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The efficacy and applicability of chimeric antigen receptor (CAR) T cell-based regimens for primary bone tumors: A comprehensive review of current evidence 基于嵌合抗原受体 (CAR) T 细胞的原发性骨肿瘤治疗方案的疗效和适用性:当前证据的全面回顾
IF 3.4 2区 医学 Q2 Medicine Pub Date : 2024-09-22 DOI: 10.1016/j.jbo.2024.100635
Primary bone tumors (PBT), although rare, could pose significant mortality and morbidity risks due to their high incidence of lung metastasis. Survival rates of patients with PBTs may vary based on the tumor type, therapeutic interventions, and the time of diagnosis. Despite advances in the management of patients with these tumors over the past four decades, the survival rates seem not to have improved significantly, implicating the need for novel therapeutic interventions. Surgical resection with wide margins, radiotherapy, and systemic chemotherapy are the main lines of treatment for PBTs. Neoadjuvant and adjuvant chemotherapy, along with emerging immunotherapeutic approaches such as chimeric antigen receptor (CAR)-T cell therapy, have the potential to improve the treatment outcomes for patients with PBTs. CAR-T cell therapy has been introduced as an option in hematologic malignancies, with FDA approval for several CD19-targeting CAR-T cell products. This review aims to highlight the potential of immunotherapeutic strategies, specifically CAR T cell therapy, in managing PBTs.
原发性骨肿瘤(PBT)虽然罕见,但由于其肺部转移的高发生率,可能会带来严重的死亡率和发病率风险。原发性骨肿瘤患者的存活率可能因肿瘤类型、治疗干预措施和诊断时间而异。尽管在过去的四十年中,对这些肿瘤患者的治疗取得了进展,但生存率似乎并没有显著提高,这意味着需要采取新的治疗干预措施。广泛边缘的手术切除、放疗和全身化疗是 PBTs 的主要治疗方法。新辅助化疗和辅助化疗以及嵌合抗原受体(CAR)-T 细胞疗法等新兴免疫治疗方法有可能改善 PBTs 患者的治疗效果。CAR-T细胞疗法已成为血液恶性肿瘤的一种选择,美国食品与药物管理局已批准了几种CD19靶向CAR-T细胞产品。本综述旨在强调免疫治疗策略(尤其是 CAR T 细胞疗法)在治疗 PBTs 方面的潜力。
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引用次数: 0
Synergistic effect between denosumab and immune checkpoint inhibitors (ICI)? A retrospective study of 268 patients with ICI and bone metastases 地诺单抗与免疫检查点抑制剂(ICI)之间的协同效应?对268名患有骨转移瘤的ICI患者的回顾性研究
IF 3.4 2区 医学 Q2 Medicine Pub Date : 2024-09-21 DOI: 10.1016/j.jbo.2024.100634

Background

Bone metastasis is a significant concern in advanced solid tumors, contributing to diminished patient survival and quality of life due to skeletal-related events (SREs). Denosumab (DMAB), a monoclonal antibody targeting the receptor activator of nuclear factor kappa-B ligand (RANKL), is used to prevent SREs in such cases. The RANK/RANKL axis, crucial in immunological processes, has garnered attention, especially with the expanding use of immune checkpoint inhibitors (ICI) in modern oncology.

Objective

Our study aims to explore the potential synergistic antitumor effects of combining immunotherapy with denosumab, as suggested by anecdotal evidence, small cohort studies, and preclinical research.

Methods

We conducted a retrospective analysis using the IMMUCARE database, encompassing patients receiving ICI treatment since 2014 and diagnosed with bone metastases. We examined overall survival (OS), progression-free survival (PFS) and switch of treatment line based on denosumab usage. Patients were stratified into groups: without denosumab, ICI followed by denosumab, and denosumab followed by ICI. Survival curves and multivariate Cox regression analyses were performed.

