Sarcopenia can affect the efficacy of neoadjuvant chemotherapy or chemoradiotherapy for esophageal squamous cell carcinoma. However, the extent of this relationship in patients treated with neoadjuvant immunochemotherapy has not been fully explored. A retrospective cohort study was conducted on 150 patients with locally advanced esophageal squamous cell carcinoma who underwent two or three cycles of neoadjuvant immunochemotherapy, followed by surgical resection. We analyzed the correlation between clinicopathological factors—including sarcopenia before neoadjuvant immunochemotherapy and excessive muscle loss during neoadjuvant therapy—and the occurrence of pathologic complete response. Before neoadjuvant immunochemotherapy, 55.3

Background Esophageal cancer, specifically esophageal squamous cell carcinoma (ESCC), poses a significant health challenge characterized by a poor prognosis and high mortality rates. Surgical interventions, such as minimally invasive esophagectomy, are the primary treatment approach; however, the occurrence of postoperative complications, particularly pneumonia, presents substantial risks. Small airway disease (SAD) affecting the bronchioles’ small airways is a frequently underestimated respiratory condition with potential implications for the postoperative outcomes of ESCC patients. Method From January 2020 to December 2023, the McKeown procedure was exclusively utilized as the treatment modality for resectable esophageal squamous cell carcinoma patients in this retrospective study. Rigorous diagnostic criteria for small airway disease and postoperative pneumonia were employed, followed by detailed statistical analyses using logistic regression models with adjustments for confounding variables. Both multivariate and univariate logistic regression analyses were performed to identify the independent risk factors contributing to postoperative pneumonia incidence. Results A total of 293 participants were included in the analysis. Baseline characteristic analysis revealed that individuals with small airway disease exhibited impaired small airway function, lower pre-albumin levels, a higher incidence of pulmonary infection, and longer hospital stays compared to those without SAD. Univariate logistic analysis identified SAD as a strong independent predictor for postoperative pneumonia, with individuals with SAD having a significantly higher risk compared to those without SAD. Multivariate logistic analysis further confirmed this association, demonstrating a robust relationship between SAD and postoperative pneumonia risk even after adjusting for confounding factors. Conclusion The preoperative identification of SAD is significantly associated with an increased risk of postoperative pneumonia in resectable ESCC patients, highlighting the importance of addressing small airway disease in perioperative management to enhance clinical outcomes. These findings underscore the significance of recognizing and managing SAD as a potential risk factor in strategies for preventing and managing postoperative pneumonia.

BackgroundPostoperative pulmonary complications (PPCs) remain a major source of morbidity after McKeown esophagectomy for esophageal squamous cell carcinoma (ESCC), particularly in patients receiving neoadjuvant chemoimmunotherapy (nICT). Readily available preoperative biomarkers may improve risk stratification. This study evaluated the predictive value of the aggregate index of systemic inflammation (AISI), the C-reactive protein-albumin-lymphocyte (CALLY) index, and their combined use for PPCs after McKeown esophagectomy following nICT.MethodsWe retrospectively analyzed 412 consecutive ESCC patients who underwent McKeown esophagectomy after nICT between January 2019 and December 2025. The primary endpoint was PPCs within 30 days after surgery. Univariable and multivariable logistic regression analyses were used to examine associations between preoperative biomarkers and PPCs. A combined AISI-CALLY model was constructed using binary logistic regression, and its predictive performance was assessed by receiver operating characteristic (ROC) analysis, DeLong testing, calibration analysis, and decision curve analysis. Propensity score matching (PSM) was performed as a sensitivity analysis.ResultsPPCs occurred in 157 of 412 patients (38.1%). In the fully adjusted model, both AISI and CALLY remained independently associated with PPCs. Higher AISI was associated with increased PPC risk (adjusted odds ratio [aOR] 1.195 per 100-unit increase, 95% CI 1.081-1.321, P < 0.001), whereas higher CALLY was associated with lower risk (aOR 0.926 per 1-unit increase, 95% CI 0.884-0.970, P = 0.001). The biomarker-only AISI-CALLY model achieved an AUC of 0.689, compared with 0.650 for AISI alone and 0.665 for CALLY alone. The final integrated model incorporating clinical variables, AISI, and CALLY showed the best discrimination (AUC 0.712, 95% CI 0.658-0.762) and provided greater net benefit on decision curve analysis. In the matched cohort, both biomarkers remained independently associated with PPCs, although discrimination was attenuated.ConclusionPreoperative AISI and CALLY were independently and complementarily associated with PPCs after McKeown esophagectomy following nICT. Their combined use provided only modest incremental predictive value and may serve as an accessible adjunct, rather than a stand-alone tool, for preoperative PPC risk stratification.

