Retrospective analysis of interventional treatment of hepatic metastasis from gastroenteropancreatic neuroendocrine tumors

Objective： To analyze the angiography appearance of liver metastases from gastroenteropancreatic neuroendocrine tumors （GEP-NETs）, and evaluate the clinical efficacy and prognostic factors of interventional treatment for hepatic metastases. Methods： Fifty GEP-NETs patients with hepatic metastases were treated from January 2012 to December 2016, and received transarterial embolization （TAE） in the hepatic tumor or hepatic arterial infusion chemotherapy （HAIC）. All patients received 179 times of the intervention therapy in total. Results： Blood supplies were identified in the 50 eases with angiography, which showed that 35 cases had abundant vessels, while 15 eases had poor blood supply. Twenty-two cases were found either collateral blood supply, or portal vein invasion or arterial-portal vein fistula. The best curative efficacy was complete remission （CR） in 4 cases, partial remission （PR） in 28 cases and stable disease （SD） in 18 eases during the process of treatment. The angiography （P=0.047） and the frequency of intervention （P=0.037） showed significantly statistical difference with Kaplan-Meier analysis. The Cox analysis showed that more than 3 times of interventional therapy was an independent prognostic factor. Conclusions： Interventional treatment is safe and effective for GEP-NETs, and is beneficial to patients with main hepatic metastases after endocrine therapy.

采用实体瘤疗效评价标准、改良实体瘤疗效评价标准和体积测定法MRI评价恶性胸膜间皮瘤治疗反应与CT的对照性研究

本研究的目的是采用实体瘤疗效评价标准（response evaluation criteria in solid tumours，RECIST）和改良的RECIST与CT对照比较来评价MRI技术在判断恶性胸膜间皮瘤（MPM）病人的早期治疗反应。50例恶性胸膜间皮瘤病人（男32例，女18例）在9周的疗程之后[6次化疗（CHT）中的3次]评价早期治疗反应。此外，还对病人在化疗前、早期治疗反应评价后4周和6个化疗周期后的诊断性随访进行评价。RECIST和改良RECIST用于CT和MRI检查[半傅里叶单次激发快速自旋回波（HASTE）、容积式内插值法屏气检查（VIBE）、T2-快速自旋回波序列]。

Establishment,functional and genetic characterization of three novel patient-derived rectal cancer cell lines

AIM To establish patient-individual tumor models of rectal cancer for analyses of novel biomarkers, individual response prediction and individual therapy regimens.METHODS Establishment of cell lines was conducted by direct in vitro culturing and in vivo xenografting with subsequent in vitro culturing. Cell lines were in-depth characterized concerning morphological features, invasive and migratory behavior, phenotype, molecular profile including mutational analysis, protein expression, and confirmation of origin by DNA fingerprint. Assessment of chemosensitivity towards an extensive range of current chemotherapeutic drugs and of radiosensitivity was performed including analysis of a combined radioand chemotherapeutic treatment. In addition, glucose metabolism was assessed with 18 F-fluorodeoxyglucose(FDG) and proliferation with 18 F-fluorothymidine.RESULTS We describe the establishment of ultra-low passage rectal cancer cell lines of three patients suffering from rectal cancer. Two cell lines(HROC126, HROC284 Met) were established directly from tumor specimens while HROC239 T0 M1 was established subsequent to xenografting of the tumor. Molecular analysis classified all three cell lines as CIMP-0/non-MSI-H(sporadic standard) type. Mutational analysis revealed following mutational profiles: HROC126: APC^(wt), TP53^(wt), KRAS^(wt), BRAF^(wt), PTEN^(wt); HROC239 T0 M1: APC^(mut), P53^(wt), KRAS^(mut), BRAF^(wt), PTEN^(mut) and HROC284 Met: APC^(wt), P53^(mut), KRAS^(mut), BRAF^(wt), PTEN^(mut). All cell lines could be characterized as epithelial(EpCAM+) tumor cells with equivalent morphologic features and comparable growth kinetics. The cell lines displayed a heterogeneous response toward chemotherapy, radiotherapy and their combined application. HROC126 showed a highly radio-resistant phenotype and HROC284 Met was more susceptible to a combined radiochemotherapy than HROC126 and HROC239 T0 M1. Analysis of 18 F-FDG uptake displayed a markedly reduced FDG uptake of all three cell lines after combined radiochemotherapy. CONCLUSION These newly established and in-depth characterized ultra-low passage rectal cancer cell lines provide a useful instrument for analysis of biological characteristics of rectal cancer.

采用全身PET／CT双重模式和全身MRI行恶性肿瘤分期

背景：恶性病变患者需准确进行全身肿瘤分期以决定合适的治疗。磁共振显像(magnetic resonance imaging，MRI)以及正电子发射体层摄影术(positron emission tomography，PET)／计算机体层摄影术(computed tomography，CT)联合法使单次扫描进行全身肿瘤分期成为可能。目的：探讨全身PET／CT和全身MRI对不同恶性疾病分期的准确性。设计、地点和病例：对98例不同恶性肿瘤患者(平均年龄58岁；年龄范围27～94岁)进行前瞻性、盲法研究。所有患者均行连续的全身[18F]-氟代脱氧葡萄糖PET／CT及全身MRI扫描，以便进行肿瘤分期。研究地点为某大学医院，时间从2001年12月到2002年10月，平均随访273天(75—515天)。图像由两组不同的读片师进行盲法分析。比较这两种影像学检查法的诊断准确性。主要观察指标：全身PET／CT和全身MRI对原发肿瘤、局部淋巴结和远处转移(TNM分期)进行分类的准确性。二级观察指标为这两种影像学方法评估T、N和M期肿瘤的准确性。结果：PET／CT对98例患者中的75例TNM分期正确(77％；95％可信区间[CI]，67％-85％)，MRI对53例TNM分期正确(54％；95％CI，44％一64％)(P<0．001)。与MRI比较，PET／CT对12例患者的治疗方案有直接影响。相对于PET／CT，MRI结果使2例患者的治疗方案发生改变。对46例病理证实的患者单独进行T分期评估显示，PET／CT对其中37例分期准确(80％；95％CI，66％-91％)，MRI24例分期准确(52％；)5％CI，37％～67％，)(P<0．001)。98例患者中，PET／CT 91例N分期准确(93％，；95％CI．86％-97％)，MRI77例N分期准确(79％；95％CI，69％-86％)(P=0．001)。对远处转移灶的发现两种方法相似。结论：研究证实了采用PET／CT和MRI进行全身肿瘤分期的可行性和诊断准确性。[18F]-氟代脱氧葡萄糖：PET／CT在TNM分期上的优越性提示其作为一种全身肿瘤分期一线检查方法是可行性的。