Objective:Small cell lung cancer(SCLC)is commonly recognized as the most fatal lung cancer type.Despite substantial advances in immune checkpoint blockade therapies for treating solid cancers,their benefits are limite...Objective:Small cell lung cancer(SCLC)is commonly recognized as the most fatal lung cancer type.Despite substantial advances in immune checkpoint blockade therapies for treating solid cancers,their benefits are limited to a minority of patients with SCLC.In the present study,novel indicators for predicting the outcomes and molecular targets for SCLC treatment were elucidated.Methods:We conducted bioinformatics analysis to identify the key genes associated with tumor-infiltrating lymphocytes in SCLC.The functional role of the key gene identified in SCLC was determined both in vitro and in vivo.Results:A significant correlation was observed between patient survival and CD56dim natural killer(NK)cell proportion.Furthermore,we noted that the hub gene ubiquitin-specific protease 1(USP1)is closely correlated with both CD56dim NK cells and overall survival in SCLC.Bioinformatics analysis revealed that USP1 is upregulated in SCLC.In addition,gene set enrichment analysis revealed that USP1 overexpression hinders NK cell-mediated immune responses.By co-cultivating NK-92 cells with SCLC cells,we demonstrated that NK cell cytotoxicity against SCLC could be improved either via USP1 knock-down or pharmacological inhibition.Furthermore,using a nude-mice xenograft tumor model,we noted that USP1 inhibition effectively suppressed tumor proliferation and increased the expression of NK cell-associated markers.Conclusions:Our study findings highlight the importance of NK cells in regulating SCLC.USP1 overexpression can inhibit NK cell-mediated immunity;therefore,USP1 may serve not only as a prognostic biomarker but also as a potential molecular target of SCLC therapy.展开更多
Objective INF2 is a member of the formins family.Abnormal expression and regulation of INF2 have been associated with the progression of various tumors,but the expression and role of INF2 in hepatocellular carcinoma(H...Objective INF2 is a member of the formins family.Abnormal expression and regulation of INF2 have been associated with the progression of various tumors,but the expression and role of INF2 in hepatocellular carcinoma(HCC)remain unclear.HCC is a highly lethal malignant tumor.Given the limitations of traditional treatments,this study explored the expression level,clinical value and potential mechanism of INF2 in HCC in order to seek new therapeutic targets.Methods In this study,we used public databases to analyze the expression of INF2 in pan-cancer and HCC,as well as the impact of INF2 expression levels on HCC prognosis.Quantitative real time polymerase chain reaction(RT-qPCR),Western blot,and immunohistochemistry were used to detect the expression level of INF2 in liver cancer cells and human HCC tissues.The correlation between INF2 expression and clinical pathological features was analyzed using public databases and clinical data of human HCC samples.Subsequently,the effects of INF2 expression on the biological function and Drp1 phosphorylation of liver cancer cells were elucidated through in vitro and in vivo experiments.Finally,the predictive value and potential mechanism of INF2 in HCC were further analyzed through database and immunohistochemical experiments.Results INF2 is aberrantly high expression in HCC samples and the high expression of INF2 is correlated with overall survival,liver cirrhosis and pathological differentiation of HCC patients.The expression level of INF2 has certain diagnostic value in predicting the prognosis and pathological differentiation of HCC.In vivo and in vitro HCC models,upregulated expression of INF2 triggers the proliferation and migration of the HCC cell,while knockdown of INF2 could counteract this effect.INF2 in liver cancer cells may affect mitochondrial division by inducing Drp1 phosphorylation and mediate immune escape by up-regulating PD-L1 expression,thus promoting tumor progression.Conclusion INF2 is highly expressed in HCC and is associated with poor prognosis.High expression of INF2 may promote HCC progression by inducing Drp1 phosphorylation and up-regulation of PD-L1 expression,and targeting INF2 may be beneficial for HCC patients with high expression of INF2.展开更多
BACKGROUND Mitochondrial genes are involved in tumor metabolism in ovarian cancer(OC)and affect immune cell infiltration and treatment responses.AIM To predict prognosis and immunotherapy response in patients diagnose...BACKGROUND Mitochondrial genes are involved in tumor metabolism in ovarian cancer(OC)and affect immune cell infiltration and treatment responses.AIM To predict prognosis and immunotherapy response in patients diagnosed with OC using mitochondrial genes and neural networks.METHODS Prognosis,immunotherapy efficacy,and next-generation sequencing data of patients with OC were downloaded from The Cancer Genome Atlas and Gene Expression Omnibus.Mitochondrial genes were sourced from the MitoCarta3.0 database.The discovery cohort for model construction was created from 70% of the patients,whereas the remaining 30% constituted the validation cohort.Using the expression of mitochondrial genes as the predictor variable and based on neural network algorithm,the overall survival time and immunotherapy efficacy(complete or partial response)of patients were predicted.RESULTS In total,375 patients with OC were included to construct the prognostic model,and 26 patients were included to construct the immune efficacy model.The average area under the receiver operating characteristic curve of the prognostic model was 0.7268[95% confidence interval(CI):0.7258-0.7278]in the discovery cohort and 0.6475(95%CI:0.6466-0.6484)in the validation cohort.The average area under the receiver operating characteristic curve of the immunotherapy efficacy model was 0.9444(95%CI:0.8333-1.0000)in the discovery cohort and 0.9167(95%CI:0.6667-1.0000)in the validation cohort.CONCLUSION The application of mitochondrial genes and neural networks has the potential to predict prognosis and immunotherapy response in patients with OC,providing valuable insights into personalized treatment strategies.展开更多
The published article titled“lncRNA FEZF1-AS1 Is Associated with Prognosis in Lung Adenocarcinoma and Promotes Cell Proliferation,Migration,and Invasion”has been retracted from Oncology Research,Vol.27,No.1,2019,pp...The published article titled“lncRNA FEZF1-AS1 Is Associated with Prognosis in Lung Adenocarcinoma and Promotes Cell Proliferation,Migration,and Invasion”has been retracted from Oncology Research,Vol.27,No.1,2019,pp.39–45.展开更多
BACKGROUND The cellular prion protein(PrPC),traditionally associated with neurodegenerative disorders,plays an important role in cancer progression and metastasis by inhibiting apoptosis.AIM To investigate the influen...BACKGROUND The cellular prion protein(PrPC),traditionally associated with neurodegenerative disorders,plays an important role in cancer progression and metastasis by inhibiting apoptosis.AIM To investigate the influence of PrPC expression in cholangiocarcinoma(CCA)on patient outcomes following surgical resection.METHODS Patients who underwent curative surgical resection for either intrahepatic or hilar CCA were enrolled in this retrospective study.Based on the immunohistochemical staining results of the surgical specimens,patients were categorized into two groups:The low PrPC group(negative or 1+)and the high PrPC group(2+or 3+).Survival analyses,including overall survival and recurrence-free survival,were conducted using the Kaplan-Meier method and compared using the log-rank test.RESULTS In total,seventy-six patients diagnosed with CCA(39 with intrahepatic and 37 with hilar CCA)underwent curative hepatectomy from January 2011 to November 2021.Among these patients,38(50%)demonstrated high PrPC expression,whereas the remaining 38(50%)showed low expression of PrPC.During a median follow-up period of 31.2 months(range:1 to 137 months),the high PrPC group had a significantly shorter median overall survival than the low PrPC group(40.4 months vs 137.9 months,respectively;P=0.041).Moreover,the high PrPC group had a significantly shorter median recurrence-free survival than the low PrPC group(13.3 months vs 23.8 months,respectively;P=0.026).CONCLUSION PrPC expression is significantly associated with early recurrence and decreased survival period in CCA patients following surgical resection.Thus,PrPC may be used as a prognostic factor in treatment planning.展开更多
BACKGROUND Studies on the application of recombinant human endostatin(RH-endostatin)intraperitoneal perfusion in gastric cancer(GC)with malignant ascites are limited.AIM To explore the effectiveness,prognosis,and safe...BACKGROUND Studies on the application of recombinant human endostatin(RH-endostatin)intraperitoneal perfusion in gastric cancer(GC)with malignant ascites are limited.AIM To explore the effectiveness,prognosis,and safety of intraperitoneal RH-endostatin perfusion in treating patients with GC and malignant ascites.METHODS Patients with GC and malignant ascites were divided into the cisplatin intraperi-toneal perfusion(control group)group and the cisplatin combined with RH-endostatin intraperitoneal perfusion group(RH-endostatin group).Efficient ascites control,overall survival(OS),quality of life,and adverse events were observed,and possible influencing factors on prognosis outcomes analyzed.RESULTS We identified no significant differences in baseline characteristics between the control and RH-endostatin groups.The latter group had higher ascites control rates than the control group.Treatment methods were identified as an independent OS factor.Clinically,RH-endostatin-treated patients had significantly improved OS rates when compared with control patients,particularly in those with small and moderate ascites volumes.Quality of life improvements in control patients were significantly lower when compared with RH-endostatin patients.Adverse events were balanced between the groups.CONCLUSION Overall,intraperitoneal RH-endostatin improved treatment efficacy and prolonged prognosis in patients with GC and malignant ascites.This approach may benefit further clinical applications for treating GC.展开更多
