1
|
Groszman L, Hubermann JA, Kooner P, Alamiri N, Bozzo A, Aoude A. The Impact of Adjunct Medical Therapy on Survival after Spine Metastasis: A Systematic Review and Pooled Data Analysis. Cancers (Basel) 2024; 16:1425. [PMID: 38611103 PMCID: PMC11011004 DOI: 10.3390/cancers16071425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 03/30/2024] [Accepted: 03/31/2024] [Indexed: 04/14/2024] Open
Abstract
Targeted therapy has greatly improved the outlook for patients with spinal metastatic cancers. Scoring systems like the Tokuhashi or Tomita scores are commonly used to predict prognosis and inform surgical decisions, but they are outdated and fail to consider recent advancements. We aimed to investigate the current state of the literature and treatment options pertaining to advancements in targeted therapy compared to other forms of medical management for metastatic spinal tumors. This study represents the first comprehensive systematic review that encompasses the most common primary cancers that metastasize to the spine and evaluates the median overall survival (mOS) across five different medical treatment modalities as well as surgical intervention. Additionally, our study analyzes the tumor receptor status in conjunction with these treatments. A PubMed search was conducted, and according to the PRISMA guidelines, 28 articles out of 1834 met the inclusion criteria. The pooled data analysis highlighted the superior efficacy of targeted therapy, evidenced by a significant improvement in the mOS and lower hazard ratios in patients with lung and breast cancers who received targeted therapy compared to those who did not. Our study provides valuable insights into the recent advancements in the medical management of metastatic spinal tumors. Future indications include incorporating this literature into personalized treatment approaches for metastatic spinal tumors.
Collapse
Affiliation(s)
| | | | | | | | | | - Ahmed Aoude
- Department of Orthopaedic Surgery, McGill University Health Centre, Montreal, QC H4A 3J1, Canada; (L.G.); (J.A.H.); (N.A.)
| |
Collapse
|
2
|
Van den Broeck J, Sealy MJ, Brussaard C, Kooijman J, Jager-Wittenaar H, Scafoglieri A. The correlation of muscle quantity and quality between all vertebra levels and level L3, measured with CT: An exploratory study. Front Nutr 2023; 10:1148809. [PMID: 36908909 PMCID: PMC9996002 DOI: 10.3389/fnut.2023.1148809] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/10/2023] [Indexed: 02/25/2023] Open
Abstract
Introduction In patients with cancer, low muscle mass has been associated with a higher risk of fatigue, poorer treatment outcomes, and mortality. To determine body composition with computed tomography (CT), measuring the muscle quantity at the level of lumbar 3 (L3) is suggested. However, in patients with cancer, CT imaging of the L3 level is not always available. Thus far, little is known about the extent to which other vertebra levels could be useful for measuring muscle status. In this study, we aimed to assess the correlation of the muscle quantity and quality between any vertebra level and L3 level in patients with various tumor localizations. Methods Two hundred-twenty Positron Emission Tomography (PET)-CT images of patients with four different tumor localizations were included: 1. head and neck (n = 34), 2. esophagus (n = 45), 3. lung (n = 54), and 4. melanoma (n = 87). From the whole body scan, 24 slices were used, i.e., one for each vertebra level. Two examiners contoured the muscles independently. After contouring, muscle quantity was estimated by calculating skeletal muscle area (SMA) and skeletal muscle index (SMI). Muscle quality was assessed by calculating muscle radiation attenuation (MRA). Pearson correlation coefficient was used to determine whether the other vertebra levels correlate with L3 level. Results For SMA, strong correlations were found between C1-C3 and L3, and C7-L5 and L3 (r = 0.72-0.95). For SMI, strong correlations were found between the levels C1-C2, C7-T5, T7-L5, and L3 (r = 0.70-0.93), respectively. For MRA, strong correlations were found between T1-L5 and L3 (r = 0.71-0.95). Discussion For muscle quantity, the correlations between the cervical, thoracic, and lumbar levels are good, except for the cervical levels in patients with esophageal cancer. For muscle quality, the correlations between the other levels and L3 are good, except for the cervical levels in patients with melanoma. If visualization of L3 on the CT scan is absent, the other thoracic and lumbar vertebra levels could serve as a proxy to measure muscle quantity and quality in patients with head and neck, esophageal, lung cancer, and melanoma, whereas the cervical levels may be less reliable as a proxy in some patient groups.
