bluuebunny/crossref_metadata_2025 huggingface dataset:
Progress of transformational therapy in colorectal liver metastases
Authors: Xiang Fang , Yin Xianli
Published: June 2023

Colorectal cancer liver metastases (CLM) treatment is very important given the high incidence of colorectal cancer with liver metastases, which are primarily treated by surgical resection. Transformational therapy such as systemic chemotherapy, hepatic arterial infusion (HAI), portal vein embolization (PVE), ablation therapy, and targeted therapy, should be applied to CLM patients who are unable to undergo immediate surgery to improve patients’ survival and quality of life.
Diaphragmatic suture with tubular stomach to prevent early delayed gastric emptying after esophagectomy
Authors: Sun Chao , Shi Weiping , Shu Yusheng , Shi Hongcan , Lu Shichun , Wang Kang
Published: June 2023

Objective

The objective of this study was to evaluate the clinical efficacy of a diaphragmatic suture with tubular stomach to prevent delayed gastric emptying (DGE) after esophagectomy through the cervico-thoracoabdominal approach.

Methods

A total of 980 patients with esophageal cancer undergoing esophagectomy through the cervico-thoracoabdominal approach were retrospectively included in this study and divided into two groups. All patients underwent tubular stomach creation (group A; n = 530) or a diaphragmatic suture and tubular stomach creation (group B; n = 450). The incidence of early DGE was observed.

Results

The incidence of early DGE in group A was significantly higher than that in group B (P < 0.05).

Conclusion

This observation study suggests that the use of a diaphragmatic suture with tubular stomach through the cervico-thoracoabdominal approach can decrease the incidence of early DGE after esophagectomy.
A clinicoepidemiological study of esophageal cancer patients at the National Cancer Institute, Cairo University, Egypt
Authors: Ezzat Soumaya , El Hossieny Hisham , Alla Mohamed Abd , Nasr Azza , Anter Nagwan , Adel Ahmed
Published: June 2023

Objective

The purposes of this study were to (1) assess the clinicoepidemiological characteristics of esophageal cancer patients, (2) analyze the prognostic factors determining treatment failure and survival, and (3) evaluate the results of various treatment modalities for locoregional and disseminated disease and their effect on disease-free survival and overall survival (OS).

Methods

Clinicoepidemiological retrospective data from 81 esophageal cancer patients treated at the National Cancer Institute of Cairo between 2007 and 2011 were evaluated.

Results

The study showed that patients with esophageal cancer commonly present with locally advanced disease (87.7% had T-stage 3 and 12.3% had T-stage 4). There was a significant correlation between surgery and survival; patients who received radical surgery and postoperative radiation had a better median survival than patients who received radical radiotherapy (20 months vs. 16 months, respectively; P = 0.04). There was also a significant statistical correlation between radical concomitant chemoradiotherapy (NCRT) and palliative treatment. Patients who received radical NCRT had a better median survival than patients who received palliative radiotherapy (16 months vs. 10 months, respectively; P = 0.001). The median follow-up period for all patients was 7 months. The median OS of the whole group was 12 months. The OS after 1 and 2 years was 57.8% and 15%, respectively.

Conclusion

High-dose NCRT is an acceptable alternative for patients unfit for surgery or with inoperable disease. High-dose radiation is more effective than low-dose radiation in terms of local control, time to relapse, and OS. Further study using a larger series of patients and introducing new treatment protocols is necessary for a final evaluation.
Imaging features of alveolar soft part sarcoma ⁎
Authors: Jin Teng , Zhang Ping , Li Xiaoming
Published: June 2023

Objective

The aim of this study was to analyze the imaging features of alveolar soft part sarcoma (ASPS).

Methods

The imaging features of 11 cases with ASPS were retrospectively analyzed. Results ASPS mainly exhibited an isointense or slightly high signal intensity on T1-weighted imaging (T1WI), and a mixed high signal on T2-weighted imaging (T2WI). ASPS was partial, with rich tortuous flow voids, or “line-like” low signal septa. The essence of the mass was heterogeneous enhancement. The 1HMRS showed a slight choline peak at 3.2 ppm.

Conclusion

The well-circumscribed mass and blood voids, combined with “line-like” low signals play a significant role in diagnosis. The choline peak and the other signs may be auxiliary diagnoses.
Low-dose radiation enhances susceptibility to cisplatin in resistant ovarian cancer cells via downregulation of ERCC1 and Bcl-2
Authors: Liu Xiaoran , Liang Donghai , Jiang Tao , Dong Qing , Yu Hongsheng
Published: June 2023

Objective

Ovarian cancer is one of the leading causes of mortality in patients with malignant gynecological tumors. After surgical intervention for ovarian cancer, cisplatin (DDP)-based chemotherapy is the first-line treatment. However, a major challenge to treating ovarian cancer is the development of chemoresistance. Thus, the first aim of this study was to determine whether low-dose radiation could enhance the susceptibility of resistant ovarian cancer cells to DDP. The second aim was to provide new strategies for treating DDP-resistant ovarian cancer by examining its mechanism.

Methods

A cell counting kit-8 (CCK8) assay was performed to measure cell proliferation. Flow cytometry was utilized to quantify the apoptosis of DDP-resistant ovarian cancer cells (SKOV3/DDP) using Annexin V and propidium iodide staining. Real-time quantitative (qPCR) was used to analyze the messenger RNA (mRNA) expression levels of excision repair cross complementing-group 1 (ERCC1) and B-cell lymphoma 2 (Bcl-2) in SKOV3/DDP.

Results

The IC50 values of the control, conventional-dose, and low-dose groups were 9.367 ± 0.16, 9.289 ± 0.16, and 3.847 ± 0.15, respectively (P < 0.05 vs control group and conventional-dose group). Compared with the control and conventional-dose groups, low-dose radiation resulted in significantly more apoptosis, as detected by flow cytometry (P < 0.05). The relative mRNA expression of ERCC1 and Bcl-2 in the low-dose group was significantly lower than that in the control group and conventional-dose group (P < 0.05).

