Benign cervical schwannoma with tracheal invasion

ABSTRACT Schwannomas commonly develop in the cervical region, 25% - 45% of cases are diagnosed in this anatomical region. Tracheal neurogenic tumors are exceedingly rare and can be misdiagnosed as invasive thyroid carcinomas or other infiltrating malignancies when present at the level of the thyroid gland. Here, we present a case of synchronous benign cervical schwannoma with tracheal invasion and papillary thyroid carcinoma in a patient who was initially hospitalized for COVID-19. The patient presented with dyspnea that was later found to be caused by tracheal extension of a cervical tumor. Surgical excision was performed, and the surgical team proceeded with segmental tracheal resection, removal of the cervical mass, and total thyroidectomy. The specimen was sent for pathological analysis, which revealed synchronous findings of a benign cervical schwannoma with tracheal invasion and papillary thyroid carcinoma. The literature on this subject, together with the present case report, suggests that neurogenic tumors should be included in the differential diagnosis of obstructing tracheal cervical masses. Surgical excision is the first-line of treatment for benign cervical schwannomas.

Invasiveness assessment by CT quantitative and qualitative features of lung cancers manifesting ground-glass nodules in 555 patients: A retrospective cohort study / 中国胸心血管外科临床杂志

@#Objective     To explore the correlation between the quantitative and qualitative features of CT images and the invasiveness of pulmonary ground-glass nodules, providing reference value for preoperative planning of patients with ground-glass nodules. Methods    The patients with ground-glass nodules who underwent surgical treatment and were diagnosed with pulmonary adenocarcinoma from September 2020 to July 2022 at the Third Affiliated Hospital of Kunming Medical University were collected. Based on the pathological diagnosis results, they were divided into two groups: a non-invasive adenocarcinoma group with in situ and minimally invasive adenocarcinoma, and an invasive adenocarcinoma group. Imaging features were collected, and a univariate logistic regression analysis was conducted on the clinical and imaging data of the patients. Variables with statistical difference were selected for multivariate logistic regression analysis to establish a predictive model of invasive adenocarcinoma based on independent risk factors. Finally, the sensitivity and specificity were calculated based on the Youden index. Results     A total of 555 patients were collected. The were 310 patients in the non-invasive adenocarcinoma group, including 235 females and 75 males, with a meadian age of 49 (43, 58) years, and 245 patients in the invasive adenocarcinoma group, including 163 females and 82 males, with a meadian age of 53 (46, 61) years. The binary logistic regression analysis showed that the maximum diameter (OR=4.707, 95%CI 2.060 to 10.758), consolidation/tumor ratio (CTR, OR=1.027, 95%CI 1.011 to 1.043), maximum CT value (OR=1.025, 95%CI 1.004 to 1.047), mean CT value (OR=1.035, 95%CI 1.008 to 1.063), spiculation sign (OR=2.055, 95%CI 1.148 to 3.679), and vascular convergence sign (OR=2.508, 95%CI 1.345 to 4.676) were independent risk factors for the occurrence of invasive adenocarcinoma (P<0.05). Based on the independent predictive factors, a predictive model of invasive adenocarcinoma was constructed. The formula for the model prediction was: Logit(P)=–1.293+1.549×maximum diameter of lesion+0.026×CTR+0.025×maximum CT value+0.034×mean CT value+0.72×spiculation sign+0.919×vascular convergence sign. The area under the receiver operating characteristic curve of the model was 0.910 (95%CI 0.885 to 0.934), indicating that the model had good discrimination ability. The calibration curve showed that the predictive model had good calibration, and the decision analysis curve showed that the model had good clinical utility. Conclusion     The predictive model combining quantitative and qualitative features of CT has a good predictive ability for the invasiveness of ground-glass nodules. Its predictive performance is higher than any single indicator.

Research progress in the pathogenesis of extramedullary disease in multiple myeloma / 国际肿瘤学杂志

Multiple myeloma (MM) lesions are mostly localized in the marrow. Extramedullary disease in multiple myeloma (MM-EMD) is defined as malignant plasma cell infiltration away from the bone marrow or adjacent soft tissue, may occur at the initial diagnosis or during the consultation. MM-EMD may be found at initial diagnosis or during the treatment. MM-EMD has high invasiveness and poor prognosis, with clinical behavior distinct from marrow-restricted myeloma. However, its pathogenesis has not been elucidated. In general, the obstructed homing of myeloma cells, enhanced invasiveness, the degradation of extracellular matrix, and increased angiogenesis capacity may be involved in the occurrence of MM-EMD. Tumor genetic abnormalities and changes in the bone marrow microenvironment play important roles in the above pathogenesis.

