Tumor Node Metastasis Stage Research Articles

Clinical Outcomes after Upfront Surgery in Clinical Stage I-IIA Small Cell Lung Cancer.

Upfront surgery followed by systemic treatment is recommended to treat clinical stage I-IIA small cell lung cancer (SCLC), but data on the clinical outcomes are sparse. Thus, this study evaluated the stage migration and long-term prognosis of surgically treated clinical stage I-IIA SCLC. We retrospectively reviewed 49 patients with clinical stage I-IIA SCLC who underwent upfront surgery between 2000 and 2020. Additionally, we re-evaluated the TNM (tumor-node-metastasis) staging according to the eighth edition of the American Joint Committee on Cancer staging system for lung cancer. The clinical stages of SCLC were cIA in 75.5%, cIB in 18.4%, and cIIA in 6.1% of patients. A preoperative histologic diagnosis was made in 65.3% of patients. Lobectomy and systematic lymph node dissection were performed in 77.6% and 83.7% of patients, respectively. The pathological stages were pI in 67.3%, pII in 24.5%, pIII in 4.1%, and pIV in 4.1% of patients. The concordance rate between clinical and pathological stages was 44.9%, and the upstaging rate was 49.0%. The 5-year overall survival (OS) rate was 67.8%. No significant difference in OS was found between stages pI and pII. However, the OS for stages pIII/IV was significantly worse than for stages pI/II (p<0.001). In clinical stage I-IIA SCLC, approximately half of the patients were pathologically upstaged, and OS was favorable after upfront surgery, particularly in pI/II patients. The poor prognosis of pIII/IV patients indicates the necessity of intensive preoperative pathologic mediastinal staging.

A prognostic nomogram incorporating tumor size and lymph node size for patients with nasopharyngeal carcinoma

PurposeThe goal of this study was to establish a nomogram that included pre-treatment tumor size and lymph node (LN) size to assess personalized overall survival (OS) of patients with nasopharyngeal carcinoma (NPC). Patients and methodsThe Surveillance, Epidemiology, and End Results dataset was used to extract statistics for 1083 individuals with NPC (training cohort). In the validation cohort, 266 patients were included from the Affiliated Cancer Hospital & Institute of Guangzhou Medical University. Age, tumor–node–metastasis (TNM) stage, pre-treatment tumor size, and LN size were chosen in both the training and validation sets to build a nomogram to forecast the 3-year and 5-year OS probability using the multivariate Cox regression model. Using the C-index, calibration plot, and receiver operating characteristic (ROC) curve, the predictive model's predictive value and discriminative capacity were determined. ResultsPre-treatment tumor size, LN size, age, and TNM stage were all independent prognostic factors in the multivariate analysis. After combining these characteristics, a nomogram with a C-index of 0.7367 in the training cohort and 0.795 in the validation cohort was created, suggesting strong predictive capacity. Analysis of the ROC curve revealed that the constructed nomogram was clinically applicable. ConclusionsIn patients with NPC, the developed nomogram, which includes pre-treatment tumor size, LN size, age, and TNM stage, is a reliable predictive predictor of OS.

Expression analysis of cytokines IL-5, IL-6, IL-8, IL-17 and VEGF in breast cancer patients.

To investigate the relationship between changes in peripheral blood vascular endothelial growth factor (VEGF), interleukin-5 (IL-5), interleukin-6 (IL-6), interleukin-8 (IL-8) and interleukin-17 (IL-17) concentrations in breast cancer patients and their significance and clinical value in breast cancer staging and invasive metastasis. From September 2021 to April 2022, 60 breast cancer patients from Chongqing Medical University Hospital No. 2022 were enrolled in the breast breast cancer surgery group, while 30 patients with benign breast disease were enrolled in the control group during the same period. Venous blood samples were collected at admission and 1 week after surgery to determine the expression of these factors in serum. Statistical methods such as Wilcoxon test and Spearman correlation analysis were used to analyze the relationship between the above factors and the clinicopathological characteristics of the patients. By analyzing data from patients with benign and malignant breast tumors, an association was found with serum levels of IL-6, IL-17 and VEGF. Their respective areas under the operating characteristic curve were 0.649, 0.734 and 0.656 (P < 0.05). There were significant differences in the cytokine expression levels of IL-17 and VEGF in different molecular typing (P values were 0.008 and 0.040, respectively). The expression levels of IL-17 and VEGF were higher in HER-2 receptor-positive and triple-negative patients than in hormone receptor-positive patients (P < 0.05). Also, no significant correlation was found between the various cytokines mentioned in the article and breast cancer lymph node metastasis and Tumor Node Metastasis stage (TNM stage). In addition, in the breast cancer surgery group, postoperative VEGF levels were lower (P < 0.05) and IL-6 levels were higher (P < 0.05) compared to preoperative levels. Serum IL-6, IL-17, and VEGF are strongly associated with breast cancer development and can be used as a reference indicators for breast cancer diagnosis. In addition, post-operative VEGF levels decreases and IL-6 levels increases compared to pre-operative levels, which can also be used as an a postoperative follow-up indicator. In contrast, IL-5 and IL-8 have not found to be significantly associated with breast cancer patients in this study, which requires further study.

