Objective To investigate the effects of betulin on the expression of matrix metalloproteinase-2（MMP-2） and matrix metalloproteinase（MMP-9）in tumor tissues of nude mice bearing human ovarian cancer xenograft and their significance. Methods The subcutaneous ovarian cancer SKOV3 xenograft model was successfully established in nude mice. Thirty nude mice were randomly divided into 5 groups（n=6）: betulin high-dose group（80mg／kg），betulin medium-dose group（40mg／kg），betulin lowdose group（20mg／kg），control group（normal saline）and paclitaxel group（135mg／m2）. All the mice received intraperitoneal injection once every two days for 21 days at a dose of 0.2ml. Then all the mice were sacrificed；the transplantated tumor mass and volume were measured to calculate the tumor inhibitory rate. The protein expression of MMP-2 and MMP-9 were deteced by immunohistochemical method. Results Tumor volumes and masses of mice treated with betulin and taxol were smaller than those of control group when mice were sacrificed（P＜0.05）. The tumor inhibitory rate of betulin low-dose group was 17.5％，lower than 44.5％ and 51.4％ in medium- and high-dose group（P＜0.05）. The expression of MMP-2 and MMP-9 in control group were（56.78±6.42）% and（69.35±5.03）%, higher than（47.13±8.67）% and （53.82±7.41）% of betulin low-dose group,（38.29±4.37）% and（48.79±4.63）% of betulin medium-dose group, and（26.88±5.12）% and （38.93±2.82）% of betulin high-dose group（P＜0.05）; the expression of the two proteins in the three betulin groups had significance（P＜0.05）. Conclusion The betulin can inhibit the growth of transplanted tumors of ovarian cancer SKOV3 cells in nude mice，which may related to the downregulation of the expression of MMP-2 and MMP-9.

Objective To explore the role of a quantitative measure of the paired boxed gene 1 （PAX1） methylation in detection of cervical cancer. Methods The percentage of PAX1 methylation was detected by real-time quantitative methylation-specific polymerase chain reaction （QMSP） in normal cervical tissues （n=20）， cervical intraepithelial neoplasiaⅠ（CINⅠ） tissues （n=15）， CINⅡtissues （n=16）， CINⅢ tissues （n=19） and cervical cancer tissues （n=22）. The methylation status of PAX1 gene in cervical cancer tissues was tested by methylation-specific polymerase chain reaction （MS-PCR）.The efficacy of PAX1 in diagnosis of cervical cancer was compared with that of the hybrid capture 2-human papilloma virus-DNA （HC2-HPV-DNA） test by ROC curve. Results The percentage of methylated reference （PMR） in cervical cancer was （75.27±30.61）％， significantly higher than （12.90±10.80）％ in CINⅢ and other milder lesions or normal tissues （P＜0.001）. The area under the ROC curve （AUC）， sensitivity and specificity of PAX1 methylation tested by QMSP was 0.98， 100.0％ and 84.3％， better than 0.82， 100.0％ and 52.5％ of HC2-HPV-DNA test （P＜0.001）. The MS-PCR test showed that the methylation rate of PAX1 in cervical cancer， metastatic cancer tissue，adjacent normal tissue and remote normal tissue was 95.0％ （19／20）， 100.0％ （4／4）， 70.0％ （14／20） and 35.0％ （7／20） with significance（P＜0.001）. Conclusion Quantitative measurement of PAX1 hypermethylation in cervical scrapings is highly sensitive and more specific than HC2-HPV-DNA test in detection of cervical cancer. Quantitative measurement of PAX1 methylation may have a potential value for diagnosis of cervical cancer in clinic.

