Survival Prognosis Of Patients Research Articles

Voltage-Gated Sodium Channel NaV1.5 Controls NHE−1−Dependent Invasive Properties in Colon Cancer Cells

Colorectal cancer (CRC) is the second leading cause of death worldwide, with 0.9 million deaths per year. The metastatic stage of the disease is identified in about 20% of cases at the first diagnosis and is associated with low patient-survival rates. Voltage-gated sodium channels (NaV) are abnormally overexpressed in several carcinomas including CRC and are strongly associated with the metastatic behavior of cancer cells. Acidification of the extracellular space by Na+/H+ exchangers (NHE) contributes to extracellular matrix degradation and cell invasiveness. In this study, we assessed the expression levels of pore-forming α-subunits of NaV channels and NHE exchangers in tumor and adjacent non-malignant tissues from colorectal cancer patients, CRC cell lines and primary tumor cells. In all cases, SCN5A (gene encoding for NaV1.5) was overexpressed and positively correlated with cancer stage and poor survival prognosis for patients. In addition, we identified an anatomical differential expression of SCN5A and SLC9A1 (gene encoding for NHE-1) being particularly relevant for tumors that originated on the sigmoid colon epithelium. The functional activity of NaV1.5 channels was characterized in CRC cell lines and the primary cells of colon tumors obtained using tumor explant methodologies. Furthermore, we assessed the performance of two new small-molecule NaV1.5 inhibitors on the reduction of sodium currents, as well as showed that silencing SCN5A and SLC9A1 substantially reduced the 2D invasive capabilities of cancer cells. Thus, our findings show that both NaV1.5 and NHE-1 represent two promising targetable membrane proteins against the metastatic progression of CRC.

Implications of Cellular Immaturity in Necrosis and Microvascularization in Glioblastomas IDH-Wild-Type.

Necrosis and increased microvascular density in glioblastoma IDH-wild-type are the consequence of both hypoxia and cellular immaturity. Our study aimed to identify the main clinical-imaging and morphogenetic risk factors associated with tumor necrosis and microvascular in the prognosis of patient survival. We performed a retrospective study (10 years) in which we identified 39 cases. We used IDH1, Ki-67 and Nestin immunomarkers, as well as CDKN2A by FISH. The data were analyzed using SPSS Statistics. The clinical characterization identified only age over 50 years as a risk factor (HR = 3.127). The presence of the tumor residue, as well as the absence of any therapeutic element from the trimodal treatment, were predictive factors of mortality (HR = 1.024, respectively HR = 7.460). Cellular immaturity quantified by Nestin was associated with reduced overall survival (p = 0.007). Increased microvascular density was associated with an increased proliferative index (p = 0.009) as well as alterations of the CDKN2A gene (p < 0.001). CDKN2A deletions and cellular immaturity were associated with an increased percentage of necrosis (p < 0.001, respectively, p = 0.017). The main risk factors involved in the unfavorable prognosis are moderate and increased Nestin immunointensity, as well as the association of increased microvascular density with age over 50 years. Necrosis was not a risk factor.

Treatment strategy and clinical characteristics of patients with cervical cancer as prognostic parameters of survival

