Signal intensity changes of dentate nucleus on plain MR T1WI innasopharyngeal carcinoma patients after radiotherapy andmultiple injections of gadolinium-base contrast agent

Objective To observe changes of plain MR T1WI signal intensity of dentate nucleus in nasopharyngeal carcinoma patients after radiotherapy and multiple times of intravenous injection of gadolinium-based contrast agent(GBCA).Methods Fifty patients with pathologically confirmed nasopharyngeal carcinoma and received intensity-modulated radiotherapy were retrospectively enrolled as the nasopharyngeal carcinoma group,and 50 patients with other malignant tumors and without history of brain radiotherapy were retrospectively enrolled as the control group.All patients received yearly GBCA enhanced MR examinations for the nasopharynx or the head.T1WI signal intensities of the dentate nucleus and the pons on same plane were measured based on images in the year of confirmed diagnosis(recorded as the first year)and in the second to the fifth years.T1WI signal intensity ratio of year i(ranging from 1 to 5)was calculated with values of dentate nucleus divided by values of the pons(ΔSI i),while the percentage of relative changes of year j(ranging from 2 to 5)was calculated withΔSI j compared toΔSI 1(Rchange j).The values of these two parameters were compared,and the correlation ofΔSI and GBCA injection year-time was evaluated within each group.Results No significant difference of gender,age norΔSI 1 was found between groups(all P>0.05).The second to the fifth yearΔSI and Rchange in nasopharyngeal carcinoma group were all higher than those in control group(all P<0.05).Within both groups,ΔSI was positively correlated with GBCA injection year-time(both P<0.05).Conclusion Patients with nasopharyngeal carcinoma who underwent radiotherapy and multiple times of intravenous injection of GBCA tended to be found with gradually worsening GBCA deposition in dentate nucleus,for which radiotherapy might be a risk factor.

Impacts of radiation therapy on quality of life and pain relief in patients with bone metastases

Bone metastases(BM)are a common complication in advanced cancer patients,significantly contributing to morbidity and mortality due to their ability to cause pain,fractures,and spinal cord compression.Radiation therapy(RT)is vital in managing these complications by targeting metastatic lesions to ease pain,improve mobility,and reduce the risk of skeletal-related events such as fractures.Evidence supports the effectiveness of RT in pain relief,showing its ability to provide significant palliation and lessen the need for opioid painkillers,thereby enhancing the overall quality of life(QoL)for patients with BM.However,optimizing RT outcomes involves considerations such as the choice of radiation technique,dose fractionation schedules,and the integration of supportive care measures to mitigate treatment-related side effects like fatigue and skin reactions.These factors highlight the importance of personalized treatment planning tailored to individual patient needs and tumor characteristics.This mini-review aims to provide comprehensive insights into the multifaceted impacts of RT on pain management and QoL enhancement in BM patients,with implications for refining clinical practices and advancing patient care through the synthesis of findings from various studies.

Efficacies of ^(89)Sr and combination treatments with regional extra-beam radiotherapy for cancer patients with multiple bone metastasis

Objective:The aim of the study was to observe the efficacies of 89Sr and combination treatments with regional extra-beam radiotherapy for cancer patients with multiple bone metastasis.Methods:A total of 106 patients were divided into two groups, and each group were 53 patients:the simple 89Sr treatment group (simple group), and local radiotherapy and 89Sr treatment group (combination group).The dose of 4 mci of 89Sr was made in every patient by intravenous injection, 6 MV linear accelerator external irradiation dose was given 30-60 Gy/2-4 weeks.Results:The effective rates of simple and combination groups were respectively 83.01% and 90.56%; the effective improvement rates of the bone focus of two groups were 75.48% and 86.8%, respectively.There was homologous improvement in general conditions.Conclusion:89Sr treatment has a certain effect to the cancers of whole-body multiple bone metastases.And the combined treatment with regional radiotherapy can improve the efficacy and life quality of cancer patients with bone metastasis.

