Pathological Stage In Patients Research Articles

Identification and validation of CCN family genes to predict the prognosis in gastric cancer

BackgroundGastric cancer (GC) is a deadly malignancy with an ever-increasing incidence worldwide. The cellular communication network (CCN) family serves as matricellular proteins and exerts their various functions via regulating cell proliferation and differentiation. This study aimed to perform an integrated analysis of CCNs to predict the prognosis in GC.MethodsThe microarray datasets were obtained from Gene Expression Omnibus database to identify the differentially expressed genes between GC and non-tumor tissues. Functional enrichment and genetic alteration analysis revealed the biological functions and alteration status associated with CCNs. We analyzed the mRNA and protein expressions of CCN family in GC patients. Furthermore, the prognostic value of distinct CCN family members were analyzed using the Kaplan–Meier plotter database. Finally, the human gastric cancer cell lines were used for in vitro experiments to further validate the role of WISP1.Results26 genes were firstly identified to be significantly highly expressed in gastric tumor tissues. CCN family genes were identified to predict the prognosis in GC. Among the six CCNs, WISP1 is upregulated in GC tissues and its highly expression is associated with poor survival in GC patients. Moreover, a significant correlation is found between the expression of WISP1 and the pathological stage of patients with GC. Additionally, in vitro experiments demonstrated that WISP1 promotes the proliferation and invasive potential of GC cells, suggesting it may be a potential therapeutic target for GC.ConclusionsA comprehensive bioinformatic analysis of CCN genes provides new insights into the potential roles of this family in GC. Importantly, WISP1 may be a good prognostic predictor and a potential therapeutic target for GC.

Machine learning and explainable artificial intelligence to predict pathologic stage in men with localized prostate cancer.

Though several nomograms exist, machine learning (ML) approaches might improve prediction of pathologic stage in patients with prostate cancer. To develop ML models to predict pathologic stage that outperform existing nomograms that use readily available clinicopathologic variables. Patients with prostate adenocarcinoma who underwent surgery were identified in the National Cancer Database. Seven ML models were trained to predict organ-confined (OC) disease, extracapsular extension, seminal vesicle invasion (SVI), and lymph node involvement (LNI). Model performance was measured using area under the curve (AUC) on a holdout testing data set. Clinical utility was evaluated using decision curve analysis (DCA). Performance metrics were confirmed on an external validation data set. The ML-based extreme gradient boosted trees model achieved the best performance with an AUC of 0.744, 0.749, 0.816, 0.811 for the OC, ECE, SVI, and LNI models, respectively. The MSK nomograms achieved an AUC of 0.708, 0.742, 0.806, 0.802 for the OC, ECE, SVI, and LNI models, respectively. These models also performed the best on DCA. Findings were consistent on both a holdout internal validation data set as well as an external validation data set. Our ML models better predicted pathologic stage relative to existing nomograms at predicting pathologic stage. Accurate prediction of pathologic stage can help oncologists and patients determine optimal definitive treatment options for patients with prostate cancer.

Comparison of clinical efficacy between modified Kamikawa anastomosis in laparoscopic proximal gastrectomy and Roux-en-Y anastomosis in laparoscopic total gastrectomy

