Detection and treatment of colorectal cancer(CRC)at an early stage is vital for long-term survival.Liquid biopsy has emerged as a promising new avenue for non-invasive screening of CRC as well as prognostication and s...Detection and treatment of colorectal cancer(CRC)at an early stage is vital for long-term survival.Liquid biopsy has emerged as a promising new avenue for non-invasive screening of CRC as well as prognostication and surveillance of minimal residual disease.Cell free DNA(cfDNA)is a promising liquid biopsy analyte and has been approved for use in clinical practice.Here,we explore the current challenges of utilizing cfDNA in the screening and prognostication of CRC but also for detecting driver mutations in healthy,presymptomatic patients with normal colonic crypts.CfDNA for the detection of cancerous or premalignant colonic lesions has already been extensively explored,however few have considered utilizing cfDNA in the detection of driver mutations in healthy patients.Theoretically,this would allow us to detect patients who are at a higher risk of tumorigenesis decades in advance of established malignancy and stratify them into higher risk groups for early-intervention screening programs.We also explore the solutions necessary to overcome the challenges that prevent liquid biopsy from entering mainstream clinical use.The potential for liquid biopsy is immense if these challenges are successfully circumvented,and can dramatically reduce CRC rates as well as improve survival in patients.展开更多
This commentary critically appraises the study by Li et al which pioneered the exploration of the triglyceride-glucose(TyG)index as a prognostic marker in hepatitis B virus-related advanced hepatocellular carcinoma pa...This commentary critically appraises the study by Li et al which pioneered the exploration of the triglyceride-glucose(TyG)index as a prognostic marker in hepatitis B virus-related advanced hepatocellular carcinoma patients undergoing combined camrelizumab and lenvatinib therapy.While we acknowledge the study’s clinical relevance in proposing an easily accessible metabolic biomarker,we delve into the mechanistic plausibility linking insulin resistance to immunotherapy response and angiogenic inhibition.We further critically examine the methodological limitations,including the retrospective design,the populationspecific TyG cut-off value,and unaddressed metabolic confounders.We highlight the imperative for future research to validate its utility across diverse etiologies and treatment settings,and to unravel the underlying immunometabolic pathways.展开更多
AIM:To evaluate the clinical characteristics and risk factors associated with visual prognosis in patients with open globe injuries(OGIs)treated at Vietnam National Eye Hospital.METHODS:A prospective observational stu...AIM:To evaluate the clinical characteristics and risk factors associated with visual prognosis in patients with open globe injuries(OGIs)treated at Vietnam National Eye Hospital.METHODS:A prospective observational study included patients with OGIs treated between June 2023 and June 2024.Data on demographics,injury features,and clinical findings were extracted from medical records.Poor visual outcome was defined as final best-corrected visual acuity(BCVA)worse than 20/400 or no light perception.Multivariable logistic regression was performed to identify independent risk factors.RESULTS:Among 509 patients(636 eyes),the mean age was 35.13y(range 20–51y),and 67.6%were male.After treatment,the proportion of eyes achieving≥20/40 increased from 12.6%to 42.1%,while no light perception decreased from 29.1%to 9.4%.Independent predictors of poor visual outcomes included delayed admission[>4h,odds ratio(OR)=3.33,95%confidence intervals(CI):1.76–6.33,P<0.001],Zone III injury(OR=5.90,95%CI:2.85–12.24,P<0.001),wound length>10 mm(OR=2.59,95%CI:1.60–4.18,P<0.001),relative afferent pupillary defect(RAPD,OR=1.65,95%CI:1.03–2.64,P=0.039),endophthalmitis(OR=1.75,95%CI:1.01–3.03,P=0.047),retinal detachment(OR=3.32,95%CI:2.02–5.45,P<0.001),and eyelid lacerations(OR=1.94,95%CI:1.13–3.33,P=0.016)associated with OGIs.Vitreous hemorrhage(OR=0.44,95%CI:0.22–0.89,P=0.023)was associated with better outcomes,and female gender appeared protective.CONCLUSION:Poor visual outcomes remain common after OGIs,despite improve visual acuity in many cases.Several clinical and injury-related factors are strongly associated with prognosis.Early recognition of these predictors can support risk stratification and improve trauma care in similar settings.展开更多
Male breast cancer(MBC)is rare,representing 0.5%–1%of all breast cancers,but its incidence is increasing due to improved diagnostics and awareness.MBC typically presents in older men,is human epidermal growth factor ...Male breast cancer(MBC)is rare,representing 0.5%–1%of all breast cancers,but its incidence is increasing due to improved diagnostics and awareness.MBC typically presents in older men,is human epidermal growth factor receptor 2(HER2)-negative and estrogen receptor(ER)-positive,and lacks routine screening,leading to delayed diagnosis and advanced disease.Major risk factors include hormonal imbalance,radiation exposure,obesity,alcohol use,and Breast Cancer Gene 1 and 2(BRCA1/2)mutations.Clinically,it may resemble gynecomastia but usually appears as a unilateral,painless mass or nipple discharge.Advances in imaging and liquid biopsy have enhanced early detection.Molecular mechanisms involve hormonal signaling,HER2/epidermal growth factor receptor(EGFR)pathways,tumor suppressor gene alterations,and epigenetic changes.While standard treatments mirror those for female breast cancer,emerging options such as cyclin-dependent kinase 4 and 6(CDK4/6),and poly(ADP-ribose)polymerase(PARP)inhibitors,immunotherapy,and precision medicine are reshaping management.Incorporating artificial intelligence,molecular profiling,and male-specific clinical trials is essential to improve outcomes and bridge current diagnostic and therapeutic gaps.展开更多
Ossiculoplasty remains a challenging surgical procedure,with outcomes heavily influenced by diverse anatomical and pathological factors.Over the decades,numerous scoring systems have been developed to predict the prog...Ossiculoplasty remains a challenging surgical procedure,with outcomes heavily influenced by diverse anatomical and pathological factors.Over the decades,numerous scoring systems have been developed to predict the prognosis of ossiculoplasty,each emphasizing different variables such as ossicular status,middle ear environment,and surgical history.This paper provides a comprehensive review of the evolution of prognostic scoring systems,including Austin's original ossicular classification,Bellucci's otorrhea staging,the Middle Ear Risk Index(MERI),the Ossiculoplasty Outcome Parameter Staging(OOPS),and the recently introduced Ear Environment Risk(EER)scale.While these systems have significantly contributed to preoperative assessment,each presents notable limitations in encompassing all variables affecting surgical success.Therefore,the aim of this paper is to provide a review of the ossiculoplasty prognostic scores and show the benefits,innovations and gaps associated with each.To address these gaps,a novel,modified scoring system is proposed,incorporating previously overlooked but clinically significant factors such as tympanic membrane status,type of tympanoplasty,ossicular replacement material,CT scan findings,and the presence of complicated ear conditions.By synthesizing elements from historical scores with updated clinical insights,the proposed system aims to provide a more holistic and predictive framework for preoperative evaluation.Future multicenter studies are encouraged to validate the efficacy and prognostic power of this new scoring system,with the goal of improving surgical planning and patient counseling in ossiculoplasty.展开更多
According to the 2024 global cancer data from GLOBOCAN,liver cancer ranks the 6th most common malignancy and the 3rd leading cause of cancer-related mortality worldwide[1].Among these cases,hepatocellular carcinoma(HC...According to the 2024 global cancer data from GLOBOCAN,liver cancer ranks the 6th most common malignancy and the 3rd leading cause of cancer-related mortality worldwide[1].Among these cases,hepatocellular carcinoma(HCC)accounts for approximately 85%−90%[2,3].Its incidence and mortality rates remain persistently high worldwide.However,China has the highest incidence and mortality rates of the disease in the world[4].And the majority of patients are diagnosed at intermediate or advanced stages.Thus,identifying novel tumor biomarkers for early detection and implementing precision therapy has long been a key focus of research.展开更多