Factors influencing comfort level in head and neck neoplasm patients receiving radiotherapy

Objective:To determine factors that influence comfort in head and neck neoplasm patients receiving radiotherapy.Methods:In total,200 head and neck neoplasm patients receiving radiotherapy were recruited from three tertiary first class hospitals.They were assessed by Radiotherapy Comfort Questionnaire for patients with head and neck neoplasm,Social Support Scale,and Medical Coping Modes Questionnaire.Results:The total score of comfort was 60.54±8.32.Multiple linear regression analysis indicated that number of radiation treatments,family accompaniment,educational level,resignation coping mode,complications due to diabetes,accompanying chemotherapy,and the utilization of social support significantly influenced comfort level(p<0.05).Among these,number of radiation treatments,complications due to diabetes,accompanying chemotherapy,and resignation coping were negative factors.Conclusion:Encouraging utilization of social support systems and a positive coping mode is important for increasing comfort level in head and neck neoplasm patients during radiotherapy.Nurses should pay particular attention to those patients during later stages of radiotherapy or chemotherapy,with diabetes,without family accompaniment,and with lower education level.

Malignant neoplasms of the uterus following radiation therapy for cervical carcinoma: a clinical study of 47 cases

Objective： To study the characteristics and clinical features of uterine neoplasms developed after radiation therapy for cervical carcinoma. Methods： Clinical data of 47 cases of uterine neoplasms occurred following radiation therapy for cervical carcinoma were retrospectively reviewed. Results： The median age at uterine neoplasms diagnosis was 62 years （range： 38-77 years）, and the median latency period from initial therapy to development of uterine neoplasms was 14 years （range： 5-35 years）. Thirty of 47 cases were endometrial carcinoma, of which 3 were uterine papillary serous carcinoma （UPSC）. Seventeen of 47 patients were uterine sarcoma, all of those were carcinosarcoma. The distribution by stage, grade, and histology of 30 cases of endometrial carcinoma was as follows： stage Ⅰb, 1 case; stage Ⅰc, 2 cases; stage Ⅱ, 6; stage Ⅲa, 4; stage Ⅲb, 2; stage Ⅲc, 11; stage Ⅳ, 4 cases; grade 1, two cases; grade 2, nine; grade 3 （include 3 UPSC patients）, seventeen; unknown grade, two; endometriod, 27; UPSC, 3 cases; 7 of 30 cases of endometrial carcinoma had recurrences （23.3%）, at median time to recurrence was 24 months, and their median survival time was 26 months. The overall 3- and 5-year survival rates were 60% and 38%, respectively. Of the 17 cases of uterine sarcoma, the median survival was 10 months, 6 patients occurred recurrence （35.9%）, at a median time to recurrence was 9 months, and their median survival was 6 months. The overall 3- and 5-year survival rates were 12% and 0, respectively. Conclusion： The main uterine neoplasms development after radiation therapy for cervical carcinoma is endometrial carcinomas, of which there is a preponderance of high-risk histological subtypes and a poor prognosis. Most of the uterine sarcomas occurred following radiation therapy for cervical carcinoma are carcinosarcomas and the prognosis is very poor.

European vs 2015-World Health Organization clinical molecular and pathological classification of myeloproliferative neoplasms

The BCR/ABL fusion gene or the Ph^1-chromosome in the t(9;22)(q34;q11)exerts a high tyrokinase acticity,which is the cause of chronic myeloid leukemia(CML).The1990 Hannover Bone Marrow Classification separated CML from the myeloproliferative disorders essential thrombocythemia(ET),polycythemia vera(PV)and chronic megakaryocytic granulocytic myeloproliferation(CMGM).The 2006-2008 European Clinical Molecular and Pathological(ECMP)criteria discovered 3variants of thrombocythemia:ET with features of PV(prodromal PV),"true"ET and ET associated with CMGM.The 2008 World Health Organization(WHO)-ECMP and 2014 WHO-CMP classifications defined three phenotypes of JAK2^(V617F)mutated ET:normocellular ET(WHO-ET),hypercelluar ET due to increased erythropoiesis(prodromal PV)and ET with hypercellular megakaryocytic-granulocytic myeloproliferation.The JAK2^(V617F)mutation load in heterozygous WHO-ET is low and associated with normal life expectance.The hetero/homozygous JAK2^(V617F)mutation load in PV and myelofibrosis is related to myeloproliferative neoplasm(MPN)disease burden in terms of symptomaticsplenomegaly,constitutional symptoms,bone marrow hypercellularity and myelofibrosis.JAK2 exon 12mutated MPN presents as idiopathic eryhrocythemia and early stage PV.According to 2014 WHO-CMP criteria JAK2 wild type MPL^(515)mutated ET is the second distinct thrombocythemia featured by clustered giant megakaryocytes with hyperlobulated stag-horn-like nuclei,in a normocellular bone marrow consistent with the diagnosis of"true"ET.JAK2/MPL wild type,calreticulin mutated hypercellular ET appears to be the third distinct thrombocythemia characterized by clustered larged immature dysmorphic megakaryocytes and bulky(bulbous)hyperchromatic nuclei consistent with CMGM or primary megakaryocytic granulocytic myeloproliferation.

