Over Survival Research Articles

Identification and Validation of an Autophagy-Related lncRNA Signature forPatients With Breast Cancer.

BackgroundAutophagy is a “self-feeding” phenomenon of cells, which is crucial in mammalian development. Long non-coding RNA (lncRNA) is a new regulatory factor for cell autophagy, which can regulate the process of autophagy to affect tumor progression. However, poor attention has been paid to the roles of autophagy-related lncRNAs in breast cancer.ObjectiveThis study aimed to construct an autophagy-related lncRNA signature that can effectively predict the prognosis of breast cancer patients and explore the potential functions of these lncRNAs.MethodsThe RNA sequencing (RNA-Seq) data of breast cancer patients was collected from The Cancer Genome Atlas (TCGA) database and the GSE20685 database. Multivariate Cox analysis was implemented to produce an autophagy-related lncRNA signature in the TCGA cohort. The signature was then validated in the GSE20685 cohort. The receiver operator characteristic (ROC) curve was performed to evaluate the predictive ability of the signature. Gene set enrichment analysis (GSEA) was used to explore the potential functions based on the signature. Finally, the study developed a nomogram and internal verification based on the autophagy-related lncRNAs.ResultsA signature composed of 9 autophagy-related lncRNAs was determined as a prognostic model, and 1,109 breast cancer patients were divided into high-risk group and low-risk group based on median risk score of the signature. Further analysis demonstrated that the over survival (OS) of breast cancer patients in the high-risk group was poorer than that in the low-risk group based on the prognostic signature. The area under the curve (AUC) of ROC curve verified the sensitivity and specificity of this signature. Additionally, we confirmed the signature is an independent factor and found it may be correlated to the progression of breast cancer. GSEA showed gene sets were notably enriched in carcinogenic activation pathways and autophagy-related pathways. The qRT-PCR identified 5 lncRNAs with significantly differential expression in breast cancer cells based on the 9 lncRNAs of the prognostic model, and the results were consistent with the tissues.ConclusionIn summary, our signature has potential predictive value in the prognosis of breast cancer and these autophagy-related lncRNAs may play significant roles in the diagnosis and treatment of breast cancer.

Impact of Androgen Receptor Gene Expression in Gastric Cancer: a Meta-Analysis Based on the GEO Database, TCGA Database, and Literature

To evaluate androgen receptor and AR gene expression impact of gastric cancer (GC). Meta-analysis of microarray data obtained from the Gene Expression Omnibus (GEO) database, TCGA (The Cancer Genome Atlas) database, and data by systematic search of PubMed, China National Knowledge Internet and Web of Science. This meta-analysis included 30 studies involving 4487 patients. From our results, we can know that the positive rate of AR expression in gastric cancer is 40%. The expression of AR was significantly higher in men (SWD = 1.00, 95% CI 0.03 ~ 1.96, P = 0.042). The higher AR expression was linked with poor over survival (OS) (HR = 1.30, 95% CI 1.13 ~ 1.49, P < 0.0001). AR gene may be an important factor affecting the poor prognosis of GC patients of different genders.

Radiotherapy Significantly Improves Long-Term Survival And Local Control Of Head And Neck Rhabdomyosarcoma (HNRMS) In Adults: Retrospective Analysis Of 64 Patients

