Objective The aims of this study were to analyze the incidence and mortality of liver cancer in Yunnan province in 2016 and the change trend from 2011 to 2016,and to provide a reference for the prevention and control of liver cancer. Methods Based on the data of tumor registration and related population in Yunnan province from 2011 to 2016,Excel 2007 and IARCcrgTools 2.05 software released by IARC were used to review and evaluate the data.SAS 9.4 and Excel 2007 were used to calculated crude incidence,mortality,age-standardized rate,cumulative rate of 0~74 years old,and truntated age-standarized rate(TASR)of 35~64 years old of liver cancer.Joinpoint 4.8 was used to calculate annual percentage change(APC)and its 95% confidence interval to comprehensively analyze the incidence and mortality of liver cancer. Results In 2016,the crude incidence of liver cancer in Yunnan province was 21.74/100,000,accounting for 10.21% of all malignant tumors,ranking fourth in the incidence of malignant tumors.The crude mortality was 19.56/100,000,accounting for 15.37% of malignant tumors,ranking second death in malignant tumors.The crude incidence and crude mortality,the China standard rate,the world standard rate,the cumulative rate(0~74 years old)and TASR(35~64 years old)of males were higher than those of females.The incidence and mortality of liver cancer in men,the Chinese standard rate,the World standard rate,the cumulative rate(0~74 years old)and the TASR(35~64 years old)were higher than women.The incidence and mortality of liver cancer in rural areas,the world standard rate,the cumulative rate(0~74 years old)and TASR(35~64 years old)were higher than those in urban areas.The incidence and mortality of liver cancer from 2011 to 2016 in Yunnan province both showed an upward trend(APC=3.90% and 5.60%;P＜ 0.05);The incidence and mortality both in rural areas and urban areas showed an upward trend(APC=4.60% and 6.50%;P＜0.05);The mortality of Chinese standard in males showed an upward trend(APC=5.40%,P＜0.05),and the rising trend of male Chinese standard mortality in urban areas was higher than that of females(APC=6.60% and 6.20%;P＜0.05). Conclusion In 2016,the incidence and death level of liver cancer in Yunnan province are lower than the national average,men are higher than women,and rural areas are higher than urban areas.The incidence and mortality of liver cancer from 2011 to 2016 are on the rise,and the incidence and death characteristics of liver cancer should be further targeted,strengthened prevention and control work.

Objective The Objective of this study was to observe the effect of miR-182 targeted regulation of PI3K/AKT/FOXO3a signaling pathway on the biological behavior of glioma stem cells(GSCs),and its mechanism of action. Methods GSCs were successfully isolated from the lesion tissues of glioma patients,before they were cultured,passaged and identified.GSCs were divided into the blank control group(physiological saline solution),miR-182 mimics group(cells transfected with miR-182 mimics)and negative control group(cell transfected nonsense sequence).After cells transfected,the transfection efficiency of miR-182 mimics was observed under an inverted fluorescence microscope.The expression of miR-182 mRNA and biological behavior changes such as proliferation,migration,invasion and apoptosis in each group were detected.The expression of PI3K/AKT/FOXO3a signaling pathway related proteins(PI3K,p-AKT,and FOXO3a)were also detected. Results The expression of miR-182 mRNA in the miR-182 mimics group was significantly higher than that of the blank control and negative control groups(P＜0.01).There was no significant difference between the blank control and negative control groups(P＞0.05).The cell proliferation rate,migration and invasion abilities of miR-182 mimics group at 24,48 and 72 h after transfection were significantly higher than those of blank control and negative control groups(P＜0.05).The apoptosis rate was significantly lower than that of blank control and negative control groups after transfection for 24 h,48 h and 72 h(P＜0.01).There was no statistical difference between the blank control and negative control groups(P＞0.05).After transfected with miR-182 mimics,the expression of PI3K and p-AKT protein in GSCs were significantly higher than those of blank control and negative control groups(P＜0.01),and the expression of FOXO3a protein was significantly lower than that of blank control and negative control groups(P＜0.01).The expression of PI3K,p-AKT,and FOXO3a protein was not statistical difference between the blank control and negative control groups(P＞0.05). Conclusion miR-182 may enhance the proliferation,migration and invasion of GSCs and inhibit cell apoptosis by activating the PI3K/AKT/FOXO3a signaling pathway.It may be a new target for clinical treatment of glioma.

