The impact of chemotherapy-naïve open radical cystectomy delay and perioperative transfusion on the recurrence-free survival: A perioperative parameters-based nomogram

Objective: To develop and internally validate a nomogram to predict recurrence-free survival (RFS) including the time to radical cystectomy (RC) and perioperative blood transfusion (PBT) as potential predictors.Methods: Patients who underwent open RC and ileal conduit between January 1996 to December 2016 were split into developing (n=948) and validating (n=237) cohorts. The time to radical cystectomy (TTC) was defined as the interval between the onset of symptoms and RC. The regression coefficients of the independent predictors obtained by Cox regression were used to construct the nomogram. Discrimination, validation, and clinical usefulness in the validation cohort were assessed by the area under the curve, the calibration plot, and decision curve analysis.Results: In the developing dataset, the 1-, 5-, and 10-year RFS were 83.0%, 47.2%, and 44.4%, respectively. On multivariate analysis, independent predictors were TTC (hazards ratio [HR] 1.07, 95% confidence interval [CI] 1.05-1.08, p<0.001), PBT (one unit: HR 1.40, 95% CI 1.03-1.90, p=0.03;two or more units: HR 1.72, 95% CI 1.29-2.29, p<0.001), bilateral hydronephrosis (HR 1.54, 95% CI 1.21-1.97, p<0.001), squamous cell carcinoma (HR 0.60, 95% CI 0.45-0.81, p=0.001), pT3-T4 (HR 1.77, 95% CI 1.41-2.22, p<0.001), lymph node status (HR 1.53, 95% CI 1.21-1.95, p<0.001), and lymphovascular invasion (HR 1.28, 95% CI 1.01-1.62, p=0.044). The areas under the curve in the validation dataset were 79.3%, 69.6%, and 76.2%, for 1-, 5-, and 10-year RFS, respectively. Calibration plots showed considerable correspondence between predicted and actual survival probabilities. The decision curve analysis revealed a better net benefit of the nomogram.Conclusion: A nomogram with good discrimination, validation, and clinical utility was constructed utilizing TTC and PBT in addition to standard pathological criteria.

Comparison of Semi-Parametric Shared Frailty Models for Bees’Survival

Survival analysis is a fundamental tool in medical science for time-to-event data. However, its application to colony organisms like bees poses challenges due to their social nature. Traditional survival models may not accurately capture the interdependence among individuals within a colony. Frailty models, accounting for shared risks within groups, offer a promising alternative. This study evaluates the performance of semi-parametric shared frailty models (gamma, inverse normal, and positive stable-in comparison to the traditional Cox model using bees’ survival data). We examined the effect of misspecification of the frailty distribution on regression and heterogeneity parameters using simulation and concluded that the heterogeneity parameter was more sensitive to misspecification of the frailty distribution and choice of initial parameters (cluster size and true heterogeneity parameter) compared to the regression parameter. From the data, parameter estimates for covariates were close for the four models but slightly higher for the Cox model. The shared gamma frailty model provided a better fit to the data in comparison with the other models. Therefore, when focusing on regression parameters, the gamma frailty model is recommended. This research underscores the importance of tailored survival methodologies for accurately analyzing time-to-event data in social organisms.

Post-radiation survival time in hepatocellular carcinoma based on predictors for CT-determined, transarterial embolization and various other parameters

AIM: In this retrospective study of unresectable hepatocellular carcinoma (HCC), we have investigated the efficacy of CT-derived parameters, laboratory measurements, clinical assessment and associated transarterial embolization (TAE) as predictors of post-radiotherapy survival time. METHODS: Sixty-six patients diagnosed with unresectable HCC that had undergone radiotherapy at two medical university hospitals in Taipei were enrolled in the study. Using multivariant analysis, pre-treatment parameters including tumor number and CT confirmation of PVT and ascites were compared. Multivariant analysis was also used for comparison of the mean pretreatment values for laboratory measurements, including alpha-fetoprotein, direct/total bilirubin and GOT/GPT levels, and clinical history of chronic hepatitis across the three survival-time categories. The x2 was used to test the significance of the relationship between survival time and TAE procedure. The P values for the above tests were deemed statistically significant where P<0.05. RESULTS: Portal vein thrombosis (P= 0.032) and ascites (P><0.05) were negative predictors of post-radiation survival time. Low-grade liver cirrhosis (A or B), lower tumor volume and low levels of AFT, GOT/GPT, and total bilirubin were predictors of longer post-radiation survival time (P<0.05). CONCLUSION: The CT and clinical and laboratory assessment provide a reference for, and enable estimation of, probable survival times in HCC patients after radiotherapy. Tumor volume, severity of liver cirrhosis, status with respect to portal vein thrombosis and ascites and AFT, GOT/GPT and total bilirubin values were significant predictors of survival in this study.

