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Shakir M, Shariq SF, Irshad HA, Khowaja AH, Tahir I, Rae AI, Hamzah R, Gupta S, Park KB, Enam SA. Barriers to Neurosurgical Care of Brain Tumors in Low- and Middle-Income Countries: A Systematic Review of the Service Delivery Challenges. World Neurosurg 2024; 187:211-222.e3. [PMID: 38740084 DOI: 10.1016/j.wneu.2024.05.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 05/16/2024]
Abstract
INTRODUCTION Brain tumors pose a major challenge in low- and middle-income countries (LMICs) due to limited resources and high costs, resulting in hampered service delivery of neurosurgical care and significant disparities in patient outcomes compared to high-income nations. Therefore, our systematic review aims to identify barriers to service delivery in providing adequate surgical care for the management of brain tumors in LMICs. METHODS We searched Scopus, PubMed, Google Scholar, and CINAHL, from inception to October 20, 2022. The data from the eligible studies were extracted and analyzed qualitatively. RESULTS The final analysis included 35 articles, which highlighted significant challenges in providing adequate surgical care for brain tumors in LMICs. Among the cited studies, 10% reported lack of multidisciplinary team structures, 61% noted delayed patient presentation, 16% highlighted delays in neuroimaging, 10% reported delays in scheduling surgery, lack of training for specialized surgery (3%), lack of intra-operative facilities (19%), power supply interruption (6%), and lack of advanced diagnostic and specialized surgery facilities (19%). Strategies for addressing these challenges include cross-border collaboration (7%), public education, and awareness (13%), establishing multidisciplinary teams (20%), utilizing alternative surgical techniques (13%), 7% intraoperative ultrasound, 13% intraoperative cytology smear), and establishing satellite hospitals for low-risk care (7%), standard operating procedure and infection control (13%). CONCLUSION Targeted interventions considering economic constraints are essential to improve the availability, affordability, and quality of neuro-oncologic services in developing countries. International collaborations and building capacity are vital for improving patient outcomes and service delivery, as well as forming multidisciplinary teams and utilizing resource-saving, innovative methods.
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Affiliation(s)
- Muhammad Shakir
- Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
| | | | | | | | - Izza Tahir
- Medical College, Aga Khan University, Karachi, Pakistan
| | - Ali I Rae
- Department of Global Health and Social Medicine, Program for Global Surgery and Social Change (PGSSC), Harvard Medical School, Boston, Massachusetts, USA
| | - Radzi Hamzah
- Department of Global Health and Social Medicine, Program for Global Surgery and Social Change (PGSSC), Harvard Medical School, Boston, Massachusetts, USA
| | - Saksham Gupta
- Department of Global Health and Social Medicine, Program for Global Surgery and Social Change (PGSSC), Harvard Medical School, Boston, Massachusetts, USA
| | - Kee B Park
- Department of Global Health and Social Medicine, Program for Global Surgery and Social Change (PGSSC), Harvard Medical School, Boston, Massachusetts, USA
| | - Syed Ather Enam
- Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
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Hua W, Zhang W, Brown H, Wu J, Fang X, Shahi M, Chen R, Zhang H, Jiao B, Wang N, Xu H, Fu M, Wang X, Zhang J, Zhang X, Wang Q, Zhu W, Ye D, Garcia DM, Chaichana K, Cooks RG, Ouyang Z, Mao Y, Quinones-Hinojosa A. Rapid detection of IDH mutations in gliomas by intraoperative mass spectrometry. Proc Natl Acad Sci U S A 2024; 121:e2318843121. [PMID: 38805277 PMCID: PMC11161794 DOI: 10.1073/pnas.2318843121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 04/25/2024] [Indexed: 05/30/2024] Open
Abstract
The development and performance of two mass spectrometry (MS) workflows for the intraoperative diagnosis of isocitrate dehydrogenase (IDH) mutations in glioma is implemented by independent teams at Mayo Clinic, Jacksonville, and Huashan Hospital, Shanghai. The infiltrative nature of gliomas makes rapid diagnosis necessary to guide the extent of surgical resection of central nervous system (CNS) tumors. The combination of tissue biopsy and MS analysis used here satisfies this requirement. The key feature of both described methods is the use of tandem MS to measure the oncometabolite 2-hydroxyglutarate (2HG) relative to endogenous glutamate (Glu) to characterize the presence of mutant tumor. The experiments i) provide IDH mutation status for individual patients and ii) demonstrate a strong correlation of 2HG signals with tumor infiltration. The measured ratio of 2HG to Glu correlates with IDH-mutant (IDH-mut) glioma (P < 0.0001) in the tumor core data of both teams. Despite using different ionization methods and different mass spectrometers, comparable performance in determining IDH mutations from core tumor biopsies was achieved with sensitivities, specificities, and accuracies all at 100%. None of the 31 patients at Mayo Clinic or the 74 patients at Huashan Hospital were misclassified when analyzing tumor core biopsies. Robustness of the methodology was evaluated by postoperative re-examination of samples. Both teams noted the presence of high concentrations of 2HG at surgical margins, supporting future use of intraoperative MS to monitor for clean surgical margins. The power of MS diagnostics is shown in resolving contradictory clinical features, e.g., in distinguishing gliosis from IDH-mut glioma.
