BACKGROUND To investigate the relationship between interstitial maturity and prognosis of colorectal cancer.AIM To examine the correlation between interstitial maturity and the prognosis of colorectal cancer.METHODS T...BACKGROUND To investigate the relationship between interstitial maturity and prognosis of colorectal cancer.AIM To examine the correlation between interstitial maturity and the prognosis of colorectal cancer.METHODS The paper database PubMed,EMBASE,Cochranelibrary,Springerlink,CNKI,and Wanfang database were searched until December 2023."tumor stroma maturity""desmoplastic stroma reaction""desmoplastic reaction""stroma reaction""degree of stroma reaction""stroma classification""stroma density""colorectal cancer""colon cancer""rectal cancer""prognosis"were searched for the search terms.Two system assessors independently screened the literature quality according to the inclusion exclusion criteria,Quality evaluation and data extraction were performed for the included literatures,and meta-analysis was performed for randomized control trials included at using Review Manager 5.2 software.RESULTS Finally,data of 9849 patients with colorectal cancer from 19 cosets in 15 literatures were included,including 4339 patients with mature type(control group),3048 patients with intermediate type(intermediate group)and 2456 patients with immature type(immature group).The results of meta-analysis showed:Relapse-free survival[hazard ratio(HR)=2.66,95%confidence interval(CI):2.30-3.08;P<0.00001],disease-free survival(HR=3.68,95%CI:2.33-5.81;P<0.00001)and overall survival(HR=1.70,95%CI:1.53-1.87;P<0.00001)were significantly lower than those in mature group(control group);relapse-free survival(HR=1.36,95%CI:1.17-1.59;P<0.0001)and disease-free survival rate(HR=1.85,95%CI:1.53-2.24;P<0.0001)was significantly lower than the mature group(control group).CONCLUSION There is the correlation between tumor interstitial maturity and survival prognosis of colorectal cancer,and different degrees of tumor interstitial maturity have a certain impact on the quality of life of colorectal cancer patients.展开更多
Objective:To establish a new genomic signature for the prognosis of survival in relation to the tumor microenvironment in esophageal adenocarcinoma.Methods:Data from The Cancer Genome Atlas(TCGA)were applied,and the s...Objective:To establish a new genomic signature for the prognosis of survival in relation to the tumor microenvironment in esophageal adenocarcinoma.Methods:Data from The Cancer Genome Atlas(TCGA)were applied,and the stromal and immune scores of patients with esophageal adenocarcinoma(EAC)were generated through the ESTIMATE algorithm.Differentially expressed genes were obtained,and genes concerning immune prognosis were identified on the basis of these scores.Functional analysis showed that these genes were primarily involved in immunobiological processes.Additionally,CIBERSORT was used to analyze 22 subgroups of tumor-infiltrating immune cells in the tumor microenvironment.Results:The results of the genomic assessment shown on the Kaplan-Meier curve revealed that EAC patients with high-risk scores have the worst survival.The risk score is valid as an independent prognostic factor for the overall survival in EAC patients.The tumor microenvironment was systematically analyzed,and the immune-related prognostic biomarkers of EAC have been proposed.Conclusion:The expression of tumor-infiltrating immune cells and immune-related genes in EAC have been identified.Some previously overlooked genes may be used as additional biomarkers for EAC in the future.展开更多
BACKGROUND The clinicopathological features and prognosis of gastric signet ring cell carcinoma(GSRC)remain controversial,particularly with regard to sensitivity to postoperative adjuvant therapy.AIM To compare the pa...BACKGROUND The clinicopathological features and prognosis of gastric signet ring cell carcinoma(GSRC)remain controversial,particularly with regard to sensitivity to postoperative adjuvant therapy.AIM To compare the pathological features of GSRC with those of gastric adenocarcinoma of different degrees of differentiation and the differences in survival prognosis between the different disease processes.METHODS By screening gastric cancer patients from 2010 to 2015 in the database of Surveillance,Epidemiology and End Results,and collecting the clinicopathological and prognostic data of gastric cancer patients who underwent surgery from January 2014 to December 2016 in the Second Affiliated Hospital of Nanchang University,we analyzed the general pathological characteristics of GSRC by the chi-square test.Univariate and multivariate analyses were conducted to compare the factors affecting the survival and prognosis of early and advanced gastric