e16000 Background: Pancreatic ductal adenocarcinoma (PDAC) remains a lethal malignancy with limited therapeutic options. Dysregulation of metal ion homeostasis is implicated in tumor progression and therapy resistance. This study aims to systematically identify metal ion transport-related prognostic genes, construct a reliable risk model, and discover novel therapeutic agents using artificial intelligence. Methods: Transcriptomic data from GEO databases (GSE183795 as training set, GSE28735 as validation set) and single-cell RNA-seq data (GSE155698) were analyzed. Differential expression analysis, functional enrichment, and protein-protein interaction networks were constructed. A prognostic risk signature was developed using LASSO-Cox regression. The tumor immune microenvironment was characterized using CIBERSORT. An innovative GraphBAN model integrated with CNN, ESM, GCN, and ChemBERTa was employed for drug prediction, followed by molecular docking. Single-cell analyses including trajectory inference and cell-cell communication were performed. Results: We identified and validated a five-gene prognostic signature (SLC20A1, SLC39A10, SLC5A3, SLC11A1, SLC4A4) significantly associated with overall survival in PDAC. The risk model demonstrated robust predictive power in both training (3-year AUC = 0.73) and external validation cohorts (5-year AUC = 0.97). High-risk patients exhibited an immunosuppressive microenvironment characterized by M2 macrophage infiltration. GraphBAN prediction and molecular docking identified Elephantin and Sinularin as high-affinity binders to SLC39A10 and SLC4A4, respectively. Single-cell analysis revealed the specific expression dynamics of these genes in macrophage and neutrophil subpopulations and delineated their evolving roles along pseudotemporal trajectories. Conclusions: We established a novel metal ion transport-related gene signature as an independent prognostic indicator for PDAC. Our integrative AI-driven framework successfully predicted candidate drugs targeting this pathway, providing a promising strategy for personalized therapy and highlighting the therapeutic potential of modulating metal ion homeostasis in PDAC.

e15578 Background: Patients with RAS wild-type (RASwt) metastatic colorectal cancer (mCRC) progressing on first-line fluoropyrimidine-based chemotherapy plus anti-EGFR therapy have limited and often suboptimal second-line treatment options. Trifluridine/tipiracil (TAS-102) is an oral cytotoxic agent that inhibits tumor growth through incorporation into DNA and disruption of DNA function, potentially overcoming fluoropyrimidine resistance. We conducted a phase II study to evaluate the efficacy and safety of bevacizumab combined with TAS-102 and irinotecan in this setting. Methods: In this single-arm phase II trial (ChiCTR2100046678), patients with RASwt mCRC who progressed after first-line anti-EGFR therapy plus chemotherapy received TAS-102 (35 mg/m², days 1–5), bevacizumab (5 mg/kg), and irinotecan (180 mg/m²) every 2 weeks. The primary endpoint was progression free survival (PFS). Secondary endpoints included objective response rate (ORR), disease control rate (DCR), overall survival (OS), and safety. Results: From August 2021 to January 2026, 27 patients were enrolled. The median age was 59 years (range, 42-75), male accounted for 81.5%,Most patients (26/27) had an ECOG status of 1. As of data cutoff (January 2026), 24 patients had ≥1 postbaseline tumor assessment; 7 remained on treatment. Best overall responses included partial response in 5 patients (20.8%), stable disease in 18 (75.0%), and progressive disease in 1 (4.2%). The confirmed ORR was 20.8% (95% CI: 3.3–38.4%) and DCR was 95.8% (95% CI: 87.2–100.0%). With a median followup of [X] months, median PFS was 7.7 months (95% CI: 4.99–10.41) and median OS was 20.7 months (95% CI: 8.83–31.31). Grade ≥3 treatmentrelated adverse events (occurring in ≥5% of patients) were neutropenia (40%), leukopenia (24%), anemia (8%), and thrombocytopenia (8%). No treatmentrelated deaths were reported. Conclusions: The combination of bevacizumab, TAS-102, and irinotecan showed promising clinical activity and manageable toxicity as secondline therapy for RASwt mCRC patients who progressed on prior anti-EGFR-based treatment. These results support further evaluation of this regimen in randomized controlled trials. Clinical trial information: ChiCTR2100046678.

