Chinese Clinical Oncology

Effect of chidamide on apoptosis and infiltration in triple negative breast cancer cell

SHI Xiuqing， MA Fei， LI Huihui， WANG Haijuan， ZHANG Xueyan， LIN Chen， QIAN Haili， XU Binghe

Chinese Clinical Oncology. 2013, 18 (12): 1057.

Abstract ( 1289 )

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Objective To investigate the effects of histone deacetylase inhibitor（HDACi）, chidamide, on proliferation， apoptosis and infiltration in triple negative breast cancer CAL51 cell line in vitro. Methods The real time cellular analysis （RTCA） assay was employed to detect proliferation inhibition efficiency by treating cells with different concentration groups of chidamide （0， 5， 10， 20， 50， 100μmol／L）. When CAL-51 cells were treated with chidamide （10， 15， 20μmol／L） for 72h， morphological changes of CAL-51 were observed under inverse microscopy. The cell apoptosis， cell cycles and stem cell proportion were analyzed by flow cytometry. RTCA assay was used to detect changes of infiltration ability after treatment. Results Chidamide was able to inhibit proliferation of CAL51 cells in vitro in a positive concentration dependent manner （r=0.791，P＜0.001）. After being treated with chidamide， cell morphology appeared great changes. Flow cytometry assay showed obvious apoptosis compared with control group with the increase of drug concentration and acting hours （P＜0.05）， but no alternation of cell cycles and stem cell proportion were detected. RTCA assay showed that cell infiltration ability was obviously inhibited after treatment. With the increase of drug concentration， the inhibition of cell invasion ability increased significantly （P＜0.05）. Conclusion Chidamide can obviously inhibit the proliferation of CAL-51 cells， induce its apoptosis and reduce the cell invasion and infiltration capacity.

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The inhibitory effects of miR-206 on triple negative breast cancer cell proliferation and its mechanism

SHI Yongguo，BIAN Weihe，HE Ye，DING Jie，ZHOU Jing，WANG Keming

Chinese Clinical Oncology. 2013, 18 (12): 1062.

Abstract ( 1104 )

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Objective To investigate the effect of miR-206 on the proliferation of triple negative breast cancer cell MDA-MB-231 in vitro and its action mechanism.
Methods MiR-206 MiR-206 mimic and miR-NC were transfected into MDA-MB231 breast cancer cell. The expression level of miR-206 was detected by real time quantitative PCR（qRT-PCR）. MTT and colony formation assays were used to detect the effect of miR-206 on breast cancer cell proliferation. Flow cytometry was used to detect the effect on cell cycle. Western blotting was used to analyze the expression of cyclinD2 in breast cancer cell after transfected with miR-206. Results The results of qRT-PCR showed that the relative expression of miR-206 was 10.2±1.5 when MiR-206 mimic was transfected into MDA-MB-231 breast cancer cell for 48h. The inhibition rate of MDAMB231 breast cancer cell which was transfected by miR206 mimic for 6，24，48，72，96h was（0±0.01）％，（0.12±0.03）％，（0.21±0.08）％,（0.28±0.11）％，（0.39±0.16）％, respectively. The colony formation assays showed that the number of conolies were 106±35， 843±143 in miR-206 mimic and miR-NC group when they were transfected for two weeks. miR206 inhibited breast cancer cell growth by blocking the G1／S transition and downregulated the expression of cyclinD2.Conclusion MiR-206 can significantly inhibit the proliferation of breast cancer cell MDA-MB-231，which might be exert its functions by regulating the cell cycle protein cyclinD2. miR-206 may be a novel therapeutic target for the treatment of breast cancer.

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Enhancement of endostar on the radiosensitivity of human rhabdomyosarcoma xenograft

YANG Mingwei， YANG Lin.

Chinese Clinical Oncology. 2013, 18 (12): 1066.

