Progression of solitary and multifocal papillary thyroid carcinoma — a retrospective study of 368 patients

Background  Papillary thyroid carcinoma (PTC) represents one of the most frequent endocrine malignancies. Several factors have been found to be involved in determining the outcome of treatment for patients with PTC. Large tumor size, diagnosis at an early age, extra-thyroidal invasion, aggressive histological variants, and distant metastases are the most important determinants of a poor outcome. BRAF^V600E mutation has been found to be a major genetic alteration in PTC. This study aimed to evaluate progression in patients with multifocal and solitary PTC.

Methods  We performed a retrospective study to analyze 368 patients with PTC who underwent surgery, including 282 patients with solitary PTC and 86 patients with multifocal PTC. The status of BRAF^V600E mutation in all tumor foci from multifocal PTC was detected.

Results  Our study suggested that multifocal PTC was more related to lymph node metastasis and vascular invasion than solitary PTC. However, the distant metastasis rate and 10-year survival rate showed no difference between these two groups. The number of tumor foci did not affect progression of disease in multifocal PTC patients. Lymph node metastasis in multifocal PTC patients was associated with larger tumors, diagnosis at early stage, and extra-thyroidal invasion.

Conclusion  The status of BRAF^V600E mutation was more frequent in multifocal PTC patients with lymph node metastasis and diagnosis at later age.

     

内蒙古地区甲状腺乳头状癌中BRAF V600E基因的表达及意义

目的：测定内蒙古地区蒙古族与汉族甲状腺乳头状癌(papillary thyroid carcinoma,PTC)患者BRAF V600E突变率及分布情况,进而评估基因突变与临床病理特征的关系。方法：从内蒙古医科大学附属医院甲乳外科及病理科收集2017-1~2019-12行手术治疗的20例汉族与40例蒙古族甲状腺乳头状癌患者的临床资料及存档石蜡组织进行基因检测及分析。结果：蒙古族PTC患者BRAF V600E突变率显著高于汉族患者(P<0.05)。蒙古族BRAF V600E突变与PTC患者是否合并桥本、淋巴结转移及被膜侵犯有关,而与年龄、性别、肿瘤直径、病灶数目、有无钙化无关。结论：内蒙古地区蒙古族与汉族BRAF V600E突变率不同,蒙古族患者BRAF V600E突变与PTC患者是否合并桥本、淋巴结转移及被膜侵犯有关,这些发现可为PTC患者手术方案的制订及预后评估提供参考。     

Preferred Revascularization Strategies in Patients with Ischemic Heart Failure: A Meta-Analysis

Clinically, coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) is generally used to treat patients with ischemic heart failure. However, the optimal treatment strategy remains unknown. This study examined the efficacy of the two coronary revascularization strategies for severe ischemic heart failure by using a meta-analysis. Studies comparing the efficacy of CABG and PCI were obtained from PubMed, EMBASE, Google Scholar and Cochrane Central Register of Controlled Trials (CENTRAL). The quality of each eligible article was evaluated by Newcastle-Ottawa Quality Assessment Scale (NOS), and the meta-analysis was performed using Stata version 12.0 software. Eventually, 12 studies involving 9248 patients (n=4872 in CABG group; n=4376 in PCI group) were subject to the meta-analysis for subsequent pooling calculation. The pooled hazard ratio (HR) [HR=0.83, 95% CI (0.76, 0.90), P<0.001; heterogeneity, P=0.218, I²=22.9%] of CABG compared with that of PCI revealed a statistical superiority of CABG to PCI in terms of the long-term mortality. Furthermore, CABG showed more advantages over PCI with respect to the incidence of myocardial infarction [HR=0.51, 95% CI (0.39, 0.67), P<0.001; heterogeneity, P=0.707, I²=0%] and repeat revascularization [HR=0.40, 95% CI (0.27, 0.59), P<0.001; heterogeneity, P<0.001, I²=80.1%]. It was concluded that CABG appears to be more advantageous than PCI for the treatment of ischemic heart failure in the given clinical setting.     

