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GAP JUNCTION FUNCTION IS ESSENTIAL FOR SURVIVAL OF ACUTE LYMPHOBLASTIC LEUKEMIA CELLS. 间隙连接功能对急性淋巴细胞白血病细胞的存活至关重要。
Pub Date : 2024-10-09 DOI: 10.15407/exp-oncology.2024.02.110
E Edwards, D Schenone, U Sivagnanalingam, S Perry, C A Mullen

Background: Acute lymphoblastic leukemia has an intimate physical relationship with nonmalignant bone marrow stromal cells. We have recently demonstrated that stromal cells contribute to the survival of leukemia cells and that there is a bidirectional transfer of intracellular material between them. Understanding the mechanisms of stromal support of leukemia may provide insights into new therapies.

Aim: To test the hypothesis that gap junctions are formed between acute lymphoblastic leukemia cells and nonmalignant stromal cells, and that gap junction function is essential for the survival of leukemia cells.

Materials and methods: We employed a well-characterized in vitro model of human bone marrow stromal cells and primary human B lymphoblastic leukemia cells and measured leukemia cell survival in coculture using flow cytometry. We measured the effects of gap junction antagonist peptides, carbenoxolone (a drug known to interfere with the gap junction function), and several leukemia chemotherapy drugs including methotrexate upon leukemia cell survival.

Results: We demonstrated that stromal cells need to be alive and metabolically active to keep leukemia cells alive. Physical contact between stromal and leukemia cells leads to an increase in gap junction proteins in leukemia cells. Gap junction inhibitory peptides impaired leukemia cell survival as did carbenoxolone, a nonpeptide inhibitor of the gap junction function. Stromal cell survival was not affected. We observed a very modest enhancement of methotrexate antileukemia activity by low-dose carbenoxolone but no significant interactions with dexamethasone, vincristine, mercaptopurine, or doxorubicin.

Conclusion: These studies demonstrate that acute lymphoblastic cell survival is impaired by interference with the gap junction function. The development of drugs targeting gap junctions may provide a novel approach to the therapy of acute lymphoblastic leukemia.

背景:急性淋巴细胞白血病与非恶性骨髓基质细胞有着密切的物理关系。我们最近证实,基质细胞有助于白血病细胞的存活,而且它们之间存在细胞内物质的双向转移。目的:检验急性淋巴细胞白血病细胞与非恶性基质细胞之间形成间隙连接的假设,以及间隙连接功能对白血病细胞存活至关重要的假设:我们采用了一种特性良好的人骨髓基质细胞和原代人B淋巴细胞白血病细胞体外模型,并使用流式细胞术测量了白血病细胞在共培养中的存活率。我们测量了间隙连接拮抗剂肽、卡泊酮(一种已知能干扰间隙连接功能的药物)和包括甲氨蝶呤在内的几种白血病化疗药物对白血病细胞存活的影响:结果:我们证明了基质细胞需要有活力和新陈代谢活跃才能使白血病细胞存活。基质细胞和白血病细胞之间的物理接触导致白血病细胞中间隙连接蛋白的增加。间隙连接抑制肽会影响白血病细胞的存活,卡贝诺酮也会影响白血病细胞的存活,卡贝诺酮是一种非肽间隙连接功能抑制剂。基质细胞的存活不受影响。我们观察到低剂量卡贝诺酮对甲氨蝶呤抗白血病活性有非常温和的增强作用,但与地塞米松、长春新碱、巯嘌呤或多柔比星没有明显的相互作用:这些研究表明,干扰间隙连接功能会影响急性淋巴细胞的存活。开发以间隙连接为靶点的药物可能会为急性淋巴细胞白血病的治疗提供一种新方法。
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引用次数: 0
DETECTION OF ORAL SQUAMOUS CELL CARCINOMA USING PRE-TRAINED DEEP LEARNING MODELS. 使用预训练的深度学习模型检测口腔鳞状细胞癌。
Pub Date : 2024-10-09 DOI: 10.15407/exp-oncology.2024.02.119
K Dhanya, D Venkata Vara Prasad, Y Venkataramana Lokeswari

Background: Oral squamous cell carcinoma (OSCC), the 13th most common type of cancer, claimed 364,339 lives in 2020. Researchers have established a strong correlation between early detection and better prognosis for this type of cancer. Tissue biopsy, the most common diagnostic method used by doctors, is both expensive and time-consuming. The recent growth in using transfer learning methodologies to aid in medical diagnosis, along with the improved 5-year survival rate from early diagnosis serve as motivation for this study. The aim of the study was to evaluate an innovative approach using transfer learning of pre-trained classification models and convolutional neural networks (CNN) for the binary classification of OSCC from histopathological images.

