Cancer Management and Research最新文献

Introduction: The development and progression of Hepatocellular Carcinoma (HCC) is more relevant to immune regulation. Therefore, there is an urgent need to find immune-related molecular markers that can predict the prognosis and immune status of HCC.

Methods: RNA-seq and clinical HCC data from the Cancer Genome Atlas (TCGA) were analyzed for differential expression of microRNA (miRNAs), mRNAs, and lncRNAs. MiRNAs associated with immune scores were identified by Spearman analysis and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment. MiRNAs and mRNAs were screened for prognosticity using COX regression. Kaplan-Meier survival analysis, risk scores, and correlation with clinical features were performed. Immune infiltration, Tumor Immune Dysfunction and Exclusion (TIDE), and chemotherapy prediction analyses were performed for high and low risk groups. Finally, prognostic mRNA expression was validated in cell lines.

Results: Five prognostic miRNAs (hsa-miR-145-3p, hsa-miR-150-3p, hsa-miR-153-3p, hsa-miR-223-3p, hsa-miR-424-3p) were identified in the study. A risk score model based on these prognostic miRNAs accurately predicted overall survival and was validated in GSE31384. Six mRNAs (KCTD17, MAFG, RAB10, SFPQ, TRMT6, UBE2D2) were further identified as prognostic. A risk model including these mRNAs also accurately predicted overall survival, and higher risk scores were associated with lower survival. Univariate and multivariate Cox regression analyses confirmed that both miRNA and mRNA risk scores were independent prognostic factors. The TIDE results showed lower TIDE scores and T-cell exclusion scores in the low risk score group. Chemotherapeutic drug sensitivity analysis revealed that the high-risk group was more sensitive to multiple chemotherapeutic agents. In addition, real-time quantitative PCR (RT-qPCR) results of the cell lines supported the results of the public database analysis.

Conclusion: This study validated immune-related prognostic miRNAs and mRNAs and identified risk signatures for HCC, potentially advancing HCC prognosis and treatment.

Intestinal flora is a complex micro-ecosystem in human body, which is called the second genome of human body. Intestinal flora imbalance plays an important role in the occurrence and development of gastric cancer through circulation, metabolism and immunity. Gastric cancer is associated with dysbacteriosis. Traditional Chinese medicine (TCM) compounds in Buyang Yiwei Decoction can reduce the clinical signs and symptoms of gastric cancer by regulating intestinal microbiota, alleviate the adverse reactions of gastric cancer after radiotherapy and chemotherapy, and improve the quality of life of patients. This article reviews whether Buyang Yiwei Decoction can reduce the risk of gastric cancer or play a therapeutic role in gastric cancer by improving the intestinal microbiota.

Bronchopleural Fistula (BPF) represents one of the gravest complications post-lobectomy. Present treatment strategies encompass a wide array of surgical techniques complemented by essential adjunct therapies. Despite numerous treatment modalities, mortality rates associated with BPF remain disconcertingly high. Advances in bronchoscopic technology have led to the widespread adoption of bronchoscopic interventions, celebrated for their safety, minimal invasiveness, and efficacy. The cornerstone of BPF management involves the use of sealants, metal-covered stents, and occlusion devices, with the success of these occlusions critically dependent on the fistula's dimensions. Particularly for expansive BPFs deemed inappropriate for surgical intervention, metal-covered stents and occlusion devices are frequently favored. This review critically assesses the therapeutic efficacy and clinical utility of metal-covered stents and occlusion devices through a comprehensive analysis of the extant literature. Additionally, it outlines risk stratification and management strategies for BPF, with the intent to furnish novel insights and methodologies for the clinical diagnosis and treatment of this complex condition.

Purpose: This study aimed to develop and validate clinical nomograms for predicting progression-free survival (PFS) and overall survival (OS) in unresectable ICC patients.

Patients and methods: Patients with ICC between 1 January 2018 and 31 May 2023 were selected and randomized into a training set and an internal validation set as a 7:3 ratio. Data analysis and modeling were conducted through R software. The univariate and multivariate Cox regression models were used to analyze the prognosis factors affecting OS and PFS. Survival analysis was conducted using the Kaplan-Meier (KM) method, and comparisons were made using the Log rank test. Then, two nomogram models were constructed to predict OS and PFS, respectively. The nomogram was evaluated and calibrated using the Harrell's C-index, receiver operating characteristic curve (ROC), and calibration plots, and the decision curve analysis (DCA) was conducted to assess its clinical utility.

