Objective To explore the expression of metastasis suppressor 1（MTSS1）in the development and progression of non-small cell lung cancer （NSCLC）and its clinical significance. Methods The paraffin-embedded tissues from 98 patients with NSCLC were collected from March 2006 to March 2008 in our hospital to construct tissue microarrays. The immunohistochemistry was used to measure the expression of MTSS1 in 98 tissues of NSCLC and paired corresponding normal adjacent tissues. The relationships between the expression of MTSS1 and clinicopathological characteristics （age，gender，lymph node metastasis，histological type，degree of differentiation and TNM stage） were analyzed. The overall survival of different expression patterns of MTSS1 was followed up. The pcDNA3.1-MTSS1 expression vector （pcDNA3.1-MTSS1 group） and pcDNA3.1 empty vector （pcDNA3.1 group） were constructed to transfect the A549 cells. Western blotting was used to analyze the protein levels of MTSS1 in both groups. The proliferation and migration of A549 cells were investigated by tetrazolium salt MTT and scratch test. Results The MTSS1 postive-expression rate of cancer tissue was higher than that of adjacent tissue （56.1％ vs. 100.0％， P＜0.05）. The MTSS1 expression was correlated with lymph node metastasis and TNM stage （P＜0.05）， rather than gender， age， degree of differentiation and pathological types. The median overall survival of MTSS1 positive expressers was 40.9 months， higher than 21.5 months of negative expressers with statistically significant （P＜0.05）. Multivariate analysis showed that MTSS1 was an independent factor affecting the prognosis of patients with NSCLC. There were a higher level of MTSS1 and lower proliferation and migration ratios in pcDNA3.1-MTSS1 group versus pcDNA3.1 group （P＜0.05）. ConclusionMTSS1 was widely lost in the development and progression of NSCLC and overexpression of MTSS1 can rescue the inhibition of cell growth， indicating that MTSS1 might modulate the development and progression of NSCLC.

Objective To explore the expression of cytokeratin （CK） 19 and mucin （MUC）-1 mRNA in the peripheral blood of patients with colorectal cancer （CRC） and their relationship with clinicopathological parameters. Methods The levels of CK19 and MUC-1 were measured by nested reverse transcription-polymerase chain reaction （RT-PCR） in the peripheral blood of 20 healthy human volunteers （Healthy group）， 20 patients with benign colorectal adenomas （Benign disease group） and 90 patients with CRC （CRC group）. The correlations between levels of CK19 and MUC-1 mRNA and clinicopathological parameters of CRC （Dukes stage， differentiation， distant metastasis and histological type） were analyzed. Results The positive rate of CK19 mRNA was 58.9％ （53／90） of CRC group， higher than 0 of Healthy group and 5.0％ （1／20） of Benign disease group with significant difference （P＜0.05）.The positive rates of MUC-1 mRNA were 52.2％（47／90）， 60.0％（12／20） and 50.0％（10／20） for CRC group， Healthy group and Benign disease group with no significant difference （P＞0.05）. No significant differences were observed between Healthy group and Benign disease group on positive rates of CK19 mRNA and MUC-1mRNA. The positive rates of CK19 mRNA and MUC-1 mRNA were related with Dukes stage， differentiation and distant metastasis， and non-related with histological type （P＜0.05）. Conclusion The positive rate of CK19 mRNA in CRC increased， and CK19 and MUC-1 mRNA related with the Dukes stage， differentiation and distant metastasis， which may play an important role in the development of CRC.

