Startseite Hemorrhagic meningioma with pulmonary metastasis: Case report and literature review
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Hemorrhagic meningioma with pulmonary metastasis: Case report and literature review

  • Xuan Cao , Qiaowei He , Mingzeng Ding , Wei Kong , Changyou Yin , Wei Zhao und Yanbin Wang EMAIL logo
Veröffentlicht/Copyright: 23. Oktober 2023

Abstract

Meningiomas are extra-axial neoplasms that originate from the arachnoid cap cells located on the inner surface of the meninges. Approximately 36% of central nervous system tumors are meningiomas. Based on earlier findings to be benign in most cases, they are categorized as slow-growing tumors that form gradually over time. Meningiomas are usually asymptomatic and discovered inadvertently. They rarely present with immediate clinical symptoms or abrupt hemorrhagic strokes. However, tumor hemorrhage can be fatal in high-grade meningiomas, particularly those with vascularization. We describe a 58-year-old man who was hospitalized after experiencing an unexpectedly acute headache. The right cerebellar hemisphere and vermis cerebellar hemorrhage were detected on computed tomography (CT), and the cerebellar hemorrhage was explained by a diagnosis of hypertension. When additional analysis of the patient’s chest CT indicated lung mass lesions, we assumed that the lung cancer had spread to the brain. However, the pathological outcomes of a guided definite pulmonary aspiration biopsy, in conjunction with resection of the cerebellar tumor, suggested a subtentorial meningioma with ruptured hemorrhage and pulmonary meningioma metastasis. The patient was transferred to a hospital closer to home for ongoing follow-up and, after 2 months, he had recovered well.

1 Introduction

More than one-third of primary central nervous system malignancies are meningiomas, which are the most common intracranial tumors [1,2,3]. The pathological types vary, with 20% of cases suggesting malignant histological features corresponding to meningioma grades II or III and higher grades of recurrence and aggressive behavior [4]. Metastatic meningioma is an uncommon clinical disease with an estimated incidence of 0.1–0.76% among all patients with meningioma [5]. Concomitant occurrences are uncommon due to the rarity of tumor hemorrhage, which only occurs in 0.5–2.4% of all documented cases of meningiomas [6].

Herein, we present the case of a middle-aged man who had a sudden headache and was initially diagnosed with hypertensive cerebellar hemorrhage on head computed tomography (CT). However, following additional magnetic resonance imaging (MRI) of the head, and chest CT, the diagnosis changed to lung cancer with brain metastases. A diagnosis of hemorrhagic stroke complicated by posterior anaplastic meningioma World Health Organization (WHO) grade III with pulmonary metastases was confirmed based on the final pathological results.

2 Case report

We report the case of a 58-year-old man who was admitted after experiencing a persistent, severe headache for 5 h, and two episodes of vomiting; however, no further symptoms or coffee-like substances were detected. He had a Glasgow Coma Scale (GCS) [7] score of 15, no neurological symptoms, and no history of cancer.

An emergency department CT scan of the head revealed cerebral hemorrhage in the right cerebellar hemisphere and vermis (Figure 1a). The results of the examination were as follows: the right cerebellar hemisphere slice images with T1-weighted (Figure 1e), T2-weighted (Figure 1f), and FLAIR (Figure 1g) signals were confusing. On the second day of hospitalization, MRI and head examination findings were significantly enhanced. A T1-weighted hyperintense and tiny patch of enhancement was visible in the center of the enhanced dissected lesion, while slightly longer T2-weighted edema with blurred boundaries was visible at the periphery of the lesion (Figure 1h). Right cerebellar MRI revealed a tumor with hemorrhage as an aberrant signal. Chest CT of the left subpleural lobe revealed a well-defined subpleural mass with somewhat less uniform density and slightly less uniform enhancement following contrast-enhanced CT (Figure 1c and d). After discussions with radiologists and neurosurgeons, it was decided that lung-occurring brain metastases were more probable.

Figure 1 
               CT scan of the emergency room showed hemorrhage in the right cerebellar hemisphere (a). Postoperative CT scans revealed clear axial plane views of the surgically cleansed meningiomas and hematomas (b). (c) An image of a subpleural mass in the left lower lobe with well-defined, well-intact margins, and a slightly less uniform density. After enhancement scanning, there is a little heterogeneous enhancement of the chest occupation, tumor size is about 3.4 cm × 3.2 cm (d). The right cerebellar hemisphere exhibits a patchy confluence of T1-weighted, T2-weighted, and FLAIR signals (e–g); the peripheral T2-weighted edema signal has fuzzy boundaries. (h) After enhancement scanning, tumor tissue shows a faintly heterogeneous enhancement. The size of the tumor in the image is about 4.3 cm × 2.1 cm.
Figure 1

CT scan of the emergency room showed hemorrhage in the right cerebellar hemisphere (a). Postoperative CT scans revealed clear axial plane views of the surgically cleansed meningiomas and hematomas (b). (c) An image of a subpleural mass in the left lower lobe with well-defined, well-intact margins, and a slightly less uniform density. After enhancement scanning, there is a little heterogeneous enhancement of the chest occupation, tumor size is about 3.4 cm × 3.2 cm (d). The right cerebellar hemisphere exhibits a patchy confluence of T1-weighted, T2-weighted, and FLAIR signals (e–g); the peripheral T2-weighted edema signal has fuzzy boundaries. (h) After enhancement scanning, tumor tissue shows a faintly heterogeneous enhancement. The size of the tumor in the image is about 4.3 cm × 2.1 cm.