Materials and methods: The dataset used for the experiments consisted of 5192 histopathological images in total. The following pre-trained deep learning models were used for feature extraction: ResNet-50, VGG16, and InceptionV3 along with a tuned CNN for classification.

Results: The proposed methodologies were evaluated against the current state of the art. A high sensitivity and its importance in the medical field were highlighted. All three models were used in experiments with different hyperparameters and tested on a set of 126 histopathological images. The highest-performance developed model achieved an accuracy of 0.90, a sensitivity of 0.97, and an AUC of 0.94. The visualization of the results was done using ROC curves and confusion matrices. The study further interprets the results obtained and concludes with suggestions for future research.

Conclusion: The study successfully demonstrated the potential of using transfer learning-based methodologies in the medical field. The interpretation of the results suggests their practical viability and offers directions for future research aimed at improving diagnostic precision and serving as a reliable tool to physicians in the early diagnosis of cancer.

背景:口腔鳞状细胞癌(OSCC口腔鳞状细胞癌(OSCC)是第 13 位最常见的癌症类型,2020 年将夺去 364 339 人的生命。研究人员发现,早期发现与更好的预后之间存在密切联系。组织活检是医生最常用的诊断方法,既昂贵又耗时。最近,利用迁移学习方法辅助医学诊断的研究越来越多,而且早期诊断提高了 5 年生存率,这些都是本研究的动机。本研究的目的是评估一种创新方法,即利用预训练分类模型和卷积神经网络(CNN)的迁移学习,对组织病理学图像中的 OSCC 进行二元分类:实验使用的数据集由总共 5192 张组织病理学图像组成。特征提取使用了以下预先训练好的深度学习模型:ResNet-50、VGG16 和 InceptionV3,以及用于分类的经过调整的 CNN:根据目前的技术水平对所提出的方法进行了评估。高灵敏度及其在医疗领域的重要性得到了强调。所有三个模型都在实验中使用了不同的超参数,并在一组 126 张组织病理学图像上进行了测试。所开发的性能最高的模型准确率达到 0.90,灵敏度达到 0.97,AUC 达到 0.94。研究使用 ROC 曲线和混淆矩阵对结果进行了可视化。研究进一步解释了获得的结果,并对未来研究提出了建议:本研究成功证明了在医学领域使用基于迁移学习的方法的潜力。对结果的解释说明了其实际可行性,并为今后的研究提供了方向,旨在提高诊断的精确度,并作为医生早期诊断癌症的可靠工具。
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引用次数: 0
MELATONIN ENHANCES TEMOZOLOMIDE-INDUCED APOPTOSIS IN GLIOBLASTOMA AND NEUROBLASTOMA CELLS. 褪黑素可增强替莫唑胺诱导的胶质母细胞瘤和神经母细胞瘤细胞凋亡。
Pub Date : 2024-10-09 DOI: 10.15407/exp-oncology.2024.02.087
A Bostanci, O Doganlar

Background: The combination of temozolomide (TMZ) and paclitaxel (PTX) is the most commonly used chemotherapy regimen for glioblastoma, but there is no specific treatment for neuroblastoma due to the acquired multidrug resistance. Approximately half of treated glioblastoma patients develop resistance to TMZ and experience serious side effects. Melatonin (MEL), a multifunctional hormone long known for its antitumor effects, has a great advantage in combination cancer therapy thanks to its ability to affect tumors differently than normal cells.

Aim: This study aims to evaluate the in vitro inhibitory effects of MEL in combination with TMZ on cancer cell viability and to elucidate the underlying mechanisms in the glioblastoma and neuroblastoma cell lines.

Materials and methods: C6 (Rattus norvegicus) and N1E-115 (Mus musculus) cancer cell lines and C8-D1A (mice) healthy cell lines were used. Cell proliferation was evaluated using the MTT test. IC50 values were determined by probit analysis. Two concentrations of TMZ (IC50 and 1/2 IC50) were used to induce cytotoxicity in the C6 and N1E-115 cell lines, both alone and in combination with PXT and MEL (all at IC50). The viable, dead, and apoptotic cells were determined by image-based cytometry using Annexin V/PI staining. The gene expression related to signaling pathways was assessed by the quantitative reverse transcription polymerase chain reaction (qRT-PCR), and key proteins were identified by the Western blot analysis.

