Diagnostic value of combined prealbumin-to-fibrinogen and albumin-to-fibrinogen ratios in Hp-negative gastric cancer

Background This study aimed to investigate the diagnostic value of prealbumin-to-fibrinogen ratio (PFR) and albumin-to-fibrinogen ratio (AFR) alone or in combination in Helicobacter pylori-negative gastric cancer (Hp-NGC) patients. Methods This study included 171 healthy controls, 180 Hp-NGC patients, and 215 Helicobacter pylori-negative chronic gastritis (HpN) patients. We compared the differences of various indicators and pathological characteristics between groups with Mann–Whitney U test and Chi-square test. The diagnostic value of PFR and AFR alone or in combination for Hp-NGC patients was assessed by the receiver operating characteristic (ROC) curve. Results PFR and AFR were related to the progression and clinicopathological characteristics of Hp-NGC. As the disease progressed, PFR and AFR values gradually decreased and were negatively related to the tumor size and depth of invasion. In addition, the area under the curves (AUCs) that resulted from combining PFR and AFR to distinguish Hp-NGC patients from healthy controls and HpN patients were 0.908 and 0.654, respectively. When combined with PFR and AFR in the differential diagnosis of tumors with a maximum diameter ≥ 5 cm and the T3 + T4 stage, the AUCs were 0.949 and 0.922; the sensitivity was 86.32% and 80.74%; and the specificity was 94.74% and 92.98%, respectively. Conclusions PFR and AFR may be used as diagnostic biomarkers for Hp-NGC. The combination of PFR and AFR was more valuable than each indicator alone in the diagnosis of Hp-NGC.

Difference in Clinical Presentation and Their Significance in Oral Squamous Cell Carcinoma – a Retrospective Analysis

Oral squamous cell carcinoma(OSCC) involving tongue and buccoalveolar complex(BAC) behaves differently. Clinical features of the two subsites and their influence on pathological factors remain least analysed. Patients are divided into two groups i.e, tongue cancer and BAC cancer group, and various clinical parameters were compared. Among 474 patients 232 had tongue cancer and 242 had BAC cancer. 30% of patients with OSCC were asymptomatic at presentation except for the ulcer. Compared to tongue cancers, lesions confined to BAC presents at an advanced stage(p=0.006). Multivariate analysis showed that dysphagia in tongue cancer(p=0.020) and external swelling or lesion in BAC cancers(p=0.002) were significant predictors of an advanced stage of disease. On histopathology perineural invasion was significantly associated tongue(p=0.008) and BAC cancers(P=0.015). Among tongue cancers, those with pain and referred otalgia had a statistically significantly high depth of invasion(DOI), compared to those without pain (DOI – no pain 6.9mm, pain 9.9mm and referred otalgia 11.4mm). There is a delay in clinical presentation of OSCC. Among tongue cancers, clinical history of pain was significantly associated with depth of invasion and perineural invasion, the significance of which needs to be prospectively analysed. Clinical history in OSCC can be used as predicting factors for various pathological characters, which is subsite specific.

Prognostic value of 18F-FDG PET/CT and MRI features in patients with high-risk and very-high-risk cutaneous squamous cell carcinoma

Objectives: This study aimed to evaluate the prognostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and magnetic resonance imaging (MRI) features in patients with high-risk and very-high-risk cutaneous squamous cell carcinoma (cSCC). Methods: This study included 54 consecutive patients with surgically resected primary high-risk and very-high-risk cSCC who underwent preoperative FDG-PET/CT and/or MRI. Among them, 14 patients (26%) had recurrences. We retrospectively reviewed the FDG-PET/CT (n = 34) and MRI (n = 48) and investigated the clinical significance and prognostic value of imaging features in cSCC. Results: On FDG-PET/CT, the maximum standardized uptake value (SUVmax) of the primary tumor (13.0 ± 6.4 vs. 6.9 ± 5.3, p < 0.05) was higher in cSCC with recurrence than in cSCC without recurrence. On MRI, the maximum diameter of the lesion (46.8 ± 24.1 mm vs 30.4 ± 17.0 mm, p < 0.05) and the frequency of muscle/tendon/bone invasion (42% vs 11%, p < 0.05) were significantly greater in cSCC with recurrence than in cSCC without recurrence. In the univariate analysis, prognostic factors for recurrence were SUVmax of the primary tumor (p < 0.01), the maximum diameter of the lesion (p < 0.05), and depth of invasion (p < 0.05). The areas under the receiver operating characteristic curves of the SUVmax (0.78) were superior to those of the maximum diameter (0.71) and depth of invasion (0.60). Conclusions: SUVmax, maximum diameter, and depth of invasion were useful parameters for prognostic factors predicting recurrence in patients with high-risk and very-high-risk cSCC. Advances in knowledge: SUVmax represents a prognostic factor.