The patient underwent right hemisphere tumor resection and external ventricular drainage because of a headache that progressively worsened throughout hospitalization, and a change in consciousness (from lucid to lethargic). We first inserted a right frontal horn external ventricular drain, which allowed us to reduce intracranial pressure during surgery by releasing cerebrospinal fluid and expanding the surgical space, taking into consideration the patient’s gradual increase in intracranial pressure. This prevented the brain tissue from swelling after the skull was opened surgically as well as the development of severe swelling during surgery. Intraoperatively, the tumor appeared fleshy red, mushy, and hypervascular, with peritumoral hematomas. The tumor’s excision size was approximately 4.5 cm × 3.2 cm × 2.5 cm, and there was no clear separation between the tumor and the surrounding brain tissue. Although it was not clear whether the tumor was a high-grade meningioma during the operation, the fact that the tumor was hemorrhagic made us more cautious; we excised the dura that was adherent to the tumor and used an artificial dura to reduce the tension and suture it. We considered that the patient was hemorrhagic from the tumor, and decompression was performed using a debulking flap. Postoperative CT of the head was performed (Figure 1d).

A malignant mesenchymal brain tumor (right cerebellar mass) was resected, with extremely diverse, and markedly mitotic cells (>20/10 HPF). The immunohistochemical findings were as follows: s-100 (+), a 60% positivity rate of KI-67, H3K27ME3 (+), CD34 (+), Vim (+) and STAT-6(−); the postoperative pathological findings are shown in Figure 2. The lesion was classified as an anaplastic meningioma (WHO III).

Figure 2 
               Neuropathological features of anaplastic meningioma. Malignant mesenchymal brain tumor, marked cell atypia, and prominent mitotic label (>20/10HFP). HE (×40). The cytoplasmic S-100 immunoreactivity was positive. Ki-67 labeling index shows nuclear immunoreactivity. H3K27me3 and CD34, which are both positively expressed in tumor tissue by immunohistochemistry, were found. Cords of tumor cells with intense Vim immunoreactivity.
Figure 2

Neuropathological features of anaplastic meningioma. Malignant mesenchymal brain tumor, marked cell atypia, and prominent mitotic label (>20/10HFP). HE (×40). The cytoplasmic S-100 immunoreactivity was positive. Ki-67 labeling index shows nuclear immunoreactivity. H3K27me3 and CD34, which are both positively expressed in tumor tissue by immunohistochemistry, were found. Cords of tumor cells with intense Vim immunoreactivity.

When comparing the pathology of head and lung cancers, meningioma metastases to the lung should be considered for left lung tumors identified using needle biopsy (Figure 3): Vim(+), Ki-67 positivity 48%, TTF1(−), and CK(−). One week after treatment, the patient was transferred to a hospital closer to home for ongoing rehabilitation, and he underwent postoperative CT of the head (Figure 1b). Two months later, a telephonic checkup revealed that the patient had recovered well.

Figure 3 
               Histopathological features of the needle biopsy of the left lung tumor. HE staining revealed that the tumor tissue does not invade lung tissue (×20), the presence of mitotic segments and microscopic heterogeneity are both obvious (×400). The ki-67 positivity rate is >30%. Tumor cell cords with potent Vim immunoreactivity. Immunohistochemistry staining showed that the tumor was negative for TTF-1 and CK, respectively.
Figure 3

Histopathological features of the needle biopsy of the left lung tumor. HE staining revealed that the tumor tissue does not invade lung tissue (×20), the presence of mitotic segments and microscopic heterogeneity are both obvious (×400). The ki-67 positivity rate is >30%. Tumor cell cords with potent Vim immunoreactivity. Immunohistochemistry staining showed that the tumor was negative for TTF-1 and CK, respectively.

  1. Informed consent: Informed consent has been obtained from all individuals included in this study.

  2. Ethical approval: The research related to human use complied with all the relevant national regulations, and institutional policies and in accordance with the tenets of the Helsinki Declaration, and has been approved by the Medical Ethics Committee of Yantai Yuhuangding Hospital (approval number: 2023–253).

3 Discussion

3.1 Clinical characteristics

The second highest incidence of meningiomas, predominantly composed of arachnoid cells and struts, is observed in the nervous system. Convex and cranial base subarachnoids can arise from various embryonic layers, which explains why meningioma development rates vary from one area of the brain to another. Most studies have reported that intracranial meningiomas are prone to exponential growth [8,9,10,11], and they arise 2.8 times more frequently in women [12]; however, men tend to develop anaplastic meningiomas more frequently [13]. However, most meningiomas grow at a linear pace of 2–4 mm/year [14].

Meningiomas typically originate on the convex surface of the brain (adjacent to the sagittal sinus, falx, or venous sinus) and thereafter in the sphenoid spine, olfactory groove, stellar region, and posterior cranial fossa at the base of the skull. Epidural and ventricular lesions are rare. Convex surfaces and other non-basal regions have the highest incidence of high-grade meningiomas. Approximately 3–6% of intracranial meningiomas are tentorial [15,16]. The WHO 2016 classification divides meningiomas into three grades, WHO grade I (benign), grade II (intermediate), and grade III (malignant) [4], containing 15 different meningioma subtypes. About 80% of WHO grade II and grade I and grade II up to 20% may display aggressive behavior [17,18,19,20].

3.2 Radiological features

MRI and additional CT are usually used to diagnose meningiomas. However, depending on the pathogenic type, meningioma signals on MRI vary. WHO grade I tumors and T2-weighted signals have different associations; grade I tumors are not related to T1-weighted signals. Invasive meningiomas are also more likely to exhibit T2WI hyperintensities [21], whereas meningiomas with calcification and T2WI hypointensities or similar on MRI have lower growth potential [22,23].

Diagnostic discrimination can be performed in conjunction with diffusion-weighted imaging, magnetic resonance spectrum, and perfusion-weighted imaging for atypical meningiomas [24,25,26,27]. In recent years, there has been a gradual increase in the radiomics of meningiomas, combining imaging features of different grades of meningiomas with the pathological and molecular features of the tumors. It has great predictive power for tumor pathology grading, subtypes, recurrence, differential diagnosis, and brain tissue invasion [3]. Additionally, the use of the mean apparent diffusion coefficient value (ADCmean) and conventional MRI characteristics as noninvasive preoperative diagnostic tools for anaplastic meningiomas may have therapeutic benefits [23]. However, factors with strong predictive values for higher tumor grades have been studied further at multiple centers.

