bluuebunny/crossref_metadata_2025 huggingface dataset:
Gene mutations in a patient with chronic myelomonocytic leukemia and changes upon progression to acute myeloid leukemia and during treatment*
Authors: Li Jiaming , Zhang Sujiang
Published: June 2023

Objective

Chronic myelomonocytic leukemia (CMML) has been categorized as an uncommon hematological malignancy with overlapping features of myelodysplastic syndromes (MDS) and myeloproliferative neoplasms that have an inherent risk of progressing to acute myeloid leukemia (AML).

Methods

This study presents a case of confirmed CMML combined with M protein, in which the molecular changes upon progression to AML and under decitabine (DAC) plus bortezomib therapy were reported by tracking variant allele frequency (VAF) of mutations in a series of bone marrow samples.

Results

First, variable sensitivity of clones was observed during DAC treatment, and incomplete mutation clearance may be associated with low overall response rate and unsustained response. Secondly, DAC cannot prevent the new genetic alterations and accumulation of genetic progression on treatment, leading to acute transformation. Finally, autoimmunity was found to have acted as an important pathogenetic factor, increasing the additive mutations that further drive the clonal evolution in CMML.

Conclusion

Overall, changes in mutations and clonal architecture during CMML progression or treatment are predictive of an early evaluation of therapeutic strategies in CMML.
Safety and efficacy of EFGR and VEGF signaling pathway inhibition therapy in patients with colorectal cancer: a meta-analysis*
Authors: Liu Siwen , Ma Rong , Cao Haixia , Yu Shaorong , Chen Dan , Jing Changwen , Wang Zhuo , Zhang Junying , Feng Jifeng , Wu Jianzhong
Published: June 2023

Objective

Epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) inhibitors are two targeted therapies for metastatic colorectal cancer (mCRC). However, few studies have focused on the safety and efficacy of combined targeted therapy against those of a single inhibition therapy of EFGR or VEGF. This meta-analysis aimed to compare the anti-tumor activity of the combined inhibition therapy and single inhibition therapy in patients with mCRC.

Methods

We searched PubMed, Medline, the Cochrane library, Embase, and annual meeting proceedings for relevant clinical trials. Objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and adverse events were extracted and calculated.

Results

Nine trials comprising 3977 patients were selected for the analysis. The combined inhibition therapy showed a 3.7% improvement in ORR compared with single inhibition, and this difference was statistically significant [hazard ratio (HR) = 1.33; 95% confidence interval (CI), 1.01-1.74; P = 0.04]. Subgroup analysis showed that the combined EGFR and VEGF inhibitor therapy had an 11.65% improvement in ORR compared with VEGF inhibitor therapy (OR = 2.14; 95% CI, 1.34-3.40; P = 0.001). EGFR and VEGF inhibitor therapy and chemotherapy had an 18.08% improvement in ORR compared with chemotherapy (OR = 2.21; 95% CI, 1.05-4.64; P = 0.04). Moreover, EGFR and VEGF inhibitor therapy significantly improved PFS compared with VEGF inhibitor therapy (OR = 0.82; 95% CI, 0.69-0.97; P = 0.02). VEGF inhibitor therapy and chemotherapy significantly improved PFS compared with EGFR and VEGF inhibitor therapy and chemotherapy (OR = 1.20; 95% CI, 1.11-1.30; P = 0.00). In addition, EGFR and VEGF inhibitor therapy showed improved OS compared with VEGF inhibitor therapy (HR = 0.78, 95% CI: 0.65-0.94; P = 0.008). Finally, the combined inhibition therapy showed an obviously increased risk of cutaneous and mucosal effects (RR = 6.45; 95% CI: 2.71-15.36; P < 0.01), diarrhea/abdominal pain (RR = 1.97; 95% CI: 1.45-2.68; P < 0.01), fatigue/asthenia (RR = 1.60; 95% CI: 1.10-2.32; P = 0.01), dehydration or electrolyte disturbance (RR = 2.78; 95% CI: 1.48-5.21; P < 0.01), nail disorder (RR = 8.23; 95% CI: 1.52-44.57; P = 0.01), and dizziness/headache (RR = 3.43; 95% CI: 1.89-6.23; P < 0.01) compared with single inhibition therapy.

Conclusion

Compared with single inhibition therapy, the combined inhibition therapy significantly improved ORR, PFS, and OS in the treatment of mCRC patients. Compared with a single-targeted agent, the combined therapy of anti-EGFR and anti-VEGF drug provided an efficacy advantage, although it led to greater toxicity.
Predictive value of tumor volume reduction rates before and after induction chemotherapy in determining the radiosensitivity and prognosis of locally advanced nasopharyngeal carcinomas
Authors: Song Yang , Wang Ge , Chen Chuan , Liu Yun , Wang Bin
Published: June 2023

Objective

This study investigated the predictive value of tumor volume reduction rates (TVRRs) before and after induction chemotherapy in determining the radiosensitivity and prognosis of patients with locally advanced nasopharyngeal carcinomas (NPCs).

Methods

The clinical data of 172 patients with locally advanced primary NPCs who were treated from January 2009 to December 2012 were collected. Tumor regression was evaluated based on the results of the computed tomography scan or magnetic resonance imaging studies. Data about the tumor diameters before and after induction chemotherapy and after radiotherapy as well as the survival times of the patients were obtained.