To investigate the short-term clinical efficacy of laparoscopic proximal gastrectomy with modified Kamikawa anastomosis and laparoscopic total gastrectomy with Roux-en-Y anastomosis. Retrospective cohort study was conducted. The clinicopathological data of 268 patients who underwent laparoscopic proximal gastrectomy for adenocarcinoma of esophagogastric junction and upper gastric adenocarcinoma from January 2016 to October 2022 were collected. Among 268 patients, 26 underwent laparoscopic proximal gastrectomy with modified Kamikawa anastomosis were assigned to Kamikawa group and 242 underwent laparoscopic total gastrectomy with Roux-en-Y anastomosis were assigned to Roux-en-Y group. The sex, age, BMI, preoperative albumin, maximum tumor diameter, histological grade, and pathological stage of patients in the Kamikawa group and the Roux-en-Y group were subjected to 1:1 propensity score matching. After matching, 16 patients in Kamikawa group and Roux-en-Y group were respectively included in this study. Outcome measures: (1) Intraoperative condition. (2) Postoperative recovery. (3) Follow-up information. The patients' nutritional status, reflux esophagitis and anastomotic stoma were investigated by outpatient and telephone follow-up. Nutritional status assessment comprising body mass index and Nutritional Risk Screening 2002 score. (1) Intraoperative condition. All patients successfully underwent laparoscopic proximal gastrectomy and total gastrectomy. Compared with Roux-en-Y group, the digestive tract reconstruction time in Kamikawa group was longer 93.0(74.0–111.0)min vs. 39.7(35.1–46.2)min, t = -2.001, P = 0.055., and the difference was statistically significant (P < 0.05). There was no statistically significant difference in total operation time and intraoperative blood loss (P > 0.05). (2) Postoperative recovery. There was no statistically significant difference between Kamikawa group and Roux-en-Y group in first anal exhaust time, first postoperative liquid intake time, postoperative hospitalization time, and postoperative complications (P > 0.05). (3) Follow-up information. All patients were followed up. BMI and NRS 2002 scores in Kamikawa group were better than those in Roux-en-Y group at 6 and 12 months after surgery 22.9 ± 3.0 kg/m2 vs. 20.8 ± 2.2 kg/m2, t = 2.165, P = 0.038; 23.1 ± 3.0 kg/m2 vs. 20.3 ± 2.2 kg/m2, t = 3.022, P = 0.005 and 2 (1–2) vs. 2 (1–3), Z = -2.585, P = 0.010; 2 (1–2) vs. 2 (1–3), Z = -2.273, P = 0.023., the difference was statistically significant (P < 0.05). There was no significant difference in GERD scale score and occurrence of ≥ Grade B reflux esophagitis at 6 and 12 months after surgery between Kamikawa group and Roux-en-Y group (P > 0.05). Anastomotic stenosis was not found in all patients by postoperative upper gastrointestinal angiography. Laparoscopic proximal gastrectomy with modified Kamikawa anastomosis is safe and feasible for the treatment of esophagogastric junction and upper gastric adenocarcinoma, and can achieve good anti-reflux effect. Besides, compared with traditional laparoscopic total gastrectomy, its postoperative nutritional status is better.

Concordance Rate of Pre-Operative Radiological Stage with Postoperative Pathological Stage in Colon Cancer

Aim: This study aimed to assess the concordance rate between pre-operative radiological staging using CT imaging and postoperative pathological staging in patients with colon cancer. Methodology: A prospective observational study was conducted at the Oncology Department of Jinnah Postgraduate Medical Center, Pakistan, with ethical committee approval between February 2023 to July 2023. Inclusion criteria involved patients diagnosed with colon adenocarcinoma aged &gt;18 receiving treatment at the center, while exclusion criteria comprised unconfirmed colon cancer, lack of consent, benign colonic polyps, metastatic cancer, chemotherapy recipients, and incomplete data. Sample size estimation yielded 227 patients. Recruitment used consecutive sampling, and data were collected using a predefined proforma. CT scans were performed, and T-stage was assessed by radiologists and pathologists. Histological analysis followed established guidelines, with final pathology serving as the gold standard. Results: The diagnostic accuracy of CT imaging was evaluated, with statistically significant concordance found between CT scans and histopathological diagnoses (p-value = 0.046). CT scans demonstrated a sensitivity of 57.14% for Stage I tumors and a specificity of 88.18% for Stage II-III tumors. The positive predictive value (PPV) was 13.3%, and the negative predictive value (NPV) was 98.48%, resulting in an overall accuracy of 87.22%. These findings suggest that CT imaging is valuable for identifying Stage II-III tumors, exhibiting good specificity and NPV, although sensitivity and PPV for Stage I tumors were comparatively lower. Chi-square testing confirmed the statistical significance of these results (p-value ≤ 0.05) Conclusion: This study highlights the utility of CT imaging in pre-operative staging of colon cancer, particularly for Stage II-III tumors, where it exhibits notable accuracy. However, improvements may be needed to enhance sensitivity and PPV for Stage I tumors. Keywords: Colon cancer, CT imaging, pathological staging, concordance rate, diagnostic accuracy.

