Tongue image feature correlation analysis in benign lung nodules and lung cancer

Objective To analyze the differences in the correlation of tongue image indicators among patients with benign lung nodules and lung cancer.Methods From July 1;2020 to March 31;2022;clinical information of lung cancer patients and benign lung nodules patients was collected at the Oncology Department of Longhua Hos-pital Affiliated to Shanghai University of Traditional Chinese Medicine and the Physical Ex-amination Center of Shuguang Hospital Affiliated to Shanghai University of Traditional Chi-nese Medicine;respectively.We obtained tongue images from patients with benign lung nod-ules and lung cancer using the TFDA-1 digital tongue diagnosis instrument;and analyzed these images with the TDAS V2.0 software.The extracted indicators included color space pa-rameters in the Lab system for both the tongue body(TB)and tongue coating(TC)(TB/TC-L;TB/TC-a;and TB/TC-b);textural parameters[TB/TC-contrast(CON);TB/TC-angular second moment(ASM);TB/TC-entropy(ENT);and TB/TC-MEAN];as well as TC parameters(perAll and perPart).The bivariate correlation of TB and TC features was analyzed using Pearson’s or Spearman’s correlation analysis;and the overall correlation was analyzed using canonical correlation analysis(CCA).Results Samples from 307 patients with benign lung nodules and 276 lung cancer patients were included after excluding outliers and extreme values.Simple correlation analysis indi-cated that the correlation of TB-L with TC-L;TB-b with TC-b;and TB-b with perAll in lung cancer group was higher than that in benign nodules group.Moreover;the correlation of TB-a with TC-a;TB-a with perAll;and the texture parameters of the TB(TB-CON;TB-ASM;TB-ENT;and TB-MEAN)with the texture parameters of the TC(TC-CON;TC-ASM;TC-ENT;and TC-MEAN)in benign nodules group was higher than lung cancer group.CCA further demon-strated a strong correlation between the TB and TC parameters in lung cancer group;with the first and second pairs of typical variables in benign nodules and lung cancer groups indicat-ing correlation coefficients of 0.918 and 0.817(P<0.05);and 0.940 and 0.822(P<0.05);re-spectively.Conclusion Benign lung nodules and lung cancer patients exhibited differences in correla-tion in the L;a;and b values of the TB and TC;as well as the perAll value of the TC;and the texture parameters(TB/TC-CON;TB/TC-ASM;TB/TC-ENT;and TB/TC-MEAN)between the TB and TC.Additionally;there were differences in the overall correlation of the TB and TC be-tween the two groups.Objective tongue diagnosis indicators can effectively assist in the diag-nosis of benign lung nodules and lung cancer;thereby providing a scientific basis for the ear-ly detection;diagnosis;and treatment of lung cancer.

Molecular signaling in cancer stem cells of tongue squamous cell carcinoma:Therapeutic implications and challenges

Head and neck squamous cell carcinoma is the seventh most common cancer worldwide with high mortality rates.Amongst oral cavity cancers,tongue carcinoma is a very common and aggressive oral cavity carcinoma.Despite the implementation of a multimodality treatment regime including surgical intervention,chemo-radiation as well as targeted therapy,tongue carcinoma shows a poor overall 5-year survival pattern,which is attributed to therapy resistance and recurrence of the disease.The presence of a rare population,i.e.,cancer stem cells(CSCs)within the tumor,are involved in therapy resistance,recurrence,and distant metastasis that results in poor survival patterns.Therapeutic agents targeting CSCs have been in clinical trials,although they are unable to reach into therapy stage which is due to their failure in trials.A more detailed understanding of the CSCs is essential for identifying efficient targets.Molecular signaling pathways,which are differentially regulated in the CSCs,are one of the promising targets to manipulate the CSCs that would provide an improved outcome.In this review,we summarize the current understanding of molecular signaling associated with the maintenance and regulation of CSCs in tongue squamous cell carcinoma in order to emphasize the need of the hour to get a deeper understanding to unravel novel targets.

