1.Presenting characteristics, histological subtypes and outcomes of adult central nervous system tumours: retrospective review of a surgical cohort.
Mervyn Jun Rui LIM ; Yilong ZHENG ; Sean Wai-Onn ENG ; Celest Wen Ting SEAH ; Shuning FU ; Lucas Zheng Long LAM ; Joel Yat Seng WONG ; Balamurugan VELLAYAPPAN ; Andrea Li-Ann WONG ; Kejia TEO ; Vincent Diong Weng NGA ; Sein LWIN ; Tseng Tsai YEO
Singapore medical journal 2025;66(10):545-550
INTRODUCTION:
The most recent local study on the incidence of histological subtypes of all brain and spinal tumours treated surgically was published in 2000. In view of the outdated data, we investigated the presenting characteristics, histological subtypes and outcomes of adult patients who underwent surgery for brain or spinal tumours at our institution.
METHODS:
A single-centre retrospective review of 501 patients who underwent surgery for brain or spinal tumours from 2016 to 2020 was conducted. The inclusion criteria were (a) patients who had a brain or spinal tumour that was histologically verified and (b) patients who were aged 18 years and above at the time of surgery.
RESULTS:
Four hundred and thirty-five patients (86.8%) had brain tumours and 66 patients (13.2%) had spinal tumours. Patients with brain tumours frequently presented with cranial nerve palsy, headache and weakness, while patients with spinal tumours frequently presented with weakness, numbness and back pain. Overall, the most common histological types of brain and spinal tumours were metastases, meningiomas and tumours of the sellar region. The most common complications after surgery were cerebrospinal fluid leak, diabetes insipidus and urinary tract infection. In addition, 15.2% of the brain tumours and 13.6% of the spinal tumours recurred, while 25.7% of patients with brain tumours and 18.2% of patients with spinal tumours died. High-grade gliomas and metastases had the poorest survival and highest recurrence rates.
CONCLUSION
This study serves as a comprehensive update of the epidemiology of brain and spinal tumours and could help guide further studies on brain and spinal tumours.
Humans
;
Retrospective Studies
;
Female
;
Male
;
Middle Aged
;
Adult
;
Aged
;
Central Nervous System Neoplasms/pathology*
;
Brain Neoplasms/pathology*
;
Treatment Outcome
;
Postoperative Complications
;
Young Adult
;
Spinal Neoplasms/pathology*
;
Neoplasm Recurrence, Local
;
Aged, 80 and over
;
Adolescent
3.Correlation between pathological features at the positive margin and biochemical recurrence after radical prostatectomy in patients with organ-confined prostate cancer.
Xin-Huan FAN ; Yan ZHANG ; Lin-Lin ZHU ; Cheng-Yi LIU ; De-Gang CHEN ; Shi-Fang SANG ; Peng-Cheng XU
National Journal of Andrology 2025;31(3):202-207
Objective: To investigate the correlation between pathological features at the positive margins and biochemical recurrence after radical prostatectomy for prostate cancer. Methods: From June 2014 to December 2019, a total of 200 patients with organ-confined prostate cancer who underwent radical prostatectomy were included in this study by the method of case matching (1∶1). One hundred patients with positive surgical margin and 100 with negative surgical margin were enrolled in this study. All patients did not receive any adjuvant treatment after surgery with a clinical stage of T2/N0. BCR-free survival was estimated using the Kaplan-Meier method. An optimal cutoff for the PSM length which differentiated risk for BCR was identified by Classification and Regression Tree analysis (CART). Cox proportional hazards regression model was used to assess the association between variables and BCR-free survival. Results: A total of 200 patients were included in this study, and 177 patients with pT2 stage were pathological after operation. The median follow-up time of this group of patients was 32.8 months ranged from 5.6 to 80.5 months. A total of 28 cases of biochemical recurrence were found through PSA follow-up after surgery, including 6 cases (6.0%) in the negative margin group and 22 cases (22.0%) in the positive margin group. The result of Kaplan Meier survival curve analysis showed that the non biochemical recurrence survival time of the negative margin group was longer than that of the positive margin group (log rank χ2=9.336, P=0.003). It was found that the length of positive margin ≥1 mm in the positive margin group was positively correlated with postoperative biochemical recurrence. Multivariate Cox proportional hazards regression was used to identify that the highest Gleason score ≥8 and the length of positive ≥1 mm were independent factors of postoperative biochemical recurrence in both the overall patients and the patients with positive margin. Conclusion: The patients with highest Gleason score ≥8 and the length of positive ≥1mm are at elevated risk for BCR.
