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A Single-Center Pilot Study of Therapeutic Apheresis in Patients with Severe Post-COVID Syndrome. 重症后冠状病毒综合征患者治疗性采血的单中心试点研究
IF 2 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-12-01 Epub Date: 2024-12-09 DOI: 10.1055/a-2445-8593
Johannes Korth, Charlotte Steenblock, Romy Walther, Mahmoud Barbir, Michael Husung, Ansgar Velthof

After the COVID-19 pandemic, many patients have reported chronic fatigue and severe post-exertional malaise, with symptoms similar to those of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The accumulation of agonistic receptor autoantibodies targeting beta-adrenergic (β1 and β2) and muscarinic (M3 and M4) neurotransmitter receptors may play a crucial role in the pathomechanism of both ME/CFS and post-COVID conditions. Therapeutic apheresis has been suggested as an effective treatment option for alleviating and mitigating symptoms in this desperate group of patients. In this single-center pilot study, we analyzed autoantibodies in a cohort of 20 post-COVID patients before and after therapeutic apheresis. Apheresis resulted in a decline of β1 or β2 adrenergic receptor antibodies in all patients. Additionally, the majority of patients experienced a concurrent reduction in symptoms such as fatigue, physical activity restrictions, myalgia, post-exertional malaise, and concentration disorders. This study clearly demonstrates an association between autoantibodies and the clinical improvement of post-COVID patients. Even if future sham-controlled trials do not show a positive outcome, extracorporeal apheresis may still be valuable for this patient group by temporarily improving microperfusion and symptoms. Success in restoring patients to work and normal life, as observed in many individuals after therapeutic apheresis, should be recognized. Therefore, we believe that extracorporeal therapeutic apheresis, as part of a multimodal treatment, should be considered an early intervention for postinfectious syndromes in selected patients.

COVID-19大流行后,许多患者报告慢性疲劳和严重的运动后不适,其症状类似于肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)。靶向β -肾上腺素能(β1和β2)和毒蕈碱(M3和M4)神经递质受体的激动受体自身抗体的积累可能在ME/CFS和covid后疾病的病理机制中发挥关键作用。治疗性采血已被认为是缓解和减轻这一绝望患者症状的有效治疗选择。在这项单中心试点研究中,我们分析了20名治疗性采血前和采血后患者的自身抗体。分离导致所有患者β1或β2肾上腺素能受体抗体下降。此外,大多数患者同时经历了疲劳、身体活动受限、肌痛、运动后不适和注意力障碍等症状的减轻。这项研究清楚地表明自身抗体与covid后患者的临床改善之间存在关联。即使未来的假对照试验没有显示出积极的结果,体外采血可能仍然是有价值的,暂时改善微灌注和症状。在许多治疗性分离后的个体中观察到,成功地使患者恢复工作和正常生活应该得到认可。因此,我们认为体外治疗性采血作为多模式治疗的一部分,应该被认为是对特定患者感染后综合征的早期干预。
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引用次数: 0
Loxenatide Alleviates High Glucose-Induced Pancreatic β-Cell Senescence via Regulating the PERK/eIF2α Pathway. 洛赛那肽通过调节 PERK/eIF2α 通路缓解高血糖诱导的胰腺β细胞衰老
IF 2 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-12-01 Epub Date: 2024-09-27 DOI: 10.1055/a-2407-9360
Junfang Yuan, Yuzhong Wang, Defeng Wang, Han Yan, Ning Wang

