Tumor

肿瘤
  • 文章类型: Journal Article
    胶质瘤是一种由神经胶质细胞发展而来的脑癌。胶质细胞为神经细胞提供营养和能量,它们还能保护血脑屏障。中枢神经系统(CNS)的原发性癌症是少突胶质细胞瘤。这表明它起源于大脑或脊髓。少突神经胶质瘤可以袭击任何年龄的人,35至44岁是最常见的年龄。少突神经胶质瘤在年轻人中很少见,在男性中比女性更常见。根据轶事数据,少突胶质细胞瘤患者在非洲可能面临治疗挑战.由于神经影像学设施的短缺,诊断和转诊存在延迟。已经提出了广泛的策略来改善低收入和中等收入国家的病理学服务。充分的指导,短期访客计划,克服供应链约束,建立培训标准,以及建立病理学家在癌症筛查和早期诊断中的作用都被提出作为解决这一问题的方法。总而言之,少突胶质细胞瘤是本研究观察的低度胶质瘤之一。脑癌是非洲严重的公共卫生问题。需要改进的筛选和治疗选择以更好地解决该问题。
    Gliomas are a kind of brain cancer that develops from glial cells. Glial cells provide nourishment and energy to nerve cells, and they also preserve the blood-brain barrier. A primary cancer of the central nervous system (CNS) is oligodendroglioma. This suggests that it originates in the brain or spinal cord. While oligodendrogliomas can strike anyone at any age, the age range of 35 to 44 is when they most commonly occur. Oligodendrogliomas are rare in young people and more common in men than women. Based on anecdotal data, patients with oligodendroglioma may present management challenges in Africa. There are delays in diagnosis and referrals due to the scarcity of neuroimaging facilities. A wide range of strategies have been put forth to improve pathology services in low- and middle-income nations. Adequate mentorship, short-term visitor programs, overcoming supply chain constraints, establishing training standards, and establishing the role of pathologists in cancer screening and early diagnosis have all been proposed as solutions to this problem. To sum up, oligodendroglioma is one of the low-grade gliomas this study looked at. Brain cancer is a serious public health concern in Africa. Improved options for screening and therapy are required to better address this problem.
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  • 文章类型: Journal Article
    癌细胞将大部分葡萄糖代谢为乳酸,即使在充足的氧气供应下。这种现象-“Warburg效应”-通常被认为尚未被理解。癌细胞改变基因表达以增加生物合成途径和糖酵解的葡萄糖的摄取和利用。但它们不能充分上调三羧酸(TCA)循环和氧化磷酸化(OXPHOS)。因此,糖酵解通量的增加导致胞质NADH的产生增加。然而,由于癌细胞中相应的基因表达变化没有被巧妙地微调,胞质NAD+通常必须通过将过量电子加载到丙酮酸上并分泌产生的乳酸来再生,即使在充足的氧气供应下。有趣的是,丙酮酸接合处的酶的米氏常数(KM值)足以解释丙酮酸在癌细胞中利用的优先级:1.用于有效生产ATP的线粒体OXPHOS,2.超过OXPHOS容量的电子需要被处理并分泌为乳酸,and3.癌细胞生长的生物合成反应。换句话说,许多胞质电子需要通过乳酸分泌从细胞中“紧急出口”来维持胞质氧化还原平衡。
    Cancer cells metabolize a large fraction of glucose to lactate, even under a sufficient oxygen supply. This phenomenon-the \"Warburg Effect\"-is often regarded as not yet understood. Cancer cells change gene expression to increase the uptake and utilization of glucose for biosynthesis pathways and glycolysis, but they do not adequately up-regulate the tricarboxylic acid (TCA) cycle and oxidative phosphorylation (OXPHOS). Thereby, an increased glycolytic flux causes an increased production of cytosolic NADH. However, since the corresponding gene expression changes are not neatly fine-tuned in the cancer cells, cytosolic NAD+ must often be regenerated by loading excess electrons onto pyruvate and secreting the resulting lactate, even under sufficient oxygen supply. Interestingly, the Michaelis constants (KM values) of the enzymes at the pyruvate junction are sufficient to explain the priorities for pyruvate utilization in cancer cells: 1. mitochondrial OXPHOS for efficient ATP production, 2. electrons that exceed OXPHOS capacity need to be disposed of and secreted as lactate, and 3. biosynthesis reactions for cancer cell growth. In other words, a number of cytosolic electrons need to take the \"emergency exit\" from the cell by lactate secretion to maintain the cytosolic redox balance.
