Tohoku Journal of Experimental Medicine最新文献

Gastrointestinal cancer (GIC) patients with tumor resection may experience surgical complications, economic burden, and weakened social connection, which could lead to adverse psychological status. Thus, this study aimed to explore multidimensional psychological status of these patients, encompassing loneliness, spiritual well-being, anxiety, depression, and attitudes to death. Totally, 210 GIC patients with tumor resection and 50 healthy controls (HCs) were enrolled to complete the University of California Los Angeles loneliness (UCLA-LS), functional assessment of chronic illness therapy-spiritual well-being (FACIT-Sp), hospital anxiety and depression scale-anxiety/depression (HADS-A/D), and death attitude profile-revised (DAP-R) scales. UCLA-LS score was increased (P < 0.001), while FACIT-Sp score was decreased (P < 0.001) in GIC patients than HCs. Additionally, HADS-A score (P < 0.001), anxiety rate (P < 0.001), moderate to severe anxiety rate (P < 0.001), HADS-D score (P < 0.001), depression rate (P < 0.001), and moderate to severe depression rate (P = 0.011) were all elevated in GIC patients versus HCs. Concerning attitude to death, DAP-R scores for fear of death (P < 0.001) and death avoidance (P < 0.001) were increased, and the scores for neutral (P < 0.001) and approach (P = 0.010) acceptance were declined in GIC patients than HCs. Notably, female sex, unmarried status, and drinking history were independently linked with increased UCLA-LS score, but gastric cancer was independently associated with decreased UCLA-LS score (all P < 0.050). Neoadjuvant therapy was independently related to anxiety (P = 0.012). Female sex was independently correlated with depression (P = 0.006). In conclusion, GIC patients with tumor resection experience loneliness, anxiety, depression, and reduced spiritual well-being. They tend to fear and avoid, rather than accept death.

Forkhead box J2 (FOXJ2) induces cell apoptosis and restrains epithelial-mesenchymal transition in lung cancer, but its capability to serve as a prognostic biomarker in non-small cell lung cancer (NSCLC) remains unclear. Hence, this study intended to investigate the association of FOXJ2 with clinical characteristics, disease-free survival (DFS), and overall survival (OS) in NSCLC patients who received surgical resection. Totally, 182 NSCLC patients who received surgical resection were retrospectively enrolled. Their tumor FOXJ2 expression was quantified by immunohistochemistry (IHC). FOXJ2 IHC score = s taining intensity × density, with a total score of 12. FOXJ2 IHC score was 0 in 128 (70.3%) patients and > 0 in the remaining 54 (29.7%) patients; meanwhile, it was ≤ 3 in 157 (86.3%) patients and > 3 in 25 (13.7%) patients. FOXJ2 was negatively related to node (N) stage (P = 0.013) and tumor-nodes-metastasis (TNM) stage (P = 0.034). Intriguingly, FOXJ2 IHC score was reduced in patients with adjuvant chemotherapy than in patients without adjuvant chemotherapy (P = 0.036). The median DFS and OS (95% confidence interval) were 35.0 (31.3-38.7) months and 48.8 (43.7-53.9) months, respectively. Notably, FOXJ2 IHC score > 0 (P = 0.006) and > 3 (P = 0.002) was correlated with prolonged DFS. Also, FOXJ2 IHC score > 0 (P = 0.027) and > 3 (P = 0.028) was associated with longer OS. After adjustment by backward stepwise multivariate model, FOXJ2 IHC score > 3 was independently associated with prolonged DFS (hazard ratio = 0.367, P = 0.009). In conclusion, tumor FOXJ2 negatively links with N stage and TNM stage; moreover, FOXJ2 IHC score > 3 estimates prolonged DFS and OS in NSCLC patients who received surgical resection.

