Prognostic and incremental value of computed tomography-based radiomics from tumor and nodal regions in esophageal squamous cell carcinoma

Objective:This study aimed to evaluate the prognostic value of preoperative radiomics and establish an integrated model for esophageal squamous cell cancer(ESCC).Methods:A total of 931 patients were retrospectively enrolled in this study(training cohort,n=624;validation cohort,n=307).Radiomics features were obtained by contrast-enhanced computed tomography(CT)before esophagectomy.A radiomics index was set based on features of tumor and reginal lymph nodes by using the least absolute shrinkage and selection operator(LASSO)Cox regression.Prognostic nomogram was built based on radiomics index and other independent risk factors.The prognostic value was assessed by using Harrell’s concordance index,time-dependent receiver operating characteristics and Kaplan-Meier curves.Results:Twelve radiomic features from tumor and lymph node regions were identified to build a radiomics index,which was significantly associated with overall survival(OS)in both training cohort and validation cohort.The radiomics index was highly correlated with clinical tumor-node-metastasis(cTNM)and pathologic TNM(pTNM)stages,but it demonstrated a better prognostic value compared with cTNM stage and was almost comparable with pTNM stage.Multivariable Cox regression showed that the radiomics index was an independent prognostic factor.An integrated model was constructed based on gender,preoperative serum sodium concentration,pTNM and the radiomics index for clinical usefulness.The integrated model demonstrated discriminatory ability better compared with the traditional clinical-pathologic model and pTNM alone,indicating incremental value for prognosis.Conclusions:CT-based radiomics for primary tumor and reginal lymph nodes was sufficient in predicting OS for patients with ESCC.The integrated model demonstrated incremental value for prognosis and was robust for clinical applications.

Salicylic acid sensitizes cervical cancer cells to radiotherapy by activating AMPK/TSC2/mTOR pathway

Objective:To investigate the radio-sensitizing effect of salicylic acid(SA)on human cervical cancer cells and its potential molecular mechanism.Methods:Cervical cancer cells were treated with SA and ionizing radiation.The expression ofγ-H2AX was evaluated by immunofluorescence(IF)assay.Cell cycle and apoptosis were analyzed by flow cytometry.Western blot was performed to detect the protein level of AMPK/TSC2/mTOR pathway.Results:SA inhibited basal proliferation of cervical cancer cells in a dose and time dependent manner.In addition,SA increased radiation-induced DNA damage,promoted apoptosis,triggered a redistribution of cell cycle from G2-M phase to G1-S phase of cervical cancer cells,and hence increased cell sensitivity to radiation.Moreover,SA treatment elevated the expression levels of p-AMPKα(t=3.996,P<0.05)and p-TSC2(t=5.308,P<0.05),whereas the level of p-mTOR(t=10.160,P<0.05)was significantly decreased.Conclusion:SA enhances the radiosensitivity of cervical cancer cells by targeting AMPK/TSC2/mTOR signaling pathway,and might serve as a promising therapeutic strategy to improve the efficacy of radiotherapy for cervical cancer.