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Affiliation(s)
- Wei Hua
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai200040, China
- National Center for Neurological Disorders, Shanghai200040, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai200040, China
- Neurosurgical Institute of Fudan University, Shanghai200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai200040, China
| | - Wenpeng Zhang
- State Key Laboratory of Precision Measurement Technology and Instruments, Department of Precision Instrument, Tsinghua University, Beijing100084, China
| | - Hannah Brown
- Department of Chemistry, Purdue University, West Lafayette, IN47907
| | - Junhan Wu
- State Key Laboratory of Precision Measurement Technology and Instruments, Department of Precision Instrument, Tsinghua University, Beijing100084, China
| | - Xinqi Fang
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai200040, China
- National Center for Neurological Disorders, Shanghai200040, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai200040, China
- Neurosurgical Institute of Fudan University, Shanghai200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai200040, China
| | - Mahdiyeh Shahi
- Department of Chemistry, Purdue University, West Lafayette, IN47907
| | - Rong Chen
- Department of Chemistry, Purdue University, West Lafayette, IN47907
| | - Haoyue Zhang
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai200040, China
| | - Bin Jiao
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai200040, China
| | - Nan Wang
- PurSpecTechnologies, Beijing100084, China
| | - Hao Xu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai200040, China
- National Center for Neurological Disorders, Shanghai200040, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai200040, China
- Neurosurgical Institute of Fudan University, Shanghai200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai200040, China
| | - Minjie Fu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai200040, China
- National Center for Neurological Disorders, Shanghai200040, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai200040, China
- Neurosurgical Institute of Fudan University, Shanghai200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai200040, China
| | - Xiaowen Wang
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai200040, China
- National Center for Neurological Disorders, Shanghai200040, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai200040, China
- Neurosurgical Institute of Fudan University, Shanghai200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai200040, China
| | - Jinsen Zhang
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai200040, China
- National Center for Neurological Disorders, Shanghai200040, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai200040, China
- Neurosurgical Institute of Fudan University, Shanghai200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai200040, China
| | - Xin Zhang
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai200040, China
- National Center for Neurological Disorders, Shanghai200040, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai200040, China
- Neurosurgical Institute of Fudan University, Shanghai200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai200040, China
| | - Qijun Wang
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai200040, China
- National Center for Neurological Disorders, Shanghai200040, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai200040, China
- Neurosurgical Institute of Fudan University, Shanghai200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai200040, China
| | - Wei Zhu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai200040, China
- National Center for Neurological Disorders, Shanghai200040, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai200040, China
- Neurosurgical Institute of Fudan University, Shanghai200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai200040, China
| | - Dan Ye
- The Molecular and Cell Biology Lab, Institute of Biomedical Sciences, Shanghai Medical College, Fudan University, Shanghai200232, China
| | | | | | - R. Graham Cooks
- Department of Chemistry, Purdue University, West Lafayette, IN47907
| | - Zheng Ouyang
- State Key Laboratory of Precision Measurement Technology and Instruments, Department of Precision Instrument, Tsinghua University, Beijing100084, China
| | - Ying Mao
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai200040, China
- National Center for Neurological Disorders, Shanghai200040, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai200040, China
- Neurosurgical Institute of Fudan University, Shanghai200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai200040, China
