ObjectiveTo analyze the expression of Hsa-miR-29c in gastric cancer and its mechanism of action, and to explore its relationship with clinicopathological characteristics and prognosis of gastric cancer patients.MethodsTheoverexpression of Hsa-miR-29c in gastric cancer cell lines of MKN28 and MKN45 were established by lentivirus transfection (transfection group), and the control group of empty lentivirus (negative control group) was established. The expressions of Hsa-miR-29c in cells of the two groups after transfection were detected by real time polymerase chain reaction (qRT-PCR), and the proliferation and clonogenesis of cells in the two groups were detected by CCK-8 and plate cloning. The expression of extracellular matrix protein 1 (ECM1), type Ⅰ collagen (Col Ⅰ), smooth muscle actin(α-SMA), matrix metalloproteinase-2 (MMP-2), and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the two groups were detected by Western blot. qRT-PCR and immunohistochemistry were used to detect the expression of Hsa-miR-29c in 70 gastric cancer tissues and adjacent tissues respectively, and then analyzed its relationship with the clinicopathological features and prognosis of gastric cancer.ResultsThe stable expression of Hsa-miR-29c gastric cancer cell line was successfully constructed in this research, the expression of Hsa-miR-29c in the transfection group was significantly higher than that in the negative control group (P<0.05). The proliferation and clone forming ability of MKN28 and MKN45 cells in the transfection group were significantly lower than those in the negative control group (P<0.05). Compared with the negative control group, the expression of Col Ⅰ and TIMP-1 in MKN28 and MKN45 cells were increased after transfection, while the expression levels of ECM1, α-SMA, and MMP-2 were significantly decreased, with significant differences between the two groups (P<0.05). The expression level of Hsa-miR-29c in gastric cancer tissues was significantly lower than that of adjacent tissues (P<0.05), and the positive expression rate was not related to age, sex, and pathological type (P>0.05), but related to tumor size, TNM stage, tumor differentiation, and lymph node metastasis (P<0.05). The mean survival time (MST) of patients with negative expression of Hsa-miR-29c was significantly shorter than that of patients with positive expression (P=0.029).ConclusionsHsa-miR-29c is down expressed in gastric cancer, and is related to the clinical characteristics and prognosis of it. The overexpression of Hsa-miR-29c can inhibit the proliferation of gastric cancer cells, and the mechanism may be related to the inhibition of extracellular matrix (ECM) signaling pathway.
Objective To investigate the clinical significance of circulating tumor cells (CTC) in gastric cancer patients treated with surgery and to assess its prognostic value for gastric cancer patients. Methods A case-control study was conducted to retrospectively collect the clinicopathological data of gastric cancer patients who underwent radical gastric cancer surgery at the Department of General Surgery, First Medical Center of the Chinese People’s Liberation Army General Hospital between April 2015 and July 2017, and who underwent postoperative CTC examination. The optimal cut-off value was determined by drawing a receiver operating characteristic (ROC) curve based on CTC levels and patient survival, and patients were divided into CTC-positive and negative groups based on this cut-off value to investigate the differences in clinicopathological characteristics between the two groups. Patients with gastric cancer were followed up and survival was recorded until September 30, 2020. The Kaplan-Meier method was used to calculate the 3-year overall survival rate and plot survival curves, and Cox regression models were used to conduct univariate and multifactorial analyses of patient prognostic factors to explore the factors affecting the survival of patients after gastric cancer surgery. Results A total of 242 patients with gastric cancer were included in this study. The results of ROC curve analysis showed that the most statistically significant CTC cut-off value for patient survival difference was 1, which meant that patients were considered positive when CTC was detected in their blood. Forty-nine cases (20.2%) in the CTC positive group had a positive cell count of 1 to 32 cells/7.5 mL, with a median of 2 cells/ 7.5 mL, and 193 cases (79.8%) in the negative group. Comparison of baseline data between the two groups showed that there were no statistically significant differences in patients’ age, gender, tumor site, surgical method, type of resection, anastomosis, tumor diameter, lymph node metastasis and nerve invasion (all P>0.05), and statistically significant differences in body mass index, choroidal carcinoma embolus, degree of tumor differentiation, tumor pathological type, and tumor TNM stage (all P<0.05). The median follow-up time after surgery for 242 gastric cancer patients was 42 (3–67) months, and the 3-year survival rates were 49.0% and 72.5% in the CTC-positive and -negative groups, respectively, with statistically significant difference (χ2=17.129, P<0.001). The results of univariate analysis showed that age, tumor site, type of resection, anastomosis, tumor diameter, lymph node metastasis, choroidal carcinoma embolism, nerve invasion, degree of tumor differentiation, tumor TNM stage, and whether CTC was positive or not were the important factors affecting the overall survival rate of gastric cancer patients (all P<0.05). The results of multivariate analysis showed that age >60 years old [HR=3.009, 95%CI(1.807, 5.010), P<0.001], tumor TNM Ⅲ–Ⅳ stage [HR=3.082, 95%CI (1.504, 6.317), P=0.002] and positive CTC [HR=2.488, 95%CI (1.475, 4.197), P=0.001] were independent risk factors affecting the survival of gastric cancer patients. Conclusion CTC is correlated with the prognosis of gastric cancer patients and can be used as a potential indicator to determine the prognosis of gastric cancer patients.