adenocarcinoma.The Kaplan-Meier curves were plotted to reveal the survival difference between early and advanced GSRC and different differentiated types of gastric adenocarcinoma.The prognosis model of advanced GSRC was established with R software,and the area under curve(AUC)and C-index were used to assess the accuracy of the model.RESULTS Analysis of pathological features revealed that signet ring-cell carcinoma(SRC)was more frequently seen in younger(<60 years),female,and White patients compared to non-SRC patients.SRC was less commonly associated with early gastric cancer(EGC)(23.60%vs 39.10%),lower N0(38.61%vs 61.03%),and larger tumour sizes>5 cm(31.15%vs 27.10%)compared to the differentiated type,while the opposite was true compared to the undifferentiated type.Survival prognostic analysis found no significant difference in the prognosis of SRC patients among EGC patients.In contrast,among advanced gastric cancer(AGC)patients,the prognosis of SRC patients was correlated with age,race,tumour size,AJCC stage,T-stage,and postoperative adjuvant therapy.The predictive model showed that the 3-year AUC was 0.787,5-year AUC was 0.806,and C-index was 0.766.Compared to non-SRC patients,patients with SRC had a better prognosis in EGC[hazard ratio(HR):0.626,95%confidence interval(CI):0.427-0.919,P<0.05]and a worse prognosis in AGC(HR:1.139,95%CI:1.030-1.258,P<0.05).When non-SRC was divided into differentiated and undifferentiated types for comparison,it was found that in EGC,SRC had a better prognosis than differentiated and undifferentiated types,while there was no significant difference between differentiated and undifferentiated types.In AGC,there was no significant difference in prognosis between SRC and undifferentiated types,both of which were worse than differentiated types.A prognostic analysis of postoperative adjuvant therapy for SRC in patients with AGC revealed that adjuvant postoperative radiotherapy or chemotherapy significantly improved patient survival(34.6%and 36.2%vs 18.6%,P<0.05).CONCLUSION The prognosis of SRC is better than that of undifferentiated type,especially in EGC,and its prognosis is even better than that of differentiated type.SRC patients can benefit from early detection,surgical resection,and aggressive adjuvant therapy.展开更多
Survival after pancreatic cancer surgery is extremely unfavorable even after curative resection. Prognostic factors have been explored but remain largely undefined. The present study was to identify the role of clinic...Survival after pancreatic cancer surgery is extremely unfavorable even after curative resection. Prognostic factors have been explored but remain largely undefined. The present study was to identify the role of clinical and laboratory variables in the prognostic significance of resectable pancreatic adenocarcinoma. A total of 96 patients who underwent curative resection for pancreatic cancer were included. Survival was evaluated based on complete follow-up visits and was associated with potential prognostic factors using the Kaplan-Meier method and Cox proportional hazard model survival analyses. The results showed that prognostic variables significantly reduced survival, including old age, poorly differentiated tumors, elevated tumor markers and positive lymph node metastasis(LNM). Age of older than 60 years(HR=1.83, P=0.04), LNM(HR=2.22, P=0.01), lymph node ratio(00.2, HR=1.92, P=0.017), initial CA199(HR=4.80, P=0.004), and CEA level(HR=2.59, P=0.019) were identified as independent prognostic factors by multivariate analysis. It was concluded that LNR may be potent predictor of survival and suggests that surgeons and the pathologists should thoroughly assess lymph nodes prior to surgery.展开更多
<strong>Objective:</strong> To evaluate early prediction value of IPS<span> </span><span><span style="font-family:Verdana;">combined with SchE and D-dimer detection for in...<strong>Objective:</strong> To evaluate early prediction value of IPS<span> </span><span><span style="font-family:Verdana;">combined with SchE and D-dimer detection for infection and survival in critically ill patients. </span><b><span style="font-family:Verdana;">Methods:</span></b></span><b><span> </span></b><span style="font-family:Verdana;">199 critically ill patients admitted to the emergency intensive care unit (EICU) of our hospital from December 2018 to December 2019 were retrospectively analyzed, including 110 infection patients (infection group) and 89 non-infection</span><span> </span><span style="font-family:Verdana;">patients (non-infection group).</span><span> </span><span><span style="font-family:Verdana;">According to the survival, the infection group was divided into death group (68 cases) and survival group (42 cases). The IPS, APACHE II, SOFA and SchE, D-dimer expression levels were detected and compared;Univariate and logistic regression analysis were used to evaluate the independent prognostic factors. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The IPS and APACHE II of patients in the infected group were higher than those in the non-infected group, the level of SchE was lower than that in the non-infected group, and the level of D-dimer was higher than that in the non-infected group (</span><i><span style="font-family:Verdana;">P</span></i></span><i><span> </span></i><span style="font-family:Verdana;"><</span><span> </span><span style="font-family:Verdana;">0.001). IPS, SOFA, APACHE</span><span style="font-family:Verdana;"> II</span><span style="font-family:Verdana;">, SchE, D-dimer, invasive mechanical ventilation, septic shock, and ICU length</span><span style="font-family:Verdana;"> of stay had significant influence on the prognosis of critically ill patients</span><span> </span><span><span style="font-family:Verdana;">(</span><i><span style="font-family:Verdana;">P</span></i></span><i><span> </span></i><span style="font-family:Verdana;"><</span><span> </span><span><span style="font-family:Verdana;">0.001). Logistic regression analysis showed that IPS (</span><i><span style="font-family:Verdana;">OR</span></i><span style="font-family:Verdana;"> = 2.821, </span><span><span style="font-family:Verdana;">95%</span><i><span style="font-family:Verdana;"> CI</span></i></span><span style="font-family:Verdana;"> 1.501</span></span><span style="font-family:Verdana;"> - </span><span><span style="font-family:Verdana;">5.227), SOFA (</span><i><span style="font-family:Verdana;">OR</span></i><span style="font-family:Verdana;"> = 5.078, </span><span><span style="font-family:Verdana;">95% </span><i><span style="font-family:Verdana;">CI</span></i></span><span style="font-family:Verdana;"> 3.327 </span></span><span style="font-family:Verdana;">-</span><span><span style="font-family:Verdana;"> 7.690), APACHE II (</span><i><span style="font-family:Verdana;">OR</span></i><span style="font-family:Verdana;"> = 14.308, </span><span><span style="font-family:Verdana;">95% </span><i><span style="font-family:Verdana;">CI</span></i></span><span style="font-family:Verdana;"> 8.901 </span></span><span style="font-family:Verdana;">-</span><span><span style="font-family:Verdana;"> 21.893), SchE (</span><i><span style="font-family:Verdana;">OR</span></i><span style="font-family:Verdana;"> = 0.223, </span><span><span style="font-family:Verdana;">95%</span><i><span style="font-family:Verdana;"> CI</span></i></span><span style="font-family:Verdana;"> 0.165 </span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> 0.291), D-dimer</span><span style="font-family:Verdana;"> (</span><i><span style="font-family:Verdana;">OR</span></i><i><span> </span></i><span style="font-family:Verdana;">=</span><span> </span><span style="font-family:Verdana;">2.10</span><span style="font-family:Verdana;">, </span><span style="font-family:Verdana;">95%</span><i><span> </span></i><i><span style="font-family:Verdana;">CI</span></i><i><span> </span></i><span style="font-family:Verdana;">1.55</span><span style="font-family:Verdana;"> - </span><span style="font-family:Verdana;">2.85</span><span style="font-family:Verdana;">)</span><span><span style="font-family:Verdana;">, septic shock (</span><i><span style="font-family:Verdana;">OR</span></i><span style="font-family:Verdana;"> = 9.948,</span></span><span> </span><span style="font-family:Verdana;">95%</span><span> </span><i><span style="font-family:Verdana;">CI</span></i><span style="font-family:Verdana;"> 7.012</span><span style="font-family:Verdana;"> - </span><span style="font-family:Verdana;">17.012)</span><span> </span><span style="font-family:Verdana;">were independent factors affecting the prognosis of critically ill patients with infection</span><span style="font-family:Verdana;"> (</span><i><span style="font-family:Verdana;">P</span></i><span> </span><span style="font-family:Verdana;"><</span><span> </span><span style="font-family:Verdana;">0.001</span><span style="font-family:Verdana;">)</span><span style="font-family:Verdana;">.</span><span> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><b><span> </span></b><span style="font-family:Verdana;">IPS and D-dimer expression level in infected patients were increased and SchE decreased significantly compared with those in non-infected patients, and they significantly correlated with</span><span> </span><span style="font-family:Verdana;">disease severity of infected</span><span> </span><span style="font-family:Verdana;">patients</span><span> </span><span style="font-family:Verdana;">and could be early prediction</span><span> </span><span style="font-family:Verdana;">for prognosis.</span>展开更多