Is there an optimal time to initiate adjuvant chemotherapy to predict benefit of survival in non-small cell lung cancer?

Objective: Adjuvant chemotherapy (AC) after curative resection is known to improve the survival of patients with non-small cell lung cancer (NSCLC); however, few studies have reported the correlation between the time to initiation of AC (TTAC) and survival in NSCLC patients. Methods: The clinical data of 925 NSCLC patients who received curative resection and post-operative AC at the Cancer Hospital of Chinese Academy of Medical Sciences between 2003 and 2013 were retrospectively analyzed. TTAC was measured from the date of surgery to the initiation of AC. Disease-free survival (DFS) was defined as the duration from surgery to the time of tumor recurrence or last follow-up evaluation. The optimal cut-off value of TTAC was determined by maximally selected log-rank statistics. The DFS curve was estimated using the Kaplan-Meier method, and the Cox proportional hazards regression model was used to identify risk factors independently associated with DFS. Propensity score matching (PSM) was performed for survival analysis using the match data. Results: The optimal discriminating cut-off value of TTAC was set at d 35 after curative resection based on which the patients were assigned into two groups: group A (<= 35 d) and group B (> 35 d). There was no significant difference in the DFS between the two groups (P=0.246), indicating that the TTAC is not an independent prognostic factor for DFS. A further comparison continued to show no significant difference in the DFS among 258 PSM pairs (P=0.283). Conclusions: There was no significant correlation between the TTAC and DFS in NSCLC patients. Studies with larger samples are needed to further verify this conclusion.

The relationship between level of plasma D-dimer and survival time in metastatic gastric cancer patients

Objective:The principal purpose of this study was to determine the relationship between level of plasma D-dimer and survival time in metastatic gastric cancer patients.Methods:We retrospectively collected the data of plasma D-dimer in metastatic gastric cancer patients admitted in our Department (Department of Oncology,The Affiliated Changzheng Hospital,The Second Military Medical University,Shanghai,China) from October 2006 to October 2008 and analyzed the relationship between level of plasma D-dimer and survival time along with other clinicopathologic parameters.Results:A total of 82 patients were studied in our research,52 were males and 30 females,and the mean age was 57 years.The 48 cases had a normal plasma D-dimer level (<300μg/L) and 34 had a high plasma D-dimer level (≥300μg/L).In the normal and high plasma D-dimer level groups,the mean survival times were 10.9 (95% CI:9.8-12.2) months and 6.8(95% CI:4.4-7.6) months respectively,and the difference was statistically significant.Conclusion:Metastatic gastric cancer patients with high plasma D-dimer level had significantly shorter survival time than those with normal plasma D-dimer level.Level of plasma D-dimer can be referred as a potential predictor in metastatic gastric cancer patients.

Studies on the Relationship between Neuroendocrine Cellular Differentiation in Gastric Cancers and Post-operative Survival Time

OBJECTIVE To examine the ultrastructure of gastric cancer ceils by the electron microscope, in order to assess the relationship between neuroendocrine differentiation and post-operative survival time. METHODS NSE, Syn and CgA immunohistochemical labeling was conducted in 168 cases with a common-type of gastric cancer. Electron microscopy was performed in 80 cases with positive immunohistochemical labeling. These cases were followed-up for over 5 years and the post-operative survival data analyzed. RESULTS Neuroendocrine granules were found by electron microscopy in 39 cases. The rate of neuroendocrine differentiation found was 23% （39/168）, using routine diagnostic criteria and electron microscopy （REM）. The post-operative survival time of gastric cancer patients with neuroendocdne differentiation was significantly shorter （P=-0.0032） compared to those without neuroendocrine differentiation. CONCLUSION It is of significant clinical importance to determine if the neuroendocrine cells are differentiated in gastdc cancers. The gastric cancer patients with neuroendocrine differentiation have a shorter post-operative survival time and a poorer prognosis. Electron microscopy is a reliable method of providing a diagnosis.