BACKGROUND Liver transplantation(LT)is recognized as an effective approach that offers survival benefits for patients with acute-on-chronic liver failure(ACLF).However,controversies remain regarding the LT selection c...BACKGROUND Liver transplantation(LT)is recognized as an effective approach that offers survival benefits for patients with acute-on-chronic liver failure(ACLF).However,controversies remain regarding the LT selection criteria,and meta-analyses reporting overall survival outcomes across different ACLF severity grades are lacking.AIM To depict a comprehensive postoperative picture of patients with ACLF of varying severity and contribute to updating LT selection.METHODS Systematic searches in Web of Science,EMBASE,PubMed,and Cochrane databases were performed,from inception to December 26,2023,for studies exploring post-transplant outcomes among ACLF patients,stratified by severity grades as identified by the European Association for the Study of the Liver-Chronic Liver Failure criteria.The primary outcome of interest was the survival rate within one year,with post-transplant complications as secondary outcomes.Additionally,the subgroup analysis examined region-specific one-year survival rates.RESULTS A total of 17 studies involving 28025 participants were included.Patients with ACLF-1 and ACLF-2 have favorable survival within one year,with survival rates reaching 87%[95%confidence interval(CI):84%-91%]and 86%(95%CI:81%-91%),respectively.Despite the relatively lower survival(73%,95%CI:66%-80%)and higher incidence of infection(48%,95%CI:29%-67%)observed in ACLF-3 patients,their survival exceeds that of those who do not undergo LT.Moreover,post-transplant survival was highest in North America across all ACLF grades.CONCLUSION LT can provide survival advantages for ACLF patients.To optimize the utilization of scarce donor organs and improve prognosis,comprehensive preoperative health evaluations are essential,especially for ACLF-3 patients.展开更多
Hypertrophic cardiomyopathy(HCM)is an autosomal dominant inherited cardiomyopathy characterized by left ventricular hypertrophy.It is one of the chief causes of sudden cardiac death in younger people and athletes.Mole...Hypertrophic cardiomyopathy(HCM)is an autosomal dominant inherited cardiomyopathy characterized by left ventricular hypertrophy.It is one of the chief causes of sudden cardiac death in younger people and athletes.Molecular-genetic studies have confirmed that the vast majority of HCM is caused by mutations in genes encoding sarcomere proteins.HCM has a relatively wide phenotypic heterogeneity,varying from asymptomatic to sudden cardiac death,because of the many different mutations and pathogenic genes underlying it.Many studies have explored the clinical symptoms and prognosis of HCM,emphasizing the importance of genotype in evaluating patient prognosis and guiding the clinical management of HCM.To elaborate the main pathogenic genes and phenotypic prognosis in HCM to promote a better understanding of this genetic disease.Retrospective analysis of literature to evaluate the association between underlying gene mutations and clinical phenotypes in HCM patients.As sequencing technology advances,the pathogenic gene mutation spectrum and phenotypic characteristics of HCM are gradually becoming clearer.HCM is a widespread inherited disease with a highly variable clinical phenotype.The precise mechanisms linking known pathogenic gene mutations and the clinical course of this heterogeneous condition remain elusive.展开更多
BACKGROUND Colorectal cancer(CRC)is a common malignancy that has become a global burden.The prognostic prediction of CRC patients on the basis of inflammatory biomarkers and nutritional biomarkers has shown some poten...BACKGROUND Colorectal cancer(CRC)is a common malignancy that has become a global burden.The prognostic prediction of CRC patients on the basis of inflammatory biomarkers and nutritional biomarkers has shown some potential but has not been fully explored.AIM To develop and validate a prognostic model for CRC based on inflammation and nutrition-related biomarkers and to evaluate its predictive value for patient outcomes.METHODS Patients were randomized at a 3:2 ratio into a training cohort(n=282)or a validation cohort(n=188).To identify the optimal prognostic factors for constructing the risk score(RS),LASSO Cox regression analysis was conducted.The association between the RS and overall survival(OS)was evaluated using receiver operating characteristic(ROC)curves and Kaplan-Meier(K-M)survival analysis.Independent risk factors were screened by multivariate Cox regression analysis.Nomograms were constructed and validated on the basis of these factors.RESULTS In the training cohort,univariate analysis of all the inflammatory and nutritional biomarkers demonstrated some predictive value.A LASSO-Cox analysis included four biomarkers and constructed an RS.Through ROC analysis,the area under the prognostic curve was 0.795.K-M survival curve analyses revealed that the five-year OS was significantly greater in the Low-RS group than in the High-RS group(P<0.001).Multivariate analysis demonstrated that the degree of differentiation(P=0.001),degree of nerve invasion(P=0.022),and RS(P<0.001)were independent risk factors.We constructed a nomogram to predict the OS of CRC patients and validated it in a separate cohort.The calibration curve showed high accuracy.Additionally,decision curve analysis for 1-year,3-year,and 5-year survival probabilities indicated significant clinical utility in predicting survival outcomes.CONCLUSION This study developed a nomogram based on the RS to predict the OS of CRC patients.This nomogram can guide treatment decisions and enable the formulation of personalized follow-up strategies on the basis of predicted recurrence risk,aiming to improve long-term prognosis.展开更多
BACKGROUND Colorectal cancer(CRC)is one of the most common malignant gastrointestinal tumors worldwide,with high incidence and mortality rates.AIM To investigate the expression significance of the chromatin-remodeling...BACKGROUND Colorectal cancer(CRC)is one of the most common malignant gastrointestinal tumors worldwide,with high incidence and mortality rates.AIM To investigate the expression significance of the chromatin-remodeling protein MORC family CW-type zinc finger 4(MORC4)as a biomarker in CRC patients,and to explore its relationship with pathological features and prognosis.METHODS A total of 143 CRC specimens and 57 adjacent tissue specimens,surgically removed from our hospital between January 2020 and January 2021,were collected.MORC4 protein expression was assessed using immunohistochemistry after paraffin embedding.The relationship between MORC4 protein expression and clinicopathological characteristics of patients was analyzed.Kaplan-Meier survival curves were plotted to analyze the relationship between MORC4 protein expression and prognosis in CRC patients.RESULTS Compared with adjacent tissues,the expression rate of MORC4 protein in CRC tissues was significantly higher(P<0.05).No significant difference was observed in the high expression rate of MORC4 protein in CRC tissues among patients of different gender,age,tumor location,tumor diameter,and primary tumor status(P>0.05).However,significant differences were found in the high expression rate of MORC4 protein in patients with different degrees of differentiation,lymph node metastasis,distant metastasis,tumor-lymph node-metastasis stage,and serum carcinoembryonic antigen levels(P<0.05).Compared with patients with low MORC4 expression,patients with high MORC4 expression had a worse prognosis(P<0.05).CONCLUSION The upregulation of MORC4 expression in CRC patients is closely related to disease severity and prognosis,suggesting its potential as an evaluation biomarker,which warrants further investigation.展开更多
Introduction: Adolescent childbirth is a public health and social problem worldwide. It is associated with both maternal and perinatal morbidity and mortality. The general objective of our study is to determine the pr...Introduction: Adolescent childbirth is a public health and social problem worldwide. It is associated with both maternal and perinatal morbidity and mortality. The general objective of our study is to determine the prevalence and profile of pregnant women, and to assess the maternal and perinatal prognosis of adolescent childbirth in Kisangani. Methods: This was a prospective, multicenter, case-control observational study conducted over a seven-month period, from February 1 to August 31, 2024, in primiparous adolescent gestational carriers (cases) and primiparous gestational carriers aged 20 to 34 years (controls) who delivered in five health facilities in the city of Kisangani, Democratic Republic of Congo. Results: The prevalence of teenage childbirth was 13.8%. Adolescents were more likely than controls to be in secondary education and to be unemployed. Compared with controls, pregnant adolescents were more likely to have poor ANC attendance. There was a statistical difference between the two groups in relation to pelvic anomaly, rupture of membranes on admission, hypertensive disorders, vicious presentation, caesarean section, episiotomy, postpartum anaemia and puerperal psychosis. In fact, these morbidities were more common in adolescent girls than in controls. Compared with controls, neonatal depression, prematurity, low birth weight and perinatal death were more prevalent in the newborns of teenage mothers. Conclusion: The prevalence of teenage childbirth is high in Kisangani;there is an association between unmarried status, lack of employment, low socio-economic status, poor ANC follow-up and teenage childbirth in Kisangani. The latter is also associated with high maternal and perinatal morbidity and mortality.展开更多
