2023 Vol. 47, No. 11
Display Method:
[PDF 2116KB]
2023, 47(11): 659-667.
doi: 10.3760/cma.j.cn121381-202301009-00338
Abstract:
Objective To explore the prognostic evaluation of the 18F-FDG PET/CT imaging response evaluation criteria in lymphoma (RECIL) for patients with non-Hodgkin's lymphoma (NHL) after autologous hematopoietic stem cell transplantation (ASCT) and compares it with the Lugano standard. Methods The clinical data and imaging data of 86 patients with NHL diagnosed by histopathological examination in Shanxi Provincial Cancer Hospital from October 2010 to November 2021 were retrospectively analyzed, including 63 male and 23 female, aged 34.0(22.0, 47.0) years old. All patients underwent 18F-FDG PET/CT imaging before and after ASCT. According to the RECIL, all patients were evaluated for efficacy after ASCT. Based on the results of the patient efficacy evaluation, patients were divided into effective groups: complete remission (CR), partial remission (PR), and minor remission (MiR), and invalid groups: stable disease(SD), and progressive disease(PD). According to the Lugano standard, the patients were divided into complete remission group (CR), partial remission group (PR), and ineffective group (SD+PD). According to the RECIL, the patients were divided into complete remission group (CR), partial remission group (PR+MiR), andineffective group (SD+PD). The three-year overall survival (OS) period of the patients was followed up and analyzed. Pearson Chi-squared test and Mann Whitney U test were used to compare the differences in clinical features and the 18F-FDG PET/CT parameters between the effective group and the ineffective group. Univariate and multivariate Cox proportional risk regression analysis were used to screen for relevant factors affecting the prognosis of patients with NHL after ASCT. Kappa test was used to evaluate the consistency of efficacy between the RECIL and Lugano standard in evaluating the efficacy of ASCT in patients with NHL. Kaplan-Meier survival analysis was used to compare the differences in three-year OS rates between RECIL and Lugano standard in complete remission, partial remission, and ineffective groups. Log rank test was used to analyze the differences in three-year OS rates among the three groups. ROC curves were used to compare the predictiveefficacy of the RECIL and Lugano standard in three-year OS rates. Results A statistically significant difference was observed in SUVmax (1.3(1.0, 2.0) vs. 5.2(4.8, 8.9)) between the effective group and the ineffective group after transplantation (Z=−6.149, P<0.001). The percentage of patients in the effective group who received less than two chemotherapy regimens before transplantation (65.7%(44/67)) was higher than those in the ineffective group (21.1%(4/19)), and the difference was statistically significant (χ2=11.949, P<0.001). The percentage of patients in the first-line consolidation treatment group (83.6% (56/67)) was higher than those in the ineffective group (31.6%(6/19)), and the difference was statistically significant (χ2=19.897, P<0.001). The results of univariate Cox proportional risk regression analysis showed the RECIL (HR=0.020, 95%CI: 0.003–0.155, P<0.001), post-transplant SUVmax (HR=1.177, 95%CI: 1.087–1.274, P<0.001), number of pretransplant chemotherapy regimens (HR=6.197, 95%CI: 1.338–28.711, P<0.05), and transplant timing (HR=8.808, 95%CI: 2.289–33.891, P<0.01) were prognostic factors for patients with NHL. The results of multivariate Cox proportional risk regression analysis showed the RECIL (HR=0.040, 95%CI: 0.004–0.439, P<0.01) was an independent risk factor for the prognosis of patients with NHL. The RECIL and Lugano standard were consistent in the efficacy evaluation of patients with NHL after ASCT (86.0%(74/86), Kappa=0.77, P<0.001). The Kaplan-Meier survival analysis results showed statistically significantdifferences in three-year OS rates (2.2%(1/49) vs. 0(0/18) vs. 52.0%(10/19), 2.2%(1/49) vs. 0(0/15) vs. 45.5%(10/22)) between the complete remission group, partial remission group, and ineffective group according to the RECIL and Lugano standard (χ2=42.727, 33.646; both P<0.001). The area under curve predicted by the RECIL for the three-year OS rate was slightly higher than that of the Lugano standard (0.884 vs. 0.865, Z=1.334, P>0.05). Conclusion The RECIL can accurately evaluate the prognosis of patients with NHL after ASCT, and the RECIL and Lugano standard have similar prognostic evaluation effects on patients with NHL after ASCT.
