BACKGROUND:The benefit of preoperative biliary drainage in jaundiced patients undergoing pancreaticoduodenectomy for a suspected malignancy of the periampullary region is still under debate. This study evaluated preoperative biliary drainage in relation to postoperative outcomes. STUDY DESIGN:At the Academic Medical Center, Amsterdam, the Netherlands, a cohort of 311 patients undergoing pancreaticoduodenectomy from June 1992 up to and including December 1999 was studied. Of this cohort 21 patients with external or surgical biliary drainage were excluded and 232 patients who had received preoperative internal biliary drainage were divided into three groups corresponding with severity of jaundice according to preoperative plasma bilirubin levels: < 40 microM (n = 177), 40 to 100 microM (n = 32), and > 100 microM (n = 23) were designated as groups 1, 2, and 3, respectively. These groups were compared with patients who underwent immediate surgery (n = 58) without preoperative drainage. RESULTS:The median number of stent (re)placements was 2 (range 1 to 6) with a median drainage duration of 41 days (range 2 to 182 days) and a stent dysfunction rate of 33%. Although patients in group 1 were better drained than patients in groups 2 and 3 (median reduction of bilirubin levels 82%, 57%, and 37%, respectively, p < 0.01), there was no difference in overall morbidity among the drained groups (50%, 50%, and 52%, respectively). There was no significant difference in overall morbidity between patients with and without preoperative biliary drainage (50% and 55%, respectively). CONCLUSIONS:Preoperative biliary drainage did not influence the incidence of postoperative complications, and although it can be performed safely in jaundiced patients it should not be used routinely.
Lymphedema is a common complication associated with breast cancer treatment, which has a serious impact on patients' limb function and quality of life. A clear and standardized diagnosis of breast cancer-related lymphedema is important for early identification of lymphedema and timely clinical diagnosis and treatment. Standardized, effective and timely management can reduce the incidence of lymphedema. This article reviews the current common diagnostic tools and methods and management methods, and evaluates their advantages and disadvantages in terms of both diagnosis and early management.
Objective:To compare the efficacy, adverse reactions and skin cosmetic effects between simultaneous integrated boost intensity-modulated radiotherapy and whole-breast intensity-modulated radiotherapy with sequential electronic boost radiotherapy for early breast cancer after breast-conserving surgery.Methods:The clinical data of 96 early breast cancer patients who underwent breast-conserving surgery in Shanxi Province Cancer Hospital from December 2015 to December 2017 were retrospectively analyzed, and the patients were divided into simultaneous integrated boost intensity-modulated radiotherapy group (observation group, 52 cases) and whole-breast intensity-modulated radiotherapy with sequential electronic boost radiotherapy group (control group, 44 cases) according to the postoperative radiotherapy method. In the observation group, the dose division scheme was 50 Gy/25 fractions (2 Gy/fraction) for the whole breast, while 60 Gy/25 fractions (2.4 Gy/fraction) was used in the tumor bed concomitantly, with a total treatment course of 33-35 d. In the control group, the dose division scheme was 50 Gy/25 fractions (2 Gy/ fraction) for the whole breast followed by tumor bed boost of 10 Gy/5 fractions (2 Gy/fraction), with a total treatment course of 40-42 d.Results:Median follow-up time of all patients was 70 months, the 5-year overall survival rates of the observation and control groups were 100.0% and 97.7%, the 5-year local recurrence-free survival rates were 98.1% and 95.5%, the 5-year disease-free survival rates were 98.1% and 93.2%, and the differences between the two groups in terms of overall survival, recurrence-free survival and disease-free survival were not statistically significant ( χ2 = 1.18, P = 0.277; χ2 = 0.44, P = 0.509; χ2 = 1.24, P = 0.265). The incidence of grade 1 and 2 acute radiation dermatitis was 63.5% (33/52) and 19.2% (10/52) in the observation group, and 50.0% (22/44) and 38.6% (17/44) in the control group, there was 1 case (2.3%) of grade 3 acute radiation dermatitis, and the difference between the two groups was statistically significant ( Z = -2.15, P = 0.032). The differences in the incidence of acute and late radiation lung injury between the two groups were not statistically significant (both P > 0.05). Except for 1 patient (2.3%) in the control group with poor cosmetic results, the rest of the patients in both groups achieved average or excellent cosmetic results ( P > 0.05). The radiotherapy time of the observation group was shorter than that of the control group, and the difference was statistically significant ( P = 0.001). Conclusions:Early breast cancer patients who received simultaneous integrated boost intensity-modulated radiotherapy or whole-breast intensity-modulated radiotherapy with sequential electronic boost radiotherapy after breast-conserving surgery could obtain good survival benefit, and the cosmetic results are all good without serious adverse effects. The treatment time of simultaneous integrated boost intensity-modulated radiotherapy is shorter and patient compliance is better.
