Aggressiveness

侵略性
  • 文章类型: Journal Article
    目的:甲状腺乳头状癌(PTC)与桥本甲状腺炎(HT)的相关性存在争议。这项研究的目的是评估HT的存在对PTC的侵袭性施加任何影响,并建立了预测PTC侵袭可能性的列线图。
    方法:对2017年1月至2020年12月373例伴有/不伴有HT的PTC患者进行回顾性分析。收集患者的临床病理和超声特征进行单变量和多变量分析。根据PTC侵袭性的危险因素建立了列线图。
    结果:男性(p=0.001),肿瘤大小>1.0cm(p=0.046)和淋巴结转移(p=0.018)与PTC和HT共存呈负相关,而与多焦频率显著正相关(p=0.010)。单变量和多变量分析表明,年龄≥55岁(p=0.000),男性(p=0.027),HT(p=0.017),肿瘤大小>1.0cm(p=0.015),多焦点(p=0.041),到囊膜的距离≤0cm(p=0.050)和血流量(I级:p=0.044)是预测PTC侵袭性的独立危险因素.进一步开发和验证了根据这些预测因子的列线图。受试者工作特征曲线(培训和验证队列的AUC=0.734和0.809,分别)和决策曲线分析表明,列线图模型在临床上有用。校准曲线表明,列线图表现出优异的一致性。
    结论:在这项研究中,共存的HT可能在预防PTC的增殖中起保护作用。通过术前识别超声和临床特征并结合预测的列线图模型,可以减少PTC中的可分配的积极治疗。
    OBJECTIVE: The association between Papillary Thyroid Carcinoma (PTC) and coexistent Hashimoto\'s Thyroiditis (HT) was controversial. The purpose of this study was to evaluate the presence of HT exerts any influence on the aggressiveness of PTC, and to establish a nomogram for predicting the possibility of aggressiveness in PTC.
    METHODS: 373 consecutive PTC patients with/without coexistent HT from January 2017 to December 2020 were retrospective reviewed. Patients\' clinicopathologic and sonographic characteristics were collected for univariate and multivariate analyses. A nomogram was established based on the risk factors for aggressiveness in PTC.
    RESULTS: Male (p = 0.001), tumor size >1.0 cm (p = 0.046) and lymph node metastasis (p = 0.018) were negatively associated with PTC coexisted with HT, while it was significantly positively associated with the frequence of multifocality (p = 0.010). Univariate and multivariate analyses suggested that age ≥55 years (p = 0.000), male (p = 0.027), HT (p = 0.017), tumor size >1.0 cm (p = 0.015), multifocality (p = 0.041), distance to capsular ≤0 cm (p = 0.050) and blood flow (Grade I: p = 0.044) were independent risk factors for predicting the aggressiveness in PTC. A nomogram according to these predictors was further developed and validated. The receiver operating characteristic curve (AUC = 0.734 and 0.809 for training and validation cohorts, respectively) and decision curve analyses indicated that the nomogram model was clinically useful. The calibration curve revealed that the nomogram exhibited an excellent consistency.
    CONCLUSIONS: In this study, the coexistent HT might play a protective role in preventing the proliferation of PTC. Dispensable aggressive treatment may be reduced in PTC by pre-operative identification of sonographic and clinical characteristics and incorporating with the predicted nomogram model.
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  • 文章类型: Journal Article
    目的:甲状腺癌是一组与代谢功能障碍相关的脂肪肝(MAFLD)密切相关的肝外癌症之一。然而,MAFLD与甲状腺乳头状癌(PTC)特征之间的联系仍未被研究。
    方法:在2020年1月至2022年10月期间,在温州医科大学附属第一医院检查了PTC患者的手术病例。从电子医疗系统中提取的临床数据在两组之间进行了严格的比较,根据MAFLD标准分类,采用Logistic回归分析。
    结果:在这项对4,410名PTC患者的研究中,18.3%患有MAFLD。在该队列中,MAFLD是淋巴结转移的明显危险因素(OR=1.230,95%CI1.018-1.487),尤其是女性(OR=1.321,95%CI1.026-1.702)和BMI≥23kg/m2(OR=1.232,95%CI1.004-1.511)。在FIB-4评分≥1.3(OR=1.968,95%CI1.107-3.496)和BMI<23kg/m2(OR=2.584,95%CI1.012-6.601)的两个亚组中,MAFLD的存在显著增加BRAFV600E突变的风险。此外,在没有非酒精性脂肪性肝病(NAFLD)的人群中,有人指出,MAFLD大大增加了肿瘤多灶性的可能性(OR=1.697,95%CI1.111-2.592)。然而,MAFLD与肿瘤大小增加没有任何相关性,甲状腺外延伸(ETE),或PTC的TNM后期阶段。
    结论:在这项横断面研究中,我们发现MAFLD与淋巴结转移发生率增加之间存在显著关联.此外,MAFLD与BRAFV600E突变的较高机会和某些亚组中多个肿瘤的存在有关。
    OBJECTIVE: Thyroid cancer is one of a set of extrahepatic cancers that closely linked to metabolic dysfunction-associated fatty liver disease (MAFLD). However, the connection between MAFLD and the characteristics of papillary thyroid cancer (PTC) remains unexplored.
