Expression of Types I and III Collagens and Ultrastructure of the Extracellular Matrix in Rectal Adenocarcinoma of Different Differentiation Degree after Neoadjuvant Radiation Therapy.

The structural organization of the extracellular matrix of rectal adenocarcinoma of different differentiation degrees without and after neoadjuvant radiation therapy was studied on postoperative material using immunohistochemistry and electron microscopy. The differences in the expression of types I and III collagens, as well as in the ultrastructural organization of the extracellular matrix of rectal adenocarcinoma of different differentiation degrees without and after neoadjuvant radiation therapy were revealed. We observed high expression of collagen I and wide channels in the collagen matrix in the central areas of the well differentiated adenocarcinomas without neoadjuvant radiation therapy and in poorly differentiated adenocarcinomas after neoadjuvant radiation therapy, which can be associated with metastasis and poor prognosis for the patients.

Correlation analysis of hemoglobin, albumin, lymphocyte, platelet score and platelet to albumin ratio and prognosis in patients with lung adenosquamous carcinoma.

Objective: To investigate the effect of hemoglobin, albumin, lymphocytes, platelet (HALP) score and platelet to albumin ratio (PAR) on prognosis of patients with lung adenosquamous carcinoma (ASC) after surgery. Patients and methods: A total of 52 patients diagnosed with ASC after surgical resection were collected from Nanjing Chest Hospital from 2012 to 2021, and their general clinical data, pathological data and laboratory indexes were collected. The changes of Alb and Plt levels before and after surgery, HALP scores (hemoglobin albumin lymphocytes/platelets), and postoperative PAR, PLR, NLR were retrospectively analyzed, and their influence on the prognosis of patients with ASC was investigated. The cut-off value of △Alb, △Plt, postoperative PAR, PLR and NLR were determined by the receiver operating characteristic (ROC) curve, the optimal cut-off value of HALP score before and after surgery was calculated by using X-tile software, and the clinicopathological characteristics were compared between the high PAR and low PAR groups and between high HALP score and low HALP score group to analyze the factors influencing the prognosis of patients with ASC. Univariate and multivariate Cox proportional regression analyses were used to assess independent risk factors affecting overall survival (OS) and disease-free survival (DFS) in patients with ASC. Kaplan-Meier method was used to evaluate the correlation between OS, DFS and PAR and HALP score. Results: A critical value of PAR was 7.40×10^9 and an area under the curve (AUC) of 0.737 (95%CI: 0.597-0.876, P = 0.004). The best cut-off value of the preoperative HALP score was 24.3. Univariate Cox analysis showed that the cut margin (P = 0.013), the degree of differentiation (P = 0.021), N stage (P = 0.049), △Plt (P = 0.010), △Alb (P = 0.016), PAR (P = 0.003), NLR (P = 0.025), PLR (P = 0.029), preoperative HALP score (P = 0.000) and post-operative HALP score (P = 0.010) were all associated with postoperative OS in ASC patients. Cut margin (P = 0.029), the degree of differentiation (P = 0.045), maximum tumor diameter (P = 0.018), N stage (P = 0.035), △Plt (P = 0.007), △Alb (P = 0.007), PAR (P = 0.004), NLR (P = 0.041), PLR (P = 0.030), preoperative HALP score (P = 0.000), and postoperative HALP score (P = 0.011) were related to postoperative DFS in ASC patients. Multivariate analysis revealed that PAR (HR: 6.877, 95%CI: 1.817-26.038, P = 0.005), differentiation degree (HR: 0.059, 95%CI: 0.006-0.591, P = 0.016) and preoperative HALP score (HR: 0.224, 95%CI: 0.068-0.733, P = 0.013) had significant effect on OS. Tumor maximum diameter (HR: 3.442, 95%CI: 1.148-10.318, P = 0.027) and preoperative HALP score (HR: 0.268, 95%CI: 0.085-0.847, P = 0.025) had significant influence on DFS. Conclusion: PAR and preoperative HALP score were potentially useful biomarkers for evaluating the outcome of patients with postoperative ASC. PAR, the degree of differentiation and preoperative HALP score were independent prognostic factors for postoperative OS in ASC patients. Maximum tumor diameter and preoperative HALP score were independent prognostic factors for postoperative DFS in ASC patients.