Macrophages are key immune cells that regulate the body's immune response by promoting the release of inflammatory cytokines upon recognition of both endogenous and exogenous pathogens. USP14, a critical deubiquitinase, plays a vital role in various cellular processes, especially in modulating immune responses. This study aims to investigate the role of USP14 in regulating macrophage immune responses. USP14 overexpression and knockdown were performed in RAW264.7 cells and mouse bone marrow macrophages via plasmid transfection and lentiviral infection, respectively. Our research demonstrates that USP14 overexpression amplified the LPS-induced inflammatory response and promoted macrophage migration, whereas USP14 knockdown produced the opposite effects. USP14 interacts with NLK, thereby attenuating Wnt/β-catenin signaling and concurrently activating the NF-κB pathway in macrophages. USP14 facilitates the deubiquitination of NLK, thereby stabilizing its activity. Moreover, the USP14 inhibitor IU1 reduces the LPS-induced inflammatory response in macrophages. Mechanistically, macrophage USP14 facilitates the deubiquitination of NLK, thereby maintaining its activity, inhibiting the Wnt/β-catenin pathway, activating the NF-κB pathway, and enhancing the cellular immune response.

Esophageal squamous cell carcinoma (ESCC) is a prevalent malignancy with a high mortality rate, for which esophagectomy remains the cornerstone of curative treatment. However, this complex surgical procedure is associated with significant postoperative morbidity and mortality. Nutritional status and systemic inflammatory response are critically intertwined and play a pivotal role in the host's ability to withstand surgical stress and mount an effective recovery. This review aims to provide a comprehensive overview of the role of nutritional and inflammatory markers in predicting postoperative complications following esophagectomy for ESCC. We first elucidate the intricate biological mechanisms through which malnutrition and systemic inflammation compromise tissue repair, immune function, and overall surgical outcomes. We then systematically evaluate the predictive value of various individual markers, such as albumin, C-reactive protein (CRP), and neutrophil-to-lymphocyte ratio (NLR), as well as combined scoring systems like the Prognostic Nutritional Index (PNI) and the Glasgow Prognostic Score (GPS). The clinical application of these markers in preoperative risk stratification, guiding perioperative immunonutrition, and dynamic monitoring for early complication detection is thoroughly discussed. Finally, we highlight future perspectives, including the integration of novel biomarkers from metabolomics and proteomics, the application of artificial intelligence in building sophisticated prediction models, and the design of marker-guided precision intervention trials. A deeper understanding and smarter utilization of these readily available and cost-effective markers will pave the way for personalized perioperative management, ultimately improving the prognosis for patients with ESCC undergoing esophagectomy.