Metastatic colorectal cancer (mCRC) patients who progress following the standard chemotherapy have maintained a favourable performance status. Nevertheless, there are limited effective treatment options, particularly for a considerable proportion of tumours with a microsatellite-stable (MSS) phenotype. Based on strong preclinical evidence demonstrating the synergistic effect between an anti-PD-1 antibody, tislelizumab, and an anti-VEGFR1-3 antibody, surufatinib, we evaluated their efficacy and safety in this population of patients with treatment-refractory disease. This single-arm phase II study that recruited patients with histologically confirmed mCRC who had received ≥ 3 previous lines of systemic therapy. Critical eligibility criteria included an Eastern Cooperative Oncology Group performance status of 0 to 1 and measurable disease according to RECIST version 1.1. Patients were administered 200 mg tislelizumab intravenously every 3 weeks combined with surufatinib 250 mg orally once daily until progressive disease, intolerable toxicity, or withdrawal of consent. The primary endpoint was progression-free survival (PFS). The secondary endpoints were the disease control rate (DCR), overall survival (OS), objective response rate (ORR), and safety. Sixteen patients (median age, 58 years) were enrolled between March 2022 and April 2025. The study was prematurely terminated for futility at a pre-planned ad hoc analysis. Only one patient achieved stable disease with a DCR of 6.3

e15560 Background: A phase II study suggested that the combination of fruquintinib (Fru) and trifluridine/tipiracil (TAS-102) could prolong progression-free survival (PFS) and overall survival (OS). However, the benefits are limited due to tolerability associated with continuous administration. This study aimed to explore the efficacy and safety of intermittent administration of Fru and TAS-102 as a 3L treatment for mCRC patients(pts). Methods: This was a single-center, single-arm, phase II study (ChiCTR2300078241). The primary endpoint was objective response rate (ORR). Secondary endpoints included PFS, OS, disease control rate (DCR), and safety. The ORR was set to ≤1% in the null hypothesis using a two-sided αof 0.05. To reject the null hypothesis and achieve an expected ORR of 10% with an 80% power, a minimum of 29 pts was required. Considering a dropout rate of 15%, the study planned to enrol 35 mCRC pts who had failed two standard treatment regimens. Eligible pts received oral Fru (3 mg, once daily, on days 1-5 and 8-12) and TAS-102 (35 mg/m², twice daily, on days 1-5) every two weeks until disease progression or unacceptable toxicity occurred. Results: A total of 35 pts were enrolled between August 2023 and March 2025. The median age was 58 years (range: 19-77). RAS mutations were present in 54.3% of pts, 62.9% had left-sided colon or rectal cancer, 54.3%, 40.0% and 45.7% had liver metastases, peritoneal metastases and multiple metastases respectively. As of December 15, 2025, 33 pts had discontinued study treatment and 2 pts were ongoing treatment. The ORR and DCR were 11.4% (4/35) and 80.0% (28/35) respectively. The median PFS (mPFS) was 7.2 (95% CI: 5.0–9.4) months(m), and median OS was 18.2 (95% CI: 10.8–25.7) m. mPFS in RAS-mutant and RAS wild-type pts were 7.2 (95% CI: 4.3-10.1) m and 6.7 (95% CI: 2.9-10.6) m, respectively (p = 0.527), with ORRs of 15.8% and 7.7% respectively. mPFS in pts with and without liver metastases were 7.0 m (95% CI: 3.0-11.0) and 7.2 m (95% CI: 6.2-8.2), respectively (p = 0.315), with ORRs of 10.5% and 12.5% respectively. Patients without peritoneal metastases or multiple metastases obtained better mPFS (7.9 m vs. 4.4 m, p = 0.041 ; 7.9 m vs. 3.7 m, p = 0.017), with ORRs of 14.3% vs. 7.1% and 15.8% vs. 6.3%. Treatment-related adverse events (TRAEs) were generally manageable and tolerable. The most common hematological TRAEs (any grade, grades 3-4) included neutropenia (80.0%, 28.6%), leukopenia (68.6%, 22.9%), and anemia (51.4%, 5.7%). Non-hematological TRAEs were mostly grades 1-2, including anorexia (37.1%), fatigue (28.6%) and nausea (14.3%). One case of grade 3 hypertension was reported. No treatment-related deaths were observed. Conclusions: An intermittent Fru+TAS-102 schedule demonstrated encouraging activity with manageable toxicity in refractory mCRC. Clinical trial information: ChiCTR2300078241.