    METHODS: Between Jan 2020 and Oct 2022, surgical cases of PTC patients were examined at the first Affiliated Hospital of Wenzhou Medical University. Clinical data extracted from the electronic medical system underwent a rigorous comparison between two groups, classified based on MAFLD criteria, using logistic regression analysis.
    RESULTS: In this study of 4,410 PTC patients, 18.3% had MAFLD. MAFLD emerged as a distinct risk factor for lymph node metastasis (OR = 1.230, 95% CI 1.018-1.487) in this cohort, especially in females (OR = 1.321, 95% CI 1.026-1.702) and those with BMI ≥ 23 kg/m2 (OR = 1.232, 95% CI 1.004-1.511). The presence of MAFLD was found to significantly elevate the risk of BRAF V600E mutation in both subgroups characterized by FIB-4 score ≥ 1.3 (OR = 1.968, 95% CI 1.107-3.496) and BMI < 23 kg/m2 (OR = 2.584, 95% CI 1.012-6.601). Moreover, among the subset of individuals without non-alcoholic fatty liver disease (NAFLD), it was noted that MAFLD considerably increased the likelihood of tumor multifocality (OR = 1.697, 95% CI 1.111-2.592). Nevertheless, MAFLD did not exhibit any correlation with increased tumor size, extra-thyroidal extension (ETE), or later TNM stage in PTC.
    CONCLUSIONS: In this cross-sectional study, we discovered a significant association between MAFLD and increased occurrences of lymph node metastasis. Furthermore, MAFLD was linked to a higher chance of BRAF V600E mutation and the presence of multiple tumors in certain subgroups.
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  • 文章类型: Journal Article
    目前尚不清楚诊断前因素是否会影响结直肠癌(CRC)的发育途径,从而增强肿瘤的侵袭性。这项研究使用了来自205,489名无癌美国卫生专业人员的前瞻性数据,调查了31个已知或推定的危险因素与侵袭性CRC风险的关联。肿瘤侵袭性的特征在于三个终点:侵袭性CRC(在诊断后5年内导致死亡的癌症),致命的CRC,和诊断时的肿瘤分期。数据增强方法用于评估危险因素和终点之间的关联差异。我们记录了3201例CRC病例,其中899是侵略性的。接受低内镜检查的保护性关联(侵略性风险比[HR]0.43,95%置信区间(CI)0.37,0.49,非侵略性风险比HR0.61,95%CI0.56,0.67)和定期使用阿司匹林(HR0.70,95%CI0.61,0.81对HR0.84,95%CI0.77,0.92)比非侵略性CRC更强(泛性<0.05)。较低的全谷类或谷类纤维摄入量和较大的饮食炎症潜能与较高的侵袭性但非侵袭性CRC风险相关。其余风险因素显示与侵袭性CRC和非侵袭性CRC的相关性相当。侵袭性病例更可能具有KRAS突变的肿瘤,但不太可能具有远端或MSI高的肿瘤(p<.007)。对于诊断时的致命性CRC和晚期肿瘤阶段观察到类似的结果。这些发现为诊断前危险因素在侵袭性CRC发病机理中的作用提供了初步证据,并建议了预防性干预的研究重点。
    It remains unclear if pre-diagnostic factors influence the developmental pathways of colorectal cancer (CRC) that could enhance tumor aggressiveness. This study used prospective data from 205,489 cancer-free US health professionals to investigate the associations of 31 known or putative risk factors with the risk of aggressive CRC. Tumor aggressiveness was characterized by three endpoints: aggressive CRC (cancer that causes death within 5 years of diagnosis), fatal CRC, and tumor stage at diagnosis. The data augmentation method was used to assess the difference in the associations between risk factors and endpoints. We documented 3201 CRC cases, of which 899 were aggressive. The protective associations of undergoing lower endoscopy (hazard ratios [HR] 0.43, 95% confidence interval (CI) 0.37, 0.49 for aggressive versus HR 0.61, 95% CI 0.56, 0.67 for non-aggressive) and regular use of aspirin (HR 0.70, 95% CI 0.61, 0.81 versus HR 0.84, 95% CI 0.77, 0.92) were stronger for aggressive than non-aggressive CRC (pHeterogeneity <0.05). Lower intake of whole grains or cereal fiber and greater dietary inflammatory potential were associated with a higher risk of aggressive but not non-aggressive CRC. The remaining risk factors showed comparable associations with aggressive CRC and non-aggressive CRC. Aggressive cases were more likely to have KRAS-mutated tumors but less likely to have distal or MSI-high tumors (p < .007). Similar results were observed for fatal CRC and advanced tumor stages at diagnosis. These findings provide initial evidence for the role of pre-diagnostic risk factors in the pathogenesis of aggressive CRC and suggest research priorities for preventive interventions.
