HSP90AA1 promotes lymphatic metastasis of hypopharyngeal squamous cell carcinoma by regulating epithelial-mesenchymal transition

Lymphatic metastasis(LM)emerges as an independent prognostic marker for hypopharyngeal squamous cell carcinoma(HSPSCC),chiefly contributing to treatment inefficacy.This study aimed to scrutinize the prognostic relevance of HSP90AA1 and its potential regulatory mechanism of concerning LM in HPSCC.Methods:In a preceding investigation,HSP90AA1,a differential gene,was discovered through transcriptome sequencing of HPSCC tissues,considering both the presence and absence of LM.Validation of HSP90AA1 expression was accomplished via qRT-PCR,western-blotting(WB),and immunohistochemistry(IHC),while its prognostic significance was assessed employing Kaplan–Meier survival analysis(KMSA),log-rank test(LR),and Cox’s regression analysis(CRA).Bioinformatics techniques facilitated the prediction and analysis of its plausible mechanisms in LM,further substantiated by in vitro and in vivo experiments utilizing FaDu cell lines.Results:HSP90AA1 is substantially upregulated in HPSCC with LM and is identified as an independent prognostic risk determinant.The down-regulation of HSP90AA1 can achieve inhibition of tumor cell proliferation,migration and invasion.Both in vivo experiments and Bioinformatics exploration hint at promoting LM by Epithelial-mesenchymal transition(EMT),regulated by HSP90AA1.Conclusions:HSP90AA1,by controlling EMT,can foster LM in HPSCC.This finding sets the foundation for delving into new therapeutic targets for HPSCC.

Axl glycosylation mediates tumor cell proliferation, invasion and lymphatic metastasis in murine hepatocellular carcinoma

AIM: To investigate the effects of Axl deglycosylation on tumor lymphatic metastases in mouse hepatocellular carcinoma cell lines. METHODS: Western blotting was used to analyze the expression profile of Axl glycoprotein in mouse hepa-tocellular carcinoma cell line Hca-F treated with tunicamycin and PNGase F 3-(4,5)-dimethylthiazol(-zyl)-3,5- diphenyltetrazolium bromide (MTT) assay, extracellular matrix (ECM) invasion assay (in vitro ) and tumor metastasis assay (in vivo ) were utilized to evaluate the effect of Axl deglycosylation on the Hca-F cell proliferation, invasion and lymphatic metastasis. RESULTS: Tunicamycin and PNGase F treatment markedly inhibited Axl glycoprotein synthesis and expression, proliferation, invasion, and lymphatic metastasis both in vitro and in vivo . In the MTT assay, proliferation was apparent in untreated Hca-F cells compared with treated Hca-F cells. In the ECM invasion assay (in vitro ), treated cells passed through the ECMatrix gel in significantly smaller numbers than untreated cells (tunicamycin 5 μg/mL: 68 ± 8 vs 80 ± 9, P=0.0222; 10 μg/mL: 50 ± 6vs 80 ± 9,P=0.0003; 20 μg/mL: 41 ± 4 vs 80 ± 9, P=0.0001); (PNGase F 8 h: 66 ± 7 vs 82 ± 8, P=0.0098; 16 h: 49 ± 4 vs 82 ± 8, P=0.0001; 24 h: 34 ± 3 vs 82 ± 8, P=0.0001). In the tumor metastasis assay (in vivo ), average lymph node weights of the untreated Hca-F group compared with treated Hca-F groups (tunicamycin 5 μg/mL: 0.84 ± 0.21 g vs 0.72 ± 0.19 g, P=0.3237; 10 μg/mL: 0.84 ± 0.21 g vs 0.54 ± 0.11 g, P=0.0113; 20 μg/mL: 0.84 ± 0.21 g vs 0.42 ± 0.06 g, P=0.0008); (PNGase F 8 h: 0.79 ± 0.15 g vs 0.63 ± 0.13 g, P=0.0766; 16 h: 0.79 ± 0.15 g vs 0.49 ± 0.10 g, P=0.0022; 24 h: 0.79 ± 0.15 g vs 0.39 ± 0.05 g, P=0.0001). Also, average lymph node volumes of the untreated Hca-F group compared with treated Hca-F groups (tunicamycin 5 μg/mL: 815 ± 61 mm 3 vs 680 ± 59 mm 3 , P=0.0613; 10 μg/mL: 815 ± 61 mm 3 vs 580 ± 29 mm 3 , P=0.0001; 20 μg/mL: 815 ± 61 mm 3 vs 395 ± 12 mm 3 , P=0.0001); (PNGase F 8 h: 670 ± 56 mm 3 vs 581 ± 48 mm 3 , P=0.0532; 16 h: 670 ± 56 mm 3 vs 412 ± 22 mm 3 , P=0.0001; 24 h: 670 ± 56 mm 3 vs 323 ± 11 mm 3 , P=0.0001). CONCLUSION: Alteration of Axl glycosylation can at-tenuate neoplastic lymphatic metastasis. Axl N-glycans may be a universal target for chemotherapy.

