Objective:Our research aims to discuss the clinical characteristics, treatment methods, and prognostic characteristics of patients with esophageal cancer spinal metastasis. It is one of the largest clinical studies on the disease to date. The purpose is to improve clinicians’ understanding of the clinical features and prognosis of esophageal spine metastases and share our experience in dealing with this entity.Methods: Six patients with spinal metastasis due to esophageal cancer who had received surgical treatment at the bone tumor center of Peking Union Medical College Hospital from January 2010 to January 2020 were selected. The clinical data, surgical records, imaging examinations, pathological reports, and immunohistochemical results of all patients were reviewed by the team. In the study, we applied two surgical treatments, namely open surgery and percutaneous vertebroplasty. Radiotherapy, chemotherapy, and targeted therapy were used as adjuvant treatments. Retrospective analysis of the patient’s basic clinical data was done.Results:All six patients with metastatic spinal esophageal cancer (MSEC) were male with an average age of 58.0 ± 5.3 years. The average duration between the esophageal cancer resection and diagnosis of spinal metastases was 24.8 (2-72) months. Of the six patients, four had spinal metastases located in the thoracic spine and two had metastases located in the lumbar spine. We referred to the revised Tokuhashi score and Tomita score to recommend individualized surgical treatment plans for patients, and fully respected the patients’ wishes. All six patients underwent surgical treatment, a total of six operations, including four percutaneous vertebroplasty and two open surgery. After the operations, the symptoms of the patients improved significantly. During the follow-up, all six patients died of the disease with the average time from spinal surgery to death being 8.8 ± 3.7 months.Conclusions: In general, patients with esophageal cancer spine metastases have a poor prognosis, and the average survival time of these patients often does not exceed 12 months. The combination of surgical treatment and postoperative adjuvant therapy can control symptoms effectively and improve the patient’s quality of life.
Objective To investigate the clinical symptoms experienced by patients with thoracic spinal tumors and verify the associated symptoms that are predictive of a decline in muscle strength in the lower limbs.Methods A single-center, retrospective cross-sectional study was conducted on in-patients diagnosed with epidural thoracic spinal tumors between January 2011 and May 2021. The study involved a review of electronic medical records and radiographs and the collection of clinical data. The differences in clinical manifestations between patients with constipation and those without constipation were analyzed. Binary logistic regression analyses were performed to identify risk factors associated with a decline in muscle strength in the lower limbs.Results A total of 227 patients were enrolled, including 131 patients with constipation and 96 without constipation. The constipation group had a significantly higher proportion of patients who experienced difficulty walking or paralysis compared to those without constipation prior to surgery (83.2% vs. 17.7%, χ 2 =99.035, P < 0.001). Constipation (OR = 9.522, 95%CI: 4.150-21.849, P < 0.001) and urinary retention (OR = 14.490, 95%CI: 4.543-46.213, P < 0.001) were independent risk factors for muscle strength decline in the lower limbs. ConclusionsThe study observed that patients with thoracic spinal tumors who experienced constipation symptoms had a higher incidence of lower limb weakness. Moreover, the analysis
Background: Advanced breast cancer commonly metastasises to the bone and the molecular mechanism explaining the bone affinity of breast cancer cells is unclear. Thus, we developed nomograms based on a competing endogenous RNA (ceRNA) network and analysed tumour-infiltrating immunecells to elucidate the molecular pathways that may predict the prognosis of breast cancer patients.Methods: We obtained the RNA expression profile of 1091 primary breast cancer samples from The Cancer Genome Atlas database, 58 of which had bone metastasis. We analysed differential RNA expression patterns between breast cancer with and without bone metastasis and developed a ceRNA network. Cibersort was employed to differentiate between immune cell types based on tumour transcripts. Nomograms were then established using the ceRNA network and immune cell analysis. The value of prognostic factors was evaluated by Kaplan-Meier survival analysis and Cox proportional risk model.Results: There were significant differences in lncRNAs, 18 miRNAs, and 20mRNAs between breast cancer with and without bone metastasis, which were used to construct a ceRNA network. We found that the protein-coding genes gjb3, cammv, ptprz1,and fbn3 were significant in our Kaplan-Meier analysis. We also observed significant differences in plasma cell and follicular helper T cell populations between the two groups. In addition, the proportions of mast cells, gamma delta T cells, and plasma cells differed depending on disease location and stage. Our analysis revealed that a high proportion of follicular helper T cells and a low proportion of eosinophils promoted survival and that dlx6-as1, wnt6,and gabbr2expression may be related to bone metastasis of breast cancer.Conclusions: We provided a bioinformatic basis for exploring the molecular mechanism of bone metastasis in breast cancer patients and identified factors that may predict this.
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