Prognosis Of Patients Research Articles

Macrophage-derived cathepsin L promotes epithelial-mesenchymal transition and M2 polarization in gastric cancer

BACKGROUND Advanced gastric tumors are extremely prone to metastasize the in 20%–30% of gastric cancer, and patients have a poor prognosis despite systemic chemotherapy. Peritoneal metastases from gastric cancer usually indicate the end stage of the disease without curative treatment. AIM To peritoneal metastasis for facilitating clinical therapy are urgently needed. METHODS Immunohistochemical staining and immunofluorescence staining were used to demonstrate the high expression of cathepsin L (CTSL) in human gastric cancer tissues and its localization in cells. Lentivirus transfection was used to construct stable cell lines. Transwell invasion assays, wound healing assays, and animal tests were used to determine the relationships between CTSL and epithelial-mesenchymal transition (EMT) and tumorigenic potential in vivo . RESULTS We observed that macrophage-derived CTSL promoted gastric cancer cell migration and metastasis via the EMT pathway in vitro and in vivo , which involved macrophage polarization. Our findings suggest that macrophages improve extracellular matrix remodeling and hence facilitate tumor metastasis. Ablation of CTSL in macrophages within the tumor microenvironment may improve tumor therapy and the prognosis of patients with gastric cancer peritoneal metastasis. CONCLUSION In consideration of our findings, tumor-associated macrophage-derived CTSL is an important factor that promotes the metastasis and invasion of gastric cancer cells, and the targeting of CTSL may potentially improve the prognosis of patients with gastric cancer with peritoneal metastasis.

Impact of glycemic treatment and blood glucose monitoring on outcomes in patients with acute ischemic stroke without prior diabetes: a longitudinal cohort study

ObjectivesTo explore the short- and long-term effects of glycemic management—through glycemic treatment and blood glucose monitoring (BGM)—on stroke recurrence and mortality specifically in patients experiencing a first-ever ischemic stroke (FIS) with hyperglycemia (FISHG) who have not previously been diagnosed with diabetes mellitus (DM).MethodsWe gathered data on patients who were registered on Taiwan’s National Health Insurance Research Database from 2000 to 2015. We one-fold propensity-score-matched (by sex, age, and index date) 207,054 patients into 3 cohorts: those with FIS (1) without hyperglycemia, (2) hyperglycemia without glycemic treatment, and (3) hyperglycemia with glycemic treatment. We used Cox proportional hazard regression to evaluate the short- (within 1 year after FIS) and long-term (9.3 ± 8.6 years after FIS) prognostic effects of glycemic management on stroke recurrence and mortality of FISHG.ResultsStroke recurrence and mortality were significantly more likely in the patients with FISHG than their counterparts without hyperglycemia (p < 0.05). Under glycemic treatment, patients with FISHG demonstrated lower risk of mortality at every follow-up than those without (p < 0.001) but were not less likely to have stroke recurrence (p > 0.05). Integrating BGM with glycemic treatment in the FISHG cohort significantly reduced the risk of stroke recurrence compared to patients receiving only glycemic treatment at 1-month, 3-month, 6-month, and 1-year post-stroke follow-ups (adjusted hazard ratios = 0.84, 0.90, 0.88, and 0.92, respectively); additionally, this approach significantly decreased mortality risk at each post-stroke follow-up period (p < 0.05).ConclusionsBGM combined with glycemic treatment significantly improves prognosis in patients with FISHG who have not been previously diagnosed with DM, reducing the risks of stroke recurrence and mortality.