Results

All 172 patients had NPCs. After radiotherapy, the TVRR in patients without residual tumor cells was higher than that in patients with residual tumor cells after induction chemotherapy (median values: 47.7% and 15.1%, respectively), and the 5-year survival rates were 80.3% and 45.6%, respectively. Neck lymph node metastasis was observed in 161 of 172 patients, and the TVRRs were similar (median values: 46.8% in 161 patients without residual tumor cells and 11.1% in 161 patients with residual tumor cells). The 5-year survival rate of the 161 patients without residual tumor cells was 84.5%, and that of patients with residual tumor cells was 37.3%. As shown by the receiver operating characteristic (ROC) curve, the area under the curve (AUC) of the ROC curve for TVRRs in patients with primary NPCs but without residual tumors was 0.851, whereas that for TVRRs in patients with neck lymph node metastasis but without residual tumors was 0.784. This result indicates that TVRR has a high diagnostic performance. The univariate Cox regression analysis showed that clinical stage, TVRR in primary NPCs, neck lymph node metastatic lesions before and after induction chemotherapy, presence or absence of residual tumor cells in primary NPCs, and neck lymph node metastatic lesions after radiotherapy were significantly correlated to overall survival (OS). Results of the multivariate Cox regression analysis showed that clinical stage and presence or absence of residual tumor cells in the lymph nodes after radiotherapy were the independent prognostic factors of OS.

Conclusion

The TVRR after induction chemotherapy may be an effective predictive indicator of the treatment efficacy of radiotherapy in patients with NPC.
MyD88 exacerbates immunological pathology in experimental viral fulminant hepatitis*
Authors: Deng Jianzhao , Ning Qin , Yan Weiming , Yang Xuan , Zhao Lizhen , Wu Yuzhang , Zhang Bei
Published: June 2023

Objective

To explore the role of MyD88 signaling in MHV-3 virus-mediated fulminant hepatitis.

Methods

We evaluated liver lesion status, the expression of multiple pro-inflammatory cytokines and HMGB1, the recruitment of inflammatory ILC3, and mortality in MyD88-/-
and WT mice.

Results

The expression of multiple pro-inflammatory cytokines that recruit inflammatory ILC3 to the liver was severely impaired in MyD88-/-
mice resulting in reduced liver pathology, viral replication, and mortality post-infection. Additionally, MHV-3 markedly increased the expression of high-mobility group box 1 (HMGB1) in infected hepatocytes/macrophages and induced HMGB1 protein migration from the nucleus to the extracellular milieu, where it activates MyD88-dependent inflammation.

Conclusion

Our findings indicate that MyD88 exacerbates immunological pathology in experimental viral fulminant hepatitis.
Investigation of therapeutic modalities of G719X, an uncommon mutation in the EGFR gene in non-small cell lung cancer
Authors: Zheng Hua , Gao Yuan , Liu Zan , Qian Zhe , Zhang Tongmei , Li Jie , Zhang Hongmei , Wang Qunhui , Hu Fanbin , Li Baolan
Published: June 2023

Objective

G719X is the most frequently seen uncommon mutation of the epidermal growth factor receptor (EGFR) gene, which is a point mutation at exon 18 with three common subtypes, G719A/G719C/G719S. This study explored the clinicopathological characteristics of the G719X mutation and investigated the efficacy of EGFR-tyrosine kinase inhibitor (TKI) treatment and chemotherapy in patients with the G719X mutation; the survival rate after these different treatment modalities were then analyzed in order to provide evidence for clinical treatment.

Methods

Clinical data of 41 patients with the G719X mutation admitted in the Beijing Chest Hospital, Capital Medical University from September 2014 to July 2018, were collected and the EGFR mutations were detected by amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). The clinicopathological characteristics of the G719X mutation were analyzed, and the relationship among the G719X mutation, the efficacy of different treatment modalities, and the progression-free survival (PFS) was analyzed.

Results

Of the 41 cases, 24 (58.5%) were G719X single mutations and 17 (41.5%) were compound mutations, including G719X/S768I, G719X/L861Q, G719X/19del, and G719X/c-Met compound mutation. The objective response rate (ORR) of first-line EGFR-TKI therapy was 50% (6/12), the disease control rate (DCR) was 83.3% (10/12), and the median PFS (mPFS) was 9 months. After resistance to EGFR-TKI in the previous treatment, the ORR (71.4%, 5/7) and DCR (100%, 7/7) were still high following EGFR-TKIs, by an mPFS of 8 months. The ORR of chemotherapy was 33.3% (2/6), the DCR was 100% (6/6), and the mPFS was 6 months.

Conclusion

G719X is an uncommon mutation of the EGFR gene and is sensitive to many EGFR-TKIs. It can be treated with the second- or third-generation EGFR-TKIs after resistance to the first-generation EGFR-TKIs. G719X mutation also showed favorable effect to chemotherapy.
Comparison of efficacy and safety between late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy for cervical cancer complicated with pelvic lymph node metastasis
Authors: Cheng Yi , Huang Nan , Zhao Jing , Wang Jianhua , Gong Chen , Qin Kai
Published: June 2023

Objective

This study aimed to compare and analyze the clinical efficacy and safety of late-course and simultaneous integrated dose-increasing intensity-modulated radiation therapy (IMRT) for cervical cancer complicated with pelvic lymph node metastasis.

Methods

Sixty patients with cervical cancer complicated with pelvic lymph node metastasis who were admitted to our hospital from January 2013 to January 2015 were enrolled. The patients were randomly divided into the late-course dose-increasing IMRT group and the simultaneous integrated dose-increasing IMRT group, with 30 cases included in each group, respectively. All patients were concurrently treated with cisplatin. After treatment, the clinical outcomes of the two groups were compared.

