tbuckley/cabot-search huggingface dataset:
Can FIT rule out colorectal cancer in symptomatic patients? Diagnostic test accuracy results from 9,822 patients in the NICE FIT study.
Authors: Theo Georgiou Delisle, Nigel D'Souza, Michelle Chen, Sally Benton, Muti Abulafi
Journal: Journal of Clinical Oncology (2020)

4093 Background: The faecal immunochemical test (FIT) is a non-invasive quantitative test that measures occult blood in faeces (faecal haemoglobin, FHb). FIT is already used worldwide in colorectal cancer (CRC) screening programmes. Bowel symptoms have low specificity for CRC; to diagnose one patient with CRC, a large number of symptomatic patients require investigation. A negative FIT test, when blood is not detected, could be used to rule out CRC in symptomatic patients without invasive investigations such as colonoscopy. We report on the largest diagnostic accuracy study to date of FIT in symptomatic patients. Methods: Patients were eligible for recruitment if they experienced bowel symptoms meeting national high-risk criteria and were triaged to investigation with colonoscopy. Patients were excluded from analysis if they did not provide a valid FIT or did not undergo complete colonoscopy. Colonoscopy results were compared to FIT measurements of FHb, and the conduct of the tests was double-blinded. Quality assurance of endoscopy and clinical data was performed by senior clinicians. External statisticians analysed anonymised data. Results: 9822 patients from 50 sites across England participated in the study between October 2017 to March 2019. The most common colonoscopy finding was absence of any colorectal disease (31%). The prevalence of CRC at colonoscopy was 3.3%. The sensitivity of FIT at FHb thresholds of 2, 10 and 150 μg/g significantly decreased from 97.0% to 90.9% and 70.8% respectively (p &lt; 0.01). FIT positivity rate at these thresholds increased from 7.6%, to 19% and 37.2% respectively (p &lt; 0.01). The positive predictive value of FIT for CRC at FHb thresholds of 2, 10 and 150 μg/g was 8.7%, 16.1% and 31.1% respectively and the negative predictive value of FIT at these thresholds was 99.8%, 99.6% and 98.9% respectively. Conclusions: The results of this study support the use of FIT at the threshold of detectable blood (2μg/g) as an initial CRC rule-out test to triage patients with high risk CRC symptoms, reducing the number of unnecessary investigations. This is the first study to report that at the lowest threshold of detectable blood, FIT sensitivity is equivalent to the current gold standard investigation of colonoscopy. Clinical trial information: ISRCTN49676259 .
Whole transcriptome changes correlate to exceptional ovarian cancer responders: A sub-analysis of a HIPEC Phase I trial.
Authors: Thanh Hue Dellinger, Xiwei Wu, Hyejin Cho, Winnie S. Liang, Ernest Soyoung Han, Mark Tsuneo Wakabayashi, Stephen Lee, Wei-Chien Lin, Mehdi Kebria, Mihaela C. Cristea, Nora Ruel, Daphne B. Stewart, Edward Wenge Wang, Mustafa Raoof, Byrne Lee, Lorna Rodriguez-Rodriguez
Journal: Journal of Clinical Oncology (2020)

