Impact of comorbid anxiety and depression on quality of life and cellular immunity changes in patients with digestive tract cancers

AIM:A study was performed to investigate the impact of comorbid anxiety and depression (CAD) on quality of life (QOL) and cellular immunity changes in patients with digestive tract cancers. METHODS: One hundred and fifty-six cases of both sexes with cancers of the digestive tract admitted between March 2001 and February 2004 in the Department of Medical Oncology, First Affiliated Hospital of Xi'an Jiaotong University were randomly enrolled in the study. Depressive and anxiety disorder diagnoses were assessed by using the Structured Clinical Interview for DSM-IV. All adult patients were evaluated with the Hamilton depressive scale (HAMD, the 24-item version), the Hamilton anxiety scale (HAMA, a modified 14-item version), quality of life questionnaire-core 30 (QLQ-C30), social support rating scale (SSRS), simple coping style questionnaire (SCSQ), and other questionnaires, respectively. In terms of HAMD ≥ 20 and HAMA ≥ 14, the patients were categorized, including CAD (n = 31) in group A, anxiety disorder (n = 23) in group B, depressive disorder (n = 37) in group C, and non-disorder (n = 65) in group D. Immunological parameters such as T-lymphocyte subsets and natural killer (NK) cell activities in peripheral blood were determined and compared among the four groups. RESULTS: The incidence of CAD was 21.15% in patients with digestive tract cancers. The average scores of social support was 43.67±7.05 for 156 cases, active coping 20.34±7.33, and passive coping 9.55±5.51. Compared with group D, subjective support was enhanced slightly in group A, but social support, objective support, and utilization of support reduced, especially utilization of support with significance (6.16 vs7.80, P<0.05); total scores of active coping decreased, while passive coping reversed; granulocytes proliferated, monocytes declined, and lymphocytes declined significantly (32.87 vs 34.00, P<0.05); moreover, the percentage of CD3, CD4, CD8 and CD56 in T lymphocyte subsets was in lower level, respectively, and CD56 showed a significant decline in group A (26.02 vs 32.20, P<0.05), however, CD4/CD8 ratio increased. Physical function, role function, fatigue, sleeplessness and constipation had significant changes among different groups by one-way ANOVA, and group A was in poor QOL. It revealed that global health-related quality of life (QL) were positively correlated with active coping and CD56; CAD was negatively correlated with QL, active coping and CD56. Furthermore, the step-wise regression analysis suggested that utilization of support, CD56, active coping, fatigue, sleeplessness and depression were significant factors contributing to QOL. CONCLUSION: CAD, which can impair QOL and cellular immunity, occurs with a higher incidence in patients with digestive tract cancers. Hence, it is essential to improve mental health for them with specifically tailored interventions.

Prognostic Value of Sox2 Expression in Digestive Tract Cancers: A Meta-analysis

The aim of the present study was to accurately evaluate the association of Sox2 expression with the survival of patients with digestive tract cancers. Relevant literatures were identified by comprehensively searching databases including the Pubmed, Embase, CBMdisc, and Wanfang（up to October 2014）. A meta-analysis was performed to clarify the association between Sox2 expression and overall survival or clinicopathological parameters of patients with digestive tract cancers（esophageal, gastric, and colorectal cancers）. The results showed a significant association between high Sox2 expression and poor overall survival in patients with digestive tract carcinomas（HR=1.55, 95% CI=1.04–2.31）, especially for patients with esophageal cancer（HR=2.04, 95%CI=1.30–3.22）, colorectal cancer（HR=1.40, 95% CI=1.04–1.89）, and digestive tract adenocarcinoma（HR=1.80, 95% CI=1.12–2.89）, for Europeans（HR=1.98, 95% CI=1.44–2.71） or patients who did not receive neoadjuvant treatment（HR=1.73, 95% CI=1.10–2.72）. Furthermore, Sox2 over-expression was highly correlated with vascular invasion（OR=1.86, 95% CI=1.25–2.77） and poor differentiation（OR=1.88, 95% CI=1.14–3.08）, especially in esophageal and colorectal cancers. In conclusion, Sox2 expression may serve as a novel prognostic factor for patients with digestive tract cancers. Over-expression of Sox2 that is correlated with vascular invasion and poor differentiation suggests poor outcomes of patients with digestive tract cancers.

Tumor circulome in the liquid biopsies for digestive tract cancer diagnosis and prognosis

Digestive tract cancer is one of the main diseases that endanger human health.At present,the early diagnosis of digestive tract tumors mainly depends on serology,imaging,endoscopy,and so on.Although tissue specimens are the gold standard for cancer diagnosis,with the rapid development of precision medicine in cancer,the demand for dynamic monitoring of tumor molecular characteristics has increased.Liquid biopsy involves the collection of body fluids via noninvasive approaches,and analyzes biological markers such as circulating tumor cells,circulating tumor DNA,circulating cell-free DNA,microRNAs,and exosomes.In recent years,liquid biopsy has become more and more important in the diagnosis and prognosis of cancer in clinical practice due to its convenience,non-invasiveness,high specificity and it overcomes temporal-spatial heterogeneity.Therefore,this review summarizes the current evidence on liquid biopsies in digestive tract cancers in relation to diagnosis and prognosis.

