Radiogenomics for predicting microsatellite instability status and PD-L1 expression with machine learning in endometrial cancers: A multicenter study.

Purpose: To evaluate the effectiveness of machine learning model based on magnetic resonance imaging (MRI) in identifying microsatellite instability (MSI) status and PD-L1 expression in endometrial cancer (EC). Methods: This retrospective study included 82 EC patients from 2 independent centers. Radiomics features from the intratumoral and peritumoral regions, obtained from four conventional MRI sequences (T2-weighted images; contrast-enhanced T1-weighted images; diffusion-weighted images; apparent diffusion coefficient), were combined with clinicopathologic characteristics to develop machine learning model for predicting MSI status and PD-L1 expression. 60 patients from center 1 were used as the training set for model construction, while 22 patients from center 2 were used as an external validation set for model evaluation. Results: For predicting MSI status, the clinicopathologic model, radscore model, and combination model achieved area under the curves (AUCs) of 0.728, 0.833, and 0.889 in the training set, respectively, and 0.595, 0.790, and 0.848 in the validation set, respectively. For predicting PD-L1 expression, the clinicopathologic model, radscore model, and combination model achieved AUCs of 0.648, 0.814, and 0.834 in the training set, respectively, and 0.660, 0.708, and 0.764 in the validation set, respectively. Calibration curve analysis and decision curve analysis demonstrated good calibration and clinical utility of the combination model. Conclusion: The machine learning model incorporating MRI-based radiomics features and clinicopathologic characteristics could be a potential tool for predicting MSI status and PD-L1 expression in EC. This approach may contribute to precision medicine for EC patients.

Potential missed opportunities for diagnosis of lymphoepithelioma-like intrahepatic cholangiocarcinoma: report of a rare case.

Lymphoepithelioma-like intrahepatic cholangiocarcinoma (LEL-ICC) is a rare distinctive variant of liver cancer with unique epidemiological and pathological characteristics, including dense lymphocyte infiltration. We herein describe a 67-year-old Chinese man with LEL-ICC. The patient had undergone endoscopic extraction of a bile duct stone 1 month prior. Contrast-enhanced abdominal computed tomography (CT) revealed a 2.5- × 2.5- × 1.5-cm low-density mass located in a covert part of the left lateral segment of the liver. Contrast-enhanced magnetic resonance imaging revealed a hyperintense lesion on T2-weighted and diffusion-weighted images of the left lateral liver, with similar size and signal characteristics in the arterial and portal venous phases. The patient subsequently underwent left lateral laparoscopic hepatectomy. The results of postoperative pathology and immunohistochemistry allowed for the definitive diagnosis. In situ hybridization using an Epstein-Barr virus-encoded RNA probe revealed extensive reactivity in the tumor cell nuclei, supporting a diagnosis of LEL-ICC. The patient was recurrence-free at 12 months postoperatively as shown by CT. A literature review indicated that in middle-aged patients with Epstein-Barr virus infection, a liver mass with a well-defined margin and a combination of hypervascularity and delayed intratumoral enhancement on CT and magnetic resonance imaging may suggest a diagnosis of LEL-ICC.

Case report: Kikuchi-Fujimoto disease: unveiling a case of recurrent fever and enlarged cervical lymph nodes in a young female patient with a literature review of the immune mechanism.

The inflammatory response to viral infection is an important component of the antiviral response, a process that involves the activation and proliferation of CD8+ T, CD4+ T, and dendritic cells; thus, viral infection disrupts the immune homeostasis of the organism, leading to an increased release of inflammatory factors. Kikuchi-Fujimoto disease (KFD) is an inflammatory self-limited disorder of unknown etiology, and it is generally believed that the pathogenesis of this disease includes two aspects: viral infection and autoimmune response. Various immune cells, such as CD8+ T lymphocytes, CD4+ T lymphocytes, and CD123+ plasmacytoid dendritic cells, as well as the cytokines they induce and secrete, such as interferons, interleukins, and tumor necrosis factors, play a crucial role in the pathogenesis of KFD. In this article, we present a case study of a young female patient from China who exhibited typical symptoms of lymph node inflammation and fever. The diagnosis of KFD was confirmed through a lymph node biopsy. She presented with elevated ESR, IL-6, and IFN-γ. Viral markers showed elevated IgG and IgM of cytomegalovirus (CMV) and elevated IgG of Epstein-Barr virus (EBV), while changes occurred in the CD4+ T and CD8+ T cell counts. Eventually, the patient achieved disease relief through steroid treatment. Based on these findings, we conducted a comprehensive review of the involvement of viral infection-induced inflammatory response processes and autoimmunity in the pathogenesis of Kikuchi-Fujimoto disease.