Bayesian Joint Modelling of Survival Time and Longitudinal CD4 Cell Counts Using Accelerated Failure Time and Generalized Error Distributions

Survival of HIV/AIDS patients is crucially dependent on comprehensive and targeted medical interventions such as supply of antiretroviral therapy and monitoring disease progression with CD4 T-cell counts. Statistical modelling approaches are helpful towards this goal. This study aims at developing Bayesian joint models with assumed generalized error distribution (GED) for the longitudinal CD4 data and two accelerated failure time distributions, Lognormal and loglogistic, for the survival time of HIV/AIDS patients. Data are obtained from patients under antiretroviral therapy follow-up at Shashemene referral hospital during January 2006-January 2012 and at Bale Robe general hospital during January 2008-March 2015. The Bayesian joint models are defined through latent variables and association parameters and with specified non-informative prior distributions for the model parameters. Simulations are conducted using Gibbs sampler algorithm implemented in the WinBUGS software. The results of the analyses of the two different data sets show that distributions of measurement errors of the longitudinal CD4 variable follow the generalized error distribution with fatter tails than the normal distribution. The Bayesian joint GED loglogistic models fit better to the data sets compared to the lognormal cases. Findings reveal that patients’ health can be improved over time. Compared to the males, female patients gain more CD4 counts. Survival time of a patient is negatively affected by TB infection. Moreover, increase in number of opportunistic infection implies decline of CD4 counts. Patients’ age negatively affects the disease marker with no effects on survival time. Improving weight may improve survival time of patients. Bayesian joint models with GED and AFT distributions are found to be useful in modelling the longitudinal and survival processes. Thus we recommend the generalized error distributions for measurement errors of the longitudinal data under the Bayesian joint modelling. Further studies may investigate the models with various types of shared random effects and more covariates with predictions.

A COMPARATIVE STUDY ON THERAPEUTIC RESPONSE AND SURVIVAL TIME OF PATIENTS WITH MULTIPLE MYELOMA TREATED WITH MODIFIED VMCP REGIMEN

Therapeutic response and survival time or 43 patients with multiple myeloma treated with modified VMCP(Vincristine,Melphalan, Cyelophosphamide and perdnisone;mVMCP)multidrug regimen are analyzed,and compared with those of 41 patients treated with VACP, M2, MP and other regimens.Therapeutic response to mVMCP regimen was better than that to other combination regimens(83. 5% VS 60.9%;P< 0.01).The median remission duration in patients responding to mVMCP was longer than that to other regimens(18.7 vs 12.2 mouths;P<0.001).But the survival time of two groups of responders was not signifficautly different(32. 5 vs 34.1 mouths; P>0.5).The prognostic significance of various pretreatment characteristics was evaluated in term of therapeutic response.The bone status and renal function had a significant inverse correlation with the survival time of patients responding to chemotherapy.Our data indicate that the patients with MM treated by mean or mVMCP regimen can obtain a better response in early treatment and maintain a longer remission duration as well as a better performance status. although the regimen can not prolong the patients survival time.

Lag time,high-risk histopathological features,metastasis,and survival interrelation in retinoblastoma:a perspective from lower-middle income country

AIM:To investigate the impact of lag time to metastasis and survival rates among patients with retinoblastoma.METHODS:This retrospective study was conducted with 52 patients from the Department of Ophthalmology and the Department of Pediatrics of Dr.Sardjito General Hospital,between 1^(st) January 2014 and 31^(st) December 2020.Lag time was defined as the time delay between the first sign of retinoblastoma to the diagnosis of retinoblastoma.The subjects with lag time>one year were included in the case group,while the subjects with lag time<one year were included in the control group.RESULTS:The lag time was significantly correlated with American Joint Committee on Cancer and Intraocular Classification of Retinoblastoma staging of retinoblastoma(P=0.005 and P=0.006,respectively).The lag time was also significantly correlated with both metastasis event[odds ratio(OR):5.06,95%Cl:1.56-16.44,P=0.006]and mortality(OR:4.54,95%Cl:1.37-15.07,P=0.011).The follow-up was continued for 32 subjects for 3y after initial diagnoses.Survival analysis revealed a significant difference among these two groups(P=0.021).Furthermore,lag time was significantly correlated with survival of retinoblastoma(r=-0.53,P=0.046).CONCLUSION:The study highlights the importance of lag time between the onset of first symptoms and the time of retinoblastoma diagnosis which significantly contribute to metastasis and mortality of patients with retinoblastoma.Examinations for the early detection of retinoblastoma should be performed for individuals at-risk to minimize lag time and improve the outcomes.

