Chinese Clinical Oncology

Efficacy and safety of oxaliplatin-based chemotherapy for advanced primary hepatic carcinoma： A systemic review and meta analysis of prospective studies

LIU Lin， ZHENG Yinghui， HAN Li， QIN Shukui

Chinese Clinical Oncology. 2015, 20 (9): 769.

Abstract ( 771 )

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Objective To systemically evaluate the efficacy and safety of oxaliplatin （OXA）based systemic chemotherapy regimens for advanced primary hepatic carcinoma，mainly hepatocellular carcinoma（HCC）. Methods The original articles were searched from PubMed，the Cochrane Library，EMBASE，Web of Science，CNKI，CBM and CECDB from inception to April 2015.Then we recruited the articles about OXA-based chemotherapy regimens for HCC，and evaluated the quality of literature. Finally we carried out a meta analysis of the eligible articles using Stata12.0. Results Twelve study reports， including 600 patients were recruited in this study. The results of meta analysis showed that OXAbased chemotherapy regimens had certain curative effect on advanced HCC patients. The overall response rate（RR）was 14.0 ％（95％CI：9.5％185％）. The median progression free survival （PFS）／median overall survival（OS）was 4.7／9.5 months，with 1 year progression free survival rate／1 year survival rate were 19.0％／35.6％. The common moderate-severe （grade 3／4） toxicities were neutropenia （16.6％）， thrombocytopenia （8.7％）， anemia （5.4％），neurotoxicity（4.9％），nausea／vomiting （1.8％） and diarrhea （2.9％）. In the subgroup analysis，RR of Asian and Western patients were 13.9％（95％CI：8.1%-19.7％） and 14.2％（95％CI：5.3％-23.1％）respectively. In Asian studies，the median PFS/median OS and 1 year progression free survival rate／1 year survival rate were 3.0／9.4 months and 12.9％／30.3％ respectively. In Western studies， median PFS／OS and 1 year progression free survival rate／1 year survival rate were 4.7 months／9.5 months and 20.0％／42.4％ respectively. RR，1 year progression free survival rate and 1 year survival rate of OXA-based systemic chemotherapy regimens for advanced HCC had no significant difference（P＞0.05） between Asian and Western patients. Conclusion OXA-based systemic chemotherapy regimens are effective and safe for advanced HCC. It indicates that OXAbased systemic chemotherapy is a good and viable option for patients with advanced HCC.

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Reversal effect of miR-490-3p on the resistance of MCF-7／ADM cells to adriamycin

WANG Xiaoxian， KONG Fanjun， LI Fei， ZHANG Shuo

Chinese Clinical Oncology. 2015, 20 (9): 780.

Abstract ( 696 )

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【Abstract】Objective To investigate the expression of miR-490-3p in adriamycin（ADM）resistant human breast cancer cell line MCF-7／ADM and its effect on the cell proliferation，apoptosis and resistance to ADM of MCF-7／ADM cell line. Methods Cultured wild-type MCF-7 human breast cancer cells and its resistant cells MCF-7／ADM were selected as research objectives. The realtime fluorescent quantitative PCR（qPCR）was used to compare the level of miR-490-3p in both cell lines. The recombinant plasmid pcDNA3.1（+）miR-490-3p to over-express miR-490-3p was transiently transfected into MCF-7／ADM cells（overexpression group）and then the transfection effect was verified by qPCR. Meanwhile，the pcDNA3.1（-）empty control group and blank control group were set up. MTT method was used to determine the effect of pcDNA3.1（+）miR-490-3p on the proliferation of each group. The inhibitory rate of ADM on the proliferation of MCF-7／ADM cells was determined, and the inhibition concentration （IC50） and the reversal factor were calculated to evaluate the sensitivity to ADM. The cells in each group were collected at 48 h post-transfection for the detection of apoptotic rate by flow cytometry with Annexin FITC／PI double staining. Meanwhile, the expression of resistance proteins including P-glycoprotein（P-gp），breast cancer resistance protein （BCRP）and multidrug resistance associated protein 1（MRP1）were tested by Western blotting，intracellular ADM concentration was detected by fluorescence photometer and Pgp activity by flow cytometry. Results The level of miR-490-3p in MCF-7／ADM cells was 0.24±0.07，significantly lower than 1.02±0.03 of wild type MCF-7 cells（P＜005）. The levels of miR-490-3p in the overexpression group were higher than those in the other two groups during 24-96 h post-transfection（P＜005）. The proliferation inhibition rates were（17.52 ±1.87）％，（31.67±2.79）％，（45.09±1.88）％ and（61.82±2.52）％ at 48，24，72 and 96 h post-transfection， all higher than those of empty control group（P＜0.05）. IC50 value of ADM for MCF-7／ADM cells was（11.27±2.34）μg／ml，lower than that of blank control group and empty control group（P＜0.05）. Moreover，reversal index was 3.35and 3.39fold of blank control group and empty control group for the overexpression group. Compared with the other two groups，there were increased apoptotic rates and intracellular drug concentration but decreased expression of P-gp，BCRP and MRP1 as well as P-gp activity in over-expression group （P＜0.05）.Conclusion Upregulation of miR-490-3p exhibits the reversal effect of resistance to ADM in MCF-7／ADM cell，possibly by reducing the resistance gene protein expression and inhibition of P-gp activity. Elevated level of miR-490-3p can inhibit proliferation and induce apoptosis.