BACKGROUND Colorectal cancer(CRC)is a malignant tumor with high morbidity and mortality rates worldwide.With the development of medical imaging technology,imaging features are playing an increasingly important role in...BACKGROUND Colorectal cancer(CRC)is a malignant tumor with high morbidity and mortality rates worldwide.With the development of medical imaging technology,imaging features are playing an increasingly important role in the prognostic evaluation of CRC.Laparoscopic radical resection is a common surgical approach for treating CRC.However,research on the link between preoperative imaging and short-term prognosis in this context is limited.We hypothesized that specific preope-rative imaging features can predict the short-term prognosis in patients under-going laparoscopic CRC resection.AIM To investigate the imaging features of CRC and analyze their correlation with the short-term prognosis of laparoscopic radical resection.METHODS This retrospective study conducted at the Affiliated Cancer Hospital of Shandong First Medical University included 122 patients diagnosed with CRC who under-went laparoscopic radical resection between January 2021 and February 2024.All patients underwent magnetic resonance imaging(MRI)and were diagnosed with CRC through pathological examination.MRI data and prognostic indicators were collected 30 days post-surgery.Logistic regression analysis identified imaging fea-tures linked to short-term prognosis,and a receiver operating characteristic(ROC)curve was used to evaluate the predictive value.RESULTS Among 122 patients,22 had irregular,low-intensity tumors with adjacent high signals.In 55,tumors were surrounded by alternating signals in the muscle layer.In 32,tumors extended through the muscular layer and blurred boundaries with perienteric adipose tissue.Tumor signals appeared in the adjacent tissues in 13 patients with blurred gaps.Logistic regression revealed differences in longitudinal tumor length,axial tumor length,volume transfer constant,plasma volume fraction,and apparent diffusion coefficient among patients with varying prognostic results.ROC analysis indicated that the areas under the curve for these parameters were 0.648,0.927,0.821,0.809,and 0.831,respectively.Sensitivity values were 0.643,0.893,0.607,0.714,and 0.714,and specificity 0.702,0.904,0.883,0.968,and 0.894(P<0.05).CONCLUSION The imaging features of CRC correlate with the short-term prognosis following laparoscopic radical resection.These findings provide valuable insights for clinical decision-making.展开更多
Introduction: The association of sickle cell disease and pregnancy is a risky situation for the mother as well as the fetus and even the neonate. The objective of this work was to study the maternal and perinatal prog...Introduction: The association of sickle cell disease and pregnancy is a risky situation for the mother as well as the fetus and even the neonate. The objective of this work was to study the maternal and perinatal prognosis of pregnancies in women with sickle cell disease at CHUD-Borgou/Alibori from 2019 to 2023. Patients and Methods: This was a case-control study with a retrospective collection of data from January 1, 2019 to June 30, 2023. It covered sickle cell and non-sickle cell women and their neonates who having given birth at the maternity ward of CHUD-Borgou/Alibori. Results: The frequency of pregnant women with sickle cell disease was 1.36% (153/11212). The average age of the pregnant women with sickle cell disease was 26.77 years ± 5.03. Vaso-occlusive crisis (VOC) was the main complication observed in pregnant women with sickle cell disease during pregnancy (26%). Regarding the complications common to the 2 groups of pregnant women, urinary tract infections (18.1%), severe anemia (22.8%), and severe malaria (26.8%) were more reported in sickle cell patients with a statistically significant difference (p-value = 0.000). Delivery was premature in 61.9% of pregnant women with sickle cell disease compared to 18.5% in pregnant women without sickle cell disease, with a significant difference (p-value = 0.000). The main route of delivery among patients with sickle cell disease was cesarean section (94.4%), while it was vaginal delivery (50.4%) among non-sickle cell pregnant women. VOC (4.8%), severe anemia (39.7%), and acute pulmonary edema (2.4%) were the main complications reported among sickle cell pregnant women in the immediate postpartum period with a significant difference (p-value = 0.000). Three cases of maternal death (2.4%) were recorded in pregnant women with sickle cell disease. The neonatal pathologies identified in the neonates of pregnant women with and without sickle cell disease were mainly neonatal bacterial infection (20.0% vs. 17.2%), hypotrophy (17.0% vs. 5.7%), prematurity (14.8% vs. 7.3%) with a significant difference (p-value = 0.000). The perinatal mortality rate was 57.14‰ in sickle cell women compared to 30‰ with a significant difference (p-value = 0.000). Conclusion: Pregnancy in women with sickle cell disease carries a high risk of maternal and perinatal morbidity and mortality. Information, awareness raising among populations and the adaptation of prenatal care are essential.展开更多
BACKGROUND Lymphovascular invasion(LVI)and perineural invasion(PNI)are associated with decreased survival in colorectal cancer(CRC),but its significance in N1c stage remains to be clearly defined.AIM We retrospectivel...BACKGROUND Lymphovascular invasion(LVI)and perineural invasion(PNI)are associated with decreased survival in colorectal cancer(CRC),but its significance in N1c stage remains to be clearly defined.AIM We retrospectively identified 107 consecutive patients who had CRC with N1c disease radically resected at our hospital.Tumors were reviewed for LVI and PNI by one pathologist blinded to the patients’outcomes.Disease-free survival(DFS),overall survival(OS)and cancer-specific survival(CSS)were determined using the Kaplan-Meier method,with LVI and PNI prognosis differences determined by multivariate analysis using the Cox multiple hazards model.Results were compared using log-rank test.The receiver operating characteristic(ROC)curve was used to evaluate the prognostic predictive ability.RESULTS The median follow-up time was 63.17(45.33-81.37)months for DFS,with 33.64%(36/107)of patients experiencing recurrence;21.5%of tumors were found to be LVI positive and 44.9%PNI positive.The 5-year DFS rate was greater for patients with LVI-negative tumors compared with LVI-positive tumors(74.0%vs 35.6%),and PNI was similar(82.5%vs 45.1%).On multivariate analysis,LVI[hazard ratio(HR)=3.368,95%confidence interval(CI):1.628-6.966,P=0.001]and PNI(HR=3.055,95%CI:1.478-6.313,P=0.002)were independent prognostic factors for DFS.All patients could be divided into three groups of patients with different prognosis according to LVI and PNI.The 5-year ROC curve for LVI,PNI and their combination prediction of DFS was 0.646,0.709 and 0.759,respectively.Similar results were seen for OS and CSS.CONCLUSION LVI and PNI could serve as independent prognostic factors of outcomes in N1c CRC patients.Patients with LVI or PNI should be given more attention during treatment.展开更多
BACKGROUND The incidence of gastric cancer in the elderly is increasing;however,standardized surgical approaches are lacking.AIM To investigate the effects of radical surgery on the trauma response,postoperative compl...BACKGROUND The incidence of gastric cancer in the elderly is increasing;however,standardized surgical approaches are lacking.AIM To investigate the effects of radical surgery on the trauma response,postoperative complications,and long-term prognosis in elderly patients with gastric cancer.METHODS Between January 2020 and December 2023,110 gastric cancer patients admitted to the Department of Oncology Jiangnan University Medical Center were cate-gorized into a control group(40 cases)and an observation group(70 cases)based on surgical method differences.The control and observation group received palli-ative surgery and radical surgery,respectively,and were further divided into open(25 cases)and laparoscopic(45 cases)surgery.Surgical outcomes,trauma indicators,complication rates,and long-term survival at 6 months,1-,and 2-years were compared.RESULTS Laparoscopic surgery showed superior surgical outcomes compared to the open surgery and control groups(P<0.05).Trauma indicators were lowest in the lapa-roscopic group and highest in the control group(P<0.05).No significant difference was observed in the complication rates between the open and laparo-scopic groups(P>0.05),but both were higher than those in the control group(P<0.05).No significant differences were found in survival rates at different follow-up periods between the laparoscopic and open groups(P>0.05);however,both groups showed higher survival rates than the control group(P<0.05).CONCLUSION Radical surgery in elderly patients with gastric cancer reduces surgical trauma response,facilitates postoperative recovery,and improves long-term survival rates,albeit with an increased risk of complications.Laparoscopic radical surgery further minimizes postoperative trauma,with no significant difference in complication rates and survival prognosis compared with open radical surgery.展开更多
