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1.
Thorac Cancer ; 2021 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-34520108

RESUMO

An inflammatory myofibroblastic tumor (IMT) of the respiratory system is an uncommon disease. In Taiwan, there is a lack of previous studies on tracheobronchial IMT. The tumor is characterized by overexpression of anaplastic lymphoma receptor tyrosine kinase (ALK)-1. Surgical resection is the standard treatment of choice nowadays.

2.
Neurol Sci ; 2021 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-34480640

RESUMO

Susac syndrome is a rare disease presenting with a classic triad of symptoms. These are sensorineural hearing loss, encephalopathy, and branch retinal artery occlusions. Initial presentation is usually headache and symptoms of encephalopathy. Hearing loss is unusual in the early stages but, when it does present, can often lead to a misdiagnosis of sudden sensorineural hearing loss. Hence, neurological and retinal examinations are essential to an accurate diagnosis. In this study, we aimed to raise awareness of Susac syndrome among physicians and facilitate recognition of its manifestation, especially in those patients presenting with hearing loss alone. Identifying Susac syndrome that presents as sudden sensorineural hearing loss can be challenging but a number of case reviews have been reported in recent years and treatment guidelines are available.

3.
Plant Dis ; 2021 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-34340557

RESUMO

Roselle (Hibiscus sabdariffa L.) plants, whose calyces are used for production of beverages or jams, are mainly cultivated in Taitung County of eastern Taiwan. Since 2016, large crown galls were observed on the roselle plants in the commercial plantations at Taimali and Jinfong Townships of Taitung County. A follow-up survey in July and August of 2017 revealed spreading of this disease to the neighboring areas including Beinan and Dawu Townships. Disease incidence was estimated to be 0.6-10%. Galls of varying sizes (2-15 cm in diameter) were usually found on the roots and crowns of the roselle plants, starting with small swellings at the infection sites. Galls were light-colored, and smooth and tender in texture at the early stage, but later turned dark-colored, and appeared rough and woody. In some cases, adventitious roots extruding from the larger crown galls could be seen. Isolation of the causal agent was performed by quadrantally streaking bacterial suspension made from surface-sterilized, macerated galls on trypticase soy agar (TSA). After incubating at 28°C for 5 days, single colonies were transferred onto new TSA plates for further cultivation at 28°C. Finally, circular, convex, viscous and milky white colonies with smooth surface similar to colony morphology of Agrobacterium tumefaciens C58 were obtained for further identification. First, all six candidate isolates (TZ-1, TL1-2, TL2-1, TD1-1, TD1-24 and TD2-1) were identified as Agrobacterium spp. using the partial sequences of the 16S rRNA gene (accession numbers MW205820 to MW205825 in the GenBank database). The selected isolates also showed some biochemical and physiological characteristics similar to A. tumefaciens, including oxidase positive, growth at 35°C and in 2% NaCl, and alkalinity from litmus milk. Moreover, they were tested negative for utilization of citrate and acid production on potato dextrose agar (PDA) supplemented with calcium carbonate. Under a transmission electron microscope, the bacterium was rod-shaped and possessed peritrichous flagella. By means of multiplex PCR using primers designed for differentiation of Agrobacterium rubi, Agrobacterium vitis and Agrobacterium biovars 1 and 2, a 184 bp product was detected in all six isolates, indicating that they all belong to Agrobacterium biovar 1. Furthermore, the recA allele of each isolate was PCR amplified using primers F2898/F2899, and recA sequence analysis assigned all six isolates to A. tumefaciens genomospecies G7 (GenBank accession numbers MZ570905-MZ570910). Pathogenicity assay was carried out by inoculating the stems of 2-week-old roselle seedlings through wounds made with a sterile needle with bacteria on it. The inoculated seedlings were kept in plastic bags to maintain high humidity. Symptoms similar to those observed in the field developed at the inoculation sites after 7 days, and Koch's postulates were fulfilled when the bacteria re-isolated from the galls were also identified as A. tumefaciens genomospecies G7 using recA gene sequence analysis. To our knowledge, this is the first report of crown gall disease caused by A. tumefaciens on Hibiscus sabdariffa in Taiwan. This disease may potentially damage the roselle industry if no action is taken to stop its spreading. Identification of the causal agent of roselle crown gall disease could help us further investigate its ecology and develop integrated pest management strategies for prevention of this disease in the future.

