ABSTRACT
Purpose@#Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal malignancy that occurs primarily in children and adolescents. The clinical and pathological features of IMT in adult patients are not well understood. @*Materials and Methods@#We retrospectively searched for records of adult patients with IMT at Fudan University Shanghai Cancer Center from 2006 to 2021. Clinicopathological data, treatments, and outcomes were collected and analyzed. @*Results@#Thirty adult patients with IMT, mostly women (60.0%), were included. The median age of the patients was 38 (21-77). The most common primary site was abdominopelvic region (53.3%), followed by lungs (20.0%). Seven patients had an abdominal epithelioid inflammatory myofibroblast sarcoma (EIMS). The positivity rate of anaplastic lymphoma kinase (ALK) was 81.5% (22/27). Sixteen patients with advanced ALK-positive disease received crizotinib, with an objective response rate (ORR) of 81.3% and a disease control rate of 87.5%. The median progression-free survival was 20.8 months. EIMS was associated with more aggressive behavior; however, the prognosis was similar to that of non-EIMS patients after treatment with an ALK inhibitor. At a median follow-up time of 30 months (95% confidence interval [CI], 13.6 to 46.4), the 5-year overall survival was 77% (95% CI, 66 to 88) in all patients. @*Conclusion@#Adult IMTs appeared more aggressive, with a higher incidence of recurrence and metastases, and patients with EIMS had more aggressive cases. Treatment with ALK inhibitors resulted in a high ORR and a durable response, which suggested that ALK inhibitors could be used as a first-line treatment option in adult patients with ALK-positive advanced IMT.
ABSTRACT
Objective; To investigate the expression levels of matrix metalloproteinase 2 (MMP-2) and matrix metalloproteinase 9 (MMP-9) in dentin of healthy adults under different adhesion conditions, and to provide the basis for improving the binding effect of matrix metalloproteinases (MMPs) inhibitors in clinic. Methods; A total of 20 adult freshlyextracted molars were collected and ground into dentin powder under liquid nitrogen cooling. The oral condition was simulated. The dentin was treated with self-etching bonding (Single Bond Universal) and totaletching bonding (35% phosphate gel +Adpter Single Bond 2). The dentin without any treatment was regarded as negative control group, the dentin treated with 10% phosphoric acid (self-etching bonding) or 10% phosphoric acid+ 35% phosphate gel (total-etching bonding) was regarded as positive control group, the dentin treated with Single Bond Universal (self-etching bonding) or 35% phosphate gel+Adper Single Bond 2 (total-etching bonding) was regarded as blank control group; the dentin pretreated with the MMPs inhibitors chlorhexidine (CHX) and minocycline (MI) during the bonding process respectively was regarded as CHX group and MI group, and the dentin treated with 10 % sodium hypochlorite was regarded as aging group; on the basis of aging group, the dentin treated with CHX and MI was regarded as CHX aging group and MI aging group. Gelatin zymography was used to perform the polyacrylamide gel electrophoresis; after incubating, staining and decoloring, the bands were analyzed by gel image analysis system, and the expression levels of MMP-2 and MMP-9 in dentin were calculated. Results: Under the condition of self-etching bonding, compared with blank control group, the expression levels of MMP-2 and MMP-9 in dentin in CHX group were decreased (P<0. 05), and the expression levels of MMP-2 and MMP-9 in the dentin powder in MI group were decreased (P<0. 05); compared with aging blank control group, the expression levels of MMP-2 and MMP-9 in dentin in CHX aging group were decreased (P<0. 05), and the expression levels of MMP-2 and MMP-9 in dentin in MI aging group were decreased (P<0. 05). Under the condition of total-etching bonding, compared with blank control group, the expression levels of MMP-2 in dentin in CHX group and MI group were decreased (P<0. 05); compared with aging blank control group, the expression levels of MMP-2 in dentin in CHX aging group and MI aging group were decreased (P<0. 05). Conclusion; In the process of dentin bonding, CHX and MI could slow down the enzymatic reaction and improve the bonding strength by decreasing the expression levels of MMP-2 and MMP-9.
ABSTRACT
Gastrointestinal stromal tumor (GIST) is the most common gastrointestinal mesenchymal tumors, mainly due to the onset of the proto-oncogene receptor tyrosine kinase, or platelet-derived growth factor receptor gene activating mutations. Molecular targeted therapy drug of imatinib mesylate inhibit KIT, platelet-derived growth factor receptor aloha (PDGFRA) gene tyrosine kinase activity, which is effective in patients with advanced GIST. However, a growing number of studies have found the presence of imatinib mesylate in primary and secondary drug resistance in the treatment of GIST process. With the in-depth study of the physiological function and mechanism of action of non-coding RNA in recent years, making it gradually realized extensive regulation of non-coding RNA gene expression, which occurs in tumor development, invasion and metastasis, drug resistance and other processes plays an important role. Non-coding RNA has the potential to explore GIST pathogenesis and resistance mechanisms to provide new ideas and direction.
ABSTRACT
Gastrointestinal stromal tumor (GIST) may be defined as mesenchymal tumors of the gastrointestinal tract,and the application of the tyrosine kinase inhibitor imatinib mesylate has changed the treatment style of the tumor.The surgical treatment is the only choice for the GIST patients before imatinib era,but now the individualized treatment combined with target therapy,surgery and laparoscope surery becomes the mainstay.The paper focus on the new development of preoperative biopsy,laparoscope surery,imatinib neoadjuvant and imatinib therapeutic effect evaluation in recent years.