Perineural Invasion in Vulvar Squamous-Cell Carcinoma Is an Independent Risk Factor for Cancer-Specific Survival, but Not for Locoregional Recurrence: Results from a Single Tertiary Referral Center

The aims of this study were to assess the prevalence of perineural invasion (PNI) in vulvar squamous cell carcinoma (VSCC) and its prognostic role in locoregional recurrence (LRR) and cancer-specific survival (CSS). We performed a retrospective analysis of 223 consecutive stage IB–IIIC surgically treated VSCCs at S. Anna Hospital, University of Turin, from 2000 to 2019. We identified 133/223 (59.6%) patients with PNI-positive VSCCs. PNI was associated with aggressive biological features (i.e., advanced FIGO stage, larger tumor diameter, greater depth of invasion, a higher number of metastatic lymph nodes, and lymphovascular invasion) and shorter 5-year CSS (78% vs. 90%, log-rank p = 0.02) compared with PNI-negative VSCCs. Multivariate analysis showed that PNI (HR 2.99 CI 95% 1.17–7.63; p = 0.02) and the presence of tumor cells on pathological surgical margins (HR 3.13 CI 95% 1.37–7.13; p = 0.007) are independent prognostic factors for CSS. PNI does not appear to be related to LRR, but is an independent prognostic factor for worse survival outcomes. Future studies are necessary to explore the possible value of PNI in tailoring the choice of adjuvant treatment.

Evaluation of Depth of Invasion and Tumor Thickness as a Prognostic Factor for Early-Stage Oral Squamous Cell Carcinoma: A Retrospective Study

The aim of this study was to compare the effect of using depth of invasion (DOI) versus tumor thickness (TT) as a prognostic factor for early-stage oral squamous cell carcinoma (OSCC). A total of 57 patients with early-stage OSCC treated surgically from 2009 to 2014 at our institution were reviewed retrospectively. Histopathological measurement of DOI and TT was performed. The validation of DOI and TT as prognostic factors was conducted using a Kaplan–Meier survival analysis. TT had no association with disease-specific survival (DSS) or progression-free survival (PFS) in this cohort; however, increased DOI was significantly associated with decreased DSS but not correlated to decreased PFS. The T category of the 7th edition of AJCC was statistically associated with both DSS and PFS; however, the T category of the 8th edition of the AJCC was only associated with DSS. In this study group, TT could not be used as a prognostic factor, and DOI was not by itself sufficient to predict prognosis for early-stage OSCC. The T category in AJCC 8th Edition cannot be considered the sole prognostic factor for early OSCC, so additional prognostic factors may need to be considered.

Pretreatment C-Reactive Protein/Albumin Ratio is Associated With Poor Survival in Patients With 2018 FIGO Stage IB-IIA HPV-Positive Cervical Cancer

