Clinicopathological Parameters Of Patients Research Articles

A new surgical strategy for T4 stage posterior buccal carcinoma: anatomical unit resection

Objective: To investigate the effect of anatomical unit resection on the overall survival rate of patients with T4 stage posterior buccal carcinoma. Methods: We conducted a retrospective study on 79 patients with T4 stage posterior buccal squamous cell carcinoma underwent radical surgery for buccal mucosa cancer and reconstruction with free anterolateral thigh flap in the Department of Oral and Maxillofacial Surgery, the Second Xiangya Hospital, Central South University from March 2014 to December 2019. The 74 patients were males and the 5 patients were females, aged from 28 to 72 years old. The 40 patients in control group underwent traditional extended resection (1.5-2.0 cm safe margin), and 39 patients in the experimental group underwent anatomical unit resection. The clinicopathological parameters of patients were collected and followed up regularly. The overall survival rate was assessed by Log-rank and Cox proportional risk regression model. Multivariate analysis was performed by linear regression model. Results: There were significant differences between experimental group and control group in overall survival rates (61.53% vs 27.50%, χ2=6.624, P=0.010) and local disease control rates (74.36% vs 27.50%, χ2=17.350, P<0.001). Multiple linear regression analysis showed that local disease control rate was significantly correlated with anatomical unit resection (t=3.880, P<0.001) and lymph node metastasis (t=2.619, P=0.011), and also Cox proportional hazards regression model analysis identified that overall survival rate was significantly correlated with anatomical unit resection (Z=2.421, P=0.016) and lymph node metastasis (Z=2.793, P=0.005). Conclusion: For posterior buccal carcinoma with multiple anatomical units involved, anatomical unit resection can significantly reduce local recurrence and improve overall survival rate of patients.

Prognostic effect of the pretreatment prognostic nutritional index in cervical, ovarian, and endometrial cancer: a meta-analysis

BackgroundThe prognostic value of the pretreatment prognostic nutritional index (PNI) for gynaecological malignancies remain unclear. This meta-analysis aimed to explore the predictive significance of the PNI for gynaecological tumours.MethodsThe PubMed, Embase, Web of Science, and Cochrane Library databases were searched up to January 30, 2024, to identify relevant studies. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess the associations of the PNI with overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) in patients with gynaecological tumours. We examined the correlation of the PNI with clinicopathological parameters of patients with gynaecological carcinoma by utilizing pooled odds ratios (ORs) and 95% CIs.ResultsA total of 28 articles involving 9,428 patients were included in the meta-analysis. The results revealed that a low PNI significantly predicted worse OS (HR = 1.60, 95% CI: 1.39–1.84, P < 0.001), PFS (HR = 1.63, 95% CI: 1.20–2.23, P = 0.002), and DFS (HR = 1.73, 95% CI: 1.19–2.52, P = 0.004). In addition, the subgroup analysis confirmed that the PNI had a prognostic effect on OS for all cancer types, but a significant association with PFS was not observed in patients with cervical cancer. A low PNI was significantly associated with FIGO stages III‒IV (OR = 2.30, 95% CI: 1.89‒2.80, P < 0.001) and LN metastasis (OR = 2.76, 95% CI: 2. 05‒3.73, P < 0.001).ConclusionThe PNI may be noninvasive and promising biomarker for predicting the prognosis of patients with gynaecological tumours.

The relationship between CXCR6+CD8+T cells and clinicopathological parameters in patients with primary biliary cholangitis.

