BACKGROUND Extramedullary plasmacytoma(EMP)is a rare kind of soft tissue plasma cell neoplasm without bone marrow involvement;this type of plasma cell neoplasm involves a lack of other systemic characteristics of mult...BACKGROUND Extramedullary plasmacytoma(EMP)is a rare kind of soft tissue plasma cell neoplasm without bone marrow involvement;this type of plasma cell neoplasm involves a lack of other systemic characteristics of multiple myeloma.Primary pulmonary plasmacytoma(PPP),with no specific clinical manifestations,is an exceedingly rare type of EMP.Because of its complexity,PPP is often difficult to diagnose,and there is no report in the literature on cases accompanied by overlap syndrome(OS).CASE SUMMARY A 61-year-old woman without a familial lung cancer history was admitted to our hospital in 2018,for intermittent cough,expectoration,and a stuffy feeling in the chest for 50 years;these symptoms appeared intermittently,especially occurred after being cold,and had been aggravated for the last 10 d.She was diagnosed with pulmonary fibrosis and emphysema,bronchiectasis,OS,and autoimmune hepatic cirrhosis in 2017.A pulmonary examination revealed rough breath sounds in both lungs;other physical examinations found no obvious abnormalities.A routine laboratory work-up showed decreased haemoglobin,increased ESR,and abnormal GGT,ALT,Ig G,γ-globulin,κ-light chain,λ-light chain,rheumatoid factor,and autoimmune antibodies.Emission computed tomography demonstrated abnormally concentrated 99 m Tc-MDP.Chest computed tomography revealed a soft tissue mass in the middle and lower lobes of the right lung.After right middle and inferior lobe resection with complete mediastinal lymph node dissection,immunohistochemical analysis revealed an isolated pulmonary plasmacytoma.The patient received chemotherapy for more than 1.5 years and remains in good general condition.CONCLUSION PPP is a type of EMP,and we report an exceedingly rare presentation of PPP accompanied by OS.展开更多
BACKGROUND Few studies have simultaneously compared the predictive value of various frailty assessment tools for outcome measures in patients undergoing gastrointestinal cancer surgery.Therefore,it is difficult to det...BACKGROUND Few studies have simultaneously compared the predictive value of various frailty assessment tools for outcome measures in patients undergoing gastrointestinal cancer surgery.Therefore,it is difficult to determine which assessment tool is most relevant to the prognosis of this population.AIM To investigate the predictive value of three frailty assessment tools for patient prognosis in patients undergoing gastrointestinal cancer surgery.METHODS This single-centre,observational,prospective cohort study was conducted at the Affiliated Lianyungang Hospital of Xuzhou Medical University from August 2021 to July 2022.A total of 229 patients aged≥18 years who underwent surgery for gastrointestinal cancer were included in this study.We collected baseline data on the participants and administered three scales to assess frailty:The comprehen-sive geriatric assessment(CGA),Fried phenotype and FRAIL scale.The outcome measures were the postoperative severe complications and increased hospital RESULTS The prevalence of frailty when assessed with the CGA was 65.9%,47.6%when assessed with the Fried phenotype,and 34.9%when assessed with the FRAIL scale.Using the CGA as a reference,kappa coefficients were 0.398 for the Fried phenotype and 0.291 for the FRAIL scale(both P<0.001).Postoperative severe complications and increased hospital costs were observed in 29(12.7%)and 57(24.9%)patients,respectively.Multivariate logistic analysis confirmed that the CGA was independently associated with increased hospital costs(odds ratio=2.298,95%confidence interval:1.044-5.057;P=0.039).None of the frailty assessment tools were associated with postoperative severe complications.CONCLUSION The CGA was an independent predictor of increased hospital costs in patients undergoing surgery for gastro-intestinal cancer.展开更多