Establishment and validation of a model for predicting infiltration of pulmonary subsolid nodules by circulating tumor cells combined with imaging features / 中国胸心血管外科临床杂志

@#Objective     To evaluate the clinical radiological features combined with circulating tumor cells (CTCs) in the diagnosis of invasiveness evaluation of subsolid nodules in lung cancers. Methods     Clinical data of 296 patients from the First Hospital of Lanzhou University between February 2019 and February 2021 were retrospectively included. There were 130 males and 166 females with a median age of 62.00 years. Patients were randomly divided into a training set and an internal validation set with a ratio of 3 : 1 by random number table method. The patients were divided into two groups: a preinvasive lesion group (atypical adenomatoid hyperplasia and adenocarcinoma in situ) and an invasive lesion group (microinvasive adenocarcinoma and invasive adenocarcinoma). Independent risk factors were selected by regression analysis of training set and a Nomogram prediction model was constructed. The accuracy and consistency of the model were verified by the receiver operating characteristic curve and calibration curve respectively. Subgroup analysis was conducted on nodules with different diameters to further verify the performance of the model. Specific performance metrics, including sensitivity, specificity, positive predictive value, negative predictive value and accuracy at the threshold were calculated. Results     Independent risk factors selected by regression analysis for subsolid nodules were age, CTCs level, nodular nature, lobulation and spiculation. The Nomogram prediction mode provided an area under the curve (AUC) of 0.914 (0.872, 0.956), outperforming clinical radiological features model AUC [0.856 (0.794, 0.917), P=0.003] and CTCs AUC [0.750 (0.675, 0.825), P=0.001] in training set. C-index was 0.914, 0.894 and corrected C-index was 0.902, 0.843 in training set and internal validation set, respectively. The AUC of the prediction model in training set was 0.902 (0.848, 0.955), 0.913 (0.860, 0.966) and 0.873 (0.730, 1.000) for nodule diameter of 5-20 mm, 10-20 mm and 21-30 mm, respectively. Conclusion     The prediction model in this study has better diagnostic value, and is more effective in clinical diagnosis of diseases.

Chinese expert consensus on multidisciplinary minimally invasive diagnosis and treatment of pulmonary nodules / 中国胸心血管外科临床杂志

@#With the widespread application of high-resolution and low-dose computed tomography (CT), especially the increasing number of people participating in lung cancer screening projects or health examinations, the detection of pulmonary nodules is increasing. At present, the relevant guidelines for pulmonary nodules focus on how to follow up and diagnose, but the treatment is vague. And the guidelines of European and American countries are not suitable for East Asia. In order to standardize the diagnosis and treatment of pulmonary nodules and address the issue of disconnection between existing guidelines and clinical practice, the Lung Cancer Medical Education Committee of the Chinese Medicine Education Association has organized domestic multidisciplinary experts, based on literature published by experts from East Asia, and referring to international guidelines or consensus, the "Chinese expert consensus on multi-disciplinary minimally invasive diagnosis and treatment of plmonary nodules" has been formed through repeated consultations and thorough discussions. The main content includes epidemiology, natural course, malignancy probability, follow-up strategies, imaging diagnosis, pathological biopsy, surgical resection, thermal ablation, and postoperative management of pulmonary nodules.

Clinical outcomes of minimally invasive coronary artery bypass grafting in 239 patients: A propensity score matching study / 中国胸心血管外科临床杂志

@#Objective     To investigate the perioperative clinical effects and follow-up results of minimally invasive coronary artery bypass grafting (MICS CABG) versus conventional coronary artery bypass grafting (CABG) in thoracotomy. Methods     The patients who received off-pump CABG in Beijing Anzhen Hospital from January 2017 to October 2021 were collected. Among them, the patients receiving MICS CABG performed by the same surgeon were divided into a minimally invasive group, and the patients receiving median thoracotomy were into a conventional group. By propensity score matching, preoperative data were balanced. Perioperative and postoperative follow-up data of the two groups were compared. Results     A total of 890 patients were collected. There were 211 males and 28 females, aged 60.54±9.40 years in the minimally invasive group, and 487 males and 164 females, aged 62.31±8.64 years in the conventional group. After propensity score matching, there were 239 patients in each group. Compared with the conventional group, patients in the minimally invasive group had longer operation time, shorter drainage duration, less drainage volume on the first postoperative day, shorter postoperative hospital stay, and lower rate of positive inotropenic drugs use, while there was no statistical difference in the mean number of bypass grafts, ICU stay, ventilator-assisted time, blood transfusion rate or perioperative complications (P>0.05). During the median follow-up of 2.25 years, there was no statistical difference in major adverse cardiovascular and cerebrovascular events, including all-cause death, stroke or revascularization between the two groups (P>0.05). Conclusion    Reasonable clinical strategies can ensure perioperative and mid-term surgical outcomes of MICS CABG not inferior to conventional CABG. In addition, MICS CABG has the advantages in terms of postoperative hospital stay, postoperative drainage volume, and rate of positive inotropic drugs use.

miRNA-3653-3p reduces the proliferation and invasion ability of endometrial cancer cells by inhibiting PLAC8-Wnt-β-catenin signaling pathway / 肿瘤研究与临床