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  • 文章类型: Journal Article
    目的:Gleason评分(GS)和阳性针头是前列腺癌(PCa)的关键侵袭性指标。本研究旨在探讨磁共振成像(MRI)影像组学模型在预测PCa系统活检的GS和阳性针中的有用性。
    方法:回顾性收集来自2个中心的218例经病理证实的PCa患者。选择小视场高分辨率T2加权成像和对比后延迟序列来提取影像组学特征。然后,方差分析和递归特征消除被用来去除冗余特征。基于MRI和各种分类器构建了预测GS和阳性针头的影像组学模型,包括支持向量机,线性判别分析,逻辑回归(LR),和LR使用最小绝对收缩和选择运算符。用受试者工作特性的曲线下面积(AUC)评估模型。
    结果:选择11个特征作为GS预测的主要特征子集,而这5个特征被选择用于阳性针头预测。选择LR作为分类器来构建影像组学模型。对于GS预测,在培训中,影像组学模型的AUC分别为0.811、0.814和0.717,内部验证,和外部验证集,分别。对于阳性针头预测,训练中的AUC分别为0.806、0.811和0.791,内部验证,和外部验证集,分别。
    结论:MRI影像组学模型适用于预测PCa系统活检的GS和阳性针头。该模型可用于使用非侵入性识别侵袭性PCa,可重复,和准确的诊断方法。
    OBJECTIVE: The Gleason score (GS) and positive needles are crucial aggressive indicators of prostate cancer (PCa). This study aimed to investigate the usefulness of magnetic resonance imaging (MRI) radiomics models in predicting GS and positive needles of systematic biopsy in PCa.
    METHODS: A total of 218 patients with pathologically proven PCa were retrospectively recruited from 2 centers. Small-field-of-view high-resolution T2-weighted imaging and post-contrast delayed sequences were selected to extract radiomics features. Then, analysis of variance and recursive feature elimination were applied to remove redundant features. Radiomics models for predicting GS and positive needles were constructed based on MRI and various classifiers, including support vector machine, linear discriminant analysis, logistic regression (LR), and LR using the least absolute shrinkage and selection operator. The models were evaluated with the area under the curve (AUC) of the receiver-operating characteristic.
    RESULTS: The 11 features were chosen as the primary feature subset for the GS prediction, whereas the 5 features were chosen for positive needle prediction. LR was chosen as classifier to construct the radiomics models. For GS prediction, the AUC of the radiomics models was 0.811, 0.814, and 0.717 in the training, internal validation, and external validation sets, respectively. For positive needle prediction, the AUC was 0.806, 0.811, and 0.791 in the training, internal validation, and external validation sets, respectively.
    CONCLUSIONS: MRI radiomics models are suitable for predicting GS and positive needles of systematic biopsy in PCa. The models can be used to identify aggressive PCa using a noninvasive, repeatable, and accurate diagnostic method.
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  • 文章类型: Journal Article
    ANXA2已被广泛记录与癌症有关。然而,ANXA2是否参与肺癌仍不确定.