Conclusion

Low-dose radiation enhanced the sensitivity of resistant ovarian cancer cells to DDP, possibly by decreasing the DNA repair capacity of tumor cells and promoting apoptosis.
Low-dose radiation reverses cisplatin resistance in ovarian cancer cells by changing Survivin and Caspase-3 expression
Authors: Dong Qing , Jiang Tao , Liang Donghai , Liu Xiaoran , Yu Hongsheng
Published: June 2023

Objective

Cisplatin (DDP) is the main chemotherapy drug for ovarian cancer. However, ovarian cancer cells tend to develop cisplatin resistance in the clinical setting. Tumor cells are sensitive to low-dose radiation (LDR). LDR therapy can improve the effects of chemotherapy drugs on ovarian cancer, but the underlying mechanisms are not clear. In this study, we explored the impact of low-dose radiation on Survivin and Caspase-3 levels in SKOV3/DDP ovarian cancer cells that are resistant to cisplatin.

Methods

Cell viability was examined by cell counting kit-8 (CCK-8) assay, and quantitative PCR was used to detect Caspase-3 and Survivin transcript levels. Flow cytometry was used to detect and quantify apoptotic cells. Results Cell viability was lower when cells were treated with LDR and cisplatin than when cells were treated with conventional radiation and cisplatin, or cisplatin alone (P < 0.05). The IC50 of cisplatin in the LDR, no-radiation control, and conventional-dose groups was 3.837 ± 0.16, 9.467 ± 0.17, and 9.389 ± 0.17, respectively. The level of Caspase-3 mRNA was higher and the level of Survivin mRNA was lower in the LDR group compared to that in the other two groups (P < 0.05).

Conclusion

LDR reverses cisplatin resistance in SKOV3/DDP cells, and may do so by suppressing Survivin expression and increasing Caspase-3 expression.
Targeting of RhoE inhibits epithelial-mesenchymal transition during colorectal cancer cell migration
Authors: Chen Gantao , Dong Weiguo
Published: June 2023

Objective

Despite microRNA (miR-200b) being proved to promote the proliferation of colorectal cancer (CRC) cells, the relationship between miR-200b and epithelial-mesenchymal transition (EMT) of CRC cells remains poorly understood. The aim of the study was to investigate the relationship between miR-200b and EMT during CRC cell migration.

Methods

The effect of miR-200b on EMT-associated markers E-cadherin and vimentin was evaluated by western blot in CRC cells (SW620 and HT-29) by treatment with miR-200b mimics and inhibitors. A luciferase reporter assay was employed to detect downstream targets of miR-200b. Transwell migration assays were used to detect CRC cell migration.

Results

Western blots revealed that treatment with miR-200b mimics led to up-regulation of E-cadherin and down-regulation of vimentin, metalloproteinase (MMP)-9, and MMP-2, whereas treatment with miR-200b inhibitor exhibited opposite effects on expression of E-cadherin and vimentin. Luciferase reporter assays demonstrated that RhoE (RND3) was targeted by miR-200b. Two predicted target sites of miR-200b were present in the 3’-UTR of RhoE. Predicted target site 1 was from nucleotides 1584 to 1591, and site 2 was from nucleotides 1729 to 1735. RhoE knockdown cell lines were also established to investigate the impact of RhoE and miR-200b on EMT and cell migration. RhoE knockdown enhanced the effect of miR-200b mimics, up-regulating E-cadherin and down-regulating vimentin. RhoE knockdown also inhibited cell migration. Furthermore, miR-200b mimic treatment further promoted the inhibitory effect of RhoE knockdown on cell migration.

Conclusion

miR-200b inhibited EMT and CRC cell migration partly via inhibiting RhoE expression in CRC. RhoE and miR-200b might therefore be promising target genes in the management of CRC.
The accuracy of magnetic resonance imaging and ultrasound in evaluating the size of early-stage breast neoplasms
Authors: Wang Zheng , Chen Hongzhi , Ma Xiaobin , Dai Zhijun , Lin Shuai , Kang Huafeng
Published: June 2023

Objective

Breast cancer is the most frequently diagnosed cancer in women. Accurate evaluation of the size and extent of the tumor is crucial in selecting a suitable surgical method for patients with breast cancer. Both overestimation and underestimation have important adverse effects on patient care. This study aimed to evaluate the accuracy of breast magnetic resonance imaging (MRI) and ultrasound (US) examination for measuring the size and extent of early-stage breast neoplasms.

Methods

The longest diameter of breast tumors in patients with T1-2N0-1M0 invasive breast cancer preparing for breast-conserving surgery (BCS) was measured preoperatively by using both MRI and US and their accuracy was compared with that of postoperative pathologic examination. If the diameter difference was within 2 mm, it was considered to be consistent with pathologic examination.

Results

A total of 36 patients were imaged using both MRI and US. The mean longest diameter of the tumors on MRI, US, and postoperative pathologic examination was 20.86 mm ± 4.09 mm (range: 11-27 mm), 16.14 mm ± 4.91 mm (range: 6-26 mm), and 18.36 mm ± 3.88 mm (range: 9-24 mm). US examination underestimated the size of the tumor compared to that determined using pathologic examination (t = 3.49, P < 0.01), while MRI overestimated it (t = −6.35, P < 0.01). The linear correlation coefficients between the image measurements and pathologic tumor size were r = 0.826 (P < 0.01) for MRI and r = 0.645 (P < 0.01) for US. The rate of consistency of MRI and US compared to that with pathologic examination was 88.89% and 80.65%, respectively, and there was no statistically significant difference between them (χ2 = 0.80, P > 0.05).