Objective To investigate the expressions of ABCB5 and vascuolarH+ATPase（V-ATPase） proteins in non-small cell lung cancer（NSCLC），and analyze the expression of ABCB5 and V-ATPase protein among different pathological types，pathological grades and TNM stages in tumor samples and their correlation. Methods The expressions of ABCB5 and V-ATPase in NSCLC were detected with EnVinsion immunohistochemistry method in tumor samples from 72 NSCLC patients and the expressions among different pathological types， pathological grades and TNM stages in tumor samples were analyzed by statistics. Results ABCB5 protein was highly expressed in lung squamous cell carcinoma and adenocarcinoma at 75.7％ and 80.0％ with significant difference（P=0.012）；and ABCB5 expression was significantly different in the pathological grades of lung squamous cell carcinoma and adenocarcinoma（P=0.030，P=0.036）；but there was no difference in the TNM stages（P=0.179，P=0.844）. V-ATPase protein was also highly expressed in lung squamous cell carcinoma and adenocarcinoma at 64.9％ and 82.9％ with significant difference（P=0.000）. The expressions at different pathological grades of lung squamous cell carcinoma and adenocarcinoma was remarkable（P=0.040，P=0.010）while there was no difference at the TNM stages（P=0.918, P=0.545）. In addition，the correlation was found between the expression of ABCB5 and V-ATPase in total samples or in adenocarcinoma and squamous cell carcinoma by correlation test（P＜0.05）. Conclusion The ABCB5 and V-ATPase proteins are highly expressed in NSCLC，and the level of expression is associated with the pathological grades. There is a positive correlation between the two proteins expressed in NSCLC. The expressions of ABCB5 and V-ATPase may provide an experimental evidence of multidrug resistance for the future research.

Objective To investigate the expression of D2-40 and CD34 with lymphatic vessel density（LVD） marked by D2-40 and microvessel density（MVD） marked by CD34 in gastric cancer and the correlation of them with clinical pathological features. Methods Expressions of D2-40 and CD34 were detected in 108 cases of gastric cancer and 36 cases of adjacent normal tissues using immunohistochemistry and tissue microarray. The LVD marked by positive D2-40 and MVD by positive CD34 were calculated，and the correlation with the clinical pathological features and prognosis were analyzed. Results The positive rate of D2-40 in gastric cancer was 85.2％（92／108），higher than 22.2％（8／36）in adjacent normal tissue with significance（P=0.000）；the positive rate of CD34 was 94.4％（102／108）in gastric cancer，higher than 36.1％（13／36） in adjacent normal tissue with significance（P=0.000）.The LVD（10.14±5.37）and MVD（45.32±15.78）in gastric cancer were significantly higher than 3.38±1.69 and 4.92±1.26 in adjacent normal tissues（P=0.000，P=0.000）. The expression of D2-40 LVD and CD34MVD in the malignancy were related to the tumor size，invasion depth，lymphatic metastasis and TNM stage，but not with age and sex. Cox multivariant analysis showed that the tumor size, invasion depth, lymphatic metastasis, TNM stage, MVD and LVD were independent factors affecting prognosis. The Kaplan-Meier analysis showed that the median overall survival of the fewlymphatic vessel group was 69.0 months（95％ CI：59.91-77.20 months） and that of the multi-lymphatic vessel group was 33.0 months（95％ CI：23.20-42.66months） with significance；the median overall survival of few-blood microvessel group was 67.0 months（95％ CI：58.10-76.39 months）and that of multi-blood microvessel group was 34.0 months（95％ CI：24.63-44.02 months） with significance（P＜0.05）. Conclusion The LVD marked by D2-40 and MVD marked by CD34 are positively correlated to the clinicopathological factors of the malignancy， and may play an predictive role in the development and progression of gastric cancer.

Objective To investigate the level of β-C-terminal telopeptide of type Ⅰ collagen（β-CTX）and osteocalcin （OST） in patients with bone metastases before and after radiotherapy and their correlation with clinicopathological characteristics and response to radiotherapy. Methods The serum OST and β-CTX in 34 patients with bone metastases were tested by electrochemiluminescence immunoassay. The relation between the level of OST， β-CTX and clinicopathological characteristics were assessed. Thirty-four patients were divided into two groups， one group received only radiation of bone metastases and the other group was treated with radiation+zoledronic acid. The correlation between the level of serum OST， β-CTX before and after radiotherapy and the response to radiotherapy were analyzed. Results The levels of serum OST and β-CTX in 34 patients before treatment were（17.07±9.03）ng／ml and（593.94± 319.26）pg／ml， respectively. The serum β-CTX had correlation with the grade of bone metastases， skeletal related events and soft tissue mass， but not related to type of bone metastases and degree of metastatic bone pain， while the OST level was not correlated with clinicopathological characteristics. The level of βCTX after treatment in radiotherapy group was higher than that before radiotherapy （P＜0.05）， while in radiotherapy+zoledronic acid group was lower than that before treatment （P＜0.05）， and the level of OST before and after treatment had no significant difference （P＞0.05）. The levels of β-CTX and OST before treatment in effective group were lower than those in ineffective group （P＜0.05）. The β-CTX levels decreased after treatment in radiotherapy+zoledronic acid group no matter how the efficacy was. The βCTX levels increased in the nonresponding patients treated with radiotherapy alone （P＜0.05）， and the increase was not statistically significant in the responder （P＞0.05）.The OST levels in the two groups showed no change after radiotherapy （P＞0.05）. Conclusion The levels of bone metabolic marker β-CTX have important significance in disease condition evaluation and radiation efficacy prediction of bone metastases with application values in clinical practice.

