Tumor metastasis

肿瘤转移
  • 文章类型: Journal Article
    转移是恶性肿瘤的重要标志,和端粒酶通常在这些肿瘤中表现出高表达。监测端粒酶的实时动态将为其与肿瘤转移的关联提供有价值的见解。在这项研究中,我们描述了一种基于差异细胞侵袭性筛选高转移性亚系的微流体系统,研究了端粒酶在肿瘤转移过程中的表达,并探讨了参与肿瘤转移的基因和信号通路。具有不同转移能力的细胞被有效地分类到不同的通道,荧光成像显示转移能力较高的细胞具有较强的端粒酶活性。此外,我们仅通过使用该系统进行一轮筛选,就成功地从人类结直肠癌LoVo细胞系中建立了高转移能力LoVo亚系(命名为LoVo-H)和低转移能力LoVo亚系(命名为LoVo-L)。结果显示,与LoVo-L细胞相比,LoVo-H细胞显示出优异的增殖和侵袭性。此外,通过转录组测序鉴定了与LoVo-L相比的6776个差异表达的LoVo-H基因。与端粒酶活性相关的基因,LoVo-H中细胞迁移和上皮向间充质转化上调,和PI3K-Akt信号通路,LoVo-H显著富集了细胞外基质-受体相互作用和Rap1信号通路。该微流体系统是用于选择高转移性亚系的高效工具,并且通过该系统建立的LoVo-H亚系为肿瘤转移研究提供了有希望的模型。此外,这项工作初步揭示了肿瘤转移过程中端粒酶的表达,为研究肿瘤转移和癌症诊断提供了新的策略。
    Metastasis is an important hallmark of malignant tumors, and telomerase often exhibits high expression in these tumors. Monitoring the real-time dynamics of telomerase will provide valuable insights into its association with tumor metastasis. In this study, we described a microfluidic system for screening highly metastatic sublines based on differential cell invasiveness, investigated telomerase expression in the process of tumor metastasis and explored the genes and signaling pathways involved in tumor metastasis. Cells with different metastasis abilities were efficiently classified into different channels, and the fluorescence imaging visually demonstrates that cells with higher metastasis ability have stronger telomerase activity. In addition, we successfully established the high-metastasis-ability LoVo subline (named as LoVo-H) and low-metastasis-ability LoVo subline (named as LoVo-L) from the human colorectal cancer LoVo cell lines through only one round of selection using the system. The results show that the LoVo-H cells display superior proliferation and invasiveness compared to LoVo-L cells. Furthermore, 6776 differentially expressed genes of LoVo-H compared with LoVo-L were identified by transcriptome sequencing. The genes associated with telomerase activity, cell migration and the epithelial to mesenchymal transition were up-regulated in LoVo-H, and PI3K-Akt signaling pathway, extracellular matrix-receptor interaction and Rap1 signaling pathway were significantly enriched in LoVo-H. This microfluidic system is a highly effective tool for selecting highly metastatic sublines and the LoVo-H subline established through this system presents a promising model for tumor metastasis research. Furthermore, this work preliminarily reveals telomerase expression during tumor metastasis and provides a new strategy for studying tumor metastasis and cancer diagnosis.
