papilloma

乳头状瘤
  • 文章类型: Journal Article
    Respiratory papilloma is a relatively common benign tumor of the respiratory tract, and a few patients may develop malignant changes. The disease has an insidious onset and lacks specific clinical manifestations, and its manifestations are closely related to the growth mode, location and size of the tumor. It can involve multiple parts, such as the larynx, trachea, bronchus, and lung parenchyma, which cause coughing, hoarseness, dysphonia, and, in severe cases, may lead to obstruction of the respiratory tract. At present, the treatment of respiratory papilloma lacks standardization, and there is no effective method to cure the disease. Surgery remains the main treatment for alleviating patients\' symptoms and preventing airway obstruction. However, due to the high recurrence rate of respiratory papilloma, multiple surgeries are often needed, which reduces the quality of life of patients and increases their disease burden and economic burden. Bevacizumab, a vascular endothelial growth factor-binding antibody inhibitor, is a promising adjuvant treatment modality that shows good potential for reducing symptoms and the frequency of surgery. This article aimed to review the efficacy and safety of bevacizumab for the treatment of respiratory papilloma and discuss the differences and efficacy of the systemic application and intralesional injection of bevacizumab for the treatment of respiratory papilloma.
    呼吸道乳头状瘤是呼吸道较常见的良性肿瘤,少数可发生恶变。该病起病隐匿,缺乏特异性临床表现,其表现与肿瘤生长方式、部位、大小密切相关,可有喉、气管、支气管、肺实质等多个部位受累,引起咳嗽、声音嘶哑、发音困难,严重者可致呼吸道梗阻。目前,呼吸道乳头状瘤的治疗缺乏规范统一的标准,且尚无治愈该病的有效方法,手术是减轻患者症状、预防气道梗阻的主要治疗方式。然而呼吸道乳头状瘤复发率高,患者往往需要经历多次手术治疗,频繁的手术降低患者的生活质量,增加患者的疾病负担与经济负担。贝伐珠单抗作为血管内皮生长因子结合抗体抑制剂,是一种有希望的辅助治疗方式,在减轻症状、减少手术频率方面表现出较好的潜力。本文主要对贝伐珠单抗治疗呼吸道乳头状瘤的有效性及安全性进行综述,并探讨全身性应用和病灶内注射贝伐珠单抗治疗呼吸道乳头状瘤的差异及疗效。.
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  • 文章类型: Case Reports
    鳞状乳头状瘤是一种良性肿瘤,起源于粘膜的复层鳞状上皮。其主要病因是人乳头瘤病毒感染,倾向于在口腔内显现。鳞状乳头状瘤主要影响腭上的区域,脸颊,嘴唇和舌头然而,据我们所知,迄今为止,下颌骨范围内鳞状乳头状瘤的发生尚未报道。本报告记录了在中山大学附属第一医院治疗的一例涉及下颌骨的鳞状乳头状瘤(广州,中国)2023年1月。病人经历了一系列复发性的颌骨炎症,表现为恶性影像学特征。随后的病理分析证实了颌骨乳头状瘤的诊断。本报告强调了长期炎症在颌骨鳞状乳头状瘤发生中的关键作用,为进一步调查提供了途径,包括炎症诱导异常细胞生长的潜力,介导细胞相互作用,协调细胞因子的作用和影响应激介质。此外,目前的研究认为,持续性炎症之间存在着一种似是而非的联系,上皮完整性受损,头颈部乳头状瘤的可能性增加,特别是关于人乳头瘤病毒感染。本文描述了颌骨乳头状瘤的罕见表现的临床属性,并深入研究了相关机制。从而有助于增强对颌骨疾病的理解。这种全面的见解为临床医生提供了更高的知识库,以更精确地诊断和治疗类似病例。
    Squamous papilloma is a benign neoplasm that originates from the stratified squamous epithelium of the mucous membrane. Its principal etiological factor is human papillomavirus infection, with a predilection for manifesting within the oral cavity. Squamous papilloma predominantly affects regions on the palate, cheeks, lips and tongue. However, to the best of our knowledge, the occurrence of squamous papilloma within the confines of the mandible remains unreported hitherto. The present report documents a case of squamous papilloma involving the mandible who was managed at the First Affiliated Hospital of Sun Yat-sen University (Guangzhou, China) in January 2023. The patient underwent a series of recurrent jaw inflammations, manifesting with malignant imaging characteristics. Subsequent pathological analysis confirmed a diagnosis of papilloma in the jaw. The present report highlights the pivotal role of prolonged inflammation in the genesis of jaw squamous papilloma, prompting avenues for further investigation, including the potential of inflammation to induce aberrant cell growth, mediate cell interactions, orchestrate cytokine actions and influence stress mediators. In addition, the current study posits a plausible connection between persistent inflammation, compromised epithelial integrity and an increased likelihood of head and neck papilloma, particularly concerning human papillomavirus infection. This article delineates the clinical attributes of the uncommon manifestations of jaw papilloma and delves into the associated mechanisms, thereby contributing to an enhanced comprehension of jaw disorders. This comprehensive insight equips clinicians with a heightened knowledge base for more precise diagnosis and treatment of analogous cases.