BACKGROUND Acute drug-induced liver injury(DILI)events caused by chronic liver disease are relatively common.Some researchers believe that nonalcoholic fatty liver(NAFL)increases the overall risk of DILI.The clinical ...BACKGROUND Acute drug-induced liver injury(DILI)events caused by chronic liver disease are relatively common.Some researchers believe that nonalcoholic fatty liver(NAFL)increases the overall risk of DILI.The clinical characteristics and prognosis of DILI in the context of NAFL disease(NAFLD)are still unclear.Therefore,hospitalized patients with NAFLD combined with DILI at the Tianjin Second People's Hospital were included in this study.The clinical manifestations,classifications,severities,laboratory indicators,and clinical outcomes of the enrolled patients were analyzed,and the clinical characteristics and prognoses of the NAFL+DILI patients were evaluated.AIM To investigate the clinical characteristics and prognosis of DILI in the context of NAFL.METHODS Eighty-nine patients diagnosed with DILI and 110 patients diagnosed with both DILI and NAFL at the Tianjin Second People's Hospital were enrolled.Clinical data,including demographic characteristics,clinical features,laboratory test results,pathology findings,autoantibody titers,suspected drugs,and outcomes,were collected from the two groups of patients.All enrolled patients were followed up to determine the liver function recovery time.RESULTS Compared with the patients in the DILI group,those in the NAFL+DILI group had higher body mass indices;Controlled Attenuation Parameter scores;and triglyceride,total cholesterol,low-density lipoprotein,and insulin levels.The levels of the cytokines interleukin-4 and complement complement c3(C3)were also greater in the NAFL+DILI group than in the DILI group.The proportions of patients with cholestatic-type DILI(16.4%vs 4.5%),cholestasis seen on pathoscopy(40.9%vs 25.8%),grade 2 or above DILI(48.18%vs 40.45%),and a recovery time for liver function ranging from 90 to 180 days(30.6%vs 15.5%)were greater in the NAFL+DILI group than in the DILI group.All of the abovementioned differences between the groups were statistically significant(P<0.05).The autoantibody positivity rates did not significantly differ between the two groups(P>0.05),and the proportions of patients who progressed to chronic drug hepatitis or autoimmune hepatitis were not significantly different between the two groups(both P>0.05).CONCLUSION In the context of NAFL,DILI is more likely to be cholestatic,with a greater degree of liver injury,a longer recovery time,and more pronounced expression of immune factors.展开更多
BACKGROUND As red blood cell distribution width(RDW)and albumin have been shown to be independent predictors of mortality from various diseases,this study aimed to investigate the effect of the RDW to albumin ratio(RA...BACKGROUND As red blood cell distribution width(RDW)and albumin have been shown to be independent predictors of mortality from various diseases,this study aimed to investigate the effect of the RDW to albumin ratio(RA)as an independent predictor of the prognosis of patients admitted to the coronary care unit(CCU).AIM To use the RDW and albumin level to predict the prognosis of patients in the CCU.METHODS Data were obtained from the Medical Information Mart Intensive Care III database.The primary outcome was 365-day all-cause mortality,whereas the secondary outcomes were 30-and 90-day all-cause mortality,hospital length of stay(LOS),and CCU LOS.Cox proportional hazards regression model,propen-sity score matching,and receiver operating characteristic curve analyses were used.RESULTS The hazard ratio(95%confidence interval)of the upper tertile(RA>4.66)was 1.62(1.29 to 2.03)when compared with the reference(RA<3.84)in 365-day all-cause mortality.This trend persisted after adjusting for demographic and clinical variables in the propensity score-matching analysis.Similar trends were observed for the secondary outcomes of hospital and CCU LOS.Receiver operating characteristic curve analysis was performed by combining the RA and sequential organ failure assessment(SOFA)scores,and the C-statistic was higher than that of the SOFA scores(0.733 vs 0.702,P<0.001).CONCLUSION RA is an independent prognostic factor in patients admitted to the CCU.RA combined with the SOFA score can improve the predictive ability of the SOFA score.However,our results should be verified in future prospective studies.展开更多
Objective:The expression of programmed death 1(PD-1)on CD8^(+)T cells is associated with their activation and exhaustion,while CD57 serves as a senescence marker.The impact of PD-1^(+)and CD57^(+)CD8^(+)T cells on the...Objective:The expression of programmed death 1(PD-1)on CD8^(+)T cells is associated with their activation and exhaustion,while CD57 serves as a senescence marker.The impact of PD-1^(+)and CD57^(+)CD8^(+)T cells on the prognosis of patients with advanced high-grade serous ovarian cancer(HGSOC)remain unclear.Methods:We assessed the percentages of PD-1^(+)and CD57^(+)CD8^(+)T cells in tumor-infiltrating lymphocytes(TILs,n=85)and tumor ascites lymphocytes(TALs,n=87)using flow cytometry.The optimal cutoffs for these markers in TILs and TALs were determined through the log-rank maximization method.Gene expression analysis elucidated the tumor immune microenvironment(TIME,n=36).Results:Patients with higher PD-1^(+)CD8^(+)TILs(>87.8%)exhibited longer platinum-free interval(PFI)and overall survival(OS).In contrast,those with elevated CD57^(+)CD8^(+)TALs(>28.69%)were more likely to experience chemotherapy and had lower complete remission rates,shorter PFI and OS.PD-1^(+)CD8^(+)TILs are primarily displayed an effector memory state with strong proliferative and secretory capabilities.Approximately 50%of CD57^(+)CD8^(+)TALs were terminally differentiated,exhibiting significantly impaired proliferation.Based on the proportions of PD-1^(+)CD8^(+)TILs and CD57^(+)CD8^(+)TALs,patients were categorized into good,median and poor prognosis groups,with median PFI of 47.78,27.29 and 11.96 months,respectively(P<0.0001).Median OS for these groups was not reach,49.23 and 30.92 months,respectively(P<0.0001).Patients with poor prognosis exhibit significantly reduced CD8^(+)T cell proportion and increased M2 macrophage in the TIME,alongside downregulation of multiple T cell activation-related pathways.Conclusions:Lower levels of PD-1^(+)CD8^(+)TILs and higher CD57^(+)CD8^(+)TALs,assessed prior to treatment,correlated with poor prognosis and suppressive TIME in advanced HGSOC.展开更多
BACKGROUND Eosinophilic gastroenteritis(EGE)is a chronic recurrent disease with abnormal eosinophilic infiltration in the gastrointestinal tract.Glucocorticoids remain the most common treatment method.However,disease ...BACKGROUND Eosinophilic gastroenteritis(EGE)is a chronic recurrent disease with abnormal eosinophilic infiltration in the gastrointestinal tract.Glucocorticoids remain the most common treatment method.However,disease relapse and glucocorticoid dependence remain notable problems.To date,few studies have illuminated the prognosis of EGE and risk factors for disease relapse.AIM To describe the clinical characteristics of EGE and possible predictive factors for disease relapse based on long-term follow-up.METHODS This was a retrospective cohort study of 55 patients diagnosed with EGE admitted to one medical center between 2013 and 2022.Clinical records were collected and analyzed.Kaplan-Meier curves and log-rank tests were conducted to reveal the risk factors for long-term relapse-free survival(RFS).RESULTS EGE showed a median onset age of 38 years and a slight female predominance(56.4%).The main clinical symptoms were abdominal pain(89.1%),diarrhea(61.8%),nausea(52.7%),distension(49.1%)and vomiting(47.3%).Forty-three(78.2%)patients received glucocorticoid treatment,and compared with patients without glucocorticoid treatments,they were more likely to have elevated serum immunoglobin E(IgE)(86.8%vs 50.0%,P=0.022)and descending duodenal involvement(62.8%vs 27.3%,P=0.046)at diagnosis.With a median follow-up of 67 mo,all patients survived,and 56.4%had at least one relapse.Six variables at baseline might have been associated with the overall RFS rate,including age at diagnosis<40 years[hazard ratio(HR)2.0408,95%confidence interval(CI):1.0082–4.1312,P=0.044],body mass index(BMI)>24 kg/m^(2)(HR 0.3922,95%CI:0.1916-0.8027,P=0.014),disease duration from symptom onset to diagnosis>3.5 mo(HR 2.4725,95%CI:1.220-5.0110,P=0.011),vomiting(HR 3.1259,95%CI:1.5246-6.4093,P=0.001),total serum IgE>300 KU/L at diagnosis(HR 0.2773,95%CI:0.1204-0.6384,P=0.022)and glucocorticoid treatment(HR 6.1434,95%CI:2.8446-13.2676,P=0.003).CONCLUSION In patients with EGE,younger onset age,longer disease course,vomiting and glucocorticoid treatment were risk factors for disease relapse,whereas higher BMI and total IgE level at baseline were protective.展开更多
BACKGROUND There is currently a shortage of accurate,efficient,and precise predictive instruments for rectal neuroendocrine neoplasms(NENs).AIM To develop a predictive model for individuals with rectal NENs(R-NENs)usi...BACKGROUND There is currently a shortage of accurate,efficient,and precise predictive instruments for rectal neuroendocrine neoplasms(NENs).AIM To develop a predictive model for individuals with rectal NENs(R-NENs)using data from a large cohort.METHODS Data from patients with primary R-NENs were retrospectively collected from 17 large-scale referral medical centers in China.Random forest and Cox proportional hazard models were used to identify the risk factors for overall survival and progression-free survival,and two nomograms were constructed.RESULTS A total of 1408 patients with R-NENs were included.Tumor grade,T stage,tumor size,age,and a prognostic nutritional index were important risk factors for prognosis.The GATIS score was calculated based on these five indicators.For overall survival prediction,the respective C-indexes in the training set were 0.915(95%confidence interval:0.866-0.964)for overall survival prediction and 0.908(95%confidence interval:0.872-0.944)for progression-free survival prediction.According to decision curve analysis,net benefit of the GATIS score was higher than that of a single factor.The time-dependent area under the receiver operating characteristic curve showed that the predictive power of the GATIS score was higher than that of the TNM stage and pathological grade at all time periods.CONCLUSION The GATIS score had a good predictive effect on the prognosis of patients with R-NENs,with efficacy superior to that of the World Health Organization grade and TNM stage.展开更多
基金supported by grants from the Dongguan Science and Technology of Social Development Program(No.20231800940192)the Talent Development Foundation of the First Dongguan Affiliated Hospital of Guangdong Medical University(No.PU2023002).
