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   Table of Contents - Current issue
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 2019
Volume 15 | Issue 4
Page Nos. 741-952

Online since Wednesday, August 14, 2019

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EDITORIAL  

Apatinib for hepatocellular carcinoma Highly accessed article p. 741
Yang Ni, Xin Ye
DOI:10.4103/jcrt.JCRT_400_19  PMID:31436225
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REVIEW ARTICLES Top

Pembrolizumab for the treatment of nonsmall cell lung cancer: Current status and future directions Highly accessed article p. 743
Qin Qin, Baosheng Li
DOI:10.4103/jcrt.JCRT_903_18  PMID:31436226
The development of inhibitors of immune checkpoints has revolutionized the treatment for a subset of patients with advanced nonsmall cell lung cancer (NSCLC), resulting in promising clinical outcomes and durable responses. Pembrolizumab, a humanized anti-programmed cell death-1 (PD-1) antibody, has been approved as a first-line treatment for patients with advanced NSCLC with PD-L1 expression of ≥50% and as a second-line treatment for PD-L1 expression of ≥1%. Pembrolizumab in combination with standard chemotherapy has shown better clinical outcomes than chemotherapy as a first-line therapy in patients with advanced NSCLC without targetable mutations, regardless of PD-L1 expression. In this review, we summarized the current indications of pembrolizumab for NSCLC, briefly described immune-relevant pneumonitis and discussed potential biomarkers to predict clinical efficacy.
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Interpretation of adverse reactions and complications in Chinese expert consensus of Iodine-125 brachytherapy for pancreatic cancer p. 751
Qingchun Li, Yun Liang, Ye Zhao, Baodong Gai
DOI:10.4103/jcrt.JCRT_884_18  PMID:31436227
Owing to the location of the pancreas and its complex anatomical relationship, it is difficult to perform radioactive Iodine-125 seed implantation in patients with pancreatic cancer as it can cause surgical side effects and further complications. To standardize the procedure of radioactive Iodine-125 seed implantation in the treatment of pancreatic cancer and reduce the occurrence of adverse reactions and complications during and after operation, the Chinese Medical Doctor Association of Radioactive Seed Implantation Technology Expert Committee, Committee of Minimally Invasive Therapy in Oncology, Chinese Anti-Cancer Association, and the Radioactive Seed Therapy Branch organized and helped establish an expert consensus in China regarding radioactive Iodine-125 seed implantation in the treatment of pancreatic cancer. This article aims at interpreting the adverse reactions and complications after the implantation of radioactive seeds.
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ORIGINAL ARTICLES Top

Diagnostic ability of percutaneous core biopsy immediately after microwave ablation for lung ground-glass opacity Highly accessed article p. 755
Jiao Wang, Yang Ni, Xia Yang, Guanghui Huang, Zhigang Wei, Wenhong Li, Xiaoying Han, Min Meng, Xin Ye, Jiayun Lei
DOI:10.4103/jcrt.JCRT_399_19  PMID:31436228
Objectives: The objective of this study is to determine the diagnostic ability of percutaneous core biopsy immediately after microwave ablation (MWA) for lung ground-glass opacity (GGO). Materials and Methods: Seventy-four patients with 74 lung GGOs were enrolled and treated with MWA. A percutaneous core needle biopsy was performed pre- and immediately post-MWA. All biopsy specimens were histologically examined by hematoxylin and eosin staining and immunostaining. Histologically, atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and invasive adenocarcinoma (AC) were identified as positive, while chronic inflammation or normal lung tissue was identified as negative. Results: The outcomes of pre-MWA histological diagnosis were AAH (n = 4), AIS (n = 16), MIA (n = 14), AC (n = 29), chronic inflammation (n = 2), and lung tissue (n = 9) with an 85.1% (63/74) positive diagnosis rate. The outcomes of the immediately post-MWA histological diagnosis were AAH (n = 5), AIS (n = 10), MIA (n = 11), AC (n = 29), chronic inflammation (n = 1), and lung tissue (n = 18) with a 74.3% (55/74) positive diagnosis rate. There was no significant difference in the positive diagnosis rate between the pre- and immediately post-MWA groups (P = 0.10). The outcomes of the combined diagnosis of pre- and immediately post-MWA were AAH (n = 4), AIS (n = 16), MIA (n = 16), AC (n = 31), chronic inflammation (n = 2), and lung tissue (n = 5) with a positive diagnosis rate of 90.5% (67/74), which was higher than that by pre-MWA biopsy (P < 0.05). The main complications were pneumothorax (n = 45, 60.8%), hemoptysis (n = 24, 32.4%), pleural effusion (n = 39, 52.7%), and pulmonary infection (n = 10, 13.5%). Conclusions: Immediately post-MWA core biopsy has promising efficacy for histological diagnosis of lung GGOs.
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The application of computed tomography-guided percutaneous coaxial biopsy combined with microwave ablation for pulmonary tumors p. 760
Jingjing Liu, Wei Huang, Zhiyuan Wu, Zhongmin Wang, Xiaoyi Ding
DOI:10.4103/jcrt.JCRT_778_18  PMID:31436229
Background: The aim of the study is to evaluate the technique, safety, efficacy, and clinical value of computed tomography (CT)-guided percutaneous coaxial biopsy combined with microwave ablation (MWA) therapy for pulmonary tumors. Materials and Methods: CT-guided percutaneous coaxial biopsy combined with MWA was performed on 27 tumors in 23 patients who received treatment at our hospital from August 2014 to November 2017. The patients were followed up from 2 to 42 months. The outcomes were evaluated with plain and contrast spiral CT scans. Results: After treatment, lower density and lower CT values than baseline values were observed in the ablated area. The positive rate of biopsy was 81.48%. Seventeen patients had complete remission, four had partial remission, and two had progressive disease, with an effective rate of 91.3%. Until February 2018, 14 patients survived. Seven patients with metastatic lung cancer died of primary tumor progression. Two patients with primary lung cancer also died; one died of a lung infection and the other of cerebral hemorrhage. The 1-year local control rate was 88.9%, and the median progression-free survival was 33 months. The 1-, 2-, and 3-year survival rates were 91.3%, 69.6%, and 60.9%, respectively. Conclusion: CT-guided percutaneous coaxial biopsy combined with MWA can improve the quality of life of patients, prolong survival, and improve the survival rate. It is currently one of the most promising interventional treatments.
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Percutaneous thermal ablation combined with simultaneous transarterial chemoembolization for hepatocellular carcinoma ≤5 cm p. 766
Mengfei Wu, Shanshan Gao, Huadan Song, Zihan Zhang, Jianhua Wang, Rong Liu, Xiaolin Wang, Jiemin Cheng, Jianjun Luo, Qingxin Liu, Yi Chen, Zhiping Yan, Lingxiao Liu
DOI:10.4103/jcrt.JCRT_250_19  PMID:31436230
Background/Aim: Percutaneous thermal ablation combined with transarterial chemoembolization (TACE) becomes a treatment option for unresectable hepatocellular carcinoma (HCC). This study aims to investigate the safety and feasibility of percutaneous thermal ablation combined with simultaneous TACE for patients with HCC ≤ 5 cm. Materials and Methods: From June 2010 to February 2017, a total of 280 patients with HCC ≤ 5 cm who underwent percutaneous thermal ablation combined with simultaneous TACE were included in our study. Their clinical data were collected and analyzed. Results: Major complications occurred in five cases (1.8%). The complete necrosis rate was 91.9%. The median overall survival (OS) was 66.5 months (95% confidence interval [CI] = 57.7–75.2). The OS rates in 1-, 3-, 5-, and 7-year were 96.7%, 76.0%, 59.7%, and 31.1%, respectively. Tumor size (hazard ratio = 1.826; 95% CI = 1.131–2.947; P = 0.014) was considered as independent prognostic factors of long-term survival. Conclusion: Percutaneous thermal ablation combined with simultaneous TACE is a safe and effective treatment for HCC ≤ 5 cm.
