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Salehi AM, Wang L, Gu X, Coates PJ, Norberg Spaak L, Sgaramella N, Nylander K. Patients with oral tongue squamous cell carcinoma and co‑existing diabetes exhibit lower recurrence rates and improved survival: Implications for treatment. Oncol Lett 2024; 27:142. [PMID: 38385115 PMCID: PMC10877229 DOI: 10.3892/ol.2024.14275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/17/2024] [Indexed: 02/23/2024] Open
Abstract
Locoregional recurrences and distant metastases are major problems for patients with squamous cell carcinoma of the head and neck (SCCHN). Because SCCHN is a heterogeneous group of tumours with varying characteristics, the present study concentrated on the subgroup of squamous cell carcinoma of the oral tongue (SCCOT) to investigate the use of machine learning approaches to predict the risk of recurrence from routine clinical data available at diagnosis. The approach also identified the most important parameters that identify and classify recurrence risk. A total of 66 patients with SCCOT were included. Clinical data available at diagnosis were analysed using statistical analysis and machine learning approaches. Tumour recurrence was associated with T stage (P=0.001), radiological neck metastasis (P=0.010) and diabetes (P=0.003). A machine learning model based on the random forest algorithm and with attendant explainability was used. Whilst patients with diabetes were overrepresented in the SCCOT cohort, diabetics had lower recurrence rates (P=0.015 after adjusting for age and other clinical features) and an improved 2-year survival (P=0.025) compared with non-diabetics. Clinical, radiological and histological data available at diagnosis were used to establish a prognostic model for patients with SCCOT. Using machine learning to predict recurrence produced a classification model with 71.2% accuracy. Notably, one of the findings of the feature importance rankings of the model was that diabetics exhibited less recurrence and improved survival compared with non-diabetics, even after accounting for the independent prognostic variables of tumour size and patient age at diagnosis. These data imply that the therapeutic manipulation of glucose levels used to treat diabetes may be useful for patients with SCCOT regardless of their diabetic status. Further studies are warranted to investigate the impact of diabetes in other SCCHN subtypes.
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Affiliation(s)
- Amir M. Salehi
- Department of Medical Biosciences/Pathology, Umeå University, SE 901 85 Umeå, Sweden
| | - Lixiao Wang
- Department of Medical Biosciences/Pathology, Umeå University, SE 901 85 Umeå, Sweden
| | - Xiaolian Gu
- Department of Medical Biosciences/Pathology, Umeå University, SE 901 85 Umeå, Sweden
| | - Philip J. Coates
- Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno 656 53, Czech Republic
| | - Lena Norberg Spaak
- Department of Medical Biosciences/Pathology, Umeå University, SE 901 85 Umeå, Sweden
| | - Nicola Sgaramella
- Department of Medical Biosciences/Pathology, Umeå University, SE 901 85 Umeå, Sweden
- Department of Oral and Maxillo-Facial Surgery, Mater Dei Hospital, I-70125 Bari, Italy
| | - Karin Nylander
- Department of Medical Biosciences/Pathology, Umeå University, SE 901 85 Umeå, Sweden
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Zhang Y, Liu Y, Gu X, Wang N, Wan J, Zhang Y, Chen L. [Epidemiological and clinical features of newly reported advanced schistosomiasis cases in Sichuan Province from 2011 to 2022]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2024; 35:621-625. [PMID: 38413023 DOI: 10.16250/j.32.1374.2023148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
OBJECTIVE To analyze the epidemiological characteristics of newly reported advanced schistosomiasis cases in Sichuan Province, so as to provide the evidence for analyzing the causes and formulating targeted control measures of newly reported advanced schistosomiasis cases. METHODS Individual case investigation forms for advanced schistosomiasis cases were collected from the Sichuan Provincial Epidemic Annual Report System from 2011 to 2022, and patients' demographics, previous medical history and liver parenchymal grading were retrieved. All advanced schistosomiasis cases' medical records were reviewed, and the subtypes of schistosomiasis-endemic villages where the cases' household registration were, floating population, survival and death and time of death were collected. RESULTS A total of 321 newly reported advanced schistosomiasis cases were found in Sichuan Province from 2011 to 2022, with a male to female ratio of 0.99 to 1. There were 274 cases at ages of over 50 years (85.4%), with the highest proportion seen at ages of 60 to 69 years (87 cases, 27.1%), and splenomegaly was the most common type (180 cases, 56.1%), with no dwarfism type detected. The highest number of cases was reported in 2011 (78 cases), followed by in 2022 (74 cases), and the highest number of cases were reported in Meishan City (199 cases, 62.0%), Dongpo District (131 cases, 40.8%), and hilly subtype areas (136 cases, 42.4%). As of the end of 2022, there were 111 deaths due to advanced schistosomiasis, with the highest number of deaths seen in 2018 (25 deaths), and the highest mortality was seen among patients with the ascites type (41.2%). There were 47 (37.3%), 40 (59.5%) and 4 (23.5%) cases with grade III liver parenchyma among patients with splenomegaly, ascites, and colonic proliferation types, respectively, and there was a significant difference in the grading of III liver parenchyma among three types of patients (H = 12.092, P < 0.05), with more severe liver parenchyma injuries seen among patients with the ascites type than among those with splenomegaly and colonic proliferation type (Z = 24.262 and 44.738, both Padjusted values < 0.05). CONCLUSIONS There have been newly reported advanced schistosomiasis cases in Sichuan Province during recent years, and patients with the ascites type should be given a high priority among advanced schistosomiasis cases in Sichuan Province. Intensified clue surveys are needed for early identification and treatment of advanced schistosomiasis cases, so as to increase the survival rate and improve the quality of life.
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Affiliation(s)
- Y Zhang
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 610000, China
| | - Y Liu
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 610000, China
| | - X Gu
- Zhongjiang County Station of Schistosomiasis Prevention and Control, Deyang City, Sichuan Province, China
| | - N Wang
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 610000, China
| | - J Wan
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 610000, China
| | - Y Zhang
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 610000, China
| | - L Chen
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 610000, China
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Gu X, Li W, Jiang X, Chang C, Wu J. Pectin-coated whey protein isolate/zein self-aggregated nanoparticles as curcumin delivery vehicles: Effects of heating, pH, and adding sequence. Int J Biol Macromol 2024; 258:128892. [PMID: 38134988 DOI: 10.1016/j.ijbiomac.2023.128892] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/15/2023] [Accepted: 12/17/2023] [Indexed: 12/24/2023]
Abstract
In this work, pectin was employed as a coating material to fabricate zein/whey protein isolate (WPI)/pectin complex nanoparticles via a pH-adjusted and heat-induced electrostatic adsorption process for potential oral administration applications of curcumin. Factors such as the order of raw material addition, heating temperature and pH, and zein concentration were comprehensively examined. In addition to electrostatic interactions, Fourier transform infrared and fluorescence spectroscopy indicated that hydrophobic interactions and hydrogen bonds were also involved in the development of complex nanoparticles. The complex nanoparticles obtained not only improved the antioxidant activity of curcumin in aqueous phase, but also contributed to its controlled release under gastrointestinal conditions. Our findings revealed that the heating pH and adding sequence of raw materials had a notable impact on the properties of complex nanoparticles, and that pectin coating had an exceptional stabilizing effect on complex nanoparticles under gastrointestinal circumstances. This study provides novel insights and perspectives for the preparation of polysaccharide-protein complex nanoparticles, signifying the potential use of zein/WPI/pectin complex nanoparticles as delivery vehicles in the functional food and pharmaceutical industries.
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Affiliation(s)
- Xiaolian Gu
- College of Food Science and Engineering, Wuhan Polytechnic University, Wuhan 430023, China
| | - Wanbing Li
- College of Food Science and Engineering, Wuhan Polytechnic University, Wuhan 430023, China
| | - Xiaoyu Jiang
- College of Food Science and Engineering, Wuhan Polytechnic University, Wuhan 430023, China
| | - Chao Chang
- College of Food Science and Engineering, Wuhan Polytechnic University, Wuhan 430023, China; Key Laboratory of Intensive Processing of Staple Grain and Oil, Ministry of Education, Key Laboratory for Processing and Transformation of Agricultural Products, Wuhan Polytechnic University, Wuhan 430023, Hubei, China.
| | - Jine Wu
- College of Food Science and Engineering, Wuhan Polytechnic University, Wuhan 430023, China; Key Laboratory of Intensive Processing of Staple Grain and Oil, Ministry of Education, Key Laboratory for Processing and Transformation of Agricultural Products, Wuhan Polytechnic University, Wuhan 430023, Hubei, China.
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Jing S, Dai Z, Wu Y, Liu X, Ren T, Liu X, Zhang L, Fu J, Chen X, Xiao W, Wang H, Huang Y, Qu Y, Wang W, Gu X, Ma L, Zhang S, Yu Y, Li L, Han Z, Su X, Qiao Y, Wang C. Prevalence and influencing factors of depressive and anxiety symptoms among hospital-based healthcare workers during the surge period of the COVID-19 pandemic in the Chinese mainland: a multicenter cross-sectional study. QJM 2023; 116:911-922. [PMID: 37561096 DOI: 10.1093/qjmed/hcad188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/06/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND From November 2022 to February 2023, the Chinese mainland experienced a surge in COVID-19 infection and hospitalization, and the hospital-based healthcare workers (HCWs) might suffer serious psychological crisis during this period. This study aims to assess the depressive and anxiety symptoms among HCWs during the surge of COVID-19 pandemic and to provide possible reference on protecting mental health of HCWs in future infectious disease outbreaks. METHODS A multicenter cross-sectional study was carried out among hospital-based HCWs in the Chinese mainland from 5 January to 9 February 2023. The PHQ-9 (nine-item Patient Health Questionnaire) and GAD-7 (seven-item Generalized Anxiety Disorder Questionnaire) were used to measure depressive and anxiety symptoms. Ordinal logistic regression analysis was performed to identify influencing factors. RESULTS A total of 6522 hospital-based HCWs in the Chinse mainland were included in this survey. The prevalence of depressive symptoms among the HCWs was 70.75%, and anxiety symptoms was 47.87%. The HCWs who perceived higher risk of COVID-19 infection and those who had higher work intensity were more likely to experience depressive and anxiety symptoms. Additionally, higher levels of mindfulness, resilience and perceived social support were negatively associated with depressive and anxiety symptoms. CONCLUSION This study revealed that a high proportion of HCWs in the Chinese mainland suffered from mental health disturbances during the surge of the COVID-19 pandemic. Resilience, mindfulness and perceived social support are important protective factors of HCWs' mental health. Tailored interventions, such as mindfulness practice, should be implemented to alleviate psychological symptoms of HCWs during the COVID-19 pandemic or other similar events in the future.
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Affiliation(s)
- S Jing
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Z Dai
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Y Wu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - X Liu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - T Ren
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - X Liu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - L Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - J Fu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - X Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - W Xiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - H Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Y Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Y Qu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - W Wang
- School of Nursing, Jining Medical University, Jining, Shandong, China
| | - X Gu
- Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi, China
| | - L Ma
- Public Health School, Dalian Medical University, Dalian, China
| | - S Zhang
- Henan Cancer Hospital, Affiliate Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Y Yu
- The First Affiliated Hospital of Baotou Medical College, Baotou, Inner Mongolia Autonomous Region, China
| | - L Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong, China
| | - Z Han
- China Foreign Affairs University, Beijing, China
| | - X Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Y Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Department of Epidemiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - C Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Chinese Academy of Engineering, Beijing, China
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Gonçalves M, Khera T, Otu HH, Narayanan S, Dillon ST, Shanker A, Gu X, Jung Y, Ngo LH, Marcantonio ER, Libermann TA, Subramaniam B. Multivariable model of postoperative delirium in cardiac surgery patients: proteomic and demographic contributions. medRxiv 2023:2023.05.30.23289741. [PMID: 37333093 PMCID: PMC10274980 DOI: 10.1101/2023.05.30.23289741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Background Delirium following cardiac surgery is common, morbid, and costly, but may be prevented with risk stratification and targeted intervention. Preoperative protein signatures may identify patients at increased risk for worse postoperative outcomes, including delirium. In this study, we aimed to identify plasma protein biomarkers and develop a predictive model for postoperative delirium in older patients undergoing cardiac surgery, while also uncovering possible pathophysiological mechanisms. Methods SOMAscan analysis of 1,305 proteins in the plasma from 57 older adults undergoing cardiac surgery requiring cardiopulmonary bypass was conducted to define delirium-specific protein signatures at baseline (PREOP) and postoperative day 2 (POD2). Selected proteins were validated in 115 patients using the ELLA multiplex immunoassay platform. Proteins were combined with clinical and demographic variables to build multivariable models that estimate the risk of postoperative delirium and bring light to the underlying pathophysiology. Results A total of 115 and 85 proteins from SOMAscan analyses were found altered in delirious patients at PREOP and POD2, respectively (p<0.05). Using four criteria including associations with surgery, delirium, and biological plausibility, 12 biomarker candidates (Tukey's fold change (|tFC|)>1.4, Benjamini-Hochberg (BH)-p<0.01) were selected for ELLA multiplex validation. Eight proteins were significantly altered at PREOP, and seven proteins at POD2 (p<0.05), in patients who developed postoperative delirium compared to non-delirious patients. Statistical analyses of model fit resulted in the selection of a combination of age, sex, and three proteins (angiopoietin-2 (ANGPT2); C-C motif chemokine 5 (CCL5); and metalloproteinase inhibitor 1 (TIMP1); AUC=0.829) as the best performing predictive model for delirium at PREOP. The delirium-associated proteins identified as biomarker candidates are involved with inflammation, glial dysfunction, vascularization, and hemostasis, highlighting the multifactorial pathophysiology of delirium. Conclusion Our study proposes a model of postoperative delirium that includes a combination of older age, female sex, and altered levels of three proteins. Our results support the identification of patients at higher risk of developing postoperative delirium after cardiac surgery and provide insights on the underlying pathophysiology. ClinicalTrials.gov ( NCT02546765 ).
