More than one third the incidence of smoking-related cancers

Reporter learned from the Tianjin Tumor Hospital, China about 100 million people die each year from smoking related diseases, deaths due to passive smoking disease more than 10 million, and passive smoking hazards awareness rate was only 35%.

In recent years, a gradual increase in the incidence of malignant tumors, the occurrence of more than one third of cancer associated with smoking, has become a threat to the health of urban and rural residents of China's number one killer. In addition to lung cancer most closely associated with smoking, the smoke will be on the larynx, oral cavity, tongue, esophagus, stomach, pancreas, bladder, kidney, and the incidence of cervical cancer and so on have an impact.

Chinese Academy of Engineering, Tianjin Cancer Hospital, said Professor Hao Xishan, active smoking and passive smoking-induced cancers will be. Secondhand smoke contains more than 40 kinds of cancer-related toxic substances. In China, the main victims of passive smoking are women and children.

HAO Xi-shan to remind you that quitting smoking is the most effective cancer prevention methods. For smokers, the early quit smoking better than later, even if the middle-age smoking, will also reduce the risk of cancer.

Going into detail in food "tumor factor"

San Francisco VA Medical Center director of Cell Growth Laboratory, U.S. Department of Health under the Department of Veterans Affairs of the Science Advisor, the study's chief scientist, Millie Hughes-Fulford, Dr. said: "The arachidonic acid is the omega-6 family of well-known members. omega-6 fatty acids can open a direct pathway to promote tumor growth. "

The results of this study was published in February of this year's "Cancer Research" on.

University of California, San Francisco for part-time professor at Hughes-Fulford said: "When we put omega-6 fatty acids added to the cell growth medium, we observed that tumor growth rate was double the control."

She further added: "In the study of why the rate of tumor growth so fast, we found that omega-6 can open a number of inflammatory genes, these genes now known to be important cancer-related genes. We continue to ask what to open these genes, eventually found that omega-6 fatty acids can indeed open the named P13 kinase signaling pathway, the enzyme in cancer played an important role. "

Hughes-Fulford believe that this result has important significance, because the modern American's daily diet omega-6 fatty acids, very high quality. omega-6 only existed squeeze the oil of vegetable seeds, such as corn oil, omega-6 fatty acid content was 25 times the health standards, in addition to canola oil, fish and green vegetables all contain omega-6 fatty acids. She also mentioned that in the past 60 years, the United States the incidence of prostate cancer has been growing steadily, which is omega-6 intake increase the same, a fact that diet and prostate cancer suggests a possible link.

The research is based on Fulford and her research team had some of the work, they found that arachidonic acid can stimulate the kind of enzyme known as cPLA-2 generation, and this enzyme would lead to the occurrence of a series of biochemical reaction chain , eventually leading to tumor growth. Mentioned in the previous text of the article, the researchers "along the trace the origin of this biochemical cascade upstream," Hughes-Fulford said: "These fatty acids is to activate signaling pathways, triggering a whole cascade of initiator. "

Hughes-Fulford and her colleagues also found that if they are added to the tumor cell culture of non-steroidal anti-inflammatory factor, or PI3K inhibitor, it will undermine the signaling pathway, these genes will not be opened, tumor growth did not accelerate occur.

Currently, Hughes-Fulford experimental animals to continue her studies, she had her experimental animals take different levels of omega-3 fatty acids and omega-6 fatty acids, observed, "the growth of tumors in animals how well."

Hughes-Fulford said she was a direct impact on the findings of her own daily diet, "I am not a doctor, and can not tell people how to eat is healthy, but I can tell you how to do it myself." She added : "I just eat canola oil and olive oil, we have the right deep-fried foods at arm's length."