Mid-long term follow-up reports on head and neck rhabdomyosarcoma in children

Objective: To analyze the clinical characteristics of children with head and neck rhabdomyosarcoma (RMS) and to summarize the mid-long term efficacy of Beijing Children's Hospital Rhabdomyosarcoma 2006 (BCH-RMS-2006) regimen and China Children's Cancer Group Rhabdomyosarcoma 2016 (CCCG-RMS-2016) regimen. Methods: A retrospective cohort study. Clinical data of 137 children with newly diagnosed head and neck RMS at Beijing Children's Hospital, Capital Medical University from March 2013 to December 2021 were collected. Clinical characteristic of patients at disease onset and the therapeutic effects of patients treated with the BCH-RMS-2006 and CCCG-RMS-2016 regimens were compared. The treatments and outcomes of patients with recurrence were also summarized. Survival analysis was performed by Kaplan-Meier method, and Log-Rank test was used for comparison of survival rates between groups. Results: Among 137 patients, there were 80 males (58.4%) and 57 females (41.6%), the age of disease onset was 59 (34, 97) months. The primary site in the orbital, non-orbital non-parameningeal, and parameningeal area were 10 (7.3%), 47 (34.3%), and 80 (58.4%), respectively. Of all patients, 32 cases (23.4%) were treated with the BCH-RMS-2006 regimen and 105 (76.6%) cases were treated with the CCCG-RMS-2016 regimen. The follow-up time for the whole patients was 46 (20, 72) months, and the 5-year progression free survival (PFS) and overall survival (OS) rates for the whole children were (60.4±4.4)% and (69.3±4.0)%, respectively. The 5-year OS rate was higher in the CCCG-RMS-2016 group than in BCH-RMS-2006 group ((73.0±4.5)% vs. (56.6±4.4)%, χ2=4.57,P=0.029). For the parameningeal group, the 5-year OS rate was higher in the CCCG-RMS-2016 group (61 cases) than in BCH-RMS-2006 group (19 cases) ((57.3±7.6)% vs. (32.7±11.8)%, χ2=4.64,P=0.031). For the group with meningeal invasion risk factors, the 5-year OS rate was higher in the CCCG-RMS-2016 group (54 cases) than in BCH-RMS-2006 group (15 cases) ((57.7±7.7)% vs. (30.0±12.3)%, χ2=4.76, P=0.029). Among the 10 cases of orbital RMS, there was no recurrence. In the non-orbital non-parameningeal RMS group (47 cases), there were 13 (27.6%) recurrences, after re-treatment, 7 cases survived. In the parameningeal RMS group (80 cases), there were 40 (50.0%) recurrences, with only 7 cases surviving after re-treatment. Conclusions: The overall prognosis for patients with orbital and non-orbital non-parameningeal RMS is good. However, children with parameningeal RMS have a high recurrence rate, and the effectiveness of re-treatment after recurrence is poor. Compared with the BCH-RMS-2006 regimen, the CCCG-RMS-2016 regimen can improve the treatment efficacy of RMS in the meningeal region.

Precision radiotherapy with molecular-profiling of CNS tumours.

Diagnoses of CNS malignancies in the primary and metastatic setting have significantly advanced in the last decade with the advent of molecular pathology. Using a combination of immunohistochemistry, next-generation sequencing, and methylation profiling integrated with traditional histopathology, patient prognosis and disease characteristics can be understood to a much greater extent. This has recently manifested in predicting response to targeted drug therapies that are redefining management practices of CNS tumours. Radiotherapy, along with surgery, still remains an integral part of treating the majority of CNS tumours. However, the rapid advances in CNS molecular diagnostics have not yet been effectively translated into improving CNS radiotherapy. We explore several promising strategies under development to integrate molecular oncology into radiotherapy, and explore future directions that can serve to use molecular diagnostics to personalize radiotherapy. Evolving the management of CNS tumours with molecular profiling will be integral to supporting the future of precision radiotherapy.

Impact of zero-positive end-expiratory pressure on blood transfusion rates in off-pump coronary artery bypass surgery: a retrospective cohort study

BackgroundBleeding are common in cardiac surgery, with significant impacts on transfusion-related complications and patient prognosis. This study aimed to determine the differences in perioperative blood loss, transfusion rates, and the incidence of postoperative pulmonary complications (PPCs) with and without the use of positive end-expiratory pressure (PEEP) in patients undergoing off-pump coronary artery bypass graft surgery (OPCAB).MethodsThis single-center, retrospective study included 106 adult patients undergoing coronary artery bypass surgery without cardiopulmonary bypass from January 2018 to March 2022. The patients were divided into two groups based on intraoperative ventilator settings: the zero-PEEP (ZEEP) group and the PEEP group. The primary outcome was the perioperative transfusion rate from the intraoperative period to postoperative 7 day. The incidence of PPCs was recorded for 1 week post-operatively. Logistic regression analysis was performed for statistical analysis.ResultsThe average PEEP in the PEEP group was 4.92 ± 0.42 cmH2O. Multiple regression analysis indicated that lower mean airway pressure during surgery tend to associate with intraoperative lower blood loss. The intraoperative transfusion rates in the ZEEP group were significantly lower than those in the PEEP group (ZEEP:14%, PEEP 38.4%, P = 0.02). Logistic regression analysis revealed that ZEEP (adjusted odds ratio [OR] 0.13, 95% confidence interval [CI] 0.04–0.78) and Society of Thoracic Surgeons(STS) scores (adjusted OR 2.31, 95% CI 1.53–3.49) were significantly associated with a reduced requirement for perioperative transfusions. No significant difference was observed between the two groups in terms of PPCs (p = 0.824). Atelectasis was the most common complication in both groups (ZEEP: 35.7%, PEEP: 40%, P = 0.832).ConclusionsZEEP and STS scores were associated with significantly reduced requirement for perioperative transfusion rates during elective OPCAB surgery. However, ZEEP did not significantly affect the incidence of PPCs.