Results

Among the 268 patients with bone metastases, 154 received treatment with ICI alone, while 114 received ICI in combination with denosumab at some point during their oncological history. No significant differences were observed in overall survival (OS) or progression-free survival (PFS) between patients receiving ICI monotherapy and those receiving ICI with denosumab (p = 0.29 and p = 0.79, respectively). However, upon analyzing patients who received denosumab following ICI initiation (17 patients), a notable difference emerged. The group receiving ICI followed by denosumab exhibited a significant advantage compared to those without denosumab (154 patients) or those receiving denosumab before ICI initiation (72 patients) (p = 0.022).

Conclusion

This retrospective investigation supports the notion of potential benefits associated with sequential administration of ICI and denosumab, although statistical significance was not achieved. Future studies, including prospective trials or updated retrospective analyses, focusing on cancers treated with first-line immunotherapy, could provide further insights into this therapeutic approach.
背景骨转移是晚期实体瘤的一个重要问题,由于骨骼相关事件(SREs)而导致患者生存率和生活质量下降。地诺单抗(Denosumab,DMAB)是一种靶向核因子卡巴-B配体受体激活剂(RANKL)的单克隆抗体,用于预防此类病例中的骨转移。RANK/RANKL轴在免疫过程中至关重要,尤其是随着免疫检查点抑制剂(ICI)在现代肿瘤学中的应用不断扩大,RANK/RANKL轴引起了人们的关注。方法我们利用IMMUCARE数据库进行了一项回顾性分析,其中包括自2014年以来接受ICI治疗并确诊为骨转移的患者。我们研究了总生存期(OS)、无进展生存期(PFS)以及根据使用地诺单抗情况转换治疗方案的情况。患者被分为三组:未使用地诺单抗组、ICI 后使用地诺单抗组和地诺单抗后使用 ICI 组。结果 在268例骨转移患者中,154例单独接受了ICI治疗,114例在肿瘤病史的某个阶段接受了ICI联合地诺单抗治疗。接受 ICI 单药治疗的患者与接受 ICI 联合地诺单抗治疗的患者在总生存期(OS)和无进展生存期(PFS)方面没有发现明显差异(分别为 p = 0.29 和 p = 0.79)。然而,在对开始接受 ICI 后接受地诺单抗治疗的患者(17 例)进行分析后,发现了一个显著的差异。与未接受地诺单抗治疗的患者(154 例)或在开始 ICI 治疗前接受地诺单抗治疗的患者(72 例)相比,接受 ICI 治疗后再接受地诺单抗治疗的患者组具有显著优势(p = 0.022)。未来的研究,包括前瞻性试验或更新的回顾性分析,重点关注接受一线免疫疗法治疗的癌症患者,可以为这种治疗方法提供更多启示。
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引用次数: 0
Preliminary discrimination and evaluation of clinical application value of ChatGPT4o in bone tumors 骨肿瘤中 ChatGPT4o 的初步鉴别和临床应用价值评估
IF 3.4 2区 医学 Q2 Medicine Pub Date : 2024-09-02 DOI: 10.1016/j.jbo.2024.100632
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引用次数: 0
Groenlandicine enhances cisplatin sensitivity in cisplatin-resistant osteosarcoma cells through the BAX/Bcl-2/Caspase-9/Caspase-3 pathway 格列宁通过 BAX/Bcl-2/Caspase-9/Caspase-3途径增强耐顺铂骨肉瘤细胞对顺铂的敏感性
IF 3.4 2区 医学 Q2 Medicine Pub Date : 2024-08-24 DOI: 10.1016/j.jbo.2024.100631

Groenlandicine is a protoberberine alkaloid isolated from Coptidis Rhizoma, a widely used traditional Chinese medicine known for its various biological activities. This study aims to validate groenlandicine’s effect on both cisplatin-sensitive and cisplatin-resistant osteosarcoma (OS) cells, along with exploring its potential molecular mechanism.

The ligand-based virtual screening (LBVS) method and molecular docking were employed to screen drugs. CCK-8 and FCM were used to measure the effect of groenlandicine on the OS cells transfected by lentivirus with over-expression or low-expression of TOP1. Cell scratch assay, CCK-8, FCM, and the EdU assay were utilized to evaluate the effect of groenlandicine on cisplatin-resistant cells. WB, immunofluorescence, and PCR were conducted to measure the levels of TOP1, Bcl-2, BAX, Caspase-9, and Caspase-3. Additionally, a subcutaneous tumor model was established in nude mice to verify the efficacy of groenlandicine.

