AIM:To evaluate the effect of hepatitis B virus (HBV) infection on liver metastasis of colorectal cancer.METHODS:A total of 1298 colorectal cancer patients were recruited from January 2001 to March 2005 in this study....AIM:To evaluate the effect of hepatitis B virus (HBV) infection on liver metastasis of colorectal cancer.METHODS:A total of 1298 colorectal cancer patients were recruited from January 2001 to March 2005 in this study.Enzyme-linked immunosorbent assay was used to test serum HBV markers for colorectal cancer.Patients were divided into study (infection) group and control (non-infection) group.Clinical features of patients in two groups were compared.RESULTS:Liver metastasis was found in 319 out of the 1298 colorectal cancer patients.The incidence of liver metastasis was significantly lower in study group than in control group (14.2% vs 28.2%,P < 0.01).HBV infection significantly decreased the risk of liver metastasis [hazard ratio (HR):0.50,95% confidence interval (95% CI):0.38-0.66],but the incidence of extrahepatic metastasis was significantly higher in study group than in control group (31.9% vs 17.0%,P < 0.01).The HR was the lowest in chronic hepatitis B group (HR:0.29,95% CI:0.12-0.72).The number of liver metastatic lesions was significantly less in study group than in control group with a higher surgical resection rate.However,no significant difference was found in survival rate between the two groups (P=0.95).CONCLUSION:HBV infection decreases the risk of liver metastasis in patients with colorectal cancer and elevates the surgical resection rate of liver metastatic lesions.展开更多
Background and Objective: Transthoracic and transabdominal approaches are commonly used for the surgical treatment of adenocarcinoma of the cardia. Which approach is better has been controversial for quite a long time...Background and Objective: Transthoracic and transabdominal approaches are commonly used for the surgical treatment of adenocarcinoma of the cardia. Which approach is better has been controversial for quite a long time. Our study aimed to compare the surgical trauma, range of lymph node dissection, and the prognosis of the transthoracic and transabdominal approaches for the treatment of adenocarcinoma of the cardia. Methods: The medical records of 331 patients with adenocarcinoma of the cardia treated in our hospital between 1994 and 2003 were analyzed. Of the 331 patients, 284 underwent operation via transthoracic approach and 47 via transabdominal approach. Surgery-related status, postoperative complications, range of removed lymph nodes and prognosis of the two groups were compared. Results: There was no significant difference in surgery-related status and postoperative complications between the two groups (P >0.05). The mean number of removed lymph nodes from the thoracic cavity was much higher in transthoracic group than in transabdominal group (P < 0.001), while that from the abdominal cavity was similar in both groups (P = 0.404). The thoracic lymph node metastasis rate was 18.8% in transthoracic group and 13.3% in transabdominal group. The median survival time was 29 months in transthoracic group and 28 months in transabdominal group, and the 5-year survival rates were 34.9% and 40.1% (P= 0.599). Conclusions: For the surgical treatment of adenocarcinoma of the cardia, the surgical trauma of the transthoracic approach is similar with that of transabdominal approach. The transthoracic approach has the advantage in thoracic lymph node dissection. The two approaches have no obvious effect on the prognosis.展开更多
BACKGROUND Poorly differentiated gastric neuroendocrine neoplasms(PDGNENs)include gastric neuroendocrine carcinoma(NEC)and mixed adenoneuroendocrine carcinoma,which are highly malignant and rare tumors,and their incid...BACKGROUND Poorly differentiated gastric neuroendocrine neoplasms(PDGNENs)include gastric neuroendocrine carcinoma(NEC)and mixed adenoneuroendocrine carcinoma,which are highly malignant and rare tumors,and their incidence has increased over the past few decades.However,the clinicopathological features and outcomes of patients with PDGNENs have not been completely elucidated.AIM To investigate the clinicopathological characteristics and prognostic factors of patients with PDGNENs.METHODS The data from seven centers in China from March 2007 to November 2019 were analyzed retrospectively.RESULTS Among the 232 patients with PDGNENs,191(82.3%)were male,with an average age of 62.83±9.11 years.One hundred and thirteen(49.34%)of 229 patients had a stage III disease and 86(37.55%)had stage IV disease.Three(1.58%)of 190 patients had no clinical symptoms,while 187(98.42%)patients presented clinical symptoms.The tumors were mainly(89.17%)solitary and located in the upper third of the stomach(cardia and fundus of stomach:115/215,53.49%).Most lesions were ulcers(157/232,67.67%),with an average diameter of 4.66±2.77 cm.In terms of tumor invasion,the majority of tumors invaded the serosa(116/198,58.58%).The median survival time of the 232 patients was 13.50 mo(7,31 mo),and the overall 1-year,3-year,and 5-year survival rates were 49%,19%,and 5%,respectively.According to univariate analysis,tumor number,tumor diameter,gastric invasion status,American Joint Committee on Cancer(AJCC)stage,and distant metastasis status were prognostic factors for patients with PDGNENs.Multivariate analysis showed that tumor number,tumor diameter,AJCC stage,and distant metastasis status were independent prognostic factors for patients with PDGNENs.CONCLUSION The overall prognosis of patients with PDGNENs is poor.The outcomes of patients with a tumor diameter>5 cm,multiple tumors,and stage IV tumors are worse than those of other patients.展开更多
Background:Currently,there is no formal consensus regarding a standard classification for gastric cancer(GC)patients with<16 retrieved lymph nodes(rLNs).Here,this study aimed to validate a practical lymph node(LN)s...Background:Currently,there is no formal consensus regarding a standard classification for gastric cancer(GC)patients with<16 retrieved lymph nodes(rLNs).Here,this study aimed to validate a practical lymph node(LN)staging strategy to homogenize the nodal classification of GC cohorts comprising of both<16(Limited set)and≥16(Adequate set)rLNs.Methods:All patients in this study underwent R0 gastrectomy.The overall survival(OS)difference between the Limited and Adequate set from a large Chinese multicenter dataset was analyzed.Using the 8th American Joint Committee on Cancer(AJCC)pathological nodal classification(pN)for GC as base,a modified nodal classification(N’)resembling similar analogy as the 8th AJCC pN classification was developed.The performance of the proposed and 8th AJCC GC subgroups was compared and validated using the Surveillance,Epidemiology,and End Results(SEER)dataset comprising of 10,208 multi-ethnic GC cases.Results:Significant difference in OS between the Limited and Adequate set(corresponding N0–N3a)using the 8th AJCC system was observed but the OS of N0_(limited)vs.N1_(adequate),N1_(limited)vs.N2_(adequate),N2_(limited)vs.N3_(aadequate),and N3_(alimited)vs.N3_(badequate)subgroups was almost similar in the Chinese dataset.Therefore,we formulated an N’classification whereby only the nodal subgroups of the Limited set,except for pT1N0M0 cases as they underwent less extensive surgeries(D1 or D1+gastrectomy),were re-classified to one higher nodal subgroup,while those of the Adequate set remained unchanged(N’0=N0_(adequate)+pT1N0M0_(limited),N’1=N1_(adequate)+N0_(limited)(excluding pT1N0M0_(limited)),N’2=N2_(adequate)+N1_(limited),N’3a=N3_(aadequate)+N2_(limited),and N’3b=N3_(badequate)+N3_(alimited)).This N’classification demonstrated less heterogeneity in OS between the Limited and Adequate subgroups.Further analyses demonstrated superior statistical performance of the pTN’M system over the 8th AJCC edition and was successfully validated using the SEER dataset.Conclusion:The proposed nodal staging strategy was successfully validated in large multi-ethnic GC datasets and represents a practical approach for homogenizing the classification of GC cohorts comprising of patients with<16 and≥16 rLNs.展开更多
