian cancer is one of the three most common malignant tumors of the female reproductive tract and ranks first in terms of mortality among gynecological tumors.Epithelial ovarian carcinoma(EOC)is the most common ovarian malignancy,accounting for 90%of all primary ovarian tumors.The clinical value of cytoreductive surgery in patients with platinum-resistant recurrent EOC remains largely unclear.AIM To evaluate the feasibility of secondary cytoreductive surgery for treating platinum-resistant recurrent EOC.METHODS This was a retrospective study of the clinical data of patients with platinumresistant EOC admitted to the Cancer Hospital of the University of Chinese Academy of Sciences between September 2012 and June 2018.Patient baseline data were obtained from clinical records.Routine follow-up of disease progression was performed as follows.CA125 assessment and physical examination were performed every 3 wk during treatment,including gynecological examination.Imaging assessment was carried out every 12 wk by B-mode ultrasound,computed tomography,or magnetic resonance imaging.The primary outcome was progression-free survival(PFS).Secondary outcomes included overall survival(OS),chemotherapy-free interval(CFI),and complications.Follow-up ended on April 15,2019.RESULTS A total of 38 patients were included.R0 resection was achieved in 25(65.8%) patients and R1/2 in 13 (34.2%). Twenty-five (65.8%) patients required organ resection. Nine(23.7%) patients had operative complications, 36 (94.7%) received chemotherapy, and five (13.2%)had targeted therapy. Median PFS and OS were 10 (95%CI: 8.27-11.73) months and 28 (95%CI:12.75-43.25) months, respectively;median CFI was 9 (95%CI: 8.06-9.94) months. R0 resection andpostoperative chemotherapy significantly prolonged PFS and OS (all P < 0.05), and R0 resectionalso significantly prolonged CFI (P < 0.05). Grade ≥ 3 complications were observed, includingrectovaginal fistula (n = 1), intestinal and urinary fistulas (n = 1), and renal failure-associated death(n = 1). Except for the patient who died after surgery, all other patients with complications weresuccessfully managed. Two patients developed intestinal obstruction and showed improvementafter conservative treatment.CONCLUSIONSecondary cytoreductive surgery is feasible for treating platinum-resistant recurrent EOC. Thesefindings provide important references for the selection of clinical therapeutic regimens.

摘要： 随着高分辨率超声,细针穿刺活检等医疗设备及技术的发展,肿瘤最大直径<10 mm的甲状腺微小乳头状癌(Papillary thyroid microcarcinoma,PTMC)的检出率大幅度提升。越来越多的PTMC患者接受了医学治疗。然而,PTMC这类肿瘤的生物学行为多数呈现为惰性,积极手术是否能使所有患者受益仍然存在争议,因此积极监测(Active surveillance,AS)策略应运而生。

摘要： 上皮-肌上皮癌(epithelial-myoepithelial carcinoma,EMC)是一种罕见的恶性肿瘤,主要起源于唾液腺,约占所有唾液腺肿瘤的1%。10~19岁发病甚为罕见。本文报道1例青少年腮腺EMC的病例,并结合相关文献复习,探讨青少年腮腺EMC的临床诊断、病理特点、治疗及预后。

摘要： 儿童及青少年的健康发展离不开医疗的保驾护航。六一儿童节到来之际,本期专刊特以儿童及青少年分化型甲状腺癌(differentiated thyroid carcinoma in children and adolescents,caDTC)为专题进行讨论。caDTC的发病率逐年上升,已成为0~14岁儿童第五大常见恶性肿瘤,青春期后更是跃居至女性患儿常见恶性肿瘤的第2位。

摘要： To the Editor:Hepatocellular carcinoma(HCC)is one of the most common cancers worldwide[1,2].Portal vein tumor thrombus(PVTT)has been demonstrated to be a poor prognostic indicator for HCC[3-5].However,effective treatment for the condition is still limited.Un-derstanding the insight into the molecular mechanisms behind PVTT development may help to establish a new therapeutic strat-egy.

