Integrative bioinformatics and in vitro exploration of EVI2A expression:unraveling its immunological and prognostic implications in kidney renal clear cell carcinoma

EVI2A has emerged as a significant biomarker in various diseases;however,its biological role and mechanism in kidney renal clear cell carcinoma(KIRC)remains unexplored.We used TCGA and GEO databases to analyze EVI2A gene expression comprehensively and performed pan-cancer assessments.Clinical relevance was evaluated through Kaplan-Meier analysis and ROC curves.The gene’s immune relevance was explored through analyses of the tumor microenvironment(TME),Tumor Immune Single-cell Hub(TISCH),immune checkpoints,and immunotherapy sensitivity.Our results indicate that EVI2A expression is upregulated in KIRC,showing correlations with tumor grade and T/N/M stage.EVI2A demonstrates high diagnostic accuracy(AUC=0.906)and predicts poor overall and progression-free survival in KIRC patients.Furthermore,EVI2A expression exhibits significant associations with immunity,including TME scores and specific immune cell types such as Tfh cells,CD4 memory T cells,and CD8+T cells.Elevated EVI2A expression suggests increased sensitivity to PD-1/CTLA-4 and tyrosine kinase inhibitors.In vitro assays confirmed the impact of EVI2A on KIRC behavior,with its knockdown resulting in reduced cell proliferation and migration.In conclusion,our comprehensive analysis identifies EVI2A as a promising biomarker and a novel therapeutic target for intervening in KIRC.These findings hold significant implications for further research and potential clinical applications.

Bidirectional regulation of the cyclic guanosine monophosphateadenosine monophosphate synthase-stimulator of interferon gene pathway and its impact on hepatocellular carcinoma

BACKGROUND Hepatocellular carcinoma(HCC)ranks as the fourth leading cause of cancerrelated deaths in China,and the treatment options are limited.The cyclic guanosine monophosphate-adenosine monophosphate synthase(cGAS)activates the stimulator of interferon gene(STING)signaling pathway as a crucial immune response pathway in the cytoplasm,which detects cytoplasmic DNA to regulate innate and adaptive immune responses.As a potential therapeutic target,cGASSTING pathway markedly inhibits tumor cell proliferation and metastasis,with its activation being particularly relevant in HCC.However,prolonged pathway activation may lead to an immunosuppressive tumor microenvironment,which fostering the invasion or metastasis of liver tumor cells.AIM To investigate the dual-regulation mechanism of cGAS-STING in HCC.METHODS This review was conducted according to the PRISMA guidelines.The study conducted a comprehensive search for articles related to HCC on PubMed and Web of Science databases.Through rigorous screening and meticulous analysis of the retrieved literature,the research aimed to summarize and elucidate the impact of the cGAS-STING pathway on HCC tumors.RESULTS All authors collaboratively selected studies for inclusion,extracted data,and the initial search of online databases yielded 1445 studies.After removing duplicates,remaining 964 records were screened.Ultimately,55 articles met the inclusion criteria and were included in this review.CONCLUSION Acute inflammation can have a few inhibitory effects on cancer,while chronic inflammation generally promotes its progression.Extended cGAS-STING pathway activation will result in a suppressive tumor microenvironment.

Immunological classification of hepatitis B virus-positive hepatocellular carcinoma by transcriptome analysis

BACKGROUND Hepatitis B virus(HBV)infection is a major factor responsible for HBV+hepatocellular carcinoma(HCC).AIM An immunological classification of HBV+HCC may provide both biological insights and clinical implications for this disease.METHODS Based on the enrichment of 23 immune signatures,we identified two immunespecific subtypes(Imm-H and Imm-L)of HBV+HCC by unsupervised clustering.We showed that this subtyping method was reproducible and predictable by analyzing three different datasets.RESULTS Compared to Imm-L,Imm-H displayed stronger immunity,more stromal components,lower tumor purity,lower stemness and intratumor heterogeneity,lower-level copy number alterations,higher global methylation level,and better overall and disease-free survival prognosis.Besides immune-related pathways,stromal pathways(ECM receptor interaction,focal adhesion,and regulation of actin cytoskeleton)and neuro-related pathways(neuroactive ligand-receptor interaction,and prion diseases)were more highly enriched in Imm-H than in Imm-L.We identified nine proteins differentially expressed between Imm-H and Imm-L,of which MYH11,PDCD4,Dvl3,and Syk were upregulated in Imm-H,while PCNA,Acetyl-a-Tubulin-Lys40,ER-α_pS118,Cyclin E2,andβ-Catenin were upregulated in Imm-L.CONCLUSION Our data suggest that“hot”tumors have a better prognosis than“cold”tumors in HBV+HCC and that“hot”tumors respond better to immunotherapy.