CMTM6 promotes hepatocellular carcinoma invasion and metastasis and tumor-associated neutrophil immunoinfiltration through the Wnt/β-catenin pathway

BackgroundCMTM6 has been closely associated with the onset and progression of various tumor types. However, the precise mechanism by which CMTM6 operates in hepatocellular carcinoma remains elusive, necessitating further investigation.MethodsExpression levels of CMTM6 in hepatocellular carcinoma tissues and cells were analyzed using immunohistochemistry and quantitative real-time PCR. The correlation between CMTM6 expression in hepatocellular carcinoma tissues and clinical pathological characteristics, as well as patient prognosis, was investigated. Proliferation and apoptosis of hepatocellular carcinoma cells with silenced or overexpressed CMTM6 were assessed, alongside measurements of β-catenin and Wnt1 protein expression levels. In vivo research was conducted utilizing a murine subcutaneous transplantation model. Gene Set Enrichment Analysis (GSEA) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were performed to elucidate the regulatory mechanism of CMTM6. Additionally, CD66b expression levels in tumor tissue were examined using immunohistochemistry, and the immune infiltration of CMTM6 and tumor-associated neutrophils (TANs) was analyzed.ResultsElevated expression levels of CMTM6 in hepatocellular carcinoma tissues and cells were found to be associated with poor patient prognosis. Overexpression of CMTM6 in hepatocellular carcinoma cells was demonstrated to promote cellular proliferation and inhibit apoptosis. Mechanistically, CMTM6 expression levels in hepatocellular carcinoma tissues were observed to positively correlate with β-catenin expression. GSEA and KEGG analysis revealed significant enrichment of CMTM6 in the Wnt/β-catenin pathway, indicating its involvement in pathway regulation. Furthermore, CMTM6 was found to be associated with immune infiltration of TANs in hepatocellular carcinoma tissues.ConclusionCMTM6 plays a pivotal role in the development and progression of hepatocellular carcinoma through regulation of the Wnt/β-catenin pathway via β-catenin. Moreover, CMTM6 demonstrates the capacity to promote immune infiltration of TANs in hepatocellular carcinoma tissues. Consequently, CMTM6 exhibits potential as both an early diagnostic marker and a novel therapeutic target for patients with hepatocellular carcinoma.

The correlation between uveal melanoma and iris nevus

PurposeTo investigate the impact of iris nevus on the incidence and prognosis of uveal melanoma (UM).MethodsA retrospective cohort study was conducted involving 1128 UM cases and 4356 healthy controls. Participants were categorized based on iris nevus presence and grade: grade 0 (no iris nevus), grade 1 (single iris nevus), grade 2 (multiple iris nevi), and grade 3 (partial or complete darkening of the iris). Propensity matching score method was employed to control for age and sex differences, while the χ 2 test was used to compare the existence rate and grade of iris nevus between groups. Univariate ANOVA evaluated differences among various iris nevus grades, the Kaplan–Meier method analyzed the prognosis of patients with different iris nevus grades, and multivariate Cox proportional risk regression analysis was conducted to evaluate the relationship between clinical data and prognosis.ResultsA total of 5484 subjects were analyzed. UM patients exhibited a higher prevalence and grade of iris nevus (all P < 0.001) after propensity matching. Patients with iris nevus in the affected eye did not show a worse prognosis (P = 0.414). However, those with partial or complete iris darkening or multiple nevi had a poorer prognosis compared to those with a single or no iris nevus (all P < 0.05). Iris nevus presence and grade in the healthy eye had no prognostic impact (P = 0.726 and P = 0.825, respectively). The multivariate COX proportional risk model showed that tumor diameter (P < 0.001), age (P = 0.020), and grade of iris nevus in the affected eye (P = 0.009) were independent risk factors for a worse prognosis. LSD analysis revealed that patients with partial or complete darkening of the iris had larger tumor diameters than those without iris nevus (P = 0.013), single nevus (P = 0.015), and multiple nevus (P = 0.023).DiscussionOur findings indicate a higher proportion and grade of iris nevus in UM patients compared to controls, and a worse prognosis for UM patients with higher-grade iris nevi in the affected eye.

Effect of Statins on the Prognosis After Thoracic Endovascular Aortic Repair for Patients With Acute Type B Aortic Dissection.