Correlation between oncogene integrator complex subunit 7 and a poor prognosis in lung adenocarcinoma.

Lung adenocarcinoma (LUAD) is one of the most common types of cancer worldwide with high incidence and mortality rates. The integrator complex subunit 7 (INTS7) encodes a subunit of the integrator complex that mediates small-nuclear ribonucleic acid (RNA) processing and has been shown to be associated with RNA polymerase II. However, the clinical significance of INTS7 in LUAD is still not clear and needs to be investigated. The single-cell sequencing of a publicly available data set was conducted to compare the expression levels and percentages of INTS7 in lung malignant cells at different classifications and stages. Further, 33 cancer types from The Cancer Genome Atlas (TCGA) database were analyzed, protein-protein interaction (PPI) networks were constructed, and functional annotations were undertaken for the INTS7 gene. INTS7 small-interfering RNAs were transfected into LUAD cell lines, and cell biological behaviors, such as migration, invasion, apoptosis and proliferation capacity, were then examined. We found that the expression of INTS7 was significantly more upregulated in the LUAD tissues than the adjacent normal tissues. Increased INTS7 messenger RNA expression was correlated with TNM (tumor node metastasis classification) stage and gender in LUAD patients. Further, the Kaplan-Meier survival analysis indicated that LUAD patients with high INTS7 expression levels had a worse prognosis than those with low INTS7 expression levels. Finally, we found that silencing INTS7 inhibited LUAD cell viability and invasion in vitro. These results suggest that INTS7 can be used as a potential therapy target and prognostic marker for LUAD. Further, INTS7 may aggravate migration and invasion, induce the proliferation, and attenuate the apoptosis capacity of cells in LUAD.

Upregulation of KLHL17 promotes the proliferation and migration of non-small cell lung cancer by activating the Ras/MAPK signaling pathway

Analysis of the Gene Expression Profiling Interactive Analysis (GEPIA) database revealed that Kelch-like 17 (KLHL17) is overexpressed in non-small cell lung cancer (NSCLC) including adenocarcinoma (ADC) and squamous cell carcinoma (SCC). We therefore explored the role of KLHL17 in the development and progression of NSCLC. Immunohistochemistry and western blotting showed that KLHL17 expression was significantly higher in the tumor tissues from 173 patients with NSCLC, compared with the corresponding non-neoplastic tissue. In addition, upregulated KLHL17 expression was positively correlated with tumor size, lymph node metastasis and tumor node metastasis (TNM) stage, and affected the overall survival (OS) of patients with NSCLC. Consistent with clinical samples, in vitro studies demonstrated that KLHL17 expression was higher in various cell lines of NSCLC (A549, H1299, H460 and SK cells) as compared to normal human bronchial epithelial cells (HBE cells). Overexpression of KLHL17 in the cell lines of NSCLC with KLHL17-Flag plasmid promoted the proliferation and migration of tumor cells, which was associated with elevated activation of Rat sarcoma/Mitogen-activated protein kinases (Ras/MAPK) signaling and increased expression of cyclin D1, cyclin D-dependent kinases 4 (CDK4), matrix metalloproteinase 2 (MMP2) and Ras homolog gene family member A (RhoA). In contrast, knockdown of KLHL17 in the cell lines of NSCLC using KLHL17 small interfering RNA suppressed the proliferation and migration of tumor cells, in association with reduced activation of Ras/MAPK signaling and decreased expression of cyclin D1, CDK4, MMP2 and RhoA. Moreover, treatment of tumor cells with Ras inhibitor salirasib prevented KLHL17-induced Ras/MAPK activity as well as tumor proliferation and migration. These results suggest that upregulated KLHL17 in NSCLC promotes the proliferation and migration of tumor by activating Ras/MAPK signaling pathway. Therefore, KLHL17 may be a novel therapeutic target for the treatment of NSCLC.Non-small cell lung cancer (NSCLC) is the most common type of lung cancer and is associated with limited treatment options. This study elucidates the role of KLHL17 in the development and progression of NSCLC using clinical samples and NSCLC cell lines. The results show that upregulated KLHL17 in NSCLC promotes the proliferation and migration of tumor by activating Ras/MAPK signaling pathway, and suggest that KLHL17 may be a novel therapeutic target for the treatment of NSCLC.