High PGC-1α Expression as a Poor Prognostic Indicator in Intracranial Glioma.

Gliomas are the most common primary brain tumors in adults. Despite multidisciplinary treatment approaches, the survival rates for patients with malignant glioma have only improved marginally, and few prognostic biomarkers have been identified. Peroxisome proliferator-activated receptor γ (PPARγ) coactivator-1α (PGC-1α) is a crucial regulator of cancer metabolism, playing a vital role in cancer cell adaptation to fluctuating energy demands. In this study, the clinicopathological roles of PGC-1α in gliomas were evaluated. Employing immunohistochemistry, cell culture, siRNA transfection, cell viability assays, western blot analyses, and in vitro and in vivo invasion and migration assays, we explored the functions of PGC-1α in glioma progression. High PGC-1α expression was significantly associated with an advanced pathological stage in patients with glioma and with poorer overall survival. The downregulation of PGC-1α inhibited glioma cell proliferation, invasion, and migration and altered the expression of oncogenic markers. These results conclusively demonstrated that PGC-1α plays a critical role in maintaining the malignant phenotype of glioma cells and indicated that targeting PGC-1α could be an effective strategy to curb glioma progression and improve patient survival outcomes.

The analysis of preoperative or intraoperative factors in predicting the escalation of surgical pathological staging of patients with clinical stage I endometrioid carcinoma: A retrospective clinical study.

To retrospectively analyze the preoperative and intraoperative influencing factors in predicting the escalation of surgical pathological staging in patients with clinical stage I endometrioid carcinoma. Patients with clinical stage I endometrioid carcinoma at Women's Hospital, School of Medicine, Zhejiang University, between January 2002 and December 2015 were enrolled in this study. Due to preoperative or intraoperative surgical exploration, the patients with one or more preoperative or intraoperative high-risk factors underwent total hysterectomy, bilateral salpingo-oophorectomy and lymphadenectomy, totaling 535 cases. The preoperative and intraoperative influencing factors that could lead to the escalation of postoperative surgical pathological staging were further analyzed. 1. There were 535 patients diagnosed with clinical stage I endometrioid carcinoma before surgery, 125 patients were upgraded with postoperative pathological staging, for a rate of 23.36%. 2. Kaplan-Meier survival curve analysis showed that the prognosis in postoperative surgical pathological staging upgraded cases was worse than that in nonupgraded cases. The tumor-free survival and overall survival rates in the 2 groups were significantly different (P < .001). 3. Univariate analysis showed that preoperative degree of myometrial infiltration, intraoperative visual myometrial infiltration depth, massive size of tumor (diameter ≥ 4 cm) and preoperative abnormal serum cancer antigen 125 (CA125) level were associated with the escalation of surgical pathological staging (P < .05). Multivariate analysis indicated that massive size of tumor and preoperative serum abnormal CA125 level were independent predictors of whether postoperative pathological staging would be upgraded (P < .05). 4. The receiver operating characteristic curve drawn with the massive size of tumor and/or the preoperative serum CA125 level abnormality could be used to predict the probability of postoperative pathological upstaging. The results showed that the area from the combination of the 2 factors under the receiver operating characteristic curve was 0.723 (95% confidence interval, 0.672-0.773), suggesting that the combination of massive size of tumor and abnormal preoperative serum CA125 level may serve as an influencing factor for predicting the postoperative pathological staging upgrades. The clinical stage I endometrioid carcinoma patients with massive size of tumor and abnormal preoperative serum CA125 level need to be fully evaluated to ensure appropriate management as soon as possible, since they are more likely to experience postoperative pathological staging upgrades.

Cellular senescence in testicular cancer. Is there a correlation with the preoperative markers and the extent of the tumor? An experimental study.

