简介：六不同治疗在与变形阉割抵抗的前列腺癌症(mCRPC)指向到病人的阶段III试用表明了改进幸存。为mCRPC的前线的治疗学的选择包括docetaxel，sipuleucel-T，abiraterone和radium-223。Post-docetaxel选择包括cabazitaxel，abiraterone，enzalutamide和radium-223。尽管有最近的年里的许多进步，多是还未知的，争论发生在最佳的治疗选择和序列上。任何一个新代理人都没与对方相比，因此，在今天的实践的医生必须基于非使随机化的比较，毒性考虑和各种各样的假设做选择。Abiraterone现在正在移动直到给最近的规章的赞同的前面线mCRPC空间，enzalutamide将很快列在后面。当时，两个神经质的代理人有更少的毒性与化学疗法的选择和这两个神经质的代理人相比被期望向前在年里在mCRPC病人的一个可观的数字被过去常。很少数据都不为post-abiraterone或post-enzalutamide背景是可得到的。在这评论，当前可得到的定序数据被总结并且解释。生气抵抗是在各种各样的治疗之间的一个潜在的问题，现在是清楚的，特别指向雄激素轴的那些代理人。这评论加亮需要让另外的研究为这些病人优化当前的治疗。

简介：Gastrointestinalmetastasisfromprimarylungcancerisrare.Inthepresentstudy,wereportthecaseofa78-year-oldmalewhowasadmittedtotheemergencydepartmentwithacutebleedingofthedigestivetract.Duringevaluation,hewasfoundtohavelungadenocarcinomametastasisinthesmallbowelleadingtohemorrhage.Ajejunumwedgeresectionwascarriedoutandbleedingwascontrolled.However,2monthsaftertheoperation,thepatientthedfromseverepulmonaryinfection.Wealsoreviewthepublishedliteratureofprimarylungcancerwithgastrointestinalmetastasis.

简介：Melanomaisthedeadliestformofskincancerandhasanincidencethatisrisingfasterthananyothersolidtumor.Metastaticmelanomatreatmenthasconsiderablyprogressedinthepastfiveyearswiththeintroductionoftargetedtherapy(BRAFandMEKinhibitors)andimmunecheckpointblockade(anti-CTLA4,anti-PD-1,andanti-PD-L1).However,eachtreatmentmodalityhaslimitations.Treatmentwithtargetedtherapyhasbeenassociatedwithahighresponserate,butwithshort-termresponses.Conversely,treatmentwithimmunecheckpointblockadehasalowerresponserate,butwithlongtermresponses.Targetedtherapyaffectsantitumorimmunity,andsynergymayexistwhentargetedtherapyiscombinedwithimmunotherapy.Thisarticlepresentsabriefreviewoftherationaleandevidenceforthepotentialsynergybetweentargetedtherapyandimmunecheckpointblockade.Challengesanddirectionsforfuturestudiesarealsoproposed.

简介：为阉割抵抗的前列腺癌症(CRPC)的治疗选择在最近的年里进展了并且显著地与这好攻击、致命的疾病为病人改进了眼界。CRPC的生物学的进一步的理解导致了几新指向的治疗并且继续强调雄激素受体(AR)的重要性指导了治疗。治疗风景很快生物学上正在改变并且推进基本原理，基于biomarker的进行中的临床的试用被需要。我们在CRPC考察主要临床的试用的最近的结果。新并且investigational代理人现在包括angiogenesis，微导管，女伴，AR和细胞内部的kinases的禁止者在临床的评估被考察，以及免疫疗法，radiopharmaceuticals和指向骨头的代理人。在为CRPC的预后的最近的改进为进一步的改进带继续的乐观主义。对治疗的临床的考验和抵抗的机制的进一步的理解的有头脑的计划将允许在耐心的照顾的继续的进步。

简介：Apocrinecarcinomaisararemalignantadnexalneoplasm.Thedifferentialdiagnosisbetweenapocrinecarcinomaandcutaneousmetastasisisoftendifficult.Here,wereportacaseoflocallyrecurrentpenileapocrinecarcinomainitiallydiagnosedasmetastaticadenocarcinomaofthecolon.A75-year-oldmanwithahistoryofsurgicalresectionduetosigmoidcoloncancerandpenilemetastasistwoyearspriortothisstudypresentedwithanoduleattheleftpenilebase.Heunderwentawidelocalresectionofthepenilemassunderasuggestedpreoperativediagnosisofextra-mammaryPaget’sdisease(EMPD)associatedwithprevioussigmoidcoloncancer.However,thepreviouslyandcurrentlyresectedpenilemasseswereidentifiedasprimaryapocrinecarcinomauponhematoxylinandeosin(H&E)stainingandimmunohistochemicalstaining.Althoughtheincidenceisextremelyrare,bothcliniciansandpathologistsshouldbealerttothepossibilityofsynchronousdoubleprimaryapocrinecarcinomaincancerpatientswithmalignantcutaneouslesions.