Nomogram to predict overall survival in patients with primary bladder neuroendocrine carcinoma: a population-based study.

Aim: To develop a prognostic model to predict the overall survival of primary bladder neuroendocrine carcinoma (BNEC) patients. Methods: Using univariate and multivariate Cox regression analyses, a nomogram was constructed. Calibration curves, receiver operating characteristic curvesand C-index were utilized to evaluate the performance. Results: The study enrolled 906 BNEC patients. The following variables were incorporated in the nomogram: age, marital status, Tumor node metastasis (TNM) stage, chemotherapyand surgery. The nomogram had a C-index of 0.702 in the training cohortand 0.724 in the validation cohort. Conclusion: Compared with the TNM staging system, the proposed nomogram exhibits superior prognostic discrimination and survival prediction.

Circulating serum miR-1246 and miR-1229 as diagnostic biomarkers in colorectal carcinoma.

Colorectal cancer (CRC) is one of the most common cancers worldwide. Although colonoscopy is considered as the "Gold Standard" technique to detect CRC, its application is invasive and cost incurred. Thus, noninvasive or minimally invasive approaches are of utmost importance. The aberrant expression of some microRNAs (miRNAs, miRs) has been suggested in association with CRC pathogenesis. This study aimed to validate if circulating serum miR-1229 and miR-1246 are diagnostic biomarkers for CRC. Serum samples were isolated from 45 CRC patients and also 45 healthy controls (HC). The expression levels of circulating serum-derived miR-1229 and miR-1246 were evaluated by quantitative real-time polymerase chain reaction. Receiver operating characteristic (ROC) curves were constructed to evaluate the CRC diagnostic accuracy of selected miRNAs. Furthermore, the association of candidate miRNAs and clinicopathological characteristics were evaluated. Functional enrichment of the candidate miRNAs was applied using in silico tools. The expression of miR-1229 and miR-1246 was significantly higher in CRC patients than HC (P < 0.0001) and also was found in association with lymph node metastasis (P < 0.05). We demonstrated a significant up-regulation of serum-derived miR-1246 in advanced tumor-node-metastasis stage III of CRC patients (P < 0.05). Areas under the ROC curve of miR-1229 and miR-1246 were 0.81 and 0.84, respectively (P < 0.0001). We confirmed the capability of circulating serum miR-1229 and miR-1246 as novel diagnostic biomarkers for CRC.

Prognostic value of the metabolic score obtained via [18F]FDG PET/CT and a new prognostic staging system for gastric cancer

We developed and validated a new staging system that includes metabolic information from pretreatment [18F]Fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) for predicting disease-specific survival (DSS) in gastric cancer (GC) patients. Overall, 731 GC patients undergoing preoperative [18F]FDG PET/CT were enrolled and divided into the training (n = 543) and validation (n = 188) cohorts. A metabolic score (MS) was developed by combining the maximum standardized uptake value (SUVmax) of the primary tumor (T_SUVmax) and metastatic lymph node (N_SUVmax). A new staging system incorporating the MS and tumor-node-metastasis (TNM) stage was developed using conditional inference tree analysis. The MS was stratified as follows: score 1 (T_SUVmax ≤ 4.5 and N_SUVmax ≤ 1.9), score 2 (T_SUVmax > 4.5 and N_SUVmax ≤ 1.9), score 3 (T_SUVmax ≤ 4.5 and N_SUVmax > 1.9), and score 4 (T_SUVmax > 4.5 and N_SUVmax > 1.9) in the training cohort. The new staging system yielded five risk categories: category I (TNM I, II and MS 1), category II (TNM I, II and MS 2), category III (TNM I, II and MS ≥ 3), category IV (TNM III, IV and MS ≤ 3), and category V (TNM III, IV and MS 4) in the training cohort. DSS differed significantly between both staging systems; the new staging system showed better prognostic performance in both training and validation cohorts. The MS was an independent prognostic factor for DSS, and discriminatory power of the new staging system for DSS was better than that of the conventional TNM staging system alone.

