BACKGROUND Malignant peritoneal mesothelioma(MPeM)is a rare cancer with a poor prognosis at advanced stage,and the standard first-line treatment for inoperable patients is chemotherapy.Although combining programmed ce...BACKGROUND Malignant peritoneal mesothelioma(MPeM)is a rare cancer with a poor prognosis at advanced stage,and the standard first-line treatment for inoperable patients is chemotherapy.Although combining programmed cell death 1(PD-1)inhibitors with chemotherapy is generally considered safe and effective in several malignant solid tumors,there are few reports regarding initial immunochemotherapy in advanced MPeM.CASE SUMMARY Here,to our knowledge,we present the first case of a patient with epithelioid subtype MPeM,who was treatment-naïve and benefited from initial PD-1 inhibitor plus standard chemotherapy with a prolonged progression-free survival(PFS)and good tolerance.A 49-year-old man was admitted to our hospital for a persistent burning sensation in the abdomen.Computed tomography revealed a solid mass in the lower abdomen,which was subsequently diagnosed histologically as epithelioid subtype MPeM by core needle biopsy.The patient received eight cycles of pemetrexed 800 mg(day 1),cisplatin 60/50 mg(day 1–2),and zimberelimab(PD-1 inhibitor)240 mg(day 1)every 3 wk.He achieved significant reduction of peritoneal tumors with remarkable improvement in symptoms.The best tumor response was partial remission with a final PFS of 7 mo.No immunerelated adverse event occurred during the combination treatment.CONCLUSION The outcome of the present case demonstrates the promising anti-tumor activity of immunochemotherapy to treat inoperable MPeM in the future.展开更多
Malignant peritoneal mesothelioma is a rare aggres-sive tumor of the peritoneum. An increasing number of malignant mesothelioma cases have been reported in recent years. We report here a very rare case of malignant pe...Malignant peritoneal mesothelioma is a rare aggres-sive tumor of the peritoneum. An increasing number of malignant mesothelioma cases have been reported in recent years. We report here a very rare case of malignant peritoneal mesothelioma with both umbilical hernia and umbilical metastasis which is also called Sister Mary Joseph's nodule. We performed laparoscopy which showed specific laparoscopic findings, and the pathological findings of the biopsy specimen led to the diagnosis. This case was associated with umbilical her-nia which could be induced by massive ascites. A newly developed abdominal hernia should be noted as a primary symptom of malignant peritoneal mesothelioma, as shown in the present case.展开更多
BACKGROUND Malignant peritoneal mesothelioma(MPM)originates from the mesothelial and subcutaneous cells of the abdominal cavity.Its diagnose is difficult due to its nonspecific and vague symptoms,and it should be diff...BACKGROUND Malignant peritoneal mesothelioma(MPM)originates from the mesothelial and subcutaneous cells of the abdominal cavity.Its diagnose is difficult due to its nonspecific and vague symptoms,and it should be differentiated from alcoholic cirrhosis and liver and pancreatic cancers.Misdiagnosis and missed diagnosis can easily occur when MPM presents with other diseases.To the best of our knowledge,no case of MPM concurrent with alcoholic cirrhosis has been reported.CASE SUMMARY A 63-year-old man presented to our hospital with abdominal distension for 20days.He had a history of alcohol consumption for nearly 30 years and no history of special drug use or toxic exposure.After treatment for alcoholic cirrhosis in a community hospital,his symptoms did not improve significantly.The patient underwent exploratory laparotomy and surgical resection.Pathologic examination showed an epithelioid MPM.He was treated with chemotherapy and intraperitoneal hyperthermic perfusion after surgery.Currently,he is in a stable condition and tumor recurrence has not occurred.CONCLUSION Misdiagnosis and missed diagnosis of MPM can easily occur because of its insidious onset.Therefore,there is a need to understand.MPM in clinical practice,make the correct diagnosis,and provide timely and effective treatment.展开更多