The Correlation Between 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography Semiquantitative Parameters and the Clinical Features and Pathological Biological Indexes of Gastric Cancer.

Objective: This study explored the application value of the maximum standard uptake value (SUVmax) of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG PET/CT) in gastric cancer. Materials and Methods: Data of 164 patients with gastric cancer who had undergone18F-FDG PET/CT before a biopsy were collected, and the correlation of SUVmax with clinical stage, pathological differentiation degree, human epidermal growth factor receptor-2 (HER-2) status, and Ki-67 index of gastric cancer was analyzed. Results: The SUVmax of poorly differentiated adenocarcinoma was significantly higher than that of moderately differentiated adenocarcinoma and signet-ring cell carcinoma (p < 0.01), and SUVmax in the well-differentiated adenocarcinoma group was higher than that in the signet-ring cell carcinoma group (p < 0.01). The SUVmax in the HER-2 negative group was higher than that in the HER-2 positive group (p < 0.01). The SUVmax was higher in the Ki-67 high expression group than in the low expression group (p < 0.01), and there was a significant positive correlation between the two (p < 0.01). Conclusion: 18F-FDG PET/CT SUVmax can, to some extent, predict the degree of differentiation, HER-2 status, and Ki-67 index of gastric cancer patients.

Factors influencing apparent diffusion coefficient value in extrahepatic cholangiocarcinoma: A retrospective study.

BACKGROUND: Most cases of extrahepatic cholangiocarcinoma (ECC) show various degrees of hyperintensity on diffusion-weighted imaging (DWI) and hypointensity on apparent diffusion coefficient (ADC). However, the factors influencing ADC values in ECC have not yet been explored extensively. Therefore, this study explored the independent factors influencing ADC values in ECC. METHODS: A total of 88 patients with ECC confirmed by surgical pathology were retrospectively assessed. All patients underwent abdominal magnetic resonance imaging (MRI) at 3.0 T and ADC values of the tumor were measured. The correlation between ADC values and multiple clinicopathological features in ECC was analyzed, and independent factors influencing the ADC values in ECC were explored further. RESULTS: The ADC value of the tumor showed a significant difference in different perineural invasion group (p = 0.048), microvascular invasion group (p = 0.001), vascular endothelial growth factor expression group (p < 0.001), lymphatic status group (p = 0.003), and differentiation degree (DD) group (p < 0.001). However, there were no significant differences in different sex (p = 0.715), tumor location (p = 0.659), and degree of T stage (p = 0.879). Moreover, ADC value was negatively correlated with microvascular density (r = -0.725, p < 0.001) and lesion size (r = -0.244, p = 0.023). Nevertheless, there was no correlation between ADC value and patient age (r = 0.026, p = 0.812). Further regression analysis indicated that ADC value was independently associated with pathological DD of ECC (R2 = 0.678, p < 0.001) but not with other clinicopathological factors (p > 0.05). CONCLUSION: ADC value of ECC is independently correlated with pathological DD of ECC, indicating that ADC value is a potential imaging biomarker for predicting the degree of ECC malignancy.

Brain morphological alterations and their correlation to tumor differentiation and duration in patients with lung cancer after platinum chemotherapy.

Objective: Chemotherapy-related brain impairments and changes can occur in patients with lung cancer after platinum chemotherapy and have a substantial impact on survivors' quality of life. Therefore, it is necessary to understand the brain neuropathological alterations and response mechanisms to provide a theoretical basis for rehabilitation strategies. This study aimed to investigate the related brain morphological changes and clarified their correlation with clinical and pathological indicators in patients with lung cancer after platinum chemotherapy. Methods: Overall, 28 patients with chemotherapy, 56 patients without chemotherapy, and 41 healthy controls were categorized in three groups, matched for age, sex, and years of education, and included in the cross-sectional comparison of brain volume and cortical thickness. 14 matched patients before and after chemotherapy were subjected to paired comparison for longitudinal observation of brain morphological changes. Three-dimensional T1-weighted images were acquired from all participants, and quantitative parameters were calculated using the formula of the change from baseline. Correlation analysis was performed to evaluate the relationship between abnormal morphological indices and clinical information of patients. Results: Brain regions with volume differences among the three groups were mainly distributed in frontal lobe and limbic cortex. Additionally, significant differences in cerebrospinal fluid were observed in most ventricles, and the main brain regions with cortical thickness differences were the gyrus rectus and medial frontal cortex of the frontal lobe, transverse temporal gyrus of the temporal lobe, insular cortex, anterior insula, and posterior insula of the insular cortex. According to the paired comparison, decreased brain volumes in the patients after chemotherapy appeared in some regions of the frontal, parietal, temporal, and occipital lobes; limbic cortex; insular cortex; and lobules VI-X and decreased cortical thickness in the patients after chemotherapy was found in the frontal, temporal, limbic, and insular cortexes. In the correlation analysis, only the differentiation degree of the tumor and duration after chemotherapy were significantly correlated with imaging indices in the abnormal brain regions. Conclusions: Our findings illustrate the platinum-related brain reactivity morphological alterations which provide more insights into the neuropathological mechanisms of patients with lung cancer after platinum chemotherapy and empirical support for the details of brain injury related to cancer and chemotherapy.

