Undifferentiated Group Research Articles

Associations between Clinicopathological Characteristics and Intraoperative Opioid Requirements during Endoscopic Submucosal Dissection with Monitored Anesthesia Care: A Retrospective Study.

Background and study aims: Endoscopic submucosal dissection is used to treat early gastric neoplasms. Compared with other endoscopic procedures, it requires higher doses of opioids, leading to adverse events during monitored anesthesia care. We investigated the correlations between clinicopathological characteristics and intraprocedural opioid requirements in patients who underwent endoscopic submucosal dissection under monitored anesthesia care. Patients and methods: The medical records of patients who underwent endoscopic submucosal dissection under monitored anesthesia care were retrospectively reviewed. The dependent variable was the total dose of fentanyl administered during the dissection, while independent variables were patient demographics, the American Society of Anesthesiologists physical status classification, preoperative vital sign data, and the pathological characteristics of the neoplasm. Correlations between variables were examined using multiple regression analysis. Results: The study included 743 patients. The median total fentanyl dose was 100 mcg. Younger age (coefficient -1.37; 95% confidence interval [CI] -1.78 to -0.95), male sex (16.12; 95% CI 6.99-25.24), baseline diastolic blood pressure (0.44; 95% CI 0.04-0.85), neoplasm length (1.63; 95% CI 0.90-2.36), and fibrosis (28.59; 95% CI 17.77-39.42) were positively correlated with the total fentanyl dose. Total fentanyl dose was higher in the differentiated (16.37; 95% CI 6.40-26.35) and undifferentiated cancers group (32.53; 95% CI 16.95-48.11) than in the dysplasia group; no significant differences were observed among the others. The mid-anterior wall (22.69; 95% CI 1.25-44.13), mid-posterior wall (29.65; 95% CI 14.39-44.91), mid-greater curvature (28.77; 95% CI 8.56-48.98), and upper groups (30.06; 95% CI 5.01-55.12) had higher total fentanyl doses than the lower group, whereas doses did not significantly differ for the mid-lesser curvature group. Conclusions: We identified variables that influenced opioid requirements during monitored anesthesia care for endoscopic submucosal dissection. These may help predict the needed opioid doses and identify factors affecting intraprocedural opioid requirements.

Outpatient management of Post-COVID syndrome – single center experience

BackgroundCOVID patients continue to experience unremitting symptoms that extend far beyond the initial illness. While there is rapid accumulation of data on acute COVID treatment in hospitalized patients, little is known regarding post-COVID management. ObjectivesTo describe our center's experience treating post-COVID sub-syndromes encountered in Post-COVID Lung Clinic. MethodsWe retrospectively reviewed data on 98 post-COVID patients evaluated in our clinic between 07/01/2020–12/31/2022. We encountered three distinct post-COVID subtypes: 1) respiratory complaints associated with increased O2 requirements and abnormal CT findings (post-COVID interstitial lung disease [ILD]), 2) respiratory complaints associated with tachycardia (post-COVID dyspnea-tachycardia syndrome [DTS]). Post-COVID ILD patients (n = 28) received steroids in combination with cell cycle inhibitor (mycophenolate mofetil-MMF). Post-COVID DTS patients (n = 16) were treated with metoprolol. 3) A third, undifferentiated group presented with mild respiratory complaints and normal spirometry (n = 17) and was followed in clinic without initiation of a specific treatment. ResultsIn treated post-COVID ILD patients, mean oxygen requirements at rest (1.96 ± 1.79 L/NC) decreased to 0.89 ± 1.29 L/NC at 6 months follow-up, p = 0.005. In patients with post-COVID DTS, mean heart rate at rest decreased (98 ± 15 bpm to 79 ± 11 bpm) at 6 months follow-up, p = 0.023. 60 % of patients reported an improvement in exertional dyspnea. ConclusionsOur descriptive study presents a single center outpatient COVID-19 clinic experience. We encountered 3 post-COVID sub-syndromes and describe their treatments: post-COVID interstitial lung disease [ILD] treated with a novel regimen of MMF and steroids, post COVID dyspnea-tachycardia syndrome [DTS] treated with metoprolol, and a third subgroup with mild undifferentiated symptoms without specific treatment.