BACKGROUND Breast cancer is one of the most prevalent malignancies affecting women worldwide,with approximately 2.3 million new cases diagnosed annually.Breast cancer stem cells(BCSCs)play pivotal roles in tumor initi...BACKGROUND Breast cancer is one of the most prevalent malignancies affecting women worldwide,with approximately 2.3 million new cases diagnosed annually.Breast cancer stem cells(BCSCs)play pivotal roles in tumor initiation,progression,metastasis,therapeutic resistance,and disease recurrence.Cancer stem cells possess selfrenewal capacity,multipotent differentiation potential,and enhanced tumorigenic activity,but their molecular characteristics and regulatory mechanisms require further investigation.AIM To comprehensively characterize the molecular features of BCSCs through multiomics approaches,construct a prognostic prediction model based on stem cellrelated genes,reveal cell-cell communication networks within the tumor microenvironment,and provide theoretical foundation for personalized treatment strategies.METHODS Flow cytometry was employed to detect the expression of BCSC surface markers(CD34,CD45,CD29,CD90,CD105).Transcriptomic analysis was performed to identify differentially expressed genes.Least absolute shrinkage and selection operator regression analysis was utilized to screen key prognostic genes and construct a risk scoring model.Single-cell RNA sequencing and spatial transcriptomics were applied to analyze tumor heterogeneity and spatial gene expression patterns.Cell-cell communication network analysis was conducted to reveal interactions between stem cells and the microenvironment.RESULTS Flow cytometric analysis revealed the highest expression of CD105(96.30%),followed by CD90(68.43%)and CD34(62.64%),while CD29 showed lower expression(7.16%)and CD45 exhibited the lowest expression(1.19%).Transcriptomic analysis identified 3837 significantly differentially expressed genes(1478 upregulated and 2359 downregulated).Least absolute shrinkage and selection operator regression analysis selected 10 key prognostic genes,and the constructed risk scoring model effectively distinguished between high-risk and low-risk patient groups(P<0.001).Single-cell analysis revealed tumor cellular heterogeneity,and spatial transcriptomics demonstrated distinct spatial expression gradients of stem cell-related genes.MED18 gene showed significantly higher expression in malignant tissues(P<0.001)and occupied a central position in cell-cell communication networks,exhibiting significant correlations with tumor cells,macrophages,fibroblasts,and endothelial cells.CONCLUSION This study comprehensively characterized the molecular features of BCSCs through multi-omics approaches,identified reliable surface markers and key regulatory genes,and constructed a prognostic prediction model with clinical application value.展开更多
Gastrointestinal tumors require personalized treatment strategies due to their heterogeneity and complexity.Multimodal artificial intelligence(AI)addresses this challenge by integrating diverse data sources-including ...Gastrointestinal tumors require personalized treatment strategies due to their heterogeneity and complexity.Multimodal artificial intelligence(AI)addresses this challenge by integrating diverse data sources-including computed tomography(CT),magnetic resonance imaging(MRI),endoscopic imaging,and genomic profiles-to enable intelligent decision-making for individualized therapy.This approach leverages AI algorithms to fuse imaging,endoscopic,and omics data,facilitating comprehensive characterization of tumor biology,prediction of treatment response,and optimization of therapeutic strategies.By combining CT and MRI for structural assessment,endoscopic data for real-time visual inspection,and genomic information for molecular profiling,multimodal AI enhances the accuracy of patient stratification and treatment personalization.The clinical implementation of this technology demonstrates potential for improving patient outcomes,advancing precision oncology,and supporting individualized care in gastrointestinal cancers.Ultimately,multimodal AI serves as a transformative tool in oncology,bridging data integration with clinical application to effectively tailor therapies.展开更多
AIM:To investigate the clinical characteristics and treatment outcomes,including visual function and overall survival(OS)of patients with ocular adnexal diffuse large B-cell lymphoma(OA-DLBCL).METHODS:This retrospecti...AIM:To investigate the clinical characteristics and treatment outcomes,including visual function and overall survival(OS)of patients with ocular adnexal diffuse large B-cell lymphoma(OA-DLBCL).METHODS:This retrospective cohort study enrolled 29 patients diagnosed with OA-DLBCL based on histopathological biopsy between 2006 and 2023.Patients were stratified into two subgroups:primary OA-DLBCL(no prior history of lymphoma)and secondary OA-DLBCL(history of DLBCL at non-ocular adnexal sites).OS was defined as the time interval from OA-DLBCL diagnosis to death from any cause.Survival analysis was performed using the Kaplan–Meier method,and prognostic factors affecting OS were identified using multivariate Cox proportional hazards regression with a stepwise selection approach.RESULTS:The cohort included 24 patients with primary OA-DLBCL(13 males,11 females;mean age:61.36±18.29y)and 5 patients with secondary OA-DLBCL(2 males,3 females;mean age:50.94±18.17y).Among the primary OA-DLBCL subgroup,12 patients(50%)presented with advanced disease(Ann Arbor stage IIIE–IV),and 16 patients(66%)were classified as T4 disease according to the tumor-node-metastasis(TNM)staging system.The mean final visual acuity was 1.72±1.10 in the primary group and 0.90±1.18 in the secondary group.The 5-year OS rate for the entire cohort was 27.7%.Multivariate analysis identified five factors significantly associated with poor survival outcomes:epiphora[adjusted hazard ratio(aHR),36.95],atherosclerotic cardiovascular disease(aHR,10.08),human immunodeficiency virus(HIV)infection(aHR,12.47),M1 stage(aHR,6.99),and secondary OA-DLBCL(aHR,6.03;all P<0.05).The median OS was 1.68y for primary OA-DLBCL and 1.12y for secondary OA-DLBCL.CONCLUSION:A substantial proportion of patients with primary OA-DLBCL present with advanced-stage disease at diagnosis.Epiphora,atherosclerotic cardiovascular disease,HIV infection,M1 stage,and secondary OA-DLBCL are independent prognostic factors for poor survival outcomes.These findings emphasize the urgent need for optimized therapeutic strategies and early screening protocols to improve the management of OA-DLBCL,particularly in developing countries.展开更多
On the basis of analysing and studyingthe mineralizing conditions and content ratinglaws, the authors infer the geology and oresnear old placers by applying the remote sens-ing technology and analogous method,
BACKGROUND Rebleeding after recovery from esophagogastric variceal bleeding(EGVB)is a severe complication that is associated with high rates of both incidence and mortality.Despite its clinical importance,recognized p...BACKGROUND Rebleeding after recovery from esophagogastric variceal bleeding(EGVB)is a severe complication that is associated with high rates of both incidence and mortality.Despite its clinical importance,recognized prognostic models that can effectively predict esophagogastric variceal rebleeding in patients with liver cirrhosis are lacking.AIM To construct and externally validate a reliable prognostic model for predicting the occurrence of esophagogastric variceal rebleeding.METHODS This study included 477 EGVB patients across 2 cohorts:The derivation cohort(n=322)and the validation cohort(n=155).The primary outcome was rebleeding events within 1 year.The least absolute shrinkage and selection operator was applied for predictor selection,and multivariate Cox regression analysis was used to construct the prognostic model.Internal validation was performed with bootstrap resampling.We assessed the discrimination,calibration and accuracy of the model,and performed patient risk stratification.RESULTS Six predictors,including albumin and aspartate aminotransferase concentrations,white blood cell count,and the presence of ascites,portal vein thrombosis,and bleeding signs,were selected for the rebleeding event prediction following endoscopic treatment(REPET)model.In predicting rebleeding within 1 year,the REPET model ex-hibited a concordance index of 0.775 and a Brier score of 0.143 in the derivation cohort,alongside 0.862 and 0.127 in the validation cohort.Furthermore,the REPET model revealed a significant difference in rebleeding rates(P<0.01)between low-risk patients and intermediate-to high-risk patients in both cohorts.CONCLUSION We constructed and validated a new prognostic model for variceal rebleeding with excellent predictive per-formance,which will improve the clinical management of rebleeding in EGVB patients.展开更多
