The aim of this study was to investigate the mechanism of action of ALKBH1 in gastric cancer (GC) in regulating tumor-associated macrophage (TAM) polarization and remodeling tumor microenvironment (TME). Through bioinformatics analysis, cellular experiments, molecular biology techniques and in vivo HSC-NPG mouse model experiments, we systematically investigated the expression pattern of ALKBH1 in macrophages and its downstream signaling pathway. Our results showed that ALKBH1 was highly expressed in GC tissues and M2 macrophages, and was closely related to the degree of polarization of M2-type macrophages. Knockdown of ALKBH1 inhibited the polarization of M2 macrophages and strengthened the activity of M1-type macrophages, while enhancing anti-tumor immunity such as CD4+, CD8+ T cells, and NK cells. Further studies showed that ALKBH1 attenuated the m6A modification of USP28 mRNA, and up-regulated USP28 expression. USP28 increased deubiquitination of MYC thereby enhancing the stability of MYC protein, forming an ALKBH1/USP28/MYC positive feedback loop, which promotes M2 polarization and GC development. Knockdown of ALKBH1 rescued the above phenomena and inhibited tumor growth and metastasis in HSC-NPG mice. Our results indicated that ALKBH1 is a key factor regulating TAM polarization and remodeling TME in gastric cancer. Knockdown of ALKBH1 can inhibit gastric cancer progression by suppressing the polarization of M2-type macrophages and enhancing the anti-tumor immune response, which provides an important reference for the development of new therapeutic strategies for GC.

Objective:Objective: To explore the prognostic factors affecting patients with glioblastoma (GBM) treated with the Stupp regimen and establish a prediction model based on hematological indicators to guide future clinical decision - making. Methods:A total of 271 GBM patients meeting the screening criteria were recruited. They were randomly divided into a training set (190 cases) and a validation set (81 cases) at a 7:3 ratio. The training set was utilized to establish a comprehensive hematology prognostic scoring system (CHPSS), and the validation set was employed to verify the CHPSS. A Risk Score (RS) was computed from the CHPSS, and a nomogram model was constructed to predict patients' overall survival (OS) based on the RS. Additionally, the relationship between RS and the surgery - to - radiotherapy interval (SRI) was analyzed. Results:Patients were categorized into low - risk and high - risk groups according to the RS calculated by CHPSS. The overall survival of patients in these two groups differed significantly. The C - indices of the nomogram model constructed based on RS and clinical features were 0.79 and 0.73 in the training and validation sets, respectively. The clinical decision curve showed that when the threshold probability exceeded 20%, the model's prediction provided the greatest net benefit for GBM patients receiving the Stupp regimen. In the overall cohort, a correlation between RS and SRI was observed, allowing for the classification of SRI into different risk subgroups based on RS. Conclusion:The nomogram model based on CHPSS can effectively evaluate the prognosis of glioblastoma patients.

BACKGROUND:Head and neck squamous cell carcinoma (HNSCC) is a lethal malignancy with a high recurrence and distant metastasis rate, posing significant challenges to patient prognosis. Recent studies suggest that tumor-associated neutrophils (TANs) can modulate immune cell infiltration and influence tumor initiation and progression. However, the potential clinical significance of TANs in HNSCC remains insufficiently explored. METHODS:TANs-specific marker genes were identified via single-cell sequencing data from HNSCC. Based on data from The Cancer Genome Atlas (TCGA), a prognostic risk model was constructed using TANs cell marker genes, and the model was validated with data from the Gene Expression Omnibus (GEO) database. The associations between the TANs signature and clinical characteristics, functional pathways, immune cell infiltration, immune checkpoint expression, and responses to immunotherapy and chemotherapy, were then investigated. Cell counting kit-8(CCK-8), Transwell, and wound healing assays were conducted to assess the functional role of TANs marker molecules. RESULTS:TANs characteristic genes were identified from single-cell sequencing data from HNSCC patients. On the basis of these characteristic genes, a tumor-associated neutrophils-associated signature (NRS) was developed and validated across internal and external cross-platform cohorts through comprehensive procedures. The NRS demonstrated robust and reliable performance in predicting overall survival. Additionally, patients with a low NRS showed enhanced immune cell infiltration, active lipid metabolism, and increased sensitivity to immunotherapy. In contrast, patients with a high NRS exhibited poor prognostic outcomes, advanced clinical stages, and significant associations with HNSCC metastasis and progression. Furthermore, we identified a TANs-associated biomarker, OLR1, and validated that OLR1 promotes HNSCC proliferation, invasion, and migration through CCK-8, Transwell invasion, and wound healing assays. CONCLUSION:This study has developed a promising TANs-based tool that may aid in personalized treatment and prognostic management for patients with HNSCC.

