Survival Analysis Using Cox Proportional Hazards Regression for Pile Bridge Piles Under Wet Service Conditions

This paper studies the deterioration of bridge substructures utilizing the Long-Term Bridge Performance(LTBP)Program InfoBridge^(TM)and develops a survival model using Cox proportional hazards regression.The survival anal­ysis is based on the National Bridge Inventory(NBI)dataset.The study calculates the survival rate of reinforced and prestressed concrete piles on bridges under marine conditions over a 29-year span(from 1992 to 2020).The state of Maryland is the primary focus of this study,with data from three neighboring regions,the District of Columbia,Vir­ginia,and Delaware to expand the sample size.The data obtained from the National Bridge Inventory are condensed and filtered to acquire the most relevant information for model development.The Cox proportional hazards regres­sion is applied to the condensed NBI data with six parameters:Age,ADT,ADTT,number of spans,span length,and structural length.Two survival models are generated for the bridge substructures:Reinforced and prestressed concrete piles in Maryland and reinforced and prestressed concrete piles in wet service conditions in the District of Columbia,Maryland,Delaware,and Virginia.Results from the Cox proportional hazards regression are used to construct Markov chains to demonstrate the sequence of the deterioration of bridge substructures.The Markov chains can be used as a tool to assist in the prediction and decision-making for repair,rehabilitation,and replacement of bridge piles.Based on the numerical model,the Pile Assessment Matrix Program(PAM)is developed to facilitate the assessment and main­tenance of current bridge structures.The program integrates the NBI database with the inspection and research reports from various states’department of transportation,to serve as a tool for condition state simulation based on mainte­nance or rehabilitation strategies.

Factors Predicting Progression to Severe COVID-19: A Competing Risk Survival Analysis of 1753 Patients in Community Isolation in Wuhan, China

Most studies of coronavirus disease 2019(COVID-19)progression have focused on the transfer of patients within secondary or tertiary care hospitals from regular wards to intensive care units.Little is known about the risk factors predicting the progression to severe COVID-19 among patients in community iso-lation,who are either asymptomatic or suffer from only mild to moderate symptoms.Using a multivari-able competing risk survival analysis,we identify several important predictors of progression to severe COVID-19—rather than to recovery—among patients in the largest community isolation center in Wuhan,China from 6 February 2020(when the center opened)to 9 March 2020(when it closed).All patients in community isolation in Wuhan were either asymptomatic or suffered from mild to moderate COVID-19 symptoms.We performed competing risk survival analysis on time-to-event data from a cohort study of all COVID-19 patients(n=1753)in the isolation center.The potential predictors we inves-tigated were the routine patient data collected upon admission to the isolation center:age,sex,respira-tory symptoms,gastrointestinal symptoms,general symptoms,and computed tomography(CT)scan signs.The main outcomes were time to severe COVID-19 or recovery.The factors predicting progression to severe COVID-19 were:male sex(hazard ratio(HR)=1.29,95%confidence interval(CI)1.04–1.58,p=0.018),young and old age,dyspnea(HR=1.58,95%CI 1.24–2.01,p<0.001),and CT signs of ground-glass opacity(HR=1.39,95%CI 1.04–1.86,p=0.024)and infiltrating shadows(HR=1.84,95%CI 1.22–2.78,p=0.004).The risk of progression was found to be lower among patients with nausea or vomiting(HR=0.53,95%CI 0.30–0.96,p=0.036)and headaches(HR=0.54,95%CI 0.29–0.99,p=0.046).Our results suggest that several factors that can be easily measured even in resource-poor set-tings(dyspnea,sex,and age)can be used to identify mild COVID-19 patients who are at increased risk of disease progression.Looking for CT signs of ground-glass opacity and infiltrating shadows may be an affordable option to support triage decisions in resource-rich settings.Common and unspecific symptoms(headaches,nausea,and vomiting)are likely to have led to the identification and subsequent community isolation of COVID-19 patients who were relatively unlikely to deteriorate.Future public health and clinical guidelines should build on this evidence to improve the screening,triage,and monitoring of COVID-19 patients who are asymtomatic or suffer from mild to moderate symptoms.