BACKGROUND Acute-on-chronic liver failure(ACLF)is a liver disease based on chronic liver disease,which is significantly influenced by clinical treatment regimen and disease status,and despite the existence of multiple...BACKGROUND Acute-on-chronic liver failure(ACLF)is a liver disease based on chronic liver disease,which is significantly influenced by clinical treatment regimen and disease status,and despite the existence of multiple prognostic assessment indicators for ACLF,the overall sensitivity and accuracy are relatively low.AIM To investigate the prognostic value of the combined detection of alpha-fetoprotein(AFP),plasma prothrombin activity(PTA),and serum prealbumin(PA)in ACLF.METHODS This retrospective study included 87 patients with ACLF admitted from February 2021 to February 2023 and categorized them into the survival(n=47)and death(n=40)groups according to their clinical outcomes 3 months posttreatment.All the participants underwent AFP,PTA,and PA level measurements upon admission.Baseline data,as well as AFP,PTA,and PA levels,were comparatively analyzed.Pearson correlation coefficients were utilized to analyze the correlations of AFP,PTA,and PA with different survival outcomes in patients with ACLF.Receiver operating characteristic(ROC)curves and areas under the curves were used to evaluate the predictive value of AFP,PTA,and PA for ACLF prognosis.RESULTS AFP,PTA,and PA levels were markedly decreased in the death group than in the survival group(P<0.05).Pearson analysis indicated a positive association of the AFP,PTA,and PA levels with the survival of patients with ACLF(P<0.05).ROC curve analysis determined the sensitivity and specificity of the combined diagnosis at 91.24%and 100.00%,respectively,both of which were notably increased compared to the single-index diagnosis.The ROC of their combined diagnosis was 0.989,significantly surpassing 0.907,0.849,and 0.853 of AFP,PTA,and PA,respectively.No statistically significant variance was determined in the sensitivity and specificity of the combined diagnosis vs the single detection(P>0.05).CONCLUSION The combined detection of AFP,PTA,and PA levels demonstrates favorable diagnostic value for the short-term prognosis of patients with ACLF,featuring high sensitivity and specificity.展开更多
BACKGROUND Emerging evidence implicates Candida albicans(C.albicans)in human oncogenesis.Notably,studies have supported its involvement in regulating outcomes in colorectal cancer(CRC).This study investigated the para...BACKGROUND Emerging evidence implicates Candida albicans(C.albicans)in human oncogenesis.Notably,studies have supported its involvement in regulating outcomes in colorectal cancer(CRC).This study investigated the paradoxical role of C.albicans in CRC,aiming to determine whether it promotes or suppresses tumor development,with a focus on the mechanistic basis linked to its metabolic profile.AIM To investigate the dual role of C.albicans in the development and progression of CRC through metabolite profiling and to establish a prognostic model that integrates the microbial and metabolic interactions in CRC,providing insights into potential therapeutic strategies and clinical outcomes.METHODSA prognostic model integrating C. albicans with CRC was developed, incorporating enrichment analysis, immuneinfiltration profiling, survival analysis, Mendelian randomization, single-cell sequencing, and spatial transcriptomics.The effects of the C. albicans metabolite mixture on CRC cells were subsequently validated in vitro. Theprimary metabolite composition was characterized using liquid chromatography-mass spectrometry.RESULTSA prognostic model based on five specific mRNA markers, EHD4, LIME1, GADD45B, TIMP1, and FDFT1, wasestablished. The C. albicans metabolite mixture significantly reduced CRC cell viability. Post-treatment analysisrevealed a significant decrease in gene expression in HT29 cells, while the expression levels of TIMP1, EHD4, andGADD45B were significantly elevated in HCT116 cells. Conversely, LIME1 expression and that of other CRC celllines showed reductions. In normal colonic epithelial cells (NCM460), GADD45B, TIMP1, and FDFT1 expressionlevels were significantly increased, while LIME1 and EHD4 levels were markedly reduced. Following metabolitetreatment, the invasive and migratory capabilities of NCM460, HT29, and HCT116 cells were reduced. Quantitativeanalysis of extracellular ATP post-treatment showed a significant elevation (P < 0.01). The C. albicans metabolitemixture had no effect on reactive oxygen species accumulation in CRC cells but led to a reduction in mitochondrialmembrane potential, increased intracellular lipid peroxidation, and induced apoptosis. Metabolomic profilingrevealed significant alterations, with 516 metabolites upregulated and 531 downregulated.CONCLUSIONThis study introduced a novel prognostic model for CRC risk assessment. The findings suggested that the C.albicans metabolite mixture exerted an inhibitory effect on CRC initiation.展开更多
Rectal neuroendocrine tumors(r-NETs)are the second most common type of neuroendocrine tumor in the gastrointestinal tract,with an increase in incidence in the last decades.They are low-grade tumors and,given their low...Rectal neuroendocrine tumors(r-NETs)are the second most common type of neuroendocrine tumor in the gastrointestinal tract,with an increase in incidence in the last decades.They are low-grade tumors and,given their low risk of meta-stasis,current guidelines recommend endoscopic resection for small lesions.The GATIS predicting score,proposed by Zeng et al,represents an innovative model designed to predict individualized survival outcomes for patients with r-NETs,analyzing the relationship between clinicopathological features and patient prog-noses.The authors identified tumor grade,T stage,tumor size,age,and progno-stic nutritional index as key prognostic factors,demonstrating that the GATIS Score provides a more accurate prognosis assessment compared to the World Health Organization classification or the tumor-node-metastasis staging system.Nevertheless,further larger prospective studies are necessary,and the scientific community's efforts in this context should be directed toward developing interna-tional multicentric prospective studies,with the ultimate aim of accurately de-fining and understanding the behavior of these conditions.展开更多
BACKGROUND Colon adenocarcinoma(COAD)ranks second in terms of cancer-related deaths.We found that fatty acid-binding protein 4(FABP4),which is related to cell adhesion and immunity,affects the occurrence and developme...BACKGROUND Colon adenocarcinoma(COAD)ranks second in terms of cancer-related deaths.We found that fatty acid-binding protein 4(FABP4),which is related to cell adhesion and immunity,affects the occurrence and development of COAD.This study focused on the possibility of using FABP4 as a biomarker for COAD and constructed a nomogram for predicting the survival of COAD patients.AIM To verify the possibility of using FABP4 as a biomarker for COAD.METHODS A total of 453 COAD tissue samples,along with 41 normal tissue samples,were obtained from The Cancer Genome Atlas database.The difference in FABP4 expression between COAD tissues and normal tissues was analyzed,and the results were verified by immunohistochemistry.The WGCNA algorithm links FABP4 expression with an enrichment analysis and with immune cell infiltration pathways.The biological functions of FABP4 and its coexpressed genes were explored through enrichment analyses.The ESTIMATE,CIBERSORT and ssGSEA methods were used for the immune infiltration analysis.Finally,risk scores were calculated by a Cox analysis.A nomogram was constructed by combining risk scores with routine clinicopathological factors.We assessed the accuracy of survival predictions based on the C-index.The C-index ranges from 0.5 to 1.0,and in general,a C-index value greater than 0.65 indicates a reasonable estimate.The results were validated using the Gene Expression Omnibus(GEO)database.RESULTS FABP4 was significantly differentially expressed in COAD.It is a promising auxiliary biomarker for screening and diagnosis.Enrichment analyses suggested that FABP4 may influence the invasion and progression of COAD through cell adhesion.The immunological analysis revealed that FABP4 expression in COAD was significantly positively correlated with immune cell infiltration.Moreover,a nomogram to predict the survival of COAD patients was successfully constructed by integrating the calculated risk scores of 15 candidate genes and routine clinicopathological factors.This nomogram could effectively predict 1-year,3-year,and 5-year survival(C-index=0.786)and was verified(C-index=0.73).CONCLUSION This study established FABP4 as an effective biomarker for screening,assisting in the diagnosis and determining the prognosis.展开更多
Gastric cancer(GC)is a leading cause of cancer-related deaths,highlighting the need for reliable prognostic biomarkers to guide treatment.Wei et al’s systematic review and meta-analysis evaluates the neutrophil-to-ly...Gastric cancer(GC)is a leading cause of cancer-related deaths,highlighting the need for reliable prognostic biomarkers to guide treatment.Wei et al’s systematic review and meta-analysis evaluates the neutrophil-to-lymphocyte ratio(NLR)as a potential biomarker for GC patients undergoing neoadjuvant chemotherapy.NLR is a simple and cost-effective measure of systemic inflammation that shows promise in predicting treatment response and survival outcomes,including overall survival and progression-free survival.However,variations in NLR thresholds and timing of measurements affect its accuracy and clinical utility.Moreover,the studies reviewed primarily involved Asian populations,which may limit the generalizability of the findings.To improve NLR’s clinical relevance,future research should focus on standardizing NLR thresholds,refining measurement timing,and incorporating additional inflammatory markers like platelet-to-lymphocyte ratio and Glasgow prognostic score.Addressing con-founders and including diverse patient populations will help improve NLR’s reliability as a prognostic marker for GC.展开更多
BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia...BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia,nausea,vomiting,and other discomforts,and often suffer from malnutrition,which in turn negatively affects perioperative safety,prognosis,and the effectiveness of adjuvant therapeutic measures.Consequently,some nutritional indicators such as nutritional risk index(NRI),prognostic nutritional index(PNI),and systemic immune-inflammatorynutritional index(SIINI)can be used as predictors of the prognosis of GC patients.AIM To examine the prognostic significance of PNI,NRI,and SIINI in postoperative patients with GC.METHODS A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018.The area under the receiver operating characteristic(ROC)curve was assessed using ROC curve analysis,and the optimal cutoff values for NRI,PNI,and SIINI were identified using the You-Review-HTMLden index.Survival analysis was performed using the Kaplan-Meier method.In addition,univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.RESULTS This study included a total of 803 patients.ROC curves were used to evaluate the prognostic ability of NRI,PNI,and SIINI.The results revealed that SIINI had superior predictive accuracy.Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group(P<0.05).Univariate analysis identified NRI[hazard ratio(HR)=0.68,95%confidence interval(CI):0.52-0.89,P=0.05],PNI(HR=0.60,95%CI:0.46-0.79,P<0.001),and SIINI(HR=2.10,95%CI:1.64-2.69,P<0.001)as prognostic risk factors for patients with GC.However,multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC(HR=1.65,95%CI:1.26-2.16,P<0.001).CONCLUSION Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC.Compared with NRI and PNI,SIINI may offer greater application for prognostic assessment.展开更多
Cardiovascular diseases(CVDs)remain the leading cause of morbidity and mortality worldwide,necessitating innovative diagnostic and prognostic strategies.Traditional biomarkers like C-reactive protein,uric acid,troponi...Cardiovascular diseases(CVDs)remain the leading cause of morbidity and mortality worldwide,necessitating innovative diagnostic and prognostic strategies.Traditional biomarkers like C-reactive protein,uric acid,troponin,and natriuretic peptides play crucial roles in CVD management,yet they are often limited by sensitivity and specificity constraints.This narrative review critically examines the emerging landscape of cardiac biomarkers and advocates for a multiple-marker approach to enhance early detection,prognosis,and risk stratification of CVD.In recent years,several novel biomarkers have shown promise in revolutionizing CVD diagnostics.Gamma-glutamyltransferase,microRNAs,endothelial microparticles,placental growth factor,trimethylamine N-oxide,retinol-binding protein 4,copeptin,heart-type fatty acid-binding protein,galectin-3,growth differentiation factor-15,soluble suppression of tumorigenicity 2,fibroblast growth factor 23,and adrenomedullin have emerged as significant indicators of CV health.These biomarkers provide insights into various pathophysiological processes,such as oxidative stress,endothelial dysfunction,inflammation,metabolic disturbances,and myocardial injury.The integration of these novel biomarkers with traditional ones offers a more comprehensive understanding of CVD mechanisms.This multiple-marker approach can improve diagnostic accuracy,allowing for better risk stratification and more personalized treatment strategies.This review underscores the need for continued research to validate the clinical utility of these biomarkers and their potential incorporation into routine clinical practice.By leveraging the strengths of both traditional and novel biomarkers,precise therapeutic plans can be developed,thereby improving the management and prognosis of patients with CVDs.The ongoing exploration and validation of these biomarkers are crucial for advancing CV care and addressing the limitations of current diagnostic tools.展开更多
BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic...BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic nutritional index(OPNI)and inflammation-related biomarkers,such as the neutrophil-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR),have been studied in the context of cancer prognosis,but their combined efficacy in predicting AL remains unclear.AIM To investigate the relationships between AL and these markers and developed a predictive model for AL.METHODS A retrospective cohort study analyzed the outcomes of 434 patients who had undergone surgery for rectal cancer at a tertiary cancer center from 2016 to 2023.The patients were divided into two groups on the basis of the occurrence of AL:One group consisted of patients who experienced AL(n=49),and the other group did not(n=385).The investigation applied logistic regression to develop a risk prediction model utilizing clinical,pathological,and laboratory data.The efficacy of this model was then evaluated through receiver operating characteristic curve analysis.RESULTS In the present study,11.28%of the participants(49 out of 434 participants)suffered from AL.Multivariate analysis revealed that preoperative levels of the OPNI,NLR,and PLR emerged as independent risk factors for AL,with odds ratios of 0.705(95%CI:0.641-0.775,P=0.012),1.628(95%CI:1.221-2.172,P=0.024),and 0.994(95%CI:0.989-0.999,P=0.031),respectively.These findings suggest that these biomarkers could effectively predict AL risk.Furthermore,the proposed predictive model has superior discriminative ability,as demonstrated by an area under the curve of 0.910,a sensitivity of 0.898,and a specificity of 0.826,reflecting its high level of accuracy.CONCLUSION The risk of AL in rectal cancer surgery patients can be effectively predicted by assessing the preoperative levels of serum nutritional biomarkers and inflammatory indicators,emphasizing their importance in the preoperative evaluation process.展开更多
Objective ZW10 interacting kinetochore protein(ZWINT)has been demonstrated to play a pivotal role in the growth,invasion,and migration of cancers.Nevertheless,whether the expression levels of ZWINT are significantly c...Objective ZW10 interacting kinetochore protein(ZWINT)has been demonstrated to play a pivotal role in the growth,invasion,and migration of cancers.Nevertheless,whether the expression levels of ZWINT are significantly correlated with clinicopathological characteristics and prognostic outcomes of patients with breast cancer remains elusive.This study systematically investigated the clinical significance of ZWINT expression in breast cancer through integrated molecular subtyping and survival analysis.Methods We systematically characterized the spatial expression pattern of ZWINT across various breast cancer subtypes and assessed its prognostic significance using an integrated bioinformatics approach that involved multi-omics analysis.The approach included the Breast Cancer Gene-Expression Miner v5.1(bc-GenExMiner v5.1),TNMplot,MuTarget,PrognoScan database,and Database for Annotation,Visualization,and Integrated Discovery(DAVID).Results Our analysis revealed consistent upregulation of ZWINT mRNA and protein expression across distinct clinicopathological subtypes of breast cancer.ZWINT overexpression demonstrated significant co-occurrence with truncating mutations in cadherin 1(CDH1)and tumor protein p53(TP53),suggesting potential functional crosstalk in tumor progression pathways.The overexpression of ZWINT correlated with adverse clinical outcomes,showing 48%increased mortality risk(overall survival:HR 1.48,95%CI 1.23–1.79),66%higher recurrence probability(relapse-free survival:1.66,95%CI 1.50–1.84),and 63%elevated metastasis risk(distant metastasis-free survival:HR 1.63,95%CI 1.39–1.90).Multivariate Cox regression incorporating TNM staging and molecular subtypes confirmed ZWINT as an independent prognostic determinant(P<0.001,Harrell’s C-index=0.7827),which was validated through bootstrap resampling(1000 iterations).Conclusion ZWINT may serve as a potential biomarker for prognosis and a possible therapeutic target alongside TP53/CDH1 in breast cancer.展开更多
文摘Detection and treatment of colorectal cancer(CRC)at an early stage is vital for long-term survival.Liquid biopsy has emerged as a promising new avenue for non-invasive screening of CRC as well as prognostication and surveillance of minimal residual disease.Cell free DNA(cfDNA)is a promising liquid biopsy analyte and has been approved for use in clinical practice.Here,we explore the current challenges of utilizing cfDNA in the screening and prognostication of CRC but also for detecting driver mutations in healthy,presymptomatic patients with normal colonic crypts.CfDNA for the detection of cancerous or premalignant colonic lesions has already been extensively explored,however few have considered utilizing cfDNA in the detection of driver mutations in healthy patients.Theoretically,this would allow us to detect patients who are at a higher risk of tumorigenesis decades in advance of established malignancy and stratify them into higher risk groups for early-intervention screening programs.We also explore the solutions necessary to overcome the challenges that prevent liquid biopsy from entering mainstream clinical use.The potential for liquid biopsy is immense if these challenges are successfully circumvented,and can dramatically reduce CRC rates as well as improve survival in patients.
