In vitro interaction of various antibiotic combinations recommended by Chinese consensus statement against carbapenems-resistant Pseudomonas aeruginosa

Pseudomonas aeruginosa is related to nosocomial infections, and it tends to become resistant during or after antimicrobial treatment. The ability to develop carbapenems resistance makes it difficult to treat. P. aeruginosa infections are often associated with high mortality, morbidity and treatment costs. A group of Chinese experts drafted a consensus for treatment of extensively drug-resistant Gram-negative bacilli (XDR-GNB) including extensively drug-resistant P. aeruginosa (XDR-PA). In this study, we studied the antibacterial activities of different antibiotic combinations against six carbapenems-resistant P. aeruginosa (CRPA) strains in vitro, and the results indicated that the combination of ceftazidime with cefoperazone-sulbatam was the best combination with excellent synergistic rate (100%). Besides, some combinations exhibited better effects than using antibiotics alone, reducing the MICs of both drugs significantly, such as ceftazidime/piperacillin-tazobactam and ceftazidime/aztreonam etc. However, there are also some combinations that showed no additional or synergistic effects, suggesting that not all combinations recommended by the guideline have the same effect against resistant P. aeruginosa. Our study screened out some effective combinations against six CRPA strains which might help to prevent the spread of antibiotic resistance through improving antibiotic effectiveness. SIGNIFICANCE AND IMPACT OF THE STUDY: This study measured the synergistic interactions between various antibiotics in vitro recommended by Chinese consensus statement against carbapenems-resistant Pseudomonas aeruginosa. The results of this study provide valuable evidence that some combinations may be a promising option for clinical treatment.

The midgut V-ATPase subunit A gene is associated with toxicity to crystal 2Aa and crystal 1Ca-expressing transgenic rice in Chilo suppressalis

Insecticidal crystal (Cry) proteins produced by the bacterium Bacillus thuringiensis (Bt) are toxic to a diverse range of insects. Transgenic rice expressing Cry1A, Cry2A and Cry1C toxins have been developed that are lethal to Chilo suppressalis, a devastating insect pest of rice in China. Identifying the mechanisms underlying the interactions of Cry toxins with susceptible hosts will improve both our understanding of Cry protein toxicology and long-term efficacy of Bt crops. In this study, we tested the hypothesis that V-ATPase subunit A contributes to the action of Cry1Ab/1Ac, Cry2Aa and Cry1Ca toxins in C. suppressalis. The full-length V-ATPase subunit A transcript was initially cloned from the C. suppressalis larval midgut and then used to generate double-stranded RNA (dsRNA)-producing bacteria. Toxicity assays using transgenic rice lines TT51 (Cry1Ab and Cry1Ac fusion genes), T2A-1 (Cry2Aa), and T1C-19 (Cry1Ca) in conjunction with V-ATPase subunit A dsRNA-treated C. suppressalis larvae revealed significantly reduced larval susceptibility to T2A-1 and T1C-19 transgenic rice, but not to TT51 rice. These results suggest that the V-ATPase subunit A plays a crucial role in mediating Cry2Aa and Cry1Ca toxicity in C. suppressalis. These findings will have significant implications on the development of future resistance management tools.

[Analysis of the overweight and obesity effects on pulmonary function in OSA patients]