Comment on survival analysis following early surgical success in intermittent exotropia surgery

Dear Editor,W e read the article by Lee et al^([1])with great interest.We would like to congratulate the authors for venturing into this area that assess the consecutive recurrence following early success of intermittent exotropia[X(T)]surgery and to determine the clinical factors that affect the survival.However,we would like to make the following comments.In the present study,it was discussed about the correlation of early postoperative overcorrection with long-term outcomes.It is known that most authors would agree to an early postoperative overcorrection in adult patients with X(T)。

Survival Analysis of Logistics Service Providers: An Empirical Study of Chengdu, Area in China

This paper worked on a sample of 6791 logistics establishments registered in Chengdu, China over the period 1984-2016 to understand the survival status of logistics service providers (LSPs) by non-parametric Kaplan-Meier estimation, together with Cox proportional hazard regression model, to identify factors affecting the failure of LSPs. In particular, it studies the interaction effect between LSPs’ size and entry timing and location. The empirical results show that: 1) Regarding the survival time, 1365 of the 6791 sample LSPs exited from the market by 2017. The exit rate is 20.1%, and the average life of the 6791 LSPs is about 6 years. 2) The survival of LSPs depends on their typology, ownership structure. And there is no significant difference in the probability of survival for both independent LSPs and logistics branches after controlling the effects of other variables. 3) Location and entry timing also play an important role in the survival of small-scale LSPs, but these factors cannot explain large-scale LSPs’ failure.

A New Statistical Modeling Approach for Survival Analysis of Cancer Patients—Multiple Myeloma Cancer

Background: The Cox Proportional Hazard (Cox-PH) model has been a popularly used method for survival analysis of cancer data given the survival times as a function of covariates or risk factors. However, it is very seldom to see the assumptions for the application of the Cox-PH model satisfied in most of the research studies, raising questions about the effectiveness, robustness, and accuracy of the model predicting the proportion of survival times. This is because the necessary assumptions in most cases are difficult to satisfy, as well as the assessment of interaction among covariates. Methods: To further improve the therapeutic/treatment strategy for cancer diseases, we proposed a new approach to survival analysis using multiple myeloma (MM) cancer data. We first developed a data-driven nonlinear statistical model that predicts the survival times with 93% accuracy. We then performed a parametric analysis on the predicted survival times to obtain the survival function which is used in estimating the proportion of survival times. Results: The new proposed approach for survival analysis has proved to be more robust and gives better estimates of the proportion of survival than the Cox-PH model. Also, satisfying the proposed model assumptions and finding interactions among risk factors is less difficult compared to the Cox-PH model. The proposed model can predict the real values of the survival times and the identified risk factors are ranked according to the percent of contribution to the survival time. Conclusion: The new proposed nonlinear statistical model approach for survival analysis of cancer diseases is very efficient and provides an improved and innovative strategy for cancer therapeutic/treatment.

Applications of Dynamic-Equilibrium Continuous Markov Stochastic Processes to Elements of Survival Analysis

In this article, we summarize some results on invariant non-homogeneous and dynamic-equilibrium (DE) continuous Markov stochastic processes. Moreover, we discuss a few examples and consider a new application of DE processes to elements of survival analysis. These elements concern the stochastic quadratic-hazard-rate model, for which our work 1) generalizes the reading of its It? stochastic ordinary differential equation (ISODE) for the hazard-rate-driving independent (HRDI) variables, 2) specifies key properties of the hazard-rate function, and in particular, reveals that the baseline value of the HRDI variables is the expectation of the DE solution of the ISODE, 3) suggests practical settings for obtaining multi-dimensional probability densities necessary for consistent and systematic reconstruction of missing data by Gibbs sampling and 4) further develops the corresponding line of modeling. The resulting advantages are emphasized in connection with the framework of clinical trials of chronic obstructive pulmonary disease (COPD) where we propose the use of an endpoint reflecting the narrowing of airways. This endpoint is based on a fairly compact geometric model that quantifies the course of the obstruction, shows how it is associated with the hazard rate, and clarifies why it is life-threatening. The work also suggests a few directions for future research.

