Rhabdomyosarcoma

横纹肌肉瘤
  • 文章类型: Journal Article
    背景:横纹肌肉瘤(RMS)是儿童和青少年中最常见的软组织肉瘤之一,其中PAX3-FOXO1融合基因阳性患者预后极差。PAX3-FOXO1已被确定为RMS的独立预后预测因子,目前没有可用的有针对性的治疗干预。新型酪氨酸激酶抑制剂安洛替尼在多种类型的癌症中表现出广泛的抗癌作用;然而,关于其在RMS中的应用尚无相关研究。
    方法:我们使用CCK-8试验研究了PAX3-FOXO1对安洛替尼疗效的影响,流式细胞术,侵袭试验,伤口愈合试验,西方印迹,定量聚合酶链反应(qPCR),和异种移植实验。进行RNA-seq和共免疫沉淀测定以确定安洛替尼调节PAX3-FOXO1表达的具体机制。
    结果:安洛替尼有效抑制RMS细胞增殖,促进细胞凋亡和G2/M期阻滞,同时阻碍体内肿瘤生长。PAX3-FOXO1的下调增强了安洛替尼的抗肿瘤作用。安洛替尼上调蛋白激酶NEK2,并通过泛素-蛋白酶体途径增加PAX3-FOXO1的降解,导致PAX3-FOXO1蛋白水平降低。
    结论:安洛替尼有效抑制RMS的恶性进展并促进融合蛋白PAX3-FOXO1的降解。安洛替尼可能是治疗PAX3-FOXO1融合阳性RMS的靶向治疗方法。
    BACKGROUND: Rhabdomyosarcoma (RMS) is one of the most common soft tissue sarcomas in children and adolescents, in which PAX3-FOXO1 fusion gene positive patients have very poor prognosis. PAX3-FOXO1 has been identified as an independent prognostic predictor in RMS, with no currently available targeted therapeutic intervention. The novel tyrosine kinase inhibitor anlotinib exhibits a wide range of anticancer effects in multiple types of cancers; however, there have been no relevant studies regarding its application in RMS.
    METHODS: We investigated the effects of PAX3-FOXO1 on the therapeutic efficacy of anlotinib using the CCK-8 assay, flow cytometry, invasion assay, wound healing assay, western blotting, quantitative polymerase chain reaction(qPCR), and xenograft experiments. RNA-seq and co-immunoprecipitation assays were conducted to determine the specific mechanism by which anlotinib regulates PAX3-FOXO1 expression.
    RESULTS: Anlotinib effectively inhibited RMS cell proliferation and promoted apoptosis and G2/M phase arrest while impeding tumor growth in vivo. Downregulation of PAX3-FOXO1 enhances the antitumor effects of anlotinib. Anlotinib upregulates protein kinase NEK2 and increases the degradation of PAX3-FOXO1 via the ubiquitin-proteasome pathway, leading to a reduction in PAX3-FOXO1 protein levels.
    CONCLUSIONS: Anlotinib effectively inhibited the malignant progression of RMS and promoted degradation of the fusion protein PAX3-FOXO1. Anlotinib could be a targeted therapeutic approach to treat PAX3-FOXO1 fusion-positive RMS.
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  • 文章类型: Journal Article
    小儿肿瘤的治疗是复杂的,通过手术,化疗,放射治疗是他们治疗的基石。肿瘤切除越来越多地通过微创方法进行,这使得术后恢复更快,术后疼痛更少。本报告的目的是概述常见儿科肿瘤的微创手术方法,重点关注技术考虑和术后结果。
    The management of pediatric tumors is complex, with surgery, chemotherapy, and radiotherapy being cornerstones in their treatment. Tumor removal is increasingly performed by a minimally invasive approach, which allows for quicker postoperative recovery and less postoperative pain. The goal of this report is to give an overview of minimally invasive surgical approaches for common pediatric tumors, with a focus on technical considerations and postoperative outcomes.