Humans
;
Male
;
Prostatectomy
;
Prostatic Neoplasms/pathology*
;
Neoplasm Recurrence, Local
;
Margins of Excision
;
Prostate-Specific Antigen/blood*
;
Proportional Hazards Models
;
Middle Aged
;
Aged
;
Neoplasm Staging
;
Kaplan-Meier Estimate
4.Effect of intraoperative blood salvage autotransfusion on the prognosis of patients after carotid body tumor resection.
Weihao LI ; Jing LI ; Xuemin ZHANG ; Wei LI ; Qingle LI ; Xiaoming ZHANG
Journal of Peking University(Health Sciences) 2025;57(2):272-276
OBJECTIVE:
To investigate the effect of intraoperative blood salvage autotransfusion on local recurrence and long-term metastasis of patients after carotid body tumor resection.
METHODS:
We retrospectively reviewed a consecutive series of 61 patients undergoing elective carotid body tumor resection from August 2009 to December 2020. Among them, 14 received intraoperative blood salvage autotransfusion (autotrasfusion group) and 47 did not (non-autotransfusion). Data of general information, surgical status and postoperative follow-up results were collected.
RESULTS:
The proportion of Shamblin Ⅲ in the autotransfusion group was 85.7%, which was significantly higher than 31.9% in the non-autotransfusion group (P=0.003). The average operation time of the 14 patients in the autotransfusion group was (264±84) min, intraoperative blood loss was 1 200 (700, 2 700) mL, and autologous blood transfusion was 500 (250, 700) mL. Of these, 8 patients (57%) required concomitant allogeneic blood with 400 (260, 400) mL of allogeneic blood. The average operation time of the 47 patients in the non-autotransfusion group was (153±75) min, and the intraoperative blood loss was 300 (100, 400) mL. Of these, 6 (13%) required allogeneic blood transfusion, and 520 (400, 520) mL of allogeneic blood was used. Compared with the non-autotransfusion group, the average operation time in the autologous blood transfusion group was significantly longer (P < 0.001), and the intraoperative blood transfusion volume was larger (P=0.007). Of the 14 patients undergoing autotransfusion, 8 (57%) needed allogeneic blood at the same time; while in the 47 non-autologous transfusion patients, 6 (13%) needed allogeneic blood transfusion. The proportion of autotransfusion group using allogeneic blood at the same time was even higher (P=0.002). The incidence of nerve injury within 30 days after surgery was 29.5%, and there was no significant difference between the two groups. No early deaths occurred. The average follow-up was (76±37) months. One case of local recurrence occurred in the non-autotransfusion group. There was no distant metastasis. There were no tumor-related deaths. The estimated 5-year and 10-year overall survival rates were 96.4% and 83.8%, respectively. There was no significant difference in overall survival between the two groups (P=0.506).
CONCLUSION
The use of intraoperative blood salvage autotransfusion increased no risk of local recurrence and distant metastasis in patients with carotid body tumor, which is safe and effective in carotid body tumor resection.
Humans
;
Blood Transfusion, Autologous/methods*
;
Operative Blood Salvage/methods*
;
Retrospective Studies
;
Male
;
Female
;
Carotid Body Tumor/pathology*
;
Middle Aged
;
Prognosis
;
Neoplasm Recurrence, Local
;
Blood Loss, Surgical
;
Aged
;
Adult
;
Operative Time
5.1 case of recurrent nasal vestibular aggressive angiomyxoma.
Yaqin WANG ; Jianwei AI ; Jingyi ZHAO ; Yuezhi KANG ; Suying GUO ; Junge WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(9):886-893
Invasive angiomyxoma(AAM) is characterized by unclear boundaries, non enveloped glial growth, high recurrence rate, and belongs to a benign tumor, but it is invasive and grows slowly. A patient with recurrent left vestibular invasive angiomyxoma was admitted to the Otorhinolaryngology ward of Beijing Traditional Chinese Medicine Hospital Affiliated with Capital Medical University. The patient underwent two repeated surgeries and underwent a combined internal and external nasal approach for the removal of the nasal vestibular angiomyxoma. The patient recovered well after the surgery and has not recurred since follow-up.
