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Objective:To investigate the efficacy and safety of anlotinib in distant metastatic radioactive iodine-refractory differentiated thyroid cancer (RAIR-DTC).Methods:Retrospective analysis was performed on 17 patients with distant metastatic RAIR-DTC (6 males, 11 females, age: 57.0(45.5, 63.0) years) from Affiliated Hospital of Qingdao University between October 2018 and February 2023, including 13 patients receiving first-line treatment and 4 patients receiving second-line treatment with anlotinib. The changes of serum thyroglobulin (Tg) during the treatment of anlotinib, the changes of maximum diameter of the target lesion at the last follow-up compared with the diameter at baseline, the imaging efficacy, and treatment-related adverse events were analyzed. The serological and imaging effects of the first-line treatment group and the second-line treatment group were compared. The Fisher exact test was used to analyze the differences between groups.Results:The follow-up time of 17 patients was 17.3(9.5, 21.4) months, and the objective response rate (ORR) and disease control rate (DCR) were 7/17 and 16/17, respectively. There were no significant differences of ORR (6/13 vs 1/4; P=0.603) and DCR (13/13 vs 3/4; P=0.235) between the first-line and second-line treatment groups. The change rates of serum Tg at 3, 6 weeks and the last follow-up were -30.2%(-61.2%, -15.5%), -64.8%(-90.6%, -32.3%), and -85.8%(-96.1%, -50.7%), respectively. At the last follow-up, the change rate of maximum diameter of target lesions was -20.0%(-45.0%, -5.2%). The incidence of treatment-related adverse reactions was 14/17, and 2 patients (2/17) had grade 3 or above adverse reactions. Conclusion:Anlotinib shows superior efficacy with tolerable toxicity in the first-line treatment of distant metastatic RAIR-DTC, and hopefully plays an important role in second-line treatment for RAIR-DTC resistant to sorafenib.
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Objective To analyze the imaging characteristics of 18 F-fluorodeoxyglucose ( FDG) PET/ CT in patients with multiple myeloma (MM). Methods Sixty-eight patients (41 males, 27 females, age (61.5±17.2) years) with pathologically proven MM were retrospectively reviewed between January 2011 and August 2016. Imaging characteristics of 18 F-FDG PET/ CT in patients were analyzed. Maximum stand-ardized uptake value (SUVmax ), score of the bone involvement (bones of whole body were classified into 10 groups, and when 1 group was involved, the score was 1), the number of bone lesions and soft tissue swell-ing around bone lesions were investigated. Results A total of 1310 lesions were detected in 68 MM pa-tients. The SUVmax varied widely and mild metabolic activity (2.5≤SUVmax<5.0) was observed in the high-est proportion of MM patients (49.8％, 652/ 1310). The SUVmax of MM patients was 6.63±3.02. The score of bone involvement was 4.49±3.01. The number of bone lesions was 10.50(3.00, 33.00), and soft tissue swelling around bone lesions was observed in 22 patients. Conclusions There are special imaging charac-teristics of 18 F-FDG PET/ CT in MM patients, such as multiple osteolytic lesions with mild to moderate met-abolic activity, clear boundary and extensive bone involvement, and lesions usually limit to the skeletal sys-tem. The characteristics are of certain value in the diagnosis and differential diagnosis of MM.
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Objective To evaluate the diagnostic role of 18 F-fluorodeoxyglucose (FDG) PET/ CT in female patients with ascites of unknown origin by analyzing the characteristics of PET/ CT images. Meth?ods From April 2011 to December 2016, 117 female (average age: 58 years) with ascites of unknown ori-gin who underwent 18 F-FDG PET/ CT or whose ascites were found by PET/ CT were retrospectively analyzed. The causes of ascites, level of ascites metabolism in PET/ CT, diagnostic efficacy of PET/ CT for localizing primary tumor and metastasis were analyzed. Two-sample t test was used to analyze the data. Results The most common cause of female ascites was ovarian cancer, accounting for 35.0％(41/ 117). The mean stand-ardized uptake value (SUVmean ) of malignant ascites was higher than that of benign ascites (1.41±0.40 vs 0. 94±0.47; t= 3.92, P<0.05). The total detection rate of 18 F-FDG PET/ CT for primary or metastatic tumor in malignant ascites was 89.4％(93/ 104), and 75.6％(31/ 41) for malignant ascites originating from ovari-an cancer. For patients with ovarian cancer, 18 F-FDG PET/ CT clearly localized the primary tumors in 24. 4％(10/ 41) patients and metastasis in 51.2％(21/ 41) patients. Conclusions Ovarian cancer is the most common cause of female ascites. 18 F-FDG PET/ CT has a high diagnostic value for qualitative and etio-logical diagnosis for ascites of unknown origin in females.