Objective To investigate the clinical and pathological characteristics, prognosis and treatment strategies of adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA). Methods We retrospectively analyzed the clinical data of 489 patients with AIS and MIA in our hospital from January 2007 to August 2015. There were 122 males and 367 females with an average age of 26–78 (51±9) years. According to the pathological types, they were divided into the AIS group (246 patients) and the MIA group (243 patients). In the AIS group, there were 60 males and 186 females with an average age of 50±7 years. In the MIA group, there were 62 males and 181 females with an average age of 54±5 years. The clinicopathological features, surgical methods and prognosis of the two groups were compared. Results There were significant differences in age, value of carcino-embryonic antigen (CEA), nodule shape and nodule size between the AIS and MIA groups (P<0.05). AIS patients were mostly under the age of 60 years with the value of CEA in the normal range which often appeared as pure ground-glass opacity lung nodules <1 cm in diameter on the CT scan. MIA often appeared as mixed ground-glass nodules <1.5 cm in diameter, accompanied by bronchiectasis and pleural indentation. The 5-year disease-free survival rate of the AIS and MIA groups reached 100%, and there was no statistical difference in the prognosis between the two groups after subtotal lobectomy (pulmonary resection and wedge resection) and lobectomy, systematic lymph node dissection and mediastinal lymph node sampling. Conclusion The analysis of preoperative clinical and imaging features can predict the AIS and MIA and provide individualized surgery and postoperative treatment program.
Objective To investigate the medication adherence to antihypertensives, antidiabetics, and lipid-lowering agents and its influence on the prognosis of individuals at high risk of stroke. Methods A total of 16892 residents aged 40 years or above in eight communities in Sichuan participated in a face-to-face study from May to September 2015. A database of a high-risk population of stroke in Sichuan province was established, and data were collected via using a standardized structured questionnaire by experienced investigators, including the treatment status and medication compliance of participants with hypertension, diabetes, or dyslipidemia during the follow-up period. Multiple logistic regression analyses were performed to explore the influencing factors of medication adherence and its influence on the prognosis of individuals at high risk of stroke. Results A total of 2893 participants at high risk of stroke were enrolled. The treatment rates of hypertension, diabetes, and dyslipidemia were 50.1%, 49.2%, and 5.1%, respectively, when the high-risk individuals were identified. At the end of follow-up (with a median follow-up period of 4.8 years), the treatment rates of hypertension, diabetes, and dyslipidemia were 24.8%, 25.0%, and 7.9%, respectively. Medication adherence to antihypertensives, antidiabetics, and lipid-lowering agents were 27.8%, 25.5%, and 18.1%, respectively. Multiple logistic regression analyses showed that the education level of high school or above [odds ratio (OR)=2.134, 95% confidence interval (CI) (1.098, 4.147), P=0.025], medical insurance for urban residents [OR=1.556, 95%CI (1.086, 2.230), P=0.016] and urban employees [OR=2.325, 95%CI (1.362, 3.967), P=0.002], having fewer children [OR=0.819, 95%CI (0.719, 0.933), P=0.003], and family history of stroke [OR=1.559, 95%CI (1.066, 2.282), P=0.022] were associated with greater adherence to antihypertensives; medical insurance for urban employees was associated with greater adherence to antidiabetics [OR=2.494, 95%CI (1.173, 5.300), P=0.018]. After adjusting for confounding factors, failure to regular use of antihypertensives [OR=2.617, 95%CI (1.414, 4.842), P=0.002], antidiabetics [OR=3.909, 95%CI (2.394, 6.380), P<0.001], and lipid-lowering agents [OR=4.828, 95%CI (2.581, 9.033), P<0.001] in patients with hypertension, diabetes, and dyslipidemia, respectively were associated with increased risk of ischemic stroke during the follow-up period. Regular use of lipid-lowering agents in patients with dyslipidemia was associated with an increased risk of intracerebral hemorrhage during the follow-up [OR=4.371, 95%CI (1.156, 16.530), P=0.030]. Conclusions The prevalences of hypertension, diabetes, and dyslipidemia are high in high-risk individuals of stroke in Sichuan province. However, the treatment rates are unsatisfactory, and the medication adherence is poor. The medication adherence is affected by a variety of demographic and socioeconomic factors. Regular treatments of hypertension, diabetes, and dyslipidemia reduce the risk of ischemic stroke in individuals at high risk of stroke, but regular use of lipid-lowering agents in patients with dyslipidemia is associated with an increased risk of intracerebral hemorrhage during the follow-up.