Results

The remission rate of symptoms in the simultaneous integrated dose-increasing IMRT group was significantly higher than that in the late-course dose-increasing IMRT group (P < 0.05). The follow-up results showed that the overall survival time, progression-free survival time, and distant metastasis time of patients in the simultaneous integrated dose-increasing IMRT group were significantly longer than those in the late-course dose-increasing IMRT group (P < 0.05). The recurrent rate of lymph nodes in the radiation field in the simultaneous integrated dose-increasing IMRT group was significantly lower (P < 0.05) than in the late-course dose-increasing IMRT group. There was no significant difference in the incidence of cervical and vaginal recurrence and distant metastasis between the two groups (P > 0.05). The radiation doses of Dmax in the small intestine, D1cc (the minimum dose to the 1 cc receiving the highest dose) in the bladder, and Dmax in the rectum in the simultaneous integrated dose-increasing IMRT group were significantly lower (P < 0.05) than in the late-course dose-increasing IMRT group. There was no significant difference in intestinal D2cc (the minimum dose to the 2 cc receiving the highest dose) between the two groups (P > 0.05). The incidence of bone marrow suppression in the simultaneous integrated dose-increasing IMRT group was significantly lower (P < 0.05) than in the late-course dose-increasing IMRT group.

Conclusion

The application of simultaneous integrated dose-increasing IMRT in the treatment of cervical cancer patients complicated with pelvic lymph node metastasis can significantly control tumor progression, improve the long-term survival time, and postpone distant metastasis time with high safety.
Whole-brain radiation therapy alone vs. combined therapy with stereotactic radiosurgery for the treatment of limited brain metastases: A systematic review
Authors: Wan Chao , Chen Biao , Liu Yuanshi , Xu Ximing
Published: June 2023

Objective

The aim of the study was to compare the efficacy and safety of whole brain radiotherapy (WBRT) used alone and combined with stereotactic radiosurgery (SRS) in the treatment of limited (1-4) brain metastases.

Methods

We searched for randomized controlled and matched-pair analysis trials comparing WBRT plus SRS versus WBRT alone for brain metastases. The primary outcomes were the overall survival (OS), intracranial control (IC), and localcontrol (LC). The secondary outcome was radiation toxicity. The log hazard ratios (lnHRs) and their variances were extracted from published Kaplan-Meier curves and pooled using the generic inverse variance method in the RevMan 5.3 software. The non-pooled outcome measures were evaluated using descriptive analysis.

Results

Three randomized controlled trials and two matched-pair analysis studies were included. There was no difference in the OS for limited brain metastases between the two groups [lnHR 0.91 (95% CI 0.76-1.09, P = 0.32) vs. 0.72 (95% CI 0.44-1.19, P = 0.20)]. The LC and IC were significantly higher in the combined treatment group [lnHR 0.69 (95% CI 0.55-0.86, P = 0.001) vs. 0.41 (95% CI 0.29-0.58, P < 0.0001)]. For patients with a single lesion, one trial showed a higher survival in the combined treatment group (median OS: 6.5 months vs. 4.9 months, P = 0.04). The combined treatment was not associated with significantly higher incidence of radiation toxicity.

Conclusion

Combined treatment with WBRT plus SRS should be recommended for patients with limited brain metastases based on the better LC and IC without increased toxicity. It should also be considered a routine treatment option for patients with solitary brain metastases based on the prolonged OS.
The prognostic potential of pretreatment C-reactive protein to albumin ratio in stage IE/IIE extranodal natural killer/T-cell lymphoma*
Authors: Quan Xiaoying , Wu Chunzhi , Lei Lei , Chen Xiaoyan , Ye Bin
Published: June 2023

Objective

The aim of this study was to determine the prognostic significance of the C-reactive protein-to-albumin ratio (CRP/Alb) for stage IE/IIE upper aerodigestive tract extranodal NK/T cell lymphoma patients.

Methods

One hundred and fourteen patients diagnosed with extranodal NK/T cell lymphoma at Sichuan Cancer Hospital from September 2011 to November 2016 were retrospectively reviewed. An optimal cutoff value of CRP/Alb for overall survival rate as an endpoint was obtained using the receiver operating curve (ROC).

Results

The optimal cutoff value of CRP/Alb was 0.15. For the low CRP/Alb group, the 3-year progression-free survival (PFS) was 78.6% and the 3-year overall survival (OS) was 80.7%. The 3-year PFS and OS values for the high CRP/Alb group were 41.6% and 45.2%, respectively. Differences for PFS (P < 0.001) and OS (P < 0.001) between the two groups were statistically significant. Univariate analysis showed that ECOG, IPI, CRP, GPS, and CRP/Alb were significantly associated with PFS. Similarly, all five were also significantly associated with OS. Multivariate analysis further confirmed that ECOG and CRP/Alb were independent prognostic factors for both PFS and OS. Moreover, the cutoff value of CRP/Alb showed superior prognostic ability in discriminating between patients with different outcomes in low-risk group based on GPS, IPI, and KPI scores.

Conclusion

CRP/Alb is a promising prognostic marker for early-stage extranodal NK/T cell lymphoma.
Identifying peptides that specifically bind to MDA-MB-468 breast cancer cells*
Authors: Dai Xiaoli , Zhang Qing , Zhang Huili , Xu Hongtao
Published: June 2023

Objective

To use phage display technique to screen for small polypeptides that specifically bind to MDAMB-468 cells.

Methods

A random heptapeptide phage display library was used for in vitro screening against target MDA-MB-468 cells. SC1180 cells were used for subtractive selection. High-affinity phage DNA was extracted, and peptides were sequenced.

