Delineation of fatty acid metabolism in gastric cancer:Therapeutic implications

BACKGROUND The prognosis of gastric cancer is extremely poor.Metabolic reprogramming involving lipids has been associated with cancer occurrence and progression.AIM To illustrate fatty acid metabolic mechanisms in gastric cancer,detect core genes,develop a prognostic model,and provide treatment options.METHODS Raw data from The Cancer Genome Atlas and Gene Expression Omnibus databases were collected and analyzed.Differentially expressed fatty acid metabolism genes were identified and incorporated into a risk model based on least absolute shrinkage and selection operator regression analysis.Then,patients from The Cancer Genome Atlas were assigned to high-and low-risk cohorts according to the mean value of the risk score as the threshold,which was verified in the Gene Expression Omnibus database.Relationships between chemotherapeutic sensitivity and tumor microenvironment features were assessed.RESULTS An integrated evaluation was performed in this study.Fatty acid metabolismrelated genes were used to construct the risk model.Patients classified into the high-risk cohort were considered to be resistant to chemotherapy based on results of the“pRRophetic”R package.Patients in the high-risk cohort were associated with type Ⅰ/Ⅱ interferon activation,increased inflammation level,immune cell infiltration,and tumor immune dysfunction based on the exclusion algorithm,indicating the potential benefit of immunotherapy in these patients.CONCLUSION We constructed a fatty acid-related risk score model to assess the comprehensive fatty acid features in gastric cancer and validated its vital role in prognosis,chemotherapy sensitivity,and immunotherapy.

Diffusion tensor imaging and proton magnetic resonance spectroscopy in brain tumor Correlation between structure and metabolism

Proton magnetic resonance spectroscopy and diffusion tensor imaging are non-invasive techniques used to detect metabolites and water diffusion in vivo. Previous studies have confirmed a positive correlation of individual fractional anisotropy values with N-acetylaspartate/creatine and N-acetylaspartate/choline ratios in tumors, edema, and normal white matter. This study divided the brain parenchyma into tumor, pedtumoral edema, and normal-appearing white matter according to MRI data, and analyzed the correlation of metabolites with water molecular diffusion. Results demonstrated that in normal-appearing white matter, N-acetylaspartate/creatine ratios were positively correlated with fractional anisotropy values, negatively correlated with radial diffusivities, and positively correlated with maximum eigenvalues. Maximum eigenvalues and radial diffusivities in peritumoral edema showed a negative correlation with choline, N-acetylaspartate, and creatine. Radial diffusivities in tumor demonstrated a negative correlation with choline. These data suggest that the relationship between metabolism and structure is markedly changed from normal white matter to peritumoral edema and tumor. Neural metabolism in the peritumoral edema area decreased with expanding extracellular space. The normal relationship of neural function and microstructure disappeared in the tumor region.

基于知识蒸馏改进U-Net网络模型用于分割CT图像中的口腔颌面部肿瘤

目的 观察基于知识蒸馏改进U-Net网络模型用于分割CT图像中的口腔颌面部肿瘤的价值。方法 收集2个医疗中心121例口腔颌面部肿瘤患者共609幅CT图像;于公开数据集HECKTOR2020搜集254例口腔颌面部肿瘤患者共1 977幅CT图像。向U-Net网络模型中引入多尺度和注意力机制,加入残差网络,建立改进U-Net模型;采用知识蒸馏技术生成学生模型,观察模型分割CT图像中的口腔颌面部肿瘤的效能。结果 改进U-Net模型大小为89.30 MB,参数数量为17.82 M,计算量为22.13 GFlops;其分割CT所示口腔颌面部肿瘤的精确率(Precision)、召回率(Recall)、戴斯相似系数和交并比分别为0.835、0.787、0.812及0.761,优于既往结合常规损失函数(Dice Loss function)所获模型及未改进模型;且除Precision之外,学生模型与教师模型差异较小。结论 基于知识蒸馏改进U-Net网络模型用于分割CT图像中的口腔颌面部肿瘤具有较高价值。