Results: MTT assay showed that the combination of TMZ and MEL significantly reduces the viability of both glioblastoma and neuroblastoma cells compared to the vehicle-treated controls. Notably, MEL combined with 1/2 IC50 TMZ showed a significant death rate of cancer cells compared to controls and PTX. According to qRT-PCR data, the TMZ + MEL combination resulted in the upregulation of the genes of antioxidative enzymes (Sod1 and Sod2) and DNA repair genes (Mlh1, Exo1, and Rad18) in both cell lines. Moreover, the levels of Nfkb1 and Pik3cg were significantly reduced following the TMZ + MEL treatment. The combination of MEL with TMZ also enhanced the cell cycle arrest and increased the expression of p53 and pro-apoptotic proteins (Bax and caspase-3), while significantly decreasing the expression of anti-apoptotic protein Bcl-2.

Conclusions: Our findings indicate that the combination of MEL with a low dose of TMZ may serve as an upstream inducer of apoptosis. This suggests the potential development of a novel selective therapeutic strategy as an alternative to TMZ for the treatment of both glioblastoma and neuroblastoma.

背景:替莫唑胺(TMZ)和紫杉醇(PTX)联合疗法是治疗胶质母细胞瘤最常用的化疗方案,但由于神经母细胞瘤具有获得性多药耐药性,目前尚无针对神经母细胞瘤的特效疗法。大约一半接受过治疗的胶质母细胞瘤患者会对 TMZ 产生耐药性,并出现严重的副作用。褪黑素(MEL)是一种多功能激素,长期以来以其抗肿瘤作用而闻名,由于其对肿瘤的影响不同于正常细胞,因此在癌症联合治疗中具有很大的优势。目的:本研究旨在评估MEL与TMZ联合使用对癌细胞活力的体外抑制作用,并阐明胶质母细胞瘤和神经母细胞瘤细胞系的潜在机制:使用 C6(鼠)和 N1E-115(麝)癌细胞株和 C8-D1A(小鼠)健康细胞株。细胞增殖采用 MTT 试验进行评估。IC50 值通过 probit 分析确定。两种浓度的 TMZ(IC50 和 1/2 IC50)用于诱导 C6 和 N1E-115 细胞系产生细胞毒性,既可单独使用,也可与 PXT 和 MEL(均为 IC50)联合使用。活细胞、死细胞和凋亡细胞是通过Annexin V/PI染色的图像细胞计数法测定的。通过定量反转录聚合酶链反应(qRT-PCR)评估与信号通路相关的基因表达,并通过 Western 印迹分析鉴定关键蛋白:MTT试验表明,与药物治疗对照组相比,TMZ和MEL联合使用可显著降低胶质母细胞瘤和神经母细胞瘤细胞的存活率。值得注意的是,与对照组和PTX相比,MEL与1/2 IC50 TMZ联用可显著提高癌细胞的死亡率。根据 qRT-PCR 数据,TMZ + MEL 组合可导致两种细胞系中的抗氧化酶基因(Sod1 和 Sod2)和 DNA 修复基因(Mlh1、Exo1 和 Rad18)上调。此外,TMZ + MEL 处理后,Nfkb1 和 Pik3cg 的水平明显降低。MEL 与 TMZ 联用还能增强细胞周期的停滞,增加 p53 和促凋亡蛋白(Bax 和 caspase-3)的表达,同时明显降低抗凋亡蛋白 Bcl-2 的表达:我们的研究结果表明,MEL与低剂量TMZ的联合用药可作为凋亡的上游诱导剂。这表明有可能开发出一种新型的选择性治疗策略,替代 TMZ 治疗胶质母细胞瘤和神经母细胞瘤。
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引用次数: 0
LONG-TERM NATURAL HISTORY OF GIANT NULL CELL PITUITARY ADENOMA. 巨型空细胞垂体腺瘤的长期自然史。
Pub Date : 2024-10-09 DOI: 10.15407/exp-oncology.2024.02.165
O Ukrainets, M Guk, O Danevych, A Chukov, A Mumliev, M Solovey, K Egorova, D Tevzadze, A Naboichenko

Pituitary adenomas that extend to the ventricular system are extremely rare. We present a 5-year natural history of a giant null cell pituitary adenoma with invasion into the cavernous sinus extending to the third ventricle. MRI series that were available could be useful for neurosurgeons, ophthalmologists, and endocrinologists as well as radiologists. Patients with the diagnosis of pituitary adenoma that are certain according to the radiological and clinical examination should be consulted by a neurosurgeon experienced in endoscopic endonasal surgery, a neuroendocrinologist, and an ophthalmologist. The surgery postponement in such cases results in disability and quality of life worsening. At that time, the surgery of giant pituitary adenomas demands high skills, and the risk of postoperative complications is high. The proper treatment modality including earlier surgery seems to be favorable for patient outcome.