To analyze the clinical efficacy of long-term statin therapy following thoracic endovascular aortic repair (TEVAR) in patients with acute type B aortic dissection (ATBAD). We retrospectively analyzed data from 645 patients treated between January 2005 and June 2022, dividing them into Statin Group (n=330) and Non-statin Group (n=315) based on whether they received long-term postoperative statin therapy. Patients were further categorized based on median admission low-density lipoprotein cholesterol (LDL-C) levels into High and Low LDL-C Groups to assess the effect of statins on the prognosis of ATBAD patients after TEVAR. The cohort had an average age of 53.44±11.42 years old, and 81.71% were male. Statin therapy significantly reduced occurrences of all-cause death (3.03% vs 8.57%, p=0.002) and aorta-related death (0.91% vs 3.81%, p=0.015), particularly in patients with high admission LDL-C levels. In addition, patients with statin therapy had a lower incidence of aorta-related adverse events (ARAE) (4.24% vs 11.11%, p=0.001). Kaplan-Meier analysis indicated statins reduced 5-year cumulative incidence rates of all-cause death and ARAE (all Log-rank p<0.05). These trends were sustained after adjustment. Multivariate Cox analysis confirmed that statin therapy was associated with reduced risks of all-cause and aorta-related deaths, as well as ARAE. Long-term statin therapy appears to decrease the risk of all-cause and aorta-related death in ATBAD patients after TEVAR, particularly patients with high admission LDL-C levels. Patients with lower LDL-C levels at admission have a reduction of aorta-related death in the follow-up period. Statin therapy also was associated with a lower incidence of ARAE in follow-up. These findings suggest that statins might be crucial in improving long-term outcomes in this patient population. Long-term statin therapy administered to patients with acute type B aortic dissection (ATBAD) following thoracic endovascular aortic repair (TEVAR) demonstrates a substantial reduction in both all-cause and aorta-related mortality. Notably, this therapeutic benefit is most evident in patients presenting with elevated low-density lipoprotein cholesterol (LDL-C) levels at admission. Furthermore, statin therapy is associated with a decreased incidence of aorta-related adverse events during follow-up. These findings underscore the pivotal role of statin therapy in enhancing long-term clinical outcomes for ATBAD patients undergoing TEVAR, thereby contributing to improved patient care and prognosis.

Prognostic Value of Systemic Inflammatory Markers in Elderly Patients with Tumor-associated Venous Thromboembolism.

Elderly tumor patients are more prone to venous thrombotic events than nontumor patients. To investigate the relationship between systemic inflammatory markers and overall survival (OS) in elderly patients with tumorassociated venous thromboembolism (TAVTE). And to evaluate the prognostic value of combined lymphocyte platelettolymphocyte ratio (PLR) with neoplasm metastasis in elderly patients. A prospective study was conducted. A total of 172 elderly patients with TAVTE admitted to the hospital from January 2017 to December 2019 were included in the study, which were followed up for 2 years. Clinical and laboratory data were collected. All-cause mortality within after discharge were followed up. The optimal cutoff values of neutrophiltolymphocyte ratio (NLR), PLR, systemic immuneinflammation index (SII), and monocyte to highdensity lipoprotein ratio (MHR) for predicting efficacy and prognosis were determined according to receiver operating characteristic (ROC) curve and the areas under the ROC curve (AUC). Kaplan-meier curves were used to analyze the survival time. Univariate and multivariate COX logistic regression analyses were used to analyze the independent predictors of OS in elderly patients with TAVTE. The cut-off values for NLR, PLR, SII, and MHR were 3.375, 274.63, 399.73 and 0.58, respectively. And the area under the curve (AUC) was 0.639(95%CI: 0.556-0.721), 0.628(95%CI:0.544-0.712), 0.595(95%CI:0.510-0.680) and 0.596(95%CI: 0.510-0.683). Survival analysis showed that OS was longer in the NLR≤3.375 group (181.07 weeks, 95% CI: 150.11 ~ 212.03) than in the NLR >3.375 group (108.95 weeks, 95%CI: 90.38 ~ 127.51) (P = 0.005). The OS of PLR≤274.63 group (160.40 weeks, 95%CI: 138.41 ~ 182.38) was longer than that of PLR >274.63 group (43.85 weeks, 95%CI: 34.08 ~ 53.63) (P < 0.001). The OS of SII≤399.73 group (176.62 weeks, 95%CI:147.26 ~ 205.97) was longer than that of SII>399.73 group (126.55 weeks,95%CI: 105.04 ~ 148.05) (P = 0.012). The OS was longer in the MHR≤0.58 group (156.24 weeks, 95% CI: 127.05-185.43) than in the MHR>0.58 group (108.11 weeks, 95%CI:86.85-129.38) (P = 0.011). Univariate and multivariate Cox analysis showed that tumor metastasis and PLR>274.63 were independent predictors of the lower OS in elderly patients with TAVTE (P < 0.001). According to the tumor metastasis and the cut-off value of PLR, a combined scoring system MPS (Metastasis and PLR System) was designed. The OS of the 0, 1 and 2 score groups was 184.08 weeks (95%CI:158.11-210.05), 82.60 weeks (95%CI:61.57-103.64), and 23.83 weeks (95%CI: 9.575-38.09) (P < 0.001), respectively. Our findings suggest that the systemic inflammatory markers (NLR, PLR, SII, MHR) may have predictive value for all-cause mortality in elderly patients with TAVTE. PLR combined with tumor metastasis may be an effective index to predict the prognosis of elderly patients with TAVTE.

