Preoperative prediction of the lymphovascular tumor thrombus of colorectal cancer with the iodine concentrations from dual-energy spectral CT

BACKGROUND

The aim of this study was to explore application value of iodine concentration from dual-energy spectral computed tomography (DESCT) in preoperative prediction of lymphovascular tumor thrombus in patients with colorectal cancer (CRC).

METHODS

We finally retrospectively analyzed 50 patients with CRC who underwent abdominal DESCT before receiving any preoperative treatment and underwent surgery to obtain pathological specimens which were stained with hematoxylin-eosin (HE) staining. According to the presence of cancer cell nests in blood vessels and lymphatic vessels, the subjects were divided into the positive group and negative group of lymphovascular tumor thrombus. Two radiologists independently measured the normalized iodine concentration (NIC) values, effective atomic number (Zeff) and CT values of virtual monochromatic images (VMIs) at 40-90 keV of the primary tumors in the arterial phase (AP) and venous phase (VP). Used SPSS 17.0 to calculate the receiver operating characteristic (ROC) curve to evaluate diagnostic value.

RESULTS

The patients were divided into lymphovascular tumor thrombus positive group(n = 16) and negative group(n = 34). The values of NIC-AP and NIC-VP in the positive group were 0.17 ± 0.09, 0.51 ± 0.13, respectively. And those in the negative group were 0.15 ± 0.06, 0.43 ± 0.12, respectively. There was significant difference in NIC-VP value between the two groups (p = 0.039), but there was no significant difference in NIC-AP value (p = 0.423). The optimal threshold value of NIC-VP value for diagnosis of lymphovascular tumor thrombus was 0.364. The sensitivity was 68.8% and the specificity was 67.6%.

CONCLUSIONS

The NIC-VP value of DESCT can be used to predict the presence or absence of the lymphovascular tumor thrombus in CRC patients before operation, which is helpful to select the best treatment scheme and evaluate its prognosis.

Chemotherapy combined with target drugs in the treatment of advanced colorectal cancer: a meta-analysis based on Chinese patients

BACKGROUND

Colorectal carcinoma is one of most diagnosed solid malignant carcinoma. The chemotherapy combined with target drugs in the treatment of advanced colorectal cancer in not conclusive.

METHODS

The clinical studies reporting the activity and adverse events between chemotherapy alone versus chemotherapy combined with anti-epidermal growth factor receptor drugs were screened in the databases of Medline, the Cochrane Library, Wanfang and CNKI and included in this meta-analysis. The risk ratio (RR) and its 95% confidence interval (CI) for treatment response and adverse events were pooled by random or fixed effect model.

RESULTS

A total of 10 clinical studies reporting chemotherapy combined with the target in the treatment of advanced colorectal cancer were included in this study. The pooled RR was 3.26 (95% CI: 1.74-6.11, P < 0.05), 1.49 (95% CI: 1.23-1.80) and 1.65 (95% CI: 1.37-1.98) for complete response (CR), partial response and objective response rate, respectively. For nausea and vomiting events, the RR was 1.62 (95% CI: 1.33-1.97, P < 0.05) indicating higher incidence of nausea and vomiting was observed in the combined group compared with chemotherapy alone. However, the diarrhea (RR = 1.10, 95% CI: 0.86-1.42, P > 0.05), liver function damage (RR = 1.03, 95% CI: 0.74-1.42), myelosuppression (RR = 1.04, 95% CI: 0.83-1.31) and neurotoxicity (RR = 1.12, 95% CI: 0.93-1.35) were not different between the two groups.

CONCLUSION

For Chinese patients with advanced colorectal cancer, chemotherapy combined with target drug can improve the response rate, but also increase the risk of nausea and vomiting.

Proposed long-range empirical potential to study the metallic glasses in the Ni-Nb-Ta system

An n-body potential is constructed for the Ni-Nb-Ta ternary metal system in the newly proposed form of long-range empirical potential. The constructed Ni-Nb-Ta potential can well reproduce the lattice constants, cohesive energies, and elastic modulus of the metals and some compounds as well as the equations of state of the system. Applying the constructed Ni-Nb-Ta potential, molecular dynamics simulations and Voronoi tessellations are carried out to study the issues related to the Ni-Nb-Ta metallic glasses. It is found that increasing the Ni content can obviously improve the glass-forming ability of the binary Nb-Ta system, which features a isomorphous phase diagram unfavoring for forming glass, indicating that the Ni solute plays a decisive role in forming the Nb-based or Ta-based Ni-Nb-Ta metallic glasses. Concerning the atomic structure, the Voronoi cell volume and coordination number (CN) of Ta are generally larger than those of Ni in the binary Ni-Ta metallic glasses. With increasing the Ni concentration, the fraction of icosidihedron (CN=13) increases, while the fractions of icosihexahedron (CN=15) and icosioctahedron (CN=16) decrease. Meanwhile, with increasing the Ni concentration, the dominating coordination numbers of Ta atoms increase. Interestingly, similar feature in the atomic structure with variation of Ni concentration is also observed in the Ni-Nb metallic glasses. For the ternary Ni-Nb-Ta alloys, it is observed from the CN distributions that the structure of the metallic glasses is mostly affected by the Ni concentration.