Objective: To construct an Immune-Related Gene Prognostic Index (IRGPI) for bladder cancer using a bioanalytical approach to analyze its molecular and immunological characteristics, as well as to assess the benefit of...Objective: To construct an Immune-Related Gene Prognostic Index (IRGPI) for bladder cancer using a bioanalytical approach to analyze its molecular and immunological characteristics, as well as to assess the benefit of Immune Checkpoint Inhibitor (ICI) therapy in the IRGPI-defined bladder cancer subgroup. Methods: Twenty-nine immune-related pivotal genes were identified by Weighted Gene Co-expression Network Analysis (WGCNA) based on The Cancer Genome Atlas (TCGA) bladder cancer immune dataset (n = 433). Six genes were identified using a multifactorial Cox regression approach to construct the IRGPI and validated against the Gene Expression Omnibus (GEO) dataset (n = 256). Then, molecular and immunological features in the subgroups defined by IRGPI were synthesized by GSEA, Kaplan-Meier survival curves, and other methods, and the benefit of ICI treatment was assessed. Results: IRGPI was constructed based on six genes including AHNAK, ILK, OGN, PDGFD, PPARGC1B, and JAM3. Patients with low IRGPI had better Overall Survival (OS) than those with high IRGPI, which was confirmed in the validation cohort of GEO. Pooled analysis showed that the low IRGPI subgroup was associated with higher infiltration of CD8 T cells, activated memory CD4 T cells, and could benefit from ICI treatment. Meanwhile, high IRGPI subgroups were associated with higher resting memory CD4T cells, M0 macrophages, and M2 macrophage content, immunosuppression, and benefited less from ICI treatment. Conclusion: IRGPI is a novel biomarker with better efficacy in differentiating the prognosis of bladder cancer, molecular and immune features, and evaluation of ICI therapy for individualized treatment of bladder cancer.展开更多
Chronic heart failure(CHF)remains a leading cause of morbidity and mortality.In the current study,we aimed to evaluate the predictive value of circulating fhrombospondin-2(TSP-2)for cumulative survival in patients...Chronic heart failure(CHF)remains a leading cause of morbidity and mortality.In the current study,we aimed to evaluate the predictive value of circulating fhrombospondin-2(TSP-2)for cumulative survival in patients with ischemic CHF due to coronary artery disease(CAD).The results showed that during a median follow-up of2.18 years,21 participants died and 106 subjects were hospitalized repeatedly.The median circulating levels of TSP-2 in patients who survived and those who died were 0.63 ng/mL(95%CI=0.55-0.64 ng/mL)and 1.03 ng/mL(95%CI=0.97-1.07 ng/mL)(P〈0.001).Circulating TSP-2 independently predicted all-cause mortality(OR=1.27;95%CI=1.08-1.59;P=0.002),CHF-related death(OR=1.16;95%CI=1.02-1.50;P〈0.001),and also CHF-related rehospitalization(OR=1.12;95%CI=1.07-1.25;P〈0.001).In conclusion,among CAD patients with symptomatic CHF,increased circulating TSP-2 is correlated with increased 3-year CHF-related death,all-cause mortality,and risk for recurrent hospitalization.展开更多
This meta-analysis was carried out to evaluate the relationship between NM23 expression and the prognosis of patients with colorectal cancer. We searched Pub Med, EMBASE and Web of Science for relevant articles. The p...This meta-analysis was carried out to evaluate the relationship between NM23 expression and the prognosis of patients with colorectal cancer. We searched Pub Med, EMBASE and Web of Science for relevant articles. The pooled odd ratios(ORs) and corresponding 95%CI were calculated to evaluate the prognostic value of NM23 expression in patients with colorectal cancer, and the association between NM23 expression and clinicopathological factors. In total, 2289 patients were pooled from 24 available studies. The incorporative OR combined by 16 studies with overall survival showed that high NM23 expression was associated with better overall survival(OR=0.67, 95%CI: 0.49–0.93, P=0.02, I2=56%, Ph=0.004). And a new estimate without heterogeneity was produced when only combining high-quality studies(OR=0.70, 95%CI: 0.56–0.86, P=0.0007, I2=46%). In disease free survival(DFS), we also obtained a good prognosis(OR=0.30, 95%CI: 0.14–0.68, P=0.004). Although we failed to find any significance in N status(P=0.10), elevated NM23 expression was related to well tumor differentiation(OR=0.60, 95%CI: 0.44–0.820, P=0.001) and Dukes' A&B(OR=0.55, 95%CI: 0.32–0.95, P=0.03). These results indicated that over-expressed NM23 might be an indicator of good prognosis, well tumor differentiation and Dukes' A&B of patients with colorectal cancer, but no significance was found in N status.展开更多