An empty tomb at the heart of childhood

After presenting a clinical case where we can see how horror invades the mind because it is impossible to contain the experience in a narrative, the author elaborates a psychoanalytic phenomenology of the process of victimization by the victim's own environment. As a result of this designation by the group, the more subjective aspects of this process remain hidden.
 The condition of victim does not belong to the subject. It is the group to which the victim belongs to that designates as a victim, or not, the person who has been subjected to violence. A catastrophic rupture disrupts the intra-psychic and interpersonal balances and radically changes the relationship between psychic reality and social reality. These two different realities merge to the point that both subject and group experience a confusion between external and internal worlds. Archaic anxieties are then reactivated, filled with psychotic elements associated with a reaction of suspicion, itself produced by insecurity in the face of the disintegration of all stable references. Danger permeates the most undifferentiated group mentality. This experience, of which nothing can be learned, reinforces the components of omnipotence and strengthens the illusion that it would be possible to avoid all forms of pain.

Clinical features and outcomes of pediatric nasopharyngeal carcinoma: A SEER database study.

e22011 Background: Nasopharyngeal carcinoma (NPC) is a rare malignant tumor. Little is known about the clinical, histological and survival characteristics of this disease in pediatric patients. Methods: We searched 17 registries of the surveillance, epidemiology, and end results (SEER) database for pediatric patients (£20 years old) with NPC who were diagnosed between 2000 to 2019. Data obtained included the demographics, histological subtype, stage, median household income, place of residence, cause specific survival (CSS) and overall survival (OS). We describe the clinical features and survival outcomes by race of pediatric patients. Results: A total of 373 primary pediatric NPC patients were reported between 2000-2019. Median age of diagnosis was 16 years (inter-quartile range 11.5 – 19 years). Of these, 68% were males, 59% were white and 27% were black. Undifferentiated non-keratinizing carcinoma group (WHO type III) was the most frequent (70%) histological sub-type. WHO type I and II disease was found to be present in 12% and 18% cases respectively. Nearly, 4 in 5 patients (83%) had stage III – IV NPC at presentation. Stage I and II disease at presentation was found to be present in 5% and 12% of NPC patients respectively. The median follow-up was 10.1 years. The 5 and 10 year survival estimates were 83% (95% CI 78.8% to 86.9%) and 79% (95% CI 73.9% to 83.1%) respectively. On multivariate Cox regression analysis, gender (Male vs Female: HR: 1.00, 95% CI 0.39-2.57; p = 0.998) and race (White vs Black: HR: 0.81 95% CI 0.311-2.10; p = 0.663) were not found to be significant predictors of survival. Conclusions: Pediatric patients at presentation with NPC were more commonly male, had undifferentiated non-keratinizing carcinoma (WHO type III) and stage III-IV disease. Gender and race were not found to be associated with an increased risk for mortality in pediatric patients presenting with NPC.

Abstract 4666: PDX, mini-brain co-cultures and patient-derived tumor organoids: Preclinical models to study the prion protein in glioblastoma biology

Abstract Glioblastoma (GBM), supported by a subpopulation of glioblastoma stem cells (GSCs), stands among the most harmful tumors. Its invasive and aggressive behavior has been correlated with poor therapy outcomes and reduced patient survival, which remains difficult to model and treat due to its cellular and molecular heterogeneity. GSCs are responsible for the malignant features of this cancer, including increased recurrence rates and resistance to therapy. Efforts have been employed to understand the molecular and cellular mechanisms underlying GSCs biology. The cellular prion protein (PrPC), encoded by the PRNP gene, is a key player in GBM biology, and our group has proposed PrPC as a scaffold protein that integrates signaling platforms involved in GSCs maintenance. A deeper understanding of the intracellular pathways modulated by PrPC is essential to identify novel targets for GBM treatment. We have analyzed bulk-RNA sequencing (RNA-seq) data from patient-derived xenografts (PDX) and in vitro preclinical experimental models. RNA-seq analyses identified differentially expressed genes (DEGs) associated with adhesion and migration signaling pathways in PDX cells with high PRNP expression (PRNP−HIGH). Morphological characterization of PDX samples with PRNP−HIGH levels showed an increase in morphologically undifferentiated cell groups, that are more commonly found in younger GBM patients. Furthermore, molecular profiling using Exome data showed that groups PRNP−HIGH present enhanced global patterns of gene mutations. Due to the importance of experimental models to translate basic science into clinical applications, we are establishing emerging models to study PrPC function in GBM biology: glioblastoma organoids (GBO) from patient’s surgically resected GBM tumors; and brain organoids derived from human-induced pluripotent stem cells. We noticed a morphological and molecular reproducibility of the cytoarchitecture of brain organoids and GBO, similar to that described in the literature, indicating consistency in 3D structures, despite the variability between patients. Furthermore, brain organoids will be co-cultured with GSCs, providing platforms for studying the interaction between tumor cells and brain parenchyma. The establishment of these models will improve our comprehension of the role of PrPC in GSCs maintenance and provide additional tools to understand GBM biology and predict tumor progression and response to treatment. Citation Format: Maria Clara da Silva Souza, Barbara P. Coelho, Camila F. Fernandes, Tiago G. Dos Santos, Stefan Knorst, Cibele Masotti, Maria Rita S. Passos-Bueno, Marilene H. Lopes. PDX, mini-brain co-cultures and patient-derived tumor organoids: Preclinical models to study the prion protein in glioblastoma biology. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4666.

