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08 August 2022, Volume 49 Issue 8 Previous Issue    Next Issue

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All for People's Health—Our Pursuit in the Past Decade

Research progress of radiomics toward lung adenocarcinoma manifesting as solitary ground glass nodule Wu Jiayu, Liu Jiacheng 2022, 49 (8):  449-452.  doi: 10.3760/cma.j.cn371439-20220303-00087 Abstract ( 332 )   HTML ( 79 )   PDF (722KB) ( 86 )   Save The detection of early lung adenocarcinoma manifesting as ground glass nodule （GGN） is increasing. The promoting precision targeted therapy arises the need of radiomics （RM） and radiogenomics, a series of noninvasively radiological technology based on multiple modality, to assist the process including determination in diagnosis, treatment and follow-up strategy and release burden in clinical practice. RM, playing an important role in lung adenocarcinoma manifesting as GGN, can provide information towards the different components of the nodules, the analysis of peritumoral areas, the reduction of over diagnosis and treatment, the selection of targeted therapy and follow-up. References | Related Articles | Metrics

Original Articles

Effects of propofol on malignant biological behaviors of prostate cancer DU145 cells and its mechanism Jin Ming, Zhen Shuqing, Wang Yanqiao, Shen Hongxia, Zhang Aimin, Hui Limei 2022, 49 (8):  453-458.  doi: 10.3760/cma.j.cn371439-20220305-00088 Abstract ( 275 )   HTML ( 62 )   PDF (1981KB) ( 106 )   Save Objective To investigate the effects of propofol on malignant biological behaviors of prostate cancer DU145 cells and its possible mechanism. Methods Control group, 5-fluorouracil group （200 ng/ml）, low-dose propofol group （100 ng/ml） and high-dose propofol group （400 ng/ml） were set up. CCK-8 kit was used to measure the level of cell proliferation, Transwell method was used to measure the abilities of cell invasion and migration, flow cytometry was used to measure the level of apoptosis, and qRT-PCR and Western blotting were used to measure hepatocyte growth factor （HGF） and c-Met mRNA and protein levels. Results The survival rates of the control group, 5-fluorouracil group, low-dose propofol group and high-dose propofol group were （83.32±3.02）%, （36.29±3.54）%, （62.01±4.69）% and （40.20±5.48）% （F=8.65, P=0.006）; the apoptosis rates were （2.36±0.41）%, （12.47±0.40）%, （6.28±0.39）% and （10.24±0.37）% （F=26.73, P=0.001）. Further pairwise comparison showed that there were statistically significant differences （all P<0.05）. The numbers of penetrating membranes of the four groups were 617.45±29.86, 125.27±24.38, 407.02±32.27 and 230.74±31.59 （F=18.33, P=0.002）; the migration distances were （603.85±27.74） μm, （121.69±25.85） μm, （395.59±28.37） μm and （233.52±30.42） μm （F=27.02, P=0.001）. Further pairwise comparison showed that there were statistically significant differences （all P<0.05）. HGF mRNA expression levels of the four groups were 6.26±0.39, 1.94±0.35, 4.15±0.37 and 2.90±0.33 （F=25.31, P=0.001）; c-Met mRNA expression levels were 5.85±0.30, 2.04±0.32, 3.89±0.31 and 2.94±0.32 （F=12.12, P=0.003）; HGF protein expression levels were 1.43±0.04, 0.34±0.08, 0.86±0.06 and 0.63±0.09 （F=17.02, P=0.001）; c-Met protein expression levels were 1.63±0.14, 0.39±0.15, 0.93±0.11 and 0.64±0.17 （F=19.89, P=0.001）. Further pairwise comparison showed that there were statistically significant differences （all P<0.05）. Conclusion Propofol has obvious inhibitory effects on the malignant biological behaviors of prostate cancer DU145 cells, and the inhibitory effect of high-dose propofol is more obvious. The mechanism may be related to the inhibition of HGF and c-Met mRNA and protein expressions of DU145 cells by propofol, which inhibits the activation of HGF/c-Met pathway. Figures and Tables | References | Related Articles | Metrics