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Yang Z, Zamarud A, Marianayagam N, Park D, Yener U, Soltys SG, Chang SD, Meola A, Lu W, Gu X. Overall Survival Prediction in Stereotactic Radiosurgery Patients with Glioblastoma Via a Deep-Learning Approach. Int J Radiat Oncol Biol Phys 2023; 117:e159. [PMID: 37784752 DOI: 10.1016/j.ijrobp.2023.06.988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Accurate and automated early survival prediction is critical for glioblastoma (GBM) patients as their poor prognosis requires timely treatment decision-making. We have developed a deep learning (DL)-based GBM overall survival (OS) prediction model based on a multi-institutional public dataset using only pre-operative basic structural multi-parametric magnetic resonance images (MRIs). The purpose of this study is to evaluate this DL-based OS prediction model with an institutional stereotactic radiosurgery (SRS) clinical trial dataset. MATERIALS/METHODS The task of this study is to classify GBM patients into 3 OS classes: long-survivors (>15 months), mid-survivors (between 10 and 15 months) and short-survivors (< 10 months). The proposed OS prediction model is an ensemble of a ResNet-based classifier and a K-NN classifier. The ResNet-based classifier is trained in a Siamese fashion to explore inter-class differences. During testing, training sample features are implemented with a K-NN classifier to ensemble with the ResNet-based classifier. A public dataset from Medical Image Computing and Computer Assisted Intervention (MICCAI) Brain Tumor Segmentation (BraTS) challenge 2020 (235 patients) were used for model establishing and initial validation. Then the validated model was evaluated on 19 GBM patients from an institutional SRS clinical trial. Each data entry consists of pre-operative basic structural multi-parametric MRIs and survival days, as well as patient ages for BraTS data and basic clinical characteristics for institutional data. GBM sub-regions, including contrast-enhancing tumor, peri-tumoral edema, and necrotic/non-enhancing tumor core, were segmented in the multi-parametric MRIs by an in-house DL model for both datasets. The OS prediction model was trained on 90% of the segmented BraTS data and validated on the rest 10%, then further evaluated on the institutional data. The model performance was assessed by prediction accuracy (ACC) and the area under the curve (AUC). RESULTS For this 3-class OS classification task, our DL-based prediction model achieved an ACC of 65.22% and an AUC of 0.81 on the BraTS dataset compared with the top-ranked result from the BraTS challenge 2020 (Rank 1st: ACC 61.7%), and an ACC of 52.63% and an AUC of 0.69 on the institutional dataset. Further analysis of the institutional dataset found that the predicted OS class had a statistically significant correlation with treatment volume (p = 0.012) and age (p = 0.006), which matches the analysis that the patients' ground truth OS class is statistical significantly correlated with treatment volume (p = 0.045). CONCLUSION Our DL-based OS prediction model for GBM using basic structural multi-parametric pre-operative MRIs has demonstrated promising performance in both public and institutional dataset with minimal manual processing requirements. This OS prediction model can be potentially applied to assist timely clinical decision-making.
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Affiliation(s)
- Z Yang
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - A Zamarud
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA
| | - N Marianayagam
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA
| | - D Park
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA
| | - U Yener
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA
| | - S G Soltys
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S D Chang
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA
| | - A Meola
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA
| | - W Lu
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - X Gu
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX; Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Montalvo SK, Ravella R, Zhang-Velten ER, Li X, Desai NB, Dan T, Timmerman RD, Jiang SB, Gu X, Parsons DDM, Kumar KA. Cardiac Sparing with Volumetric Modulated Arc Therapy Enabled Total Body Irradiation (CS VMAT-TBI). Int J Radiat Oncol Biol Phys 2023; 117:e477-e478. [PMID: 37785513 DOI: 10.1016/j.ijrobp.2023.06.1693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Volumetric modulated arc therapy (VMAT) enabled total body irradiation (TBI) has replaced conventional TBI in our institution given the improved treatment accuracy, patient comfort, and dose modulation ability. The risk of cardiovascular disease is several folds higher among transplant patients who receive TBI, likely related to dose to the heart. We hypothesize that a cardiac-sparing (CS) VMAT-TBI technique is feasible and can meaningfully reduce dose to the heart while still adequately covering nearby lymphatic tissue. MATERIALS/METHODS VMAT-TBI is delivered via multi-isocentric external beams in a frame-based setup. Heart is contoured as per published guidelines. A lymph node contour, which includes tonsils, neck nodal stations, mediastinal, abdominal, retroperitoneal, and pelvic nodes is created. Coverage of the lymph node contour is prioritized over organ-sparing during inverse optimization; with a goal of V90% greater than 99.5% and mean dose less than 800 cGy for the lymph nodes and heart, respectively. An IRB-approved retrospective review was performed with mean heart dose collected for all patients treated with CS VMAT-TBI and compared to a representative cohort of five patients treated with VMAT-TBI without cardiac sparing. RESULTS Thirty-one patients were treated with CS VMAT-TBI between 2020-2022 with a median follow up time of 11.5 months. Mean heart dose was 796 ± 71 cGy in the CS VMAT-TBI compared to 1247 ± 29 cGy in the VMAT-TBI group without cardiac sparing (p < 0.001). Of those treated with CS VMAT-TBI, three patients relapsed; one relapse occurred in bone marrow only, one relapse occurred in bone marrow and cervical, thoracic, and intra-abdominal lymphoid tissues, and one patient was simulated but never received induction therapy due to overt progression. 100-day relapse-free survival and overall survival were 82.5% and 86.2%, respectively. Median survival time has not been met. CONCLUSION Cardiac sparing is feasible in VMAT-TBI and is associated with significant decrease in mean heart dose of ∼450 cGy. This is estimated to confer a 33.3% decreased absolute risk for lifetime major coronary events compared to patients treated with VMAT-TBI without cardiac sparing. Although limited by short follow-up time, there does not appear to be a significant risk for early relapse despite de-escalating cardiac tissue, likely due to prioritizing coverage of lymph nodes. Prospective clinical studies are needed to further validate cardiac and other organ at risk sparing VMAT-TBI techniques.
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Affiliation(s)
- S K Montalvo
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - R Ravella
- UT Southwestern Medical Center, Dallas, TX
| | - E R Zhang-Velten
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - X Li
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - N B Desai
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - T Dan
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - R D Timmerman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - S B Jiang
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - X Gu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - D D M Parsons
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - K A Kumar
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
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Jiang H, Fu J, Melemenidis S, Viswanathan V, Dutt S, Lau B, Soto LA, Manjappa R, Skinner L, Yu SJ, Surucu M, Graves EE, Casey K, Rankin E, Lu W, Loo BW, Gu X. An Online AI-Powered Interactive Histological Image Annotation Platform for Analyzing Intestinal Regenerating Crypts in Post-Irradiated Mice. Int J Radiat Oncol Biol Phys 2023; 117:e676. [PMID: 37785993 DOI: 10.1016/j.ijrobp.2023.06.2130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The goal of this project is to build an online AI-powered interactive annotation platform to accurately and efficiently annotate intestinal regenerating crypts in histological images of mice after abdominal irradiation. MATERIALS/METHODS The proposed platform is developed by the seamless integration of a front-end web client and a back-end server. Such client/server design allows the users to access the platform without software installation on local computers. Our front-end client is developed with SvelteJS + WebGL technology stack, allowing access from any common web browsers and enabling user interaction, such as image importing/visualization, interactive crypt annotating, and annotation saving/deleting. The back-end server is responsible for executing the tasks requested from the web client, for instance, image pre-processing, AI-based crypts automatic identification, and database management. The image preprocessing is designed to extract a single cross section image using morphological operations because multiple hematoxylin and eosin (H&E) stained jejunum cross sections from post-irradiated mice are scanned within one slide. The auto-crypt identification is powered by a trained and validated AI engine U-Net, classifying image grid tiles into two groups with and without regenerating crypts. The database is implemented with the self-contained SQLite to support recording and indexing the annotated grid tiles with regenerating crypts. The workflow for crypt analysis on this interactive platform has 5 steps: 1) manually import a whole H&E slide image; 2) auto-preprocess the slide by extracting single cross-section images; 3) auto-identify regenerating crypts with an AI engine; 4) interactively annotate (add, delete, modify) auto-identified crypt markers; 5) save and/or output the annotation to the database or the local drive. RESULTS The performance of the developed interactive crypt analysis platform was evaluated in aspects of accuracy and efficiency. The AI-powered crypt auto-identification accuracy was assessed by computing the mean absolute error (MAE) on crypt number per cross section between manual and auto annotation using a testing dataset containing 80 cross sections. It achieved an MAE of 3.5±4.8 crypts per cross section, and 81.25% of the cross sections have no more than 5 crypts difference. The efficiency was assessed under two conditions with the server on the cloud and a local computer. It took about 2-3 minutes to finish the entire workflow on the cloud, while 1-2 minutes on the local by saving ∼1 minute on image uploading. CONCLUSION The developed web client/server platform enables online automatic identification and interactive annotation of mice crypts in minutes. It is a convenient tool that allows accurate and efficient crypt analysis and can be extended for other histologic image analyses.
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Affiliation(s)
| | - J Fu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S Melemenidis
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - V Viswanathan
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S Dutt
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - B Lau
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L A Soto
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - R Manjappa
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Skinner
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S J Yu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M Surucu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - E E Graves
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - K Casey
- Department of Comparative Medicine, Stanford University School of Medicine, Stanford, CA
| | - E Rankin
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - W Lu
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - B W Loo
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - X Gu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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9
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Cai S, Xie L, Li M, Gu X, Tian Y. Green Tea Derivative (-)-Epigallocatechin-3-Gallate (EGCG) for Prevention of Acute Radiation-Induced Intestinal Injury: A Prospective Phase II Clinical Study in Pelvic Cancer Patients. Int J Radiat Oncol Biol Phys 2023; 117:e505. [PMID: 37785584 DOI: 10.1016/j.ijrobp.2023.06.1755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiation-induced intestinal injury (RIII) remains the most common dose-limiting toxicity following radiotherapy (RT) for pelvic malignancies. However, few efficient and safe methods for the prevention of RIII are available in the clinical practice. Our previous study proved that the green tea polyphenol (-)-epigallocatechin-3-gallate (EGCG) efficiently attenuates radiation-induced intestinal injury (RIII) in animal level. Therefore, this prospective phase II clinical study (ChiCTR2100053703) evaluated the efficacy of EGCG in the prevention of RIII. MATERIALS/METHODS Cervical or endometrial cancer patients who received adjuvant or radical RT in our department were enrolled, 400mg EGCG was taken daily, and RIII was evaluated weekly according to the RTOG criteria. RESULTS Between February 2022 to January 2023, 37 patients were enrolled (30 were cervical cancer and the other 7 were endometrial cancer), and were followed-up regularly. Among them, the majority patients (75.7%, 28 patients) developed grade 0 or 1 RIII, for which no medical intervention was required. Meanwhile, the occurrence of grade 2 RIII was 24.3% (9 patients), which was significantly lower than that in the historical controls (usually 60% to 80%). Besides that, no patients developed grade 3 or worse RIII. CONCLUSION In this phase II clinical trial, compared to historical controls, the prophylactic use of EGCG significantly reduced the incidence and severity of RIII in patients receiving pelvic RT. Therefore, EGCG has the potential to become a novel medical countermeasure for the prevention of RIII for pelvic cancer patients.
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Affiliation(s)
- S Cai
- Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - L Xie
- Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - M Li
- Soochow University, Suzhou, China
| | - X Gu
- The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Y Tian
- Department of Radiotherapy and Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, China
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10
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Rahimi AS, Kim N, Leitch M, Gu X, Parsons DDM, Nwachukwu CR, Alluri PG, Lu W, Nichols EM, Becker SJ, Ahn C, Zhang Y, Spangler A, Farr D, Wooldridge R, Bahrami S, Stojadinovic S, Lieberman M, Neufeld S, Timmerman RD. Multi-Institutional Phase II Trial Using Dose Escalated Five Fraction Stereotactic Partial Breast Irradiation (S-PBI) with GammaPod TM for Early-Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e203. [PMID: 37784857 DOI: 10.1016/j.ijrobp.2023.06.1082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) We report on our early experience of a multi-institutional phase II study of dose escalated five fraction stereotactic partial breast irradiation (S-PBI) for early-stage breast cancer after partial mastectomy using the GammaPodTM stereotactic radiation system. MATERIALS/METHODS Patient eligibility included DCIS or invasive epithelial histologies, AJCC clinical stage 0, I, or II with tumor size < 3 cm, and negative margins. Prior safety of Phase I dose escalation has been reported. Dose was 40 Gy delivered in 5 fractions to the CTV, and minimum dose 30 Gy in 5 fractions to the PTV. CTV margin was 1 cm and PTV margin 3 mm. For PTV cavities larger than 100cc, dose was reduced to 35Gy in 5 fractions to the CTV and 30 Gy in 5 fractions to the PTV. Primary endpoint of the study is to determine the 3-year patient global cosmesis score (4-point scale excellent, good, fair, or poor) and adverse cosmesis using a dose escalated approach with smaller PTV margins than conventional methods. Both patients and physicians completed baseline and subsequent cosmesis outcome questionnaires. Treatment related toxicity was graded using the NCI version 4.0 and RTOG/EORTC late radiation scale. RESULTS From 3/2019-10/2021, 74 patients were treated respectively. Of these, 38 were treated to 40Gy and 36 were treated to 35 Gy. Median follow up (f/u) was 24 months (mo), range (r) 3-39mo. Median age was 63 years (r 43-77). Histology included 28 DCIS, and 46 invasive carcinomas. 45/46 invasive tumors were ER+. 60/74 (81%) patients received endocrine therapy, and 7/74 patient received chemotherapy. There were 221 acute grade 1 toxicities, and 28 Grade 2 toxicities. No grade 3 or higher acute toxicities were reported (< 90 days). The most common Grade 2 toxicities were radiation dermatitis (10), breast pain (8), blister (4), skin infection (2), nipple discharge (2), and fatigue (2). In the late period, there were 54 Grade 1 late toxicities, 4 Grade 2 late toxicities, and no Grade 3 or higher late toxicities. Grade 2 toxicities included fibrosis (2), and pain (2). Two patients developed grade 1 asymptomatic nonpalpable fat necrosis both diagnosed at 12 months after radiation treatments. The most common grade 1 late toxicities were breast pain (14), hyperpigmentation (8), fibrosis (10), and fatigue (5). Physicians scored cosmesis excellent or good 70/73 (95.8%), 58/60 (96.7%), 36/36 (100%),17/17(100%) respectively at baseline, 12 months, 24 months, and 36months post SBRT, while patients scored the same periods 62/71 (83.7%), 53/59 (89.8%), 33/36 (91.6%), 17/18 (94.4%). There have been no reports of disease recurrences. CONCLUSION Results at 24-month median follow-up, of our dose escalated stereotactic partial breast 5 fraction regimen, has low acute and late toxicity, while maintaining high proportion of excellent/good cosmetic outcomes. Continued analysis of all cohorts is in progress. CLINICAL TRIALS gov identifier is NCT03581136.
