宝石能谱CT能谱曲线在肿瘤定性诊断中的应用

目的探讨宝石能谱CT能谱曲线在肿瘤定性诊断中的应用及其价值。方法选取我院2022年4月至2023年11月胃肠道占位性病变25例患者作为研究对象。按病变部位分为两组,胃腺癌中低分化组15例;结肠腺癌高分化组10例。应用GE宝石能谱CT对病变部位进行CT增强能谱扫描,将扫描获得的GSI-DATA数据传至AW4.71智汇后处理工作站,应用GSI-Viewer打开动脉期GSI-DATA数据,选取感兴趣区(ROI)通过能谱软件后处理生成能谱曲线,计算能谱曲线的斜率(KA),对能谱曲线斜率应用统计学方法进行统计分析。结果胃腺癌中低分化组15例能谱曲线斜率平行或相近,其差异无统计学意义(P>0.05),结肠腺癌高分化组10例能谱曲线斜率平行或相近,其差异无统计学意义(P>0.05);胃腺癌中低分化组与结肠腺癌高分化组能谱曲线斜率分离或相交叉,差异有统计学意义(P<0.05)。相同的病理结果具有平行或相似的能谱曲线斜率。结论应用宝石能谱CT对胃肠道肿瘤性病变进行能谱扫描,通过能谱后处理软件可获得能谱曲线,分析能谱曲线的斜率在肿瘤性病变的定性诊断中具有较高的价值。

CT引导下经皮肺穿刺活检术在肺肿瘤定性诊断中的应用价值研究

观察CT引导经皮肺穿刺活检术在肺肿瘤定性诊断中的应用效果,为肺肿瘤诊断提供可靠依据。方法 本研究以2022年6月至2023年6月收治的96例肺部周边性肿瘤病人为研究对象,采用随机数表法将其分成两组,每组48例。观察组采用CT导引下经皮肺活检,并与对照组进行对比分析。结果 观察组与对照组比较,有显著性差异(P<0.05);观察组术后并发症明显少于对照组(P<0.05)。探讨CT导引下经皮肺活检的可行性,为肺癌的诊治提供新的思路和方法。

电脑肿瘤定性仪临床检测结果分析

应用DY -电脑肿瘤定性仪 (以下简称定性仪 )对 2 49例恶性肿瘤患者 ,19例良性肿瘤患者及 2 2例健康体检者进行了检测。结果显示 ,定性仪对恶性肿瘤的诊断正确率为 86 35 % ,良性肿瘤诊断正确率为 84 2 1% ,健康人诊断正确率为 94 45 %。其灵敏度为 86 35 % ,特异性为 90 2 4%。表明电脑肿瘤定性仪可作为肿瘤普查的初筛方法推广应用。

动态增强磁共振成像用于肌骨系统肿瘤定性诊断的可行性探讨

目的:肌骨系统肿瘤疾病早期病症不明显,不利于及早诊断,基于此,本次研究将动态增强磁共振应用到该病的定性诊断中,并就该检测手段的可行性加以评估。方法:将参与本次研究的对象选定为2018年1月-2019年10月期间入院治疗的肌骨系统肿瘤患者,抽取90例。观察患者在动态增强磁共振检查下,其良性、交界性、恶性肿瘤Ktrans、Kep和Ve值的检测情况,并与病理诊断结果相对比,评估动态增强磁共振的诊断价值。结果:于良性肿瘤而言,动态增强磁共振与病理诊断结果显示,二者Ktrans、Kep值无显著差异(P>0.05),而前者Ve值显著高于后者;与交界性肿瘤而言,两种检测方法的Ve值无明显差异,而动态增强磁共振检测下Ktrans、Kep值均高于病理诊断(P<0.05);与恶性肿瘤而言,动态增强磁共振检测下三个指标的数值均高于病理诊断(P<0.05)。结论:在肌骨系统肿瘤的检查中,动态增强磁共振更为敏感、诊断率更高,具有相当优势。

动态增强磁共振成像用于肌骨系统肿瘤定性的诊断价值

目的:探究在肌骨系统肿瘤定性的诊断中动态增强磁共振成像的应用价值。方法:在我院2016年12月至2018年12月期间收治的所有肌骨系统肿瘤患者中选出80例作为此次研究对象。所有患者均接受动态增强磁共振成像检查,依据患者病理诊断结果可分为良性、交界性与恶性肿瘤,同时将病灶层面为正常肌肉组织的患者划分为对照组,将良性、交界性与恶性肿瘤同对照组Ktrans、Ve和Kep值进行对比。结果:良性肿瘤与对照组比较发现Ktrans、Kep值不存在显著差异(P>0.05),但Ve值高于对照组;交界性肿瘤与对照组比较发现Ktrans、Kep值高较对照组高,但两组Ve值无显著差异存在(P<0.05);恶性肿瘤与对照组比较发现Ktrans、Kep和Ve值均高于对照组(P<0.05)。结论:动态增强磁共振成像扫描在肌骨系统肿瘤定性诊断方面上具有积极意义,值得临床多加应用。