Comparative study on the clinical value of contrast-enhanced ultrasound- and CT-guided percutaneous puncture biopsy in peripheral lung masses Chen Huangjing, Zhu Pengfei, Zhang Qing, Chen Guifang, Yang Chunlin, He Ying 2022, 49 (8):  459-463.  doi: 10.3760/cma.j.cn371439-20220408-00089 Abstract ( 421 )   HTML ( 56 )   PDF (1176KB) ( 106 )   Save Objective To compare the clinical value of contrast-enhanced ultrasound （CEUS）- and CT-guided percutaneous puncture biopsy in the diagnosis of peripheral lung masses. Methods The clinical data of 90 patients with peripheral lung masses who underwent puncture biopsy in Tumor Hospital Affiliated to Nantong University from October 2019 to December 2021 were retrospectively analyzed. According to different puncture guidance methods, patients were divided into CEUS-guided percutaneous puncture biopsy group （CEUS group, n=40） and the CT-guided percutaneous puncture biopsy group （CT group, n=50）, and the differences in puncture success rates, complication rates and other factors between the two groups were evaluated. Meanwhile, the correlations between microvascular density （MVD） and CEUS parameters were detected. Results The puncture success rate in the CEUS group was higher than that in the CT group, but there was no statistically significant difference [97.5%（39/40） vs. 92.0%（46/50）, P=0.337], and the complication rate in the CEUS group was significantly lower than that in the CT group [0（0/40） vs. 12.0%（6/50）, P=0.032]. Compared with the CT group, the CEUS group has fewer punctures [（2.0±1.6） times vs. （2.8±1.2） times, t=-2.43, P=0.018], shorter duration [（7.6±2.5） min vs. （15.3±2.6） min, t=-8.86, P<0.001] and lower cost of surgery [（1 308.4±545.6） yuan vs. （2 046.4±645.3） yuan, t=-2.01, P=0.046]. The MVD, CEUS peak intensity and enhancement index of lung adenocarcinoma were higher than those of squamous cell carcinoma [（25.4±4.9）/HP） vs. （16.6±7.3）/HP, t=3.43, P=0.002; （46.9±6.5）db vs. （36.8±5.4）db, t=4.12, P<0.001; 5.2±1.4 vs. 4.1±1.2, t=3.27, P=0.006]. The peak intensity and intensity index of CEUS in lung adenocarcinoma or squamous cell carcinoma were positively correlated with itself MVD （squamous cell carcinoma： r=0.66, P<0.001; r=0.56, P<0.001; adenocarcinoma： r=0.62, P<0.001; r=0.70, P<0.001）. Conclusion Although CEUS-guided percutaneous puncture biopsy does not achieve a higher puncture success rate in the diagnosis of peripheral lung masses compared to CT, it really decreases the complication rate, and has the advantages of less time, low cost, no radiation and real-time dynamic monitoring, which is worth promoting in clinic. Moreover, there are correlations between CEUS quantitative parameters of adenocarcinoma and squamous cell carcinoma of the lung and MVD, which may be useful for diagnosis. Figures and Tables | References | Related Articles | Metrics