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  • 文章类型: Journal Article
    癌症转移对当前的临床治疗提出了重大挑战。蛇床子素(OST)已显示出治疗宫颈癌和抑制转移的功效。尽管取得了这些积极成果,其有限的溶解度,口服吸收不良,低生物利用度,光敏感性阻碍了其临床应用。为了解决这个限制,谷胱甘肽(GSH)响应的纳米草药递送系统(HA/MOS@OST&L-Arg纳米颗粒,HMOANP)被设计用于靶向递送具有可级联激活的一氧化氮(NO)释放的OST。利用增强的通透性和保留(EPR)效应和由结合糖蛋白CD44的透明质酸(HA)介导的主动靶向来工程化HMOANP系统。货物,包括OST和L-精氨酸(L-Arg),由于GSH响应的介孔有机二氧化硅(MOS)的降解而迅速释放。然后在高浓度的NAD(P)H醌氧化还原酶1(NQO1)的存在下,从OST产生丰富的活性氧(ROS),通过催化L-Arg的胍基产生NO和随后的高毒性过氧亚硝酸盐(ONOO-)。这些ROS,NO,和ONOO-分子通过降低线粒体膜电位和抑制三磷酸腺苷(ATP)的产生直接影响线粒体功能,从而促进细胞凋亡增加和抑制转移。总的来说,结果表明,HMOANPs作为临床治疗宫颈癌的一种有希望的替代药物具有巨大的潜力。
    Cancer metastasis poses significant challenges in current clinical therapy. Osthole (OST) has demonstrated efficacy in treating cervical cancer and inhibiting metastasis. Despite these positive results, its limited solubility, poor oral absorption, low bioavailability, and photosensitivity hinder its clinical application. To address this limitation, a glutathione (GSH)-responded nano-herb delivery system (HA/MOS@OST&L-Arg nanoparticles, HMOA NPs) is devised for the targeted delivery of OST with cascade-activatable nitric oxide (NO) release. The HMOA NPs system is engineered utilizing enhanced permeability and retention (EPR) effects and active targeting mediated by hyaluronic acid (HA) binding to glycoprotein CD44. The cargoes, including OST and L-Arginine (L-Arg), are released rapidly due to the degradation of GSH-responsive mesoporous organic silica (MOS). Then abundant reactive oxygen species (ROS) are produced from OST in the presence of high concentrations of NAD(P)H quinone oxidoreductase 1 (NQO1), resulting in the generation of NO and subsequently highly toxic peroxynitrite (ONOO-) by catalyzing guanidine groups of L-Arg. These ROS, NO, and ONOO- molecules have a direct impact on mitochondrial function by reducing mitochondrial membrane potential and inhibiting adenosine triphosphate (ATP) production, thereby promoting increased apoptosis and inhibiting metastasis. Overall, the results indicated that HMOA NPs has great potential as a promising alternative for the clinical treatment of cervical cancer.
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  • 文章类型: Journal Article
    转移是与肿瘤相关的死亡率的主要贡献者。化疗和免疫疗法经常用于转移性实体瘤的治疗。然而,这些治疗方式与严重的不良反应和预防转移的效果有限有关.这里,我们报告了一种新的治疗策略,称为饥饿-免疫疗法,其中免疫检查点抑制剂与超长效L-天冬酰胺酶组合,所述超长效L-天冬酰胺酶是包含L-天冬酰胺酶(ASNase)和弹性蛋白样多肽(ELP)的融合蛋白,称为ASNase-ELP。ASNase-ELP的热敏感性使其能够在肿瘤内注射后产生原位储库,产生增加的剂量耐受性,改善药代动力学,持续释放,优化的生物分布,与游离ASNase相比,肿瘤保留增加。因此,在口腔癌的鼠模型中,黑色素瘤,还有宫颈癌,通过选择性和可持续地消耗肿瘤细胞存活所必需的L-天冬酰胺,ASNase-ELP的抗肿瘤功效明显优于ASNase或顺铂,一线抗实体瘤药物,没有任何可观察到的不利影响。此外,在阻止黑色素瘤转移方面,ASNase-ELP和免疫检查点抑制剂的组合比任一单独治疗更有效.总的来说,饥饿-免疫疗法的协同策略在重塑难治性转移性肿瘤的治疗前景和为下一代肿瘤治疗提供新的替代方案方面具有极好的前景.
