Efficacy of radiofrequency ablation combined with sorafenib for treating liver cancer complicated with portal hypertension and prognostic factors

BACKGROUND Patients with liver cancer complicated by portal hypertension present complex challenges in treatment.AIM To evaluate the efficacy of radiofrequency ablation in combination with sorafenib for improving liver function and its impact on the prognosis of patients with this condition.METHODS Data from 100 patients with liver cancer complicated with portal hypertension from May 2014 to March 2019 were analyzed and divided into a study group(n=50)and a control group(n=50)according to the treatment regimen.The research group received radiofrequency ablation(RFA)in combination with sorafenib,and the control group only received RFA.The short-term efficacy of both the research and control groups was observed.Liver function and portal hypertension were compared before and after treatment.Alpha-fetoprotein(AFP),glypican-3(GPC-3),and AFP-L3 levels were compared between the two groups prior to and after treatment.The occurrence of adverse reactions in both groups was observed.The 3-year survival rate was compared between the two groups.Basic data were compared between the survival and non-surviving groups.To identify the independent risk factors for poor prognosis in patients with liver cancer complicated by portal hypertension,multivariate logistic regression analysis was employed.RESULTS When comparing the two groups,the research group's total effective rate(82.00%)was significantly greater than that of the control group(56.00%;P<0.05).Following treatment,alanine aminotransferase and aspartate aminotransferase levels increased,and portal vein pressure decreased in both groups.The degree of improvement for every index was substantially greater in the research group than in the control group(P<0.05).Following treatment,the AFP,GPC-3,and AFP-L3 levels in both groups decreased,with the research group having significantly lower levels than the control group(P<0.05).The incidence of diarrhea,rash,nausea and vomiting,and fatigue in the research group was significantly greater than that in the control group(P<0.05).The 1-,2-,and 3-year survival rates of the research group(94.00%,84.00%,and 72.00%,respectively)were significantly greater than those of the control group(80.00%,64.00%,and 40.00%,respectively;P<0.05).Significant differences were observed between the survival group and the non-surviving group in terms of Child-Pugh grade,history of hepatitis,number of tumors,tumor size,use of sorafenib,stage of liver cancer,histological differentiation,history of splenectomy and other basic data(P<0.05).Logistic regression analysis demonstrated that high Child-Pugh grade,tumor size(6–10 cm),history of hepatitis,no use of sorafenib,liver cancer stage IIIC,and previous splenectomy were independent risk factors for poor prognosis in patients with liver cancer complicated with portal hypertension(P<0.05).CONCLUSION Patients suffering from liver cancer complicated by portal hypertension benefit from the combination of RFA and sorafenib therapy because it effectively restores liver function and increases survival rates.The prognosis of patients suffering from liver cancer complicated by portal hypertension is strongly associated with factors such as high Child-Pugh grade,tumor size(6-10 cm),history of hepatitis,lack of sorafenib use,liver cancer at stage IIIC,and prior splenectomy.

Prognostic value of potential biomarkers in prostate cancer via bioinformatic analysis

Background:The Genotype-Tissue Expression was used to expanded normal tissue of the Cancer Genome Atlas database.This study aimed to investigate genes associated with the pathogenesis and prognosis of prostate cancer.Methods:We conducted prognostic related genes for prostate cancer by using transcriptome data from the Genotype-Tissue Expression Project and the Cancer Genome Atlas data sources,which were analyzed using an integrated bioinformatics strategy.Clinically significant modules were distinguished,and GO and KEGG analysis were used to Database for Annotation,Visualization and Integrated Discovery.Further annotation was performed through Gene set enrichment analysis.Logistic regression was carried out to analyze the associations between clinicopathologic characteristics and the hub genes.Logistic regression model and survival analysis were performed.Results:By using data available from the Cancer Genome Atlas and the Genotype-Tissue Expression databases,we here show that 53 differential expression genes were identified.Through GO and KEGG analysis a prognostic related gene signature consisted of GOLM1,EIF4A1,ABCC4,RPL7P16,NPIPB12 and PCA3 was constructed with a good performance in predicting overall survivals.The majority of the six hub genes were associated with clinical characteristics of prostate cancer.Conclusion:These genes might be considered as new targets for further investigating the diagnostic and prognostic biomarkers to facilitate the molecular targeting therapy since they showed differently expressed in prostate cancer and correlate with overall survival prognosis.