Results

(1) The original library capacity of the polypeptide library was 2 × 1013 pfu/mL, and phage titer was determined over 4 rounds. The average library capacity was 1.8 × 1013 pfu/mL. (2) Subtractive screening showed that the phage library volume of each round was 1.8 × 1012 pfu/mL, and that there was an enrichment effect in each subsequent round. Screening was stopped after the fourth round. (3) PCR results showed that the size of 39 products (78.0%) and 11 products (22%), were 300 bp and 258 bp, respectively. Thirty positive phages were selected for DNA extraction and sequencing, and the corresponding amino acid sequence was LMTRXSK. The sequence had no homology with known genes or proteins.

Conclusion

Using the phage display technique, we identified that the short polypeptide, LMTRXSK, specifically binds MDA-MB-468 human breast cancer cells.
Expression and significance of PAX8 gene in ovarian cancer based on Oncomine database Meta-analysis
Authors: Yan Kun , Yan Hua , Zhou Qin , Wan Min , Ge Yanyan , Lu Jin
Published: June 2023

Objective

Although great progress has been made in the diagnosis and treatment of ovarian cancer, this disease is still the leading cause of death due to female reproductive system tumors. It has been reported that the paired box 8 (PAX8) gene is involved in the occurrence and development of a variety of human tumors. However, few researchers have investigated this phenomenon in detail.

Methods

Here, the BioGPS database was used to analyze the expression of the PAX8 gene in normal tissues. The Oncomine database was used to search for PAX8 gene information, and the findings were analyzed via a meta-analysis with regard to the significance of this gene in ovarian cancer. The Kaplan-Meier Plotter database was used to analyze the prognosis of patients with ovarian cancer. The Cancer Cell Line Encyclopedia (CCLE) was used only for obtaining cell line analysis data regarding the PAX8 gene.

Results

The relevant results of the BioGPS database analysis showed that PAX8 is not expressed or under-expressed in normal ovarian tissues. Oncomine data showed 454 different results; there were 417 study samples in total, with 9 results showing a significant statistical difference in PAX8 expression, 5 of which were related to high expression of PAX8 and 4 of which were related to low PAX8 expression. Cell line analysis data of the PAX8 gene obtained from CCLE showed high expression in ovarian cancer, which is consistent with the high expression of PAX8 in ovarian cancer research found using the Oncomine database. The Kaplan-Meier Plotter database showed that the expression level of PAX8 had a significant effect on the overall survival time of patients (P = 0.042). Compared with the low expression group, the overall survival time of ovarian cancer patients in the high expression group of PAX8 was significantly low (P < 0.05).

Conclusion

Through an in-depth study of the gene information of ovarian cancer-related genes using the gene chip data in the Oncomine database, it was concluded that PAX8 is highly expressed in ovarian cancer tissues and directly correlates to the prognostic survival of ovarian cancer patients. These findings provide an important basis for the development of clinical gene-targeted cancer therapeutic drugs.
Clinical significance of S100A7 protein in predicting recurrence of breast cancer in patients undergoing breast-conserving surgery with radiotherapy*
Authors: Zhang Chao , Li Changyou , Lin Gaoyang , Qi Yao , Li Zhenfeng , Xu Jing , Su Tianhui , Liu Xin , Zou Xiao
Published: June 2023

Objective

To investigate the relationship between the expression of S100A7 protein and prediction of recurrence and prognosis of breast cancer in patients undergoing breast-conserving surgery combined with radiotherapy.

Methods

349 samples of carcinoma tissue wax blocks were selected from January 2011 to January 2014 in Qingdao Central Hospital. All the patients had undergone breast-conserving surgery. We analyzed S100A7 expression in tumor tissue by immunohistochemical staining. Using univariate and multivariate analyses, we evaluated the relationship between S100A7 and clinical results, to explore independent risk factors for local regional recurrence (LRR).

Results

The positive expression of S100A7 in the recurrence group (66.7%) was significantly higher than in the non-recurrence group (38.4%), P = 0.025. A log-rank test showed that high S100A7 expression was significantly correlated with 5-year regional recurrence free survival rate (RFS) (94.9% vs 89.5%, P = 0.0408), distant metastasis free survival rate (DFS) (95.4% vs 83.5%, P < 0.001), and overall survival rate (OS) (99.0% vs 92.5%, P = 0.0011). Histological grade, vessel carcinoma embolus, lymph node metastasis, S100A7 expression, and tumor size were factors that influenced RFS. Multivariate analysis of the Cox proportional hazard model showed that high S100A7 expression was an independent risk factor that affected breast cancer RFS (HR = 6.864, 95 % CI: 1.575 - 29.915, P = 0.01). Thus, we concluded that high S100A7 expression is associated with increased risk of LRR and distant metastasis of breast cancer after breast-conserving surgery and postoperative radiotherapy. S100A7 can be used as a molecular marker to screen for patients with high recurrence risk after breast-conserving surgery.
Value of partial hepatectomy for the treatment of hilar cholangiocarcinoma: a Meta-analysis study*
Authors: Yang Ming , Zhang Yanhong , Cui Miaohang , Chen Jianhua , Liu JinLong
Published: June 2023

Objective

To discuss the value of partial hepatectomy in patients with hilar cholangiocarcinoma.

Methods

English articles related to hilar cholangiocarcinoma were screened from January 1, 1990 to May 12, 2019 in the PubMed, MEDLINE, EMBASE, and Cochrane Library databases. Information on postoperative radical cure, survival, morbidity, and mortality after surgery were extracted from articles that met the inclusion criteria for the meta-analysis.

