PD-L1表达与胃癌预后及临床病理特征相关性Meta分析

目的 程序性死亡受体-配体1(programmed cell death-Ligand 1,PD-L1)在恶性肿瘤的免疫逃逸中起到重要作用.本研究采用Meta分析评价方法,探讨PD-L1表达与胃癌预后及临床病理特征的相关性.方法 检索Medline/PubMed、EMBASE、Cochrane Library、Springer、万方、维普和中国知网等数据库,收集2016-05-25前公开发表的关于PD-L1表达与胃癌预后相关性的回顾性队列研究.采用RevMan5.3软件进行Meta分析,Newcastle-OttawaScale (NOS)量表进行文献质量评价,漏斗图评估文献的发表偏移.采用比值比(odds ratio,OR)及95％可信区间(confidence interval,CI)评价关联强度.结果 共纳入8篇文献(1 322例患者)进行Meta分析.结果显示,PD-L1阳性表达与胃癌患者3年总体生存率(OR=2.88,95％CI:2.19～3.79,P＜0.001)及5年总体生存率(OR=2.95,95％CI:1.70～5.10,P＜0.001)降低有关.PD-L1表达差异与淋巴结转移(OR=3.32,95％CI:2.35～4.68,P＜0.001)、肿瘤大小(OR=1.52,95％CI:1.12～2.05,P=0.007)有关,而与性别(OR=1.14,95％CI:0.89～1.46,P=0.290)、分化程度(OR=1.02,95％CI:0.68～1.53,P=0.920)、浸润深度(OR=2.14,95％CI:0.93～4.94,P=0.080)、TNM分期(OR=1.99,95％CI:0.77～5.16,P=0.160)无关.结论 PD-L1与胃癌预后有关,其阳性表达在淋巴结转移阳性、肿瘤直径＞5 cm的胃癌患者中更常见.     

HIF-1α蛋白在乳腺癌中表达意义的Meta分析

[目的]评价乳腺癌中乏氧诱导因子-1α(HIF-1α)的表达及其与临床预后的关系.[方法]计算机检索Pubmed、EMBASE、Cochrane Library、中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊全文数据库等,同时追查纳入文献的参考文献,纳入有关HIF-1α与乳腺癌关系的临床试验.采用Stata 11.0软件进行统计学分析.[结果]共纳入18篇文献1503例乳腺癌患者.Meta分析结果显示:HIF-1α在乳腺癌中的阳性表达水平明显增高(OR=23.11,95％CI:10.07～53.03,P＜0.001).HIF-1α在乳腺癌T3～4期与T1～2期的表达差异无统计学意义(OR=1.21,95％CI:0.87～1.87,P=0.392);HIF-1α在乳腺癌低分化组与中高分化组(OR=3.77,95％CI:2.78～5.11,P＜0.001)、淋巴结转移组与非淋巴结转移组(OR=3.03,95％CI:1.76～5.22,P＜0.001)、临床分期Ⅲ～Ⅳ期组与Ⅰ～Ⅱ期组(OR=2.82,95％CI:1.94～4.10,P＜0.001)的表达差异均具有统计学意义.HIF-1α的表达明显增加了乳腺癌中血管内皮生长因子(VEGF)的表达( OR=6.55,95％CI:4.33～9.68,P＜0.001).HIF-1α阳性表达乳腺癌患者的5年生存率明显低于HIF-1α阴性表达者(RR=0.54,95％CI:0.35～0.83,P＜0.001).[结论]HIF-1α在乳腺癌中高表达,增加了其恶性行为的发生风险,降低了患者的5年生存率,乳腺癌中HIF-1α与VEGF的表达有一定的相关性.     

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目的 探讨循环癌细胞(CTCs)和胃癌患者肿瘤分期、淋巴结转移和预后的相关性.方法 计算机检索Embase、Medline和PubMed数据库,根据纳入和排除标准筛选文献,对入选文献的特征、研究结果的内容进行摘录和评价,并对各研究结果进行异质性检验和数据合并.结果 入选文献18篇,均发表于2000-2011年.Ⅰ～Ⅱ期胃癌术前CTCs阳性率显著低于Ⅲ期患者(RR=0.63,95％CI:0.48～0.84),有淋巴结转移患者的CTCs阳性率高于无淋巴结转移的患者(RR=1.42,95％CI:1.20～1.68).术前CTCs阳性的患者术后发生复发或转移的风险显著高于阴性患者(RR=2.42,95％ CI:1.94～3.02),而且总体生存率更低(HR=1.83,95％CI:1.30～2.60).结论 术前CTCs检测阳性是胃癌患者预后不良的一个重要判断指标,可为胃癌的治疗决策提供参考.     

