Chinese Clinical Oncology

Clinical study of recombinant anti-tumor and anti-virus protein injection compared with placebo in metastatic colorectal cancer after failure of secondline and more than second-line treatment

MAO Xiaoyang，WANG Yan，LIN Li，XU Nong，XIONG Jianping，BAI Li，SHEN Lin，LIU Wei，XU Jianming

Chinese Clinical Oncology. 2013, 18 (8): 673.

Abstract ( 1243 )

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Objective To observe the efficacy， safety and doseresponse relationship of novaferon in treatment of metastatic colorectal cancer patients who had received at least two prior palliative regimens， and assess the effects on the immune function of subjects. Methods One hundred and five patients were enrolled from May 2011 to December 2012. According to the different treatment modalities and ultimately maintain therapeutic dose， the subjects were divided into three groups： the placebogroup（15 cases, saline），the lowdose treatment group（69 cases, novaferon ＜40μg each time, 3 times a week） and the highdose treatment group（21 cases, novaferon 40μg each time, 3 times a week）. The proportions of NK and CD4+CD25high Foxp3+Treg cells in the peripheral blood samples were detected from 57 subjects by flow cytometry before and after treatment. Then， the changes of NK and Treg cells were analyzed. Results After 6 weeks of treatment， disease control rate（DCR） of the highdose treatment group was 47.4%, higher than 21.4% of the placebo group. The difference was statistically significant（P＜0.05）. The major adverse reactions of novaferon were “flulike” symptoms， bone marrow suppression， abnormal liver function and gastrointestinal discomfort. After treatment， the NK cells in the highdose treatment group had increased significantly， Treg cells decreased significantly compared with baseline（P＜0.05）. Conclusion Novaferon has moderate efficacy and less adverse reactions in treatment of metastatic colorectal cancer. Furthermore, it can improve the immune function and life quality of patients.

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Research of methylation of the LINE-1 promoter in peripheral plasma of hepatocellular carcinoma

GAO Xudong， QU Jianhui， HE Yan， GUAN Xue， FENG Fan， WANG Chunping， LU Yinying， BAI Wenlin， WANG Hong， YANG Yongping

Chinese Clinical Oncology. 2013, 18 (8): 679.

Abstract ( 1198 )

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Objective To investigate the change of methylation levels of the long interspersed nucleotide acids element-1（LINE-1） promotor by using bisulfite sequencing PCR（BSP） in peripheral plasma of hepatocellular carcinoma（HCC）. Methods BSP method was used to detect the methylation levels of the LINE-1 promotor in 67 plasma samples from 33 cases of HCC（HCC group）， 18 cases of cirrhosis（cirrhosis group） and 16 healthy volunteers（normal group）. Results The results of BSP showed that methylation levels of the LINE-1 promotor in patients with HCC were significantly lower than those in cirrhosis group and normal group（P＜0.05）. The receiveroperating characteristic curve analysis of methylation of some CpG sites（site 1, site 7, site 8） in the LINE-1 promotor revealed an important diagnostic efficacy for HCC， and the sensitivity and specificity of the site 1，site 7，site 8 were 80.0％ and 78.8％， 81.8％ and 71.4％， 82.9％ and 75.8％， respectively. Conclusion The promotor of LINE-1 has hypomethylation in HCC， and methylation of some CpG sites（site 1, site 7, site 8） in peripheral plasma may be important diagnostic efficacy for HCC.

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Preliminary study of the effects of β-elemene on breast cancer stem cells in cell line MCF-7／ADM

LI Luan， DONG Yan， WANG Ling， GAO Yajie

Chinese Clinical Oncology. 2013, 18 (8): 683.

Abstract ( 1307 )

