BACKGROUND:Thyroid cancer stem cells are one of the reasons for tumor resistance that promotes tumor development. The research of thyroid cancer stem cells has provides a new clinic means for the diagnosis and treatment of thyroid cancer. OBJECTIVE:To overview the discovery, identification, and correlation of thyroid cancer stem cells with thyroid cancer. METHODS:A computer-based online search of PubMed database and Wan Fang database between 1995-01/2014-01 was performed to search related articles with the key words of“thyroid cancer, cancer stem cell, stem cell, cancer suppressor gene”in English and Chinese, respectively. Literatures related to thyroid cancer stem cells were selected;in the same field, the articles published lately in authoritative journals were preferred. RESULTS AND CONCLUSION:A total of 561 literatures were primarily selected, and 57 documents were involved for result analysis according to inclusion criteria. Cancer stem cells have become a focus in the study of carcinogenesis. Stem cells also exist in the thyroid gland and its tumor. At present, there are several ways to isolate and identify thyroid cancer stem cells. The tumor thyroid stem cells are closely related to the occurrence, transfer and treatment of tumors. But whether we can cure thyroid cancer through restraining or eliminating thyroid cancer stem cells is stil unknown that needs further studies.

Objective To study the major risk factors for female thyroid tumor in Hohhot of Inner Mongolia and to provide a scientific basis for prevention and treatment of the disease.Methods A case control study was carried out,190 female patients who had suffered thyroid tumor and had been operated on in the Affiliated Hospital of Inner Mongoha Medical College and Inner Mongolia Hospital from March 2010 to September 2011 were selected.Meanwhile,190 female patients who were excluded from being suffering this disease were chosen as controls.A formal questionnaire was made,including the following contents:the general situation,the life style and behavior habit,women's physiological and reproductive situation,job and life factors,personal disease,and medicine and genetic factors.Then,trained investigators who had at least got the bachelor degree interviewed all the patients in the two groups and the doctors in the office of ultrasound and pathology made the check-up.All data made up a database;statistical description and analysis was done with software SPSS 17.0.Through Logistic regression analysis,the relationship between all factors and female thyroid tumor was analyzed in order to find major risk factors related to female thyroid tumor in Hohhot.Results The results of Logistic regression analysis showed that the delay of the first pregnancy,the higher Body Mass Index,too much preserved food and seafood in the diet,higher level of education,negative live event were apparently related to female thyroid tumor (OR =1.527,22.729,2.271,4.303,1.117,1.489,all P ＜ 0.05).Conclusions The female thyroid tumor in Hohhot is a result of comprehensive effect of multiple factors.This study found that the delay of the first pregnancy,the higher Body Mass Index,too much preserved food and seafood in the diet,higher level of education,and negative live event are apparently related to female thyroid tumor,and these factors may be major risk factors for thyroid tumor based on the current epidemiological study.

OBJECTIVENimotuzumab is a humanized monoclonal antibody targeted against epidermal growth factor receptor (EGFR). Recent clinical studies show that patients with malignant gliomas could benefit from nimotuzumab treatment. The aim of the present study was to evaluate the efficacy and side effects of nimotuzumab in combination with chemotherapy for patients with malignant gliomas.

METHODSThe patients received 200 mg of nimotuzumab infusion intravenously over 60 minutes once weekly for the first eight weeks and then once every two weeks until unacceptable toxicity or tumor progression occurred. Individualized chemotherapy was administered based on O(6)-methylguanine-DNA methyltransferase (MGMT) expression and previous chemotherapy responses in combined with nimotuzumab.

RESULTSFourteen patients received a total of 122 times of nimotuzumab ranging from 2 to 20 (median 7.5 times). Combined chemotherapy regimens included: continuous 21-day temozolomide (10 cases), standard 5-day temozolomide (2 cases), teniposide plus cisplatin (1 case), and teniposide plus nimustine (1 case). Partial response (PR) and stable disease (SD) were found in 3 patients (21.4%)and 6 patients (42.9%), respectively. Disease control rate (PR + SD) was 64.3%. The median progression-free survival (PFS) was 4 months (95%CI: 0.7 - 7.3) and PFS at 6 months was 30.6%. The most common toxicities include grade I-II neutropenia (2 cases), thrombocytopenia (2 cases), lymphopenia (1 case), nausea and vomitting (3 case) and asymptomatic transaminase increase (1 case). One patient developed grade IV neutropenia and thrombocytopenia. One patient developed nimotuzumab-related acneiform rash.

CONCLUSIONSNimotuzumab in combination with chemotherapy has moderate activity in patients with malignant gliomas and the toxicities are well tolerable, therefore, worth further investigation.