Culture-loaded words refer to words with specific cultural connotations that can express an abstract or a specific concept,which may be related to religious beliefs or social customs,but do not exist in other language...Culture-loaded words refer to words with specific cultural connotations that can express an abstract or a specific concept,which may be related to religious beliefs or social customs,but do not exist in other languages and cultures.Therefore,culture-loaded words bring some difficulties to translation work.Huang Di Nei Jing(《黄帝内经》Huangdi’s Internal Classic)is the foundation of traditional Chinese medicine(TCM)theory,and is listed as the first of the four classics of TCM.It contains a large number of cultureloaded words,which embody the ancient Chinese traditional culture.The translation of culture-loaded words is a difficult but crucial point in the translation of Huangdi’s Internal Classic and directly relates to the quality of the translation of Huangdi’s Internal Classic as a whole.Taking the two English versions of Maoshing Ni and Li Zhaoguo as examples,this work identifies the culture-loaded words appearing in the chapter“Yin Yang Ying Xiang Da Lun”(阴阳应象大论Comprehensive Discourse on Phenomena Corresponding to the Yin and Yang).This work studies the strategies and translation process of culture-loaded words in Huangdi’s Internal Classic,with a view to contribute to the English translation of TCM classics.展开更多
The 2023 update of the Chinese Society of Clinical Oncology(CSCO)Clini-cal Guidelines for Gastric Cancer focuses on standardizing cancer diagnosis and treatment in China,reflecting the latest advancements in evidence-...The 2023 update of the Chinese Society of Clinical Oncology(CSCO)Clini-cal Guidelines for Gastric Cancer focuses on standardizing cancer diagnosis and treatment in China,reflecting the latest advancements in evidence-based medicine,healthcare resource availability,and precision medicine.These updates address the differences in epidemiological characteristics,clinicopatho-logical features,tumor biology,treatment patterns,and drug selections between Eastern and Western gastric cancer patients.Key revisions include a structured template for imaging diagnosis reports,updated standards for molecular marker testing in pathological diagnosis,and an elevated recommendation for neoadju-vant chemotherapy in stage III gastric cancer.For advanced metastatic gastric cancer,the guidelines introduce new recommendations for immunotherapy,anti-angiogenic therapy and targeted drugs,along with updated management strategies for human epidermal growth factor receptor 2(HER2)-positive and deficient DNA mismatch repair(dMMR)/microsatellite instability-high(MSI-H)patients.Additionally,the guidelines offer detailed screening recommendations for hereditary gastric cancer and an appendix listing drug treatment regimens for various stages of gastric cancer.The 2023 CSCO Clinical Guidelines for Gastric Cancer updates are based on both Chinese and international clinical research and expert consensus to enhance their applicability and relevance in clinical practice,particularly in the heterogeneous healthcare landscape of China,while maintaining a commitment to scientific rigor,impartiality,and timely revisions.展开更多
Bananas(Musa spp.)are one of the world’s most important fruit crops and play a vital role in food security for many developing countries.Most banana cultivars are triploids derived from inter-and intraspecific hybrid...Bananas(Musa spp.)are one of the world’s most important fruit crops and play a vital role in food security for many developing countries.Most banana cultivars are triploids derived from inter-and intraspecific hybrid-izations between the wild diploid ancestor species Musa acuminate(AA)and M.balbisiana(BB).We report two haplotype-resolved genome assemblies of the representative AAB-cultivated types,Plantain and Silk,and precisely characterize ancestral contributions by examining ancestry mosaics across the genome.Widespread asymmetric evolution is observed in their subgenomes,which can be linked to frequent homol-ogous exchange events.We reveal the genetic makeup of triploid banana cultivars and verify that subge-nome B is a rich source of disease resistance genes.Only 58.5%and 59.4%of Plantain and Silk genes,respectively,are present in all three haplotypes,with>50%of genes being differentially expressed alleles in different subgenomes.We observed that the number of upregulated genes in Plantain is significantly higher than that in Silk at one-week post-inoculation with Fusarium wilt tropical race 4(Foc TR4),which con-firms that Plantain can initiate defense responses faster than Silk.Additionally,we compared genomic and transcriptomic differences among the genes related to carotenoid synthesis and starch metabolism between Plantain and Silk.Our study provides resources for better understanding the genomic architecture of culti-vated bananas and has important implications for Musa genetics and breeding.展开更多
Epstein-Barr virus(EBV)-associated gastric cancer(GC)manifests an intriguing immunotherapy response.However,the cellular basis for EBV-imprinted tumour immunity and on-treatment response remains undefined.This study a...Epstein-Barr virus(EBV)-associated gastric cancer(GC)manifests an intriguing immunotherapy response.However,the cellular basis for EBV-imprinted tumour immunity and on-treatment response remains undefined.This study aimed to finely characterize the dynamic tumour immune contexture of human EBV(+)GC treated with immunochemotherapy by longitudinal scRNA-seg and paired scTCR/BCR-seq.EBV(+)GC exhibits an inflamed-immune phenotype with increased T-cell and B-cell infiltration.展开更多
Background Circulating tumor DNA(ctDNA)is a promising biomarker for predicting relapse in multiple solid cancers.However,the predictive value of ctDNA for disease recurrence remains indefinite in locoregional gastric ...Background Circulating tumor DNA(ctDNA)is a promising biomarker for predicting relapse in multiple solid cancers.However,the predictive value of ctDNA for disease recurrence remains indefinite in locoregional gastric cancer(GC).Here,we aimed to evaluate the predictive value of ctDNA in this context.Methods From 2016 to 2019,100 patients with stage II/III resectable GC were recruited in this prospective cohort study(NCT02887612).Primary tumors were collected during surgical resection,and plasma samples were collected perioperatively and within 3 months after adjuvant chemotherapy(ACT).Somatic variants were captured via a targeted sequencing panel of 425 cancer-related genes.The plasma was defined as ctDNA-positive only if one or more variants detected in the plasma were presented in at least 2%of the primary tumors.Results Compared with ctDNA-negative patients,patients with positive postoperative ctDNA had moderately higher risk of recurrence[hazard ratio(HR)=2.74,95%confidence interval(CI)=1.37–5.48;P=0.003],while patients with positive post-ACT ctDNA showed remarkably higher risk(HR=14.99,95%CI=3.08-72.96;P<0.001).Multivariate analyses indicated that both postoperative and post-ACT ctDNA positivity were independent predictors of recurrence-free survival(RFS).Moreover,post-ACT ctDNA achieved better predictive performance(sensitivity,77.8%;specificity,90.6%)than both postoperative ctDNA and serial cancer antigen.A comprehensive model incorporating ctDNA for recurrence risk prediction showed a higher C-index(0.78;95%CI=0.71–0.84)than the model without ctDNA(0.71;95%CI=0.64–0.79;P=0.009).Conclusions Residual ctDNA after ACT effectively predicts high recurrence risk in stage II/III GC,and the combination of tissue-based and circulating tumor features could achieve better risk prediction.展开更多
