Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 11 de 11
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Radiol Med ; 129(3): 439-456, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38349417

RESUMO

PURPOSE: We aimed to systematically assess the methodological quality and clinical potential application of published magnetic resonance imaging (MRI)-based radiomics studies about endometrial cancer (EC). METHODS: Studies of EC radiomics analyses published between 1 January 2000 and 19 March 2023 were extracted, and their methodological quality was evaluated using the radiomics quality score (RQS) and Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Pairwise correlation analyses and separate meta-analyses of studies exploring differential diagnoses and risk prediction were also performed. RESULTS: Forty-five studies involving 3 aims were included. The mean RQS was 13.77 (range: 9-22.5); publication bias was observed in the areas of 'index test' and 'flow and timing'. A high RQS was significantly associated with therapy selection-aimed studies, low QUADAS-2 risk, recent publication year, and high-performance metrics. Raw data from 6 differential diagnosis and 34 risk prediction models were subjected to meta-analysis, revealing diagnostic odds ratios of 23.81 (95% confidence interval [CI] 8.48-66.83) and 18.23 (95% CI 13.68-24.29), respectively. CONCLUSION: The methodological quality of radiomics studies involving patients with EC is unsatisfactory. However, MRI-based radiomics analyses showed promising utility in terms of differential diagnosis and risk prediction.


Assuntos
Neoplasias do Endométrio , Radiômica , Humanos , Feminino , Imageamento por Ressonância Magnética , Neoplasias do Endométrio/diagnóstico por imagem , Diagnóstico Diferencial
2.
Chem Sci ; 14(34): 9186-9190, 2023 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-37655040

RESUMO

Chiral fluorinated reagents provide new opportunities for the discovery of drugs and functional materials because the introduction of a fluorinated group significantly alters a molecule's physicochemical properties. Chiral gem-difluoroalkyl fragments (R-CF2-C*) are key motifs in many drugs. However, the scarcity of synthetic methods and types of chiral gem-difluoroalkyl reagents limits the applications of these compounds. Herein, we report two types of chiral gem-difluoroalkyl reagents chiral gem-difluoroalkyl propargylic borons and gem-difluoroalkyl α-allenols and their synthesis by means of methods involving rhodium-catalyzed enantioselective B-H bond insertion reactions of carbenes and Lewis acid-promoted allenylation reactions. The mild, operationally simple method features a broad substrate scope and good functional group tolerance. These two types of reagents contain easily transformable boron and alkynyl or allenyl moieties and thus might facilitate rapid modular construction of chiral molecules containing chiral gem-difluoroalkyl fragments and might provide new opportunities for the discovery of chiral gem-difluoroalkyl drugs and other functional molecules.

3.
Insights Imaging ; 14(1): 117, 2023 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-37395888

RESUMO

OBJECTIVES: We aimed to present the state of the art of CT- and MRI-based radiomics in the context of ovarian cancer (OC), with a focus on the methodological quality of these studies and the clinical utility of these proposed radiomics models. METHODS: Original articles investigating radiomics in OC published in PubMed, Embase, Web of Science, and the Cochrane Library between January 1, 2002, and January 6, 2023, were extracted. The methodological quality was evaluated using the radiomics quality score (RQS) and Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Pairwise correlation analyses were performed to compare the methodological quality, baseline information, and performance metrics. Additional meta-analyses of studies exploring differential diagnoses and prognostic prediction in patients with OC were performed separately. RESULTS: Fifty-seven studies encompassing 11,693 patients were included. The mean RQS was 30.7% (range - 4 to 22); less than 25% of studies had a high risk of bias and applicability concerns in each domain of QUADAS-2. A high RQS was significantly associated with a low QUADAS-2 risk and recent publication year. Significantly higher performance metrics were observed in studies examining differential diagnosis; 16 such studies as well as 13 exploring prognostic prediction were included in a separate meta-analysis, which revealed diagnostic odds ratios of 25.76 (95% confidence interval (CI) 13.50-49.13) and 12.55 (95% CI 8.38-18.77), respectively. CONCLUSION: Current evidence suggests that the methodological quality of OC-related radiomics studies is unsatisfactory. Radiomics analysis based on CT and MRI showed promising results in terms of differential diagnosis and prognostic prediction. CRITICAL RELEVANCE STATEMENT: Radiomics analysis has potential clinical utility; however, shortcomings persist in existing studies in terms of reproducibility. We suggest that future radiomics studies should be more standardized to better bridge the gap between concepts and clinical applications.