Identification of ITGA3 as an Oncogene in Human Tongue Cancer via Integrated Bioinformatics Analysis

Human tongue cancer （TC） is an aggressive malignancy with a very poor prognosis. There is an urgent need to elucidate the underlying molecular mechanisms involved in TC progression, mRNA expression profiles play a vital role in the exploration of cancer-related genes. Therefore, the purpose of our study was to identify the progression associated candidate genes of TC by bioinformatics analysis. Five microarray datasets of TC samples were downloaded from the Gene Expression Onmibus （GEO） database and the data of 133 TC patients were screened from The Cancer Genome Atlas （TCGA） head and neck squamous cell carcinoma （HNSC） database. The integrated analysis of five microarray datasets and the RNA sequencing data of TC samples in TCGA-HNSC was performed to obtain 1023 overlapping differentially expressed genes （DEGs） in TC and adjacent normal tissue （ANT） samples. Next, Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway analysis was conducted to enrich the significant pathways of the 1023 DEGs and PI3K- Akt signaling pathway （P=0.011） was selected to be the candidate pathway. A total of 23 DEGs with ｜log2 fold change （FC）｜ ≥1.0 in phosphatidylinositol 3-kinase-serine/threonine kinase （PI3K-Akt） signaling pathway were subjected to survival analysis of 125 eligible TC samples in TCGA database, indicating increased integrin-α3 gene （ITGA3） expression was significantly associated with poorer prognosis. Taken together, our study suggested ITGA3 may facilitate the development of TC via activating PI3K-Akt signaling pathway.

ERK phosphorylation functions in invadopodia formation in tongue cancer cells in a novel silicate fibre-based 3D cell culture system

To screen for additional treatment targets against tongue cancer, we evaluated the contributions of extracellular signal-related kinase(ERK), AKT and ezrin in cancer development. Immunohistochemical staining showed that ERK and ezrin expressions were significantly higher in invasive squamous cell carcinoma than in carcinoma in situ. To investigate the roles of ERK and ezrin in cancer development, we used the non-woven silica fibre sheet Cellbedwith a structure resembling the loose connective tissue morphology in a novel 3 D culture system. We confirmed that the 3 D system using CellbedTMaccurately mimicked cancer cell morphology in vivo. Furthermore, cell projections were much more apparent in 3 D-cultured tongue cancer cell lines than in 2 D cultures. Typically, under conventional 2 D culture conditions, F-actin and cortactin are colocalized in the form of puncta within cells.However, in the 3 D-cultured cells, colocalization was mainly observed at the cell margins, including the projections. Projections containing F-actin and cortactin colocalization were predicted to be invadopodia. Although suppressing ezrin expression with small interfering RNA transfection caused no marked changes in morphology, cell projection formation was decreased, and the tumour thickness in vertical sections after 3 D culture was markedly decreased after suppressing ERK activity because both the invasion ability and proliferation were inhibited. An association between cortactin activation as well as ERK activity and invadopodia formation was detected. Our novel 3 D culture systems using Cellbed? are simple and useful for in vitro studies before conducting animal experiments. ERK contributes to tongue cancer development by increasing both cancer cell proliferation and migration via cortactin activation.