Results

Twenty-two articles that met the inclusion criteria were classified into 4 study groups: the hepatectomy radical cure group (19 articles), the hepatectomy survival group (16 articles), the hepatectomy morbidity group (9 articles), and the hepatectomy mortality group (17 articles). We found that the rate of radical cure after partial hepatectomy (odds ratio [OR] 0.32, 95% confidence interval [CI] 0.20-0.51) and the survival rate (hazard ratio [HR] 0.67, 95% CI 0.58-0.79) were significantly higher than after simple bile duct resection, but that morbidity (OR 1.99, 95% CI 1.37-2.90) and mortality (OR 2.71, 95% CI 1.47-4.98) in patients within the partial hepatectomy group were also higher than in the simple bile duct resection group, taking into account the significant heterogeneity in the articles pertaining to the hepatectomy radical cure group (I
2 = 68.3%, P = 0.000), a sub-group analysis was subsequently conducted. Its results showed that when the branches of the secondary bile ducts were not involved during hilar cholangiocarcinoma, then a bile duct resection had a similar radical cure outcome as combined partial hepatectomy (OR 0.94, 95% CI 0.54-1.65).

Conclusion

Partial hepatectomy can increase the proportion of radical cure in patients with hilar cholangiocarcinoma and extend the survival time after surgery. However, the morbidity and mortality after surgery are higher than those in simple bile duct resections. Therefore, simple bile duct resection is still a relevant and efficient tool in the treatment of Bismuth-Corlette Type I and II hilar cholangiocarcinomas.
Evaluation of the safety and efficacy of glucocorticoid therapy for hyperbilirubinemia in patients with hepatocellular carcinoma who have undergone transcatheter arterial chemoembolization
Authors: Wang Jingyan , Zhang Linzhi , Peng Xiaoming , Zhao Yun , Zhou Lin
Published: June 2023

Objective

The aim of this study was to analyze the safety and efficacy of glucocorticoid treatment for hyperbilirubinemia in patients with hepatocellular carcinoma (HCC) who have undergone transcatheter arterial chemoembolization (TACE).

Methods

We conducted a retrospective analysis of the clinical data of 198 patients with HCC who were admitted to The Fifth Medical Center of PLA General Hospital from June 2014 to August 2019 and underwent TACE therapy. The patients were divided into glucocorticoid (GCC) treatment group and control group. Standard liver-protecting procedures were used in both groups. The treatment group also received intravenous injections of methylprednisolone sodium succinate for 3-5 days. Reduction in bilirubin concentration, mean duration of hospitalization, and complications were compared between the two groups to investigate the safety and efficacy of GCCs for treatment of hyperbilirubinemia after TACE treatment.

Results

Bilirubin concentrations were significantly lower in the treatment group than in control group on days 3 and 5 after GCC/conventional liver-protecting treatment (P < 0.05). The treatment group had significantly shorter durations of total post-surgery hospitalization, and recovery time than the control group (14.5 ± 4.6 days vs. 17.5 ± 6.6 days, P < 0.001; 9.2 ± 3.3 days vs. 11.8 ± 5.4 days, P = 0.001; 7.0 ± 3.3 days vs. 9.3 ± 4.6 days, P < 0.001). No GCC-associated complications were detected in the treatment group.

Conclusion

Short-term use of GCCs to treat hyperbilirubinemia in patients with HCC who have undergone TACE is safe and associated with rapid decline in bilirubin concentration and shorter hospital stay compared with patients who did not receive GCCs.
Prognostic factors for pN2 non-small cell lung cancer: a comprehensive evidence from 73 studies involving 23,772 patients*
Authors: Li Shuo , Feng Yanlin , Liang Chunzi , Tu Jiancheng
Published: June 2023

Obojective

Non-small-cell lung cancer (NSCLC) is a common malignancy. pN2 NSCLC, with pathologically confirmed ipsilateral mediastinal/subcarinal nodes metastasis, has been known as a very heterogeneous subgroup in terms of its anatomical, biological and patient characteristics. Prognostic factors based on patient characteristics were not well determined yet in this subgroup, and there is currently no standard treatment recommendation for these heterogeneous pN2 subjects. Apparent disagreements and inconsistency exist in study reports concerning the prognostic significance of certain factors in pN2 NSCLC, especially regarding to the issue about whether skip N2 metastasis benefit from surgery.

Methods

We therefore performed this comprehensive summary of the published literatures to draw a more precise and less uncertain conclusion. After a comprehensive literature search, a total of 73 studies involving 23,773 subjects were included according to eligibility criteria.

Results

As expected, most of the investigated factors, such as old age, male, advanced pathological T stage, advanced clinical N stage, multiple N2 stations, extended surgical resection (pneumonectomy), and incomplete resection, but not post-operation treatment (eg. chemotherapy and radiotherapy) were significantly associated with poor survival. However, skip N2 metastasis was favourable prognostic factors in operable pN2 NSCLC subjects. Other factors (histological type and primary tumour side) were neutral in terms of association with overall survival. We highlighted a number of important prognostic factors for pN2 NSCLC patients. Particularly, patients with skip N2 disease benefit from surgery.

Conclusion

Our findings could be used as reference information for decision-making in clinical practice and future study design.
Application of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) combined with magnetic resonance spectroscopy (MRS) in prostate cancer diagnosis
Authors: He Yakun , Wang Min , Deng Heping , Ren Jin
Published: June 2023

Objective

The aim of the study was to investigate the application of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) combined with magnetic resonance spectroscopy (MRS) in prostate cancer diagnosis.