Groenlandicine reduced the migration and proliferation while promoting apoptosis in OS cells, effectively damaging them. Meanwhile, groenlandicine exhibited weak cytotoxicity in 293T cells. Combination with cisplatin enhanced tumor-killing activity, markedly activating BAX, cleaved-Caspase-3, and cleaved-Caspase-9, while inhibiting the Bcl2 pathway in cisplatin-resistant OS cells. Moreover, the level of TOP1, elevated in cisplatin-resistant OS cells, was down-regulated by groenlandicine both in vitro and in vivo. Animal experiments confirmed that groenlandicine combined with cisplatin suppressed OS growth with lower nephrotoxicity.

Groenlandicine induces apoptosis and enhances the sensitivity of drug-resistant OS cells to cisplatin via the BAX/Bcl-2/Caspase-9/Caspase-3 pathway. Groenlandicine inhibits OS cells growth by down-regulating TOP1 level.Therefore, groenlandicine holds promise as a potential agent for reversing cisplatin resistance in OS treatment.

格根地新是从黄连中分离出来的一种原小檗碱,黄连是一种广泛使用的传统中药,以其多种生物活性而闻名。本研究采用配体虚拟筛选法(LBVS)和分子对接法来筛选药物。采用配体虚拟筛选(LBVS)法和分子对接法筛选药物,并用CCK-8和FCM测定格仑地新对转染过表达或低表达TOP1慢病毒的OS细胞的影响。细胞划痕试验、CCK-8、FCM 和 EdU 试验用于评估格列宁对顺铂耐药细胞的影响。WB、免疫荧光和 PCR 检测了 TOP1、Bcl-2、BAX、Caspase-9 和 Caspase-3 的水平。此外,还建立了裸鼠皮下肿瘤模型来验证格仑地新的疗效。格仑地新在促进 OS 细胞凋亡的同时减少了其迁移和增殖,有效地破坏了 OS 细胞。同时,格陵兰碱对 293T 细胞的细胞毒性较弱。与顺铂联用可增强肿瘤杀伤活性,显著激活顺铂耐药 OS 细胞中的 BAX、裂解-Caspase-3 和裂解-Caspase-9,同时抑制 Bcl2 通路。此外,在顺铂耐药的OS细胞中升高的TOP1水平在体外和体内均被格罗恩地辛下调。动物实验证实,格罗兰地辛与顺铂联用可抑制OS的生长,且肾毒性较低。格罗兰地辛通过BAX/Bcl-2/Caspase-9/Caspase-3途径诱导细胞凋亡,并增强耐药OS细胞对顺铂的敏感性。因此,格罗兰地辛有望成为逆转顺铂治疗耐药性的潜在药物。
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引用次数: 0
Improved localization and segmentation of spinal bone metastases in MRI with nnUNet radiomics 利用 nnUNet 放射组学改进核磁共振成像中脊柱骨转移瘤的定位和分割
IF 3.4 2区 医学 Q2 Medicine Pub Date : 2024-08-23 DOI: 10.1016/j.jbo.2024.100630

Objective

Variability exists in the subjective delineation of tumor areas in MRI scans of patients with spinal bone metastases. This research aims to investigate the efficacy of the nnUNet radiomics model for automatic segmentation and identification of spinal bone metastases.

Methods

A cohort of 118 patients diagnosed with spinal bone metastases at our institution between January 2020 and December 2023 was enrolled. They were randomly divided into a training set (n = 78) and a test set (n = 40). The nnUNet radiomics segmentation model was developed, employing manual delineations of tumor areas by physicians as the reference standard. Both methods were utilized to compute tumor area measurements, and the segmentation performance and consistency of the nnUNet model were assessed.

Results

The nnUNet model demonstrated effective localization and segmentation of metastases, including smaller lesions. The Dice coefficients for the training and test sets were 0.926 and 0.824, respectively. Within the test set, the Dice coefficients for lumbar and thoracic vertebrae were 0.838 and 0.785, respectively. Strong linear correlation was observed between the nnUNet model segmentation and physician-delineated tumor areas in 40 patients (R2 = 0.998, P < 0.001).