Camrelizumab (CAM) combined with apatinib plus chemotherapy as a first-line treatment shows good efficacy in advanced or metastatic esophageal squamous cell carcinoma (ESCC) patients. This study aimed to explore the potential of CAM combined with apatinib plus irinotecan (IRT) as a second-line treatment in advanced or metastatic ESCC patients. A total of 59 advanced or metastatic ESCC patients receiving CAM combined with apatinib plus IRT as second-line treatment were enrolled in this study between January 2020 and March 2024. The primary endpoint was progression-free survival (PFS), with secondary endpoints including overall survival (OS), the objective response rate (ORR), the disease control rate (DCR), and the assessment of toxicity. Concurrently, a model was constructed utilizing patients’ clinical characteristics and radiomic features to predict the patients’ prognoses. At the time of analysis, 58 patients were withdrawn due to disease progression (n = 9), death (n = 43), or lost to follow-up (n = 6), and 1 patient was ongoing. The ORR and DCR were 37.7

INTRODUCTION:Following resection for gastroesophageal cancer, patients may experience symptoms like reflux, anorexia, and weight loss that can significantly impact their quality of life (QoL). Patient-reported outcomes (PROs) are becoming more important for symptom monitoring. Nevertheless, there is limited knowledge on symptom management post-gastroesophageal cancer resection. METHODS:A single-center, randomized controlled trial was conducted on postoperative patients with gastroesophageal cancer. Participants were randomly assigned to the PRO group and usual care (the control group), with a 1:1 ratio. The PRO-based symptom management included symptom assessment, monitoring, and personalized interventions such as lifestyle guidance, nutritional support, and drug therapy. An electronic system was developed on the Research Electronic Data Capture (REDCap) platform to monitor and assess patients' symptoms, QoL, and provide diagnosis and treatment. The study focused on five key symptom events: anorexia, reflux, depression, nutritional risk, and underweight. In the PRO group, assessments were conducted every 3-4 weeks for a minimum of 16 weeks. Interventions for this group primarily involved counseling, patient education, and medication prescriptions based on individual symptoms. The control group's symptoms and QoL were assessed only at baseline and week 16. The primary outcome measure was the total number of symptoms at 16 weeks, with secondary outcomes including the incidence of symptoms at the same time point. QoL was also evaluated as part of the study. RESULTS:Between April 2021 and May 2022, a total of 124 patients were divided into two groups: 60 in the PRO group and 64 in the control group. The PRO group exhibited notably fewer overall symptoms at the 16-week mark compared to the control group (1.20 ± 1.16 vs. 2.50 ± 1.47), along with a lower prevalence of nutritional risk (63.3% vs. 81.3%), anorexia (18.3% vs. 60.9%), reflux (13.3% vs. 57.8%), and depression (5.0% vs. 20.3%). The QoL scores were markedly higher in the PRO group. Furthermore, the PRO group displayed lower nutritional status, reflux, and depression scale trends, as well as higher anorexia trends when compared to the control group. CONCLUSIONS:PRO-based symptom management led to superior symptom control and enhanced QoL in postoperative gastroesophageal cancer patients when compared to standard care.

