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TIM-3 Expression on Dendritic Cells in Colorectal Cancer 大肠癌树突状细胞上的 TIM-3 表达
Pub Date : 2024-05-15 DOI: 10.3390/cancers16101888
Mei Sakuma, Masanori Katagata, H. Okayama, S. Nakajima, Katsuharu Saito, Takahiro Sato, Satoshi Fukai, Hideaki Tsumuraya, H. Onozawa, W. Sakamoto, Motonobu Saito, Z. Saze, T. Momma, Kosaku Mimura, Koji Kono
TIM-3 was originally identified as a negative regulator of helper T cells and is expressed on dendritic cells (DCs). Since the inhibition of TIM-3 on DCs has been suggested to enhance T cell-mediated anti-tumor immunity, we examined its expression on DCs within the tumor microenvironment (TME) in colorectal cancer (CRC) using transcriptomic data from a public database (n = 592) and immunohistochemical evaluations from our cohorts of CRC (n = 115). The expression of TIM-3 on DCs in vitro was examined by flow cytometry, while the expression of its related molecules, cGAS and STING, on immature and mature DCs was assessed by Western blotting. The expression of HAVCR2 (TIM-3) was strongly associated with the infiltration of DCs within the TME of CRC. Immunohistochemical staining of clinical tissue samples revealed that tumor-infiltrating DCs expressed TIM-3; however, their number at the tumor-invasive front significantly decreased with stage progression. TIM-3 expression was higher on immature DCs than on mature DCs from several different donors (n = 6). Western blot analyses showed that the expression of STING was higher on mature DCs than on immature DCs, which was opposite to that of TIM-3. We demonstrated that TIM-3 was highly expressed on tumor-infiltrating DCs of CRC and that its expression was higher on immature DCs than on mature DCs.
TIM-3 最初被认为是辅助性 T 细胞的负调控因子,在树突状细胞(DC)上表达。由于有人认为抑制 TIM-3 在 DCs 上的表达可增强 T 细胞介导的抗肿瘤免疫力,因此我们利用公共数据库中的转录组数据(n = 592)和我们的 CRC 队列(n = 115)中的免疫组化评估,研究了 TIM-3 在结直肠癌(CRC)肿瘤微环境(TME)中 DCs 上的表达。流式细胞术检测了 TIM-3 在体外直流细胞上的表达,Western 印迹法评估了其相关分子 cGAS 和 STING 在未成熟和成熟直流细胞上的表达。HAVCR2(TIM-3)的表达与CRC TME中DC的浸润密切相关。对临床组织样本进行免疫组化染色后发现,肿瘤浸润的DC表达TIM-3,但它们在肿瘤浸润前沿的数量会随着阶段的进展而显著减少。来自不同供体的未成熟直流细胞(n = 6)的 TIM-3 表达高于成熟直流细胞。Western 印迹分析表明,STING 在成熟 DCs 上的表达高于未成熟 DCs,这与 TIM-3 的表达相反。我们证明了TIM-3在CRC肿瘤浸润DC上的高表达,而且其在未成熟DC上的表达高于在成熟DC上的表达。
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引用次数: 0
Integrating Imaging and Circulating Tumor DNA Features for Predicting Patient Outcomes 综合成像和循环肿瘤 DNA 特征预测患者预后
Pub Date : 2024-05-15 DOI: 10.3390/cancers16101879
Mark Jesus M. Magbanua, Wen Li, Laura J. van ’t Veer
Biomarkers for evaluating tumor response to therapy and estimating the risk of disease relapse represent tremendous areas of clinical need. To evaluate treatment efficacy, tumor response is routinely assessed using different imaging modalities like positron emission tomography/computed tomography or magnetic resonance imaging. More recently, the development of circulating tumor DNA detection assays has provided a minimally invasive approach to evaluate tumor response and prognosis through a blood test (liquid biopsy). Integrating imaging- and circulating tumor DNA-based biomarkers may lead to improvements in the prediction of patient outcomes. For this mini-review, we searched the scientific literature to find original articles that combined quantitative imaging and circulating tumor DNA biomarkers to build prediction models. Seven studies reported building prognostic models to predict distant recurrence-free, progression-free, or overall survival. Three discussed building models to predict treatment response using tumor volume, pathologic complete response, or objective response as endpoints. The limited number of articles and the modest cohort sizes reported in these studies attest to the infancy of this field of study. Nonetheless, these studies demonstrate the feasibility of developing multivariable response-predictive and prognostic models using regression and machine learning approaches. Larger studies are warranted to facilitate the building of highly accurate response-predictive and prognostic models that are generalizable to other datasets and clinical settings.
