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Female workers in the asbestos processing industry of Eastern China are at high risk of developing multiple types of cancer, and more data are urgently needed to better understand and address this issue. Death certificate data were selected from an asbestos processing city in China from 2005 to 2006. Information was investigated using the relatives of those individuals who had died as sources of information. Individuals were classified into one of three asbestos exposure levels. Standardized mortality ratio and 95% confidence interval were calculated. A total of 2,964 individual deaths were identified from 2005 to 2006; of these, 21.4% were occupationally exposed to asbestos. The main cause of death was circulatory system diseases (21.2%). The proportion of individuals with respiratory system diseases increased by age among each exposure subgroup (Ptrend < 0.01). Among females, a significant trend was observed between increased asbestos exposure and mortality due to respiratory system diseases and lung cancer. Our study indicated that asbestos exposure was associated with excess mortality from lung cancer and respiratory diseases, particularly among female workers in an asbestos processing area in Eastern China. [ABSTRACT FROM AUTHOR]

Introduction: Papillary thyroid cancer (PTC) is one of the most common malignancies involving the endocrine system. Aim: To explore the clinical value of ultrasound-based radiomics for predicting the recurrence of PTC after complete endoscopic resection. Material and methods: The general data of 361 PTC patients were collected. They were randomly assigned to the modeling group (n = 253) and the validation group (n = 108) according to the ratio of 7: 3. In the modeling group, the PyRadiomics package was applied to extract radiomic features from preoperative ultrasound images, and least absolute shrinkage and selection operator (LASSO) was used to screen and to construct a radiomics score (Radscore). Independent prognostic predictors were identified using the Cox proportional hazards model, and a nomogram prediction model was constructed by R software. Results: Using the LASSO regression model, 7 radiomic features were screened and then the Rad-score was calculated. Based on the Rad-score, modeling and validation groups were divided into low-, medium- and high-risk groups, and the 10-year recurrence-free survival rates were 94.7% vs. 95.9%, 83.6% vs. 80.0%, and 50.0% vs. 66.6%, respectively (p < 0.001). Multivariate analysis revealed that age, lymph node metastasis and Rad-score were independent predictors for recurrence-free survival (p < 0.05). Conclusions: The ultrasound-based radiomics score can effectively predict the postoperative recurrence-free survival in patients with PTC. The nomogram prediction model is superior to the AJCC staging system in terms of predictive accuracy and consistency. [ABSTRACT FROM AUTHOR]

The rapid development of nanotechnology has greatly benefited modern science and engineering and also led to an increased environmental exposure to nanoparticles (NPs). While recent research has established a correlation between the exposure of NPs and cardiovascular diseases, the intrinsic mechanisms of such a connection remain unclear. Inhaled NPs can penetrate the air–blood barrier from the lung to systemic circulation, thereby intruding the cardiovascular system and generating cardiotoxic effects. In this study, on-site cardiovascular damage was observed in mice upon respiratory exposure of silica nanoparticles (SiNPs), and the corresponding mechanism was investigated by focusing on the interaction of SiNPs and their encountered biomacromolecules en route. SiNPs were found to collect a significant amount of apolipoprotein A-I (Apo A-I) from the blood, in particular when the SiNPs were preadsorbed with pulmonary surfactants. While the adsorbed Apo A-I ameliorated the cytotoxic and proinflammatory effects of SiNPs, the protein was eliminated from the blood upon clearance of the NPs. However, supplementation of Apo A-I mimic peptide mitigated the atherosclerotic lesion induced by SiNPs. In addition, we found a further declined plasma Apo A-I level in clinical silicosis patients than coronary heart disease patients, suggesting clearance of SiNPs sequestered Apo A-I to compromise the coronal protein’s regular biological functions. Together, this study has provided evidence that the protein corona of SiNPs acquired in the blood depletes Apo A-I, a biomarker for prediction of cardiovascular diseases, which gives rise to unexpected toxic effects of the nanoparticles. [ABSTRACT FROM AUTHOR]