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  • 文章类型: Journal Article
    尽管在临床实践中引入了血清学肿瘤生物标志物和典型的放射学特征,肝活检(LB)通常仍然需要建立组织学诊断,尤其是在模棱两可的情况下。如今,经皮入路LB(PC-LB),在计算机断层扫描(CT)扫描或超声检查(US)指导下,是选择的路线。然而,某些局灶性肝脏病变可能具有挑战性。在这种情况下,内镜超声(EUS)引导的细针活检(FNB)可能代表一个有吸引力的,微创替代。这项回顾性观察性研究旨在评估疗效,诊断性能,EUS-FNB对位于两个肝叶的58个局灶性肝脏病变进行了安全性。FNB样本对位于左叶和右叶的局灶性肝脏病变的充分性分别为100%和81.2%,分别,差异有统计学意义(p=0.001)。两个肝叶的技术成功率均为100%。总体敏感性和特异性分别为95%和100%,分别。EUS-FNB可有效地对位于两个肝叶的局灶性肝脏病变进行准确的诊断,具有出色的安全性。
    Despite the introduction of serological neoplastic biomarkers and typical radiological characteristics in clinical practice, liver biopsy (LB) is often still necessary to establish a histological diagnosis, especially in ambiguous cases. Nowadays, LB via the percutaneous approach (PC-LB), under computed tomography (CT) scan or ultrasonography (US) guidance, is the route of choice. However, certain focal liver lesions can be challenging to access percutaneously. In such cases, endoscopic ultrasound (EUS)-guided fine needle biopsy (FNB) may represent an attractive, minimally invasive alternative. This retrospective observational study aimed to evaluate the efficacy, diagnostic performance, and safety of EUS-FNB conducted on 58 focal liver lesions located in both liver lobes. The adequacy of FNB samples for focal liver lesions located in the left and right lobes was 100% and 81.2%, respectively, and the difference was statistically significant (p = 0.001). Technical success was 100% for both liver lobes. The overall sensitivity and specificity were 95% and 100%, respectively. EUS-FNB is effective in making an accurate diagnosis with an excellent safety profile for focal liver lesions located in both liver lobes.
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  • 文章类型: Journal Article
    头颈部鳞状细胞癌(HNSCC)是世界上最常见的癌症之一;并非所有与此类癌症中角蛋白表达相关的机制都是已知的。这项研究的目的是评估II型细胞角蛋白(KRT):KRT6A,KRT6B,54例头颈部鳞状细胞癌(HNSCC)肿瘤和边缘样本中的KRT6C蛋白浓度。此外,我们研究了蛋白质浓度与临床和人口统计学变量之间的可能关联.使用酶联免疫吸附测定(ELISA)测量蛋白质浓度。与手术边缘相比,在HNSCC样品中发现显著更高的KRT6A蛋白浓度。观察到KRT6B和KRT6C蛋白的反比关系。我们显示了肿瘤和边缘样本中KRT6C蛋白水平与临床参数T和N之间的关联。在分析吸烟和饮酒对KRT6A的影响时,KRT6B,和KRT6C电平,我们在肿瘤和边缘样本中证明了有规律或偶尔吸烟和饮酒习惯的患者与没有任何吸烟和饮酒习惯的患者之间存在统计学上的显著差异.此外,我们发现肿瘤样本中KRT6B和KRT6C浓度与增殖指数Ki-67和HPV状态之间存在相关性.我们的结果表明,肿瘤和边缘样本中KRT6的浓度不同,并且与临床和人口统计学参数有关。我们将有关KRT6s同工型在HNSCC中的作用的信息添加到当前知识中。我们推测,所研究的KRT6蛋白同种型的变化可能是由于肿瘤及其微环境的存在和发展所致。重要的是要注意,分析是在肿瘤和手术边缘进行的,可以提供有关正常和癌细胞功能以及响应于各种因素的调节的更准确信息。
    Head and neck squamous cell carcinomas (HNSCCs) are one of the most frequently detected cancers in the world; not all mechanisms related to the expression of keratin in this type of cancer are known. The aim of this study was to evaluate type II cytokeratins (KRT): KRT6A, KRT6B, and KRT6C protein concentrations in 54 tumor and margin samples of head and neck squamous cell carcinoma (HNSCC). Moreover, we examined a possible association between protein concentration and the clinical and demographic variables. Protein concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Significantly higher KRT6A protein concentration was found in HNSCC samples compared to surgical margins. An inverse relationship was observed for KRT6B and KRT6C proteins. We showed an association between the KRT6C protein level and clinical parameters T and N in tumor and margin samples. When analyzing the effect of smoking and drinking on KRT6A, KRT6B, and KRT6C levels, we demonstrated a statistically significant difference between regular or occasional tobacco and alcohol habits and patients who do not have any tobacco and alcohol habits in tumor and margin samples. Moreover, we found an association between KRT6B and KRT6C concentration and proliferative index Ki-67 and HPV status in tumor samples. Our results showed that concentrations of KRT6s were different in the tumor and the margin samples and varied in relation to clinical and demographic parameters. We add information to the current knowledge about the role of KRT6s isoforms in HNSCC. We speculate that variations in the studied isoforms of the KRT6 protein could be due to the presence and development of the tumor and its microenvironment. It is important to note that the analyses were performed in tumor and surgical margins and can provide more accurate information on the function in normal and cancer cells and regulation in response to various factors.
