Glioma tectal pediátrico con hidrocefalia y ventriculomegalia. Dos casos clínicos / Pediatric tectal glioma presented with acute hydrocephalus and ventriculomegaly. Two case reports

Los gliomas tectales representan un subtipo de tumores de bajo grado que se desarrollan en la región tectal, en la parte superior del tronco encefálico. Los síntomas incluyen los causados por el aumento de la presión intracraneal por hidrocefalia obstructiva. Son comunes la cefalea, la visión borrosa o doble, las náuseas y los vómitos. El tratamiento de la hidrocefalia es la ventriculostomía endoscópica del tercer ventrículo o la derivación ventrículo-peritoneal. Los gliomas tectales se diagnostican habitualmente en la infancia, pero son frecuentes también en adultos. En general son benignos y de progresión lenta; es suficiente el seguimiento ambulatorio clínico y radiológico. Se presentan dos pacientes pediátricos con tumores de la placa tectal mesencefálica. Un niño de 11 años y una niña de 15 años concurrieron al Departamento de Emergencias con diferentes síntomas. El niño fue tratado con derivación ventrículo-peritoneal por hidrocefalia aguda.

Tectal gliomas represent a subset of low-grade tumors that arise in the tectal region at the roof of the brainstem. Symptoms of tectal glioma include those caused by increased intracranial pressure due to obstructive hydrocephalus. Headache, blurred vision, double vision, nausea and vomiting are common symptoms. In the treatment, ETV (endoscopic third ventriculostomy) or VP-shunt (ventriculoperitoneal) can be applied to treat hydrocephalus. Tectal gliomas are usually diagnosed in childhood and often occur in adults. They are often benign, slowly progressing lesions; outpatient clinical and radiological followup is sufficient. We present two cases of pediatric patients with mesencephalic tectal plate tumors. An 11-year-old boy and a 15-year-old girl applied to the Emergency Department with different complaints. The 11 year-old-boy was treated with VP-shunt due to acute hydrocephalus.

Radionecrosis cerebral en un adulto

Se presenta el caso clínico de un paciente de 37 años de edad con el antecedente de haber recibido radioterapia por una lesión tumoral en la región frontal derecha, el cual acudió a consulta en el Instituto de Neurología y Neurocirugía de Cuba por presentar cefalea intensa y hemiparesia izquierda. Luego de realizados los exámenes necesarios, se estableció el diagnóstico clínico-imagenológico de lesión por radionecrosis en el hemisferio contralateral, que fue corroborado en el estudio anatomopatológico una vez que se extirpó el tumor; seguidamente, se indicó inmunoterapia. La evolución del paciente fue satisfactoria, pues se logró el control de la enfermedad y la resolución de los síntomas.

The case report of a 37-year-old patient with history of having received radiotherapy due to a tumor lesion in the right frontal region is presented, who attended to the Institute of Neurology and Neurosurgery in Cuba because of intense headache and left hemiparesis. After carrying out the necessary examinations, the clinical-imaging diagnosis of a radionecrosis lesion in the contralateral hemisphere was established, which was corroborated in the pathological examination once the tumor was removed; then, immunotherapy was indicated. The patient had a favorable clinical course because the control of the disease was achieved as well as the resolution of symptoms.

Research on the Role and Clinical Application Value of the Histone H2A Deubiquitinase BAP1 in the Occurrence and Progression of Malignant Glioma Cells / 现代检验医学杂志

Objective To explore the role of breast/ovarian cancer susceptibility gene 1 associated protein 1(BAP1)in the occurrence and progression of human malignant glioma and the feasibility of BAP1 as a clinical diagnostic marker for malignant glioma.Methods The differential expression of BAP1 in normal and glioma tissue was analyzed based on the GSE4290 and GSE90598 sub-datasets from the gene expression omnibus(GEO)database.Receiver operating characteristic(ROC)curve analysis was conducted to assess the early diagnostic value of BAP1 for malignant glioma.Primary lesion tissues from 28 nonpaired malignant glioma patients and non-tumor brain tissues removed by internal decompression surgery in 5 patients with traumatic brain injury collected independently were collected,and the expression levels of BAP1 were measured using quantitative real-time polymerase chain reaction(qRT-PCR).Specific small interfering RNAs(siRNAs)targeting BAP1 were transiently transfected into U251 cells to further evaluate their interference efficiency.Flow cytometry was employed to analyze changes in the cell cycle and apoptosis of U251 cells with BAP1 knockdown.Results The results of bioinformatics showed that the expression of BAP1 in malignant glioma tissues was lower than that in normal brain tissues(GSE 4290:1 209±18.49 vs 1 476±53.90,GSE 90598:5.19±0.10 vs 5.65±0.21),and the differences were significant(t=5.115,2.267,all P<0.05).ROC curve showed that BAP1 could efficiently differentiate malignant glioma tissue from normal brain tissue(GSE4290:AUC=0.78,GSE90598:AUC=0.75,all P<0.05).The expression level of BAP1 in primary malignant glioma tissue was lower than that in normal brain tissue(0.27±0.04 vs 1.06±0.07),and the difference was significant(t=10.22,P<0.001).After down-regulating the expression of BAP1 in U251 cells,the proportion of S phase cells increased from 17.59%to 27.21%(siBAP1-1)and 25.79%(siBAP1-2),respectively,and the differences were significant(t=6.576,6.642,all P<0.01).However,the apoptosis levels decreased from 10.17%to 2.70%(siBAP-1)and 3.00%(siBAP-2),respectively,and the differences were significant(t=10.31,9.428,all P<0.01).Conclusion Histone H2A deubiquitinase BAP1 could exert the function of tumor suppressor genes by inhibiting rapid cell cycle progression and promoting apoptosis in malignant glioma,and could serve as a potential clinical diagnostic biomarker for malignant glioma.