4.
Ther Adv Respir Dis ; 15: 1753466621989532, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33541248

RESUMO

BACKGROUND: Tuberculosis (TB) is a constant threat even with a worldwide active public health campaign. Diagnosis of TB pleurisy is challenging in the case of pleural effusion of unknown origin after aspiration analysis. The study was designed to demonstrate a simple image interpretation technique to differentiate TB pleurisy from non-TB pleurisy using semi-rigid pleuroscopy. METHODS: The study retrospectively enrolled 117 patients who underwent semi-rigid pleuroscopy from April 2016 to August 2018 in a tertiary hospital. We analyzed the possibility of TB pleurisy using three simple pleuroscopic images via semi-rigid pleuroscopy. RESULTS: Among 117 patients, 28 patients (23.9%) were diagnosed with TB pleurisy. Sago-like nodules/micronodules, adhesion, and discrete distribution were noted in 20 (71.4%), 20 (71.4%), and 19 (67.9%) patients with TB pleurisy, respectively. Sago-like nodules/micronodules, adhesion, and discrete distribution were noted in six (6.7%), 37 (41.6%), and no (0.0%) patients with non-TB pleurisy, respectively. The positive and negative predictive values of any two out of three pleuroscopic patterns for TB pleurisy were 100.0% and 93.7%, respectively. CONCLUSIONS: A high positive predictive value for TB pleurisy was demonstrated by the presence of any two out of the three characteristic features. Absence of all three features had an excellent negative predictive value for TB pleurisy. Our diagnostic criteria reconfirm that pleuroscopic images can be used as predictors for TB pleurisy in patients with undiagnosed pleural effusion.The reviews of this paper are available via the supplementary material section.

5.
NMR Biomed ; 33(5): e4282, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32124504

RESUMO

The aim of this study was to evaluate the imaging quality and diagnostic performance of fast spin echo diffusion-weighted imaging with periodically rotated overlapping parallel lines with enhanced reconstruction (FSE-PROP-DWI) in distinguishing parotid pleomorphic adenoma (PMA) from Warthin tumor (WT). This retrospective study enrolled 44 parotid gland tumors from 34 patients, including 15 PMAs and 29 WTs with waived written informed consent. All participants underwent 1.5 T diffusion-weighted imaging including FSE-PROP-DWI and single-shot echo-planar diffusion-weighted imaging (SS-EP-DWI). After imaging resizing and registration among T2WI, FSE-PROP-DWI and SS-EP-DWI, imaging distortion was quantitatively analyzed by using the Dice coefficient. Signal-to-noise ratio and contrast-to-noise ratio were qualitatively evaluated. The mean apparent diffusion coefficient (ADC) of parotid gland tumors was calculated. Wilcoxon signed-rank test was used for paired comparison between FSE-PROP-DWI versus SS-EP-DWI. Mann-Whitney U test was used for independent group comparison between PMAs versus WTs. Diagnostic performance was evaluated by receiver operating characteristics curve analysis. P < 0.05 was considered statistically significant. The Dice coefficient was statistically significantly higher on FSE-PROP-DWI than SS-EP-DWI for both tumors (P < 0.005). Mean ADC was statistically significantly higher in PMAs than WTs on both FSE-PROP-DWI and SS-EP-DWI (P < 0.005). FSE-PROP-DWI and SS-EP-DWI successfully distinguished PMAs from WTs with an AUC of 0.880 and 0.945, respectively (P < 0.05). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy in diagnosing PMAs were 100%, 69.0%, 62.5%, 100% and 79.5% for FSE-PROP-DWI, and 100%, 82.8%, 75%, 100% and 88.6% for SS-EP-DWI, respectively. FSE-PROP-DWI is useful to distinguish parotid PMAs from WTs with less distortion of tumors but lower AUC than SS-EP-DWI.