Liver tumor infiltrating lymphocytes: Comparison of hepatocellular and cholangiolar carcinoma

AIM: To investigate the role of tumor inf iltrating lym-phocytes (TIL) in primary hepatocellular and cholangio-lar carcinomas of the liver.METHODS: Immunohistochemical analysis was per-formed including antibodies to CD3, CD4, CD8, CD20, CD56 and TIA-1 in formalin-f ixed and paraff in-embed-ded tissue of 35 liver resection specimens of hepatocel-lular or cholangiocellular carcinomas. Semiquantitative evaluation was performed with emphasis on the area of the tumor itself and of the tumor/liver interface.RESULTS: All hepatocellular carcinomas showed in-filtration of lymphocytes predominantly around the tumor in the tumor/liver interface consisting mainly of CD3+ CD4+ T lymphocytes [164.3/10 high power f ields (HPF)] and in the tumor itself of CD8+ cells (54.9/10 HPF). Cholangiocarcinomas contained a heterogeneous amount of TIL, composed mainly of CD3+ T cells with a predominance of CD8+ cells in the tumor tissue (52.6/10 HPF) and of CD4+ cells in the interface region (223.1/10 HPF). CD56+ cells of the innate immune system were scarce. There was no significant difference between hepatocellular or cholangiolar carcinoma. No correlation with the clinicopathological data was seen. CONCLUSION: Liver TIL consists of intratumoral CD8+ T cells and peritumoral CD4+ T cells indepen-dent of histogenetic origin. Different functions of lym-phocytes in these regions seem possible.

Cutaneous metastasis from esophageal squamous cell carcinoma:A case report

BACKGROUND Esophageal cancer is a common cause of cancer-related death worldwide.Cutaneous metastasis of esophageal squamous cell carcinoma is rare,particularly in diffuse skin metastasis.CASE SUMMARY In this case report,we describe an 82-year-old male who was diagnosed with esophageal squamous cell carcinoma.The tumor was staged as T4N3M1(Stage IVB).The pathological findings revealed poorly differentiated squamous cell carcinoma of the esophagus.Four months after diagnosis,the patient began chemotherapy,and symptoms were relieved after four cycles of chemotherapy.After that,the patient returned home without a systematic physical examination.One year after diagnosis,the patient realized that the skin of the abdominal wall was hard and rough without pain,and the color became darker than normal skin.Thirteen months after diagnosis,a biopsy of the patient’s abdominal lesion revealed that the skin metastasis was derived from the esophagus.Then the patient received two cycles of apatinib combined with docetaxel,but the abdominal lesion worsened.Two cycles of nivolumab were administered,but the patient eventually died of multiple organ failure.CONCLUSION This report highlights cutaneous metastasis as a late and untreatable metastasis of esophageal cancer.

Spontaneous regression of hepatocellular carcinoma: A mini-review

Spontaneous tumor regression is an extremely rare phenomenon in the oncology field. However, there are several case reports resulted in the regression of hepatocellular carcinoma(HCC) and the accumulation of clinical information and analyses of the mechanism can contribute to the development of a novel therapy. For this purpose, we have carefully reviewed 23 cases of spontaneously regressed HCC published in recent 5 years and our case. The information regarding the tumor size, tumor marker, treatments, etc., have been summarized. The mechanism of spontaneous regression has been discussed to date and presumed to be due to many factors, including hypoxia and immunological reactions. In this careful review of the 24 cases based on the clinical information, hypoxia, systemic inflammation, and both upon spontaneous regression were seen in 3, 8, and 4 cases, respectively amo ng t he 15 c as e s f or w hic h t he inf o r mat io n regarding the proposed mechanisms are available. Recent development of immunotherapeutic approaches in oncology shows promising results, therefore, accumulation of additional cases and analysis of mechanisms underlying the spontaneous regression of HCC are essential and could lead to the development of a new generation of immunotherapies including antibodies directed against immune reactions.