Glucagon-like peptide-1 (GLP-1) receptor agonists are effective hypoglycemic agents for type 2 diabetes mellitus (T2DM). It was reported that T2DM was implicated in pancreatic β-cell senescence. Whether loxenatide regulates cellular senescence of pancreatic β-cells is to be investigated. Our results revealed that high glucose (HG)-induced cellular senescence and elevated expression of SASP factors inhibited cell proliferation and stimulated DNA damage, which were reversed by loxenatide treatment. In addition, HG induction resulted in promoted insulin secretion and insulin synthesis of pancreatic β-cells and loxenatide treatment further strengthened these influences. In addition, loxenatide could inactivate the PERK/eIF2α signaling pathway via decreasing the levels of p-PERK and p-eIF2α in HG-induced pancreatic β-cells. Furthermore, CCT020312, an activator of the PERK/eIF2α signaling pathway, abolished loxenatide-mediated inhibiting cellular senescence, elevating cell proliferation and improving DNA damage and enhancing insulin secretion of HG-induced pancreatic β-cells. In conclusion, our results indicated that loxenatide impeded cellular senescence, promoted cell proliferation, improved DNA damage, enhanced insulin secretion and insulin synthesis of HG-induced pancreatic β-cells through modulating the PERK/eIF2α signaling pathway.

胰高血糖素样肽-1(GLP-1)受体激动剂是治疗 2 型糖尿病(T2DM)的有效降糖药物。据报道,T2DM 与胰腺 β 细胞衰老有关。洛塞那肽是否能调节胰腺β细胞的衰老有待研究。我们的研究结果表明,高糖(HG)诱导的细胞衰老和SASP因子表达的升高抑制了细胞增殖并刺激了DNA损伤,而洛赛那肽处理可逆转这些现象。此外,高血糖诱导促进了胰岛β细胞的胰岛素分泌和胰岛素合成,而洛舍那肽治疗进一步加强了这些影响。此外,洛赛那肽还能通过降低 HG 诱导的胰岛β细胞中 p-PERK 和 p-eIF2α 的水平,使 PERK/eIF2α 信号通路失活。此外,PERK/eIF2α信号通路的激活剂CCT020312可抑制loxenatide介导的抑制细胞衰老、促进细胞增殖、改善DNA损伤和增强HG诱导的胰腺β细胞的胰岛素分泌。总之,我们的研究结果表明,洛赛那肽通过调节PERK/eIF2α信号通路,阻碍了HG诱导的胰岛β细胞的细胞衰老,促进了细胞增殖,改善了DNA损伤,增强了胰岛素分泌和胰岛素合成。
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引用次数: 0
Correction: A Single-Center Pilot Study of Therapeutic Apheresis in Patients with Severe Post-COVID Syndrome.
IF 2 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-12-01 Epub Date: 2025-01-22 DOI: 10.1055/a-2505-6713
Johannes Korth, Charlotte Steenblock, Romy Walther, Mahmoud Barbir, Michael Husung, Ansgar Velthof
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引用次数: 0
Thyroid Hormone and Diabetes Mellitus Interplay: Making Management of Comorbid Disorders Complicated. 甲状腺激素与糖尿病的相互作用:让并发症的管理变得复杂。
IF 2 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-12-01 Epub Date: 2024-08-19 DOI: 10.1055/a-2374-8756
Ayush Chauhan, Snehal S Patel

Insulin and thyroid hormones play important roles in our body. Insulin helps regulate the glucose level while the thyroid hormones affect various cells and tissues, metabolizing protein, lipids, and glucose. Hyperthyroidism and thyrotoxicosis are potential hazards for type 2 diabetes mellitus. There is a high prevalence of hypothyroidism being more common compared to hyperthyroidism coexisting with diabetes mellitus. Thyroid hormones affect glucose metabolism through its action on peripheral tissues (gastrointestinal tract, liver, skeletal muscles, adipose tissue, and pancreas). High-level thyroid hormone causes hyperglycemia, upregulation of glucose transport, and reduction in glycogen storage. The reverse is observed during low levels of thyroid hormone along with insulin clearance. The net result of thyroid disorder is insulin resistance. Type 2 diabetes mellitus can downsize the regulation of thyroid stimulating hormones and impair the conversion of thyroxine to triiodothyronine in peripheral tissues. Furthermore, poorly managed type 2 diabetes mellitus may result in insulin resistance and hyperinsulinemia, contributing to the proliferation of thyroid tissue and an increase in nodule formation and goiter size. Although metformin proves advantageous for both type 2 diabetes mellitus and thyroid disorder patients, other antidiabetics like sulfonylureas, pioglitazone, and thiazolidinediones may have adverse effects on thyroid disorders. Moreover, antithyroid drugs such as methimazole can weaken glycemic control in individuals with diabetes. Thus, an interplay between both endocrinopathies is observed and individualized care and management of the disorder needs to be facilitated.