BACKGROUND Malignant peritoneal mesothelioma(MPM)is a rare malignancy arising in mesothelial cells in the peritoneum.It can be mistaken for many other diseases,such as peritoneal carcinomatosis and tuberculous periton...BACKGROUND Malignant peritoneal mesothelioma(MPM)is a rare malignancy arising in mesothelial cells in the peritoneum.It can be mistaken for many other diseases,such as peritoneal carcinomatosis and tuberculous peritonitis(TBP),because its clinical manifestations are often nonspecific.Therefore,the diagnosis of MPM is often challenging and delayed.CASE SUMMARY A 42-year-old man was referred to our hospital with lower abdominal pain for 1 wk and ascites observed under abdominal sonography.His laboratory findings revealed an isolated elevated tumor marker of carcinoma antigen 125(167.4 U/m L;normal,<35 U/m L),and contrast enhanced computed tomography showed peritoneal thickening.Thus,differential diagnoses of TBP,carcinomatosis of an unknown nature,and primary peritoneal malignancy were considered.After both esophagogastroduodenoscopy and colonoscopy produced negative findings,laparoscopic intervention was performed.The histopathological results revealed mesothelioma invasion into soft tissue composed of a papillary,tubular,single-cell arrangement of epithelioid cells.In addition,immunohistochemical staining was positive for mesothelioma markers and negative for adenocarcinoma markers.Based on the above findings,TBP was excluded,and the patient was diagnosed with MPM.CONCLUSION It is important to distinguish MPM from TBP because they have similar symptoms and blood test findings.展开更多
BACKGROUND Malignant peritoneal mesothelioma(MPM) is an extremely rare tumor with nonspecific clinical manifestations,which is extremely difficult to diagnose.Herein,we reported a case of MPM in the abdominal cavity w...BACKGROUND Malignant peritoneal mesothelioma(MPM) is an extremely rare tumor with nonspecific clinical manifestations,which is extremely difficult to diagnose.Herein,we reported a case of MPM in the abdominal cavity with massive shortterm ascites as the first symptom.CASE SUMMARY A 65-year-old woman presented to the hospital with abdominal pain,distention,and shortness of breath that persisted for 15 d.The serum CA-125 level was 1075 U/m L.The abdominal computed tomography showed massive ascites and no obvious tumor lesions.The pathological examination of the ascitic fluid showed numerous heterotypic cells with some papillary structures.The immunohistochemistry and fluorescence in situ hybridization showed the deletion of CDX2(-),WT-1(-),Ki-67(about 10% +),CEA(-),Glut-1(+++),desmin(-),PD-L1(-),and CDKN2A(P16).The final diagnosis was MPM.The patient refused tumor cytoreductive surgery and received two cycles of cisplatin plus pemetrexed bidirectional chemotherapy.In the second cycle,she received an additional cycle of hyperthermic intraperitoneal chemotherapy and immune checkpoint inhibitor therapy due to massive recalcitrant ascites.She died of disease progression 2 mo after diagnosis.CONCLUSION In case of massive unexplained ascites,the possibility of MPM should not be excluded to avoid misdiagnosis and delay in treatment.展开更多
Objective： To observe the effects of the new technique of flexible 3D-conformal radiotherapy with combination of photon and electron （3DCRT） in the treatment of the patients with diffuse malignant pleural mesotheli...Objective： To observe the effects of the new technique of flexible 3D-conformal radiotherapy with combination of photon and electron （3DCRT） in the treatment of the patients with diffuse malignant pleural mesothelioma （MPM）, and carry out the comparative study between flexible 3DCRT and hemithoracic conventional radiotherapy （CRT）. Methods： From January 2004 to October 2007, 8 patients with MPM were treated with flexible 3DCRT. 5 patients had received cycles of chemotherapy before radiation. New technique of flexible 3DCRT with combination of photon and electron was used in our study, and DT 32.2-64 Gy with conventional split were delivered. CRT technique was mimicked to compare with 3DCRT technique to predict the possibility of lung damage in two methods. Results： One patient reached CR and other 7 patients got PR after radiation. Two patients died during the follow-up. The median survival time （MST） was 15.4 months and it was 18.8 months for sequential chemotherapy and radiotherapy group and 9.7 months for radiotherapy alone group. The V20, V30, and ipsilateral and contralateral median lung dosage （MLD） were 20.5%, 15.6%, 18.8 Gy and 2.2 Gy