Antitumor activities of human autologous cytokineinduced killer(CIK)cells against hepatocellular carcinoma cells in vitro and in vivo

AIM: To characterize the anticancer function of cytokine-induced killer cells (CIK) and develop an adoptive immunotherapy for the patients with primary hepatocellular carcinoma (HCC), we evaluated the proliferation rate, phenotype and the antitumor activity of human CIK cells from healthy donors and HCC patients in vitro and in vivo. METHODS: Peripheral blood mononuclear cells (PBMC) from healthy donors and patients with primary HCC were incubated in vitro and induced into CIK cells in the presence of various cytokines such as interferon-gamma (IFN-gamma), interleukin-1 (IL-1), IL-2 and monoclonal antibody (mAb) against CD3. The phenotype and characterization of CIK cells were identified by flow cytometric analysis. The cytotoxicity of CIK cells was determined by (51)Cr release assay. RESULTS: The CIK cells were shown to be a heterogeneous population with different cellular phenotypes. The percentage of CD3+/CD56+ positive cells, the dominant effector cells, in total CIK cells from healthy donors and HCC patients, significantly increased from 0.1-0.13% at day 0 to 19.0-20.5% at day 21 incubation, which suggested that the CD3+ CD56+ positive cells proliferated faster than other cell populations of CIK cells in the protocol used in this study. After 28 day in vitro incubation, the CIK cells from patients with HCC and healthy donors increased by more than 300-fold and 500-fold in proliferation cell number, respectively. CIK cells originated from HCC patients possessed a higher in vitro antitumor cytotoxic activity on autologous HCC cells than the autologous lymphokine-activated killer (LAK) cells and PBMC cells. In in vivo animal experiment, CIK cells had stronger effects on the inhibition of tumor growth in Balb/c nude mice bearing BEL-7402-producing tumor than LAK cells (mean inhibitory rate, 84.7% vs 52.8%, P【0.05) or PBMC (mean inhibitory rate, 84.7% vs 37.1%, P【0.01). CONCLUSION: Autologous CIK cells are of highly efficient cytotoxic effector cells against primary hepatocellular carcinoma cells and might serve as an alternative adoptive therapeutic strategy for HCC patients.

Immune aspects of hepatocellular carcinoma:From immune markers for early detection to immunotherapy

Hepatocellular carcinoma(HCC)is one of the most prevalent cancers and one of the main causes of cancer-related deaths worldwide.Most HCCs develop in an inflammatory microenvironment,and mounting evidence emphasizes the importance of immune aspects in hepatocarcinogenesis.In normal physiology,both innate and adaptive immune responses are responsible for eliminating malignantly transformed cells,thus preventing the development of liver cancer.However,in the setting of impaired natural killer cells and exhaustion of T cells,HCC can develop.The immunogenic features of HCC have relevant clinical implications.There is a large number of immune markers currently being studied for the early detection of liver cancer,which would be critical in order to improve surveillance programs.Moreover,novel immunotherapies have recently been proven to be effective,and the combination of atezolizumab and bevacizumab is currently the most effective treatment for advanced HCC.It is expected that in the near future different subgroups of patients will benefit from specific immunotherapy.The better we understand the immune aspects of HCC,the greater the benefit to patients through surveillance aiming for early detection of liver cancer,which allows for curative treatments,and,in cases of advanced disease,through the selection of the best possible therapy for each individual.

Changes in the frequency of myeloid-derived suppressor cells after transarterial chemoembolization with gelatin sponge microparticles for hepatocellular carcinoma