Conclusion

MRI and US are both effective methods to assess the size of breast tumors, and they maintain good consistency with pathologic examination. MRI has a better correlation with pathology. However, we should be careful about the risk of inaccurate size estimation.
Efficacy and time course of palliative radiotherapy for pain relief in 70 patients with bone metastases ⁎
Authors: Zhang Peng , Gong Chen , Xiong Huihua
Published: June 2023

Objective

The aim of this study was to evaluate the efficacy and time course of radiotherapy for pain relief in patients with bone metastases.

Methods

A total of 70 patients with painful bone metastases were investigated between January 2013 and August 2015. The patients were divided into 3 groups and each group was treated with radiotherapy using 30 Gy in 10 fractions, 20 Gy in 5 fractions, or a single dose of 8 Gy. The pain over the irradiated site was assessed using a numerical rating scale (NRS) ranging from 0 to 10. Pain relief was assessed every 5 days based on a pain questionnaire.

Results

Complete pain relief was achieved in 14.3% (10/70) patients; partial pain relief in 74.3% (52/70); and no response in 11.4% (8/70). The overall response rate was 88.6%. No significant difference was observed between single fraction radiotherapy and multifraction radiotherapy. There was no relationship between the pain relief and treated sites. The pain score gradually decreased and most patients reached a moderate pain score (NRS < 7) on day 10-15.

Conclusion

Local radiotherapy is a very rapid and effective palliative treatment for painful bone metastases; however, the optimal dose and fractionation regimen remain debatable. Individualized therapy for painful bone metastases should be considered according to the patient’s condition and life expectancy.
Prophylaxis and management of perioperative hemorrhage in retropubic radical prostatectomy
Authors: Pan Dongliang
Published: June 2023

Retropubic radical prostatectomy (RRP) has commonly been performed for localized prostate cancer. In the past decade, with the development of laparoscopic and robotic techniques, laparoscopic radical prostatectomy (LRP) or robotic-assisted LRP has been widely used due to its less invasive nature along with its shorter recovery, reduced blood loss, and improved visualization of the operative region compared to open techniques. Severe hemorrhage following prostatectomy is relatively rare (0.5% to 1.6%), but it is a serious complication. Here, we summarize circumstances in which perioperative severe hemorrhage can develop and interventions needed to achieve hemostasis.
Bronchoscopic biopsy for diagnosis of lung cancer in the absence of visible endobronchial abnormalities
Authors: Zheng Hua , Lu Baohua , Wang Qunhui , Hu Fanbin , Ding Weimin , Li Baolan
Published: June 2023

Objective

Bronchoscopy has been extensively used in the diagnosis of respiratory diseases, and particularly, malignant diseases. However, endoscopists do not normally perform bronchoscopic biopsy in case lesions are undetected via bronchoscopy. The aim of this study was to evaluate whether performing bronchoscopic biopsy could be established in the diagnosis of lung cancer in case of endobronchial abnormalities undetectable to the naked eye.

Methods

We retrospectively analyzed 109 cases between January 2008 and December 2012. The inclusion criteria were confirmed lung cancer diagnosis, transbronchial biopsy performed in the absence of visible endobronchial manifestations, brushing, and bronchoalveolar lavage (BAL) according to the images obtained from high-resolution computed tomography (HRCT). Data regarding age, sex, pathology, tumor stage; the method of diagnosis; location of primary lesion (central, peripheral, or intermediate); tumor size, mediastinal lymph node metastasis, and the serum carcinoembryonic antigen (CEA) value were collected. The Pearson chi-square test or Fisher’s exact and McNemar tests were used in the univariate analysis.

Results

Among the 109 patients, the diagnosis of 37 (33.9%) patients was confirmed through bronchoscopy. Brushing and BAL had higher positive detection rates than biopsy (P = 0.004). There were no differences in the positive detection rates between the sex, pathology, lesion location, tumor size, lymph node metastasis, and the serum CEA value (P > 0.05 for all groups).

Conclusion

Despite the normal appearance of the endobronchial manifestations, lesions undetectable by bronchoscopy could be indicated. Therefore, we suggest performing bronchoscopic biopsy and that brushing and BAL might increase the positive detection rate of bronchoscopic examination.
A dosimetric evaluation of flattening filter-free volumetric modulated arc therapy for postoperative treatment of cervical cancer ⁎
Authors: Zhang Fuli , Jiang Huayong , Xu Weidong , Wang Yadi , Gao Junmao , Liu Qingzhi , Wang Ping , Lu Na , Chen Diandian , Yao Bo , Hou Jun , He Heliang , Chen Jianping
Published: June 2023

Objective

The aim of the study was to compare flattening filter-free (FFF) beams and conventional flattening filter (FF) beams in volumetric modulated arc therapy (VMAT) for cervical cancer after surgery, through a retrospective planning study.

Methods

VMAT plans of FFF beams and normal FF beams were designed for a cohort of 15 patients. The prescribed dose was 45 Gy to 1.8 Gy per fraction, and at least 95% of the planning target volume received this dose. Doses were computed with a commercially available treatment planning system using a Monte Carlo (MC) algorithm. Plans were compared according to dose-volume histogram analysis in terms of planning target volume homogeneity and conformity indices (HI and CI), as well as organs at risk (OAR) dose and volume parameters.

Results

FFF-VMAT was similar to FF-VMAT in terms of CI, but inferior to FF-VMAT considering HI. No statistically differences were observed between FFF-VMAT and FF-VMAT in following organ at risks including pelvic bone marrow, small bowel, bladder, rectum, and normal tissue (NT). .