PVSG and WHO vs European Clinical,Molecular and Pathological Criteria for prefibrotic myeloproliferative neoplasms

The Polycythemia Vera Study Group(PVSG),World Health Organization(WHO) and European Clinical,Molecular and Pathological(ECMP) classifications agree upon the diagnostic criteria for polycythemia vera(PV) and advanced primary myelofibrosis(MF). Essential thrombocythemia(ET) according to PVSG and 2007/2008 WHO criteria comprises three variants of JAK2V617 F mutated ET when the ECMP criteria are applied. These include normocellular ET,hypercellular ET with features of early PV(prodromal PV),and hypercellular ET due to megakaryocytic,granulocytic myeloprolifera-tion(ET.MGM). Evolution of prodromal PV into overt PV is common. Development of MF is rare in normocellular ET(WHO-ET) but rather common in hypercellular ET.MGM. The JAK2V617 F mutation burden in heterozygous mutated normocellular ET and in heterozygous/homozygous or homozygous mutated PV and ET.MGM is of major prognostic significance. JAK2/MPL wild type ET associated with prefibrotic primary megakaryocytic and granulocytic myeloproliferation(PMGM) is characterized by densely clustered immature dysmorphic megakaryocytes with bulky(bulbous) hyperchromatic nuclei,which are never seen in JAK2V617 F mutated ET,and PV and also not in MPL515 mutated normocellular ET(WHO-ET). JAK2V617 mutation burden,spleen size,LDH,circulating CD34+ cells,and pre-treatment bone marrow histopathology are mandatory to stage the myeloproliferative neoplasms ET,PV,PMGM for proper prognosis assessment and therapeutic implications. MF itself is not a disease because reticulin fibrosis and reticulin/collagen fibrosis are secondary responses of activated polyclonal fibroblasts to cytokines released from the clonal myeloproliferative granulocytic and megakaryocytic progenitor cells in ET.MGM,PV and PMGM.

Efficacy and safety of radiotherapy combined with zoledronic acid in the treatment of lung cancer with bone metastasis: a meta-analysis

Objective: To evaluate the efficacy and safety of radiotherapy combined with zoledronic acid fOr the treatment of bone metastases. Methods: Use Pubmed, Cochrane Library, Embase, CBM, CNKI, Wanfang, Weipu tools to search-related databases at home and abroad. From 2013.1 to March 2019, radiotherapy combined with zoledronic acid and radiotherapy alone for bone metastasis of lung cancer were collected. Experimental studies;quality evaluation and data extraction for each of the included studies, and Cochrane risk bias assessment tools for quality evaluation of the literature. Data processing was performed using RevMan 5.3 and Stata 15.0 software, including risk ratio (OR), 95% CI, I2, and P values. Line sensitivity test, publication bias evaluation is using Egger's, Bgge's method quantitative calculation using Revman 5.3 and Stata 15.0 software for statistical analysis. Results: The total of 8 articles was included, and the number of cases was 703. The results of the meta-analysis showed that the radiotherapy, combined with the zoledronic acid group was effective in the treatment of lung cancer with bone metastasis. The meta-analysis was Z = 6.31 (P < 0.00001), OR (95% CI = 3.57, (2.41, 5.30)), the difference was statistically significant. The combined effect of bone metastases was better than that of the single-stage group. The meta-analysis results were Z = 3.18 (P = 0.001) and OR (95% CI = 3.21, (1.57, 6.59)), indicating the therapeutic effect of the two groups in the treatment of bone metastases. The difference is statistically significant. Adverse reactions include: (1) bone marrow suppression, blood toxicity;(2) fever and rash;(3) nausea, vomiting, and fatigue;(4) liver damage and loss of appetite, meta-analysis results are: bone marrow suppression, blood toxicity: Z =0.73 ( P = 0.47), OR (95% CI = 0.58 (0.13, 2.54));fever, rash: Z = 0.36 (P = 0.36), OR (95% CI = 1.3 (0.31, 5.38));nausea, vomiting, Weakness: Z = 0.29 (P = 0.77), OR (95% CI = 0.85 (0.27, 2.62));liver function damage and loss of appetite: Z = 0.00 (P = 1.00), OR (95% CI = 1.00 (0.17, 6.00)). The P values of the four meta-analyses were all greater than 0.05, and the difference was not statistically significant, indicating that the addition of zoledronic acid to the bone metastasis of lung cancer did not aggravate the changes of the above four adverse reactions. Conclusion: Radiotherapy combined with the zoledronic acid group is better than the single radiotherapy group in treating pain caused by bone metastasis. It can effectively treat bone metastasis and will not aggravate the occurrence of adverse reactions.

