Background Non-invasive lung adenocarcinoma could benefit from limited resection, nonetheless, there is a lack of method to determine preoperative tumour invasiveness. We aimed to investigate whether folate receptor-positive circulating tumour cells (FR + -CTCs) in combination with maximum tumour diameter (MTD) determines, before surgery, the invasiveness of small-sized, indeterminate solitary pulmonary nodules (SPNs). Methods A total of 382 patients with suspicious lung adenocarcinoma on computed tomography who were expected to undergo lung resection were enrolled in this study at three participating institutes and randomly assigned into training and validation cohorts. Before surgery, 3 mL peripheral blood was collected from all participants. FR + -CTCs were analyzed using immunomagnetic leukocyte depletion and quantitated by ligand-targeted PCR method. After surgery, the resected tissues were diagnosed by pathologists according to IASLC/ATS/ERS classification. Findings FR + -CTC levels in the peripheral blood can differentiate benign from malignant nodules with a sensitivity of 78·6%–82·7% and a specificity of 68·8%–78·4%. Both FR + -CTC and MTD are independent predictive indices of invasive tumours for lung adenocarcinoma ≤2 cm based on multivariate analyses. Further, FR + -CTC count in combination with MTD can differentiate non-invasive cancers from invasive cancers with a sensitivity of 63·6%–81·8% and a specificity of 71·4%–89·7%. Interpretation Detection of FR + -CTC is a reliable method to differentiate malignancy of indeterminate SPNs. Combining of FR + -CTC count and MTD could possibly enhance preoperative determination of the invasiveness of lung nodules and guide surgeons to select limited lung resection and avoid overtreatment for patients with non-invasive lesions. Fund None.
Although several morphological variations and classification of the suprascapular notch (SSN) were reported in western populations, little attention has been paid to this anatomic issue in the Chinese population. In this research of SSN morphology in Chinese people, 295 specimens of intact dry Chinese adult scapulas were investigated and measured thoroughly and systematically. Morphological features of SSN variations were observed by visual inspection, and correlation parameters of variability and classification were measured in digital images with image processing software and bones with a vernier caliper, respectively. The incidence of different subtypes of SSN classification and comparative analysis of correlation parameters were calculated. It was interesting that a new variable morphology of SSN with a double suprascapular foramen had been found. We found the most prevalent groups were Type II (an incisura that was longer in its transverse diameter) and Type III (an incisura that was longer in its vertical diameter) which accounted for 58.16 and 28.23%, respectively. The circumference and area of Type II and Type III was larger than those of Type IV. The thickness of 1 mm below the lowest point of the SSN ranges from 0.55 to 3.00 mm. Eight cases with a narrow groove on the lowest point of SSN and four cases with bony canals formed by the ossified superior transverse scapular ligament were found. Further, the distance between the SSN and bony landmarks were varied. For AD (the distance between the lowest point of the SSN and the supraglenoid tubercle), Type I was largest, followed by the Type II, Type III, and Type IV. For AE (the distance between the lowest point of the SSN and the base of the spinoglenoid notch), Type IV was the shortest and there was no statistical difference between other types. This study reveals that SSN variations are common in Chinese population. This anatomic information is important in the management of entrapment neuropathy or interventional procedure of the SSN.
Background Glioblastoma is a paradigm of cancer‐associated immunosuppression, limiting the effects of immunotherapeutic strategies. Thus, identifying the molecular mechanisms underlying immune surveillance evasion is critical. Recently, the preferential expression of inhibitory natural killer (NK) cell receptor CD161 on glioma‐infiltrating cytotoxic T cells was identified. Focusing on the molecularly annotated, large‐scale clinical samples from different ethnic origins, the data presented here provide evidence of this immune modulator's essential roles in brain tumor biology. Methods Retrospective RNA‐seq data analysis was conducted in a cohort of 313 patients with glioma in the Chinese Glioma Genome Atlas (CGGA) database and 603 patients in The Cancer Genome Atlas (TCGA) database. In addition, single‐cell sequencing data from seven surgical specimens of glioblastoma patients and a model in which patient‐derived glioma stem cells were cocultured with peripheral lymphocytes, were used to analyze the molecular evolution process during gliomagenesis. Results CD161 was enriched in high‐grade gliomas and isocitrate dehydrogenase (IDH)‐wildtype glioma. CD161 acted as a potential biomarker for the mesenchymal subtype of glioma and an independent prognostic factor for the overall survival (OS) of patients with glioma. In addition, CD161 played an essential role in inhibiting the cytotoxicity of T cells in glioma patients. During the process of gliomagenesis, the expression of CD161 on different lymphocytes dynamically evolved. Conclusion The expression of CD161 was closely related to the pathology and molecular pathology of glioma. Meanwhile, CD161 promoted the progression and evolution of gliomas through its unique effect on T cell dysfunction. Thus, CD161 is a promising novel target for immunotherapeutic strategies in glioma treatment.
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