肿瘤代谢标志物在肺癌液体活检中的研究进展

液体活检被逐渐应用于肺癌临床诊疗中。目前,随着代谢组学的发展,越来越多代谢标志物被认为是潜在的反映肿瘤发生发展的敏感标志物。本文概括了肺癌主要代谢途径的改变,包括葡萄糖代谢、氨基酸代谢、脂质代谢、鞘脂代谢、甘油磷脂代谢和嘌呤代谢。同时,本文综述了代谢标志物在肺癌早期诊断、预测疾病进展、评估化疗与免疫治疗疗效的作用,旨在为肿瘤诊疗提供有效的标志物。

胃肠道神经内分泌肿瘤与代谢综合征的相关性研究进展

胃肠道神经内分泌肿瘤(gastrointestinal neuroendocrine neoplasms,GI-NENs)是一种罕见的异质性肿瘤,近年其发病率不断上升。随着生活水平的提高,有证据指出代谢综合征(metabolic syndrome,MS)或其组分是GI-NENs发生、发展的危险因素。然而国内对两者间关系的研究尚少,具体机制更亟待探索,本文就两者关系的最新研究及可能存在的机制作一综述。

肠道菌群对乳腺癌发生发展的影响及其治疗应用的研究进展

乳腺癌发病率逐年上升,其发病机制十分复杂。肠道菌群功能紊乱与乳腺癌发生发展有密切关联。肠道菌群产生的β-葡萄糖醛酸酶,可通过肠肝循环调节雌激素水平,进而影响激素受体阳性乳腺癌的发生发展并导致他莫昔芬耐药;肠道菌群来源的短链脂肪酸(SCFAs)和石胆酸(LCA)等代谢产物可参与调节肿瘤细胞周期和细胞增殖;肠道菌群的定植维持了肠道屏障的完整性并调控T淋巴细胞介导的抗肿瘤免疫。维持肠道菌群稳态可提高肿瘤化疗和免疫治疗效果,并减轻抗肿瘤治疗中的不良反应。免疫治疗中工程益生菌的靶向作用可协助提升药物治疗精准度。肠道菌群对放射治疗的影响尚不明确,但调节肠道菌群可辅助治疗放射性肠病。现对肠道菌群与乳腺癌的相关性及影响进行综述,并分析其在乳腺癌治疗中的作用。

Classificatory updates in verrucous and cuniculatum carcinomas:Insights from the 5^(th) edition of WHO-IARC head and neck tumor classification

The International Agency for Research on Cancer(IARC)and World Health Organization(WHO)collaboratively produce the'WHO Blue Books'essential tools standardizing the diagnostic process for human cancers.Regular updates in this classification accommodate emerging molecular discoveries,advances in immunohistochemical techniques,and evolving clinical insights.The 5th edition of the WHO/IARC classification of head and neck tumors refines the'Oral Cavity and Mobile Tongue'chapter,including sections for non-neoplastic lesions,epithelial tumors,and tumors of uncertain histogenesis.Notably,the epithelial tumors section is rearranged by tumor behavior,starting with benign squamous papillomas and progressing through potentially malignant oral disorders to oral squamous cell carcinoma(OSCC).The section on OSCC reflects recent information on epidemiology,pathogenesis,and histological prognostic factors.Noteworthy is the specific categorization of verrucous carcinoma(VC)and carcinoma cuniculatum(CC),both associated with the oral cavity and distinct in clinical and histologic characteristics.This classification adjustment emphasizes the oral cavity as their predominant site in the head and neck.Designating specific sections for VC and CC aims to provide comprehensive insights into these unique subtypes,elucidating their clinical features,distinct histological characteristics,prevalence,significance,and clinical relevance.By categorizing these subtypes into specific sections,the 5th edition of the WHO classification aims to provide a more nuanced and detailed account,enhancing our understanding of these specific variants within the broader spectrum of head and neck tumors.