Objective To investigate the level of miR-455-3p in gastric carcinoma and its relationship with microvascular density （MVD） and vascular endothelial growth factor （VEGF）. Methods The quantitative real-time PCR was used to examine the level of miR-455-3p in 80 gastric carcinoma tissues （gastric carcinoma group）. The vascular endothelial growth factor （VEGF） expression and microvascular density （MVD） were measured by immunohistochemical method in 80 gastric carcinoma tissues. The correlations between level of miR-455-3p and MVD， VEGF expression were analyzed. Thirty-seven superficial gastritis and 12 normal gastric mucosa tissues were chosen as control （control group）. Results The level of miR-455-3p in gastric carcinoma group was 1.16±0.59， lower than 2.61±0.88 in control group with significant difference （P＜0.05）. The gastric carcinoma group’s positive expression rates of VEGF and MVD were 71.3％ （57／80） and 54.9±7.3， higher than 28.6％ （14／49） and 27.5±6.1 in control group with significant difference （P＜0.05）. The miR-455-3p was negatively correlated with VEGF expression （r=-0.783， P＜0.05） and MVD （r=-0.824， P＜0.05） in gastric carcinoma. Conclusion There was a decreased level of miR-455-3p in gastric carcinoma. The miR-455-3p was negatively correlated with VEGF expression and MVD in gastric carcinoma， which may play an important role in the regulation of blood vessel growth.

ObjectiveTo investigate the expression and clinical significance of filamin A（FLNA）in renal cell carcinoma.
MethodsThe immunohistochemistry（SP method）and Western blotting were used to analyze the positive expression rate and level of FLNA on tissue sections from 70 renal cell carcinoma tissues and 38 adjacent tissues. Then the relationships between FLNA expression and clinicopathological variables（sex， age， tumor size， histological type， lymph node metastasis， clinical stage and histological grade）were analyzed.Results The positive expression rate and level of FLNA in renal cell carcinoma tissues were 37.1％（26／70）and 0.27±0.04， lower than 71.1％（27／38）and 0.83±0.08 in adjacent tissues with significant difference（P＜0.05）. The FLNA expression is related with lymph node metastasis， clinical stage and histological grade（P＜0.05）， but not with sex， age， tumor size and histological type（P＞0.05）.Conclusion There was a decreased expression rate and level of FLNA protein in renal cell carcinoma tissues， and its expression was related with lymph node metastasis， clinical stage and histological grade， indicating that FLNA may play an important role in the development of renal cell carcinoma.

Objective To investigate the clinical and prognostic significance of EphA2 expression in diffuse large B-cell lymphoma（DLBCL）.Methods The immunohistochemistry（EnVision method）was applied to detect the protein expression of EphA2 on tissue sections from 72 DLBCL and 10 normal lymph tissues. Then the relationships between EphA2 expression and clinicopathological variables including gender， age， stage， B symptoms， lactate dehydrogenase（LDH）， international prognostic index（IPI） and pathological type were analyzed. The DLBCL patients were followed up for medium progression-free survival（PFS）and overall survival（OS）. Multivariate analysis of these prognostic factors was then performed using the Cox proportional hazards. Results Positive expression rate of EphA2 was 58.3％（42／72）in DLBCL tissues， higher than 20.0％（2／10）of normal lymph tissues（P＜0.05）. EphA2 expression was related with staging and pathological type， but not with sex， age， B symptoms， LDH and IPI（P＞0.05）. The median PFS and OS of 72 DLBCL patients were 15.5 and 22.0 months. LDH was an independent prognostic factor for PFS and OS. IPI only was the independent prognostic factor for PFS， while staging and EphA2 protein expression were independent prognostic factors for OS（P＜0.05）. Conclusion There was a high expression rate of EphA2 protein in DLBCL， and its expression was related with staging and pathological type. The positive expression of EphA2 indicated a poor prognosis for DLBCL.

Objective To explore the expressions of costimulatory molecule B7-H1 in malignant cutaneous tumor tissues and their clinical significance. Methods The expressions of B7-H1 were detected by ElivsionTM plus immunohistochemical technique in tumor tissues from 51 patients with squamous cell carcinoma （SCC group） and 93 patients with non-squamous cell carcinoma. Tissues obtained from 10 patients with actinic keratosis （precancerous lesions group） and 10 patients with benign cutaneous tumors （benign tumor group） were chosen as control. The positive rates of B7-H1 in precancerous lesions group， benign tumor group， SCC group and non-squamous cell carcinoma were analyzed. The relationships between expressions of B7-H1 and clinicopathological characteristics （age， sex， tumor size， tumor location， exposure， location and degree of differentiation） in SCC were investigated. Results The B7-H1 was characterized by diffuse brown staining and mainly expressed in cell membrane and cytoplasm. The positive rates of B7-H1 in precancerous lesions group， benign tumor group and SCC group were 10.0％ （1／10）， 40.0％ （4／10） and 76.5％ （39／51）， respectively. There was no significant correlation between expression of B7-H1 and clinicopathological characteristics. The B7-H1 was also expressed in common epithelial origin non-squamous cell carcinoma， including basal cell carcinoma， sweat gland carcinoma， Paget’s disease， adenoid cystic carcinoma and sebaceous carcinoma with positive expression rates of 81.4％ （35／43）， 70.0％ （7／10）， 100.0％ （3／3）， 100.0％ （2／2）， 100.0％ （1／1） and 76.2％ （16／21）. No expression was observed in the non-epithelial origin bulge fibrosarcoma.Conclusion B7-H1 is involved in the carcinogenesis and development of malignant cutaneous tumor.