脑室内及侵入脑室内肿瘤的MRI诊断:定位与定性

目的探讨脑室内及侵入脑室内肿瘤的定位、定性及它们间的鉴别诊断。方法43例均行横、冠、矢三维的MR平扫及增强扫描,并回顾性分析肿瘤的MR征象。结果43例肿瘤,9类病种,其中室管膜瘤10例,髓母细胞瘤6例,脑膜瘤8例,星形细胞瘤8例,少支胶质瘤3例,脉络丛乳头状瘤、中央性神经细胞瘤、海绵状血管瘤和胶样囊肿各2例。误诊原因主要是肿瘤发生的位置不典型和肿瘤MR征象不典型。结论注意观察脑室内、外的MR定位征象和加强对少见征象的认识,有助于提高诊断。

微卫星不稳定性恶性肿瘤合成致死新靶点WRN的研究进展

微卫星不稳定性(microsatellite instability,MSI)是一种肿瘤细胞中由错配修复受损或缺陷导致而出现新的微卫星等位基因的现象。MSI可以导致肿瘤细胞基因组进一步紊乱和突变,从而促进恶性肿瘤的发生发展,是公认的重要致癌途径之一。Werner syndrome protein(WRN)解旋酶是属于RecQ家族的DNA解旋酶,该酶在DNA修复和维持基因组稳定性中发挥着重要的作用。近年来研究发现,MSI恶性肿瘤的生长高度依赖WRN解旋酶,提示WRN是潜在的MSI恶性肿瘤合成致死新靶点。文章系统综述了WRN解旋酶的结构和生物学功能,总结该蛋白作为合成致死新靶点的最新进展,以及WRN解旋酶抑制剂的研究进展,以期为MSI恶性肿瘤的治疗和WRN抑制剂研发提供参考。

微卫星不稳定性与肿瘤的研究进展

近年来微卫星不稳定性与肿瘤发生发展的关系成为肿瘤标志物研究、肿瘤的特性及其预后的一个热点,但其结果、结论不尽相同。全文对肿瘤中微卫星不稳定性研究进展作一综述。

Synthesis and stability evaluation of 5-FU-acetic podophyllic ester as anti-tumor agent

Aim To study a new anti-cancer drug 5-FU-acetic podophyllic ester derivatized from podophyllotoxin. Methods A novel derivative of podophyllotoxin was synthesized. Its inhibitory effects against P-388, A-549, Bel-7402 and HL-60 in vitro were tested. The stability tests under different kinds of conditions were carried out. Results The novel derivative showed stronger inhibitory activities against P-388, A-549 and Bel-7402 in vitro than VP-16. The novel derivative was found to be stable at 60 ℃ and 4500 1x light in solid-state, but was less stable in humid condition. It was more stable in methanol （4 ℃ ） and chloroform （25 ℃ ） than in methanol （25 ℃）, and less stable in artificial gastric juice （ AGJ, 37 ℃ ）. Its stabilities were decreased while increasing the pH of buffer solutions. Conclusion These results could provide useful information for further study of this compound.

Lived experiences with unmet supportive care needs in pediatric cancer:Perspective of Chinese children and their parents

Objective:Unmet supportive care needs(SCNs)impact pediatric cancer patients and their parents.This study aimed to explore the unmet SCNs from the perspective of Chinese children with cancer and their parents through lived experiences.Methods:The data of this study was collected using face-to-face semi-structured interviews.The participants were recruited from the oncology units of three children’s hospitals in China’s cities(Shanghai,Guangzhou,and Hefei)from October 2020 to December 2021.Data were analyzed using Colaizzi’s sevenstep phenomenological analysis method.Results:Eight pediatric cancer patients and twenty-four parents were enrolled in the study.Four main themes and eight subthemes(both children’s and parent’s perspectives)were generated:1)meeting the ongoing needs along the cancer trajectory(can you tell me what comes next;our needs are growing);2)communicating with a family focus(they only talk to my parents;let each family member have a voice);3)providing care beyond the treatment(I am bigger than my body[the children’s needs for emotional consolidation and information about their prognosis];there are things beyond treatment);4)getting support from the community(I am not a monster[the children were unhappy about being treated differently];we want to connect with the resources near us).Conclusion:This study revealed multiple unmet SCNs from the perspective of Chinese children with cancer and their parents.The findings call for comprehensive and in-depth supportive care beyond treatment,integration of the family member voice in pediatric cancer care,and a coordinated pediatric cancer support mechanism in the Chinese healthcare system.