Single-cell genomic profile-based analysis of tissue differentiation in colorectal cancer.

Colorectal cancer (CRC) progression is associated with cancer cell dedifferentiation and sternness acquisition. Several methods have been developed to identify sternness signatures in CRCs. However, studies that directly measured the degree of dedifferentiation in CRC tissues are limited. It is unclear how the differentiation states change during CRC progression. To address this, we develop a method to analyze the tissue differentiation spectrum in colorectal cancer using normal gastrointestinal single-cell transcriptome data. Applying this method on 281 tumor samples from The Cancer Genome Atlas Colon Adenocarcinoma dataset, we identified three major CRC subtypes with distinct tissue differentiation pattern. We observed that differentiation states are closely correlated with anti-tumor immune response and patient outcomes in CRC. Highly dedifferentiated CRC samples escaped the immune surveillance and exhibited poor outcomes; mildly dedifferentiated CRC samples showed resistance to anti-tumor immune responses and had a worse survival rate; well-differentiated CRC samples showed sustained anti-tumor immune responses and had a good prognosis. Overall, the spectrum of tissue differentiation observed in CRCs can be used for future clinical risk stratification and subtype-based therapy selection.

Radiomics model of magnetic resonance imaging for predicting pathological grading and lymph node metastases of extrahepatic cholangiocarcinoma.

The aim of this study was to evaluate diagnostic performance of radiomics models of MRI in the detection of differentiation degree (DD) and lymph node metastases (LNM) of extrahepatic cholangiocarcinoma (ECC). We retrospectively enrolled 100 patients with ECC confirmed by pathology from January 2011 to December 2018. Three hundred radiomics features were extracted from each region of interest using MaZda software. Next, the radiomics model was developed by incorporating the optimal radiomics signatures and ADC values of tumors to predict DD (model A) and LNM (model B) of ECC, respectively, through the random forest algorithm. After which, the performance of the radiomics models were further evaluated. The model A showed better performance in both training and testing cohorts to discriminate high and medium-low differentiation groups of ECC, with an average AUC of 0.78 and 0.80, respectively. The model B also yielded the good average AUC of 0.80 and 0.90 to predict the LNM of ECC in training and testing cohorts. The radiomics models based on MRI performed well in predicting DD and LNM of ECC and have significant potential in clinical noninvasive diagnosis and in the prediction of ECC.

A Novel Approach to Assessing Differentiation Degree and Lymph Node Metastasis of Extrahepatic Cholangiocarcinoma: Prediction Using a Radiomics-Based Particle Swarm Optimization and Support Vector Machine Model.