The Correlation of Lung Function Indexes and Survival Time of Patients with Advanced Lung Cancer

Background: To those patients with advanced lung cancer, the ultimate objective is to improve the quality of life, and lung function is an important factor affecting quality of life. We detect lung function of patients with lung cancer and study the correlation between lung function and the patients’ survival time, to provide reference for evaluation of disease progression and prognosis. Methods: Lung function was detected on 59 cases of lung cancer and 63 normal controls. The relationship between lung function indexes and survival time was analyzed. Results: There was significant difference in ventilation function and diffusing capacity between lung cancer group and control group. Vital capacity (VC), Forced expiratory volume in one second (FEV1), Forced vital capacity (FVC), peak expiratory flow (PEF), peak expiratory flow% (PEF%), Maximal ventilatory volume (MVV) were positively correlated to survival time in patients with advanced lung cancer (r = 0.28522064, 0.28053851, 0.28289252, 0.26908133, 0.26335034, 0.28409036, P 0.05), residual volume/total lung capacity was negatively correlated to survival time (r = ?0.30760097, P 0.05). Conclusions: The lung function decrease in the patients with lung cancer. Vital capacity (VC), Forced expiratory volume in one second (FEV1), Forced vital capacity (FVC), peak expiratory flow (PEF), peak expiratory flow% (PEF%), Maximal ventilatory volume (MVV), and residual volume/total lung capacity are correlated to survival time in patients with advanced lung cancer. The lung function indexes are important marker of prognosis of patients with lung cancer.

Predictive formulas expressing relationship between dose rate and survival time in total body irradiation in mice

The Gompertz model is the long-time well-known mathematical model of exponential expression among mortality models in the literature that are used to describe mortality and survival data of a population. The death rate of the “probacent” model developed by the author based on animal experiments, clinical applications and mathematical reasoning was applied to predict age-specific death rates in the US elderly population, 2001, and to express a relationship among dose rate, duration of exposure and mortality probability in total body irradiation in humans. The results of both studies revealed a remarkable agreement between “probacent”-formula-predicted and published-reported values of death rates in the US elderly population or mortality probabilities in total body irradiation in humans (p - value > 0.995 in χ2 test in each study). In this study, both the Gompertz and “probacent” models are applied to the Sacher’s comprehensive experimental data on survival times of mice daily exposed to various doses of total body irradiation until death occurs with an assumption that each of both models is applicable to the data. The purpose of this study is to construct general formulas expressing relationship between dose rate and survival time in total body irradiation in mice. In addition, it is attempted to test which model better fits the reported data. The results of the comparative study revealed that the “probacent” model not only fit the Sacher’s reported data but also remarkably better fit the reported data than the Gompertz model. The “probacent” model might be hopefully helpful in research in human tolerance to low dose rates for long durations of exposure in total body irradiation, and further in research in a variety of biomedical phenomena.

A Measure for Assessing Functions of Time-Varying Effects in Survival Analysis

A standard approach for analyses of survival data is the Cox proportional hazards model. It assumes that covariate effects are constant over time, i.e. that the hazards are proportional. With longer follow-up times, though, the effect of a variable often gets weaker and the proportional hazards (PH) assumption is violated. In the last years, several approaches have been proposed to detect and model such time-varying effects. However, comparison and evaluation of the various approaches is difficult. A suitable measure is needed that quantifies the difference between time-varying effects and enables judgement about which method is best, i.e. which estimate is closest to the true effect. In this paper we adapt a measure proposed for the area between smoothed curves of exposure to time-varying effects. This measure is based on the weighted area between curves of time-varying effects relative to the area under a reference function that represents the true effect. We introduce several weighting schemes and demonstrate the application and performance of this new measure in a real-life data set and a simulation study.