COMPARATIVE ANALYSIS OF LYMPHATIC METASTASIS——ASSOCIATED GENES IN MOUSE HEPATOCELLULAR CARCINOMA CELL LINES WITH DIFFERENT METASTATIC POTENTIAL

Objective： To investigate the neoplasm lymphatic metastasis-associated genes and its molecular mechanisms. Methods： 22690 mouse genome cDNA microarrays （including 14500 known genes and 4371 ESTs） were used to compare and analyze the gene expression profiles of mouse hepatocellular carcinoma cell lines Hca-F （highly lymphatic metastasis potential） and Hca-P （low potential）. Results： 901 genes and 129 ESTs were up-regulated at least 2-fold in Hca-F cell. 33 genes showing significant alterations in expression were presented, including endoglin （EDG）, MCAM, Cdc42ep5, F2r, D7Ertd458e, Serpin hl （HSP47）, AXL, Areg and so on. These genes have functions of angiogenesis, cell adhesion, signal transduction, cell motility, chaperone activity, protein kinase activity and receptor binding. Conclusion： cDNA microarray combined with lymphatic metastasis models might contribute new methods and clues to the neoplasm lymphatic metastasis research. Some overexpressed genes might provide novel clues to the molecular mechanisms of neoplasm lymphatic metastasis.

Pattern of Lymphatic Metastasis and Influencing Factors in Thoracic Esophageal Carcinoma