Abstract Objective To analyze the efficacy and adverse effects of anti‐PD‐1 immune checkpoint inhibitors aimed at nasopharyngeal carcinoma (NPC). Methods During the first stage of the study, using 40 patients with stage III/IVa NPC treated with anti‐PD‐1 immune checkpoint inhibitors in combination with chemoradiotherapy as a first‐line treatment (observation group) and 70 patients with NPC treated with chemoradiotherapy alone (control group). In the second stage of the study, 88 patients with NPC treated with immune checkpoint inhibitors were grouped according to the number of lines of immunotherapy, the number of times, and the types of application. Results Observation of the short‐term effects in the first stage indicated that the objective response rate (ORR) of the observation group and the control group against primary foci of NPC was 75.0% versus 40.0%; the mortality rate of the observation group was much lower than that of the control group. The overall first‐line treatment evaluation of the observation vs. control groups were as follows: ORR (67.5% vs. 38.6%); median PFS (17.52 vs. 17.21 months); and median OS (18.68 vs. 18.14 months), respectively (p < 0.05). The second stage of the study had an ORR of 53.4%, and the efficacy of immunotherapy was related to staging, timing, and frequency. Conclusion Anti‐PD‐1 immune checkpoint inhibitors combined with chemoradiotherapy as the first‐line treatment for nasopharyngeal carcinoma may improve patient outcomes significantly. Timing, frequency, and the type of immunotherapy exerted an effect on the efficacy of immunotherapy. Adverse effects that occurred during treatment were tolerable and controllable.

Brainstem gliomas (BSGs) are a class of clinically refractory malignant tumors for which there is no uniform and effective treatment protocol. Ultrasound and radiation can activate hematoporphyrin and produce sonodynamic and radiodynamic effects to kill cancer cells. Therefore, we conducted the first phase I clinical trial of sonodynamic therapy (SDT) combined with radiotherapy (RT) for the treatment of BSGs to verify its safety and efficacy. We conducted a study of SDT combined with RT in 11 patients with BSGs who received SDT and RT after hematoporphyrin administration. Magnetic resonance imaging was performed during this period to assess the tumor, and adverse events were recorded. All adverse events recorded were grade 1-2; no grade 3 or more serious adverse events were observed. Treatment was well tolerated, and no dose-limiting toxicities were observed. There were no treatment-related deaths during the course of treatment. 8 of 11 patients (72.7%) maintained stable disease, 2 (18.2%) achieved partial response, and the tumors were still shrinking as of the last follow-up date. The median progression-free survival (PFS) for patients was 9.2 (95% confidence interval [CI] 6.2-12.2) months, and the median overall survival (OS) was 11.7 (95% CI 9.6-13.8) months. Therefore, SDT combined with RT has a favorable safety and feasibility and shows a preliminary high therapeutic potential.