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Objective To investigate the differences between breast cancer cell line MCF-7／ADM resistant to adriamycin（ADM） and sensitive cell line MCF-7／S in proportion of breast cancer stem cells（BCSCs） and expression levels of breast cancer resistance protein（BCRP） and Pglycoprotein（P-gp），and to further observe the effects of traditional Chinese medicine β-elemene（β-ELE） on BCSCs and expressions of BCRP and P-gp. Methods MCF-7／ADM and MCF-7／S cell lines were cultured in the serumfree medium（SFM） and microspheres formation ratio was observed under phase contrast microscope. The expression levels of resistance genes BCRP and P-gp were detected by RTPCR. The ratio of BCRP and Pgp positive cells and percentage of CD44+CD24-／low subpopulation were analyzed by flow cytometry. The microsphere formation ratio and the expressions of BCRP, Pgp protein and mRNA in cell line MCF-7/ADM were detected after being treated by 15μg/ml β-ELE for 48h. Results The results of morphology and RTPCR indicated that microspheres formation ratio in the SFM and expression levels of BCRP and P-gp in MCF-7／ADM were higher than those in MCF-7／S.The flow cytometry analysis showed the positive rates of protein expressions of BCRP and P-gp in MCF-7／ADM were （77.78±9.55）％ and （32.33±5.12）％， and the percentage of CD44+CD24-／low subpopulation was （64.79±11.78）％， significantly higher than （3.97±1.51）％，（14.26±2.51）％，（18.79±3.28）％ in MCF-7／S with statistically significant differences. β-ELE inhibited obviously microspheres formation ratio， decreased mRNA and protein levels of BCRP and P-gp. Conclusion MCF-7／ADM cell line is a resistant cell population which enriched relatively BCSCs and highexpressed resistance proteins. β-ELE can inhibit proportion of BCSCs and microspheres formation ratio， and reduce the expression levels of resistance proteins in MCF-7／ADM.

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Expression of EML4-ALK in nonsmall cell lung cancer and its clinical significance

WANG Meng，YANG Jiyuan，LI Junchuan，CHEN Yanxuan.

Chinese Clinical Oncology. 2013, 18 (8): 688.

Abstract ( 1265 )

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Objective To investigate the expression of EML4-ALK in nonsmall cell lung cancer（NSCLC） and the correlation with clinical pathological features.
Methods The expression of EML4-ALK was detected in 245 cases of NSCLC and 80 cases of adjacent normal tissues using immunohistochemistry and tissue microarray technique. The correlation between the clinicopathological features and the expression of EML4ALK was analyzed. Results The positive rate of EML4-ALK in NSCLC was 7.35％（18／245），while it was 0（0／80）in adjacent normal tissues. EML4-ALK expression was significantly correlated with gender， smoking history， histological type and clinical stage（P＜0.05）. Conclusion EML4-ALK may play an important role in the occurrence and development of NSCLC. It may become a potential target of clinical therapy.

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Expression of miR-122 in hepatocellular carcinoma and its relationship with cell cycle regulation

ZHANG Ying， JIA Shaochang， XIANG Fang， LU Lei， WANG Xuan.

Chinese Clinical Oncology. 2013, 18 (8): 691.

Abstract ( 1243 )

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Objective To investigate the expression of miR-122 in hepatocellular carcinoma cells and its relationship with cell cycle regulation. Methods The in situ hybridization and quantitative reverse transcription —PCR（qRT-PCR） were used to detect the expression of miR-122 in 50 cases of primary hepatocellular carcinoma and corresponding adjacent normal tissues，and flow cytometry was used to detect the cell cycle. The correlation between the expression of miR122 and the cell cycle was analyzed. Results The expression of miR122 in hepatocellular carcinoma tissues was（17.74±9.20）％ of adjacent normal tissues，while it was（19.89±8.80）％ in well and moderately differentiated hepatocellular carcinoma and（9.16±4.77）％ in poorly differentiated hepatocellular carcinoma； The positive rate of miR122 was 80.0％（40／50） in adjacent normal tissues， and 30.0％（15／50） in hepatocellular carcinoma（P＜0.05）. The percentage of S-phase cells was increased and the percentage of G1／G0 phase cells was decreased in hepatocellular carcinoma compared with the adjacent normal tissues （P＜0.05）. In the miR-122 negative expressed hepatocellular carcinoma， the percentage of S phase cells was increased and the percentage of G1／G0 phase cells was significantly decreased（P＜0.05）， compared with the miR-122 positive expressed hepatocellular carcinoma.Conclusion Downregulation of miR122 in hepatocellular carcinoma provokes the division and proliferation of cancer cells.

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The expression and clinical significance of survivin and Ki-67 in non-hodgkin's lymphoma in oral and maxillofacial region

LIU Zhuoxing， LIU Wenling.

Chinese Clinical Oncology. 2013, 18 (8): 695.