Palliative radiotherapy for bone metastases from lung cancer: Evidence-based medicine?

To review current recommendations for palliative radiotherapy for bone metastases secondary to lung cancer, and to analyze surveys to examine whether global practice is evidence-based, English language publications related to best practice palliative external beam radiotherapy(EBRT) for bone metastases(BM) from lung cancer were sought via literature search(2003-2013). Additional clinical practice guidelines and consensus documents were obtained from the online Standards and Guidelines Evidence Directory. Eligible survey studies contained hypothetical case scenarios which required participants to declare whether or not they would administer palliative EBRT and if so, to specify what dose fractionation schedule they would use. There is no convincing evidence of differential outcomes based on histology or for spine vs non-spine uncomplicated BM. For uncomplicated BM, 8Gy/1 is widely recommended as current best practice; this schedule would be used by up to 39.6% of respondents to treat a painful spinal lesion. Either 8Gy/1 or 20Gy/5 could be considered standard palliative RT for BM-related neuropathic pain; 0%-13.2% would use the former and 5.8%-52.8% of respondents the latter(range 3Gy/1-45Gy/18). A multifraction schedule is the approach of choice for irradiation of impendingpathologic fracture or spinal cord compression and 54% would use either 20Gy/5 or 30Gy/10. Survey results regarding management of complicated and uncomplicated BM secondary to lung cancer continue to show a large discrepancy between published literature and patterns of practice.

Analysis of radiotherapy curative effects on pains of bone metastases of breast cancer

Objective To investigate the radiotherapy curative effects on pains of bone metastases of breast cancer. Methods To analysis 32 patients retrospectively, in which 22 patients received radiotherapy(17 moderate pain, 5 severe pain, 6 dysfunction). Result 16 patients obtained complete remission with 6 cases partial response to radiation. Karnorfsky’s score was improved and malfunction disappeared. Conclusion Radiotherapy is a simple and effective treatment on bone metastases of breast cancer with quick and persistent pain relieves.

Epithelioid Angiosarcoma of Bone: A Neoplasm with Potential Pitfalls in Diagnosis

Angiosarcoma of bone is an exceedingly rare primary bone malignancy that can present as an aggressive osteolytic lesion. This subset can radiologically mimic non-vascular neoplasms and impose serious challenges in reaching the correct diagnosis. Meanwhile histological diagnosis can be extremely challenging too, as the pathological features often resemble that of aneurysmal bone cysts. We present an unusual case of a 22-year-old woman who presented with a rapidly growing humeral tumor of 8 months’ duration. The case of intraosseous angiosarcoma presented as a diagnostic dilemma and the relevant radiological and pathologic findings were discussed. We describe the clinical, radiological and pathological features of this unique case, and review the literature concerning Angiosarcoma of bone. Our case highlights the diagnostic difficulties for such very rare tumours and clinico-pathological correlation is of paramount importance to differential diagnosis.