Background. Cervical cancer (CRC) ranks second in the world among all malignant neoplasms of the female genital organs. According to the WHO, more than 500000 new cases of CRC are detected annually in the world. In 2021, 3398 new cases of the disease were registered in Ukraine. Currently a number of factors that have a rather high individual prognostic significance influences the CRC development. Among these factors are those which are associated with an adverse outcome: heavy hereditary anamnesis, growth form of tumor and its localization, variant of spread, depth of invasion into the stroma, morphological structure, methods of treatment, etc. Over the last decade, there has been an unfavorable trend towards an increase in the number of young patients who have an advanced tumor process, which significantly restricts methods and reduces the chances of the successful treatment. Thereby, the high level of morbidity and mortality from CRC, especially among young patients, as well as the unsatisfactory results of 5-year survival after traditional methods of treatment, indicate that the cancer of this type is the prior problem in domestic oncology.
 Purpose. To make scientific analysis of modern treatment strategies and characteristics of CRC as prognostic survival parameters.
 Materials and methods. The literature review included available full-text publications, which were obtained as a result of an in-depth analysis of foreign and domestic scientific publications.
 Results. Authors gave analysis of modern domestic and foreign literature on the evaluation of the effectiveness of treatment of cervical cancer patients; namely, how treatment strategies, individual characteristics of patients and characteristics of the tumor affect the results of treatment and prognosis of patient survival. It is shown which parameters, factors and important nuances of the disease should be taken into account, which is decisive in choosing treatment tactics and preventing complications.
 Conclusions. Knowing and taking into account the prognostic parameters of the survival of cervical cancer patients is important for the assessment of treatment standards, as well as the development of personalized tactics for the treatment and monitoring of this disease.

Internal carotid artery embolization in endoscopic salvage surgery for recurrent nasopharyngeal carcinoma: a single-center retrospective study

Objective: To evaluate the efficiency of internal carotid artery (ICA) embolization technology in endoscopic salvage surgery for recurrent nasopharyngeal carcinoma (rNPC) invading the ICA. Methods: From January 2016 to March 2021, 83 patients with rNPC who invaded the ICA and underwent endoscopic extended nasopharyngectomy were retrospectively collected from the Eye & ENT Hospital in Fudan University, including 60 males and 23 females. The age of the patients ranged from 27 to 77 years. The standard of ICA invasion was that the distance from the lesion to the ICA on enhanced MRI was ≤ 1.8 mm. The clinical characteristics, ICA management strategy and survival prognosis of patients were analyzed, and the effectiveness of ICA embolization was evaluated. Kaplan-Meier method was used to calculate the survival rate and Log-rank test was used to compare the difference. Results: In 83 patients with rNPC, there were 13 patients with rT2, 38 patients with rT3, 32 patients with rT4, and 16 patients had lymph node metastasis. A total of 37 patients (44.6%) underwent ICA coil embolization before surgery, of which 2 cases underwent external carotid-middle cerebral artery artery bypass grafting and ICA embolization due to positive balloon occlusion test (BOT). Patients with positive surgical margin accounted for 24.1% (20/83). Among them, patients with rT4 and patients without ICA embolization had a higher positive rate of surgical margin (P value was 0.001, 0.043, respectively). The 3-year overall survival (OS) and progression free survival (PFS) rate of all patients was 46.5% and 26.7%, respectively. In addition, the 3-year OS and PFS of patients with ICA embolization was significantly higher than those without ICA embolization, respectively (69.1% vs 27.8%, P=0.003; 33.9% vs 18.9%, P=0.018). Only 2 patients (2/37, 5.4%) had cerebral infarction complications after coil embolization of the affected ICA due to negative BOT. Conclusion: Preoperative ICA embolization can be used to treat patients with rNPC invading the ICA, improve the total removal rate and survival rate of patients, which is an effective salvage treatment.

Targeting Heat Shock Proteins in Malignant Brain Tumors: From Basic Research to Clinical Trials.

Heat shock proteins (HSPs) are conservative and ubiquitous proteins that are expressed both in prokaryotic and eukaryotic organisms and play an important role in cellular homeostasis, including the regulation of proteostasis, apoptosis, autophagy, maintenance of signal pathways, protection from various stresses (e.g., hypoxia, ionizing radiation, etc.). Therefore, HSPs are highly expressed in tumor cells, including malignant brain tumors, where they also associate with cancer cell invasion, metastasis, and resistance to radiochemotherapy. In the current review, we aimed to assess the diagnostic and prognostic values of HSPs expression in CNS malignancies as well as the novel treatment approaches to modulate the chaperone levels through the application of inhibitors (as monotherapy or in combination with other treatment modalities). Indeed, for several proteins (i.e., HSP10, HSPB1, DNAJC10, HSPA7, HSP90), a direct correlation between the protein level expression and poor overall survival prognosis for patients was demonstrated that provides a possibility to employ them as prognostic markers in neuro-oncology. Although small molecular inhibitors for HSPs, particularly for HSP27, HSP70, and HSP90 families, were studied in various solid and hematological malignancies demonstrating therapeutic potential, still their potential was not yet fully explored in CNS tumors. Some newly synthesized agents (e.g., HSP40/DNAJ inhibitors) have not yet been evaluated in GBM. Nevertheless, reported preclinical studies provide evidence and rationale for the application of HSPs inhibitors for targeting brain tumors.

