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Objective To investigate the clinicopathological features and prognosis in patients with thymoma and patients with thymoma and myasthenia gravis ( MG) . Methods A retrospective analysis was performed on the clinicopathological data of 161 patients pathologically diagnosed with thymoma alone or thymoma and MG from 2008 to 2014. In those patients, 128 had thymoma with MG and 33 had thymoma alone. The survival rates were calculated using the Kaplan?Meier method and analyzed using χ2 test or Fisher′s exact probability test. Results The mean age of onset was 45. 2 years for patients with thymoma and MG and 48. 5 years for patients with thymoma alone. In patients with thymoma and MG, 74. 2% had a tumor diameter of ≤5 cm, while 75. 8% of patients with thymoma alone had a tumor diameter of ≥5 cm. According to the Masaoka staging system, 78. 1% of patients with thymoma and MG had stage Ⅰ+Ⅱdisease, while 51. 1% of patients with thymoma alone had stage Ⅲ+Ⅳ disease. There was no significant difference in the 3?year overall survival ( OS) rate between the two groups ( 98. 1% vs. 81. 8%, P=1. 000) . The 5?year OS rate was significantly higher in patients with thymoma and MG than in patients with thymoma alone ( 91. 1% vs. 42. 9%, P= 0. 000 ) . In all patients, 140 patients with complete resection had significantly higher 3?and 5?year OS rates than 21 patients with incomplete resection ( 97. 2% vs. 58. 8%, P=0. 000;92. 7% vs. 25. 0%, P=0. 000). In patients with stage Ⅱ disease, there were no significant differences in the 3?or 5?year OS rates between patients with complete resection alone ( n=25) and patients with complete resection and postoperative radiotherapy ( n=25) ( 95% vs. 100%, P=1. 000;86% vs. 100%, P=0. 467). Conclusions Compared with patients with thymoma alone, patients with thymoma and MG have an earlier age of onset, substantially smaller tumor diameters, and earlier Masaoka stages. MG and complete resection are positive prognostic factors for patients with thymoma. Radiotherapy after complete resection can reduce the recurrence rate in patients with stage Ⅱ disease.
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Objective To investigate the clinical and pathological features and prognostic factors for thymoma with myasthenia gravis (MG).Methods The clinical and pathological data of 126 patients with thymoma and MG confirmed by postoperative pathological examination from 2008 to 2014 were analyzed retrospectively.The Kaplan-Meier method was used to calculate survival rates;the log-rank test was applied for univariate prognostic analysis;the Cox regression model was applied for multivariate prognostic analysis.Results The numbers of patients who received the follow-up visits at 3 and 5 years were 88 and 45,respectively (the patients who were admitted before the end of October 2011 and the end of October 2009).The 3-and 5-year survival rates were 97.9％ and 91.8％,respectively.The 3-and 5-year survival rates for patients with WHO types A+AB+B1 +B2 and B3 were 98.6％/95.2％ and 90.6％/92.9％,respectively (P=0.764),and those for patients with Masaoka stages Ⅰ-Ⅱ and Ⅲ-Ⅳ were 98.6％/95.2％ and 97.4％/72.7％,respectively (P=0.791).The 3-and 5-year survival rates for patients with complete and partial resection were 97.8％/91.7％ and 100.0％/50.0％,respectively (P=0.964),and those for patients with complete resection alone and complete resection+postoperative radiotherapy were 96.8％/93.1％ and 100.0％/94.7％,respectively (P=1.000).Conclusions The major treatment modality for thymoma with MG is complete resection followed by radiotherapy according to the specific circumstances after surgery.Complete resection,postoperative radiotherapy,WHO type,and Masaoka stage may be associated with prognosis.
