Objective To evaluate the clinical value of multi-detector row helical CT (MDCT) in Diagnosing the TN staging and typing of adenocarcinoma of esophagogastric junction. Methods From January 2008 to June 2011，149 consecutive cases with AEG confirmed surgery were examined by using MDCT scanner before surgery in West China Hospital，pathologic and operative finding diagnosis were correlated with that results of MDCT . Results The accuracies of MDCT for the T1, T2, T3, and T4 staging was 97.3%，91.3%，84.5%， and 89.3%，respectively， and for the typing of Ⅰ,Ⅱ, andⅢwas 84.6%, 63.8%, and 79.2%，respectively. The accuracies of MDCT to judge the metastasis of lymph node was 88.6%（132/149）. The feature of metastasis of lymph node with circular and fusion，significantly and obviously enhanced，ring and heterogeneous enhanced, which the positive rate of pathological metastasis was higher (P=0.000). Conclusions MDCT is an excellent diagnostic tool for the diagnosis of the TN staging and typing of AEG, which is useful for the selection of the surgical procedure and decision operation path.
Cancer immunotherapy refers to the therapeutic effect of controlling or eliminating tumor cells by interfering with the immune system to restore the anti-tumor immune response. Immune checkpoint inhibitor therapy that blocks programmed death -1/programmed cell death ligand-1/cytotoxic T lymphocyte-associated antigen 4 is one of the most commonly used tumor immunotherapies, with good efficacy and wide application. These drugs cause immune-related ocular complications such as uveitis, autoimmune retinopathy, and scleritis, which represent a new etiology of ocular inflammation. The ophthalmologist's grasp of the clinical characteristics of these diseases is helpful for timely diagnosis. At the same time, the ophthalmologist will work closely with the oncologist to make a comprehensive judgment based on the patient's primary tumor, survival prognosis, severity of adverse reactions related to ocular immunotherapy, and visual prognosis, and develop suitable therapeutic strategie, thereby saving the patients' vision and improving the quality of life.
PURPOSE:Studying the multidrug resistance(MDR) phenotype occurring in retinoblastoma and its mechanism. METHODS:Using the procedure of stepwise increase in drug concentrations to obtain a retinoblastoma subline which resistant to 600ng/ml vincristine (HXO-RB/VCR). Characteristics of this drug-resistant cell line were investigated by cell counting,drugcontents determinatin,drug sensitivity evaluation and radiation sensitivity test. RESULTS:This cell line was cross-resistant to VDS,MMC VP16，ADM ,DDP,CBP,but not resistant to BCNU and 5-Fu. It was proved to be collaterally sensitive to MTX,and the response to 60Co gamma;-ray was modified slightly in HXO-RB/VCR cell line. Intracellular levels of VCR was much higher in HXO-RB44 cells than in the resistant subline. Those cross-resistances can be reversed by verapamil partly. CONCLUSIONS:MDR and radiation resistance of retinoblastoma can be induced by exposing to VCR and reversed by verapamil partly. （Chin J Ocul Fundus Dis,1997,13: 6-9）
Objective To choose suitable free flaps for reconstructing headand neck defects caused by tumor resection. Methods A retrospective analyses was made in 86 cases of head and neck defects treated with four kinds of free flaps between January 1999 and January 2002. The head and neck defects were caused by tumor resection. The locations were oral cavity (n=32), hypopharynx (n=27), mandible (n=12), skull base (n=5), scalp and skin (n=6) andmidface(n=4). The donor sites of free flaps included the rectus abdominis (n=32), anterolateral thigh (n=10),jejunum (n=25), fibula (n=11), latissimus dorsi (n=4), forearm (n=3) and scapula (n=1). The sizesof the cutaneous/musculocutaneous flaps ranged from 4 cm×5 cm to 14 cm×24 cm. The lengths of the fibula were 4-16 cm,of jejunum 9-20 cm. Results The overall free flap success rate was 92% (79/86). Of 32 oral cavity defects, 22 were reconstructed by rectus abdominis (69%) and 10 by anterolateral thigh flaps (31%). Of 27 hypopharyngeal defects, 25 were restored by jejunum flaps (93%). Eleven of 12 mandibular defects were reconstructed by fibula flaps(92%). Four of 5 defects of skull base were reconstructed by rectus abodominis flaps (80%). The free flaps of rectus abodominis, anterolateral thigh, jejunum and fibula were most frequently used, accounting for 91%(78/86) of all flaps in head and neck defect reconstruction. Conclusion Although head and neck defects represent a complicated spectrum of subsites and loss, these four freeflaps can manage most reconstruction problems.