Conclusion

For patients with cervical cancer after hysterectomy, the FFF beam achieved target and OAR dose distribution similar to that of the FF beam. Reduction of beam-on time in cervical cancer is beneficial.
Mammography combined with breast dynamic contrast-enhanced-magnetic resonance imaging for the diagnosis of early breast cancer
Authors: He Yakun , Xu Guohui , Ren Jin , Feng Bin , Dong Xiaolei , Lu Hao , He Changjiu
Published: June 2023

Objective

The aim of this study was to investigate the application of mammography combined with breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for the diagnosis of early breast cancer.

Methods

Mammography and DCE-MRI were performed for 120 patients with breast cancer (malignant, 102; benign; 18).

Results

The sensitivity of mammography for early diagnosis of breast cancer was 66.67%, specificity was 77.78%, and accuracy was 68.33%. The sensitivity of MRI for early diagnosis of breast cancer was 94.12%, specificity was 88.89%, and accuracy was 93.33%. However, the sensitivity of mammography combined with DCE-MRI volume imaging with enhanced water signal (VIEWS) scanning for early diagnosis of breast cancer was 97.06%, specificity was 94.44%, and accuracy was 96.67%.

Conclusion

Mammography combined with DCE-MRI increased the sensitivity, specificity, and accuracy of diagnosing early breast cancer.
Modulation of MMP-2 and TIMP-2 by low dose radiation in mice bearing S180 sarcoma
Authors: Jia Xiangmin , Yu Hongsheng
Published: June 2023

Objective

To investigate the inhibition of low dose radiation (LDR) on S180 sarcomas and its modulation of MMP-2 and TIMP-2 in mice.

Methods

S180 subcutaneously implanted tumor model mice were randomly divided into two groups: control (N) and low dose radiation (LDR) groups. N mice were sacrificed after 12 h, whereas LDR mice were sacrificed after 12 (LDR-12 h), 24 (LDR-24 h), 48 (LDR-48 h), and 72 (LDR-72 h) h. Thereafter, we measured the tumor volumes. Histopathology was performed, and P-V immunohistochemistry was applied to assess MMP-2 and TIMP-2 expression.

Results

Compared with the control group, the tumor growth was significantly inhibited in the LDR groups (P < 0.05). MMP-2 expression was considerably reduced in LDR-24h (P < 0.05) and LDR-48h (P < 0.05), whereas the change of TIMP-2 was not obvious in the LDR groups (P > 0.05) in contrast to that of the control group.

Conclusion

LDR can effectively suppress the growth of S180 implanted tumors by reducing MMP-2, which is associated with invasion and metastasis.
Transsphenoidal microsurgical treatment of infradiaphragmatic craniopharyngioma ⁎
Authors: Lei Ting , Wang Baofeng , Chen Juan , Xu Yu , Shu Kai , Sun Wei , Liu Shaozheng , Li Xiaopeng
Published: June 2023

Objective

Typically, the transcranial approach has been used for the treatment of craniopharyngiomas with suprasellar extension, whereas the transsphenoidal approach has been used mostly for infradiaphragmatic craniopharyngioma. Total resection of craniopharyngioma can reduce the recurrence rate, especially in young children, but it may lead to severe complications. Therefore, any benefit of the degree of resection must be weighed against the risk of complications by the surgeons. The purpose of this study was to explore the therapeutic outcome after transsphenoidal microsurgical treatment of infradiaphragmatic craniopharyngioma and share our experiences.

Methods

Between January 2003 and June 2013, 30 patients with infradiaphragmatic craniopharyngioma underwent transsphenoidal microsurgical resection in our hospital. The neurological, visual, and endocrine functions, and extent of resection were analyzed retrospectively. Recurrence or growth of residual tumor tissue during follow-up was assessed using magnetic resonance imaging (MRI).

Results

Total resection was achieved in 25 patients (83.3%), subtotal resection was achieved in 4 patients (13.3%), and partial resection was achieved in 1 patient (3.4%). There were no perioperative deaths. Cerebrospinal fluid (CSF) leakage occurred in 6 patients, and among them, 2 required surgical repair of the sella. New-onset postoperative diabetes insipidus (DI) developed in 8 patients. Vision and visual fields were improved at different levels in 13 out of 16 patients who had sight impediments before treatment. Tumor recurrence and regrowth was observed in 2 patients; 1 patient underwent transsphenoidal reoperation, the condition of the other patient who had undergone several craniotomies grew worse over the 6-month follow-up period.

Conclusion

Transsphenoidal surgery is an ideal choice in treating infradiaphragmatic craniopharyngioma. The transsphenoidal approach, which preserves pituitary function and avoids damage to the hypothalamic structures and optic nerve, is associated with fewer complications than the transcranial approach and a low mortality rate.
IL-13Ra2- and glioma stem cell-pulsed dendritic cells induce glioma cell death in vitro
Authors: Wang Ying , Xie Ruifan , Niu Hongquan , Lei Ting
Published: June 2023

Objective

Gliomas are the most common malignant tumors in the central nervous system. Despite multiple therapies including surgery, chemotherapy, and radiotherapy, the prognosis of patients remains poor. Immunotherapy is an alternative method of treating glioma, and the use of dendritic cell vaccines is one of the promising treatment options. However, there is no specific tumor cell antigen that can trigger dendritic cells (DCs). IL-13Ra2 is a specific antigen expressed in glioma cells; in the current study, we have attempted to explore whether IL-13Ra2 could be the antigen that triggers DCs and to envisage its application as potential therapy for glioma.

Methods

The expression of IL-13Ra2 was detected in U251 glioma cell lines and primary glioma tissues using different methods. DCs from human blood were isolated and pulsed with recombinant IL-13Ra2, following which the cytotoxicity of these DCs on glioma cells was detected and analyzed.

