查看更多>>摘要：甲状腺癌发生颈淋巴结转移与疾病复发和患者预后密切相关。准确判断淋巴结转移对肿瘤分期及治疗至关重要，可有效改善患者预后。然而，术前发现颈淋巴结转移是甲状腺癌患者个体化诊治的重点和难点。目前，临床上常使用细针穿刺洗脱液甲状腺球蛋白检测在术前评估分化型甲状腺癌颈淋巴结转移情况，其诊断效能较高。对肿瘤标记物及新兴生物标记物的不断探索与应用，为甲状腺癌术前淋巴结转移诊断研究提供了崭新的视角。液体活检作为一种新型无创的检测技术，获取样本方便，在早期诊断甲状腺癌颈淋巴结转移方面具有广阔的临床应用前景。此外，液体活检生物标志物的分析与应用，将有助于临床诊疗策略的制定，为甲状腺癌患者的早期精准治疗提供可能。本文围绕甲状腺癌颈淋巴结转移相关分子标志物的研究进展进行综述。 Cervical lymph node metastasis in thyroid cancer is closely related to the disease recurrence and prognosis of patients. Accurate judgment of lymph node metastasis is vital for tumor stage and treatment in patients with thyroid cancer, which can effectively improve the prognosis of patients. However, preoperative detection of cervical lymph node metastasis is the key points and difficulties in individualized treatment of thyroid cancer. Currently, fine needle aspiration washout fluid thyroglobulin is often used to assess cervical lymph node metastasis of differentiated thyroid cancer preoperatively, and it has a higher diagnostic efficacy. The continuous exploration and application of tumor markers and emerging biomarkers have provided new perspectives for the preoperative diagnosis of lymph node metastasis in thyroid cancer. As a new non-invasive detection technique, liquid biopsy is convenient to obtain samples and has broad clinical application in early diagnosis of cervical lymph node metastasis of thyroid cancer. In addition, the analysis and application of liquid biopsy biomarkers will help the development of clinical diagnosis and treatment strategies, and provide the possibility of early precision therapy for thyroid cancer patients. This review summarizes current research surrounding the molecular markers related to cervical lymph node metastasis of thyroid cancer.
查看更多>>摘要：传统化疗是胃癌综合治疗的基石，但复发率和转移率较高，总体预后不甚理想。免疫检查点抑制剂(ICI)的兴起为胃癌患者带来了新的曙光，并改变了当前胃癌综合治疗的格局。随着ICI的使用增加，免疫相关不良反应(irAEs)，如皮肤毒性、胃肠道毒性等也愈发常见。科学认识、早期诊断、分级管理是目前处理irAEs的主要策略。本文将就ICI治疗胃癌后irAEs的发生机制、临床表现以及如何对irAEs进行预测、治疗和管理进行综述，以期提高临床医师对irAEs的认识，更好地管理免疫治疗相关不良反应，从而改善患者的预后和生活质量。 Traditional chemotherapy is the cornerstone of comprehensive treatment for gastric cancer, but its recurrence and metastasis rates are high, and the overall prognosis is not ideal. The rise of immune checkpoint inhibitors (ICI) has brought new hope to gastric cancer patients and changed the current pattern of comprehensive treatment for gastric cancer. With the increasing use of ICI, immune related adverse reactions (irAEs) such as skin toxicity and gastrointestinal toxicity are becoming increasingly common. Scientific understanding, early diagnosis, and graded management are currently the main strategies for handling irAEs. This article aims to review the mechanisms, clinical manifestations, and prediction, treatment, and management of irAEs after ICI treatment of gastric cancer, in order to enhance the understanding of irAEs among clinical physicians, better manage immunotherapy related adverse reactions, and improve the prognosis and quality of life of patients.
查看更多>>摘要：微创食管癌根治术是食管癌的首选治疗方法，已经在临床上广泛普及并发展成熟。然而，吻合口相关并发症仍然较为常见，如吻合口瘘、吻合口狭窄、食管胃反流等，严重地影响患者术后的快速康复和生活质量。食管胃吻合术是该术式的核心与难点所在。近年来，人们发现了不同的食管胃吻合方法和技巧，可降低吻合口相关并发症的发生率和改善临床结局。本文将归纳近几年国内外有关食管胃吻合技术的发展与进步，为广大胸外科医师提供参考，促进食管胃吻合技术的进步。 Minimally invasive esophagectomy is the preferred treatment for esophageal cancer, which has been widely popularized and developed in clinical practice. However, anastomotic complications are still common, such as anastomotic leakage, anastomotic stenosis, and gastroesophageal reflux, which seriously affect the rapid recovery and quality of life of patients after surgery. Esophagogastrostomy is the core and difficulty of the operation. In recent years, different esophagogastric anastomosis methods and techniques have been found to reduce the incidence of anastomotic complications and improve clinical outcomes. This article will summarize the development and progress of esophagogastric anastomosis techniques at home and abroad in recent years in order to provide reference for the majority of thoracic surgeons and to promote the progress of esophagogastric anastomosis techniques.
查看更多>>摘要：胃癌是威胁人类健康的重大疾病之一，发病率较高，早期诊断率低。治疗过程中遇到许多瓶颈。提高早期诊断率并寻找新的治疗靶点是当前亟待解决的难题。端粒酶在正常组织中检测不到，但在大多数癌症中表现出较高的特异性和敏感性，且与预后有明确相关性，有可能作为血清肿瘤标志物和预后指标。人端粒酶逆转录酶(hTERT)基因多态性可以调节人群对胃癌的易感性，并通过其靶基因影响胃癌发生发展及增殖和凋亡过程。抵抗素、visfatin、G-四链体、胡椒胺等物质则可以通过调节端粒酶表达来影响胃癌的发生发展。目前关于hTERT参与调节肿瘤侵袭和转移的机制尚不清楚，阐明其作用机制具有重要意义。本文将对这一机制近年来的研究进展进行综述。 Gastric cancer is one of the major diseases threatening human health, with a high incidence and a low early diagnostic rate. There are many bottlenecks encountered during its treatment. Consequently, improving the early diagnostic rate and exploring new therapeutic targets are currently urgent challenges that need to be addressed. Telomerase is undetectable in normal tissues, but it exhibits high specificity and sensitivity in most cancers and has a definite correlation with prognosis. It may serve as a serum tumor marker and prognostic indicator. Human telomerase reverse transcriptase (hTERT) gene polymorphism can regulate the susceptibility of people to gastric cancer, and affect the occurrence, development, proliferation and apoptosis of gastric cancer through its target gene. Substances such as resistin, visfatin, G-quadruplex and methylenedioxyaniline can affect the occurrence and development of gastric cancer by regulating telomerase expression. The mechanism by which hTERT regulates tumor invasion and metastasis is currently unclear, so elucidating its mechanism is of great significance.This paper will review the research progress of this mechanism in recent years.
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