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Neddylation,a novel post-translational modification of proteins, is overactivated in digestive system tumors and can be used as a potential anti-tumor molecular target. Targeting Neddylation pathway plays an anti-tumor role by inducing cell cycle arrest, apoptosis, senescence and autophagy of digestive system tumor cells, as well as enhancing the sensitivity of digestive system tumor cells to the radiotherapy and chemotherapy. Targeting Neddylation pathway and its inhibnitor MLN4924 can act as poential targets against digestive system tumors.
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Objective:To investigate the effect of radioactive 125I seed on angiogenesis of subcutaneously transplanted hepatocellular carcinoma in nude mice and underlying mechanism. Methods:The subcutaneous transplanted tumor model of human hepatocellular carcinoma Huh7 cells was established in nude mice. Twelve nude mice were randomly divided into observation group and control group with 6 mice in each group. The 125I seed with activity of 2.96×10 7Bq was implanted into the transplanted tumor of observation group and another with 0 Bq as control group, respectively. The volume of the transplanted tumor was measured every 4 d and the growth curve of the tumor was recorded. The microvessel density (MVD) of the transplanted tumor was evaluated by immunohistochemical detection of CD31. VEGF-A and HIF-1α protein and mRNA were detected by immunohistochemistry and RT-PCR, respectively. Results:The growth rate of tumor in the observation group was slower than that in the control group, and the difference of tumor volume between two groups at 12 d after 125I seed implantation was significantly different( t=3.167, P<0.05). At 28 d after transplantation, the tumor volumes of control and observation group approached to (963.61 ± 89.56) mm 3and (602.10±75.98) mm 3, respectively. The MVD of the observation group was significantly lower than that of the control group ( t=6.361, P<0.05). The relative expression of VEGF-A and HIF-1α mRNA in the observation group was significantly lower than that in the control group ( t=10.480, 6.414, P<0.05). Protein expression levels of VEGF-A and HIF-1α in the observation group were lower than those in the control group ( t=10.890, 12.250, P<0.05). Conclusions:Radioactive 125I seed can inhibit the growth of HCC xenografts by reducing tumor microvessels, which may be related to the decrease of VEGF-A and HIF-1α expression.
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Objective:To compare the differences in dosimetric parameters of target areas between 125I seed implantation with degradable catheters and by hand under the assistance of a real-time intraoperative treatment planning system (TPS). Methods:Forty-two simulated lesions were divided into a degradable catheter group and a free-hand group, with twenty-one lesions in each group. 125I seeds were implanted according to the TPS.The pre-plan and post-implant dosimetric parameters were collected, including the minimum dose ( Dmin), maximum dose ( Dmax), mean dose ( Dmean), conformal index (CI), external index (EI), homogeneity index (HI), minimum prescription dose delivered to 90% of the target volume ( D90), and the mean percentage of volume receiving 90% of the prescription doses ( V90). The Bland-Altman method was employed to analyze the consistency of pre-plan and post-implant dosimetric parameters and the Wilcoxon rank-sum test was used for the comparison of the two groups. Results:According to the Bland-Altman analysis, the dosimetric parameters of the two groups were all in agreement before and after seed implantation except for the Dmin and V90 of the free-hand group.Furthermore, the degradable catheter group had smaller error ranges of Dmax ( Z=-3.824, P<0.005), CI ( Z=-1.962, P<0.005), HI ( Z=-2.352, P<0.005), D90 ( Z=-2.453, P<0.005), and V90 ( Z=-3.159, P<0.005). Conclusions:The dosimetric parameters of 125I seed implantation with degradable catheters under the assistance of real-time TPS have good pre-plan and post-implant consistency and smaller error ranges.
