目的探讨血清前Ⅲ型胶原氨基端肽(typeⅢprocollagen,PRO-C3)与高尔基体蛋白73(golgi protein 73,GP73)动态变化对人工肝治疗乙型肝炎慢加急性肝衰竭(hepatitis B virus-related acute-on-chronic liver failure,HBV-ACLF)患者短期预后...目的探讨血清前Ⅲ型胶原氨基端肽(typeⅢprocollagen,PRO-C3)与高尔基体蛋白73(golgi protein 73,GP73)动态变化对人工肝治疗乙型肝炎慢加急性肝衰竭(hepatitis B virus-related acute-on-chronic liver failure,HBV-ACLF)患者短期预后的评估价值。方法回顾性分析138例接受≥3次人工肝治疗的HBV-ACLF患者(生存组85例,死亡组53例)。检测基线及治疗2周后血清PRO-C3、GP73水平及常规肝肾功能指标,分析其与临床预后的相关性。血清PRO-C3采用罗氏cobas®分析仪(ECLIA法)检测;血清GP73采用ELISA法(北京热景生物试剂盒)检测。通过多因素Cox回归构建联合预测模型,并采用ROC曲线评估预测效能。结果对两组基线情况进行对比分析,结果显示,死亡组的总胆红素、肌酐、MELD水平均显著高于生存组(总胆红素535.5±118.7 vs 380.9±108.0μmol/L、肌酐96.6±29.6 vs 66.9±28.6μmol/L、MELD评分33.5±5.5 vs 20.7±4.3,均P<0.001);生存组PRO-C3与GP73降幅显著大于死亡组(P<0.001);多因素Cox回归显示,MELD评分为独立危险因素,PRO-C3降幅和GP73降幅为保护因素;联合动态指标(ΔPRO-C3%+ΔGP73%+MELD)的AUC达0.993,阴性预测值89.8%;按标志物降幅分组(良好/部分/无应答),3个月生存率分别为95.2%、65.5%、11.4%(P<0.001)。结论PRO-C3联合GP73的动态监测可精准评估人工肝治疗应答,其构建的预测模型对HBV-ACLF患者3个月预后具有显著的判别价值,尤其阴性预测效能突出。展开更多
Objectives:Gastric cancer(GC)remains a major global health concern,and Phosphoinositide-3-Kinase Regulatory Subunit 1(PIK3R1),a regulatory subunit of the PI3K signaling pathway,may play a critical yet underexplored ro...Objectives:Gastric cancer(GC)remains a major global health concern,and Phosphoinositide-3-Kinase Regulatory Subunit 1(PIK3R1),a regulatory subunit of the PI3K signaling pathway,may play a critical yet underexplored role in GC progression.This study aimed to investigate the prognostic significance of PIK3R1 in GC and its association with the tumor immune microenvironment.Methods:PIK3R1 expression and its clinical relevance were analyzed using datasets from GC patients who underwent gastrectomy,including cohorts from The Cancer Genome Atlas(TCGA)and the Sun Yat-sen University Cancer Center(SYSUCC).Prognostic models integrating PIK3R1 expression with clinical parameters were constructed for both cohorts.The immune microenvironment associated with PIK3R1 expression was assessed through immunohistochemistry and single-cell RNA sequencing.In vitro assays were conducted to evaluate the effects of PIK3R1 on GC cell proliferation and migration.Results:PIK3R1 was significantly overexpressed in GC tissues and was closely associated with aggressive tumor characteristics and poor clinical outcomes.A nomogram combining PIK3R1 expression with clinicopathological features effectively predicted patient prognosis.Knockdown of PIK3R1 in GC cells reduced proliferation and migration in vitro.Immunological profiling revealed that high PIK3R1 expression correlated