3.3 Meningioma metastasis

WHO grade II and III meningiomas are more likely to show recurrence, aggressive behavior, and distant metastasis [3]. With an estimated incidence of 0.1–0.76% among all meningioma patients, metastatic dissemination of meningiomas is a rare clinical complication. Regarding the tumor grading, there are no discernible differences in the sizes of the detected metastases [28].

A total of 115 patients who had 164 metastases of metastatic meningiomas between 1990 and 2012 were reviewed; approximately 33.9% of the cases were considered to be grade I, 20.9% were considered to be grade II, and 40% were found to be grade III. The most common sites of metastatic disease were the lungs (37.2%), bones (16.5%), intraspinal areas (15.2%), and the liver (9.2%) [29]. Meningioma metastasis is associated with WHO grade III meningiomas. In one series, the incidence of metastasis was 0.67% for all meningiomas and was higher in WHO grade II (2%) and III (9%) meningiomas, which is consistent with the metastatic trend reported by most clinical investigators [20,30]. The literature suggests that tumor invasion of the venous sinus system, ventricular system, or skull is common with metastatic meningiomas. Tumor infiltration of the venous sinuses occurs mainly in the superior sagittal, cavernous, occipital, and transverse sinuses. Nearly all distant metastases of meningiomas infiltrating the venous sinus system occur in the lung [31]. Although meningiomas possess considerable metastatic potential, many researchers are intrigued by the very low overall rate of metastasis. Simply put, the tight cohesion of tumor cells, the lack of cerebral lymphatics, and the probable absence of “fertile soil” at distant locales may all contribute to the rarity of extracranial metastases [32].

3.4 Intracranial hemorrhage from a meningioma

Approximately 1.5–5.4% of all tumors, especially in malignant pathologies such as metastatic neoplasms or gliomas, occur with intracranial hemorrhage [33]. Spontaneous bleeding from meningiomas is rare. Documented HMs account for only 0.5–2.4% of cases [6]. Despite the appearance of multiple exhaustive reviews, numerous uncertainties still exist surrounding the pathophysiological mechanism associated with hemorrhage from an unsuspected meningioma.

These reviews have led to the following current hypotheses regarding hemorrhage [34,35,36,37]: (1) the artery that supplies the tumor grows tortuous as the tumor grows, the vessel walls become more brittle and less elastic, and the ability to control stress reactions like blood pressure variations are lost, leading to hemorrhage; (2) vascular networks that are growing abnormally or are immature within meningiomas under specific circumstances may result in hemorrhage; (3) bleeding may be a result of a meningioma with distensive growth or from lacerations of the pontine veins; (4) hemorrhage may occur owing to burst intratumor or peritumoral veins, followed by increased intratumor pressure and venous regurgitation as a result of thrombosis or thrombosis of the vessels in the meningioma; and (5) hemorrhage may also be brought on by other systemic causes that are not directly linked to the tumor, such as coagulation abnormalities, peritumoral edema, and tumor malignancy. In a large-scale study, the following factors were identified as risk factors for meningioma bleeding: (1) age of 30 years or >70 years; (2) tumor location in the ventricle or convex meningioma; (3) highly malignant, fibrous, or angioblast-producing lesions on histological examination; and (4) hypertension, anticoagulation, and traumatic brain injury [38]. Based on this, Pressman et al. [36] hypothesized that high-dose estrogen replacement and serotonin modulation therapy may be unique causes of meningioma hemorrhage.

3.5 Management and prognosis

We report the case of a 58-year-old man with postoperative pathology confirmed as WHO grade III meningioma complicated by hemorrhage without a supratentorial tumor. The patient’s head MRI results were suggestive of a tumor hemorrhage; we considered metastases and hemangioblastomas for tumors in the posterior cranial fossa and did not consider high-grade meningiomas. In general, meningiomas can be diagnosed using clinical features together with specific MRI findings. However, the probability of meningioma hemorrhage is low, and subsequent concave meningioma hemorrhages are much less frequent. Therefore, we usually treat meningiomas as benign tumors and ignore the meningioma diagnosis.

Heavy bleeding and the absence of typical imaging characteristics are more likely to be inappropriately identified as acute cerebrovascular ailments in individuals with HMs who have undergone insufficient imaging examinations [39]. Our patient was admitted to the hospital in an emergency with a simple diagnosis of cerebral hemorrhage.

The characteristics of meningiomas and the side effects of different treatments for different patients vary widely, necessitating individualized therapy. However, the Simpson grade [40] is still used as a measure of the extent of resection for growing and symptomatic meningiomas of different grades. Radiotherapy and stereotactic radiosurgery are used as adjuvant treatments for newly diagnosed atypical and degenerative meningiomas, especially in cases where complete resection is not possible.

Adjuvant external beam radiation therapy (EBRT) is very commonly used to treat WHO grade III meningiomas; however, there are no biomarkers to predict the response to therapy, and there is a limited understanding of how to optimize adjuvant EBRT for patients with WHO grade III meningiomas. One week after surgery, the patient was transferred to a rehabilitation hospital. We recommend that the patient undergo radiotherapy at our center as soon as possible; however, the patient chose to undergo radiotherapy at a medical center closer to his home, based on factors such as accessibility and health insurance.