Assuntos
Adenolinfoma/diagnóstico por imagem , Adenolinfoma/diagnóstico , Adenoma Pleomorfo/diagnóstico por imagem , Adenoma Pleomorfo/diagnóstico , Imagem de Difusão por Ressonância Magnética , Neoplasias Parotídeas/diagnóstico por imagem , Neoplasias Parotídeas/diagnóstico , Neoplasias das Glândulas Salivares/diagnóstico por imagem , Neoplasias das Glândulas Salivares/diagnóstico , Diagnóstico Diferencial , Humanos , Processamento de Imagem Assistida por Computador , Curva ROC , Processamento de Sinais Assistido por Computador , Razão Sinal-Ruído
6.
Biomedicines ; 8(2)2020 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-32092879

RESUMO

Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) is the standard first-line therapy for metastatic lung adenocarcinoma harboring sensitive EGFR mutations. Tumor surface programmed death-ligand 1 (PD-L1) is expressed in some metastatic EGFR-mutated lung adenocarcinoma, but its impact on the efficacy of EGFR-TKIs is unclear. We retrospectively investigated 117 untreated metastatic lung EGFR mutated adenocarcinoma patients with a PD-L1 immunohistochemistry test. The PD-L1 expression level was classified by tumor proportion scores (TPS). Forty-five patients had negative expression (TPS < 1%), 45 had a weak expression (TPS 1-49%), and 27 had a strong expression (≥50%). All patients recruited in this study received EGFR-TKIs as a first-line therapy. No significant differences were observed for objective response rates (68.9% versus 62.2% versus 73.1%, p = 0.807) and median time to treatment failure (TTF) (12.17 versus 13.17 versus 11.0 months, p = 0.443) of first-line EGFR-TKIS among the three groups of patients (negative versus weak versus strong). The median overall survival was 21.27 versus 20.63 versus 19.43 months among the three groups of patients (p = 0.77). Our results demonstrated that PD-L1 did not affect the efficacy of first-line EGFR-TKIs in metastatic EGFR mutated lung adenocarcinoma. Thus, EGFR-TKIs are suggested as the preferred clinical therapy for these patients, despite their PD-L1 levels.

7.
Cancer Genomics Proteomics ; 17(1): 91-100, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31882554

RESUMO

BACKGROUND/AIM: Circulating mRNA can be a useful source of cancer biomarkers. We took advantage of direct transcriptomic analysis in plasma RNA to identify novel mRNA markers for non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: Plasma RNA from NSCLC patients and healthy individuals was profiled with cDNA-mediated annealing, selection, extension and ligation (DASL) microarrays. The microarray results were further validated in plasma RNA. RESULTS: Through RNA profiling and online database mining, four gene transcripts were filtered as candidate markers of NSCLC. After validation, the PCTAIRE-1 transcript was identified as a circulating mRNA marker. The diagnostic potential of PCTAIRE-1 was evaluated by receiver operating characteristic curve analysis, which gave a sensitivity and specificity of 60% and 85%, respectively. In addition, high plasma PCTK1 levels were also correlated with poor progression-free survival (p=0.008). CONCLUSION: Circulating mRNA can be profiled with the DASL assay. From the profile, PCTAIRE-1 RNA in the plasma we discovered as a novel diagnostic/prognostic biomarker and an indicator of poor survival in NSCLC patients.


Assuntos
Biomarcadores Tumorais/sangue , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Quinases Ciclina-Dependentes/sangue , Regulação Neoplásica da Expressão Gênica , Neoplasias Pulmonares/diagnóstico , RNA Mensageiro/sangue , Transcriptoma , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/genética , Carcinoma Pulmonar de Células não Pequenas/sangue , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/genética , Estudos de Casos e Controles , Quinases Ciclina-Dependentes/genética , Feminino , Seguimentos , Humanos , Biópsia Líquida , Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/genética , Masculino , Pessoa de Meia-Idade , Prognóstico , RNA Mensageiro/genética , Curva ROC , Taxa de Sobrevida
8.
Oncol Lett ; 18(6): 6143-6149, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31788088

RESUMO

Pretreatment tumor metabolic burden, measured using fluorine-18 fluorodeoxyglucose positron emission tomography/computerized tomography (18F-FDG PET/CT), has been demonstrated to predict outcomes in various types of malignancies. Additionally, Epstein-Barr virus (EBV) serum titer is associated with stages of pulmonary lymphoepithelioma-like carcinoma (LELC). The present study aimed to investigate the prognostic value of the functional parameters of 18F-FDG PET/CT in pulmonary LELC and their association with serum EBV DNA. The present retrospective study analyzed data from 71 patients with pulmonary LELC; among these, 32 patients with pulmonary LELC underwent pretreatment 18F-FDG PET/CT staging between January 2008 and December 2016. EBV viral load and functional parameters of 18F-FDG PET/CT were used for survival analysis. Multivariate analysis identified tumor stage IV as a significant predictor of poor progression-free survival [hazard ratio (HR), 4.85; P=0.049], whereas elevated total metabolic tumor volume (MTV ≥72.6 ml) independently predicted worse overall survival (OS; HR, 12.59; P=0.024). Pretreatment serum EBV DNA titer was significantly positively associated with total MTV (P=0.0337) and total lesion glycolysis (TLG; P=0.0093), but could not predict outcomes. Total MTV was an independent predictor of OS, and may guide clinical management for pulmonary LELC.