2023, 47(11): 668-673.
doi: 10.3760/cma.j.cn121381-202304006-00359
Abstract:
Objective To evaluate the detection and qualitative diagnostic efficacy of artificial intelligence (AI) in pulmonary nodules. Method A retrospective study method was used to select 355 patients (205 females and 150 males, aged (55.1±12.2) years old) from the lung nodule case database of Hebei Petro China Central Hospital from 2020 to 2021 through simple random sampling. Lung CT images were imported into the AI system. The diagnostic results of AI were compared with those of three junior professional physicians. Two intermediate professional physicians reviewed the CT images in accordance with the double-blind principle, and the consistent opinions of two intermediate professional physicians were used as reference standards for the diagnosis of true nodules. The sensitivities of AI and junior professional physicians in the detection of pulmonary nodules were also compared. A total of 105 patients underwent preoperative-CT guided puncture histopathological examination or postoperative histopathological examination after lung tissue resection. The histopathological examination results were used as the "gold standard" to compare the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of AI and the deputy chief physician in the qualitative diagnosis of pulmonary nodules. Intergroup comparison of counting data was conducted using chi-square or Fisher's exact probability test. Results A total of 1 072 true nodules were detected in the CT images of 355 patients. Among these nodules, 1 063 were detected by AI, with a sensitivity of 99.16% (1 063/1 072), and 9 were missed. A total of 1 009 true nodules were detected by the junior professional physicians, with a sensitivity of 94.12% (1 009/1 072), and 63 were missed. In terms of pulmonary nodule detection, AI exhibited a significantly higher sensitivity than the junior professional physicians, and the difference was statistically significant (χ2=41.907, P<0.05). Meanwhile, 105 patients were confirmed to have 88 malignant nodules and 17 benign nodules via histopathological examination. A total of 86 cases were true positive, 15 were false positive, 2 were true negative, and 2 were false negative in the qualitative diagnosis of pulmonary nodules using AI. The deputy chief physician identified 83 true positive cases, 1 false positive case, 16 true negative cases, and 5 false negative cases in the qualitative diagnosis of pulmonary nodules. The specificity and positive predictive value of the qualitative diagnosis of pulmonary nodules by the deputy chief physician were significantly higher than those of AI (94.12% (16/17) vs. 11.76% (2/17) and Fisher's exact probability test, P<0.05; 98.81% (83/84) vs. 85.15% (86/101)), χ2=9.172, P<0.05).The deputy chief physician attained a lower sensitivity than AI in terms of the in qualitative diagnosis of pulmonary nodules, but no statistically significant difference was observed (94.32% (83/88) vs. 97.73% (86/88), χ2=0.595, P>0.05). A higher negative predictive value was detected in the qualitative diagnosis of pulmonary nodules by the deputy chief physician compared with that of the AI. However, the difference was not statistically significant (76.19% (16/21) vs. 50.00% (2/4), Fisher's exact probability test, P>0.05). Overall, the deputy chief physician attained a higher accuracy in the qualitative diagnosis of pulmonary nodules compared with the AI (94.29% (99/105) vs. 83.81% (88/105)), χ2=8.796, P<0.05). Conclusions AI shows a high sensitivity in the detection and qualitative diagnosis of pulmonary nodules. However, its specificity, positive predictive value, negative predictive value, and accuracy are low. In clinical work, physicians can use the good sensitivity of AI to improve work efficiency, but it cannot replace manual analysis results as the standard for the qualitative diagnosis of pulmonary nodules.