Expression of Plectin-1 and Trichohyalin in Human Tongue Cancer Cells

In basal squamous cells, plectin-1 interacts with intermediate filaments, whereas trichohyalin, which is distributed primarily in the medulla and inner root sheath cells of human hair follicles, plays a role in strengthening cells during keratinization. Although both cytoskeletal proteins occur in trace amounts in human tongue epithelial cells, there are minimal data on their expression in human tongue primary cancer cells. We therefore investigated the expression of plectin-1 and trichohyalin in human tongue epithelial cell line (DOK) and tongue cancer cell line (BICR31) using western blotting and FITC-labeled immunocytochemistry techniques. DOK and BICR31 cells were cultivated to subconfluence in Dulbecco’s Modified Eagle’s Medium containing 0.4 μg/ml of hydrocortisone and 10% fetal bovine serum, and the levels of trichohyalin and plectin-1 were determined by western blot analysis and immunocytochemical staining. Trichohyalin expression was clearly observed, with no differences between DOK and BICR31 cells. Although DOK cells expressed trace levels of plectin-1, obvious plectin-1 bands were detected in western blot analyses of BICR31 cells. Immunocytochemical staining revealed that trichohyalin and plectin-1 localize in the cytoplasm. Trichohyalin was diffusely distributed in both cell lines, and colocalization of trichohyalin and cytokeratin 1/10 was observed in almost all BICR31 cells. There were no correlations between western blot and immunocytochemical data for trichohyalin. Conversely, correlations in immunochemical reactions for plectin-1 were observed. Most DOK cells showed no localization of plectin-1, but strong reactions were detected in the cytoplasm of BICR31 cells. These results indicate that trichohyalin is expressed by cancerous tongue epithelial cells during various stages of malignancy and that plectin-1 provides an index of malignancy.

Co-registered photoacoustic and ultrasound imaging for tongue cancer detection

Tongue cancer is an increasingly common disease with high morbidity,Besides clinical obser-vation,biomedical imaging techniques have been investigated for early detection of tonguecancer.In this paper,we proposed a co-registered dual-modality photoacoustic(PA)and ul.trasound imaging technique to simultaneously map the functional and structural information ofhuman tongue,which has the potential to detect and diagnose tongue cancer in early stage,Theimaging probe comprises a 20-MHz side-view focused transducer for ultrasound imaging and PAdetection,a light path constructed by a multimode optical fiber,and a prism for PA illumination.Phantom experiments were conducted to evaluate the performance of the system includingpenetration depth,spatial resolution and signal-to-noise ratio.In vivo imaging of animaltumor and human tongue was carried out to show the feasibility of the proposed technique todetect tumor lesions in human tongue.The results of phantom and in vivo experiments suggestthat the proposed technique has the potential to detect the early-stage cancer lesions in humantongue.

Foreign body granuloma in the tongue differentiated from tongue cancer:A case report

BACKGROUND Embedded foreign bodies in the tongue are rarely seen in clinical settings.An untreated foreign body can cause a granuloma which often presents as an enlarged tongue mass.However,if foreign body ingestion status is unknown,physical examination and magnetic resonance imaging(MRI)tend to lead to suspicion of tongue cancer,especially in older patients.Thus,differential diagnosis of an enlarged tongue mass is important,especially because it is closely related to the choice of treatment method.CASE SUMMARY A 61-year-old woman was admitted to the hospital with pain and noticeable swelling in the tongue that had persisted for over 1 mo.She had no previous medical history.MRI revealed abnormal signal intensities that were indicative of a neoplasm.Thus,the oral surgeon and radiologist arrived at a primary diagnosis of tongue cancer.The patient visited the Ear Nose and Throat Department for further consultation and underwent an ultrasound examination of the tongue.The ultrasonography was consistent with a linear hyperechoic foreign body which was indicative of an embedded foreign body(bone)in the tongue,even though the patient denied any history of foreign body ingestion.Complete surgical enucleation of the lesion was conducted.The mass which included a fish bone was completely removed.The post-operative pathological examination confirmed that the mass was a granuloma containing collagen fibers,macrophages and chronic inflammatory cells.The patient recovered without complications over a 2 mo follow-up period.CONCLUSION We report a rare case of foreign body granuloma in the tongue that was primarily diagnosed as tongue cancer.The MRI and ultrasound examinations revealed a piece of bone in the left lateral aspect of the tongue.The granuloma,which contained a fish bone,was completely removed via surgery and confirmed via biopsy.Differential diagnosis of the enlarged tongue mass was critical to the selection of treatment method.