胰岛素和甲状腺激素在人体内发挥着重要作用。胰岛素帮助调节血糖水平,而甲状腺激素则影响各种细胞和组织,代谢蛋白质、脂类和葡萄糖。甲状腺功能亢进症和甲状腺毒症是 2 型糖尿病的潜在危害。与甲状腺功能亢进症并发糖尿病相比,甲状腺功能减退症的发病率更高。甲状腺激素通过对外周组织(胃肠道、肝脏、骨骼肌、脂肪组织和胰腺)的作用影响葡萄糖代谢。高水平的甲状腺激素会导致高血糖、葡萄糖转运上调和糖原储存减少。在甲状腺激素水平较低时,胰岛素清除会出现相反的情况。甲状腺功能紊乱的最终结果就是胰岛素抵抗。2型糖尿病会降低促甲状腺激素的调节能力,并损害甲状腺素在外周组织中向三碘甲状腺原氨酸的转化。此外,管理不善的2型糖尿病可能会导致胰岛素抵抗和高胰岛素血症,促使甲状腺组织增生,增加结节的形成和甲状腺肿的大小。虽然二甲双胍对2型糖尿病和甲状腺疾病患者都有好处,但磺脲类、吡格列酮和噻唑烷二酮类等其他抗糖尿病药物可能会对甲状腺疾病产生不良影响。此外,甲巯咪唑等抗甲状腺药物也会削弱糖尿病患者的血糖控制。因此,两种内分泌疾病之间存在相互作用,需要促进对疾病的个体化护理和管理。
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引用次数: 0
Evaluation of the Malignancy Risk in Nodules Expanding the Thyroid Gland Capsule. 评估甲状腺囊肿结节的恶性风险
IF 2 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-12-01 Epub Date: 2024-06-28 DOI: 10.1055/a-2356-8223
Ismail Emre Arslan, Hayri Bostan, Sema Hepşen, Pinar Akhanli, Muhammed Erkam Sencar, Erman Cakal

There has been an increase in the diagnosis of thyroid nodules in recent years. In addition to the well-known criteria, features that are likely to increase the risk of malignancy are in the research process. In this study, we aimed to evaluate the malignant potential of nodules that expand the thyroid capsule ultrasonographically. A total of 109 patients with thyroid capsule-expanding nodules and 288 patients with non-expanding nodules were included in the study. Demographical data, ultrasonography features, and cytology results were noted, and histopathological findings were determined in operated patients. While malignant cytology was detected in 5.5% of capsule-expanding nodules in FNAB results, this rate was 0.7% in the non-capsule expanding group (p<0.001). According to the histopathological results, the incidence of malignancy was 15.6% in the capsule-expanding nodule group, while it was 3.1% in the other group (p=0.001). As a result of logistic regression analysis, it was determined that the risk of malignancy increased by 4.44-fold (95% CI 1.4-13.8, p=0.01) in patients with capsule-expanding nodules. Other features that increased the risk of malignancy were hypoechogenicity, microcalcification, and irregular margin presence. In this study, we found that the risk of malignancy increased in nodules expanding the thyroid capsule. Based on the increasing study data on this subject, monitoring thyroid capsule expansion in nodules may take its place among the criteria for malignancy in future evaluations.