CXCR6+CD8+T cells have been implicated in the pathogenesis of various liver and autoimmune diseases. However, their involvement in primary biliary cholangitis (PBC) has not been elucidated. We used immunohistochemistry and flow cytometry to quantify CXCR6+CD8+T cells in hepatic tissue and peripheral blood samples obtained from CXCR6+CD8+T cells obtained from PBC patients. Then, we performed comprehensive statistical analyses to access the correlation between the abundance of these cells and clinical as well as pathological data across different stages of PBC. Our research revealed that CXCR6+ cell frequencies in CD3+CD8+T cells from PBC patients significantly exceeded that of healthy controls (HCs) (2.24 vs. 0.61%, p < 0.01). A similar pattern emerged for hepatic CXCR6+CD8+T cell counts, which were notably higher in the PBC cohort compared to HCs. Our cohort consisted of 118 PBC patients, categorized into 62 early-stage (E-PBC) and 56 late-stage (L-PBC) cases. Notably, significant disparities existed between these groups in terms of liver enzyme and lipid profile levels (p < 0.05), with no notable differences observed in gender, age, blood counts, cholesterol levels, or autoantibodies (p > 0.05). Intriguingly, the quantity of hepatic CXCR6+CD8+T cells per high power field (HPF) was significantly elevated in both E-PBC and L-PBC patients as opposed to normal liver samples, indicating a substantial increase in these cells across all stages of PBC (p = 0.000). Spearman's rank correlation analysis showed a positive correlation between CXCR6+CD8+T cell counts and serum levels of Alkaline Phosphatase (AKP) and Gamma-Glutamyl Transferase (GGT), ANA, IgG and IgM, while revealing a negligible correlation with Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST). Subsequent findings indicated significant variances in CXCR6+ cell numbers not only among different PBC stages but also across various degrees of inflammation and fibrosis (p ≤ 0.007). In a follow-up study post-Ursodeoxycholic Acid (UDCA) treatment, stark differences were identified in biochemical and immunohistochemical profiles between responder (31 patients) and non-responder (33 patients) groups (p < 0.05). A Wilcoxon rank-sum test further demonstrated a significant difference in the level of hepatic CXCR6+CD8+T cells between these two response groups (p = 0.002). CXCR6+CD8+T cells play a vital role in the pathogenesis of PBC, exhibiting correlations with the extent of inflammation, staging of liver fibrosis, and response to pharmacological interventions in PBC patients.

Clinical and pathological significance of Orai1 channel expression in human diabetic nephropathy.

Targeted therapies for diabetic nephropathy (DN) are lacking, partly due to their irreversible nature. The role of Orai1, a store-operated Ca2+ channel, in DN remains debated, with conflicting evidence on its effect on proteinuria in animal models. We aimed to elucidate the functional relevance of Orai1 expression for clinicopathological parameters in patients with DN. In this study, we included 93 patients diagnosed with DN between 2009 and 2019. Immunohistochemical staining for Orai1 was performed on paraffin-embedded kidney sections. The significance of Orai1 expression in human DN was assessed by examining its correlation with DN's pathological and clinical parameters using Pearson's correlation coefficient and univariate logistic regression. Orai1 was significantly overexpressed in DN patients compared to control. A strong correlation was observed between increased Orai1 expression and higher Renal Pathology Society DN classification, enhanced interstitial fibrosis and tubular atrophy scores. Positive correlations with serum creatinine levels and prognosis of chronic kidney disease (CKD) by glomerular filtration rate (GFR) and albuminuria category were noted but the estimated GFR was inversely related to Orai1 expression. Orai1's association with advanced CKD stages persisted even after adjusting for confounding variables in multivariate logistic regression analysis. Orai1 expression is closely associated with histological and clinical severities of DN, suggesting its potential as a predictive biomarker for disease progression and prognosis. These findings provide new perspectives on therapeutic interventions targeting Orai1 in DN.

Relationship Between Serum HBV-RNA Levels, Sero-biochemical Indices, and Clinicopathological Parameters in Patients with Hepatitis B Virus