9.
Am J Emerg Med ; 37(9): 1808.e1-1808.e3, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31230923

RESUMO

Influenza-associated acute encephalopathy (IAE) is more prevalent in children than in adults and often results in neurological sequelae or even death. Diagnosis of IAE is difficult as clinical presentation varies significantly and the influenza virus is rarely detected in cerebrospinal fluid. Moreover, seizures in adults due to influenza infection are rare. Herein, we describe the case of an adult presenting with both acute encephalitis and seizures. A 38-year-old female was admitted to the emergency department with acute respiratory symptoms and fever, followed by quick progression to stupor within 24 h. A rapid antigen test was influenza A-positive, and polymerase chain reaction of nasal secretions confirmed the H3N2 subtype. Brain magnetic resonance imaging showed bilateral water restriction lesions at the thalamus and the cerebellum and an electroencephalogram showed frequent episodic generalized sharp-and-slow waves over the bilateral frontal region. Based on the neuroimaging and laboratory findings, we diagnosed the patient with adult influenza A (H3N2)-related encephalitis complicated by seizure. Treatment with oseltamivir and anticonvulsants led to complete neurologic recovery by day 14. This report describes two unusual neurological manifestations of influenza A, i.e., encephalitis and seizures, in an adult. We emphasize that, in adults presenting with acute viral encephalitis, clinicians should consider influenza infection as part of the differential diagnosis, and that typical neuroimaging in conjunction with laboratory detection of influenza virus and/or intrathecal antibody production suggestive of IAE, may help establish an accurate diagnosis.


Assuntos
Encefalite Viral/virologia , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Influenza Humana/diagnóstico , Doença Aguda , Adulto , Anticonvulsivantes/administração & dosagem , Antivirais/administração & dosagem , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Diagnóstico Diferencial , Encefalite Viral/complicações , Encefalite Viral/diagnóstico , Encefalite Viral/tratamento farmacológico , Feminino , Humanos , Influenza Humana/complicações , Influenza Humana/tratamento farmacológico , Influenza Humana/virologia , Levetiracetam/administração & dosagem , Imageamento por Ressonância Magnética , Oseltamivir/administração & dosagem , Convulsões/tratamento farmacológico , Convulsões/etiologia
10.
Clin Nucl Med ; 44(2): e68-e75, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30608914

RESUMO

PURPOSE: Compared with other forms of non-small cell lung cancer, pulmonary lymphoepithelioma-like carcinoma (LELC) is rarer and portends better outcomes. We sought to investigate the prognostic role and clinical impact of pretreatment F-FDG PET in pulmonary LELC. METHODS: A total of 71 patients with pulmonary LELC were identified through a retrospective review of clinical records. Of them, 41 underwent F-FDG PET for primary staging. Outcomes were assessed using the Kaplan-Meier method and Cox regression models with a forward stepwise selection procedure. Staging changes served as the main outcome measure for assessing the impact of F-FDG PET. For the purpose of analyses, all patients were restaged according the American Joint Committee on Cancer Staging Manual eighth edition. RESULTS: Stage and pretreatment F-FDG PET were significantly independent predictors of overall survival (OS) on multivariate analysis. Five-year OS rates for patients with stages I-II, III-IVA, and IVB were 92.3%, 70.4%, and 20.0%, respectively. The use of F-FDG PET for staging purposes was associated with a better OS (P = 0.003). Specifically, the 5-year OS rates for patients who were staged with and without F-FDG PET were 85.4% and 49.7%, respectively (P = 0.012). F-FDG PET resulted in a disease upstage in 28.6% of patients with CT-defined stages III-IVA; of them, 14.3% were upstaged to IVB disease. CONCLUSIONS: The American Joint Committee on Cancer eighth edition stage and pretreatment F-FDG PET were independent prognostic factors for OS in patients with pulmonary LELC. F-FDG PET imaging resulted in a better disease staging with a corresponding optimization of therapeutic interventions, which ultimately improved survival outcomes.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/patologia , Células Epiteliais/patologia , Fluordesoxiglucose F18 , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Tomografia por Emissão de Pósitrons , Idoso , Carcinoma Pulmonar de Células não Pequenas/terapia , Feminino , Humanos , Neoplasias Pulmonares/terapia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
11.
Eur J Nucl Med Mol Imaging ; 46(2): 467-477, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30415280