Objective To investigate the prognosis of stage ⅡB osteosarcoma in extremities treated with combined therapy， and the possible prognostic factors. Methods The data of 200 patients of stage ⅡB osteosarcoma were reviewed. Kaplan-Meier method was used to test the overall survival（OS） of osteosarcoma patients. Cox proportionalhazards regression model was employed to analyze the prognostic factors.
Results The 1-，2-and 3-year survival rates were 87.0％， 71.5％ and 51.5％，and the median OS was 37.0 months（95%CI: 25.67-48.33 months）. The univariate analysis showed that OS was significantly related to sex，surgical methods，adjuvant chemotherapeutic cycles，the serum level of alkaline phosphatease（AKP）after neo-chemotherapy and pathological types. Neo-adjuvant chemotherapy had approximate significance，while age had no influence on OS. Moreover，Cox proportional-hazards regression model revealed that adjuvant chemotherapeutic cycles，the serum level of AKP after neo-chemotherapy and pathological types were the independent factors affecting OS. Conclusion Standardization of chemotherapy plays an important role in improving OS in patients with osteosarcoma of stage ⅡB. The patients can be provided with individualized treatment based on pathological types and the serum level of AKP after neo-chemotherapy.

Objective To compare the clinical efficacy and toxicity of nolatrexed plus cisplatin （LP regimen） versus fluorouracil plus cisplatin （FP regimen） in the treatment of metastatic nasopharyngeal carcinoma（NPC）. Methods Thirty-three cases of metastatic NPC patients from October 2005 to March 2011 were collected and randomly divided into LP regimen and FP regimen according to 1∶1. Sixteen patients and seventeen patients were treated with LP regimen and FP regimen， respectively. LP regimen：nolatrexed 740mg／m2 civ 120h d1-d5；cisplatin 25mg／m2 iv d2-d4；FP regimen：fluorouracil 600mg／m2 civ 120h d1-d5; cisplatin 25mg／m2 iv d2-d4.The two regimens were repeated every three weeks and lasted for 2 to 6 cycles. Results The response rate，disease control rate，the median time to progress and the median overall survival of LP regimen and FP regimen were 31.3％ and 35.3％， 68.8％ and 76.5％， 3.4 months and 3.8 months，and 9.5 months and 10.0 months without significance between the two regimens（P＞005）.Toxicity of the two regimens were mainly in grade 1-2，oral toxicity of LP regimen was significantly lower than that of the FP regimen （P＜0.05） and other toxicities between the two groups had no differences. Conclusion The efficacy of LP regimen is similar to that of FP regimen，but the oral toxicity of LP regimen is much lower than that of FP regimen. LP regimen is expected to become one of the first-line regimens for metastatic NPC.

Objective To evaluate the efficacy and adverse effects of cetuximab combined with FOLFIRI regimen for advanced colorectal cancer with K-Ras wild-type patients. Methods From January 2008 to June 2010，44 patients with K-Ras wildtype advanced colorectal cancer proved by pathology were treated with cetuximab biweekly plus FOLFIRI regimen.Cetuximab was given by 500mg／m2iv every 2 weeks，irinotican 180mg／m2 iv dl，calcium folinate 200mg／m2 iv dl，fluorouracil 400mg／m2 ivp dl and then 2400mg／m2 civ 46h. Every 2 weeks was a cycle.All the patients recieved at least 4 cycles of chemotherapy.Adverse reaction was assessed by the NCI CTC 3.0 standard. Results In 44 patients，2 cases received CR（4.6％），22 cases PR（50.0％），17 cases SD（38.6％），3 cases PD（6.8％），the response rate（RR）was 54.6％and disease control rate（DCR）was 93.2％.The univariate analysis showed that RR was related to primary site，but not with gender，age，number of metastatic organs，metastatic sites and ECOG score，and DCR was not related to any clinical features. Logistic regression analysis showed that primary site was the independent factor influencing RR（P=0.0455）. The median overall survival（OS）was 25.7 months（95％CI：20.5-34.6months），and the median progressionfree survival （PFS）was 8.4 months（95％CI：6.3-11.7months）. The Cox regression model showed that ECOG score was the independent influential factor of PFS，and gender influenced OS. The common adverse events were skin rash，digestive reaction and neutropenia，mainly in grade 1-2. Conclusion Cetuximab combined with FOLFIRI regimen every 2 weeks for the patients with advanced colorectal cancer is effective，and the adverse effect is tolerable，worth further study.