评估肿瘤对治疗的反应和估计疾病复发风险的生物标志物是临床需求量巨大的领域。为评估治疗效果,通常使用正电子发射断层扫描/计算机断层扫描或磁共振成像等不同的成像模式来评估肿瘤反应。最近,循环肿瘤 DNA 检测试剂的开发为通过血液检测(液体活检)评估肿瘤反应和预后提供了一种微创方法。将基于成像和循环肿瘤 DNA 的生物标记物结合起来,可能会改善对患者预后的预测。在这篇微型综述中,我们检索了科学文献,寻找结合定量成像和循环肿瘤 DNA 生物标记物来建立预测模型的原创文章。七项研究报告了建立预后模型来预测无远处复发、无进展或总生存期的情况。三项研究讨论了使用肿瘤体积、病理完全反应或客观反应作为终点建立预测治疗反应的模型。这些研究中报告的文章数量有限,队列规模也不大,这证明了这一研究领域尚处于起步阶段。不过,这些研究证明了使用回归和机器学习方法开发多变量反应预测和预后模型的可行性。有必要进行更大规模的研究,以促进建立可推广到其他数据集和临床环境的高精度反应预测和预后模型。
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引用次数: 0
Identifying Key Regulatory Genes in Drug Resistance Acquisition: Modeling Pseudotime Trajectories of Breast Cancer Single-Cell Transcriptome 识别耐药性获得过程中的关键调控基因:乳腺癌单细胞转录组伪时间轨迹建模
Pub Date : 2024-05-15 DOI: 10.3390/cancers16101884
Keita Iida, Mariko Okada
Single-cell RNA-sequencing (scRNA-seq) technology has provided significant insights into cancer drug resistance at the single-cell level. However, understanding dynamic cell transitions at the molecular systems level remains limited, requiring a systems biology approach. We present an approach that combines mathematical modeling with a pseudotime analysis using time-series scRNA-seq data obtained from the breast cancer cell line MCF-7 treated with tamoxifen. Our single-cell analysis identified five distinct subpopulations, including tamoxifen-sensitive and -resistant groups. Using a single-gene mathematical model, we discovered approximately 560–680 genes out of 6000 exhibiting multistable expression states in each subpopulation, including key estrogen-receptor-positive breast cancer cell survival genes, such as RPS6KB1. A bifurcation analysis elucidated their regulatory mechanisms, and we mapped these genes into a molecular network associated with cell survival and metastasis-related pathways. Our modeling approach comprehensively identifies key regulatory genes for drug resistance acquisition, enhancing our understanding of potential drug targets in breast cancer.
单细胞 RNA 测序(scRNA-seq)技术在单细胞水平上为了解癌症耐药性提供了重要线索。然而,在分子系统水平上理解细胞的动态转变仍然有限,这需要一种系统生物学方法。我们介绍了一种结合数学建模和伪时间分析的方法,该方法使用了从接受他莫昔芬治疗的乳腺癌细胞系 MCF-7 中获得的时间序列 scRNA-seq 数据。我们的单细胞分析确定了五个不同的亚群,包括他莫昔芬敏感群和耐药群。利用单基因数学模型,我们发现 6000 个基因中约有 560-680 个基因在每个亚群中呈现多稳态表达状态,其中包括关键的雌激素受体阳性乳腺癌细胞存活基因,如 RPS6KB1。我们通过分叉分析阐明了这些基因的调控机制,并将这些基因映射到与细胞存活和转移相关通路的分子网络中。我们的建模方法全面确定了耐药性获得的关键调控基因,加深了我们对乳腺癌潜在药物靶点的了解。
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引用次数: 0
Health-Related Quality of Life and Return to Work after Surgery for Spinal Schwannoma: A Population-Based Cohort Study 脊髓许旺瘤手术后与健康相关的生活质量和重返工作岗位:一项基于人群的队列研究
Pub Date : 2024-05-15 DOI: 10.3390/cancers16101882
Aman Singh, Ann-Christin von Vogelsang, V. G. El-Hajj, Ali Buwaider, Alexander Fletcher-Sandersjöö, Jenny Pettersson-Segerlind, E. Edström, Adrian Elmi-Terander
Spinal schwannomas are the second most common primary intradural spinal tumor. This study aimed to assess health-related quality of life (HRQoL) and the frequency of return to work after the surgical treatment of spinal schwannomas. HRQoL was compared to a sample of the general population. Patients operated for spinal schwannomas between 2006 and 2020 were identified in a previous study and those alive at follow-up (171 of 180) were asked to participate. Ninety-four (56%) responded and were included in this study. Data were compared to the Stockholm Public Health Survey 2006, a cross-sectional