Collapse
Affiliation(s)
- Jona Van den Broeck
- Experimental Anatomy Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Martine J Sealy
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, Netherlands
| | - Carola Brussaard
- Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Jasmijn Kooijman
- Department of Medical Imaging and Radiation Therapy, Hanze University of Applied Sciences, Groningen, Netherlands
| | - Harriët Jager-Wittenaar
- Experimental Anatomy Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, Netherlands.,Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Aldo Scafoglieri
- Experimental Anatomy Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| |
Collapse
|
3
|
Takei D, Tagami K. Management of cancer pain due to bone metastasis. J Bone Miner Metab 2022; 41:327-336. [PMID: 36418587 DOI: 10.1007/s00774-022-01382-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/13/2022] [Indexed: 11/26/2022]
Abstract
Bone metastases frequently occur in patients with cancer. Skeletal-related events (SREs), including pain, impaired mobility, hypercalcemia, pathological fracture, spinal cord and nerve root compression, and bone marrow infiltration, can decrease the quality of life of the patients and increase the risk of morbidity. The mechanism of pain due to bone metastasis is complicated and involves various interactions among tumor cells, bone cells, activated inflammatory cells, and bone-innervating neurons. Cancer pain due to bone metastasis can be crippling and a chronic state that causes sarcopenia. For pain management, it is important to diagnose whether the pain is based on background pain or breakthrough pain due to bone metastasis. In addition, the management goal of cancer pain due to bone metastasis is not only to achieve pain relief but also to prevent pain progression and SREs. Pain mechanisms should be applied to achieve optimal management. This review aims to discuss the mechanisms of cancer pain due to bone metastasis and review the recommended drug therapies.
Collapse
Affiliation(s)
- Daisuke Takei
- Department of Pharmacy, Saitama Cancer Center, Saitama, Japan.
| | - Keita Tagami
- Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| |
Collapse
|
4
|
Qian H, Huang Z, Sun X, Ren P. Skeletal muscle metastasis from extrahepatic cholangiocarcinoma: A case report and literature review. Front Surg 2022; 9:922834. [PMID: 36034354 PMCID: PMC9411020 DOI: 10.3389/fsurg.2022.922834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 07/25/2022] [Indexed: 11/18/2022] Open
Abstract
Background Cholangiocarcinoma (CCA) is a type of malignant tumor that arises from the epithelium of the bile ducts. According to anatomical location, CCA can be classified as intrahepatic (ICC), perihilar (PCC), or extrahepatic (ECC). CCA can invade and metastasize to other tissues in various ways, but distal skeletal muscle metastasis (SMM) is extremely rare. There are several reports on SMM from ICC or PCC, but SMM from ECC has not yet been reported. Case presentation A 71-year-old woman was diagnosed with ECC, for which she underwent pancreatoduodenectomy and partial hepatectomy. Nine months after surgery, she was re-admitted to the hospital complaining of a rapidly growing mass on her right thigh with progressive lower extremity edema. Magnetic resonance imaging of the right thigh showed two masses with iso-signal intensity on T1-weighted images and hyper-intensity on T2-weighted images compared with the surrounding muscles. Pathological examination of the fine-needle biopsy specimen revealed that it was similar to the previously detected ECC, and the diagnosis was metastasis of ECC. The patient was treated with opioid analgesics and died of systemic failure three months later. Conclusion SMM should be considered during the follow-up period despite its low incidence, and perineural invasion may be an essential pathway of distant metastasis in CCA.