ObjectiveTo summarize progress of immune response in severe acute pancreatitis (SAP) and to provide a basis for appropriate immunotheraphy.MethodThe relevant literatures about the effect of immune response in the SAP with infectious complications in recent years were reviewed.ResultsThe inflammatory cascade reaction occurred in the early stage of SAP. Subsequently, the compensatory anti-inflammatory response syndrome (CARS) arised and immune response of the organism was suppressed. At this stage, the rate of infection was higher than before.ConclusionsCARS is one of major reasons in SAP with infectious complications. At present, fluid infusion, fasting, parenteral nutrition and like are major therapies in SAP. If corresponding immunotherapy could be carried out according to immune mechanism of SAP infection, that is, early appropriate immunosuppressive therapy and dynamic monitoring of body’s immune system state should be performed, when it is found that immunosuppression is present, appropriate immunostimulus therapy will be possible to reduce mortality of SAP and improve its prognosis.
ObjectiveTo explore the influence of sentinel lymph node (SLN) status on the prognosis of elderly breast cancer patients ≥70 years old, and to screen patients who may be exempted from sentinel lymph node biopsy (SLNB), so as to guide clinical individualized treatment for such patients. MethodsA retrospective analysis was made on 270 breast cancer patients aged ≥70 years old who underwent SLNB in the Affiliated Hospital of Southwest Medical University from 2012 to 2021. The clinicopathological characteristics of the total cases were compared according to the status of SLN. Kaplan-Meier method was used to draw the survival curve, and the influence of SLN status on the overall survival (OS) time, local recurrence (LR) and distant metastasis (DM) of patients were analyzed, and used log-rank to compare between groups. At the same time, the patients with hormone receptor (HR) positive were analyzed by subgroup. The differences between groups were compared by single factor χ2 test, and multivariate Cox regression model was used to analyze and determine the factors affecting OS, LR and DM of patients. ResultsThe age of 270 patients ranged from 70 to 95 years, with a median age of 74 years. One hundred and sixty-nine (62.6%) patients’ tumor were T2 stage. Invasive ductal carcinoma accounted for 83.0%, histological gradeⅡ accounted for 74.4%, estrogen receptor positive accounted for 78.1%, progesterone receptor positive accounted for 71.9%, and human epidermal growth factor receptor 2 negative accounted for 83.3%. The number of SLNs obtained by SLNB were 1-9, and the median was 3. SLN was negative in 202 cases (74.8%) and positive in 68 cases (25.2%). Thirty-five patients (13.0%) received axillary lymph node dissection. There was no significant difference in LR between the SLN positive group and the SLN negative group (P>0.05), but the SLN negative group had fewer occurrences of DM (P=0.001) and longer OS time (P=0.009) compared to the SLN positive group. The results of univariate and multivariate analysis suggest that the older the patient, the shorter the OS time and the greater the risk of DM. Analysis of HR positive subgroups showed that SLN status did not affect patient survival and prognosis, but age was still associated with poor OS time and DM. ConclusionsFor patients with invasive ductal carcinoma of breast in T1-T2 stage, HR positive, clinical axillary lymph nodes negative, and age ≥70 years old, SLNB may be exempted. According to the patient’s performance or tumor biological characteristics, patients who need systemic adjuvant chemotherapy may still consider SLNB.