If a meningioma metastasizes and recurs, the prognosis is poor, and the patient’s chance of survival is significantly reduced [41,42]. Local therapeutic alternatives, including surgery and radiotherapy, continue to pose a therapeutic challenge for patients with metastatic and recurring meningiomas. Many researchers and doctors continue to attempt to treat meningiomas systematically, but there are currently scant historical benchmark data on the outcomes of high-grade meningiomas and controlled trials [40]. Systemic therapeutic techniques being developed in meningioma treatment research include anti-angiogenic medications, immunotherapeutic approaches, and, more recently, genomic studies.

4 Conclusion

Meningiomas are often asymptomatic and any primary symptoms (focal neurological symptoms, seizures, and increased intracranial pressure) may often be linked to the effects of a mass. Although meningiomas are typically benign, meningioma hemorrhage and metastatic cases have been documented. Meningiomas may only rarely arise within the posterior fossa; nonetheless, they usually develop along the falx, sphenoid bone, and where there is convexity. Regular follow-up is crucial because of the likelihood of recurrence after meningioma surgery, even if the tumor has been completely resected.

  1. Funding information: Authors state no funding involved.

  2. Author contributions: X.C. and J.H. contributed to the conception of the study and wrote the manuscript; M.Z. and W.K. contributed significantly to the analysis and manuscript preparation; C.Y. and W.Z. helped perform the analysis with constructive discussions; and Y.W. directed the discussion, wrote, reviewed, and revised the manuscript. The authors X.C. (Xuan Cao) and Q.H. (Qiaowei He) contributed equally to this paper.

  3. Conflicts of interest: Authors state no conflict of interest.

  4. Data availability statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Received: 2023-07-04
Revised: 2023-08-30
Accepted: 2023-09-04
Published Online: 2023-10-23