Expression of TRIP4 and DDIT4 in Glioma Tissue and Their Relationship with Clinical Pathological Parameters and Prognosis / 现代检验医学杂志

Objective To study the expression of thyroid hormone receptor binding protein 4(TRIP4)and DNA damage inducing transcription factor 4(DDIT4)in glioma tissue and their relationship with clinical pathological characteristics and prognosis.Methods 94 glioma patients admitted to the First Hospital of Hebei Medical University from February 2018 to February 2019 were selected as the research subjects.The expression of TRIP4,DDIT4 proteins in tissues were detected by immunohistochemistry.The relationship between the expression of TRIP4,DDIT4 proteins in glioma tissues and clinical pathological characteristics were compared.The differences in survival prognosis of glioma patients with different levels of TRIP4,DDIT4 protein expression were analyzed by Kaplan-Meier survival curve.Univariate and multivariate COX regression analysis was conducted to analyze the factors affecting the survival prognosis of glioma patients.Results The positive rates of TRIP4(68.09%),DDIT4(65.96%)proteins in glioma tissues were higher than those in adjacent tissues(13.83%,10.64%),with statistically significant differences(χ2=57.212,60.866,all P<0.05).There was a significant positive correlation between TRIP4 and DDIT4 protein expression in glioma tissues(r=0.722,P<0.05).The positive rates of TRIP4(83.64%vs 46.15%,80.00%vs 51.28%)and DDIT4(80.00%vs 46.15%,76.36%vs 51.28%)proteins in glioma tissues with tumor diameter≥3cm,WHO grade Ⅲ were significantly higher than those in tissues with tumor diameter＜3cm,WHO grade Ⅰ～Ⅱ(χ2=6.393～14.754,P<0.05).The 3-year overall survival rates of the TRIP4 positive and negative expression groups were 37.50%(24/64)and 66.67%(20/30),respectively.The 3-year cumulative survival of the TRIP4 positive expression group was significantly lower than that in the TRIP4 negative expression group(Log-rank χ2=5.949,P=0.015).The 3-year overall survival rate of DDIT4 positive and negative expression group was 37.10%(23/62)and 70.00%(21/30),respectively.The 3-year cumulative survival of the DDIT4 positive expression group was significantly lower than that in the DDIT4 negative expression group(Log-rank χ2=7.642,P=0.006).Tumor diameter≥3cm(HR=1.614,P=0.000),WHO grade Ⅲ(HR=1.790,P=0.000),positive TRIP4(HR=1.665,P=0.000)and positive DDIT4(HR=1.476,P=0.000)were independent risk factors affecting the survival prognosis of glioma patients.Conclusion The expression of TRIP4 and DDIT4 protein in glioma tissue was increased.Both of them were related to tumor diameter and WHO grade,and are potential tumor markers for survival prognosis of glioma.

Prediction of isocitrate dehydrogenase status of glioma via diffusion tensor imaging parameters and clinical features / 实用放射学杂志

Objective To noninvasively predict isocitrate dehydrogenase(IDH)status of glioma via combining imaging and clini-cal features before surgery,so as to provide basis for individualized clinical treatment decision.Methods A total of 47 patients with glioma confirmed by pathological and molecular genetic tests were included,including 20 with IDH mutant type and 27 with IDH wild type.After diffusion tensor imaging(DTI)scanning,fractional anisotropy(FA)and mean diffusivity(MD)values of tumor paren-chyma were calculated.Combining DTI parameters with MRI morphological features of tumor,blood neutrophil/lymphocyte ratio(NLR)and patient's age,binary logistic regression model was established to effectively predict IDH status of glioma patients before surgery.Results There were significant differences in FAmean/FANAWM,MDmin,NLR,tumor location and age between IDH mutant type and IDH wild type groups(P<0.05).The binary logistic regression model concluding,FAmean/FANAWM,MDmin,cystic degeneration,NLR and age,predicted IDH status of glioma with area under the curve(AUC)of 0.961 and 95%confidence interval(CI)of 0.914-1.00.Conclusion The regression model established via combining DTI,MRI morphological features and blood NLR has great performance in classifying IDH status of glioma,and can help predict IDH status noninvasively before surgery,so as to assist clinical individualized treatment.

