AIM: To investigate the effect of knockdown of Forkhead box M1 (FoxM1) on the proliferation and invasion capacities of human gallbladder carcinoma (GBC)-SD cells.
BACKGROUND: Liver transplantation(LT) and liver resection(LR) are currently considered the standard treatment of patients with hepatocellular carcinoma(HCC). However, the outcomes of LT and LR are still inconclusive.D...BACKGROUND: Liver transplantation(LT) and liver resection(LR) are currently considered the standard treatment of patients with hepatocellular carcinoma(HCC). However, the outcomes of LT and LR are still inconclusive.DATA SOURCES: MEDLINE, EMBASE, and Cochrane Library were searched for relevant studies. Surgical safety indices such as treatment-related morbidity and mortality, and efficacy indices such as overall and tumor-free survival outcomes were evaluated. Weighted mean differences and odds ratios(ORs)were calculated using a random-effects model.RESULTS: Seventeen studies were included in this metaanalysis.LT achieved significantly higher rates of surgeryrelated morbidity(OR=1.47; 95% CI: 1.02-2.13) and mortality(OR=2.12; 95% CI: 1.11-4.05). Likewise, the 1-year survival rate was lower in LT(OR=0.86; 95% CI: 0.61-1.20). However, the 3-and 5-year survival rates were significantly higher in LT than in LR and the ORs were 1.12(95% CI: 0.96-1.30) in 3 years and1.84(95% CI: 1.49-2.28) in 5 years. Furthermore, the tumorfree survival rate in LT was significantly higher than that in LR in 1, 3, 5 years after surgery, with the ORs of 1.72(95% CI:1.24-2.41), 3.75(95% CI: 2.94-4.78) and 5.64(95% CI: 4.35-7.31),respectively.CONCLUSIONS: One-year morbidity and mortality are higher in LT than in LR for patients with HCC. However, long-term survival and tumor-free survival rates are higher in patients treated with LT than those treated with LR.展开更多
AIM:To explore the prognostic value in the monitoring of treatment efficacy of serial α-fetoprotein(AFP) in hepatocellular carcinoma(HCC) patients.METHODS:We searched MEDLINE,EMBASE and COCHRANE LIBRARY through April...AIM:To explore the prognostic value in the monitoring of treatment efficacy of serial α-fetoprotein(AFP) in hepatocellular carcinoma(HCC) patients.METHODS:We searched MEDLINE,EMBASE and COCHRANE LIBRARY through April 21,2012,to find qualifying articles.Our overall search strategy included terms for HCC,AFP,treatment response,and prognosis.Literature was limited to English-language,human studies.Studies reporting cumulative survival rates were summa-rized qualitatively.For the prognostic meta-analysis,we undertook a series of meta-analyses that summarised the Cox proportional hazard ratios(HRs) by assuming a random effects model.With regards to the correlation of AFP change with radiologic response,the categorical dichotomous variables were assessed using Poisson relative risks(RRs),which were incorporated into the random effects model meta-analysis of accuracy prediction.Between-study heterogeneity was estimated by use of the I2 statistic.Publication bias was evaluated using the Begg funnel plot and Egger plot.Sensitivity analyses were conducted first by separating systemic treatment estimates from locoregional therapy estimates,evaluating different AFP response cut-off point effects,and exploring the impact of different study sizes.RESULTS:Of 142 titles identified in our original search,11 articles(12 clinical studies) met our criteria.Six studies investigated outcome in a total of 464 cases who underwent systemic treatment,and six studies investigated outcome in a total of 510 patients who received locoregional therapy.A random-effects model metaanalysis showed that AFP response was associated with an mortality HR of 0.55(95%CI,0.47-0.65) across HCC in overall survival(OS) and 0.50(95%CI,0.38-0.65) in progression-free survival.Restricting analysis to the six eligible analyses of systemic treatment,the pooled HRs were 0.64(95%CI,0.53-0.77) for OS.Limiting analysis to the six analyses of locoregional therapy,the pooled HRs for OS was 0.39(95%CI,0.29-0.53).We showed a larger pooled HR in the 50% definition studies(HR,0.67,95%CI,0.55-0.83) compared with that from the 20% definition studies(HR,0.41,95%CI,0.32-0.53).Restricting analysis to the four studies including over 100 patients individually,the pooled HR was 0.65(95%CI,0.54-0.79),with a pooled HR for OS of 0.35(95%CI,0.23-0.46) in the studies of less than 100 patients.As to radiological imaging,43.1%(155/360) of the patients in the AFP response group presented with a radiological overall response,while the response rate decreased to 11.5%(36/313) in the patients from theAFP nonresponse group.The RR of having no overall response was significantly lower in the AFP response group than the AFP nonresponse group(RR,0.67;95%CI,0.61-0.75).In terms of disease control rate,86.9%(287/330) in the AFP response group and 51.0%(153/300) in the AFP nonresponse group showed successful disease control,respectively.The RR of disease control failure,similarly,was significantly lower in the AFP response group(RR,0.37;95%CI,0.23-0.58).But these findings could be overestimates because of publication and reporting bias.CONCLUSION:HCC patients presenting with an AFP response are at decreased risk of mortality.In addition,patients with an AFP response also present with a higher overall response rate and disease control rate.展开更多