Objective:The aim of this study was to assess the feasibility and safety of implanting covered stents in cases of advanced head and neck squamous cell carcinoma(ASCCHN)where the carotid artery was involved.Methods:A t...Objective:The aim of this study was to assess the feasibility and safety of implanting covered stents in cases of advanced head and neck squamous cell carcinoma(ASCCHN)where the carotid artery was involved.Methods:A total of 30 patients(29 males and one female)were included in this study,with ages ranging from 40 to 79 years.Among these patients,28 patients had received radiotherapy and 17 received subsequent adjuvant therapy,while one was receiving treatment for the first time.Eighteen were treated with covered stent implantation in conjunction with surgery,and the remaining 12 received stent implantation alone.The study evaluated and compared the stent implantation's success rate,overall survival(OS),and associated complications.Results:Successful implantation of covered stents was achieved in all 30 cases.No instances of significant hemorrhage or thromboembolic cerebral infarction occurred during surgery.Of the patients in the salvage surgical group,15 underwent complete tumor resection with a success rate of 83.3%(15/18),of which four experienced tumor recurrence with a local recurrence rate of 26.7%(4/15).The OS rates at 6 months for all patients,the salvage surgical group,the 15 patients with complete tumor resection,and the nonsurgical group were 64.0%,66.8%,75.5%,and 58.6%,respectively.At 12 months,the OS rates were 21.4%,29.3%,43.2%,and 11.8%,respectively.Notably,the OS of the 15 patients who underwent complete tumor resection was significantly higher than that of the 12 patients who received stent implantation alone(p=0.044).All cerebrovascular accidents occurred in patients with radiotherapy history,and subsequent adjuvant therapy had no significant effect on the OS time in the salvage surgical and nonsurgical groups(p=0.935;p=0.526).Conclusion:In cases of ASCCHN involving the carotid artery,the implantation of covered stents is a safe and feasible procedure.展开更多
This article provides an overview of the current evidence on the epidemiology,overlapping risk factors,and pathophysiology of cardiovascular disease(CVD)in patients with cancer.It explores the cardiotoxic effects of a...This article provides an overview of the current evidence on the epidemiology,overlapping risk factors,and pathophysiology of cardiovascular disease(CVD)in patients with cancer.It explores the cardiotoxic effects of anticancer therapy and their impact on prognosis.Although cancer survival rates have improved over the last two decades,the risk of CVD has risen over time in patients with cancer.CVD and cancer share similar risk factors and a common pathophysiology involving inflammation.Many chemotherapeutic agents used to treat cancer are associated with cardiovascular complications(such as heart failure,myocardial infarction,and thrombosis).Current evidence indicates a significant burden of CVD in patients with cancer,particularly in the first year following cancer diagnosis,with elevated risk persisting beyond this period.This short-and long-term risk of CVD may vary depending on the cancer type and treatment regimen.Early identification of potential cardiovascular risk in patients with cancer,can lead to more favorable clinical and survival outcomes.Given the acute and long-term consequences,patients with cancer require increased cardiovascular care and lifestyle optimization.This article offers valuable insights into the cardiovascular burden and needs of patients with cancer.It is intended for a general medical research readership interested in the intersection of cardiology and oncology.展开更多
Background The importance of polymorphisms in the methylenetetrahydrofolate reductase （MTHFR） gene for the prediction of the response to fluorouracil-based adjuvant chemotherapy in gastric cancer patients remains un...Background The importance of polymorphisms in the methylenetetrahydrofolate reductase （MTHFR） gene for the prediction of the response to fluorouracil-based adjuvant chemotherapy in gastric cancer patients remains unclear. The aim of this study is to assess the predictive value of several polymorphisms of the MTHFR gene for clinical outcomes of gastric cancer patients treated with fluorouracil-based adjuvant chemotherapy in Chinese population. Methods Three hundred and sixty-two Chinese patients with gastric cancer were treated with fluorouracil-based adjuvant chemotherapy. DNA samples were isolated from peripheral blood collected before treatment. The three single nucleotide polymorphisms （SNPs） （rs1801131, rs1801133, rs2274976） genotypes of the MTHFR gene were determined by matrix- assisted laser desorption/ionization time-of-flight mass spectrometry （MALDI-TOF MS）. Results The average response rate for chemotherapy was 46.7%. Homozygous genotypes rs2274976G/G （X2=22.7, P 〈0.01） and rs1801131A/A （X2=14.3, P=0.008） were over-represented in responsive patients. Carriers of the rs2274976A allele genotypes （G/A and A/A） and of the rs1801131C allele genotypes （A/C and C/C）were prevalent in nonresponsive patients. In the haplotype association analysis, there was a significant difference in global haplotype distribution between the groups （X2=20.69, P=0.000 124）. Conclusions These results suggest that polymorphisms of the MTHFR gene may be used as predictors of the response to fluorouracil-based chemotherapy for gastric cancer patients in Chinese population. Well-designed, comprehensive, and prospective studies on determining these polymorphisms of MTHFR gene as clinical markers for predicting the response to fluorouracil-based therapy in gastric cancer patients is warranted.展开更多