6060 Background: Advanced stage ovarian cancer patients benefit from hyperthermic intraperitoneal chemotherapy (HIPEC), prolonging overall survival by nearly 12 months. However, molecular changes triggered by HIPEC are not well characterized, and no molecular signatures of response are known. We analyzed early gene expression changes after HIPEC treatment in ovarian tumors. Methods: This is an interval subgroup analysis of a single institution Phase I trial using HIPEC with cisplatin 75 mg/m 2 at time of optimal cytoreduction. Snap-frozen biopsies from tumor and normal peritoneum from 20 patients with ovarian cancer before and after HIPEC underwent whole-transcriptome sequencing using Illumina’s NovaSeq 6000 for paired 100 base-pair reads. Differential expression analysis comparing post and pre-samples was done to identify significantly changed genes, and pathway analysis was conducted using GSEA. Results: Sixty-three genes were differentially expressed (P &lt; 0.05, fold change ≥2) between pre- and post-HIPEC tumors. Hierarchical clustering analysis of these genes confirmed that all tumors and normal tissues clustered based on pre-HIPEC versus post-HIPEC status, and not based on their patient source. Gene set enrichment analysis using a collection of 50 “hallmark” gene sets revealed that post-HIPEC tumors demonstrate significant upregulation in immune pathways (TNFA signaling via NFKB, coagulation, complement), followed by epithelial-mesenchymal transition, inflammation, apoptosis, hypoxia, angiogenesis, KRAS signaling and JAK/STAT3 signaling. In contrast, post-HIPEC normal tissues exhibited upregulation in cell cycle pathways (Myc targets V2, G2M checkpoint). As expected, both post-HIPEC tumor and normal samples shared upregulation of genes related to inflammatory response. Lastly, post-HIPEC normal samples revealed downregulation of growth and metabolism pathways; in contrast, cell cycle or DNA repair pathways were downregulated in post-HIPEC tumors. Two exceptional-responders with recurrent platinum-sensitive disease (ongoing PFS 47 and 12+ months) demonstrated the most substantial changes in gene expression. Conclusions: Exceptional ovarian cancer responders to HIPEC are characterized by extensive gene expression changes; specifically, early HIPEC-induced molecular changes are strongly associated with immune pathways changes, implicating a role for immunotherapy after HIPEC in ovarian cancer. Clinical trial information: NCT01970722.
对住院患者实施健康教育的方法
Authors: 刘亚萍, 李玲珍
Journal: BMJ (2004)

急重症患者入院时,护士在积极地配合医生救治的同时,应及时向患者及家属强调当前危及患者生命安全的事项.如对脑血管病患者护士首先强调让患者绝对卧床休息,保持呼吸道的通畅,头偏向一侧防止呕吐物误入气管引起窒息等.待患者病情稳定后再详细介绍主管医生、责任护士、环境、制度、用药注意事项、饮食等,以尽快消除陌生感.病情较轻及慢性病患者入院时,责任护士先做自我介绍,并介绍主管医生、病区环境、制度、同室病友等,然后将患者送入病室,帮助整理床辅,放好随身携带物品,教会患者使用各种设施。
Massage on the trigger points of neck muscles for tension-type headache
Authors: Xin-ming Li, Ding-ming Li, An-ning Wei
Journal: BMJ (2010)

Seventy two patients with tension type headache (TTH) were divided randomly into two groups: massage group was treated with massage on the trigger points of neck muscles, and control group was treated with drugs.The frequency, duration, severity of TTH, use of painkiller and electromyography of pericranial muscle (temporalis muscle and masseter muscle ) were recorded before and after treatment.The frequency, duration and severity of TTH, the frequency of painkiller use, and amplitude and frequency on electromyography of pericranial muscles in massage groups after treatment were reduced significantly (P ＜0.05 ) .In summary, massage on the trigger points in neck muscles has significant therapeutic effects for TTH.

Key words: 
Massage;  Tension-type headache
Clinical, genetic, and pathologic determinants of prostate cancer brain metastasis.
Authors: Mira Patel, N. Ari Wijetunga, Stephanie Lobaugh, Zhigang Zhang, Sean Matthew McBride, Timothy An-thy Chan
Journal: Journal of Clinical Oncology (2020)

