1.Pelvic epithelioid inflammatory myofibroblastic sarcoma complicated with peritoneal metastasis: a case report
Wenpeng HUANG ; Lele SONG ; Xiaoyan XIAO ; Liming LI ; Yongkang QIU ; Jianbo GAO ; Lei KANG
Journal of Chinese Physician 2025;27(3):357-360
Objective:To analyze the clinical features, imaging features and diagnosis and treatment process of a female pelvic epithelioid inflammatory myofibroblastic sarcoma (EIMS) with peritoneal metastasis, so as to improve the clinical understanding and diagnostic ability of the disease and avoid misdiagnosis and missed diagnosis.Methods:The clinical data of a female patient with pelvic EIMS combined with peritoneal metastasis in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.Results:The triad examination of the patient involved an irregular solid mass in the pelvic cavity about 8.0 cm×9.0 cm in size. Laboratory examination revealed human epididymal protein 4(HE4)154.00 pmol/L. The ultrasonography showed multiple low-echo masses in deep pelvic cavity with unclear boundary and uneven internal echo, and color doppler flow imaging (CDFI) showed abundant internal blood flow signals. Enhanced CT showed uneven and obvious enhancement of the lesion. Pathological examination showed the infiltration of inflammatory cells in the mucous interstitial background. The tumor cells were round and epithelioid, with large nuclei, deep staining and obvious nucleolus. Immunohistochemistry showed anaplastic lymphoma kinase (ALK) positive, and molecular pathology fluorescence in situ hybridization showed ALK gene amplification (positive). Combined with pathological, immunohistochemical and genetic tests, EIMS was diagnosed. Conclusions:EIMS should be considered when there are single or multiple solid or cystic nodules or masses in the pelvic cavity with obvious enhancement, invasive growth and peritoneal implantation metastasis, and the correct diagnosis can be made according to the pathological findings, immunohistochemistry and genetic test results.
2.Research progress of nucleic acid aptamer AS1411 in tumor molecular imaging
Wenpeng HUANG ; Xinyao SUN ; Xiaoyue ZHANG ; Qi YANG ; Lele SONG ; Lei KANG
Journal of Chinese Physician 2025;27(4):622-626
Nucleic acid aptamers are a type of single-stranded oligonucleotides screened through in vitro exponentially enriched ligand phylogenetic technology, and they can bind to various targets with high specificity and high affinity. AS1411 is a 26-base guanine-rich DNA aptamer, and its target nucleolin is widely distributed in multiple locations within the cell, including the nucleolus, nucleoplasm, cytoplasm and cell membrane. AS1411 demonstrates multiple advantages, such as weak immunogenicity, low toxicity, easy structural modification, and strong tissue penetration ability. Despite numerous challenges in the clinical transformation process, with the continuous advancement of molecular imaging technology, AS1411 has demonstrated great potential in the fields of targeted imaging and targeted delivery of cancer drugs. This article mainly focuses on the research progress of AS1411 in the field of molecular imaging, covering its applications in magnetic resonance imaging, fluorescence imaging and nuclear medicine imaging, etc.
3.Research progress of nucleic acid aptamer AS1411 in tumor molecular imaging
Wenpeng HUANG ; Xinyao SUN ; Xiaoyue ZHANG ; Qi YANG ; Lele SONG ; Lei KANG
Journal of Chinese Physician 2025;27(4):622-626
Nucleic acid aptamers are a type of single-stranded oligonucleotides screened through in vitro exponentially enriched ligand phylogenetic technology, and they can bind to various targets with high specificity and high affinity. AS1411 is a 26-base guanine-rich DNA aptamer, and its target nucleolin is widely distributed in multiple locations within the cell, including the nucleolus, nucleoplasm, cytoplasm and cell membrane. AS1411 demonstrates multiple advantages, such as weak immunogenicity, low toxicity, easy structural modification, and strong tissue penetration ability. Despite numerous challenges in the clinical transformation process, with the continuous advancement of molecular imaging technology, AS1411 has demonstrated great potential in the fields of targeted imaging and targeted delivery of cancer drugs. This article mainly focuses on the research progress of AS1411 in the field of molecular imaging, covering its applications in magnetic resonance imaging, fluorescence imaging and nuclear medicine imaging, etc.
