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1.
Sci Rep ; 10(1): 4695, 2020 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-32170092

RESUMO

Depth of invasion (DOI) can be calculated preoperatively by MRI, and whether MRI-determined DOI can predict prognosis as well as whether it can be used as an indicator of neck dissection in cT1N0 tongue squamous cell carcinoma (SCC) remains unknown. The main goal of the current study was to answer these unknowns. A total of 151 patients with surgically treated cT1N0 tongue SCC were retrospectively enrolled, and MRI-determined DOI was measured based on T1-weighted layers with a 3.0T scan. The Chi-square test was used to evaluate the association between clinical pathologic variables and neck lymph node metastasis, and the factors that were significant in the Chi-square test were then analyzed in a multivariate logistic regression analysis model to determine the independent predictors. The main study endpoints were locoregional control (LRC) and disease-specific survival (DSS), and the Kaplan-Meier method (log-rank test) was used to calculate the LRC and DSS rates. The factors that were significant in univariate analysis were then analyzed in the Cox model to determine the independent prognostic factors. A value of p < 0.05 was considered significant, and all statistical analyses were performed with SPSS 20.0. Occult neck lymph node metastasis was noted in 26 (17.2%) patients, and the ROC curve indicated that the optimal cutoff value of MRI-determined DOI was 7.5 mm for predicting neck lymph node metastasis, with a sensitivity of 86.9%. The factors of lymphovascular invasion, MRI-determined DOI, pathologic DOI, and pathologic tumor grade were significantly associated with the presence of neck lymph node metastasis in univariate analysis, and further logistic regression analysis confirmed the independence of lymphovascular invasion, MRI-determined DOI, and pathologic DOI in predicting neck lymph node metastasis. The 5-year LRC and DSS rates were 84% and 90%, respectively. Cox model analysis suggested the MRI-determined DOI was an independent prognostic factor for both LRC and DSS. Therefore, elective neck dissection is suggested if MRI-determined DOI is greater than 7.5 mm in cT1N0 tongue SCC, and MRI-determined DOI ≥ 7.5 mm indicates additional risk for disease recurrence and cancer-related death.

2.
Biomater Sci ; 2020 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-32211626

RESUMO

Theranostics is a new trend integrating diagnostic and therapeutic functions in tumour research. Theranostic nanoparticles enabling both tumour imaging and drug delivery are a promising platform for image-guided cancer therapy. Photodynamic therapy (PDT) has great potential in synergy with traditional chemotherapy but faces great challenges due to hypoxia, poor targeting ability and the limited penetration depth of visible light. To solve these problems, we presented a novel nanosystem of FA/UCNPs-RB/HCPT/PFH@lipid (denoted as FURH-PFH-NPs), with a perfluorohexane (PFH) carrying rich oxygen core and a folic acid-modified lipid shell. The shell contains 10-hydroxycamptothecin (HCPT) and self-fluorescing photosensitizer compounds, namely, upconversion nanoparticles and rose bengal (UCNPs-RB). In this study, FURH-PFH-NPs aggregated in SKOV3 cells (in vitro) and the nude xenograft tumour region when combined with folic acid receptors. When triggered by low-intensity focused ultrasound (LIFU), FURH-PFH-NPs released PFH, UCNPs-RB and HCPT. The above procedure was monitored through multimodal imaging, which simultaneously guided the tumour therapy. UCNPs-RB and PFH promoted the PDT effect under LIFU. Through PDT and HCPT, we obtained better therapeutic effects and good biosafety against SKOV3 nude xenograft tumours. FURH-PFH-NPs combined with LIFU and laser irradiation might be a promising strategy for ovarian cancer.