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Experimental study on hepatocelluar carcinoma cell line HepG2 by sorafenib，oxaliplatin monotherapy or combination therapy

XU Haijun， HUA Haiqing， LI Wenming， CHEN Yu， YANG Honghong， HAN Shuzhen， CHEN Huiying， YANG Aizhen

Chinese Clinical Oncology. 2015, 20 (9): 787.

Abstract ( 820 )

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【Abstract】Objective To observe the effect of sorafenib，oxaliplatin alone or in different combination on the proliferation，migration and invasion of human hepatic carcinoma cell line HepG2. Methods Human hepatic carcinoma cell line HepG2 was chosen and divided into 6 groups： oxaliplatin group （0.5 μg／ml，O），sorafenib group（2.0 μmol／L，S），combination group（oxaliplatin 0.5 μg／ml，sorafenib 2.0 μmol／L； O+S），oxaliplatin sequent by sorafenib group （oxaliplatin 0.5 μg／ml，sorafenib 2.0 μmol／L；OS），sorafenib sequent by oxaliplatin group（sorafenib 2.0 μmol／L，oxaliplatin 0.5 μg／ml；SO），and the negative control group（100 μl common culture，C）. MTT method， immunofluorescence technique，flow cytometry， migration experiment，and invade experiment were used to observe sorafenib，oxaliplatin alone or in different combination on the proliferation， invasion and metastasis of HepG2 cells. Results The results determined by MTT method showed that the treatment groups significantly inhibited the proliferation of HepG2 cells after 48 h. Cell inhibition rate of O+S group was （72.13±0.99）％，which was significantly higher than that of O，S groups and SO group（P＜0.01）， except OS group. Flow cytometry and fluorescence microscopy analysis showed that the apoptosis rate of HepG2 cells in O+S group was the highest（65.33％）at 48 h，but it had no significant difference compared with OS group（P＞0.05）. Cell migration experiment showed that the inhibition rate of cell migration in O+S group was（71.67±6.66）％，which was significantly higher than that of O，S groups and SO group（P＜0.01），except OS group. O+S group and OS group exhibited synergistic effect of both sorafenib and oxaliplatin （P＜0.01），while SO group showed additive effect（P＜0.05）. Cells invade experiment showed that cell invasion inhibition rate of O+S group was（76.00±5.57）％，which was significantly higher than that of O，and S groups（P＜0.01）. There were two drugs synergistic effect in O+S group and OS group. Conclusion Compared with single drug of sorafenib or oxaliplatin，the inhibition of proliferation, migration and invasion of HepG2 cells treated by combination and sequential application of sorafenib，oxaliplatin are higher. The synergistic effect is similar between oxaliplatin sequent by sorafenib and sorafenib in combination with oxaliplatin，which are better than sorafenib sequent by oxaliplatin.

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Effect of microRNA-545 on the proliferation and apoptosis of cervical cancer Hela cells

YAN Feng， XI Yanni

Chinese Clinical Oncology. 2015, 20 (9): 793.