Purpose: A series of clinical studies have established the safety and efficacy of transcatheter arterial chemoembolization(TACE) with gelatin sponge microparticles(GSMs) in treating hepatocellular carcinoma(HCC). HCC can lead to obvious necrosis inside tumors, especially larger ones, although it is unclear whether such necrotic tumor tissue can induce favorable immune reactions against the tumor. Myeloid-derived suppressor cells(MDSCs)have immunosuppressive functions and are currently considered a very important cell type affecting tumor immunity. This study observed changes in MDSC frequency in peripheral blood before and after GSM–TACE to evaluate the effect on the immune function of HCC patients.Methods: Eight patients diagnosed with HCC underwent GSM–TACE treatment in the Hepatobiliary Interventional Department of Beijing Tsinghua Chang Gung Hospital, Beijing, China;we followed up with the patients over a period of 30 days post-surgery. We used flow cytometry(FCM) to quantify the frequency of MDSCs in peripheral blood before TACE, 10 days after surgery and 30 days after surgery.Results: MDSC frequency after GSM–TACE had a significant downward trend. Pre-TACE, it was 30.73% ? 11.93%,decreasing to 18.60% ? 11.37% at 10 days after operation. This decrease was not statistically significant(P > 0.05). MDSC frequency was even lower 30 days after TACE(7.63% ? 7.32%) than at 10 days after TACE(P < 0.05), and there was a significant difference compared with pre-TACE(P < 0.001). We evaluated tumor response at 30 days after GSM–TACE according to the Modified Response Evaluation Criteria in Solid Tumors(mRECIST), and all eight patients showed partial response(PR).Conclusion: Our results confirmed that GSM–TACE was beneficial for improving anti-tumor immunity in the treatment of HCC.

Relationship between expression of apoptosis-related antigens in hepatocelular carcinoma and in situ end labeling

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EXPRESSION OF PRE-S_1 AND PRE-S_2 ANTIGENS OF HEPATITIS B VIRUS AND THEIR SIGNIFICANCE IN HUMAN PRIMARY HEPATIC CARCINOMA

The specimens of 135 cases of primary hepatic carcinoma were obtained from the Pathological Laboratory of the First Affiliated Hospital of the Fourth Military Medical University, Xi' an, PRC. Ten percent formalin-fixed and paraffin- embedded sections were stained by HE and by ABC and PAP immunohistochemical methods. Positive rates of pre- S1 and pre- S2 antigens in cancerous tissue were 22. 2% and 20. 0%, respectively, while those in surrounding hepatic tissue were 60.6% and 59.6%, separately. The pre- S1 and pre- S2 antigens were found to coexist In 16. 3% of cancerous tissue and in 55. 6% of surrounding hepatic tissue. In all the 135 cases of hepatic carcinoma, the cancerous tissue showed positive HBsAg in 16. 3%, HBxAg in 55. 6% and HBcAg in 8. 9%; in the surrounding hepatic tissue, positive HBsAg was 59.6%, HBxAg 78.8% and HBcAg 24.2%. The results of this study suggestes that positive rates of pre- S1 and pre-S2 antigens in cancerous tissue were slightly higher than that of HBsAg, but markedly lower than that of HBxAg. The positive rate of pre-S1 and pre- S2 antigens in surrounding hepatic tissue was nearly the same as HBsAg, but slightly lower than that of HBxAg. Antigens of pre-S1 and pre-S2 are the new markers of HBV infection. The same as other antigens, they may play an important role in the development of hepatic carcinoma. The mechanism of their effect will be further investigated,

Non-alcoholic fatty liver disease-related hepatocellular carcinoma:Is there a role for immunotherapy?

Hepatocellular carcinoma(HCC)is among the most common cancers and it is a major cause of cancer-related deaths.Non-alcoholic fatty liver disease(NAFLD)affects approximately one fourth of individuals worldwide and it is becoming one of the most important causes of HCC.The pathogenic mechanisms leading to NAFLD-related HCC are complex and not completely understood.However,metabolic,fibrogenic,oncogenic,inflammatory and immunological pathways seem to be involved.First-line therapy of advanced HCC has recently undergone major changes,since the combination of atezolizumab and bevacizumab was proven to increase survival when compared to sorafenib.Other immune-oncology drugs are also demonstrating promising results in patients with advanced HCC when compared to traditional systemic therapy.However,initial studies raised concerns that the advantages of immunotherapy might depend on the underlying liver disease,which seems to be particularly important in NAFLD-related HCC,as these tumors might not benefit from it.This article will review the mechanisms of NAFLD-related hepatocarcinogenesis,with an emphasis on its immune aspects,the efficacy of traditional systemic therapy for advanced NAFLD-related HCC,and the most recent data on the role of immunotherapy for this specific group of patients,showing that the management of this condition should be individualized and that a general recommendation cannot be made at this time.

