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08 April 2024, Volume 51 Issue 4 Previous Issue    Next Issue

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Risk factors of postoperative recurrence in patients with primary brain glioma and prediction model construction Liu Pingping, He Xuefang, Zhang Yi, Yang Xu, Zhang Shanshan, Ji Yifei 2024, 51 (4):  193-197.  doi: 10.3760/cma.j.cn371439-20231213-00032 Abstract ( 92 )   HTML ( 37 )   PDF (918KB) ( 42 )   Save Objective To investigate the risk factors of postoperative recurrence in patients with primary brain glioma and to construct a prediction model. Methods A total of 98 patients with primary brain glioma treated by radical surgery in Nanchong Central Hospital from January 2018 to January 2021 were retrospectively included， and were divided into recurrent group （40 cases） and non-recurrent group （58 cases） according to whether there was recurrence or not during the follow-up period. The independent influencing factors for postoperative recurrence in patients with primary brain glioma were evaluated by multivariate logistic regression. Logistic prediction model of postoperative recurrence risk of patients with primary brain glioma was established， and the predictive efficacy of each index was calculated by receiver operator characteristic （ROC） curve. Results There were statistically significant differences between recurrent group and non-recurrent group in glioma World Health Organization （WHO） grade（χ2=12.48，P<0.001）， isocitrate dehydrogenase （IDH）1/2 mutation （χ2=13.24， P<0.001）， mean platelet volume （MPV）（t=5.34， P<0.001）， and MPV/platelet count （PLT）（t=9.73，P<0.001）. Multivariate analysis showed that WHO grade Ⅲ-Ⅳ （OR=8.54， 95%CI：1.62-44.99， P=0.011）， IDH1/2 wild type （OR=9.08， 95%CI：1.68-49.19， P=0.010）， low MPV （OR=0.46， 95%CI：0.21-0.99， P=0.048） and low MPV/PLT （OR=0.02， 95%CI：0.01-0.03， P<0.001） were independent risk factors for postoperative recurrence in patients with primary brain glioma. The logistic prediction model based on the above indicators was logit（P）=11.78+2.15×WHO grade+2.21×IDH1/2 mutation situation-0.78×MPV-200.70×MPV/PLT （R2=0.785）.The ROC curve analysis results showed that WHO grade， IDH1/2 mutation， MPV， MPV/PLT， and logistic prediction model P-value could all be used to predict the risk of postoperative recurrence in patients with primary brain glioma； The areas under the curve were 0.681， 0.684， 0.783， 0.920 and 0.964， respectively. In the area under ROC curve comparison of each indicator， the predictive performance of the logistic regression model P-value was significantly higher than that of other indicators （all P<0.05）. Conclusion Postoperative recurrence in patients with primary brain glioma may be related to glioma WHO grade， IDH1/2 mutation and platelet related laboratory indexes. The model constructed based on the above indicators can be used to predict the recurrence risk in patients with primary brain glioma after surgery. Figures and Tables | References | Related Articles | Metrics