Abstract ( 703 )

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【Abstract】Objective To investigate the expression of microRNA-545（miR-545）in cervical cancer tissues and cell lines as well as its effect on the biological behavior of cervical cancer Hela cells. Methods The real time quantitative PCR（qPCR）was used to detect the level of miR-545 in 52 cases of cervical cancer，30 cases of cervical intraepithelial neoplasia（CIN）and 25 cases of normal cervical tissues. The relationship between miR-545 expression and clinical pathological parameters of cervical cancer was analyzed. The expression of miR545 in cervical cancer cell lines（Siha，Hela，CaSki，C33a）and normal epithelial cells was also detected. The miR545 expression vector pcDNA6.2／GW／EmGFP-miR-545 was transfected into cervical cancer cells with the lowest level of miR-545(overexpression group). Meanwhile, the pcDNA6.2/GM/EmGFP-miR empty control group and black control group were set up. The proliferation level（methylthiazolyl tetrazolium），apoptosis（flow cytometry with Annexin V／PI double staining） and cell cycle（flow cytometry with PI staining）of Hela cells were analyzed.
Results The relative level of miR-545 was 0.245±0.051 in cervical cancer tissues，lower than 0.761±0.073 in CIN tissues and 1.027±0.024 in normal cervical tissue with statistical significance（P＜0.05）. The miR-545 level in cervical cancer tissues was associated with clinical stage，differentiation degree and lymph node metastasis（P＜0.05）. Compared with normal cervical cells，the miR-545 levels of cervical cancer cells were decreased，which were followed by CaSki，C33a，Siha and Hela cells. Compared with empty control group and blank control group，the cell proliferation inhibition rate，apoptosis rate and the percentage of G0／G1 phase cells were increased but the proportion of S and G2／M phase cells were decreased in over-expression group with statistical difference（P＜0.05）. Conclusion miR-545 is low expressed in cervical cancer tissues and cells，and up-regulation of miR-545 exhibited the effect of inhibiting proliferation,inducing apoptosis and arresting cell cycle，which has certain value in the prevention and treatment of cervical cancer.

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Expression and clinical significance of Snail and E-cad in metaplastic breast cancer

GAO Yue， LU Yajing， MIAO Yang， MA Changying， SUN Minghua， WU Xu， LI Dingnan， Gao Jing， ZHANG Qingyuan

Chinese Clinical Oncology. 2015, 20 (9): 799.

Abstract ( 728 )

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Objective To investigate the expression of Snail and E-cadherin（E-cad）in metaplastic breast cancer（MBC）tissues as well as their relationship with clinicopathological parameters. Methods The expression of Snail and Ecad in 58 cases of MBC were detected by immunohistochemical SP method. The corresponding clinical data were collected and then the relationship of Snail，E-cad expression and the pathological parameters of MBC were analyzed. The relationship between the Snail，E-cad expression and recurrence／metastasis were analyzed according to the follow-up data. Results In these 58 MBC patients，Snail was expressed in 45 cases（77.6％）and E-cad was expressed in 28 cases（48.3％）. The expression of Snail was associated with clinical stage，lymph node metastasis and ER expression（P＜0.05）. The expression of E-cad was associated with histological grade and lymph node metastasis（P＜0.05）. The two proteins had no relationchip with age, tumor size, menopausal status, HER-2 expression and pathological types（P＞0.05）. The expression of Snail and Ecadherin had a negative association （r=-0.308，P=0.019）. In MBC，both of them had relationship with local recurrence and distant metastasis（P＜0.05）.
Conclusion Snail and E-cadherin may have the ability to recognize the tent of malignancy and invasion of MBC，which may be potential treatment target in MBC.

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Expression of ubiquitin ligase Hrd1 and LAT1 in gastric carcinoma and their significance

PENG Junlu， SHI Lianghui

Chinese Clinical Oncology. 2015, 20 (9): 804.