Protein succinylation associated with the progress of hepatocellular carcinoma.

Although post-translational modification is critical to tumorigenesis, how succinylation modification of lysine sites influences hepatocellular carcinoma (HCC) remains obscure. 90 tumours and paired adjacent normal tissue of liver cancer were enrolled for succinylation staining. 423 HCC samples with 20 genes related to succinylation modification from TCGA were downloaded for model construction. Statistical methods were employed to analyse the data, including the Non-Negative Matrix Factorization (NMF) algorithm, t-Distributed Stochastic Neighbour Embedding (t-SNE) algorithm, and Cox regression analysis. The staining pan-succinyllysine antibody staining indicated that tumour tissues had a higher succinyllysine level than adjacent tissues (p < 0.001), which could be associated with a worse prognosis (p=0.02). The survival was associated with pathological stage, tumour recurrence status and succinyllysine intensity in the univariate or multivariable cox survival analysis model. The risk model from 20 succinyllysine-related genes had the best prognosis prediction. The high expression of succinylation modification in HCC contributed to the worse patient survival prognosis. Model construction of 20 genes related to succinylation modification (MEAF6, OXCT1, SIRT2, CREBBP, KAT5, SIRT4, SIRT6, SIRT7, CPT1A, GLYATL1, SDHA, SDHB, SDHC, SDHD, SIRT1, SIRT3, SIRT5, SUCLA2, SUCLG1 and SUCLG2) could be reliable in predicting prognosis in HCC.

Which Scoring System Is the Most Accurate for Assessing Survival Prognosis in Patients Undergoing Surgery for Spinal Metastases from Lung Cancer? A Single-Center Experience

To compare different survival prognosis scores among patients operated on for spinal metastasis from lung cancer. A single-center retrospective review of patients with lung cancer and spinal metastases who underwent spinal surgery at our institution from January 2008 to October 2020 was conducted. We calculated the prognostic value of the following scoring systems: revised Tokuhashi, revised Bauer, Skeletal Oncology Research Group classic, and New England Spinal Metastatic Score. For each scoring system, discrimination was assessed by computing the area under the curve. The study included 94 patients operated on for spinal metastasis from lung cancer. Mean patient age was 62 years (range, 32-79 years); 51% of patients were male. The 1-year survival rate was 18%, and the median survival time was 4 months. The 6- and 12-month area under the curve was 60% and 76%, respectively, for revised Tokuhashi, 55% and 58% for revised Bauer, 58% and 63% for Skeletal Oncology Research Group classic, and 61% and 69% for New England Spinal Metastatic Score. The revised Tokuhashi score seemed to be the most accurate scoring system for assessing survival prognosis in patients operated on for spinal metastasis from lung cancer. Newer scores including biological parameters did not add further precision among this specific population.

Criteria for choosing anticoagulant therapy in COVID19 patients

Objective: While COVID-19 continues to circulate around the world, there are still many uncertainties on how to treat patients infected with the potentially deadly virus and, more importantly, for how long! COVID-19 causes many different symptoms, among which coagulopathy seems to play an essential role in the survival prognosis of patients. While WHO recommends thromboprophylaxis in all admitted covid patients, it is still not routinely used in many medical centers worldwide. It is also worth mentioning that there is no animosity on the anticoagulant agents' choice or the duration they should be prescribed. Recent data suggest that it is wise to prescribe a prophylactic dose of anticoagulant for a minimum of 3 months post-discharge to minimize the risk of thrombosis in COVID-19 patients.