RESUMO

PURPOSE: The role of brain FDG-PET in patients with lung cancer and brain metastases remains unclear. Here, we sought to determine the prognostic significance of whole-body PET/CT plus brain PET/MR in predicting the time to neurological progression (nTTP) and overall survival (OS) in this patient group. METHODS: Of 802 patients with non-small cell lung cancer who underwent primary staging by a single-day protocol of whole-body PET/CT plus brain PET/MR, 72 cases with adenocarcinoma and brain metastases were enrolled for a prognostic analysis of OS. On the basis of the available follow-up brain status, only 52 patients were eligible for prognostic analysis of nTTP. Metastatic brain tumors were identified on post-contrast MR imaging, and the tumor-to-brain ratio (TBR) was measured on PET images. RESULTS: Multivariate analysis revealed that FDG-PET findings and eligibility for initial treatment with targeted therapy were significant independent predictors of nTTP and OS. A new index, termed the molecular imaging prognostic (MIP) score, was proposed to define three disease classes. MIP scores were significant predictors of both nTTP and OS (P < 0.001). Pre-existing prognostic indices such as Lung-molGPA scores were significant predictors of OS but did not predict nTTP. CONCLUSIONS: When staging is performed with whole-body PET/CT plus brain PET/MR, our new prognostic index may be helpful to stratify the outcomes of patients with lung adenocarcinoma and brain metastases. The superior prognostic power of this index for nTTP might be used to select appropriate patients for intracranial control and thereby achieve better quality of life.


Assuntos
Adenocarcinoma de Pulmão/patologia , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/secundário , Encéfalo/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Imageamento por Ressonância Magnética , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Análise de Sobrevida , Imagem Corporal Total
13.
Cancer Cell ; 34(6): 954-969.e4, 2018 12 10.
Artigo em Inglês | MEDLINE | ID: mdl-30537515

RESUMO

Multiple mechanisms of resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have been identified in EGFR-mutant non-small cell lung cancer (NSCLC); however, recurrent resistance to EGFR TKIs due to the heterogeneous mechanisms underlying resistance within a single patient remains a major challenge in the clinic. Here, we report a role of nuclear protein kinase Cδ (PKCδ) as a common axis across multiple known TKI-resistance mechanisms. Specifically, we demonstrate that TKI-inactivated EGFR dimerizes with other membrane receptors implicated in TKI resistance to promote PKCδ nuclear translocation. Moreover, the level of nuclear PKCδ is associated with TKI response in patients. The combined inhibition of PKCδ and EGFR induces marked regression of resistant NSCLC tumors with EGFR mutations.


Assuntos
Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Proteína Quinase C-delta/antagonistas & inibidores , Inibidores de Proteínas Quinases/farmacologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/metabolismo , Carcinoma Pulmonar de Células não Pequenas/patologia , Linhagem Celular Tumoral , Núcleo Celular/genética , Núcleo Celular/metabolismo , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/genética , Receptores ErbB/antagonistas & inibidores , Receptores ErbB/genética , Receptores ErbB/metabolismo , Feminino , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/patologia , Masculino , Microscopia Confocal , Pessoa de Meia-Idade , Terapia de Alvo Molecular/métodos , Mutação , Proteína Quinase C-delta/metabolismo , Interferência de RNA
14.
AJR Am J Roentgenol ; 210(6): 1330-1337, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29667889

RESUMO

OBJECTIVE: The objective of this article is to propose a Warthin tumor (WT) score to distinguish WTs from other parotid tumors. MATERIALS AND METHODS: The study included 78 patients with 92 histologically proven parotid tumors, including 42 WTs, 30 pleomorphic adenomas (PMAs), and 20 carcinomas. Echo-planar DW images were acquired. The WT score, which comprised the mean apparent diffusion coefficient (ADCM) and the SD of the ADC (ADCSD) of tumors, patient age, and patient sex, was used to predict WTs. The diagnostic performance of the WT score was evaluated using ROC analyses. Statistical significance was denoted by p < 0.05. RESULTS: With the use of optimized criteria, including an ADCM less than or equal to 1.016 × 10-3 mm2/s (WT score, 1), an ADCSD less than or equal to 0.1171 × 10-3 mm2/s (WT score, 1), patient age older than 49 years (WT score, 1), and male sex (WT score, 1), a WT score greater than 2 had a sensitivity, specificity, positive negative value, negative predictive value, and accuracy of 85.7%, 100.0%, 100.0%, 89.3%, and 93.4%, respectively. CONCLUSION: The WT score allows parotid WTs to be distinguished from PMAs and carcinomas with high accuracy.


