Journal of cancer research and therapeutics最新文献

Abstract: Inflammatory myofibroblastoma tumor (IMT) is rare neoplasm that has high recurrence rate and low likelihood of metastasis. Here, we report the efficacy and safety of microwave ablation (MWA) combined with transarterial embolization in a patient with unresectable retroperitoneal IMT measuring 89 mm in maximum diameter. Multiple courses of MWA, the last of which was performed under magnetic resonance imaging guidance, and one course of transarterial embolization resulted in complete response without complications. After more than 1.5 years of the last MWA treatment, follow-up showed sustained complete response. This case suggested that the combination of MWA and transarterial embolization is a new option for retroperitoneal IMT. A multicenter and large-sample clinical trial is required to confirm the efficacy and safety of MWA combined with transarterial embolization for retroperitoneal IMT.

Purpose: To summarize and analyze the computed tomography (CT) and magnetic resonance imaging (MRI) features of uterine sarcoma.

Methods and material: This retrospective study reviewed the clinical data and CT/MRI findings of 15 patients with uterine sarcomas confirmed by surgery and pathology, focusing on their characteristic imaging manifestations.

Results: Among the 15 patients, eight had uterine smooth muscle sarcoma (four with lesions confined to the uterine cavity and four presenting as large pelvic masses; all were cystic); one had undifferentiated uterine sarcoma [low signal on TI-weighted imaging (T1WI), high signal on T2-weighted imaging (T2WI) with the clear border, and marginal ring-shaped high signals on diffusion-weighted image (DWI)]; two had uterine adenosarcoma (mixed-density nodular and mass-like lesions with marked heterogeneous enhancement); three had low-grade endometrial stromal sarcoma (iso- or hypointense on T1WI, hyper- or slightly hyperintense on T2WI, and markedly hyperintense on DWI); and one had high-grade endometrial stromal sarcoma (a large cystic-solid pelvic mass). Pathology confirmed that this last lesion invaded the plasma membrane and involved local sub-plasma tissue of the intestinal wall.

Conclusion: Uterine sarcoma commonly presents as the large cystic pelvic mass with indistinct margins, irregular shape, and possible invasion of adjacent structures. MRI typically shows iso- or slightly low T1WI signals, mixed high T2WI signals, high or slightly high DWI signals, and heterogeneous enhancement. These findings may aid in improving diagnostic accuracy and guiding clinical management of uterine sarcoma.

Objective: To explore the evaluation value of different reconstruction methods of enhanced computed tomography (CT) images on the cardiac structure dose in patients undergoing radiotherapy for breast cancer.

Methods: A retrospective analysis of the cardiac structure data of 200 female patients with left-sided breast cancer, who underwent enhanced CT scans was conducted. Image reconstruction was performed with a time interval of 5% of the cardiac cycle (0%-95%), obtaining maximum intensity projection (MIP), minimum intensity projection (MinIP), and average intensity projection (AIP) images. The left ventricle (LV) and the left anterior descending artery (LAD) were delineated on the four types of images.

Results: The MinIP, MIP, and AIP images showed larger LAD volumes than enhanced CT images (P < 0.05). Compared with the dose sum, the changes in V5Gy, V30Gy, V40Gy, Dmax, and Dmean for LV on MIP images were all <5% (4.02%, 2.17%, 1.39%, 2.99%, and 1.93%, respectively). The Dmax and Dmean change rates for LV on MinIP images were both <5%, at 2.00% and 4.73%, respectively; the Dmax and Dmean change rates for LV on AIP images were also both <5%, at 3.01% and 3.99%. Compared with the dose sum, only the Dmax change rates for LAD on MIP, MinIP, and AIP images were <5% (all P > 0.05), at 4.96%, 4.01%, and 4.07%, respectively.

Conclusion: In LV dose-volume assessment, the differences in assessment metrics between MIP images and enhanced CT images are small, indicating that MIP imaging can serve as a supplementary method to enhanced CT imaging for this form of assessment.