Peritoneal mesothelioma

Peritoneal mesothelioma is the primary peritoneal mesothelial cells in the tumor. Does not have the characteristic clinical manifestations, common signs and symptoms include: abdominal pain, ascites, abdominal distention and abdominal mass and so on.
Overview of primary peritoneal mesothelioma is peritoneal mesothelial cells in the tumor. Does not have the characteristic clinical manifestations, common signs and symptoms include: abdominal pain, ascites, abdominal distention and abdominal mass and so on. Peritoneal mesothelioma accounts for about 20% of all mesothelioma cases may occur in 2-92 years, mean age was 54 years, of which about 63% of cases are 45-64 years of age, children are rarely sick.

Clinical manifestations 1. Abdominal pain, abdominal distention, ascites, abdominal mass; 2. Anorexia, nausea, vomiting, diarrhea, constipation; 3. Fatigue, fever, weight loss, anemia; 4. Low blood sugar, diffuse abdominal ossification; 5. other parts of the merger, such as mesothelioma, peritoneal mesothelioma, metastasis to other organs and complications of the corresponding performance. Based on a diagnosis. Abdominal pain, abdominal distention, ascites, abdominal mass in patients, especially those with asbestos exposure history; 2. Imaging studies have a thin sheet of peritoneal signs and ascites tumor; 3. Ascites cytology; 4. Peritoneal biopsy, laparoscopy and laparotomy and pathological examination can be taken to make the organization confirmed.

Treatment principles 1. Surgical treatment; 2. Radiotherapy; 3. Chemotherapy; 4. Symptomatic supportive care. The principle of a medication. Combination therapy (such as cis-platinum + cyclophosphamide + vincristine), with intraperitoneal injection of chemotherapy drugs (such as cis-platinum); 2. Intra-abdominal injection of 32P, or colloidal gold, radiotherapy and chemotherapy drugs; 3. surgical cases can not be removed using radiotherapy (60Co) and chemotherapy (cyclophosphamide, vincristine, dactinomycin, etc.). Auxiliary examination 1. Check box limit "A" will help other than confusing the disease; 2. Check box limit "B" will help diagnosis.

Evaluation of a. Cure: remove the tumor without complications, wound healing, clinical symptoms disappeared; 2. Improved: radiotherapy, chemotherapy, symptoms improved after the tumor shrink or slow down the growth rate, appetite improved, weight gain; 3. Unhealed: clinical symptoms and signs do not disappear. Expert Tips peritoneal mesothelioma originated in the peritoneal epithelium and mesothelial organizations, asbestos dust for the disease-causing substances, may also be caused by certain viruses causes of mesothelioma.

Pathology of peritoneal mesothelioma can be divided into: adenomatoid tumor, cystic mesothelioma, and three kinds of malignant mesothelioma. Peritoneal mesothelioma clinical manifestations are not specific, the test positive rate is not high, specificity is not strong, clinical diagnosis very difficult. With laparoscopy, ultrasound and CT-guided biopsy technology, carry out, as well as pathology, immunohistochemistry and electron microscopy diagnosis of a higher level, more and more cases during his lifetime, or be clearly preoperative pathological diagnosis. Peritoneal mesothelioma should primarily with tuberculous peritonitis, intra-abdominal metastatic carcinoma, other primary tumors in the peritoneal omentum phase identification. To date, peritoneal mesothelioma is still a lack of effects of treatment, the vast majority of scholars, advocates, including surgical resection, postoperative radiotherapy and chemotherapy comprehensive treatment measures.

Histological types of peritoneal mesothelioma

Membrane mesothelioma (peritoneal mesothelioma) for the primary in the peritoneal epithelium and mesothelial cancer organizations, clinical rare. Can be categorized as pathological adenomatoid mesothelioma (adenomatoid mesothelioma), cystic mesothelioma (cystic mesothelioma) and malignant mesothelioma (peritoneal malignant mesothelioma, PMM).
Malignant mesothelioma is also known as "mesothelial sarcoma." Mostly occurs in the pleura and peritoneum, testis sheath, pericardium, meninges. More men than women, the ratio of 1.33:1. Occurs can be divided into parts according to the limitations and diffuse types. Limitations may have good evil points, both diffuse malignant. Among them, mostly diffuse peritoneal and pericardial. Low incidence of malignant mesothelioma, clinical rare.