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  • 文章类型: Journal Article
    腮腺病理学代表了鉴别诊断的网络。有许多复杂的病例需要广泛的诊断测试才能进行完整和正确的最终病理诊断。目前,腮腺肿瘤的官方分类范围超过40种亚型。我们对PubMed数据库进行了查询,以了解分子生物学测试在特定情况下对肿瘤进行更好的表征。通过使用荧光原位杂交(FISH),逆转录聚合酶链反应(RT-PCR)或下一代测序,管理复杂病例的团队可以提供个性化的治疗解决方案。我们根据过去5年发表的文章对许多类型的腮腺肿瘤进行了分子鉴别诊断,从良性到交界性恶性肿瘤到恶性侵袭性肿瘤。粘液表皮样癌是腮腺恶性肿瘤的一种独特亚型,是许多文章的主题。然而,分子生物学诊断技术更有助于排除粘液表皮样癌的诊断,并可能回顾性地限制了最终诊断的病例数。在罗马尼亚,分子生物学诊断仅在有限的研究设施中可用,并且应该获得更一致的资金,这将使其在更大范围内可用。这项范围审查的新颖之处在于,我们提出了一种用于腮腺中可能遇到的肿瘤的分子鉴别诊断的算法。
    Parotid gland pathology represents a web of differential diagnoses. There are many complex cases that require extensive diagnostic tests for a complete and correct final pathology diagnosis. Currently the official classification of parotid gland tumors extends over more than 40 subtypes. We performed a query of the PubMed database regarding the use of molecular biology tests in performing a better characterization of the tumors in specific cases. By using fluorescence in situ hybridization (FISH), reverse transcription polymerase chain reaction (RT-PCR) or next-generation sequencing, the team managing complex cases can offer a personalized therapeutic solution. We review the molecular differential diagnosis according to published articles in the last 5 years for many types of parotid gland tumors ranging from benign to borderline malign tumors to malign aggressive tumors. Mucoepidermoid carcinoma is a distinct subtype of parotid malignancy that was the subject of a consistent number of articles. However, the molecular biology diagnosis techniques helped more in excluding the diagnosis of mucoepidermoid carcinoma, and probably retrospectively limiting the number of cases with this final diagnosis. In Romania, the molecular biology diagnosis is available only in limited research facilities and should receive more consistent funding that will make it available on a larger scale. The novelty of this scoping review is that we propose an algorithm for molecular differential diagnosis of the tumors that could be encountered in the parotid gland.
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  • 文章类型: Journal Article
    背景:腮腺脓肿(PA)是急性细菌性腮腺炎的并发症,可能危及生命。迄今为止,PA的诊断和治疗数据很少,主要由病例报告或病例系列组成.因此,这项研究旨在全面分析双机构环境中的微生物谱和治疗管理。
    方法:在德国的两个三级护理中心进行回顾性临床检查,以确定所有接受PA手术治疗的患者。人口统计数据,临床管理和微生物数据,包括物种鉴定,致病性,抗生素治疗的类型,调整抗生素,抗生素敏感性测试,并提取涂片检查结果。分析干预相关变量和病因与结果变量的统计关联。
    结果:总体而言,包括85名患者。大多数患者(92.9%)接受了手术切口。大约一半的患者(45.9%)在局部麻醉下治疗。未观察到面神经麻痹。最常见的病原体是链球菌(n=23),其次是金黄色葡萄球菌(n=6),包括1例耐甲氧西林金黄色葡萄球菌。大多数患者(68.2%)接受了氨基青霉素±β-内酰胺酶抑制剂作为经验性抗生素治疗。在6例患者中,接受抗生素检查后对抗生素治疗进行了修改。4例患者(5.2%)出现PA复发。病因为特发性(42.4%),其次是肿瘤(12.9%),阻塞性,和免疫抑制(各11.8%)。有牙齿病灶(p=0.007)的患者住院时间较长。
    结论:结果表明,局部麻醉下PA的手术治疗是安全的。应常规进行牙科检查以排除牙科焦点。必须获得微生物样本以在必要时修改抗生素治疗,并获得组织病理学样本以排除肿瘤病因。
    BACKGROUND: A parotid abscess (PA) is a complication of an acute bacterial parotitis with a potentially life-threatening course. To date, data on the diagnosis and therapy of PA is sparse and mostly consists of case reports or case series. Therefore, this study aimed at comprehensively analyzing the microbiological spectrum and the therapeutic management in a bi-institutional setting.