Abstract ( 774 )

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【Abstract】Objective To investigate the expressions of ubiquitin ligase Hrd1 and L-type amino acid transporter 1（LAT1）in gastric carcinoma tissues and their clinical significance. Methods The expression of Hrd1 and LAT1 in 62 samples of gastric carcinoma and adjacent normal tissues was detected by immunohistochemical SP method，RT-PCR and Western blotting. Results The positive expression rate of Hrd1，LAT1 protein in gastric carcinoma tissues was 54.8％（34／62）and 564％（35／62），higher than 25.0％（5／20）and 20.0％（4／20）of adjacent normal tissue with significant differences（P＜0.05）. The expression of Hrd1 in gastric carcinoma tissues was only related with tumor size，and LAT1 expression was related with tumor size and clinical stage（P＜0.05）. RT-PCR showed that the quantitive expression of Hrd1 and LAT1 were 4.22±0.83 and 5.80±1.72 of grastric carcinoma tissue, higher than 1.14±0.39 and 1.32±0.77 of adjacent normal tissue（P＜0.05）. Western blotting showed that the quantitive expression of Hrd1 and LAT1 were 0.855±0.153 and 0.896±0.148, higher than 0.357±0.178 and 0.439±0.136 of adjacent normal tissue（P＜005）. There was a positive correlation between the expression of Hrd1 and LAT1 in gastric carcinoma（r=0.820，P＜0.001）. Conclusion Hrd1 and LAT1 are highly expressed in gastric carcinoma. They may play an important role in the occurrence and development of gastric carcinoma.

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The correlation of Helicobacter pylori infection and expression of HIF-2α，ABCG-2 in gastric cancer tissues

REN Panpan， FENG Yuguang， GUO Wenjun， YUAN Mingliang， GUI Zhongna

Chinese Clinical Oncology. 2015, 20 (9): 808.

Abstract ( 765 )

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【Abstract】Objective To study the helicobacter pylori（Hp）infection and the expression of hypoxiainducible factor-2α(HIF-2α）and ABCG-2 in gastric cancer tissues and discuss Hp infection in the initiation and development of gastric cancer as well as chemotherapy resistance induction. Methods Hp infection was identified by rapid urease test and immunocytochemistry in gastric cancer（n=60）and chronic gastritis（n=45）. Immunohistochemistry was used to detect the expression of HIF-2α and ABCG2 proteins in gastric cancer tissue. Results Hp positive rate of gastric cancer group（67.3％） was higher than that of chronic gastritis group（45.2％）with statistic significance（P=0.029）. Hp infection was correlated with the depth of infiltration and lymph node metastasis（P＜0. 05），but not with gender，age，tissue differentiation and distant metastasis（P＞0.05）. The positive rate of HIF2α protein in Hp（+）and Hp（-）gastric cancer tissues were 81.1％ and 50.0％. Hp infection and the expression of HIF-2α protein in gastric cancer tissues was positively correlated（r=0.321，P=0.017）. The positive rate of ABCG-2 protein in the Hp（+）and Hp（-）gastric cancer tissues were 86.5％ and 55.6％. Hp infection and the expression of ABCG-2 protein in gastric cancer tissues was positively correlated（r=0.342，P=0.011）. The expression of HIF-2α was positively correlated with ABCG-2 in Hp（+）gastric cancer tissue（r=0.604，P＜0.0001）. Conclusion Hp can stimulate the expression of HIF-2α and ABCG-2 in gastric cancer tissues by activating HIF-2α-ABCG-2 pathway，suggesting that Hp may play an important role in inducing stem cellularization of gastric cancer cells and chemotherapy resistance.

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Long-term outcome and prognostic factor analysis in 195 cases of nasopharyngeal carcinoma treated by intensity-modulated radiotherapy

XU Lixian， HUANG Shengfu， CHEN Yanan， HE Xia， ZHANG Yiqin， WANG Lijun

Chinese Clinical Oncology. 2015, 20 (9): 813.