Predictive value of serum TGF-β1 and VEGF levels in patients with non-small cell lung cancer after single-port thoracoscopic radical resection Wang Kun, Zhou Zhongxin, Zang Qiwei 2024, 51 (4):  198-203.  doi: 10.3760/cma.j.cn371439-20230515-00033 Abstract ( 73 )   HTML ( 15 )   PDF (975KB) ( 32 )   Save Objective To analyze the predictive value of serum transforming growth factor-β1 （TGF-β1） and vascular endothelial growth factor （VEGF） in patients with non-small cell lung cancer （NSCLC） after single-port thoracoscopic radical resection. Methods A total of 50 patients with NSCLC who underwent single-port thoracoscopic radical resection in Affiliated Hospital of Xuzhou Medical University from May 2018 to May 2020 were selected as the observation objects. Serum TGF-β1， VEGF levels and Karnofsky functional status （KPS） scores before and after surgery were compared， and the total incidence of complications was calculated. All subjects were followed up for 3 years， and serum levels of TGF-β1， VEGF and KPS scores were compared between relapsed group and non-relapsed group， survival group and death group. Pearson correlation analysis was used to explore the correlation between TGF-β1， VEGF and KPS scores. The receiver operator characteristic （ROC） curve was plotted and the area under the curve （AUC） was calculated to evaluate the predictive value of serum TGF-β1 and VEGF alone and combined detection in patients with NSCLC after single-port thoracoscopic radical resection. Results The serum levels of TGF-β1 and VEGF were （7.16±1.94） μg/L and （42.26±5.04） ng/L in 50 patients with NSCLC one month after single-port thoracoscopic radical resection， which were lower than those before surgery [（13.62±3.52） μg/L and （136.52±20.66） ng/L， t=11.37， P<0.001； t=31.34， P<0.001]. The KPS score one month after surgery was 66.57±8.11， which was higher than that before surgery （53.62±5.62， t=9.28， P<0.001）. Postoperative wound healing was delayed in 1 of the 50 patients， pulmonary infection in 1 patient， and no pulmonary embolism and other complications occurred. The total incidence of complications was 4.00%. The serum levels of TGF-β1 and VEGF in patients in the relapsed group （n=6） were （12.95±4.26） μg/L and （72.46±6.05） ng/L respectively， which were higher than those in the non-relapsed group （n=44） [（6.37±1.25） μg/L and （38.14±5.37） ng/L； t=8.34， P<0.001； t=29.99， P<0.001]. The KPS score in the relapsed group was 52.16±8.16， which was lower than that in the non-relapsed group （67.55±12.67， t=2.88， P=0.006）. Serum levels of TGF-β1 and VEGF in the death group （n=5） were （13.99±6.82） μg/L and （75.95±9.05） ng/L， which were higher than those in the survival group （n=45） [（6.41±3.06） μg/L and （38.52±8.37） ng/L； t=4.56，P<0.001； t=21.47， P<0.001]. The KPS score in the death group was 1.25±0.34， which was lower than that in the survival group （65.11±12.94， t=10.93， P<0.001）. Pearson correlation analysis showed that serum levels of TGF-β1 （r=-0.45， P<0.001） and VEGF （r=-0.48， P<0.001） were negatively correlated with KPS scores. ROC curve analysis showed that when the optimal cut-off value of TGF-β1 was 8.14 µg/L， the AUC for predicting recurrence after single-port thoracoscopic radical resection was 0.516 （95%CI：0.446-0.676）， the sensitivity was 71.85%， and the specificity was 80.69%. When the optimal cut-off value of VEGF was 142 ng/L， the AUC was 0.659 （95%CI：0.534-0.761）， the sensitivity was 76.04%， and the specificity was 82.52%. The AUC of the combined detection was 0.828 （95%CI：0.786-0.951）， the sensitivity was 91.86%， and the specificity was 87.52%. The AUC of combined detection was higher than that of serum TGF-β1 （Z=2.63，P=0.007）， VEGF（Z=2.32，P=0.013） single detection. Conclusion The serum levels of TGF-β1 and VEGF are significantly decreased in NSCLC patients after one month of single-port thoracoscopic radical resection， and the combined detection of the two has predictive value for recurrence after single-port thoracoscopic radical resection. Figures and Tables | References | Related Articles | Metrics

