Is human kallikrein-11 in gastric cancer treated with surgery and adjuvant chemoradiotherapy associated with survival?

Human kallikreins (hKs) have been reported to be involved in human cancers, and several hKs are promising biomarkers of various cancers, such as prostate, ovarian, breast, and testicular cancer. In the present study, we aimed to evaluate the prognostic value of immunohistochemical expression of hK11 in patients with gastric cancer. The study included 55 (36 men and 19 women; 58 ± 10 years of mean age) patients with gastric cancer treated with surgery and adjuvant chemoradiotherapy. Tissue sections were evaluated immunohistochemically with a monoclonal anti-hK11 antibody. Of the 55 patients, 35 (63.6%) were hK11-positive and 20 (36.4%) were hK11-negative. Disease-free and overall survival rates were significantly higher in patients with hK11 positive than in those with hK-11 negative expression (24 months vs. 11 months, p: 0.043; 29 months vs. 13 months, p: 0.038, respectively). In conclusion, hK11 expression in gastric cancer appears to be associated with a better prognosis. hK11 may be a prognostic biomarker of gastric cancer. On the other hand, it is needed to elucidate the mechanisms underlying the regulation of hK11 expression in gastric cancer.     

UNC5H3和DCC在胃癌中的表达与增殖的关系及其预后

目的 探讨UNC5H3和DCC在胃癌组织的表达,与临床病理特征和增殖的关系以及与患者生存和预后的关系。 方法 应用组织芯片和免疫组织化学技术,分析60例胃癌组织中UNC5H3、DCC和Ki-67的表达,并对其表达进行相关分析。利用图像分析软件Image-Pro Plus 6.0测量切片积分吸光度,对结果进行验证。采用Kaplan-Meier限乘法计算生存率。建立Cox回归模型,评价UNC5H3和DCC作为胃癌患者预后的独立影响因素的可行性。结果 在60例胃癌组织中,UNC5H3、DCC和Ki-67的阳性表达率分别为43.3%、53.3%和60.0%。UNC5H3和DCC与淋巴转移和远处转移之间,差异有显著性(P<0.05)。UNC5H3和DCC表达与Ki-67表达相互之间无相关性（P>0.05）。用Kaplan-Meier生存曲线经 Log-rank检验发现,UNC5H3的阳性表达与胃癌患者生存之间存在相关性（P<0.05）。DCC的阳性表达与胃癌患者生存之间无相关性（P>0.05）。经Cox回归分析,UNC5H3和DCC的表达与胃癌患者预后无明显相关性。结论 依赖性受体UNC5H3和DCC共同参与了胃癌的发生进展,检测UNC5H3和DCC可作为反映胃癌临床病理学特点的指标,检测UNC5H3可作为胃癌患者生存期的指标,但UNC5H3和DCC的表达不是判断胃癌患者预后的独立影响因素。     

晚期非小细胞肺癌组织中ERCC1、RRM1表达水平与含铂治疗方案疗效及预后相关性分析

目的：探讨ERCC1及RRM1的表达在预测晚期非小细胞肺癌含铂治疗方案疗效及预后中的作用。方法：用免疫组织化学的方法检测124例ⅢB和Ⅳ期非小细胞肺癌患者的石蜡包埋活检组织标本中ERCC1和RRM1的表达水平,并分析其与临床病理特征以及疗效、预后的相关性。124例均为接受以铂类为基础的三代药物联合化疗的初治患者。结果：ERCC1、RRM1表达阳性者分别为43例（35％）和50例（40％）。ERCC1及RRM1的表达与疗效相关,ERCC1表达阴性者疗效达PR的患者（54％）明显高于阳性者（33％）,差异有统计学意义（P=0．022）。同样,RRM1表达阴性患者疗效为PR的明显高于RRM1阳性者（53％VS34％,P=0．042）。ERCC1和RRM1同时阴性表达者的中位生存时问明显长于同时阳性表达者（11．7个月VS9．2个月,P=0．025）,多因素分析表明,ERCC1为独立的预后预测因素（P=0．0066）。结论：ERCC1的表达与晚期非小细胞肺癌预后及含铂治疗方案疗效相关。     

