Biochemical recurrence

生化复发
  • 文章类型: Journal Article
    背景:由于前列腺癌(PCa)的异质性,传统上,临床指标无法满足个性化医疗的要求。RNA修饰的领域已经成为一个越来越相关的领域,阐明其在肿瘤异质性中的关键作用。然而,RNA修饰调节因子在PCa中的具体作用仍未被研究.
    方法:在本研究中,我们进行了文献综述,总结了常见的8种RNA修饰类型(ac4c,AI,APA,m1A,m5c,M6A,m7G,Φ)涵盖总共84个监管机构。此外,我们将多中心队列与Ridge回归进行整合,以建立调节因子共表达评分(RMCCoeS).然后,我们评估了RMSCoeS在几个临床方面的作用,如生化复发(BCR),对化疗的反应,雄激素受体信号传导抑制剂(ARSI)治疗和免疫治疗PCa。最后,我们通过免疫组织化学和体外试验验证了5种hub基因的促癌性能.
    结果:在RNA修饰调节因子的突变景观中,我们观察到总体突变率相对较低.值得注意的是,RMCCoeS,包含81个RNA修饰调节因子,在接受BCR的PCa患者中表现出准确预测预后和治疗反应的显着能力,化疗,ARSI治疗,和免疫疗法。高RMSCoeS表明预后不良和不利的治疗反应。功能富集分析揭示了RMCCoeS可能通过各种代谢途径对PCa的进展产生影响。此外,较高的RMSCoeS与CNV突变升高呈正相关.最后,我们验证了CPSF4,WBSCR22,RPUSD3,TRMT61A,和NSUN5-五个中心监管机构-在PCa的背景下。
    结论:不同RNA修饰的功能是相互关联的。包含八个不同的RNA修饰调节因子,RMCCoeS在PCa的各个方面表现出多方面的作用,包括疾病进展,预后,以及对多种疗法的反应。此外,我们提供了PCa中与WBSCR22、RPUSD3、TRMT61A和NSUN5相关的癌基因效应的初步验证。我们的发现为RNA修饰在PCa个性化医疗中的意义提供了新的见解。
    BACKGROUND: Owing to the heterogeneity of prostate cancer (PCa), the clinical indicators traditionally fall short of meeting the requirements for personalized medicine. The realm of RNA modification has emerged as an increasingly relevant domain, shedding light on its pivotal role in tumor heterogeneity. However, the specific contributions of RNA modification regulators within the context of PCa remain largely unexplored.
    METHODS: In this study, we undertook a literature review to summarize the common 8 types of RNA modifications (ac4c, AI, APA, m1A, m5c, m6A, m7G, Ψ) encompassing a total of 84 regulators. Moreover, we integrated multi-center cohorts with Ridge regression to develop the Regulators\' Co-Expression Score (RMRCoeS). Then we assessed the role of RMRCoeS in several clinical aspects such as biochemical recurrence (BCR), responses to chemotherapy, androgen receptor signaling inhibitor (ARSI) therapy and immunotherapy in PCa. Finally, we validated the cancer-promoting performance of five hub genes through immunohistochemistry and in vitro assays.
    RESULTS: Within the mutation landscape of RNA modification regulators, we observed a relatively low overall mutation rate. Remarkably, RMRCoeS, comprising 81 RNA modification regulators, exhibited a notable capability for accurately predicting the prognosis and therapeutic responses in PCa patients subjected to BCR, chemotherapy, ARSI therapy, and immunotherapy. A high RMRCoeS was indicative of a poor prognosis and unfavorable therapy responses. Functional enrichment analysis unveiled that RMRCoeS may exert its influence on PCa progression through various metabolic pathways. Furthermore, a higher RMRCoeS showed a positive correlation with elevated CNV mutations. Lastly, we validated the oncogene effects of CPSF4, WBSCR22, RPUSD3, TRMT61A, and NSUN5-five hub regulators-within the context of PCa.
    CONCLUSIONS: The function of different RNA modifications is interconnected. Comprising eight distinct RNA modifications\' regulators, RMRCoeS exhibits multifaceted roles in various aspects of PCa, including disease progression, prognosis, and responses to multiple therapies. Furthermore, we provide the initial validation of the oncogene effect associated with WBSCR22, RPUSD3, TRMT61A and NSUN5 in PCa. Our findings offer novel insights into the significance of RNA modifications in PCa personalized medicine.