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  • 文章类型: Journal Article
    背景:尽管采用了包括手术在内的多模式方法,化疗和放疗,横纹肌肉瘤(RMS)的5年无事件生存率,儿童时期最常见的软组织肉瘤,对于转移性患者来说仍然非常差,主要是由于肿瘤细胞的选择和增殖驱动抵抗机制。使用新药或靶向治疗与常规治疗相结合的基于个性化医学的方案有可能增强治疗效果。同时最大限度地减少各种人类恶性肿瘤对健康组织的损害,开始了几项临床试验。在这项研究中,我们分析了,第一次,合成d的复合物SFX-01的抗肿瘤活性,在α-环糊精中稳定的l-萝卜硫素(EvgenPharmaplc,英国),用作单剂并与辐照结合使用,在四种肺泡和胚胎RMS的临床前模型中。的确,SFX-01在临床前研究中显示了其调节参与炎症和氧化应激的细胞途径的能力的前景,这对于癌症治疗中的控制至关重要。
    方法:RH30,RH4(肺泡RMS),使用RD和JR1(胚胎RMS)细胞系以及RMS的小鼠异种移植模型来评估SFX-01处理诱导的生物学和分子效应。流式细胞术和通过q-PCR和蛋白质印迹分析的关键标志物的调节用于评估细胞增殖,凋亡,暴露于SFX-01的RMS细胞中自噬和细胞内活性氧(ROS)的产生。还通过特定的测定研究了迁移和侵入的能力。在体外和体内研究中研究了SFX-01与电离辐射(IR)之间可能的协同作用。学生t检验或双向方差分析用于检验两个或多个比较的统计学显著性,分别。
    结果:SFX-01治疗表现出细胞抑制和细胞毒性作用,由G2细胞周期阻滞介导,细胞凋亡诱导和自噬抑制。此外,SFX-01作为单一疗法并与IR组合能够抑制3D肿瘤球的形成和增殖。最后,SFX-01,当作为单一药物口服时,在RMS异种移植小鼠模型中显示出减少肿瘤块生长的功效;当与放射治疗方案结合使用时,观察到它协同行动,导致比单独添加每个暴露所预期的更积极的结果。
    结论:总之,我们的结果为SFX-01在RMS肿瘤临床前模型中的抗肿瘤特性提供了证据,既作为独立治疗,也与照射相结合。这些即将到来的发现对于SFX-01抗RMS分子机制的深入研究以及在RMS患者中建立临床试验至关重要,以便使用SFX-01/IR共同治疗作为有前途的治疗方法。特别是在侵袭性RMS疾病的临床管理中。
    BACKGROUND: Despite a multimodal approach including surgery, chemo- and radiotherapy, the 5-year event-free survival rate for rhabdomyosarcoma (RMS), the most common soft tissue sarcoma in childhood, remains very poor for metastatic patients, mainly due to the selection and proliferation of tumour cells driving resistance mechanisms. Personalised medicine-based protocols using new drugs or targeted therapies in combination with conventional treatments have the potential to enhance the therapeutic effects, while minimizing damage to healthy tissues in a wide range of human malignancies, with several clinical trials being started. In this study, we analysed, for the first time, the antitumour activity of SFX-01, a complex of synthetic d, l-sulforaphane stabilised in alpha-cyclodextrin (Evgen Pharma plc, UK), used as single agent and in combination with irradiation, in four preclinical models of alveolar and embryonal RMS. Indeed, SFX-01 has shown promise in preclinical studies for its ability to modulate cellular pathways involved in inflammation and oxidative stress that are essential to be controlled in cancer treatment.
    METHODS: RH30, RH4 (alveolar RMS), RD and JR1 (embryonal RMS) cell lines as well as mouse xenograft models of RMS were used to evaluate the biological and molecular effects induced by SFX-01 treatment. Flow cytometry and the modulation of key markers analysed by q-PCR and Western blot were used to assess cell proliferation, apoptosis, autophagy and production of intracellular reactive oxygen species (ROS) in RMS cells exposed to SFX-01. The ability to migrate and invade was also investigated with specific assays. The possible synergistic effects between SFX-01 and ionising radiation (IR) was studied in both the in vitro and in vivo studies. Student\'s t-test or two-way ANOVA were used to test the statistical significance of two or more comparisons, respectively.