Peritoneal mesothelioma histologic sub-three types: epithelial 15%, connective tissue-type 25%, mixed 60%. Longitudinal spread along the peritoneal surface lesion showed growth and invasion, and less distant metastasis, multi-spread along the serosa to the adjacent organs, involving the adjacent serous cavity; dual lymph node metastasis may occur; distant metastasis. Particularly prevalent in the hepatopulmonary bone. This case is almost are evil CT of peritoneal mesothelioma, symptoms of non-specific and therefore difficult early diagnosis. The main symptoms were (1), abdominal pain, generally expressed as a fixed part of the dull pain. (2) abdominal mass. (3) of the patients have incomplete obstruction. (4) ascites is a common symptom, and many more abdominal distension with ascites treatment. (5) late shows weakness, weight loss, weight loss, more than half a year were found; a minimum of two weeks. Easy-to-tissue adhesion tumor removal surgery is not easy.

CT manifestations of its performance, often as follows: (1) ascites, the amount of the number of ranges, and often bloody. (2), diffuse peritoneal thickening, thickening of the omentum and mesentery density increased, and some may have calcification, mesangial shadow blurred between the blood vessels. (3), nodule or mass formation, in the backdrop of ascites nodules more clearly, especially in the liver margin of spleen edge more pronounced. (4), omentum, or mesentery tumor was tie-shaped cakes, mesenteric stiffness, shrinkage star-shaped radiation bowels into a fan-shaped distribution of the fixed focus. But not its unique, ovarian, colon, pancreas, and mesenteric lymphoma may be represented by similar change.

What is the peritoneum mesothelioma the cause?