3.
Eur Radiol ; 2020 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-32086576

RESUMO

OBJECTIVES: To evaluate the diagnostic accuracy of unenhanced and contrast-enhanced MRI in the differentiation of mucosal high-grade neoplasia (MHN) from early invasive squamous cell cancer (EISCC) of the esophagus. METHODS: Between March 2015 and January 2019, 72 study participants with MHN (n = 46) and EISCC (n = 26) of the esophagus were enrolled in this prospective study. Postoperative histopathologic analysis was the reference standard. All participants underwent MRI (T2-multi-shot turbo spin-echo sequence (msTSE), diffusion-weighted imaging (DWI), and 3D gradient-echo-based sequence (3D-GRE)). Two radiologists, blinded to participants' data, independently evaluated MRI and assigned MR features including shape (mucosal thickening or focal mass), signal on T2-msTSE and DWI, enhancement degree (intense or slight), and enhancement pattern (homogeneous, heterogeneous, or heart-shaped). Diagnostic performance of the 5 features was compared using the chi-square test; kappa values were assessed for reader performance. RESULTS: Surgery was performed within 3.6 + 3.5 days after MR imaging. Inter-reader agreement on MR features was excellent (kappa value = 0.854, p < 0.001). All 8 mass-like MHN were "heart-shaped" in appearance. The degree of enhancement showed the best diagnosis performance in differentiating between MHN and EISCC of the esophagus. The combination of all 5 features had only borderline improved sensitivity, specificity, and AUC of 100%, 96.2%, and 0.999, respectively, which was not statistically significant compared with the degree of enhancement alone. CONCLUSIONS: MRI can differentiate MHN from EISCC in esophagus; the presence of "heart-shaped" appearance favors the diagnosis of MHN. KEY POINTS: • All 8 mass-like MHN showed a "heart-shaped" enhancement pattern which may help differentiating MHN from EISCC. • Degree of enhancement had the best diagnostic performance in differentiating between MHN and EISCC in esophagus. • The combined 5 features (shape, signal in T2-msTSE and DWI, enhancement degree, and enhancement pattern) provided sensitivity, specificity, and AUC of 100%, 96.2%, and 0.999, respectively, which was not statistically significant than tumor enhancement alone in distinguishing MHN from EISCC.

4.
World J Gastroenterol ; 26(6): 657-669, 2020 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-32103874

RESUMO

BACKGROUND: The treatment outcome of transarterial chemoembolization (TACE) in unresectable hepatocellular carcinoma (HCC) varies greatly due to the clinical heterogeneity of the patients. Therefore, several prognostic systems have been proposed for risk stratification and candidate identification for first TACE and repeated TACE (re-TACE). AIM: To investigate the correlations between prognostic systems and radiological response, compare the predictive abilities, and integrate them in sequence for outcome prediction. METHODS: This nationwide multicenter retrospective cohort consisted of 1107 unresectable HCC patients in 15 Chinese tertiary hospitals from January 2010 to May 2016. The Hepatoma Arterial-embolization Prognostic (HAP) score system and its modified versions (mHAP, mHAP2 and mHAP3), as well as the six-and-twelve criteria were compared in terms of their correlations with radiological response and overall survival (OS) prediction for first TACE. The same analyses were conducted in 912 patients receiving re-TACE to evaluate the ART (assessment for re-treatment with TACE) and ABCR (alpha-fetoprotein, Barcelona Clinic Liver Cancer, Child-Pugh and Response) systems for post re-TACE survival (PRTS). RESULTS: All the prognostic systems were correlated with radiological response achieved by first TACE, and the six-and-twelve criteria exhibited the highest correlation (Spearman R = 0.39, P = 0.026) and consistency (Kappa = 0.14, P = 0.019), with optimal performance by area under the receiver operating characteristic curve of 0.71 [95% confidence interval (CI): 0.68-0.74]. With regard to the prediction of OS, the mHAP3 system identified patients with a favorable outcome with the highest concordance (C)-index of 0.60 (95%CI: 0.57-0.62) and the best area under the receiver operating characteristic curve at any time point during follow-up; whereas, PRTS was well-predicted by the ABCR system with a C-index of 0.61 (95%CI: 0.59-0.63), rather than ART. Finally, combining the mHAP3 and ABCR systems identified candidates suitable for TACE with an improved median PRTS of 36.6 mo, compared with non-candidates with a median PRTS of 20.0 mo (log-rank test P < 0.001). CONCLUSION: Radiological response to TACE is closely associated with tumor burden, but superior prognostic prediction could be achieved with the combination of mHAP3 and ABCR in patients with unresectable liver-confined HCC.

5.
Eur Radiol ; 30(4): 2324-2333, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31953668

RESUMO

OBJECTIVES: To build a dual-energy CT (DECT)-based deep learning radiomics nomogram for lymph node metastasis (LNM) prediction in gastric cancer. MATERIALS AND METHODS: Preoperative DECT images were retrospectively collected from 204 pathologically confirmed cases of gastric adenocarcinoma (mean age, 58 years; range, 28-81 years; 157 men [mean age, 60 years; range, 28-81 years] and 47 women [mean age, 54 years; range, 28-79 years]) between November 2011 and October 2018, They were divided into training (n = 136) and test (n = 68) sets. Radiomics features were extracted from monochromatic images at arterial phase (AP) and venous phase (VP). Clinical information, CT parameters, and follow-up data were collected. A radiomics nomogram for LNM prediction was built using deep learning approach and evaluated in test set using ROC analysis. Its prognostic performance was determined with Harrell's concordance index (C-index) based on patients' outcomes. RESULTS: The dual-energy CT radiomics signature was associated with LNM in two sets (Mann-Whitney U test, p < 0.001) and an achieved area under the ROC curve (AUC) of 0.71 for AP and 0.76 for VP in test set. The nomogram incorporated the two radiomics signatures and CT-reported lymph node status exhibited AUCs of 0.84 in the training set and 0.82 in the test set. The C-indices of the nomogram for progression-free survival and overall survival prediction were 0.64 (p = 0.004) and 0.67 (p = 0.002). CONCLUSION: The DECT-based deep learning radiomics nomogram showed good performance in predicting LNM in gastric cancer. Furthermore, it was significantly associated with patients' prognosis. KEY POINTS: • This study investigated the value of deep learning dual-energy CT-based radiomics in predicting lymph node metastasis in gastric cancer. • The dual-energy CT-based radiomics nomogram outweighed the single-energy model and the clinical model. • The nomogram also exhibited a significant prognostic ability for patient survival and enriched radiomics studies.

