基于肿瘤浸润深度及大小的TTS 评分系统对可切除胃癌患者预后判断的价值

目的:探讨基于肿瘤浸润深度及大小的TTS评分系统对可切除胃癌患者预后判断的价值。方法:选择行根治性切除的234例胃癌患者为研究对象。根据肿瘤浸润深度（T分期）和肿瘤大小构建TTS评分系统，分为TTS 0级、1级、2级，代表肿瘤侵袭性逐渐升高。通过Cox多因素模型分析TTS评分系统作为预后判断工具的可行性。结果:T1-T4期患者肿瘤的平均大小分别为(3.3±2.7)cm、(4.1±3.1)cm、(6.6±3.1)cm、(9.4±4.9)cm。单因素分析显示，肿瘤浸润深度与肿瘤大小、淋巴结转移、TNM分期、淋巴浸润和血管浸润显著相关(P＜0.01)。ROC曲线显示，45 mm为肿瘤大小的最佳界值，可有效区分患者是否存在淋巴结转移，曲线下面积(area under curve,AUC)为0.762。综合肿瘤大小的临界值和肿瘤浸润深度，构建TTS评分系统,TTS 0级、TTS 1级和TTS 2级的患者5年生存率分别为95.6%、83.3%和70.2%，两两比较后发现，不同TTS状态患者的生存率之间均存在显著差异(P＜0.01)。Cox多因素分析发现，TTS评分是影响患者预后的独立性危险因素（P＜0.05）。结论:本研究根据肿瘤浸润深度和大小构建了TTS评分系统，并证明了TTS评分与胃癌患者的预后密切相关。     

胆囊癌切除范围研究进展

胆囊癌是胆道系统最常见的恶性肿瘤，早期诊断困难，恶性程度高，易发生转移和复发。以手术为主的综合治疗是改善胆囊癌病人生存的唯一方法，但仍存在若干争议，如T2期是否需要行肝段切除、扩大根治术是否可以延长晚期胆囊癌病人的生存时间、各期胆囊癌淋巴结清扫范围等。结合术中所见、病理学检查等判断胆囊癌的肿瘤分期，并依据分期规范切除范围和淋巴结清扫是提高R0根治切除率的关键，且扩大根治术可以改善晚期病人的预后。     

Validation of the Eighth Edition TNM Lung Cancer Staging System

IntroductionWe performed a validation study at our institution, the International Union Against Cancer (Union for International Cancer Control latest version of TNM Classification of Malignant Tumors Eighth Edition).MethodsData were collected from the Queensland Oncology Online registry of NSCLC or SCLC cases between 2000 and 2015 and validated against the Queensland Integrated Lung Cancer Outcomes Project registry using case identification number, first name, last name, and date of birth. Where data were available, cases were classified according to the Union for International Cancer Control TNM seventh edition stage groupings and then compared with the eighth edition groupings. Kaplan-Meier curves were plotted, and the log-rank test of survival differences was performed with SPSS version 25 (IBM Corp, Armonk, NY).ResultsOf the 3636 cases, 3352 and 1031 had complete clinical and pathologic staging, respectively. Median survival time was found to reduce with increasing clinical stage: seventh edition (IA: 88, IB: 44, IIA: 31, IIB: 18, IIIA: 15, IIIB: 8, and IV: 5 mo) versus eighth edition TNM stage (IA1: not reached, IA2: 88, IA3: 53, IB: 56, IIA: 36, IIB: 22, IIIA: 14, IIIB: 9, IIIC: 8, IVA: 6, and IVB: 3 mo). A similar overall pattern was reflected in the pathologic stage: seventh edition (IA: 124, IB: 110, IIA: 48, IIB: 42, IIIA: 26, IIIB: 31, and IV: 27 mo) versus eighth edition (IA1: not reached, IA2: 122, IA3: 125, IB: 144, IIA: 98, IIB: 57, IIIA: 31, IIIB: 24, and IVA: 7 mo). The log-rank test for survival curves was significant at p < 0.001.ConclusionsOur external validation study confirms the prognostic accuracy of the eighth edition TNM lung cancer classification. Our analyses also indicated that IIIB, IIIC, and IVA stage groups had similar survival outcomes and suggest further research for refinement.     

