PET for diagnosis and therapy of brain tumors

Main contribution of PET in the management of brain tumors is at the therapeutic level. Specific reasons explain this role of molecular imaging in the therapeutic management of brain tumors, especially gliomas. Gliomas are by nature infiltrating neoplasms and the interface between tumor and normal brain tissue may not be accurately defined on CT and MRI. Also, gliomas are often histologically heterogeneous with anaplastic areas evolving within a low-grade tumor, and the contrast-enhancement on CT or MRI does not represent a good marker for anaplastic tissue detection. Finally, assessment of tumor residue, recurrence or progression may be altered by different signals related to inflammation or adjuvant therapies, even on contrast-enhanced CT and MRI. These limitations of the conventional neuroimaging in delineating tumor and detecting anaplastic tissue lead to potential inaccuracy in lesion targeting at different steps of the management (diagnostic, surgical, and post-therapeutic stages). Molecular information provided by PET has proved helpful to supplement morphological imaging data in this context. ¹⁸F-FDG (FDG) and amino-acid tracers such as ¹¹C-methionine (MET), provides complementary metabolic data that are independent from the anatomical MR information. These tracers help in the definition of glioma extension, in the detection of anaplastic areas and in the postoperative follow-up. Additionally, PET data have an independent prognostic value. To take advantage of PET data in glioma treatment, PET might be integrated in the planning of image-guided biopsies, radiosurgery and resection.     

食管癌Egr-1基因表达及其与细胞凋亡的关系

目的：研究早期生长反应基因-1（Egr-1基因）和Bcl-X1蛋白在人食管癌变过程中的表达及与细胞凋亡的关系。方法：应用原位杂交、免疫组织化学和TUNEL法检测66例食管鳞状细胞癌及癌旁粘膜、上切缘粘膜中Egr-1mRNA和蛋白、凋亡相关蛋白Bcl-X1和原位细胞凋亡。结果：食管上皮和食管癌细胞Egr-1基因原位杂交、Bcl-X1.蛋白免疫组化阳性物定位于细胞浆,Egr-1蛋白免疫组化阳性产物、TUNEL法阳性信号定位于细胞核。在食管癌变过程中,细胞凋亡发生率和凋亡指数逐渐升高;Egr-1mRNA及蛋白在食管粘膜上皮非典型增生中呈高表达。在癌组织,Egr-1阳性表达时凋亡指数显著高于其阴性表达;而Bcl-X1.阳性表达时凋亡指数显著低于其阴性表达。结论：细胞凋亡发生在食管癌变的全过程。Egr-1mRNA和蛋白在食管癌前病变呈高表达;Egr-1阳性鳞癌的凋亡指数显著升高;Egr-1有促进凋亡的作用。Egr-1的表达和细胞凋亡在食管癌变过程中可能有重要生物学意义。     

Focus: Rare Disease: Sinonasal Glomangiopericytoma: Review of Imaging Appearance and Clinical Management Update for a Rare Sinonasal Neoplasm

Introduction: Glomangiopericytoma (GPC) is a rare tumor in the nasal cavity or paranasal sinuses with low malignant potential. Initially deemed a hemangiopericytoma, in 2005 it was classified as a distinct entity by the World Health Organization (WHO). Case Presentation: A male patient in his early 60s presented with new-onset right arm and leg weakness/numbness, who was incidentally found to have a left ethmoid sinus mass with extension in the olfactory fossa. On CT and MRI, the mass enhanced with well-defined borders and eroded the bone, but without dural enhancement. The mass was surgically excised, and pathology confirmed the diagnosis of glomangiopericytoma by microscopic appearance and staining. Discussion: Glomangiopericytoma has less than 0.5% incidence of all neoplasms of the sinonasal cavity, making it rare. Most diagnosed patients are in their 6th or 7th decade of age, with a slight female predominance. Treatment is complete surgical excision, with excellent prognosis, although there is up to 17% local recurrence. Despite the non-specific appearance on CT and MRI, imaging can help provide differential diagnosis, tumor extent, size, and reassuring non-aggressive characteristics of the tumor prior to surgery. GPC tumors are relatively resistant to radiation and chemotherapy. Conclusion: It is important to recognize glomangiopericytoma in the differential of masses of the nasal cavities or paranasal sinuses, as they rarely warrant aggressive treatment beyond local excision. Each reported case of glomangiopericytoma helps to build guidance for imaging and treatment since GPC is rare and not well-represented in the medical literature.     

Can abundant colloid exclude oncocytic (Hürthle cell) carcinoma in thyroid fine needle aspiration? Cytohistological correlation of 127 oncocytic (Hürthle cell) lesions

Objective:  The objective of the present study was to find out whether the presence or absence of certain cytological features can exclude oncocytic (Hürthle cell) carcinoma in thyroid fine needle aspiration (FNA) to minimize unnecessary surgery. Methods:  Over a 17‐year period, 127 hypercellular, oncocyte‐exclusive, lymphocyte‐absent aspirates obtained via ultrasound‐guided FNA with on‐site assessment had histology slides for review. The presence or absence of six cytological features (microfollicular arrangement, discohesive single cells, small cell dysplasia, large cell dysplasia, transgressing blood vessels and colloid) and one histological feature (macrofollicular component) were determined for each case independently by two cytopathologists. Results:  Histology showed 12 (9.4%) cases of Hashimoto thyroiditis, 23 (18.1%) oncocytic adenomatoid nodules in nodular goitre, 66 (52.0%) oncocytic adenomas and 26 (20.5%) oncocytic carcinomas (13 minimally invasive without angioinvasion, six minimally invasive with angioinvasion, seven widely invasive). Histologically, a macrofollicular component was present in seven of 26 (26.9%) oncocytic carcinomas, including one case with abundant thin colloid. A microfollicular arrangement, discohesive single cells, small cell dysplasia, large cell dysplasia and transgressing vessels were present in oncocytic carcinoma, oncocytic adenoma and oncocytic adenomatoid nodules in nodular goitre. Conclusions:  A macrofollicular component is frequently present in oncocytic carcinoma, oncocytic adenoma and oncocytic adenomatoid nodules in nodular goitre. None of the cytological features studied, including abundant colloid, can exclude oncocytic carcinoma. Oncocytic carcinoma can only be excluded by thorough histological examination of thyroidectomy specimens. A molecular marker is needed to triage oncocytic lesions in thyroid FNA.     

