Objective To evaluate the relationship between body mass index (BMI) and malignant lymphoma by means of Meta-analysis. Methods Such databases as Web of Science, PubMed, EBbase, CNKI, Wanfang, VIP and CBM were searched from the date of their establishment to April 2011 to collect the case control studies on the relationship between BMI and malignant lymphoma. Two researchers independently selected studies, extracted data and assessed the quality according to the inclusive and exclusive criteria, and then conducted Meta-analyses by using RevMan5.0 software for heterogeneity test and pooled OR calculation. Results Seven case control studies involving 8416 malignant lymphoma patients and 14760 other patients were included. The quality of all studies scored 4, indicating reliable quality. Meta-analyses of the low BMI, overweight and obesity population were OR=0.8, 95%CI 0.79 to 0.95, P=0.003; OR=1.04, 95%CI 0.98 to 1.11, P=0.16; and OR=1.22 95%CI 1.04 to 1.43, P=0.01, respectively. The stratified Meta-analysis on histological subtypes showed that obesity was associated with a significantly increased risk of diffuse large B cell lymphoma (OR=1.33 95%CI 1.18 to 1.50, Plt;0.000 01), but was not associated with the follicular lymphoma or small lymphocytic lymphoma/chronic lymphocytic leukemia. Conclusion These findings demonstrate that low BMI is associated with the decrease of malignant lymphoma, and obesity is an increasing risk of malignant lymphoma, especially, the diffuse large B cell lymphoma.
Objective To formulate an evidence-based treatment for a patient newly diagnosed with follicular lymphoma. Methods Based on the clinical questions we raised, evidence including systematic reviews and randomized controlled trials was collected from ACP Journal Club (1991 to November 2007), The Cochrane Library (Issue 4, 2007) and PubMed. The retrieved studies were further critically appraised. Results The addition of rituximab to chemotherapy (R-chemo) was superior to chemotherapy alone in patients with follicular lymphoma. The regimen of CVP chemotherapy plus rituximab (R-CVP) was administered to the patient. After 4 courses of R-CVP, the patient had a complete response (CR). Conclusion In newly diagnosed patients with follicular lymphoma, R-chemo is an effective treatment regimen.
Diffuse large B-cell lymphoma is highly heterogeneous and is diagnosed according to the 2016 World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues. The decision of treatment should be upon age, International Prognostic Index score and the tolerability of chemotherapy. High-dose chemotherapy and autologous stem cell transplantation is the standard care for relapsed, chemotherapy sensitive patients. Clinical trials are recommended in specific conditions.
To investigate the diagnosis and treatment of primary colonic malignant lymphoma. Retrospective analysis of 14 cases of primary colonic malignant lymphoma in our hospital from 1983 to 1995. Result: All patients were treated surgically. The resection rate was 93% and the radical operative rate was 69%. Their pathological types were all NHL including 9 cases of B cell lymphoma and 6 cases of T cell lymphoma. 5-year survival rate was 35.7%. Conclusion: grasping of clinical manifestations of this disease is important to diagnosis. The combined therapies with the surgical resection as the first selection are advocated. Immunohistochemistry classification is a sensitive index to prognosis.