Abstract ( 877 )

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【Abstract】Objective To investigate the long-term outcome and prognostic factors of nasopharyngeal carcinoma patients（NPC）treated with intensitymodulated radiotherapy（IMRT）. Methods The clinical results of 195 newly diagnosed NPC patients treated by IMRT from March 2005 to May 2010 were reviewed. According to the standard of NPC 2008 staging system，there were 9 cases of stageⅠ，24 cases of stage Ⅱ，70 cases of stage Ⅲ and 92 cases of stage Ⅳ. Survival analysis was performed with Kaplan-Meier method. Logrank test was used for evaluating the differences between groups. Multivariate prognostic factors were analyzed by Cox regression model. Results The followup rate was 995％. There were 150 patients followed-up more than 5 years. The 5-year local control rate（LCR），distant metastasis-free survival rate（DMFSR），overall survival rate（OSR）and disease-free survival rate(DESR)were 89.2％，81.9％，76.9％ and 66.2％，respectively. Multivariate analysis showed that the independent prognostic factors for 5-year OSR，DMFSR and DFSR were T stage，N stage and the combination with chemotherapy. Gender is an independent prognostic factor for 5-year DMFSR and DFSR. Conclusion NPC treated by IMRT can get good long-term survival with high quality of life. T stage，N stage and gender are important independent prognostic factors for NPC treated by IMRT. The role of combined chemotherapy for locally advanced NPC treated by IMRT needs further investigation.

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Multicenter phase Ⅱclinical trial of -NC injection in the treatment of malignant tumors

ZHANG Weijing， KE Xiaoyan， WANG Jiejun， WANG Mei， ZHU Jun， ZHANG Shucai， ZHANG Qiaohua， YU Ding， RAO Zhiguo， YU Shiying， XIE Conghua

Chinese Clinical Oncology. 2015, 20 (9): 819.

Abstract ( 876 )

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【Abstract】Objective To investigate the clinical efficacy，safety and life quality improvement of recombinant mutant humanNC（rhTNF-NC）in the treatment of malignant tumors or pleural effusions and ascites. Methods A total of 320 patients with malignant tumors or pleural effusions and ascites were enrolled into this multicenter，open and nonrandomized phase Ⅱ clinical trial，including malignant lymphoma（n=71）， malignant pleural effusions and ascites（n=169），malignant melanoma（n=18），lung cancer（n=20），liver cancer（n=12），breast cancer（n=10），colon cancer（n=7）and renal cell carcinoma（n=3）. For malignant tumors，rhTNF-NC was intravenously dropped at a dose of 600-900 KU／m2 every day for 28 days. For malignant pleural effusions and ascites，rhTNF-NC was infused intralpeurally at a dose of 2000-3000 KU a time，1-2 times per week for 2-3 weeks. For melanoma，intratumor injection was combined with intravenous injection at a dose of 500-1000 KU／time，2-3 times per week. Results Three hundred and ten patients could be evaluated，including 169 cases of malignant pleural effusions and ascites，and 141 cases of solid tumors. In solid tumor patients，2 cases got CR，21 in PR， with reponse rate（RR）of 16.3％（23／141） and disease control rate（DCR） of 79.4％（112／141）. The malignant lymphoma's RR was 28.2％（20／71），and DCR was 84.5％（60／71）. Malignant melanomas RR was 11.1％（2／18），and DCR was 83.3％（15／18）. In lung cancer，no one got CR，1 in PR，and 2 in MR. 1 case of MR was in renal cell carcinoma. It showed no significant effect in liver cancer，colon cancer and breast cancer. In malignant pleural effusions and ascites，15 got CR，102 in PR with RR of 69.2％（117／169）and DCR of 98.8％（167／169）. Among them，the malignant pleural effusionss RR was 74.5％（105／141），and the malignant ascitess RR was 42.9％（12／28）.The KPS score of the whole group increased significantly after treatment（P=0.013），especially in the subgroup of malignant pleural effusion patients. The major adverse reaction was fever（38.8％）and shiver（23.5％） mainly in grade 1 and 2. Conclusion The rhTNF-NC injection is effective in the control of various malignant tumors and malignant pleural effusions and ascites，with mild and tolerable adverse effects，and can dramatically improve the patients'quality of life.

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Clinical significance of ALK protein positive expression in 141 patients with non-small cell lung cancer

WANG Jian，WU Gang，LIU Jun，ZHANG Sheng，ZHANG Ruiguang

Chinese Clinical Oncology. 2015, 20 (9): 825.

