Infleunce of Body Mass Index (BMI) on Outcome of Colon Cancer in Relationships with Other Clinicopathological Factors

Background: Colon cancer is the third most common cancer. High (BMI) contributes hazardously for several types of malignancies including colon cancer while the effect of BMI as a prognostic factor is poorly defined. Objective: Demonstrating the influence of increasing (BMI) on colon cancer recurrence. Patients and Methods: Case-control study involved a sample of 312 patients and 131 patients were excluded from this study and only 181 patients of colon cancer are included in the study with stage 2 and 3 who did underwent a surgical operation and received adjuvant chemotherapy recruited from an oncology teaching hospital, Al Jawad oncology center (Alkadhemiya hospital) and Babylon Oncology center. Results: The study involved 181 patients of colon cancer patients with mean age of 56.25 ±11.74years the highest proportion of study patients (90.6%) were aged more than 40yrs with a male to female ratio (1.2:1). Overweight patients constituted 39.2% and obese 23.8% and normal body weight 37%. In this study majority of tumors are ulcerating for about 72.5% and sigmoid and left side colon was the most common site of the tumor in about 53% with stage three is a most common type. Regarding recurrence, 54.1% of study patients have recurrence, and the majority of the 41.8% occurs between 1-3years after primary tumors diagnoses and treatment with a high prevalence of recurrence was seen in obese patients (74.4%) with a significant association between prevalence of recurrence and increasing BMI. In this study, 61.2% of patients with lymphovascular invasion have recurrences of malignancy with significant associations between recurrences and LVIe. Also more than 50% of patient older than 40years got recurrences with significant associations between recurrences with age of patients. In this study we take the effect of each clinicopathological feature on the outcome of colon cancer and then to excluded its effect by logistic regression to see the effect of only BMI on the outcome of colon cancer. Conclusion: Increase body mass index is associated with increase recurrence of colon cancer Keywords: Colon cancer recurrence, body mass index, Clinicopathological Factors

A Distinct Clinicopathological Feature and Prognosis of Young Gastric Cancer Patients Aged ≤ 45 Years Old

PurposeThe aim of this retrospective study was to probe into clinicopathological features and prognosis of early-onset gastric cancer (EOGC) patients aged ≤ 45 years old.MethodsThis study selected 154 young gastric cancer patients aged ≤ 45 years old and 158 elderly gastric cancer patients aged > 50 years old admitted to West China Hospital of Sichuan University in 2009-2019 as the research object. These patients were further divided into two groups according to whether tumor can be resected radically. The following parameters were analyzed: age, gender, helicobacter pylori (HP) infection status, Her-2 status, pathological type and stage, chemotherapy, tumor differentiation degree, overall survival (OS).ResultsMore than 3,000 patients with gastric carcinoma were screened, and 154 young gastric cancer patients aged ≤ 45 years old were identified as EOGC. Among them, the number of female patients in EOGC group was significantly higher than that of males, accounting for 63.6%. In addition, EOGC were associated with diffuse Laur´en type and poorly differentiated tumors. Interestingly, the Kaplan–Meier method showed that the OS of unresectable EOGC group was significantly lower than that of unresectable LOGC group (P = 0.0005) and chemotherapy containing paclitaxel tended to be more effective in the young people (P = 0.0511). Nevertheless, there was no significant difference in OS between young and elderly patients with gastric cancer in the radical resection group (P = 0.3881).ConclusionEOGC patients have a worse prognosis than late-onset gastric cancer (LOGC) patients with advanced unresectable gastric cancer. Palliative surgery or chemotherapy containing paclitaxel may improve the OS of unresectable young individuals with gastric cancer. Additional randomized controlled trials are required for guiding clinical practice.

Complement C1q (C1qA, C1qB, and C1qC) May Be a Potential Prognostic Factor and an Index of Tumor Microenvironment Remodeling in Osteosarcoma

The tumor microenvironment (TME) has important effects on the tumorigenesis and development of osteosarcoma (OS). However, the dynamic mechanism regulating TME immune and matrix components remains unclear. In this study, we collected quantitative data on the gene expression of 88 OS samples from The Cancer Genome Atlas (TCGA) database and downloaded relevant clinical cases of OS from the TARGET database. The proportions of tumor-infiltrating immune cells (TICs) and the numbers of immune and matrix components were determined by CIBERSORT and ESTIMATE calculation methods. Protein-protein interaction (PPI) network construction and Cox regression analysis were conducted to analyze differentially expressed genes (DEGs). The complement components C1qA, C1qB and C1qC were then determined to be predictive factors through univariate Cox analysis and PPI cross analysis. Further analysis found that the levels of C1qA, C1qB and C1qC expression were positively linked to OS patient survival time and negatively correlated with the clinicopathological feature percent necrosis at definitive surgery. The results of gene set enrichment analysis (GSEA) demonstrated that genes related to immune functions were significantly enriched in the high C1qA, C1qB and C1qC expression groups. Proportion analysis of TICs by CIBERSORT showed that the levels of C1qA, C1qB and C1qC expression were positively related to M1 and M2 macrophages and CD8+ cells and negatively correlated with M0 macrophages. These results further support the influence of the levels of C1qA, C1qB and C1qC expression on the immune activity of the TME. Therefore, C1qA, C1qB and C1qC may be potential indicators of remodeling in the OS TME, which is helpful to predict the prognosis of patients with OS and provide new ideas for immunotherapy for OS.