Coronavirus disease 2019 (COVID-19) emerged as viral pandemic in the year 2019 and surgical intervention was forced to be restricted during the pandemic. This study aims to compare the perioperative outcomes of surgeries for acute cholecystitis in the period following the COVID-19 pandemic. A retrospective analysis was conducted on the demographic and perioperative data of 246 cholecystectomy cases performed between June 2017 and November 2022. This analysis focused on comparing patient background and perioperative outcomes before and after the COVID-19 pandemic. As a result, prior to the pandemic, 72 emergency surgeries for acute cholecystitis were performed, compared with 174 cases following the COVID-19 pandemic onset. This increase, particularly in mild and moderate acute cholecystitis cases, led to a significant rise in the proportion of laparoscopic resections and a concurrent decrease in postoperative hospital stays. Our findings suggest a potential increase in acute cholecystitis cases at our hospital coinciding with the COVID-19 pandemic. Early laparoscopic cholecystectomy, when feasible within the medical system's capacity, can be an effective treatment strategy during the pandemic.

Transient receptor potential canonical 1 (TRPC1) facilitates the proliferation, invasion, and metastasis of thyroid cancer cells through up-regulating vascular endothelial growth factor receptor 2 (VEGFR2), while its clinical role in papillary thyroid carcinoma (PTC) is unknown. This study intended to evaluate the prognostic value of TRPC1 and its correlation with VEGFR2 in PTC patients. In this retrospective study, tumor TRPC1 immunohistochemistry (IHC) score was evaluated in 287 PTC patients who underwent surgical resection and 30 thyroid benign lesion (TBL) patients. Moreover, 50 tumor tissue samples from PTC patients were randomly selected for VEGFR2 IHC score evaluation. Our study showed that tumor TRPC1 IHC score was increased in PTC patients versus TBL patients (P = 0.006). Meanwhile, tumor TRPC1 IHC score was related to extrathyroidal invasion (P = 0.028) and pathological node stage 1 (P = 0.011) in PTC patients. Tumor TRPC1 IHC score > 0 was not related to disease-free survival (DFS) or overall survival (OS) (both P > 0.05); however, tumor TRPC1 IHC score > 3 was linked with shortened DFS (P = 0.005) and OS (P = 0.020) in PTC patients. By time-dependent area under curve (AUC) analyses, tumor TRPC1 IHC score showed good values in estimating relapse and death risks over 7 years with all AUCs above 0.7. Furthermore, tumor TRPC1 IHC score > 3 independently predicted shorter DFS (hazard ratio = 2.948, P = 0.045), but not OS (P > 0.05) in PTC patients. Tumor TRPC1 IHC score was positively associated with tumor VEGFR2 IHC score in PTC patients (P = 0.010). Collectively, TRPC1 links with extrathyroidal and lymph node invasion, elevated disease relapse risk, and increased VEGFR2 in PTC patients.

Reminiscence therapy (RT) is an effective psychological intervention to address mental disorders in the elderly; however, it is insufficiently appraised in elderly postoperative cervical cancer patients complicated with anxiety or depression. Hence, this study aimed to explore the effect of RT-engaged care (RTEC) on this population. Totally, 112 elderly postoperative cervical cancer patients with anxiety or depression were enrolled in this single-center, randomized, controlled study, and randomized into RTEC group (N = 56) or usual care group (N = 56) for a 12-week intervention. Evaluations were performed at baseline and the 4 ^th week (W4), 8^th week (W8), and 12^th week (W12) after intervention initiation.Hospital anxiety and depression scale (HADS)-anxiety score at W12 (P = 0.028) as well as HADS-depression score at W8 (P = 0.028) and W12 (P = 0.017) were reduced in RTEC group compared to usual care group. However, the mini-mental state examination score at W4, W8, and W12 was not different between the two groups (all P > 0.050). Concerning quality of life (QoL), EuroQol 5-dimensions score at W12 was reduced in RTEC group than in usual care group (P = 0.010). Both quality of life questionnaire Core 30 (QLQ-C30) global-health-status score and QLQ-C30 function score at W8 and W12 were elevated in RTEC group compared to usual care group (all P < 0.050). Whereas no difference was seen in QLQ-C30 symptom score at these timepoints between the two groups (all P > 0.050). In conclusion, RTEC alleviates psychological burden and improves QoL in elderly postoperative cervical cancer patients with anxiety or depression, while the effect in enhancing cognitive function is not obvious.