Humans
;
Myxoma/pathology*
;
Neoplasm Recurrence, Local
;
Nose Neoplasms/pathology*
6.Programmed death-ligand 1 regulates ameloblastoma growth and recurrence.
Linzhou ZHANG ; Hao LIN ; Jiajie LIANG ; Xuanhao LIU ; Chenxi ZHANG ; Qiwen MAN ; Ruifang LI ; Yi ZHAO ; Bing LIU
International Journal of Oral Science 2025;17(1):29-29
Tumor cell-intrinsic programmed death-ligand 1 (PD-L1) signals mediate tumor initiation, progression and metastasis, but their effects in ameloblastoma (AM) have not been reported. In this comprehensive study, we observed marked upregulation of PD-L1 in AM tissues and revealed the robust correlation between elevated PD-L1 expression and increased tumor growth and recurrence rates. Notably, we found that PD-L1 overexpression markedly increased self-renewal capacity and promoted tumorigenic processes and invasion in hTERT+-AM cells, whereas genetic ablation of PD-L1 exerted opposing inhibitory effects. By performing high-resolution single-cell profiling and thorough immunohistochemical analyses in AM patients, we delineated the intricate cellular landscape and elucidated the mechanisms underlying the aggressive phenotype and unfavorable prognosis of these tumors. Our findings revealed that hTERT+-AM cells with upregulated PD-L1 expression exhibit increased proliferative potential and stem-like attributes and undergo partial epithelial‒mesenchymal transition. This phenotypic shift is induced by the activation of the PI3K-AKT-mTOR signaling axis; thus, this study revealed a crucial regulatory mechanism that fuels tumor growth and recurrence. Importantly, targeted inhibition of the PD-L1-PI3K-AKT-mTOR signaling axis significantly suppressed the growth of AM patient-derived tumor organoids, highlighting the potential of PD-L1 blockade as a promising therapeutic approach for AM.
Ameloblastoma/metabolism*
;
Humans
;
B7-H1 Antigen/metabolism*
;
Neoplasm Recurrence, Local/pathology*
;
Signal Transduction
;
Cell Proliferation
;
Up-Regulation
;
TOR Serine-Threonine Kinases/metabolism*
;
Proto-Oncogene Proteins c-akt/metabolism*
;
Telomerase/metabolism*
;
Jaw Neoplasms/metabolism*
;
Epithelial-Mesenchymal Transition
;
Animals
;
Cell Line, Tumor
;
Female
;
Male
8.Expressions of PRMT5 and DKK3 proteins in prostate cancer tissue correlate to biochemical recurrence after radical prostatectomy.
Mei-Man TAO ; Kang CHENG ; Peng PAN ; Tao GUO ; Bing-Hai CHEN ; Ke-Jun MA
National Journal of Andrology 2024;30(12):1074-1080
OBJECTIVE:
To investigate the relationship of the expression levels of protein arginine methyltransferase 5 (PRMT5) and Dickkopf-related protein 3 (DKK3) in the PCa tissue with biochemical recurrence (BR) of the malignancy after radical surgery.
METHODS:
This study included 105 cases of PCa diagnosed in our hospital from January 2016 to December 2020 and, according to BR within 3 years after surgery, we divided them into a BR (n = 22) and a non-BR group (n = 83). We detected the expressions of PRMT5 and DKK3 in the prostate tissues of the patients by immunohistochemistry, analyzed the correlation of the expression levels of PRMT5 and DKK3 using the Spearman method, and conducted a multivariate analysis of postoperative BR of the malignancy using the Cox multivariate regression model.
RESULTS:
The positive expression of PRMT5 was significantly higher while that of DKK3 remarkably lower in the PCa than in the adjacent tissue (P<0.05). Spearman correlation analysis showed a negative correlation between the expression levels of PRMT5 and DKK3 in the PCa tissue (r = -0.532, P<0.05). The expressions of PRMT5 and DKK3 were significantly associated with tumor-node-metastasis (TNM) stages, positive surgical margins, peripheral nerve invasion, capsular invasion, seminal vesicle invasion and vascular invasion (P<0.05). The percentage of TNM stages III-IV, the positive expression of PRMT5 and the negative expression of DKK3 were remarkably higher in the BR than in the non-BR group (P<0.05). PRMT5 was found to be an independent risk factor for while DKK3 a protective factor against postoperative BR of PCa in the patients (P<0.05).