    RESULTS: SFX-01 treatment exhibited cytostatic and cytotoxic effects, mediated by G2 cell cycle arrest, apoptosis induction and suppression of autophagy. Moreover, SFX-01 was able to inhibit the formation and the proliferation of 3D tumorspheres as monotherapy and in combination with IR. Finally, SFX-01, when orally administered as single agent, displayed a pattern of efficacy at reducing the growth of tumour masses in RMS xenograft mouse models; when combined with a radiotherapy regime, it was observed to act synergistically, resulting in a more positive outcome than would be expected by adding each exposure alone.
    CONCLUSIONS: In summary, our results provide evidence for the antitumour properties of SFX-01 in preclinical models of RMS tumours, both as a standalone treatment and in combination with irradiation. These forthcoming findings are crucial for deeper investigations of SFX-01 molecular mechanisms against RMS and for setting up clinical trials in RMS patients in order to use the SFX-01/IR co-treatment as a promising therapeutic approach, particularly in the clinical management of aggressive RMS disease.
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  • 文章类型: Case Reports
    横纹肌肉瘤是儿童常见的软组织肿瘤,但在成人中很少见。肺泡横纹肌肉瘤代表横纹肌肉瘤的亚型,在成年人中极为罕见,尤其是在鼻腔内.成人的治疗方案通常基于儿科病例中使用的方案。我们介绍了一个有乳腺癌病史的56岁女性患者的病例,该患者发展为鼻腔的肺泡横纹肌肉瘤,第三阶段,最初用化疗管理,导致部分反应。随后,患者接受同步放化疗.临床过程以18个月后局部缓解和转移性进展为标志。肺泡横纹肌肉瘤在成人中并不常见,其治疗管理仍不规范。然而,它通常是基于最初的化疗,然后是局部治疗。尽管治疗取得了进展,预后仍然很差。
    Rhabdomyosarcoma is a common soft tissue tumor in children but rare in adults. Alveolar rhabdomyosarcoma represents a subtype of rhabdomyosarcoma, extremely rare in adults, especially within the nasal cavities. Therapeutic protocols for adults are often based on those used in pediatric cases. We present the case of a 56-year-old female patient with a history of breast cancer who developed alveolar rhabdomyosarcoma of the nasal cavity, stage III, managed initially with chemotherapy resulting in partial response. Subsequently, the patient underwent concomitant chemoradiotherapy. The clinical course was marked by local remission with metastatic progression after 18 months. Alveolar rhabdomyosarcoma is uncommon in adults, and its therapeutic management remains non-standardized. However, it is typically based on initial chemotherapy followed by local treatment. Despite therapeutic advances, the prognosis remains poor.
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  • 文章类型: English Abstract
    Objective:To explore the imaging features of rare tumors of nasal cavity and sinuses, and to improve the understanding of these diseases, thereby aiding clinical diagnosis and treatment. Methods:The CT and MRI findings of 79 cases of rare neoplasm of nasal cavity and sinuses confirmed by pathology were retrospectively analyzed, and the imaging features were summarized. Results:Among the 79 cases, there were 16 cases of neuroendocrine carcinoma, most showing expansive and infiltrative bone destruction without hyperosteogeny and sclerosis. The sphenoid sinus exhibited a \"pigeon\" shape. In 28 cases of malignant melanoma, MRI signals were diverse, typical signals were rare, but mixed signals were more common. In 12 cases of rhabdomyosarcoma, MRI enhancement mostly showed \"grape-like\" enhancement and partial ring enhancement; There were 10 cases of olfactory neuroblastoma, the lesions were consistent with the distribution area of olfactory mucosa, most of them were lobulated, marginal nodules, and \"flower ring\" enhancement, and 2 cases grew across intracranial and external, with multiple cystic lesions and surrounding flaky edema bands. In 5 cases of solitary fibrous tumor, Benign tumors had regular shape and uniform density, while malignant tumors had irregular shape and uneven density, The enhancement was obviously uneven and showed a \"pattern\" change. There were 2 cases of sarcomatoid carcinoma, both with lobed appearance, uneven density, lamellar low-density shadow, and osteolytic bone destruction. In 4 cases of schwannoma, the enhancement showed obvious inhomogeneous enhancement. One case showed cystic necrosis, one case showed calcification, and the surrounding structure was compressed without damage. There was 1 case of neurofibroma, with many cystic components, low signal separation and compartmentalized enhancement. One case of paraganglioma showed moderate enhancement in the arterial phase and progressive enhancement in the venous phase, accompanied by significant swelling bone destruction. Conclusion:Rare tumors of nasal cavity and paranasal sinuses have distinctive imaging features. CT and MRI can effectively show the extent of the lesions and the degree of infiltration into adjacent tissues and organs, which is helpful for early clinical diagnosis and staging. However, definitive diagnosis still depends on pathology and immunohistochemistry.