    Metastasis stands as the primary contributor to mortality associated with tumors. Chemotherapy and immunotherapy are frequently utilized in the management of metastatic solid tumors. Nevertheless, these therapeutic modalities are linked to serious adverse effects and limited effectiveness in preventing metastasis. Here, we report a novel therapeutic strategy named starvation-immunotherapy, wherein an immune checkpoint inhibitor is combined with an ultra-long-acting L-asparaginase that is a fusion protein comprising L-asparaginase (ASNase) and an elastin-like polypeptide (ELP), termed ASNase-ELP. ASNase-ELP\'s thermosensitivity enables it to generate an in-situ depot following an intratumoral injection, yielding increased dose tolerance, improved pharmacokinetics, sustained release, optimized biodistribution, and augmented tumor retention compared to free ASNase. As a result, in murine models of oral cancer, melanoma, and cervical cancer, the antitumor efficacy of ASNase-ELP by selectively and sustainably depleting L-asparagine essential for tumor cell survival was substantially superior to that of ASNase or Cisplatin, a first-line anti-solid tumor medicine, without any observable adverse effects. Furthermore, the combination of ASNase-ELP and an immune checkpoint inhibitor was more effective than either therapy alone in impeding melanoma metastasis. Overall, the synergistic strategy of starvation-immunotherapy holds excellent promise in reshaping the therapeutic landscape of refractory metastatic tumors and offering a new alternative for next-generation oncology treatments.
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  • 文章类型: Journal Article
    中性粒细胞胞外陷阱(NETs)是由细胞质内容物组成的网状结构,DNA染色质和各种颗粒蛋白释放的中性粒细胞响应病毒,细菌,免疫复合物和细胞因子。研究表明,NET可以促进其发生,肿瘤的发展和转移。在本文中,NETs形成和降解的潜在机制以及NETs的恶性生物学行为,如促进肿瘤细胞增殖,上皮间质转化,细胞外基质重塑,血管生成,免疫逃避和肿瘤相关的血栓形成,有详细描述。NET作为肿瘤的治疗靶标正被越来越多地研究。我们总结了靶向NETs或干扰NETs与癌细胞相互作用的策略,并探讨了NETs作为生物标志物在癌症诊断和治疗中的潜在应用价值。以及NETs与治疗抗性之间的关系。
    Neutrophil extracellular traps (NETs) are web-like structures composed of cytoplasmic contents, DNA chromatin and various granular proteins released by neutrophils in response to viruses, bacteria, immune complexes and cytokines. Studies have shown that NETs can promote the occurrence, development and metastasis of tumors. In this paper, the mechanism underlying the formation and degradation of NETs and the malignant biological behaviors of NETs, such as the promotion of tumor cell proliferation, epithelial mesenchymal transition, extracellular matrix remodeling, angiogenesis, immune evasion and tumor-related thrombosis, are described in detail. NETs are being increasingly studied as therapeutic targets for tumors. We have summarized strategies for targeting NETs or interfering with NET-cancer cell interactions and explored the potential application value of NETs as biomarkers in cancer diagnosis and treatment, as well as the relationship between NETs and therapeutic resistance.
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  • 文章类型: Journal Article
    卵巢癌是妇科最常见的恶性肿瘤之一。复发和转移常发生在治疗后,在所有妇科肿瘤中死亡率最高。肿瘤干细胞(CSC)是具有自我更新能力的小细胞群,多向分化,无限扩散。它们已被证明在肿瘤生长中起重要作用,转移,耐药性,和血管生成。卵巢癌侧群(SP)细胞,一种CSC,已被证明在肿瘤形成中起作用,菌落形成,异种移植瘤形成,腹水形成,和肿瘤转移。肿瘤血管生成的快速进展是肿瘤生长所必需的;然而,驱动这一过程的许多机制尚不清楚,CSC的贡献也不清楚.这篇综述的目的是记录有关卵巢癌干细胞(OCSCs)调节肿瘤血管生成的分子机制的最新知识。
    Ovarian cancer is one of the most common gynecologic malignancies. Recurrence and metastasis often occur after treatment, and it has the highest mortality rate of all gynecological tumors. Cancer stem cells (CSCs) are a small population of cells with the ability of self-renewal, multidirectional differentiation, and infinite proliferation. They have been shown to play an important role in tumor growth, metastasis, drug resistance, and angiogenesis. Ovarian cancer side population (SP) cells, a type of CSC, have been shown to play roles in tumor formation, colony formation, xenograft tumor formation, ascites formation, and tumor metastasis. The rapid progression of tumor angiogenesis is necessary for tumor growth; however, many of the mechanisms driving this process are unclear as is the contribution of CSCs. The aim of this review was to document the current state of knowledge of the molecular mechanism of ovarian cancer stem cells (OCSCs) in regulating tumor angiogenesis.