文摘This commentary critically appraises the study by Li et al which pioneered the exploration of the triglyceride-glucose(TyG)index as a prognostic marker in hepatitis B virus-related advanced hepatocellular carcinoma patients undergoing combined camrelizumab and lenvatinib therapy.While we acknowledge the study’s clinical relevance in proposing an easily accessible metabolic biomarker,we delve into the mechanistic plausibility linking insulin resistance to immunotherapy response and angiogenic inhibition.We further critically examine the methodological limitations,including the retrospective design,the populationspecific TyG cut-off value,and unaddressed metabolic confounders.We highlight the imperative for future research to validate its utility across diverse etiologies and treatment settings,and to unravel the underlying immunometabolic pathways.
文摘AIM:To evaluate the clinical characteristics and risk factors associated with visual prognosis in patients with open globe injuries(OGIs)treated at Vietnam National Eye Hospital.METHODS:A prospective observational study included patients with OGIs treated between June 2023 and June 2024.Data on demographics,injury features,and clinical findings were extracted from medical records.Poor visual outcome was defined as final best-corrected visual acuity(BCVA)worse than 20/400 or no light perception.Multivariable logistic regression was performed to identify independent risk factors.RESULTS:Among 509 patients(636 eyes),the mean age was 35.13y(range 20–51y),and 67.6%were male.After treatment,the proportion of eyes achieving≥20/40 increased from 12.6%to 42.1%,while no light perception decreased from 29.1%to 9.4%.Independent predictors of poor visual outcomes included delayed admission[>4h,odds ratio(OR)=3.33,95%confidence intervals(CI):1.76–6.33,P<0.001],Zone III injury(OR=5.90,95%CI:2.85–12.24,P<0.001),wound length>10 mm(OR=2.59,95%CI:1.60–4.18,P<0.001),relative afferent pupillary defect(RAPD,OR=1.65,95%CI:1.03–2.64,P=0.039),endophthalmitis(OR=1.75,95%CI:1.01–3.03,P=0.047),retinal detachment(OR=3.32,95%CI:2.02–5.45,P<0.001),and eyelid lacerations(OR=1.94,95%CI:1.13–3.33,P=0.016)associated with OGIs.Vitreous hemorrhage(OR=0.44,95%CI:0.22–0.89,P=0.023)was associated with better outcomes,and female gender appeared protective.CONCLUSION:Poor visual outcomes remain common after OGIs,despite improve visual acuity in many cases.Several clinical and injury-related factors are strongly associated with prognosis.Early recognition of these predictors can support risk stratification and improve trauma care in similar settings.
文摘Male breast cancer(MBC)is rare,representing 0.5%–1%of all breast cancers,but its incidence is increasing due to improved diagnostics and awareness.MBC typically presents in older men,is human epidermal growth factor receptor 2(HER2)-negative and estrogen receptor(ER)-positive,and lacks routine screening,leading to delayed diagnosis and advanced disease.Major risk factors include hormonal imbalance,radiation exposure,obesity,alcohol use,and Breast Cancer Gene 1 and 2(BRCA1/2)mutations.Clinically,it may resemble gynecomastia but usually appears as a unilateral,painless mass or nipple discharge.Advances in imaging and liquid biopsy have enhanced early detection.Molecular mechanisms involve hormonal signaling,HER2/epidermal growth factor receptor(EGFR)pathways,tumor suppressor gene alterations,and epigenetic changes.While standard treatments mirror those for female breast cancer,emerging options such as cyclin-dependent kinase 4 and 6(CDK4/6),and poly(ADP-ribose)polymerase(PARP)inhibitors,immunotherapy,and precision medicine are reshaping management.Incorporating artificial intelligence,molecular profiling,and male-specific clinical trials is essential to improve outcomes and bridge current diagnostic and therapeutic gaps.
文摘Ossiculoplasty remains a challenging surgical procedure,with outcomes heavily influenced by diverse anatomical and pathological factors.Over the decades,numerous scoring systems have been developed to predict the prognosis of ossiculoplasty,each emphasizing different variables such as ossicular status,middle ear environment,and surgical history.This paper provides a comprehensive review of the evolution of prognostic scoring systems,including Austin's original ossicular classification,Bellucci's otorrhea staging,the Middle Ear Risk Index(MERI),the Ossiculoplasty Outcome Parameter Staging(OOPS),and the recently introduced Ear Environment Risk(EER)scale.While these systems have significantly contributed to preoperative assessment,each presents notable limitations in encompassing all variables affecting surgical success.Therefore,the aim of this paper is to provide a review of the ossiculoplasty prognostic scores and show the benefits,innovations and gaps associated with each.To address these gaps,a novel,modified scoring system is proposed,incorporating previously overlooked but clinically significant factors such as tympanic membrane status,type of tympanoplasty,ossicular replacement material,CT scan findings,and the presence of complicated ear conditions.By synthesizing elements from historical scores with updated clinical insights,the proposed system aims to provide a more holistic and predictive framework for preoperative evaluation.Future multicenter studies are encouraged to validate the efficacy and prognostic power of this new scoring system,with the goal of improving surgical planning and patient counseling in ossiculoplasty.
基金supported by a grant from the Central Level Public Welfare Research Institutes Basic Research Expenses of Chinese Academy of Medical Sciences(No.2023-RW320-05)。
文摘According to the 2024 global cancer data from GLOBOCAN,liver cancer ranks the 6th most common malignancy and the 3rd leading cause of cancer-related mortality worldwide[1].Among these cases,hepatocellular carcinoma(HCC)accounts for approximately 85%−90%[2,3].Its incidence and mortality rates remain persistently high worldwide.However,China has the highest incidence and mortality rates of the disease in the world[4].And the majority of patients are diagnosed at intermediate or advanced stages.Thus,identifying novel tumor biomarkers for early detection and implementing precision therapy has long been a key focus of research.
基金the Natural Science Foundation of Yongchuan District,No.2023yc-jckx20021.