Objective The aim of this study was to conduct a bibliometric and visual analysis of the literature related to breast cancer caregivers,to understand the developmental trend of breast cancer caregivers,and to provide references for future research. Methods Relevant literatures about breast cancer caregivers were obtained by searching the Embase database.The Excel 2016 software was used to produce and publish histograms of different authors,institutions,countries and the frequency of keywords,and generate high-yield authors,high-yield institutions,high-yield countries and high-frequency keyword tables.The VOSviewer 1.6.15 software was used to extract the authors,countries,institutions and keywords to generate a network map of high-yield authors,institutions and high-frequency keywords clustering network. Results A total of 698 documents meeting the requirements were retrieved,and the number of researches showed an overall upward trend.The authors came from 63 countries and 1,350 institutions.The country with the largest number of articles was the United States.The most prominent institution was University of California.The author formed 5 cooperative groups,with less cooperation among different groups.The research topics of breast cancer caregivers were relatively concentrated,among which the quality of life,the burden of caregivers,and palliative treatment were the focus of researchers. Conclusion The burden of breast cancer caregivers has gradually attracted attention;however,there is a lack of researchers and groups who have been engaged in this research field for a long time.The breadth and depth of research need to be further strengthened.At the same time,the communication and cooperation between different groups need to be strengthened to jointly produce high-quality research.The life quality of breast cancer patients and their caregivers are improved to provide guidance.

Objective The aims of this study were to investigate the relationship between the pre-treatment neutrophils to lymphocytes ratio(NLR)and prognosis of patients with non small cell lung cancer(NSCLC),and to explain the relevant mechanism. Methods A total of 302 NSCLC patients who received radiotherapy in Harbin Medical University Cancer Hospital from January 2007 to December 2009 were collected as the modeling group,and 96 patients from January 2010 to June 2010 were collected as the validation group.The ROC curve in the modeling group was used to evaluate the predictive value of NLR for patient recurrence;the relationship between NLR and clinical indications and prognosis before treatment,and the factors affecting the prognosis of patients were analyzed.A nomogram model was established and verified in the validation group.Immunohistochemistry was used to detect serum amyloid A(SAA)and neutrophil expression in tumor tissues;ELISA was used to detect the plasma concentration of SAA in patients;RT-PCR and Western blotting were used to detect the expression of SAA in NSCLC cells;Flow cytometry was used to analyze the effect of SAA on neutrophil apoptosis and detect the expression of apoptosis protein. Results The ROC curve in the modeling group showed that NLR had a certain diagnostic value for the recurrence of NSCLC patients before treatment(AUC=0.679,P=0.013),and the best cutoff of NLR was 2.53;Grouped by high and low NLR,NLR was correlated withand ECOG,pathological stage and tumor grade;Patients in the low NLR group have longer overall survival and disease-free survival(P＜0.01).The AUC values of the overall survival nomogram model for the prediction of the 3 and 5 year survival rates in the modeling group were 0.723 and 0.625,respectively,and the AUC values for the prediction of the 3 and 5 year survival rates in the validation group were 0.749 and 0.705,respectively.Patients with high NLR had a high neutrophil infiltration and high expression of SAA in tumor tissues(P＜0.01);The concentration of SAA in patients' serum was significantly increased(P＜0.01),and SAA concentration was positively correlated with the number of neutrophils(P＜0.01);expression of SAA mRNA and protein in NSCLC cells were significantly increased(P＜0.01);Flow cytometry results showed that SAA effectively inhibited neutrophil apoptosis;After neutrophils treated with SAA,the expression of Caspase-3 decreased,and Bcl-2 expression increased(P＜0.05). Conclusion The level of NLR before treatment can be used as an indicator of prognostic risk for NSCLC patients;SAA inhibits neutrophil apoptosis and affects the level of NLR.