    使用开放存取方法下载来自癌症基因组图谱(TCGA)数据库的数据。利用R软件进行公开可用数据的检查。使用实时定量PCR(qPCR)检测特定分子的mRNA水平。使用Western印迹测定法检测特定分子的蛋白质水平。使用CCK8测定法评估癌细胞的细胞增殖能力。使用Transwell测定法评估癌细胞的侵袭和迁移能力。使用电子显微镜和粒度分析进行外来体提取的验证。
    在这项研究中,基于系列实验,我们发现ANXA2可以通过外泌体通路促进神经星形胶质细胞CP-H122的活化。此外,我们发现ANXA2可以通过外泌体途径从A549细胞传递到CP-H122,并进一步促进CP-H122的激活。活化的CP-H122细胞进一步增强增殖,A549细胞的侵袭和转移。同时,我们进行了转录组测序以探索ANXA2的下游基因,从而筛选潜在的靶标用于后续研究.基于公开数据的分析表明,ANXA2与肺癌的生存表现和临床特征较差有关。基于Hallmark基因集的基因集富集分析表明,具有高ANXA2表达的患者可能具有更高的顶表面活性,活性氧途径,血管生成,TGF-β信号,MYC目标,但胰腺β细胞的活性较低。更重要的是,我们的结果表明,ANXA2可以影响肺癌的免疫治疗反应和重塑免疫微环境。
    本研究表明ANXA2激活CP-H122细胞,影响A549细胞行为,并影响肺癌预后和免疫治疗反应。
    UNASSIGNED: ANXA2 has been extensively documented in relation to cancer. Nevertheless, the involvement of ANXA2 in lung carcinoma remains uncertain.
    UNASSIGNED: Data from The Cancer Genome Atlas (TCGA) database was downloaded using open-access methods. The examination of publicly available data was conducted utilizing the R software. The mRNA level of specific molecules was detected using Real-time Quantitative PCR (qPCR). The protein level of specific molecules was detected using the Western blot assay. The cell proliferation ability of cancer cells was assessed using the CCK8 assay. The invasion and migration capability of cancer cells was assessed using the Transwell assay. Validation of exosomes extraction was conducted using electron microscopy and particle size analysis.
    UNASSIGNED: In this study, based on series experiments, we found that ANXA2 can promote the activation of neuroastrocytes cells CP-H122 through the exosome pathway. Also, we found that ANXA2 can be transmitted from A549 cells to CP-H122 through the exosomes pathway and further promote the activation of CP-H122. Activated CP-H122 cells further enhance the proliferation, invasion and metastasis of A549 cells. Meanwhile, we performed transcriptome sequencing to explore the downstream genes of ANXA2 to screen potential targets for follow-up studies. Analysis based on public data showed that ANXA2 was related to the worse survival performance and clinical features of lung cancer. Gene set enrichment analysis based on the Hallmark gene set indicated that the patient with high ANXA2 expression might have a higher activity of the apical surface, reactive oxygen species pathway, angiogenesis, TGF-β signaling, MYC target, but lower activity of pancreas-β cells. More important, our results showed that ANXA2 can affects immunotherapy response and reshape immune microenvironment of lung cancer.
    UNASSIGNED: This study demonstrates that ANXA2 activates CP-H122 cells, affects A549 cell behavior, and impacts lung cancer prognosis and immunotherapy response.
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  • 文章类型: Journal Article
    先前的研究表明,马赛人和欧洲人倾向于对马赛人男性面孔的体力和侵略性进行评级。校准到手的握力(HGS)。然而,不同人群对这些面孔吸引力的看法不同。在这项研究中,通过几何形态计量学创造了三个年轻的马赛人变形,并描绘平均样本和两个极值(HGS的±4SD),来自坦桑尼亚的男性和女性进行了评估,捷克共和国,俄罗斯,巴基斯坦,中国,和墨西哥(总样本=1540)。这项研究的目的是测试跨文化差异的感知年轻马赛人的复合材料校准HGS,关注四个特征:体力,吸引力,侵略性,和乐于助人。来自所有六种文化的个体能够区分低,中等,和高HGS肖像。在所有研究人群中,HGS较低的马赛人的肖像被认为不那么有吸引力,更具侵略性,和更少的帮助。这表明来自不同人群的人对基于面部形状的体力有着相似的看法,以及将类似的社交品质,如侵略性和乐于助人归因于这些面部图像。来自所有样本的参与者都将弱小的马赛人的合成图像评为最不吸引人。
    Previous research has demonstrated that Maasai and Europeans tend to align in their ratings of the physical strength and aggressiveness of Maasai male faces, calibrated to hand grip strength (HGS). However, perceptions of attractiveness of these faces differed among populations. In this study, three morphs of young Maasai men created by means of geometric morphometrics, and depicting the average sample and two extrema (± 4 SD of HGS), were assessed by men and women from Tanzania, Czech Republic, Russia, Pakistan, China, and Mexico (total sample = 1540). The aim of this study was to test cross-cultural differences in the perception of young Maasai men\'s composites calibrated to HGS, focusing on four traits: physical strength, attractiveness, aggressiveness, and helpfulness. Individuals from all six cultures were able to distinguish between low, medium, and high HGS portraits. Across all study populations, portrait of Maasai men with lower HGS was perceived as less attractive, more aggressive, and less helpful. This suggests that people from diverse populations share similar perceptions of physical strength based on facial shape, as well as attribute similar social qualities like aggressiveness and helpfulness to these facial images. Participants from all samples rated the composite image of weak Maasai men as the least attractive.