The value of lactate dehydrogenase to albumin ratio and immune inflammation biomarkers in colorectal cancer.

Colorectal cancer (CRC) is one of the most prevalent gastrointestinal cancers. Evidence for the importance of inflammation and immunology in the development and progression of CRC is growing steadily. The purpose of this study was to determine the clinical importance of Lactic Dehydrogenase (LDH) to Albumin (ALB) Ratio (LAR) and immune-inflammation biomarkers (IIBs) in patients with CRC. This study enrolled 382 CRC patients. The LAR was determined as the serum LDH(U/l) to ALB(g/l) ratio. We compared the levels of LAR and IIBs in different TNM stages and tumor differentiation. The relationship between LAR and IIBs and overall survival (OS) of CRC was determined by Cox regression models. A prognostic nomogram was created using the results of the multivariate analysis and the effectiveness of the nomogram was assessed using the ROC, calibration, and decision curves. We evaluated the relationship between LAR and IIBs and clinical features of CRC. The levels of LAR, SII, NLR and PLR in TNM IV stage group (LAR:5.92 (5.23-8.24); SII: 1040.02 (499.51-1683.54); NLR: 2.87 (2.07-5.3); PLR:187.08 (125.31-276.63)) were significantly higher than those in other groups. LAR and NLR showed no significant difference in different tumor differentiation groups, while SII and PLR in undifferentiated groups (SII:543.72 (372.63-1110.20); PLR: 147.06 (106.04-203.92)) were significantly higher than those in well and moderate groups (SII: 474.29 (323.75-716.01); PLR: 126.28 (104.31-167.88)). LAR (HR = 1.317, 95% CI = 1.019-1.454), TNM stage (HR = 2.895, 95% CI = 1.838-4.559), age (HR = 1.766, 95% CI = 1.069-2.922) and lymphocytes (HR = 0.663, 95% CI = 0.456-0.963) were predictors of OS. IIBs, including SII, NLR, and PLR are independent of OS. The LAR-based nomogram AUCs of 1-year, 3-year and 5-year survival probabilities in the training cohort were 0.86, 0.72, and 0.71, respectively, and the AUCs of the validation cohort were 0.85, 0.71, and 0.69 respectively. The LAR-based nomogram's ROC curves and calibration curves demonstrated higher OS discriminative performance. The decision curves demonstrated greater net benefit in the survival prediction. Preoperative LAR is a potential prognostic marker in CRC patients, while SII, NLR, and PLR are independent of OS. LAR was associated with tumor stage in CRC patients, but not with tumor differentiation.

Clinicopathological characteristics of early gastric cancer with different level of undifferentiated component and nomogram to predict lymph node metastasis.