OBJECTIVE To explore the regular patterns of lymphatic metastasis in thoracic esophageal carcinoma （TEC） and the factors influencing these patterns. METHODS Data of 229 TEC patients who underwent radical esophagectomy and thoracoabdominal 2-field lymphadenectomy were reviewed. Within this patient population, a total of 2458 lymph nodes were dissected during surgery. The distribution of the nodular metastasis rates （NMR） in various diseased regions in the esophageal carcinoma （EC） patients as well as factors influencing metastases such as the depth of tumor infiltration, tumor size, tumor morphology, and degree of tumor differentiation were analyzed. RESULTS i） Lymphatic metastasis （LM） occurred in 102 EC cases, and the lymphatic metastasis rate （LMR） was 44.5% （102/229）. The NMR was 9.5% （258/2458）. ii） The NMRs were 19.0%, 6.7%, 9.8% and 12.2% in the superior, middle and inferior mediastinum, and abdominal cavity, respectively, in patients with EC in the superior thoracic segment; 26.1%, 7.4%, 11.8% and 11.9% in the same sites of the mediastinum, respectively, in those with middle thoracic-segment EC; and 0%, 1.6%, 5.3%, and 10.0%, respectively, in the same sites in those with inferior thoracic EC. iii） The LMRs of the EC patients in stage-T1, T2, T3 and T4 were 28.6%, 43.8%, 47.6% and 31.3%, respectively, and the NMRs of the patients were 7.9%, 10.8%, 10.7% and 10.8%, respectively. There were no significant differences between the LMR and the NMR of the EC patients in stage T1 to T4 （X^2 = 2.733, P = 0.435 and X2 = 0.686, P = 0.876）. iv） The LMR of the patients with the length of tumor 〈 3 cm, 〉 3 cm and 〈 5 cm, and 〉 5 cm were 45.2%, 43.4% and 46.2%, respectively, and the NMR according to the same range of the tumor size above were 9.1%, 11.6% and 11.7%, respectively. There were no significant differences between the groups （X2 --- 0.094, P = 0.954 and X2 = 3.933, P = 0.140）. v） The NMRs of the medullary, ulcerative, fungoid and sclerotic-type EC were 14.0%, 9.6%, 4.3% and 18.3%, respectively （X^2 = 19.292, P = 0.000）, among which the NMR of the fungoid-type EC was the lowest. The LMRs were 42.5% and 75.0%, respectively in the cases with squamous cell carcinoma （SqCC） and poorly differentiated SqCC （X^2 = 4.852, P = 0.028）, and the NMRs were 9.5% and 18.6% correspondingly in the 2 groups （X^2 = 11.323, P = 0.001）. LM was commonly seen in the cases with poorly differentiated tumors. CONCLUSION Lymph node metastases of TEC spreads widely and can involve many regions. Metastasis can even be found in early stages of EC. Morphologic type and the degree of tumor differentiation are the main factors affecting the LM.

Detection of D2-40 monoclonal antibody-labeled lymphatic vessel invasion in esophageal squamous cell carcinoma and its clinicopathologic significance

Objective： This study aims to investigate the clinicopathologic significance of lymphatic vessel invasion （LVI） labeled by D2-40 monoclonal antibody in esophageal squamous cell carcinoma （ESCC）. Methods： Immunohistochemical assay was used to detect the expression of D2-40 and LVI in 107 ESCC patients. Then, the correlation between the clinicopathologic feature and the overall survival time of the patients was analyzed. Results： The lymph node metastasis rates were 70% and 21% in the LVI-positive and LVI-negative groups, respectively. The nodal metastasis rate was higher in the LVI-positive group than in the LVI-negative group. Multivariate regression analysis showed that LVI was related to nodal metastasis （P〈0.001）. The median survival time of the patients was 26 and 43 months in the LVI-positive and LVI-negative groups, respectively. Mthough univariate regression analysis showed significant difference between the two groups （P=0.014）, multivariate regression analysis revealed that LVI was not an independent prognostic factor for overall survival in the ESCC patients （P=0.062）. Lymphatic node metastasis （P=0.031）, clinical stage （P=0.019）, and residual tumor （P=0.026） were the independent prognostic factors. Conclusion： LVI labeled by D2-40 monoclonal antibody is a risk factor predictive of lymph node metastasis in ESCC patients.

Expression Profile of Metastasis-associated Genes in Esophageal Squamous Cell Carcinoma

The differentially expressed genes between esophageal squamous cell carcinoma （ESCC） with or without lymphatic metastasis were investigated by gene chip, and the lymphatic metastasisassociated genes were screened out. Expression array was used to detect the mRNA from both the primary carcinoma and the corresponding esophageal epithelium in 15 cases of human ESCC. The lymphatic metastasis-associated genes were screened by bioinformatics between ESCC with or without lymphatic metastasis. The results showed that 43 （4. 85 %） genes significantly differed between the ESCC with and without lymphatic metastasis （P〈0.05）, of which 18（2.03 %）were upregulated and 25 （2.82 %） down-regulated. The up-regulated genes were involved in cell adhesion molecules and cell membrane receptors and the down-regulated genes were mostly cell cycle regulators and intracellular signaling molecules. It was suggested that lymphatic metastasis-associated genes were screened by gene chip, which was helpful to understand the molecular mechanism of ESCC lymphatic metastasis and lymphatic metastasis-associated genes might be used as diagnostic markers and therapeutic targets for lymphatic metastasis.

