Cox Risk Regression Model Research Articles

Breast-Conserving Surgery in Triple-Negative Breast Cancer: A Retrospective Cohort Study.

The aim of the study is to evaluate the efficacy and prognosis of neoadjuvant chemotherapy (NAC) combined with breast-conserving surgery (BCS) in treating triple-negative breast cancer (TNBC) and analyze the influencing factors and predictors of the efficiency and prognosis of NAC. A retrospective cohort study was conducted by dividing patients into two groups according to two different therapy methods. With BCS as the exposure factor, 46 cases were assigned to the exposed group and 80 cases to the nonexposed group. We compare the difference in operation-related indicators, postoperative complications, local recurrence rate, distant metastasis rate, and overall survival (OS) rate between the two groups. The factors affecting the efficiency and prognosis of NAC were analyzed by binary logistic regression, and the optimal cutoff value was determined by the area under the ROC curve (AUC). The survival curve was plotted, and the univariate log-rank test was performed to analyze the difference in OS between the two groups. The influencing factors of OS were analyzed by the Cox risk regression model. NAC + BCS resulted in significantly less intraoperative blood loss, lower incidence of postoperative complications, and shorter operative time and length of hospital stay than that in NAC (P < 0.05). There was no significant difference in local recurrence, distant metastasis, or OS between the two groups (P > 0.05). Multivariate analysis showed that the clinical stage I and Ki-67 high expression were independent protective factors of the efficacy of NAC. The high expression of Ki-67 and nondecline expression of Ki-67 were independent risk factors of prognosis. Ki-67 high expression was an independent risk factor of OS (P < 0.05). The ROC curve showed that the AUC of Ki-67 for NAC efficacy, prognosis, and OS were 0.706, 0.820, and 0.687, respectively, with optimal cutoff values of 25.5%, 29.0%, and 32.5%, respectively. Survival analysis showed that the OS of patients with NAC + BCS was 73.9% and NAC + MRM was 70.0% (P > 0.05). In the low expression subgroup of Ki-67, the OS of the two groups were 100.0% and 77.8%, respectively (P=0.060). In the high expression subgroup of Ki-67, the OS of the two groups were 53.8% and 63.6%, respectively (P=0.419). NAC + BCS is a good method for treating TNBC, which has an obvious short-term effect and a good long-term prognosis. Clinical stage I and the high expression of Ki-67 are independent protective factors for the efficacy of NAC. The high expression of Ki-67 and nondecline expression of Ki-67 are independent risk factors of prognosis. Ki-67 is a potential predictor for the efficacy, prognosis, and OS of NAC in TNBC patients. The high expression of Ki-67 indicates better NAC efficacy, a poorer prognosis, and a lower OS.

Prognostic effect of radiotherapy in breast cancer patients underwent immediate reconstruction after mastectomy.

It is still unclear whether radiotherapy affects the long-term survival of breast cancer (BC) patients after immediate breast reconstruction (IBR). This study aims to evaluate the actual prognostic impact of radiotherapy on BC patients undergoing IBR, and to construct survival prediction models to predict the survival benefit of radiotherapy. Data on eligible BC patients were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Competing risk models were used to assess breast cause-specific death (BCSD) and non-breast cancer cause-specific death (NBCSD). Kaplan-Meier curve, Cox risk regression model and forest map were used to evaluate and demonstrate overall survival (OS) and breast cancer-specific survival (BCSS). Survival prediction nomograms were used to predict OS and BCSS probabilities. A total of 22,218 patients were selected, 24.9% received radiotherapy and 75.1% were without radiotherapy. Competing risk models showed that whether BCSD or NBCSD, the cumulative long-term risk of death in the radiotherapy group was higher than that in the non-radiotherapy group. The Kaplan-Meier curve showed that patients with different lymph node metastasis had different radiotherapy benefits. Multivariate stratified analysis showed that radiotherapy after autologous reconstruction was associated with poor BCSS in patients with stage N0, and radiotherapy after autologous reconstruction and combined reconstruction improved OS and BCSS in patients with stage N3. The C-indexes of nomogram (between 0.778 and 0.847) and calibration curves showed the good prediction ability of survival prediction model. Radiotherapy can improve OS and BCSS in N3 stage BC patients undergoing immediate autologous reconstruction after mastectomy. The practical nomograms can be used to predict OS and BCSS of patients with or without radiotherapy, which is helpful for individualized treatment.

