Role of oxysterol-binding protein-related proteins in malignant human tumours

The oxysterol-binding protein-related protein(ORP)family is a group of proteins that mediate oxysterol metabolism and bioactivity in cells.ORPs constitute a large family of lipid transfer proteins.Much of the current evidence indicates that certain members of the family of oxysterol-binding proteins(OSBPs)can lead to cancer.Many studies have revealed the putative roles of OSBPs in various cancer types.However,the exact effects and mechanisms of action of members of the OSBP/ORP family in cancer initiation and progression are currently unclear.This review focuses on ORP family members that can accelerate human tumour cell proliferation,migration,and invasion.The mechanisms and functions of various ORPs are introduced in detail.We also attempt to identify the roles of these proteins in malignant tumours with the ultimate aim of determining the exact role of the OSBP/ORP family in human tumour cells.

DIAGNOSIS AND TREATMENT OF MALIGNANT PANCREATICENDOCRINE TUMOUR

Objective To summarize our experience in the diagnosis and treatment of malignant pancreatic endocrine tumour. Methods We retrospectively reviewed 36 cases of malignant pancreatic endocrine tumours in our hospital from July 1987 to April 2002, and summarized its clinical features. Results Liver metastasis was the main malignant manifestation of malignant pancreatic endocrine tumours (incidence rate 72.2%). Removals of primary lesion and isolated hepatic metastatic lesion were means of curative therapy. Interventional chemotherapy was an important adjuvant treatment. Conclusion Comprehensive therapy plays an important role in improving the prognosis of malignant pancreatic endoc-rine tumour.

Primary extragenital mixed malignant Mullerian tumour presenting as a painful splenic mass: A case report and review of the literature

BACKGROUND Mixed malignant Mullerian tumours(MMMTs)are highly aggressive cancers that present at a late stage and are associated with a poor long-term prognosis.They are characterised by the presence of both epithelial and sarcomatous tissue types on histological examination and hence are known as biphasic tumours or carcinosarcomas.MMMTs almost always arise in the female genital tract(most commonly the uterus)but extragenital sites are also possible.Treatment options are limited and usually consists of surgery and adjuvant chemotherapy.CASE SUMMARY A 74-year-old woman presented with a 1-wk history of worsening left upper quadrant abdominal pain and a perisplenic mass on computed tomography(CT)scan.Features on imaging raised the possibility of a malignant process but were not diagnostic.Splenectomy was performed and histology confirmed the presence of a mixed malignant Mullerian tumour.A subsequent pelvic ultrasound identified another heterogenous cystic mass in the Pouch of Douglas without evidence of primary pathology in the uterus or adnexa.A second operation was performed for this with curative intent but previously-unknown widespread metastases were encountered at laparotomy.A biopsy of the pelvic mass confirmed it was also a MMMT with identical histological features to the perisplenic mass.There was no clinical or histological evidence of the MMMT having arisen primarily from the female genital tract.The patient subsequently suffered multi-organ failure and was palliated,succumbing to death on the 19th post-operative day.CONCLUSION Primary extragenital MMMT arising from the spleen or peritoneum represents an atypical form of an already rare gynaecological tumour.

Primary Cutaneous Leiomyosarcoma of the Face: A Rare Tumor that Is Difficult to Diagnose

Leiomyosarcoma is a rare malignant tumour of the lower limbs. Its differential histological diagnosis is difficult and is made in the presence of young scar tissue, leimyoma, dermatofibroma, melanoma, rabdomyosarcoma, sarcomatoid carcinoma, fibroxantoma, Darrier Ferrand dermatofibrosarcoma and myofibroblastic tumours. Treatment is essentially surgical, with margins of 3 to 5 centimetres. We report two observations of tumours localised to the face, including one case of a known leiomyosarcoma and another case initially diagnosed as a leiomyosarcoma which turned out to be a cellular myofibroma with no sign of malignancy after several readings. The aim of this work is to review the literature on this pathology while highlighting the diagnostic and therapeutic difficulties. Conclusion: A rare smooth muscle tumour with a high risk of local recurrence in the event of incomplete treatment, leiomyosarcoma in its dermal component is preferentially located in the head and neck. Its treatment is exclusively surgical and highly mutilating.

Impact of Three-month Home Enteral Nutritional Supplementation on the Nutritional Status of Patients with Malignancy

Objective We analysed the impact of home nutritional interventions on the nutritional risk and the incidence and severity of malnutrition in patients with malignancy.Methods In this prospective interventional study,we recruited 60 patients with malignancy who were at nutritional risk(NRS 2002≥3 scores).These patients were given home enteral nutritional supplementation(HES)for 3 months.The HES included nutritional counselling,oral nutritional supplements(ONS)and tube feeding.The incidence and severity of nutritional risk and malnutrition,as well as the body composition and results of routine blood tests,were compared before and after the intervention.Results A total of 58 patients completed the study.After three months of home enteral nutritional intervention,the incidence and severity of nutritional risk and malnutrition were significantly reduced(the NRS 2002 score was reduced from 3 to 1,the PG-SGA score was reduced from 8.00 to 3.00,P<0.05).The patients’body mass index(BMI)and upper arm circumference increased(P<0.05),the muscle mass,appendicular skeletal muscle mass index(ASMI)and phase angle(PA)increased(P<0.05).The serum albumin,pre-albumin and haemoglobin levels increased significantly,while the neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)decreased significantly(P<0.05).The incidence of hypoproteinaemia and anaemia also decreased significantly(P<0.05).Conclusion HES can effectively improve the nutritional status of patients and reduce the risk and severity of malnutrition.

Predictors of mortality in patients with acute smallbowel perforation transferred to ICU after emergency surgery:a single-centre retrospective cohort study

Background Although small-bowel perforation is a life-threatening emergency even after immediate surgical intervention,studies have rarely investigated surgical outcomes due to its relatively low incidence.This study aimed to investigate the outcomes of emergency surgery for patients with small-bowel perforation transferred to the intensive care unit(ICU)and the risk factors for mortality.Methods Consecutive patients with small-bowel perforation who were confirmed via emergency surgery and transferred to the ICU in Zhongshan Hospital,Fudan University(Shanghai,China)between February 2011 and May 2020 were retrospectively analysed.Medical records were reviewed to determine clinical features,laboratory indicators,surgical findings,and pathology.Results A total of 104 patients were included in this study,among whom 18(17.3%),59(56.7%),and 27(26.0%)underwent perforation repair,segmental resection with primary anastomosis,and small-bowel ostomy,respectively.Malignant tumours were the leading cause of perforation in these patients(40.4%,42/104).The overall post-operative complication rate and mortality rates were 74.0%(77/104)and 19.2%(20/104),respectively.Malignant tumour-related perforation(odds ratio[OR],4.659;95%confidence interval[CI],1.269–17.105;P=0.020)and high post-operative arterial blood-lactate level(OR,1.479;95%CI,1.027–2.131;P=0.036)were identified as independent risk factors for post-operative mortality in patients with small-bowel perforation transferred to the ICU.Conclusions Patients with small-bowel perforation who are transferred to the ICU after emergency surgery face a high risk of post-operative complications and mortality.Moreover,those patients with malignant tumour-related perforation and higher post-operative blood-lactate levels have poor prognosis.