Assuntos
Adenolinfoma/diagnóstico por imagem , Adenoma Pleomorfo/diagnóstico por imagem , Carcinoma/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética/métodos , Imagem Ecoplanar , Neoplasias Parotídeas/diagnóstico por imagem , Adenolinfoma/patologia , Adenoma Pleomorfo/patologia , Adenoma Pleomorfo/cirurgia , Biópsia com Agulha de Grande Calibre , Carcinoma/patologia , Carcinoma/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Parotídeas/patologia , Neoplasias Parotídeas/cirurgia , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade
15.
J Cell Mol Med ; 22(6): 3139-3148, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29575535

RESUMO

Although tumour PD-L1 (CD274) expression had been used as a predictive biomarker in checkpoint immunotherapy targeting the PD1/PD-L1 axis in various cancers, the regulation of PD-L1 (CD274) expression is unclear. Yes-associated protein (YAP), an important oncogenic protein in Hippo signalling pathway, reportedly promotes cancer development. We investigated whether inhibition of YAP down-regulates PD-L1 (CD274) in human malignant pleural mesothelioma (MPM). Western blotting showed that 2 human MPM cell lines (H2052 and 211H) had increased PD-L1 protein expression compared to H290, MS-1 and H28 cells. In H2052 and 211H cells, PD-L1 mRNA expression was significantly increased compared to other MPM cell lines; YAP knockdown by small interfering RNA decreased PD-L1 protein and mRNA expression. Forced overexpression of the YAP gene increased PD-L1 protein expression in H2452 cells. Chromatin immunoprecipitation (ChIP) assay showed the precipitation of PD-L1 enhancer region encompassing 2 putative YAP-TEAD-binding sites in H2052 cells. We found that, in human MPM tissue microarray samples, YAP and PD-L1 concurrently expressed in immunohistochemistry stain (n = 70, P < .05, chi-square). We conclude that PD-L1 is correlated with YAP expression, and inhibition of YAP down-regulates PD-L1 expression in human MPM. Further study of how YAP regulates PD-L1 in MPM is warranted.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/genética , Antígeno B7-H1/genética , Neoplasias Pulmonares/genética , Mesotelioma/genética , Fosfoproteínas/genética , Neoplasias Pleurais/genética , Proteínas Adaptadoras de Transdução de Sinal/antagonistas & inibidores , Biomarcadores Tumorais/genética , Linhagem Celular Tumoral , Proliferação de Células/genética , Regulação Neoplásica da Expressão Gênica , Humanos , Neoplasias Pulmonares/patologia , Mesotelioma/patologia , Mesotelioma Maligno , Fosfoproteínas/antagonistas & inibidores , Neoplasias Pleurais/patologia , Transdução de Sinais/genética , Fatores de Transcrição
16.
PLoS One ; 13(2): e0192411, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29438424

RESUMO

PURPOSE: We estimated the volume of vestibular schwannomas by an ice cream cone formula using thin-sliced magnetic resonance images (MRI) and compared the estimation accuracy among different estimating formulas and between different models. METHODS: The study was approved by a local institutional review board. A total of 100 patients with vestibular schwannomas examined by MRI between January 2011 and November 2015 were enrolled retrospectively. Informed consent was waived. Volumes of vestibular schwannomas were estimated by cuboidal, ellipsoidal, and spherical formulas based on a one-component model, and cuboidal, ellipsoidal, Linskey's, and ice cream cone formulas based on a two-component model. The estimated volumes were compared to the volumes measured by planimetry. Intraobserver reproducibility and interobserver agreement was tested. Estimation error, including absolute percentage error (APE) and percentage error (PE), was calculated. Statistical analysis included intraclass correlation coefficient (ICC), linear regression analysis, one-way analysis of variance, and paired t-tests with P < 0.05 considered statistically significant. RESULTS: Overall tumor size was 4.80 ± 6.8 mL (mean ±standard deviation). All ICCs were no less than 0.992, suggestive of high intraobserver reproducibility and high interobserver agreement. Cuboidal formulas significantly overestimated the tumor volume by a factor of 1.9 to 2.4 (P ≤ 0.001). The one-component ellipsoidal and spherical formulas overestimated the tumor volume with an APE of 20.3% and 29.2%, respectively. The two-component ice cream cone method, and ellipsoidal and Linskey's formulas significantly reduced the APE to 11.0%, 10.1%, and 12.5%, respectively (all P < 0.001). CONCLUSION: The ice cream cone method and other two-component formulas including the ellipsoidal and Linskey's formulas allow for estimation of vestibular schwannoma volume more accurately than all one-component formulas.


