RESUMO
Aims: Yin Yang 1 (YY1) is a multifunctional transcription factor that plays an important role in tumour development and progression, while its clinical significance in diffuse large B-cell lymphoma (DLBCL) remains largely unexplored. This study aimed to investigate the expression and clinical implications of YY1 in DLBCL. Methods: YY1 expression in 198 cases of DLBCL was determined using immunohistochemistry. The correlation between YY1 expression and clinicopathological parameters as well as the overall survival (OS) and progression-free survival (PFS) of patients was analyzed. Results: YY1 protein expression was observed in 121 out of 198 (61.1 %) DLBCL cases. YY1 expression was significantly more frequent in cases of the GCB subgroup than in the non-GCB subgroup (P = 0.005). YY1 was positively correlated with the expression of MUM1, BCL6, pAKT and MYC/BCL2 but was negatively associated with the expression of CXCR4. No significant relationships were identified between YY1 and clinical characteristics, including age, sex, stage, localization, and B symptoms. Univariate analysis showed that the OS (P = 0.003) and PFS (P = 0.005) of patients in the YY1-negative group were significantly worse than those in the YY1-positive group. Multivariate analysis indicated that negative YY1 was a risk factor for inferior OS (P < 0.001) and PFS (P = 0.017) independent of the international prognostic index (IPI) score, treatment and Ann Arbor stage. Furthermore, YY1 is more powerful for stratifying DLBCL patients into different risk groups when combined with MYC/BCL2 double-expression (DE) status. Conclusions: YY1 was frequently expressed in DLBCL, especially in those of GCB phenotype and with MYC/BCL2-DE. As an independent prognostic factor, YY1 expression could predict a favourable outcome in DLBCL. In addition, a complex regulatory mechanism might be involved in the interactions between YY1 and MYC, pAKT as well as CXCR4 in DLBCL, which warrants further investigation.
RESUMO
OBJECTIVE: To investigate the anatomical relationships of facial nerve canal related to middle ear and mastoid surgery by multi-slice computed tomography (MSCT) and its multiplanar reconstruction ( MPR) technology. METHODS: High-resolution CT scanning with multislice spiral CT of temporal bones without bone abnormality of 373 ears in 187 adult patients were examined. All original images were processed by MPR. The distances between facial nerve canal (FNC) and jugular foramen (JF), lateral surface of mastoid bone (M), external acoustic canal (EAC), posterior fossa dural plate (PFD), sigmoid sinus (SS), promontory (P), cochlear window (CW), pyramidal eminence (PE), posterior semicircular canal (PSC), oval window (OW), head of malleus (MH), incus lenticular process (ILP) and lateral semicircular canal (LSC) were measured on different MPR images. These measurements were also analyzed with respects to side, gender, pneumatization and jugular foramen position differences. RESULTS: On average, FNC-JF was 5.43 mm, FNC-M 15.99 mm, FNC-EAC 4.42 mm, FNC-PFD 9.01 mm, FNC-SS 9.44 mm, FNC-P 6.02 mm, FNC-CW 6.51 mm, FNC-PE 2.64 mm, FNC-PSC 3.12 mm, FNC-OW 1.19 mm, FNC-MH 2.27 mm, FNC-ILP 3.09 mm and FNC-LSC 0.90 mm. FNC-M was longer in males than that of females (P < 0.05). FNC-JF and FNC-SS were longer on left side than those of the right (P < 0.05). FNC-PFD was shorter on left side (P < 0.05). FNC-PFD, FNC-EAC, FNC-SS and FNC-M were longer in well pneumatized mastoids than those of poorly pneumatized mastoids (P < 0.05). FNC-PE was longer in poorly pneumatized mastoids than that of well pneumatized mastoids (P < 0.05). FNC-PFD, FNC-P, FNC-CW and FNC-PSC were longer in bones with jugular foramen variation than those of bones without jugular foramen variation (P < 0.05). FNC-JF, FNC-SS and FNC-M were longer in bones without jugular foramen variation than those of bones with jugular foramen variation (P < 0.05). CONCLUSIONS: Anatomical relationships of facial nerve canal related to middle ear and mastoid surgery can be accurately measured on MSCT-MPR images. It is helpful to avoid injuring facial nerve in middle ear and mastoid surgery.