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25 December 2021, Volume 20 Issue 06 Previous Issue    Next Issue

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The prognostic value of pretreatment 18F-FDG PET/CT in extranodal natural killer/T-cell lymphoma FENG Guowei, ZHANG Xiaojuan, GUO Rui, GUAN Zhe, WANG Yue 2021, 20 (06):  533-539.  DOI: 10.16150/j.1671-2870.2021.06.004 Abstract ( 203 )   HTML ( 4 )   PDF (863KB) ( 97 )   Objective: To assess use of pretreatment 18F-FDG PET/CT in prognosis prediction of extranodal natural killer/T-cell lymphoma(ENKTL). Methods: Sixty consecutive patients with newly diagnosed ENKTL underwent pretreatment 18F-FDG PET/CT were included and all patients received a pegaspargase-based regime. The maximum standardized uptake value (SUVmax), mean SUV (SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG) of the tumor, and clinical parameters including gender, age, ENKTL stage, nasal lymphoma infiltration range, extranasal lymphoma infiltration, lymph node involvement, bone marrow involvement. Survival curves and log-rank test were performed, and Cox proportional hazards model was used to assess the independent risk factors for overall survival(OS) and progression-free survival (PFS). Results: Survival analysis showed that MTV (P<0.001), TLG (P<0.001), PET/CT-based Ann Arbor stage (P<0.001), extranasal lymphoma infiltration (P=0.006), lymph node involvement (P=0.031), and bone marrow involvement on PET/CT (P<0.001) were predictive factors for 2-year OS, while SUVmax (P=0.653), SUVmean (P=0.446), and nasal lymphoma infiltration range (P=0.308) were not. SUVmax (P=0.274), SUVmean (P=0.213), nasal lymphoma infiltration range (P=0.621), and lymph node involvement (P=0.069) were not predictive factors for 2-year PFS,and MTV (P=0.001), TLG (P=0.009), PET/CT-based Ann Arbor stage(P<0.001), extranasal lymphoma infiltration (P<0.001), and bone marrow involvement on PET/CT (P<0.001) were predictive factors. Multivariate analysis showed PET/CT-based bone marrow involvement and Ann Arbor stage were independent prognostic factors for 2-year OS (P=0.046 and 0.019, respectively) and PFS (P=0.033 and 0.015), respectively. Conclusions: It reveals that 18F-FDG PET/CT-based bone marrow involvement and Ann Arbor stage are independent prognostic factors for both OS and PFS of newly diagnosed ENKTL. Figures and Tables | References | Related Articles | Metrics

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Comparison of magnetic resonance whole body diffusion weighted imaging with FS-T2WI and FDG-PET/CT for initial staging and detection of lesion in newly diagnosed lymphoma YUE Jingjing, SONG Qi, JIANG Xufeng, WANG Li, ZHAO Weili, YAN Fuhua 2021, 20 (06):  540-546.  DOI: 10.16150/j.1671-2870.2021.06.005 Abstract ( 321 )   HTML ( 6 )   PDF (957KB) ( 83 )   Objective: To compare the application value of magnetic resonance whole body diffusion weighted ima-ging(MR WB-DWI) combined with FS-T2WI sequence and PET/CT in detection of disease lesion and staging in newly dia-gnosed lymphoma. Methods: A total of 25 patients with newly diagnosed lymphoma and without a history of treatment for lymphoma admitted to Department of Hematology in Shanghai Ruijin Hospital from May 2014 to September 2020 were retrospectively analyzed. All the patients were histologically confirmed, including 24 cases of non-Hodgkin lymphoma and 1case of Hodgkin lymphoma. MR WB-DWI with FS-T2WI and 18F-FDG PET/CT were performed and coincidence of results between the two techniques in lesion detection and disease staging were compared. The clinical criterion was taken as the gold standard (comprehensive analysis of clinical, pathological, imaging, bone marrow puncture and 6-month follow-up results, referring to Ann-Arbor staging method). Results: Results of WB-DWI with FS-T2WI in 466 node regions out of 500 areas were congruen with those of PET/CT (K=0.807, P>0.05), there were no significant difference between two techniques in detection of intranodal lesions. The two imaging techniques agreed on 444 organs out of 450 organs analyzed (K=0.857, P>0.05). The stages based on WB-DWI with FS-T2WI was concordant with those of PET/CT in 20 patients out of 25 patients (K=0.731, P>0.05). Compared with clinical stage, PET/CT underestimated disease stage in 3 cases and WB-DWI combined with FS-T2WI underestimated disease in 2 cases. Conclusions: WB-DWI combined FS-T2WI sequence have high consistency with 18F-FDG PET/CT in lesions detection and disease staging in newly diagnosed lymphoma, and could serve as a suppliment of PET/CT. Figures and Tables | References | Related Articles | Metrics