(A) causes of morbidity
The etiology and pathogenesis of asbestos exposure and contacts on its very long intervals often more than 30 years as early as 40 years in the 20th century, foreign scholars have discovered that the occurrence of mesothelioma and asbestos exposure close to the shipyard workers, pipeline workers, construction workers, welders and paint the incidence of 300 times more than the average height of a man close relationship between mesothelioma and asbestos exposure has been more and more confirmed by the fact that at the same time Europe and the United States with recognized scholars found that about 60% of peritoneal mesothelioma patients have occupational asbestos exposure history or lung tissue There are asbestos bodies in the use of asbestos-induced pleural mesothelioma in experimental animals is also a small number of animals, peritoneal mesothelioma, peritoneal mesothelioma, note the occurrence and the relationship between asbestos exposure has some different types of asbestos fibers in turn pathogenic risk as follows: crocidolite "amosite" chrysotile is generally believed that a long diameter of 0.5 ~ 50μm asbestos dust first and then through the diaphragm into the respiratory lymphoid tissue or blood into the abdominal cavity and the net deposition of the formation of asbestos bodies in the peritoneal asbestos bodies sometimes can occur around foreign body giant cell reaction to ingestion of asbestos fibers through the digestive tract can also be reached through the intestinal wall and peritoneal mesothelioma from exposure to asbestos have been detected an average of 35 ~ 40 years of peak incidence 45 years after exposure to asbestos-caused mesothelioma, the exact mechanism is not very clear but about 30% of mesothelioma patients with no history of exposure to asbestos fibers and asbestos quantitative examinations found no contact with a large number of asbestos fibers with the performance reported in the literature related to the occurrence of mesothelioma and other factors are history of exposure to radiation therapy thorium dioxide, (usually related to patients receiving diagnostic history) also occurs in patients with a history of Hodgkin increase the risk of mesothelioma
Infection: simian virus (simian virus 40SV40) It is a DNA tumor virus, according to the United States reported in the literature about 50% of the biopsy specimens of patients with mesothelioma it is present in SV40-induced telomerase activity in primary mesothelioma, but does not affect the fibroblasts 72h after infection of wild-type SV40 can be measured telomerase activity after 1 week shows a clear structure of DNA in the cell tower ladder of telomerase activity and SV40 T antigen is directly proportional to the number of SV40 infected mesothelial cells, the telomere enzyme activity is not easy to increase apoptosis of mesothelial cells allows the formation of mesothelioma, easily understood
Mesothelioma also may be related to the following factors: exposure Fluorspar scars of chronic inflammation of tuberculosis genetic susceptibility and other radioactive substances
(B) the pathogenesis of
According to their biological behavior and tumor invasion and scope can be divided into benign and malignant mesothelioma limitations and diffuse mesothelioma cases in the large coverage of about 57.1% occurred in the pleura 39.5%, occurred in the peritoneum can be 1% occurred in the pericardial involving multiple serosal surface or even in the testis sheath
1. Mesothelioma earlier that the genetic organization of two kinds of cells from the surface of the peritoneal mesothelial cells and connective tissue cells, has recently been confirmed to be from a single cell that the mesothelial cells of mesothelial cells to epithelial cells and fiber cells were two kinds of morphological differentiation Dardick (1984) found in sarcomatoid mesothelioma in the region does not show ultrastructural characteristics of fibroblasts display different stages of differentiation characteristics of epithelial cells using immunohistochemical methods Blobel prove cytokeratin polypeptide ( cytokeratin polypeptide) in the fibrous mesothelioma, and the expression of epithelial mesothelioma are wavy fibrin (fibrin) in the same or the same tumor cells also express the two-way display Expression of mesothelioma
2. Peritoneal mesothelioma can be divided into low-grade malignant cystic well-differentiated papillary mesothelioma, mesothelioma and malignant mesothelioma
(1) low-grade cystic mesothelioma: is common in middle-aged women, often located within the pelvic extraperitoneal tumors can invade and more often ill-defined capsule was not obvious in the structure of the surrounding pelvic adhesions aspect for multi-cystic wall smooth capsule containing clear liquid or thin mucous cyst lining flat to low columnar mesothelial cells can be shaped with mild to moderate papillary hyperplasia and metaplasia cyst showed fibrous stromal hyperplasia in which no significant chronic inflammatory cell infiltration
(2) well-differentiated papillary mesothelioma: surgery is not commonly found even in women of childbearing age occur in the general principles of good prognosis for malignant mesothelioma can develop even visible pelvic peritoneum and omentum showed multiple papillary or nodular off-white solid lesion diameter <2cm tumor may also occur in the peritoneum and mesenteric gastrointestinal endoscopic papillary tumor coating the surface of single-storey flat to cuboidal mesothelial cells, rare mitotic nucleus is no different-type cytoplasm axis of fibrous stromal tumors can be seen from the mesothelial cells formed branching tubule-like cord or a piece of solid block occasionally psammoma body
(3) malignant mesothelioma: The tumor was single or multiple dispersed growth at the same time involving the visceral and parietal peritoneum can be classified according to shape and limitations of diffuse-type localized malignant mesothelioma, a clear boundary or envelope was hard and tough pedicle low level of diffuse malignant mesothelioma, malignant peritoneal involvement showed diffuse thickening of the surface of papillary plaque or nodular in general have seen a high degree of malignant peritoneal surface are widely distributed, ranging from the size of the tumor nodules in isolation like strings of beads or was cluster-like clumps from a few millimeters to a few centimeters in diameter was yellow-white or off-white hard like rubber-like material was significantly thicker than the late peritoneal peritoneal tumor tissue was covered by dense white so that organ into a "frozen" (frozen) state of tumor organizations and the abdominal viscera, especially the digestive tract sticky fused with each other easily separated or in the peritoneal surface of abdominal organ with multiple nodular tumor was found in grape-like or diffuse peritoneal surface of diaphragm abdominal peritoneal surface and omentum after the small intestine and mesenteric colon serosal bladder surface or the liver surface and sometimes multiple nodules fused into lumps
Peritoneal mesothelial cell tumor of the general pathological view of human peritoneal mesothelial cell tumor of the general observation is similar to pleural mesothelioma, there are two kinds of types that diffuse peritoneal mesothelial cell tumor and limitations of peritoneal mesothelial cell tumor of general diffuse mesothelioma 75% of malignant mesothelioma of the limitations of the former are mostly benign tumor tissue showed numerous small nodules or plaques on the lining of the parietal or visceral peritoneal tumor development with massive thickening of the films showed a wide range blanket in the parietal peritoneal, or abdominal organs may be associated with the surface of tumor or nodules of varying sizes Duocheng off-white tumor tissue was hard and tough can also have bleeding and necrosis of jelly tumor tissue fibrosis and even glass-like tumor tissue can be changed invasive liver or intestine but rarely invade deep organs in the greater omentum can be completely replaced by tumor tissue intestinal adhesions can occur within the abdominal cavity exudate and even the limitations of bloody ascites in the peritoneal mesothelial cell tumor or nodular tumor tissue showed plaque is located in visceral peritoneal lining, or off-white material was clearly very few hard limits bleeding and necrosis (Figure 1)