Objective:To compare the value of 3 methods (threshold method, visual method and CT method) based on 18F-FDG PET-CT for qualitative diagnosis of solitary pulmonary nodules (SPN). Methods:The clinical characteristics, pathological results, CT signs and maximum standardized uptake value (SUV max) of 226 SPN patients who underwent 18F-FDG PET-CT and met lung imaging reporting and data system (Lung-RADS1.1) grading criteria grade 2-4 in Shanxi Province Cancer Hospital from January 2015 to January 2019 were retrospectively analyzed, and the diagnostic efficacy of threshold method (according to SUV max), visual method [according to the degree of fluorodeoxyglucose (FDG) uptake in the mediastinum or liver blood pool] and CT method (according to Lung-RADS1.1 grading criteria) for SPN were compared by using receiver operating characteristic (ROC) curve. The highest diagnostic accuracy of CT method and the highest diagnostic accuracy of threshold method and visual method were combined as PET-CT comprehensive diagnosis method, and the diagnostic efficiency of which was compared with the other methods. Results:Among the 226 patients with SPN, 174 cases were malignant and 52 cases were benign in pathology. ROC curve analysis showed that the area under the curve (AUC) of CT method 2 (defined Lung-RADS1.1 grade 4A and below as benign, grade 4B and above as malignant) in CT methods for qualitative diagnosis of SPN was 0.622, the sensitivity was 87.93%, and the accuracy was 76.11%, the diagnostic efficiency was higher than method 2. The AUC of the threshold method 1 (defined solid nodules that SUV max≥2.5 and ground-glass nodules that SUV max≥1.14 as malignant, the others as benign) in threshold methods for qualitative diagnosis of SPN was 0.675, the sensitivity was 85.06%, and the accuracy was 76.99%, the diagnostic efficiency was higher than other methods in the threshold methods and visual methods. The AUC of PET-CT comprehensive diagnosis method (combination of CT method 2 and threshold method 1) for qualitative diagnosis of SPN was 0.652, the sensitivity was 97.70%, and the accuracy was 82.74%, the diagnostic efficiency was higher than other methods. Conclusions:There is no significant difference among threshold method, visual method and CT method based on 18F-FDG PET-CT in qualitative diagnosis of SPN. The diagnostic efficiency of combining CT method with threshold method is significantly improved.
Objective:To investigate the influencing factors for underdiagnosis of high-grade squamous intraepithelial lesion (HSIL) of the uterine cervix and cervical cancer by colposcopy.Methods:The clinical data of 957 patients who underwent colposcopy and were diagnosed as HSIL or cervical cancer by histopathology at the Second Hospital of Shanxi Medical University from January 2017 to June 2022 were retrospectively analyzed, and logistic regression was used to analyze the influencing factors for underdiagnosis of HSIL and cervical cancer by colposcopy.Results:The results of univariate analysis showed that the underdiagnosis of HSIL and cervical cancer by colposcopy was related to whether or not menopause was present, whether or not there was coitus bleeding, whether or not there was irregular bleeding, liquid-based thin-layer cytology test (TCT) results, the morphology of the uterine cervix, the results of acetowhitening test, the results of iodine test, whether or not there was cuffed crypt (gland) openings, whether or not there was mosaicism, whether or not there was punctate vessels, whether or not the transformed zone was completely visible, the type of transformed zone, and whether or not the lesions involved the glands (all P < 0.05), but the underdiagnosis didn't related to whether or not there was human papillomavirus (HPV) infection, whether or not there was high-risk HPV multiple infections and the results of endocervical curettage (all P > 0.05). The results of multivariate logistic regression analysis showed that irregular bleeding ( OR = 4.279, 95% CI 2.170-8.441, P < 0.001), atypical squamous cells of uncertain significance (ASC-US) by TCT ( OR = 0.415, 95% CI 0.226-0.761, P = 0.004), atypical squamous cells, cannot exclud high-grade squamous intraepithelial lesion (ASC-H)/HSIL by TCT ( OR = 0.389, 95% CI 0.206-0.735, P = 0.004), thick acetowhite epithelium by acetowhitening test ( OR = 0.015, 95% CI 0.004-0.055, P < 0.001), and punctate vessels ( OR = 0.327, 95% CI 0.173-0.616, P = 0.001) were independent influencing factors for underdiagnosis of HSIL and cervical cancer by colposcopy. Conclusions:A history of irregular bleeding is a risk factor for underdiagnosis of HSIL of the uterine cervix and cervical cancer by colposcopy, while TCT results of ASC-US, ASC-H/HSIL and colposcopic visualization of thick acetowhite epithelium and punctate vessels could reduce the risk of underdiagnosis
目的:探讨下咽癌合并食管癌患者同期和分期手术的短期效果。方法:回顾性分析2015年8月至2022年12月山西省肿瘤医院收治的43例下咽癌合并食管癌患者的临床资料，根据手术策略的不同，分为同期手术组（SYN组，33例）和分期手术组（STG组，10例），比较两组患者手术时间、术中出血量、术后住院时间、术后并发症发生率（咽瘘/吻合口瘘、出血、血管危象、肺部感染）。结果:SYN组、STG组第1次、STG组第2次手术失血量和术后住院时间分别为（213±67）ml、（26.6±6.9）d、（55±13）ml和（13.9±3.0）d、（148±60）ml、（12.9±3.9）d，两组差异均有统计学意义（均 P<0.05）；SYN组与STG组第1次手术时间差异无统计学意义（ P＝0.620）；SYN组与STG组第2次手术时间差异有统计学意义 （ P＝0.001）。SYN组、STG组第1次手术与STG组第2次手术的出血、血管危象、吻合口瘘发生率比较，差异均无统计学意义（均 P>0.05）；SYN组、STG组第1次手术与STG组第2次手术的肺部感染发生率比较，差异均有统计学意义（均 P<0.05）。 结论:对于下咽癌合并食管癌患者，分期手术可以减轻手术压力，提高患者安全性。
