1.Deep learning-based radiomics allows for a more accurate assessment of sarcopenia as a prognostic factor in hepatocellular carcinoma.
Zhikun LIU ; Yichao WU ; Abid Ali KHAN ; L U LUN ; Jianguo WANG ; Jun CHEN ; Ningyang JIA ; Shusen ZHENG ; Xiao XU
Journal of Zhejiang University. Science. B 2024;25(1):83-90
		                        		
		                        			
		                        			Hepatocellular carcinoma (HCC) is one of the most common malignancies and is a major cause of cancer-related mortalities worldwide (Forner et al., 2018; He et al., 2023). Sarcopenia is a syndrome characterized by an accelerated loss of skeletal muscle (SM) mass that may be age-related or the result of malnutrition in cancer patients (Cruz-Jentoft and Sayer, 2019). Preoperative sarcopenia in HCC patients treated with hepatectomy or liver transplantation is an independent risk factor for poor survival (Voron et al., 2015; van Vugt et al., 2016). Previous studies have used various criteria to define sarcopenia, including muscle area and density. However, the lack of standardized diagnostic methods for sarcopenia limits their clinical use. In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP) renewed a consensus on the definition of sarcopenia: low muscle strength, loss of muscle quantity, and poor physical performance (Cruz-Jentoft et al., 2019). Radiological imaging-based measurement of muscle quantity or mass is most commonly used to evaluate the degree of sarcopenia. The gold standard is to measure the SM and/or psoas muscle (PM) area using abdominal computed tomography (CT) at the third lumbar vertebra (L3), as it is linearly correlated to whole-body SM mass (van Vugt et al., 2016). According to a "North American Expert Opinion Statement on Sarcopenia," SM index (SMI) is the preferred measure of sarcopenia (Carey et al., 2019). The variability between morphometric muscle indexes revealed that they have different clinical relevance and are generally not applicable to broader populations (Esser et al., 2019).
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Sarcopenia/diagnostic imaging*
		                        			;
		                        		
		                        			Carcinoma, Hepatocellular/diagnostic imaging*
		                        			;
		                        		
		                        			Muscle, Skeletal/diagnostic imaging*
		                        			;
		                        		
		                        			Deep Learning
		                        			;
		                        		
		                        			Prognosis
		                        			;
		                        		
		                        			Radiomics
		                        			;
		                        		
		                        			Liver Neoplasms/diagnostic imaging*
		                        			;
		                        		
		                        			Retrospective Studies
		                        			
		                        		
		                        	
2.Association Between Constipation and a Reduction in Lower Limb Muscle Strength in Preoperative Patients with Thoracic Spinal Tumors.
Yong LIU ; Si-Yuan YAO ; Xi ZHOU ; Shu-Zhong LIU ; Yan-Yan BIAN
Chinese Medical Sciences Journal 2023;38(2):109-116
		                        		
		                        			
		                        			Objective To investigate the clinical symptoms experienced by patients with thoracic spinal tumors and verify the associated symptoms that are predictive of a decline in muscle strength in the lower limbs. Methods A single-center, retrospective cross-sectional study was conducted on in-patients diagnosed with epidural thoracic spinal tumors between January 2011 and May 2021. The study involved a review of electronic medical records and radiographs and the collection of clinical data. The differences in clinical manifestations between patients with constipation and those without constipation were analyzed. Binary logistic regression analyses were performed to identify risk factors associated with a decline in muscle strength in the lower limbs.Results A total of 227 patients were enrolled, including 131 patients with constipation and 96 without constipation. The constipation group had a significantly higher proportion of patients who experienced difficulty walking or paralysis compared to those without constipation prior to surgery (83.2% vs. 17.7%, χ2 = 99.035,P < 0.001). Constipation (OR = 9.522, 95%CI: 4.150-21.849, P < 0.001) and urinary retention (OR = 14.490, 95%CI: 4.543-46.213, P < 0.001) were independent risk factors for muscle strength decline in the lower limbs. Conclusions The study observed that patients with thoracic spinal tumors who experienced constipation symptoms had a higher incidence of lower limb weakness. Moreover, the analysis revealed that constipation and urinary retention were independent risk factors associated with a preoperative decline in muscle strength of lower limbs.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Constipation/etiology*
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		                        			Cross-Sectional Studies
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		                        			Lower Extremity
		                        			;
		                        		
		                        			Muscle Strength
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Spinal Neoplasms
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		                        			Urinary Retention
		                        			
		                        		
		                        	
4.Mammary myofibroblastoma: a clinicopathological analysis of fifteen cases.
Hua Yan REN ; Xin HE ; Hong LYU ; Hui Fen HUANG ; Yu Qiong LIU ; Na WEI ; Lan ZHANG ; Wen Cai LI ; Hui Xiang LI
Chinese Journal of Pathology 2023;52(7):683-689
		                        		