6.
Medicine (Baltimore) ; 98(48): e18148, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770255

RESUMO

RATIONALE: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder that is most frequently induced by ovarian teratoma in young females. The condition can be controlled and reversed via ovarian tumor resection and immunotherapy. However, anti-NMDAR encephalitis induced by bilateral ovarian teratomas with distinct histopathologic types is rarely reported in the literature. PATIENT CONCERNS: A 23-year-old woman presented with seizures. DIAGNOSES: The diagnosis was anti-NMDAR encephalitis associated with ovarian teratomas based on positive anti-NMDAR antibody tests in both the cerebrospinal fluid and serum, and the detection of bilateral ovarian lesions on pelvic computed tomography. The postoperative histopathologic examination confirmed that the left lesion was an immature teratoma, and the right lesion was a mature teratoma. INTERVENTIONS: We performed surgical resection of the ovarian teratomas and administered immunotherapy for the control of anti-NMDAR encephalitis. Chemotherapy was administered for the immature teratoma. OUTCOMES: The patient recovered without any postoperative complications. She has been confirmed to be in complete clinical remission, and has not had a recurrence during 18 months of follow-up. LESSONS: Anti-NMDAR encephalitis induced by bilateral ovarian teratomas of differing histopathologic types (1 immature and 1 mature) is rare. Early diagnosis and treatment with tumor resection, immunotherapy, and chemotherapy are critical for a good prognosis.


Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato , Imunoterapia/métodos , Neoplasias Ovarianas , Ovariectomia/métodos , Receptores de N-Metil-D-Aspartato/imunologia , Teratoma , Encefalite Antirreceptor de N-Metil-D-Aspartato/diagnóstico , Encefalite Antirreceptor de N-Metil-D-Aspartato/etiologia , Encefalite Antirreceptor de N-Metil-D-Aspartato/imunologia , Encefalite Antirreceptor de N-Metil-D-Aspartato/terapia , Autoanticorpos/sangue , Tratamento Farmacológico/métodos , Feminino , Humanos , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Ovarianas/imunologia , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , Prognóstico , Teratoma/diagnóstico por imagem , Teratoma/tratamento farmacológico , Teratoma/imunologia , Teratoma/patologia , Teratoma/cirurgia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Adulto Jovem
7.
Exp Cell Res ; 384(2): 111652, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31574287

RESUMO

The tumor microenvironment harbors multiple immunosuppressive mechanisms, many of which involve suppressive immune cells. B regulatory (Breg) cells, as critical regulators of immune responses, were investigated in patients with gastric carcinoma. In the present study, the B cells that expressed IL-10 were highly enriched in tumor-infiltrating B cells, and could also be found at reduced frequencies in circulating B cells. These cells expressed high CD19 and CD20, and were almost exclusively CD27+CD10-. The IL-10 expression was significantly higher in CD27+CD10--sorted B cells than in CD27-CD10--sorted B cells. In an in vitro coculture of B cells and autologous T cells, CD27+CD10- B cells were capable of reducing the levels of CD4 T cell-mediated IFNγ, TNF, and IL-17 expression and the levels of CD8 T cell-mediated IFNγ and TNF expression. These regulatory effects were dependent on IL-10 as well as CD80/CD86. Interestingly, CD27+CD10- B cells also significantly elevated IL-10 production from CD4 and CD8 T cells in an IL-10-dependent manner. Overall, we here report enrichment of IL-10-expressing CD27+CD10- B cells in the intratumoral environment, which could significantly alter the cytokine production profile by CD4 and CD8 T cells.