There exist differences in the epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selections between gastric cancer patients from the Eastern and ...There exist differences in the epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selections between gastric cancer patients from the Eastern and Western countries.The Chinese Society of Clinical Oncology(CSCO)has organized a panel of senior experts specializing in all sub-specialties of gastric cancer to compile a clinical guideline for the diagnosis and treatment of gastric cancer since 2016 and renews it annually.Taking into account regional differences,giving full consideration to the accessibility of diagnosis and treatment resources,these experts have conducted expert consensus judgment on relevant evidence and made various grades of recommendations for the clinical diagnosis and treatment of gastric cancer to reflect the value of cancer treatment and meeting health economic indexes in China.The 2021 CSCO Clinical Practice Guidelines for Gastric Cancer covers the diagnosis,treatment,follow-up,and screening of gastric cancer.Based on the 2020 version of the CSCO Chinese Gastric Cancer guidelines,this updated guideline integrates the results ofmajor clinical studies from China and overseas for the past year,focused on the inclusion of research data from the Chinese population for more personalized and clinically relevant recommendations.For the comprehensive treatment of non-metastatic gastric cancer,attentions were paid to neoadjuvant treatment.The value of perioperative chemotherapy is gradually becoming clearer and its recommendation level has been updated.For the comprehensive treatment of metastatic gastric cancer,recommendations for immunotherapy were included,and immune checkpoint inhibitors fromthird-line to the first-line of treatment for different patient groups with detailed notes are provided.展开更多
China is one of the countries with the highest incidence of gastric cancer.There are differences in epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and ...China is one of the countries with the highest incidence of gastric cancer.There are differences in epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selection between gastric cancer patients from the Eastern and Western countries.Non-Chinese guidelines cannot specifically reflect the diagnosis and treatment characteristics for the Chinese gastric cancer patients.The Chinese Society of Clinical Oncology(CSCO)arranged for a panel of senior experts specializing in all sub-specialties of gastric cancer to compile,discuss,and revise the guidelines on the diagnosis and treatment of gastric cancer based on the findings of evidence-based medicine in China and abroad.By referring to the opinions of industry experts,taking into account of regional differences,giving full consideration to the accessibility of diagnosis and treatment resources,these experts have conducted experts’consensus judgement on relevant evidence and made various grades of recommendations for the clinical diagnosis and treatment of gastric cancer to reflect the value of cancer treatment and meeting health economic indexes.This guideline uses tables and is complemented by explanatory and descriptive notes covering the diagnosis,comprehensive treatment,and follow-up visits for gastric cancer.展开更多
Background:The 8th edition of the American Joint Committee on Cancer/Union for International Cancer Control(AJCC/UICC)pathological tumor-node-metastasis(pTNM)staging system may have increased accuracy in predicting pr...Background:The 8th edition of the American Joint Committee on Cancer/Union for International Cancer Control(AJCC/UICC)pathological tumor-node-metastasis(pTNM)staging system may have increased accuracy in predicting prognosis of gastric cancer due to its important modifications from previous editions.However,the homogeneity in prognosis within each subgroup classified according to the 8th edition may still exist.This study aimed to compare and analyze the prognosis prediction abilities of the 8th and 7th editions of AJCC/UICC pTNM staging system for gastric cancer and propose a modified pTNM staging system with external validation.Methods:In total,clinical data of 7911 patients from three high-capacity institutions in China and 10,208 cases from the Surveillance,Epidemiology,and End Results(SEER)Program Registry were analyzed.The homogeneity,discrimina-tory ability,and monotonicity of the gradient assessments of the 8th and 7th editions of AJCC/UICC pTNM staging system were compared using log-rank χ^(2),linear-trend χ^(2),likelihood-ratioχ2 statistics and Akaike information criterion(AIC)calculations,on which a modified pTNM classification with external validation using the SEER database was proposed.Results:Considerable stage migration,mainly for stage III,between the 8th and 7th editions was observed in both cohorts.The survival rates of subgroups of patients within stage IIIA,IIIB,or IIIC classified according to both editions were significantly different,demonstrating poor homogeneity for patient stratification.A modified pTNM staging system using data from the Chinese cohort was then formulated and demonstrated an improved homogeneity in these abovementioned subgroups.This staging system was further validated using data from the SEER cohort,and similar promising results were obtained.Compared with the 8th and 7th editions,the modified pTNM staging system displayed the highest log-rank χ^(2),linear-trend χ^(2),likelihood-ratio χ^(2),and lowest AIC values,indicating its superior discriminatory ability,monotonicity,homogeneity and prognosis prediction ability in both populations.Conclusions:The 8th edition of AJCC/UICC pTNM staging system is superior to the 7th edition,but still results in homogeneity in prognosis prediction.Our modified pTNM staging system demonstrated the optimal stratification and prognosis prediction ability in two large cohorts of different gastric cancer populations.展开更多
Background and objective:The role of additional gastrectomy after non-curative endoscopic resection remains uncertain.The present meta-analysis aimed to explore the risk factors for early-stage gastric-cancer patients...Background and objective:The role of additional gastrectomy after non-curative endoscopic resection remains uncertain.The present meta-analysis aimed to explore the risk factors for early-stage gastric-cancer patients after non-curative endoscopic resection and evaluate the efficacy of additional gastrectomy.Methods:Relevant studies that reported additional gastrectomy after non-curative endoscopic resection were comprehensively searched in MedLine,Web of Science and EMBASE.We first investigated the risk factors for residual tumor and lymph-node metastasis after non-curative endoscopic resection and then analysed the survival outcome,including 5-year overall survival(OS)and 5-year disease-free survival,of additional gastrectomy.Results:Twenty-one studies comprising 4870 cases were included in the present study.We found that residual tumor was associated with larger tumor size(>3 cm)(odds ratio[OR]=2.81,P<0.001),undifferentiated tumor type(OR=1.78,P=0.011)and positive horizontal margin(OR=9.78,P<0.001).Lymph-node metastasis was associated with larger tumor size(>3 cm)(OR=1.73,P<0.001),elevated tumor type(OR=1.60,P=0.035),deeper tumor invasion(>SM1)(OR=2.68,P<0.001),lymphatic invasion(OR=4.65,P<0.001)and positive vertical margin(OR=2.30,P<0.001).Patients who underwent additional gastrectomy had longer 5-year OS(hazard ratio[HR]=0.34,P<0.001),5-year disease-free survival(HR=0.52,P=0.001)and 5-year disease-specific survival(HR=0.50,P<0.001)than those who did not.Moreover,elderly patients also benefited from additional gastrectomy regarding 5-year OS(HR=0.41,P=0.001).Conclusions:Additional gastrectomy with lymph-node dissectionmight improve the survival of early-stage gastric-cancer patients after non-curative endoscopic resection.However,risk stratification should be performed to avoid excessive treatment.展开更多
