BACKGROUND Gastric cancer(GC)is one of the most common malignant tumors of the digestive system worldwide,the prognosis of patients with advanced GC remains poor.AIM To evaluate the combined expression characteristics...BACKGROUND Gastric cancer(GC)is one of the most common malignant tumors of the digestive system worldwide,the prognosis of patients with advanced GC remains poor.AIM To evaluate the combined expression characteristics of cancer stem cell markers CD24 and CD133 in GC pathological tissues,and to explore their association with patients’clinicopathological parameters and postoperative survival outcomes.METHODS A total of 304 GC patients who underwent surgical treatment in our hospital from January 2018 to January 2020 were retrospectively included.Immunohistochemistry was used to detect the protein expression of CD24 and CD133 in tumor tissues,adjacent tissues,and normal gastric mucosa tissues.Based on staining intensity and the proportion of positive cells,expression levels were classified into low and high expression,while clinicopathological parameters were recorded.χ2 test was used to evaluate the correlation between expression and categorical variables,Spearman rank correlation analysis was performed to assess the correlation between the expression intensities of the two markers,and multivariate regression models were applied to identify independent risk factors influencing co-expression.Kaplan-Meier survival curves and Log-rank test were used to compare survival differences among groups with different expression patterns.RESULTS Among the 304 patients,155 cases(50.99%)were CD24 positive,including 91 low-expression and 64 highexpression;133 cases(43.75%)were CD133 positive,including 81 low-expression and 52 high-expression.There were 74 cases(24.34%)with double positivity and 81 cases(26.64%)with double negativity.Compared with tumor tissues,the positive rates of CD24 and CD133 in normal gastric tissues and adjacent tissues were significantly lower(P<0.05).Univariate analysis showed that co-expression of CD24 and CD133 in GC tissues was significantly correlated with tumor size,Lauren classification,T stage,N stage,and vascular invasion(P<0.05),but not with patient age,gender,tumor site,World Health Organization histological classification,or M stage(P>0.05).Further multivariate regression analysis suggested that tumor size,T stage,N stage,and vascular invasion were independent risk factors promoting CD24 and CD133 double positivity.Spearman rank correlation analysis indicated a moderate positive correlation between their expression intensities(r=0.420,P<0.001).During follow-up,29 of 304 patients were lost(loss rate 9.54%);146 deaths occurred.According to expression combination,there were 89 cases of CD24 single positivity(39 deaths),68 cases of CD133 single positivity(31 deaths),81 cases of double negativity(25 deaths),and 66 cases of double positivity(51 deaths).Log-rank test showed significant differences in overall survival among the four groups(χ2=20.89,P<0.001),with CD24+/CD133+group showing the worst prognosis.CONCLUSION CD24 and CD133 exhibit high positive detection rates in GC tissues,and their co-positivity is closely associated with tumor stage progression and significantly indicates unfavorable survival outcomes.The co-expression of CD24/CD133 may reflect higher aggressiveness and metastatic potential of GC,serving as a potential prognostic marker and a direction for targeted therapeutic strategies.However,as this is a single-center retrospective study with limitations such as patient loss to follow-up and sample size,further prospective,multicenter,and mechanistic studies are required to validate its clinical applicability and biological role.展开更多
目的分析程序性细胞死亡因子5(programmed cell death 5,PDCD5)、半胱天冬酶1(cysteinyl aspartate specific proteinase-1,Caspase-1)及分化簇64(cluster of differentiation 64,CD64)联合与甲型H1N1流行性感冒病毒性肺炎患者短期预后...目的分析程序性细胞死亡因子5(programmed cell death 5,PDCD5)、半胱天冬酶1(cysteinyl aspartate specific proteinase-1,Caspase-1)及分化簇64(cluster of differentiation 64,CD64)联合与甲型H1N1流行性感冒病毒性肺炎患者短期预后的相关性及预测价值,构建甲型H1N1流行性感冒病毒性肺炎患者短期不良预后的预测模型。方法选取2023年3月—2024年8月在上海市同仁医院确诊的甲型H1N1流行性感冒病毒性肺炎患者362例,并依据28 d内生存结局分为生存组259例与死亡组103例。收集比较2组入院时的临床特征资料,通过多因素Logistic回归分析确定甲型H1N1流行性感冒病毒性肺炎28 d死亡的独立危险因素,通过R 4.3.1绘制列线图模型。绘制受试者工作特征(receiver operating characteristic,ROC)曲线、校准曲线、临床决策曲线分析(decision curve analysis,DCA)评估列线图模型的预测效能及临床获益。