A Comparison of Within-Subjects and Between-Subjects Designs in Studies with Discrete-Time Survival Outcomes

Crossover designs are well-known to have major advantages when comparing the effects of various non-curative treatments. We compare efficiencies of several crossover designs along with the Balaam’s design with that of a parallel group design pertaining to longitudinal studies where event time can only be measured in discrete time intervals. With equally sized sequences, the parallel group design results in the greater efficiency if the number of time periods is small. However, the crossover and Balaam’s designs tend to be more efficient as the study duration increases. The degree to which these designs add efficiency depends on the baseline hazard function and effect size. Additionally, we incorporate different cost considerations at the subject level when comparing the designs to determine the most cost-efficient design. Researchers might consider the crossover or Balaam’s design more efficient if the duration of the study is long enough, especially if the costs of applying the baseline treatment are higher.

Risk evaluation of splenic hilar lymph node metastasis and survival analysis of patients with advanced gastric cancer

Background:There is no consensus regarding the influence of prophylactic no.10 lymph node(LN)dissection in patients with advanced gastric cancer(AGC).We aimed to evaluate whether patients with AGC could benefit from no.10 LN dissection and to explore the clinicopathological indicators of no.10 LN metastasis.Methods:We analyzed the data of 218 patients with AGC who underwent standard D2 lymphadenectomy(SD2;n=108)or modified D2 lymphadenectomy(MD2;n=110)between January 2017 and January 2021.In addition,we examined factors influencing no.10 LN metastasis in the SD2 group.Results:Differentiation,tumor location,and no.4 positive LNs were significantly correlated with no.10 LN metastasis(P<0.05).Borrmann classification,differentiation,depth of invasion,LN metastasis(N),and tumor size were found to correlate with survival in univariate analyses.Age,sex,extent of gastrectomy,tumor location,and extent of lymphadenectomy were not associated with survival(P>0.05).The median survival times were 72.23 and 68.56months for the SD2 andMD2 groups,respectively(P=0.635).Postoperative major morbidity and mortality rates were 37.96%and 3.70%in the SD2 group,and 23.64%and 1.82%in the MD2 group,respectively.Conclusions:Based on our findings,prophylactic no.10 lymphadenectomy may be recommended in patients with AGC who exhibit positive no.4 LN status,poor differentiation,and tumors located on the greater curvature.

多维邻近性对国际技术标准生存时间的影响研究——基于ITU国际技术标准生存分析

在技术快速变革和迭代的时代背景下,构建技术标准联盟是各类组织适应技术快速发展的必要手段。技术标准联盟的组织构成正在朝着跨国化和多样化发展,联盟成员间特征差异程度的提升对技术标准生存时间产生了重要影响。根据协同创新理论,基于2010—2021年ITU国际技术标准联盟的相关数据,运用生存分析方法,分析多维邻近性与技术标准生存时间的内在关联。结果表明,地理邻近性与技术邻近性能显著提高ITU国际技术标准生存时间;组织邻近性与制度邻近性对ITU国际技术标准生存时间具有显著负向影响;地理邻近性与技术邻近性、组织邻近性与制度邻近性的交互作用对ITU国际技术标准生存时间具有显著负向影响,地理邻近性与组织邻近性、地理邻近性与制度邻近性、技术邻近性与组织邻近性以及技术邻近性与制度邻近性的交互作用对ITU国际技术标准生存时间具有显著正向影响。研究有助于深化对技术标准联盟协同创新的理论解释,丰富了技术标准生存时间驱动因素的理论成果,可为我国信息和通信技术行业国际技术标准制定的管理实践提供重要参考。