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  • 文章类型: Journal Article
    背景:肝细胞癌(HCC)是消化系统最常见的恶性肿瘤之一,肝癌的确切机制尚不清楚。转录因子7样2(TCF7L2)在细胞增殖和干细胞维持中起关键作用。然而,TCF7L2在HCC中的确切机制尚不清楚。
    方法:使用临床样本和公共数据库分析TCF7L2在HCC中的表达和预后。在体外和体内研究了TCF7L2在HCC中的功能。使用ChIP和荧光素酶测定来探索TCF7L2的分子机制。通过组织微阵列在HCC临床样品中验证了TCF7L2和NEDD9之间的关系。
    结果:肝癌中TCF7L2的表达上调,TCF7L2高表达与HCC患者预后不良有关。过表达TCF7L2促进肝癌的体内外转移,而TCF7L2的敲低显示出相反的效果。机械上,TCF7L2激活的神经前体细胞通过与NEDD9启动子区的-1522/-1509位点结合而表达发育下调的蛋白9(NEDD9)转录,从而增加AKT和mTOR的磷酸化水平。TCF7L2和NEDD9的组合可以区分HCC患者的生存。
    结论:本研究表明TCF7L2通过激活AKT/mTOR通路以NEDD9依赖性方式促进HCC转移,提示TCF7L2和NEDD9作为HCC预后标志物和治疗靶点的潜力。
    BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors of the digestive system, and the exact mechanism of HCC is still unclear. Transcription factor 7 like 2 (TCF7L2) plays a pivotal role in cell proliferation and stemness maintenance. However, the exact mechanism of TCF7L2 in HCC remains unclear.
    METHODS: Clinical samples and public databases were used to analyze the expression and prognosis of TCF7L2 in HCC. The function of TCF7L2 in HCC was studied in vitro and in vivo. ChIP and luciferase assays were used to explore the molecular mechanism of TCF7L2. The relationship between TCF7L2 and NEDD9 was verified in HCC clinical samples by tissue microarrays.
    RESULTS: The expression of TCF7L2 was upregulated in HCC, and high expression of TCF7L2 was associated with poor prognosis of HCC patients. Overexpression of TCF7L2 promoted the metastasis of HCC in vitro and in vivo, while Knockdown of TCF7L2 showed the opposite effect. Mechanically, TCF7L2 activated neural precursor cell expressed developmentally downregulated protein 9 (NEDD9) transcription by binding to the -1522/-1509 site of the NEDD9 promoter region, thereby increasing the phosphorylation levels of AKT and mTOR. The combination of TCF7L2 and NEDD9 could distinguish the survival of HCC patients.
    CONCLUSIONS: This study demonstrated that TCF7L2 promotes HCC metastasis by activating AKT/mTOR pathway in a NEDD9-dependent manner, suggesting that potential of TCF7L2 and NEDD9 as prognostic markers and therapeutic targets for HCC.