respectively when the flexible 3DCRT technique was used, whereas they were 36.8%, 27.9%, 31.1 Gy and 1.2 Gy respectively when the CRT technique was used. They were statistically different for the lung V20, V30 and ipsilateral MLD between the two techniques （P 〈 0.01）, whereas there was no different for the contralateral MLD （P = 0.08）. All patients received radiation were found to have lung fibrosis and classified as grades 1-2 radiation pneumonitis. The quality of life was increased from score 2.83 to 3.76 and it was significantly different （P 〈 0.01）. Conclusion： MPM is moderately sensitive to radiation. The flexible 3DCRT technique is feasible in the treatment of MPM and lung damage is reduced apparently comparing with the CRT technique. The quality of life of patients with MPM is improved after irradiation.展开更多
Objective: Bronchopleural fistula (BPF) is a life threatening complication after pneumonectomy. Extra thoracic skeletal muscle transposition especially latissimus dorsi muscle flap (LDMF) had been used to prevent this...Objective: Bronchopleural fistula (BPF) is a life threatening complication after pneumonectomy. Extra thoracic skeletal muscle transposition especially latissimus dorsi muscle flap (LDMF) had been used to prevent this complication. The aim of this study was to assess the effectiveness of LDMF in preventing BPF developing after extrapleural pneumonectomy (EPP) and external radiation therapy in malignant pleural mesothelioma (MPM). Methods: Between May 1999 and Dec. 2008, 37 patients with MPM were operated upon by EPP using LDMF prophylactically to reinforce the bronchial stump, and then received external radiation therapy with or without postoperative chemotherapy. Results: The mean age of all patients was 46.7 (range 26-57) years. Twenty five patients were males and 12 patients were females. Twenty three patients had MPM of the right side and 14 patients had MPM of the left side. The peri-operative mortality was 2.7% and only few flap related postoperative morbidity were reported in the form of minor seroma and subcutaneous surgical emphysema. The median follow up was 17 (range 9-43) months. All cases completed their postoperative external radiation therapy with no reported cases of early or late BPF. Conclusion: Intrathoracic pedicled LDMF transposition is proved to be effective in prevention of BPF developing after EPP and external radiation therapy in MPM and it is advised to be a routine step in EPP in these cases and to use more sophisticated technique of postoperative external beam radiotherapy (3D conformal or IMRT) to minimize this complication.展开更多
Peritoneal surface malignancies (PSM) are a clinical entity with an unfavourable prognosis.They comprise peritoneal carcinomatosis,pseudomyxoma peritonei,and primitive tumors of the peritoneum.Because the treatment of...Peritoneal surface malignancies (PSM) are a clinical entity with an unfavourable prognosis.They comprise peritoneal carcinomatosis,pseudomyxoma peritonei,and primitive tumors of the peritoneum.Because the treatment of PSM presents unique and challenging problems to the cancer clinician,many new approaches have been attempted in recent years.In the current and next issues of World Journal of Gastrointestinal Oncology,some international groups of researchers discuss the most important and innovative aspects of PSM treatment,with particular accuracy for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.In conclusion,because this new approach to PSM has a reputation for being based more on common sense than on experimental data,I hope that highlighting this topic can make a contribution to the treatment of this group of diseases.展开更多
Malignant peritoneal mesothelioma(MPM) is a rare tumor that develops in the peritoneum.In this paper,we describe an extremely rare case of MPM metastasizing to the appendix in a 48-year-old female who initially presen...Malignant peritoneal mesothelioma(MPM) is a rare tumor that develops in the peritoneum.In this paper,we describe an extremely rare case of MPM metastasizing to the appendix in a 48-year-old female who initially presented with a persistent high fever.The woman reported a slight lower abdominal discomfort which had been relieved by urination for four months.She had lost 5 kg of weight.There was no nausea,vomiting,diarrhea,ab-dominal pain,or abdominal