4.Pelvic epithelioid inflammatory myofibroblastic sarcoma complicated with peritoneal metastasis: a case report
Wenpeng HUANG ; Lele SONG ; Xiaoyan XIAO ; Liming LI ; Yongkang QIU ; Jianbo GAO ; Lei KANG
Journal of Chinese Physician 2025;27(3):357-360
Objective:To analyze the clinical features, imaging features and diagnosis and treatment process of a female pelvic epithelioid inflammatory myofibroblastic sarcoma (EIMS) with peritoneal metastasis, so as to improve the clinical understanding and diagnostic ability of the disease and avoid misdiagnosis and missed diagnosis.Methods:The clinical data of a female patient with pelvic EIMS combined with peritoneal metastasis in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.Results:The triad examination of the patient involved an irregular solid mass in the pelvic cavity about 8.0 cm×9.0 cm in size. Laboratory examination revealed human epididymal protein 4(HE4)154.00 pmol/L. The ultrasonography showed multiple low-echo masses in deep pelvic cavity with unclear boundary and uneven internal echo, and color doppler flow imaging (CDFI) showed abundant internal blood flow signals. Enhanced CT showed uneven and obvious enhancement of the lesion. Pathological examination showed the infiltration of inflammatory cells in the mucous interstitial background. The tumor cells were round and epithelioid, with large nuclei, deep staining and obvious nucleolus. Immunohistochemistry showed anaplastic lymphoma kinase (ALK) positive, and molecular pathology fluorescence in situ hybridization showed ALK gene amplification (positive). Combined with pathological, immunohistochemical and genetic tests, EIMS was diagnosed. Conclusions:EIMS should be considered when there are single or multiple solid or cystic nodules or masses in the pelvic cavity with obvious enhancement, invasive growth and peritoneal implantation metastasis, and the correct diagnosis can be made according to the pathological findings, immunohistochemistry and genetic test results.
5.Progress of seed 125I implantation combined with other regimens in the treatment of unresectable pancreatic cancer
Wenpeng HUANG ; Sitong WU ; Lele SONG ; Qi YANG ; Lei KANG
Journal of Chinese Physician 2024;26(2):301-305
pancreatic cancer is a common malignant tumor of digestive system, with poor prognosis. About 80% of patients have lost the opportunity of surgical resection when diagnosed. In different treatment schemes, radioactive seed 125I implantation can improve the quality of life of patients with unresectable pancreatic cancer and is expected to improve their survival rate. This article reviews the clinical applications of 125I particle implantation therapy combined with chemotherapy, cryotherapy, intracavitary irradiation, stent placement, radiofrequency ablation, nanoknife, and bypass surgery, in order to better promote its clinical application. However, it is necessary to establish unified dosage standards and regulatory guidelines to make them safer and more widely serve clinical practice.
6.Mechanism of Cangxitongbi Capsules in Mediating Chondrocyte Pyroptosis in Knee Osteoarthritis via Regulating p38 MAPK/NLRP3/Caspase-1 Pathway
Zhimeng ZHANG ; Daotong YUAN ; Ximin JIN ; Rui GONG ; Zhenlong SONG ; Yongkui ZHANG ; Xiaole WANG ; Rongxiu BI ; Wenpeng XIE
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):61-68
