Xiupeng Lv

Hypopharyngeal squamous cell carcinoma (HPSCC) has a poor prognosis due, in large part, to distant metastasis (DM). Although induction therapy (IT) can reduce DM rates, its translation to an overall survival (OS) benefit remains unclear, highlighting the need for tools to identify patients who would benefit most from IT. This study developed a nomogram to predict the risk for DM in patients with HPSCC, and assessed the survival benefit of IT across risk groups. Data from patients obtained from the Surveillance, Epidemiology, and End Results (i.e., "SEER") database (2004-2015) were randomly assigned to 1 of 2 groups at a ratio of 7:3: training; and internal validation. The external validation set comprised patients from 2 medical centers in China. Risk factors were identified using multivariate logistic regression analysis. Male sex, T classification ≥ 2, N classification ≥ 1, and poorer histological grade were independent risk factors for DM. The nomogram demonstrated good discriminative ability, with areas under the receiver operating characteristic curve of 0.702 (95% confidence interval [CI]: 0.669-0.735) in the training set, 0.704 (95% CI: 0.648-0.759) in the internal validation set, and 0.863 (95% CI: 0.804-0.923) in the external validation set. Based on the optimal cut-off value, patients were stratified into high- and low-risk groups. In the high-risk group, patients who received IT exhibited significantly improved OS (hazard ratio [HR] 0.364; 95% CI: 0.165-0.805; P = 0.040) and progression-free survival (PFS; HR 0.420; 95% CI: 0.190-0.928; P = 0.042) compared with those who did not receive IT. There was no significant survival benefit from IT in the low-risk group (OS: HR 0.881; 95% CI: 0.414-1.875, P = 0.095; PFS: HR 0.544 95% CI: 0.182-1.626, P = 0.250). This study constructed and preliminarily validated a nomogram for predicting DM in patients with HPSCC, and may serve as an exploratory tool for screening high-risk patients who are likely to benefit from IT, thereby providing a reference for the design of future prospective intervention trials.

SLC16A3, belonging to the SLC16 gene family, is involved in the transportation of monocarboxylate. SLC16A family members play important roles in tumorigenesis, nonetheless, the specific involvement of SLC16A3 in tumor prognosis and diagnosis in human cancers remains unelucidated. This study dealt with the exploration of SLC16A3 expression in human pan-cancer and its significance regarding disease prognosis. For this investigation, the mRNA expression data of SLC16A3 were acquired from the TCGA and the GTEx datasets. The Kaplan-Meier plots, univariate Cox regression, and the ROC curve were employed for assessing the prognostic and diagnostic significance of SLC16A3 in pan-cancer. Furthermore, the cBioPortal database was used to analyze the SLC16A3 genomic alterations. Moreover, the association of the infiltration of immune cells and immune checkpoint genes with SLC16A3 was analyzed by the TIMER database. Gene Ontology and KEGG pathway analysis were employed to explore the function of SLC16A3 in pan-cancer. The resulting data demonstrated that SLC16A3 mRNA expression was overexpressed in most cancers and its protein expression was also high across diverse cancer types. Moreover, upregulated SLC16A3 expression was linked to poor OS and PFI of certain cancers. Cox regression analysis further indicated that SLC16A3 is a risk factor for patients with PAAD, CESC, LUSC, LUAD, CHOL, LGG, MESO, and OSCC. The ROC curve revealed that SLC16A3 exhibited a high accuracy (AUC > 0.9) in BRCA, CHOL, ESCA, GBM, and KIRC prediction. Moreover, the acquired data indicated that in pan-cancer, the SLC16A3 expression exhibited correlations with immune checkpoint genes and immune cells. These findings collectively suggest that SLC16A3 holds promise as a biomarker for diagnostic and prognostic purposes in pan-cancer.

Temporal muscle thickness measured on 3D MRI has recently been linked to prognosis in glioblastoma patients and may serve as an independent prognostic indicator. This single-center study looked at temporal muscle thickness and prognosis in patients with primary glioblastoma. Overall survival was the major study outcome. For a retrospective analysis from 2010 to 2020, clinical data from 102 patients with glioblastoma at the Department of Oncology Radiotherapy of the First Affiliated Hospital of Dalian Medical University were gathered. Fifty-five cases from 2016 to 2020 contained glioblastoma molecular typing data, of which 45 were IDH wild-type glioblastomas and were analysed separately. TMT was measured on enhanced T1-weighted magnetic resonance images in patients with newly diagnosed glioblastoma.Overall patient survival (OS) was calculated by the Kaplan–Meier method and survival curves were plotted using the log-rank-sum test to determine differences between groups, and multifactorial analyses were performed using a Cox proportional-risk model.The median TMT for 102 patients was 6.775 mm (range: 4.95–10.45 mm). Patients were grouped according to median TMT, and the median overall survival (23.0 months) was significantly longer in the TMT > median group than in the TMT median group (P 0.001; Log-rank test). Analysing 45 patients with IDH wild type alone, the median overall survival (12 months) of patients in the TMT > median group was significantly longer than that of patients in the TMT ≤ median group (8 months) (P < 0.001; Log-rank test).TMT can serve as an independent prognostic factor for glioblastoma.