Hsa_circ_0000231 affects the progression of tongue squamous cell carcinoma by activating Wnt/β-catenin signaling pathway

Objective: To explore the action mechanism of hsa_circ_0000231 in the occurrence and development of tongue squamous cell carcinoma (TSCC). Methods: Tissue samples of 60 TSCC patients were examined. The patients, including 32 males and 28 females, aged from 36 to 84 years old, underwent surgery in the Affiliated Hospital of Nantong University and Affiliated Tumor Hospital of Nantong University from December 2014 to December 2017. Saliva samples were obtained from healthy volunteers (5 males and 5 females, aged from 40 to 75 years old) and 10 TSCC patients. The TSCC cell lines (CAL-27, Tca-8113 and HN-4) were used. The expression levels of hsa_circ_0000231 in 60 pairs of freshly matched TSCC and para-carcinoma tissue samples, 10 pairs of saliva samples and 3 TSCC cell lines were detected by quantitative real-time polymerase chain reaction (qRT-PCR). hsa_circ_0000231 gene interference and lentiviral transfection were constructed, hsa_circ_0000231 in TSCC cell lines CAL-27 and Tca-8113 was knocked down, and the expressions of hsa_circ_0000231 in hsa_circ_0000231 interference group (sh-circ) and no-load lentivirus group (negative control) were tested with qRT-PCR. Cells with the highest knock-down efficiency were selected for CCK-8 test, colony formation assay, transwell invasion assay and scratch assay. The expressions of EMT-related proteins including E-cadherin, snail protein, N-cadherin and vimentin and proteins related to Wnt/β-catenin signaling pathway including β-catenin, C-myc, Bcl-2, MMP-9 and Cyclin D1 were measured by western blot. After TSCC cells in the interference group were co-cultured with Wnt/β-catenin pathway activator LiCl, the expressions of above proteins were re-measured by western blot. TSCC cells in interference group and control group were subcutaneously injected into nude mice to compare the effect of hsa_circ_0000231 knockdown on the growths of the tumors grafted subcutaneously in the nude mice. Statistical analysis software 25.0 was used for data analysis, and t-test or chi-square test was used for comparison between groups. Results: hsa_circ_0000231 was highly expressed in the tissue and saliva samples of TSCC patients and cell lines CAL-27, Tca-8113 and HN-4, but lowly expressed in paired para-carcinoma tissues, saliva samples of healthy people and normal human oral keratinocytes (all P<0.05). Log-rank univariate analysis showed that hsa_circ_0000231 expression level, tumor differentiation degree and T stage were related to the survival of TSCC patients (all P<0.05). Multivariate Cox risk regression model analysis suggested that hsa_circ_0000231 expression level (χ2=5.77,P=0.016) and T stage (χ2=5.27,P=0.029) were independent factors for the poor prognosis of TSCC patients. Western blot showed the expressions of snail protein, N-cadherin and vimentin were down-regulated, but E-cadherin was up-regulated in interference group compared with control group. In interference group, the expressions of β-catenin, C-myc, Bcl-2, MMP-9 and CyclinD1 were down-regulated, which were reversed after TSCC cells were co-cultured with LiCl. The knockdown of hsa_circ_0000231 reduced the proliferation, invasion and metastasis abilities of CAL-27 and Tca-8113 cells, which were reversed after TSCC cells were co-cultured with LiCl. The growth rate and volume of the tumors grafted subcutaneously in interference group using LiCl were greater than those in negative control group. Conclusion: hsa_circ_0000231 is an independent prognostic factor of TSCC. Highly expressed hsa_circ_0000231 can promote the proliferation, invasion and metastasis of TSCC cells.

Network Pharmacology and Bioinformatics Analysis Identifies Potential Therapeutic Targets of Paxlovid Against LUAD/COVID-19.

BackgroundCoronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a pandemic in many countries around the world. The virus is highly contagious and has a high fatality rate. Lung adenocarcinoma (LUAD) patients may have higher susceptibility and mortality to COVID-19. While Paxlovid is the first oral drug approved by the U.S. Food and Drug Administration (FDA) for COVID-19, its specific drug mechanism for lung cancer patients infected with COVID-19 remains to be further studied.MethodsCOVID-19 related genes were obtained from NCBI, GeneCards, and KEGG, and then the transcriptome data for LUAD was downloaded from TCGA. The drug targets of Paxlovid were revealed through BATMAN-TCM, DrugBank, SwissTargetPrediction, and TargetNet. The genes related to susceptibility to COVID-19 in LUAD patients were obtained through differential analysis. The interaction of LUAD/COVID-19 related genes was evaluated and displayed by STRING, and a COX risk regression model was established to screen and evaluate the correlation between genes and clinical characteristics. The Venn diagram was drawn to select the candidate targets of Paxlovid against LUAD/COVID-19, and the functional analysis of the target genes was performed using KEGG and GO enrichment analysis. Finally, Cytoscape was used to screen and visualize the Hub Gene, and Autodock was used for molecular docking between the drug and the target.ResultBioinformatics analysis was performed by combining COVID-19-related genes with the gene expression and clinical data of LUAD, including analysis of prognosis-related genes, survival rate, and hub genes screened out by the prognosis model. The key targets of Paxlovid against LUAD/COVID-19 were obtained through network pharmacology, the most important targets include IL6, IL12B, LBP. Furthermore, pathway analysis showed that Paxlovid modulates the IL-17 signaling pathway, the cytokine-cytokine receptor interaction, during LUAD/COVID-19 treatment.ConclusionsBased on bioinformatics and network pharmacology, the prognostic signature of LUAD/COVID-19 patients was screened. And identified the potential therapeutic targets and molecular pathways of Paxlovid Paxlovid in the treatment of LUAD/COVID. As promising features, prognostic signatures and therapeutic targets shed light on improving the personalized management of patients with LUAD.

Screening of Differentially Expressed Iron Death-Related Genes and the Construction of Prognosis Model in Patients with Renal Clear Cell Carcinoma.

Objective In this study, we used the TCGA database and ICGC database to establish a prognostic model of iron death associated with renal cell carcinoma, which can provide predictive value for the identification of iron death-related genes and clinical treatment of renal clear cell carcinoma. Methods The gene expression profiles and clinical data of renal clear cell carcinoma and normal tissues were obtained in the TCGA database and ICGC database, and the differential genes related to iron death were screened out. The differential genes were screened out by single and multifactor Cox risk regression model. R software, “edge” package (version 4.0), was used to identify the DELs of 551 transcriptional gene samples and 522 clinical samples. The risk prediction model with genes was established to analyze the correlation between the genes in the established model and clinical characteristics, Through the final screening of iron death related genes, it can be used to predict the prognosis of renal clear cell carcinoma and provide advice for clinical targeted therapy. Results Seven iron death differential genes (CLS2, FANCD2, PHKG2, ACSL3, ATP5MC3, CISD1, PEBP1) associated with renal clear cell carcinoma were finally screened and were refer to previous relevant studies. These genes are closely related to iron death and have great value for the prognosis of renal clear cell carcinoma. Conclusion Seven iron death genes can accurately predict the survival of patients with renal clear cell carcinoma.

Usefulness of sequential organ failure assessment score on admission to predict the 90-day mortality in patients with exertional heatstroke: An over 10-year intensive care survey

Background and objectivesDespite a growing understanding of exertional heatstroke (EHS), there is a paucity of clinical evidence for risk-stratification of patients with EHS. The objective of this study was to identify an appropriate scoring system for prognostic assessment of EHS. MethodsThis was a retrospective cohort study of all patients with EHS admitted to intensive care unit (ICU) of the General Hospital of Southern Theatre Command of PLA between October 2008 and May 2019. Inflammatory indices and organ function parameters at admission, the Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, Sequential Organ Failure Assessment (SOFA) scores, and Glasgow Coma Scale (GCS) score were collected. Risk factors for 90-day mortality were identified using multivariate Cox proportional hazard risk regression model. Results189 patients (all male) were finally included, with a median age of 21.0 years (IQR 19.0–27.0), median APACHE II score of 11.0 (IQR 8.0–16.0), median SOFA score of 3.0 (IQR 2.0–6.0), and median GCS score of 12.0 (IQR 7.0–14.0). There were 166 survivors (87.8%) and 23 non-survivors (12.2%). Compared with survivor group, non-survivors had higher incidence of severe organ damage, including rhabdomyolysis (46.1% vs 63.6%), disseminated intravascular coagulation (25.6% vs 90.0%), acute liver injury (69.4% vs 95.7%), and acute kidney injury (36.6% vs 95.7%). Multivariate Cox risk regression model showed that SOFA score was an independent risk factor for 90-day mortality, with an optimal cutoff score of 7.5. ConclusionsSOFA score may be a clinically useful predictor of death in EHS. Prospective studies are required to confirm the effectiveness of SOFA score and the optimal cutoff level.