ObjectiveTo investigate the correlation between programmed death ligand 1(PD-L1), tumor mutation burden (TMB) and the short-term efficacy and clinical characteristics of anti-PD-1 immune checkpoint inhibitor combination chemotherapy in NSCLC patients. The efficacy of the prediction model was evaluated.MethodsA total of 220 NSCLC patients receiving first-line treatment with anti-PD-1 immune checkpoint inhibitor combined with chemotherapy were retrospectively collected. The primary endpoint was short-term efficacy ORR. The correlation between short-term efficacy, PD-L1, TMB, and clinical characteristics using χ2 test or t-test was evaluated. Screen the independent prognostic factors using univariate and multivariate logistic regression analyses, and construct a nomogram prediction model using the “rms” package in R software. Using receiver operating characteristic (ROC) curve analysis to evaluate the independent Prognostic factors and the prediction model. Using decision curve analysis (DCA) to verify the superiority of the prediction model.ResultsThe mean values of PD-L1, TMB, neutrophils, lymphocytes, neutrophil-to-lymphocyte ratio, and albumin were the highest in the ORR group, PD-L1 expression and TMB correlated with epidermal growth factor receptor expression. Multivariate analyses showed that PD-L1, TMB, and neutrophil were independent prognostic factors for ORR. The area under the ROC curve (AUC) values of the ROC constructed based on these three indicators were 0.7104, 0.7139, and 0.7131, respectively. The AUC value under the ROC of the nomogram model was 0.813. The DCA of the model showed that all three indicators used together to build the prediction model of the net return were higher than those of the single indicator prediction model.ConclusionPD-L1, TMB, and neutrophils are independent prognostic factors for short-term efficacy. The nomogram prediction model constructed using these three indicators can further improve predictive efficacy of ICIs in patients with NSCLC.

Microwave (MW) dynamic therapy (MDT) can efficiently eliminate tumor residue resulting from MW thermal therapy. However, MDT is currently in its infancy, and luck of effective MDT sensiters severely limits its clinical therapeutic effect. Herein, based on TiMOF (TM), a high-efficiency MW sensitizer is designed for MW thermo-dynamic therapy. TM can generate heat and cytotoxic reacyive oxygen species (ROS) under MW irradiation and has the potential to be used as an MW sensitizer, while the suboptimal MW dynamic sensitization effect of TM limits its application. Inorder to improve the MW dynamic sensitization performance, a covalent organic framework (COF) with good stability and a large conjugate system is used to cover TM, which is conductive to electron and energy transfer, thus increasing the ROS generation rate and prolonging the ROS lifetime. In addition, loading Ni NPs endow nanomaterials with magnetic resonance imaging capabilities. Therefore, this work develops an MW sensitizer based on TM for the first time, and the mechanism of COF coating to enhance the MW dynamic sensitization of TM is preliminarily explored, which provides a new idea for the further development of MW sensitizer with great potential.

目的 探讨甲磺酸阿帕替尼在复发性卵巢癌治疗中的应用价值.方法 选取2014年6月至2016年10月郑州大学第一附属医院肿瘤科收治的94例复发性卵巢癌患者作为研究对象,其中47例接受以紫杉醇、顺铂(腹腔热灌注顺铂)为基础化疗方案治疗(对照组),另外47例在对照组基础上给予甲磺酸阿帕替尼治疗(研究组),至少接受2个周期治疗;对比2组的近期疗效、生存情况及化疗前后血清糖类抗原125(CA125)、人附睾蛋白4(HE4)、人激肽释放酶10(hK10)水平变化.结果 研究组总有效率66.67％,高于对照组的45.65％,差异有统计学意义(x2=4.078,P=0.043).研究组化疗后血清CA125、HE4、hK10水平均低于对照组,差异均有统计学意义(t=2.643,P=0.010;t=3.348,P=0.001;t=3.098,P=0.003).研究组 3 a 生存率 45.90％,高于对照组的32.40％(x2=5.597,P=0.018);研究组总生存时间35.0个月,长于对照组的28.0个月(x2=5.796,P=0.016).2组的恶心呕吐、腹泻、骨髓抑制、脱发、肝肾功能损害发生程度比较差异均无统计学意义(x2=0.410,P=0.524;x2=1.606,P=0.208;x2=2.678,P=0.150;x2=1.038,P=0.311;x2=0.762,P=0.365).结论 在常规化疗方案的基础上加用甲磺酸阿帕替尼有利于降低复发性卵巢癌患者血清肿瘤标志物水平,提高近远期疗效.

