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Objective To explore the efficacy difference of diffusion kurtosis imaging (DKI) and ultrasound elastography (UE) in the diagnosis of liver fibrosis. Methods Thirty-five patients whose serological examination showed hepatitis B or hepatitis C virus infection, disease course≥ 1 year, and finally liver biopsy confirmed pathological fibrosis grade in Tianjin Second People's Hospital from December 2015 to April 2017 were prospectively enrolled as patient group. During the same period, twenty healthy volunteers who matched the age, sex and BMI with patient group and showed normal liver function within the last month were enrolled as control group. All of the subjects underwent DKI experiment, and subjects in patient group underwent UE experiment in addition. Liver mean apparent diffusion (MD) and mean kurtosis (MK) were obtained in all subjects and liver stiffness measurement (LSM) was obtained in patient group. The patient group was staged for hepatic fibrosis based on liver biopsy results (S0 to S4). Differences in liver MD and MK values between control and patient groups were tested using independent sample t test (normal distribution) or Mann-Whitney U test (skewed distribution). Differences in liver MD, MK, and LSM between patients with different fibrosis stages were tested using One-way ANOVA (normal distribution) or Kruskal-Wallis test (skewed distribution). The correlation between liver MD, MK and LSM values with fibrosis stages were analyzed using Pearson correlation test. The diagnostic performance in staging fibrosis was analyzed using ROC analysis. Results Liver MD in patient group was lower than that in control group, and the difference was statistically significant (P<0.01). There was no significant difference in liver MK between the two groups (P>0.05). The AUC value for the diagnosis of liver fibrosis by MD was 0.950 (95％CI:0.855 to 0.990). Of the 35 patients, 15 were S1 (mild fibrosis), 13 were S2 (moderate fibrosis), 4 were S3, 3 were S4 (S3+S4 were severe fibrosis). The difference of MD and LSM between different stages of liver fibrosis was statistically significant (P<0.05), and there was no significant difference in MK (P>0.05). Liver fibrosis stages was highly correlated with MD (r=-0.757, P<0.01), and had no correlation with MK (r=-0.010, P=0.956), and moderately correlated with LSM (r=0.440, P<0.01). The AUC values of liver MD and LSM for characterization of ≥S2 stage liver fibrosis were 0.867 and 0.800, respectively, without statistically significant difference (P=0.486). The AUC values for characterization of≥S3 stage liver fibrosis were 0.918 and 0.653, respectively, with a statistically significant difference (P=0.032). Conclusion MD derived from DKI can be used for noninvasive assessment of liver fibrosis, and it is superior to LSM in distinguishing different fibrosis stages and detecting severe fibrosis.
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Objective@#To investigate the relationships between the expression of programmed death 1 (PD-1) and the epidermal growth factor receptor (EGFR) gene mutations in non-small cell lung cancer (NSCLC). The study also attempted to investigate the clinicopathological features and prognosis in NSCLC patients.@*Methods@#The expression of PD-1 protein in 88 cases of NSCLC tumor tissues and adjacent tissues was detected by immunohistochemistry. The mutations of EGFR in NSCLC were detected by Polymerase Chain Reaction-Amplification Refractory Mutation System(PCR-ARMS) method. The expression of PD-1 and patients′ clinical characteristics and prognosis were analyzed.@*Results@#PD-1 was positive in 63.6%(56/88) NSCLC tumor tissues, which was significantly higher than that in adjacent normal tissues (21.6%, 19/88) (P<0.05). EGFR gene mutations were found in 43 cases (48.9%), in which 30 cases (69.8%)were PD-1 positive expression. 45 cases had the wild types of EGFR gene, in which 26 cases (57.8%) were PD-1 positive. There were 24 cases of 19Del EGFR mutations, including 20 cases (83.3%) of PD-1 positive expression. 19 patients had 21L858 EGFR mutations, including 10 cases (52.6%) of PD-1 positive expression. The expression of PD-1 in NSCLC was related to patients′ smoking status, lymph node metastasis and EGFR gene mutations (P<0.05). The median progression-free survival time of patients with PD-1 positive and negative expression was 7.03 and 18.66 months, respectively (P=0.007). In patients with wild-type EGFR gene, the median progression-free survival time of PD-1 positive and negative expression was 25.21 and 38.24 months, respectively. The difference was statistically significant (P=0.024). The median progression-free survival time in 43 cases of EGFR mutant patients with PD-1 positive and negative expression was 21.23 and 31.44 months. The difference was not statistically significant (P=0.128).@*Conclusions@#PD-1 expresses in both EGFR mutant and wild-type NSCLC, and its expression levelis different with various EGFR mutations. The expression of PD-1 in NSCLC is related to the prognosis of patients, and the prognosis of patients with positive PD-1 expression was poor.