The aim of this experimental study is to investigate the correlation between the presence of senescent cells and the tumor size, the lymphovascular invasion (LVI), the invasion of rete testis (RTI), the preoperative tumor markers or pathological stage in patients who underwent orchiectomy for malignant purposes. This experimental study included patients with a history of radical orchiectomy performed from January 2011 to January 2019. The testicular tissue specimens underwent an immunohistopathological process for the detection of the presence of cellular senescence. Besides, the tumor size, the histopathological type, the pathological stage of the tumor and the presence of Lymphovascular (LVI) or rete testis (RTI) invasions were also recorded. Additionally, the preoperative serum levels of alpha-fetoprotein, beta-human chorionic gonadotropin and lactate dehydrogenase were recorded. After the completion of immunohistochemical analysis, the rate of senescent cells in each specimen was also recorded. The mean senescent cell rate was estimated to be 14.11 ± 11.32% and 15.46 ± 10.58% in patients with presence of LVI or absence of LVI, respectively (p = 0.46). The mean senescent cell rate was calculated at 18.13±12.26% and 12.56 ± 9.38% (p = 0.096) in patients with presence of RTI or absence of RTI, respectively. The mean senescent cell rate in the pT1 group was calculated at 14.58 ± 9.82%, while in T2 and T3 groups the mean senescent cell rate was estimated to be 15.22 ± 12.03% and 15.35 ± 14.21%, respectively (p = 0.98). A statistically significant correlation was detected between the senescence rate and the tumor size (Pearson score 0.40, p = 0.027) and between the rate of senescent cells and the preoperative level of lactate dehydrogenase (LDH) (Pearson score -0.53, p = 0.002). The presence of cellular senescence was correlated with the extent of the testicular tumor in terms of tumor size as well as the preoperative level of the LDH serum marker.

Comprehensive Pan-Cancer Analysis Reveals the Potential Biological, Immunological, and Prognostic Value of NKG2A

Background. NKG2A (KLRC1) belongs to the NKG2 family, which has been shown to affect the activity of natural killer (NK) cells and CD8T cells. However, a comprehensive biological analysis and exploration of NKG2A in different cancers is lacking and this needs to be further investigated. Methods. A comprehensive pan-cancer analysis of NKG2A was performed based on multiple databases. The Cancer Genome Atlas (TCGA) and Genotype–Tissue Expression (GTEx) databases were used to analyze the expression profile of NKG2A in pan-cancer. The relevance of NKG2A to the prognosis of different cancers was assessed using Kaplan–Meier survival analysis. In addition, we explored the correlation between NKG2A expression and gene mutations, pathological staging, tumor-infiltrating immune cells (TIICs), DNA methyltransferase (DNMT) genes, tumor mutation burden (TMB), microsatellite instability (MSI), mismatch repair (MMR), and immune checkpoints (ICPs). Finally, the expression levels of NKG2A in several cancer cell lines were verified by qRT-PCR. Results. Pan-cancer comprehensive analysis showed that NKG2A expression levels were significantly different between multiple cancers and corresponding normal tissues. The differential expression of NKG2A was related to the prognosis and pathological staging of patients with multiple cancers, and was closely related to the excessive infiltration of immune cells and the regulation of ICP genes in the tumor microenvironment (TME). In addition, TMB, MSI, MMR, and DNMT genes in many cancer types are also affected by NKG2A expression. Gene set enrichment analysis (GSEA) showed that NKG2A was associated with multiple immune-related functions and pathways in malignant tumors. qRT-PCR results showed that NKG2A was underexpressed in liver, gastric, and colon cancer cell lines compared to normal cells, which was consistent with bioinformatics analysis. Conclusion. The present study suggests that NKG2A may be a potential predictive biomarker for cancer immune response and prognosis.

Comparison of Clinical and Pathological Staging in Patients with Head and Neck Cancer After Neck Dissection.