目的 探讨多形性腺瘤基因1(PLAG1)在结直肠癌(CRC)组织中的表达情况,分析其表达水平与CRC患者临床病理特征及预后的关系.方法 选择2014年1月—2017年3月手术切除的CRC组织及相应癌旁组织80例,检测PLAG1在癌组织及相应癌旁组织中的表达水平.应用GEPIA2数据库及临床样本评估PLAG1表达水平与CRC患者临床病理特征和预后的相关性.结果 CRC组织中PLAG1阳性表达率高于癌旁组织(P<0.01).CRC组织中PLAG1的高表达与T分期、N分期和临床病理分期显著相关(P<0.05).GEPIA2分析和临床样本Kaplan-Meier分析显示,PLAG1高表达CRC患者的总生存期和无病生存期均短于PLAG1低表达者(P<0.05);Cox回归分析提示PLAG1高表达是CRC患者预后独立危险因素(P<0.05).KEGG通路富集分析结果显示,PLAG1基因可能参与调节WNT、Hedgehog、Notch、Hippo、mTOR、PI3K-Akt等多种信号通路.结论 PLAG1在CRC组织中表达水平升高,且与T分期、N分期、临床病理分期和临床预后相关,是CRC预后的独立危险因素.

目的 探索胃癌患者胃原发灶切除手术前外周血中性粒细胞/淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、血浆纤维蛋白原水平(FIB)及临床病理特征与术后发生卵巢转移时间的相关性.方法 回顾性分析2016年1月-2019年9月安徽省立医院收治的胃癌术后发生卵巢转移患者49例的临床病理资料,分析其外周血NLR、PLR、FIB及临床病理特征与胃癌原发灶手术至术后发生卵巢转移时间的相关性.结果 所有患者胃癌原发灶切除手术时间至首次发生卵巢转移的中位时间为19.43个月;单因素分析显示,不同年龄、原发灶部位、原发灶大小、T分期、N分期、手术方式、术前PLR的患者手术至卵巢转移时间比较,差异无统计学意义(P>0.05);弥漫型胃癌、术前高NLR、术前高FIB水平的患者手术至卵巢转移时间短于肠型胃癌、术前低NLR、术前低FIB水平的患者,差异有统计学意义(P<0.05);多因素分析显示,原发灶Lauren分型、术前外周血NLR是影响胃癌术后发生卵巢转移时间的独立影响因素.结论 胃癌患者术前外周血NLR升高、FIB升高及弥漫型胃癌患者可能发生卵巢转移的时间较早,胃癌原发灶术后Lauren分型、术前外周血NLR可能是影响胃癌术后发生卵巢转移的独立危险因素.

Previous studies have indicated that centromere protein K (CENPK) is upregulated in several cancers and related to tumorigenesis. Nevertheless, the potential function of CENPK in gastric cancer (GC) remains unknown. Here, we investigated the function of CENPK on oncogenicity and explored its underlying mechanisms in GC. Our results showed that CENPK was dramatically overexpressed in GC and was associated with poor prognosis through bioinformatics analysis. We demonstrated that CENPK is upregulated in GC tissues and cell lines. Moreover, knockdown of CENPK significantly inhibited proliferation in vitro and attenuated the growth of implanted GCs in vivo. In addition, CENPK silencing induced G1 phase cell cycle arrest and facilitated apoptosis of GC cells. KEGG pathway analysis indicated that the PI3K-AKT signalling pathway was considerably enriched. Knockdown of CENPK decreased the expression of PI3K, p-Akt (Ser437) and p-GSK3β (Ser9) in GC cells, and increased the expression of PTEN. In conclusion, this study indicated that CENPK was overexpressed in GC and may promote gastric carcinogenesis through the PTEN-PI3K-AKT signalling pathway. Thus, CENPK may be a potential target for cancer therapeutics in GC.

