2022 Vol. 46, No. 1
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2022, 46(1): 0-1.
Abstract:
2022, 46(1): 3-9.
doi: 10.3760/cma.j.cn121381-202012022-00146
Abstract:
Objective To evaluate the clinical efficacy and prognosis of neoadjuvant chemoradiotherapy combined with radical resection in patients with stage ⅡA1 cervical cancer. Methods The clinical data of 120 patients aged 41–63 (49.2±4.6) years old with stage ⅡA1 cervical cancer and who were diagnosed at the 900th Hospital of Joint Logistics Support Force of PLA from June 2012 to December 2014 were analyzed retrospectively. The patients were divided into the study group and the control group (60 cases in each group) in accordance with different treatment methods. The patients in the study group underwent neoadjuvant chemoradiotherapy combined with radical resection and those in the control group underwent radical resection. The changes in the clinical stages of the patients in the study group after undergoing neoadjuvant chemoradiotherapy were observed. The differences in perioperative complications, postoperative high-risk factors, interstitial invasion, and vascular tumor thrombus between the two groups were compared. The acute and chronic radiation injuries of the two groups were evaluated and compared by using the later radiation injury scoring standard. The differences in the 5-year progression-free survival (PFS) rate and overall survival (OS) rate between the two groups were compared. χ2 test was used to compare the count data of the groups, and the Kaplan-Meier method and Log-rank test were used for survival analysis. Results In the study group, the decline rate of the clinical stage was 95.0% (57/60) and the pathological complete remission rate was 15.0% (9/60) after neoadjuvant chemoradiotherapy. No significant differences in perioperative bleeding, incidences of perioperative complications, and postoperative recovery time were observed between the two groups (χ2=0.430, 0.137, 0.100; all P>0.05). The comparison of postoperative high-risk factors revealed that the incidences of lymph node (+), stump (+), and parauterine infiltration in the study group were 3.3% (2/60), 1.7% (1/60), and 0 (0/60), respectively, and were lower than those (8.3% (5/60), 3.3% (2/60), and 6.7% (4/60)) in the control group (χ2=5.335, P<0.05). Among the patients with postoperative interstitial infiltration in the study group, the pathological complete remission rate and the proportion of shallow interstitial infiltration in 1/3 were 15.0% (9/60) and 31.7% (19/60), respectively, and were higher than those (0 (0/60) and 20.0% (12/60)) in the control group. The proportions of the middle 1/3 and deep 1/3 in the study group were 41.7% (25/60) and 11.7% (7/60), respectively, and were lower than those (50.0% (30/60) and 30.0% (18/60)) in the control group (χ2=15.875, P<0.01). The incidence of postoperative vascular tumor thrombus in the study group was 26.7% (16/60) and was significantly lower than that (56.7% (34/60)) in the control group (χ2=11.109, P<0.01). The incidences of grade 1–2 acute and chronic radiation enteritis, acute and chronic radiation cystitis, and acute hematological toxicity in the study group were lower than those in the control group (χ2=3.927–6.508, all P<0.05). The 5-year PFS rate and OS rate in the study group were 66.7% and 80.0% respectively, and were higher than those (65.0% and 78.3%) in the control group. However, no significant difference was observed between groups (χ2=1.27, 1.96; both P>0.05). Conclusion In patients with stage Ⅱ A1 cervical cancer, neoadjuvant chemoradiotherapy combined with radical resection can effectively reduce postoperative high-risk factors and radiation injuries but did not affect the incidence of perioperative complications and prognosis.
2022, 46(1): 10-15.
doi: 10.3760/cma.j.cn121381-202101030-00142
Abstract:
Objective To provide valuable experience for the nationwide surveys through the pre-survey and implementation analysis of the Chinese medical diagnostic X-ray workers' tumor effect cohort research project carried out in 6 districts of Chongqing. Methods Based on the list of follow-up surveys in 1995, 126 medical staff who worked in 6 district and county hospitals in Chongqing from 1950 to 1980 were selected as the survey subjects, and 65 medical staff who had been engaged in radiation work were selected as the radiation group, including 54 males and 11 females; medical staff in internal medicine, surgery, otorhinolaryngology and 61 medical staff who haven't engaged in radiation work were used as the control group, including 54 males and 7 females. The information of previous surveys was in 1995 verified, a combination of retrospective and prospective cohort methods was used to identify malignancies, causes of death, and changes in radiation work among cohorts. The comparison of enumeration data was performed by χ2 test, and the comparison of measurement data was performed by Studet's t test, both of which were two-sided. Results The pre-survey results show that a total of 95 team members have completed follow-up, including 59 cases in the radiation group, 36 cases in the radiation group. During the period 1950−2019 a total of 18 cases with tumors, including 13 cases in the radiation group, 5 cases in the control group. In 15 cases of tumor death, 10 cases in the radiation group and 5 cases in the control group. A total of 33 cases were dead, 31 cases were lost, and the rate of loss of follow-up was 24.6% (31/126). The rate of loss of follow-up in the control group was as high as 41.0% (25/61), was higher than in the radiation group (9.2%, 6/65), and the difference between the two groups was statistically significant (χ2=17.104, P<0.001). In the pre-survey, the error rate of names of team members in pre-survey was 20.0% (19/95) and year of birth error rate 78.9% (75/79), and there is still a problem that the lack of completeness of the questionnaires. Conclusion It provides a reference solution for the national X-ray worker tumor effect cohort study, such as supplementing confounding factors investigation, using resources from various regions to carry out work, establishing an online reporting system, etc.