Rhabdomyosarcomas in adults were rarely reported in the literature. The aim of this study was to analyze the primary site, stage, treatment and prognosis of HNRMS in Adults. The clinical data of adult patients with pathologic diagnosis of HNRMS admitted from October 1999 to July 2018 in Chinese Academy of Medical Sciences Cancer Hospital were retrospectively analyzed. The clinical staging and risk grouping were performed according to International RMS Study Group (IRSG) criterion. A total of 64 patients were included (30 males, 34 females). The median age was 28 years (16-69ys). The pathological type consisted of 28 (43.8%) embryonic RMS, 25 (39.1%) alveolar RMS and 5 (7.9%) pleomorphic RMS. 21 patients (32.8%) got tumors invasion of parameningeal, 38 patients (59.4%) had orbital invasion, included 19 patients (29.7%) had both orbital and parameningeal invasion. IRSG I-IV stage accounted for 57.8%, 10.9%, 18.8%, 12.5% of all the patients. 35.6% patients were classified as low risk, 50.8% patients as medium risk and 13.6% patients as high risk. 28 patients (43.8%) received radical resection, 13 patients achieved R0 resection. 54 patients (84.4%) received radical /adjuvant radiotherapy. Median dose was 69.96Gy (37.5-71.04Gy) of GTV / GTVtb. 46 patients (85.2%) received cervical lymphatic drainage area radiation. A total of 44 patients (68.8%) median completed 4 cycles (1-12 cycles) of chemotherapy. The main chemotherapy regimen was IFO + EPI (52.3%) and CTX + VCR + EPI (25%). Median follow-up for surviving patients was 48 months. 47 patients (73.4%) failed after the treatment, 14 (21.9%) had local recurrence, 34 (53.1%) had distant metastasis. 43 patients (67.2%) were died. The overall 1-, 3- and 5-year over survival (OS) rates were 81.7%, 35.7% and 23.7%, respectively. The median survival time was 20 months. The addition of radiotherapy in treatment significantly improved the OS, progression free survival (PFS) and local-regional recurrence free survival (LRRFS) (3ys OS 36.5% vs 21.8% P = 0.03, 3ys-PFS 27.2% vs 0% P < 0.01, 3ys-LRRFS 77.1% vs 0% P < 0.01). There was no significant difference in LRRFS between patients who received radical radiotherapy and patients received radical surgery (3ys-LRRFS 76.2% vs 70.9% P = 0.79). Multivariate analysis indicated that addition of radiotherapy was the only independent prognostic factor associated with improved OS (RR:0.40, 95%CI 0.20-0.90, P = 0.03). The Adult HNRMS is a kind of tumor with high malignancy and poor prognosis. Radiotherapy added to treatment significantly improved long-term OS and PFS. However, multimodality treatment (surgery, radiotherapy, and chemotherapy) planning and risk stratification is required for all patients to improve the prognosis of Adult HNRMS.

Significance of Tumor-Infiltrating Immune Cells in the Prognosis of Colon Cancer.

ObjectiveIncreasing evidence has indicated an association between immune infiltration in colon cancer and clinical outcomes. The aim of this research is to comprehensively investigate the effect of 22 tumor-infiltrating immune cells (TIICs) on the prognosis of colon cancer patients.MethodsIn our research, CIBERSORT algorithm was used to calculate the proportion of 22 TIICs in 369 colon cancer cases and 39 normal cases from the TCGA cohort. Cox regression analysis was used to analyze the effect of 22 TIICs on the prognosis of colon cancer. Immune risk scoring model was constructed based on the statistical correlation between TIICs subpopulation and survival. Meanwhile, multivariate Cox regression analysis was utilized to investigate whether the immune risk score model was an independent factor for predicting the prognosis of colon cancer. Nomogram was constructed to comprehensively predict the survival rate of colon cancer. P< 0.05 was considered to be statistically significant.ResultsThe results of the difference analysis showed that except for 12 TIICs, the remaining immune cells exhibited no differential infiltration between normal and colon cancer tissues (p<0. 05). Univariate Cox regression analysis revealed 5 immune cells statistically correlated with colon cancer-related survival risk, including B cells naive, B cells memory, monocytes, macrophages M0, macrophages M1 (P<0.05). In addition, a four-cell based immune risk scoring model was constructed through LASSO Cox regression analysis. KM curve indicated that patients in highrisk were associated with poor outcomes (p<0.001). ROC curve indicated that the immune risk score model was reliable in predicting survival risk (AUC=0.848). Our model showed satisfying AUC and survival correlation in the validation dataset (3-year over survival (OS) AUC=0.941, 5-year OS AUC=0.865, P=0.022). Furthermore, multivariate Cox regression analysis confirmed that the immune risk score model was an independent factor for predicting the prognosis of colon cancer (hazard ratio (HR) =5.017, 95% confidence interval (CI) =2.336–10.777; P<0.001). Ultimately, a nomogram was established to comprehensively predict the survival of colon cancer patients with the results of multivariate Cox regression analysis.ConclusionCollectively, tumor-infiltrating immune cells played an essential role in the prognosis of colon cancer. Furthermore, immune risk score was an independent predictive factor of colon cancer, indicating a poor survival.

The Prognostic Significance of Metastatic Nodal Size in Non-surgical Patients With Esophageal Squamous Cell Carcinoma.