目的 分析以肺转移为首发表现的结肠癌患者的预后的因素.方法 回顾性分析2011年10月～2020年4月安徽医科大学附属省立医院确诊的以肺转移为首发表现的47例结肠癌患者资料,采用Kaplan-Meier法分析临床病理特征(年龄、性别、原发灶位置、N分期、分化程度、有无肠梗阻、肺部病灶位置、有无肝转移、肿瘤标志物CEA及CA199)与无疾病生存期(DFS)的关系,并采用多因素Cox模型分析影响患者DFS的独立因素.结果 全组患者中位DFS为16.5个月.单因素分析显示,肺部病灶位置及有无肝转移与DFS有关(P<0.05);而年龄、性别、原发灶位置、N分期、分化程度、有无肠梗阻、肿瘤标志物CEA及CA199与DFS无相关性(P>0.05).多因素分析显示,肺部病灶位置、有无肝转移为影响DFS的独立因素.结论 在以肺转移为首发表现的结肠癌中肺部病灶位置、有无肝转移可能为影响疾病进展的独立预后因素.

目的 探讨胃癌术后外周血单核细胞、淋巴细胞水平变化对胃癌肝转移患者预后的影响.方法 回顾性分析63例胃癌术后发生肝转移患者的临床资料,分析不同临床特征与肝转移时间的关系、单核细胞与肝转移时间的关系及不同临床特征与生存时间的关系、淋巴细胞与生存时间的关系.结果 共纳入胃癌肝转移患者63例,其中单核细胞升高患者27例,降低患者36例,胃癌术后中位肝转移时间为8.47个月;术后单核细胞升高患者中位肝转移时间为11.97个月,单核细胞降低患者的肝转移时间为7.13个月,二者比较,差异有统计学意义(P<0.05);Cox单因素分析显示,病理分化程度、N分期、原发灶大小、单核细胞水平变化影响胃癌肝转移时间(P<0.05);Cox多因素分析显示,N分期、术后单核细胞变化是影响胃癌术后肝转移时间的独立预后因素;Kaplan-Meier生存分析显示,术后单核细胞升高患者发生肝转移的时间晚于术后单核细胞降低患者(P<0.05).术后淋巴细胞升高患者23例,降低患者40例,肝转移发生后中位生存时间为10.04个月;术后淋巴细胞升高患者中位生存期为11.33个月,术后降低患者生存期为6.93个月,二者比较,差异有统计学意义(P<0.05);Cox单因素分析显示,胃癌原发灶大小、术后淋巴细胞升高、肝转移灶数目、肝转移时ALB升高是胃癌肝转移预后的影响因素(P<0.05);Cox多因素分析显示,术后淋巴细胞变化和原发灶大小是影响肝转移后生存期的独立预后因素.Kaplan-Meier生存曲线显示,术后淋巴细胞升高患者生存期长于降低患者(P<0.05).结论 胃癌术后外周血单核细胞升高的患者发生肝转移时间较晚,淋巴细胞升高患者总生存期较长,而胃癌原发灶大小是肝转移后总生存期的独立危险因素.