Occipital lymph node metastasis from nasopharyngeal carcinoma:a special case report and literature review

Cervical lymph node metastasis is common in patients with nasopharyngeal carcinoma(NPC),but occipital lymph node metastasis in NPC patients has not yet been reported.In this case report,we describe an NPC patient with occipital lymph node metastasis.The clinical presentation,diagnostic procedure,treatment,and outcome of this case were presented,with a review of the related literature.

基于能谱CT碘图的影像组学诊断甲状腺乳头状癌颈部淋巴结转移的价值

目的:探讨基于能谱CT碘图的影像组学特征对甲状腺乳头状癌患者颈部转移性淋巴结的诊断价值。方法:收集术前两周行颈部能谱CT检查的甲状腺乳头状癌患者,共纳入117枚转移性和176枚非转移性淋巴结,按照3︰1的比例随机分为训练集和验证集。从静脉期碘图中提取并筛选淋巴结的影像组学特征。采用Logistic回归分别建立影像组学模型、常规CT图像特征模型及联合模型,并绘制列线图将联合模型可视化。各模型的诊断效能、校准能力及临床实用性分别通过ROC曲线、校准曲线及决策曲线分析评估。结果:联合模型在训练集和验证集中均表现出最佳的诊断效能,其次是影像组学模型,且两者显著优于常规CT图像特征模型。所有模型均显示出良好的校准能力,决策曲线分析表明列线图的临床实用性优于其余两种模型。结论:能谱CT的影像组学特征在诊断甲状腺乳头状癌淋巴结转移方面表现出良好的性能,联合常规CT图像特征后诊断效能进一步提高。

能谱CT影像组学非小细胞肺癌淋巴结转移的预测模型构建

目的:构建基于能谱CT影像组学对非小细胞肺癌(NSCLC)术前淋巴结转移(LNM)的预测模型,并分析其诊断效能。方法:收集2019年1月—2023年1月在我院行能谱CT检查的NSCLC且接受肺癌切除术及淋巴结清扫术的153例患者的影像图像、肿瘤标记物及临床资料,按照7∶3比例分为训练集(n=107,其中LNM 37例,无LNM 70例)和验证集(n=46,其中LNM 15例,无LNM 31例),分别用于预测模型的训练和验证,比较两组患者一般临床资料及能谱CT参数,在CT平扫及增强图像上手动勾画肺癌病灶和目标淋巴结的感兴趣区(ROI)。应用人工智能软件自动化提取ROI的纹理参数,并从中筛选出能够鉴别LNM的纹理参数。利用LASSO回归筛选影像组学特征并建立影像组学标签,纳入多因素Logistic回归构建基于肿瘤组织及目标淋巴结纹理参数与影像组学特征的联合预测模型,采用受试者工作特征(ROC)曲线下面积(AUC)来评估能谱参数模型、影像组学模型及联合模型对术前LNM的诊断效能。运用DeLong检验对比各预测模型AUC的差异。通过决策曲线分析(DCA)对各预测模型的临床获益度进行评估。P<0.05为差异有统计学意义。结果:训练集和验证集中,LNM患者静脉期标准化碘浓度(NIC)低于无LNM患者,淋巴结短径高于无LNM患者(P<0.05);共提取207个影像组学特征,经LASSO回归筛选,最终纳入5个影像组学特征,包括灰度大小区域矩阵、灰度游程矩阵各2个,灰度依赖矩阵1个;多因素Logistic回归分析显示,淋巴结短径、静脉期NIC、Rad-score是预测NSCLC LNM的独立影响因素(P<0.05);ROC曲线分析显示,能谱参数模型预测训练集和验证集LNM的AUC分别为0.746、0.739,影像组学模型预测训练集和验证集LNM的AUC分别为0.747、0.726,联合模型预测训练集和验证集LNM的AUC分别为0.847、0.813,经Delong检验联合模型预测LNM的AUC高于能谱参数模型和影像组学模型预测LNM的AUC(P<0.05)。结论:基于能谱CT影像组学对NSCLC术前LNM具有较好的预测价值。