Conclusions

The nnUNet model exhibits efficacy in automatically localizing and segmenting spinal bone metastases in MRI scans.

目的脊柱骨转移患者核磁共振扫描中肿瘤区域的主观划分存在差异。本研究旨在探究 nnUNet 放射组学模型在自动分割和识别脊柱骨转移瘤方面的功效。方法在 2020 年 1 月至 2023 年 12 月期间,我院共招募了 118 例确诊为脊柱骨转移瘤的患者。他们被随机分为训练集(n = 78)和测试集(n = 40)。我们开发了 nnUNet 放射组学分割模型,采用医生手动划分肿瘤区域作为参考标准。结果nnUNet模型对转移灶(包括较小的病灶)进行了有效的定位和分割。训练集和测试集的 Dice 系数分别为 0.926 和 0.824。在测试集中,腰椎和胸椎的 Dice 系数分别为 0.838 和 0.785。在 40 例患者中,nnUNet 模型分割与医生划定的肿瘤区域之间存在很强的线性相关性(R2 = 0.998,P < 0.001)。
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引用次数: 0
Radiographic imaging and diagnosis of spinal bone tumors: AlexNet and ResNet for the classification of tumor malignancy 脊柱骨肿瘤的放射成像和诊断:用于肿瘤恶性程度分类的 AlexNet 和 ResNet
IF 3.4 2区 医学 Q2 Medicine Pub Date : 2024-08-18 DOI: 10.1016/j.jbo.2024.100629

Objective

This study aims to explore the application of radiographic imaging and image recognition algorithms, particularly AlexNet and ResNet, in classifying malignancies for spinal bone tumors.

Methods

We selected a cohort of 580 patients diagnosed with primary spinal osseous tumors who underwent treatment at our hospital between January 2016 and December 2023, whereby 1532 images (679 images of benign tumors, 853 images of malignant tumors) were extracted from this imaging dataset. Training and validation follow a ratio of 2:1. All patients underwent X-ray examinations as part of their diagnostic workup. This study employed convolutional neural networks (CNNs) to categorize spinal bone tumor images according to their malignancy. AlexNet and ResNet models were employed for this classification task. These models were fine-tuned through training, which involved the utilization of a database of bone tumor images representing different categories.

Results

Through rigorous experimentation, the performance of AlexNet and ResNet in classifying spinal bone tumor malignancy was extensively evaluated. The models were subjected to an extensive dataset of bone tumor images, and the following results were observed. AlexNet: This model exhibited commendable efficiency during training, with each epoch taking an average of 3 s. Its classification accuracy was found to be approximately 95.6 %. ResNet: The ResNet model showed remarkable accuracy in image classification. After an extended training period, it achieved a striking 96.2 % accuracy rate, signifying its proficiency in distinguishing the malignancy of spinal bone tumors. However, these results illustrate the clear advantage of AlexNet in terms of proficiency despite a lower classification accuracy. The robust performance of the ResNet model is auspicious when accuracy is more favored in the context of diagnosing spinal bone tumor malignancy, albeit at the cost of longer training times, with each epoch taking an average of 32 s.

Conclusion

Integrating deep learning and CNN-based image recognition technology offers a promising solution for qualitatively classifying bone tumors. This research underscores the potential of these models in enhancing the diagnosis and treatment processes for patients, benefiting both patients and medical professionals alike. The study highlights the significance of selecting appropriate models, such as ResNet, to improve accuracy in image recognition tasks.