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Affiliation(s)
- A S Rahimi
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - N Kim
- Vanderbilt University Department of Radiation Oncology, Nashville, TN
| | - M Leitch
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - X Gu
- Stanford University Department of Radiation Oncology, Palo Alto, CA
| | - D D M Parsons
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - C R Nwachukwu
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - P G Alluri
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - W Lu
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - E M Nichols
- University of Maryland School of Medicine, Baltimore, MD
| | - S J Becker
- University of Maryland School of Medicine, Baltimore, MD
| | - C Ahn
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | - Y Zhang
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - A Spangler
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - D Farr
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - R Wooldridge
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Bahrami
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Stojadinovic
- University of Texas Southwestern Medical Center, Dallas, TX
| | - M Lieberman
- University of Texas Southwestern Medical Center, Dallas, TX
| | - S Neufeld
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - R D Timmerman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
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11
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Fu J, Jiang H, Melemenidis S, Viswanathan V, Dutt S, Lau B, Soto LA, Manjappa R, Skinner L, Yu SJ, Surucu M, Graves EE, Casey K, Rankin E, Lu W, Loo BW, Gu X. Deep Learning-Based Pipeline for Automatic Identification of Intestinal Regenerating Crypts in Mouse Histological Images. Int J Radiat Oncol Biol Phys 2023; 117:S117-S118. [PMID: 37784305 DOI: 10.1016/j.ijrobp.2023.06.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) A classical approach for evaluating normal tissue radiation response is to count the number of intestinal regenerating crypts in mouse histological images acquired after abdominal radiation. However, manual counting is time-consuming and subject to inter-observer variations. The goal of this study is to build a deep learning-based pipeline for automatically identifying intestinal regenerating crypts to facilitate high-throughput studies. MATERIALS/METHODS Sixty-six healthy C57BL/6 female mice underwent 16 MeV whole abdominal electron irradiation. The small bowel was collected from each mouse 4 days post-irradiation, and 9 jejunal cross-sections from each were processed together in a single slide. The slides were stained with hematoxylin and eosin (H&E) and subsequently scanned (x20), providing one electronic histological image per mouse. Regenerating crypts, consisting of more than 10 basophilic crypt epithelial cells, were manually identified using point annotations in histological images. The pipeline was built to take the input of the image containing 9 cross sections and automatically identify the regenerating crypts on each cross section. It mainly consists of two components, cross section segmentation using intensity thresholding and morphological operations and crypt identification using a UNet. The dataset was randomly split into 46, 10, and 10 slide images for UNet training, validation, and testing. Each slide image was split into grid tiles with a voxel size of 200 × 200, and 40 × 40 square masks were placed with centers at manual point annotations on tiles with regenerating crypts. 5203/5198 tiles (w/wo crypt mask) were extracted to train UNet by minimizing dice loss. The mask probability map generated by the UNet was post-processed to identify the crypt position. Postprocessing hyperparameters were tuned using the validation dataset. The model accuracy was evaluated using the testing dataset by computing the mean absolute error (MAE) of the crypt number averaged across all cross sections. RESULTS The number of regenerating crypts on testing cross sections ranges from 1 to 63. The testing cross-section-wise MAE achieved by the platform is 3.5±4.8 crypts. 81.25% of testing cross sections have absolute number differences less than or equal to 5 crypts. CONCLUSION Our established deep learning-based pipeline can accurately count the number of regenerating crypts in mouse intestinal histological images. We have integrated it into an online platform that enables automatic crypt identification and allows users to interactively modify auto-identified crypt annotations. The acquired annotations from the platform will be used to finetune the deep learning model to achieve better identification performance.
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Affiliation(s)
- J Fu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | | | - S Melemenidis
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - V Viswanathan
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S Dutt
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - B Lau
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L A Soto
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - R Manjappa
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Skinner
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S J Yu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M Surucu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - E E Graves
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - K Casey
- Department of Comparative Medicine, Stanford University School of Medicine, Stanford, CA
| | - E Rankin
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - W Lu
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - B W Loo
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - X Gu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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12
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Yang Z, Fu J, Melemenidis S, Viswanathan V, Dutt S, Lau B, Soto LA, Manjappa R, Skinner L, Yu SJ, Surucu M, Casey K, Rankin E, Lu W, Jr BWL, Gu X. Equivalent Dose Estimation in FLASH Irradiation with a Deep Learning Approach. Int J Radiat Oncol Biol Phys 2023; 117:e272. [PMID: 37785029 DOI: 10.1016/j.ijrobp.2023.06.1241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Ultra-high dose rate (FLASH) irradiation has been reported to provide decreased normal tissue toxicity without compromising tumor control compared with conventional (CONV) irradiation. However, a comprehensive understanding of the FLASH biological effect requires precise quantification of radiobiology. The study is to explore whether deep learning (DL) can tackle the task. As a proof of concept, we investigate a DL model for estimating FLASH dose to its equivalent CONV dose. MATERIALS/METHODS Healthy C57Bl/6 female mice underwent FLASH (200Gy/s; n = 43) or CONV (0.12Gy/s; n = 41) whole abdominal irradiation using ∼16 MeV electron beams with a dose escalation scheme of 5 groups (n = 8 or 9) at 1Gy increments: 12-16Gy FLASH, 11-15Gy CONV. 4 days post-irradiation, 9 jejunum cross-sections per mouse were H&E stained for histological analysis. Each cross-section image was processed to remove lumen background and oversampled into multiple large-scale and small-scale patches along jejunal circumference. In CONV dataset, we randomly selected the data of 32 mice (80%) for model training and the rest (20%) for model validation. A ResNet101-based DL model, pre-trained with an unsupervised contrastive learning scheme, was retrained with only CONV training set to estimate corresponding CONV dose. For comparison, a crypt counting (CC) approach was implemented by manually counting the number of regenerating crypts on each cross-section image. An exponential function of dose vs crypt number was fitted with the CONV training set and used for dose estimation on the testing set. Mean squared error (MSE) was used to assess the accuracy of DL and CC approaches in estimating dose levels in CONV irradiation. The validated DL model was applied to the FLASH set to project FLASH dose into corresponding CONV dose that results in equivalent biological response. RESULTS The CONV dose estimated by DL and CC approaches and DL-estimated FLASH equivalent dose were summarized in Table 1. The DL model achieved an MSE of 0.21 Gy2 on CONV testing set compared with 0.32 Gy2 of the CC approach. FLASH equivalent dose estimated by DL model for 12, 13, 14, 15 and 16Gy were 12.16±0.40, 12.53±0.32, 12.72±0.24, 12.85±0.20 and 13.04±0.27 Sv, respectively. CONCLUSION Our proposed DL model can accurately estimate the CONV dose based on histological images. The DL predictions of FLASH dataset demonstrate that FLASH may reduce normal tissue toxicity with a lower equivalent dose, especially at high irradiated dose levels. Our study indicates that deep learning can be potentially used to assess the equivalent dose of FLASH irradiation to normal tissue.
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Affiliation(s)
- Z Yang
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - J Fu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S Melemenidis
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - V Viswanathan
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S Dutt
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - B Lau
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L A Soto
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - R Manjappa
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Skinner
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S J Yu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M Surucu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - K Casey
- Department of Comparative Medicine, Stanford University School of Medicine, Stanford, CA
| | - E Rankin
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - W Lu
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - B W Loo Jr
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - X Gu
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX; Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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13
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Kwon YS, Parsons DDM, Kim N, Lu W, Gu X, Stojadinovic S, Alluri PG, Arbab M, Lin MH, Chen L, Gonzalez Y, Chiu TD, Zhang Y, Timmerman RD, Rahimi AS. Assessment of Cardiac Radiation Dose in the Co-60 Prone Based Stereotactic Partial Breast Irradiation (CP-sPBI) Using the Distance from the Heart to the Planning Treatment Volume as a Surrogate Marker. Int J Radiat Oncol Biol Phys 2023; 117:e682. [PMID: 37786008 DOI: 10.1016/j.ijrobp.2023.06.2144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Irradiation of the breast has shown to provide sharp dose gradients using Co-60 prone based stereotactic partial breast irradiation (CP-sPBI), a contemporary device for stereotactic radiotherapy for breast cancer (BC) for accelerated partial breast irradiation (APBI). In addition, the precise setup of CP-sPBI permits a small planning treatment volume (PTV) margin of 3 mm creating a greater distance from PTV to organs at risk. However, to date the factors that influence dose gradients and subsequent cardiac doses of ionizing radiation using CP-sPBI have not been well-studied. Here we evaluate distance of the heart to the lumpectomy PTV cavity and how this effects cardiac dose. MATERIALS/METHODS A retrospective database of 113 consecutive patients treated by CP-sPBI for APBI from March 2019 to February 2023 who were treated with 30 Gy in 5 fractions were queried for analysis. The minimum distance from the heart to the PTV (hP) was measured in either the axial or sagittal view. A group of 28 patient cases were randomly selected to achieve an even distribution of 28 cases with hP < 2.75 cm and hP ≥ 2.75 cm to compare cardiac toxicities based on hP. Descriptive analyses were performed to evaluate various cardiac dosimetric parameters based on laterality of BC and hP, using the student's t test. RESULTS The mean (range) hP was 4.58 cm (0.80-12.23) for all cases. The subgroup analyses of 28 patient cases with cardiac parameters showed the heart mean (range) dose of 1.20 Gy (0.01-2.11). The mean and max heart dose to the left-sided BC were similar to those to the right-sided BC (mean dose: 1.20 vs. 1.19 Gy; P = 0.97 and max dose: 10.47 vs. 5.66 Gy; P = 0.06). An inverse correlation between hP and mean heart dose was shown with the correlation coefficient of -0.81. Using a cutoff of 2.75 cm hP, the differences between hP < 2.75 and hP ≥ 2.75 cm for all cardiac dosimetric evaluations were all statistically significant, including mean (1.67 vs. 0.79 Gy; p<0.01) and maximal heart dose (14.48 vs. 4.11 Gy; p<0.01) CONCLUSION: CP-sPBI treatment delivery system was able to achieve acceptable clinically relevant heart dosimetric parameters when delivering 5 fraction APBI with a mean heart dose of 1.20 Gy for all locations of PTV cavity volume in the breast. Due to CP-sPBIs excellent dose fall-off characteristics, APBI using CP-SPBI showed clinically acceptable cardiac dosimetric parameters, particularly for PTVs located > 2.75 cm from the heart.
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Affiliation(s)
- Y S Kwon
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - D D M Parsons
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - N Kim
- Vanderbilt University Department of Radiation Oncology, Nashville, TN
| | - W Lu
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - X Gu
- Stanford University Department of Radiation Oncology, Palo Alto, CA
| | - S Stojadinovic
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - P G Alluri
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - M Arbab
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - M H Lin
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - L Chen
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Y Gonzalez
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - T D Chiu
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - Y Zhang
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - R D Timmerman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - A S Rahimi
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
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14
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Simmons A, Sher DJ, Kim N, Leitch M, Haas JA, Gu X, Ahn C, Gao A, Spangler A, Morgan HE, Farr D, Wooldridge R, Seiler S, Goudreau S, Bahrami S, Neufeld S, Mendez C, Lieberman M, Timmerman RD, Rahimi AS. Financial Toxicity and Patient Experience Outcomes on a Multi-Institutional Phase I Single Fraction Stereotactic Partial Breast Irradiation Protocol for Early-Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e259-e260. [PMID: 37784994 DOI: 10.1016/j.ijrobp.2023.06.1212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Given the demonstrated financial toxicity (FT) of radiation treatment on breast cancer patients shown in both conventional and our recent 5 fraction stereotactic APBI (S-PBI) study, we assessed the FT, as well as patient-reported utility, quality-of-life and patient experience measures, on patients treated in our phase I single fraction S-PBI trial. MATERIALS/METHODS A phase I single fraction dose escalation trial of S-PBI for early-stage breast cancer was conducted. Women with in-situ or stage I-II (AJCC 6) invasive breast cancer following breast conserving surgery were treated with S-PBI in 1 fraction to a total dose of 22.5, 26.5 or 30 Gy (Clinical trials.gov ID NCT02685332). At one month follow-up, patients were asked to complete our novel "Patient Perspective Cost and Convenience of Care Questionnaire". Patients also completed the EQ-5D-5L, including the visual analogue scale of overall health (VAS), at enrollment, 6, 12-, 24-, 36-, and 48-month follow-up. RESULTS Of 29 patients enrolled and treated, questionnaire data was available for all patients. Our trial encompassed a wide range of annual household incomes, education, and employment status. Overall, 44.8% (n = 13/29) of patients reported that radiation treatment presented a financial burden. Interestingly, no demographic information, such as patient race, marital status, education, household income, or employment during treatment predicted perceived FT. Patients reporting FT trended towards younger age (median 64 vs 70.5) and having a cancer related co-pay similar to our 5 fraction S-PBI FT trial; however, due to the small size of this study, this did not reach significance (p = 0.24 and 0.10, respectively). VAS and utility scores were calculated per the EQ-5D-5L and remained unchanged from baseline through 4-year follow-up. Likewise, there was no difference in the utility or VAS between patients who reported FT and those who did not. Interestingly, while patient reported cosmesis was similar for all patients at enrollment, patients who reported FT noted significantly worse cosmesis scores (fair/poor vs good/excellent) at 6 month and 2-year follow-ups (p = 0.01 and 0.04, respectively). Finally, patients were surveyed on treatment related disruption to their daily activities and enjoyment of life. The median values were 0 (scale 0-10, with 0 being no disruption) regardless of perceived FT. Patients were also uniformly satisfied with treatment time with a median score of 10 (scale 0-10, 10 being most satisfied). CONCLUSION Here, we show that despite using SPBI in a single fraction, nearly half of the patients treated still reported FT of treatment. Importantly, single fraction S-PBI has no negative impact on patient VAS or utility scores, and all patients were uniformly satisfied with treatment time without significant disruption to their life.
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Affiliation(s)
- A Simmons
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - D J Sher
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - N Kim
- Vanderbilt University Department of Radiation Oncology, Nashville, TN
| | - M Leitch
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - J A Haas
- Department of Radiation Oncology, Perlmutter Cancer Center at New York University Langone Hospital - Long Island, Mineola, NY
| | - X Gu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - C Ahn
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | - A Gao
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | - A Spangler
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | | | - D Farr
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - R Wooldridge
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Seiler
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Goudreau
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Bahrami
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Neufeld
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - C Mendez
- Department of Radiation Oncology, Perlmutter Cancer Center at New York University Langone Hospital - Long Island, Mineola, NY
| | - M Lieberman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - R D Timmerman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - A S Rahimi
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
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15
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Yang Z, Chen M, Kazemimoghadam M, Wardak Z, Chukwuma C, Stojadinovic S, Timmerman RD, Dan T, Lu W, Gu X. Predicting Neurocognitive Decline in Multiple Brain Metastases Patients Undergoing Distributed Stereotactic Radiosurgery. Int J Radiat Oncol Biol Phys 2023; 117:e159. [PMID: 37784751 DOI: 10.1016/j.ijrobp.2023.06.987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Stereotactic radiosurgery (SRS) is the standard of care for treating a limited number (<3) of brain metastasis (BMs), which offers reduced neurotoxicity compared to whole brain radiotherapy (WBRT). Contemporary advancements in SRS made it possible to also commonly treat multiple (>4) BMs (mBMs). Emphasizing the value of preserving quality of life (QoL) after SRS, there is an urgent need for a systematic study of potential neurocognitive decline in patients receiving SRS treatment for mBMs. The purpose of this study is to use routine MRIs to predict neurocognitive decline for patients treated with distributed SRS, allowing for timely and effective treatment strategy design. MATERIALS/METHODS This study uses data from an institutional phase I/II clinical trial to determine the neurocognitive decline in patients with (>6) mBMs treated with distributed SRS. In the first 12 months post-SRS, participants are followed and evaluated with routine MRIs and the Hopkins Verbal Learning Test-Revised (HVLT-R) at 2 to 3-month intervals. Changes in HVLT-Delayed Recall scores between two visits are used to define neurocognitive decline. For each visit, an in-house deep learning model segments 66 cortical and 55 subcortical brain regions of interest (ROIs) from the T1 structural MRI and extracts 253 ROI features, including the surface area and thickness of cortical ROIs, and the volume of all ROIS. The difference in ROI features between two visits, together with other clinical factors (e.g., prescription, number of BMs, etc.), is considered as one sample. The study included 22 subjects with 91 visits, resulting in 171 samples with neurocognitive decline labels. The entire sample set is split into 10 folds on patient level for cross validation. In each fold, feature engineering is conducted to remove redundancy and to select the most-important features. The top 20% most frequently selected features are applied with Support Vector Machine to predict the neurocognitive decline label of each sample. RESULTS As a preliminary result, the proposed method achieves an accuracy of 76%, with an area under the curve (AUC) of 0.75, sensitivity of 0.65 and specificity of 0.83 for predicting neurocognitive decline in mBMs SRS patients using only routine T1 MRIs. The volume of lateral occipital complex, the thickness of inferior parietal lobe and postcentral gyrus, and the surface area of lateral orbitofrontal cortex and pars triangularis are identified as the 5 most important features for this task. CONCLUSION Our method shows promising findings for post-SRS neurocognitive decline prediction solely based on routine baseline and follow-up MRIs. In addition, it can identify critical brain ROIs associated with the post-SRS cognitive function. This method has the potential to assist treatment planning strategy to help preserve patients' QoL.