© 2023 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  8. Isoimperatorin alleviates lipopolysaccharide-induced periodontitis by downregulating ERK1/2 and NF-κB pathways
  9. Immunoregulation of synovial macrophages for the treatment of osteoarthritis
  10. Novel CPLANE1 c.8948dupT (p.P2984Tfs*7) variant in a child patient with Joubert syndrome
  11. Antiphospholipid antibodies and the risk of thrombosis in myeloproliferative neoplasms
  12. Immunological responses of septic rats to combination therapy with thymosin α1 and vitamin C
  13. High glucose and high lipid induced mitochondrial dysfunction in JEG-3 cells through oxidative stress
  14. Pharmacological inhibition of the ubiquitin-specific protease 8 effectively suppresses glioblastoma cell growth
  15. Levocarnitine regulates the growth of angiotensin II-induced myocardial fibrosis cells via TIMP-1
  16. Age-related changes in peripheral T-cell subpopulations in elderly individuals: An observational study
  17. Single-cell transcription analysis reveals the tumor origin and heterogeneity of human bilateral renal clear cell carcinoma
  18. Identification of iron metabolism-related genes as diagnostic signatures in sepsis by blood transcriptomic analysis
  19. Long noncoding RNA ACART knockdown decreases 3T3-L1 preadipocyte proliferation and differentiation
  20. Surgery, adjuvant immunotherapy plus chemotherapy and radiotherapy for primary malignant melanoma of the parotid gland (PGMM): A case report
  21. Dosimetry comparison with helical tomotherapy, volumetric modulated arc therapy, and intensity-modulated radiotherapy for grade II gliomas: A single‑institution case series
  22. Soy isoflavone reduces LPS-induced acute lung injury via increasing aquaporin 1 and aquaporin 5 in rats
  23. Refractory hypokalemia with sexual dysplasia and infertility caused by 17α-hydroxylase deficiency and triple X syndrome: A case report
  24. Meta-analysis of cancer risk among end stage renal disease undergoing maintenance dialysis
  25. 6-Phosphogluconate dehydrogenase inhibition arrests growth and induces apoptosis in gastric cancer via AMPK activation and oxidative stress
  26. Experimental study on the optimization of ANM33 release in foam cells
  27. Primary retroperitoneal angiosarcoma: A case report
  28. Metabolomic analysis-identified 2-hydroxybutyric acid might be a key metabolite of severe preeclampsia
  29. Malignant pleural effusion diagnosis and therapy
  30. Effect of spaceflight on the phenotype and proteome of Escherichia coli
  31. Comparison of immunotherapy combined with stereotactic radiotherapy and targeted therapy for patients with brain metastases: A systemic review and meta-analysis
  32. Activation of hypermethylated P2RY1 mitigates gastric cancer by promoting apoptosis and inhibiting proliferation
  33. Association between the VEGFR-2 -604T/C polymorphism (rs2071559) and type 2 diabetic retinopathy
  34. The role of IL-31 and IL-34 in the diagnosis and treatment of chronic periodontitis
  35. Triple-negative mouse breast cancer initiating cells show high expression of beta1 integrin and increased malignant features
  36. mNGS facilitates the accurate diagnosis and antibiotic treatment of suspicious critical CNS infection in real practice: A retrospective study
  37. The apatinib and pemetrexed combination has antitumor and antiangiogenic effects against NSCLC
  38. Radiotherapy for primary thyroid adenoid cystic carcinoma
  39. Design and functional preliminary investigation of recombinant antigen EgG1Y162–EgG1Y162 against Echinococcus granulosus
  40. Effects of losartan in patients with NAFLD: A meta-analysis of randomized controlled trial
  41. Bibliometric analysis of METTL3: Current perspectives, highlights, and trending topics
  42. Performance comparison of three scaling algorithms in NMR-based metabolomics analysis
  43. PI3K/AKT/mTOR pathway and its related molecules participate in PROK1 silence-induced anti-tumor effects on pancreatic cancer
  44. The altered expression of cytoskeletal and synaptic remodeling proteins during epilepsy
  45. Effects of pegylated recombinant human granulocyte colony-stimulating factor on lymphocytes and white blood cells of patients with malignant tumor
  46. Prostatitis as initial manifestation of Chlamydia psittaci pneumonia diagnosed by metagenome next-generation sequencing: A case report
  47. NUDT21 relieves sevoflurane-induced neurological damage in rats by down-regulating LIMK2
  48. Association of interleukin-10 rs1800896, rs1800872, and interleukin-6 rs1800795 polymorphisms with squamous cell carcinoma risk: A meta-analysis
  49. Exosomal HBV-DNA for diagnosis and treatment monitoring of chronic hepatitis B
  50. Shear stress leads to the dysfunction of endothelial cells through the Cav-1-mediated KLF2/eNOS/ERK signaling pathway under physiological conditions
  51. Interaction between the PI3K/AKT pathway and mitochondrial autophagy in macrophages and the leukocyte count in rats with LPS-induced pulmonary infection
  52. Meta-analysis of the rs231775 locus polymorphism in the CTLA-4 gene and the susceptibility to Graves’ disease in children
  53. Cloning, subcellular localization and expression of phosphate transporter gene HvPT6 of hulless barley
  54. Coptisine mitigates diabetic nephropathy via repressing the NRLP3 inflammasome
  55. Significant elevated CXCL14 and decreased IL-39 levels in patients with tuberculosis
  56. Whole-exome sequencing applications in prenatal diagnosis of fetal bowel dilatation
  57. Gemella morbillorum infective endocarditis: A case report and literature review
  58. An unusual ectopic thymoma clonal evolution analysis: A case report
  59. Severe cumulative skin toxicity during toripalimab combined with vemurafenib following toripalimab alone
  60. Detection of V. vulnificus septic shock with ARDS using mNGS
  61. Novel rare genetic variants of familial and sporadic pulmonary atresia identified by whole-exome sequencing
  62. The influence and mechanistic action of sperm DNA fragmentation index on the outcomes of assisted reproduction technology
  63. Novel compound heterozygous mutations in TELO2 in an infant with You-Hoover-Fong syndrome: A case report and literature review
  64. ctDNA as a prognostic biomarker in resectable CLM: Systematic review and meta-analysis
  65. Diagnosis of primary amoebic meningoencephalitis by metagenomic next-generation sequencing: A case report
  66. Phylogenetic analysis of promoter regions of human Dolichol kinase (DOLK) and orthologous genes using bioinformatics tools
  67. Collagen changes in rabbit conjunctiva after conjunctival crosslinking
  68. Effects of NM23 transfection of human gastric carcinoma cells in mice
  69. Oral nifedipine and phytosterol, intravenous nicardipine, and oral nifedipine only: Three-arm, retrospective, cohort study for management of severe preeclampsia
  70. Case report of hepatic retiform hemangioendothelioma: A rare tumor treated with ultrasound-guided microwave ablation
  71. Curcumin induces apoptosis in human hepatocellular carcinoma cells by decreasing the expression of STAT3/VEGF/HIF-1α signaling
  72. Rare presentation of double-clonal Waldenström macroglobulinemia with pulmonary embolism: A case report