Few studies showed that mixed type early gastric cancer (EGC) relates to higher risk of lymph node metastasis. We aimed to explore the clinicopathological feature of GC according to different proportions of undifferentiated components (PUC) and develop a nomogram to predict status of lymph node metastasis (LNM) in EGC lesions. Clinicopathological data of the 4,375 patients who underwent surgically resection for gastric cancer in our center were retrospectively evaluated and finally 626 cases were included. We classified mixed type lesions into five groups (M1:0% < PUC ≤ 20%, M2:20%<PUC ≤ 40%, M3:40%<PUC ≤ 60%, M4:60%<PUC ≤ 80%, M5:80%<PUC < 100%). Lesions with 0% PUC were classified as pure differentiated group (PD) and lesions with 100% PUC were classified as pure undifferentiated group (PUD). Compared with PD, LNM rate was higher in group M4 and group M5 (p < 0.05 after Bonferroni correction). Differences of tumor size, presence of lymphovascular invasion (LVI), perineural invasion and invasion depth also exist between groups. No statistical difference of LNM rate was found in cases who met the absolute endoscopic submucosal dissection (ESD) indications for EGC patients. Multivariate analysis revealed that tumor size over 2 cm, submucosa invasion to SM2, presence of LVI and PUC level M4 significantly predicted LNM in EGC. With the AUC of 0.899(P < 0.05), the nomogram exhibited a good discrimination. Internal validation by Hosmer-Lemeshow test showed a good fitting effect in model (P > 0.05). PUC level should be considered as one of the predicting risk factors of LNM in EGC. A nomogram that predicts the risk of LNM in EGC was developed.

American Thyroid Association guidelines for evaluation of thyroid nodule: Our experience of patients presenting to AKUH

Thyroid nodules are one of the frequently seen presentations in the clinic. Thyroid nodules are present in almost 5% of females and 1% males in iodine-sufficient regions [1]. On the other hand it can incidentally be found in as high as 67% of the patients on ultrasound neck. Among all the thyroid nodules, 5-15% come out to be malignant on final histopathology [1]. Thyroid carcinomas can be divided into Differentiated Thyroid Carcinomas (DTC) and undifferentiated carcinomas. The differentiated thyroid carcinomas include papillary, follicular and hurthle cell carcinomas [1]. Among all the thyroid carcinomas reported, 90% tend to be DTC. The undifferentiated group includes anaplastic thyroid cancers [1,2]. Over last 3 decades, the incidence of thyroid cancer is increasing worldwide [1,3]. An increase of almost 4 folds have been seen between 1988 and 2002 in incidence of papillary thyroid carcinoma [1].

Investigating the Role of Suicidality and Ethnic Identity among Black Adolescents: A Latent Profile Analysis

Objective Suicide among Black adolescent youth has steadily increased in recent years, yet few studies describe how facets of social identity shape suicidal thoughts and behaviors (STBs) during this critical stage of development. Ethnic identity represents an underexplored, yet important element of social identity among Black youth that may contribute to differential associations with STBs. This study examined the association between ethnic identity and self-reported suicidal ideation, planning, and attempts. Methods Data were drawn from 1,170 African American (n = 810) and Caribbean Black (n = 368) adolescents aged 13–17 (Mean age = 15) that participated in the National Survey of American Life Adolescent supplement study. Results Using latent profile analyses, three patterns of ethnic identity were identified: Undifferentiated, Low Ethnic Identification, and Alienated. Caribbean Black adolescents were more likely to be in the Low Ethnic Identification class relative to the Undifferentiated class. Adolescents in the Undifferentiated group reported higher proportions of suicidal ideation, planning, and attempts compared to the remaining latent profile groups. Conclusion Findings demonstrate that ethnic identity is an important aspect of social identity that can influence STBs among Black adolescents. Considering increased suicide attempts and death rates among Black youth, findings underscore the importance of examining culturally relevant developmental processes that may shape suicidal beliefs and behaviors.

Relationships between Gender Roles and Attitudes Towards Menstruation and Perception of Menstrual Pain in Iranian Women

Background: Menstruation is a prominent mark of womanhood. It is necessary to explore what factors may develop female attitudes towards this natural phenomenon in different populations. Objective: This study aimed to explore the relationships between gender roles and attitudes towards menstruation and perception of menstrual pain among Iranian women. Methods: This cross-sectional study was conducted on 164 women of reproductive age in Torbat-e Heydariyeh in the east of Iran between September and December 2019. The participants completed the Bem Sex-Role Inventory (BSRI), Menstrual Attitude Questionnaire (MAQ), and Verbal Multidimensional Scoring System (VMSS). Data analysis was then performed in SPSS 16.0. Results: According to the results, menstruation was perceived as a natural phenomenon more significantly by the androgynous group than by the undifferentiated and masculine groups (p&lt;0.05). It was also perceived as a predictable phenomenon more significantly by the feminine women than by the other gender role groups (p&lt;0.05). Furthermore, the gender role groups had no significant differences in the prevalence and severity of menstrual pain (p&gt;0.05). Conclusion: Androgynous women considered menstruation a natural phenomenon more often. Psychological interventions should focus on the correction of attitudes towards menstruation, especially in women with femininity, masculinity, and undifferentiated gender roles.

