强化营养支持辅助奥曲肽治疗肝硬化合并食管胃底静脉曲张破裂出血的疗效及再出血危险因素

目的探究强化营养支持辅助奥曲肽治疗肝硬化合并食管胃底静脉曲张破裂出血(EGVB)的疗效及再出血危险因素。方法选取2020年1月至2023年6月无锡市人民医院收治的肝硬化合并EGVB患者112例,剔除资料不全或不愿参加研究的患者后共纳入90例患者。所有患者行强化营养支持辅助奥曲肽治疗,观察临床疗效并比较所有患者治疗前后的营养状况[三头肌皮皱厚度(TSF)、上臂围(AC)、体重指数(BMI)]。根据治疗后是否再出血分为观察组(25例,治疗后再出血)和对照组(65例,治疗后未发生出血)。比较两组的临床资料,单因素及多因素logistic分析肝硬化合并EGVB患者在强化营养支持辅助奥曲肽治疗后再出血的独立危险因素。结果90例患者治疗后,所有患者均未出现活动性出血治疗成功率为100.00%。治疗后再出血25例,未出血65例,复发率27.78%。所有患者治疗后的TSF水平低于治疗前,AC、BMI水平高于治疗前(P<0.05)。单因素logistic分析显示,年龄≥65岁、门静脉内径、Child-Pugh评分、血钠、白蛋白浓度是肝硬化合并EGVB患者治疗后发生再出血的危险因素(P<0.05)。多因素logistic回归分析显示,年龄≥65岁、门静脉内径、Child-Pugh评分、血钠、白蛋白浓度均是肝硬化合并EGVB患者治疗后发生再出血的独立危险因素(OR=6.556、3.404、0.598、1.320、2.028,P=0.001、0.000、0.000、0.002、0.000,95%CI=3.124~6.335、1.381~2.358、3.252~8.612、1.513~2.192;P均<0.05)。结论强化营养支持辅助奥曲肽治疗肝硬化合并EGVB的疗效确切,年龄≥65岁、门静脉内径、Child-Pugh评分、血钠、白蛋白浓度均是患者治疗后再出血的独立危险因素,临床医师在治疗时应重视上述因素,并对疾病进展进行积极控制,以减少治疗后再出血的风险。

CXCL5/CXCR2 axis in tumor microenvironment as potential diagnostic biomarker and therapeutic target

The components of the tumor microenvironment(TME)in solid tumors,especially chemokines,are currently attracting much attention from scientists.C-X-C motif chemokine ligand 5(CXCL5)is one of the important chemokines in TME.Over-expression of CXCL5 is closely related to the survival time,recurrence and metasta-sis of cancer patients.In TME,CXCL5 binds to its receptors,such as C-X-C motif chemokine receptor 2(CXCR2),to participate in the recruitment of immune cells and promote angiogenesis,tumor growth,and metastasis.The CXCL5/CXCR2 axis can act as a bridge between tumor cells and host cells in TME.Blocking the trans-mission of CXCL5/CXCR2 signals can increase the sensitivity and effectiveness of immunotherapy and slow down tumor progression.CXCL5 and CXCR2 are also regarded as biomarkers for predicting prognosis and molecular targets for customiz-ing the treatment.In this review,we summarized the current literature regarding the biological functions and clinical significance of CXCL5/CXCR2 axis in TME.The possibility to use CXCL5 and CXCR2 as potential prognostic biomarkers and thera-peutic targets in cancer is also discussed.

Emerging roles of long noncoding RNAs in cholangiocarcinoma:Advances and challenges

Cholangiocarcinoma(CCA),a cancer with a relatively low incidence rate,is usually associated with poor prognosis.Current modalities for the diagnosis and treatment of CCA patients are still far from satisfactory.In recent years,numerous long noncoding RNAs(lncRNAs)have been identified as crucial players in the development of various cancers,including CCA.Abnormally expressed lncRNAs in CCA,regulated by some upstream molecules,significantly influence the biological behavior of tumor cells and are involved in tumor development through various mechanisms,including interactions with functional proteins,participation in competing for endogenous RNA(ceRNA)regulatory networks,activation of cancer-related signaling pathways and epigenetic modification of gene expression.Furthermore,several lncRNAs are closely associated with the clinicopathological features of CCA patients,and are promising biomarkers for diagnosing and prognostication of CCA.Some of these lncRNAs play an important role in chemotherapy drug resistance.In addition,lncRNAs have also been shown to be involved in the inflammation microenvironment of CCA and malignant outcome of CCA risk factors,such as cholestatic liver diseases.In view of the difficulty of diagnosing CCA,more attention should be paid to detectable lncRNAs in the serum or bile.This review summarizes the recent knowledge on lncRNAs in CCA and provides a new outlook on the molecular mechanisms of CCA development from the perspective of lncRNAs.Moreover,we also discussed the limitations of the current studies and differential expression of lncRNAs in different types of CCA.