Morphine enhances renal cell carcinoma aggressiveness through promotes survivin level

Background: Morphine is an opioid analgesic drug often used for pain relief in cancer patients. However, there is growing evidence that morphine may modulate tumor growth, progression and metastasis. Unfortunately, the results obtained by these studies are still contradictory.

Methods: In this study, we investigated the effect of morphine in human clear cell renal cell carcinoma 786-O, RLC-310 cells and whether morphine affects on tumor growth in human clear cell renal cell carcinoma 786-O, RLC-310 cells. The cell proliferation was determined by MTT assay, cell proliferation, migration and invasion assays. Immunofluorescence staining and Q-PCR was used to determine the Survivin expression.

Results: It was shown that morphine enhances proliferation of 786-O, RLC-310 cells, whereas morphine promoted the growth and aggressive phenotype of 786-O and RLC-310 cells in vitro though Survivin-dependent signaling.

Conclusions: Our data showed that morphine promotes RCC growth and increases RCC progression via over-expression of Survivin.     

DWI在肾脏乏脂肪血管平滑肌脂肪瘤与透明细胞癌鉴别诊断的价值

目的探讨DW-MRI在肾乏脂肪血管平滑肌脂肪瘤(lipid poor renal angiomyolipoma,LPRAML)与肾透明细胞癌(renal clear cell carcinoma,RCCC)的鉴别诊断价值,提高LPRAML的诊断准确率。方法对经病理证实为LPRAML的21例和RCCC 20例术前磁共振图像进行分析,分别测量病灶的ADC值并计算出平均值,用独立样本t检验比较两组病例的平均ADC值的差异。结果 LPRAML的病灶的ADC值为(1.21±0.21)×10~(﹣3)mm~2/s;RCCC的平均ADC值为(0.89±0.08)×10~(﹣3)mm~2/s,LPRAML的ADC值高于RCCC,且差异具有统计学意义(t=8.32,P0.01)。结论 LPRAML和RCCC具有不同的扩散特征,ADC值对两者的鉴别诊断具有重要价值。     

肾透明细胞癌患者预后危险因素分析

目的 探讨术前纤维蛋白原和血小板计数在预测肾透明细胞癌患者（CCRCC）预后中的价值。方法 回顾性分析我院2005 年1 月至2015 年1 月行手术治疗的300 例非转移性CCRCC 患者的临床资料。应用Kaplan-Meier 法和Log-rank 检验进行单因素生存分析,比较患者临床病理特征与肿瘤特异性生存（CSS）和无复发生存（RFS）的关系,应用Cox 比例风险回归模型进行独立危险因素分析,筛选与CSS 和RFS 有关的独立危险因素。结果 单因素分析结果显示,纤维蛋白原是以CSS 和RFS 为终点事件的预后因素（P＜0.001,P＜0.001）。血小板计数是以RFS 为终点事件的预后因素（P＜0.001）。多因素分析结果显示,纤维蛋白原是以CSS 和RFS 为终点事件的独立预后因素（P＜0.001,P＝0.029）。血小板计数是以RFS 为终点事件的独立预后因素（P＝0.015）。结论 术前纤维蛋白原和血小板计数是CCRCC 患者预后的独立影响因子,对预后评估具有十分重要的临床意义。     

Renal cell carcinoma: A nomogram for the CT imaging-inclusive prediction of indolent,non-clear cell renal cortical tumours

AimTo develop a nomogram from clinical and computed tomography (CT) data for pre-treatment identification of indolent renal cortical tumours.Patients and methodsA total of 1201 consecutive patients underwent dedicated contrast-enhanced CT prior to nephrectomy for a renal cortical tumour between January 2000 and July 2011. Two radiologists evaluated all tumours on CT for size, necrosis, calcification, contour, renal vein invasion, collecting system invasion, contact with renal sinus fat, multicystic tumour architecture, nodular enhancement, and the degree of nephrographic phase enhancement. CT and clinical predictors (gender, body mass index [BMI], age) were incorporated into the nomogram. We employed multivariable logistic regression analysis to predict tumour type and internally validated the final model using the data from reader 1. External validation was performed by using all data from reader 2. We applied Wilcoxon rank sum test and Fisher’s exact test to investigate for differences in tumour size, BMI, age, and differences in CT imaging features between patients with aggressive and those with indolent tumours.Results63.6% (764/1201) of patients had clear-cell or other aggressive non-clear-cell RCC (i.e. papillary RCC type 2, unclassified RCC) and 36.4% (437/1201) had indolent renal cortical tumours (i.e. papillary RCC type 1, chromophobe RCC, angiomyolipoma, or oncocytoma). On CT, indolent tumours were significantly smaller (p < 0.001) than aggressive tumours and significantly associated with well-defined tumour contours (p < 0.001). Aggressive RCC were significantly associated with necrosis, calcification, renal vein invasion, collecting system invasion, contact with renal sinus fat, multicystic tumour architecture, and nodular enhancement (all, p < 0.001). The nomogram’s concordance index (C-index) was 0.823 after internal and 0.829 after external validation.Concluding statementWe present a nomogram based on 1201 patients combining CT features with clinical data for the prediction of indolent renal cortical tumours. When externally validated, this nomogram resulted in a C-index of 0.829.     