Influence of marital status on the treatment and survival of middle-aged and elderly patients with primary bone cancer.

The role of spousal support has been recognized to benefit patients with many chronic diseases and cancers. However, the impact of marital status on the survival of middle-aged and elderly patients with primary bone tumors remains elusive. The data of patients aged ≥ 45 years with primary bone tumors diagnosed between 2000 and 2018 were extracted from the Surveillance, Epidemiology, and End Results Database. Kaplan-Meier analysis was used to assess the overall survival and tumor-specific survival of patients. The Cox proportional hazards and Fine-and-Gray models were used to calculate the hazard ratios (HRs) and sub-distribution HRs (sHR) and the corresponding 95% confidence interval (CI) of all-cause mortality and tumor-specific mortality, respectively. A total of 5,640 primary bone tumors were included in the study. In 45-59 years cohort, married, unmarried, divorced and widowed accounted for 66.0, 21.0, 11.2, and 1.8%, respectively; while 64.3, 10.1, 8.8, and 16.8% in 60+ years cohort, respectively. The widowed patients had a lower proportion of early-stage tumors at diagnosis than that married, unmarried, and divorced patients (31.0% vs. 36% vs. 37.1% vs. 39.4%; P = 0.008), and had a higher proportion of patients who did not undergo surgery than that of married, unmarried, and divorced patients (38.6% vs. 21.3% vs. 24.6% vs. 24.4%; P < 0.001). The widowed population had an increased risk of all-cause mortality (HR, 1.68; 95% CI, 1.50-1.88; P < 0.001) and disease-related mortality (HR, 1.33; 95% CI, 1.09-1.61; P = 0.005) compared with the married population. The marital status of middle-aged and elderly people can affect the tumor stage at diagnosis, treatment, and survival prognosis of patients with primary bone cancer. Widowed patients are more inclined to choose non-surgical treatment and have the worst prognosis.

The relationship between NLR/PLR/LMR levels and survival prognosis in patients with non-small cell lung carcinoma treated with immune checkpoint inhibitors: Erratum.

The relationship between NLR/PLR/LMR levels and survival prognosis in patients with non-small cell lung carcinoma treated with immune checkpoint inhibitors: Erratum.

A novel prognostic signature based on N7-methylguanosine-related long non-coding RNAs in breast cancer.

Long non-coding RNA (lncRNA) are closely associated with the occurrence and progression of tumors. However, research on N7-methylguanosine (m7G)-related lncRNA in breast cancer is lacking. Therefore, the present study explored the prognostic value, gene expression characteristics, and effects of m7G-related lncRNA on tumor immune cell infiltration and tumor mutational burden (TMB) in breast cancer. lncRNA expression matrices and clinical follow-up data of patients with breast cancer were obtained from The Cancer Genome Atlas, revealing eight significantly differentially expressed and prognostically relevant m7G-related lncRNAs in breast cancer tissues: BAIAP2-DT, COL4A2-AS1, FARP1-AS1, RERE-AS1, NDUFA6-DT, TFAP2A-AS1, LINC00115, and MIR302CHG. A breast cancer prognostic signature was created based on these m7G-related lncRNAs according to least absolute shrinkage and selection operator Cox regression. The prognostic signature combined with potential prognostic factors showed independent prognostic value, reliability, and specificity. Meanwhile, we constructed a risk score-based nomogram to assist clinical decision-making. Gene set enrichment analysis revealed that low- and high-risk group were associated with metabolism-related pathways. Our study demonstrated the association between tumor immune cell infiltration based on analyses with the CIBERSORT algorithm and prognostic signature. We also assessed the correlation between prognostic signature and TMB. Lastly, quantitative real-time polymerase chain reaction analysis was performed to validate differentially expressed lncRNAs. The effective prognostic signature based on m7G-related lncRNAs has the potential to predict the survival prognosis of patients with breast cancer. The eight m7G-related lncRNAs identified in this study might represent potential biomarkers and therapeutic targets of breast cancer.

