首页期刊导航|国际肿瘤学杂志
期刊信息/Journal information
国际肿瘤学杂志
国际肿瘤学杂志

韩金祥

月刊

1673-422X

gjzlxjn@126.com

0531-82919917

250062

山东省济南市经十路18877号

国际肿瘤学杂志/Journal Journal of International Oncology北大核心CSTPCD
查看更多>>1974年创刊，中华人民共和国卫生部主管，中华医学会、山东省医学科学院主办。本刊原《国外医学肿瘤学分册》，主要栏目有综述、论著、病例报道等。被IC、CA、CSA、Ulrich PD、CABI、WPRIM收录，为中国科技论文统计源期刊（中国科技核心期刊）。曾获卫生部首届医药卫生优秀期刊、中华医学会系列杂志优秀期刊三等奖、首届山东省科技情报科学技术一等奖、山东省学术类优秀期刊。
正式出版
收录年代

    中国食管癌放射治疗指南（2023年版）

    李宝生葛红颜建华
    1-20页
    查看更多>>摘要：（除非特别注明，均为2A类证据）

    食管肿瘤放射疗法临床指南

      原文链接:
    • 万方数据

    绿原酸通过抑制PI3K-Akt信号通路诱导肺癌A549细胞线粒体功能障碍

    张科平赵永生杨娟付茂勇...
    21-28页
    查看更多>>摘要：目的 探讨绿原酸能否通过作用于PI3K-Akt信号通路造成线粒体功能障碍，从而抑制肺癌A549细胞增殖、迁移、侵袭和促进其凋亡。 方法 采用梯度浓度（0、25、50、100、150、200 μg/ml）的绿原酸干预A549细胞48 h，CCK-8实验检测细胞增殖率并计算半抑制浓度（IC50）。将A549细胞分成空白组、绿原酸组（IC50）和绿原酸+740YP组（IC50绿原酸+50 μg/ml 740YP），干预48 h后使用细胞划痕实验检测细胞迁移距离，细胞侵袭实验检测细胞侵袭能力，流式细胞术检测细胞周期、细胞凋亡水平与线粒体膜电位变化情况，酶联免疫吸附试验检测细胞上清丙二醛（MDA）含量，蛋白质印迹法检测细胞中p-PI3K、p-Akt和Caspase3蛋白表达情况。 结果 绿原酸对A549细胞的IC50为57.45 μg/ml。细胞划痕实验结果显示，空白组、绿原酸组和绿原酸+740YP组细胞48 h迁移距离分别为（424.80±14.43）、（289.67±18.93）和（402.22±17.99）μm，细胞侵袭实验结果显示，3组细胞48 h侵袭细胞数量分别为（96.00±6.24）、（35.33±7.64）和（83.00±2.00）个，流式细胞术结果显示，3组细胞48 h凋亡率分别为（6.15±0.17）%、（54.63±0.72）%和（17.27±0.39）%，差异均具有统计学意义（F=105.98，P<0.001；F=90.62，P<0.001；F=8 321.99，P<0.001）；与空白组相比，绿原酸组和绿原酸+740YP组细胞迁移距离和侵袭数量均减少（均P<0.05），细胞凋亡率显著升高（均P<0.001）；与绿原酸组相比，绿原酸+740YP组细胞迁移距离增加（P<0.001），细胞侵袭数量增多（P<0.001），细胞凋亡率降低（P<0.001）。流式细胞术结果显示，空白组、绿原酸组和绿原酸+740YP组细胞G0/G1期比例分别为（65.75±0.58）%、（55.84±0.78）%和（55.24±1.37）%，G2/M期比例分别为（11.21±1.03）%、（20.23±0.62）%和（9.96±0.33）%，S期比例分别为（23.04±0.49）%、（23.92±1.36）%和（34.80±1.15）%，差异均具有统计学意义（F=111.02，P<0.001；F=181.26，P<0.001；F=113.05，P<0.001）；与空白组相比，绿原酸组和绿原酸+740YP组细胞G0/G1期比例减少（均P<0.001），绿原酸组G2/M期比例增加（P<0.001），绿原酸+740YP组细胞S期比例增加（P<0.001）；与绿原酸组相比，绿原酸+740YP组细胞G2/M期比例减少、S期比例增加（均P<0.001）。线粒体膜电位检测结果显示，空白组、绿原酸组和绿原酸+740YP组线粒体JC-1荧光强度分别为39.51±1.32、10.05±0.19和21.85±1.45，差异具有统计学意义（F=508.82，P<0.001）；与空白组相比，绿原酸组和绿原酸+740YP组荧光强度均降低（均P<0.001）；与绿原酸组相比，绿原酸+740YP组荧光强度升高（P<0.001）。酶联免疫吸附试验结果显示，空白组、绿原酸组和绿原酸+740YP组细胞MDA含量分别为（0.47±0.01）、（0.61±0.01）和（0.56±0.01）nmol/ml，差异具有统计学意义（F=162.30，P<0.001）；与空白组相比，绿原酸组和绿原酸+740YP组细胞MDA含量均增加（均P<0.001）；与绿原酸组相比，绿原酸+740YP组细胞MDA含量减少（P=0.001）。蛋白质印迹法结果显示，空白组、绿原酸组和绿原酸+740YP组细胞p-PI3K蛋白相对表达水平分别为1.01±0.33、0.28±0.14和0.34±0.20，p-Akt蛋白相对表达水平分别为1.00±0.16、0.43±0.05和0.95±0.14，Caspase3蛋白相对表达水平分别为1.00±0.04、1.41±0.05和0.70±0.13，差异均具有统计学意义（F=8.48，P=0.018；F=19.11，P=0.002；F=57.50，P<0.001）；与空白组相比，绿原酸组细胞p-PI3K、p-Akt蛋白表达均降低、Caspase3蛋白表达升高（均P<0.05），绿原酸+740YP组p-PI3K、Caspase3蛋白表达均降低（均P<0.05）；与绿原酸组相比，绿原酸+740YP组细胞p-Akt蛋白表达升高、Caspase3蛋白表达降低（均P<0.05）。 结论 绿原酸可能通过减少PI3K与Akt蛋白磷酸化抑制PI3K-Akt信号通路，造成线粒体功能受损，引起MDA累积，最终导致肺癌A549细胞功能受损与活性降低，促进细胞凋亡。 