Purpose: Malignant phyllodes tumor of the breast (MPTB) is a rare type of breast cancer, with an incidence of less than 1%. The value of adjuvant radiotherapy (RT) for MPTB has been controversial. The aim of the study was to explore the effect of radiotherapy on the long-term survival of female patients with MPTB at different ages. Methods: Female MPTB patients were selected from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2020. A Kaplan–Meier survival analysis was conducted to investigate the value of RT for the long-term survival of MPTB patients in different age groups. Additionally, univariate and multivariate Cox regression analyses were performed for overall survival (OS) and breast cancer-specific survival (BCSS) of MPTB patients. Furthermore, propensity score matching (PSM) was also performed to balance the differences in baseline characteristics. Results: 2261 MPTB patients were included in this study, including 455 patients (20.12%) with RT and 1806 patients (79.88%) without RT. These patients were divided into four cohorts based on their ages: 18–45, 46–55, 56–65, and 65–80. Before adjustment, there was a statistically significant difference in long-term survival between RT-treated and non-RT-treated patients in the younger age groups (age group of 18–45 years: OS P = 0.019, BCSS P = 0.016; age group of 46–55 years: OS P < 0.001, BCSS P < 0.001). After PSM, no difference was found in long-term survival of patients in both younger and older groups regardless of whether they received RT (age group of 18–45 years: OS P = 0.473, BCSS P = 0.750; age group of 46–55 years: OS P = 0.380, BCSS P = 0.816, age group of 56–65 years: OS P = 0.484, BCSS P = 0.290; age group of 66–80 years: OS P = 0.997, BCSS P = 0.763). In multivariate COX regression analysis, RT did not affect long-term survival in patients with MPTB. Conclusion: There is no evidence that long-term survival of MPTB patients in specific age groups can benefit from RT.

Background: Hematological parameters have been associated with prognosis in patients with nasopharyngeal carcinoma (NPC). The present meta‐analysis investigated the utility of neutrophil‐lymphocyte ratio (NLR) in the prognosis of patients with NPC.Methods: Multiple electronic databases, including PubMed, Embase, the Cochrane Library, and the Web of Science, were systematically searched for studies assessing the association between NLR and NPC from 2011 to 2021. The primary outcomes were overall survival (OS) and progression‐free survival (PFS). Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were utilized to estimate effect size. Use of a fixed effect or random effect model was based on heterogeneity stability was tested by sensitivity analysis, and the risk of bias was assessed by funnel plots. Random effects models were used based on the actual results. Because the NLR grouping criteria for the included studies differed, subgroup analyses were performed.Results: A search of the electronic databases identified 14 studies, encompassing 6693 patients, that met the selection criteria. NLR higher than the cutoff value was significantly associated with poorer OS [HR 1.760, 95% CI 1.470–2.120, p p = .006]. Sensitivity analysis showed that the results of the meta‐analysis were relatively stable, and funnel plots were used to exclude the risk of bias.Conclusions: Elevated pretreatment NLR in peripheral blood is predictive of poorer OS and PFS in patients with NPC. NLR is an easily measured and important prognostic factor in patients with NPC.

Temporal muscle thickness measured on 3D MRI has recently been linked to prognosis in glioblastoma patients and may serve as an independent prognostic indicator. This single-center study looked at temporal muscle thickness and prognosis in patients with primary glioblastoma. Overall survival was the major study outcome. For a retrospective analysis from 2010 to 2020, clinical data from 102 patients with glioblastoma at the Department of Oncology Radiotherapy of the First Affiliated Hospital of Dalian Medical University were gathered. Of these, 55 cases from 2016 to 2020 included glioblastoma molecular typing data, which were analyzed separately.TMT was measured using improved T1-weighted magnetic resonance imaging at the time of GBM diagnosis. The overall survival (OS) of the patients was calculated using the Kaplan-Meier technique, the differences between the groups were assessed using the log-rank test, and the clinical outcomes of the two groups were compared using the Cox proportional risk model and multifactorial analysis. In 102 patients, the median TMT was 6.775 mm (range 4.95–10.45). Patients were grouped according to median TMT, and those in the TMT > median group had a considerably longer median overall survival (23.0 months) than those in the TMT median group (P 0.001; Log-rank test). Data from 55 cases containing molecular staging of glioblastoma alone were analyzed, and the median overall survival of patients in the TMT > median group (17.5 months) was significantly increased compared with the median overall survival of patients in the ≤ median group (9 months) (P < 0.001; Log-rank test). We can concluded that TMT can serve as an independent predictor of survival prognosis in patients with primary GBM, as well as in the era of molecular typing.