Abstract ( 686 )

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Objective To investigate the clinicopathological features of anaplastic lymphoma kinase（ALK）protein positive expression in nonsmall cell lung cancer（NSCLC）patients. Methods The expression of ALK protein was detected in 141 cases of NSCLC by immunohistochemistry（IHC）. The data of clinicopathological features of patients with ALK positive expression was collected and analyzed. Results The positive rate of ALK protein in NSCLC was 9.2％（13／141）.The positive rate was closely associated with age and epidermal growth factor receptor（EGFR） mutation（P＜0.05），but not correlated with sex，smoking，drinking，histopathology，primary site，lymph node metastasis and the expression of thyroid transcription factor-1（P＞0.05）. Conclusion Young age（≤57 years），EGFR negative patients with NSCLC are recommended the detection of ALK.

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Comparison of hemodynamics of primary and metastatic small hepatic carcinomas on contrast-enhanced ultrasonography

LV Xiaoping， SI Qin， QIAN Xiaoli， CHEN Mingyue， FENG Nian， TANG Shengying

Chinese Clinical Oncology. 2015, 20 (9): 829.

Abstract ( 796 )

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Objective To analyze the hemodynamics of primary and metastatic small hepatic carcinomas on contrast-enhanced ultrasonography.
Methods Totally，210 primary and 93 metastatic small hepatic carcinoma lesions were examined by contrast-enhanced ultrasound. The enhancement patterns on the arterial，portal and delayed phases between the two groups were summarized. Results（1）In 303 small primary hepatic carcinoma lesions，contrast-enhanced ultrasound showed rapid enhancement in the arterial phase，and clearance in the portal and delay phase. While dynamic contrast-enhanced ultrasonography displayed that the enhancement peak time and the time from clearance of enhancement echo to hypoecho of metastatic small hepatic carcinoma were obviously earlier than those of primary hepatic carcinoma（P＜0.05）.（2） Contrast-enhanced ultrasound showed that 95.7％（201/210）of primary small hepatic carcinoma and 23％（2/93） of metastatic small hepatic carcinoma in the arterial phase were hyperechoic（P＜0.05），while hemodynamic changes of primary and metastatic small hepatic carcinomas had no statistical difference（P＞0.05）in the portal and delayed phase.（3）On the arterial contrast enhancement pattern，93.4％（196／210）lesions of primary small hepatic carcinoma showed overall uniformity，while that in metastatic small hepatic carcinoma was 35.5％（33／93）with statistic significance（P＜0.05）. And 54.8％（51／93）lesions of metastatic small hepatic carcinoma showed peripheral annular enhancement or irregular enhancement，much higher than 5.2％（11／210）in primary small hepatic carcinoma （P＜0.05）. Conclusion Metastatic and primary small hepatic carcinomas present hyper-enhancement in the arterial phase of contrastenhanced ultrasound. However，they are different at enhancment pattern and the time from clearance of enhancement echo to hypoecho. Contrast-enhanced ultrasound has an important clinical value for diagnosis and differential diagnosis of primary and metastatic small hepatic carcinomas.

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Curative effects on breast cancer with brain metastasis treated by sodium glycididazole in combination with radiotherapy

GAO Huiquan，FAN Xiaoyi，DONG Guizhi，DU Zhaohui，LIU Jingjun，WANG Ling，MA Xuezhen

Chinese Clinical Oncology. 2015, 20 (9): 833.

Abstract ( 709 )

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Objective To observe the efficacy and safety of sodium glycididazole（CMNa） in combination with radiotherapy on breast cancer with brain metastasis. Methods Thirty-six breast cancer patients with brain metastasis were enrolled in this study. Sixteen patients were treated with CMNa+radiotherapy（CMNa group），and 20 patients were treated with radiotherapy alone（radiation group）. The total dosage of radiation was 40 Gy／20 f，or 30 Gy／10 f. CMNa was taken 800 mg／m2 three times a week. The response rate（RR），median intracranial progression-free survival（PFS）and side effects were analyzed. Results The RR of CMNa group was 87.5％，and 50.0％ in radiation group，with significant differences（P＜0.05）. The median intracranial PFS of CMNa group was 9.9 months，and 5.3 months in radiation group，with significant differences（P＜0.05）.The main side effects of the two groups were hair loss，headache，nausea/vomitting and leukopenia of grade 1-2（P＞0.05）. Conclusion CMNa in combination with radiotherapy is a feasible and effective treatment for breast cancer with brain metastasis without increase in side effects.