Biomimetic astrocyte cell membrane-fused nanovesicles for protecting neurovascular units in hypoxic ischemic encephalopathy

Hypoxic ischemic encephalopathy (HIE) refers to neonatal hypoxic brain injury caused by severe asphyxia during the perinatal period. With a high incidence rate and poor prognosis, HIE accounts for 2.4% of the global disease burden, imposing a heavy burden on families and society. Current clinical treatment for HIE primarily focuses on symptomatic management and supportive care. Therefore, the developments of effective treatment strategies and new drug formulations are critical for improving the prognosis of HIE patients. In order to protect the compromised neurovascular units after HIE, we prepared membrane-fused nanovesicles for delivering rapamycin and si EDN1 (TRCAM@RAPA@si EDN1). Due to the homotypic targeting feature of membrane-fused nanovesicles, we employed astrocyte membranes as synthetic materials to improve the targeting of astrocytes in brain while reducing the clearance of nanovesicles by circulatory system. Additionally, the surface of cell membrane was modified with CXCR3 receptors, enhancing the homing of nanovesicles to infarcted lesions. Lipid vesicles were modified with TK and RVG29 transmembrane peptides, enabling responsive release of internal drugs and blood-brain barrier penetration. Internally loaded rapamycin could promote protective autophagy in astrocytes, improve cellular oxidative stress, while si EDN1 could reduce the expression level of endothelin gene, thereby reducing secondary damage to neurovascular units.Graphical

Construction of a prognostic model based on disulfidptosis-related genes and identification of CCNA2 as a novel biomarker for hepatocellular carcinoma

BackgroundDisulfidptosis, identified as an innovative form of cellular death subsequent to cuproptosis, is currently under investigation for its mechanisms in oncological contexts. In-depth analyses exploring the relationship between disulfidptosis-related genes (DRGs) and hepatocellular carcinoma (HCC) are currently limited.MethodsTranscriptomic data and clinical information were retrieved from the TCGA and GEO databases (GSE76427 and GSE54236), concentrating on the expression levels of 24 DRGs. Subsequently, multifactor and LASSO regression analyses were utilized to construct the 5-DRG prognostic signature. Immunohistochemistry (IHC) was employed to assess Cyclin A2 (CCNA2) protein expression levels. Quantitative real-time PCR (qRT-PCR) and western blot analyses were conducted to detect transcriptomic and protein expression of CCNA2-targeting short interfering RNA (siRNA). The Cell Counting Kit-8 (CCK-8) assay, EdU staining, and scratch experiments were employed to observe the proliferation and migration of hepatoma cell lines subsequent to CCNA2 inhibition.ResultsThree HCC patterns were identified, among which pattern B exhibited the the most unfavorable survival outcomes. Five DRGs (STC2, PBK, CCNA2, SERPINE1, and SLC6A1) were involved to establish the 5-DRG prognostic signature. High-risk groups (HRGs) exhibited prolonged survival durations in comparison to low-risk groups (LRGs). Both bioinformatics analyses and experimental methodologies corroborated the association of CCNA2 with poor prognosis in HCC patients. Functional studies elucidated that interference with CCNA2 significantly inhibited proliferation and migration, while simultaneously promoting apoptosis in hepatoma cells and resulting in the downregulation of epithelial-mesenchymal transition (EMT)-related protein markers.ConclusionsThe 5-DRG prognostic signature is proficient in predicting clinical outcomes, informing therapeutic strategies, and elucidating the characteristics of the immune microenvironment in HCC patients. Furthermore, this study elucidates the potential of CCNA2 as an innovative biomarker for HCC.

Effects of intravenous anesthesia and inhalation anesthesia on postoperative inflammatory markers in patients with esophageal cancer: a retrospective study

BackgroundInflammatory markers have been confirmed to be associated with the prognosis of cancer patients. In this study, we compared the impacts of intravenous anesthesia and inhalation anesthesia on the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), and the systemic immune-inflammation index (SII) after esophageal cancer surgery.MethodsWe retrospectively reviewed the electronic medical records of patients who underwent esophagectomy from January 1, 2014 to December 31, 2016. Patients respectively received total intravenous anesthesia (TIVA) or inhalational anesthesia (INHA). Inverse probability of treatment weighting (IPTW) was employed to minimize differences. The Mann-Whitney U test or Kruskal Wallis test was utilized to compare the effect of the two groups on postoperative NLR, PLR and SII.ResultsA total of 519 patients who had undergone esophageal cancer resection were recruited in this study, among whom 339 patients were eligible (TIVA group, n = 201, INHA group, n = 138). After IPTW, there was no statistically significant difference in NLR, PLR, and SII on the first postoperative day(P = 0.1951), (P = 0.5611), (P = 0.9684) and on the third postoperative day(P = 0.5961), (P = 0.1804), (P = 0.9653) between the two groups.ConclusionsIn conclusion, there was no significant difference in NLR, PLR and SII between intravenous anesthesia or inhalational anesthesia. TIVA is not superior to INHA in reducing the perioperative inflammatory response of esophageal cancer.SynopsisInflammatory markers play an important role in the recurrence, metastasis and survival of tumor patients after surgery. In this study, we will compare the effects of different anesthesia methods on inflammatory markers.

The clinical applications of dual-layer spectral detector CT in digestive system diseases.

