Diagnostic value of negative enrichment and immune fluorescence in situ hybridization for intraperitoneal free cancer cells of gastric cancer

Objective:To explore the intraperitoneal free cancer cell(IFCC)detection value of negative enrichment and immune fluorescence in situ hybridization(NEimFISH)on chromosomes(CEN)8/17.Methods:To verify the reliability of NEimFISH,29 gastric cancer tumors,their adjacent tissues and greater omental tissues were tested.Our study then included 105 gastric cancer patients for IFCC.We defined patients as IFCC-positive if a signal was detected,regardless of the detailed cancer cell numbers.A comparison of clinicopathological features was conducted among IFCC groups.We also compared the diagnosis value and peritoneal recurrence predictive value among different detection methods.The comparison of IFCC number was also conducted among different groups.Results:A cutoff of 2.5 positive cells could distinguish all benign tissue samples and 97%of malignant tissue samples in our study.Compared to intestinal gastric cancer,patients with diffuse gastric cancer tended to have more IFCCs(6 vs.4,P=0.002).The IFCC counts were often higher in the lymphovascular invasion positive group than negative group(3 vs.1,P=0.022).All IFCC samples that were considered positive using conventional cytology were also found to be positive using NEimFISH.When compared to conventional cytology and paraffin pathology,NEimFISH had a higher IFCC positive rate(68.9%)and higher one-year peritoneal recurrence predictive value with area under the curve(AUC)of 0.922.Conclusions:Gastric cancer could be effectively diagnosed by NEimFISH.The IFCC number found using NEimFISH on CEN8/17 is closely associated with Lauren type and vascular invasion of cancer.NEimFISH is a reliable detection modality with a higher positive detection rate,higher one-year peritoneal recurrence predictive value and quantitative features for IFCC of gastric cancer.

THE RELATIONSHIP BETWEEN SEROSAL TYPES, PATHOLOGICAL CHARACTERISTICS AND FREE CANCER CELLS IN THE PERITONEAL CAVITY OF GASTRIC CANCER PATIENTS

The relationship between free cancer cells and the pathological characteristics of gastric cancer were studied. Of 100 cases of gastric cancer, free cancer cells in the peritoneal cavity were detected in 32 cases (32%). Free cancer cells were most often found in tendonoid (62.2%) and colour diffused (60.0%) serosal types. When the area of serosal invasion was over 20 cm, the positive free cancer cell rate was 56.6% and only 2.5% if below 20 cm. Free cancer cells were related to the depth of cancer infiltration, often found in the S2 and S3 invasion layers, as well as to the pathological characteristics of gastric cancer. Free cancer cells were often seen in infiltrated type cancer, histologically poorly differentiated or undifferentiated adenocarcinoma. and nest or diffused growth types. In patients without peritoneal metastasis (P0), the positive rate was 26.1%. This study proved that Chen's serosal classification is correct and useful in assessing whether the cancer cells have penetrated through the serosa or not during surgery. Different treatments should be used in the cases with different serosal types. In addition to surgery, destruction of free cancer cells should be considered in tendonoid and colour diffused serosal types, so as to prevent peritoneal metastasis.

Prediction of peritoneal free cancer cells in gastric cancer patients by golden-angle radial sampling dynamic contrast-enhanced magnetic resonance imaging

Objectiveperitoneal free cancer cells can negatively impact disease progression and patient outcomes in gastric cancer. This study aimed to investigate the feasibility of using golden-angle radial sampling dynamic contrast-enhanced magnetic resonance imaging (GRASP DCE-MRI) to predict the presence of peritoneal free cancer cells in gastric cancer patients.MethodsAll enrolled patients were consecutively divided into analysis and validation groups. Preoperative magnetic resonance imaging (MRI) scans and perfusion were performed in patients with gastric cancer undergoing surgery, and peritoneal lavage specimens were collected for examination. Based on the peritoneal lavage cytology (PLC) results, patients were divided into negative and positive lavage fluid groups. The data collected included clinical and MR information. A nomogram prediction model was constructed to predict the positive rate of peritoneal lavage fluid, and the validity of the model was verified based on data from the verification group.ResultsThere was no statistical difference between the proportion of PLC-positive cases predicted by GRASP DCE-MR and the actual PLC test. MR tumor stage, tumor thickness, and perfusion parameter Tofts-Ketty model volume transfer constant (Ktrans) were independent predictors of positive peritoneal lavage fluid. The nomogram model featured a concordance index (C-index) of 0.785 and 0.742 for the modeling and validation groups, respectively.ConclusionsGRASP DCE-MR could effectively predict peritoneal free cancer cells in gastric cancer patients. The nomogram model constructed using these predictors may help clinicians to better predict the risk of peritoneal free cancer cells being present in gastric cancer patients.