ObjectiveTo retrospectively analyze the efficacy，safety and progrostic factors affecting responses of imatinib mesylate as the first-line therapy for Chinese patients with recurrent or metastatic gastrointestinal stromal tumors（GISTs）. Methods Patients treated with imatinib mesylate 400mg daily as the first-line treatment from Apr. 2003 to Mar. 2012 were followed up. Short-term efficacy was evaluated according to RECIST version 1.0 criteria and toxicity according to NCI CTC version 3.0 criteria. Relative factors affecting time to progress（TTP）and overall survival（OS）were stratified analyzed using SPSS 13.0 software. Results Totally there were 105 cases enrolled in this retrospective analysis，with median followingup duration of 126 months（range：44-348months），meanwhile 36 patients died during the period. The response rate was 66.6％ and disease control rate was 79.9％，including 8（7.6％）cases of CR，62（59.0％）of PR, 14（13.3％）of SD and 21 cases（20.0%）of PD. Median TTP and OS of all cases were 61.5months and 60.0 months（95％CI：52.1-67.8 months），respectively. After being stratified，cases were enlisted into three comparative groups：adjuvant or not groups，second-line or not groups and treatment discontinued or not groups. TTP and OS of patients in adjuvant or second-line groups had no significant differences compared with “not” groups. Contrarily，TTP and OS of patients with treatment discontinued for 3-12months was significantly decreased compared with discontinued less than 3 months（P＜0.05）or continued group（P＜0.05），while no difference observed between latter two groups. Common toxicities were fatigue, skin mucosal edema, leukopenia, diarrhea, etc. mainly in grade 1-2，with no treatment-related death. Conclusion Imatinib mesylate 400mg daily as the first-line therapy for patients with recurrent or metastatic GISTs was safety and effective. Considering the compliances and economy of Chinese GISTs'patients，receiving adjuvant or second-line therapies or not probably have minor influences on TTP and OS. Impressively，treatment discontinued longer than 3 months maybe induce disease progression and translate into disadvantage of OS finally.

Objective To investigate the efficacy and toxicity of S-1 plus oxaliplatin versus S-1 plus cisplatin as the first-line treatment for elderly patients with advanced gastric cancer. Methods Fifty-six elderly patients with advanced gastric cancer were randomly divided into S-1 plus oxaliplatin group（SOX，n=30）and S-1 plus cisplatin group（SP，n=26）. In SOX group, S-1 was administered orally（4060mg，bid） from d1 to d14，and oxalipatin（130mg／m2）was administered intravenously on d1. Every 21 days was a cycle. In SP group，cisplatin was administered intravenously 25mg／m2 on d1-d3，and the administration of S-1 followed the same dosage as SOX group. Every 21 days was a cycle. Efficacy was evaluated every two cycles. Results The effective rates of SOX group and SP group were 46.7％ and 38.5％（P=0.596），the disease control rates were 80.0％ and 76.9％（P=1.000），the median progress-free survival were 6.0 months and 5.6 months（P=0.831），and the median overall survival were 123months and 11.5 months（P=0.401）.The main toxicity in the two groups was hematological toxicity，and the occurrence of grade 3-4 toxicity in SOX group and SP group had no difference. The nonhematological toxicity in the two groups was all in grade 1-2，and the main toxicity was peripheral neuritis in SOX group, while in SP group were abnormal renal function and nausea/vomitting. The improvement rate of KPS score in SOX group and SP group were 83.3％ and 46.2％（P=0.027），and the increased rate of FACT-G score were 76.7％ and 38.5％（P=0.006）. Conclusion Both SOX and SP regimen are effective for elderly patients with advanced gastric cancer. Compared with SP regimen， SOX regimen is better tolerated as the first-line treatment for advanced gastric cancer.

