Prognostic role of the ABO blood types in Chinese patients with curatively resected non-small cell lung cancer:a retrospective analysis of 1601 cases at a single cancer center

Background:A positive association between the ABO blood types and survival has been suggested in several malignancies.The aim of this study was to assess the role of the ABO blood types in predicting the prognosis of Chinese patients with curatively resected non-small cell lung cancer(NSCLC).Methods:We retrospectively analyzed 1601 consecutive Chinese patients who underwent curative surgery for NSCLC between January 1,2005 and December 31,2009.The relationship between the ABO blood types and survival was investigated.In addition,univariate and multivariate analyses were performed.Results:Group 1(patients with the blood type O or B) had significantly prolonged overall survival(OS) compared with group 2(patients with the blood type A or AB),with a median OS of 74.9 months versus 61.5 months[hazard ratio(HR) 0.83;95%confidence interval(CI) 0.72-0.96;P = 0.015].Additionally,group 1 had significantly longer disease-free survival(DFS;HR 0.86;95%CI 0.76-0.98;P = 0.022) and locoregional relapse-free survival(LRFS;HR 0.79;95%CI 0.64-0.98;P = 0.024) than group 2.The association was not significantly modified by other risk factors for NSCLC,including smoking status,pathologic tumor-node-metastasis stage,pT category,pN category,and chemotherapy.Conclusions:There is an association between the ABO blood types and the survival of Chinese patients with resected NSCLC.Patients with the blood type O or B had significantly prolonged OS,DFS,and LRFS compared with those with the blood type A or AB.

Novel blood-based microRNA biomarker panel for early diagnosis of pancreatic cancer

AIM:To develop a panel of blood-based diagnostic biomarkers consisting of circulating microRNAs for the detection of pancreatic cancer at an early stage.METHODS:Blood-based circulating microRNAs were profiled by high throughput screening using microarray analysis,comparing differential expression between early stage pancreatic cancer patients(n = 8) and healthy controls(n = 11).A panel of candidate microRNAs was generated based on the microarray signature profiling,including unsupervised clustering and statistical analysis of differential expression levels,and findings from the published literature.The selected candidate microRNAs were then confirmed using TaqMan real-time quantitative reverse transcription polymerase chain reaction(RT-qPCR) to further narrow down to a three-microRNA diagnostic panel.The three-microRNA diagnostic panel was validated with independent experimental proce-dures and instrumentation of RT-qPCR at an independent venue with a new cohort of cancer patients(n = 11),healthy controls(n = 11),and a group of high risk controls(n = 11).Receiver operating characteristic curve analysis was performed to assess the diagnostic capability of the three-microRNA panel.RESULTS:In the initial high throughput screening,1220 known human microRNAs were screened for differential expression in pancreatic cancer patients versus controls.A subset of 42 microRNAs was then generated based on this data analysis and current published literature.Eight microRNAs were selected from the list of 42 targets for confirmation study,and three-microRNAs,miR-642b,miR-885-5p,and miR-22,were confirmed to show consistent expression between microarray and RT-qPCR.These three microRNAs were then validated and evaluated as a diagnostic panel with a new cohort of patients and controls and found to yield high sensitivity(91%) and specificity(91%) with an area under the curve of 0.97(P < 0.001).Compared to the CA19-9 marker at 73%,the three-microRNA panel has higher sensitivity although CA19-9 has higher specificity of 100%.CONCLUSION:The identified panel of three microRNA biomarkers can potentially be used as a diagnostic tool for early stage pancreatic cancer.

Long-lasting discussion: Adverse effects of intraoperative blood loss and allogeneic transfusion on prognosis of patients with gastric cancer

Gastrectomy with radical lymph node dissection is the most promising treatment avenue for patients with gastric cancer. However, this procedure sometimes induces excessive intraoperative blood loss and requires perioperative allogeneic blood transfusion. There are lasting discussions and controversies about whether intraoperative blood loss or perioperative blood transfusion has adverse effects on the prognosis in patients with gastric cancer. We reviewed laboratory and clinical evidence of these associations in patients with gastric cancer. A large amount of clinical evidence supports the correlation between excessive intraoperative blood loss and adverse effects on the prognosis. The laboratory evidence revealed three possible causes of such adverse effects: anti-tumor immunosuppression, unfavorable postoperative conditions, and peritoneal recurrence by spillage of cancer cells into the pelvis. Several systematic reviews and meta-analyses have suggested the adverse effects of perioperative blood transfusions on prognostic parameters such as all-cause mortality, recurrence, and postoperative complications. There are two possible causes of adverse effects of blood transfusions on the prognosis: Anti-tumor immunosuppression and patient-related confounding factors (e.g., preoperative anemia). These factors are associated with a worse prognosis and higher requirement for perioperative blood transfusions. Surgeons should make efforts to minimize intraoperative blood loss and transfusions during gastric cancer surgery to improve patients’ prognosis.