Chinese Medicine Prolongs Overall Survival of Chinese Patients with Advanced Gastric Cancer: Treatment Pattern and Survival Analysis of a 20-Year Real-World Study

Objective To describe the treatment patterns and survival status of advanced gastric cancer(AGC)in China in the past two decades,and objectively evaluate the impact of standardized Chinese medicine(CM)treatment on the survival of AGC patients.Methods This multicenter registry designed and propensity score analysis study described the diagnosis characteristics,treatment-pattern development and survival status of AGC from 10 hospitals in China between January 1,2000 and July 31,2021.Overall survival(OS)was evaluated between non-CM cohort(standard medical treatment)and CM cohort(integrated standard CM treatment≥3 months).Propensity score matching(PSM)and inverse probability of treatment weighting(IPTW)were performed to adjust any difference in average outcomes for bias.Results A total of 2,001 patients histologically confirmed locally advanced and/or metastasis stomach and gastroesophageal junction adenocarcinoma were enrolled.Among them,1,607 received systemic chemotherapy,215(10.74%)accepted molecular targeted therapy,44(2.2%)received checkpoint inhibitor therapy,and 769(38.43%)received CM.Two-drug regimen was the main choice for first-line treatment,with fluoropyrimidine plus platinum as the most common regimen(530 cases,60.09%).While 45.71%(16 cases)of patients with HER2 amplification received trastuzumab in first-line.The application of apatinib increased(33.33%)in third-line.The application of checkpoint inhibitors has increased since 2020.COX analysis showed that Lauren mixed type(P=0.017),cycles of first-line treatment>6(P=0.000),CM(P=0.000),palliative gastrectomy(P=0.000),trastuzumab(P=0.011),and apatinib(P=0.008)were independent prognostic factors for the OS of AGC.After PSM and IPTW,the median OS of CM cohort and non-CM cohort was 18.17 and 12.45 months,respectively(P<0.001).Conclusions In real-world practice for AGC in China,therapy choices consisted with guidelines.Two-drug regimen was the main first-line choice.Standardized CM treatment was an independent prognostic factor and could prolong the OS of Chinese patients with AGC.(Registration No.NCT02781285)

Influence of donor age on liver transplantation outcomes: A multivariate analysis and comparative study

BACKGROUND The growing disparity between the rising demand for liver transplantation(LT)and the limited availability of donor organs has prompted a greater reliance on older liver grafts.Traditionally,utilizing livers from elderly donors has been associated with outcomes inferior to those achieved with grafts from younger donors.By accounting for additional risk factors,we hypothesize that the utili-zation of older liver grafts has a relatively minor impact on both patient survival and graft viability.AIM To evaluate the impact of donor age on LT outcomes using multivariate analysis and comparing young and elderly donor groups.METHODS In the period from April 2013 to December 2018,656 adult liver transplants were performed at the University Hospital Merkur.Several multivariate Cox propor-tional hazards models were developed to independently assess the significance of donor age.Donor age was treated as a continuous variable.The approach involved univariate and multivariate analysis,including variable selection and assessment of interactions and transformations.Additionally,to exemplify the similarity of using young and old donor liver grafts,the group of 87 recipients of elderly donor liver grafts(≥75 years)was compared to a group of 124 recipients of young liver grafts(≤45 years)from the dataset.Survival rates of the two groups were estimated using the Kaplan-Meier method and the log-rank test was used to test the differences between groups.RESULTS Using multivariate Cox analysis,we found no statistical significance in the role of donor age within the constructed models.Even when retained during the entire model development,the donor age's impact on survival remained insignificant and transformations and interactions yielded no substantial effects on survival.Consistent insigni-ficance and low coefficient values suggest that donor age does not impact patient survival in our dataset.Notably,there was no statistical evidence that the five developed models did not adhere to the proportional hazards assumption.When comparing donor age groups,transplantation using elderly grafts showed similar early graft function,similar graft(P=0.92),and patient survival rates(P=0.86),and no significant difference in the incidence of postoperative complications.CONCLUSION Our center's experience indicates that donor age does not play a significant role in patient survival,with elderly livers performing comparably to younger grafts when accounting for other risk factors.