Sodium Tanshinone ⅡA Sulfonate Injection as Adjuvant Treatment for Unstable Angina Pectoris: A Meta-Analysis of 17 Randomized Controlled Trials

Objective: To systematically evaluate the effectiveness and safety of Sodium Tanshinone ⅡA Sulfonate Injection(STS) as one adjuvant therapy for treating unstable angina pectoris(UAP). Methods: Randomized controlled trials(RCTs) of UAP treated by STS were searched in the China National Knowledge Infrastructure Database(CNKI), VIP Database for Chinese Technical Periodicals(VIP), Wanfang Database, the Chinese Biomedical Literature Database(CBM), Web of Science, the Cochrane Library, Embase, and Pub Med, which from inception to January, 2016. The Cochrane Risk Assessment Tool was used to evaluate the methodological quality of the RCTs. The Review Manager 5.3 software was used to conduct the metaanalysis. Results: The results showed that 17 RCTs involving 1,372 patients were included. The meta-analysis indicated that the combined use of STS and Western medicine(WM) in the treatment of UAP can obviously improve the total effective rate [risk ratio(RR)=1.31, 95% confidence interval(CI)(1.24,1.39), P0.0001], and the total effective rate of electrocardiogram [RR=1.43, 95% CI(1.30,1.56), P0.0001], decrease the level of CRP [mean difference(MD)=–3.06, 95%CI(–3.85, –2.27), P0.00001], fibrinogen [MD=–1.03, 95% CI(–1.16, –0.89), P0.00001], and whole blood high shear viscosity [MD=–0.70, 95% CI(–0.92, –0.49), P0.00001]. Additionally, the occurrence of adverse drug reaction of the experimental group was significantly higher than that of the control group [RR=3.57, 95% CI(1.28, 9.94), P0.05]. Conclusions: Compared with WM, the combined use of STS was more effective.     

甲状腺乳头状癌中BRAF V600E突变及其与甲状腺超声表现的关系

目的:探讨甲状腺乳头状癌(papillary thyroid carcinoma,PTC)中BRAF V600E突变及其与甲状腺超声表现的关系。方法:采用PCR反应扩增及DNA直接测序法检测34例PTC患者手术切除的新鲜甲状腺组织及其癌旁组织的BRAF V600E突变情况,比较PTC发生和未发生BRAF V600E突变患者的甲状腺超声检查影像。结果:34例PTC癌组织标本中有18例发生BRAF V600E突变,16例未发生突变;34例PTC癌旁组织标本均未检测到BRAF V600E突变。PTC BRAF V600E突变患者与未发生突变患者甲状腺超声检查的癌块大小、边界是否清楚及有无钙化差异均无统计学意义(P>0.05)。结论:PTC中BRAFV600E突变率较高;BRAF V600E突变与甲状腺超声表现无明显关系。甲状腺超声表现不能预测PTC中BRAF V600E突变的存在。     

甲状腺乳头状癌CD44v6表达的免疫组化研究

目的;探讨甲状腺乳头状癌ＣＤ４４ｖ６的表达与淋巴结转移的方法。方法：应用免疫组化ＳＰ法对２０例有颈淋巴结转移的甲状腺乳头状癌（ＰＴＣ＋ＬＮＭ）,３０例无颈部淋巴结转移的甲状腺乳头状癌（ＰＴＣ）,１０例甲状腺腺瘤（ＴＡ）和１０例正常甲状腺组织（ＮＴＴ）进行了ＣＤ４４ｖ６检测。     

