RESUMO
Objective:To evaluate the value of pretreatment 18F-fluorodeoxyglucose (FDG) PET/CT-based heterogeneity for early prediction of targeted therapy outcome in patients with human epidermal growth factor receptor 2 (HER2) positive metastatic breast cancer. Methods:From May 2012 to April 2018, 29 patients (all females, median age: 52 (32-69) years) who had HER2 positive metastatic breast cancer and underwent pretreatment 18F-FDG PET/CT in Fudan University Shanghai Cancer Center were retrospectively enrolled. All patients received trastuzumab as first-line treatment and were followed up for 6-87 (median time: 35) months. The relations between clinicopathologic parameters or PET/CT-based parameters and progression-free survival (PFS)/overall survival (OS) were analyzed with Cox univariate analysis. The parameters with P≤0.01 were further analyzed with Cox multivariate analysis. Optimal cut-off values were determined by time-dependent receiver operating characteristic (ROC) curve analysis. The survival analyses were estimated by Kaplan-Meier method and log-rank test. Results:The median OS of the 29 patients was 30 (6-83) months, and the median PFS was 10 (2-29) months. The PET/CT-based heterogeneity index(HI), including the maximum standardized uptake value (SUV max) ratio (SUV max-R; hazard ratio ( HR)=8.6, 95% CI: 2.7-27.8, P<0.001), the mean standardized uptake value (SUV mean)-2.5 (the cut-off value of standardized uptake value (SUV)=2.5) ratio (SUV mean-2.5-R; HR=2.6, 95% CI: 1.2-5.9, P=0.020), the metabolic tumor volume(MTV)-2.5 ratio(MTV-2.5-R; HR=2.4, 95% CI: 1.1-5.2, P=0.030), and the total lesion glycolysis(TLG)-2.5 ratio(TLG-2.5-R; HR=3.2, 95% CI: 1.4-7.4, P=0.008) of the lesion with the highest SUV max to that with the lowest SUV max, were significantly associated with PFS. None of the parameters was significantly associated with OS (all P>0.05). Multivariate analysis showed that the SUV max-R was the only independent predictor for PFS ( HR=6.8, 95% CI: 1.8-26.1, P<0.01). Area under the ROC curve for SUV max-R was 0.747. With a cut-off value of 1.8, SUV max-R could effectively distinguish the benefit from non-benefit population treated with trastuzumab (15.0 vs 7.0 months; χ2=18.68, P<0.01). Conclusion:Pretreatment 18F-FDG PET/CT-based HI has potential value for early prediction of first-line trastuzumab treatment outcome in patients with HER2 positive metastatic breast cancer.
RESUMO
Response assessment in breast cancer by 18F-fluorodeoxyglucose (FDG) PET/CT can measure breast cancer cell glucose metabolic level. The evaluation criteria mainly include the European Organization for Research and Treatment of Cancer (EORTC) criteria and PET response evaluation criteria in solid tumors (PERCIST). This review describes and compares the methods and clinical applications of EORTC criteria and PERCIST in response assessment among patients with locally advanced breast cancer after neoadjuvant chemotherapy and recurrent and (or) metastatic breast cancer after systematic therapy.
RESUMO
Background and purpose:In preparation for using this tracer in humans, this study estimated thedosimetry of18F-FES with the method established by MIRD based on whole-body PET imaging of mice.Methods:Three female mice receivedⅣ tail injections of18F-FES and were scanned for 160 min in an Inveon dedicated PET/CT scanner. This study selected some important organs (brain, lung, liver, heart wall, small intestine, large intestine, kidney and urinary bladder), computed their residence times. Then, the residence times in mice organs were converted to human values using scale factors based on differences between organ and body weights. OLINDA/EXM 1.1 software was used to compute the absorbed human doses in multiple organs for both adult female and adult male body phantoms. Results:The highest absorbed doses in gallbladder wall, urinary bladder wall, small intestine, upper large intestine and liver are 0.072 5, 0.044 5, 0.043 0, 0.031 5 and 0.028 2 mGy/MBq, respectively. The organs which have the lowest ab-sorbed doses were brain (0.005 2 mGy/MBq), followed by skin (0.001 1 mGy/MBq), breast (0.001 1 mGy/MBq), heart wall (0.001 2 mGy/MBq) and thyroid (0.001 2 mGy/MBq). The mean absorbed doses for the other major organs ranged from 0.009 5 to 0.023 5 mGy/MBq. The total mean effective dose is 0.019 0 mSv/MBq and the mean effective doses equivalent is 0.025 0 mGy/MBq. A 370-MBq injection of18F-FES leads to an estimated effective dose of 7.03 mSv for the female. There was no statistical difference in the doses results obtained from direct measurement of18F-FES ab-sorption in normal people between previous publications by others and our work.Conclusion:The whole-body mouse imaging can be used as a preclinical tool for initial estimation of the absorbed doses of18F-FES in humans. Furthermore, the potential radiation risk associated with18F-FES imaging is well within the accepted limits.