Evaluation by Survival Analysis on Effect of Traditional Chinese Medicine in Treating Children with Respiratory Syncytial Viral Pneumonia of Phlegm-Heat Blocking Fei Syndrome

Objective:To objectively evaluate the clinical effect of traditional Chinese medicine in treating children's respiratory syncytial viral pneumonia(RSVP) of phlegm-heat blocking Fei(肺) syndrome(PHBFS). Methods:A single-blinded multi-center,blocked,randomized and parallel-controlled method was adopted.The clinical study was carried out on 206 children with RSVP-PHBFS who were assigned to two groups,108 in the test group treated through intravenous dripping of Qingkailing Injection(清开灵注射液) in combination of...

Multi-task regression learning for survival analysis via prior information guided transductive matrix completion

Survival analysis aims to predict the occurrence time of a particular event of interest,which is crucial for the prognosis analysis of diseases.Currently,due to the limited study period and potential losing tracks,the observed data inevitably involve some censored instances,and thus brings a unique challenge that distinguishes from the general regression problems.In addition,survival analysis also suffers from other inherent challenges such as the high-dimension and small-sample-size problems.To address these challenges,we propose a novel multi-task regression learning model,i.e.,prior information guided transductive matrix completion(PigTMC)model,to predict the survival status of the new instances.Specifically,we use the multi-label transductive matrix completion framework to leverage the censored instances together with the uncensored instances as the training samples,and simultaneously employ the multi-task transductive feature selection scheme to alleviate the overfitting issue caused by high-dimension and small-sample-size data.In addition,we employ the prior temporal stability of the survival statuses at adjacent time intervals to guide survival analysis.Furthermore,we design an optimization algorithm with guaranteed convergence to solve the proposed PigTMC model.Finally,the extensive experiments performed on the real microarray gene expression datasets demonstrate that our proposed model outperforms the previously widely used competing methods.

Identification of differentially expressed metastatic genes and their signatures to predict the overall survival of uveal melanoma patients by bioinformatics analysis

AIM:To identify metastatic genes and mi RNAs and to investigate the metastatic mechanism of uveal melanoma(UVM).METHODS:GSE27831,GSE39717,and GSE73652 gene expression profiles were downloaded from the Gene Expression Omnibus(GEO)database,and the limma R package was used to identify differentially expressed genes(DEGs).Gene Ontology(GO)term enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis were performed using the DAVID online tool.A comprehensive list of interacting DEGs was constructed using the Search Tool for the Retrieval of Interacting Genes(STRING)database and Cytoscape software.The Cytoscape MCODE plug-in was used to identify clustered sub-networks and modules of hub genes from the proteinprotein interaction network.GEPIA online software was used for survival analysis of UVM patients(n=80)from the The Cancer Genome Atlas(TCGA)cohort.Oncomi R online software was used to find that the mi RNAs were associated with UVM prognosis from the TCGA cohort.Target Scan Human 7.2 software was then used to identify the mi RNAs targeting the genes.RESULTS:There were 1600 up-regulated genes and 1399 down-regulated genes.The up-regulated genes were mainly involved in protein translation in the cytosol,whereas the down-regulated genes were correlated with extracellular matrix organization and cell adhesion in the extracellular space.Among the 2999 DEGs,five genes,Znf391,Mrps11,Htra3,Sulf2,and Smarcd3 were potential predictors of UVM prognosis.Otherwise,three mi RNAs,hsa-mi R-509-3-5 p,hsa-mi R-513 a-5 p,and hsa-mi R-1269 a were associated with UVM prognosis.CONCLUSION:After analyzing the metastasis-related enriched terms and signaling pathways,the up-regulated DEGs are mainly involved in protein synthesis and cell proliferation by ribosome and mitogen-activated protein kinase(MAPK)pathways.However,the down-regulated DEGs are mainly involved in processes that reduced cell-cell adhesion and promoted cell migration in the extracellular matrix through PI3 K-Akt signaling pathway,focal adhesion,and extracellular matrix-receptor interactions.Bioinformatics and interaction analysis may provide new insights on the events leading up to the development and progression of UVM.