Background:Myeloid Zinc Finger 1 (MZF1) is a zinc finger transcription factor gene that regulates gene expression by recognizing and binding to specific DNA sequences. Preliminary studies have suggested that MZF1 plays a pivotal role in the invasion and metastasis of various solid cancers. However, its role within the tumor immune microenvironment, as well as its prognostic value and potential for predicting responses to immunotherapy across different cancer types, remains inadequately explored and warrants a comprehensive systematic analysis. Methods:MZF1 expression levels in various cancers were obtained from the Cancer Genome Atlas (TCGA) database. The TISCH web tool analyzed MZF1 expression in 32 cell types. A spatial distribution map of MZF1 related to cancer tissue markers was created using the STOmics DB. A univariate Cox regression analysis was performed to evaluate MZF1's prognostic value. The cBioPortal database helped explore potential MZF1 mutations across cancer types. The TIMER2.0 database was used to study the relationship between MZF1 expression and immune cell infiltration. Gene Set Enrichment Analysis (GSEA) and Gene Set Variation Analysis (GSVA) were performed to elucidate signaling pathways modulated by MZF1. Drug sensitivity testing for MZF1 was done using the CellMiner, the Cancer Therapeutics Response Portal (CTRP), and the Genomics of Drug Sensitivity in Cancer (GDSC) databases. Finally, MZF1 knockdown was achieved with siRNA silencing. Results:Changes in MZF1 expression are linked to the prognosis of most cancer patients. In the tumor microenvironment, MZF1 is mainly found in CD4 Tconv cells and monocytes/macrophages. Studies show that MZF1 is associated with cancer immunotherapy markers, immune cell infiltration, and immune modulators. Additionally, its role in immune regulation was confirmed through analysis of StromalScore, ImmuneScore, ESTIMATE, and immune infiltration. Molecular docking identified MZF1-targeted drugs, with validated effects on breast cancer and gastric cancer cell survival and migration in vitro. Lastly, the knockdown of MZF1 can suppress cancer cell migration. Conclusion:Collectively, these findings underscore the pivotal role of MZF1 in tumor biology and immune modulation. MZF1 emerges as a promising prognostic biomarker and potential therapeutic target, offering novel avenues for cancer treatment strategies.

It remains undetermined regarding the impact of neoadjuvant therapy on immunogenic cell death (ICD) and subsequent tumor microenvironment (TME) remodeling in esophageal squamous cell carcinoma (ESCC). And it is of paramount significance to identify beneficiaries from neoadjuvant therapy in treatment-naïve ESCC. In this study, 88 ESCC samples undergoing neoadjuvant therapy plus surgery (NA+S) or surgery alone (SA) were subjected to bulk-RNA sequencing. A five-gene RINscore incorporating ICD-related signature genes with TME-based hub genes was established to predict clinical outcomes and pharmacological responses, in which SLAMF7 and IL1R1 were selected out as co-expressed genes. The regulatory mechanism of the repressive co-transcription factor BATF of SLAMF7 and IL1R1 was further demonstrated. Our data demonstrated that NA+S led to high abundance in kinds of T helper cells, nature killer T cells and M1-like macrophages with increased CD8+T cells infiltration compared with SA. ICD phenotypes were further characterized in treatment-naïve ESCC to determine their differences in TME and potential benefits from NA. Our findings not only offered novel insights into the distinct TME and ICD profiles of ESCC undergoing different therapeutic modes, but also provided the RINscore, which may aid oncologists in determining individualized (neo)adjuvant immunotherapy regimen.

GMIP, a member of the RhoGAP family, plays a critical role in cytoskeletal remodelling, cell migration and immune modulation. Its aberrant expression in cancers suggests a pivotal role in tumour progression. GMIP expression was assessed using transcriptomic datasets from GDC and UCSC XENA, and protein distribution across tissues via HPA and GeneMANIA. The TISCH database identified primary GMIP-expressing cell types in the tumour microenvironment. Univariate Cox regression assessed GMIP's prognostic potential, while cBioPortal and GSCA explored genomic alterations. TIMER 2.0 was used to investigate immune cell infiltration and GMIP's role in immune regulation. GSEA and GSVA unveiled GMIP-related biological pathways, and molecular docking with CellMiner identified potential drug interactions. In vitro assays confirmed GMIP's functional relevance in breast cancer. GMIP exhibits differential expression across multiple cancer types, demonstrating significant prognostic implications. Its expression is inversely correlated with CNV and methylation in several cancers. GMIP is closely linked to immunotherapy biomarkers and immune suppression, influencing therapeutic responses. Functional studies suggest that GMIP inhibition reduces cancer cell proliferation and migration. GMIP is identified as a promising oncological biomarker, particularly in breast cancer, with potential therapeutic implications. GMIP's therapeutic potential is especially pronounced in BRCA-mutated tumours, underscoring its relevance for novel anticancer interventions.