Objective To investigate whether chlorogenic acid can inhibit the proliferation, migration, invasion and promote apoptosis of lung cancer A549 cells by causing mitochondrial dysfunction through PI3K-Akt pathway. Methods A549 cells were treated with chlorogenic acid at concentrations of 0, 25, 50, 100, 150, and 200 μg/ml for 48 h. CCK-8 assay was used to detect the cell proliferation rate and calculate the half maximal inhibitory concentration (IC 50). A549 cells were divided into three groups: control group, chlorogenic acid group (IC50) and chlorogenic acid + 740-YP group (IC50 chlorogenic acid +50 μg/ml 740YP). After 48 h of intervention, the cell migration distance was detected by cell scratch assay. Cell invasion assay was used to detect cell invasion ability. Cell cycle, apoptosis and mitochondrial membrane potential were detected by flow cytometry. The content of malondialdehyde (MDA) in cell supernatant was detected by enzyme-linked immunosorbent assay (ELISA). Western blotting was used to detect the protein expression of p-PI3K, p-Akt and Caspase3. Results The IC50 of chlorogenic acid to A549 cells was 57.45 μg/ml. The results of cell scratch assay showed that the 48 h migration distances of the control group, chlorogenic acid group and chlorogenic acid + 740YP group were (424.80±14.43), (289.67±18.93) and (402.22±17.99) μm, respectively. The results of cell invasion assay showed that the numbers of invasive cells after 48 h were 96.00±6.24, 35.33±7.64 and 83.00±2.00, and the results of flow cytometry showed that the 48 h apoptosis rates were (6.15±0.17) %, (54.63±0.72) % and (17.27±0.39) %, respectively, among the three groups with statistically significant differences ( F=105.98, P<0.001 F=90.62, P<0.001 F=8 321.99, P<0.001). Compared with the control group, the cell migration distances and invasive numbers of chlorogenic acid group and chlorogenic acid + 740YP group were decreased (all P<0.05), while the apoptosis rates were significantly increased (both P<0.001). Compared with chlorogenic acid group, the cell migration distance of chlorogenic acid + 740YP group increased (P<0.001), the number of cell invasion increased (P<0.001), and the apoptosis rate decreased (P<0.001). The results of flow cytometry showed that the proportions of cells in G0/G1 phase in the control group, chlorogenic acid group and chlorogenic acid + 740YP group were (65.75±0.58) %, (55.84±0.78) % and (55.24±1.37) %, respectively. The proportions of G2/M phase were (11.21±1.03) %, (20.23±0.62) % and (9.96±0.33) %, and the proportions of S phase were (23.04±0.49) %, (23.92±1.36) % and (34.80±1.15) %, respectively, with statistically significant differences (F=111.02, P<0.001 F=181.26, P<0.001 F=113.05, P<0.001). Compared with the control group, the proportions of G0/G1 phase cells in chlorogenic acid group and chlorogenic acid + 740YP group decreased (both