Value of MR 3D-ASL,DWI combined with MGMT in the differential diagnosis of postoperative recurrence and pseudoprogression of high-grade glioma / 实用放射学杂志

Objective To explore the value of brain MR three-dimensional arterial spin labeling(3D-ASL),diffusion weighted imaging(DWI)combined with MGMT gene detection in the differential diagnosis of postoperative recurrence and pseudoprogression of high-grade glioma.Methods A total of 30 patients with high-grade glioma were selected,and all patients were divided into pseudoprogression group and recurrence group according to pathological results.The differences in average relative cerebral blood flow(rCBF)and average relative apparent diffusion coefficient(rADC)were compared between recurrence groups and pseudoprogression groups.Results The rCBF in the enhanced center and edge areas in the recurrence group was significantly higher than those in the pseudoprogression group,and the rADC was significantly lower than that in the pseudoprogression group,and the difference was statistically significant(P<0.05).There were correlations between the postoperative recurrence and pseudoprogression of high-grade glioma and the promoter situation of methylation of MGMT gene.Conclusion Brain MR 3D-ASL,DWI combined with MGMT gene detection has important clinical value in the differential diagnosis of postoperative recurrence and pseudoprogression of high-grade glioma.

Correlation of ncRNA-mediated Up-regulation of EphB4 with Poor Prognosis and Tumor Immunoinfiltration in Low-grade Glioma / 医学研究杂志

Objective To investigate the expression of erythropoietin-producing human hepatocellular receptors B4(EphB4)and its upstream targets as well as correlation with prognosis in low-grade glioma(LGG),for analyzing its potential role as a therapeutic tar-get.Methods Firstly analyzed the expression of EphB4 in glioma and normal brain tissue by The Cancer Genome Atlas(TCGA)data-base.Then,Gene Expression Profiling Interactive Analysis(GEPIA)database was used to analyze the effects of EphB4 on various cancer survival.The possible upstream regulatory non-coding RNA(ncRNA)of EphB4 were analyzed by R and starBase database.The correla-tion of EphB4 with tumor immune cell infiltration,biomarkers of immune cells and immune checkpoint expression were analyzed using the Tumor Immune Estimation Resource(TIMER)database.Results UBA6-AS1/hsa-miR-346 axis was the most potential upstream non-coding RNA(ncRNA)related pathway to influence expression of EphB4 in LGG.At the same time,the level of EphB4 was posi-tively correlated with the tumor immune cell infiltration,immune cell biomarkers and immune checkpoint in LGG.Conclusion NcRNA-mediated up-regulation of EphB4 is associated with poor prognosis and tumor immunoinfiltration in LGG.

Synergistic sensitization of hUMSCs-derived supernatant combined with temozolomide in different glioma cell lines / 中国病理生理杂志

AIM:To explore the synergistic sensitization effect of human umbilical cord mesenchymal stem cell culture supernatant(hUMSC-CM)combined with temozolomide(TMZ)on various glioma cell lines,and to elucidate the underlying mechanisms.METHODS:The hUMSC-CM was harvested using two different serum deprivation tech-niques at 24 and 48 h,and was converted into freeze-dried powder,which was then given to rat malignant glioma cell line RG-2,human astrocytoma cell line U251 and human glioblastoma cell line LN-428 at 5 concentrations(0,1,3,6 and 9 g/L).The effectiveness and sensitivity of hUMSC-CM for inhibiting growth of glioma cells at 24,48 and 72 h were as-sessed using CCK-8 assay.Hematoxylin-eosin(HE)staining combined with CCK-8 assay was employed to evaluate the chemotherapy sensitivity of glioma cells after 48 h of treatment with TMZ at 6 concentrations(0,25,50,100,200 and 400 μmol/L).Two concentrations(3 and 9 g/L)of hUMSC-CM and 3 concentrations(50,100 and 200 μmol/L)of TMZ were chosen for concurrent treatment of glioma cells to assess the proliferation and pathological alterations.TUNEL staining was utilized to detect apoptosis.Flow cytometry was utilized to analyze cell cycle modifications.The expression alterations of apoptosis-inducing proteins,cleaved caspase-3,cleaved caspase-8 and cleaved PARP1,as well as autophagy-inducing proteins beclin-1 and LC3,were examined using Western blot to investigate the synergistic sensitization mechanism of hUMSC-CM combined with TMZ in vitro.RESULTS:The susceptibility of glioma cell lines to hUMSC-CM and TMZ varied,with RG-2 showing the highest sensitivity,followed by U251,and then LN-428.The inhibitory effect of hUMSC-CM(3 and 9 g/L)and TMZ(50,100 and 200 μmol/L)combined treatment on glioma cells was significantly greater than that that of single-agent treatments(P＜0.05),demonstrating a dose-and concentration-dependent enhancement.Notably,the combination of 9 g/L hUMSC-CM(C9)with 50 μmol/L TMZ(T50)effectively suppressed glioma cell growth.CCK-8 as-say indicated a significant reduction of cell viability in C9+T50 group compared with either C9 or T50 alone(P＜0.05).HE staining and TUNEL staining revealed pronounced morphological changes and significant apoptotic features in glioma cells treated with C9+T50.Flow cytometric analysis confirmed that C9+T50 induced cell cycle arrest in glioma cells.Fur-thermore,compared with control group,the levels of cleaved caspase-3,cleaved caspase-8,cleaved PARP1,beclin-1,and LC3-Ⅱ/LC3-Ⅰ were significantly elevated in the C9+T50-treated glioma cells(P＜0.01).CONCLUSION:(1)The concomitant administration of hUMSC-CM and TMZ exerts a broad inhibitory effect on glioma cells,with a synergistic sen-sitization observed across different cell lines.(2)The enhancement of glioma cell sensitivity to TMZ by hUMSC-CM may be attributed to the modulation of caspase-8/caspase-3/PARP1 signaling pathway and the induction of both apoptosis and autophagy in glioma cells.