    METHODS: A retrospective clinical chart review was performed to identify all patients surgically treated for PA at two tertiary care centers in Germany. Data on demographics, clinical management and microbiological data including species identification, pathogenicity, type of antibiotic therapy, adjustment of antibiotics, antibiotic sensitivity testing, and smear test results were extracted. Intervention-related variables and etiology were analyzed for their statistical association with outcome variables.
    RESULTS: Overall, 85 patients were included. Most patients (92.9%) underwent surgical incision. Around half of the patients (45.9%) were treated under local anesthesia. No facial nerve palsy was observed. The most frequently detected pathogens were Streptococci (n = 23), followed by Staphylococcus aureus (n = 6) including one case of methicillin-resistant Staphylococcus aureus. Most patients (68.2%) received an aminopenicillin ± beta-lactamase inhibitor as empiric antibiotic therapy. In 6 cases the antibiotic therapy was modified after receiving the antibiogram. Four patients (5.2%) presented with recurrent PA. Etiology was idiopathic (42.4%), followed by tumorous (12.9%), obstructive, and immunosuppressive (each 11.8%). Patients with a dental focus (p = 0.007) had a longer duration of hospitalization.
    CONCLUSIONS: The results show that the surgical therapy of PA under local anesthesia is safe. A dental examination should routinely be performed to rule out a dental focus. Obtaining a microbiological specimen in order to modify antibiotic therapy if necessary and a histopathological specimen to rule out a tumorous etiology is obligate.
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  • 文章类型: Journal Article
    低氧条件(缺氧)主要与分裂细胞中的细胞周期停滞有关。巨噬细胞在G0中通常是静止的,但可以响应于组织信号而增殖。在这里,我们显示缺氧(1%氧分压)导致巨噬细胞可逆进入细胞周期。细胞周期进程在很大程度上限于G0-G1/S相变,几乎没有进展到G2/M。这种细胞周期转变由HIF2α指导的转录程序触发。这种反应伴随着细胞周期相关蛋白的表达增加,包括CDK1,已知CDK1在T592磷酸化SAMHD1,从而调节抗病毒活性。丙基羟化酶(PHD)抑制剂能够概括巨噬细胞中HIF2α依赖性细胞周期的进入。最后,肺癌中的肿瘤相关巨噬细胞(TAM)表现出转录组特征,代表在单细胞水平对低氧和细胞周期进程的反应.这些发现对低氧环境常见的炎症和肿瘤进展/转移有影响。
    Low-oxygen conditions (hypoxia) have been associated primarily with cell-cycle arrest in dividing cells. Macrophages are typically quiescent in G0 but can proliferate in response to tissue signals. Here we show that hypoxia (1% oxygen tension) results in reversible entry into the cell cycle in macrophages. Cell cycle progression is largely limited to G0-G1/S phase transition with little progression to G2/M. This cell cycle transitioning is triggered by an HIF2α-directed transcriptional program. The response is accompanied by increased expression of cell-cycle-associated proteins, including CDK1, which is known to phosphorylate SAMHD1 at T592 and thereby regulate antiviral activity. Prolyl hydroxylase (PHD) inhibitors are able to recapitulate HIF2α-dependent cell cycle entry in macrophages. Finally, tumor-associated macrophages (TAMs) in lung cancers exhibit transcriptomic profiles representing responses to low oxygen and cell cycle progression at the single-cell level. These findings have implications for inflammation and tumor progression/metastasis where low-oxygen environments are common.