结果死亡组年龄、体温、心率、呼吸频率、白细胞计数、中性粒细胞、C反应蛋白、乳酸脱氢酶、降钙素原、乳酸、血二氧化碳分压、血氧分压、吸入氧浓度、丙氨酸转氨酶、天冬氨酸转氨酶、尿素氮、血肌酐、PDCD5、Caspase-1、CD64、中性粒细胞与淋巴细胞比值(neutrophil-tolymphocyte ratio,NLR)、急性生理与慢性健康评分II(acute physiology and chronic health evaluationII,APACHEII)评分、序贯器官衰竭估计评分、临床肺部感染(clinical pulmonary infection score,CPIS)评分、机械通气高于生存组,收缩压、舒张压、淋巴细胞低于生存组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,PDCD5(OR=1.02,95%CI:1.01~1.03)、Caspase-1(OR=1.03,95%CI:1.01~1.05)、CD64(OR=1.03,95%CI:1.01~1.05)、NLR(OR=1.23,95%CI:1.08~1.40)、APACHEII评分(OR=1.58,95%CI:1.24~2.02)、CPIS评分(OR=1.69,95%CI:1.29~2.22)、机械通气(OR=5.73,95%CI:2.97~11.08)均为甲型H1N1流行性感冒病毒性肺炎患者28 d死亡的独立相关因素(均P<0.05)。PDCD5、Caspase-1、CD64单项预测28 d死亡的曲线下面积(area under the curve,AUC)分别为0.723、0.704和0.639,三者联合预测模型的AUC为0.923。模型经Bootstrap法重抽样1000次内部验证后,C-index为0.903(95%CI:0.874~0.927)。校准曲线显示,预测概率与实际发生率拟合良好;DCA结果提示,当预测28 d死亡风险阈值概率在5%~62%范围内时,列线图模型可获得较高的净临床获益。结论基于PDCD5、Caspase-1、CD64构建甲型H1N1流行性感冒病毒性肺炎患者短期预后预测模型可对高危甲型H1N1流行性感冒病毒性肺炎患者进行早期预警。展开更多
基金National Natural Science Foundation of China,No.82003223and China Postdoctoral Science Foundation,No.2020M671398.
文摘BACKGROUND Gastric cancer(GC)is one of the most common malignant tumors of the digestive system worldwide,the prognosis of patients with advanced GC remains poor.AIM To evaluate the combined expression characteristics of cancer stem cell markers CD24 and CD133 in GC pathological tissues,and to explore their association with patients’clinicopathological parameters and postoperative survival outcomes.METHODS A total of 304 GC patients who underwent surgical treatment in our hospital from January 2018 to January 2020 were retrospectively included.Immunohistochemistry was used to detect the protein expression of CD24 and CD133 in tumor tissues,adjacent tissues,and normal gastric mucosa tissues.Based on staining intensity and the proportion of positive cells,expression levels were classified into low and high expression,while clinicopathological parameters were recorded.χ2 test was used to evaluate the correlation between expression and categorical variables,Spearman rank correlation analysis was performed to assess the correlation between the expression intensities of the two markers,and multivariate regression models were applied to identify independent risk factors influencing co-expression.Kaplan-Meier survival curves and Log-rank test were used to compare survival differences among groups with different expression patterns.RESULTS Among the 304 patients,155 cases(50.99%)were CD24 positive,including 91 low-expression and 64 highexpression;133 cases(43.75%)were CD133 positive,including 81 low-expression and 52 high-expression.There were 74 cases(24.34%)with double positivity and 81 cases(26.64%)with double negativity.Compared with tumor tissues,the positive rates of CD24 and CD133 in normal gastric tissues and adjacent tissues were significantly lower(P<0.05).Univariate analysis showed that co-expression of CD24 and CD133 in GC tissues was significantly correlated with tumor size,Lauren classification,T stage,N stage,and vascular invasion(P<0.05),but not with patient age,gender,tumor site,World Health Organization histological classification,or M stage(P>0.05).Further multivariate regression analysis suggested that tumor size,T stage,N stage,and vascular invasion were independent risk factors promoting CD24 and CD133 double positivity.Spearman rank correlation analysis indicated a moderate positive correlation between their expression intensities(r=0.420,P<0.001).During follow-up,29 of 304 patients were lost(loss rate 9.54%);146 deaths occurred.According to expression combination,there were 89 cases of CD24 single positivity(39 deaths),68 cases of CD133 single positivity(31 deaths),81 cases of double negativity(25 deaths),and 66 cases of double positivity(51 deaths).Log-rank test showed significant differences in overall survival among the four groups(χ2=20.89,P<0.001),with CD24+/CD133+group showing the worst prognosis.CONCLUSION CD24 and CD133 exhibit high positive detection rates in GC tissues,and their co-positivity is closely associated with tumor stage progression and significantly indicates unfavorable survival outcomes.The co-expression of CD24/CD133 may reflect higher aggressiveness and metastatic potential of GC,serving as a potential prognostic marker and a direction for targeted therapeutic strategies.However,as this is a single-center retrospective study with limitations such as patient loss to follow-up and sample size,further prospective,multicenter,and mechanistic studies are required to validate its clinical applicability and biological role.