Results

About 55.9% human glioma tissue cells expressed IL-13Ra2, while normal brain tissue cells did not show any expression. DC vaccines loaded with IL-13Ra2, glioma cell antigen, and brain tumor stem cell (BTSC) antigen could significantly stimulate the proliferation of T lymphocytes and induce cell death in the glioma tissue. Compared to other groups, DC vaccines loaded with BTSC antigen showed the strongest ability to activate cytotoxic T lymphocytes (CTLs), while the glioma cell antigen group showed no significant difference.

Conclusion

IL-13Ra2, which is expressed in gliomas and by glioma stem cells, as well as IL-13Ra2 could prove to be potential antigens for DC vaccine-based immunotherapy.
Progress of anti-checkpoint therapy in metastatic colorectal cancer ⁎
Authors: Zhu Lizhen , Fang Xuefeng , Zhong Chenhan , Yuan Ying
Published: June 2023

Ying Yuan,

Professor, Department of Medical Oncology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, P. R. China. Prof. Yuan has focused on the clinical practice and research on personalized therapy of gastrointestinal cancer, especially of colorectal cancer. Prof. Yuan is also interested in the scientific research. She has acquired several grants and published 99 papers, including 42 SCI papers. Besides, she has achieved a few honors and awards, such as “The Southern California Society of Colorectal Surgeons Award”, “Scientific Achievement Award of Zhejiang Province”, “National Science and Technology Progress Award”, and so on. Her current academic society memberships include: member and director of genetics group, colorectal cancer professional committee of Chinese Society of Clinical Oncology; member of clinical trial committee and molecular targeted drugs committee of Chinese Society of Clinical Oncology; core expert of gastrointestinal cancer rational drug use commission, National Health and Family Planning Commission; expert of colorectal cancer diagnostic and treatment practices group, National Health and Family Planning Commission; permanent member and secretary of colorectal cancer MDT management board, National Health and Family Planning Commission.
Two cases of chronic myelomonocytic leukemia combined with monoclonal gammopathy of undetermined significance and a literature review
Authors: Min Fengling , Zhai Lijia , Zhou Wei , Gao Xiaohui , Zhang Lina
Published: June 2023

To describe myelodysplastic syndrome (MDS)/myeloproliferative neoplasm (MPN) combined with monoclonal gammopathy of undetermined significance (MGUS) in order to investigate the potential association between these 2 diseases. Two cases of confirmed chronic myelomonocytic leukemia (CMML) combined with MGUS were reported. In addition, prior publications of cases with combined MDS or MPN with MGUS were reviewed. The first case was of a 77-year-old man whose routine blood tests showed abnormal hemogram results. The diagnosis was CMML combined with IgM monoclonal gammopathy, and the disease course was 4 years. The CMML gradually progressed and the patient presented with anemia, thrombocytopenia, autoimmune hemolysis, and an increase in the number of immature cells in the bone marrow. Although the MGUS caused fluctuations in the concentrations of IgM, no IgM-associated organ damage was observed. Eventually, this patient died from a lung infection. The second case was of a 78-year-old man who sought treatment because of fever and a cough. An increase in the number of monocytes was discovered in the peripheral blood. Bone marrow smear results suggested obvious active granulocytes and an increase in the percentages of promyelocytes, myelocytes, and metamyelocytes. Unhealthy granulocytes and immature monocytes could also be observed, and the percentage of monocytes was increased. In addition, serum IgG levels were increased, and immunofixation electrophoresis results showed IgG-κ type M proteins. The diagnosis was CMML combined with IgG monoclonal gammopathy. These diseases were stable and follow-up was conducted for 1 year after diagnosis. The cases in this study combined with those that were reviewed in the relevant literature indicate that the presence of these 2 diseases in the same patient might not be a coincidence. The development of the 2 diseases in case 1 was different, and we speculate that they might have had different clonal origins. Whether CMML is a risk factor for MGUS and the role of clonal plasma cells in the occurrence and development of MDS and MDS/MPN requires further studies on a larger number of cases.
BRAF V600E/TERT promoter mutations and NIS/TSHR expression in differentiated thyroid carcinoma and their clinical significance ⁎
Authors: Ru Xiaoting , Liu Qinjiang , Zhou Haihong , Yang Rong , Bao Lie
Published: June 2023

Objective

Telomerase reverse transcriptase (TERT) promoter mutations have recently been described in thyroid carcinoma. The purpose of this study was to investigate the clinical significance of (v-raf murine sarcoma viral oncogene homolog B1) BRAF V600E and TERT promoter mutations in differentiated thyroid carcinoma (DTC). The relationship between the two mutations and NIS/TSHR expression was also analyzed.

Methods

We have detected BRAF V600E and TERT promoter mutations by direct sequencing and NIS/TSHR expression by immunohistochemistry in 229 cases of DTC, 52 cases of benign nodular goiter, and 31 cases of normal thyroid tissue.

Results

The BRAF V600E mutation was detected in 142 (62.0%) of 229 cases of DTC [141 cases of papillary thyroid carcinoma (PTC) and 1 case of follicular thyroid carcinoma (FTC)]. TERT promoter mutations were detected in 18 (7.9%) of 229 cases of DTC (14 cases of PTC and 4 cases of FTC), including the mutations C228T (0.9%) and C250T (7.0%), which were mutually exclusive. Moreover, 11 (61.1%) cases also harbored the BRAF V600E mutation, which was not associated with gender, age, tumor size, lymph node metastasis, and recurrence risk stratification (P >0.05). The rate of TERT promoter mutation was higher in males, age ≥45, and in the middle/high-risk group (P <0.05), and the rate of simultaneous BRAF V600E and TERT promoter mutations were higher in the middle/high-risk group (P <0.05). In addition, NIS positive rate in the concurrent BRAF V600E and TERT promoter mutation group (45.5 %) was lower than in other groups (that is, the DTC group with BRAF V600E or TERT promoter mutations (55.1%), the DTC group with no BRAF V600E or TERT promoter mutation (57.5%), the nodules and normal group (75.9%); | r | = 0.171, P = 0.002).

