Esophageal cancer(EC)is one of the most common aggressive malignant tumors in the digestive system with a severe epidemiological situation and poor prognosis.The early diagnostic rate of EC is low,and most EC patients...Esophageal cancer(EC)is one of the most common aggressive malignant tumors in the digestive system with a severe epidemiological situation and poor prognosis.The early diagnostic rate of EC is low,and most EC patients are diagnosed at an advanced stage.Multiple multimodality treatments have gradually evolved into the main treatment for advanced EC,including surgery,chemotherapy,radiotherapy,targeted therapy,and immunotherapy.And the emergence of targeted therapy and immunotherapy has greatly improved the survival of EC patients.This review highlights the latest advances in targeted therapy and immunotherapy for EC,discusses the efficacy and safety of relevant drugs,summarizes related important clinical trials,and tries to provide references for therapeutic strategy of EC.展开更多
Diffuse large B-cell lymphoma(DLBCL)and follicular lymphoma(FL)are the most common forms of aggressive and indolent lymphoma,respectively.The majority of patients are cured by standard R-CHOP immunochemotherapy,but 30...Diffuse large B-cell lymphoma(DLBCL)and follicular lymphoma(FL)are the most common forms of aggressive and indolent lymphoma,respectively.The majority of patients are cured by standard R-CHOP immunochemotherapy,but 30%–40%of DLBCL and 20%of FL patients relapse or are refractory(R/R).DLBCL and FL are phenotypically and genetically hereterogenous B-cell neoplasms.To date,the diagnosis of DLBCL and FL has been based on morphology,immunophenotyping and cytogenetics.However,next-generation sequencing(NGS)is widening our understanding of the genetic basis of the B-cell lymphomas.In this review we will discuss how integrating the NGS-based characterization of somatic gene mutations with diagnostic or prognostic value in DLBCL and FL could help refine B-cell lymphoma classification as part of a multidisciplinary pathology work-up.We will also discuss how molecular testing can identify candidates for clinical trials with targeted therapies and help predict therapeutic outcome to currently available treatments,including chimeric antigen receptor T-cell,as well as explore the application of circulating cell-free DNA,a non-invasive method for patient monitoring.We conclude that molecular analyses can drive improvements in patient outcomes due to an increased understanding of the different pathogenic pathways affected by each DLBCL subtype and indolent FL vs R/R FL.展开更多
The treatment of gastrointestinal cancer has always been a crucial research area,and targeted therapy has been receiving increasing attention.At present,the effect of targeted therapy is unsatisfactory for gastric can...The treatment of gastrointestinal cancer has always been a crucial research area,and targeted therapy has been receiving increasing attention.At present,the effect of targeted therapy is unsatisfactory for gastric cancer.Thus,the discovery of new targets is crucial.Claudin 