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Byun YH, Won JK, Hong DH, Kang H, Kim JH, Yu MO, Kim MS, Kim YH, Park KJ, Jeong MJ, Hwang K, Kong DS, Park CK, Kang SH. A prospective multicenter assessor blinded pilot study using confocal laser endomicroscopy for intraoperative brain tumor diagnosis. Sci Rep 2024; 14:6784. [PMID: 38514670 PMCID: PMC10957981 DOI: 10.1038/s41598-024-52494-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/19/2024] [Indexed: 03/23/2024] Open
Abstract
In this multi-center, assessor-blinded pilot study, the diagnostic efficacy of cCeLL-Ex vivo, a second-generation confocal laser endomicroscopy (CLE), was compared against the gold standard frozen section analysis for intraoperative brain tumor diagnosis. The study was conducted across three tertiary medical institutions in the Republic of Korea. Biopsy samples from newly diagnosed brain tumor patients were categorized based on location and divided for permanent section analysis, frozen section analysis, and cCeLL-Ex vivo imaging. Of the 74 samples from 55 patients, the majority were from the tumor core (74.3%). cCeLL-Ex vivo exhibited a relatively higher diagnostic accuracy (89.2%) than frozen section analysis (86.5%), with both methods showing a sensitivity of 92.2%. cCeLL-Ex vivo also demonstrated higher specificity (70% vs. 50%), positive predictive value (PPV) (95.2% vs. 92.2%), and negative predictive value (NPV) (58.3% vs. 50%). Furthermore, the time from sample preparation to diagnosis was notably shorter with cCeLL-Ex vivo (13 min 17 s) compared to frozen section analysis (28 min 28 s) (p-value < 0.005). These findings underscore cCeLL-Ex vivo's potential as a supplementary tool for intraoperative brain tumor diagnosis, with future studies anticipated to further validate its clinical utility.
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Affiliation(s)
- Yoon Hwan Byun
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae-Kyung Won
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Duk Hyun Hong
- Department of Neurosurgery, Korea University Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Ho Kang
- Department of Neurosurgery, Seoul National University Bundang Hospital, Gyeonggi-Do, Republic of Korea
| | - Jang Hun Kim
- Department of Neurosurgery, Korea University Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Mi Ok Yu
- Department of Neurosurgery, Korea University Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Min-Sung Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Jae Park
- Department of Neurosurgery, Korea University Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | | | | | - Doo-Sik Kong
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Shin-Hyuk Kang
- Department of Neurosurgery, Korea University Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
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Harms JWA, Streckert EMS, Kiolbassa NM, Thomas C, Grauer O, Oertel M, Eich HT, Stummer W, Paulus W, Brokinkel B. Confounders of intraoperative frozen section pathology during glioma surgery. Neurosurg Rev 2023; 46:286. [PMID: 37891361 DOI: 10.1007/s10143-023-02169-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/31/2023] [Accepted: 09/24/2023] [Indexed: 10/29/2023]
Abstract
Although frozen section pathology (FSP) is commonly performed during surgery for glioma-suspicious lesions, confounders of accuracy are largely unknown. FSP and final diagnosis were compared in 398 surgeries for glioma-suspicious lesions. Diagnostic accuracy, risk factors for diagnostic shift from neoplastic to non-neoplastic tissue and vice versa according to the final diagnosis, and the impact on intraoperative and postoperative decision-making were analyzed. Diagnostic shift occurred in 70 cases (18%), and sensitivity, specificity, and the positive (PPV) and negative (NPV) predictive value of FSP were 82.5%, 77.8%, 99.4%, and 9.3%, respectively. No correlations between shift and patients' age and sex, sample fluorescence or volume, tumor location, correct information on the pathology form, final high- or low-grade histology, or molecular alterations were found (p > .05, each). Shift was more common after irradiation (25% vs 15%; p = .025) or chemotherapy (26% vs 15%; p = .022) than in treatment naïve cases and correlated with the type of surgery (p = .002). FSP altered intraoperative decision-making in 25 cases (6%). Postoperative shift led to repeated surgery in 12 patients (3%). In 45 cases, in which FSP and final diagnosis based on the same tissue, shift occurred in only 5 patients (11%), and sensitivity, specificity, PPV, and NPV for FSP were 77.4%, 78.6%, 88.9%, and 61.1%, respectively. No correlations between diagnostic shift and any of the analyzed variables were found (p > .05, each). Although accuracy of FSP during glioma surgery is sufficient, moderate NPV should be considered during intraoperative decision-making. While confounders are sparse, accuracy might be increased by repeated sampling. Diagnostic shift rarely alters postoperative treatment strategy.