近年来,甲状腺结节的诊断率越来越高。除了众所周知的标准外,可能增加恶性风险的特征也在研究过程中。在这项研究中,我们旨在通过超声波检查评估甲状腺囊扩张结节的恶性可能性。研究共纳入了109例甲状腺囊扩张性结节患者和288例非扩张性结节患者。研究人员记录了手术患者的人口统计学数据、超声波特征和细胞学结果,并确定了组织病理学结果。在 FNAB 结果中,5.5% 的囊性扩张结节被检测出恶性细胞学结果,而在非囊性扩张结节组中,这一比例仅为 0.7%(P<0.05)。
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引用次数: 0
Andrew Victor Schally - Nobel Prize Winner in Medicine, Legend and Pioneer in Endocrinology and a Great Friend and Supporter of the TransCampus. 安德鲁·维克多·沙利-诺贝尔医学奖得主,内分泌学的传奇人物和先驱,也是TransCampus的伟大朋友和支持者。
IF 2 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-12-01 Epub Date: 2024-12-09 DOI: 10.1055/a-2452-0604
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引用次数: 0
Prediction of Prognosis in Patients with Sepsis Based on Platelet-Related Genes. 基于血小板相关基因预测败血症患者的预后。
IF 2 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-12-01 Epub Date: 2024-06-13 DOI: 10.1055/a-2331-1362
Jing Jiang, Juan Zhang, Ting Wang, Daihua Yu, Xiu Ren

The study aimed to develop a risk prognostic model using platelet-related genes (PRGs) to predict sepsis patient outcomes. Sepsis patient data from the Gene Expression Omnibus (GEO) database and PRGs from the Molecular Signatures Database (MSigDB) were analyzed. Differential analysis identified 1139 differentially expressed genes (DEGs) between sepsis and control groups. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses revealed enrichment in functions related to immune cell regulation and pathways associated with immune response and infectious diseases. A risk prognostic model was established using LASSO and Cox regression analyses, incorporating 10 PRGs selected based on their association with sepsis prognosis. The model demonstrated good stratification and prognostic effects, confirmed by survival and receiver operating characteristic (ROC) curve analyses. It served as an independent prognostic factor in sepsis patients. Further analysis using the CIBERSORT algorithm showed higher infiltration of activated natural killer (NK) cells and lower infiltration of CD8 T cells and CD4 T cells naïve in the high-risk group compared to the low-risk group. Additionally, expression levels of human leukocyte antigen (HLA) genes were significantly lower in the high-risk group. In conclusion, the 10-gene risk model based on PRGs accurately predicted sepsis patient prognosis and immune infiltration levels. This study provides valuable insights into the role of platelets in sepsis prognosis and diagnosis, offering potential implications for personalized treatment strategies.

该研究旨在利用血小板相关基因(PRGs)建立一个风险预后模型,以预测脓毒症患者的预后。研究人员分析了基因表达总库(GEO)数据库中的脓毒症患者数据和分子特征数据库(MSigDB)中的血小板相关基因。差异分析确定了败血症组和对照组之间的 1139 个差异表达基因(DEGs)。基因本体(GO)和京都基因和基因组百科全书(KEGG)分析显示,与免疫细胞调控相关的功能以及与免疫反应和感染性疾病相关的通路得到了丰富。利用 LASSO 和 Cox 回归分析建立了一个风险预后模型,其中纳入了根据与败血症预后相关性选出的 10 个 PRGs。通过生存率和接收者操作特征曲线(ROC)分析,该模型显示出良好的分层和预后效果。它是脓毒症患者的一个独立预后因素。使用 CIBERSORT 算法进行的进一步分析表明,与低风险组相比,高风险组中活化的自然杀伤(NK)细胞浸润较高,而 CD8 T 细胞和 CD4 T 细胞的浸润较低。此外,高风险组的人类白细胞抗原(HLA)基因表达水平也明显较低。总之,基于 PRGs 的 10 基因风险模型能准确预测败血症患者的预后和免疫浸润水平。这项研究为血小板在脓毒症预后和诊断中的作用提供了宝贵的见解,为个性化治疗策略提供了潜在的意义。
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引用次数: 0
The Prognostic Impact of Radioiodine Therapy in Patients with Papillary Thyroid Cancer. 放射性碘疗法对甲状腺乳头状癌患者预后的影响
IF 2 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-01 Epub Date: 2024-11-07 DOI: 10.1055/a-2423-4849
Matthias Schott, Patricia Schott-Ohly, Sarah Krieg, Cora Thomaschky, Jan-Hendrik Wieltsch, Alexander Petrovitch, Andreas Krieg