BackgroundThe clinical value of preoperative immunochemotherapy and simple chemotherapy induction regimen in the conversion therapy of locally advanced unresectable esophageal squamous cell carcinoma (ESCC) is still unclear.MethodRetrospective analysis was conducted on patients with unresectable cT4b stage ESCC who underwent conversion surgery in our hospital from January 2020 to December 2022. According to the preoperative induction treatment plan, they were divided into induction immunochemotherapy group (iICT group) and induction chemotherapy group (iCT group). The conversion surgery rate, R0 resection rate, radiological and pathological tumor responses, safety, and short-term survival outcomes were analyzed.ResultsThe results showed that a total of 199 patients with cT4b locally advanced unresectable ESCC who underwent preoperative induction therapy were included in this study. Among them, there were 64 cases (32.2%) in the iICT group, 135 cases (67.8%) in the iCT group. There was a statistically significant difference in objective response rate (73.5% vs 48.9%) and conversion surgery rate (81.3% vs 66.7%), between the iICT and iCT groups (P=0.001 and P=0.019). Among the two groups of patients who underwent surgery, there were statistically significant differences in R0 resection rate (94.2% vs 82.2%) and pathological complete remission rate (23.1% vs 6.7%) between the iICT and iCT groups (P=0.043 and P=0.004). And there was no statistically significant difference in the incidence of grade 3 and above between two groups (P=0.928). The 2-year EFS of the iICT group and iCT group were 76.4% and 42.4%, respectively, with statistically significant differences (P=0.006).ConclusionsCompared with simple chemotherapy, the combination of PD-1 inhibitors and chemotherapy can achieve better conversion surgery rate, tumor response and event-free survival in the conversion therapy of locally advanced unresectable ESCC.

OBJECTIVE:CENPF-differentially expressed in various types of cancers-is a marker of poor prognosis. However, studies on the impact of CENPF on patient prognosis in lung adenocarcinoma regarding immune infiltration are lacking.METHODS:CENPF expression profiles were analyzed in the GEO and TCGA databases. qRT-PCR was used to verify CENPF mRNA expression in lung adenocarcinoma cell lines. The prognostic value of CENPF was evaluated by combining data from clinical samples in the GEPIA2 and TCGA databases. Metascape and WebGestalt were used for enrichment analysis of gene sets most positively associated with CENPF. Immune cell infiltration score data were retrieved from TCGA and the correlation between CENPF expression and immune cell infiltration was analyzed.RESULTS:CENPF expression was elevated in 29 types of cancer. CENPF was highly expressed and increased with tumor grade in lung adenocarcinoma. Immunohistochemical and qRT-PCR analyses revealed that CENPF expression was upregulated in lung adenocarcinoma tissues and cells. High expression of CENPF significantly worsened prognoses in patients with multiple malignancies, including lung adenocarcinoma. Results from gene set enrichment analysis indicated significant enrichment of the progesterone-mediated oocyte maturation pathway. Immune infiltration analysis revealed that CD4+ Th2 cell infiltration was significantly higher in the high CENPF expression group.CONCLUSION:Upregulation of CENPF expression was related to poor progression-free survival, disease- free survival, and overall survival in patients with lung adenocarcinoma. High expression of CENPF was markedly related to genes associated with the immune checkpoint. Lung adenocarcinoma samples with high CENPF expression had increased CD4+ Th2 cell infiltration. Our findings indicate that CENPF promotes CD4+ Th2 cell infiltration through oncogenic activity and may be used as a biomarker for predicting patient outcomes in lung adenocarcinoma.