4.
Medicine (Baltimore) ; 97(31): e11679, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30075560

RESUMO

RATIONALE: The perivascular epithelioid cell tumor (PEComa) is rare in young man and rarely occurs in the large intestine. PATIENT CONCERNS: The clinical characteristics, diagnosis, and managements in a 28-year-old boy who presented with sudden onset of cramping and abdominal pain and intermittent melena with a blood pressure of 74/39 mm Hg was retrospectively reviewed. CT scan of the abdomen revealed a 8.9 × 7.2 cm mass in the pelvic floor. DIAGNOSES: Given the difficulty of obtaining a diagnostic specimen, surgical resection was performed. The pathology report of lower anterior resection was malignant PEComa of the rectum in 2006. INTERVENTIONS: Treatment consisted of surgical resection only without additional adjuvant therapy. Over the next 49 months (until 2010) after surgery, abdominal CT showed a 0.6-cm hypodense mass over the liver with suspected liver metastasis. He refused any further evaluation and treatment. After 4 years (2014), abdominal CT showed that the original mass had increased from 0.6 to 1.5 cm and the number of tumors had increased from 1 to 3. In August 2014, he underwent a metastatic hepatectomy without additional chemotherapy or radiotherapy. OUTCOMES: We noted that the metastatic progression was slow in the 4 years after the first operation. At 28 months after metastatic hepatectomy, the patient was doing well. There was also no recurrence of the PEComa of the rectum at the 120-month follow-up in 2016. LESSONS: To the best of our knowledge, this is the first report of a PEComa of the rectum with liver metastases treated with only surgical resection. At approximately 8.8 cm, this is the largest PEComa of the rectum reported in the recent literature.


Assuntos
Hepatectomia/métodos , Neoplasias Hepáticas/cirurgia , Recidiva Local de Neoplasia/cirurgia , Neoplasias de Células Epitelioides Perivasculares/cirurgia , Neoplasias Retais/patologia , Adulto , Humanos , Neoplasias Hepáticas/secundário , Masculino , Recidiva Local de Neoplasia/secundário , Neoplasias de Células Epitelioides Perivasculares/secundário
5.
Transl Oncol ; 8(6): 474-9, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26692528

RESUMO

PURPOSE: This study aimed to identify the efficacy and toxicity of the FOLFIRI regimen (fluorouracil, leucovorin, and irinotecan) with irinotecan dose escalation plus bevacizumab as first-line chemotherapy for metastatic colorectal cancer (mCRC) via UGT1A1 genotyping. METHODS: We administered bevacizumab plus FOLFIRI with irinotecan dose escalation to treat 70 mCRC patients. The UGT1A1 *1/*1 and *1/*28 genotypes started with a 180-mg/m(2) dose of irinotecan, and UGT1A1 *28/*28 genotype started with a dose of 120 mg/m(2). The dose of irinotecan was escalated at increasing intervals of 20 to 30 mg/m(2) until grade 3/4 adverse events (AEs) occurred. The clinical response rate, toxicity, and survival were analyzed. RESULTS: The clinical response and disease control rates of mCRC patients treated with FOLFIRI plus bevacizumab were significantly better in patients with UGT1A1 *1/*1 and *1/*28 genotypes than in patients with UGT1A1 *28/*28 (P = .006 and P < .001, respectively). Grade 3/4 AEs were significantly more common in mCRC patients with the UGT1A1 *28/*28 genotype (P < .001). Progression-free survival was significantly higher in UGT1A1 *1/*1 and *1/*28 patients (P = .002). mCRC patients who underwent metastasectomy achieved better overall survival than those who did not undergo metastasectomy (P = .015). CONCLUSIONS: Our study showed that mCRC patients with UGT1A1 *1/*1 and *1/*28 genotypes could receive escalated doses of irinotecan to obtain a more favorable clinical outcome without significant AEs.

6.
Med Princ Pract ; 23(5): 478-81, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24642571

RESUMO

OBJECTIVE: To report a metastatic colorectal cancer patient with hyperbilirubinemia treated with a combination of bevacizumab and FOLFIRI (5-fluorouracil, leucovorin, and irinotecan) using uridine diphosphate glucuronosyl transferase (UGT1A1) genotyping. CLINICAL PRESENTATION AND INTERVENTION: A 46-year-old male was diagnosed with rectosigmoid colon cancer with liver metastases and hyperbilirubinemia presenting with severe jaundice. UGT1A1 genotyping was used before therapy to ascertain whether genotype-adjusted dosages of irinotecan plus bevacizumab could alleviate the toxicity. Then, the patient was treated with FOLFIRI. CONCLUSION: The FOLFIRI regimen was successfully used in this patient without concerns regarding toxicity.