胃癌组织中SOX2表达及其临床病理特征的Meta分析

目的 探讨性别决定区Y框蛋白2（SOX2）在胃癌组织中的表达及其与临床病理特征的关系,为临床提供参考。方法 计算机检索PubMed、EMBASE以及中国知网、万方、维普等数据库中有关SOX2表达与胃癌研究的文献,检索年限为各数据库建库起至2016年10月1日。按照纳入和排除标准筛选文献、提取资料并评价质量,采用RevMan 53软件进行Meta分析,计算合并OR值及其95%CI,并进行发表偏倚评估。结果 共纳入13篇文献包括胃癌组织1492例,正常胃组织724例。Meta分析结果显示,SOX2在胃癌与正常胃组织（OR=0.16,95％CI：0.11～0.23）、胃癌高中分化组与低分化组（OR=2.66,95％CI：1.54～4.59）中的表达差异均有统计学意义（P＜0.05）;SOX2在淋巴结转移组与无淋巴结转移组（OR=0.54,95％CI：0.26～1.11）、临床Ⅰ+Ⅱ期与临床Ⅲ+Ⅳ期（OR=2.23,95％CI：0.82～6.09）、浸润深度T1+T2与T3+T4（OR=1.44,95％CI：0.64～3.22）、男性与女性（OR=1.10,95％CI：0.82～1.47） 中的表达差异均无统计学意义（P＞0.05）。结论 SOX2的表达与胃癌及其临床病理特征有关,但受纳入研究数量和质量限制,上述结论尚待开展更多高质量研究加以验证。     

缺氧诱导因子1α蛋白过表达与肝细胞癌临床病理学特征及预后关系Meta分析

目的 缺氧诱导因子-1α(hypoxia-inducible factor 1α,HIF-1α)是细胞应对缺氧时的关键转录因子,在多种恶性肿瘤中过表达.本研究系统评价HIF-1α蛋白过表达在肝细胞癌(hepatocellular carcinoma,HCC)发生、发展及患者预后中所起的作用.方法 计算机检索Cochrane Library、PubMed、EMbase、中国知网、万方及维普数据库至2016-07,搜集国内外公开发表关于HIF-1α蛋白表达与HCC不同临床病理特征及预后相关性的研究.按纳入与排除标准筛选文献、提取资料并评价纳入研究的质量后,运用Stata 11.0软件进行Meta分析,应用比值比(odds ratio,OR)或风险比(hazard ratio,HR)及95％可信区间(confidence interval,CI)评价结局指标,并进行发表偏倚评估及敏感性分析.结果 共纳入9个病例研究,共计1 178例患者.Meta分析结果显示,HIF-1α蛋白表达在HCC伴包膜侵犯组明显高于无包膜侵犯组(OR=1.48,95％CI为1.07～2.05,P=0.018);在HCC伴微血管浸润组明显高于无血管浸润组(OR=2.40,95％CI为1.16～5.00,P=0.019);在TNM临床分期Ⅰ～Ⅱ期组明显低于Ⅲ～Ⅳ期组(OR=0.43,95％CI为0.31～0.61,P＜0.001);但在年龄≥50岁组与＜50岁组(OR=0.79,95％CI为0.33～1.89,P=0.602)、男性组与女性组(OR=1.33,95％CI为0.70～2.50,P=0.381)的表达差异无统计学意义.HIF-1α过表达患者总生存期(overall survival,OS)(HR=1.73,95％CI为1.47～2.04,P＜0.001)和无进展生存期(progression free survival,PFS)(HR=1.88,95％CI为1.29～2.73,P=0.001)均较短,HIF-1α过表达可促进HCC患者术后复发,增加术后死亡风险,可能是HCC的预后可能危险因素.结论 HIF-1α蛋白与HCC包膜侵犯、微血管浸润及临床分期等临床病理学特征密切相关;HIF-1α过表达预示患者预后不良.     