Objective This study aimed to compare the effectiveness of adjuvant chemoradiotherapy(CRT)and adjuvant chemotherapy(ChT)for T3–4/N+gastric cancer(GC)following D2/R0 dissection,and identify the specific subgroups that...Objective This study aimed to compare the effectiveness of adjuvant chemoradiotherapy(CRT)and adjuvant chemotherapy(ChT)for T3–4/N+gastric cancer(GC)following D2/R0 dissection,and identify the specific subgroups that could benefit from adjuvant CRT.Methods All eligible patients were divided into the CRT group and ChT group.We assessed the survival outcomes and patterns of recurrence for each group,and determined the prognostic factors for survival by performing Cox proportional risk regression analyses.Results A total of 192 gastric cancer patients were included in the study.The estimated 3-year and 5-year disease-free survival(DFS)probabilities in the CRT and ChT groups were 52.9%vs.36.7%(P=0.024)and 41.2%vs.31.1%(P=0.148),respectively,and the estimated 3-year and 5-year overall survival(OS)probabilities were 82.4%vs.70.0%(P=0.044)and 52.0%vs.35.6%(P=0.022).Patients in the CRT group had a lower risk of locoregional recurrence than those in the ChT group(20.6%vs.34.4%;P=0.031).The subset analyses revealed that patients with stage N1–2 disease were more likely to benefit from adjuvant CRT than from adjuvant ChT(DFS:53.1%vs.36.4%;P=0.039;OS:53.1%vs.38.6%;P=0.036).Conclusion For locally advanced gastric cancer patients with LN+,adjuvant CRT showed superior survival benefits compared with adjuvant ChT alone.Patients with N1–2 achieved better survival from adjuvant CRT.展开更多
文摘BACKGROUND To investigate the relationship between interstitial maturity and prognosis of colorectal cancer.AIM To examine the correlation between interstitial maturity and the prognosis of colorectal cancer.METHODS The paper database PubMed,EMBASE,Cochranelibrary,Springerlink,CNKI,and Wanfang database were searched until December 2023."tumor stroma maturity""desmoplastic stroma reaction""desmoplastic reaction""stroma reaction""degree of stroma reaction""stroma classification""stroma density""colorectal cancer""colon cancer""rectal cancer""prognosis"were searched for the search terms.Two system assessors independently screened the literature quality according to the inclusion exclusion criteria,Quality evaluation and data extraction were performed for the included literatures,and meta-analysis was performed for randomized control trials included at using Review Manager 5.2 software.RESULTS Finally,data of 9849 patients with colorectal cancer from 19 cosets in 15 literatures were included,including 4339 patients with mature type(control group),3048 patients with intermediate type(intermediate group)and 2456 patients with immature type(immature group).The results of meta-analysis showed:Relapse-free survival[hazard ratio(HR)=2.66,95%confidence interval(CI):2.30-3.08;P<0.00001],disease-free survival(HR=3.68,95%CI:2.33-5.81;P<0.00001)and overall survival(HR=1.70,95%CI:1.53-1.87;P<0.00001)were significantly lower than those in mature group(control group);relapse-free survival(HR=1.36,95%CI:1.17-1.59;P<0.0001)and disease-free survival rate(HR=1.85,95%CI:1.53-2.24;P<0.0001)was significantly lower than the mature group(control group).CONCLUSION There is the correlation between tumor interstitial maturity and survival prognosis of colorectal cancer,and different degrees of tumor interstitial maturity have a certain impact on the quality of life of colorectal cancer patients.
基金College-Level Youth Fund Project(Project Number:ZZYQ2012).
文摘Objective:To establish a new genomic signature for the prognosis of survival in relation to the tumor microenvironment in esophageal adenocarcinoma.Methods:Data from The Cancer Genome Atlas(TCGA)were applied,and the stromal and immune scores of patients with esophageal adenocarcinoma(EAC)were generated through the ESTIMATE algorithm.Differentially expressed genes were obtained,and genes concerning immune prognosis were identified on the basis of these scores.Functional analysis showed that these genes were primarily involved in immunobiological processes.Additionally,CIBERSORT was used to analyze 22 subgroups of tumor-infiltrating immune cells in the tumor microenvironment.Results:The results of the genomic assessment shown on the Kaplan-Meier curve revealed that EAC patients with high-risk scores have the worst survival.The risk score is valid as an independent prognostic factor for the overall survival in EAC patients.The tumor microenvironment was systematically analyzed,and the immune-related prognostic biomarkers of EAC have been proposed.Conclusion:The expression of tumor-infiltrating immune cells and immune-related genes in EAC have been identified.Some previously overlooked genes may be used as additional biomarkers for EAC in the future.