A Case of Bilateral Secondary Pneumothorax Shortly after the Completion of Concurrent Chemoradiotherapy for Tongue Cancer

Metastatic lung tumours rarely lead to development of pneumothorax, and no case of bilateral secondary pneumothorax due to lung metastases arising from tongue cancer has been reported. Here, we report a case of a patient with tongue cancer with lung metastases complicated by bilateral secondary pneumothorax soon after the completion of concurrent chemoradiotherapy. A 39-year-old man with cervical lymph node metastases originating from pT2N0M0 tongue cancer underwent neck dissection and postoperative concurrent chemoradiotherapy. Shortly after the completion of chemoradiotherapy, he developed bilateral secondary pneumothorax. Subsequently, he underwent partial lung resection for the pulmonary fistulae for diagnostic and therapeutic purposes;nodular lesions found in both the lungs. The diagnosis of secondary pneumothorax was based on histopathological findings. Although all pulmonary fistulae disappeared after partial lung resection, he died of the primary disease despite our best efforts to control the metastatic pulmonary lesions.

Parotid lymph node metastasis in a patient with tongue cancer

Parotid lymph node (LN) metastasis occurs most commonly from cutaneous squamous cell carcinoma (CSCC) of the head and neck, but rarely from oral squamous cell carcinoma (OSCC). Here, we present a rare case of metastasis to the parotid LN in a patient with tongue cancer. Although usual extent of modified radical neck dissection that includes resection of the tail of the parotid gland is below the line of the mandibular angle and the mastoid process was performed, the parotid LN metastasis occurred. The patient was treated with partial parotidectomy and chemoradiotherapy. One year and two months later, there was no evidence of local recurrence, although multiple lung metastases were observed. We also review the literature on parotid LN metastasis from OSCC.

Thick tongue coating: diagnostic markers for metastatic colorectal cancer?

Background:According to World Health Organization,colorectal cancer is the third most common cancer in the world.The prognosis assessment and condition judgment of the colorectal cancer remains a challenge clinically.Therefore,identification of diagnostic markers to evaluate the prognosis of colorectal cancer clinically should be urgently developed.We have observed that a lot of cancer patients had thick tongue clinically,but what is the relationship between tongue coating and the tumor?Methods:Seventy-four patients with colorectal carcinoma were collected through the outpatients of Tianjin Medical University Cancer Institute and Hospital from May 2010 to September 2011,in which there were 49 patients confirmed with recurrence or metastasis.All photos of patients’tongue were taken with a SONY camera in the same room and under constant conditions such as brightness or distance.Regression equation predicting thickness of tongue coating was constructed using binary logistic regression analysis.The optimal cut off of probabilities to diagnosis thick tongue coating was determined by receiver operating curve analysis.χ2 test for paired data and kappa test were used to determine the diagnostic value for recurrence and/or metastasis in colorectal cancer patients.Kolmogorov-Smirnov test was used to determine the distribution of ALT,AST,ALP ALB,TP,GLO,TBIL,DBIL,GGT,LDH,GLU,UA,CA724,CA199,CA242 and CEA.Data with the skewed distribution were presented as median(quartile interval).The association between the thickness of tongue coating and clinical-pathological character was evaluated by chi square test and two-independent-sample test.The two-independent-samplesχ2 was used to determine whether there were significant differences in the thin coating and thick coating between patients with recurrence and/or metastasis and patients without recurrence and/or metastasis.Kaplan-Meier method was used to analyze survival time.Statistical analysis was performed by SPSS(version 16.0).Results:Through retrospective clinical study we found that overall survival of colorectal cancer patients with thick greasy tongue coating is less than the patients with less tongue coating.What’s more,the risk for recurrence or/and metastasis overall survival in thick coating group was higher than thin coating group.In addition,the histological staining of the tongue slices of rats showed that EGFR receptors in the tongue root were the most among whole tongue surface.Tongue thick coating may be due to tumor patients with high levels of serum EGF which results in significantly increasing tongue coating.This finding suggested that the tongue coating of cancer patients may reflect the level of serum EGF levels in patients which may be related to shorter survival time.In addition,another study showed that serum lactic dehydrogenase level in patients with thick tongue coating is higher than patients with thin tongue coating.Conclusions:These studies suggest that tongue coating is likely to reflect some of the growth factor and enzyme levels.By observing the tongue coating we could predict the prognosis of patients and the characteristics of tongue coating may be used as new diagnostic markers to patients with colorectal carcinoma.

