NI-16 Verification of APT image and relationship with T2/FLAIR mismatch sign in WHO2016 brain tumor pathology classification

Introduction: Amide Proton Transfer Imaging(APT)is an MRI imaging method that images the increased concentration of amide groups in tumors and is expected to be clinically applied to the diagnostic imaging of gliomas.On the other hand,T2/FLAIR mismatch sign(T2/FLms)has been proposed as an MRI finding specific to astrocytoma with IDH gene mutation.This time,in the WHO2016 Brain Tumor Pathological Classification,we report the verification of the pathological gene classification of APT and the retrospective verification based on the pathological diagnosis results of whether there is a relationship between APT and T2/FLms. Method: We examined 88 cases of preoperative glioma (Grade:G2/3/4)in which APT/T2/FLAIR was imaged.resultIt showed a high value in high malignancy and a significant difference was observed.In the verification of genetic classification, the measured APT values were 1.91 ±0.71 for oligodendroglioma(16 cases),2.58±0.17 for astrocytoma(2 cases),2.40±0.90 for anaplastic oligodendroglioma(12 cases),Anaplastic astrocytoma(20 cases)2.63±0.42,The oligodendroglioma system showed lower values than the astrocytoma system.For anaplastic astrocytoma IDH mutant and glioblastoma IDH mutant,APT measurement values were measured after evaluating the presence or absence of T2/FL ms. APT measured values are anaplastic astrocytoma IDH mutant T2/FL ms present(7 cases) 2.63±0.38,T2/FL ms not (5 cases) 2.76±0.37, glioblastoma IDH mutant T2/FL ms present(5 cases)2.67±0.50, no T2/FL ms(3 cases)3.48±0.27,suggesting low APT measured values with T2/FL ms,respectively.ConclusionIn the verification of genetic classification, the oligodendroglioma system shows a lower value than the astrocytoma system,and it is considered that it can be one of the options such as treatment policy.Regarding the relationship between T2/FL ms and APT,it was suggested that the APT measured value with T2/FL ms tended to be low,but since it wasreported that the sensitivity of T2/FL ms was 30%,it was verified by accumulating cases.is required.

CBIO-10. TARGETING HISTONE H4 Lys 20 MONOMETHYLATION IN THE TREATMENT OF GLIOBLASTOMA

BACKGROUND Glioblastoma (GBM) is the most malignant primary tumor of the central nervous system, while the pathogenesis remains unclear. Protein lysine methyltransferase SETD8, which is responsible for the modification of histone H4K20me1, has been shown to play an important role in cellular transcriptional regulation and the development of a variety of tumors, yet its role in the malignant progression of GBM has not been elucidated. MATERIAL AND METHODS In the present study, we used primary GBM cell lines, intracranial xenograft model, transcriptome sequencing together with ChIP-sequencing, aiming to elucidate the molecular mechanism of SETD8-mediated H4K20me1 transcriptional regulation in promoting GBM progression. Furthermore, we evaluated the potential therapeutic significance in GBM using SETD8 small molecule inhibitor, UNC0379. RESULTS We found that SETD8 is aberrantly expressed in GBM tissues, accompanied by the dysregulation of H4K20me1 modification, which is associated with tumor pathology and prognosis. Using SETD8 inhibitor UNC0379 or knockdown of SETD8 significantly inhibited GBM cell proliferation in vitro and in vivo, and downregulated H4K20me1 modification level as well as transcriptome expression. CONCLUSION In summary, our work provide a novel insight into the role of SETD8/H4K20me1 axis. SETD8 overexpression mediated aberrant H4K20me1 modification act as a novel "transcriptional switch" in the malignant progression of glioma.

An analysis of research biopsy core variability from over 5000 prospectively collected core samples

Factors correlated with biopsy tissue adequacy and the prevalence of within-biopsy variability were evaluated. Totally, 1149 research biopsies were performed on 686 patients from which 5090 cores were assessed. Biopsy cores were reviewed for malignant percentage (estimated percentage of cells in the core that were malignant) and malignant area (estimated area occupied by malignant cells). Linear mixed models and generalized linear mixed models were used for the analysis. A total of 641 (55.8%) biopsies contained a core with <10% malignant percentage (inadequate core). The chance of an inadequate core was not influenced by core order, though the malignant area decreased with each consecutive core (p < 0.001). Younger age, bone biopsy location, appendiceal tumor pathology, and responding/stable disease prior to biopsy increased the odds of a biopsy containing zero adequate cores. Within-biopsy variability in core adequacy is prevalent and suggests the need for histological tumor quality assessment of each core in order to optimize translational analyses.