  73. Giant duplication of the transverse colon in an adult: A case report and literature review
  74. Ectopic thyroid tissue in the breast: A case report
  75. SDR16C5 promotes proliferation and migration and inhibits apoptosis in pancreatic cancer
  76. Vaginal metastasis from breast cancer: A case report
  77. Screening of the best time window for MSC transplantation to treat acute myocardial infarction with SDF-1α antibody-loaded targeted ultrasonic microbubbles: An in vivo study in miniswine
  78. Inhibition of TAZ impairs the migration ability of melanoma cells
  79. Molecular complexity analysis of the diagnosis of Gitelman syndrome in China
  80. Effects of maternal calcium and protein intake on the development and bone metabolism of offspring mice
  81. Identification of winter wheat pests and diseases based on improved convolutional neural network
  82. Ultra-multiplex PCR technique to guide treatment of Aspergillus-infected aortic valve prostheses
  83. Virtual high-throughput screening: Potential inhibitors targeting aminopeptidase N (CD13) and PIKfyve for SARS-CoV-2
  84. Immune checkpoint inhibitors in cancer patients with COVID-19
  85. Utility of methylene blue mixed with autologous blood in preoperative localization of pulmonary nodules and masses
  86. Integrated analysis of the microbiome and transcriptome in stomach adenocarcinoma
  87. Berberine suppressed sarcopenia insulin resistance through SIRT1-mediated mitophagy
  88. DUSP2 inhibits the progression of lupus nephritis in mice by regulating the STAT3 pathway
  89. Lung abscess by Fusobacterium nucleatum and Streptococcus spp. co-infection by mNGS: A case series
  90. Genetic alterations of KRAS and TP53 in intrahepatic cholangiocarcinoma associated with poor prognosis
  91. Granulomatous polyangiitis involving the fourth ventricle: Report of a rare case and a literature review
  92. Studying infant mortality: A demographic analysis based on data mining models
  93. Metaplastic breast carcinoma with osseous differentiation: A report of a rare case and literature review
  94. Protein Z modulates the metastasis of lung adenocarcinoma cells
  95. Inhibition of pyroptosis and apoptosis by capsaicin protects against LPS-induced acute kidney injury through TRPV1/UCP2 axis in vitro
  96. TAK-242, a toll-like receptor 4 antagonist, against brain injury by alleviates autophagy and inflammation in rats
  97. Primary mediastinum Ewing’s sarcoma with pleural effusion: A case report and literature review
  98. Association of ADRB2 gene polymorphisms and intestinal microbiota in Chinese Han adolescents
  99. Tanshinone IIA alleviates chondrocyte apoptosis and extracellular matrix degeneration by inhibiting ferroptosis
  100. Study on the cytokines related to SARS-Cov-2 in testicular cells and the interaction network between cells based on scRNA-seq data
  101. Effect of periostin on bone metabolic and autophagy factors during tooth eruption in mice
  102. HP1 induces ferroptosis of renal tubular epithelial cells through NRF2 pathway in diabetic nephropathy
  103. Intravaginal estrogen management in postmenopausal patients with vaginal squamous intraepithelial lesions along with CO2 laser ablation: A retrospective study
  104. Hepatocellular carcinoma cell differentiation trajectory predicts immunotherapy, potential therapeutic drugs, and prognosis of patients
  105. Effects of physical exercise on biomarkers of oxidative stress in healthy subjects: A meta-analysis of randomized controlled trials
  106. Identification of lysosome-related genes in connection with prognosis and immune cell infiltration for drug candidates in head and neck cancer
  107. Development of an instrument-free and low-cost ELISA dot-blot test to detect antibodies against SARS-CoV-2
  108. Research progress on gas signal molecular therapy for Parkinson’s disease
  109. Adiponectin inhibits TGF-β1-induced skin fibroblast proliferation and phenotype transformation via the p38 MAPK signaling pathway
  110. The G protein-coupled receptor-related gene signatures for predicting prognosis and immunotherapy response in bladder urothelial carcinoma
  111. α-Fetoprotein contributes to the malignant biological properties of AFP-producing gastric cancer
  112. CXCL12/CXCR4/CXCR7 axis in placenta tissues of patients with placenta previa
  113. Association between thyroid stimulating hormone levels and papillary thyroid cancer risk: A meta-analysis
  114. Significance of sTREM-1 and sST2 combined diagnosis for sepsis detection and prognosis prediction
  115. Diagnostic value of serum neuroactive substances in the acute exacerbation of chronic obstructive pulmonary disease complicated with depression
  116. Research progress of AMP-activated protein kinase and cardiac aging
  117. TRIM29 knockdown prevented the colon cancer progression through decreasing the ubiquitination levels of KRT5
  118. Cross-talk between gut microbiota and liver steatosis: Complications and therapeutic target
  119. Metastasis from small cell lung cancer to ovary: A case report
  120. The early diagnosis and pathogenic mechanisms of sepsis-related acute kidney injury
  121. The effect of NK cell therapy on sepsis secondary to lung cancer: A case report
  122. Erianin alleviates collagen-induced arthritis in mice by inhibiting Th17 cell differentiation
  123. Loss of ACOX1 in clear cell renal cell carcinoma and its correlation with clinical features
  124. Signalling pathways in the osteogenic differentiation of periodontal ligament stem cells
  125. Crosstalk between lactic acid and immune regulation and its value in the diagnosis and treatment of liver failure
  126. Clinicopathological features and differential diagnosis of gastric pleomorphic giant cell carcinoma
  127. Traumatic brain injury and rTMS-ERPs: Case report and literature review
  128. Extracellular fibrin promotes non-small cell lung cancer progression through integrin β1/PTEN/AKT signaling
  129. Knockdown of DLK4 inhibits non-small cell lung cancer tumor growth by downregulating CKS2
  130. The co-expression pattern of VEGFR-2 with indicators related to proliferation, apoptosis, and differentiation of anagen hair follicles
  131. Inflammation-related signaling pathways in tendinopathy
  132. CD4+ T cell count in HIV/TB co-infection and co-occurrence with HL: Case report and literature review
  133. Clinical analysis of severe Chlamydia psittaci pneumonia: Case series study
  134. Bioinformatics analysis to identify potential biomarkers for the pulmonary artery hypertension associated with the basement membrane
  135. Influence of MTHFR polymorphism, alone or in combination with smoking and alcohol consumption, on cancer susceptibility
  136. Catharanthus roseus (L.) G. Don counteracts the ampicillin resistance in multiple antibiotic-resistant Staphylococcus aureus by downregulation of PBP2a synthesis
  137. Combination of a bronchogenic cyst in the thoracic spinal canal with chronic myelocytic leukemia
  138. Bacterial lipoprotein plays an important role in the macrophage autophagy and apoptosis induced by Salmonella typhimurium and Staphylococcus aureus
  139. TCL1A+ B cells predict prognosis in triple-negative breast cancer through integrative analysis of single-cell and bulk transcriptomic data