Conclusion

TERT promoter mutations were lower in patients with DTC, with the C250T mutation being the most common. The detection of BRAF V600E mutation combined with TERT promoter mutations was instructive for the prognosis assessment and treatment of DTC.
Expression pattern of BIM, BCL-6, and c-MYC in adult B-cell acute lymphoblastic leukemia ⁎
Authors: Zheng Chanli , Xu Lin , Xie Yanjun , He Dongmei , Li Yangqiu
Published: June 2023

Objective

We aimed to evaluate the expression pattern of the genes BIM, BCL-6, and c-MYC in adult patients at initial diagnosis of B-cell acute lymphoblastic leukemia (B-ALL).

Methods

Relative mRNA levels of BIM, BCL-6, and c-MYC in peripheral blood mononuclear cells (PBMCs) from B-ALL patients were determined by quantitative reverse-transcription polymerase chain reaction (qRT-PCR) using SYBR Green dye. PBMCs from healthy volunteers served as a control. GAPDH was used as a reference gene.

Results

Relative expression of BIM, BCL-6, and c-MYC mRNA in B-ALL patients was significantly lower than in healthy controls (P < 0.05). Furthermore, this result was observed for both newly diagnosed B-ALL patients and those incomplete remission (CR) (P < 0.05). There were no statistically significant differences in the expression levels of BIM, BCL-6, and c-MYC between these B-ALL patient groups (P > 0.05). Spearman’s rank correlation analyses revealed the expression level of BIM to be positively correlated with that of BCL-6 in B-ALL patients.

Conclusion

Expression of the genes BIM, BCL-6, and c-MYC is decreased in adult B-ALL patients. Moreover, the expression pattern of these genes may be similar in such patients at initial diagnosis and following CR. The expression characteristics of BIM, BCL-6, and c-MYC may constitute useful markers for the diagnosis of adult B-ALL.
Breast ultrasound elastography
Authors: Cui Xinwu , Deng Youbin
Published: June 2023

Youbin Deng

Professor of Medical Ultrasound, Doctoral Supervisor, Director of the Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College of HUST, China. He obtained his bachelor degree of medicine in 1983 and Master degree of Medicine in 1986 from Tongji Medical University. He obtained PhD in 1996 from Kanazawa Medical University in Japan. Dr. Deng worked as a research fellow in The Second Department of Internal Medicine in University of Tokyo from April 1988 to March 1989, in UCSD Medical Center from August 1991 to May 1992 and in Kanazawa Medical University from August 1993 to March 1998. He served as member of standing committee of Medical Ultrasound Society of Chinese Medical Association beginning in 2005 until now, Chairman of Medical Ultrasound Society of Hubei Province Medical Association from 2004 to 2009 and Chairman of Medical Ultrasound Society of Wuhan City Medical Association from 2011 to 2015. His major research interest is cardiovascular ultrasound diagnosis. He published more than 100 papers in international peer-reviewed academic journals including Circulation, J Am Coll Cardiol, Am Heart J, Am J Cardiol, Radiology and Ultrasound in Med and Biol.
Mechanisms of radioresistance in hepatocellular carcinoma
Authors: de Jesús Kihn-Alarcón Alba , Xu Ximing
Published: June 2023

Hepatocellular carcinoma (HCC), one of the most common cancers in the world, is characterized by poor prognosis and recurrence after resection. Its prevalence is highest in developing countries, particularly where there is high incidence of hepatitis B virus infection. Several curative treatments are available for early stage HCC; however, these options are not available for advanced disease. New techniques allowing the specific delivery of high-dose radiotherapy enable their use in the treatment of HCC, which has been avoided in the past due to low hepatic tolerance for radiation. This presents a new challenge—the development of resistance to radiotherapy and subsequent disease recurrence. Recently, the mechanisms controlling radioresistance have begun to be elucidated. Understanding the molecular basis of radioresistance is key to developing new strategies with better treatment response and increased patient survival.
ALDH 1A1 and caveolin-1 expression in triple negative breast cancer
Authors: Atwa Hanaa A. , Ibrahim Hanaa M. , Ismail Eman I. , Ibrahim Islam M.
Published: June 2023

Objective

Triple negative breast cancer (TNBC) contains a high proportion of breast cancer stem cells (BCSCs) and exhibits resistance to chemotherapy treatments. Therefore, the identification of BCSCs that are novel molecular targets may improve patient survival. Aldehyde dehydrogenase-1 (ALDH 1A1) has been considered a cancer stem cell marker in different tumors. Caveolin-1 (Cav-1), a membrane transporter protein, regulates cancer chemo-resistance and stem cell signaling. Thus, the aim of this study was to evaluate the expression of ALDH 1A1 and Cav-1 in patients with TNBC by immunohistochemistry (IHC) and to correlate their expression with clinical and pathological parameters.

Methods

Paraffin blocks of 30 breast cancer patients who underwent modified radical mastectomy between January 2013 and December 2016 in Zagazig University Hospitals (Egypt) were evaluated. Antibodies to ALDH 1A1 and Cav-1 were used.

Results

ALDH 1A1 and Cav-1 significantly correlated with tumor size. A significant association between ALDH 1A1/Cav-1 IHC staining and relapse was found. Cav-1 and ALDH 1A1-positive expression correlated with a short 3-year disease-free survival rate and a 3-year overall survival rate (P < 0.001).

