World Journal of Surgical Oncology最新文献

Aims: To investigate the expression and potential mechanism of action of miR-146b-5p in prostate cancer (PCa).

Methods: Quantification of miR-146b-5p and FOXO3 expression by RT-qPCR was performed on 140 paired PCa and normal adjacent tissues. Kaplan-Meier curves and Cox regression models were used to analyze the relationship between miR-146b-5p expression and 5-year survival outcomes. In vitro experiments were performed in PC-3 and 22RV1 cells to explore the regulatory relationship between miR-146b-5p and FOXO3.

Results: miR-146b-5p is markedly upregulated in PCa tissues and cell lines, exhibiting a significant correlation with tumor stage, Gleason score, lymph node metastasis, and unfavorable prognosis. miR-146b-5p overexpression promoted PCa cell proliferation, migration, and invasion, while inhibition exerted opposite effects. Bioinformatics prediction and dual-luciferase assay confirmed that miR-146b-5p directly targeted the 3'UTR of FOXO3, negatively regulating its expression. Rescue experiments demonstrated that silencing FOXO3 reversed the inhibitory effects of miR-146b-5p inhibitor on PCa cell malignancy.

Conclusions: miR-146b-5p drives PCa progression through the targeted downregulation of FOXO3, implicating it as a promising prognostic marker and therapeutic target.

Background: Transarterial chemoembolization (TACE) is a primary treatment for hepatocellular carcinoma (HCC). Despite its benefits, not all patients experience prolonged survival. Hence, this study aimed to develop a prognostic model using data from HCC patients who underwent TACE.

Methods: This study collected patients with hepatocellular carcinoma who received TACE treatment in the Second Hospital of Dalian Medical University from September 2014 to September 2024 and randomly divided them into the training set and the validation set in a 7:3 ratio. Meanwhile, the data of patients who received TACE treatment at Zhongshan Hospital Affiliated to Dalian University from September 2021 to September 2024 were collected for external validation. Univariable and multivariable Cox analyses in the training cohort identified independent risk factors. Based on these factors, two predictive models were established via Cox regression and random survival forest (RSF). The predictive accuracy of models was appraised using the concordance index (C-index) and the area under the receiver operating characteristic curve (AUC). The calibration of models was assessed via calibration curves.

Results: This study collected clinical data from 815 HCC patients receiving TACE. Independent risk factors included tumor size, TNM stage, serum alpha-fetoprotein, TACE therapy count, and post-treatment direct bilirubin, lactate dehydrogenase, and gamma-glutamyl transferase levels. In the RSF model, AUCs for predicting 1-, 3-, and 5-year OS 0.88 (95% CI: 0.81-0.94), 0.80 (95% CI: 0.74-0.86), and 0.75 (95% CI: 0.67-0.81) in the internal validation cohort, and 0.87(95%CI:0.76,0.98), 0.91(95%CI:0.85,0.97) and 0.89(95%CI:0.82,0.96) in the external validation cohort. The Cox regression model yielded AUCs for OS at 1, 3, and 5 years of 0.92 (95% CI: 0.87-0.96), 0.83 (95% CI: 0.76-0.89), and 0.81 (95% CI: 0.74-0.88) in the internal validation cohort, and 0.86(95%CI:0.75,0.97), 0.89(95%CI:0.82,0.96)and 0.90(95%CI:0.81,0.99) in the external validation cohort. Given its superior AUC and C-index, a more interpretable survival nomogram was built using the Cox model.

Conclusions: The prognostic nomogram, constructed based on routine, interpretable clinical features in this study, may help estimate the risk of death in TACE-treated HCC patients. This tool may provide a crucial reference for decision-making in follow-up treatment and rehabilitation.

Trial registration: Not applicable.

Objectives: The aim of this study was to investigate the impact of interleukin-27 (IL- 27) gene polymorphism and additional interactions with environmental factors on non-small cell lung cancer (NSCLC) risk based on a Chinese population.

Methods: SNPStats online software (http://bioinfo.iconcologia.net/SNPstats) was used for Hardy-Weinberg equilibrium (HWE) testing. Stratified analysis was performed by logistic regression model to examine the impact of IL- 27 gene SNPs and environmental factors, and additional gene-environment interaction on NSCLC risk.