    目的:探讨鼻腔鼻窦少见肿瘤的影像学特点,提高对该类疾病的认识,为临床诊断和治疗提供帮助。 方法:回顾性分析经病理证实的79例鼻腔鼻窦少见肿瘤的CT和MRI表现,总结其影像学特征。 结果:79例中,神经内分泌癌16例,骨质破坏多表现为膨胀性骨质破坏与浸润性骨质破坏并存,而不伴骨质增生硬化,位于蝶窦者双侧对称呈“鸽”形;恶性黑色素瘤28例,MRI信号表现多样,典型者少见,而以混杂信号多见;横纹肌肉瘤12例,MRI增强多呈“葡萄状”强化、部分环状强化;嗅神经母细胞瘤10例,病灶与嗅黏膜分布区一致,多呈分叶状,边缘结节状,“花环状”强化,2例跨颅内外生长,颅内病灶见多发囊变及周围片状水肿带;孤立性纤维性肿瘤5例,良性者形态规则,密度均匀,恶性者形态不规则,密度不均,增强明显不均匀强化,呈“地图样”改变;肉瘤样癌2例,形态似分叶,密度不均,内见片状低密度影,均有溶骨性骨质破坏;神经鞘瘤4例,增强呈明显欠均匀强化,1例见囊变坏死,1例见钙化,周围结构受压而无破坏;神经纤维瘤1例,囊变成分多,内见低信号分隔,增强呈分隔样强化;副神经节瘤1例,增强动脉期中度强化,静脉期进行性明显强化,伴有明显膨胀性骨质破坏。 结论:鼻腔鼻窦少见肿瘤具有一定的影像学特征,CT和MRI能更好地显示病灶范围及对邻近组织器官的浸润程度,有助于临床早期诊断和分期,确诊仍需依靠病理和免疫组织化学。.
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  • 文章类型: Journal Article
    一只老年荷兰罗布兔子因急性跛行而出现。诊断为右股骨远端病理性骨折并伴有多形性横纹肌肉瘤,和分期X线片显示首次出现时没有明显的转移。截肢并提交显微镜检查。免疫组织化学评估显示,肿瘤细胞的结蛋白和MyoD1阳性,而细胞角蛋白AE1/AE3,CD204,IBA-1和SMA阴性。Gross,组织学,免疫组织化学评估证实了多形性横纹肌肉瘤的诊断。病人在截肢后396天死亡,尸检显示多器官转移性肉瘤.
    A geriatric Holland Lop rabbit presented for acute lameness. A pathologic fracture of the right distal femur associated with a pleomorphic rhabdomyosarcoma was diagnosed, and staging radiographs showed no overt metastasis upon initial presentation. The limb was amputated and submitted for microscopic examination. Immunohistochemical evaluation revealed the neoplastic cells were positive for desmin and MyoD1, and negative for cytokeratin AE1/AE3, CD204, IBA-1, and SMA. Gross, histologic, and immunohistochemical evaluation confirmed a diagnosis of pleomorphic rhabdomyosarcoma. The patient died 396 days after amputation, and a post-mortem examination showed metastatic sarcoma to multiple organs.
