Risk factors of rib metastases in nasopharyngeal carcinoma patients with rib 99mTc- MDP foci on whole-body bone scansCSCD

Objective To investigate the correlation of rib 99mTc-MDP foci on whole-body bone scan with clinical variables and rib metastases in nasopharyngeal carcinoma(NPC) patients, and to screen the risk factors of rib metastases. Methods We retrospectively reviewed 312 NPC patients with rib 99mTc-MDP foci on wholebody bone scan. Chi-square test and logistic regression were performed to evaluate the correlation between clinical variables and rib metastases. Results In all 312 NPC patients, rib metastases were associated with T stage, skull base bone invasion, other bone metastasis, number of rib foci, lateral localization on rib and foci type (P<0.01), and the risk factors of rib metastasis included skull base bone invasion, other bone metastases, lateral localization on rib and foci type (P<0.05). In 176 patients with pure rib foci, rib metastases were closely related to T stage, skull base bone invasion, other bone metastasis, number of rib foci and lateral localization on rib (P<0.05), while only lobar distribution (P=0.029) was the effective risk factor. In 198 patients with single rib focus, rib metastases were affected by skull base bone invasion and foci type (P<0.01), while only foci type (P=0.000) was the effective risk factor. In all 566 rib foci, uptake level and localization on rib were the effective risk factors of rib metastases(P<0.01). Conclusion In NPC patients with rib foci on whole body bone scan, the effective risk factors of rib metastases include skull base bone invasion, other bone metastases, lateral localization on rib, foci type, uptake level and anterior and posterior localization on rib. Follow up should be the main way for the pure rib foci on unilateral ribs. For multiples rib foci on bilateral ribs or single rib focus combined with other bones foci, additional image modalities should be required to exclude bone metastasis. © 2020, CHINA RESEARCH ON PREVENTION AND TREATMENT. All rights reserved.     

细胞黏附分子CD99在人髓母细胞瘤中的表达及意义

目的 探讨细胞黏附分子CD99在人髓母细胞瘤组织中的表达特点及其临床意义。方法 采用免疫组化法检测107例髓母细胞瘤及15例瘤旁正常脑组织标本中CD99的表达。所有病人均随访至死亡或截止至2013年12月，随访时间为12~80个月，利用Kaplan-Meier生存曲线进行生存分析。结果 髓母细胞瘤CD99阳性表达率（57.94%，62/107）明显高于瘤周正常脑组织（0%，0/15；P<0.05）。CD99的表达水平与病人性别、年龄、肿瘤的病理组织学分型和分子亚型均无明显相关性（P>0.05）。CD99的高表达与髓母细胞瘤病人的预后呈显著负相关（P<0.05）。结论 CD99高表达与髓母细胞瘤预后显著相关，可作为预后判断的指标及治疗髓母细胞瘤潜在的新靶点。     

Oesophageal carcinoma with solitary patellar metastasis: a rare case report

The incidence of tumours found in the patella, including primary and metastatic tumours, is low. Solitary metastasis of oesophageal carcinoma (OC) in the patella is even rarer. A 50-year-old man presented to our clinic because of pain and limited range of motion in the right knee for 4 hours and after a fall. On the basis of the patient’s medical history, he was diagnosed with OC 2 months previously and underwent two cycles of paclitaxel liposome combined with tiggio chemotherapy (oral tiggio, 40 mg, two times/day, with a treatment cycle of 3 weeks). A 99mTc-methylene diphosphonate bone scintigraphy scan showed increased radioactivity in the right patella. A right knee biopsy showed the presence of patellar metastasis from OC. Unfortunately, the patient denied additional treatment and was discharged for personal reasons. At the 1-month follow-up, which was conducted by a telephone survey, we learned that the patient had died of acute pulmonary embolism. X-rays and computed tomography are useful for diagnosing patellar metastases, but 99mTc-methylene diphosphonate bone scintigraphy can help physicians diagnose patellar metastasis of OC more rapidly. Biopsy with pathology is the gold standard for diagnosing patellar metastases. Additionally, timely surgical treatment prolongs the survival time of these patients.     

Time-Dependent Effects of Cryoablation for Renal Tumor on Overall and Split Renal Function

Purpose

To evaluate the influence of percutaneous cryoablation for renal cell carcinoma on function of the affected kidney.