Experimental study on regulation of immune effect of brain glioma cells by NKG2D mediated by miR-10b / 中国免疫学杂志

Objective:To observe the regulatory effect of microRNA-10b(miR-10b)on the immune effect of glioma cells and explore its mechanism.Methods:Human glioma cell U251 was cultured to obtain cells in logarithmic growth stage.The cell suspen-sion was prepared according to the concentration of 1.0×105 cells/ml,and the control group,overexpression group,low expression group and blank group were set up,with 6 wells in each group.The negative control,miR-10b mimics and miR-10b inhibitor were transfected by liposome transfection in control group,overexpression group and low expression group,respectively.The blank group was given the same amount of sterile normal saline.Natural killer(NK)cells from peripheral blood of a healthy volunteer was isolated and cultured.The killing activity of NK cells was detected by MTT method.The expression of NK cell activated receptor(NKG2D)on the surface of NK cells in each group were detected by flow cytometry,and the expression of major histocompatibility complex class Ⅰ chain-related gene A(MICA),UL16 binding protein 2(ULBP2)and UL16 binding protein 3(ULBP3)on the surface of U251 hu-man glioma cells in each group were detected.Results:The transfection efficiency of control group,overexpression group and low ex-pression group were(93.55±2.05)％,(95.67±3.14)％,(94.18±3.26)％,respectively.Compared with control group and blank group,the expression of miR-10b increased in overexpression group and decreased in low expression group,and the difference were statisti-cally significant(P<0.05).There was no significant difference in the expression of miR-10b between control group and blank group(P>0.05).Compared with control group and blank group,the killing activity of NK cells with different effect target ratios in overex-pression group decreased,the expression of NKG2D decreased,the killing activity of NK cells with different effect target ratios in low expression group increased,and the expression of NKG2D increased,and the difference were statistically significant(P<0.05).The killing activity of NK cells in each group increased with the increase of effect target ratio,and the difference were statistically signifi-cant(P<0.05),and there was no significant difference in NK cell killing activity and NKG2D expression between control group and blank group(P>0.05).Compared with control group and blank group,the expression of MICA,ULBP2 and ULBP3 on the surface of human glioma cell U251 in overexpression group decreased,and the expression of MICA,ULBP2 and ULBP3 on the surface of human glioma cell U251 in low expression group increased,the difference were statistically significant(P<0.05),and there was no signifi-cant difference in the expression of MICA,ULBP2 and ULBP3 on the surface of U251 glioma cells between control group and blank group(P>0.05).Conclusion:Inhibiting the expression of miR-10b can increase the expression of NKG2D on the surface of NK cells and MICA,ULBP2 and ULBP3 on the surface of human glioma cell U251,and enhance the killing activity of NK cells against human glioma cell U251.

Relationship between GLI1 expression and tumor immune infiltration and clinical prognosis of gastric cancer / 中国现代普通外科进展

Objective:To investigate the correlation between the expression of GLI1 and im-mune invasion and clinical prognosis in gastric cancer.To study the effect of GLI1 expression on drug resistance in gastric cancer.Methods:The expression difference of GLI1 in gastric cancer and normal tissues was analyzed by using TCGA database,and the effect of clinical features and GLI1 gene ex-pression level on prognosis of patients with gastric cancer was analyzed.The correlation between GLI1 gene expression and tumor immune cell infiltration in gastric cancer tissues was analyzed to explore its influence on drug resistance of chemotherapy drugs and targeted drugs.Clinical samples were collect-ed to analyze the difference of GLI1 expression in gastric cancer and paracancer tissues.Results:The expression of GLI1 in gastric cancer tissues was 1.7 times that in normal tissues,and the overall sur-vival and disease-free survival of patients with high expression are shorter than those with low ex-pression(P＜0.05).The interstitial score,immune score and abundance of immunoinfiltrating cells were higher in the high expression of GLI1 in gastric cancer tissues.High expression of GLI1 reduces drug sensitivity and is positively correlated with the expression of immune checkpoint markers PDCD1(P＜0.05).GLI1 expression was significantly increased in patients with subdifferentiated gastric cancer.Conclusions:GLI1 expression is associated with the prognosis and immune infiltration of patients with gastric cancer,and it may lead to poor prognosis of patients by regulating chemotherapy resis-tance,which may be a potential therapeutic target and molecular marker for gastric cancer.

