OpusJournal

Online ISSN:
2831-090X

ISSN:
2831-0896

Volume 23 , Issue 2, (2023)

Published:
11.07.2023.

Open Access

Vol.23 No.2

Published: 11.07.2023.

Authors in this issue:

Abdella M Habib, Abdul-Badi Abou-Samra, Aleksandra Aracki Trenkić, Angela Pia Cazzolla, Atalla Hammouda, Benjie Xu, Boris Zec, Cheng Rao, Chenwei Li, Chunyue Feng, Dan Li, Dejan Nesic, Domenico Ciavarella, Dominik Vilímek, Dragan Stojanov, Eleonora Lo Muzio, Elina Beleva, Fang Li, Fei Liu, Feng Wang, Francesca Di Serio, Francesca Spirito, Gaofei Cao, Gordana Petrovic, Haibo Lu, Hao Jiang, Haowen Pang, Hongbing Ma, Hua Yang, Ivanka Nenova, Jan Malůš, Jaroslav Uchytil, Jianguang Shi, Jiayue Shao, Jie Gong, Jie Lian, Jieqiu Zhang, Jieyun Huang, Jin Li, Jun Wang, Justin Clark, Kai Sun, Lichun Wei, Lina Zhao, Ling-Yu Long, Lishuang Wang, Liu Shi, Lorenzo Lo Muzio, Lucia Varraso, Luigi Santacroce, Luka Nikolic, Marek Bužga, Maria Pepe, Mario Dioguardi, Matej Pekař, Mei Shi, Mengyao Zhang, Michele Di Cosola, Milica Radovanović, Milica Živanović, Miroslav Mišić, Mohan Dong, Moustapha Hamdi, Nan Xu, Omran A H Musa, Pavol Holéczy, Petr Kutáč, Qian Jiang, Qian Zhang, Qiong Qing, Quan-Bing Zhang, Ren Wang, Renato Contino, Roberto Lovero, Rui Zhang, Run Zhang, Saif Badran, Sanja Ninic, Sara Alharami, Sasa Popovic, Semir Vranic, Sergej Prijic, Shigao Huang, Shuli Tang, Siqi Liu, Snezana Ristic, Snezhana Stoencheva, Srdjan Pasic, Stasa Krasic, Suhail A Doi, Tanya Deneva, Veronika Horká, Vito Crincoli, Vladislav Vukomanovic, Vuk Milošević, Vukota Radovanović, Weijie Wu, Weiwei Li, Wen-Min Chen, Wudong Wang, Xiangyi Pang, Xiao-Jun Huang, Xiaopeng Yao, Xiaoxiao Liu, Xin Wang, Xinjian Li, Xu Wang, Xuejing Zhong, Ya-Zhen Qin, Yanhui Chen, Ying Zhang, Yingying Jin, Yongrong Zhang, Yuchen Wang, Yun Zhou, Zdeněk Švagera, Zhanet Grudeva-Popova, Zhenjing Jin, Zishan Wang,

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𝐁𝐢𝐨𝐦𝐨𝐥𝐞𝐜𝐮𝐥𝐞𝐬 𝐚𝐧𝐝 𝐁𝐢𝐨𝐦𝐞𝐝𝐢𝐜𝐢𝐧𝐞 (formerly 𝐁𝐉𝐁𝐌𝐒) is the first address for discoveries in the field of biomedical research.

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Editor’s choice articles

The aim is to provide a snapshot of some of the most exciting work published in the various research areas of the journal.

Sacituzumab govitecan expands its therapeutic spectrum among breast cancer subtypes

Semir Vranic

16.03.2023.

Research article

Prevention of sarcopenia in patients with obesity after bariatric and metabolic surgery: The effect of programmed training on the muscle tissue and anthropometric functions—A randomized controlled trial (SarxOb study protocol)