甲状腺癌新生淋巴管与淋巴转移的研究进展

甲状腺癌是常见的内分泌恶性肿瘤,多数呈惰性,淋巴转移是其常见的转移方式,决定肿瘤的临床分期和预后。肿瘤的淋巴转移机制是多年来的研究热点,目前已取得一些成果。本文将从淋巴管分子标志物及在新生肿瘤中的临床应用、淋巴管新生机制及在肿瘤淋巴转移中的作用、淋巴管引流示踪前哨淋巴结及超声在甲状腺癌颈部淋巴结转移中的应用等进行综述,尤其对常规超声、经静脉超声造影、经淋巴超声造影在甲状腺癌颈部淋巴结转移中的应用进行详细描述。

术前超声检查评估甲状腺微小乳头状癌颈部淋巴结转移的临床价值

目的探讨术前超声检查评估甲状腺微小乳头状癌颈部淋巴结转移的临床价值。方法选取甲状腺微小乳头状癌患者90例,其中颈部淋巴结转移患者42例作为观察组,非颈部淋巴结转移者48例为对照组,均行超声检测评估病灶的数目,测量计算直径、纵横比,并观察病灶结节形态、结节边界、结节回声、微钙化、侵犯被膜、内部血供等状况。结果颈部淋巴结转移患者的主要超声特征为内部低回声、伴有微钙化点、囊性变、内部血流丰富。观察组病灶多发、直径(≥5 mm)、纵横比(≥1)、占比分别为47.62%、80.95%、69.05%,均高于对照组的14.58%、14.58%、20.83%,差异有统计学意义(P<0.05)。结论超声检查能对甲状腺微小乳头状癌患者颈部淋巴结是否转移进行预测。

Effect of cell fusion on metastatic ability of mouse hepatocarcinoma cell lines

AIM To study the effect of cell fusion on metastatic ability of mouse hepatocarcinoma cells and the factors involved in the process of metastasis. METHODS By the method of successively increasing the concentrations, cell fusion and limit dilution, 8 Ag resistant cells were selected, and HGPRT - Hca P cells and eight cloned hybridoma cells were obtained. To observe their metastatic ability, they were inoculated into mice foodtaps and the drainage lymph nodes were examined under microscope. RESULTS The end concentration of 8 Ag which was used to select HGPRT deficient Hca P cells was 30mg/L . All the cells selected died in HAT culture medium in one week. Fused cells appeared approximately 9 days later. They were round, transparent and a little larger than their parental cells. Eight clones of hybridoma cells were obtained and named as PSH1 PSH8. The metastatic rate of HGPRT - Hca P cells and PSH7 cells was 28 6% and 71 4% respectively, the difference being significant ( P <0 05). The metastatic rate of other clones was no more than 20% and there was no significant difference from HGPRT - Hca P cells ( P >0 05). CONCLUSION In normal mice splenic lymphocytes, there are some factors that could inhibit tumor metastasis, however, there are some other factors accelerating tumor cells to metastasize. The establishment of PSH7 provides an experimental model which could be used to study the factors involved in metastasis.