延伸至脑室系统的垂体腺瘤极为罕见。我们介绍了一个侵犯海绵窦并延伸至第三脑室的巨大空细胞垂体腺瘤的 5 年自然病史。现有的核磁共振成像系列对神经外科医生、眼科医生、内分泌科医生以及放射科医生都很有用。根据放射学和临床检查确诊为垂体腺瘤的患者,应接受有内窥镜手术经验的神经外科医生、神经内分泌科医生和眼科医生的会诊。在这种情况下推迟手术会导致残疾和生活质量恶化。当时,巨大垂体腺瘤的手术对医生的技术要求很高,术后并发症的风险也很高。适当的治疗方式,包括尽早手术,似乎有利于患者的预后。
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引用次数: 0
CONSIDERING DIMETHYL SULFOXIDE SOLVENT TOXICITY TO MAMMALIAN CELLS AND ITS BIOLOGICAL EFFECTS. 考虑二甲基亚砜溶剂对哺乳动物细胞的毒性及其生物效应。
Pub Date : 2024-10-09 DOI: 10.15407/exp-oncology.2024.02.174
Siti Nazihahasma Hassan, Farizan Ahmad

Dimethyl sulfoxide (DMSO) is a common solvent in biological and medical research for dissolving water-insoluble compounds and drugs. However, the impact of DMSO goes beyond its primary function. High-throughput and in vitro assays have uncovered various effects of DMSO in mammalian cells. The present article highlights the biological effects of DMSO on normal and cancerous mammalian cells.

二甲基亚砜(DMSO)是生物和医学研究中常用的溶剂,用于溶解不溶于水的化合物和药物。然而,二甲基亚砜的影响超出了它的主要功能。高通量和体外检测发现了二甲基亚砜对哺乳动物细胞的各种影响。本文重点介绍了二甲基亚砜对正常和癌变哺乳动物细胞的生物效应。
{"title":"CONSIDERING DIMETHYL SULFOXIDE SOLVENT TOXICITY TO MAMMALIAN CELLS AND ITS BIOLOGICAL EFFECTS.","authors":"Siti Nazihahasma Hassan, Farizan Ahmad","doi":"10.15407/exp-oncology.2024.02.174","DOIUrl":"https://doi.org/10.15407/exp-oncology.2024.02.174","url":null,"abstract":"<p><p>Dimethyl sulfoxide (DMSO) is a common solvent in biological and medical research for dissolving water-insoluble compounds and drugs. However, the impact of DMSO goes beyond its primary function. High-throughput and in vitro assays have uncovered various effects of DMSO in mammalian cells. The present article highlights the biological effects of DMSO on normal and cancerous mammalian cells.</p>","PeriodicalId":94318,"journal":{"name":"Experimental oncology","volume":"46 2","pages":"174-178"},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
CLINICAL SIGNIFICANCE OF SALIVARY MIR-21, -155, AND -375 IN PATIENTS WITH SQUAMOUS CELL CARCINOMA OF ORAL CAVITY. 口腔鳞状细胞癌患者唾液 mir-21、-155 和 -375 的临床意义。
Pub Date : 2024-10-09 DOI: 10.15407/exp-oncology.2024.02.139
O Burtyn, T Borikun, O Rossylna, A Kopchak, О Kravets

Background: The current prognostic markers in oral squamous cell carcinoma (OSCC) have limited accuracy sometimes leading to inappropriate treatment decisions. Identifying new markers would help clinicians tailor treatment plans based on the individual patient risk factors leading to improved survival rates and quality of life.

Aim: To estimate the value of the miRNA expression indicators in saliva as prognostic and predictive markers of the effectiveness of neoadjuvant chemotherapy (NACT).

Materials and methods: The work is based on the results of the examination and treatment of 61 patients with stage II-IV OSCC. The miR-21, miR-155, and miR-375 expression levels in the saliva samples were analyzed by the real-time reverse transcription polymerase chain reaction.

Results: The salivary miR-21 and -155 expression levels in healthy volunteers were 2.49 and 2.84 times lower than in OSCС patients (p < 0.05). The positive association of miR-21 and miR-155 expression levels and the negative correlation of miR-375 expression level with T index by TNM (r = 0.68, r = 0.75, and r = -0.67, respectively) (p < 0.05) and the presence of lymph node metastasis (r = 0.78, r = 0.71, and r = ‒0.59, respectively) (p < 0.05) were found. Patients with good response to NACT had lower miR-21 and -155, and higher miR-375 levels in saliva compared to those with resistant tumors.

Conclusions: Our study suggests that salivary miR-21, miR-155, and miR-375 may be potential biomarkers for the prognosis of cancer course and the response to NACT in OSCC patients.