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Affiliation(s)
| | | | | | - Christian Thomas
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Oliver Grauer
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Münster, Germany
| | - Michael Oertel
- Department of Radiation Oncology, University Hospital Münster, Münster, Germany
| | - Hans Theodor Eich
- Department of Radiation Oncology, University Hospital Münster, Münster, Germany
| | - Walter Stummer
- Department of Neurosurgery, University Hospital Münster, Münster, Germany
| | - Werner Paulus
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Benjamin Brokinkel
- Department of Neurosurgery, University Hospital Münster, Münster, Germany.
- Institute of Neuropathology, University Hospital Münster, Münster, Germany.
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5
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Shakir M, Altaf A, Hussain H, Abidi SMA, Petitt Z, Tariq M, Gilani A, Enam SA. Unveiling the potential application of intraoperative brain smear for brain tumor diagnosis in low-middle-income countries: A comprehensive systematic review. Surg Neurol Int 2023; 14:325. [PMID: 37810296 PMCID: PMC10559528 DOI: 10.25259/sni_491_2023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/15/2023] [Indexed: 10/10/2023] Open
Abstract
Background Immediate intraoperative histopathological examination of tumor tissue is indispensable for a neurosurgeon to track surgical resection. A brain smear is a simple, rapid, and cost-effective technique, particularly important in the diagnosis of brain tumors. The study aims to determine the effectiveness of intraoperative brain smear in the diagnosis of brain tumors in low- and middle-income countries (LMICs), while also evaluating its sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy. Methods A comprehensive search of the literature was conducted using PubMed, Scopus, and Google Scholar. The retrieved articles were independently screened by two reviewers. The data was extracted, processed, and organized using Microsoft Excel. Results A total of 59 out of 553 articles screened were included in the final analysis. The sensitivity and specificity of the intraoperative smear of brain tumors were found to be over 90% in most studies. The PPV was consistently above 90% in 11 studies, reaching 100% in one study and the NPV varied, ranging from 63% to 100%, and the accuracy was found to be >80% in most studies. One recurrent theme in the majority of the included studies was that an intraoperative brain smear is a cost-effective, quick, accessible, and accurate method of diagnosing brain tumors, requiring minimal training and infrastructure. Conclusion Intraoperative brain smear is a simple, rapid, cost-effective, and highly sensitive diagnostic modality for brain tumors. It can be a viable and accessible alternative to more traditional methods such as frozen sections and can be incorporated into neurosurgical practice in LMICs as a reliable and efficient diagnostic tool.
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Affiliation(s)
- Muhammad Shakir
- Department of Surgery, Section of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Ahmed Altaf
- Department of Surgery, Section of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Hawra Hussain
- Medical School, Aga Khan University Hospital, Karachi, Pakistan
| | | | - Zoey Petitt
- Duke University School of Medicine, Durham, North Carolina, United States
| | - Mahnoor Tariq
- Department of Surgery, Section of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Ahmed Gilani
- Department of Pathology, Aga Khan University Hospital, Karachi, Pakistan
| | - S. Ather Enam
- Department of Surgery, Section of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan
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Yan F, Zhuang J, Yu Q, Dou Z, Jiang X, Tan S, Han Y, Wu X, Zang Y, Li C, Li J, Chen H, Hu L, Li X, Chen G. Strategy of De Novo Design toward First-In-Class Imaging Agents for Simultaneously Differentiating Glioma Boundary and Grades. ACS Sens 2021; 6:3330-3339. [PMID: 34448576 DOI: 10.1021/acssensors.1c01168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The extent of resection and tumor grade are two predominant prognostic factors for glioma. Fluorescent imaging is promising to facilitate accurate resection and simultaneous tumor grading. However, no probe fulfilling this task has been reported. Herein, we proposed a strategy of de novo design toward first-in-class fluorescent probes for simultaneously differentiating glioma boundary and grades. By bioinformatics analysis in combination with experimental validation, platelet-derived growth factor receptor β (PDGFRβ) was revealed as a promising biomarker for glioma imaging and grading. Then, fluorogenic probe PDGFP 1 was designed, guided by the structure-activity relationship study. Finally, the probe was demonstrated to stain glioma cells and tissues in the mice orthotopic glioma model with high selectivity over normal brain cells or tissues. Meanwhile, ex vivo experiments using patient-derived samples indicated that the fluorescence was significantly positively correlated with the tumor grades. This result highlighted the feasibility of the three-step de novo probe design strategy and suggested PDGFP 1 as a promising probe for simultaneously differentiating glioma boundary and grades, showing prospects of clinical translation.