Objective:To investigate the effect of miRNA-3653-3p (miR-3653-3p) on the proliferation and invasion ability of endometrial cancer cells and its related mechanisms.Methods:The data of 356 endometrial cancer patients were downloaded from the OncoLnc database (http://www.oncolnc.org, updated version 2020), and the Kaplan-Meier method was used to analyze the relationship between the expression level of miR-3653-3p and the overall survival of endometrial cancer patients. The miRGator database (https://bio.tools/mirgator_v2.0, updated version 2019) was used to predict the target gene binding to miR-3653-3p. Human endometrial cancer cell lines AN3CA, HEC-1A, HEC-1B, Ishikawa and human normal endometrial epithelial cell line ESC were selected, and the relative expression level of miR-3653-3p was detected by using quantitative real-time fluorescent polymerase chain reaction (qRT-PCR). The cell line with the lowest expression of miR-3653-3p was selected as the research object, which was divided into the negative control group and miR-3653-3p group, and transfected with the control empty vector plasmid and miR-3653-3p overexpression plasmid. CCK-8 method was used to detect the proliferation ability of cells, Transwell method was used to detect the invasion ability of cells, and qRT-PCR and Western blot were used to detect the expression of miR-3653-3p target gene. The effect of miR-3653-3p on the related protein expression of Wnt- β-catenin signaling pathway was detected by using Western blot.Results:Data analysis in the OncoLnc database showed that compared with endometrial cancer patients with low miR-3653-3p expression, patients with high miR-3653-3p expression had better overall survival ( P < 0.01). Compared with human normal endometrial epithelial ESC, the expression levels of miR-3653-3p in endometrial cancer cell lines AN3CA, HEC-1A, HEC-1B, and Ishikawa were all decreased (all P < 0.05), and the relative expression level of miR-3653-3p was the lowest in HEC-1A cells, and HEC-1A cells were selected for subsequent experiments. The result of CCK-8 showed that compared with the negative control group, the ability of HEC-1A cells in the miR-3653-3p group decreased on the 2nd, 3rd, 4th, and 5th days (all P < 0.05). The result of the Transwell chamber invasion test showed that the number of HEC-1A cell invasion after culturing for 26 h in the negative control group and the miR-3653-3p group was (80±11) and (21±4), respectively, and the difference was statistically significant ( t = 5.18, P < 0.01); compared with the negative control group, the number of cell invasion in the miR-3653-3p group decreased. The miRGator database was used to predict that the target gene of miR-3653-3p might be placenta-specific protein 8 (PLAC8). The relative expression levels of PLAC8 mRNA in HEC-1A cells in the negative control group and miR-3653-3p group were (6.26±0.83) and (0.97±0.31), respectively, and the difference was statistically significant ( t = 6.00, P < 0.01); the relative expression level of PLAC8 mRNA in the miR-3653-3p group was lower than that in the negative control group. Compared with the negative control group, the PLAC8 protein of HEC-1A cells decreased, and the expression of Wnt-β-catenin signaling pathway related proteins β-catenin, transforming growth factor β (TGF-β), GSK-3β, and Rac1 decreased in the miR-3653-3p group. Conclusions:miR-3653-3p may inhibit the proliferation and invasion of endometrial cancer cells by regulating the PLAC8-Wnt-β-catenin signaling pathway.

Predictive value of vascular endothelial growth factor expression and microvascular density for the depth of infiltration in early gastric cancer / 肿瘤研究与临床

Objective:To investigate the predictive value of vascular endothelial growth factor (VEGF) expression and microvascular density (MVD) for the depth of infiltration in early gastric cancer.Methods:The pathological tissues of 24 patients with early gastric cancer (early gastric cancer group), 23 patients with advanced gastric cancer (advanced gastric cancer group) and 10 patients with gastritis (gastritis group) who admitted to Fenyang Hospital Affiliated of Shanxi Medical University from January 2020 to January 2022 were retrospectively collected. Immunohistochemistry was used to detect VEGF expression and MVD in the lesion tissues of each group, and the correlation of VEGF expression and MVD in gastric cancer tissues with the clinicopathological characteristics of patients was analyzed. Postoperative pathological diagnosis was treated as the gold standard. The efficacy of VEGF and MVD in predicting the depth of infiltration in gastric cancer and early gastric cancer was assessed by using the receiver operating characteristic (ROC) curve.Results:The VEGF positive expression rate was 10.00% (1/10), 29.17% (7/24) and 78.26% (18/23) in gastritis group, early gastric cancer group and advanced gastric cancer group, respectively, and the MVD was (21±5) strips/field, (23±9) strips/field and (43±15) strips/field, respectively. The positive expression rate of VEGF and MVD were related with the tumor diameter [>2 cm vs. ≤2 cm:69.70% (23/33) vs. 14.29% (2/14), (39±15) strips/field vs. (20±8) strips/field] and infiltration depth of gastric cancer [intramucosal carcinoma vs. submucosal carcinoma vs. advanced gastric cancer: 26.31% (5/19) vs. 40.00% (2/5) vs. 78.26% (18/23), (20±7) strips/field vs. (36±3) strips/field vs. (43±15) strips/field] (all P > 0.01), while not related with gender, age, tumor location, differentiation degree (all P > 0.05). The ROC curve analysis showed that the area under the curve (AUC) of VEGF and MVD in predicting the depth of infiltration in gastric cancer was 0.716 (95% CI 0.581-0.828) and 0.711 (95% CI 0.573-0.823), respectively; the optimal cut-off value of VEGF and MVD was positive and 24.8 strips/field, with the sensitivity of 53.19%, 61.70%, and the specificity of 90.00% both. The AUC of VEGF and MVD in predicting the depth of infiltration in early gastric cancer was 0.596 (95% CI 0.414-0.760) and 0.506 (95% CI 0.330-0.681) , respectively; the optimal cut-off value of VEGF and MVD was positive and 32.5 strips/field, with the sensitivity of 29.17% , 70.83%, and the specificity of 90.00%, 0, respectively. Conclusions:VEGF expression and MVD are elevated with the increase of depth of gastric cancer infiltration, while the value of the combination of both in predicting the depth of infiltration in early gastric cancer is not high.