方法 我们选取了2016年1月至2023年12月期间在我院接受治疗的580例确诊为原发性脊柱骨肿瘤的患者作为研究对象,从该影像数据集中提取了1532幅图像(679幅良性肿瘤图像,853幅恶性肿瘤图像)。训练和验证的比例为 2:1。作为诊断工作的一部分,所有患者都接受了 X 光检查。本研究采用卷积神经网络(CNN)根据恶性程度对脊柱骨肿瘤图像进行分类。该分类任务采用了 AlexNet 和 ResNet 模型。结果通过严格的实验,对 AlexNet 和 ResNet 在脊柱骨肿瘤恶性程度分类方面的性能进行了广泛评估。对这两个模型进行了广泛的骨肿瘤图像数据集测试,结果如下。AlexNet:该模型在训练过程中表现出了值得称赞的效率,每个epoch平均耗时3秒,其分类准确率约为95.6%。ResNet:ResNet 模型在图像分类方面表现出了卓越的准确性。经过长时间的训练,其准确率达到了惊人的 96.2%,这表明它在区分脊柱骨肿瘤的恶性程度方面非常熟练。不过,这些结果表明,尽管分类准确率较低,AlexNet 在熟练度方面仍具有明显优势。在诊断脊柱骨肿瘤恶性程度时,如果更看重准确性,ResNet 模型的稳健表现则是吉兆,尽管代价是训练时间更长,每个epoch平均耗时32 秒。这项研究强调了这些模型在加强患者诊断和治疗过程中的潜力,使患者和医疗专业人员都能从中受益。这项研究强调了选择合适的模型(如 ResNet)来提高图像识别任务准确性的重要性。
{"title":"Radiographic imaging and diagnosis of spinal bone tumors: AlexNet and ResNet for the classification of tumor malignancy","authors":"","doi":"10.1016/j.jbo.2024.100629","DOIUrl":"10.1016/j.jbo.2024.100629","url":null,"abstract":"<div><h3>Objective</h3><p>This study aims to explore the application of radiographic imaging and image recognition algorithms, particularly AlexNet and ResNet, in classifying malignancies for spinal bone tumors.</p></div><div><h3>Methods</h3><p>We selected a cohort of 580 patients diagnosed with primary spinal osseous tumors who underwent treatment at our hospital between January 2016 and December 2023, whereby 1532 images (679 images of benign tumors, 853 images of malignant tumors) were extracted from this imaging dataset. Training and validation follow a ratio of 2:1. All patients underwent X-ray examinations as part of their diagnostic workup. This study employed convolutional neural networks (CNNs) to categorize spinal bone tumor images according to their malignancy. AlexNet and ResNet models were employed for this classification task. These models were fine-tuned through training, which involved the utilization of a database of bone tumor images representing different categories.</p></div><div><h3>Results</h3><p>Through rigorous experimentation, the performance of AlexNet and ResNet in classifying spinal bone tumor malignancy was extensively evaluated. The models were subjected to an extensive dataset of bone tumor images, and the following results were observed. AlexNet: This model exhibited commendable efficiency during training, with each epoch taking an average of 3 s. Its classification accuracy was found to be approximately 95.6 %. ResNet: The ResNet model showed remarkable accuracy in image classification. After an extended training period, it achieved a striking 96.2 % accuracy rate, signifying its proficiency in distinguishing the malignancy of spinal bone tumors. However, these results illustrate the clear advantage of AlexNet in terms of proficiency despite a lower classification accuracy. The robust performance of the ResNet model is auspicious when accuracy is more favored in the context of diagnosing spinal bone tumor malignancy, albeit at the cost of longer training times, with each epoch taking an average of 32 s.</p></div><div><h3>Conclusion</h3><p>Integrating deep learning and CNN-based image recognition technology offers a promising solution for qualitatively classifying bone tumors. This research underscores the potential of these models in enhancing the diagnosis and treatment processes for patients, benefiting both patients and medical professionals alike. The study highlights the significance of selecting appropriate models, such as ResNet, to improve accuracy in image recognition tasks.</p></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221213742400109X/pdfft?md5=c94f1dae2cfd227a4fe0e1942824e827&pid=1-s2.0-S221213742400109X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142020916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does liquid nitrogen recycled autograft for treatment of bone sarcoma impact local recurrence rate? A systematic review 液氮回收自体移植治疗骨肉瘤会影响局部复发率吗?系统回顾
IF 3.4 2区 医学 Q2 Medicine Pub Date : 2024-08-08 DOI: 10.1016/j.jbo.2024.100628