AIM To evaluate the prognostic power of different molecular data in liver cancer.METHODS Cox regression screen and least absolute shrinkage and selection operator were performed to select significant prognostic variab...AIM To evaluate the prognostic power of different molecular data in liver cancer.METHODS Cox regression screen and least absolute shrinkage and selection operator were performed to select significant prognostic variables. Then the concordance index was calculated to evaluate the prognostic power. For the combination data, based on the clinical cox model, molecular features that better fit the model were combined to calculate the concordance index. Prognostic models were built based on the arithmetic summation of the significant variables. Kaplan-Meier survival curve and log-rank test were performed to compare the survival difference. Then a heatmap was constructed and gene set enrichment analysis was performed for pathway analysis.RESULTS The m RNA data were the most informative prognostic variables in all kinds of omics data in liver cancer, with the highest concordance index(C-index) of 0.61. For the copy number variation, methylation and mi RNA data, the combination of molecular data with clinical data could significantly boost the prediction accuracy of the molecular data alone(P < 0.05). On the other hand, the combination of clinical data with methylation, mi RNA and m RNA data could significantly boost the prediction accuracy of the clinical data itself(P < 0.05). Based on the significant prognostic variables, different prognostic models were built. In addition, the heatmap analysis, survival analysis, and gene set enrichment analysis validated the practicability of the prognostic models.CONCLUSION In all kinds of omics data in liver cancer, the m RNA data might be the most informative prognostic variable. The combination of clinical data with molecular data might be the future direction for cancer prognosis and prediction.展开更多
We corrected the mistake of Figure 3,and replaced the incorrect images with the correct ones.The“adenovirus”was a typographical error in writing,and should be revised to“lentivirus”.
基金supported by Science Foundation of the First Affiliated Hospital of Medical College,Xi’an Jiaotong University,No.2010YK1
文摘AIM: To investigate the effect of knockdown of Forkhead box M1 (FoxM1) on the proliferation and invasion capacities of human gallbladder carcinoma (GBC)-SD cells.
基金supported by grants from the National Natural Science Foundation of China(30872482 and 81072051)
文摘BACKGROUND: Liver transplantation(LT) and liver resection(LR) are currently considered the standard treatment of patients with hepatocellular carcinoma(HCC). However, the outcomes of LT and LR are still inconclusive.DATA SOURCES: MEDLINE, EMBASE, and Cochrane Library were searched for relevant studies. Surgical safety indices such as treatment-related morbidity and mortality, and efficacy indices such as overall and tumor-free survival outcomes were evaluated. Weighted mean differences and odds ratios(ORs)were calculated using a random-effects model.RESULTS: Seventeen studies were included in this metaanalysis.LT achieved significantly higher rates of surgeryrelated morbidity(OR=1.47; 95% CI: 1.02-2.13) and mortality(OR=2.12; 95% CI: 1.11-4.05). Likewise, the 1-year survival rate was lower in LT(OR=0.86; 95% CI: 0.61-1.20). However, the 3-and 5-year survival rates were significantly higher in LT than in LR and the ORs were 1.12(95% CI: 0.96-1.30) in 3 years and1.84(95% CI: 1.49-2.28) in 5 years. Furthermore, the tumorfree survival rate in LT was significantly higher than that in LR in 1, 3, 5 years after surgery, with the ORs of 1.72(95% CI:1.24-2.41), 3.75(95% CI: 2.94-4.78) and 5.64(95% CI: 4.35-7.31),respectively.CONCLUSIONS: One-year morbidity and mortality are higher in LT than in LR for patients with HCC. However, long-term survival and tumor-free survival rates are higher in patients treated with LT than those treated with LR.