Objective To introduce the key points about the transplantation of lymphatic transverse rectus abdominis myocutaneous/deep inferior epigastric perforator（TRAM／DIEP） and evaluate the therapeutic effect of lymphatic TRAM／DIEP to treat mastectomy related upper limb lymphedema.
Methods Ten patients of postoperative lymphedema after breast cancer surgery from Jan. 2008 to Mar. 2011 were enrolled in this study. All the patients suffered from unilateral upperlimb lymphedema accepted abdominal transplantation of lymphatic TRAM/DIEP. Results All flaps worked well. One case with breast reconstruction was found to have delayed cure of breast cuts. All the patients felt the pain and swellings of edematous upper limbs relieved. Conclusion To apply the transplantation of lymphatic TRAM／DIEP to treat mastectomy related upper limb lymphedema， accompanied by using elastic bandages as an auxiliary postoperative treatment is considered to be an effective method to restore the breast configuration and upper limb function.

ObjectiveTo investigate the efficacy and safety of interventional treatment for locally advanced cervical cancer.
Methods There were 122 cases of advanced cervical cancer patients diagnosed by pathology. All the patients were treated by the feeding artery embolism together with either uterine artery chemoembolization or internal iliac-arterial infusion chemotherapy. Chemotherapy was based on cisplatin-based combination regimens. The gelfoam particle containing mitomycin or epirubicin was employed as embolic agent. The change of tumor size was observed and clinical data were evaluated 2 weeks after the operation of intervention. Results The clinical remission was 100.0％. Twenty-two cases achieved CR，66 cases achieved PR，28 cases achieved SD and 6 cases achieved PD. The reponse rate was 72.1％. Among the 122 patients, the interventional treatment was carried out one time in 29, two times in 42, three times in 35 and four times in 16. Ninety-eight cases underwent successful surgical resection. The main adverse reactions after interventional procedure included fever,digestive reaction,lellkocytopenia and abdominal pain, and these could be controlled by symptomatic treatment. Eighty-six patients were followed-up，the survival rates of 3- and 5-year were 81.4％ and 68.6％，respectively. Conclusion Interventional treatment for locally advanced cervical cancer is safe and effective. It reduces the tumor size，decreases tumor staging，and improves the resection rates.

Objective To evaluate the efficacy and safety of continuous intrathecal morphine infusion therapy in patients with moderate to severe abdominal visceral cancer pain. Methods Thirty-two patients with moderate to severe abdominal visceral cancer pain were implanted with intrathecal catheter and connected with continuous external electronic PCA pump to implement intrathecal morphine analgesia， and the VAS score and the QLQC30 quality of life score before and after analgesic application were recorded. Adverse reactions were observed. Results After the application of continuous intrathecal morphine analgesia with 1 week dose adjust，the VAS pain score was 3.12±1.12，lower than 8.01±0.81 before the application（P＜0.05），and the QLQ-C30 quality of life score was 45.52±3.34，higher than 29.45±2.50 before application（P＜0.05）. No respiratory depression and intrathecal inflammation occurred in all patients；the adverse effects included pruritus，constipation，headache and urinary retention. Conclusion The effect of continuous intrathecal morphine infusion is effective，with low incidence of adverse reactions，low-cost and convenient operation，providing satisfied treatment for patients with moderate to severe cancer pain.

Objective To evaluate the efficacy and safety of rh-endostatin（endostar） combined with FOLFIRI regimen in colorectal cancer with hepatic metastasis.
Methods Twenty-nine patients with hepatic metastasis of colorectal cancer were treated with endostar and FOLFIRI regimen from September 2006 to January 2011. Endostar 15mg solved in 500ml normal saline was slowly intravenously dropped from day 1 to day 10 biweekly. FOLFIRI regimen：irinotecan 180mg／m2 iv，d1；leucovorin 400mg／m2 introvenous infusion to match duration of irinotecan infusion，d1；fluorouracil 400mg／m2 iv bolus d1，and then 2400mg／m2 for 46-48h continuously infusion. Every 2 weeks was a cycle. The safety was evaluated after 1 cycle while the efficacy was evaluated after 3-4 cycles.
ResultsAll the cases were evaluated for safety and 27 cases for efficacy with 1 of CR，10 of PR，9 of SD and 7 of PD. The response rate was 40.7％ and disease control rate was 74.1％. The quality of life in 14 cases was improved. The median progress-free survival was 7.8 months（95％CI：5.3-10.2 months）. The adverse effects were mainly in grade 1-2，including hematological toxicities， nausea and vomiting and tardive diarrhea. There was no serious event in cardiovascular system. Conclusion The efficacy and tolerability of endostar plus FOLFIRI regimen in hepatic metastasis of colorectal cancer was good with tolerable adverse effect.