8.
ACS Appl Mater Interfaces ; 11(43): 39493-39502, 2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31576732

RESUMO

Recently, the chemodynamic therapy (CDT) has been widely reported and applied to tumor therapy. However, only low level hydroxyl radicals (•OH) generated by the endogenous hydrogen peroxide alone are insufficient to kill the cancer cells. To overcome the insufficient therapeutic effect, this study reports a novel CDT based on Fenton catalyst Au@Prussian blue nanocubes (Au@PB NCs), subsequently encapsulated with doxorubicin (Dox). The in vitro and in vivo results indicate that the Dox-Au@PB NCs can take synergistic effects on tumor suppressor by CDT. In addition, Au@PB NCs possess high X-ray computed tomography contrast enhanced efficiency about ∼27.13 HU·mL·mg-1. This study highlights a great potential of the Dox-Au@PB NCs for tumor diagnosis and CDT.

9.
BMC Cancer ; 19(1): 999, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31651280

RESUMO

BACKGROUND: To compare the value of two dynamic contrast-enhanced Magnetic Resonance Images (DCE-MRI) reconstruction approaches, namely golden-angle radial sparse parallel (GRASP) and view-sharing with golden-angle radial profile (VS-GR) reconstruction, and evaluate their values in assessing response to neoadjuvant chemotherapy (nCT) in patients with esophageal cancer (EC). METHODS: EC patients receiving nCT before surgery were enrolled prospectively. DCE-MRI scanning was performed after nCT and within 1 week before surgery. Tumor Regression Grade (TRG) was used for chemotherapy response evaluation, and patients were stratified into a responsive group (TRG1 + 2) and a non-responsive group (TRG3 + 4 + 5). Wilcoxon test was utilized for comparing GRASP and VS-GR reconstruction, Kruskal-Wallis and Mann-Whitney test was performed for each parameter to assess response, and Spearman test was performed for analyzing correlation between parameters and TRGs, as well as responder and non-responder. The receiver operating characteristic (ROC) was utilized for each significant parameter to assess its accuracy between responders and non-responders. RESULTS: Among the 64 patients included in this cohort (52 male, 12 female; average age of 59.1 ± 7.9 years), 4 patients showed TRG1, 4 patients were TRG2, 7 patients were TRG3, 11 patients were TRG4, and 38 patients were TRG5. They were stratified into 8 responders and 56 non-responders. A total of 15 parameters were calculated from each tumor. With VS-GR, 10/15 parameters significantly correlated with TRG and response groups. Of these, only AUCmax showed moderate correlation with TRG, 7 showed low correlation and 2 showed negligible correlation with TRG. 8 showed low correlation and 2 showed negligible correlation with response groups. With GRASP, 13/15 parameters significantly correlated with TRG and response groups. Of these, 10 showed low correlation and 3 showed negligible correlation with TRG. 11 showed low correlation and 2 showed negligible correlation with TRG. Seven parameters (AUC* > 0.70, P < 0.05) showed good performance in response groups. CONCLUSIONS: In patients with esophageal cancer on neoadjuvant chemotherapy, several parameters can differentiate responders from non-responders, using both GRASP and VS-GR techniques. GRASP may be able to better differentiate these two groups compared to VS-GR. Trial registration for this prospective study: ChiCTR, ChiCTR-DOD-14005308. Registered 2 October 2014.


Assuntos
Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/tratamento farmacológico , Imagem por Ressonância Magnética/métodos , Terapia Neoadjuvante , Idoso , Meios de Contraste , Confiabilidade dos Dados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Curva ROC , Estatísticas não Paramétricas , Resultado do Tratamento
10.
Nan Fang Yi Ke Da Xue Xue Bao ; 39(8): 891-897, 2019 Aug 30.
Artigo em Chinês | MEDLINE | ID: mdl-31511207

RESUMO

OBJECTIVE: To observe the inhibitory effects of PEG-APTES-MNP magnetic heating on liver cancer cells. METHODS: The magnetic nanoparticle complex PEG-APTES-MNP was synthesized and its physiochemical properties and biocompatibility were characterized. HepG2 cells were incubated with the PEG-APTES-MNP nanoparticles for magnetic heating or nanoparticle therapy. Prussian blue staining was used to detect the uptake efficiency of the magnetic nanoparticles by HepG2 cells. MTT assay and flow cytometry were used to evaluate the inhibitory effect of the nanoparticles on HepG2 cells, and laser scanning confocal microscopy was used to detect the production of reactive oxygen species (ROS) in the cells. Fifteen nude mice bearing HepG2 cell xenografts were randomized equally into PEG-APTES-MNP injection group (with nanocomposite injection only), PEG-APTES-MNP magnetic heating group and control group (with PBS injection), and the tumor growth were observed in the mice after the treatments. RESULTS: The synthesized PEG-APTES-MNP nanoparticles showed good physicochemical properties and biocompatibility. Incubation of HepG2 with the nanoparticles resulted in significantly increased ROS production, obvious inhibition of the cell growth through the synergetic effects of magnetic heating (P < 0.05), and significantly enhanced cell apoptosis. In the tumor-bearing nude mice, the nanoparticles strongly inhibited the tumor growth by magnetic heating (P < 0.05). CONCLUSIONS: The magnetic nanocomposite PEG-APTES-MNP has good physicochemical properties and bioavailability and can strongly inhibit the growth of liver cancer cells both in vitro and in nude mice through magnetic heating, demonstrating its potential as a candidate nanomedicine for liver cancer treatment.