survey of a representative sample of the general population. An analysis for any potential non-response bias was performed and showed no significant differences between the groups. HRQoL was equal between the spinal schwannoma sample and the general population sample in all but one dimension; men in the spinal schwannoma sample reported more moderate problems in the usual activities dimension than men in the general population (p = 0.020). In the schwannoma sample, there were no significant differences between men and women in either of the dimensions EQ-5Dindex or EQVAS. Before surgery, a total of 71 (76%) were working full-time and after surgery almost all (94%) returned to work, most of them within 3 months of surgery. Eighty-nine (95%) of the patients responded that they would accept the surgery for their spinal schwannoma if asked again today. To conclude, surgical treatment of spinal schwannomas is associated with good HRQoL and with a high frequency of return to work.
脊柱裂孔瘤是第二大最常见的原发性脊柱硬膜内肿瘤。本研究旨在评估脊柱裂孔瘤手术治疗后与健康相关的生活质量(HRQoL)和重返工作岗位的频率。HRQoL与普通人群样本进行了比较。先前的一项研究确定了2006年至2020年期间接受脊柱裂孔瘤手术的患者,并要求随访时仍健在的患者(180人中的171人)参与研究。94名患者(56%)做出了回应,并被纳入本研究。数据与 2006 年斯德哥尔摩公共卫生调查进行了比较,后者是一项对具有代表性的普通人群样本进行的横断面调查。对任何潜在的非响应偏差进行了分析,结果显示两组之间没有显著差异。除一个维度外,脊髓分裂瘤样本与普通人群样本在所有维度上的 HRQoL 都相同;脊髓分裂瘤样本中的男性比普通人群中的男性在日常活动维度上报告了更多中度问题(p = 0.020)。在脊神经分裂瘤样本中,男性和女性在 EQ-5Dindex 或 EQVAS 两个维度上都没有显著差异。手术前,共有 71 人(76%)从事全职工作,手术后,几乎所有人(94%)都重返工作岗位,其中大部分人在手术后 3 个月内重返工作岗位。89名患者(95%)回答说,如果今天再问他们,他们会接受脊神经分裂瘤手术治疗。总之,脊管分裂瘤的手术治疗与良好的 HRQoL 和恢复工作的高频率有关。
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引用次数: 0
The Value of PET/CT in Particle Therapy Planning of Various Tumors with SSTR2 Receptor Expression: Comparative Interobserver Study PET/CT 在对 SSTR2 受体表达的各种肿瘤进行粒子治疗规划中的价值:观察者间比较研究
Pub Date : 2024-05-15 DOI: 10.3390/cancers16101877
C. Lütgendorf-Caucig, Patricia Wieland, Eugen Hug, Birgit Flechl, S. Tubin, R. Galalae, Petra Georg, P. Fossati, M. Mumot, S. Harrabi, Irina Pradler, M. Pelak
The overexpression of somatostatin receptor type 2 (SSTR2) is a property of various tumor types. Hybrid imaging utilizing [68Ga]1,4,7,10-tetraazacyclododecane-1,4,7,10-tetra-acetic acid (DOTA) may improve the differentiation between tumor and healthy tissue. We conducted an experimental study on 47 anonymized patient cases including 30 meningiomas, 12 PitNET and 5 SBPGL. Four independent observers were instructed to contour the macroscopic tumor volume on planning MRI and then reassess their volumes with the additional information from DOTA-PET/CT. The conformity between observers and reference volumes was assessed. In total, 46 cases (97.9%) were DOTA-avid and included in the final analysis. In eight cases, PET/CT additional tumor volume was identified that was not detected by MRI; these PET/CT findings were potentially critical for the treatment plan in four cases. For meningiomas, the interobserver and observer to reference volume conformity indices were higher with PET/CT. For PitNET, the volumes had higher conformity between observers with MRI. With regard to SBGDL, no significant trend towards conformity with the addition of PET/CT information was observed. DOTA PET/CT supports accurate tumor recognition in meningioma and PitNET and is recommended in SSTR2-expressing tumors planned for treatment with highly conformal radiation.