Prognostic factors of primary gastrointestinal stromal tumors： a cohort study based on high-volume centers

Objective： We aimed to evaluate the clinicopathologic characteristics, immunohistochemical expression and prognostic factors of patients with primary gastrointestinal stromal tumors（GISTs）.Methods： Data from 2,570 consecutive GIST patients from four medical centers in China（January2001–December 2015） were reviewed. Survival curves were constructed by the Kaplan-Meier method, and Cox regression models were used to identify independent prognostic factors.Results： Of the included patients, 1,375（53.5%） were male, and the patient age range was 18 to 95（median, 58）years. The tumors were mostly found in the stomach（64.5%）, small intestine（25.1%） and colorectal region（5.1%）.At the time of diagnosis, the median tumor size was 4.0（range： 0.1–55.0） cm, and the median mitotic index per 50 high power fields（HPFs） was 3（range： 0–254）. Of the 2,168 resected patients, 2,009（92.7%） received curative resection. According to the modified National Institutes of Health（NIH） classification, 21.9%, 28.9%, 14.1% and35.1% were very low-, low-, intermediate-and high-risk tumors, respectively. The rate of positivity was 96.4% for c-Kit, 87.1% for CD34, 96.9% for delay of germination 1（DOG-1）, 8.0% for S-100, 31.0% for smooth muscle actin（SMA） and 5.1% for desmin. However, the prognostic value of each was limited. Multivariate analysis showed that age, tumor size, mitotic index, tumor site, occurrence of curative resection and postoperative imatinib were independent prognostic factors. Furthermore, we found that high-risk patients benefited significantly from postoperative imatinib（P〈0.001）, whereas intermediate-risk patients did not（P=0.954）.Conclusions： Age, tumor size, mitotic index, tumor site, occurrence of curative resection and postoperative imatinib were independent prognostic factors in patients with GISTs. Moreover, determining whether intermediate-risk patients can benefit from adjuvant imatinib would be of considerable interest in future studies.

Intertumoral heterogeneity of molecular phenotype and analysis of prognosis in multifocal and multicentric breast cancer

Objective This study was designed to investigate the prognostic implications of the intertumoral heterogeneity of molecular phenotype in multifocal and multicentric breast cancer(MMBC).Methods The clinical and follow-up data of 146 patients with MMBC from Jan.2009to Dec.2009 treated in Tumor Hospital Affiliated to Zhengzhou University were retrospectively analyzed.

Analysis of clinical features and prognosis of anti-glomerular basement membrane antibody positive patients with anti-neutrophil cytoplasmic antibodies

Objective To investigate the characteristics and outcome of glomerulonephritis in patients with both antineutrophil cytoplasmic antibody and anti-glomerular basement membrane antibody.Methods The sera of 23 antiGBM glomerulonephritis patients were collected and were tested for ANCA respectively.Characteristics and outcome of patients with coexisting anti-GBM antibody

Survival Analysis of Hepatocellular Carcinoma： A Comparison Between Young Patients and Aged Patients

Background： To compare the clinicopathological features and prognosis between younger and aged patients with hepatocellular carcinoma （HCC）. Methods： We analyzed the outcome of 451 HCC patients underwent liver resection, transcatheter arterial chemoembolization and radiofrequency ablation, respectively. Then risk factors for aged and younger patients＇ survival were evaluated by multivariate analysis, respectively. Results： The patients who were older lhan 55 years old were defined as the older group. The overall survival for aged patients was significantly worse than those younger patients. The younger patients had similar liver fhnctional reserve but more aggressive tumor Paclors than aged patients. Cox regression analysis showed that tile elevated levels ofaspartate aminotransferase （AST） （Waldx2= 3.963, P = 0.047, hazard ratio [HR] -1.453, 95% confidence interval [CI]： 1.006-2.098）, lower albumin （Wald X2 = 12.213, P 〈 0.001, HR 1.982, q5% CI： 1.351 2.910）, tumor size （Wald X2 = 8.179, P- 0,004, HR - 1.841,95% CI： 1.212-2.797）, and higher alpha-fetoprotein level （Wald X2=4.044, P = 0.044, HR = 1,465, 95% （CI： 1.010 2.126） were independent prognostic factors for aged patients, while only elevated levelsofAST（WaldZ= 14.491,P〈0.001,HR 2.285, 95%CI： 1.493-3.496）andtumorsize（WaldX2= 21.662, P〈0.001,HR= 2.928, 95% CI： 1.863-4.604） were independent prognostic factors for younger patients. Conclusions： Age is a risk factor to determine the prognosis of patients with HCC. Aged patients who have good liver lhnctional reserve are still encouraged to receive curative therapy.