ObjectiveTo analyze the expression of cold-induced RNA-binding protein (CIRBP) in lung adenocarcinoma and its clinical significance based on bioinformatics, in order to provide a new direction for the study of therapeutic targets for lung adenocarcinoma.MethodsThe CIRBP gene expression data and patient clinical information data in lung adenocarcinoma tissues and adjacent tissues were downloaded from The Cancer Genome Atlas and Gene Expression Omnibus databases. The expression of CIRBP in lung adenocarcinoma was analyzed. Furthermore, its relationship with clinicopathological features and prognosis in patients with lung adenocarcinoma was analyzed. GO and KEGG enrichment analysis were carried out for the screened genes. The CIRBP protein interaction network was constructed by STRING, and the correlation analysis was carried out using the GEPIA online website.ResultsThe expression level of CIRBP gene in lung adenocarcinoma tissues was significantly lower than that in adjacent tissues (P<0.01), and its expression level was correlated with T stage and N stage in clinicopathological features. The prognosis of patients with high CIRBP expression in lung adenocarcinoma was significantly better than that with low CIRBP expression. Univariate and multivariate Cox regression analysis showed that CIRBP was an independent prognostic factor in patients with lung adenocarcinoma. GO functional annotation showed its enrichment in organelle fission, nuclear fission, chromosome separation, and DNA replication, etc. KEGG analysis showed that it was mainly involved in cell cycle and DNA replication. Protein interaction network and GEPIA online analysis showed that the expression level of CIRBP was negatively correlated with the expression level of cyclin B2.ConclusionCIRBP gene is down-regulated in lung adenocarcinoma tissues, and its expression level is closely related to patient prognosis. CIRBP gene may be a potential therapeutic target and prognostic marker for lung adenocarcinoma.
Objective To clarify relationship between signal heterogeneity on hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI and prognosis of hepatocellular carcinoma (HCC). Methods From January 2014 to January 2017 in the First Affiliated Hospital of Chongqing Medical University, a total of 77 patients with the pathologically proved HCC underwent Gd-EOB-DTPA-enhanced MRI prior to surgery were included in this study. On the basis of the signal heterogeneity in the hepatobiliary phase, the included patients were designed to homogeneous hypointensity group and heterogeneous hyperintensity group. The disease-free survival time were compared between the 2 groups and it’s influencing factors were analyzed. Results Seventy-seven patients with HCC were included, including 45 cases of homogeneous hypointensity and 32 cases of heterogeneous hyperintensity. There were no significant differences in the age, gender, etiology, liver function, alpha-fetoprotein, differentiated degree, Child-Pugh grade, lesion diameter, lesion border, and number of lesions between the 2 groups (P>0.05). However, the HCC patients with heterogeneous hyperintensity had a later BCLC staging (P=0.001). The disease-free survival time of the patients with homogeneous hypointensity and heterogeneous hyperintensity was (17.0±9.8) months and (12.4±10.4)months, respectively. The Kaplan-Meier survival curve showed that the disease-free survival time in the patients with homogeneous hypointensity was significantly better than that in the patients with heterogeneous hyperintensity (P=0.020). The results of univariate analysis showed that the other confounding factors had no effect on the disease-free survival time of patients with hepatocellular carcinoma (P>0.05) except for the signal of hepatobiliary phase (P<0.05). Furthermore, the hepatobiliary phase signal, BCLC stage, and degree of differentiation, which might be clinically considered as potentially influencing for the prognosis of patients with HCC, were included in the Cox multivariate proportional hazard regression model and found that the heterogeneous hyperintensity was still the risk factor of the disease-free survival rate in patients with HCC (P=0.047). Conclusion Signal heterogeneity on hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI is related to prognosis of patients with HCC, heterogeneous hyperintensity may indicate a lower disease-free survival rate.