基金the National Nature Science Foundation of China,No.81500430 and No.U1304802the Science and Technology Planning Project of Henan Province,No.192102310045,No.182102310544,No.182102310566,and No.182102310573the Henan Medical Science and Technology Tackling Project,No.2018020337,No.2018020332,No.2018020334,and No.2018020320。
文摘BACKGROUND Extramedullary plasmacytoma(EMP)is a rare kind of soft tissue plasma cell neoplasm without bone marrow involvement;this type of plasma cell neoplasm involves a lack of other systemic characteristics of multiple myeloma.Primary pulmonary plasmacytoma(PPP),with no specific clinical manifestations,is an exceedingly rare type of EMP.Because of its complexity,PPP is often difficult to diagnose,and there is no report in the literature on cases accompanied by overlap syndrome(OS).CASE SUMMARY A 61-year-old woman without a familial lung cancer history was admitted to our hospital in 2018,for intermittent cough,expectoration,and a stuffy feeling in the chest for 50 years;these symptoms appeared intermittently,especially occurred after being cold,and had been aggravated for the last 10 d.She was diagnosed with pulmonary fibrosis and emphysema,bronchiectasis,OS,and autoimmune hepatic cirrhosis in 2017.A pulmonary examination revealed rough breath sounds in both lungs;other physical examinations found no obvious abnormalities.A routine laboratory work-up showed decreased haemoglobin,increased ESR,and abnormal GGT,ALT,Ig G,γ-globulin,κ-light chain,λ-light chain,rheumatoid factor,and autoimmune antibodies.Emission computed tomography demonstrated abnormally concentrated 99 m Tc-MDP.Chest computed tomography revealed a soft tissue mass in the middle and lower lobes of the right lung.After right middle and inferior lobe resection with complete mediastinal lymph node dissection,immunohistochemical analysis revealed an isolated pulmonary plasmacytoma.The patient received chemotherapy for more than 1.5 years and remains in good general condition.CONCLUSION PPP is a type of EMP,and we report an exceedingly rare presentation of PPP accompanied by OS.
基金the Postgraduate Research&Practice Innovation Program,No.SJCX22_1293Lianyungang City Aging Health Research Project,No.L202206.
文摘BACKGROUND Few studies have simultaneously compared the predictive value of various frailty assessment tools for outcome measures in patients undergoing gastrointestinal cancer surgery.Therefore,it is difficult to determine which assessment tool is most relevant to the prognosis of this population.AIM To investigate the predictive value of three frailty assessment tools for patient prognosis in patients undergoing gastrointestinal cancer surgery.METHODS This single-centre,observational,prospective cohort study was conducted at the Affiliated Lianyungang Hospital of Xuzhou Medical University from August 2021 to July 2022.A total of 229 patients aged≥18 years who underwent surgery for gastrointestinal cancer were included in this study.We collected baseline data on the participants and administered three scales to assess frailty:The comprehen-sive geriatric assessment(CGA),Fried phenotype and FRAIL scale.The outcome measures were the postoperative severe complications and increased hospital RESULTS The prevalence of frailty when assessed with the CGA was 65.9%,47.6%when assessed with the Fried phenotype,and 34.9%when assessed with the FRAIL scale.Using the CGA as a reference,kappa coefficients were 0.398 for the Fried phenotype and 0.291 for the FRAIL scale(both P<0.001).Postoperative severe complications and increased hospital costs were observed in 29(12.7%)and 57(24.9%)patients,respectively.Multivariate logistic analysis confirmed that the CGA was independently associated with increased hospital costs(odds ratio=2.298,95%confidence interval:1.044-5.057;P=0.039).None of the frailty assessment tools were associated with postoperative severe complications.CONCLUSION The CGA was an independent predictor of increased hospital costs in patients undergoing surgery for gastro-intestinal cancer.
基金supported by the Project of Nanjing Municipal Health Commission grant number YKK22249,2022.