distension.Many broad spectrum antibiotics were given without relief of fever.Computed tomography(CT) scans revealed a thickened omentum majus and diffused multiple omental nodules.An omentec-tomy,appendectomy,and adnexectomy were carried out.A gross pathologic specimen of omentum tissue revealed a firm gray-white mass.Microscopic and immunohistochemical examinations confirmed the diagnosis of appendiceal and bilateral adnexal metastases of an MPM.These results suggest that MPM should be considered in the differential diagnosis of unexplained persistent high fever.Awareness of such atypical presentations of mesothelioma may help to make a correct diagnosis.展开更多
Activating transcription factor 2(ATF2)is a member of the ATF/cyclic AMP-responsive element bind-ing protein family of transcription factors.However,the information concerning ATF2 ion-mediated DNA binding module and ...Activating transcription factor 2(ATF2)is a member of the ATF/cyclic AMP-responsive element bind-ing protein family of transcription factors.However,the information concerning ATF2 ion-mediated DNA binding module and function of ATF2 in malignant pleural mesothelioma(MPM)has never been addressed.In this study,by using GRNInfer and GVedit based on linear pro-gramming and a decomposition procedure,with integrated analysis of the function cluster using Kappa statistics and fuzzy heuristic clustering in MPM,we identified one ATF2 ion-mediated DNA binding module involved in invasive function including ATF2 inhibition to target genes FALZ,C20orf31,NME2,PLOD2,RNF10,and RNASEH1,upstream RNF10 and PLOD2 activation to ATF2,upstream RNASEH1 and FALZ inhibition to ATF2 from 40 MPM tumors and 5 normal pleural tissues.Remarkably,our results showed that the predominant effect of ATF2 occupancy is to suppress the activation of target genes on MPM.Importantly,the ATF2 ion-mediated DNA binding module reflects‘mutual’positive and negative feedback regulation mechanism of ATF2 with up-and down-stream genes.It may be useful for developing novel prognostic markers and therapeutic targets in MPM.展开更多
文摘BACKGROUND Malignant peritoneal mesothelioma(MPeM)is a rare cancer with a poor prognosis at advanced stage,and the standard first-line treatment for inoperable patients is chemotherapy.Although combining programmed cell death 1(PD-1)inhibitors with chemotherapy is generally considered safe and effective in several malignant solid tumors,there are few reports regarding initial immunochemotherapy in advanced MPeM.CASE SUMMARY Here,to our knowledge,we present the first case of a patient with epithelioid subtype MPeM,who was treatment-naïve and benefited from initial PD-1 inhibitor plus standard chemotherapy with a prolonged progression-free survival(PFS)and good tolerance.A 49-year-old man was admitted to our hospital for a persistent burning sensation in the abdomen.Computed tomography revealed a solid mass in the lower abdomen,which was subsequently diagnosed histologically as epithelioid subtype MPeM by core needle biopsy.The patient received eight cycles of pemetrexed 800 mg(day 1),cisplatin 60/50 mg(day 1–2),and zimberelimab(PD-1 inhibitor)240 mg(day 1)every 3 wk.He achieved significant reduction of peritoneal tumors with remarkable improvement in symptoms.The best tumor response was partial remission with a final PFS of 7 mo.No immunerelated adverse event occurred during the combination treatment.CONCLUSION The outcome of the present case demonstrates the promising anti-tumor activity of immunochemotherapy to treat inoperable MPeM in the future.
文摘Malignant peritoneal mesothelioma is a rare aggres-sive tumor of the peritoneum. An increasing number of malignant mesothelioma cases have been reported in recent years. We report here a very rare case of malignant peritoneal mesothelioma with both umbilical hernia and umbilical metastasis which is also called Sister Mary Joseph's nodule. We performed laparoscopy which showed specific laparoscopic findings, and the pathological findings of the biopsy specimen led to the diagnosis. This case was associated with umbilical her-nia which could be induced by massive ascites. A newly developed abdominal hernia should be noted as a primary symptom of malignant peritoneal mesothelioma, as shown in the present case.
基金Shandong Province Medical and Health Science and Technology Development Plan,No.202003030878.