目的:提高对合并重度回盲部溃疡的白塞综合征的认识。方法:回顾性分析山西省肿瘤医院2021年12月收治的1例合并重度回盲部溃疡的白塞综合征患者的临床资料，并进行文献复习。结果:患者，女性，27岁。因口腔溃疡3年余，反复发作，近1年不规律间断下腹隐痛。结肠镜检查提示回盲部巨大溃疡，腹部CT检查提示急性阑尾炎，回盲部管壁增厚。回盲部溃疡病理切片提示慢性炎伴溃疡，局灶淋巴结增生，病理诊断为溃疡坏死及肉芽组织，抗酸染色阴性，结合患者既往病史、结肠镜检查以及病理诊断，考虑为白塞综合征。给予甲泼尼龙、美沙拉嗪及肠道益生菌等治疗，患者自觉症状较前明显缓解。结论:合并消化道溃疡的白塞综合征较少见，易误诊，需与消化道肿瘤、肠结核、克罗恩病等相鉴别。确诊需要结合口腔溃疡和生殖器溃疡等病史、结肠镜检查以及病理诊断等，采用甲泼尼龙、美沙拉嗪肠溶片和肠道益生菌等联合治疗有良好的效果。
Paget disease of the vulva is the most common type of extramammary Paget disease and is a rare clinical malignancy occurring in the vulva. At present, the specific pathogenesis is not clear, and the lesions mainly involve areas rich in apocrine sweat glands, such as the external genitalia. The clinical manifestations show no obvious heterogeneity, and may be characterized by erythema, pruritus, scurf and tingling in the lesion area, with erosion and exudation in severe cases. Diagnosis requires histopathological examination and immunohistochemistry. Paget disease of the vulva is often misdiagnosed as eczema or dermatitis due to the lack of knowledge about this disease in clinicians. This article reviews the current research progress of Paget disease of the vulva, in order to deepen clinicians' understanding of this disease and effectively improve clinical diagnosis and treatment abilities.
Body mass index (BMI) is an index closely related to the total body fat. It is often used to measure the degree of obesity and reflect the nutritional status of the human body to a certain extent. The incidence rate and mortality rate of gynecological malignancies remain high. Some studies have found that BMI has certain value in the incidence and prognosis evaluation of gynecological malignancies, and is crucial to prolong the survival of patients. This review summarizes the recent research progress on the correlation between BMI and common gynecological malignancies and the mechanism of BMI on its occurrence and development.
Objective:To explore the differences in clinicopathological features, survival status and prognostic influencing factors of breast cancer patients with different molecular subtypes, and to provide bases for the prevention and treatment of breast cancer.Methods:The clinicopathological data of new-onset female breast cancer patients hospitalized in Shanxi Province Cancer Hospital from January 2015 to December 2016 were retrospectively analyzed, and patients were followed up. The clinicopathological features of patients with different molecular subtypes were compared. The follow-up was performed until June 30, 2021. Kaplan-Meier method was used to analyze the survival of patients, and Cox proportional hazards model was used to analyze the factors affecting overall survival (OS) of patients with different molecular subtypes.Results:There were 272 (14.9%), 1 005 (55.2%), 277 (15.2%) and 268 (14.7%) patients with subtypes of Luminal A, Luminal B, human epidermal growth factor receptor 2 (HER2) overexpression and triple-negative breast cancer (TNBC), respectively. The differences in the distribution of patients with age at diagnosis, age at menarche, menopausal status, age at menopause, pathological type, longest tumor diameter, T staging, N staging, histological grading, and TNM staging were statistically significant among the four groups (all P < 0.05). At a median follow-up of 60 months, the 5-year OS rates of Luminal A, Luminal B, HER2 overexpression and TNBC subtypes were 93.8%, 89.2%, 77.6% and 78.0%, respectively, and the difference was statistically significant ( χ2 = 58.76, P < 0.001). M staging was an independent influencing factor for OS in patients with Luminal A breast cancer ( HR = 16.789, 95% CI 4.972-56.690, P < 0.001); T staging ( HR = 2.721, 95% CI 1.715-4.319), N staging ( HR = 4.460, 95% CI 2.399-8.291) and M staging ( HR = 3.364, 95% CI 1.988-6.670) were independent influencing factors for OS in patients with Luminal B breast cancer (all P < 0.001); N staging ( HR = 4.428, 95% CI 1.836-10.677) and M staging ( HR = 13.489, 95% CI 6.043-30.107) were independent influencing factors for OS of patients with HER2 overexpression breast cancer (both P < 0.01); T staging ( HR = 3.052, 95% CI 1.575-5.915), N staging ( HR = 2.492, 95% CI 1.298-4.785) and M staging ( HR = 33.012, 95% CI 8.606-126.637) were independent influencing factors for OS of patients with TNBC (all P < 0.01). Conclusions:The clinicopathological features and prognostic influencing factors of breast cancer patients with different molecular subtypes are different, and the prognosis of HER2 overexpression and TNBC patients is poor. Clinicians should provide individualized treatment and follow-up programs for patients with different molecular subtypes of breast cancer.
The incidence of breast cancer has jumped to the first place in malignant tumors, posing a severe threat to women's health. Different from oxidative phosphorylation metabolism of normal cells, breast cancer cells often undergo metabolic reediting characterized by aerobic glycolysis. In the process of initiating aerobic glycolysis, phosphofructokinase-2/fructose bisphosphatase-2 (PFK-2/FBPase-2) family isozymes PFKFB3 and PFKFB4 play key roles and are involved in the growth and proliferation, invasion and migration, autophagy, and drug resistance of breast cancer. This review summarizes the correlation of PFKFB3 and PFKFB4 with breast cancer, aiming to provide a reference for future breast cancer-related research and clinical translation.