Efficacy of postoperative radiotherapy based on modified clinical target volume according to high-frequency recurrence regions in patients with esophageal squamous cell carcinoma Wu Puyuan, Qi Liang, Wang Tao, Shi Minke, Sun Yuwei, Wang Lifeng, Liu Baorui, Yan Jing, Ren Wei 2022, 49 (8):  464-472.  doi: 10.3760/cma.j.cn371439-20220524-00090 Abstract ( 324 )   HTML ( 42 )   PDF (1914KB) ( 114 )   Save Objective To analyze the survival efficacy, prognostic factors and failure patterns of patients with esophageal squamous cell carcinoma （ESCC） underwent postoperative radiotherapy （PORT） using modified clinical target volume （CTV） based on postoperative high-frequency recurrence regions, so as to provide reference for the further optimization of CTV of PORT. Methods The patients with ESCC underwent radical operation in Comprehensive Cancer Center of Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School from April 28, 2014 to November 29, 2018 were retrospectively analyzed. Patients with stage pT3-4aN0 or N+, who underwent PORT with modified CTV based on postoperative high-frequency recurrence regions, were included in the study. Kaplan-Meier method was used to calculate overall survival （OS） and locoregional recurrence free survival （LRFS）, adverse events of patients were evaluated, Cox proportional hazards model was used for univariate and multivariate survival analysis, and the failure patterns of patients after PORT were analyzed. Results A total of 85 patients were included in this study, and the median follow-up time was 52.6 months. The median OS of the whole group was 74.1 months. The 1-year, 2-year and 3-year OS rates were 97.6%, 84.7% and 71.7% respectively. The median LRFS was not reached, and the 1-year, 2-year and 3-year LRFS rates were 92.9%, 78.6% and 71.5% respectively. The incidence of grade 3-4 adverse events was 17.6% （15/85）, mainly including lymphopenia, bone marrow suppression, gastrointestinal reaction and skin reaction. Univariate analysis of OS after PORT showed that the degree of differentiation （set G1+G1-2+G2 group as the control group, G2-3+G3 group HR=4.19, 95%CI： 1.91-9.17, P<0.001; NA+basal-like group HR=4.16, 95%CI： 1.29-13.44, P=0.017） and postoperative stage （HR=2.19, 95%CI： 1.09-4.39, P=0.030） were the influencing factors of OS. Cox multivariate analysis showed that the degree of differentiation was an independent prognostic factor for OS after PORT （set G1+G1-2+G2 group as the control group, G2-3+G3 group HR=5.24, 95%CI： 2.30-11.93, P<0.001; NA+basal-like group HR=4.83, 95%CI： 1.33-17.62, P=0.017）. The first failure patterns analysis showed that 39 cases （45.9%） had recurrence, among which, 22 cases （25.9%） had locoregional recurrence with the median onset time of 15.2 months after operation, 19 cases （22.4%） had distant metastasis with the median onset time was 14.1 months after operation, and 2 cases （2.4%） were mixed failure mode. Among the locoregional recurrence, 16 cases （72.7%） recurred in the radiation field. Among all the local recurrence sites, the lymph node drainage regions in the supraclavicular, upper middle mediastinum and upper abdominal perigastric/celiac artery trunk areas were the most common sites. Among the distant metastatic organs, lung, bone and liver metastases were the most common. Conclusion Patients of ESCC with high risk of recurrence after radical esophagectomy have long survival time and high safety after PORT with modified CTV according to the high-frequency recurrence regions. It is worthy of further confirmation by multicenter, large sample and prospective clinical trials. Figures and Tables | References | Related Articles | Metrics

