The gold standard for diagnosis of 2019 novel coronavirus (2019-nCoV) infection is the new coronavirus nucleic acid in swabs, sputum, secretions from the lower respiratory tract or blood. However, due to the quite low sensitivity, short of supply and a relatively long period of new coronavirus nucleic acid kits, suspected cases with false-negative results remain a severe problem. Besides, a long incubation period (3-7 days, up to 14 days) and superior transmission capacity of new viruses contribute to the fast spread of 2019-nCoV. Under the circumstances, computed tomography imaging is not only useful for the detection, location of lesions but also helpful in the evaluation of the dynamic changes of patients with 2019-nCoV.
Case presentationA 47-year-old man had a history of cough, sputum production, sore throat and throbbing headache for 3 days without fever. He has been living in Chengdu, Sichuan province, for a long time. However, his mother had traveled to Wuhan a week ago and was diagnosed with the new coronavirus after she got back home. He has referred to the emergency department of our institution on 2 February 2020. General physical examination showed that moist rales were audible over both lungs, and the body temperature was 36.7 C, and other results were unremarkable. The laboratory tests showed that white blood cell count kept in the normal range (5.11 Â 109/l), and the differential count showed decreased lymphocyte (16.8%, normal range 20-50%) and increased C-reactive protein (22.50 mg/l; normal range <5 mg/l). Chest computed tomography (CT) (2 February 2020) showed that there were ground-glass opacities, consolidation or both in bilateral lungs ( Figure 1A). Considering the contact history with his mother and the CT features, a real-time fluorescence polymerase chain reaction of the patient's throat Figure 1. Chest CT images in a 47-year-old man. (A) CT images show that there are ground-glass opacities, consolidation or both in bilateral lungs, and 'halo sign' is visible in the basal segment of the lower lobe of the right lung. (B) The extent and density of lesions are significantly decreased. (C and D) At the third time of reexamination, CT scan shows multiple patchy ground-glass opacities, consolidation in bilateral lungs and the new lesions are in different locations.
Purpose. This study was performed to investigate the association of CEP55 expression with liver cancer and explore potential underlying mechanisms. Materials and Methods. Data obtained from The Cancer Genome Atlas (TCGA) was used to investigate CEP55 expression, its prognostic value, the potential mechanisms of its upregulation, CEP55-related pathways, and its biological functions in liver cancer. Data from Gene Expression Omnibus (GEO) and International Cancer Genome Consortium (ICGC) was used to validate survival analysis. The correlation between CEP55 and tumor-infiltrating immune cells (TIICs) in liver cancer was determined by using Tumor Immune Estimation Resource (TIMER). Results. CEP55 was significantly overexpressed in the liver tumor sample compared to the adjacent normal liver sample. High CEP55 expression was significantly associated with histological grade, advanced stages, histological type, high T classification, and survival status. High CEP55 expression was significantly related to dismal prognosis compared with low CEP55 expression, which was validated by the GSE54236 dataset and ICGC database. Meanwhile, CEP55 was identified as the risk factor to independently predict overall survival (OS) for patients with liver cancer upon multivariate analysis. Enrichment analysis indicated that cell cycle, DNA replication, pathways in cancer, mTOR signaling pathway, and VEGF signaling pathway were significantly enriched in the high CEP55 expression group. In addition, the CEP55 expression was significantly related to the infiltration level of B cells, CD4+ T cells, CD8+ T cells, macrophages, neutrophils, and dendritic cells in hepatocellular carcinoma (HCC). CEP55 methylation level was negatively correlated to its mRNA expression. And patients with CEP55 hypermethylation and low expression can achieve a better prognosis than those with CEP55 hypomethylation and high expression. Conclusion. CEP55 may serve as a candidate treatment target for it is a determinant of prognosis and immune infiltration in liver cancer patients. DNA hypomethylation might contribute to the overexpression of CEP55 in liver cancer.
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