甲状腺乳头状癌患者BRAF基因V600E检测的意义

目的 评估免疫组化法检测BRAF基因V600E突变对甲状腺乳突状癌的诊断价值,进一步明确BRAF基因V600E突变与甲状腺乳头状癌外扩散的相关性。方法 2011年3月至2014年3月37例经病理确诊甲状腺乳突状癌患者,对于免疫组化染色阳性肿瘤进行染色强度分类。评估年龄、甲状腺外扩散、侵袭淋巴管血管、区域淋巴结转移病理变化。结果 直接测序法显示28例（75.7%）PTC BRAF基因V600E阳性;免疫组化染色显示25（67.6%）BRAF基因V600E阳性。以直接测序法为标准,免疫组化法对BRAF基因V600E特异抗体检测突变的敏感性为89.3%、特异性为100%,阳性预测值为100%,阴性预测值为75.0%。 结论 免疫组化染色是检测甲状腺乳突状癌中BRAF基因V600E突变准确的方法,能够量化BRAF基因V600E表达,预测肿瘤侵袭性。     

BRAF V600E Mutation as a Predictive Factor of Anti-EGFR Monoclonal Antibodies Therapeutic Effects in Metastatic Colorectal Cancer：a Meta-analysis

Objective To investigate the correlation between BRAF V600E mutation and anti-epidermal growth factor receptor （EGFR） monoclonal antibodies （MoAbs） therapeutic effects in metastatic colorectal cancer. Methods Studies were included into meta-analysis to investigate the association between BRAF V600E mutation and clinical outcome in metastatic colorectal cancer patients treated with anti-EGFR MoAbs.Results A total of 7 studies were included in this meta-analysis. The 7 studies included 1352 patients in total, sample sizes ranged from 67 to 493. Objective response rate （ORR）, progression-free survival （PFS） and overall survival （OS） were collected from included studies and were used to assess the strength of the relation. In patients with wild-type KRAS, the pooled odds ratio for ORR of mutant BRAF over wild-type BRAF was 0.27 （95%CI=0.10-0.70）. BRAF mutation predicted a deterioration in PFS and OS in wild-type KRAS patients treated with anti-EGFR MoAbs （hazard ratio=2.78, 95% CI=1.62-4.76;hazard ratio=2.54, 95%CI=1.93-3.32）. 〈br〉 Conclusion BRAF V600E mutation is related to lack of response and worse survival in wild-type KRAS metastatic colorectal cancer patients treated with anti-EGFR MoAbs.     

Foxp3 expression in CD4<Superscript>+</Superscript>CD25<Superscript>+</Superscript>Foxp3<Superscript>+</Superscript> regulatory T cells promotes development of colorectal cancer by inhibiting tumor immunity

The mechanism underlying CD4⁺CD25⁺Foxp3⁺ regulatory T cells (Tregs) promoting the development of colorectal cancer (CRC) was elucidated in the present study. Forty-eight cases of colorectal carcinomas, 22 cases of colon polyps and 21 cases of normal colorectal tissues were collected. The correlation among Foxp3, IL-10 and Stat3, and the clinical relevance of these three indexes were analyzed. The results showed that the levels of Foxp3 expressed in infiltrating CD4⁺CD25⁺Foxp3⁺Tregs, and IL-10 and Stat3 in CRC tissues were all significantly higher than those in polypus tissues and normal colon tissues (P< 0.01). Pearson correlation analysis indicated that the expression level of Foxp3 was positively correlated with Stat3 at mRNA level (r=0.526, P=0.036), and was positively correlated with IL-10 at protein level (r=0.314, P=0.030). The Foxp3 expressed in CD4⁺CD25⁺Foxp3⁺Tregs was correlated with the histological grade, lymph node metastasis and TNM stage of CRC (P<0.05 for all). The IL-10 expression was correlated with the histological grade and TNM stage (both P<0.05). The Stat3 expression was correlated with the lymph node metastasis and TNM stage (both P<0.05). It was concluded that CD4⁺CD25⁺Foxp3⁺Tregs can inhibit tumor immunity in combination with some other related inhibitory cytokines and that Foxp3 expression in CD4⁺CD25⁺Foxp3⁺Tregs correlates with CRC progression.     