复方苦参注射液联合西黄丸对晚期结直肠癌姑息治疗患者癌性疼痛和疲乏中位生存期及并发症发生率影响

目的:探讨复方苦参注射液联合西黄丸对晚期结直肠癌姑息治疗患者癌性疼痛和疲乏、中位生存期及并发症发生率影响。方法:将2020年1月至2021年5月成都医学院第一附属医院收治的153例晚期结直肠癌患者随机分为对照组(常规姑息治疗)、单药组(常规姑息治疗+西黄丸)、联合组(常规姑息治疗+西黄丸+复方苦参注射液),各51例。比较三组治疗前、治疗1个周期及治疗3个周期后癌性疼痛[疼痛数字分级法(NRS)]、癌因性疲乏[Piper疲乏修订量表(PFS-R)]、生存情况[功能状态评分(KPS)]评分、炎症因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)、IL-8、IL-1β]、免疫功能(总T淋巴细胞、总B淋巴细胞、NK细胞),并比较三组肿瘤控制效果、并发症、毒副反应及中位生存期。结果:联合组肿瘤稳定占比高于对照组、单药组,且单药组高于对照组,进展患者占比低于单药组、对照组,且单药组低于对照组(P<0.05);联合组治疗1个、3个周期后NRS评分、PFS-R评分低于单药组、对照组,且单药组低于对照组,KPS评分高于单药组、对照组,且单药组高于对照组(P<0.05);联合组治疗1个、3个周期后总T淋巴细胞、总B淋巴细胞、NK细胞高于单药组、对照组,且单药组高于对照组(P<0.05);联合组治疗1个、3个周期后IL-6、CRP、IL-8、IL-1β低于单药组、对照组,且单药组低于对照组(P<0.05);联合组便秘、失眠、肠梗阻、肠出血、低热、感染发生率低于单药组、对照组,单药组便秘、失眠、肠梗阻、低热、感染发生率低于对照组(P<0.05);联合组恶心呕吐、骨髓抑制发生率低于单药组、对照组,且单药组低于对照组(P<0.05);随访2年,均失访2例,联合组死亡7例,单药组死亡20例,对照组死亡34例。联合组、单药组、对照组中位生存期分别为18、14、13个月,联合组中位生存期长于单药组、对照组(P<0.05)。结论:复方苦参注射液联合西黄丸可有效减轻晚期结直肠癌姑息治疗患者癌性疼痛和疲乏,改善患者生存质量,提高免疫功能,降低炎症反应及并发症发生率。

术前淋巴细胞与单核细胞比值在乳腺癌预后评估的探讨

目的探究外周血中淋巴细胞/单核细胞比值对乳腺癌患者中预后评估作用。方法收集2013年-2018年军区总医院接受手术切除的乳腺癌患者82例,分析淋巴细胞单核细胞比值与患者临床资料、预后评估的价值。结果(1)根据无疾病生存期,建立ROC曲线,根据约登指数取最佳敏感度及特异度,得出淋巴细胞单核细胞比值临界值为5.78。(2)按照LMR5.78分组,通过单因素方差分析得出术前高值LMR组与低值LMR组的临床资料中,年龄、绝经状态、TNM分期、雌激素受体、孕激素受体等均与LMR分组无统计学意义,DFS与LMR分组有统计学意义(P<0.05)。(3)生存函数分析,高LMR组乳腺癌患者的DFS明显延长,差异有统计学意义(P<0.05)。结论术前LMR≥5.78是乳腺癌预后有力的因素,术前LMR检测方便、低廉、结果稳定可作为乳腺癌患者预后的生物学标志物之一。

子宫内膜癌组织NF-κB、STAT3蛋白对子宫内膜癌的诊断及预后价值意义分析

目的探讨与分析子宫内膜癌(EC)组织核因子κB(NF-κB)、信号转导与转录激活因子3(STAT3)蛋白对子宫内膜癌的诊断及预后价值意义。方法选择2019年9月—2022年11月石河子大学第一附属医院收治的88例子宫内膜癌患者作为研究对象,取所有患者术中切除的新鲜子宫内膜癌肿瘤组织标本(肿瘤组)和癌旁正常子宫内膜组织(癌旁组),采用免疫组化法检测NF-κB、STAT3蛋白表达阳性率,调查患者的病理特征、随访预后并进行相关性分析。结果肿瘤组NF-κB、STAT3蛋白表达阳性率显著高于癌旁组,差异具有统计学意义(P<0.05)。在88例患者中,不同年龄、临床分期、分化程度、肌层浸润、淋巴结转移患者的NF-κB、STAT3蛋白表达阳性率比较,差异具有统计学意义(P<0.05)。所有患者随访到2023年6月1日,生存患者NF-κB、STAT3蛋白表达阳性率明显低于死亡患者,差异具有统计学意义(P<0.05)。Cox回归分析显示NF-κB、STAT3蛋白表达阳性率为影响预后中位生存时间的重要因素,差异有统计学意义(P<0.05)。结论子宫内膜癌组织多伴随有NF-κB、STAT3蛋白的高表达,其表达水平与患者的临床病理特征和预后生存情况都存在相关性。