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Affiliation(s)
- Z Yang
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - M Chen
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - M Kazemimoghadam
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - Z Wardak
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - C Chukwuma
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - S Stojadinovic
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - R D Timmerman
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - T Dan
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - W Lu
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - X Gu
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX; Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Kazemimoghadam M, Yang Z, Chen M, Rahimi AS, Kim DN, Alluri PG, Nwachukwu CR, Lu W, Gu X. A Comprehensive Deep Learning Framework for Automatic Target Volumes Segmentation in Post-Operative Stereotactic Partial Breast Irradiation (S-PBI). Int J Radiat Oncol Biol Phys 2023; 117:e183. [PMID: 37784808 DOI: 10.1016/j.ijrobp.2023.06.1038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) In S-PBI, accurate delineation of post-surgical tumor bed volume (TBV) and clinical target volume (CTV) are crucial tasks to achieve effective radiotherapy outcomes. However, manual contouring is labor intensive, time consuming, and largely relies on the experience of clinicians. We aimed to propose a deep learning (DL) approach which mimics physicians' contouring practice to accurately segment target volumes in post-operative breast CT images. MATERIALS/METHODS Our approach incorporated domain knowledge into a 3D U-Net based DL model for breast target volumes (TBV and CTV) delineation. Our TBV segmentation approach was inspired by the marker-guidance procedure in manual delineation, where the visual clues provided by the markers assist physicians in defining TBV. For this purpose, a distance-transformation coupled with a Gaussian filter was adopted to convert markers' locations on the CT images to saliency maps. Subsequently, the CT images and the corresponding saliency maps formed a two-channel input for the segmentation model. For CTV segmentation, TBV was incorporated as an input in addition to the CT images, guiding the model to encode the location-related image features. The architecture allowed the network to emulate the oncologist's manual delineation where CTV is derived from TBV via a margin expansion, followed by correcting the extensions for anatomical barriers of tumor invasion (e.g., skin, chest wall). We retrospectively collected 175 prone CT images from 35 post-operative breast cancer patients who received 5-fraction partial breast irradiation (PBI) regimen on a Co-60 prone based S-PBI unit. The 35 patients were randomly split into 25, 5, and 5 for model training, validation, and testing respectively. RESULTS We evaluated the performance of the developed DL model on the testing dataset by comparing the predicted volumes with the manually delineated contours (ground truth) using Dice similarity coefficient (DSC), 95th percentile Hausdorff distance (HD95), and average symmetric surface distance (ASD). For TBV segmentation, our model achieved mean (standard deviation) of 0.76 (±2.7), 6.76 (±1.83) mm, and 1.9 (±0.66) mm for DSC, HD95, and ASD respectively. For CTV segmentation, our model achieved 0.94 (±0.02), 2.46 (±0.5) mm, and 0.53 (±0.14) mm for DSC, HD95, and ASD respectively. The proposed auto-segmentation approach generated TBV and CTV masks in ∼11 seconds per CT volume, implying significantly improved efficiency compared to manual contouring. CONCLUSION We developed a comprehensive DL framework mimicking clinical contouring practice for auto-segmentation of target volumes in S-PBI. The results demonstrated high levels of agreement between the predicted contours and physicians' manual contours. The approach is promising for improving the efficiency and accuracy of the on-line treatment planning workflow, such as adaptive based S-PBI.
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Affiliation(s)
- M Kazemimoghadam
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - Z Yang
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - M Chen
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - A S Rahimi
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - D N Kim
- Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX
| | - P G Alluri
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - C R Nwachukwu
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - W Lu
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - X Gu
- Stanford University Department of Radiation Oncology, Palo Alto, CA
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Wang JY, Chen Y, Pham D, Lewis J, Beadle BM, Gensheimer MF, Le QT, Gu X, Xing L. Prospective Clinical Adoption of Artificial Intelligence for Organ Contouring in Head and Neck Radiation Treatment Planning. Int J Radiat Oncol Biol Phys 2023; 117:e490-e491. [PMID: 37785549 DOI: 10.1016/j.ijrobp.2023.06.1721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patients that undergo head and neck (H&N) radiation therapy (RT) require laborious delineation of organs-at-risk (OARs) on computed tomography (CT) scans in a treatment planning system (TPS) to minimize radiation to normal tissue. This task can be completed rapidly and accurately with recently developed artificial intelligence-based semantic segmentation models. The current study aims to deploy and evaluate a strategy for improving clinical practice with this technology. MATERIALS/METHODS Deep learning models were trained and tested with CT scans and OAR contours from previous H&N RT cases at our clinic. Two medical physicists vetted the models and selected a 2.5D U-Net for further implementation. The model was embedded in a dedicated server at the hospital, programmed to read H&N CT scans staged for import into the TPS, generate auto-contours, and write them into a TPS-compatible format made available alongside the scan. In the pilot implementation, the auto-contouring service was utilized for more than 60 cases, prospectively. The auto-contours were quantitatively evaluated against the treatment-approved contours to determine how much modification was performed by the clinical team. RESULTS The 2.5D U-Net selected for clinical integration segments 21 OARs in less than 3 minutes per scan. Across all the prospective cases, the mean Dice score and mean 95th percentile Hausdorff distance (mm) between the auto-contour and treatment-approved contour for each of the 21 OARs were as follows, respectively: brainstem (0.93, 1.94), optic chiasm (0.70, 2.96), left cochlea (0.69, 2.37), right cochlea (0.68, 2.44), esophagus (0.88, 2.46), left globe (0.93, 1.50), right globe (0.93, 1.63), glottis (0.91, 2.13), larynx (0.93, 2.76), mandible (0.90, 4.86), left optic nerve (0.78, 1.64), right optic nerve (0.82, 1.65), oral cavity (0.86, 8.46), left parotid gland (0.91, 2.78), right parotid gland (0.91, 2.39), pharynx (0.85, 2.39), spinal cord (0.87, 2.27), left submandibular gland (0.85, 3.46), right submandibular gland (0.83, 3.69), left temporal lobe (0.94, 2.20), and right temporal lobe (0.95, 2.09). The auto-contours for the optic chiasm, optic nerves, cochleas, and submandibular glands differed substantially from the final contours, a finding corroborated by the clinical team; the rest were clinically acceptable with minor or no edits necessary. CONCLUSION The proposed strategy provides a sophisticated starting point for treatment planning that has garnered overall favorable feedback from the participating radiation oncologists and dosimetrists. Consequently, the technique is being extended to other treatment sites.
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Affiliation(s)
- J Y Wang
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - Y Chen
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - D Pham
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - J Lewis
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - B M Beadle
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M F Gensheimer
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - Q T Le
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - X Gu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - L Xing
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Shen L, Xing BL, Gu X, Zhang YY, Zhang X. [Primary salivary gland-type duct carcinoma of lung: report of a case]. Zhonghua Bing Li Xue Za Zhi 2023; 52:958-960. [PMID: 37670632 DOI: 10.3760/cma.j.cn112151-20230106-00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Affiliation(s)
- L Shen
- Department of Pathology, Shanghai Zhoupu Hospital Affiliated Health Medical College, Shanghai 201318, China
| | - B L Xing
- Department of Pathology, Shanghai Zhoupu Hospital Affiliated Health Medical College, Shanghai 201318, China
| | - X Gu
- Department of Pathology, Shanghai Zhoupu Hospital Affiliated Health Medical College, Shanghai 201318, China
| | - Y Y Zhang
- Department of Pathology, Shanghai Zhoupu Hospital Affiliated Health Medical College, Shanghai 201318, China
| | - X Zhang
- Department of Pathology, Shanghai Zhoupu Hospital Affiliated Health Medical College, Shanghai 201318, China
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Geng ZY, Chen NX, You W, Liu K, Gu X, Wei J, Ma L, Zhang XX. [Efficacy of non-surgical comprehensive treatment for locally advanced hypopharyngeal carcinoma with cervical esophagus invasion]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 58:773-780. [PMID: 37599238 DOI: 10.3760/cma.j.cn115330-20221108-00670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Objective: To analyze the treatment effects and side effects of non-surgical comprehensive treatment for locally advanced hypopharyngeal carcinoma invading cervical esophagus. Methods: A retrospective analysis was performed on sixty-six patients with locally advanced hypopharyngeal carcinoma invade the esophagus. These patients were treated in the Department of Otolaryngology, Head and Neck Surgery of Chinese People's Liberation Army General Hospital between January 2011 and May 2022, including sixty-five males and one female, aged 43-71 years. Treatment regimen consisted of induction chemotherapy and concurrent chemoradiothrapy and epidermal growth factor receptor (EGFR)-targeted therapy, three of these cases were treated with programmed cell death 1 (PD-1) immunotherapy. The Kaplan-Meier method was used for survival analysis. Side effects were evaluated with the established CTCAE (Common Terminology Criteria for Adverse Events) 5.0 criteria. The factors affecting prognosis were analyzed by Cox multivariate regression analysis. Results: Sixty-four (97.0%, 64/66) patients completed the radiotherapy and chemotherapy plan. The most common grade three side effects were radioactive oropharyngeal mucositis (89.1%, 57/64) and leukopenia (23.4%, 15/64). Five (7.8%, 5/64) patients showed grade three hoarseness; two patients (3.1%, 2/64) suffered from grade three swallowing dysfunction and required feeding tube and intravenous nutrition; the remaining patients(89.1%) retained good vocal and swallowing functions. The overall survival (OS) of all patients was 81.5% after one year, 54.0% after three years, and 39.9% after five years; the progression-free survival (PFS) was 78.3% after one year, 54.9% after three years, and 42.6% after five years; local control rate (LCR) was 80.9% after one year, 62.5% after three years, and 52.0% after five years. T4a patients showed better OS, PFS and LCR than T4b patients, with statistically significant differences (χ2=8.10, 8.27, and 6.64, respectively, all P<0.05). Cox multivariate regression analysis showed that lymph node metastasis was an independent factor affecting prognosis (χ2=10.21, P<0.05). Conclusion: Non-surgical comprehensive treatment can provide with another option of radical treatment for locally advanced hypopharyngeal carcinoma with cervical esophagus invasion, offering the patients higher rate of larynx and esophageal preservation with tolerable side effects.
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Affiliation(s)
- Z Y Geng
- College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
| | - N X Chen
- College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
| | - W You
- College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
| | - K Liu
- College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
| | - X Gu
- College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
| | - J Wei
- College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
| | - L Ma
- Department of Radiology, the First Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China
| | - X X Zhang
- College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
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Gu X, Salehi A, Wang L, Coates PJ, Sgaramella N, Nylander K. Early detection of squamous cell carcinoma of the oral tongue using multidimensional plasma protein analysis and interpretable machine learning. J Oral Pathol Med 2023. [PMID: 37428440 DOI: 10.1111/jop.13461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/15/2023] [Accepted: 06/06/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Interpretable machine learning (ML) for early detection of cancer has the potential to improve risk assessment and early intervention. METHODS Data from 261 proteins related to inflammation and/or tumor processes in 123 blood samples collected from healthy persons, but of whom a sub-group later developed squamous cell carcinoma of the oral tongue (SCCOT), were analyzed. Samples from people who developed SCCOT within less than 5 years were classified as tumor-to-be and all other samples as tumor-free. The optimal ML algorithm for feature selection was identified and feature importance computed by the SHapley Additive exPlanations (SHAP) method. Five popular ML algorithms (AdaBoost, Artificial neural networks [ANNs], Decision Tree [DT], eXtreme Gradient Boosting [XGBoost], and Support Vector Machine [SVM]) were applied to establish prediction models, and decisions of the optimal models were interpreted by SHAP. RESULTS Using the 22 selected features, the SVM prediction model showed the best performance (sensitivity = 0.867, specificity = 0.859, balanced accuracy = 0.863, area under the receiver operating characteristic curve [ROC-AUC] = 0.924). SHAP analysis revealed that the 22 features rendered varying person-specific impacts on model decision and the top three contributors to prediction were Interleukin 10 (IL10), TNF Receptor Associated Factor 2 (TRAF2), and Kallikrein Related Peptidase 12 (KLK12). CONCLUSION Using multidimensional plasma protein analysis and interpretable ML, we outline a systematic approach for early detection of SCCOT before the appearance of clinical signs.
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Affiliation(s)
- Xiaolian Gu
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Västerbotten, Sweden
| | - Amir Salehi
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Västerbotten, Sweden
| | - Lixiao Wang
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Västerbotten, Sweden
| | - Philip J Coates
- Research Centre for Applied Molecular Oncology (RECAMO), Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Nicola Sgaramella
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Västerbotten, Sweden
- Department of Oral and Maxillo-Facial Surgery, Mater Dei Hospital, Bari, Italy
| | - Karin Nylander
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Västerbotten, Sweden
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Zhou JS, Xu RZ, Yu XQ, Cheng FJ, Zhao WX, Du X, Wang SZ, Zhang QQ, Gu X, He SM, Li YD, Ren MQ, Ma XC, Xue QK, Chen YL, Song CL, Yang LX. Evidence for Band Renormalizations in Strong-Coupling Superconducting Alkali-Fulleride Films. Phys Rev Lett 2023; 130:216004. [PMID: 37295091 DOI: 10.1103/physrevlett.130.216004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 02/06/2023] [Accepted: 04/17/2023] [Indexed: 06/12/2023]
Abstract
There has been a long-standing debate about the mechanism of the unusual superconductivity in alkali-intercalated fullerides. In this Letter, using high-resolution angle-resolved photoemission spectroscopy, we systematically investigate the electronic structures of superconducting K_{3}C_{60} thin films. We observe a dispersive energy band crossing the Fermi level with the occupied bandwidth of about 130 meV. The measured band structure shows prominent quasiparticle kinks and a replica band involving the Jahn-Teller active phonon modes, which reflects strong electron-phonon coupling in the system. The electron-phonon coupling constant is estimated to be about 1.2, which dominates the quasiparticle mass renormalization. Moreover, we observe an isotropic nodeless superconducting gap beyond the mean-field estimation (2Δ/k_{B}T_{c}≈5). Both the large electron-phonon coupling constant and large reduced superconducting gap suggest a strong-coupling superconductivity in K_{3}C_{60}, while the electronic correlation effect is suggested by the observation of a waterfall-like band dispersion and the small bandwidth compared with the effective Coulomb interaction. Our results not only directly visualize the crucial band structure but also provide important insights into the mechanism of the unusual superconductivity of fulleride compounds.