Obesity is a serious metabolic disease that significantly increases cardiovascular risks and other health complications. Sarcopenia is an independent risk factor for morbidity and mortality in patients suffering from obesity that increases the health risks and is associated with cardiac, respiratory, and other diseases. Bariatric and metabolic surgery (BMS) leads to significant changes in body composition. Our pilot study showed that bariatric patients are at risk of sarcopenia after BMS. This finding resulted in a hypothesis that an exercise plan in the experimental group will lead to postural stabilization and a lower decline in muscle homotopy, further leading to a greater reduction in fat mass and a positive effect of exercise on skeletal muscle volume and strength and endocrine-metabolic function. The aim of the present study is to determine the effect of programmed aerobic and strength training on muscle function, volume, and morphology in patients after BMS. The study is a single-center, randomized clinical trial after sleeve gastrectomy focused on muscle tissue. The experimental group will perform targeted physical activity once a week for 12 months and the training plan will include anaerobic and aerobic components. Magnetic resonance imaging of skeletal muscles will be correlated with the values of densitometry examination and changes in body composition, certain blood parameters of myokines, biomechanical analysis of movement abnormalities, and behavioral and dietary counseling. This study will address the research questions about the effect of programmed training on muscle tissue and muscular functions after BMS.

Marek Bužga, Matej Pekař, Jaroslav Uchytil, Veronika Horká, Jan Malůš, Dominik Vilímek, Zdeněk Švagera, Petr Kutáč, Pavol Holéczy

16.03.2023.

Research article

Intrinsic resistance and efficacy of immunotherapy in microsatellite instability-high colorectal cancer: A systematic review and meta-analysis

Some patients with microsatellite instability-high colorectal cancer (MSI-H CRC) have shown a poor response to immunotherapy in clinical trials. We investigated the intrinsic resistance to and efficacy of immunotherapy in patients with MSI-H CRC. The PubMed and Web of Science databases were searched using keywords such as “colorectal cancer,” “immunotherapy,” and “clinical experiment.” Random-effects models were used to generate the combined complete response, partial response, stable disease, progressive disease, objective response rate (ORR), disease control rate (DCR), and incidence of adverse events. We then performed a subgroup analysis based on the ORR and incidence of intrinsic resistance. The meta-analysis included seven clinical trials. The incidences of complete response, partial response, stable disease, and progressive disease summarized by the random-effects model were 8%, 37%, 26%, and 25%, respectively. The ORR and DCR were 45% and 71%, respectively. The ORRs of programmed cell death protein 1 inhibitor (anti-PD-1), programmed death ligand 1 inhibitor (anti-PD-L1), and anti-PD-1 combined with cytotoxic T lymphocyte-associated antigen 4 inhibitor (anti-CTLA-4) immunotherapy were 38%, 54%, and 57%, respectively. The ORR of immune checkpoint inhibitors for first- and third-line therapy was 56% and 32%, respectively. Dual-drug immunotherapy significantly reduced the incidence of intrinsic resistance to immunotherapy (12% vs 31%). The incidences of intrinsic resistance to first-line therapy and second-line and later therapy were 29% and 26%, respectively. Approximately 25% of patients with MSI-H CRC had intrinsic resistance to immunotherapy. Anti-PD-1 combined with anti-CTLA-4 significantly increased the ORR, thereby reducing the incidence of intrinsic resistance. Moving immunotherapy into earlier lines of therapy, although not reducing the incidence of intrinsic resistance, can improve the ORR in patients with MSI-H CRC.

Ren Wang, Jie Lian, Xin Wang, Xiangyi Pang, Benjie Xu, Shuli Tang, Jiayue Shao, Haibo Lu

16.03.2023.

Research article

The role of magnetic resonance imaging in the diagnosis and prognosis of dementia

Dementia is a syndrome characterized by multidomain acquired chronic cognitive impairment that has a profound impact on daily life. Neurogenerative diseases such as Alzheimer’s disease or nondegenerative diseases such as vascular dementia are considered to cause dementia. The need for further diagnostic improvement originates from the prevalence of these conditions, especially in developed countries with a predominance of the elderly population. Today, the diagnosis and follow-up of all neurodegenerative diseases cannot be performed without radiological imaging, primarily magnetic resonance imaging (MRI). The introduction of 3T MRI and its modern techniques, such as arterial spin labeling, has enabled better visualization of morphologic changes in dementia. For better diagnosis and follow-up in patients with dementia, various semiquantitative scales have been designed to improve the accuracy of assessment and decrease interobserver variability. Moreover, there is a growing need for MRI in the assessment of novel therapies and their side effects. To better apply MRI findings in the diagnosis of both already developed dementia and its early stages, the aim of this paper is to review the available literature and summarize the specific MRI changes.