文摘Objective:Small cell lung cancer(SCLC)is commonly recognized as the most fatal lung cancer type.Despite substantial advances in immune checkpoint blockade therapies for treating solid cancers,their benefits are limited to a minority of patients with SCLC.In the present study,novel indicators for predicting the outcomes and molecular targets for SCLC treatment were elucidated.Methods:We conducted bioinformatics analysis to identify the key genes associated with tumor-infiltrating lymphocytes in SCLC.The functional role of the key gene identified in SCLC was determined both in vitro and in vivo.Results:A significant correlation was observed between patient survival and CD56dim natural killer(NK)cell proportion.Furthermore,we noted that the hub gene ubiquitin-specific protease 1(USP1)is closely correlated with both CD56dim NK cells and overall survival in SCLC.Bioinformatics analysis revealed that USP1 is upregulated in SCLC.In addition,gene set enrichment analysis revealed that USP1 overexpression hinders NK cell-mediated immune responses.By co-cultivating NK-92 cells with SCLC cells,we demonstrated that NK cell cytotoxicity against SCLC could be improved either via USP1 knock-down or pharmacological inhibition.Furthermore,using a nude-mice xenograft tumor model,we noted that USP1 inhibition effectively suppressed tumor proliferation and increased the expression of NK cell-associated markers.Conclusions:Our study findings highlight the importance of NK cells in regulating SCLC.USP1 overexpression can inhibit NK cell-mediated immunity;therefore,USP1 may serve not only as a prognostic biomarker but also as a potential molecular target of SCLC therapy.
文摘Objective INF2 is a member of the formins family.Abnormal expression and regulation of INF2 have been associated with the progression of various tumors,but the expression and role of INF2 in hepatocellular carcinoma(HCC)remain unclear.HCC is a highly lethal malignant tumor.Given the limitations of traditional treatments,this study explored the expression level,clinical value and potential mechanism of INF2 in HCC in order to seek new therapeutic targets.Methods In this study,we used public databases to analyze the expression of INF2 in pan-cancer and HCC,as well as the impact of INF2 expression levels on HCC prognosis.Quantitative real time polymerase chain reaction(RT-qPCR),Western blot,and immunohistochemistry were used to detect the expression level of INF2 in liver cancer cells and human HCC tissues.The correlation between INF2 expression and clinical pathological features was analyzed using public databases and clinical data of human HCC samples.Subsequently,the effects of INF2 expression on the biological function and Drp1 phosphorylation of liver cancer cells were elucidated through in vitro and in vivo experiments.Finally,the predictive value and potential mechanism of INF2 in HCC were further analyzed through database and immunohistochemical experiments.Results INF2 is aberrantly high expression in HCC samples and the high expression of INF2 is correlated with overall survival,liver cirrhosis and pathological differentiation of HCC patients.The expression level of INF2 has certain diagnostic value in predicting the prognosis and pathological differentiation of HCC.In vivo and in vitro HCC models,upregulated expression of INF2 triggers the proliferation and migration of the HCC cell,while knockdown of INF2 could counteract this effect.INF2 in liver cancer cells may affect mitochondrial division by inducing Drp1 phosphorylation and mediate immune escape by up-regulating PD-L1 expression,thus promoting tumor progression.Conclusion INF2 is highly expressed in HCC and is associated with poor prognosis.High expression of INF2 may promote HCC progression by inducing Drp1 phosphorylation and up-regulation of PD-L1 expression,and targeting INF2 may be beneficial for HCC patients with high expression of INF2.
基金Supported by National Key Technology Research and Developmental Program of China,No.2022YFC2704400 and No.2022YFC2704405.
文摘BACKGROUND Mitochondrial genes are involved in tumor metabolism in ovarian cancer(OC)and affect immune cell infiltration and treatment responses.AIM To predict prognosis and immunotherapy response in patients diagnosed with OC using mitochondrial genes and neural networks.METHODS Prognosis,immunotherapy efficacy,and next-generation sequencing data of patients with OC were downloaded from The Cancer Genome Atlas and Gene Expression Omnibus.Mitochondrial genes were sourced from the MitoCarta3.0 database.The discovery cohort for model construction was created from 70% of the patients,whereas the remaining 30% constituted the validation cohort.Using the expression of mitochondrial genes as the predictor variable and based on neural network algorithm,the overall survival time and immunotherapy efficacy(complete or partial response)of patients were predicted.RESULTS In total,375 patients with OC were included to construct the prognostic model,and 26 patients were included to construct the immune efficacy model.The average area under the receiver operating characteristic curve of the prognostic model was 0.7268[95% confidence interval(CI):0.7258-0.7278]in the discovery cohort and 0.6475(95%CI:0.6466-0.6484)in the validation cohort.The average area under the receiver operating characteristic curve of the immunotherapy efficacy model was 0.9444(95%CI:0.8333-1.0000)in the discovery cohort and 0.9167(95%CI:0.6667-1.0000)in the validation cohort.CONCLUSION The application of mitochondrial genes and neural networks has the potential to predict prognosis and immunotherapy response in patients with OC,providing valuable insights into personalized treatment strategies.
文摘The published article titled“lncRNA FEZF1-AS1 Is Associated with Prognosis in Lung Adenocarcinoma and Promotes Cell Proliferation,Migration,and Invasion”has been retracted from Oncology Research,Vol.27,No.1,2019,pp.39–45.
基金Supported by National Research Foundation of Korea Grant Funded by the Korea Government,No.RS-2023-00213951.
文摘BACKGROUND The cellular prion protein(PrPC),traditionally associated with neurodegenerative disorders,plays an important role in cancer progression and metastasis by inhibiting apoptosis.AIM To investigate the influence of PrPC expression in cholangiocarcinoma(CCA)on patient outcomes following surgical resection.METHODS Patients who underwent curative surgical resection for either intrahepatic or hilar CCA were enrolled in this retrospective study.Based on the immunohistochemical staining results of the surgical specimens,patients were categorized into two groups:The low PrPC group(negative or 1+)and the high PrPC group(2+or 3+).Survival analyses,including overall survival and recurrence-free survival,were conducted using the Kaplan-Meier method and compared using the log-rank test.RESULTS In total,seventy-six patients diagnosed with CCA(39 with intrahepatic and 37 with hilar CCA)underwent curative hepatectomy from January 2011 to November 2021.Among these patients,38(50%)demonstrated high PrPC expression,whereas the remaining 38(50%)showed low expression of PrPC.During a median follow-up period of 31.2 months(range:1 to 137 months),the high PrPC group had a significantly shorter median overall survival than the low PrPC group(40.4 months vs 137.9 months,respectively;P=0.041).Moreover,the high PrPC group had a significantly shorter median recurrence-free survival than the low PrPC group(13.3 months vs 23.8 months,respectively;P=0.026).CONCLUSION PrPC expression is significantly associated with early recurrence and decreased survival period in CCA patients following surgical resection.Thus,PrPC may be used as a prognostic factor in treatment planning.
基金Supported by Scientific Research Project of Tianjin Municipal Education Commission,No.2018KJ015.