The TGF-β signaling pathway plays a pivotal role in controlling organogenesis during fetal development. Although the role of TGF-β signaling in promoting lung alveolar epithelial growth has been determined, mesenchymal TGF-β signaling in regulating lung development has not been studied in vivo due to a lack of genetic tools for specifically manipulating gene expression in lung mesenchymal cells. Therefore, the integral roles of TGF-β signaling in regulating lung development and congenital lung diseases are not completely understood. Using a Tbx4 lung enhancer-driven Tet-On inducible Cre transgenic mouse system, we have developed a mouse model in which lung mesenchyme-specific deletion of TGF-β receptor 2 gene (Tgfbr2) is achieved. Reduced airway branching accompanied by defective airway smooth muscle growth and later peripheral cystic lesions occurred when lung mesenchymal Tgfbr2 was deleted from embryonic day 13.5 to 15.5, resulting in postnatal death due to respiratory insufficiency. Although cell proliferation in both lung epithelium and mesenchyme was reduced, epithelial differentiation was not significantly affected. Tgfbr2 downstream Smad-independent ERK1/2 may mediate these mesenchymal effects of TGF-β signaling through the GSK3β-β-catenin-Wnt canonical pathway in fetal mouse lung. Our study suggests that Tgfbr2-mediated TGF-β signaling in prenatal lung mesenchyme is essential for lung development and maturation, and defective TGF-β signaling in lung mesenchyme may be related to abnormal airway branching morphogenesis and congenital airway cystic lesions. [ABSTRACT FROM AUTHOR]

Objective: To investigate the treatment strategies of squamous cell carcinoma of cervical lymph nodes from an unknown primary site (SCCUP) and the value of neck dissection (ND).Materials and Methods: The study included 133 patients referred to the Zhejiang Cancer Hospital from 2001 to 2012, with 109 males and 24 females. Distribution of patients by N status was as follows: N1 - 14 cases; N2a - 21 cases; N2b - 78 cases; N2c - 7 cases; and N3 - 13 cases. 104 patients underwent surgeries of ND while 29 patients underwent nonsurgical treatment. Among 104 patients, 24 underwent classic radical ND, 16 modified ND, 53 selective ND, and 11 extended ND. The selection of surgical strategy was determined by the extent and location of disease. According to the range of ND, 50 patients underwent ND for Levels I-V, 46 for Levels II-V, 4 for Levels I-III, 3 for Levels II-VI, and 1 for Levels I-VI. The data were analyzed with SPSS version 16.0. The differences between groups were calculated by χ2 tests. The actual overall survival (OS) rates were calculated by the Kaplan-Meier method. Different factors affecting the OS were determined by the log-rank test on univariate analysis. Cox regression was used to evaluate the multivariate analysis.Results: The 5-year OS rate of the whole cohort was 67.1%; and the median survival time was 70.0 months. The 5-year OS of ND group and of the non-ND group were 71.3% and 53.2%, respectively (P = 0.061). Cox analysis indicated that N stage (P = 0.000), bilateral neck metastasis (P = 0.001), extracapsular spread (ES) (P = 0.016), and ND (P = 0.028) were independent prognostic factors for the OS of SCCUP. 25 patients (18.8%) had neck recurrence or residue. The locoregional failure rate of ND group and of the non-ND group were 13.5% and 37.9%, respectively (P = 0.003). Logistic regression analysis indicated that higher N stage was the main risk factor for locoregional failure (P = 0.015).Conclusion: N stage, bilateral neck metastasis, ES, and ND were the main factors for the survival rate of SCCUP. N3 stage was the independent risk factor for locoregional failure. ND could significantly increase the locoregional control and may benefit the survival rate. [ABSTRACT FROM AUTHOR]