Study on changes of proliferation, migration and invasion abilities of radiation-induced polyploid colon cancer SW1116 cells and their progeny and the related mechanisms / 肿瘤研究与临床

Objective:To investigate the characteristics related to proliferation, migration and invasion of radiation-induced polyploid colon cancer SW1116 cells and their progeny.Methods:Colon cancer SW1116 cells were conventionally cultured in Leibovitz's L-15 medium containing 10% fetal bovine serum. SW1116 cells at logarithmic growth stage were irradiated with 7 Gy X-ray, and the morphological changes of the cells were observed by inverted microscope on days 3, 5, 10 and 19 after radiation induction. According to the morphological changes of the cells, the cells at day 3 after radiation induction were labeled as polyploid giant cancer cell (PGCC) group, and the cells at day 19 were recorded as PGCC progeny group. SW1116 cells without radiation induction were used as control group. Flow cytometry was used to detect cell ploidy in the control, PGCC and PGCC progeny groups, CCK-8 assay was used to detect the proliferation ability of the three groups, cell migration and invasion abilities of the three groups were detected by cell scratch assay and Transwell assay, and Western blotting was used to detect the expressions of cell cycle and proliferation-related proteins and epithelial-mesenchymal transition (EMT) marker N-cadherin (N-cad) in the three groups.Results:The volume of SW1116 cells gradually became larger on days 3, 5 and 10 after radiation induction, and returned to normal on day 19. The proportions of polyploid (DNA content >4N) cell subsets in the control group, PGCC group and PGCC progeny group were (2.3±1.1)%, (23.1±8.1)% and (3.2±0.5)%, the difference was statistically significant ( F = 18.52, P < 0.05), and the proportion of polyploid cell subpopulations in the PGCC group was higher than that in the control group ( t = 5.38, P < 0.01), but the differences between the PGCC progeny group and the control group were not statistically significant ( t = 0.22, P > 0.05). After 72 h of culture, the cell proliferation rates of the control, PGCC and PGCC progeny groups were (100.0±4.1)%, (73.5±0.7)% and (123.9±3.5)%, and the difference was statistically significant ( F = 190.27, P < 0.001). After 48 h of cell scratching, the scratch healing rates in the control, PGCC and PGCC progeny groups were (38.0±2.7)%, (41.5±4.0)% and (63.7±4.2)%, and the difference was statistically significant ( F = 43.05, P < 0.001). After 24 h of culture, the number of invasive cells in the control, PGCC and PGCC progeny groups was 12.9±1.2, 3.4±0.6 and 23.7±1.5, and the difference was statistically significant ( F = 63.64, P < 0.001). The expression levels of cell cycle-related proteins P-cdc25c, cdc25c and cdc2 in the PGCC group were lower than those in the control group (all P < 0.05), and the expression levels of transcription factor-related proteins E2F-2, E2F-3 and EMT marker N-cad were downregulated compared with the control group (all P < 0.05); the expression levels of P-cdc25c, cdc25c, cdc2, E2F-2, E2F-3 and N-cad proteins in the PGCC progeny group were higher than those in the control group (all P < 0.05). Conclusions:Radiation can induce colon cancer SW1116 cells to produce polyploid, which may then generate daughter cells through asymmetric mitosis and gain new life, and then promote the recurrence and metastasis of colon cancer.