Milica Živanović, Aleksandra Aracki Trenkić, Vuk Milošević, Dragan Stojanov, Miroslav Mišić, Milica Radovanović, Vukota Radovanović

16.03.2023.

Research article

Artificial intelligence in renal pathology: Current status and future

Renal biopsy pathology is an essential gold standard for the diagnosis of most kidney diseases. With the increase in the incidence rate of kidney diseases, the lack of renal pathologists, and an imbalance in their distribution, there is an urgent need for a new renal pathological diagnosis model. Advances in artificial intelligence (AI) along with the growing digitization of pathology slides for diagnosis are promising approach to meet the demand for more accurate detection, classification, and prediction of the outcome of renal pathology. AI has contributed substantially to a variety of clinical applications, including renal pathology. Deep learning, a subfield of AI that is highly flexible and supports automatic feature extraction, is increasingly being used in multiple areas of pathology. In this narrative review, we first provide a general description of AI methods, and then discuss the current and prospective applications of AI in the field of renal pathology. Both diagnostic and predictive prognostic applications are covered, emphasizing AI in renal pathology images, predictive models, and 3D in renal pathology. Finally, we outline the challenges associated with the implementation of AI platforms in renal pathology and provide our perspective on how these platforms might change in this field.

Chunyue Feng, Fei Liu

16.03.2023.

Research article

Metabolic aspects of surgical subcutaneous fat removal: An umbrella review and implications for future research

Although obesity is a preventable disease, maintaining a normal body weight can be very challenging and difficult, which has led to a significant increase in the demand for surgical subcutaneous fat removal (SSFR) to improve physical appearance. The need for SSFR is further exacerbated because of the global rise in the number of bariatric surgeries, which is currently the single most durable intervention for mitigating obesity. Fat tissue is now recognized as a vital endocrine organ that produces several bioactive proteins. Thus, SSFR-mediated weight (fat) loss can potentially have significant metabolic effects; however, currently, there is no consensus on this issue. This review focuses on the metabolic sequelae after SSFR interventions for dealing with cosmetic body appearance. Data were extracted from existing systematic reviews and the diversity of possible metabolic changes after SSFR are reported along with gaps in the knowledge and future directions for research and practice. We conclude that there is a potential for metabolic sequelae after SSFR interventions and their clinical implications for the safety of the procedures as well as for our understanding of subcutaneous adipose tissue biology and insulin resistance are discussed.

Saif Badran, Suhail A Doi, Moustapha Hamdi, Atalla Hammouda, Sara Alharami, Justin Clark, Omran A H Musa, Abdul-Badi Abou-Samra, Abdella M Habib

16.03.2023.

Research article

Reduced circulating interleukin 35 is associated with enhanced peripheral T cell function in primary biliary cholangitis

Interleukin 35 (IL-35) mediates immunosuppression of T cells in autoimmune diseases. T cells play an important role in primary biliary cholangitis (PBC) with incompletely elucidated pathogenesis. Thus, we aimed to investigate the role of IL-35 regulation on T cells in PBC patients. Fifty-one PBC patients and 28 controls were enrolled in this study. Plasma IL-35 level was measured. Purified peripheral CD4+ and CD8+ T cells were stimulated with exogenous IL-35 to investigate their functional phenotypes. IL-35-treated CD8+ T cells were cultured with human intrahepatic biliary epithelial cell line to determine the cytotoxicity of CD8+ T cells from PBC patients. Plasma IL-35 concentration was lower in PBC patients and negatively correlated with alkaline phosphatase. CD4+ T cells from PBC patients exhibited elevated transcription factor expressions and cytokine secretion, whereas CD8+ T cells produced increased cytotoxic molecules and cytokines. In vitro IL-35 stimulation suppressed the production of IL-17 and IL-22 by CD4+ T cells from PBC patients. CD8+ T cells treated with IL-35 mediated reduced target cell death in the direct contact co-culture system in PBC patients. This process was accompanied by reduced production of cytotoxic molecules and cytokines and increased expressions of immune checkpoint receptors in CD8+ T cells. Reduced circulating IL-35 might be insufficient to suppress T cell function, leading to the immune dysregulation in PBC patients.

Siqi Liu, Qian Zhang, Mengyao Zhang, Xuejing Zhong, Wudong Wang, Lishuang Wang, Zhenjing Jin

16.03.2023.