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AwB subtype caused by a novel ABO *A allele and its molecular mechanisms ZHOU Lu, LEI Hang, HONG Ye, JIN Shuang, DONG Yongqin, WANG Xuefeng, CAI Xiaohong 2021, 20 (06):  547-551.  DOI: 10.16150/j.1671-2870.2021.06.006 Abstract ( 260 )   HTML ( 5 )   PDF (853KB) ( 119 )   Objective: To investigate the molecular mechanism of AwB subtype by performing serological and gene detection in a Chinese individual. Methods: One case of AwB subtype was determined by ABO serology using standard serological method, and 7 exons of ABO gene and their flanks were amplified by PCR, and then cloned and sequenced. Glycosyl Transferase A (GTA) mutants were constructed by Chimera software, and was mapped and analyzed by PyMOL software. Results: Serological identification showed that this individual had AwB subtype. DNA cloning and gene sequen-cing analysis showed that the A gene from the proband was A cis-expressed allele of A1.02 and A3.03, and the genotype was ABO*Avar/B.01. In the ISBT database, the A allele of this variant should be a novel allele, with missense mutations in c. 467C>T and c. 838C>T, which could result in p.P.156L and p.L.280F amino acid replacement in GTA. Analysis of the spatial structure of GTA showed, p.L280F resulted in the phenotypes, and did not lead to changes in the overall structure of GTA proteins, which altered the hydrogen bond network between amino acid 280 and surrounding amino acid residues, resulting in local conformation changes. Conclusions: AwB subtype caused by a novel A allele-is reported for the first time. The formation mechanism may be as follows: p.L280F mutations in glycosyltransferases encoded by the A1.02 allele alter the interactions between adjacent amino acids, resulting in reduced activity of the A enzyme,and AwB subtype occurs when co-expressing with the B allele. Figures and Tables | References | Related Articles | Metrics

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Clinicopathological analysis of 31 cases of gastric schwannoma WANG Zhaohui, WU Haibo 2021, 20 (06):  552-556.  DOI: 10.16150/j.1671-2870.2021.06.007 Abstract ( 208 )   HTML ( 4 )   PDF (1267KB) ( 109 )   Objective: To investigate the clinicopathological characteristics of gastric schwannomas (GSs). Methods: The 31 GS cases, including 12 males and 19 females with a median age of 51 years (22-70), of 17 223 surgical procedures performed from January 2014 through March 2020 were retrieved for histological and immunological studies. The diagnosis, differentiation, treatment and prognosis were discussed with reference to relevant literatures. Results: The pre-operative imaging study suggested gastrointestinal stromal tumor(GIST) in 20 cases. Only two patients had the tumor breaking the serosa, and the tumor found on 29 patients was located between the muscularis propria and serosa of the stomach. Histological examination revealed well-circumscribed tumor with a prominent peripheral lymphoid cuff. The tumor was mainly composed with spindle cells, arranged in bundles and small clusters or in a haphazard fashion. The common features of soft tissue schwannoma, such as Antoni A zone and Antoni B zone, were absent or rarely found. Although the atypical nucleus could be identified, the mitosis was rare or absent. GS were diffusely positive for S100 and SOX10. Conclusions: GS is a rare benign mesenchymal tumor of the stomach, most of which are easy to be misdiagnosed as gastrointestinal stromal tumor. The diagnosis should be established based on histological features and immunophenotypes. Figures and Tables | References | Related Articles | Metrics