5536 Background: Prostate cancer (PCa) brain metastasis (BM) is a rare event occurring in 0.16-0.63% of PCa patients. Current clinical data on this phenomenon is limited to small retrospective cohorts and our understanding of it is incomplete. We sought to identify clinical and molecular predictors of PCa BM in a large retrospective cohort treated at our institution. Methods: Men diagnosed with Pca from 1995-2017 with ≥6 months of follow-up were included. Data was collected on clinical and tumor characteristics at diagnosis, PCa treatment, brain and bone metastasis, and tumor genetic profile based on Integrated Mutation Profiling of Actionable Cancer Targets (IMPACT) analysis. Results were examined using Kyoto Encyclopedia of Genes and Genome (KEGG) pathway. Genes altered in ≥5% of patients were included. Time to brain metastasis (TTBM) and overall survival (OS) were analyzed with univariable (UVA) Fine-Gray competing risks regression and Cox proportional hazards. TTBM and OS were landmarked at 6 months after PCa diagnosis. False discovery rate (FDR) adjustment accounted for multiple comparisons. Results: 27,887 men met inclusion criteria; 74 developed BM. Clinical variables associated with increased hazard of TTBM in UVA were high-clinical and pathologic-* (p&lt;.001) T stage, node-positive disease* (p&lt;.001), primary* and total* Gleason (p&lt;.001), receipt of abiraterone* (HR 52.51 (95% CI 7.1-389.8), p&lt;.001), and receipt of leuprolide* (HR 3.0 (95% CI 1.7-5.4), p&lt;.001). Tumor alterations associated with BM include mutations in BRCA2 (HR 2.94 (95% CI 1.1-8.0), p=.04), MYC (HR 3.41 (95% CI 1.2-9.5), p=.02), PTEN (HR 2.90 (95% CI 1.2-6.9), p=.02), RB1 (HR 3.09 (95% CI 1.2-8.0), p=.02), and pathways involving homologous recombination (HR 2.70 (95% CI 1.1-6.4), p=.02), Fanconi anemia* (HR 4.22 (95% CI 1.8-10.0), p&lt;.001), Ras signaling* (HR 4.6 (95% CI 1.5-13.9), p=.006), mTOR signaling (HR 2.88 (95% CI 1.1-7.9), p=.04), VEGF signaling* (HR 3.60 (95% CI 1.5-8.8), p=.005), and GnRH signaling* genes (HR 3.93 (95% CI 1.6-9.6), p0.003). Variables associated with increased hazard of BM after FDR adjustment are denoted with an asterisk. Variables associated with reduced OS after FDR adjustment were neuroendocrine or blastoma histology, node-positive disease, high-T stage, high initial PSA, receipt of leuprolide, and alterations in AR, TP53, and CDK12 genes. Conclusions: PCa BM is significantly associated with high-stage and grade disease, receipt of androgen deprivation agents such as abiraterone and leuprolide, and alterations in the Fanconi anemia, Ras, VEGF, and GnRH pathways.
降低社区人群糖尿病发病率的研究
Authors: 王鲁娜
Journal: BMJ (2004)

对人群健康体检中筛查出的256例高血糖患者(其中确诊2型糖尿病178例,空腹血糖损害和糖耐量损害78例)进行系统管理,即糖尿病教育、饮食调整、运动疗法,必要时药物治疗.3年后同一人群糖尿病年发病率降低0.48%。
Analysis on blood lipid profile in patients with type 2 diabetes by different diagnostic criteria for metabolic syndrome
Authors: 林寰东, 胡予, 吴丹, 高鑫
Journal: BMJ (2006)

目的 采用3种不同的代谢综合征建议诊断标准,观察2型糖尿病患者代谢综合征的发生状况以及组分数目的累积对血脂谱的影响,探讨2型糖尿病患者心血管疾病增加的可能原因.方法横断面观察157例2型糖尿病患者.采用1999年世界卫生组织(WHO)、2001年美国国家胆固醇教育计划第三次报告(NCEP-ATPⅢ)和2004年中华医学会糖尿病学分会(CDS)的代谢综合征建议诊断标准对这些患者的代谢综合征组分和血脂谱进行分析.结果在2型糖尿病患者中WHO,NCEP-ATPⅢ和CDS定义的代谢综合征发生率分别为73.9%、49.7%和52.9%.血脂异常发生率分别为54.8%、61.2%和54.8%.最常见的代谢综合征组合中均包括血脂异常.随着代谢综合征组分数目的增加,均显示甘油三酯水平显著升高,高密度脂蛋白胆固醇水平显著下降,低密度脂蛋白颗粒直径显著缩小.其中CDS标准的相关系数高于其他两种标准.结论2型糖尿病患者中,代谢综合征的发生率可达50%以上,且通常都伴有血脂异常,这种血脂异常表现为容易导致心血管疾病的血脂谱,即甘油三酯水平升高、高密度脂蛋白胆固醇水平降低和低密度脂蛋白颗粒直径的缩小.在中国人群中,CDS诊断标准能更客观地反映这种血脂谱的变化。
Exercise training of chromic heart failure
Authors: 孟涵, 王惠芳
Journal: BMJ (2009)