Research article

Deletion of sphingosine kinase 2 attenuates cigarette smoke-mediated chronic obstructive pulmonary disease-like symptoms by reducing lung inflammation

Cigarette smoke (CS) is the leading cause of chronic obstructive pulmonary disease (COPD), which is characterized by chronic bronchial inflammation and emphysema. Growing evidence supports the hypothesis that dysfunctional cystic fibrosis transmembrane conductance regulator (CFTR) is critically involved in the pathogenesis of CS-mediated COPD. However, the underlying mechanism remains unclear. Here, we report that supressed CFTR expression is strongly associated with abnormal phospholipid metabolism and increased pulmonary inflammation. In a CS-exposed mouse model with COPD-like symptoms, we found that pulmonary expression of sphingosine kinase 2 (SphK2) and sphingosine-1-phosphate (S1P) secretion were significantly upregulated. Therefore, we constructed a SphK2 gene knockout (SphK2−/−) mouse. After CS exposure for six months, histological lung section staining showed disorganized alveolar structure, increased pulmonary fibrosis, and emphysema-like symptoms in wild-type (WT) mice, which were less pronounced in SphK2−/− mice. Further, SphK2 deficiency also decreased CS-induced pulmonary inflammation, which was reflected by a remarkable reduction in pulmonary infiltration of CD45+CD11b+ neutrophils subpopulation and low levels of IL-6 and IL-33 in bronchial alveolar lavage fluid. However, treatment with S1P receptor agonist suppressed CFTR expression and increased Nf-κB-p65 expression and its nuclear translocation in CS-exposed SphK2−/− mice, which also aggravated small airways fibrosis and pulmonary inflammation. In contrast, inhibition of S1P signaling with the S1P receptor analogue FTY720 rescued CFTR expression, suppressed Nf-κB-p65 expression and nuclear translocation, and alleviated pulmonary fibrosis and inflammation after CS exposure. Our results demonstrate that SphK2-mediated S1P production plays a crucial role in the pathogenesis of CS-induced COPD-like disease by impairing CFTR activity and promoting pulmonary inflammation and fibrosis.

Yanhui Chen, Yongrong Zhang, Cheng Rao, Jieyun Huang, Qiong Qing

16.03.2023.

Research article

Effect of vascular endothelial growth factor rs35569394 in esophageal cancer and response to chemotherapy

The objective of this study was to investigate the possible association between the single-nucleotide polymorphism, rs35569394, of the vascular endothelial growth factor (VEGF) gene and the risk of esophageal cancer (EC) in the Han Chinese population. A total of 290 EC subjects and 322 ethnically matched unrelated healthy controls free from the esophageal disease were studied. Genomic DNA was isolated from peripheral blood by salting out. Genotyping of VEGF rs35569394 polymorphism was carried out through polymerase chain reaction followed by agarose gel electrophoresis. The results showed that the distribution of genotypes was significantly different across the gender groups (p ═ 0.032) and clinical stages of the esophageal cancer (p ═ 0.034). VEGF rs35569394 was associated with EC risk (p ═ 0.012, OR ═ 1.34). A gender analysis breakdown showed that rs35569394-D allele frequency was significantly higher in females than in the controls (p ═ 0.0004, OR ═ 1.81). Moreover, significant associations were also found in females under the dominant model (II vs. ID+DD: χ2 ═ 8.18, p ═ 0.003, OR ═ 2.12) and the recessive model (II+ID vs. DD: χ2 ═ 8.25, p ═ 0.004, OR ═ 2.39). In addition, we found that the genotype, rs35569394-DD, was associated with a complete response and partial response to chemotherapy when compared with rs35569394-II (χ2 ═ 4.67, p ═ 0.030, OR ═ 0.47). In conclusion, our case–control study showed that the VEGF rs35569394 was significantly associated with the clinical stages and the increased risk of EC in Han Chinese females. In addition, the genotype rs35569394-DD showed a better response to chemotherapy.

Zishan Wang, Chenwei Li, Xinjian Li, Jianguang Shi, Weijie Wu

16.03.2023.