Colorectal cancer screening: Comparison of transferrin and immuno fecal occult blood test

AIM: To evaluate the sensitivity and specificity of transfesrrin dipstick test (Tf) in colorectal cancer (CRC) screening and precancerous lesions screening. METHODS: Eight hundreds and sixty-one individuals at high-risk for CRC were recruited. Six hundreds and eleven subsequently received the three fecal occult blood tests and colonoscopy with biopsy performed as needed. Fecal samples were obtained on the day before colonoscopy. Tf, immuno fecal occult blood test (IFOBT) and guaiac fecal occult blood test (g-FOBT) were performed simultaneously on the same stool. To minimize false-negative cases, all subjects with negative samples were asked to provide an additional stool specimen for a second test even a third test. If the results were all negative after testing three repeated samples, the subject was considered a true negative. The performance characteristics of Tf for detecting CRC and precancerous lesions were examined and compared to those of IFOBT and the combination of Tf, IFOBT and g-FOBT. RESULTS: A total of six hundreds and eleven subjects met the study criteria including 25 with CRC and 60 with precancerous lesions. Sensitivity for detecting CRC was 92% for Tf and 96% for IFOBT, specificities of Tf and IFOBT were both 72.0% (95% CI: 68.2%-75.5%; χ2 = 0.4, P > 0.05); positive likelihood ratios of those were 3.3 (95% CI: 2.8-3.9) and 3.4 (95% CI: 2.9-4.0), respectively. In precancerous lesions, sensitivities for Tf and IFOBT were 50% and 58%, respectively (χ 2 = 0.8, P > 0.05); specificities of Tf and IFOBT were 71.5% (95% CI: 67.6%-75.1%) and 72.2% (95% CI: 68.4%-75.8%); positive likelihood ratios of those were 1.8 (95% CI: 1.3-2.3) and 2.1 (95% CI: 1.6-2.7), respectively; compared to IFOBT, g-FOBT+ Tf+ IFOBT had a significantly higher positive rate for precancerous lesions (83% vs 58%, respectively; χ 2 = 9.1, P < 0.05). In patients with CRC and precancerous lesions, the sensitivities of Tf and IFOBT were 62% and 69% (χ 2 = 0.9, P > 0.05); specificities of those were 74.5% (95% CI: 70.6%-78.1%) and 75.5% (95% CI: 71.6%-79.0%); positive likelihood ratios of those were 2.5 (95% CI: 2.0-3.1) and 2.8 (95% CI: 2.3-3.5). Compared to IF-OBT alone, combining g-FOBT, IFOBT and Tf led to significantly increased sensitivity for detecting CRC and cancerous lesions (69% vs 88%, respectively; χ 2 = 9.0, P < 0.05). CONCLUSION: Tf dipstick test might be used as an ad- ditional tool for CRC and precancerous lesions screening in a high-risk cohort.

ABO blood type is associated with endometrial cancer risk in Chinese women

ABO blood type has been associated with risk of several malignancies. However, results are not consistent. In this population-based case-control study including 1204 incident endometrial cancer cases and 1212 population controls, we examined the association of self-reported serologic blood type with endometrial cancer risk using a logistic regression model. Women with endometrial cancer were more likely to have blood type A. Compared to women with blood type O, the adjusted odds ratios for endometrial cancer were 1.00 [95% confidence interval (CI), 0.79-1.28] for type B, 1.24 (95% CI, 0.90-1.69) for type AB, and 1.50 (95% CI, 1.19-1.90) for type A. A significant dose-response relationship was observed for cancer risk and level of antigen A (P for trend = 0.0003). The positive association of blood type A with cancer risk was observed regardless of menopausal status, body mass index, oral contraceptive use, or family cancer history. Our results suggest that ABO blood type may be involved in the development of endometrial cancer.