文摘BACKGROUND Malignant peritoneal mesothelioma(MPM)originates from the mesothelial and subcutaneous cells of the abdominal cavity.Its diagnose is difficult due to its nonspecific and vague symptoms,and it should be differentiated from alcoholic cirrhosis and liver and pancreatic cancers.Misdiagnosis and missed diagnosis can easily occur when MPM presents with other diseases.To the best of our knowledge,no case of MPM concurrent with alcoholic cirrhosis has been reported.CASE SUMMARY A 63-year-old man presented to our hospital with abdominal distension for 20days.He had a history of alcohol consumption for nearly 30 years and no history of special drug use or toxic exposure.After treatment for alcoholic cirrhosis in a community hospital,his symptoms did not improve significantly.The patient underwent exploratory laparotomy and surgical resection.Pathologic examination showed an epithelioid MPM.He was treated with chemotherapy and intraperitoneal hyperthermic perfusion after surgery.Currently,he is in a stable condition and tumor recurrence has not occurred.CONCLUSION Misdiagnosis and missed diagnosis of MPM can easily occur because of its insidious onset.Therefore,there is a need to understand.MPM in clinical practice,make the correct diagnosis,and provide timely and effective treatment.
文摘BACKGROUND Malignant peritoneal mesothelioma(MPM)is a rare malignancy arising in mesothelial cells in the peritoneum.It can be mistaken for many other diseases,such as peritoneal carcinomatosis and tuberculous peritonitis(TBP),because its clinical manifestations are often nonspecific.Therefore,the diagnosis of MPM is often challenging and delayed.CASE SUMMARY A 42-year-old man was referred to our hospital with lower abdominal pain for 1 wk and ascites observed under abdominal sonography.His laboratory findings revealed an isolated elevated tumor marker of carcinoma antigen 125(167.4 U/m L;normal,<35 U/m L),and contrast enhanced computed tomography showed peritoneal thickening.Thus,differential diagnoses of TBP,carcinomatosis of an unknown nature,and primary peritoneal malignancy were considered.After both esophagogastroduodenoscopy and colonoscopy produced negative findings,laparoscopic intervention was performed.The histopathological results revealed mesothelioma invasion into soft tissue composed of a papillary,tubular,single-cell arrangement of epithelioid cells.In addition,immunohistochemical staining was positive for mesothelioma markers and negative for adenocarcinoma markers.Based on the above findings,TBP was excluded,and the patient was diagnosed with MPM.CONCLUSION It is important to distinguish MPM from TBP because they have similar symptoms and blood test findings.
基金Supported by the National Traditional Chinese Medicine Clinical Research Base,No.2018131the Guangzhou Science and Technology Program Key Projects,No.202206080015。
文摘BACKGROUND Malignant peritoneal mesothelioma(MPM) is an extremely rare tumor with nonspecific clinical manifestations,which is extremely difficult to diagnose.Herein,we reported a case of MPM in the abdominal cavity with massive shortterm ascites as the first symptom.CASE SUMMARY A 65-year-old woman presented to the hospital with abdominal pain,distention,and shortness of breath that persisted for 15 d.The serum CA-125 level was 1075 U/m L.The abdominal computed tomography showed massive ascites and no obvious tumor lesions.The pathological examination of the ascitic fluid showed numerous heterotypic cells with some papillary structures.The immunohistochemistry and fluorescence in situ hybridization showed the deletion of CDX2(-),WT-1(-),Ki-67(about 10% +),CEA(-),Glut-1(+++),desmin(-),PD-L1(-),and CDKN2A(P16).The final diagnosis was MPM.The patient refused tumor cytoreductive surgery and received two cycles of cisplatin plus pemetrexed bidirectional chemotherapy.In the second cycle,she received an additional cycle of hyperthermic intraperitoneal chemotherapy and immune checkpoint inhibitor therapy due to massive recalcitrant ascites.She died of disease progression 2 mo after diagnosis.CONCLUSION In case of massive unexplained ascites,the possibility of MPM should not be excluded to avoid misdiagnosis and delay in treatment.