Abstract ( 862 )

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Objective To observe the radiosensitizing effect of recombinant human endostatin （endostar） on rhabdomyosarcoma xenograft， and to further explore the underlying mechanism. Methods The subcutaneous xenograft model of femal BALB／C mice with A673 rhabdomyosarcoma was successfully established， and the mice were randomly assigned to four groups： the control group， the endostar group， the radiotherapy group， and the endostar combined with radiotherapy group. The condition of the xenografts were observed and measured to evaluate the antitumor effect. Immunohistochemical assay was used to determine the expressions of vascular endothelial growth factor （VEGF） and microvessel density （MVD） in each group. Results The tumor inhibition rates of the endostar group， the radiotherapy group and the endostar combined with radiotherapy group were 13.16％， 23.82％ and 34.04％， respectively. The radiotherapy group and the endostar group had the inhibitory tendency， but the difference was not significant compared with the control group（P＞0.05）. Significant antitumor activity was found in the endostar combined with radiotherapy group compared with the control group（P＜0.05）. The MVD of the control group， the endostar group， the radiotherapy group and the endostar combined with radiotherapy group were 21.16±6.53, 13.02±1.99, 12.21±1.58, 7.84±0.91， respectively. The MVD expression were reduced remarkably in all the treatment groups compared with the control group（P＜0.05）， with the endostar combined with radiotherapy group the most significant（P＜0.05）. And the VEGF levels of the control group， the endostar group， the radiotherapy group and the endostar combined with radiotherapy group were 2.01±016，1.46±0.46，3.37±0.74，2.41±0.21，respectively. The VEGF level in the radiotherapy group was higher than those in the control group and endostar group. The level of VEGF in the endostar combined with radiotherapy group decreased remarkably compared with the radiotherapy group（P＜0.05）. Conclusion Endostar in conjunction with radiotherapy can significantly restrict the growth of rhabdomyosarcoma xenograft， and the underlying mechanism may include the inhibition of angiogenesis， the decrease of MVD and the expression of VEGF induced by radiation.

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Expressions of NOK and FGFR2 in nonsmall cell lung cancer and their clinical significance

LIU Haitao，ZHANG Zhipei，GE Zhonghu， WANG Xuejiao， WEN Miaomiao，WANG Jian， LI Xiaofei

Chinese Clinical Oncology. 2013, 18 (12): 1071.

Abstract ( 1114 )

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Objective To detect the expressions of novel oncogene with kinasedomain（NOK） and fibroblast growth factor receptor 2（FGFR2） protein in nonsmall cell lung cancer（NSCLC）， and analyze the expressions among different pathological types， pathological grades， TNM stages and their correlation. Methods The expressions of NOK and FGFR2 protein were detected with immunohistochemical En Vision method in 163 NSCLC samples， the expressions among different pathological types， pathological grades， TNM stages and the correlation between expressions of NOK and FGFR2 in tumor samples were analyzed. Results The positive rate of NOK and FGFR2 protein in 163 NSCLC tissues were 66.7％ and 852％，respectively. The positive rate of NOK protein in lung squamous cell carcinoma and adenocarcinoma were 64.5％ and 72.6％ with no statistical difference（P＞0.05）. NOK protein was expressed among different TNM stages with statistical difference（P=0.000），and the expressions also different in pathological grades（P=0.000）. The positive rate of FGFR2 protein in lung squamous cell carcinoma and adenocarcinoma were 886％ and 85.7％ with no statistical difference（P＞0.05）. The expression of FGFR2 protein at different TNM stages and different pathological grades were also different statistically（P=0.000）. The positive correlation between NOK and FGFR2 expression was found in NSCLC samples（r=0.640，P=0.000）， squamous cell carcinoma（r=0.684，P=0.000） and adenocarcinoma（r=0.597，P=0.00）. Conclusion NOK and FGFR2 protein are highly expressed in NSCLC， and their expressions correlates with pathological types， pathological grades and TNM stages， which may be related to the occurrence and development of NSCLC.

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Expressions of WT1 and β-catenin protein in nonsmall cell lung cancer and their significance

ZHOU Feng，MAO Guoxin

Chinese Clinical Oncology. 2013, 18 (12): 1076.