BACKGROUND: Radiomics can improve the accuracy of traditional image diagnosis to evaluate extrahepatic cholangiocarcinoma (ECC); however, this is limited by variations across radiologists, subjective evaluation, and restricted data. A radiomics-based particle swarm optimization and support vector machine (PSO-SVM) model may provide a more accurate auxiliary diagnosis for assessing differentiation degree (DD) and lymph node metastasis (LNM) of ECC. OBJECTIVE: The objective of our study is to develop a PSO-SVM radiomics model for predicting DD and LNM of ECC. METHODS: For this retrospective study, the magnetic resonance imaging (MRI) data of 110 patients with ECC who were diagnosed from January 2011 to October 2019 were used to construct a radiomics prediction model. Radiomics features were extracted from T1-precontrast weighted imaging (T1WI), T2-weighted imaging (T2WI), and diffusion-weighted imaging (DWI) using MaZda software (version 4.6; Institute of Electronics, Technical University of Lodz). We performed dimension reduction to obtain 30 optimal features of each sequence, respectively. A PSO-SVM radiomics model was developed to predict DD and LNM of ECC by incorporating radiomics features and apparent diffusion coefficient (ADC) values. We randomly divided the 110 cases into a training group (88/110, 80%) and a testing group (22/110, 20%). The performance of the model was evaluated by analyzing the area under the receiver operating characteristic curve (AUC). RESULTS: A radiomics model based on PSO-SVM was developed by using 110 patients with ECC. This model produced average AUCs of 0.8905 and 0.8461, respectively, for DD in the training and testing groups of patients with ECC. The average AUCs of the LNM in the training and testing groups of patients with ECC were 0.9036 and 0.8889, respectively. For the 110 patients, this model has high predictive performance. The average accuracy values of the training group and testing group for DD of ECC were 82.6% and 80.9%, respectively; the average accuracy values of the training group and testing group for LNM of ECC were 83.6% and 81.2%, respectively. CONCLUSIONS: The MRI-based PSO-SVM radiomics model might be useful for auxiliary clinical diagnosis and decision-making, which has a good potential for clinical application for DD and LNM of ECC.

Correlations Between Clinicopathological Features and the Vegetative Nervous System in Gastric Cancer.

Gastric cancer currently represents one of the most important public health problems. Recent studies have demonstrated the existence of strong correlations between the vegetative nervous system and the role it plays in the initiation of the oncogenetic process and the progression of cancer. The purpose of this paper is to demonstrate the involvement of the sympathetic and parasympathetic vegetative nervous system in the evolution of gastric cancer, according to the stage of tumor differentiation. In this current paper we have included a number of four patients diagnosed with gastric cancer post UGI (Upper Gastrointestinal Endoscopy) and have analyzed relations that exist between the tumor differentiation degree and the metanephrine and normetanephrine serum level in the blood of the patients. Following the research, we have observed an increased value of the metanephrine and normetanephrine serum level in the patient which displayed the lowest degree of differentiation.

Preliminary study on the relationship between the contrast-enhanced ultrasonography of liver metastasis and the differentiation degree of neuroendocrine tumors / 中华超声影像学杂志

Objective To retrospectively analyze contrast-enhanced ultrasound ( CEUS ) manifestations of neuroendocrine tumors ( NETs) liver metastases ,and explore the relationship between CEUS parameters and differentiation of NETs . Methods From January 2014 to June 2018 ,36 patients who had been performed CEUS due to liver metastasis of NETs with pathological diagnosis and immunohistochemical staining results were enrolled in this study . The CEUS findings of NETs liver metastases were summarized . According to the Ki-67 index ,CgA results ,and the stage G ,the patients were divided into Ki-67>20％ group and Ki-67≤20％ group ,CgA negative group and CgA positive group ,and group G1+G2 and group G3 ,respectively . The CEUS parameters of NETs liver metastases between the above groups were compared . Results In 36 lesions ,during the arterial phase of CEUS ,66 .7％ (24/36) showed hyperenhancement ,16 .7％ (6/36) isoenhancement ,13 .9％ (5/36) rim-like enhancement ,and 5 .6％ ( 2/36 ) hypoenhancement ; During the portal phase , 13 .9％ ( 5/36 ) showed hyper or iso enhancement ,86 .1％ (31/36) showed hypoenhancement . The average washout time was ( 67 .5 ± 56 .1)s ,of which 5 (13 .9％ ) lesions were washed out after 120 s . The mean starting washout time was statistically different between the CgA negative group and the positive group[(91.6±81.5)svs(60.1±38.7)s,P =0 .001] . There was no statistically significant difference in all observations between the group of Ki-67≤20％ and >20％ ,group G1+G2 and group G3( P >0 .05) . Conclusions CEUS of NETs liver metastasis has certain characteristics ,among which hyperenhancement is its main enhancement mode ,and some lesions have a longer wash out time . The relationship with the degree of differentiation needs further investigation .