2022, 46(1): 16-26.
doi: 10.3760/cma.j.cn121381-202011025-00145
Abstract:
Objective To investigate the effect and mechanism of circular RNA (circRNA)_0128846 on the radioresistance of human non-small cell lung cancer (NSCLC) cells. Methods The circRNA with the most significant differential expression in the human NSCLC cell line A549 and its radioresistant cell line (A549R) was considered as the target circRNA. It was screened by using the GEO database and detected through fluorescence real-time quantitative polymerase chain reaction (qRT-PCR). qRT-PCR was utilized to detect the expression of the target circRNA in the human bronchial epithelial cell strain Beas-2B and NSCLC cells A549, H460, H1299, and H1975. A549 cells were transfected with a silencing vector, and A549R cells were transfected with an overexpression vector. Clone formation assay was used to detected the clone formation ability of the cells after 8 Gy X-ray irradiation. The downstream miRNA of the target circRNA was predicted with the human circular RNA database and circinteractome database. qRT-PCR was applied to detect the miRNA with the expression level that had increased most significantly after the target circRNA was silenced in the A549R cells, and regarded it as the target miRNA. The expression of the target miRNA after the overexpression of the target circRNA in A549 cells was detected with qRT-PCR. A dual-luciferase reporter gene system was employed to analyze the expression of the target circRNA after the target miRNA was overexpressed in human embryonic kidney cells 293T. The expression level of the target miRNA in A549 and A549R cells was detected through qRT-PCR. The silencing and overexpression vectors of the target miRNA were transfected into A549 and A549R cells, respectively. Then, clone formation ability was detected after 8 Gy X-ray irradiation. The A549 cells overexpressing the target circRNA were irradiated with 8 Gy X-ray, and the target miRNA was overexpressed in the cells to detect their clone formation ability. Data were compared between groups by using independent sample t test. Results qRT-PCR results revealed that circRNA_0128846 was the target circRNA, and its relative expression level in human NSCLC cells A549, H460, H1299, and H1975 was higher than that in the human bronchial epithelial cell line Beas-2B (t=6.200, 7.903, 6.010, 6.132; all P<0.01). After circRNA_0128846 was overexpressed, the clone formation ability of irradiated A549 cells was enhanced (0.22% vs. 0.45%, t=4.427, P<0.05). After circRNA_0128846 was silenced, the clone formation ability of irradiated A549R cells decreased (0.23% vs. 0.10%, t=3.780, P<0.05). qRT-PCR results showed that miR-1183 was the target miRNA, and the overexpression of circRNA_0128846 in A549 cells significantly down-regulated the expression of miR-1183 (t=6.002, P<0.01). Dual-luciferase reporter gene analysis confirmed that the overexpression of miR-1183 could significantly reduce the expression of circRNA_0128846 (t=4.562, P<0.05). The relative expression level of miR-1183 in A549R cells was significantly lower than that in parental A549 cells (t=6.025, P<0.01). The overexpression of miR-1183 significantly reduced the clone formation ability of A549R cells after irradiation; the silencing of miR-1183 significantly enhanced the clone formation ability of A549 cells after irradiation (0.26% vs. 0.15%, 0.21% vs. 0.31%; t=3.671, 3.293; both P<0.05); and the overexpression of miR-1183 significantly reduced the promoting effect of the overexpression of circRNA_0128846 on the clone formation ability in A549 cells (1.90% vs. 1.20%, t=6.325, P<0.01). Conclusion In human NSCLC cells, circRNA_0128846 acts as a miR-1183 adsorption sponge that can inhibit the radiosensitization effect of miR-1183 by reducing miR-1183 expression, thereby promoting NSCLC radioresistance.