RESUMO
Background and purpose:16α-[18F]lfuoroestradiol (18F-FES) is an in vivo speciifc imaging agent for estrogen receptor (ER). We investigated the concordance between tumor ER status as determined by FES-PET and in vitro immunohistochemical assays. Methods: 18F-FES was prepared by ourselves. Twenty-six patients were enrolled (17 primary and 9 metastatic/recurrent). Patients underwent both 18F-FES and 18F-FDG PET/CT. Results:We found good overall agreement (96.15%) between in vitro ER assays and FES-PET. The ER status diagnosis sensitivity of 18F-FES was 93.33%and the speciifcity was 100%when using cut-off value of SUVmax≥1.5. There was a positive correlation between in vitro ER, PR assays and the SUVmax of 18F-FES while in vitro HER-2/neu assays correlatived negatively with 18F-FES SUVmax. Conclusion:These results suggested 18F-FES may be useful for studying the ER expression of all malignant lesions in patients with breast cancer and guiding individual therapy.
RESUMO
Background and purpose: 18F-FDG has been considered to be of limited value for the detection of bladder lesions because of interference by the 18F-FDG excreted in urine. Delayed pelvic images with“diluted and iflled bladder”use a method of 18F-FDG PET/CT with delayed images after oral hydration so as to increase the detection rate of 18F-lfuorodeoxyglucose(FDG) PET/CT imaging for the lesions of bladder. Methods:48 patients with bladder lesions(35 patients with bladder primary tumor and 13 patients with metastatic tumor) underwent 18F-FDG PET/CT detection and were required oral hydration of 1200-1800 mL water, urination frequently, holding urine when the more scan began. Lesions conifrmed by histopathology, MRI, CT or clinical follow-up at least 1 year. Results:89%(43/48) of patients were obtained good clearance and the urine SUVmax declined from 33.14(9-66.80)to 3.23(1.35-5.65) signiifcantly and the statistical difference was signiifcant (t=8.703, P<0.01). The interval time between two scan was 2 h approximately. At the same time, the SUVmax of bladder lesion was 2.8-25.0. Detection sensitivity, speciifcity and accuracy were 90.47%(19/21), 81.48%(22/27)and 85.41%(41/48), respectively. Conclusion: 18F-FDG activity in the bladder signiifcantly decreased in most patients with“diluted and iflled bladder”. The PET/CT scan can highly detect lesions of bladder tissues. Our method with high accuracy and better endurance could be applied to detect the lesions in bladder.
RESUMO
Objective To observe the rates of local complications (bleeding/swelling) after trans-radial coronary intervention (TRI),to investigate possible impact factors,in order to provide guidance for the prevention of these adverse events.Methods A total of 198 cases who performed TRI at the department of interventional cardiology of the First Affiliated Hospital of Sun Yat-sen University from August to December,2011 were included in the present study.Data with regards to local complications were collected peri-operatively,by means of direct inquiry,point-of-care observation and measurements,and laboratory testing.Patients who developed complications and patients who did not were compared in terms of compressor position,loosening protocol and so on.Variables with statistical significance in univariate analysis were further included in Cox regression.SPSS 18.0 software was applied for all statistical analysis.Results The relative risks (RR) of the following two variables,namely whether or not the midpoint of compressor was on the midline of forearm,and the vertical distance from the horizontal plate of the compressor to the puncture site,were 2.602 and 1.403,respectively.Conclusions The midpoint of compressor on the midline of forearm,and the vertical distance from the horizontal plate of the compressor to the puncture site were major risk factors of local complications after TRI.