Primary liver cancer is the sixth most common malignancy and the third leading cause of cancer-related death worldwide, and hepatocellular carcinoma (HCC) constitutes the majority of primary liver cancer cases. The Liver Imaging Reporting and Data System (LI-RADS) was introduced to standardize the lexicon, acquisition, interpretation, reporting, and data collection of imaging results in patients at increased risk for HCC. LI-RADS allows effective categorization of focal liver lesions, and has been applied in the full clinical spectrum of HCC from diagnosis, biological behavior characterization, prognosis prediction, to treatment response assessment. This review aimed to summarize the recent applications of CT/MRI LI-RADS in the diagnosis, biological behavior characterization and prognosis prediction of HCC, discuss current challenges and shed light on potential future directions.
ObjectiveTo investigate the risk factors for lymph node metastasis (LNM) and prognosis of T1-stage esophageal squamous carcinoma (ESC).MethodsClinical data of 387 patients with T1-stage ESC who underwent surgical treatment in our hospital from March 2013 to March 2018 were collected. There were 281 males and 106 females aged 60 (41-80) years. The patients were divided into a lymph node metastasis group (n=77) and a non-metastasis group (n=310). The risk factors for LNM and prognosis were analyzed.ResultsAmong 387 patients with T1-stage ESC, 77 (19.9%) patients had LNM. The incidence of LNM was 8.4% (8/95) in T1a-stage patients and 23.6% (69/292) in T1b-stage patients. Univariate analysis showed that tumor size, differentiation degree, depth of invasion and vascular tumor thrombus were associated with LNM (P<0.05). Multivariate logistic regression analysis showed that invasion depth of tumor [OR=2.456, 95%CI (1.104, 5.463), P<0.05] and vascular tumor thrombus [OR=15.766, 95%CI (4.880, 50.938), P<0.05] were independent risk factors for LNM. The follow-up time was 41 (12, 66) months. The 1-year, 3-year and 5-year survival rates were 98.71%, 89.67% and 86.82%, respectively. Univariate analysis showed statistically significant differences in tumor invasion depth, vascular tumor thrombus and LNM between the survival group and the death group. Cox analysis showed that LNM [OR=3.794, 95%CI (2.109, 6.824), P<0.05] was an independent risk factor for prognosis.ConclusionT1-stage ESC patients with deeper invasion or vascular tumor thrombus have a higher risk of LNM. The prognosis of T1-stage ESC with LNM is relatively poor.
ObjectiveTo explore the potential role of tumor spread through air spaces (STAS) as a prognostic indicator of non-small cell lung cancer (NSCLC) through meta-analysis.MethodsPubMed, EMbase and Web of Science, from inception to February 2022 were searched by computer about the research of the 5-year overall survival (OS) and recurrence free survival (RFS) of NSCLC patients with or without STAS. The Newcastle-Ottawa scale (NOS) was used to evaluate the quality of each study.ResultsTotally 13 published articles were included with 4 647 patients, and1 424 (30.6%) patients had STAS. The NOS score of all studies≥6 points. The meta-analysis showed that compared with the NSCLC patients without STAS, those with STAS had a worse prognosis of 5-year RFS, and the combined HR was 1.89 (95%CI 1.61-2.23); they had a shorter 5-year OS, and the combined HR was 2.25 (95%CI 1.79-2.84). There was no statistical heterogeneity among studies.ConclusionThe presence of STAS may be a poor prognostic factor for patients with NSCLC, and enough attention should be paid. The STAS should be recorded in the pathological report to guide the comprehensive treatment and evaluate the prognosis of patients.
ObjectiveTo explore the prognostic factors of malignant tumors in ampulla, lower bile duct, head of pancreas, uncinate process, and neck of pancreas after operation.MethodThe recent literatures on malignant tumors in this region at home and abroad were summarized.ResultsThe prognosis of five groups of malignant tumors in ampulla, lower bile duct, head of pancreas, uncinate process, and neck of pancreas was correlated with their origin, growth site, tumor diameter, nerve invasion, vascular invasion, lymphatic metastasis, pathological and histological classification, and cutting edge status. The different location and pathological classification of tumors made the different neurovascular invasion rate, lymphatic metastasis rate, and R0 resection rate.ConclusionsBy summarizing and analyzing the origin, growth site, diameter, nerve invasion, vascular invasion, lymphatic metastasis, pathological and histological classification, and cutting edge status of tumors, we can improve the clinical prediction of tumors in this region, select appropriate surgical methods before operation, and formulate more reasonable adjuvant treatment plan after operation, in order to improve the pertinence of the treatment of tumors in this region, improve the prediction, and finally better serve the clinical work.