摘要： 甲状腺未分化癌(aplastic thyroid carcinoma,ATC)又称为间变性癌或肉瘤样癌,是一种罕见的恶性肿瘤,约占甲状腺癌5%-10%,多见于50岁以上的女性。尽管罕见,但其高度恶性,很早发生转移和浸润周围组织,占甲状腺癌死亡的大多数。甲状腺乳头状癌(papillary thyroid carcinoma,PTC)在甲状腺癌中最常见,约占甲状腺癌93%,女性患者多见,预后好,10年存活率超90%。

摘要： Objective SET8 is a member of the SET domain-containing family and the only known lysine methyltransferase(KMT)that monomethylates lysine 20 of histone H4(H4 K20 me1).SET8 has been implicated in many essential cellular processes,including cell cycle regulation,DNA replication,DNA damage response,and carcinogenesis.There is no conclusive evidence,however,regarding the effect of SET8 on radiotherapy.In the current study we determined the efficacy of SET8 inhibition on radiotherapy of tumors and the underlying mechanism.Methods First,we explored the radiotherapy benefit of the SET8 expression signature by analyzing clinical data.Then,we measured a series of biological endpoints,including the xenograft tumor growth in mice and apoptosis,frequency of micronuclei,and foci of 53 BP1 andγ-H2 AX in cells to detect the SET8 effects on radiosensitivity.RNA sequencing and subsequent experiments were exploited to verify the mechanism underlying the SET8 effects on radiotherapy.Results Low expression of SET8 predicted a better benefit to radiotherapy in lung adenocarcinoma(LUAD)and invasive breast carcinoma(BRCA)patients.Furthermore,genetic deletion of SET8 significantly enhanced radiation treatment efficacy in a murine tumor model,and A549 and MCF7 cells;SET8 overexpression decreased the radiosensitivity.SET8 inhibition induced more apoptosis,the frequency of micronuclei,and blocked the kinetics process of DNA damage repair as 53 BP1 andγ-H2 AX foci remained in cells.Moreover,RNF8 was positively correlated with the SET8 impact on DNA damage repair.Conclusion Our results demonstrated that SET8 inhibition enhanced radiosensitivity by suppressing DNA damage repair,thus suggesting that SET8 potentiated radiotherapy of carcinomas.As new inhibitors of SET8 are synthesized and tested in preclinical and clinical settings,combining SET8 inhibitors with radiation warrants consideration for precise radiotherapy.

摘要： 上尿路尿路上皮癌(upper urinary tract urothe-lial carcinoma,UTUC)是一种起源于肾盂、肾盏和输尿管的少见肿瘤[1],术后易出现复发、转移。一旦复发、转移,现有的化疗方案治疗疗效不佳,且对患者身体状况要求较高,令临床医生颇为棘手,对待老年患者更是缺少有效的治疗手段,亟需新方法改善现状。

摘要： BACKGROUND As the most common cancer in women,breast cancer is the leading cause of death.Most patients are initially diagnosed as stage I-III.Among those without distant metastases,64%are local tumors and 27%are regional tumors.Patients in stage IIA-IIIC and those who meet the breast-conserving criterion with the exception of tumor size can consider neoadjuvant chemotherapy(NACT).It is worth noting that the status of tumor cell biomarkers is not consistently static.Endocrine-related estrogen receptor(ER),progesterone receptor(PR)and human epidermal growth factor receptor 2(HER2)encoded by erythroblastic leukemia viral oncogene homolog 2 gene can all alter from positive to negative or vice versa,especially in luminal B subtype after NACT.In addition,determination of HER2 status currently mainly relies on immunohistochemistry(IHC)and fluorescence in situ hybridization(FISH),but FISH is commonly used when the result of IHC is uncertain.HER2 is regarded as negative when the IHC result is 0/1+without the addition of FISH.To the best of our knowledge,this is the first report of a case harboring HER2 status transformation and IHC1+with positive amplification by FISH after NACT.CASE SUMMARY A 49-year-old woman discovered a mass in her right breast and underwent diagnostic workup.Biopsies of the right breast lesion and axillary lymph nodes were obtained.The results pointed to invasive ductal carcinoma with the IHC result for ER(80%),PR(60%),Ki-67(20%)and ambiguous expression of HER2(IHC 2+)with negative amplification by FISH(HER2/CEP17 ratio of 1.13).She underwent surgery after NACT.The pathological findings of the surgically resected sample supported invasive ductal carcinoma with the tumor measuring 1.1 cm×0.8 cm×0.5 cm and had spread to one of fifteen dissected lymph nodes.Retesting of the specimen showed that the tumor was positive for ER(2+,85%)and PR(2+,10%)but negative for HER2 by IHC(1+).Also Ki-67 had dropped to 2%.The patient was regularly monitored every 3 mo without evidence of recurrence.CONCLUSION Biomarker status should be reassessed after NACT especially in luminal subtypes.