Objective:To investigate the overweight and obesity effects on pulmonary function in OSA patients.Method:Randomly selected 90 cases OSA patients who were treated January 2017 to December 2017. On the basis of BMI were divided into three groups, the normal OSA group(A,30 cases), overweight OSA group(B,30 cases) and obesity OSA group(C,30 cases). Comparative analysis between groups of age, AHI, lowest arterial saturation oxygen(LSaO₂), the longest apnea time(LAD) and pulmonary function indicators include: a second volume(FEV1),forced vital capacity(FVC), FEV1/FVC,the chase volume(MVV), per minute resting ventilation(MV), peak expiratory flow velocity(PEF),tidal volume(VT), the residual gas volume(RV), functional residual capacity(FRC) and expiratory reserve volume volume(ERV), total lung volume(TLC) vital capacity(VC), deep inspiratory capacity(IC), RV/TLC. Result:Compared group C with B and A, B and A, AHI increased significantly(P<0.01); compared group C with B and A, LSaO₂ significantly reduced(P<0.01); compared group C with A, LAD is prolonged(P<0.05).Compared group C with A, MVV, MV, TLC and IC increased significantly(P<0.05), FRC, ERV significantly reduced(P<0.05); compared C with B, MVV, MV and TLC increased significantly(P<0.05). Compared group B with A,MVV,MV,MEF75,ERV and IC increased significantly(P<0.05); AHI and VT,RV,TLC and FRC has significant positive correlation(P<0.05), and VT, MVV and FEV1/FVC has significant negative correlation(P<0.05);LAD with BMI,VC,FVC,FEV1,MEF50,PEF and MVV is a significant positive correlation(P<0.05).FEV1/FVC, IC is the independence of overweight and obesity OSA severe impact factor. Conclusion:With the increasing of BMI, not only increase the severity of OSA, and further damage to the pulmonary function; the OSA severity of overweight and obesity are closely associated with multiple pulmonary function index; FEV1% FVC, IC for overweight and obesity independent factor influencing the severity of OSA. Pulmonary function can be used as overweight and obesity auxiliary to assess the severity of OSA patients.

Socioeconomic burden of severe fever with thrombocytopenia syndrome in endemic areas of Anhui Province, eastern China

Understanding the socioeconomic burden of severe fever with thrombocytopenia syndrome (SFTS) is important for making decisions on health resources allocation. This study aimed to assess the economic burden of patients with this syndrome in endemic areas of the Anhui Province in 2018. A total of 114 patients were recruited, and the median age was 63.5 years, 62 (54.4%) were female, 97 (85.1%) were farmers, 108 (94.7%) were survival patients, and 71 (62.3%) had a family monthly income less than $453.3. The median times of hospital visits and hospitalizations of patients were three times, and the median lost work days of these patients, caregivers and visitors were 14.5 days, 14.5 days and 7.5 days, respectively. The median direct costs of the patient were $3,761.6, and the median indirect costs were $508.3. Taking direct and indirect costs into consideration, the median total economic costs of patients were $4,323.9, and the total annual cost of 2018 was $1,396,913.6. Although 113 (99.1%) patients had medical insurance, only 25.8% of costs were covered by reimbursement, and the total cost paid for by the patients and their families was $1,041,073.6 in 2018. Our findings revealed that the patients and their families had a significant economic burden, and preventive measures should be strengthened in endemic areas. The findings also provided baseline data for assessing the cost-effectiveness of the vaccines or anti-viral drugs in the near future in China.

[Influence of directed restrictive fluid management strategy on patients with serious burns complicated by severe inhalation injury]