with increased infiltration of forkhead box protein P3(Foxp3^(+))and cluster of differentiation 73(CD73^(+))T cells.Patients with low PIK3R1 expression and low CD73^(+)T cell infiltration had significantly better survival.Conclusions:PIK3R1 overexpression is linked to poor prognosis in GC and influences the extent of immune cell infiltration within the tumor microenvironment.A novel prognostic model integrating PIK3R1 and CD73 expression with clinical parameters was established to stratify GC patients into distinct risk groups,offering potential value for personalized therapeutic strategies.展开更多
目的分析血清肝纤维化4因子指数(fibrosis 4 index,FIB-4)、壳多糖酶3样蛋白1(Chitinase-3-like protein 1,CHI3L1)、高尔基蛋白73(Golgi protein 73,GP73)、甲胎蛋白(alpha fetoprotein,AFP)联合检测在乙型肝炎肝硬化中的临床预测价值...目的分析血清肝纤维化4因子指数(fibrosis 4 index,FIB-4)、壳多糖酶3样蛋白1(Chitinase-3-like protein 1,CHI3L1)、高尔基蛋白73(Golgi protein 73,GP73)、甲胎蛋白(alpha fetoprotein,AFP)联合检测在乙型肝炎肝硬化中的临床预测价值。方法选取2022年5月—2024年5月甘肃省兰州市第二人民医院接收并确诊的171例乙型肝炎患者作为研究对象,根据是否发生肝硬化将其分为肝硬化组与对照组。肝硬化组包含81例已发生肝硬化的患者,而对照组则由90例未发生肝硬化的患者组成。比较两组FIB-4、CHI3L1、GP73、AFP水平,并采用受试者工作特征(receiver operating characteristics,ROC)曲线分析上述指标的诊断价值。结果两组的年龄、身体质量指数、性别、饮酒史、吸烟史、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、总胆红素(total bilirubin,TBIL)、白蛋白(albumin,ALB)水平比较,差异无统计学意义(P>0.05)。肝硬化组的FIB-4、CHI3L1、GP73、AFP水平均高于对照组,差异有统计学意义(P<0.05)。FIB-4、CHI3L1和GP73的曲线下面积(area under the curve,AUC)分别为0.930、0.956和0.910,显示出较高的预测准确性。相比之下,AFP的AUC为0.698,预测效能相对较低。FIB-4、CHI3L1和GP73的敏感性分别高达85.2%、90.1%和88.9%,而AFP仅为39.5%。特异性分别为95.6%、92.2%和93.3%,而AFP的特异性为91.1%。当这四个指标联合应用时,其预测效能显著提升,AUC达到0.988,敏感性高达97.5%,特异性为83.3%。结论血清FIB-4、CHI3L1、GP73、AFP联合检测在乙型肝炎肝硬化鉴别诊断中具有显著的价值,该联合检测方案值得在临床实践中应用。展开更多
文摘目的探讨血清前Ⅲ型胶原氨基端肽(typeⅢprocollagen,PRO-C3)与高尔基体蛋白73(golgi protein 73,GP73)动态变化对人工肝治疗乙型肝炎慢加急性肝衰竭(hepatitis B virus-related acute-on-chronic liver failure,HBV-ACLF)患者短期预后的评估价值。方法回顾性分析138例接受≥3次人工肝治疗的HBV-ACLF患者(生存组85例,死亡组53例)。检测基线及治疗2周后血清PRO-C3、GP73水平及常规肝肾功能指标,分析其与临床预后的相关性。血清PRO-C3采用罗氏cobas®分析仪(ECLIA法)检测;血清GP73采用ELISA法(北京热景生物试剂盒)检测。通过多因素Cox回归构建联合预测模型,并采用ROC曲线评估预测效能。结果对两组基线情况进行对比分析,结果显示,死亡组的总胆红素、肌酐、MELD水平均显著高于生存组(总胆红素535.5±118.7 vs 380.9±108.0μmol/L、肌酐96.6±29.6 vs 66.9±28.6μmol/L、MELD评分33.5±5.5 vs 20.7±4.3,均P<0.001);生存组PRO-C3与GP73降幅显著大于死亡组(P<0.001);多因素Cox回归显示,MELD评分为独立危险因素,PRO-C3降幅和GP73降幅为保护因素;联合动态指标(ΔPRO-C3%+ΔGP73%+MELD)的AUC达0.993,阴性预测值89.8%;按标志物降幅分组(良好/部分/无应答),3个月生存率分别为95.2%、65.5%、11.4%(P<0.001)。结论PRO-C3联合GP73的动态监测可精准评估人工肝治疗应答,其构建的预测模型对HBV-ACLF患者3个月预后具有显著的判别价值,尤其阴性预测效能突出。
基金supported by the National Natural Science Foundation of China(grant no.81602426).