Radioiodine (RAI) therapy after surgery, is an important component for the treatment of patients with papillary thyroid cancer (PTC), the most common thyroid cancer. In this study we sought to evaluate the cancer-specific survival (CSS) impact of RAI in specific thyroid cancer subgroups. The Surveillance, Epidemiology, and End Results (SEER) database were used to identify patients with PTC who underwent surgery between 2000 and 2019. Patients not treated with RAI were compared to those treated with RAI using propensity score matching (PSM) on the basis of identical inclusion criteria. A total of 106 333 patients were identified from the SEER database. RAI therapy was associated with improved CSS in the matched cohort (HR: 0.83; 95% CI: 0.72-0.96, p=0.01) but not in the unmatched data set (HR: 1.46; 95% CI: 1.30-1.64, p<0.001) among all PTC patients regardless of disease stage. Detailed analyses, however, showed that only patients with high-risk disease (pT3N1, pT4N1) experienced the greatest benefit in CSS. In the lower disease stages, no significant differences were recognized in the group of PTC patients with or without RAI therapy. One exception: in the group of PTC patients in stage pT1bN0, a significant difference was seen towards RAI. This is, however, most likely due to the large number of patients investigated. In summary, RAI therapy should not be used in low-risk PTC patients and might be used to some extent in intermediate-risk PTC patients. The histological suptype of the tumor needs to be considered in this context.

手术后的放射性碘(RAI)治疗是治疗最常见的甲状腺癌--甲状腺乳头状癌(PTC)患者的重要组成部分。在这项研究中,我们试图评估 RAI 在特定甲状腺癌亚组中对癌症特异性生存(CSS)的影响。我们使用监测、流行病学和最终结果(SEER)数据库来识别在2000年至2019年期间接受手术的PTC患者。在相同纳入标准的基础上,采用倾向得分匹配法(PSM)将未接受 RAI 治疗的患者与接受 RAI 治疗的患者进行比较。从 SEER 数据库中总共确定了 106 333 例患者。在配对队列中,RAI治疗与CSS的改善相关(HR:0.83;95% CI:0.72-0.96,P=0.01),但在未配对数据集中,RAI治疗与CSS的改善无关(HR:1.46;95% CI:1.30-1.64,P=0.01)。
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引用次数: 0
Identification and Verification of a Glycolysis-Related lncRNA Prognostic Signature for Hepatocellular Carcinoma. 肝细胞癌糖酵解相关lncRNA预后特征的鉴定与验证
IF 2 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-01 Epub Date: 2024-05-21 DOI: 10.1055/a-2314-0988
Fakai Qiu, Guozheng Yu, Mei Li, Zhubin Li, Qinyang Zhang, Xudong Mu, Yuan Cheng, Pengtao Zhai, Qunyi Liu

Hepatocellular carcinoma (HCC) is a primary liver cancer with a high mortality rate. The search for a new biomarker could help the prognosis of HCC patients. We identified the glycolytic gene set associated with HCC and the glycolytic lncRNA based on TCGA and MsigDB databases. According to these lncRNAs, K-means clustering, and regression analysis were performed on the patients. Two groups of HCC patients with different lncRNA expression levels were obtained based on K-means clustering results. The results of difference analysis and enrichment analysis showed that DEmRNA in the two HCC populations with significant survival differences was mainly enriched in transmembrane transporter complex, RNA polymerase II specificity, cAMP signaling pathway, and calcium signaling pathway. In addition, a prognostic model of HCC with 4 DElncRNAs was constructed based on regression analysis. ROC curve analysis showed that the model had good predictive performance. Drug predictionresults showed that the efficacy of JQ1, niraparib, and teniposide was higher in the low-risk group than in the high-risk group. In conclusion, this study preliminarily identified glycolytic-related prognostic features of lncRNAs in HCC and constructed a risk assessment model. The results of this study are expected to guide the prognosis assessment of clinical HCC patients.