The most dangerous variety of glioma, glioblastoma, has a high incidence and fatality rate. The prognosis for patients is still bleak despite numerous improvements in treatment approaches. We urgently need to develop clinical parameters that can evaluate patients' conditions and predict their prognosis. Various parameters are available to assess the patient's preoperative performance status and degree of frailty, but most of these parameters are subjective and therefore subject to interobserver variability. Sarcopenia can be used as an objective metric to measure a patient's physical status because studies have shown that it is linked to a bad prognosis in those with cancers. For the purpose of identifying sarcopenia, temporal muscle thickness has demonstrated to be a reliable alternative for a marker of skeletal muscle content. As a result, patients with glioblastoma may use temporal muscle thickness as a potential marker to correlate with the course and fate of their disease. This narrative review highlights and defines the viability of using temporal muscle thickness as an independent predictor of survival in glioblastoma patients, and it evaluates recent research findings on the association between temporal muscle thickness and prognosis of glioblastoma patients.

Astrocytoma is a common brain tumor that can occur in any part of the central nervous system. This tumor is extremely harmful to patients, and there are no clear studies on the risk factors for astrocytoma of the brain. This study was conducted based on the SEER database to determine the risk factors affecting the survival of patients with astrocytoma of the brain. Patients diagnosed with brain astrocytoma in the SEER database from 2004 to 2015 were screened by inclusion exclusion criteria. Final screened brain astrocytoma patients were classified into low grade and high grade according to WHO classification. The risk factors affecting the survival of patients with low-grade and high-grade brain astrocytoma were analyzed by univariate Kaplan–Meier curves and log-rank tests, individually. Secondly, the data were randomly divided into training set and validation set according to the ratio of 7:3, and the training set data were analyzed by univariate and multivariate Cox regression, and the risk factors affecting the survival of patients were screened and nomogram was established to predict the survival rates of patients at 3 years and 5 years. The area under the ROC curve (AUC value), C-index, and Calibration curve are used to evaluate the sensitivity and calibration of the model. Univariate Kaplan–Meier survival curve and log-rank test showed that the risk factors affecting the prognosis of patients with low-grade astrocytoma included Age, Primary site, Tumor histological type, Grade, Tumor size, Extension, Surgery, Radiation, Chemotherapy and Tumor number; risk factors affecting the prognosis of patients with high-grade astrocytoma include Age, Primary site, Tumor histological type, Tumor size, Extension, Laterality, Surgery, Radiation, Chemotherapy and Tumor number. Through Cox regression, independent risk factors of patients with two grades were screened separately, and nomograms of risk factors for low-grade and high-grade astrocytoma were successfully established to predict the survival rate of patients at 3 and 5 years. The AUC values of low-grade astrocytoma training set patients were 0.829 and 0.801, and the C-index was 0.818 (95% CI 0.779, 0.857). The AUC values of patients in the validation set were 0.902, 0.829, and the C-index was 0.774 (95% CI 0.758, 0.790), respectively. The AUC values of high-grade astrocytoma training set patients were 0.814 and 0.806, the C-index was 0.774 (95% CI 0.758, 0.790), the AUC values of patients in the validation set were 0.802 and 0.823, and the C-index was 0.766 (95% CI 0.752, 0.780), respectively, and the calibration curves of the two levels of training set and validation set were well fitted. This study used data from the SEER database to identify risk factors affecting the survival prognosis of patients with brain astrocytoma, which can provide some guidance for clinicians.