目的 探讨肌少症对食管鳞癌围手术期临床结局的影响.方法 采用回顾性病例对照研究方法.收集2020年1月至2021年12月南京医科大学附属淮安第一人民医院收治的1 148例食管鳞癌患者的临床病理资料;男789例,女359例;年龄为(67±7)岁.所有患者行胸腹腔镜联合食管癌根治术.观察指标:(1)食管鳞癌患者并发肌少症情况.(2)食管鳞癌并发肌少症患者与食管鳞癌非肌少症患者的一般资料比较.(3)食管鳞癌并发肌少症患者与食管鳞癌非肌少症患者的临床结局比较.(4)食管鳞癌患者并发肌少症的影响因素分析.正态分布的计量资料以(x)±s表示,组间比较采用t检验;计数资料以绝对数表示,组间比较采用x2检验;等级资料采用Mann-Whitney U检验.单因素分析采用Logistic回归分析,多因素分析采用Logistic逐步回归向后模型.结果 (1)食管鳞癌患者并发肌少症情况.1 148例食管鳞癌患者中,469例并发肌少症,679例非肌少症,肌少症发生率为40.854％(469/1 148).469例并发肌少症患者中,男313例,女156例;年龄＜65岁、≥65岁且＜70岁、≥70岁且＜75岁、≥75岁分别为125、145、106、93例.(2)食管鳞癌并发肌少症患者与食管鳞癌非肌少症患者的一般资料比较.469例食管鳞癌并发肌少症患者的年龄,肿瘤长径,体质量指数,T分期(T1期、T2期、T3期),术前白蛋白,术前血清前白蛋白,腰大肌指数,腰大肌密度分别为(68±7)岁,(3.3±1.5)cm,(22.4±2.9)kg/m2,100、105、264例、(43±4)g/L,(193±38)mg/dL.(3.9±0.8)cm2/m2,(48±8)HU;679例食管鳞癌非肌少症患者上述指标分别为(66±7)岁,(3.2±1.4)cm,(23.8±3.0)kg/m2,173、170、336例,(44± 4)g/L,(206±37)mg/dL,(6.0±2.2)cm2/m2,(50±7)HU,两者上述指标比较,差异均有统计学意义(t=5.74、2.11、7.57,Z=-2.93,t=2.25、5.52、20.36、4.18,P＜0.05).(3)食管鳞癌并发肌少症患者与食管鳞癌非肌少症患者的临床结局比较.469例食管鳞癌并发肌少症患者的术后住院时间、术后住院时间＞30 d、肺炎、急性呼吸衰竭、吻合口瘘、心律失常例数分别为(17±9)d、32例、158例、39例、33例、103例,679例食管鳞癌非肌少症患者上述指标分别为(15±6)d、15例、102例、18例、19例、85例,两者上述指标比较,差异均有统计学意义(t=4.89,x2=15.04、55.17、18.86、11.52、18.06,P＜0.05).(4)食管鳞癌患者并发肌少症的影响因素分析.多因素分析结果显示:年龄≥65岁是食管鳞癌患者并发肌少症的独立危险因素(优势比=1.64,95％可信区间为1.26～2.14,P＜0.05);术前血清前白蛋白≥200mg/dL、腰大肌密度≥48 HU和体质量指数＞24 kg/m2是食管鳞癌患者并发肌少症的独立保护因素(优势比=0.64、0.72、0.53,95％可信区间为0.50～0.82、0.56～0.92、0.41～0.69,P＜0.05).结论 年龄≥65岁是食管鳞癌患者并发肌少症的独立危险因素,而术前血清前白蛋白≥200 mg/dL、腰大肌密度≥48 HU和体质量指数＞24 kg/m2是食管鳞癌患者并发肌少症的独立保护因素.与食管鳞癌非肌少症患者比较,食管鳞癌并发肌少症患者术后更易发生肺炎、急性呼吸衰竭、吻合口瘘、心律失常等并发症,且术后住院时间更长.