3. Peritoneal mesothelial cell tumor of microscopic observation peritoneal mesothelial cells are generally three kinds of tumor histological type:
(1) fibrous mesothelioma: fibrous mesothelioma tumor cells from the elongated spindle cells, spindle cells accompanied by the number of collagen fibers, ranging from the limitations of this type more common in mesothelioma, fibrous mesothelioma in and fibrous tissue is sometimes difficult to distinguish tumor cells were spindle-shaped cells around the tumor may have or may have weave of collagen-like structure of focal calcification or ossification obvious when interstitial fibrosis or hyalinization, when some people call them Desmoid mesothelioma Recently, there were will come from the subcutaneous connective tissue between the source of fibroid tumors is called peritoneal mesothelial cells from the surface, said fibrous mesothelioma was based solely on morphology, but is sometimes difficult to distinguish between the two years (Figure 2)



(2) epithelioid mesothelioma: epithelioid mesothelioma is cube-shaped or polygonal tumor cells often have veins tubular or papillary structures found in most epithelial mesothelioma, diffuse mesothelioma, in the differentiation of tumor cells was different from the state can form well-differentiated tubular or papillary structures can also be presented on-chip block undifferentiated tumor showed solid tumor cells of different sizes of the connective tissue surrounding the tumor tissue of tubular papillary structure or composition of adenoid cystic tubular lining by cubic or flat epithelial-like cells of the same size vacuole nucleus can be seen 1 to 2 nucleoli outline a clear cytoplasm rich in tumor cells, slit-like or form can also be presented, ranging from the size of cysts lined with flat epithelial cells of these Sometimes fissures can be seen within the papillary adenocarcinoma papillary protrusions similar to some cases of solid tumor cells arranged in cord-like or nested structure without adenoid or papillary tumor tissue but sometimes the material surrounding the formation of mucus may have a similar structure of mucus cell morphology in Lake more consistent when the nuclear large and small cytoplasm vacuolization containing mucopolysaccharide material (Figure 3)



(3) mixed mesothelioma: mesothelioma, also known as bi-directional differentiation of the tumor accompanied by the same two kinds of fibers and epithelial components Zllzllki (1980) reported 210 cases of diffuse malignant mesothelioma, epithelioid in 67% 26% mixed fibers accounted for 7 percent of the latter is most common in the limitations of mesothelioma, mesothelioma tumor tissue within the hybrid cells and by epithelial-like morphology similar to the sarcoma-like ingredients synovial sarcoma spindle cell sarcoma-like component formed by the It is often transitional form with the epithelial component and thus can be displayed mesothelioma is a cell from a single source of asbestos-related mesothelioma, we often see this form of mucin stain in differentiating between adenocarcinoma and mesothelioma help but differentiated adenocarcinoma low mucus staining can also be negative and mesothelioma tumor cells can also show positive staining Alcianblue and such mucus can also be found in the extracellular interstitial reticular fiber staining in the tumor cells can be seen between the rich reticular fiber distinct adenocarcinoma helpful when the tumor was found asbestos bodies (asbestosbody) be helpful when the diagnosis of mesothelioma is pleural mesothelioma, in particular due to asbestos and the occurrence of adenocarcinoma of the lung and therefore also the relationship between asbestos bodies found in only a reference value ( Figure 4)