Results: Logistic regression analysis showed a significant association between rs153109, rs181206 and increased NSCLC risk. However, no significant relationship was found between NSCLC risk and rs17855750 or rs40837 genotype with minor allele. Logistic regression also indicated a significant association between smoking status or alcohol consumption and NSCLC risk in this study. We performed crossover analysis to investigate the interaction between two SNPs (rs153109 and rs181206) and two environmental factors (smoking status and alcohol consumption) using logistic regression. We found that ever or current smokers with rs153109- AG or GG genotype have the highest NSCLC risk, compared with never smokers with the AA genotype after covariate adjustment, OR (95%CI) = 3.02 (1.97-5.12), p = 0.012. However, no significant interaction effect was found between rs153109 and alcohol consumption, rs181206 and smoking, rs181206 and alcohol consumption.

Conclusion: Our results support an important association of the IL- 27 gene rs153109, rs181206, smoking and alcohol consumption with increased NSCLC risk. We also found a significant impact of an interaction between rs153109 minor allele and ever or current smoking on NSCLC risk.

Background: Gastric cancer remains a significant global health challenge. Surgical resection continues to be the cornerstone of treatment, but traditional gastrectomy is often associated with negative impacts on nutritional status and quality of life. Function-preserving surgical techniques, widely adopted in East Asian countries due to early cancer detection, have shown promise in improving postoperative outcomes. In contrast, Western guidelines have yet to integrate these procedures into routine practice.

Main body: Function-preserving surgeries, including pylorus-preserving gastrectomy and proximal gastrectomy, aim to maintain gastric function while ensuring oncological safety. These procedures are primarily indicated for early gastric cancers and have demonstrated comparable survival outcomes to standard resections in well-selected patients. Endoscopic resections and segmental gastrectomy represent additional function-sparing options under investigation. The main functional complications, such as gastric stasis or reflux esophagitis, have prompted the development of various reconstructive techniques, including double-tract methods, jejunal interposition, and pouch reconstructions. Despite their proven benefits in Eastern countries, the implementation of these surgeries in Western settings is limited. Challenges include the lower incidence of early gastric cancer, lack of surgeon experience, and absence of guideline endorsement. However, increased centralization of care, enhanced diagnostic accuracy, and growing emphasis on patient-reported outcomes have reignited interest in adapting these strategies for Western populations. Additionally, emerging evidence suggests that even patients with more advanced disease may benefit from improved short-term functional outcomes, potentially aiding in faster recovery and return to adjuvant therapies.

Conclusion: Function-preserving surgery in gastric cancer offers oncologically safe alternatives that may significantly improve postoperative quality of life and nutritional outcomes. As global treatment paradigms evolve, adapting these techniques in the West, particularly within high-volume centers, could represent a significant step forward. Further randomized trials and Western-centric data are essential to validate the broader applicability of these procedures and refine patient selection criteria.

The infrapyloric lymph nodes (LNs) are defined as No. 6 LNs and as one of the regional gastric LNs in the Japanese classification of gastric carcinoma. No. 6 LNs are recommended to be dissected completely even in D1 lymphadenectomy for distal and total gastrectomy in the Japanese Gastric Cancer Treatment Guideline. Omento-bursectomy, whose survival advantage for advanced gastric cancer patients was not shown by the Japanese Clinical Oncology Group 1001 trial, has been proposed to be a useful technique for safe and secure dissection of No. 6 LNs in gastric cancer surgery. In the present review, we first discuss the reason why omento-bursectomy is considered to be a useful technique for dissection of No. 6 LNs, reframing the gastric LNs as a parapancreatic lymph chain based on the dorsal pancreas, mesogastrium, and mesoduodenum embryology. Second, we introduce the outermost layer-oriented dissection (OLD) of No. 6 LNs in performing an omentum-preserving gastrectomy (OPG) devised at Fujita Health University and their favorable outcomes. Last, we discuss the reason why the incidence of postoperative pancreatic fistula in laparoscopic distal gastrectomy is significantly higher than open gastrectomy for stage Ⅰ gastric cancer patients, for whom the OPG is likely performed, in a retrospective cohort study based on the Japanese National Clinical Database. Although single-institution retrospective clinical studies are referenced in this review, it is considered that reframing the gastric LNs as a parapancreatic lymph chain based on the embryology can enhance safe No.6 LNs dissection in the various types of gastric cancer surgery.