Expression of Med 19 Protein in Tongue Cancer and Its Significance

[Objectives] To study the expression of Med 19 protein in tongue cancer and its significance. [Methods] Immunohistochemical method was used to detect the expression of Med 19 protein in tongue cancer tissue and paracancerous tissue. [Results]The expression of Med19 protein in tongue cancer tissue was higher than paracancerous tissue and normal tissue. The expression of Med 19 protein was related to the tumor lymph node metastasis. However,there was no significant difference in sex,age,Tumor Node Metastasis( TNM),and differentiation degree. [Conclusions] Med 19 protein participates in incidence and development of tongue cancer and may become diagnostic indicator and therapeutic target for tongue cancer.

Tongue swelling as a manifestation of tongue metastasis from pulmonary sarcomatoid carcinoma: A case report

BACKGROUND Sarcomatoid carcinoma is a rare subtype of non-small-cell lung cancer,commonly associated with locally advanced disease,early metastasis,and poor prognosis.Tongue metastasis from lung cancer is a rare condition that may occur in advanced stage of the disease.CASE SUMMARY The patient was a 70-year-old female with a history of resected pulmonary sarcomatoid carcinoma(PSC)who presented with subacute tongue swelling,imparting the clinical impression of a lingual abscess.However,histologic examination of the partial glossectomy revealed a high-grade,poorly differentiated spindle and epithelioid carcinoma consistent with metastatic PSC.CONCLUSION Although uncommon,clinicians should be cognizant of the possibility of a metastatic process to the tongue mimicking a benign or inflammatory process.A high index of suspicion for metastatic disease should be maintained when tongue swelling is observed in patients with a known history of PSC.

Granulocyte colony-stimulating factor-producing squamous cell carcinoma of the tongue exhibiting characteristic fluorine-18 deoxyglucose accumulation on positron emission tomography–computed tomography: A case report

BACKGROUND Granulocyte colony-stimulating factor(G-CSF)is a cytokine produced in inflammatory environments that induces differentiation and proliferation of neutrophils in bone marrow.We report a rare case of aggressive G-CSFproducing squamous cell carcinoma of the tongue exhibiting fluorine-18 deoxyglucose(FDG)accumulation in primary lesion,metastatic lymph nodes,spleen,and bone marrow on positron emission tomography–computed tomography(PET/CT).CASE SUMMARY We report a 58-year-old female with a rapid enlarged lingual mass with partial necrosis.Blood test results from the initial examination revealed a leukocyte count of 21380/μL.On PET/CT,extensive FDG accumulation was observed in the tongue and bilateral cervical lymph nodes,with elevated FDG accumulation in the spleen and bone marrow although no distant metastases were observed.We performed partial glossectomy and bilateral neck dissection.Immunohistochemical staining with G-CSF antibodies on biopsy specimen and resected samples revealed that both specimens were G-CSF positive.This is a rare case of G-CSF producing tongue carcinoma with elevated FDG accumulation in the spleen and bone marrow.CONCLUSION In patients with the tongue cancer and hyperleukocytosis,where FDG accumulations in the spleen and bone marrow are observed using PET/CT and when these accumulations are not caused by metastasis,G-CSF-producing tumors,with associated poor prognosis,should be considered.