OBJECTIVE:To explore the influence of lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio (NLR) on the prognosis of patients with extranodal NK/T cell lymphoma (ENKTL).METHODS:The clinical data of 203 patients with ENKTL admitted to the First Affiliated Hospital of Zhengzhou University from January 2011 to January 2020 were retrospectively analyzed. The ROC curve determined the limit values of LMR and NLR; Categorical variables were compared using a chi-square test, expressed as frequency and percentage (n,%). Continuous variables were expressed as medians and extremes and compared with the Mann-Whitney U test; Progression-free survival (PFS) and overall survival (OS) of different grouped LMR and NLR patients were analyzed using Kaplan-Meier curves and compared with log-rank tests. The COX proportional risk regression model was used to perform one-factor and multi-factor analysis of PFS and OS.RESULTS:The optimal critical values of LMR and NLR were determined by the ROC curve, which were 2.60 and 3.40, respectively. LMR≤2.60 was more likely to occur in patients with bone marrow invasion (P=0.029) and higher LDH (P=0.036), while NLR≥3.40 was more likely to occur in patients with higher ECOG scores (P=0.002), higher LDH (P=0.008), higher blood glucose (P=0.024), and lower PLT (P=0.010). Kaplan-Meier survival analysis showed that PFS and OS of patients in the high LMR group were significantly better than the low LMR group, while PFS and OS in the low NLR group were significantly better than the high NLR group. The results of multivariate COX analysis showed that EBV-DNA positive (P=0.047), LMR≤2.60 (P=0.014), NLR≥3.40 (P=0.023) were independent risk factors affecting PFS in patients with ENKTL. LMR≤2.60 (P<0.001), NLR≥3.40 (P=0.048), and high β2-MG (P=0.013) were independent risk factors affecting OS in patients with ENKTL.CONCLUSION:Low LMR and high NLR before treatment are associated with poor prognosis in patients with ENKTL, which also can be used as an easily testable, inexpensive, and practical prognostic indicator in the clinic.

Most of the patients with oral and maxillofacial malignancy are in the middle and advanced stages at diagnosis and the incidence rate is increasing in recent years. Chemotherapy alone is difficult to benefit the survival of patients with advanced oral and maxillofacial malignancy. Ultrasound hyperthermia is a new and effective treatment for malignant tumor, which is developing rapidly in addition to conventional treatment. However, at present, ultrasound hyperthermia has not been widely used in the treatment of oral and maxillofacial malignancy. Therefore, formation of a guideline on ultrasound hyperthermia for oral and maxillofacial malignancy is mandatory, in order to promote and standardize the clinical practice of ultrasound hyperthermia in this field, and improve the long-term survival rate and quality of life of patients.

PURPOSE:The prognosis of recurrent glioblastoma (rGBM) is poor, and there is currently no effective treatment strategy. Sonodynamic therapy (SDT) is a new method for cancer treatment that uses a combination of low-frequency ultrasound and sonosensitisers to produce antitumor effects, which have shown good therapeutic effects in preclinical studies. Therefore, we initiated an open, prospective pilot study to evaluate the safety, tolerability, and efficacy of SDT for the treatment of rGBM.METHODS:Nine patients with rGBM were enrolled who had received multiple treatments, but the nidus continued to progress without additional standard treatments. After MRI localisation, porphyrin drugs were injected, and intermittent low-frequency ultrasound therapy was performed for five days.RESULTS:None of the nine patients in this clinical trial showed any clinical, neurological, haematological, or skin-targeted adverse effects associated with SDT. After the completion of the trial, one patient maintained stable disease, and eight patients experienced disease progression. Among the eight with progressive disease, the median progression-free survival time was 84 days. Four patients died, and the median overall survival duration after recurrence was 202.5 days.CONCLUSION:The number of patients in this study was small; therefore, a long-term survival benefit was not demonstrated. However, this study suggests that SDT has potential as a treatment for rGBM and warrants further exploration. Trial information: Chinese Clinical Trial Registry ( http://www.chictr.org.cn/ ): ChiCTR2200065992. November 2, 2022, retrospectively registered.