Assuntos
Neoplasias Hepáticas , Nanocompostos , Animais , Linhagem Celular Tumoral , Proliferação de Células , Humanos , Hipertermia Induzida , Magnetismo , Camundongos , Camundongos Nus
11.
BMC Cancer ; 19(1): 754, 2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31366389

RESUMO

BACKGROUND: This study sought to determine whether thyroidectomy is associated with self-reported cough through a prospective analysis. METHODS: Patients undergoing unilateral thyroidectomy were prospectively enrolled. The control group was selected to avoid the effect of general anaesthesia. The experimental group consisted of 300 patients (202 females and 98 males) who underwent thyroidectomy, with a mean age of 48.6 years, and the control group consisted of 103 patients (53 females and 50 males) who underwent other head and neck operations, with a mean age of 50.3 years. All patients were required to complete the Leicester Cough Questionnaire (LCQ) preoperatively and 2 weeks postoperatively. RESULTS: The postoperative mean total LCQ scores in the experimental and control groups were 17.9 ± 5.0 and 19.8 ± 4.2, respectively; the difference was significant (p = 0.014). Adverse event analysis showed that patients in the experimental group scored significantly worse on items for chest or stomach pains, phlegm, feeling in control of coughing, sleep disturbances, coughing bouts, frustration, and feeling fed up with coughing. In the analysis of the three LCQ domains, a significant difference was noted in the physical domain between the two groups (p < 0.001). In the one-way analysis of variance, the factors of sex and anaesthesia time were associated with the postoperative LCQ score; in further multifactor analysis of variance, only the factor of sex was significantly related to the postoperative LCQ score. CONCLUSION: Thyroidectomy may be associated with postoperative cough, and a higher number of female patients complained of cough and related symptoms.


Assuntos
Tosse/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Tireoidectomia , Tosse/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Autorrelato , Inquéritos e Questionários
12.
J Oncol ; 2019: 2408946, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31281357

RESUMO

Purpose: Associations between XRCC1, XRCC3, and ERCC2 gene polymorphism and prognosis have been investigated in several cancers. The aim of this meta-analysis was to assess the prognostic value of XRCC1, XRCC3, and ERCC2 gene polymorphism in hepatocellular carcinoma (HCC). Methods: A systematic literature search was performed to identify relevant studies in PubMed, Embase, and the Cochrane library up to December 2018. The prognostic values of XRCC1, XRCC3, and ERCC2 polymorphisms in HCC were estimated using crude HRs with 95% CIs. Results: Ten studies involving 2687 patients were included in the quantitative analysis. There were no statistically significant associations between XRCC1 rs1799782 C>T, XRCC1 rs25487 G>A, and ERCC2 rs1799793 G>A polymorphisms and overall survival (OS). OS was significantly longer for the ERCC2 rs13181 CC genotype than for AA (CC vs. AA: HR = 0.33, 95% CI = 0.15-0.72). A significantly lower OS was observed for patients with the CT genotype compared with the CC genotype at XRCC3 rs861539 (CT vs. CC: HR = 1.64, 95% CI = 1.11-2.42). Conclusion: The ERCC2 rs13181 A>C polymorphism and XRCC3 rs861539 C>T polymorphism may be predictive markers for prognosis in patients with HCC. Well-designed studies with larger sample sizes are needed to verify our findings.