Objective To observe the different clinical response patterns of uveal melanoma (UM) patients after external scleral plaque radiotherapy (PRT), and to investigate the risk factors of secondary enucleation after treatment failure. MethodsA single-centre retrospective study. Demographic baseline characteristics and clinical data were collected from 465 UM patients treated with 125I external scleral PRT at Beijing Tongren Hospital from March 2011 to September 2017. Among them, 217 were male and 248 were female, tumor all occurred monocularly. The mean age of subjects was 46.7±12.1 years. Reasons for secondary enucleation included local tumor treatment failure, glaucoma, scleral necrosis and patient request. Tumor grading was based on the grading standards established by the American Joint Committee on Cancer (AJCC). The pattern of tumor response after PRT was classified as degenerated type, growth type, stable type or other types according to literature criteria. The median follow-up time after PRT was 59 months to observe tumor changes. Complete follow-up records of 3 or more color doppler ultrasound imaging (CDI) was available in 245 cases. A t-test was performed to compare the patient's age, intraocular pressure, best corrected visual acuity, tumor thickness and maximum basal diameter before treatment; a chi-square test was performed to compare the patient's gender, AJCC T classification of the tumor, whether the ciliary body was involved, presence of subretinal fluid, optic disc invasion and vitreous hemorrhage, tumor shape and location. Kaplan-Meier survival analysis was used to estimate the cumulative probability of secondary enucleation after extra-scleral PRT. Univariate and multivariate Cox proportional hazards regression analyses were used to evaluate the relationship between tumor characteristics and secondary enucleation after extra-scleral PRT. ResultsAmong 465 patients, eecondary enucleation was performed on 78 (16.8%, 78/465) patients during the follow-up period. The 1, 3 and 5 year secondary enucleation rates were 5.4%, 9.3% and 17.1%, respectively. Eye preservation was successful in 387 cases (83.2%, 387/465). Patients treated by secondary enucleation had a larger maximum basal diameter of tumor, a higher proportion of irregular and diffuse morphology, a cumulative macular involved and a higher AJCC T classification, the difference was statistically significant (P＜0.05). There were 115, 76, 27, and 27 cases of degenerated type, stable type, growth type, and other type, respectively. The tumor thickness of the growth type and other types was significantly smaller than that of the degenerated type and the stable type, and the difference was statistically significant (P＜0.05). Univariate Cox analysis showed that the maximum basal diameter of the tumor (HR=1.19), tumor thickness (HR=1.08), AJCC T classification (HR=1.90), growth type response pattern (relative to degenerated type response pattern) (HR=4.20) was associated with failure of eye preservation (P＜0.05). In the multivariate Cox analysis, the largest tumor basal diameter (HR=1.24) and the growth type response pattern (relative to the degenerated type response pattern) (HR=4.59) were still associated with failure of eye preservation (P＜0.05). ConclusionsThe tumor thickness of UM patients with growing and other response patterns after PRT is smaller before treatment; the maximum basal diameter of the tumor and the growing response pattern are independent risk factors for secondary enucleation.
Objective To observe the effects of immunologic cytokines or anti-angiogenesis gene transfer mediated by electroporation for choroidal melanoma cells.Methods The human embryo kidney cells and malignant choroidal melanoma cells were transfected with plasmids pNGVL-mIL2, pNGVL-mIL12, pCI-sFLK-1, pCR3.1-antiVEGF121,pCI-ExTek. Then the expression of mIL2, mIL12, sFLK-1, VEGF and ExTek were detected by enzymelinked immunosorbentassay (ELISA) and Western blot. Nude mice models of malignant choroidal melanoma were established and they were divided into four groups randomly. Each group was treated with 30 mu;l of 0.9% NaCl, 30 mu;g pNGVL, 30 mu;g antiVEGF121+sFLK-1+ExTek and 30 mu;g mIL2+mIL12 respectively by electroporation. Seven，14, 21, 28, 35 and 42 days after treatment, the tumor volumes were measured to calculate the tumor inhibition rate. Results ELISA and Western blot showed that mIL2，mIL12，sFLK-1 and ExTek were expressed after electroporation，VEGF expression was decreased remarkably. After treatment，the tumors of mIL2+mIL12 group were greatly inhibited with a tumor inhibition rate of 97.33%，while the tumors of antiVEGF121+sFLK-1+ExTek and pNGVL group were partially inhibited with tumor inhibition rates of 53.33% and 36.33% respectively.Conclusions Immunologic cytokines transfer mediated by electroporation can inhibit the growth of melanoma，but anti-angiogenesis only have a mild effects.