		                        			
		                        			Objective: To investigate the clinicopathological features, diagnosis and differential diagnosis of breast myofibroblastoma. Methods: The clinicopathological data and prognostic information of 15 patients with breast myofibroblastoma diagnosed at the Department of Pathology of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China from 2014 to 2022 were collected. Their clinical characteristics, histological subtypes, immunophenotypes and molecular characteristics were analyzed. Results: There were 12 female and 3 male patients, ranging in age from 18 to 78 years, with a median and average age of 52 years. There were 6 cases in the left breast and 9 cases in the right breast, including 12 cases in outer upper quadrant, 2 cases in inner upper quadrant and 1 case in outer lower quadrant. Most of the cases showed a well-defined nodule grossly, including pushing growth under the microscope in 13 cases, being completely separated from the surrounding breast tissue in 1 case, and infiltrating growth in 1 case. Among them, 12 cases were classic subtype and composed of occasional spindle cells with varying intervals of collagen fiber bundles; eight cases had a small amount of fat; one case had focal cartilage differentiation; one case was epithelioid subtype, in which epithelioid tumor cells were scattered in single filing or small clusters; one case was schwannoma-like subtype, and the tumor cells were arranged in a significant palisade shape, resembling schwannoma, and one case was invasive leiomyoma-like subtype, in which the tumor cells had eosinophilic cytoplasm and were arranged in bundles, and infiltrating into the surrounding mammary lobules like leiomyoma. Immunohistochemical studies showed that the tumor cells expressed desmin (14/15) and CD34 (14/15), as well as ER (15/15) and PR (15/15). Three cases with histologic subtypes of epithelioid subtype, schwannoma-like subtype and infiltrating leiomyoma-like subtype showed RB1 negative immunohistochemistry. Then FISH was performed to detect RB1/13q14 gene deletion, and identified RB1 gene deletion in all three cases. Fifteen cases were followed up for 2-100 months, and no recurrence was noted. Conclusions: Myofibroblastoma is a rare benign mesenchymal tumor of the breast. In addition to the classic type, there are many histological variants, among which the epithelioid subtype is easily confused with invasive lobular carcinoma. The schwannoma-like subtype is similar to schwannoma, while the invasive subtype is easily misdiagnosed as fibromatosis-like or spindle cell metaplastic carcinoma. Therefore, it is important to recognize the various histological subtypes and clinicopathological features of the tumor for making correct pathological diagnosis and rational clinical treatment.
		                        		
		                        		
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Antigens, CD34
		                        			;
		                        		
		                        			Biomarkers, Tumor/analysis*
		                        			;
		                        		
		                        			Leiomyoma/pathology*
		                        			;
		                        		
		                        			Neoplasms, Muscle Tissue/pathology*
		                        			;
		                        		
		                        			Neurilemmoma
		                        			;
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Young Adult
		                        			;
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Aged
		                        			
		                        		
		                        	
6.A case report of nasopharyngeal inflammatory myofibroblastoma in infant.
Chao CHENG ; Jianwen ZHONG ; Shuncheng WANG ; Dabo LIU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):989-992
		                        		
		                        			
		                        			Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal soft tissue tumor characterized by borderline or low-grade malignancy. It is rare childhood tumor with an average age of onset of 10 years old. It is even rarer in infants and toddlers, and the etiology and pathogenesis of this tumor are still unclear. The clinical presentation of IMT is non-specific and are related to the location of the tumor. When the tumor compresses adjacent organs, it can cause pain and functional impairment. According to the current literature, IMT is most commonly found in the digestive and respiratory systems, but also occasionally occur in the genitourinary system, head and neck, and limbs. At present, there have been no reports of nasopharyngeal IMT involving nasal cavity of infants and toddlers at home and abroad.This article reports a case of a massive inflammatory myofibroblastic tumor involving the nasal cavity and nasopharynx in an infant. Plasma-assisted minimally invasive surgery was performed through multiple surgical approaches and achieved satisfactory therapeutic results. This case report may provide valuable reference for the treatment of similar diseases.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Infant
		                        			;
		                        		
		                        			Granuloma, Plasma Cell/pathology*
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		                        			Nasopharynx/pathology*
		                        			;
		                        		
		                        			Neoplasms, Muscle Tissue
		                        			;
		                        		
		                        			Soft Tissue Neoplasms
		                        			
		                        		
		                        	
10.Body composition changes following chemotherapy for testicular germ cell tumor: obesity is the long-term problem.
Yuki TAKAI ; Sei NAITO ; Hidenori KANNO ; Atsushi YAMAGISHI ; Mayu YAGI ; Toshihiko SAKURAI ; Hayato NISHIDA ; Takuya YAMANOBE ; Tomoyuki KATO ; Norihiko TSUCHIYA
Asian Journal of Andrology 2022;24(5):458-462
		                        		
		                        			
		                        			Metabolic syndrome is a long-term complication of systemic chemotherapy for testicular germ cell tumor (TGCT). It is believed to be caused by secondary hypogonadism or toxic medicines because of orchidectomy followed by systemic chemotherapy. In this study, changes in the body composition of patients over time were quantitatively analyzed up to 24 months after chemotherapy. This study retrospectively analyzed 44 patients with TGCT who underwent chemotherapy at our institution from January 2008 to December 2016. Subcutaneous and visceral fat areas and psoas and skeletal muscle areas were measured by computed tomography before and immediately after chemotherapy as well as 3 months, 6 months, 12 months, and 24 months after chemotherapy. The subcutaneous and visceral fat indices and psoas and skeletal muscle indices were calculated as each area divided by body height squared. The total fat area had already significantly increased 3 months after the initiation of chemotherapy (P = 0.004). However, it did not return to prechemotherapeutic levels even at 24 months after chemotherapy. The skeletal muscle area was significantly decreased at the end of chemotherapy (P < 0.001); however, the value returned to baseline within 12 months. In multivariable analysis, the prechemotherapeutic skeletal muscle index and number of chemotherapy cycles were independently associated with the reduction of skeletal muscle at the end of chemotherapy (P = 0.001 and P = 0.027, respectively). In patients with TGCT, skeletal muscle mass decreased during chemotherapy and recovered within 12 months, whereas fat mass progressively increased from the initiation of chemotherapy until 24 months after chemotherapy.
		                        		
		                        		
		                        		
		                        			Body Composition
		                        			;
		                        		
		                        			Body Mass Index
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Muscle, Skeletal
		                        			;
		                        		
		                        			Neoplasms, Germ Cell and Embryonal
		                        			;
		                        		
		                        			Obesity
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Sarcopenia
		                        			;
		                        		
		                        			Testicular Neoplasms
		                        			
		                        		
		                        	
            
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