Adjuvant treatment in biliary tract cancer: To treat or not to treat?

Biliary tract cancer is a rare malignant tumor. There is limited knowledge about biology and natural history of this disease and considerable uncertainty remains regarding its optimal diagnostic and therapeutic man- agement. The role of adjuvant therapy is object of debate and controversy. Although resection is identified as the most effective and the only potentially curative treatment, there is no consensus on the impact of ad- juvant chemotherapy and/or radiotherapy on the high incidence of disease recurrence and on survival. This is mainly due to the rarity of this disease and the consequent difficulty in performing randomized trials. The only two prospectively controlled trials concluded that adjuvant chemotherapy did not improve survival. Most of the retrospective trials, which had limited sample size and included heterogeneous patients population and non-standardized therapies, suggested a marginal benefit of chemoradiotherapy in reducing locoregional recurrence and an uncertain impact on survival. Welldesigned multi-institutional randomized trials are necessary to clarify the role of adjuvant therapy. Two ongoing phase Ⅲ trials may provide relevant information.

肝癌微波消融术前超声造影对肝脏肿瘤再定性的应用价值

目的:评价肝癌微波消融术前进行超声造影对肝脏肿瘤再定性的价值。方法:选取2019-01-2019-12本院接收的70例拟接受微波消融术的肝癌患者为研究对象,依次行彩色多普勒血流显像与超声造影检查,并与病理结果进行比较。观察各自准确性。结果:超声造影与彩色多普勒血流显像相比,诊断肝癌的敏感度,阳性特异度,阴性特异度,准确性均显著提高,P<0.05,差异具有统计学意义。结论:超声造影诊断肿瘤性质的准确性较高,可以减少误诊。

Nuclear and mitochondrial DNA microsatellite instability in hepatocellular carcinoma in Chinese

AIM：To study the nuclear microsatellite instability (nMSI) at BAT26 and mitochondral microsalellite instability (mtMSI) in the occurrence and development of hepatocellular carcinoma and the relationship between nMSI and mtMSI.METHODS: nMSI was observed with PCR and mtMSI with PCR-SSCP in 52 cases of hepatocellular carcinoma.RESULTS:mtMSI was detected in 11 out of the 52 cases of hepatocellular carcinoma (21.2%). Among the 11 cases of hepatocellular carcinoma with mtMSI, 7 occured in one locus and 4 in 2 loci. The frequency of mtMSI in the 52 cases of hepatocellular carcinoma showed no correlation to sex, age,infection of hepatitis B, liver cirrhosis as well as positive AFP of the patients (P>0.05). In addition, nMSI was detected in 3 out of 52 cases of hepatocellular carcinoma (5.8%) and there was no correlation of the incidence of mtMSI to that of nMSI (P>0.05).CONCLUSION:mtMSI may be involved in the coccurrence and development of hepatocellular carcinoma and it is independent of nMSI.

Colorectal cancer carcinogenesis:a review of mechanisms

Colorectal cancer(CRC) is the second most common cancer in women and the third most common in men globally. CRC arises from one or a combination of chromosomal instability, Cp G island methylator phenotype, and microsatellite instability. Genetic instability is usually caused by aneuploidy and loss of heterozygosity. Mutations in the tumor suppressor or cell cycle genes may also lead to cellular transformation. Similarly, epigenetic and/or genetic alterations resulting in impaired cellular pathways, such as DNA repair mechanism, may lead to microsatellite instability and mutator phenotype. Non-coding RNAs, more importantly micro RNAs and long non-coding RNAs have also been implicated at various CRC stages. Understanding the specific mechanisms of tumorigenesis and the underlying genetic and epigenetic traits is critical in comprehending the disease phenotype. This paper reviews these mechanisms along with the roles of various non-coding RNAs in CRCs.