An evaluation of treatments and survival rates for pancreatic adenocarcinoma through survival analysis with inverse probability of treatment weighting:a population-based study

Objective:This study conducted inverse probability of treatment weighting(IPTW)survival analysis to examine survival in pancreatic adenocarcinoma patients.Methods:In this population-based study,data from the Surveillance,Epidemiology,and End Results program of the United States were analyzed to identify patients diagnosed with adenocarcinoma of the pancreas 2004 to 2014.Differences in survival rates were examined among patients who underwent pancreatectomy alone,radiotherapy alone,and those who had pancreatectomy plus adjuvant radiotherapy.Kaplan-Meier estimates and Cox proportional hazards models with the IPTW were performed to determine the effect of different treatments on overall and cancer-specific survival.This study was approved by the Ethics Review Board of Weifang Medical University.Results:A total of 8191 patients were included,with 3409 taking pancreatectomy only,2865 taking radiotherapy only,and 1917 taking pancreatectomy plus adjuvant radiotherapy.Patients who received surgery plus adjuvant radiotherapy had statistically a higher survival rate than those who received the other 2 treatments.Survival analysis with the IPTW for the 3 different groups showed that the difference in median overall survival time among these patient groups was significant.Conclusion:Using IPTW survival analysis,the present study shows that surgery with adjuvant radiotherapy is significantly associated with improved overall and cancer-specific survival among patients with pancreatic adenocarcinoma.

Clinical features and prognostic factors in 49 patients with follicular lymphoma at a single center:A retrospective analysis

BACKGROUND Follicular lymphoma(FL)is a type of B-cell lymphoma that originates at the germinal center and has a low malignancy rate.FL has become the most common inert lymphoma in Europe and America but has a relatively low incidence in Asia.AIM To explore the clinical features,curative effects,and prognostic factors of FL.METHODS Completed medical records of 49 patients with FL who were admitted to the Ningbo First Hospital from June 2010 to June 2021 were examined.These patients were definitively diagnosed by pathological biopsy or immunohistochemical staining.The diagnostic criteria were based on the 2008 World Health Organization classification of lymphomas.Ann Arbor staging was performed according to the imaging and bone marrow examination results.Risk stratification of all patients was performed based on the International Prognostic Index(IPI),age-adjusted IPI,Follicular Lymphoma International Prognosis Index(FLIPI),and FLIPI2 to compare the efficacy of different treatment regimens and analyze the related prognostic factors.RESULTS The age of onset in patients ranged from 24 to 76 years,with a median age of 51 years.Most patients developed the disease at 40–59 years of age,and the male:female ratio was 1.6:1.No significant difference was noted in the curative effect between the non-chemotherapy,combined chemotherapy,and other chemotherapy regimens(P>0.05).Hemoglobin(Hb)level<120 g/L,Ki-67 value>50%,bone marrow involvement,and clinical stagesⅢ–IV were associated with a poor prognosis of FL(P<0.05).However,the influence of other indicators was not statistically significant.Risk grouping was performed using the FLIPI,and the results showed that 24.5%,40.8%,and 34.7%of patients were in the low-,moderate-,and high-risk groups,respectively.According to the survival analysis results,the survival rate of patients was lower in the high-risk group than in the other low-risk and moderate-risk groups(P<0.05).CONCLUSION FL mainly occurs in middle-aged and elderly men,primarily affecting lymph nodes and bone marrow.Hb level,Ki-67 value,bone marrow involvement,and clinical staging were used to evaluate prognosis.

Fibrinogen-to-albumin ratio predicts overall survival of hepatocellular carcinoma