Will High Dose Rate Interstitial Brachytherapy Be a Surrogate to Surgery in Early Mobile Squamous Cell Carcinoma of Tongue—An Indian Experience

The study was intended to highlight functional outcome and survival advantage when High Dose Rate (HDR) interstitial implant was used for anterior 2/3rd tongue, either as a primary or as boost depending upon stage of disease. Materials and Methods: Fifty-one patients with squamous cell carcinoma of anterior 2/3rd tongue received interstitial brachytherapy either as primary or as boost with Iridium 192 remote after loading high dose rate (Microselectron or Gamma MediX) machines from November 2008 to September 2013. Age group ranged from 32 to 73 years, mean 52.1. Of these 51, 37 were males and 14 were females. 8 patients belonged to Stage I, 18 from Stage II and 28 patients were Stage III. Stage I patients received primary brachytherapy alone of dose 38.50 Gy to 40 Gy and fraction dose ranged from 250 cGy to 350 cGy. Stage II and Stage III patients received external beam radiation of dose 44 Gy/200cGy per fraction for 22 fractions followed by spinal cord sparing for 6 Gy/200cGy per fraction for 3 fractions. Brachytherapy boost of dose 21 Gy was delivered after external beam radiation. Stage III patients received concurrent chemotherapy with Injection Cisplatin along with external beam radiotherapy 44 Gy/200cGy per fraction for 22 fractions followed by spinal cord sparing for 6 Gy/200cGy per fraction for 3 fractions. Brachytherapy boost of dose 21 Gy was delivered after external beam radiation. 55% of patients were habituated to tobacco and alcohol in one form or the other or both. Surprisingly 45% of patients were nonsmokers and non-alcoholic. Results: Follow-up period ranged from eight months to sixty months. 42 patients had complete response. 9 patients had residual disease. 2 patients died due to non-cancerous cause though they had excellent local control, one with pulmonary tuberculosis and the other with massive Myocardial Infarction. 2 patients died due to disease progression. Overall complete response rate was 82.35%. Those patients who had good coverage index and conformal index had good response compared to those patients with lesser these values. Conclusion: It is surprising to observe from the study that oral cavity cancers are not uncommon in non-smokers and non-alcoholics. Overall complete response of 82% is comparable to any other study quoted in literature. Surgery offers same cure rate but at the rate of organ loss and functional impairment. Organ preservation with good functional outcome is possible in radiotherapy unlike surgery. This study proves brachytherapy can be considered as a surrogate to surgery in early stage tongue cancers with good functional outcome and with lesser morbidity.

Excision margins in squamous cell carcinoma of the tongue: A retrospective audit and review of the literature

The incidence of close and involved tongue resection margins for squamous cell carcinoma (SCC) were reviewed with the aim to identify any possible need for change in the surgical approach to glossectomies. The histopathological reports of 101 partial glossectomies for SCC between 2006 and 2012 were retrospectively reviewed. Results: Overall 52 (51.5%) patients had one or more close or involved margin and 9 (8.9%) had both close and involved margins. 42 (41.5%) patients had close margins and 11 (10.9%) had involved margins. The inferior/lateral muscoal margin was most frequently close/involved (32%) followed by deep margin (27%). The anterior margin was least close/involved (5%). The posterior and superior/medical margins were close/involved in 12% and 11% of cases respectively. Conclusions: 52.5% of patients had close or involved margins following surgery, potentially requiring further treatment to avoid an increased risk of tumour recurrence and the associated increase in morbidity and mortality. The inferior/lateral and deep margins were most frequently involved possible due to the anatomical difficulties visualising and dissecting these margins. The potential explanations for these disparities and possible solutions are discussed.

KIF18A is a potential prognostic factor and promotes tumor progression in oral tongue squamous cell carcinoma

The kinesin family member 18A protein was dysregulated in several human cancers and involved in cancer progression.However,the significance in oral tongue squamous cell carcinoma(OTSCC)has not been studied.The present study was intended to explore the functions of KIF18A in oral tongue squamous cell carcinoma.The immunohistochemistry(IHC)assay was performed to assess the relationships between the KIF18A protein expression level and clinical-pathological features of the patients.The biological functions of KIF18A in OTSCC cells were investigated by the experiments in vitro and in vivo.Based on immunohistochemistry,we found that KIF18A was correlated with the clinical-pathological features of OTSCC patients.High expression of KIF18A was associated with the lymph node metastasis,and clinical stages.In vitro experiments revealed that silencing of KIF18A significantly inhibited the expression of the proliferation and migration related proteins such as Ki67,proliferating cell nuclear antigen,matrix metalloproteinase-7 and matrix metalloproteinase-9,and thereby inhibiting the proliferation,migration and invasion of tumor cells.In vivo,knocking-down of KIF18A could inhibit the tumor growth in nude mice.In conclusion,we found KIF18A promoted tumor progression in vivo and in vitro and might become an effective target for the treatment of OTSCC.