背景:目前口腔鳞状细胞癌(OSCC)的预后指标准确性有限,有时会导致治疗决策不当。目的:估计唾液中 miRNA 表达指标作为新辅助化疗(NACT)有效性的预后和预测指标的价值:本研究以61例II-IV期OSCC患者的检查和治疗结果为基础。结果:唾液样本中的 miR-21、miR-155 和 miR-375 表达水平通过实时逆转录聚合酶链反应进行了分析:结果:健康志愿者唾液中miR-21和-155的表达水平分别是OSCС患者的2.49倍和2.84倍(P < 0.05)。研究发现,miR-21和miR-155的表达水平与TNM的T指数(r = 0.68、r = 0.75和r = -0.67,分别为0.68、r = 0.75和r = -0.67)呈正相关,与淋巴结转移(r = 0.78、r = 0.71和r = -0.59,分别为0.78、r = 0.71和r = -0.59)呈负相关(p < 0.05)。与耐药肿瘤患者相比,对NACT反应良好的患者唾液中的miR-21和-155水平较低,而miR-375水平较高:我们的研究表明,唾液中的miR-21、miR-155和miR-375可能是预测OSCC患者癌症病程和对NACT反应的潜在生物标志物。
{"title":"CLINICAL SIGNIFICANCE OF SALIVARY MIR-21, -155, AND -375 IN PATIENTS WITH SQUAMOUS CELL CARCINOMA OF ORAL CAVITY.","authors":"O Burtyn, T Borikun, O Rossylna, A Kopchak, О Kravets","doi":"10.15407/exp-oncology.2024.02.139","DOIUrl":"https://doi.org/10.15407/exp-oncology.2024.02.139","url":null,"abstract":"<p><strong>Background: </strong>The current prognostic markers in oral squamous cell carcinoma (OSCC) have limited accuracy sometimes leading to inappropriate treatment decisions. Identifying new markers would help clinicians tailor treatment plans based on the individual patient risk factors leading to improved survival rates and quality of life.</p><p><strong>Aim: </strong>To estimate the value of the miRNA expression indicators in saliva as prognostic and predictive markers of the effectiveness of neoadjuvant chemotherapy (NACT).</p><p><strong>Materials and methods: </strong>The work is based on the results of the examination and treatment of 61 patients with stage II-IV OSCC. The miR-21, miR-155, and miR-375 expression levels in the saliva samples were analyzed by the real-time reverse transcription polymerase chain reaction.</p><p><strong>Results: </strong>The salivary miR-21 and -155 expression levels in healthy volunteers were 2.49 and 2.84 times lower than in OSCС patients (p < 0.05). The positive association of miR-21 and miR-155 expression levels and the negative correlation of miR-375 expression level with T index by TNM (r = 0.68, r = 0.75, and r = -0.67, respectively) (p < 0.05) and the presence of lymph node metastasis (r = 0.78, r = 0.71, and r = ‒0.59, respectively) (p < 0.05) were found. Patients with good response to NACT had lower miR-21 and -155, and higher miR-375 levels in saliva compared to those with resistant tumors.</p><p><strong>Conclusions: </strong>Our study suggests that salivary miR-21, miR-155, and miR-375 may be potential biomarkers for the prognosis of cancer course and the response to NACT in OSCC patients.</p>","PeriodicalId":94318,"journal":{"name":"Experimental oncology","volume":"46 2","pages":"139-145"},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
LABORATORY PREDICTORS FOR DIAGNOSING COLORECTAL ANASTOMOTIC LEAKAGE. 诊断结肠直肠吻合口漏的实验室预测指标。
Pub Date : 2024-10-09 DOI: 10.15407/exp-oncology.2024.02.146
M Gordiichuk, S Myasoyedov

Background: An important concern in oncological coloproctology is colorectal anastomotic leakage (AL), which occurs in 3.5%-21% of patients. Predicting the occurrence of failure based on the results of laboratory markers can be decisive for the treatment of this complication.

Aim: To improve the early diagnosis of AL by establishing combinations and threshold values of laboratory markers - predictors of the inflammatory process.

Materials and methods: The prospective study, conducted from 2020 to 2023, included 213 rectal cancer patients who underwent low anterior resection after neoadjuvant chemoradiotherapy. The inflammatory biomarkers were assessed before surgery and on the 3rd, 5th, and 7th days of the postoperative period.