Effects of bunched cognitive behavior intervention on disease fear and psychological security in glioma patients / 中华行为医学与脑科学杂志

Objective:To investigate the effects of bunched cognitive behavior intervention on disease fear and psychological security in patients with glioma.Methods:A total of 92 patients with glioma who underwent surgical treatment from January 2022 to June 2023 were selected.According to the order of enrollment, all subjects were divided into research group( n=44)and control group( n=48). The patients in control group received routine medical and nursing intervention, and patients the research group adopted glioma bunched cognitive behavior intervention on the basis of routine medical and nursing intervention, including 4 intervention cycles.At enrollment, 2 weeks after intervention, and 4 weeks after intervention, all subjects were evaluated by the fear of progression questionnaire-short form (FoP-Q-SF), safety questionnaire (SQ), self-rating anxiety scale (SAS) and self-rating depression scale (SDS). All the data in this study were processed by SPSS 26.0 statistical software.The scores of FoP-Q-SF, SQ, SAS and SDS before and after intervention were compared by repeated measures ANOVA between the two groups. Results:(1)The total FoP-Q-SF score, physiological health dimension scores, and social family dimension scores of the two groups showed significant interaction effects before and after intervention ( F=254.839, 52.738, 12.237, all P<0.05). Further simple effect analysis showed that after 2 and 4 weeks of intervention, the FoP-Q-SF scores of the research group (2 weeks after intervention: 33.80±4.94, 36.48±4.04; 4 weeks after intervention: 31.25±4.55, 35.94±4.47) and social family dimensions (2 weeks after intervention: 15.32±2.56 points, 17.06±2.14; 4 weeks after intervention: 14.05±2.59, 16.96±1.99) were lower than those of the control group (all P<0.05). The physiological health dimension score of the research group was lower than that of the control group after 4 weeks of intervention (4 weeks after intervention: 17.30±2.92, 19.06±2.38) ( P<0.05). After 4 weeks of intervention, the FoP-Q-SF score, physiological health dimension score, and social family dimension score of the research group were all lower than those at 2 weeks after intervention and before intervention (all P<0.05). (2)The total SQ score, interpersonal security dimension score and the determined control score of the two groups showed significant interaction effects before and after intervention( F=193.129, 54.706, 44.015, all P<0.05). Further simple effect testing showed that after 2 and 4 weeks of intervention, the total SQ score and interpersonal security score of the research group were higher than those of the control group (all P<0.05). The determined control score of the research group was higher than that of the control group after 4 weeks of intervention ( P<0.05). After 2 and 4 weeks of intervention, the total SQ score, interpersonal security score, and determination control score of the research group were higher than before intervention (all P<0.05), and the total SQ score and interpersonal security score of the research group were higher than 2 weeks after intervention (both P<0.05). (3)The SAS score and SDS score of the two groups showed significant interaction effects before and after intervention( F=237.867, 282.882, both P<0.05). Further simple effect analysis showed that after 2 and 4 weeks intervention, the SAS and SDS scores of the research group were lower than those of the control group (all P<0.05). The SAS and SDS scores of the research group were lower after 2 weeks and 4 weeks intervention than before intervention (all P<0.05). The SAS and SDS scores of the research group at 4 weeks after intervention were lower than those at 2 weeks after intervention (both P<0.05). Conclusion:Bundled cognitive behavioral intervention can improve disease fear and negative emotions in patients with glioma, and enhance psychological security.

Mechanism of silymarin on malignant growth of glioma cells by regulating miR-124-3p/WEE1 axis / 中国医科大学学报

Objective To investigate the impact of silymarin(SM)on the malignant growth of glioma cells and the regulatory mechanism on the miR-124-3p/WEE1 axis.Methods Glioma U87 cells were grouped into control,SM low,medium,and high concentration groups,and SM high concentration + miR-124-3p inhibitor group(SM high + miR-124-3p inhibitor group).CCK-8 was used to measure the proli-feration rate of cells;Transwell? assay was applied to assay the migration and invasion of cells;cell cycle progression was detected by flow cytometry;Western blotting was applied to measure the expression of cyclin D1 and apoptosis-related proteins;the levels of miR-124-3p and WEE1 mRNA were determined by qRT-PCR;and a luciferase activity test was applied to verify the targeting relationship between miR-124-3p and WEE1;in addition,the establishment,administration,and analysis of a NOD/SCID mouse model of intracranial trans-planted tumor were conducted.Results Compared with the control group,the cell proliferation,the numbers of migrating and invading cells,the expression of cyclin D1,and the level of WEE1 mRNA in the various SM treatment groups decreased,the number of cells in G0/G1 phase,the expression of cleaved caspase-8,cleaved caspase-9,cleaved caspase-3 and miR-124-3p increased(P＜0.05);furthermore,transfection of miR-124-3p inhibitor reversed the inhibitory effect of SM on the malignant behavior of glioma cells.In vivo experiments with mice showed that the weights and volumes of tumors in the SM treatment group were lower than those in the model group(P＜0.05),and there was no discernible change in the weight of the mice(P＞0.05).Conclusion SM can inhibit the malignant growth of glioma cells by upregulating miR-124-3p and downregulating WEE1.