Coexisting clear cell adenocarcinoma and squamous cell carcinoma arising from ovarian endometriosis

A case of clear cell adenocarcinoma and squamous cell carcinoma coexisting in the ovary is presented. These two malignancies were adjacent but were not admixed, and ovarian endometriosis was confirmed concurrently. The clear cell adenocarcinoma was contiguous to monolayered glandular cells with cytological and architectural atypia, while squamous metaplasia with cellular atypia was observed adjacent to the squamous cell carcinoma. We concluded that these two malignancies arose independently from ovarian endometriosis. To our knowledge, this is the first report of such a case. Received: April 19, 2000 / Accepted: August 28, 2000     

Clear cell sarcoma of the abdominal wall with peritoneal sarcomatosis: CT features

Clear cell sarcoma, also called malignant melanoma of soft parts, is an uncommon neoplasm that involves tendons or aponeuroses of the lower extremity. The CT features of a clear cell sarcoma arising from the abdominal wall with later peritoneal dissemination are described. Peritoneal sarcomatosis from soft tissue sarcomas is a very rare condition previously unreported in the radiologic literature. Metastases to peritoneal surfaces must therefore be considered a possible site for systemic dissemination of soft tissue sarcomas. Received: 22 September 1998; Revised: 8 February 1999; Accepted: 17 March 1999     

透明细胞丘疹病57例临床特征分析

【摘要】 目的 总结透明细胞丘疹病的临床及病理特征。方法 收集重庆医科大学附属儿童医院皮肤科2014年11月至2022年3月诊断的57例透明细胞丘疹病患儿的临床资料,分析临床及病理特征。结果 57例患儿中,男30例,女27例;年龄6个月至7岁10个月;发病年龄1 ~ 74个月,39例（68.4%）于婴儿期发病;病程1 ~ 84个月。皮疹主要表现为粟粒至黄豆大小类圆形白色斑疹或1 ~ 2 cm短条状白色斑疹。49例（85.9%）皮疹数量 < 20个。好发部位依次为下腹部（35例,61.4%）、胸前或上腹部（34例,59.6%）、腋前或腋下（17例,29.8%）、外阴（11例,19.3%）。胸前或上腹部、腋前或腋下的皮疹以短条状白色斑疹相对多见［23/34例（65.7%）、10/17例］,下腹部皮疹以类圆形白色斑疹占明显优势［30/35例（85.7%）］,外阴皮疹都表现为类圆形白色斑疹。组织病理表现为表皮基底层或基底层上方散在的胞质丰富淡染体积稍大的细胞,这些细胞CK7阳性、癌胚抗原阳性和过碘酸希夫染色阳性。结论 透明细胞丘疹病患病年龄小,下腹部和外阴的皮疹大多是类圆形白色斑疹,胸前或上腹部、腋前或腋下的皮疹以短条状白色斑疹相对多见,有较强的临床识别特征。     

Effectiveness of an anterior mini-screw in achieving incisor intrusion and palatal root torque for anterior retraction with clear aligners:: A finite element study

ObjectivesTo analyze the biomechanical system of anterior retraction with clear aligner therapy (CAT) with and without an anterior mini-screw and elastics.Materials and MethodsModels including a maxillary dentition (without first premolars), maxilla, periodontal ligaments (PDLs), attachments, and aligners were constructed and imported to finite element software. Three model groups were created: (1) control (CAT alone), (2) labial elastics (CAT with elastics between the anterior mini-screw and buttons on central incisors), and (3) linguoincisal elastics (CAT with elastics between the anterior mini-screw and precision cuts on the lingual sides of the aligner). Elastic forces (0–300 g, in 50 g increments) were applied.ResultsCAT alone caused lingual tipping and extrusion of the incisors. Labial elastics caused palatal root torquing and intrusion and mesial tipping of the central incisors, while linguoincisal elastics produced palatal root torquing and intrusion of both central and lateral incisors. Second premolars were intruded in all three groups, with less intrusion in the linguoincisal elastics group. For the control group, stress was concentrated on both labial and lingual root surfaces, alveolar ridge, and cervical and apical PDLs. Stress was more concentrated in the labial elastics group and less concentrated in the linguoincisal elastics group.ConclusionsCAT produced lingual tipping and extrusion of incisors during anterior retraction. Anterior mini-screws and elastics can achieve incisor intrusion and palatal root torquing. Linguoincisal elastics are superior to labial elastics with a lower likelihood of buccal open bite. Root resorption and alveolar defects may occur in CAT, more likely for labial elastics and less likely for linguoincisal elastics.     

HLA-G和Fas配体在肾透明细胞癌中的表达及意义

目的：探讨两种免疫抑制分子人类白细胞表面抗原HLA—G和Fas配体（FasL）与经典型肾透明细胞癌（ccRCC）分级和分期的相关性。方法：采用免疫组织化学方法对60例ccRCC标本石蜡切片进行检测,数据由SPSS软件进行统计分析。结果：肿瘤旁正常肾组织中无HLA—G表达;肾癌组织中,40例（66．7％）表达HLA—G,36例（60．0％）表达FasL。31例（51．7％）两者均表达,15例（25．0％）两者均不表达。在同一标本中,肿瘤侵犯脉管或淋巴结后,其HLA-G或FasL表达较原位肿瘤明显增强。统计分析显示HLA—G表达的阳性率和表达强度与肿瘤的分期、分级均呈正相关（P〈0．01）。FasL表达的阳性率与肿瘤分级呈正相关（P〈0．05）,而表达强度与肿瘤分期呈正相关（P〈0．01）。结论：ccRCC中HLAG和FasL的表达与肿瘤的分期、分级均呈正相关,与淋巴结转移有一定关系;晚期ccRCC高表达免疫抑制分子的机制需进一步研究。