The prognostic role of pre-treatment neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in esophageal squamous cell carcinoma treated with concurrent chemoradiotherapy

PURPOSE

In this study, we retrospectively investigated the prognostic role of pre-treatment neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in esophageal squamous cell carcinoma patients (ESCC) treated with concurrent chemo-radiotherapy (CCRT).

METHODS

We retrospectively analyzed the records of 338 patients with pathologically diagnosed esophageal squamous cell carcinoma that underwent concurrent chemo-radiotherapy from January 2013 to December 2017. Univariate and multivariate analyses were used to identify prognostic factors for progression free survival (PFS) and overall survival (OS).

RESULTS

The result showed that the thresholds for NLR and PLR were 2.47 and 136.0 by receiver operating characteristic curve. High NLR and PLR were both associated with tumor length (P < 0.05). High NLR and PLR were significantly associated with poor PFS and OS. Multivariate analyses identified NLR, PLR and TNM stage were independent risk factors for PFS and OS.

CONCLUSIONS

We show that the pre-treatment NLR and PLR may serve as prognostic indicators for esophageal squamous cell carcinoma treated with concurrent chemo-radiotherapy.

Microwave ablation combined with percutaneous vertebroplasty for treating painful non-small cell lung cancer with spinal metastases under real-time temperature monitoring

PURPOSE

To retrospectively study the therapeutic effect and safety performance of the combination strategies of the computed tomography (CT)-guided microwave ablation (MWA) and percutaneous vertebroplasty (PVP) as a treatment for painful non-small cell lung cancer (NSCLC) with spinal metastases.

MATERIALS AND METHODS

A retrospective review included 71 patients with 109 vertebral metastases who underwent microwave ablation combined with percutaneous vertebroplasty by the image-guided and real-time temperature monitoring. Treatment efficacy was determined by comparing visual analog scale (VAS) scores, daily morphine equivalent opioid consumption, and Oswestry Disability Index (ODI) scores before treatment and during the follow-up period.

RESULTS

Technical success was achieved in all patients. The mean pre-procedure VAS score and morphine doses were 6.6 ± 1.8 (4-10) and 137.2 ± 38.7 (40-200) mg, respectively. The mean VAS scores and daily morphine doses at 24 h and 1, 4, 12, and 24 weeks postoperatively were 3.3 ± 1.9 and 73.5 ± 39.4 mg; 2.2 ± 1.5 and 40.2 ± 29.8 mg; 1.7 ± 1.2 and 31.3 ± 23.6 mg; 1.4 ± 1.1 and 27.3 ± 21.4 mg; and 1.3 ± 1.1 and 24.8 ± 21.0 mg, respectively (all P < 0.001). ODI scores significantly decreased (P < 0.05). Minor cement leakage occurred in 51 cases (46.8%), with one patient having a grade 3 neural injury. No local tumor progression was observed by follow-up imaging.

CONCLUSIONS

MWA combined with PVP can significantly relieve pain and improve patients' quality of life, which implied this is an effective treatment option for painful NSCLC with spinal metastases. Additionally, its efficacy should be further verified through the mid- and long-term studies.

Association of serum lipids and abnormal lipid score with cancer risk: a population-based prospective study

BACKGROUND

Serum lipid levels are associated with cancer risk. However, there still have uncertainties about the single and combined effects of low lipid levels on cancer risk.

METHODS

A prospective cohort study of 33,773 adults in Shanghai between 2016 and 2017 was conducted. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels were measured. Cox proportional hazard models were used to assess the association of single and combined lipids with overall, lung, colon, rectal, thyroid gland, stomach, and female breast cancers. The effect of the combination of abnormal lipid score and lifestyle on cancer was also estimated.

RESULTS

A total of 926 incident cancer cases were identified. In the RCS analysis, hazard ratios (HRs) of overall cancer for individuals with TC < 5.18 mmol/L or with LDL-C < 3.40 mmol/L were higher. Low TC was associated with higher colorectal cancer risk (HR [95% CI] = 1.76 [1.09-2.84]) and low HDL-C increased thyroid cancer risk by 90%. Abnormal lipid score was linearly and positively associated with cancer risk, and smokers with high abnormal lipid scores had a higher cancer risk, compared to non-smokers with low abnormal lipid scores (P < 0.05).

CONCLUSIONS

Low TC levels were associated with an increased risk of overall and colorectal cancer. More attention should be paid to participants with high abnormal lipid scores and unhealthy lifestyles who may have a higher risk of developing cancer. Determining the specific and comprehensive lipid combinations that affect tumorigenesis remains a valuable challenge.

Efficacy and safety of CT-guided 125I seed implantation by coplanar template as a salvage therapy for vertebral metastases after failure of external beam radiation therapy: a retrospective study

Purpose

To evaluate the efficacy safety of computed tomography (CT)-guided ¹²⁵I seed implantation by coplanar template for vertebral metastases after failure of external beam radiation therapy (EBRT).

Material and methods

Retrospective analysis of the clinical outcomes of 58 patients with vertebral metastases after failure of EBRT, who underwent ¹²⁵I seed implantation as a salvage treatment with a CT-guided coplanar template-assisted technique from January 2015 to January 2017.