Objective The aim of this study is to evaluate whether neutrophil-lymphocyte ratio(NLR)is associated with vulvar biopsy pathology,and to examine whether NLR can be used as an inflammatory marker to differentiate vulvar squamous cell carcinoma(VSCC)from its precancerous lesion vulvar intraepithelial neoplasia(VIN). Methods A retrospective study was performed on 386 patients undergoing vulvar biopsy from December 2012 to June 2020.The correlation between preoperative NLR and the biopsy pathologic findings were evaluated. Results The mean NLR of the patients with VSCC was significantly higher than that of the patients with VIN.The cut-off value of NLR in detecting VSCC from VIN selected on the ROC curve was 3.01 with 88.2% sensitivity and 67.8% specificity.Multivariate analysis identified an elevated NLR,age,and tumor size were associated with the presence of vulvar carcinoma and patients with elevated NLR have the highest risk of VSCC(OR=4.84,95% CI:4.17~7.14,P＜0.001). Conclusion NLR may be a useful marker to differentiate VSCC from VIN,and it may help in decision making(pre)cancerous pathologies of the vulvar.

Objective The aim of this study was to explore the related factors affecting the efficacy of neoadjuvant chemotherapy in patients with Luminal A type breast cancer,so as to provide screening indicators for patients with Luminal A type breast cancer and ultimately provide reference for improving the efficacy of neoadjuvant chemotherapy. Methods The clinical data of patients with Luminal A type breast cancer who received preoperative neoadjuvant chemotherapy and surgical treatment in our hospital from August 23,2013 to November 1,2019 were retrospectively analyzed.A total of 191 patients with type A breast cancer met the inclusion criteria.RECIST1.1 score was used to evaluate the efficacy.According to the clinical efficacy,these patients were divided into the Cr+PR group and non Cr+PR group.The relationship between clinicopathological features,efficacy and the related factors affecting efficacy were analyzed. Results Amongst 191 cases of Luminal A type breast cancer,147 cases were clinically effective(147 in the CR+PR group 44 cases were not clinically effective(44 cases in the non-CR+PR group),and the clinical effective rate of 77.0%.The degradation rate of axillary lymph nodes was 26.8%(45/168).Age ≤50 years old,premenopausal state,estrogen receptor(ER)＜ 70%,progesterone receptor(PR)＜50% and tumor located in the lateral quadrant were associated with the clinical effective rate(P＜0.05).Logistic regression analysis showed that tumor location and clinical stage were independent factors affecting the clinical efficacy of neoadjuvant chemotherapy in patients with Luminal A type breast cancer(P＜0.05). Conclusion Patients with Luminal A type breast cancer distributed in the lateral quadrant and clinical stage Ⅲ are more likely to be clinically effective,and patients with Luminal A type breast cancer can be evaluated and screened before neoadjuvant chemotherapy,so as to improve the curative effect.

Objective The aim of this study was to evaluate the clinical value of the software for automatic delineation of organs at risk in radiotherapy based on artificial intelligence technology. Methods Thirty cases of nasopharyngeal carcinoma treated in the department of Oncology at Zigong First people's Hospital from April 2019 and April 2020 were selected for the study.First,the AccuContour software was used to delineate the organs at risk(OARs)of 30 nasopharyngeal cancer patients,and then the Varian Eclipse v13.6 treatment planning system was used to manually delineate the OARs.Finally,the OARs automatically sketched and manually sketched were compared on the Eclipse system,and the geometric accuracy of the automatic sketching software was evaluated by comparing the volume difference,location difference,coincidence difference,similarity difference and other parameters,so as to verify its feasibility in the clinical application. Results Compared with manual delineation,the volume difference of small-size organs was larger,reaching 0.8,but the location difference was smaller.The coincidence and similarity of large size organs were larger,basically above 0.7.There was a big gap between automatic delineation and manual one in some CT sections of OARs. Conclusion The software based on artificial intelligence technology has a high accuracy in the delineation of organs at risk in nasopharyngeal carcinoma,and can be used in clinical work with slight modification,which can improve the efficiency of clinical work.