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  • 文章类型: Journal Article
    结外NK/T细胞淋巴瘤(ENKTCL)是一种极具侵袭性的淋巴瘤,缺乏特异性的诊断标志物。该研究旨在揭示白细胞介素-33(IL-33)在ENKTCL中的作用。进行RT-qPCR以评估ENKTCL组织和细胞的mRNA水平,同时进行蛋白质印迹分析以评估蛋白质水平。平板克隆实验和transwell测定法用于测量ENKTCL的侵袭性。进行管形成测定以确定血管生成能力。设计小鼠ENKTCL异种移植模型以探测IL-33在体内的影响。IL-33和致瘤性2受体(ST2,IL-33受体)的抑制在ENKTCL中增强。IL-33抑制抑制活力,迁移,和ENKTCL细胞的侵袭。此外,IL-33敲低限制人脐静脉内皮细胞(HUVECs)的血管生成。此外,Wnt/β-catenin通路相关蛋白(β-catenin,c-myc,和细胞周期蛋白D1)因IL-33的丢失而下调。然而,这些影响被Wnt/β-连环蛋白信号激动剂氯化锂(LiCl)所推翻.此外,IL-33沉默在体内通过Wnt/β-catenin途径发挥抗肿瘤作用。IL-33沉默通过Wnt/β-catenin信号通路抑制ENKTCL肿瘤发生和血管生成。因此,IL-33可能是ENKTCL的一个前瞻性治疗靶点。
    Extranodal NK/T cell lymphoma (ENKTCL) is an extremely aggressive form of lymphoma and lacks of specific diagnostic markers. The study intended to unearth the role of interleukin-33 (IL-33) in ENKTCL. RT-qPCR was conducted to assess mRNA levels of ENKTCL tissues and cells, while western blot assay was performed for evaluating protein levels. Plate cloning experiment and transwell assay were employed to measure aggressiveness of ENKTCL. Tube formation assay was executed to determine the angiogenesis ability. Mice ENKTCL xenograft model was designed to probe the impacts of IL-33 in vivo. IL-33 and suppression of tumorigenicity 2 receptor (ST2, receptor of IL-33) were enhanced in ENKTCL. IL-33 inhibition suppressed viability, migration, and invasion of ENKTCL cells. Moreover, IL-33 knockdown restricted angiogenesis in human umbilical vein endothelial cells (HUVECs). Furthermore, Wnt/β-catenin pathway associated proteins (β-catenin, c-myc, and cyclin D1) were downregulated by loss of IL-33. However, these impacts were overturned by Wnt/β-catenin signaling agonist lithium chloride (LiCl). Additionally, IL-33 silencing exerted anti-tumor effect via Wnt/β-catenin pathway in vivo. Silencing of IL-33 inhibited ENKTCL tumorigenesis and angiogenesis by inactivating Wnt/β-catenin signaling pathway. As such, IL-33 might be a prospective treatment target for ENKTCL.