Dual-layer spectral detector CT (DLCT) has several advantages in clinical practice, this study aims to reveal the clinical applications of DLCT in digestive system diseases. We searched PubMed and Cochrane Reviews for articles published from January 1, 2010 to May 31, 2024, using the terms "dual-layer spectral detector CT" or "dual-layer CT" combined with "hepatic fat" or "hepatic fibrosis" "hepatocellular carcinoma" or "pancreatic ductal adenocarcinoma" or "pancreatic neuroendocrine tumors" or "gastric cancer" or "colorectal cancer" or "Crohn's disease" or "bowel ischemia" or "acute abdominal conditions". DLCT consists of a top layer sensitive to lower-energy photons and a bottom layer sensitive to higher-energy photons. This configuration enables simultaneous acquisition of two energy spectra from a single X-ray beam ensuring consistent spatial alignment and temporal resolution. Spectral raw images allow image post-processing to improve image quality, reduce radiation doses and contrast media doses, and generate multiple quantitative parameters. It has broad potential for early detection, accurate staging, efficacy assessment, and prognosis prediction of liver, pancreatic, and gastrointestinal diseases, as well as for the assessment of digestive system vasculature. DLCT not only provides valuable information for the clinical diagnosis and therapeutic effect evaluation of digestive system diseases but also may play a more important role in the overall management of digestive diseases and in the decision-making of individualized medicine. Question What are the advantages of DLCT compared to traditional single-energy CT in the early detection, staging, and therapeutic evaluation of digestive system diseases? Findings DLCT enhances image quality, improves tissue characterization, and allows for multi-parametric analysis, making it superior in detecting and evaluating liver, pancreatic, and gastrointestinal diseases. Clinical relevance DLCT provides high-quality, multi-parametric imaging that improves the accuracy of diagnosing digestive diseases, facilitates more precise treatment planning, and enhances monitoring of treatment response, ultimately contributing to better patient management and prognosis.

The radiohumeral synovial plica: anatomy, histology, and implications in chronic lateral epicondylitis.

Our study aimed to elucidate synovial plica (SP) of the elbow histological characteristics and the anatomical relationship with adjacent structures. Subsequently, we sought to assess the relationship between SP and clinical symptoms as well as magnetic resonance imaging (MRI) features in patients with chronic lateral epicondylitis. MRI was performed on eight cadaveric elbows specimens. The MRI findings were compared with those in anatomic sections and histologic preparations. In addition, ninety-nine patients with chronic lateral epicondylitis who underwent preoperative elbow MRI and arthroscopic surgery were included. The patients were divided into SP and without SP groups. The differences in clinical symptoms and MRI features between the two groups were compared. SP is located proximal to the annular ligament that extends into the joint cavity, then moves to the lateral collateral ligament (LCL) complex, and finally attaches to the lateral epicondyle of the elbow along with the common extensor tendon (CET). The SP, ligament, and tendon blend imperceptibly without distinct boundaries. Furthermore, in a study of patients with chronic lateral epicondylitis, we found that compared to the without SP group, patients in the SP group had higher preoperative and 3-week postoperative VAS scores and more severe abnormalities in LCL complex and CET. The SP is distinct from the annular ligament and closely correlates with the LCL complex and CET enthesis at the lateral epicondyle. Chronic lateral epicondylitis patients with SP have more severe abnormalities of the LCL complex and CET, more severe pain, and longer postoperative recovery times. Question Synovial plica (SP) cause lateral elbow pain, but few studies regarding histological and imaging features of SP and its relationship to chronic lateral epicondylitis exist. Findings The presence of SP leads to more severe common extensor tendon abnormalities and higher visual analog scale scores in patients with chronic lateral epicondylitis. Clinical relevance The combination of magnetic resonance imaging and clinical symptoms to further understand the effect of SP on the clinical symptoms and postoperative recovery in chronic lateral epicondylitis can help refine treatment strategies and improve the prognosis of patients.

Detection of Circulating Tumor Cells in the Prognostic Significance of Patients With Breast Cancer: A Retrospective Study.

Breast cancer (BC) is an aggressive tumor. Circulating tumor cells (CTCs) are a potential biomarker for the prognosis of cancer patients. This study aimed to explore the prognostic significance of CTCs in patients with BC. Retrospectively, 108 BC patients were collected between January 2011 and December 2019, while 10 patients with benign nodules were included as controls. CTCs with different phenotypes of patients were isolated using CanPatrol and tricolor RNA insitu hybridization (RNA-ISH) methods. Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER-2) levels were measured by immunohistochemistry (IHC). The progression-free survival (PFS) was calculated using the Kaplan-Meier method. Independent risk factors for BC recurrence were determined by Cox proportional risk regression analysis. The higher the cancer stage (p = 0.00), the higher the ki-67 expression level (p < 0.01), and the lower the histologic grade (p < 0.01), the higher the number of CTCs. The PFS of patients with high CTCs was shorter than that of patients with low CTCs (p < 0.05). Total CTCs (≥ 6) and positive mesenchymal CTCs (MCTCs) were also associated with recurrence and metastasis. Total CTCs in BC patients have an independent influence on PFS reduction. Higher total CTCs and MCTCs in peripheral blood are biomarkers for predicting the prognosis of BC patients. HER-2 high expression is also associated with the prognosis of the disease.