Bone marrow-sparing intensity-modulated radiotherapy for postoperative treatment of cervical cancer

Objective： The aim of this study was to compare bone marrow-sparing intensity-modulated radiotherapy （IMRT） with IMRT without entering pelvic bone marrow as a planning constraint in the treatment of cervical cancer after hysterectomy. Methods： For a cohort of 10 patients, bone marrow-sparing IMRT and routine IMRT planning were designed. The prescribed dose was 45 Gy/1.8 Gy/25f, 95% of the planning target volume received this dose. Doses were computed with a commercially available treatment planning system （TPS） using convolution/superimposition （CS） algorithm. Plans were compared according to dose-volume histogram （DVH） analysis in terms of planning target volume （PTV） homogeneity and conformity indices （HI and CI） as well as organs at risk （OARs） dose and volume parameters. Results： Bone marrow-sparing IMRT had an vantages over routine IMRT in terms of CI, but inferior to the latter for HI. Compared with routine IMRT, V5, Vl0, V20, V30, V40 of pelvic bone marrow of bone marrow-sparing IMRT reduced by 1.81%, 8.61%, 31.81%, 29.50%, 28.29%, respectively. No statistically significant differences were observed between bone marrow-sparing IMRT and routine IMRT in terms of small bowel, bladder and rectum. Conclusion： For patients with cervical cancer after hysterectomy, bone marrowsparing IMRT reduced the pelvic bone marrow volume irradiated at all dose levels and might be conducive to preventing the occurrence of acute bone marrow toxicity.

Pain relief by palliative radiotherapy in patients with advanced bone metastases

Objective: To compare 3 local field radiation therapies for bone metastases to determine the strategy producing the best results. Methods: Among 104 patients with bone metastases, 30 patients were given 8 Gy in single fraction, 31 given 20 Gy in 5 fractions, 43 given 40 Gy in 20 fractions. Results and Conclusion: The method of 40 Gy in 20 fractions had a higher pain relief rate and a lower pain relapse rate, suggesting that large-dose fractioned treatment regimen is more appropriate for patients with bone metastasis.

Dosimetric analysis of tomotherapy-based intensity-modulated radiotherapy with and without bone marrow sparing for the treatment of cervical cancer

Objective The aim of the study was to compare tomotherapy-based bone marrow-sparing intensity-mod- ulated radiotherapy （BMS-IMRT） with intensity-modulated radiotherapy （IMRT） without entering the pelvic bone marrow as a planning constraint in the treatment of cervical cancer after hysterectomy. Methods BMS-IMRT and IMRT plans were designed for a cohort of nine patients. The prescribed dose was 45 Gy in 1.8 Gy daily fractions, and 95% of the planned target volume received this dose. The doses were computed using a commercially available treatment planning system with the convolution/superposition algorithm. Plans were compared according to dose-volume histogram analysis in terms of planning target volume homogeneity and conformity indices （HI and CI） as well as organ at risk dose and volume parameters. Results BMS-IMRT had advantages over IMRT in terms of CI, but was equivalent to the latter in H1. V5, V10, V20, V30, and V40 of pelvic bone marrow in BMS-IMRT decreased by 0.06%, 17.33%, 22.19%, 13.85%, and 16.46%, respectively, compared with IMRT. Except for V30 of the small bowel and V30 and V40 of the bladder, no statistically significant differences were found between BMS-IMRT and IMRT in the small bowel, bladder, and rectum. Conclusion For cervical cancer patients receiving tomotherapy-based radiotherapy after hysterectomy, BMS-IMRT reduced pelvic bone marrow volume receiving low-dose radiation, and it may be conducive to preventing acute hematologic toxicity.

3D氨基质子转移加权成像联合弥散加权成像鉴别良、恶性骨与软组织肿瘤

目的探讨3D氨基质子转移加权成像(APTWI)、弥散加权成像(DWI)及二者联合鉴别良、恶性骨与软组织肿瘤的价值。方法前瞻性对96例骨盆或下肢骨与软组织肿瘤患者采集平扫MRI、APTWI及DWI。分别基于APTWI及DWI获得偏移量为3.5 ppm的非对称性磁化传递率(MTRasym)图及表观弥散系数(ADC)图,测量病灶MTRasym(3.5 ppm)最大值(MTRasym_(max))、均值(MTRasym_(mean))及最小值(MTRasym_(min)),以及ADC最大值(ADC_(max))、均值(ADC_(mean))及最小值(ADC_(min));比较良、恶性肿瘤各参数差异,绘制受试者工作特征曲线,计算曲线下面积(AUC),评估APTWI、DWI及二者联合的鉴别诊断效能。结果96例中,良性41例、恶性55例。恶性肿瘤MTRasym(MTRasym_(max)、MTRasym_(mean)和MTRasym_(min))均明显高于,而ADC(ADC_(max)、ADC_(mean)和ADC_(min))均明显低于良性肿瘤(P均<0.05)。MTRasym_(max)和ADC_(min)鉴别良、恶性肿瘤的AUC分别为0.791和0.873,差异无统计学意义(P=0.122);二者联合的AUC为0.944,高于单一项(P<0.001、P=0.041)。结论APTWI联合DWI鉴别良、恶性骨与软组织肿瘤的效能较高。