体生长抑素受体 2 型(SSTR2)的过度表达是各种肿瘤类型的一个特性。利用[68Ga]1,4,7,10-四氮杂环十二烷-1,4,7,10-四乙酸(DOTA)进行混合成像可提高肿瘤和健康组织的区分度。我们对 47 例匿名患者进行了实验研究,其中包括 30 例脑膜瘤、12 例 PitNET 和 5 例 SBPGL。四名独立的观察者被要求在计划核磁共振成像上勾画宏观肿瘤体积,然后根据 DOTA-PET/CT 的附加信息重新评估其体积。对观察者与参考体积之间的一致性进行了评估。共有 46 个病例(97.9%)与 DOTA 相关并纳入最终分析。在 8 个病例中,PET/CT 发现了核磁共振成像未检测到的额外肿瘤体积;在 4 个病例中,PET/CT 的这些发现可能对治疗计划至关重要。对于脑膜瘤,PET/CT 的观察者之间和观察者与参考容积的一致性指数更高。对于 PitNET,MRI 观察者之间的体积一致性更高。至于 SBGDL,在增加 PET/CT 信息后,未观察到明显的一致性趋势。DOTA PET/CT 可准确识别脑膜瘤和 PitNET 中的肿瘤,推荐用于计划采用高适形放射治疗的 SSTR2 表达肿瘤。
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引用次数: 0
A Gold Standard-Derived Modular Barcoding Approach to Cancer Transcriptomics 癌症转录组学的黄金标准模块化条形码方法
Pub Date : 2024-05-15 DOI: 10.3390/cancers16101886
Yan Zhu, M. Koleilat, J. Roszik, Man Kam Kwong, Zhonglin Wang, D. Maru, S. Kopetz, Lawrence N. Kwong
A challenge with studying cancer transcriptomes is in distilling the wealth of information down into manageable portions of information. In this resource, we develop an approach that creates and assembles cancer type-specific gene expression modules into flexible barcodes, allowing for adaptation to a wide variety of uses. Specifically, we propose that modules derived organically from high-quality gold standards such as The Cancer Genome Atlas (TCGA) can accurately capture and describe functionally related genes that are relevant to specific cancer types. We show that such modules can: (1) uncover novel gene relationships and nominate new functional memberships, (2) improve and speed up analysis of smaller or lower-resolution datasets, (3) re-create and expand known cancer subtyping schemes, (4) act as a “decoder” to bridge seemingly disparate established gene signatures, and (5) efficiently apply single-cell RNA sequencing information to other datasets. Moreover, such modules can be used in conjunction with native spreadsheet program commands to create a powerful and rapid approach to hypothesis generation and testing that is readily accessible to non-bioinformaticians. Finally, we provide tools for users to create and interpret their own modules. Overall, the flexible modular nature of the proposed barcoding provides a user-friendly approach to rapidly decoding transcriptome-wide data for research or, potentially, clinical uses.