Research article

Possible mechanism of static progressive stretching combined with extracorporeal shock wave therapy in reducing knee joint contracture in rats based on MAPK/ERK pathway

The study aimed to observe the therapeutic effect of static progressive stretching (SPS) combined with extracorporeal shock wave therapy (ESWT) on extension knee joint contracture in rats and the effect on the mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase (ERK) pathway in the development of joint capsule fibrosis. Thirty-six Sprague Dawley rats were randomly divided into blank control group, immobilization model group, natural recovery group, ESWT intervention group, SPS intervention group, and SPS combined with ESWT intervention group. The left knee joints of the rats, except for the control group, were fixed with an external fixation brace for four weeks at full extension to form joint contracture. The therapeutic effect of each intervention was assessed by evaluating total and arthrogenic contracture, the number of total cells and collagen deposition in the anterior joint capsule, the protein levels of TGF-β1, FGF-2, and ERK2 in the anterior joint capsule, the mean optical density of upstream RAS and downstream ERK2 positive expression in the MAPK/ERK pathway. SPS in combination with ESWT was more effective in relieving joint contracture, improving the histopathological changes in the anterior joint capsule, and suppressing the high expression of target proteins and the overactivated MAPK/ERK pathway. The overactivated MAPK/ERK pathway was involved in the formation of extension knee joint contracture in rats. SPS in combination with ESWT was effective in relieving joint contracture and fibrosis of joint capsule. Moreover, the inhibition of the overactivated MAPK/ERK pathway may be the potential molecular mechanism for its therapeutic effect.

Run Zhang, Quan-Bing Zhang, Yun Zhou, Rui Zhang, Feng Wang

16.03.2023.

Research article

Assessment of clinical utility and predictive potential of pre-chemotherapy soluble urokinase plasminogen activator receptor: Observational single center study

Alteration of urokinase plasminogen activator receptor (uPAR) in neoplasms is a pre-requisite for invasiveness and metastatic ability. In the present study, we aimed to evaluate the relationship of pre-chemotherapy soluble uPAR (suPAR) with the odds for metastasis, lack of disease control, and its predictive ability for progression-free survival (PFS). Baseline plasma suPAR levels were measured by ELISA in 89 patients with various cancers prior to initiation of systemic treatment. Patients were followed prospectively until metastatic progression or death. TCGA Pan-Cancer dataset was mined for available RNAseq expression data of the PLAUR gene in patients with breast, colon, and lung cancer, and the relevant genomic and clinical data were extracted for further analysis. Pre-chemotherapy suPAR levels were significantly associated with white blood cell counts and fibrinogen and were significantly elevated both in patients with metastatic disease and in patients with progression. Increasing suPAR was significantly associated with odds for progression in the prespecified multivariate analysis (odds ratio 2.47, 95% confidence interval 1.3–5.11). In univariate Cox regression, suPAR was predictive of shortened PFS (hazard ratio 1.065, 95% confidence interval 1.002–1.13; p = 0.041). There was a trend toward shortened PFS in patients with higher baseline suPAR levels (cutoff 8.1 ng/mL). In the TCGA lung cancer cohort, PLAUR mRNA expression was significantly associated with shortened PFS in both univariate and multivariate analyses. High PLAUR gene expression conferred significant survival disadvantage only in patients with colon and lung cancer. SuPAR may bear predictive potential for adverse outcomes in cancer, but its utility as a biomarker seems to be more pronounced in cancers with associated inflammatory state.

Elina Beleva, Snezhana Stoencheva, Tanya Deneva, Ivanka Nenova, Zhanet Grudeva-Popova

16.03.2023.

Research article

Clinical features and outcomes of fusion gene defined adult Ph-negative B-cell precursor acute lymphoblastic leukemia patients: A single institutional report