The gold standard treatment for primary bone sarcomas has been surgical resection with wide margins. However, there is no consensus regarding an optimal method for limb salvage reconstruction. In 2005, a technique for recycling resected bone after intraoperative treatment with liquid nitrogen was described. This technique has been reported to have a spectrum of advantages; nonetheless, acceptance for routine use has been limited, primarily for fear of local recurrence. A systematic search of the literature using PubMed and Google Scholar was performed. Full-text articles published between 2008 and 2023 were included if the study presented sufficient information regarding patients with a diagnosis of a primary bone sarcoma of the limbs or pelvis who had undergone reconstruction with liquid nitrogen recycled autografts. Sixteen studies that included 286 patients met criteria for analyses. Local recurrence occurred in 25 patients (8.7 %) during the first 4 years following limb salvage reconstruction using recycled autografts for treatment of primary bone sarcomas, which compares favorably to the 15–30 % local recurrence rates reported for patients undergoing limb salvage reconstruction using artificial implants. Systematic synthesis of the current evidence regarding local recurrence rates following use of the liquid nitrogen recycled autograft technique for limb salvage reconstruction after bone sarcoma resection suggests a favorable comparison to other limb salvage reconstruction options. As such, this technique warrants further consideration as a viable option for indicated patients based on relative advantages regarding costs, availability, and biologic and surgical reconstruction benefits.

原发性骨肉瘤的金标准治疗方法是手术切除,并保留较宽的边缘。然而,对于肢体挽救重建的最佳方法还没有达成共识。2005 年,一种在术中用液氮处理后回收切除骨的技术被描述出来。据报道,该技术具有一系列优点,但常规使用的接受度有限,主要原因是担心局部复发。我们使用 PubMed 和 Google Scholar 对文献进行了系统检索。2008年至2023年期间发表的全文文章,只要能提供足够的信息,说明确诊为四肢或骨盆原发性骨肉瘤的患者接受了液氮回收自体移植物重建手术,均被纳入研究范围。16项研究共纳入286名患者,符合分析标准。在使用回收自体移植物治疗原发性骨肉瘤进行肢体救治重建后的最初 4 年中,有 25 名患者(8.7%)出现局部复发,与使用人工植入物进行肢体救治重建的患者 15%-30% 的局部复发率相比,复发率较高。对目前使用液氮再循环自体移植物技术进行骨肉瘤切除术后肢体救治重建的局部复发率相关证据进行系统综合后发现,与其他肢体救治重建方案相比,该技术的局部复发率较高。因此,基于成本、可用性、生物和手术重建优势等方面的相对优势,该技术值得进一步考虑作为适用患者的可行选择。
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引用次数: 0
An enhanced AlexNet-Based model for femoral bone tumor classification and diagnosis using magnetic resonance imaging 利用磁共振成像对股骨头肿瘤进行分类和诊断的增强型基于 AlexNet 的模型
IF 3.4 2区 医学 Q2 Medicine Pub Date : 2024-08-03 DOI: 10.1016/j.jbo.2024.100626

Objective

Bone tumors, known for their infrequent occurrence and diverse imaging characteristics, require precise differentiation into benign and malignant categories. Existing diagnostic approaches heavily depend on the laborious and variable manual delineation of tumor regions. Deep learning methods, particularly convolutional neural networks (CNNs), have emerged as a promising solution to tackle these issues. This paper introduces an enhanced deep-learning model based on AlexNet to classify femoral bone tumors accurately.

Methods

This study involved 500 femoral tumor patients from July 2020 to January 2023, with 500 imaging cases (335 benign and 165 malignant). A CNN was employed for automated classification. The model framework encompassed training and testing stages, with 8 layers (5 Conv and 3 FC) and ReLU activation. Essential architectural modifications included Batch Normalization (BN) after the first and second convolutional filters. Comparative experiments with various existing methods were conducted to assess algorithm performance in tumor staging. Evaluation metrics encompassed accuracy, precision, sensitivity, specificity, F-measure, ROC curves, and AUC values.

