Pancreatic cancer is a highly malignant digestive system tumor with a poor prognosis.Most pancreatic cancer patients are diagnosed at an advanced stage or even metastasis due to its highly aggressive characteristics a...Pancreatic cancer is a highly malignant digestive system tumor with a poor prognosis.Most pancreatic cancer patients are diagnosed at an advanced stage or even metastasis due to its highly aggressive characteristics and lack of typical early symptoms.Thus,an early diagnosis of pancreatic cancer is crucial for improving its prognosis.Currently,screening is often applied in high-risk individuals to achieve the early diagnosis of pancreatic cancer.Fully understanding the risk factors of pancreatic cancer and pathogenesis could help us identify the high-risk population and achieve early diagnosis and timely treatment of pancreatic cancer.Notably,accumulating studies have been undertaken to improve the detection rate of different imaging methods and the diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)which is the golden standard for pancreatic cancer diagnosis.In addition,there are currently no biomarkers with sufficient sensitivity and specificity for the diagnosis ofpancreatic cancer to be applied in the clinic. As the only serum biomarkerapproved by the United States Food and Drug Administration, carbohydrateantigen 19-9 (CA19-9) is not recommended to be used in the early screeningof pancreatic cancer because of its limited specificity. Recently, increasingnumbers of studies focused on the discovering of novel serum biomarkersand exploring their combination with CA19-9 in the detection of pancreaticcancer. Besides, the application of liquid biopsy involving circulating tumor cells(CTCs), circulating tumor DNA (ctDNA), microRNAs (miRNAs), and exosomesin blood and biomarkers in urine, and saliva in pancreatic cancer diagnosis aredrawing more and more attention. Furthermore, many innovative technologiessuch as artificial intelligence, computer-aided diagnosis system, metabolomicstechnology, ion mobility spectrometry (IMS) associated technologies, and novelnanomaterials have been tested for the early diagnosis of pancreatic cancer andhave shown promising prospects. Hence, this review 展开更多
Objective: For patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy(NCRT), significant pathological response of the primary tumor has been proposed to identify candidates for orga...Objective: For patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy(NCRT), significant pathological response of the primary tumor has been proposed to identify candidates for organ preservation. However, this does not address metastatic lymph nodes in the mesorectum. The aim of this study was to assess the incidence of lymph node metastases in ypT0 patients treated with NCRT and curative resection and to explore risk factors associated with survival.Methods: This was a retrospective study of patients with ypT0 rectal cancer after NCRT and curative resection at a tertiary care center in China from 2005 to 2014.Results: A total of 60(18.6%) patients who underwent surgery after NCRT and achieved ypT0 were enrolled in this study; one patient was excluded owing to lack of follow-up. Of these 59 patients, lymph node metastases were found in the mesorectum(ypT0N+) in eight(13.6%) patients. After a median follow-up of 52 months, 5-year recurrence-free survival(82.7% vs. 62.5%, P=0.014) and overall survival(OS)(90.9% vs. 70.0%, P=0.032) were much higher in ypN0 than yp N+ patients. Multivariate analyses showed that ypN+ status(P=0.009) and perioperative blood transfusion(BT)(P=0.001) were significantly independent risk factors associated with recurrence; however, no factor was correlated with 5-year OS.Conclusions: Patients with ypT0N0 rectal cancer can achieve excellent long-term outcomes; however, positive lymph nodes or tumor deposits can still be found in 13.6% of ypT0 patients. Nodal positivity in the mesorectum and perioperative BT are independent risk factors for recurrence.展开更多
基金This study was supported by Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(2018PT32014)Chinese Academy of Medical Science Innovation Fund for Medical Science(2017-I2M-1-001).
文摘Pancreatic cancer is a highly malignant digestive system tumor with a poor prognosis.Most pancreatic cancer patients are diagnosed at an advanced stage or even metastasis due to its highly aggressive characteristics and lack of typical early symptoms.Thus,an early diagnosis of pancreatic cancer is crucial for improving its prognosis.Currently,screening is often applied in high-risk individuals to achieve the early diagnosis of pancreatic cancer.Fully understanding the risk factors of pancreatic cancer and pathogenesis could help us identify the high-risk population and achieve early diagnosis and timely treatment of pancreatic cancer.Notably,accumulating studies have been undertaken to improve the detection rate of different imaging methods and the diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)which is the golden standard for pancreatic cancer diagnosis.In addition,there are currently no biomarkers with sufficient sensitivity and specificity for the diagnosis ofpancreatic cancer to be applied in the clinic. As the only serum biomarkerapproved by the United States Food and Drug Administration, carbohydrateantigen 19-9 (CA19-9) is not recommended to be used in the early screeningof pancreatic cancer because of its limited specificity. Recently, increasingnumbers of studies focused on the discovering of novel serum biomarkersand exploring their combination with CA19-9 in the detection of pancreaticcancer. Besides, the application of liquid biopsy involving circulating tumor cells(CTCs), circulating tumor DNA (ctDNA), microRNAs (miRNAs), and exosomesin blood and biomarkers in urine, and saliva in pancreatic cancer diagnosis aredrawing more and more attention. Furthermore, many innovative technologiessuch as artificial intelligence, computer-aided diagnosis system, metabolomicstechnology, ion mobility spectrometry (IMS) associated technologies, and novelnanomaterials have been tested for the early diagnosis of pancreatic cancer andhave shown promising prospects. Hence, this review
基金supported by National Key R&D Program of China (No. 2017YFC0908203)CAMS Initiative for Innovative Medicine (No. CAMS-I2M-003)
文摘Objective: For patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy(NCRT), significant pathological response of the primary tumor has been proposed to identify candidates for organ preservation. However, this does not address metastatic lymph nodes in the mesorectum. The aim of this study was to assess the incidence of lymph node metastases in ypT0 patients treated with NCRT and curative resection and to explore risk factors associated with survival.Methods: This was a retrospective study of patients with ypT0 rectal cancer after NCRT and curative resection at a tertiary care center in China from 2005 to 2014.Results: A total of 60(18.6%) patients who underwent surgery after NCRT and achieved ypT0 were enrolled in this study; one patient was excluded owing to lack of follow-up. Of these 59 patients, lymph node metastases were found in the mesorectum(ypT0N+) in eight(13.6%) patients. After a median follow-up of 52 months, 5-year recurrence-free survival(82.7% vs. 62.5%, P=0.014) and overall survival(OS)(90.9% vs. 70.0%, P=0.032) were much higher in ypN0 than yp N+ patients. Multivariate analyses showed that ypN+ status(P=0.009) and perioperative blood transfusion(BT)(P=0.001) were significantly independent risk factors associated with recurrence; however, no factor was correlated with 5-year OS.Conclusions: Patients with ypT0N0 rectal cancer can achieve excellent long-term outcomes; however, positive lymph nodes or tumor deposits can still be found in 13.6% of ypT0 patients. Nodal positivity in the mesorectum and perioperative BT are independent risk factors for recurrence.