简介：Agiantcelltumoroccursmainlyintheproximaltibia,humerus,distalradiusboneandthepelvicbone.Itisrarelyobservedinsuchsitesastheribsandthetemporalbone.Theconditionisprimarilytreatedwithsurgicalexcisionandfunctionalreconstruction.Theeffectofchemotherapyonlungmetastasesandlocallyadvancedgiantcelltumorshasremainedunknown.Wecollectedandanalyzedthedataofsixpatientswithraregiantcelltumorslocatedintheheadandneckpatients.Afteranaveragefollow-upof42.6monthsaftersurgery(14to90months),nolocalrecurrenceormetastasiswasobserved.Wealsocollectedandanalyzedthedataoffivepatientswithmetastaticgiantcelltumorswhowereundergoingsurgeryfortheprimarytumorbefore;ofthreepatientswhohadexperiencedmultiplechemotherapycycles,onehadspontaneousregression,andonesurvivedforlongtimerdespiteprogression.Theothertwopatientshadtheirmajormetastaticlesionsresectedbysurgery,andpresentedlong-termsurvivalduringthefollowup.Inaddition,thisstudyreportsonepatientwithlocallyadvancedgiantcelltumoroftherib,whohasundergonesuccessfulsurgicalresectionfollowingtwocyclesofchemotherapywithifosfamideandliposomaldoxorubicin.Completeresectionofthelesionattheheadandneckisthekeytorelapse-freesurvival.Theprognosisoflungmetastasesinpatientswithgiantcelltumorsisrelativelysatisfying.Neoadjuvantchemotherapyisalsoconducivetothesurgeryforlocallyadvancedlesionsandimprovementofthequalityoflife.

简介：AbstractBreast neuroendocrine carcinoma is a rare entity. It constitutes less than 0.5% of breast malignancies, and is usually diagnosed in older women. The occurrence of this type in young patients during pregnancy is extremely rare. Only 2 cases were previously reported. Both were diagnosed at earlier stage with the appearance of a palpable breast mass. Hereby, we present the case of a young patient at 28 weeks’ gestation admitted for severe diffuse back pain and neurologic deficit due to spinal cord compression at the level of C5 vertebra, and nerve root compression at the level of L5 vertebrae. To the best of our knowledge, this is the first case of oncologic emergency during pregnancy due to a metastatic poorly differentiated breast carcinoma with neuroendocrine differentiation in the absence of a detectable primary focus of malignancy in the breast. We also discuss the management and the obstetrical outcome of this patient.

简介：Objectives:ToexploretheprognosticrelevanceofthenumberandratioofmetastaticlymphnodesinresectedCarcinomaoftheampullaofVater(CAV).Methods:Theclinicaldataof155patientswhounderwentpancreaticoduodenectomy(PD)forcanceroftheampullaofVaterbetweenJanuary1990andDecember2010wereretrospectivelyanalyzed.KaplanMeiermethodwasusedinsurvivalanalysisandLogrankmethodincomparison.MultivariateanalysiswasperformedusingCoxproportionalhazardsmodel.Results:Amongthese155patients,thein-hospitalmortalityratewas4.5%,lymphnodepositivediseasewas21.3%,andthe5-yearsurvivalratewas51.6%.Patientswithalymphnoderatio(LNR)>20%weremorelikelytohavetumordifferentiation,depthofduodenalinvolvement,depthofpancreaticinvasion,T-stageandTNM-Stage.ThenumberofthemetastaticlymphnodesisimportantprognosticfactorsoftheCAV.Univariateanalysisshowedthatthefactorsassociatedwiththeprognosisincludedtumorsize(P=0.036),tumordifferentiation(P=0.019),LNR(P=0.032),numberofmetastaticlymphnodes(P=0.024),lymphnodemetastasis(P=0.03),depthofpancreaticinvasion(P=0.001),T-stage(P=0.002),TNMstage(P=0.001),elevatedCA19-9(P=0.000),andjaundice(P=0.021).Multivariateanalysisshowedthatthefactorsassociatedwiththeprognosiswerethenumberofmetastaticlymphnodes(P=0.032;RR:1.283;95%CI:1.022-1.611),tumorsize(P=0.043;RR:1.736;95%CI:1.017-2.963),andelevatedCA19-9(P=0.003;RR:3.247;95%CI:1.504-7.010).Conclusions:LNRisausefulfactorforpredictingtheprognosisoftheradicaltreatmentforCAV,whereasthenumberofmetastaticlymphnodesisthemostimportantfactor.Furtherresearchonthelocations,number,andLNRwillbeclinicallymeaningfultoimprovesurvivalinpatientswithCAV.