文摘BACKGROUND Studies on the application of recombinant human endostatin(RH-endostatin)intraperitoneal perfusion in gastric cancer(GC)with malignant ascites are limited.AIM To explore the effectiveness,prognosis,and safety of intraperitoneal RH-endostatin perfusion in treating patients with GC and malignant ascites.METHODS Patients with GC and malignant ascites were divided into the cisplatin intraperi-toneal perfusion(control group)group and the cisplatin combined with RH-endostatin intraperitoneal perfusion group(RH-endostatin group).Efficient ascites control,overall survival(OS),quality of life,and adverse events were observed,and possible influencing factors on prognosis outcomes analyzed.RESULTS We identified no significant differences in baseline characteristics between the control and RH-endostatin groups.The latter group had higher ascites control rates than the control group.Treatment methods were identified as an independent OS factor.Clinically,RH-endostatin-treated patients had significantly improved OS rates when compared with control patients,particularly in those with small and moderate ascites volumes.Quality of life improvements in control patients were significantly lower when compared with RH-endostatin patients.Adverse events were balanced between the groups.CONCLUSION Overall,intraperitoneal RH-endostatin improved treatment efficacy and prolonged prognosis in patients with GC and malignant ascites.This approach may benefit further clinical applications for treating GC.
基金Supported by National Natural Science Foundation of China,No.82300857.
文摘BACKGROUND Liver transplantation(LT)is recognized as an effective approach that offers survival benefits for patients with acute-on-chronic liver failure(ACLF).However,controversies remain regarding the LT selection criteria,and meta-analyses reporting overall survival outcomes across different ACLF severity grades are lacking.AIM To depict a comprehensive postoperative picture of patients with ACLF of varying severity and contribute to updating LT selection.METHODS Systematic searches in Web of Science,EMBASE,PubMed,and Cochrane databases were performed,from inception to December 26,2023,for studies exploring post-transplant outcomes among ACLF patients,stratified by severity grades as identified by the European Association for the Study of the Liver-Chronic Liver Failure criteria.The primary outcome of interest was the survival rate within one year,with post-transplant complications as secondary outcomes.Additionally,the subgroup analysis examined region-specific one-year survival rates.RESULTS A total of 17 studies involving 28025 participants were included.Patients with ACLF-1 and ACLF-2 have favorable survival within one year,with survival rates reaching 87%[95%confidence interval(CI):84%-91%]and 86%(95%CI:81%-91%),respectively.Despite the relatively lower survival(73%,95%CI:66%-80%)and higher incidence of infection(48%,95%CI:29%-67%)observed in ACLF-3 patients,their survival exceeds that of those who do not undergo LT.Moreover,post-transplant survival was highest in North America across all ACLF grades.CONCLUSION LT can provide survival advantages for ACLF patients.To optimize the utilization of scarce donor organs and improve prognosis,comprehensive preoperative health evaluations are essential,especially for ACLF-3 patients.
基金Supported by National Natural Science Foundation of China,No.81770379 and 81470521.
文摘Hypertrophic cardiomyopathy(HCM)is an autosomal dominant inherited cardiomyopathy characterized by left ventricular hypertrophy.It is one of the chief causes of sudden cardiac death in younger people and athletes.Molecular-genetic studies have confirmed that the vast majority of HCM is caused by mutations in genes encoding sarcomere proteins.HCM has a relatively wide phenotypic heterogeneity,varying from asymptomatic to sudden cardiac death,because of the many different mutations and pathogenic genes underlying it.Many studies have explored the clinical symptoms and prognosis of HCM,emphasizing the importance of genotype in evaluating patient prognosis and guiding the clinical management of HCM.To elaborate the main pathogenic genes and phenotypic prognosis in HCM to promote a better understanding of this genetic disease.Retrospective analysis of literature to evaluate the association between underlying gene mutations and clinical phenotypes in HCM patients.As sequencing technology advances,the pathogenic gene mutation spectrum and phenotypic characteristics of HCM are gradually becoming clearer.HCM is a widespread inherited disease with a highly variable clinical phenotype.The precise mechanisms linking known pathogenic gene mutations and the clinical course of this heterogeneous condition remain elusive.
基金Supported by Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01C297.
文摘BACKGROUND Colorectal cancer(CRC)is a common malignancy that has become a global burden.The prognostic prediction of CRC patients on the basis of inflammatory biomarkers and nutritional biomarkers has shown some potential but has not been fully explored.AIM To develop and validate a prognostic model for CRC based on inflammation and nutrition-related biomarkers and to evaluate its predictive value for patient outcomes.METHODS Patients were randomized at a 3:2 ratio into a training cohort(n=282)or a validation cohort(n=188).To identify the optimal prognostic factors for constructing the risk score(RS),LASSO Cox regression analysis was conducted.The association between the RS and overall survival(OS)was evaluated using receiver operating characteristic(ROC)curves and Kaplan-Meier(K-M)survival analysis.Independent risk factors were screened by multivariate Cox regression analysis.Nomograms were constructed and validated on the basis of these factors.RESULTS In the training cohort,univariate analysis of all the inflammatory and nutritional biomarkers demonstrated some predictive value.A LASSO-Cox analysis included four biomarkers and constructed an RS.Through ROC analysis,the area under the prognostic curve was 0.795.K-M survival curve analyses revealed that the five-year OS was significantly greater in the Low-RS group than in the High-RS group(P<0.001).Multivariate analysis demonstrated that the degree of differentiation(P=0.001),degree of nerve invasion(P=0.022),and RS(P<0.001)were independent risk factors.We constructed a nomogram to predict the OS of CRC patients and validated it in a separate cohort.The calibration curve showed high accuracy.Additionally,decision curve analysis for 1-year,3-year,and 5-year survival probabilities indicated significant clinical utility in predicting survival outcomes.CONCLUSION This study developed a nomogram based on the RS to predict the OS of CRC patients.This nomogram can guide treatment decisions and enable the formulation of personalized follow-up strategies on the basis of predicted recurrence risk,aiming to improve long-term prognosis.
基金was approved by the Ethics Committee of Cangzhou Central Hospital,No.29795793.
文摘BACKGROUND Colorectal cancer(CRC)is one of the most common malignant gastrointestinal tumors worldwide,with high incidence and mortality rates.AIM To investigate the expression significance of the chromatin-remodeling protein MORC family CW-type zinc finger 4(MORC4)as a biomarker in CRC patients,and to explore its relationship with pathological features and prognosis.METHODS A total of 143 CRC specimens and 57 adjacent tissue specimens,surgically removed from our hospital between January 2020 and January 2021,were collected.MORC4 protein expression was assessed using immunohistochemistry after paraffin embedding.The relationship between MORC4 protein expression and clinicopathological characteristics of patients was analyzed.Kaplan-Meier survival curves were plotted to analyze the relationship between MORC4 protein expression and prognosis in CRC patients.RESULTS Compared with adjacent tissues,the expression rate of MORC4 protein in CRC tissues was significantly higher(P<0.05).No significant difference was observed in the high expression rate of MORC4 protein in CRC tissues among patients of different gender,age,tumor location,tumor diameter,and primary tumor status(P>0.05).However,significant differences were found in the high expression rate of MORC4 protein in patients with different degrees of differentiation,lymph node metastasis,distant metastasis,tumor-lymph node-metastasis stage,and serum carcinoembryonic antigen levels(P<0.05).Compared with patients with low MORC4 expression,patients with high MORC4 expression had a worse prognosis(P<0.05).CONCLUSION The upregulation of MORC4 expression in CRC patients is closely related to disease severity and prognosis,suggesting its potential as an evaluation biomarker,which warrants further investigation.
文摘Introduction: Adolescent childbirth is a public health and social problem worldwide. It is associated with both maternal and perinatal morbidity and mortality. The general objective of our study is to determine the prevalence and profile of pregnant women, and to assess the maternal and perinatal prognosis of adolescent childbirth in Kisangani. Methods: This was a prospective, multicenter, case-control observational study conducted over a seven-month period, from February 1 to August 31, 2024, in primiparous adolescent gestational carriers (cases) and primiparous gestational carriers aged 20 to 34 years (controls) who delivered in five health facilities in the city of Kisangani, Democratic Republic of Congo. Results: The prevalence of teenage childbirth was 13.8%. Adolescents were more likely than controls to be in secondary education and to be unemployed. Compared with controls, pregnant adolescents were more likely to have poor ANC attendance. There was a statistical difference between the two groups in relation to pelvic anomaly, rupture of membranes on admission, hypertensive disorders, vicious presentation, caesarean section, episiotomy, postpartum anaemia and puerperal psychosis. In fact, these morbidities were more common in adolescent girls than in controls. Compared with controls, neonatal depression, prematurity, low birth weight and perinatal death were more prevalent in the newborns of teenage mothers. Conclusion: The prevalence of teenage childbirth is high in Kisangani;there is an association between unmarried status, lack of employment, low socio-economic status, poor ANC follow-up and teenage childbirth in Kisangani. The latter is also associated with high maternal and perinatal morbidity and mortality.