Objective The aim of this study was to investigate the value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the diagnosis of mediastinal lymph node metastasis of lung cancer. Methods Thirty-two patients with lung cancer who underwent DCE-MRI before surgery from January 2019 to June 2020 were collected.A total of 116 mediastinal lymph nodes confirmed by surgery and pathology were removed,including 21 metastatic lymph nodes and 95 non-metastatic lymph nodes.The DCE-MRI quantitative parameters of mediastinal lymph nodes were following:volume transfer constant(K^trans),rate constant(K_ep),and extravascular extracellular volume fraction(V_e).The differences between the DCE-MRI quantitative parameter values of the metastatic lymph nodes and non-metastatic lymph nodes were compared.The diagnostic efficiency of each quantitative parameter value for mediastinal lymph node metastasis was evaluated. Results The K^trans and Ve values of metastatic lymph nodes were higher than those of non-metastatic lymph nodes,the difference was statistically significant(P＜0.05).The ROC curves of K^trans,K_ep and V_e with pathological results were used as the gold standard,showing that the areas under the curve were 0.764,0.549,and 0.816,respectively.The areas under the curve of K^trans and Ve were all over 0.7,which has a certain diagnostic power,and the best diagnostic cut-off values were 0.117 min^-1 and 0.074,respectively.The sensitivity and specificity of K^trans were 87.37% and 66.67%,respectively,and the sensitivity and specificity of Ve were 75.79% and 90.48%,respectively. Conclusion The quantitative parameters of K^trans and Ve(DCE-MRI)can distinguish whether the mediastinal lymph nodes of lung cancer have metastasis,and have a certain diagnostic efficiency,which can provide more useful information for guiding the clinical development of individualized treatment plans.

Objective The aim of this study was to explore the different mammographic features of breast invasive ductal carcinoma with different molecular subtypes and the correlation with histological grade. Methods The complete diagnosis and treatment data of patients hospitalized with breast tumors during the period and all received preoperative mammography to be finally diagnosed with invasive ductal carcinoma of the breast through pathological examination were collected and sorted out.Referring to the 2019 Chinese Society for Clinical Oncology Breast Cancer Diagnosis and Treatment Guidelines(CSCO BC Guidelines)recommend methods for molecular typing,the preoperative X-ray images and postoperative pathological data were retrospectively analyzed to compare the differences in X-ray images between different molecular subtype groups and the relationship with histopathological grade. Results The five groups of molecular subtypes showed significant differences in X-ray images in terms of gland type,malignant calcification,and mass characteristics(P＜0.05).Among them,the three-negative gland type was mostly scattered and fibrous(52.8%,19/36),and the proportion of malignant calcification(13.9%,5/36),blurred edges(16.3%,7/36)and astral signs(9.3%,4/36)on the edges of the tumor was significantly reduced.The five molecular subtypes had significant differences in histological grading(P＜0.01),of which the proportion of three-negative poorly differentiated group(63.9%,23/69)and the proportion of Luminal A's moderately differentiated group(97.2%,72/74)were significantly higher than the other subgroups.Multivariate logistic regression showed that X-ray images with clear tumor edges were a risk factor for the poorly differentiated group(P＜0.05). Conclusion The X-ray images of invasive ductal carcinoma of the breast can help predict its molecular classification and histological grade to a certain extent,and can provide some help for personalized diagnosis and treatment and prognostic analysis of breast cancer patients.

Advanced gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs)have limited therapeutic drugs and poor efficacy.As a promising treatment method,immunotherapy has been initially explored in GEP-NENs in recent years.Current research results show that immune checkpoint inhibitors have good anti-tumor activity and safety in GEP-NENs.The expression of PD-L1 in the primary site of different GEP-NENs is different,and it is negatively correlated with the degree of differentiation.The effect of PD-L1 expression and immune cell infiltration on the prognosis of GEP-NENs patients is still controversial.The biomarkers that can predict the benefits of immunotherapy have not yet been determined.This article reviews the research progress of immunotherapy for GEP-NENs.

