Journal of Buon最新文献

Purpose: The authors evaluated the results of stereotactic radiosurgery (SRS) for the treatment of metastatic brain tumors from esophageal carcinoma.

Methods: We retrospectively analyzed the clinical characteristics and treatment outcomes in 21 patients with metastatic brain tumors from esophageal carcinoma who underwent SRS between July 2011 and February 2019.

Results: 21 patients (25 SRS procedures) of a total of 88 tumors underwent Gamma knife SRS. Tumor histology was adenocarcinoma in 6 patients (28.6%) and squamous cell carcinoma in 15 patients (71.4%). The median age was 66 years (range 58-73). Eleven patients (52.4%) presented with multiple metastases (range 2-11), and 10 . (47.6%) with a single metastasis. The median tumor volume was 0.55 cm3 (range 0.004-44.64 cm3). No complications related to radiosurgical treatment were identified. The local tumor control rate in this group was 94.2 %. The median survival time from the diagnosis of esophageal cancer was 22 months and the median survival from SRS was 16 months. Higher Karnofsky Performance Scale (KPS) at the time of procedure was associated with increased survival (p=0.003). After SRS, 4 patients had subsequent SRS (1 for boost therapy, 3 for new metastatic deposits), 1 patient underwent craniotomy due to tumor progression. Of the 19 patients who have died, 17 (89.5%) succumbed to systemic disease progression and 2 (10.5%) had neurologic deaths.

Conclusion: SRS is an effective and minimally invasive treatment that can prolong survival. Accordingly, SRS could be used as the initial treatment modality, if possible, even in patients with multiple metastases.

Purpose: An early diagnosis is of great significance in improving the survival rate of patients. At present, the application values of different diagnostic methods in ovarian cancer are different, and the clinical diagnosis alone is not ideal. Therefore, this study explored the application value of Doppler ultrasound combined with CA125 and CA19.9 in the early diagnosis of epithelial ovarian cancer.

Methods: A total of 58 patients with ovarian diseases were divided into an observation group (epithelial ovarian cancer group, n=29) and a control group (benign ovarian tumour group, n=29). Doppler ultrasound results and serum CA125 and CA19.9 detection results of the two groups were collected to analyse and compare the application values of ultrasound and different kinds of tumour markers in the early diagnosis of epithelial ovarian cancer.

Results: The results of Doppler ultrasound showed that the resistance index of the blood flow in the observation group was lower than that in the control group, and the ultrasound score was higher than that in the control group (p<0.05). The levels of serum tumour markers CA125 and CA19.9 in the observation group were significantly higher than those in the control group (p<0.05). The results of the repeated measurement analysis of variance showed that there were significant differences in the ultrasound score, blood flow resistance index, and CA125 and CA19.9 levels in different stages of ovarian cancer (p<0.05). There was no difference in the ultrasonographic score between stage I and the partum stage, while the stages of menstruation and implantation showed a gradually increasing trend (p<0.05). The blood flow resistance index and CA125 and CA19.9 levels increased gradually with the stage (p<0.05). The sensitivity (93.1%), specificity (96.55%), positive predictive value (96.43%), negative predictive value (93.33%) and diagnosis rate (94.83%) of Doppler ultrasonography combined with CA125 and CA19.9 in the diagnosis of epithelial ovarian cancer were higher than those of the single indicator detection method or the two combined diagnostic detection methods.

Conclusion: Doppler ultrasound combined with CA125 and CA19.9 has high sensitivity, high specificity and high coincidence rate and can improve the early clinical diagnosis of epithelial ovarian cancer.

Purpose: The characteristics of pathogenic microbes are useful for understanding the microbe-driven tumorigenesis. There is a lack of studies on the lung microecology for lung cancer (LC) patients without any respiratory infection. In this work, we aimed to describe the profiles of pathogenic microbes in lung microenvironment of non-small cell lung cancer (NSCLC) patients using pathogen targeted sequencing and 16S rDNA sequencing.