Results: A total of 110 patients were enrolled in this study, with 77 to the training set and 33 to the validation set. In the entire population, the OS rates at 6 and 12 months were 75.5% and 35.5%, respectively, while the PFS rates at 6 and 12 months were 47.3% and 20%, respectively. Cox regression analyses showed that ECOG, Tumor volume, HBsAg and AFP were the prognosis factors of OS, and the predictors in the model of PFS included Gender, Stage of tumor, CDC20 expression and AFP. The nomograms were constructed based on the predictors above. The C-index for predicting OS was 0.802 (0.755, 0.849) in the training set, 0.813 (0.764, 0.862) in the internal validation set; the C-index for predicting PFS was 0.658 (0.568, 0.748) in the training set, and 0.795 (0.705, 0.885) in the internal validation set. Finally, calibration curves and DCA indicated that two nomograms showed favorable performance.

Conclusion: Two practical and effective prognostic nomograms were developed to assist clinicians in evaluating OS and PFS in patients with unresectable ICC.

Purpose: To investigate the local recurrence rate, joint preservation status, and functional outcomes after extended curettage and postoperative denosumab treatment for Campanacci Grade III giant cell tumors of the extremities.

Methods: We retrospectively reviewed 23 patients with Campanacci Grade III GCTB of the extremities in our hospital between January 2017 and June 2023 who underwent extended curettage and postoperative denosumab administration alone, without preoperative denosumab treatment. Patients were followed-up for adverse events of denosumab, surgical outcomes, limb function of lesions, and local recurrence following extended curettage with postoperative denosumab.

Results: All incisions healed without deep infections or internal fixation failure. The mean age of the patients at surgery was 36.6 years, and the mean follow-up was 35.8 months (range, 6-72 months). There of the 3 patients experienced a postoperative local recurrence. The recurrence rate was found to be 13.0%. Two patients were treated with repeat intralesional surgery with no additional recurrence two years later, and the other was treated with en bloc resection and reconstruction with a vascularized fibular graft. One patient experienced knee osteoarthritis without oral analgesics. No patient developed pulmonary metastases or malignant transformation of the GCTB. The mean Musculoskeletal Tumor Society functional score at the last follow up was 27.3 30 (range, 25-29). No serious adverse events were observed after the denosumab treatment.

Conclusion: Our observations suggest that extended curettage with postoperative denosumab administration is a reasonable option for treating Campanacci Grade III giant cell tumors of the extremities. Extended curettage with adjuvant denosumab therapy results in beneficial surgical downstaging, including a less morbid surgical procedure or delayed en bloc resection. Resection should be considered when the structural integrity cannot be regained after bone grafting or bone cement filling combined with internal fixation.

Background: Tumor-specific antigens play an important role in dendritic cell (DC)-based immunotherapy. The acquisition of tumor-specific antigens, which are essential for DC-based immunotherapy, poses a significant challenge. This study aimed to explore the efficacy of hypoxia inducible factor-1α (HIF-1α) overexpression tumor antigens in DC-based immunotherapy.

Methods: An HIF-1α over-expression cell line was constructed to prepare HIF-1α overexpression tumor antigens. The expression of CD14, CD40, CD80, CD86, and HLA-DR on the surface of dendritic cells derived from monocytes was assessed using flow cytometry after stimulation with tumor antigens enriched in HIF-1α. T cell proliferation was analyzed by CFSE division following incubation with mature DCs. The apoptotic tumor cells were detected through annexin V/PI staining following coculture with dendritic cells (DCs) stimulated by HIF-1α enriched antigens. The detection of damage-associated molecular pattern molecules (DAMPs) HMGB1 and calreticulin (CALR) was performed using Western blotting.

Results: The results demonstrated that HIF-1α-enriched tumor antigens significantly upregulated the expression of CD40, CD80, CD86, and HLA-DR in DCs compared to normal tumor antigens. Furthermore, co-incubation with HIF-1α-enriched tumor antigen-activated DCs enhanced T cell proliferation and stimulated the T cell-mediated cytotoxicity. Notably, the expression of DAMPs, such as HMGB1 and CALR, was elevated in HIF-1α-enriched tumor antigens.

Conclusion: Our findings demonstrate that tumor antigens enriched with HIF-1α may encompass tumor-specific antigens capable of stimulating DC activation, thereby enhancing T cell proliferation and cytotoxicity. These results provide support for the further advancement of HIF-1α enriched tumor antigens in preclinical and clinical investigations pertaining to tumor treatment.

Objective: Myeloid leukemia is a stem cell disease with high mortality due to the challenges of high-dose treatments and side effects. Innovative nanoparticle drug delivery systems are being explored to enhance efficacy and tissue-targeted therapy. This study investigates the potential of Bentonite (BNT)-based nanoparticles (NPs) as drug carriers for azacitidine (AZA) in treating THP-1 and K562 myeloid leukemia (AML) cell lines, aiming to improve drug stability, bioavailability, and therapeutic efficacy while ensuring controlled release.

Material and method: Bentonite clay morphology was analyzed using Scanning Electron Microscopes. The BNT-AZA combination was tested in THP-1 and K562 cell cultures via in vitro proliferation tests, CCK-8 assays, and drug release tests with dialysis membranes. Apoptosis and internalization were evaluated using Annexin V-FITC and fluorescence methods, respectively.