Introduction Clinical and pathological staging plays an important role on the prognosis of head and neck cancer (HNC) patients. Objective The present study aims to compare clinical and pathological T, N and overall staging in patients with HNC, to identify factors associated with these discrepancies, and to analyze and compare survival or disease-free survival in staging disagreements. Methods Retrospective cohort including every patient submitted to neck dissection from January 2010 to December 2020 in the department of Otorhinolaryngology of a tertiary hospital center. Results A total of 79 patients were analyzed; their mean age was 58.52 ± 13.15 years old and 88.9% were male. Assessing overall staging, discrepancies were noted in 53% (36.4% upstaging and 16.6% downstaging) and were significantly associated with clinical overall staging ( p = 0.006). Regarding T staging, differences were noted in 45.5% (30.3% upstaging and 15.2% downstaging) and were significantly associated with imaging modality ( p = 0.016), clinical T staging ( p = 0.049), and histology ( p = 0.017). Discrepancies in N staging were noted in 38% (25.3% upstaging and 12.7% downstaging) and were significantly associated with age ( p = 0.013), clinical N staging ( p < 0.001), and presence of extranodal invasion ( p < 0.001). Both in Overall, T, and N staging, the aforementioned disagreements were not associated with either higher mortality or higher disease relapse. Conclusion Overall, T, and N staging disagree in an important number of cases, and the overall stage can disagree in up to 53% of the cases. These disagreements do not seem to influence overall and disease-free survival.

Predicting the risk of distant metastasis in patients with locally advanced rectal cancer using model based on pre-treatment T2WI-based radiomic features plus postoperative pathological stage.

To assess the prognostic value of a model based on pre-treatment T2WI-based radiomic features and postoperative pathological staging in patients with locally advanced rectal cancer who have undergone neoadjuvant chemoradiotherapy. Radiomic features were derived from T2WI, and a radiomic signature (RS) was established and validated for the prediction of distant metastases (DM). Subsequently, we designed and validated a nomogram model that combined the radiomic signature and postoperative pathological staging for enhanced DM prediction. Performance measures such as the concordance index (C-index) and area under the curve (AUC) were computed to assess the predictive accuracy of the models. A total of 260 patients participated in this study, of whom 197 (75.8%) were male, and the mean age was 57.2 years with a standard deviation of 11.2 years. 15 radiomic features were selected to define the radiomic signature. Patients with a high-risk radiomic signature demonstrated significantly shorter distant metastasis-free survival (DMFS) in both the development and validation cohorts. A nomogram, incorporating the radiomic signature, pathological T stage, and N stage, achieved an area under the curve (AUC) value of 0.72 (95% CI, 0.60-0.83) in the development cohort and 0.83 (95% CI, 0.73-0.92) in the validation cohort. A radiomic signature derived from T2WI-based radiomic features can effectively distinguish patients with varying risks of DM. Furthermore, a nomogram integrating the radiomic signature and postoperative pathological stage proves to be a robust predictor of DMFS.

Prognostic Significance of Volumetric Parameters Based on FDG PET/CT in Patients with Lung Adenocarcinoma Undergoing Curative Surgery.

FDG PET/CT is a robust imaging modality to diagnose and stratify prognoses for non-small cell lung carcinoma. However, the role of FDG PET/CT in operable lung adenocarcinoma patients has not been previously investigated in a large cohort with varying pathological stages. The prognostic value of volumetric parameters based on FDG PET/CT was investigated in patients with stage I-III lung adenocarcinoma receiving curative surgery. This retrospective study included 432 patients with lung adenocarcinoma undergoing preoperative FDG PET/CT between January 2016 and December 2017. Clinicopathologic variables, conventional image parameters, such as the maximum standardized uptake value (SUVmax) and mean SUV (SUVmean) of the primary tumor, and volumetric parameters, such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG), were included in Cox regression analysis. Subgroup analysis was conducted to compare hazard ratios (HRs) based on MTV in each pathological stage. A new staging system including volumetric parameters was suggested. A total of 432 patients (median age: 62 years; interquartile range: 56-70 years; 225 males) were evaluated. Sex, age, presence of EGFR mutation, pathological stage, MTV, and TLG of the primary tumor were selected as statistically significant prognostic factors for overall survival irrespective of other variables (OS; p < 0.05 for all). Pathological stage, MTV, and TLG of the primary tumor were selected as statistically significant prognostic factors for disease-free survival irrespective of other variables (p < 0.05 for all). The suggested new staging system including MTV as an additional criterion showed better discrimination and prediction for OS than the conventional pathological staging system despite statistical insignificance (concordance index: 0.698 vs. 0.673). The volumetric parameters of the primary tumor based on preoperative FDG PET/CT were independent prognostic factors in addition to pathological stage in patients with operable lung adenocarcinoma. The suggested new staging system considering MTV predicted the prognoses better than the conventional pathological staging system.