ObjectiveTo analyze the distribution, prognostic differences, and characteristics of patients with colorectal cancer (CRC) from 2007 to 2022 based on the current version of the Database from Colorectal Cancer (DACCA), so as to provide a basis for clinical decision-making. MethodsThe eligible CRC patients based on the established screening criteria from the updated DACCA were collected. The distribution and survival status of CRC patients in different residence places were analyzed. The residence places included 21 cities (prefectures) within Sichuan Province. ResultsA total of 5 416 cases that met the screening criteria from 2007 to 2022 were collected. Among these, CRC patients were predominantly concentrated in Chengdu (44.77%), Meishan (5.78%), and Nanchong (4.56%) cities. A heatmap depicting the superimposed trend of CRC patients origins revealed the distribution of patients was basically divided into eastern and western regions along the axis of “Mianyang–Chengdu–Yaan cities”. The majority of patients (5 359 cases, 98.95%) was distributed in the eastern region, while a few in the western region (57 cases, 1.05%). The patients in the eastern region were more high clustered (especially Chengdu city), while those in the western region was sporadically dispersed, and the patients in the western region increased slowly without aggregation. The 1, 3, and 5-year cumulative overall survival rates of the CRC patients in the DACCA were 96.2%, 89.7%, and 85.1%, respectively. The multivariate Cox proportional hazards regression model showed that the male, age ≥35-year old, adenocarcinoma (mucinous adenocarcinoma as a reference), poorly differentiated degree, pTNM stages Ⅲ and Ⅳ, obstruction, and perforation were the risk factors for median overall survival shortening in the CRC patients (all P<0.05). The survival curve of patients with CRC drawn by Kaplan-Meier method showed that the overall survival of CRC patients in different cities (prefectures) had no statistical differences as compared with the integral CRC patients (P>0.05), except for Neijiang city (was worse than that of the integral CRC patients, P<0.05). ConclusionsBased on data analysis for the DACCA from 2007 to 2022, the majority of CRC patients clusters in the eastern region. Chengdu city exhibits a high clustering, while the western region shows a sporadic distribution without aggregation phenomena. It is found that the cumulative overall survival of CRC patients in Neijiang city is worse than that of the integral CRC patients, while which in the other cities (prefectures) was relatively close to that of the integral CRC patients in Sichuan Province.
ObjectiveTo investigate the rule of lymph node metastasis and its relationship with prognosis in stage N1 thoracic esophageal squamous cell carcinoma. MethodsThe clinical and follow-up data of 121 stage N1 (1 to 2 lymph node metastases) thoracic esophageal squamous cell carcinoma patients, who underwent radical resection of esophageal carcinoma in our hospital from 2015 to 2017, were retrospectively analyzed. There were 104 (86.0%) males and 17 (14.0%) females with an average age of 64.9±8.3 years. ResultsThe early metastasis rates of the left upper paratracheal, right upper paratracheal, lower thoracic paraesophageal, paracardial, lesser curvature and greater curvature lymph nodes were 22.6%, 28.0%, 21.2%, 41.7%, 25.0% and 25.0%, respectively. The three-year survival rates in the group with and without left upper paratracheal lymph node metastasis were 8.3% and 34.9%, respectively (P=0.000). The three-year survival rates of the subcarinal lymph node metastasis group and the non-metastasis group were 10.5% and 36.3%, respectively (P=0.032). Multivariate Cox regression analysis showed that, left upper paratracheal lymph node metastasis (P=0.000) and subcarinal lymph node metastasis (P=0.010) were independent prognostic factors for early stage lymph node metastasis of esophageal squamous cell carcinoma. The three-year survival rates of patients with simple abdominal lymph node metastasis and those with simple thoracic lymph node metastasis were 51.1% and 25.0%, respectively (P=0.016). ConclusionThe lymph nodes of N1 stage thoracic esophageal squamous cell carcinoma are more likely to metastasize to left upper paratracheal lymph nodes, right upper paratracheal lymph nodes, lower thoracic paraesophageal lymph nodes, paracardial lymph nodes, lesser curvature of stomach and greater curvature of stomach lymph nodes. Lymph node metastases of left upper paratracheal and subcarinal are independent factors for the prognosis of patients with stage N1 thoracic esophageal squamous cell carcinoma. The prognosis of patients with simple abdominal lymph node metastasis is better than that of patients with simple thoracic lymph node metastasis.
ObjectiveTo investigate the clinical effect of thoracoscopic lobectomy versus segmentectomy in the treatment of T1bN0M0 non-small cell lung cancer (NSCLC). MethodsClinical data of 181 patients with T1bN0M0 NSCLC admitted to our hospital from 2012 to 2015 were retrospectively analyzed. They were divided into a lobectomy group and a segmentectomy group according to surgical methods. There were 117 patients in the lobectomy group (46 males and 71 females aged 61.32±8.94 years) and 64 patients in the segmentectomy group (20 males and 44 females aged 58.55±12.57 years). Perioperative indicators and prognosis were compared between the two groups. ResultsThe segmentectomy group had longer operation time, less intraoperative blood loss, shorter postoperative hospital stay and more preservation of lung function compared with the lobectomy group (P<0.05). The lobectomy group had higher consolidation tumor ratio, bigger tumor diameter, and more lymph node sampling compared with the segmentectomy group (P<0.05). There was no statistical difference in 5-year overall survival or recurrence-free survival between the two groups (P<0.05). ConclusionFor patients with T1bN0M0 NSCLC, thoracoscopic segmentectomy and lobectomy have similar prognosis, but segmentectomy has advantages with less injury and faster recovery over lobectomy.