Abstract ( 844 )

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Objective To investigate the expressions of Wilms tumor 1 （WT1） and βcatenin protein in nonsmall cell lung cancer （NSCLC）, and analyze their relationship with clinicopathological characteristics and the correlation between the two proteins. Methods A total of 48 paraffin-embedded tissue samples from NSCLC patients were stained by En Vision two steps method to evaluate the expressions of WT1 and β-catenin protein， and 20 adjacent normal tissues were collected as control. Results The positive rate of WT1 protein was 62.5％ in NSCLC， higher than 10.0％ in adjacent normal lung tissue （P＜0.05）. The aberrant expression rate of β-catenin protein was 72.9％ in NSCLC， higher than 15.0％ in adjacent normal lung tissue （P＜0.05）. The expression of WT1 protein was related to the status of lymph node metastasis（P＜0.05）， but not with gender， age， tumor diameter， pathological types， histological differentiation or pTNM staging（P＞0.05）. There was significant difference between βcatenin protein aberrant expression and histological differentiation（P＜0.05）， while no differences were found in gender， age， tumor diameter， pathological types， status of lymph node metastasis or pTNM staging（P＞0.05）. WT1 protein was positively related to β-catenin protein in NSCLC（r=0.331，P＜0.05）.
Conclusion The expressions of WT1 protein and β-catenin protein may be correlated to the occurrence and development of NSCLC.

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The relationship between the expression of LDH-A and HDAC1 in intestinaltype gastric cancer

ZHANG Yongjie， QIN Shukui， WANG Jiejun， WANG Xi， YU Guanzhen， Chen Ying.

Chinese Clinical Oncology. 2013, 18 (12): 1081.

Abstract ( 1105 )

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Objective To investigate the correlation between the expression of lactate dehydrogenase A（LDH-A） and histone deacetylase 1（HDAC1） in intestinaltype gastric cancer（ITGC） and analyze the relationship between their expressions and prognosis. Methods The LDH-A siRNAexpressing lentiviral vector was constructed and used to transfect into ITGC cell line SGC7901. Western blotting was applied to detect the expression of HDAC1 protein. The expressions of LDH-A and HDAC1 in 661 ITGC specimens and the corresponding noncancerous tissues were performed by immunohistochemistry technique. Results According to Western blotting results， LDH-A expression was significantly upregulated in SGC7901 cells and the knockdown of LDH-A in SGC7901 cells significantly downregulated the expression of HDAC1. Based on the analysis of immunohistochemistry results， the high expression rate of LDH-A protein in ITGC was 54.8％（362／661），significantly higher than 12.9％（85／661）in paired adjacent noncancerous tissues（P＜0.01）； the high expression rate of HDAC1 protein in ITGC was 51.3％（339／661）， significantly higher than 15.4％（102／661） in paired adjacent noncancerous tissues（P＜0.01）； LDHA expression was positively related to HDAC1 expression（r=0.324， P＜0.001）. Univariate analysis showed that the survival curve of patients with low LDH-A／low HDAC1 expression was significantly better than that of other combinations in ITGC（P＜0.001）. Multivariate survival analysis showed that LDHA and HDAC1expression were independent prognostic factors.
ConclusionThe expressions of LDH-A and HDAC1 have positive correlation in ITGC. Targeted inhibition of both LDH-A and HDAC1 is promising to bring longer overall survival.

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Expressions of KLF4 and KLF5 in breast invasive ductal carcinoma and their clinical significance

CUI Naipeng， YAN Weitao， LIU Caiyun， SHI Jianhong， WEN Ming， MA Zhenfeng， WANG Yanan， CHEN Baoping

Chinese Clinical Oncology. 2013, 18 (12): 1087.

Abstract ( 1210 )

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Objective To investigate the expression levels of Kruppel-like factor （KLF） 4 and KLF5 and the relationship between their expressions and clinicopathological characteristics in breast invasive ductal carcinoma.
Methods Thirty cases of surgical removal of breast cancer tissue diagnosed with invasive ductal carcinoma by postoperative paraffin pathology and 10 cases of normal breast tissue adjacent to carcinoma were collected from March 2012 to October 2012 in the Affiliated Hospital of Hebei University. The immunohistochemical staining was performed to detect KLF4 and KLF5 levels in invasive ductal carcinoma or adjacent normal breast tissues. The correlation between their expressions and clinicopathological characteristics were analyzed. Results Immunohistochemical results showed both of KLF4 and KLF5 mainly expressed in the nucleus. The KLF4 expression level in invasive ductal carcinoma was significantly lower than that in adjacent normal breast tissues （6.7％ vs. 70.0％, P＜0.05）. The KLF5 expression level in invasive ductal carcinoma was significantly higher than that in adjacent normal breast tissues （90.0％ vs. 30.0％, P＜0.05）. The positive expression rates of KLF4 and KLF5 were not significantly associated with patients age， menopausal status， histological grade， lymph node metastasis, ER and PR expression levels （P＞0.05）. The KLF5 expression level in breast cancer was correlated with HER2 expression level （P＜0.05）. Moreover， no correlation was found between KLF4 and KLF5 expression in invasive ductal carcinoma（r=-0.356, P=0.053）. Conclusion The KLF4 expression level decreases and KLF5 expression level increases in invasive ductal carcinoma， suggesting their important roles of KLFs in breast cancer.