Changing Patterns in Treatment, Remission Status, and Categories in a Long-Term Nordic Cohort Study of Juvenile Idiopathic Arthritis.

To explore sustainability of achieved remission off medication and defined International League of Associations for Rheumatology (ILAR) categories in juvenile idiopathic arthritis (JIA) and describe the trajectory of disease course over time by comparing treatment, disease activity, and ILAR categories from baseline, 8 years, and 18 years after disease onset. A total of 373 of the 510 included patients were initially recruited consecutive cases of JIA from the prospective, longitudinal, population-based Nordic JIA cohort with disease onset during 1997-2000 from Denmark, Norway, Sweden, and Finland in an 18-year follow-up study. Clinical data were collected consecutively at baseline, 8 years, and 18 years after disease onset and were evaluated regarding treatment, disease activity, and ILAR category. Significantly more patients (70%) were off medication after 18 years of follow-up compared to after 8 years (59.7%); nevertheless, the number of patients in remission had not increased (52% off medication versus 51% on medication). Twelve percent of patients changed ILAR category between 8 years and 18 years after disease onset. Almost half of the changes were due to updated information about heredity in a first-degree relative. In the same period, the psoriatic arthritis group increased significantly in number (P < 0.001), in contrast to the oligoarticular category, which decreased (P=0.02). The undifferentiated group increased 24% from 8 to 18 years of follow-up; however, this increase was not significant (P=0.06). In this Nordic JIA cohort study, the remission rate did not increase even though significantly more patients were off medication at the 18-year follow-up compared to at the 8-year follow-up after disease onset. The distribution of patients in the ILAR categories continued to change significantly throughout the 18-year study period.

Is Tribe a Homogeneous Category? Evidence From Tripura in North-East India

Anthropological–sociological studies since the colonial period in India largely saw tribes as homogeneous, unchanging and undifferentiated groups which were free from conflicts or exploitation. This article critiques this notion of tribe and shows heterogeneity within tribes through an analysis of the social history of Tripura in the north-east region of India and mass movement of tribal organisations like the Ganamukti Parishad therein in the late 1940s, 1950s and 1960s. As a princely State, Tripura showed the presence of socio-economic exploitation and contradiction between social strata in the second half of nineteenth century. In the late 1940s, the GMP formulated a notion of tribe that intersected the categories of peasant and class. It was the result of this formulation that class unity between tribal and non-tribal (Bengali) peasantry was an important pivot in its mass movement during this period. In addition, the development of landed class among Tripura tribes over the last few decades is a new and important feature of the state’s agrarian structure, and was further proof of the development of socio-economic heterogeneity within tribes. This article, thus, argues for a dynamic notion of tribe that changes with time and has close linkages with other categories like peasant and class.

Differentiation of Microencapsulated Neonatal Porcine Pancreatic Cell Clusters in Vitro Improves Transplant Efficacy in Type 1 Diabetes Mellitus Mice.

BackgroundNeonatal porcine pancreatic cell clusters (NPCCs) have been proposed as an alternative source of β cells for islet transplantation because of their low cost and growth potential after transplantation. However, the delayed glucose lowering effect due to the immaturity of NPCCs and immunologic rejection remain as a barrier to NPCC’s clinical application. Here, we demonstrate accelerated differentiation and immune-tolerant NPCCs by in vitro chemical treatment and microencapsulation.MethodsNPCCs isolated from 3-day-old piglets were cultured in F-10 media and then microencapsulated with alginate on day 5. Differentiation of NPCCs is facilitated by media supplemented with activin receptor-like kinase 5 inhibitor II, triiodothyronine and exendin-4 for 2 weeks. Marginal number of microencapsulated NPCCs to cure diabetes with and without differentiation were transplanted into diabetic mice and observed for 8 weeks.ResultsThe proportion of insulin-positive cells and insulin mRNA levels of NPCCs were significantly increased in vitro in the differentiated group compared with the undifferentiated group. Blood glucose levels decreased eventually after transplantation of microencapsulated NPCCs in diabetic mice and normalized after 7 weeks in the differentiated group. In addition, the differentiated group showed nearly normal glucose tolerance at 8 weeks after transplantation. In contrast, neither blood glucose levels nor glucose tolerance were improved in the undifferentiated group. Retrieved graft in the differentiated group showed greater insulin response to high glucose compared with the undifferentiated group.ConclusionIn vitro differentiation of microencapsulated immature NPCCs increased the proportion of insulin-positive cells and improved transplant efficacy in diabetic mice without immune rejection.