Background: The present study aimed to determine the prognostic value of the size of metastatic lymph node (LN) in non-surgical patients with esophageal squamous cell carcinoma (ESCC).Methods: Three hundred seventy-six ESCC patients treated with definitive (chemo-) radiotherapy from January 2013 to March 2016 were reviewed. We analyzed potential associations of metastatic nodal size with responses, patterns of failure, and survival. Log-rank testing and Cox proportional hazards regression models were used to assess the impact of the clinical factors on survival.Results: The 3-years over survival (OS) rates following a median follow-up of 28.2 months were 53.2, 46.2, 35.5, and 22.7% for the N0 group, the >0.5 to ≤1 cm group, the >1 to ≤2 cm group, and the >2 cm group, respectively. The progression-free survival (PFS) rates for 2 years were 50.9, 44.2, 26.6, and 23.4% for the N0 group, the >0.5 to ≤1 cm group, the >1 to ≤2 cm group, and the >2 cm group, respectively. The objective response rates (ORR) for the 280 patients with metastatic LNs were 43.1% for the LN >0.5 to ≤1 cm group, 46.9% for the LN >1 to ≤2 cm group, and 25.5% for the LN ≥2 cm group. The LN >2 cm group had the worst ORR of the three groups with LNs. Gross tumor volume (GTV) failure was the most common failure pattern, followed by distant failure and out of GTV LN failure, with incidences of 47.9% (180 of 376), 42% (158 of 376), and 13.8% (52 of 376), respectively. Nodal size correlated statistically with GTV failure and distant failure but not with out-of-GTV nodal failure. After adjusting for age, sex, T category, Primary tumor location, and CRT, the size of metastatic LNs was an independent prognostic factor for OS and PFS in multivariate analyses.Conclusions: Nodal size is one of prognostic factors for non-surgical patients with ESCC and correlated statistically with GTV failure and distant failure.

Identification of microRNAs and their Endonucleolytic Cleavaged target mRNAs in colorectal cancer

BackgroundColorectal cancer (CRC) ranks the third among the most common malignancies globally. It is well known that microRNAs (miRNAs) play vital roles in destabilizing mRNAs and repressing their translations in this disease. However, the mechanism of miRNA-induced mRNA cleavage remains to be investigated.MethodIn this study, high-throughput small RNA (sRNA) sequencing was utilized to identify and profile miRNAs from six pairs of colorectal cancer tissues (CTs) and adjacent tissues (CNs). Degradome sequencing (DS) was employed to detect the cleaved target genes. The Database for Annotation, Visualization and Integrated Discovery (DAVID) software was used for GO (Gene Ontology) and KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway analysis.ResultsIn total, 1278 known miRNAs (clustered into 337 families) and 131 novel miRNAs were characterized in the CT and CN libraries, respectively. Of those, 420 known and eight novel miRNAs were defined as differentially expressed miRNAs (DEmiRNAs) by comparing the expression levels observed in the CT and CN libraries. Furthermore, through DS, 9685 and 202 potential target transcripts were characterized as target genes for 268 known and 33 novel miRNAs, respectively. It was further predicted that a total of 264 targeted genes for the 85 DEmiRNAs are involved in proteoglycans in cancer and the AMP-activated protein kinase signaling pathway. After systemic analysis of prognosis-related miRNA targets in those cancer-related signal pathways, we found that two targets ezrin (EZR) and hematopoietic cell-specific Lyn substrate 1 (HCLS1) had the potential prognostic characteristics with CRC regarding over survival (OS) or recurrence.ConclusionIn total, we found that endonucleolytic miRNA-directed mRNA cleavage occurs in CRC. A number of potential genes targeted by CRC-related miRNAs were identified and some may have the potential as prognosis markers of CRC. The present findings may lead to an improved better appreciation of the novel interaction mode between miRNAs and target genes in CRC.

Long-Term Outcome in Gastric Cancer Patients with Different Body Composition Score Assessed via Computed Tomography

Background The purpose of this study was to assess the body composition score (BCS) impact on 3-year survival after radical gastrectomy in patients with gastric cancer. Methods This retrospective study included patients with gastric cancer from September 2015 to June 2017. The patients were divided into three groups: BCS0 (having normal skeletal muscle or adipose mass), BCS1 (having low skeletal muscle mass only), and BCS2 (having low skeletal muscle and adipose mass) according to their third lumbar vertebra skeletal muscle index and fat index calculated using abdominal computed tomography. The clinicopathological indicators, postoperative complications, 3-year over survival (OS) rate after radical gastrectomy, and cause of death among the three groups were compared. Results A total of 187 patients were enrolled in the study, in which 102 patients (54.6%) had BCS0, 76 (40.6%) had BCS1 and 9 (4.8%) had BCS2. There was no significant difference in postoperative complications among the groups. 3-year OS was significantly shortened with each 1-score increase in BCS (Log-rank p < 0.001). Multivariate Cox regression analyses showed that no neoadjuvant chemotherapy, tumor stage III, BCS1, and BCS2 were independent prognostic factors for 3-year OS after radical gastrectomy. The main cause of death was cancer-related. Conclusion We demonstrated that BCS1 and BCS2 were strongly associated with poor 3-year survival for patients with gastric cancer who underwent radical gastrectomy, suggesting that special attention may be required for nutritional support while determining therapeutic strategies.