简介：AIM:Tumorangiogenesishasbeenshowntobepromotedbyvascularendothelialgrowthfactor(VEGF)viastimulatingendothelialcellproliferation,migration,andsurvival.BlockadeofVEGFsignalingbydifferentmeanshasbeendemonstratedtoresultinreducedtumorgrowthandsuppressionoftumorangiogenesisindistincttumorentities.Here,wetestedarecombinantadenovirus,AdsFIt1-3,thatencodesanantagonisticallyactingfragmentoftheVEGFreceptor1(Flt-1),forsystemicantitumoreffectsinpre-establishedsubcutaneousCRCtumorsinmice.METHODS:Murinecolorectalcarcinomacells(CT26)wereinoculatedsubcutaneouslyintoBalb/cmiceforinvivostudies.Tumorsizeandsurvivalweredetermined.293celllinewasusedforpropagationoftheadenoviralvectors.HumanlungcancerlineA549andhumanumbilicalveinendothelialcellsweretransfectedforinvitroexperiments.RESULTS:InfectionoftumorcellswithAdsFlt1-3resultedinproteinsecretionintocellsupernatant,demonstratingcorrectvectorfunction.Asexpected,thesecretedsFlt1-3proteinhadnodirecteffectonCT26tumorcellproliferationinvitro,butendothelialcellfunctionwasinhibitedbyabout46%ascomparedtotheAdLacZcontrolinatubeformationassay.WhenAdsFlt1-3(5×109PFU/animal)wasappliedtotumorbearingmice,wefoundatumorinhibitionby72%atd12aftertreatmentinitiation.Inspiteoftheseantitumoraleffects,thesurvivaltimewasnotimproved.AccordingtoreducedintratumoralmicrovesseldensityinAdsFIt1-3-treatedmice,theantitumormechanismcanbeattributedtoangiostaticvectoreffects.WedidnotdetectincreasedsystemicVEGFlevelsafterAdsFlt1-3treatmentandlivertoxicitywaslowasjudgedbyserumalanineaminotransferasedetermination.CONCLUSION:InthisstudyweconfirmedthevalueofasystemicadministrationofAdsFIt1-3toblockVEGFsignalingasantitumortherapyinanexperimentalmetastaticcolorectalcarcinomamodelinmice.

简介：ＴＨＥＥＦＦＥＣＴＯＦＲＥＴＩＮＯＩＣＡＣＩＤＯＮＣＥＬＬＭＥＭＢＲＡＮＥＡＮＤＭＥＴＡＳＴＡＴＩＣＡＢＩＬＩＴＹＯＦＭＯＵＳＥＦＯＲＥＳＴＯＭＡＣＨＣＡＲＣＩＮＯＭＡＣＥＬＬＹｕＸｉａｏｄａｎ于晓；ＺｈａｏＸｕｅｍｅｉ赵雪梅；ＧａｏＪｉｎ高进（Ｉｎ...