慢性心力衰竭(心衰)是临床最常见的疾病之一,任何损害心室充盈能力或射血能力的器质性或功能性心脏病都能引起慢性心衰.尽管药物治疗可以降低心衰患者的死亡率,但却无法有效地提高患者的运动耐力,这严重影响患者的生活质量。
Lung cancer as a subsequent neoplasm: A report from the Childhood Cancer Survivor Study (CCSS).
Authors: Taumoha Ghosh, Yan Chen, Andrew C Dietz, Gregory T. Armstrong, Rebecca M. Howell, Daniel A. Mulrooney, Lucie Marie Turcotte, Yan Yuan, Yutaka Yasui, Joseph Philip Neglia
Journal: Journal of Clinical Oncology (2020)

10551 Background: Lung cancer has been reported as a subsequent neoplasm (SN) in childhood cancer survivors. We aimed to assess the prevalence of and risk factors for lung cancer in the CCSS. Methods: Among 25,654 five-year survivors participating in the CCSS, lung cancer was self-reported and then confirmed by pathologic record review. Cancer treatment exposures were evaluated including chemotherapy and chest radiation by field size (none, small, large) and in a dose group (0-10 Gy, 10-30 Gy, 30-40 Gy, and &gt; 40 Gy). Standardized incidence ratios (SIR) were calculated using rates from the Surveillance, Epidemiology, and End Results program. Hazard ratios (HR) were estimated for demographic and treatment variables using Cox proportional-hazards models. Results: Forty-two survivors developed subsequent malignant lung cancer (SIR 4.0, 95% CI 2.9-5.4), including 25 carcinomas, 7 mesotheliomas and 10 others. Two additional benign neoplasms were also identified. The cumulative incidence of lung SNs was 0.18% at 30 years (95% CI 0.10-0.25). Median time from primary diagnosis was 28 years (range 11-46); median age at diagnosis was 45 years of age (range 15-65). A multivariable model, including all covariates with a p-value &lt; 0.2 in univariate analysis, showed significant associations between lung cancer and older age at diagnosis (HR 10.5, 95% CI 1.4-76.4, for 15-21 years vs. 0-4 years), as well as with primary diagnoses (relative to leukemia, HR 8.7, 95% CI 1.1-66.0, for Hodgkin lymphoma; HR 20.7, 95% CI 1.3-331.0 for neuroblastoma; and HR 21.4, 95% CI 2.3-202.7, for bone cancer). In a treatment model, maximum chest radiation dose (HR 4.1, 95% CI 1.4-11.7, for 30-40 Gy; and HR 8.1, 95% CI 3.0-22.2, for &gt; 40 Gy, relative to 0-10Gy), but not sex, smoking status, or chemotherapy exposures, was associated with lung cancer. Notably, six survivors who developed lung cancer received no radiation and of these, five had a primary bone cancer. At the end of follow-up, 65.9% of survivors with lung cancer were deceased vs. 14.1% of survivors without lung cancer ( p &lt; 0.001). Conclusions: Survivors of childhood cancer are at increased risk for developing lung cancer associated with exposure to high doses of chest radiotherapy. To our knowledge, this is the first study to describe associations with neuroblastoma and bone cancer. Future studies to understand additional treatment-related risk factors beyond chest radiotherapy dose are needed.
Wiskott-Aldrich综合征二例报告及文献复习
Authors: 郭城, 刘玲, 艾雪梅, 陈琍
Journal: BMJ (2012)