Development and external validation of a clinical prediction model for survival in patients with IDH wild-type glioblastoma.

Prognostication of glioblastoma survival has become more refined due to the molecular reclassification of these tumors into isocitrate dehydrogenase (IDH) wild-type and IDH mutant. Since this molecular stratification, however, robust clinical prediction models relevant to the entire IDH wild-type glioblastoma patient population are lacking. This study aimed to provide an updated model that predicts individual survival prognosis in patients with IDH wild-type glioblastoma. Databases from Germany and the Netherlands provided data on 1036 newly diagnosed glioblastoma patients treated between 2012 and 2018. A clinical prediction model for all-cause mortality was developed with Cox proportional hazards regression. This model included recent glioblastoma-associated molecular markers in addition to well-known classic prognostic variables, which were updated and refined with additional categories. Model performance was evaluated according to calibration (using calibration plots and calibration slope) and discrimination (using a C-statistic) in a cross-validation procedure by country to assess external validity. The German and Dutch patient cohorts consisted of 710 and 326 patients, respectively, of whom 511 (72%) and 308 (95%) had died. Three models were developed, each with increasing complexity. The final model considering age, sex, preoperative Karnofsky Performance Status, extent of resection, O6-methylguanine DNA methyltransferase (MGMT) promoter methylation status, and adjuvant therapeutic regimen showed an optimism-corrected C-statistic of 0.73 (95% confidence interval 0.71-0.75). Cross-validation between the national cohorts yielded comparable results. This prediction model reliably predicts individual survival prognosis in patients with newly diagnosed IDH wild-type glioblastoma, although additional validation, especially for long-term survival, may be desired. The nomogram and web application of this model may support shared decision-making if used properly.

Prognostic significance of SPARC expression in non-small cell lung cancer: A meta-analysis and bioinformatics analysis.

The aim of the present study was to elucidate the significance of secreted protein acidic and cysteine rich (SPARC) expression in non-small cell lung cancer (NSCLC) in terms of clinicopathology, immune-cell infiltration and survival prognosis. A meta-analysis and bioinformatics analysis were performed using studies retrieved with PubMed, Web of Science, Wanfang Data and the Chinese National Knowledge Infrastructure databases. The meta-analysis suggested that, compared with normal tissues, SPARC expression was elevated in NSCLC tissues. The expression of SPARC was not significantly associated with TNM stage and lymph-node metastasis, and was positively associated with patient gender. Regarding the differential expression of SPARC and the relationship between expression levels and survival, the Oncomine database was consulted and Kaplan-Meier curves were drawn. It was indicated that SPARC mRNA expression levels were higher in NSCLC tissues than in normal tissues. Low expression of SPARC mRNA was negatively associated with overall survival, first progression survival and post-progression survival of patients. Further exploration of the relationship between SPARC expression and survival by univariate analysis indicated that TNM stage, lymph node metastasis, distant metastasis and depth of infiltration of lung cancer were negatively associated with patient prognosis. Cox multifactorial analysis suggested that SPARC expression levels and TNM stage were risk factors significantly affecting the prognosis of patients with NSCLC. Analysis with the GEPIA and UALCAN databases further indicated that the mRNA expression level of SPARC in lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC) was higher than that in normal lung tissue, and the SPARC expression levels were affected by factors such as the TNM stage of lung cancer. A lower the level of SPARC mRNA expression was associated with a better relative survival prognosis of patients. In the Human Protein Atlas database, the expression level of SPARC protein was higher in LUAD and LUSC than in normal lung tissue. In the Timer database, the expression level of SPARC was closely linked to immune cells related to the occurrence of lung cancer, and the degree of immune-cell infiltration and SPARC protein expression were closely related to the prognosis of patients with lung cancer. Immune cells were indicated to exhibit significant inhibition of DNA proliferation mutation mechanisms in lung cancer (P<0.05). In summary, SPARC expression may be used as a valuable indicator of prognosis in patients with NSCLC, which may provide new approaches for preventative treatment.