Methods

In the outpatient department of our hospital (Sichuan Cancer Hospital, Chengdu, China), 60 patients diagnosed with prostate disease were selected randomly and included in a prostate cancer group, 60 patients with benign prostatic hyperplasia were included in a proliferation group, and 60 healthy subjects were included in a control group, from January 2013 to January 2017. Using Siemens Avanto 1.5 T high-field superconducting MRI for DCE-MRI and MRS scans, after the MRS scan was completed, we used the workstation spectroscopy tab spectral analysis, and eventually obtained the crest lines of the prostate metabolites choline (Cho), creatine (Cr), citrate (Cit), and the values of Cho/Cit, and (Cho + Cr)/Cit.

Results

Participants who had undergone 21-s, 1-min, and 2-min dynamic contrast-enhanced MR revealed significant variations among the three groups. The spectral analysis of the three groups revealed a significant variation as well. DCE-MRI and MRS combined had a sensitivity of 89.67%, specificity of 95.78%, and accuracy of 94.34%.

Conclusion

DCE-MRI combined with MRS is of great value in the diagnosis of prostate cancer.
Assessing anxiety, depression, and stress among inpatients with cancer*
Authors: Xu Honghong , Xue Ruotong , Cheng Yi , Zhang Yujie , Rao Jie , Liu Mei , Yu Shiying , Liu Lingxiang , Liu Yiqian , Shu Yongqian , Yang Liuqing , Shi Hanping
Published: June 2023

Objective

This study aimed to assess anxiety, depression, and stress among inpatients with cancer.

Methods

Two hundred thirty-five hospitalized patients with cancer were surveyed with the Depression Anxiety Stress Scales (simplified Chinese Version). The software program SPSS 25.0 was used for statistical analysis of the survey data.

Results

The average scores of depression, anxiety, and stress of inpatients with cancer were 12.17, 11.84, and 13.98 respectively, which were higher than the normal range. The scores of anxiety and stress of inpatients with different caregivers were statistically different (P = 0.024/0.036). The anxiety and stress scores of inpatients with spouses as caregivers were higher than those of inpatients with children as caregivers. There was a statistically significant difference in the incidence of stress between inpatients with cancer with religious beliefs and inpatients with cancer without religious beliefs (P = 0.026), and those with religious beliefs had greater incidence of stress. The score of anxiety was significantly higher for inpatients with children than for inpatients without children (P = 0.040).

Conclusion

The anxiety, depression, and stress levels of inpatients with cancer are relatively high. It is necessary to pay special attention to the psychological status of these patients during clinical diagnosis and treatment to improve their quality of life.
Combination of TACE and FOLFOX4 in the treatment of unresectable advanced hepatocellular carcinoma: a prospective cohort study*
Authors: Wang Jingyan , Zhang Linzhi , Peng Xiaoming , Zhao Yun , Zhou Lin
Published: June 2023

Objective

The aim of the study was to assess the effectiveness and safety of a combined therapy with transcatheter arterial chemoembolization (TACE) and FOLFOX4, in patients with unresectable advanced hepatocellular carcinoma (HCC).

Methods

In this study, patients with advanced HCC, that received treatment between November 2015 and October 2017, were recruited. Among these, 30 patients were treated with TACE only (TACE group); whereas 33 patients were treated with a combination of FOLFOX4 chemotherapy and TACE (combination group). Survival analyses, including overall survival (OS) and progression free survival (PFS) analysis, were performed for both groups. Following this, the responses of patients to treatment were evaluated every 3 months, and the toxic and adverse events were observed.

Results

The median follow-up time was 9.2 months (3-36 months). In the combination group, at 3 months, a disease control rate (DCR) of 60.6%, and a median OS of 9.1 months was obtained [95% confidence interval (CI) 6.5-11.7]. In the TACE group, the DCR and OS were 33.3% and 5.5 months (95% CI 4.3-6.7), respectively. On the other hand, the PFS in the combination and TACE groups were observed as 5.6 months (95% CI 3.6-7.6) and 2.6 months (95% CI 2.0-3.2), respectively. Both these findings indicate a statistically significant difference (P = 0.01) between both the groups. Similar TACE associated adverse events were observed in both groups. In the combination group, frequently observed FOLFOX4 related adverse effects included nausea (90.9%), leukopenia (75.8%), thrombocytopenia (69.7%), and vomiting (69.7%). Most adverse reactions were between grades I-III and were alleviated after symptomatic treatments.

Conclusion

The combination of TACE with FOLFOX4 therapy has better effectivity and safety than TACE alone.
Link between miR-19b and the mTOR signaling pathway in cancer prognosis*
Authors: Feng Yanlin , Maman Souraka Tapara Dramani , Li Shuo , He Dingdong , Tu Jiancheng
Published: June 2023

Objective

Previous studies have reported differing conclusions regarding the prognostic value of miR-19b in cancers. Moreover, miR-19b may affect tumor growth by different pathways, mainly targeting PTEN-PI3K-AKT, which activates the downstream mTOR pathway. Therefore, we performed data mining to explore the possible correlation between miR-19b and mTOR in cancer prognosis.

Methods

We conducted online search and collected a total of 943 articles. According to different authors cross check and our study including/excluding criteria we at end retained 21 articles with 25 studies in this meta-analysis. Then TCGA data containing miR-19b level with cancer progression were obtained using OncomiR. Furthermore, Trial Sequential Analysis (TSA) was performed to determine whether the results of our meta-analysis could be used in clinical applications. After that, articles regarding the mechanism of miR-19b in various cancers were analyzed and KEGG pathway database was used to find the main regulatory function of miR-19b in human cancers.