Comparison of peritoneal free gastric cancer cells' detecting rates between laparoscopically assisted and open radical gastrectomy

Objective： To compare laparoscopic gastrectomy and conventional surgery on the dissemination and seeding of tumor cells. Methods：Intraoperative peritoneal lavage cytologic examination was performed in 65 patients with gastric cancer, during laparoscopic gastrectomy （n = 34） and conventional surgery （n = 31）. Cytology was examined twice, immediately after opening the peritoneal cavity and just before closing the abdomen. Saline was poured into the peritoneal cavity, and 100 ml fluid was retrieved after irrigation. Laparoscopic instruments were lavaged after surgery with 100 ml saline. Carbon dioxide （COz） was derived through the trocar side orifice after pneumoperitoneum during laparoscopic gastrectomy and filtered through 100 ml saline. Cytologic examination of the filtrate was performed after the filtration process. Results： The incidence of positive cytology during laparoscopic surgery was 32.26% in the preoperative lavage and 22.58% in the postoperative lavage. The incidence of positive cytology during conventional surgery was 41.18% before lavage and 26.47% after lavage. Only one positive cytology was detected in the CO2 filtrate gas. The incidence of positive cytology in the lavage of the instruments during laparoscopic surgery was 6.45 %. Conclusion： During gastric laparoscopic surgery, CO2 pneumoperitoneum does not affect tumor cell dissemination and seeding. In this study, laparoscopic techniques used in gastric cancer surgery were not associated with a higher risk for intraperitoneal dissemination of cancer cells than the conventional surgery.

Detection methods and clinical significance of free peritoneal tumor cells found during colorectal cancer surgery

Peritoneal washing is now part of the standard clinical practice in several abdominal and pelvic neoplasias. However, in colorectal cancer surgery, intra-peritoneal free cancer cells(IFCC) presence is not routinely investigated and their prognostic meaning is still unclear. When peritoneal washing results are positive for the presence of IFCC a worse outcome is usually expected in these colorectal cancer operated patients, but it what is not clear is whether it is associated with an increased risk of local recurrence. It is authors' belief that one of the main reasons why IFCC are not researched as integral part of the routine staging system for colon cancer is that there still isn't a diagnostic or detection method with enough sensibility and specificity. However, the potential clinical implications of a routine research for the presence IFCC in colon neoplasias are enormous: not only to obtain a more accurate clinical staging but also to offer different therapy protocols, based on the presence of IFCC. Based on this, adjuvant chemotherapy could be offered to those patients found to be positive for IFCC; also, protocols of proactive intraperitoneal chemotherapy could be applied. Although presence of IFCC appears to have a valid prognostic significance, further studies are needed to standardize detection and examination procedures, to determine if there are and which are the stages more likely to benefit from routine search for IFCC.

Isolation and Identification of Cancer Stem Cells from Human Osteosarcom by Serum-free Three-dimensional Culture Combined with Anticancer Drugs

The cancer stem cells(CSCs)from human osteosarcoma by serum-free three-dimensional culture combined with anticancer drugs were isolated and identified.The primary cells derived from human osteosarcoma were digested by trypsin to prepare a single-cell suspension,and mixed homogeneously into 1.2% alginate gel.Single-cell alginate gel was cultured with serum-free DMEM/F12 medium.Epirubicin(0.8μg/mL)was added to the medium to enrich CSCs.After cultured conventionally for 7 to 10 days,most of cells suspended in ...