Objective:To construct a prognostic risk model of bladder cancer using cuproptosis-associated long non-coding RNA (lncRNA) and test its predictive efficacy.Methods:RNA expression sequencing data and clinical data of corresponding samples were downloaded from The Cancer Gene Atlas (TCGA) database. The 17 key genes associated with cuproptosis was obtained from the published literature, and then lncRNA of the key genes associated with cuproptosis was screened by correlation analysis based on the lncRNA data from TCGA database. The cuproptosis lncRNA associated with the prognosis of bladder cancer patients were screened by using Cox regression and Lasso regression. A total of 403 bladder cancer patients with complete clinical information screened from TCGA database were divided into a training set (203 cases) and a test set (200 cases), and the prognostic risk prediction model was constructed based on the samples in the training set and the above key independent prognosis-related cuproptosis lncRNA. According to the median value of the risk score, patients in all the datasets, the test set and the training set of bladder cancer screened from TCGA database were divided into high-risk group and low-risk group, and R language survival package was applied to compare the differences in overall survival between the two groups in each dataset. The predictive effect of the model was verified using principal component analysis (PCA) and receiver operating characteristic (ROC) curve. Univariate and multivariate Cox regression analysis were used to analyze the factors affecting overall survival of 403 bladder cancer patients, and ROC curve was used to analyze the efficacy of each factor for predicting the prognosis of bladder cancer.Results:After screening, a total of 4 cuproptosis lncRNA with independent prognostic significance were included (AC104564.3, LINC00649, AL136084.3 and AL136295.2), and the prognostic model constructed based on these 4 lncRNA was as follows: risk score = -0.713 42×AC104564.3-0.744 94×LINC00649+0.410 93×AL136084.3-0.736 89×AL136295.2. Survival analysis showed that the overall survival of the high-risk group in all datasets, the test set and the training set was poorer than that of the low-risk group (all P < 0.05), suggesting that a high risk score predicted poor prognosis. ROC curve analysis showed that the areas under the curve of applying the risk prediction model to predict 1-, 3- and 5-year overall survival of all 403 patients in TCGA database were 0.665, 0.629 and 0.692. Multivariate Cox regression analysis showed that age (≥ 65 years old vs. < 65 years old: OR = 1.027, 95% CI 1.011-1.044, P < 0.001), stage (stage Ⅳ vs. stage Ⅲ vs. stage Ⅱ vs. stage Ⅰ vs. unknown stage: OR = 1.593, 95% CI 1.308-1.939, P < 0.001) and risk score (high vs. low: OR = 1.258, 95% CI 1.126-1.406, P < 0.001) were the independent influencing factors of patients' overall survival. ROC curve analysis showed that the areas under the curve of age, stage and risk score for predicting the patients' 5-year overall survival were 0.614, 0.685 and 0.692, suggesting that the risk prediction model had better predictive efficacy. Conclusions:A prognosis risk prediction model for bladder cancer patients is constructed based on 4 lncRNA associated with cuproptosis, and the model is internally validated to have a high predictive efficacy.
目的:探讨局部晚期乳腺癌的手术治疗方式及效果。方法:回顾性分析山西省肿瘤医院2021年12月收治的1例接受乳腺癌改良根治术联合背阔肌皮瓣转移+胸壁修复术的局部晚期乳腺癌患者临床资料，并进行文献复习。结果:患者为53岁女性，因左乳肿物并广泛侵犯皮肤，左腋下肿大淋巴结行左乳肿物穿刺活组织检查，提示为浸润性癌伴随淋巴结转移，分期为T 4N 2M 0，Ⅲ B期。先给予新辅助化疗联合靶向治疗6个周期，后采用乳腺癌改良根治术联合背阔肌皮瓣转移术+胸壁修复术，术后患者恢复良好，随访9个月未发生远处转移，生命质量良好。 结论:乳腺癌改良根治术联合背阔肌皮瓣转移术+胸壁修复术可用于因乳腺病变范围过大而无法采用常规手术方式治疗的局部晚期乳腺癌患者。
目的:提高对儿童肝母细胞瘤（HB）CT及临床病理特征的认识。方法:回顾性分析山西省儿童医院经病理证实的15例HB患儿的CT及临床病理特征，并进行文献复习。结果:15例患儿中，男性10例，女性5例，年龄1天至9岁。初诊甲胎蛋白水平均升高。10例肿瘤位于右叶，3例累及左右两叶，2例位于左叶。11例为单发，4例为多发。中位肿瘤长径为9.8 cm（5.2~12.2 cm）。15例均见斑片状或裂隙样低密度影，1例见小片出血，7例见斑点或小斑片状钙化。肿瘤均呈分隔状、结节状不均匀强化，10例强化程度较周围肝实质低，5例强化程度明显高于正常肝实质。1例初诊发现肺转移，2例合并胸腹腔积液。PRETEXT分期Ⅰ期1例，Ⅱ期7例，Ⅲ期6例，Ⅳ期1例。病理类型胎儿型3例，胚胎型9例，上皮间叶混合型2例，未明确分型1例。9例直接行肿瘤切除术，6例新辅助化疗后行根治性切除术。中位随访23个月，无术后复发、转移病例。结论:螺旋CT多期扫描对提示HB病理分型具有一定参考价值。综合分析HB的CT表现、PRETEXT分期、临床特征和病理分型有助于HB的诊断和预后判断。
