RESUMO
The aim of the present study was to identify a novel strategy that predicts the metastatic status of lymph nodes (LNs) in patients diagnosed with colorectal cancer, using detailed characteristics of contrast-enhanced CT scan images. A total of 284 preoperative CT scans derived from patients diagnosed with colorectal cancer at Second Affiliated Hospital, Zhejiang University School of Medicine between January 2013 and July 2018 were retrospectively reviewed. A total of 794 LNs were assessed for size, margins, morphology and subtle internal enhancements in the equilibrium phase. Imaging features were analyzed by two abdominal radiologists (Department of Radiology, Second Affiliated Hospital, Zhejiang University School of Medicine and Departments of Radiology; Shaoxing Second Hospital Departments of Radiology, Shaoxing Second Hospital) in a blind manner. If the conclusions were not concordant, the final score was determined by a senior radiologist who specialized in abdominal radiology for ≥30 years. According to the histopathology results, 27.3% (217/794) of LNs were metastatic (LN+). In addition, LNs >10 mm in size demonstrated sensitivity, specificity, positive predictive values (PPVs) and negative predictive values (NPVs) of 47.0, 80.9, 48.1 and 80.2%, respectively [odds ratio (OR), 3.77; 95% confidence interval (CI), 2.69-5.28]. LNs in the shape of a kidney bean (middle fat depression like kidney) and/or those with an oblong shape were more likely to be metastasis negative LNs (LN-), while lobulated and irregular LNs were more likely to be LN+. In magnified images, internal enhancement characteristics of LN- were defined as homogeneous, spotted, striped and core enhancing. By contrast, rim and heterogeneity enhancement features for LN+ demonstrated sensitivity, specificity, PPVs and NPVs of 46.5, 89.9, 63.5 and 81.7%, respectively (OR, 7.79; 95% CI, 5.33-11.40). The results demonstrated that the internal enhancement features of LNs may be used as a predictor of metastasis. The detailed benign characteristics, such as homogeneity, spotted, striped and core enhancement of LNs may facilitate the identification of LN- in patients with colorectal cancer.
RESUMO
PURPOSE: The tetraspanin CD151 acts as a promoter of metastasis and invasion in several tumors. However, the role of CD151 in human gastric cancer (HGC) remains unclear. METHODS: Twenty HGC specimens and matched nontumor samples, human gastric epithelial cells (HGEC), and four gastric cancer cell lines were used to analyze CD151 expression. Short hairpin RNA-mediated downregulation of CD151 expression in HGC cells was performed to examine the role of CD151 in the proliferation and metastasis/invasion of HGC cells in vivo and in vitro. The relationship of CD151 with integrin α3 in HGC cells was investigated by silencing integrin α3 followed by co-immunoprecipitation and immunofluorescence staining. Finally, the prognostic value of CD151 and integrin α3 was evaluated by immunohistochemistry in tissue microarrays of 76 HGC patients. RESULTS: CD151 was expressed at higher levels in HGC tissues and HGC cells than in nontumor tissues and HGEC cells. Down-regulation of CD151 by vshRNA-CD151 impaired metastasis and invasion of HGC-27 cells, but did not affect cell proliferation. CD151 formed a complex with integrin α3 in HGC cells. CD151-cDNA transfection rescued the metastatic potential and invasiveness of HGC-27-vshCD151 cells, but not those of HGC-27-vshintegrin α3 cells in vitro. Clinically, CD151 overexpression was significantly correlated with high TNM stage, depth of invasion and positive lymph node involvement (p<0.05), and high levels of integrin α3 were associated with large tumor size, high TNM stage, depth of invasion and lymph node involvement (p<0.05). Importantly, the postoperative 5-year overall survival of patients with CD151(low) and/or integrin α3(low) was higher than that of patients with CD151(high) and/or integrin α3(high). CONCLUSION: CD151 is positively associated with the invasiveness of HGC, and CD151 or the combination of CD151 and integrin α3 is a novel marker for predicting the prognosis of HGC patients and may be potential therapeutic targets.