Immunotherapy in hepatocellular carcinoma: Combination strategies

Liver cancer is one of the most common causes of cancer death globally,and its incidence in the United States is increasing.Patients with advanced hepatocellular carcinoma(HCC)who are not candidates for surgical resection,liver transplant,or locoregional therapies can be treated with systemic therapies.Multiple agents,including sorafenib,lenvatinib,and regorafenib are approved for use as either first-or second-line therapy in this patient population,but all have relatively modest survival benefits.HCC is potentially susceptible to therapy with checkpoint inhibitors,including agents such as nivolumab and pembrolizumab,which are both approved by the Food and Drug Administration for patients previously treated with sorafenib but have not demonstrated superior overall survival in phase III trials.It is clear that more effective approaches are needed to potentiate the effects of checkpoint inhibitors in patients with HCC.This review will outline and appraise the current literature on the use of checkpoint inhibitors in HCC as part of a combination treatment involving an additional mode of therapy.The list of agents that can be paired with checkpoint inhibitors includes an additional checkpoint inhibitor,vascular endothelial growth factor or vascular endothelial growth factor receptor inhibitors,tyrosine kinase inhibitors,OX-40 agonists,and PT-112 inhibitors.The main non-pharmacologic therapies currently being studied for inclusion in a combination strategy include radiation therapy,trans-arterial chemoembolization,and ablation.

Changes in immunological function after treatment with transarterial chemoembolization plus radiofrequency ablation in hepatocellular carcinoma patients

Background Different strategies for hepatocellular carcinoma （HCC） may have distinct effects on the immune system.The aim of this research was to investigate changes in the immunological function after transcatheter arterial chemoembolization （TACE） plus radiofrequency ablation （RFA） in HCC patients.Methods A total of 51 consecutive HCC treatment-naive patients was enrolled in this study and 20 healthy subjects served as controls.The therapeutic strategy was selected according to the tumor stage and general conditions.TACE was performed in 25 cases,TACE plus RFA in 17 and RFA in nine.All the patients underwent routine examinations and peripheral blood was harvested for the detection of lymphocyte subset by flow cytometry 1 day before,and 2 and 4 weeks after the treatment.The serum levels of alpha-fetoprotein （AFP）,ALT and AST were also measured before and 4 weeks after treatment for the evaluation of therapeutic efficacy and liver function impairment.Results When compared with healthy controls,the CD4/CD8 ratio and the number of B cells and natural killer （NK） cells were significantly decreased in HCC patients before treatment （P 〈0.05）.When compared with before treatment,the CD4＋ cells and CD4/CD8 ratio decreased but CD8＋ cells increased in the TACE group （P 〈0.05）; the CD4/CD8 ratio and NK cells decreased but CD8＋ cells increased in the TACE-RFA group （P 〈0.05）; the CD3＋ cells,CD4＋ cells,CD4/CD8 ratio and NK cells increased in the RFA group （P 〈0.05）.Significant differences in the CD3＋ cells,CD8＋ cells,CD4/CD8 ratio and NK cells were observed among groups （P 〈0.05）.Moreover,the AFP level decreased and transaminase level increased in all groups （P 〈0.05）.Differences of pre and post treatment between groups were statistically significant （P =0.016,0.025,0.018 respectively）.Conclusions Immunity was compromised in HCC patients; TACE and TACE plus RFA lowered immunologic function to a certain extent.RFA improved it accompanied by a protective effect on liver function.

Updates in immunotherapy for hepatocellular carcinoma

Hepatocellular carcinoma(HCC)carries an unfavorable prognosis and novel therapeutic strategies are needed.Until now,only few systemic agents have improved survival in patients with advanced stage disease.Immunotherapy changed the landscape in several tumor types by producing unprecedented clinical outcomes with a favorable safety profile.Liver presents a particular immune-suppressive microenvironment and HCC develops in a background of chronic inflammation in the vast majority of cases.In this regard,immunotherapy may be a suitable strategy.Preliminary research focused on therapies involving immune cells and anti-tumor immune response for HCC has shown encouraging preliminary results.Immune checkpoint inhibitors,such the anti-PD-1/PD-L1 monoclonal antibodies,have provided durable responses in patients with advanced stage disease,although the pioneers phaseⅢtrials did not confirm survival superiority over the available agents.Cancer vaccines,adoptive cellular therapies and combinations of local modalities with immunotherapy are promising approaches under active research.