Multimodal treatment of aggressive forms of breast cancer.

UNLABELLED: Aggressive breast cancer is an invasive form with G3, G4 differentiation degree, the absence of receptors for estrogen and progesterone and the absence or presence of HER2 (+ or 3+) gene. The final diagnosis is established by cumulating the clinical, paraclinical, histopathological and immunohistochemical diagnosis. MATERIAL AND METHOD: 84 out of 268 aggressive breast cancer cases were presented in the study, which were operated in October 2011-September 2013. The inclusion and exclusion criteria are exposed in the study lot and the treatment schemes. RESULTS: For the study lot (lot A made up of 36 cases, lot B made up of 41 cases, lot C made up of 7 cases) the distribution was presented on age groups, histopathological and immunohistochemical classification, etiologic factors, type of surgery, postoperative staging and complications. CONCLUSIONS: The treatment of aggressive breast cancer depends on the level of the aggressiveness of the disease, the biologic status and the age that imposes the order of chemotherapy, radiotherapy, surgical treatment and target therapy.

Expression of CD147, MMP-9 and HER-2 in patients with gastric cancer and their correlation with clinicopathology and prognosis / 中国基层医药

Objective@#To investigate the correlation between the expression of extracellular matrix metalloproteinase-inducible factor (CD147), matrix metalloproteinase-9 (MMP-9) and human epidermal growth factor receptor-2 (HER-2) in gastric cancer tissues and clinical pathology and prognosis.@*Methods@#From June 2016 to June 2018, 80 gastric cancer specimens from the First People's Hospital of Taizhou were collected as observation group, and another 60 normal specimens of gastric mucosa adjacent to cancer were selected as control group.The expressions of CD147, MMP-9 and HER-2 were detected by SP immunohistochemical method.The positive rates of CD147, MMP-9 and HER-2 protein expression, the positive rates of CD147, MMP-9 and HER-2 protein expression in different pathological characteristics, and the positive rates of CD147, MMP-9 and HER-2 protein expression in different prognosis were compared between the two groups.@*Results@#The positive rates of CD147 (73.75%), MMP-9 (76.25%) and HER-2 (42.50%) in the observation group were higher than those in the control group (21.67%, 25.00%, 5.00%), the differences were statistically significant (χ2=37.233, 36.288, 24.797, all P<0.05). There were no statisticallysignificant differences in the positive expression rates of CD147, MMP-9 and HER-2 protein among different gender, age, tumor diameter and differentiation (all P>0.05). The positive rates of CD147 (93.88%), MMP-9 (95.92%) and HER-2 (61.22%) with lymph node metastasis were higher than those without lymph node metastasis (41.94%, 45.16%, 12.90%), the differences were statistically significant (χ2=26.462, 27.012, 18.142, all P<0.05). The positive rates of CD147 (96.15%), MMP-9 (92.31%) and HER-2 (69.23%) in the death group were higher than those in the survival group (62.96%, 68.52%, 29.63%), the differences were statistically significant(χ2=9.987, 5.484, 11.263, all P<0.05).@*Conclusion@#High expression of CD147, MMP-9 and HER-2 proteins in gastric cancer tissues is closely related to invasion and metastasis, which can become a new prognostic marker and therapeutic target of gastric cancer.

Application of dual-source CT spectrum energy curve and iodine quantification in determination of differentiation degree of clear cell renal carcinoma / 实用放射学杂志

Objective To explore the value of dual-source CT spectrum energy curve and iodine quantification in determining the degree of differentiation of clear cell renal carcinoma(ccRCC).Methods The radiographic data of 38 cases with pathologically confirmed ccRCC were analyzed retrospectively.All patients underwent dual-source CT,cortical phase and nephrographic phase dual energy scan,including 22 well-moderated differentiated(gradeⅠ,gradeⅡ)and 16 poorly differentiated neoplasms(gradeⅢ,gradeⅣ).The slope of spectrum energy curve (40-70 keV,70-100 keV,100-140 keV)and the normalized iodine concentration (NIC)between the two grades were compared. Results In the spectrum energy curve 40-70 keV and 70-100 keV segment interval,the slope of spectrum of well-moderated differentiated group was higher than that of poorly differentiated group,the difference was statistically significant(P<0.05).In the 100-140 keV segment interval,the slope of spectrum of well-moderated differentiated group was higher than that of poorly differentiated group, but the difference was insignificant(P>0.05).The NIC of well-moderated differentiated group was significantly higher than that of poorly differentiated group(P<0.05).Conclusion The slope of spectrum energy curve and NIC are correlated with the differentiation degree of ccRCC.The slope of spectrum energy curve and iodine quantification of dual-source CT could be used as new methods for preoperative grading of ccRCC.