RESUMO
Background and purpose: One of the main mechanism of chemotherapy is inducing tuomr apoptosis. Molecular imaging can allow noninvasively and dynamically monitor tumor apoptosis in vivo, and help to drug screening and therapeutic evaluation. The purpose of this study was to evaluate the feasibility of 18F-SFB-Annexin B1 in detecting apoptosis at an early phase after chemotheraphy. Methods:Annexin B1 was labeled with 18F using SFB as a chelating agent. Tissue distribution of 18F-SFB-Annexin B1 was studied in healthy mice by the dissection method. W256 tumor-bearing rats were injected with 18F-SFB-Annexin B1 intravenously at 24 h after the treatment of cyclophosphamide (CTX 200 mg/kg) or saline. Then imaging was acquired at 1, 2, 3, and 4 h postinjection on a PET/CT, and the tumor-to-muscle ratio of SUVmax (T/M) and the AI from TUNEL testing were compared. Results: 18F-SFB-Annexin B1 had a radiochemical pruity (RCP)>95%. Biodistribution of this probe showed a predominant uptake in the kidney, then was liver, spleen, and myocardium, rapid clearance from blood and urinary was observed. The radios of T/M were 4.38±0.56, 6.75±1.16, 6.44±1.12, 4.81±0.17, respectively at 1, 2, 3, 4 h post injection of the chemotherapy group, much higher than that of the saline group (2.35±0.14, 2.99±0.55, 3.04±0.41, 2.33±0.47, respectively). The differences between the two groups were significant (F=23.790, 16.913, 14.046, 77.517, respectively, all P<0.05). TUNEL staining revealed that chemotherapy treatment significantly increased the percentage of apoptosis cells with an AI of (21.00±0.04)%in the chemotherapy group, higher than that in the saline group (8.58±0.01)%, the difference was significant (F=21.539, P<0.05). The radios of T/M were significantly correlated with the values of AI (r=0.91, P<0.05). Conclusion: 18F-SFB-Annexin B1 can be used to apoptosis imaging and early therapeutic evaluation in vivo because it can reflect apoptosis at an early stage after chemotheraphy.
RESUMO
Objective To investigate influencing factors of puncture site bleeding after trans-radial coronary intervention (TRI)in order to provide guidance for prevention of post-operative bleeding complications.Methods A total of 198 patients with TRI hospitalized at the department of interventional cardiology of our hospital from August,2011 to December,2011 were recruited in the study.In the prospective study,they were divided into two groups:bleeding group(n=62)and non-bleeding group(n=136).The general status,medication,position of radial compressor,time of immobilization of the wrist joint,duration of loosing tourniquet between the first time and second time and number of laps,time for depression,duration for total release of compression device and laboratory testing were recorded as data.Cox regression analysis was done to explore factors influencing bleeding.Results The factors for puncture site bleeding after trans-radial coronary intervention included pre-operative medications,location of compression device at the midline of operated forearm,distance between the compression device midpoint and the second wrist crease,and time for total release of compression device,with their RR=2.001,3.521,1.470 and 0.999,respectively.Conclusion Factors contributing to increased risk of local bleeding at puncture site following TRI included pre-operative medications,location of compression device at the midline of operated forearm,distance between the compression device midpoint and the second wrist crease;whereas the time for total release of compression device may be a protective factor.