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Objective:To investigate the effect and related mechanism of TRAP1 on the invasion and migration of human bladder cancer through TGF/Smad3 signal path.Methods: Selected from BIU-87 of high expression of TRAP1 in bladder cancer cell lines through Western blot techniques.TRAP1 knockdown lentivirus (LV3-TRAP1) was used to silence the expression of TRAP1.GFP fluorescene and PCR detector was used to detected the efficiency of gene silencing and the effectiveness of gene silencing;effect of TRAP1 on the invasion and migration ability of BIU-87 were detected by Transwell matrigel invasion assays and wound healing assays,CM-H2DCFDA fluorescent staining was used to deteced the cell ROS of BIU-87 with LV3-TRAP1.Detected the level of TGF/Smad3 signal protein by Western blot.Results: LV3-TRAP1 lentivirus could effectively inhibit the expression of TRAP1 compared with LV3-NC.LV3-TRAP1 lentivirus could effectively inhibit the cell RPS of BIU-87.Knockdown the expression of TRAP1 could inhibit the invasion and migration of BIU-87.Knockdown the expression of TRAP1 in BIU-87 could reduce the protein level of TGF/Smad3.Conclusion: Silencing TRAP1 could inhibit the invasion and migration of bladder cancer cell through TGF/Smad3 signal pathway.
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Objective To investigate the application of MSCT three-dimensional digital navigated biopsy in subcarinal lesions.Methods 82 patients were enrolled.Study subjects were randomly divided into control group and research group.Three-dimensional positioning and three-dimensional navigation needle biopsy were used in research groups, while CT cross-sectional image positioning with conventional puncture needle was used in control group.Puncture accuracy, one-time success rate of puncture, complications, diagnosis accuracy and operation time were compared between the two groups.Results Puncture success rate, definite diagnosis rate were 87.80%(36/41) and 97.56%(40/41) for the research group,and 60.97%(24/41) and 80.49% (33/41) for the control group, respectively,which on the research group were higher than that on the control group(χ2=8.945, 6.116;P<0.05).Complication rate and operating time were 14.63% (6/41) and (11.64±2.76) min for the research group, and 41.45% (17/41) and (22.22±6.31) min for the control group, respectively, which were lower on the research group than that on the control group (χ2=7.31,t=-11.70,P<0.05).Conclusion MSCT three-dimensional digital navigated biopsy technique could promote the efficiency of subcarinal space puncture biopsy significantly,which is a novel, convenient, precise and safe method.
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Objective To investigate the value of 18F-FDG PET/CT for differentiating multiple myeloma from bone metastases with undetermined origin.Methods A retrospective study was performed on patients with multiple bone destructions and without extraosseous primary malignant tumor in 18F-FDG PET/CT imaging.A total of 26 patients (12 males,average age 55.4 years) with multiple myeloma and 20 patients (9 males,average age 50.2 years) with multiple bone metastases confirmed by biopsy or histopathology from January 2011 to December 2013 were included into this study.The characteristics of 18F-FDG PET/CT and urine Bence-Jones protein were used to establish the diagnostic criteria.Myeloma was diagnosed if two or more of the following conditions could be satisfied:more than 10 bone lesions,osteolytic or mixed bone destruction,SUVmax＜4.0,and positive urine Bence-Jones protein.Two-sample t test and x2 test were used.Results The average number of bone lesions in multiple myeloma patients was 15.8,which was more than that (7.8) in patients with bone metastases.About 71.8％ (296/412) of bone lesions in multiple myeloma and 28.8％ (45/156) of bone metastases were osteolytic.The percentage of osteolytic lesions was significantly higher in multiple myeloma (x2=87.2,P＜0.05).The SUVmax of bone lesions of multiple myeloma and bone metastases were 3.81 ±2.17 and 5.82± 3.44 (t =8.29,P＜0.05) respectively.According to the diagnostic criteria,the sensitivity,specificity and accuracy of 18F-FDG PET/CT for the differentiation of myeloma from bone metastases were 88.5％ (23/26),85.0％ (17/20) and 87.0％ (40/46).Its diagnostic efficiency was higher than urine Bence-Jones protein (sensitivity:65.4％ (17/26);x2=3.90) and original 18 F-FDG PET/CT evaluation (specificity:10/18,accuracy:64.1％ (25/39);x2 =3.99,6.12) respectively (all P＜0.05).Conclusion Combining the evaluation of structural properties and metabolism on 18F-FDG PET/CT with urine Bence-Jones protein level may provide additional value for the differentiation of multiple myeloma from bone metastases with undetermined origin.