目的 探讨食管小细胞癌(SCEC)患者治疗前血小板淋巴细胞比值(PLR)、外周血中性粒细胞淋巴细胞比值(NLR)与预后的关系及其临床意义.方法 回顾性分析2004年1月至2016年6月间52例SCEC的病历资料,治疗前采集患者外周血检测血小板、淋巴细胞和中性粒细胞,计算NLR、PLR,根据中位值分为高NLR组、PLR组及低NLR组、PLR组.采用Kaplan-Meier法计算生存,差异行Log-rank检验.单因素和多因素分析影响SCEC患者总生存期(OS)的预后因素.结果 SCCE患者高NLR组(NLR≥3.1)患者28例,低NLR组(NLR＜3.1)患者24例;高PLR组(PLR≥135.8)患者26例,低PLR组(PLR＜ 135.8)患者26例.与低NLR、低PLR组比较,高NLR、高PLR组患者多处于广泛期(P＜0.05).单因素分析结果显示,年龄≥60岁、广泛期、肿瘤位于食管上段、未接受化疗、未接受放疗、NLR≥3.1、PLR≥135.8是SCCE预后不良的影响因素(P＜0.05).Cox多因素分析结果显示:年龄(RR=2.825,95％CI:1.319～6.048,P=0.008)、分期(RR=3.774,95％CI:1.074～13.266,P=0.038)、放疗与否(RR=0.453,95％ CI:0.211 ～0.970,P=0.042)及NLR(RR=2.647,95％ CI:1.234 ～5.676,P=0.012)是影响SCCE患者OS的独立预后因素.结论 NLR、PLR升高的SCCE患者OS较短,其中NLR升高是SCEC患者OS的独立不良预后因素.

Objective: The immune makers including CD4+CD25+ T cells, natural killer cells, and T cells subgroup were retrospectively analyzed to find the relationship between apatinib and the immune system in the patients treated with apatinib. Method: Forty-two patients with advanced malignant tumors orally took apatinib as treatment and 16 patients with the same situation did not take apatinib as a control group. These patients were all included in the study, and they orally received apatinib 500 mg daily as monotherapy or combination. The treatment was continued until disease progression or intolerable toxicity. CD4+CD25+ T cells, natural killer cells, and T cells subgroup were detected before and 1 month after therapy for all the patients. The relationship between the changing number of immune cells and progression-free survival was analyzed in this study. Result: For the apatinib group, the rate of CD4+CD25+ T cells significantly increased (P = .048). The median progression-free survival was 3.25 months for the 42 patients. The median progression-free survival in the patients with the rate of CD4+CD25+ T cells increased and decreased was 5.8 months and 2.9 months, respectively (P = .012). Multivariate analysis found the increased rate of CD4+CD25+ T cells was an independent prognostic factor for a longer progression-free survival. The rate of natural killer cells and T cells subgroup did not change much after apatinib therapy, and they were not independent prognostic factors for progression-free survival. Conclusion: The rate of CD4+CD25+ T cells is very important in patients with apatinib treatment. The changing number of CD4+CD25+ T cells may be a good indicator for apatinib prognosis. Natural killer cells and T cells subgroup did not change much after apatinib, and they were not independent prognostic factors for progression-free survival.

目的 构建胃癌患者根治术后早期复发风险预测模型,指导个体化治疗与随访.方法 收集接受根治性手术治疗的胃癌患者114例,通过最小绝对收缩和选择算子回归分析进行变量筛选,应用COX回归分析构建预测模型并绘制列线图,通过受试者工作特征曲线(ROC)、log-rank检验、COX回归分析和校准图评价其预测的准确性.结果 通过变量筛选与COX回归分析,构建了基于年龄、性别、黏液腺癌、中分化腺癌、Lauren混合型、病理N分期以及病理分期7个临床病理特征参数的复发指数(RI)预测模型,RI的1年、2年ROC曲线下面积>0.7,是术后无复发生存的独立风险因素,根据RI,低复发风险患者RFS明显长于高复发风险患者.列线图预测的术后1年、2年复发风险与理想预测值较接近.结论 该模型可以较准确地预测胃癌患者术后早期复发风险,值得在临床上进一步证实与推广.

目的 探讨乳腺肉瘤的临床特点及合理的治疗方案.方法 对收治的17例乳腺肉瘤患者的临床资料进行回顾性分析.结果 随访40个月至16年.7例患者发生远处转移,5年生存率为47％,10年生存率为18％.患者主要死于肺、脑、骨、肝和全身广泛转移.结论 本病主要通过病理确诊,手术是本病的主要治疗手段,对于恶性程度高,分化差的肿瘤,应辅以放化疗,减少患者复发,提高生存.