In vivo monitoring of treatment response is of great significance for tumor therapy in clinical trials, but it remains a formidable challenge. Herein, we demonstrate a logic AND gate theranostic nanoagent that responds to the coexistence of endogenous and exogenous stimuli, namely HAuCl4@1-Tetradecanol@Gd-based metal-organic framework@SiO2 nanocomposites (APGS NCs). Upon microwave (MW) irradiation, HAuCl4 in the inner part of APGS NCs reacts with the tumor-associated glutathione (GSH). Subsequently, it transforms into an active luminescent form of Au@1-Tetradecanol@Gd-MOF@SiO2 nanocomposites (AuPGS NCs). The intensity of generated fluorescence is correlated with the tumor thermal-injury status. Thus, the generation of AuPGS NCs with high intensity fluorescence under the co-activation of MW and GSH can visualize the treatment effects during MW thermal therapy and instantly modulate the irradiation time and range for optimal outcomes. Hence, this logic gate controlled APGS NCs makes MW thermal therapy eliminate tumor cells completely. This research offers an effective strategy for the design and preparation of activatable theranostic nanoagents for precise tumor imaging and therapy.

Objective:To evaluate the effect of hyperthermia on the apoptosis and the expression levels of cysteine-containing aspartate-specific protease-3 (Caspase-3) and phosphorylated protein kinase B (p-AKT) in laryngeal squamous cell carcinoma cells.Methods:A prospective study was conducted on 30 patients with laryngeal squamous cell carcinoma who were treated at the First Affiliated Hospital of Zhengzhou University from October, 2021 to October, 2022. Three times of hyperthermia were performed with a time interval of 24 h. The tumor tissue samples were collected from 30 patients before and after hyperthermia and divided into before hyperthermia group (group A ) and after hyperthermia group (group B). Self-control study mode was adopted for comrparative analysis. The cell apoptosis was detected by TUNEL assay. The expression levels of Caspase-3 and p-AKT in the tissues were detected by immunohistochemistry. Positive cell ratio and immunohistochemistry (IHC) score were recorded. Comparison between two groups was performed by paired t-test. The correlation between the degree of apoptosis and the changes of Caspase-3 and p-AKT molecules was assessed by Pearson correlation analysis. Results:No evident adverse reactions were observed in 30 patients after hyperthermia. The apoptosis index of laryngeal squamous cell carcinoma cells in group A was 2.37%±1.33%, and 4.27%±3.93% in group B ( P=0.006). In group A, the ratio of Caspase-3 positive cells in tumor tissues was 62.31%±19.49% and 80.79%±17.15% in group B ( P=0.001). The ratio of p-AKT positive cells in group A was 31.26%±19.30%, and 26.26%±15.86% in group B ( P=0.023). There was a positive correlation between the degree of apoptosis and the changes of Caspase-3 molecule ( r=0.544, P=0.002), but a negative correlation was noted between the degree of apoptosis and the changes of p-AKT molecule ( r=-0.434, P=0.017). Conclusion:Hyperthermia can promote the apoptosis of tumor cells in laryngeal squamous cell carcinoma, which may be related to Caspase-3 dependent apoptosis, and the inhibition of AKT phosphorylation is also involved in this process.

目的:探讨治疗前纤维蛋白原(Fib)与中性粒细胞淋巴细胞比值(NLR)的联合指标(F-NLR评分)在接受调强放射治疗(IMRT)的鼻咽癌(NPC)患者中的预后价值.方法:回顾性分析我院放疗科2016 年1 月至2018 年12 月收治的接受IMRT的NPC患者的临床资料.根据受试者工作特征曲线计算Fib及NLR的最佳截断值,并对患者进行分组.采用χ2 检验或Fisher确切概率法比较不同分组间临床特征和近期疗效的差异.运用Cox比例风险模型进行单因素和多因素生存分析,探讨影响预后的风险因素.通过Kaplan-Meier法绘制生存曲线,采用Log-rank法比较各组生存曲线的差异.P<0.05 为差异具有统计学意义.结果:Fib和NLR的最佳截断值分别为3.455 g/L和 2.99.不同F-NLR分组的饮酒和T分期存在显著差异.不同Fib、NLR和F-NLR分组的近期疗效存在显著差异.多因素分析显示F-NLR评分、TNM分期和EBV DNA拷贝数是影响NPC患者OS的独立危险因素.不同F-NLR分组的OS和PFS生存曲线两两之间存在显著差异(P<0.001).结论:治疗前高F-NLR评分是接受IMRT的NPC患者的独立预后不良因素,联合TNM分期和EBV DNA拷贝数可更加准确预测鼻咽癌患者预后.