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  • 文章类型: Journal Article
    目的:多氯联苯(PCBs)引起了极大的环境关注。该研究旨在探讨PCBs暴露与前列腺癌(PCa)之间的潜在分子机制。
    方法:通过CTD来研究多氯联苯暴露与前列腺癌之间的关系,TCGA,和GEO数据集。进行了基因本体论(GO)和京都基因和基因组百科全书(KEGG)富集分析,以探索与多氯联苯相关基因(PRG)相关的途径。使用Lasso回归分析,建立了一种新的多氯联苯相关预后模型.进行内部和外部验证以评估模型的有效性。分子对接用于评估多氯联苯与关键基因的结合能力。最后,进行了初步的实验验证,以证实Aroclor1254在PCa细胞中的生物学作用。
    结果:对PRG的GO富集分析表明,生物过程在从RNA聚合酶II启动子的转录调控和信号转导中最为富集。KEGG富集分析显示,在癌症中的通路是最显著富集的。接下来,建立了多氯联苯相关模型。在训练中,test,GSE70770和GSE116918同伙,高风险评分患者的生化复发无生存率明显较低.四个队列中5年的AUC分别为0.691、0.718、0.714和0.672,展示了适度的预测能力。构建了包含临床特征的列线图。抗癌药物敏感性分析的结果表明,化疗可能对低风险患者更有益。分子对接分析表明,多氯联苯具有与关键基因结合的能力。以1μM的浓度暴露于Aroclor1254的PCa细胞显示出增加的增殖和侵袭能力。
    结论:这项研究为多氯联苯在多氯联苯中的功能提供了新的见解,并强调需要更深入地探索多氯联苯暴露与多氯联苯进展之间的机制联系。
    OBJECTIVE: Polychlorinated biphenyls (PCBs) have caused great environmental concerns. The study aims to investigate underlying molecular mechanisms between PCBs exposure and prostate cancer (PCa).
    METHODS: To investigate the association between PCBs exposure and prostate cancer by using CTD, TCGA, and GEO datasets. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were conducted to explore pathways associated with PCBs-related genes (PRGs). Using Lasso regression analysis, a novel PCBs-related prognostic model was developed. Both internal and external validations were conducted to assess the model\'s validity. Molecular docking was utilized to assess the binding capacity of PCBs to crucial genes. At last, preliminary experimental validations were conducted to confirm the biological roles of Aroclor 1254 in PCa cells.
    RESULTS: The GO enrichment analysis of PRGs revealed that the biological processes were most enriched in the regulation of transcription from the RNA polymerase II promoter and signal transduction. The KEGG enrichment analysis showed that of the pathways in cancer is the most significantly enriched. Next, a PCBs-related model was constructed. In the training, test, GSE70770, and GSE116918 cohorts, the biochemical recurrences free survival of the patients with high-risk scores was considerably lower. The AUCs at 5 years were 0.691, 0.718, 0.714, and 0.672 in the four cohorts, demonstrating the modest predictive ability. A nomogram that incorporated clinical characteristics was constructed. The results of the anti-cancer drug sensitivity analysis show chemotherapy might be more beneficial for patients at low risk. The molecular docking analysis demonstrated PCBs\' ability to bind to crucial genes. PCa cells exposed to Aroclor 1254 at a concentration of 1 μM showed increased proliferation and invasion capabilities.
    CONCLUSIONS: This study provides new insights into the function of PCBs in PCa and accentuates the need for deeper exploration into the mechanistic links between PCBs exposure and PCa progression.
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  • 文章类型: Journal Article
    目的:本研究通过双参数磁共振成像分析前列腺癌根治术后生化复发的特点。
    方法:回顾性选取我院2016年1月至2021年1月收治的200例前列腺癌根治术患者作为观察对象。根据手术后是否有生化复发,将患者分为异常组(n=62)和正常组(n=138)。临床数据,封装渗透,收集并比较两组患者的精囊浸润和前列腺影像学报告及数据系统(PI-RADS)。采用倾向评分匹配法(PSM)平衡两组基线资料。采用t检验和卡方检验对数据进行分析。
    结果:PSM以1:1的比例进行,共有72例患者被纳入异常组和正常组。各组患者的基线数据无统计学意义。异常组腹膜外侵犯和精囊侵犯的发生率高于正常组,两组患者PI-RADS评分差异有统计学意义(p<0.05)。囊外侵入,精囊侵入,PI-RADS评分与生化复发显著相关(p<0.05)。PI-RADS评分对生化复发有较高的预测价值,曲线下面积值为0.824,敏感性为0.667,特异性为0.861,Youden指数为0.528。
    结论:双参数磁共振成像对前列腺癌根治术后生化复发有很高的预测价值,为早期干预措施提供参考。
    OBJECTIVE: This study aimed to analyse the characteristics of biochemical recurrence after radical prostatectomy via bi-parametric magnetic resonance imaging.