Background:Few studies have shown nomograms that may predict disease-specific survival(DSS)probability after curative D2 gastrectomy for advanced gastric cancer(AGC),particularly among Chinese patients.This study soug...Background:Few studies have shown nomograms that may predict disease-specific survival(DSS)probability after curative D2 gastrectomy for advanced gastric cancer(AGC),particularly among Chinese patients.This study sought to develop an elaborative nomogram that predicts long-term DSS for AGC in Chinese patients.Methods:A retrospective study was conducted on 6753 AGC patients undergoing D2 gastrectomy between January 1,2000 and December 31,2012 from three large medical hospitals in China.We assigned patients from Sun Yat-sen University Cancer Center to the training set,and patients from the First Affiliated Hospital of China Medical University and Tianjin Medical University Cancer Hospital to two separate external validation sets.A multivariate survival analysis was performed using Cox proportional hazards regression model in a training set,and a nomogram was constructed.Harrell’s C-index was used to evaluate discrimination and calibration plots were used to validate similarities between survival probabilities predicted by the nomogram model and actual survival rates in two validation sets.Results:The multivariate Cox regression model identified age,tumor size,location,Lauren classification,lymphatic/venous invasion,depth of invasion,and metastatic lymph node ratio as covariates associated with survival.In the training set,the nomogram exhibited superior discrimination power compared with the 8th American Joint Com-mittee on Cancer TNM classification(Harrell’s C-index,0.82 vs.0.74;P<0.001).In two validation sets,the nomogram’s discrimination power was also excellent relative to TNM classification(C-index,0.83 vs.0.75 and 0.81 vs.0.74,respec-tively;P<0.001 for both).After calibration,the nomogram produced survival predictions that corresponded closely with actual survival rate.Conclusions:The established nomogram was able to predict 3-,5-,and 10-year DSS probabilities for AGC patients.Validation revealed that this nomogram exhibited excellent discrimination and calibration capacity,suggesting its clinical utility.展开更多
Untargeted metabolomics aims to comprehensively profile metabolites as many as possible in biological samples.Recently,ion mobility-mass spectrometry(IM-MS)has emerged as a powerful technology for untargeted metabolom...Untargeted metabolomics aims to comprehensively profile metabolites as many as possible in biological samples.Recently,ion mobility-mass spectrometry(IM-MS)has emerged as a powerful technology for untargeted metabolomics.The emerging role of IM-MS in untargeted metabolomics enables the separation of metabolite isomers and generation of multidimension data to support the identification of metabolites.In this review,we first introduced the basic principles of IM-MS instruments commonly used for untargeted metabolomics.Then,we demonstrated the application of IM-MS for metabolite separation and identification of both known and unknown metabolites.Finally,we discussed the future developments of IM-MS technology to improve untargeted metabolomics.展开更多
Background and objective:Biomarkers are important tools for prompt diagnosis of cancer.This study aimed to identify reliable biomarkers for clinical applications in the diagnosis of gastric cancer and lymph-node(LN)me...Background and objective:Biomarkers are important tools for prompt diagnosis of cancer.This study aimed to identify reliable biomarkers for clinical applications in the diagnosis of gastric cancer and lymph-node(LN)metastasis.Methods:Between 1 December 2014 and 31 December 2015,we prospectively collected samples of gastric-cancer tissues,corresponding matched-pair normal gastric mucosa,and their peri-gastric metastatic and non-metastatic LNs to identify quantitatively reliable genes using quantitative real-time polymerase chain reaction.Relative quantity(RQ)was used to calculate the mRNA expression levels of our target genes.Statistics were calculated using one-way analysis of variance(ANOVA)and Tukey’s multiple comparison test.Analytical graphs were plotted using GraphPad Prism.Results:Of nine assessed genes,the mRNA levels of inhibin beta A(INHBA)and secreted phosphoprotein 1(SPP1)were most consistently highly expressed in tumor tissues by 15.4-and 15.6-fold,respectively,as compared with normal tissues(P<0.001),with 91.3%sensitivity and 95.7%specificity(receiver operating characteristic[ROC]curve area=0.974)for the former and 82.6%sensitivity and 87.0%specificity(ROC curve area=0.924)for the latter.Further analysis revealed no differentiating significance of SPP1 mRNA expression between metastatic and non-metastatic LNs(P=0.470).In contrast,the INHBA mRNA level was up-regulated 4.1-fold in metastatic LNs(P<0.001),with 80.0%sensitivity and 81.5%specificity(ROC curve area=0.857),and was also able to successfully differentiate between more severe disease conditions,T3 and T4(P=0.003),M0 and M1(P=0.043)and different histological variants(intestinal type vs diffuse type,P=0.019).Conclusions:Our results showed that INHBA was the most optimally reliable biomarker for diagnosing gastric cancer and LN metastasis.展开更多
基金Supported by National Natural Science Foundation of China,No.30672408
文摘AIM:To evaluate the effect of hepatitis B virus (HBV) infection on liver metastasis of colorectal cancer.METHODS:A total of 1298 colorectal cancer patients were recruited from January 2001 to March 2005 in this study.Enzyme-linked immunosorbent assay was used to test serum HBV markers for colorectal cancer.Patients were divided into study (infection) group and control (non-infection) group.Clinical features of patients in two groups were compared.RESULTS:Liver metastasis was found in 319 out of the 1298 colorectal cancer patients.The incidence of liver metastasis was significantly lower in study group than in control group (14.2% vs 28.2%,P < 0.01).HBV infection significantly decreased the risk of liver metastasis [hazard ratio (HR):0.50,95% confidence interval (95% CI):0.38-0.66],but the incidence of extrahepatic metastasis was significantly higher in study group than in control group (31.9% vs 17.0%,P < 0.01).The HR was the lowest in chronic hepatitis B group (HR:0.29,95% CI:0.12-0.72).The number of liver metastatic lesions was significantly less in study group than in control group with a higher surgical resection rate.However,no significant difference was found in survival rate between the two groups (P=0.95).CONCLUSION:HBV infection decreases the risk of liver metastasis in patients with colorectal cancer and elevates the surgical resection rate of liver metastatic lesions.