文摘Objective： To observe the effects of the new technique of flexible 3D-conformal radiotherapy with combination of photon and electron （3DCRT） in the treatment of the patients with diffuse malignant pleural mesothelioma （MPM）, and carry out the comparative study between flexible 3DCRT and hemithoracic conventional radiotherapy （CRT）. Methods： From January 2004 to October 2007, 8 patients with MPM were treated with flexible 3DCRT. 5 patients had received cycles of chemotherapy before radiation. New technique of flexible 3DCRT with combination of photon and electron was used in our study, and DT 32.2-64 Gy with conventional split were delivered. CRT technique was mimicked to compare with 3DCRT technique to predict the possibility of lung damage in two methods. Results： One patient reached CR and other 7 patients got PR after radiation. Two patients died during the follow-up. The median survival time （MST） was 15.4 months and it was 18.8 months for sequential chemotherapy and radiotherapy group and 9.7 months for radiotherapy alone group. The V20, V30, and ipsilateral and contralateral median lung dosage （MLD） were 20.5%, 15.6%, 18.8 Gy and 2.2 Gy respectively when the flexible 3DCRT technique was used, whereas they were 36.8%, 27.9%, 31.1 Gy and 1.2 Gy respectively when the CRT technique was used. They were statistically different for the lung V20, V30 and ipsilateral MLD between the two techniques （P 〈 0.01）, whereas there was no different for the contralateral MLD （P = 0.08）. All patients received radiation were found to have lung fibrosis and classified as grades 1-2 radiation pneumonitis. The quality of life was increased from score 2.83 to 3.76 and it was significantly different （P 〈 0.01）. Conclusion： MPM is moderately sensitive to radiation. The flexible 3DCRT technique is feasible in the treatment of MPM and lung damage is reduced apparently comparing with the CRT technique. The quality of life of patients with MPM is improved after irradiation.
文摘Objective: Bronchopleural fistula (BPF) is a life threatening complication after pneumonectomy. Extra thoracic skeletal muscle transposition especially latissimus dorsi muscle flap (LDMF) had been used to prevent this complication. The aim of this study was to assess the effectiveness of LDMF in preventing BPF developing after extrapleural pneumonectomy (EPP) and external radiation therapy in malignant pleural mesothelioma (MPM). Methods: Between May 1999 and Dec. 2008, 37 patients with MPM were operated upon by EPP using LDMF prophylactically to reinforce the bronchial stump, and then received external radiation therapy with or without postoperative chemotherapy. Results: The mean age of all patients was 46.7 (range 26-57) years. Twenty five patients were males and 12 patients were females. Twenty three patients had MPM of the right side and 14 patients had MPM of the left side. The peri-operative mortality was 2.7% and only few flap related postoperative morbidity were reported in the form of minor seroma and subcutaneous surgical emphysema. The median follow up was 17 (range 9-43) months. All cases completed their postoperative external radiation therapy with no reported cases of early or late BPF. Conclusion: Intrathoracic pedicled LDMF transposition is proved to be effective in prevention of BPF developing after EPP and external radiation therapy in MPM and it is advised to be a routine step in EPP in these cases and to use more sophisticated technique of postoperative external beam radiotherapy (3D conformal or IMRT) to minimize this complication.
文摘Peritoneal surface malignancies (PSM) are a clinical entity with an unfavourable prognosis.They comprise peritoneal carcinomatosis,pseudomyxoma peritonei,and primitive tumors of the peritoneum.Because the treatment of PSM presents unique and challenging problems to the cancer clinician,many new approaches have been attempted in recent years.In the current and next issues of World Journal of Gastrointestinal Oncology,some international groups of researchers discuss the most important and innovative aspects of PSM treatment,with particular accuracy for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.In conclusion,because this new approach to PSM has a reputation for being based more on common sense than on experimental data,I hope that highlighting this topic can make a contribution to the treatment of this group of diseases.