Adolescent ; Adult ; Antibodies, Monoclonal, Humanized ; administration & dosage ; adverse effects ; therapeutic use ; Antineoplastic Agents, Alkylating ; adverse effects ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Astrocytoma ; drug therapy ; Child ; Cisplatin ; administration & dosage ; adverse effects ; Dacarbazine ; adverse effects ; analogs & derivatives ; therapeutic use ; Disease-Free Survival ; Female ; Glioblastoma ; drug therapy ; Glioma ; drug therapy ; Humans ; Infusions, Intravenous ; Male ; Nausea ; chemically induced ; Neutropenia ; chemically induced ; Nimustine ; administration & dosage ; adverse effects ; Teniposide ; administration & dosage ; adverse effects ; Thrombocytopenia ; chemically induced ; Young Adult

Child ; Child, Preschool ; Cryptorchidism ; diagnosis ; surgery ; Humans ; Infant ; Laparoscopy ; methods ; Male

Objective To explore the relationship between T lymphocyte subsets and both glioma malignancy and its prognosis, and determine a clinical immunologic index for evaluating preoperative glioma malignancy and its prognosis. Methods The data of 117 inpatients with primary intracranial tumors, including glioma (n=85) and meningioma (n=32), were retrospectively analyzed. Fluorescence-activated cell sorting (FACS) analysis was performed to detect the preoperative contents of T lymphocyte subsets on 32 patients with meningioma and patients with glioma, including 45 high-grade glioma (WHO, grade Ⅲ-Ⅳ) and 40 low-grade glioma (WHO, grade Ⅰ -Ⅱ); and then the differences of their immunologic indexes were analyzed. Based on the detection result of T lymphocyte subsets, patients with glioma were divided into two groups: CD4~+CD8~+<1 and CD4~+CD8~+>1. Follow-up for 3-5 years was performed and the survival difference of these two groups was analyzed. Results Patients with high-grade glioma showed a decreased ratio of CD4~+CD8~+ and an increased value of CD8~+ with significant difference as compared with patients with low-grade glioma (P<0.05); patients with high-grade glioma showed a decreased ratio of CD4~+CD8~+, and an increased value of CD8~+ with statistical significance compared with patients with meningioma (P <0.05); patients with low-grade glioma showed a decreased ratio of CD4~+CD8~+ with statistical significance compared with the patients with meningioma (P<0.05). Patients with glioma showed a decreased ratio of CD4~+CD8~+ and CD4~+, and an increased CD8~+ with statistical significance compared with patients with meningioma (P<0.05). After follow-up for 3-5 years, 48 patients with glioma was found in the CD4~+CD8~+>1 group with 21 death (43.8%) and 31 months as a median survival time; 37 patients with glioma was found in the CD4~+CD8~+<1 group with 23 death (62.2%) and 16 months as a median survival time. The Kaplan-Meier survival curves were analyzed with statistical significance (P<0.05). Conclusion The prognosis is poor in patients with low ratio of CD4~+CD8~+. The preoperative level of T lymphocyte subsets in peripheral blood, correlated to the glioma malignancy, can be considered as an index to evaluate the glioma malignancy and the prognosis in patients with glioma.

Objective To explore whether aggressive treatment of primary focus can benefit nonsmall cell lung cancer(NSCLC)patients with synchronous brain metastasis,and search the appropriate treatment protocols.Methods The clinical data of 19 NSCLC patients with synchronous brain metastasis,received treatment at our Cancer Center from January 2000 to January 2009,were reviewed; their treatments and survival statuses were analyzed.Results Median survival time of these patients was 14.5 months; the 1-year survival rate was 52.6％,and 2-year survival rate was 17.5％.Patients had different survival rates when different treatments were given to the primary focus,and significant difference was noted(x2=10.532,P=0.005); after neurosurgical intervention,patients underwent thoracic operation and chemotherapy(24.9 months)had a significantly longer survival time than those underwent chemotherapy(14.5 months)or palliative therapy(5.4 months,P＜0.05).The survival time of patients with single metastases was 16.3 months,and that of those with multiple metastases was 5.4 months; and significant difference was noted between them(P＜0.05).Conclusion Aggressive therapy including neurosurgical intervention,pulmonary resection and chemotherapy should be recommended for NSCLC patients with synchronous brain metastasis,especially those with single brain metastasis.

Image-guided radiation therapy (IGRT) is a visual image-guided radiotherapy technique that has many advantages such as increasing the dose of tumor target area and reducing the dose of normal organ exposure. Cone beam CT (CBCT) is one of the most commonly used medical images in IGRT, and the rapid and accurate targeting of CBCT and the segmentation of dangerous organs are of great significance for radiotherapy. The current research method mainly includes partitioning method based on registration and segmentation method based on deep learning. This study reviews the CBCT image segmentation method, existing problems and development directions.