Liquid biopsy in patients with pancreatic cancer: Circulating tumor cells and cell-free nucleic acids

Despite recent advances in surgical techniques and perioperative management, the prognosis of pancreatic cancer(PCa) remains extremely poor. To provide optimal treatment for each patient with Pca, superior biomarkers are urgently needed in all phases of management from early detection to staging, treatment monitoring, and prognosis. In the blood of patients with cancer, circulating tumor cells(CTCs) and cell-free nucleic acids(cf NAs), such as DNA, m RNA, and noncoding RNA have been recognized. In the recent years, their presence in the blood has encouraged researchers to investigate their potential use as novel blood biomarkers, and numerous studies have demonstrated their potential clinical utility as a biomarker for certain types of cancer. This concept, called "liquid biopsy" has been focused on as a less invasive, alternative approach to cancer tissue biopsy for obtaining genetic and epigenetic aberrations that contribute to oncogenesis and cancer progression. In this article, we review the available literature on CTCs and cfN As in patients with cancer, particularly focusing on PCa, and discuss future perspectives in this field.

Prognostic and predictive blood biomarkers in gastric cancer and the potential application of circulating tumor cells

Gastric cancer(GC), with its high incidence and mortality rates, is a highly fatal cancer that is common in East Asia particularly in China. Its recurrence and metastasis are the main causes of its poor prognosis. Circulating tumor cells(CTCs) or other blood biomarkers that are released into the circulating blood stream by tumors are thought to play a crucial role in the recurrence and metastasis of gastric cancer. Therefore, the detection of CTCs and other blood biomarkers has an important clinical significance; in fact, they can help predict the prognosis, assess the staging, monitor the therapeutic effects and determine the drug susceptibility. Recent research has identified many blood biomarkers in GC, such as various serum proteins, autoantibodies against tumor associated antigens, and cell-free DNAs. The analysis of CTCs and circulating cell-free tumor DNA(ctDNA) in the peripheral blood of patients with gastric cancer is called as liquid biopsy. These blood biomarkers provide the disease status for individuals and have clinical meaning. In this review, we focus on the recent scientific advances regarding CTCs and other blood biomarkers, and discuss their origins and clinical meaning.

Adjuvant treatment for triple-negative breast cancer: a retrospective study of immunotherapy with autologous cytokine-induced killer cells in 294 patients

Objective: To examine the efficacy and safety of a sequential combination of chemotherapy and autologous cytokine-induced killer(CIK) cell treatment in triple-negative breast cancer(TNBC) patients.Methods: A total of 294 post-surgery TNBC patients participated in the research from January 1, 2009 to January 1, 2015. After adjuvant chemotherapy, autologous CIK cells were introduced in 147 cases(CIK group), while adjuvant chemotherapy alone was used to treat the remaining 147 cases(control group). The major endpoints of the investigation were the disease-free survival(DFS) and overall survival(OS). Additionally, the side effects of the treatment were evaluated.Results: In the CIK group, the DFS and OS intervals of the patients were significantly longer than those of the control group(DFS:P = 0.047;OS: P = 0.007). The multivariate analysis demonstrated that the TNM(tumor-node-metastasis) stage and adjuvant CIK treatment were independent prognostic factors for both DFS [hazard ratio(HR)= 0.520, 95% confidence interval(CI):0.271-0.998, P = 0.049;HR = 1.449, 95% CI:1.118-1.877, P = 0.005, respectively] and OS(HR=0.414, 95% CI:0.190-0.903, P = 0.027;HR= 1.581, 95% CI:1.204-2.077, P = 0.001, respectively) in patients with TNBC. Additionally, longer DFS and OS intervals were associated with increased number of CIK treatment cycles(DFS: P = 0.020;OS: P = 0.040). The majority of the patients who benefitted from CIK cell therapy were relatively early-stage TNBC patients.Conclusion: Chemotherapy in combination with adjuvant CIK could be used to lower the relapse and metastasis rate, thus effectively extending the survival time of TNBC patients, especially those at early stages.