Assuntos
Adenocarcinoma/tratamento farmacológico , Inibidores da Angiogênese/administração & dosagem , Anticorpos Monoclonais Humanizados/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Camptotecina/análogos & derivados , Neoplasias Colorretais/tratamento farmacológico , Hiperbilirrubinemia/complicações , Adenocarcinoma/genética , Adenocarcinoma/secundário , Bevacizumab , Camptotecina/uso terapêutico , Neoplasias Colorretais/genética , Neoplasias Colorretais/patologia , Fluoruracila/uso terapêutico , Genótipo , Glucuronosiltransferase/genética , Humanos , Hiperbilirrubinemia/genética , Leucovorina/uso terapêutico , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade
7.
Transl Res ; 164(2): 169-76, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24462762

RESUMO

This study compared the clinical responses of patients with metastatic colorectal cancer (mCRC) with 5-fluorouracil/leucovorin with irinotecan (FOLFIRI) plus bevacizumab therapy either with or without uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) genotyping and irinotecan dose escalation. Of 107 total patients with mCRC, 79 were classified as the study group and 28 as the control group. The study group received irinotecan dose escalation based on UGT1A1 genotyping whereas the control group did not. Clinicopathologic features, response rates, and survival were compared for the 2 groups. The clinical response rate of patients with mCRC treated with FOLFIRI plus bevacizumab under UGT1A1 genotyping and irinotecan dose escalation was significantly better than that of those without these prospective tests and dose escalation (P = 0.028). Both progression-free survival (PFS) and overall survival were significantly greater in clinical responders than nonresponders (both, P < 0.001), and PFS was significantly greater among the study group patients than among the control group patients, with a median PFS of 12.2 months vs 9.4 months (P = 0.025). Grade 3/4 adverse events were not significantly different between the 2 groups (P = 0.189). Patients with mCRC undergoing UGT1A1 genotyping may receive escalated doses of irinotecan to obtain a better clinical response/outcome with comparable toxicities.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Camptotecina/análogos & derivados , Neoplasias Colorretais/tratamento farmacológico , Glucuronosiltransferase/genética , Adulto , Idoso , Anticorpos Monoclonais Humanizados/administração & dosagem , Bevacizumab , Camptotecina/administração & dosagem , Neoplasias Colorretais/genética , Neoplasias Colorretais/patologia , Relação Dose-Resposta a Droga , Feminino , Fluoruracila/administração & dosagem , Genótipo , Glucuronosiltransferase/metabolismo , Humanos , Irinotecano , Leucovorina/administração & dosagem , Masculino , Pessoa de Meia-Idade , Prognóstico , Complexo Vitamínico B/administração & dosagem
8.
Int J Mol Sci ; 14(2): 4121-34, 2013 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-23429196

RESUMO

Using the comprehensive approach to selecting polymorphisms to date, we sought to examine whether recurrence in colorectal cancer was associated with inherited variation in three genes involved in DNA repair and cell proliferation. Three polymorphisms, which are excision repair cross-complementation 1 (ERCC1), xeroderma pigmentosum group D (XPD) and epidermal growth factor receptor (EGFR), were assessed in 257 postoperative stage II/III CRC patients with 5-fluorouracial chemotherapy in Taiwan. In addition, the correlations between genetic polymorphisms and patients' clinicopathological features were investigated. Genotypes of XPD codon751 A/A and ERCC1 codon118 T/T were associated with regional recurrence in a statistically significant way (p = 0.018). Patients who carried XPD AA and ERCC1 TT genotypes demonstrated a significantly greater regional recurrence risk (OR = 5.625, 95% CI, 1.557-20.32). Inherited variation in XPD and ERCC1 was associated with outcome in patients with colorectal cancer in Taiwan. As the significant association of single-nucleotide polymorphisms has not been studied previously in colorectal cancer, these findings suggest novel sites of variation, in part explaining the range of treatment responses seen in this disease.

9.
Hepatogastroenterology ; 59(116): 1006-9, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22580649

RESUMO

BACKGROUND/AIMS: The optimal timing for laparoscopic cholecystectomy (LC) in acute cholecystitis (AC) remains controversial. In this study, we aggressively performed three types of LC techniques in AC patients at different time with our care procedure. METHODOLOGY: Forty-three patients with AC were retrospectively divided into two groups: Group one (n=16, within 72 hrs at the onset of symptoms) and Group two (n=27, beyond 72 hrs after the onset of symptoms). Standard, subtotal or prograde cholecystectomy were performed for all cases, depending on the fragility of gallbladder wall, difficulty of gallbladder dissection, assurance of Calot's triangle and quality of retraction over Hartman pouch. RESULTS: There were no statistical differences between both groups with regards to age, operation time, length of hospital stay and complications. Gangrenous cholecystitis was found in 6.3% of cases in Group one and 26.9% in Group two, although not statistically different. Four cases (two in each of groups) underwent prograde cholecystectomy and four cases in the group 2 received subtotal cholecystectomy; all with longer operation time and length of stay, as compared to standard cholecystectomy. None of the 43 patients was converted to open procedure. Complications in this study were minor. CONCLUSIONS: LC can be safely performed in patients with AC with special care, regardless of the duration between the onset of symptoms and operation. In addition to standard procedures, subtotal and prograde cholecystectomy could help to manage inflammatory gallbladder and obscured Calot's triangle.