Background: Studies have indicated that HBV RNA exhibits a distinct profile, and the plasma amino acid profile significantly correlates with the different stages of HBV infection. Objectives: This study investigates the relationship between HBV RNA and the plasma amino acid profile and the levels of HBeAg, HBsAg, HBV DNA levels, and other clinical indexes in diagnosing chronic HBV infection diseases. Methods: In this observational study, a total of 155 patients were included. They were categorized as Hepatitis B virus carriers, chronic Hepatitis B (CHB), Hepatitis B-related cirrhosis, and hepatocellular carcinoma patients. Following routine laboratory techniques, the DNA, RNA, serological indexes (HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb), biochemical indexes (ALT, AST), and the concentration of amino acids were determined from the serum. Results: Any relationship between different parameters considered was determined with the chi-square test, correlation, and multivariate logistic regression analysis. We observed that the HBV DNA and RNA levels were significantly higher in patients with chronic Hepatitis B compared to other groups (P &lt; 0.01). The HBV RNA levels significantly correlated with methionine levels (P &lt; 0.05) and not with other amino acids considered in this study. Further, the HBV DNA levels emerged as an independent risk factor for HBV RNA levels, and the area under the ROC curve was 0.840 (P &lt; 0.01) when the levels of HBV RNA, HBV DNA, and methionine were combined to diagnose chronic Hepatitis B. Conclusions: Our study shows that the levels of HBV RNA are correlated with methionine metabolism levels, and this relationship can be used to diagnose and predict the efficacy of treatment for different stages of HepatitisHepatitis B virus infectious diseases.

AB033. SOH24AB_089. Assessing the clinical utility of preoperative neutrophil-lymphocyte ratio as a predictor of clinicopathological parameters in patients being treated for primary breast cancer

AB033. SOH24AB_089. Assessing the clinical utility of preoperative neutrophil-lymphocyte ratio as a predictor of clinicopathological parameters in patients being treated for primary breast cancer

FTO promotes gastric cancer progression by modulating MAP4K4 expression via demethylation in an m6A-dependent manner.

Gastric cancer (GC) is a serious malignant tumour with a high mortality rate and a poor prognosis. Recently, emerging evidence has suggested that N6-methyladenosine (m6A) modification plays a crucial regulatory role in cancer progression. However, the exact role of m6A regulatory factors FTO in GC is unclear. First, the expression of m6A methylation-related regulatory factors in clinical samples and the clinical data of the corresponding patients were obtained from The Cancer Genome Atlas (TCGA-STAD) dataset, and correlation analysis between FTO expression and patient clinicopathological parameters was subsequently performed. qRT-PCR, immunohistochemistry (IHC) and western blotting (WB) were used to verify FTO expression in GC. CCK-8, EdU, flow cytometry and transwell assays were used to evaluate the effect of FTO on the behaviour of GC cells. Transcriptome sequencing and RNA immunoprecipitation analysis were used to explore the potential regulatory mechanisms mediated by FTO. FTO was highly expressed in GC tissues and cells, and high expression of FTO predicted a worse prognosis than low expression. Functionally, overexpression of FTO promoted the proliferation, migration and invasion of GC cells but inhibited cell apoptosis. Mechanistically, we found that FTO is upregulated in GC and promotes GC progression by modulating the expression of MAP4K4. Taken together, our findings provide new insights into the effects of FTO-mediated m6A demethylation and could lead to the development of new strategies for GC monitoring and aggressive treatment.

Effects of transmembrane serine protease 4 on the survival in patients with pancreatic ductal adenocarcinoma undergoing surgery followed by adjuvant chemotherapy.

The transmembrane serine protease 4 (TMPRSS4) gene is upregulated in various human cancers. However, its biological functions in pancreatic ductal adenocarcinoma remain unclear. We examined the expression of TMPRSS4 in pancreatic ductal adenocarcinoma tissues and its correlation with clinicopathological parameters in patients with pancreatic ductal adenocarcinoma who underwent surgery. The TMPRSS4 expression was immunohistochemically examined in 81 PDAC patients with pancreatic ductal adenocarcinoma. We analyzed the association between the TMPRSS4 expression and clinicopathological factors, the recurrence-free survival (RFS), and the overall survival (OS) and examined the effect of TMPRSS4 expression on cell migration and sensitivity to 5-fluorouracil. The expression rate of TMPRSS4 in the samples was 62.9% (51/81). The TMPRSS4 expression was not correlated with any clinicopathological feature. The five-year overall and recurrence-free survival rates were significantly lower in the TMPRSS4-positive group than in the TMPRSS4-negative group. On a multivariate analysis, TMPRSS4 positivity, poorly differentiated histology, and non-adjuvant chemotherapy predicted a poor OS, while TMPRSS4 positivity and poorly differentiated histology predicted a poor RFS. TMPRSS4-silenced pancreatic ductal adenocarcinoma cells showed higher sensitivity to 5-fluorouracil than did the control siRNA-transfected cells. TMPRSS4 can be considered a prognostic factor and therapeutic target for pancreatic ductal adenocarcinoma.