Identification of Potentially Functional CircRNA-miRNA-mRNA Regulatory Network in Gastric Carcinoma using Bioinformatics Analysis.

BackgroundAs all we know, gastric cancer (GC) is a highly aggressive disease. Recently, circular RNA (circRNA) was found to play a vital role in regulation of GC. Some circRNAs could regulate messenger RNA (mRNA) expression by functioning as a microRNA (miRNA) sponge. Nevertheless, the circRNA-miRNA-mRNA regulatory network involved GC rarely has been explored and researched.Material/MethodsAll the differentially expressed circRNAs, miRNAs, and mRNA were derived from Gene Expression Omnibus (GEO) microarray data (GSE78092, GSE89143, GSE93415, and GSE54129). GC level 3 miRNA-sequencing data and clinical information were downloaded from The Cancer Genome Atlas (TCGA) database. Furthermore, a circRNA-miRNA-mRNA regulatory network was constructed by Cytoscape (version 3.6.1). Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway revealed the functions and signaling pathways associated with these target genes. Hub genes of protein-protein interaction (PPI) network were identified by STRING database and cytoHubba.ResultsThe regulatory network consists of 3 circRNAs, 22 miRNAs, and 128 mRNAs. Only 3 miRNAs of the network were consistent with the expression of TCGA and were associated with some clinical features. The results of the functional analysis of 128 mRNAs showed that GO analysis and KEGG pathways of inclusion criteria were 49 and 24, respectively. PPI network and Cytoscape showed that the top 10 hub genes were MYC, CTGF, TGFBR2, TGFBR1, SERPINE1, KRAS, ZEB1, THBS1, CDK6, and TNS1; 4 of which were verified by GEPIA based on TCGA. Highly expressed SERPINE1 had a poor OS (over survival) and DFS (disease-free survival), and TGFBR1 expression increased along with the increase of clinical stages.ConclusionsThis study looked at a circRNA-miRNA-mRNA regulatory network associated with GC and explored the potential functions of mRNA in the network, then identified a new molecular marker for prediction, prognosis, and therapeutic targets for clinical patients.

PATH-09. MGMT PROMOTER METHYLATION IS A STRONG PROGNOSTIC FACTOR FOR SURVIVAL AFTER PROGRESSION IN HIGH GRADE GLIOMAS

Abstract High grade gliomas (HGGs: anaplastic gliomas and GBM) are the most lethal type of primary brain tumor. Maximal resection and postoperative concurrent chemoradiotherapy, and followed with adjuvant chemotherapy is the standard treatment. But patients with HGGs have a relapse rapidly and short survival. Studies have identified many clinical characteristics and biomarkers were associated with progression free survival (PFS) and over survival (OS). However, there has not yet a comprehensive study on the effects of these factors to survival after the first progression (SAP). 319 patients with HGGs were conducted maximum resection followed by radiotherapy and/or temozolomide chemotherapy and have been confirmed the first progression. Clinical characteristics, biomarkers (IDH1/2 mutation, MGMT promoter methylation, LOH1p/19q, TP53 mutation, EGFR amplification, Ki-67 expression) and clinical interventions (extent of resection, chemoradiotherapy, operation after progression) were analyzed in accordance with SAP. The 1-year SAP was 14.2% (median SAP: 5.1 months). Significant prognostic factors of improved SAP were tumor grade, MGMT promoter methylation and Ki-67 expression in univariate analysis (p&lt; 0.05). Further multivariate analysis showed that MGMT promoter methylation and Ki-67 expression were independently prognostic markers for SAP (p&lt; 0.05). In our data, HGGs could be divided into low, intermediate and high risk groups for SAP by MGMT promoter methylation and Ki-67 expression. However, analysis of 308 patients with GBM from The Cancer Genome Atlas (TCGA) found that MGMT promoter methylation is the only prognostic marker for SAP in multivariate analysis (p&lt; 0.05). Consequently, MGMT promoter methylation is independently prognostic marker for SAP in patients with HGGs. MGMT promoter methylation, combined with Ki-67 expression, might establish a risk model for SAP and this stratification may aid in treatment strategy selection and clinical prognosis evaluation in HGGs.