Clinical impact and management of comorbidities in severe asthma

As asthma management has become increasingly focused on the personalized management of severe asthma, the recognition of the role and of the importance of comorbid conditions has increased. In different age groups, comorbidities can present varying challenges, including diagnostic difficulties due to mimicking or exacerbating asthma symptoms and therapy for comorbid conditions affecting asthma and vice versa. Asthma is frequently associated with multiple comorbidities that are more common in patients with severe asthma than in those with mild or moderate ashma, or in the general population. This group of patients have frequent exacerbations and hospitalizations, absences from work, generating high costs. Although some comorbidities are commonly known, some are likely to remain undiagnosed, requiring a thorough approach and further investigations. Asthma and comorbid conditions often share common risk factors, suggesting the presence of similar inflammatory pathways, where inflammation plays a key role in the onset and development of different comorbidities, so understanding the mechanisms involved is essential for the development of an effective treatment strategy. Systematic assessment of potentially severe asthma to identify treatment barriers and symptom triggers, including comorbidities, improves disease control and the quality of life for many patients considered to have severe asthma, reduces healthcare costs, while optimizing therapy by preventing overtreatment. In addition, the appropriate treatment of associated conditions is an essential step in distinguishing the subgroup of patients with severe biological asthma from the undifferentiated group of patients with difficult-to-treat asthma. This article provides an overview of the main comorbidities likely to be encountered in general practice, their prevalence and clinical impact on severe asthma, and provides a simplified and guideline-based approach to the assessment and management of these comorbid conditions.

The Impact of Mass Media-Delivered Family Planning Campaigns in Low- and Middle-Income Countries: A Meta-Analysis of Advertising and Entertainment-Education Format Effects.

Effective family planning methods are shown to save lives, contribute to gender equality, and boost economic development. Mass media communication campaigns in low- and middle-income countries have been effective in increasing contraceptive use, although the strategies that increase the likelihood of success are unclear. The present study uses meta-analyses to uncover the average effect of media campaigns on family planning behaviors in low- and middle-income countries and to examine the effectiveness of two communication strategies: entertainment-education and advertising/public service announcements. Results indicated that mass media-delivered family planning campaigns have a positive impact on family planning behaviors: d = 0.19, 95% CI [0.15, 0.24] for women (k = 64), d = 0.16, 95% CI [0.11, 0.21] for men (k = 27), and d = 0.20, 95% CI [0.17, 0.23] for an undifferentiated target group of men and women (k = 37). The use of an entertainment-education format, often in addition to campaign advertising messages, was associated with greater campaign success rates for women. Men, however, responded negatively to education-entertainment and positively to campaigns using only advertising and public service announcement formats. Recommendations for future family planning mass media campaigns and academic research opportunities are discussed.

Clinical and biochemical characteristics of Sjögren’s syndrome and its differences from keratoconjunctivitis sicca

Objective: In this study we aimed to compare the clinical and biochemical characteristics of primary Sjögren’s syndrome patients with that of keratoconjunctivitis sicca, secondary Sjögren syndrome and undifferentiated disease. Patients and Methods: Patients with Sjögren’s syndrome and keratoconjunctivitis sicca who applied between August 2009 and January 2010 were included in this study. Demographic data, laboratory characteristics, Schirmer’s test and salivary gland biopsies of the patients were recorded. Results: Average diagnosis age for 87 primary Sjögren’s syndrome, 25 secondary Sjögren’s syndrome, 27 keratoconjunctivitis sicca and 44 undifferentiated group patients were 45±13, 43±14, 44±11 ve 45±11 years (p&amp;gt;0.05), accordingly. Critical and severe mouth dryness rate was 45% in primary Sjögren’s syndrome group and 7% in keratoconjunctivitis sicca group, critical and severe eye dryness was 43% in primary Sjögren’s syndrome group and 78% in keratoconjunctivitis sicca group (p&amp;lt;0.001). Grade 3≥ positivity in salivary gland biopsy was found as 71.2% in primary Sjögren’s syndrome group and 27.2% in the undifferentiated group (p&amp;lt;0.001). Conclusions: More dense lymphocyte infiltration was detected in primary Sjögren’s syndrome in salivary gland biopsies. As 27.2% of undifferentiated group patients had positive salivary gland biopsies, they might need follow-ups in terms of having increased risk of developing primary Sjögren’s syndrome.