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  • 文章类型: Journal Article
    背景:随着医学和经济的进步,预计上呼吸道乳头状瘤病的临床特征会发生变化。这项研究的目的是检查上呼吸道乳头状瘤病的当前临床特征,因为文献中没有最新的数据。
    方法:回顾性分析1894例上呼吸道乳头状瘤病患者的临床资料。提取的数据包括临床特征,喉镜图像,和外科手术数据。
    结果:口咽部上呼吸道乳头状瘤病的发生率为69.1%,喉部占到28.9%。术后总复发率为2.4%。喉乳头状瘤病的复发率为6.5%。大约2.6%的病例发生在儿童身上。所有患儿术后复发均为喉部,复发率为30.4%。
    结论:口咽部发生上呼吸道乳头状瘤病的频率最高。喉部,然而,术后复发率最高。与成年人相比,儿童更有可能出现术后复发.
    BACKGROUND: With advancements in medicine and economy, it would be expected that there will be changes in the clinical characteristics of upper respiratory papillomatosis. The aim of this study was to examine the current clinical characteristics of upper respiratory papillomatosis, as there are no recent data in the literature.
    METHODS: The medical records of 1894 patients with upper respiratory papillomatosis were retrospectively reviewed. Data extracted included clinical features, laryngoscopy images, and surgical procedure data.
    RESULTS: The upper frequency of upper respiratory papillomatosis in the oropharynx was 69.1 %, and in the larynx was held 28.9 %. The overall postoperative relapse rate was 2.4 %. The relapse rate of laryngeal papillomatosis was 6.5 %. Approximately 2.6 % of cases were in children. All postoperative recurrences in children were laryngeal, and the recurrence rate was 30.4 %.
    CONCLUSIONS: The oropharynx has the highest frequency of upper respiratory papillomatosis. The larynx, however, has the highest rate of postoperative recurrence. Compared to adults, children are more likely to experience a postoperative recurrence.
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  • 文章类型: Case Reports
    孤立的混合鳞状细胞和腺乳头状瘤是一种极其罕见的良性肿瘤。我们描述了患有高血清癌胚抗原水平(63.3ng/mL;参考,<5ng/mL)。肿瘤显示出强烈的FDG摄取,SUVmax为23.8,模拟肺癌。
    UNASSIGNED: Solitary mixed squamous cell and glandular papilloma of the lung is an extremely rare benign neoplasm. We describe FDG PET/CT findings in a case of solitary mixed squamous cell and glandular papilloma of the lung with high serum carcinoembryonic antigen level (63.3 ng/mL; reference, <5 ng/mL). The tumor showed intense FDG uptake with SUVmax of 23.8 mimicking lung cancer.
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  • 文章类型: Case Reports
    背景:本文介绍了一个具有挑战性的案例,该案例涉及一名老年男性患者,该患者患有误诊的乳腺导管内乳头状瘤,最初通过超声成像被确定为汗腺腺瘤。本研究旨在探讨其组织病理学,临床表现,和两种情况的超声特征,强调导致诊断失误的因素。
    方法:一名61岁男性报告持续的左乳房肿块,伴随着疼痛和肿胀,持续时间为6个月。
    方法:超声检查表明,正方形,左乳头内的混合回声肿块,最初提示汗腺腺瘤。然而,全身麻醉切除后的病理分析证实为导管内乳头状瘤.