An Investigation on the Phenotype of Cultured Dendritic Cells from the Peripheral Blood of Patients with Breast Cancer

Objective To induce and culture the dendritic cells in the peripheral blood of breast cancer patients and research on their phenotype. Methods Mononuclear cells were isolated by Ficoll Hypaque centrifugation from 32 breast cancer patients peripheral blood. These cells were plated in six well culture plates(10 6/ml,2 ml/well) in RPMI 1640 medium supplemented with 10% heat inactivated fetal bovine serum,100 ng/ml GM CSF,20 ng/ml IL 4,and/or 20 ng/ml TNF α.Two hours later, nonadherent cells were gently removed and fresh medium was added. Cultured cells were analyzed by flow cytometry with fluorescence labeled monoclonal antibodies. Pictures of cultured and fluorescence stained cells were taken by confocal scanning microscope. Results The diameter of the cells was between 10 and 20 micron. Cells displayed a characteristic CD1a +,CD40 +,CD80 +, CD86 + and CD83 + phenotypes. All of these molecules were not specific for dendritic cells. CD1a and CD83 molecules could also be expressed on the surface of CD3 + T lymphocytes and CD19 + B lymphocytes, especially on activated lymphocytes. Conclusion The molecules of CD1a and CD83 are not specific phenotypes for dendritic cells. Currently, we still need to apply both cell morphology and costimulatory molecules such as CD40,CD80, and CD86 to the identification of dendritic cells.

ABO blood group is a predictor of survival in patients with laryngeal cancer

Background: Whether the ABO blood group is associated with the survival of patients with laryngeal cancer remains unknown. The purpose of this study was to investigate the association between the ABO blood group and clinico?pathologic characteristics of patients with laryngeal cancer and assess whether the ABO blood group was associated with prognosis.Methods: We analyzed the records of 1260 patients with laryngeal cancer who underwent curative treatment at Sun Yat?sen University Cancer Center between January 1993 and December 2009. The Chi?square test was used to assess the relationship between the ABO blood group and clinicopathologic characteristics. The Kaplan–Meier method was used to estimate 3?, 5?, and 10?year overall survival(OS) rates. The Cox proportional hazards model was used in univariate and multivariate analyses of OS.Results: No signiicant association was found between the ABO blood group and clinicopathologic characteristics except for primary tumor site. The median OS for patients with blood groups A, B, AB, and O were 87.0, 80.0, 90.0, and 72.5 months, respectively. The 3?, 5?, and 10?year OS rates were 82.4%, 76.0%, and 67.5% for patients with blood group A; 77.4%, 69.8%, and 58.4% for patients with blood group B; 82.2%, 73.1%, and 65.6% for patients with blood group AB; and 71.7%, 66.4%, and 55.5% for patients with blood group O, respectively. Univariate and multivariate analyses showed that the ABO blood group had signiicant efects on prognosis in patients with laryngeal cancer.Conclusions: The ABO blood group is associated with survival in patients with laryngeal cancer. Patients with blood group O had signiicantly shorter OS than patients with other ABO blood groups.

EXPRESSION AND CLINICAL SIGNIFICANCE OF CD44 IN THEPERIPHERAL BLOOD OF PATIENTS WITH CASTRIC CANCER

Objective: To investigate the clinical significance of cell adhesive molecule (CD44) expression on periphery blood (PB) of patients with gastric cancer. Methods: Both the level of CD44 and the immunocyte phenotype of the lymphocytes of 110 patients with gastric cancer and 100 healthy subjects were examined by flow cytometry, and the results were analyzed pathologically and statistically. Results: The mean of the CD44% in PB of the healthy subjects was 46.14±3.4 and there were no statistic differences for their age and sex. Site of tumor growth: The significant difference (P<0.01) was present between the patients with the cardiac part (C) or body of gastric (M+C) cancer and normal individuals. The significant difference (P<0.05) was present between patients with the 3 sites involved gastric cancer and normal individuals. Type of tumor mass: The significant difference (P<0.05) was present between patients with mixed type gastric cancer and normal individuals. Size of tumor mass: The significant difference was present between the normal individuals and patients with gastric cancer > 10 cm mass (P<0.01) and 7–10 cm mass (P<0.05). Degree of tumor differentiation: The significant difference (P<0.01) was present between the patients with low differentiation gastric cancer and normal individuals. The significant difference (P<0.01) was present between patients with metastatic stage: The significant difference (P<0.01) was present lymph node gastric cancer and normal individuals. Clinical between the patients with advanced or relapsed gastric cancer and normal individuals. Age: The significant difference (P<0.01) was present between the gastric cancer patients under 59 years and normal individuals. Conclusion: The increased level of CD44 in the PB of patients with gastric cancer indicated the possible existence of relapse, advance or metastasis of tumors. When the tumor was poorly differentiated and bigger in tumor mass, the level of CD44% would be higher. Examining the level of CD44 by flow cytometry in the periphery blood of patients with gastric cancer was useful for the prognosis.