Relative T2-FLAIR signal intensity surrounding residual cavity is associated with survival prognosis in patients with lower-grade gliomas.

AimsTo investigate whether the relative signal intensity surrounding the residual cavity on T2-fluid-attenuated inversion recovery (rFLAIR) can improve the survival prediction of lower-grade glioma (LGG) patients.MethodsClinical and pathological data and the follow-up MR imaging of 144 patients with LGG were analyzed. We calculated rFLAIR with Image J software. Logistic analysis was used to explore the significant impact factors on progression-free survival (PFS) and overall survival (OS). Several models were set up to predict the survival prognosis of LGG.ResultsA higher rFLAIR [1.81 (0.83)] [median (IQR)] of non-enhancing regions surrounding the residual cavity was detected in the progressed group (n=77) than that [1.55 (0.33)] [median (IQR)] of the not-progressed group (n = 67) (P<0.001). Multivariate analysis showed that lower KPS (≤75), and higher rFLAIR (>1.622) were independent predictors for poor PFS (P<0.05), whereas lower KPS (≤75) and thick-linear and nodular enhancement were the independent predictors for poor OS (P<0.05). The cutoff rFLAIR value of 1.622 could be used to predict poor PFS (HR = 0.31, 95%CI 0.20–0.48) (P<0.001) and OS (HR = 0.27, 95%CI 0.14–0.51) (P=0.002). Both the areas under the ROC curve (AUCs) for predicting poor PFS (AUC, 0.771) and OS (AUC, 0.831) with a combined model that contained rFLAIR were higher than those of any other models.ConclusionHigher rFALIR (>1.622) in non-enhancing regions surrounding the residual cavity can be used as a biomarker of the poor survival of LGG. rFLAIR is helpful to improve the survival prediction of posttreatment LGG patients.

A Deep Neural Network for Gastric Cancer Prognosis Prediction Based on Biological Information Pathways.

Background Gastric cancer (GC) is one of the deadliest cancers in the world, with a 5-year overall survival rate of lower than 20% for patients with advanced GC. Genomic information is now frequently employed for precision cancer treatment due to the rapid advancements of high-throughput sequencing technologies. As a result, integrating multiomics data to construct predictive models for the GC patient prognosis is critical for tailored medical care. Results In this study, we integrated multiomics data to design a biological pathway-based gastric cancer sparse deep neural network (GCS-Net) by modifying the P-NET model for long-term survival prediction of GC. The GCS-Net showed higher accuracy (accuracy = 0.844), area under the curve (AUC = 0.807), and F1 score (F1 = 0.913) than traditional machine learning models. Furthermore, the GCS-Net not only enables accurate patient survival prognosis but also provides model interpretability capabilities lacking in most traditional deep neural networks to describe the complex biological process of prognosis. The GCS-Net suggested the importance of genes (UBE2C, JAK2, RAD21, CEP250, NUP210, PTPN1, CDC27, NINL, NUP188, and PLK4) and biological pathways (Mitotic Anaphase, Resolution of Sister Chromatid Cohesion, and SUMO E3 ligases) to GC, which is consistent with the results revealed in biological- and medical-related studies of GC. Conclusion The GCS-Net is an interpretable deep neural network built using biological pathway information whose structure represents a nonlinear hierarchical representation of genes and biological pathways. It can not only accurately predict the prognosis of GC patients but also suggest the importance of genes and biological pathways. The GCS-Net opens up new avenues for biological research and could be adapted for other cancer prediction and discovery activities as well.