    方法:患者在全身麻醉下接受左乳肿块手术切除。
    结果:手术后,患者表现出令人满意的恢复;然而,遗憾的是,他失去了后续行动。
    结论:这项研究强调了仅根据超声特征区分透明细胞汗腺腺瘤和男性乳腺导管内乳头状瘤的挑战。它强调了基于超声的诊断对误解的敏感性,强调必须进行全面的病理检查以确定明确的诊断。
    BACKGROUND: This article presents a challenging case involving an elderly male patient with a misdiagnosed intraductal mammary papilloma initially identified as a sweat adenoma through ultrasound imaging. The study aims to explore the histopathology, clinical presentations, and sonographic features of both conditions, emphasizing the contributing factors to the diagnostic misstep.
    METHODS: A 61-year-old male reported a persistent left breast mass, along with pain and swelling, spanning a 6-month duration.
    METHODS: Ultrasound examination indicated a deep, square, mixed-echo mass in the left nipple, initially suggestive of a sweat adenoma. However, subsequent pathological analysis following resection under general anesthesia confirmed an intraductal papilloma.
    METHODS: The patient underwent surgical resection of the left breast mass under general anesthesia.
    RESULTS: Post-surgery, the patient exhibited satisfactory recovery; however, regrettably, he was lost to follow-up.
    CONCLUSIONS: This study underscores the challenge in differentiating between clear cell sweat adenoma and male intraductal mammary papilloma solely based on ultrasonic characteristics. It emphasizes the susceptibility of ultrasound-based diagnoses to misinterpretation, highlighting the critical need for a comprehensive pathological examination to establish a definitive diagnosis.
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  • 文章类型: Journal Article
    N-亚硝基甲基苄胺(NMBzA)诱导的食管鳞状细胞癌(ESCC)的大鼠模型通常用于研究ESCC的发生,进展和新的治疗策略。然而,该模型耗时且恶性肿瘤发病率低。这里,我们报道了使用多激酶抑制剂索拉非尼作为肿瘤促进剂来建立有效的两阶段NMBzA诱导的大鼠ESCC癌变模型,导致肿瘤发病率增加并缩短肿瘤形成时间。通过建立模型并应用全基因组测序,我们发现良性乳头状瘤和恶性ESCC中存在大多数在大鼠ESCC中发现的“驱动”事件(例如Ras家族的复发性突变,Hippo和Notch途径以及组蛋白修饰基因)以及大鼠和人类ESCC的突变景观广泛重叠。我们产生来自NMBzA诱导的乳头状瘤和ESCCs的肿瘤细胞系,表明乳头状瘤细胞比癌细胞保留更多的正常上皮细胞的特征,特别是他们的正常大鼠细胞核型和免疫缺陷小鼠无法形成肿瘤的表现。三维(3-D)类器官培养和单细胞RNA测序(scRNA-seq)表明,与对照和乳头状瘤器官相比,ESCC类器官在组织和单细胞水平显示出显著的异常。多组分析表明,NMBzA诱导的大鼠ESCC伴随着FAT-Hippo-YAP1轴的进行性过度激活,而YAP1的siRNA或抑制剂阻断了大鼠ESCC的生长。一起来看,这些研究提供了使用有效的大鼠ESCC模型来研究ESCC癌变的多级功能基因组学的框架,这证明靶向YAP1作为ESCC的治疗策略是合理的。
    Rat model of N-nitrosomethylbenzylamine (NMBzA)-induced esophageal squamous cell carcinoma (ESCC) is routinely used to study ESCC initiation, progression and new therapeutic strategies. However, the model is time-consuming and malignant tumor incidences are low. Here, we report the usage of multi-kinase inhibitor sorafenib as a tumor promoter to establish an efficient two-stage NMBzA-induced rat ESCC carcinogenesis model, resulting in increments of tumor incidences and shortened tumor formation times. By establishing the model and applying whole-genome sequencing, we discover that benign papillomas and malignant ESCCs harbor most of the \"driver\" events found in rat ESCCs (e.g. recurrent mutations in Ras family, the Hippo and Notch pathways and histone modifier genes) and the mutational landscapes of rat and human ESCCs overlap extensively. We generate tumor cell lines derived from NMBzA-induced papillomas and ESCCs, showing that papilloma cells retain more characteristics of normal