The Anti—tumor Effects of an Anti—CD71 Chimeric Antibody in Vitro and Its Distribution in a Tumor Xenograft Model

Objective To investigate the anti-tumor effects in vitro and in vivo distribution of the human/murine chimeric antibody (D2C). Methods The CD71 positive target cells (K562, GEM and SMMC7721) and the effector cells, freshly isolated human PBMC, with the ratio of target cells to effector cells 1:50, were incubated in various dilutions of D2C antibody ( Ab) . Antibody dependent cytotoxicity (AD-CC) was tested by using an LDH-release assay. Instead of effector cells, complement was added to the target cells (GEM, SMMC-7721) with various dilutions of D2C Ab. A method of counting death cells was used in complement dependent cytotoxicity (CDC) assay. Tumor localization and distribution of the chimeric antibody (D2C) were observed by labeling the chimeric Ab with radioiodine(131I) and injecting it into nude mice (Balb/c nu/nu) transplanted with human hepatocellular carcinoma cells (SMMC-7721).Results A significant ADCC was observed with the increased concentration of the D2C Ab. Cytolysis of CD71-positive target cells by the D2C Ab was found in the presence of fresh rabbit complement. Labeled D2C administered by intraperitoneal as well as tumor regional injection, was visualized by SPECT. The distribution of D2C Ab in murine organs and tissues showed that non-specific binding was lower following tumor regional administration than when the antibody was administered by an intraperitoneal injection. The human/murine chimeric antibody (D2C) has in vitro anti-tumor effects and can exert its effects in specific tumor localization. Its distribution and local effects in vivo can be detected by radioimmunoimaging.Conclusion CD71 human/murine chimeric antibody showed marked killing of tumor cells in vitro, and specific recognition and high affinity binding to tumor tissue in vivo

Clinical significance of serum vascular endothelial growth factor in advanced malignant tumors

Objective： To elucidate the clinical significance of serum vascular endothelial growth factor （VEGF） level in pa- tients with advanced cancer. Methods： Enzyme linked immunosorbent assay （ELISA） was used to determine the serum VEGF concentration in 40 patients with advanced cancer [non-small cell rung cancer （NSCLC）, esophageal cancer （EC） and nasopharyngeal carcinoma （NPC）] before and after chemotherapy and 10 healthy volunteers as control group. Results： The serum VEGF concentrations in 40 cases of advanced cancer patients were significantly higher than those of 10 healthy control cases [（477.07 ± 374.10 ） pg/mL vs （139.09 ± 133.41 ） pg/mL; P = 0.016]. The serum VEGF concentrations in patients with NSCLC, EC and NPC were （518.53 _± 378.99） pg/mL, （399.21 ± 393.69） pg/mL and （500.68 ± 348.48） pg/mL, respectively. The differences were all statistically significant as compared with healthy control group （P values were 0.011,0.044 and 0.019, respectively）. The serum VEGF concentrations of the patients in response to chemotherapy was significantly lower than those of the same patients before they undergoing chemotherapy [（400.41 ± 332.84） pg/mL vs （777.10 ± 666.01） pg/mL; P = 0.034]. Conclusion： The serum VEGF level might be a novel and promising tumor marker of advanced malignancies and a predictor of disease progression, prognosis and therapeutic efficacy,

Expression of HIF-1α in breast cancer and precancerous lesions and the relationship to clinicopathological features