CD56-多发性骨髓瘤患者临床特征及预后分析

目的探讨CD56-多发性骨髓瘤(MM)患者临床特征及预后。方法回顾性分析48例新发MM患者的临床资料、实验室检查资料及治疗方案,比较CD56-MM患者与CD56+MM患者临床特征及预后。结果 48例MM患者中,CD56-MM患者14例(29%),CD56+MM患者34例(71%)。比较CD56-MM与CD56+MM患者在发病年龄、性别、临床分期方面无明显差异;两组患者均以骨痛、骨质疏松、病理性骨折、贫血、感染为最常见首发症状,CD56+MM患者骨痛的发生率明显高于CD56-MM患者(P<0.05),其他临床表现和起病方式上无明显差异;反映疾病进展程度的指标,如血红蛋白、血小板、血清钙、免疫球蛋白水平、血肌酐水平及24h尿蛋白定量两组比较无明显差异(均P>0.05);反映预后相关因素如骨髓浆细胞数量、β2-微球蛋白、C-反应蛋白、血沉水平两组比较亦无明显差异(均P>0.05);CD56-MM患者多发骨质破坏发生率明显低于CD56+MM患者(64.3%vs 91.2%,P<0.05);对两组患者进行生存期分析,CD56-MM和CD56+MM患者中位生存期分别为14.7个月和15个月,两组比较无统计学差异(P=0.348)。结论 CD56-MM患者骨痛和骨质破坏的发生率明显低于CD56+MM患者,其它临床特征及预后指标与CD56+MM患者比较无明显差异。     

Primary myelofibrosis: risk stratification by IPSS identifies patients with poor clinical outcome

OBJECTIVES:

To evaluate whether risk scores used to classify patients with primary myelofibrosis and JAK-2 V617F mutation status can predict clinical outcome.

METHODS:

A review of clinical and laboratory data from 74 patients with primary myelofibrosis diagnosed between 1992 and 2011. The IPSS and Lille scores were calculated for risk stratification and correlated with overall survival.

RESULTS:

A V617F JAK2 mutation was detected in 32 cases (47%), with no significant correlation with overall survival. The patients were classified according to the scores: Lille - low, 53 (73.%); intermediate, 13 (18%); and high, 5 (7%); and IPSS – low, 15 (26%); intermediate-1, 23 (32%); intermediate-2, 19 (26%); and high, 15 (31%). Those patients presenting a higher risk according to the IPSS (high and intermediate-2) had a significantly shorter overall survival relative to the low risk groups (intermediate-1 and low) (p = 0.02).

CONCLUSIONS:

These results emphasize the importance of the IPSS prognostic score for risk assessment in predicting the clinical outcome of primary myelofibrosis patients.     

Obesity and high neutrophil-to-lymphocyte ratio are prognostic factors in non-metastatic breast cancer patients

Obesity has been associated with an increased risk of breast cancer recurrence and death. Some readily available biomarkers associated with systemic inflammation have been receiving attention as potential prognostic indicators in cancer, including neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). This study aimed to explore the correlation between body mass index (BMI) and invasive breast cancer and the association of NLR, PLR, and BMI with breast cancer outcomes. We undertook a retrospective study to evaluate patients treated for breast cancer over 14 years. Clinicopathological data was obtained before receiving any treatment. Of the 1664 patients included with stage I-III, 567 (34%) were obese (BMI≥30 kg/m²). Obese patients had larger tumors compared to non-obese patients. Higher BMI was associated with recurrence and worse survival only in patients with stage I disease. NLR and PLR were classified into high and low level groups. The NLR^high (NLR>4) was found to be an independent prognostic factor for recurrence and mortality, while the PLR^high (PLR>150) group had no impact on survival. A subgroup of patients with NLR^high and BMI^high had the worst disease-free survival (P=0.046), breast cancer-specific survival (P<0.001), and overall survival (P=0.006), compared to the other groups. Patients with early-stage breast cancer bearing NLR^high and BMI^high had worse outcomes, and this might be explained by the dysfunctional milieu of obesity in adipose tissue and its effects on the immune system. This study highlights the importance of lifestyle measures and the immune system interference with clinical outcomes in the early breast cancer setting.     