    METHODS: A total of 200 patients with radical prostatectomy admitted to our hospital from January 2016 to January 2021 were retrospectively enrolled as observation objects. According to whether there was biochemical recurrence after surgery, the patients were divided into the abnormal group (n = 62) and normal group (n = 138). Clinical data, encapsulation infiltration, seminal vesicle infiltration and prostate imaging report and data system (PI-RADS) were collected and compared between the two groups. Propensity score matching (PSM) was used to balance the baseline data of the two groups. Student\'s t-test and Chi-square test were used to analyse the data.
    RESULTS: PSM was performed in a 1:1 ratio, and a total of 72 patients were included in the abnormal and normal groups. The baseline data of the patients in each group were not statistically significant. The incidence of extraperitoneal invasion and seminal vesicle invasion was higher in the abnormal group than in the normal group, and we observed a significant difference in PI-RADS scores between the two groups (p < 0.05). Extracapsular invasion, seminal vesicle invasion, PI-RADS score and biochemical recurrence were significantly correlated (p < 0.05). The PI-RADS score has a high value for predicting biochemical recurrence, with an area under the curve value of 0.824, sensitivity of 0.667, specificity of 0.861 and Youden index of 0.528.
    CONCLUSIONS: Bi-parametric magnetic resonance imaging has a high predictive value in biochemical recurrence after radical prostatectomy, which can provide reference for early intervention measures.
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  • 文章类型: Journal Article
    背景:据报道,非酒精性脂肪性肝病(NAFLD)有助于识别患前列腺癌的高危个体。我们的目的是研究转移性前列腺癌患者NAFLD与生化复发之间的关系。
    方法:我们回顾性调查了602例接受雄激素剥夺治疗的转移性前列腺癌患者。通过计算机断层扫描(CT)扫描以肝脏与脾脏的比率估计肝脏脂肪。用Cox模型研究NAFLD与生化复发之间的关系。针对多个变量调整生化复发模型。
    结果:当调整每个体重指数时,Gleason评分≥4+3的患者的NAFLD与生化复发显着相关(风险比[HR]=1.38;95%置信区间[CI]=1.08-1.77;p=0.01),内脏脂肪组织(HR=1.36;95%CI=1.07-1.74;p=0.01),高血压(HR=1.41;95%CI=1.10-1.80;p=0.01),和糖尿病(HR=1.42;95%CI=1.11-1.82;p=0.01),使用年龄和前列腺特异性抗原水平作为潜在的混杂因素。Gleason评分≥4+3的NAFLD患者2年生化复发率分别为84.0%(100/119)和72.2%(130/180),分别(p=0.018)。Gleason评分≥4+3例伴和不伴NAFLD患者的中位无生化复发生存期分别为17个月和21个月,分别(p=0.005)。
    结论:NAFLD是高级别转移性前列腺癌患者生化复发的独立危险因素。如果在前瞻性研究中得到验证,未来的研究应该测试NAFLD的治疗是否可以导致更好的预后.
    BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) has been reported to be helpful to identify high-risk individuals of developing prostate cancer. Our aim is to investigate the relationship between NAFLD and biochemical recurrence in metastatic prostate cancer patients.
    METHODS: We retrospectively investigated 602 patients with metastatic prostate cancer receiving the androgen deprivation therapy. Liver fat was estimated with liver-to-spleen ratio by computed tomography (CT) scans. The relationship between NAFLD and biochemical recurrence was investigated with Cox models. The model for biochemical recurrence was adjusted for multiple variables.