Risk of isolated metastatic disease outside the abdomen is low in cT1a renal cancer: A retrospective analysis of a large cohort from the Scottish Renal Cancer Consortium

Objectives: Chest computed tomography (CT) is recommended by the European Association of Urology guidelines as part of the evaluation of patients presenting with renal tumours. There are no direct recommendations for the use of computed tomography (CT) pelvis, but this is often included routinely in the assessment for metastatic disease. The incidence of metastatic disease in cT1a renal cell carcinoma (RCC) is low. Predictive algorithms may be able to guide the selective use of chest CT in the pre-operative evaluation of patients. We sought primarily to assess the clinical utility of these algorithms in predicting lung and pelvic metastases in a national cohort of purely cT1a tumours. Patients and Methods: Patients with sporadic, unilateral cT1a renal tumours diagnosed between January 2012 and December 2017 were identified from a prospectively collected national database. Patient clinico-pathological parameters and treatment type were recorded. Details on clinical presentation and bloods at diagnosis were taken from local electronic records retrospectively. Differences between those with and without metastatic disease were assessed. Results: Of the total 696 patients, 7 (1.0%) patients had metastatic disease exclusively outside the abdomen. Indeterminate lung lesions were present in 114 (16.6%) patients, with 2 (1.8%) progressing to presumed metastatic disease. Patients with metastatic disease were more likely to be anaemic than those without metastatic disease (85.7% and 25.7%, respectively, p = 0.020). Conclusion: Metastatic disease at presentation with cT1a renal cancer was uncommon in our national multi-centre series, with limited impact on clinical management. Patients with cT1a without intra-abdominal metastatic disease could safely avoid CT chest or pelvic CT at diagnosis, with benefits in terms of radiation exposure and resource utilisation. Level of evidence: 3.

Prognostic value and therapeutic potential of NEK family in stomach adenocarcinoma.

Never in mitosis gene A-related kinase (NEK) is an 11-membered family of serine/threonine kinases (NEK1-NEK11), which are known to play important roles in the formation and development of cancer. However, few studies have examined the roles of these kinases in the development of stomach adenocarcinoma (STAD). In this study, we conducted a comprehensive analysis of the relationships between the NEKs family members and STAD. The differential expression of the NEK genes in STAD was validated using The Cancer Genome Atlas (TCGA) and Tumor Immune Estimation Resource (TIMER) databases, and their prognostic and diagnostic values of NEKs in STAD were assessed using the Kaplan-Meier plotter and TCGA data. The effect of NEK expression on immune cell infiltration in STAD was analysed using the TIMER and TISIDB databases. The expression levels of the majority of the NEK family members were consistently upregulated in STAD, whereas that of NEK10 was downregulated. The upregulation of NEK2/3/4/5/6/8 was closely associated with clinicopathological parameters of patients, and the overexpressed levels of these proteins had good diagnostic value for the disease. NEK1/8/9/10/11 expression correlated with poor overall survival and post-progressive survival, whereas a higher NEK1/6/9/11 level implied worse first progressive survival. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses revealed that the NEKs may be related to immunological responses. Additionally, our study confirmed that these kinases correlated with immune cell infiltration and different immune infiltration subtypes in STAD. Our results suggest that NEK9 in particular has the potential to be used as a diagnostic and prognostic biomarker of STAD development and progression and an immune target for treatment of the disease. These findings expand our understanding of the biological functions of the NEK family members in STAD.

Lymphocyte to Monocyte Ratio Is an Independent Prognostic Factor in Patients With Esophageal Cancer Who Receive Curative Treatment.