More clinical studies are needed to clarify the risk stratification by the integration of all fusion genes in adult B-cell precursor acute lymphoblastic leukemia (BCP-ALL). A total of 320 consecutive adult Ph-negative BCP-ALL patients who had been tested classical fusions (KMT2A rearrangement and TCF3-PBX1) at diagnosis were further retrospectively screened novel fusion genes (Ph-like, ZNF384, and MEF2D fusions) by multiplex real-time quantitative PCR (RQ-PCR). Classical fusions were identified in 12.5% of patients, while 4.4%, 17.2%, and 3.8% of patients were identified Ph-like, ZNF384, and MEF2D fusions, respectively. 1-course CR rate, relapse-free survival (RFS), and overall survival (OS) rates tended to show or showed statistically significant differences among fusion-defined subgroups (P ═ 0.084, <0.001, and 0.0093, respectively). Based on individual outcomes, patients with KMT2A rearrangement, TCF3-PBX1, Ph-like, and MEF2D fusions were classified into fusion-defined high-risk group (n ═ 66, 20.6%). High-risk group had significantly lower 3-year RFS and 3-year OS rates than standard-risk group (P < 0.001 and ═ 0.0022) and was an independent adverse prognostic factor for RFS in the entire cohort (P < 0.001). In conclusion, the spectrum of fusion genes in the current Chinese cohort was distinct from that in reports from western countries. Detection of fusion genes improved risk stratification in adult Ph-negative BCP-ALL patients.

Kai Sun, Jun Wang, Wen-Min Chen, Nan Xu, Ling-Yu Long, Xu Wang, Hao Jiang, Qian Jiang, Xiao-Jun Huang, Ya-Zhen Qin

16.03.2023.

Research article

Efficacy and safety of PEG-rhG-CSF in preventing chemoradiotherapy-induced neutropenia in patients with locally advanced cervical cancer

The standard of care for locally advanced cervical cancer is concurrent chemoradiotherapy, which is associated with significant toxicity, especially hematologic toxicity. To evaluate the efficacy and safety of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in preventing neutropenia during radical chemoradiotherapy for cervical cancer, 40 patients receiving prophylaxis from February 2018 to July 2019 were randomly divided into two arms in a 1:1 ratio. Patients in the study arm (N ═ 21) received PEG-rhG-CSF, while patients in the control arm (N ═ 19) received short-acting rhG-CSF. The primary endpoint was the incidence of grade 3–4 neutropenia, and the secondary endpoints were the incidence of febrile neutropenia, chemotherapy delay, and radiotherapy interruption. In addition, dynamic changes in absolute neutrophil count during radical chemoradiotherapy and adverse events were compared between the two groups. There were 0 and 4 cycles of grade 3–4 neutropenia in the PEG-rhG-CSF and rhG-CSF groups, respectively. The incidence of neutropenia of all grades was lower in patients on PEG-rhG-CSF than that on rhG-CSF [24.05% (19/79) vs. 56.94% (41/72); p < 0.001]. No patient developed neutropenic fever. The lowest values of neutropenia during chemoradiotherapy cycles were 2.73 ± 1.02 and 1.91 ± 0.79 × 10 9/mL in the PEG-rhG-CSF and rhG-CSF groups, respectively (p < 0.001). In the PEG-rhG-CSF and rhG-CSF groups, 0 and 8 (11.11%) cycles of chemotherapy were delayed due to neutropenia, respectively (p ═ 0.01). There was no delay of radiotherapy by more than one week in either group. Prophylactic use of PEG-rhG-CSF during chemoradiotherapy for cervical cancer can effectively prevent neutropenia and associated adverse events. PEG-rhG-CSF may be an effective strategy to provide uninterrupted radical chemoradiotherapy for cervical cancer.

Weiwei Li, Mohan Dong, Shigao Huang, Liu Shi, Hua Yang, Ying Zhang, Jie Gong, Mei Shi, Lichun Wei, Lina Zhao

16.03.2023.

Research article

Development and validation of radiomics machine learning model based on contrast-enhanced computed tomography to predict axillary lymph node metastasis in breast cancer

Preoperative identification of axillary lymph node metastasis can play an important role in treatment selection strategy and prognosis evaluation. This study aimed to establish a clinical nomogram based on lymph node images to predict lymph node metastasis in breast cancer patients. A total of 193 patients with non-specific invasive breast cancer were divided into training (n ═ 135) and validation set (n ═ 58). Radiomics features were extracted from lymph node images instead of tumor region, and the least absolute shrinkage and selection operator logistic algorithm was used to select the extracted features and generate radiomics score. Then, the important clinical factors and radiomics score were integrated into a nomogram. A receiver operating characteristic curve was used to evaluate the nomogram, and the clinical benefit of using the nomogram was evaluated by decision curve analysis. We found that clinical N stage and radiomics score were independent clinical predictors. Besides, the nomogram accurately predicted axillary lymph node metastasis, yielding an area under the receiver operating characteristic curve of 0.95 (95% confidence interval 0.93–0.98) in the validation set, indicating satisfactory calibration. Decision curve analysis confirmed that the nomogram had higher clinical utility than clinical N stage or radiomics score alone. Overall, the nomogram based on radiomics features and clinical factors can help radiologists to predict axillary lymph node metastasis preoperatively and provide valuable information for individual treatment.