Anlotinib plus etoposide increases survival in patients with small-cell lung cancer after chemoradiotherapy

ObjectivesSmall-cell lung cancer is a recalcitrant subtype of lung cancer with rapid progression and high metastasis. This study compared the efficacy of anlotinib plus etoposide with etoposide alone for extensive-stage small-cell lung cancer after chemoradiotherapy. MethodsA total of 100 patients who had standard first-line chemoradiotherapy were enrolled, 50 of whom were treated with anlotinib plus etoposide and the other 50 with etoposide. The therapeutic efficacy and treatment-related adverse events were respectively evaluated using the Response Evaluation Criteria in Solid Tumors version 1.0 and the Common Terminology Criteria for Adverse Events version 4.0. The progression-free survival and overall survival of patients were analyzed using the Kaplan-Meier method. The univariate and multivariate prognostic analyses were conducted using the Cox's proportional risk regression model. ResultsThe median of progression-free survival in patients treated with anlotinib plus etoposide was 7 months, compared to 5.5 months for patients treated with etoposide. The 1- and 2-year survival rates of patients treated with anlotinib plus etoposide were 70% (35/50) and 20% (10/50), compared with 50% (25/50) and 8% (4/50) for patients treated with etoposide. The incidence of neutropenia was higher in patients treated with anlotinib plus etoposide than in those treated with etoposide alone. Smoking status and tumor-lymph node-metastasis stage were independent risk factors while the treatment of anlotinib plus etoposide was the independent protective factor for the relapse of the cancer. ConclusionAnlotinib plus etoposide was more effective in extending progression-free survival and overall survival in extensive-stage small-cell lung cancer patients compared to etoposide alone.

TNM Staging and Overall Survival in Patients With Pheochromocytoma and Sympathetic Paraganglioma.

Pheochromocytomas and paragangliomas (PPGL) are rare neuroendocrine tumors. Metastases develop in 15% to 20%. The American Joint Committee on Cancer (AJCC) established inaugural guidelines for PPGL tumor-node-metastasis (TNM) staging. The objective of this analysis is to investigate the associations between TNM staging and overall survival (OS). We retrospectively applied the TNM staging at the time of diagnosis of the primary tumor. The primary outcome was OS. Unadjusted survival rates were estimated by the Kaplan-Meier method. Cox proportional hazards regression models were used to evaluate the associations between OS and covariates of interest. The study included 458 patients. Median OS was 18.0 (95% CI, 15.6-not reached) years. At diagnosis, 126 (27.5%) tumors were stage I, 213 (46.5%) were stage II, 47 (10.3%) were stage III, and 72 (15.7%) were stage IV. The 10-year OS probabilities were 0.844 (95% CI, 0.768-0.928) for patients with stage I tumors, 0.792 (95% CI, 0.726-0.865) for stage II, 0.595 (95% CI, 0.435-0.813) for stage III, and 0.221 (95% CI, 0.127-0.384) for stage IV. Compared with stage I, the hazard ratios (HR) for death were 1.50 (0.87-2.57) for stage II, 2.85 (1.45-5.63) for stage III, and 8.88 (5.16-15.29) for stage IV (P < 0.001). Compared with patients with no germline mutations, those with RET 634/918 had better OS (HR: 0.28; 95% CI, 0.12-0.69). Other germline mutations, including SDHB, did not exhibit worse OS than patients with metastasis and sporadic disease. OS rates correlated with the recently developed AJCC TNM staging and were not worse in hereditary disease. Stage IV disease exhibited a significantly shorter OS compared with stages I-III. Future staging systems could be adjusted to better separate stages I and II.