乳腺癌保乳术后应用3D技术填充瘤腔进行适形放疗的临床研究

目的探究乳腺癌保乳术后应用3D技术填充瘤腔进行适形放疗的靶区剂量、不良反应及美容度。方法选择2021年1月至2022年12月西安交通大学第一附属医院收治的48例乳腺癌患者,按照手术不同分为3D技术填充瘤腔组(24例)及对照组(24例)。全部患者均开展乳腺癌根治手术治疗,仅保乳方式不同,术后实施强度调控适形放射治疗计划下的加速部分乳腺照射。结果应用3D技术填充瘤腔保乳术后放疗的适形度指数及均匀性指数均明显高于常规保乳术后放疗(P<0.05)。3D技术填充瘤腔保乳术后放疗的肺及心脏危及器官剂量(平均剂量),肺的V 5、V 10、V 20、V 30、V 40及V 50均显著低于常规保乳术后放疗组(P<0.05)。2组患者的皮肤损伤、心律失常、骨髓抑制及消化道反应发生率差异无统计学意义。3D技术填充瘤腔保乳术后组患者的美容度要显著优于常规保乳术后患者(P<0.05)。结论乳腺癌保乳术后应用3D技术填充瘤腔显著增强乳腺的美容度,且不影响放疗的安全及有效性。

长链非编码RNA-ROR介导上皮-间质转化对鼻咽癌细胞放疗抵抗作用的体外研究

目的 探讨lncRNA-ROR介导上皮-间质转化在鼻咽癌细胞放疗抵抗中的作用。方法 将鼻咽癌细胞CNE2分为空白组、阴性对照组、lncRNA-ROR沉默组,进行相应的处理。将CNE2细胞分为空白组、放疗组、放疗+阴性对照组、放疗+lncRNA-ROR过表达组(放疗处理为6 Gy射线照射24 h),进行相应的处理。用CCK-8法检测CNE2增殖能力,通过细胞划痕实验和Transwell 细胞迁移实验检测细胞迁移能力,用流式细胞术检测细胞凋亡的情况,用蛋白印迹法检测凋亡相关蛋白和上皮-间质转化相关蛋白的表达。结果 与空白组、阴性对照组相比,抑制lncRNA-ROR表达48、72 h后鼻咽癌细胞CNE2的增殖能力均减弱(均P<0.05)。抑制lncRNA-ROR表达后鼻咽癌细胞CNE2的迁移率低于阴性对照组(P<0.05),而放疗+lncRNA-ROR过表达组CNE2细胞的迁移能力高于放疗组与放疗+阴性对照组(均P<0.05)。与放疗组、放疗+阴性对照组相比,放疗+lncRNA-ROR过表达组CNE2细胞的凋亡率均降低(均P<0.05)。抑制lncRNA-ROR后,活化的caspase 3、caspase 9蛋白表达均较空白组和阴性对照组升高(均P<0.05);而放疗+lncRNA-ROR过表达组活化的caspase 3、caspase 9蛋白表达均较放疗组和放疗+阴性对照组下降(均P<0.05)。抑制lncRNA-ROR可导致上皮标志蛋白(E-钙黏蛋白、β-联蛋白)表达升高,间质标志蛋白(N-钙黏蛋白、波形蛋白)表达下降(均P<0.05);而与放疗组和放疗+阴性对照组相比,放疗+lncRNA-ROR过表达组CNE2细胞的上皮标志蛋白表达下降、间质标志蛋白表达升高(均P<0.05)。结论 lncRNA-ROR可通过调控鼻咽癌细胞增殖、迁移、凋亡及上皮-间质转化影响其放疗抵抗,是逆转鼻咽癌细胞放疗抵抗的潜在靶点。