Objective To evaluate clinical efficacy and adverse events of oxaliplatin（OXA）-based regimen for patients with sorafenib-resistant advanced primary liver carcinoma. Methods Patients with sorafenib-resistant advanced primary liver carcinoma were treated with FOLFOX 4 or XELOX regimens. FOLFOX regimen was given as follow： OXA 85mg／m2 iv，d1； calcium folinate 200mg／m2 iv， d1， d2； fluorouracil（5-FU）400mg／m2 bolus，d1，d2；5-FU 600mg／m2 civ, d1，d2. Two weeks was a cycle. XELOX regimen was applied as follow： OXA 130mg／m2 iv， d1； capecitabine 1250mg／m2 twice daily with oral administration，d1-d14. Three weeks was a cycle. Tumor evaluation for FOLFOX 4 regimen was performed every 3 cycles and XELOX regimen was every 2 cycles. The time to progression（TTP）and overall survival（OS）were observed. Toxicities were evaluated according to NCI CTC 3.0. Serum α-fetoprotein（AFP）level was also monitored according to the schedule. HBV DNA was monitored for patients with HBV. ResultsThe efficacy of 13 patients could be evaluated. No one achieved CR， PR in 2 patients， SD in 6 patients and PD in 4 patients. The response rate and disease control rate were 15.4％ and 61.5％， respectively. The median TTP was 110 days and the median OS was 225 days. AFP decreased rate was 38.5％. Hepatitis B virus reactivation was observed in 2 patients， and decreased to normal while receiving anti-HBV therapy. The main adverse event is myelosuppression including leucopenia and thrombocytopenia. Other adverse events including nausea， vomiting， liver injury， periphery and neurotoxicity were well-tolerated. Conclusion FOLFOX 4 or XELOX regimen for patients with sorafenib resistant advanced primary liver carcinoma is effective and well-tolerable and further study should be taken to observe.

Objective To evaluate the efficacy and toxicity of modified DCF regimen compared with FOLFOX 4 regimen as the first-line treatment for patients with advanced gastric cancer. Methods Form January 2010 to July 2013， 47 advanced gastric carcinoma patients were enrolled in this study. Twenty-four patients received modified DCF regimen（docetaxel 60mg／m2iv，d1； oxaliplatin 100mg／m2 iv, d1； fluorouracil 400 mg／m2 iv, d1-d2； fluorouracil 600 mg／m2civ 48h， d2-d3； 21 days was a cycle） and 23 patients received FOLFOX 4 regimen（oxaliplatin 85mg／m2 iv，d1； calcium folinate 200mg／m2 iv， d1-d2； fluorouracil 400mg／m2iv， d1-d2； fluorouracil 600 mg／m2 civ 22h； 14 days was a cycle）. The efficacy was evaluated every 6 weeks. The response rate（RR）， disease control rate（DCR）， progression-free survival（PFS）and overall survival（OS）were analyzed between the two groups. Results Efficacy could be evaluated in all patients. Patients in modified DCF group achieved PR in 6 cases， SD in 16 cases and PD in 2 cases with RR of 25.0％ and DCR of 91.6％. Patients in FOLFOX 4 group achieved PR in 2 cases， SD in 16 cases and PD in 5 cases with RR of 8.6％ and DCR of 78.2％. The differences of DCR and RR between the two groups had no significance（P＞0.05）. Meanwhile， the median PFS and OS were 8.2 and 11.5 months in modified DCF group and 5.8 and 10.1 months in FOLFOX 4 group with no significant differences（P＞0.05）. The main toxicities were myelosuppression and digestive tract reaction， mainly in grade 1-2， and the incidence of the two groups had no differences（P＞0.05）. Conclusion There are similar efficacy and toxicities between modified DCF regimen and FOLFOX 4 regimen， which is worth further study.