The correlation of serum sirt6 with clinical outcome and prognosis in patients with gastric cancer

We aimed to evaluate the correlation between serum sirtuin 6 (sirt6) level and clinicopathological characteristics and prognosis of gastric cancer (GC) patients. The serum sirt6 levels of subjects (135 cases of GC, 68 cases of atrophic gastritis, 60 cases of healthy controls) were analyzed by enzyme-linked immunosorbent assay. The predictive and prognostic values of sirt6 serum level for GC were determined by performing receiver operating characteristic curve (ROC), Kaplan-Meier analysis, as well as univariate and multivariate Cox regression, respectively. GC patients showed lower sirt6 serum levels than that of atrophic gastritis patients and healthy control. Taking the healthy control as a reference, the area under the ROC curve (AUC) of sirt6 serum level for diagnosing GC was 0.955 with a sensitivity of 91.85% and a specificity of 90.0%. Based on ROC analysis using atrophic gastritis as the state variable, serum sirt6 had a high diagnostic efficiency for GC (AUC = 0.754). Serum sirt6 was related to the clinicopathological features (tumor size, Lauren's classification, tumor node metastasis staging, lymph node metastasis) and overall survival (log-rank χ2 = 12.22, P < .001). The AUC of serum sirt6 predicting death in GC patients was 0.731. At the optimal cutoff value (16.83 ng/mL), the sensitivity and specificity of sirt6 were 59.57% and 79.55%, respectively. Moreover, lower sirt6 level as independent risk factor was revealed to affect prognosis of GC patients (P = .018). Serum sirt6 level was positively associated with the tumor stage and metastasis conditions, which could be served as diagnostic and predictive biomarkers in GC.

Novel staging for gastric neuroendocrine neoplasms by incorporating the WHO grading into the TNM staging system.

The 8th tumor-node-metastasis (TNM) classification of the American Joint Committee on Cancer (AJCC) can be used to estimate the prognosis of gastric neuroendocrine tumor (gNET) and gastric neuroendocrine carcinoma (gNEC) patients but not gastric neuroendocrine neoplasms (gNENs). First, in the SEER (training) dataset, a TNMG system was built by combining the WHO G grade (G1-4; NEC grouped into G4) with the 8th AJCC T (T1-4), N (N0-1), and M (M0-1) stage, which was then validated in a Chinese (validation) cohort. In all, 2245 gNENs cases from the training dataset and 280 cases from the validation dataset were eligible. The T stage, M stage, and G grade were independent prognostic factors for OS in both datasets (all p <0.05). The TNMG staging system demonstrated better C-index for predicting OS than the 8th AJCC TNM staging system in both the training (0.87, 95%CI: 0.86-0.88 vs. 0.79, 95%CI: 0.77-0.81) and validation (0.77, 95%CI: 0.73-0.80 vs. 0.75, 95%CI: 0.71-0.79) datasets. The AUC of the 3-year OS for the TNMG staging system was 0.936 and 0.817 in the SEER and validation dataset, respectively; higher than those of the 8th AJCC system (vs. 0.843 and 0.779, respectively). DCA revealed that compared with the 8th AJCC TNM staging system, the TNMG staging system demonstrated superior net prognostic benefit in both the training and validation datasets. The proposed TNMG staging system could more accurately predict the 3- and 5-year OS rate of gNENs patients than the 8th AJCC TNM staging system.

Plasma metabolomics for the assessment of the progression of non-small cell lung cancer.