Results: The BNT-AZA exhibited controlled release over 8 hours, with 50% released within 2 hours, 90% by the 4th hour, and prolonged release beyond 8 hours. This profile reduces side effects while increasing efficacy in target cells. Bentonite demonstrated significant drug-loading capacity, controlled release, and tumor-targeting capabilities. At concentrations of 10, 25, 50, and 100 µg/mL, BNT showed dose-dependent antiproliferative effects, maintaining low cytotoxicity at lower concentrations. The combination of azacytidine and bentonite exhibited a synergistic effect in inhibiting cell proliferation, with significant decreases in cell viability in the 1 µM azacytidine + 10 µg/mL bentonite, 5 µM azacytidine + 10 µg/mL bentonite, and 10 µM azacytidine + 10 µg/mL bentonite groups compared to the controls. The combination of 1 µM AZA with 10 µg/mL BNT achieved similar efficacy to 10 µM AZA alone, suggesting a potential for dose reduction and improved safety.

Conclusion: BNT nanoparticles are promising carriers for AZA, enhancing targeted delivery, reducing side effects, and potentially lowering the required dose for leukemia treatment. These findings support further investigation into the clinical application of BNT-AZA in hematologic cancers.

Background: Oncoplastic breast-conserving surgery (OBCS) has emerged as a pivotal approach in the management of breast cancer, ensuring both oncological safety and aesthetic outcomes. However, challenges persist, particularly in upper inner quadrant (UIQ) tumors, where achieving satisfactory cosmetic results while preserving oncological integrity remains intricate.

Methods: 15 patients with UIQ breast cancer received OBCS using a pedicled pectoralis major myofascial flap (PMMF). All medical records, preoperative imaging findings, and post-operative data were gathered retrospectively.

Results: This study showed good cosmetic outcomes after OBCS of the upper inner pole and the patients were satisfied with the results. There were no recurrences or metastases in any of the patients.

Conclusion: PMMF as a technique is reliable blood supply, easy to master, no need for additional incision, and minimal surgical trauma and functional impact.

Introduction: Sebaceous carcinoma (SC) is a rare malignancy and can be divided into two types, ocular and extra-ocular SC. Extra-ocular SC is typically associated with a better prognosis than ocular SC. However, extra-ocular SCs located in atypical areas, such as the inguinal region, along with multiple metastases, are uncommon and present significant challenges, often leading to poorer outcomes.

Case description: We present the case of a 68-year-old male patient who initially presented with a mass in the right inguinal region with multiple metastasis. A PET-CT scan revealed multiple enlarged lymph nodes and soft tissue masses in the abdominal and pelvic cavities. A biopsy confirmed the diagnosis of extra-ocular SC. Unfortunately, the disease progressed rapidly, and the patient succumbed to his illness just four months after diagnosis.

Conclusion: This case highlights the aggressive nature of extra-ocular SC in unusual locations, underscoring the necessity for heightened awareness and further research on this rare condition. Our findings contribute to a better understanding of extra-ocular SC and emphasize the urgent need for more investigation into optimal management strategies.

Purpose: Lung cancer is a severe malignant tumor. This study aims to more comprehensively characterize lung cancer patients and identify combination markers for immunotherapy.

Patients and methods: We gathered data from 166 lung cancer patients at the Cancer Hospital Affiliated with Xinjiang Medical University. The collected samples underwent NGS sequencing using a panel of 616 genes associated with cancer. Subsequently, data analysis was conducted to identify markers that are more suitable for lung cancer immunotherapy.

Results: In this study, the most common variant genes in LUAD were TP53, EGFR, MST1, KMT2C, RBM10, LRP1B. Meanwhile, the highest mutation frequency genes in LUSC samples were TP53, KMT2D, LRP1B, FAT1, MST1, KMT2C. Mutation frequencies, tumor mutation burden (TMB), PD-L1 expression, and mutant-allele tumor heterogeneity (MATH) values differed between LUAD and LUSC, with LUSC exhibiting higher values than LUAD. Irrespective of LUAD or LUSC, patients with TMB≥10 demonstrated better immunotherapy efficacy compared to patients with TMB<10. Similarly, when PD-L1≥50%, whether in LUAD or LUSC, the immunotherapy effect was superior to that of patients with PD-L1<50%. Combining TMB≥10 and PD-L1≥50% as immunotherapy markers, in both LUAD and LUSC, resulted in a very favorable immunotherapy effect, with the overall response rate (ORR) reaching 100%.

Conclusion: We observed distinct mutation patterns and clinical factors between LUAD and LUSC, and noted that patients with TMB≥10 and PD-L1≥50% exhibited enhanced immunotherapy effects. Combining TMB≥10 and PD-L1≥50% proved to be a more effective predictor of immunotherapy efficacy.