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Expressions of β-catenin，LEF-1 and PTEN in breast cancer and their significance

GUO Weidong，ZHANG Huijie，NIU Desen，QV Zhenjie

Chinese Clinical Oncology. 2013, 18 (12): 1091.

Abstract ( 1068 )

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Objective To investigate the expressions of β-catenin， lymphoid enhancerbinding factor-1（LEF-1） and PTEN in breast cancer， and analyze their relationship with clinicopathological features and the correlation among the three proteins. Methods The expressions of β-catenin， LEF-1 and PTEN were detected by immunohistochemistry in 65 cases of breast cancer tissues， 30 cases of breast fibroadenoma tissues and 30 cases of adjacent normal breast tissues. The clinicopathological features and relevance of three proteins were analyzed. Results In adjacent normal tissues， breast fibroadenoma tissues and breast cancer tissues， the positive expression rate of β-catenin was 26.7％（8／30）， 33.3％（10／30）， 61.5％（40／65）, respectively； the positive expression rate of LEF-1 was 10.0％（3／30）， 23.3％（7／30）， 56.9％（37／65）, respectively； the positive expression rate of PTEN was 90.0％（27／30）， 83.3％（25／30）， 41.5％（27／65）, respectively； and the differences were statistically significant（P＜0.05）. The expressions of the three proteins in breast cancer tissue had no correlation with age， tumor size and tumor site（P＞0.05）， but with TNM stage and lymph node metastasis（P＜0.05）. The expression of βcatenin and LEF1 in breast cancer was positive correlated（r=0.845，P＜0.05）， while βcatenin and PTEN was negative correlated（r=-0.874，P＜0.05）. Conclusion The abnormal expressions of β-catenin， LEF-1 and PTEN are closely related with the occurrence， progression， invasion and metastasis in breast cancer. The combined detection of the three proteins may play an important role in judging biological behavior of breast cancer.

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The expression of ERCC1 mRNA in breast carcinoma and its clinical significance

LIN Xiaoying， CHEN Xiaoyan， HUANG Ying

Chinese Clinical Oncology. 2013, 18 (12): 1096.

Abstract ( 1033 )

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Objective To investigate the expression of excision repair cross complement group 1（ERCC1） in breast carcinoma and their relationship between the expression and clinicopathological characteristics and prognosis.
MethodsRealtime quantitative PCR was used to determine the mRNA expression of ERCC1 in 363 breast carcinoma patients. The relationship between the expression and clinicopathological characteristics and prognosis were analyzed. Results The median expression level of ERCC1 mRNA was 102×10-2 in 363 breast carcinoma tissues， with 181 patients in high level group， and 182 in low level group. Expression of ERCC1 mRNA was associated with expressions of ER， PR（P＜0.05）， but not with patients age， tumor size， axillary lymph node metastasis， pathological type， histological grade， HER-2（P＞0.05）. The median diseasefree survival in patients with high ERCC1 mRNA expression and low ERCC1 mRNA expression were both not reached with no statistical difference（P＞0.05）. The median progress-free survival（PFS） was 34.0 months（95%CI: 32.004-35.996） in patients with high ERCC1 mRNA expression. The median PFS in patients with low ERCC1 mRNA expression was not reached. There was statistical difference（P=0.017）.Conclusion The expression of ERCC1 mRNA in breast cancer may be closely related to estrogen metabolism of patients. Detection of ERCC1 mRNA expression may help to predict the survival and prognosis of breast cancer patients.

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The correlation between BRAFV600E mutation and clinicopathological characteristics and prognosis of stage Ⅰ-Ⅱ papillary thyroid cancer

WANG Hao， LU Ruichun， DONG Xianning， LIANG Jun.

Chinese Clinical Oncology. 2013, 18 (12): 1100.