Objective:To investigate the prognostic factors of patients with stages Ⅰ-]Ⅲ left-sided colon cancer (LCC) versus right-sided colon cancer (RCC) receiving radical surgery.Methods:A retrospective analysis of clinical data from 332 patients with stages Ⅰ-Ⅲ colorectal cancer (CRC) who underwent radical surgery in Anhui Provincial Hospital,Anhui Medical University between February 2008 and February 2012 was conducted.The differences in clinicopathological characteristics by tumor location (RCC vs LCC) were examined by using x2 test.The comparisons of overall 5-year survival rate between RCC and LCC within each stage and for all stages were done by using Kaplan-Meier method.The univariate analysis of prognosis was performed by using log-rank test,and the multivariate analysis was performed by using COX regression model.Results:The overall 5-year survival rate of all patients was 69.9％.The LCC patients had significantly higher overall 5-year survival rate than RCC patients (72.6％ vs 66.9％,P =0.020).The stage Ⅲ LCC patients had significantly higher overall 5-year survival rate than the stage Ⅲ RCC patients (62.5％ vs 52.2％,P =0.018),but no significant difference in overall 5-year survival rate was found between stage Ⅰ or Ⅱ RCC and LCC patients (P ＞ 0.05).There were significant differences in T stage,histologic type,degree of differentiation,tumor size,hemoglobin,albumin,fibrinogen and carcinoembryonic antigen (CEA) between RCC and LCC patients (all P ＜0.05).The univariate analysis showed that tumor location,T stage,N stage,histologic type,degree of differentiation,tumor size,hemoglobin,albumin,fibrinogen and CEA were significantly correlated with overall 5-year survival rate of CRC patients (all P ＜ 0.05).Multivatiate analysis showed that N stage,histologic type,degree of differentiation,hemoglobin,albumin,fibrinogen and CEA were independent prognostic factors of CRC (all P ＜ 0.05).Conclusion:For patients with stages Ⅰ-Ⅲ CRC treated with radical surgery,the factors of higher tumor N stage,mucinous adenocarcinoma/signet ring cell carcinoma,poorly differentiated carcinoma,anemia,hypoproteinemia,fibrinogen level more than 4 g/L and CEA level more than 10 ng/mL indicate a poor prognosis.The significant differences in clinicopathological characteristics and prognosis are found between RCC and LCC,but the tumor location is not an independent prognostic factor.

Objective To analyze prognostic-related factors of 46 cases of gastric cancer with bone metastasis as an&nbsp;initial presentation. Methods The retrospective study included 64 cases of gastric cancer with bone metastasis as an initial presentation. The Kaplan-meier was used to evaluate survival. The median overall survival( OS) was ana-lyzed among different clincal pathological parameters, including sex, age, differentiation degree, the number of bone metastases, bone metastasis site andother parts, radiotherapy or not, ECOG score, bone related events, serum calcium,alkaline phosphatase, the tumor markers carcinoembryonic antigen and carbohydrate antigen 199. The COX model was employed to analyze the independent factors of patients. Results The median OS of 64 gastric cancer patients was 6. 13 months. The single factor analysis showed that the degree of differentiation, the number of bone metastasis, bone metastasis site, extraosseous metastasis or not, ECOG score and the tumor markers CEA and CA199 were related to the prognosis of patients with gastric cancer ( P <0. 05 ) . The multivariate analysis showed that the independent factors of OS were bone metastasis(OR=0. 524, 95% CI:0. 275~0. 996, P=0. 049), ex-traosseous metastasis(OR =2. 343, P =0. 003,95% CI:1. 338 ~4. 101), the ECOG score(OR =2. 914,P =0. 003, 95% CI:1. 422~5. 972). Conclusion Bone metastasis site and extraosseous metastasis, ECOG score at first visit of gastric cancer with bone metastasis as an initial presentation may be the independent prognostic predic-tors with long-term survival.