  140. Ezrin promotes esophageal squamous cell carcinoma progression via the Hippo signaling pathway
  141. Ferroptosis: A potential target of macrophages in plaque vulnerability
  142. Predicting pediatric Crohn's disease based on six mRNA-constructed risk signature using comprehensive bioinformatic approaches
  143. Applications of genetic code expansion and photosensitive UAAs in studying membrane proteins
  144. HK2 contributes to the proliferation, migration, and invasion of diffuse large B-cell lymphoma cells by enhancing the ERK1/2 signaling pathway
  145. IL-17 in osteoarthritis: A narrative review
  146. Circadian cycle and neuroinflammation
  147. Probiotic management and inflammatory factors as a novel treatment in cirrhosis: A systematic review and meta-analysis
  148. Hemorrhagic meningioma with pulmonary metastasis: Case report and literature review
  149. SPOP regulates the expression profiles and alternative splicing events in human hepatocytes
  150. Knockdown of SETD5 inhibited glycolysis and tumor growth in gastric cancer cells by down-regulating Akt signaling pathway
  151. PTX3 promotes IVIG resistance-induced endothelial injury in Kawasaki disease by regulating the NF-κB pathway
  152. Pancreatic ectopic thyroid tissue: A case report and analysis of literature
  153. The prognostic impact of body mass index on female breast cancer patients in underdeveloped regions of northern China differs by menopause status and tumor molecular subtype
  154. Report on a case of liver-originating malignant melanoma of unknown primary
  155. Case report: Herbal treatment of neutropenic enterocolitis after chemotherapy for breast cancer
  156. The fibroblast growth factor–Klotho axis at molecular level
  157. Characterization of amiodarone action on currents in hERG-T618 gain-of-function mutations
  158. A case report of diagnosis and dynamic monitoring of Listeria monocytogenes meningitis with NGS
  159. Effect of autologous platelet-rich plasma on new bone formation and viability of a Marburg bone graft
  160. Small breast epithelial mucin as a useful prognostic marker for breast cancer patients
  161. Continuous non-adherent culture promotes transdifferentiation of human adipose-derived stem cells into retinal lineage
  162. Nrf3 alleviates oxidative stress and promotes the survival of colon cancer cells by activating AKT/BCL-2 signal pathway
  163. Favorable response to surufatinib in a patient with necrolytic migratory erythema: A case report
  164. Case report of atypical undernutrition of hypoproteinemia type
  165. Down-regulation of COL1A1 inhibits tumor-associated fibroblast activation and mediates matrix remodeling in the tumor microenvironment of breast cancer
  166. Sarcoma protein kinase inhibition alleviates liver fibrosis by promoting hepatic stellate cells ferroptosis
  167. Research progress of serum eosinophil in chronic obstructive pulmonary disease and asthma
  168. Clinicopathological characteristics of co-existing or mixed colorectal cancer and neuroendocrine tumor: Report of five cases
  169. Role of menopausal hormone therapy in the prevention of postmenopausal osteoporosis
  170. Precisional detection of lymph node metastasis using tFCM in colorectal cancer
  171. Advances in diagnosis and treatment of perimenopausal syndrome
  172. A study of forensic genetics: ITO index distribution and kinship judgment between two individuals
  173. Acute lupus pneumonitis resembling miliary tuberculosis: A case-based review
  174. Plasma levels of CD36 and glutathione as biomarkers for ruptured intracranial aneurysm
  175. Fractalkine modulates pulmonary angiogenesis and tube formation by modulating CX3CR1 and growth factors in PVECs
  176. Novel risk prediction models for deep vein thrombosis after thoracotomy and thoracoscopic lung cancer resections, involving coagulation and immune function
  177. Exploring the diagnostic markers of essential tremor: A study based on machine learning algorithms
  178. Evaluation of effects of small-incision approach treatment on proximal tibia fracture by deep learning algorithm-based magnetic resonance imaging
  179. An online diagnosis method for cancer lesions based on intelligent imaging analysis
  180. Medical imaging in rheumatoid arthritis: A review on deep learning approach
  181. Predictive analytics in smart healthcare for child mortality prediction using a machine learning approach
  182. Utility of neutrophil–lymphocyte ratio and platelet–lymphocyte ratio in predicting acute-on-chronic liver failure survival
  183. A biomedical decision support system for meta-analysis of bilateral upper-limb training in stroke patients with hemiplegia
  184. TNF-α and IL-8 levels are positively correlated with hypobaric hypoxic pulmonary hypertension and pulmonary vascular remodeling in rats
  185. Stochastic gradient descent optimisation for convolutional neural network for medical image segmentation
  186. Comparison of the prognostic value of four different critical illness scores in patients with sepsis-induced coagulopathy
  187. Application and teaching of computer molecular simulation embedded technology and artificial intelligence in drug research and development
  188. Hepatobiliary surgery based on intelligent image segmentation technology
  189. Value of brain injury-related indicators based on neural network in the diagnosis of neonatal hypoxic-ischemic encephalopathy
  190. Analysis of early diagnosis methods for asymmetric dementia in brain MR images based on genetic medical technology
  191. Early diagnosis for the onset of peri-implantitis based on artificial neural network
  192. Clinical significance of the detection of serum IgG4 and IgG4/IgG ratio in patients with thyroid-associated ophthalmopathy
  193. Forecast of pain degree of lumbar disc herniation based on back propagation neural network
  194. SPA-UNet: A liver tumor segmentation network based on fused multi-scale features
  195. Systematic evaluation of clinical efficacy of CYP1B1 gene polymorphism in EGFR mutant non-small cell lung cancer observed by medical image
  196. Rehabilitation effect of intelligent rehabilitation training system on hemiplegic limb spasms after stroke
  197. A novel approach for minimising anti-aliasing effects in EEG data acquisition
  198. ErbB4 promotes M2 activation of macrophages in idiopathic pulmonary fibrosis
  199. Clinical role of CYP1B1 gene polymorphism in prediction of postoperative chemotherapy efficacy in NSCLC based on individualized health model
  200. Lung nodule segmentation via semi-residual multi-resolution neural networks
  201. Evaluation of brain nerve function in ICU patients with Delirium by deep learning algorithm-based resting state MRI
  202. A data mining technique for detecting malignant mesothelioma cancer using multiple regression analysis
  203. Markov model combined with MR diffusion tensor imaging for predicting the onset of Alzheimer’s disease
  204. Effectiveness of the treatment of depression associated with cancer and neuroimaging changes in depression-related brain regions in patients treated with the mediator-deuterium acupuncture method
  205. Molecular mechanism of colorectal cancer and screening of molecular markers based on bioinformatics analysis