不同代谢肥胖表型与女性乳腺癌发病风险关联:一项前瞻性队列研究

背景早期研究发现超重/肥胖与女性乳腺癌发病风险增加有关。然而,有研究发现单纯分析超重/肥胖与女性乳腺癌的关联可能并不科学,因为超重/肥胖可分为不同代谢表型。目前关于不同代谢肥胖表型与乳腺癌关联的结论并不一致。目的通过队列研究分析不同代谢肥胖表型与女性乳腺癌发病风险的关联。方法本研究为前瞻性队列研究。选取2006年度和2008年度在开滦总医院及其附属共11家医院首次参与健康体检的女性开滦职工为研究对象(n=23406),对研究对象进行问卷调查、体格检查和实验室检查。根据代谢综合征和BMI的类型将研究对象分为代谢正常体质量正常(MHNW)组(n=12739)、代谢异常体质量正常(MUNW)组(n=1060)、代谢正常超重/肥胖(MHO)组(n=6394)和代谢异常超重/肥胖(MUO)组(n=3213)。对研究对象进行随访,以首次参加体检为随访起点,以新发乳腺癌、死亡或随访时间结束(2020-12-31)为随访终点。采用多因素Cox比例风险回归模型分析四组代谢表型与乳腺癌发病风险的关联。结果研究对象平均随访(13.26±1.85)年,乳腺癌新发病例为353例,总人群发病密度为11.38例/万人年。MHNW组、MUNW组、MHO组、MUO组发病例数分别为154、21、113、65例,发病密度依次为9.08、15.37、13.27、15.49例/万人年,乳腺癌累积发病率分别为1.22%、2.01%、1.67%、1.93%。多因素Cox比例风险回归模型分析结果显示,校正混杂因素后,与MHNW组相比,MHO组、MUO组乳腺癌发病风险分别增加42%(HR=1.42,95%CI=1.11~1.82)、59%(HR=1.59,95%CI=1.17~2.17)。按照绝经状态进行分层分析,结果显示:绝经前,与MHNW组相比,MUO组发病风险增加69%(HR=1.69,95%CI=1.01~2.83);绝经后,与MHNW组相比,MUNW组、MHO组和MUO组乳腺癌发病风险分别增加85%(HR=1.85,95%CI=1.09~3.14)、50%(HR=1.50,95%CI=1.06~2.13)、55%(HR=1.55,95%CI=1.05~2.28)。结论超重/肥胖是女性发生乳腺癌的危险因素,超重/肥胖合并代谢异常者乳腺癌发病风险进一步增加;绝经后,体质量正常但代谢异常者乳腺癌发病风险也增加。

Different risk factors for advanced colorectal neoplasm in young adults

AIM: To compare the risk of developing advanced colorectal neoplasm(ACRN) according to age in Koreans.METHODS: A total of 70428 Koreans from an occupational cohort who underwent a colonoscopy between 2003 and 2012 at Kangbuk Samsung Hospital were retrospectively selected. We evaluated and compared odds ratios(OR) for ACRN between the young-adults(YA < 50 years) and in the older-adults(OA ≥ 50 years). ACRN was defined as an adenoma ≥ 10 mm in diameter, adenoma with any component of villous histology, high-grade dysplasia, or invasive cancer.RESULTS: In the YA group, age(OR = 1.08, 95%CI: 1.06-1.09), male sex(OR = 1.26, 95%CI: 1.02-1.55), current smoking(OR = 1.37, 95%CI: 1.15-1.63), family history of colorectal cancer(OR = 1.46, 95%CI: 1.01-2.10), diabetes mellitus related factors(OR = 1.27, 95%CI: 1.06-1.54), obesity(OR = 1.23, 95%CI: 1.03-1.47), CEA(OR = 1.04, 95%CI: 1.01-1.09) and low-density lipoprotein-cholesterol(OR = 1.01, 95%CI: 1.01-1.02) were related with an increased risk of ACRN. However, age(OR = 1.08, 95%CI: 1.06-1.09), male sex(OR = 2.12, 95%CI: 1.68-2.68), current smoking(OR = 1.38, 95%CI: 1.12-1.71), obesity(OR = 1.34, 95%CI: 1.09-1.65) and CEA(OR = 1.05, 95%CI: 1.01-1.09) also increased the risk of ACRN in the OA group.CONCLUSION: The risks of ACRN differed based on age group. Different colonoscopic screening strategies are appropriate for particular subjects with risk factors for ACRN, even in subjects younger than 50 years.