新鲜穿刺样本和HE染色细胞样本在甲状腺穿刺BRAF基因V600检测中的价值

目的评价以新鲜穿刺样本和经苏木精-伊红(HE)染色后的细胞样本作为甲状腺穿刺鼠类肉瘤滤过性毒菌致癌同源体B1(BRAF)基因V600突变检测样本的适用性。方法收集370例甲状腺乳头状癌(papillary thyroid carcinoma, PTC)患者的临床资料,及术前细针穿刺(fine-needle aspiration, FNA)细胞学样本和术后福尔马林固定石蜡包埋(formalin-fixed, paraffin embedded, FFPE)样本,并按照FNA样本类型的不同,分为两个亚组。采用扩增阻滞突变系统(amplification refractory mutation system, ARMS)法进行BRAF基因V600的突变检测,并分析其与临床病理特征的关系。结果在术后FFPE样本的分析中,BRAF基因V600的突变率与大多临床病理特征无关,但与病灶数显著相关(P=0.028)。在FNA细胞学样本的分析中,BRAF基因V600的突变率与其细胞学诊断分类极显著相关(P=0.002)。新鲜穿刺样本和HE染色后的细胞样本与术后FFPE样本相比,灵敏度分别为95.7%和98.8%;一致性分别为93.7%和95%。结论不论是新鲜穿刺样本还是HE染色的细胞样本,在BRAF基因V600突变状态检测方面均有很高的灵敏度。在甲状腺的细胞学诊断中,二者均可以成为BRAF基因V600检测的有效补充样本。     

Genetic variants in <Emphasis Type="Italic">CHEK1</Emphasis> gene are associated with the prognosis of thoracic esophageal squamous cell carcinoma patients treated with radical resection

CHEK1 gene is known to play an important role in tumor progression by cell cycle control. However, the association between CHEK1 and the prognosis of esophageal squamous cell carcinoma (ESCC) is unclear. In this study, we explored the association between genetic variants in CHEK1 gene and prognosis of ESCC patients treated with radical resection. A total of 131 thoracic ESCC patients who underwent radical resection were included in this retrospective study and genotyped using the MassArray method. According to the univariate Cox hazard analysis, the GT/TT genotype of CHEK1 rs555752 was shown to be strongly related to a decreased overall survival (OS) (HR=2.560, 95% CI: 1.415–4.631, P=0.002) and disease-free survival (DFS) (HR=2.160, 95% CI: 1.258–3.710, P=0.005). Furthermore, according to the multivariate Cox hazard analysis and multiple testing, patients with the GT/TT genotype of CHEK1 rs555752 had a notably decreased OS (HR=2.735, 95% CI: 1.468–5.096, P=0.002, Pc=0.006) and DFS (HR=2.282, 95% CI: 1.292–4.023, P=0.004, Pc=0.012). In conclusion, genetic variants of the CHEK1 gene are significantly related to OS and DFS of ESCC patients, and may therefore be predictors of the prognosis of thoracic ESCC after surgery.     

Ginkgo Leaf Extract and Dipyridamole Injection as Adjuvant Treatment for Angina Pectoris: A Meta-Analysis of 41 Randomized Controlled Trials

Objective: To provide information about the effectiveness and safety of Ginkgo Leaf Extract and Dipyridamole Injection(GD) as one adjuvant therapy for treating angina pectoris(AP) and to evaluate the relevant randomized controlled trials(RCTs) with meta-analysis. Methods: RCTs concerning AP treated by GD were searched in China Biology Medicine Disc(SinoMed), PubMed, the China National Knowledge Infrastructure Database(CNKI), the Chinese Scientific Journals Database(VIP), Wanfang Database, Embase, and the Cochrane Library, from inception to February, 2017. The Cochrane Risk Assessment Tool was adopted to assess the methodological quality of the RCTs. The Review Manager 5.3 software was utilized to conduct the meta-analysis. Results: A total of 41 RCTs involving 4,462 patients were included in the meta-analysis. The results indicated that the combined use of GD and Western medicine(WM) against AP was associated with a higher total effective rate [risk ratio(RR)=1.25, 95% confidence interval(CI): 1.21–1.29, P0.01], total effective rate of electrocardiogram(RR=1.29, 95% CI: 1.21–1.36, P0.01). Additional, GD combined with WM could decrease the level of plasma viscosity [mean difference(MD)=–0.56, 95% CI: –0,81 to –0.30, P0.01], fibrinogen [MD=–1.02, 95% CI: –1.50 to –0.54, P0.01], whole blood low shear viscosity [MD=–2.27, 95% CI: –3.04 to –1.49, P0.01], and whole blood high shear viscosity(MD=–0.90, 95% CI: 1.37 to –0.44, P0.01). Conclusions: Comparing with receiving WM only, the combine use of GD and WM was associated with a better curative effect for patients with AP. Nevertheless, limited by the methodological quality of included RCTs more large-sample, multi-center RCTs were needed to confirm our findings and provide further evidence for the clinical utility of GD.     