Objective： The aim of this study was to observe the expressions and clinical significance of HIF-1a in breast cancer and precancerous lesions, and analyze the relationship between the expressions and clinicopathological features in breast cancer. Methods： We analyzed the HIF-1a expression in 128 cases of invasive ductal carcinomas, 146 precancerous lesions patients including 89 cases of ductal carcinoma in situ and 57 cases of atypical ductal hyperplasia. 53 cases of usual ductal hyperplasia breast tissues were selected as a control group. The specimens were evaluated for HIF-1a, estrogen receptor （ER） ＆ progesterone receptor （PR）, epidermal growth factor receptor type 2 （HER2/neu） and Ki-67. Immunoreactivity was semi-quantitatively evaluated in at least 1000 cells examined under the microscope at 40 x magnification and recorded as the percentage of positive tumor cells over the total number of cells examined in the same area. The percentage scores were subsequently categorized. The express of HIF-1a and their relationship with multiple biological parameters including ER ＆ PR, HER2/neu and Ki-67, the biomarkers levels of CA153, CA125 TSGF, and CEA in blood serum and nipple discharge, histological grade, region lymph node metastasis, distant metastasis and recurrence on files were also assessed. Results： Compared with usual ductal hyperplasia, the positive expression rate of HIF-1a in atypical ductal hyperplasia, ductal carcinoma in situ and invasive ductal carcinomas group was significantly increased （P 〈 0.01）. The positive rates of HIF-1a in invasive ductal carcinomas were 68.75%, which were significantly higher than that in ductal carcinoma in situ （43.8%）, atypical ductal hyperplasia （31.6%）, usual ductal hyperplasia （9.4%; X2 = 13.44, 22.27, 52.79, respectively, P 〈 0.01）. Statistical analysis showed that difference of abnormal expression rate of HIF-1a between ductal carcinoma in situ and usual ductal hyperplasia （X2 = 18.37, P = 0.00）, atypical ductal hyperplasia and usual ductal hyperplasia （x2 = 8.14, P = 0.00） was significant （P = 0.00）. However, no significant difference in the positive expression rate of HIF-1a was found between atypical ductal hyperplasia and ductal carcinoma in situ tissue （X2 = 2.19, P = 0.14）. There was a significantly difference in the mean HIF-1a frequency between ER ＆ PR positive invasive ductal carcinomas group and negative group, epidermal growth factor receptor type 2 （HER2/neu） positive and negative groups, Ki-67 proliferation index 〈 14% and 〉 14% groups, histological grade （I ＋ II） and grade III invasive ductal carcinomas groups, with lymph node metastasis, distant metastasis and recurrence groups （P 〈 0.05） and without groups （P 〈 0.05）. However, there was not difference in the mean HIF-1a between age （〈 50 years vs 〉 50 years）, tumor diameter （〈 2 cm vs 〉 2 cm; P 〉 0.05）. The nipple discharge and serum levels of CA153, TSGF, CA125 and CEA in invasive ductal carcinomas HIF-1a positive patients were significantly higher than those in the negative patients （P 〈 0.05）. Conclusion： In breast cancer, HIF-1a expressibn was abnormally increased. The aberration of HIF-1a may play a key role during oncogenesis （atypical ductal hyperplasia or ductal carcinoma in situ） and promote breast cellular transformation into malignancy, a finding useful for further understanding of tumorigenesis. The abnormal expression of HIF-1a may be as an early event in the development of breast tumor. The over-expression of HIF-1a might be important biological markers for invasion, metastasis and recurrence of breast cancer.

B7-H4 Expression and Increased Death Risk of Cancer Patients： A Meta-Analysis

OBJECTIVE The relationship between higher levels of B7-H4 expression and death risk of cancer patients remains to be clarified. In the current study, information from an ordinary scale and those from several outcome scales were combined to make a single estimate. PubMed databases were searched for survival studies on the hazard ratios （HR） of malignant tumors associated with higher B7-H4 expression from 1999 to 2010. METHODS The fixed effect model was used to estimate the combined HRs of six studies. Sensitivity analysis was performed to assess the stability. Publication bias was also estimated. Six studies that meet the inclusion criteria were identified; these studies reported the associations between the higher B7-H4 expression and death risk of cancer patients. RESULTS A 42% increase in death risk was observed in patients with higher B7-H4 expression （HR = 1.42; 95% confidence interval： 1.16-1.72）. Sensitivity analyses found the results robust. The analysis shows that higher levels of B7-H4 expression are associated with the death risk of patients suffering from various cancers. CONCLUSION B7-H4 may be a negative regulatory molecule for antitumor immune responses and a molecular target for tumor immunotherapy.

肺结节的鉴别诊断

探讨常用影像学诊断在肺结节鉴别诊断中的价值,分析常规CT平扫、CT动态增强的应用价值。方法 选取2020年1月至2021年1月经体检发现的肺结节患者为研究对象,共88例。观察对象均接受CT扫描检查,包括CT常规平扫,CT动态增强扫描。以患者穿刺活检或手术病理诊断结果作为金标准,分析两种CT诊断方式在肺结节良恶性鉴别诊断中的灵敏度、特异度。同时分析不同性质肺结节的CT值差异。结果 88例患者中,经肺部穿刺活检或手术病理诊断证实有40例患者恶性结节,占比为45.45%,48例患者为良性结节,占比为54.55%。CT常规平扫的灵敏度、特异度、准确度分别为77.50%(31/40)、75.00%(36/48)、76.14%(67/88)。CT动态增强扫描的灵敏度、特异度、准确度分别为92.50%(37/40)、95.83%(46/48)、94.32%(83/88)。CT动态增强其特异度、准确度显著高于CT常规平扫,差异有统计学意义(P<0.05)。CT平扫良性结节、恶性结节的CT值对比差异不显著(P>0.05);CT动态增强延迟15 s、30 s、60 s、120 s、180 s良性结节CT值低于恶性结节,差异有统计学意义(P<0.05)。结论 CT在肺结节良恶性鉴别诊断中具有较高的价值,尤其是CT动态增强扫描,能较为准确地定性肺结节,最大程度避免漏诊、误诊的发生。