粒细胞集落刺激因子在非小细胞肺癌组织中的表达及其临床病理意义

目的 观察粒细胞集落刺激因子(G-CSF)在非小细胞肺癌(NSCLC)中的表达并探讨其临床病理意义.方法 收集解放军总医院2001 - 2010年伴有大量粒细胞浸润的NSCLC 53例,同时选用无粒细胞浸润的NSCLC 61例作对照,共114例.观察癌组织中粒细胞浸润情况,同时用免疫组织化学(EnVision法)检测癌组织中G-CSF的表达情况.对G-CSF表达情况及其与NSCLC临床病理特征的关系进行统计学分析,并随访全部患者,分析G-CSF表达对预后的影响.结果 114例NSCLC中55例癌细胞表达G-CSF.其中大细胞癌41例(41/54,75.9％),腺癌9例(9/30,30.0％),鳞状细胞癌5例(5/30,16.7％).G-CSF表达与癌组织中粒细胞浸润、组织学类型、坏死、肿瘤分级、局部淋巴结转移和远处转移、复发密切相关(P＜0.01),而与原发肿瘤大小无密切关联(P＞0.05);表达阳性者发生坏死、淋巴结转移、远处转移复发的相对危险度分别是阴性者的5.57、6.28和5.24倍(P＜0.05).阳性者与阴性者中位生存期分别为42和62个月,5年生存率分别为0和12.1％,生存期间的差异具有统计学意义(P＜0.01).结论 部分NSCLC能产生G-CSF,且以大细胞癌最常见.产生G-CSF的NSCLC组织分化差,异型性明显,恶性度高;易发生广泛坏死,常伴有粒细胞浸润;易发生淋巴结转移、远处转移和复发;生存率低,预后差.     

Clinical significance of sirtuin 1 level in sepsis: correlation with disease risk,severity, and mortality risk

This study aimed to investigate the value of sirtuin 1 (SIRT1) in differentiating sepsis patients from healthy controls (HCs), and its correlation with inflammation, disease severity, as well as prognosis in sepsis patients. Serum samples were collected from 180 sepsis patients and 180 age- and gender-matched HCs. The SIRT1 level in the serum samples was detected by enzyme-linked immunoassay. The clinical data of the sepsis patients were documented, and their disease severity scores and 28-day mortality rate were assessed. SIRT1 was decreased in sepsis patients compared with HCs, and the receiver operating characteristic curve (ROC) showed that SIRT1 distinguished sepsis patients from HCs (area under the curve (AUC): 0.901; 95% confidence interval (CI): 0.868-0.934). In sepsis patients, SIRT1 negatively correlated with serum creatinine (Scr), white blood cells (WBC), C-reactive protein (CRP), acute physiology, and chronic health evaluation II (APACHE II) score, and sequential organ failure assessment (SOFA) score, while it positively correlated with albumin. No correlation of SIRT1 with primary infection site or primary organism was observed. Furthermore, SIRT1 was reduced in 28-day non-survivors compared with 28-day survivors, and subsequent ROC showed that SIRT1 predicted 28-day mortality of sepsis patients (AUC: 0.725; 95% CI: 0.651-0.800), and its prognostic value was not inferior to Scr, albumin, WBC, and CRP, but was less than SOFA score and APACHE II score. In conclusion, measurement of serum SIRT1 might assist with the optimization of disease assessment, management strategies, and survival surveillance in sepsis patients.