2022, 46(1): 27-34.
doi: 10.3760/cma.j.cn121381-202104011-00144
Abstract:
Objective To investigate the feasibility of magnetic resonance apparent diffusion coefficient (ADC) value for preoperative quantitative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) and to compare the diagnostic efficacy of ADC mean value (ADCmean) and ADC minimum value (ADCmin) for preoperative quantitative prediction of MVI in HCC. Methods PubMed, Embase, Web of Science, Cochrane Library, CNKI, and Wanfang data were researched from establishment to October 2020. Literature was screened in accordance with the inclusion and exclusion criteria; the basic characteristics and diagnostic parameters of the study were extracted, and the research quality was scored using the quality assessment of diagnostic accuracy studies-2 scale. The summary receiver operating characteristic (SROC) curve was drawn, and the area under curve (AUC) was calculated. In addition, the Mann-Whitney U test was used to compare the differences among the groups. Egger's funnel chart and independent sample t test were used to compare the publication bias for the included literature. Results A total of 13 up-to-standard literature with 1432 cases of HCC (2303 lesions of HCC) were included in the meta-analysis. ADCmean and ADCmin in MVI-positive lesions were significantly lower than those in MVI-negative lesions, with mean differences of −0.17×10−3 mm2/s (95%CI: (−0.23 – −0.12)×10−3 mm2/s, Z=6.58, P<0.001) and −0.15×10−3 mm2/s (95% CI: (−0.18 – −0.12)×10−3 mm2/s, Z=9.91, P<0.001), respectively. Moreover, the best cutoff values of ADCmean and ADCmin for preoperative diagnosis of HCC MVI were 1.11×10−3 mm2/s and 0.959×10−3 mm2/s, respectively, based on the maximum Youden index. The pooled sensitivity of ADCmean and ADCmin in the preoperative quantitative prediction of MVI-positive lessions with HCC was 0.74 and 0.65; the specificity was 0.69 and 0.68, and SROC AUC was 0.7722 and 0.7326, respectively. However, this result showed no significant difference (Z=−0.917, −0.525, −0.131; all P>0.05). Furthermore, subgroup analysis showed that the year of publication, MVI positive and negative ratio, and the number of b-values might cause heterogeneity, and Egger's funnel plots of ADCmean and ADCmin showed no statistically significance (no publication bias; t=−1.58, −0.71; both P>0.05). Conclusions The ADC value can be used as a reliable and noninvasive indicator for preoperative quantitative prediction of MVI in HCC. Compared with ADCmin, ADCmean has superior diagnostic efficacy in predicting MVI-positive patients with HCC.
2022, 46(1): 35-41.
doi: 10.3760/cma.j.cn121381-202101045-00129
Abstract:
Alzheimer disease (AD) is a progressive neurodegenerative disease. Amyloid beta-peptides (Aβ) deposition and neurofibrillary tangles (NFT) formed by hyperphosphorylated Tau protein are the pathological features of the disease. In the past two decades, molecular imaging probes have made great progress in the diagnosis and treatment of AD, and have perfomred the important role beyond traditional cerebral perfusion and glucose metabolism imaging. Molecular imaging probes which specifically bind to Aβ or NFT can become valuable tools for accurate and early diagnosis of AD, and have been proposed as biomarkers in the recently revised clinical diagnostic criteria. In this paper, the research status and advances of Aβ and NFT molecular imaging probes are reviewed.
Alzheimer disease (AD) is a progressive neurodegenerative disease. Amyloid beta-peptides (Aβ) deposition and neurofibrillary tangles (NFT) formed by hyperphosphorylated Tau protein are the pathological features of the disease. In the past two decades, molecular imaging probes have made great progress in the diagnosis and treatment of AD, and have perfomred the important role beyond traditional cerebral perfusion and glucose metabolism imaging. Molecular imaging probes which specifically bind to Aβ or NFT can become valuable tools for accurate and early diagnosis of AD, and have been proposed as biomarkers in the recently revised clinical diagnostic criteria. In this paper, the research status and advances of Aβ and NFT molecular imaging probes are reviewed.
2022, 46(1): 42-46.
doi: 10.3760/cma.j.cn121381-202105005-00131
Abstract:
According to different risk stratification results of differentiated thyroid cancer (DTC) patients after surgery, some patients may need further 131I treatment, but 131I can emit radiation to the surrounding population. Therefore, the correct assessment of radiation dose in patients is crucial to the individualization of radiation protection and the optimization of 131I treatment process. For the measurement method of radiation dose during 131I treatment after DTC, there are mainly two types, which are in vivo and in vitro. In vitro measurements include urine and blood measurement methods; in vivo measurements mainly include local and systemic measurement methods. The authors mainly discuss dose-related measurement methods and clinical application.
According to different risk stratification results of differentiated thyroid cancer (DTC) patients after surgery, some patients may need further 131I treatment, but 131I can emit radiation to the surrounding population. Therefore, the correct assessment of radiation dose in patients is crucial to the individualization of radiation protection and the optimization of 131I treatment process. For the measurement method of radiation dose during 131I treatment after DTC, there are mainly two types, which are in vivo and in vitro. In vitro measurements include urine and blood measurement methods; in vivo measurements mainly include local and systemic measurement methods. The authors mainly discuss dose-related measurement methods and clinical application.