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Affiliation(s)
- J S Zhou
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - R Z Xu
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - X Q Yu
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - F J Cheng
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - W X Zhao
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - X Du
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - S Z Wang
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - Q Q Zhang
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - X Gu
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - S M He
- Department of Physics, Clarendon Laboratory, University of Oxford, Parks Road, Oxford OX1 3PU, United Kingdom
| | - Y D Li
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - M Q Ren
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - X C Ma
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
- Collaborative Innovation Center of Quantum Matter, Beijing 100084, China
| | - Q K Xue
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
| | - Y L Chen
- Department of Physics, Clarendon Laboratory, University of Oxford, Parks Road, Oxford OX1 3PU, United Kingdom
- School of Physical Science and Technology, ShanghaiTech University and CAS-Shanghai Science Research Center, Shanghai 201210, China
- ShanghaiTech Laboratory for Topological Physics, Shanghai 200031, China
| | - C L Song
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
- Collaborative Innovation Center of Quantum Matter, Beijing 100084, China
| | - L X Yang
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
- Frontier Science Center for Quantum Information, Beijing 100084, China
- Collaborative Innovation Center of Quantum Matter, Beijing 100084, China
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Wang Q, Li Y, Gu X, Zhang N, Xie J, Niu B, Xing Y, He Y. Imaging diagnosis of intravenous leiomyomatosis: an institutional experience. Clin Radiol 2023:S0009-9260(23)00138-1. [PMID: 37365113 DOI: 10.1016/j.crad.2023.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 03/14/2023] [Accepted: 03/28/2023] [Indexed: 06/28/2023]
Abstract
AIM To review and summarise the clinical and imaging characteristics of intravenous leiomyomatosis (IVL), a rare smooth muscle tumour originating from the uterus. MATERIALS AND METHODS Twenty-seven patients with a histopathological diagnosis of IVL who underwent surgery were reviewed retrospectively. All patients underwent pelvic ultrasonography, inferior vena cava (IVC) ultrasonography, and echocardiography before surgery. Computed tomography (CT) with contrast enhancement was performed in patients with extrapelvic IVL. Some patients underwent pelvic magnetic resonance imaging (MRI). RESULTS Mean age was 44.81 years. Clinical symptoms were non-specific. IVL was intrapelvic in seven patients and extrapelvic in 20. Preoperative pelvic ultrasonography missed the diagnosis in 85.7% of patients with intrapelvic IVL. Pelvic MRI was useful to evaluate the parauterine vessels. Incidence of cardiac involvement was 59.26%. Echocardiography showed a highly mobile sessile mass in the right atrium with moderate-to-low echogenicity that originates from the IVC. Ninety per cent of extrapelvic lesions showed unilateral growth. The most common growth pattern was via the right uterine vein-internal iliac vein-IVC pathway. CONCLUSION The clinical symptoms of IVL are non-specific. For patients with intrapelvic IVL, early diagnosis is difficult. Pelvic ultrasound should focus on the parauterine vessels, the iliac and ovarian veins should be explored carefully. MRI has obvious advantages in evaluating parauterine vessel involvement, which is helpful for early diagnosis. For patients with extrapelvic IVL, CT should be performed before surgery as part of a comprehensive evaluation. IVC ultrasonography and echocardiography are recommended when IVL is highly suspected.
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Affiliation(s)
- Q Wang
- Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, China
| | - Y Li
- Department of Radiology, The Seventh Affiliated Hospital of Sun Yat-sen University, China
| | - X Gu
- Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, China
| | - N Zhang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, China
| | - J Xie
- Department of Cardiology, Jiahui International Hospital, China
| | - B Niu
- Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, China
| | - Y Xing
- Department of Comprehensive Ultrasound, Beijing Anzhen Hospital, Capital Medical University, China
| | - Y He
- Echocardiography Medical Center, Beijing Anzhen Hospital, Capital Medical University, China.
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Hao Y, Si J, Wei J, Gu X, Wang W, Zhang Y, Guan Y, Huang H, Xu C, Song Z. 221P Comparison of efficacy and safety of carboplatin combined with nab-paclitaxel or paclitaxel as first-line therapy for advanced thymic epithelial tumors. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00474-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Cai SY, Gu X, Liu PJ, Li RS, Jiang JJ, Zhao SP, Yao W, Jiang YN, Yin YH, Yu B, Yuan ZY, Wang JA. [Efficacy and safety of various doses of hybutimibe monotherapy or in combination with atorvastatin for primary hypercholesterolemia: a multicenter, randomized, double-blind, double-dummy, parallel-controlled phase Ⅲ clinical trial]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:180-187. [PMID: 36789598 DOI: 10.3760/cma.j.cn112148-20230105-00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Objective: To evaluate the efficacy and safety of hybutimibe monotherapy or in combination with atorvastatin in the treatment of primary hypercholesterolemia. Methods: This was a multicenter, randomized, double-blind, double-dummy, parallel-controlled phase Ⅲ clinical trial of patients with untreated primary hypercholesterolemia from 41 centers in China between August 2015 and April 2019. Patients were randomly assigned, at a ratio of 1∶1∶1∶1∶1∶1, to the atorvastatin 10 mg group (group A), hybutimibe 20 mg group (group B), hybutimibe 20 mg plus atorvastatin 10 mg group (group C), hybutimibe 10 mg group (group D), hybutimibe 10 mg plus atorvastatin 10 mg group (group E), and placebo group (group F). After a dietary run-in period for at least 4 weeks, all patients were administered orally once a day according to their groups. The treatment period was 12 weeks after the first dose of the study drug, and efficacy and safety were evaluated at weeks 2, 4, 8, and 12. After the treatment period, patients voluntarily entered the long-term safety evaluation period and continued the assigned treatment (those in group F were randomly assigned to group B or D), with 40 weeks' observation. The primary endpoint was the percent change in low density lipoprotein cholesterol (LDL-C) from baseline at week 12. Secondary endpoints included the percent changes in high density lipoprotein cholesterol (HDL-C), triglyceride (TG), apolipoprotein B (Apo B) at week 12 and changes of the four above-mentioned lipid indicators at weeks 18, 24, 38, and 52. Safety was evaluated during the whole treatment period. Results: Totally, 727 patients were included in the treatment period with a mean age of (55.0±9.3) years old, including 253 males. No statistical differences were observed among the groups in demographics, comorbidities, and baseline blood lipid levels. At week 12, the percent changes in LDL-C were significantly different among groups A to F (all P<0.01). Compared to atorvastatin alone, hybutimibe combined with atorvastatin could further improve LDL-C, TG, and Apo B (all P<0.05). Furthermore, there was no significant difference in percent changes in LDL-C at week 12 between group C and group E (P=0.991 7). During the long-term evaluation period, there were intergroup statistical differences in changes of LDL-C, TG and Apo B at 18, 24, 38, and 52 weeks from baseline among the statins group (group A), hybutimibe group (groups B, D, and F), and combination group (groups C and E) (all P<0.01), with the best effect observed in the combination group. The incidence of adverse events was 64.2% in the statins group, 61.7% in the hybutimibe group, and 71.0% in the combination group during the long-term evaluation period. No treatment-related serious adverse events or adverse events leading to death occurred during the 52-week study period. Conclusions: Hybutimibe combined with atorvastatin showed confirmatory efficacy in patients with untreated primary hypercholesterolemia, which could further enhance the efficacy on the basis of atorvastatin monotherapy, with a good overall safety profile.
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Affiliation(s)
- S Y Cai
- Department of Cardiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - X Gu
- Department of Cardiology, Subei People's Hospital of Jiangsu Province, Yangzhou 225001, China
| | - P J Liu
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang 212001, China
| | - R S Li
- Department of Cardiology, Liuzhou People's Hospital, Liuzhou 545026, China
| | - J J Jiang
- Department of Cardiology, Taizhou Hospital of Zhejiang Province, Taizhou 317000, China
| | - S P Zhao
- Department of Cardiology, the Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - W Yao
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Y N Jiang
- Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - Y H Yin
- Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - B Yu
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Z Y Yuan
- Department of Cardiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - J A Wang
- Department of Cardiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
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Fusée L, Salomao N, Ponnuswamy A, Wang L, López I, Chen S, Gu X, Polyzoidis S, Vadivel Gnanasundram S, Fahraeus R. The p53 endoplasmic reticulum stress-response pathway evolved in humans but not in mice via PERK-regulated p53 mRNA structures. Cell Death Differ 2023; 30:1072-1081. [PMID: 36813920 PMCID: PMC10070458 DOI: 10.1038/s41418-023-01127-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 01/27/2023] [Accepted: 02/01/2023] [Indexed: 02/24/2023] Open
Abstract
Cellular stress conditions activate p53-dependent pathways to counteract the inflicted damage. To achieve the required functional diversity, p53 is subjected to numerous post-translational modifications and the expression of isoforms. Little is yet known how p53 has evolved to respond to different stress pathways. The p53 isoform p53/47 (p47 or ΔNp53) is linked to aging and neural degeneration and is expressed in human cells via an alternative cap-independent translation initiation from the 2nd in-frame AUG at codon 40 (+118) during endoplasmic reticulum (ER) stress. Despite an AUG codon in the same location, the mouse p53 mRNA does not express the corresponding isoform in either human or mouse-derived cells. High-throughput in-cell RNA structure probing shows that p47 expression is attributed to PERK kinase-dependent structural alterations in the human p53 mRNA, independently of eIF2α. These structural changes do not take place in murine p53 mRNA. Surprisingly, PERK response elements required for the p47 expression are located downstream of the 2nd AUG. The data show that the human p53 mRNA has evolved to respond to PERK-mediated regulation of mRNA structures in order to control p47 expression. The findings highlight how p53 mRNA co-evolved with the function of the encoded protein to specify p53-activities under different cellular conditions.
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Affiliation(s)
- Leila Fusée
- Inserm U1131, 27 Rue Juliette Dodu, 75010, Paris, France
| | - Norman Salomao
- Inserm U1131, 27 Rue Juliette Dodu, 75010, Paris, France
| | | | - Lixiao Wang
- Department of Medical Biosciences, Umea University, 90185, Umea, Sweden
| | - Ignacio López
- Biochemistry-Molecular Biology, Faculty of Science, Universidad de la República, Iguá 4225, 11400, Montevideo, Uruguay
| | - Sa Chen
- Department of Medical Biosciences, Umea University, 90185, Umea, Sweden
| | - Xiaolian Gu
- Department of Medical Biosciences, Umea University, 90185, Umea, Sweden
| | - Stavros Polyzoidis
- Department of Neurosurgery, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Robin Fahraeus
- Inserm U1131, 27 Rue Juliette Dodu, 75010, Paris, France. .,Department of Medical Biosciences, Umea University, 90185, Umea, Sweden. .,RECAMO, Masaryk Memorial Cancer Institute, Zluty kopec 7, 65653, Brno, Czech Republic.
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26
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Xu RZ, Gu X, Zhao WX, Zhou JS, Zhang QQ, Du X, Li YD, Mao YH, Zhao D, Huang K, Zhang CF, Wang F, Liu ZK, Chen YL, Yang LX. Development of a laser-based angle-resolved-photoemission spectrometer with sub-micrometer spatial resolution and high-efficiency spin detection. Rev Sci Instrum 2023; 94:023903. [PMID: 36859063 DOI: 10.1063/5.0106351] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
Angle-resolved photoemission spectroscopy with sub-micrometer spatial resolution (μ-ARPES), has become a powerful tool for studying quantum materials. To achieve sub-micrometer or even nanometer-scale spatial resolution, it is important to focus the incident light beam (usually from synchrotron radiation) using x-ray optics, such as the zone plate or ellipsoidal capillary mirrors. Recently, we developed a laser-based μ-ARPES with spin-resolution (LMS-ARPES). The 177 nm laser beam is achieved by frequency-doubling a 355 nm beam using a KBBF crystal and subsequently focused using an optical lens with a focal length of about 16 mm. By characterizing the focused spot size using different methods and performing spatial-scanning photoemission measurement, we confirm the sub-micron spatial resolution of the system. Compared with the μ-ARPES facilities based on the synchrotron radiation, our LMS-ARPES system is not only more economical and convenient, but also with higher photon flux (>5 × 1013 photons/s), thus enabling the high-resolution and high-statistics measurements. Moreover, the system is equipped with a two-dimensional spin detector based on exchange scattering at a surface-passivated iron film grown on a W(100) substrate. We investigate the spin structure of the prototype topological insulator Bi2Se3 and reveal a high spin-polarization rate, confirming its spin-momentum locking property. This lab-based LMS-ARPES will be a powerful research tool for studying the local fine electronic structures of different condensed matter systems, including topological quantum materials, mesoscopic materials and structures, and phase-separated materials.