Methods: A total of 22 NSCLC patients (13 adenocarcinomas and 9 squamous cell carcinomas) without any pulmonary infection were enrolled. Among them, we collected 15 pieces of tumor tissues, 5 pieces of peritumoral tissues, 6 blood serum samples, and 5 broncho-alveolar lavage fluid (BALF) samples. Pathogen targeted sequencingand16S rDNA sequencing was performed for microbial classification.

Results: The pathogen targeted sequencing results showed that 33, 14, 11, and 27 pathogenic microorganisms were detected in tumor tissues, peritumoral tissues, blood samples, and BALF, respectively. No common microorganisms were shared by four sample types. However, some common elements were shared by three sets: Streptococcus cristatus, Enterococcus, Staphylococcus haemolyticus, Corynebacterium pseudodiphtheria, Acinetobacter jungii, Haemophilus haemolyticus and Haemophilus parainfluenzae. Based on the 16S rDNA sequencing of two BALF samples, there were 104 OTUs found in one BALF sample and 127 OTUs in the other BALF sample; among them, there were 82 common ones, such as OTU1, OTU10, OTU101, OTU105, OTU106, and so on. Based on the above microbial classification and abundance, there might be enriched function in COG terms like COG1132, COG0438 and COG0745, and KEGG terms like K06147, K02029, and K09687.

Conclusion: This study emphasizes the role of the microbiome in LC patients without respiratory infection. These potential biomarkers of LC based on the taxonomic composition of pathogenic microorganisms might have clinical application.

Purpose: To explore the effect of erythropoietin-producing hepatocellular receptor A5 (EPHA5) on the stemness of non-small cell lung cancer cells and its molecular mechanism.

Methods: Highly-expressed EPHA5 in NCI-H460 and NCI-H1229 cells was silenced. After EPHA5 silencing, the positive expression level of cluster of differentiation 133 (CD133) in NCI-H460 and NCI-H1229 cells was detected by flow cytometry, and the expression levels of stemness markers sex determining region Y-box 2 (Sox2), Nanog, Kruppel-like factor 4 (KLF4) and octamer-binding transcription factor 4 (Oct4) in cells were detected by Western blotting.

Results: The expression level of EPHA5 in non-small cell lung cancer H460 and H1229 cells was higher than that in A549 and SPC-A1 cells. After EPHA5 silencing, the levels of CD133 and stemness markers Sox2, Nanog, KLF4 and Oct4 in H460 and H1229 cells all declined. CCK-8 assay showed that Wnt agonists at a concentration of 2.5 and 5 μm had little effect on the proliferative activity of H460 and H1229 cells. Western blotting revealed that Wnt agonists at a concentration of 5 μm could better enhance the expression of β-catenin. After treatment with Wnt agonists, the expression of CD133 in H460 and H1229 cells with EPHA5 silencing by siRNA3 was higher than that before treatment, and the expression levels of Sox2, Nanog, KLF4 and Oct4 in the above two cells were also increased compared with those before treatment. However, the levels of the above indexes were all lower after treatment with Wnt agonists than those before silencing.

Conclusion: Activating the Wnt signaling pathway can induce the increase in EPHA5 expression and enhance the stemness of non-small cell lung cancer cells.

Purpose: To explore the efficacy and safety of 125I radioactive seed implantation combined with epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in the treatment of advanced non-small cell lung cancer (NSCLC).

Methods: 108 patients with EGFR mutation-positive unresectable advanced NSCLC (stage IIIB-IV) were randomly divided into 125I group (treated with 125I radioactive seed implantation combined with EGFR-TKIs, n=54) and EGFR-TKIs group (treated with EGFR-TKIs alone, n=54). The short-term efficacy and adverse reactions were analyzed and evaluated, the changes in the levels of peripheral blood T lymphocyte subsets, natural killer (NK) cells and related immune-inflammatory factors were analyzed, and the long-term survival and progression of disease were recorded.