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  • 文章类型: Retraction of Publication
    在本文发表之后,有关读者提请编辑注意,图中所示的某些Transwell入侵和迁移测定数据。1B和C与不同作者在不同研究机构撰写的其他文章中以不同形式出现的数据惊人地相似,它要么已经出版,要么正在考虑同时出版。由于上述文章中的有争议的数据在提交给分子医学报告之前已经发表,编辑已经决定这篇论文应该从期刊上撤回。作者被要求解释这些担忧,但编辑部没有收到回复。编辑对读者造成的不便表示歉意。[分子医学报告17:4203-4212,2018;DOI:10.3892/mmr.2018.8444]。
    Following the publication of this paper, it was drawn to the Editor\'s attention by a concerned reader that certain of the Transwell invasion and migration assay data shown in Fig. 1B and C were strikingly similar to data appearing in different form in other articles written by different authors at different research institutes, which had either already been published or were under consideration for publication at around the same time. Owing to the fact that the contentious data in the above article had already been published prior to its submission to Molecular Medicine Reports, the Editor has decided that this paper should be retracted from the Journal. The authors were asked for an explanation to account for these concerns, but the Editorial Office did not receive a reply. The Editor apologizes to the readership for any inconvenience caused. [Molecular Medicine Reports 17: 4203‑4212, 2018; DOI: 10.3892/mmr.2018.8444].
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  • 文章类型: English Abstract
    Objective: To analyze the correlation between the histological classification of hepatocellular carcinoma (HCC), especially macrotrabecular-massive (MTM), tumor invasiveness, and prognosis. Methods: The clinical and follow-up data of 246 consecutive HCC cases who met the inclusion criteria from 2015 to 2018 were retrospectively analyzed. They were divided into trabecular/pseudoglandular, trabecular/patchy, and MTM types according to the histological classification. The relationship between each type and related clinicopathological features was analyzed. The Kaplan-Meier method was used to plot tumor-free survival (DFS) and overall survival (OS) curves. Log rank tests, COX univariate, and multivariate regression analyses were conducted to analyze the relationship between clinical features, including histological classification, DFS, and OS. Results: Trabecular/pseudoglandular, trabecular/nodular, and MTM type proportions were 44.7% (110 cases), 32.9% (81 cases), and 22.4% (55 cases), respectively. The results of the clinicopathological features showed that MTM-type HCC was significantly more invasive than the other two types, with alpha-fetoprotein (AFP) ≥400 ng/ml, tumor diameter≥8 cm, no tumor capsule, poor differentiation, and MVI positivity proportions, and the differences were statistically significant (P < 0.05).The proportion of MTM-type HCC patients with American Joint Committee on Cancer TNM Stage III to IV and Chinese Liver Cancer Staging (CNLC) II to II was significantly higher than that of the first two types, and the differences were statistically significant (P < 0.05). In addition, the proportion of MTM subtypes undergoing transcatheter arterial chemoembolization was also raised (P < 0.05). The DFS and OS were significantly lower for MTM-type HCC compared to trabecular/pseudoductal-type HCC at 1-, 3-, and 5-years, and the differences were statistically significant (P < 0.05). Univariate analysis indicated that strongly invasive clinical pathological features such as alpha fetoprotein (AFP) ≥400 ng/ml, tumor diameter ≥ 8 cm, no tumor capsule, poor differentiation, positive microvascular invasion, tumor stage, and MTM staging were all risk factors affecting DFS and OS (P < 0.05). Multivariate COX analysis showed that MTM histological staging, AFP ≥ 400 ng/ml, tumor non-encapsulation, satellite nodules, CNLC stages II~III, and TNM stages III~IV were independent risk factors for DFS (P < 0.05), while AFP ≥ 400 ng/ml, tumor non-encapsulation, and CNLC stage II~III were independent risk factors for OS ( P < 0.05). Conclusion: Histological classification is highly correlated with tumor invasiveness and HCC prognosis. Trabecular/pseudoglandular types have lower malignancy and a better prognosis, while MTM types exhibit strong invasive features and a poor prognosis.