Assuntos
Colecistectomia Laparoscópica/métodos , Colecistite/cirurgia , Doença Aguda , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo
10.
Pharmacogenet Genomics ; 21(1): 18-25, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21057378

RESUMO

OBJECTIVES: The objective of the study is to investigate whether multiple chemotherapeutic agent-related genetic polymorphisms are associated with the clinical outcomes of Taiwanese metastatic colorectal cancers (mCRC) patients treated with the first-line FOLFOX-4 chemotherapy. METHODS: Consecutive mCRC patients were prospectively enrolled into this study. Peripheral blood samples were used for genotyping of polymorphisms in MTHFR, DPD, GSTP1, MDR1, TYMS, ERCC1, XRCC1, and ERCC2 genes by polymerase chain reaction-restriction fragment length polymorphism technique and DNA sequencing. The primary end point of the study was to investigate the association of each genetic polymorphism with progression-free survival and overall survival (OS). RESULTS: Favorable genotypes from polymorphisms in ERCC1 codon 118C/C [hazard ratio (HR)=0.061, 95% confidence interval (CI): 0.014-0.274, P<0.001] and XRCC1 codon 399G/G (HR=0.306, 95% CI: 0.103-0.905, P=0.032) that are associated with progression-free survival were identified. Furthermore, ERCC1 codon 118C/C (HR=0.065, 95% CI: 0.011-0.377, P=0.002) and XRCC1 codon 399G/G (HR=0.152, 95% CI: 0.041-0.568, P=0.005) were significantly associated with favorable OS. Combining ERCC1 and XRCC1 genetic polymorphisms, patients with both favorable genotypes of ERCC1 codon 118C/C and XRCC1 codon 399G/G were associated with the better OS than those with one or without any favorable genotypes (P<0.001). CONCLUSION: The genetic polymorphisms of ERCC1 and XRCC1 may be useful in predicting clinical outcome in Taiwanese mCRC patients treated with FOLFOX-4. However, further prospective studies will be needed for the potential clinical implication.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma/tratamento farmacológico , Carcinoma/genética , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/genética , Polimorfismo Genético , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma/diagnóstico , Carcinoma/patologia , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/patologia , Feminino , Fluoruracila/uso terapêutico , Estudos de Associação Genética , Humanos , Leucovorina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Metástase Neoplásica , Compostos Organoplatínicos/uso terapêutico , Polimorfismo Genético/fisiologia , Prognóstico , Taiwan , Resultado do Tratamento
11.
Int J Colorectal Dis ; 24(11): 1281-6, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19609535

RESUMO

PURPOSE: The high mobility group proteins (HMGs) include the HMGI family members HMGI-C and HMGI(Y), whose expressions in adult tissues generally correlate with malignant tumor phenotypes. The aim of this study was to assess the relationship of HMGI-C or HMGI(Y) gene expression and prognosis in colorectal cancer patients. METHODS: The gene expressions of HMGI-C and HMGI(Y) in 31 paired samples of colorectal tumor and corresponding non-tumor were determined by real-time reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: The expression of HMGI(Y) in a colorectal cancer tumor was associated with Dukes staging (p = 0.044), while, in non-tumor, the expression of this gene was significant with metastasis (p = 0.003). Patients with Dukes stage A and B present high HMGI(Y) expression in non-tumor of colorectal cancer (p = 0.006). However, patients with Dukes stage C and D present high HMGI-C expression in colorectal tumor (p = 0.023). In the non-metastasis group, HMGI(Y) was highly expressed in non-tumor of colorectal cancer. However, in the metastasis group, there was no significant difference between tumor and non-tumor tissues in both HMGI-C and HMGI(Y) gene expressions. CONCLUSIONS: The HMGI-C and HMGI(Y) quantitations by real-time RT-PCR are associated with Dukes staging and metastasis; hence, the gene expression levels may be useful in clinical practice.


Assuntos
Neoplasias Colorretais/genética , Neoplasias Colorretais/patologia , Regulação Neoplásica da Expressão Gênica , Proteína HMGA1a/genética , Proteína HMGA2/genética , Idoso , Feminino , Proteína HMGA1a/metabolismo , Proteína HMGA2/metabolismo , Humanos , Masculino , Metástase Neoplásica , Estadiamento de Neoplasias
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...