Background:Low-grade endometrial stromal sarcoma(LG-ESS)is a rare tumor that lacks a prognostic prediction model.Our study aimed to develop a nomogram to predict overall survival of LG-ESS patients.Methods:A total of ...Background:Low-grade endometrial stromal sarcoma(LG-ESS)is a rare tumor that lacks a prognostic prediction model.Our study aimed to develop a nomogram to predict overall survival of LG-ESS patients.Methods:A total of 1172 patients confirmed to have LG-ESS between 1988 and 2015 were selected from the Surveillance,Epidemiology and End Results(SEER)database.They were further divided into a training cohort and a validation cohort.The Akaike information criterion was used to select variables for the nomogram.The discrimination and calibration of the nomogram were evaluated using concordance index(C-index),area under time-dependent receiver operating characteristic curve(time-dependent AUC),and calibration plots.The net benefits of the nomogram at different threshold probabilities were quantified and compared with those of the International Federation of Gynecology and Obstetrics(FIGO)criteria-based tumor staging using decision curve analysis(DCA).Net reclassification index(NRI)and integrated discrimination improvement(IDI)were also used to compare the nomogram’s clinical utilitywith that of the FIGO criteria-based tumor staging.The risk stratifications of the nomogram and the FIGO criteria-based tumor staging were compared.Results:Seven variables were selected to establish the nomogram for LG-ESS.The C-index(0.814 for the training cohort and 0.837 for the validation cohort)and the time-dependent AUC(>0.7)indicated satisfactory discriminative ability of the nomogram.The calibration plots showed favorable consistency between the prediction of the nomogram and actual observations in both the training and validation cohorts.The NRI values(training cohort:0.271 for 5-year and 0.433 for 10-year OS prediction;validation cohort:0.310 for 5-year and 0.383 for 10-year OS prediction)and IDI(training cohort:0.146 for 5-year and 0.185 for 10-year OS prediction;validation cohort:0.177 for 5-year and 0.191 for 10-year OS prediction)indicated that the established nomogram performed significantly better than the FIGO criteria-based 展开更多
Objective：Gastroscopy combined with gastric mucosa biopsies is currently regarded as a gold standard for diagnosis of gastric cancer.However,its application is restricted in clinical practice due to its invasive prop...Objective：Gastroscopy combined with gastric mucosa biopsies is currently regarded as a gold standard for diagnosis of gastric cancer.However,its application is restricted in clinical practice due to its invasive property.A new noninvasive population screening process combining the assay ofanti-Helicobacterpylori antibody and serum pepsinogen （PG） （ABC method） is adopted to recognize the high-risk patients for further endoscopy examination,avoiding the unnecessary gastroscopy for most population and saving the cost consumption for mass screening annually.Nevertheless,controversies exist for the grouping of ABC method and the intervals of gastroscopy surveillance for each group.In this review,we summarized these popular concerned topics for providing useful references to the healthcare practitioner in clinical practice.Data Sources：The PubMed databases were systematically searched from the inception dates to November 22,2017,using the keywords ＂Helicobacterpylori,＂ ＂Pepsinogens,＂ and ＂Stomach Neoplasms.＂Study Selection：Original articles and reviews on the topics were selected.Results：Anti-H.pylori antibody and serum PG concentration showed significant changes under the different status ofH.pylori infection and the progression of atrophic gastritis,which can be used for risk stratification of gastric cancer in clinic.In addition,anti-H,pylori antibody titer can be used for further risk stratification of gastric cancer contributing to determine better endoscopy surveillance interval.Conclusions：The early detection and diagnosis of gastric cancer benefit from the risk stratification,but the cutoff values for H.pylori antibody and serum PG concentration require further modification.展开更多
MicroRNAs(miRNAs) are small, single-stranded, noncoding RNAs that can post-transcriptionally regulate the expression of various oncogenes and tumor suppressor genes. Dysregulated expression of many miRNAs have been sh...MicroRNAs(miRNAs) are small, single-stranded, noncoding RNAs that can post-transcriptionally regulate the expression of various oncogenes and tumor suppressor genes. Dysregulated expression of many miRNAs have been shown to mediate the signaling pathways critical in the multistep carcinogenesis of colorectal cancer(CRC). MiR NAs are stable and protected from RNase-mediated degradation, thereby enabling its detection in biological fluids and archival tissues for biomarker studies. This review focuses on the role and application of miRNAs in the prognosis and therapy of CRC. While stage Ⅱ CRC is potentially curable by surgical resection, a significant percentage of stage Ⅱ CRC patients do develop recurrence. MiRNA biomarkers may be used to stratify such high-risk population for adjuvant chemotherapy to provide better prognoses. Growing evidence also suggests that miRNAs are involved in the metastatic process of CRC. Certain of these miRNAs may thus be used as prognostic biomarkers to identify patients more likely to have micro-metastasis, who could be monitored more closely after surgery and/or given more aggressive adjuvant chemotherapy. Intrinsic and acquired resistance to chemotherapy severely hinders successful chemotherapy in CRC treatment. Predictive miRNA biomarkers for response to chemotherapy may identify patients who will benefit the most from a particular regimen and also spare the patients from unnecessary side effects. Selection of patients to receive the new targeted therapy is becoming possible with the use of predictive miRNA biomarkers. Lastly, forced expression of tumor suppressor miRNA or silencing of oncogenic miRNA in tumors by gene therapy can also be adopted to treat CRC alone or in combination with other chemotherapeutic drugs.展开更多
基金supported by grants no.81670123 and no.81670144 from the National Natural Science Foundation of China(NSFC).