文摘目的:探讨恶性腹膜间皮瘤(malignant peritoneal mesothelioma,MPM)临床病理特点及预后,寻找影响预后独立指标。方法:收集首都医科大学附属北京世纪坛医院2013年1月至2021年12月手术的100例MPM病例,研究石棉接触、CA125、腹水、腹膜癌指数(peritoneal cancer index,PCI)评分、完全细胞减灭(completeness of cytoreduction,CC)评分、TNM分期、组织学分型、脉管瘤栓、神经侵犯、Ki-67指数,收集随访资料。采用Kaplan-Meier法计算患者生存率;生存预后模型进行单因素和多因素分析,研究独立影响MPM预后的临床病理学因素。结果:本研究男性48例(48%),女性52例(52%),中位年龄54(24~72)岁,有石棉接触史患者19例(19%),腹水患者90例(90%),CA125≥35 U/mL 58例(59%),PCI评分≥25分56例(56%)、CC评分为0~1分49例(49%)、2~3分51例(51%)。上皮样型79例(79%),非上皮样型21例(21%),Ⅰ期患者10例(10%)、Ⅱ期和Ⅲ期患者均为45例(45%)。单因素分析发现影响患者生存主要指标:石棉接触、PCI评分、CA125、组织学类型、Ki-67指数、TNM分期。多因素分析显示,有石棉接触史患者死亡风险是无接触史患者的2.3倍(95%CI:0.233~0.806,P=0.008),PCI评分≥25分患者的死亡风险是<25分患者的2.9倍(95%CI:0.200~0.612,P<0.001),Ki-67指数>10%患者死亡风险是指数≤10%患者的5.90倍(95%CI:0.072~0.401,P<0.001)。上皮样型与非上皮样型MPM的Ki-67指数呈显著性差异(P=0.001)。结论:石棉接触史、PCI评分和Ki-67指数是MPM的独立预后因子。
文摘Malignant peritoneal mesothelioma(MPM) is a rare tumor that develops in the peritoneum.In this paper,we describe an extremely rare case of MPM metastasizing to the appendix in a 48-year-old female who initially presented with a persistent high fever.The woman reported a slight lower abdominal discomfort which had been relieved by urination for four months.She had lost 5 kg of weight.There was no nausea,vomiting,diarrhea,ab-dominal pain,or abdominal distension.Many broad spectrum antibiotics were given without relief of fever.Computed tomography(CT) scans revealed a thickened omentum majus and diffused multiple omental nodules.An omentec-tomy,appendectomy,and adnexectomy were carried out.A gross pathologic specimen of omentum tissue revealed a firm gray-white mass.Microscopic and immunohistochemical examinations confirmed the diagnosis of appendiceal and bilateral adnexal metastases of an MPM.These results suggest that MPM should be considered in the differential diagnosis of unexplained persistent high fever.Awareness of such atypical presentations of mesothelioma may help to make a correct diagnosis.
基金supported by the National Natural Science Foundation of China(Grant No.60673109)the Teaching and Scientific Research Foundation for the Returned Overseas Chinese Scholars,Ministry of Education of China.
文摘Activating transcription factor 2(ATF2)is a member of the ATF/cyclic AMP-responsive element bind-ing protein family of transcription factors.However,the information concerning ATF2 ion-mediated DNA binding module and function of ATF2 in malignant pleural mesothelioma(MPM)has never been addressed.In this study,by using GRNInfer and GVedit based on linear pro-gramming and a decomposition procedure,with integrated analysis of the function cluster using Kappa statistics and fuzzy heuristic clustering in MPM,we identified one ATF2 ion-mediated DNA binding module involved in invasive function including ATF2 inhibition to target genes FALZ,C20orf31,NME2,PLOD2,RNF10,and RNASEH1,upstream RNF10 and PLOD2 activation to ATF2,upstream RNASEH1 and FALZ inhibition to ATF2 from 40 MPM tumors and 5 normal pleural tissues.Remarkably,our results showed that the predominant effect of ATF2 occupancy is to suppress the activation of target genes on MPM.Importantly,the ATF2 ion-mediated DNA binding module reflects‘mutual’positive and negative feedback regulation mechanism of ATF2 with up-and down-stream genes.It may be useful for developing novel prognostic markers and therapeutic targets in MPM.