The landscape in telomere related gene prognostic signature for survival and medication treatment effectiveness prediction in hepatocellular carcinoma

ObjectiveTelomeres, made of repetitive DNA sequences and shelterin complexes, which were found at the ends of chromosomes and had been extensively studied in cancer research. However, in hepatocellular carcinoma (HCC) was still relatively scarce. In this study, we investigated the correlation between telomerase-related genes (TRGs) and the prognosis and immunotherapy of HCC patients to enhance clinical outcomes.MethodsIn this work, TRGs were gathered using TelNet, while clinical information and gene expression data for HCC patients were retrieved from the Cancer Genome Atlas (TCGA) database. A risk prediction model based on TRGs was created using COX and Lasso regression analyses, with ROC curves used to assess prognostic efficacy. Univariate and multifactorial COX regression analyses were used to determine if the risk model had an independent impact on prognosis. Nomograms were created to enhance clinical usability, and calibration curves were used to assess predictive ability at various time points. The Tumor Immune Dysfunction and Exclusion (TIDE) score was used to analyze differences in immune infiltrating cells between risk groups. The study analyzed the relationship between risk ratings and drug treatment effectiveness using data from the CellMiner database. The hub gene was identified and its relationship to prognostic markers of HCC patients was examined. The expression of hub genes in immune cell subpopulations was also investigated by single-cell data.Results2093 TRGs were identified, with 949 showing significant differences in expression between HCC and paracancerous tissues. Seven risk genes were overexpressed in tumor tissues, leading to lower survival rates in high-risk patients. Risk model could independently predict the prognosis of HCC patients. Analysis of tumor immune infiltrating cells revealed significant differences in cell abundance between risk groups, with notable variations in immune subset enrichment between subgroups. Higher risk scores correlated with increased sensitivity to sorafenib, mitoxantrone, oxaliplatin, gemcitabine, and entinostat, while sensitivity decreased for vincristine, etc. CDCA8 was identified as a key gene in the Protein Interaction Network, while high expression associated with poorer overall survival, tumor proliferation and metastasis. The results of single-cell data analysis suggest that CDCA8 may promote the development of HCC by affecting T lymphocytes.ConclusionThe TRG-based risk model could predict HCC patient prognosis and closely linked to tumor immune environment, which could offer new possibilities for clinical treatment.

Genetic overlap between breast cancer and sarcopenia: exploring the prognostic implications of SLC38A1 gene expression

BackgroundSarcopenia, an age-related syndrome characterized by a decline in muscle mass, not only affects patients’ quality of life but may also increase the risk of breast cancer recurrence and reduce survival rates. Therefore, investigating the genetic mechanisms shared between breast cancer and sarcopenia is significant for the prevention, diagnosis, and treatment of breast cancer.MethodsThis study downloaded gene expression datasets and clinical data related to breast cancer and skeletal muscle aging from the GEO database. Data preprocessing, integration, differential gene identification, functional enrichment analysis, and construction of protein-protein interaction networks were performed using R language. Subsequently, COX proportional hazards model analysis and survival analysis were conducted, and survival curves and nomograms were generated. The expression levels of genes in tissues were detected using qRT-PCR, and the Radiant DICOM viewer software was used to delineate the pectoralis major muscle area in CT images.ResultsWe identified 152 differentially expressed genes (P < .05) and 226 sarcopenia-related genes (r > .4) associated with skeletal muscle aging. The TCGA-BRCA dataset revealed 106 genes associated with breast cancer (P < .05, logFC = 1). Functional enrichment analysis indicated significant enrichment in cell proliferation and growth pathways. The PPI network identified critical molecules involved in muscle aging and tumor progression. After dimensionality reduction, a strong correlation was observed between the expression of the muscle aging-related gene set and the prognosis of breast cancer patients (P < .01). The expression of SLC38A1 identified through multivariate COX analysis was significantly associated with poor prognosis in breast cancer patients (P = .03). Incorporating SLC38A1 expression, the prognostic model precisely forecasted breast cancer survival (P < .01). External validation confirmed the higher expression of the SLC38A1 gene in breast cancer tissues compared to adjacent non-cancerous tissues (P < .01). The SLC38A1 index, calculated in combination with the patient’s age and BMI, can optimize the prognostic prediction model, providing a powerful tool for personalized treatment of breast cancer.ConclusionHigh SLC38A1 gene expression was significantly associated with poor prognosis in breast cancer patients. The combination of SLC38A1 expression and the pectoralis major muscle area provided an optimized prognostic prediction model, offering a potential tool for personalized breast cancer treatment.