Jieqiu Zhang, Gaofei Cao, Haowen Pang, Jin Li, Xiaopeng Yao

16.03.2023.

Research article

Intensity-modulated radiation therapy for elderly patients with esophageal cancer: Our experience

The aim of this study was to discuss the treatment mode of radical radiotherapy (RT) for elderly patients with esophageal cancer (EC). The clinical data of 136 elderly patients (≥60 years old) with EC who received radical intensity-modulated RT in The Second Affiliated Hospital of Xi’an Jiaotong University from January 2015 to December 2019 were retrospectively analyzed. Cox risk model was used for multivariate prognostic analysis, and Kaplan–Meier method was used to calculate progression free survival (PFS) and overall survival (OS). Cox regression analysis showed that ECOG score, basic diseases, T stage, radiation dose, radiation injury, and chemotherapy were the prognostic factors of elderly patients. The median OS of the RT group, concurrent chemoradiotherapy group, and sequential chemoradiotherapy group were 17, 41, and 10 months (p ═ 0.009), respectively. The 3-year OS and PFS of concurrent intravenous chemotherapy and oral chemotherapy were 50% and 42.9%, and 34.1% and 28.6% (p ═ 0.641, p ═ 0.702), respectively. The median OS of involved field irradiation and elective nodal irradiation (ENI) were 23 and 24 months (p ═ 0.219) and the local recurrence rate were 59.8% and 43.2% (p ═ 0.069), respectively, but the incidence and mortality of radiation pneumonia and esophagitis in ENI were higher. The 3-year OS and PFS of the low-dose group (≤60 Gy) and the high-dose group (>60 Gy) were 19.1% and 40.4%, and 14.9% and 29.2% (p ═ 0.012, p ═ 0.049), respectively. In conclusion, for elderly patients with inoperable EC, radical chemoradiotherapy should be considered a preferable selection. Among them, oral drugs and high-dose involved field irradiation exhibited better curative effects and safety.

Dan Li, Xiaoxiao Liu, Yuchen Wang, Yingying Jin, Fang Li, Hongbing Ma

16.03.2023.

Research article

Analysis of cardiac manifestation and treatment of multisystem inflammatory syndrome in children related to SARS-CoV-2

Cardiovascular (CV) manifestations are common (35%–100%) in the multisystem inflammatory syndrome in children. Our study aimed to analyze treatment impact and CV involvement in patients with multisystem inflammatory syndrome in children. The retrospective cohort included 81 patients treated between April 2020 and December 2021 (9.3 ± 4.6 years). Elevated cardiac troponin I and pro-B-type natriuretic peptide were observed in 34.2% and 88.5% of patients, respectively. Myocardial dysfunction was observed in 50.6%. Children older than 10 years had a 4-fold increased risk of myocardial dysfunction (odds ratio [OR] 3.6, 95% confidence interval [CI] 1.4–8.9; p ═ 0.006). A moderate negative correlation was proved between left ventricular ejection fraction and C-reactive protein (rr ═ −0.48; p < 0.001). More than one-fifth of the patients presented with shock. Coronary artery dilatation was observed in 6.2% of patients. Mild pericardial effusion was detected in 27.1% of children. On standard electrocardiogram, 52.6% of children had negative T waves in the inferior and/or precordial leads; transient QTc prolongation was registered in 43% of patients. Treatment failure was observed in 19 patients. Patients initially treated with intravenous immunoglobulins had 10-fold higher chances for treatment failure than patients treated with corticosteroids (OR 10.6, 95% CI 3.18–35.35; p < 0.001). CV manifestations were observed in more than half of the patients, with acute myocardial dysfunction being the most common, especially in children older than 10 years. We established a negative association between the degree of elevation of inflammatory markers and left ventricular ejection fraction. Patients treated with intravenous immunoglobulins who had CV manifestations had treatment failures more frequently than patients treated with corticosteroids.