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Thermosensitive liposomal doxorubicin plus radiofrequency ablation increased tumor destruction and improved survival in patients with medium and large hepatocellular carcinoma: A randomized, double-blinded, dummy-controlled clinical trial in a single center p. 773
Wei Yang, Jung-Chieh Lee, Min-Hua Chen, Zhong-Yi Zhang, Xiu-Mei Bai, Shan-Shan Yin, Kun Cao, Song Wang, Wei Wu, Kun Yan
DOI:10.4103/jcrt.JCRT_801_18  PMID:31436231
Background: Lyso-thermosensitive liposomal doxorubicin (LTLD, ThermoDox) consists of doxorubicin encapsulated contained within a heat-sensitive liposome. Aims and Objectives: We sought to evaluate whether the use of combined radiofrequency ablation (RFA) and LTLD would result in larger coagulation volume and longer overall survival (OS) compared with the use of RFA alone in patients with 3–7 cm unresectable hepatocellular carcinoma (HCC). Materials and Methods: Between 2010 and 2012, 22 HCC patients were randomly assigned to one of two treatments in our center: (1) ultrasound-guided percutaneous RFA plus intravenous (IV) infusion of LTLD (combination, n = 11) or (2) RFA plus IV dummy (RFA, n = 11). Four patients withdrew from the study, and the remaining 18 patients entered the final analysis. There were 14 male and 4 female patients with an average age of 61.1 ± 9.3 years (range: 40–73 years). The average tumor size was 4.2 ± 1.0 cm (range: 3.1–6.1 cm). One-month enhanced computed tomography was used to evaluate the ablation efficacy and coagulation volume after RFA. Regular follow-up after RFA was performed to assess toxicity, local response rates, and OS rates. Results: A major complication (empyema) occurred in one case in the combination group. Combination treatment region did not induce any additional toxicity beyond doxorubicin. The primary ablation success rate was 93.3% (14/15 tumors) in the combination group and 77.8% (7/9 tumors) in the RFA group (P = 0.308). The difference in coagulation volume between pre- and post-RFA in the combination group was significantly larger than that of the RFA group (105.7 ± 73.8 cm 3 vs. 37.3 ± 8.5 cm 3, P = 0.013). The follow-up period ranged from 11 to 80 months (average: 49.1 ± 24.8 months). The local progression rate was 6.7% (1/15 tumors) in the combination group and 22.2% (2/9 tumors) in the RFA group. The mean OS for the combination group was 68.5 ± 7.2 months, which was significantly greater compared with the RFA group (46.0 ± 10.6 months, P = 0.045). Conclusions: RFA with heat target delivery chemotherapy facilitated better tumor coagulation necrosis without additional toxicity. This combined treatment may improve the clinical efficacy of RFA or free doxorubicin and prolong survival in patients with medium to large HCC.
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Efficacy of ultrasound-, computed tomography-, and magnetic resonance imaging-guided radiofrequency ablation for hepatocellular carcinoma p. 784
Chunwang Yuan, Zhuhui Yuan, Xiongwei Cui, Wenfeng Gao, Peng Zhao, Ning He, Shichang Cui, Yang Wang, Yonghong Zhang, Wei Li, Jiasheng Zheng
DOI:10.4103/jcrt.JCRT_836_18  PMID:31436232
Purposes: This study aimed to investigate the efficacy of ultrasound (US)-, computed tomography (CT)-, and magnetic resonance imaging (MRI)-guided radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC). Materials and Methods: This retrospective study included 141 patients with HCC who were treated with US-guided (n = 29), CT-guided (n = 50), or MRI-guided RFA (n = 62). The primary endpoint was progression-free survival (PFS). The secondary endpoints included overall survival (OS), technique success (TS), and technique efficacy (TE). Cox model and logistic regression were used to determine the risk factors for tumor recurrence and TE. Results: The US, CT, and MRI groups did not show a significant difference in terms of baseline variables. The three groups did not differ significantly in PFS rate (P = 0.072) and OS rate (P = 0.231). The PFS rates at 3 years for the US, CT, and MRI groups were 40.90%, not reached, and 14.80%, respectively. The OS rates at 3 years were 94.70%, 97.50%, and 85.50% for US, CT, and MRI groups, respectively. No significant differences were observed between the three groups in terms of TS rate (P = 0.113) and TE rate (P = 0.682). In multivariate analysis, liver cirrhosis (P = 0.001), level of alpha-fetoprotein (AFP, P = 0.004), and number of tumors (P = 0.012) were independent risk factors for PFS. For TE, the level of AFP (P = 0.018) was an independent factor. Conclusion: US-, CT-, and MRI-guided RFA was effective for treating HCC patients. Liver cirrhosis, AFP level, and tumor number were associated with tumor recurrence, and the level of AFP was an independent risk factor affecting TE.
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Feasibility of three-dimensional-printed template-guided 125I seed brachytherapy and dosimetric evaluation in patients with malignant tumor p. 793
Hongtao Zhang, Devjoy Dev, Huimin Yu, Xuemin Di, Yansong Liang, Lijuan Zhang, Xiaoli Liu, Jinxin Zhao, Zezhou Liu, Aixia Sui, Juan Wang, Man Hu
DOI:10.4103/jcrt.JCRT_347_18  PMID:31436233
Objective: The objective of the study is to test whether three-dimensional (3D)-printed template can be used reproducibly for guiding malignant tumors brachytherapy and study the dosimetric consistency and adequacy between pre- and post-plan. Materials and Methods: Between January and December 2016 in our hospital, a total of 14 patients underwent 3D-printed template-guided brachytherapy. All the patients were fixed into position using a vacuum cushion before undertaking a computed tomography (CT) scan. After the preplan was designed, the templates were printed. The tumors were punctured through predesigned needle holes. Following this, another CT scan was used to confirm the locations of needles, and then the 125 I radioactive seeds were implanted into the tumor according to the preplan. Postplan was performed after the operation. Data of the D90 (minimum absorbed dose of 90% target volume), V90 (90% prescription dose coverage volume percentage of target volume), V100, V150, and seed number pre- and post-operation were collected and compared. Results: The mean D90, V90, V100, V150, and seed number preoperation were 94.96 ± 16.43 Gy, 94.64% ± 1.43%, 91.21% ± 1.59%, 65.01% ± 5.78%, and 46.67 ± 21.87, respectively. The mean D90, V90, V100, V150, and seed number postoperation were 91.97 ± 17.54 Gy, 93.35% ± 2.45%, 89.35% ± 3.21%, 63.40% ± 6.36%, and 46.60 ± 22.85, respectively. No significant difference between pre- and post-operation was observed across the data (P >0.05). Conclusion: For immobilized malignant tumors, 3D-printed template can be used reproducibly. The dose parameters in preplan can be achieved easily and satisfactorily by 3D-printed template guided brachytherapy, and it may become an easily reproducible standardized procedure in the future.
