ABSTRACT
<p><b>BACKGROUND</b>Carcinoma of unknown primary (CUP) encompasses a heterogeneous group of tumors with varying clinical features. The management of patients of CUP remains a clinical challenge. The purpose of this study was to evaluate the clinical applications of integrated (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) information in patients with CUP, including detecting the occult primary tumor and effecting on disease therapy.</p><p><b>METHODS</b>One hundred and forty-nine patients with histologically-proven metastases of CUP were included. For all patients, the conventional diagnostic work-up was unsuccessful in localizing the primary site. Whole-body PET/CT images were obtained approximately 60 minutes after intravenous injection of 350 - 425 MBq of (18)F-FDG.</p><p><b>RESULTS</b>In 24.8% of patients, FDG PET/CT detected primary tumors that were not apparent after conventional workup. In this group of patients, the overall sensitivity, specificity, and accuracy rates of FDG PET/CT in detecting unknown primary tumors were 86.0%, 87.7%, and 87.2%, respectively. FDG PET/CT imaging also led to the detection of previously unrecognized metastases in 29.5% of patients. Forty-seven (31.5%, 47 of 149) patients underwent a change in therapeutic management.</p><p><b>CONCLUSIONS</b>FDG PET/CT is a valuable tool in patients with CUP, because it assisted in detecting unknown primary tumors and previously unrecognized distant metastases, and optimized the management of these patients.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Carcinoma , Diagnostic Imaging , Pathology , Fluorodeoxyglucose F18 , Positron-Emission Tomography , Methods , Radiography , Reproducibility of ResultsABSTRACT
<p><b>OBJECTIVE</b>To explore the effect of cardiopulmonary bypass (CPB) on the profile of protein expression in peripheral blood mononuclear cells (PBMCs).</p><p><b>METHODS</b>Eleven patients undergoing cardiac surgery under cardiopulmonary bypass were enrolled in the study. Peripheral blood samples were collected before CPB (T0), 1 h after CPB (T1) and at the end of operation (T2), and PBMCs were obtained by gradient centrifugation. The profile of protein expression was analyzed using 2-D gel electrophoresis (2-DE) and mass spectrometry. The candidate proteins were further identified by Western blotting.</p><p><b>RESULT</b>Compared to protein profile at T0, 12 protein spots were identified to be up-regulated in PBMCs at T1 (P <0.05), among which S100A9 reached the peak level at T1 and decreased after operation,but not returned to its initial level.</p><p><b>CONCLUSION</b>Results indicate that 12 proteins are likely to be involved in CPB, however, their roles need to be elucidated.</p>