Objective: To explore the influence of directed restrictive fluid management strategy (RFMS) on patients with serious burns complicated by severe inhalation injury. Methods: Sixteen patients with serious burns complicated by severe inhalation injury hospitalized in our department from December 2014 to December 2017, meeting the inclusion criteria and treated with RFMS, were enrolled in directed treatment group. Thirty-four patients with serious burns complicated by severe inhalation injury hospitalized in our department from December 2012 to December 2017, meeting the inclusion criteria and without RFMS, were enrolled in routine treatment group. Medical records of patients in 2 groups were retrospectively analyzed. Within post injury day 2, mean arterial pressure (MAP), central venous pressure (CVP), extravascular lung water index (ELWI), global end-diastolic volume index, and pulmonary vascular permeability index of patients in directed treatment group were monitored by pulse contour cardiac output monitoring technology, while MAP and CVP of patients in routine treatment group were monitored by routine method. On post injury day 3 to 7, patients in 2 groups were treated with routine fluid supplement therapy of our Department to maintain hemodynamic stability, and patients in directed treatment group were treated according to RFMS directed with goal of ELWI≤7 mL·kg(-1)·m(-2). On post injury day 3 to 7, total fluid intake, total fluid output, and total fluid difference between fluid intake and output within 24 h, value of blood lactic acid, and oxygenation index of patients in 2 groups were recorded. Occurrence of acute respiratory distress syndrome (ARDS) on post injury day 3 to 7 and 8 to 28, mechanical ventilation time within post injury day 28, and occurrence of death of patients in 2 groups were counted. Data were processed with chi-square test, t test, and analysis of variance for repeated measurement. Results: The total fluid intakes within 24 h of patients in directed treatment group were close to those in routine treatment group on post injury day 3, 4, 5, 6, 7 (t=-0.835, -1.618, -2.463, -1.244, -2.552, P>0.05). The total fluid outputs and total fluid differences between fluid intake and output within 24 h of patients in 2 groups on post injury day 3 were close (t=0.931, -2.274, P>0.05). The total fluid outputs within 24 h of patients in directed treatment group were significantly higher than those in routine treatment group on post injury day 4, 5, 6, 7 (t=2.645, 2.352, 1.847, 1.152, P<0.05). The total fluid differences between fluid intake and output within 24 h of patients in directed treatment group were (2 928±768), (2 028±1 001), (2 186±815), and (2 071±963) mL, significantly lower than (4 455±960), (3 434±819), (3 233±1 022), and (3 453±829) mL in routine treatment group (t=-4.331, -3.882, -3.211, -4.024, P<0.05). The values of blood lactic acid of patients in directed treatment group and routine treatment group on post injury day 3, 4, 5, 6, 7 were close (t=0.847, 1.221, 0.994, 1.873, 1.948, P>0.05). The oxygenation indexes of patients in directed treatment group on post injury day 3 and 4 were (298±78) and (324±85) mmHg (1 mmHg=0.133 kPa ), which were close to (270±110) and (291±90) mmHg in routine treatment group (t=-1.574, 2.011, P>0.05). The oxygenation indexes of patients in directed treatment group on post injury day 5, 6, 7 were (372±88), (369±65), and (377±39) mmHg, significantly higher than (302±103), (313±89), and (336±78) mmHg in routine treatment group (t=3.657, 3.223, 2.441, P<0.05). On post injury day 3, 4, 5, 6, 7, patients with ARDS in directed treatment group were less than those in routine treatment group, but with no significantly statistical difference between the 2 groups (χ(2)=0.105, P>0.05). On post injury day 8 to 28, patients with ARDS in directed treatment group were significantly less than those in routine treatment group (χ(2)=0.827, P<0.05). The mechanical ventilation time within post injury day 28 of patients in directed treatment group was apparently shorter than that in routine treatment group (t=-2.895, P<0.05). Death of patients in directed treatment group within post injury day 28 was less than that in routine treatment group, but with no significantly statistical difference between the 2 groups (χ(2)=0.002, P>0.05). Conclusions: Under the circumstance of hemodynamics stability, RFMS directed with goal of ELWI≤7 mL·kg(-1)·m(-2) on post injury day 3 to 7 is an useful strategy, which can reduce occurrence rate of ADRS and shorten mechanical ventilation time of patients with serious burns complicated by severe inhalation injury at late stage of burns.

Effects of ambient temperature on bacillary dysentery: A multi-city analysis in Anhui Province, China

BACKGROUND

Rising ambient temperature is expected to increase incidence of bacillary dysentery (BD), but few studies have compared the temperature-BD effects of different age groups and cities in China, especially in a multi-city setting.

OBJECTIVES

We used city-specific data including BD cases and meteorological variables to determine the relationship between BD incidence and temperature at provincial level.

METHODS

Weekly BD disease surveillance data and meteorological variables were collected in all 16 prefecture-level cities in Anhui Province of China. Firstly, city-specific weekly mean temperature-BD incidence associations were estimated with Distributed Lag Nonlinear Model (DLNM). Secondly, city-specific estimates were pooled at province-level through multivariate meta-analysis. Also, we conducted subgroup analyses for ages (children <5 years old and population of other ages) and urbanization of cities (high and low level), respectively.

RESULTS

In Anhui, BD morbidity risk increased with increasing weekly mean temperature. Relative risks (RR) at the 90th percentile (27.5 °C) versus the 50th percentile (17 °C) of weekly mean temperature were 1.42 (95% confidence interval (CI): 1.16, 1.75) and 2.02 (95% CI: 1.76, 2.32) for children <5 and population of other ages, respectively. The relative risk of high temperature on other ages group was higher than that of children under five years old (p = 0.006). Children under 5 in high urbanized cities appeared to be more vulnerable to the effects of ambient high temperature (RR: 1.56, 95% CI: 1.20, 1.92) than in low urbanized cities (RR: 1.01, 95% CI: 0.70, 1.46), the difference between two intervals was statistically significant (p = 0.044).