Results

Overall hazard ratio (HR) results showed that higher levels of miR-19b expression were correlated with shorter overall survival time [HR = 1.54, 95% confidence interval (CI) = 1.20-1.98] by promoting distant metastasis, but had no correlation with disease-free survival (DFS)/progression-free survival (PFS; HR = 0.61, 95% CI = 0.31-1.19). Data from The Cancer Genome Atlas also revealed the role of miR-19b in tumorigenesis. According to trial sequential analysis results, more evidence is required to confirm that miR-19b is not correlated with DFS/PFS. Exploration of the mechanism revealed a possible link between miR-19b and the mTOR pathway.

Conclusion

miR-19b may have a pro-carcinogenic role through the mTOR pathway and thus, it is likely to be a therapeutic target for cancers.
A missense variant of MASP2 is associated with increased risk of radiation pneumonitis in lung cancer patients treated with radiation therapy*
Authors: Tang Yang , Yang Li , Qin Wan , Yi Minxiao , Liu Bo , Yuan Xianglin
Published: June 2023

Objective

In this study, mannan-binding lectin-associated serine protease 2 (MASP2) gene variant was evaluated to assess the risk of radiation pneumonitis (RP) in patients with pulmonary malignancies.

Methods

A total of 169 lung cancer patients with radiotherapy were included in our prospective study (NCT02490319) and genotyped using the Sanger sequencing method. Multivariate Cox hazards analysis and multiple testing were applied to estimate the hazard ratio (HR) and 95% confidence intervals (CIs) of all factors possibly associated with RP risk.

Results

Patients with mean lung disease ≥ 15 Gy and V20 ≥ 24% had higher risk of RP ≥ grade 2 compared with their counterparts (HR = 1.888, 95% CI: 1.186-3.004, P = 0.007; HR = 2.126, 95% CI: 1.338-3.378, P = 0.001, respectively). Importantly, CC + CA genotype of MASP2: rs12711521 was strongly associated with an increased occurrence of RP ≥ grade 2 (HR = 1.949, 95% CI: 1.278-2.971, P = 0.002).

Conclusion

MASP2: rs12711521 was found to be significantly associated with RP ≥ grade 2 in our cohort and may thus be one of the important predictors of severe RP before radiotherapy, if further validated in larger population.
Implications of the autophagy core gene variations on brain metastasis risk in non-small cell lung cancer treated with EGFR-TKI*
Authors: Yuan Ye , Han Hu , Jin Yu , Zhou Xiao , Yi Minxiao , Tang Yang , Li Qianxia
Published: June 2023

Objective

The brain is the main site of failure in cancer patients with epidermal growth factor receptor (EGFR) mutations undergoing treatment. However, identifying patients who may develop brain metastases (BM) is difficult. Autophagy is critical for cancer initiation and progression. We hypothesized that genetic variants in autophagy core genes might contribute to BM risk of non-small cell lung cancer (NSCLC) following treatment with EGFR tyrosine kinase inhibitor (EGFR-TKIs).

Methods

We systematically examined 16 potentially functional genetic polymorphisms in seven autophagy core genes among 105 TKI-treated NSCLC patients. Kaplan-Meier curves were plotted to assess the cumulative BM probability. Univariate and multivariate Cox proportional hazard regression analyses were utilized to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). We evaluated the potential associations of these genes with subsequent BM development.

Results

We found that ATG16L1: rs2241880, ATG10: rs10036653, rs3734114, and ATG3: rs7652377 are significantly associated with NSCLC treated with EGFR-TKIs (all P < 0.05). BM developed more often in patients with ATG3 rs7652377 CC genotype (33%), ATG10 rs10036653 AA genotype (43%), ATG10: rs3734114 CT/CC genotype (46%), and ATG16L1 rs2241880 AA genotype (37%) compared to patients with AA genotypes at rs7652377 (12%), AT/TT genotypes at rs10036653 (16%), the TT genotype at rs3734114 (13%), or AG/GG genotypes at rs2241880 (17%).

Conclusion

These associations may be critical for understanding the role of autophagy in BM risk. Future prospective studies are needed to determine if prophylactic cranial irradiation (PCI) could offer a survival benefit in this group of patients.
A study of the potential adverse effects of electrosurgical smoke on medical staff during malignant tumor surgery*
Authors: Luo Zhaoxia , Li Xiuze , Li Shuhua , Hou Bo
Published: June 2023

Objective

The aim of this study was to investigate the potential adverse effects of electrosurgical smoke on medical staff performing malignant tumor surgery.

Methods

This study was divided into two parts: in vitro and in vivo experiments. The human thyroid cancer cell line, ARO, was cultured and passaged. The tumor cells were burned with an ultrasonic scalpel, and the surgical smoke was absorbed by a transwell membrane. The captured particles were diluted in 3 mL of culture medium, and cell survival was assessed under a microscope. DNA was extracted from the cells for genotyping. BALB/c mice were used to construct thyroid cancer xenograft models. The tumor tissues were dissected on day 14 using an ultrasonic scalpel. The smoke from the electrosurgical procedure was collected on a transwell membrane. The membrane was washed in 2 mL of rinsing solution, and the solution was then injected into the right armpit of 10 mice. After sacrifice, the tumor tissues were removed and stained with hematoxylin and eosin (HE).

Results

Viable ARO cells could be seen on the first day after culturing cell fragments from surgical smoke, and vigorous cell proliferation could be seen on the 17th day of incubation. The genotype of the cells cultured in the presence of smoke particles was identical to the genotype of the original cells. Tumor growth was observed in four out of 10 mice injected with the smoke particle rinse. HE staining showed a significantly increased number of nuclei in the tumor tissue, which was consistent with the general morphological characteristics of malignant tumors.