Study on the correlations between AGR, PLR and NLR changes and chemotherapy efficacy of metastatic colorectal cancer Zhao Ying, Zhang Gehong 2022, 49 (8):  473-477.  doi: 10.3760/cma.j.cn371439-20220610-00091 Abstract ( 491 )   HTML ( 51 )   PDF (730KB) ( 111 )   Save Objective To investigate the correlations between albumin globulin ratio （AGR）, platelet lymphocyte ratio （PLR）, neutrophil lymphocyte ratio （NLR） and efficacy of chemotherapy for patients with metastatic colorectal cancer （mCRC）. Methods The clinical data of 107 mCRC patients who were treated at the First Hospital of Shanxi Medical University for chemotherapy from January 2016 to September 2020 were selected, and the values of AGR, NLR and PLR before chemotherapy and after 3 cycles of chemotherapy were collected for retrospective analysis. After 3 cycles, patients were divided into three groups according to efficacy evaluation： partial response （PR） group, stable disease （SD） group and progressive disease （PD） group. The changes of AGR, PLR and NLR values before and after chemotherapy, and the relationships between the degrees of changes and the therapeutic effects were analyzed. Results There were 18 cases in the PR group, 53 cases in the SD group and 36 cases in the PD group. There were no significant differences in age, sex, distant metastasis site, cancer site, T stage and N stage among the three groups （F=0.33, P=0.721; χ2=2.94, P=0.230; χ2=2.34, P=0.674; χ2=0.80, P=0.669; χ2=5.68, P=0.224; χ2=2.06, P=0.375）. The AGR, PLR and NLR values before chemotherapy in the PR group were 1.57±0.19, 180.05±102.77 and 5.19 （4.50, 5.83）, and they were 1.45±0.23, 115.81±55.79 and 1.83 （1.06, 2.84） after chemotherapy, with statistically significant differences （t=2.32, P=0.033; t=2.84, P=0.011; Z=-2.94, P=0.003）. In the SD group, AGR, PLR and NLR values before chemotherapy were 1.66 （1.40, 1.77）, 158.18 （103.81, 236.26）, 2.41 （1.75, 4.07）, and they were 1.35 （1.15,1.60）, 123.85 （94.86, 176.44）, 1.49 （1.27, 2.33） after chemotherapy, with statistically significant differences （Z=-4.51, P<0.001; Z=-3.31, P=0.001; Z=-3.90, P<0.001）. The AGR, PLR and NLR values in the PD group before chemotherapy were 1.60 （1.48, 1.87）, 122.07 （77.14, 175.72）, 2.37 （1.28, 4.20）, and they were 1.26 （1.08,1.40）, 176.39 （139.89, 280.64） and 4.71 （3.71, 6.96） after chemotherapy, with statistically significant differences （Z=-4.49, P<0.001; Z=-3.42, P=0.001; Z=-4.18, P<0.001）. The differences in AGR （OR=3.66, 95%CI： 1.29-10.39, P=0.015）, PLR （OR=0.99, 95%CI： 0.99-1.00, P<0.001） and NLR （OR=0.59, 95%CI： 0.49-0.70, P<0.001） before and after chemotherapy were related to clinical efficacy. The greater the difference of AGR, the worse the short-term efficacy. The greater the difference of PLR and NLR, the better the short-term efficacy. The correlation between the changes in AGR, PLR and NLR before and after treatment and the clinical efficacy was sorted in descending order ΔNLR>ΔPLR>ΔAGR （r=-0.68, P<0.001; r=-0.51, P<0.001; r=0.25, P=0.009）. Conclusion The changes in the levels of AGR, NLR and PLR before and after chemotherapy are correlated with the short-term efficacy of mCRC, and it has certain significance for monitoring the curative effects of patients and further optimizing the treatment plan. Figures and Tables | References | Related Articles | Metrics

Reviews

Methyltransferase like protein 14 and tumor Hu Ru, Li Donglin, Yan Xuebing 2022, 49 (8):  478-483.  doi: 10.3760/cma.j.cn371439-20220511-00092 Abstract ( 320 )   HTML ( 51 )   PDF (763KB) ( 87 )   Save N6-methyladenosine （m6A） modification, as the most prevalent epigenetic modification of RNA, plays a crucial role in the initiation and development of malignancies. Methyltransferase like protein 14 （METTL14） is a major methylase catalyzing m6A modification and regulating biological processes such as RNA splicing, translation and degradation. Recent studies have demonstrated that METTL14 not only regulates the growth, invasion and metastasis of tumors through various molecular mechanisms, but also is closely correlated with the prognosis of tumor patients and clinical efficacy of anti-tumor therapies. In-depth understanding of the mechanism of METTL14 in breast, digestive system and urinary system tumors is helpful to provide new clinical markers and drug targets for the prevention and treatment of tumors based on m6A modification. References | Related Articles | Metrics