4. Peritoneal mesothelial cell tumor ultrastructure and electron microscopy, especially transmission electron microscopy in the diagnosis of mesothelial tumors have a high value of their ultrastructure is characterized by: mesothelioma tumor cells have a large number of thin brush kind of Microvilli appear on the surface of tumor cells but it can also appear in the cytoplasm, but in adenocarcinoma of the small number of short rod-like microvilli of mesothelioma cells has a huge nuclei prominent nucleoli moderate amount of mitochondria has been rough endoplasmic Net glycogen granules into the surrounding common beam tonofilaments and intracellular vacuole smooth endoplasmic reticulum is not well developed extracellular substrates but most do not have a complete connection can also be found between cells with ultrastructural features of these major desmosome found in epithelial cells or mixed mesothelioma mesothelioma mesothelioma in the fibrous ultrastructure similar to the fibroblast cells in the spindle tumor cells have abundant rough endoplasmic reticulum occasionally a tiny cavity between cells gap as well as the microvilli (Figure 5)



5. Peritoneal mesothelial cell tumors by immunohistochemistry Immunohistochemical differential diagnosis of mesothelioma and adenocarcinoma of definite help cytokeratin (cytokeratin) showed positive in mesothelioma, but CEA was negative or weakly positive; adenocarcinoma CEA mostly strong positive and keratin (keratin) often as a focal positive or negative, but due to various reasons in the literature for the immunohistochemical staining in differentiating mesothelioma and adenocarcinoma of the reports have different results and so therefore can not simply make a final conclusion must be Integrated other technologies to make an objective diagnosis of certain mesothelioma patients associated with metabolic disorders such as reducing blood sugar disorders such limitations occasionally peritoneal mesothelial cells showed multi-cystic tumor can be lined with simple cuboidal or squamous epithelial capsule containing a transparent liquid
Mesothelioma cells, electron microscopy and enzyme histochemical features: mesothelioma mainly by the epithelial-like cells (epithelioid cellEC) fibroblast-like cells (fibroblast-like cellFLC) intermediate cell (interim cellIC) and primitive mesenchymal cells (primary mesenchymal cellPMC ) EC to four kinds of cells characterized by abundant microvilli on cell surface microvilli on their long slender diameter and width and the ratio reached 10:1 ~ 15:1 This is far greater than the proportion of adenocarcinoma of several other tumor cell showed sinus-like gap around the inside of its slender microvilli, there are many intertwined FLC in the rough endoplasmic reticulum are more EC dehydrogenase and oxidase activity in higher and lower hydrolytic activity of the FLC cell activity and the EC On the contrary it may be related to functional activity of the two types of cells different from the
Mesothelioma immunohistochemical features: Since the original mesenchymal cells directly or through intermediate-type cells to epithelial-like cells can also be directly differentiated into fibrous mesothelioma of the immune cells, thus staining the complex types of mesothelial immunohistochemical features of tumor cells, such as in Table 1



As can be seen from the table a variety of mesothelioma, the expression of immunohistochemical reaction of the variety of situations to express their positive and negative results were not 100%, therefore certain abdominal tumors, especially ovarian serous papillary cystadenocarcinoma and epithelial papillary mesothelioma of the tubular structure is difficult to identify the former on the carcinoembryonic antigen expression of only 2% of the pairs of epithelial membrane antigen and human milk fat globulin expression there is a higher percentage of it immunohistochemical staining using the above it is difficult to two are distinguished from the recent application of Ber-Ep4 antibody able to identify malignant mesothelioma and adenocarcinoma Ber-Ep4 pairs of abdominal and retroperitoneal and peritoneal adenocarcinoma metastatic adenocarcinoma of the positive expression rate of 100% while the 115 cases of mesothelioma expression of only 1 case (accounting for 0.87%), therefore the use of a comprehensive analysis of immunohistochemical staining can make a correct pathological diagnosis of mesothelioma, if the conditions are even more improved electron microscope examination