13.
Int J Biol Sci ; 15(5): 929-941, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31182914

RESUMO

The mTORC1 inhibitors, such as rapamycin and its analogs, show limited antitumor activity in clinic, reasons for which have not been clearly elucidated. Here, we undertook an effort to uncover the mechanisms underlying the limited efficacy of rapamycin, and found that the transit suppression of 4EBP1 phosphorylation led to cap-dependent translation and cell proliferation in breast cancer cells. AKT only partially contributed to 4EBP1 re-phosphorylation. By taking advantage of mass spectrometry-based phosphoproteomic analysis, we identified SGK3 as a potent kinase involved in 4EBP1 re-phosphorylation. SGK3 deletion inhibited 4EBP1 phosphorylation and cap-dependent translation. Importantly, 4EBP1 phosphorylation was positively correlated with SGK3 activity in 67 clinical breast cancer specimens. Moreover, SGK3 deletion in combination with AKT inhibition almost blocked the 4EBP1 re-phosphorylation that was induced by rapamycin and profoundly enhanced rapamycin-induced growth inhibition in vitro and in an MCF7 breast cancer mouse xenograft model in vivo. Mechanistically, the feedback activation of SGK3 by rapamycin was dependent on hVps34 and mTORC2, and reactivated mTORC1/4EBP1 axis by phosphorylating TSC2. Collectively, our study reveals a critical role of SGK3 in mediating rapamycin resistance, and provides a rationale for targeting SGK3 to improve mTOR-targeted therapies.

14.
Br J Radiol ; 92(1099): 20180896, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31045432

RESUMO

OBJECTIVE: To assess the safety and efficacy of transcatheter arterial embolization (TAE) of the inferior mesenteric artery (IMA) for the management of post-partum hemorrhage (PPH). METHODS: A retrospective analysis was performed regarding eight patients (mean age, 34.4 y; age range, 31 - 40 y) who underwent TAE of the IMA for PPH between March 2001 and September 2018. Obstetric records, including maternal characteristics, clinical manifestations, complications, and clinical outcomes, as well as TAE details were obtained. RESULTS: All eight patients had primary PPH and the vaginal delivery mode. CT scans of two patients showed active bleeding from the lower uterus or hematoma and with the origin of contrast extravasation abutting the adjacent rectum. In seven patients, an aortogram or IMA arteriogram following persistent vaginal bleeding after sufficient embolization of the bleeding focus from the bilateral iliac arteries, found the bleeding focus of the IMA, while in one patient, the IMA bleeding focus was found at the second session 4 h after the first session. TAE of the IMA was technically successful in all eight patients and cessation of bleeding without repeated TAE or additional hemostatic surgery was achieved in all patients after TAE of the IMA. There were neither procedure-related complications nor bowel ischemia during follow-up. CONCLUSION: TAE of the IMA for PPH was safe and effective with successful hemostasis. Bleeding from the IMA should be suspected when there is persistent vaginal bleeding after sufficient embolization of bleeders from the bilateral iliac arteries. ADVANCES IN KNOWLEDGE: Bleeding from the IMA should be suspected when there is persistent vaginal bleeding after sufficient embolization of bleeders from the bilateral iliac arteries.


Assuntos
Embolização Terapêutica/métodos , Artéria Ilíaca/diagnóstico por imagem , Artéria Mesentérica Inferior/diagnóstico por imagem , Artéria Mesentérica Inferior/fisiopatologia , Hemorragia Pós-Parto/terapia , Adulto , Angiografia por Tomografia Computadorizada/métodos , Feminino , Humanos , Artéria Ilíaca/fisiopatologia , Hemorragia Pós-Parto/diagnóstico por imagem , Estudos Retrospectivos , Resultado do Tratamento
15.
Clin Cancer Res ; 25(12): 3538-3547, 2019 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-30842125

RESUMO

PURPOSE: We evaluated the performance of the newly proposed radiomics of multiparametric MRI (RMM), developed and validated based on a multicenter dataset adopting a radiomic strategy, for pretreatment prediction of pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC) in breast cancer. EXPERIMENTAL DESIGN: A total of 586 potentially eligible patients were retrospectively enrolled from four hospitals (primary cohort and external validation cohort 1-3). Quantitative imaging features were extracted from T2-weighted imaging, diffusion-weighted imaging, and contrast-enhanced T1-weighted imaging before NAC for each patient. With features selected using a coarse to fine feature selection strategy, four radiomic signatures were constructed based on each of the three MRI sequences and their combination. RMM was developed based on the best radiomic signature incorporating with independent clinicopathologic risk factors. The performance of RMM was assessed with respect to its discrimination and clinical usefulness, and compared with that of clinical information-based prediction model. RESULTS: Radiomic signature combining multiparametric MRI achieved an AUC of 0.79 (the highest among the four radiomic signatures). The signature further achieved good performances in hormone receptor-positive and HER2-negative group and triple-negative group. RMM yielded an AUC of 0.86, which was significantly higher than that of clinical model in two of the three external validation cohorts. CONCLUSIONS: The study suggested a possibility that RMM provided a potential tool to develop a model for predicting pCR to NAC in breast cancer.