Clinical Study of Airway Stent Implantation in the Treatment of Patients with Malignant Central Airway Obstruction.

Background Airway stenting is a therapeutic option for malignant central airway obstructions (MCAO), including both intraluminal and extraluminal obstructions. The objective of this study is to investigate the clinical features and results of long-term improved prognosis for MCAO patients after airway stent implantation. Methods Ninety-eight MCAO patients who underwent stent placement in our hospital from January 2013 to April 2020 were included in this study. The data included baseline data, clinical characteristics, laboratory test data, stent implantation data, and treatment as well as survival after stent implantation. The survival rates among individuals were compared via log-rank tests. Potential prognostic factors were identified using multivariate cox hazard regression models. Results A retrospective analysis of these patients was generated. MCAO was mainly caused by lung cancer (53/98, 54.08%), esophageal cancer (22/98, 22.45%), and thyroid cancer (3/98, 3.06%). The median survival time of participants was 5.5 months. Univariate analysis indicated that the survival rate was related to primary disease, ECOG PS score, stent site, hemoglobin (Hb), albumin (ALB), and serum lactate dehydrogenase (LDH) (P < 0.05). The cox risk regression model showed that the survival rate was significantly influenced by ECOG PS score (OR = 3.468, 95%CI = 1.426–8.432, P = 0.006) and stent site (OR = 1.544, 95%CI = 1.057–2.255, P = 0.025). Conclusions Compared with the site of stent placement, the ECOG PS score is the primary factor in the survival rate of MCAO patients after airway stenting.

The Influencing Factors of Breastfeeding for Full-Term Singleton Within Six Months of Birth in Xi'an Before the Covid-19 Pandemic.

ObjectiveThe study is designed to understand the situation of full-term infants breastfeeding within 6 months of birth in Xi'an before the Covid-19 pandemic and analyze the influencing factors of exclusive breastfeeding.MethodsFive hospitals in Xi'an province have been selected as research centers. Full-term infants who met the inclusion and exclusion criteria were recruited from these centers between January 1 and February 28, 2019. The feeding situation at 10 days, 42 days, 3 months, and 6 months after birth were investigated. A self-designed breastfeeding questionnaire was used for investigation and follow-up. SPSS 22.0 was applied for statistical analysis of the data.ResultsThe exclusive breastfeeding rate of full-term infants on days 10 and 42 and at months three and six after birth was 61.38%, 54.78%, 48.83%, and 38.78%, respectively, with a decreasing trend over time. During breastfeeding within 48 h after delivery, 1,653 cases (91.83%) of puerpera had different grades of pain, including 1,325 cases (80.16%) of mild discomfort, 321 cases (19.42%) of moderate pain, and seven cases (0.42%) of severe pain. Within 24–48 h postpartum, 1,607 (89.27%) mothers faced problems related to postpartum breastfeeding. Among them, 694 (43,19%) neonates could not be fed effectively; 665 (41.38%) mothers had wound pain and had inconvenience to turn over; 598 (37.21%) neonates were difficult to wake up; 439 (27.32%) mothers had incorrect feeding posture; 181 (11.26%) mothers experienced other problems. The Cox risk regression model showed that weight gain during pregnancy was higher than the recommended standard. Living in suburban counties was a risk factor of exclusive breastfeeding for full-term infants. Participation in breastfeeding courses during pregnancy, feeding more than eight times daily after delivery, were the protective factors of exclusive breastfeeding for full-term infants.ConclusionThe body weight gain of parturients should be controlled within a reasonable range during pregnancy. Parturients were encouraged by medical staff to participate in breastfeeding courses or watch the breastfeeding process during pregnancy to increase their self-confidence and improve the rate of exclusive breastfeeding for full-term infants. In addition, it is necessary to strengthen the publicity of breastfeeding in suburban areas to promote breastfeeding.

Clinical characteristics and prognostic value of EGFR mutation in stage I lung adenocarcinoma with spread through air spaces after surgical resection.