CONCLUSIONS

This study suggests that high temperatures may be an important trigger of BD incidence, and especially lead to a substantial burden of BD for high urbanized cities in Anhui Province of China.

Oxymatrine therapy inhibited epidermal cell proliferation and apoptosis in severe plaque psoriasis

Background

Psoriasis is a chronic skin disorder that manifests as epidermal keratinocyte hyperplasia.

Objectives

We examined the effect of oxymatrine treatment on cell proliferation and apoptosis in skin lesions of psoriasis.

Patients and methods

Patients with severe plaque psoriasis were treated with oxymatrine or with acitretin. The skin lesions were stained with proliferating cell nuclear antigen (PCNA), Ki‐67 and Bcl‐2, as well as examined by terminal deoxynucleotidyl transferase‐mediated dUTP nick‐end labelling (TUNEL). We performed correlations of the Psoriasis Area and Severity Index (PASI) and the proliferation and apoptosis index.

Results

Oxymatrine significantly reduced the psoriasis lesions as demonstrated by the reduced PASI score after treatment [6·91; 95% confidence interval (CI) 5·00–8·81, P < 0·001]. In the oxymatrine group, the mitotic index was 26·15 (95% CI 24·80–27·49) before oxymatrine treatment, decreasing to 14·52 (95% CI 13·82–15·25; P < 0·001) after treatment, but remained higher than the normal group (6·24; 95% CI 5·87–6·61, P < 0·001). Oxymatrine also inhibited the proliferation of epidermal cells in the skin lesion as indicated by the reduced proliferation index after treatment (P < 0·01). In addition, oxymatrine treatment reduced cellular apoptosis as shown by increased Bcl‐2 expression and a decrease in TUNEL‐positive cells. The PASI score was positively correlated with mitotic index, proliferation index and apoptotic index (TUNEL), but negatively correlated with Bcl‐2 expression.

Conclusions

Oxymatrine treatment reduced proliferation but inhibited apoptosis of cells in the skin lesion. The balance between cell proliferation and turnover may contribute to the significant alleviation of psoriasis by oxymatrine.

What's already known about this topic?

Psoriasis manifests as epidermal keratinocyte hyperplasia with proliferation, keratinocyte maturation and turnover rates.

Current drugs for psoriasis may inhibit cell proliferation but could not adjust the balance of cell division, differentiation and apoptosis.

What does this study add?

We studied the efficacy of oxymatrine in the treatment of psoriasis and analysed the correlation of skin lesions, proliferation and apoptosis index before and after oxymatrine treatment.

What is the translational message?

Our study has demonstrated that oxymatrine is effective in the treatment of severe plaque psoriasis.

It has comparable efficacy with acitretin.

Because acitretin treatment was sometimes associated with metabolic abnormalities, our study suggests oxymatrine therapy as an alternative treatment for psoriasis in the context of acitretin allergy or adverse reactions.

https://www.bjdonline.com/article/oxymatrine-therapy-inhibited-epidermal-cell-proliferation-and-apoptosis-in-severe-plaque-psoriasis/

Linked Comment: https://doi.org/10.1111/bjd.18299.

Differences of the immune cell landscape between normal and tumor tissue in human prostate

BACKGROUND

Over the past few decades, immunological checkpoint therapy has been an increasingly prominent strategy in the treatment of tumors, including prostate cancer (PC). There are few systematic studies of the phenotypic of tumor-infiltrating immune cells in PC tissues.

METHODS

CIBERSORT is an analytical tool for estimating the abundance of member cell types in mixed cell population by gene expression data. Herein, we analyzed different levels of tumor-infiltrating immunity cells in normal tissue compared with PC using CIBERSORT.

RESULTS

The results showed that proportion of M1 macrophages and resting mast cells presented significant differences in prostate tumor than these normal tissues. A higher proportion of resting mast cells was associated with a worse outcome and M1 macrophages was associated with a favorable outcome. Moreover, the radiotherapy and targeted molecular therapy can affect the immune infiltration of M1 macrophages and resting mast cells.