Abstract ( 831 )

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Objective To investigate the expression of survivin,Ki-67 in the primary non-Hodgkin's lymphoma (NHL) in oral and maxillofacial region and the relationship between the expression of survivin,Ki-67 and histological phenotypes of NHL.Methods The expression of survivin and Ki-67 was determined by En Vision immunohistochemical technique in 39 cases with NHL in oral and maxillofacial region and 20 cases with lymphadenitis as the control.Results The positive expression rates of survivin and Ki-67 in NHL in maxillofacial region were 66.7%（26/39）and 71.8%（28/39）,significantly higher than 20.0%(4/20) and 10.0%(2/20) in lymphadenitis tissue(P<0.05). The positive expression rates of survivin and Ki-67 in nodal and extra-nodal NHL were higher than those in the control group(P<0.05). There were statistical differences between survivin, Ki67 expression in nodal and extra-nodal NHL (P＞0.05). The expression of survivin and Ki67 in highly malignant NHL was higher than that in lowly malignant (P<0.05). The expression of survivin (r= 0.471, P=0.018) and Ki-67 (r=0.691, P=0.000) was positively related to the level of histological phenotypes.Conclusion The survivin and Ki-67 expression play important roles in the occurrence and development of NHL in oral and maxillofacial region. They can be regarded as the prognostic indexes.

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Analysis of intensity-modulated radiotherapy for untreated patients with nasopharyngeal carcinoma

TANG Jianmin， MA Xiumei， HOU Yanli， DAI Liyan， CAO Hongbin， YE Ming， BAI Yongrui

Chinese Clinical Oncology. 2013, 18 (8): 699.

Abstract ( 1149 )

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Objective To investigate the clinical effects and toxicity of intensity-modulated radiotherapy（IMRT） for untreated nasopharyngeal carcinoma（NPC） patients. Methods Seventy-four NPC patients receiving IMRT were enrolled from January 2005 to April 2011. The prescription dose was given 69.9 Gy／30f to the nasophaxynx gross tumor volume（GTVnx）， 69.9Gy／30f to positive neck lymph nodes（GTVnd）， 60Gy／30f to the first clinical target volume（CTV1） and 54Gy／30f to the second clinical target volume（CTV2）. The acute and late radiation injury were evaluated according to RTOG/EORTC criteria. KaplanMeier method was used to calculate the overall survival rate（OS）， distant metastasisfree survival rates（DMFS） and locoregional control rates from the last day of therapy. Results The median followup time was 39 months（range 13 to 80）. The 1-，2-，3- and 5-year survival rates were 97.3％，93.8％，88.2％ and 77.2％ respectively； 1-, 2-, 3- and 5-year DMFS were 93.2％，91.1％，91.1％ and 84.1％ and the 1-, 2-, 3- and 5- year loco-regional control rates were 98.6％，91.0％，86.8％ and 80.6％，respectively. The statistically significant difference in OS was found in different N stage（P＜0.05）， rather than for both clinical stage and T stage （P＞0.05）. Out of 12 failure patients， there were 6 with recurrence at the primary site（50.0％）， 2 patients in the neck（16.7％），and 7 patients（58.3％） by distant metastases. Among the 74 cases，3 cases had grade 3 xerostomia, one case had radio encephalopathy, four cases had grade 3 trismus. No patients suffered cranial nerves palsy. Conclusion The IMRT technique with the prescription dose of 69.9 Gy／30f to GTV provides favorable long-term effects with acceptable toxicity in NPC patients without distant metastasis. N stage is a prognostic factor for NPC patients.

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Clinical observation on XELOX regimen as systemic chemotherapy for advanced primary liver carcinoma

YANG Liuqing， QIN Shukui， HUA Haiqing， GONG Xinlei， LIU Xiufeng， XIA Zhaojun， CHEN Yingxia， WANG Lin.

Chinese Clinical Oncology. 2013, 18 (8): 704.