Objective The present study examined the association between HPV infection and P16 expression in Chinese patients with advanced NSCLC.Methods A total of 83 advanced NSCLC patients were enrolled in the study.The status and genotype of HPV infec-tion were determined by luminex liquid chip and the presence of P16 expression in tumor tissue was determined by immunohistochemis-try.Clinical characteristics of these patients were also recorded to investigate the impact of HPV infection and P16 expression on pro-gression-free survival.Results HPV DNA was detected in 20 out of 83 (24%)lung tumors and was observed more frequently in non-smokers,patients with no lymph node metastasis,and patients with poorly differentiated tumors (P =0.048,P =0.044 and P =0.024, respectively).Eight (40%)were positive for P16 expression.Multivariate analysis revealed that poor differentiation alone (odds ratio=0.163)was an independent predictive factor of HPV infection in advanced NSCLC.P16-positive patients had a significantly longer survival time when compared with P16-negative patients(P <0.023,log-rank test).Conclusions Our results suggest that P16 protein expression is not associated with the expression of HPV DNA,but that P16 expression may be an independent prognostic factor of long survival in advanced NSCLC.

Objective To analyze the relationship between ER-β and clinical prognosis by detecting its expression in NSCLC with symptoms of bone metastases at the time of diagnosis. Methods The expression of ER-βin tissues was investigated by immunohistochemistry. The differences between groups were analyzed by chi-square test. The survival rates were calculated using the Kaplan-Meier method. The log-rank method was used for univariate analy-sis, and the Cox regression model was used for multivariate analysis. Results The positive percentage of ER-βex-pressed in 46 NSCLC patients with bone metastases at the time of diagnosis was 78. 3 %. The expression of ER-βhad no difference among groups of sex, age, tumor subtype, number of bone metastases, more than one bone me-tastasis, ALK, CEA. Chi-square test did not find statistical differences of ER-βexpression among groups. Multiva-riate analysis showed that ER-βwas an independent predictor of overall survival (OS) (P=0. 035). Univariate a-nalysis showed that the patients who had ER-β positive expression had longer survival time ( P<0. 05 ) . The pa-tients with lung adenocarcinoma or NSCLC with single bone metastasis who present with ER-β positive expression had a significant superior survival rate to ER-β negative expression patients ( P<0. 05 ) . Conclusion Higher ex-pression of ER-β was found in NSCLC patients with bone metastases at time of diagnosis. The patients with ER-βpositive expression have a favorable prognosis, and it may be an independent prognosis predictor of these patients. In addition, ER-β positive expression may be closely related with OS of NSCLC patients who have single bone me-tastasis or adenocarcinoma.

Objective To analyze prognosis-related factors of the non-small lung cancer( NSCLC) patients with bone metasta-sis as an initial presentation. Methods In the retrospective study, 46 NSCLC patients with bone metastasis as an initial presentation from Anhui Provincial Hospital Affiliated to Anhui Medical University and Anhui Provincial Cancer Hospital between February 2010 and February 2012 were investigated. The Kaplan-Meier method was employed to evaluate survival. Then the median overall survival ( OS) was analyzed among different clinicopathological parameters, including age, sex, smoking, pathological type, the number of bone metastasis, bone related events, other parts of the transfer, ECOG score, alkaline phosphatase and carcinoembryonic antigen. The Cox multivariate analysis was used to evaluate the independent factors affecting survival of patients. Results The median OS of 46 NSCLC patients was 237 days. The univariate analysis showed that tumor subtype, number of bone metastasis and ECOG performance status were prognostic factors. Multivariate analysis showed that the independent predictors of OS were tumor subtype ( OR=2.996, 95%CI:1.070-8.389, P=0.037) and the number of bone metastasis( OR=3.263, 95%CI:1.083-9.827, P=0.036) . Conclusion Tumor subtype and the number of bone metastasis of NSCLC patients with bone metastasis as an initial presentation may be independ-ent prognosis predictors.