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Objective To explore the role of pulmonary function analysis in drug efficacy evaluation of radiation-induced lung injury.Methods Totally 30 C57BL/6 mice were randomly divided into 3 groups:control group, radiation group and dexamethasone group.Mice in radiation group and dexamethasone group were irradiated with 20 Gy X-ray on the whole chest.Then mice in dexamethasone group was intraperitoneally injected with dexamethasone at the dose of 4.5 mg/( kg· d) for 2 weeks and then the dose was halved up to 1 month after radiation while control group and radiation group were intraperitoneally injected with 0.9%saline.One month after irradiation, pulmonary function of all the mice was tested with EMKA system.Then mice were sacrificed and pathological changes of pulmonary tissue were observed by HE staining. Furthermore, the area of alveolar cavity was measured with the Image-pro plus software.Results One month after irradiation, the pulmonary function parameters of mice in radiation and dexamethasone groups, such as mid-expiratory flow, minute volume,tidal volume,peak inspiratory flow,and peak expiratory flow,decreased obviously compared with the control group, but those parameters of the dexamethasone group decreased much less significantly than in the radiation group.The pathological changes of pulmonary tissues showed that the area of alveolar cavity of radiation group and dexamethasone group was smaller than that of the control group, but the extent of the loss of alveolar cavity area of the dexamethasone group was less than in the radiation group.Neutrophils infiltration could be found in the radiation group and dexamethasone group, but was less serious in the dexamethasone group.The result of pulmonary function analysis was coincident with pathological changes of the lung.Conclusion Dexamethasone can alleviate radiation induced pulmonary injury.Pulmonary function analysis combined with pathological observation of pulmonary tissues can effectively evaluate the efficacy of drugs in radiation induced lung injury.
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Objective To discuss the relationship between lung function before and after radiotherapy and radiation-induced pneumonitis in locally advanced non-small-cell lung cancer.Methods 76 patients were evaluated by pulmonary function tests before radiotherapy and in 1 month and 3 month after radiotherapy respectively.Results All patients were treated radiotherapy with irradiation dose of 60-70 Gy,the radiation pneumonitis occurred in 26 patients (group A),22 patients were grade 1,3 patients were grade 2,1 patient grade 3 and no patient was grade 4 and 5.50 patients without radiation pneumonitis were group B.There were significant difference between group A and group B for FEV1 before radiotherapy [(51.67±19.03) ％,(69.03± 14.54) ％,t =2.34,P ＜ 0.05].There were no significant difference between in 1 month and 3 months after radiotherapy for FVC (P ＞ 0.05).There was significant difference between in 1 month and 3 months after radiotherapy for DLCO (group A,P ＜ 0.01; group B,P ＜ 0.05).Conclusions For locally advanced non-small-cell lung cancer patients,the lower of FEV1 before radiotherapy inclineds to develop radiation pneumonitis,DLCO levels are lower significantly in patients prones to radiation pneumonitis.FEV1 and DLCO are sensitive indicators to predict radiation pneumonitis.
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The production of mature functional T cells requires many signals from the thymus such as Wnt,Notch and Hedgehog,et al.The Hedgehog protein family signals for development,patterning and organogenesis of many tissues during mammalian embryogenesis.In recent years,more and more research groups focus their attention on it because of its relationship between tumors.Abnormal differentiation and development of T cells may cause various immunological diseases and tumors.Illuminating the roles of Hedgehog signaling in T cell differentiation and development can provide a theoretical guide in the treatment of tumor.