epithelial cells than carcinoma cells, especially their exhibitions of normal rat cell karyotypes and inabilities of forming tumors in immunodeficient mice. Three-dimensional (3-D) organoid cultures and single cell RNA sequencing (scRNA-seq) indicate that, when compared to control- and papilloma-organoids, ESCC-organoids display salient abnormalities at tissue and single-cell levels. Multi-omic analyses indicate that NMBzA-induced rat ESCCs are accompanied by progressive hyperactivations of the FAT-Hippo-YAP1 axis and siRNA or inhibitors of YAP1 block the growth of rat ESCCs. Taken together, these studies provide a framework of using an effective rat ESCC model to investigate multilevel functional genomics of ESCC carcinogenesis, which justify targeting YAP1 as a therapeutic strategy for ESCC.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    DEK:AFF2融合相关乳头状鳞状细胞癌是一种新颖的实体,其特征是其独特的易位和恶性临床过程。在这项研究中,在复发性鼻腔鼻窦乳头状瘤中进行了AFF免疫组织化学(IHC),以回顾未诊断的DEK::AFF2癌的患病率,并研究AFFIHC在DEK::AFF2癌诊断中的表现。恢复了二十年来手术切除后的复发性鼻窦乳头状瘤。回顾了组织切片的DEK::AFF2癌的特征。进行了AFFIHC,任何(>1%)核阳性的病例均通过DEK分解荧光原位杂交进行验证。共纳入43例,包括28个倒置的,6外生性,一个嗜酸细胞,8例非特异性鼻窦乳头状瘤。5例(11.6%)AFFIHC阳性。三例表现出斑片状弱至中等染色强度,主要呈颗粒状细胞质模式。两例表现出强烈和弥漫性(>90%)的核染色。弱染色病例DEK重排阴性,而强染色者为阳性。两例DEK::AFF2癌都表现出侵袭性行为,具有广泛的局部侵袭和淋巴结转移。背景基质浆细胞,当存在时,始终显示出强烈和弥漫的染色。在浆细胞瘤样品中进一步进行AFFIHC作为对照,并显示强且弥散的免疫反应性。少数复发性鼻窦乳头状瘤代表DEK::AFF2癌。颗粒状,细胞质,或不完全AFF染色应视为阴性。鉴于DEK::AFF2癌的罕见性,浆细胞和浆细胞肿瘤是潜在的内部和替代外部控制。
    DEK::AFF2 fusion-associated papillary squamous cell carcinoma is a novel entity characterized by its unique translocation and malignant clinical course. In this study, AFF immunohistochemistry (IHC) was performed in recurrent sinonasal papillomas for reviewing the prevalence of undiagnosed DEK::AFF2 carcinomas and to investigate the performance of AFF IHC in diagnosis of DEK::AFF2 carcinomas. Recurrent sinonasal papillomas after surgical excision in a two-decade period were retrieved. Histologic slides were reviewed for features of DEK::AFF2 carcinoma. AFF IHC was performed, and cases with any (> 1%) nuclear positivity were validated by DEK break apart fluorescence in situ hybridization. Totally 43 cases were included, comprising 28 inverted, 6 exophytic, one oncocytic, and 8 non-specified sinonasal papillomas. Five (11.6%) cases exhibited positivity to AFF IHC. Three cases exhibited patchy weak to moderate staining intensity predominantly in a granular cytoplasmic pattern. Two cases exhibited strong and diffuse (> 90%) nuclear staining. Cases showing weak staining were negative for DEK rearrangement, while those with strong staining were positive. Both cases of DEK::AFF2 carcinoma showed aggressive behavior with extensive local invasion and nodal metastasis. Background stromal plasma cells, when present, consistently showed strong and diffuse staining. AFF IHC was further performed in plasmacytoma samples as control and showed strong and diffuse immunoreactivity. A significant minority of recurrent sinonasal papillomas represent DEK::AFF2 carcinomas. Granular, cytoplasmic, or incomplete AFF staining should be considered as negative. In view of the rarity of DEK::AFF2 carcinomas, plasma cells and plasma cell neoplasms are potential for internal and surrogate external controls.