Oncometabolic surgery:Emergence and legitimacy for investigation

Studies on morbid obesity have shown remarkable improvement of diabetes in patients who have undergone bariatric operations.It was subsequently shown that these operations induce diabetes remission independent of the resultant weight loss;as a result,surgeons began to investigate whether operations for gastric cancer(GC)could have the same beneficial effect on diabetes as bariatric operations.It was then shown in multiple reports that followed that certain operations for GC were able to improve or even cure type 2 diabetes mellitus(T2 DM)in GC patients.This finding gave rise to the concept of"oncometabolic surgery",in which a patient diagnosed with both GC and T2 DM undergo a single operation with the purpose of treating both diseases.With the increasing incidence of T2 DM,oncometabolic surgery has the potential to improve the quality of life and even extend survival of many GC patients.However,because the GC patient population and the bariatric patient population are wildly different and because different GC operations have different properties,the effect of oncometabolic surgery must be carefully assessed and engineered in order to maximize benefit and avoid harm.This manuscript aims to summarize the findings made so far in the field of oncometabolic surgery and to provide an outlook regarding the possibility of oncometabolic surgery being incorporated into standard clinical practice.

Metabolic syndrome in the development and progression of prostate cancer

Prostate cancer(PCa)is the most common noncutaneous malignancy and second leading cause of cancerspecific mortality for men in the United States.There is a wide spectrum of aggressiveness ranging from biologically significant to indolent disease,which has led to an interest in the identification of risk factors for its development and progression.Emerging evidence has suggested an association between metabolic syndrome(MetS)and PCa.MetS represents a cluster of metabolic derangements that confer an increased risk of cardiovascular disease and type 2 diabetes mellitus.Its individual components include obesity,dyslipidemias,high blood pressure,and high fasting glucose levels.Met S has become pervasive and is currently associated with a high socioeconomic cost in both industrialized and developing countries throughout the world.The relationship between MetS and PCa is complex and yet to be fully defined.A better understanding of this relationship will facilitate the development of novel therapeutic targets for the prevention of PCa and improvement of outcomes among diagnosed men in the future.In this review,we evaluate the current evidence on the role of MetS in the development and progression of PCa.We also discuss the clinical implications on the manage-ment of PCa and consider the future direction of this subject.

内镜下经口鼻联合入路手术切除颅底脊索瘤

目的总结内镜下经口鼻联合入路手术切除颅底脊索瘤的疗效及安全性。方法回顾分析2008年12月至2022年12月首都医科大学宣武医院收治的192例颅底脊索瘤患者临床资料和随访数据,根据肿瘤切除程度、临床症状缓解、手术相关并发症发生率及预后评价手术疗效,Kaplan⁃Meier法行生存分析。结果内镜下经口鼻联合入路行颅底脊索瘤切除术,80.21%(154/192)达到影像学全切除(全切除组)、19.79%(38/192)存在影像学残留(残留组)。围手术期死亡2例,术后并发症包括脑脊液漏[6.77%(13/192)]、新发脑神经功能障碍[6.25%(12/192)]、蛛网膜下腔出血[2.08%(4/192)]和颅内耐药菌感染[1.56%(3/192)]。随访81(52,120)个月,死亡57例;全切除组中位生存时间为7.41年、残留组4.33年,两组生存时间差异具有统计学意义(χ2=23.018,P=0.002)。结论内镜下经口鼻联合入路手术可有效切除颅底脊索瘤,患者生存时间延长、预后良好;手术全切除肿瘤是预测预后的重要指标。

