Objective Factors impacting surgical options and outcomes in patients with cervical ossification of the posterior longitudinal ligament (OPLL) were explored. Methods A retrospective analysis was conducted of 127 eligible cervical OPLL patients (61 males, 66 females) aged 41-70 years (mean 55.2 years) selected from 152 total OPLL patients treated from 2002 to 2006, with 5-10-year (mean 6.8 years) follow-up. Patients underwent anterior subtotal corpectomy with ossification ligament resection (anterior surgery, n = 68) or posterior cervical double-door laminoplasty (posterior surgery, n = 59). Radiographic assessments of cervical curvature, T2-weighted MRI (MRIT2) signal, and OPLL occupying ratio were correlated with surgical strategy before surgery and at 1, 5 weeks, and 5 years. Results Lordosis increased following anterior surgery, though kyphosis improved by 10.3 %. The canal stenosis occupying ratio was [50 %, and short-term improvement following anterior surgery was significantly higher than posterior surgery (P [ 0.0001). Superior neurological function was observed in patients with unchanged versus high spinal MRIT2 signals (P = 0.0434). No significant differences were observed in short-term outcomes between anterior and posterior surgeries in high spinal MRIT2 signal patients, but anterior surgery produced significantly better long-term outcomes at 1 week (P = 0.7564) and 1 year (P = 0.0071). Complications occurred in five anterior and three posterior surgeries. Conclusion Preoperative assessment of cervical curvature, MRIT2 signal, and occupying ratio can be used to guide clinical surgical approach selection to potentially produce better long-term outcomes in patients with OPLL.
The effects of single nucleotide polymorphisms (SNPs) at APE1 have been investigated in several types of cancer. However, no reports of the association of APE1 polymorphisms with osteosarcoma (OS) have been published. The present study was designed to determine whether APE1 polymorphisms (rs1130409, rs1760944, rs1760941, rs2275008, rs17111750) are associated with OS. A 2-stage case-control study was performed in a total of 378 OS patients and 616 normal controls. Individuals carrying TG and GG genotypes had significantly lower risk of developing OS than those with the WT genotype TT at rs1760944 (OR = 0.65, 95%CI 0.49–0.86; OR = 0.50, 95%CI 0.34–0.74, respectively). OS patients with allele G at rs1760944 were less susceptible to low differentiation tumor and metastasis (OR = 0.73, 95%CI 0.54–0.98; OR = 0.63, 95%CI 0.43–0.92, respectively). Kaplan-Meier curves and log-rank results revealed that OS patients harboring genotype GG and G allele at rs1760944 had better survival (P < 0.001 for both). In addition, the APE1 protein was underexpressed in individuals who carried G allele at rs1760944. This study suggested that APE1 rs1760944 polymorphism is associated with decreased risk of developing OS and better survival of OS patients.
Th17 cells were recruited to an inflamed synovium, and inflammatory cytokine IL-17 was expressed at an increased level in the hip synovium of ONFH patients, which possibly contributed to clinical syndrome development. Overall, this study will help in identifying new therapeutic strategies for ONFH, especially the targeting of IL-17 to decrease inflammation and pain. < p > < /p >.
Malignant fibrous histiocytoma of the bone (MFH-B) is an extremely rare and aggressive malignancy. The clinicopathological characteristics and prognosis of patients with MFH-B have not been defined. We conducted a retrospective study using the data of all MFH-B patients from the Surveillance, Epidemiology and End Results (SEER) database between 1975 and 2016. Initially, the clinicopathological characteristics were described. The difference in prognosis between patients with MFH-B and those with osteosarcoma was compared using propensity score matching analysis. Then, the features affecting the prognosis of patients with MFH-B were further determined using Cox regression analysis. A total of 318 patients with MFH-B were identified. The median overall survival (mOS) of all 318 patients with MFH-B was 29.0 months. The 1-, 3-, 5-, and 10-year survival rates were 67.4%, 53.6%, 38.7%, and 28.7%, respectively. The multivariate Cox regression analysis showed that older age, distant metastases, and flat bone lesion were independent factors for worse prognosis, whereas surgery was an independent factor for favorable survival, and this intervention could decrease risk of death by 61% (HR = 0.39, 95% CI 0.28-0.54). Apart from this, the prognosis of patients with MFH-B was significantly worse than that of patients with osteosarcoma in both unmatched and matched cohorts. In conclusion, MFH-B is a rare malignant bone cancer, with relatively worse prognosis than osteosarcoma. Older age, distant metastases, flat bone lesion, and surgery were independently associated with prognosis. In order to understand this disease more thoroughly and accurately, more cases with adequate information are required in the future.
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