18.2(CLDN18.2),a member of the claudin family,belongs to the tight junction protein family that controls the flow of molecules between cell layers.CLDN18.2 expression has been discussed in many studies.In recent years,there have been many studies on targeted therapy with CLDN18.2-ideal monoclonal antibody 362.Furthermore,CLDN18.2-specific chimeric antigen receptor T therapy has been used for CLDN18.2-positive tumors,such as gastric and pancreatic cancers.Considerable research has been focused on CLDN18.2.CLDN18.2,a newly discovered marker for precise targeted therapy of gastric cancer,could offer new hope for the treatment of gastric cancer.展开更多
目的探讨超声造影靶向穿刺区造影时间-强度曲线参数在血清总前列腺特异性抗原(total prostate specific antigen, tPSA)值为4~10μg/L前列腺增生症与前列腺癌鉴别诊断中的作用。方法血清tPSA为4~10μg/L且直肠指检异常的疑诊前列腺癌患...目的探讨超声造影靶向穿刺区造影时间-强度曲线参数在血清总前列腺特异性抗原(total prostate specific antigen, tPSA)值为4~10μg/L前列腺增生症与前列腺癌鉴别诊断中的作用。方法血清tPSA为4~10μg/L且直肠指检异常的疑诊前列腺癌患者103例,均行超声造影,依据造影图像行靶向穿刺及系统穿刺活检,依据组织病理结果分为前列腺癌组47例、前列腺增生组56例。比较2组超声造影靶向穿刺区造影时间-强度曲线参数上升时间(rise time, RT)、达峰时间(time to peak, TTP)、平均通过时间(mean transit time, MTT)、强度降半时间(peak to one half time, HT)、峰值强度(peak intensity, PI)、曲线下面积(area under the curve, AUC)、上升支斜率(wash in slope, WIS);绘制ROC曲线分析各参数对血清tPSA为4~10μg/L前列腺癌的诊断价值。结果前列腺癌组RT[6.18(5.41,9.17)s]、TTP[25.70(23.55,30.18)s]较前列腺增生组[9.53(6.11,16.99)、35.76(26.47,44.90)s]短(P<0.05),PI[8.70(6.89,10.84)dB]、AUC[536.31(396.28,772.11)dBs]、WIS[1.10(0.73,1.57)dB/s]较前列腺增生组[5.23(3.41,7.96)dB、288.84(172.71,402.50)dBs、0.49(0.26,0.99)dB/s]高(P<0.05),MTT[31.68(23.83,37.48)s]、HT[45.54(32.44,53.87)s]与前列腺增生组[27.48(21.07,40.63)s、39.54(30.30,50.29)s]差异无统计学意义(P>0.05)。ROC曲线分析结果显示,超声造影靶向穿刺区造影时间-强度曲线参数AUC、PI分别以413.62 dBs、5.23 dB为最佳截断值,诊断血清tPSA为4~10μg/L前列腺癌的AUC分别为0.807(95%CI:0.717~0.878,P<0.001)、0.779(95%CI:0.686~0.855,P<0.001);RT、TTP、WIS分别以9.88 s、36.02 s、0.66 dB/s为最佳截断值,诊断血清tPSA为4~10μg/L前列腺癌的AUC分别为0.677(95%CI:0.577~0.766,P=0.002)、0.734(95%CI:0.637~0.816,P<0.001)、0.744(95%CI:0.648~0.825,P<0.001)。结论对血清tPSA为4~10μg/L的疑诊前列腺癌患者,超声造影时间-强度曲线参数AUC>413.62 dBs或PI>5.23 dB时,应行前列腺穿刺活检明确诊断。展开更多
目的：探讨前列腺超声造影在经直肠前列腺靶向穿刺活检中的临床应用价值.方法选择96例血清PSA在4~20 ng/ml行前列腺穿刺活检的患者，其中50例行经直肠超声前列腺13针系统性穿刺活检；46例先行经直肠前列腺超声造影，后对超声造影异常增...目的：探讨前列腺超声造影在经直肠前列腺靶向穿刺活检中的临床应用价值.方法选择96例血清PSA在4~20 ng/ml行前列腺穿刺活检的患者，其中50例行经直肠超声前列腺13针系统性穿刺活检；46例先行经直肠前列腺超声造影，后对超声造影异常增强区靶向穿刺加6点常规穿刺，超声造影无异常者同系统性穿刺.比较两组穿刺活检的效率.结果系统性穿刺组前列腺癌的阳性率为22.0％，造影穿刺组为41.3％，两组间对单纯移行区肿瘤的检出率有统计学差异（P＜0.05）.系统穿刺组人均穿刺13.0针，单针阳性率为11％；造影穿刺组人均穿刺10.9针，单针阳性率为20％；两组单针阳性率、人均穿刺针数差异均有统计学意义（P＜0.05）.超声造影异常的患者单针阳性率明显高于普通超声检查的患者（31.5％ v s 11.3％），同时人均穿刺针数低于超声引导下系统性穿刺（9.7 vs 13.0针），差异具有统计学意义（P＜0.05）.系统性穿刺组前列腺癌患者总 Gleason评分为74分，人均6.7分，超声造影穿刺组则分别为133、7.0分，两组比较有统计学差异.两组无严重并发症.结论对于PSA＜20 ng/ml 的患者，超声造影对引导经直肠前列腺靶向穿刺活检具有更高的效率，可减轻患者的痛苦.展开更多
基金supported by grants from the National Natural Science Foundation of China(No.82002619)the Key Medical Research Projects of Shanxi Province(No.2020XM55)+2 种基金the Talent Introduction Scientific Research Start-up Fund of Shanxi Bethune Hospital(No.2020RC006)the special fund for Science and Technology Innovation Teams of Shanxi Province(No.202204051001031)Fundamental Research Program of Shanxi Province(No.202203021222349)