Results

The mean post-operative NRS score decreased significantly at T_4w (3.5 ± 0.9, p<0.01), T_8w (2.1 ± 0.9, p<0.01), T_12w (1.5 ± 0.7, p< 0.01) and T_6m (1.2 ± 0.6, p< 0.01) respectively. The local control rates after 3, 6, 9 and 12 months were 100% (58/58), 93.1% (54/58), 87.9% (51/58), and 81% (47/58), respectively. The median overall survival time was 18.52months (95% CI, 16.24-20.8), and 1- and 2-year survival rates were 81% (47/58) and 34.5% (20/58), respectively. By performing a paired t-test analysis, there was no significant difference in D90, V90, D100, V100, V150, V200, GTV volume, CI, EI and HI between preoperative and postoperative (p>0.05).

Conclusions

¹²⁵I seed implantation can be used as a salvage treatment for patients with vertebral metastases after failure of EBRT.

Percutaneous microwave ablation with osteoplasty and interventional internal fixation for impending pathologic fracture of the proximal humerus

Humerus is the long bone second-most commonly affected by metastases. An impending pathologic humeral fracture requires rigid surgical stabilization to prevent it from fully fracturing. In the present study, we report a case of a 71-year-old male patient with a visual analog score of 10 (indicating extreme pain) and an impending pathologic fracture that allowed for combined treatment with percutaneous microwave ablation and simultaneous injection of bone cement during Kirschner wire insertion. The procedure was performed successfully with no complications. The patient reported pain relief and improved quality of life and functional status 1 day, 7 days, 1 month, and 2 months after his procedure.

[Mechanism of silk hydrates on modulating the blood glucose metabolism in rats with experimental diabetes]

Thirty eight adult male Wistar rats injected with streptozotocin(STZ) 30 mg/kg BW via tail vein and fed on a diet of high fat, high sucrose and high calorie for 3 weeks and then for another 8 weeks were successfully established as the diabetes model(type II diabetes mellitus). The effects of feeding silk hydrates(SH) for 12 weeks on the activities of insulin receptors and postreceptors were observed. The results showed that: 1) SH greatly improved the glucose tolerance of diabetic rats, but no effect on the secretion of insulin in rats with or without diabetes; 2) Only the low-affinity constant of insulin binding rates(K2) in skeletal muscle cell membranes of diabetic rats fed with SH were obviously increased, the high-affinity binding constant and the number of receptors were not changed; 3) the uptake of glucose in skeletal muscle of diabetic rats fed on SH was significantly increased. 4) SH partly improved the metabolism of serum lipids. The results indicated that SH could modulate the metabolism of blood glucose mainly through the mechanism on the activity of insulin postreceptor.

[Effects of silk hydrates on the blood glucose metabolism in rats with experimental diabetes]

Male Wistar rats were divided into two groups by random. One group was injected with streptozotocin(STZ) 30 mg/kg BW via tail vein. Three weeks later, the rats were fed on diet of high fat, high sucrose and high calorie for another 8 weeks. There were 38 rats with impaired glucose tolerance and insulin level higher or equal to the control group selected as the diabetic model group. Another 36 rats not injected with STZ and fed on normal diet were selected as controls. The two groups were divided into two subgroups and fed with normal diet for another 4 weeks. The four subgroups were normal control group, normal +SH group, diabetes control group and diabetes +SH group. The rats in normal +SH group and diabetes +SH group were tube feeding every day with silk hydrate (SH) 1.0 g/kg BW for 4 weeks. The results showed that in the diabetes +SH group, the glucose tolerance, blood lipid and the predictive index of coronary heart disease were significantly improved, but no effect on their blood insulin level. There was no change in the normal +SH group. The results suggested that SH could modulate the metabolism of blood glucose and partly improve the disorder of the serum lipid of diabetic rats.

[The cytologic ultrastructure and cytochemical features of human dendritic cells from peripheral blood]

OBJECTIVE

To observe the cytomorphological, cellular ultrastructure and cytochemical features of the dendritic cell (DC) enriched populations in vitro.

METHODS

Fresh peripheral blood from healthy volunteers was collected and mononuclear cells (PBMC) were isolated on lymphocyte separating solution. The PBMC were cultured in mediums containing rhGM-CSF, rhIL-4 and rhTNF-alpha 9-12 days to generate DC-enriched populations, the morphological features and numbers of DC were identified and counted respectively by light microscope (LM) and confirmed by immunofluorescence assay (IFA), the ultrastructure characteristics of the DC populations were observed by transmission electron microscope, and the cytochemical features of them were also examined.

RESULTS

The percentage of DCs was 70%-80% in the DC-enriched populations as confirmed by IFA using mABXII. Transmission electron microscopy revealed that the DC populations contained two subsets of DC, one was considered as precursor cell derived DC(PC-DC), the cell surface of which had many irregular dendrites with a irregular nucleus, small nucleoli, numerous mitochondria, but scanty lysosomes, ribosome, rough endoplasmic reticulum and free polysomes. Cytochemical staining showed the DCs were both peroxidase (POX) and non-specific esterase (NSE) negative. The other was indentified as monocyte-derived DC(MO-DC), the features of which included: irregular shape, many ruffles and some rough lames on cell surfaces, nephritic or horseshoe nuclei with a thick rim of heterochromatin, numerous mitochondria, much more lysosomes, ribosomes, rough endoplasmic reticulum and Golgiosome. The cytochemical reactions indicated that most of them had POX-positive granules, and were NSE slightly positive.

CONCLUSION

Cytokines in vitro induced DCs from human peripheral blood are heterogeneous.