P<0.001), and the proportion of G2/M phase in chlorogenic acid group increased (P<0.001), and the proportion of S phase cells in chlorogenic acid + 740YP group increased (P<0.001). Compared with chlorogenic acid group, the proportion of G2/M phase cells decreased and the proportion of S phase cells increased in chlorogenic acid + 740YP group (both P<0.001). The results of mitochondrial membrane potential detection showed that the JC-1 fluorescence intensity of mitochondria in the control group, chlorogenic acid group and chlorogenic acid + 740YP group were 39.51±1.32, 10.05±0.19 and 21.85±1.45, respectively, with a statistically significant difference (F=508.82, P<0.001). Compared with the control group, the fluorescence intensity of chlorogenic acid group and chlorogenic acid + 740YP group decreased (both P<0.001). Compared with chlorogenic acid group, the fluorescence intensity of chlorogenic acid + 740YP group increased (P<0.001). ELISA results showed that the MDA contents of the control group, chlorogenic acid group and chlorogenic acid + 740YP group were (0.47±0.01), (0.61±0.01) and (0.56±0.01) nmol/ml, respectively, with a statistically significant difference (F=162.30, P<0.001). Compared with the control group, MDA contents in chlorogenic acid group and chlorogenic acid + 740YP group increased (both P<0.001). Compared with chlorogenic acid group, MDA content in chlorogenic acid + 740YP group decreased (P=0.001). Western blotting results showed that the relative protein expression levels of p-PI3K in the control group, chlorogenic acid group and chlorogenic acid + 740YP group were 1.01±0.33, 0.28±0.14 and 0.34±0.20, respectively. The relative protein expression levels of p-Akt were 1.00±0.16, 0.43±0.05 and 0.95±0.14, and the relative protein expression levels of Caspase3 were 1.00±0.04, 1.41±0.05 and 0.70±0.13, respectively, and there were statistically significant differences (F=8.48, P=0.018 F=19.11, P=0.002 F=57.50, P<0.001). Compared with the control group, the expressions of p-PI3K and p-Akt protein in chlorogenic acid group decreased, and the expression of Caspase3 protein increased (all P<0.05). The expressions of p-PI3K and Caspase3 protein in chlorogenic acid + 740YP group decreased (both P<0.05). Compared with chlorogenic acid group, the expression of p-Akt protein in chlorogenic acid + 740YP group increased, and the expression of Caspase3 protein decreased (both P<0.05) . Conclusion Chlorogenic acid may inhibit the PI3K-Akt pathway by reducing the phosphorylation of PI3K and Akt proteins, resulting in the damage of mitochondrial function and the accumulation of MDA, which eventually leads to the damage of lung cancer A549 cells function and the reduction of cells activity, and then promotes cells apoptosis.