This study evaluated the clinical impact of the lymphocyte-to-monocyte ratio (LMR) in patients with esophageal cancer who received curative treatment and perioperative adjuvant treatment. The association between LMR and the clinicopathological characteristics of patients with esophageal cancer was also investigated. This study included 181 patients who underwent curative treatment for esophageal cancer between 2005 and 2020. The prognosis and clinicopathological parameters of patients with high and low LMR statuses were analyzed. The OS rates at 3 and 5 years after surgery were significantly lower (40.6% and 33.8%, respectively) in the low-LMR group than in the high-LMR group (67.1% and 58.4%, respectively). The pretreatment LMR was selected as an independent prognostic factor in the multivariate analysis model [hazard ratio (HR)=2.606; 95%CI=1.504-4.516, p<0.001]. Similar results were observed for RFS. Furthermore, LMR was associated with the occurrence of postoperative surgical complications and hematological recurrence. The incidence of anastomotic leakage was 63.3% in the low-LMR group and 27.2% in the high-LMR group (p<0.001). Moreover, the hematologic recurrence rate in the low-LMR group was significantly higher than that in the high-LMR group (46.7% vs. 23.8%, p=0.011). The LMR may be a promising prognostic and predictive factor for esophageal cancer, and may be used to select optimal treatment strategies in the future.

Investigation of the Role of Preoperative Serum CA 125 Levels in Determining the Necessity of Lymphadenectomy in Cases Diagnosed with Endometrium Cancer: A Retrospective Study

Objective: The aim of this study is to investigate the relationship between preoperative serum CA 125 levels and clinicopathological parameters in patients operated for endometrial carcinoma (EC) and to reveal the effectiveness of preoperative serum CA 125 levels in determining the necessity of lymphadenectomy. Materials and Methods: The study included retrospective data of 88 patients who underwent surgery due to EC. The relationship between the patients' preoperative serum tumor marker CA-125 levels and tumor grade, stage, histological type, lymph node positivity was evaluated statistically. The statistical significance of CA-125 levels in determining the need for lymph node dissection was analyzed. Results: When the preoperative diagnostic methods of the cases were evaluated according to their surgical stage; the mean CA 125 value was 31.21±35.54 (4.4-150.3) IU/ml in early stage (Stage I-II) patients and 349.13±497.34 (19.5-1566) IU/ml in advanced stage (Stage III-IV) patients (p=0.001). Considering the depth of myometrial invasion and preoperative CA 125 values, the mean preoperative CA 125 values were 21.43±20.06 (4.4-44.1) IU/ml in cases with myometrial invasion less than 1/2, while this value was 141.03±329.47 (6.8-1566) IU/ml in cases with more than 1/2 and the difference between the groups was found to be statistically significant (p=0.025). CA 125 levels of cases with positive lymph nodes were statistically significantly higher than CA 125 levels of cases with negative lymph nodes (p&lt;0.05). While the CA 125 level was 35 IU/ml and above in all cases with positive lymph nodes, the CA 125 level was 35 IU/ml and above in 30.2% of the cases with negative lymph nodes (p&lt;0.05). Conclusions: The results we obtained in this study support the association of increased preoperative CA 125 levels with lymph node positivity, advanced stage and myometrial involvement above ½ in cases with EC.

Telomerase reverse transcriptase gene polymorphisms and cervical cancer susceptibility in high-risk human papillomavirus-infected women.

To investigate the relationship between Human telomerase reverse transcriptase (hTERT) gene polymorphisms and the susceptibility and clinicopathological parameters of cervical cancer in women infected with high-risk human papillomavirus (HR-HPV). A total of 380 patients with HPV-infected cervical cancer who were admitted to the Jilin province Maternal and Child Health Care Hospital (Jilin province Obstetrics Quality Control Center) from July 2019 to July 2023 were selected as case group, and 408 women with negative HPV results in the cervical cancer screening results of the physical examination in the same hospital were selected as the control group. Restriction fragment length polymorphisms polymerase chain reaction was used to detect the polymorphisms of hTERT, and its relationship with the susceptibility to high-risk HPV infection and clinicopathological parameters in patients with cervical cancer was analysed. Individuals carrying the GA and AA genotypes of rs2736122 were significantly associated with an increased risk of cervical cancer when compared with the GG genotype and the adjusted ORs were 0.53 (0.37-0.79) for the AA genotype and 0.73 (0.59-0.88) for the A allele genotype. Besides, GG genotype or G allele of rs2853677 presented a significant influence on cervical cancer, with ORs of 0.59 (0.41-0.86) and 10.77 (0.63-0.94), respectively, when compared with the AA genotype. And rs2853677 have statistically significant difference in tumour diameter and degree of differentiation subgroup(p < 0.05). The results of this study indicate that the hTERT gene rs2736122AA and rs2853677 GG genotypes can increase the susceptibility of high-risk HPV infection in cervical cancer patients. And rs2853677 is related to tumours above 4 cm and highly differentiated tumours. But both have nothing to do with the patient's chemotherapy sensitivity.