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Objective@#To investigate the safety and efficacy of irreversible electroporation (IRE) hepatic ablation with high-frequency bipolar pulse in swine.@*Methods@#The experimental study was conducted. A total of 18 swines of either gender, aged (6.8+ 0.8)months with a range of 5.5-8.0 months, were collected from Animal Laboratory Center of Army Medical University. were randomly divided into 15 in experimental group and 3 in control group. The swines in experimental group underwent IRE hepatic ablation with high-frequency bipolar pulse, and 3 swines were chose randomly and underwent enhanced CT examination immediately after ablation, and at 3, 7, 14, and 28 days after ablation. The liver tissues were taken for histopathological examination. The swines in the control group underwent IRE hepatic ablation with high-frequency monopolar burst, and was performed enhanced CT examination at 3 days after ablation. Liver tissues were taken for histopathological examination. Observation indicators: (1) comparison of muscle contraction of siwnes between two groups; (2) imaging performance on enhanced CT after IRE ablation in the experimental group; (3) hepatic histopathological findings after IRE ablation in the experimental group; (4) comparison of apoptotic index in the ablation zone between two groups. The measurement data with normal distribution were expressed as Mean±SD, and comparison between groups was performed by the independent sample t test.@*Results@#(1) Comparison of muscle contraction between two groups: swines in both groups underwent ablation successfully. The degree of muscle contraction was (9.8±0.4)m/s2 and (48.6±0.5)m/s2 in the experimental group and in the control group, respectively, showing statistically significant difference between the two groups (t=-163.50, P<0.05). (2) Imaging performance on enhanced CT after IRE ablation in the experimental group: the enhanced CT examination of swines immediately after IRE ablation showed a low-density shadow and clear boundary in the ablation zone. There was no obvious abnormality in the ablation zone and its adjacent large vessels. No serious complications occurred after the ablation. The boundary between the ablation zone and the normal liver tissue of the experimental group gradually became blurred over time, and the ablation zone was gradually replaced by normal liver tissue. The ablation zone at the 28 days after ablation was significantly reduced or even disappeared on imaging of enhanced CT examination.The maximum diameter of the ablation zone was (1.81±0.17)cm immediately after ablation, (1.75±0.19)cm at the 3 days after ablation, (1.32±0.22)cm at the 7 days after ablation, (0.65±0.14)cm at the 14 days after ablation, (0.28±0.10)cm at the 28 days after ablation, respectively. (3) Hepatic histopathological findings after IRE ablation in the experimental group: the HE staining of ablated tissue immediately after ablation showed that the cells in the ablation zone were swollen, arranged disorderly, and bleeding was observed around some of the needles.The bile ducts and blood vessels were intact in the ablation zone, and a large number of deeply stained nuclei were seen at 3 days after ablation, some of the nucleus and apoptotic bodies were partially dissolved or cleaved. A large number of inflammatory cell were infiltrated around the ablation zone. Intact vascular and biliary endothelial cells were observed by von Willebrand factor staining, a larger number of apoptotic cells with deeply stained nuclei in the ablation zone were observed by terminal-deoxynucleoitidyl transferase mediated nick end labeling staining, and partial deposited dark brown calcium salt was seen by Von Kossa staining. More newborn hepatocytes were observed growing from the periphery of the ablation zone to the center at the 7, 14, 28 days after ablation. Smooth muscle cell proliferation was observed at 14 and 28 days after ablation. The ablation zone was replaced by new cells on 28 days after ablation. (4) Comparison of apoptotic index in the ablation zone between two groups: the apoptotic index of the ablation zone was significantly higher in the experimental group than in the control group on the 3 days after operation (76.67%±0.04% vs. 64.03%±0.05%, t=4.79, P<0.05).@*Conclusion@#IRE hepatic ablation of swine using high-frequency bipolar pulse is safe and reliable, and it has more apoptotic cells than IRE ablation with high-frequency monopolar burst.