简介：DuckhepatitisBvims(DHBV)DNAwasdetectedindifferenttumorousnodulesofduckswithhepaticmulticentriccancerorintrahepaticmetastasisbySouthernblottechnique.Among7duckswithhepatocellularcarcinomaofmultipletumornodules,thehybridizationpatternofIntegratedDHBVDNAIndifferenttumorousnoduleswasidenticalin3casesanddifferentin2cases.OnecaseshowedasimilarhybridizationpatternintwotumorousnodulesandotheronewasnegativetorDHBVDNA.IntegratedDHBVDNAwasalsoidentifiedinametastaticlungcancerofduckswithhepatocellularcarcinoma.Thehybridizationpatternofmetastasisoflungswasasthesomeasthatinprimaryhepatocellularcarcinoma.ThesamediscretehybridizationbandsInthedifferenttumorousnodulesindicatethatthesenodulesmightarisefromonetransformedcell.ThedifferenthybridizationpatternsInvarioustumorousnodulesshowthatthesetumorousnodulesmightarisefromvarioustransformedcells.Theresultssuggestthatthehyb

简介：AIM:ToinvestigatewhethertheevaluationoftumorbuddingcancomplementK-RASanalysistoimprovetheindividualizedpredictionofresponsetoanti-epidermalgrowthfactorreceptorbasedtherapiesinmetastaticcolorectalcancer(mCRC)patients.METHODS:Forty-threepatientswithmCRCtreatedwithcetuximaborpanitumumabwereenteredintothisstudy.AccordingtotheResponseEvaluationCriteriainSolidTumorscriteria,30patientshadstableorprogressivedisease(non-responsive),while13patientshadapartialresponse.Tumorbudswereevaluatedfromwholetissuesectionsstainedforpan-cytokeratin,evaluatedinthedensestregionusinga40×objectiveand'high-grade'tumorbuddingwasdefinedas15buds/high-powerfield.RESULTS:TumorbudsandK-RASmutationbothcorrectlyclassified68%ofpatients.AllpatientswithK-RASmutation(n=7)orhigh-gradetumorbudding(n=11)werenon-responsive,ofwhich4patientshadbothfeatures.All13partialresponderswereK-RASwild-typewithlow-gradetumorbudding.Combined,thepredictivevalueofK-RASandtumorbuddingwas80%.Additionally,high-gradetumorbuddingwassignificantlyrelatedtoworseprogression-freesurvival[HR(95%CI):2.8(1.3-6.0,P=0.008)].CONCLUSION:Ifconfirmedinlargercohorts,theadditionoftumorbuddingtoK-RASanalysismayrepresentaneffectiveapproachforindividualizedpatientmanagementinthemetastaticsetting.

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简介：ＴＨＥＲＯＬＥＯＦＭＲＩＩＮＴＨＥＩＬＬＵＳＴＲＡＴＩＯＮＯＦＭＥＴＡＳＴＡＴＩＣＬＹＭＰＨＡＴＩＣＰＡＴＨＷＡＹＳＡＮＤＣＬＩＮＩＣＡＬＮＳＴＡＧＩＮＧＯＦＮＡＳＯＰＨＡＲＹＮＧＥＡＬＣＡＲＣＩＮＯＭＡＷｅｉＸｉｏｎｇ韦雄ＬｉＪｉａｎｊｕｎ李建军...

简介：AbstractIncreasing numbers of targeted drugs are used in hormone receptor (HR)-positive metastatic breast cancer (MBC) to overcome or delay resistance to endocrine therapy. This study will systemically review the progress made in endocrine therapy combined with targeted therapy in the treatment of HR-positive MBC. From the "AI (aromatase inhibitor) era" represented by aromatase inhibitors, we have gradually entered the "post-AI era" represented by fulvestrant. Under the guidance of research on the molecular mechanism of endocrine therapy resistance, the "combination of endocrine therapy and targeted therapy" era is approaching. The development of drugs that target endocrine therapy resistance has concentrated on cyclin-dependent kinase 4/6 inhibitors, histone deacetylase inhibitors, and inhibitors of drug targets in the phosphatidylinositol 3 kinase-protein kinase B-mammalian target of rapamycin (PI3K-AKT-mTOR) pathway, providing new strategies for HR-positive MBC. Exploring biomarkers to guide the more precise use of targeted drugs in endocrine therapy for MBC is the focus of current and future research.