Abstract ( 1213 )

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Objective To observe the efficacy and safety of oxaliplatin plus capecitabine（XELOX regimen） for advanced patients with primary liver carcinoma（PLC）. Methods From April 2005 to December 2012， 31 advanced patients with PLC were enrolled. They were treated with XELOX regimen as systemic chemotherapy（OXA 150 mg， iv， d₁， d₁₅； CF 50mg， PO，d₁-d₁₄； CAP 1000mg each time， Bid， PO， d₁-d₁₄）. Four weeks was a cycle. Tumor evaluation was performed every 2 cycles according to RECIST 1.0 criteria. Toxicities were evaluated according to NCICTC AE 30. The time to progression（TTP） and survival rate of 6 months and 1 year were observed. Serum alpha fetoprotein（AFP） level was also monitored according to the schedule. Results Thirty-one patients were observed and 28 patients were evaluable for efficacy. One patient obtained complete response（CR）， 1 patient had partial response（PR）， 10 patients got stable disease（SD）， and 16 patients got disease progression（PD）. The objective response rate（RR） was 7.1％ and disease control rate（DCR） was 42.9％. The median TTP was 82 days. The survival rate of 6 months and 1 year was 68.2% and 57.7％， respectively. The serum AFP respond rate was 18.5％. The main adverse effects were myelosuppression and gastrointestinal reaction, most of these side effects were grade 1-2. There were no treatment-related death. Conclusion Systemic chemotherapy with XELOX regimen for advanced PLC shows better efficacy and some survival benefits with mild adverse effects. Thus， it's worthy of further study.

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Clinical observation of forty-three advanced hepatocellular carcinoma patients treated with sorafenib

WANG Nanya， ZHAO Hengjun， HE Hua， MIAO Fenghua， CUI Guozhen， LI Wei.

Chinese Clinical Oncology. 2013, 18 (8): 709.

Abstract ( 1150 )

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Objective To investigate the efficacy and safety of sorafenib in treatment of advanced hepatocellular carcinoma （HCC）. Methods Forty-three mid-advanced patients with HCC who were treated with sorafenib for more than 3 months from June 2008 to December 2011 in Cancer Center of First Hospital of Jilin University were reviewed retrospectively. Twentytwo patients took oral sorafenib alone at a dose of 400mg twice daily. Twentyone patients were treated with sorafenib（400mg po, bid） combined with other regional therapies. The efficacy was evaluated by CT or MRI every 3 months according to the modified response evaluation criteria in solid tumors（mRECIST） and the median overall survival （mOS） time were observed during follow-up. The side effects were evaluated according to NCICTC 3.0 criteria. Results The efficacy of 43 patients could be evaluated. Two patients achieved complete response （CR）， 15 patients achieved partial response（PR），13 patients achieved stable disease（SD） lasting for more than 6 months. The disease control rate（DCR） was 69.8％. In sorafenib monotherapy group, none of them achieved CR， 2 patitents attained PR， 10 patients achieved SD lasting for more than 6 months. In combination therapy group, 2 patients achieved CR， 13 patients attained PR， and 3 patients were SD for more than 6 months duration. The disease control rate（DCR） of the combination therapy group was higher than that of sorafenib monotherapy group（85.7％ vs.54.5％，P=0.03）. The mOS of 43 patients was 22 months （4-39 months）. Subgroup analysis according to the BCLC stage suggested patients of stage A had not reached the mOS， while the mOS of patients with stage B was 12 months，and the patients with stage C was 9 months. the mOS of patients with ChildPugh grades A was longer than that of the patients with ChildPugh grades B（24.0 months vs.4.9 months，P=0.002）.Furthermore， the patiens treated with sorafenib and other regional treatments had longer mOS than the patients treated with sorafanib monotherapy（25.0 months vs.8.7 months，P=0.043）. The most common adverse effects were handfoot skin reaction， hypertension， diarrhea and so on. Only 3 patients got adverse effects in grade 3 and the other 40 patients were less than grade 2. Conclusion Sorafenib is safe and effective for advanced HCC and the side effects were tolerable.

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Clinical observation of CT-guided¹²⁵I seed implantation on refractory metastatic liver cancer

LI Baoguo，GUO Zhi，WANG Haitao，ZHANG Weihao.

Chinese Clinical Oncology. 2013, 18 (8): 713.