Endoplasmic reticulum stress(ERS)is an extremely important signal response pathway.When the ER is stressed,the survival pathway-the unfolded protein response(UPR)is first initiated,and the prolonged ERS will initiate the apoptosis pathway.At present,more and more studies have shown that liver cancer is closely related to ERS,and it has been confirmed that the tumor microenvironment of liver cancer can cause ERS.According to the dual role of ER reported in relevant literature,ERS can not only induce the transformation of liver cancer,but it also inhibits the proliferation and metastasis of liver cancer.Therefore,ERS provides the possibility of new treatment methods for liver cancer.This article reviews the research progress on the relationship between ERS and liver cancer.

The abnormal expression of Notch signaling pathway in many tumor cells,due to its high background correlation,shows the role of proto-oncogene or tumor suppressor gene.When the expression of Notch signal is affected by external stimulation or intracellular signal,Notch signal can promote or inhibit tumor cell apoptosis through“crosstalk” with other cell signaling pathways or by directly regulating apoptotic proteins.This paper reviews the mechanism of Notch signaling pathway in promoting and inhibiting tumor cell apoptosis,and provides theoretical support for anti-tumor therapy of Notch signaling pathway through the different effects of Notch signaling pathway on various apoptosis pathways.

The incidence of radiation proctitis is relatively high in patients with locally advanced cervical cancer receiving radiotherapy.This complication is the most common side effect of radiotherapy.In recent years,many studies at home and abroad have confirmed that the radiation rectal reaction in and after radiotherapy for locally advanced cervical cancer will affect the life quality of the patients.There are many factors that affect radiation proctitis,such as external irradiation technology,intracavitary therapy,DICRU point dose and dose volume.In this paper,the influencing factors of rectal function after radiotherapy for locally advanced cervical cancer are reviewed at home and abroad,so as to provide a reference for the clinical treatment of radiation-induced rectal toxicity.

Podoplanin is a transmembrane sialate-like glycoprotein expressed on the surface of a variety of tumor cells.It is the endogenous ligand of platelet C-type lectin-like receptor(CLEC2).Podoplanin can induce powerful platelet aggregation through CLEC2,and participate in cancer-related thrombosis.Based on these findings,anti-podoplanin and anti-CLEC2 targeted drugs are expected to become new therapies for the treatment of tumors.This review will discuss deeply the role of podoplanin-CLEC2 activated platelets in tumorigenesis and development,and discuss how to develop podoplanin-CLEC2 as a therapeutic target.

Most patients with head and neck squamous cell carcinoma(HNSCC)are in advanced stage when they are diagnosed.The recurrence rate and metastasis rate of traditional regimen are about 60% and 30%,respectively.However,the treatment of recurrent and metastatic HNSCC(R/M HNSCC)is limited,and the long-term survival rate needs to be improved.The emergence of immune checkpoint inhibitors can effectively improve the overall survival of these patients,and bring hope for HNSCC patients.This paper summarizes the research progress of programmed death protein-1(PD-1),programmed death ligand-1(PD-L1)and cytotoxic T lymphocyte associated antigen 4(CTLA-4)inhibitors and their combination therapy in HNSCC in recent years,hoping to provide a new treatment for clinicians.

In recent years,PARP inhibitors have become a new hot spot in clinical research on the treatment of breast cancer.A large number of studies have confirmed that they are beneficial in patients with BRCA1/2 mutant metastatic breast cancer.This article reviews the mechanism of PARP inhibitors and the research progress of several PARP inhibitors in the treatment of patients with BRCA1/2 mutated metastatic breast cancer.

Threonine and tyrosine kinase(TTK)are the core components of the spindle assembly checkpoint.Many studies have found that TTK inhibitors can be used in the treatment of malignant tumors.The combination of chemotherapy and radiotherapy improves the treatment effect,and TTK can be used as an independent biomarker to indicate prognosis.This article reviews the research progress of TTK inhibitors and their combined use with radiotherapy and chemotherapy in tumor therapy and TTK in predicting tumor prognosis.