Clinico-Pathological and Prognostic Significance of a Combination of Tumor Biomarkers in Iranian Patients With Breast Cancer

PurposeBreast cancer is one of the most common cancers in the world. It is a multifaceted malignancy with different histopathological and biological features. Molecular biomarkers play an essential role in accurate diagnosis, classification, prognosis, prediction of treatment response, and cancer surveillance. This study investigated the clinico-pathological and prognostic significance of HER3 and ROR1 in breast cancer samples. MethodsTissue microarrays (TMA) were constructed using tissue blocks of 444 Iranian breast cancer patients diagnosed with breast cancer. Overall survival (OS) and disease-free survival (DFS) were assessed after 5 years follow-up. TMA slides were stained with monoclonal antibodies against ROR1, HER3, ER, PR, Ki67, P53, HER2 and CK5/6 using IHC and correlation between the investigated tumor markers and the clinico-pathological parameters of patients were analyzed. ResultsOur results showed a significant correlation between ROR1 and ER, PR, HER3, and CK5/6 expression. Additionally, there was a significant correlation between HER3 and ER, PR, HER2, and Ki67 expression. Ki67 was also correlated with HER2 and P53 expression. HER3 expression was significantly correlated with tumor stage, lymph node metastasis, perineural invasion, and multifocal tumors. Furthermore, ROR1 expression was significantly associated with tumor metastasis, lympho-vascular invasion, and perineural invasion. While HER2-HER3 coexpression was significantly associated with poor OS, HER3-ROR1 coexpression was associated with lymph node invasion, lymph node metastasis, and distant metastasis. ConclusionROR1 and HER3 displayed significant association with different clinic-pathological features and in addition to the other tumor biomarkers could be considered as diagnostic and prognostic biomarkers in breast cancer patients.

Prevalence of Androgen Receptor in Invasive Breast Cancer and Its Association with Clinicopathologic Features in East Azarbaijan Province of Iran: A Cross-Sectional Study.

Background: Breast cancer is the most common malignancy and the leading cause of cancer-related deaths in females. Accordingly, the evaluation of new prognostic markers and therapeutic targets is of vital importance. Here, we aimed to detect androgen receptor (AR) status and define its association with clinicopathologic parameters in patients with invasive breast cancer. Materials and Methods: In this study, AR status was studied in 104 patients with invasive breast carcinoma by immunohistochemistry. Besides, its association with clinicopathologic factors, i.e., age, menopausal status, tumor size, lymph node involvement, tumor stage, tumor grade and estrogen receptor (ER), progesterone receptor (PR), Her2/neu, Ki-67and P53 were investigated. Results: AR was positive in 84 patients (80.8%), and its expression in ER-positive (85.7%) and PR-positive (85.6%) patients were remarkably higher than in ER-negative (46.2%) and PR-negative (50%) patients (p= 0.001 and p=0.002, respectively). AR expression was noticeably lower in Her2/neu-positive (25%) patients compared to Her2/neu-negative (87.9%) ones (p=0.000). AR expression was also higher in patients with smaller, earlier stage, and low mitotically active tumors, but the association was not statistically significant. Conclusion: The expression of AR in patients with breast cancer was found to be high and its association with ER-positive, PR-positive, and HER2/neu-negative tumors was found to be significant. In that light, this receptor may play an important role in the determination of prognosis and targeted therapy in breast cancer.

The Impact of Obesity on Mortality and Complications in Posterior Retroperitoneoscopic Adrenalectomy.