2023, 47(11): 674-689.
doi: 10.3760/cma.j.cn121381-202206012-00358
Abstract:
Objective To investigate the effects of long non-coding RNA microRNA503 host gene (LncRNA MIR503HG) on the radiosensitivity of colon cancer cells by regulating the expression of microRNA-224-5p chondroitin sulfate synthas 1 (miR-224-5pCHSY1). Methods A retrospective analysis was conducted on 48 patients with colon cancer treated in PLA Rocket Force Characteristic Medical Center from March 2019 to January 2022. These patients were selected as tissue samples. The cohort included 28 males and 20 females, aged (57.43±5.28) years. On the basis of the lesions after radiotherapy, they were divided into the radiation resistance group (n=23) and the radiosensitive group (n=25). The expression levels of LncRNA MIR503HG and miR-224-5pCHSY1 in colon cancer tissues and cell lines (CCD841, COLO320, SW480, RKO, and HCT116) were detected by real-time quantitative polymerase chain reaction (qRT-PCR). The radiation-resistant colon cancer cell line HCT116R was constructed and divided into the overexpressing LncRNA MIR503HG (MIR503HG) and its negative control group (mimic-NC), miR-224-5pCHSY1 inhibition group (anti-miR-224-5p) and its negative control group (anti-miR-NC), overexpressing LncRNA MIR503HG+overexpressing miR-224-5pCHSY1 group (MIR503HG+miR-224-5p), and overexpressing LncRNA MIR503HG+negative control group (MIR503HG+miR-NC). The targeting effect of LncRNA MIR503HG and miR-224-5pCHSY1 was verified by dual-luciferase assay, and the cell survival fraction (SF) and apoptosis rate were detected. The data between two groups were compared using t-test. Results Compared with the radiosensitive group, the expression of LncRNA MIR503HG in the radiation resistance group was significantly lower (1.40±0.36 vs. 0.72±0.17), and the expression of miR-224-5pCHSY1 was significantly higher (1.06±0.25 vs. 1.54±0.27) in the radioresistant group, and the differences were statistically significant (t=8.247, 6.529; both P<0.05). The relative expression levels of LncRNA MIR503HG in the CCD841, COLO320, SW480, RKO, HCT116, and HCT116R cell lines were 2.38±0.06, 1.03±0.05, 0.87±0.03, 0.86±0.02, 0.77±0.04, and 0.54±0.09, respectively. The expression of miR-224-5pCHSY1 were 0.38±0.06, 0.56±0.01, 0.59±0.02, 0.59±0.05, 0.63±0.04, and 0.82±0.06, respectively. Compared with the normal cell line CCD841, the relative expression of LncRNA MIR503HG in the colon cancer cell lines COLO320, SW480, RKO, and HCT116 decreased significantly (t=2.061, 1.665, 4.058, 6.201; all P<0.05), while the expression of miR-224-5pCHSY1 increased significantly (t=1.238, 1.930, 2.037, 1.742; all P<0.05). Compared with the HCT116 cell line, the relative expression of LncRNAMIR503HG in HCT116R significantly decreased ((0.77±0.04)% vs. (0.54±0.09)%), whereas the expression of miR-224-5pCHSY1 significantly increased ((0.63±0.04)% vs. (0.82±0.06)%)(t=1.267, 2.370; both P<0.05). When the irradiation doses were 4, 6, and 8 Gy, the SF of HCT116R cells in the MIR503HG group were significantly lower than that in the mimic-NC group ((7.25±1.11)% vs. (11.34±2.65)%, (2.85±0.58)% vs. (6.08±1.10)%, and (0.58±0.05)% vs. (3.08±0.84)%), and the differences were statistically significant( t=1.064, 1.937, 2.650; all P<0.05)). After overexpression of LncRNAMIR503HG, HCT116R sensitization enhancement ratio (SER) of the MIR503HG group was 1.399. The apoptosis rates of HCT116R cells in the mimic-NC, MIR503HG, mimic-NC+4 Gy, and MIR503HG+4 Gy groups were (8.10±0.23)%, (18.44±1.57)%, (17.33±2.35)%, and (29.83±1.89)%, respectively. Compared with the mimic-NC group, the apoptosis rates of HCT116R cells in the