Conclusion

ALDH 1A1 and Cav-1 expression in TNBC was significantly positively correlated with poor clinicopathological parameters and shortened survival. Expression of both markers was significantly positively correlated with each other (P < 0.001). ALDH 1A1 and Cav-1 could be potential therapeutic targets in breast cancer.
Comparative analysis of ATP-based tumor chemosensitivity assay-directed chemotherapy versus physician-decided chemotherapy in platinum-resistant recurrent ovarian cancer*
Authors: Li Ning , Gao Yutao , Zhang Wei , Li Xiaoguang , Li Bin , Tian Haimei , Li Yanfen , Wu Lingying
Published: June 2023

Objective

The aim of the study was to evaluate the role of ATP-based tumor chemosensitivity assay (ATP-TCA) in patients with platinum-resistant recurrent ovarian cancer (PRROC).

Methods

A total of 43 patients with PRROC who underwent chemotherapy based on the results of ATP-TCA in the Cancer Hospital, Chinese Academy of Medical Sciences were included in the present study. As controls, we selected another 43 patients with PRROC who were treated at the physician's discretion within the same time period and had the same clinical characteristics as the patients in the ATP-TCA group. Log-rank test and Cox proportional hazards model were adopted for analysis.

Results

A total of 86 patients were retrospectively analyzed in the present study. Patients were routinely monitored to evaluate the rate of progression-free survival (PFS). The median follow-up time was 13 months. The PFS for the ATP-TCA and control groups was 5 and 3 months, respectively (P = 0.027). Multivariate analysis showed that the type of treatment was an independent prognostic factor for PFS (P = 0.040; HR: 0.623; 95% CI: 0.313-0.973). Subgroup analysis showed that among patients with a treatment-free interval (TFI) of ≥ 3 months (n = 50), those in the ATP-TCA group had longer PFS than those in the control group (7 vs 4 months, P = 0.010). Meanwhile, the median PFS of patients who underwent ≤ 2 prior chemotherapy regimens (PCR, n = 52) in the ATP-TCA and control groups was 6 months and 4 months, respectively (P = 0.025).

Conclusion

ATP-TCA-directed chemotherapy might improve the PFS in PRROC. In particular, the survival benefit from ATP-TCA is higher in patients with a TFI of ≥ 3 months or treated with ≤ 2 PCR.
Prognostic significance of the number of pelvic lymph nodes removed in patients with early cervical cancer
Authors: Zhao Jing , Dong Weihong
Published: June 2023

Objective

The aim of this research was to study the prognostic significance of the number of pelvic lymph nodes removed in patients with early cervical cancer.

Methods

We searched the PubMed database using the terms “cervical cancer” and “lymph nodes” or “lymphadenectomy”. Studies on the association between number of lymph nodes removed and prognosis or survival were identified. We retrospectively studied the relevant research.

Results

Ten retrospective studies were included. Two studies indicated that the number of lymph nodes had no association with prognosis whereas three studies found a positive relationship. Five studies indicated some factors that could influence the relationship between number of lymph nodes and prognosis.

Conclusion

The number of lymph nodes removed may positively influence the prognosis of patients with cervical cancer. Some factors may influence the relationship between the extent of lymph nodes removed and patient prognosis. Additional multicenter, prospective studies with large samples are required to confirm the study findings.
Accidental finding of renal myxoma and a literature review
Authors: Hong Yuxiang , Yang Qingtao , Zheng Junhong , Hou Gaoming
Published: June 2023

We present the case of a middle-aged Chinese woman who presented as asymptomatic; however, we found an irregular right renal mass in this patient. She underwent partial nephrectomy after comprehensive evaluation, and she was finally diagnosed with renal myxoma according to pathological and immunohistochemical studies. Myxomas are rare, benign, soft-tissue tumors that mainly occur in the heart and skin, although various anatomical locations have been described. The kidneys are a rare location of myxoma; thus, renal myxomas may easily be misdiagnosed. To date, approximately 17 cases of renal myxoma have been reported in the English literature since 1968. All the patients in these cases underwent nephrectomy as treatment, and were disease-free on follow-up. Postoperative pathology facilitates a decisive diagnosis that differentiates benign from malignant myxoma, which is vital for the following treatment and prognosis.
The effects of miR-375 expression in NSCLC via the 14-3-3ζ/ERK/MYC pathway
Authors: Meng Haining , Wu Junyu , Huang Qiao , Ren Jiwen , Huang Jiawei , Yuan Weijun , He Xuekun , Wang Yuhuan , Cui Congxian , Xu Shengwei , Shen Ruowu
Published: June 2023

Objective

There are several reports that suggest a significant role played by microRNAs (miRNAs) in cell invasion, metastasis, differentiation, and apoptosis in lung cancers. miR-375 is one such miRNA that has been detected in a variety of tumors, but its specific activity in non-small cell lung cancer (NSCLC) remains unclear.

Methods

In this study, we regulated the expression of miR-375, to evaluate its influence on the 14-3-3ζ/ERK/MYC pathway in NSCLC.

Results

The results of our experiments suggest that miR-375 and 14-3-3ζ are highly expressed in NSCLC, and the over-expression of miR-375 increases the invasive, metastatic, and proliferative ability and decreases the apoptotic ability of NSCLC cells. In addition, protein expression levels of 14-3-3ζ, p-ERK, and MYC increased following the overexpression of miR-375.