Comparison Between Clinical and Pathological Staging After Elective Neck Dissection in Head and Neck Cancer.

Head and neck squamous cell carcinomas (HNSCC) are the most common malignancies in the head and neck. Previous studies have shown discrepancies in clinical and pathological staging, with a significant number of head and neck cancer patients who were not correctly staged. This has important implications regarding the treatment and prognosis of these patients. The aim of this study was to analyze potential disagreements in clinical and pathological staging in patients with head and neck cancer who underwent elective neck dissection. A retrospective study of patients with squamous cell carcinoma of the head and neck, who underwent elective neck dissection, between January 2018 and December 2020. We analyzed 87 patients, with an average age of 64 ± 10.05 years, of whom 96.6% were male. The primary tumor location was the glottis (31%), oropharynx (26.4%), hypopharynx (19.5%), supraglottis (11.5%), and oral cavity (11.5%). In 87.3% there was a history of smoking and/or drinking. Pathological N (pN) staging was higher than clinical staging in 34.3% of patients (N1 in 22.9%; N2 in 8%; N3 in 3.4%). There were no significant differences between the number of nodes removed and the pN staging. However, there was a significant survival difference in patients with>15 nodes removed (p=0.05). There was also a significant difference in patients with pN up-staging regarding survival (p=0.005).Pathological T staging was different from clinical T staging (p<0.05), with an up-staging in 18.4% of the patients and a down-staging in 14.9%, without significant differences regarding survival or recurrence (p>0.05).Adjuvant treatment with radiotherapy was performed in 41.4% and with chemo-radiotherapy in 13.8% of the patients. Locoregional recurrence occurred in 17.5%. This study revealed that clinical and pathological N staging after elective neck dissection disagreed in a substantial number of patients, with pathological upstaging and significant differences regarding survival. With relation to T staging, there were no significant differences regarding survival. We should be aware of staging disagreements since they can have significant implications on the treatment and prognosis of cancer patients.

Systematic analysis of the prognostic and immunological role of DHX33 in pan-cancer.

DEAH-box helicase 33 (DHX33) is a potent oncogenic agent on patients with hepatocellular carcinoma and colon cancer. Nevertheless, the prognostic significance of DHX33 in human pan-cancers remains unclear. Various bioinformatics tools have been used to clarify the oncogenic effects of DHX33 in pan-cancers. The Cancer Genome Atlas (TCGA) and Human Protein Atlas (HPA) were used to evaluate DHX33 at the mRNA and protein levels, respectively. The pan-cancer prognostic prediction value of DHX33 was evaluated using the Kaplan-Meier plotter. The association between DHX33 levels and clinicopathological features was then determined using the UALCAN database. In addition, gene set enrichment analysis and nomogram prediction models were constructed. The association between DHX33 levels and immune cell infiltration was then assessed using TISIDB. We determined that DHX33 is aberrantly overexpressed in pan-cancers and related to lung adenocarcinoma (LUAD) clinical stage (p < .001). Moreover, DHX33 overexpression was indicative of poor overall survival, disease-free survival, and progression-free interval in patients with LUAD (p < .05). Furthermore, DHX33 levels were associated with age, N stage, T stage, and pathologic stage in patients with LUAD (p < .001). Additionally, multivariate Cox analysis revealed that DHX33 was an independent risk factor for OS in patients with LUAD. A nomogram model between DHX33 levels and characteristic clinical parameters was developed. Additionally, DHX33 levels correlated with immunomodulators and chemokines. Finally, gene set enrichment analysis revealed that the amyloid fiber formation pathway and the WICH complex positively regulates RNA expression pathway, which was the most enriched in LUAD. Our data revealed oncogenic effects of DHX33 in various cancers. We suggest that DHX33 may serve as a biomarker for poor prognosis in LUAD.