Prediction of Overall Survival in Gastric Cancer Using a Nine-lncRNA.

Long noncoding RNA (lncRNA) was closely attached to various cancers according to previous studies. In this study we aimed to investigate an lncRNA signature with prognostic value of over survival (OS) outcomes of gastric cancer (GC). Profiles of mRNAs expression and clinical information of 381 GC tissues and 32 nontumor gastric tissues were downloaded from The Cancer Genome Atlas database. Comparison of various lncRNA expression between cancer tissue and normal tissue was made among these data. In the end, a nine-lncRNA signature was discovered using univariate and multivariate Cox regression analyses, with a prospect possibility of the OS in GC patients. Receiver operating characteristic (ROC) was used to evaluate the accuracy of survival model. The gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses were used to predict the possible functions and pathways of these lncRNAs. Altogether 720 distinctively expressed lncRNAs were selected between GC and normal tissues. By univariate and multivariate Cox regression analyses, nine lncRNAs were eventually filtered to set a predictive model, distributing patients into high-risk and low-risk groups with extraordinary different OS. Area under the curve of the ROC curve for the nine-lncRNA signature's prediction of 5-year OS was 0.795. Further functional enrichment analyses indicated that these lncRNAs may be associated with biological processes such as protein binding, DNA replication, and cell cycle. Our study identified a nine-lncRNA signature, which could act as a potential prognostic biomarker in the prediction of GC patients' OS.

MIR31HG promotes cell proliferation and invasion by activating the Wnt/β-catenin signaling pathway in non-small cell lung cancer.

Long non-coding RNAs (lncRNAs) have recently been demonstrated to serve crucial roles in various diseases including tumor initiation and progression. However, the role of the lncRNA MIR31HG in non-small cell lung cancer (NSCLC) was not well established. The present study demonstrated that MIR31HG was significantly increased in tumor tissues compared with adjacent normal tissues, and increased MIR31HG expression levels were associated with histological differentiation grade, lymph node metastasis and Tumor-node metastasis (TNM) stage in patients with NSCLC. Patients who had a higher MIR31HG expression level, were predicted a shorter over survival (OS) time. Using in vitro assays, the present study demonstrated that the downregulation of MIR31HG expression significantly inhibited cell proliferation and cell invasion abilities. Furthermore, it was identified that knockdown of MIR31HG expression suppressed the cell epithelial-mesenchymal transition (EMT) phenotype by reducing the expression levels of Twist1 and Vimentin, but also increased the expression level of E-cadherin in NSCLC cells. Furthermore, the results of the present study demonstrated that downregulated MIR31HG inhibited the Wnt/β-catenin signaling pathway by decreasing the expression of glycogen synthase kinase 3β (GSK3β) and β-catenin, but increasing the phosphorylated (p)-GSK3β expression in NSCLC cells. Together, these data demonstrated that MIR31HG could be identified as a poor prognostic biomarker and a novel therapeutic target for patients with NSCLC.

The crucial role of predicting brain metastases development in non-small cell lung cancer patients.

Over the past ten years we have witnessed many advances in the management of non-small cell lung cancer (NSCLC), with the 5-year over survival (OS) in the advanced disease that has shifted to approximately 15% both in NSCLC patients with epidermal growth factor receptor (EGFR) + NSCLC treated with tyrosine kinase inhibitors (TKIs) (1) and in those treated with immune-checkpoint inhibitors (ICPIs) (2) and up to approximately 50% in NSCLC patients with anaplastic lymphoma kinase (ALK)+ tumours following first-line crizotinib (3).

Surgical management of spinal solitary fibrous tumor/hemangiopericytoma: a case series of 20 patients