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  • 文章类型: Journal Article
    镁(Mg)缺乏与结直肠癌(CRC)的风险和恶性肿瘤增加有关,然而,潜在的机制仍然难以捉摸。这里,我们使用基因组,蛋白质组学,和磷酸蛋白质组数据来阐明镁缺乏对CRC的影响。基因组分析确定了160个低镁肿瘤中突变频率较高的基因,包括关键驱动基因,如KMT2C和ERBB3。出乎意料的是,CRC的起始驱动基因,如TP53和APC,在高Mg肿瘤中显示出更高的突变频率。此外,蛋白质组和磷酸化蛋白质组数据表明,肿瘤中的低Mg含量可能通过调节炎症或重塑癌细胞的磷酸化蛋白质组激活上皮-间质转化(EMT)。值得注意的是,我们观察到S142的DBN1磷酸化(DBN1S142p)与Mg含量之间呈负相关。模拟DBN1S142p的S142突变为D(DBN1S142D)上调MMP2并增强细胞迁移,当用MgCl2处理时,DBN1S142p减少,从而逆转这种表型。机械上,Mg2+通过降低DBN1S142p减弱了DBN1-ACTN4的相互作用,进而增强ACTN4与F-肌动蛋白的结合并促进F-肌动蛋白的聚合,最终降低MMP2表达。这些发现为Mg缺乏在CRC进展中的关键作用提供了新的思路,并表明Mg补充可能是CRC的有希望的预防和治疗策略。
    Magnesium (Mg) deficiency is associated with increased risk and malignancy in colorectal cancer (CRC), yet the underlying mechanisms remain elusive. Here, we used genomic, proteomic, and phosphoproteomic data to elucidate the impact of Mg deficiency on CRC. Genomic analysis identified 160 genes with higher mutation frequencies in Low-Mg tumors, including key driver genes such as KMT2C and ERBB3. Unexpectedly, initiation driver genes of CRC, such as TP53 and APC, displayed higher mutation frequencies in High-Mg tumors. Additionally, proteomic and phosphoproteomic data indicated that low Mg content in tumors may activate epithelial-mesenchymal transition (EMT) by modulating inflammation or remodeling the phosphoproteome of cancer cells. Notably, we observed a negative correlation between the phosphorylation of DBN1 at S142 (DBN1S142p) and Mg content. A mutation in S142 to D (DBN1S142D) mimicking DBN1S142p upregulated MMP2 and enhanced cell migration, while treatment with MgCl2 reduced DBN1S142p, thereby reversing this phenotype. Mechanistically, Mg2+ attenuated the DBN1-ACTN4 interaction by decreasing DBN1S142p, which in turn enhanced the binding of ACTN4 to F-actin and promoted F-actin polymerization, ultimately reducing MMP2 expression. These findings shed new light on the crucial role of Mg deficiency in CRC progression and suggest that Mg supplementation may be a promising preventive and therapeutic strategy for CRC.
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  • 文章类型: Journal Article
    The protein kinase B (Akt) pathway can regulate the growth, proliferation, and metabolism of tumor cells and stem cells through the activation of multiple downstream target genes, thus affecting the development and treatment of a range of diseases. Thioesterase superfamily member 4 (THEM4), a member of the thioesterase superfamily, is one of the Akt kinase-binding proteins. Some studies on the mechanism of cancers and other diseases have shown that THEM4 binds to Akt to regulate its phosphorylation. Initially, THEM4 was considered an endogenous inhibitor of Akt, which can inhibit the phosphorylation of Akt in diseases such as lung cancer, pancreatic cancer, and liver cancer, but subsequently, THEM4 was shown to promote the proliferation of tumor cells by positively regulating Akt activity in breast cancer and nasopharyngeal carcinoma, which contradicts previous findings. Considering these two distinct views, this review summarizes the important roles of THEM4 in the Akt pathway, focusing on THEM4 as an Akt-binding protein and its regulatory relationship with Akt phosphorylation in various diseases, especially cancer. This work provides a better understanding of the roles of THEM4 combined with Akt in the treatment of diseases.
    蛋白激酶B(Akt)通路可通过激活下游多个靶基因来调控肿瘤细胞和干细胞的生长、增殖和代谢等,从而影响一系列疾病的发生和治疗。硫酯酶超家族成员4(THEM4)作为硫酯酶超家族成员中的一员,也是Akt激酶的结合蛋白之一。癌症等疾病的机制研究发现THEM4可以与Akt结合从而调控Akt的磷酸化。最初,THEM4被认为是Akt的内源性抑制剂,在肺癌、胰腺癌和肝癌等疾病中抑制Akt的磷酸化。但随后的研究发现,THEM4在乳腺癌和鼻咽癌中通过正向调节Akt活性促进肿瘤细胞的增殖,这与之前的研究结果正好相反。面对这两种截然不同的观点,本文综述了THEM4在Akt通路中的重要作用,重点探讨了THEM4作为一种Akt结合蛋白,在各种疾病(尤其是癌症)中与Akt磷酸化的调控关系。这将有助于更好地了解THEM4联合Akt在疾病治疗中的作用。.
