RESUMO
Objective:To explore the clinical characteristics,the diagnostic framework,and the treatment methods of B cell lymphoblastic lymphoma(B-LBL),and to clarify the progress of diagnosis and treatment of B-LBL to improve the clinician's understanding of the disease and provide the guidance for prognostic evaluation and therapeutic options.Methods:The clinical data including symptoms,physical signs,ancillary testings,diagnosis, treatment and disease prognosis of a child suffered from B-LBL were retrospectively analyzed;in the meantime,the relative literatures were reviewed.Results:The patient was definitly diagnosed as B-LBL according to the clinical characteristics and received combination therapy with vincristine,daunorubicin,L-asparaginase,and prednisone as the first course,along with the intrathecal injection of methotrexate and dexamethasone to prevent central nervous system leukemia(CNS-L).The patient achieved complete remission(CR)25 d after the first circle chemotherapy but was diagnosed as degree 4 myelosuppression.Therefore,the second cycle combination therapy was adjusted with cyclophosphamide,cytarabine and 6-MP,and the intrathecal injection to prevent CNS concomitantly.DegreeⅣ myelosuppression appeared repeatedly after 2 cycles and the combination chemotherapy was reajdusted. So mercaptopurine and high dose of methotrexate were given as the 4th cycle,and CNS was prevented continously. The patient kept CR until the second cycle finished but get recurrence after the third chemotherapy(prolymphocytes 10%).Then remission and recurrence were found in the disease counrse during which mary chemotherapy methods were attempted until the patient got stable CR after treatment for 31 months.Then the patient was treated with oral mercaptopurine(50 g·d-1)and methotrexate(25 mg per week)and kept disease-free survival for more than 3 years.Conclusion:B-LBL is a rapidly developed disease with the bone marrow involvement occurring in the short term and easy to relapse during treatment.However,it is extremely easy to transform to recurrent and refractory B-LBL after the first remission.It is of great importance to estimate the risk stratification and to evaluate the prognosis of LBL patients in order to treat as soon as possible for the improvement of one's life quality and the prolongation of survival.
RESUMO
Objective:To study the effects of Hedgehog signal transduction pathway on the cell proliferation, apoptosis and connexin 32 (Cx32)and connexin 43 (Cx43)membranous distribution of breast cancer cells,and to explore its mechanism in the cell proliferation and metastasis of breast cancer.Methods:The breast cancer MCF-7 cells at logarithmic growth period were divided into cyclopamine groups and blank control groups. The MCF-7 in cyclopamine groups were treated with 5,10,20,30 and 40μmol·L-1 for 24,48 and 72 h;MTT assay was applied to detect the inhibitory rate of proliferation of MCF-7 cells. After the MCF-7 cells were treated with 0 (negative control group)and 25μmol·L-1 cyclopamine for 48 h,flow cytometry was employed to determine the apoptotic rate and to analyze membranous distribution of Cx32 and Cx43 in the MCF-7 cells.Results:Compared with blank control group,the inhibitory rates of proliferation in cyclopamine groups were increased (P<0.05), and the inhibitory effect of proliferation was increased with the increasing of cyclopamine doses and prolongation of treatment time.After treated with 25μmol·L-1 cyclopamine,the apoptotic rate of MCF-7 cells was higher than that in blank control group (P<0.05).The positive expression rates of Cx32 and Cx43 48 h after treatment were higher than those in negative control group (P<0.05).Conclusion:Hedgehog signal transduction pathway can inhibit the apoptosis and mediate membranous distribution of Cx32 and Cx43 in breast cancer cells.