Differential Diagnosis of a Solitary Bone Lesion Using SPECT/CT Method

Relevance: Radionuclide bone scan signs of lesions are not specific and require radiological identification. Hybrid tomographic technology is a combination of spatial distribution of radiopharmaceuticals and its anatomical binding. Thus, makes it possible to accurately identify the affected bone structure and also determine the nature of this changes (radiological anatomy). In cancer patients, SPECT/CT method allows to visualize tumor pathology in the bones, but also keeps to a minimum errors and other excessive examinations.Purpose: To demonstrate the most frequent diseases and conditions that simulate tumor lesions in bones on bone scan.Material and methods: We analyzed the results of examinations of 81 patients with various tumor diseases (2015–2020). Bone scan was performed in the whole body 3 hours later, after intravenous administration of 99mTc-phosphotech on a Symbia E, T2 (Siemens, Germany). SPECT/CT was performed after WB Bone Scan.Results: The most frequent reasons for the focal increased uptake of radiopharmaceutical were: reactive increase in metabolism and as a result additional mineral repair: deforming osteoarthritis, osteophytes; post‑traumatic and postoperative changes; fractures (osteoporosis and stress fractures); inflammatory processes; focal uptake due to the benign neoplasms of bones and dysplasia. Combination of highly sensitive but non-specific scintigraphy with highly specific computed tomography makes it especially useful in anatomically difficult areas.Conclusion: SPECT/CT reveals a direct pater of anatomical and structural abnormalities with changes in bone tissue metabolism in case of different injuries and minimizes a number of ambiguous conclusions. SPECT/CT in oncological practice greatly helps nuclear medicine physician in the differential diagnostic process and reduces time of examination for the patient.

Surgical Management of Sinonasal Cancers: A Comprehensive Review

Surgery plays an important role in the treatment of sinonasal cancer. Many surgical approaches have been described, including open, endoscopic, or combined approaches. The choice is based on several criteria: general criteria related to the oncological results and morbidity of each technique, specific criteria related to the tumor (tumor extensions, tumor pathology), the patient, or the surgeon himself. The aims of this review are (i) to provide a complete overview of the surgical techniques available for the management of sinonasal malignant tumors, with a special focus on recent developments in the field of transnasal endoscopic surgery; (ii) to summarize the criteria that lead to the choice of one technique over another. In particular, the oncological outcomes, the morbidity of the different techniques, and the specificities of each histologic subtype will be discussed based on a comprehensive literature review.

APLN/APLNR Signaling Controls Key Pathological Parameters of Glioblastoma

Glioblastoma (GBM) is the most common and aggressive primary brain tumor in adults. GBM-expansion depends on a dense vascular network and, coherently, GBMs are highly angiogenic. However, new intratumoral blood vessels are often aberrant with consequences for blood-flow and vascular barrier function. Hence, the delivery of chemotherapeutics into GBM can be compromised. Furthermore, leaky vessels support edema-formation, which can result in severe neurological deficits. The secreted signaling peptide Apelin (APLN) plays an important role in the formation of GBM blood vessels. Both APLN and the Apelin receptor (APLNR) are upregulated in GBM cells and control tumor cell invasiveness. Here we summarize the current evidence on the role of APLN/APLNR signaling during brain tumor pathology. We show that targeting APLN/APLNR can induce anti-angiogenic effects in GBM and simultaneously blunt GBM cell infiltration. In addition, we discuss how manipulation of APLN/APLNR signaling in GBM leads to the normalization of tumor vessels and thereby supports chemotherapy, reduces edema, and improves anti-tumorigenic immune reactions. Hence, therapeutic targeting of APLN/APLNR signaling offers an interesting option to address different pathological hallmarks of GBM.