文摘Background:Low-grade endometrial stromal sarcoma(LG-ESS)is a rare tumor that lacks a prognostic prediction model.Our study aimed to develop a nomogram to predict overall survival of LG-ESS patients.Methods:A total of 1172 patients confirmed to have LG-ESS between 1988 and 2015 were selected from the Surveillance,Epidemiology and End Results(SEER)database.They were further divided into a training cohort and a validation cohort.The Akaike information criterion was used to select variables for the nomogram.The discrimination and calibration of the nomogram were evaluated using concordance index(C-index),area under time-dependent receiver operating characteristic curve(time-dependent AUC),and calibration plots.The net benefits of the nomogram at different threshold probabilities were quantified and compared with those of the International Federation of Gynecology and Obstetrics(FIGO)criteria-based tumor staging using decision curve analysis(DCA).Net reclassification index(NRI)and integrated discrimination improvement(IDI)were also used to compare the nomogram’s clinical utilitywith that of the FIGO criteria-based tumor staging.The risk stratifications of the nomogram and the FIGO criteria-based tumor staging were compared.Results:Seven variables were selected to establish the nomogram for LG-ESS.The C-index(0.814 for the training cohort and 0.837 for the validation cohort)and the time-dependent AUC(>0.7)indicated satisfactory discriminative ability of the nomogram.The calibration plots showed favorable consistency between the prediction of the nomogram and actual observations in both the training and validation cohorts.The NRI values(training cohort:0.271 for 5-year and 0.433 for 10-year OS prediction;validation cohort:0.310 for 5-year and 0.383 for 10-year OS prediction)and IDI(training cohort:0.146 for 5-year and 0.185 for 10-year OS prediction;validation cohort:0.177 for 5-year and 0.191 for 10-year OS prediction)indicated that the established nomogram performed significantly better than the FIGO criteria-based
基金This work was supported by grants from the Natural Science Foundation of Guangdong Province, China （No. $2011010001430）, the Science and Technology Planning Project of Guangdong Province, China （No. 2017A030223006, 2016A020215128, 2014A020212636, and 2013B021800161）, the Science and Technology Planning Project of Guangzhou, China （No. 201704020077）, the Research Fund of Guangdong General Hospital （No. y012015338）, the Yuexiu Science and Information Center of Guangzhou Scientific Foundation （No. 2012-GX-046）.
文摘Objective：Gastroscopy combined with gastric mucosa biopsies is currently regarded as a gold standard for diagnosis of gastric cancer.However,its application is restricted in clinical practice due to its invasive property.A new noninvasive population screening process combining the assay ofanti-Helicobacterpylori antibody and serum pepsinogen （PG） （ABC method） is adopted to recognize the high-risk patients for further endoscopy examination,avoiding the unnecessary gastroscopy for most population and saving the cost consumption for mass screening annually.Nevertheless,controversies exist for the grouping of ABC method and the intervals of gastroscopy surveillance for each group.In this review,we summarized these popular concerned topics for providing useful references to the healthcare practitioner in clinical practice.Data Sources：The PubMed databases were systematically searched from the inception dates to November 22,2017,using the keywords ＂Helicobacterpylori,＂ ＂Pepsinogens,＂ and ＂Stomach Neoplasms.＂Study Selection：Original articles and reviews on the topics were selected.Results：Anti-H.pylori antibody and serum PG concentration showed significant changes under the different status ofH.pylori infection and the progression of atrophic gastritis,which can be used for risk stratification of gastric cancer in clinic.In addition,anti-H,pylori antibody titer can be used for further risk stratification of gastric cancer contributing to determine better endoscopy surveillance interval.Conclusions：The early detection and diagnosis of gastric cancer benefit from the risk stratification,but the cutoff values for H.pylori antibody and serum PG concentration require further modification.
基金Supported by the Direct Grant for Research,Faculty of Medicine,the Chinese University of Hong Kong,No.4054371
文摘MicroRNAs(miRNAs) are small, single-stranded, noncoding RNAs that can post-transcriptionally regulate the expression of various oncogenes and tumor suppressor genes. Dysregulated expression of many miRNAs have been shown to mediate the signaling pathways critical in the multistep carcinogenesis of colorectal cancer(CRC). MiR NAs are stable and protected from RNase-mediated degradation, thereby enabling its detection in biological fluids and archival tissues for biomarker studies. This review focuses on the role and application of miRNAs in the prognosis and therapy of CRC. While stage Ⅱ CRC is potentially curable by surgical resection, a significant percentage of stage Ⅱ CRC patients do develop recurrence. MiRNA biomarkers may be used to stratify such high-risk population for adjuvant chemotherapy to provide better prognoses. Growing evidence also suggests that miRNAs are involved in the metastatic process of CRC. Certain of these miRNAs may thus be used as prognostic biomarkers to identify patients more likely to have micro-metastasis, who could be monitored more closely after surgery and/or given more aggressive adjuvant chemotherapy. Intrinsic and acquired resistance to chemotherapy severely hinders successful chemotherapy in CRC treatment. Predictive miRNA biomarkers for response to chemotherapy may identify patients who will benefit the most from a particular regimen and also spare the patients from unnecessary side effects. Selection of patients to receive the new targeted therapy is becoming possible with the use of predictive miRNA biomarkers. Lastly, forced expression of tumor suppressor miRNA or silencing of oncogenic miRNA in tumors by gene therapy can also be adopted to treat CRC alone or in combination with other chemotherapeutic drugs.