    癌,非小细胞肺绿原酸磷酸肌醇3-激酶类细胞凋亡线粒体

      原文链接:
    • 万方数据

    基于GBD数据的中国和美国肺癌发病和死亡趋势及危险因素对比分析

    贺嘉慧胡钦勇颜建华
    29-36页
    查看更多>>摘要：目的 基于全球疾病负担研究2019（GBD 2019）数据对比分析1990—2019年中国和美国肺癌发病和死亡情况、发病率和死亡率的长期变化趋势以及危险因素。 方法 使用GBD 2019数据库提取1990—2019年中国和美国按照不同性别和年龄组的肺癌新发病例、死亡病例、年龄标准化率数据，用于分析1990—2019年中国和美国基于不同性别和年龄组的肺癌发病和死亡情况。采用Joinpoint软件计算1990—2019年中国和美国肺癌年龄标准化发病率（ASIR）和年龄标准化死亡率（ASMR）的年度变化百分比（APC）和平均年度变化百分比（AAPC），分析其长期变化趋势。采用伤残调整生命年（DALY）分析中美两国的肺癌死亡相关危险因素。 结果 中国肺癌新发病例由1990年的25.70万例上升至2019年的83.29万例，ASIR由1990年的30.20/10万上升至2019年的41.71/10万；死亡病例由1990年的25.63万例上升至2019年的75.72万例，ASMR由1990年的31.18/10万上升至2019年的38.70/10万。美国肺癌的ASIR由1990年的58.87/10万下降至2019年的45.13/10万，ASMR由1990年的49.35/10万下降至2019年的36.11/10万。从性别上看，1990年和2019年中国男性的肺癌疾病负担高于女性，男性肺癌新发病例由1990年的17.90万例上升至2019年的57.62万例，ASIR由1990年的44.29/10万上升至2019年的61.74/10万；死亡病例由1990年的17.79万例上升至2019年的52.32万例，ASMR由1990年的46.33/10万上升至2019年的58.10/10万。中国女性肺癌新发病例数由1990年的7.81万例上升至2019年的25.67万例，ASIR由1990年的18.01/10万上升至2019年的24.76/10万；死亡病例数由1990年的7.84万例上升为2019年的23.40万例，ASMR由1990年的18.63/10万上升至2019年的22.86/10万。2019年，中美两国男性和女性肺癌发病率随年龄的增长呈先上升后下降趋势，中国男性和女性肺癌发病率均在85~89岁年龄组达到高峰；美国男性肺癌发病率在85~89岁年龄组达到高峰，女性发病率在80~84岁年龄组达到高峰。2019年，中国男性肺癌死亡率随年龄增长呈先上升后下降趋势，在85~89岁年龄组达到高峰，女性肺癌死亡率随年龄增长呈上升趋势，在≥95岁年龄组达到高峰；美国男性和女性肺癌死亡率随年龄增长呈先上升后下降趋势，分别在85~89岁和80~84岁年龄组达到高峰。1990年及2019年中国和美国各年龄组男性的发病率和死亡率均高于女性。Joinpoint软件分析结果显示，1990—2019年，中国肺癌ASIR和ASMR整体呈上升趋势，ASIR的AAPC为1.16%（95%CI为0.93%~1.38%，P<0.001），ASMR的AAPC为0.78%（95%CI为0.56%~1.01%，P<0.001）；1997—2004年ASIR和ASMR上升趋势最为明显，APC分别为2.84%和2.58%。美国肺癌的ASIR和ASMR呈下降趋势，ASIR的AAPC为-1.08%（95%CI为-1.20%~0.96%，P<0.001），ASMR的AAPC为-1.05%（95%CI为-1.24%~-0.87%，P<0.001）。1990年及2019年中国和美国肺癌主要的死亡相关危险因素是吸烟，中国女性肺癌最主要的死亡相关危险因素为环境颗粒物污染。 结论 1990—2019年中国肺癌的ASIR及ASMR呈上升趋势，美国肺癌ASIR及ASMR呈下降趋势。2019年，中国男性和女性肺癌发病率均随年龄的增长呈先上升后下降趋势，男性肺癌死亡率随年龄增长呈先上升后下降趋势，女性肺癌死亡率随年龄增长呈上升趋势；美国男性和女性肺癌发病率、死亡率均随年龄增长呈先上升后下降趋势。1990年和2019年中国和美国各年龄组男性的发病率及死亡率均高于女性。吸烟是中国和美国肺癌主要的死亡相关危险因素，环境颗粒物污染是中国女性主要的肺癌死亡相关危险因素。 Objective To conduct comparative analysis of lung cancer incidence and mortality, as well as long-term trends in incidence and mortality rates and risk factors in China and the United States from 1990 to 2019 based on data from the Global Burden of Disease Study 2019 (GBD 2019) . Methods The GBD 2019 database was used to extract new lung cancer cases, deaths, and age-standardized rate data for the analysis of lung cancer incidence and deaths in China and the United States based on different sex and age groups from 1990 to 2019. Joinpoint software was used to calculate and analyze annual percentage change (APC) and average annual percentage change (AAPC) of age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of lung cancer in China and the United States from 1990 to 2019, and to analyze the long-term trends. Risk factors associated with lung cancer mortality in China and the United States were analyzed using the disability-adjusted life years (DALYs) . Results New cases of lung cancer in China increased from 257 000 cases in 1990 to 832 900 cases in 2019, and ASIR increased from 30.20/100 000 in 1990 to 41.71/100 000 in 2019 deaths increased from 256 300 cases in 1990 to 757 200 cases in 2019, and ASMR increased from 31.18/100 000 in 1990 to 38.70/100 000 in 2019. ASIR and ASMR for lung cancer in the United States showed a decreasing trend from 1990 to 2019, with ASIR decreasing from 58.87/100 000 in 1990 to 45.13/100 000 in 2019, and ASMR decreasing from 49.35/100 000 in 1990 to 36.11/100 000 in 2019. In terms of gender, the disease burden of lung cancer in Chinese males was