RESUMEN
OBJECTIVE: To explore the potential of intratumoral metabolism and its heterogeneous parameters, as measured by preoperative fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) imaging, to predict mediastinal occult lymph node metastasis in cN0 lung invasive adenocarcinoma. SUBJECTS AND METHODS: Seventy five patients were consecutively enrolled from January 2018 to December 2022. All patients underwent 18F-FDG PET/CT scans within two weeks before surgery, and had mediastinal lymph node metastasis confirmed by pathologic diagnosis after surgery. Metabolic parameters including the maximum standardized uptake value (SUVmax), mean SUV (SUVmean), maximum average SUV (SUVpeak), tumor metabolic volume (MTV), and metabolic heterogeneity (HF) were measured. The relationship between primary focal metabolism, its heterogeneity parameters, and occult mediastinal lymph node metastasis was analyzed using an independent-sample t-test, analysis of covariance, and Mann-Whitney U test. A multivariate logistic regression model was used to analyze independent risk factors for mediastinal lymph node metastasis, while the receiver operating characteristic (ROC) curve assessed the predictive value of metabolic heterogeneity parameters for mediastinal occult lymph node metastasis. RESULTS: A total of 20 out of 75 patients (26.7%) were pathologically confirmed to have mediastinal lymph node metastasis. Analysis of covariance showed that the SUVmax, SUVmean, SUVpeak and MTV were significantly higher in patients with metastasis than in those without (all P<0.05). The metabolic heterogeneity parameters HF2 and HF3 were significantly higher in patients with mediastinal lymph node metastasis than in those without (P=0.013, 0.001), but not HF1. Multivariate Logistic regression analysis identified that tumor size, SUVmax, SUVpeak, lymph node SUVmax, and HF2 of the primary tumor as independent risk factors for mediastinal lymph node metastasis. Metabolic heterogeneity 3 demonstrated high predictive value for mediastinal occult lymph node metastasis (AUC=0.720, P=0.004). CONCLUSION: Metabolism and heterogeneity, as measured by preoperative 18F-FDG PET/CT in lung invasive adenocarcinoma, potentially have clinical value for predicting mediastinal occult lymph node metastasis.
RESUMEN
Vaccines represent one of the most powerful and cost-effective innovations for controlling a wide range of infectious diseases caused by various viruses and bacteria. Unlike mRNA and DNA-based vaccines, subunit vaccines carry no risk of insertional mutagenesis and can be lyophilized for convenient transportation and long-term storage. However, existing adjuvants are often associated with toxic effect and reactogenicity, necessitating expanding the repertoire of adjuvants with better biocompatibility, for instance, designing self-adjuvating polymeric carriers. We herein report a novel subunit vaccine delivery platform constructed via in situ free radical polymerization of C7A (2-(Hexamethyleneimino) ethyl methacrylate) and acrylamide around the surface of individual protein antigens. Using ovalbumin (OVA) as a model antigen, we observed substantial increases in both diameter (â¼70 nm) and surface potential (-1.18 mV) following encapsulation, referred to as n(OVA)C7A. C7A's ultra pH sensitivity with a transition pH around 6.9 allows for rapid protonation in acidic environments. This property facilitates crucial processes such as endosomal escape and major histocompatibility complex (MHC)-I-mediated antigen presentation, culminating in the substantial CD8+ T cell activation. Additionally, compared to OVA nanocapsules without the C7A components and native OVA without modifications, we observed heightened B cell activation within the germinal center, along with remarkable increases in serum antibody and cytokine production. It's important to note that mounting evidence suggests that adjuvant effects, particularly its targeted stimulation of type I interferons (IFNs), can contribute to advantageous adaptive immune responses. Beyond its exceptional potency, the nanovaccine also demonstrated robust formation of immune memory and exhibited a favorable biosafety profile. These findings collectively underscore the promising potential of our nanovaccine in the realm of immunotherapy and vaccine development.