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Objective To investigate the safety and efficacy of irreversible electroporation (IRE) hepatic ablation with high-frequency bipolar pulse in swine.Methods The experimental study was conducted.A total of 18 swines of either gender,aged (6.8+0.8)months with a range of 5.5-8.0 months,were collected from Animal Laboratory Center of Army Medical University.were randomly divided into 15 in experimental group and 3 in control group.The swines in experimental group underwent IRE hepatic ablation with high-frequency bipolar pulse,and 3 swines were chose randomly and underwent enhanced CT examination immediately after ablation,and at 3,7,14,and 28 days after ablation.The liver tissues were taken for histopathological examination.The swines in the control group underwent IRE hepatic ablation with high-frequency monopolar burst,and was performed enhanced CT examination at 3 days after ablation.Liver tissues were taken for histopathological examination.Observation indicators:(1) comparison of muscle contraction of siwnes between two groups;(2) imaging performance on enhanced CT after IRE ablation in the experimental group;(3) hepatic histopathological findings after IRE ablation in the experimental group;(4) comparison of apoptotic index in the ablation zone between two groups.The measurement data with normal distribution were expressed as Mean±SD,and comparison between groups was performed by the independent sample t test.Results (1) Comparison of muscle contraction between two groups:swines in both groups underwent ablation successfully.The degree of muscle contraction was (9.8±0.4)m/s2 and (48.6±0.5) m/s2 in the experimental group and in the control group,respectively,showing statistically significant difference between the two groups (t =-163.50,P＜0.05).(2) Imaging performance on enhanced CT after IRE ablation in the experimental group:the enhanced CT examination of swines immediately after IRE ablation showed a low-density shadow and clear boundary in the ablation zone.There was no obvious abnormality in the ablation zone and its adjacent large vessels.No serious complications occurred after the ablation.The boundary between the ablation zone and the normal liver tissue of the experimental group gradually became blurred over time,and the ablation zone was gradually replaced by normal liver tissue.The ablation zone at the 28 days after ablation was significantly reduced or even disappeared on imaging of enhanced CT examination.The maximum diameter of the ablation zone was (1.81±0.17) cm immediately after ablation,(1.75±0.19) cm at the 3 days after ablation,(1.32±0.22)cm at the 7 days after ablation,(0.65±0.14)cm at the 14 days after ablation,(0.28±0.10)cm at the 28 days after ablation,respectively.(3) Hepatic histopathological findings after IRE ablation in the experimental group:the HE staining of ablated tissue immediately after ablation showed that the cells in the ablation zone were swollen,arranged disorderly,and bleeding was observed around some of the needles.The bile ducts and blood vessels were intact in the ablation zone,and a large number of deeply stained nuclei were seen at 3 days after ablation,some of the nucleus and apoptotic bodies were partially dissolved or cleaved.A large number of inflammatory cell were infiltrated around the ablation zone.Intact vascular and biliary endothelial cells were observed by yon Willebrand factor staining,a larger number of apoptotic cells with deeply stained nuclei in the ablation zone were observed by terminal-deoxynucleoitidyl transferase mediated nick end labeling staining,and partial deposited dark brown calcium salt was seen by Von Kossa staining.More newborn hepatocytes were observed growing from the periphery of the ablation zone to the center at the 7,14,28 days after ablation.Smooth muscle cell proliferation was observed at 14 and 28 days after ablation.The ablation zone was replaced by new cells on 28 days after ablation.(4) Comparison of apoptotic index in the ablation zone between two groups:the apoptotic index of the ablation zone was significantly higher in the experimental group than in the control group on the 3 days after operation (76.67％±0.04％ vs.64.03％±0.05％,t=4.79,P＜0.05).Conclusion IRE hepatic ablation of swine using high-frequency bipolar pulse is safe and reliable,and it has more apoptotic cells than IRE ablation with high-frequency monopolar burst.
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Objective To investigate the CT findings of primary orbital lipid prolapse. Methods The CT data of 13 patients with primary orbital lipid prolapse in Jiaxing Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University from January 2012 to June 2018 were retrospectively analyzed. Results In all of the 13 cases of primary orbital lipid prolapse, there were 12 cases of bilateral orbital lipid prolapse and 1 case of unilateral orbital lipid prolapse. The CT images showed that the fat density masses in the posterior orbital septum were herniated from the outer quadrant of the orbit. The tumor was crescent shaped and connected with the orbital adipose tissue. The mass and the orbital adipose tissue were natural and homogeneous. Conclusions CT has distinctive imaging findings in the diagnosis of primary orbital lipid prolapse, and it is helpful for the diagnosis and differential diagnosis of this disease.