2022, 46(1): 47-52.
doi: 10.3760/cma.j.cn121381-202106022-00128
Abstract:
Exosomes are important substances involved in intercellular signal transduction and have high biological values. Accordingly, exosomes have become a research hotspot. Highly specific and sensitive exosome-tracing method is the key to revealing the biological function of exosomes. Exosome tracing relies mostly on molecular imaging and its advantages focus primarily on nuclear-medicine molecular imaging, which includes direct and indirect radionuclide-labeling methods. Nuclear-medicine molecular imaging could be combined with anatomical imaging to quantitatively monitor exosome distribution and could be used to evaluate the therapeutic effect of exosomes. It plays an extremely important role in exosome tracing. This paper reviews the biological value of exosomes and the research progress in tracing exosomes through nuclear-medicine molecular imaging.
Exosomes are important substances involved in intercellular signal transduction and have high biological values. Accordingly, exosomes have become a research hotspot. Highly specific and sensitive exosome-tracing method is the key to revealing the biological function of exosomes. Exosome tracing relies mostly on molecular imaging and its advantages focus primarily on nuclear-medicine molecular imaging, which includes direct and indirect radionuclide-labeling methods. Nuclear-medicine molecular imaging could be combined with anatomical imaging to quantitatively monitor exosome distribution and could be used to evaluate the therapeutic effect of exosomes. It plays an extremely important role in exosome tracing. This paper reviews the biological value of exosomes and the research progress in tracing exosomes through nuclear-medicine molecular imaging.
2022, 46(1): 53-57.
doi: 10.3760/cma.j.cn121381-202101014-00133
Abstract:
As one kind of semi-rigid, avascular and non-innervated connective tissue, cartilage has a variety of physiological functions such as load-bearing, stress-cushioning and movement-assisting. The intrinsic self-repair ability of cartilage is poor, and it is not easy for cartilage to reverse and is difficult to treat the injury. In recent years, many studies have shown that appropriate electromagnetic radiation has positive significance for the maintenance of chondrocytes morphology, the secretion of its related cytokines, the homeostasis of cartilage extracellular matrix, and the treatment of osteoarthritis. This paper reviews the biological effects of electromagnetic radiation on cartilage and its possible mechanism.
As one kind of semi-rigid, avascular and non-innervated connective tissue, cartilage has a variety of physiological functions such as load-bearing, stress-cushioning and movement-assisting. The intrinsic self-repair ability of cartilage is poor, and it is not easy for cartilage to reverse and is difficult to treat the injury. In recent years, many studies have shown that appropriate electromagnetic radiation has positive significance for the maintenance of chondrocytes morphology, the secretion of its related cytokines, the homeostasis of cartilage extracellular matrix, and the treatment of osteoarthritis. This paper reviews the biological effects of electromagnetic radiation on cartilage and its possible mechanism.
2022, 46(1): 58-63.
doi: 10.3760/cma.j.cn121381-202012025-00138
Abstract:
The incidence of prostate cancer (PCa) ranks second among male malignancies worldwide. With the quickening growth of population aging, the incidence and case fatality rate of PCa are also increasing year by year. Failure to detect, test, and diagnose PCa early will seriously harm the health of elderly men. Since the new specification of multiparameter magnetic resonance imaging (mpMRI) sequence and score were updated in the prostate imaging reporting and data system V2.1, the application prospect of mpMRI in PCa has became more extensive. A number of studies have reported the application value of mpMRI in PCa before biopsy and in guiding prostate-targeted biopsy, active surveillance, local recurrence, and metastasis after radical prostatectomy. However, mpMRI still has limitations in the evaluation of PCa. This article mainly focuses on the new criteria of mpMRI key sequences and scores as well as the application progress of mpMRI in the evaluation of PCa and its current limitations and potential solutions.
The incidence of prostate cancer (PCa) ranks second among male malignancies worldwide. With the quickening growth of population aging, the incidence and case fatality rate of PCa are also increasing year by year. Failure to detect, test, and diagnose PCa early will seriously harm the health of elderly men. Since the new specification of multiparameter magnetic resonance imaging (mpMRI) sequence and score were updated in the prostate imaging reporting and data system V2.1, the application prospect of mpMRI in PCa has became more extensive. A number of studies have reported the application value of mpMRI in PCa before biopsy and in guiding prostate-targeted biopsy, active surveillance, local recurrence, and metastasis after radical prostatectomy. However, mpMRI still has limitations in the evaluation of PCa. This article mainly focuses on the new criteria of mpMRI key sequences and scores as well as the application progress of mpMRI in the evaluation of PCa and its current limitations and potential solutions.
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