Development and validation of a novel competing risk model for predicting survival of esophagogastric junction adenocarcinoma: a SEER population-based study and external validation

Background Adenocarcinoma in Esophagogastric Junction (AEG) is a severe gastrointestinal malignancy with a unique clinicopathological feature. Hence, we aimed to develop a competing risk nomogram for predicting survival for AEG patients and compared it with new 8th traditional tumor-node-metastasis (TNM) staging system. Methods Based on data from the Surveillance, Epidemiology, and End Results (SEER) database of AEG patients between 2004 and 2010, we used univariate and multivariate analysis to filter clinical factors and then built a competing risk nomogram to predict AEG cause-specific survival. We then measured the clinical accuracy by comparing them to the 8th TNM stage with a Receiver Operating Characteristic (ROC) curve, Brier score, and Decision Curve Analysis (DCA). External validation was performed in 273 patients from China National Cancer Center. Results A total of 1755 patients were included in this study. The nomogram was based on five variables: Number of examined lymph nodes, grade, invasion, metastatic LNs, and age. The results of the nomogram was greater than traditional TNM staging with ROC curve (1-year AUC: 0.747 vs. 0.641, 3-year AUC: 0.761 vs. 0.679, 5-year AUC: 0.759 vs. 0.682, 7-year AUC: 0.749 vs. 0.673, P < 0.001), Brier score (3-year: 0.198 vs. 0.217, P = 0.012; 5-year: 0.198 vs. 0.216, P = 0.008; 7-year: 0.199 vs. 0.215, P = 0.014) and DCA. In external validation, the nomogram also showed better diagnostic value than traditional TNM staging and great prediction accuracy. Conclusion We developed and validated a novel nomogram and risk stratification system integrating clinicopathological characteristics for AEG patients. The model showed superior prediction ability for AEG patients than traditional TNM classification.

Association of Caveolin-1 Expression With Prostate Cancer: A Systematic Review and Meta-Analysis

PurposeThe prognostic value of caveolin-1 in prostate cancer remains uncertain. Hence, this meta-analysis was performed to evaluate the prognostic value of caveolin-1 in prostate cancer, as well as ascertain the relationship between caveolin-1 expression and clinicopathological characteristics of prostate cancer patients.MethodsThe PubMed, Embase, Chinese National Knowledge Infrastructure and Chinese Biology Medicine databases were electronically searched to retrieve published studies on caveolin-1 expression in prostate cancer. After study selection and data extraction, the meta-analysis was conducted using Review manager 5.3 software. Odds ratio (OR) with 95% confidence interval (CI) was used to estimate the pooled effect. Funnel plot was used to assess publication bias.ResultsA total of ten studies were enrolled, which included 3976 cases of prostate cancer, 72 cases of high-grade intraepithelial neoplasia (HGPIN), and 157 normal controls. Results of the meta-analysis showed that the positive rate of caveolin-1 expression in prostate cancer was 18.28 times higher than that in normal control (OR= 18.28, 95% CI: 9.02–37.04, p&lt;0.01), and 4.73 times higher than that in HGPIN (OR= 4.73, 95% CI: 2.38–9.42, p&lt;0.01). The relationship between caveolin-1 and clinicopathological characteristics of prostate cancer showed that the differences in caveolin-1 expression in patients with prostate-specific antigen (PSA) &gt;10 vs. ≤ 10 (OR=2.09, 95% CI: 1.35–3.22, p&lt;0.01), differentiation degree low vs. medium/high (OR=2.74, 95% CI: 1.84–4.08, p&lt;0.01), TNM stage T3+T4 vs. T1+T2 (OR=2.77, 95% CI: 1.78–4.29, p&lt;0.01), and lymph node metastasis present vs. absent (OR=2.61, 95% CI: 1.84–3.69, p&lt;0.01) were statistically significant. The correlation analysis between caveolin-1 and the survival time of patients with prostate cancer demonstrated that caveolin-1 was closely related to the prognosis of prostate cancer patients (HR=1.50, 95% CI: 1.28–1.76, p&lt;0.01).ConclusionCaveolin-1 is overexpressed in prostate cancer, which can serve as a risk factor and adverse clinicopathological feature of prostate cancer. Caveolin-1 can also predict poor survival in prostate cancer patients after radical prostatectomy.