NM23基因与非小细胞肺癌临床病理学特征及^(18)F-FDG PET/CT影像特征的相关性

目的 比较非小细胞肺癌中NM23基因表达情况不同在其临床病理学特征、^(18)F-FDG PET/CT影像特征、生存时间的差异。方法 选择2018年1月~2022年12月于新疆医科大学附属医院病理确诊为非小细胞癌的107例患者的术后标本,运用免疫组化方法检测NM23表达情况,分为NM23低表达组(≤++)(n=64)与NM23高表达组(>++)(n=43),比较两组的临床病理学特征、^(18)FFDG FDG PET/CT图像上影像特征、生存期方面的差异。结果 NM23低表达组与高表达组在性别、临床分期、组织类型、分化程度、吸烟、PET/CT图像上生长部位、生存时间的差异无统计学意义(P>0.05),但在原发灶分期、PET/CT图像上淋巴结转移情况的差异有统计学意义(P<0.05)。结论 NM23基因在非小细胞癌患者T分期、淋巴结转移方面支持其为抑癌基因。

帕博利珠单抗联合化疗治疗晚期不可切除食管鳞状细胞癌的效果

目的探究帕博利珠单抗联合化疗对晚期不可切除食管鳞状细胞癌患者的疗效。方法遴选2019年12月至2022年9月郑州大学第一附属医院收治的晚期食管鳞状细胞癌患者纳入研究,依据治疗方法的不同进行分组,将采用化疗方案(紫杉类+顺铂)治疗的患者纳入化疗组,将采用帕博利珠单抗联合化疗方案的患者纳入免疫联合组,经倾向性评分匹配排除年龄、性别混杂因素,经1:1匹配法两组各纳入34例。比较两组近期实体瘤疗效和生存情况,治疗前后肿瘤标志物[鳞状细胞癌抗原(SCCA)、糖抗原242(CA242)和细胞角蛋白19片段(CYFRA21-1)]、血清可溶性程序性死亡蛋白1/可溶性程序性死亡蛋白配体1(sPD-1/sPD-L1)及人转化生长因子-β1(TGF-β1)水平变化,记录两组药品不良反应。结果免疫联合组疾病客观缓解率(67.65%)高于化疗组(41.18%)(P<0.05),两组疾病控制率(88.24%vs 85.29%)比较差异无统计学意义(P>0.05);免疫联合组总生存期(OS)(11.47±0.33)个月,无病生存期(DFS)(11.03±0.47)个月,1年生存率及无病生存率91.18%、76.47%,化疗组对应为(11.01±0.48)个月、(8.85±1.13)个月、85.29%、61.76%,两组OS比较差异无统计学意义(log rankχ^(2)=0.598,P>0.05),DFS比较差异有统计学意义(log rankχ^(2)=4.216,P<0.05);治疗4个周期后,免疫联合组血清SCCA、CA242和CYFRA21-1水平[分别为(3.14±0.61)ng·mL^(-1),(50.12±6.88)U·mL^(-1),(3.57±0.71)μg·L^(-1)]低于化疗组[分别为(3.81±0.74)ng·mL^(-1),(57.53±7.14)U·mL^(-1),(4.43±0.83)μg·L^(-1)](t=4.074、4.358、4.591,均P<0.05);治疗4个周期后,免疫联合组血清sPD-1/sPD-L1、TGF-β1水平[分别为(0.69±0.07)ng·mL^(-1),(33.47±6.47)ng·mL^(-1)]低于化疗组[分别为(0.75±0.05)ng·mL^(-1),(40.65±7.12)ng·mL^(-1)](t=4.067、4.067,均P<0.05);免疫联合组药品不良反应(胃肠道反应、过敏性皮疹、贫血和肝肾损伤)与化疗组比较,差异无统计学意义(P>0.05)。结论帕博利珠单抗联合化疗治疗食管鳞状细胞癌可明显改善肿瘤标志物水平及血清免疫状态。