Acute pancreatitis (AP) can be complicated by inflammatory disorders of remote organs, such as lung injury, in which Jumonji domain-containing protein 3 (JMJD3) plays a vital role in proinflammatory responses. Currently, we found that JMJD3 expression was upregulated in the pancreas and lung in an AP male mouse model, which was also confirmed in AP patients. Further experiments revealed that the upregulation of JMJD3 and proinflammatory effects were possibly exerted by mitochondrial DNA (mtDNA) or oxidized-mtDNA from tissue injury caused by AP. The release of mtDNA and oxidized-mtDNA contributed to the infiltration of inflammatory monocytes in lung injury through the stimulator of IFN genes (STING)/TLR9-NF-κB-JMJD3-TNF-α pathway. The inhibition of JMJD3 or utilization of Jmjd3-cKO mice significantly alleviated pulmonary inflammation induced by AP. Blocking mtDNA oxidation or knocking down the TLR9/STING pathway effectively alleviated inflammation. Therefore, inhibition of JMJD3 or STING/TLR9 pathway blockage might be a potential therapeutic strategy to treat AP and the associated lung injury.

Recently, the dysregulation of circRNAs has been increasingly implicated in the pathogenesis of nasopharyngeal carcinoma (NPC). Among these circRNAs, circMAN1A2 has been highlighted for the up-regulated expression in NPC, whereas the underlying mechanisms have not been clearly established. Thus, the aim of this study was to delineate the tumor-supporting role of circMAN1A2 in the oncogenesis and metastases of NPC. We validated through qRT-PCR that circMAN1A2 was highly expressed in NPC tissues and NPC cells. Survival analysis through Kaplan–Meier method showed that the overall survival, disease-free survival, and distant metastasis-free survival of patients was negatively correlated with the expression of circMAN1A2. Then, gain- and loss-of function assays demonstrated that circMAN1A2 knockdown could impede the proliferation, migration, invasion, and EMT in NPC cells. Further, we conducted dual luciferase reporter gene, RIP, and RNA pull down assays, unveiling that circMAN1A2 functioned as a sponge of miR-135a-3p, and miR-135a-3p targeted UBR5. Additionally, UBR5 interacted with ATMIN to foster the ubiquitination of ATMIN, thereby expediting the malignant behaviors of NPC cells as well as the lung and inguinal lymph node metastases of NPC tumors in vivo. Together, our study uncovered the tumor-initiating and pro-metastatic role of circMAN1A2-miR-135a-3p-UBR5-ATMIN axis in NPC regulation that may be a potential therapeutic target for human NPC.

Cellular metabolic reprogramming is an important feature of malignant tumors. Metabolic reprogramming causes changes in the levels or types of specific metabolites inside and outside the cell, which affects tumorigenesis and progression by influencing gene expression, the cellular state, and the tumor microenvironment. During tumorigenesis, a series of changes in the glucose metabolism, fatty acid metabolism, amino acid metabolism, and cholesterol metabolism of tumor cells occur, which are involved in the process of cellular carcinogenesis and constitute part of the underlying mechanisms of tumor formation. Hyperthermia, as one of the main therapeutic tools for malignant tumors, has obvious effects on tumor cell metabolism. In this paper, we will combine the latest research progress in the field of cellular metabolic reprogramming and focus on the current experimental research and clinical treatment of hyperthermia in cellular metabolic reprogramming to discuss the feasibility of cellular metabolic reprogramming-related mechanisms guiding hyperthermia in malignant tumor treatment, so as to provide more ideas for hyperthermia to treat malignant tumors through the direction of cellular metabolic reprogramming.