Aurora-A基因过表达与消化道肿瘤临床病理特征相关性Meta分析

目的 Aurora-A在消化道肿瘤组织中存在过表达,本研究通过Meta分析的方法综合评价Aurora-A基因过表达与消化道肿瘤患者临床病理特征的相关性,为消化道肿瘤的诊断和治疗寻求新的靶点.方法 计算机检索PubMed、Cochrane、Highwire Press、中国知网(CNKI)、维普中文科技期刊全文数据库(VIP)、万方和中国生物医学文献数据库(CBM)等,检索时间均为建库至2015-08-01.通过设置的纳入与排出标准筛选研究文献并提取资料,根据Newcastle-Ottowa Scale (NOS)评价纳入资料的质量,采用Review Manager 5.2软件进行系统分析.结果 符合条件的13篇(其中食管癌4篇,胃癌5篇,肠癌4篇)文献中样本量合计1 973例.Aurora-A蛋白表达与肿瘤浸润深度Meta分析共纳入9篇文献,样本量711例,Aurora-A在浅层浸润组(T1～T2)和深层浸润组(Ts～T4)表达差异有统计学意义,OR=2.90,95％CI为2.09～4.04,P＜0.001;Aurora-A蛋白表达与淋巴结转移Meta分析共纳入8篇文献,样本量758例,Aurora-A在淋巴结转移组和无淋巴结转移组表达差异有统计学意义,OR=1.47,95％CI为1.07～2.01,P=0.02;但Aurora-A过表达与肿瘤分化程度及临床分期无相关性.结论 Aurora-A基因过表达可以促进消化道肿瘤的侵袭和转移,与消化道肿瘤的恶性程度呈正相关,将这为消化道肿瘤的早期诊断、预后分析及靶向治疗提供重要的参考价值.     

COX-2、VEGF在胃癌中的表达及其预后意义

目的 :研究COX 2、VEGF表达对胃癌的预后意义。方法 :收集我院 1990～ 1999年早、中期胃癌 2 81例 ,对有完整存档蜡块资料的 2 32例进行免疫组织化学染色。检测COX 2、VEGF及MVD在胃癌组织中的表达 ,并分析其预后意义。结果 :胃癌组织中COX 2、VEGF阳性表达的MVD值均显著高于COX 2、VEGF阴性表达者(P <0 0 1) ;COX 2、VEGF阳性表达及MVD值与胃癌淋巴结转移、血管浸润均密切相关 (P <0 0 1) ;COX 2、VEGF阳性表达者五年生存率明显低于阴性者 (P <0 0 1)。多因素分析显示 ,VEGF表达、淋巴结转移、COX 2表达、浸润深度、血管浸润均为胃癌独立的预后因素。结论 :COX 2、VEGF在胃癌组织呈过度表达状态 ,与胃癌的生长和浸润转移关系密切 ,可以作为反映胃癌生物学行为和判断预后的有效指标。     

胃癌组织中人表皮生长因子受体2和瘦素的表达及意义

目的 探讨胃癌组织中人表皮生长因子受体2(HER-2)、瘦素与瘦素受体的表达及其与临床病理特征和预后的关系,明确HER-2在胃癌原发灶与转移淋巴结的表达的一致性及胃癌组织中HER-2、瘦素和血管内皮生长因子(VEGF)表达水平的关系.方法 选取110例胃癌手术切除组织和相应转移淋巴结作为研究对象,以96例正常胃黏膜组织作为对照,应用免疫组织化学法检测HER-2、瘦素、瘦素受体b亚型(OB-Rb)和VEGF蛋白的表达水平.结果 HER-2、瘦素和OB-Rb在胃癌组织的表达阳性率分别为19.1％、49.1％和60.9％,显著高于正常胃黏膜组织(分别为8.0％、34.0％和46.0％,均P＜0.05).HER-2在胃癌原发灶与淋巴结转移灶中的表达状态差异无统计学意义(P=0.607),一致性呈中等水平(Kappa=0.581).在胃癌组织中,HER-2和瘦素的表达呈正相关(r=0.217,P=0.023),HER-2和瘦素与VEGF的表达也呈正相关(r=0.263,P=0.005;r=0.200,P=0.036).HER-2和瘦素的表达与肿瘤浸润深度、淋巴结及远处转移、TNM分期等因素有关,而OB-Rb的表达与各临床病理学因素皆无关.Cox回归多因素分析结果显示,肿瘤低分化、体积大、转移淋巴结比例高、分期晚、术后不接受化疗和HER-2高表达为胃癌患者的独立不良预后因素.结论 HER-2在胃癌原发灶与转移淋巴结中的表达状态基本一致.HER-2与瘦素在胃癌的侵袭进展、血管形成过程中可能起重要作用,HER-2高表达是胃癌患者的不良预后因素.     