癌症转录组研究面临的一个挑战是如何将大量信息提炼成易于管理的信息部分。在本资源中,我们开发了一种方法,可以创建癌症类型特异性基因表达模块并将其组装成灵活的条形码,从而适应各种用途。具体来说,我们建议从癌症基因组图谱(The Cancer Genome Atlas,TCGA)等高质量黄金标准中有机提取的模块可以准确捕捉和描述与特定癌症类型相关的功能相关基因。我们的研究表明,此类模块可以(1) 发现新的基因关系并提名新的功能成员,(2) 改进并加快对较小或较低分辨率数据集的分析,(3) 重新创建并扩展已知的癌症亚型方案,(4) 作为 "解码器 "连接看似不同的既定基因特征,以及 (5) 高效地将单细胞 RNA 测序信息应用于其他数据集。此外,这些模块还可与本地电子表格程序命令结合使用,为非生物信息学家提供一种强大而快速的假设生成和测试方法。最后,我们还为用户创建和解释自己的模块提供了工具。总之,条形码灵活的模块化特性为快速解码整个转录组的数据提供了一种用户友好型方法,可用于研究或潜在的临床用途。
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引用次数: 0
RETRACTED: Godugu et al. Anti-Cancer Activities of Thyrointegrin αvβ3 Antagonist Mono- and Bis-Triazole Tetraiodothyroacetic Acid Conjugated via Polyethylene Glycols in Glioblastoma. Cancers 2021, 13, 2780 转载:Godugu等人通过聚乙二醇共轭的甲状腺整合素αvβ3拮抗剂单三唑和双三唑四碘甲状腺乙酸在胶质母细胞瘤中的抗癌活性。癌症 2021,13,2780
Pub Date : 2024-05-15 DOI: 10.3390/cancers16101880
Kavitha Godugu, Mehdi Rajabi, Shaker A. Mousa
The journal retracts the article, “Anti-Cancer Activities of Thyrointegrin αvβ3 Antagonist Mono- and Bis-Triazole Tetraiodothyroacetic Acid Conjugated via Polyethylene Glycols in Glioblastoma” [...]
该杂志撤销了文章《通过聚乙二醇共轭的甲状腺整合素αvβ3拮抗剂单三唑和双三唑四碘甲状腺乙酸在胶质母细胞瘤中的抗癌活性》[...]。
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引用次数: 0
Historical Perspective and Current Trends in Anticancer Drug Development 抗癌药物开发的历史展望和当前趋势
Pub Date : 2024-05-15 DOI: 10.3390/cancers16101878
Katarzyna Gach-Janczak, Joanna Drogosz-Stachowicz, Anna Janecka, Karol Wtorek, Marek Mirowski
Cancer is considered one of the leading causes of death in the 21st century. The intensive search for new anticancer drugs has been actively pursued by chemists and pharmacologists for decades, focusing either on the isolation of compounds with cytotoxic properties from plants or on screening thousands of synthetic molecules. Compounds that could potentially become candidates for new anticancer drugs must have the ability to inhibit proliferation and/or induce apoptosis in cancer cells without causing too much damage to normal cells. Some anticancer compounds were discovered by accident, others as a result of long-term research. In this review, we have presented a brief history of the development of the most important groups of anticancer drugs, pointing to the fact that they all have many side effects.
癌症被认为是 21 世纪的主要死亡原因之一。数十年来,化学家和药理学家一直在积极寻找新的抗癌药物,重点是从植物中分离出具有细胞毒性的化合物,或筛选成千上万的合成分子。有可能成为新型抗癌药物候选物质的化合物必须具有抑制癌细胞增殖和/或诱导癌细胞凋亡的能力,同时又不会对正常细胞造成太大损害。有些抗癌化合物是偶然发现的,有些则是长期研究的结果。在这篇综述中,我们简要介绍了最重要的几类抗癌药物的发展史,并指出它们都有许多副作用。
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引用次数: 0
Heterogeneous Profile of ROR1 Protein Expression across Tumor Types 不同肿瘤类型中 ROR1 蛋白表达的异质性特征
Pub Date : 2024-05-15 DOI: 10.3390/cancers16101874
Maria Gabriela Raso, Elizve Barrientos Toro, Kurt Evans, Yasmeen Rizvi, Rossana Lazcano, Argun Akcakanat, Patrizia Sini, Francesca Trapani, Eva Johanna Madlener, Lorenz Waldmeier, Alexander J. Lazar, Funda Meric-Bernstam