Background: Chondrosarcoma is the second most common malignant primary bone tumor. Given the poorer prognosis of high-grade chondrosarcomas and the lack of prognostic tools, this study aimed to develop a nomogram for better prognosis evaluation.

Methods: A comprehensive approach was adopted, involving Kaplan-Meier analysis for survival curve generation, log-rank test for comparing survival differences, and multivariate Cox regression analysis for identifying independent prognostic determinants. Utilizing the "rms" package, nomograms were constructed to predict overall survival (OS) and cancer-specific survival (CSS) of patients with high-grade chondrosarcoma. Nomogram reliability was validated through the concordance index (C-index) and calibration curves, which quantitatively and graphically evaluated the predictive accuracy.

Results: A total of 1,198 high-grade chondrosarcoma cases retrieved from the SEER database were retrospectively analyzed. Following Kaplan-Meier survival analysis, several variables (age, sex, tumor size, stage, metastasis, surgery, chemotherapy, and radiation for OS) were incorporated into the multivariate Cox regression models for OS and CSS. Nomograms for OS and CSS were established based on the derived independent prognostic factors. The C-indices of the training and validation cohorts were 0.8117 and 0.7642 for the OS and 0.8475 and 0.8173 for the CSS analysis, respectively. The calibration plots further corroborated the nomograms' accurate predictive capacity for both OS and CSS.

Conclusion: Nomograms capable of precisely estimating OS and CSS in high-grade chondrosarcoma were successfully developed. These nomograms offer clinicians a valuable tool for more accurate survival prediction of patients with high-risk chondrosarcoma, which optimizes postoperative treatment strategies and improves patient management and outcomes.

Context: Thyroid nodules with intermediate- and low-suspicion patterns are difficult to diagnose, based on the 2015 American Thyroid Association (ATA) stratification.

Aims: We evaluated the performance of shear wave elastography (SWE) as an adjunctive tool to ultrasound (US) in predicting the malignancy of these thyroid nodules.

Settings and design: Thyroid nodules (n = 270) collected from January to April 2018 with low or intermediate suspicion for malignancy were evaluated.

Methods, materials, and statistical analyses: The maximum SWE elasticity values (Emax) for the nodules were examined and subsequently confirmed by pathology. SWE and ATA guidelines, as well as a combination of the two, were applied.

Results: Combined with SWE, the diagnostic accuracy of the ATA categories was superior to the ATA categories alone (area under the curve, AUC 0.81 vs. 0.72, P < 0.05). Based on the ATA categories, the percentages of malignancy in the nodules with low and intermediate suspicion for malignancy were 21.1% (12/57) and 54.2% (13/24), respectively. After adjustments for the use of SWE, the nodules were restratified as very low, low, intermediate, and high suspicion of malignancy. The percentages of malignancy for the very low, low, intermediate, and high suspicion nodules were 0 (0/26), 27.3% (3/11), 37.8% (12/31), and 76.9% (10/13), respectively.

Conclusion: SWE may be used to differentiate malignant and benign nodules in addition to the ATA pattern. Combined with the ATA pattern, SWE supplemented US for predicting nodules with low and intermediate suspicion of malignancy.

Background: The prognosis for patients with small cell lung cancer (SCLC), who develop liver metastases (LM) is extremely poor, and treatment options are limited. This study aimed to evaluate the efficacy and safety of hepatic arterial infusion (HAI) chemotherapy combined with systemic chemotherapy for patients diagnosed with LM-SCLC.

Subject and methods: From January 2019 to December 2023, HAI catheter systems were implanted in 15 patients with LM-SCLC, guided by digital subtraction angiography. All patients received systemic chemotherapy in combination with HAI using gemcitabine and floxuridine (FUDR).