higher than that of females in 1990 and 2019, with new cases of lung cancer in males rising from 179 000 in 1990 to 576 200 in 2019, and ASIR rising from 44.29/100 000 in 1990 to 61.74/100 000 in 2019, mortality rising from 177 900 in 1990 to 523 200 in 2019, and ASMR rising from 46.33/100 000 in 1990 to 58.10/100 000 in 2019. The number of new cases of lung cancer in Chinese females rose from 78 100 in 1990 to 256 700 in 2019, and ASIR rose from 18.01/100 000 in 1990 to 24.76/100 000 in 2019 the number of deaths rose from 78 400 in 1990 to 234 000 in 2019, and ASMR rose from 18.63/100 000 in 1990 to 22.86/100 000 in 2019. In 2019, lung cancer incidence rates for males and females in China and the United States showed an increasing and then decreasing trend with age, with incidence rates of lung cancer in Chinese males and females peaking in the age group of 85-89 years old and in the United States, incidence rates of lung cancer in males peaked in the age group of 85-89 years old, and incidence rates of females peaked in the age group of 80-84 years old. In 2019, it was shown that mortality rate of lung cancer among males in China increased and then decreased with age, reaching a peak in the age group of 85-89 years old, and mortality rate of lung cancer among females increased with age, reaching a peak in the age group of ≥95 years old. In the United States, lung cancer mortality rate for males and females showed an increasing and then decreasing trend with age, peaking in the 85-89 and 80-84 age groups, respectively. Incidence and mortality rates were higher for males than females in all age groups in China and the United States in 1990 and 2019. The analysis results of Joinpoint software showed that ASIR and ASMR of lung cancer in China showed an overall increasing trend from 1990 to 2019, with an AAPC of 1.16% (95%CI: 0.93%-1.38%, P<0.001) for ASIR and 0.78% (95%CI: 0.56%-1.01%, P<0.001) for ASMR, with the most obviously increasing trend in ASIR and ASMR from 1997 to 2004, the APC were 2.84% and 2.58%, respectively. Lung cancer ASIR and ASMR in the United States population showed a decreasing trend, with an AAPC of -1.08% (95%CI: -1.20%-0.96%, P<0.001) for ASIR and -1.05% (95%CI: -1.24%--0.87%, P<0.001) for ASMR. In 1990 and 2019, the major mortality-related risk factor for lung cancer in China and the United States was smoking, and the major mortality-related risk factor for lung cancer in Chinese females was environmental particulate matter pollution. Conclusion ASIR and ASMR of lung cancer in China show an increasing trend from 1990 to 2019, and ASIR and ASMR of lung cancer in the United States show a decreasing trend. In 2019, incidence rate of lung cancer in males and females in China show an increasing and then decreasing trend with age, mortality rate of lung cancer for males show an increasing and then decreasing trend with age, and mortality rate of lung cancer for females show an increasing trend with age. Lung cancer incidence and mortality rates for males and females in the United States in 2019 show an increasing and then decreasing trend with age. In both 1990 and 2019, incidence rates and mortality rates are higher for males than for females in all age groups in both China and the United States. Smoking is the major mortality-related risk factor for lung cancer in China and the United States, and environmental particulate matter pollution is the major mortality-related risk factor for lung cancer in Chinese females.