Wiskott-Aldrich综合征(WAS)又称为湿疹血小板减少伴免疫缺陷综合征,以血小板减少、湿疹、免疫缺陷、易患自身免疫性疾病和恶性肿瘤为特点.现报告我科收治的2例.一、临床资料例1,男,1岁2个月,主因皮肤瘀斑7d入院.患者于7d前无明显诱因出现双耳廓瘀斑,轻咳,半天前出现鼻衄,量不多,可自行缓解.于当地医院查WBC 16.4×109/L,分类中性粒细胞(N)0.46,淋巴细胞(L)0.41;RBC 4.68×1012/L,Hb98 g/L,平均红细胞体积(MCV)69.7 n,平均血红蛋白含量( MCH)20.9 pg,平均血红蛋白浓度(MCHC) 301 g/L;PLT9×109/L. 关键词：Wiskott-Aldrich综合征
Is there an association between air pollution levels and lung cancer incidence?
Authors: Seema Patel, Anees B. Chagpar
Journal: Journal of Clinical Oncology (2020)

e13584 Background: PM 2.5 particles are an indicator of air pollution levels associated with various respiratory illnesses. We sought to determine the association between air pollution levels and lung cancer incidence across different countries. Methods: Country-specific data for median PM 2.5 levels and age-standardized lung cancer incidence rates (ASLCIR) were collected for the year 2016 from the World Health Organization and the Global Cancer Observatory, respectively. Country-specific data for median age and proportion of smokers were collected from the Central Intelligence Agency and Our World in Data, respectively. Statistical analyses were performed using SPSS Version 26.0. Results: Across 105 countries, the median PM 2.5 level was 18 ug/m 3 (range; 6-94 ug/m 3 ). The WHO has set 10 ug/m 3 as the upper limit for PM 2.5 levels; 91 (86.7%) of countries had rates higher than this. The ASLCIR was surprisingly higher in countries with PM2.5 ≤ 10 ug/m 3 (median 28.7 vs. 13.9 per 100,000 population, Pearson correlation coefficient -0.386, p &lt; 0.001). Countries with PM 2.5 levels ≤ 10 ug/m 3 tended to have a higher GDP (median $55,709 vs. $5,931, p &lt; 0.001), and an older population (median 41.5 vs. 30.4, p &lt; 0.001); however, the proportion of population who smoked was no different in countries with low vs. high PM 2.5 levels (20.3% vs. 22.5%, p = 0.847). Controlling for age, GDP, and proportion of the population who smoke in a multiple linear regression model, ASLCIR were not influenced by median PM 2.5 (see linear regression table below, p = 0.888). Removing PM 2.5 levels from the model did not significantly affect the model fit (R 2 = 0.749 in both models). Conclusions: These results demonstrate that air pollution levels do not significantly impact lung cancer incidence rates, which are more related to age, tobacco use, and GDP. [Table: see text]
北京宣武区社区卫生服务机构暗访考核综合评价分析
Authors: 李薇, 李宁燕, 高宇
Journal: BMJ (2012)

2007年10月到2010年10月采取询问居民、拨打医务人员健康通、假扮患者体验就诊全过程的方式,对宣武区37家社区卫生服务机构共行7次暗访考核.结果提示暗访是对社区卫生服务外部考核的有效方式,是绩效考核有益补充。
Associations of neonatal high birth weight with maternal pre-pregnancy body mass index and gestational weight gain: a case-control study in women from Chongqing, China
Authors: 谢瑶洁, 彭容, 韩令力, 周小利, 熊正爱, 张媛, 李俊男, 姚若雪, 李廷玉, 赵勇, 刘颖译
Journal: BMJ (2017)

目的
研究中国西南部地区产妇孕前体质指数（BMI）和孕期体重增长（GWG）与高出生体重（HBW）新生儿的关系。


方法
以中国重庆地区住院分娩的产妇作为研究对象，采用配对病例对照研究的方法，纳入221例分娩巨大儿（出生体重>4.0 kg）的产妇作为病例组，并按年龄(年龄差在2岁以内)匹配221例分娩正常出生体重新生儿(出生体重2.5~4.0 kg)的产妇作为对照组，采用条件Logistic回归分析产妇分娩巨大儿的暴露比值比（OR）。并将产妇孕前BMI分为低体重、正常体重、超重和肥胖，GWG情况分为不足、适宜和过多进行分层分析。