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Objective To compare the dosimetric differences between pencil beam convolution (PBC) and anisotropic analytical algorithm (AAA) in Eclipse treatment planning system for intensitymodulated radiotherapy (IMRT) planning of lung cancer patients and dosimetric verification.Methods 10 IMRT plans of lung cancer patients were calculated using the PBC and AAA and the differences of dosimetric parameter were analyzed according to dose-volume histogram of planning target volume (PTV),lung and spinal cord.The verification measurements were performed on an inhomogeneous thorax phantom using a pinpoint ionization chamber.The agreement between calculated and measured doses was determined.The paired t test was used to compare the results.Results Compared with PBC,the AAA predicted higher maximum PTV dose (t =-4.03,P =0.010),lower minimum PTV dose (t =5.09,P =0.040),and a reduction of the volume of PTV covered by the prescribed dose.The AAA also predicted slightly increases than the PBC algorithm in the mean dose to the lung and the V20 as well as the maximum dose to the spinal cord,and the differences were statistically significant (t =-3.99,-2.79,-5.46,P =0.010,0.038,0.003).In the verification measurements,the agreement between the AAA and measurement was within 2％and superior to the PBC algorithm on isocenter (t =-3.82,P =0.012).Conclusions For IMRT treatment planning of lung cancer,the PBC algorithm overestimates the dose to the PTV and underestimates the dose to the lung and the spinal cord,so the AAA for treating planning in which the tissue inhomogeneous such as lung is present is recommended.
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Thymoma is a rare tumor with little evidence available to guide its treatment. A few systematic reviews of the literature have been performed in recent years and the following treatment recommendations have been developed. For early stage patients, complete resection of the entire thymus should be performed without post-operative chemotherapy and radiation therapy;however, for high-risk tumors, adjuvant radiation should be considered to reduce recurrence. For locally advanced patients, surgery combined with pre- or post-operative chemoradiotherapy are recommended.
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Objective:To compare the dosimetric differences of the planning target volume(PTV)and the organs at risk(OAR)for postoperative patients with cervical cancer on intensity-modulated radiotherapy(IMRT)and conventional 4 fields(4F)or 2 fields(2F)radiotherapy.Methods:Six postoperative patients with cervical cancer were chosen randomly.The next steps were CT scan,PTV and OAR contouring.The treatment protocols were designed into conventional 4F,2F and IMRT by TPS.Finally,the doso distribution and DVH were compared.Results:About the conformability of PTV,IMRT showed a significantly superior dose distribution over conventional 4F(P=0.015),and conventional 4F was superior to 2F(P=0.043).IMRT as compared with conventional 4F or 2F protocols,the received dose of the 50%volume of bladder was reduced by 25.8%and 27.5%,the rectum was reduced by 12%and 14.3%,the small intestine was reduced by 36.5%and 50%.But the differences of the femoral head(left & right)and the ilium have no statistical significance.Conclusion:in postoperative radiotherapy for cervical cancer,IMRT have Inore dosimetric advantages than conventional radiotherapy.
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Objective To investigate the detection of BJ-75A-9 mHNA, WNX and CK19 mRNA in peripheral blood cells of lung cancer patients and evaluate its diagnostic value. Methods The expression of BJ-TSA-9, LUNX and CK19 mRNA in peripheral blood cells was delected from 84 lung cancer patients, 32 benign lung lesions and 20 healthy volunteers by nested reverse transcription polymerase chain re-action (Nested-RT-PCR). Results The positive detection rates of BJ-75A-9,LUNX and CK19 mRNA in the peripheral blood of the pa-tients with lung cancer were 59.5%,40.4%and 22.6% respectively. In the 32 peripheral blood samples of the patients with benign lung le-sions,the positive detection rate of BJ-TSA-9,LUNX and CK19 mRNA were 9.3%, 12.5% and 6.3% respectively. No expression of BJ-TSA-9,LUNX and CK19 was detected in lhe samples of the healthy volunteers. The expression level of BJ-TSA-9, WNX and CKI9 mRNA in the peripheral blood of lung cancer stage IV patients was significantly higher than those of stages II and ID (P< 0.05). Conclusion RT-PCR amplification of BJ-TSA-9, LUNX and CK19 mRNA are an efficient way to detect early haematogenous dissemination of cancer cells for lung cancer patients. The detection of BJ-TSA-9 expression is sensitive and specific for lung cancer,and it is superior to both LUNX and CK19 mRNA. The expression of BJ-7SA-9 mRNA in peripheral blood might predict the hematogenous metastatic spreading of lung cancer cells.