文摘Background and Objective: Transthoracic and transabdominal approaches are commonly used for the surgical treatment of adenocarcinoma of the cardia. Which approach is better has been controversial for quite a long time. Our study aimed to compare the surgical trauma, range of lymph node dissection, and the prognosis of the transthoracic and transabdominal approaches for the treatment of adenocarcinoma of the cardia. Methods: The medical records of 331 patients with adenocarcinoma of the cardia treated in our hospital between 1994 and 2003 were analyzed. Of the 331 patients, 284 underwent operation via transthoracic approach and 47 via transabdominal approach. Surgery-related status, postoperative complications, range of removed lymph nodes and prognosis of the two groups were compared. Results: There was no significant difference in surgery-related status and postoperative complications between the two groups (P >0.05). The mean number of removed lymph nodes from the thoracic cavity was much higher in transthoracic group than in transabdominal group (P < 0.001), while that from the abdominal cavity was similar in both groups (P = 0.404). The thoracic lymph node metastasis rate was 18.8% in transthoracic group and 13.3% in transabdominal group. The median survival time was 29 months in transthoracic group and 28 months in transabdominal group, and the 5-year survival rates were 34.9% and 40.1% (P= 0.599). Conclusions: For the surgical treatment of adenocarcinoma of the cardia, the surgical trauma of the transthoracic approach is similar with that of transabdominal approach. The transthoracic approach has the advantage in thoracic lymph node dissection. The two approaches have no obvious effect on the prognosis.
基金National Key R&D Program of China,No.2019YFB1309704。
文摘BACKGROUND Poorly differentiated gastric neuroendocrine neoplasms(PDGNENs)include gastric neuroendocrine carcinoma(NEC)and mixed adenoneuroendocrine carcinoma,which are highly malignant and rare tumors,and their incidence has increased over the past few decades.However,the clinicopathological features and outcomes of patients with PDGNENs have not been completely elucidated.AIM To investigate the clinicopathological characteristics and prognostic factors of patients with PDGNENs.METHODS The data from seven centers in China from March 2007 to November 2019 were analyzed retrospectively.RESULTS Among the 232 patients with PDGNENs,191(82.3%)were male,with an average age of 62.83±9.11 years.One hundred and thirteen(49.34%)of 229 patients had a stage III disease and 86(37.55%)had stage IV disease.Three(1.58%)of 190 patients had no clinical symptoms,while 187(98.42%)patients presented clinical symptoms.The tumors were mainly(89.17%)solitary and located in the upper third of the stomach(cardia and fundus of stomach:115/215,53.49%).Most lesions were ulcers(157/232,67.67%),with an average diameter of 4.66±2.77 cm.In terms of tumor invasion,the majority of tumors invaded the serosa(116/198,58.58%).The median survival time of the 232 patients was 13.50 mo(7,31 mo),and the overall 1-year,3-year,and 5-year survival rates were 49%,19%,and 5%,respectively.According to univariate analysis,tumor number,tumor diameter,gastric invasion status,American Joint Committee on Cancer(AJCC)stage,and distant metastasis status were prognostic factors for patients with PDGNENs.Multivariate analysis showed that tumor number,tumor diameter,AJCC stage,and distant metastasis status were independent prognostic factors for patients with PDGNENs.CONCLUSION The overall prognosis of patients with PDGNENs is poor.The outcomes of patients with a tumor diameter>5 cm,multiple tumors,and stage IV tumors are worse than those of other patients.
基金the National Natural Science Foundation of China(81802451)the China Postdoctoral Science Foundation(2017M622879)+1 种基金the Natural Science Foundation of Guangdong Province(2114050002182,2018A030313827 and 2021A1515011327)the Young Teacher Training Program of Sun Yat-sen University(19ykpy172).
文摘Background:Currently,there is no formal consensus regarding a standard classification for gastric cancer(GC)patients with<16 retrieved lymph nodes(rLNs).Here,this study aimed to validate a practical lymph node(LN)staging strategy to homogenize the nodal classification of GC cohorts comprising of both<16(Limited set)and≥16(Adequate set)rLNs.Methods:All patients in this study underwent R0 gastrectomy.The overall survival(OS)difference between the Limited and Adequate set from a large Chinese multicenter dataset was analyzed.Using the 8th American Joint Committee on Cancer(AJCC)pathological nodal classification(pN)for GC as base,a modified nodal classification(N’)resembling similar analogy as the 8th AJCC pN classification was developed.The performance of the proposed and 8th AJCC GC subgroups was compared and validated using the Surveillance,Epidemiology,and End Results(SEER)dataset comprising of 10,208 multi-ethnic GC cases.Results:Significant difference in OS between the Limited and Adequate set(corresponding N0–N3a)using the 8th AJCC system was observed but the OS of N0_(limited)vs.N1_(adequate),N1_(limited)vs.N2_(adequate),N2_(limited)vs.N3_(aadequate),and N3_(alimited)vs.N3_(badequate)subgroups was almost similar in the Chinese dataset.Therefore,we formulated an N’classification whereby only the nodal subgroups of the Limited set,except for pT1N0M0 cases as they underwent less extensive surgeries(D1 or D1+gastrectomy),were re-classified to one higher nodal subgroup,while those of the Adequate set remained unchanged(N’0=N0_(adequate)+pT1N0M0_(limited),N’1=N1_(adequate)+N0_(limited)(excluding pT1N0M0_(limited)),N’2=N2_(adequate)+N1_(limited),N’3a=N3_(aadequate)+N2_(limited),and N’3b=N3_(badequate)+N3_(alimited)).This N’classification demonstrated less heterogeneity in OS between the Limited and Adequate subgroups.Further analyses demonstrated superior statistical performance of the pTN’M system over the 8th AJCC edition and was successfully validated using the SEER dataset.Conclusion:The proposed nodal staging strategy was successfully validated in large multi-ethnic GC datasets and represents a practical approach for homogenizing the classification of GC cohorts comprising of patients with<16 and≥16 rLNs.