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Objective To explore the value of SUV in patients with ascites of unknown cause.Methods A total of 55 patients (24 males,31 females,average age 54.8 years,age range:23-82 years) with ascites of unknown cause who underwent 18F-FDG PET/CT scan were retrospectively enrolled in this study.SUVmax and SUVmean of ascites and liver were measured and their ratios (T/NT) were calculated and compared by two-sample t test.All patients were followed up and had final diagnoses.Sensitivity,specifici ty,accuracy,positive predictive value and negative predictive value were calculated respectively.The diagnostic efficiency was compared among 18F-FDG PET/CT tumor localization alone,ascites radioactivity and ascites cytology examination by x2 test or Fisher exact test.Results Besides the high metabolized primary lesions and/or metastasis,the liver and spleen swamped by ascites with high radioactivity were visualized on MIP images.The SUVmax and SUVmean of malignant ascites were 1.78±0.65 and 1.37±0.38 respectively,which were higher than those of benign ascites (1.11±0.36 and 0.72±0.22; t=4.13,6.82,both P＜0.05).T/NT of malignant ascites was higher than that of benign ascites (SUVmax:0.64±0.20 vs 0.48±0.12,t =3.27,SUVmeax:0.68±0.17 vs 0.38±0.10,t =7.21 ; both P＜0.05).The diagnostic sensitivity,specificity and accuracy of SUV in ascites were 75.0％ (27/36),94.7％ (18/19) and 81.8％ (45/55),respectively.The sensitivity and accuracy of SUV were higher than those of cytological examination (44.4％ (16/36) and 63.6％ (35/55) ; x2 =6.98,4.58,both P＜0.05).The specificity of SUV was higher than that of tumor localization by 18F-FDG PET/CT (63.2％,12/19; x2 =5.70,P＜0.05).Conclusion Significantly higher SUVmax and SUV in malignant ascites than benign ascites were noted,which might play an adjuvant role in patients with ascites of unknown cause.
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Objective To investigate the relationship between tumor location and the risk of developing bladder cancer in pafients treated by nephroureterectomy(NU)for upper urinary tract transitional cell carcinoma(UUT-TCC).Methods The clinical data of 168 UUT-TCC patients who underwent NU were reviewed.Univariate and multivariate analysis were carried out to determine the risk factors for intravesical recurrence after NU.Results The recurrence-free survival rate at 1,3 and 5 years after NU were 88%, 76%and 63%.All patients were followed up for a median period of 45(12-107)months During this period, a total of 49 patients developed bladder tamors after surgery,of which 28 cases were renal pelvic carcinoma, 2 cases were rniddle ureter carcinoma and 19 cases were distal ureter carcinoma.The recurrence-free survival of renal pelvic carcinoma and ureter carcinoma had no significant difference by Log-Rank test(P>0.05).On multivariate analysis,only locating in distal ureter carcinoma was the independent risk predictor for intravesical recurrence after NU (P<0.01).Conclusion Pafients with UUT-TCC at distal ureter carry a higher risk for intraeesieal recunerrce after NU than those with TCC at other location of upper urinary tract.