Analysis and validation of the potential of the MYO1E gene in pancreatic adenocarcinoma based on a bioinformatics approach.

Pancreatic adenocarcinoma (PAAD) is a common digestive cancer, and its prognosis is poor. Myosin 1E (MYO1E) is a class I myosin family member whose expression and function have not been reported in PAAD. In the present study, bioinformatics analysis was used to explore the expression levels of MYO1E in PAAD and its prognostic value, and the immunological role of MYO1E in PAAD was analyzed. The study revealed that a variety of malignancies have substantially increased MYO1E expression. Further investigation demonstrated that PAAD tissues exhibited greater levels of MYO1E mRNA and protein expression than normal tissues. High MYO1E expression is associated with poor prognosis in patients with PAAD. MYO1E expression was also associated with pathological stage in patients with PAAD. Functional enrichment analysis demonstrated that MYO1E was linked to multiple tumor-related mechanisms in PAAD. The pancreatic adenocarcinoma tumor microenvironment (TME) was analyzed and it was revealed that MYO1E expression was positively associated with tumor immune cell infiltration. In addition, MYO1E was closely associated with some tumor chemokines/receptors and immune checkpoints. In vitro experiments revealed that the suppression of MYO1E expression could inhibit pancreatic adenocarcinoma cell proliferation, invasion and migration. Through preliminary analysis, the present study evaluated the potential function of MYO1E in PAAD and its function in TME, and MYO1E may become a potential biomarker for PAAD.

Intraoperative evaluation of metastases in sentinel nodes through one-step nucleic acid amplification: Initial experience in asingle institution.

The objective of this study was to gain our initial experience in one-step nucleic acid amplification (OSNA) for detecting sentinel lymph node (SLN) metastasis as compared to standard pathological staging in patients with breast cancer. Fifteen patients with preoperatively confirmed early breast cancer eligible for breast‑saving therapy and sentinel lymph node biopsy (SLNB) were enrolled in the study. Lymphatic mapping and SLNs detection were performed through the magnetic method. Excised SLNs were intraoperatively examined through OSNA and frozen‑section methods. All lymph nodes were postoperatively examined through histopathology and immunohistochemistry. The results of latter methods were correlated. Our initial experience proved OSNA to be a sensitive and efficient alternative to intraoperative assessment of metastases in SLN in breast cancer patients. Moreover, the information obtained by the OSNA method provides the surgeon with the possibility of assessing a more accurate prognosis during the initial surgery (Tab. 3, Fig. 4, Ref. 36). Text in PDF www.elis.sk Keywords: breast cancer, metastases, surgery, sentinel nodes, OSNA.

53: SIGNIFICANCE OF NEOADJUVANT DOWNSTAGING IN ADENOCARCINOMA OF THE STOMACH

Abstract Background and aim Neoadjuvant chemotherapy is established in the treatment of gastric adenocarcinoma. Histopathological regression as a result of neoadjuvant treatment may have important prognostic implications. There is little data comparing the prognosis of clinical versus pathological stage in patients receiving neoadjuvant treatment. Equally, comparison of outcomes of patients with comparable pathological stage that have received neoadjuvant treatment with those having surgery as their initial treatment is not known. The aim of this study is to determine the impact of neoadjuvant chemotherapy upon the prognosis of patients treated for gastric adenocarcinoma. Methods Consecutive patients with gastric cancer from a single, centre between 2007 and 2017 were evaluated. All patients with gastric adenocarcinoma were treated with either a subtotal or total gastrectomy and D2 lymphadenectomy. The impact of downstaging on outcomes and a stage-by-stage comparison of pTNM with ypTNM was performed. Results 654 patients underwent gastrectomy, 345 patients received neoadjuvant chemotherapy. Patients with downstaged disease had improved overall survival than patients with tumours that did not respond to neoadjuvant chemotherapy (P &amp;lt; 0.001). Downstaging by more than 3 stages was the strongest independent predictor of overall survival when compared with patients who did not respond to neoadjuvant treatment (median survival: 122 vs 66 months, P &amp;lt; 0.001). Survival was significantly improved for patients with advanced overall staging when a stage-wise comparison was performed between patients in like-for-like ypTNM and pTNM groups (ypT 3/4 N2/3 vs pT3/4 N2/3 median survival: 33 vs 16 months, P = 0.001). Conclusion Pathological staging following neoadjuvant chemotherapy is better for survival prognostication compared to clinical stage. Downstaging is associated with improved prognosis. There is a significant improvement in survival when comparing pathological stage post neoadjuvant treatment compared to those with a similar stage who had surgical treatment initially.