Conclusion

Overall, our findings indicate that miR-375 increases the malignant potential of NSCLC via the 14-3-3ζ/ERK/MYC pathway.
Primary pure squamous cell carcinoma of the duodenum: a case report and review of literature
Authors: Wang Xin , Ren Yinghong , Tian Xiaojian , Liu Haiyang
Published: June 2023

Primary pure squamous cell carcinomas (SCC) of the duodenum are very uncommon. To the best of our knowledge, only a few cases of SCC of the duodenum exist in the reported literature. Here, we report a case of SCC of the duodenum in northern China. A 45-year-old Chinese Han male patient presented with abdominal pain and weight loss. CT, endoscopic examinations, X-rays, and immunohistochemical markers were used to confirm this rare diagnosis of SCC. We performed a pancreaticoduodenectomy with a curative intention. However, histological examination revealed SCC of the duodenum. Postoperative chemotherapy was started after surgery. To the best of our knowledge, pancreaticoduodenectomy is the preferred form of treatment for carcinoma of the duodenum. This is supplemented with chemotherapy, which can further prolong survival.
Dosimetric evaluation of VMAT radiation therapy technique for breast cancer after conservative surgery based on three different types of multileaf collimators
Authors: Zhang Fuli , Xu Weidong , Jiang Huayong , Wang Yadi , Gao Junmao , Liu Qingzhi
Published: June 2023

Objective

Radiotherapy combined with conservative surgery plays an important role in the treatment of early-stage breast cancer. Volumetric modulated arc therapy (VMAT) has been introduced into clinical practice. The purpose of this study was to investigate the dosimetric effects of different multileaf collimators (MLC) on VMAT radiotherapy plans for treating breast cancer.

Methods

Fifteen breast cancer patients who were treated using a conventional technique in our department were selected to participate in this retrospective analysis. VMAT plans based on three types of Elekta MLCs [Beam Modulator (BM) with 4-mm leaf width, Agility with 5-mm leaf width and MLCi2 with 10-mm leaf width] were independently generated for each patient. Plan comparisons were performed based on dose-volume histogram (DVH) analysis including dosimetric parameters such as the homogeneity index (HI), conformity index (CI), Dmax, Dmin, and Dmean for the planning treatment volume (PTV), in addition to dose-volume parameters for the organs at risk (OARs). The delivery efficiency of the three types of MLCs was compared in terms of the beam delivery time and the monitor units (MUs) per fraction for each plan.

Results

Both target uniformity and conformity were improved in plans for Agility and BM MLC compared with the plan using MLCi2. The mean HI decreased from 1.14 for MLCi2 to 1.13 for BM and 1.10 for Agility, while the mean CI increased from 0.68 for MLCi2 to 0.73 for BM and 0.75 for Agility. Furthermore, at both low and high dose levels, smaller volumes of ipsilateral lung, heart, contralateral lung, and breast were irradiated with Agility MLC than with the other two types of MLCs. The delivery time with Agility MLC was reduced by 10.8% and 32.1%, respectively, compared with that for MLCi2 and BM.

Conclusion

Our results indicate that the Agility MLC exhibits a dosimetric advantage and a significant improvement in delivery efficiency for the treatment of breast cancer using VMAT.
Superior mesenteric venous thrombosis after laparoscopic radical resection of rectal cancer: a report of a rare case and literature review*
Authors: Jin Xinliang , Xue Weijie , Wang Yixiu , Xue Qinkai , Gong Zhiqi , Liu Yongke , Niu Zhaojian , Zhu Chengzhan
Published: June 2023

Mesenteric venous thrombosis (MVT) is rare, but life-threatening. MVT is often characterized by occult and nonspecific signs and symptoms. Diagnosis requires a high index of clinical suspicion, and emergency surgery is necessary to optimize patient survival, especially in people aged more than 70 years. MVT is a rare but fatal complication after laparoscopic radical surgery for rectal cancer. This study reports a case of extensive intestinal ischemic infarction caused by acute MVT after laparoscopic radical surgery for rectal cancer in a 70-year-old male.
Prognostic significance of PD-L1 expression in patients with colorectal cancer: a meta-analysis*
Authors: Liu Siwen , Ma Rong , Cao Haixia , Chen Dan , Jing Changwen , Wang Zhuo , Zhang Junying , Wu Yang , Feng Jifeng , Wu Jianzhong
Published: June 2023

Background

The association between the expression of programmed cell death 1 (PD-1) or its ligand [programmed cell death ligand-1 (PD-L1)] and colorectal cancer (CRC) survival rates remains unclear. Thus, we conducted a meta-analysis to investigate the prognostic value of PD-L1 expression in CRC patients.

Methods

All eligible studies related to evaluation of PD-L1 expression and survival of CRC patients were searched in PubMed, Medline, Cochrane library, and the EMBASE database. Hazard ratios (HRs) and 95% confidence intervals (CI) of overall survival (OS) were examined to assess the effect of PD-L1 expression on the survival of CRC patients. The outcomes of this meta-analysis were synthesized based on random-effects model. Subgroup analyses were also performed.

Results

Seven studies, wherein OS data were stratified according to the expression status of PD-L1, were analyzed. CRC patients showing positive PD-L1 expression were associated with significantly poorer prognoses in terms of overall survival, compared with those displaying negative PD-L1 expression (HR = 1.43, 95% CI: 1.07-1.92; P = 0.02). In the subgroup analyses, H-scores as well as the percentage of stained cells indicated that PD-L1 expression was significantly associated with poor prognosis (HR = 1.90, 95% CI: 1.38-2.62, P < 0.01; HR = 1.81, 95% CI: 1.08-3.03, P = 0.02). Immunohistochemical staining, utilizing a rabbit anti-PD-L1 antibody, revealed significantly superior survival in the PD-L1 negative group compared with the PD-L1 positive expression group (HR = 1.92; 95% CI, 1.40-2.63; P < 0.01). Moreover, PD-L1 expression was significantly associated with poor prognosis when polyclonal antibodies were used (HR = 1.84; 95% CI, 1.30-2.61; P < 0.01).

Conclusion

Our meta-analysis indicated that PD-L1 expression status is a significant prognostic factor for CRC patients. Positive PD-L1 expression was associated with worse CRC survival. Evaluation via different immunohistochemistry based techniques may partly account for the contradictory results. Therefore, further investigative studies using larger sample sizes are felt to be needed to elucidate the prognostic value of PD-L1 expression in CRC patients.