Abstract ( 1172 )

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Objective To evaluate the clinical value of CT-guided radioactive 125I seed implantation brachytherapy for refractory metastatic liver cancer.
Methods Forty refractory metastatic liver cancer patients with 94 measurable metastatic foci were treated under the CT-guided with the 125I radioactivity seed interstitial brachytherapy from January 2010 to January 2012. The clinical effects， postoperative complications and adverse reactions were evaluated. Results After operation for 6 months， of all the 94 measurable metastatic foci， 32 foci got complete response （CR）， partial response （CR） was observed in 48 foci， stable disease（SD） in 9 foci and progressive disease （PD） in 5 foci. The response rate （RR） was 85.1％. The follow-up ranged from 4 to 31 months （average 13 months）. At the end of the followup period， 1-year survival rate was 75.0％. No serious operative or postoperative complications and grade 3-4 adverse effects occurred. Conclusion CT-guided 125I seed implantation brachytherapy showed good clinical effects but fewer side effects. It can be used as a new treatment option for patients with refractory metastatic liver cancer.

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Clinicopathological features of primary hepatic malignant vascular tumors： A analysis on 41 cases

ZHAO Qian， LIU Haiping， XIAN Zhihong， LU Xinyuan， DONG Hui， CONG Wenming.

Chinese Clinical Oncology. 2013, 18 (8): 718.

Abstract ( 1190 )

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Objective To investigate the clinicopathological and prognostic features of primary hepatic malignant vascular tumor（PHMVT）. Methods Forty-one patients with PHMVT who underwent surgical resection and confirmed by pathology in our hospital from January 1982 to December 2012 were analyzed for their clinical manifestations， pathological characteristics and prognosis. Results Of the 41 patients， pathological classification contained 19 EHE（46.3％），14 PHA（34.1％），5 IHE（12.2％）and 3 MHP（7.3％）. The average diameters of the 4 kinds tumor were followed by 4.9cm（1.2-6.3 cm）， 8.3cm（3.0-14.0 cm）， 3.8cm（1.2-6.3cm） and 7.8cm（2.1-13.0cm）. Immunohistochemistry showed all of 41 cases expressed Vimentin， CD34 or factor Ⅷ. EHE patients showed better postoperative survival than PHA patients（87 months vs. 12 months， P＜0.05）. Two patients with MHP who had complete followup data， one patient relapsed at the 84th month postoperative， another died of disease in 43 months after operation. Patients with IHE recovered well with no recurrence after operation. Conclusion The prognosis of patients with PHMVT is associated with pathological types； and the malignant degree of PHMVT are in sequence of PHA＞MHP＞EHE＞IHE.

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Clinical observation of neoadjuvant chemotherapy with docetaxel plus lobaplatin regimen in triple negative breast cancer〖

YAO Yufeng， GONG Jianping， TANG Jinhai， QIN Jianwei.

Chinese Clinical Oncology. 2013, 18 (8): 723.

Abstract ( 1208 )

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Objective To evaluate the efficacy and adverse reaction of neoadjuvant chemotherapy with docetaxel plus lobaplatin regimen in triple negative breast cancer （TNBC）. Methods Thirty TNBC patients accepted neoadjuvant chemotherapy with docetaxel and lobaplatin（docetaxel 75mg/m2 iv, d1; lobaplatin 30mg/m2 iv, d1; 21 days was a cycle）. The objective response and side effects were evaluated by WHO standard or histopathological reaction after surgery. Results Eight patients finished chemotherapy for 2 cycles， 17 patients for 4 cycles and 5 patients for 6 cycles. All patients were evaluable， 9 cases got CR， 15 cases got PR， 4 cases had SD， 2 cases were PD. The clinical benefit rate was 80.0％. Six cases achieved pCR according to the histopathological detection after surgery. The main adverse reaction was myelosuppression，with grade 12 leukopenia in 17 cases， grade 34 leukopenia in 5 cases， grade 1-2 thrombocytopenia in 7 cases， grade 3-4 thrombocytopenia in 2 cases and grade 12 anemia in 6 cases. Nonhemotologic toxicities were modest and recoverable. Conclusion Neoadjuvant chemotherapy with docetaxel plus lobaplatin regimen in TNBC is effective and well tolerated，which gives us a new choice.

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Comparison of pemetrexed plus cisplatin regimen and vinorelbine plus cisplatin regimen as the first-line treatment of advanced non-small cell lung cancer

GENG Chunyan， CAI Wei， CHEN Bin.

Chinese Clinical Oncology. 2013, 18 (8): 726.

