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Objective:To investigate the histopathological morphology, immunophenotype, molecular pathological features, clinical prognosis and treatment of monomorphic epithelial intestinal T-cell lymphoma (MEITL).Methods:The clinicopathological data of 5 patients with MEITL in Sichuan Jinyu Medical Laboratory Center Co., Ltd from March 2019 to February 2021 were retrospectively analyzed, and literatures were reviewed. All cases were tested by using histopathology, immunohistochemistry, in situ hybridization of Epstein-Barr virus (EBV) and T-cell clonability assessment, and 1 case had second-generation sequencing (NGS) test. Clinical follow-up was performed in 2 patients.Results:All 5 MEITL cases were middle-aged and old men. The histopathology showed that intestinal wall was diffuse with tumor cells infiltrating, and the cells were obviously epitheliophilic. All the tumor cells CD3, CD8, CD56, GrB were positively expressed, and expressions of other T-cell markers were different, among which 1 case had CD30 positive and 1 case had CD20 positive. All 5 cases were negative for EBV by in situ hybridization. Monoclonal rearrangement of T-cell receptor gene was detected in all 5 cases. Mutations of BCOR, JAK3, STAT5B and ATM were detected in 1 case by using NGS. Among 2 cases followed-up, 1 patient relapsed 7 months after he had the initial onset and underwent the first operation, and then he had another operation. This patient finally died of extensive metastasis in the lung, liver and abdominal cavity as well as ascites 13 months later; another patient died 1 month after emergency surgery for perforation.Conclusions:MEITL is a rare primary T-cell lymphoma of the digestive tract. The oncogenic event in the pathogenesis of MEITL mainly involves mutations in the tumor suppressor gene SETD2 and mutations in one or more genes of the JAK/STAT pathway. Currently, there is no standard treatment for MEITL. Most treatment options include surgical resection and anthracycline-based chemotherapy.
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Objective:To explore the correlation between enhanced CT quantitative parameters and malignant biological behavior and prognosis of colon cancer.Methods:From February 2017 to October 2019, 100 patients with colon cancer in Anhui Wanbei Coal-Electrivity Group Gernal Hospital were selected as the research subjects, and all performed enhanced CT examination. The serum tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) levels were detected. According the mean value of CEA, CA19-9, the patients were divided into different group, and CEA< 28.36 pmol/L was considered to below level, ≥ 28.36 pmol/L was high; CA19-9<40.26 pmol/L was considered to below level, ≥ 40.26 pmol/L was high. The quantitative parameters of enhanced CT in patients with colon cancer with different serum CEA and CA19-9 levels and different pathological indicators (CT scan value, enhanced value, degree of enhancement) were compared. The correlation between serum tumor marker levels, malignant biological behavior of colon cancer and quantitative parameters of enhanced CT were explored. After 12-months′ followed-up, the clinical data of patients with different prognosis and enhanced CT parameters were counted. The factors affecting the prognosis of colon cancer patients and the predictive value of enhanced CT quantitative parameters on the prognosis of patients were explored.Results:The CT scan value, enhancement value and enhancement degree of colon cancer patients with low levels of serum CEA and CA19-9 were lower than those with high levels: (30.16 ± 5.14) HU vs. (38.51 ± 5.72) HU, (55.74 ± 8.12)HU vs. (78.62 ± 8.97) HU, (25.58 ± 3.60) HU vs. (40.11 ± 3.14) HU, the differences were statistically significant ( P<0.05). There was a positive correlation between serum CEA and CA19-9 levels in patients with colon cancer and CT scan value, enhancement value, and degree of enhancement ( P<0.05). The CT enhancement value and enhancement degree of colon cancer patients were related to Dukes staging, differentiation degree, lymph node metastasis and lymphatic infiltration in colon cancer patients. The CT scan value was related to Dukes staging, lymph node metastasis and lymphatic infiltration of colon cancer patients ( P<0.05). The risk factors for death of colon cancer patients included age, Dukes staging, degree of differentiation, lymph node metastasis, lymphatic invasion, CT scan value, enhancement value, and degree of enhancement ( P<0.05). The area under the curve (AUC) of CT scan value, enhancement value, and enhancement degree combined to predict the prognosis of colon cancer patients was 0.873, which was greater than the single prediction of each parameter. The best sensitivity and specificity of combined prediction were 76.92% and 88.37%, respectively. Conclusions:There is a certain correlation between the enhanced CT quantitative parameters and the malignant biological behavior of patients with colon cancer. The increased detection value is risk factor for the prognosis.