The clinical data of stage I invasive lung adenocarcinoma patients with spread through air spaces (STAS) who underwent lobectomy from January 1, 2013 to January 1, 2016 at the Department of Thoracic Surgery of Hebei Medical University were analyzed retrospectively, and statistical analysis was carried out to explore their clinical features and prognostic value of EGFR mutation. A total of 280 patients were included in the study cohort, and EGFR mutations were detected in 154 patients. EGFR mutations were more common in non-smokers (p=0.045), females (p<0.001), without vascular tumor thrombus (p=0.037), and histological subtype LPA/APA/PPA (p=0.001). Multivariate analysis of the Cox risk regression model showed that EGFR gene mutation (p=0.807) was not an independent influencing factor of recurrence-free survival (RFS), but EGFR mutation was an independent influencing factor of overall survival (OS) (p=0.012), and OS of patients with EGFR mutation was better. The EGFR mutation also significantly increased the progression-free survival (PFS) of relapsed patients (p<0.001), but the PFS of relapsed EGFR mutation patients who received adjuvant chemotherapy after the operation was worse than that of patients who did not receive adjuvant chemotherapy (p=0.029). EGFR gene mutation is not a risk factor for postoperative recurrence in patients with stage I lung adenocarcinoma with STAS but the 5-year survival rate of patients with EGFR gene mutation is better than that of wild-type. Postoperative adjuvant chemotherapy for patients with EGFR mutation should be carefully considered.

Landscape and Clinical Significance of Immune Checkpoint in Cutaneous Melanoma.

BackgroundThe incidence of cutaneous melanoma (CM) is increasing, and its prognosis is not optimistic. Although immune checkpoint (ICP) inhibitors are effective in the treatment of CM patients, they are not effective for all CM patients. There is an urgent need for a marker to predict both the prognosis and the immunotherapy effect in patients with CM.ApproachesTwo groups of patients with greatly different prognosis and response to immunotherapy were identified by unwatched cluster exploration of TCGA on the basis of 34 ICPs. The prognosis and immunotherapy effect of CM were predicted by developing a precise and given signature on the basis of ICPs, and a multivariate Cox risk regression model was established from the TCGA cohort consisting of 454 CM samples. The model was validated in 210 and 231 samples in the test and verification cohorts, respectively.ResultsThe prognosis in clinical subgroups was predicted by the classification system. High-risk patients had poorer responses to chemotherapy and immunotherapy. Finally, the signature was recognized as an independent prognostic factor. Based on checkpoint-based signature (ICPBS) and clinical characteristics, we constructed a nomogram for the prognosis in patients with CM, which was superior to ICPBS in efficacy than ICPBS alone.ConclusionAs a useful prognostic tool to further improve cancer immunotherapy, the signature can accurately predict recurrence and overall survival among patients with CM.

Prognostic Value of Preoperative NLR and Vascular Reconstructive Technology in Patients With Pancreatic Cancer of Portal System Invasion: A Real World Study.

The purpose was aimed to establish a simple computational model to predict tumor prognosis by combining neutrophil to lymphocyte Ratio (NLR) and biomarkers of oncological characteristics in patients undergoing vascular reconstructive radical resection of PDAC. The enrolled patients was divided into high or low NLR group with the cutoff value determined by the receiver operator characteristic (ROC) curve. Different vascular anastomoses were selected according to the Chaoyang classification of PDAC. Survival rates were calculated using the Kaplan-Meier and evaluated with the log-rank test. Cox risk regression model was used to analyze the independent risk factors for prognostic survival. The optimal cut-off value of NRL was correlated with the differentiation, tumor size, TNM stage and distant metastasis of advanced PDAC. A curative resection with vascular reconstructive of advanced PDAC according to Chaoyang classification can obviously improve the survival benefits. Cox proportional hazards demonstrated higher evaluated NLR, incisal margin R1 and lymphatic metastasis were the independent risk predictor for prognosis with the HR > 2, meanwhile, age beyond 55, TNM stage of III-IV or Tumor size > 4cm were also the obvious independent risk predictor for prognosis with the HR ≤ 2. The advanced PADC patients marked of RS group (3 < RS ≤ 6) showed no more than 24 months of survival time according to RS model based on the six independent risk predictors. Vascular reconstruction in radical resection of advanced PDAC improved survival, higher elevated NLR (>2.90) was a negative predictor of DFS and OS in those patients accompanying portal system invasion.