MIR503HG and mimic-NC+4 Gy groups were significantly higher (t=2.003, 1.475; both P<0.05). Compared with the anti-miR-NC group, the luciferase activity of MIR503HG-Wt in the anti-miR-224-5p group increased significantly (1.02±0.20 vs. 1.60±0.25), and the difference was statistically significant (t=5.366, P<0.05). After the mutation of the miR-224-5pCHSY1 and LncRNA MIR503HG binding site, there was no significant difference in MIR503HG-Mut activity between the anti-miR-224-5p group and anti-miR-NC group (0.97±0.25 vs. 1.00±0.22)(t=0.291, P>0.05). Compared with the mimic-NC group, the expression of miR-224-5pCHSY1 in the MIR503HG group was significantly lower (1.97±0.13 vs. 1.12±0.12), and the difference was statistically significant (t=3.915, P<0.05). Moreover, the expression of miR-224-5pCHSY1 in the anti-miR-224-5p group was significantly lower than that in the anti-miR-NC group (1.99±0.19 vs. 0.92±0.18)(t=2.664, P<0.05). When the irradiation doses were 4, 6, and 8 Gy, the SF of HCT116R cells in the anti-miR-224-5p group was significantly lower than that in the anti-miR-NC group ((0.59±0.08)% vs. (0.79±0.12)%, (0.39±0.06)% vs. (0.67±0.07)%, and (0.19±0.04)% vs. (0.52±0.04)%), the differences were statistically significant (t=1.281, 2.034, 2.911; all P<0.05). After inhibiting the expression of miR-224-5pCHSY1, the SER of HCT116R cells in the anti-miR-224-5p group was 1.403. The apoptosis rates of the anti-miR-NC, anti-miR-224-5p, anti-miR-NC+4 Gy, and anti-miR-224-5p+4 Gy groups were (5.08±0.78)%, (14.48±1.21)%, (13.89±1.36)%, and (23.64±1.03)%, respectively. Compared with the anti-miR-NC group, the apoptosis rates of the anti-miR-224-5p and anti-miR-NC+4 Gy groups were significantly higher (t=2.067, 1.934; both P<0.05). Compared with the anti-miR-NC+4 Gy group, the apoptosis rate of the anti-miR-224-5p+4 Gy group was significantly higher (t=4.026, P<0.05). The SFs of the mimic-NC, MIR503HG, MIR503HG+miR-NC, and MIR503HG+miR-224-5p groups were (0.82±0.17)%, (0.53±0.12)%, (0.54±0.11)%, and (0.78±0.15)%, respectively, when the irradiation dose was 4 Gy; (0.66±0.13)%, (0.38±0.09)%, (0.35±0.08)%, and (0.57±0.10)%, respectively, when the radiation dose was 6 Gy; and (0.49±0.10)%, (0.15±0.06)%, (0.13±0.05)%, and (0.43±0.11)%, respectively, when the radiation dose was 8 Gy. Compared with the mimic-NC group, the SF of HCT116R cells in the MIR503HG group decreased significantly when the irradiation dose was ≥4 Gy (t=1.609, 1.533, 1.927; all P<0.05), and the SF of HCT116R cells in the MIR503HG+miR-NC group decreased significantly (t=1.294, 1.490, 1.825; all P<0.05). Compared with the MIR503HG+miR-NC group, the SF of HCT116R cells in the MIR503HG+miR-224-5p group increased significantly when the irradiation dose was ≥ 4 Gy, and the differences were statistically significant (t=1.573, 1.204, 1.937; all P<0.05). After overexpression of miR-224-5pCHSY1, the SER of HCT116R cells in the MIR503HG+miR-224-5p group was 0.825, which was significantly lower than that of MIR503HG group. The apoptosis rates of the mimic-NC, MIR503HG, MIR503HG+miR-NC, and MIR503HG+miR-224-5p groups were (11.61±2.10)%, (24.97±0.91)%, (24.81±1.27)%, and (16.15±1.10)%, respectively. Compared with the mimic-NC group, the apoptosis rate of HCT116R cells in the MIR503HG and MIR503HG+miR-NC groups were significantly higher (t=2.304, 2.159; both P<0.05). Compared with the MIR503HG+miR-NC group, the apoptosis rate of HCT116R cells in the MIR503HG+miR-224-5p group was significantly lower (t=2.067, P<0.05). Conclusion Overexpression of LncRNA MIR503HG can increase the radiosensitivity of colon cancer cells by inhibiting miR-224-5pCHSY1 expression.