肿瘤相关巨噬细胞相关性miR-99a对子宫内膜癌细胞生长和侵袭的调控作用

背景与目的：肿瘤相关巨噬细胞（tumor-associated macrophage，TAM）浸润与肿瘤进展密切相关，但作用机制尚不明确，因此，探索miR-99a对单核巨噬细胞极化的影响及其对子宫内膜癌（endometrial cancer，EC）细胞生长、侵袭的影响。方法：检测EC组织中巨噬唾液酸蛋白（macrosialin）CD68表达并分析其与临床病理学特征之间的关系；运用人EC细胞系HEC-1B、RL95-2培养上清液诱导人单核细胞U937向TAM（M2型巨噬细胞）分化；将人工合成的miR-99a模拟物片段转染至诱导后的巨噬细胞，转染后运用实时荧光定量聚合酶链反应（real-time fluorescence quantitative polymerase chain reaction，RTFQ-PCR）及流式细胞术检测巨噬细胞相关因子CD68、CD163以及巨噬细胞甘露糖受体（mcrophage mannose receptor）CD206表达量变化，并运用酶联免疫吸附法（enzyme-linked immunosorbent assay，ELISA）检测巨噬细胞分泌相关细胞因子IL-12、IL-4和IL-10分泌量变化；将转染miR-99a的诱导后巨噬细胞与EC细胞共培养，运用细胞计数试剂盒（cell counting kit-8，CCK-8）和transwell法检测其对EC细胞增殖和侵袭能力的影响，并初步分析其可能的作用机制。结果：EC组织CD68高表达并与肿瘤肌层浸润及血管生成呈正相关；肿瘤细胞培养上清液成功诱导单核细胞向M2型TAM极化。转染miR-99a后单核细胞组CD68及CD163表达较对照组下降（P＜0.01），而CD206表达差异无统计学意义（P＞0.05），流式细胞术进一步证实上述表达变化；ELISA结果发现，转染miR-99a诱导后巨噬细胞中IL-12分泌增多（P＜0.01），而IL-4、IL-10分泌减少（P＜0.01），提示巨噬细胞向M2型极化受抑制。将诱导后巨噬细胞与EC细胞共培养，共培养后EC细胞增殖侵袭能力较对照组增加，而转染miR-99a模拟片段至诱导后巨噬细胞能够抑制其对增殖（P＜0.01）及侵袭能力的促进作用（P＜0.05）。诱导后巨噬细胞中过表达miR-99a后细胞中mTOR及其通路受到抑制。结论：EC间质巨噬细胞浸润与肿瘤肌层浸润及血管新生相关，miR-99a能够逆转单核细胞向M2表型极化，并抑制EC细胞介导TAM的促EC细胞生长和侵袭作用，其作用可能通过调控mTOR通路产生。     

Evaluation of the Safety and Feasibility of Same-Day Holmium-166 -Radioembolization Simulation and Treatment of Hepatic Metastases

PurposeTo evaluate the safety and feasibility of same-day treatment, including the simulation procedure for assessment of intrahepatic and extrahepatic distribution of the microspheres, with holmium-166 (¹⁶⁶Ho)-radioembolization.Materials and MethodsThis was a secondary analysis of patients included in the 4 prospective studies (HEPAR I, HEPAR II, HEPAR PLuS, and SIM) on ¹⁶⁶Ho-radioembolization. The technical success rate of the same-day treatment protocol, defined as the number of patients who completed the same-day treatment, was measured. Total in-room time, duration of the scout procedure, time to imaging, and duration of the treatment procedure were recorded. Reasons for discontinuation or adjustment of treatment were identified. Adverse events that occurred during the treatment day were recorded.ResultsOne hundred five of 120 scheduled patients completed the same-day treatment with ¹⁶⁶Ho-radioembolization (success rate, 88%). After the simulation procedure, treatment was cancelled in 15 patients because of extrahepatic deposition (n = 8), suboptimal tumor targeting (n = 1), unanticipated vascular anatomy (n = 5), and dissection (n = 1). In another 14 patients, the treatment plan was adjusted. The median total procedure time (ie, simulation, imaging, and treatment) was 6:39 hours:minutes (range, 3:58–9:17 hours:minutes). Back pain was a major same-day treatment-related complaint (n = 28).Conclusion¹⁶⁶Ho-radioembolization as a same-day treatment procedure is feasible in most selected patients, although treatment was adjusted in 12% of patients and cancelled in 12% of patients. This approach might be beneficial for a select patient population, such as patients needing a radiation segmentectomy.     

不明原因消化道出血的影像学检查

消化道出血的检查方法有消化道内镜、影像学和手术探查,其中影像学检查大多无创,对进一步消化道内镜检查、介入栓塞治疗和手术治疗均有指导意义。其中显性出血的影像学检查以CT血管造影、DSA和99mTc-RBC显像为主要检查方法,隐性出血的主要成像方法有CT小肠造影、99mTcO4-显像。当胃镜和结肠镜检查未发现异常,推测出血可能源于小肠时,需进行小肠检查。目前CT小肠造影不仅有可能检测到小肠隐匿性出血,而且还可以提供肠腔内外的病变信息,达到病因诊断。