Purpose: To evaluate the feasibility of using a simplified non-coplanar volumetric modulated arc therapy (NC-VMAT) and investigate its dosimetric advantages compared with intensity modulated radiation therapy (IMRT) and coplanar volumetric modulated arc therapy (C-VMAT) for hippocampal-avoidance whole brain radiation therapy (HA-WBRT).Methods: Ten patients with brain metastase (BM) were included for HA-WBRT. Three treatment plans were generated for each case using IMRT, C-VMAT, and NC-VMAT, respectively.Results: The dosimetric results of the three techniques complied roughly with the RTOG 0933 criteria. After dose normalization, the V_30Gy of whole brain planned target volume (WB-PTV) in all the plans was controlled at 95%. Homogeneity index (HI) of WB-PTV was significantly reduced in NC-VMAT (0.249 ± 0.017) over IMRT (0.265 ± 0.020, p=0.005) and C-VMAT (0.261 ± 0.014, p=0.020). In terms of conformity index (CI), NC-VMAT could provide a value of 0.821 ± 0.010, which was significantly superior to IMRT (0.788 ± 0.019, p2% of WB-PTV, NC-VMAT could provide a value of 35.62 ± 0.37Gy, significantly superior to IMRT (36.43 ± 0.65Gy, p50% of WB-PTV, NC-VMAT can achieve the lowest value of 33.18 ± 0.29Gy, significantly different from IMRT (33.47 ± 0.43, p=0.034) and C-VMAT (33.58 ± 0.37, p=0.006). Regarding D_2%, D_98%, and D_mean of hippocampus, NC-VMAT could control them at 15.57 ± 0.18Gy, 8.37 ± 0.26Gy and 11.71 ± 0.48Gy, respectively. D_2% and D_mean of hippocampus for NC-VMAT was significantly lower than IMRT (D_2%: 16.07 ± 0.29Gy, p=0.001 D_mean: 12.18 ± 0.33Gy, p2%: 15.92 ± 0.37Gy, p=0.009 D_mean: 12.21 ± 0.54Gy, p2% of the right optic nerves and the right lenses, NC-VMAT had the lowest values of 31.86 ± 1.11Gy and 7.15 ± 0.31Gy, respectively, which were statistically different from the other two techniques. For other organs including eyes and optic chiasm, NC-VMAT could achieve the lowest doses, different from IMRT statistically.Conclusion: The dosimetry of the three techniques for HA-WBRT could roughly comply with the proposals from RTOG 0933. After dose normalization (D_95%=30Gy), NC-VMAT could significantly improve dose homogeneity and reduce the D_50% in the brain. Besides, it can reduce the D_2% of the hippocampus, optic nerves, and lens. With this approach, an efficient and straightforward plan was accomplished.

The aim of this study was to analyze the clinicopathologic significance of ERα protein that localized in the cell cytoplasm and/or cell membrane of human breast cancer and explore what kind of protein that the cytoplasm/membrane ERα belongs to. ERα expressions in 61 cases of breast cancer are detected by immunohistochemistry, grouping is performed according to the positive staining of different subcellular localizations, the expression levels of ERα66 and ERα36 in cancer tissues of groups with different subcellular localizations are detected by Western blot, and correlation between the indicators and its clinicopathologic significance are analyzed by combining with the clinical pathological parameters. Localization by immunohistochemical staining in breast cancer cells shows that there are two types of ERα—in the cell nucleus and/or the cell membrane; there are four groups as ER nuclear staining positive + membrane staining positive (N+/C+), 23 cases; ER nuclear staining positive + membrane staining negative (N+/C−), 16 cases; ER nuclear staining negative + membrane staining positive (N−/C+), 8 cases; and ER nuclear staining negative + membrane staining negative (N+/C+), 14 cases. ER expression in the cytoplasm and/or membrane of cancer cells is correlated with the high expression of HER-2, the lymphatic metastasis, and the late clinical stage. Western blot results show that ER protein in breast cancer tissues mainly consists of ERα66 and ERα36 bands, and among all the groups, all the cases from the N+/C+ group (n = 23) have both ERα66 and ERα36 expressions; in the N+/C− group, 14 cases of which only have the ERα66 expression without ERα36 expression and 2 cases of which have both ERα66 and ERα36 expression; all the cases from the N−/C+ group have only the ERα36 expression without ERα66 expression; and in the N−/C− group, there is no either ERα66 or ERα36 expression. The expression level of ERα36 relates to the age of patients, the menopause, the lymphatic metastasis, and the tumor size (p < 0.05), and no statistical significance was shown between it and the family history of patients as well as the clinical staging parameters (p > 0.05). The expression level of ERα66 relates to the tumor size of breast cancer and the clinical stages (p < 0.05), and no statistical significance was shown between it and the age of patients, the history of menopause, and the family history as well as the parameters of lymphatic metastasis (p > 0.05). ER protein expression of human breast cancer is localized in the cell nucleus and/or the cell membrane, with poor prognosis of cytoplasm/membrane-positive patients; ER protein that localized in the nucleus is mainly ERα66 and that localized in the cytoplasm and/or membrane is mainly ERα36.