Abstract ( 1228 )

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Objective To investigate the status of BRAFV600E mutation in stage ⅠⅡ papillary thyroid cancer（PTC） and evaluate the correlation between BRAFV600E mutation and clinicopathological characteristics and prognosis.
MethodsThe BRAFV600E mutation of stage Ⅰ-Ⅱ PTC was detected by RTPCR. The relationship was analyzed between BRAFV600E mutation and clinicopathological characteristics and prognosis of PTC. Results The BRAFV600E mutation rate in 374 cases of PTC was 40.37％（151／374）. The BRAFV600E mutation correlated with capsule invasion， multifocality， multiple radioiodine courses（P＜0.05）. Thirtyone patients were recurrent in 374 cases of PTC, including 22 patients with BRAFV600E mutation. The median survival time was 5.3 years（95%CI： 3.9-6.7） in the recurrent PTC patients with BRAFV600E mutation which had shorter trend compared with 7.0 years（95%CI： 5.1-8.9） in the patients without mutation. But no statistical difference was found. The BRAFV600E mutation and capsule invasion were prognostic factors in predicting the recurrence of the disease by multiple logistic regression test（P＜0.05）. Conclusion The BRAFV600E mutation may be an independent prognostic factor in predicting the prognosis of stage Ⅰ-Ⅱ PTC patients.

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Expression of B7-H4 in epithelial ovarian carcinoma and its significance

ZHANG Yu，CHEN Zengyan

Chinese Clinical Oncology. 2013, 18 (12): 1104.

Abstract ( 1096 )

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Objective To detect the expression of B7-H4 in epithelial ovarian carcinoma， and analyze the relationship between B7-H4 and clinical pathological characteristics， prognosis of epithelial ovarian carcinoma.
Methods The expression of B7-H4 protein was examined in 66 cases of epithelial ovarian carcinoma，5 cases of border line ovarian tumors， 8 cases of benign ovarian tumors and 20 normal ovary tissues by immunohistochemical technique. The association between the expression of B7-H4 protein and clinicopathological characteristics， prognosis in patients with epithelial ovarian carcinoma was further analyzed.
Results The positive expression rate of B7-H4 in epithelial ovarian carcinoma was 86.4％， while it did not express in borderline ovarian tumors， benign ovarian tumors and normal ovarian tissue. The positive rates of B7-H4 protein in serous adenocarcinoma， endometrioid carcinoma and clear cell carcinoma were 100.0％， 90.0％ and 87.5％， higher than 50.0％ in mucinouscarcinomas（P＜0.05）.The positive rate of B7-H4 protein was related with clincal stage， histological grade and lymphatic metastasis， but not with age and ascitescytology. B7-H4 was not correlated with survival of patients（P＞0.05）. Conclusion The expression of B7-H4 is up-regulated in epithelial ovarian carcinoma， and it plays an important role in the occurrence and development of epithelial ovarian carcinoma.

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The relationship of CD4+／CD25+ and CD28+／TCR+T cells with the prognosis in patients with advanced nasopharyngeal carcinoma

LI Yongqiang， LIU Zhihui， HU Xiaohua， LIN Yan， LIAO Xiaoli， LIANG Rong， YUAN Chunling， LIAO Sina.

Chinese Clinical Oncology. 2013, 18 (12): 1108.

Abstract ( 833 )

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Objective To compare the differences of the proportions of CD4+／CD25+and CD28+／TCR+T cells in peripheral blood between patients with advanced nasopharyngeal carcinoma（NPC） and healthy volunteers， and explore the potential significance of the aberrant lymphocyte subpopulations of T cells for prognosis in NPC patients. Methods Twenty-nine healthy volunteers（control group） and 53 patients with advanced NPC（NPC group） were recruited. The peripheral venous blood samples were harvested and the peripheral lymphocytes were isolated and collected by ficollhypaque density centrifugation. The proportions of CD4+／CD25+ and CD28+／TCR+T cells were measured by flow cytometry. The relationship between the aberrant proportions of these T cells and the risk of relapse in NPC patients was analyzed according to the followup data of 18 months after chemoradiotherapy. Results The proportion of CD4+／CD25+T cells in NPC group was（10.6±2.7）％， higher than（7.7±2.0）% in control group（P＜0.05）， whereas the proportion of CD28+／TCR+T cells in NPC group was（1.9±0.6）％， lower than（2.9±1.0）% in control group（P＜0.05）. According to the 95％ confidence interval of the proportions of CD4+／CD25+and CD28+／TCR+T cells in control group， the NPC group was divided into normal（≤8.5％） and elevated（＞8.5％） CD4+／CD25+T subgroup or normal（≥2.5％） and reduced（＜2.5％） CD28+／TCR+T subgroup. The relapse rate of elevated CD4+／CD25+T subgroup within 18 months after treatment was 32.1%, higher than 87% of normal subgroup with significant difference（P＜005）. No difference was observed between subgroups of CD28+／TCR+T. Conclusion The proportion of CD4+／CD25+T cells is a potential prognostic factor for the risk of relapse in patients with advanced NPC.