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  • 文章类型: English Abstract
    Objective: To investigate the gene mutation of telomerase reverse transcriptase (TERT) promoter in inverted urothelial lesions of the bladder and its significance in differential diagnosis. Methods: From March 2016 to February 2022, a total of 32 patients with inverted urothelial lesions diagnosed in Department of Pathology at Qingdao Chengyang People\'s Hospital and 24 patients at the Affiliated Hospital of Qingdao University were collected, including 7 cases of florid glandular cystitis, 13 cases of inverted urothelial papilloma, 8 cases of inverted urothelial neoplasm with low malignant potential, 17 cases of low-grade non-invasive inverted urothelial carcinoma, 5 cases of high-grade non-invasive inverted urothelial carcinoma, and 6 cases of nested subtype of urothelial carcinoma were retrospectively analyzed for their clinical data and histopathological features. TERT promoter mutations were analyzed by Sanger sequencing in all the cases. Results: No mutations in the TERT promoter were found in the florid glandular cystitis and inverted urothelial papilloma. The mutation rates of the TERT promoter in inverted urothelial neoplasm with low malignant potential, low grade non-invasive inverter urothelial carcinoma, high grade non-invasive inverted urothelial carcinoma and nested subtype urothelial carcinoma were 1/8, 8/17, 2/5 and 6/6, respectively. There was no significant difference in the mutation rate of TERT promoter among inverted urothelial neoplasm with low malignant potential, low-grade non-invasive inverted urothelial carcinoma, and high-grade non-invasive inverted urothelial carcinoma (P>0.05). All 6 cases of nested subtype of urothelial carcinoma were found to harbor the mutation, which was significantly different from inverted urothelial neoplasm with low malignant potential and non-invasive inverted urothelial carcinoma (P<0.05). In terms of mutation pattern, 13/17 of TERT promoter mutations were C228T, 4/17 were C250T. Conclusions: The morphology combined with TERT promoter mutation detection is helpful for the differential diagnosis of bladder non-invasive inverted urothelial lesions.
    目的: 探讨端粒酶逆转录酶(TERT)启动子在膀胱内翻性尿路上皮病变中的突变情况及其在鉴别诊断中的意义。 方法: 收集2016年3月至2022年2月青岛市城阳区人民医院32例及青岛大学附属医院24例病理科诊断为膀胱内翻性尿路上皮病变56例,包括7例旺炽性腺性膀胱炎、13例内翻性尿路上皮乳头状瘤、8例内翻性低度恶性潜能的尿路上皮肿瘤、17例低级别非浸润性内翻性尿路上皮癌、5例高级别非浸润性内翻性尿路上皮癌及6例巢状亚型尿路上皮癌,总结其临床资料及组织病理学特征,并通过一代测序分析TERT启动子突变情况。 结果: 旺炽性腺性膀胱炎和内翻性尿路上皮乳头状瘤中均未发现有TERT启动子突变,TERT启动子在内翻性低度恶性潜能的尿路上皮肿瘤、低级别和高级别非浸润性内翻性尿路上皮癌以及巢状亚型尿路上皮癌中的突变比例分别为1/8、8/17、2/5和6/6。TERT启动子突变比例在内翻性低度恶性潜能的尿路上皮肿瘤、低级别以及高级别非浸润性内翻性尿路上皮癌之间差异均无统计学意义(P>0.05)。巢状亚型尿路上皮癌中6例全部突变,与内翻性低度恶性潜能的尿路上皮肿瘤和非浸润性内翻性尿路上皮癌突变比例相比,差异有统计学意义(P<0.05)。突变形式上,TERT启动子突变13/17为C228T,4/17为C250T。 结论: 形态学结合TERT启动子突变检测有助于对膀胱非浸润性内翻性尿路上皮病变的鉴别诊断。.