2023, 47(11): 690-698.
doi: 10.3760/cma.j.cn121381-202301006-00360
Abstract:
Objective To explore the effect of melatonin on gut microbiota of a mouse model of γ-ray-induced radiation intestinal injury. Methods C57BL/6J male mice were divided into three groups using a simple random grouping method, namely, the control (without any treatment), irradiation (abdominal irradiation of mice at a dose of 13 Gy), and melatonin+irradiation groups (administration of melatonin to the mice for five consecutive days, followed by abdominal irradiation at a dose of 13 Gy), with five mice in each group. Mouse feces were collected 3 days after radiation, and gut microbiota analysis was conducted via 16S rDNA amplicon sequencing. Operational taxonomic units clustering and species annotation were analyzed using Uparse software. Sample complexity analysis and multisample comparative analysis were completed using the Qiime microbiome analysis platform. Results Pasteurella, Candidatus Arthromitus, and Bacteroides were the most abundant bacteria in the intestines of mice in the melatonin+irradiation group. Compared with the control group, the melatonin+irradiation group showed decreased abundance and diversity of gut microbiota (both P<0.01) and increased community structure (P<0.001). From phylum to species, Proteobacteria phylum/class, Enterobacteriales order/family, Pasteurellales order/family/genus/species and Clostridiales class/order were the most abundant gut microbiota of mice in melatonin+irradiation group. In the construction of a symbiotic network of dominant species in mouse gut microbiota, the dominant interacting species under Proteobacteria, Actinobacteria, Bacteroidetes, and Firmicutes and their interacting relationships were identified. Conclusion The dominant species in the intestines of mice from melatonin+irradiation group might contribute to the relief of γ-ray-induced radiation intestinal injury mediated by melatonin.
2023, 47(11): 699-706.
doi: 10.3760/cma.j.cn121381-202211016-00346
Abstract:
Gastric cancer is one of the most common malignant tumors in China, with significant tumor heterogeneity in biology and genetics. PET is a non-invasive, real-time in vivo examination method. The use of PET imaging for early detection, treatment planning and efficacy monitoring is helpful to assist diagnosis and prognosis, improve the five-year survival rate of gastric cancer patients, and help clinicians to diagnose and identify its heterogeneity, so as to select individualized treatment plans. Therefore, the research of specific probes for gastric cancer based on PET imaging has been highly valued by researchers. The author summarized the hot research on specific targets and corresponding molecular probes for gastric cancer, describes and analyzes their development history and research results, hoping to provide reference and guidance for the development of novel PET imaging probes for gastric cancer.
Gastric cancer is one of the most common malignant tumors in China, with significant tumor heterogeneity in biology and genetics. PET is a non-invasive, real-time in vivo examination method. The use of PET imaging for early detection, treatment planning and efficacy monitoring is helpful to assist diagnosis and prognosis, improve the five-year survival rate of gastric cancer patients, and help clinicians to diagnose and identify its heterogeneity, so as to select individualized treatment plans. Therefore, the research of specific probes for gastric cancer based on PET imaging has been highly valued by researchers. The author summarized the hot research on specific targets and corresponding molecular probes for gastric cancer, describes and analyzes their development history and research results, hoping to provide reference and guidance for the development of novel PET imaging probes for gastric cancer.