An AAS Dependent Method for Quantitative Analysis of Essential Trace Elements from Blood Samples of Pakistani Female Breast Cancer Patients

Breast cancer is the second leading cancer in the world. The long-term exposure of some metallic compounds induces different forms of cancer, including breast cancer. Trace elements are essential metals for the physiological functions of the cell on a molecular level and also contribute in treatment of many diseases. The aim of study was to compare the level of essential trace elements, sodium, potassium, calcium, iron, and zinc in breast cancer patients with normal healthy adult women. Total forty-five patients (age range from 25 - 73 years) were included in this study and divided into three groups according to three different stages of breast cancer including tumor-II, tumor-III and tumor-IV. Blood was collected from all participants after taking history, clinical data and taking consent. However, about fifteen non-cancer healthy women in age range from 26 - 69 years were subjected to this study. The elemental concentrations were determined through atomic absorption spectrophotometer subsequent to microwave-induced acid digestion. The results of Na, K, Zn, Fe, Ca, were observed to decrease in blood samples of breast cancer patients as compared to non-cancer subjects. The results are reliable with other numerous literature reported studies, the efficiency, and deficiency of these trace metals may contribute an important role in the progress of breast cancer.

Effect of insulin on functional status of cord blood-derived dendritic cells and on dendritic cell-induced CTL cytotoxicity against pancreatic cancer cell lines

BACKGROUND: Dendritic cells (DCs) are the most important antigen-presenting cells in the human body, and DCs with different mature status possess different or even opposite functions. This study was designed to explore the influence of insulin on the functional status of cord blood-derived DCs and on DC-induced cytotoxic T lymphocyte (CTL) activity against pancreatic cancer cell lines. METHODS: Mononuclear cells were isolated from fresh cord blood. Interleukin-4 (IL-4) and granulocytemacrophage colony-stimulating factor (GM-CSF) were used to induce or stimulate the mononuclear cells. Insulin at different concentrations served to modify DCs, and then DC morphology, number, and growth status were assessed. The DC immunophenotype was detected with a flow cytometer. The IL-12 in DC supernatant was determined by ELISA. DC functional status was evaluated by the autologous mixed lymphocyte reaction. T lymphocytes were induced by insulin-modified DCs to become CTLs. The CTL cytotoxicity against pancreatic cancer cell lines was determined. RESULTS: Mononuclear cells from cord blood can be differentiated into DCs by cytokine induction and insulin modification. With the increase in insulin concentration (2.5-25 mg/L), the expression of DC HLA-DR, CD1 alpha, CD80, and CD83 was significantly increased, the DC ability to secrete IL-12 was significantly improved, DC function to activate autologous lymphocytes was significantly enhanced, and the cytotoxicity of CTLs induced by insulin-modified DCs against pancreatic cancer cell lines was significantly strengthened. CONCLUSIONS: Insulin may facilitate DC induction and maturation, and improve the reproductive activity of autologous lymphocytes. The cytotoxicity of CTLs induced by insulin-modified DCs against pancreatic cancer cell lines was significantly enhanced. Insulin may serve as a factor modifying DCs and inducing CTLs in vitro in insulin biotherapy.

Blood Microbiota and Cancer: Cell Wall-Deficient L-Forms of Bacteria and Fungi as Cancer-Promoting Environment

In recent years, valuable experience and insights have been gained into L-forms (cell-wall-deficient variants) of bacteria and fungi and their disease-trigger potential in cases with chronic infections, autism spectrum disorders, autoimmune and neurodegenerative diseases. Based on the concept of “internal” blood microbiota, consisting of L-forms and its relevance to health and disease, the current study aims to outline the profile of dysbiotic disorders in three cancer patients (with endometrial cancer, breast cancer and acute myeloid leukemia), all in a phase before chemotherapy. Venous blood samples from the patients and from one control healthy person, were microbiologically studied. The used novel methodology of blood microbiota assessment was based on the following phases: isolation of L-forms, development and propagation, cultivation and conversion of L-forms into classical bacteria and fungi, as well as their identification with MALDI-TOF method. From the patients were isolated L-forms of opportunistic bacteria (Enterococcus faecalis, Esherichia coli, Enterobacter cloacae and Pseudomonas oryzihabitans) and fungi such as Rhodotorula mucilaginosa, Aspergillus fumigatus and Mucorales. In conclusion, the common feature found for the three cancer patients was the isolation from the blood of highly associated communities consisting of morphologically indistinguishable L-bodies, which through reversion in broth, were identified as distinct bacterial and fungal species. Unlike classic bacteria or fungi causing sepsis and bacteremia/fungemia, the presence of L-forms in blood is hidden, it does not demonstrate clinical signs nor it can be detected by conventional methods. It should be noted, however, that the dysbiotic blood microbiota shows unique and individual characteristics for the concrete cancer patient, correlates to the common state of the organism and tumor localization in the body, as well as it outlines the cancer promoting role of L-forms in processes of malignization, cancer genesis and progression.