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A retrospective study of different treatments of limitedstage small cell esophageal carcinoma and associated prognostic factor analysis

PENG Jin， ZHU Weiguo， LUO Honglei.

Chinese Clinical Oncology. 2013, 18 (12): 1112.

Abstract ( 930 )

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Objective To explore the outcomes of different treatments and prognostic factors influencing overall survival（OS） in patients with limitedstage small cell esophageal carcinoma（SCEC）. Methods One hundred and six patients with limited-stage SCEC were divided into 4 groups according to different treatment methods： surgery alone（n=14）， surgery and postoperative chemotherapy（n=42）， radiotherapy alone（n=11） and concurrent chemoradiotherapy（n=39）. The 5-year overall survival rates， median OS and the rates of metastasis were analyzed retrospectively， and Cox model was used to analyze prognostic factors. Results The 5year survival rates of patients with and without chemotherapy were 27.2％ and 0， and median OS were 22.0 and 11.0 months with a hazard ratio（HR） of 2.30（95％CI： 1.42-3.73， P=0.001）. The 5-year survival rates of patients treated with surgery and postoperative chemotherapy or concurrent chemoradiotherapy were 31.0％ and 23.1％， and median OS were 26.0 and 18.0 months with a HR of 1.25（95％ CI： 0.75-2.09， P=0.725）. Multivariate survival analysis using Coxs regression model showed that chemotherapy was a positive independent prognostic factor for SCEC（HR=2.92， 95％ CI： 1.25-6.80）.
Conclusion Chemotherapy-based treatment may be beneficial in increaseing the longterm survival of patients with limited-stage SCEC. Similar overall survival rates are achieved between surgery combined with chemotherapy and concurrent chemoradiotherapy. Chemotherapy is an independent prognostic factor. Randomized， controlled， prospective studies are urgent in need to identify optimal chemotherapy regimens for treating SCEC.

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Clinical observation of albuminbound paclitaxel plus carboplatin as first-line therapy in patients with advanced non-small cell lung cancer

XU Hongxia， MEI Jingfeng， WANG Xiaohua， HONG Zhuan

Chinese Clinical Oncology. 2013, 18 (12): 1117.

Abstract ( 923 )

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Objective To compare the efficacy and safety of nab-paclitaxel plus carboplatin （nab-PC） versus paclitaxel plus carboplatin （PC） in the treatment of patients with advanced nonsmall cell lung cancer （NSCLC）.
MethodsSixty patients with advanced NSCLC diagnosed by histological or cytological examination were randomly divided into nab-PC group （n=30； albuminbound paclitaxel 130 mg／m2， d1， d8； carboplatin AUC=6， d1） and PC group （n=30； paclitaxel 175mg／m2， d1； carboplatin AUC=6， d1）. Three weeks were a cycle. The WHO grading system for acute and subacute toxicity was used to evaluate the adverse reaction and the version 1.1 of Response Evaluation Criteria in Solid Tumors （RECIST） guideline was employed to evaluate the objective response.
ResultsAll patients can be evaluated. The response rate （RR） and disease control rate （DCR） in nabPC group were 400％ and 80.0％， higher than 23.3％ and 60.0％ in PC group with significant difference （P＜0.05）. The RR of squamous cell carcinoma and nonsquamous cell carcinoma were 57.1％（8／14） and 25.0％（4／16） in nab-PC group and 23.1％（3／13） and 23.3％（4／17） in PC group. There was significant difference in the RR of squamous cell carcinoma between both groups. The median progression-free survival were 6.5 months and 5.9 months in nab-PC and PC group without statistical significance （P＞0.05）. No significant difference was observed in grade 3-4 toxicities between both groups， but the incidence of neutropenia of nabPC group was higher than that of PC group （P＜0.05）. Conclusion The albuminbound paclitaxel plus carboplatin as firstline therapy shows favorable benefits and can be well tolerated in patients with advanced NSCLC.