Objective To investigate the clinical features and differential diagnosis of lepromatous type brain abscess. Methods A total of 18 cases with brain abscess admitted to Department of Neurosurgery, Cancer Center, Sun Yat-sen University during October 2000 to February 2007 were retrospectively analyzed with regard to their clinical data and prognosis during follow-up.Results 11 cases had been diagnosed with gliomas and 7 cases had been diagnosed with metastatic tumors in other hospitals. Among the 18 cases, 16 patients took the onset in winter and spring. All of the 18 cases had not found the primary focus of infection. Two cases among them had got a fever 1 month prior to hospitalization. Among the 18 cases, 7 cases had higher total white blood cells (10.1×109/L-13.7×109/L), and 6 cases had higher neutrophil rate (80.8%-90.5%). And the other 11 cases had normal blood routine. After hospitalization, all of the patients received MRI. 14 cases of them were diagnosed with brain abscess, 2 cases with metastatic tumor, 1 case with glioma, and 1 case with parasite. All of the patients got bacterial culture, and showed asepsis in 9 cases, Gram-positive bacteria in 4 cases, streptococci in 3 cases,Staphylococcus epidermidis in 1 case, and Klebsiella pneumoniae in 1 case. Twelve cases underwent resection, and 6 cases received puncture and drainage. During the follow-up ranging 1-6 years, 17 cases healed well, and 1 case get better. Conclusion Lepromatous type brain abscess commonly occurs in winter and spring. The clinical manifestations are untypical. MRI is the most valuable auxiliary examination, and the magnetic resonance spectroscopy and diffusion weighted imaging takes an important role in differential diagnosis between brain abscess and cystic brain tumor with necroses.

Objective:To investigate the prediction of the tumor proliferation antigen(Ki-67) expression status in breast cancer patients based on ultrasound radiomics combined with clinicopathologic features.Methods:Breast cancer patients who underwent 2D ultrasound and Ki-67 examination from January 2018 to February 2022 in Changzhou Second People′s Hospital, Nanjing Medical University were retrospectively analyzed. Among them, 427 patients from Chengzhong campus were randomly divided into training and validation sets in the ratio of 8∶2, and 229 patients from Yanghu campus were used as an independent external test set. Radiomics features were extracted from the region of interest of 2D ultrasound images, and the Mann-Whitney U test, recursive feature elimination, and minimum absolute shrinkage and selection operators were used to perform feature dimensionality reduction and to establish a radiomics score(Rad-score). Subsequently, single/multifactor logistic regression regression analyses were used to construct a joint prediction model based on Rad-score and clinicopathological features. Model performance and utility were assessed using the subject operating characteristic area under the curve (AUC), calibration curve, and decision curve analyses. Results:The AUCs of the joint model for predicting Ki-67 expression status in breast cancer in the training, validation, and test sets were 0.858, 0.797, and 0.802, respectively, which were superior to those of the radiomics (0.772, 0.731, and 0.713) and clinical models (0.738, 0.750, and 0.707). Calibration curve and decision curve analyses indicated that the joint model had good calibration and clinical value.Conclusions:A joint model based on ultrasound radiomics and clinicopathological features can effectively predict the Ki-67 expression status of breast cancer, which is expected to become a non-invasive tool for Ki-67 detection and provide clinicians with an important auxiliary diagnostic and therapeutic decision-making basis.

Objective:To construct a cycle dual-task network based on cycleGAN to implement 3D CT synthesis from single-view projection for adaptive radiotherapy of thoracic tumor and then evaluate image quality and dose accuracy.Methods:A total of 45 thoracic tumor patients admitted to the Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University were collected, and 991 cases were also selected from public dataset as pretrained dataset. Multi-view projections were acquired by ASTRA algorithm. The public dataset was divided into a training set of 800 cases, a validation set of 160 cases and a test set of 31 cases. The dataset obtained from patients in our hospital was divided into a training set of 40 cases and a test set of 5 cases. The network included synthetic CT model and multi-view projection prediction model and achieved the dual-task training. The final test only used the synthetic CT model to acquire the predicted CT images and deliver image quality [mean absolute error (MAE), peak signal-to-noise ratio (PSNR) and structural similarity index (SSIM)] and dose evaluation.Results:Image quality evaluation metrics for synthetic CT showed high image synthesis accuracy with MAE of 0.05±0.01, PSNR of 19.08±1.69, SSIM of 0.75±0.04, respectively. The dose distribution calculated on synthetic CT was also close to the actual dose distribution. The mean 3%/3 mm γ pass rate for synthetic CT was 93.1%.Conclusions:A dual-task cycle network modified on cycleGAN has been implemented to rapidly and accurately predict 3D CT from single-view projection, which can be applied to the workflow of adaptive radiotherapy for thoracic cancer. Both image generation quality and dosimetric evaluation demonstrate that synthetic CT can meet the clinical requirements for radiotherapy.