Non-small cell lung cancer (NSCLC) is a leading type of lung cancer with a high mortality rate worldwide. Although many procedures for the diagnosis and prognosis assessment of lung cancer exist, they are often laborious, expensive, and invasive. This study aimed to develop an ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS)-based analysis method for the plasma biomarkers of NSCLC with the potential to indicate the stages and progression of this malignancy conveniently and reliably. A total of 53 patients with NSCLC in early stages (I-III) and advanced stage (IV) were classified into the early and advanced groups based on the tumor node metastasis staging system. A comprehensive metabolomic analysis of plasma from patients with NSCLC was performed via UPLC-MS/MS. Principal component analysis and partial least squares-discriminant analysis were conducted for statistical analysis. Potential biomarkers were evaluated and screened through receiver operating characteristic analyses and correlation analysis. Main differential metabolic pathways were also identified by utilizing metaboanalyst. A total of 129 differential metabolites were detected in accordance with the criteria of VIP ≥ 1 and a P-value of ≤ 0.05. The receiver operating characteristic curves indicated that 11 of these metabolites have the potential to be promising markers of disease progression. Apparent correlated metabolites were also filtered out. Furthermore, the 11 most predominant metabolic pathways with alterations involved in NSCLC were identified. Our study focused on the plasma metabolomic changes in patients with NSCLC. These changes may be used for the prediction of the stage and progression of NSCLC. Moreover, we discussed the metabolic pathways wherein the altered metabolites were mainly enriched.

Renal Carcinoma Patterns and Prevalence in Bahrain: A Descriptive Study.

Cancer is a major health problem with a significant impact on society and healthcare systems. In 2018, approximately 18.1 million cases of cancer were diagnosed and 9.6 million deaths were documented. Urological cancers account for 12.9% of new cases recorded and 8% of deaths due to cancer worldwide. The latest cancer registries covering the Gulf Cooperation Council (GCC) countries report that 4078 cases of renal cell carcinoma were diagnosed from 1998 to 2012. Urological cancers comprised 9.4% of all cases with an incidence rate of 16.1% in males and 3.2% in females. All renal cancer cases documented in Salmaniya Medical Complex (SMC) from 2014 to 2018 were reviewed. Data collected for all patients from the electronic health record system includedage at diagnosis, gender, laterality of cancer (where applicable), histological type, and TNM (tumor, node, metastasis) classification and staging. Furthermore, World Health Organization (WHO) grade and data were collected for kidney cancer cases. Statistical analysis was carried out using Statistical Package for the Social Sciences (SPSS) version 23(IBM Corp, Armonk, NY). From 2014 to 2018, there were 65 documented cases of kidney cancer with an average caseload of 13 cases per year. The mean age at diagnosis was 57.6 years. Clear cell carcinoma was the most common histological subtype (37.5%). Stage 1 was the most common stage at diagnosis (35.4%) and the age-standardized mortality rate for males and females were 4.59 and 4.58 in 100,000, respectively. Kidney cancer is a urological malignancy that can pose a burden on both the patient and the healthcare system. There should be a national effort to better understand the etiology and epidemiology of this disease entity with regardto our population. Such efforts would make data regarding diagnosis, management, and follow-up more accessible and would add positively to our healthcare system.

Prognostic and predictive value of a pathomics signature in gastric cancer

The current tumour-node-metastasis (TNM) staging system alone cannot provide adequate information for prognosis and adjuvant chemotherapy benefits in patients with gastric cancer (GC). Pathomics, which is based on the development of digital pathology, is an emerging field that might improve clinical management. Herein, we propose a pathomics signature (PSGC) that is derived from multiple pathomics features of haematoxylin and eosin-stained slides. We find that the PSGC is an independent predictor of prognosis. A nomogram incorporating the PSGC and TNM staging system shows significantly improved accuracy in predicting the prognosis compared to the TNM staging system alone. Moreover, in stage II and III GC patients with a low PSGC (but not in those with a high PSGC), satisfactory chemotherapy benefits are observed. Therefore, the PSGC could serve as a prognostic predictor in patients with GC and might be a potential predictive indicator for decision-making regarding adjuvant chemotherapy.

Comparison of the geriatric nutritional risk index and the prognostic nutritional index in determining survival outcome in patients with non-small cell lung cancer undergoing surgical resection: A cohort study.