CONCLUSIONS

Resting mast cells and M1 macrophages has an important role in the prognosis of prostate cancer. Our data provides valuable information about the future treatment of PC.

Abstract P6-20-03: Tumor epichaperome expression using 124I PU-H71 PET (PU-PET) as a biomarker of response for PU-H71 plus nab-paclitaxel in HER2 negative (HER2-) metastatic breast cancer (MBC)

Background: The epichaperome is a new cancer target required for tumor survival (Joshi et al. Nature Reviews Cancer 2018). PU-H71 is a synthetic, purine scaffold epichaperome inhibitor that binds to the ATP-binding site of HSP90 specifically when HSP90 is integrated into the epichaperome (Rodina et al. Nature 2016). It has demonstrated antitumor activity in multiple xenograft models. Furthermore, sequential administration of nab-paclitaxel and PU-H71 in TNBC xenograft models augmented epichaperome levels, and in turn resulted in super-synergistic drug action with ablation of xenografted tumors and cures in mice.

Methods: This is an open label phase1b study of PU-H71 + nab-paclitaxel in pts with HER2- MBC. Pts received nab-paclitaxel at a standard dose of 260mg/m2 IV Q 3weeks. PU-H71 was administered IV 6 hrs (+/-1 hr) post nab-paclitaxel Q3weeks in 2 escalating dose levels (225mg/m2 and 300 mg/m2). All pts underwent FDG PET/CT every 6 weeks. Additionally, patients had the option to enroll on a separate diagnostic PU-PET protocol to measure epichaperome expression prior to initiating treatment on the phase 1b study, wherein they received a single dose of up to 11mci of 124I-PU-H71 IV and underwent imaging at 3-4hrs and 20-24 hrs. Primary objective was to establish the MTD/RP2D of this regimen. Secondary objectives were to assess PK of PU-H71 + nab-paclitaxel and clinical efficacy. Exploratory analysis included correlation of epichaperome expression at baseline using PU-PET with tumor response.

Results: 12 patients (5 ER+/HER2- ; 7 TNBC) were enrolled (6 at 225mg/m2 of PU-H71 and 6 at 300mg/m2). Median Age: 54 yrs (range: 37-71). Median ECOG: 0. Median lines of therapy in the metastatic setting: 6 (range 1-11) including prior taxanes in 75% of pts. Most common toxicities included diarrhea G1 58%; G2 7%, G3 7%) that was easily managed with anti-diarrheal agents, G1 fatigue (25%), G1/2 peripheral neuropathy (17%), G1 hyperglycemia (67%), G1 increases in alk phos (58%), AST (50%) and ALT (42%). Hematological toxicities included G3 leukopenia (42%), G3/4 neutropenia (67%), G3 anemia (50%) and G2 thrombocytopenia (17%). There were no DLTs. 33% (4/12) had PR, 58% (7/12) achieved SD with only 1 PD at the time of first scan; 5 pts are currently ongoing including 2 TNBC pts with PR who have been on therapy &gt; 7 months. PK data will be presented. 8/12 patients also underwent PU-PET at baseline. A higher tumor to muscle SUV ratio at 24 hrs on PU-PET predicted response and increased PU-H71 retention on PU-PET at 24 hrs correlated with a longer duration of response.

Conclusion: The RP2D of PU-H71 was 300mg/m2 with 260mg/m2 of nab-paclitaxel administered IV every 3 weeks. The regimen is well tolerated with promising clinical activity in this heavily pre-treated cohort. Tumor epichaperome expression at baseline using PU-PET has the potential to serve as a predictive biomarker of response. A Phase 2 trial of this combination along with baseline PU-PET is currently planned.

Citation Format: Jhaveri K, Dunphy M, Wang R, Comen E, Fornier M, Moynahan ME, Bromberg J, Ma W, Patil S, Taldone T, Rodina A, Sterlin V, Khoshi S, Lewis J, Norton L, Chiosis G, Modi S. Tumor epichaperome expression using 124I PU-H71 PET (PU-PET) as a biomarker of response for PU-H71 plus nab-paclitaxel in HER2 negative (HER2-) metastatic breast cancer (MBC) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-20-03.