18F-FDOPA PET/CT for evaluating efficacy of radiotherapy combined with chemotherapy for advanced glioma / 中国医学影像技术

Objective To observe the value of 18F-fluoro-dihydroxy-phenylalanine(18F-FDOPA)PET/CT for evaluating the efficacy of radiochemotherapy for advanced glioma.Methods Data of 84 patients with advanced glioma who received precision radiotherapy combined with synchronous chemotherapy were retrospectively analyzed.The patients were divided into effective group(complete remission+partial remission+stable disease,n=60)and ineffective group(progressive disease,n=24)according to the efficacy of radiochemotherapy.18F-FDOPA PET/CT metabolic parameters of tumors,including tumor metabolic tumor volume(MTV),maximum standard uptake value(SUVmax)and mean standard uptake value(SUVmean)were compared between groups,also before and after radiochemotherapy within groups.Spearman correlation analysis was used to observe the correlations of metabolic parameters and the efficacy of radiochemotherapy.Results After radiochemotherapy,MTV,SUVmax and SUVmean of tumors in effective group were lower than those of tumors in ineffective group(all P＜0.05).Significant differences of metabolic parameters were found before and after radiochemotherapy in effective group(all P＜0.05).MTV,SUVmax and SUVmean of advanced glioma were negatively correlated with the efficacy of radiochemotherapy(r=-0.63,-0.52,-0.50,P＜0.001,P=0.007,P=0.010).Conclusion 18F-FDOPA PET/CT was helpful for evaluating the efficacy of radiochemotherapy for advanced glioma.

Differentiation Between High-Grade Glioma and Single Brain Metastases Based on Three-Dimensional DenseNet / 中国医学影像学杂志

Purpose To explore the value of three-dimensions densely connected convolutional networks(3D-DenseNet)in the differential diagnosis of high-grade gliomas(HGGs)and single brain metastases(BMs)via MRI,and to compare the diagnostic performance of models built with different sequences.Materials and Methods T2WI and T1WI contra-enhanced(T1C)imaging data of 230 cases of HGGs and 111 cases of BMs confirmed by surgical pathology in Lanzhou University Second Hospital from June 2016 to June 2021 were retrospectively collected,and the volume of interest under the 3D model was delineated in advance as the input data.All data were randomly divided into a training set(n=254)and a validation set(n=87)in a ratio of 7∶3.Based on the 3D-DenseNet,T2WI,T1C and two sequence fusion prediction models(T2-net,T1C-net and TS-net)were constructed respectively.The predictive efficiency of each model was evaluated and compared by the receiver operating characteristic curve,and the predictive performance of models built with different sequences were compared.Results The area under curve(AUC)of T1C-net,T2-net and TS-net in the training and validation sets were 0.852,0.853,0.802,0.721,0.856 and 0.745,respectively.The AUC and accuracy of the validation set of T1C-net were significantly higher than those of T2-net and TS-net,respectively,and the AUC and accuracy of the validation set of TS-net were significantly higher than those of T2-net.There was a significant difference between T1C-net and T2-net models(P<0.05),while there were no statistical differences between the models of TS-net and T2-net,T1C-net and TS-net(P>0.05).The T1C-net model based on 3D-DenseNet had the best performance,the accuracy of the validation set was 80.5%,the sensitivity was 90.9%,the specificity was 62.5%.Conclusion The 3D-DenseNet model based on MRI conventional sequence has better diagnostic performance,and the model built by T1C-net sequence has better performance in differentiating HGGs and BMs.Deep learning models can be a potential tool to identify HGGs and BMs and to guide the clinical formulation of precise treatment plans.

Clinical research progress in boron neutron capture therapy for glioma / 中华放射肿瘤学杂志

Boron neutron capture therapy (BNCT) is an emerging treatment modality. BNCT is performed by injecting patients with the boron containing drugs, which has strong affinity with cancer cells. After undergoing irradiation with neutrons, the boron containing drugs can yield alpha and lithium particles, which can kill tumor cells precisely. To date, clinical studies of BNCT have been conducted in a variety of tumors, including glioblastoma multiforme, meningioma, head and neck cancer, sarcoma, malignant skin tumor, malignant melanoma and recurrent cancers, etc. With continuous construction of BNCT treatment centers around the world, this new technology will be quickly and comprehensively spread. In this article, clinical research progress in the application of BNCT for glioma treatment was reviewed.