PurposeSpinal solitary fibrous tumor/hemangiopericytoma (SFT/HPC), a rare mesenchymal tumor that arises from pericytes of Zimmerman, comprises only 0.08% of all primary bone tumors and 0.1% of primary malignant bone tumor and rarely occurs in the spine. We attempt to correlate the clinical factors and different treatment options with the recurrence rate and overall survival of SFT/HPC over time.MethodsA retrospective study of 20 patients with spinal osseous SFT/HPCs who were surgically treated in our center between 2003 and 2015 was performed. Kaplan–Meier curves and log-rank tests were used to compare the survival probability or recurrence-free probability between groups, and P values < 0.05 were considered statistically significant.ResultsThree surgical management strategies, including subtotal resection, piecemeal total resection, and total en bloc spondylectomy (TES) were applied. Postoperative radiotherapy was carried out in 14 cases. The mean follow-up period was 38.3 (median 35, range 7–93) months, and 6 patients passed away with the mean follow-up time of 47.7 (median 41, range 24–77) months. Relapse was detected in 9 patients (45%) with the mean time from surgery to recurrence being 36.6 (median 28, range 12–73) months. Our results indicate that grade III is an adverse prognostic factor for both recurrence and over survival (OS) for spinal osseous SFT/HPC, while total resection, especially TES, is a positive prognostic factor.ConclusionsSpinal osseous SFT/HPC is a challenging clinical entity given its high local recurrence rate. Surgical management plays a crucial role in the whole treatment of spinal SFT/HPCs and total excision, especially TES, should be strived for whenever possible. Postoperative radiotherapy is recommended to lower the recurrent rate. This study also confirms that pathology grade III is an adverse prognostic factor for spinal osseous SFT/HPCs.

Long Non-Coding RNA SPRY4-IT1 Can Predict Poor Prognosis in Digestive System Malignancies: a Meta-Analysis

Recent studies have reported that long non-coding RNA SPRY4 intron transcript1 (SPRY4-IT1) is abnormally expressed in malignant digestive tumors and associated with prognosis. But its clinical relevance is unclear. Here, we performed a meta-analysis aims to evaluate the prognostic value of SPRY4-IT1 in digestive system malignancies. We systematic search the PubMed, Web of Science, ScienceDirect and Wiley Online Library database to eligible studies. The pooled hazard ratios (HRs) with a 95% confidence interval (95% CI) were calculated to explored the association of lncRNA SPRY4-IT1 with prognosis. Five studies were eligible for analysis, a total of 518 patients were included. Meta-analysis indicated that overexpression of SPRY4-IT1 was associated with poor over survival (OS) (HR=1.24, 95%CI:0.49-1.98; random-effects model). The clinicopathological parameters analysis further showed that increased expression level of SPRY4-IT1 was positively correlated with lymph node metastasis (HR=1.45, 95% CI =0.88-2.02; fixed-effects model), TNM stage (HR=1.24,95% CI=0.78-1.70; fixed-effects model), and invasion depth (HR=1.25,95% CI=0.63-1.88; fixed-effects model). lncRNA SPRY4-IT1 may serve as a potential prognostic marker in malignant digestive tumors.

Prognostic nomogram for patients with non-B non-C hepatocellular carcinoma after curative liver resection

BackgroundThe proportion of the both serum hepatitis B surface antigen and hepatitis C antibody negative hepatocellular carcinoma (NBNC HCC) patients are tended to increase recently. We investigated the characteristics and surgical outcome for those patients after liver resection. MethodsFour hundred and thirty-five NBNC patients were involved in our study. According to the results of the HBcAb in the serum, those patients were divided into HBcAb-positive subgroup (n = 328) and HBcAb-negative subgroup (n = 107). Based on the multivariate risk factors, the nomogram was constructed for predicting the possibility for over survival (OS) rate. ResultsFor all of the NBNC HCC patients, the median OS was 57 months with 5-year OS rate 54.0%. The positive HBcAb NBNC patients were associating with a better liver function (p = 0.026), higher AFP (p < 0.001) and more proportion of micro-vascular invasion (p = 0.001). Multivariate analysis revealed that worse liver function (Child-Pugh B, HR = 1.93; 95% CI: 1.23–3.04), vascular invasion (MIVI vs negative, HR = 1.86; 95% CI: 1.21–2.86, MAVI vs negative, HR = 2.05; 95% CI: 1.37–3.06), poorer ES differentiation (HR = 2.34; 95% CI: 1.67–3.30) and larger tumor size (HR = 1.10; 95% CI: 1.06–1.15) were associated with the worse OS. ConclusionWe established a novel prognostic nomogram to predict the OS of NBNC HCC patients after liver resection. The prognosis of NBNC HCC was mainly determined by tumor stage and liver function not by the previous etiologies.

Better cancer specific survival in young small cell lung cancer patients especially with AJCC stage III.