Fertility preservation in ovary pathologies in pediatric patients

Purpose: To study cases with ovarian torsion or ovarian tumors and hemorrhagic cysts and to review those who underwent ovary sparing surgery in a follow up period of 1 month, 3 months and 1 year. Methods: A prospective study of 46 youth and adolescent patients, from 6 to 16 years old, were prospectively studied from October 2015 to October 2020, in a single tertiary care children's hospital. All underwent radical or ovary- sparing operative management, due to ovarian torsion or ovarian tumor/cyst. Statistical analysis was performed with SPSS (ve 24 SPSS Inc., Chicago, IL,USA). Results: Sixteen patients underwent radical surgery, while ovary sparing surgery was performed in thirty three. Overall, 5 were diagnosed with ovarian torsion, 11 with ovarian or fallopian tube torsion due to hemorrhagic cyst or tumor and 30 with ovarian tumor (23 benign and 7 malignant). Benign or malignant etiology was confirmed through biopsy. Ultrasound was used for diagnosis in all patients, while CT scan or MRI only in 18 cases, especially in those with strong indications of tumor pathology. Initial operation was performed laparoscopically in 30% of patients, without any conversion to open surgery. In all patients postoperative ovarian ultrasound imaging was performed 1 and 3 months after surgery. An ultrasound follow-up 12 months postoperatively was performed in 38 patients. Conclusion: Ovarian-sparing operations are safe for ovarian torsion and benign ovarian tumors and conferred successful clinical outcomes of low recurrence and repeated surgery rates. It is also a viable approach in children and young girls in an attempt to preserve future fertility.

A Single-Institutional Study of Human Immunodeficiency Virus-Related Bladder Cancer

Purpose: We wished to investigate the clinical characteristics, treatments for tumor, pathology and outcomes of bladder cancer patients with HIV-infected.Patients and methods: We identified 10 cases of bladder cancer with HIV-infected from 2015 to 2020.We retrospectively investigated the clinical characteristics of the cases including demographic information, clinical presentation, TNM stage and so on. We investigated treatments for tumor, pathology, outcomes and HIV-relevant parameters during patients’ hospitalization course as well. Results: In our study, it was astonished to find that bladder cancer patients with HIV-infected were males at the median age of 51 years old, and no females were diagnosed on the contrary. Nine (90%)patients presented with painless gross hematuria, while one patient with incidental findings on ultrasonic examination. Six(60%) patients co-infected with another kind of infectious disease, four with syphilis, and two with HBV respectively. The median CD4+ T-lymphocyte cell count was 493/ul withthin 2 weeks prior to the diagnosis bladder cancer. Cystoscope examination manifested that the lesions were located in the trigonum of the bladder in four(40%)patients. All patients underwent surgeries successfully, six underwent transurethral resection of bladder tumor(TURBT),two of whom relapsed once, and one underwent TURBT twice due to recurrence and then RC and urethrectomy because of urethral invasion. All non muscle-invasive bladder cancer(NMIBC)patients received intravesical chemotherapy with pirarubicin 30mg for at least half year conventionally, and only one patient occurred mild adverse reaction of irritative symptoms of bladder. Pathologic analysis documented that all patients(100%) had transitional cell carcinoma(TCC). Tumor grade classification showed that three cases were identified with low grade TCC, and six cases with high grade or invasive TCC, two of whom occurred recurrence for once or twice respectively. One patient was identified with low grade TCC of primary tumor and high grade TCC of recurrent focal(Figure 2).Five cases(50%) were ascertained as (NMIBC) with pT1N0M0, while the rest five patients(50%) were muscle-invasive bladder cancer(MIBC) with at least pT2N0M0. During the median follow-up of 56 months (range from 5 months to 68 months) six cases(five were MIBC patients )died due to distant metastases. No patients acceptted adjuvent immunotherapy mainly due to the role of PD-1+ T cells in HIV transcription in treated aviremic individuals, concerns of unknown adverse effects and economic factors.Conclusions: It seemed like that bladder caner patients had higher tumor stage and more aggressive pathology. we did not find any evidence on the relationship between immunodeficiency and cancer progression because of relatively stable HIV status of this crew in our study. MIBC patients with HIV-infected really have worse outcomes, and more attention is warranted to pay to this special population in this situation when they present with hematuria extraordinarily.