The role of circular RNA circSEPT9 in the radioresistance of glioma by targeting miR-432-5p / 中华放射肿瘤学杂志

Objective:To investigate the role of circular RNA (circRNA) circSEPT9 in the radioresistance of glioma and its molecular mechanism.Methods:Pathological samples were collected from 40 glioma patients who underwent surgery and postoperative radiotherapy in the First Affiliated Hospital of Zhengzhou University from January 2019 to January 2022. All patients were divided into the radiation-sensitive and radiation-resistant groups. The expression levels of circSEPT9 were assessed using real-time reverse transcription PCR (RT-qPCR) in two groups. The radiation-resistant glioma cell U251R was constructed based on human glioma cell U251. The U251R cells were divided into the negative control (si-NC), circSEPT9 knockdown (si-circSEPT9), negative control combined with irradiation (si-NC+4 Gy), circSEPT9 knockdown combined with irradiation (si-circSEPT9+4 Gy), circSEPT9 knockdown combined with control inhibitor and irradiation (si-circSEPT9+NC inhibitor+4 Gy), and circSEPT9 knockdown combined with miR-432-5p inhibitor and irradiation (si-circSEPT9+miR-432-5p inhibitor+4 Gy) groups. The targeting relationship between circSEPT9 and miR-432-5p was verified through dual-luciferase reporter assay. Colony formation assay was employed to assess the survival rate of U251R cells. Flow cytometry was adopted to measure the apoptosis rate. The expression level of circSEPT9 in glioma tissues was statistically analyzed using independent sample t-test. The survival and apoptosis rates in each group were evaluated using one-way ANOVA. Results:The expression level of circSEPT9 was up-regulated in the glioma tissues of patients in the radiation-resistant group (1.00±0.18 vs. 3.25±0.13, P<0.05). Compared to the si-NC group, the U251R cells in the si-circSEPT9 group exhibited a significant reduction in survival fraction and a notable increase in apoptosis rate (9.24±0.83 vs. 19.36±2.13, both P<0.05). After radiation exposure at 4, 6 and 8 Gy, si-circSEPT9 treatment significantly decreased the survival fraction in U251R cells (all P<0.05). Compared with the si-NC+4 Gy group, the apoptosis rate was increased in the si-circSEPT9+4 Gy group (18.83±1.94 vs. 35.23±3.56, P<0.05). Dual-luciferase reporter assay showed that circSEPT9 could target and negatively regulate the expression level of miR-432-5p. Compared with the si-circSEPT9+NC inhibitor+4 Gy group, the survival fraction of U251R was significantly increased in the si-circSEPT9+miR-432-5p inhibitor+4 Gy group ( P<0.05). Conclusion:Knockdown of circSEPT9 enhances the radiosensitivity of glioma cells by regulating cell apoptosis through targeting the miR-432-5p.

Efficacy of concurrent tumor treating fields and chemoradiation in patients with high-grade glioblastoma / 中华放射肿瘤学杂志

Objective:To evaluate the safety and efficacy of tumor-treating fields (TTFields) and chemoradiation in patients with high-grade glioblastoma.Methods:Clinical data of 38 patients admitted to the Jiangsu Cancer Hospital from September 2021 to May 2023 who were diagnosed with high-grade glioblastoma (36 cases of World Health Organization grade Ⅳ and 2 cases of grade Ⅲ) were retrospectively analyzed. All patients received TTFields combined with concurrent chemoradiation after surgery. Response assessment in neuro-oncology (RANO) criteria was used to evaluate the glioma responses as tumor remission, stable or progression. Common terminology criteria for adverse events v5.0 and TTFields related skin adverse reaction (dAE) criteria were used to evaluate the adverse events. Treatment compliance was assessed by data on the NovoTTF-200A therapeutic device, calculated as a percentage of daily TTFields usage time. Survival analysis was estimated by the Kaplan-Meier method and compared by the log-rank test.Results:The median duration of treatment with TTFields in 38 patients was 20 h (rang: 2.4-22.6 h), and the median treatment compliance was 83% (range: 10%-94%). After 42 days of TTFields combined with concurrent chemoradiation, 12 patients who underwent complete tumor resection were assessed as stable according to RANO criteria. Among the 26 patients who underwent partial tumor resection, 23 (88%) were evaluated as disease remission according to RANO criteria. The 7-, 10-, 13-month progression-free survival rate was 81.0%、64.0%、49.5%, repectively. The common adverse events included grade 1 (45%) and grade 2 (8%) dAE, without grade 3-4 dAE. Typical presentations included contact dermatitis, blisters, lesions or ulcers, and abscesses. The median follow-up time was 10.0 months (range: 1.6-21.3 months). At follow-up as of July 2023, 26 of the 38 patients were stable and 12 had disease progression (8 died).Conclusion:The preliminary results show that TTFields combined with chemoradiation is effective, safe and reliable treatment for high-grade glioblastoma.