Therapeutic effect and apoptosis mechanism of lung-tonifying and expectorant decoction on lung cancer rats with Qi deficiency and blood stasis

Objective:To explore the effect and specific mechanism of lung-tonifying and expectorant decoction on lung cancer rats with Qi deficiency and blood stasis,and aim to provide a new idea on treating the disease with traditional Chinese medicine based on syndrome differentiation.Methods:A total of 60 C57BL/6J male rats were included in the study.The model of Qi deficiency and blood stasis was established in 60 rats by using multiple-factor stimulation.About 10 rats were randomly taken to verify whether the model establishment was successful and the rest of 50 rats were divided into 5 groups with 10 rats each:blank control group,cisplatin group,low dose group,medium dose group and high dose group.The blank control group was treated with normal saline,and cisplatin group was treated with cisplatin while the other three groups were treated with lung-tonifying and expectorant decoction at different doses.The volume change in transplanted tumor,tumor inhibition rate,apoptosis rate,and expression of Bc1-2,Bax.cleaved caspase-3 and cleaved caspase-9 in 5 groups were compared.Results:The rapidest growth rate of transplanted tumor volume was observed in blank control group and the slowest in cisplatin group.The growth rate was gradually decreased with the increasing dose of lung-tonifying and expectorant decoction,and the difference in growth of tumor volume among groups was statistically significant(P<0.05).The cisplatin group showed the highest tumor inhibition rate,with dose-dependent increase(P<0.05).The apoptosis rate in low dose group was higher than blank control group but lower than high dose group(P<0.05).The apoptosis rate in medium dose group was significantly higher man blank control group(P).05).The apoptosis rate in high dose group was significantly higher than control group(P<0.05).The positive expression rates of Bel-2 and Bax in all groups showed statistically significant difference(P<0.05),while expression of cleaved caspase-3 and cleaved caspase-9 in 5 groups was significantly different,with dose-dependent increase(P<0.05).Conclusions:The lung-tonifying and expectorant decoction inhibits the proliferation of tumor cells by inducing and activating the cell apoptosis in treatment of lung cancer with Qi deficiency and blood stasis,probably with good clinical therapeutic effect.

ABO blood type, long-standing diabetes, and the risk of pancreatic cancer

AIM: To retrospectively study pancreatic cancer patients with respect to their ABO blood type and diabetes. METHODS: Our analysis included a cohort of 1017 patients with pancreatic ductal cancer diagnosed at our hospital in Tokyo. They were divided into two groups: 114 patients with long-standing type 2 diabetes (DM group, defined as diabetes lasting for at least three years before the diagnosis of pancreatic cancer) and 903 patients without diabetes (non-DM group). Multivariate analysis was performed to identify factors that are associated with long-standing diabetes. The DM group was further divided into three subgroups according to the duration of diabetes (3-5 years, 5.1-14.9 years, and 15 years or more) and univariate analyses were performed. RESULTS: Of the 883 pancreatic cancer patients with serologically assessed ABO blood type, 217 (24.6%) had blood type O. Compared with the non-DM group, the DM group had a higher frequency of blood type B [odds ratio (OR) = 2.61, 95%CI: 1.24-5.47; reference group: blood type A]. Moreover, male (OR = 3.17, 95%CI: 1.67-6.06), older than 70 years of age (OR = 2.19, 95%CI: 1.20-3.98) and presence of a family history of diabetes (OR = 6.21, 95%CI: 3.38-11.36) were associated with long-standing type 2 diabetes. The mean ages were 64.8 ± 9.2 years, 67.1 ± 9.8 years, and 71.7 ± 7.0 years in the subgroups with the duration of diabetes, 3-5 years, 5.1-14.9 years, and 15 years or more, respectively (P = 0.007). A comparison of ABO blood type distribution among the subgroups also showed a significant difference (P = 0.03). CONCLUSION: The association of pancreatic cancer with blood type and duration of diabetes needs to be further examined in prospective studies.