Neck observation versus elective neck dissection in management of clinical T1/2N0 oral squamous cell carcinoma: a retrospective study of 232 patients

Objective: The management of early-stage (cT1/2N0) oral squamous cell carcinoma (OSCC) remains a controversial issue. The aim of this study was to compare the clinical outcomes of neck observation (OBS) and elective neck dissection (END) in treating patients with cT1/2N0 OSCC. Methods: A total of 232 patients with cT1/2N0 OSCC were included in this retrospective study. Of these patients, 181 were treated with END and 51 with OBS. The survival curves of 5-year overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) rates were plotted using the Kaplan-Meier method for each group, and compared using the Log-rank test. Results: There was no significant difference in 5-year OS and DSS rates between END and OBS groups (OS: 89.0% vs. 88.2%, P=0.906; DSS: 92.3% vs. 92.2%, P=0.998). However, the END group had a higher 5-year RFS rate than the OBS group (90.1% vs. 76.5%, P=0.009). Patients with occult metastases in OBS group (7/51) had similar 5-year OS rate (57.1% vs. 64.1%, P=0.839) and DSS rate (71.4% vs. 74.4%, P=0.982) to those in END group (39/181). In the regional recurrence patients, the 5-year OS rate (57.1% vs. 11.1%, P=0.011) and DSS rate (71.4% vs. 22.2%, P=0.022) in OBS group (7/51) were higher than those in END group (9/181). Conclusions: The results indicated that OBS policy could obtain the same 5-year OS and DSS as END. Under close follow-up, OBS policy may be an available treatment option for patients with clinical T1/2N0 OSCC.

Transarterial embolization of metastatic mediastinal hepatocellular carcinoma

This paper introduces an innovative treatment for extrahepatic metastasis of hepatocellular carcinoma. A 71-yearold patient had a stable liver condition following treatment for hepatocellular carcinoma, but later developed symptomatic mediastinal metastasis. This rapidly growing mediastinal mass induced symptoms including cough and hoarseness. Serial sessions of transarterial embolization (TAE) successfully controlled this mediastinal mass with limited side effects. The patient's survival time since the initial diagnosis of the mediastinal hepatocellular carcinoma was 32 mo, significantly longer than the 12 mo mean survival period of patients with similar diagnoses: metastatic hepatocellular carcinoma and a liver condition with a Child-Pugh class A score. Currently, oral sorafenib is the treatment of choice for metastatic hepatocellular carcinoma. Recentstudies indicate that locoregional treatment of extrahepatic metastasis of hepatocellular carcinomas might also significantly improve the prognosis in patients with their primary hepatic lesions under control. Many effective locoregional therapies for extrahepatic metastasis, including radiation and surgical resection, may provide palliative effects for hepatocellular carcinoma-associated mediastinal metastasis. This case report demonstrates that TAE of metastatic mediastinal hepatocellular carcinoma provided this patient with tumor control and increased survival time. This finding is important as it can potentially provide an alternative treatment option for patients with similar symptoms and diagnoses.

Sentinel lymph node detection by combined dye-isotope technique and its predictive value for cervical lymph node metastasis in patients with lingual carcinoma

Objectives To investigate the clinical value of combined dye-isotope technique in detecting sentinel lymph node (SLN) and to examine whether the characteristics of SLN accurately predict cervical lymph node metastasis in lingual carcinoma. Methods Thirty patients with lingual carcinoma without lymph metastasis were injected with a dose of about 18.5 MBq of 99m Tc-SC (sulfur colloid), around the tumor tissues before surgery,and lymphoscintigraphy was performed 5,10,30,60 minutes,and 6 hours after injection. In the following day,all patients were injected with isosulfan blue dye around the primary tumor during surgery to trace SLN and underwent standard cervical lymph node dissection after SLN dissection. The pathological results of SLN were compared with standard lymph node dissection for their ability to accurately predict the final pathological status of the cervical lymph nodes.Results SLN was successfully identified in 100% of the patients. Both positive and negative predictive values of SLN were 100%. The accuracy rate was 100%,and there were no false negatives. Conclusions The detection of SLN using combined dye-isotope technique could accurately predict cervical lymph node metastasis in lingual carcinoma.