    RESULTS: NAFLD was significantly associated with biochemical recurrence in patients with Gleason score ≥4+3 when adjusting for each of body mass index (hazards ratio [HR] = 1.38; 95% confidence interval [CI] = 1.08-1.77; p = 0.01), visceral adipose tissue (HR = 1.36; 95% CI = 1.07-1.74; p = 0.01), hypertension (HR = 1.41; 95% CI = 1.10-1.80; p = 0.01), and diabetes mellitus (HR = 1.42; 95% CI = 1.11-1.82; p = 0.01), using age and prostate-specific antigen level as potential confounder. The 2-year biochemical recurrence rate in the Gleason score ≥4+3 patients with and without NAFLD was 84.0% (100/119) and 72.2% (130/180), respectively (p = 0.018). The median biochemical recurrence free survival of the Gleason score ≥4+3 patients with and without NAFLD were 17 and 21 months, respectively (p = 0.005).
    CONCLUSIONS: NAFLD is an independent risk factor for biochemical recurrence in patients with high-grade metastatic prostate cancer. If validated in prospective studies, future research should test whether treatment of NAFLD can lead to better prognosis.
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  • 文章类型: Journal Article
    肿瘤侵袭和转移的主要原因之一是抗肛门凋亡。前列腺癌(PCa)的生化复发(BCR)是其远处转移的先兆。然而,失稳在PCa生化复发中的作用尚未完全阐明.
    根据TCGA和GeneCards数据库,使用差异表达分析来鉴定与失巢凋亡相关的基因。利用LASSO回归构建预后模型,单变量和多变量Cox回归分析。此外,应用基因表达综合数据集(GSE70770和GSE46602)作为验证群组。基因本体论,KEGG和GSVA用于探索生物学途径和分子机制。Further,使用CIBERSORT评估免疫谱,ssGSEA,和潮汐,同时通过GDSC数据库分析抗癌药物的敏感性。此外,使用在线数据库(人蛋白质图谱和肿瘤免疫单细胞中心)检查模型中的基因表达。
    发现了113个差异表达的失巢凋亡相关基因。四个基因(EEF1A2,RET,选择FOSL1,PCA3)构建预后模型。利用Cox回归分析的结果,我们将患者分为高危组和低危组.高危人群预后较差,最大AUC为0.897。此外,记忆B细胞的免疫浸润百分比较大,CD8T细胞,中性粒细胞,和M1巨噬细胞在高危组比在低危组观察到,而高风险组中激活的肥大细胞和树突状细胞的百分比较低。在高危人群中发现了增加的TIDE评分,提示ICI治疗的有效性降低。此外,化疗药物的IC50结果表明,低危组对大多数药物更敏感.最后,EEF1A2,RET,根据HPA网站,FOSL1在PCa病例中表达。TISCH数据库表明,这四种ARG可能有助于PCa的肿瘤微环境。
    我们利用四种ARG创建了一个风险模型,可以有效预测PCa患者的BCR风险。这项研究为BCR的PCa患者的风险分层和生存结局预测奠定了基础。
    UNASSIGNED: One of the primary reasons for tumor invasion and metastasis is anoikis resistance. Biochemical recurrence (BCR) of prostate cancer (PCa) serves as a harbinger of its distant metastasis. However, the role of anoikis in PCa biochemical recurrence has not been fully elucidated.
    UNASSIGNED: Differential expression analysis was used to identify anoikis-related genes based on the TCGA and GeneCards databases. Prognostic models were constructed utilizing LASSO regression, univariate and multivariate Cox regression analyses. Moreover, Gene Expression Omnibus datasets (GSE70770 and GSE46602) were applied as validation cohorts. Gene Ontology, KEGG and GSVA were utilized to explore biological pathways and molecular mechanisms. Further, immune profiles were assessed using CIBERSORT, ssGSEA, and TIDE, while anti-cancer drugs sensitivity was analyzed by GDSC database. In addition, gene expressions in the model were examined using online databases (Human Protein Atlas and Tumor Immune Single-Cell Hub).