Abstract ( 1122 )

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Objective To compare the efficacy and toxicity of pemetrexed plus cisplatin regimen and vinorelbine plus cisplatin regimen as the firstline treatment of advanced nonsmall cell lung cancer （NSCLC）. Methods In a retrospective study， 68 patients with advanced NSCLC receiving pemetrexed or vinorelbine plus cisplatin as the firstline chemotherapy from January 2008 to December 2010 were enrolled. Subgroup and chemotherapy regimen were： PC regimen group（n=32， pemetrexed 500mg／m²， d₁; cisplatin 25mg／m²， d₁-d₃）and NP regimen group（n=36， vinorelbine 25mg／m²， d₁， d₈; cisplatin 25mg／m²， d₁-d₃）. Three weeks was a cycle. The efficacy was evaluated every 2 cycles. Results All patients were available for the objective response evaluation， but no complete response was observed in both groups. No significant difference was found between PC regimen group and NP regimen group on the objective response rate （40.6％ vs. 36.1％）， disease control rate （71.9％ vs. 61.1％） and median time to progress （6.2 vs. 5.2 months）. There was a higher incidence of grade 3-4 leukopenia and neutropenia in the NP regimen group compared with the PC regimen group （P＜0.05）. Conclusion Pemetrexed plus cisplatin shows similar efficacy and less toxicity compared with vinorelbine plus cisplatin as the firstline treatment of advanced NSCLC.

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Prognostic value of positive lymph node ratio in colorectal cancer

LI Qinggang， QIAN Wenbiao，HU Xiaocui，LIU Dan.

Chinese Clinical Oncology. 2013, 18 (8): 730.

Abstract ( 1177 )

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Objective To investigate the prognostic value of lymph node ratio（LNR） in predicting overall survival and diseasefree survival in colorectal cancer(CRC) patients with metatastic lymph nodes. Methods From July 2003 to December 2007， data from a total of 102 patients who underwent radical operation for CRC with lymph node metastases were analyzed. The patients were stratified into four groups according to LNR quartiles：LNR1（LNR≤Q1），LNR2（Q1＜LNR≤Q2），LNR3（Q2＜LNR＜Q3） and LNR4（LNR≥Q3）.KaplanMeier method was used to evaluate the survival. A Cox regression model was used for multivariate analyses. Results The 3-year overall survival rate and diseasefree survival rate were 72.5％ and 61.8％ in CRC patients with stage ⅢⅣ. The 3year overall survival rate in patients with adenocarcinoma and low grade differentiation was higher（P＜0.05）. The 3year overall survival rates of patients with LNR1， LNR2， LNR3 and LNR4 were 100.0％，76.9％，68.0％ and 42.3％，respectively（P＜0.001）. The 3year disease-free survival rates of patients with LNR1， LNR2， LNR3 and LNR4 were 92.0％， 61.5％， 68.0％ and 26.9％， respectively（P＜0.001）. Kaplan-Meier analysis showed that the prognosis in LNR1+LNR2 group was superior to LNR3+LNR4 group（P＜0.05）. Cox proportional hazards regression analysis revealed that LNR was an independent significant factor in predicting 3-year overall and diseasefree survival for CRC patients（P=0.036）. Conclusion The LNR is a major independent prognostic factor for the CRC patients with node-positive.

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Levels of CEA， CA125 and CA19-9 in postoperative peritoneal fluid drainage of colorectal cancer and their clinical significance

ZHUANG Xiaoquan，ZHAO Yong，XIANG Beiting，WANG Jianyun，XU Ting.

Chinese Clinical Oncology. 2013, 18 (8): 734.

Abstract ( 839 )

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Objective To investigate the levels of carcinoembryonic antigen（CEA）， carbohydrate antigen（CA）125 and CA19-9 in postoperative peritoneal fluid drainage of colorectal cancer（CRC） and their relationship with clinical staging and peritoneal micrometastasis. Methods The peritoneal fluid drainage on postoperative day 1 was collected from 86 patients with CRC（CRC group） and 30 patients with benign intestinal disease（control group）.The levels of CEA， CA125 and CA19-9 in postoperative peritoneal fluid drainage of CRC were detected and their relationship with clinicopathological features were analyzed. Results The level of CEA was higher in CRC group than that in the control group（P＜0.05）， while there was no significant difference in CA125, CA199 between both groups（P＞0.05）. There was significant correlation between the state of lymph node metastasis， depth of invasion and clinical stage with the level of CEA， while no relationship was found between the levels of CA125, CA199 and clinicopathological features. Conclusion The level of CEA in postoperative peritoneal fluid drainage of CRC can be used to predict clinical staging， peritoneal micrometastasis and prognosis.