CONCLUSION
PRMT5 is highly while DKK3 lowly expressed in PCa tissue, and their expressions are both closely related to the biochemical recurrence of PCa after radical surgery.
Humans
;
Male
;
Protein-Arginine N-Methyltransferases/metabolism*
;
Prostatectomy
;
Prostatic Neoplasms/pathology*
;
Neoplasm Recurrence, Local
;
Adaptor Proteins, Signal Transducing
;
Intercellular Signaling Peptides and Proteins/metabolism*
;
Middle Aged
;
Immunohistochemistry
9.Advances in the diagnosis and prognosis of extranodal extension in head and neck squamous cell carcinoma.
Zhihai WANG ; Min PAN ; Quan ZENG ; Guohua HU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(12):1190-1202
Objective:The extranodal extension(ENE) is widely found in head and neck squamous cell carcinoma(HNSCC), which displays the aggressiveness of the tumor and increasing the risk of local recurrence and distant metastasis, so the ENE often has been used as an important indicator of prognosis and treatment. Although the pathologic and radiologic tests are currently the main diagnostic techniques for ENE, there is still a lack of uniform standards. The article reviews the prognostic value, pathologic and radiologic diagnosis of ENE in HNSCC over the recent years.
Humans
;
Head and Neck Neoplasms/pathology*
;
Prognosis
;
Squamous Cell Carcinoma of Head and Neck/diagnosis*
;
Carcinoma, Squamous Cell/diagnosis*
;
Extranodal Extension
;
Neoplasm Recurrence, Local
;
Lymphatic Metastasis
10.An autophagy-related gene prognostic index predicting biochemical recurrence, metastasis, and drug resistance for prostate cancer.
Wei-Zhen ZHU ; De-Chao FENG ; Qiao XIONG ; Xu SHI ; Fa-Cai ZHANG ; Qiang WEI ; Lu YANG
Asian Journal of Andrology 2023;25(2):208-216
Given the dual role of autophagy presenting in tumorigenesis and inhibition, we established an autophagy-related gene prognostic index (ARGPI) with validation to well predict the biochemical recurrence (BCR), metastasis, as well as chemoresistance for patients with prostate cancer (PCa) who underwent radical radiotherapy or prostatectomy. Then, Lasso and COX regression was used to develop the ARGPI. We performed the whole analyses through R packages (version 3.6.3). Secreted phosphoprotein 1 (SPP1), single-minded 2 (SIM2), serine protease inhibitor b5 (SERPINB5), aldehyde dehydrogenase 2 (ALDH2), and acyl-CoA synthetase long-chain 3 (ACSL3) were eventually used to establish the ARGPI score. Patients were divided into two different-risk groups based on the median ARGPI score, high-risk patients with a higher risk of BCR than low-risk patients (hazard ratio [HR]: 5.46, 95% confidence interval [CI]: 3.23-9.24). The risk of metastasis of high-risk patients was higher than low-risk patients (HR: 11.31, 95% CI: 4.89-26.12). In The Cancer Genome Atlas (TCGA) dataset, we observed similar prognostic value of ARGPI in terms of BCR-free survival (HR: 1.79, 95% CI: 1.07-2.99) and metastasis-free survival (HR: 1.80, 95% CI: 1.16-2.78). ARGPI score showed a diagnostic accuracy of 0.703 for drug resistance. Analysis of gene set enrichment analysis (GSEA) indicated that patients in the high-risk group were significantly positively related to interleukin (IL)-18 signaling pathway. Moreover, ARGPI score was significantly related to cancer-related fibroblasts (CAFs; r = 0.36), macrophages (r = 0.28), stromal score (r = 0.38), immune score (r = 0.35), estimate score (r = 0.39), as well as tumor purity (r = -0.39; all P < 0.05). Drug analysis showed that PI-103 was the common sensitive drug and cell line analysis indicated that PC3 was the common cell line of PI-103 and the definitive gene. In conclusion, we found that ARGPI could predict BCR, metastasis, and chemoresistance in PCa patients who underwent radical radiotherapy or prostatectomy.
Male
;
Humans
;
Prognosis
;
Neoplasm Recurrence, Local/pathology*
;
Prostatic Neoplasms/pathology*
;
Prostatectomy
;
Drug Resistance
;
Aldehyde Dehydrogenase, Mitochondrial

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