Effects of long non-coding RNA RP11-1212A22.4 on the cell viability and invasive ability of ovarian cancer cell lines through targeting miRNA-483-5p / 肿瘤研究与临床

Objective:To investigate the effects of long non-coding RNA (lncRNA) RP11-1212A22.4 on the cell viability and invasive ability of esophageal cancer cell lines by targeting miRNA-483-5p (miR-483-5p).Methods:The expression of RP11-1212A22.4 in esophageal cancer tissues was analyzed by using GEPIA online database. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression of RP11-1212A22.4 in human esophageal cancer cell lines EC9706, KYSE30, TE-13, Eca109 and normal esophageal epithelial cell line HET-1A. The lowest expression level of EC9706 cell line in RP11-1212A22.4 was divided into RP11-1212A22.4 group (transfected with pcDNA-RP11-1212A22.4 plasmid) and the control group (transfected with pcDNA-NC plasmid). The cell viability of EC9706 cell was analyzed by using methyl thiazolyl tetrazolium (MTT) method, and the invasion ability of EC9706 cell was detected by using Transwell assay. The targeting relationship between RP11-1212A22.4 and miR-483-5p was verified by using StarBase database prediction and dual luciferase reporter assay. The relative expression level of miR-483-5p of EC9706 cell in two groups was detected by using qRT-PCR. Western blot was used to detect the expressions of cyclin-dependent kinase 6 (CDK6), matrix metalloproteinase 2 (MMP-2), cyclin-dependent kinase 4 (CDK4), and matrix metalloproteinase 9 (MMP-9) proteins in two groups.Results:In GEPIA online database, compared with adjacent tissues, the relative expression level of RP11-1212A22.4 in esophageal cancer tissues was decreased, and the difference was statistically significant ( P < 0.001). The relative expression levels of RP11-1212A22.4 in esophageal cancer cell lines EC9706, KYSE30, TE-13, Eca109 and normal esophageal mucosal epithelial cell line HET-1A were 0.11±0.08, 0.32±0.09, 0.72±0.09, 0.59±0.13 and 0.97±0.12, and the difference was statistically significant ( F = 40.42, P < 0.001). The relative expression levels of RP11-1212A22.4 in EC9706 cells of RP11-1212A22.4 group and the control group were 11.9±2.4 and 1.0±0.3, respectively, and the difference was statistically significant ( t = 8.89, P < 0.001). Compared with the control group, the cell viability of EC9706 cell in RP11-1212A22.4 group was decreased (all P < 0.05). The number of invasive cells in RP11-1212A22.4 group was lower than that in the control group (48±12 vs. 106±22, t = 4.63, P < 0.001). StarBase database prediction and dual luciferase reporter assay both showed that RP11-1212A22.4 targeted miR-483-5p. The relative expression level of miR-483-5p in RP11-1212A22.4 group was lower than that in the control group (0.24±0.11 vs. 1.02±0.23, t = 5.98, P = 0.001). Compared with the control group, the expressions of CDK6, MMP-2, CDK4 and MMP-9 proteins in the RP11-1212A22.4 group were decreased. Conclusions:RP11-1212A22.4 is lowly expressed in esophageal cancer tissues and cell lines, and it inhibits the cell viability and invasive ability of esophageal cancer cells by targeting miR-483-5p.

Diagnostic value of 18F-PSMA-1007 PET/CT in seminal vesicle invasion of prostate cancer / 中华核医学与分子影像杂志

Objective:To evaluate the diagnostic value of the 18F-prostate specific membrane antigen (PSMA)-1007 PET/CT in seminal vesicle invasion (SVI) of prostate cancer. Methods:Clinical and pathological materials of 88 patients (age: 51-84 years) who underwent radical prostatectomy (RP) between May 2019 and December 2021 in the First Affiliated Hospital of Xi′an Jiaotong University were analyzed retrospectively. All patients underwent 18F-PSMA-1007 PET/CT examination for primary staging before surgery. The diagnostic efficiency of 18F-PSMA-1007 PET/CT in SVI was obtained using postoperative pathological results as the " gold standard" and ROC curve was drawn. Furthermore, univariate and multivariate logistic regression analyses were used to screen the influencing factors for 18F-PSMA-1007 PET/CT prediction of SVI. Results:The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of 18F-PSMA-1007 PET/CT in diagnosing SVI were 79.55%(70/88), 72.73%(16/22), 81.82%(54/66), 57.14%(16/28) and 90.00%(54/60), respectively. The ROC AUC was 0.77. Results of univariate logistic regression showed that total prostate specific antigen (tPSA), primary SUV max, Gleason score, International Society of Urological Pathology (ISUP) grade group were associated with 18F-PSMA-1007 PET/CT prediction of SVI. Results of multivariate logistic regression showed that Gleason score (odds ratio ( OR)=2.04, 95% CI: 1.19-3.50, P=0.009) was a predictor of SVI in prostate cancer. Conclusion:18F-PSMA-1007 PET/CT has certain diagnostic value in SVI of prostate cancer, and combining with Gleason score can improve the diagnostic efficiency.