Assuntos
Imageamento por Ressonância Magnética/métodos , Neuroma Acústico/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neuroma Acústico/patologia , Reprodutibilidade dos Testes , Adulto Jovem
17.
Phys Med Biol ; 63(6): 065005, 2018 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-29446758

RESUMO

Lung cancer screening aims to detect small pulmonary nodules and decrease the mortality rate of those affected. However, studies from large-scale clinical trials of lung cancer screening have shown that the false-positive rate is high and positive predictive value is low. To address these problems, a technical approach is greatly needed for accurate malignancy differentiation among these early-detected nodules. We studied the clinical feasibility of an additional protocol of localized thin-section CT for further assessment on recalled patients from lung cancer screening tests. Our approach of localized thin-section CT was integrated with radiomics features extraction and machine learning classification which was supervised by pathological diagnosis. Localized thin-section CT images of 122 nodules were retrospectively reviewed and 374 radiomics features were extracted. In this study, 48 nodules were benign and 74 malignant. There were nine patients with multiple nodules and four with synchronous multiple malignant nodules. Different machine learning classifiers with a stratified ten-fold cross-validation were used and repeated 100 times to evaluate classification accuracy. Of the image features extracted from the thin-section CT images, 238 (64%) were useful in differentiating between benign and malignant nodules. These useful features include CT density (p = 0.002 518), sigma (p = 0.002 781), uniformity (p = 0.032 41), and entropy (p = 0.006 685). The highest classification accuracy was 79% by the logistic classifier. The performance metrics of this logistic classification model was 0.80 for the positive predictive value, 0.36 for the false-positive rate, and 0.80 for the area under the receiver operating characteristic curve. Our approach of direct risk classification supervised by the pathological diagnosis with localized thin-section CT and radiomics feature extraction may support clinical physicians in determining truly malignant nodules and therefore reduce problems in lung cancer screening.


Assuntos
Detecção Precoce de Câncer/métodos , Processamento de Imagem Assistida por Computador/métodos , Neoplasias Pulmonares/classificação , Aprendizado de Máquina , Nódulos Pulmonares Múltiplos/classificação , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Nódulos Pulmonares Múltiplos/diagnóstico , Nódulos Pulmonares Múltiplos/diagnóstico por imagem , Estudos Retrospectivos
18.
Can Respir J ; 2017: 7170687, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29270067

RESUMO

Background: Cryobiopsy is used to biopsy peripheral lung lesions through flexible bronchoscopy with fluoroscopic guidance. However, fluoroscopy is not available at some institutions. This study evaluated the feasibility of radial endobronchial ultrasound-guided bronchoscopic cryobiopsy without fluoroscopy. Methods: This retrospective study was conducted at Chang Gung Memorial Hospital, Linkou branch, in Taiwan. This study enrolled patients who received bronchoscopy examinations with cryotechnology between July 2014 and June 2016. The data were collected through medical chart review. Results: During the study period, 101 patients underwent bronchoscopy examinations with cryotechnology. Ninety patients with endobronchial tumors were excluded from this study. Eleven patients who underwent radial endobronchial ultrasound-guided bronchoscopic cryobiopsy for lung parenchymal lesions were enrolled into this study. The mean age was 61.1 ± 13.8 years. Five patients were men, and the other six were women. The number of cryobiopsies ranged from 1 to 3. In the histological biopsies, the mean specimen diameter was 0.53 ± 0.23 cm, and the mean biopsy area was 0.20 ± 0.19 cm2. Nine of 11 patients had pathological diagnoses. No complications, including pneumothorax, respiratory failure, or major bleeding, were recorded after the procedure. Conclusions: Endobronchial ultrasound is used to ensure biopsy location, and endobronchial ultrasound-guided cryobiopsy is a feasible technique to biopsy peripheral lung lesions in selected cases at institutions without fluoroscopy equipment. This study provided some rationale for further studies examining the impact of fluoroscopy.