文摘Objectives:Gastric cancer(GC)remains a major global health concern,and Phosphoinositide-3-Kinase Regulatory Subunit 1(PIK3R1),a regulatory subunit of the PI3K signaling pathway,may play a critical yet underexplored role in GC progression.This study aimed to investigate the prognostic significance of PIK3R1 in GC and its association with the tumor immune microenvironment.Methods:PIK3R1 expression and its clinical relevance were analyzed using datasets from GC patients who underwent gastrectomy,including cohorts from The Cancer Genome Atlas(TCGA)and the Sun Yat-sen University Cancer Center(SYSUCC).Prognostic models integrating PIK3R1 expression with clinical parameters were constructed for both cohorts.The immune microenvironment associated with PIK3R1 expression was assessed through immunohistochemistry and single-cell RNA sequencing.In vitro assays were conducted to evaluate the effects of PIK3R1 on GC cell proliferation and migration.Results:PIK3R1 was significantly overexpressed in GC tissues and was closely associated with aggressive tumor characteristics and poor clinical outcomes.A nomogram combining PIK3R1 expression with clinicopathological features effectively predicted patient prognosis.Knockdown of PIK3R1 in GC cells reduced proliferation and migration in vitro.Immunological profiling revealed that high PIK3R1 expression correlated with increased infiltration of forkhead box protein P3(Foxp3^(+))and cluster of differentiation 73(CD73^(+))T cells.Patients with low PIK3R1 expression and low CD73^(+)T cell infiltration had significantly better survival.Conclusions:PIK3R1 overexpression is linked to poor prognosis in GC and influences the extent of immune cell infiltration within the tumor microenvironment.A novel prognostic model integrating PIK3R1 and CD73 expression with clinical parameters was established to stratify GC patients into distinct risk groups,offering potential value for personalized therapeutic strategies.
文摘目的分析血清肝纤维化4因子指数(fibrosis 4 index,FIB-4)、壳多糖酶3样蛋白1(Chitinase-3-like protein 1,CHI3L1)、高尔基蛋白73(Golgi protein 73,GP73)、甲胎蛋白(alpha fetoprotein,AFP)联合检测在乙型肝炎肝硬化中的临床预测价值。方法选取2022年5月—2024年5月甘肃省兰州市第二人民医院接收并确诊的171例乙型肝炎患者作为研究对象,根据是否发生肝硬化将其分为肝硬化组与对照组。肝硬化组包含81例已发生肝硬化的患者,而对照组则由90例未发生肝硬化的患者组成。比较两组FIB-4、CHI3L1、GP73、AFP水平,并采用受试者工作特征(receiver operating characteristics,ROC)曲线分析上述指标的诊断价值。结果两组的年龄、身体质量指数、性别、饮酒史、吸烟史、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、总胆红素(total bilirubin,TBIL)、白蛋白(albumin,ALB)水平比较,差异无统计学意义(P>0.05)。肝硬化组的FIB-4、CHI3L1、GP73、AFP水平均高于对照组,差异有统计学意义(P<0.05)。FIB-4、CHI3L1和GP73的曲线下面积(area under the curve,AUC)分别为0.930、0.956和0.910,显示出较高的预测准确性。相比之下,AFP的AUC为0.698,预测效能相对较低。FIB-4、CHI3L1和GP73的敏感性分别高达85.2%、90.1%和88.9%,而AFP仅为39.5%。特异性分别为95.6%、92.2%和93.3%,而AFP的特异性为91.1%。当这四个指标联合应用时,其预测效能显著提升,AUC达到0.988,敏感性高达97.5%,特异性为83.3%。结论血清FIB-4、CHI3L1、GP73、AFP联合检测在乙型肝炎肝硬化鉴别诊断中具有显著的价值,该联合检测方案值得在临床实践中应用。