Imaging Manifestations of Intrahepatic Reactive Lymphoid Hyperplasia: A Case Report and Literature Review.

Reactive lymphoid hyperplasia (RLH) of the liver is a rare benign disease. This article describes a 77-year-old female patient with RLH of the liver. The patient was admitted to the hospital due to atrial fibrillation. A liver tumor was incidentally found during abdominal enhanced CT. Further magnetic resonance imaging (MRI) and PET/CT showed four lesions in the liver. The imaging findings suggested hepatocellular carcinoma (HCC), but it was not consistent that the patient had no history of liver cirrhosis and hepatitis, and a variety of tumor markers were within the normal range. The largest lesion was surgically removed and microscopically diagnosed as RLH of the liver. The pathology included a large number of reactive hyperplastic lymphoid follicles. Immunohistochemical examination showed that the infiltrating lymphocytes were polyclonal. The authors believe that the perinodular enhancement on MRI, the obvious limitation of diffusion on DWI, the insignificant increase of SUVmax on PET-CT delayed phase, and the support of clinical data can help distinguish liver RLH from lymphoma and HCC.

Correlation between quantitative perfusion histogram parameters of DCE-MRI and PTEN, P-Akt and m-TOR in different pathological types of lung cancer.

BACKGROUND: To explore if the quantitative perfusion histogram parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) correlates with the expression of PTEN, P-Akt and m-TOR protein in lung cancer. METHODS: Thirty-three patients with 33 lesions who had been diagnosed with lung cancer were enrolled in this study. They were divided into three groups: squamous cell carcinoma (SCC, 15 cases), adenocarcinoma (AC, 12 cases) and small cell lung cancer (SCLC, 6 cases). Preoperative imaging (conventional imaging and DCE-MRI) was performed on all patients. The Exchange model was used to measure the phar- macokinetic parameters, including Ktrans, Vp, Kep, Ve and Fp, and then the histogram parameters meanvalue, skewness, kurtosis, uniformity, energy, entropy, quantile of above five parameters were analyzed. The expression of PTEN, P-Akt and m-TOR were assessed by immunohistochemistry. Spearman correlation analysis was used to compare the correlation between the quantitative perfusion histogram parameters and the expression of PTEN, P-Akt and m-TOR in different pathological subtypes of lung cancer. RESULTS: The expression of m-TOR (P = 0.013) and P-Akt (P = 0.002) in AC was significantly higher than those in SCC. Vp (uniformity) in SCC group, Ktrans (uniformity), Ve (kurtosis, Q10, Q25) in AC group, Fp (skewness, kurtosis, energy), Ve (Q75, Q90, Q95) in SCLC group was positively correlated with PTEN, and Fp (entropy) in the SCLC group was negatively correlated with PTEN (P < 0.05); Kep (Q5, Q10) in the SCLC group was positively correlated with P-Akt, and Kep (energy) in the SCLC group was negatively correlated with P-Akt (P < 0.05); Kep (Q5) in SCC group and Vp (meanvalue, Q75, Q90, Q95) in SCLC group was positively correlated with m-TOR, and Ve (meanvalue) in SCC group was negatively correlated with m-TOR (P < 0.05). CONCLUSIONS: The quantitative perfusion histogram parameters of DCE-MRI was correlated with the expression of PTEN, P-Akt and m-TOR in different pathological types of lung cancer, which may be used to indirectly evaluate the activation status of PI3K/Akt/mTOR signal pathway gene in lung cancer, and provide important reference for clinical treatment.