Effects of continuous positive airway pressure therapy on plasma aldosterone levels in patients with obstructive sleep apnea: A meta-analysis

Obstructive sleep apnea (OSA) is an independent risk factor for cardiovascular diseases. Aldosterone was reported to be increased in patients with OSA and correlated with OSA severity. Many studies investigated the effect of continuous positive airway pressure (CPAP) therapy on plasma aldosterone concentrations (PAC) in OSA patients. The results, however, were inconsistent. In the present study, we aimed to evaluate the effects of CPAP therapy on PAC by performing a meta-analysis. Literature search was carried out in electronic databases including PubMed/Medline, Cochrane Library, Embase and Web of Science. Eligible full-text articles were identified, and important data were extracted. Pooled analysis was performed using the STATA12.0 and RevMan 5.2. Standardized mean difference (SMD) was calculated to estimate the treatment effects. A total of eight studies involving 219 patients were included for our final analysis. PAC was found unchanged after CPAP treatment in OSA patients (SMD=–0.36, 95% CI:–0.91 to 0.18, Z=1.32, P=0.19). Meanwhile, CPAP therapy showed no impact on PAC (SMD=–0.21, 95% CI:–0.85 to 0.42, Z=0.66, P=0.51) in a separate meta-analysis including 3 randomized controlled trials. In conclusion, the evidence for the use of CPAP therapy to decrease PAC in OSA patients is low, and further studies are still warranted.     

甲状腺乳头状癌患者临床病理特征和BRAF V600E基因突变对其颈部淋巴结转移的影响

探讨甲状腺乳头状癌（PTC）患者颈部淋巴结转移与原发灶临床病理特征和BRAFV600E基因突变的关联性，阐明PTC患者颈部淋巴结转移的影响因素。     

Is Chinese Herbal Medicine Effective for Elderly Isolated Systolic Hypertension? A Systematic Review and Meta-Analysis

Objective: To study the efficacy of Chinese medicine (CM) on isolated systolic hypertension. Methods: Seven electronic databases were searched for randomized controlled trials (RCTs) published until August 2015. Subgroup analyses and meta-analysis were performed to assess the efficacy and safety of the included studies. Results: A total of 24 studies, including 2,096 patients (1,058 patients in the intervention group and 1,038 in the control group), were evaluated in the final analysis. Compared with a conventional therapy used alone, CM as additional intervention was more effective on systolic blood pressure [mean difference (MD)=–0.66, 95% confidence interval (CI)=(–0.97, –0.36), P<0.00001] and significantly diminished the pulse pressure [MD=–7.49, CI=(–12.69, –2.29), P<0.00001]. However it showed no additional benefit on diastolic blood pressure [MD=1.16, CI=(0.02, 2.29), P=0.87]. Adverse events were not explicitly reported in most RCTs. Conclusions: CM might be a promising approach for the elderly with isolated systolic hypertension, while the evidence for CM employed alone was insufficient. Considering the inherent limitations of the included studies, larger high-quality RCTs with extensive follow-up should be performed to validate our findings in the future.     