盐酸羟考酮对舌癌根治术患者术后血流动力学和氧化应激反应的影响

目的 探讨盐酸羟考酮对舌癌根治术患者术后血流动力学和氧化应激反应的影响。方法 选取医院2021年2月至2022年2月行舌癌根治术的舌癌患者113例,按随机数字表法分为观察组(57例)和对照组(56例)。两组患者均采用舒苏太尼复合咪达唑仑进行麻醉诱导,右美托咪定复合瑞芬太尼进行麻醉维持。术后,观察组给予盐酸羟考酮自控镇痛泵,对照组给予舒芬太尼自控镇痛泵。结果 术后2,6,24 h,观察组患者的平均动脉压、心率均显著低于对照组(P <0.05);观察组患者的苏醒期血清血红素加氧酶-1、超氧化物歧化酶水平均显著高于对照组(P <0.05),丙二醛水平显著低于对照组(P <0.05);观察组患者术毕警觉-镇静分级量表(OAA/S)评分显著高于对照组(P <0.05),疼痛数字等级评定量表(NRS)评分显著低于对照组(P <0.05);两组患者的苏醒时间、不良反应发生率相当(P> 0.05)。结论 盐酸羟考酮用于舌癌根治术患者的术后镇痛,可有效缓解患者的术后疼痛程度,减轻氧化应激反应,稳定围术期血流动力学水平,且不影响麻醉苏醒时间,安全性高。

非共面照射野在舌癌放疗中对脊髓和下颌骨重点保护的效果评价

目的 :在舌癌术后放疗计划中重点保护脊髓和下颌骨的前提下,通过比较共面野与非共面野计划两者放疗剂量分布的差异,探讨非共面照射野在放疗计划中对脊髓和下颌骨的重点保护效果,从而选择合理放疗方案,以应对舌癌复发需再次放疗的可能性。方法:选择上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科在2018年2月—2023年2月收治的15例舌癌术后放疗患者作为研究对象,采用实际治疗的靶区作为计算目标,正常组织剂量限值参照国家标准,在其他参数保持不变的前提下,仅仅变动脊髓以及下颌骨的限量函数。函数采用serial函数,限量由低到高分为20、25、30、35、40,在Monaco计划系统中自动计算,对计划各个参数进行评价(靶区CI、HI、D98、D95、D5、D2),正常组织脊髓的最大量,腮腺、喉、下颌骨的平均量。采用SPSS 20.0软件包对数据进行统计学分析。结果:非共面野的各项评价指标优于共面野计划。共面野计划在serial函数限值为20、25时,靶区评价指标D98、D95、D5、D2形成剂量趋势曲线存在发散状态,靶区归一性较差。随着限值提高,2组计划的靶区剂量趋势曲线相差变小,靶区归一性基本统一。统计结果显示,相对于非共面野计划,共面野计划在seiral函数为20、25时,脊髓、左右侧腮腺、喉、下颌骨以及靶区的CI、HI的结果较差,2组差异有统计学意义(P<0.05);特别在serial函数为20时差异值最大,HI指数差异为7.7%,CI差异为14%。随着限值提高,2组数据差异逐渐变小,多数评价指标差值有统计学意义(P<0.05)。结论:舌癌术后放疗计划中,在脊髓、下颌骨限量较为严格时,2组计划剂量差异较大,计划射野时建议选择非共面角度。随着限量提高,差异性逐渐变小。虽然多数指标仍存在统计学差异,但鉴于非共面野有转床的误差存在,计划射野时,可根据患者情况以及机器精度进行合理选择。