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Objective To investigate the CT and MRI finding of extrapleural solitary fibrous tumor (ESFT) to improve the preoperative diagnostic ability of such tumors. Methods The clinical data and CT/MRI finding of 11 ESFT patients confirmed by pathology from January 2007 to June 2018 in Jiaxing Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medicine University were retrospectively analyzed. CT scan was performed in 9 cases and MRI scan in 4 cases. Results Of the 11 patients with ESFT, 6 cases occurred in the abdominal cavity, 3 cases in the cavitas pelvis and 2 cases in the ocular region. All the tumors were solitary, and the maximum diameter of the lesion was (8.3 ± 4.2) cm. The boundary of the tumor was clear in 7 cases, and the boundary was not clear in 4 cases. The tumor form was circular or fusiform in 6 cases and lobulated in 5 cases (some tumors had notch sign). CT scanning presented isodensity or inhomogeneous low density, including 4 cases of cystic degeneration accompanied by inner grid separation, and 3 cases of patchy calcification. The enhanced scanning mass showed 6 cases of geographic enhancement and 7 cases of earthworm drilling soil. MRI T1WI showed slightly lower signal intensity; T2WI fat-suppression sequences showed slightly higher mixed signal intensity in 2 cases and an iso-to high mixed signal intensity in 2 cases; and DWI showed uneven high signal intensity in 3 cases. The solid part of the enhanced scanning showed'fast enhancement and slow washout'. Conclusions ESFT is usually manifested as isolated mass, and its CT and MRI finding has certain characteristics, especially in the diagnosis and differential diagnosis of the disease, such as geographic enhancement and earthworm drilling soil signs.
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Objective To compare the accuracy of 125I seeds longitudinal distance between groups by degradable catheters and hand.Methods The study was divided into two groups (implantation by degradable catheters and that by hand).There were 12 simulated lesions in each group.Seed needle and 125I seeds were implanted by three physicians according to the set longitudinal distance (0.5 and 1.0 cm).Postoperative CT was conducted and the longitudinal distance between seeds was measured,and then the data was analyzed between the actual distance and the designed distance in each group.Results The degree of deviation from the set distance were (0.184 ±0.047) and (0.127 ±0.051) cm in the group by hand,and (0.007 ± 0.006) and (-0.003 ± 0.006) cm in degradable catheters group.The degree of deviation of the seeds in the catheter group was significantly lower than the group by hand (t =3.804,2.499,P ＜0.05).Conclusions The accuracy of the longitudinal distance of the group by catheter is much better than that by hand.
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Objective To investigate the characteristics of multislice spiral CT in solitary pulmonary mucinous adenocarcinoma and its relationship with pathology. Methods The clinical data, CT characteristics and pathological features of 16 patients with solitary pulmonary mucinous adenocarcinoma confirmed by pathology from March 2010 to May 2018 were analyzed, and the number, distribution, size, shape, boundary, density, adjacent structure changes and intensifying performance were observed and compared with pathological results. Results The single lesion was distributed in the lung lobe in 16 cases, in the lower lobe in 13 cases, in the middle lobe in 1 case, and in the upper lobe in 2 cases, of which 12 cases were located under the pleura. There were 2 cases of central type and 14 cases of peripheral type. The longest diameter of tumor was 1.2- 3.0 cm, with an average of (2.1 ± 0.9) cm. Eleven lesions were round or approximately round, 5 lesions were irregular, 8 lesions had clear boundary, 6 lesions had irregular boundary and burr sign, 12 lesions had shallow or deep lobulation, 2 lesions had small vacuoles and 2 lesions had vascular aggregation. Multislice spiral CT plain scan showed that the density of lesions was lower than that of the same level muscle density. Enhanced scanning showed mild to moderate homogeneous or heterogeneous enhancement. Microscopic examination revealed that the cytoplasm of tumor cells contained large amounts of mucus and mucus was fluid. Most of the tumor cells were attached to the cell wall. Some of the tumor cells were floating in mucus and flowing with mucus. Conclusions If the tumor distribution and morphology is associated with the gravity factor, the enhanced scan is stripe like, and there is no invasion of the pleural, no pleural effusion and no metastasis when the tumor is large, and the solitary pulmonary mucinous adenocarcinoma should be highly suspected.