Advances of nimotuzumab in the treatment of esophageal squamous cell carcinoma Dai Lichen, Hu Lijun, Yu Jingping 2022, 49 (8):  484-489.  doi: 10.3760/cma.j.cn371439-20220506-00093 Abstract ( 369 )   HTML ( 45 )   PDF (754KB) ( 101 )   Save Esophageal squamous cell carcinoma （ESCC） is the most predominant pathological type of esophageal cancer in China. In recent years, with the development of molecular targeted drugs, targeted therapy has become a hot research topic in the field of ESCC treatment. Nimotuzumab is the first humanized monoclonal antibody targeting epidermal growth factor receptor （EGFR） in China, which has been approved for the treatment of early or locally advanced nasopharyngeal carcinoma. Several phase Ⅱ-Ⅲ clinical trials have explored the use of nimotuzumab in the treatment of ESCC, confirming its significant efficacy and survival benefit in the treatment of advanced ESCC, as well as its favorable safety profile. References | Related Articles | Metrics

Mechanism of FOXA2 in colorectal cancer and its application in diagnosis and treatment Huang Mengpan, Wang Xuehong, Lu Yongfu 2022, 49 (8):  490-493.  doi: 10.3760/cma.j.cn371439-20220429-00094 Abstract ( 233 )   HTML ( 45 )   PDF (714KB) ( 101 )   Save Forkhead box protein A2 （FOXA2）, characterized by its unique DNA binding domain, plays a key role in transcriptional regulation. FOXA2 transcription factor is highly expressed in colorectal cancer, and binds with corresponding targeted genes to regulate tumor growth and inflammatory response, thus playing the role of oncogenes. In-depth understanding of the role and function of human FOXA2 transcription factor in colorectal cancer will contribute to further development of FOXA2 as a potential therapeutic target and diagnostic and prognostic marker of colorectal cancer. References | Related Articles | Metrics

Efficacy and safety of blinatumomab in the treatment of B-cell acute lymphoblastic leukemia Lu Jialing, Huang Huijuan, Liu Dan, Chen Yanxin, Ma Xiao, Wu Depei 2022, 49 (8):  494-498.  doi: 10.3760/cma.j.cn371439-20220330-00095 Abstract ( 179 )   HTML ( 43 )   PDF (762KB) ( 77 )   Save Blinatumomab, as a novel bispecific antibody targeting CD19 and CD3, can induce T lymphocytes to precisely target CD19 positive B lymphocytes to apoptosis. At present, it is the only bispecific antibody approved for the treatment of hematological malignancies in China. Blinatumomab is effective in the treatment of newly diagnosed, relapsed/refractory, minimal residual disease positive patients with B-cell acute lymphoblastic leukemia （B-ALL）. It can improve the survival of the patients and is well tolerated. The further study of blinatumomab can provide theoretical basis and new ideas for induction therapy, salvage therapy and subsequent hematopoietic stem cell transplantation in patients with B-ALL. References | Related Articles | Metrics

Clinical application of histone deacetylase inhibitors in non-Hodgkin lymphoma Yin Yunyan, Li Hui, Li Yuchen, Hui Hui, Xu Jingyan 2022, 49 (8):  499-504.  doi: 10.3760/cma.j.cn371439-20220408-00096 Abstract ( 167 )   HTML ( 39 )   PDF (785KB) ( 56 )   Save Great progress has been made in the treatment of lymphoma in recent decades, but the prognosis for patients with relapsed or refractory lymphoma is often disappointing. Studies have found that the pathogenesis of non-Hodgkin lymphoma is associated with changes in histone acetylation. Histone deacetylase inhibitors can increase the level of histone acetylation in lymphoma cells, and exert anti-lymphoma effects through mechanisms such as cell cycle inhibition, induction of apoptosis, and immunomodulation. However, histone deacetylase inhibitors alone have limited therapeutic effects, and the combination with other antineoplastic drugs for the treatment of relapsing and refractory non-Hodgkin lymphoma has shown good efficacy. Summarizing basic research and clinical trials of histone deacetylase inhibitor containing regimens provides ideas for the treatment of lymphoma. References | Related Articles | Metrics