Results: AL diagnosed in 25 (11.74%) patients by the grade of severity was as follows: A (radiological) in 7 (3.29%) patients; B (clinical) - 4 (1.88%); C (clinically expressed, peritonitis) - 11 (5.16%), and P (late) - 3 (1.41%) patients. The changes in the laboratory indicators of the inflammatory response such as С-reactive protein (CRP), procalcitonin (PCT), the counts of neutrophils (NEU), lymphocytes (LYM), platelets (PLT), and neutrophil/lymphocyte ratio (NLR) were significant only in B or C AL grades. Among them, only three indicators were identified as significant for predicting AL when assessed 24 h before the onset of this complication, namely LYM (threshold value ≤ 0.97 × 103/mm3, sensitivity 66.7% and specificity 81.3%, p < 0.001); PLT (threshold value > > 257 103/mm3, sensitivity 58.6%, and specificity 86.7%, p < 0.001); and NLR (threshold value > 4.42, sensitivity 58.1%, and specificity 86.7%, p < 0.001). The three-factor model based on these selected indicators was set up, and the prognosis index (Prog) was proposed with the decision threshold Progcrit = 2.23. The sensitivity of the model was 80% (95% CI 51.9%-95.7%), and the specificity - 74.2% (67.6%-80.2%).

Conclusion: Based on the routine laboratory predictors used in the complex diagnosis of AL, B or C AL grades may be predicted allowing for the timely effective early diagnosis, medication, and surgical intervention..

背景:肿瘤结直肠科的一个重要问题是结直肠吻合口漏(AL),发生率为3.5%-21%。目的:通过建立实验室标记物的组合和阈值--炎症过程的预测因子,提高 AL 的早期诊断率:这项前瞻性研究于2020年至2023年进行,纳入了213名在新辅助化放疗后接受低位前切除术的直肠癌患者。在手术前和术后第3、5、7天对炎症生物标志物进行了评估:25例(11.74%)患者确诊为AL,严重程度分级如下:A(放射学)7 例(3.29%);B(临床)4 例(1.88%);C(临床表现,腹膜炎)11 例(5.16%);P(晚期)3 例(1.41%)。炎症反应的实验室指标,如С-反应蛋白(CRP)、降钙素原(PCT)、中性粒细胞(NEU)、淋巴细胞(LYM)、血小板(PLT)和中性粒细胞/淋巴细胞比值(NLR)的变化仅在 B 或 C AL 等级中显著。在这些指标中,只有三个指标在并发症发生前 24 小时进行评估时对预测 AL 有显著意义,它们是 LYM(阈值≤ 0.97 × 103/mm3,灵敏度为 66.7%,特异度为 81.3%,P<0.001);PLT(阈值>>257 103/mm3,灵敏度为 58.6%,特异度为 86.7%,P<0.001);NLR(阈值>4.42,灵敏度为 58.1%,特异度为 86.7%,P<0.001)。根据这些选定的指标建立了三因素模型,并提出了预后指数(Prog),决策阈值为 Progcrit = 2.23。该模型的灵敏度为 80%(95% CI 51.9%-95.7%),特异性为 74.2%(67.6%-80.2%):结论:根据用于 AL 复杂诊断的常规实验室预测指标,可以预测 AL 的 B 级或 C 级,以便及时有效地进行早期诊断、药物治疗和手术干预。
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引用次数: 0
DIFFERENTIAL TREATMENT EFFECTS OF STANDARD AND HYPOFRACTIONATED RADIATION REGIMENS IN GLIOBLASTOMA PATIENTS. 对胶质母细胞瘤患者采用标准和低分次放射治疗方案的不同治疗效果。
Pub Date : 2024-10-09 DOI: 10.15407/exp-oncology.2024.02.129
O Glavatskyi, A Gryazov, V Stuley, A Loeser, D Rades, O Zemskova

Background: The identification of the subgroups with differential treatment effects (DTE) is important for decisionmaking in personalized treatment. The DTE analysis assists in identifying patients who are more likely to benefit from a particular treatment regimen. The aim of the study was to analyze DTE in terms of the survival of glioblastoma (GBM) patients in the groups of standard radiotherapy (SRT) and hypofractionated radiotherapy (HRT) by the multicluster modeling of homogenous groups while retaining the statistical characteristics of the overall primary study cohort.

Patients and methods: The cohort of 159 patients with newly diagnosed GBM stratified according to the radiotherapy regimen (HRT group (n = 110/69.2%); SRT group (n = 49/30.8%)) was evaluated retrospectively. Forty-eight subgroups (multiclusters) were created by enumerating all possible combinations of 5 significant covariates (age, sex, the radicality of the surgical resection, chemotherapy, and Karnofsky performance status) of the Cox model. The DTE for the cancerspecific survival (CSS) within 48 modeled multiclusters were studied by comparing the interpolated Weibull CSS curves according to the Kolmogorov - Smirnov test.