文摘BACKGROUND Colorectal cancer(CRC)is a malignant tumor with high morbidity and mortality rates worldwide.With the development of medical imaging technology,imaging features are playing an increasingly important role in the prognostic evaluation of CRC.Laparoscopic radical resection is a common surgical approach for treating CRC.However,research on the link between preoperative imaging and short-term prognosis in this context is limited.We hypothesized that specific preope-rative imaging features can predict the short-term prognosis in patients under-going laparoscopic CRC resection.AIM To investigate the imaging features of CRC and analyze their correlation with the short-term prognosis of laparoscopic radical resection.METHODS This retrospective study conducted at the Affiliated Cancer Hospital of Shandong First Medical University included 122 patients diagnosed with CRC who under-went laparoscopic radical resection between January 2021 and February 2024.All patients underwent magnetic resonance imaging(MRI)and were diagnosed with CRC through pathological examination.MRI data and prognostic indicators were collected 30 days post-surgery.Logistic regression analysis identified imaging fea-tures linked to short-term prognosis,and a receiver operating characteristic(ROC)curve was used to evaluate the predictive value.RESULTS Among 122 patients,22 had irregular,low-intensity tumors with adjacent high signals.In 55,tumors were surrounded by alternating signals in the muscle layer.In 32,tumors extended through the muscular layer and blurred boundaries with perienteric adipose tissue.Tumor signals appeared in the adjacent tissues in 13 patients with blurred gaps.Logistic regression revealed differences in longitudinal tumor length,axial tumor length,volume transfer constant,plasma volume fraction,and apparent diffusion coefficient among patients with varying prognostic results.ROC analysis indicated that the areas under the curve for these parameters were 0.648,0.927,0.821,0.809,and 0.831,respectively.Sensitivity values were 0.643,0.893,0.607,0.714,and 0.714,and specificity 0.702,0.904,0.883,0.968,and 0.894(P<0.05).CONCLUSION The imaging features of CRC correlate with the short-term prognosis following laparoscopic radical resection.These findings provide valuable insights for clinical decision-making.
文摘Introduction: The association of sickle cell disease and pregnancy is a risky situation for the mother as well as the fetus and even the neonate. The objective of this work was to study the maternal and perinatal prognosis of pregnancies in women with sickle cell disease at CHUD-Borgou/Alibori from 2019 to 2023. Patients and Methods: This was a case-control study with a retrospective collection of data from January 1, 2019 to June 30, 2023. It covered sickle cell and non-sickle cell women and their neonates who having given birth at the maternity ward of CHUD-Borgou/Alibori. Results: The frequency of pregnant women with sickle cell disease was 1.36% (153/11212). The average age of the pregnant women with sickle cell disease was 26.77 years ± 5.03. Vaso-occlusive crisis (VOC) was the main complication observed in pregnant women with sickle cell disease during pregnancy (26%). Regarding the complications common to the 2 groups of pregnant women, urinary tract infections (18.1%), severe anemia (22.8%), and severe malaria (26.8%) were more reported in sickle cell patients with a statistically significant difference (p-value = 0.000). Delivery was premature in 61.9% of pregnant women with sickle cell disease compared to 18.5% in pregnant women without sickle cell disease, with a significant difference (p-value = 0.000). The main route of delivery among patients with sickle cell disease was cesarean section (94.4%), while it was vaginal delivery (50.4%) among non-sickle cell pregnant women. VOC (4.8%), severe anemia (39.7%), and acute pulmonary edema (2.4%) were the main complications reported among sickle cell pregnant women in the immediate postpartum period with a significant difference (p-value = 0.000). Three cases of maternal death (2.4%) were recorded in pregnant women with sickle cell disease. The neonatal pathologies identified in the neonates of pregnant women with and without sickle cell disease were mainly neonatal bacterial infection (20.0% vs. 17.2%), hypotrophy (17.0% vs. 5.7%), prematurity (14.8% vs. 7.3%) with a significant difference (p-value = 0.000). The perinatal mortality rate was 57.14‰ in sickle cell women compared to 30‰ with a significant difference (p-value = 0.000). Conclusion: Pregnancy in women with sickle cell disease carries a high risk of maternal and perinatal morbidity and mortality. Information, awareness raising among populations and the adaptation of prenatal care are essential.
基金Supported by the National High Level Hospital Clinical Research Funding,No.2023-NHLHCRF-BQ-32 and No.2023-NHLHCRFYYPPLC-ZR-13the Elite Medical Professionals Project of China-Japan Friendship Hospital,No.ZRJY2024-GG01.
文摘BACKGROUND Lymphovascular invasion(LVI)and perineural invasion(PNI)are associated with decreased survival in colorectal cancer(CRC),but its significance in N1c stage remains to be clearly defined.AIM We retrospectively identified 107 consecutive patients who had CRC with N1c disease radically resected at our hospital.Tumors were reviewed for LVI and PNI by one pathologist blinded to the patients’outcomes.Disease-free survival(DFS),overall survival(OS)and cancer-specific survival(CSS)were determined using the Kaplan-Meier method,with LVI and PNI prognosis differences determined by multivariate analysis using the Cox multiple hazards model.Results were compared using log-rank test.The receiver operating characteristic(ROC)curve was used to evaluate the prognostic predictive ability.RESULTS The median follow-up time was 63.17(45.33-81.37)months for DFS,with 33.64%(36/107)of patients experiencing recurrence;21.5%of tumors were found to be LVI positive and 44.9%PNI positive.The 5-year DFS rate was greater for patients with LVI-negative tumors compared with LVI-positive tumors(74.0%vs 35.6%),and PNI was similar(82.5%vs 45.1%).On multivariate analysis,LVI[hazard ratio(HR)=3.368,95%confidence interval(CI):1.628-6.966,P=0.001]and PNI(HR=3.055,95%CI:1.478-6.313,P=0.002)were independent prognostic factors for DFS.All patients could be divided into three groups of patients with different prognosis according to LVI and PNI.The 5-year ROC curve for LVI,PNI and their combination prediction of DFS was 0.646,0.709 and 0.759,respectively.Similar results were seen for OS and CSS.CONCLUSION LVI and PNI could serve as independent prognostic factors of outcomes in N1c CRC patients.Patients with LVI or PNI should be given more attention during treatment.
文摘BACKGROUND The incidence of gastric cancer in the elderly is increasing;however,standardized surgical approaches are lacking.AIM To investigate the effects of radical surgery on the trauma response,postoperative complications,and long-term prognosis in elderly patients with gastric cancer.METHODS Between January 2020 and December 2023,110 gastric cancer patients admitted to the Department of Oncology Jiangnan University Medical Center were cate-gorized into a control group(40 cases)and an observation group(70 cases)based on surgical method differences.The control and observation group received palli-ative surgery and radical surgery,respectively,and were further divided into open(25 cases)and laparoscopic(45 cases)surgery.Surgical outcomes,trauma indicators,complication rates,and long-term survival at 6 months,1-,and 2-years were compared.RESULTS Laparoscopic surgery showed superior surgical outcomes compared to the open surgery and control groups(P<0.05).Trauma indicators were lowest in the lapa-roscopic group and highest in the control group(P<0.05).No significant difference was observed in the complication rates between the open and laparo-scopic groups(P>0.05),but both were higher than those in the control group(P<0.05).No significant differences were found in survival rates at different follow-up periods between the laparoscopic and open groups(P>0.05);however,both groups showed higher survival rates than the control group(P<0.05).CONCLUSION Radical surgery in elderly patients with gastric cancer reduces surgical trauma response,facilitates postoperative recovery,and improves long-term survival rates,albeit with an increased risk of complications.Laparoscopic radical surgery further minimizes postoperative trauma,with no significant difference in complication rates and survival prognosis compared with open radical surgery.
文摘BACKGROUND Acute drug-induced liver injury(DILI)events caused by chronic liver disease are relatively common.Some researchers believe that nonalcoholic fatty liver(NAFL)increases the overall risk of DILI.The clinical characteristics and prognosis of DILI in the context of NAFL disease(NAFLD)are still unclear.Therefore,hospitalized patients with NAFLD combined with DILI at the Tianjin Second People's Hospital were included in this study.The clinical manifestations,classifications,severities,laboratory indicators,and clinical outcomes of the enrolled patients were analyzed,and the clinical characteristics and prognoses of the NAFL+DILI patients were evaluated.AIM To investigate the clinical characteristics and prognosis of DILI in the context of NAFL.METHODS Eighty-nine patients diagnosed with DILI and 110 patients diagnosed with both DILI and NAFL at the Tianjin Second People's Hospital were enrolled.Clinical data,including demographic characteristics,clinical features,laboratory test results,pathology findings,autoantibody titers,suspected drugs,and outcomes,were collected from the two groups of patients.All enrolled patients were followed up to determine the liver function recovery time.RESULTS Compared with the patients in the DILI group,those in the NAFL+DILI group had higher body mass indices;Controlled Attenuation Parameter scores;and triglyceride,total cholesterol,low-density lipoprotein,and insulin levels.The levels of the cytokines interleukin-4 and complement complement c3(C3)were also greater in the NAFL+DILI group than in the DILI group.The proportions of patients with cholestatic-type DILI(16.4%vs 4.5%),cholestasis seen on pathoscopy(40.9%vs 25.8%),grade 2 or above DILI(48.18%vs 40.45%),and a recovery time for liver function ranging from 90 to 180 days(30.6%vs 15.5%)were greater in the NAFL+DILI group than in the DILI group.All of the abovementioned differences between the groups were statistically significant(P<0.05).The autoantibody positivity rates did not significantly differ between the two groups(P>0.05),and the proportions of patients who progressed to chronic drug hepatitis or autoimmune hepatitis were not significantly different between the two groups(both P>0.05).CONCLUSION In the context of NAFL,DILI is more likely to be cholestatic,with a greater degree of liver injury,a longer recovery time,and more pronounced expression of immune factors.