    目的: 分析肝细胞癌(HCC)组织学分型,特别是粗梁实体(MTM)型与肿瘤侵袭性及预后的相关性。 方法: 回顾性分析2015至2018年符合纳入标准连续246例HCC患者的临床和随访资料,依据组织学分型分为细梁/假腺管型、粗梁/团片型、MTM型,分析各型与相关临床病理特征关系,Kaplan-Meier法绘制无瘤生存率(DFS)和总生存率(OS)曲线并行Log-rank检验,COX单因素及多因素回归分析包括组织学分型在内的临床特征与DFS和OS关系。 结果: 细梁/假腺管型、粗梁/团片型、MTM型比例分别为44.7%(110例)、32.9%(81例)和22.4%(55例)。结果显示,MTM型HCC中提示高侵袭性的临床病理特征甲胎蛋白(AFP) ≥ 400 ng/ml、肿瘤直径≥ 8 cm、无肿瘤包膜、分化差、微血管侵犯(MVI)阳性比例显著高于其他2种类型,差异均有统计学意义(P值均< 0.05)。MTM型HCC TNM III~IV期和中国肝癌分期(CNLC)II~II期患者的比例显著也高于其他2种类型,差异均有统计学意义(P值均< 0.05),且MTM亚型行经导管动脉化疗栓塞术比例也较高(P < 0.05)。MTM型HCC的1、3、5年DFS和OS显著低于细梁/假腺管型HCC的1、3、5年DFS和OS,差异均有统计学意义(P值均< 0.05)。单因素分析提示高侵袭性的临床病理特征甲胎蛋白(AFP) ≥ 400 ng/ml、肿瘤直径≥ 8 cm、无肿瘤包膜、分化差、微血管侵犯阳性、肿瘤分期和MTM分型均是影响DFS和OS的危险因素(P值均< 0.05)。多因素COX分析显示MTM组织学分型、AFP ≥ 400 ng/ml、肿瘤无包膜、卫星灶、CNLC II~III期及TNM III~IV期是DFS的独立危险因素(P值均< 0.05);而AFP ≥ 400 ng/ml、肿瘤无包膜和CNLC II~III期是OS的独立危险因素(P值均< 0.05)。 结论: 组织学分型与HCC肿瘤侵袭性和预后高度相关,细梁/假腺管型恶性程度较低,预后较好,而MTM型则表现出强侵袭性特征,预后不良。.
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  • 文章类型: Randomized Controlled Trial
    目的:根据术前计算机断层扫描(CT)特征开发列线图以预测无功能胰腺神经内分泌肿瘤(NF-pNETs)的侵袭性。
    方法:本研究包括176例接受NF-pNETs根治性切除术的患者。这些患者被随机分为训练集(n=123)和验证集(n=53)。根据单变量和多变量逻辑回归分析确定的NF-pNETs侵袭性的术前预测因子,得出列线图。NF-pNETs的侵袭性被定义为包括G3分级的复合措施,N+,远处转移,和/或疾病复发。
    结果:总之,在训练和验证集中,具有高侵袭性NF-pNETs的患者人数分别为37(30.08%)和15(28.30%),分别。多变量逻辑回归分析确定肿瘤大小,胆胰管扩张,淋巴结病,和增强模式是术前侵袭性的预测因子。这些变量用于开发具有0.89和0.86的良好一致性统计的列线图,用于预测训练和验证集中的攻击性。分别。列线图得分为59分,将NF-pNETs患者分为低侵袭性组和高侵袭性组。高侵袭性组的总生存期(OS)和无病生存期(DFS)降低。此外,列线图在预测3年、5年和10年的OS和DFS方面表现良好。
    结论:结合CT特征的列线图有助于术前预测NF-pNETs的侵袭性,并可能促进临床决策。
    OBJECTIVE: To develop a nomogram to predict the aggressiveness of non-functional pancreatic neuroendocrine tumors (NF-pNETs) based on preoperative computed tomography (CT) features.
    METHODS: This study included 176 patients undergoing radical resection for NF-pNETs. These patients were randomly divided into the training (n = 123) and validation sets (n = 53). A nomogram was developed based on preoperative predictors of aggressiveness of the NF-pNETs which were identified by univariable and multivariable logistic regression analysis. The aggressiveness of NF-pNETs was defined as a composite measure including G3 grading, N+, distant metastases, and/ or disease recurrence.
    RESULTS: Altogether, the number of patients with highly aggressive NF-pNETs was 37 (30.08 %) and 15 (28.30 %) in the training and validation sets, respectively. Multivariable logistic regression analysis identified that tumor size, biliopancreatic duct dilatation, lymphadenopathy, and enhancement pattern were preoperative predictors of aggressiveness. Those variables were used to develop a nomogram with good concordance statistics of 0.89 and 0.86 for predicting aggressiveness in the training and validation sets, respectively. With a nomogram score of 59, patients with NF-pNETs were divided into low-aggressive and high-aggressive groups. The high-aggressive group had decreased overall survival (OS) and disease-free survival (DFS). Moreover, the nomogram showed good performance in predicting OS and DFS at 3, 5, and 10 years.
    CONCLUSIONS: The nomogram integrating CT features helped preoperatively predict the aggressiveness of NF-pNETs and could potentially facilitate clinical decision-making.
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