结果
在病例组中，产妇孕前BMI均值（21.8±2.8）kg/m2，产妇GWG均值为（19.7±5.2）kg，新生儿出生体重均值为（4.2±0.2）kg。在对照组，相应的数值分别为（21.3±3.4）kg/m2、（16.4±5.0）kg和（3.3±0.5）kg。和对照组比较，病例组GWG过多的比例更高（80.1%比48.4%, P 0.05],而当校正妊娠次数、怀孕年龄、新生儿性别和家庭收入后，GWG与巨大儿成正相关（OR=1.18，95% CI：1.12~1.25；P<0.001)。和GWG适宜组比较，GWG过多组分娩巨大儿的校正OR值为5.39(95%CI：2.94~9.89；P<0.001)。在分层分析中，这种GWG过多与生产巨大儿的关联在孕前体重正常的产妇中巨大儿更高(OR=10.27，95%CI：3.20~32.95；P<0.001)。


结论
产妇的GWG与分娩巨大儿成正相关关系，但产妇孕前BMI与分娩巨大儿无独立的相关性。
A deeper and distributed search for culture
Authors: Paul S. Strand
Journal: Behavioral and Brain Sciences (2020)

Abstract The target article does not address the neural mediation of complex social behavior. I review evidence that such mediation may be compatible with proposed Bayesian information-processing principles. Notably, however, such mediation occurs subcortically as well as cortically, concerns reward uncertainty and information uncertainty, and impacts culture via group-level payoff structures that define individualism and collectivism.
偶发皮疹2次,右下肢红肿半个月,发热10d
Authors: 乔玲, 侯进, 乔顺凤, 祝墡珠
Journal: BMJ (2012)

病史摘要患者女性,30岁 因偶发皮疹2次,右下肢红肿半个月,发热10d入院.患者于2011年8月1 3日及11月17日无明显诱因下出现全身性皮疹,以双下肢为主,色红,略高于皮肤,伴瘙痒,无发热等不适,自服西替利嗪10 mg,3 d后皮疹消退 11月15日无明显诱因下,出现右下肢伸侧局部红肿,伴轻度瘙痒,无疼痛,无发热,门诊考虑局部炎症,予消炎止痛膏外敷及冰栀散局部喷,症状无明显改善。
Urgent cancer genetic counseling and testing for young, premenopausal women with breast cancer (BC): Impact on surgical decision-making for contralateral risk-reducing mastectomy.
Authors: Phuong L. Mai, Shenin Dettwyler, Ronald Johnson, Priscilla F. McAuliffe, Jennifer G. Steiman, Darcy Thull, Emilia Diego
Journal: Journal of Clinical Oncology (2020)

1533 Background: In women newly diagnosed with unilateral breast cancer (BC), contralateral risk-reducing mastectomy (CRRM) to decrease risk for additional primary BC is an appropriate option for some individuals, such as those with significantly increased risk due to a pathogenic variant (PV) in a breast cancer predisposition gene. Genetic testing at the time of BC diagnosis for young women has become more available and could aid in the decision-making process. We evaluated the trends for CRRM in a cohort of women diagnosed with BC at age ≤45 years who were seen in a multidisciplinary clinic where genetic counseling and testing is offered to each patient. Methods: A single institution, prospectively maintained database of patients seen in a BC multidisciplinary clinic between November 2014 and June 2019 was reviewed. Patients were included if they had non-metastatic, unilateral BC diagnosed ≤45 years of age, and underwent genetic testing at the time of BC diagnosis. Associations between surgical treatment (lumpectomy, mastectomy, or mastectomy with CRRM) and age at diagnosis, BC stage, family history, and genetic testing results were evaluated. Results: 184 patients were included in the analysis. The prevalence of a PV in a breast cancer predisposition gene was 15.8% (29/184; 1 in ATM, 12 in BRCA1, 8 in BRCA2, 5 in CH EK2, 2 in NBN, and 1 in NF1). 69% of the PV were in BRCA1 and BRCA2. 126 (68.4%) tested negative, and 29 (15.8%) had a variant of uncertain significance (VUS) in various genes. Overall, 63 patients (34.2%) elected to have CRRM. Of the 29 patients with a PV, 24 (82.8%) had CRRM. Women who chose CRRM were younger, more likely to test positive for a PV in a breast cancer predisposition gene, and more likely to have a significant family history of breast and/or ovarian cancer. Among the 155 patients who tested negative or had a VUS, there was no statistically significant association between CRRM and age (p = 0.58), test result (negative vs. VUS. p = 0.12), or family history (p = 0.32). Conclusions: For young women with BC seen in a multidisciplinary clinic, a younger age, significant family history, and positive genetic testing result were found to be associated with the decision to undergo CRRM. Among those without a genetic predisposition, having a VUS result was not associated with choosing CRRM. Incorporation of genetic services in the initial evaluation of young patients newly diagnosed with BC could add relevant information in surgical decision making and promote risk-appropriate management.
眼眶郎格罕斯细胞组织细胞增生症临床病理分析
Authors: 石少辉, 刘红刚
Journal: BMJ (2006)