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  • 文章类型: Journal Article
    探讨计算机断层扫描(CT)引导下125I放射性粒子植入治疗放射性碘难治性分化型甲状腺癌(RAIR-DTC)淋巴结转移的可行性,并评估其安全性和有效性。验证计算机三维治疗计划系统(TPS)在剂量水平下采用125I粒子植入治疗淋巴结转移瘤的准确性。
    回顾性分析了2016年12月至2019年1月在北部战区总医院收治的42例RAIR-DTC和淋巴结转移患者。在这个分析中,医师利用术前CT图像设计使用TPS的术中计划.然后将术后计划的剂量学参数与术前计划进行比较。此外,这项研究检测了患者术后2,6和12个月时肿瘤大小和肿瘤相关标志物甲状腺球蛋白(Tg)值的变化.
    42例患者植入的125I放射性粒子数量为226个,平均每个病灶植入14.5个(范围2.0-30.0个)粒子。局部缓解率为97.62%(41/42),88.10%(37/42),术后2、6和12个月85.71%(36/42),分别。治疗后2,6,12个月病灶体积分别为(4.44±1.57)cm3,(4.20±1.70)cm3,(4.23±1.77)cm3,分别,较术前基线水平(6.87±1.67)cm3明显下降(t值:9.466、9.923、7.566,均P<0.05)。Tg为15.95(5.45,73.93)μg/L,8.90(2.20,39.21)μg/L,治疗后2、6、12个月分别为6.00(1.93、14.18)μg/L,分别,显著低于术前基线水平53.50(20.94,222.92)μg/L(Z值:-5.258,-5.009,-4.987,均P<0.001)。术后,在95.23%(40/42)的患者中,给予90%的GTV(D90)略低于处方剂量,但差异无统计学意义[(12,378.8±3,182.0),(12,497.8±1,686.4)cGy;t=0.251,P>0.05],和术后剂量参数传递到100%的总肿瘤体积(GTV)(D100)(6,881.5±1,381.8)cGy,GTV接受150%处方剂量的体积百分比(V150)(58.5±18.40)%低于术前计划D100(8,085.8±2,330.0)cGy,V150(66.5±17.70)%;t值=8.913和3.032,均P<0.05;其余指标与术前计划无显著差异(植入颗粒数的差异,规划目标体积(PTV),接受100%处方剂量(V100)的GTV的体积百分比,均一性指数(HI)无统计学意义(t/Z=-0.593、-1.604、-0.663,均P>0.05)。
    参考TPS术前计划,125I粒子植入治疗RAIR-DTC淋巴结转移能达到预期的剂量分布,确保精确的短期局部肿瘤控制疗效。
    UNASSIGNED: To investigate the feasibility and evaluate the safety and effectiveness of Computed Tomography (CT) guided125I radioactive particle implantation for treating lymph node metastases in radioiodine-refractory differentiated thyroid cancer (RAIR-DTC). To verify the accuracy of the computerized three-dimensional treatment planning system (TPS) in treating lymph node metastasis using125I particle implantation at the dosimetric level.
    UNASSIGNED: A retrospective analysis was conducted on 42 patients with RAIR-DTC and lymph node metastases who were admitted to the General Hospital of the Northern Theater Command between December 2016 and January 2019. During this analysis, physicians utilized preoperative CT images to design an intraoperative plan using TPS. The dosimetric parameters of the postoperative plan were then compared to the preoperative plan. Additionally, this study examined the changes in tumor size and tumor-related marker Thyroglobulin (Tg) values in patients at 2, 6, and 12 months after the operation.