ObjectiveTo analyze the dosimetric differences and evaluate the clinical efficacy and acute side reaction of box technique and intensity modulated radiation therapy（IMRT）in whole pelvic radiotherapy of stage ⅡB cervical carcinoma. Methods CT simulation was given to 10 pathologically confirmed patients with stage ⅡB cervical carcinoma. 3D TPS was used to make box technique plan and three IMRT plans with different fields’ distribution for each patient. Dose-volume histogram（DVH）was shown to evaluate planning target volume（PTV）and organs at risk（OAR）. A total of 77 patients with stage ⅡB cervical carcinoma from January 2011 to October 2012 were divided into box technique group with 33 patients and IMRT group with 44 patients according to their own wishes， and were treated with box technique or 9-filed IMRT associated with intracavitary irradiation and concurrent chemotherapy consisted of cisplatin per week. Clinical efficacy and acute side reaction were analyzed retrospectively. Results Conformity index（CI） and homogeneity index（HI） in three IMRT plans were better than those in box technique plan（P＜0.05）. V30 and V40 of the bladders， V20， V30， V40， Dmean， D50 of the small bowel， and V30， V40， Dmean， D50 of the rectum in three IMRT plans were lower than those in box technique plan（P＜0.05）. There were no differences in CI and HI of the three IMRT plans. With the increase of the radiation fields in the IMRT plans， V30， V40， Dmean， D50 of the bladder and V20， V30， V40， Dmean， D50 of the rectum were decreased gradually. The differences of V30， V40of bladder were statistically significant（P＜0.05）. Complete remission rate of box technique group was 84.8％，while the ratio of nine-filed IMRT group was 88.6％（P＞0.05）. The incidence of acute radiation enteritis and radiocystitis in 9-filed IMRT group were lower（P＜0.05）. All of the patients suffered bone marrow toxicity， but there was no significant difference between two groups（P＞0.05）.Conclusion Nine-field IMRT is recommended to patients with stage ⅡB cervical carcinoma as the protection for OARs is better both in the comparison of dosimetry and clinical efficacy.

Objective To investigate the expression of DNA excision repair cross-complementing gene 1（ERCC1）in local andvanced nasopharyngeal carcinoma， and to analyze the relationship between the expression of ERCC1 and the efficacy of concurrent radiochemotherapy in the treatment of nasopharyngeal carcinoma. Methods Seventy-six patients with none differentiated and the diversification nasopharyngeal carcinoma by nasopharyngeal neoplasm biopsy accepted single-agent cisplatin（DDP 80mg／m2， intravenous drip） concurrent chemoradiotherapy from January 2010 to December 2010. Radiation therapy was performed with the conventional segmentation illuminate 5/week on d1， d22， d43 with mean dose of 74Gy（70-78Gy） for nasopharyngeal. The curative effects were evaluated and the long-term survival was followed up. Immunohistochemistry was used to detect the ERCC1 protein expression in nasopharyngeal carcinoma tissue. The relationship between the expression of ERCC1 and the sensitivity of concurrent radiochemotherapy and long-term survival rate were analyzed. Results The positive rate of ERCC1 in 76 patients was 42.1％（32／76）. The expression of ERCC1 was related to the T classification and clinical stage（P＜0.05）， but not to gender， age and N staging. The response rates of the ERCC1 positive and negative patients were 75.0％ and 97.7％ with statistical significance（P＜0.05）. Of 72 follow-up cases， the 1-，2-and 3-year survival rates of all were 91.0％，83.3％ and 79.0％ and those for the ERCC1 negative and the positive patients were 92.4％， 87.8％， 80.5％ and 87.9％， 77.4％， 77.4％， respectively. The overall survival（OS） of ERCC1 positive and negative patients had no statistically significant difference（P＞0.05）. The medium OS of ERCC1 positive patients among different classification had statistically significant difference（P＜0.05）.
ConclusionThe ERCC1 expression may be a sensitive prognostic indicator of the concurrent radiochemotherapy in local advanced nasopharyngeal carcinoma.