Objective:To explore the effects of breast cancer mesenchymal stem cells (BC-MSC) on the proliferation and migration of breast cancer MCF-7 cells and the related mechanisms.Methods:The resected cancer tissues and paracancerous tissues were taken from breast cancer patients after surgery, and the bone marrow samples of healthy people were selected. BC-MSC, breast cancer paracancerous mesenchymal stem cells (BCN-MSC) and bone marrow mesenchymal stem cells (BM-MSC) of healthy people were isolated and cultured by tissue adhesion method, and their differentiation ability was induced by the addition of osteogenic and lipogenic induction, and their surface markers were detected by flow cytometry. The supernatants of BC-MSC, BCN-MSC and BM-MSC of healthy people cultured for 48 h were collected and used for the culture of MCF-7 cells as BC-MSC group, BCN-MSC group and BM-MSC group, respectively, and the control group was the conventional cultured MCF-7 cells. The proliferation ability of MCF-7 cells in each group was detected by methyl thiazol tetrazolium (MTT) assay, the clone formation ability of MCF-7 cells was detected by plate cloning assay, the migration ability of MCF-7 cells was detected by Transwell assay, and the mRNA relative expressions of interleukin (IL)-6 and epithelial mesenchymal transition (EMT)-related genes (E-cadherin, vimentin, snail) were detected by quantitative real-time fluorescence polymerase chain reaction (qRT-PCR) in MCF-7 cells. Western blotting was used to detect expressions of p-STAT3, E-cadherin, vimentin and snail proteins in MCF-7 cells. Luminex liquid microarray technology was used to detect cytokine levels in culture supernatants of different mesenchymal stem cells (MSC). IL-6 neutralizing antibody was added into the supernatant of BC-MSC, MCF-7 cells were cultured with the supernatant (BC-MSC+IL-6 neutralizing antibody group), and then the proliferation and migration abilities of MCF-7 cells were tested, as well as the expression changes of related genes and proteins.Results:BC-MSC, BCN-MSC and BM-MSC were successfully isolated; BC-MSC had positive expressions of CD29, CD44 and CD90 and negative expressions of CD14, CD34 and CD45, which were in line with the characteristics of MSC. MTT assay showed that the absorbance values of MCF-7 cells cultured for 48 h in the control group, BC-MSC group, BCN-MSC group and BM-MSC group were 0.31±0.02, 0.54±0.03, 0.43±0.02 and 0.42±0.02, respectively, and the difference was statistically significant ( F = 56.52, P < 0.05); the results of plate cloning experiments showed that the number of clones in each petri dish of the four groups were 180±9, 439±17, 319±16 and 306±19, respectively, and the difference was statistically significant ( F = 222.70, P < 0.05); Transwell assay showed that the numbers of membrane-penetrating cells in the four groups were 6.5±1.0, 23.2±2.4, 16.0±1.3 and 14.8±2.0, respectively, with the statistically significant difference ( F = 49.44, P < 0.05); qRT-PCR assay showed that the relative expressions of IL-6 mRNA in the control group, BC-MSC group, BCN-MSC group and BM-MSC group were 1.07±0.11, 13.79±3.80, 6.68±1.66 and 6.12±1.52, respectively, and the difference was statistically significant ( F = 107.60, P < 0.05), and the relative expression of E-cadherin mRNA in MCF-7 cells of BC-MSC, BCN-MSC and BM-MSC groups was lower than that of the control group, while the relative expressions of vimentin and snail mRNA were higher than those of the control group, and the differences were statistically significant (all P < 0.05). Western blotting assay showed that the relative expression of E-cadherin mRNA in MCF-7 cells of BC-MSC, BCN-MSC and BM-MSC groups was lower than that of the control group. Western blotting showed that the level of E-cadherin protein in BC-MSC, BCN-MSC and BM-MSC groups was lower than that in the control group, and the levels of vimentin and snail proteins were higher than those in the control group; Luminex liquid microarray technology showed that the content of IL-6 cytokine in the supernatants of BC-MSC, BCN-MSC and BM -MSC cultures were higher, and the relative expressions were 1.75±0.21, 1.00±0.10 and 0.96±0.08, respectively, and the difference was statistically significant ( F = 43.22, P < 0.05). The results of MTT assay showed that the absorbance values of MCF-7 cells in BC-MSC group and BC-MSC+IL-6 neutralizing antibody group were 0.56±0.05 and 0.42±0.04, respectively, and the difference was statistically significant ( t = -3.11, P < 0.05); the results of Transwell assay showed that the numbers of membrane-penetrating cells in the two groups were 30.3±1.5 and 17.3±2.1, respectively, and the difference was statistically significant ( t = -7.12, P < 0.05); qRT-PCR assay showed that the relative expressions of E-cadherin mRNA were 0.44±0.05 and 0.76±0.05 ( t = 6.40, P < 0.01), the relative expressions of vimentin mRNA were 2.90±0.21 and 1.79±0.21 ( t = 5.29, P < 0.01), and the relative expressions of snail mRNA were 3.20±0.20 and 1.91±0.30 ( t = 2.16, P < 0.01); Western blotting assay showed that the degrees to down-regulate the expression of E-cadherin protein and up-regulate the expressions of vimentin and snail proteins in the BC-MSC+IL-6 neutralizing antibody group were weakened compared with the BC-MSC group. Conclusions:BC-MSC can promote the proliferation and migration of breast cancer MCF-7 cells probably through activating IL-6-STAT3 signaling pathway-induced EMT by its secretion of IL-6.
