直肠癌淋巴结转移的深度神经网络评判研究进展

正目前,临床上对于直肠癌常用的影像评估方法有MRI、螺旋CT、PET-CT、直肠腔内超声(ERUS)等。而MRI作为首选检查方式,对肿瘤位置、浸润深度、淋巴结转移、血管侵犯、环周切缘及周围器官侵犯等方面的评估均具有明显优势~([1-2])。通过MRI诊断淋巴结的方法通常是影像科医师逐层浏览每一幅图像,从中识别淋巴结的形状、界限及密度来判断,这种传统方式耗时较长且存在主观偏倚,导致     

Utility of Tissue Similarity Maps Based on Relative Cerebral Blood Volume for Grading Gliomas as Validated by Histological Results

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原发癌灶定位与甲状腺微小癌颈侧区淋巴结转移关系研究

目的 探究原发灶定位与甲状腺乳头状微小癌（PTMC）颈侧区淋巴结转移的关系，评估超声检查预测颈侧区淋巴结转移的准确率。方法 回顾性分析2014年1月至2015年12月天津医科大学肿瘤医院收治的134例PTMC病人的临床资料，均行中央区淋巴结清扫+改良颈侧区淋巴结清扫。依据超声定位分组，分析癌灶位置与颈侧区淋巴结转移的关系。结果 颈侧各分区淋巴结转移发生率分别为：Ⅱ区30.6%、Ⅲ区50.7%、Ⅳ区57.5%、Ⅴ区11.3%。癌灶位于中上极者颈侧区淋巴结转移发生率高于癌灶位于下极者（89.7% vs. 75.7%，P=0.038），靠近外侧者较内侧者更易出现颈侧区淋巴结转移（93.7% vs. 81.4%，P=0.049）。超声检查判定Ⅱ、Ⅲ、Ⅳ、Ⅴ区淋巴结转移的敏感度分别为43.9%、85.3%、85.7%、14.3%；特异度为91.4%、57.6%、35.1%、99.1%。超声预测Ⅲ、Ⅳ区淋巴结转移敏感度较高，Ⅱ、Ⅴ区淋巴结转移特异度较高。结论 癌灶位置与甲状腺微小癌颈侧区淋巴结转移密切相关，超声可为临床确定颈侧区淋巴结的清扫范围提供依据。     

转录调节因子c-Myb通过炎症因子Ccl2抑制乳腺癌肺转移的实验研究

目的:研究乳腺癌细胞中转录调节因子c-Myb的表达对肺转移的影响及其分子机制。方法:构建c-Myb高表达的4T1乳腺癌细胞株，种植小鼠构建乳腺癌动物模型，检测实验动物肺转移情况，通过荷瘤抑制试验检测肺转移抑制效果。提取组织进行荧光PCR检测相关炎症因子的表达。利用Medisapiens数据库的生物信息学资源，对c-Myb和Ccl2的表达与乳腺癌患者的预后进行分析。结果:高表达c-Myb的荷瘤小鼠肺部转移灶明显减少，其中炎症相关因子表达受限。由数据库分析得出，c-Myb高表达患者生存期得以延长。结论:乳腺癌中c-Myb的表达能够通过炎症因子Ccl2抑制肺转移从而延长患者生存期。     

Hiperplasia endotelial papilar intravascular (tumor Masson) de localización ginecológica

Intravascular papillary endothelial hyperplasia or Masson's tumour is a non-neoplastic vascular lesion of reactive character. It is a rare diagnosis, clinically non-specific and with diverse locations. It is essential to take it into consideration and make a differential diagnosis with malignant vascular tumours such as angiosarcoma. Pathological study is fundamental for diagnosis. Treatment consists of complete resection of the tumour, including sufficiently wide margins to avoid recurrence.The case reported is an exceptional event, because of the pelvic location of the Masson's tumour that was diagnosed as part of the surgical staging of an ovarian cancer.     

Stereotactic Body Radiotherapy Versus Metastasectomy in Patients With Pulmonary Metastases From Soft Tissue Sarcoma

The lung is the preferred site of metastasis from soft tissue sarcoma (STS). This systematic review aims to evaluate the outcomes of stereotactic body radiotherapy (SBRT) and metastasectomy (MTS) for the treatment of lung metastases from STS. A systematic review was carried out according to the PRISMA protocol. PubMed, Medline, EMBASE, Cochrane Library, Ovid and Web of Knowledge databases were searched for English-language articles to December 2018 using a predefined strategy. Retrieved studies were independently screened and rated for relevance. Data were extracted by two researchers. In total, there were 1306 patients with STS: 1104 underwent MTS and 202 had SBRT. The mean age ranged from 40 to 55.8 years in the MTS group and from 47.9 to 64 years in the SBRT group. The cumulative death rate was 72% (95% confidence interval 59–85%) in the MTS group and 56% (38–74%) in the SBRT group. The cumulative mean overall survival time was 46.7 months (36.4–57.0%) in the MTS group and 47.6 months (33.7–61.5%) in the SBRT group. The cumulative rate of patients alive with disease was 5% (2–9%) in the MTS group and 15% (6–36%) in the SBRT group. Finally, the cumulative rate of patients alive without disease in the two groups was 19% (9–29%) and 20% (10–50%), respectively. Our study showed that local treatment of pulmonary metastases from STS with SBRT, compared with surgery, was associated with a lower cumulative overall death rate and similar overall survival time and survival rates without disease. By contrast, SBRT was associated with a higher survival rate with disease than MTS. Large randomised trials are necessary to confirm these findings and to establish whether SBRT may be a reliable option for early stage disease.     

Tumor-to-tumor metastases: Latent renal cell carcinoma discovered after elective surgical resection of a convexity meningioma

BackgroundTumor-to-tumor metastases are extremely rarely reported lesions, which usually involve an indolent lesion hosting a more aggressive neoplasm. We present an unusual initial manifestation of a previously unknown clear cell renal cell carcinoma as a tumor-to-tumor metastasis in a typical meningothelial meningioma.Case reportA 73-year old patient with transient left slight monoparesis was addressed to our Neurosurgical Department after being evaluated by his general practitioner and passing a cerebral MRI which revealed a right frontotemporal mass attached to the meninge. At presentation, no deficits were identified; therefore an elective surgery was proposed. Histological analysis revealed a typical meningothelial meningioma containing a metastatic clear cell renal cell carcinoma. Additional thoraco-abdominal computer tomography identified a 6 cm diameter lesion within the right kidney with radiological features highly suggestive of a primary clear cell renal cell carcinoma.ConclusionOur case highlights the need for a specialized neuropathological approach to clinical and imagistic indolent meningiomas, as they may require important differential diagnosis that can highly impact the treatment and follow-up of brain tumor patients.     

外泌体在肿瘤转移前微环境形成中的作用

肿瘤的转移前微环境（pre-metastatic niche，PMN）特指原发肿瘤灶为肿瘤细胞远处播散和定植准备的微环境，此微环境的六个特征包括炎症、免疫抑制、血管生成/血管通透性、亲器官性、重编程和淋巴管生成。PMN形成的关键成分包括肿瘤源性分泌因子、细胞外囊泡（含外泌体）、骨髓源性细胞、免疫抑制细胞和宿主基质细胞等，其中，外泌体作为细胞间重要的信使，在肿瘤PMN的形成中具有重要作用。本综述就外泌体在肿瘤PMN形成中的作用进行探讨。