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Preliminary investigation of computed tomography-guided iodine-125 seed implantation treatment efficacy in patients with iliac lymph nodes metastases p. 801
Hongtao Zhang, Huimin Yu, Yansong Liang, Zeyang Wang, Xuemin Di, Lijuan Zhang, Jinxin Zhang, Zezhou Liu, Aixia Sui, Juan Wang
DOI:10.4103/jcrt.JCRT_570_17  PMID:31436234
Objectives: The objective of this study is to assess the technical feasibility, safety, and efficacy of computed tomography (CT)-guided iodine-125 (125 I) seed implantation to treat malignant iliac lymph node metastases. Materials and Methods: In this retrospective study, 11 patients with a total of 11 iliac lymph node metastases were implanted with 125 I seeds (14.8–25.9 MBq) under CT-guidance, both the seed quantity and distribution were measured with a computerized treatment planning system. Treatment effects and adverse events were evaluated. Results: 125 I seeds were successfully implanted in all patients, and the minimum peripheral dose of seeds was ranged from 30 to 110 Gy (median of 75 Gy). The median follow-up period was 11 months (ranged 3–39 months). Follow-up at 2 months after implantation revealed partial response in eight patients, stable disease in two patients, and progressive disease in one patient. The overall response rate and the local tumor control rate at 2 months were 72.73% and 90.91%, respectively. The rates of refractory pain and leg edema relief were 100% and 50% within 2 weeks after treatment, respectively. Survival rate at 1 year was 45.45%. No peri-interventional mortality or major complication was observed. Conclusion: 125 I seed implantation was a safe and effective technique for minimally invasive treatment for iliac lymph node malignant metastasis.
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Clinical efficacy of computed tomography-guided iodine-125 seed implantation therapy for patients with metastatic epidural spinal cord compression: A retrospective study p. 807
Yun Liu, Chuang He, Yang Li, Yu-Xiao Chen, Li Yang, Ting-Yuan Li, Liang-Shan Li, Xue-Quan Huang
DOI:10.4103/jcrt.JCRT_750_17  PMID:31436235
Background: This study evaluated the clinical efficacy of computed tomography (CT)-guided radioactive iodine-125 (125 I) seed implantation in patients with metastatic epidural spinal cord compression (MESCC). Materials and Methods: A cohort of 22 patients with MESCC were retrospectively enrolled. All patients underwent CT-guided 125 I seed implantation therapy via standard procedures. Clinical indexes, including the University of Texas MD Anderson Cancer Center (MDA) criteria for tumor responses, numerical rating scale (NRS) for the degree of pain, Karnofsky Performance Status (KPS) for quality of life, American Spinal Injury Association (ASIA) impairment scale, grade of ESCC, and radiation dose, were evaluated and recorded pre- and post-operation. A follow-up evaluation was performed at least 3 months after the operation. Finally, pre- and post-operative differences in these clinical indexes were compared. Overall survival was recorded. Results: Operations were successfully performed on all patients. A median of 48 (range, 7–103) seeds were implanted in lesions, and the postoperative target verified dose D90 was 11,072.4 ± 1773.5 cGy. Patients were followed for a median of 6 months (range, 3–38 months). The median survival time was 10 months; the response rate was 18/22 (82%); the local control rates at 3, 6, and 12 months were 91.3%, 81.9%, and 81.9%, respectively; and the survival rates were 80%, 50.0%, and 21.9% at 6, 12, and 18 months, respectively. The ESCC grade was significantly lower (P < 0.05). Based on the ASIA impairment scale, the nerve functional reservation, recovery, and decline rates were 63.7% (14/22), 27.3% (6/22), and 9% (2/22), respectively. The NRS and KPS were both significantly improved in the 3rd month of follow-up (P < 0.05). Conclusion: CT-guided 125 I seed implantation represents an effective and safe palliative care for patients with MESCC, which can effectively relieve pain and spinal cord compression and improve nerve function and quality of life.
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Evaluating the effectiveness of computed tomography-guided 125I seed interstitial implantation in patients with secondary adrenal carcinoma p. 813
Zheng-Yu Lin, Jia-You Yang, Jin Chen, Jian Chen
DOI:10.4103/jcrt.JCRT_6_19  PMID:31436236
Aim: This study aimed to evaluate the feasibility, safety, and clinical efficacy of computed tomography (CT)-guided 125 I seed interstitial implantation in patients with secondary adrenal carcinoma. Materials and Methods: Twenty patients with secondary adrenal carcinoma received CT-guided 125 I seed interstitial implantation. A three-dimensional treatment planning system was used to calculate the dose distribution before 125 I seed interstitial implantation. CT scans were performed every 2 months after the treatment to evaluate local therapeutic efficacy according to the Response Evaluation Criteria in Solid Tumors. Results: The mean follow-up time was 23.65 months (5–102 months). The mean maximum tumor diameter was 34.16 ± 18.94 mm at the beginning of follow-up and 14.42 ± 24.07 mm at the end of follow-up. Eleven patients had complete response (CR), seven had partial response (PR), one had stable disease, and one had progressive disease. Local control rate (CR + PR) was 90% (18/20). The median survival time was 19 months (5–71 months). The 1-, 2-, 3-, and 5-year overall survival rates were 83.70%, 46.8%, 20.80%, and 20.80%, respectively. Conclusion: CT-guided 125 I radioactive seed interstitial implantation may be a feasible, safe, effective, and minimally invasive treatment for secondary adrenal carcinoma.
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Computed tomography-magnetic resonance imaging fusion-guided iodine-125 seed implantation for single malignant brain tumor: Feasibility and safety p. 818
Shi-Feng Liu, Jian Lu, Hong Wang, Yan Han, De-Feng Wang, Li-Li Yang, Zi-Xiang Li, Xiao-Kun Hu
DOI:10.4103/jcrt.JCRT_70_19  PMID:31436237
Background: To investigate the feasibility and safety of computed tomography-magnetic resonance imaging (CT-MRI) fusion-guided iodine-125 seed implantation for a single malignant brain tumor. Methods: From November 2015 to October 2016, 12 patients with a single malignant brain tumor were treated with permanent iodine-125 seeds implantation. CT-MRI fusion images were used to make the preoperative treatment plan, intraoperative dose optimization, postoperative verification, and tumor response follow-up. The dosimetry parameters of CT-MRI image fusion plans were compared between preprocedures and postprocedures, including plan target volume, V100 (the percentage of the target volume covered by the prescription dose [PD]), D90 (the dose that covers 90% of the target volume), and V200 (the percentage volume of the brain tumor receiving 200% of the PD). Adverse events were graded by the Common Terminology Criteria for Adverse Events. Clinical and radiological follow-ups were performed at a 3-month interval. Results: All the interstitial implantations were completed successfully under the guidance of CT-MRI image fusion. The dosimetry parameters of CT-MRI image fusion postplans did not differ significantly from those of preplans (P > 0.05). No higher than Grade 2 adverse events were observed during the follow-up. Tumor control was achieved in 10 of 12 patients (83.33%). The median overall survival time was 15.05 ± 3.35 months (95% confidence interval 12.99–17.26). Conclusions: CT-MRI image fusion is feasible for the design, optimization, and verification of treatment planning. CT-MRI fusion-based brachytherapy may improve dosimetry of brain tumor while sparing the normal structures, potentially impacting disease control, treatment-related toxicity, and long-term survival.