BACKGROUND Fibrinogen-to-albumin ratio(FAR)has been found to be of prognostic significance for several types of malignant tumors.However,less is known about the association between FAR and survival outcomes in hepatocellular carcinoma(HCC)patients.AIM To explore the association between FAR and prognosis and survival in patients with HCC.METHODS A total of 366 histologically confirmed HCC patients diagnosed between 2013 and 2018 in a provincial cancer hospital in southwestern China were retrospectively selected.Relevant data were extracted from the hospital information system.The optimal cutoff for baseline serum FAR measured upon disease diagnosis was established using the receiver operating characteristic(ROC)curve.Univariate and multivariate Cox proportional hazards models were used to determine the crude and adjusted associations between FAR and the overall survival(OS)of the HCC patients while controlling for various covariates.The restricted cubic spline(RCS)was applied to estimate the dose-response trend in the FAR-OS association.RESULTS The optimal cutoff value for baseline FAR determined by the ROC was 0.081.Multivariate Cox proportional hazards model revealed that a lower baseline serum FAR level was associated with an adjusted hazard ratio of 2.43(95%confidence interval:1.87–3.15)in the OS of HCC patients,with identifiable dose-response trend in the RCS.Subgroup analysis showed that this FAR-OS association was more prominent in HCC patients with a lower baseline serum aspartate aminotransferase or carbohydrate antigen 125 level.CONCLUSION Serum FAR is a prominent prognostic indicator for HCC.Intervention measures aimed at reducing FAR might result in survival benefit for HCC patients.

Correction:Propensity-matched analysis of patients with intrahepatic cholangiocarcinoma or mixed hepatocellularcholangiocarcinoma and hepatocellular carcinoma undergoing a liver transplant

Rereading the article“Propensity-matched analysis of patients with intrahepatic cholangiocarcinoma or mixed hepatocellular-cholangiocarcinoma and hepatocellular carcinoma undergoing a liver transplant”(DOI:10.5306/wjco.v13.i8.688),published on August 24,we observe,with concern,that figures 3 and 4 are wrong.The authors have attached the correct figures for correction.

Bioinformatics analysis of key genes associated with the prognosis of breast cancer

Objective:We sought to identify potential therapeutic targets for breast cancer patients by employing a bioinformatics analysis to screen for genes linked with an unfavorable prognosis.Methods:The Gene Expression Omnibus(GEO)database was utilized to obtain three gene expression profile datasets,namely GSE42568,GSE86374,and GSE71053.To identify differentially expressed genes(DEGs),the GEO2R online tool was employed.Subsequently,a func-tional enrichment analysis was conducted.Moreover,a protein-protein interaction network was established using STRING,and DEGs were subjected to module analysis via Cytoscape software to identify pivotal genes.Additionally,the selected pivotal genes underwent further ex-amination and validation utilizing three databases:GEPIA,UALCAN,and Kaplan-Meier Plotter.Results:A total of 121 DEGs were detected,comprising 74 genes with increased expression and 47 genes with decreased expression.Ten key genes were identified:HMMR,RRM2,CDK1,TOP2A,AURKA,CCNB1,MAD2L1,KIF2C,BUB1B,UBE2C.Validation in the GEPIA database revealed high expression levels for all key genes except CDK1.A survival analysis conducted using the Kaplan-Meier Plotter database revealed noteworthy associations between nine crucial genes and the overall survival(OS)of individuals diagnosed with breast cancer.Moreover,these nine key genes exhibited significantly increased expression across different molecular subtypes of breast cancer according to the UALCAN data platform.Conclusions:We identified nine crucial genes significantly linked to the onset,progression,and unfavorable prognosis of breast cancer,providing potential targets for novel treatment options and biomarkers to predict patient outcomes.

Clinical analysis of recipients with survival over ten years after cardiac transplantation:a report of 13 cases

Objective To retrospectively analyze clinical management and follow - up of 13 recipients with survival over ten years after cardiac transplantation. Methods Thirteen male recipients underwent orthotopic heart transplantation between August 1995 and June 2001 in our center and received standard immunosuppressive

Association of tumor budding with clinicopathological features and prognostic value in stage III-IV colorectal cancer