BRAF V600E和TERT启动子突变与甲状腺乳头状癌临床病理特征的关系

  目的  探讨鼠类肉瘤滤过性毒菌致癌同源体B1(BRAF)V600E和端粒酶逆转录酶(TERT)启动子突变与甲状腺乳头状癌(PTC)临床病理特征之间的关系。  方法  采用聚合酶链式反应(PCR)直接测序检测326例PTC患者肿瘤组织的BRAF V600E和TERT启动子的突变情况,并分析其与临床病理特征之间的关系。  结果  BRAFV600E突变率为82.52% (269/326),TERT启动子突变率为3.37%(11/326),其中C228T位点突变9例,C250T位点突变2例,BRAF V600E和TERT启动子同时突变者10例(3.07%)。单因素分析结果显示BRAF V600E基因突变与PTC患者年龄及是否肿瘤复发/远处转移有关(P＜0.05),TERT启动子突变与患者年龄、肿瘤最大径、是否甲状腺腺外侵犯、T分期、AJCC分期及是否肿瘤复发/远处转移有关(P < 0.05)。BRAF V600E和TERT启动子同时突变与患者年龄、肿瘤最大径、是否甲状腺腺外侵犯、T分期及AJCC分期有关(P＜0.05)。  结论  PTC患者肿瘤组织BRAF V600E和TERT启动子同时突变时提示肿瘤侵袭性高。     

Chinese Medicine for Idiopathic Parkinson's Disease: A Meta Analysis of Randomized Controlled Trials

Objective:To evaluate the efficacy of Chinese medicine(CM) adjunct to conventional medications for idiopathic Parkinson's disease(PD).Methods:Electronic English and Chinese databases including PubMed,Cochrane Library,Web of Science,Chinese Medical Current Contents,China National Knowledge Infrastructure,China Science and Technology Journal Database,Wanfang Med Database,and Traditional Chinese Medical Database System were used for key words searching in a highly sensitive search strategy.The extracted data was analyzed by the Review Manager 5.0.Results:Twelve trials involving 869 participants were included in the meta-analysis.Unified PD Rating Scale(UPDRS) I,Ⅱ,Ⅲ,Ⅳ scores and UPDRS Ⅰ-Ⅳ total scores were used to be the primary outcomes,Parkinson Disease Question-39(PDQ-39) and Scores of Chinese Medical Symptoms were the secondary outcomes.CM adjunct therapy had greater improvement in UPDRS Ⅰ[2 trials;standardized mean difference(SMD)-0.40,95%confidence interval(CI)-0.71 to-0.09;Z=2.49(P=0.01)],Ⅱ[5 trials;SMD-0.47,95%CI-0.69 to-0.25;Z=4.20(P0.01)],Ⅲ[5 trials;SMD-0.35,95%CI-0.57 to-0.13;Z=3.16(P=0.002)],Ⅳ scores[3 trials;SMD-0.32,95%CI-0.60 to-0.03;Z=2.17(P=0.03)],UPDRS Ⅰ-Ⅳ total scores[7 trials;SMD-0.36,95%CI-0.53 to-0.20;Z=4.24(P0.05)].PDQ-39 and Chinese medical symptoms compared to the conventional medication only.Conclusion:CM adjunct therapy has potential therapeutic benefits by decreasing UPDRS scores and reducing adverse effect.     