Objective To investigate the clinical features of non-gastrointestinal mucosa-associated lymphoid tissue ( MALT) lymphoma.Methods Forty-eight pathologically proved cases of nongastrointestinal MALT lymphoma, admitted into Peking Union Medical College Hospital fromJanuary 2000 to July 2011, were retrospectively analyzed.Results There were 32 females and 16 males. The median age at diagnosis was 55. 4 years old ( range, 21-76 years) . The most commonly affected sites were lung, salivary glands, thyroid and ocular adnexa. In5 cases, the lymphoma presented at multiple mucosal sites. 27 patients were asymptomatic while 13 had non-specific symptoms. Blood test showed mild or moderate anemia in 8 cases, elevated erythrocyte sedimentation rate in 19 cases, and elevated lactate dehydrogenase in 6 patients.Imaging examinations revealed enlarged lymph nodes in 20 patients. 6 patients had a history of Sjoren’s syndrome, in whom3 cases were salivary gland diseases. In the patients with lung involvement, pathological diagnosis was obtained by bronchial biopsies in 3 cases, by CT-guided percutaneous lung biopsies in 11 cases, and by surgical biopsies in 9 cases. While in the patients without lung involvement, pathological diagnosis was obtained all by surgical biopsies. Of the 23 patients with lung involvement, 1 remain untreated,while 22 received various combinations of treatment ( surgery alone in 3 patients, surgery plus chemotherapy in 6 patients, and chemotherapy alone in 13 patients) . Of the 25 patients without lung involvement, 11 patients received surgery alone, 10 patients received surgery plus chemotherapy, 3 patients received chemotherapy alone, and 1 patient received surgery plus chemotherapy and radiotherapy. 46 patients remained alive during the median follow-up of 46. 7 months ( range, 4-133 months) . While 1 patient with lung involvement died from unknown causes, another 1 patient with lung involvement died from lung infection. Conclusions Non-gastrointestinal MALT lymphoma tends to occur in old-aged females, and commonly occurs in lung, salivary gland and thyroid sites. Most patients are asymptomatic or have only nonspecific symptoms. CT-guided percutaneous lung biopsies and surgical biopsies are helpful to the diagnosis.Prognosis for this lymphoma tends to be indolent.
ObjectiveTo investigate the proliferation and apoptosis effects of adenovirus-mediated interleukin-24 (Ad-IL-24) gene on Karpas299 cells in vitro. MethodsThe Karpas299 cells were divided into blank control group, Ad-IL-24 group, and the adenovirus which carrying green fluorescent protein gene group (Ad-GFP group). Karpas299 cells of Ad-IL-24 group were infected by adding 200.0 μL Ad-IL-24, Karpas299 cells of Ad-GFP group were infected by adding 200.0 μL Ad-GFP, but Karpas299 cells of blank control group were treated by adding 200.0 μL PBS. Cells' proliferation inhibition rates of 3 groups were detected by cell counting kit (CCK-8) method at 12, 24, and 48 hours after treatment, respectively, and the cells' apoptosis rates of 3 groups were detected by flow cytometry at 48 hours after treatment. ResultsAd-IL-24 can suppress the growth of Karpas299 cells, and the inhibition rate increased over time. Compared with Ad-GFP group at the same time, the cell' proliferation inhibition rate of Ad-IL-24 group was higher at 12, 24, and 48 hours after treatment (P<0.05). In addition, the cells' apoptosis rate of Ad-IL-24 group was higher than those of Ad-GFP group and blank control group at 48 hours after treatment (P<0.05). ConclusionAd-IL-24 can suppress the growth of Karpas299 cells and induce the apoptosis of it.
ObjectiveTo investigate the value of MRI in the diagnosis of central nervous system lymphoma (CNSL). MethodsWe retrospectively analyzed the clinical data of 20 cases of primary CNSL (PCNSL) and 13 cases of secondary CNSL (SCNSL) from the Second People's Hospital of Chengdu and Chengdu 363 Hospital from January to December 2013, and analyzed their clinical data and MRI image data. We observed the tumor location, tumor size and signal, and carried out the statistical analysis. ResultsTwenty patients had PCNSL in the brain, including single lesion in 9 (45.0%), and multiple in 11 (55.0%). Among the 48 lesions, there were 23 (47.9%) nodular lesions, 21 (43.8%) crumb lesions, and 4 (8.3%) dot patch lesions; MRI showed slightly low T1 signal and slightly high T2 signal in most lesions, and showed significant even enhancing, and mild to moderate edema around the tumor. SCNSL lesions were mainly meningeal disseminated with 3 cases (23.1%) of single lesions and 10 cases (76.9%) of multiple ones, and there were a total of 30 lesions. MRI manifested that T1 and T2 mainly showed equal signals, and showed an obviously even enhancing status, and mild to moderate edema around the tumor. ConclusionThe central nervous system lymphoma has a certain characteristic MRI image, and MRI images of the primary and secondary central nervous system lymphoma were similar.