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Affiliation(s)
- R Z Xu
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
| | - X Gu
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
| | - W X Zhao
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
| | - J S Zhou
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
| | - Q Q Zhang
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
| | - X Du
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
| | - Y D Li
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
| | - Y H Mao
- College of Advanced Interdisciplinary Studies, National University of Defense Technology, Changsha, Hunan 410073, China
| | - D Zhao
- Department of Optics and Optical Engineering, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - K Huang
- Department of Optics and Optical Engineering, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - C F Zhang
- College of Advanced Interdisciplinary Studies, National University of Defense Technology, Changsha, Hunan 410073, China
| | - F Wang
- ShanghaiTech Laboratory for Topological Physics, Shanghai 200031, China
| | - Z K Liu
- ShanghaiTech Laboratory for Topological Physics, Shanghai 200031, China
| | - Y L Chen
- ShanghaiTech Laboratory for Topological Physics, Shanghai 200031, China
| | - L X Yang
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing 100084, China
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Yang LJ, Zhou JZ, Zheng YF, Hu X, He ZY, Du LJ, Gu X, Huang XY, Li J, Li YQ, Pan LY, Zhang XX, Gu XJ. Association of non-alcoholic fatty liver disease with total testosterone in non-overweight/obese men with type 2 diabetes mellitus. J Endocrinol Invest 2023:10.1007/s40618-023-02006-6. [PMID: 36725809 DOI: 10.1007/s40618-023-02006-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/04/2023] [Indexed: 02/03/2023]
Abstract
PURPOSE Non-alcoholic fatty liver disease (NAFLD) is considered as both a vital risk factor and a consequence of type 2 diabetes mellitus (T2DM). Low total testosterone (TT) is common in men with T2DM, contributing to increased risks of metabolic diseases. This study aimed to investigate the association between TT levels and the prevalence of NAFLD in men with T2DM. METHODS In this cross-sectional study, 1005 men with T2DM were enrolled in National Metabolic Management Center (MMC) of First Affiliated Hospital of Wenzhou Medical University between January 2017 and August 2021. NAFLD was diagnosed using ultrasound as described by the Chinese Liver Disease Association. Overweight/obesity was defined as body mass index (BMI) ≥ 25 kg/m2 according to WHO BMI classifications. RESULTS Individuals without NAFLD had higher serum TT levels than those with NAFLD. After adjustments for potential confounding factors, the top tertile was significantly associated with lower prevalence of NAFLD compared with the bottom tertile of TT level [odds ratio (OR) 0.303, 95% confidence interval (CI) 0.281-0.713; P < 0.001]. The association between TT with NAFLD in individuals with normal weight (OR 0.175, 95% CI 0.098-0.315; P < 0.001) was stronger than in individuals with overweight/obesity (OR 0.509, 95% CI 0.267-0.971; P = 0.040). There was a significant interaction of TT with overweight/obesity (P for interaction = 0.018 for NAFLD). CONCLUSION Higher serum TT was significantly associated with a lower prevalence of NAFLD in men with T2DM. We found that the relationship of TT and NAFLD was stronger in individuals with non-overweight/obesity.
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Affiliation(s)
- L J Yang
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - J Z Zhou
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - Y F Zheng
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - X Hu
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - Z Y He
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - L J Du
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - X Gu
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - X Y Huang
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - J Li
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - Y Q Li
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - L Y Pan
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - X X Zhang
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China
| | - X J Gu
- Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China.
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Gu X, Wang L, Coates PJ, Gnanasundram SV, Sgaramella N, Sörlin J, Erdogan B, Magan M, Nylander K. Evidence for etiologic field changes in tongue distant from tumor in patients with squamous cell carcinoma of the oral tongue. J Pathol 2023; 259:93-102. [PMID: 36314576 PMCID: PMC10108103 DOI: 10.1002/path.6025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 10/07/2022] [Accepted: 10/27/2022] [Indexed: 11/05/2022]
Abstract
Oral cancer is a paradigm of Slaughter's concept of field cancerization, where tumors are thought to originate within an area of cells containing genetic alterations that predispose to cancer development. The field size is unclear but may represent a large area of tissue, and the origin of mutations is also unclear. Here, we analyzed whole exome and transcriptome features in contralateral tumor-distal tongue (i.e. distant from the tumor, not tumor-adjacent) and corresponding tumor tissues of 15 patients with squamous cell carcinoma of the oral tongue. The number of point mutations ranged from 41 to 237 in tumors and from one to 78 in tumor-distal samples. Tumor-distal samples showed mainly clock-like (associated with aging) or tobacco smoking mutational signatures. Tumors additionally showed mutations that associate with cytidine deaminase AID/APOBEC enzyme activities or a UV-like signature. Importantly, no point mutations were shared between a tumor and the matched tumor-distal sample in any patient. TP53 was the most frequently mutated gene in tumors (67%), whereas a TP53 mutation was detected in only one tumor-distal sample, and this mutation was not shared with the matched tumor. Arm-level copy number variation (CNV) was found in 12 tumors, with loss of chromosome (Chr) 8p or gain of 8q being the most frequent events. Two tumor-distal samples showed a gain of Chr8, which was associated with increased expression of Chr8-located genes in these samples, although gene ontology did not show a role for these genes in oncogenic processes. In situ hybridization revealed a mixed pattern of Chr8 gain and neutral copy number in both tumor cells and adjacent nontumor epithelium in one patient. We conclude that distant field cancerization exists but does not present as tumor-related mutational events. The data are compatible with etiologic field effects, rather than classical monoclonal field cancerization theory. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Xiaolian Gu
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Sweden
| | - Lixiao Wang
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Sweden
| | - Philip J Coates
- Research Centre for Applied Molecular Oncology (RECAMO), Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | | | - Nicola Sgaramella
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Sweden
| | - Jonas Sörlin
- Clinical Genetics, Laboratory Medicine, Norrlands Universitetssjukhus, Umeå, Sweden
| | - Baris Erdogan
- Department of Clinical Sciences/ENT, Umeå University, Umeå, Sweden
| | - Mustafa Magan
- Department of Clinical Sciences/ENT, Umeå University, Umeå, Sweden
| | - Karin Nylander
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Sweden
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Wu MN, Liu WF, Li FD, Huang YW, Gu X, Zhai YJ, Zhang T, Xu L, Lin JF. Association between Iodized Salt Intake and Cognitive Function in Older Adults in China. J Nutr Health Aging 2023; 27:1005-1011. [PMID: 37997722 DOI: 10.1007/s12603-023-1997-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 09/12/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES To investigate the association between iodized salt intake and cognitive function in older adults. DESIGN A cross-sectional study. SETTINGS Individuals from the Zhejiang Major Public Health Surveillance Program (ZPHS). PARTICIPANTS Data of 10,217 participants (including 4,680 coastal residents and 5,537 inland residents) aged ≥ 60 years were analyzed. MEASUREMENTS Salt intake was evaluated using a questionnaire, and participants were stratified into the following three groups: iodized salt, non-iodized salt, and mixed salt. Cognitive function was assessed through the Mini-Mental State Examination and defined using education-specific cut-off points. Logistic regression models controlling for an extensive range of potential confounders were generated to examine the association between salt intake and cognitive function among all participants. RESULTS Data from 10,217 participants with a 16.1% prevalence of cognitive impairment were analyzed. Compared with non-iodized salt intake, consumption of iodized salt was inversely associated with cognitive impairment (odds ratio [OR], 0.410; 95% confidence interval [CI], 0.351-0.480; P < 0.001) in all participants after multivariable adjustment. An association between iodized salt intake and cognitive impairment was observed in coastal (OR, 0.441; 95% CI, 0.340-0.572; P < 0.001) and inland residents (OR, 0.569; 95% CI, 0.439-0.738; P < 0.001). Despite the insufficient sample size, the results for individuals consuming mixed salt suggested an inverse association between mixed salt intake and cognitive impairment among coastal residents (OR, 0.598; 95% CI, 0.405-0.885; P = 0.010) after multivariable adjustment. CONCLUSION Our results indicate that iodized salt intake may reduce the risk of cognitive impairment in older adults living in coastal or inland areas, and the protective effect of iodized salt intake is greater in coastal areas than in inland areas.
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Affiliation(s)
- M N Wu
- Junfen Lin, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Binjiang District, Hangzhou 310051, Zhejiang, China, E-mail address: , Tel: +86 057187115131, Fax: +86 057187115278
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Salomao N, Maslah N, Giulianelli A, Drevon L, Aguinaga L, Gu X, Cassinat B, Giraudier S, Fenaux P, Fahraeus R. Reduced murine double minute 2 and
4
protein, but not
messenger RNA
, expression is associated with more severe disease in myelodysplastic syndromes and acute myeloblastic leukaemia. Br J Haematol 2022; 201:234-248. [PMID: 36546586 DOI: 10.1111/bjh.18608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/04/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
The human homologues of murine double minute 2 (MDM2) and 4 (MDM4) negatively regulate p53 tumour suppressor activity and are reported to be frequently overexpressed in human malignancies, prompting clinical trials with drugs that prevent interactions between MDM2/MDM4 and p53. Bone marrow samples from 111 patients with acute myeloblastic leukaemia, myelodysplastic syndrome or chronic myelomonocytic leukaemia were examined for protein (fluorescence-activated cell sorting) and messenger RNA (mRNA) expression (quantitative polymerase chain reaction) of MDM2, MDM4 and tumour protein p53 (TP53). Low protein expression of MDM2 and MDM4 was observed in immature cells from patients with excess of marrow blasts (>5%) compared with CD34+ /CD45low cells from healthy donors and patients without excess of marrow blasts (<5%). The mRNA levels were indistinguishable in all samples examined regardless of disease status or blast levels. Low MDM2 and MDM4 protein expression were correlated with poor survival. These data show a poor correlation between mRNA and protein expression levels, suggesting that quantitative flow cytometry analysis of protein expression levels should be used to predict and validate the efficacy of MDM2 and MDM4 inhibitors. These findings show that advanced disease is associated with reduced MDM2 and MDM4 protein expression and indicate that the utility of MDM2 and MDM4 inhibitors may have to be reconsidered in the treatment of advanced myeloid malignancies.
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Affiliation(s)
- Norman Salomao
- Inserm UMRS1131, Institut de Recherche Saint‐Louis, Institut de Génétique Moléculaire, Université de Paris‐Cité, Hôpital St. Louis Paris France
| | - Nabih Maslah
- Inserm UMRS1131, Institut de Recherche Saint‐Louis, Institut de Génétique Moléculaire, Université de Paris‐Cité, Hôpital St. Louis Paris France
| | - Anouk Giulianelli
- Service d'Hématologie Senior—Hôpital Saint‐Louis—Assistance Publique Hôpitaux de Paris, and Paris Cité university Paris France
| | - Louis Drevon
- Inserm UMRS1131, Institut de Recherche Saint‐Louis, Institut de Génétique Moléculaire, Université de Paris‐Cité, Hôpital St. Louis Paris France
- Service d'Hématologie Senior—Hôpital Saint‐Louis—Assistance Publique Hôpitaux de Paris, and Paris Cité university Paris France
| | - Lorea Aguinaga
- Inserm UMRS1131, Institut de Recherche Saint‐Louis, Institut de Génétique Moléculaire, Université de Paris‐Cité, Hôpital St. Louis Paris France
- Service d'Hématologie Senior—Hôpital Saint‐Louis—Assistance Publique Hôpitaux de Paris, and Paris Cité university Paris France
| | - Xiaolian Gu
- Department of Medical Biosciences Building 6M, Umeå University Umeå Sweden
| | - Bruno Cassinat
- Inserm UMRS1131, Institut de Recherche Saint‐Louis, Institut de Génétique Moléculaire, Université de Paris‐Cité, Hôpital St. Louis Paris France
- Service d'Hématologie Senior—Hôpital Saint‐Louis—Assistance Publique Hôpitaux de Paris, and Paris Cité university Paris France
| | - Stephane Giraudier
- Inserm UMRS1131, Institut de Recherche Saint‐Louis, Institut de Génétique Moléculaire, Université de Paris‐Cité, Hôpital St. Louis Paris France
- Service d'Hématologie Senior—Hôpital Saint‐Louis—Assistance Publique Hôpitaux de Paris, and Paris Cité university Paris France
| | - Pierre Fenaux
- Service d'Hématologie Senior—Hôpital Saint‐Louis—Assistance Publique Hôpitaux de Paris, and Paris Cité university Paris France
| | - Robin Fahraeus
- Inserm UMRS1131, Institut de Recherche Saint‐Louis, Institut de Génétique Moléculaire, Université de Paris‐Cité, Hôpital St. Louis Paris France
- Department of Medical Biosciences Building 6M, Umeå University Umeå Sweden
- RECAMO, Masaryk Memorial Cancer Institute Brno Czech Republic
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Wang B, Gan J, Liu Z, Hui Z, Wei J, Gu X, Mu Y, Zang G. An organoid library of salivary gland tumors reveals subtype-specific characteristics and biomarkers. J Exp Clin Cancer Res 2022; 41:350. [PMID: 36527158 PMCID: PMC9758872 DOI: 10.1186/s13046-022-02561-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/04/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Salivary gland tumors (SGTs) include a large group of rare neoplasms in the head and neck region, and the heterogeneous and overlapping features among the subtypes frequently make diagnostic difficulties. There is an urgent need to understand the cellular mechanisms underlying the heterogeneity and overlap among the subtypes, and explore the subtype-specific diagnostic biomarkers. METHODS The tumor tissue and the adjacent normal tissue from the 6 most common types of SGTs were processed for organoid culture which only maintained tumor epithelial cells. Organoids were histologically evaluated based on phenotype markers, followed by transcriptional profiling using RNA-sequencing. The transcriptomic similarities and differences among the subtypes were analyzed by subtype consensus clustering and hierarchical clustering. Furthermore, by comparative transcriptional analysis for these 6 types of SGTs and the matched organoids, the potential diagnostic biomarkers from tumor epithelium were identified, in which two selected biomarkers were evaluated by qPCR and confirmed by immunohistochemistry staining using a tissue microarray. RESULTS We generated a biobank of patient-derived organoids (PDOs) with 6 subtypes of SGTs, including 21 benign and 24 malignant SGTs. The PDOs recapitulated the morphological and transcriptional characteristics of the parental tumors. The overlap in the cell types and the heterogenous growth patterns were observed in the different subtypes of organoids. Comparing the bulk tissues, the cluster analysis of the PDOs remarkably revealed the epithelial characteristics, and visualized the intrinsic relationship among these subtypes. Finally, the exclusive biomarkers for the 6 most common types of SGTs were uncovered by comparative analysis, and PTP4A1 was demonstrated as a useful diagnostic biomarker for mucoepidermoid carcinoma. CONCLUSIONS We established the first organoid biobank with multiple subtypes of SGTs. PDOs of SGTs recapitulate the morphological and transcriptional characteristics of the original tumors, which uncovers subtype-specific biomarkers and reveals the molecular distance among the subtype of SGTs.