腹腔镜下D2根治术联合CME对局部进展期胃癌术后腹腔游离癌细胞检出率及预后的影响

目的:探讨腹腔镜下D2根治术联合完整系膜切除术(complete mesocolic excision,CME)对局部进展期胃癌腹腔游离癌细胞及预后的影响。方法:回顾性分析2021年06月至2022年06月于医院住院治疗的128例局部进展期胃癌患者临床资料,将64例实施腹腔镜下D2根治术的患者纳入对照组,64例实施腹腔镜下D2根治术联合CME的患者纳入研究组。记录两组手术、住院及并发症情况,采用生活质量综合评定问卷-74(GQOLI-74)评定生活质量。分别于腹腔镜探查后和肿瘤切除后收集腹腔冲洗液,应用细胞学检查检测腹腔游离癌细胞。术后随访1年,记录总生存期(OS)及无进展生存期(PFS)情况。结果:研究组淋巴结清扫总数及阳性淋巴结数量显著大于对照组(P<0.05)。与术前比较,研究组术后腹腔游离癌细胞阳性率显著降低(P<0.05)。与术前比较,两组术后GQOLI-74评分均显著增加,且研究组高于对照组(P<0.05)。两组腹腔感染/积液、胃排空障碍、肠梗阻、吻合口瘘、胰瘘、淋巴漏发生率及不良反应总发生率比较,差异均无统计学意义(P>0.05)。研究组术后1年PFS率和OS率均显著高于对照组(P<0.05)。结论:腹腔镜下D2根治术联合CME有利于彻底清除局部进展期胃癌淋巴结,减少术后复发,促进术后康复,且不增加腹腔游离癌细胞脱落和手术并发症风险,具有临床推广价值。

Maintaining clarity:Review of maintenance therapy in nonsmall cell lung cancer

The purpose of this article is to review the role of maintenance therapy in the treatment of advanced nonsmall cell lung cancer(NSCLC). A brief overview about induction chemotherapy and its primary function in NSCLC is provided to address the basis of maintenance therapies foundation. The development of how maintenance therapy is utilized in this population is discussed and current guidelines for maintenance therapy are reviewed. Benefits and potential pitfalls of maintenance therapy are addressed, allowing a comprehensive review of the achieved clinical benefit that maintenance therapy may or may not have on NSCLC patient population. A review of current literature was conducted and a table is provided comparing the results of various maintenance therapy clinical trials. The table includes geographical location of each study, the number of patients enrolled, progression free survival and overall survival statistics, post-treatment regimens and if molecular testing was conducted. The role of molecular testing in relation to therapeutic treatment options foradvanced NSCLC patients is discussed. A treatment algorithm clearly depicts first line and second line treatment for management of NSCLC and includes molecular testing, maintenance therapy and the role clinical trials have in treatment of NSCLC. This treatment algorithm has been specifically tailored and developed to assist clinicians in the management of advanced NSCLC.

基于Label-free技术的非小细胞肺癌蛋白质差异研究

目的 基于非小细胞肺癌(non-small-cell lung cancer,NSCLC)及与其配对的非癌性邻近组织(non-cancerous adjacent tissues,NATs)的蛋白质组学分析,寻找NSCLC诊断相关蛋白标志物。方法 应用非标记定量蛋白组学(LFP)技术,以NSCLC患者配对的NATs为对照,对5例NSCLC患者进行癌组织蛋白质组学分析。以差异倍数>1.5(上调)或<0.67(下调)且P<0.05为标准筛选差异蛋白。应用String网站和R语言对差异蛋白进行基因本体论(gene ontology,GO)分析、京都基因和基因组百科全书(Kyoto Encyclopedia of Genes and Genomes,KEGG)分析,为进一步研究提供良好基础。结果 本研究发现差异蛋白共644个,其中339个蛋白表达上调,305个蛋白表达下调。PCA结果显示,差异蛋白可明显区分NSCLC与NATs。GO分析结果表明,差异蛋白大多以细胞外泌体的形式存在且主要富集于调节胞外分泌、胞外分泌、骨髓细胞激活参与免疫反应等的生物学过程以及钙粘着蛋白绑定、细胞外基质绑定等的分子功能。KEGG分析结果显示,差异蛋白主要富集在抗坏血酸和醛酸代谢、组氨酸代谢、蛋白质消化吸收、丙酮酸代谢等通路(P<0.05)。结论 NSCLC与NATs存在明显差异,可为发现NSCLC新型标志物提供线索。