This study aimed to assess the diagnostic potential of microRNA-181 (miR-181) family members in oral biofluids, namely saliva and gingival crevicular fluid (GCF), as biomarkers for periodontitis severity. A cohort of 150 patients with periodontitis, including 82 with mild to moderate and 68 with advanced periodontitis, along with 90 healthy controls, were recruited. Analysis of miR-181 family expression using quantitative real-time polymerase chain reaction (qRT-PCR) revealed differential expression levels in oral biofluids among the study groups. Salivary miRNAs, particularly miR-181a, displayed significant discriminatory ability in distinguishing periodontitis patients from healthy controls and between different stages of periodontitis severity, with high sensitivity and moderate to high specificity. In GCF samples, miR-181a and miR-181b exhibited robust discriminatory ability, while miR-181c showed moderate discriminatory ability. Conversely, miR-181d demonstrated lower discriminatory power in both saliva and GCF. Additionally, combination diagnosis using miR-181 family showed superior performance compared to individual miRNAs. Furthermore, enzyme-linked immunosorbent assay (ELISA) analysis of inflammatory biomarkers (TNF-α, IL-6, and IL-1β) in GCF revealed elevated levels in periodontitis patients compared to healthy controls, with a further increase observed in advanced periodontitis. Spearman correlation analysis demonstrated a significant negative correlation between miR-181 family expression in GCF and inflammatory biomarker levels, indicating their potential role in modulating periodontal inflammation. Overall, these findings suggest that miR-181 family members in oral biofluids, particularly saliva, hold promise as diagnostic biomarkers for periodontitis severity. Additionally, their negative correlation with inflammatory biomarkers highlights their potential as modulators of periodontal inflammation, providing valuable insights into the pathogenesis of periodontitis.

The optimal immunosuppressive therapy for elderly patients with ulcerative colitis (UC) remains unclear. We aimed to evaluate clinical practice and prognosis in elderly patients with UC through comparing between those with elderly-onset UC (EOUC) and those with long-standing elderly UC (LEUC). In this retrospective single-center cohort study, we evaluated elderly patients with UC aged ≥ 60 in August 2022 through collecting medical record data from the time of diagnosis of UC until August 2022. The patients were divided into two groups based on age at disease onset: EOUC (age at onset, ≥ 60 years) and LEUC (age at onset, < 60 years). We assessed the cumulative rates of systemic steroid and molecular targeted drug (MTD) initiation, and colectomy. We enrolled 97 eligible patients (EOUC group, n = 30; LEUC group, n = 67). The cumulative rates of initiating systemic steroid (46% vs. 22% at 1 year, respectively; P = 0.002) and MTD (17% vs. 5% at 1 year, respectively; P = 0.002) were higher in the EOUC group than in the LEUC group. In multivariate analysis, elderly onset was significantly associated with systemic steroid (hazard ratio [HR] 2.74, 95% confidence interval [CI] 1.43-5.29; P = 0.003) and MTD (HR 2.76, 95% CI 1.30-5.87; P = 0.008) initiation. Cumulative colectomy rates did not differ significantly between the two groups. Patients with EOUC were initiated on systemic steroids and MTDs sooner following disease onset than patients with LEUC. Our findings suggest rapid progression and refractoriness in patients with EOUC.

An enlarging ground-glass nodule (GGN) in the lungs closely resembles the characteristic appearance of a well differentiated lung adenocarcinoma or adenocarcinoma in situ (AIS). Herein, we present an unusual case characterized by clinical features suggestive of AIS but pathologically confirmed as exhibiting pulmonary alveolar proteinosis (PAP)-like changes. Patients with enlarging pure GGNs warrant consideration for diagnostic and curative surgery. While a considerable proportion of such cases receives a pathological diagnosis of lung malignancy, it is imperative to consider alternative benign conditions in the differential diagnosis, such as PAP-like changes.