Establishment of a prognostic scoring model for regional recurrent nasopharyngeal carcinoma after neck dissection

Objective:The main aim of this study was to establish a scoring model to predict risk of progression and survival in patients with regionally recurrent nasopharyngeal carcinoma(NPC).Methods:Three hundred and forty-eight patients subjected to neck dissection from 2003 to 2017 were included for study.Clinicopathologic information for each patient was analyzed.Independent prognostic factors were selected using the Cox proportional hazards model and incorporated into the scoring model.Concordance index(C-index)and calibration curves were used to verify discrimination and calibration,respectively and the results validated using bootstrap resampling.Results:Microscopic positive lymph node>2[hazard ratio(HR),2.19;95%confidence interval(CI),1.30–3.68;P=0.003],extranodal extension(HR,2.75;95%CI,1.69–4.47;P<0.001),and lower neck involvement(HR,1.78;95%CI,1.04–3.04;P=0.034)were identified from multivariate analysis as independent factors for overall survival(OS).A qualitative 4-point scale was generated to stratify patients into 4 risk groups for predicting OS and progression-free survival(PFS).The novel scoring model demonstrated enhanced discrimination(C-index=0.69;95%CI,0.62–0.76)relative to the original recurrent tumor-node-metastasis(rTNM)staging system(C-index=0.56;95%CI,0.50–0.62),and was internally validated with a bootstrap-adjusted C-index of 0.70.The calibration curve showed good agreement between predicted probabilities and actual observations.Conclusions:The scoring system established in this study based on a large regionally recurrent NPC cohort fills a gap regarding assessment of risk and prediction of survival outcomes after neck dissection in this population and could be further applied to identify high-risk patients who may benefit from more aggressive intervention.

Expression of Vascular Endothelial Growth Factor C and Its Clinical Significance in Human Esophageal Squamous Cell Carcinoma

OBJECTIVE To examine the expression of vascular endothelial growth factor C （VEGF-C） in human esophageal squamous cell carcinoma （ESCC）, and to clarify its role in lymphatic metastasis in ESCC patients.METHODS Esophageal carcinoma EC9706 cells and samples from 49 patients with primary ESCC were investigated by using S-P immunohistochemistry （IHC）, the semi-quantitative reverse transcriptase-polymerase chain reaction （RT-PCR） and in situ hybridization （ISH） methods for VEGF-C expression. RESULTS VEGF-C positive expression was found in EC9706 cells through IHC, ISH and RT-PCR. Positive IHC for VEGF-C was observed in 36 of 49 cases of ESCC. There was a significant difference between the expression of VEGF-C in a lymph-node-positive group compared to a node-negative group （χ^2=4.7, P〈0.05）. Positive ISH for VEGF-C mRNA was observed in 23 of 49 cases of ESCC. There was a significant difference between the expression of VEGF-C in the lymph-node-positive group and node-negative group （χ^2=31.3, P〈0.01）. The expression of VEGF-C was significantly higher in the lymph-node-positive group compared to the node-negative group. Of 49 ESCC tissues, RT-PCR for VEGF-C mRNA was observed positively in 29 cases. There was a significant difference between the expression of VEGF-C in the lymph-node-positive group and node-negative group （χ^2=23.3, P〈0.01）. The expression of VEGF-C was significantly higher in the lymphnode-positive group compared to the node-negative group. Expressions of VEGF-C were not significantly associated with age, gender, and pathological grade. There was a relationship between VEGF-C mRNA expressions by RT-PCR and ISH （χ^2=18.5, P〈0.01） in ESCC cases, but with no significant difference between the two methods. CONCLUSION VEGF-C expression may induce lymphangiogenesis in human ESCC. There was a close correlation between VEGF-C expression and lymph node metastasis. VEGF-C can serve as a useful prognostic factor for ESCC patients.