复方红豆杉胶囊维持治疗气虚痰瘀证晚期非小细胞肺癌的多中心、大样本、前瞻性队列研究

目的:探讨复方红豆杉胶囊维持治疗气虚痰瘀证晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床疗效和安全性。方法:采用多中心、大样本、前瞻性队列研究方法,纳入一线化疗4~6周期后疗效评价疾病稳定以上进入维持治疗阶段患者,根据患者意愿分为治疗组160例,对照组109例。对照组根据鳞癌和非鳞癌分别给予吉西他滨和培美曲塞单药化疗维持治疗,治疗组给予复方红豆杉胶囊维持治疗。均以21天为1个疗程,两组干预至少2个疗程,每周期进行生活质量评价,每2疗程进行影像学疗效评价。比较两组疾病无进展生存时间(progression-free survival time,PFS)、生活质量,同时进行药物安全性评价。结果:269例入组患者中,246例患者出现PFS终点事件(91.45%),其中治疗组145例,中位PFS为106天,对照组101例,中位PFS为120天,两组PFS比较差异无统计学意义(P>0.05)。采用美国肺癌生存质量量表(FACT-L4.0版)和欧洲五维健康量表中视觉模拟量表(EQ-5D-VAS)对两组患者生活质量评分进行比较,两种生活质量评价量表均提示治疗组较对照组在提高生活质量方面存在优势(P<0.05)。治疗期间两组共有19例患者出现ADR,治疗组7例(占治疗组人数4.38%),对照组12例(占对照组人数11.01%),ADR发生率在治疗组中更低,尤其表现在骨髓抑制不良反应的发生率方面。结论:在延长PFS方面,复方红豆杉胶囊维持治疗气虚痰瘀证晚期NSCLC的疗效非劣于现代医学单药维持化疗,且在高生活质量、低不良反应方面,复方红豆杉胶囊更具有一定优势。

血浆游离RNA作为结直肠癌生物标志物的研究进展

近年来,血浆游离RNA成为了一种新型且极具吸引力的液体活检标志物。随着测序技术的快速发展,人们对于血浆游离RNA的认识愈加全面。转录组测序技术的发展使血浆游离RNA能够提供多种靶基因的表达水平、RNA的结构及序列等重要信息。此外,肿瘤特异性转录本的过表达能够增加血浆中肿瘤来源的RNA信号,克服了由于循环肿瘤DNA数量少而导致的局限性。该文的目的是对血浆游离RNA及其作为结直肠癌诊断、预后、预测和耐药生物标志物的现状进行综述。最后,我们讨论了血浆游离RNA在临床实际应用中的局限性及未来发展趋势。

系统免疫炎症指数对根治性放疗Ⅲ期肺鳞癌患者长期生存的预测价值

目的探讨系统免疫炎症指数(SII)对接受根治性放疗的Ⅲ期肺鳞癌患者长期生存的预测价值。方法回顾性收集接受根治性放疗的Ⅲ期肺鳞癌患者的临床资料。计算患者放疗前1周内的SII及相关炎症指标,同时应用X-Tile软件确定最佳截断值。分析患者的生存情况以及SII对患者总生存(OS)及无进展生存(PFS)的影响。结果共纳入了453例患者,低SII组336例(<1277.3),高SII组117例(≥1277.3)。高SII组的中位OS和中位PFS均较低SII组缩短(OS:20.8个月vs.31.0个月,Log-rankχ2=18.015,P<0.01;PFS:13.0个月vs.21.0个月,Log-rankχ2=15.062,P<0.01)。多因素Cox回归分析显示,高SII是患者OS(HR=1.628,95%CI:1.294~2.047,P<0.001)和PFS(HR=1.559,95%CI:1.240~1.961,P<0.001)的独立危险因素,其他的影响因素包括较晚的TNM分期、放疗疗效欠佳,HALP评分下降。结论SII可作为接受根治性放疗Ⅲ期肺鳞癌患者长期生存的评价指标,SII升高提示预后较差。