Results

The analysis of precision, sensitivity, specificity, and F1 score from the results demonstrates that the method introduced in this paper offers several advantages, including a low feature dimension and robust generalization (with an accuracy of 98.34 %, sensitivity of 97.26 %, specificity of 95.74 %, and an F1 score of 96.37). These findings underscore its exceptional overall detection capabilities. Notably, when comparing various algorithms, they generally exhibit similar classification performance. However, the algorithm presented in this paper stands out with a higher AUC value (AUC=0.848), signifying enhanced sensitivity and more robust specificity.

Conclusion

This study presents an optimized AlexNet model for classifying femoral bone tumor images based on convolutional neural networks. This algorithm demonstrates higher accuracy, precision, sensitivity, specificity, and F1-score than other methods. Furthermore, the AUC value further confirms the outstanding performance of this algorithm in terms of sensitivity and specificity. This research makes a significant contribution to the field of medical image classification, offering an efficient automated classification solution, and holds the potential to advance the application of artificial intelligence in bone tumor classification.

目的骨肿瘤以其发生率低和成像特征多样而著称,需要精确区分为良性和恶性。现有的诊断方法在很大程度上依赖于费力且多变的人工划定肿瘤区域。深度学习方法,尤其是卷积神经网络(CNN),已成为解决这些问题的一种有前途的解决方案。本文介绍了一种基于 AlexNet 的增强型深度学习模型,用于对股骨头肿瘤进行准确分类。方法本研究涉及 2020 年 7 月至 2023 年 1 月期间的 500 例股骨头肿瘤患者,共 500 例影像病例(良性 335 例,恶性 165 例)。采用 CNN 进行自动分类。模型框架包括训练和测试阶段,共有 8 层(5 个 Conv 层和 3 个 FC 层)和 ReLU 激活。基本的架构修改包括在第一和第二个卷积滤波器之后进行批量归一化(BN)。为了评估该算法在肿瘤分期方面的性能,我们与现有的各种方法进行了对比实验。评估指标包括准确度、精确度、灵敏度、特异性、F-measure、ROC 曲线和 AUC 值。结果对精确度、灵敏度、特异性和 F1 分数的分析表明,本文介绍的方法具有多种优势,包括特征维度低和强大的泛化能力(准确度为 98.34%,灵敏度为 97.26%,特异性为 95.74%,F1 分数为 96.37)。这些发现凸显了其卓越的整体检测能力。值得注意的是,在比较各种算法时,它们通常表现出相似的分类性能。本研究提出了一种基于卷积神经网络对股骨头肿瘤图像进行分类的优化 AlexNet 模型。与其他方法相比,该算法具有更高的准确度、精确度、灵敏度、特异性和 F1 分数。此外,AUC 值进一步证实了该算法在灵敏度和特异性方面的突出表现。这项研究为医学图像分类领域做出了重大贡献,提供了一种高效的自动分类解决方案,并有望推动人工智能在骨肿瘤分类中的应用。
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引用次数: 0
Bone niches in the regulation of tumour cell dormancy 骨龛在肿瘤细胞休眠调节中的作用
IF 3.4 2区 医学 Q2 Medicine Pub Date : 2024-08-01 DOI: 10.1016/j.jbo.2024.100621

Secondary metastases, accounting for 90 % of cancer-related deaths, pose a formidable challenge in cancer treatment, with bone being a prevalent site. Importantly, tumours may relapse, often in the skeleton even after successful eradication of the primary tumour, indicating that tumour cells may lay dormant within bone for extended periods of time. This review summarises recent findings in the mechanisms underlying tumour cell dormancy and the role of bone cells in this process. Hematopoietic stem cell (HSC) niches in bone provide a model for understanding regulatory microenvironments. Dormant tumour cells have been shown to exploit similar niches, with evidence suggesting interactions with osteoblast-lineage cells and other stromal cells via CXCL12-CXCR4, integrins, and TAM receptor signalling, especially through GAS6-AXL, led to dormancy, with exit of dormancy potentially regulated by osteoclastic bone resorption and neuronal signalling. A comprehensive understanding of dormant tumour cell niches and their regulatory mechanisms is essential for developing targeted therapies, a critical step towards eradicating metastatic tumours and stopping disease relapse.

