Objective: High-dose chemotherapy(HDC) followed by autologous stem cell transplantation(ASCT) is the standard of care in the upfront or relapsed/refractory setting in some patients with non-Hodgkin lymphoma(NHL).Howev...Objective: High-dose chemotherapy(HDC) followed by autologous stem cell transplantation(ASCT) is the standard of care in the upfront or relapsed/refractory setting in some patients with non-Hodgkin lymphoma(NHL).However,a proportion of patients do not respond to ASCT.^(18)F-fluorodeoxyglucose(FDG) positron emission tomography(PET)/computed tomography(CT) has been widely used for staging,response evaluation,and prognosis prediction.Here,we investigated the prognostic role of PET/CT in NHL patients before and after ASCT.Methods: A retrospective study was conducted at Peking University Cancer Hospital.All NHL patients who underwent ASCT between March 2010 and July 2016 were identified.Patients who had PET/CT scan before and after ASCT were included.Deauville criteria(5-point scale) were used to interpret PET scans.Univariate and multivariate survival analyses were performed using Cox regression.The predictive value of PET scanning was estimated by comparing the area under the receiver operating characteristic(ROC) curve.Results: In total,79 patients were enrolled in this study.In univariate analysis,pre-and post-ASCT PET result was identified as prognostic factors for 3-year progression-free survival(PFS) and overall survival(OS).Patients with negative pre-ASCT PET result demonstrated significantly better PFS(84.2% vs.54.2%) and OS(89.2% vs.63.6%) than patients with positive pre-ASCT PET result.PFS(91.6% vs.25.3%) and OS(96.5% vs.36.8%) were also significantly different between patients with negative and positive post-ASCT PET result.Multivariate analysis also showed a significant association between survival and post-ASCT PET result.ROC analysis revealed that the predictive value of post-ASCT PET result was superior to that of pre-ASCT PET result alone.Combined pre-and post-ASCT PET result is better for predicting outcomes in patients with NHL receiving transplantation.Deauville criteria score >3 was identified as the best cutoff value for post-ASCT PET.Conclusions: Post-ASCT PET result was more important than pre-ASCT PET result in predicting outcomes for NHL patients who underwent ASCT.The prognostic significance can be improved when combining preASCT PET result with post-ASCT PET result.Deauville criteria can be used for interpreting PET scans in this scenario.展开更多
To investigate the expression of apoptosis-related protein (Fas, FasL, and Bcl-2) in the pathogenesis of autoimmune thyroid disorders (ATDs), immunohistochemical staining was performed on 20 Hashimoto's thyroiditi...To investigate the expression of apoptosis-related protein (Fas, FasL, and Bcl-2) in the pathogenesis of autoimmune thyroid disorders (ATDs), immunohistochemical staining was performed on 20 Hashimoto's thyroiditis (HT), 20 Graves' disease (GD), and 20 thyroid follicular adenoma (TFA, as control). All the cases expressed Fas, mainly on the cell surface and cytoplasm. FasL was found in 17 cases of the TFA. Bcl-2 was detected in 15 cases of HT, 19 of GD and 17 of TFA. In TFA, a moderate Fas expression and a minimal or no FasL expression was detected on follicular cells. In HT, the follicles adjacent to infiltrating lymphocytes showed increased levels of Fas and FasL expression. A weaker staining of Fas and FasL was exhibited on infiltrating lymphocytes than on thyrocytes. In a comparison of GD with HT, thyrocytes and lymphocytes showed similar Fas staining, but for FasL the staining was rather weaker in HT. The expression of Bcl-2 was nearly identical in GD and TFA, but much weaker on the follicular cells in vicinity of lymphocytes and on the lymphocytes located in germinal centers of HT tissues. The expression of Fas, FasL, Bcl-2 in Hashimoto's thyroiditis and Graves' disease were almost same. FasL strong expression and Bcl-2 weak expression on the follicles in HT may induce apoptosis. These results provided evidence for expression of Fas, FasL and Bcl-2 in the pathogenesis of autoimmune thyroid disease. The lymphocytes seem not to be directly engaged in the process via their own FasL, but they may provide some cytokines that, in turn, upregulate Fas and/or FasL expression to induce apoptosis.展开更多