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  • 文章类型: Journal Article
    背景:成人头颈部横纹肌肉瘤(HNRMS)非常罕见,对病理学家来说仍然具有挑战性。
    方法:从摩洛哥拉巴特专科医院病理科(HSR)的档案中检索了5例成人HNRMS(≥19岁),超过5年。对苏木精和伊红载玻片的临床和病理发现以及Desmin和Myogenin的免疫组织化学进行了综述。
    中位年龄为33岁,以男性为主(3米/2华氏度)。组织学分析显示3例肺泡横纹肌肉瘤(RMS),一个多态RMS,和一个梭形细胞/硬化RMS。除了在每个RMS中观察到的典型组织学之外,我们发现了棘手的生长模式,这可能是误诊的原因。所有5例病例均显示Desmin和Myogenin的可变阳性。
    结论:HNRMS病例与小儿RMS病例具有不同的病理特征。我们确定了罕见的亚型,如多形性和梭形细胞/硬化RMS,表现出不寻常的形态模式。
    BACKGROUND: Adult Head and neck Rhabdomyosarcomas (HNRMS) are exceedingly rare and remain challenging for pathologists.
    METHODS: Five cases of adult HNRMS (≥19 years) were retrieved from the archives of the Department of Pathology of Hospital of Specialities in Rabat (HSR) in Morocco, over 5 years. Clinical and pathologic findings from hematoxylin and eosin slides and immunohistochemistry for Desmin and Myogenin were reviewed.
    UNASSIGNED: The median age was 33, with a men\'s predominance (3 M/2F). Histological analysis revealed three cases of Alveolar Rhabdomyosarcoma (RMS), one Pleomorphic RMS, and one spindle cell/sclerosing RMS. In addition to the typical histology observed in each RMS, we found tricky growth patterns that could be a source of misdiagnosis. All five cases demonstrated variable positivity for Desmin and Myogenin.
    CONCLUSIONS: HNRMS cases have different pathological features than pediatric RMS cases. We identified rare subtypes such as pleomorphic and spindle cell/sclerotic RMS, which exhibit unusual morphological patterns.
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  • 文章类型: Case Reports
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    由群体间横纹肌肉瘤(RMS)研究组和儿童肿瘤学组进行的临床试验对于建立RMS的诊断和治疗的现行标准至关重要。在理解RMS的生物学和临床行为方面的最新进展导致了更细致的诊断方法。风险分层,和治疗。这些进步带来的复杂性,再加上RMS的稀有性,对进行大规模的3期临床试验以评估RMS的新治疗策略构成挑战。鉴于这些挑战,RMS未来临床试验的系统规划对于解决有关药物治疗功效的相关问题至关重要。反应的生物标志物,治疗相关毒性,和患者的生活质量。在这里,作者概述了儿童肿瘤学小组软组织肉瘤委员会对下一代RMS临床试验的拟议战略方法,重点关注五个主题:改进的新剂识别和临床前到临床的翻译,更有效的试验开发和实施,在试验期间扩大了知识生成的机会,治疗毒性降低和生活质量,和病人的参与。
    Clinical trials conducted by the Intergroup Rhabdomyosarcoma (RMS) Study Group and the Children\'s Oncology Group have been pivotal to establishing current standards for diagnosis and therapy for RMS. Recent advancements in understanding the biology and clinical behavior of RMS have led to more nuanced approaches to diagnosis, risk stratification, and treatment. The complexities introduced by these advancements, coupled with the rarity of RMS, pose challenges to conducting large-scale phase 3 clinical trials to evaluate new treatment strategies for RMS. Given these challenges, systematic planning of future clinical trials in RMS is paramount to address pertinent questions regarding the therapeutic efficacy of drugs, biomarkers of response, treatment-related toxicity, and patient quality of life. Herein, the authors outline the proposed strategic approach of the Children\'s Oncology Group Soft Tissue Sarcoma Committee to the next generation of RMS clinical trials, focusing on five themes: improved novel agent identification and preclinical to clinical translation, more efficient trial development and implementation, expanded opportunities for knowledge generation during trials, therapeutic toxicity reduction and quality of life, and patient engagement.
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