文摘目的分析程序性细胞死亡因子5(programmed cell death 5,PDCD5)、半胱天冬酶1(cysteinyl aspartate specific proteinase-1,Caspase-1)及分化簇64(cluster of differentiation 64,CD64)联合与甲型H1N1流行性感冒病毒性肺炎患者短期预后的相关性及预测价值,构建甲型H1N1流行性感冒病毒性肺炎患者短期不良预后的预测模型。方法选取2023年3月—2024年8月在上海市同仁医院确诊的甲型H1N1流行性感冒病毒性肺炎患者362例,并依据28 d内生存结局分为生存组259例与死亡组103例。收集比较2组入院时的临床特征资料,通过多因素Logistic回归分析确定甲型H1N1流行性感冒病毒性肺炎28 d死亡的独立危险因素,通过R 4.3.1绘制列线图模型。绘制受试者工作特征(receiver operating characteristic,ROC)曲线、校准曲线、临床决策曲线分析(decision curve analysis,DCA)评估列线图模型的预测效能及临床获益。结果死亡组年龄、体温、心率、呼吸频率、白细胞计数、中性粒细胞、C反应蛋白、乳酸脱氢酶、降钙素原、乳酸、血二氧化碳分压、血氧分压、吸入氧浓度、丙氨酸转氨酶、天冬氨酸转氨酶、尿素氮、血肌酐、PDCD5、Caspase-1、CD64、中性粒细胞与淋巴细胞比值(neutrophil-tolymphocyte ratio,NLR)、急性生理与慢性健康评分II(acute physiology and chronic health evaluationII,APACHEII)评分、序贯器官衰竭估计评分、临床肺部感染(clinical pulmonary infection score,CPIS)评分、机械通气高于生存组,收缩压、舒张压、淋巴细胞低于生存组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,PDCD5(OR=1.02,95%CI:1.01~1.03)、Caspase-1(OR=1.03,95%CI:1.01~1.05)、CD64(OR=1.03,95%CI:1.01~1.05)、NLR(OR=1.23,95%CI:1.08~1.40)、APACHEII评分(OR=1.58,95%CI:1.24~2.02)、CPIS评分(OR=1.69,95%CI:1.29~2.22)、机械通气(OR=5.73,95%CI:2.97~11.08)均为甲型H1N1流行性感冒病毒性肺炎患者28 d死亡的独立相关因素(均P<0.05)。PDCD5、Caspase-1、CD64单项预测28 d死亡的曲线下面积(area under the curve,AUC)分别为0.723、0.704和0.639,三者联合预测模型的AUC为0.923。模型经Bootstrap法重抽样1000次内部验证后,C-index为0.903(95%CI:0.874~0.927)。校准曲线显示,预测概率与实际发生率拟合良好;DCA结果提示,当预测28 d死亡风险阈值概率在5%~62%范围内时,列线图模型可获得较高的净临床获益。结论基于PDCD5、Caspase-1、CD64构建甲型H1N1流行性感冒病毒性肺炎患者短期预后预测模型可对高危甲型H1N1流行性感冒病毒性肺炎患者进行早期预警。