Background Obesity is a global epidemic. It influences surgical technique, ergonomics, safety, and outcomes. However, there is a paucity of evidence of obesity-related impact in posterior retroperitoneoscopic adrenalectomy (PRA). This study compared perioperative outcomes of obese and non-obese participants undergoing PRA. Methodology This is a multi-center retrospective cohort study of elective PRA from March 2014 to December 2022. Patient demographics, surgical techniques, clinicopathological parameters, and outcomes, including overall complication rate, were analyzed using SPSS version 27 (IBM Corp., Armonk, NY, USA). Results Seventy-five patients underwent a PRA, of which 97.3% were completed retroperitoneoscopically. The overall complication rate was (9.3%), and on subgroup analysis, the obese cohort had a lower percentage complication profile at 6.5%. Male participants comprised 52%, with a median age of 55 (IQR=19). The median BMI was 29.0 (IQR=8), of which 41% were obese, and 40% were overweight. Univariate analysis showed that being obese was not significantly associated with a higher complication rate (p=0.471). In addition, there was no significant increase in conversion (p=0.508), bleeding/transfusion (p=0.508), surgical site infection (SSI; p=1.000), incisional hernia (p=1.000), ICU or high dependency unit admission (p=0.292) and any-cause mortality (p=1.000). No sentinel deaths directly related to PRA were recorded. Procedure duration was longer in obese (117 mins) vs. non-obese participants (88.9 mins, p=0.022). However, there was no significant difference in the length-of-hospital stay (p=0.592). The cohort conversion rate was (2.7%), and tumor size was associated with a higher conversion rate (35.4 vs. 62.5mm, p=0.040). Conclusion Posterior retroperitoneoscopic adrenalectomy can be a safe procedure in obese populations, and obesity does not increase perioperative morbidity or mortality.

Immunohistochemical study of mismatch repair and programmed death ligand-1 protein expression in prostatic acinar adenocarcinoma in correlation with patient clinicopathological parameters

Background Castrate-resistant prostate cancer (CRPC) is the main challenge among prostate cancer patients; most are metastatic and eventually resist any treatment. No cure yet exists for them. Aim Investigate the immunohistochemical expression of mismatch repair genes (MMR) protein products for loss of expression and programmed death ligand-1 (PDL-1) overexpression in prostatic acinar adenocarcinoma cases as a trial to find benefit from using immune checkpoint inhibitor drugs as a new therapeutic modality, especially in CRPC. Patients and methods This study included 166 cases of prostatic acinar adenocarcinoma of different grades and stages along with different responses to therapy including 57% being classified as CRPC. Tissue microarray was applied using mostly three cores from each donor case, resulting in the formation of six new recipient blocks. Immunohistochemical staining for MSH2, MSH6, MLH1, PMS2, and PDL-1 was done. Interpretation of the results, their correlation with all collected clinical and pathological parameters, and statistical analysis of the results were done. Results Most of the studied cases showed retained nuclear stain for all MMR genes (MSH2, MSH6, MLH1, PMS2), with total loss of the nuclear stain found in few cases ranging from one (0.7%) case in MLH1 to six (4.2%) cases in MSH2. PDL-1 was expressed in about seven (4.8%) cases. No significant correlation was found between MMR protein loss or PDL-1 expression and the different clinicopathological parameters including CRPC. Conclusion The limited cases that showed MMR protein loss or PDL-1 expression may suggest that the immune checkpoint inhibitors are of limited value in CRPC but can be used as the last option after investigations of these markers as still few cases can show these changes. Patchy loss of MMR proteins is suggested to be further investigated by molecular studies.