CAFs联合LVD对早期宫颈鳞癌淋巴结转移的预测价值

目的:探讨肿瘤相关成纤维细胞(CAFs)联合淋巴管密度(LVD)对早期宫颈鳞状细胞癌(CSCC)淋巴结转移(LNM)的预测价值。方法:利用免疫组化及多重免疫荧光检测132例早期CSCC组织标本(手术切除标本92例,活检组织标本40例)中α-SMA+CAFs和D2-40+LVs表达水平。分析CAFs密度与LVD的相关性,并与临床病理资料进行相关性统计学分析。建立logistic回归模型,绘制受试者工作特征曲线(ROC)分析CAFs和LVD对早期CSCC淋巴结转移的预测价值,将手术标本的病理评估结果与术前活检结果进行比较,以明确活检标本的预测效果。结果:92例手术切除标本中,早期CSCC组织的CAFs密度与LVD呈正相关(Spearman’s rho=0.597,P<0.001),CAFs密度和LVD均与LNM、淋巴脉管浸润(LVI)密切相关(P<0.05)。ROC分析显示,与LVD单独诊断LNM相比,CAFs密度联合LVD具有更高的敏感性(84.40%vs 71.90%,P<0.05)和相当的特异性(96.70%vs 98.30%,P>0.05)。CAFs密度与LVD结合具有最大的AUC(0.958,95%CI=0.919~0.997)。40例活检组织标本中,CAFs密度与LVD呈正相关(Spearman’s rho=0.487,P<0.001),二者表达水平在LNM组均高于non-LNM组(P<0.05)。活检标本与术后病理诊断淋巴结转移的总符合率为97.5%。结论:联合检测早期CSCC组织的CAFs密度、LVD水平在预测早期CSCC淋巴结转移中具有重要参考价值。

基于医学图像的影像组学和深度学习在头颈部鳞状细胞癌颈部淋巴结转移预测中的研究现状

颈淋巴结转移是影响头颈部鳞状细胞癌治疗效果的重要和独立预后因素。影像组学作为一种影像信息处理方式,具有无创、定量等特点,用于颈部淋巴结转移评估是目前研究的热点。而深度学习可以解决传统影像组学技术自动化、标准化程度低,耗时耗力的问题。本文介绍影像组学和深度学习在预测和鉴别颈部淋巴结转移、评估胞膜外侵犯和预后中的应用,旨在为临床医师制定精准的医疗决策提供依据。

^(99)Tc^(m)-3PRGD_(2)SPECT/CT评估非小细胞肺癌淋巴结转移

目的观察^(99)Tc^(m)-3PRGD_(2)SPECT/CT评估非小细胞肺癌(NSCLC)淋巴结转移的价值。方法回顾性分析25例NSCLC患者^(99)Tc^(m)-3PRGD_(2)SPECT/CT资料;以术后病理结果为金标准,观察SPECT/CT定性(目视观察)及半定量分析[计算病灶/本底放射性计数比值(T/B)]评估NSCLC淋巴结转移的效能。结果肺内NSCLC病灶均呈明显^(99)Tc^(m)-3PRGD_(2)摄取阳性,其摄取程度差异无统计学意义(Z=-1.19,P=0.234);伴与不伴淋巴结转移肺内原发灶之间T/B差异具有统计学意义(Z=-2.52,P=0.012);以9.23为阈值,根据肺内原发灶T/B评估NSCLC淋巴结转移的AUC为0.79。共40个淋巴结区域存在转移,其中27个区域呈^(99)Tc^(m)-3PRGD_(2)明显阳性摄取、13个区域呈轻度摄取或无摄取;131个区域为良性淋巴结,包括15个区域呈阳性摄取、116个区域呈阴性摄取。转移性与良性淋巴结之间,摄取^(99)Tc^(m)-3PRGD_(2)程度差异具有统计学意义(Z=-7.19,P<0.001);T/B差异亦有统计学意义(Z=-7.82,P<0.001)。淋巴结定性分析及半定量分析评估NSCLC淋巴结转移的曲线下面积(AUC)分别为0.78及0.91,差异具有统计学意义(Z=4.19,P<0.001)。结论^(99)Tc^(m)-3PRGD_(2)SPECT/CT有助于评估NSCLC淋巴结转移。