The imaging features of extrapancreatic perineural invasion (EPNI) in pancreatic Cancer：A comparative retrospective study

BackgroundExtrapancreatic perineural invasion (EPNI) is a risk factor for the prognosis of patients with pancreatic cancer. Few reliable clinical indicators can be used to evaluate EPNI. MethodsWe reviewed clinicopathological information of pancreatic cancer patients received radical surgery in our center from 2014 to 2019. The minimum distance between the tumor boundary and celiac artery (CA), superior mesenteric arteria (SMA) was respectively measured on enhanced-contrast CT images. Receiver Operating Characteristic (ROC) analysis was used to evaluate the diagnostic efficacy, and the optimal cut-off value was determined by Youden index. The latter was used as a diagnostic indicator for imaging perineural invasion (iPNI). K-M method and Cox risk regression model were applied to analyze the prognostic value of iPNI. ResultsA total of 384 patients were enrolled in this study. ROC analysis showed the minimum distance is an efficient indicator, and the best cut-off value 6.5 mm provided 71.63% sensitivity and specificity 84.31%. Cox regression model showed that iPNI was an independent risk factor for disease-free survival (DFS) and overall survival (OS). Subgroup analysis indicated that patients with larger tumor size and iPNI positive suggested a worse prognosis. ConclusionsThe minimum distance between tumor boundary and arteries is an efficient imaging indicator for diagnosing EPNI. iPNI is an independent risk factor for DFS and OS. The novel typing method based on plexus pancreaticus capitalis (PLX) potentially invaded may have guiding significance for extent of dissection.

The effect of psychological condition before radiotherapy on prognosis in 390 patients initially treated for nasopharyngeal carcinoma.

To explore whether anxiety and depression are prognostic indexes for overall survival in patients with nasopharyngeal carcinoma (NPC) who underwent intensity-modulated radiotherapy (IMRT). Clinical data were collected for NPC patients who underwent IMRT. Anxiety and depression were investigated before radiotherapy by using the Hospital Anxiety and Depression Scale (HADS). The survival rate was calculated by the Kaplan-Meier method, and survival curves were compared among patients with different levels of anxiety and depression. The Cox risk regression model was used to screen the factors affecting survival. A total of 390 initially treated NPC patients were included in the study. Among them, 166 patients suffered from anxiety, and 95 patients suffered from depression before radiotherapy. The 5-year overall survival rates for patients with and without anxiety before radiotherapy were 71.6% and 81.8% (χ2 = 5.31, P = 0.021), respectively. The 5-year overall survival rates for patients with and without depression before radiotherapy were 74.3% and 78.1% (χ2 = 0.05, P = 0.82), respectively. Cox regression analysis indicated clinical stages (HR = 3.982, 95% CI: 2.365~6.705), anxiety (HR = 1.832, 95% CI: 1.140~2.944), and gender (HR = 0.555, 95% CI: 0.313~0.984) as independent prognostic factors. Anxiety before radiotherapy is associated with poor prognosis in NPC patients.

Correlation Between Promoter Hypomethylation and Increased Expression of Syncytin-1 in Non-Small Cell Lung Cancer.

IntroductionSyncytin-1 is a human endogenous retroviral (HERVW) envelope protein, which has been implicated in trophoblast and cancer cell fusions as well as in immunomodulatory functions. We investigated syncytin-1 expression and promoter methylation in non-small cell lung cancer (NSCLC) and the adjacent, para-carcinoma tissues. In addition, the correlation to patient survival differentiation of between 5-year survival and death group was analyzed.MethodsSurvival ratio was calculated by Kaplan-Meier survival curve. Death risk assessment was executed by Cox risk regression model. The 5ʹ-LTR methylation level of HERVW promoter was detected by EpiTYPER method.ResultsSyncytin-1 expression in NSCLC tissue was found to be significantly higher than in para-carcinoma tissues. Moreover, the 5-year survival group has a lower syncytin-1 expression than the death group. Clinical stage and the percentage of syncytin-1 positive cells were top risk factors according to Cox ratio risk regression model analysis. While the methylation level of the 5ʹ-LTR in HERVW gene promoter was relatively lower in NSCLC than para-carcinoma tissues, the methylation status of a CpG-2 site overlapping the Oct-1 binding site was found to be an important element potentially involved in the epigenetic regulation of HERVW gene expression.ConclusionThese findings suggest that syncytin-1 could be a biomarker for the diagnosis/prognosis of NSCLC, and further studies are required to elucidate the exact role of syncytin-1 in the development of NSCLC as well as the underlying molecular mechanism for syncytin-1 function and regulation.

Clinical Significance of a Novel Tumor Progression-Associated Immune Signature in Colorectal Adenocarcinoma.