奥利司他联合EZH2抑制剂GSK126对胰腺癌细胞脂质代谢重编程的影响

目的:阐明果蝇zeste基因增强子的人类同源物2(EZH2)抑制剂抗胰腺癌疗效不理想的可能机制,为探索新的胰腺癌治疗方案提供依据。方法:采用不同浓度(0~50μmol·L-1)EZH2抑制剂GSK126分别处理胰腺癌PANC-1细胞、CFPAC-1细胞和胰腺转移癌SW1990细胞,CCK-8法检测各组细胞存活率。将3种细胞各分为对照组和GSK126组,GSK126孵育48 h后采用流式细胞术检测各组细胞凋亡率,油红O染色观察各组细胞中脂滴形成情况,检测各组细胞中甘油三酯(TG)水平,实时荧光定量PCR(RT-qPCR)法检测各组细胞中凋亡基因含半胱氨酸的天冬氨酸蛋白水解酶1、3、7、9(Caspase-1、Caspase-3、Caspase-7、Caspase-9)和血管内皮生长因子A(VEGFA)、E-钙黏蛋白(E-cadherin)及干性标志基因CD133、CD24和CD44 mRNA表达水平,以及脂代谢相关基因脂肪酸合成酶(FASN)、乙酰辅酶A羧化酶a(ACACA)、柠檬酸合成酶(CS)、ATP柠檬酸裂解酶(ACLY)、硬脂酰辅酶A去饱和酶(SCD)和酰基辅酶A合成酶短链家族成员2(ACSS2)mRNA表达水平。将3种细胞各分为对照组、GSK126组、FASN抑制剂奥利司他(Orlistat)组和GSK126+Orlistat组,细胞孵育48 h后,CCK-8法检测各组细胞存活率,计算两药联合指数(CI),油红O染色观察各组细胞中脂滴形成情况,检测各组细胞中TG水平,流式细胞术检测各组细胞凋亡率,RT-qPCR法检测各组细胞中凋亡基因Caspase-1、Caspase-3、Caspase-7和Caspase-9及干性基因CD133、CD24和CD44 mRNA表达水平。结果:GSK126呈浓度依赖性抑制胰腺癌细胞增殖。与对照组比较,GSK126组3种细胞凋亡率和凋亡基因mRNA表达水平差异无统计学意义(P>0.05),GSK126组SW1990细胞中VEGFA和PANC-1细胞中E-cadherin mRNA表达水平明显降低(P<0.05),3种细胞中CD133及CFPAC-1和SW1990细胞中CD24 mRNA表达水平均明显升高(P<0.01)。与对照组比较,GSK126组3种细胞中脂滴数量明显增加,TG水平和FASN mRNA表达水平均明显升高(P<0.05或P<0.01),其他脂代谢相关基因也有不同程度升高。与对照组、GSK126组和Orlistat组比较,GSK126+Orlistat组细胞存活率明显降低(P<0.05或P<0.01),经计算两药CI均<1,具有协同作用。与对照组、GSK126组和Orlistat组比较,GSK126+Orlistat组细胞中脂滴数量明显减少;与对照组和GSK126组比较,GSK126+Orlistat组细胞中TG水平明显降低(P<0.01),凋亡基因和干性基因mRNA表达水平明显升高(P<0.05或P<0.01);与对照组、GSK126组和Orlistat组比较,GSK126+Orlistat组细胞凋亡率明显升高(P<0.01)。结论:GSK126在抑制胰腺癌细胞增殖的同时可诱发细胞内脂代谢重编程,削弱了其抗癌效果,联合使用FASN抑制剂Orlistat可部分逆转该效应,协同抑制细胞增殖,明显增强细胞凋亡并降低干性基因表达。

肠道菌群代谢产物在结肠炎相关结直肠癌中的作用

炎症性肠病(IBD)患者罹患结肠炎相关结直肠癌(CAC)的风险显著增加,肠道菌群代谢产物与CAC的关系备受关注,通过调节肠道菌群代谢或增加有益代谢产物可能对预防CAC具有重要作用。本文就肠道菌群代谢产物在CAC中的作用作一综述。