基金Supported by National Natural Science Foundation of China,No.81860433Natural Science Youth Foundation of Jiangxi Province,No.20192BAB215036+2 种基金Jiangxi Province Natural Science Key R&D Project-General Project,No.20202BBG73024Training Plan for Academic and Technical Young Leaders of Major Disciplines in Jiangxi Province,No.20204BCJ23021Jiangxi Provincial Education Department,Science and Technology Research Project-Youth Project,No.GJJ210252。
文摘BACKGROUND The clinicopathological features and prognosis of gastric signet ring cell carcinoma(GSRC)remain controversial,particularly with regard to sensitivity to postoperative adjuvant therapy.AIM To compare the pathological features of GSRC with those of gastric adenocarcinoma of different degrees of differentiation and the differences in survival prognosis between the different disease processes.METHODS By screening gastric cancer patients from 2010 to 2015 in the database of Surveillance,Epidemiology and End Results,and collecting the clinicopathological and prognostic data of gastric cancer patients who underwent surgery from January 2014 to December 2016 in the Second Affiliated Hospital of Nanchang University,we analyzed the general pathological characteristics of GSRC by the chi-square test.Univariate and multivariate analyses were conducted to compare the factors affecting the survival and prognosis of early and advanced gastric adenocarcinoma.The Kaplan-Meier curves were plotted to reveal the survival difference between early and advanced GSRC and different differentiated types of gastric adenocarcinoma.The prognosis model of advanced GSRC was established with R software,and the area under curve(AUC)and C-index were used to assess the accuracy of the model.RESULTS Analysis of pathological features revealed that signet ring-cell carcinoma(SRC)was more frequently seen in younger(<60 years),female,and White patients compared to non-SRC patients.SRC was less commonly associated with early gastric cancer(EGC)(23.60%vs 39.10%),lower N0(38.61%vs 61.03%),and larger tumour sizes>5 cm(31.15%vs 27.10%)compared to the differentiated type,while the opposite was true compared to the undifferentiated type.Survival prognostic analysis found no significant difference in the prognosis of SRC patients among EGC patients.In contrast,among advanced gastric cancer(AGC)patients,the prognosis of SRC patients was correlated with age,race,tumour size,AJCC stage,T-stage,and postoperative adjuvant therapy.The predictive model showed that the 3-year AUC was 0.787,5-year AUC was 0.806,and C-index was 0.766.Compared to non-SRC patients,patients with SRC had a better prognosis in EGC[hazard ratio(HR):0.626,95%confidence interval(CI):0.427-0.919,P<0.05]and a worse prognosis in AGC(HR:1.139,95%CI:1.030-1.258,P<0.05).When non-SRC was divided into differentiated and undifferentiated types for comparison,it was found that in EGC,SRC had a better prognosis than differentiated and undifferentiated types,while there was no significant difference between differentiated and undifferentiated types.In AGC,there was no significant difference in prognosis between SRC and undifferentiated types,both of which were worse than differentiated types.A prognostic analysis of postoperative adjuvant therapy for SRC in patients with AGC revealed that adjuvant postoperative radiotherapy or chemotherapy significantly improved patient survival(34.6%and 36.2%vs 18.6%,P<0.05).CONCLUSION The prognosis of SRC is better than that of undifferentiated type,especially in EGC,and its prognosis is even better than that of differentiated type.SRC patients can benefit from early detection,surgical resection,and aggressive adjuvant therapy.
基金supported in part by the National Natural Science Foundation of China(No.81470039,No.81330014,and No.81272656)
文摘Survival after pancreatic cancer surgery is extremely unfavorable even after curative resection. Prognostic factors have been explored but remain largely undefined. The present study was to identify the role of clinical and laboratory variables in the prognostic significance of resectable pancreatic adenocarcinoma. A total of 96 patients who underwent curative resection for pancreatic cancer were included. Survival was evaluated based on complete follow-up visits and was associated with potential prognostic factors using the Kaplan-Meier method and Cox proportional hazard model survival analyses. The results showed that prognostic variables significantly reduced survival, including old age, poorly differentiated tumors, elevated tumor markers and positive lymph node metastasis(LNM). Age of older than 60 years(HR=1.83, P=0.04), LNM(HR=2.22, P=0.01), lymph node ratio(00.2, HR=1.92, P=0.017), initial CA199(HR=4.80, P=0.004), and CEA level(HR=2.59, P=0.019) were identified as independent prognostic factors by multivariate analysis. It was concluded that LNR may be potent predictor of survival and suggests that surgeons and the pathologists should thoroughly assess lymph nodes prior to surgery.