CCL2 promotes lymphatic metastasis via activating RhoA and Rac1 pathway and predict prognosis to some extent in tongue cancer

ABSTRACT Background Oral tongue cancer is an extremely malignant tumor with high rate of lymphatic metastasis. Little is known about its invasion and metastasis mechanisms so far. Methods To clarify the main role of CCL2 in tongue cancer progression, we performed Transwell migration assay to confirm the effects of different concentrations of CCL2 on the migration and invasion of tongue cancer cells. Next, by siRNA interference of RhoA and Rac1 in LNMTca8113 cells, we are able to observe that these two molecules block the effect of CCL2 on cell migration and cytoskeleton reorganization by laser confocal microscopy. Moreover, the AKT phosphorylation level of PI3K downstream molecule under the action of CCL2 also be detected by qRT-PCR and western blot, so as to determine whether CCL2 affects the proliferation of LNMTca8113 cells through PI3K/AKT pathway. Finally, we analyzed the relationship between plasma CCL2 level and various clinicopathological parameters in patients with tongue cancer. Results: We found that tongue cancer cells treated with CCL2 migrate faster at first. CCL2 may enhance the invasion and migration of LNMTca8113 cells by activating RhoA and Rac1 to promote cytoskeleton reorganization. Promotion of LNMTca8113 migration induced by CCL2 was inhibited by silence of RhoA and Rac1. CCL2 could increase the phosphorylation of downstream Akt/PI3K signal and promoted the proliferation. Plasma concentration confirmed that the CCL2 level was closely related to the clinical stage of tongue cancer. Patients with lower CCL2 levels had a relatively longer progression-free survival and total survival time. Results After adding CCL2, the number of proliferation and migration of tongue cancer cells increased and the expression of RhoA and Rac1 rose up in LNMTca8113 cell line. The cytoskeleton reorganization was notable. Patients with higher serum levels of CCL2 had shorter progression-free survival than those with lower levels of CCL2 (P < 0.0001). Conclusions CCL2 promotes the invasion and metastasis of tongue cancer by PI3K/Akt pathway. The plasma level of CCL2 may predict prognosis of tongue cancer patients. CCL2 can serve as a potential therapeutic target for tongue cancer treatment.

Presence of schistosome eggs in lymph node predict unfavorable prognosis in schistosomal colorectal cancer.

The purpose of this study was to investigate the prognostic significance of schistosome eggs' location in schistosomal colorectal cancer (SCRC). 172 cases of SCRC were retrospectively analyzed. Patient clinicopathological parameters and survival rates were analyzed. There were 102 males and 70 females, the median age was 71 years (range, 44-91). All patients were followed, and the median time was 50.1 months (range, 1.0-79.7). There were 87 patients with PS1 (presence site 1, eggs deposited in the mucosa) and 85 patients with PS2 (presence site 2, eggs deposited in the muscularis propria or throughout the full thickness of the intestinal wall), 159 patients presented with eggs in cutting edge and 83 patients presented with eggs in lymph node (LN). Hepatic schistosomiasis was found in 27.3% of patients by imaging modalities and correlated to patients with PS2 ( P < 0.001) and LNs' eggs ( P < 0.001). Survival analyses showed that in stage III SCRC, eggs' presence in LN associated with worse DFS ( P = 0.004) or marginally worse OS ( P = 0.056), patients with PS2 had shorter OS ( P = 0.044). Multivariate analyses revealed hepatic schistosomiasis was an independent prognostic factor for DFS and OS in stage III SCRC ( P = 0.001, 0.002, respectively). In adjusted multivariate analysis, eggs' presence in LN was an independent prognostic factor for DFS in stage III SCRC ( P = 0.006). In stage III SCRC, eggs' presence in LN could predict poor prognosis and hepatic schistosomiasis was an independently unfavorable prognosis factor.

Prognostic value of lymphocyte-C-reactive protein ratio in patients with liver cancer: ameta-analysis.

Background: The impact of lymphocyte-C-reactive protein ratio (LCR) on clinical outcomes has been reported in liver cancer such as hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC), but the results remain inconsistent. Methods: We searched PubMed, Scopus, Web of Science, Embase and Cochrane Library databases for relevant studies evaluating the association of LCR with survival outcomes and clinicopathological parameters. Results: Eight studies with 4316 patients were included in this meta-analysis. Low LCR was significantly associated with poor overall survival, disease-free survival/relapse-free survivaland disease progression clinicopathological parameters in patients with HCC or ICC. Conclusion:Low pretreatment LCR was an adverse prognostic indicator in patients with HCC or ICC. In addition, it wascorrelated with clinicopathological parameters indicating a higher stage of malignancy.