Collapse
Affiliation(s)
- Hongwei Qian
- Department of Hepatobiliary and Pancreatic Surgery, Shaoxing People’s Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
- Shaoxing Key Laboratory of Minimally Invasive Abdominal Surgery and Precise Treatment of Tumor, Shaoxing, China
| | - Zhikun Huang
- Department of Hepatobiliary and Pancreatic Surgery, Shaoxing People’s Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
- Shaoxing Key Laboratory of Minimally Invasive Abdominal Surgery and Precise Treatment of Tumor, Shaoxing, China
| | - Xuezheng Sun
- Department of Hepatobiliary and Pancreatic Surgery, Shaoxing People’s Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
- Shaoxing Key Laboratory of Minimally Invasive Abdominal Surgery and Precise Treatment of Tumor, Shaoxing, China
| | - Peitu Ren
- Department of Hepatobiliary and Pancreatic Surgery, Shaoxing People’s Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing, China
- Shaoxing Key Laboratory of Minimally Invasive Abdominal Surgery and Precise Treatment of Tumor, Shaoxing, China
- Correspondence: Peitu Ren
| |
Collapse
|
5
|
Ururi-Cupi K, Oliva-Zapata F, Salazar-Talla L, Cuba-Ruiz S, Urrunaga-Pastor D, Runzer-Colmenares FM, Parodi JF. SARC-F and SARC-CalF Scores as Mortality Risk Factors in Older Men with Cancer: A Longitudinal Study from Peru. J Nutr Health Aging 2022; 26:856-863. [PMID: 36156677 PMCID: PMC9473478 DOI: 10.1007/s12603-022-1844-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/07/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES We aimed to evaluate the role of SARC-F and SARC-CalF scores as risk factors for mortality in adults over 60 years of age with cancer of the Centro Médico Naval (CEMENA) in Callao, Peru during 2012-2015. METHODS We performed a secondary analysis of data from a prospective cohort carried out from September 2012 to February 2013 in the Geriatrics Department of CEMENA. The outcome variable was mortality at two years of follow-up, while the exposure variable was the risk of sarcopenia assessed using the SARC-F and SARC-CalF scales. We carried out Cox proportional-hazards models to assess the role of SARC-F and SARC-CalF scores as risk factors for mortality. We estimated crude (cHR) and adjusted (aHR) hazard ratios (HR) with their respective 95% confidence intervals (95%CI). Likewise, we calculated the area under the curve (AUC) of both exposure variables in relation to mortality. RESULTS We analyzed data from 922 elderly men with cancer; 43.1% (n=397) were between 60 and 70 years old. 21.5% (n=198) and 45.7% (n=421) were at risk of sarcopenia according to SARC-F and SARC-CalF, respectively, while the incidence of mortality was 22.9% (n=211). In the adjusted Cox regression model, we found that the risk of sarcopenia measured by SARC-F (aHR=2.51; 95%CI: 1.40-2.77) and SARC-CalF (aHR=2.04; 95%CI: 1.55-4.02) was associated with a higher risk of death in older men with cancer. In the diagnostic performance analysis, we found that the AUC for mortality prediction was 0.71 (95%CI: 0.68-0.75) for SARC-F and 0.80 (95%CI: 0.78-0.82) for SARC-CalF. CONCLUSIONS The risk of sarcopenia evaluated by SARC-F and SARC-CalF scores was associated with an increased risk of mortality in older men with cancer. Both scales proved to be useful and accessible instruments for the identification of groups at risk of mortality.