文摘背景与目的目前鲜有文献报道接受D2根治性切除术的进展期胃癌(advanced gastric cancer,AGC)患者的疾病特异性生存(disease?specific survival,DSS)预测系统,尤其针对中国胃癌患者。本研究拟构建一种精准预测中国进展期胃癌患者预后的列线图(Nomogram)模型。方法回顾性纳入2000年1月1日至2012年12月31日间在中国三家大型医院接受D2胃切除术的6753例AGC患者。中山大学肿瘤防治中心患者作为训练集,中国医科大学附属第一医院和天津医科大学肿瘤医院患者作为两个独立的外部验证集。在训练集中采用Cox比例风险回归模型进行多因素生存分析,并构建Nomogram模型,在验证集中通过Harrell’s C-index和校准曲线评价该模型的准确性、实际生存情况和模型预测的一致性。结果 Cox回归模型显示年龄、肿瘤大小、部位、Lauren分型、淋巴管/血管浸润、肿瘤浸润深度和淋巴结转移率为患者预后相关因素。在训练集中,Nomogram模型的预测准确度较美国癌症研究联合会(American Joint Committee on Cancer,AJCC)TNM癌症分期系统(第8版)更高(C-index,0.82 vs. 0.74,P <0.001)。在两个验证集中,亦出现类似的结果(C-index分别为0.83 vs. 0.75和0.81 vs. 0.74;两者均P <0.001)。校准曲线显示Nomogram模型预测的患者生存与和实际生存高度接近。结论本研究构建的Nomogram模型能够预测AGC患者的3年、 5年和10年疾病特异性生存,经外部验证显示其具有较高的准确性和区分效能,预示潜在的临床应用前景。
基金financed by the grant from the National Social Science Fund Major Project of China."Research on Mining,Sorting And Translation Standardization of Basic Terms of Traditional Chinese Medicine"(No.19ZDA301)。
文摘Culture-loaded words refer to words with specific cultural connotations that can express an abstract or a specific concept,which may be related to religious beliefs or social customs,but do not exist in other languages and cultures.Therefore,culture-loaded words bring some difficulties to translation work.Huang Di Nei Jing(《黄帝内经》Huangdi’s Internal Classic)is the foundation of traditional Chinese medicine(TCM)theory,and is listed as the first of the four classics of TCM.It contains a large number of cultureloaded words,which embody the ancient Chinese traditional culture.The translation of culture-loaded words is a difficult but crucial point in the translation of Huangdi’s Internal Classic and directly relates to the quality of the translation of Huangdi’s Internal Classic as a whole.Taking the two English versions of Maoshing Ni and Li Zhaoguo as examples,this work identifies the culture-loaded words appearing in the chapter“Yin Yang Ying Xiang Da Lun”(阴阳应象大论Comprehensive Discourse on Phenomena Corresponding to the Yin and Yang).This work studies the strategies and translation process of culture-loaded words in Huangdi’s Internal Classic,with a view to contribute to the English translation of TCM classics.
文摘The 2023 update of the Chinese Society of Clinical Oncology(CSCO)Clini-cal Guidelines for Gastric Cancer focuses on standardizing cancer diagnosis and treatment in China,reflecting the latest advancements in evidence-based medicine,healthcare resource availability,and precision medicine.These updates address the differences in epidemiological characteristics,clinicopatho-logical features,tumor biology,treatment patterns,and drug selections between Eastern and Western gastric cancer patients.Key revisions include a structured template for imaging diagnosis reports,updated standards for molecular marker testing in pathological diagnosis,and an elevated recommendation for neoadju-vant chemotherapy in stage III gastric cancer.For advanced metastatic gastric cancer,the guidelines introduce new recommendations for immunotherapy,anti-angiogenic therapy and targeted drugs,along with updated management strategies for human epidermal growth factor receptor 2(HER2)-positive and deficient DNA mismatch repair(dMMR)/microsatellite instability-high(MSI-H)patients.Additionally,the guidelines offer detailed screening recommendations for hereditary gastric cancer and an appendix listing drug treatment regimens for various stages of gastric cancer.The 2023 CSCO Clinical Guidelines for Gastric Cancer updates are based on both Chinese and international clinical research and expert consensus to enhance their applicability and relevance in clinical practice,particularly in the heterogeneous healthcare landscape of China,while maintaining a commitment to scientific rigor,impartiality,and timely revisions.
基金funded by the Strategy of Rural Vitalization of Guangdong Provinces (2022-NPY-00-003,2022-NJS-00-001)the National Natural Science Foundation of China (32270712)+4 种基金the earmarked fund for CARS (CARS-31-01)GDAAS (202102TD,R2020PY-JX002)the Ba-Gui Scholar Program of Guangxi (to Z.-G.H)the Laboratory of Lingnan Modern Agriculture Project (NT2021004)the Maoming Branch Grant (2021TDQD003).
文摘Bananas(Musa spp.)are one of the world’s most important fruit crops and play a vital role in food security for many developing countries.Most banana cultivars are triploids derived from inter-and intraspecific hybrid-izations between the wild diploid ancestor species Musa acuminate(AA)and M.balbisiana(BB).We report two haplotype-resolved genome assemblies of the representative AAB-cultivated types,Plantain and Silk,and precisely characterize ancestral contributions by examining ancestry mosaics across the genome.Widespread asymmetric evolution is observed in their subgenomes,which can be linked to frequent homol-ogous exchange events.We reveal the genetic makeup of triploid banana cultivars and verify that subge-nome B is a rich source of disease resistance genes.Only 58.5%and 59.4%of Plantain and Silk genes,respectively,are present in all three haplotypes,with>50%of genes being differentially expressed alleles in different subgenomes.We observed that the number of upregulated genes in Plantain is significantly higher than that in Silk at one-week post-inoculation with Fusarium wilt tropical race 4(Foc TR4),which con-firms that Plantain can initiate defense responses faster than Silk.Additionally,we compared genomic and transcriptomic differences among the genes related to carotenoid synthesis and starch metabolism between Plantain and Silk.Our study provides resources for better understanding the genomic architecture of culti-vated bananas and has important implications for Musa genetics and breeding.
基金This work was supported by National Natural Science Foundation of China(81930065,82173128 to R-H.X.,82073377,81772587 to M.Z.Q.,82172861 to Q.Z.)CAMS Innovation Fund for Medical Sciences(CIFMS)(2019-12M-5-036,to R.-H.X.)+2 种基金Natural Science Foundation of Guangdong(2021A1515012439 to M.Z.Q.2021A1515011743 to Q.Z.)Opening Fund of Guangdong Provincial Key Laboratory of Biomedical Imaging(No.GPKLBI202108 of 2018B030322006 to H.Y.Z.)Ministry of Education Frontiers Science Centre for Precision Oncology,University of Macao(SP2023-00001-FSCPO to H.Y.Z.).
文摘Epstein-Barr virus(EBV)-associated gastric cancer(GC)manifests an intriguing immunotherapy response.However,the cellular basis for EBV-imprinted tumour immunity and on-treatment response remains undefined.This study aimed to finely characterize the dynamic tumour immune contexture of human EBV(+)GC treated with immunochemotherapy by longitudinal scRNA-seg and paired scTCR/BCR-seq.EBV(+)GC exhibits an inflamed-immune phenotype with increased T-cell and B-cell infiltration.
基金support by the Science and Technology Program of Guangdong(2019B020227002,to RHX)the CAMS Innovation Fund for Medical Sciences(CIFMS)(2019-I2M-5-036,to RHX)+4 种基金the International Cooperation and Exchanges National Natural Science Foundation of China(82061160373,to FW)the National Natural Science Foundation of China(General Program,81872011,to FW)the Sun Yat-sen University Clinical Research 5010 Program(2018014,to FW)the Young Physician Scientist Program of Sun Yat-sen University Cancer Center(16zxqk03,to FW)the Guangdong Esophageal Cancer Institute Science and Technology Program(M202210,to SQY).