Retrospective evaluation of lymphatic and blood vessel invasion and Borrmann types in advanced proximal gastric cancer

BACKGROUND The Borrmann classification system is used to describe the macroscopic appearance of advanced gastric cancer,and Borrmann typeⅣdisease is independently associated with a poor prognosis.AIM To evaluate the prognostic significance of lymphatic and/or blood vessel invasion(LBVI)combined with the Borrmann type in advanced proximal gastric cancer(APGC).METHODS The clinicopathological and survival data of 440 patients with APGC who underwent curative surgery between 2005 and 2012 were retrospectively analyzed.RESULTS In these 440 patients,LBVI+status was associated with Borrmann typeⅣ,low histological grade,large tumor size,and advanced pT and pN status.The 5-year survival rate of LBVI+patients was significantly lower than that of LBVI– patients,although LBVI was not an independent prognostic factor in the multivariate analysis.No significant difference in the prognosis of patients with Borrmann typeⅢ/LBVI+disease and patients with Borrmann typeⅣdisease was observed.Therefore,we proposed a revised Borrmann typeⅣ(r-BorⅣ)as Borrmann typeⅢplus LBVI+,and found that r-BorⅣwas associated with poor prognosis in patients with APGC,which outweighed the prognostic significance of pT status.CONCLUSION LBVI is related to the prognosis of APGC,but is not an independent prognostic factor.LBVI status can be used to differentiate Borrmann typesⅢandⅣ,and the same approach can be used to treat r-BorⅣand Borrmann typeⅣ.

Blood parameters score predicts long-term outcomes in stage Ⅱ-Ⅲ gastric cancer patients

BACKGROUND Increasing numbers of laboratory blood parameters(BPM)have been reported to greatly affect the long-term outcomes of gastric cancer(GC)patients.However,the existing prognostic models do not comprehensively analyze these predictors.AIM To construct a new prognostic tool,based on all the prognostic BPM,to achieve more accurate prognosis prediction for GC.METHODS We retrospectively assessed 850 consecutive patients who underwent curative resection for stage II-III GC from January 2010 to April 2013.The patients were classified into developing(n=567)and validation(n=283)cohorts using computer-generated random numbers.A scoring system,namely BPM score,was then constructed using least absolute shrinkage and selection operator(LASSO)Cox regression model in the developing cohort,and validated in the validation cohort.A nomogram consisting of BPM score and tumor-lymph node-metastasis(TNM)stage was further created.The discrimination and calibration of the nomogram were evaluated via Harrell’s C-statistic and the Hosmer-Lemeshow test.RESULTS Using the LASSO model,we established the BPM score based on five BPM:Albumin,lymphocyte-to-monocyte ratio,neutrophil-to-lymphocyte ratio,carcinoembryonic antigen,and carbohydrate antigen 19-9.The BPM scores were divided into high-and low-BPM groups based on a cut-off value of-0.93.High-BPM patients were significantly older and had more advanced,larger tumors.In the developing cohort,significant differences were found in 5-year overall survival(OS)and 5-year disease-specific survival between the high-BPM and low-BPM patients.Similar results were found in the validation group.Multivariable analysis showed that the BPM score was an independent predictor of OS.High-BPM patients had a poorer 5-year OS for each subgroup.Furthermore,a nomogram that combined the BPM score and TNM stage had significantly better prognostic value compared with TNM stage alone.CONCLUSION The BPM score provides more accurate prognosis prediction in stage Ⅱ-Ⅲ GC patients and is an effective complement to the TNM staging system.

Application of Circulating Tumor Cells in Peripheral Blood in Judging the Prognosis of Patients with Renal Cancer and Related Indexes of Blood Coagulation

Objective: To investigate the value of the number of circulating tumor cells (CTC) in peripheral blood in the prognosis and coagulation-related indicators of patients with renal cancer. Methods: 65 patients with renal cell carcinoma (RCC) confirmed pathologically were divided into CTC positive group and CTC negative group according to the CTC count (5 pcs/3.5 ml). Compare the age, gender, tumor location, TNM (clinical stage), pathological grade, tissue type, lymph node metastasis, distant metastasis, prognosis and prothrombin time (PT), fibrinogen (FIB), partial coagulation of the two groups of patients The correlation between the results of zymogen time (APTT) and D-dimer (DD) and the number of CTC. Results: There were significant differences in TNM, lymph node metastasis, and distant metastasis between the two groups (P < 0.05). The number of CTC in patients was correlated with FIB and D-D levels (P < 0.05). Conclusion: The number of CTC in patients with renal cell carcinoma is correlated with some clinical phenotypes (TNM, lymph node metastasis, distant metastasis) and some coagulation indexes (FIB, D-D), and can jointly predict the prognosis of renal cancer.