The Wnt receptor ROR1 has generated increased interest as a cancer therapeutic target. Research on several therapeutic approaches involving this receptor is ongoing; however, ROR1 tissue expression remains understudied. We performed an immunohistochemistry analysis of ROR1 protein expression in a large cohort of multiple tumor and histologic types. We analyzed 12 anonymized multi-tumor tissue microarrays (TMAs), including mesothelioma, esophageal and upper gastrointestinal carcinomas, and uterine endometrioid carcinoma, among other tumor types. Additionally, we studied 5 different sarcoma types of TMAs and 6 patient-derived xenografts (PDX) TMAs developed from 19 different anatomic sites and tumor histologic types. A total of 1142 patient cases from different histologic types and 140 PDXs placed in TMAs were evaluated. Pathologists assessed the percentage of tumor cells in each case that were positive for ROR1 and the intensity of staining. For determining the prevalence of staining for each tumor type, a case was considered positive if >1% of its tumor cells showed ROR1 staining. Our immunohistochemistry assays revealed a heterogeneous ROR1 expression profile. A high prevalence of ROR1 expression was found in mesothelioma (84.6%), liposarcoma (36.1%), gastrointestinal stromal tumors (33.3%), and uterine endometrioid carcinoma (28.9%). Other histologic types such as breast, lung, renal cell, hepatocellular, urothelial carcinoma, and colon carcinomas; glioblastoma; cholangiocarcinoma; and leiomyosarcoma showed less ROR1 overall expression, ranging between 0.9 and 13%. No ROR1 expression was seen in mesenchymal chondrosarcoma, rhabdomyosarcoma, or gastric adenocarcinoma cases. Overall, ROR1 expression was relatively infrequent and low in most tumor types investigated; however, ROR1 expression was infrequent but high in selected tumor types, such as gastroesophageal GIST, suggesting that ROR1 prescreening may be preferable for those indications. Further, mesothelioma exhibited frequent and high levels of ROR1 expression, which represents a previously unrecognized therapeutic opportunity. These findings can contribute to the development of ROR1-targeted therapies.
作为癌症治疗靶点,Wnt 受体 ROR1 引起了越来越多的关注。涉及该受体的几种治疗方法的研究正在进行中;然而,对 ROR1 组织表达的研究仍然不足。我们对大量多种肿瘤和组织学类型的 ROR1 蛋白表达进行了免疫组化分析。我们分析了 12 个匿名的多肿瘤组织微阵列(TMA),包括间皮瘤、食管癌、上消化道癌、子宫内膜样癌以及其他肿瘤类型。此外,我们还研究了 5 种不同肉瘤类型的 TMA 和 6 种从 19 个不同解剖部位和肿瘤组织学类型中提取的患者异种移植 (PDX) TMA。共评估了 1142 例不同组织学类型的患者病例和 140 例放置在 TMA 中的 PDX。病理学家评估了每个病例中 ROR1 阳性的肿瘤细胞百分比和染色强度。为了确定每种肿瘤类型的染色流行率,如果病例中有超过 1% 的肿瘤细胞显示 ROR1 染色,则该病例被视为阳性。我们的免疫组化检测结果显示,ROR1 的表达情况各不相同。间皮瘤(84.6%)、脂肪肉瘤(36.1%)、胃肠道间质瘤(33.3%)和子宫内膜样癌(28.9%)的 ROR1 表达率较高。其他组织学类型,如乳腺癌、肺癌、肾细胞癌、肝细胞癌、尿路上皮癌、结肠癌、胶质母细胞瘤、胆管癌和子宫肌瘤的 ROR1 总表达量较少,介于 0.9% 和 13% 之间。间质软骨肉瘤、横纹肌肉瘤和胃腺癌病例中未见 ROR1 表达。总体而言,ROR1在所调查的大多数肿瘤类型中的表达相对较少且较低;然而,ROR1在某些肿瘤类型(如胃食管GIST)中的表达较少但较高,这表明ROR1预筛可能更适用于这些适应症。此外,间皮瘤显示出频繁和高水平的ROR1表达,这代表了一种以前未曾认识到的治疗机会。这些发现有助于开发ROR1靶向疗法。
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引用次数: 0
Unsatisfactory Neurological Outcome in an Intramedullary Thoracic Intermediate-Grade Melanocytoma—Systematic Review and Illustrative Case 胸腔髓内中分级黑色素细胞瘤不理想的神经系统预后--系统综述与案例说明
Pub Date : 2024-05-14 DOI: 10.3390/cancers16101867
Marco Battistelli, Fulvio Grilli, A. Rapisarda, Michele Di Domenico, Nicola Montano, Marco Gessi, Alessandro Olivi, Alessio Albanese, F. Polli
