BACKGROUND Gastric cancer is an aggressive disease with frequent lymph node(LN)involvement.The NCCN recommends a D2 lymphadenectomy and the harvesting of at least 16 LNs.This threshold has been the subject of great de...BACKGROUND Gastric cancer is an aggressive disease with frequent lymph node(LN)involvement.The NCCN recommends a D2 lymphadenectomy and the harvesting of at least 16 LNs.This threshold has been the subject of great debate,not only for the extent of surgery but also for more appropriate staging.The reclassification of stage IIB through IIIC based on N3b nodal staging in the eighth edition of the American Joint Committee on Cancer(AJCC)staging system highlights the efforts to more accurately discriminate survival expectancy based on nodal number.Furthermore,studies have suggested that pathologic assessment of 30 or more LNs improve prognostic accuracy and is required for proper staging of gastriccancer.AIM To evaluate the long-term survival of advanced gastric cancer patients who deviated from expected survival curves because of inadequate nodal evaluation.METHODS Eligible patients were identified from the Surveillance,Epidemiology,and End Results database.Those with stage II-III gastric cancer were considered for inclusion.Three groups were compared based on the number of analyzed LNs.They were inadequate LN assessment(ILA,<16 LNs),adequate LN assessment(ALA,16-29 LNs),and optimal LN assessment(OLA,≥30 LNs).The main outcomes were overall survival(OS)and cancer-specific survival.Data were analyzed by the Kaplan-Meier product-limit method,log-rank test,hazard risk,and Cox proportional univariate and multivariate models.Propensity score matching(PSM)was used to compare the ALA and OLA groups.RESULTS The analysis included 11607 patients.Most had advanced T stages(T3=48%;T4=42%).The pathological AJCC stage distribution was IIA=22%,IIB=18%,IIIA=26%,IIIB=22%,and IIIC=12%.The overall sample divided by the study objective included ILA(50%),ALA(35%),and OLA(15%).Median OS was 24 mo for the ILA group,29 mo for the ALA group,and 34 mo for the OLA group(P<0.001).Univariate analysis showed that the ALA and OLA groups had better OS than the ILA group[ALA hazard ratio(HR)=0.84,95%confidence interval(CI):0.79-0.88,P<0.001 and OLA HR=0.73,95%CI:0.68-0.79,P<0.001].The OS outcome was confirmed by multivariate analysis(ALA HR=0.68,95%CI:0.64-0.71,P<0.001 and OLA:HR=0.48,95%CI:0.44-0.52,P<0.001).A 1:1 PSM analysis in 3428 patients found that the OLA group had better survival than the ALA group(OS:OLA median=34 mo vs ALA median=26 mo,P<0.001,which was confirmed by univariate analysis(HR=0.81,95%CI:0.75-0.89,P<0.001)and multivariate analysis:(HR=0.71,95%CI:0.65-0.78,P<0.001).CONCLUSION Proper nodal staging is a critical issue in gastric cancer.Assessment of an inadequate number of LNs places patients at high risk of adverse long-term survival outcomes.展开更多
The effect of nitrate (NO3-) on rice (Oryza sativa L.) growth as well as N absorption and assimilation during different growth stages was examined using three typical rice cultivars. Dry weight, yield, N uptake, nitra...The effect of nitrate (NO3-) on rice (Oryza sativa L.) growth as well as N absorption and assimilation during different growth stages was examined using three typical rice cultivars. Dry weight, yield, N uptake, nitrate reductase activity (NRA) in leaves, and glutamine synthetase activity (GSA) in roots and leaves during their entire growth periods, as well as the kinetic parameters of ammonium (NH4+) uptake at the seedling stage, were measured with solution culture experiments. Results indicated that addition of NH4+-N and NO3--N at a ratio of 75:25 (NH4++NO3- treatment) when compared with that of NH4+-N alone (NH4+ treatment) increased the dry weight of 'Nanguang' cultivar by 30% and 'Yunjing 38' cultivar by 31%, and also increased their grain yield by 21% and 17%, respectively. For the four growth stages, the total N accumulation in plants increased by an average of 36% for 'Nanguang' and 31% for 'Yunjing 38', whereas the increasing effect of NO3- in the '4007' cultivar was only found at the seedling stage. In the NH4++NO3-treatment compared to the NH4+ treatment, NRA in the leaves increased by 2.09 folds, and GSA increased by 92% in the roots and 52% in the leaves of the three cultivars. NO3- supply increased the maximum uptake rate (Vmax) in the 'Nanguang' and 'Yunjing 38' cultivars, reflecting that the NO3- itself, not the increasing N concentration, increased the uptake rate of NH4+ by rice. There was no effect on the apparent Michaelis-Menten constant (Km) of the three cultivars. Thus, some replacement of NH4+ with NO3- could greatly improve the growth of rice plants, mainly on account of the increased uptake of NH4+ promoted by NO3-, and future studies should focus on the molecular mechanism of the increased uptake of NH4+ by NO3-.展开更多