Expression levels and clinical significance of serum miR-497 and miR-383 in patients with esophageal cancer Wan Fang, Yang Gang, Li Rui, Wan Qijing 2024, 51 (4):  204-209.  doi: 10.3760/cma.j.cn371439-20231130-00034 Abstract ( 59 )   HTML ( 18 )   PDF (915KB) ( 39 )   Save Objective To observe the serum levels of miR-497 and miR-383 in patients with esophageal cancer， and to analyze the clinical significance for esophageal cancer. Methods Esophageal cancer patients admitted to Union Wuhan Red Cross Hospital from July 2018 to February 2020 were collected as the esophageal cancer group （n=96）， which were divided into a recurrence group （n=29） and a non recurrence group （n=67） based on follow-up results. The control group included healthy individuals who underwent physical examinations at this hospital during the corresponding period （n=83）， and the benign lesion group included patients with benign esophageal lesions who underwent treatment at same hospital during the corresponding period （n=78）. Real time fluorogenic quantitative PCR was applied to detect serum levels of miR-497 and miR-383 in each group； Pearson method was applied to analyze the correlation between serum levels of miR-497 and miR-383 in esophageal cancer patients； Relationship between serum levels of miR-497， miR-383 and clinical pathological characteristics in esophageal cancer patients was analyzed； Receiver operator characteristic （ROC） curve was plotted to analyze the efficacy of serum miR-497， miR-383， and their combination in predicting the prognosis of esophageal cancer patients. Results The serum miR-497 levels in the control group， benign lesion group and the esophageal cancer group were 1.01±0.18， 0.86±0.15， 0.77±0.14， respectively， and the serum miR-383 levels were 1.02±0.21， 0.95±0.15， 0.84±0.15， respectively， with statistically significant differences （F=52.59， P<0.001； F=25.12， P<0.001）； There were statistically significant differences in serum miR-497 and miR-383 levels between any two of the three groups （all P<0.05）. Pearson correlation analysis reveled that serum miR-497 level was positively correlated with miR-383 level in esophageal cancer patients （r=0.46， P<0.001）. There were statistically significant differences in serum miR-497 and miR-383 levels among esophageal cancer patients with different tumor diameters （t=6.58， P<0.001； t=5.06， P<0.001）， lymph node metastases （t=5.55， P<0.001； t=4.63， P<0.001） and TNM stages （t=5.00， P<0.001； t=2.75， P<0.001）. The serum miR-497 （0.83±0.15 vs. 0.62±0.11， t=6.78， P<0.001） and miR-383 （0.91±0.16 vs. 0.67±0.13， t=7.12， P<0.001） levels in the non recurrence group were both higher than those in the recurrence group. ROC curve showed that the critical value of serum miR-497 for predicting the prognostic situation of esophageal cancer was 0.72， with a sensitivity of 68.97%， a specificity of 68.66%， and an area under the curve （AUC） of 0.756； The critical value of serum miR-383 was 0.84， with a sensitivity of 82.76%， a specificity of 67.16%， and an AUC of 0.827； The sensitivity of the combination of the two was 79.31%， the specificity was 85.07%， and the AUC was 0.899； The combination of the two had a better prediction effect than that of serum miR-497 （Z=3.31， P=0.001） and miR-383 （Z=2.51， P=0.012） alone. Conclusion The serum levels of miR-497 and miR-383 in patients with esophageal cancer are lower than those in healthy individuals and patients with benign lesions， which are related to tumor diameter， lymph node metastasis， TNM stage， and prognosis. The combined detection of the two has certain predictive value for the prognosis of esophageal cancer. Figures and Tables | References | Related Articles | Metrics

Comparison of efficacy and safety between sintilimab and tislelizumab in neoadjuvant therapy for advanced esophageal squamous cell carcinoma Yang Hao, Shi Guidong, Zhang Chengcheng, Zhang Yue, Zhang Liwen, Fu Maoyong 2024, 51 (4):  210-216.  doi: 10.3760/cma.j.cn371439-20230811-00035 Abstract ( 117 )   HTML ( 20 )   PDF (723KB) ( 52 )   Save Objective To analyze and compare the short-term efficacy and safety of sintilimab and tislelizumab in neoadjuvant therapy for advanced esophageal squamous cell carcinoma. Methods The clinical data of 95 patients with esophageal squamous cell carcinoma who received neoadjuvant chemotherapy （paclitaxel + nedaplatin） combined with immunotherapy in the Department of Thoracic Surgery of the Affiliated Hospital of North Sichuan Medical College from January 2021 to October 2022 were collected. According to the different use of immune drugs， they were divided into the sintilimab group （n=58） and the tislelizumab group （n=37）. The objective remission rate （ORR）， adverse reactions， R0 resection rate， pathological complete response （pCR） rate， etc. were analyzed and compared between the two groups after neoadjuvant therapy. Results After 2 cycles of neoadjuvant therapy， the sintilimab group and the tislelizumab group had a similar ORR [72.4% （42/58） vs. 56.8% （21/37）， χ2=2.48， P=0.115]. The main adverse reactions of the two groups of patients included gastrointestinal reactions （nausea， vomiting， diarrhea）， hematological toxicity， hypothyroidism， alopecia， liver and kidney dysfunction， pneumonia， etc. The incidence of grade 3 adverse reactions was less than 15%， with no grade 4 adverse reactions. The incidence of hypothyroidism in the sintilimab group was significantly higher than that in the tislelizumab group [56.9% （33/58） vs. 16.2% （6/37）]， with a statistically significant difference （χ2=15.45， P<0.001）； There was no statistically significant difference in surgical resection （χ2=1.26， P=0.661） and pCR rate [31.0% （18/58） vs. 32.4% （12/37）， χ2=0.02， P=0.886] between the two groups of patients. In terms of postoperative complications， both groups of patients experienced partial pulmonary infections and anastomotic fistulas， but the incidence was relatively low [19.0% （11/58） vs. 24.3% （9/37）， 3.4% （2/58） vs. 2.7% （1/37）]， with no statistically significant difference （χ2=0.39， P=0.532； χ2<0.01， P>0.999）. Conclusion For preoperative neoadjuvant therapy of advanced esophageal squamous cell carcinoma， the use of either sintilimab or tislelizumab in addition to chemotherapy has good short-term efficacy and safety. Thyroid function should be monitored carefully when using sintilimab. Figures and Tables | References | Related Articles | Metrics