文摘BACKGROUND Breast cancer is one of the most prevalent malignancies affecting women worldwide,with approximately 2.3 million new cases diagnosed annually.Breast cancer stem cells(BCSCs)play pivotal roles in tumor initiation,progression,metastasis,therapeutic resistance,and disease recurrence.Cancer stem cells possess selfrenewal capacity,multipotent differentiation potential,and enhanced tumorigenic activity,but their molecular characteristics and regulatory mechanisms require further investigation.AIM To comprehensively characterize the molecular features of BCSCs through multiomics approaches,construct a prognostic prediction model based on stem cellrelated genes,reveal cell-cell communication networks within the tumor microenvironment,and provide theoretical foundation for personalized treatment strategies.METHODS Flow cytometry was employed to detect the expression of BCSC surface markers(CD34,CD45,CD29,CD90,CD105).Transcriptomic analysis was performed to identify differentially expressed genes.Least absolute shrinkage and selection operator regression analysis was utilized to screen key prognostic genes and construct a risk scoring model.Single-cell RNA sequencing and spatial transcriptomics were applied to analyze tumor heterogeneity and spatial gene expression patterns.Cell-cell communication network analysis was conducted to reveal interactions between stem cells and the microenvironment.RESULTS Flow cytometric analysis revealed the highest expression of CD105(96.30%),followed by CD90(68.43%)and CD34(62.64%),while CD29 showed lower expression(7.16%)and CD45 exhibited the lowest expression(1.19%).Transcriptomic analysis identified 3837 significantly differentially expressed genes(1478 upregulated and 2359 downregulated).Least absolute shrinkage and selection operator regression analysis selected 10 key prognostic genes,and the constructed risk scoring model effectively distinguished between high-risk and low-risk patient groups(P<0.001).Single-cell analysis revealed tumor cellular heterogeneity,and spatial transcriptomics demonstrated distinct spatial expression gradients of stem cell-related genes.MED18 gene showed significantly higher expression in malignant tissues(P<0.001)and occupied a central position in cell-cell communication networks,exhibiting significant correlations with tumor cells,macrophages,fibroblasts,and endothelial cells.CONCLUSION This study comprehensively characterized the molecular features of BCSCs through multi-omics approaches,identified reliable surface markers and key regulatory genes,and constructed a prognostic prediction model with clinical application value.
基金Supported by Xuhui District Health Commission,No.SHXH202214.
文摘Gastrointestinal tumors require personalized treatment strategies due to their heterogeneity and complexity.Multimodal artificial intelligence(AI)addresses this challenge by integrating diverse data sources-including computed tomography(CT),magnetic resonance imaging(MRI),endoscopic imaging,and genomic profiles-to enable intelligent decision-making for individualized therapy.This approach leverages AI algorithms to fuse imaging,endoscopic,and omics data,facilitating comprehensive characterization of tumor biology,prediction of treatment response,and optimization of therapeutic strategies.By combining CT and MRI for structural assessment,endoscopic data for real-time visual inspection,and genomic information for molecular profiling,multimodal AI enhances the accuracy of patient stratification and treatment personalization.The clinical implementation of this technology demonstrates potential for improving patient outcomes,advancing precision oncology,and supporting individualized care in gastrointestinal cancers.Ultimately,multimodal AI serves as a transformative tool in oncology,bridging data integration with clinical application to effectively tailor therapies.
基金Supported by the Faculty of Medicine,Prince of Songkla University.Wainipitapong S has received grants from the Faculty of Medicine,Prince of Songkla University。
文摘AIM:To investigate the clinical characteristics and treatment outcomes,including visual function and overall survival(OS)of patients with ocular adnexal diffuse large B-cell lymphoma(OA-DLBCL).METHODS:This retrospective cohort study enrolled 29 patients diagnosed with OA-DLBCL based on histopathological biopsy between 2006 and 2023.Patients were stratified into two subgroups:primary OA-DLBCL(no prior history of lymphoma)and secondary OA-DLBCL(history of DLBCL at non-ocular adnexal sites).OS was defined as the time interval from OA-DLBCL diagnosis to death from any cause.Survival analysis was performed using the Kaplan–Meier method,and prognostic factors affecting OS were identified using multivariate Cox proportional hazards regression with a stepwise selection approach.RESULTS:The cohort included 24 patients with primary OA-DLBCL(13 males,11 females;mean age:61.36±18.29y)and 5 patients with secondary OA-DLBCL(2 males,3 females;mean age:50.94±18.17y).Among the primary OA-DLBCL subgroup,12 patients(50%)presented with advanced disease(Ann Arbor stage IIIE–IV),and 16 patients(66%)were classified as T4 disease according to the tumor-node-metastasis(TNM)staging system.The mean final visual acuity was 1.72±1.10 in the primary group and 0.90±1.18 in the secondary group.The 5-year OS rate for the entire cohort was 27.7%.Multivariate analysis identified five factors significantly associated with poor survival outcomes:epiphora[adjusted hazard ratio(aHR),36.95],atherosclerotic cardiovascular disease(aHR,10.08),human immunodeficiency virus(HIV)infection(aHR,12.47),M1 stage(aHR,6.99),and secondary OA-DLBCL(aHR,6.03;all P<0.05).The median OS was 1.68y for primary OA-DLBCL and 1.12y for secondary OA-DLBCL.CONCLUSION:A substantial proportion of patients with primary OA-DLBCL present with advanced-stage disease at diagnosis.Epiphora,atherosclerotic cardiovascular disease,HIV infection,M1 stage,and secondary OA-DLBCL are independent prognostic factors for poor survival outcomes.These findings emphasize the urgent need for optimized therapeutic strategies and early screening protocols to improve the management of OA-DLBCL,particularly in developing countries.
文摘On the basis of analysing and studyingthe mineralizing conditions and content ratinglaws, the authors infer the geology and oresnear old placers by applying the remote sens-ing technology and analogous method,
基金Supported by National Natural Science Foundation of China,No.81874390 and No.81573948Shanghai Natural Science Foundation,No.21ZR1464100+1 种基金Science and Technology Innovation Action Plan of Shanghai Science and Technology Commission,No.22S11901700the Shanghai Key Specialty of Traditional Chinese Clinical Medicine,No.shslczdzk01201.
文摘BACKGROUND Rebleeding after recovery from esophagogastric variceal bleeding(EGVB)is a severe complication that is associated with high rates of both incidence and mortality.Despite its clinical importance,recognized prognostic models that can effectively predict esophagogastric variceal rebleeding in patients with liver cirrhosis are lacking.AIM To construct and externally validate a reliable prognostic model for predicting the occurrence of esophagogastric variceal rebleeding.METHODS This study included 477 EGVB patients across 2 cohorts:The derivation cohort(n=322)and the validation cohort(n=155).The primary outcome was rebleeding events within 1 year.The least absolute shrinkage and selection operator was applied for predictor selection,and multivariate Cox regression analysis was used to construct the prognostic model.Internal validation was performed with bootstrap resampling.We assessed the discrimination,calibration and accuracy of the model,and performed patient risk stratification.RESULTS Six predictors,including albumin and aspartate aminotransferase concentrations,white blood cell count,and the presence of ascites,portal vein thrombosis,and bleeding signs,were selected for the rebleeding event prediction following endoscopic treatment(REPET)model.In predicting rebleeding within 1 year,the REPET model ex-hibited a concordance index of 0.775 and a Brier score of 0.143 in the derivation cohort,alongside 0.862 and 0.127 in the validation cohort.Furthermore,the REPET model revealed a significant difference in rebleeding rates(P<0.01)between low-risk patients and intermediate-to high-risk patients in both cohorts.CONCLUSION We constructed and validated a new prognostic model for variceal rebleeding with excellent predictive per-formance,which will improve the clinical management of rebleeding in EGVB patients.