Herpetic Oncogenic Virus Co ? Infections Impinge Cell Cycle Regulatory Gene Expressions in Oral Cavity Malignancies

Oral squamous cell carcinoma (OSCC) is the most encountered type of oral malignant neoplasm. P27 is a nuclear cell cycle inhibitory protein, that can be transported to the cytoplasm to deactivate it's role, Similarly the mechanism is used by cancer cells to unlock cell cycle arrest. In reaction to damage to DNA caused, either by the cell cycle arresting or apoptosis, the tumor suppressor p73 is activated. Epstein-Barr virus (EBV) that infects human beings has oncogenic capacity in different kinds of human neoplasia. Human Cytomegalovirus (HCMV) is a prevalent opportunistic pathogen that causes severe disease in various immunosuppressed patient. The aim of this study is to investigate the impact of EBV and HCMV contagions togetherness on p27 and p73 gene products in Oral cavity carcinomas. This study included a total number of seventy three (73) formalin-fixed, paraffin-embedded tissue blocks from OSCC patients. The confirmatory re-examination for histopathological samples were donea Chromogenic In Situ Hybridization assay (CISH) for EBV-EBERs and HCMV-PP65 DNA localization and immunohistochemistry assay (IHC) for p73 and p27 gene expression were performed). The results illustrate that the presence of these two viruses in OSCC were at highest percentage in undifferentiated grade (74.47%%). On the other hand, co-presence of p27 and p73 was highest in undifferentiated group (70.27%).

Abstract PS13-23: Evaluation of a beneficial effect of adjuvant chemotherapy in patients with stage I triple-negative breast cancer: A population-based study using the SEER 18 database

Abstract Background:Triple-negative breast cancer (TNBC), a subtype of breast cancer, due to the lack of an effective therapy target, the only postoperative approach that seems to work for TNBC is chemotherapy treatment. For TNBC that is less than 1 cm and has no lymph node metastasis, administering chemotherapy is controversial at present. The word "consider" is used in the description of the National Comprehensive Cancer Network (NCCN), and the level of evidence is IIb. The Chinese Society of Clinical Oncology (CSCO) guidelines do not provide a specific recommendation for this group of patients but recommend that all patients with TNBC should receive postoperative chemotherapy. In this study, the SEER database was used to evaluate the benefit of chemotherapy. The results will help confirm whether patients with stage T1aN0M0 and T1bN0M0 TNBC should be administered adjuvant chemotherapy.Purpose To evaluate the effect of adjuvant chemotherapy on improving the prognosis of patients with stage I triple-negative breast cancer (TNBC).Methods TNBC patients diagnosed in the SEER 18 database from 2010 to 2015 were included. Kaplan-Meier plots and log-rank tests were used to compare the differences in breast cancer-specific survival (BCSS) and overall survival (OS) between subgroups of variables. A Cox proportional hazard model was used to determine the prognostic factors affecting BCSS and OS.Results A total of 9,256 patients were enrolled in this study. Among these patients, 380 died from breast cancer, and 703 died from all causes. Patients who received chemotherapy had significantly better BCSS and OS than those who did not receive chemotherapy for stage T1cN0M0 (BCSS, hazard ratio (HR) = 0.68, 95% confidence interval (CI) = 0.51-0.90; OS, HR = 0.54, 95% CI = 0.44-0.67) and stage IB (BCSS, HR = 0.39, 95% CI = 0.16-0.95; OS, HR = 0.41, 95% CI = 0.19-0.87) disease. Patients who received chemotherapy did not have significantly better BCSS or OS than those who did not receive chemotherapy for stage T1aN0M0 or T1bN0M0 disease. The patients who received chemotherapy in the poorly differentiated and undifferentiated groups had better BCSS (HR = 0.68, 95% CI = 0.52-0.88) and OS (HR = 0.54, 95% CI = 0.44-0.66) than the patients who did not receive chemotherapy.Conclusion According to current clinical guidelines, patients with stage T1bN0M0 TNBC are probably overtreated. The prognosis of these patients with stage T1aN0M0 or T1bN0M0 disease is good enough that adjuvant chemotherapy cannot improve it further. TABLE: The effect of adjuvant chemotherapy on BCSS stratified by the tumor stageStageChemotherapyCasesDeath from breast cancerlog-rank PUnivariate CoxMultivariate CoxaHR (95%CI)PHR (95%CI)PT1aN0M00.446No857121.00(reference)1.00(reference)Yes24651.50(0.53-4.25)0.4491.17(0.33-4.12)0.808T1bN0M00.700No886281.00(reference)1.00(reference)Yes1341370.91(0.56-1.48)0.7001.00(0.57-1.74)0.999T1cN0M02.73×10-5No1410971.00(reference)1.00(reference)Yes41891710.59(0.46-0.76)3.41×10-50.68(0.51-0.90)0.007IBNo49100.0031.00(reference)1.00(reference)Yes278200.33(0.16-0.71)0.0050.39(0.16-0.95)0.038a Adjusted by age, laterality, grade, total number of malignant tumors per patient and radiotherapy.Patients who received chemotherapy had significantly better BCSS than those who did not receive chemotherapy for stage T1cN0M0 and stage IB disease. In contrast, no significant associations of chemotherapy with BCSS were observed for stage T1aN0M0 or stage T1bN0M0 disease. Citation Format: Yang Wang, Bailin Zhang. Evaluation of a beneficial effect of adjuvant chemotherapy in patients with stage I triple-negative breast cancer: A population-based study using the SEER 18 database [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS13-23.