简介：AbstractPancreatic neuroendocrine tumors (PNETs) are a rare group of neoplasms originating from the endocrine pancreas. PNETs are classified as functional or non-functional tumors. PNETs are more often diagnosed at a higher stage with distant metastases or advanced locoregional disease. The majority of individuals with hepatic metastases will ultimately die of liver failure; therefore, the treatment of liver tumor burden is critical to providing a survival impact. While surgical resection remains the only chance of cure for disease confined to the pancreas or for locoregional disease, the treatment of advanced or metastatic PNETs is more complex and often requires a multimodal approach. This review focuses on treatment options for well and moderately differentiated PNETs with metastatic disease to the liver. These include surgery, liver-directed therapies including ablative and intra-arterial therapies, and systemic therapies such as somatostatin analogues, targeted therapies, chemotherapy, and peptide receptor radionuclide therapy. Developing an individualized treatment strategy requires careful assessment of liver tumor burden and predicted biological behavior. Aggressive surgical resection of hepatic metastases secondary to PNET primary tumors is associated with improved survival in multiple retrospective studies. General goals of treatment for metastatic disease include prolonging overall survival and progression free survival, improving quality of life, and control of symptoms.

简介：Metastasisoflungcancertothetemporalboneisaveryrarediseaseandsubjectivetinnitusasthepresent-ingsymptominthesepatientsisevenrarer.Herewereportacaseinwhicha42-year-oldmalepresentedwithsubjectivetinnitusofthreemonths,withnopulmonarydiseasesymptoms.Puretoneaudiometryindi-catedmoderateconductivedeafnessinleftearwithanair-bonegapof21.3dB.HRCTtemporalbonescan-ningindicatedhigh-densityshadowsintheleftepitympaniccavity,sinustympaniandmastoidcavity.Chron-icotitismediawithcholesteatomawassuspectedandsurgicaltreatmentrecommended.However,preopera-tivechestx-rayrevealedhigh-densitymilletlesionsscatteredwidelyinbothlungs.HRCTlungscanningconfirmedthelungslesionsandindicatedlungcancer.Inordertodeterminecorrelationsbetweenthetempo-ralboneandpulmonarylesions,aCT-guidedtrans-mastoidaspirationbiopsyandimmunohistochemicalstudywereconducted,whichconfirmedthatthetemporalbonelesionwasmetastaticfromthelungs.Thepa-tientwasgivenaseriesofchemotherapyimmediatelyandhistinnitussignificantlyimprovedafterthreemonthsoftreatment,withfullrecoveryofhishearingandcompleteresolutionofshadowsinthemastoidcavity.Unfortunately,hesubsequentlydevelopedmultiplebonemetastasesinthe9thmonthandcerebralmetastasisinthe18thmonth.Multipleorganfailureresultedindeathin2.5years.

简介：AbstractGastric carcinoma is extremely rare in pregnancy and the prognosis for this malignancy tends to be dismal. We herein describe a case of gastric cancer in pregnancy to alert clinicians to this rare possibility. A 29-year-old woman developed abdominal spastic pain and diarrhea during the 26 weeks of gestation and her condition was confusing and hard to recognize. The patient was initially misdiagnosed as enterogastritis and inflammatory intestinal obstruction and was finally confirmed by exploratory laparotomy with intestinal and peritoneum metastases. Because the disease was not detected early enough and progressed rapidly, the pregnancy was terminated by cesarean section at 30 weeks of gestation, and then followed by systemic chemotherapy, but eventually succumbed to the lethal pneumonia. Therefore, it is of great significance to alert clinicians to note this rare possibility and to consider the differential diagnosis of this disease in pregnant women with a long course of gastrointestinal symptoms that cannot be explained by pregnancy alone, and cancer should be suspected and tested with sophisticated diagnostic procedures.

简介：调查瘤的目的淋巴的联系转移的基因；它的分子的机制。方法22690鼠标染色体cDNA微数组(包括14500知道基因；4371EST)被用来比较；分析老鼠肝细胞癌房间线Hca-F(高度淋巴的转移潜力)的基因表示侧面；Hca-P(低潜力)。结果901基因；129EST至少是起来调整的在Hca-F的2褶层房间。在表示显示出重要改变的33基因被介绍，包括endoglin(EDG)，MCAM，Cdc42ep5，F2r，D7Ertd458e，Serpinh1(HSP47)，AXL，Areg；那么上。这些基因有血管生成的函数，房间粘附，信号转导变异，房间活动性，女伴活动，蛋白质激酶活动；受体绑定。微数组与淋巴的转移模型相结合的结论cDNA可能贡献新方法；淋巴的转移研究的瘤的线索。在表示基因上的一些可能提供新奇线索给瘤的分子的机制淋巴的转移。

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