Assuntos
Adenocarcinoma de Pulmão/patologia , Broncoscopia/métodos , Criocirurgia/métodos , Endossonografia/métodos , Biópsia Guiada por Imagem/métodos , Neoplasias Pulmonares/patologia , Pulmão/patologia , Pneumonia/patologia , Fibrose Pulmonar/patologia , Idoso , Biópsia , Estudos de Viabilidade , Feminino , Hemorragia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pneumotórax/epidemiologia , Estudos Retrospectivos
19.
PLoS One ; 12(10): e0186567, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29065153

RESUMO

INTRODUCTION: The prognostic value of epidermal growth factor receptor (EGFR) mutations and the correlation between EGFR mutations and the new International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) histological classification remain controversial. The current study aimed to investigate the pure prognostic role of EGFR mutations in treatment-naïve patients with resected stage I lung adenocarcinoma. METHODS: We retrospectively reviewed 373 patients with stage I pulmonary non-small-cell lung cancer who underwent complete surgical resection between January 2010 and May 2014. The tumors were classified according to IASLC/ATS/ERS criteria. EGFR mutation status was determined by established methods. RESULTS: A total of 120 patients were included for analysis; 87 had tumors with EGFR mutations and 33 had wild-type tumors. More low- and intermediate-grade tumors had EGFR mutations, and nearly half of the high-grade tumors were wild-type (75.7% versus 46.2%, p = 0.041). Patients with low-grade tumors had significantly greater median disease-free survival (DFS) (76.8 versus 13 months, p < 0.0001) and better overall survival (OS) (median OS not reached, p = 0.0003) than those with intermediate- and high-grade tumors. Tumor recurrence was 41.4% and 30.3% in mutant and wild-type patients. The 5-years survival rate was 54% and 71.2%. Multivariate analysis revealed that the new histological classification and the pathologic stage were independent predictors of both DFS and OS. EGFR mutation status had no prognostic implications. CONCLUSION: Low grade tumors according to IASLC/ATS/ERS histological classification and the pathologic stage IA tumors of resected stage I lung adenocarcinomas independently predict better DFS and OS. EGFR mutations were frequently seen in histologically low- and intermediate-grade tumors but not a prognostic factor.


Assuntos
Adenocarcinoma/genética , Receptores ErbB/genética , Neoplasias Pulmonares/genética , Mutação , Adenocarcinoma/patologia , Idoso , Feminino , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Prognóstico
20.
BMC Neurol ; 17(1): 178, 2017 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-28882124

RESUMO

BACKGROUND: The disease course and early signs specific to ATTR Ala97Ser, the most common endemic mutation in Taiwan, have not been well described. Since new medications can slow down the rate of disease progression, the early diagnosis of this heterogeneous and fatal disease becomes critical. METHODS: We retrospectively reviewed the characteristics of genetically confirmed ATTR Ala97Ser patients at a tertiary referral medical center. RESULTS: Eight patients from 7 different families were enrolled (61.7 ± 5.5 years). Gastrointestinal symptoms, dyspnea or chest tightness, rather than sensory symptoms, were the initial symptoms in two patients (2/7 = 29%). Body weight loss (3/7 = 43%), muscle wasting (4/7 = 57%), or dysphagia (3/7 = 43%) were the consecutive symptoms. Orthostatic symptoms including orthostatic hypotension (7/7 = 100%), dizziness (6/7 = 86%) and syncope (5/7 = 71%) tended to develop in the late phase of the disease. Autonomic dysfunction was conspicuous. Cardiographic findings included a combination of ventricular wall thickening and pericardial effusion (7/7 = 100%), a granular sparkling appearance of the ventricular myocardium (4/7 = 57%), or conduction abnormalities (5/7 = 71%). CONCLUSIONS: This study broadens the recognition of the initial signs and symptoms, including cardiographic findings and longitudinal manifestations in Taiwanese individuals with ATTR Ala97Ser mutation. These manifestations should prompt doctors to perform further studies and make an early diagnosis.


Assuntos
Amiloidose/genética , Pré-Albumina/genética , Idoso , Grupo com Ancestrais do Continente Asiático , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Fenótipo , Estudos Retrospectivos , Taiwan
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