Effect of different surgical approaches on the prognosis of patients with postoperative radiotherapy for stage IIB–IVA esophageal squamous cancer

ObjectiveTo investigate the effect and clinical significance of different thoracic surgical approaches for patients with stage IIB–IVA esophageal squamous cell carcinoma on the survival and prognosis of postoperative radiotherapy patients.MethodsOne hundred thirty-two patients with stage IIB–IVA esophageal squamous cancer who received radiotherapy after surgery were screened for baseline characteristics and survival analysis. The Kaplan-Meier method was used to draw the survival curve for the follow-up data, and the log-rank test was used to compare the difference in survival rate between the two groups. The Cox regression model was used for multivariate survival analysis.ResultFor stage IIB–IVA esophageal squamous cell carcinoma, the results of multivariate analysis showed that different surgical methods and clinical staging were independent factors affecting the survival and prognosis of patients after radiotherapy. The 1-, 3-, and 5-year survival rates of patients with advanced esophageal cancer through the left chest approach were 84.2%, 61.4%, and 36.8% respectively. The 1-, 3-, and 5-year survival rates of patients with advanced esophageal cancer through the right chest approach were 73.3%, 40.0%, and 21.3% respectively. There was no significant difference in the 1-year survival rate (P = 0.135) between the two surgical procedures. The 3-year survival rate (P < 0.05) and the 5-year survival rate (P < 0.05) were significantly different.ConclusionFor patients with stage IIB–IVA esophageal squamous cell carcinoma undergoing radiotherapy after surgery, the long-term survival prognosis of patients after the left thoracic approach is significantly higher than that of the right thoracic approach.

Gene-microRNA Network Analysis Identified Seven Hub Genes in Association with Progression and Prognosis in Non-Small Cell Lung Cancer.

Introduction: Lung cancer is the leading cause of cancer deaths in the world and is usually divided into non-small cell lung cancer (NSCLC) and small cell lung cancer. NSCLC is dominant and accounts for 85% of the total cases. Currently, the therapeutic method of NSCLC is not so satisfactory, and thus identification of new biomarkers is critical for new clinical therapy for this disease. Methods: Datasets of miRNA and gene expression were obtained from the NCBI database. The differentially expressed genes (DEGs) and miRNAs (DEMs) were analyzed by GEO2R tools. The DEG-DEM interaction was built via miRNA-targeted genes by miRWalk. Several hub genes were selected via network topological analysis in Cytoscape. Results: A set of 276 genes were found to be significantly differentially expressed in the three datasets. Functional enrichment by the DAVID tool showed that these 276 DEGs were significantly enriched in the term “cancer”, with a statistic p-value of 1.9 × 10−5. The subdivision analysis of the specific cancer types indicated that “lung cancer” occupies the largest category with a p-value of 2 × 10−3. Furthermore, 75 miRNAs were shown to be differentially expressed in three representative datasets. A group of 13 DEGs was selected by analysis of the miRNA–gene interaction of these DEGs and DEMs. The investigation of these 13 genes by GEPIA tools showed that eight of them had consistent results with NSCLC samples in the TCGA database. In addition, we applied the KMplot to conduct the survival analysis of these eight genes and found that seven of them have a significant effect on the prognosis survival of patients. We believe that this study could provide effective research clues for the prevention and treatment of non-small cell lung cancer.

The role of asymmetrical prominent veins sign in early neurological deterioration of acute ischemic stroke patients.

Background and purposeAsymmetrical prominent veins sign (APVS) often appears on susceptibility-weighted angiography (SWAN) images in patients with acute stroke. Early neurological deterioration (END) is highly correlated with survival prognosis in patients with ischemic stroke. This study sought to explore the relationship between APVS and END in patients with acute stroke.MethodsThe subjects retrospectively enrolled in this study were patients with acute ischemic stroke in the middle cerebral artery supply area. All patients underwent head MRI, including the SWAN sequence, within 7 days of stroke symptom onset. END was defined as clinical deterioration or recurrence within 72 h after ischemic stroke. The volume of infarction on diffusion-weighted imaging was measured. Univariate and multivariate analyses were used to analyze the relationship between APVS and END. Spearman correlation between APVS grades and infarct volume, white matter hyperintensity (WMH) volume, and offending vessel were also analyzed.ResultsA total of 157 patients with middle cerebral artery infarct between September 2018 and April 2020 were included in the study. APVS appeared on MRI in 84 of 157 patients, and 34 of 157 patients were diagnosed with END. In patients with END, the proportion of severe APVS was higher than in patients without END (P = 0.001, x2 = 14.659). Patients with END were older and had a larger volume of infarct and WMH than patients without END (all P < 0.05). After adjustments were made for related risk factors of END, the severity of APVS was still related to END (OR = 2.56, 95% CI, 1.38–4.75; P for trend = 0.003). Spearman correlation showed that APVS grades were positively related to infarct volume (r = 0.289, P < 0.001) and 3-month modified Rankin Scale score (r = 0.203, P = 0.011) and negatively related to offending vessels (r = −0.170, P = 0.034).ConclusionAPVS may be an important predictor of END in patients with acute ischemic stroke.