罗汉松实提取物对鼻咽癌CNE-2R移植瘤生长和放射敏感性的影响

目的:研究罗汉松实提取物(SPE)对鼻咽癌CNE-2R移植瘤生长和放射敏感性的影响,并探讨其潜在的作用机制。方法:荷瘤裸鼠分为模型组、SPE组(60 mg/kg)、照射组、SPE+照射组,另取正常裸鼠设为空白组。SPE组和SPE+照射组灌胃给予SPE药液,其余各组给予生理盐水10 mL/kg,1次/d,连续7 d。末次给药后6 h,照射组和SPE+照射组以2 Gy X线照射,1次/d,连续3d,SPE+照射组同时给予SPE,至照射后第4天停止给药。各组动物取血,取肿瘤组织,称质量,计算抑瘤率;HE染色法观察肿瘤组织切片病理学变化;ELISA法测定血清中IL-2、TNF-α和IFN-γ含量;RT-PCR和Western Blot法分别检测肿瘤组织中C-Raf、MEK、ERK1、ERK2 mRNA和蛋白的表达。结果:SPE、照射和SPE+照射能显著抑制肿瘤生长,抑瘤率分别为42.37%、66.89%和78.38%,且SPE+照射的作用强于单纯照射;各组肿瘤细胞大量坏死。与模型组比较,SPE和SPE+照射组IL-2和TNF-α含量显著增加(P<0.05);SPE组IFN-γ含量也显著增加(P<0.05)。RT-PCR结果显示,照射和SPE+照射组C-Raf、ERK1和ERK2 mRNA显著降低,且SPE+照射对C-Raf和ERK2表达的抑制作用强于单纯照射(P<0.05)。WB结果显示,SPE、照射和SPE+照射C-Raf、MEK、ERK1和ERK2蛋白表达水平显著降低,且SPE+照射的作用强于单纯照射(P<0.05)。结论:SPE能抑制鼻咽癌CNE-2R移植瘤的生长,并提高肿瘤组织对射线的敏感性。其机制可能与促进IL-2和TNF-α释放,调节免疫功能,下调Raf/MEK/ERK信号通路C-Raf和ERK2 mRNA和蛋白表达有关。

基于症状管理理论的全方位护理对原发性肝癌伴门静脉高压病人TIPS术后康复效果、免疫功能、心理状态、并发症的影响

目的:探讨基于症状管理理论的全方位护理对原发性肝癌(PHC)伴门静脉高压(PHT)病人经颈静脉肝内门体静脉分流术(TIPS)后康复效果、免疫功能、心理状态、并发症的影响。方法:选取医院2021年1月-2022年12月收治的PHC伴PHT病人90例作为研究对象,均行TIPS术治疗,通过随机抽签法将病人分为全方位护理组和常规护理组各45例。常规护理组在TIPS围术期采用常规护理,全方位护理组在常规护理基础采用基于症状管理理论的全方位护理干预。统计对比两组术后恢复情况、免疫功能(CD_3^(+)、CD_4^(+)、CD_(8)^(+))、心理状况[焦虑自评量表(SAS)、抑郁自评量表(SDS)]及并发症情况。结果:全方位护理组住院时间、首次进食时间、首次排便时间、首次下床活动时间均明显短于常规护理组(P<0.05);干预后全方位护理组CD_3^(+)、CD_(4)^(+)水平均明显高于常规护理组,CD_(8)^(+)明显低于常规护理组(P<0.05);干预后全方位护理组SAS、SDS评分均低于常规护理组(P<0.05);干预期间全方位护理组并发症发生率明显低于常规护理组,护理满意率高于常规护理组(P<0.05)。结论:基于症状管理理论的全方位护理用于行TIPS术治疗的PHC伴PHT病人围术期,可明显提升病人的免疫功能,改善病人的负性心理状况,降低并发症发生率,促进术后快速恢复,进而提升病人护理的满意度。