    UNASSIGNED: The number of125I radioactive particles implanted in 42 patients was 226, with an average of 14.5 (range 2.0-30.0) particles implanted per lesion. The local remission rates were 97.62% (41/42), 88.10% (37/42), and 85.71% (36/42) at 2, 6, and 12 months postoperatively, respectively. The volume of the lesions was (4.44 ± 1.57) cm3, (4.20 ± 1.70) cm3, and (4.23 ± 1.77) cm3at 2, 6, and 12 months after treatment, respectively, which significantly decreased from the preoperative baseline level of (6.87 ± 1.67) cm3(t-values: 9.466, 9.923, 7.566, all P<0.05). The Tg levels were 15.95 (5.45, 73.93) μg/L, 8.90 (2.20, 39.21) μg/L, and 6.00 (1.93, 14.18) μg/L at 2, 6, and 12 months after treatment, respectively, which were significantly lower than the preoperative baseline levels of 53.50 (20.94, 222.92) μg/L (Z values: -5.258, -5.009, -4.987, all P < 0.001). Postoperatively, Delivered to 90% of the GTV(D90) was slightly lower than the prescribed dose in 95.23% (40/42) of patients, but the difference was not statistically significant [(12,378.8 ± 3,182.0), (12,497.8 ± 1,686.4) cGy; t=0.251, P>0.05], and postoperative dose parameters delivered to 100% of the gross tumor volume (GTV)(D100) (6,881.5 ± 1,381.8) cGy, the volume percentages of GTV receiving 150% of the prescribed dose(V150) (58.5 ± 18.40)%) were lower than the preoperative plan D100 (8,085.8 ± 2,330.0) cGy, V150 (66.5 ± 17.70)%; t-value=8.913 and 3.032, both P<0.05; the remaining indicators were not significantly different from the preoperative plan (the differences in the number of implanted particles, Planning Target Volume(PTV), the volume percentages of GTV receiving 100% of the prescribed dose(V100), Homogeneity Index(HI)were not statistically significant (t/Z = -0.593, -1.604, 1.493, -0.663, all P>0.05).
    UNASSIGNED: Referring to the TPS preoperative plan, the125I particle implantation therapy for RAIR-DTC lymph node metastasis can achieve the expected dose distribution, ensuring precise short-term local tumor control efficacy.
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  • 文章类型: Journal Article
    背景:结直肠癌(CRC)是一种常见的恶性肿瘤,肝转移是严重影响患者生存率和生活质量的主要复发转移方式之一。白蛋白胆红素(ALBI)评分等指标,肝功能指标,和癌胚抗原(CEA)在预测肝转移方面显示出一定的潜力,但尚未得到充分的探索。
    目的:通过ALBI联合分析评价其对结直肠癌肝转移的预测价值。肝功能指标,CEA,为临床治疗提供更准确的肝转移风险评估工具。
    方法:本研究回顾性分析2018年1月至2023年7月在我院接受手术治疗的CRC患者的临床资料,随访24个月。根据后续结果,将纳入的患者分为肝转移组和非肝转移组,并以2:1的比例随机分为模型组和验证组.分析结直肠癌患者肝转移的危险因素,通过最小绝对收缩和选择算子(LASSO)逻辑回归构建了预测模型,内部验证是通过引导方法进行的,通过受试者-工作特征曲线评估预测模型的可靠性,校正曲线,和临床决策曲线,并绘制了柱状图来显示预测结果。
    结果:在符合纳入和排除标准的195例CRC患者中,有130例患者纳入模型组,65例患者纳入验证组。通过LASSO回归变量筛选和logistic回归分析。ALBI得分,丙氨酸氨基转移酶(ALT),发现CEA是CRC患者肝转移的独立预测因子[比值比(OR)=8.062,95%置信区间(CI):2.545-25.540],(OR=1.037,95CI:1.004-1.071)和(OR=1.025,95CI:1.008-1.043)。模型组联合预测CRLM的受试者工作特征曲线下面积(AUC)为0.921,灵敏度为78.0%,特异性为95.0%。H指数为0.921,H-L拟合曲线的χ2=0.851,P值为0.654,校准曲线的斜率接近1。这表明该模型非常准确,和临床决策曲线表明,它可以有效地应用在现实世界中。我们使用Bootstrap方法对建模组数据的一千个重采样进行了内部验证。AUC为0.913,而准确性为0.869,κ一致性为0.709。验证组联合预测CRC患者肝转移的AUC为0.918,敏感性为85.0%,特异性为95.6%,C指数为0.918,H-L拟合曲线χ2=0.586,P=0.746。
    结论:ALBI评分,ALT水平,CEA水平对预测结直肠癌患者肝转移有一定的价值。这三个标准在预测诊断为CRC的患者的肝转移方面表现出高水平的功效。这项工作开发的风险预测模型显示出巨大的实际应用潜力。