神经浸润与胃癌预后关系的Meta分析

目的 神经浸润与胃癌预后之间的关系仍未达成一致,通过Meta分析,系统回顾分析神经浸润与胃癌预后的关系.方法 通过中国知网、万方数据、PubMed、Embase数据库中进行截止2016年的相关文献检索,合并HR及95％CI用于评估神经浸润对胃癌预后的价值.结果 14篇相关文献共17162例行胃癌根治术患者,神经浸润阳性率为23.1％.神经浸润与胃癌不良预后显著相关(HR=1.33,95％CI:1.08～1.57,P＜0.05),亚组分析显示神经浸润与胃癌预后不受地区、神经浸润阳性率、论文质量得分影响.结论 胃癌术后神经浸润阳性的患者预后差,神经浸润是影响胃癌预后的独立危险因素,也是术后辅助治疗的参考指标.     

诱导型一氧化氮合酶在鼻咽癌中表达及意义的Meta分析

[目的]系统评价诱导型一氧化氮合酶(iNOS)在鼻咽癌(NPC)组织中的表达及其临床意义.[方法]电子检索Pubmed、Embase、Cochrane、CBM、CNKI、VIP和万方数据库,收集有关iNOS在鼻咽癌组织中的表达及其与临床特征关系的病例对照研究.用Stata9.2统计软件包进行Meta分析.[结果]共纳入病例对照研究8篇,合计研究对象502例.Meta分析结果显示,iNOS在鼻咽癌组织的表达高于正常鼻咽黏膜组织(OR=27.42,95％CI:13.51～55.64);在鼻咽癌组织中,有淋巴结转移者的iNOS表达高于无淋巴结转移者(OR=2.39,95％CI:1.33～4.30),低T分期者的iNOS表达低于高T分期者(OR=0.30,95％CI:0.14～0.64);而在不同年龄及性别中iNOS的表达差异无统计学意义.[结论]iNOS在鼻咽癌组织中呈高表达,并与淋巴结转移和T分期关联密切,提示其过度表达与鼻咽癌的发生、发展、浸润和转移密切相关.     

Heparanase mRNA and Protein Expression Correlates with Clinicopathologic Features of Gastric Cancer Patients: a Metaanalysis

Background: Heparanase is believed to be involved in gastric carcinogenesis. However, the clinicopathologic features of gastric cancer with high heparanase expression remain unclear. Aim : The purpose of this study was to comprehensively and quantitatively summarize available evidence for the use of heparanase mRNA and protein expression to evaluate the clinicopathological associations in gastric cancer in Asian patients by meta-analysis. Materials and Methods: Relevant articles listed in MEDLINE, CNKI and the Cochrane Library databases up to MARCH 2015 were searched by use of several keywords in electronic databases. A meta-analysis was performed to clarify the impact of heparanase mRNA and protein on clinicopathological parameters in gastric cancer. Combined ORs with 95%CIs were calculated by Revman 5.0, and publication bias testing was performed by stata12.0. Results: A total of 27 studies which included 3,891 gastric cancer patients were combined in the final analysis. When stratifying the studies by the pathological variables of heparanase mRNA expression, the depth of invasion (633 patients) (OR=4.96; 95% CI=2.38-1.37; P<0.0001), lymph node metastasis (639 patients) (OR=6.22; 95%CI=2.70–14.34, P<0.0001), and lymph node metastasis (383 patients) (OR=6.85; 95% CI=2.04-23.04; P=0.002) were all significant. When stratifying the studies by the pathological variables of heparanase protein expression, this was the case for depth of invasion (1250 patients) (OR=2.76; 95% CI=1.52–5.03; P=0.0009), lymph node metastasis (1178 patients) (OR=4.79 ; 95% CI=3.37-6.80, P<0.00001), tumor size (727 patients) (OR=2.06 ; 95% CI=1.31-3.23; P=0.002) (OR=2.61; 95% CI=2.09-3.27; P=0.000), and TNM stage (1233 patients) (OR=6.85; 95% CI=2.04-23.04; P=0.002). Egger’s tests suggested publication bias for depth of invasion, lymph node metastasis, lymph node metastasis and tumor size of heparanase mRNA and protein expression. Conclusions: This metaanalysis suggests that higher heparanase expression in gastric cancer is associated with clinicopathologic features of depth of invasion, lymph node metastasis and TNM stage at mRNA and protein levels, and of tumor size only at the protein level. Egger’s tests suggested publication bias for these clinicopathologic features of heparanase mRNA and protein expression, and which may be caused by shortage of relevant studies. As a result, although abundant reports showed heparanase may be associated with clinicopathologic features in gastric cancer, this meta-analysis indicates that more strict studies were needed to evaluate its clinicopathologic significance.     