Collapse
Affiliation(s)
- K. Ururi-Cupi
- Universidad Científica del Sur, Facultad de Ciencias de la Salud, Carrera de Medicina Humana, Lima, Peru
| | - F. Oliva-Zapata
- Universidad Científica del Sur, Facultad de Ciencias de la Salud, Carrera de Medicina Humana, Lima, Peru
| | - L. Salazar-Talla
- Grupo Estudiantil de Investigación en Salud Mental (GISAM), Sociedad Científica de Estudiantes de Medicina de la Universidad de San Martin de Porres, Lima, Peru
| | - S. Cuba-Ruiz
- Universidad de San Martin de Porres, Facultad de Medicina Humana, Lima, Peru
| | - Diego Urrunaga-Pastor
- Universidad San Ignacio de Loyola, Unidad para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
- Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Campus 2, Avenida La Fontana 750, La Molina, Lima, Peru
| | - Fernando M. Runzer-Colmenares
- Universidad Científica del Sur, Facultad de Ciencias de la Salud, Carrera de Medicina Humana, Lima, Peru
- Carrera de Medicina, Universidad Científica del Sur, Lima, Perú Carretera Panamericana Sur 19, Distrito de Villa El Salvador, 15067
| | - J. F. Parodi
- Universidad de San Martin de Porres, Facultad de Medicina Humana, Centro de investigación del envejecimiento (CIEN), Lima, Peru
| |
Collapse
|
6
|
Tsai KJ, Chang CC, Lo LC, Chiang JY, Chang CS, Huang YJ. Automatic segmentation of paravertebral muscles in abdominal CT scan by U-Net: The application of data augmentation technique to increase the Jaccard ratio of deep learning. Medicine (Baltimore) 2021; 100:e27649. [PMID: 34871238 PMCID: PMC8568419 DOI: 10.1097/md.0000000000027649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 09/17/2021] [Accepted: 10/11/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT Sarcopenia, characterized by a decline of skeletal muscle mass, has emerged as an important prognostic factor for cancer patients. Trunk computed tomography (CT) is a commonly used modality for assessment of cancer disease extent and treatment outcome. CT images can also be used to analyze the skeletal muscle mass filtered by the appropriate range of Hounsfield scale. However, a manual depiction of skeletal muscle in CT scan images for assessing skeletal muscle mass is labor-intensive and unrealistic in clinical practice. In this paper, we propose a novel U-Net based segmentation system for CT scan of paravertebral muscles in the third and fourth lumbar spines. Since the number of training samples is limited (i.e., 1024 CT images only), it is well-known that the performance of the deep learning approach is restricted due to overfitting. A data augmentation strategy to enlarge the diversity of the training set to boost the performance further is employed. On the other hand, we also discuss how the number of features in our U-Net affects the performance of the semantic segmentation. The efficacies of the proposed methodology based on w/ and w/o data augmentation and different feature maps are compared in the experiments. We show that the Jaccard score is approximately 95.0% based on the proposed data augmentation method with only 16 feature maps used in U-Net. The stability and efficiency of the proposed U-Net are verified in the experiments in a cross-validation manner.
Collapse
Affiliation(s)
- Kuen-Jang Tsai
- Department of Surgery, E-Da Cancer Hospital, Taiwan
- College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Chih-Chun Chang
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Lun-Chien Lo
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - John Y. Chiang
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chao-Sung Chang
- Department of Hematology/Oncology, E-Da Cancer Hospital, School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Jung Huang
- Department of Electronic Engineering, I-Shou University, Kaohsiung, Taiwan
| |
Collapse
|
7
|
Yao H, Dohzono S, Sasaoka R, Takamatsu K, Nakamura H. Prognostic value of psoas major muscle density in patients with breast cancer metastases to bone: a retrospective single-center cohort study. Jpn J Clin Oncol 2021; 52:8-13. [PMID: 34642753 DOI: 10.1093/jjco/hyab166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 10/01/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Although sarcopenia is associated with poor prognosis for cancer patients, the relationship between muscle quantity and quality, and prognosis of breast cancer patients with bone metastases is unclear. This study aims to evaluate the association of muscle parameters, muscle area and density, and overall survival (OS) from the diagnosis of bone metastases in breast cancer patients with bone metastases. METHODS This study retrospectively investigated the prognostic value of muscle area and density in 90 women who were diagnosed with breast cancer with bone metastases between September 2005 and June 2018. We measured psoas major muscle and paravertebral muscle area and density on single axial computed tomography images at the L3 level and subgrouped the patients into higher or lower groups for each muscle measurement, using median values as cutoffs. We evaluated associations between OS and muscle parameters, using a Cox proportional hazards model adjusted by age and prognostic score for bone metastases (modified Katagiri score). RESULTS Median OS among patients with lower psoas major muscle density (25 months) was significantly shorter than in the higher psoas major muscle density group (61 months; hazard ratio: 1.79, 95% confidence interval: 1.01-3.16, P = 0.045). However, muscle area and paravertebral muscle density were not associated with OS in this setting. CONCLUSION Lower psoas major muscle density was a predictor of poor prognosis in patients with breast cancer metastases to bone. The association between psoas major muscle density and prognosis allows wider research into interventions that can prevent loss of muscle density.
