Prognostic factors and multidisciplinary treatment modalities for brain metastases from colorectal cancer: analysis of 93 patients.

BACKGROUND: The purpose of this study was to review patient characteristics and evaluate the potential factors affecting prognosis in cases of brain metastasis (BM) from colorectal cancer (CRC). METHODS: We retrospectively reviewed 93 cases of BM from CRC in our hospital. Patient demographics, neurologic symptoms, and location and number of BMs were recorded. Factors analyzed included: age; sex; Karnofsky performance score; number of BMs; presence of extracranial metastases; dimensions; location of tumors; treatment modalities. RESULTS: The overall 1- and 2-year survival rates were 27.7 and 9.9%. On multivariate analysis, the number of BMs, extracranial metastases and the initial treatment modalities were found to be independent prognostic factors for overall survival. Patients treated with surgical resection followed by WBRT or SRS had an improved prognosis relative to those treated with surgery alone (P=0.02 and P=0.02, respectively). No significance difference in survival rate was found between patients treated with SRS alone or SRS plus WBRT (P=0.11). CONCLUSIONS: Surgical resection of BMs from CRC in selected patients may help prolong survival. Additional radiotherapy following surgery is valuable in improving prognosis. Extracranial metastasis, multiple BM lesions and initial non operation can be considered as independent factors associated with poor prognosis.

HIV-infection resistance in PMBC-derived dendritic cells modified with recombinant virus.

This study aimed to identify the characteristics of recombinant-adenovirus-modified PBMC-derived dendritic cells and their resistance to HIV-1 infection by integrating the CCR5∆32, CCR5siRNA, HIV-1 pol and HIV-1 int genes into a recombinant adenovirus vector using the AdEasy system. Dendritic cells (DCs) were isolated from human PBMCs from blood of healthy donors. The expression of CCR5∆32, CCR5, CXCR4 and HIV-1 p24 in PBMCs or modified cells was measured by western blot, p24 expression in cell lysates was measured by ELISA, and HIV-1 entry was measured by ß-galactosidase assay. Furthermore, T-cell immunity induced by the recombinant adenovirus was measured by ELISPOT assay. After the cells were modified by Ad-R5∆32siRNA, the expression of CCR5∆32 increased, while the expression of CCR5 and CXCR4 decreased. There was no adverse effect of adenoviral gene transfer on DC development. CD83 expression on the surface of mature DCs did not change after gene transfer. The expression of p24 remained at low levels in modified cells when challenged by HIV-1. The modified cells showed resistance to HIV-1 infection. Results indicated that recombinant-adenovirus-modified cells demonstrated good resistance to HIV-1 infection. Modification of HSC-derived immune cells, such as DCs, may be a potent strategy to resist HIV-1 infection.

Multiple synchronous anorectal melanomas with different colors: A case report.

BACKGROUND: Anorectal melanoma (AM) is an extremely rare malignant tumor originating from anorectal melanocytes with a poor prognosis. AM has been reported to have a much lower incidence than cutaneous or choroid melanoma, accounting for 0.4%-1.6% of all melanomas. CASE SUMMARY: We report a 76-year-old female patient diagnosed with anorectal malignant melanoma by colonoscopy and biopsy. Intraoperative examination revealed two distinct anorectal tumors, one melanotic and another amelanotic, as well as two pigmented mucosal zones at the dentate line level. Abdominal perineal resection was performed. A pathological report confirmed all four lesions to be melanomas. Postoperatively, we followed an immunotherapy protocol targeting PD-1 (nivolumab). The patient had 24 mo of disease-free follow-up upon completion of nivolumab treatment. CONCLUSION: This is the first reported case presenting coexistence of pigmented and unpigmented AMs in the same patient.

[Influence of serum prolactin on interleukin-6 secretion by peripheral blood mononuclear cells in patients with systemic lupus erythematosus].

OBJECTIVE: To detect serum prolactin (PRL) level in patients with systemic lupus erythematosus (SLE) and its correlations to SLE activity and interleukin-6 (IL-6) by peripheral blood mononuclear cells (PBMCs). METHODS: An electrochemiluminescence assay was employed to examine the serum content of PRL in 40 SLE patients and 20 healthy subjects, and the levels of IL-6 secretion by the PBMCs were detected using enzyme-linked immunosorbent assay. RESULTS: SLE patients showed a significantly higher serum level of PRL than healthy subjects, which was especially obvious in the active stage of the disease (P=0.000. Serum PRL in SLE patients was found to positively correlate to SLE Disease Activity Index (SLEDAI) (r=0.568, P=0.000). SLE patients with hyperprolactinemia showed a significantly higher level of IL-6 secretion by the PBMCs than those with normal serum PRL level (P=0.000). IL-6 secretion by the PBMCs isolated from SLE patients with normal PRL level and from healthy controls, especially the latter, increased significantly after stimulation of the cells with recombinant human PRL in vitro (P=0.000). CONCLUSION: Serum PRL may play a role in the pathogenesis of SLE. An elevated PRL level is closely related to SLE activity and can be used to assess SLE activity. Increased serum PRL level can up-regulate the secretion of IL-6 by the PBMCs.