基金sponsored by Scientific Research Foundation for the Returned Overseas Chinese ScholarsMinistry of Human Resources and Social SecurityBeijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support(No.XMLX201502)
文摘Objective: High-dose chemotherapy(HDC) followed by autologous stem cell transplantation(ASCT) is the standard of care in the upfront or relapsed/refractory setting in some patients with non-Hodgkin lymphoma(NHL).However,a proportion of patients do not respond to ASCT.^(18)F-fluorodeoxyglucose(FDG) positron emission tomography(PET)/computed tomography(CT) has been widely used for staging,response evaluation,and prognosis prediction.Here,we investigated the prognostic role of PET/CT in NHL patients before and after ASCT.Methods: A retrospective study was conducted at Peking University Cancer Hospital.All NHL patients who underwent ASCT between March 2010 and July 2016 were identified.Patients who had PET/CT scan before and after ASCT were included.Deauville criteria(5-point scale) were used to interpret PET scans.Univariate and multivariate survival analyses were performed using Cox regression.The predictive value of PET scanning was estimated by comparing the area under the receiver operating characteristic(ROC) curve.Results: In total,79 patients were enrolled in this study.In univariate analysis,pre-and post-ASCT PET result was identified as prognostic factors for 3-year progression-free survival(PFS) and overall survival(OS).Patients with negative pre-ASCT PET result demonstrated significantly better PFS(84.2% vs.54.2%) and OS(89.2% vs.63.6%) than patients with positive pre-ASCT PET result.PFS(91.6% vs.25.3%) and OS(96.5% vs.36.8%) were also significantly different between patients with negative and positive post-ASCT PET result.Multivariate analysis also showed a significant association between survival and post-ASCT PET result.ROC analysis revealed that the predictive value of post-ASCT PET result was superior to that of pre-ASCT PET result alone.Combined pre-and post-ASCT PET result is better for predicting outcomes in patients with NHL receiving transplantation.Deauville criteria score >3 was identified as the best cutoff value for post-ASCT PET.Conclusions: Post-ASCT PET result was more important than pre-ASCT PET result in predicting outcomes for NHL patients who underwent ASCT.The prognostic significance can be improved when combining preASCT PET result with post-ASCT PET result.Deauville criteria can be used for interpreting PET scans in this scenario.
文摘To investigate the expression of apoptosis-related protein (Fas, FasL, and Bcl-2) in the pathogenesis of autoimmune thyroid disorders (ATDs), immunohistochemical staining was performed on 20 Hashimoto's thyroiditis (HT), 20 Graves' disease (GD), and 20 thyroid follicular adenoma (TFA, as control). All the cases expressed Fas, mainly on the cell surface and cytoplasm. FasL was found in 17 cases of the TFA. Bcl-2 was detected in 15 cases of HT, 19 of GD and 17 of TFA. In TFA, a moderate Fas expression and a minimal or no FasL expression was detected on follicular cells. In HT, the follicles adjacent to infiltrating lymphocytes showed increased levels of Fas and FasL expression. A weaker staining of Fas and FasL was exhibited on infiltrating lymphocytes than on thyrocytes. In a comparison of GD with HT, thyrocytes and lymphocytes showed similar Fas staining, but for FasL the staining was rather weaker in HT. The expression of Bcl-2 was nearly identical in GD and TFA, but much weaker on the follicular cells in vicinity of lymphocytes and on the lymphocytes located in germinal centers of HT tissues. The expression of Fas, FasL, Bcl-2 in Hashimoto's thyroiditis and Graves' disease were almost same. FasL strong expression and Bcl-2 weak expression on the follicles in HT may induce apoptosis. These results provided evidence for expression of Fas, FasL and Bcl-2 in the pathogenesis of autoimmune thyroid disease. The lymphocytes seem not to be directly engaged in the process via their own FasL, but they may provide some cytokines that, in turn, upregulate Fas and/or FasL expression to induce apoptosis.