LINC00205 promotes proliferation,migration and invasion of HCC cells by targeting miR-122-5p

Long non-coding RNAs (lncRNAs) have been identified as crucial regulators in the tumorigenesis and progression of hepatocellular carcinoma (HCC). Recently, long intergenic non-protein coding RNA 205 (LINC00205) has been identified as a prognostic biomarker in HCC. However, the biological role of LINC0205 and its potential molecular mechanism are poorly investigated. Here, we found that the expression of LINC00205 was dramatically up-regulated in HCC tissues compared to adjacent nontumor tissues. Furthermore, the level of LINC00205 in both Hep3B and Huh7 cells was prominently higher than that in normal hepatic cell line LO2. Notably, the high expression of LINC00205 was strongly correlated with tumor size ≥5 cm, venous infiltration and advanced tumor stages. Functionally, LINC00205 knockdown obviously repressed the proliferation, migration and invasion of Hep3B and Huh7 cells in vitro. An inverse correlation between LINC00205 and miR-122-5p was detected in HCC tissues. Interestingly, LINC00205 knockdown increased the level of miR-122-5p in both Hep3B and Huh7 cells. Mechanistically, luciferase reporter assay demonstrated LINC00205 acted as a competing endogenous RNA (ceRNA) by directly interacting with miR-122-5p. More importantly, miR-122-5p overexpression significantly restrained the proliferation, migration and invasion of HCC cells. Collectively, our study provides solid evidence to support the oncogenic role of LINC00205 in HCC, which may be benefit for the improvement of HCC therapy.     

Profiles of immune cell infiltration and their clinical significance in head and neck squamous cell carcinoma

It is well established that there exist comprehensive interactions between tumor immunology and tumor biology. Tumor-infiltrating immune cells (TIICs) have been appealing therapeutic targets due to their significance in regulating cancer progression. The purpose of this study was to illustrate the comprehensive landscape of TIICs composition in head and neck squamous cell carcinoma (HNSCC) and their clinical significance. CIBERSORT was applied to calculate the 22 immune cell types proportion in HNSCC and further analysis suggested that six kinds of immune cells (resting memory CD4 T cells, M1 macrophages, resting dendritic cells, resting mast cells, monocytes, and eosinophils) were closely correlated with HNSCC progression. Moreover, memory CD4 T cells may serve as prognosis indicator for HNSCC patients. Collectively, this study uncovered the immune cells infiltration landscape in HNSCC and illustrated their potential relationships with clinical parameters, thereby contributing to the development of customized treatment strategy.     

癌组织中KLF9、TFAP4基因表达在非小细胞肺癌患者预后中的应用价值

目的 探究癌组织中Kruppel样转录因子9（KLF9）、转录因子激活增强子结合蛋白4（TFAP4）基因表达在非小细胞肺癌（NSCLC）患者预后中的应用价值。方法选取NSCLC患者94例作为研究对象,检测癌组织及癌旁组织中KLF9、TFAP4 mRNA表达量。并以基因表达量均数为界分为低表达组、高表达组。比较两组年龄、性别、病理类型、TNM分期、淋巴结转移、分化程度、肿瘤最大径、癌组织中KLF9、TFAP4 mRNA表达量,采用Pearson分析癌组织中KLF9、TFAP4 mRNA与TNM分期、淋巴结转移、分化程度、肿瘤最大径的相关性,采用logistic多元回归方程行多因素分析,采用Kaplan-Meier曲线进行生存分析。结果癌组织KLF9 mRNA表达水平低于癌旁组织,TFAP4 mRNA表达水平高于癌旁组织（P<0.05）;KLF9、TFAP4 mRNA高表达组TNM分期、淋巴结转移、分化程度、肿瘤最大径与低表达组相比,差异有统计学意义（P<0.05）;KLF9 mRNA与TNM分期、淋巴结转移、肿瘤最大径呈负相关,与分化程度呈正相关,TFAP4 mRNA与TNM分期、淋巴结转移、肿瘤最大径呈正相关,与分化程度呈负相关（P<0.05）;KLF9 mRNA、TFAP4 mRNA高表达与低表达患者生存曲线比较,差异有统计学意义（P<0.05）。结论NSCLC患者癌组织中KLF9、TFAP4基因表达与TNM分期、淋巴结转移、肿瘤最大径、分化程度显著相关,可影响患者预后,靶向KLF9、TFAP4基因可能有助于预后的改善。