文摘BACKGROUND As red blood cell distribution width(RDW)and albumin have been shown to be independent predictors of mortality from various diseases,this study aimed to investigate the effect of the RDW to albumin ratio(RA)as an independent predictor of the prognosis of patients admitted to the coronary care unit(CCU).AIM To use the RDW and albumin level to predict the prognosis of patients in the CCU.METHODS Data were obtained from the Medical Information Mart Intensive Care III database.The primary outcome was 365-day all-cause mortality,whereas the secondary outcomes were 30-and 90-day all-cause mortality,hospital length of stay(LOS),and CCU LOS.Cox proportional hazards regression model,propen-sity score matching,and receiver operating characteristic curve analyses were used.RESULTS The hazard ratio(95%confidence interval)of the upper tertile(RA>4.66)was 1.62(1.29 to 2.03)when compared with the reference(RA<3.84)in 365-day all-cause mortality.This trend persisted after adjusting for demographic and clinical variables in the propensity score-matching analysis.Similar trends were observed for the secondary outcomes of hospital and CCU LOS.Receiver operating characteristic curve analysis was performed by combining the RA and sequential organ failure assessment(SOFA)scores,and the C-statistic was higher than that of the SOFA scores(0.733 vs 0.702,P<0.001).CONCLUSION RA is an independent prognostic factor in patients admitted to the CCU.RA combined with the SOFA score can improve the predictive ability of the SOFA score.However,our results should be verified in future prospective studies.
基金supported by National Natural Science Foundation of China(No.82372888)National Key Research and Development Program of China(No.2022YFC2704000)+6 种基金National Natural Science Foundation of China(No.82273383)the Capital’s Funds for Health Improvement and Research(No.2020-2-4098)Youth program of Beijing Municipal Natural Science Foundation(No.7204328)Clinical Medicine Plus X-Young Scholars Project,Peking University(No.PKU2022LCXQ020)Key Clinical Project of Peking University Third Hospital(No.BYSY2022050)Key Clinical Projects of Peking University Third Hospital(No.BYSYZD2021006)Key Clinical Projects of Peking University Third Hospital(No.BYSYZD2019034).
文摘Objective:The expression of programmed death 1(PD-1)on CD8^(+)T cells is associated with their activation and exhaustion,while CD57 serves as a senescence marker.The impact of PD-1^(+)and CD57^(+)CD8^(+)T cells on the prognosis of patients with advanced high-grade serous ovarian cancer(HGSOC)remain unclear.Methods:We assessed the percentages of PD-1^(+)and CD57^(+)CD8^(+)T cells in tumor-infiltrating lymphocytes(TILs,n=85)and tumor ascites lymphocytes(TALs,n=87)using flow cytometry.The optimal cutoffs for these markers in TILs and TALs were determined through the log-rank maximization method.Gene expression analysis elucidated the tumor immune microenvironment(TIME,n=36).Results:Patients with higher PD-1^(+)CD8^(+)TILs(>87.8%)exhibited longer platinum-free interval(PFI)and overall survival(OS).In contrast,those with elevated CD57^(+)CD8^(+)TALs(>28.69%)were more likely to experience chemotherapy and had lower complete remission rates,shorter PFI and OS.PD-1^(+)CD8^(+)TILs are primarily displayed an effector memory state with strong proliferative and secretory capabilities.Approximately 50%of CD57^(+)CD8^(+)TALs were terminally differentiated,exhibiting significantly impaired proliferation.Based on the proportions of PD-1^(+)CD8^(+)TILs and CD57^(+)CD8^(+)TALs,patients were categorized into good,median and poor prognosis groups,with median PFI of 47.78,27.29 and 11.96 months,respectively(P<0.0001).Median OS for these groups was not reach,49.23 and 30.92 months,respectively(P<0.0001).Patients with poor prognosis exhibit significantly reduced CD8^(+)T cell proportion and increased M2 macrophage in the TIME,alongside downregulation of multiple T cell activation-related pathways.Conclusions:Lower levels of PD-1^(+)CD8^(+)TILs and higher CD57^(+)CD8^(+)TALs,assessed prior to treatment,correlated with poor prognosis and suppressive TIME in advanced HGSOC.
基金National High Level Hospital Clinical Research Funding,No.2022-PUMCH-B-022CAMS Innovation Fund for Medical Sciences,No.CIFMS 2021-1-I2M-003and Undergraduate Innovation Program,No.2023zglc06076.
文摘BACKGROUND Eosinophilic gastroenteritis(EGE)is a chronic recurrent disease with abnormal eosinophilic infiltration in the gastrointestinal tract.Glucocorticoids remain the most common treatment method.However,disease relapse and glucocorticoid dependence remain notable problems.To date,few studies have illuminated the prognosis of EGE and risk factors for disease relapse.AIM To describe the clinical characteristics of EGE and possible predictive factors for disease relapse based on long-term follow-up.METHODS This was a retrospective cohort study of 55 patients diagnosed with EGE admitted to one medical center between 2013 and 2022.Clinical records were collected and analyzed.Kaplan-Meier curves and log-rank tests were conducted to reveal the risk factors for long-term relapse-free survival(RFS).RESULTS EGE showed a median onset age of 38 years and a slight female predominance(56.4%).The main clinical symptoms were abdominal pain(89.1%),diarrhea(61.8%),nausea(52.7%),distension(49.1%)and vomiting(47.3%).Forty-three(78.2%)patients received glucocorticoid treatment,and compared with patients without glucocorticoid treatments,they were more likely to have elevated serum immunoglobin E(IgE)(86.8%vs 50.0%,P=0.022)and descending duodenal involvement(62.8%vs 27.3%,P=0.046)at diagnosis.With a median follow-up of 67 mo,all patients survived,and 56.4%had at least one relapse.Six variables at baseline might have been associated with the overall RFS rate,including age at diagnosis<40 years[hazard ratio(HR)2.0408,95%confidence interval(CI):1.0082–4.1312,P=0.044],body mass index(BMI)>24 kg/m^(2)(HR 0.3922,95%CI:0.1916-0.8027,P=0.014),disease duration from symptom onset to diagnosis>3.5 mo(HR 2.4725,95%CI:1.220-5.0110,P=0.011),vomiting(HR 3.1259,95%CI:1.5246-6.4093,P=0.001),total serum IgE>300 KU/L at diagnosis(HR 0.2773,95%CI:0.1204-0.6384,P=0.022)and glucocorticoid treatment(HR 6.1434,95%CI:2.8446-13.2676,P=0.003).CONCLUSION In patients with EGE,younger onset age,longer disease course,vomiting and glucocorticoid treatment were risk factors for disease relapse,whereas higher BMI and total IgE level at baseline were protective.
基金Supported by National Natural Science Foundation of China,No.82072736 and No.81874184the Key Project of Hubei Health Commission,No.WJ2019Q030.
文摘BACKGROUND There is currently a shortage of accurate,efficient,and precise predictive instruments for rectal neuroendocrine neoplasms(NENs).AIM To develop a predictive model for individuals with rectal NENs(R-NENs)using data from a large cohort.METHODS Data from patients with primary R-NENs were retrospectively collected from 17 large-scale referral medical centers in China.Random forest and Cox proportional hazard models were used to identify the risk factors for overall survival and progression-free survival,and two nomograms were constructed.RESULTS A total of 1408 patients with R-NENs were included.Tumor grade,T stage,tumor size,age,and a prognostic nutritional index were important risk factors for prognosis.The GATIS score was calculated based on these five indicators.For overall survival prediction,the respective C-indexes in the training set were 0.915(95%confidence interval:0.866-0.964)for overall survival prediction and 0.908(95%confidence interval:0.872-0.944)for progression-free survival prediction.According to decision curve analysis,net benefit of the GATIS score was higher than that of a single factor.The time-dependent area under the receiver operating characteristic curve showed that the predictive power of the GATIS score was higher than that of the TNM stage and pathological grade at all time periods.CONCLUSION The GATIS score had a good predictive effect on the prognosis of patients with R-NENs,with efficacy superior to that of the World Health Organization grade and TNM stage.