RELATIONSHIP BETWEEN DRINKING WATER,VEGETABLES AND CANCER DEATH IN THE HIGH INCIDENCE AREA OF DIGESTIVE TRACT CANCER

The Paper analyzed of investigation datas on thedeath causes of digestive tract cancer in high-incidencearea between 70s and 80s. The results showed that thecancer-adjusted mortalities were 224.14/100000 and226.66/100000: it was 7 times as high as low-incidence(31.19/100000 and 29.82/100000). In 70s, the cancer deathof esophagus, stomach and liver (87.41/100000,73.93/100000 and 8.59/100000) were 28 times, 10 timesand 4 times as high as low-incidence area (3.70/100000,10.57/100000 and 1.94/100000), respectively (P<0.001). In80s, the cancer death of esophagus, stomach and liver(68.26/100000, 109.39/100000 and 23.89/100000) were 17times, 10 times and 4 times as high as low-incidence area(4.54/100000, 10.84/100000 and 6.35/100000), respectively(P<0.001). In high-incidence area, the cancer death ofesophagus was lower, of stomach and liver were higherin 80s than 70s, respectively (P<0.01)- The result alsoshowed that the nitrate content of drinking water andvegetables were 21.45mg/1 and 1185.27mg/kg in high-incidence area; it were significant higher than that in low-incidence area (2.14mg/1 and 41.6omg/kg), the nitritecontent (0.01mg/l) of drinking water in high-incidencearea was significant higher than that in low-incidencearea (0.004mg/l), but the nitrite content among vegetableswas no significant difference between the two regions(N0.05). Our results suggest that the nitrate and nitritecontents increase in drinking water and vegetables maybe an important risk factor of upper alimentary cancer inhigh-incidence area.

A study of the clinical characteristics in patients with digestive tract cancer related cognitive impairment

Objective:The aims of this study was to explore the clinical characteristics of patients with digestive tract cancer-related cognitive impairment(CRCI),and provide reference for the comprehensive clinical understanding,early prevention and treatment.Methods:164 patients with digestive tract cancer were divided into CRCI group and non-CRCI impairment group based on the Montreal Cognitive Assessment Scale(MOCA)and the Minimal Mental State Scale(MMSE).Baseline features,blood biochemical indexes,anxiety and depression were compared.Statistical analysis were carried out by SPSS software(version 20.0).Results:Among all the patients with CRCI,males were more common.Also,there were statistically differences in marital status,liver metastasis,hypertension,ferritin(FER),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C),NK cells,anxiety and depression(P<0.05).Conclusion:Part of patients with digestive tract cancer have varied degrees of cognitive dysfunction.Marital status,hypertension,immune function,liver metastasis and serum lipid metabolism were the risk factors for patients with digestive tract CRCI.Early identification of CRCI is of great significance to ensure the integrity of treatment,improve the quality of life and prognosis for patients with digestive tract CRCI.

Immunomodulatory and chemopreventive effects of resveratrol on the digestive system cancers

Resveratrol(RSV),the primary polyphenol found in grapes,has been revealed to have anti-inflammatory properties by reducing the capacity of the peripheral blood mononuclear cells to produce pro-inflammatory cytokines,including IL-1β,IL-6,IL-1ra and TNFα.Considering the close association between chronic inflammation and cancer development,RSV’s immunomodulatory properties are one way by which the polyphenol may inhibit cancer initiation,proliferation,neovascularization,and migration.Resveratrol influences the generation of microtumor environment which is one of the key factors in cancer progress.In addition to immunomodulation,RSV inhibits cancer development by expressing anti-oxidant effects,causing cell cycle arrest,stimulating the function of certain enzymes,and activating cell signaling pathways.The end outcome is one of the various forms of cell death,including apoptosis,pyroptosis,necroptosis,and more,as it has been observed in vitro.RSV has been shown to act against cancer in practically every organ,while its effects on colon cancer have been documented more frequently.It is remarkable that longer-term clinical studies that may have established the potential for this natural substance to serve as a therapeutic adjuvant to traditional anti-cancer medications were not prompted by the encouraging outcomes seen with cancer cells treated with non-toxic doses of resveratrol.The current review aims to assess the recent findings about the immunological and anti-cancer characteristics of RSV,with a particular emphasis on cancers of the digestive tract,as a challenge for future clinical research that may contribute to the better prognosis of cancer.

Double Primary Cancers in Extragastric Sites with Gastric Cancer: Report of Six Cases and Literature Review

OBJECTIVE To explore the clinical features, pathologiccharacteristics and prognosis of double primary malignant tumorswith involvement of the stomach and an extragastric site.METHODS We reviewed the records of 496 patients whounderwent surgery for gastric cancer in our department fromJanuary 2004 to December 2006. Synchronous double primarycancer was defined as an extragastric cancer diagnosed within a6-month interval before the detection of gastric cancer; any gastriccancer metastasis to other areas of the body was excluded.RESULTS Synchronous and metachronous double primarycancers were identified in 1 and in 5 patients, respectively. Theextragastric sites of the primary tumors in patients with gastriccancer were esophagus in 1 case, right colon in 1, rectum in 1,breast in 2 and lung in 1. Following gastric surgery, 5 patientsdied (within 2 mon, 24 mon, 30 mon, 48 mon and 60 mon). Only 1patient has survived and remains disease free.CONCLUSION The prognosis of patients with gastric cancerand a second primary is relatively poor. It is necessary to performregular esophagogastroduodenoscopy (EGD) on patients whohave been diagnosed with extragastric cancer, regardless of theirsymptoms.