Objective:To investigate the clinical application value of radiochemotherapy conversion therapy in unresectable locally advanced esophageal cancer.Methods:A total of 298 patients with unresectable locally advanced esophageal cancer who received radiochemotherapy with or without surgery from 2010 to 2016 were screened in the U.S. Surveillance, Epidemiology, and End Results (SEER) 18 oncology database, and the patients were divided into the conversion therapy group (received surgery after radiotherapy, 83 cases) and the radiochemotherapy group (215 cases) according to whether they were operated after radiotherapy. A 1∶1 propensity matching analysis was conducted on the two groups of patients using R language. The information of age, gender, race, T stage, G stage, pathological type and N stage of the patients in the two groups before and after matching was compared. The Kaplan-Meier method was used for survival analysis to compare the cancer specific survival and overall survival (OS) between the two groups before and after matching. A multivariate Cox proportional hazards model was used to analyze the influencing factors of prognosis of patients with unresectable locally advanced esophageal cancer.Results:There were statistically significant differences in gender, race, G stage, pathological type, T stage, and N stage between the conversion therapy group and the radiochemotherapy group before matching (all P < 0.05). There was no statistically significant difference in clinicopathological characteristics between the conversion therapy group and the radiochemotherapy group after matching (all P > 0.05). Before matching, the median OS time of patients in the conversion therapy group was 23 months; the 1-year, 2-year, 3-year, and 5-year OS rates were 68.9%, 42.9%, 24.7%, and 19.8%, respectively; the 1-year, 2-year, 3-year, and 5-year cancer specific survival rates were 68.9%, 45.0%, 28.0%, and 28.0%, respectively. The median OS time of patients in the radiochemotherapy group was 12 months; the 1-year, 2-year, 3-year and 5-year OS rates were 44.5%, 20.5%, 14.0%, and 6.0%, respectively; the 1-year, 2-year, 3-year and 5-year cancer specific survival rates were 46.4%, 21.8%, 14.9%, and 9.1%, respectively. Compared with the radiochemotherapy group, patients in the conversion therapy group had a better cancer specific survival ( χ2 = 15.01, P = 0.001) and OS ( χ2 = 14.85, P < 0.001). After matching, cancer specific survival ( χ2 = 5.06, P = 0.024) and OS ( χ2 = 6.12, P = 0.013) of the conversion therapy group were still superior to the radiochemotherapy group. The results of multivariate Cox regression analysis showed that the cancer specific survival risk and overall survival risk in the radiochemotherapy group were 1.874 times (95% CI 1.275-2.755, P = 0.001) and 1.790 times (95% CI 1.235-2.593, P = 0.002) higher than those in the conversion therapy group. Conclusions:Radiochemotherapy conversion therapy can improve the prognosis of patients with unresectable locally advanced esophageal cancer.

It was to explore the effect of neoadjuvant therapy (NAT) on serum-related indicators and prognosis of patients with locally advanced esophageal cancer (EC). 400 EC patients were grouped as controls (295 cases, radical EC resection alone) and research group (105 cases, NAT plus radical EC resection). The levels of serum carbohydrate antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA), and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), programmed death-1 (PD-1), PD-2, transforming growth factor-β1 (TGF-β1), and squamous cell carcinoma (SCC) antigen were detected before and after treatment. The follow-up lasted for 3 years. The quality of life (QoL) was evaluated by QLQ-OES24. The recurrence rate, recurrence time, overall survival rate (SR), disease-free SR, and complication rate were compared. Compared with controls, the levels of serum CA19-9, CEA, CYFRA21-1, PD-1, PD-2, TGF-β1, and SCC were decreased, the QoL score was increased 3 years post-treatment, and the recurrence time was prolonged in the research group (P<0.05). The R0 resection rate, recurrence rate, 3-year overall SR, and disease-free SR of the two groups were 67.12% vs 85.71%, 21.36% vs 6.67%, 56.27% vs 77.14%, 29.83% vs 45.71%, respectively (P<0.05). The complication rates of the two groups were 32.54% and 29.52%, respectively (P>0.05). NAT plus radical resection of EC can effectively reduce the level of serum oncology markers in patients with locally advanced EC, reduce the postoperative recurrence rate, improve QoL and SR, and has high safety.

