01,P<0.01);PTEN、TP53阳性表达率在远端无癌组织中高于癌组织(P<0.01,P<0.05));3MYC表达与分化程度(P<0.05)、TNM分期(P<0.05)、淋巴结转移(P<0.01)和侵犯深度(P<0.05)有关;PTEN表达与分化程度有关(P
目的:探讨PTEN、Survivin和Caspase-3的表达与食管鳞癌临床病理学特征之间的关系。方法:采用免疫组织化学SP法检测PTEN、Survivin和Caspase-3在65例食管鳞癌组织中的表达,分析三者的表达与食管鳞癌组织学分化程度、浸润深度及淋巴结转移的关系。结果:随着食管鳞癌细胞分化程度的减低和浸润深度的增加,PTEN和Caspase-3的阳性表达率均显著降低(P0.05)。PTEN、Caspase-3阳性表达率无淋巴结转移的癌组织中明显高于有淋巴结转移组(P<0.05),而Survivin阳性表达率无淋巴结转移的癌组织低于有淋巴结转移组(P<0.01)。Survivin与Caspase-3在食管鳞癌中表达呈负相关。结论:PTEN、Survivin和Caspase-3在食管鳞癌中的异常表达与食管鳞癌细胞的临床病理学特征关系密切,三者可能在食管鳞癌的发生发展过程中起重要作用。
肺癌是全球发病率和致死率最高的疾病之一。非小细胞肺癌(non-small

cell lung cancer,NSCLC)是肺癌最为常见的组织学类型。近些年,分子生物学的发展让我们对NSCLC的认识从组织水平深入到分子水平。表皮生长因子受体(epidermal RG7420 growth factor receptor,EGFR)基因突变和间变性淋巴瘤激酶(anaplastic lymphoma kinase,ALK)融合基因是NSCLC患者最为重要的两个肿瘤驱动基因。针对它们的酪氨酸激酶抑制剂(tyrosine kinase inhibitors,TKIs)显著改善了带有这类分子特征的NSCLC患者的生存。不幸的是,目前几乎所有针对这两种突变的初始靶向治疗都会不可避免地出现耐药问题。有关EGFR-TKIs的耐药机制及其应对策略已经有很多文章进行阐述,而对于ALK 哪里 TKIs治疗后出现耐药问题的机制和相应的治疗策略还未曾有过详细的综述。因此,本文针对一代ALK TKI(克唑替尼)治疗ALK融合基因阳性的NSCLC患者(ALK+NSCLC)后引起耐药问题的机制和有关后续治疗策略做一综述。
Gastrointestinal stromal tumors(GISTs)

are the most common type of mesenchymal tumor of the gastrointestinal tract. The tumorigenesis of GISTs is driven by gain-of-function mutations in KIT or plateletderived growth factor receptor α(PDGFRA),resultingin constitutive activation of the tyrosine kinase and its downstream signaling pathways. Oncogenic 更多 KIT or PDGFRA mutations are compelling therapeutic targets for the treatment of GISTs,and the KIT/PDGFRA inhibitor imatinib is the standard of care for patients with

metastatic GISTs. However,most GIST patients develop clinical resistance to imatinib and other tyrosine kinase inhibitors. Five mechanisms of resistance have been characterized:(1) acquisition of a secondary point mutation in KIT or PDGFRA;(2) genomic amplification of KIT;(3) activation of an alternative receptor tyrosine kinase;(4) loss of KIT oncoprotein expression; and(5) wild-type GIST. Currently,sunitinib is used as a secondline treatment for patients after imatinib failure,and regorafenib has been approved for patients whose disease is progressing on both imatinib and sunitinib. Phase Ⅱ/Ⅲ trials are currently in progress to evaluate novel inhibitors and immunotherapies targeting KIT,its downstream effectors such as phosphatidylinositol 3-kinase,protein kinase B and mammalian target of rapamycin,heat shock protein 90,and histone deacetylase inhibitor. Other candidate targets have been identified,including ETV1,AXL,insulin-like growth factor 1 receptor,KRAS,FAS receptor,protein kinase c theta,ANO1(DOG1),CDC37,and aurora kinase A. These candidates warrant clinical evaluation as novel therapeutic targets in GIST.