文摘Background Circulating tumor DNA(ctDNA)is a promising biomarker for predicting relapse in multiple solid cancers.However,the predictive value of ctDNA for disease recurrence remains indefinite in locoregional gastric cancer(GC).Here,we aimed to evaluate the predictive value of ctDNA in this context.Methods From 2016 to 2019,100 patients with stage II/III resectable GC were recruited in this prospective cohort study(NCT02887612).Primary tumors were collected during surgical resection,and plasma samples were collected perioperatively and within 3 months after adjuvant chemotherapy(ACT).Somatic variants were captured via a targeted sequencing panel of 425 cancer-related genes.The plasma was defined as ctDNA-positive only if one or more variants detected in the plasma were presented in at least 2%of the primary tumors.Results Compared with ctDNA-negative patients,patients with positive postoperative ctDNA had moderately higher risk of recurrence[hazard ratio(HR)=2.74,95%confidence interval(CI)=1.37–5.48;P=0.003],while patients with positive post-ACT ctDNA showed remarkably higher risk(HR=14.99,95%CI=3.08-72.96;P<0.001).Multivariate analyses indicated that both postoperative and post-ACT ctDNA positivity were independent predictors of recurrence-free survival(RFS).Moreover,post-ACT ctDNA achieved better predictive performance(sensitivity,77.8%;specificity,90.6%)than both postoperative ctDNA and serial cancer antigen.A comprehensive model incorporating ctDNA for recurrence risk prediction showed a higher C-index(0.78;95%CI=0.71–0.84)than the model without ctDNA(0.71;95%CI=0.64–0.79;P=0.009).Conclusions Residual ctDNA after ACT effectively predicts high recurrence risk in stage II/III GC,and the combination of tissue-based and circulating tumor features could achieve better risk prediction.
文摘There exist differences in the epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selections between gastric cancer patients from the Eastern and Western countries.The Chinese Society of Clinical Oncology(CSCO)has organized a panel of senior experts specializing in all sub-specialties of gastric cancer to compile a clinical guideline for the diagnosis and treatment of gastric cancer since 2016 and renews it annually.Taking into account regional differences,giving full consideration to the accessibility of diagnosis and treatment resources,these experts have conducted expert consensus judgment on relevant evidence and made various grades of recommendations for the clinical diagnosis and treatment of gastric cancer to reflect the value of cancer treatment and meeting health economic indexes in China.The 2021 CSCO Clinical Practice Guidelines for Gastric Cancer covers the diagnosis,treatment,follow-up,and screening of gastric cancer.Based on the 2020 version of the CSCO Chinese Gastric Cancer guidelines,this updated guideline integrates the results ofmajor clinical studies from China and overseas for the past year,focused on the inclusion of research data from the Chinese population for more personalized and clinically relevant recommendations.For the comprehensive treatment of non-metastatic gastric cancer,attentions were paid to neoadjuvant treatment.The value of perioperative chemotherapy is gradually becoming clearer and its recommendation level has been updated.For the comprehensive treatment of metastatic gastric cancer,recommendations for immunotherapy were included,and immune checkpoint inhibitors fromthird-line to the first-line of treatment for different patient groups with detailed notes are provided.
文摘China is one of the countries with the highest incidence of gastric cancer.There are differences in epidemiological characteristics,clinicopathological features,tumor biological characteristics,treatment patterns,and drug selection between gastric cancer patients from the Eastern and Western countries.Non-Chinese guidelines cannot specifically reflect the diagnosis and treatment characteristics for the Chinese gastric cancer patients.The Chinese Society of Clinical Oncology(CSCO)arranged for a panel of senior experts specializing in all sub-specialties of gastric cancer to compile,discuss,and revise the guidelines on the diagnosis and treatment of gastric cancer based on the findings of evidence-based medicine in China and abroad.By referring to the opinions of industry experts,taking into account of regional differences,giving full consideration to the accessibility of diagnosis and treatment resources,these experts have conducted experts’consensus judgement on relevant evidence and made various grades of recommendations for the clinical diagnosis and treatment of gastric cancer to reflect the value of cancer treatment and meeting health economic indexes.This guideline uses tables and is complemented by explanatory and descriptive notes covering the diagnosis,comprehensive treatment,and follow-up visits for gastric cancer.
基金supported by the Major Program of Collaborative Innovation of Guangzhou(No.201508030042)the Natural Science Foundation of Guangdong Province(No.2015A030313089,2018A030313631)+3 种基金Guangdong Provincial Scientific and Technology Project(No.2014A020232331)Guangzhou Medical,Health Science and Technology Project(No.20151A011077)China Postdoctoral Science Foundation Grant(No.2017M622879)National Natural Science Foundation of China(No.81802451).
文摘Background:The 8th edition of the American Joint Committee on Cancer/Union for International Cancer Control(AJCC/UICC)pathological tumor-node-metastasis(pTNM)staging system may have increased accuracy in predicting prognosis of gastric cancer due to its important modifications from previous editions.However,the homogeneity in prognosis within each subgroup classified according to the 8th edition may still exist.This study aimed to compare and analyze the prognosis prediction abilities of the 8th and 7th editions of AJCC/UICC pTNM staging system for gastric cancer and propose a modified pTNM staging system with external validation.Methods:In total,clinical data of 7911 patients from three high-capacity institutions in China and 10,208 cases from the Surveillance,Epidemiology,and End Results(SEER)Program Registry were analyzed.The homogeneity,discrimina-tory ability,and monotonicity of the gradient assessments of the 8th and 7th editions of AJCC/UICC pTNM staging system were compared using log-rank χ^(2),linear-trend χ^(2),likelihood-ratioχ2 statistics and Akaike information criterion(AIC)calculations,on which a modified pTNM classification with external validation using the SEER database was proposed.Results:Considerable stage migration,mainly for stage III,between the 8th and 7th editions was observed in both cohorts.The survival rates of subgroups of patients within stage IIIA,IIIB,or IIIC classified according to both editions were significantly different,demonstrating poor homogeneity for patient stratification.A modified pTNM staging system using data from the Chinese cohort was then formulated and demonstrated an improved homogeneity in these abovementioned subgroups.This staging system was further validated using data from the SEER cohort,and similar promising results were obtained.Compared with the 8th and 7th editions,the modified pTNM staging system displayed the highest log-rank χ^(2),linear-trend χ^(2),likelihood-ratio χ^(2),and lowest AIC values,indicating its superior discriminatory ability,monotonicity,homogeneity and prognosis prediction ability in both populations.Conclusions:The 8th edition of AJCC/UICC pTNM staging system is superior to the 7th edition,but still results in homogeneity in prognosis prediction.Our modified pTNM staging system demonstrated the optimal stratification and prognosis prediction ability in two large cohorts of different gastric cancer populations.