Interferon‑stimulated gene 15 promotes progression of endometrial carcinoma and weakens antitumor immune response.

Endometrial carcinoma (EC) is one of the most common gynecological cancers with a poor prognosis. Therefore, clarifying the details of the molecular mechanisms is of great importance for EC diagnosis and clinical management. Interferon-stimulated gene 15 (ISG15) plays an important role in the development of various cancers. However, its role in EC remains unclear. High ISG15 expression was observed in EC, which was associated with poor clinical outcomes and pathological stage of patients with EC, thus representing a promising marker for EC progression. Further exploratory analysis revealed that the elevated ISG15 levels in EC were driven by aberrant DNA methylation, independent of copy number variation and specific transcription factor aberrations. Accordingly, knockdown of ISG15 by small interfering RNA attenuated the malignant cellular phenotype of EC cell lines, including proliferation and colony formation in vitro. Finally, investigation of the molecular mechanisms indicated that ISG15 promoted the cell cycle G1/S transition in EC. Furthermore, ISG15 promoted EC progression by activating the MYC proto-oncogene protein signaling pathway. Moreover, ECs with high levels of ISG15 harbored a more vital immune escape ability, evidenced not only by significantly less invasive CD8+ T cells, but also higher expression of T cell inhibitory factors, such as programmed death-ligand 1. These results suggest a tumor-promoting role of ISG15 in EC, which may be a promising marker for diagnosis, prognosis and therapeutic immunity.

SC303 - Role of inflammatory markers and frailty index as predictors of adverse pathological stage in patients with kidney cancer: a multicenter analysis

SC303 - Role of inflammatory markers and frailty index as predictors of adverse pathological stage in patients with kidney cancer: a multicenter analysis

P-167 Comparison of Clinical and Pathological Staging in Patients with Head and Neck Cancer After Elective Neck Dissection

P-167 Comparison of Clinical and Pathological Staging in Patients with Head and Neck Cancer After Elective Neck Dissection

Circ‑0000212 promotes cell proliferation of colorectal cancer by sponging miR‑491 and modulating FOXP4 expression

Colorectal cancer (CRC) is a lethal and common malignancy worldwide. Non-coding (nc)RNAs have been shown to modulate tumor progression in several types of cancer. The present study aimed to investigate the role of hsa_circ_0000212 in CRC, as a sponge of microRNA (miR)-491. The expression levels of miR-491 and forkhead box P4 (FOXP4) were analyzed using data from The Cancer Genome Atlas. The association between miR-491 and FOXP4 and the clinicopathological characteristics were also analyzed. A novel circular (circ)RNA, hsa_circ_0000212, was found to sponge miR-491 based on bioinformatics analysis. The potential binding site between miR-491 and FOXP4 or circ-0000212 was validated using luciferase and RNA immunoprecipitation assays. The expression levels and distribution of circ-0000212 was also determined. Cell Counting Kit-8 and colony formation assays were performed to determine the role of miR-491 or circ-0000212 on the proliferation of the CRC cells. Decreased miR-491 or increased FOXP4 expression levels were associated with the pathological stage in patients with CRC. In addition, miR-491 inhibited cell proliferation by targeting FOXP4. circ-0000212 was increased in CRC tissues and was predominantly localized in the cytoplasm. Furthermore, circ-0000212 augmented viability of the CRC cells by sponging miR-491 and modulating FOXP4. In conclusion, circ-0000212 may serve as a novel tumor-promoter and drug target in CRC.