16.
Biochem Biophys Res Commun ; 511(3): 597-603, 2019 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-30826059

RESUMO

As chemo-radiotherapy continues to increase the lifespan of patients with nasopharyngeal carcinoma (NPC), adverse reaction and drug resistance remain two major problems when using cisplatin (CDDP). In this study, we took the lead in designing a dual-mechanism anti-cancer system modified with cell-penetrating peptide on the surface of superparamagnetic iron oxide nanoparticles (SPION) to enhance CDDP delivery efficacy to NPC cells, especially CDDP resistant NPC cells. The combinatorial delivery of CDDP and iron oxide nanoparticles showed an unexpected effect on reversal of CDDP resistance due to the Fenton reaction with an average decrease in the half maximal inhibitory concentration (IC 50) of 85% and 94% in HNE-1/DDP and CNE-2/DDP resistant cells respectively compared to CDDP alone. On this basis, modification with TAT peptide (YGRKKRRQRRR) significantly improved tumor intracellular uptake, devoting to better curative effects and minimized side effects by reducing CDDP therapeutic doses. Furthermore, we specifically labelled CDDP with fluorescence for detection of intracellular nanoparticles uptake and mechanism research through drug tracing. This novel compound provides a promising therapy for reducing chemotherapy side effects and reversing CDDP-resistant nasopharyngeal carcinoma.


Assuntos
Antineoplásicos/administração & dosagem , Cisplatino/administração & dosagem , Nanopartículas de Magnetita/química , Carcinoma Nasofaríngeo/tratamento farmacológico , Neoplasias Nasofaríngeas/tratamento farmacológico , Fragmentos de Peptídeos/química , Produtos do Gene tat do Vírus da Imunodeficiência Humana/química , Antineoplásicos/farmacocinética , Antineoplásicos/farmacologia , Linhagem Celular Tumoral , Cisplatino/farmacocinética , Cisplatino/farmacologia , Portadores de Fármacos/química , Resistencia a Medicamentos Antineoplásicos , Humanos
17.
Opt Lett ; 44(4): 935-938, 2019 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-30768024

RESUMO

We propose and experimentally demonstrate a single optical element, termed as spiral forked plates (SFPs), to simultaneously generate two tightly focused optical vortices (OVs). The key idea is to combine a spiral zone plate (SZP) and a forked grating (FG) through a logic XOR operation. Both theoretical and experimental results demonstrate that SFPs not only can completely suppress the undesirable zeroth (central) order diffraction, but also can further manipulate the topological charges (TCs) of the two resultant focused OVs by varying the TCs of the SZP and FG, following the so-called TC transformation rule. Thus, SFPs show promising potential for advancing the shrinking and integrating applications of orbital angular momentum superpositions.

18.
J Hepatol ; 70(5): 893-903, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30660709

RESUMO

BACKGROUND & AIMS: Previous prognostic scores for transarterial chemoembolization (TACE) were mainly derived from real-world settings, which are beyond guideline recommendations. A robust model for outcome prediction and risk stratification of recommended TACE candidates is lacking. We aimed to develop an easy-to-use tool specifically for these patients. METHODS: Between January 2010 and May 2016, 1,604 treatment-naïve patients with unresectable hepatocellular carcinoma (HCC), Child-Pugh A5-B7 and performance status 0 undergoing TACE were included from 24 tertiary centres. Patients were randomly divided into training (n = 807) and validation (n = 797) cohorts. A prognostic model was developed and subsequently validated. Predictive performance and discrimination were further evaluated and compared with other prognostic models. RESULTS: The final presentation of the model was "linear predictor = largest tumour diameter (cm) + tumour number", which consistently outperformed other currently available models in both training and validation datasets as well as in different subgroups. The thirtieth percentile and the third quartile of the linear predictor, namely 6 and 12, were further selected as cut-off values, leading to the "six-and-twelve" score which could divide patients into 3 strata with the sum of tumour size and number ≤6, >6 but ≤12, and >12 presenting significantly different median survival of 49.1 (95% CI 43.7-59.4) months, 32.0 (95% CI 29.9-37.5) months, and 15.8 (95% CI 14.1-17.7) months, respectively. CONCLUSIONS: The six-and-twelve score may prove an easy-to-use tool to stratify recommended TACE candidates (Barcelona Clinic Liver Cancer stage-A/B) and predict individual survival with favourable performance and discrimination. Moreover, the score could stratify these patients in clinical practice as well as help design clinical trials with comparable criteria involving these patients. Further external validation of the score is required. LAY SUMMARY: There is currently no prognostic model specifically developed for recommended or ideal transarterial chemoembolization (TACE) candidates with hepatocellular carcinoma, despite these patients being frequently identified as the best target population in pivotal randomized controlled trials. The six-and-twelve score provides patient survival prediction, especially in ideal candidates of TACE, outperforming other currently available models in both training and validation sets, as well as different subgroups. With cut-off values of 6 and 12, the score can stratify ideal TACE candidates into 3 strata with significantly different outcomes and may shed light on risk stratification of these patients in clinical practice as well as in clinical trials.