Predictive value of serum SOCS3 and TXNIP levels for the prognosis of patients with hepatocellular carcinoma treated with TACE Yao Yixin, Shen Yulin 2024, 51 (4):  217-222.  doi: 10.3760/cma.j.cn371439-20230908-00036 Abstract ( 61 )   HTML ( 13 )   PDF (890KB) ( 35 )   Save Objective To investigate the prognostic value of serum suppressor of cytokine signaling 3 （SOCS3） and thioredoxin-interacting protein （TXNIP） levels in transcatheter arterial chemoembolization （TACE） treatment of hepatocellular carcinoma （HCC）. Methods A total of 107 HCC patients who underwent TACE treatment in Wuhan Hanyang Hospital from December 2019 to July 2021 were selected as the observation objects. According to the situation after TACE treatment， the patients were divided into poor prognosis group （n=47） and good prognosis group （n=60）. Serum SOCS3 and TXNIP levels were detected by enzyme-linked immunosorbent assay， the prognostic factors were analyzed by logistic regression. The predictive value of serum SOCS3 and TXNIP levels before treatment for TACE treatment prognosis in patients with HCC was analyzed by receiver operator characteristic （ROC） curve. Results There were no statistically significant differences between good prognosis group and poor prognosis group in age （χ2=0.56， P=0.453）， gender （χ2=0.06， P=0.800）， tumor size （χ2=1.46， P=0.227）， Child-Pugh grade （χ2=0.26， P=0.608）， tumor number （χ2=0.77， P=0.382）， cirrhosis （χ2=0.03， P=0.860）， TACE times （χ2=0.16， P=0.691）， alpha-fetoprotein level before treatment （χ2=0.79， P=0.374）， and hepatitis B surface antigen （χ2=0.58， P=0.446）. The proportion of TNM stage Ⅲ patients in the poor prognosis group （57.45%， 27/47） was higher than that in the good prognosis group （25.00%， 15/60）， with a statistically significant difference （χ2=11.64， P=0.001）. The serum levels of SOCS3 and TXNIP in the good prognosis group before treatment were （114.34±20.39） and （45.64±6.41） pg/ml， respectively， while those in the poor prognosis group were （82.83±15.97） and （34.82±6.36） pg/ml， respectively， serum SOCS3 and TXNIP levels in the poor prognosis group were lower than those in the good prognosis group， with statistically significant differences （t=8.71， P<0.001； t=8.70， P<0.001）. After treatment， the serum SOCS3 and TXNIP levels in the good prognosis group were （139.65±24.32） and （64.75±7.58） pg/ml， respectively， while those in the poor prognosis group were （92.41±16.15） and （41.74±7.23） pg/ml， serum SOCS3 and TXNIP levels in the poor prognosis group were lower than those in the good prognosis group， with statistically significant differences （t=11.48， P<0.001； t=15.90， P<0.001）. Serum SOCS3 and TXNIP levels in both groups were significantly higher after treatment than before （all P<0.05）. Multivariate analysis showed that TNM stage （OR=2.53， 95%CI：1.27-5.02， P=0.008） was an independent risk factor for prognosis in HCC patients after TACE treatment， SOCS3 （OR=0.65， 95%CI：0.44-0.96， P=0.031） and TXNIP （OR=0.57， 95%CI：0.36-0.89， P=0.014） were independent protective factors for prognosis in HCC patients after TACE treatment. ROC curve analysis showed that the sensitivity and specificity of the combined detection of serum SOCS3 and TXNIP before treatment in predicting prognosis of TACE treatment in HCC patients were 81% and 92%， respectively， the area under the curve was 0.92 （95%CI：0.85-0.96）. Conclusion The low levels of serum SOCS3 and TXNIP before TACE treatment in HCC patients may indicate poor prognosis after TACE treatment. The combined detection of the two has certain predictive value for judging the prognosis of HCC patients after TACE treatment. Figures and Tables | References | Related Articles | Metrics