Results: The findings showed that the SRT group was superior to the HRT group by CSS only in 3 of the modeled clusters presenting clinical scenarios with a non-radical tumor resection, no chemotherapy, and low Karnofsky functional status (≤ 70 scores) (Cluster 10: male aged < 60; Cluster 21: female aged ≥ 60; Cluster 22: male aged ≥ 60). Most of the studied clinical variants (45 of 48 multiclusters) did not demonstrate a significant difference when comparing the interpolated Weibull curves of the CSS for the SRT and HRT groups according to the Kolmogorov - Smirnov test (p ≥ 0.05).

Conclusions: We propose a novel multicluster modeling approach that addresses DTE in relatively small samples of GBM patients receiving SRT or HRT. This original analytical method can be taken into consideration while designing new well-powered prospective trials aimed at the subgroup analysis in GBM patients who will be most beneficial from personalized treatment strategies.

背景:识别具有不同治疗效果(DTE)的亚组对于个性化治疗的决策非常重要。DTE 分析有助于确定哪些患者更有可能从特定的治疗方案中获益。该研究旨在通过同质组的多簇建模,分析标准放疗(SRT)组和低分量放疗(HRT)组胶质母细胞瘤(GBM)患者生存率方面的DTE,同时保留整个主要研究队列的统计特征:回顾性评估了根据放疗方案分层的159例新诊断GBM患者队列(HRT组(n = 110/69.2%);SRT组(n = 49/30.8%))。通过列举 Cox 模型中 5 个重要协变量(年龄、性别、手术切除根治性、化疗和 Karnofsky 表 现状态)的所有可能组合,创建了 48 个亚组(多群)。根据 Kolmogorov - Smirnov 检验,通过比较插值 Weibull CSS 曲线,研究了 48 个建模多组内癌症特异性生存(CSS)的 DTE:研究结果表明,SRT组的CSS优于HRT组,仅在3个模型群组中存在非根治性肿瘤切除、无化疗和低Karnofsky功能状态(≤70分)的临床情况(群组10:男性年龄<60岁;群组21:女性年龄≥60岁;群组22:男性年龄≥60岁)。根据 Kolmogorov - Smirnov 检验(p ≥ 0.05),在比较 SRT 组和 HRT 组 CSS 的内插 Weibull 曲线时,所研究的大多数临床变异(48 个多聚类中的 45 个)未显示出显著差异:我们提出了一种新颖的多簇建模方法,可解决接受 SRT 或 HRT 的相对较小样本 GBM 患者的 DTE 问题。在设计新的有充分证据支持的前瞻性试验时,可以考虑采用这种独创的分析方法,对最能从个性化治疗策略中获益的 GBM 患者进行亚组分析。
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引用次数: 0
SEVERE DISEASE PROGRESSION OF POSTMOLAR GESTATIONAL NEOPLASM IN A VIETNAMESE YOUNG FEMALE PATIENT AFTER TREATMENT REFUSAL: INSIGHTS FROM A CASE REPORT AND LITERATURE REVIEW. 一名越南年轻女性患者在拒绝接受治疗后,乳晕后妊娠肿瘤出现严重的疾病进展:病例报告和文献综述的启示。
Pub Date : 2024-10-09 DOI: 10.15407/exp-oncology.2024.02.154
Thanh Nhan Vo, Phuc Nhon Nguyen

Choriocarcinoma is characterized as the most aggressive malignant alternation of gestational trophoblastic neoplasm; however, this illness is a curable malignancy. Although a rarity, this disease affects a female patient's life and causes a fatal condition. Choriocarcinoma is a life-threatening disease since it is initially insidious and can rapidly lead to masive hemorrhage, even death. Choriocarcinoma should be suspected in childbearing-age women with the high-risk scores according to FIGO. The study aims to report a severe case of widespread metastatic choriocarcinoma to optimize the treatment with multiagent chemotherapy and a multidisciplinary cooperation at our center. A G1P0 20-year-old woman was referred to the hospital for suspicion of metastatic choriocarcinoma after self-stopping chemotherapy because of the COVID-19 pandemic. During hospitalization, the tumor metastasized and presented profuse intraabdominal hemorrhage. The patient underwent immediate surgical intervention to control bleeding, and a definitive diagnosis was accurately established by the histopathological examination. After surgery, the EMA/CO regimen was administered as the first line of treatment, despite the patient being in a coma and requiring a ventilator machine. After 6 cycles of the EMA/CO regimen, her serum β-hCG level decreased to 8 mUI/mL, however, her β-hCG concentration was not down to a negative value. Thus, the patient received paclitaxel/cisplatin alternating with paclitaxel/etoposide (TP/TE regimen) for complete remission following 2 cycles. The delays in choriocarcinoma treatment are prognostic factors for worse outcomes, whereas chemotherapy may be considered a suitable treatment even in a patient's coma, thus improving a prognosis substantially.