Objective To investigate the efficacy and safety of raltitrexed／bevacizumab in combination with irinotecan or oxaliplation for advanced colorectal cancer as the second-line and second-line above treatment. Methods Fifteen cases of advanced colorectal cancer were enrolled to receive regimens including raltitrexed／bevacizumab combined with irinotecan or oxaliplation. Two cases were treated with raltitrexed+bevacizumab regimen，9 cases with raltitrexed+bevacizumab+irinotecan regimen，and 4 cases with raltitrexed+bevacizumab+oxaliplatin regimen. The doses of the drugs were as follows：bevacizumab 5mg／kg iv，d1；raltitrexed 2mg／m2 iv 15min，d2； irinotecan 180mg／m2 iv 1h，d2; and oxaliplatin 85mg／m2 iv 2h d2. Two weeks was a cycle for each regimen. Results The efficacy of the 15 patients could be evaluated. Two cases were in PR，10 cases in SD，3 cases in PD，the response rate was 13.3％， and the disease control rate was 80.0％. The median progress-free survival was 5.1 months（95％CI：3.4046.813 months），and the median overall survival was 11.5 months（95％CI：8.985-13.930 months）. The adverse effect included anorexia，nausea／vomiting，fatigue，leukopenia，thrombocytopenia，etc.，and the main 3-4 grade adverse effects were anorexia，nausea／vomiting， fatigue，and thrombocytopenia. Conclusion Raltitrexed／bevacizumab combined with irinotecan or oxaliplatin as the secondline and secondline above treatment for advanced colorectal cancer has high disease control rates， and the adverse effect is well tolerated. The combined regimen can be recommended as a phase Ⅲ clinical research and secondline and secondline above treatment for advanced colorectal cancer.

Human epidermal growth factor receptor-2（HER-2） positive inflammatory breast cancer is a very aggressive type of inflammatory breast cancer（IBC） with HER-2 over-expression or amplified. Clinically，such cancer is more aggressive and characterized by rapid local and systemic progression and overlying skin inflammation or discoloration without ulceration. With poor prognosis, but，combinations of neo-adjuvant systemic chemotherapy， surgery and radiation therapy，especially molecular targeted therapy can drastically alter the natural course of this disease. This article reviews the progress in molecular targeted therapy for HER-2 positive IBC in recent years.

The echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase（EML4ALK）fusion gene resulting from the chromosome inversion inv（2）（p21；p23）recently was identified in non-small cell lung cancer. EML4ALK fusion gene is oncogenic，which could be suppressed by ALK-inhibitor through blocking the downstream signaling pass-way of EML4-ALK. This review will focus on the clinicopathologic characteristics and targeted therapy of EML4-ALK in lung cancer.

lung cancer molecular pathologic evaluation is applied to clear classification of lung cancer，determine the scope of tumor invasion，distinguish whether it is primary lung cancer or metastatic tumors，confirm the involvement degree of the surgical margin（i.e.，positive or negative margin）. It is also used for molecular diagnostic studies，so as to determine whether there are specific gene expression abnormalities or mutations，to predict the prognosis and efficacy of lung cancer for individualized treatment as well. In this paper，the progression of the aspects are summarized in this review.

Small cell lung cancer（SCLC）is a highly aggressive tumor and characterized by relapse and metastasis after highly effctive chemotherapy，which may be due at least in part to the existence of cancer stem cells（CSCs）. CSCs are known as the source of origin，progression，drug resistance，recurrence and metastasis in malignant tumors. CSCs use many of the same signaling pathways that are found in normal stem cells，such as Hedgehog, Notch and Wnt. The role that embryonic signaling pathways plays in the function of CSCs in SCLC，the development of new antiCSCs signaling pathways therapeutic agents，and the complexity of potential CSC signaling crosstalk are described in this review.