    BACKGROUND: Colorectal cancer (CRC) is a common malignant tumor, and liver metastasis is one of the main recurrence and metastasis modes that seriously affect patients\' survival rate and quality of life. Indicators such as albumin bilirubin (ALBI) score, liver function index, and carcinoembryonic antigen (CEA) have shown some potential in the prediction of liver metastasis but have not been fully explored.
    OBJECTIVE: To evaluate its predictive value for liver metastasis of CRC by conducting the combined analysis of ALBI, liver function index, and CEA, and to provide a more accurate liver metastasis risk assessment tool for clinical treatment guidance.
    METHODS: This study retrospectively analyzed the clinical data of patients with CRC who received surgical treatment in our hospital from January 2018 to July 2023 and were followed up for 24 months. According to the follow-up results, the enrolled patients were divided into a liver metastasis group and a nonliver metastasis group and randomly divided into a modeling group and a verification group at a ratio of 2:1. The risk factors for liver metastasis in patients with CRC were analyzed, a prediction model was constructed by least absolute shrinkage and selection operator (LASSO) logistic regression, internal validation was performed by the bootstrap method, the reliability of the prediction model was evaluated by subject-work characteristic curves, calibration curves, and clinical decision curves, and a column graph was drawn to show the prediction results.
    RESULTS: Of 130 patients were enrolled in the modeling group and 65 patients were enrolled in the verification group out of the 195 patients with CRC who fulfilled the inclusion and exclusion criteria. Through LASSO regression variable screening and logistic regression analysis. The ALBI score, alanine aminotransferase (ALT), and CEA were found to be independent predictors of liver metastases in CRC patients [odds ratio (OR) = 8.062, 95% confidence interval (CI): 2.545-25.540], (OR = 1.037, 95%CI: 1.004-1.071) and (OR = 1.025, 95%CI: 1.008-1.043). The area under the receiver operating characteristic curve (AUC) for the combined prediction of CRLM in the modeling group was 0.921, with a sensitivity of 78.0% and a specificity of 95.0%. The H-index was 0.921, and the H-L fit curve had χ2 = 0.851, a P value of 0.654, and a slope of the calibration curve approaching 1. This indicates that the model is extremely accurate, and the clinical decision curve demonstrates that it can be applied effectively in the real world. We conducted internal verification of one thousand resamplings of the modeling group data using the bootstrap method. The AUC was 0.913, while the accuracy was 0.869 and the kappa consistency was 0.709. The combination prediction of liver metastasis in patients with CRC in the verification group had an AUC of 0.918, sensitivity of 85.0%, specificity of 95.6%, C-index of 0.918, and an H-L fitting curve with χ 2 = 0.586, P = 0.746.
    CONCLUSIONS: The ALBI score, ALT level, and CEA level have a certain value in predicting liver metastasis in patients with CRC. These three criteria exhibit a high level of efficacy in forecasting liver metastases in patients diagnosed with CRC. The risk prediction model developed in this work shows great potential for practical application.
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