    UNASSIGNED: 113 differentially expressed anoikis-related genes were found. Four genes (EEF1A2, RET, FOSL1, PCA3) were selected for constructing a prognostic model. Using the findings from the Cox regression analysis, we grouped patients into groups of high and low risk. The high-risk group exhibited a poorer prognosis, with a maximum AUC of 0.897. Moreover, larger percentage of immune infiltration of memory B cells, CD8 Tcells, neutrophils, and M1 macrophages were observed in the high-risk group than those in the low-risk group, whereas the percentage of activated mast cells and dendritic cells in the high-risk group were lower. An increased TIDE score was founded in the high-risk group, suggesting reduced effectiveness of ICI therapy. Additionally, the IC50 results for chemotherapy drugs indicated that the low-risk group was more sensitive to most of the drugs. Finally, the genes EEF1A2, RET, and FOSL1 were expressed in PCa cases based on HPA website. The TISCH database suggested that these four ARGs might contribute to the tumor microenvironment of PCa.
    UNASSIGNED: We created a risk model utilizing four ARGs that effectively predicts the risk of BCR in PCa patients. This study lays the groundwork for risk stratification and predicting survival outcomes in PCa patients with BCR.
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  • 文章类型: Journal Article
    Aurora激酶A(AURKA)和肿瘤浸润淋巴细胞(TIL)都在肿瘤发生中起重要作用。然而,AURKA和TILs在甲状腺髓样癌(MTC)中的表达和预后价值尚未研究。收集
    137例MTC患者的手术标本和临床资料。通过免疫组织化学和苏木精-伊红染色定量AURKA表达和TIL浸润。随后,评估了MTC中AURKA表达和TIL浸润的预后价值。
    AURKA在多灶性肿瘤患者中高表达,颈淋巴结转移,和先进的TNM阶段,表明复发的可能性很高。AURKA还与TILs呈正相关(R=0.44,P<0.001)。AURKA的高表达和低数量的TIL(AURKAhigh/TILslow)被确定为生化复发(比值比:4.57,95%置信区间:1.54-14.66,P<0.01)和无复发生存(风险比:3.64,95%置信区间:1.52-8.71,P<0.001)的独立预后因素。AURKA和TILs的组合明显改善了MTC的生化复发(曲线下面积:0.751)和结构复发(曲线下面积:0.836)的预后价值。值得注意的是,AURKAhigh/TILslow对预测远处或不可切除的局部复发具有很高的价值,总体准确率为86.9%。
    AURKAhigh与MTC恶性肿瘤相关。AURKAhigh/TILslow的组合被确定为MTC的新的独立预后标志物,预测不治之症复发具有较高的准确性。
    UNASSIGNED: Aurora kinase A (AURKA) and tumor-infiltrating lymphocytes (TILs) are both known to play an essential role in tumorigenesis. However, the expression and prognostic value of the AURKA and TILs in medullary thyroid carcinoma (MTC) have not yet been investigated.
    UNASSIGNED: Surgical specimens and clinical data of 137 patients diagnosed with MTC were collected. AURKA expression and TILs infiltration were quantified by immunohistochemistry and hematoxylin-eosin staining. Subsequently, the prognostic value of AURKA expression and TIL infiltration in MTC was evaluated.
    UNASSIGNED: AURKA was highly expressed in patients with multifocal tumor, cervical lymph node metastasis, and an advanced TNM stage, indicating a high probability of recurrence. AURKA further exhibited a positive correlation with TILs (R = 0.44, P < 0.001). High expression of AURKA combined with a low numbers of TILs (AURKAhigh/TILslow) was identified as an independent prognostic factor for biochemical recurrence (odds ratio: 4.57, 95% confidence interval: 1.54-14.66, P < 0.01) and recurrence-free survival (hazard ratio: 3.64, 95% confidence interval: 1.52-8.71, P < 0.001). The combination of AURKA and TILs apparently improves the prognostic value for biochemical recurrence (area under the curve: 0.751) and structural recurrence (area under the curve: 0.836) of MTC. Notably, AURKAhigh/TILslow demonstrated a high value for prediction of distant or unresectable locoregional recurrence, with an overall accuracy of 86.9%.
    UNASSIGNED: AURKAhigh is associated with the MTC malignancy. The combination of AURKAhigh/TILslow was identified as novel independent prognostic marker in MTC, predicting incurable disease recurrence with high accuracy.