A diaphragm-free fiber Fabry-Perot gas pressure sensor

A diaphragm-free fiber gas pressure sensor based on the extrinsic Fabry-Perot interferometer (EFPI) is proposed and experimentally demonstrated. The sensor is fabricated by fusion splicing a sandwich structure of a single mode fiber, a hollow core fiber (HCF), and a coreless fiber. A femtosecond (fs) laser is employed to drill a micro-channel on the side wall of the HCF to allow gas entering/exiting the HCF. The refractive index of the gas has a linear relationship with the gas pressure. Thus, the gas pressure can be detected by investigating the optical path difference of the EFPI. The experimental results show that the proposed sensor exhibits a high gas pressure sensitivity of ∼1.80 µm/MPa from vacuum to 10 MPa at room temperature. Pressure responses under high temperatures are also investigated. The proposed sensor has properties of robust structure, miniature size, large measuring range, and high sensitivity.

[Short-term impact of temperature on infectious diarrhea in southeast coastal area of China, 2005-2013]

To investigate the short-term impact of temperature on infectious diarrhea in southeast coastal area of China from 2005 to 2013. Two-stage analysis was used to deal with the data of infectious diarrhea from 41 cities in Zhejiang, Fujian and Guangdong Province. Compared with the P(50) temperature, the risk of infectious diarrhea within lag 0-3 d increased when the temperature was between P(22.8) and P(40.4) or higher than P(51.6). The RR value was highest (1.17, 95%CI: 1.11-1.23) when the temperature is at P(90.1). High temperature could increase the risk of infectious diarrhea in southeast coastal area of China.

Preparation and evaluation of a green solvent-based molecularly imprinted monolithic column for the recognition of proteins by high-performance liquid chromatography

A protein-based molecularly imprinted monolithic column was synthesized based on ionic liquids (ILs) and deep eutectic solvents (DESs) in a stainless steel column (50 mm × 4.6 mm id).

Up-regulation of miR-340-5p promotes progression of thyroid cancer by inhibiting BMP4

PURPOSE

The incidence of thyroid cancer is increasing and the proliferation of thyroid cancer cells is incompletely understood. microRNAs may play key roles in thyroid cancer progression.

METHODS

We analyzed miR-340-5p in thyroid cancer tissue and normal tissue, and using informatics to predict its target. Cell lines and a mouse model were used to study the role of miR-340-5p in cancer proliferation.

RESULTS

Overexpression of miR-340-5p was found in thyroid cancer specimens. Tumors with higher pathological grade had higher levels of miR-340-5p. Overexpression of miR-340-5p significantly enhanced cell viability and colony formation. Treatment of anti-miR-340-5p, however, showed opposite alterations. We predicted that bone morphogenetic protein 4 (BMP4) is a possible target, and found a negative correlation between miR-340-5p and BMP4 levels in thyroid cancer tissue. miR-340-5p reduced BMP4 expression. BMP4 overexpression attenuated the effects of miR-340-5p in cell viability and colony formation. In addition, using a xenograft mouse model we proved that anti-miR-340-5p was able to inhibit tumor growth.

CONCLUSIONS

miR-340-5p promotes thyroid cancer proliferation by inhibiting BMP4. Anti-miR-340-5p can be a promising strategy to control thyroid cancer.

Epithelial membrane protein 2: a novel biomarker for circulating tumor cell recovery in breast cancer

PURPOSE

EpCAM is a common marker used in the detection of circulating tumor cells (CTC). Disseminated cancer cells display the characteristics of epithelial-to-mesenchymal transition events. The purpose of this study was to assess the potential of epithelial membrane protein 2 (EMP2) as a novel biomarker for CTC retrieval in breast cancer.

METHODS

MCF7 and MDA-MB-231 cells were stained with either anti-EpCAM or anti-EMP2 mAbs, respectively, followed by flow cytometric assay to measure their expression levels. PBMCs isolated from healthy donors were used for breast cancer cell spiking. CD45-depleted PBMCs from breast cancer patients' blood were used for CTC capturing. Immunomagnetic separation was used to enrich breast cancer cells. Cytospin centrifugation was performed to concentrate the captured cells, followed by immunofluorescence staining with anti-CD45 mAb, anti-pan cytokeratin mAb and DAPI. Fluorescent images were taken using a confocal microscope for CTC counts.