文摘Objective:The aim of this study was to assess the feasibility and safety of implanting covered stents in cases of advanced head and neck squamous cell carcinoma(ASCCHN)where the carotid artery was involved.Methods:A total of 30 patients(29 males and one female)were included in this study,with ages ranging from 40 to 79 years.Among these patients,28 patients had received radiotherapy and 17 received subsequent adjuvant therapy,while one was receiving treatment for the first time.Eighteen were treated with covered stent implantation in conjunction with surgery,and the remaining 12 received stent implantation alone.The study evaluated and compared the stent implantation's success rate,overall survival(OS),and associated complications.Results:Successful implantation of covered stents was achieved in all 30 cases.No instances of significant hemorrhage or thromboembolic cerebral infarction occurred during surgery.Of the patients in the salvage surgical group,15 underwent complete tumor resection with a success rate of 83.3%(15/18),of which four experienced tumor recurrence with a local recurrence rate of 26.7%(4/15).The OS rates at 6 months for all patients,the salvage surgical group,the 15 patients with complete tumor resection,and the nonsurgical group were 64.0%,66.8%,75.5%,and 58.6%,respectively.At 12 months,the OS rates were 21.4%,29.3%,43.2%,and 11.8%,respectively.Notably,the OS of the 15 patients who underwent complete tumor resection was significantly higher than that of the 12 patients who received stent implantation alone(p=0.044).All cerebrovascular accidents occurred in patients with radiotherapy history,and subsequent adjuvant therapy had no significant effect on the OS time in the salvage surgical and nonsurgical groups(p=0.935;p=0.526).Conclusion:In cases of ASCCHN involving the carotid artery,the implantation of covered stents is a safe and feasible procedure.
文摘This article provides an overview of the current evidence on the epidemiology,overlapping risk factors,and pathophysiology of cardiovascular disease(CVD)in patients with cancer.It explores the cardiotoxic effects of anticancer therapy and their impact on prognosis.Although cancer survival rates have improved over the last two decades,the risk of CVD has risen over time in patients with cancer.CVD and cancer share similar risk factors and a common pathophysiology involving inflammation.Many chemotherapeutic agents used to treat cancer are associated with cardiovascular complications(such as heart failure,myocardial infarction,and thrombosis).Current evidence indicates a significant burden of CVD in patients with cancer,particularly in the first year following cancer diagnosis,with elevated risk persisting beyond this period.This short-and long-term risk of CVD may vary depending on the cancer type and treatment regimen.Early identification of potential cardiovascular risk in patients with cancer,can lead to more favorable clinical and survival outcomes.Given the acute and long-term consequences,patients with cancer require increased cardiovascular care and lifestyle optimization.This article offers valuable insights into the cardiovascular burden and needs of patients with cancer.It is intended for a general medical research readership interested in the intersection of cardiology and oncology.
文摘Background The importance of polymorphisms in the methylenetetrahydrofolate reductase （MTHFR） gene for the prediction of the response to fluorouracil-based adjuvant chemotherapy in gastric cancer patients remains unclear. The aim of this study is to assess the predictive value of several polymorphisms of the MTHFR gene for clinical outcomes of gastric cancer patients treated with fluorouracil-based adjuvant chemotherapy in Chinese population. Methods Three hundred and sixty-two Chinese patients with gastric cancer were treated with fluorouracil-based adjuvant chemotherapy. DNA samples were isolated from peripheral blood collected before treatment. The three single nucleotide polymorphisms （SNPs） （rs1801131, rs1801133, rs2274976） genotypes of the MTHFR gene were determined by matrix- assisted laser desorption/ionization time-of-flight mass spectrometry （MALDI-TOF MS）. Results The average response rate for chemotherapy was 46.7%. Homozygous genotypes rs2274976G/G （X2=22.7, P 〈0.01） and rs1801131A/A （X2=14.3, P=0.008） were over-represented in responsive patients. Carriers of the rs2274976A allele genotypes （G/A and A/A） and of the rs1801131C allele genotypes （A/C and C/C）were prevalent in nonresponsive patients. In the haplotype association analysis, there was a significant difference in global haplotype distribution between the groups （X2=20.69, P=0.000 124）. Conclusions These results suggest that polymorphisms of the MTHFR gene may be used as predictors of the response to fluorouracil-based chemotherapy for gastric cancer patients in Chinese population. Well-designed, comprehensive, and prospective studies on determining these polymorphisms of MTHFR gene as clinical markers for predicting the response to fluorouracil-based therapy in gastric cancer patients is warranted.
