Objective This study analyzed metabolic factors associated with lymphovascular space invasion (LVSI) and compared the difference between type 1 and type 2 endometrial cancer (EC). Methods Four hundred patients primarily diagnosed with EC who underwent hysterectomy with pathological results at Fujian Medical University Cancer Hospital from January 2019 to January 2021 were included. Demographic variable data were collected as well as pathological results. Laboratory evaluations included fasting blood glucose (FBG), serum cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), apolipoprotein A (Apo A) and apolipoprotein B (Apo B). Characterization of binary logistic regression models was used to test the odds ratios (ORs) between LVSI and its metabolic parameters with different subtypes of EC. Results The results indicated that CA125, ROMA, Ki67 score, FBG and TC were higher in EC patients with LVSI (all p<0.05). Negative ER and PR expression was positively associated with LVSI (P<0.05). CA125, ROMA, FBG, TC and ER were found to be independent risk factors for LVSI. CA125, ROMA and FBG were significantly elevated in type 1 EC patients with LVSI compared with those without LVSI (all p<0.05). TC and Ki67 scores were much higher in type 2 EC patients with vs without LVSI (all p<0.05). Negative PR expression was positively related to both type 1 and type 2 EC patients with LVSI. Consequently, CA125, ROMA, FBG and Apo B were found to be independent risk factors for LVSI in type 1 EC, and TC was found to be an independent risk factor for LVSI in type 2 EC. Conclusion FBG and TC were both independent risk factors for LVSI in EC. FBG and Apo B were independent risk factors for LVSI in type 1 EC. TC was an independent risk factor for LVSI in type 2 EC.

Background: The impact of perioperative blood transfusion (PBT) on the prognosis of esophageal cancer patients remains inconclusive. The purpose of this study was to assess the association between PBT and survival in esophageal squamous cell carcinoma (ESCC) patients. Materials and Methods: In this retrospective study, patients with ESCC who underwent esophageal resection from January 2008 to December 2011 were analyzed. The overall survival and postoperative outcomes between PBT and non-PBT patients were compared using Cox regression and propensity score matching (PSM) analysis. Results: A total of 935 patients were enrolled in this study. Before PSM, the 5-year overall survival rates in PBT and non-PBT patients were 48.4% and 56.3% (P=0.001), respectively. The postoperative infection rate in PBT patients was 32.32%, which exceeded the rate of 24.22% in non-PBT patients (P=0.008). PSM created 306 pairs of patients. After PSM, the 5-year overall survival rates in PBT and non-PBT patients were 49.4% and 51.0% (P=0.334), respectively. The postoperative infection rate in PBT patients was 31.04%, which was higher than the rate of 26.47% in non-PBT patients (P=0.105). Multivariable Cox regression analyses showed that PBT was not an independent risk factor for overall survival (HR: 0.792, 95% CI: 0.615-1.021, P=0.072). Conclusion: Perioperative blood transfusion has no effect on the overall survival of ESCC patients.

AIM:Venous thromboembolism (VTE) is a well-recognized complication in gynecological oncology patients, and has an impact on the overall outcome. The purpose of this study was to identify whether thrombelastography (TEG) predicts VTE in gynecological oncology patients.METHODS:This retrospective study included patients with gynecological oncology who were hospitalized at the Fujian Provincial Cancer Hospital from May 2014 to April 2016. Univariate and logistic regression multivariate analyses were performed to determine the clinical and laboratorial factors for VTE in gynecological oncology patients. The sensitivity and specificity of predictors was calculated using receiver operating characteristic curve.RESULTS:The study included 376 patients; 39 (10.37%) developed VTE. Logistic regression multivariate analysis revealed that TEG coagulation index (CI) value, D-dimer, arrhythmia, coronary heart disease, surgery within four weeks and chemotherapy within four weeks were independent risk factors for VTE. The area under the curve values were 0.71 (95% confidence interval 0.63-0.79, P = 0.000) for TEG CI and 0.67 (95% confidence interval 0.58-0.76, P = 0.000) for D-Dimer. The TEG CI cut-off value was 2.55, which had 53.8% sensitivity and 75.4% specificity for VTE.CONCLUSIONS:These results indicated that the TEG CI value may be predictive of VTE in gynecological oncology patients.

OBJECTIVETo examine the impact of hemoglobin levels in predicting outcomes and evaluate whether transfusion could improve the outcomes of chemotherapy on gastric cancer patients.METHODSA total 310 patients were divided into two groups: high Hb group (Hb >90 g/L) and low Hb group (Hb <90 g/L). A portion of patients in low Hb group received transfusion. The effect of hemoglobin level on the chemotherapy outcomes was determined according to the comparison between patients with high hemoglobin and patients with low hemoglobin without transfusion. The effect of transfusion on the chemotherapy outcomes was evaluated by comparing the two low groups (with and without transfusion).RESULTSA total of 310 patients were within the study criteria. Among them, 27.7% patients in high Hb group, 44.5% patients in low Hb without transfusion and 27.7% patients in low Hb with transfusion were followed up. The 5-years survival rates of high Hb group, low Hb group without transfusion and with transfusion were respectively 29%, 10% and 8%. The survival rate of patients in Hb group without transfusion was higher. The chemotherapy rates of patients in high Hb group, low Hb without transfusion group and with transfusion group were respectively 32.56%, 42.03% and 18.6%.CONCLUSIONLow nadir Hb (<90 g/L) during chemotherapy had an effect on the survival and chemotherapy response rate. The chemotherapy outcomes could not be improved through increasing Hb level by red blood cell (RBC) transfusion.