Stasa Krasic, Sanja Ninic, Sergej Prijic, Sasa Popovic, Srdjan Pasic, Gordana Petrovic, Boris Zec, Snezana Ristic, Dejan Nesic, Luka Nikolic, Vladislav Vukomanovic

16.03.2023.

Research article

Evaluation of qualitative and quantitative taste alterations in COVID-19

A large percentage of coronavirus disease 2019 (COVID-19) patients have taste dysfunction. Interleukin 6 (IL-6) levels in mild and moderate COVID-19 patients with the type (quantitative or qualitative) of taste disorders were compared in this observational study. The 208 COVID-19 patients (118 men and 90 women) revealing only taste dysfunctions as prodromic symptoms were classified as mild and moderate patients. Survey results were used to evaluate the taste disorder. The IL-6 levels were measured using a chemiluminescence assay. Statistical analysis was conducted using the Wilcoxon rank, Welch’s, and Mann–Whitney tests. The findings revealed that neither the presence of dysgeusia or phantogeusia nor the perception of sour and salty, differed significantly between moderate and mild patients (P > 0.05). But between moderate and mild patients, there were significant differences in umami, bitter, sweet, and parageusia perception (P < 0.05). There was an impairment of multiple tastes up to ageusia in patients with high IL-6 levels. The findings demonstrated that parageusia and dysfunctions in umami, bitter, and sweet taste perception can be indicators of more severe forms of COVID-19.

Angela Pia Cazzolla, Roberto Lovero, Francesca Spirito, Michele Di Cosola, Luigi Santacroce, Eleonora Lo Muzio, Domenico Ciavarella, Mario Dioguardi, Vito Crincoli, Maria Pepe, Lucia Varraso, Renato Contino, Francesca Di Serio, Lorenzo Lo Muzio

16.03.2023.

Corrigendum

Corrigendum: Evaluation of cerebrospinal fluid neurofilament light chain levels in multiple sclerosis and non-demyelinating diseases of the central nervous system: clinical and biochemical perspective

Vol.23 No.2

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Volume 23, Issue 2, 2023

Volume 23, Issue 2, 2023

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Volume 14, Issue 1,

Sacituzumab govitecan expands its therapeutic spectrum among breast cancer subtypes

Prevention of sarcopenia in patients with obesity after bariatric and metabolic surgery: The effect of programmed training on the muscle tissue and anthropometric functions—A randomized controlled trial (SarxOb study protocol)

Intrinsic resistance and efficacy of immunotherapy in microsatellite instability-high colorectal cancer: A systematic review and meta-analysis

The role of magnetic resonance imaging in the diagnosis and prognosis of dementia

Artificial intelligence in renal pathology: Current status and future

Metabolic aspects of surgical subcutaneous fat removal: An umbrella review and implications for future research

Reduced circulating interleukin 35 is associated with enhanced peripheral T cell function in primary biliary cholangitis

Deletion of sphingosine kinase 2 attenuates cigarette smoke-mediated chronic obstructive pulmonary disease-like symptoms by reducing lung inflammation

Effect of vascular endothelial growth factor rs35569394 in esophageal cancer and response to chemotherapy

Possible mechanism of static progressive stretching combined with extracorporeal shock wave therapy in reducing knee joint contracture in rats based on MAPK/ERK pathway

Assessment of clinical utility and predictive potential of pre-chemotherapy soluble urokinase plasminogen activator receptor: Observational single center study

Clinical features and outcomes of fusion gene defined adult Ph-negative B-cell precursor acute lymphoblastic leukemia patients: A single institutional report

Efficacy and safety of PEG-rhG-CSF in preventing chemoradiotherapy-induced neutropenia in patients with locally advanced cervical cancer

Development and validation of radiomics machine learning model based on contrast-enhanced computed tomography to predict axillary lymph node metastasis in breast cancer

Intensity-modulated radiation therapy for elderly patients with esophageal cancer: Our experience

Analysis of cardiac manifestation and treatment of multisystem inflammatory syndrome in children related to SARS-CoV-2

Evaluation of qualitative and quantitative taste alterations in COVID-19

Corrigendum: Evaluation of cerebrospinal fluid neurofilament light chain levels in multiple sclerosis and non-demyelinating diseases of the central nervous system: clinical and biochemical perspective

ABSTRACTING AND INDEXING