  206. Monitoring and evaluation of anesthesia depth status data based on neuroscience
  207. Exploring the conformational dynamics and thermodynamics of EGFR S768I and G719X + S768I mutations in non-small cell lung cancer: An in silico approaches
  208. Optimised feature selection-driven convolutional neural network using gray level co-occurrence matrix for detection of cervical cancer
  209. Incidence of different pressure patterns of spinal cerebellar ataxia and analysis of imaging and genetic diagnosis
  210. Pathogenic bacteria and treatment resistance in older cardiovascular disease patients with lung infection and risk prediction model
  211. Adoption value of support vector machine algorithm-based computed tomography imaging in the diagnosis of secondary pulmonary fungal infections in patients with malignant hematological disorders
  212. From slides to insights: Harnessing deep learning for prognostic survival prediction in human colorectal cancer histology
  213. Ecology and Environmental Science
  214. Monitoring of hourly carbon dioxide concentration under different land use types in arid ecosystem
  215. Comparing the differences of prokaryotic microbial community between pit walls and bottom from Chinese liquor revealed by 16S rRNA gene sequencing
  216. Effects of cadmium stress on fruits germination and growth of two herbage species
  217. Bamboo charcoal affects soil properties and bacterial community in tea plantations
  218. Optimization of biogas potential using kinetic models, response surface methodology, and instrumental evidence for biodegradation of tannery fleshings during anaerobic digestion
  219. Understory vegetation diversity patterns of Platycladus orientalis and Pinus elliottii communities in Central and Southern China
  220. Studies on macrofungi diversity and discovery of new species of Abortiporus from Baotianman World Biosphere Reserve
  221. Food Science
  222. Effect of berrycactus fruit (Myrtillocactus geometrizans) on glutamate, glutamine, and GABA levels in the frontal cortex of rats fed with a high-fat diet
  223. Guesstimate of thymoquinone diversity in Nigella sativa L. genotypes and elite varieties collected from Indian states using HPTLC technique
  224. Analysis of bacterial community structure of Fuzhuan tea with different processing techniques
  225. Untargeted metabolomics reveals sour jujube kernel benefiting the nutritional value and flavor of Morchella esculenta
  226. Mycobiota in Slovak wine grapes: A case study from the small Carpathians wine region
  227. Elemental analysis of Fadogia ancylantha leaves used as a nutraceutical in Mashonaland West Province, Zimbabwe
  228. Microbiological transglutaminase: Biotechnological application in the food industry
  229. Influence of solvent-free extraction of fish oil from catfish (Clarias magur) heads using a Taguchi orthogonal array design: A qualitative and quantitative approach
  230. Chromatographic analysis of the chemical composition and anticancer activities of Curcuma longa extract cultivated in Palestine
  231. The potential for the use of leghemoglobin and plant ferritin as sources of iron
  232. Investigating the association between dietary patterns and glycemic control among children and adolescents with T1DM
  233. Bioengineering and Biotechnology
  234. Biocompatibility and osteointegration capability of β-TCP manufactured by stereolithography 3D printing: In vitro study
  235. Clinical characteristics and the prognosis of diabetic foot in Tibet: A single center, retrospective study
  236. Agriculture
  237. Biofertilizer and NPSB fertilizer application effects on nodulation and productivity of common bean (Phaseolus vulgaris L.) at Sodo Zuria, Southern Ethiopia
  238. On correlation between canopy vegetation and growth indexes of maize varieties with different nitrogen efficiencies
  239. Exopolysaccharides from Pseudomonas tolaasii inhibit the growth of Pleurotus ostreatus mycelia
  240. A transcriptomic evaluation of the mechanism of programmed cell death of the replaceable bud in Chinese chestnut
  241. Melatonin enhances salt tolerance in sorghum by modulating photosynthetic performance, osmoregulation, antioxidant defense, and ion homeostasis
  242. Effects of plant density on alfalfa (Medicago sativa L.) seed yield in western Heilongjiang areas
  243. Identification of rice leaf diseases and deficiency disorders using a novel DeepBatch technique
  244. Artificial intelligence and internet of things oriented sustainable precision farming: Towards modern agriculture
  245. Animal Sciences
  246. Effect of ketogenic diet on exercise tolerance and transcriptome of gastrocnemius in mice
  247. Combined analysis of mRNA–miRNA from testis tissue in Tibetan sheep with different FecB genotypes
  248. Isolation, identification, and drug resistance of a partially isolated bacterium from the gill of Siniperca chuatsi
  249. Tracking behavioral changes of confined sows from the first mating to the third parity
  250. The sequencing of the key genes and end products in the TLR4 signaling pathway from the kidney of Rana dybowskii exposed to Aeromonas hydrophila
  251. Development of a new candidate vaccine against piglet diarrhea caused by Escherichia coli
  252. Plant Sciences
  253. Crown and diameter structure of pure Pinus massoniana Lamb. forest in Hunan province, China
  254. Genetic evaluation and germplasm identification analysis on ITS2, trnL-F, and psbA-trnH of alfalfa varieties germplasm resources
  255. Tissue culture and rapid propagation technology for Gentiana rhodantha
  256. Effects of cadmium on the synthesis of active ingredients in Salvia miltiorrhiza
  257. Cloning and expression analysis of VrNAC13 gene in mung bean
  258. Chlorate-induced molecular floral transition revealed by transcriptomes
  259. Effects of warming and drought on growth and development of soybean in Hailun region
  260. Effects of different light conditions on transient expression and biomass in Nicotiana benthamiana leaves
  261. Comparative analysis of the rhizosphere microbiome and medicinally active ingredients of Atractylodes lancea from different geographical origins
  262. Distinguish Dianthus species or varieties based on chloroplast genomes
  263. Comparative transcriptomes reveal molecular mechanisms of apple blossoms of different tolerance genotypes to chilling injury
  264. Study on fresh processing key technology and quality influence of Cut Ophiopogonis Radix based on multi-index evaluation
  265. An advanced approach for fig leaf disease detection and classification: Leveraging image processing and enhanced support vector machine methodology
  266. Erratum
  267. Erratum to “Protein Z modulates the metastasis of lung adenocarcinoma cells”
  268. Erratum to “BRCA1 subcellular localization regulated by PI3K signaling pathway in triple-negative breast cancer MDA-MB-231 cells and hormone-sensitive T47D cells”
  269. Retraction
  270. Retraction to “Protocatechuic acid attenuates cerebral aneurysm formation and progression by inhibiting TNF-alpha/Nrf-2/NF-kB-mediated inflammatory mechanisms in experimental rats”
Heruntergeladen am 22.9.2025 von https://www.degruyterbrill.com/document/doi/10.1515/biol-2022-0745/html
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