肝细胞癌(HCC)是一种死亡率很高的原发性肝癌。寻找新的生物标志物有助于HCC患者的预后。我们根据 TCGA 和 MsigDB 数据库确定了与 HCC 相关的糖酵解基因集和糖酵解 lncRNA。根据这些lncRNA,我们对患者进行了K-均值聚类和回归分析。根据K-means聚类结果,得出了两组不同lncRNA表达水平的HCC患者。差异分析和富集分析结果表明,两组HCC患者中具有显著生存差异的DEmRNA主要富集于跨膜转运体复合物、RNA聚合酶II特异性、cAMP信号通路和钙信号通路。此外,基于回归分析,构建了包含 4 个 DElncRNAs 的 HCC 预后模型。ROC曲线分析表明,该模型具有良好的预测性能。药物预测结果显示,JQ1、尼拉帕利和替尼泊苷在低危组的疗效高于高危组。总之,本研究初步确定了HCC中与糖酵解相关的lncRNA预后特征,并构建了风险评估模型。该研究结果有望为临床HCC患者的预后评估提供指导。
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引用次数: 0
Construction and Validation of a Prognostic Model Based on Mitochondrial Genes in Prostate Cancer. 构建并验证基于线粒体基因的前列腺癌预后模型
IF 2 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-11-01 Epub Date: 2024-06-13 DOI: 10.1055/a-2330-3696
Dan Wang, Hui Pan, Shaoping Cheng, Zhigang Huang, Zhenlei Shi, Hao Deng, Junwu Yang, Chenghua Jin, Jin Dai

This study attempted to build a prostate cancer (PC) prognostic risk model with mitochondrial feature genes. PC-related MTGs were screened for Cox regression analyses, followed by establishing a prognostic model. Model validity was analyzed via survival analysis and receiver operating characteristic (ROC) curves, and model accuracy was validated in the GEO dataset. Combining risk score with clinical factors, the independence of the risk score was verified by using Cox analysis, followed by generating a nomogram. The Gleason score, microsatellite instability (MSI), immune microenvironment, and tumor mutation burden were analyzed in two risk groups. Finally, the prognostic feature genes were verified through a q-PCR test. Ten PC-associated MTGs were screened, and a prognostic model was built. Survival analysis and ROC curves illustrated that the model was a good predictor for the risk of PC. Cox regression analysis revealed that risk score acted as an independent prognostic factor. The Gleason score and MSI in the high-risk group were substantially higher than in the low-risk group. Levels of ESTIMATE Score, Immune Score, Stromal Score, immune cells, immune function, immune checkpoint, and immunopheno score of partial immune checkpoints in the high-risk group were significantly lower than in the low-risk group. Genes with the highest mutation frequencies in the two groups were SPOP, TTN, and TP53. The q-PCR results of the feature genes were consistent with the gene expression results in the database. The 10-gene model based on MTGs could accurately predict the prognosis of PC patients and their responses to immunotherapy.

本研究试图利用线粒体特征基因建立前列腺癌(PC)预后风险模型。筛选出与 PC 相关的 MTGs 进行 Cox 回归分析,然后建立预后模型。通过生存分析和接收者操作特征曲线(ROC)分析了模型的有效性,并在GEO数据集中验证了模型的准确性。将风险评分与临床因素相结合,使用 Cox 分析验证了风险评分的独立性,然后生成了一个提名图。在两个风险组中分析了格里森评分、微卫星不稳定性(MSI)、免疫微环境和肿瘤突变负荷。最后,通过 q-PCR 测试验证了预后特征基因。筛选出10个与PC相关的MTG,并建立了预后模型。生存分析和ROC曲线表明,该模型能很好地预测PC风险。Cox 回归分析显示,风险评分是一个独立的预后因素。高风险组的 Gleason 评分和 MSI 远高于低风险组。高风险组的ESTIMATE评分、免疫评分、基质评分、免疫细胞、免疫功能、免疫检查点和部分免疫检查点的免疫评分水平明显低于低风险组。两组中突变频率最高的基因是 SPOP、TTN 和 TP53。特征基因的 q-PCR 结果与数据库中的基因表达结果一致。基于MTGs的10基因模型可以准确预测PC患者的预后及其对免疫疗法的反应。
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引用次数: 0
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