Sample preference for colorectal cancer screening tests: Blood or stool?

Objective: Despite the high prevalence of CRC and the proven benefits of faecal sampling tests, participation rates in CRC screening are suboptimal. Literature has identified a number of barriers to participation, including faecal aversion. Emerging test technologies suggest blood-based molecular markers might provide an alternative, more acceptable option, for CRC screening tests. We aim to determine preference for blood compared to faeces as the sample for the screening test. Methods: A survey was mailed to 956 South Australians aged 50 to 74 years. Data were collected on sample preference, demographic variables, and ratings of screening test convenience and comfort. Results: The survey yielded a 43% response rate. The majority of participants preferred to provide a blood sample (78% v 22%, p < 0.001). Women were more likely to prefer blood than men (82% vs 74%, p = 0.05). Sample experience influenced preferences, with a significantly higher preference for faeces among participants with experience in faecal sampling (27% vs 17% with no experience, p < 0.05). Participants who preferred to provide a faecal sample rated it significantly more convenient (p < 0.001), more comfortable (p < 0.001), and more acceptable (p < 0.001) than those who preferred blood sampling. Conclusions: Survey participants overwhelmingly indicate a preference for the idea of a blood sample over a faecal sample for CRC screening. Preference was influenced by gender, experience with sampling method and the individual’s perception of sampling convenience, sampling comfort and sample acceptability. Our results suggest population participation rates are likely to improve with blood-based screening tests.

The Value of Continuous Noninvasive Hemoglobin Monitoring in Intraoperative Blood Transfusion Practice during Abdominal Cancer Surgery

Introduction: Patients undergoing major oncological surgery may suffer from severe bleeding. Sometimes, it is difficult to anesthesiologist to take decision about timing of administration blood products to such patients. The aim of this study is to evaluate the use of continuous noninvasive hemoglobin monitoring as a guide for blood transfusion practice. Methods: One hundred patients undergoing elective abdominal cancer surgeries were randomly allocated into two groups, Group I (n = 50): laboratory Hb was obtained at baseline (immediate preoperative), intraoperative (when to suggest transfusion triggering value) and immediate postoperative. Group II (n = 50): The probe of Masimo for SpHb monitoring was applied immediately after induction of anesthesia at the index finger. Laboratory Hb was obtained at baseline (immediate preoperative), intraoperative (when to suggest transfusion triggering value) and immediate postoperative. Results: A number of transfused units of RBC were significantly lower in SpHb group than in control group (p value 0.05). Conclusion: SpHb monitoring had clinically acceptable absolute and trend accuracy. SpHb monitoring altered transfusion decision making and resulted in decreased RBC utilization and decreased RBC costs while facilitating earlier transfusions when indicated.

Altered Levels of Blood Glucose and Serum Lipids in Sudanese Patients with Ovarian Cancer