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Dosage titration of transdermal fentanyl by fentanyl patientcontrolled intravenous analgesia in the treatment of cancer pain

YANG yang， LI Jie， WANG Shouhui，DAI Haifeng， ZHAO Yun，WANG Yeping，YANG Bo

Chinese Clinical Oncology. 2013, 18 (12): 1121.

Abstract ( 1088 )

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Objective To evaluate the safety and efficacy of transdermal fentanyl（duragesic） dosage titrated by fentanyl patientcontrolled intravenous analgesia（PCIA） in patients with cancer pain. Methods From December 2011 to August 2013， 26 patients with moderate to severe cancer pain were studied. Titration conditions， pain score（NRS）， scores of pain impacting on life and adverse reactions were assessed and recorded respectively in the four period of treatment（before fentanylPCIA， the period of fentanylPCIA, duragesic with fentanylPCIA and the period of duragesic）. Results There were 21 cases of successful titration and 5 cases failed. The general pain score， the most serious pain score， activity pain score， resting pain score and scores of pain impacting on life were significantly reduced in the period of fentanyl-PCIA， the period of duragesic with fentanylPCIA and the period of duragesic compared with those before fentanyl-PCIA（P＜0.05）. The main adverse reactions occurred in the treatment were nausea and vomiting and no obvious muscle rigidity， loss of consciousness， cough， itching， respiratory depression and bradycardia were observed. Conclusion Titration of transdermal fentanyl with fentanyl administrated by PCIA is not only safe， effective and convenient， but also relieving breakthrough pain quickly， be worthy of clinical promotion.

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Retrospective study of albumin-bound paclitaxel based chemotherapy in recurrent epithelial ovarian cancer and primary peritoneal cancer

WEN Hao，WU Xiaohua.

Chinese Clinical Oncology. 2013, 18 (12): 1127.

Abstract ( 1170 )

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Objective To investigate the efficacy and tolerability of albuminbound paclitaxel（ABX） based chemotherapy in recurrent ovarian cancer and primary peritoneal cancer. Methods Patients who treated with ABX based chemotherapy between January 2010 and November 2012 at Fudan University Shanghai Cancer Center were analyzed retrospectively. Response was evaluated per GCIG CA125 or RECIST criteria. The frequence of dose reduction， treatment delay and interruption were assessed for treatment tolerability. Results 15.6％（5／32）and 84.4％（27／32） of the patients were platinumsensitive and primary／sencondary platinum resistant／refractory，respectively. At baseline， mean serum CA125 value was （477.5±654.9）U／ml and 26（81.3％） had elevation of CA125. The overall response rate was 28.0％（9／32）， with CA125 complete responses in 5 patients. Response rate was 60.0％（3／5） in platinumsensitive and 22.2％（6／27） in platinum resistant／refractory recurrences with no statistical difference（P＞0.05）. Six courses in 5 patients were delayed over one week and neither dose reductions or treatment interruptions nor hypersensitivity to ABX were noted. Conclusion Nab-paclitaxel based regimens are effective in platinum sensitive or platinum resistant recurrences and generally well tolerated in heavily pretreated patients with epithelial ovarian cancer and primary peritoneal cancer.

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Clinical observation of albumin bound paclitaxel combined with S1 as thirdline and beyond therapy in patients with advanced non-small cell lung cancer

FANG Ying， WANG Li， XIA Guohao， SHI Meiqi

Chinese Clinical Oncology. 2013, 18 (12): 1131.