10140例肾结石患者临床合并症及相关因素分析

目的评估肾结石患者的人口学分布和临床合并症特点并探索其相关因素,为临床防治提供依据。方法回顾性分析2017年1月至2020年12月海军军医大学(第二军医大学)第一附属医院门诊及住院患者中影像学报告为肾结石的10140例患者资料。根据肾脏受累情况,分为单侧肾结石组(单侧组)及双侧肾结石组(双侧组),比较两组患者在年龄、性别、实验室检查指标、常见临床合并症上的差异,采用logistic回归分析探寻可能影响双侧肾结石形成的相关因素。结果10140例肾结石患者的年龄为(57.75±13.30)岁,其中≤30岁276例(2.7%),31~64岁6647例(65.6%),≥65岁3217例(31.7%);男7021例(69.3%),女3119例(30.7%),男女比例为2.25∶1。所有肾结石患者最常见的临床合并症依次为高血压病(3285例,32.4%)、肿瘤(2775例,27.4%)、高尿酸血症(2007例,19.8%)、糖尿病(1526例,15.0%)、冠心病(1072例,10.6%)、脑血管疾病(473例,4.7%)。单侧组8171例(80.6%),双侧组1969例(19.4%)。双侧组年龄低于单侧组,男性占比高于单侧组,血清肌酐、尿酸、尿pH值水平高于单侧组,高密度脂蛋白胆固醇水平低于单侧组,合并高血压病、高尿酸血症的患者占比高于单侧组,合并肿瘤、冠心病的患者占比低于单侧组,差异均有统计学意义(P均<0.05);两组患者BMI、空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平及合并糖尿病、脑血管疾病的患者比例差异均无统计学意义(P均>0.05)。logistic回归分析结果显示,性别(男性)、高尿酸血症可能是双侧肾结石形成的重要危险因素,而合并肿瘤则更多见于单侧肾结石患者(P均<0.05)。结论肾结石更多见于中年男性,代谢综合征相关疾病在肾结石的发展过程中起着重要作用,有必要加强这些疾病的早期防治。肾结石患者肿瘤合并率高,提示两者存在关联。此外,较单侧肾结石而言,男性、合并高尿酸血症与双侧肾结石形成关系更为密切,应当引起重视。

代谢综合征参与子宫内膜癌发病机制研究进展

子宫内膜癌是女性生殖系统最常见的癌症之一,其疾病的发生发展与代谢综合征具有明确相关性。近年来,以胰岛素抵抗和脂质代谢紊乱为代表的代谢综合征促进子宫内膜癌发生发展关键分子机制的研究取得了很大进展。该研究综述了代谢综合征中关键分子调控通路在内膜癌发生发展机制的研究进展,有利于进一步深入了解子宫内膜癌相关代谢综合征的分子机制,为子宫内膜癌防控及治疗提供新的靶点。

双歧杆菌三联活菌联合序贯早期肠内营养对胃癌术后病人免疫炎症指标及体脂代谢水平的影响

目的:探讨双歧杆菌三联活菌联合序贯早期肠内营养对胃癌术后免疫炎症指标及体脂代谢水平的影响。方法:采用随机抽样法选取择期手术的胃癌病人42例,分为观察组22例和对照组20例。对照组给予术前常规营养支持,术后给予早期肠内营养支持;观察组序贯早期肠内营养联合双歧杆菌三联活菌摄入。比较2组病人手术前后营养状态、免疫炎症反应指标、体脂代谢水平和术后胃肠功能状态。结果:术前2组病人营养指标、免疫和炎症指标及体脂代谢指标差异均无统计学意义(P>0.05)。术后7 d,观察组前白蛋白水平高于对照组(P<0.05),免疫球蛋白A、免疫球蛋G水平均明显高于对照组(P<0.01),C反应蛋白、白细胞介素6均明显低于对照组(P<0.01),基础代谢高于对照组(P<0.05)。术后观察组首次通气时间、首次通便时间、恢复经口进食时间和首次下床活动时间均明显优于对照组(P<0.01),腹泻、腹胀、恶心呕吐发生率均低于对照组(P<0.05~P<0.01)。结论:双歧杆菌三联活菌联合序贯早期肠内营养应用于胃癌术后病人,能改善病人短期营养状况,提高免疫功能,减轻炎症反应,促进胃肠功能恢复,减少胃肠道不良反应发生率。