Collapse
Affiliation(s)
- Hana Yao
- Department of Orthopaedic Surgery, Yodogawa Christian Hospital, Osaka, Japan
| | - Sho Dohzono
- Department of Orthopaedic Surgery, Yodogawa Christian Hospital, Osaka, Japan
| | - Ryuichi Sasaoka
- Department of Orthopaedic Surgery, Yodogawa Christian Hospital, Osaka, Japan
| | - Kiyohito Takamatsu
- Department of Orthopaedic Surgery, Yodogawa Christian Hospital, Osaka, Japan
| | - Hiroaki Nakamura
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| |
Collapse
|
8
|
Mori N, Maeda K, Yamanaka Y, Matsuyama R, Nonogaki T, Kato R, Ishida Y, Shimizu A, Ueshima J. Prognostic role of low muscle mass and strength in palliative care patients with incurable cancer: a retrospective study. JCSM CLINICAL REPORTS 2021. [DOI: 10.1002/crt2.39] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Naoharu Mori
- Department of Palliative and Supportive Medicine, Graduate School of Medicine Aichi Medical University 1‐1 Yazakokarimata Nagakute Aichi 480‐1195 Japan
| | - Keisuke Maeda
- Department of Palliative and Supportive Medicine, Graduate School of Medicine Aichi Medical University 1‐1 Yazakokarimata Nagakute Aichi 480‐1195 Japan
| | - Yousuke Yamanaka
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine Aichi Medical University 1‐1 Yazakokarimata Nagakute Aichi 480‐1195 Japan
| | - Remi Matsuyama
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine Aichi Medical University 1‐1 Yazakokarimata Nagakute Aichi 480‐1195 Japan
| | - Tomoyuki Nonogaki
- Department of Pharmacy Aichi Medical University Hospital 1‐1 Yazakokarimata Nagakute Aichi 480‐1195 Japan
| | - Ryoko Kato
- Department of Pharmacy Aichi Medical University Hospital 1‐1 Yazakokarimata Nagakute Aichi 480‐1195 Japan
| | - Yuria Ishida
- Department of Nutrition Aichi Medical University Hospital 1‐1 Yazakokarimata Nagakute Aichi 480‐1195 Japan
| | - Akio Shimizu
- Department of Nutrition Hamamatsu City Rehabilitation Hospital 1‐6‐1 Wagokita, Naka‐Ku Hamamatsu Shizuoka 433‐8511 Japan
| | - Junko Ueshima
- Department of Clinical Nutrition and Food Services NTT Medical Center Tokyo 5‐9‐22 Higashi‐Gotanda, Shinagawa‐Ku Tokyo 141‐0022 Japan
| |
Collapse
|
9
|
Song Q, Sun XF, Wu XL, Dong Y, Wang L. Skeletal muscle metastases of hepatocellular carcinoma: A case report and literature review. World J Clin Cases 2021; 9:3334-3341. [PMID: 34002142 PMCID: PMC8107905 DOI: 10.12998/wjcc.v9.i14.3334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/24/2020] [Accepted: 01/07/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The metastasis of liver cancer to skeletal muscle is extremely rare compared to other sites. We herein report a case of rapidly developing skeletal metastases following liver transplantation due to primary liver cancer.