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Navigated magnetic resonance imaging-guided celiac plexus neurolysis using an open magnetic resonance system for pancreatic cancer patients with upper abdominal pain p. 825
Guangxin Jin, Xiaoxia Qiu, Min Ding, Mengjun Dai, Xuebin Zhang
DOI:10.4103/jcrt.JCRT_38_19  PMID:31436238
Aims: The study aimed to evaluate the safety and efficacy of navigated magnetic resonance imaging (MRI)-guided celiac plexus neurolysis (CPN) using a 0.4 T open magnetic resonance system. Materials and Methods: A retrospective analysis was performed on 23 patients with unresectable pancreatic cancer who underwent MRI-guided CPN between January 2013 and October 2017. Clinical outcomes were evaluated by recording the complications, the opioid intake, and questionnaire before the intervention and at the time point of 1 day, 1 month, and 3 months postprocedure using a numerical visual analog scale (VAS). Results: Navigated MRI guidance allowed the precise placement of needle in the targeted area and the visualization of the injected neurolysis agents for all cases. The VAS scores decreased from 8.8 ± 1.0 to 2.9 ± 0.9, 4.2 ± 1.7, and 4.7 ± 1.8 at 1 day, 1 month, and 3 months postprocedure (P < 0.05). This intervention reduced the dosage of opioid consumption 1 month after the procedure (52.3 ± 10.4 mg before the treatment vs. 28.2 ± 4.9 mg after the treatment; P < 0.001). Treatment-related side effects included hematoma in one patient, short episodes of diarrhea in three patients, and hypotension in four patients. Conclusions: With the assistance of the navigation system, MRI-guided CPN is a safe and effective treatment approach for managing the upper abdominal pain in patients with unresectable pancreatic cancer.
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High-intensity focused ultrasound ablation for advanced pancreatic cancer p. 831
Baorang Zhu, Jing Li, Liyan Diao, Ke Ma, Yanna Fan, Wuwei Yang
DOI:10.4103/jcrt.JCRT_408_18  PMID:31436239
Aims: The aim of this study was to evaluate the efficacy, safety, and survival factors of high-intensity focused ultrasound (HIFU) ablation in the treatment of advanced pancreatic cancer. Subjects and Methods: A retrospective analysis was conducted between September 2010 and March 2016. Advanced pancreatic cancer patients with HIFU treatment were enrolled in the analysis to evaluate the efficacy of local ablation, pain relief, and relative complications of HIFU therapy. The main factors that affected Overall survival rate (OSR) and median survival time (MST) were also analyzed. Results: Eighty-six patients received HIFU treatment, with a total of 93 treatments performed, and 83 cases were evaluated. Complete response rate (RR) was 3.6% (3/83) and partial RR was 79.5% (66/83). After HIFU treatment, pain reduction was observed in 74 patients, and the total remission rate was 97.6% (74/76). The total MST was 9.9 months (2–58.7 months), the total OSR in 1 and 2 years was 41.5% and 9.6%, respectively. Minor complications occurred in 97.7% (42/43) patients, including transient fever, abdominal pain, skin burn, and amylase elevation. The univariate analysis showed that the clinical stage, treatment method, ablation efficacy, and combined treatment were significant prognostic factors. Conclusion: HIFU can significantly alleviate cancer-related pain and prolong the survival time of patients with pancreatic cancer.
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Efficacy of apatinib on multiple advanced-stage nongastric cancers p. 836
Xueyuan Wu, Haowen Wang, Yue Wu, Jingjing Jin, Yu Zhan, Guanxia Zhu, Fengmin Zhang, Chaolei Zhang, Jianfeng Gan, Wenfeng Li
DOI:10.4103/jcrt.JCRT_24_19  PMID:31436240
Background: Apatinib has been approved for the treatment of advanced gastric adenocarcinoma and gastric-esophageal junctional adenocarcinoma, but its efficacy is unknown for other advanced solid tumors. Aims and Objectives: We retrospectively reviewed the use of apatinib for multiple advanced-stage non-gastric cancers. Ninety-two patients from 7 hospitals who received additional treatment except apatinib more than once were enrolled. Materials and Methods: The primary end-point was the overall response rate (ORR), and the secondary end-points included progression-free survival (PFS), disease control rate (DCR), overall survival, and adverse reactions. We categorized all the patients into six groups according to their cancer type. Results: In the lung cancer group, the ORR was 9% (95% confidence interval [CI], 3%–23%), DCR was 88% (95% CI, 74%–96%), and median PFS was 3 months (95% CI, 1.9–5.4 months). In the cervical cancer group, the ORR was 25% (95% CI, 3%–65%), DCR reached 100%, and median PFS was 3.5 months (95% CI, 0.6–9.0 months). There were different ORRs between the other cancer groups. In addition, the most common adverse effect of apatinib was palmar–plantar erythrodysesthesia syndrome (37%), followed by proteinuria (14%) and hypertension (13%). Conclusion: These results suggest that apatinib might be effective for not only gastric cancer but also other carcinomas including lung cancer, colorectal cancer, cervical cancer, liver cancer, breast cancer, and nasopharyngeal cancer. Thus, apatinib is a promising targeted drug for multiple types of cancer.
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Relationship between the maximum standardized uptake value of fluoro-2-deoxyglucose-positron emission tomography/computed tomography and clinicopathological characteristics in tongue squamous cell carcinoma p. 842
Dong Zheng, Lixuan Niu, Wenpeng Liu, Changgang Zheng, Ruyi Yan, Liyan Gong, Zhongxing Dong, Jun Fei, Ke Li
DOI:10.4103/jcrt.JCRT_855_18  PMID:31436241
Aim: Tongue carcinoma is one of the most common oral and maxillofacial malignant tumors worldwide, maximum standardized uptake value (SUVmax) in 18 F-fluoro-2-deoxyglucose-positron emission tomography/computed tomography (PET/CT) has been widely used in cancer research; however, there are few systematical reports on the relationship between SUVmax and clinicopathological characteristics in tongue squamous cell carcinoma (TSCC). This study aimed to investigate the relationship between them and whether SUV parameters can predict lymph node metastasis. Materials and Methods: PET/CT manifestations and clinicopathological features of 52 patients with TSCC confirmed by pathology were retrospectively analyzed. Single-factor and multiple regression analyses were conducted on possible factors influencing TSCC SUVmax, including sex, age, smoking history, tumor location and size, histological differentiation, and tumor node metastasis (TNM) stages, T stages, and N stages. Diagnostic performance of SUVmax for lymph node metastasis was measured by the area under the receiver operating characteristic curve, and sensitivity and specificity were determined by Youden's J statistic. Results: SUVmax was correlated with sex, tumor location and size, and TNM stages, T stages, and N stages (P < 0.05) but was not correlated with histological differentiation, smoking history, and age (P > 0.05). Sex, tumor location, tumor size, and N stage were influencing factors independent of TSCC SUVmax (P < 0.05). TSCC SUVmax had predictive value for lymph node metastasis. When the cutoff value was 6.57, the diagnostic efficiency was the highest, with the sensitivity being 79.2% and the specificity being 85.7%. Conclusions: SUVmax was higher among male patients with TSCC with posterior tumor location, larger tumor size, and lymph node metastasis, and TSCC SUVmax was important in predicting lymph node metastasis.