Objective To investigate the prognosis and related influencing factors for elderly advanced gastric cancer. Methods The data of 174 patients over 70 years with advanced gastric cancer who received chemotherapy from January 2010 and December 2012 was reviewed. Kaplan-Meier method was employed to analyze survival and Cox proportional hazard model was used for multifactor analysis. Results The response rate （RR） was 31.5％（51／162）and the disease control rate （DCR） was 73.5％（119／162）.The median overall survival （OS） was 11.4 months （95％ CI： 10.4-12.4） and the 1-， 2-year survival rates were 39.0％ and 17.0％. The RR and median OS of 2-drug therapy were better than those of monotherapy （35.8％ vs. 17.9％， P=0.037； 14.1months vs. 7.5 months，P=0.010）， but the difference of DCR had no significance （P＞0.05）. The median OS of patients receiving chemotherapy of 1-2， 3-4 and ＞5 cycles were 7.7， 13.1 and 21.5months （P＜0.001）. The median OS of receiving first-line therapy alone was shorter than those receiving second-line after disease progression （10.7 months vs. 16.7 months， P=0.006）. Cox regression model showed that ECOG score， number of metastatic lesions， CEA， CA19-9， lactate dehydrogenase， chemotherapy cycles and the second-line chemotherapy were the independent prognostic factors influencing prognosis. Conclusion Multiple cycles of chemotherapy and the application of second-line chemotherapy after disease progression may improve the prognosis of elderly patients bearing advanced gastric cancer.

Objective To explore the influences of different methods of nasal irrigation on long-term survival， incidence of sinusitis and quality of survival of patients with nasopharyngeal carcinoma （NPC）. Methods According to the random number table， 1134 patients with NPC from July 2008 to December 2012 of our hospital were randomly assigned to receive nasal irrigation by nasal wash machine （group A）， homemade nasal irrigation fittings combined with enemator （group B） or nasal spray （group C） with 378 for each. All patients were followed up for long-term survival and the acute adverse reactions were recorded. The Sino-Nasal Outcome Test 20 was employed to investigate the quality of survival before treatment （T0） and at 6th month （T1）， 1st year （T2）， 2nd year （T3） and 3rd year （T4） after treatment， respectively. Meanwhile， the incidence of sinusitis was recorded. Results All patients were followed up for 3 to 92 months with 5-year overall survival rate and progression-free survival rate of 80.5％ and 73.2％. No significant differences were observed among three groups on overall survival， progression-free survival and incidences of salivary gland and neck skin damage. The incidence of grade 3／4 oropharyngeal mucosa damage of group C was higher than those of other two groups with significant difference （P＜0.05）. The incidences of sinusitis at T0， T1， T2， T3 and T4 were 41.7％， 56.3％， 74.0％， 54.1％ and 69.6％. The incidences of sinusitis at T2， T3 and T4of Group A were lower than other two groups （P＜0.05）. There were a lower incidence at T2 and a higher incidence at T4 in Group B versus Group C （P＜0.05）. The sinusitis symptom scores at T1 and T2 were lower than those at T0 in all three groups （P＜0.05）， while only the Group C’s sinusitis symptom scores were lower at T3 and T4 than T0 （P＜0.05）. The Group C’s sinusitis symptom scores were lower than other two groups at T2 and T4 （P＜0.05）.Conclusion Different methods of nasal irrigation had no influence on the long-term survival of patients with NPC. Nasal spray can increase the risk of oropharyngeal mucosa damage with a worst quality of survival during the follow-up.

