ABSTRACT
Background: Conventional magnetic resonance imaging (MRI) does not accurately evaluate lymph node (LN) status, which is essential for the treatment and prognosis assessment in patients with rectal cancer. Objective: The aim of this study is to evaluate the diagnostic value of intravoxel incoherent motion (IVIM) MRI in differentiating metastatic and nonmetastatic mesorectal LNs with different short-axis diameters in rectal cancer patients. Materials and Methods: Forty patients (154 LNs) were divided into three groups based on short-axis diameter: 3 mm ≤ × ≤5 mm, 5 mm < × ≤7 mm, and × >7 mm. MRI characteristics and IVIM parameters were compared between the metastatic and nonmetastatic LNs to determine the diagnostic value for discriminating them. Results: In the 3 mm ≤ × ≤ 5 mm group, mean D values were significantly lower in metastatic than in the nonmetastatic LNs (P < 0.001). In the 5 mm < × ≤7 mm group, mean f values were significantly lower in metastatic than nonmetastatic LNs (P < 0.05). In the × >7 mm group, only the short-axis diameter of metastatic LNs was significantly greater than that of nonmetastatic LNs (P < 0.05). The area under the curve, sensitivity, specificity, and cutoff values were used for differentiating the metastatic from the nonmetastatic LNs. Conclusion: IVIM parameters can differentiate metastatic from nonmetastatic LNs with smaller short-axis diameters (× ≤7 mm) in rectal cancer, and the short-axis diameter is a significant factor in identifying metastatic and nonmetastatic LNs in larger short-axis diameter groups (× >7 mm).
ABSTRACT
@# Objective: The present study was aimed to explore the role and distinctive mechanism of SPIDR, the key regulatory protein of homologous recombination pathway, in progression of small cell lung cancer (SCLC). Methods: 60 SCLC specimens and 44 normal lung tissues were collected from the patients undergoing tumor resection and bronchoscopic puncture in Shanghai Pulmonary Hospital Affiliated to Tongji University from January 2013 to January 2015. The expression of SPIDR in clinical samples and NCIH446 (SCLC cell line) and MRC-5 (normal cell line) were assayed by Real-time PCR. The role of SPIDR in SCLC was investigated in vivo and in vitro by the expression of SPIDR were artificially modified in NCI-H446. Results: Smoking was significantly associated with the occurrence of SCLC (P<0.01). The expression of SPIDR mRNAin SCLC tissues was lower than that of normal lung tissues (P <0.01), and the SPIDR transcriptional and translational levels of NCI-H446 cells were also lower than that of MRC-5.Although there is no significant changes of cell growth rate and susceptibility to cisplatin and etoposide in the NCI-H446 cells overexpressing SPIDR. However, the volume of xenograft tumors of overexpressed SPIDR group decreased by 58.99% (P<0.01) and 61.84% (P<0.01) than that of the original NCI-H446 cells and the NCI-H446 cells transfected with vector (pMSCV) and the average tumor mass decreased by 61.70% (P<0.01) and 70.25% (P<0.01) respectively. When the fetal bovine serum content in the medium was reduced to 3%, the growth rate of NCI-H446 cells overexpressing SPIDR was 22.33% (P<0.01) and 20.24% (P<0.05) lower than that of the original NCIH446 cells and control group, the similar results were obtained from the 1% serum concentration experiment as well. Conclusion: The expression of SPIDR, the key regulatory protein in the DNAdouble strand break homologous recombination repair pathway, was significantly suppressed in SCLC tissues, which markedly accelerated the growth of NCI-H446 cells in vivo and reduced the reliance of NCIH446 cells to the serum. The detailed mechanism is worthy of further investigation.
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@#Objective To investigate the clinical efficacy of video-assisted thoracoscopic surgery (VATS) and pleurodesis for spontaneous pneumothorax. Methods A retrospective analysis of 157 patients with spontaneous pneumothorax undergoing VATS from January 2012 to March 2016 in our hospital was done. According to different treatments, patients were divided into two groups: a group A (65 patients receving pleurodesis, 52 males and 13 females with a mean age of 34.77 years ranging from 17 to 73 years) and a group B (92 patients without pleurodesis, 76 males and 16 females with a mean age of 34.66 years ranging from 16 to 72 years). In the group A 29 patients underwent closed thoracic drainage; while in the group B there were 39 patients. Results The patients were followed up for 3 months to 4 years. The recurrence rate of the group A was lower than that of the group B, but the difference was not statistically significant. For patients receving closed thoracic drainage preoperatively, intraoperative drainage volume at postoperative 24 h in the group A was more than that of the group B, but postoperative hospital stay was less than that of the group B (P<0.05). For patients not receving closed thoracic drainage preoperatively, drainage volume at postoperative 24 h, total drainage volume, postoperative hospital stay in the group A were more than those of the group B (P<0.05). Conclusion Pleurodesis can not reduce the recurrence rate of spontaneous pneumothorax. Preoperative closed thoracic drainage combined with intraoperative pleurodesis can effectively reduce postoperative hospitalization; therefore pleurodesis is recommended. If preoperative closed thoracic drainage is not adopted, surgery without pleurodesis can effectively reduce thoracic drainage at postoperative 24 h, total drainage volume and hospital stay and the perioperative results are better; therefore mechanical pleurodesis is not recommended.