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Evaluation of surgery plus postoperative radiotherapy or definitive radiotherapy in older patients with thoracic esophageal squamous cell cancer p. 849
Wanrong Jiang, Xiangdong Sun, Bin Zhou, Chenglong Han, Feng Liu, Jingwei Zheng, Xinchen Sun
DOI:10.4103/jcrt.JCRT_789_18  PMID:31436242
Purpose: This study investigated the outcome of elderly patients (≥65 years) with thoracic esophageal squamous cell carcinoma (TESCC) treated with esophagectomy and postoperative radiotherapy (PORT) or definitive radiotherapy (DRT). Patients and Methods: One hundred and ninety patients (median age of 72 years) who received PORT (n = 68) or DRT (n = 122) for TESCC were analyzed. Majority of them showed locally advanced disease (T3/4: 70.5%, N+: 70.5%, Stage III: 51.6%). Compared to patients who received DRT, those who received PORT had lower Age-Adjusted Charlson Comorbidity Index (AACCI) scores (2.49 ± 0.61 vs. 3.73 ± 1.28, χ2 = 7.283; P = 0.000) and higher Karnofsky Performance Scale (KPS) (χ2 = 9.016; P = 0.003) and were of younger ages (68.90 ± 3.00 vs. 75.17 ± 5.71, χ2 = 9.925; P = 0.000). Results: Overall survival (OS) was significantly higher in the PORT group (median, 61.2 months; 95% confidence interval [CI], 46.04–76.36) than in the DRT group (median, 24.37 months; 95% CI, 15.43–33.31). Multivariate analysis showed that treatment method (hazard ratio [HR]: 2.38, 95% CI, 1.46–3.90; P = 0.001), clinical T stage (HR: 0.57, 95% CI, 0.34–0.95; P = 0.031), and lymph node metastasis (HR: 0.51, 95% CI, 0.31–0.84; P = 0.008) were independent prognostic factors. Regarding subgroup analysis, OS of patients receiving PORT was significantly higher than that of DRT in the T3–4 group (HR: 2.98, 95% CI, 1.80–4.92; P = 0.000) and the N+ group (HR: 2.20, 95% CI, 1.26–3.83; P = 0.006). Conclusions: The efficacy of PORT for the treatment of elderly TESCC patients was superior to DRT. With regard to AACCI, KPS, and age, DRT is still a treatment option for elderly TESCC patients, especially for those >75 years of age.
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Pancreatic fistula after pancreaticoduodenectomy: Risk factors and preventive strategies p. 857
Jian-Shu Chen, Gang Liu, Tian-Ran Li, Jian-Yu Chen, Qi-Ming Xu, Yan-Zhen Guo, Ming Li, Li Yang
DOI:10.4103/jcrt.JCRT_364_18  PMID:31436243
Purpose: Postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) is a worrisome and life-threatening complication. This study aimed to investigate the risk factors and preventive strategies for POPF after PD. Materials and Methods: We retrospectively reviewed 301 consecutive patients who underwent PD at our hospitals between January 2011 and December 2017. We analyzed the pancreatic fistula rate according to the clinical characteristics, pathologic and laboratory findings, and the anastomotic methods and summarized the prevention measures. Results: Postoperative morbidities included pancreatic leakage in 10.30% (31/301), delayed gastric emptying in 22.92% (69/301), abdominal infection in 6.98% (21/301), post-PD hemorrhage in 4.65% (14/301), and bile leakage in 4.98% (15/301), and the mortality rate was 2.33% (7/301). POPF was the most prominent factor for preoperative morbidity. Significant risk factors for pancreatic fistula were a soft pancreas, small pancreatic duct, tumor location, and interrupted anastomosis. Of these, soft texture, pancreatic duct <4 mm, and end-to-end anastomosis through hand suture closure were independent risk factors on multivariate analysis, while interrupted anastomosis, internal stent, and somatostatin use were risk factors in the high-risk pancreas subgroup. Conclusions: Our study demonstrated that pancreatic fistula is related to a soft texture and small pancreatic duct. The surgeon must consider these risk factors when performing PD. Thus, we propose a risk- and indication-adapted choice of anastomosis or an individualized approach for the pancreatic remnant to reduce the pancreatic fistula rate.
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Breast hamartoma: Ultrasound, elastosonographic, and contrast-enhanced ultrasound features p. 864
Gang Liu, Zhi Li Wang, Meng Ke Zhang, Yan He, Yuan Liu
DOI:10.4103/jcrt.JCRT_711_18  PMID:31436244
Aims: To present the ultrasound (US), shear-wave elastography (SWE), and contrast-enhanced ultrasonography (CEUS) features of breast hamartomas. Subjects and Methods: In this retrospective analysis, we included 36 breast hamartomas of 36 female patients who had been scheduled for US-guided vacuum-assisted biopsy (VAB) or surgical excision between May 2013 and October 2016. In the 36 patients, US, CEUS, and SWE were performed, and the pathology results from surgical or VAB were obtained. The US, SWE, and CEUS features of the lesions were analyzed. Results: All breast hamartomas had an oval-shaped and a circumscribed margin. Of the 36 hamartomas, 30 (83.3%) had heterogeneous echogenicity and 28 (77.8%) displayed no changes in posterior echogenicity. There were no significant differences in the maximum, mean, and minimum elasticity between the hamartomas and peripheral parenchyma (P = 0.885, 0.683, and 0.451, respectively). All hamartomas appeared with a clear edge on CEUS, and none showed lesion diameter expansion after the injection of contrast. Compared with the peripheral parenchyma, 10 hamartomas (27.8%) showed rapid perfusion mode, 23 (63.9%) showed equal perfusion mode, 24 (66.7%) showed equal enhancement, and 9 (25.0%) showed hyperenhancement. The mean peak intensity and area under the curve of hamartomas were significantly higher than those of peripheral parenchyma (P = 0.013 and P = 0.011, respectively). The peak time and increasing-start time were not significantly different between hamartomas and peripheral parenchyma (P = 0.321 and P = 0.215, respectively). Conclusions: Hamartomas have typical features on US, SWE, and CEUS. Applying multiple ultrasound techniques would be helpful for their diagnosis.
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Diagnostic performance of minimum apparent diffusion coefficient value in differentiating the invasive breast cancer and ductal carcinoma in situ p. 871
Suhong Zhao, Guangrui Shao, Peipei Chen, Liang Li, Yuhai Yang, Xianhua Zhao, Weihua Guo
DOI:10.4103/jcrt.JCRT_607_18  PMID:31436245
Background: This study is to explore the role of the minimum apparent diffusion coefficient (ADC-min) value in the diagnosis of invasive breast cancer and ductal carcinoma in situ (DCIS). Materials and Methods: A total of 196 breast cancer patients with pathologically verified lesions were included. They received diffusion-weighted imaging and dynamic breast magnetic resonance imaging before the pathological confirmation. The ADC-min value and its relationship with invasive ductal carcinoma (IDC), IDC-DCIS, and DCIS were analyzed. Results: Of the 196 breast cancer patients, there were 115 (58.67%) cases of IDC, 53 (27.04%) cases of IDC-DCIS, and 28 (14.29%) cases of DCIS. The mean ADC-min values for IDC, IDC-DCIS, and DCIS were (0.96 ± 0.16) × 10-3, (1.10 ± 0.13) × 10-3, and (1.24 ± 0.17) × 10-3 mm 2/s, respectively. The mean ADC-min value of IDC was significantly lower than that of IDC-DCIS and that of IDC-DCIS was significantly lower than that of DCIS (P < 0.01). The mean ADC-min value was also significantly different between invasive cancer and DCIS (P < 0.01). The mean ADC-min value can be used in the differential diagnosis of DCIS, with a cutoff point of 1.02 × 10-3 mm 2/s (sensitivity of 92.9% and specificity of 57.7%). Conclusions: The ADC-min values are significantly different among IDC, IDC-DCIS, and DCIS, with the lowest ADC-min values in IDC, followed by IDC-DCIS and DCIS. The ADC-min maybe used as a promising parameter to differentiate DCIS and invasive cancer.