    肺肿瘤发病率死亡率全球疾病负担

      原文链接:
    • 万方数据

    基于MR加速器的MR引导放疗在食管癌患者中的临床应用

    高新雨李振江孙洪福韩丹...
    37-42页
    查看更多>>摘要：目的 初步探讨基于MR加速器的MR引导放疗在食管癌中的应用流程、疗效及安全性。 方法 回顾性分析2021年9月至2022年7月于山东省肿瘤防治研究院应用MR加速器治疗的食管癌患者的临床数据，探讨食管癌应用MR加速器的治疗流程，分析患者的疗效及安全性。全组患者均接受MR引导放疗，接受CT和MR定位、靶区勾画、Monaco治疗计划系统计划设计，MR加速器下摆位并调整计划。全组患者中位分割次数25次，计划靶体积中位单次剂量1.8 Gy，中位总剂量50.2 Gy，中位随访时长为16个月。 结果 全组12例患者包括颈部食管癌1例，胸上段食管癌3例，胸中段食管癌4例，胸下段食管癌4例。其中新辅助放疗3例，根治性放疗9例。所有患者治疗过程顺利，分次中位治疗时长为33 min，依从性良好。根治性放疗患者放疗后1个月客观有效例数为3例，疾病控制例数为9例，放疗后6个月客观有效例数为3例，疾病控制例数为6例。新辅助放疗的患者均在2个月内接受了手术，1例患者达病理完全缓解。最常见的急性不良反应为放射性食管炎（7例）和骨髓抑制中的白细胞计数减少（8例），晚期不良反应为放射性肺炎（1例），放疗不良反应轻微，未见4级及以上不良反应。 结论 基于MR加速器的MR引导放疗应用于食管癌的临床治疗流程可行，疗效良好且不良反应轻微。 Objective To explore the application process, efficacy and safety of MR-guided radiotherapy based on MR-linac in esophageal cancer. Methods The clinical data of patients with esophageal cancer treated with MR-linac at Shandong Cancer Hospital and Institute from September 2021 to July 2022 were retrospectively analyzed, to investigate the treatment process of esophageal cancer with MR-linac, and to analyze the efficacy and safety of patients. All patients received MR-guided radiotherapy, underwent CT and MR localization, target area delineation, and design of the Monaco treatment planning system plan. Adaptation-to-position adjustment was conducted during the pre-treatment evaluation. The median number of fractions was 25, the median single dose of planning target volume was 1.8 Gy, and the median total dose was 50.2 Gy. Median follow-up was 16 months. Results Among the 12 patients in the whole group, there were 1 case of cervical esophageal cancer, 3 cases of upper thoracic esophageal cancer, 4 cases of middle thoracic esophageal cancer and 4 cases of lower thoracic esophageal cancer, including 3 cases of neoadjuvant radiotherapy and 9 cases of radical radiotherapy. All patients had a smooth treatment process. The median treatment time was 33 min, and the patients had good compliance. For patients with radical radiotherapy, one month after radiotherapy, the number of objective remission cases was 3, and the number of disease-control cases was 9 six months after radiotherapy, the number of objective remission cases was 3, and the number of disease-control cases was 6. All patients treated with neoadjuvant radiotherapy underwent surgery within 2 months, and one patient achieved pathological complete remission. The most common acute adverse reactions were radiation esophagitis (7 cases) and leukopenia in bone marrow suppression (8 cases), with late-stage adverse reactions being radiation pneumonia (1 case). The adverse reactions to radiotherapy were slight, and no grade 4 or above adverse reactions were observed. Conclusion The clinical treatment process for esophageal cancer under MR-guided radiotherapy based on MR-linac is feasible, with good curative effects and mild adverse reactions.