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Clinical observation of 18 cases of adult rare liver tumors or tumorlike lesions

LI Zengcai， ZHANG Bin，WANG Xuan， LIU Xianzhong，WANG Bingji

Chinese Clinical Oncology. 2015, 20 (9): 837.

Abstract ( 780 )

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Objective To investigate the diagnosis and treatment of adult rare liver tumors or tumor-like lesins. Methods The clinical data of 18 cases of rare liver tumors or tumor-like lesions were collected from June 2009 to May 2015. The clinical diagnosis and treatment of various types of liver tumors or tumor-like lesions were analyzed retrospectively. Results In 18 cases of adult rare liver tumors or tumor-like lesions，there were 2 cases of fibrous tumor，3 cases of adenoma，4 cases of focal nodular hyperplasia，2 cases of carcinosarcoma，2 cases of liver hamartoma，2 cases of inflammatory pseudotumor，1 case of spindle cell tumor，1 case of primary malignant liver mesenchymal tumor，and 1 case of hepatic tuberculosis. Imaging misdiagnosis occurred in 8 cases, and the diagnostic accuracy of benign and malignant lesions was 50%.CA19-9 was significantly increased（246.4 kU／L）in 1 cases of inflammatory pseudo tumor，and the tumor markers were normal in other cases. One adenoma case underwent radiofrequency ablation and one hepatic tuberculosis case did not undergo tumor resection and other cases underwent liver lesions complete resection（including local resection and hepatic segmental resection）. Conclusion The rare liver tumors are difficult to diagnose preoperatively，and the misdiagnosis rate is high. Diagnosis is mainly based on the pathological indicators. Surgery is the main therapy for rare liver tumors or tumor-like lesions.

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Expert consensus on the clinical practice of apatinib in the treatment of gastric cancer

ASMC

Chinese Clinical Oncology. 2015, 20 (9): 841.

Abstract ( 676 )

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Re-recognition of treatments in patients of non-small cell lung cancer harboring EGFR-TKI resistance

HE Yuan， YOU Changxuan

Chinese Clinical Oncology. 2015, 20 (9): 848.

Abstract ( 723 )

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Globally，lung cancer is the leading cause of cancerrelated death with high morbidity, mortality and poor prognosis. The epidermal growth factor receptor-tyrosine kinase inhibitor（EGFR-TKI），a means of molecularly targeted therapy，offers a novel approach for the treatment of patients with NSCLC harboring EGFR mutation effectively. However，the problem of EGFRTKI resistance exists inevitably. A number of promising strategies based on different mechanisms have now been evaluated in phase Ⅰ／Ⅱ trials. These include EGFR-TKI discontinuation，EGFR-TKI continuing，EGFR-TKI+local treatment，EGFR+other molecularly targeted drugs，EGFR-TKI+chemotherapy，EGFR-TKI rechallenge，chemotherapy，chemotherapy+other molecularly targeted drugs and EGFR-TKI+immunotherapy. The purpose of this paper will draw a summary on the progress of treatments in patients with NSCLC harboring EGFR-TKI resistance.

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Emerging role of long non-coding RNA in gastric cancer

LIAN Yifan， DING Jie， WANG Keming

Chinese Clinical Oncology. 2015, 20 (9): 852.

Abstract ( 821 )

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Gastric cancer（GC），as the most common malignancy，is one of the major causes of cancer-related mortality worldwide. While the molecular mechanisms of GC，chemoresistance， early diagnosis and clinical outcome are still poorly understood. Recent studies have demonstrated that long non-coding RNAs（lncRNAs）are closely associated with the development and progression of various cancers，especially in GC. Dysregulation of lncRNAs is closely related to GC cell proliferation，metastasis，drug resistance, tumor marker discovering and prognosis prediction. The aim of this review is to discuss current and emerging lncRNA in GC.

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标准刊号：	ISSN 1009-0460
	CN 32-1577/R