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Affiliation(s)
- Feng Yan
- College of Pharmaceutical Sciences, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Jianfeng Zhuang
- College of Pharmaceutical Sciences, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Qian Yu
- College of Pharmaceutical Sciences, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Zhangqi Dou
- College of Pharmaceutical Sciences, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Xuefeng Jiang
- College of Pharmaceutical Sciences, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Shuyu Tan
- College of Pharmaceutical Sciences, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Yifeng Han
- Department of Chemistry, Zhejiang Sci-Tech University, Hangzhou 310018, China
| | - Xinyan Wu
- College of Pharmaceutical Sciences, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Yi Zang
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Cong Li
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Jia Li
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Huaijun Chen
- College of Pharmaceutical Sciences, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Libin Hu
- College of Pharmaceutical Sciences, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Xin Li
- College of Pharmaceutical Sciences, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Gao Chen
- College of Pharmaceutical Sciences, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China
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Qian J, Xu Y, Xu X, Tao Z, Luo Y, Xu Y, Zhang Y, Qian C. Hsa_circ_0091581 promotes glioma progression by regulating RMI1 via sponging miR-1243-5p. J Cancer 2021; 12:3249-3256. [PMID: 33976734 PMCID: PMC8100801 DOI: 10.7150/jca.55558] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 03/04/2021] [Indexed: 01/03/2023] Open
Abstract
Glioma is a pervasive malignancy and the main cause of cancer-related deaths worldwide. Circular RNA is an important subject of cancer research, and its role and function in glioma are poorly understood. This study demonstrated that hsa_circ_0091581 is upregulated in glioma tissues and cells. The results of the CCK-8, EdU, and transwell assays indicated that hsa_circ_0091581 promotes proliferation, migration, and invasion of glioma cells. The results of the luciferase reporter and RNA immunoprecipitation assays indicated that the mechanism of the effects of hsa_circ_0091581 on glioma cells involves sponging miR-1243-5p to regulate RMI1. The results of the rescue experiments indicated that hsa_circ_0091581 regulates proliferation, migration, and invasion of glioma cells by targeting RMI1 in a miR-1243-5p dependent manner. The results of the nude mice xenograft assays showed that knockdown of hsa_circ_0091581 inhibits glioma growth in vivo. Thus, our study determined the role of hsa_circ_0091581/miR-1243-5p/RMI1 in glioma and suggests that this axis may be a novel therapeutic target in glioma.
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Affiliation(s)
- Jin Qian
- Department of Neurosurgery, People's Hospital of Xuancheng City, Xuancheng, Anhui, China
| | - Yingna Xu
- Department of Neurosurgery, People's Hospital of Xuancheng City, Xuancheng, Anhui, China
| | - Xing Xu
- Department of Neurosurgery, People's Hospital of Xuancheng City, Xuancheng, Anhui, China
| | - Zhenyu Tao
- Department of Neurosurgery, People's Hospital of Xuancheng City, Xuancheng, Anhui, China
| | - Yang Luo
- Department of Neurosurgery, People's Hospital of Xuancheng City, Xuancheng, Anhui, China
| | - Yichang Xu
- Department of Neurosurgery, People's Hospital of Xuancheng City, Xuancheng, Anhui, China
| | - Yong Zhang
- Department of Neurosurgery, People's Hospital of Xuancheng City, Xuancheng, Anhui, China
| | - Chunfa Qian
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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