BACKGROUND Endoscopic submucosal dissection(ESD)and surgical resection are the standard of care for cT1N0M0 esophageal cancer(EC),whereas definitive chemoradiotherapy(d-CRT)is a treatment option.Nevertheless,the compa...BACKGROUND Endoscopic submucosal dissection(ESD)and surgical resection are the standard of care for cT1N0M0 esophageal cancer(EC),whereas definitive chemoradiotherapy(d-CRT)is a treatment option.Nevertheless,the comparative efficiency and safety of ESD,surgery and d-CRT for cT1N0M0 EC remain unclear.AIM To compare the efficiency and safety of ESD,surgery and d-CRT for cT1N0M0 EC.METHODS We retrospectively analyzed the hospitalized data of a total of 472 consecutive patients with cT1N0M0 EC treated at Sun Yat-sen University Cancer center between 2017-2019 and followed up until October 30th,2022.We analyzed demographic,medical recorded,histopathologic characteristics,imaging and endoscopic,and follow-up data.The Kaplan-Meier method and Cox proportional hazards modeling were used to analyze the difference of survival outcome by treatments.Inverse probability of treatment weighting(IPTW)was used to minimize potential confounding factors.RESULTS We retrospectively analyzed patients who underwent ESD(n=99)or surgery(n=220)or d-CRT(n=16)at the Sun Yat-sen University Cancer Center from 2017 to 2019.The median follow-up time for the ESD group,the surgery group,and the d-CRT group was 42.0 mo(95%CI:35.0-60.2),45.0 mo(95%CI:34.0-61.75)and 32.5 mo(95%CI:28.3-40.0),respectively.After adjusting for background factors using IPTW,the highest 3-year overall survival(OS)rate and 3-year recurrence-free survival(RFS)rate were observed in the ESD group(3-year OS:99.7% and 94.7% and 79.1%;and 3-year RFS:98.3%,87.4% and 79.1%,in the ESD,surgical,and d-CRT groups,respectively).There was no difference of severe complications occurring between the three groups(P≥0.05).Multivariate analysis showed that treatment method,histology and depth of infiltration were independently associated with OS and RFS.CONCLUSION For cT1N0M0 EC,ESD had better long-term survival and lower hospitalization costs than those who underwent d-CRT and surgery,with a similar rate of severe complications occurring.展开更多
Proinflammatory microglia rely predominantly on glycolysis to maintain cytokine production during ischemia,accompanied with the increases of inducible nitric oxide synthase(iNOS)and monocarboxylate transporter 1(MCT1)...Proinflammatory microglia rely predominantly on glycolysis to maintain cytokine production during ischemia,accompanied with the increases of inducible nitric oxide synthase(iNOS)and monocarboxylate transporter 1(MCT1).Whether there is a link between iNOS and MCT1 expression patterns and pyruvate could act as an energy source to sustain the M1 proinflammatory microglial phenotype,however,remain unclear.In the present study,we examined responses from microglia in the mouse brains subjected to ischemia,and treated with low glucose treatment in vitro.展开更多
目的探讨新辅助化疗及改良根治术后放疗对cT1~2N1M0期乳腺癌患者预后的影响。方法通过提取美国国立癌症研究所监测、流行病学和结果(The Surveillance,Epidemiology,and End Results,SEER)数据库2010年至2017年期间诊断的已行新辅助化...目的探讨新辅助化疗及改良根治术后放疗对cT1~2N1M0期乳腺癌患者预后的影响。方法通过提取美国国立癌症研究所监测、流行病学和结果(The Surveillance,Epidemiology,and End Results,SEER)数据库2010年至2017年期间诊断的已行新辅助化疗及改良根治术的cT1~2N1M0期乳腺癌患者917例,采用倾向性评分匹配法将720例匹配患者分为放疗组(n=360)和未放疗组(n=360)。采用Cox比例风险回归模型探索影响乳腺癌特异性生存(breast cancer specific survival rate,BCSS)的影响因素。结果本研究患者均获访,中位随访时间为65个月,放疗组的5年BCSS率为91.9%,未放疗组为93.2%,差异无统计学意义(χ^(2)=0.292,P=0.589),在腋窝淋巴结未转移、腋窝淋巴结转移1枚、腋窝淋巴结转移2枚、腋窝淋巴结转移3枚患者中均是如此(χ^(2)=0.139,P=0.709;χ^(2)=0.578,P=0.447;χ^(2)=2.617,P=0.106;χ^(2)=0.062,P=0.803)。多因素Cox比例风险回归分析结果显示:在控制Grade分级、诊断到治疗的时间、新辅助化疗疗效、腋窝淋巴结阳性数、分子分型和初诊肿瘤直径后,放疗对BCSS的影响无统计学意义[HR=1.048,95%CI(0.704,1.561),P=0.817]。结论放疗对已行新辅助化疗及改良根治术后腋窝淋巴结转移0~3枚的cT1~2N1M0期乳腺癌患者BCSS的影响价值有限,但是否行放疗仍需根据肿瘤患者个体的综合风险来决定。展开更多
基金Supported by the Guangdong Esophageal Cancer Institute Science and Technology Program,No.M202013Guangdong Medical Research Foundation,No.A2021369.