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Multiple MicroRNAs synergistically promote tolerance to epidermal growth factor receptor-targeted drugs in smoked lung cancer therapies p. 876
Li Pan, Hailong Wang, Chengwen Jiang, Wei Li, Yongzi Chen, Guoguang Ying
DOI:10.4103/jcrt.JCRT_208_18  PMID:31436246
Aims: Lung cancer is one of the leading causes of cancer-related mortality. Tobacco usage is considered as associated with the carcinogenesis, progression, and prognosis of lung cancer. Previous studies have demonstrated that the smoking inhibited medical therapy results from K-Ras gene mutation through suppressing the epidermal growth factor receptor (EGFR) pathway. However, recent clinical trials have revealed that few smoked lung cancer patients present K-Ras gene mutation; yet, the majority of smoked lung cancer patients remain K-Ras nonmutation. The chemo-resistant mechanism remains unclear. Recently, microRNA (miRNA) interaction has been found to play an important role in drug resistance process. We hypothesized that miRNA may exert medicine resistance during the processes of lung cancer therapy. Methods: Here, we analyzed miRNA array data from the GEO database. Results: Our results showed that the interaction network among hsa-miR-30d-3p, hsa-miR-184, hsa-miR-500a, hsa-miR-542-3p, among others, inhibited EGFR-targeted medicine therapy. Conclusion: The research will provide evidence that promotes novel therapy of lung cancers.
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Tim-3 expression in glioma cells is associated with drug resistance p. 882
Ji Zhang, Zheng Quan Zhu, Yan Xia Li, Qiu Feng Zhuang, Yuanhong Lai, Shao Fang Li, Xiao Bing Xu, Jian Min Liu
DOI:10.4103/jcrt.JCRT_630_18  PMID:31436247
Objective: T-cell immunoglobulin and mucin-domain containing-3 (Tim-3) has been widely recognized as a negative regulator of antitumor immunity. However, the mechanism by which Tim-3 suppresses antitumor treatment in gliomas remains unclear. This study aims to explore whether Tim-3 is expressed and to evaluate its effect in drug-fasted glioma cells. Subjects and Methods: U87 and U251 glioma cell lines were tested. Cell proliferation activity, cell viability, and the protein and mRNA levels of Tim-3 were detected using CCK-8, flow cytometry, Western blotting, and reverse transcription-quantitative polymerase chain reaction, respectively. Enhancement of the sensitivity of glioma cells to chemotherapeutic agents was tested after inhibiting Tim-3 expression using Tim-3 small interfering RNAs (siRNA). Results: As temozolomide (TMZ) concentration increased, the ratio of apoptotic cells also increased accordingly. However, the level of Tim-3 expression in living cells from the high-dose group was higher than in the low- and middle-dose groups. After interfering with the expression of Tim-3 using siRNA against Tim-3, the killing effect of TMZ rose through an increase in apoptosis. Conclusions: The presence of Tim-3 mRNA and protein in glioma cells was detected. Significantly, knocking down Tim-3 expression improved the potential of TMZ treatment.
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Anticancer effects of FL34 through the inhibition of GLI1 in glioblastoma p. 889
Yan Li, Ke Tang, Lulu Huang, Chunxia Liu, Qianqian Du, Tiegang Li, Chen Yan, Zhiqiang Feng, Xueji Li
DOI:10.4103/jcrt.JCRT_564_18  PMID:31436248
Background: The hedgehog (HH) signaling pathway is abnormally activated in glioblastoma (GBM); thus, its downstream effector GLI1 may be a suitable target for the treatment of GBM. The aim of the present study was to evaluate the antitumor activities of a novel compound, FL34, in GBM through the inhibition of GLI1. Methods: The effect of FL34 on suppressing the proliferation, angiogenesis, and invasion of GBM cells was investigated in vitro using proliferation, invasion, tube formation, flow cytometry, GLI1 dual luciferase, reverse transcription-quantitative polymerase chain reaction, and western blot assays. A subcutaneously transplanted and orthotopic U-87 MG GBM cell xenograft model was used to study the effect of FL34 on tumor growth in vivo. Results: The results of the present study demonstrated that FL34 markedly inhibited the proliferation, invasion, and angiogenesis of GBM, in addition to decreasing the transcriptional activity and expression of GLI1, resulting in the downregulation of GLI1 target genes, including B-cell lymphoma-2, vascular endothelial growth factor, and matrix metalloproteinases. Furthermore, FL34 inhibited the activation of GLI1 without influencing upstream canonical HH/Smoothened signaling or through crosstalk with other oncogenic pathways, including Ras/ERK and AKT signaling. At a dose of 30.0 mg/kg, FL34 suppressed tumor growth by 78.74% in tumor weight in subcutaneously transplanted U-87 MG xenograft models and by 64.24% in volume in orthotopic U-87 MG GBM xenograft models. Conclusions: These data suggested that FL34 exerted antitumor activity mediated by the inhibition of GLI1 and that FL34 may be a potential antitumor candidate compound that could be used to develop new antitumor drugs for the treatment of GBM.
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Methylation of RUNX3 and RASSF1A and the risk of Malignancy in small solitary pulmonary nodules p. 899
Jinglan Zhao, Xiangyu Cui, Xiuying Huang, Ruizhen Lu, Peng Chen, Zhixue Zhang
DOI:10.4103/jcrt.JCRT_790_18  PMID:31436249
Background: This study aimed to evaluate the methylation of RUNX3 and RASSF1A gene promoter regions as a marker to distinguish between benign and malignant of small solitary pulmonary nodule (SPN) ≤10 mm in size. Materials and Methods: A total of 147 patients with pathologically confirmed SPNs were enrolled. DNA samples were extracted from biopsy tissues or serum. Methylation of RUNX3 and RASSF1A gene promoter regions was detected by the methylation-specific polymerase chain reaction. The expression of RUNX3 and RASSF1A in SPN tissues was detected by western blot. Results: Of the 147 patients, 89 had benign SPNs and 58 had malignant SPNs. The rate of serum RUNX3 and RASSF1A gene methylation in malignant SPNs was significantly higher than that in benign SPNs (65.5% vs. 12.3%, and 67.2% vs. 10.1%, respectively; P < 0.05). The expression of RUNX3 and RASSF1A in malignant SPN tissues was lower than that in benign SPN tissues. The hypermethylation status of RUNX3 or RASSF1A genes was not significantly associated with age, gender, and smoking. Conclusions: The methylation level of the RUNX3 and RASSF1A gene promoter regions is a promising marker for assessing SPNs.