Background: Intramedullary melanocytomas are exceedingly rare, with only twenty-four cases reported up to now. They present as local invasive tumors despite their benign biological behavior. Attempting a complete safe resection often results in severe post-operative neurological deficits, as in our case presented here. Methods: A systematic review was conducted across the PubMed and Scopus databases including studies published till February 2024. Results: A total of 19 studies were included, encompassing 24 cases. A similar distribution between sexes was noted (M:F 13:11), with ages ranging from 19 to 79 years. The thoracic segment was most affected, and intermediate-grade melanocytoma (19 cases) was the most common histotype. Radiographically, intramedullary melanocytomas usually appear as hyperintense hemorrhagic lesions peripheral to the central canal with focal nodular enhancement. Intraoperatively, they are black–reddish to tan and are tenaciously adherent lesions. In the sampled studies, IONM employment was uncommon, and post-operative new-onset neurological deficits were described in 16 cases. Adjuvant RT was used in four cases and its value is debatable. Recurrence is common (10 cases), and adjuvant therapies (RT or repeated surgery) seem to play a palliative role. Case presentation: A 68-year-old woman presented with a three-year history of worsening spastic paraparesis and loss of independence in daily activities (McCormick grade 4). An MRI revealed an intramedullary tumor from Th5 to Th7, characterized by T1-weighted hyperintensity and signs of recent intralesional hemorrhage. Multimodal neuromonitoring, comprising the D-Wave, guided the resection of a black–tan-colored tumor with hyper-vascularization and strong adherence to the white matter. During final dissection of the lesion to obtain gross total resection (GTR), a steep decline in MEPs and D-Wave signals was recorded. Post-operatively, the patient had severe hypoesthesia with Th9 level and segmental motor deficits, with some improvement during neurorehabilitation. Histopathology revealed an intermediate-grade melanocytoma (CNS WHO 2021 classification). A four-month follow-up documented the absence of relapse. Conclusions: This literature review highlights that intramedullary T1 hyperintense hemorrhagic thoracic lesions in an adult patient should raise the suspicion of intramedullary melanocytoma. They present as locally aggressive tumors, due to local invasiveness, which often lead to post-operative neurological deficits, and frequent relapses, which overwhelm therapeutic strategies leading to palliative care after several years.
背景:髓内黑色素细胞瘤极为罕见,迄今为止仅有 24 例报道。尽管它们具有良性生物学行为,但表现为局部浸润性肿瘤。试图完全安全切除往往会导致术后严重的神经功能缺损,就像我们这里的病例一样。研究方法对 PubMed 和 Scopus 数据库中截至 2024 年 2 月发表的研究进行了系统回顾。结果:共纳入 19 项研究:共纳入 19 项研究,涵盖 24 个病例。性别分布相似(男:女 13:11),年龄从 19 岁到 79 岁不等。胸段患者最多,中度黑色素细胞瘤(19 例)是最常见的组织类型。从影像学角度看,髓内黑色素细胞瘤通常表现为中央管外围的高密度出血性病变,并伴有局灶性结节强化。术中,它们呈黑红色至棕褐色,是顽固的粘连性病变。在抽样研究中,IONM的就业情况并不常见,有16例描述了术后新出现的神经功能缺损。有四例病例使用了辅助 RT,其价值值得商榷。复发很常见(10 例),辅助疗法(RT 或重复手术)似乎起到了缓解作用。病例介绍:一名 68 岁的妇女因痉挛性截瘫恶化和丧失日常生活自理能力(麦考密克 4 级)就诊 3 年。核磁共振成像检查发现了一个从Th5到Th7的髓内肿瘤,其特征是T1加权高密度和近期髓内出血的迹象。在多模态神经监测(包括D波)的指导下,切除了一个黑褐色的肿瘤,该肿瘤血管扩张,与白质紧密粘连。在对病灶进行最后解剖以获得全切除术(GTR)时,记录到 MEPs 和 D 波信号急剧下降。术后,患者出现了严重的低麻痹,Th9水平和节段性运动障碍,在神经康复治疗期间有所改善。组织病理学检查显示为中度黑色素细胞瘤(中枢神经系统 WHO 2021 分类)。四个月的随访表明该患者没有复发。结论:这篇文献综述强调,成年患者胸部髓内T1高张力出血性病变应引起对髓内黑色素细胞瘤的怀疑。这些肿瘤具有局部侵袭性,通常会导致术后神经功能缺损,而且经常复发,使治疗策略不堪重负,数年后只能接受姑息治疗。
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引用次数: 0
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Cancers
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