The prognostic value of E‐cadherin in gastric cancer: A meta‐analysis

The prognostic impact of E‐cadherin downregulation in gastric cancer has been assessed for years while the results are controversial and heterogeneous. We thus comprehensively reviewed the evidence for evaluation of E‐cadherin expression in gastric cancer to determine this effect. We searched PubMed and Embase to identify eligible studies, and 26 studies comprising 4,383 gastric cancer patients were included to assess the association between E‐cadherin immunohistochemical expression and overall survival (OS) and clinicopathological characteristics. Summary hazard ratios (HRs) or odds ratios (ORs) with 95% confidence interval (95% CI) were calculated to estimate the effect. We also performed meta‐regression and subgroup analysis according to study location, publication year, number of patients, quality score of studies and cut‐off value. Reduced E‐cadherin expression was significantly correlated with poor OS of gastric cancer patients (HR 1.62, 95% CI 1.34–1.96). Subgroup analysis indicated that E‐cadherin low‐expression had an unfavorable impact on OS in Asian patients (HR 1.87, 95% CI 1.45–2.41). Moreover, downregulation of E‐cadherin was significantly associated with TNM stage (OR 2.52, 95% CI 1.85–3.43), the depth of invasion (OR 2.01, 95% CI 1.39–2.90), lymph node metastasis (OR 2.39, 95% CI 1.68–3.40), distant metastasis (OR 2.23, 95% CI 1.21–4.11), grade of differentiation (OR 2.26, 95% CI 1.60–3.21), vascular invasion (OR 1.86, 95% CI 1.10–3.13) and histological type of gastric cancer (OR 4.22, 95% CI 2.96–6.02). This meta‐analysis revealed that E‐cadherin expression might be a predicative factor of poor prognosis for gastric cancer particularly in Asia.     

Associations of matrix metalloproteinase-9 protein polymorphisms with lymph node metastasis but not invasion of gastric cancer.

PURPOSE: Like most cancers, gastric cancer has a complex multistep etiology that involves both environmental and genetic factors. Matrix metalloproteinase-9 (MMP-9) is frequently overexpressed in gastric cancer. We investigated the effect of the genetic differences in MMP-9 coding region on the occurrence and progression of gastric cancer. EXPERIMENTAL DESIGN: A case-control study was conducted in a population of 74 patients and 100 healthy people in southeast China. Individuals were genotyped for two single nucleotide polymorphisms (SNP) in MMP-9: R279Q and P574R. Genotypic distributions between patient and control groups were compared for correlations with cancer occurrence. Associations between genotypic distributions and several clinicopathologic features were also analyzed using univariate tests, multivariate logistic regression modeling, and stratified analyses. RESULTS: Significant associations were revealed between both SNPs and lymph node metastasis [P = 0.012 and 0.025; odds ratio (OR), 3.4 and 2.8, respectively]. After adjustment using logistic regression for the potential confounding effects of gender, age, and location of the tumors, homozygous MMP-9 279RR and 574PP are more evidently associated with lymph node metastasis with OR(adjusted) of 5.7 [95% confidence interval (95% CI), 1.80-18.34] and 4.2 (95% CI, 1.37-12.69). The homozygous 279R-574P haplotype showed a stronger association by an OR(adjusted) of 6.1 (95% CI, 1.92-12.29) and was also associated with the 1-year postoperative mortality (OR(adjusted), 6.5; 95% CI, 1.18-35.74). Interestingly, our data also suggested that the MMP-9 polymorphisms seem to result in higher risk of lymph node metastasis through a pathway independent of cancer invasion because no positive associations were found between these polymorphisms and cancer invasion (OR, 0.59 < 1). The stratified analyses indicated a synergistic interaction between the MMP-9 polymorphisms and the type of diffuse in affecting lymph node metastasis (OR, 13.4; P(between strata) = 0.04). Significant association between both SNPs and the overall occurrence of gastric cancer was not observed. CONCLUSION: The present study has shown significant associations between the two nonsynonymous MMP-9 polymorphisms with lymph node metastasis in gastric cancer, especially with the diffuse type. The relatively large values of ORs and disassociation with cancer invasion suggest that the genetic differences of MMP-9 protein play an important and specific role in lymph node metastases, and therefore, further investigation of the underlying molecular mechanism is warranted.     