RESULT

MDA-MB-231 cells had 2.56 times higher EMP2 expression than MCF7 cells, and EMP2 had a significantly higher capture efficiency than EpCAM for MCF7 cells. Furthermore, anti-EMP2 was capable of capturing MCF7 cells that escaped in the flow-through of anti-EpCAM. Likewise, EMP2 had a significantly higher capture efficiency on MDA-MB-231 cells when compared to MCF7 cells. Most importantly, EMP2 biomarker was successfully used for CTC capture in patients with primary breast cancer.

CONCLUSIONS

EMP2 is superior to EpCAM for capturing both MCF7 and MDA-MB-231 cells. Additionally, EMP2 is a novel biomarker and capable of capturing breast cancer cells in patient blood samples.

[The influence of Thymidine Phosphorylase genetic variation on clinical outcomes and safety of colorectal cancer patients received adjuvant chemotherapy after R0 resection]

Objective: To study the association between Thymidine Phosphorylase (TYMP) genetic variation and clinical outcomes and safety of postoperative colorectal cancer (CRC) patients. Methods: A total of 235 patients with colorectal cancer underwent surgical treatment were included in this retrospective analysis. Peripheral blood and the postoperative tissue specimen of the CRC patients were collected for the genotyping of polymorphism and TYMP mRNA expression, respectively. The correlation between polymorphism and clinical outcomes and safety of postoperative CRC patients were analysed. Results: Located in the upstream, 5633C>T was of clinical significance. The prevalence of 5633C>T in TYMP among the CRC patients were as follows: CC genotype 149 cases (63.40%), CT genotype 73 cases (31.06%), TT genotype 13 cases (5.54%), minor allele frequency of 5633C>T is 0.21. The distribution of three genotypes was in accordance with Hardy-Weinberg Equilibrium (P=0.313). CT genotype and TT genotype patients were merged in the comparison of prognosis. The survival analysis of patients with different genotypes found that the median Overall Survival (OS) of CT/TT genotype and CC genotype were 5.8 and 4.5 year, which was statistically significant (P=0.009). Adjusted in multivariate Cox regression analysis, CT/TT genotype was an independent favorable factor for OS (HR=0.67, P=0.015). Additionally, of the 87 postoperative tissue specimens, the results showed that the expression of TYMP in cancer tissues of the patients with CT or TT genotypes were significantly higher than those of the wild type CC genotype patients (P=0.019). And the safety analysis showed that the incidence of grade 3 hand-foot syndrome among CT/TT genotype patients were higher than that of CC genotype patients (33.72% vs 20.13%, OR=1.68, P=0.021). Conclusion: The polymorphism 5633C>T of TYMP may impact the prognosis of CRC patients received adjuvant chemotherapy by influencing the mRNA expression of TYMP.

Breast cancer Ki67 expression prediction by DCE-MRI radiomics features

AIM

To investigate whether quantitative radiomics features extracted from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) are associated with Ki67 expression of breast cancer.

MATERIALS AND METHODS

This institutional review board-approved retrospective study comprised 377 Chinese women who were diagnosed with invasive breast cancer in 2015. This cohort included 53 low-Ki67 expression (Ki67 proliferation index less than 14%) and 324 cases with high-Ki67 expression (Ki67 proliferation index more than 14%). A binary-classification of low-versus high- Ki67 expression was performed. A set of 56 quantitative radiomics features, including morphological, greyscale statistic, and texture features, were extracted from the segmented lesion area. Three machine learning classification methods, including naive Bayes, k-nearest neighbour and support vector machine, were employed for the classification and the least absolute shrink age and selection operator (LASSO) method was used to select most predictive features set for the classifiers. Classification performance was evaluated by the area under receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity.

RESULES

The model that used naive Bayes classification method achieved the best performance than the other two methods, yielding 0.773 AUC, 0.757 accuracy, 0.777 sensitivity and 0.769 specificity. Three most predictive features, i.e., contrast, entropy and line likeness, were selected by the LASSO method and showed a statistical significance (p<0.05) in the classification.

CONCLUSION

The present study showed that quantitative radiomics imaging features of breast tumour extracted from DCE-MRI are associated with breast cancer Ki67 expression. Future larger studies are needed in order to further evaluate the findings.