Clinicopathological Feature of Adult Small Bowel Intussusception Diagnosed and Managed by Double-Balloon Enteroscopy : A Single Centre Study

Background: Adult small bowel intussusception usually has an aetiology that leads to small bowel obstruction. Here, we aimed to identify the clinicopathological features of adult small bowel intussusception managed with Balloon-Assisted Enterosopy (BAE) and to explore the clinical usefulness of BAE for the management of small bowel intussusception.Method: We retrospectively analysed the clinical data of 13 patients who were diagnosed with adult small bowel intussusception at Korea University Guro Hospital between 2010 and 2019.Results: The type of intussusception was ileoileal in eight (61.5%) patients and jejunal-jejunal in five (38.5%) patients. Eight cases of small bowel intussusception (61.5%; five idiopathic causes, two Peutz-Jeghers polyps, and one Crohn’s disease) were successfully managed with BAE. The remaining five patients underwent laparoscopic small bowel resection due to management of the primary aetiology (two diffuse large B-cell lymphoma, one lipomatosis, one Peutz-Jeghers polyps, and one angiomyolipoma).Concusions: In many cases, adult small bowel intussusception had a benign and idiopathic aetiology. The diagnosis and treatment of adult small bowel intussusception with BAE may reduce the requirement for small bowel resection in selected patients.

Prognostic implications of metabolism-associated gene signatures in colorectal cancer

Colorectal cancer (CRC) is one of the most common and deadly malignancies. Novel biomarkers for the diagnosis and prognosis of this disease must be identified. Besides, metabolism plays an essential role in the occurrence and development of CRC. This article aims to identify some critical prognosis-related metabolic genes (PRMGs) and construct a prognosis model of CRC patients for clinical use. We obtained the expression profiles of CRC from The Cancer Genome Atlas database (TCGA), then identified differentially expressed PRMGs by R and Perl software. Hub genes were filtered out by univariate Cox analysis and least absolute shrinkage and selection operator Cox analysis. We used functional enrichment analysis methods, such as Gene Ontology, Kyoto Encyclopedia of Genes and Genomes, and Gene Set Enrichment Analysis, to identify involved signaling pathways of PRMGs. The nomogram predicted overall survival (OS). Calibration traces were used to evaluate the consistency between the actual and the predicted survival rate. Finally, a prognostic model was constructed based on six metabolic genes (NAT2, XDH, GPX3, AKR1C4, SPHK1, and ADCY5), and the risk score was an independent prognostic prognosticator. Genetic expression and risk score were significantly correlated with clinicopathologic characteristics of CRC. A nomogram based on the clinicopathological feature of CRC and risk score accurately predicted the OS of individual CRC cancer patients. We also validated the results in the independent colorectal cancer cohorts GSE39582 and GSE87211. Our study demonstrates that the risk score is an independent prognostic biomarker and is closely correlated with the malignant clinicopathological characteristics of CRC patients. We also determined some metabolic genes associated with the survival and clinical stage of CRC as potential biomarkers for CRC diagnosis and treatment.

N6-methyladenosine (m6A) RNA methylation signature as a predictor of stomach adenocarcinoma outcomes and its association with immune checkpoint molecules

Objective Although N6-methyladenosine (m6A) RNA methylation is the most common mRNA modification process, few studies have examined the role of m6A in stomach adenocarcinomas (STADs). Methods In this retrospective study, we analyzed 293 STAD samples from The Cancer Genome Atlas with complete clinicopathological feature profiles. The m6A methylation risk signature was derived from LASSO–Cox regression analyses with 15 m6A regulators. Statistical analysis was performed and figures were prepared using R software ( https://www.R-project.org/ ). Results The m6A signature was established as follows: risk score = FTO × 0.127 + YTHDF1 × 0.004 + KIAA1429 × 0.044 + YTHDC2 × 0.112 − RBM15 × 0.135 − ALKBH5 × 0.019 − YTHDF2 × 0.028, which was confirmed as an independent prognostic indicator to predict overall survival of patients with STAD. Risk scores and tumor grades were closely associated. Cell cycle, p53 signaling pathways, DNA mismatch repair, and RNA degradation were enriched in the low-risk subgroup. This subgroup showed significantly higher expression of immune checkpoint molecules including PD-1 (programmed death 1), PD-L1 (programmed death-ligand 1), and CTLA-4 (cytotoxic T-lymphocyte–associated antigen 4), suggesting that the signature may be a useful immunotherapy predictor. Conclusions We established an m6A methylation signature as an independent prognostic tool to predict overall survival, which may also be useful as an immunotherapy predictor.