SEC14L2 regulates the transport of cholesterol in non-small cell lung cancer through SCARB1

BackgroundInhibiting cholesterol metabolism has shown great potential in non-small cell lung cancer (NSCLC). However, the regulatory mechanism of the lipid metabolism key factor Sect. 14-like lipid binding 2 (SEC14L2) in NSCLC remains unclear. This study investigates the effects of differentially expressed genes related to cholesterol metabolism on the development of NSCLC.MethodsCox regression and survival analysis were performed to screen cholesterol metabolism-related genes and predict survival prognosis in NSCLC patients. The proliferation and migration of NSCLC cells were assessed by CCK-8, EdU, colony formation and wound-healing assay. Cholesterol depletion and rescue trials were used to evaluate the effect of SEC14L2 on cholesterol transport in NSCLC cells. IF and Co-IP were used to analyze the targeting relationship between SEC14L2 and scavenger receptor class B member 1 (SCARB1).ResultsSEC14L2 was a key gene related to prognosis in NSCLC patients and was highly expressed in A549 and Calu-1 cells. Subsequent studies demonstrated that knockdown of SEC14L2 significantly reduced the proliferation and migration of NSCLC cells, resulting in inhibited tumor growth. Furthermore, both in vitro and in vivo experiments indicated that SEC14L2 regulated cholesterol uptake. Silencing SEC14L2 partially counteracted the promotion of cholesterol content by MβCD-chol in A549 and Calu-1 cells. We then verified that there was a protein interaction between SEC14L2 and SCARB1.ConclusionSEC14L2 promoted cholesterol uptake in NSCLC cells by up-regulating SCARB1 expression, thereby promoting NSCLC development.

Identification of pyroptosis-associated miRNAs in the immunoscape and prognosis of hepatocellular carcinoma

BackgroundHepatocellular carcinoma is one of the most prevalent types of liver malignancy and poses a severe threat to global health. Despite recent improvements in therapeutic approaches, treatment options for patients with advanced or recurrent HCC are still limited.Materials and methodsOur study analyzed miRNA differential expression using data from hepatocellular carcinoma patients in the Cancer Genome Atlas. Pyroptosis-related genes were identified from gene cards. Differential expression of miRNAs was analyzed using DESeq2 and visualized using ggplot2 and pheatmap. A prognostic risk model for pyroptosis-associated miRNAs was constructed using LASSO regression and validated by principal component analysis, Kaplan-Meier survival and ROC curve analysis. We also performed gene and pathway enrichment analysis. Immune cell infiltration and function in HCC were assessed using single-sample genomic enrichment analysis, and correlations with immune cells and function were explored. Also, CCK-8 assay as well as migration and invasion assays were performed after knockdown of miR-6844.ResultsWe have established and validated a prognostic risk model based on ten DEmiRNAs, which is important for the survival of HCC patients. Significant changes in immune cell infiltration and immune function were also found in high-risk patients. It also demonstrated that knockdown of miR-6844 inhibited HCC cell proliferation, migration and invasion, highlighting its role in HCC progression.ConclusionOur study reveals the implications of pyroptosis-associated differential miRNAs on the prognosis of patients with hepatocellular carcinoma and provides a foundation for novel HCC therapies, especially immunotherapy.

Dual-specificity phosphatase 23 functions as a promising prognostic biomarker in non-small cell lung cancer.

The mechanical remodeling of tumor microenvironment is critical for non-small cell lung cancer (NSCLC) progression. Dual-specificity phosphatase 23 (DUSP23) has been previously identified as a mechano-responsive gene, but its role in NSCLC progression remains unknown. We aim to elucidate the clinical significance of DUSP23 in NSCLC progression. We analyzed the expression of DUSP23 in cancer using polyacrylamide hydrogels designed to mimic the stiffness of normal (soft; ~0.5kPa) and cancerous (stiff; ~40kPa) tissues. The prognostic significance of DUSP23 expression in patients was examined using public databases. Additionally, we conducted various cell-based assays and transcriptomic analyses in DUSP23-silenced NSCLC cell lines. A risk score prognosis model was constructed using univariate Cox regression and Kaplan-Meier analysis. Our findings show that DUSP23 is upregulated in stiff matrices and is highly associated with poor prognosis in patients with solid cancers such as NSCLC and breast cancer. Silencing of DUSP23 resulted in decreased cell proliferation and invasion. Transcriptomic profiling revealed that 182 genes were downregulated, and 230 genes upregulated following DUSP23-depletion. Notably, 182 downregulated genes were enriched in cancer-related pathways, including cell cycle progression and cytoskeleton organization. Through KEGG pathway analysis, we identified 11 cancer-related genes and developed a prognostic risk model. In this model, the high-risk group of NSCLC patients exhibited significantly shorter overall survival compared to low-risk group, based on public datasets. Our study demonstrates the clinical significance of DUSP23 as a prognostic marker in NSCLC and highlights its potential role of DUSP23 in promoting NSCLC progression.