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Clinical efficacy of glutamine for the prevention and treatment of acute radiationinduced diarrhea

GU Wendong， PEI Honglei， HUANG Jin， XI Dan， CHEN Yuan， WEI Jun

Chinese Clinical Oncology. 2013, 18 (8): 737.

Abstract ( 1135 )

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Objective To investigate the protective and therapeutic effects of glutamine on radiationinduced diarrhea in pelvic radiotherapy. Methods Sixty-three patients suffered from cervical carcinoma or endometrial cancer were randomly divided into glutaminetreated group and control group. The glutamine（100ml, once a day, total 10 times） was administered intravenously every day in the last two weeks of the radiation period only in the glutaminetreated group. The incidence and severity of acute diarrhea were analyzed between groups as well as the frequency and dosage of antidiarrheal medication. Results The overall diarrhea incidence of glutamine-treated group and control group were 87.1％ and 90.6％，respectively. There was no significant difference between two groups（P＞0.05）. The average times of diarrhea everyday in both groups were 2.6 and 3.0 times with no significant difference（P＞0.05）. In the fifth week， the average times of diarrhea everyday in glutaminetreated group were less than those in the control group（P＜0.05）. The frequency and dose of antidiarrheic in the glutaminetreated group were less than those in the control group（P＜0.05）. Conclusion Glutamine is an effective therapy on radiationinduced diarrhea， but the protective effects needs more clinical trial.

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Clinical observation of lobaplatin used for intracavitary instillation on malignant pleuroperitoneal cavity hydrops

TIAN Xin，ZHANG Zhenyong，WU Lina，WU Rong

Chinese Clinical Oncology. 2013, 18 (8): 740.

Abstract ( 1139 )

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Objective To observe the curative effects and adverse reaction about lobaplatin used for intracavitary instillation on malignant pleuroperitoneal cavity hydrops. Methods Thirty-two patients with malignant pleuroperitoneal cavity hydrops，locationed by B-ultrasonic wave and given puncturing and inserting catheter，were given lobaplatin for intracavitary instillation，once a week，for 2 weeks，4 times at most. The curative effects and toxicity were evaluated after 2 weeks. Results Thirty-two patients were given intracavitary instillation for at least 2 times. Of all the patients, complete response（CR） was observed in 9 patients（28.1%）, partial response in 15 patients（46.9%）, NS in 8 patients（25.0%）. The response rate（RR） was 75.0%. The RR of pleural effusion and seroperitoneum was 80.0% and 66.7%, respectively. The toxicity mainly included chest or abdominal pain，fever，low platelets and digestive tract reaction. Conclusion Lobaplatin is effective used for intracavitary instillation on malignant pleuroperitoneal cavity hydrops with mild adverse reaction，so it is worth to be popularized.

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Comparison of the clinical effect in patients with resectable esophageal cancer after esophagectomy followed by gastric tube or whole stomach reconstruction

LI Yong， WANG Huayong， WANG Lei， WANG Gaoming， GAO Peng

Chinese Clinical Oncology. 2013, 18 (8): 743.

Abstract ( 1174 )

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Objective To evaluate the clinical therapeutic effect in patients with resectable esophageal cancer after esophagectomy followed by gastric tube or whole stomach reconstruction.
Methods Clinical data of patients underwent esophagectomy for esophageal cancer in our hospital from 2007 to 2012 were retrospectively analyzed. Patients were divided into two groups，Group A（n=53） patients underwent gastric tube esophagectomy；Group B（n=48） patients underwent whole stomach reconstruction esophagectomy.
The clinical indexes such as the level of anastomosis, the intraoperative bleeding, operation time, postoperative thoracic drainage and gastrointestinal decompression, drainage tube removal time,
postoperative complications and respiratory function （ratio of predicted values of MVV％，FEV1.0％，VC％） in patients of two groups were compared.
Results Patients in Group A had lower rate of reflux esophagitis than patients in Group B. The difference was statistically significant（5.7％ vs. 25.0％，P=0.01）. Patients in Group A had lower rate of thoracic stomach syndrome than patients in Group B（0 vs. 8.3％）. Patients in Group A had higher values of VC％，MVV％ and FEV1.0％ than patients in Group B. The difference was statistically significant（P＜0.01）. Conclusion The patients received esophagectomy followed by gastric tube has lower rate of reflux esophagitis and thoracic stomach syndrome than patients received esophagectomy followed by whole stomach reconstruction. Esophagectomy followed by gastric tube has less influence of postoperative respiratory function on patients.