A model of predicting infiltration depth of colorectal cancer based on narrow band imaging system and endoscopic ultrasonography / 中国医师杂志

Objective:To establish a model of improving diagnostic capability in infiltration depth of colorectal cancer (CRC) with combining narrow band imaging system(NBI) and endoscopic ultrasonography (EUS).Methods:CRC patients who were treated in Chongqing Fifth People′s Hospital from April 2015 to March 2021 were selected retrospectively as the research objects. All patients were diagnosed by postoperative pathological diagnosis. In the end, a total of 288 CRC patients were included. Using the random number table method, the study subjects were divided into modeling group ( n=192) and verification group ( n=96) at a ratio of 2∶1. The patients′ general information, NBI and EUS examination results were collected; logistic regression was used to analyze the independent risk factors of CRC submucosal infiltration, and a model was built to predict the depth of CRC infiltration; receiver operating characteristic (ROC) was used to identify the diagnostic ability of model. The diagnostic efficacy of CRC submucosal infiltration was verified internally by the verification group. Results:In the modeling group, lymph node metastasis ( OR=6.492, 95% CI: 5.128-7.855, P<0.001), low tumor differentiation ( OR=2.736, 95% CI: 1.731-3.741, P<0.001) and tumor length ( OR=2.049, 95% CI: 1.524-2.574, P<0.001) were independent risk factors for submucosal infiltration in CRC patients; The nomograph model constructed according to the above independent risk factors had a strong diagnostic ability for the depth of submucosal infiltration of CRC, and was internally validated in the validation group. AUC values of the modeling group and the validation group were 0.945 (0.935-0.955) and 0.951 (0.942-0.961), respectively. Conclusions:The nomogram model established by the combination of endoscopic narrow band imaging technology and ultrasound endoscopy can diagnose the depth of CRC infiltration better.

Value of shear wave elastography combined with contrast-enhanced ultrasound in diagnosing the invasiveness of papillary thyroid microcarcinoma / 中国医师进修杂志

Objective:To study the value of shear wave elastography (SWE) combined with contrast-enhanced ultrasound (CEUS) in diagnosing the invasiveness of papillary thyroid microcarcinoma (PTMC), and analyze its risk factors.Methods:This study included 200 patients with pathologically confirmed PTMC who underwent surgery in Fenyang Hospital from January 2019 and June 2021. All were diagnosed with SWE and CEUS before surgery. The value of the two methods in diagnosing the invasiveness of PTMC was explored. The patients′ data were collected to screen the risk factors for the invasiveness of PTMC.Results:It was pathologically confirmed that among the 200 patients with PTMC, there were 112 cases with malignant nodules, 88 cases with benign nodules, 75 cases with cervical lymph node metastasis (including 71 cases with capsular invasion) and 125 cases without lymph node metastasis. CEUS parameters of malignant nodules were significantly higher than those of benign nodules ( P<0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of SWE combined with CEUS to diagnose capsular invasion were 94.66%, 85.60%, 89.00%, 79.77% and 96.39%, with high consistency with the pathological results ( Kappa>0.75). Multivariate Logistic regression analysis showed that multiple foci, irregular shape, breakthrough capsule and small calcification were independent risk factors for the invasiveness of PTMC (VIF<3). The ROC curve results showed that the AUC of SWE combined with CEUS to diagnose capsular invasion was 0.772, and the diagnostic sensitivity and specificity were 73.91% and 80.56%. Conclusions:SWE combined with CEUS can significantly improve the diagnostic accuracy for the invasiveness of PTMC.

Evaluation and Current Clinical Progress of Invasiveness in Postoperative Residual Regrowth and Recurrence of Pituitary Adenoma / 肿瘤防治研究

Pituitary adenoma is one common type of intracranial tumors, accounting for about 10% of intracranial tumors. Although pituitary adenomas are benign tumors, the complete resection and recurrence prevention remain challengeable due to aggressive growth of tumor, limited equipment conditions and surgical techniques of the surgeon. The proportion of recurrent pituitary adenomas is rising year by year and the difficulty of treatment also increases. This article reviews the diagnosis and treatment of recurrent pituitary adenomas based on the summary data of invasive or recurrent pituitary adenomas cases in our center, including indication for the second transsphenoidal surgery, surgical techniques, and prevention and treatment of postoperative complications, to provide reference for clinicians in this field.

Research advances in the molecular mechanism of long non-coding RNA in invasion and metastasis of pancreatic cancer / 临床肝胆病杂志

As a highly malignant gastrointestinal tumor, pancreatic cancer is highly invasive and metastatic, which leads to the low overall survival rate of patients with pancreatic cancer. Studies have shown that long non-coding RNA (lncRNA) is involved in the development, progression, invasion, and metastasis of pancreatic cancer through epigenetic, transcriptional or post-transcriptional regulation. Dysregulated expression of lncRNA is observed in pancreatic cancer and induces epithelial mesenchymal transition (EMT) through specific regulatory mechanisms, thereby causing the changes in the biological behavior of tumor cells. This article reviews the mechanisms of lncRNA in promoting EMT, regulating tumor biological function as competing endogenous RNA, and affecting the development, invasion, and metastasis of pancreatic cancer via multiple pathways by regulating the ferroptosis, autophagy, and exosome of tumor cells, in order to provide a theoretical basis and new targets for the early diagnosis and treatment of pancreatic cancer.