基于甲基化特异性PCR的外周血循环游离DNA甲基化检测对乳腺癌诊断价值的荟萃分析

目的通过Meta分析系统评估基于甲基化特异性PCR(MSP)的外周血循环游离DNA(cfDNA)甲基化检测对乳腺癌的诊断价值。方法检索PubMed、Embase、Cochrane数据库,检索时间为2011年1月至2021年12月,以“Breast neoplasms”“Breast cancer”“Methylation”“Cell-free DNA”等为检索词,检索有关血液循环cfDNA甲基化用于乳腺癌诊断的文献,根据纳入及排除标准筛选文献。使用QUADAS-2对纳入文献进行质量评价,提取研究数据并使用Stata 16.0对各效应量进行合并,分析异质性及来源,以Deek’s法检验发表偏倚。结果共检索318篇文献,最终纳入12篇文献的27项研究进行Meta分析,患者2195例,纳入研究存在高度异质性(I^(2)>50.00%)。采用随机效应模型合并灵敏度为0.43[95%CI(0.31~0.56)],合并特异度为0.97[95%CI(0.94~0.99)],合并阳性似然比(LR+)为16.30[95%CI(7.00~37.80)],合并阴性似然比(LR-)为0.59[95%CI(0.47~0.73)],合并诊断比值比(DOR)为28.00[95%CI(11.00~70.00)],合并AUC为0.85[95%CI(0.82~0.88)]。结论基于MSP的外周血cfDNA甲基化检测对乳腺癌有较高的辅助诊断价值。

管中窥豹:肺癌液态活检的现状与挑战

肺癌是中国最常见的恶性肿瘤之一,亟需新的诊断方法来检测肿瘤并监测治疗反应。液态活检作为一种非侵入性的肿瘤检测方法在肺癌的早筛诊断和治疗管理中展现出巨大的潜力。液态活检通过分析血液中的循环肿瘤细胞(CTCs)、细胞游离DNA(cfDNA)和循环肿瘤DNA(ctDNA),能够提供关于肿瘤的遗传信息,有利于肺癌早期诊断、病情监测以及疗效评估。相较于传统的组织活检,液态活检具有操作简便、风险低、可以反复进行以及能更全面反映肿瘤异质性等优点。该文回顾了液态活检在肺癌中的应用现状,探讨当前液态活检技术面临的挑战。旨在为肺癌的精准诊疗提供科学依据,推动液态活检技术在临床实践中的应用和发展。

晚期NSCLC患者接受吉非替尼靶向联合化疗治疗疗效及无进展生存预测因子研究

目的:探究晚期非小细胞肺癌(NSCLC)患者接受吉非替尼靶向联合化疗治疗疗效及分析无进展生存期(PFS)预测因子。方法:回顾性分析于2019年1月至2021年12月期间在本院诊治的255例晚期NSCLC患者的临床资料,依据治疗方式将研究对象分为对照组(n=78)、联合组(n=177),对照组行常规化疗治疗,联合组行吉非替尼靶向联合化疗治疗。比较对照组和联合组近期疗效,采用Kaplan-Meier绘制两组PFS生存曲线以评估远期疗效,采用单因素和多因素COX回归分析联合组PFS的预测因子。结果:与对照组相比较,联合组客观缓解率(ORR)(68.36%vs55.13%)、疾病控制率(DCR)(97.14%vs87.18%)均更高(P<0.05);联合组中位PFS为14个月,对照组相中位PFS 9个月,Log-rank检验比较显示两组生存曲线有差别(95%CI:1.12~2.17,Log-rank检验χ2=7.624,P=0.006);单因素分析显示,年龄、胸腔积液、合并骨转移、表皮生长因子受体(EGFR)突变、肿瘤分期、肿瘤直径、乳酸脱氢酶(LDH)水平、近期疗效与PFS具有相关性(P<0.05);多因素COX回归分析显示,胸腔积液(95%CI:1.025~1.166)、EGFR突变(95%CI:1.018~1.067)、肿瘤分期ⅣA-ⅣB(95%CI:1.021~1.140)、肿瘤直径≥5cm(95%CI:1.039~1.159)、LDH>245U/L(95%CI:1.055~1.150)、近期疗效(95%CI:1.548~4.752)为PFS的独立预测因子(P<0.05)。结论:吉非替尼靶向联合化疗治疗晚期NSCLC的近期效果较佳,且能够有效改善患者远期预后。胸腔积液、肿瘤分期、肿瘤直径、LDH水平、近期疗效等为吉非替尼靶向联合化疗治疗晚期NSCLC患者PFS的独立预测因子。