Background Patients with single station mediastinal lymph node (N2) non-small call lung ccancer (NSCLC) have a better prognosis than those with multilevel N2.The molecular factors which are involved in disease pro...Background Patients with single station mediastinal lymph node (N2) non-small call lung ccancer (NSCLC) have a better prognosis than those with multilevel N2.The molecular factors which are involved in disease progression remain largely unknown.The purpose of this study was to investigate gene expression differences between single station and multilevel N2 NSCLC and to identify the crucial molecular factors which are associated with progress and prognosis of stage N2 NSCLC.Methods Gene expression analysis was performed using Agilent 4x44K Whole Human Genome Oligo Microarray on 10 freshfrozen lymph node tissue samples from single station N2 and paired multilevel N2 NSCLC patients.Real-time reverse transcription (RT)-PCR was used to validate the differential expression of 14 genes selected by cDNA microarray of which four were confirmed.Immunohistochemical staining for these validated genes was performed on formalin-fixed,paraffinembedded tissue samples from 130 cases of stage N2 NSCLC arranged in a high-density tissue microarray.Results We identified a 14 gene expression signature by comparative analysis of gene expression.Expression of these genes strongly differed between single station and multilevel N2 NSCLC.Four genes (ADAM28,MUC4,CLDN1,and IGF2) correlated with the results of microarray and real-time RT-PCR analysis for the gene-expression data in samples from 56 NSCLC patients.Immunohistochemical staining for these genes in samples from 130 cases of stage N2 NSCLC demonstrated the expression of IGF2 and CLDN1 was negatively correlated with overall survival of stage N2 NSCLC.Conclusions Our results suggest that the expression of CLDN1 and IGF2 indicate a poor prognosis in stage N2 NSCLC.Further,CLDN1 and IGF2 may provide potential targeting opportunities in future therapies.展开更多
文摘BACKGROUND Gastric cancer is an aggressive disease with frequent lymph node(LN)involvement.The NCCN recommends a D2 lymphadenectomy and the harvesting of at least 16 LNs.This threshold has been the subject of great debate,not only for the extent of surgery but also for more appropriate staging.The reclassification of stage IIB through IIIC based on N3b nodal staging in the eighth edition of the American Joint Committee on Cancer(AJCC)staging system highlights the efforts to more accurately discriminate survival expectancy based on nodal number.Furthermore,studies have suggested that pathologic assessment of 30 or more LNs improve prognostic accuracy and is required for proper staging of gastriccancer.AIM To evaluate the long-term survival of advanced gastric cancer patients who deviated from expected survival curves because of inadequate nodal evaluation.METHODS Eligible patients were identified from the Surveillance,Epidemiology,and End Results database.Those with stage II-III gastric cancer were considered for inclusion.Three groups were compared based on the number of analyzed LNs.They were inadequate LN assessment(ILA,<16 LNs),adequate LN assessment(ALA,16-29 LNs),and optimal LN assessment(OLA,≥30 LNs).The main outcomes were overall survival(OS)and cancer-specific survival.Data were analyzed by the Kaplan-Meier product-limit method,log-rank test,hazard risk,and Cox proportional univariate and multivariate models.Propensity score matching(PSM)was used to compare the ALA and OLA groups.RESULTS The analysis included 11607 patients.Most had advanced T stages(T3=48%;T4=42%).The pathological AJCC stage distribution was IIA=22%,IIB=18%,IIIA=26%,IIIB=22%,and IIIC=12%.The overall sample divided by the study objective included ILA(50%),ALA(35%),and OLA(15%).Median OS was 24 mo for the ILA group,29 mo for the ALA group,and 34 mo for the OLA group(P<0.001).Univariate analysis showed that the ALA and OLA groups had better OS than the ILA group[ALA hazard ratio(HR)=0.84,95%confidence interval(CI):0.79-0.88,P<0.001 and OLA HR=0.73,95%CI:0.68-0.79,P<0.001].The OS outcome was confirmed by multivariate analysis(ALA HR=0.68,95%CI:0.64-0.71,P<0.001 and OLA:HR=0.48,95%CI:0.44-0.52,P<0.001).A 1:1 PSM analysis in 3428 patients found that the OLA group had better survival than the ALA group(OS:OLA median=34 mo vs ALA median=26 mo,P<0.001,which was confirmed by univariate analysis(HR=0.81,95%CI:0.75-0.89,P<0.001)and multivariate analysis:(HR=0.71,95%CI:0.65-0.78,P<0.001).CONCLUSION Proper nodal staging is a critical issue in gastric cancer.Assessment of an inadequate number of LNs places patients at high risk of adverse long-term survival outcomes.