单细胞测序技术解析上皮性卵巢癌免疫微环境的研究进展

上皮性卵巢癌(epithelial ovarian cancer,EOC)是女性生殖系统恶性肿瘤中致死率最高的疾病。肿瘤免疫微环境中,免疫细胞与肿瘤细胞的相互作用可能形成恶性循环,促进肿瘤发展。因此,深入探索肿瘤免疫微环境对制定EOC的免疫治疗方案至关重要。传统高通量测序技术仅能检测细胞群体平均的基因表达水平,难以捕捉稀有异质性细胞,限制了对复杂肿瘤免疫微环境的全面理解。单细胞测序技术的出现突破了这一限制,通过高分辨率测序实现了从单细胞水平揭示肿瘤免疫微环境的异质性,这项技术能够精确识别不同免疫细胞亚群,分析其发育分化路径,并探究细胞间的相互作用。本综述还特别关注了EOC多部位的免疫微环境特征,总结了单细胞测序技术在指导个体化免疫治疗中的应用前景,并指出了未来研究方向,为促进EOC的免疫治疗提供重要参考。

超声对具有神经内分泌特征乳腺癌的诊断价值

目的探讨超声图像对具有神经内分泌特征乳腺癌的诊断价值。方法选取2011-2021年间本院接受治疗的36例具有神经内分泌特征的乳腺癌患者为研究对象,回顾性分析其手术前的超声图像、临床及病理结果资料各项指标与神经内分泌特征乳腺癌的相关性。结果36例患者中,高分化神经内分泌瘤占13.9%,低分化神经内分泌癌占5.5%,伴神经内分泌特征的浸润性乳腺癌占80.6%。超声特征包括形态不规则(91.7%)、平行生长(83.3%)、低回声(94.4%)、边缘不光整(83.3%)、后方回声无变化(69.4%)、无钙化(77.8%)、血流信号Ⅱ-Ⅲ级(61.1%)。BI-RADS分类为4A类41.7%、4B类22.2%、4C类25%和5类11.1%。72.2%的患者已绝经,淋巴转移阳性率为25%。免疫组织化学检测显示ER、PR、HER-2、CgA和Syn的阳性率分别为94.4%、94.4%、11.1%、86.1%和100%,Ki-67增殖指数在2%~90%之间。ROC曲线显示变量的诊断效能较低(AUC:0.365~0.640),多因素Logistic回归分析未能筛选出独立判断因素。结论超声检查对具有神经内分泌特征乳腺癌有较高的检出率,但超声图像特征不能早期预测不同病理类型。

经口腔入路腔镜甲状腺肿瘤切除术治疗甲状腺微小乳头状癌患者的优势基于血清甲状旁腺功能和免疫功能

目的探讨基于甲状旁腺功能和免疫功能经口腔入路腔镜甲状腺肿瘤切除术治疗甲状腺微小乳头状癌患者的优势。方法收集2022年2月—2023年4月在南阳市中心医院治疗的甲状腺微小乳头状癌患者90例,随机分为观察组(经口腔前庭入路腔镜手术,n=45)和对照组(颈部开放手术,n=45),分别对比两组患者手术总时长、术中失血量、术后引流量、疼痛评分、甲状旁腺功能和免疫功能指标以及两组患者的并发症发生率。结果观察组的手术总时长明显长于对照组,但术中失血量、术后引流量和疼痛评分均显著优于对照组(P<0.05)。在甲状旁腺功能方面,两组患者的甲状旁腺激素(PTH)和血清钙离子水平在手术后均有不同程度的下降,但观察组患者的PTH水平下降的程度更为轻微,差异具有统计学意义(P<0.05)。在免疫功能指标方面,手术前,两组患者的IgG和IgA水平差异无统计学意义(P>0.05),手术后观察组患者的IgG和IgA水平明显高于对照组患者,差异有统计学意义(P<0.05)。观察组患者的并发症发生率明显低于对照组患者(P<0.05)。结论相对于颈部开放手术,经口腔入路腔镜手术在治疗甲状腺微小乳头状癌方面具有明显的优势。经口腔入路腔镜手术创伤小、手术效果好、术后恢复快,且对甲状旁腺功能和免疫功能的影响更为轻微。因此,经口腔入路腔镜手术可以作为治疗甲状腺微小乳头状癌的首选方法之一。