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Clincopathological analysis of hepatic epithelioid hemangioendothelioma

ZHOU Mei， LI Jingying， BAI Jingping， ZHAO Feng， WANG Cuicui

Chinese Clinical Oncology. 2013, 18 (8): 746.

Abstract ( 1156 )

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Objective To investigate the clinicopathological characteristics， differential diagnosis and prognosis of hepatic epithelioid hemangioendothelioma（EH）.
MethodsThe morphological characteristics of 4 cases of hepatic EH were observed. The immunohistochemical approach and literature review were employed. Results The tumor cells were epithelioid， spindle or polygonalshaped and exhibited cordlike， small nests or intravascular papillary growth pattern. Some tumor cells formed empty cytoplasmic vacuoles， of which contained red blood cell fragments. The tumor cells showed rare mitotic figures， abundant eosinophilic cytoplasm and unclear cellcell boundaries with mesenchymal mucus or hyaline appearance. The tumor cells were positive for CD31，CD34 and Vim. Conclusion Hepatic EH is a rare， lowgrade， malignant neoplasm of vascular origin that may be easily misdiagnosed by imaging. Pathological morphology and immunohistochemistry are needed to facilitate the identification and diagnosis.

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Progression of metronomic chemotherapy on inducing tumor dormancy

QIAO Jingjing，XIN Yan

Chinese Clinical Oncology. 2013, 18 (8): 750.

Abstract ( 1208 )

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Dormancy is the main reason of tumor recurrence and metastasis. Circulating tumor cells， tumor stem cells and micrometastasis may be dormancy cells. Targeted therapy and endocrine therapy can induce tumor dormancy in a long interval， that may reduce tumor relapse. Low-dose and short interval are two characteristics of metronomic chemotherapy. It can suppress tumor angiogenesis and induce antitumor immunity. That means it can induce tumor dormancy through tumor microconditions. But how to use lowdose chemotherapy and what the optimal doses and interval time are unknown. How it affect tumor cells’ actions is not clear， that needs indepth studies， including many investigations in vitro and in vivo.

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Progress in relationship between EZH2 and gastric cancer

ZHANG Qi， SHEN Lili， CHEN Jinfei.

Chinese Clinical Oncology. 2013, 18 (8): 755.

Abstract ( 835 )

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Gastric cancer is one of the most common malignancies in the world. It has continued to be a threat to human life. The progress of gastric cancer is a multifactor，multistage and multigene mutation process induced by activation of telomerase，tumor suppressor gene inactivation，oncogene activation and so on. Specific biological markers，diagnosing and predicting patients survival and treatment response，play a role in improving the quality of life for gastric cancer patients. EZH2 gene， enhancer of zeste homolog 2， is a human homolog gene of the drosophila zeste gene enhancer. A number of studies in recent years have found that the expression level of EZH2 in gastric carcinoma is significantly higher than that in normal tissue. It plays an important role in the development of gastric cancer and has a potential clinical value for improving the detection rate and treatment of gastric cancer. This paper summarizes research progress of the correlation between EZH2 and gastric cancer.

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Prevention and treatment progress of tumor-associated venous thromboembolism

DENG Yi，CHEN Xiaopin

Chinese Clinical Oncology. 2013, 18 (8): 760.

Abstract ( 1117 )

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Venous thromboembolism（VTE） is a common complication and one of the most leading causes of death in patients with cancer. In addition to surgery and prolonged hospital stays， chemotherapy is increasingly recognized as a risk factor for VTE in patients with cancer. VTE will increase the morbidity and mortality in cancer patients， influence the antitumor effects and aggravate the medical resources and patients’ economic burdens. Recently， risk prediction models are used for effective assessment of the risk factors for VTE. More and more clinical trials show benefits of prophylaxis and treatment for cancer patients.

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标准刊号：	ISSN 1009-0460
	CN 32-1577/R