RESUMEN
The incidence of spine metastasis is increasing due to the aging demography and improvement of cancer diagnosis and treatments.Spine metastasis is one of the serious complications of advanced cancers,and its treatment should pay attention to patients' quality of life and consider interdisciplinary cooperation.Expected life span can guide doctors to select the appropriate treatment for spine metastasis patients,and various scoring systems have been developed.We elicited relevant literatures in WanFang,CNKI,PubMed and Embase databases.Articles aiming at developing model for spine metastasis or describing the clinical effectiveness and pitfalls of the existed systems were included.As a result,48 articles were carefully reviewed.In this review,thosc scoring systems were stratified into two groups:Traditional scoring systems,which were published before or in 2005,including original/revised Tokuhashi scoring systems,Tomita scoring system,Bauer scoring system,Linden scoring system,and Sioutos scoring system;and new scoring systems,which were designed during the last three years,including Lei & Liu scoring system,Bollen scoring system,Rades scoring system,Oswestry spinal risk index (OSRI),and Katagiri scoring system.The usefulness of the traditional scoring systems has been validated by many studies.However,the applicability of those scoring system were controversial due to improvement of cancer treatment and survival period in recent years.Although the improvement of life span was considered,those new scoring systems have not penetrated into clinical routine because of the lack of validation.Currently,which system has the highest accuracy rates still remains unclear.Next generation of scoring systems should take into account the practicality and reliability at the same time.In this review,we introduced above mentioned scoring systems,described the validity and limitation of those scoring system,and suggested the future directions of next generation of scoring systems.
RESUMEN
Tumor cells can secrete various cytokines which can enhance the activity of osteoclast in the bone microenvi?ronment, and osteoclast can promote the release of many growth factors buried in bone matrix which would promote the growth and invasion of tumor cells. Thus, a‘vicious cycle’of bone destruction is developed in the bone metastatic microenvironment. Bone metastatic microenvironment facilitate this‘vicious cycle’, while it also provides potential targets for the treatment of bone metas?tases. Osteoprotegerin, receptor activator of nuclear factor?κB and its ligand system are the typicality of molecular targets. Bone metastasis can promote the secretion of RANKL and the expression of OPG. The disbalance of RANKL/OPG is an important induc?ing factor for bone destruction. Many studies have shown that transforming growth factor?βwhich is produced by osteoclast plays an important role in mediating‘vicious cycle’. Src family tyrosine kinase, endothelin A receptor, matrix metalloproteinase, and ca?thepsin K are the potential targets of bone metastasis. Pharmacologic agents such as denosumab, can inhibit the‘vicious cycle’of bone metastasis. In addition to suppress bone destruction by Pharmacologic agents, they also can produce direct antitumor effect. They can delay the occurrence of skeletal related events, prolong the overall survival, and play an important role in patient ’s quali?ty of life at last. Patients with bone metastasis have already benefited from systemic molecular targeted therapies, and further re?searches would be of great importance in improving patient therapeutically selections and enhancing the effect.
RESUMEN
Objective To study the expression changes of?-catenin in the hair follicle before and after GasderminA3 gene mutation.Methods Using SP immunohistochemical staining,RT-PCR,Western blotting to detect the expression of?-catenin in the hair follicle in GSDMa3 mutant and C57BL/6(B6) mice on postnatal 11(anagen) ,16(early catagen) ,18(late catagen) and 24 d(telogen) respectively.Results The expression of?-catenin is gradually weakened from 11 d to 24 d in GSDMa3 mutation mice and B6 mice,but stronger expression was found in GSDMa3 mutation mice than in the B6 mice at different time points.In anagen,?-catenin was expressed in the inner and outer root sheath and hair matrix cells,with stronger expression in GSDMa3 mutant mice than in B6 mice.In catagen,?-catenin was mainly expressed in the outer root sheath and hair matrix cells,with more stronger expression in GSDMa3 mutant mice than in B6 mice.In telogen,?-catenin was expressed in the outer root sheath cells in the mutant mice while little in the hair follicle in B6 mice.Conclusion GSDMa3 gene affects the hair follicle growth and development,probably through regulating the expression of?-catenin.