文摘BACKGROUND Acute-on-chronic liver failure(ACLF)is a liver disease based on chronic liver disease,which is significantly influenced by clinical treatment regimen and disease status,and despite the existence of multiple prognostic assessment indicators for ACLF,the overall sensitivity and accuracy are relatively low.AIM To investigate the prognostic value of the combined detection of alpha-fetoprotein(AFP),plasma prothrombin activity(PTA),and serum prealbumin(PA)in ACLF.METHODS This retrospective study included 87 patients with ACLF admitted from February 2021 to February 2023 and categorized them into the survival(n=47)and death(n=40)groups according to their clinical outcomes 3 months posttreatment.All the participants underwent AFP,PTA,and PA level measurements upon admission.Baseline data,as well as AFP,PTA,and PA levels,were comparatively analyzed.Pearson correlation coefficients were utilized to analyze the correlations of AFP,PTA,and PA with different survival outcomes in patients with ACLF.Receiver operating characteristic(ROC)curves and areas under the curves were used to evaluate the predictive value of AFP,PTA,and PA for ACLF prognosis.RESULTS AFP,PTA,and PA levels were markedly decreased in the death group than in the survival group(P<0.05).Pearson analysis indicated a positive association of the AFP,PTA,and PA levels with the survival of patients with ACLF(P<0.05).ROC curve analysis determined the sensitivity and specificity of the combined diagnosis at 91.24%and 100.00%,respectively,both of which were notably increased compared to the single-index diagnosis.The ROC of their combined diagnosis was 0.989,significantly surpassing 0.907,0.849,and 0.853 of AFP,PTA,and PA,respectively.No statistically significant variance was determined in the sensitivity and specificity of the combined diagnosis vs the single detection(P>0.05).CONCLUSION The combined detection of AFP,PTA,and PA levels demonstrates favorable diagnostic value for the short-term prognosis of patients with ACLF,featuring high sensitivity and specificity.
基金Supported by Gansu Province Joint Fund General Program,No.24JRRA878Gansu Provincial Science and Technology Program Project,No.24JRRA1020+2 种基金Gansu Province Key Talent Program,No.2025RCXM006Teaching Research and Reform Program for Postgraduate Education at Gansu University of Traditional Chinese Medicine(GUSTCM),No.YBXM-202406Special Fund for Mentors of“Qihuang Talents”in the First-Level Discipline of Chinese Medicine,No.ZYXKBD-202415。
文摘BACKGROUND Emerging evidence implicates Candida albicans(C.albicans)in human oncogenesis.Notably,studies have supported its involvement in regulating outcomes in colorectal cancer(CRC).This study investigated the paradoxical role of C.albicans in CRC,aiming to determine whether it promotes or suppresses tumor development,with a focus on the mechanistic basis linked to its metabolic profile.AIM To investigate the dual role of C.albicans in the development and progression of CRC through metabolite profiling and to establish a prognostic model that integrates the microbial and metabolic interactions in CRC,providing insights into potential therapeutic strategies and clinical outcomes.METHODSA prognostic model integrating C. albicans with CRC was developed, incorporating enrichment analysis, immuneinfiltration profiling, survival analysis, Mendelian randomization, single-cell sequencing, and spatial transcriptomics.The effects of the C. albicans metabolite mixture on CRC cells were subsequently validated in vitro. Theprimary metabolite composition was characterized using liquid chromatography-mass spectrometry.RESULTSA prognostic model based on five specific mRNA markers, EHD4, LIME1, GADD45B, TIMP1, and FDFT1, wasestablished. The C. albicans metabolite mixture significantly reduced CRC cell viability. Post-treatment analysisrevealed a significant decrease in gene expression in HT29 cells, while the expression levels of TIMP1, EHD4, andGADD45B were significantly elevated in HCT116 cells. Conversely, LIME1 expression and that of other CRC celllines showed reductions. In normal colonic epithelial cells (NCM460), GADD45B, TIMP1, and FDFT1 expressionlevels were significantly increased, while LIME1 and EHD4 levels were markedly reduced. Following metabolitetreatment, the invasive and migratory capabilities of NCM460, HT29, and HCT116 cells were reduced. Quantitativeanalysis of extracellular ATP post-treatment showed a significant elevation (P < 0.01). The C. albicans metabolitemixture had no effect on reactive oxygen species accumulation in CRC cells but led to a reduction in mitochondrialmembrane potential, increased intracellular lipid peroxidation, and induced apoptosis. Metabolomic profilingrevealed significant alterations, with 516 metabolites upregulated and 531 downregulated.CONCLUSIONThis study introduced a novel prognostic model for CRC risk assessment. The findings suggested that the C.albicans metabolite mixture exerted an inhibitory effect on CRC initiation.
文摘Rectal neuroendocrine tumors(r-NETs)are the second most common type of neuroendocrine tumor in the gastrointestinal tract,with an increase in incidence in the last decades.They are low-grade tumors and,given their low risk of meta-stasis,current guidelines recommend endoscopic resection for small lesions.The GATIS predicting score,proposed by Zeng et al,represents an innovative model designed to predict individualized survival outcomes for patients with r-NETs,analyzing the relationship between clinicopathological features and patient prog-noses.The authors identified tumor grade,T stage,tumor size,age,and progno-stic nutritional index as key prognostic factors,demonstrating that the GATIS Score provides a more accurate prognosis assessment compared to the World Health Organization classification or the tumor-node-metastasis staging system.Nevertheless,further larger prospective studies are necessary,and the scientific community's efforts in this context should be directed toward developing interna-tional multicentric prospective studies,with the ultimate aim of accurately de-fining and understanding the behavior of these conditions.
基金Supported by the University Scientific Research Project of Anhui Province,No.2024AH051916the Quality Engineering Project of Anhui Province,No.2022sx159 and No.2022sdxx031the Key Research and Development Project of Anhui Province,No.2022e07020036.
文摘BACKGROUND Colon adenocarcinoma(COAD)ranks second in terms of cancer-related deaths.We found that fatty acid-binding protein 4(FABP4),which is related to cell adhesion and immunity,affects the occurrence and development of COAD.This study focused on the possibility of using FABP4 as a biomarker for COAD and constructed a nomogram for predicting the survival of COAD patients.AIM To verify the possibility of using FABP4 as a biomarker for COAD.METHODS A total of 453 COAD tissue samples,along with 41 normal tissue samples,were obtained from The Cancer Genome Atlas database.The difference in FABP4 expression between COAD tissues and normal tissues was analyzed,and the results were verified by immunohistochemistry.The WGCNA algorithm links FABP4 expression with an enrichment analysis and with immune cell infiltration pathways.The biological functions of FABP4 and its coexpressed genes were explored through enrichment analyses.The ESTIMATE,CIBERSORT and ssGSEA methods were used for the immune infiltration analysis.Finally,risk scores were calculated by a Cox analysis.A nomogram was constructed by combining risk scores with routine clinicopathological factors.We assessed the accuracy of survival predictions based on the C-index.The C-index ranges from 0.5 to 1.0,and in general,a C-index value greater than 0.65 indicates a reasonable estimate.The results were validated using the Gene Expression Omnibus(GEO)database.RESULTS FABP4 was significantly differentially expressed in COAD.It is a promising auxiliary biomarker for screening and diagnosis.Enrichment analyses suggested that FABP4 may influence the invasion and progression of COAD through cell adhesion.The immunological analysis revealed that FABP4 expression in COAD was significantly positively correlated with immune cell infiltration.Moreover,a nomogram to predict the survival of COAD patients was successfully constructed by integrating the calculated risk scores of 15 candidate genes and routine clinicopathological factors.This nomogram could effectively predict 1-year,3-year,and 5-year survival(C-index=0.786)and was verified(C-index=0.73).CONCLUSION This study established FABP4 as an effective biomarker for screening,assisting in the diagnosis and determining the prognosis.