早期胃癌腹腔镜辅助远端胃切除术疗效评价的Meta分析

目的评价腹腔镜辅助远端胃切除术（laparoscopy-assisted distal gastrectomy,LADG）与传统开腹手术（con-ventional open distal gastrectomy,CODG）治疗早期胃癌的临床疗效和安全性。方法检索PubMed、EmBase、临床对照试验资料库（cochrane controlled trials register,CCTR）及中国生物医学数据库（Chinese biomedical literature database,CBM）发表的临床随机对照研究文献,对纳入研究的文献采用Newcastle-Ottawa量表进行质量评价。提取文献原始数据,采用Revman 5.0统计软件对数据进行Meta分析,计算合并OR值和95%可信区间。结果经筛选有8个随机对照试验（ran-domized controlled trials,RCT）共734例患者纳入系统评价。与开腹手术组相比,腹腔镜手术组手术时间长,加权均数差（weighted mean difference,WMD）63.35;95%可信区间（confidence interval,95%CI）[57.96,68.74];P〈0.00001）。出血量少（WMD：-127.95;95%CI[-147.97,-107.93];P〈0.00001）。清扫淋巴结数量少（WMD：-4.21;95%CI[-6.10,-2.31];P〈0.0001）,术后肠道功能恢复快（WMD：-0.43;95%CI[-0.61,-0.24];P〈0.00001）,住院时间短（WMD：-1.29;95%CI[-1.76,-0.83];P〈0.00001）。腹腔镜手术组术后并发症发生率与开腹手术组之间的差异无统计学意义（OR：0.70;95%CI[0.46,1.06];P=0.09）。结论早期胃癌LADG可减少术中出血和术后并发症,但却增加了手术时间,减少了淋巴结的清扫数量;远期效果尚需进一步的RCT研究证实。     

Subcutaneous <Emphasis Type="Italic">versus</Emphasis> Intravenous Bortezomib Administration for Multiple Myeloma Patients: a Meta-analysis

Bortezomib, the first potent therapeutic proteasome inhibitor, has been suggested as a standard care in patients with newly diagnosed and relapsed multiple myeloma (MM). However, evidence bearing on the efficacy and safety of subcutaneous (SC) versus intravenous (IV) administration of bortezomib for MM patients is controversial. Randomised controlled trials (RCTs) and observational studies were enrolled in our meta-analysis to investigate the efficacy and safety of bortezomib via SC vs. IV administration on MM patients. Sixteen trials with a total of2575 patients with MM (SC, n=1191; IV, n=1384) were included in our meta-analysis. There were no significant differences between these two arms regarding overall response rate (ORR), complete response (CR), or very good partial response (VGPR). The pooled RRs for rate of adverse events (AEs), such as thrombocytopenia and bortezomib-induced peripheral neuropathy (BIPN), were 0.79 (95% CI: 0.68-0.92) and 0.63 (95% CI: 0.51-0.79), respectively. Moreover, there was much more largely decreased incidence of grade 3 and higher thrombocytopenia and BIPN in bortezomib SC administration than IV route. In general, alternative SC administration should be considered instead of IV administration in use of bortezomib for patients with MM. Key words: bortezomib; multiple myeloma; meta-analysis; subcutaneous administration     

甲状腺乳头状癌钠碘转运体表达与BRAFV600E突变的相关性研究

目的 探究甲状腺乳头状癌(PTC)中常见的遗传学事件BRAFV600E突变与钠碘转运体(NIS)表达的关系。 方法 选取104例行手术治疗的PTC病人为观察对象,留取术中新鲜PTC组织和癌旁正常组织标本,通过荧光定量PCR法检测NISmRNA含量,石蜡包块行免疫组织化学检测NIS蛋白表达,同时行BRAFV600E突变基因检测。 结果 104例PTC组织中BRAFV600E基因突变型共70例(67.3%),高于癌旁正常组织0例(P < 0.01);PTC组织中NISmRNA的表达浓度低于癌旁正常组织(P < 0.01),但NIS蛋白表达强度则高于癌旁正常组织(P < 0.01);PTC组织中NISmRNA表达下调同时NIS蛋白表达上调的比例高于癌旁正常组织(P < 0.01);PTC BRAFV600E基因突变病人NISmRNA表达浓度低于野生型病人(P < 0.01),但NIS蛋白比较差异无统计学意义(P>0.05)。 结论 BRAFV600E基因突变仅存在于癌组织中,可能与癌组织中NISmRNA低表达及NIS蛋白高表达具有相关性,且推测PTC中NIS蛋白可能是主要表达于细胞质中,影响其正常运输功能而导致病人无法聚碘。