继发性转移占癌症相关死亡的 90%,给癌症治疗带来了巨大挑战,而骨骼是继发性转移的主要部位。重要的是,即使成功根除了原发肿瘤,肿瘤仍有可能复发,而且往往是在骨骼中复发,这表明肿瘤细胞可能在骨骼中长期处于休眠状态。本综述总结了肿瘤细胞休眠机制的最新发现以及骨细胞在这一过程中的作用。骨骼中的造血干细胞(HSC)龛为了解调节性微环境提供了一个模型。有证据表明,通过CXCL12-CXCR4、整合素和TAM受体信号(特别是通过GAS6-AXL)与成骨细胞系细胞和其他基质细胞的相互作用导致了休眠,休眠的退出可能受到破骨细胞骨吸收和神经元信号的调控。全面了解休眠肿瘤细胞龛及其调控机制对于开发靶向疗法至关重要,这是根除转移性肿瘤和阻止疾病复发的关键一步。
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引用次数: 0
Pharmacologic Hedgehog inhibition modulates the cytokine profile of osteolytic breast cancer cells 药理刺猬素抑制可调节溶骨性乳腺癌细胞的细胞因子谱
IF 3.4 2区 医学 Q2 Medicine Pub Date : 2024-08-01 DOI: 10.1016/j.jbo.2024.100625

The establishment and progression of bone metastatic breast cancer is supported by immunosuppressive myeloid populations that enable tumor growth by dampening the innate and adaptive immune response. Much work remains to understand how to target these tumor-myeloid interactions to improve treatment outcomes. Noncanonical Hedgehog signaling is an essential component of bone metastatic tumor progression, and prior literature suggests a potential role for Hedgehog signaling and its downstream effector Gli2 in modulating immune responses. In this work, we sought to identify if inhibition of noncanonical Hedgehog signaling alters the cytokine profile of osteolytic breast cancer cells and the subsequent communication between the tumor cells and myeloid cells. Examination of large patient databases revealed significant relationships between Gli2 expression and expression of markers of myeloid maturation and activation as well as cytokine expression. We found that treatment with HPI-1 reduced tumor cell expression of numerous cytokine genes, including CSF1, CSF2, and CSF3, as well as CCL2 and IL6. Secreted CSF-1 (M−CSF) was also reduced by treatment. Changes in tumor-secreted factors resulted in polarization of THP-1 monocytes toward a proinflammatory phenotype, characterized by increased CD14 and CD40 surface marker expression. We therefore propose M−CSF as a novel target of Hedgehog inhibition with potential future applications in altering the immune microenvironment in addition to its known roles in reducing tumor-induced bone disease.

骨转移性乳腺癌的形成和发展离不开免疫抑制性髓细胞群的支持,它们通过抑制先天性和适应性免疫反应使肿瘤得以生长。要了解如何针对这些肿瘤-髓系相互作用改善治疗效果,仍有许多工作要做。非规范的刺猬信号是骨转移性肿瘤进展的重要组成部分,先前的文献表明刺猬信号及其下游效应物 Gli2 在调节免疫反应中的潜在作用。在这项研究中,我们试图确定抑制非典型刺猬信号是否会改变溶骨性乳腺癌细胞的细胞因子谱,以及肿瘤细胞与髓细胞之间的后续交流。对大型患者数据库的研究显示,Gli2 的表达与髓细胞成熟和活化标志物的表达以及细胞因子的表达之间存在显著关系。我们发现,用 HPI-1 治疗可减少肿瘤细胞对多种细胞因子基因的表达,包括 CSF1、CSF2 和 CSF3 以及 CCL2 和 IL6。分泌的CSF-1(M-CSF)也因治疗而减少。肿瘤分泌因子的变化导致 THP-1 单核细胞向促炎表型极化,其特点是 CD14 和 CD40 表面标志物表达增加。因此,我们建议将 M-CSF 作为刺猬蛋白抑制剂的一个新靶点,除了其在减少肿瘤诱导的骨病方面的已知作用外,它还具有改变免疫微环境的潜在应用前景。
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Journal of Bone Oncology
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