RESUMO
Background and purpose: As the most common tracer used for PET/CT to detect malignant tumors. ~(18)F-fluorodeoxyglucose (~(18)F-FDG) can reflect the metabolism of glucose. However, there exists physiologic uptake in the intestinal tract of healthy people. Because ileocecal foci is predilection site of malignant tumors and inflammatory disease, the purpose of this study was to investigate the discrimination of PET/CT detection of incidental ileocecal high FDG uptake. Methods: We retrospectively analyzed 28 unexpected ileocecal focal uptake of ~(18)F-FDG localized by PET/CT, and then semi-quantitatively analyzed the extent of radioactive uptake in ileocecal foci. After PET/CT, the etiology of the findings was confirmed histologically by surgery, endoscopic or by long-term follow-up. All the data were assessed for statistical significance using one-way ANOVA. Results: In all the ileocecal foci, there were 14(50%) physiologic FDG uptake, 8 (28.6%) benign diseases and 6 (21.4%) malignant tumor. Maximal standardized uptake value was 5.2±1.6 in physiologic uptake, 6.8±4.1 in benign lesions and 12.8±5.5 in malignant lesions. There was statistically significant difference between malignant tumors and the other 2 groups. According to ROC analysis, when SUN_(max) was 6.75, the sensitivity and specificity of ileocecal malignant tumor were 100% and 86.4%, respectively. Conclusion: The significant value of discrimination between benign and malignant lesions of ileocecal focal FDG uptake by PET/CT was affirmative. It is very important to recognize physiologic uptake of ileocecal conjunction in the interpretation of image. Semi-quantitative analyze was not helpful to identify benign lesions from physiologic uptake.
RESUMO
With the rapid development of industrial biotechnology, breakthrough in enzymology and biocatalysis has been made in recent years, especially in areas of stability and activity of enzyme in nonaqueous media, screening, construction and modification of solvent-tolerant biocatalysts, as well as the development of green solvent with excellent biological and environmental compatibility. Recent trend and future focus include: in silico virtual screening and construction of solvent-tolerant biocatalysts based on bioinformatic technology, modification and construction of native solvent-tolerant biocatalysts, the development of environmental friendly green solvent such as ionic liquids.
Assuntos
Animais , Humanos , Biocatálise , Biotecnologia , Enzimas , Química , Genética , SolventesRESUMO
Simvastatin, a semisynthetic derivertive of lovastatin, is an important drug for the treatment of hypercholesteromia, and is traditionally prepared by direct alkylation of lovastatin. Chemical reaction conditons are very rigid, and the final product is difficult to purify, also the pressure of labor protection and environment protection is very high. Recently, with the devolpement in the research of lovastatin biosynthesis, more and more attention has been paid to simvastatin biosynthesis. This paper compared the chemical and biological routes in simvastatin production. Simvastatin could be produced by direct fermentation with combinational biosynthesis method, and could also be synthesized from monacolin J with acyltransferase LovD.
Assuntos
Aciltransferases , Genética , Metabolismo , Anticolesterolemiantes , Metabolismo , Catálise , Escherichia coli , Genética , Metabolismo , Fermentação , Lovastatina , Naftalenos , Metabolismo , Sinvastatina , Metabolismo , Transformação BacterianaRESUMO
Objective To evaluate retrospectively the methods and outcomes of surgical treatment of patients with intrahepatic cholelithiasis and biliary stricture.Methods The data of the surgical therapy of 165 cases of cholelithiasis and biliary stricture admitted between January 1995 and January 2003 were analyzed.Group A included 85 cases managed by various types of hepatectomy or hepatic segmental resection(HSR).In group A,40 patients underwent simultaneous cholangiojejunostomy,in 10 patients the dilated bile duct on(resected) surface of liver and bile duct of hepatic hilum were separately anastomosed to the jejunum by double stoma anostomosis,T-tube drainage was done in 21 cases and U-tube drainage in 14 cases.Group B(patients)(n=80) were treated by operation without HSR,included 23 cases with choledochotomy and stone removal plus T-tube drainage,15 cases with choledochotomy and stone removal plus U-tube drainage,42(cases) with choledochotomy and stone removal plus biliary-enteric anastomosis;in group B,plastic operation of the hepatic duct stricture was proforemed in 46 cases.Results In Group A,no operative death occurred.The cases were followed up after operation from 2 to 7 years,and showed residual calculus rate was 4.71%,and symptoms recurrence rate 3.53%.No patient was operated again.In Group B,no operative death(occurred).The cases were followed up from 2 to 7 years after operation,and residual stones were found in 12 cases,a residual calculus rate of 15.00%.After operation,10 cases complained of upper abdominal pain and(fever),with a symptoms recurrence rate of 12.5%.The residual stones of 5 cases were removed by fiber biliary(endoscopy),while 3 cases of the other 6 cases received hepatectomy.Conclusions The combined(hepatic) resection and other operation is an ideal and effective surgical method to treat hepatolithiasis.