Objective:To explore the factors affecting the prognosis of human epidermal growth factor receptor 2 (HER2)-positive stage Ⅲ breast cancer patients receiving neoadjuvant therapy (NAT) based on bioinformatics methods, and to construct a prognostic prediction model.Methods:Clinical data of HER2-positive stage Ⅲ breast cancer patients with NAT registered from January 2010 to December 2019 were collected using National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database*Stat 8.3.9 software. Data on general information and clinicopathological characteristics of patients were obtained. Patients were divided into modeling and validation groups using R 4.2.1 software createDataPartition tool in 7∶3. Cox proportional hazards model was used to analyze the influencing factors of breast cancer patient-specific survival (BCSS), and the BCSS prediction nomogram model was constructed using R 4.2.1 software survival package and rms package. The predictive efficacy of the nomogram model was assessed using consistency index (C-index), receiver operating characteristic (ROC) curve and area under the curve (AUC), and survival calibration curve; the optimal cut-off value of the prognostic-related scores was calculated using the X-tile software, and the survival curves were plotted using Kaplan-Meier method. Decision curve analysis (DCA) was used to observe the net benefit of the nomogram model.Results:A total of 1 790 HER2-positive stage Ⅲ breast cancer patients receiving NAT were enrolled, and they were randomly divided into a modeling group (1 250 patients) and a validation group (540 patients) according to the ratio of 7∶3, and the differences in the general information of patients between the two groups were not statistically significant (all P > 0.05). The result of multivariate Cox regression analysis showed that no radiotherapy, histologic grade Ⅲ-Ⅳ, estrogen receptor (ER) negative, progesterone receptor (PR) negative, stage T 4, lymph node metastasis rate of 1%-30%, lymph node metastasis rate of 31%-60%, and lymph node metastasis rate of > 61% were the independent risk factors for BCSS (all P < 0.05). The nomogram model for prognosis of HER2-positive stage Ⅲ breast cancer patients with NAT was constructed based on the above factors. After internal validation, the C-index of the modeling group was 0.732 (95% CI 0.724-0.739), and the C-index of the validation group was 0.728 (95% CI 0.721-0.737). The AUC of the modeling group for predicting the rates of BCSS at 3, 6 and 9 years was 0.724, 0.719 and 0.775, and the AUC of the validation group was 0.773, 0.699 and 0.758. The survival calibration curves showed that the 3-, 6- and 9-year BCSS rates in the modeling and validation groups were highly fitted to the actual observations. The total score of the nomogram model of patients included in the SEER database was calculated, and the optimal cut-off value for predicting prognosis were 80.0 points and 142.0 points. According to the optimal cut-off value, the patients were divided into low-risk group (total score ≤80.0 points), intermediate-risk group (total score > 80.0 points and ≤142.0 points) and high-risk group (total score >142.0 points), and they were also classified into stage Ⅲ A, stage Ⅲ B and stage Ⅲ C according to the American Joint Committee on Cancer (AJCC) staging, the differences in BSCC among these groups were statistically significant (all P < 0.001), and the nomogram model risk stratification was more effective in differentiating BCSS. The DCA curves showed that compared with AJCC staging and the two extremes of treatment modalities (complete treatment and no treatment at all), the nomogram model had a higher net gain in predicting BCSS of HER2-positive stage Ⅲ breast cancer patients with NAT. Conclusions:The prognostic factors affecting HER2-positive stage Ⅲ breast cancer patients with NAT are whether or not they are treated with radiotherapy, histologic grading, ER status, PR status, T stage, and lymph node metastasis rate. The constructed nomogram model has better efficacy and greater benefit than traditional AJCC staging in predicting BCSS.
Objective:To explore the clinical application value of general coagulation indices and neutrophil-to-lymphocyte ratio (NLR) for assessing coagulation status of patients with ovarian cancer.Methods:The data of 190 patients with ovarian cancer who were admitted to the Second Hospital of Shanxi Medical University from October 2019 to September 2022 were retrospectively analyzed. According to the International Federation of Gynecology and Obstetrics (FIGO) staging, the patients were divided into early (stage Ⅰ-Ⅱ) ovarian cancer group (70 cases) and advanced (stage Ⅲ-Ⅳ) ovarian cancer group (120 cases). Forty-four patients with benign ovarian tumors who were treated in the Second Hospital of Shanxi Medical University during the same period were selected. Plasma D-dimer (D-D), activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FIB) and thrombin time (TT) were tested. Platelet count (Plt), neutrophil count and lymphocyte count were measured by blood cell analyzer, and NLR was calculated. The receiver operating characteristic (ROC) curve was used to analyze the value of coagulation indices and NLR in the assessment of venous thromboembolism (VTE) in patients with ovarian cancer.Results:Compared with the benign ovarian tumor group, PT of patients in the early and advanced ovarian cancer groups was shorter (both P < 0.05), and D-D and Plt increased (both P < 0.05). Compared with the benign ovarian tumors group, TT of patients in the advanced ovarian cancer group decreased ( P < 0.05), and FIB and NLR increased (both P < 0.05). Compared with the early ovarian cancer group, PT and TT in the advanced ovarian cancer group were shorter (both P < 0.05), and FIB, D-D, NLR and Plt increased (all P < 0.05). The optimal cut-off values of FIB, D-D and NLR in stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ patients with VTE in ovarian cancer group were 3.165, 333.500 and 2.455, and the area under the curve (AUC) was 0.731, 0.837 and 0.759. Conclusions:The coagulation indices of patients with ovarian cancer are abnormal during treatment, suggesting that patients may produce active thrombosis, and the symptoms of patients in advanced stage are more serious.