Background: The etiology of ovarian cancer is not well-understood;numerous metabolomics profiling, epidemiological, and hospital-based case control studies have associated abnormal levels of blood glucose and serum lipids with the risk and the prognosis of various types of cancers including ovarian cancer. The association between the risk of the incidence of ovarian cancer and the alterations in the levels of blood glucose and serum lipids is not well defined. Objective: In this study we aimed to compare the levels of blood glucose, triacylglycerols, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol in patients with different stages of ovarian cancer and healthy controls to determine how they relate to the risk and prognosis of ovarian cancer. Methodology: In a case-control cross sectional study, we enrolled ninety-nine Sudanese women, diagnosed with ovarian cancer but had not received any kind of treatment as the study group, and a control group of forty-one age-matched, apparently healthy women. The patients were classified according to the International Federation of Obstetricians and Gynecologists staging system into two groups: early stages (stage I & II) and late stages (stages III & IV). Blood glucose and serum lipids;triacylglycerols, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol were determined by enzymatic colorimetric methods using commercially available analytical kits. The IBM SPSS version 20 software was used for statistical analysis. A Mann-Whitney U test was used for comparison of the median concentrations of blood glucose, triacylglycerols, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol in the study groups. Logistic regression model was used to estimate the relative risk of ovarian cancer in relation to levels of blood glucose and serum lipids. P value of 0.05 was considered significant. Results: Our data indicated significantly higher levels of blood glucose (p < 0.001), triacylglycerols (p = 0.002), and low-density lipoprotein cholesterol (p < 0.001), and lower levels of high-density lipoprotein cholesterol (p = 0.023), in ovarian cancer patients compared to the control subjects. No significant difference was found in the levels of blood glucose or any of the serum lipids between patients in the early stages (stage I & II) and those in late stages (stage III & IV) of ovarian cancer. The logistic regression analysis indicated significant association between the elevated levels of the blood glucose, triacylglycerols and low-density lipoprotein cholesterol and the risk of the ovarian cancer. Conclusion: We conclude that the levels of blood glucose, triacylglycerols, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol differ significantly between ovarian cancer patients and the healthy control subjects. The risk of ovarian cancer was positively associated with the levels of blood glucose, triacylglycerols and low-density lipoprotein cholesterol, and negatively associated with levels of high-density lipoprotein cholesterol. Therefore, determination of blood glucose and serum lipids, particularly, triacylglycerols, low-density lipoprotein cholesterol may be helpful as diagnostic indicators of ovarian cancer (OC).

EXPRESSION OF IL-2R ON PERIPHERAL BLOOD LYMPHOCYTES OF PATIENTS WITH COLORECTAL CANCER AND ITS CLINICAL SIGNIFICANCE

Objective: To study expression of membrane receptors of interleukin-2 (CD25) on the peripheral blood lymphocytes (PBL) of patients with colorectal cancer and its clinical significance. Methods: CD25 percentages (CD25%) in PBL of 105 colorectal cancer patients before operation and 100 normal individuals were examined by flow cytometer, and the results were clinically and pathologically analyzed. Results: The mean of CD25% in PBL of the normal individuals was 17.24±5.33, it was significantly lower (P<0.01) than that of the colon cancer patients (21.29±7.95) or rectal cancer patients (21.62±6.11). In contrast to the normal individuals, the means of CD25% in PBL in ulcer type (20.53±6.50) or protruded type (21.56±6.16) colorectal cancer patients were notably elevated (P<0.01). The significant difference (P<0.01) of means of CD25% in PBL was observed between the normal individuals and patients with less than 4 cm mass (22.10±5.43) or 4cm–8cm mass (20.90±6.96). The significant difference (P<0.05) of means of CD25% in PBL was also observed between the normal individuals and patients with greater than 8 cm mass (21.56±5.41). The mean of CD25% in PBL in patients with well differentiation colorectal cancer was 22.20±5.50, it was significantly higher than that in normal individuals (P<0.05). The means of CD25% in PBL in patients with middle or poor differentiation colorectal cancer were 21.30±6.89 and 22.15±5.71 respectively, they were obviously higher than that in normal individuals (P<0.01). The significant difference (P<0.01) of means of CD25% in PBL was present between the colorectal cancer patients without metastatic lymph nodes (22.06±6.90) and normal individuals. The significant difference (P<0.05) of means of CD25% in PBL was present between the colorectal cancer patients with metastatic lymph nodes (20.73±6.40) and normal individuals. The means of CD25% in PBL in colorectal cancer patients in various clinic stages were significantly higher than that in the health subjects (P<0.01). The significant difference (P<0.01) of means of CD25% in PBL was present between the patients whose ages were equal to or less than 60 (21.00±5.76) and normal individuals in the same age group. The significant difference (P<0.05) of means of CD25% in PBL was also present between the patients whose ages were greater than 60 (22.54±7.75) and normal individuals in the same age group. The significant difference (P<0.01) of means of CD25% in PBL was present between the male patients (22.55±7.05) and normal men. The significant difference (P<0.05) of means of CD25% in PBL was also present between the female patients (20.09±5.48) and normal women. Conclusion: The mean of CD25% in PBL of colorectal cancer patients was significantly higher than that in health subjects. Abnormally elevated CD25% were correlative with site of tumor growth, macropathology type of tumor, the degree of tumor differentiation, clinical stage and patient’s age and sex. It may be helpful to detect CD25% in PBL of colorectal cancer patients before operation for diagnosis, immune treatment and judging prognosis.