Objective To evaluate the efficacy and toxicity of pemetrexed combined with cisplatin as second-line treatment in advanced gastric cancer. Methods Forty-six patients with advanced gastric cancer who had previously failed to first-line chemotherapy from December 2011 to February 2013 received pemetrexed （500mg／m2 iv， d1） combined with cisplatin （25mg／m2 iv， d1-d3） as second-line treatment. Twenty-one days was a cycle. The response evaluation criteria in solid tumors （RECIST） 1.0 was employed to evaluate the short-term efficacy and calculated the response rate （RR） and disease control rate （DCR）. The toxicity was evaluated using NCI CTC 3.0 criteria. Progression-free survival （PFS） and overall survival （OS） were calculated from the date of follow-up.Results Forty-six patients were evaluable for short-term efficacy. There were 10 cases of partial response， 12 of stable disease and 24 of progressive disease with RR of 21.7％ and DCR of 47.8％. The follow-up ranged from 3 to 20 months. The median PFS and OS were 3.5 and 8.4 months， respectively. The KPS was 77.6±4.3 after chemotherapy， higher than 65.7±5.0 before chemotherapy， but there was no significant difference on painkiller usage before and after chemotherapy. The major side effects were grade 1-3 marrow toxicities and gastrointestinal response. The incidence of grade 4 side effect was rare with only one case of grade 4 leukopenia. Two cases were grade 1 abnormal liver function. There was no renal dysfunction， fever， rash and chemotherapy-related deaths. Conclusion Pemetrexed combined with cisplatin as second-line treatment in advanced gastric cancer showed a good effect with mild toxicities and good tolerance.

Objective To analyze the diagnostic process of a rare case diagnosed of myeloid／nature killer cell precursor acute leukemia（M／NKPAL）and to improve the recognition of M／NKPAL. Methods Cell morphology was analyzed by marrow smear and related cell chemical staining. Immunophenotyping of blast cells was performed by flow cytometry. Cytogenetics technique was used for karyotype analysis. PCR was applied for detection of T-cell recepter gene rearrangement or fusion gene associated with leukemia. The related articles were reviewed. Results With regard to morphology， most of leukemic cells demonstrated that 90.4％ blasts in the bone marrow were generally L2-shaped with negative reactivity of myeloperoxidase staining and Auer’s rods were occasionally found. Expression of CD34， HLA-DR，CD33，CD7，CD56，CD38 and cyCD3（dim），but no other markers including cyMPO，CD3 and CD4 were observed. Cytogenetics examination revealed abnormal karyotype. Clonal T-cell recepter gene rearrangement and fusion gene were not detected.Conclusion M／NKPAL is considered extremely rare and diagnosis is difficult depending merely on the morphology. It is important to be distinguished from T-cell acute lymphoblastic leukemia with expression of myeloid-antigen， acute myeloid leukemia with minimal differentiation， mixed-phenotype acute leukemia with T／myeloid lineage and blastic NK cell leukemia／lymphoma.

Non-small cell lung cancer （NSCLC） accounts for about 80％-85％ of lung cancer. The main treatment of advanced NSCLC is medical treatment such as chemotherapy which shows poor efficacy. Recently， epidermal growth factor receptor-tyrosine kinase inhibitor （EGFR-TKI） in the treatment of patients with advanced NSCLC has made a new breakthrough. Icotinib as a domestic EGFR-TKI， preclinical studies and clinical studies show that it has promising safety， tolerability and efficacy in patients with advanced NSCLC.

The expressions of estrogen receptor，progesterone receptor and human epidermal growth factor receptor 2 are not only closely associated with the prognosis of breast cancer， but also can be served as targets for breast cancer therapy. Recent studies have found that androgen receptor（AR）is associated with the occurrence， development， relapse and metastasis， as well as the prognosis and outcome in breast cancer， and may be a prognostic predictor. Currently， AR in breast cancer is becoming a hot spot. In this paper， we make a preliminary discussion on relationship between AR and breast cancer.

The occurrence of tumor is not only closely related to a variety of carcinogenic factors from outside，but also keeps a close relationship with the body’s own immune response and genetic factors. B7-H4，a newly discovered immune regulatory proteins members of the family of B7， over-expresses in a number of malignant tumors. It acts as the second signal in the immune response， regulates immune activity and promotes the occurrence， development and prognosis of tumors. As described below，we discussed structure， function of molecules B7-H4 and its new progression with gynecologic malignant tumors.