ObjectiveTo explore the mechanism of Cangxi Tongbi capsules (CXTB) in regulating the p38 mitogen-activated protein kinase (p38 MAPK)/NOD-like receptor protein 3 (NLRP3)/cysteine protease-1 (Caspase-1) signaling pathway to inhibit pyroptosis of cartilage cells in knee osteoarthritis (KOA). MethodSixty male SD rats were randomly divided into a sham operation group, a model group, low, medium, and high dose CXTB groups, and a positive control group, with 10 rats per group. The modified Hulth method was employed to establish a rat model of KOA. According to their respective assignments, rats were administered CXTB (0.25, 0.5, 1.0 g·kg-1) and Celecoxib (24 mg·kg-1) by gavage. The sham operation and model groups were given an equivalent volume of physiological saline. Treatment was performed once daily for 28 days. Micro-computed tomography (Micro-CT) was used to assess bone volume/total volume (BV/TV) and trabecular separation (Tb.Sp). Joint degeneration was evaluated through hematoxylin-eosin (HE) staining, safranin-fast green (SO) staining, and Osteoarthritis Research Society International (OARSI) scoring. Western blot analysis was conducted to measure the expression levels of p38 MAPK, phosphorylated p38 MAPK (p-p38 MAPK), NLRP3, Caspase-1, and gasdermin D (GSDMD) proteins. Real-time PCR was used to assess mRNA expression levels of p38 MAPK, NLRP3, Caspase-1, and GSDMD genes. Enzyme-linked immunosorbent assay (ELISA) was used to measure serum concentrations of inflammatory cytokines including tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and interleukin-18 (IL-18). After knee replacement surgery, cartilage tissue was analyzed using Western blot to assess the protein expression levels of p38 MAPK, p-p38 MAPK, NLRP3, Caspase-1, and GSDMD, and Real-time PCR was used to evaluate gene expression levels of p38 MAPK, NLRP3, Caspase-1, and GSDMD. ResultMicro-CT analysis revealed significant narrowing of the joint space and increased bone spur formation in KOA rats compared with the sham operation group, with a decrease in BV/TV ratio and an increase in Tb.Sp value (P<0.01). Serum levels of TNF-α, IL-1β, and IL-18 were elevated (P<0.01). The protein expression levels of p-p38 MAPK, NLRP3, Caspase-1, and GSDMD in cartilage were significantly increased (P<0.01), and the mRNA expression levels of p38 MAPK, NLRP3, Caspase-1, and GSDMD were also enhanced (P<0.01). Significant differences in protein expression of p-p38 MAPK, NLRP3, Caspase-1, and GSDMD were observed between normal and diseased cartilage tissues after knee replacement surgery (P<0.05), and the gene expression of p38 MAPK, NLRP3, Caspase-1, and GSDMD were also significantly different (P<0.01). HE and SO staining showed roughened joint surfaces, reduced cartilage thickness, and disordered cellular arrangement in KOA rats. OARSI scores were significantly higher (P<0.01). Compared with the model group, treatment with low, medium, and high concentrations of CXTB resulted in increased BV/TV ratios and decreased Tb.Sp values in the knee joints of rats (P<0.01). HE and SO staining indicated a trend towards smoother joint surfaces and reduced OARSI scores (P<0.01). The protein expression levels of p-p38 MAPK, NLRP3, Caspase-1, and GSDMD were notably decreased (P<0.05), as were the mRNA expression levels of p38 MAPK, NLRP3, Caspase-1, and GSDMD (P<0.01). Additionally, serum concentrations of TNF-α, IL-1β, and IL-18 were significantly reduced (P<0.01). ConclusionCXTB intervention may alleviate knee joint degeneration in KOA rats and inhibit the expression of inflammatory factors and pyroptosis of cartilage cells, thereby protecting cartilage. The underlying mechanism may involve modulation of the p38 MAPK/NLRP3/Caspase-1 signaling pathway.