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  • 文章类型: Journal Article
    背景:考虑到前列腺癌(PCa)的年龄相关性以及cGAS-STING途径在衰老和癌症中的参与,我们旨在将PCa分类为不同的分子亚型,并从cGAS-STING通路的新角度鉴定关键基因.基于遗传学证据指导肿瘤靶向治疗的个性化干预具有重要意义。
    方法:纳入来自TCGA数据库的430例PCa患者。我们整合了29个参与cGAS-STING通路的关键基因,并分析了差异表达基因和无生化复发(BCR)生存相关基因。对肿瘤干性和异质性以及肿瘤微环境(TME)进行评估以揭示潜在的机制。
    结果:使用AURKB将PCa患者分为两种不同的亚型,TREX1、STAT6和亚型1的预后比亚型2差(HR:21.19,p<0.001)。这些发现在MSKCC2010队列中得到了验证。在亚型1和亚型2中,前十位的突变基因是MUC5B,DNAH9,SLC5A10,ZNF462,USP31,SIPA1L3,PLEC,HRAS,MYOM1和ITGB6。基因集变异分析显示E2F靶标在亚型1中高度富集,基因集富集分析显示碱基切除修复显著富集,细胞周期,和亚型1的DNA复制。TME评估表明,与亚型2相比,亚型1的T细胞滤泡辅助细胞水平明显更高,浆细胞水平更低。
    结论:由cGAS-STING途径介导的分子亚型和遗传风险评分可能有助于识别潜在的高危PCa患者,这些患者可能受益于针对cGAS-STING途径的药物治疗。
    BACKGROUND: Considering the age relevance of prostate cancer (PCa) and the involvement of the cGAS-STING pathway in aging and cancer, we aim to classify PCa into distinct molecular subtypes and identify key genes from the novel perspective of the cGAS-STING pathway. It is of significance to guide personalized intervention of cancer-targeting therapy based on genetic evidence.
    METHODS: The 430 patients with PCa from the TCGA database were included. We integrated 29 key genes involved in cGAS-STING pathway and analyzed differentially expressed genes and biochemical recurrence (BCR)-free survival-related genes. The assessments of tumor stemness and heterogeneity and tumor microenvironment (TME) were conducted to reveal potential mechanisms.
    RESULTS: PCa patients were classified into two distinct subtypes using AURKB, TREX1, and STAT6, and subtype 1 had a worse prognosis than subtype 2 (HR: 21.19, p < 0.001). The findings were validated in the MSKCC2010 cohort. Among subtype 1 and subtype 2, the top ten mutation genes were MUC5B, DNAH9, SLC5A10, ZNF462, USP31, SIPA1L3, PLEC, HRAS, MYOM1, and ITGB6. Gene set variation analysis revealed a high enrichment of the E2F target in subtype 1, and gene set enrichment analysis showed significant enrichment of base excision repair, cell cycle, and DNA replication in subtype 1. TME evaluation indicated that subtype 1 had a significantly higher level of T cells follicular helper and a lower level of plasma cells than subtype 2.
    CONCLUSIONS: The molecular subtypes mediated by the cGAS-STING pathway and the genetic risk score may aid in identifying potentially high-risk PCa patients who may benefit from pharmacologic therapies targeting the cGAS-STING pathway.
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  • 文章类型: Journal Article
    背景:17基因基因组前列腺评分(GPS)测试已在临床上用于预测前列腺癌的不良预后。在这个荟萃分析中,我们旨在评估17基因GPS在前列腺癌患者中的预后价值.
    方法:通过搜索PubMed,WebofScience,Embase数据库从成立到2023年12月1日。如果他们评估了17基因GPS与远处转移的关联,则认为这些研究是合格的。生化复发,或前列腺癌患者的前列腺癌特异性死亡率(PCSM)。为了估计预后价值,我们将高与低GPS组或每增加20个单位的GPS的校正风险比(HR)与95%置信区间(CI)合并.
    结果:7项队列研究报告了8篇文章,包括1,962名患者,符合资格标准。Meta分析显示GPS每增加20个单位与远处转移显著相关(HR2.99;95%CI1.97-4.53),生化复发(HR2.18;95%CI1.64-2.89),和PCSM(HR3.14;95%CI1.86-5.30)。此外,高GPS(>40分)患者发生远处转移的风险增加(HR5.22;95%CI3.72-7.31),生化复发(HR4.41;95%CI2.29-8.49),和PCSM(HR3.81;95%CI1.74-8.33)比GPS低(≤40点)。
    结论:较高的17基因GPS可显著预测远处转移,生化复发,和PCSM在男性临床局限性前列腺癌中的应用。然而,需要大规模多中心前瞻性研究来进一步验证这些发现.