Expression of miR-128-3p in gastric cancer and its effect on migration and invasion of gastric cancer cells / 中华普通外科杂志

Objective:To study the effects of miR-128-3p on the migration and invasion of the gastric cancer cells.Methods:qRT-PCR was used to detect the expression of miR-128-3p in 126 gastric cancer tissues and adjacent tissues from Jan 2014 to Jan 2016 at He'nan Cancer Hospital. The effect of miR-128-3p on the invasion and migration of gastric cancer cell line was detected.The expression of miR-128-3p related proteins was detected by Western blotting, miRNA on-line target prediction tool for the prediction of miR-128-3p directly regulated downstream target genes.Results:the expression of miR-128-3p in gastric cancer was significantly higher than that in adjacent non-tumor tissues ( P<0.05). The expression of miR-128-3p was correlated with the vascular tumor thrombus, pN staging and pTNM staging, the prognosis of patients with high expression of miR-128-3p was poor (all P<0.05). MiR-128-3p expression was significantly higher in gastric cancer cell lines ( P<0.05). Online target prediction tool and double luciferase reporter gene showed that CLDN18 was a downstream target gene directly regulated by mir-128-3p. Conclusion:The high expression of miR-128-3p is related to the poor prognosis of gastric cancer patients.

Allogeneic vein replacement in abdominal surgery / 中华普通外科杂志

Objective:To evaluate the perioperative safety and long-term prognosis of allogeneic vein replacement in abdominal surgery.Methods:Clinical data of 115 patients receiving allogeneic vein replacement from Jan 2013 to Dec 2020 was retrospectively analyzed.Results:The most common operation was radical pancreatoduodenectomy for pancreatic cancer (75.7%), and the most common vascular replacement sites were the junction of portal vein system (53.9%), followed by superior mesenteric vein (23.5%) and portal vein (18.3%). In our group, 6 patients died (5.2%), 31 patients had complications (27.0%), and 2 patients had portal vein thrombosis (1.7%). During the follow-up period, 8 cases (7.5%) had mild stenosis, 12 cases (11.5%) had moderate stenosis and 14 cases (13.2%) had severe stenosis. The half-year, one-year and two-year incidence of moderate and severe stenosis were 8.0%, 24.4% and 34.5% respectively.Conclusions:The early and mid-term result of allogeneic vein replacement is satisfactory. Use of postoperative anticoagulation may help reduce the incidence of thrombogenesis or stenosis .

Clinical application of 18F-FDG PET/CT parameters in predicting tumor spread through air spaces in patients with lung adenocarcinomas at T1-2 stage / 中华核医学与分子影像杂志

Objective:To evaluate the clinical value of 18F-FDG PET/CT findings in patients with T1-2 lung adenocarcinoma spread through air spaces (STAS). Methods:From June 2018 to June 2020, a total of 80 patients (36 males, 44 females; age: 19-84 (59.9±11.8) years) with surgically and pathologically confirmed T1-2 lung adenocarcinomas in Jiangmen Central Hospital were enrolled retrospectively. All patients underwent 18F-FDG PET/CT examination preoperatively and were divided into STAS positive and negative groups according to the histopathological diagnosis. Independent-sample t test, Mann-Whitney U test, χ2 test and Fisher exact test were used to analyze differences of gender, age, tumor biomarker, SUV max, SUV mean, features showed on high resolution CT (HRCT; including diameter, lesion location, morphology, density, lobulated sharp, spiculated sign, vacuole sign, air bronchgram sign, pleural traction and para-emphysema), and pathologic findings (micropapillary pattern, lymphvascular inversion, pleural inversion and lymph node metastasis) between the two groups, and then multivariate logistic regression was performed. The ROC curve was employed to evaluate the predictive value of parameters for STAS of T1-2 lung adenocarcinomas. Results:Among the 80 patients with T1-2 lung adenocarcinomas, 12 (15.0%) were STAS positive and 68 (85.0%) were STAS negative. Significant differences were shown in SUV max, SUV mean, micropapillary pattern, lymphvascular inversion and lymph node metastasis between the two groups ( z values: -2.60, -2.17; χ2 values: 29.56, 9.28, 17.40, P<0.001 or P<0.05). SUV max (odds ratio ( OR): 1.348 (95% CI: 1.071-1.695), P=0.011), micropapillary pattern ( OR=47.444 (95% CI: 4.592-490.214), P=0.001) and lymph node metastasis ( OR=8.201 (95% CI: 1.129-59.576), P=0.038) were independent risk factors for STAS positive in multivariation logistic regression analysis. The optimum cut-off value for SUV max was 3.85 in the ROC analysis with the AUC of 0.737 (95% CI: 0.614-0.859), the sensitivity of 11/12, the specificity of 55.9%(38/68) and the accuracy of 61.2%(49/80). The AUC of the SUV max combined with micropapillary pattern and lymph node metastasis was 0.945 (95% CI: 0.892-0.999) with the sensitivity of 11/12, the specificity of 88.2%(60/68) and the accuracy of 88.7%(71/80). Conclusions:The PET/CT characteristics may be useful in differentiating STAS status among patients with T1-2 lung adenocarcinoma. SUV max >3.85, pathological papillary pattern and lymph node metastasis are independent risk factors to predict STAS.

