九游网页版 -蝇蚋是什么意思

　　通过近期研究表明，在癌症患者中，早期诊断通常包括原发肿瘤的检测以及转移性肿瘤的存在与否，原发肿瘤的细胞从它们的原始位置脱离后迁移到病人的其它组织中并继续进行生长。然而，在人类肿瘤的5%到10%之间的这一过程已经完成：转移性肿瘤被诊断出，但原发肿瘤通过各种诊断测试却没有被检测出来。这种情况被称为原发灶不明转移癌。肿瘤的类型是九游体育未知的，这些患者的生存时间是非常有限的。

　　“几年前，我们意识到化学模式可针对每个组织来调节基因的活性(表观基因组)。例如，相比肺癌细胞来说它们在胰腺癌细胞中是不同的。”Esteller博士说。“我们对超过10000种人类肿瘤的每种类型进行了九游彩票官网分析，了解到它们特殊的表观遗传特征。我们现在研究了病人未知肿瘤起源的转移肿瘤的DNA，通过研究得到的表观基因组的影像告诉我们，它可属于胰腺癌，肺癌、结肠癌、乳腺癌等等家族，换句话也就是说，我们将会得出肿瘤起源的诊断结果。

　　通过表观遗传测试鉴别癌症的类型，将会对治疗的选择产生重大影响。“从现在开始，病人不会再进行盲目治疗，因为我们能够提供一个肿瘤类型的更特定的治疗方案。实际上，通过分析初始数据发现表明肿瘤患者幸存率是双倍的。”Esteller博士解释道。

　　doi:九游棋牌10.1016/S1470-2045(16)30297-2

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　　Epigeneticprofiling to classify cancer of unknown primary: a multicentre, retrospective analysis

　　Moran S, Martínez-Cardús A, Sayols S, Musulén E, Balana C, Estival-Gonzalez A, Moutinho C, Heyn H, Diaz-Lagares A, Castro de Moura M, Stella GM, Comoglio PM, Ruiz-Miró M, Matias-Guiu X, Pazo-Cid R, Antón A, Lopez-Lopez R, Soler G, Longo F, Guerra I, Fernandez S, Assenov Y, Plass C, Morales R, Carles J, Bowtell D, Mileshkin L, Sia D, Tothill R, Tabernero J, Llovet JM, Esteller M.

　　Background Cancer of unknown primary ranks in the top ten cancer presentations and has an extremely poor prognosis. Identification of the primary tumour and development of a tailored site-specific therapy could improve the survival of these patients. We examined the feasability of using DNA methylation profiles to determine the occult original cancer in cases of cancer of unknown primary. Methods We established a classifier of cancer type based on the microarray DNA methylation signatures (EPICUP) in a training set of 2790 tumour samples of known origin representing 38 tumour types and including 85 metastases. To validate the classifier, we used an independent set of 7691 known tumour samples from the same tumour types that included 534 metastases. We applied the developed diagnostic test to predict the tumour type of 216 well-characterised cases of cancer of unknown primary. We validated the accuracy of the predictions from the EPICUP assay using autopsy examination, follow-up for subsequent clinical detection of the primary sites months after the initial presentation, light microscopy, and comprehensive immunohistochemistry profiling. Findings The tumour type classifier based on the DNA methylation profiles showed a 99·6% specificity (95% CI 99·5–99·7), 97·7% sensitivity (96·1–99·2), 88·6% positive predictive value (85·8–91·3), and 99·9% negative predictive value (99·9–100·0) in the validation set of 7691 tumours. DNA methylation profiling predicted a primary cancer of origin in 188 (87%) of 216 patients with cancer with unknown primary. Patients with EPICUP diagnoses who received a tumour type-specific therapy showed improved overall survival compared with that in patients who received empiric therapy (hazard ratio [HR] 3·24, p=0·0051 [95% CI 1·42–7·38]; log-rank p=0·0029). Interpretation We show that the development of a DNA methylation based assay can significantly improve diagnoses of cancer of unknown primary and guide more precise therapies associated with better outcomes. Epigenetic profiling could be a useful approach to unmask the original primary tumour site of cancer of unknown primary cases and a step towards the improvement of the clinical management of these patients. Funding European Research Council (ERC), Cellex Foundation, the Institute of Health Carlos III (ISCIII), Cancer Australia, Victorian Cancer Agency, Samuel Waxman Cancer Research Foundation, the Health and Science Departments of the Generalitat de Catalunya, and Ferrer.