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Up-regulation of Wnt5a inhibits proliferation and migration of hepatocellular carcinoma cells Highly accessed article p. 904
Tianxiao Wang, Xiaohong Liu, Jun Wang
DOI:10.4103/jcrt.JCRT_886_18  PMID:31436250
Objectives: Increasing evidence suggests that Wnt5a plays an important role in tumorigenesis. In particular, its expression is downregulated in hepatocellular carcinoma (HCC). The aim of this study was to explore the effect of Wnt5a overexpression on HCC cells. Materials and Methods: We transfected the human HCC cell line SMMC-7721 with pcDNA3.1-Wnt5a overexpression vectors or empty pcDNA3.1 vectors. The expression of Wnt5a in transfected SMMC-7721 cells was confirmed by the western blot. Cell proliferation was examined by the colony formation test and cell cycle assay in vitro. The effect of Wnt5a overexpression on cell migration was studied using a scratch assay. In vivo tumorigenesis was assessed using a mouse xenograft model. Results: Wnt5a overexpression inhibited SMMC-7721 cell proliferation with a significant reduction in S-phase cells and an enrichment of G1-phase cells, a lower colony formation rate, and decreased tumor volumes in the xenograft model compared with those that of control tumors. The in vitro scratch assay revealed that Wnt5a overexpression diminished the capacity of cell migration, which may be mediated by the change in phosphorylated β-catenin and E-cadherin expression. Conclusion: Wnt5a may act as a tumor suppressor in HCC, partly through the β-catenin/E-cadherin signaling pathway.
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Prevalence of MET exon 14 skipping mutation in pulmonary sarcomatoid carcinoma patients without common targetable mutations: A single-institute study p. 909
Yongfeng Yu, Qing Zhang, Jie Zhang, Shun Lu
DOI:10.4103/jcrt.JCRT_591_18  PMID:31436251
Background: Pulmonary sarcomatoid carcinoma (PSC) is a rare histologic subtype of nonsmall cell lung cancer with limited targeted treatment options. In this study, we aimed to investigate the prevalence of MET ex14 skipping mutation in PSC patients without common targetable mutations in EGFR, KRAS, ALK, ROS1, and RET. Materials and Methods: In total, 46 resected specimens of PSC without these mutations were assessed for MET ex14 skipping mutation by next-generation sequencing (NGS) based on the Oncomine Focus Assay libraries. Results: Among 52 cancer-relevant genes included in the targeted NGS panel, the MET ex14 skipping mutation was the only mutation identified in our cohort, which was present in 4 (9%) of 46 patients. For patients with METex14 skipping mutation, the median overall survival (OS) was 35 months (1050 days) compared with a median OS of 27 months (807 days) for those without METex14 skipping mutation (hazard ratio [HR] = 0.59, P = 0.488). The median disease-free survival (DFS) in METex14 skipping mutation-positive patients was 18 months (540 days) compared with a median DFS of 13.6 months (408 days) for negative patients (HR = 0.76, P = 0.680). Conclusions: These findings reflect the prevalence of MET ex14 skipping mutation as up to 9% in Chinese patients with PSC negative for other common targetable mutations, allowing provision of appropriate genetic counseling and treatment in these patients. A larger population-based study is warranted to determine the clinicopathological and prognostic implications of MET ex14 skipping mutation in PSC.
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mRNA expression of programmed cell death ligand 1 and components of the phosphatidylinositol 3-kinase/AKT/phosphatase and tensin homolog pathway in epidermal growth factor receptor mutation-positive lung adenocarcinoma p. 914
Ke Han, Yi Zhang
DOI:10.4103/jcrt.JCRT_636_18  PMID:31436252
Objective: The objective of this study is to investigate the relationship between programmed cell death ligand 1 (PD-L1) expression and the mutation status of epidermal growth factor receptor (EGFR) in lung adenocarcinoma, as well as the correlation between the clinical features of patients and mRNA levels of PD-L1 and components of the phosphatidylinositol 3-kinase (PI3K)/ protein kinase B (AKT)/phosphatase and tensin homolog (PTEN) pathways. Methods: mRNA levels of PD-L1, PI3K, AKT, and PTEN in tumor and matched normal tissues of patients with EGFR mutation-positive lung adenocarcinoma were determined by real-time polymerase chain reaction. Results: Twenty-three patients with EGFR mutation-positive lung adenocarcinoma were enrolled, and 46 samples (23 pairs of tumor and matched normal lung tissues) were collected. PD-L1 and AKT mRNA levels were higher in EGFR mutation-positive lung adenocarcinoma than in matched normal lung tissues (P = 0.047 and P = 0.046, respectively), whereas PI3K and PTEN mRNA levels were significantly lower in the cancerous tissues (P = 0.009 and P = 0.039, respectively). PD-L1 expression was positively correlated with PI3K/AKT signaling pathway activation. PD-L1 upregulation in lung adenocarcinoma was positively correlated with EGFR exon 19 mutations (P = 0.034). AKT mRNA upregulation was correlated with lymph node metastasis (P = 0.034). PTEN mRNA downregulation was correlated with high tumor staging and lymph node metastasis (P = 0.035 and P = 0.014, respectively). Conclusion: Elevated PD-L1 mRNA expression in lung adenocarcinoma is associated with EGFR mutation and may be mediated through the PI3K-AKT pathway. EGFR exon 19 mutations closely correlate with increased PD-L1 mRNA expression. Increased AKT mRNA expression correlates with lymph node metastasis, while decreased PTEN mRNA levels correlate with advanced tumor stage and lymph node metastasis.
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A study of natural IgG antibodies against ATP-binding cassette subfamily C member 3 in oral squamous cell carcinoma p. 921
Xiu Liu, Zhicheng Huang, Ziyi He, Qingyong Meng, Xiaoyu Wang, Ying Hu
DOI:10.4103/jcrt.JCRT_150_18  PMID:31436253
Aims: ATP-binding cassette subfamily C member 3 (ABCC3) is involved in multidrug resistance and is overexpressed in some solid tumors. Recent work revealed an increase in circulating anti-ABCC3 antibodies in lung and esophageal cancers. This in vitro study was undertaken to investigate the effects of the natural IgG antibody against the ABCC3-derived peptide antigen on proliferation of oral squamous cell carcinoma (OSCC) cells and augment the development of efficient and effective treatments in patients with OSCC. Subjects and Methods: An in-house enzyme-linked immunosorbent assay was applied to detect anti-ABCC3 IgG antibody in human plasma. Two OSCC cell lines, CAL27 and SCC15, were cultured with 20% plasma either positive or negative for anti-ABCC3 IgG. Cell proliferation was quantified by the CCK-8 method, and cell apoptosis and cell cycle distribution were analyzed by flow cytometry. The expression of the ABCC3 gene in the cell lines was analyzed by reverse transcriptase quantitative real-time polymerase chain reaction. Results: The results showed that plasma anti-ABCC3 IgG significantly inhibited the proliferation of CAL27 cells but not SCC15 cells, although ABCC3 was expressed in both cell lines. The proportion of apoptotic cells was significantly higher in CAL27 cells treated with anti-ABCC3 IgG-positive plasma than in those treated with IgG-negative plasma. Cell cycle progression was arrested in CAL27 cells treated with anti-ABCC3 IgG-positive plasma. Conclusions: Our data suggest that human plasma anti-ABCC3 IgG may be a promising agent in anti-OSCC therapy, although further studies are needed to arrive at a definitive conclusion.