文摘Background and objective:The role of additional gastrectomy after non-curative endoscopic resection remains uncertain.The present meta-analysis aimed to explore the risk factors for early-stage gastric-cancer patients after non-curative endoscopic resection and evaluate the efficacy of additional gastrectomy.Methods:Relevant studies that reported additional gastrectomy after non-curative endoscopic resection were comprehensively searched in MedLine,Web of Science and EMBASE.We first investigated the risk factors for residual tumor and lymph-node metastasis after non-curative endoscopic resection and then analysed the survival outcome,including 5-year overall survival(OS)and 5-year disease-free survival,of additional gastrectomy.Results:Twenty-one studies comprising 4870 cases were included in the present study.We found that residual tumor was associated with larger tumor size(>3 cm)(odds ratio[OR]=2.81,P<0.001),undifferentiated tumor type(OR=1.78,P=0.011)and positive horizontal margin(OR=9.78,P<0.001).Lymph-node metastasis was associated with larger tumor size(>3 cm)(OR=1.73,P<0.001),elevated tumor type(OR=1.60,P=0.035),deeper tumor invasion(>SM1)(OR=2.68,P<0.001),lymphatic invasion(OR=4.65,P<0.001)and positive vertical margin(OR=2.30,P<0.001).Patients who underwent additional gastrectomy had longer 5-year OS(hazard ratio[HR]=0.34,P<0.001),5-year disease-free survival(HR=0.52,P=0.001)and 5-year disease-specific survival(HR=0.50,P<0.001)than those who did not.Moreover,elderly patients also benefited from additional gastrectomy regarding 5-year OS(HR=0.41,P=0.001).Conclusions:Additional gastrectomy with lymph-node dissectionmight improve the survival of early-stage gastric-cancer patients after non-curative endoscopic resection.However,risk stratification should be performed to avoid excessive treatment.
基金supported by the Natural Science Foundation of Guangdong Province(No.2015A030313089)the Major Program of Collaborative Innovation of Guangzhou(No.201508030042).
文摘Background:Few studies have shown nomograms that may predict disease-specific survival(DSS)probability after curative D2 gastrectomy for advanced gastric cancer(AGC),particularly among Chinese patients.This study sought to develop an elaborative nomogram that predicts long-term DSS for AGC in Chinese patients.Methods:A retrospective study was conducted on 6753 AGC patients undergoing D2 gastrectomy between January 1,2000 and December 31,2012 from three large medical hospitals in China.We assigned patients from Sun Yat-sen University Cancer Center to the training set,and patients from the First Affiliated Hospital of China Medical University and Tianjin Medical University Cancer Hospital to two separate external validation sets.A multivariate survival analysis was performed using Cox proportional hazards regression model in a training set,and a nomogram was constructed.Harrell’s C-index was used to evaluate discrimination and calibration plots were used to validate similarities between survival probabilities predicted by the nomogram model and actual survival rates in two validation sets.Results:The multivariate Cox regression model identified age,tumor size,location,Lauren classification,lymphatic/venous invasion,depth of invasion,and metastatic lymph node ratio as covariates associated with survival.In the training set,the nomogram exhibited superior discrimination power compared with the 8th American Joint Com-mittee on Cancer TNM classification(Harrell’s C-index,0.82 vs.0.74;P<0.001).In two validation sets,the nomogram’s discrimination power was also excellent relative to TNM classification(C-index,0.83 vs.0.75 and 0.81 vs.0.74,respec-tively;P<0.001 for both).After calibration,the nomogram produced survival predictions that corresponded closely with actual survival rate.Conclusions:The established nomogram was able to predict 3-,5-,and 10-year DSS probabilities for AGC patients.Validation revealed that this nomogram exhibited excellent discrimination and calibration capacity,suggesting its clinical utility.
基金The work was supported by National Natural Science Foundation of China(Grant No.31971356)Shang-hai Municipal Science and Technology Major Project(Grant No.2019SHZDZX02)。
文摘Untargeted metabolomics aims to comprehensively profile metabolites as many as possible in biological samples.Recently,ion mobility-mass spectrometry(IM-MS)has emerged as a powerful technology for untargeted metabolomics.The emerging role of IM-MS in untargeted metabolomics enables the separation of metabolite isomers and generation of multidimension data to support the identification of metabolites.In this review,we first introduced the basic principles of IM-MS instruments commonly used for untargeted metabolomics.Then,we demonstrated the application of IM-MS for metabolite separation and identification of both known and unknown metabolites.Finally,we discussed the future developments of IM-MS technology to improve untargeted metabolomics.
基金This work was supported by the Natural Science Foundation of Guangdong Province(Grant number 2015A030313089,2018A030313631)Guangzhou University-Institute-Industry Collaborative Innovation Major Projects(Grant number 201508030042,201604020038)+1 种基金Center for Nasopharyngeal Carcinoma Research,Hong Kong(Grant number AoE/M-06/08)Shenzhen Dept.of Science and Information(Grant number JCYJ20130329110752138).
文摘Background and objective:Biomarkers are important tools for prompt diagnosis of cancer.This study aimed to identify reliable biomarkers for clinical applications in the diagnosis of gastric cancer and lymph-node(LN)metastasis.Methods:Between 1 December 2014 and 31 December 2015,we prospectively collected samples of gastric-cancer tissues,corresponding matched-pair normal gastric mucosa,and their peri-gastric metastatic and non-metastatic LNs to identify quantitatively reliable genes using quantitative real-time polymerase chain reaction.Relative quantity(RQ)was used to calculate the mRNA expression levels of our target genes.Statistics were calculated using one-way analysis of variance(ANOVA)and Tukey’s multiple comparison test.Analytical graphs were plotted using GraphPad Prism.Results:Of nine assessed genes,the mRNA levels of inhibin beta A(INHBA)and secreted phosphoprotein 1(SPP1)were most consistently highly expressed in tumor tissues by 15.4-and 15.6-fold,respectively,as compared with normal tissues(P<0.001),with 91.3%sensitivity and 95.7%specificity(receiver operating characteristic[ROC]curve area=0.974)for the former and 82.6%sensitivity and 87.0%specificity(ROC curve area=0.924)for the latter.Further analysis revealed no differentiating significance of SPP1 mRNA expression between metastatic and non-metastatic LNs(P=0.470).In contrast,the INHBA mRNA level was up-regulated 4.1-fold in metastatic LNs(P<0.001),with 80.0%sensitivity and 81.5%specificity(ROC curve area=0.857),and was also able to successfully differentiate between more severe disease conditions,T3 and T4(P=0.003),M0 and M1(P=0.043)and different histological variants(intestinal type vs diffuse type,P=0.019).Conclusions:Our results showed that INHBA was the most optimally reliable biomarker for diagnosing gastric cancer and LN metastasis.