Expression of cyclooxygenase-2 in renal cell carcinoma: correlation with tumor cell proliferation, apoptosis, angiogenesis, expression of matrix metalloproteinase-2, and survival.

PURPOSE: Cyclooxygenase (COX)-2 plays an important role in tumor cell proliferation, resistance to apoptosis, angiogenesis, and invasion in various malignant tumors. However, the relationships between COX-2 expression and these biological processes, clinicopathological features, and survival rate in patients with renal cell carcinoma are not clear. EXPERIMENTAL DESIGN: Tumor sections surgically removed from 131 patients were examined for COX-2 expression by immunohistochemistry. We also examined Ki-67 labeling index, apoptotic index, microvessel density, and matrix metalloproteinase (MMP)-2 expression, and correlated COX-2 expression with various clinicopathological features and survival. RESULTS: Of 131 sections, 70 (53.4%) were positive for COX-2 expression. COX-2 expression was associated significantly with various clinicopathological features, and correlated with the Ki-67 labeling index, microvessel density, and MMP-2 expression (P < 0.01), but not with the apoptotic index (P = 0.054). COX-2 expression was also identified as an independent risk factor for large tumor size (>7 cm) in multivariate logistic regression model. COX proportional hazards analysis showed that distant metastasis and high T stage were independent prognostic factors [odds ratio (OR), 9.41; 95% confidence interval (CI), 2.16-41.11; P < 0.01 and OR, 5.19; 95% CI, 1.02-26.54; P = 0.048, respectively), whereas COX-2 expression was not (OR, 1.46; 95% CI, 0.24-9.00; P = 0.68). CONCLUSION: COX-2 expression in patients with renal cell carcinoma is associated with several clinicopathological factors, and appeared to play an important role in tumor cell proliferation and MMP-2 expression, but is not a significant prognostic factor.     

Clinicopathologic Features Predicting Involvement of Nonsentinel Axillary Lymph Nodes in Iranian Women with Breast Cancer

Background: Almost half of the breast cancer patients with positive sentinel lymph nodes have no additional disease in the remaining axillary lymph nodes. This group of patients do not benefit from complete axillary lymph node dissection. This study was designed to assess the clinicopathologic factors that predict non-sentinel lymph node metastasis in Iranian breast cancer patients with positive sentinel lymph nodes. Materials and Methods: The records of patients who underwent sentinel lymph node biopsy, between 2003 and 2012, were reviewed. Patients with at least one positive sentinel lymph node who underwent completion axillary lymph node dissection were enrolled in the present study. Demographic and clinicopathologic characteristics including age, primary tumor size, histological and nuclear grade, lymphovascular invasion, perineural invasion, extracapsular invasion, and number of harvested lymph nodes, were evaluated. Results: The data of 167 patients were analyzed. A total of 92 (55.1%) had non-sentinel lymph node metastasis. Univariate analysis of data revealed that age, primary tumor size, histological grade, lymphovascular invasion, perineural invasion, extracapsular invasion, and the number of positive sentinel lymph nodes to the total number of harvested sentinel lymph nodes ratio, wereassociated with non-sentinel lymph node metastasis. After logistic regression analysis, age (OR=0.13; 95% CI, 0.02-0.8), primary tumor size (OR=7.7; 95% CI, 1.4-42.2), lymphovascular invasion (OR=19.4; 95% CI, 1.4-268.6), extracapsular invasion (OR=13.3; 95% CI, 2.3-76), and the number of positive sentinel lymph nodes to the total number of harvested sentinel lymph nodes ratio (OR=20.2; 95% CI, 3.4-121.9), were significantly associated with non-sentinel lymph node metastasis. Conclusions: According to this study, age, primary tumor size, lymphovascular invasion, extracapsular invasion, and the ratio of positive sentinel lymph nodes to the total number of harvested sentinel lymph nodes, were found to be independent predictors of non-sentinel lymph node metastasis.     