Adamantinomatous craniopharyngioma (ACP) is a neuroendocrine tumor whose pathogenesis remains unclear. This study investigated the role of glioma-associated oncogene family zinc finger 1 (GLI1), a transcription factor in the sonic hedgehog (SHH) signaling pathway, in ACP. We discovered that GLI1 regulates the expression of IL-6, thereby triggering inflammatory responses in ACP and influencing the tumor's progression. Analyzing the Gene Expression Omnibus (GEO) database chip GSE68015, we found that GLI1 is overexpressed in ACP, correlating positively with the spite of ACP and inflammation markers. Knockdown of GLI1 significantly inhibited the levels of tumor necrosis factor α, interleukin-6 (IL-6), and IL-1β in ACP cells, as well as cell proliferation and migration. We further identified a binding site between GLI1 and the promoter region of IL-6, demonstrating that GLI1 can enhance the expression of IL-6. These findings were verified in vivo, where activation of the SHH pathway significantly promoted GLI1 and IL-6 expressions in nude mice, inducing inflammation and tumor growth. Conversely, GLI1 knockdown markedly suppressed these processes. Our study uncovers a potential molecular mechanism for the occurrence of inflammatory responses and tumor progression in ACP.

目的 探讨治疗前全身免疫炎症指数(systemic immune-inflammation index,SII)在结外 NK/T 细胞淋巴瘤(extranodal NK/T-cell lymphoma,ENKTCL)中的预后价值.方法 回顾性分析 2012 年 1 月至 2019 年 12 月郑州大学第一附属医院确诊为ENKTCL的 176 例患者的临床资料,采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)计算SII的最佳截断值,Cox比例风险回归模型进行多因素分析,Kaplan-Meier法进行生存分析.结果 ROC曲线得到SII最佳截断值为 796.74,曲线下面积为 0.752.Kaplan-Meier生存分析发现SII<796.74 组患者的总生存率显著高于SII≥796.74 组(χ2=28.662,P<0.001),两组患者的无进展生存率比较差异无统计学意义(χ2=0.756,P=0.384).单因素分析发现,国际预后指数(international prognostic index,IPI)评分、B症状、淋巴结侵犯、EBV-DNA均与患者的无进展生存相关(P<0.05),IPI评分、B症状、淋巴结侵犯、EBV-DNA、SII均与患者的总生存相关(P<0.05);Cox多因素分析发现,有B症状(HR=2.636)、有淋巴结侵犯(HR=2.381)、EBV-DNA≥500copies/ml(HR=2.212)均是影响患者无进展生存的独立危险因素;有B症状(HR=2.378)、SII≥796.74(HR=2.501)均是影响患者总生存的独立危险因素.结论 SII是影响ENKTCL患者预后的独立危险因素,且SII值较高的患者整体生存预后较差.

目的 探讨早期宫颈癌患者术后放疗效果与影响预后的因素.方法 选取83 例早期宫颈癌患者,所有患者均行手术治疗,在术后均行放疗,观察放疗效果,并随访3 年,观察所有患者的生存情况.同时应用多因素Logistic回归分析模型探究影响患者预后的有关因素.结果 83 例早期宫颈癌患者,经放疗后,完全缓解30 例(36.14%),部分缓解49 例(59.04%),疾病稳定3 例(3.61%),疾病进展1 例(1.20%),治疗总有效率为95.18%(79/83);随访3 年,83 例患者共存活70 例,存活率为84.34%(70/83);单因素分析显示:年龄、体重指数(BMI)、病理类型、治疗前血清鳞状细胞癌抗原(SCC-Ag)水平、临床分期与早期宫颈癌患者预后无关(P＞0.05);而分化程度、淋巴结转移、合并心血管并发症、肿瘤直径与早期宫颈癌患者预后有关(P＜0.05);多因素分析显示:低分化、有淋巴结转移、合并心血管并发症、肿瘤直径＞4cm为早期宫颈癌患者预后的独立影响因素(P＜0.05).结论 早期宫颈癌患者行放疗后可获得确切疗效,获得较高的生存率,而低分化、有淋巴结转移、合并心血管并发症、肿瘤直径＞4cm为影响预后的重要因素,临床需予以高度重视,积极采集规范的措施进行干预,从而最大程度地确保患者身心健康.