ObjectivesThe objective of this study is to investigate whether the evaluation of postoperative outcomes or overall survival in patients who undergo surgery for esophageal cancer can be achieved by assessing sarcopenia using psoas muscle mass index and peak expiratory flow.MethodsThis retrospective study analyzed the clinical data of 356 elderly patients (≥ 65 years) who had undergone radical surgery for esophageal cancer. Muscle mass and muscle strength were assessed by psoas muscle mass index (bilateral psoas area/height2) and peak expiratory flow, using preoperative computed tomography and spirometry, respectively. Sarcopenia is defined as a condition where both the psoas muscle mass index and peak expiratory flow fall below their gender-specific cutoff values. Survival and postoperative complications were compared between patients with and without sarcopenia.ResultsOut of the 356 elderly individuals diagnosed with esophageal cancer, 84 patients (23.6%) were found to have sarcopenia. The group with sarcopenia showed a notably higher occurrence of postoperative pneumonia (29.8% vs 16.9%, P < 0.001) and anastomotic leak (9.5% vs 3.7%, P < 0.05) compared to those without sarcopenia. Additionally, a multivariate analysis concluded that sarcopenia independently acted as a risk factor for postoperative pneumonia, possessing an odds ratio of 1.90 (P < 0.05). The survival rate after 3 years for individuals with sarcopenia was considerably lower than those without sarcopenia (57.8% vs 70.2%, P < 0.05). Sarcopenia was identified as an unfavorable prognostic factor for overall survival, with a hazard ratio of 1.51 (P < 0.05).ConclusionsPreoperative sarcopenia diagnosed by psoas muscle mass index and peak expiratory flow is associated with reduced overall survival and adverse postoperative outcomes among elderly individuals suffering from esophageal cancer.

目的 探讨放化疗在初治不可手术切除的ⅢB期非小细胞肺癌(non-small cell lung cancer,NSCLC)转化治疗中的应用价值.方法 选择2004年-2016年美国国家癌症研究所监测、流行病学和最终结果(surveillance,epidemiology,and end results program,SEER)数据库收录的接受放化疗或放化疗后再行手术的4364例ⅢB期NSCLC患者资料纳入研究,根据放疗后是否接受手术治疗分为转化治疗组(n=147例)和放化疗组(n=4217例).转化治疗组接受放化疗后再行手术治疗,放化疗组接受单独放化疗治疗,分析并比较转化治疗对ⅢB期NSCLC患者预后的影响,同时采用1:2倾向性匹配方法分析两组患者预后情况.结果 转化治疗组肿瘤特异性生存、总体生存均明显优于放化疗组,差异有统计学意义(χ2=56.658、57.725,P<0.001);多因素Cox回归分析提示,放化疗组肿瘤特异性死亡风险及总体死亡风险分别是转化治疗组的2.306(95％CI 1.840～2.891,P<0.001)倍、2.168(95％CI 1.760～2.671,P<0.001)倍.1:2倾向性匹配后分析提示,转化治疗组肿瘤特异性生存、总体生存均明显优于放化疗组,差异有统计学意义(χ2=42.281、41.520,P<0.001).结论 放化疗转化治疗后的手术治疗能够明显改善不可切除的ⅢB期NSCLC患者的预后.

目的 探讨卡瑞利珠单抗联合化疗在初治不可切除的局部晚期食管癌转化治疗中的应用价值.方法 我院2020年2月～2021年12月收治初治不可切除的局部晚期食管鳞癌病人行转化治疗22例,采用描述性病例系列研究.术前予以卡瑞利珠单抗+白蛋白紫杉醇+顺铂方案行3～4周期治疗;经多学科联合会诊后评估为可R0切除的病人行手术治疗.分析病人转化治疗的效果、不良反应及手术情况.结果 经免疫联合化疗的诱导治疗后,22例病人中有6例完全缓解、14例部分缓解,客观缓解率为90.91％(20/22);16例病人经转化治疗后选择行手术治疗,手术转化率为72.73％(16/22);R0手术切除率为93.75％(15/16).结论 卡瑞利珠单抗联合化疗在初治局部晚期不可切除食管癌转化治疗中可以获得较好的临床缓解和较高的手术转化率.

