目的探讨甲状腺肉瘤的诊断与治疗。 方法回顾性分析2008年1月至2013年8月期间贵阳医学院附属医院甲状腺外科和贵州肿瘤医院甲状腺外科收治的5例甲状腺肉瘤患者的临床资料。 结果5例患者均行根治性手术，3例行术后化疗及放疗。术后均未发生声音嘶哑、呼吸困难、呛咳、肺部感染等并发症，切口均甲级愈合。经病理学免疫组化检查，具体分型为甲状腺组织细胞肉瘤1例，甲状腺血管肉瘤2例，甲状腺平滑肌肉瘤1例，甲状腺未分化肉瘤1例；波形蛋白（Vimentin）阳性5例，角蛋白（CK）阳性2例，平滑肌肌动蛋白（SMA）、结蛋白（Des）及S-100各阳性1例，甲状腺球蛋白（TG）、上皮膜抗原（EMA）、甲状腺转录因子（TTF）及降钙素均为阴性。术后5例患者均经电话随访，随访时间3～9个月，中位数为6个月。随访期间，3例患者因复发和转移而死亡；余2例仍在化疗及放疗中，无复发及转移。 结论甲状腺肉瘤的恶性程度高，宜采用以手术为主的综合治疗方案。
ObjectiveTo investigate the effects of cinobufagin on the apoptosis in U-2OS osteosarcomas cells (U-2OS cells) and explore its potential mechanism. MethodsThe cytostatic effects of cinobufagin (10, 20, 50, 100, 200, and 400 nmol/L) on U-2OS cells were evaluated by MTT assay at 24, 48, and 72 hours after culture; simple U-2OS cells served as control group. The impact of cinobufagin (100 nmol/L) on the apoptosis in U-2OS cells was determined by flow cytometry at 48 hours after culture, which were treated with cinobufagin (experimental group) or with cinobufagin plus Z-VAD-FMK (control group), and simple U-2OS cells served as blank control group. The Caspase-3 activity was measured by Caspase-3 activity assay kit at 48 hours after culture, which were treated with cinobufagin (20, 50, and 100 nmol/L), and simple U-2OS cells served as control group.The expression of apoptosis signal pathway related proteins in U-2OS cells treated with cinobufagin were detected by Western blot at 48 hours after culture, which were treated with cinobufagin (20, 50, and 100 nmol/L), and simple U-2OS cells served as control group. ResultsThe results of MTT assay showed that cinobufagin inhibited the proliferation of U-2OS cells in a dose- and time-dependent manners. At each time point, the growth rate of U-2OS cells was significantly reduced with the increasing cinobufagin concentration, and as time prolonged, the growth rate of U-2OS cells behaved the same way in the same group. There were significant differences among different time points and groups (P<0.05). The apoptotic rate of experimental group (46.87%±11.23%) was significantly higher than that of the control group (2.34%±0.98%) and blank control group (1.04%±0.25%) (P<0.05). The Caspase-3 activity in 20, 50, and 100 nmol/L groups were 1.14±0.32, 1.31±0.41, and 1.92±0.54, respectively, which were significantly higher than that in control group (P<0.05). Compared with 20 and 50 nmol/L groups, 100 nmol/L group significantly increased the Caspase-3 activity in U-2OS cells (P<0.05). Compared with the control group, the expressions of cleaved Caspase-3, cleaved Caspase-9, and Bax were obviously up-regulated; the Bcl-2 expression was down-regulated; and the ratio of Bax/Bcl-2 was increased in different cinobufagin-treated groups (P<0.05). The same tendency was seen in different cinobufagin-treated goups, showing significant differences among groups (P<0.05). ConclusionCinobufagin can inhibite the proliferation of U-2OS cells, and induce cell apoptosis. The potential mechanism of cinobufagin-induced apoptosis may be related to the mitochondria-mediated pathway.
ObjectiveTo systematically review the predictive value of ezrin expression in bone and soft tissue sarcomas.MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 2, 2016), CNKI, CBM, VIP, and WanFang Data were searched to collect cohort studies about the prognostic value of ezrin expression in bone and soft tissue sarcomas from inception to May 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using RevMan 5.3 software.ResultsFinally, a total of 17 cohort studies, involving 1 460 patients were included. The results of meta-analysis showed that: the overall survival (HR=1.90, 95%CI 1.70 to 2.13, P<0.000 01), event-free survival (HR=2.42, 95%CI 1.53 to 3.84, P=0.0002), metastasis-free survival (HR=2.09, 95%CI 1.10 to 3.97, P=0.02) in the bone and soft tissue sarcomas patients with ezrin high expression were lower than patients with lower expression. The same results were also observed in subgroup analysis according to histologica type and ethnicity in overall survival.ConclusionEzrin high expression may be used as a predictive maker for poor prognosis in bone and soft tissue sarcomas. For the quantity and quality limitation of the included studies, this conclusion still needs to be further proved by performing more high quality studies.