文摘<strong>Objective:</strong> To evaluate early prediction value of IPS<span> </span><span><span style="font-family:Verdana;">combined with SchE and D-dimer detection for infection and survival in critically ill patients. </span><b><span style="font-family:Verdana;">Methods:</span></b></span><b><span> </span></b><span style="font-family:Verdana;">199 critically ill patients admitted to the emergency intensive care unit (EICU) of our hospital from December 2018 to December 2019 were retrospectively analyzed, including 110 infection patients (infection group) and 89 non-infection</span><span> </span><span style="font-family:Verdana;">patients (non-infection group).</span><span> </span><span><span style="font-family:Verdana;">According to the survival, the infection group was divided into death group (68 cases) and survival group (42 cases). The IPS, APACHE II, SOFA and SchE, D-dimer expression levels were detected and compared;Univariate and logistic regression analysis were used to evaluate the independent prognostic factors. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The IPS and APACHE II of patients in the infected group were higher than those in the non-infected group, the level of SchE was lower than that in the non-infected group, and the level of D-dimer was higher than that in the non-infected group (</span><i><span style="font-family:Verdana;">P</span></i></span><i><span> </span></i><span style="font-family:Verdana;"><</span><span> </span><span style="font-family:Verdana;">0.001). IPS, SOFA, APACHE</span><span style="font-family:Verdana;"> II</span><span style="font-family:Verdana;">, SchE, D-dimer, invasive mechanical ventilation, septic shock, and ICU length</span><span style="font-family:Verdana;"> of stay had significant influence on the prognosis of critically ill patients</span><span> </span><span><span style="font-family:Verdana;">(</span><i><span style="font-family:Verdana;">P</span></i></span><i><span> </span></i><span style="font-family:Verdana;"><</span><span> </span><span><span style="font-family:Verdana;">0.001). Logistic regression analysis showed that IPS (</span><i><span style="font-family:Verdana;">OR</span></i><span style="font-family:Verdana;"> = 2.821, </span><span><span style="font-family:Verdana;">95%</span><i><span style="font-family:Verdana;"> CI</span></i></span><span style="font-family:Verdana;"> 1.501</span></span><span style="font-family:Verdana;"> - </span><span><span style="font-family:Verdana;">5.227), SOFA (</span><i><span style="font-family:Verdana;">OR</span></i><span style="font-family:Verdana;"> = 5.078, </span><span><span style="font-family:Verdana;">95% </span><i><span style="font-family:Verdana;">CI</span></i></span><span style="font-family:Verdana;"> 3.327 </span></span><span style="font-family:Verdana;">-</span><span><span style="font-family:Verdana;"> 7.690), APACHE II (</span><i><span style="font-family:Verdana;">OR</span></i><span style="font-family:Verdana;"> = 14.308, </span><span><span style="font-family:Verdana;">95% </span><i><span style="font-family:Verdana;">CI</span></i></span><span style="font-family:Verdana;"> 8.901 </span></span><span style="font-family:Verdana;">-</span><span><span style="font-family:Verdana;"> 21.893), SchE (</span><i><span style="font-family:Verdana;">OR</span></i><span style="font-family:Verdana;"> = 0.223, </span><span><span style="font-family:Verdana;">95%</span><i><span style="font-family:Verdana;"> CI</span></i></span><span style="font-family:Verdana;"> 0.165 </span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> 0.291), D-dimer</span><span style="font-family:Verdana;"> (</span><i><span style="font-family:Verdana;">OR</span></i><i><span> </span></i><span style="font-family:Verdana;">=</span><span> </span><span style="font-family:Verdana;">2.10</span><span style="font-family:Verdana;">, </span><span style="font-family:Verdana;">95%</span><i><span> </span></i><i><span style="font-family:Verdana;">CI</span></i><i><span> </span></i><span style="font-family:Verdana;">1.55</span><span style="font-family:Verdana;"> - </span><span style="font-family:Verdana;">2.85</span><span style="font-family:Verdana;">)</span><span><span style="font-family:Verdana;">, septic shock (</span><i><span style="font-family:Verdana;">OR</span></i><span style="font-family:Verdana;"> = 9.948,</span></span><span> </span><span style="font-family:Verdana;">95%</span><span> </span><i><span style="font-family:Verdana;">CI</span></i><span style="font-family:Verdana;"> 7.012</span><span style="font-family:Verdana;"> - </span><span style="font-family:Verdana;">17.012)</span><span> </span><span style="font-family:Verdana;">were independent factors affecting the prognosis of critically ill patients with infection</span><span style="font-family:Verdana;"> (</span><i><span style="font-family:Verdana;">P</span></i><span> </span><span style="font-family:Verdana;"><</span><span> </span><span style="font-family:Verdana;">0.001</span><span style="font-family:Verdana;">)</span><span style="font-family:Verdana;">.</span><span> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><b><span> </span></b><span style="font-family:Verdana;">IPS and D-dimer expression level in infected patients were increased and SchE decreased significantly compared with those in non-infected patients, and they significantly correlated with</span><span> </span><span style="font-family:Verdana;">disease severity of infected</span><span> </span><span style="font-family:Verdana;">patients</span><span> </span><span style="font-family:Verdana;">and could be early prediction</span><span> </span><span style="font-family:Verdana;">for prognosis.</span>
文摘Objective: To construct an Immune-Related Gene Prognostic Index (IRGPI) for bladder cancer using a bioanalytical approach to analyze its molecular and immunological characteristics, as well as to assess the benefit of Immune Checkpoint Inhibitor (ICI) therapy in the IRGPI-defined bladder cancer subgroup. Methods: Twenty-nine immune-related pivotal genes were identified by Weighted Gene Co-expression Network Analysis (WGCNA) based on The Cancer Genome Atlas (TCGA) bladder cancer immune dataset (n = 433). Six genes were identified using a multifactorial Cox regression approach to construct the IRGPI and validated against the Gene Expression Omnibus (GEO) dataset (n = 256). Then, molecular and immunological features in the subgroups defined by IRGPI were synthesized by GSEA, Kaplan-Meier survival curves, and other methods, and the benefit of ICI treatment was assessed. Results: IRGPI was constructed based on six genes including AHNAK, ILK, OGN, PDGFD, PPARGC1B, and JAM3. Patients with low IRGPI had better Overall Survival (OS) than those with high IRGPI, which was confirmed in the validation cohort of GEO. Pooled analysis showed that the low IRGPI subgroup was associated with higher infiltration of CD8 T cells, activated memory CD4 T cells, and could benefit from ICI treatment. Meanwhile, high IRGPI subgroups were associated with higher resting memory CD4T cells, M0 macrophages, and M2 macrophage content, immunosuppression, and benefited less from ICI treatment. Conclusion: IRGPI is a novel biomarker with better efficacy in differentiating the prognosis of bladder cancer, molecular and immune features, and evaluation of ICI therapy for individualized treatment of bladder cancer.