Reviews

Electronic nose and nematode nose as new tool for early cancer screening Hu Tingting, Wang Yuehua 2024, 51 (4):  223-226.  doi: 10.3760/cma.j.cn371439-20230616-00037 Abstract ( 60 )   HTML ( 6 )   PDF (677KB) ( 18 )   Save Regular cancer screening is crucial for early detection and treatment of cancer. Most cancer screening methods are cumbersome， invasive， and expensive， especially when conducting multi-organ examinations. How to improve the speed and effectiveness of routine cancer screening remains a significant challenge in healthcare. Multi-cancer early detection is a promising concept and a potentially effective solution to the current routine cancer screening methods. In recent years， several multi-cancer early detection technologies have been developed， such as detecting cell-free tumor DNA in blood， electronic nose technology， and using organisms like Caenorhabditis elegans as early cancer detection tools， with testing samples of non-blood fluids such as exhaled breath condensate and urine. References | Related Articles | Metrics

Advances in immunotherapy for breast cancer Sa Qiang, Xu Hangcheng, Wang Jiayu 2024, 51 (4):  227-234.  doi: 10.3760/cma.j.cn371439-20231017-00038 Abstract ( 187 )   HTML ( 16 )   PDF (764KB) ( 105 )   Save According to the latest global cancer burden data for 2020 released by the WHO's International Agency for Research on Cancer， breast cancer has become the malignant tumor with the highest incidence worldwide. Based on existing internal medicine treatment means like chemotherapy， targeted therapy and endocrine therapy， the development of immunotherapy provides novel solutions for the treatment of breast cancer. To date， the clinical research of immunotherapy in various molecular types and stages of breast cancer has reached certain achievements. In addition， the exploration of joint application with other therapies， predictive markers for efficacy， and immune-related adverse effects is also ongoing. The research and development in the field of breast cancer immunotherapy holds a promising prospect， and approaching research advances will promote the further application of immunotherapy in breast cancer. Figures and Tables | References | Related Articles | Metrics

Research progress of tumor microenvironment mediated drug resistance in targeted therapy of breast cancer Yang Zhi, Lu Yiqiao, Gu Huayan, Ding Jialing, Guo Guilong 2024, 51 (4):  235-238.  doi: 10.3760/cma.j.cn371439-20230925-00039 Abstract ( 82 )   HTML ( 11 )   PDF (687KB) ( 28 )   Save Targeted therapy for breast cancer can significantly improve the prognosis， quality of life and survival of breast cancer patients， but the emergence of primary or acquired drug resistance will eventually lead to disease progression， recurrence or metastasis. Tumor microenvironment （TME） is a complex environment for breast cancer cells to survive. Breast cancer cells and TME are currently known to be a functional whole， and the crosstalk between them plays a key role in breast cancer progression and resistance to targeted therapies. Therefore， clarifying TME abnormalities is important to reveal the underlying mechanisms of targeted therapy resistance and to develop therapeutic strategies against targeted therapy-resistant malignancies. References | Related Articles | Metrics

Research progress on the molecular mechanism and related treatments of ferroptosis in osteosarcoma Wang Zihao, Wang Yu, Yang Xin, He Yi, Mo Xingkui, Yuan Tao 2024, 51 (4):  239-244.  doi: 10.3760/cma.j.cn371439-20231229-00040 Abstract ( 99 )   HTML ( 6 )   PDF (1545KB) ( 35 )   Save Osteosarcoma is one of the most common primary malignant bone tumors， which has reached a "bottleneck" in the current clinical treatment of patients with osteosarcoma due to its poor prognosis and lack of therapeutic modalities. Recently， more and more researches have found that ferroptosis， as a novel cell death modality， may play an important role in osteosarcoma treatment. In recent years， with more in-depth studies on the mechanisms and molecular pathways related to ferroptosis， its specific therapeutic strategies in osteosarcoma have also been validated， which is expected to provide new ideas for the clinical treatment of osteosarcoma patients. Figures and Tables | References | Related Articles | Metrics