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Objective To determine the main CT features and the key points of differential diagnosis of multilocular cystic renal cell carcinoma (MCRCC) classified according to 2004 WHO pathological diagnostic criteria. Methods According to the criteria, 40 patients were divided into two groups: MCRCC group and other subtypes of cystic renal cell carcinoma (CRCC). The CT findings were evaluated and compared between two groups for cystic content, wall, septum, nodularity, calcification and enhancement. ROC curve was used to determine the cut-off value of the possible CT feature which could distinguish MCRCC from other subtypes of CRCC. Results Seventeen cases of MCRCC group and 23 cases of CRCC group were included in this study according to the diagnostic criteria. MCRCC appeared as a well defined multilocular cystic mass with thin wall and sepia and no expansile solid nodules. Thickness of cystic wall and/or septum is was main CT findings to distinguish MCRCC from other subtypes of CRCC (P ＜ 0.01 ). The cut-off value of the thickness was 6 mm and its sensibility, specificity was 89% ,75% respectively. Conclusion Cystic wall and/or septum with a thickness of less than 6 mm are the main CT findings to dis tinguish MCRCC from other subtypes of CRCC.
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Objective To Validate the prognostic significance of the European Organization for Research and Treatment of Cancer (EORTC) risk tables in Chinese patients with non-muscle invasive bladder cancer (NMIBC). Methods According to the scoring standard of the EORTC system, 225 NMIBC patients were reviewed and divided into 3 groups: low, intermediate and high risk groups for recurrence and progression respectively. The probabilities of recurrence and progression at 1 year and 5 year for each group were calculated using life-table analysis and then compared with the EORTC risk tables. Log-Rank test and multivariable analysis were used to analyze the possible differences between risk groups and to find independent prognostic factors. Results For low (n= 32, 25), intermediate (n=109, 128) and high (n=84, 72) risk groups, the probabilities of recurrence and progression at 1 year were 15. 1%, 31.2%, 55.5% and 0. 3%, 2. 0%, 15.5% respectively. The probabilities at 5 year were 28. 2%, 55.2%, 75.0% and 1.4%, 12.9%, 54. 7%. All the results were similar to that of EORTC tables except the probability of progression at 5 year for the high progression risk group.The differences between different risk groups were significant (P＜0.01). In a multivariable analysis for recurrence and progression, the EORTC scores had independent significance (P＜0.01). Conclusions EORTC risk tables could stratify NMIBC patients effectively according to the risk of recurrence and progression. It could be a useful tool for Chinese urologists.
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Objective:To investigate the changes of lung lymphocytes in OVA induced murine asthma model,and study the involvement of NK cells in this process.Methods:C57BL/6J(B6) mice were induced to develop asthma by intrapenitoneal injection of OVA with alum as adjuvant, and then inhalation of nebulized OVA. After collecting serum and Bronchoalveolar Lavage Fluid(BALF),IL-4 level was determined by ELISA. The kinetics of pulmonary lymphocyte recruitment and cytokine release were detected by flow cytometry.Results:IL-4 expression increased in BALF after OVA nebulization, while there was no significant difference in serum. IFN-?,IL-4+NK cells accumulation in lung parenchymal tissues,and exhibited an evident NK2 shift in mice with asthma.Conclusion:NK cell involved in OVA-induced mouse asthma and NK2 shift accompany with Th2, indicating that NK2 played an important role in this process.
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Objective To discuss the diagnostic value of multi-slice spiral CT 2D and 3D reconstruction for atlantoaxial occult fracture.Methods Multi-slice spiral CT scans were performed in 38 patients who were suspected of fracture but were not detected with radiography,and the images were post-processed with Vitrea workstation(including MPR,MIP,VR and SSD).The images were observed by two experienced radiologists.Results Of 38 cases,28 cases were detected having small fractures with spiral CT reconstruction.Conclusion Multi-slice spiral CT 2D and 3D reconstructions are of important value in diagnosing atlantoaxial occult fracture.
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Objective: To explore whether high epidural blockade(HEB) can lower the elevated serum free fatty acids(FFA) level in the patients with acute myocardial infarction(AMI). Method:In 7 patients with AMI,HEB at T 15 was performed by injecting 5 to 7ml of 0.5%-0.75% lidocaine every 2 to 4 hours for 7 successive days;while the other 7 patients with AMI didn't use HEB as control. only morphine or dolantine was used for relieving angina cordis. Result: The elevated FFA level returned to normal range in 12 hours following HEB in the study group, but in one week in the control group. Conclusion:HEB(T1-5) can lower the elevated FFA level in AMI patients to normal within12 hours.