BACKGROUND Tumor budding(TB)has emerged as a promising independent prognostic biomarker in colorectal cancer(CRC).The prognostic role of TB has been extensively studied and currently affects clinical decision making in patients with stage I and II CRC.However,existing prognostic studies on TB in stage III CRC have been confined to small retrospective cohort studies.Consequently,this study investigated the correlation among TB categories,clinicopathological features,and prognosis in stage III-IV CRC to further enhance the precision and individualization of treatment through refined prognostic risk stratification.AIM To analyze the relationship between TB categories and clinicopathological characteristics and assess their prognostic value in stage III-IV CRC to further refine the prognostic risk stratification of stage III-IV CRC.METHODS The clinical data of 547 CRC patients were collected for this retrospective study.Infiltration at the front edge of the tumor buds was counted according to the 2016 International Tumor Budding Consensus Conference guidelines.RESULTS Multivariate Cox proportional hazards regression analysis demonstrated that chemotherapy(P=0.004),clinical stage IV(P<0.001),≥4 regional lymph node metastases(P=0.004),left-sided colonic cancer(P=0.040),and Bd 2-3(P=0.002)were independent prognostic factors in patients with stage III-IV CRC.Moreover,the density of tumor infiltrating lymphocytes was higher in Bd 1 than in Bd 2-3,both in the tumor stroma and its invasive margin.CONCLUSION TB has an independent predictive prognostic value in patients with stage III-IV CRC.It is recommended to complete the TB report of stage III-IV CRC cases in the standardized pathological report to further refine risk stratification.

Nomogram model including LATS2 expression was constructed to predict the prognosis of advanced gastric cancer after surgery

BACKGROUND Gastric cancer is a leading cause of cancer-related deaths worldwide.Prognostic assessments are typically based on the tumor-node-metastasis(TNM)staging system,which does not account for the molecular heterogeneity of this disease.LATS2,a tumor suppressor gene involved in the Hippo signaling pathway,has been identified as a potential prognostic biomarker in gastric cancer.AIM To construct and validate a nomogram model that includes LATS2 expression to predict the survival prognosis of advanced gastric cancer patients following ra-dical surgery,and compare its predictive performance with traditional TNM staging.METHODS A retrospective analysis of 245 advanced gastric cancer patients from the Fourth Hospital of Hebei Medical University was conducted.The patients were divided into a training group(171 patients)and a validation group(74 patients)to deve-lop and test our prognostic model.The performance of the model was determined using C-indices,receiver operating characteristic curves,calibration plots,and decision curves.RESULTS The model demonstrated a high predictive accuracy with C-indices of 0.829 in the training set and 0.862 in the validation set.Area under the curve values for three-year and five-year survival prediction were significantly robust,suggesting an excellent discrimination ability.Calibration plots confirmed the high concordance between the predictions and actual survival outcomes.CONCLUSION We developed a nomogram model incorporating LATS2 expression,which significantly outperformed conven-tional TNM staging in predicting the prognosis of advanced gastric cancer patients postsurgery.This model may serve as a valuable tool for individualized patient management,allowing for more accurate stratification and im-proved clinical outcomes.Further validation in larger patient cohorts will be necessary to establish its generaliza-bility and clinical utility.

STAT-3 correlates with lymph node metastasis and cell survival in gastric cancer

AIM:To investigate the correlation between gastric cancer growth and signal transducer and activator of transcription-3(STAT3) expression.METHODS:We assessed the expressions of STAT3,phosphor-STAT3(pSTAT3),suppressor of cytokine signaling-1(SOCS-1),survivin and Bcl-2 in gastric cancer patients after gastrectomy by immunohistochemical method.In addition,in situ hybridization was used to further demonstrate the mRNA expression of STAT3 in gastric cancer.RESULTS:With the univariate analysis,expressions of STAT3,pSTAT3,SOCS-1,survivin and Bcl-2,the size of primary tumor and the lymph node metastasis were found to be associated with the overall survival(OS) of gastric cancer patients.However,only pSTAT3 expression and the lymph node metastasis were identified as the independent factors of OS of gastric cancer with multivariate analysis.STAT3 expression was correlated with the lymph node metastasis.There were positive correlations between expressions of STAT3,survivin,Bcl-2 and pSTAT3 in gastric cancer,whereas there was negative correlation between STAT3 expression and SOCS-1 expression in gastric cancer.CONCLUSION:STAT3 can transform into pSTAT3 to promote the survival and inhibit the apoptosis of gastric cancer cells.SOCS-1 might be the valid molecular antagonist to inhibit the STAT3 expression in gastric cancer.