Objective To explore the clinical characteristics, diagnosis and treatment plan of pulmonary lymphomatoid granulomatosis in order to deepen the understanding of this disease. MethodsA case of pulmonary lymphomatoid granulomatosis complicated with tuberculosis and human immunodeficiency virus (HIV) infection was reported. Literature reviews were searched in PubMed database with "pulmonary, lung, lymphomatoid granulomatosis" as the key words, and in China Knowledge Network and Wanfang database with "lung, lymphomatoid granulomatosis" as the key words. The search time was from January 1, 2017 to December 31, 2021. ResultsThe patient was diagnosed as pulmonary tuberculosis at the beginning of the disease, and the lesion was obviously absorbed and improved after regular anti-tuberculosis treatment. Six months after anti-tuberculosis treatment, chest CT examination showed multiple new circular nodules in both lungs. Intensive anti-tuberculosis treatment did not improve, further lung biopsy, pathology revealed lymphomatoid granulomatosis, grade 2; During the period, HIV infection was proven, and the patient underwent anti-viral infection and re-examination of chest CT lung lesions significantly improved absorption. Literature reviews found 47 same patients, therefore totally 48 patients were analyzed, in which this former case was included. Among the 48 patients, 26 were male (54.2%) and 22 were female (45.8%), with a median age of 60 years old (4 to 87 years old). The most common symptoms were cough, fever and shortness of breath, some of them may be accompanied with fatigue, weight loss, night sweats and loss of appetite. 20.9% of the patients had rashes, mainly manifested as erythema or papules. 39.6% of the patients were accompanied by immune system related diseases or immunosuppressants; The most common manifestations of chest CT were multiple nodules or masses involving both lungs. The main way of diagnosis was surgical lung biopsy, or CT-guided lung puncture biopsy. The positive rate of bronchoscopy biopsy was low. The pathological grade was mainly grade 3 (56.3%). The treatment plan was mainly R-CHOP, with an effective rate of 71.4%. For patients considered drug-induced disease, it was necessary to stop using induced drugs first, and then combined chemotherapy if there was no improvement. For HIV-infected patients, highly active antiretroviral therapy should be given first, if there was no improvement, then took combined chemotherapy; Of the 48 patients, 41 patients had clear follow-up results with a median follow-up time of 12 months, of which 14 patients were dead (34.1%), and the others got better in different degrees. Conclusions Pulmonary lymphomatoid granulomatosis is a rare disease. Clinicians should improve their understanding of it in order to identify the disease early, and choose the appropriate treatment scheme to improve its prognosis.
ObjectiveTo explore the therapeutic efficacy of crizotinib for patients with anaplastic lymphoma kinase (ALK)-positive advanced non-small-cell lung cancer (NSCLC). MethodsWe retrospectively analyzed the clinical data of 31 ALK-positive NSCLC patients who received crizotinib treatment between November 2012 and May 2014 in the Department of Thoracic Oncology of West China Hospital. The median age of the patients was 51 years old, and the percentage of male and female patients was 45.2% and 54.8%, respectively. Among them, 74.2% were non-smokers, 74.2% had an ECOG performance status of 0-2. Histologically, adenocarcinoma was the highest proportion of 96.8%, and one (3.2%) patient had large cell carcinoma. Fifteen (48.4%) ALK-positive patients were given crizotinib in the first-line setting, and 16 (51.6%) accepted crizotinib in the second-line and beyond. ResultsThe objective response rate (ORR) of the patients treated with crizotinib was 61.3%, and the disease control rate (DCR) was 90.3%. The median progression-free survival (time) was 10.0 months [(95% CI (2.9, 17.0) months]. The difference of ORR and DCR between the patients given crizotinib in the first-line setting and the patients given crizotinib in the second-line or beyond was not statistically significant (P=0.716 and P=0.600, respectively). The most frequent treatment-related adverse events were increased aspartate aminotransferase/alanine aminotransferase (64.5%), nausea and vomiting (35.5%), leukopenia (16.7%), vision disorder (16.1%), edema (12.9%), and diarrhea (12.9%), and most toxicities were grade 1 and 2. ConclusionThis study shows that crizotinib can increase the objective response rate and disease control rate, prolong progression-free survival time in patients with advanced ALK-positive non–small-cell lung cancer. Crizotinib has relative fewer side effects and can be tolerated by the patients.