2023, 47(11): 707-711.
doi: 10.3760/cma.j.cn121381-202302010-00343
Abstract:
Prostate cancer (PCa) is the most common urinary tumor in men. Prostate specific membrane antigen (PSMA) is specific in PCa expression. Radionuclide labeled PSMA PET has unique advantages in early diagnosis, staging and treatment of PCa. This paper reviews the latest research progress of PSMA PET in the diagnosis and treatment of PCa.
Prostate cancer (PCa) is the most common urinary tumor in men. Prostate specific membrane antigen (PSMA) is specific in PCa expression. Radionuclide labeled PSMA PET has unique advantages in early diagnosis, staging and treatment of PCa. This paper reviews the latest research progress of PSMA PET in the diagnosis and treatment of PCa.
2023, 47(11): 712-718.
doi: 10.3760/cma.j.cn121381-202302016-00357
Abstract:
Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome with complex mechanisms. The diagnosis of HFpEF is challenging due to the absence of specificity in early signs and symptoms. With the rapid development of related imaging techniques, further progress has been made in the study of the pathogenesis and pathophysiological changes of HFpEF, which opens up a new direction for the early diagnosis and clinical management of HFpEF. The paper reviews the current research status and progress on the imaging of HFpEF in recent years.
Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome with complex mechanisms. The diagnosis of HFpEF is challenging due to the absence of specificity in early signs and symptoms. With the rapid development of related imaging techniques, further progress has been made in the study of the pathogenesis and pathophysiological changes of HFpEF, which opens up a new direction for the early diagnosis and clinical management of HFpEF. The paper reviews the current research status and progress on the imaging of HFpEF in recent years.
2023, 47(11): 719-723.
doi: 10.3760/cma.j.cn121381-202211025-00355
Abstract:
Sclerosing angiomatoid nodular transformation (SANT) of spleen is a rare benign proliferative vascular lesion, histopathology is the "gold standard" for diagnosis. The author reported two cases of splenic SANT with 18F-fluorodeoxyglucose (FDG) PET/CT imaging, and analyzed the clinical, histopathological, therapeutic, and 18F-FDG PET/CT imaging aspects of the disease and deepened the understanding of this disease through literature review. A full understanding of the diagnostic criteria and imaging manifestations of SANT can help to obtain more information and make an accurate diagnosis.
Sclerosing angiomatoid nodular transformation (SANT) of spleen is a rare benign proliferative vascular lesion, histopathology is the "gold standard" for diagnosis. The author reported two cases of splenic SANT with 18F-fluorodeoxyglucose (FDG) PET/CT imaging, and analyzed the clinical, histopathological, therapeutic, and 18F-FDG PET/CT imaging aspects of the disease and deepened the understanding of this disease through literature review. A full understanding of the diagnostic criteria and imaging manifestations of SANT can help to obtain more information and make an accurate diagnosis.
2023, 47(11): 724-726.
doi: 10.3760/cma.j.cn121381-202211026-00363
Abstract:
Occult thyroid carcinoma (OTC) is rare in differentiated thyroid carcinoma (DTC), and cases of OTC with extensive systemic metastasis are rarely reported at home and abroad. This paper reported a case of follicular carcinoma of thyroid with extensive metastasis from skeleton, lungs, adrenal gland and other parts of the whole body without primary focus, by analyzing the diagnosis and treatment process, laboratory examination, histopathological examination results and reviewing the relevant literature, the possible causes of OTC and the treatment scheme of extensive metastasis in the whole body were discussed.
Occult thyroid carcinoma (OTC) is rare in differentiated thyroid carcinoma (DTC), and cases of OTC with extensive systemic metastasis are rarely reported at home and abroad. This paper reported a case of follicular carcinoma of thyroid with extensive metastasis from skeleton, lungs, adrenal gland and other parts of the whole body without primary focus, by analyzing the diagnosis and treatment process, laboratory examination, histopathological examination results and reviewing the relevant literature, the possible causes of OTC and the treatment scheme of extensive metastasis in the whole body were discussed.
Submit
Author Login
Referees
Editor-in-Chief
Editor Center
Email alert
RSS