ObjectiveTo investigate the relation between disulfidptosis-related genes (DRGs) and prognosis or immunotherapy response of patients with pancreatic cancer (PC). MethodsThe transcriptome data, somatic mutation data, and corresponding clinical information of the patients with PC in The Cancer Genome Atlas (TCGA) were downloaded. The DRGs mutated in the PC were screened out from the 15 known DRGs. The DRGs subtypes were identified by consensus clustering algorithm, and then the relation between the identified DRGs subtypes and the prognosis of patients with PC, immune cell infiltration or functional enrichment pathway was analyzed. Further, a risk score was calculated according to the DRGs gene expression level, and the patients were categorized into high-risk and low-risk groups based on the mean value of the risk score. The risk score and overall survival of the patients with high-risk and low-risk were compared. Finally, the relation between the risk score and (or) tumor mutation burden (TMB) and the prognosis of patients with PC was assessed. ResultsThe transcriptome data and corresponding clinical information of the 177 patients with PC were downloaded from TCGA, including 161 patients with somatic mutation data. A total of 10 mutated DRGs were screened out. Two DRGs subtypes were identified, namely subtype A and subtype B. The overall survival of PC patients with subtype A was better than that of patients with subtype B (χ2=8.316, P=0.003). The abundance of immune cell infiltration in the PC patients with subtype A was higher and mainly enriched in the metabolic and conduction related pathways as compaired with the patients with subtype B. The mean risk score of 177 patients with PC was 1.921, including 157 cases in the high-risk group and 20 cases in the low-risk group. The risk score of patients with subtype B was higher than that of patients with subtype A (t=14.031, P<0.001). The overall survival of the low-risk group was better than that of the high-risk group (χ2=17.058, P<0.001), and the TMB value of the PC patients with high-risk was higher than that of the PC patients with low-risk (t=5.642, P=0.014). The mean TMB of 161 patients with somatic mutation data was 2.767, including 128 cases in the high-TMB group and 33 cases in the low-TMB group. The overall survival of patients in the high-TMB group was worse than that of patients in the low-TMB group (χ2=7.425, P=0.006). ConclusionDRGs are closely related to the prognosis and immunotherapy response of patients with PC, and targeted treatment of DRGs might potentially provide a new idea for the diagnosis and treatment of PC.
Objective To explore the association between the preoperative systemic immune-inflammation index (SII) and prognosis in non-small cell lung cancer (NSCLC) patients. Methods A comprehensive literature survey was performed on PubMed, Web of Science, EMbase, The Cochrane Library, Wanfang, and CNKI databases to search the related studies from inception to December 2021. The hazard ratio (HR) and 95% confidence interval (CI) were combined to evaluate the correlation of the preoperative SII with overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS) in NSCLC patients. Results A total of 11 studies involving 9 180 patients were eventually included. The combined analysis showed that high SII levels were significantly associated with worse OS (HR=1.61, 95%CI 1.36-1.90, P<0.001), DFS (HR=1.50, 95%CI 1.34-1.68, P<0.001), and RFS (HR=1.17, 95%CI 1.04-1.33, P<0.001). Subgroup analyses also further verified the above results. Conclusion Preoperative SII is a powerful prognostic biomarker for predicting outcome in patients with operable NSCLC and contribute to prognosis evaluation and treatment strategy formulation. However, more well-designed and prospective studies are warranted to verify our findings.