基金Project supported by the National Natural Science Foundation of China (Nos. 30390082 and 40471074)
文摘The effect of nitrate (NO3-) on rice (Oryza sativa L.) growth as well as N absorption and assimilation during different growth stages was examined using three typical rice cultivars. Dry weight, yield, N uptake, nitrate reductase activity (NRA) in leaves, and glutamine synthetase activity (GSA) in roots and leaves during their entire growth periods, as well as the kinetic parameters of ammonium (NH4+) uptake at the seedling stage, were measured with solution culture experiments. Results indicated that addition of NH4+-N and NO3--N at a ratio of 75:25 (NH4++NO3- treatment) when compared with that of NH4+-N alone (NH4+ treatment) increased the dry weight of 'Nanguang' cultivar by 30% and 'Yunjing 38' cultivar by 31%, and also increased their grain yield by 21% and 17%, respectively. For the four growth stages, the total N accumulation in plants increased by an average of 36% for 'Nanguang' and 31% for 'Yunjing 38', whereas the increasing effect of NO3- in the '4007' cultivar was only found at the seedling stage. In the NH4++NO3-treatment compared to the NH4+ treatment, NRA in the leaves increased by 2.09 folds, and GSA increased by 92% in the roots and 52% in the leaves of the three cultivars. NO3- supply increased the maximum uptake rate (Vmax) in the 'Nanguang' and 'Yunjing 38' cultivars, reflecting that the NO3- itself, not the increasing N concentration, increased the uptake rate of NH4+ by rice. There was no effect on the apparent Michaelis-Menten constant (Km) of the three cultivars. Thus, some replacement of NH4+ with NO3- could greatly improve the growth of rice plants, mainly on account of the increased uptake of NH4+ promoted by NO3-, and future studies should focus on the molecular mechanism of the increased uptake of NH4+ by NO3-.
基金Thiswork was supported by grants from National Natural Science Foundation of China (No. 30801377, No. 81000899, No. 81201649) and Tianjin Municipal Science and Technology Commission Key Application Research Project (No. 11JCZDJC 18900).
文摘Background Patients with single station mediastinal lymph node (N2) non-small call lung ccancer (NSCLC) have a better prognosis than those with multilevel N2.The molecular factors which are involved in disease progression remain largely unknown.The purpose of this study was to investigate gene expression differences between single station and multilevel N2 NSCLC and to identify the crucial molecular factors which are associated with progress and prognosis of stage N2 NSCLC.Methods Gene expression analysis was performed using Agilent 4x44K Whole Human Genome Oligo Microarray on 10 freshfrozen lymph node tissue samples from single station N2 and paired multilevel N2 NSCLC patients.Real-time reverse transcription (RT)-PCR was used to validate the differential expression of 14 genes selected by cDNA microarray of which four were confirmed.Immunohistochemical staining for these validated genes was performed on formalin-fixed,paraffinembedded tissue samples from 130 cases of stage N2 NSCLC arranged in a high-density tissue microarray.Results We identified a 14 gene expression signature by comparative analysis of gene expression.Expression of these genes strongly differed between single station and multilevel N2 NSCLC.Four genes (ADAM28,MUC4,CLDN1,and IGF2) correlated with the results of microarray and real-time RT-PCR analysis for the gene-expression data in samples from 56 NSCLC patients.Immunohistochemical staining for these genes in samples from 130 cases of stage N2 NSCLC demonstrated the expression of IGF2 and CLDN1 was negatively correlated with overall survival of stage N2 NSCLC.Conclusions Our results suggest that the expression of CLDN1 and IGF2 indicate a poor prognosis in stage N2 NSCLC.Further,CLDN1 and IGF2 may provide potential targeting opportunities in future therapies.