7.Increased risk of subsequent primary lung cancer among female hormone-related cancer patients: A meta-analysis based on over four million cases
Yan WANG ; Wenpeng SONG ; Haoyu WANG ; Guonian ZHU ; Yangqian LI ; Zhoufeng WANG ; Weimin LI ; Guowei CHE
Chinese Medical Journal 2024;137(15):1790-1801
Background::The incidence rate of lung cancer in women has significantly increased over the past decade, and previous evidence has indicated a significant relationship between the elevated levels of sex hormones and the risk of lung cancer. Therefore, we hypothesized that female hormone-related cancer (FHRC) patients, including breast, endometrial, cervical, and ovarian cancer patients, may experience a higher risk of developing subsequent lung cancer. This meta-analysis aimed to identify the risk of lung cancer among FHRC patients compared to the general population.Methods::The PubMed, Web of Science, EMBASE, Cochrane Library, and CNKI databases were searched up to May 11, 2022. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were used to identify the risk of subsequent lung cancer after FHRC. Subgroup analyses based on the follow-up time and tumor type were also conducted.Results::A total of 58 retrospective cohort studies involving 4,360,723 FHRC participants were included. The pooled results demonstrated that FHRC patients had a significantly increased risk of developing subsequent primary lung cancer (SIR = 1.61, 95% CI: 1.48-1.76, P <0.001). Subgroup analysis revealed an obvious trend of increasing lung cancer risk over time (SIRs for <5 years, ≥5 years, ≥10 years, ≥20 years, and ≥30 years after FHRC: 1.32, 1.59, 1.57, 1.68, and 1.95, respectively). In addition, subgroup analysis stratified by tumor type indicated an increased risk of developing subsequent lung cancer after breast (SIR = 1.25, P <0.001), endometrial (SIR = 1.40, P = 0.019), cervical (SIR = 2.56, P <0.001), and ovarian cancer (SIR = 1.50, P = 0.010). Conclusion::FHRC patients are more likely to develop lung cancer than the general population. Furthermore, the increased risk of subsequent primary lung cancer is more obvious with a longer survival time and is observed in all types of hormone-related cancer.Registration::International Platform of Registered Systematic Review and Meta-analysis Protocols: No. INPLASY202270044; https://inplasy.com/
8.Research progress of 18F-FDG PET/CT in the diagnosis and prognosis of follicular lymphoma
Wenpeng HUANG ; Xinyao SUN ; Lele SONG ; Qi YANG ; Lei KANG
Journal of Chinese Physician 2024;26(4):621-626
Follicular lymphoma (FL) is the most common inert B-cell lymphoproliferative disease characterized by extensive lymph node involvement, splenomegaly, and bone marrow infiltration. In recent years, with the development of molecular imaging technology and precision medicine, the imaging research of FL has been moving towards a more refined direction. 18F-FDG PET/CT plays an increasingly important role in the diagnosis, staging, efficacy evaluation, and prognosis judgment of FL patients, promoting more precise personalized treatment and improving the efficacy and survival of FL patients. This article reviews the research progress of 18F-FDG PET/CT in the diagnosis and prognosis of FL based on domestic and foreign research progress, summarizing existing literature, in order to provide reference for personalized diagnosis and treatment of FL.
9.The association of hyponatremia with clinicopathological and prognostic characteristics of non-small cell lung cancer patients: A systematic review and meta-analysis
Xiaowei WANG ; Shuai CHANG ; Wenpeng SONG ; Guowei CHE
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2023;30(03):428-433
Objective To explore the association of pretreatment hyponatremia with clinicopathological and prognostic characteristics of non-small cell lung cancer (NSCLC) patients. Methods The PubMed, EMbase, Web of Science, VIP, CNKI and WanFang databases were searched from the inception to July 12, 2021 for relevant literatures. The quality of included studies was assessed by the Newcastle-Ottawa Scale (NOS) score. The relative risk (RR) and hazard ratio (HR) with 95% confidence interval (CI) were combined to assess the relationship between pretreatment hyponatremia and clinicopathological and prognostic characteristics. The prognostic indicators included the overall survival (OS) and progression-free survival (PFS). All statistical analysis was conducted by the STATA 15.0 software. Results A total of 10 high-quality studies (NOS score≥6 points) involving 10 045 patients were enrolled and all participants were from Asian or European regions. The pooled results demonstrated that male [RR=1.18, 95%CI (1.02, 1.36), P=0.026], non-adenocarcinoma [RR=0.86, 95%CI (0.81, 0.91), P<0.001] and TNM Ⅲ-Ⅳ stage [RR=1.17, 95%CI (1.12, 1.21), P<0.001] patients were more likely to experience hyponatremia. Besides, pretreatment hyponatremia was significantly related to worse OS [HR=1.83, 95%CI (1.53, 2.19), P<0.001] and PFS [HR=1.54, 95%CI (1.02, 2.34), P=0.040]. Pretreatment hyponatremia was a risk factor for poor prognosis of NSCLC patients. Conclusion Male, non-adenocarcinoma and advance stage NSCLC patients are more likely to experience hyponatremia. Meanwhile, the pretreatment sodium level can be applied as one of the prognostic evaluation indicators in NSCLC and patients with hyponatremia are more likely to have poor survival. However, more researches are still needed to verify above findings.

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