Effect and mechanism of lncRNA GACAT3 on the radiation resistance of gliomas by regulating the miR-497/YAP1 axis / 中华放射肿瘤学杂志

Objective:To investigate the role and mechanism of long non-coding RNA (lncRNA) gastric cancer associated transcript 3 (GACAT3) in glioma radioresistance.Methods:Real-time reverse transcription PCR (RT-qPCR) was used to detect the expression of lncRNA GACAT3 and miR-497 in human astrocyte NHA cells and glioma cells U251. NC-siRNA and GACAT3-siRNA were transfected into U251 cells, and the cells were treated with X-ray irradiation. Colony formation assay was used to detect the survival fraction of U251 cells. The apoptosis of U251 cells was detected by flow cytometry. Western blot was used to detect the expression of cysteine containing aspartate specific protease 3 (Caspase-3) in U251 cells. Bioinformatics software and dual luciferase reporter gene assay were used to predict and verify the targeting relationship between lncRNA GACAT3 and miR-497, and between miR-497 and Yes-associated protein 1 (YAP1), respectively. NC mimic, miR-497 mimic, GACAT3-siRNA and NC inhibitor, GACAT3-siRNA and miR-497 inhibitor were co-transfected into U251 cells. Colony formation assay, flow cytometry and Western blot were adopted to evaluate the effect of miR-497 overexpression and lncRNA GACAT3 on the radiosensitivity of U251 cells by regulating miR-497.Results:Compared with NHA cells, the expression of lncRNA GACAT3 in U251 cells was significantly up-regulated, and the expression of miR-497 in U251 cells was significantly down-regulated (both P<0.05). After knockdown of GACAT3, the survival fraction of irradiated U251 cells was significantly decreased, while the apoptosis rate and Caspase-3 protein expression were significantly increased (all P<0.05). lncRNA GACAT3 targeted and negatively regulated the expression of miR-497. Overexpression of miR-497 significantly reduced the survival fraction of U251 cells after irradiation, and increased the apoptosis rate and Caspase-3 protein expression. Inhibition of miR-497 significantly reversed the promoting effect of lncRNA GACAT3 knockdown on the radiosensitivity of U251 cells. miR-497 targeted and negatively regulated the expression of YAP1. Conclusion:Knockdown of lncRNA GACAT3 can enhance the radiosensitivity of glioma cells by regulating the miR-497/YAP1 axis.

New Advances in the Use of 18F-FET PET in the Diagnosis and Management of Adult High-Grade Gliomas / 罕见病研究

Gliomas are the most common primary intracranial tumors in adults, among which high-grade glioma patients are characterized by short survival and poor prognosis. The diagnosis, treatment, evaluation of effective treatments, and prognosis prediction of high-grade gliomas are of great significance for improving patient survival. Conventional enhanced magnetic resonance imaging has deficiencies in delineating tumor extent, identifying tumor progression and treatment-related changes. Therefore, there is a broad consensus to incorporate amino acid PET, and 18F-FET PET inparticular, into the diagnostic and therapeutic process of high-grade gliomas. In this article, we review the new research progress of 18F-FET PET in the diagnosis and treatment of adult high-grade glioma in recent years.

Application value of radiomics model based on multiparametric MRI glioma peritumoral region in glioma prognosis evaluation / 安徽医科大学学报

Objective @# To evaluate the prognostic value of a radiomics model based on the peritumoral region of gli- oma．@*Methods @#138 patients with glioma were retrospectively analyzed ，medical imaging interaction toolkit ( MITK) software was used to obtain the magnetic resonance imaging (MRI) images of peritumoral area 5 mm，10 mm and 20 mm from the tumor edge and extract texture features．The texture features were screened the radiomics model was established and the radiomic score was calculated．A clinical prediction model and a combined predic- tion model along with Rad-score and clinical risk factors were established．The combined prediction model was dis- played as a nomogram，and the predictive performance of the model for survival in glioma patients was evaluated. @*Results @# In the validation set，the C-index value of the radiomics model based on the peritumoral region 10 mm a- way from the tumor edge based on T2 weighted image (T2WI) images was 0. 663 (95% CI = 0. 72－0. 78) ，resul- ting in the best prediction performance．On the training set and validation set，the C-index of the nomogram was 0. 770 and 0. 730，respectively，indicating that the prediction performance of nomogram was better than those of the radiomics model and clinical prediction model．The model had the highest prediction effect on the 3-year survival rate of glioma patients (training set area under curve (AUC) = 0. 93，95% CI = 0. 83 － 0. 98 ; validation set AUC = 0. 88，95% CI = 0. 76 －0. 99) ．The calibration curve showed that the joint prediction nomogram in both the training set and the validation set had good performance．@*Conclusion @# The combined prediction model based on the preoperative T2WI images in the peritumoral region 10 mm from the tumor edge and the clinicopathological risk factors can accurately predict the prognosis of glioma，providing the best effect of prediction on the 3-year survival rate of glioma.