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  • 文章类型: Journal Article
    背景:服用BRAF抑制剂如维罗非尼(PLX4032)治疗黑色素瘤的患者中有20%至30%会发生皮肤鳞状细胞癌。
    目的:本研究旨在阐明水薄荷精油的化学预防作用。石灰(EO)及其主要成分,柠檬烯和香芹酮(L+C)占环氧乙烷的45.68%,针对PLX4032诱导的皮肤副作用。
    方法:PLX4032在7,12-二甲基苯并[a]蒽(DMBA)/12-O-十四烷酰基佛波醇-13-乙酸酯(TPA)诱导的两阶段皮肤癌发生小鼠模型中加速皮肤乳头状瘤形成和角质形成细胞HRAS突变使用EO和L+C的体内生物功效评估。西方印迹,免疫化学,和角质形成细胞-巨噬细胞共培养试验。
    结果:用EO处理抑制了集落形成能力,细胞迁移,入侵,并诱导PDVHRASQ61L角质形成细胞的G2/M细胞周期阻滞和凋亡,和L+C处理抑制集落形成,PDV细胞的细胞迁移和侵袭。在用DMBA/TPA(DT组)或DMBA/TPA与PLX4032(DTP组)刺激的小鼠皮肤中,与DT或DTP对照组相比,局部应用EO和L+C可显著延迟乳头状瘤的出现并降低乳头状瘤的发生率.组织病理学结果显示EO和L+C处理减弱了K14+角质形成细胞增殖和矛盾的MAPK激活,并将小鼠皮肤微环境中的巨噬细胞从M2(CD163)转移到M1(iNOS)。EO或L+C预处理的PDV角质形成细胞的条件培养基促进M0巨噬细胞从THP-1细胞分化成M1样巨噬细胞。
    结论:这项研究表明,EO和L+C联合使用可通过重编程巨噬细胞群和抑制角质形成细胞活性来预防PLX4032诱导的小鼠皮肤副作用和皮肤癌变。薄荷EO和天然产物L+C均可被认为是有效的化学预防剂,其可用于减少施用BRAF抑制剂的人类患者的皮肤损伤。
    BACKGROUND: Twenty to thirty percent of patients taking BRAF inhibitors such as vemurafenib (PLX4032) for melanoma develop cutaneous squamous cell carcinomas.
    OBJECTIVE: This study aimed to elucidate the chemopreventive effect of essential oil from Mentha aquatica L. cv. Lime (EO) and its major constituents, limonene and carvone (L + C) that made up 45.68% of the EO, against PLX4032-induced cutaneous side effects.
    METHODS: PLX4032 accelerated skin papilloma formation and keratinocyte HRAS mutation in 7,12-dimethylbenz[a]anthracene (DMBA)/12-O-tetradecanoylphorbol-13-acetate (TPA)-induced two-stage skin carcinogenesis mouse model was used to evaluate the in vivo bioefficacy of EO and L + C. The effects and molecular mechanisms of EO and L + C on deregulating mouse PDVHRASQ61L keratinocyte activities were demonstrated using a spectrum of bioactivity assays, western blotting, immunochemistry, and keratinocyte-macrophage co-culture assay.
    RESULTS: Treatment with EO suppressed colony formation ability, cell migration, invasion, and induced G2/M cell-cycle arrest and apoptosis in PDVHRASQ61L keratinocytes, and L + C treatment inhibited colony formation, cell migration and invasion of PDV cells. In mouse skin irritated with DMBA/TPA (DT group) or DMBA/TPA with PLX4032 (DTP group), topical application of EO and L + C significantly delayed papilloma appearance and reduced papilloma incidence compared to DT or DTP controls. Histopathology results showed that EO and L + C treatment attenuated K14+ keratinocyte proliferation and paradoxical MAPK activation, and shifted the macrophage population from M2 (CD163+) to M1 (iNOS+) in the mouse skin microenvironment. The conditioned medium of EO or L + C pre-treated PDV keratinocytes promoted M0 macrophages to differentiate from THP-1 cells into M1-like macrophages.
    CONCLUSIONS: This study demonstrates that EO and L + C in combination prevent PLX4032-induced cutaneous side-effects and skin carcinogenesis in mice through reprogramming the macrophage cell population and inhibiting keratinocyte activity. Both mint EO and the natural products L + C can be considered to be effective chemopreventive agents that might be useful in reducing cutaneous lesions in human patients administrated with BRAF inhibitors.
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