Prognostic Value of PLCE1 Expression in Upper Gastrointestinal Cancer: a Systematic Review and Meta-analysis

Background: A number of studies have identified a shared susceptibility locus in phospholipase C epsilon 1(PLCE1) for esophageal squamous cell carcinoma (ESCC) and gastric cardia adenocarcinomas (GCA). However,the results of PLCE1 expression in esophageal and gastric cancer remain inconsistent and controversial.Moreover, the effects on clinicopathological features remain undetermined. This study aimed to provide aprecise quantification of the association between PLCE1 expression and the risk of ESCC and GCA throughmeta-analysis. Materials and Methods: Eligible studies were identified from PubMed, Wanfang Data, ISI Web ofScience, and the Chinese National Knowledge Infrastructure databases. Using RevMan5.2 software, pooled oddsratios (ORs) with 95% confidence intervals (CIs) were employed to assess the association of PLCE1 expressionwith clinicopathological features relative to ESCC or GCA. Results: Seven articles were identified, including761 esophageal and gastric cancer cases and 457 controls. Overall, we determined that PLCE1 expression wasassociated with tumor progression in both esophageal cancers (pooled OR=5.93; 95%CI=3.86 to 9.11) and gastriccancers (pooled OR=9.73; 95%CI=6.46 to 14.7). Moreover, invasion depth (pooled OR=3.62; 95%CI=2.30 to5.70) and lymph node metastasis (pooled OR=4.21; 95%CI=2.69 to 6.59) were linked with PLCE1 expressionin gastric cancer. However, no significant associations were determined between PLCE1 overexpression andthe histologic grade, invasion depth, and lymph node metastasis in esophageal cancer. Conclusions: Our metaanalysisresults indicated that upregulated PLCE1 is significantly associated with an increased risk of tumorprogression in ESCC and GCA. Therefore, PLCE1 expression can be appropriately regarded as a promisingbiomarker for ESCC and GCA patients.     

Asian patients with gastric carcinoma in the United States exhibit unique clinical features and superior overall and cancer specific survival rates

BACKGROUND: The 5-year survival rate from gastric carcinoma, stratified by stage, is markedly greater in the Far East than in the United States. This survival rate advantage may reflect differences in diagnostic criteria, more complete staging, more radical surgery, or less aggressive tumor biology. METHODS: A historic cohort of consecutive cases of gastric carcinoma reported to the population-based California Cancer Registries of Orange, San Diego and Imperial Counties from 1984 to 1996 was studied. Factors associated with Asian race were profiled using logistic regression. Multivariate survival analyses were performed using a Cox proportional hazard model. RESULTS: Two thousand four hundred sixteen patients (64%) were non-Latino white; 690 (18%) were Latino; 94 (2.5%) were black; 541 (14%) were of Asian descent: Korean (22%), Vietnamese (20%), Japanese (20%), Chinese (14%), and Filipino (12%). Asian patients were more likely to have localized (lymph node negative) disease (odds ratio [OR], 1.61; 95% confidence interval [CI], 1.23-2.10), less likely to have tumors of the gastroesophageal junction (OR, 0.22; 95% CI, 0.15-0.31,), and less likely to be older than 50 years (OR, 0.58; 95% CI, 0.43-0.77). Asian patients with gastric carcinoma were twice as likely as non-Latino whites to be alive at 5 years (20.9% vs. 10.2%; P < 0.0001). Multivariate analyses indicated that whites had an increased risk of dying from all causes (relative risk [RR], 1.34; 95% CI, 1.16-1.55; P < 0.01) and of dying from cancer in comparison to Asian patients (RR, 1.26; 95% CI, 1.07-1.48; P < 0.05). CONCLUSIONS: Asians who received a diagnosis of gastric carcinoma in the United States have less advanced disease than non-Asians. The increased proportion of localized disease and improved survival rates of patients of Asian descent in the United States is consistent with less aggressive tumor biology.     