Objectives: The present study aimed to identify the predictive value of inflammatory indexes stratified according to human papillomavirus (HPV) infection status in women with FIGO 2018 stage IB∼IIA cervical cancer. We also explored the influences of HPV infection status on the survival of cervical cancer patients.Methods: We collected data for 583 women with stage IB∼IIA cervical cancer in Sun Yat-sen University Cancer Center between 2009 and 2017. The t-test, chi-squared (χ2) test and Fisher’s exact test were applied to compare the differences of inflammatory indexes and clinicopathological features between HPV-positive and HPV-negative groups. Univariate and multivariate analyses were used to identify clinicopathological factors that were associated with the prognosis of cervical cancer patients.Results: There were no differences in overall survival (OS) and progression-free survival (PFS) between HPV-positive and HPV-negative groups. In HPV-positive group, the maximum tumor size, neoadjuvant chemotherapy and the body mass index (BMI) correlated significantly with C-reactive protein/albumin ratio (CAR). The maximum tumor size and the prognostic nutritional index (PNI) correlated significantly with the platelet-lymphocyte ratio (PLR). The maximum tumor size, neoadjuvant chemotherapy and PLR correlated significantly with PNI. Univariate and multivariate analyses showed that the depth of tumor invasion (HR: 3.651, 95% CI: 1.464–9.103, p = 0.005; HR: 2.478, 95% CI: 1.218–5.043, p = 0.012) and CAR (HR: 5.201, 95% CI: 2.080–13.004, p &lt; 0.0001; HR: 2.769, 95% CI: 1.406–5.455, p = 0.003) were independent predictors of poor OS and PFS. PNI was an independent protective factor of OS (HR: 0.341, 95% CI: 0.156–0.745, p = 0.007). PLR was an independent factor of PFS (HR: 1.991, 95% CI: 1.018–3.894, p = 0.044). In HPV-negative group, BMI correlated significantly with CAR. Only depth of invasion (HR: 9.192, 95% CI: 1.016–83.173, p = 0.048) was the independent predictor of poor OS, and no inflammation indexes were independent predictors of prognosis.Conclusion: In patients with HPV-positive cervical cancer, depth of invasion, PNI and CAR are independent factors of OS, and depth of invasion, PLR and CAR are independent factors for PFS. For patients with HPV-negative disease, no inflammation indexes had predictive value for prognosis. The predictive value of inflammation indexes on prognosis is more significant in patients with HPV-positive cervical cancer. Stratification of HPV infection status promotes a more precise clinical application of inflammation indexes, thus improving their accuracy and feasibility.

The Value of miR-296 and miR-517c in Evaluating the Prognosis of Patients with Glioma after Radiotherapy and Chemotherapy

Objective. To explore the value of miR-296 and miR-517c in evaluating the prognosis of patients with glioma after radiotherapy and chemotherapy. Methods. 732 patients with glioma were selected from January 2012 to January 2018. According to the effect of postoperative chemotherapy, the patients were divided into two groups: the effective group and the ineffective group. The serum miR-296, miR-517c, and clinicopathological parameters of the two groups before chemotherapy were compared. The factors affecting the sensitivity of radiotherapy and chemotherapy and the predictive efficacy of miR-296 and miR-517c on the prognosis of patients were analyzed. Results. The expression level of miR-296 in glioma tissue was significantly correlated with tumor pathological grade and depth of invasion ( P < 0.05 ), and the expression level of miR-296 in glioma tissue was significantly correlated with tumor pathological grade ( P < 0.05 ). Logistic regression analysis showed that tumor size, WHO grade, and serum miR-296 and miR-517c levels were all factors affecting chemosensitivity ( P < 0.05 ). The sensitivity, specificity, accuracy, and AUC of serum miR-296 prediction were 76.95%, 89.64%, 85.35%, and 0.891, respectively. The sensitivity, specificity, accuracy, and AUC of serum miR-517c prediction were 72.81%, 86.50%, 82.19%, and 0.739, respectively. Conclusion. miR-296 and miR-517c are closely related to the chemosensitivity and prognosis of glioma patients. High levels of miR-296 and miR-517c can enhance chemosensitivity and serve as reliable indexes to predict the prognosis of patients with glioma.

Utility of Blood Biomarkers as a Predictor of Pathological Lymph Node Metastasis in Clinical Stage T1N0 Esophageal Squamous Cell Carcinoma

Background Accurate preoperative evaluation of lymph node (LN) metastasis is important for determining the treatment strategy for superficial esophageal cancer. There have been reports on the clinical significance of blood biomarkers, such as the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR), as predictors of LN metastasis for different cancers. Methods Patients (n = 185) with cT1N0M0 esophageal squamous cell carcinoma (ESCC) who underwent esophagectomy with R0 resection between April 2003 and August 2021 were enrolled. This study investigated the ability of the pretreatment NLR, PLR, and LMR to predict pathological LN metastasis. Results The optimal cut-off NLR, PLR, and LMR values to predict pathological LN metastasis were 2.1, 122, and 4.8, respectively. Univariate and multivariate analyses revealed that the primary tumor length, depth of invasion, and NLR were significant predictors of LN metastasis. Furthermore, similar to the five-year overall survival, the five-year relapse-free survival was significantly better in the low NLR group than in the high NLR group. Conclusions The NLR was the most useful predictor of pathological LN metastasis, which is difficult to predict by imaging for clinical stage T1N0M0 ESCC. Patients diagnosed with clinical stage I ESCC and with a high NLR require adequate LN dissection and may be good candidates for preoperative adjuvant therapy.