Objective:To explore the effect of chemotherapy on prognosis of patients with non-small cell lung cancer (NSCLC) undergoing total pneumonectomy.Methods:This non-random sampling cohort study included NSCLC patients undergone total pneumonectomy in the US National Cancer Institute′s Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2016, Efficacy analysis of chemotherapy were performed on the two groups which comprised pneumonectomy group, 491 (received pneumonectomy alone), combined chemotherapy group, 573 (received pneumonectomy + chemotherapy); and the prognosis of patients was analyzed by 1∶1 propensity score matching.Results:The overall survival rate (30.1% vs 16.8%, χ2=79.30, P<0.001) and cancer-specific survival rate (38.5% vs 34.3%, χ2=38.31, P<0.001) in combined chemotherapy group were increased than those in pneumonectomy group.Totally 329 pairs of NSCLC patients treated by pneumonectomy combined with chemotherapy or single pneumonectomy were obtained after propensity score matching.The overall survival (30.9% vs 17.7%, χ2=52.70, P<0.001) and cancer specific survival (39.8% vs 34.4%, χ2=27.38, P<0.001) were better in combined chemotherapy group than in pneumonectomy group.Stepwise multiple Cox regression model analysis showed that adjuvant chemotherapy was an independent factor affecting the overall survival or cancer specific survival of postoperative patients, whether before or after matching. Conclusions:Combined chemotherapy can improve the postoperative prognosis of NSCLC patients.

目的:探讨术后辅助化疗对T2 N0期行肺癌根治术的大细胞类肺癌患者预后的影响.方法:将美国SEER数据库2004年-2016年间收录的接受肺癌根治术的T2N0期311例病理类型为大细胞癌或大细胞神经内分泌癌的肺癌患者资料纳入研究,其中接受行肺癌根治术联合化疗的有96例(手术+化疗组),仅接受肺癌根治术的有215例(单纯手术组).分析并比较辅助化疗对T2N0期行肺癌根治术的大细胞类肺癌患者预后的影响,同时采用1:1倾向性匹配方法分析两组患者预后情况.结果:倾向性匹配前,与单纯手术组相比,手术+化疗组的总预后及肿瘤特异性预后均有明显优势(P<0.05);多因素Cox回归分析提示治疗方式是影响本组患者总预后及肿瘤特异性预后的关键因素(P<0.05),而病理类型对预后的影响较小(P>0.05).倾向性匹配后亚组分析发现,手术+化疗组的总预后及肿瘤特异性预后均明显优于单纯手术组(P<0.05);多因素Cox回归分析提示,治疗方式和年龄是影响本组患者总预后及肿瘤特异性预后的关键因素(P<0.05).结论:辅助化疗能够明显改善T2N0期大细胞类型肺癌患者的预后,值得临床推荐.

目的 探讨集束化干预策略在胃癌患者围手术期营养支持中的临床价值.方法 收集2016年6月—2018年5月在南京医科大学附属淮安第一医院行胃癌根治术的患者200例,其中2017年6月—2018年5月共100例胃癌患者围手术期采用集束化干预策略进行营养干预(研究组);2016年6月—2017年5月共100例胃癌患者围手术期按常规营养支持处理(对照组).结果 2组患者术前营养评估及实验室指标的营养状况对比差异无统计学意义(P>0.05);研究组患者术后第7天营养评分、白蛋白及前白蛋白指标明显优于对照组,差异有统计学意义(P<0.05);研究组并发症的发生率明显低于对照组(χ2=4.348,P=0.037);与对照组相比,研究组术后肛门首次通气时间、术后首次排便时间、术后住院时间均显著缩短,住院总费用明显减少,差异均有统计学意义(P<.05).结论 胃癌患者围手术期的快速康复依赖于充分的营养支持.集束化营养干预策略的运用可有效改善胃癌患者术后的营养状态、减少并发症发生和改善患者临床结局.

1Department of Emergency Surgery, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huai’an, Jiangsu, People’s Republic of China; 2Department of Emergency, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People’s Republic of China; 3Department of Cardio-Thoracic Surgery, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huai’an, Jiangsu, People’s Republic of China; 4Department of General Surgery, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huai’an, Jiangsu, People’s Republic of China Background and Objectives: RING finger protein 38 (RNF38) has been reported to be