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Affiliation(s)
- Bo Wang
- grid.412449.e0000 0000 9678 1884Liaoning Provincial Key Laboratory of Oral Disease, School and Hospital of Stomatology, China Medical University, Nanjingbeijie 117, Shenyang City, 110051 People’s Republic of China
| | - Jiaxing Gan
- grid.412449.e0000 0000 9678 1884Liaoning Provincial Key Laboratory of Oral Disease, School and Hospital of Stomatology, China Medical University, Nanjingbeijie 117, Shenyang City, 110051 People’s Republic of China
| | - Zhengyan Liu
- grid.412449.e0000 0000 9678 1884Liaoning Provincial Key Laboratory of Oral Disease, School and Hospital of Stomatology, China Medical University, Nanjingbeijie 117, Shenyang City, 110051 People’s Republic of China
| | - Zhixuan Hui
- grid.412449.e0000 0000 9678 1884Liaoning Provincial Key Laboratory of Oral Disease, School and Hospital of Stomatology, China Medical University, Nanjingbeijie 117, Shenyang City, 110051 People’s Republic of China
| | - Jinhui Wei
- grid.412449.e0000 0000 9678 1884Liaoning Provincial Key Laboratory of Oral Disease, School and Hospital of Stomatology, China Medical University, Nanjingbeijie 117, Shenyang City, 110051 People’s Republic of China
| | - Xiaolian Gu
- grid.12650.300000 0001 1034 3451Department of Medical Bioscience, Building 6M, Umeå University, 90185 Umeå, SE Sweden
| | - Yabing Mu
- grid.412449.e0000 0000 9678 1884Liaoning Provincial Key Laboratory of Oral Disease, School and Hospital of Stomatology, China Medical University, Nanjingbeijie 117, Shenyang City, 110051 People’s Republic of China ,grid.12650.300000 0001 1034 3451Department of Medical Bioscience, Building 6M, Umeå University, 90185 Umeå, SE Sweden
| | - Guangxiang Zang
- grid.412449.e0000 0000 9678 1884Liaoning Provincial Key Laboratory of Oral Disease, School and Hospital of Stomatology, China Medical University, Nanjingbeijie 117, Shenyang City, 110051 People’s Republic of China
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Ravella R, Zhang-Velten E, Parsons D, Desai N, Dan T, Timmerman R, Jiang S, Gu X, Kumar K. Volumetric Modulated Arc Therapy Enabled Total Body Irradiation (VMAT-TBI) vs. Conventional TBI (cTBI): A Comparison of Treatment Outcomes and Toxicities. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Montalvo S, Bennett A, All S, Lue B, Kakadiaris E, Westover K, Iyengar P, Lu W, Gu X, Munshi N, Zaha V, Dianels J, Link M, Alluri P. Association between Thoracic Radiation and Heart Rhythm Disorders: Toward a Model for Describing Long-Term Cardiac Risk from Radiotherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Attaran N, Coates P, Zborayova K, Erdogan B, Magan M, Sgaramella N, Nylander K, Gu X. Antigen peptide transporters are upregulated in squamous cell carcinoma of the oral tongue and show sex‑specific associations with survival. Oncol Lett 2022; 24:390. [PMID: 36276482 PMCID: PMC9533359 DOI: 10.3892/ol.2022.13510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/30/2022] [Indexed: 11/24/2022] Open
Abstract
Transporter associated with antigen processing 1 (TAP1) and TAP2 serve pivotal roles in adaptive immunity. Tumor cells often show reduced antigen presentation on their surface as one mechanism to escape immune recognition. Whether downregulation of TAPs is a common mechanism of tumor immune evasion in squamous cell carcinoma of the oral tongue (SCCOT) is unclear. In the present study, samples from 78 patients with SCCOT and 17 patients with benign hyperplastic tongue lesions were analyzed for TAP1 and TAP2 expression by immunohistochemistry. The percentage of positive cells and staining intensity were scored. Associations with clinicopathological variables and survival outcome were also investigated. The results demonstrated that TAP1 and TAP2 levels were highly associated with each other in individual samples and were upregulated in SCCOT compared with benign lesions (P<0.001). The proportion of TAP1- or TAP2-positive tumor cells was >80% in all but two of the tumors, whereas 25.6 and 23.0% of the tumors showed weak intensity of TAP1 and TAP2, respectively. There were no significant associations with clinicopathological variables or survival outcomes between TAP-intermediate/strong and TAP-weak tumors. However, in patients <70 years old and with early stage SCCOT, male patients had better outcomes than female patients (log-rank P<0.05), and the best outcome was observed in male patients with intermediate/strong TAP expression. In conclusion, loss of TAP was not a frequent event in SCCOT and stronger TAP expression in male patients was associated with improved survival, providing further evidence for sex-specific immune modulation in cancer.
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Affiliation(s)
- Nima Attaran
- Department of Medical Biosciences/Pathology, Umeå University, Umeå 901 87, Sweden
| | - Philip Coates
- Regional Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno 656 53, Czech Republic
| | - Katarina Zborayova
- Department of Clinical Sciences, Division of Ear, Nose and Throat Diseases, Umeå University, Umeå 901 87, Sweden
| | - Baris Erdogan
- Department of Clinical Sciences, Division of Ear, Nose and Throat Diseases, Umeå University, Umeå 901 87, Sweden
| | - Mustafa Magan
- Department of Clinical Sciences, Division of Ear, Nose and Throat Diseases, Umeå University, Umeå 901 87, Sweden
| | - Nicola Sgaramella
- Department of Medical Biosciences/Pathology, Umeå University, Umeå 901 87, Sweden
| | - Karin Nylander
- Department of Medical Biosciences/Pathology, Umeå University, Umeå 901 87, Sweden
| | - Xiaolian Gu
- Department of Medical Biosciences/Pathology, Umeå University, Umeå 901 87, Sweden
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Salehi A, Wang L, Coates PJ, Norberg Spaak L, Gu X, Sgaramella N, Nylander K. Reiterative modeling of combined transcriptomic and proteomic features refines and improves the prediction of early recurrence in squamous cell carcinoma of head and neck. Comput Biol Med 2022; 149:105991. [PMID: 36007290 DOI: 10.1016/j.compbiomed.2022.105991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/11/2022] [Accepted: 08/14/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Patients with squamous cell carcinoma of the head and neck (SCCHN) have a high-risk of recurrence. We aimed to develop machine learning methods to identify transcriptomic and proteomic features that provide accurate classification models for predicting risk of early recurrence in SCCHN patients. METHODS Clinical, genomic, transcriptomic and proteomic features distinguishing recurrence risk were examined in SCCHN patients from The Cancer Genome Atlas (TCGA). Recurrence within one year after treatment was classified as high-risk and no recurrence as low-risk. RESULTS No significant differences in individual clinicopathological characteristics, mutation profiles or mRNA expression patterns were seen between the groups using conventional statistical analysis. Using the machine learning algorithm, extreme gradient boosting (XGBoost), ten proteins (RAD50, 4E-BP1, MYH11, MAP2K1, BECN1, NF2, RAB25, ERRFI1, KDR, SERPINE1) and five mRNAs (PLAUR, DKK1, AXIN2, ANG and VEGFA) made the greatest contribution to classification. These features were used to build improved models in XGBoost, achieving the best discrimination performance when combining transcriptomic and proteomic data, providing an accuracy of 0.939 and an Area Under the ROC Curve (AUC) of 0.951. CONCLUSIONS This study highlights machine learning to identify transcriptomic and proteomic factors that play important roles in predicting risk of recurrence in patients with SCCHN and to develop such models by iterative cycles to enhance their accuracy, thereby aiding the introduction of personalized treatment regimens.
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Affiliation(s)
- Amir Salehi
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Sweden
| | - Lixiao Wang
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Sweden
| | - Philip J Coates
- Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, 656 53, Czech Republic
| | - Lena Norberg Spaak
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Sweden
| | - Xiaolian Gu
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Sweden
| | - Nicola Sgaramella
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Sweden
| | - Karin Nylander
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Sweden.
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Luo Y, Rao Y, Gu X, Chai P, Yang Y, Lin J, Xu X, Jia R, Xu S. Novel MSH6 mutation predicted metastasis in eyelid and periocular squamous cell carcinoma. J Eur Acad Dermatol Venereol 2022; 36:2331-2342. [PMID: 35855666 DOI: 10.1111/jdv.18454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 06/03/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Our previous research revealed the relative local aggressiveness of eyelid and periocular squamous cell carcinoma (EPSCC), but its distinct genetic characteristics involved remain unknown. OBJECTIVES We conducted this study based on next-generation sequencing to identify the genetic distinctiveness of EPSCC and damaging mutations for possible etiology and poor prognosis. METHODS We performed sequencing using a 556-gene panel (smartonco) in 48 EPSCCs. Cox hazards model was applied to explore mutated genes that increase risk of metastasis and death. Pathogenesis of the mutations was predicted by sequence alignment algorithms. RESULTS The most commonly mutated genes were KMT2C (N=17, 35%), LRP1B (N=14, 29%), KMT2D (N=12, 25%), PTCH1(N=10, 21%) and TP53(N=10, 21%). DNA mismatch repair (MMR) genes (42%) like MSH6(19%) and MLH3(12%) were among the most frequently mutated genes. Cell cycle regulators including TP53(21%) and CDKN2A (10%) were less frequently mutated than in other squamous cell carcinomas (SCCs). Ultra violet exposure, MMR deficiency and aging were the main etiology. Of note, KMT2C has a deleterious mutation hotspot. Patients burdened with MSH6 mutation has a higher risk of overall metastasis (P=0.045, HR=5.165) and nodal metastasis (P=0.022, HR=14.038). Moreover, a hotspot mutation MSH6E52A brought an even higher risk of nodal metastasis (P=0.011, HR=18.745). CONCLUSIONS EPSCCs displayed a unique mutation profile from cutaneous SCCs and mucosal SCCs. We have identified novel damaging mutations in epigenetic regulators like KMT2C boosted early onset of EPSCCs in addition to UVR, aging or MMR deficiency. And malfunction of MMR genes worsened prognosis.
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Affiliation(s)
- Y Luo
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Y Rao
- Department of pathology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - X Gu
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - P Chai
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Y Yang
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - J Lin
- Department of pathology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - X Xu
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - R Jia
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - S Xu
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
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Jia T, He K, Chen D, Qian J, Gu X, Shen B, Sun Y, Shi T, Wang Y, Zhang B, Gong X. The measurements by diamagnetic loops in EAST. Fusion Engineering and Design 2022. [DOI: 10.1016/j.fusengdes.2022.113091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Chen Y, Xiong J, Chen W, Xie D, Zhang Y, Mo Y, Gu X, Zhang L. Morphological classification and measurement of the glenoid cavity using three-dimensional reconstruction in a Chinese population. Folia Morphol (Warsz) 2022; 82:325-331. [PMID: 35187632 DOI: 10.5603/fm.a2022.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The purpose of this study was to examine the various shapes and record the morphometric data of the glenoid cavity in a Chinese population. MATERIALS AND METHODS A total of 501 scapulae, 247 left and 254 right, were analyzed. We classified the shape of the glenoid cavity as type Ⅰ (pear-shaped), type Ⅱ (oval-shaped), type Ⅲ (teardrop-shaped), type Ⅳ (calabash-shaped) or type Ⅴ (inverted comma-shaped). Four defined parameters, the superior-inferior glenoid diameter (AB), upper anterior-posterior glenoid diameter (CD), lower anterior-posterior glenoid diameter (EF) and glenoid index (GI), were measured, and five shapes were classified via three-dimensional reconstruction. RESULTS The mean AB, CD, EF and GI values of the glenoid were 3.51±0.41 cm, 1.95±0.28 cm, 2.60±0.34 cm, and 1.35±0.12 cm, respectively. The AB value of type Ⅱ glenoid cavities was significantly smaller than that of type Ⅰ and Ⅲ glenoid cavities (P<0.05), but the GI value of type Ⅱ glenoid cavities was larger than that of type Ⅲ cavities (P<0.05). The CD value showed a difference between type Ⅰ and type Ⅲ glenoid cavities (P<0.05). For the EF parameter, the values of type Ⅲ glenoid cavities were significantly larger than those of type Ⅰ and Ⅱ glenoid cavities (P<0.05). CONCLUSIONS Measuring and observing the variety of shapes and sizes of the glenoid cavity in Chinese people is conducive to for better understand its morphological features. This information can also guide surgeons in the design and selection of suitable prostheses for total shoulder arthroplasty in the Chinese population in order to reduce postoperative complications.
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Affiliation(s)
- Y Chen
- Department of Orthopedics, Chinese and Western Medicine Hospital of Yibing, Yibing, China
| | - J Xiong
- School of Clinical Medicine, Southwest Medical University, Luzhou, China
| | - W Chen
- Department of Orthopedics, Chinese and Western Medicine Hospital of Yibing, Yibing, China
| | - D Xie
- Department of Orthopedics, Chinese and Western Medicine Hospital of Yibing, Yibing, China
| | - Y Zhang
- Department of Orthopedics, Chinese and Western Medicine Hospital of Yibing, Yibing, China
| | - Y Mo
- Department of Orthopedics, Chinese and Western Medicine Hospital of Yibing, Yibing, China
| | - X Gu
- Department of Orthopedics, Chinese and Western Medicine Hospital of Yibing, Yibing, China
| | - L Zhang
- Department of Orthopedics, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China. .,Center for Orthopedic Diseases Research, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China. .,Expert Workstation in Luzhou, Luzhou, China. .,Clinical Base of Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Guangdong Province Medical 3D Printing Application Transformation Engineering Technology Research Center, Luzhou, China.
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Gu X, Liu K, Gou HC, Chen NX, Zhang XX. [Retrospective analysis on 77 cases of T4b hypopharyngeal carcinoma treated by non-surgical treatments]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:22-28. [PMID: 35090205 DOI: 10.3760/cma.j.cn115330-20210630-00407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To analyze the effectiveness, safety and factors influencing the clinical prognosis of patients with hypopharyngeal carcinoma in T4b by nonsurgical treatments. Methods: The clinical data of 77 patients with T4b hypopharyngeal cancer treated in the College of Otolaryngology Head and Neck Surgery of the Chinese People's Liberation Army General Hospital from January 2010 to June 2021 were analyzed retrospectively. All were males, aged(57.0±8.0)years old. Patients were treated with induction chemotherapy plus concurrent chemoradiotherapy. Kaplan Meier survival analysis was used to compare the effects of different factors on prognosis. Adverse reactions during treatments and the causes of death were analyzed. Results: 98.7% of 77 patients with T4b hypopharyngeal cancer completed the chemotherapy plan and 94.8% completed the radiotherapy plan. The most common adverse reactions were grade 2 radiation oral mucositis (50/77, 64.9%) and grade 2 leukopenia (50/77, 64.9%). The incidence of grade 3 severe hoarseness was 7.8% (6/77), one patient (1.3%) underwent gastrostomy due to dysphagia, and pronunciation and swallowing function were effectively preserved in other patients. The overall survival rate was 71.9% at 1 year, 45.6% at 3 years and 29.7% at 5 years. The location of tumor, the presence of liquefaction necrosis in tumor, the use of molecular targeted drugs and the approach of radiotherapy were independent factors,each of which that affected the prognosis of T4b patients with advanced hypopharyngeal cancer [HR (95%CI) were 1.867(1.085-3.213), 3.018 (1.437-6.335), 0.372 (0.181-0.764) and 2.158 (1.015-4.588), respectively, P<0.05]. The two leading causes of death with high incidence were disease recurrence (12/32, 37.5%) and cervical large vessel rupture and hemorrhage (11/32, 34.4%). Conclusions: Non-surgical comprehensive treatment offers a high laryngeal preservation rate in patients with T4b hypopharyngeal cancer. The location of tumor, the liquefaction necrosis within tumor, the use of molecular targeted drugs, and the approach of radiotherapy are independent prognostic factors.