Imparting External Stress-Free Two-Way Shape Memory Effect to Commodity Polyolefins by Manipulation of Their Hierarchical Structures.

Two simple methods are proposed to respectively impart external force-free reversible shape memory effect to commercial polyolefins: ultrahigh molecular weight polyethylene (UHMWPE) and polypropylene (PP). The key issues lie in the utilization of the partially entangled molecular chains of UHMWPE and the medium crystalline phases of PP as the reversible internal stress providers. The acquired reversible shape memory effect further proves to be applicable for assisting repeatedly self-healing of wider cracks. Compared to the conventional approaches, which used to introduce cross-linkages into the target materials, the present ones only need physical treatment, so that the valuable thermoplasticity of polyolefins is retained. This work can be regarded as an example of the concept "physically converting instead of chemically modifying" for the preparation of functional polymeric materials based on market available plastics.

A Comparison between Prethoracoscopy Localization of Small Pulmonary Nodules by Means of Medical Adhesive versus Hookwire.

PURPOSE: To compare prethoracoscopy localization of small pulmonary nodules (SPNs) by means of medical adhesive versus hookwire. MATERIALS AND METHODS: One hundred seven patients who underwent video-assisted thoracoscopic surgery resection for SPNs were consecutively recruited in this retrospective cohort study. Patients were divided into 2 groups according to the material used for localization of the SPNs: the medical adhesive group (n = 88) and the hookwire group (n = 19). The baseline data were collected, and operation waiting time (OWT; the time gap between localization and surgery), wedge resection performing time (WRPT), pathologic result, and complications of the 2 groups were assessed. RESULTS: All SPNs were successfully marked. No differences in pathologic result (P = .676), wedge resection, or segmentectomy rate (P = .679) were observed. OWT was markedly longer in the medical adhesive group than in the hookwire group (P < .001), whereas WRPT was similar in the 2 groups (P = .926). There were significantly (P = .004) fewer complications in the medical adhesive group (37.42%) than in the hookwire group (15.79%). Regarding individual complications, hemorrhage occurred significantly less in the medical adhesive group than in the hookwire group (9% vs 68%; P < .001), and no differences of cough, pneumothorax, or chest pain were found between the 2 groups (all P > .05). Multivariate logistic regression analysis further validated that hookwire was independently correlated with a higher risk of complication occurrence (P = .008) and hemorrhage occurrence (P < .001) compared with medical adhesive. CONCLUSIONS: Compared with hookwire, localization via medical adhesive can achieve a flexible time gap between localization and surgery. It also decreases the complication rate and increases convenience owing to no need for an anchor hook.

The S1-S2 linker determines the distinct pH sensitivity between ZmK2.1 and KAT1.

Efficient stomatal opening requires activation of KAT-type K(+) channels, which mediate K(+) influx into guard cells. Most KAT-type channels are functionally facilitated by extracellular acidification. However, despite sequence and structural homologies, the maize counterpart of Arabidopsis KAT1 (ZmK2.1) is resistant to pH activation. To understand the structural determinant that results in the differential pH activation of these counterparts, we analysed chimeric channels and channels with point mutations for ZmK2.1 and its closest Arabidopsis homologue KAT1. Exchange of the S1-S2 linkers altered the pH sensitivity between the two channels, suggesting that the S1-S2 linker is essentially involved in the pH sensitivity. The effects of D92 mutation within the linker motif together with substitution of the first half of the linker largely resemble the effects of substitution of the complete linker. Topological modelling predicts that one of the two cysteines located on the outer face section of the S5 domain may serve as a potential titratable group that interacts with the S1-S2 linker. The difference between ZmK2.1 and KAT1 is predicted to be the result of the distance of the stabilized linkers from the titratable group. In KAT1, residue K85 within the linker forms a hydrogen bond with C211 that enables the pH activation; conversely, the linker of ZmK2.1 is distantly located and thus does not interact with the equivalent titration group (C208). Thus, in addition to the known structural contributors to the proton activation of KAT channels, we have uncovered a previously unidentified component that is strongly involved in this complex proton activation network.