BackgroundSome colorectal adenocarcinoma (CRC) patients are susceptible to recurrence, and they rapidly progress to advanced cancer stages and have a poor prognosis. There is an urgent need for efficient screening criteria to identify patients who tend to relapse in order to treat them earlier and more systematically.MethodsWe identified two groups of patients with significantly different outcomes by unsupervised cluster analysis of GSE39582 based on 101 significantly differentially expressed immune genes. To develop an accurate and specific signature based on immune-related genes to predict the recurrence of CRC, a multivariate Cox risk regression model was constructed with a training cohort composed of 519 CRC samples. The model was then validated using 129, 292, and 446 samples in the real-time quantitative reverse transcription PCR (qRT-PCR), test, and validation cohorts, respectively.ResultsThis classification system can also be used to predict the prognosis in clinical subgroups and patients with different mutation states. Four independent datasets, including qRT-PCR and The Cancer Genome Atlas (TCGA), demonstrated that they can also be used to accurately predict the overall survival of CRC patients. Further analysis suggested that high-risk patients were characterized by worse effects of chemotherapy and immunotherapy, as well as lower immune scores. Ultimately, the signature was identified as an independent prognostic factor.ConclusionThe signature can accurately predict recurrence and overall survival in patients with CRC and may serve as a powerful prognostic tool to further optimize cancer immunotherapy.

The Change Trend of Cause of Death in Patients With Stage I Non-Small Cell Lung Cancer After Surgery in US: A Long-Term Follow-Up Study Based on SEER Database.

There are few studies on the cause of death in patients with stage I non-small cell lung cancer after surgery. Our aim is to study the trend of cause of death and risk factors affecting prognosis in the patients. We retrospectively reviewed patients in Surveillance, Epidemiology and End results database from 2004 to 2015. The change trend between cause of death and follow-up time was studied by calculating the proportion of cause of death at different periods and analyzing the cumulative risk. COX risk regression model was performed by univariate and multivariate analyses for survival analysis. Finally, 23,652 patients were enrolled. In the whole cohort, lung cancer accounted for 18.68% of deaths, followed by other causes (9.57%), heart disease (5.12%) and COPD (3.89%). With the increasing of follow-up time, the cumulative incidence of lung cancer was always the highest, but the growth rate in the late follow-up period was slower than that caused by heart disease and COPD. The proportion of death due to lung cancer decreased from 53.1%-73.1% in 0-30 months after follow-up to 7.8%-41.4% in 90 months after follow-up, while the proportion of deaths due to heart disease and COPD increased. Age was an independent risk factor for lung cancer-, heart disease- and COPD-specific survival, while lobectomy resection was a protective factor, even in patients older than 70 years old. In conclusion, during the follow-up period, lung cancer was still the main cause of death, but the proportion of patients died of heart disease and COPD increased gradually, especially in elderly. Furthermore, age was an important independent factor affecting prognosis, particularly for heart disease- and COPD-related mortality. The application of wedge resection in elderly patients needs further exploration.

Analysis of correlation factors and prognosis of local recurrence of laryngeal squamous cell carcinoma

Objective:To explore the correlation factors and prognosis of local recurrence of laryngeal squamous cell carcinoma. Method:The clinical data of 69 patients with local recurrence of laryngeal squamous cell carcinoma were analyzed retrospectively. The survival curve was analyzed by Kaplan-Meier method, and the survival rate was compared by chi-square test and log rank test, Cox risk regression model was used to analyze multivariate survival. Result:Patients with local recurrence of laryngeal cancer had DFS and OS at 3 years of 17.4% and 63.8%, at 5 years of 4.3% and 40.6%, respectively. The invasion of the thyroid cartilage plate is significantly related to the prognosis of the patient, and the degree of squamous cell carcinoma differentiation is an independent factor influencing the prognosis, patients with non-invasive thyroid cartilage plate and high differentiated squamous cell carcinoma have better prognosis. Conclusion:Local recurrence of laryngeal carcinoma is common among patients with moderately or poorly differentiated squamous cell carcinoma, invasion of the thyroid cartilage plate, and positive or insufficient resection margins. And the prognosis of above patients is still poor after receiving salvage surgery; comprehensive treatment and closer follow-up should be paid to these patients.

Screening of Clinical Factors Related to Prognosis of Breast Cancer Based on the Cox Proportional Risk Model.