Gynaecological cancers and their cell lines

Cell lines are widely used for various research purposes including cancer and drug research. Recently, there have been studies that pointed to discrepancies in the literature and usage of cell lines. That is why we have prepared a comprehensive overview of the most common gynaecological cancer cell lines, their literature, a list of currently available cell lines, and new findings compared with the original studies. A literature review was conducted via MEDLINE, PubMed and ScienceDirect for reviews in the last 5 years to identify research and other studies related to gynaecological cancer cell lines. We present an overview of the current literature with reference to the original studies and pointed to certain inconsistencies in the literature. The adherence to culturing rulesets and the international guidelines helps in minimizing replication failure between institutions. Evidence from the latest research suggests that despite certain drawbacks, variations of cancer cell lines can also be useful in regard to a more diverse genomic landscape.     

When plant teratomas turn into cancers in the absence of pathogens

Habituated calli have long been classified as neoplasms together with tumors from different origins. The general opinion is that habituation is a reversible process with an epigenetic basis. This is probably true in most cases examined. However, we show here that there might be several degrees of habituation, which can be considered as steps of a neoplastic progression leading to cancerisation in the absence of an introduced oncogenic pathogen. Cell rejuvenation, loss of the capacity to organize meristematic centers, and loss of totipotency are proposed to define plant cancer through this neoplastic progression of a callus.
Habituated tissues share many morphological and biochemical similarities with so-called vitreous shoots from micropropagation. Vitrification and hyperhydric malformations of shoots raised in vitro may be considered as steps of another neoplastic progression, which leads to cancerisation also in the absence of introduced oncogenic pathogens. In this case death of the whole organism occurs either through direct apex necrosis or indirectly, from the loss of the capacity for the primary meristems to function normally, which gives rise to completely anarchic structures. As in the animal kingdom, carcinogenesis in plants is the final result of a multistep process involving the irreversible conversion of a stem cell to a terminal-differentiation-resistant cell.     

Relationship between levels of Skp2 and P27 in breast carcinomas and possible role of Skp2 as targeted therapy

Estrogen receptor-negative breast carcinomas are more aggressive and are unresponsive to anti-estrogens. Thus, they clearly require new therapies targeted against specific genes and proteins actively engaged in the pathophysiology of cancer. The S-phase kinase-associated protein Skp2 is required for the ubiquitin-mediated degradation of the cdk-inhibitor p27 and is a bona fide proto-oncoprotein. We attempted to explore whether Skp2 may be a potential specific therapeutic target in the subset of aggressive breast carcinomas by investigating the possible relationship between expression of Skp2 and p27 proteins and estrogen receptor (ER). Immunohistochemical analysis of tumor tissues was employed to determine the expression of Skp2, p27, and ER proteins in 82 cases of primary breast carcinoma. Higher levels of Skp2 were detected more frequently in ER-negative tumors and tumors metastatic to the axillary lymph nodes. The expression of p27 was inverse with the histologic grade. Statistical analysis showed that the percentage of high Skp2 expressors was significantly greater in the group with low p27 expression than in the group with high p27 expression. The current study, together with the results from a previous study, demonstrated the existence of a subtype of high-grade, negative ER breast carcinomas with high Skp2 and low p27 levels. This implies that Skp2 may be a potential specific therapeutic target in a subset of aggressive breast carcinomas. Thus far, there is no specific therapy for the ER-negative and HER-2/neu resistant groups, which are among the subset of aggressive tumors.     

肿瘤旋磁治疗机的基本原理与临床初步应用

ZCX-Ⅱ型旋磁治疗机由上下两对磁头组成,下磁头由电动马达驱动,而上磁头则是在下磁头耦合力的作用下而发生同步旋转,以达到人体组织纤维与磁力线发生相对运动,从而产生磁生物学效应的目的,属国际首创。随机选择的32例临床放弃治疗的晚期恶性肿瘤患者,使用ZCX-Ⅱ型肿瘤旋磁治疗机,采用不同的治疗参数进行治疗。结果观察,症状完全缓解率达28.1%,部分缓解率达65.6%,总有效率为93.8%1,年生存率为28.1%。治疗后所有患者的临床症状和体征均可得到不同程度的改善和缓解,且无任何严重地毒副作用。文中介绍了该设备的基本原理、使用方法和临床疗效,并对其临床相关问题进行简要讨论。     

[F]Fluorodeoxyglucose positron emission tomography in advanced thyroid cancer

In recent years, [¹⁸F]Fluorodéoxyglucose-PET imaging has emerged as an important oncological imaging modality. In metastatic thyroid carcinoma (M1), [¹⁸F]FDG-PET has been shown to have a high sensitivity in non iodine-avid metastases and/or dedifferentiated tumours and may therefore provide real-time prognostic information. The use of [¹⁸F]FDG-PET is more controversial in M0 patients with low residual serum Tg values but is very sensitive in aggressive histotypes such as tall cell variants of papillary thyroid carcinomas.