To assess the clinical feasibility of the geriatric nutritional risk index (GNRI) and prognostic nutritional index (PNI) as determinants of survival in patients with stage I to III non-small cell lung cancer (NSCLC). This retrospective study included patients with stage I to III NSCLC from all age groups. Hazard ratios (HRs) for overall survival (OS), cancer-specific survival (CSS), and relapse-free survival (RFS) were calculated using the Cox regression analysis. The concordance index (C-index) of the models was evaluated following the establishment of the prognostic models for survival. The median patient age was 69 years, and 64.6% of the patients were male. In total, 172 (65.4%) patients were classified as having stage I disease, 52 (19.8%) as stage II disease, and 39 (14.8%) as stage III disease. Using multivariate Cox regression analysis, the HRs of GNRI for OS, CSS, and RFS were 0.37 (P = .003), 0.47 (P = .041), and 0.38 (P < .001), respectively. However, the HRs of the PNI for survival outcomes were not statistically significant. Overall, age, sex, tumor-node-metastasis (TNM) stage, pleural invasion (PI), and GNRI were significant determinants of OS and constituted the OS model (concordance index [C-index], 0.824). In addition, age, TNM stage, PI, and GNRI were significant determinants of CSS and constituted the CSS model (C-index, 0.828). Finally, TNM stage, PI, lymphatic invasion, and GNRI were significant determinants of RFS and constituted the RFS model (C-index, 0.783). Our study showed that GNRI, but not PNI, was a predictor of OS, CSS, and RFS in patients with stage I-III NSCLC across all age groups. Excellent discriminant power was observed for OS, CSS, and RFS models.

Characterization of glycosylation regulator-mediated glycosylation modification patterns and tumor microenvironment infiltration in hepatocellular carcinoma.

Background: Previous studies have shown that glycosylation of proteins ofen plays an important role in HCC. However, the potential mechanism of glycosylation in HCC has not been described systematically. Methods: We comprehensively evaluated the glycosylation patterns in HCC samples based on 43 glycosylation regulators, and annotated the modification patterns with the enrichment of immune cells and stromal cells. Considering the heterogeneity of HCC patients, the glycosylation score was constructed using single-sample gene set enrichment analysis (ssGSEA). We also explored the drugs that different HCC patients were sensitive to based on glycosylation mode and score. Results: We identified three glycosylation-regulated gene subtypes. By annotating the subtypes, it was found that the glycosylation regulated gene subtypes was highly matched with three immunophenotypes of HCC (immune-inflamed, immune-excluded, and immune-desert), regardless of the characteristics of immune cell infiltration or prognosis. Based on the characteristic genes of glycosylation-regulated gene subtypes, we constructed a glycosylation-related model, and found that glycosylation-related model was highly consistent with the glycosylation regulated gene subtypes. The glycosylation score that evaluates the glycosylation characteristics of a single HCC sample has high prognostic value, and the prognosis of patients with high glycosylation score is significantly worse. Interestingly, we found that the glycosylation score was closely related to tumor node metastasis (TNM) staging. By applying glycosylation-regulated gene subtypes and glycosylation score to explore the sensitivity of different patients to anticancer drugs, it was found that the sensitivity of Thapsigargin, Shikonin, Embelin and Epothilone. B was closely related to the glycosylation mode. Conclusion: This study reveals that the diversity of glycosylation patterns plays an important role in HCC. Therefore, evaluating the glycosylation patterns of patients with HCC will be helpful in identifying the characteristics of immune cell infiltration and selecting accurate treatment methods.

LINC00958 may be a new prognostic biomarker in various cancers: A meta-analysis and bioinformatics analysis.

Background: There have been many studies on long non-coding RNAs (lncRNAs) as tumor markers. LINC00958 is a lncRNA that has been studied in a variety of tumor types. This meta-analysis aims to explore the relationship between LINC00958 and clinical prognosis and pathological characteristics in various cancers. Methods: We searched for related studies from PubMed, Web of Science, The Cochrane Library and Embase (up to October 2021). The association of LINC00958 expression with clinicopathological characteristics and prognosis was evaluated using the pooled odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs). Results: 16 studies (1,121 patients) were included in this meta-analysis, we found that overexpression of LINC00958 was associated with poor overall survival (OS) (HR = 1.84; 95% CI: 1.36-2.49; p < 0.001). We also found that LINC00958 overexpression was correlated with positive lymph node metastasis (LNM) (OR = 1.91; 95% CI: 1.39-2.63; p < 0.001), advanced degree of infiltration (OR = 1.64; 95% CI: 1.11-2.41; p = 0.013), advanced tumor-node-metastasis (TNM) stage (OR = 2.80; 95% CI: 1.48-5.33; p = 0.002). Other clinicopathological characteristics have no obvious correlation, such as age, sex, tumor size, distant metastasis, and differentiation grade (p > 0.05). Conclusion: In summary, the overexpression of LINC00958 is significantly correlated with poor OS, positive LNM, advanced degree of infiltration, and advanced TNM stage. LINC00958 might serve as a potential prognostic biomarker and therapeutic target for a variety of cancers. However, rigorous studies with large sample sizes are still needed for further research and demonstration.