    食管肿瘤磁共振成像放射疗法,影像引导治疗结果

      原文链接:
    • 万方数据

    三维超声在前列腺癌图像引导放疗中的应用与评价研究

    赵鑫范学武田龙胡逸民...
    43-49页
    查看更多>>摘要：目的 以锥形束CT校准为金标准，评价前列腺癌图像引导放疗中三维超声校准的准确度，并分析影响其准确度的危险因素。 方法 选择2018年12月至2021年12月河北北方学院附属第一医院放疗科51例前列腺癌患者为研究对象。患者均接受每周3次分次容积旋转调强放疗前基于骨骼的锥形束CT校准和基于软组织的三维超声校准。以锥形束CT校准数据为金标准，采用Bland-Altman法分析三维超声校准数据与其一致性。准确度允许阈值设置为3 mm，评价三维超声相对锥形束CT校准的准确度。采用logistic回归分析影响三维超声校准准确度的危险因素。 结果 共获取51例患者左右、头脚、腹背3个方向上765对锥形束CT和三维超声校准数据。左右方向上三维超声校准数据和锥形束CT校准数据分别为（1.39±0.11）和（1.13±0.07）mm，头脚方向上分别为（1.98±0.20）和（1.61±0.12）mm，腹背方向上分别为（2.68±0.48）和（1.78±0.27）mm，差异均具有统计学意义（t=-6.42，P<0.001；t=-7.07，P<0.001；t=-7.34，P<0.001）。Bland-Altman法分析结果显示，两种方法校准数据在3个方向上一致性可以接受。3个方向上三维超声相对锥形束CT校准数据差异<3 mm的数据分别为左右676对（88.37%）、头脚604对（78.95%）、腹背577对（75.42%）。左右方向上差异具有统计学意义的因素包括年龄（χ2=18.27，P<0.001）、前列腺体积（χ2=14.55，P<0.001）、查尔森合并症指数（CCI）（χ2=8.01，P=0.005）和射野范围（χ2=11.30，P<0.001），其中年龄（OR=2.02，95%CI为1.90～3.39，P=0.010）和射野范围（OR=1.45，95%CI为1.18～2.55，P=0.020）均为影响左右方向三维超声校准准确度的独立危险因素。头脚方向上差异具有统计学意义的因素包括年龄（χ2=80.68，P<0.001）、体质量指数（χ2=35.89，P<0.001）和射野范围（χ2=40.39，P<0.001），其中年龄（OR=1.49，95%CI为1.15～2.09，P=0.021）和射野范围（OR=1.10，95%CI为1.01～1.90，P=0.034）均为影响头脚方向三维超声校准准确度的独立危险因素。腹背方向上差异具有统计学意义的因素包括年龄（χ2=46.07，P<0.001）、CCI（χ2=47.97，P<0.001）和射野范围（χ2=11.86，P=0.001），其中年龄（OR=1.91，95%CI为1.22～3.45，P=0.015）和射野范围（OR=2.89，95%CI为1.45～3.90，P=0.001）均为影响腹背方向三维超声校准准确度的独立危险因素。 结论 三维超声相对锥形束CT校准结果的一致性和准确度均可以接受。进行三维超声校准前需考虑患者年龄和射野范围，从而降低对准确度的影响。 Objective To evaluate the accuracy of 3D ultrasound calibration in image guided radiotherapy for prostate cancer by taking cone beam CT calibration as the gold standard, and to analyze the risk factors of accuracy. Methods From December 2018 to December 2021, 51 patients with prostate cancer from the Department of Radiation Oncology, First Affiliated Hospital of Hebei North University were selected as the study subjects. They received cone beam CT calibration based on bone and 3D ultrasound calibration based on soft tissue before fraction volumetric modulated arc therapy treatment three times a week. Taking cone beam CT calibration data as the gold standard, the Bland-Altman method was used to analyze the consistency of 3D ultrasound calibration data with the former. Taking 3 mm as the allowable threshold of accuracy, the calibration accuracy of 3D ultrasound relative to cone beam CT was evaluated. Logistic regression was used to analyze the risk factors affecting the accuracy of 3D ultrasound calibration. Results A total of 765 pairs of cone beam CT and 3D ultrasound calibration data were obtained from 51 patients in left-right, superior-inferior and anterior-posterior directions. The calibration data of 3D ultrasound and cone beam CT were (1.39±0.11) and (1.13±0.07) mm in the left-right direction, (1.98±0.20) and (1.61±0.12) mm in the superior-inferior direction, (2.68±0.48) and (1.78±0.27) mm in the anterior-posterior direction, respectively, with statistically significant differences (t=-6.42, P<0.001 t=-7.07, P<0.001 t=-7.34, P<0.001). The analysis results of Bland-Altman showed that the consistency of calibration data of the two methods were acceptable in three directions. The number of pairs of 3D ultrasound relative to cone beam CT calibration data difference <3 mm in the three directions were 676 (88.37%) on the left-right direction, 604 (78.95%) on the superior-inferior direction, and 577 (75.42%) on the anterior-posterior direction. The factors with statistically significant differences in the left-right direction included age ( χ2=18.27, P<0.001), prostate volume (χ2=14.55, P<0.001), Charlson comorbidity index (CCI) (χ2=8.01, P=0.005) and field range (χ2=11.30, P<0.001). Age (OR=2.02, 95%CI: 1.90-3.39, P=0.010) and the field range (OR=1.45, 95%CI: 1.18-2.55, P=0.020) were the independent risk factors affecting the accuracy of 3D ultrasound calibration in the left-right direction. The factors with statistically significant differences in the superior-inferior direction included age (χ2=80.68, P<0.001), body mass index (χ2=35.89, P<0.001) and field range (χ2=40.39, P<0.001). Age (OR=1.49, 95%CI: 1.15-2.09, P=0.021) and the field range (OR=1.10, 95%CI: 1.01-1.90, P=0.034) were the independent risk factors affecting the accuracy of 3D ultrasound calibration in the superior-inferior direction. The factors with statistically significant differences in the anterior-posterior direction included age (χ2=46.07, P<0.001), CCI (χ2=47.97, P<0.001) and field range (χ2=11.86, P=0.001). Age (OR=1.91, 95%CI: 1.22-3.45, P=0.015) and the field range (OR=2.89, 95%CI: 1.45-3.90, P=0.001) were the independent risk factors affecting the accuracy of 3D ultrasound calibration in the anterior-posterior direction. Conclusion The consistency and accuracy of the calibration results of 3D ultrasound relative to cone beam CT are acceptable. It is necessary to consider the patient's age and field range to reduce the impact on accuracy before conducting 3D ultrasound calibration.