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BACKGROUND@#The preferred therapy for patients with pulmonary nodules which highly suspected as lung cancer by low-dose spiral computed tomography (CT) is surgery, but the best screening method of whole body is not clear yet. The aim of this study is to investigate the differences in the progression-free survival (PFS) of patients with Ia stage non-small cell lung cancer after screening of positron emission computed tomography (PET)-CT and conventional imaging (B-ultrasound/CT/MRI/ECT, BCME).@*METHODS@#A total of 300 cases of Ia stage non-small cell lung cancer were collected, of which 170 cases were performed PET-CT and 130 cases were performed BCME before operation. The basic characteristics of the two groups were analyzed by propensity score matching (PSM), and 114 cases of each group were included in the study. The survival analysis was carried out by the Kaplan-Meier survival curve and the Cox regression analysis.@*RESULTS@#There was no significant difference between each group analyzed by PSM. The PFS of PET-CT and BCME were (44.9±27.2) months and (44.1±33.1) months (χ2=1.284, P=0.257). Both of the method ssucceed in screening. It is not the PFS influence factors. The false positive of PET-CT and BCME were 10 cases and 8 cases (χ2=0.241, P=0.623).@*CONCLUSIONS@#Both PET-CT and BCME can be used as a screening method for Ia stage non-small cell lung cancer according to individualized choice of patients.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Carcinoma, Non-Small-Cell Lung , Diagnostic Imaging , Pathology , General Surgery , Disease-Free Survival , Early Detection of Cancer , Methods , Fluorodeoxyglucose F18 , Lung Neoplasms , Diagnostic Imaging , Pathology , General Surgery , Neoplasm Staging , Positron Emission Tomography Computed Tomography , Preoperative PeriodABSTRACT
Objective To investigate the diagnostic value of CT-guided percutaneous biopsy of peritoneum for unknown ascites.Methods The clinical data of 106 cases of unknown peritoneum in our hospital were collected retrospectively over the past five years (May 23,2011 to August 2,2016).The sensitivity and specificity of the percutaneous biopsy of peritoneum in diagnosis of the patients with unknown etiological ascites were evaluated.Complications were collected to evaluate the safety.Results The 106 patients with unknown ascites were performed with CT-guided percutaneous biopsy of peritoneum.The diagnoses of 91 patients were confirmed pathologically,accounted for 85.85％ of the total.Among the 91 patients,there were 60 cases (56.60％) of malignant and 31 cases (29.25％) of benign.The other 15 patients had no clinical diagnosis,which accounted for 14.15％ of the total.The diagnostic sensitivity and specificity was 88.35％ and 100％ respectively,which were significantly superior to cytological examination,biochemical markers and other routine analysis.No severe complications were observed in all patients.Conclusion CT-guided percutaneous biopsy of peritoneum for unknown ascites plays an important instructive role in diagnosis with high accuracy,and it is a safe and effective method.
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Objective To investigate the risk factors of pneumorrhagia and pneumothorax occurring after CT-guided cutting needle biopsy for pulmonary solid nodules.Methods The clinical data and imaging materials of 320 patients with pulmonary solid nodule (≤3 cm),who received 16 G semi-automatic cutting needle biopsy,were retrospectively analyzed.Both univariate and multivariate logistic regression analysis methods were used to evaluate the risk factors of pneumorrhagia and pneumothorax.Results The incidence of needle track hemorrhage was 33.1％ and the incidence of pneumothorax was 18.1％,the diagnostic accuracy for benign and malignant nodules was 99.6％.Needle track length was an independent risk factor for pneumorrhagia;every increase of 3 cm in needle track length,the risk of pneumorrhagia would increase 3.881 times,besides,the risk of pneumorrhagia had a parallel relationship with the time used for puncturing (P=0.061) as well as with the number of pleural puncturing (P=0.062).The age,lesion's location and needle-pleural angle were independent risk factors for pneumothorax.Each increase of 10 years in age,the risk of pneumothorax would increase 2.102 times.The pneumothorax risk of pulmonary lesion located at upper lung lobe was strikingly lower than that of pulmonary lesion located at lower lung lobe.Each increase of 20 degrees in needle-pleural angle,the risk of pneumothorax would increase 2.413 times.Emphysema was excluded from the equation because it had only a minute difference (P=0.086).Based on the pneumorrhagia and pneumothorax probability values,ROC curves of pneumorrhagia and pneumothorax were drawn,and AUC values of pneumorrhagia and pneumothorax were 0.753 and 0.725 respectively.Conclusion The occurrences of pneumorrhagia and pneumothorax after CT-guided cutting needle biopsy for pulmonary solid nodules are affected by many factors.Careful preoperative evaluation and skilled intraoperative manipulation can effectively reduce the incidence of pneumorrhagia and pneumothorax.