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Affiliation(s)
- X Gu
- College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
| | - K Liu
- College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
| | - H C Gou
- College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
| | - N X Chen
- College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
| | - X X Zhang
- College of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
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Li FD, Tong ZD, Chang Y, Li KF, Gu X, Zhang T, Lin JF. Eggs Consumption in Relation to Lower Risk of Cognitive Impairment in Elderly: Findings from a 6-Year Cohort Study. J Nutr Health Aging 2022; 26:771-777. [PMID: 35934821 DOI: 10.1007/s12603-022-1810-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To evaluate the longitudinal association of eggs consumption with cognitive function in Chinese elderly. DESIGN Prospective cohort study. PARTICIPANTS 9028 participants aged ≥60 years from Zhejiang Ageing and Health Cohort Study without cognitive impairment at baseline survey. MEASUREMENTS Cognitive function was assessed through the Mini-Mental State Examination (MMSE) at baseline and three waves of follow-up (2015, 2016, and 2019-2020). Data on eggs consumption was collected in the diet habits section within the questionnaire at baseline. Log-binomial regression models with the Generalized Estimating Equations, controlled for an extensive range of potential confounders, were used to evaluate the association and estimate relative risks (RRs). RESULTS After 6 years of follow-up, 3266 (36.18%) participants were indicated as cognitive impairment by MMSE at least once. Compared with non-consumers or less-than-weekly consumers, participants consuming 0.1-2.9 eggs/week and 3.0-5.9 eggs/week had 18% (RR=0.82, 95%CI 0.76-0.89) and 9% (RR=0.91, 95%CI 0.84-0.99) lower risks of cognitive impairment respectively, whereas no association was found in those consuming ≥6.0 eggs/week (P=0.32). Moreover, infrequent lower-quantity consumption (1-2 days/week and 0.1-1.9 eggs/day), infrequent higher-quantity consumption (1-2 days/week and ≥2.0 eggs/day), and frequent lower-quantity consumption (≥3 days/week and 0.1-1.9 eggs/day) were associated with better cognitive performance, whereas null association was found among frequent higher-quantity consumers (≥3 days/week and ≥2.0 eggs/day). The sensitivity analyses yielded consistent results to the main analysis. CONCLUSION Limited eggs consumption is prospectively related to a lower risk of cognitive impairment in Chinese elderly.
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Affiliation(s)
- F D Li
- Professor Junfen Lin, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Binjiang District, Hangzhou 310051, Zhejiang, China. . Tel: +86-571-87115131. Fax: +86-571-87115298
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Gu X, Coates P, Wang L, Erdogan B, Salehi A, Sgaramella N, Zborayova K, Nylander K. Variation in Plasma Levels of TRAF2 Protein During Development of Squamous Cell Carcinoma of the Oral Tongue. Front Oncol 2021; 11:753699. [PMID: 34888239 PMCID: PMC8649619 DOI: 10.3389/fonc.2021.753699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/01/2021] [Indexed: 12/09/2022] Open
Abstract
As early detection is crucial for improvement of cancer prognosis, we searched for biomarkers in plasma from individuals who later developed squamous cell carcinoma of the oral tongue (SCCOT) as well as in patients with an already established SCCOT. Levels of 261 proteins related to inflammation and/or tumor processes were measured using the proximity extension assay (PEA) in 179 plasma samples (42 collected before diagnosis of SCCOT with 81 matched controls; 28 collected at diagnosis of SCCOT with 28 matched controls). Statistical modeling tools principal component analysis (PCA) and orthogonal partial least square - discriminant analysis (OPLS-DA) were applied to provide insights into separations between groups. PCA models failed to achieve group separation of SCCOT patients from controls based on protein levels in samples taken prior to diagnosis or at the time of diagnosis. For pre-diagnostic samples and their controls, no significant OPLS-DA model was identified. Potentials for separating pre-diagnostic samples collected up to five years before diagnosis (n = 15) from matched controls (n = 28) were seen in four proteins. For diagnostic samples and controls, the OPLS-DA model indicated that 21 proteins were important for group separation. TNF receptor associated factor 2 (TRAF2), decreased in pre-diagnostic plasma (< 5 years) but increased at diagnosis, was the only protein showing altered levels before and at diagnosis of SCCOT (p-value < 0.05). Taken together, changes in plasma protein profiles at diagnosis were evident, but not reliably detectable in pre-diagnostic samples taken before clinical signs of tumor development. Variation in protein levels during cancer development poses a challenge for the identification of biomarkers that could predict SCCOT development.
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Affiliation(s)
- Xiaolian Gu
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | - Philip Coates
- Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czechia
| | - Lixiao Wang
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | - Baris Erdogan
- Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Amir Salehi
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | | | | | - Karin Nylander
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
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Kazemimoghadam M, Chi W, Rahimi A, Kim N, Alluri P, Nwachukwu C, Lu W, Gu X. Saliency-Guided Deep Learning Network for Automatic Target Delineation in Post-Operative Stereotactic Partial Breast Irradiation. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ma L, Chen M, Gu X, Lu W. Generalizability Study of a Fluence Map Prediction Network. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Gu X, Lu W, Timmerman R, Dianels J, Wu R. A Multi-Staged Treatment Planning Framework for Large-Volume Ventricular Tachycardia Stereotactic Ablation. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Chi W, D'Cunha P, Chen M, Ma L, Kazemimoghadam M, Yang Z, Gu X, Albuquerque K, Lu W. An Artificial Intelligence Approach for Automatic Delineation of Para-Aortic Clinical Target Volume. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kang L, Du X, Zhou JS, Gu X, Chen YJ, Xu RZ, Zhang QQ, Sun SC, Yin ZX, Li YW, Pei D, Zhang J, Gu RK, Wang ZG, Liu ZK, Xiong R, Shi J, Zhang Y, Chen YL, Yang LX. Band-selective Holstein polaron in Luttinger liquid material A 0.3MoO 3 (A = K, Rb). Nat Commun 2021; 12:6183. [PMID: 34702828 PMCID: PMC8548323 DOI: 10.1038/s41467-021-26078-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/14/2021] [Indexed: 11/09/2022] Open
Abstract
(Quasi-)one-dimensional systems exhibit various fascinating properties such as Luttinger liquid behavior, Peierls transition, novel topological phases, and the accommodation of unique quasiparticles (e.g., spinon, holon, and soliton, etc.). Here we study molybdenum blue bronze A0.3MoO3 (A = K, Rb), a canonical quasi-one-dimensional charge-density-wave material, using laser-based angle-resolved photoemission spectroscopy. Our experiment suggests that the normal phase of A0.3MoO3 is a prototypical Luttinger liquid, from which the charge-density-wave emerges with decreasing temperature. Prominently, we observe strong renormalizations of band dispersions, which are recognized as the spectral function of Holstein polaron derived from band-selective electron-phonon coupling in the system. We argue that the strong electron-phonon coupling plays an important role in electronic properties and the charge-density-wave transition in blue bronzes. Our results not only reconcile the long-standing heavy debates on the electronic properties of blue bronzes but also provide a rare platform to study interesting excitations in Luttinger liquid materials.
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Affiliation(s)
- L Kang
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing, 100084, China
| | - X Du
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing, 100084, China
| | - J S Zhou
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing, 100084, China
| | - X Gu
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing, 100084, China
| | - Y J Chen
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing, 100084, China
| | - R Z Xu
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing, 100084, China
| | - Q Q Zhang
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing, 100084, China
| | - S C Sun
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing, 100084, China
| | - Z X Yin
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing, 100084, China
| | - Y W Li
- School of Physical Science and Technology, ShanghaiTech University and CAS-Shanghai Science Research Center, Shanghai, 201210, China.,ShanghaiTech Laboratory for Topological Physics, Shanghai, 200031, China
| | - D Pei
- Department of Physics, Clarendon Laboratory, University of Oxford, Oxford, OX1 3PU, UK
| | - J Zhang
- School of Physical Science and Technology, ShanghaiTech University and CAS-Shanghai Science Research Center, Shanghai, 201210, China
| | - R K Gu
- Department of Physics, Clarendon Laboratory, University of Oxford, Oxford, OX1 3PU, UK
| | - Z G Wang
- International Center for Quantum Materials, School of Physics, Peking University, Beijing, 100871, China
| | - Z K Liu
- School of Physical Science and Technology, ShanghaiTech University and CAS-Shanghai Science Research Center, Shanghai, 201210, China.,ShanghaiTech Laboratory for Topological Physics, Shanghai, 200031, China
| | - R Xiong
- Department of Physics, Wuhan University, Wuhan, 430072, China
| | - J Shi
- Department of Physics, Wuhan University, Wuhan, 430072, China
| | - Y Zhang
- International Center for Quantum Materials, School of Physics, Peking University, Beijing, 100871, China
| | - Y L Chen
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing, 100084, China. .,School of Physical Science and Technology, ShanghaiTech University and CAS-Shanghai Science Research Center, Shanghai, 201210, China. .,ShanghaiTech Laboratory for Topological Physics, Shanghai, 200031, China. .,Department of Physics, Clarendon Laboratory, University of Oxford, Oxford, OX1 3PU, UK.
| | - L X Yang
- State Key Laboratory of Low Dimensional Quantum Physics, Department of Physics, Tsinghua University, Beijing, 100084, China. .,Frontier Science Center for Quantum Information, Beijing, 100084, China.
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Qin JL, Wei JG, Lin XN, Lin XD, Hou P, Gu X, He P. [Clinicopathological and molecular genetic study of 10 cases of tracheal glomus tumors]. Zhonghua Bing Li Xue Za Zhi 2021; 50:1051-1053. [PMID: 34496499 DOI: 10.3760/cma.j.cn112151-20210129-00100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- J L Qin
- Department of Pathology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - J G Wei
- Department of Pathology, Shaoxing People's Hospital of Zhejiang Province, Shaoxing 312000, China
| | - X N Lin
- Department of Pathology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - X D Lin
- Department of Pathology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - P Hou
- PET-CT Center, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - X Gu
- Department of Pathology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - P He
- Department of Pathology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
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Gu X, Xiao Y, Li S, Su J, Li J, Shan S, Wang X, Wu B, Tao J, Kang X, Zou B, Chen X, Shen M. Air pollution and meteorological factors are associated with dermographism: a population-based study in college students. J Eur Acad Dermatol Venereol 2021; 35:e920-e921. [PMID: 34365686 DOI: 10.1111/jdv.17586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 07/29/2021] [Indexed: 11/28/2022]
Affiliation(s)
- X Gu
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China
| | - Y Xiao
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China
| | - S Li
- Department of Surveying and Remote Sensing Science, School of Geosciences and Info-physics, Central South University, Changsha, China
| | - J Su
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China
| | - J Li
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China
| | - S Shan
- Department of Dermatology, Xiang'an Hospital, Xiamen University, Xiamen, China
| | - X Wang
- Department of Dermatology, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - B Wu
- Department of Dermatology, The Affiliated People's Hospital of Inner Mongolia Medical University, Hohhot, China
| | - J Tao
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - X Kang
- Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China
| | - B Zou
- Department of Surveying and Remote Sensing Science, School of Geosciences and Info-physics, Central South University, Changsha, China
| | - X Chen
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China
| | - M Shen
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China.,Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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Zhuang S, Gu X, Chai B, Feng T, Zhou CY, He Y, Shang HF, Zhou HY, Liu J, Xiong KP, Zhang YC, Mao CJ, Liu CF. [Transcranial sonographic characteristics of Parkinson's disease with symptoms of restless legs syndrome]. Zhonghua Yi Xue Za Zhi 2021; 101:1566-1571. [PMID: 34098683 DOI: 10.3760/cma.j.cn112137-20200907-02588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective: To evaluate the transcranial sonographic characteristics in patients with Parkinson's disease (PD) with symptoms of restless legs syndrome (RLS). Methods: Patients with diagnosis of definite PD from the Second Affiliated Hospital of Soochow University and 3 other participating hospitals between September 2018 and December 2019 were consecutively enrolled. Concurrent RLS symptoms were determined using Non-motor Symptoms Questionnaire. Transcranial sonography (TCS) and clinical assessments were performed during the same time and the related variables were compared between the two groups using t-test, non-parametric test, Chi-square test and Spearman correlation analysis, respectively. Results: Among 349 patients with PD, the prevalence of RLS symptoms was 22.6%. Compared to patients without RLS symptoms, those with RLS had longer disease duration (43.0 (24.0, 91.0) months vs 37.0 (20.0, 60.0) months, P<0.05) and higher Hoehn-Yahr stage (2.5 (2.0, 3.0) vs 2.0 (1.5, 2.5), P<0.01).TCS revealed that patients with RLS symptoms were more likely to have abnormality in the raphe nucleus (21.50% vs 7.78%, χ²=15.9, P<0.001) and increased third ventricle width ((6.22±1.97) mm vs (5.16±1.90) mm, P<0.001). No significant differences were found regarding parameters of substantia nigra. Conclusions: Concurrent RLS symptoms are common in PD patients. Abnormal echogenicity of raphe nucleus and increased third ventricle width could be characteristics of TCS in PD patients with RLS symptoms.
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Affiliation(s)
- S Zhuang
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - X Gu
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - B Chai
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - T Feng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - C Y Zhou
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Y He
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, China
| | - H F Shang
- Department of Neurology, West China Hospitalof Sichuan University, Chengdu 610041, China
| | - H Y Zhou
- Department of Neurology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200020, China
| | - J Liu
- Department of Neurology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200020, China
| | - K P Xiong
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - Y C Zhang
- Department of Ultrasound, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - C J Mao
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
| | - C F Liu
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
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50
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Gu X, Jin Y, Li R, Zhang D, Dong C, Zhang Q, Xue Z, Gu Z. AB0343 THE CHARACTERISTICS OF T CELLS IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS WITH ANXIETY BASED ON MACHINE LEARNING. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Systemic lupus erythematosus (SLE) is an autoimmune disease, the immune system of patients to be disordered, especially in T cell subsets1. They were prone to mental diseases, anxiety particularly, which lead to suicide2. The recent study had reported that CD4+ T cells in the peripheral blood played the key role in like anxiety behavior of mice3. Although there showed that the level of serum TNF-α in SLE patients with anxiety was higher than without anxiety4, finding the important special mediators especially in T cell subsets was still necessary for the prevention of anxiety in SLE patients.Objectives:In total, 108 SLE patients, which met the diagnostic criteria of the American Society of rheumatology (v1997), were enrolled in this study from Affilliated Hospital of Nantong University, China. Exclusion criteria included other autoimmune diseases and active infection (including hepatitis B or C virus, Epstein-Barr virus, human immunodeficiency virus or Mycobacterium tuberculosis infection).Methods:We surveyed the abundance of 74 immune cell subpopulations from 108 SLE patients using flow cytometry, and investigated their differences between patients with and without anxiety (24 versus 84). Moreover, machine learning including Lasso regression, Random forest (RF) and Sparsity partial least squares discriminant analysis (sPLS-DA) was employed to build models and futher selected important features for the classification of SLE patients with anxiety.Results:SLE patients with anxiety showed higher body mass index (BMI) and lower quality of life. In their peripheral blood, the proportion of internal cell subsets composition of Th cell and Treg cells changed. By machine learning, we finally found that BMI and PD1-CD28- Treg played important rules to developing lupus anxiety.Conclusion:In this study, machine learning was applied to build models to select the most important T cell subset in SLE patients with anxiety. These findings suggested that BMI and imbalance of PD1-CD28- Treg containing effector memory Treg cells and effector Treg cells mostly played important roles in the development of SLE anxiety.Disclosure of Interests:None declared
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