A novel long non-coding RNA-based prognostic signature for renal cell carcinoma patients with stage IV and histological grade G4

ABSTRACT This study aimed to establish a lncRNA-based signature for predicting the prognosis of patients with high stage and grade renal cell carcinoma (RCC). According to the Surveillance, Epidemiology, and End Results (SEER) database, sex, age, grade, stage, surgery, chemotherapy, radiation, tumor size, and marital status were the independent prognostic factors for RCC and also had significant correlations with the overall survival through Cox univariate and multivariate analyses. Noticeably, among these influencing factors, the histological classification of undifferentiated group and pathological stage IV had the greatest prognostic risks for RCC patients. Furthermore, based on the samples at stage IV and histological grade G4 from The Cancer Genome Atlas (TCGA) portal, 9 key lncRNAs, including KIAA2012, CCNT2-AS1, ITPKB-AS1, TBX2-AS1, NUTM2A-AS1, LINC02522, LINC02384, LINC01559, and LINC00865 were identified and a prognostic signature was constructed by Lasso analysis and Cox regression model. The Kaplan-Meier analysis suggested that patients at stage IV and histological grade of G4 in high risk score group had a worse overall survival than that in low risk score group. The following receiver operating characteristic curve (ROC) curves also showed that this signature possesses a better predictive power performance. Pathway enrichment analysis discovered that 9 lncRNAs held potential roles in cell division, cell cycle, DNA damage and cytokines levels in RCC. This work indicates that the established 9-lncRNA signature has a good capacity in predicting the prognosis of RCC patients with stage IV and histological grade of G4, and may be helpful for guiding the treatment strategies for RCC patients.

Human Spheroids from Adipose-Derived Stem Cells Induce Calvarial Bone Production in a Xenogeneic Rabbit Model.

Calvarial defects can result from several causes. Tissue engineering hold the potential to restore native form and protective function. We have recently shown that stemness and differentiation ability of spheroids from adipose-derived stem cells (S-ASCs) promotes osteoblasts growth within Integra in a small vertebral lesion. In our study, we aimed to test osteogenic potential of S-ASCs in aiding regeneration of a calvarial defect. Groups containing Integra showed increased bone regeneration at the calvarial defect-Integra interface compared with the control group. In particular, S-ASC-derived osteoblasts group showed a superior calvarial remodeling than undifferentiated S-ASCs group. Clusters of ossification were observed in these both groups with enhanced microvasculature density and fibrosis. In conclusion, seeding of S-ASCs in dermal regeneration templates enhanced bone healing in a rabbit calvarial defect model. These findings could prompt the elective use of S-ASCs with enhanced multilineage differentiation potential for tissue engineering purposes.