    前列腺肿瘤超声检查危险因素图像引导

      原文链接:
    • 万方数据

    髓源性抑制细胞在肿瘤血管生成中的研究进展

    刘筱迪苏剑飞张静娴卫雪芹...
    50-54页
    查看更多>>摘要：髓源性抑制细胞（MDSC）作为一种免疫抑制细胞，是免疫微环境的重要组成部分，除了主要的促肿瘤免疫逃逸功能，近年研究发现，MDSC的促血管生成等非免疫学功能也能对肿瘤发展发挥促进作用。MDSC可通过血管内皮细胞生长因子信号通路直接促进肿瘤血管生成，也可通过分泌基质金属蛋白酶9、碱性成纤维细胞生长因子、血管生成肽Bv8、血小板衍生生长因子等细胞因子、外泌体或与其他细胞发生相互作用间接促进肿瘤生长和血管生成。探究MDSC的扩增活化、募集及促血管生成机制可为基于靶向MDSC的个体化诊疗提供新的思路。 As a kind of immunosuppressive cells, myeloid-derived suppressor cells (MDSCs) are an important component of the immune microenvironment. MDSCs play a significant role in promoting tumor immune escape. In addition, non-immunological functions such as promoting angiogenesis can also promote tumor development with the deepening of research. MDSCs can promote tumor angiogenesis directly through vascular endothelial growth factor signaling pathway, or promote tumor growth and angiogenesis by secreting cytokines such as matrix metalloprotein-9, basic fibroblast growth factor, angiogenic peptide Bv8, platelet derived growth factor, exosomes, or interacting with other cells. Exploring the expansion, activation, recruitment and angiogenesis mechanism of MDSCs will provide new ideas for regulating the individualized diagnosis and treatment based on targeted MDSCs.

    髓源性抑制细胞肿瘤微环境血管生成

      原文链接:
    • 万方数据

    乳房微生物群与乳腺癌：现状与未来

    顾花艳朱腾郭贵龙颜建华...
    55-58页
    查看更多>>摘要：近年来研究发现，乳腺癌组织与正常乳房组织之间存在不同的乳房微生物群。乳房微生物群与乳腺癌的发生、发展有着密切关系，其作用机制包括影响雌激素水平、脂质代谢、免疫调节和炎症反应等。调整饮食、合理使用抗生素及口服益生菌等可调节乳房微生物群，是预防和治疗乳腺癌的新方向。 In recent years, studies have found that breast microbiota differs between breast cancer tissue and normal breast tissue. Breast microbiota is closely related to the occurrence and development of breast cancer, and its mechanism includes affecting estrogen levels, lipid metabolism, immune regulation, and inflammatory response. Adjusting diet, rational use of antibiotics and oral probiotics can regulate breast microbiota, which is a new direction for the prevention and treatment of breast cancer.

    乳腺肿瘤微生物群肿瘤微环境雌激素类

      原文链接:
    • 万方数据

    循环肿瘤DNA在肝细胞癌诊疗中的研究进展

    黄镇陈永顺宋洪伟
    59-64页
    查看更多>>摘要：肝细胞癌（HCC）是我国发病率第4、死亡率第2的恶性肿瘤，晚期患者已失去手术治疗机会，生存期短，预后极差。组织病理活检是恶性肿瘤临床诊断的金标准，但组织病理活检不仅是有创性检查，而且获得的组织样本较少，不能反映肿瘤的异质性，也难以动态监测肿瘤的进展情况或治疗疗效。因此，寻找新的非侵入性策略以早期发现HCC并监测HCC疗效具有重要的临床意义。循环肿瘤DNA是无创的液体活检方法，取样简单且能动态监测肿瘤基因组学变化，在HCC的早期诊断、疗效监测以及预后评估中具有重要应用价值。 Hepatocellular carcinoma (HCC) is malignant tumor with the fourth incidence rate and the second mortality rate in China, and patients with advanced stage have lost the chance of surgical treatment, short survival period and extremely poor prognosis. Histopathological biopsy is the gold standard for clinical diagnosis of malignant tumors, but histopathological biopsy is not only invasive, but also obtains fewer tissue samples, which does not reflect the heterogeneity of tumors, and makes it difficult to dynamically monitor the progression of tumors or the efficacy of treatment. Therefore, it is clinically important to find new non-invasive strategies for early detection of HCC and to monitor the efficacy of HCC. Circulating tumor DNA is a non-invasive liquid biopsy method with simple sampling and can dynamically monitor the genomic changes of tumors, which has great application value in early diagnosis, therapeutic efficacy monitoring, and prognostic evaluation of HCC.

    癌,肝细胞循环肿瘤DNA早期诊断预后

      原文链接:
    • 万方数据