Abstract ( 1128 )

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Objective To investigate the efficacy and safety of albumin bound paclitaxel combined with S-1 as thirdline and beyond therapy for advanced nonsmall cell lung cancer（NSCLC）. Methods Eighteen patients with advanced NSCLC were treated with albumin bound paclitaxel with S-1（Albumin bound paclitaxel was 125 mg／m2 on the first and the eighth day， S-1 was administered at 80mg per day for patients with a body surface area＜125m2， 100mg per day for those with a body surface area of 1.25-1.5m2， and 120mg per day for those with a body surface area≥1.5m2, twice a day， from d1 to d14. Twenty-one days was a cycle）. Each patient received at least 2 cycles. The efficacy was evaluated according to RECIST criteria and the adverse events were evaluated according to NCI criteria.
ResultsAmong 18 NSCLC patients， 4 achieved partial responses， 9 reached stable disease， and 5 reached progressive disease. The response rate（RR） was 22.2％（4/18） and the disease control rate（DCR） was 72.2％（13/18）. The median progressionfree survival time（PFS） was 3.0 months. The common treatment related adverse events were bone marrow suppression， badlness and neurotoxicity, but they were tolerable.
ConclusionDue to its high efficacy， low toxicity and convenient usage， albumin bound paclitaxel combined with S-1 regimen can provide another choice for patients of advanced NSCLC treated with thirdline and beyond therapy.

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The association between coagulation function and pathological types and stages in lung cancer patients

ZHEN Fuxi， ZHONG Jian，ZHAO Chen， LUO Jinhua， ZHANG Jing

Chinese Clinical Oncology. 2013, 18 (12): 1135.

Abstract ( 1084 )

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Objective To study the association between coagulation function and pathological types and stages in patients with lung cancer.
Methods A total of 76 patients from the Department of Cardiothoracic Surgery of the First Affiliated Hospital of Nanjing Medical University from January 2012 to June 2012 were enrolled in the study. The levels of plasma tissue factor（TF）, Ddimer, plasma fibrinogen（FIB）, fibrinogen degradation product（FDP） and platelet couts were detected and compared in patients of different clinical stages and pathological types.
Results The plasma TF，D-dimer levels were significantly higher in patients with stage Ⅲ，Ⅳ than those in stage Ⅱ （P＜0.05）. The TF, D-dimer levels were higher in adenocarcinoma than those in squamous cell carcinoma（P＜0.05）. Conclusion Patients with lung cancer are in high hypercoagulable state， which are significantly relevant with clinical stages and pathological types of malignant tumors， it may be served as prognostic marker for lung cancer.

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Progression of toll-like receptors in breast cancer

CAO Caihong，ZHAO Shu，ZHANG Qingyuan

Chinese Clinical Oncology. 2013, 18 (12): 1138.

Abstract ( 919 )

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Tolllike receptors are the specific type Ⅰ transmembrane receptors and pathogen pattern recognition receptors in the innate immune system and play an important role in acute inflammatory response，cellular signal transduction and apoptosis. Recent research indicate that many kinds of tumor cells express several TLRs. Some may be related to immune escape and tumor progression， but others may be involved in the antitumor immune responses. In this review，we summarize the main TLRs known to be expressed by breast cancer cells and their associated signal transduction pathways.

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Advances of microRNAs in cancer stem cells

YANG Ruina， WANG Xinshuai， GAO Shegan.

Chinese Clinical Oncology. 2013, 18 (12): 1141.

Abstract ( 1168 )

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microRNAs（miRNAs） are a class of noncoding RNAs that are believed to play important roles during tumorigenesis and cancer metastasis. Cancer stem cells are a major source leading to tumor recurrence， metastasis and drug resistance. Researches reported that miRNAs could promote or inhibit the stemness of cancer stem cells， regulate the differentiation and selfrenewal process of cancer stem cells. The purpose of this paper is to describe the phenotype and regulation mechanism of miRNAs in cancer stem cells， and explain its potential role in tumor diagnosis and treatment.

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Maintenance treatment of advanced breast cancer

ZENG Huihui， ZHENG Rongsheng.

Chinese Clinical Oncology. 2013, 18 (12): 1145.

Abstract ( 1037 )

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Treatment of advanced breast cancer is aim to prolong survival time and improve the quality of life. Patients with metastatic breast cancer who obtain clinical benefit by means of firstline treatment are in stable condition， through making use of highefficiency， low toxicity, convenient drugs of maintenance treatment so as to extend progressionfree survival as far as possible and relieve sickness， delay progress and prolong survival time. This article from maintenance treatments concept and theory， treatment mode， drug research discusses maintenance treatment of advanced breast cancer and introduces the relevant research progress.

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标准刊号：	ISSN 1009-0460
	CN 32-1577/R