IVIM-DKI定量参数诊断口腔癌颈部淋巴结转移可行性的初步研究

目的:探讨体素内不相干运动-扩散峰度成像(IVIM-DKI))定量参数诊断口腔癌(OCC)颈部淋巴结转移的可行性和价值。方法:回顾性收集2023年2—8月经病理证实的29例口腔癌患者的临床、MRI资料,共纳入转移淋巴结15枚,非转移淋巴结31枚。测量和记录相应淋巴结的IVIM-DKI定量参数,包括真扩散系数(D)、伪扩散系数(D*)、灌注分数(f)、平均扩散率(MD)、平均扩散峰度(MK)。采用Mann Whitney U检验比较口腔癌颈部淋巴结转移组与非转移组间定量参数的差异,通过受试者工作特征(ROC)曲线评价IVIM-DKI各定量参数鉴别转移淋巴结和非转移淋巴结的诊断效能,通过逐步逻辑回归筛选出独立预测因子。结果:转移淋巴结组与非转移淋巴结组D值、f值、MD值间比较具有统计学差异(P<0.05),转移淋巴结组与非转移淋巴结组D*值、MK值间比较无统计学差异。D值、f值、MD值的曲线下面积(AUC)分别为0.754、0.824、0.714,分别以0.88×10^(-3)mm^(2)/s、27.77%、1.52×10^(-3)mm^(2)/s为阈值,诊断淋巴结转移的敏感度分别为66.67%、86.67%、40.00%,特异度分别为77.42%、70.97%、93.55%。结论:IVIM-DKI定量参数D值、f值、MD值对颈部淋巴结转移具有良好的诊断效能,其中f值是鉴别转移和非转移淋巴结的独立预测因子。

Warburg效应及其关键酶在口腔鳞状细胞癌治疗中作用的研究进展

口腔鳞状细胞癌(OSCC)是口腔颌面部最常见的恶性肿瘤,具有侵袭性强、复发率高、预后差的特点。恶性肿瘤细胞最显著的能量代谢特点是即使在氧气供应充分的情况下,也主要由糖酵解而非氧化磷酸化获取能量,这种肿瘤细胞糖酵解异常活跃的现象称为Warburg效应。了解肿瘤葡萄糖代谢异常对OSCC的临床治疗有重要意义。本文综述Warburg效应及糖酵解关键酶在OSCC治疗中作用的研究进展,为OSCC治疗提供新思路。

口腔鳞状细胞癌^(18)F-FDG PET/MR与PET/CT对比分析

目的比较^(18)F-FDG PET/CT与PET/MR口腔鳞状细胞癌(oral cavity squamous cell carcinoma,OCSCC)的图像,探讨PET/MR在口腔癌中的应用价值。方法回顾性分析22例同时接受体部PET/CT与头颈部MR检查的OCSCC患者,对PET阳性病灶在PET/CT、PET/MR上的图像质量、融合准确度及病灶清晰度进行评分比较。结果22例患者共有35个阳性病灶,包括阳性原发灶22个、阳性淋巴结13个。PET/CT、PET/MR T_(1)WI和PET/MR T_(2)WI在图像质量及融合准确度方面比较,差异均无统计学意义(P均>0.05);在显示阳性原发灶的清晰度方面,PET/MR T_(1)WI和PET/MR T_(2)WI均优于PET/CT(P<0.05);在显示阳性淋巴结的清晰度方面,PET/CT、PET/MR T_(1)WI和PET/MR T_(2)WI比较,差异无统计学意义(P>0.05)。结论PET/MR在OCSCC诊断中有良好临床应用前景。