Proper evaluation of the relevant clinical factors for the prognosis of breast cancer is particularly important in the selection of appropriate therapeutic strategies. To further screen and identify the clinically significant factors associated with breast cancer, the Cox risk regression model analysis was performed in this study. The follow-up data of intact breast cancer patients were downloaded from METABRIC (Molecular Taxonomy of Breast Cancer International Consortium) database, and the prognostic factors correlated with radiotherapy factors were screened using the Cox risk regression model analysis of prognostic factors. The response of different clinical features to radiotherapy was also evaluated by survival prognosis analysis and prediction. A total of 1980 breast cancer patients were enrolled in this study, including 1173 patients who received the radiotherapy treatment and 807 patients without radiotherapy treatment. To further study the correlation between the clinical prognostic factors and the overall survival, the single factor and multivariate Cox regression analysis were performed, and the clinical prognostic factors implied that the patients with age <60 years, receiving radiotherapy, grade 1, stage 0-1, or human epidermal growth factor receptor 2 (HER2) negative had a better overall clinical survival. The association analysis of the radiotherapy treatment and the clinical prognostic factors implied that the patients with younger age, stage lower, or HER2 negative showed a better overall clinical survival, and the patients who received radiotherapy had a better 3-year survival probability and 5-year survival probability. Screening and identifying the clinically significant factors associated with breast cancer can help predict the risk of disease. Age, stage, or HER2 status was the prognostic factors correlated with radiotherapy treatment.

Risk Factors for the 90-Day Prognosis Of Severe Heat Stroke: a Case-Control Study

Severe heat stroke is a clinical syndrome caused by host stress dysfunction due to heat stress and subsequent life-threatening organ dysfunction. We aimed to explore the early risk factors affecting the 90-day prognosis of severe heat stroke patients. A case-control study was used to retrospectively analyze the clinical data of 117 severe heat stroke patients admitted to the intensive care unit of the General Hospital of Southern Theater Command from April 2014 to May 2019. The risk factors affecting the 90-day mortality of the patients were analyzed, and subgroup analysis was performed comparing the complete recovery and the sequelae subgroups of survivors. Thirteen patients (11.1%) died within 90 days. The multivariate Cox risk regression model showed that cooling time (HR 4.87; 95% CI: 1.94-12.18; P = 0.001), heart rate (HR 1.04; 95% CI: 1.01-1.09; P = 0.027), and Sequential Organ Failure (SOFA) score (HR 1.41; 95% CI: 1.21-1.65; P < 0.001) were independent risk factors affecting the survival of patients. The area under the Receiver Operating Characteristic (ROC) curve of the combination of cooling time, heart rate, and SOFA score for the prediction of mortality due to severe heat stroke was 98.1% (95% CI 0.957-1.000, P < 0.001), the sensitivity was 96.2%, and the specificity was 92.3%. The longer the cooling duration, the faster the heart rate at admission, and the higher the SOFA score, the lower the 90-day survival rate was. These three indicators can be used in combination to predict 90-day mortality and poor prognosis in patients with severe heat stroke.

Establishment and Evaluation of a 6-Gene Survival Risk Assessment Model Related to Lung Adenocarcinoma Microenvironment.

Objective A survival risk assessment model associated with a lung adenocarcinoma (LUAD) microenvironment was established and evaluated to identify effective independent prognostic factors for LUAD. Methods The public data were downloaded from the TCGA database, and ESTIMATE prediction software was used to score immune cells and stromal cells for tumor purity prediction. The samples were divided into the high-score group and the low-score group by the median value of the immune score (or stromal score). The Wilcoxon test was used for differential analysis. GO and KEGG enrichment analysis of differentially expressed genes (DEGs) was performed using “clusterProfiler” of R package. Meanwhile, univariate and multivariate regression analysis was performed on DEGs to construct a multivariate Cox risk regression model with variable gene expression levels as independent prognostic factors affecting a tumor microenvironment (TME) and tumor immunity. Results This study found that LUAD patients with high immune cell (stromal cell) infiltration had better prognosis and were in earlier staging. Functional enrichment analysis revealed that most DEGs were related to the proliferation and activation of immune cells or stromal cells. A survival prediction model composed of 6 TME-related genes (CLEC17A, TAGAP, ABCC8, BCAN, FLT3, and CCR2) was established, and finally, the 6 feature genes closely related to the prognosis of LUAD were proved. The AUC value of the ROC curve in this model was 0.7, indicating that the model was reliable. Conclusion Six genes related to the LUAD microenvironment have a predictive prognostic value in LUAD.