动态对比增强MRI评估化学治疗用于兔VX2恶性骨肿瘤模型早期效果

目的观察动态对比增强MRI(DCE-MRI)评估化学治疗(简称化疗)用于兔VX2恶性骨肿瘤模型早期效果的价值。方法以30只实验兔成功建立VX2恶性骨肿瘤模型,以其中14只为化疗组,经静脉注射顺铂7 mg/kg体质量,以另16只为对照组,经静脉注射等量生理盐水。分别于造模2周后(干预前)及干预后3天采集平扫MRI及DCE-MRI,对MRI与病理所见进行点对点对照,获取瘤体区域容积转移常数(K^(trans))、速率常数(K_(ep))、血管外细胞外容积分数(V_(e))及血浆容积分数(V_(p)),以及微血管密度(MVD)。比较组内干预前、后MRI结果,以及干预后组间MRI结果,以受试者工作特征(ROC)曲线及曲线下面积(AUC)评估各参数判断是否曾接受化疗的效能,分析干预后DCE-MRI各参数与MVD的相关性。结果化疗组干预前、后平扫MRI所见肿瘤最大径差异无统计学意义(P>0.05)。相比干预前,化疗组实体瘤区域K^(trans)、K_(ep)均降低、对照组均升高(P均<0.05),而2组V_(e)及V_(p)差异均无统计学意义(P均>0.05)。干预后化疗组K^(trans)及K_(ep)值均低于对照组(P均<0.05),而组间V_(e)及V_(p)差异均无明显统计学意义(P均>0.05)。以K^(trans)、K_(ep)、V_(e)及V_(p)判断是否曾接受化疗的AUC分别为0.964、0.933、0.317及0.455。干预后化疗组实体瘤区域MVD低于对照组(P<0.05);2组实体瘤区域K^(trans)、K_(ep)值均与MVD呈正相关(r=0.876、0.881,P均<0.05),而V_(e)或V_(p)值与MVD无显著相关性(r=0.118、0.202,P均>0.05)。结论DCE-MRI定量分析参数K^(trans)和K_(ep)可较为敏感地反映化疗用于VX2恶性骨肿瘤模型兔早期效果及其MVD变化。

乳腺癌细胞条件培养基对骨髓间充质干细胞生物学行为的影响

目的探讨MCF-7乳腺癌细胞条件培养基对骨髓间充质干细胞(BMSC)增殖、凋亡和迁移的影响及分子机制。方法正常环境下培养的BMSC为对照组,以MCF-7细胞条件培养基培养的BMSC为MCF-7条件培养基组,向MCF-7条件培养基组添加10 nmol/L GSK690693(Akt抑制剂)为Akt抑制剂组,向MCF-7条件培养基组添加10µmol/L Reparixin(CXCR1/2抑制剂)为CXCR1/2抑制剂组。MTT实验检测各组BMSC增殖情况,Annexin V-FITC/PI双标记流式细胞凋亡实验检测各组BMSC凋亡率,Transwell细胞迁移实验检测各组BMSC的迁移能力,酶联免疫吸附试验检测两种细胞培养上清液和MCF-7细胞条件培养基中白细胞介素(IL)-8蛋白含量,Western blot检测各组BMSC的蛋白激酶B(Akt)/磷酸化Akt(p-Akt)和哺乳动物雷帕霉素靶蛋白(mTOR)/磷酸化mTOR(p-mTOR)蛋白表达。结果与对照组相比,MCF-7条件培养基组BMSC的细胞增殖水平、迁移数目以及p-Akt和p-mTOR蛋白相对表达量均增高,细胞凋亡率降低(P<0.05);与MCF-7条件培养基组相比,CXCR1/2抑制剂组和Akt抑制剂组BMSC的细胞增殖水平、迁移数目以及p-Akt和p-mTOR蛋白相对表达量均降低,细胞凋亡率增加(P<0.05);MCF-7细胞条件培养基和MCF-7培养上清液中IL-8蛋白含量均较BMSC培养上清液中IL-8蛋白含量高(P<0.05)。结论MCF-7细胞条件培养基通过激活Akt-mTOR信号通路促进BMSC增殖和迁移,抑制BMSC凋亡,其中IL-8-CXCR1/2轴发挥关键作用。