Objective: To investigate the treatment strategies of squamous cell carcinoma of cervical lymph nodes from an unknown primary site (SCCUP) and the value of neck dissection (ND). Materials and Methods: The study included 133 patients referred to the Zhejiang Cancer Hospital from 2001 to 2012, with 109 males and 24 females. Distribution of patients by N status was as follows: N1 - 14 cases; N2a - 21 cases; N2b - 78 cases; N2c - 7 cases; and N3 - 13 cases. 104 patients underwent surgeries of ND while 29 patients underwent nonsurgical treatment. Among 104 patients, 24 underwent classic radical ND, 16 modified ND, 53 selective ND, and 11 extended ND. The selection of surgical strategy was determined by the extent and location of disease. According to the range of ND, 50 patients underwent ND for Levels I-V, 46 for Levels II-V, 4 for Levels I-III, 3 for Levels II-VI, and 1 for Levels I-VI. The data were analyzed with SPSS version 16.0. The differences between groups were calculated by χ² tests. The actual overall survival (OS) rates were calculated by the Kaplan-Meier method. Different factors affecting the OS were determined by the log-rank test on univariate analysis. Cox regression was used to evaluate the multivariate analysis. Results: The 5-year OS rate of the whole cohort was 67.1%; and the median survival time was 70.0 months. The 5-year OS of ND group and of the non-ND group were 71.3% and 53.2%, respectively (P = 0.061). Cox analysis indicated that N stage (P = 0.000), bilateral neck metastasis (P = 0.001), extracapsular spread (ES) (P = 0.016), and ND (P = 0.028) were independent prognostic factors for the OS of SCCUP. 25 patients (18.8%) had neck recurrence or residue. The locoregional failure rate of ND group and of the non-ND group were 13.5% and 37.9%, respectively (P = 0.003). Logistic regression analysis indicated that higher N stage was the main risk factor for locoregional failure (P = 0.015). Conclusion: N stage, bilateral neck metastasis, ES, and ND were the main factors for the survival rate of SCCUP. N3 stage was the independent risk factor for locoregional failure. ND could significantly increase the locoregional control and may benefit the survival rate. [ABSTRACT FROM AUTHOR]

Background: Malignant parotid tumors are rare metastases originating from nasopharyngeal carcinoma (NPC). This study aimed to investigate the clinicopathological features and outcome of patients with metastasis of NPC to parotid lymph nodes after surgical therapy. Methods: We enrolled 14 NPC patients who had metastatic disease to parotid lymph nodes after IMRT. They received surgical treatment by total parotidectomy with neck dissection, superficial parotidectomy with neck dissection, partial parotidectomy with neck dissection, total parotidectomy, or superficial parotidectomy. Their age, gender, histopathology, clinical findings, and treatment outcome were analyzed. Results: After radiotherapy, parotid metastasis represented as uncontrolled disease in three cases and as recurrent disease in 11 cases. All the 14 patients received salvaged surgery successfully. Pathologic findings showed grade 3 in most patients. The follow-up ranged from 11 to 120 months and the overall three- and five-year survival was 49.5% and 37.1%, respectively. Conclusions: Metastasis to parotid lymph nodes should be examined in NPC patients after IMRT. Resection of the inferior parotid lymph nodes is recommended for patients with cervical metastasis, and superficial or total parotidectomy and adjuvant therapy are recommended for intraparotid lymph node metastasis. [ABSTRACT FROM AUTHOR]

Background Malignant parotid tumors are rare metastases originating from nasopharyngeal carcinoma (NPC). This study aimed to investigate the clinicopathological features and outcome of patients with metastasis of NPC to parotid lymph nodes after surgical therapy. Methods We enrolled 14 NPC patients who had metastatic disease to parotid lymph nodes after intensity-modulated radiation therapy (IMRT). They received surgical treatment by total parotidectomy with neck dissection, superficial parotidectomy with neck dissection, partial parotidectomy with neck dissection, total parotidectomy, or superficial parotidectomy. Their age, gender, histopathology, clinical findings, and treatment outcome were analyzed. Results After radiotherapy, parotid metastasis represented as uncontrolled disease in three cases and as recurrent disease in 11 cases. All the 14 patients received salvaged surgery successfully. Pathologic findings showed grade 3 in most patients. The follow-up ranged from 11 to 120 months and the overall three- and five-year survival was 49.5% and 37.1%, respectively. Conclusions Metastasis to parotid lymph nodes should be examined in NPC patients after IMRT. Resection of the inferior parotid lymph nodes is recommended for patients with cervical metastasis, and superficial or total parotidectomy and adjuvant therapy are recommended for intraparotid lymph node metastasis. [ABSTRACT FROM AUTHOR]