It has been reported that younger patients with non-small cell lung cancer (NSCLC) tend to have a better prognosis. Yet, few studies have focused on the clinicopathological characteristics and prognosis of young small cell lung cancer (SCLC), especially for patients with age < 50. In our study, we used Surveillance, Epidemiology, and End Results (SEER) population-based data and identified 16503 patients with SCLC including 711 patients aged < 50, 3338 patients aged 50–59, 5937 patients aged 60–69, 4649 patients aged 70–79 and 1868 patients aged ≥ 80 between 2010 and 2013. The Kaplan-Meier methods was used to develop the survival curve, and the results showed that the SCLC patients with aged < 50 tended to a better over survival (OS) and cancer specific survival (CSS) (all, P < 0.001). In addition, Cox regression model was used to analyze survival prognosis factors and perform subgroup analysis. The results showed that age was an independent prognostic factor for CSS (P < 0.001). Importantly, we found that for the patients with AJCC stage III subgroup, the age < 50 had apparent CSS benefit compared with any other age group (all, P < 0.01). Interestingly, for the patients with no surgery, radiation and no radiation subgroup, the age < 50 had no apparent CSS benefit only compared with age 50–59 (all, P > 0.05). In conclusion, our study demonstrated that the SCLC patients with aged < 50 tended had a better survival benefit, especially for patients with AJCC stage III.

Long non-coding RNA SNHG20 predicts a poor prognosis for HCC and promotes cell invasion by regulating the epithelial-to-mesenchymal transition

Recently, Accumulating evidence indicates that long noncoding RNAs (lncRNAs) have been shown to have critical regulatory roles in human tumor biology and development. However, the expression pattern and biological function of lncRNA small nucleolar RNA host gene 20 (SNHG20) in hepatocellular carcinoma (HCC) remains largely unknown. The expression of SNHG20 in 96 paired HCC tissues and cell lines were detected by quantitative real-time PCR (qRT-PCR) analysis. Kaplan-Meier survival analysis and log-rank test was used to reveal the association between SNHG20 expression and the overall survival time in HCC patients. CCK8 cell proliferation and transwell invasion assays were performed to analyze the cell proliferation and cell invasion ability. QRT-PCR and western-blotting analysis were performed to demonstrate the mRNA levels and protein expression of ZEB1, ZEB2 and relative epithelial-to-mesenchymal transition (EMT) markers (E-cadherin, N-cadherin and Vimentin). We showed that the expression level of SNHG20 was significantly up-regulated in 96 pairs of HCC tissues and adjacent normal tissues. Higher SNHG20 expression was positively correlated with larger tumor size and advanced TNM stage, and negatively correlated with the over survival (OS) time for HCC patients. In vitro, loss-function assays revealed that knockdown of SNHG20 inhibited cell proliferation and invasion, whereas, gain-of-function promoted cell proliferation and invasion. Furthermore, knockdown of SNHG20 inhibited ZEB1, ZEB2, N-cadherin and Vimentin expression and up-regulated the E-cadherin expression in HCC cells. Mechanistic investigation revealed that SNHG20 could bind to enhancer of zeste homolog 2 (EZH2) and regulated E-cadherin expression. Our results showed that the SNHG20/EZH2/E-cadhein regulator pathway might contribute to the development of novel therapeutic strategies for HCC patients.

Prognostic value of RDW in cancers: a systematic review and meta-analysis.

Red blood cell distribution width (RDW), a parameter that used to differentiate the type of anemia for several decades, recent studies suggest it was a prognostic factor in various types of cancer patients. However, the prognostic value of RDW in cancer patients remains controversial. Here, we performed a meta-analysis and systematic review to evaluate the prognostic value of RDW in cancer patients. Relevant studies were picked out from the databases of Web of Science, Embase, Pubmed and Cochrane Library. A total of 16 papers with 4267 patients were included in this meta-analysis, and the combined results indicated that elevated RDW was associated with poor over survival (OS) (HR = 1.47, 95%CI:1.29-1.66), poor cancer-specific survival (CSS) (HR = 1.46, 95%CI:1.08-1.85), poor disease-free survival (DFS) (HR = 1.91, 95%CI:1.27-2.56), poor event-free survival (EFS) (HR = 2.98, 95%CI:0.57-5.39) and poor progress-free survival (PFS) (HR = 3.21, 95%CI:0.33-6.75) after treatment. Furthermore, the similar results were observed in subgroup analysis stratified by cancer type, cutoff value of RDW, sample size and ethnicity. In conclusion, this meta-analysis demonstrated that RDW may be a potential prognostic marker in patients with cancer, and high RDW may also be associated with poor outcomes.