Correlation analysis between SUV index in 18F-FDG PET/CT imaging and invasiveness of early lung adenocarcinoma / 中华核医学与分子影像杂志

Objective:To investigate the correlation between the SUV index (SUV max of the lesion/SUV mean of the liver) in 18F-FDG PET/CT imaging and the invasiveness of early lung adenocarcinoma presenting as ground-glass nodule (GGN). Methods:From January 2012 to March 2020, 167 GGN patients (49 males, 118 females; age: (61.5±9.0) years) with early lung adenocarcinoma who underwent PET/CT imaging in Changzhou First People′s Hospital were retrospectively enrolled. The image parameters including the GGN number, location, type, edge, shape, abnormal bronchus sign, vacuole sign, pleural depression, vessel convergence sign, GGN diameter ( DGGN), solid component diameter ( Dsolid), consolidation to tumor ratio (CTR, Dsolid/ DGGN), CT values (CT value of ground-glass opacity (CT GGO), CT value of lung parenchyma (CT LP), ΔCT GGO-LP (CT GGO-CT LP)) and SUV index were analyzed. Single and multivariate logistic regressions were used to analyze the correlation between SUV index and infiltration. The generalized additive model was used for curve fitting, and the piece-wise regression model was used to further explain the nonlinearity. Results:In 189 GGNs, invasive adenocarcinoma accounted for 85.2% (161/189). Single logistic regression showed that the GGN number, type, shape, edge, abnormal bronchus sign, pleural depression, vessel convergence sign, DGGN, Dsolid, CTR, CT GGO, ΔCT GGO-LP and SUV index were related factors of infiltration (odds ratio ( OR) values: 0.396-224.083, P<0.001 or P<0.05). After fully adjusting for confounding factors, SUV index was significantly correlated with increased risk of invasion ( OR=2.162 (95% CI: 1.191-3.923), P=0.011). Curve fitting showed that the SUV index was non-linearly related to the risk of infiltration, and the risk of infiltration increased significantly only when the SUV index was greater than 0.43 ( OR=3.509 (95% CI: 1.429-8.620), P=0.006). The correlation between SUV index and infiltration had no interaction between age, vacuoles, pleural depression and CTR subgroups (all P>0.05). Conclusions:SUV index is an independent factor related to the invasiveness of early lung adenocarcinoma. The higher the SUV index, the greater the risk of invasion; but the two are not simply linearly correlated.

Application of 18F-FDG PET/CT metabolic parameters in the prediction of perineural invasion in non-metastatic rectal cancer / 中华核医学与分子影像杂志

Objective:To investigate the value of 18F-FDG PET/CT metabolic parameters in predicting perineural invasion (PNI) in patients with non-metastatic rectal cancer. Methods:From August 2012 to April 2020, 81 patients (51 males, 30 females, median age: 63 years) who received PET/CT examination and pathologically confirmed as rectal cancer in the Affiliated Hospital of Qingdao University were retrospectively analyzed. The 18F-FDG PET/CT metabolic parameters including SUV max, metabolic tumor volume (MTV) and total lesion glycolysis (TLG), and clinicopathological factors including gender, age, carcinoembryonic antigen (CEA), carbohydrate antigen (CA)19-9, maximum tumor diameter, degree of differentiation, T stage, lymph node metastasis, and TNM stage were recorded. Mann-Whitney U test and χ2 test were used to compare the differences of each parameter between PNI positive group and PNI negative group. Multivariate logistic regression was used to analyze the independent predictor of positive PNI. ROC curve was used to analyze its predictive efficacy. Results:Of 81 patients, 32(39.51%) were PNI positive and 49(60.49%) were PNI negative. There were significant differences of T stage ( χ2=10.73, P=0.010), lymph node metastasis ( χ2=6.21, P=0.013), TNM stage ( χ2=7.61, P=0.022), MTV (14.6(10.4, 24.7)and 9.0(5.4, 14.5) cm 3; U=-3.48, P=0.001) and TLG (108.588(72.749, 182.707) and 65.365(35.593, 117.682) g; U=-2.79, P=0.005) between PNI positive group and PNI negative group. Multivariate logistic regression analysis showed that MTV was the independent predictor of positive PNI in non-metastatic rectal cancer patients (odds ratio ( OR)=1.130, 95% CI: 1.025-1.245, P=0.014). The optimal threshold of MTV was 9.53 cm 3 and AUC was 0.73 with the sensitivity of 81.82%(27/33) and the specificity of 59.18%(29/49). Conclusion:18F-FDG PET/CT metabolic parameter MTV can predict PNI in non-metastatic rectal cancer with high sensitivity.