    BACKGROUND: The 17-gene Genomic Prostate Score (GPS) test has been clinically employed to predict adverse prognosis in prostate cancer. In this meta-analysis, we aimed to evaluate the prognostic value of the 17-gene GPS in patients with prostate cancer.
    METHODS: Potentially relevant studies were obtained by searching PubMed, Web of Science, Embase databases from their inception to December 1, 2023. Studies were considered eligible if they evaluated the association of the 17-gene GPS with distant metastases, biochemical recurrence, or prostate cancer-specific mortality (PCSM) in prostate cancer patients. To estimate the prognostic value, we pooled the adjusted hazard ratio (HR) with 95% confidence intervals (CI) for the high versus low GPS group or per 20-unit increase in GPS.
    RESULTS: Seven cohort studies that reported on 8 articles comprising 1,962 patients satisfied the eligibility criteria. Meta-analysis showed that per 20-unit increase in GPS was significantly associated with distant metastases (HR 2.99; 95% CI 1.97-4.53), biochemical recurrence (HR 2.18; 95% CI 1.64-2.89), and PCSM (HR 3.14; 95% CI 1.86-5.30). Moreover, patients with high GPS (> 40 points) had an increased risk of distant metastases (HR 5.22; 95% CI 3.72-7.31), biochemical recurrence (HR 4.41; 95% CI 2.29-8.49), and PCSM (HR 3.81; 95% CI 1.74-8.33) than those with low GPS (≤ 40 points).
    CONCLUSIONS: A higher 17-gene GPS significantly predicts distant metastases, biochemical recurrence, and PCSM in men with clinically localized prostate cancer. However, large-scale multicenter prospective studies are necessary to further validate these findings.
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  • 文章类型: Case Reports
    卵巢癌是女性生殖系统常见的恶性肿瘤,经常保持隐藏,直到它达到一个高级阶段。标准治疗方案包括卵巢癌细胞减灭术加术后巩固化疗和维持治疗,尽管它有很高的复发率。在治疗期间,化疗会导致骨髓抑制,一种称为化疗诱导的骨髓抑制(CIM)的疾病。这种抑制可能需要剂量减少或化疗治疗周期延迟。在严重的情况下,CIM会导致感染,发烧,以及对患者生命的潜在危害。这里,我们报道了1例卵巢恶性肿瘤生化复发的女性患者,该患者接受了化疗联合Trilaciclib治疗,先前的围手术期化疗后发生严重的M。化疗前静脉注射Trilaciclib,这显著减轻了化疗的副作用,减少严重CIM的发生,提高患者的生活质量,减轻了住院的经济负担。我们希望该病例的回顾性分析可以为某些恶性肿瘤患者在化疗期间预防和治疗严重的M提供参考。最终使更多的肿瘤患者受益。
    Ovarian cancer is a prevalent malignant tumor of the female reproductive system, often remaining concealed until it reaches an advanced stage. The standard treatment protocol includes cytoreductive surgery for ovarian cancer plus postoperative consolidation chemotherapy and maintenance therapy, although it carries a high recurrence rate. During the treatment period, chemotherapy can lead to bone marrow suppression, a condition known as Chemotherapy-Induced Myelosuppression (CIM). This suppression may necessitate dose reduction or chemotherapy treatment cycle delay. In severe cases, CIM can result in infection, fever, and potential harm to the patient\'s life. Here, we report a case of a female patient with ovarian malignant tumor of biochemical recurrence who treated with chemotherapy combined with Trilaciclib, following previous perioperative chemotherapy with occurrence of severe CIM. It involves an intravenous injection of Trilaciclib before chemotherapy, which significantly abates the side effects of chemotherapy, reduces the occurrence of severe CIM, improves the patients\' quality of life, and decreases the economic burden of hospitalization. We hope that this retrospective analysis of the case may serve as a reference in preventing and treating severe CIM during chemotherapy in some patients with malignant tumors, ultimately benefiting more patients with tumors.