文摘Gastric cancer(GC)is a leading cause of cancer-related deaths,highlighting the need for reliable prognostic biomarkers to guide treatment.Wei et al’s systematic review and meta-analysis evaluates the neutrophil-to-lymphocyte ratio(NLR)as a potential biomarker for GC patients undergoing neoadjuvant chemotherapy.NLR is a simple and cost-effective measure of systemic inflammation that shows promise in predicting treatment response and survival outcomes,including overall survival and progression-free survival.However,variations in NLR thresholds and timing of measurements affect its accuracy and clinical utility.Moreover,the studies reviewed primarily involved Asian populations,which may limit the generalizability of the findings.To improve NLR’s clinical relevance,future research should focus on standardizing NLR thresholds,refining measurement timing,and incorporating additional inflammatory markers like platelet-to-lymphocyte ratio and Glasgow prognostic score.Addressing con-founders and including diverse patient populations will help improve NLR’s reliability as a prognostic marker for GC.
基金Supported by the Scientific Research Project of Hospital Pharmacy of Guangxi Pharmaceutical Association in 2022,No.GXYXH1-202202.
文摘BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia,nausea,vomiting,and other discomforts,and often suffer from malnutrition,which in turn negatively affects perioperative safety,prognosis,and the effectiveness of adjuvant therapeutic measures.Consequently,some nutritional indicators such as nutritional risk index(NRI),prognostic nutritional index(PNI),and systemic immune-inflammatorynutritional index(SIINI)can be used as predictors of the prognosis of GC patients.AIM To examine the prognostic significance of PNI,NRI,and SIINI in postoperative patients with GC.METHODS A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018.The area under the receiver operating characteristic(ROC)curve was assessed using ROC curve analysis,and the optimal cutoff values for NRI,PNI,and SIINI were identified using the You-Review-HTMLden index.Survival analysis was performed using the Kaplan-Meier method.In addition,univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.RESULTS This study included a total of 803 patients.ROC curves were used to evaluate the prognostic ability of NRI,PNI,and SIINI.The results revealed that SIINI had superior predictive accuracy.Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group(P<0.05).Univariate analysis identified NRI[hazard ratio(HR)=0.68,95%confidence interval(CI):0.52-0.89,P=0.05],PNI(HR=0.60,95%CI:0.46-0.79,P<0.001),and SIINI(HR=2.10,95%CI:1.64-2.69,P<0.001)as prognostic risk factors for patients with GC.However,multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC(HR=1.65,95%CI:1.26-2.16,P<0.001).CONCLUSION Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC.Compared with NRI and PNI,SIINI may offer greater application for prognostic assessment.
文摘Cardiovascular diseases(CVDs)remain the leading cause of morbidity and mortality worldwide,necessitating innovative diagnostic and prognostic strategies.Traditional biomarkers like C-reactive protein,uric acid,troponin,and natriuretic peptides play crucial roles in CVD management,yet they are often limited by sensitivity and specificity constraints.This narrative review critically examines the emerging landscape of cardiac biomarkers and advocates for a multiple-marker approach to enhance early detection,prognosis,and risk stratification of CVD.In recent years,several novel biomarkers have shown promise in revolutionizing CVD diagnostics.Gamma-glutamyltransferase,microRNAs,endothelial microparticles,placental growth factor,trimethylamine N-oxide,retinol-binding protein 4,copeptin,heart-type fatty acid-binding protein,galectin-3,growth differentiation factor-15,soluble suppression of tumorigenicity 2,fibroblast growth factor 23,and adrenomedullin have emerged as significant indicators of CV health.These biomarkers provide insights into various pathophysiological processes,such as oxidative stress,endothelial dysfunction,inflammation,metabolic disturbances,and myocardial injury.The integration of these novel biomarkers with traditional ones offers a more comprehensive understanding of CVD mechanisms.This multiple-marker approach can improve diagnostic accuracy,allowing for better risk stratification and more personalized treatment strategies.This review underscores the need for continued research to validate the clinical utility of these biomarkers and their potential incorporation into routine clinical practice.By leveraging the strengths of both traditional and novel biomarkers,precise therapeutic plans can be developed,thereby improving the management and prognosis of patients with CVDs.The ongoing exploration and validation of these biomarkers are crucial for advancing CV care and addressing the limitations of current diagnostic tools.
基金Supported by Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01C297.
文摘BACKGROUND Anastomotic leakage(AL)is a serious complication following rectal cancer surgery and is associated with increased recurrence,mortality,extended hospital stays,and delayed chemotherapy.The Onodera prognostic nutritional index(OPNI)and inflammation-related biomarkers,such as the neutrophil-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR),have been studied in the context of cancer prognosis,but their combined efficacy in predicting AL remains unclear.AIM To investigate the relationships between AL and these markers and developed a predictive model for AL.METHODS A retrospective cohort study analyzed the outcomes of 434 patients who had undergone surgery for rectal cancer at a tertiary cancer center from 2016 to 2023.The patients were divided into two groups on the basis of the occurrence of AL:One group consisted of patients who experienced AL(n=49),and the other group did not(n=385).The investigation applied logistic regression to develop a risk prediction model utilizing clinical,pathological,and laboratory data.The efficacy of this model was then evaluated through receiver operating characteristic curve analysis.RESULTS In the present study,11.28%of the participants(49 out of 434 participants)suffered from AL.Multivariate analysis revealed that preoperative levels of the OPNI,NLR,and PLR emerged as independent risk factors for AL,with odds ratios of 0.705(95%CI:0.641-0.775,P=0.012),1.628(95%CI:1.221-2.172,P=0.024),and 0.994(95%CI:0.989-0.999,P=0.031),respectively.These findings suggest that these biomarkers could effectively predict AL risk.Furthermore,the proposed predictive model has superior discriminative ability,as demonstrated by an area under the curve of 0.910,a sensitivity of 0.898,and a specificity of 0.826,reflecting its high level of accuracy.CONCLUSION The risk of AL in rectal cancer surgery patients can be effectively predicted by assessing the preoperative levels of serum nutritional biomarkers and inflammatory indicators,emphasizing their importance in the preoperative evaluation process.
基金supported by the Research Project of Maternal and Child Health Hospital of Hubei Province(No.2023SFYM008)Key Project of Hubei Provincial Natural Science Foundation(No.JCZRLH202500304).
文摘Objective ZW10 interacting kinetochore protein(ZWINT)has been demonstrated to play a pivotal role in the growth,invasion,and migration of cancers.Nevertheless,whether the expression levels of ZWINT are significantly correlated with clinicopathological characteristics and prognostic outcomes of patients with breast cancer remains elusive.This study systematically investigated the clinical significance of ZWINT expression in breast cancer through integrated molecular subtyping and survival analysis.Methods We systematically characterized the spatial expression pattern of ZWINT across various breast cancer subtypes and assessed its prognostic significance using an integrated bioinformatics approach that involved multi-omics analysis.The approach included the Breast Cancer Gene-Expression Miner v5.1(bc-GenExMiner v5.1),TNMplot,MuTarget,PrognoScan database,and Database for Annotation,Visualization,and Integrated Discovery(DAVID).Results Our analysis revealed consistent upregulation of ZWINT mRNA and protein expression across distinct clinicopathological subtypes of breast cancer.ZWINT overexpression demonstrated significant co-occurrence with truncating mutations in cadherin 1(CDH1)and tumor protein p53(TP53),suggesting potential functional crosstalk in tumor progression pathways.The overexpression of ZWINT correlated with adverse clinical outcomes,showing 48%increased mortality risk(overall survival:HR 1.48,95%CI 1.23–1.79),66%higher recurrence probability(relapse-free survival:1.66,95%CI 1.50–1.84),and 63%elevated metastasis risk(distant metastasis-free survival:HR 1.63,95%CI 1.39–1.90).Multivariate Cox regression incorporating TNM staging and molecular subtypes confirmed ZWINT as an independent prognostic determinant(P<0.001,Harrell’s C-index=0.7827),which was validated through bootstrap resampling(1000 iterations).Conclusion ZWINT may serve as a potential biomarker for prognosis and a possible therapeutic target alongside TP53/CDH1 in breast cancer.