ObjectiveTo summarize the predictive factors of recurrence of retroperitoneal sarcoma.MethodsThe literatures on the recurrence of retroperitoneal sarcoma at home and abroad were reviewed and analyzed.ResultsTumor size, margin negative resection, tumor grade, multifocal, and histological types were important predictors of the recurrence of retroperitoneal sarcoma. In addition, combined organ resection, diversity of tumor growth patterns, and tumor-free surgical techniques could also affect the recurrence of retroperitoneal sarcoma.ConclusionUnderstanding the predictive factors of the recurrence of retroperitoneal sarcoma is of great significance to guide surgeons to understand and recognize the disease, to reduce the recurrence of retroperitoneal sarcoma.
Objective To assess effectiveness of chemotherapy versus non-chemotherapy in the treatment of soft tissue sarcoma. Methods We searched MEDLINE (1966 to Dec. 2008), EMBASE (1984 to Dec. 2008), OVID (1980 to Dec. 2008), CBMdisc (1980 to Dec. 2008), and the Cochrane Central Register of Controlled Trials. We also handsearched Journal of Chinese Oncology, Journal of Chinese Clinical Oncology, and Tumor (from inception to Dec. 2008). The quality of the included studies was evaluated by two reviewers independently and meta-analysis was performed for results of the homogenous studies. Results Six studies involving 836 participants related to primary, high grade, nonmetastatic soft tissue sarcoma were included. All included studies were unclear in reporting randomization and blinding; all studies reported the number and the reason of withdraw; and baseline conditions of all studies were compared. The results of meta-analyses showed that there were no significant differences in 5-year overal survival (RR=0.90, 95%CI0.76 to 1.06), local recurrence (OR=0.69, 95%CI 0.36 to 1.32), distant recurrence (OR=0.83, 95%CI 0.62 to 1.11), and overall recurrence (RR=0.91, 95%CI 0.78 to 1.06) between the chemotherapy group and the control group. But as to 5-year disease-free survival, the chemotherapy group was better than the control group (RR=0.73, 95%CI 0.63 to 0.86). Conclusion There is no advantage for the chemotherapy group over the control group in 5-year overal survival, local recurrence, distant recurrence and overall recurrence. Due to the risk of selection bias, performance bias and published bias, the evidence is not b enough to judge whether chemotherapy is better than control in treating soft tissue sarcoma. Our conclusion suggests that larger-scale randomized trials should be performed in future.
Objective To reveal the association between the single nucleotide polymorphism (SNP) of v-maf musculoaponeurotic fibrosarcoma oncogene homolog B (MAFB) gene rs17820943 locus and non-syndromic cleft l ip with or without cleft palate (NSCL/P) in the southern Chinese Han population. Methods Genotyping of MAFB gene rs17820943 polymorphism was carried out in 300 patients with NSCL/P, 354 normal controls, and an additional 168 case-parent trios with matrix-assisted laser desorption/ionisation time-of-fl ight (MALDI-TOF) mass spectrometry. Then based on the genotypingresults, both a case-control association study and a case-parent trio association study were performed. Results Significant differences were found in the allele and genotype frequencies of rs17820943 locus between case and control groups (Pallele=0.001 and Pgenotype=0.002, respectively). To be specific, the odds radio (OR) values and 95% confidence interval (95%CI) of allele T (frequencies of cases ∶ controls = 0.358 ∶ 0.448) and genotype TT (frequencies of cases ∶ controls = 0.110 ∶ 0.195) were ORT = 0.69 (95%CI: 0.55-0.86) and ORTT = 0.43 (95%CI: 0.26-0.70), respectively. Subsequent case-parent trio analysis also indicated an association between MAFB rs17820943 variant and the risk of NSCL/P (ORT vs. C = 0.55, 95%CI: 0.41-0.75, P value of transmission disequilibrium test was 0.000). Conclusion Polymorphism of MAFB gene rs17820943 locus is associated with NSCL/P in the southern Chinese Han population; MAFB rs17820943 variant may be a susceptible gene of NSCL/P.
Objective To investigate the clinical features, diagnosis, and treatment of patients with localized epithelioid sarcoma (ES).Methods From January 2000 to September 2006, 11 patients with ES weretreated. There were 7 males and 4 females aged 14-41 years. The patients’ agesat the initial onset were 9-41 years, averaged 27.7 years. The ES was located in the upper extremity in 7 patients，lower extremity in 3, and abdomen in 1. Among the patients, 10 had a recurrence. Tumor lt; 2cm was seen in 7 patients, 2-5cm in 1, and gt;5 cm in 3. One patient underwent an operation of local resection at another hospital. Seven patients underwent an expanding resection surgery, and the tumors with the surrounding normal tissues 3 cm above were removed. Three patients underwent a radical surgery, including extremity amputation or finger amputation. All the patients underwent routine radiotherapy and chemotherapy after operation. Results All the wounds had a healing at the firstintention without complications. All the flaps survived and the grafted bone had a fusion. Among the 11 patients followed up for 5-54 months averaged 23.2 months, 8 had a recurrence 2-20 months (average, 8.9 months) after operation, witha recurrence rate of 73%. And among the patients, 3 had a further radical surgery of extremity amputation. Four patients had a metastasis in the axillary lymphnodes 6-24 months after operation, and 1 patient had a lung metastasis 10 months after operation. They did not have a further surgical treatment. Four patients died of systemic failure 6-14 months after operation. Conclusion An early expanding resection surgery combined with postoperative chemotherapy and radiotherapy is the therapy of choice for treating ES.