食管癌患者循环肿瘤细胞与临床特征和全身炎症标志物的关系及其预后价值

目的构建一个列线图模型来评估食管癌(EC)患者根治性手术(RS)后的生存率,并通过限制性立方样条(RCS)来评估循环肿瘤细胞(CTC)、全身炎症标志物和预后之间的非线性关系。方法测定RS后采集的500例EC患者血液中CTC计数,计算系统免疫炎症指数(SII)、中性粒细胞与淋巴细胞和血小板的比值(NLPR)、全身炎症聚集指数(AISI)和全身炎症反应指数(SIRI),分析临床数据与这些指标的相关性。评估CTC计数和全身炎症标志物对总生存期(OS)和无进展生存期(PFS)的预测价值。结果CTC与临床特征(新辅助治疗、术前合并症、病理分级、脉管侵犯、神经侵犯和肿瘤大小)和炎症标志物(SII、NLPR、SIRI、AISI)存在较强的相关性。单因素和多因素Cox回归分析显示:新辅助治疗(P=0.031)、术前合并症(P=0.028)、治疗方式(P<0.001)、病理分级(P=0.006)、脉管侵犯(P=0.012)、神经侵犯(P=0.012)、SII(P<0.001)、NLPR(P=0.008)、AISI(P<0.001)、CTC(P<0.001)为独立的预后影响因素。T分期(P=0.036)、N分期(P=0.002)和脉管侵犯(P<0.001)与PFS有相关性。RCS图显示CTC、SII、NLPR、SIRI和AISI与预后呈非线性关系。Kaplan-Meier生存曲线显示,CTC、SII、NLPR、SIRI和AISI值较低的患者OS和PFS较长(P<0.05)。结论CTC、SII、NLPR和AISI可能是EC患者行RS的临床预后的有力指标,结合这些因素的列线图和RCS有助于临床实践中患者预后的个体化判断。

血清钾、红细胞和血红蛋白对前列腺癌内分泌治疗后疾病无进展生存期的预测价值

目的探索治疗前血清钾、红细胞和血红蛋白对前列腺癌患者内分泌治疗后疾病无进展生存期(PFS)的预测作用。方法收集2013年1月至2017年12月郑州大学第一附属医院收治的190例前列腺癌患者的临床资料。提取可能影响前列腺癌预后的因素,包括患者年龄、前列腺癌TNM分期、前列腺癌Gleason评分、内分泌治疗的药物类型及治疗前空腹血清钾浓度、红细胞计数、血红蛋白水平、碱性磷酸酶(ALP)水平、白细胞计数和血小板计数6个血液学指标。结果190例患者中位PFS为40.8个月。Kaplan-Meier生存分析显示,TNM分期(P=0.046)、空腹血清钾浓度(P=0.014)、红细胞计数(P=0.029)、血红蛋白水平(P=0.018)和ALP(P=0.008)与前列腺癌患者PFS有关。血红蛋白水平与红细胞计数具有显著正相关性(r=0.869、P<0.001)。将TNM分期、空腹血清钾浓度、红细胞计数和ALP纳入COX比例风险回归模型进行多因素生存分析,结果表明,TNM分期(P=0.007)、空腹血清钾浓度(P=0.006)和红细胞计数(P=0.018)是预测PFS的独立预后因素。结论TNM分期、治疗前空腹血清钾浓度和红细胞计数是预测前列腺癌患者内分泌治疗后PFS的独立预后因素,TNM分期早、空腹血清钾浓度正常范围内较低、红细胞计数正常的前列腺癌患者比TNM分期晚、空腹血清钾浓度正常范围内较高、红细胞计数低的患者拥有更长的PFS。