Objective:To investigate the expression of calcium binding-protein A9 (S100A9) in cervical cancer and its relationship with the efficacy of TC (paclitaxel+carboplatin) regimen chemotherapy in patients.Methods:A total of 119 patients with cervical cancer who were scheduled to undergo TC regimen chemotherapy in the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from July 2017 to May 2021 were selected to conduct a prospective study. The tissue samples of all patients were obtained by biopsy before treatment, and the expressions of S100A9, matrix metalloproteinase-9 (MMP-9) and vascular endothelial growth factor (VEGF) in cervical cancer tissues and paracancerous normal tissues were detected by immunohistochemistry. The correlation of S100A9 expression with MMP-9 and VEGF expressions in cervical cancer tissues were analyzed by using Spearman method. The patients were divided into the effective group (complete remission+partial remission) and the ineffective group (stable disease+progressive disease) according to the effectiveness of chemotherapy, and the expressions of S100A9, MMP-9 and VEGF in cervical cancer tissues of the two groups were compared. The influencing factors for TC regimen chemotherapy efficacy were analyzed by using multivariate logistic regression method.Results:Compared with paracancerous tissues, the positive expression rates of S100A9 [90.76% (108/119) vs. 45.38% (54/119)], MMP-9 [55.46% (66/119) vs. 17.65% (21/119)] and VEGF [78.99% (94/119) vs. 24.37% (29/119)] were all elevated in cervical cancer tissues ( χ2 values were 47.03, 36.69 and 71.09, all P < 0.001). The S100A9 expression in cervical cancer tissues was positively correlated with MMP-9 and VEGF expressions ( r values were 0.619 and 0.784, both P < 0.001). The effective rate of TC regimen chemotherapy was 47.06% (56/119). The positive expression rate of S100A9 in cervical cancer tissues of the effective group was higher than that of the ineffective group [98.21% (55/56) vs. 84.13% (53/63), P < 0.05], while the positive expression rates of MMP-9 [35.71% (20/56) vs. 73.02% (46/63)] and VEGF [67.86% (38/56) vs. 88.89% (56/63)] were lower than those of the ineffective group (both P < 0.001). Multivariate logistic regression analysis showed that clinical stage Ⅳ ( OR = 2.707, 95% CI 1.865-4.119, P < 0.05), lymph node metastasis ( OR = 4.468, 95% CI 3.221-5.823, P < 0.001), deep myometrial invasion ( OR = 5.686, 95% CI 4.308-7.247, P < 0.001), vascular tumor thrombus or parauterine invasion ( OR = 3.758, 95% CI 2.584-5.163, P < 0.001), MMP-9 positive expression in cancer tissues ( OR = 3.904, 95% CI 2.876-5.228, P < 0.001) and VEGF positive expression in cancer tissues ( OR = 2.609, 95% CI 1.793-4.052, P < 0.05) were the risk factors affecting the TC regimen chemotherapy efficacy, while the S100A9 positive expression in cancer tissues was the protective factor for TC regimen chemotherapy efficacy ( OR = 0.660, 95% CI 0.417-0.854, P < 0.05). Conclusions:The expression of S100A9 in cervical cancer tissues increases and correlates with MMP-9 and VEGF expressions. The high expression of S100A9 could increase the effectiveness of TC regimen chemotherapy in cervical cancer patients, while clinical stage Ⅳ, lymph node metastasis, deep muscle invasion, vascular tumor thrombus or parauterine invasion, MMP-9 positive expression and VEGF positive expression may increase the risk of ineffective chemotherapy with TC regimen in patients.