Objective To investigate the changes of autophagy after spinal cord injury (SCI) in rats and its relationship with multisite phosphorylation of B-cell lymphoma-2 (Bcl-2) protein. Methods Forty male Sprague-Dawley rats aged 8 weeks were used to prepare SCI models by modified Allen method, and the SCI model were prepared successfully in 36 rats. The 36 SCI models were randomly divided into SCI group, autophagy inhibitor group, and autophagy promoter group, with 12 rats in each group. Another 12 rats were selected as sham operation group with only laminectomy and no spinal cord injury. At the end of modeling, the autophagy inhibitor group and the autophagy promoter group were intrathecally injected with 20 μL of 600 nmol/L 3-methyladenine and 25 nmol/L rapamycin, respectively, once a day for 4 weeks. The sham operation group and the SCI group were injected with only 20 μL of normal saline at the same time point. The motor function of rat in each group was evaluated by the Basso-Beattie-Bresnahan (BBB) score at 1 day and 1, 2, 4 weeks after modeling. The rats in each group were sacrificed at 24 hours after the last injection and the spinal cord tissues were taken. ELISA assay was used to detect the levels of inflammatory factors in spinal cord tissues, including myeloperoxidase (MPO), tumor necrosis factor α (TNF-α), and interleukin 1β (IL-1β); the morphological changes of spinal cord were observed by HE staining; the autophagy of mitochondria in spinal cord tissues was observed by transmission electron microscopy; the expressions of Beclin1 and microtubule-associated protein light chain 3 (LC3) were detected by immunofluorescence staining; neuronal apoptosis in spinal cord tissues were observed by TUNEL staining; LC3/TUNEL positive cells were calculated by immunofluorescence double staining; the expressions of Bcl-2 associated X protein (Bax), Bcl-2, p-Bcl-2 (Ser87), and p-Bcl-2 (Ser70) were detected by Western blot. Results Compared with sham operation group, BBB score of SCI group decreased at each time point, while the levels of MPO, TNF-α, and IL-1β increased; peripheral space of nerve cells enlarged, cells swelled, vacuoles appeared, and autophagic bodies appeared in mitochondria; the positive rates of Beclin1 and LC3 proteins, and apoptotic rate of neurons significantly increased; the LC3/TUNEL positive cells significantly increased; the expressions of Bax, p-Bcl-2 (Ser87), and p-Bcl-2 (Ser70) proteins increased, while the expression of Bcl-2 protein decreased; all showing significant differences (P<0.05). Compared with SCI group, BBB score in autophagy inhibitor group decreased at each time point, while the levels of MPO, TNF-α, and IL-1β increased; a few autophagic vesicles appeared in mitochondria; the positive rates of Beclin1 and LC3 proteins decreased and the apoptotic rate of neurons increased significantly; the LC3 positive cells decreased and the TUNEL positive cells increased; the expressions of Bax, p-Bcl-2 (Ser87), and p-Bcl-2 (Ser70) proteins increased, while the expression of Bcl-2 protein decreased. The results of autophagy promoter group were opposite to those of autophagy inhibitor group; all showing significant differences between groups (P<0.05). Conclusion Induction of autophagy after SCI in rats can reduce neuronal apoptosis and protect spinal cord function, which may be related to the inhibition of Bcl-2 protein multisite phosphorylation.