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Objective To explore the prognostic value of pre-chemotherapy serum cystatin C (Cys C) in patients with castration-resistant prostate cancer (CRPC).Methods The medical records of 48 patients with CRPC were reviewed.These patients were diagnosed and underwent docetaxel-based chemotherapy in Xinjiang Military Command General Hospital between January 2009 and January 2015.Statistical analysis was performed to identify the clinical and prognosis value of Cys C.Results Of 48 patients with CRPC,the expression of serum Cys C before chemotherapy was related with Gleason score (x2 =4.218,P =0.040) and distant metastasis(x2 =4.090,P =0.043).23 patients was in high group (Cys C ＞ 1.61 mg/L),25 in low (Cys C ≤ 1.61 mg/L).The median survival time of high group and low group were 15.6 and 25.3 months,respectively (x2 =13.876,P ＜ 0.001).Univariate analysis showed that TNM stage (x2 =6.934,P =0.018),Gleason score (x2 =7.933,P =0.005),baseline prostate specific antigen (PSA) (x2 =9.038,P =0.003),number of chemotherapy cycles (x2 =5.024,P =0.028),distant metastases (x2 =6.963,P =0.013) and serum Cys C before chemotherapy (x2 =6.976,P =0.012) were associated with overall survival of patients with CRPC.COX multivariate analysis showed that baseline PSA at diagnosis (x2 =4.257,P =0.039),number of chemotherapy cycles (x2 =6.245,P =0.017),distant metastases (x2 =5.122,P =0.028) and serum Cys C before chemotherapy (x2 =8.172,P =0.004) were independent risk factors of overall survival of patients with CRPC,especially serum Cys C before chemotherapy (HR =2.394).Conclusion The patients with high Cys C level have poor prognosis,and the pre-chemotherapy Cys C is an independent risk factor for prognosis of CRPC patients treated with docetaxel-based chemotherapy which can be used as an effective indicator to assess the prognosis of CRPC.
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Objective:To investigate the effect and elucidate the mechanism of the selective cyclooxygenase-2(COX-2)inhibitor NS-398 on apoptosis and survivin, XIAP and c-IAP1 expressions of hepatocarcinoma cell lines. Methods:The proliferation of hepatocarcinoma BEL-7402 cells treated with NS-298 at different concentrations were evaluated by MTT assay. The apoptosis was detected by flow cytometry (FCM) and TUNEL assay. Expressions of COX-2, survivin, XIAP and c-IAP1 were analyzed by immunocytochemical staining. Results: NS-398 significantly inhibited cell proliferation of BEL-7402 cells and induced apoptosis. Immunocytochemisty indicated that the expressions of COX-2, survivin, XIAP and c-IAP1 were significantly down-regulated in BEL-7402 cells by NS-398 treatment compared with untreatment group (P<0.01). Conclusion:NS-398 inhibits the proliferation and induced apoptosis of BEL-7402 cells. The mechanism may be related with down-regulation of the survivin, XIAP and c-IAP1 expression.