Results: The overall response rate for intrahepatic lesions was 66.7%, including one patient (6.7%) with a complete response and nine (60.0%) with a partial response. Additionally, the median overall survival (mOS) was 13 months (95% confidence interval, 11.4-14.6 months). Notably, none of the patients experienced grade 4 adverse effects. However, the grade 3 adverse effects included leukopenia and neutropenia, which were well tolerated by all the patients.

Conclusions: HAI of gemcitabine and FUDR, alongside systemic chemotherapy, may serve as an effective treatment strategy for achieving a high local response and prolonging mOS in patients with LM-SCLC, while also being associated with a relatively low incidence of adverse effects.

Objectives: MDM2 inhibition restores p53 function, and even mutant p53 can induce cancer cell apoptosis. Notably, apoptosis and pyroptosis may interconvert during chemotherapy. This study aimed to explore the role of the MDM2-p53 pathway in the regulation of GSDME-mediated pyroptosis in lung adenocarcinoma.

Methods: Immunohistochemistry and Western blotting were employed to measure the expression levels of GSDMD, GSDME, cleaved PARP, and MDM2. Nutlin-3, an MDM2 inhibitor, was administered to 5-FU-treated wild-type A549 cells, wild-type HBE cells, GSDME-overexpressing HBE cells, and A549 cells overexpressing p53 codon 72 mutation.

Results: GSDMD and GSDME were expressed in lung adenocarcinoma tissues, adjacent nontumor tissues, and noncancerous lung tissues, whereas only GSDME was expressed in A549 and HBE cells. After chemotherapy, the N-terminal fragment of GSDME was expressed in HBE and A549 cells. GSDME had a significantly lower protein level in HBE cells than in A549 cells ( P = 0.0092). GSDME overexpression markedly increased pyroptosis in A549 ( P = 0.01) and HBE cells ( P = 1.72 × 10 -6 ). Nutlin-3 significantly reduced cell viability and pyroptosis while increasing apoptosis in 5-FU-treated wild-type A549 cells, A549 cells with the p53 codon 72 mutation, and GSDME-overexpressing HBE cells. However, it exerted no significant effects on wild-type HBE cells.

Conclusions: GSDME-mediated pyroptosis plays a pivotal role in chemotherapy-induced cell death in lung adenocarcinoma. MDM2 inhibition, which switches pyroptosis to apoptosis, can be employed to regulate chemotherapy-induced pyroptosis in lung cancer cells and normal tissue cells.

Background: Invasive breast carcinoma of no special type with medullary pattern (BCNST-MP) is a rare subtype of breast cancer. Previous studies have reported the high prevalence of the triple-negative phenotype in BCNST-MP. This study aimed to investigate the prevalence of human epidermal growth factor receptor 2 (HER2)-low and androgen receptor (AR) expression in this distinct breast cancer subtype.

Methods: We conducted a retrospective analysis of breast cancer patients diagnosed at our center between 2019 and 2024. Medical records and pathology reports were reviewed to assess the clinicopathological characteristics of BCNST-MP.

Results: A total of 45 patients with BCNST-MP met the inclusion criteria. The median age at diagnosis was 51 years. Most tumors (93.3%) measured ≤5 cm, and axillary lymph node metastasis was observed in 26.7% of cases. Eighty percent of the patients were estrogen receptor (ER)-negative, 84% were progesterone receptor (PR)-negative, and 75.6% were AR-negative. Regarding the HER2 status, 15.6% were HER2-positive, 33.3% exhibited HER2-low expression, and 51.1% had HER2-zero expression. With a median follow-up duration of 26 months, only one patient-a 30-year-old with triple-negative breast cancer-developed distant metastasis. An 82-year-old died of a cerebrovascular accident.

Conclusions: Our findings suggest that BCNST-MP tumors are rarely larger than 5 cm and are frequently lymph node-negative. Most patients were negative for ER, PR, AR, and HER2. Notably, HER2-low expression was observed in approximately 30% of cases, suggesting therapeutic implications.