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Construction of fluorescent human zona pellucida fusion protein expression vectors and expression in CHO cells WANG Mingyi, ZHU Yan 2021, 20 (06):  557-561.  DOI: 10.16150/j.1671-2870.2021.06.008 Abstract ( 193 )   HTML ( 6 )   PDF (658KB) ( 88 )   Objective: To construct expression vectors of the fluorescent fusion proteins of all four human zona pellucida (ZP) genes respectively, and explore their expression in Chinese hamster ovary(CHO) cells and oocytes in vitro. Methods: The desired fluorescent protein sequence was inserted into a specific site of the zona pellucida gene sequence using the Gibson Assembly multi-fragment one-step splicing method to form the desired fusion gene fragment, and both ends of the fragment contained a specific sticky cleavage site of the entry vector. The entry vector pENTR 1A (no ccdB) and the fusion gene fragment were digested with a specific double enzyme, and the target gene fragment was ligated into the entry vector by T4 DNA ligase. Transfer genes from entry vector into destination vector via the LR reaction of the Gateway cloning technology. The plasmids validated by DNA sequencing were amplified and transfected into CHO cells. The expression of desired fusion protein was proved by RT-PCR and Western Blot. The distribution of target proteins in cytoplasm of CHO cells was visualized by laser confocal microscopy. Results: The expression vectors were successfully constructed, and the expression of each ZP protein in CHO cells was detected by RT-PCR and Western blot. The laser confocal microscopy revealed the distribution of ZP proteins. Conclusions: In this study, we successfully constructed fluorescent fusion protein expression plasmids of human zona pellucida genes, enabling the diagnosis of infertility caused by oocyte abnormalities. Figures and Tables | References | Related Articles | Metrics

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The stress-induced hyperglycemia ratio in the prognosis prediction of patients with acute ischemic stroke one year after thrombolytic therapy LIANG Yali, ZHAO Haigang, XIANG Guangyu 2021, 20 (06):  562-566.  DOI: 10.16150/j.1671-2870.2021.06.009 Abstract ( 206 )   HTML ( 4 )   PDF (527KB) ( 64 )   Objective: To explore the association of stress-induced hyperglycemia ratio (SHR) and the prognosis of patients with acute ischemic stroke one year after thrombolytic therapy. Methods: A total of 262 patients with acute ischemic stroke, including 84 diabetics and 178 non-diabetics, who received thrombolytic therapy from January 2018 to January 2020 were enrolled in the study. The average levels of SHR calculated within 24 hours of admission were 0.859 and 0.914 in non-diabetics and diabetics, and patients were divided into low and high SHR group, with SHR below or above average level. The general clinical parameters and the mortality rate within 1 year after discharge were compared among diabetic and non-diabetics in low and the high SHR group. Cox univariate and multivariate regression were adopted in independent risk factor analysis for prognosis, and the Receiver operating curve (ROC) was plotted to evaluate the SHR in prognosis prediction. Results: Both diabetic and nondiabetic patients in high SHR group had higher NIHSS score, incidence of stress hyperglycemia, fasting blood glucose and glycosylated hemoglobin levels than patients in low SHR groups (P<0.05). The 1-year mortality rate of the non-diabetic and diabetic high SHR groups were 32.9%(28/85) and 48.9% (22/45), which were higher than their counterparts in low SHR groups, with 17.2%(16/93) and 17.9% (7/39) respectively ( χ2=5.910, P=0.015; and χ2=10.008, P=0.002). For patients with high SHR, the diabetics had higher 1-year mortality rate than the non-diabetics( χ2=4.075, P=0.044). NIHSS score, stress hyperglycemia, glycosylated hemoglobin, and SHR levels were all independent risk factors for the prognosis of patients 1 year after discharge. The ROC curve of SHR for adverse outcomes within one year after discharge revealed the AUC of 0.897 (95%CI=0.814-0.913) and 0.841(95%CI=0.804-0.861) in diabetics and non-diabetics with acute ischemic stroke respectively. Conclusions: High SHR is associated with decreased 1-year survival rate after thrombolytic therapy for acute ischemic stroke and is an independent risk factor for poor prognosis. Figures and Tables | References | Related Articles | Metrics