Objective To observe the influence of the indomethacin on the proliferative and invasive activity of OCM-1 human choroidal melanoma cells. Methods OCM-1 cells were cultured with different concentrations of indomethacin (25, 50, 100, 200, 400 mu;mol/L ), and their proliferation were assessed by methyl thiazolyl tetrazolium（MTT）, invasive behaviors were examined by cell invasion assays, expression of survivin and VEGF were evaluated by reverse transcriptase polymerase chain reaction（RT-PCR）, immunofluorescence staining, ELISA and western blot analysis. Result All concentrations of indomethacin in this study can inhibit the proliferation and invasion of OCM-1 cells in a time and dosage-dependant manner（MTT/24 h：F=19.642，P＜0.01；MTT/48 h：F=136.597，P＜0.01；MTT/72 h：F=582.543，P＜0.01；invasion assays：F=54.225，P＜0.01）. Immunofluorescence staining indicated that survivin and VEGF mainly expressed in the cytoplasm of OCM-1 cells. Survivin mRNA in OCM-1 cells was inhibited by 100, 200, 400 mu;mol/L indomethacin（F=16.679，P＜0.01）. The concentrations of survivin were (787.3plusmn;47.37), (257.0plusmn;26.21), (123.3plusmn;8.02) pg/ml in control group and 100, 400 mu;mol/L indomethacin groups, respectively. Survivin expression was also significantly down-regulated in indomethacin-treated cells by Western blot analysis.Indomethacin had no effects on VEGF expression in OCM-1 cells.Conclusions Indomethacin can inhibit proliferation and invasion of OCM-1 cells in vitro,down-regulated expression of survivin may be the mechanism.
Uveal melanoma (UM) is one of the most common primary intraocular malignancy in adults. The incidence of UM is lower in Asia than in Europe and the United States, however, the age of onset of UM patients in Asia is earlier than in the European and American populations. With the improvement of economic living standards in recent years, UM as a rare intraocular tumor has been gradually recognized by the public. In the past 10 years, the research of UM in China has been characterized by a large number and rapid development. Among them, the direction of molecular genetics represented by non-coding RNA, the frontier development of potential anticancer drugs for UM and Chinese traditional medicines are the research hotspots for scholars in China. In the past 10 years, China has made a relatively complete understanding and research progress on the pathogenesis, diagnosis and treatment of UM. On the other hand, compared with European and American countries, China still lacks in frontier research such as immunotherapy. With the further efforts of Chinese ophthalmology researchers and research teams, and with the further development of scientific research in my country, it is believed that the mechanism affecting tumors can be further elucidated, providing more possibilities for treatment and improving the prognosis of UM patients in China.
PURPOSE:To measure the concentration changes of tumor necrosis factor a (TNF-alpha;)in vitreous during the development of experimental PVR induced by macrophages and explore the initial and mediated factors which stimulate the cellular proliferation. METHODS:Rabbit PVR model was induced by macrophages and the vitreous was taken at the 7th,14th,21st and 28th day and 4 eyes in each group. The TNF-alpha; levels in vivreous of the above examinated and control eyes were measured with an ELISA kit. RESULTS:The TNF-alpha; level in the vitreous reached its peak 434mu;g/ml at 21st day in the mod-el, then rappidly decreased to 122mu;g/ml at 28th day. CONCLUSION:The changes of TNF-a in the vitreous of the PVR model were parallel to the natrual phases of the development of PVR,indicating TNF-alpha; may play an important role in initiating and mediating the inflammation and cellular proliferation in the vitreous. （Chin J Ocul Fundus Dis,1997,13: 231-233）
ObjectiveTo summarize the research progress of bioenergetic metabolic mechanisms regulated of tumor cells by microRNA in recent years. MethodsLiteratures about the recent studies on the bioenergetic metabolic mechanisms regulated of tumor cells by microRNA were reviewed according to the results searched from PUBMED. ResultsAerobic glycolysis(Warburg effect) is the most significant characteristics of bioenergetic metabolism in tumor cells. MicroRNAs can regulate many key progressions involved in tumor cells bioenergetic metabolism, such as uptake of glucose, glycolytic pathway, tricarboxylic acid cycle(TAC), and the relationship among lipid metabolism, amino acid metabolism and TAC, resulting in accelerated uptake of glucose and glycolysis. Thus we believe that the transportation and metabolic procession are vital important for tumor cells and related to poor prognosis of patients. ConclusionsThe studies on relationship between microRNA and bioenergetic metabolism have come an important insight for malignant biological behavior of tumor cells based on abnormal bioenergetic metabolism and also become new and important supplementary means of diagnosis and treatment of cancer. As far as the research progress about tumor cells bioenergetic metabolism regulated by microRNA, one of the things must be revealed is that which metablic factors can directly change tumor biological behavior after tumor cells bioenergetic metabolism changed caused by microRNA.