Value of MR 3D-ASL,DWI combined with MGMT in the differential diagnosis of postoperative recurrence and pseudoprogression of high-grade glioma / 实用放射学杂志

Objective To explore the value of brain MR three-dimensional arterial spin labeling(3D-ASL),diffusion weighted imaging(DWI)combined with MGMT gene detection in the differential diagnosis of postoperative recurrence and pseudoprogression of high-grade glioma.Methods A total of 30 patients with high-grade glioma were selected,and all patients were divided into pseudoprogression group and recurrence group according to pathological results.The differences in average relative cerebral blood flow(rCBF)and average relative apparent diffusion coefficient(rADC)were compared between recurrence groups and pseudoprogression groups.Results The rCBF in the enhanced center and edge areas in the recurrence group was significantly higher than those in the pseudoprogression group,and the rADC was significantly lower than that in the pseudoprogression group,and the difference was statistically significant(P<0.05).There were correlations between the postoperative recurrence and pseudoprogression of high-grade glioma and the promoter situation of methylation of MGMT gene.Conclusion Brain MR 3D-ASL,DWI combined with MGMT gene detection has important clinical value in the differential diagnosis of postoperative recurrence and pseudoprogression of high-grade glioma.

Clinical efficacy of non-steroidal anti-inflammatory drugs and α1-adrenergic antagonist on the patients with ureteral stones / 中国综合临床

Objective To investigate the clinical effect of non-steroidal anti-inflammatory drugs and αl-adrenergic antagonist on treating patients with ureteral stones.Methods A total of 128 patients with ureteral colic due to ureteral stones were randomly divided into control and treatment group,and 64 cases in each group.Both two groups were treated with tamsulosin 0.4 mg oral,intravenous injection of saline 1000 mL Patients in treatment group were received intramuscular non-steroidal anti-inflammatory drugs(10 mg) and patients in control group were received pethidine hydrochloride(10 mg).Ultrasound exam were performed after 6-8 h to evaluate the stone expulsive rate.Extracorporeal shock wave lithotripsy and other treatment were underwent when the stone was still not discharge.Results The effective rate of analgesia was 96.9％ (62/64) in treatment group and 100％ (64/64) in control group(x2 =2.03,P =0.50).The stone expulsion rate in treatment group was 28.1％ (18/64),higher than that in control group(12.5％ (8/64),x2 =4.83,P =0.05).Conclusion It is effective to relive ureteral cohc with non-steroidal anti-inflammatory drugs only,and it is better than pethidine in promote stone expulsion when they both used with α1-adrenergic antagonist.

Comparison of Direct Sequencing, PNA Clamping-Real Time Polymerase Chain Reaction, and Pyrosequencing Methods for the Detection of EGFR Mutations in Non-small Cell Lung Carcinoma and the Correlation with Clinical Responses to EGFR Tyrosine Kinase Inhibito

BACKGROUND: The aims of this study were to evaluate the abilities of direct sequencing (DS), peptide nucleic acid (PNA) clamping, and pyrosequencing methods to detect epidermal growth factor receptor (EGFR) mutations in formalin-fixed paraffin-embedded (FFPE) non-small cell lung carcinoma (NSCLC) samples and to correlate EGFR mutational status as determined by each method with the clinical response to EGFR tyrosine kinase inhibitors (TKIs). METHODS: Sixty-one NSCLC patients treated with EGFR TKIs were identified to investigate somatic mutations in the EGFR gene (exons 18-21). RESULTS: Mutations in the EGFR gene were detected in 38 of the 61 patients (62%) by DS, 35 (57%) by PNA clamping and 37 (61%) by pyrosequencing. A total of 44 mutations (72%) were found by at least one of the three methods, and the concordances among the results were relatively high (82-85%; kappa coefficient, 0.713 to 0.736). There were 15 discordant cases (25%) among the three different methods. CONCLUSIONS: All three EGFR mutation tests had good concordance rates (over 82%) for FFPE samples. These results suggest that if the DNA quality and enrichment of tumor cells are assured, then DS, PNA clamping, and pyrosequencing are appropriate methods for the detection of EGFR mutations.