3384例晚期结直肠癌患者中医舌象特征研究

目的探讨晚期结直肠癌(Advanced colorectal cancer,ACRC)患者舌象在不同临床因素中的分布规律以及对辨证的重要意义,为中医临床诊治ACRC提供参考。方法选取2017年1月1日—2022年9月30日期间在中国中医科学院西苑医院肿瘤科杨宇飞教授门诊治疗的3384例ACRC患者作为研究对象,收集整理3384例患者的一般人口学信息、舌象信息以及诊疗信息。探讨ACRC患者舌象特点,分析在不同临床因素中ACRC患者的舌象分布差异。使用SPSS 26.0统计学软件对数据进行描述性统计分析,主要采用χ^(2)检验或Fisher精确检验对计数资料进行差异性比较。结果纳入3384份ACRC病例进行分析,其中男性1891例,女性1493例,男女构成比为1.27∶1,平均年龄(60.90±25.66)岁,其中男性年龄分布较女性前移;异常舌色以暗红舌、红舌、淡暗舌居多,异常舌形以齿痕舌、裂纹舌以及舌有瘀斑为主,异常舌苔以腻苔与厚苔为主。相关性分析结果显示,发病部位与舌色(暗红,淡暗)、舌形(齿痕)、苔色(黄、白)、苔质(厚、腻、水滑)存在显著统计学差异;初次确诊状态(初发晚期,非初发晚期)与舌色(淡红、淡暗)、舌形(嫩、胖大、齿痕)、苔色(黄、白)、苔质(腻、润、水滑、无)存在显著统计学差异;转移部位(肝转移/肺转移)在舌色(暗红)、舌形(嫩舌、瘦薄舌)、苔色(黄苔、白苔)、苔质(薄苔、厚苔、腻苔)方面存在显著统计学差异;基因突变状态(RAS、BRAF基因突变/野生)与舌色(绛、淡暗舌)、舌形(裂纹、瘀斑、嫩、齿痕)、苔质(腻、厚)存在显著统计学差异;微卫星状态与舌色(红)、舌形(裂纹、齿痕、瘀斑),苔色(黄、白)存在显著统计学差异。结论ACRC患者以虚实夹杂的舌象最为多见,可见不同程度的脾虚、痰湿、阴虚、血瘀、热邪等舌象表现,不同临床因素影响下的ACRC舌象特征具有一定规律性,能够为中医临床诊治ACRC提供参考。

结直肠癌患者舌苔变化与舌苔菌群和肠道菌群的相关性研究

目的:探讨结直肠癌患者腻苔舌苔变化与舌苔菌群和肠道菌群的相关性。方法:选取2022年9月至2023年3月哈尔滨医科大学附属第一医院结直肠外科收治的63例结直肠癌患者,根据其舌象特征分层随机抽样采集其中12例黄腻苔和9例白腻苔患者的舌苔、癌组织及癌旁组织样本,同时采集6例肠镜检查无异常的薄白苔健康人舌苔样本。所有样本均行高通量5R 16S rDNA测序分析。结果:结直肠癌患者舌苔变化以黄腻苔和白腻苔为主。舌苔奇异菌属(Atopobium)和肠道颗粒链菌属(Granulicatella)可能是黄腻苔结直肠癌患者的特征性菌属;舌苔孪生球菌属(Gemella)和肠道罗氏菌属(Roseburia)、希瓦氏菌属(Shewanella)可能是白腻苔结直肠癌患者的特征性菌属。具核梭杆菌(Fusobacterium nucleatum)、龋齿放线菌(Actinomyces odontolyticus)和口炎消化链球菌(Peptostreptococcus stomatis)或分别为黄腻苔和白腻苔结直肠癌患者潜在的口-肠相关菌。结论:结直肠癌患者舌苔变化与舌苔、肠道菌群结构和丰度的变化相关,舌苔菌群与癌组织菌群、癌旁组织菌群不同的重叠种类及程度提示中医舌诊腻苔的变化能反映出结直肠癌口-肠菌群的特征性变化,为后期研究中药靶向微生物干预结直肠癌的发展提供客观依据。