Conclusion

Viable tumor cells were detected in surgical smoke generated by ultrasonic scalpel dissection, and these cells had growth activity. Thus, it is necessary to protect patients and medical staff from electrosurgical smoke.
Meningeal melanocytoma in the cerebellopontine angle: A rare case report and review of the literature
Authors: Dong Minhai , Xiao Qungen , Hu Jinyang , Li Xiaopeng , Guo Dongsheng , Wang Baofeng
Published: June 2023

Primary meningeal melanocytoma (MM) in the cerebellopontine angle (CPA) region is an extremely rare neoplasm that originates from the melanocytes in the leptomeninges. These lesions are usually misdiagnosed as they mimic other common CPA lesions through their nonspecific presenting symptoms, signs, and radiological characteristics. Here, we report a 47-year-old Chinese female patient who presented with a 1-month history of the right-sided tongue numbness and 1-week history of the right-sided face numbness that had been worsening for 2 days. The tumor, in the right CPA region, showed a slight isointensity on T1-weighted image and mixed signal intensity on T2-weighted image. The clinical presentation, surgical treatment, and pathologic characteristics were determined. The tumor was microsurgically resected and gross-total resection was achieved. The tumor revealed a solid, capsulated, brown-black lesion. Immunohistochemistry showed that the tumor cells were positive for human melanoma black-45 (HMB-45), melanoma antigen (MelanA), S100, SOX10, and BRAF, confirming the final diagnosis of meningeal melanocytoma. Ultimately, no signs of radiological local recurrence were observed during the two-year follow-up. Collectively, meningeal melanocytoma is difficult to distinguish from common tumors in the CPA region before operation due to the lack of specificity in imaging and symptoms. Complete surgical resection is the best therapeutic option for this tumor. Although the tumor is commonly considered as a benign lesion, recurrence and metastasis are common, and pathogenesis remains unclear.
Effects of long non-coding RNA GAS5 on proliferation and apoptosis of hepatocellular carcinoma cells through miR-26a-5p action
Authors: Yi Zunli , Guo Xiaoguang , Jiang Xianxue , Luo Fengmei
Published: June 2023

Objective

Long non-coding RNAs (lncRNAs) regulate tumor development and progression by promoting tumor proliferation, invasion, and metastasis. The aim of the study was to investigate the effects of lncRNA growth arrest-special 5 (GAS5) on proliferation and apoptosis of hepatocellular carcinoma (HCC) cells through miR-26a-5p action.

Methods

Expression levels of GAS5 were detected in cancerous and paracancerous tissue of 80 HCC patients by RT-qPCR. The starBase tool predicted that GAS5 had binding sites for the miRNA miR-26a-5p, which was also highly expressed in HCC tissue. The relationship between GAS5 and miR-26a-5p was confirmed using a luciferase reporter assay. The role of these lncRNAs was further explored by transfecting plasmids into SMMC-7721 cells and classifying the cells as follows: NC group, GAS5 group, anti-miR-26a-5p group, and GAS5 + miR-26a-5p group. Cell proliferation, cell cycle, and apoptosis were detected in each group. The relationship between miR-26a-5p and phosphatase and tensin homolog deleted on chromosome 10 (PTEN) was analyzed by TargetScan database prediction and luciferase reporter assay. Western blotting was used to quantify PTEN, phosphatidylinositol 3-kinase (PI3K), phosphorylated protein kinase B (p-Akt), cyclin D1, and human P27 protein (P27).

Results

GAS5 was downregulated, while miR-26a-5p was upregulated in HCC tissue compared to in paracancerous tissue. High GAS5 levels and low miR-26a-5p levels inhibited cell proliferation, increased the number of G0/G1 phase cells, promoted cell apoptosis, promoted PTEN and P27 expression, and inhibited PI3K, P-Akt, and cyclin D1 expression at the protein level. Upregulation of miR-26a-5p attenuated the effects of GAS5 upregulation on the proliferation, cell cycle, and apoptosis of HCC cells and on the expression of PTNE/PI3K/Akt signaling pathway-related proteins.

Conclusion

Low GAS5 levels regulate the proliferation and apoptosis of HCC cells via the PTNE/PI3K/Akt signaling pathway and are linked to upregulation of miR-26a-5p.
Ultrasound-guided No Touch liver pedicle microwave ablation in hepatocellular carcinoma treatment
Authors: Wang Dan , Zhu Shu , Zhu Peng , Cheng Yi , Luo Hongchang , Wang Jianhua
Published: June 2023

Objective

This study aimed to investigate the feasibility, safety, and clinical effect of No Touch liver pedicle microwave ablation (NTLP-MWA).

Methods

The outcomes of 118 patients diagnosed with hepatocellular carcinoma (HCC) between 2014 and 2015 were retrospectively analyzed. Patients were divided into three groups. In group A, 35 patients underwent ultrasound-guided NTLP-MWA, 27 in Group B were treated with routine microwave ablation (RMWA), and 56 in group C underwent anatomic hepatectomy (AH). The preoperative basic data, intraoperative data, and postoperative data were analyzed among the three groups.

Results

The treatment time, intraoperative blood loss, and postoperative liver function (alanine transaminase) in the NTLP-MWA and RMWA groups were significantly different from those in the AH group (all P < 0.005). There was no difference in the complete elimination rate and local recurrence within 1 year among the three groups. Treatment was not an independent risk factor for early postoperative recurrence. There was no significant difference in the 5-year overall survival rates among the three groups.

Conclusion

NTLP-MWA is safe and reliable, in accordance with the principles of oncology treatment, and worth further promotion in clinical practice.