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Acute kidney injury and acute respiratory distress syndrome are the most common organ failure in intensive care unit with high mortality.Both lung and kidney are involved in maintaining acid-base balance in the body, and both organs contain a large vascular network, which is the primary target organ for distant organ effects in the failure of each other.This article reviewed the possible pathogenesis of lung-kidney cross-talk in renal injury or acute respiratory distress syndrome, in order to deepen the understanding of both diseases and improve the prognosis.
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AIM:To investigate radiosensitization effect of apatinib, a vascular endothelial growth factor (VEGF) receptor2 tyrosine kinase inhibitor, on human gastric carcinoma cell line SGC-7901 and its mechanism.METHODS:SGC-7901 cells were divided into control group, apatinib group, radiotherapy group and combination group.The cell viability was measured by CCK-8 assay.The changes of cell apoptosis and cell cycle were analyzed by flow cytometry.The protein levels of cell apoptosis biomarkers, such as PARP, cleaved caspase-9, cleaved caspase-3 and Bcl-2, and cell proliferation biomarkers, p-PLCγ1 and p-ERK1/2, were detected by Western blot.γ-H2AX expression was detected by immunofluorescence.RESULTS:Compared with apatinib group and radiation group, the cell viability was inhibited after treatment with both apatinib and X-ray (P<0.01).The protein levels of cell proliferation markers p-PLCγ1 and p-ERK1/2 were down-regulated.The cell apoptosis was enhanced (P<0.01).The protein levels of cell apoptosis makers such as PARP, cleaved caspase-9 and cleaved caspase-3 were up-regulated, while Bcl-2 was down-regulated.The disappearance of γ-H2AX foci in the nucleus was delayed, indicating that apatinib impaired the repair of radiation-induced DNA double-strand breaks.The proportion of G2 phase was significantly increased (P<0.01).The combination treatment had more significant effect on SGC-7901 cells than treating with apatinib or radiotherapy alone.CONCLUSION:Apatinib increases the radiosensitivity of gastric cancer cells via blocking VEGF pathway.
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Objective To further clarify the pathogenesis of different types of Kaposi′s sarcoma (KS) by measuring the protein expressions of caspase-3 and E-cad in tumor tissues of Xinjiang Uygur patients with acqured immunodeficiency syndrome (AIDS)-Kaposi′s sarcoma (KS) and classical KS.Methods From July 2011 to October 2014, 38 patients with KS at the First Affiliated Hospital of Xinjiang Medical University and Urumqi Infectious Disease Hospital were enrolled, among whom 28 were male and 10 were female, and all of them were uygur.Immunohistochemical and Western blot methods were used to detect the expressions of caspase-3 and E-cad proteins in 22 cases of AIDS-KS patients and 16 cases of classic KS.The quantitative data of normal distribution were analyzed by t test, while count data were compared with χ2 test with R × C table.Results KS lesions in patients with classic KS were confined to the skin, without mucosal, lymph node or visceral involvement.Lesions in AIDS-KS patients were not only confined to the skin and superficial lymph nodes, but also oral mucosa involved in 12 cases and internal organs involved in 7 cases.Liver and lung involvement was more common.The CD4+T lymphocyte count in patients with AIDS-KS was (200.8±166)/μL.All 15 AIDS cases with CD4+ T cell count less than 200/μL developed opportunistic infections.CD4+ T lymphocyte count of patients with classic KS was (562.52±222.66)/μL and the 16 patients with CD4+T lymphocyte count greater than 350/μL had no opportunistic infections.The results of immunohistochemistry showed that the positive expression rate of caspase-3 protein in KS tissues in patients with AIDS-KS was 68.2%, in patients with classic KS was 100.0%, with significant difference between two groups (χ2=7.37, P=0.01).The positive expression rate of E-cad protein in KS tissues in patients with AIDS-KS was 72.7%, in patients with classic KS was 100.0%, with significant difference between two groups (χ2=5.18, P=0.03).Western blotting showed that the gray value of caspase-3 in the KS tissue of patients with AIDS-KS was 0.55±0.36, and that in patients with classic KS was 0.86±0.56, with significant difference between two groups (t=-2.070, P<0.05).The gray value of E-cad in the KS tissue of patients with AIDS-KS was 0.54±0.41, and that in patients with classic KS was 0.85±0.45, with significant difference between two groups (t=-2.060,P<0.05).Conclusions There are differences in the protein expressions of caspase-3 and E-cad in tumor tissues of patients with AIDS-KS and classical KS in Xinjiang Uygur patients with Kaposi's sarcoma, which may correlate with a faster progression and a higher mortality rate for AIDS-KS.