基金Supported by National Natural Science Foundation of ChinaNo. 30872482 and No. 81072051
文摘AIM:To explore the prognostic value in the monitoring of treatment efficacy of serial α-fetoprotein(AFP) in hepatocellular carcinoma(HCC) patients.METHODS:We searched MEDLINE,EMBASE and COCHRANE LIBRARY through April 21,2012,to find qualifying articles.Our overall search strategy included terms for HCC,AFP,treatment response,and prognosis.Literature was limited to English-language,human studies.Studies reporting cumulative survival rates were summa-rized qualitatively.For the prognostic meta-analysis,we undertook a series of meta-analyses that summarised the Cox proportional hazard ratios(HRs) by assuming a random effects model.With regards to the correlation of AFP change with radiologic response,the categorical dichotomous variables were assessed using Poisson relative risks(RRs),which were incorporated into the random effects model meta-analysis of accuracy prediction.Between-study heterogeneity was estimated by use of the I2 statistic.Publication bias was evaluated using the Begg funnel plot and Egger plot.Sensitivity analyses were conducted first by separating systemic treatment estimates from locoregional therapy estimates,evaluating different AFP response cut-off point effects,and exploring the impact of different study sizes.RESULTS:Of 142 titles identified in our original search,11 articles(12 clinical studies) met our criteria.Six studies investigated outcome in a total of 464 cases who underwent systemic treatment,and six studies investigated outcome in a total of 510 patients who received locoregional therapy.A random-effects model metaanalysis showed that AFP response was associated with an mortality HR of 0.55(95%CI,0.47-0.65) across HCC in overall survival(OS) and 0.50(95%CI,0.38-0.65) in progression-free survival.Restricting analysis to the six eligible analyses of systemic treatment,the pooled HRs were 0.64(95%CI,0.53-0.77) for OS.Limiting analysis to the six analyses of locoregional therapy,the pooled HRs for OS was 0.39(95%CI,0.29-0.53).We showed a larger pooled HR in the 50% definition studies(HR,0.67,95%CI,0.55-0.83) compared with that from the 20% definition studies(HR,0.41,95%CI,0.32-0.53).Restricting analysis to the four studies including over 100 patients individually,the pooled HR was 0.65(95%CI,0.54-0.79),with a pooled HR for OS of 0.35(95%CI,0.23-0.46) in the studies of less than 100 patients.As to radiological imaging,43.1%(155/360) of the patients in the AFP response group presented with a radiological overall response,while the response rate decreased to 11.5%(36/313) in the patients from theAFP nonresponse group.The RR of having no overall response was significantly lower in the AFP response group than the AFP nonresponse group(RR,0.67;95%CI,0.61-0.75).In terms of disease control rate,86.9%(287/330) in the AFP response group and 51.0%(153/300) in the AFP nonresponse group showed successful disease control,respectively.The RR of disease control failure,similarly,was significantly lower in the AFP response group(RR,0.37;95%CI,0.23-0.58).But these findings could be overestimates because of publication and reporting bias.CONCLUSION:HCC patients presenting with an AFP response are at decreased risk of mortality.In addition,patients with an AFP response also present with a higher overall response rate and disease control rate.
文摘AIM To evaluate the prognostic power of different molecular data in liver cancer.METHODS Cox regression screen and least absolute shrinkage and selection operator were performed to select significant prognostic variables. Then the concordance index was calculated to evaluate the prognostic power. For the combination data, based on the clinical cox model, molecular features that better fit the model were combined to calculate the concordance index. Prognostic models were built based on the arithmetic summation of the significant variables. Kaplan-Meier survival curve and log-rank test were performed to compare the survival difference. Then a heatmap was constructed and gene set enrichment analysis was performed for pathway analysis.RESULTS The m RNA data were the most informative prognostic variables in all kinds of omics data in liver cancer, with the highest concordance index(C-index) of 0.61. For the copy number variation, methylation and mi RNA data, the combination of molecular data with clinical data could significantly boost the prediction accuracy of the molecular data alone(P < 0.05). On the other hand, the combination of clinical data with methylation, mi RNA and m RNA data could significantly boost the prediction accuracy of the clinical data itself(P < 0.05). Based on the significant prognostic variables, different prognostic models were built. In addition, the heatmap analysis, survival analysis, and gene set enrichment analysis validated the practicability of the prognostic models.CONCLUSION In all kinds of omics data in liver cancer, the m RNA data might be the most informative prognostic variable. The combination of clinical data with molecular data might be the future direction for cancer prognosis and prediction.
文摘We corrected the mistake of Figure 3,and replaced the incorrect images with the correct ones.The“adenovirus”was a typographical error in writing,and should be revised to“lentivirus”.