郎格罕斯细胞组织细胞增生症(Langerhans cell histiocytosis,LCH)是一种单核巨噬细胞系统和网状细胞系统增生性疾病,以病灶内浸润的组织细胞中含有病理性郎格罕斯细胞(LC)为诊断依据.其发病可呈单灶或多灶性,好发于扁平骨,如颅骨、盆骨、肋骨等,也可累及全身脏器.自1996年1月至2005年1月我院确诊眼眶LCH 10例,现对这些患者的临床病理进行回顾性分析,并结合文献探讨该病的临床病理特点及发病机制。
Presence of circulating tumor cells is more significant than tumor stage in characterizing cellular local immunity in colorectal cancer.
Authors: Anastasia O. Sitkovskaya, Oleg I. Kit, Elena Yu. Zlatnik, Inna A. Novikova, Aleksandr B. Sagakyants, Elena P. Ulianova, Oksana G. Shulgina, Vladimir E. Kolesnikov, Nairi B. Oganyan, Vladislav K. Pavlov, Timofey S. Karasev, Elena A. Dzhenkova, Alexander V. Shaposhnikov, Aleksandr V. Snezhko, Roman E. Tolmakh, Yuriy A. Fomenko, Dmitry S. Petrov
Journal: Journal of Clinical Oncology (2020)

e16073 Background: The purpose of the study was a correlation analysis of parameters of local immunity and markers of the epithelial-mesenchymal transition (EMT) with the number of circulating tumor cells (CTCs) in patients with stage II-IV colorectal cancer (CRC). Methods: The study included 60 patients newly diagnosed with stage II-IV CRC. CTCs were detected with the Cell Search System (Janssen Diagnostics, LLC) prior to surgery. CTC≤3 were considered negative, CTC &gt; 3 – positive. After surgery, IHC analysis of tumor infiltration with immune system cells was performed with monoclonal antibodies for human CD3, CD4, CD8, CD20 and CD56; expression of EMT-associated proteins (E-cadherin, N-cadherin) was measured. All patients were informed of the goal of the study and provided informed consent. Results: CTC-negative patients with later cancer stages showed the loss of connection between the local levels of CD4+ and CD8+, and in stage IV - between CD3+ and CD4+. Starting from stage III, a negative correlation was observed between the expressions of E- and N-cadherin, not associated with the studied indices of local cellular immunity. The presence of CTCs in all 3 investigated stages of CRC, apparently, causes the loss of many connections between the indicators of the 3 units of local cellular immunity. While negative correlations were revealed between T-, B- and NK-cells in CTC-negative status, in CTC+ their number decreased to 1. An important positive correlation was between local levels of CD3+ and CD8+, indicating the predominance of cytotoxic T cells in the tumor and detected at all stages in CTC-negative patients, losing significance in the presence of CTCs regardless of the stage. In stage II, the only correlation (inverse one) was observed between the parameters of local (CD4+) immunity and the expression of cadherins (E-cadherin), which probably reflected the presence of immunosuppressive and growth-stimulating Tregs fraction among these cells. Conclusions: In general, the presence of CTCs was more significant for the number and nature of interconnections of cellular parameters of the local immunity than the tumor stage.