ObjectiveTo understand the impact of preoperative nutritional status on the postoperative complications for patients with low/ultra-low rectal cancer undergoing extreme sphincter-preserving surgery following neoadjuvant therapy. MethodsThe patients with low/ultra-low rectal cancer who underwent extreme sphincter-preserving surgery following neoadjuvant therapy from January 2009 to December 2020 were retrospectively collected using the Database from Colorectal Cancer (DACCA), and then who were assigned into a nutritional risk group (the score was low than 3 by the Nutrition Risk Screening 2002) and non-nutritional risk group (the score was 3 or more by the Nutrition Risk Screening 2002). The postoperative complications and survival were analyzed for the patients with or without nutritional risk. The postoperative complications were defined as early-term (complications occurring within 30 d after surgery), middle-term (complications occurring during 30–180 d after surgery), and long-term (complications occurring at 180 d and more after surgery). The survival indicators included overall survival and disease-specific survival. ResultsA total of 680 patients who met the inclusion criteria for this study were retrieved from the DACCA database. Among them, there were 500 (73.5%) patients without nutritional risk and 180 (26.5%) patients with nutritional risk. The postoperative follow-up time was 0–152 months (with average 48.9 months). Five hundreds and forty-three survived, including 471 (86.7%) patients with free-tumors survival and 72 (13.3%) patients with tumors survival. There were 137 deaths, including 122 (89.1%) patients with cancer related deaths and 15 (10.9%) patients with non-cancer related deaths. There were 48 (7.1%) cases of early-term postoperative complications, 51 (7.5%) cases of middle-term complications, and 17 (2.5%) cases of long-term complications. There were no statistical differences in the incidence of overall complications between the patients with and without nutritional risk (χ2=3.749, P=0.053; χ2=2.205, P=0.138; χ2=310, P=0.578). The specific complications at different stages after surgery (excluding the anastomotic leakage complications in the patients with nutritional risk was higher in patients without nutritional risk, P=0.034) had no statistical differences between the two groups (P>0.05). The survival curves (overall survival and disease-specific survival) using the Kaplan-Meier method had no statistical differences between the patients with and without nutritional risk (χ2=3.316, P=0.069; χ2=3.712, P=0.054). ConclusionsFrom the analysis results of this study, for the rectal cancer patients who underwent extreme sphincter-preserving surgery following neoadjuvant therapy, the patients with preoperative nutritional risk are more prone to anastomotic leakage within 30 d after surgery. Although other postoperative complications and long-term survival outcomes have no statistical differences between patients with and without nutritional risk, preoperative nutritional management for them cannot be ignored.
ObjectiveTo elucidate the clinical and pathological features and review the progress of diagnosis and treatment in patients with brain metastasis (BM) from colorectal cancer (CRC), so as to provide a reference for the whole process management for patients with BM from CRC in China.MethodThe latest research results and previous literatures about patients with BM from CRC were reviewed.ResultsThe prognosis of BM from CRC was poor, its molecular pathological mechanism was complex and diverse, and some risk factors associated with the occurrence of BM had been identified. Typical imaging features of BM from CRC were helpful to the diagnosis of patients. At present, radiotherapy was still the main treatment. Bevacizumab treatment or immunotherapy combined with radiotherapy was expected to improve the survival of BM from CRC.ConclusionScientific and standardized prevention, diagnosis, and treatment are beneficial to reduce incidence of BM from CRC and improve survival.
Objective To study the diagnostic and prognostic value of serum soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) and cyclooxygenase-2 (COX-2) in abdominal infection-caused sepsis. Methods A total of 170 patients with abdominal infection treated in the First Hospital of Qinhuangdao between January 2019 and March 2022 were retrospectively selected and divided into sepsis group (n=76) and non-sepsis group (n=94) according to whether they were combined with abdominal infection-caused sepsis. In addition, 80 healthy people in the same period were selected as the control group. The levels of serum sTREM-1 and COX-2 in the three groups were detected and the differences were compared. The laboratory indexes, including white blood cell count, high-sensitivity C-reactive protein, and procalcitonin of patients with abdominal infection-caused sepsis were detected. The Sequential Organ Failure Assessment score, Acute Physiology and Chronic Health Evaluation System Ⅱ and prognosis (survival or death) of patients with abdominal infection-caused sepsis were evaluated. The correlations of serum sTREM-1 and COX-2 with the severity of sepsis were analyzed, and the diagnostic and prognostic value of sTREM-1 and COX-2 in abdominal infection-caused sepsis was assessed. Results The levels of serum sTREM-1 and COX-2 in the sepsis group were higher than those in the control group and the non-sepsis group (P<0.05). The levels of serum sTREM-1 and COX-2 in the sepsis group were positively correlated with white blood cell count, high-sensitivity C-reactive protein, procalcitonin, Sequential Organ Failure Assessment score, Acute Physiology and Chronic Health Evaluation System Ⅱ score (P<0.05). The serum levels of sTREM-1 and COX-2 of patients who died during hospitalization in the sepsis group were higher than those of the surviving patients. The areas under the receiver operating characteristic curves of the serum sTREM-1 and COX-2 levels for diagnosing sepsis caused by abdominal infection were 0.814 [95% confidence interval (CI) (0.746, 0.882), P<0.001] and 0.848 [95%CI (0.788, 0.905), P<0.001], respectively, with critical values of 1.879 pg/mL and 18.75 ng/mL, respectively, and those for predicting the prognosis of patients with sepsis caused by abdominal infection were 0.775 [95%CI (0.659, 0.890), P<0.001] and 0.784 [95%CI (0.679, 0.889), P<0.001], respectively, with critical values of 2.283 pg/mL and 23.02 ng/mL, respectively (P<0.05). Conclusion The serum levels of sTREM-1 and COX-2 have certain value in the diagnosis and prognosis prediction of abdominal infection-caused sepsis.