19.
AJR Am J Roentgenol ; 212(4): 788-795, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30673335

RESUMO

OBJECTIVE: The purpose of this study was to explore the value of 3-T MRI for evaluating the preoperative T staging of esophageal cancer (EC) treated with neoadjuvant chemotherapy (NAC), with histopathologic confirmation. SUBJECTS AND METHODS: This prospective study enrolled patients for whom endoscopic biopsy showed EC and pretreatment CT showed stage cT1N+M0 or cT2-T4aN0-N3M0. All patients received two cycles of NAC (paclitaxel and nedaplatin protocol) followed by 3-T MRI and surgical resection. Readers assigned a T category on MRI, and postoperative pathologic confirmation was considered the reference standard. Interreader agreement, the diagnostic accuracy of T staging on T2-weighted turbo spin-echo (TSE) BLADE (Siemens Healthcare), contrast-enhanced StarVIBE (Siemens Healthcare), high-resolution delayed phase StarVIBE, and the combination of the three sequences were analyzed and compared with postoperative pathologic T staging. RESULTS: The study included 79 patients. Mean time between NAC and MRI was 23 days. Interreader agreements of T category assignment were excellent for T2-weighted TSE BLADE (κ = 0.810, p < 0.0001), contrast-enhanced StarVIBE (κ = 0.845, p < 0.0001), high-resolution delayed phase StarVIBE (κ = 0.897, p < 0.0001), and the combination of the three sequences (κ = 0.880, p < 0.0001). The highest accuracy for T0, T1, T2, and T4a lesions was on high-resolution delayed phase StarVIBE (96.2%, 92.4%, 91.1%, and 91.1% for reader 1; 94.9%, 89.9%, 91.1%, and 94.9% for reader 2), and the highest accuracy for T3 lesions was on T2-weighted TSE BLADE (92.4% and 94.9% for reader 1 and reader 2, respectively). Diagnostic accuracy of the combination of the three sequences was not improved compared with individual sequences. CONCLUSION: High-resolution delayed phase StarVIBE had the highest diagnostic accuracy in staging EC after NAC for all T categories except T3, for which T2-weighted TSE BLADE had the highest accuracy. Combining all three sequences did not improve diagnostic accuracy.


Assuntos
Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/patologia , Imagem por Ressonância Magnética/métodos , Adulto , Idoso , Quimioterapia Adjuvante , Meios de Contraste , Feminino , Gadolínio DTPA , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estadiamento de Neoplasias , Compostos Organoplatínicos/administração & dosagem , Paclitaxel/administração & dosagem , Estudos Prospectivos
20.
Eur Radiol ; 29(2): 906-914, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30039220

RESUMO

PURPOSE: To assess the role of the MR radiomic signature in preoperative prediction of lymph node (LN) metastasis in patients with esophageal cancer (EC). PATIENTS AND METHODS: A total of 181 EC patients were enrolled in this study between April 2015 and September 2017. Their LN metastases were pathologically confirmed. The first half of this cohort (90 patients) was set as the training cohort, and the second half (91 patients) was set as the validation cohort. A total of 1578 radiomic features were extracted from MR images (T2-TSE-BLADE and contrast-enhanced StarVIBE). The lasso and elastic net regression model was exploited for dimension reduction and selection of the feature space. The multivariable logistic regression analysis was adopted to identify the radiomic signature of pathologically involved LNs. The discriminating performance was assessed with the area under receiver-operating characteristic curve (AUC). The Mann-Whitney U test was adopted for testing the potential correlation of the radiomic signature and the LN status in both training and validation cohorts. RESULTS: Nine radiomic features were selected to create the radiomic signature significantly associated with LN metastasis (p < 0.001). AUC of radiomic signature performance in the training cohort was 0.821 (95% CI: 0.7042-0.9376) and in the validation cohort was 0.762 (95% CI: 0.7127-0.812). This model showed good discrimination between metastatic and non-metastatic lymph nodes. CONCLUSION: The present study showed MRI radiomic features that could potentially predict metastatic LN involvement in the preoperative evaluation of EC patients. KEY POINTS: • The role of MRI in preoperative staging of esophageal cancer patients is increasing. • MRI radiomic features showed the ability to predict LN metastasis in EC patients. • ICCs showed excellent interreader agreement of the extracted MR features.


Assuntos
Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/patologia , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Imagem por Ressonância Magnética/métodos , Estudos de Casos e Controles , Humanos , Interpretação de Imagem Assistida por Computador , Metástase Linfática , Pessoa de Meia-Idade , Estudos Prospectivos , Curva ROC , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
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