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Interleukin 10 promotes growth and invasion of glioma cells by up-regulating KPNA 2 in vitro p. 927
Zihao Zhang, Xiaoming Huang, Jie Li, Haitao Fan, Fan Yang, Rui Zhang, Yihang Yang, Shaobin Feng, Dong He, Wei Sun, Tao Xin
DOI:10.4103/jcrt.JCRT_284_19  PMID:31436254
Objective: Glioma is one of the leading causes of death worldwide with high incidence, recurrence, and mortality. Interleukin-10 (IL-10) is a cytokine with dual function in many types of tumors. Although IL-10 is overexpressed and promotes tumor progression in human primary brain tumor, the mechanisms are largely unknown. Materials and Methods: Glioma cells were treated with different dosages of IL-10. The cell growth was detected by CCK-8, and the invasion was measured by Transwell. The relative expression of messenger RNAs was detected by quantitative real-time polymerase chain reaction. Results: We found that IL-10 treatment significantly enhanced glioma cell growth and invasion. Moreover, KPNA2 was significantly upregulated after treatment with IL-10. By performing knockdown experiments, we found that the glioma cell growth and invasion were significantly declined. Conclusions: The results indicated that knockdown of KPNA2 significantly inhibited the growth and invasion of glioma cells. Moreover, IL-10 promotes glioma progression via upregulation of KPNA2. This study will be of important significance and provides a potential target for treatment of patients with glioma.
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Correlation between long non-coding RNAs (lncRNAs) H19 expression and trastuzumab resistance in breast cancer p. 933
Zhigang Sun, Chi Zhang, Tiantian Wang, Peng Shi, Xingsong Tian, Ying Guo
DOI:10.4103/jcrt.JCRT_208_19  PMID:31436255
Introduction: Trastuzumab resistance is a major obstacle encountered in human epidermal growth factor receptor 2 (HER2)-positive breast cancer therapy. Long non-coding RNAs (lncRNAs) have been confirmed to play important roles in both tumorigenesis and tumor development. However, whether lncRNAs are associated with trastuzumab resistance is not yet clear. Subjects and Methods: We evaluated trastuzumab sensitivity in breast cancer cell lines, SKBR3, HCC1954, and MDA-MB-231. We also evaluated H19 expression in these cell lines after treatment with different trastuzumab concentrations. Besides, H19 was downregulated to investigate its role in cell viability and trastuzumab sensitivity and a trastuzumab resistance cell line was cultured to verify the effect of H19 in trastuzumab resistance. Forty-eight HER2-positive breast cancer patients treated with trastuzumab in the first-line setting were selected retrospectively to explore the relationship between H19 expression and tumor-node-metastasis (TNM) stage as well as trastuzumab resistance. Results: H19 is a trastuzumab-responsive lncRNA and its expression was upregulated in a trastuzumab-resistant breast cancer cell. Downregulation of H19 restored the sensitivity of trastuzumab-resistant cells to this drug. The expression of H19 significantly correlated with TNM stage. Patients with higher expression of H19 showed an evidently shorter progression-free survival than those with low H19 expression. H19 overexpression was negatively correlated to the trastuzumab-therapy response. Conclusions: Our results provide evidence for the H19-mediated regulation of trastuzumab resistance in HER2-positive breast cancer cells. H19 could act as a potential predictive biomarker for HER2-positive breast cancer patients, and downregulation of H19 could reverse trastuzumab resistance and enhance the inhibitory function of this drug.
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Establishment of a predictive model for short-term efficacy of transcatheter arterial chemoembolization treatment in hepatocellular carcinoma and its clinical application p. 941
Jian Wei, Zhenchang Wang
DOI:10.4103/jcrt.JCRT_52_19  PMID:31436256
Objective: This study aimed to establish a predictive model for the presence of transcatheter arterial chemoembolization (TACE) resistance in hepatocellular carcinoma (HCC) Barcelona Clinic Liver Cancer classification stage B or stage C4 (BCLC B/C) and further verify its accuracy, enabling clinicians to accurately predict the efficacy of TACE and propose individualized therapy to further optimize multidisciplinary team plans. Materials and Methods: A retrospective database review was performed, including 191 patients (39 females and 152 males; aged 50–76 years with a mean age of 55 ± 10 years) who received three consecutive TACE sessions for treating HCC (BCLC B/C) in 1 month apart, for a total of 3 months. After three TACE treatments, a total of 95 patients among the 191 patients showed TACE resistance, 112 cases were randomly selected to build the modeling group, and the remaining 79 cases formed a verification group. Some prognostic risk factors were obtained through clinical observation. Then, univariate and multivariate analyses were performed using the logistic proportional hazard regression model. Based on multivariate analysis results, a risk-index model was established and its effects on predicting the incidence of TACE resistance of those patients were evaluated. Results: Based on the results of the multivariate analysis, to show that were four-independent factors affecting a prognosis of patients with TACE resistance after three consecutive TACE treatment in 3 months, which were red blood cell (RBC), neutrophil count (NC), model for end-stage liver disease (MELD), and Apoprotein A1. The risk index model established according to the above factors was expressed as a predictive indice (PI), and PI = −3.79 + 4.916 × RBC − 1.547 × NC − 4.142 × MELD + 10.789 × ApoA1. The area under the receiver operating characteristic curves (AUROC) of PI of the modeling group was 0.986, which was significantly higher than that of each component index in the equation. The specificity of the modeling group was 86.3%, and the sensitivity was 70.4%, and 43 of 61 patients with PI ≤ 5.36 (70.5%) had a good outcome 3 months after consecutive TACE. From of the PI, among 51 patients with TACE resistance after consecutive TACE, 32 (62.7%) had a PI > 5.36, and only 19 patients were misidentified as having TACE resistance because of their PI > 5.36. The accuracy was 82.1%. The specificity of the validation group was 85.9%, and the sensitivity was 77.9%. The disease was under control in 29 of the 35 patients with PI ≤ 5.36 (82.9%) after consecutive TACE. According to PI, among the 44 patients with TACE resistence after consecutive TACE, 38 (86.4%) had PI > 5.36, and only 6 patients were misidentified as TACE resistance due to their PI > 5.36, with an accuracy of 87.3%, respectively. Conclusions: According to the PI of this study, we investigated the risk factors and protective factors to estimate the presence of TACE resistance after three consecutive TACE treatment, so as it could help doctors to evaluate the patientet condition and choose more reasonable treatment methods.
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Undifferentiated sarcoma of the soft tissues with cystic degeneration: Case report and review of literature p. 947
Changhua Wu, Liang Wang, Lei Guo, Lihong Zhang, Jing Li
DOI:10.4103/jcrt.JCRT_818_18  PMID:31436257
Undifferentiated sarcoma (UNDS) of the soft tissue is an exceedingly rare disease. Its diagnosis depends mainly on molecular and immunohistochemical analyses to exclude other soft-tissue sarcomas. It is difficult to confirm a positive diagnosis by imaging pathological features because of their rarity and similarity with other conditions. Since 2013, only 13 cases of undifferentiated soft-tissue sarcoma, mostly diagnosed through imaging of solid tumors in infant and children, have been reported. The authors present a rare case of a 3-month-old Chinese boy with UNDS primarily in the left lower extremity and characterized by a cystic and solid growth pattern.
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