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  • 文章类型: Journal Article
    N6-甲基腺苷(m6A)是真核RNA中最常见的内部修饰之一。转录本上m6A的存在可以影响一系列基本的细胞过程,包括mRNA剪接,核运输,稳定性,和翻译。m6A修饰是由m6A甲基转移酶(writer)引入的,被去甲基酶(橡皮擦)移除,并被m6A结合蛋白(阅读器)识别。目前的研究表明,m6A甲基化通过控制癌症相关基因的表达参与肿瘤恶性表型的调节。非编码RNA(ncRNA)是一组不编码蛋白质的RNA分子,广泛存在于人类基因组中。该组包括microRNAs(miRNAs),长链非编码RNA(lncRNA),环状RNA(circularRNAs),和PIWI相互作用RNA(piRNA)。它们通过各种机制充当癌基因或肿瘤抑制因子,调节癌症的发生和进展。以前对m6A的研究主要集中在编码RNA上,但是最近的发现揭示了m6A在ncRNAs中的重要调节作用。同时,ncRNAs还通过调节稳定性发挥其影响,拼接,翻译,和m6A相关酶的其他生物过程。m6A和ncRNAs之间的相互作用共同促进了人类恶性肿瘤的发生和发展。本文综述了m6A调控因子与ncRNAs之间的相互作用及其对肿瘤的影响。
    N6-methyladenosine (m6A) is one of the most common internal modifications in eukaryotic RNA. The presence of m6A on transcripts can affect a series of fundamental cellular processes, including mRNA splicing, nuclear transportation, stability, and translation. The m6A modification is introduced by m6A methyltransferases (writers), removed by demethylases (erasers), and recognized by m6A-binding proteins (readers). Current research has demonstrated that m6A methylation is involved in the regulation of malignant phenotypes in tumors by controlling the expression of cancer-related genes. Non-coding RNAs (ncRNAs) are a diverse group of RNA molecules that do not encode proteins and are widely present in the human genome. This group includes microRNAs (miRNAs), long non-coding RNAs (lncRNAs), circular RNAs (circRNAs), and PIWI interaction RNAs (piRNAs). They function as oncogenes or tumor suppressors through various mechanisms, regulating the initiation and progression of cancer. Previous studies on m6A primarily focused on coding RNAs, but recent discoveries have revealed the significant regulatory role of m6A in ncRNAs. Simultaneously, ncRNAs also exert their influence by modulating the stability, splicing, translation, and other biological processes of m6A-related enzymes. The interplay between m6A and ncRNAs collectively contributes to the occurrence and progression of malignant tumors in humans. This review provides an overview of the interactions between m6A regulatory factors and ncRNAs and their impact on tumors.
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  • 文章类型: Case Reports
    炎性肌纤维母细胞瘤(IMT)是具有中等恶性潜能的间充质肿瘤。胃IMT很少见,通常会影响年轻人。它们通常与胃肠道间质瘤混淆,炎性纤维息肉,和平滑肌肉瘤.IMT的病因仍不清楚,但理论上是由于对慢性感染的高炎症反应。我们介绍了一名中年妇女,发现胃部幽门螺杆菌呈阳性,接受了内窥镜超声检查,只有在部分胃切除术后才明确诊断胃IMT,CD-117,S-100,ALK-1免疫组织化学阴性,波形蛋白和SMA阳性。
    Inflammatory myofibroblastic tumors (IMTs) are mesenchymal tumors of intermediate malignant potential. Gastric IMTs are rare and commonly affect young adults. They are typically confused with gastrointestinal stromal tumors, inflammatory fibroid polyps, and leiomyosarcomas. The etiology of IMTs remains unclear, but is theorized to be due to hyperinflammatory response to chronic infections. We present a middle-aged woman found to have a gastric mass positive for Helicobacter pylori, underwent multiple endoscopies with endoscopic ultrasound, and a definitive diagnosis of gastric IMT was only made after a partial gastrectomy with immunohistochemistry negative for CD-117, S-100, ALK-1, and positive for vimentin and SMA.
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  • 文章类型: Case Reports
    嗜酸性膀胱炎是一种罕见的膀胱炎症,其特征是嗜酸性粒细胞浸润膀胱壁。它影响所有年龄段的人,没有性别差异。嗜酸性膀胱炎可以模仿膀胱肿瘤和其他慢性膀胱炎,这使得它的诊断具有挑战性。在这篇文章中,我们将讨论原因,症状,诊断,和治疗嗜酸性粒细胞性膀胱炎,以及它可能被误认为是膀胱肿瘤。
    Eosinophilic cystitis is a rare inflammatory condition of the bladder characterized by eosinophils infiltrating the bladder wall. It affects people of all ages and with no gender difference. Eosinophilic cystitis can mimic bladder tumors and other chronic cystitis, which makes it a challenging condition to diagnose. In this article, we will discuss the causes, symptoms, diagnosis, and treatment of eosinophilic cystitis, as well as how it might be mistaken for bladder tumors.
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