文摘Chronic heart failure(CHF)remains a leading cause of morbidity and mortality.In the current study,we aimed to evaluate the predictive value of circulating fhrombospondin-2(TSP-2)for cumulative survival in patients with ischemic CHF due to coronary artery disease(CAD).The results showed that during a median follow-up of2.18 years,21 participants died and 106 subjects were hospitalized repeatedly.The median circulating levels of TSP-2 in patients who survived and those who died were 0.63 ng/mL(95%CI=0.55-0.64 ng/mL)and 1.03 ng/mL(95%CI=0.97-1.07 ng/mL)(P〈0.001).Circulating TSP-2 independently predicted all-cause mortality(OR=1.27;95%CI=1.08-1.59;P=0.002),CHF-related death(OR=1.16;95%CI=1.02-1.50;P〈0.001),and also CHF-related rehospitalization(OR=1.12;95%CI=1.07-1.25;P〈0.001).In conclusion,among CAD patients with symptomatic CHF,increased circulating TSP-2 is correlated with increased 3-year CHF-related death,all-cause mortality,and risk for recurrent hospitalization.
文摘This meta-analysis was carried out to evaluate the relationship between NM23 expression and the prognosis of patients with colorectal cancer. We searched Pub Med, EMBASE and Web of Science for relevant articles. The pooled odd ratios(ORs) and corresponding 95%CI were calculated to evaluate the prognostic value of NM23 expression in patients with colorectal cancer, and the association between NM23 expression and clinicopathological factors. In total, 2289 patients were pooled from 24 available studies. The incorporative OR combined by 16 studies with overall survival showed that high NM23 expression was associated with better overall survival(OR=0.67, 95%CI: 0.49–0.93, P=0.02, I2=56%, Ph=0.004). And a new estimate without heterogeneity was produced when only combining high-quality studies(OR=0.70, 95%CI: 0.56–0.86, P=0.0007, I2=46%). In disease free survival(DFS), we also obtained a good prognosis(OR=0.30, 95%CI: 0.14–0.68, P=0.004). Although we failed to find any significance in N status(P=0.10), elevated NM23 expression was related to well tumor differentiation(OR=0.60, 95%CI: 0.44–0.820, P=0.001) and Dukes' A&B(OR=0.55, 95%CI: 0.32–0.95, P=0.03). These results indicated that over-expressed NM23 might be an indicator of good prognosis, well tumor differentiation and Dukes' A&B of patients with colorectal cancer, but no significance was found in N status.
文摘Objective This study aimed to compare the effectiveness of adjuvant chemoradiotherapy(CRT)and adjuvant chemotherapy(ChT)for T3–4/N+gastric cancer(GC)following D2/R0 dissection,and identify the specific subgroups that could benefit from adjuvant CRT.Methods All eligible patients were divided into the CRT group and ChT group.We assessed the survival outcomes and patterns of recurrence for each group,and determined the prognostic factors for survival by performing Cox proportional risk regression analyses.Results A total of 192 gastric cancer patients were included in the study.The estimated 3-year and 5-year disease-free survival(DFS)probabilities in the CRT and ChT groups were 52.9%vs.36.7%(P=0.024)and 41.2%vs.31.1%(P=0.148),respectively,and the estimated 3-year and 5-year overall survival(OS)probabilities were 82.4%vs.70.0%(P=0.044)and 52.0%vs.35.6%(P=0.022).Patients in the CRT group had a lower risk of locoregional recurrence than those in the ChT group(20.6%vs.34.4%;P=0.031).The subset analyses revealed that patients with stage N1–2 disease were more likely to benefit from adjuvant CRT than from adjuvant ChT(DFS:53.1%vs.36.4%;P=0.039;OS:53.1%vs.38.6%;P=0.036).Conclusion For locally advanced gastric cancer patients with LN+,adjuvant CRT showed superior survival benefits compared with adjuvant ChT alone.Patients with N1–2 achieved better survival from adjuvant CRT.