Clinical value of preoperative methylated septin 9 in Chinese colorectal cancer patients

BACKGROUND The methylated septin 9(mSEPT9) assay was the first blood-based test approved by the United States Food and Drug Administration as a colorectal screening test.However, the diagnostic and prognostic role of preoperative mSEPT9 for colorectal cancer(CRC) in Chinese patients is still unknown.AIM To improve the understanding of diagnostic and prognostic factors, serum m SEPT9 was detected in Chinese CRC patients.METHODS A retrospective analysis of 354 cases, of which 300 had CRC and 54 were normal,was performed in China. Patients' characteristics, treatments, and laboratory data, including age, the date of surgery, Union for International Cancer Control(UICC) stages, distant metastasis(M), and so on, were collected. Methylation levels of SEPT9 were quantified by quantitative, methylation-specific polymerase chain reaction before surgery. In addition, the effects of mSEPT9 on the occurrence and prognosis of 330 CRC cases from The Cancer Genome Atlas(TCGA) database were evaluated using bioinformatics analyses. Potential prognostic factors for overall survival(OS) and progression-free survival(PFS)were evaluated by Kaplan-Meier univariate analysis.RESULTSIn Chinese CRC patients, positive mSEPT9 was strongly associated with advanced UICC stages, deeper invasion by the primary tumor, and more distant metastasis. Methylation levels of SEPT9 were stage-dependent and showed a stepwise increase in UICC stages(I–IV), primary tumor categories(T1–T4),regional node categories(N0–N2), and distant metastasis categories(M0–M1).The patients with positive mSEPT9 showed a tendency toward lower PFS. After analyzing TCGA clinical data, the high mSEPT9 group was found to be obviously correlated only with more distant metastasis. The patients with high mSEPT9 levels showed a tendency toward lower OS. Besides, nine meaningful mSEPT9 sites were found to provide guidance for the follow-up studies.CONCLUSION MSEPT9 analysis may add valuable information to current tumor staging. Serum m SEPT9 in Chinese CRC patients appears to offer promising novel prognostic markers and might be considered for monitoring CRC recurrence.

Prognostic significance of preoperative lymphocyte to monocyte ratio in patients with signet ring gastric cancer

BACKGROUND The ratio of lymphocytes to monocytes(LMR)has been shown to be an effective predictor of gastric cancer prognosis.However,its predictive accuracy for signet ring gastric cancer is currently not well understood.AIM To evaluate the prognosis predictive accuracy of preoperative LMR in signet ring gastric cancer.METHODS A total of 212 signet ring gastric cancer patients admitted at the Xiangya Hospital of Central South University,Department of Gastrointestinal Surgery,from January 2012 to December 2016 were enrolled in the study.The prognosis predictive accuracy of preoperative LMR was explored based on the area under the receiver operating characteristic.Factors that significantly affect the survival of patients were identified using single factor analysis,and those that were independently associated with signet ring gastric cancer were identified through multivariate analysis.RESULTS The results of the single factor analysis revealed a strong correlation between the survival of signet ring gastric cancer patients and several factors,including tumor invasion(χ^(2)=49.726;P<0.001),lymph node metastasis(χ^(2)=30.269;P<0.001),pTNM stage(χ^(2)=49.322;P<0.001),surgical approach(χ^(2)=8.489;P=0.004),age(t=-2.213;P<0.028),carcinoembryonic antigen(CEA)(Z=-3.265;P=0.001),platelet-to-lymphocyte ratio(Z=-2.196;P=0.028),LMR(Z=-2.226;P=0.026),ALB(t=3.284;P=0.001),prognostic nutritional index(t=-3.789;P<0.001)and FIB(Z=-3.065;P=0.002).Furthermore,the multivariate analysis further demonstrated that age(HR:0.563,95%CI:0.363-0.873),tumor invasion depth(HR:0.226,95%CI:0.098-0.520),pTNM stage(HR:0.444,95%CI:0.255-0.771),preoperative CEA level(HR:0.597,95%CI:0.386-8.790),and preoperative LMR level(HR:1.776,95%CI:1.150-2.741)were independent factors influencing the prognosis of signet ring gastric cancer.CONCLUSION In signet ring gastric cancer patients,a low preoperative LMR level predicts poor prognosis.The death risk ratio of the low LMR group compared to the high LMR group is 1.776.

Applying artificial intelligence for cancer immunotherapy

Artificial intelligence(AI)is a general term that refers to the use of a machine to imitate intelligent behavior for performing complex tasks with minimal human intervention,such as machine learning;this technology is revolutionizing and reshaping medicine.AI has considerable potential to perfect health-care systems in areas such as diagnostics,risk analysis,health information administration,lifestyle supervision,and virtual health assistance.In terms of immunotherapy,AI has been applied to the prediction of immunotherapy responses based on immune signatures,medical imaging and histological analysis.These features could also be highly useful in the management of cancer immunotherapy given their ever-increasing performance in improving diagnostic accuracy,optimizing treatment planning,predicting outcomes of care and reducing human resource costs.In this review,we present the details of AI and the current progression and state of the art in employing AI for cancer immunotherapy.Furthermore,we discuss the challenges,opportunities and corresponding strategies in applying the technology for widespread clinical deployment.Finally,we summarize the impact of AI on cancer immunotherapy and provide our perspectives about underlying applications of AI in the future.