Background: Carcinoma ex pleomorphic adenoma (CXPA) is an uncommon malignant tumor with highly aggressive biological behavior. Our goal was to investigate the prognosis of CXPA in the major salivary glands and factors influencing it. Methods: We retrospectively reviewed 51 patients diagnosed with CXPA of the major salivary glands between 1999 and 2006, comprising 36 males and 15 females, aged from 23 to 86 years. All patients underwent surgery with curative intention, and 21 received postoperative radiation therapy. Results: Of the 51 patients, 39.2% developed locoregional recurrence and 27.5% developed distant metastases. Median follow-up was 54 months. At the time of analysis, 29 (56.9%) patients were deceased. Overall survival was 62.7% at 3 years and 50.3% at 5 years. Tumor-specific survival was 64.4% at 3 years and 53.5% at 5 years. Using chi-squared tests, invasiveness, T stage, lymph node involvement and clinical stage were found to be significantly associated with locoregional recurrence. Histological grade, invasiveness, lymph node involvement and perineural invasion were associated with distant metastases (P < 0.05). Cox analysis showed that T stage, lymph node involvement, histological grade and perineural invasion were independent prognostic factors for overall survival. Conclusion: T stage, lymph node involvement, histological grade, perineural invasion and extent of invasion are important prognostic factors of CXPA in the major salivary glands. Surgery is the primary treatment modality for CXPA and postoperative radiation therapy may be used in patients with factors for poor prognosis. [ABSTRACT FROM AUTHOR]

In this study, we explored the temporal characteristics of superoxide dismutase (SOD) activity, malondialdehyde (MDA) concentration, and the effect of oxidative stress on DNA damage, and cell apoptosis after exposure to 2,4,5,2′,4′,5′-hexachlorobiphenyl (PCB153) on cultured rat Sertoli cells (SC). SOD activity and MDA concentration were determined after cell exposure to 10, 20, 30 μmol L−1 PCB153 for 6, 12, 24, 36 or 48 h. Antioxidant N-acetyl-l-cysteine (NAC) was added to one group as a pre-treatment at the time point having the best dose–effect relationship. DNA damage, cell apoptosis, and morphological observation were determined by comet assay, flow cytometry, and fluorescence photomicrographs, respectively. After exposure to PCB153, SOD activity increased initially, but decreased subsequently. Each group reached a respective maximum value after 24 h when MDA concentration started increasing. No significant difference was observed in DNA damage after 24 h exposure, but cell apoptosis increased with the level of PCB153, although NAC-pretreatment provided protection. These were corroborated by the morphological observation. These findings suggest that 24 h was the best time point to determine oxidative stress indicators after exposure to PCB153 on cultured rat SC. Furthermore, PCB153-induced oxidative stress could increase cell apoptosis, while DNA damage was not evident. [ABSTRACT FROM AUTHOR]

Genetic damage in workers occupationally exposed to an antineoplastic drug was studied using the micronucleus (MN) test, the comet assay, the hprt gene mutation assay and the TCR gene mutation assay. The subjects were divided into two groups: (i) 21 workers from a plant producing methotrexate (MTX); (ii) 21 controls were matched according to age, gender and smoking. Fresh blood samples were collected from the workers and controls. The results of the MN test showed that the mean micronuclei rate (MNR) and mean micronucleated cell rate (MCR) in workers were 10.10 ± 0.95‰ and 8.05 ± 0.75‰, respectively, which were significantly higher than those (5.48 ± 0.82‰ and 4.38 ± 0.58‰) in controls (P < 0.01). It was found in the comet assay that the mean tail length (MTL) of workers and controls were 1.30 ± 0.06 µm and 0.07 ± 0.01 µm, respectively. There was a significant difference between workers and controls for MTL (P < 0.01), but the difference between the mean tail moment (MTM, 0.23 ± 0.03) of workers and MTM (0.17 ± 0.04) of controls was not significant (P > 0.05). The results of hprt gene mutation assay showed that the average mutation frequency (Mf-hprt) of hprt in workers was 1.00 ± 0.02‰, which was significantly higher than that (0.86 ± 0.01‰) in controls (P < 0.01). Meanwhile, the results of TCR gene mutation assay indicated that Mfs-TCR gene mutation frequencies of workers and controls were 6.87 ± 0.52 × 10−4 and 1.67 ± 0.14 × 10−4, respectively, which were significantly different (P < 0.01). The results of our experiment suggest that genetic damage is detectable in the 21 workers occupationally exposed to methotrexate. [ABSTRACT FROM AUTHOR]