Expression of Galectin-7 in squamous cell carcinoma of the cervix and its association with HPV 16 infection / 临床与实验病理学杂志

Purpose To study the expression of Galectin-7 in squamous carcinoma of the cervix and its correlation with HPV 16 infec-tion in Uyghur and Han women. Methods The expression of Galectin-7 in paraffin-embedded cervical tissues collected from Uyghur women including 21 patients with cervicitis and 49 patients with squamous carcinoma of the cervix and Han women including 25 patients with cervicitis and 29 patients with squamous cervical cancer was evaluated by immunohistochemical SP method. The infection of HPV 16 was evaluated by PCR amplification of HPV DNA from the corresponding cervical tissue samples. The expression of levels of Galec-tin-7 in cervical tissues was analyzed according to the corresponding integrated optical density ( IOD) value of Galectin-7 in cervical le-sions with professional image analysis software Image-Pro Plus (IPP) 6. 0. Results PCR detection of HPV 16 in Uyghur patients from Kashghar showed that 20 patients were positive and 29 cases were negative for HPV 16 in squamous cervical cancer patients whereas in patients with cervicitis, only 5 cases were positive, 16 cases were negative for HPV 16. Furthermore the detection of HPV 16 in Han patients showed that 2 cases were positive and 27 cases was negative in patients with squamous cervical cancer patients, and all the ca-ses were negative for HPV 16 in patients with cervicitis. The expression of Galectin-7 in squamous cervical cancer tissues was signifi-cantly lower than that in the cervicitis patients (P<0. 05). The expression of Galectin-7 in HPV 16 positive squamous cervical cancer patients was significantly lower than that in HPV 16 negative patients ( P<0. 05 ) . There was no obvious correlation between the ex-pression levels of Galectin-7 in squamous cervical cancer patients with the differentiation degree and disease oneset age both in Uyghur and Han patients. Conclusion Compared with cervicitis tissues, Galectin-7 expression in squamous cervical cancer is down-regulated in Uyghur women from Kashghar region implying that the expression of Galectin-7 may play a certain role in the occurrence and develop-ment of squamous cervical cancer, and its detection has a certain reference value for the diagnosis of cervical cancer for Uyghur women.

Preliminary study of cervical lymph node extracapsular spread direction of oral squamous cell carcinoma / 实用口腔医学杂志

Objective:To study the direction of cervical node extracapsular spread(ECS)of oral squamous cell carcinoma(OSCC). Methods:57 cases of OSCC were treated by combined radical operation.The relationship between ECS and T stage,tumor thick-ness,differentiation degree of OSCC,lymph node size and the ECS direction in each lymph node level were statistically analysed. Results:ECS was found in 30 of the 57 cases,and in 78 of the 174 metastasis positive lymph nodes.29 ECS nodes in levelⅠ,the frequency of the shallow side was 26,the deep side 13(P=0.000 3).But the difference in other levels was not statistically signifi-cant(P>0.05).It was not statistically significant between the incidence of ECS and T stage;it was statistically significant between the incidence of ECS and tumor thickness(P<0.05),tumor differentiation degree(P<0.05)and the lymph node size(P<0.01). Conclusion:ECS of OSCC on the shallow side is more than that in the deep side of lymph nodes in levelⅠ.ECS is positively corre-lated with the tumor thickness of OSCC,metastasied lymph node size;negatively related to the differentiation degree of OSCC.

Analysis about Lab Exam of Histology and Embryology / 中华医学教育探索杂志

The hardship and differentiation degrees are important judgments about test questions.The key purpose about analyzing hardship and differentiation degrees is not only to keep the qualified test questions,eliminate the unqualified and refine the test questions,but also to accumulate valuable data to make exams more scientific,standardized and specified.