文摘Esophageal cancer(EC)is one of the most common aggressive malignant tumors in the digestive system with a severe epidemiological situation and poor prognosis.The early diagnostic rate of EC is low,and most EC patients are diagnosed at an advanced stage.Multiple multimodality treatments have gradually evolved into the main treatment for advanced EC,including surgery,chemotherapy,radiotherapy,targeted therapy,and immunotherapy.And the emergence of targeted therapy and immunotherapy has greatly improved the survival of EC patients.This review highlights the latest advances in targeted therapy and immunotherapy for EC,discusses the efficacy and safety of relevant drugs,summarizes related important clinical trials,and tries to provide references for therapeutic strategy of EC.
文摘Diffuse large B-cell lymphoma(DLBCL)and follicular lymphoma(FL)are the most common forms of aggressive and indolent lymphoma,respectively.The majority of patients are cured by standard R-CHOP immunochemotherapy,but 30%–40%of DLBCL and 20%of FL patients relapse or are refractory(R/R).DLBCL and FL are phenotypically and genetically hereterogenous B-cell neoplasms.To date,the diagnosis of DLBCL and FL has been based on morphology,immunophenotyping and cytogenetics.However,next-generation sequencing(NGS)is widening our understanding of the genetic basis of the B-cell lymphomas.In this review we will discuss how integrating the NGS-based characterization of somatic gene mutations with diagnostic or prognostic value in DLBCL and FL could help refine B-cell lymphoma classification as part of a multidisciplinary pathology work-up.We will also discuss how molecular testing can identify candidates for clinical trials with targeted therapies and help predict therapeutic outcome to currently available treatments,including chimeric antigen receptor T-cell,as well as explore the application of circulating cell-free DNA,a non-invasive method for patient monitoring.We conclude that molecular analyses can drive improvements in patient outcomes due to an increased understanding of the different pathogenic pathways affected by each DLBCL subtype and indolent FL vs R/R FL.
文摘The treatment of gastrointestinal cancer has always been a crucial research area,and targeted therapy has been receiving increasing attention.At present,the effect of targeted therapy is unsatisfactory for gastric cancer.Thus,the discovery of new targets is crucial.Claudin 18.2(CLDN18.2),a member of the claudin family,belongs to the tight junction protein family that controls the flow of molecules between cell layers.CLDN18.2 expression has been discussed in many studies.In recent years,there have been many studies on targeted therapy with CLDN18.2-ideal monoclonal antibody 362.Furthermore,CLDN18.2-specific chimeric antigen receptor T therapy has been used for CLDN18.2-positive tumors,such as gastric and pancreatic cancers.Considerable research has been focused on CLDN18.2.CLDN18.2,a newly discovered marker for precise targeted therapy of gastric cancer,could offer new hope for the treatment of gastric cancer.