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  • 文章类型: Journal Article
    背景:甲状腺髓样癌(MTC)是一种发病率较低的恶性肿瘤。目前,大多数研究都集中在MTC的预后危险因素,不管怎样,与降钙素正常化(CN)和生化持久性/复发(BP)相关的时间动力学和危险因素尚未阐明。
    方法:对190例MTC患者进行回顾性研究。分析与降钙素正常化(CN)和生化持续/复发(BP)相关的危险因素。确定了降钙素正常化时间(CNT)和生化持续/复发时间(BPT)的预测因子。Further,还证明了CNT和BPT的预后作用。
    结果:5年和10年DFS分别为86.7%和70.2%,分别。5年和10年OS分别为97.6%和78.8%,分别。120例(63.2%)患者获得CN,而末次随访时,76例(40.0%)患者出现BP。经过治愈性手术,39例(32.5%)和106例(88.3%)患者在1周和1个月内达到CN。所有未能达到CN的患者随着时间的推移转向BP,其中32/70出现结构性复发。CNT和BPT的中位时间为1个月(1天至84个月)和6个月(3天至63个月),分别。LNR>0.23和男性是CN和BP的独立预测因子。LNR>0.23(危险比(HR),0.24;95%CI,0.13-0.46;P<0.01)和男性(HR,0.65;95%CI,0.42-0.99;P=0.045)是较长CNT的独立预测因子。LNR>0.23(HR,5.10;95%CI,2.15-12.11;P<0.01)仍是术前血清Ctn>1400ng/L(HR,2.34;95%CI,1.29-4.25;P=0.005)对于较短的BPT。在生存分析中,原发肿瘤大小>2cm(HR,5.81;95%CI,2.20-15.38;P<0.01),CNT>1个月(HR,5.69;95%CI,1.17-27.61;P=0.031)和多灶性(HR,3.10;95%CI,1.45-6.65;P=0.004)是DFS的独立预测因子。
    结论:根治性手术后Ctn的早期变化可以预测生化和结构性复发的长期风险,提供了有用的实时预后信息。LNR显著影响生化预后的时光动力学。肿瘤负荷和CNT在MTC生存中起着至关重要的作用,必须相应地调整后续行动的强度。
    BACKGROUND: Medullary thyroid carcinoma (MTC) is a malignant tumor with low incidence. Currently, most studies have focused on the prognostic risk factors of MTC, whatever, time kinetic and risk factors related to calcitonin normalization (CN) and biochemical persistence/recurrence (BP) are yet to be elucidated.
    METHODS: A retrospective study was conducted for 190 MTC patients. Risk factors related to calcitonin normalization (CN) and biochemical persistence/recurrence (BP) were analyzed. The predictors of calcitonin normalization time (CNT) and biochemical persistent/recurrent time (BPT) were identified. Further, the prognostic roles of CNT and BPT were also demonstrated.
    RESULTS: The 5- and 10-year DFS were 86.7% and 70.2%, respectively. The 5- and 10-year OS were 97.6% and 78.8%, respectively. CN was achieved in 120 (63.2%) patients, whereas BP was presented in 76 (40.0%) patients at the last follow up. After curative surgery, 39 (32.5%) and 106 (88.3%) patients achieved CN within 1 week and 1 month. All patients who failed to achieve CN turned to BP over time and 32/70 of them developed structural recurrence. The median time of CNT and BPT was 1 month (1 day to 84 months) and 6 month (3 day to 63months), respectively. LNR > 0.23 and male gender were independent predictors for CN and BP. LNR > 0.23 (Hazard ratio (HR), 0.24; 95% CI,0.13-0.46; P < 0.01) and male gender (HR, 0.65; 95% CI, 0.42-0.99; P = 0.045) were independent predictors for longer CNT. LNR > 0.23 (HR,5.10; 95% CI,2.15-12.11; P < 0.01) was still the strongest independent predictor followed by preoperative serum Ctn > 1400ng/L (HR,2.34; 95% CI,1.29-4.25; P = 0.005) for shorter BPT. In survival analysis, primary tumor size > 2 cm (HR, 5.81; 95% CI,2.20-15.38; P < 0.01), CNT > 1 month (HR, 5.69; 95% CI, 1.17-27.61; P = 0.031) and multifocality (HR, 3.10; 95% CI, 1.45-6.65; P = 0.004) were independent predictor of DFS.
    CONCLUSIONS: Early changes of Ctn after curative surgery can predict the long-term risks of biochemical and structural recurrence, which provide a useful real-time prognostic information. LNR significantly affect the time kinetic of biochemical prognosis. Tumor burden and CNT play a crucial role in MTC survival, the intensity of follow-up must be tailored accordingly.
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