Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine.
The epidermal growth factor receptor (EGFR) family belongs to type I receptor tyrosine kinases. Overexpression or mutation of EGFR/ErbB1 gene has been detected in a large number of human solid tumours. According to some previous report, this gene is not expressed in hematological malignancies. However, two recent clinical case reports showed that erlotinib caused complete remission of acute myeloid leukaemia (AML)-M1 in patients who had both AML-M1 and non-small-cell lung cancer. These results are supported by preclinical studies in which EGFR tyrosine kinase inhibitors have anti-proliferative effects on AML. These findings prompted us to determine whether EGFR is expressed in human AML, through a large-scale screening of both leukaemic cell lines and clinical samples. Our results show that EGFR is expressed by about 33% of human AML (containing M1 to M7 subtypes) and by some human leukaemia cell lines (K562, MEG-01, CEM and SKO-007). Its expression is not limited to certain AML types but has been detected in many leukaemic cells. In addition, EGFR expression was intimately associated with the poor clinical outcomes. Finally, we find that only EGFR-positive leukaemic cells respond to antibody-dependent cellular cytotoxicity of cetuximab, the monoclonal antibodies against EGFR.
Cetuximab improves the survival of patients with metastatic colorectal cancer. The main limitation is primary and secondary resistance, the underlying mechanism of which requires extensive investigation. We proved that PRSS expression levels are significantly negatively associated with the sensitivity of cancer cells to cetuximab. Detailed mechanistic analysis indicated that PRSS can cleave cetuximab, leading to resistance. Cetuximab or bevacizumab combined with SPINK1, a PRSS inhibitor, inhibited cell growth more efficiently than cetuximab or bevacizumab alone in xenograft models. PRSS levels in the serum of 156 patients with mCRC were analyzed, and poor efficacy of cetuximab therapy was observed in patients with aberrant PRSS expression. PRSS expression in monoclonal antibody (mAb)-treated patients with cancer from The Cancer Genome Atlas database was also evaluated to determine whether patients with higher PRSS expression have significantly reduced progression-free survival. Our work provides a strong scientific rationale for targeting PRSS in combination with cetuximab therapy.
Primary heterotopic meningiomas are lesions that are not associated with a cranial nerve foramen, vertebral canal, or intracranial structure. The most common histopathological subtype is meningeal epithelioma. In clinical practice, primary heterotopic nasal meningioma occurs relatively rarely, and its most common pathological type is psammomatous meningioma, whereas nasal fibrous meningioma is infrequent. In our case, a 31-year-old male patient was admitted to the hospital with “progressive nasal obstruction on the right side for half a year.” Computed tomography examination of the paranasal sinuses revealed a polyploid mass in the right nasal cavity. The patient underwent surgical resection of the mass under nasal endoscopy. Histopathological examination confirmed that the mass was an ectopic meningioma of the nasal cavity. The patient was regularly followed up for 2 years without recurrence of the tumor. Primary heterotopic fibrous meningioma of the nasal cavity is clinically rare but should be considered as a differential diagnosis for hemangioma of the nasal cavity, inverted papilloma, and nasal polyp. The final diagnosis is based on pathology and immunohistochemistry analysis results.
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