文摘目的探讨超声造影靶向穿刺区造影时间-强度曲线参数在血清总前列腺特异性抗原(total prostate specific antigen, tPSA)值为4~10μg/L前列腺增生症与前列腺癌鉴别诊断中的作用。方法血清tPSA为4~10μg/L且直肠指检异常的疑诊前列腺癌患者103例,均行超声造影,依据造影图像行靶向穿刺及系统穿刺活检,依据组织病理结果分为前列腺癌组47例、前列腺增生组56例。比较2组超声造影靶向穿刺区造影时间-强度曲线参数上升时间(rise time, RT)、达峰时间(time to peak, TTP)、平均通过时间(mean transit time, MTT)、强度降半时间(peak to one half time, HT)、峰值强度(peak intensity, PI)、曲线下面积(area under the curve, AUC)、上升支斜率(wash in slope, WIS);绘制ROC曲线分析各参数对血清tPSA为4~10μg/L前列腺癌的诊断价值。结果前列腺癌组RT[6.18(5.41,9.17)s]、TTP[25.70(23.55,30.18)s]较前列腺增生组[9.53(6.11,16.99)、35.76(26.47,44.90)s]短(P<0.05),PI[8.70(6.89,10.84)dB]、AUC[536.31(396.28,772.11)dBs]、WIS[1.10(0.73,1.57)dB/s]较前列腺增生组[5.23(3.41,7.96)dB、288.84(172.71,402.50)dBs、0.49(0.26,0.99)dB/s]高(P<0.05),MTT[31.68(23.83,37.48)s]、HT[45.54(32.44,53.87)s]与前列腺增生组[27.48(21.07,40.63)s、39.54(30.30,50.29)s]差异无统计学意义(P>0.05)。ROC曲线分析结果显示,超声造影靶向穿刺区造影时间-强度曲线参数AUC、PI分别以413.62 dBs、5.23 dB为最佳截断值,诊断血清tPSA为4~10μg/L前列腺癌的AUC分别为0.807(95%CI:0.717~0.878,P<0.001)、0.779(95%CI:0.686~0.855,P<0.001);RT、TTP、WIS分别以9.88 s、36.02 s、0.66 dB/s为最佳截断值,诊断血清tPSA为4~10μg/L前列腺癌的AUC分别为0.677(95%CI:0.577~0.766,P=0.002)、0.734(95%CI:0.637~0.816,P<0.001)、0.744(95%CI:0.648~0.825,P<0.001)。结论对血清tPSA为4~10μg/L的疑诊前列腺癌患者,超声造影时间-强度曲线参数AUC>413.62 dBs或PI>5.23 dB时,应行前列腺穿刺活检明确诊断。
文摘目的：探讨前列腺超声造影在经直肠前列腺靶向穿刺活检中的临床应用价值.方法选择96例血清PSA在4~20 ng/ml行前列腺穿刺活检的患者，其中50例行经直肠超声前列腺13针系统性穿刺活检；46例先行经直肠前列腺超声造影，后对超声造影异常增强区靶向穿刺加6点常规穿刺，超声造影无异常者同系统性穿刺.比较两组穿刺活检的效率.结果系统性穿刺组前列腺癌的阳性率为22.0％，造影穿刺组为41.3％，两组间对单纯移行区肿瘤的检出率有统计学差异（P＜0.05）.系统穿刺组人均穿刺13.0针，单针阳性率为11％；造影穿刺组人均穿刺10.9针，单针阳性率为20％；两组单针阳性率、人均穿刺针数差异均有统计学意义（P＜0.05）.超声造影异常的患者单针阳性率明显高于普通超声检查的患者（31.5％ v s 11.3％），同时人均穿刺针数低于超声引导下系统性穿刺（9.7 vs 13.0针），差异具有统计学意义（P＜0.05）.系统性穿刺组前列腺癌患者总 Gleason评分为74分，人均6.7分，超声造影穿刺组则分别为133、7.0分，两组比较有统计学差异.两组无严重并发症.结论对于PSA＜20 ng/ml 的患者，超声造影对引导经直肠前列腺靶向穿刺活检具有更高的效率，可减轻患者的痛苦.