绒毛膜癌是妊娠滋养细胞肿瘤中最具侵袭性的恶性变异,但这种疾病是一种可以治愈的恶性肿瘤。这种疾病虽然罕见,但却会影响女性患者的生命,并导致死亡。绒毛膜癌是一种危及生命的疾病,因为它起病隐匿,可迅速导致大出血,甚至死亡。根据 FIGO 的规定,育龄妇女在进行高风险评分时应怀疑是否患有绒毛膜癌。本研究旨在报告一例严重的广泛转移性绒毛膜癌病例,以优化本中心多药化疗和多学科合作的治疗方案。一名 20 岁的 G1P0 女性患者因 COVID-19 大流行而自行停止化疗,因怀疑转移性绒毛膜癌而转入我院。住院期间,肿瘤发生转移并出现腹腔内大量出血。患者立即接受了手术治疗以控制出血,并通过组织病理学检查准确确诊。手术后,尽管患者处于昏迷状态,需要使用呼吸机,但仍将 EMA/CO 方案作为一线治疗方案。经过6个周期的EMA/CO治疗后,她的血清β-hCG水平降至8 mUI/mL,但β-hCG浓度并未降至负值。因此,患者接受了紫杉醇/顺铂与紫杉醇/依托泊苷交替治疗(TP/TE 方案),两个周期后病情完全缓解。绒毛膜癌治疗的延误是预后较差的因素,而化疗即使在患者昏迷时也可被视为一种合适的治疗方法,从而大大改善预后。
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引用次数: 0
ONCOLYTIC ACTIVITY OF HUMAN RESPIRATORY SYNCYTIAL VIRUS. 人类呼吸道合胞病毒的溶瘤活性。
Pub Date : 2024-10-09 DOI: 10.15407/exp-oncology.2024.02.081
D Dahrizal, Ibrahim M Aziz, Gani Asa Dudin, R Bhat

Oncolytic viruses (OVs) are emerging as novel tools in cancer therapy. Oncolytic virotherapy offers an attractive therapeutic combination of tumor-specific killing and immune co-stimulation, therefore amplifying the host immune response against tumors. Moreover, OVs can be engineered for the expression of different immunostimulatory molecules to optimize and enhance the efficacy of oncolytic virotherapy. The effectiveness of OVs has been demonstrated in many preclinical studies for different types of cancers to achieve the aim of personalized cancer therapy. Human respiratory syncytial virus (RSV), an RNA virus of the Pneumoviridae family causes severe lower respiratory tract infections in infants and immunocompromised individuals. Interestingly, the oncolytic activity of RSV demonstrated in human prostate, hepatocellular, and dermal cancer cells is mostly mediated via apoptotic cell death associated with the impaired NF-κB activation or with the defect of the IFNα/β-induced STAT-1 activation. At the same time, the studies on cervical cancer revealed that RSV infection resulted in autophagy activation and apoptosis through the ROS-BAX and TNF- α-mediated pathways. The rational combinations of OVs, including RSV, with other approaches may benefit patients whose response to conventional therapies is limited. Here, we discuss the oncolytic activity of RSV and its potential use against different types of cancer.

肿瘤溶解病毒(OV)正在成为癌症治疗的新工具。肿瘤溶解病毒疗法将肿瘤特异性杀伤与免疫协同刺激相结合,从而增强了宿主对肿瘤的免疫反应。此外,还可以设计表达不同免疫刺激分子的 OV,以优化和提高溶瘤病毒疗法的疗效。在许多临床前研究中,OVs 对不同类型癌症的疗效已得到证实,从而实现了个性化癌症治疗的目标。人类呼吸道合胞病毒(RSV)是肺炎病毒科的一种 RNA 病毒,会导致婴儿和免疫力低下的人出现严重的下呼吸道感染。有趣的是,RSV 在人类前列腺癌、肝癌和皮肤癌细胞中的溶瘤活性主要是通过与 NF-κB 激活受损或 IFNα/β 诱导的 STAT-1 激活缺陷相关的细胞凋亡介导的。同时,对宫颈癌的研究表明,RSV 感染可通过 ROS-BAX 和 TNF- α 介导的途径导致自噬激活和细胞凋亡。将包括RSV在内的OV与其他方法合理结合,可能会使对传统疗法反应有限的患者受益。在此,我们将讨论 RSV 的溶瘤活性及其用于治疗不同类型癌症的潜力。
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引用次数: 0
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Experimental oncology
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