Objective:To investigate the expression of INHBA in colorectal cancer and its relationship with microsatellite status and clinicopathological features.Methods:Bioinformatics analysis was conducted based on Gene Expression Omnibus (GEO) database and Gene Expression Profiling Interaction Analysis (GEPIA) database, and the differentially expressed prognosis-related target genes in colorectal cancer were selected. Wax mass tissues of 107 patients with colorectal cancer who underwent surgery from January 2016 to June 2022 in the Third Affiliated Hospital of Jinzhou Medical University were collected, and the tissue microarrays were prepared. The clinicopathological microsatellite status [positive expressions of the mismatch repair (MMR) proteins MLH1, MSH2, MSH6, and PMS2 were mismatch repair proficient (pMMR), which represented low microsatellite instability or microsatellite stabilization; if any of these indexes was negative, it was judged to be mismatch repair deficient (dMMR), which represented high microsatellite instability] and INHBA expression in colorectal cancer tissues were detected by immunohistochemistry, data of the patients were retrospectively analyzed. The relationship between INHBA and microsatellite status as well as clinicopathological features was analyzed.Results:Three data sets of colorectal cancer were selected from GEO database: GSE110223 (13 cancer tissues, 13 paracancerous tissues), GSE110224 (17 cancer tissues, 17 paracancerous tissues), GSE113513 (14 cancer tissues, 14 paracancerous tissues), and the top 50 genes that were differentially up-regulated and down-regulated between cancer tissues and paracancerous tissues were screened. Intersection genes of 3 data sets were analyzed by Venn diagram, and 12 up-regulated genes and 17 down-regulated genes were screened out. According to GEPIA database, AQP8, ZG16 and INHBA genes among the up-regulated and down-regulated differential genes were associated with the prognosis of colorectal cancer. INHBA was higher expressed in colorectal cancer tissues than in paracancerous tissues (≥5 cm from the tumor margin) ( P < 0.05), and INHBA gene was selected for analysis. Immunohistochemical detection of collected colorectal cancer wax samples showed that the proportion of patients with high INHBA expression in colorectal cancer tissues was higher than that in paracancerous tissues [85.05% (91/107) vs. 67.29% (72/107), P < 0.05]. The high expression of INHBA in cancer tissues was related to the lesion site [right colon vs. left colon: 94.00% (47/50) vs. 77.19% (44/57)], maximum tumor diameter [>5 cm vs. ≤5 cm: 92.73% (51/55) vs. 76.92% (40/52)] and the depth of invasion [stage T 3-4 vs. stage T 1-2: 96.43% (54/56) vs. 72.55% (37/51)], differentiation degree [low and medium differentiation vs. high differentiation: 91.04% (61/67) vs. 75.00% (30/40)], lymph node metastasis [yes vs. no: 93.02% (40/43) vs. 78.13% (50/64)] (all P < 0.05), but had no correlation with age, sex, thrombus and nerve invasion (all P > 0.05). The proportion of patients with high expression of INHBA in colorectal cancer tissues in pMMR group was higher than that in dMMR group [93.22% (55/59) vs. 75.00% (36/48), χ2 = 6.91, P = 0.008]. Conclusions:INHBA is highly expressed in colorectal cancer tissues, and the highly expressed INHBA is closely related to clinicopathological features and microsatellite status of colorectal cancer. INBHA may be a new target for diagnosis, treatment and prognosis of colorectal cancer.
Objective:To investigate the expressions of miRNA-4686 (miR-4686) and protein disulfide isomerase A4 (PDIA4) in esophageal cancer tissues, and the effect of miR-4686 on the proliferation and migration of esophageal cancer cells in vitro and possible mechanisms.Methods:The complementary integration of miR-4686 and PDIA4 mRNA were predicted using the miRWalk version 3 online website. The expression profiles of miR-4686 and PDIA4 mRNA were obtained from the University of California, Santa Cruz Genome (UCSC) database, and the relative expression of miR-4686 and PDIA4 mRNA in esophageal cancer tissues and paracancerous tissues were analyzed. The UCSC database was used to obtain the localization of miR-4686 in human cells. The relative expressions of miR-4686 and PDIA4 mRNA in esophageal cancer Eca109, TE-13, EC9706 and KYSE-510 cells and normal esophageal epithelial HET-1A cells were detected by real-time fluorescent quantitative polymerase chain reaction (qRT-PCR). Eca109 cells with the lowest relative expression of miR-4686 were selected for subsequent research, and the Eca109 cells were divided into miR-4686 group (transfected with miR-4686 mimic) and miR-NC group (transfected with miR-4686 negative control sequence mimic). The proliferation ability of Eca109 cells in the two groups was detected by colony formation assay, the migration ability of Eca109 cells was detected by scratch healing assay, and the targeting relationship between miR-4686 and PDIA4 mRNA was verified by dual luciferase reporter gene assay; the expressions of PDIA4 protein and PI3K-AKT-mTOR signaling pathway-related proteins were detected by Western blotting.Results:Compared with the paracancerous tissues, miR-4686 expression was low and PDIA4 mRNA expression was high in esophageal cancer tissues (both P < 0.01). Compared with normal esophageal epithelial HET-1A cells (0.98±0.15), the relative expression of miR-4686 in esophageal cancer Eca109 (0.11±0.04), TE-13 (0.58±0.10), EC9706 (0.34±0.05) and KYSE-510 cells (0.69±0.06) were all decreased (all P < 0.05). Compared with the miR-NC group, the relative expression of miR-4686 in Eca109 cells of the miR-4686 group increased (9.4±2.1 vs. 1.0±0.4, t = 3.88, P = 0.008), the number of colony formation decreased (38±9 vs. 114±18, t = 3.78, P = 0.009), the scratch healing rate decreased [(27.13±0.91)% vs. (45.05±3.89)%, t = 4.48, P = 0.004], and the relative expression of PDIA4 mRNA decreased [1.0±0.5 vs. 6.3±0.9, t = 5.04, P = 0.002]. Compared with wild type (WT)-PDIA4+miR-NC group, the relative luciferase activity of Eca109 cells in WT-PDIA4+ miR-4686 group decreased (0.31±0.08 vs. 0.99±0.08, t = 5.96, P < 0.001). Compared with miR-NC group, the expressions of PDIA4, p-PI3K, p-AKT and p-m-TOR proteins in Eca109 cells of the miR-4686 group were all decreased. Conclusions:In esophageal cancer tissues, miR-4686 is lowly expressed and PDIA4 mRNA is highly expressed. miR-4686 may inhibit the proliferation and migration of esophageal cancer Eca109 cells by targeting regulation of PDIA4 expression.