Ultra-early endovascular treatment improves prognosis in High grade aneurysmal subarachnoid hemorrhage: A single-center retrospective study.

BackgroundThe long-term survival prognosis of patients with high-grade (Hunt-Hess grade IV–V or World Federation of Neurosurgical Societies grade IV–V) aneurysmal subarachnoid hemorrhage (aSAH) is generally poor, and the association between endovascular treatment timing and the prognosis of high-grade aSAH has not been explored in depth. This retrospective cohort study aimed to determine whether endovascular treatment within 24 h of high-grade aSAH is associated with a better prognosis.MethodsWe retrospectively analyzed the clinical data of patients with high-grade aSAH who were admitted to our institution between January 2018 and January 2021. The Modified Rankin Scale score was used to assess the 6-month prognosis of patients. Univariate and multivariate logistic regression analyses were used to identify the factors associated with prognosis. The area under the receiver operating characteristic (ROC) curve was used to assess the model's discriminatory ability.ResultsEighty-six patients were included in the study. In the multivariate analysis, the timing of endovascular treatment (odds ratio = 7.003 [1.800–27.242], P = 0.005) was an independent risk factor for prognosis. The ROC curve showed that the predictive power of the timing of endovascular treatment was 0.744, the best cut-off value was 12.5 h, and the corresponding sensitivity and specificity were 71.4 and 70.5%, respectively. Hydrocephalus (P = 0.005) and pulmonary infection (P = 0.029) were also associated with prognosis. In addition, cerebrospinal fluid drainage immediately after endovascular treatment had a significant effect on reducing hydrocephalus formation.ConclusionsEndovascular therapy within 24 h is feasible and improves the prognosis of patients with high-grade aSAH.

Prognosis of the Course of Chronic Obstructive Pulmonary Disease with Obstructive Sleep Apnea-Hypopnea Syndrome

The objective: to evaluate the prognosis of 4-year survival in patients with chronic obstructive pulmonary disease (COPD) and concomitant obstructive sleep apnea-hypopnea syndrome (OSAHS).Subjects and Methods. 62 patients with COPD and OSAHS were enrolled in the study, they all had been diagnosed in accordance with the recommendations of GOLD (2017). The clinical and functional examination included assessment of respiratory function parameters and a 6-minute step test, a survey using the validated questionnaire of the dyspnea scale by Medical Research Council (MRC) followed by the calculation of body mass index and the BODE index.Results. Patients with COPD and concomitant OSAHS demonstrated higher intensity of dyspnea, deterioration of functional obstructive disorders, and lower exercise tolerance. The course of the disease was characterized by multiple exacerbations requiring hospitalization, 77.4% of COPD patients with OSAHS suffered from cardiovascular diseases and 95.2% were obese. Evaluation of the integral BODE index in COPD patients with OSAHS showed that only 35.5% of them had a 4-year survival rate exceeding 57%. A strong inverse correlation was established between the BODE index and the maximum desaturation rate (r = -0.78) and the moderate inverse correlation was established between the BODE index and SaO2 (r = -0.37). As a result of a 12-year follow-up (2008-2019), mortality in COPD patients with OSAHS was established in 22.2% of cases, mainly among COPD patients with severe OSAHS.