直肠癌组织PI3K和Survivin及VEGF表达与肿瘤侵袭转移相关性的探讨

目的:探讨磷脂酰肌醇3-激酶(PI3K)、存活素(Survivin)及血管内皮生长因子(VEGF)蛋白在人直肠癌组织中的表达,及其与直肠癌临床分期、组织学分级和侵袭转移的相关性及意义.方法:免疫组化SP法检测PI3K、Survivin和VEGF蛋白在60例直肠癌、30例直肠腺瘤及10例正常直肠组织中的表达.结果:PI3K在直肠癌、腺瘤和正常组织中的异常表达率分别为81.7％(49/60)、36.7％(11/30)和30.0％(3/10),差异有统计学意义,x2=17.86,P=0.001;Survivin的阳性表达率分别为90.0％(54/60)、80.0％(24/30)和20.0％(2/10),差异有统计学意义,x2=9.54,P=0.002;VEGF的异常表达率分别为71.7％(43/60)、43.3％(13/30)和30.0％(3/10),差异有统计学意义,x2=5.68,P=0.025.PI3K、Survivin及VEGF的异常表达均与临床分期及转移密切相关,P值均＜0.05.VEGF在直肠癌组织中染色阳性者(11.04±1.68)微血管密度(MVD)较染色阴性者(7.66±1.22)高,t=7.53,P＜0.05.在直肠癌组织中PI3K与Survivin(r=0.396,P=0.001)和VEGF (r=0.417,P=0.000 5)表达呈正相关,Survivin与VEGF表达呈正相关,r=0.332,P=0.005.PI3K和Survivin及VEGF蛋白协同阳性表达的侵袭转移率为55.0％(33/60),其中Ⅳ期远处转移率为93.8％(15/16).结论:PI3K和Survivin及VEGF蛋白的表达与临床分期及肿瘤侵袭转移密切相关,提示PI3K和Survivin及VEGF信号转导通路在人直肠癌侵袭转移中起重要作用.     

Clinicopathological and Prognostic Significance of Ubiquitin-Specific Protease 39 Overexpression in solid Cancers: A Meta-Analysis

Objectives: This meta-analysis aimed to evaluate the association between USP39 expression, the prognosis of patients with solid cancer, and to identify the clinicopathological characteristics of these patients. Material and Method: This study was carried out using PRISMA strategy. Pubmed, ScienceDirect, Google Scholar, Ebsco, Cochrane Library electronic databases were searched for relevant studies published up to April 2022. 14 studies was included in this study. Hazard ratio (HR) and 95% confidence interval (CI) data were collected, including number of samples, detection methods, number of sample with high USP39 expression, and cut-off value. HR and 95% CI was used to evaluate the prognostic value of USP39 expression. Odds ratio (OR) with 95% CI was used to assess the effect of USP39 expression on clinicopathological parameters. Results: Qualitative analysis using 14 included studies and quantitative analysis using 7 included studies. We found that USP39 expression has significant risk for histological grade (OR 3.14, CI 95% 2.15-4.58, p<0.001), TNM stage (OR 2.23, CI 95% 1.66-3.00, p<0.001), tumor size (OR 2.17, CI 95% 1.56-3.03, p<0.001), lymph node metastasis (OR 2.31, CI 95% 1.23-4.33, p=0.009), vascular invasion (OR = 1.76, 95% CI = 1.13-2.73, p=0.01). Furthermore, high expression of USP39 protein was associated with worse OS (OR 1.17, CI 95% 1.13-1.21, p<0.001) and DFS (OR 1.39, CI 95% 1.23-1.57, p<0.001) in cancer patients. Conclusion: It can be concluded that USP39 has a significant prognostic value in patients with solid cancer and was found to have a significant relationship in the clinicopathology of solid cancer patients.