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2017-2020 survey of HPV infection subtypes in the cervical exfoliated cells in Shanghai MENG Jun, XU Xiaosheng, LU Yiyi, FAN Zhenjia, CAI Gang 2021, 20 (06):  567-572.  DOI: 10.16150/j.1671-2870.2021.06.010 Abstract ( 260 )   HTML ( 6 )   PDF (585KB) ( 75 )   Objective: To survey the status of infection of human papillomavirus (HPV) in cervical exfoliated cells and identify the local epidemiological characteristics of HPV infections. Methods: The HPV subtype test was carried out on cervical exfoliated cells obtained from 58 883 female subjects in the gynecological clinic and physical examination center from October 2017 through December 2020. The results were retrospectively reviewed and distribution of 25 common HPV subtypes in patients of different age groups and with different types of cervical disease (chronic cervicitis, cervical neoplasia, cervical malignant tumor) were analyzed. Results: Of 58 883 female subjects surveyed, 9 168(15.57%) cases were positive for HPV infection, including 6 971 single infection cases and 2 197 multiple infection cases. The HPV52 (3.31%), HPV58 (2.05%), and HPV16 (1.92%) were subtypes mostly detected. The HPV infection rate in females aged under 20 (37.34%) and between 21-30 (19.52%) were significantly higher than subjects of other age groups. Of 2 105 patients with cervical lesions, the HPV52 (16.92%), HPV58 (10.68%) and HPV16 (10.16%) were mostly identified in patients with chronic cervicitis; the HPV52 ( 22.22%), HPV16 (17.46%), HPV58 (14.29%) were mostly associated with cervical epithelial neoplasia; and the HPV16 (29.59%), HPV52 (11.24%), HPV58 (10.06%) were the most common subtypes detected in patients with cervical malignant tumors. Conclusions: The HPV infection rate in females of Shanghai is 15.57%, and the HPV52, HPV58, and HPV16 are the predominant subtypes detected. The three subtypes are also highly associated with patients with cervical lesions and cervical cancer, which indicates that the HPV52, HPV58, and HPV16, instead of HPV16 and HPV18 suggested in foreign epidemic studies, are the carcinogenic subtypes of HPV in Shanghai. Figures and Tables | References | Related Articles | Metrics

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The relationship between plasma total testosterone and osteocalcin levels in males with newly diagnosed type 2 diabetes WANG Guangyu, YANG Xin, ZHANG Lijuan, TAN Jiaorong 2021, 20 (06):  573-578.  DOI: 10.16150/j.1671-2870.2021.06.011 Abstract ( 171 )   HTML ( 1 )   PDF (625KB) ( 69 )   Objective: To explore the relationship between plasma total testosterone and osteocalcin levels in males with newly diagnosed type 2 diabetes. Methods: A total of 146 males with newly diagnosed type 2 diabetes mellitus admitted from January 2018 through June 2020 were enrolled in the study. The patients were divided into four groups according to the level of osteocalcin: Q1 group (<8.0 nmol/L), Q2 group (8.0-<10.9) nmol/L, Q3 group (10.9-<14.7 nmol/L) and Q4 group (≥14.7 nmol/L). The parameters of glucose and lipid metabolism and total testosterone levels were compared among groups and multiple linear regression was adopted to analyze the relationship of osteocalcin, total testosterone and other indexes. Results: It revealed that 58 (39.72%) patients also had hypogonadism, with the level of osteocalcin decreased to (11.27±5.62) nmol/L, significantly lower than patients with normal gonadal function(13.22±5.83 nmol/L)(P<0.05). The total testosterone level in males with newly diagnosed type 2 diabetes increased along with osteocalcin (P<0.05). Pearson correlation analysis showed that osteocalcin was positively correlated with total testosterone, serum creatinine and serum calcium (P<0.05). Partial correlation analysis showed that after adjusting for age, body mass index (BMI), smoking, drinking, serum creatinine, blood calcium, total cholesterol, triglyceride, fasting insulin (FINS), glycosylated hemoglobin (HbA1c) and insulin resistance index(HOMR-IR), the level of osteocalcin was still positively correlated with total testosterone(P<0.01). Patients with higher osteocalcin had higher levels of total testosterone and blood calcium(Q4 Group), but lower BMI, HOMR-IR, fasting blood glucose and HbA1c. Multiple stepwise regression analysis revealed that high osteocalcin was an independent factor for elevated level of total testosterone (β value 0.197, P<0.05). Conclusions: Plasma total testosterone level is positively correlated with osteocalcin in newly diagnosed male patients with type 2 diabetes mellitus. Figures and Tables | References | Related Articles | Metrics