Loss of PTEN Expression is an Independent Poor Prognostic Factor in Non-small Cell Lung Cancer

BACKGROUND: Alterations in the phosphatase and tensin homolog (PTEN) are correlated with tumor progression. Downregulation of PTEN is related to drug resistance of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors in non-small cell lung cancer (NSCLC). The aim of this study was to evaluate the prognostic significance of PTEN in patients with NSCLC and its correlation with EGFR. METHODS: Two hundred eighty eight surgically resected NSCLC samples, including 168 adenocarcinomas (ADCs), 99 squamous cell carcinomas (SCCs) and 21 other NSCLCs were analyzed for the PTEN. The results were correlated with other clinicopathological variables including EGFR amplification and mutation. RESULTS: Loss of PTEN was detected in 42.4% of NSCLCs, specifically 28.6% of ADCs, 66.7% of SCCs, and 38.1% of others. Loss of PTEN was significantly associated with SCC, smoking, male gender, and higher stage. In a multivariate analysis, loss of PTEN was significantly associated with short progression-free survival (p=0.037). No association between PTEN and EGFR was observed. CONCLUSIONS: These results suggest that loss of PTEN results in shorter progression-free survival in patients with NSCLC, and loss of PTEN is more associated with SCC, smoking, male gender, and higher T stage by the 7th tumor, node and metastasis staging system but not EGFR status.

ERCC1 Predicts a Poorer Platinum-based Chemotherapy Outcome but a Better Outcome for Uracil-Tegafur in the Resected Stage I-II NSCLC

BACKGROUND: The role of excision repair cross-complementation group 1 (ERCC1) has been controversial in non-small cell lung cancer (NSCLC) patients who received adjuvant chemotherapy with a platinum agent. We investigated ERCC1 expression in stage I-II NSCLC to clarify its significance for adjuvant chemotherapy. METHODS: The ERCC1 expression profile was evaluated by immunohistochemistry and compared according to adjuvant chemotherapeutic agents in 146 patients who underwent surgical resection for stage I-II NSCLC. The patients were divided into 3 groups; adjuvant chemotherapy with a platinum based agent (18.5%, 27/146); adjuvant chemotherapy with uracil-tegafur (UFT) (40.4%, 59/146); surgery-alone (41.1%, 60/146). RESULTS: Nuclear ERCC1 expression was detected in 71.9% (105/146) of NSCLC and was significantly associated with a shortened survival period in the group 1 patients who received the platinum based regimen after surgery. The group 2 patients who received UFT showed the longest survival period, followed by the surgery-alone group (overall survival, p=0.049; disease-free survival [DFS], p<0.001). CONCLUSIONS: These results suggest that stage I-II NSCLC patients with ERCC1 expression experience a shorter DFS period with adjuvant chemotherapy with a platinum based regimen and may benefit from adjuvant chemotherapy with UFT, instead of platinum after surgery.

Clinicopathologic Implications of ALK Gene Copy Number Gain in Non-small Cell Lung Cancer

PURPOSE: The anaplastic lymphoma kinase (ALK) gene is a potential molecular target in non-small cell lung carcinoma (NSCLC). The clinicopathologic implication of a change in the ALK gene copy number (GCN) is unclear. MATERIALS AND METHODS: A total of 434 primary NSCLC samples were analyzed by fluorescence in situ hybridization (FISH) for ALK GCN. RESULTS: Ninety-six cases (22.1%) showed ALK GCN gain with amplification in 16 (3.7%) cases. The cases with ALK GCN gain consisted of 47 adenocarcinomas (49.0%), 41 squamous cell carcinomas (42.7%), 5 adenosquamous carcinomas (5.2%) and 3 other NSCLCs (3.1%). ALK gene amplification was identified in 7 adenocarcinomas (43.7%) and 9 squamous cell carcinomas (56.3%). There was no significant difference between ALK GCN gain/amplification and histologic subtypes. Univariate survival analysis revealed that patients with ALK GCN gain/amplification showed shorter progression-free survival durations and decreased overall survival rates (p<0.001). However, multivariate analysis proved that ALK GCN gain/amplification is not an independent prognostic factor for progression-free survival or overall survival. CONCLUSION: ALK GCN gain is frequently identified in NSCLCs and the incidence is similar among histologic subtypes. Although ALK GCN gain/amplification is not an independent prognostic marker, it is associated with tumor progression in NSCLC.