Results: The objective response rate was 61.1% (33/54) and 51.9% (28/54), and the disease control rate was 88.9% (48/54) and 68.5% (37/54), respectively, in 125I group and EGFR-TKIs group. At 6 months after treatment, the levels of peripheral blood cluster of differentiation 3+ (CD3+), CD4+, CD4+/CD8+ and NK cells significantly rose in both groups compared with those before treatment (p<0.05), while the levels of CD8+, serum tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-6 (IL-6) and IL-10 significantly declined compared with those before treatment. The 2-year overall survival (OS) rate was 53.7% (29/54) and 40.7% (22/54), and the median progression-free survival (PFS) was 14.5 months and 9.8 months, respectively, in 125I group and EGFR-TKIs group.

Conclusions: 125I radioactive seed implantation combined with EGFR-TKIs is safe and effective in the treatment of advanced NSCLC, and its short-term efficacy and long-term survival rate of patients are significantly superior to those of EGFR-TKIs alone. At the same time, it can regulate the expressions of T lymphocyte subsets, NK cells and immune-inflammatory factors in patients, and improve their immune function.

Purpose: Venetoclax (VEN) is an oral selective inhibitor of antiapoptotic protein B-cell leukemia/lymphoma-2 (BCL-2).

Methods: We report 7 relapsed/refractory (R/R) acute myeloid leukemia (AML) patients treated with venetoclax and hypomethylating agents (HMA).

Results: More than half of the patients could go on with venetoclax for only a few months.

Conclusion: Using venetoclax combined with HMA in R/R AML should be kept in mind as an alternative salvage option.

Purpose: To evaluate the effect of adding adjuvant ifosfamide/doxorubicin combination chemotherapy (CTX) to adjuvant radiotherapy (RT) on the survival in patients with surgically treated high-risk soft tissue sarcomas (STSs).

Methods: The study included 69 patients (group A) receiving adjuvant RT and 74 patients (group B) receiving adjuvant CTX after adjuvant RT.

Results: The median relapse-free survival (RFS) was 18.2 months (95% CI, 11.9-43.4) in group A and 27.2 months (95% CI, 17.6-36.8) in group B (p = 0.004). The median overall survival (OS) was 45.6 months (95% CI, 26.4-64.8) in group A and 110.1 mo (95% CI, 44.3-175.8) in group B (p = 0.007). Receiving adjuvant CTX was an independent predictive factor for both RFS [HR: 0.482, (0.307-0.757), p = 0.002) and OS (HR: 0.549, [0.348-0.867], p = 0.010).

Conclusion: There are conflicting literature data regarding the survival benefit of adjuvant CTX for surgically treated STSs. However, appropriate patient selection may provide a significant survival benefit in RFS and OS with CTX in the adjuvant treatment of high-risk STSs.

Purpose: Cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal intraoperative chemotherapy (HIPEC) is the standard treatment for tumors presented with peritoneal metastases (PM). Data in the literature about the treatment of rare tumors with PM are limited and of low-quality. The aim of the study was to assess the outcome and safety of CRS and HIPEC for these tumors.

Methods: Patients with rare tumors with PM that underwent CRS and HIPEC between 2005-2018, were retrospectively analyzed. Clinical and histopathological variables were correlated to survival.

Results: 43 patients, mean age 55.7 ± 12.9 years, underwent 48 cytoreductions. The most frequent histopathologic type was sarcomatosis (31.3%). The majority of the patients (70.8%) had limited extent of peritoneal disease. Complete or near-complete cytoreduction was achieved in 83.3% of the cases. Severe morbidity was recorded in 12.6%. The median disease-free survival and overall survival were 11 and 63 months, respectively. Although the completeness of cytoreduction was found to be significantly related to survival, the extent of peritoneal carcinomatosis was the single prognostic factor.

Conclusions: CRS followed by HIPEC is an effective and safe method in the treatment of rare tumors with PM. Further large, well-designed prospective studies are needed to validate these results.