Impact of socioeconomic status on cancer staging, survival in non-small cell lung cancer.

We performed this study to evaluate the association of socioeconomic status (SES) factors with cancer-specific survival (CSS) of patients with non-small cell lung cancer (NSCLC). We further assessed the predictive value of a novel Tumor Node Metastasis (TNM)-SES staging system, combining the TNM stage with the SES stage. Using the Surveillance, Epidemiology, and End Results (SEER) database, we selected 40,378 patients diagnosed with NSCLC from 2012 to 2016. Cox regression method and Harrell's concordance index (C-index) were performed to select the SES factors related to CSS and evaluate the predictive ability of the novel TNM-SES stage. We used Kaplan-Meier curves and a log-rank test to conduct a survival analysis. We identified four SES factors (marriage, insurance, education, and household income) associated with CSS and constructed the SES stage (SES-1 and SES-2). NSCLC patients with SES-2 stage (low SES) was associated with young adult, black race, male, squamous carcinoma, upper lobe site, and advanced stage. SES-2 stage patients were significantly associated with a dismal prognosis of patients with NSCLC, with a 21.0% increased risk (HR = 1.21, 95%CI (1.18-1.24), p < 0.001). The C-index of our novel TNM-SES stage was 0.732 [95% CI (0.728-0.736)], higher than the traditional TNM stage [0.717, 95% CI (0.715-0.719)], indicating superior predictive value. Our population-based study indicated that SES was significantly associated with cancer staging and SCC in patients with NSCLC. Our novel TNM-SES staging system showed a superior predictive value to the traditional TNM stage. The impact of SES on patients with NSCLC should receive more concern in clinical management.

Malignant testicular unclassified sex cord stromal tumor: a case report

BackgroundMost testicular tumors are germ cell tumors; sex cord stromal tumors are infrequent, accounting for only 3–5% of testicular tumors. Unclassified sex cord stromal tumors are extremely rare. Generally, 10% of sex cord stromal tumors are malignant. We report a case of malignant unclassified sex cord stromal tumor with retroperitoneal lymph node metastasis at first visit and a corresponding literature review.Case presentationA 72-year-old Japanese man visited our department primarily for indolent right scrotum enlargement in September 2020. Blood biochemistry examination, urinalysis, and tumor markers (alpha-fetoprotein, human chorionic gonadotropin, and lactate dehydrogenase) showed no abnormal findings. Contrast-enhanced computed tomography showed enlarged para-aortic lymph node (18 × 16 and 10 × 102 mm); a 50 × 452 mm mass with uneven contents was found in the right testicle. The patient underwent inguinal orchiectomy in September 2020. As per immunohistochemistry, the tumor cells were diffusely positive for SF-1 and Ki-67, partially positive for inhibin, and negative for CAM5.2, CK7, CK20, C-KIT, CD30, LCA, GATA-3, TTF-1, and PAX8. Calretinin was expressed in approximately 5% of tumor cells; thus, sex cord/gonadal stroma components were considered to be involved. The final pathological diagnosis was unclassified malignant sex cord stromal tumor. The patient was diagnosed with pT1, N1, M0, S0, and tumor–node–metastasis stage IIA disease. The patient received postoperative chemotherapy with four courses of etoposide and cisplatin therapy from November 2020. Post-chemotherapeutic computed tomography showed new metastatic lesions including lung, liver, pancreas, and para-aortic lymphadenopathy, which increased in size. Disease progression was observed. Cancer genome research was performed using the OncoGuide National Cancer Center oncopanel system; however, no gene mutation for which the drug could be expected to be effective was found. The patient opted for best supportive care at a nearby hospital and died from cancer progression in January 2022.ConclusionWe encountered a case of malignant testicular unclassified sex cord stromal tumor pathologically diagnosed as testicular tumor with retroperitoneal lymph node metastasis in a patient who underwent inguinal orchiectomy. Future data collection is necessary to establish multimodality therapy for malignant testicular unclassified sex cord stromal tumor.