文摘BACKGROUND Endoscopic submucosal dissection(ESD)and surgical resection are the standard of care for cT1N0M0 esophageal cancer(EC),whereas definitive chemoradiotherapy(d-CRT)is a treatment option.Nevertheless,the comparative efficiency and safety of ESD,surgery and d-CRT for cT1N0M0 EC remain unclear.AIM To compare the efficiency and safety of ESD,surgery and d-CRT for cT1N0M0 EC.METHODS We retrospectively analyzed the hospitalized data of a total of 472 consecutive patients with cT1N0M0 EC treated at Sun Yat-sen University Cancer center between 2017-2019 and followed up until October 30th,2022.We analyzed demographic,medical recorded,histopathologic characteristics,imaging and endoscopic,and follow-up data.The Kaplan-Meier method and Cox proportional hazards modeling were used to analyze the difference of survival outcome by treatments.Inverse probability of treatment weighting(IPTW)was used to minimize potential confounding factors.RESULTS We retrospectively analyzed patients who underwent ESD(n=99)or surgery(n=220)or d-CRT(n=16)at the Sun Yat-sen University Cancer Center from 2017 to 2019.The median follow-up time for the ESD group,the surgery group,and the d-CRT group was 42.0 mo(95%CI:35.0-60.2),45.0 mo(95%CI:34.0-61.75)and 32.5 mo(95%CI:28.3-40.0),respectively.After adjusting for background factors using IPTW,the highest 3-year overall survival(OS)rate and 3-year recurrence-free survival(RFS)rate were observed in the ESD group(3-year OS:99.7% and 94.7% and 79.1%;and 3-year RFS:98.3%,87.4% and 79.1%,in the ESD,surgical,and d-CRT groups,respectively).There was no difference of severe complications occurring between the three groups(P≥0.05).Multivariate analysis showed that treatment method,histology and depth of infiltration were independently associated with OS and RFS.CONCLUSION For cT1N0M0 EC,ESD had better long-term survival and lower hospitalization costs than those who underwent d-CRT and surgery,with a similar rate of severe complications occurring.
文摘Proinflammatory microglia rely predominantly on glycolysis to maintain cytokine production during ischemia,accompanied with the increases of inducible nitric oxide synthase(iNOS)and monocarboxylate transporter 1(MCT1).Whether there is a link between iNOS and MCT1 expression patterns and pyruvate could act as an energy source to sustain the M1 proinflammatory microglial phenotype,however,remain unclear.In the present study,we examined responses from microglia in the mouse brains subjected to ischemia,and treated with low glucose treatment in vitro.
文摘目的:检测食管鳞状细胞癌(esophageal squamous cell cancer,ESCC)组织标本及细胞株中β-环连蛋白抑制基因1(dishevelled-binding antagonist of beta-catenin 1,DACT1)Cp G岛旁区域及转录起始点(transcription start site,TSS)区域的甲基化状态,并进一步探讨DACT1基因两个不同区域甲基化状态对基因转录及预后的影响。方法:应用甲基化特异性PCR(methylation specific PCR,MSP)及RT-PCR的方法检测ESCC细胞株(TE1、TE13、T.Tn和Eca109)及河北省上消化道肿瘤高发区159例ESCC患者癌及相应癌旁组织中DACT1基因两个不同区域的甲基化状态及m RNA的表达情况。结果:DACT1基因在4株ESCC细胞系中均呈弱表达或阴性表达。应用甲基化抑制剂5-Aza-Dc处理该细胞株后,DACT1 m RNA表达明显增强;同时,MSP检测结果显示,此两区域的甲基化条带均明显减弱或消失;而应用组蛋白去乙酰化酶抑制剂TSA处理细胞株后,该基因在各细胞株中的表达无明显改变。DACT1 m RNA在ESCC组织中的表达较癌旁组织明显下调(P<0.01),且与该基因TSS区域异常甲基化状态有关(P<0.01);DACT1基因Cp G岛旁区域的甲基化频率在癌及相应癌旁组织中均较高(P>0.05),不具有肿瘤组织特异性,且对DACT1基因的转录抑制无明显影响(P>0.05);生存分析显示,DACT1基因TSS区域的甲基化状态与ESCC癌患者的生存期相关(P<0.01)。结论:ESCC中DACT1基因TSS区域的异常高甲基化状态是引起其表达下调的机制之一,并有望作为ESCC患者预后的甲基化标志物。
文摘目的探讨新辅助化疗及改良根治术后放疗对cT1~2N1M0期乳腺癌患者预后的影响。方法通过提取美国国立癌症研究所监测、流行病学和结果(The Surveillance,Epidemiology,and End Results,SEER)数据库2010年至2017年期间诊断的已行新辅助化疗及改良根治术的cT1~2N1M0期乳腺癌患者917例,采用倾向性评分匹配法将720例匹配患者分为放疗组(n=360)和未放疗组(n=360)。采用Cox比例风险回归模型探索影响乳腺癌特异性生存(breast cancer specific survival rate,BCSS)的影响因素。结果本研究患者均获访,中位随访时间为65个月,放疗组的5年BCSS率为91.9%,未放疗组为93.2%,差异无统计学意义(χ^(2)=0.292,P=0.589),在腋窝淋巴结未转移、腋窝淋巴结转移1枚、腋窝淋巴结转移2枚、腋窝淋巴结转移3枚患者中均是如此(χ^(2)=0.139,P=0.709;χ^(2)=0.578,P=0.447;χ^(2)=2.617,P=0.106;χ^(2)=0.062,P=0.803)。多因素Cox比例风险回归分析结果显示:在控制Grade分级、诊断到治疗的时间、新辅助化疗疗效、腋窝淋巴结阳性数、分子分型和初诊肿瘤直径后,放疗对BCSS的影响无统计学意义[HR=1.048,95%CI(0.704,1.561),P=0.817]。结论放疗对已行新辅助化疗及改良根治术后腋窝淋巴结转移0~3枚的cT1~2N1M0期乳腺癌患者BCSS的影响价值有限,但是否行放疗仍需根据肿瘤患者个体的综合风险来决定。