Efficacy of allogeneic hematopoietic stem cell transplantation in treatment of children with severe aplastic anemia-II

Objective To explore the efficacy and safety of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for children with severe aplastic anaemia (SAA) Ⅱ. Methods The clinical data of 19 children with SAA-Ⅱ receiving allo-HSCT from January 2003 to May 2015 were retrospectively analyzed, including 11 male and 8 female, with median age of 9(2-14) years old.There were 9 patients received human leukocyte antigen-matched sibling donor (MSD) allo-HSCT, and 10 patients received unrelated donor (URD) allo-HSCT.Conditioning regimen was Cyclophosphamide+ Antithymocyte globulin±Fludarabine±Busulfan±total body irradition; graft-versus-host disease (GVHD) preventing regimen was cyclosporine A/Tacrolimus + Methotrexate±Mycophenolate mofetil.The median reinfusion quantity of CD34+ was 8.82×106/kg in 15 cases received bone marrow transplantation or peripheral blood stem cell transplantation, and 6.32×105/kg in 4 cases received cord blood transplantation. Results Hemato-poiesis reconstitution was achieved in 18 children (94.74%). The median time of neutrophils and platelets were 13 d (10-22 d) and 14 d (10-49 d) in the evaluable patients, respectively.The cumulative incidence of acute GVHD, chronic GVHD and graft rejection were 22.22%(4/18 cases), 11.11%(2/18 cases) and 11.11%(2/18 cases), respectively.In all the recipients, the infection of bacteria and fungus, cytomegalovirus and EB virus were 84.21%(16/19 cases), 72.22%(13/18 cases)and 44.44%(8/18 cases), respectively.The cumulative incidence of the liver, the kidney and the heart failure was 5.26%(1/19 cases), 21.05%(4/19 cases) and 21.05%(4/19 cases), respectively.Median follow-up time was 17 months (6-153 months). Fifteen patients survive, and estimated 5 years over survival (OS) was (77.8±9.3)%; transplant-related mortality was 21.05%.There was no difference in OS between URD allo-HSC and MSD allo-HSCT(χ2=1.198, P=0.656). Conclusions Allo-HSCT is an effective therapy for children with SAA-Ⅱ, especially for those receiving MSD allo-HSCT.URD allo-HSCT is feasible for SAA-Ⅱchildren without HLA-matched sibiling donors. Key words: Aplastic anemia, severe; Child; Hematopoietic stem cell transplantation, allogeneic; Unrelated donor

Influence of immediate breast reconstruction after mastectomy on postoperative survival

To compare over survival(OS),recurrence free survival(RFS) of 5 years and survival quality between patients with immediate breast reconstruction and patients without breast reconstruction after mastectomy. From January 2009 to December 2010,156 patients were diagnosed as breast cancer. Among them,56 patients, aged 30-55 years old, were treated with mastectomy and immediate breast reconstruction as rec onstruction group.100 patients, aged 30-55 years old, were treated with mastectomy without breast reconstruction as control group. The last follow-up time was June 2015.Patients' age, pathological type, clinical stage, lymph node metastasis were analyzed retrospectively. RFS and OS of 5 years and survival was compared by Kaplan Meier method. Survival quality of 1 year and 2 years after operation was compared between them. Pathologic classification, clinical staging, sentinel lymph node positive rate, axillary lymph node positive rate and triple negative breast cancer had no difference between two groups(P ＞0.05).The median follow-up time was 56.3±13.7 (23-78) and 57.9 ± 14.1(27-78) months in the reconstruction group and control group respectively at end of the June of 2015.RFS 5 years was 75.2％ and 63.3％ respectively in the reconstruction group and control group, showing significant difference between them (P < 0.05).OS 5 years was 81.7％ and 83.3％ respectively in the reconstruction group and control group, with no statistical difference (P ＞ 0.05).Five aspects of physiological status, social/family status, emotion, functional status,additional focus in the reconstruction group 1 year postoperative were higher than those in control group (P ＜ 0.05).Physiology, social/family situation, emotion, functional status of the reconstruction group 2 years after operation were higher than that in control group (P ＜ 0.05).Scores of physiologic al status, social/family status, emotion, functional status and addition of 2 years in the reconstruction group were higher than those in 1 year after operation, with significant difference (P ＜ 0.05).The score improvement in control group was not obvious. Immediate breast reconstruction after mastectomy of breast improve the survival quality and postoperative RFS, but has no obvious effect on overall survival.