CASE SUMMARY A 70-year-old male with underlying chronic hepatitis B virus infection was diagnosed with hepatocellular carcinoma (HCC), for which he underwent liver transplantation in 2014. Six years after receiving the transplant, pathological examination confirmed the presence of HCC without vascular invasion. He was admitted to the hospital with a rapidly growing mass on his right thigh. Ultrasound examination revealed a mixed echo mass in the lateral soft tissue of the middle part of the right femur. Magnetic resonance imaging showed heterogeneous iso-signal intensity on T1-weighted images and heterogeneous hyper-intensity on T2-weighted images compared to the surrounding muscles. Pathological examination of the ultrasound-guided needle biopsy specimen revealed that it was similar to the previously detected liver cancer; the diagnosis was metastasis of HCC. Surgical excision was performed. There were no other sites of metastasis, and the patient recovered well after surgery.
CONCLUSION This report presents a rare case of skeletal metastasis following liver transplantation for HCC. The study suggests a possible role for skeletal muscle metastasis mechanisms, which should be the focus of future research.
Collapse
Affiliation(s)
- Qi Song
- Department of Ultrasound, Bethune First Hospital of Jilin University, Changchun 130000, Jilin Province, China
| | - Xiao-Feng Sun
- Department of Ultrasound, Bethune First Hospital of Jilin University, Changchun 130000, Jilin Province, China
| | - Xiao-Li Wu
- Department of Ultrasound, Bethune First Hospital of Jilin University, Changchun 130000, Jilin Province, China
| | - Yi Dong
- Department of Ultrasound, Bethune First Hospital of Jilin University, Changchun 130000, Jilin Province, China
| | - Le Wang
- Department of Ultrasound, Bethune First Hospital of Jilin University, Changchun 130000, Jilin Province, China
| |
Collapse
|
10
|
Antinociceptive Effects of Shenling Baizhu through PI3K-Akt-mTOR Signaling Pathway in a Mouse Model of Bone Metastasis with Small-Cell Lung Cancer. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:4121483. [PMID: 32655659 PMCID: PMC7327581 DOI: 10.1155/2020/4121483] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/20/2020] [Accepted: 03/03/2020] [Indexed: 12/26/2022]
Abstract
Shenling Baizhu additive powder (SLBZ-AP), a formulation of a variety of natural medicinal plants, has clinical efficacy in treating cancers in previous studies. We explored the effect of SLBZ-AP in bone metastasis of lung cancer (BMLC) mice, and the possible mechanism involved was further investigated in the present study. Mice model of BMLC was made and treated with SLBZ-AP. Pain behavioral tests were performed to explore the effect on BMLC-induced pain in mice. TUNEL staining was used to investigate apoptosis. The mRNA expression of markers in the PI3K/Akt/mTOR pathway was measured by qPCR, and protein expression was detected by western blotting and immunohistochemistry analysis. SLBZ-AP relieved BMLC-induced pain and prolonged animals' survival, promoted cell apoptosis in the marrow from the tibia of BMLC mice, and inhibited mRNA and protein expression of AKT, mTOR, P70S6, and VEGF, as well as protein expression of p-AKT, p-mTOR, p-P70S6, and VEGF upregulation in the marrow of tibia induced by BMLC, an effect which was similar to rapamycin. Our results suggested that SLBZ-AP may have antinociceptive effect and prolong survival of BMLC mice at least partially by inhibiting cell proliferation and promoting apoptosis through the PI3K/Akt/mTOR signaling pathway. SLBZ-AP may be a potential candidate for BMLC therapy.
Collapse
|