Prognostic value of lymphocyte-to-monocyte ratio in gastric cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis

Background

Emerging evidence suggests a correlation between the lymphocyte-monocyte ratio (LMR) and the prognosis in patients with gastric cancer (GC) undergoing immune checkpoint inhibitor (ICI) therapy. Nevertheless, the existing findings remain contentious.

Methods

A comprehensive search of literature was conducted in databases including PubMed, Embase, Web of Science, and the Cochrane Library, spanning from the inception of each database to August 30, 2023 to collect studies exploring the interplay between LMR and clinical outcomes. Eligible studies were selected following predefined inclusion and exclusion criteria. Primary outcomes encompassed progression-free survival (PFS) and overall survival (OS), which were estimated using hazard ratios (HR) and corresponding 95% confidence intervals (CI).

Results

Our analysis incorporated eight cohort studies, involving 815 patients. Aggregate data revealed associations between an elevated LMR at baseline and prolonged PFS (HR=0.58; 95% CI: 0.47-0.71, p<0.00001) and improved OS (HR=0.51, 95% CI: 0.33-0.79; p=0.003). Furthermore, LMR exhibited a favorable association with PFS after treatment (HR=0.48; 95% CI: 0.29-0.79; p= 0.004), while such a correlation was not evident in the OS analysis. Importantly, a high level of LMR was associated with prolonged PFS across varying sample sizes, follow-up duration, treatment combinations, line of therapy, and cut-off values.

Conclusion

A high pre-treatment LMR is associated with improved OS and PFS in GC patients treated with ICIs. LMR emerges as a potent biomarker for prognostic assessment in these patients, offering valuable insights for informed treatment decisions within the domain of GC immunotherapy.

Systematic review registration

PROSPERO, identifier CRD42021228512.

Risk and incidence of colorectal stricture progressing to colorectal neoplasia in patients with inflammatory bowel disease: a systematic review and meta-analysis

This study aims to assess the risk of colorectal stricture progressing to colorectal neoplasia (CRN) in patients with inflammatory bowel disease (IBD). The literature from PubMed, Embase, Web of Science, and Cochrane Library databases was searched from the date of databases' creation to 5 November 2022. The Newcastle-Ottawa Scale was used to evaluate the quality of the included literature. Meta-analysis was conducted using the Stata 15 software and R 4.04 software. Two case-control studies and 12 cohort studies were eventually included. Colorectal stricture in patients with IBD increased the risk of progressing to CRN [odds ratio (OR): 1.52, 95% confidence interval (CI): 1.02-2.29, P = 0.042], but was irrelevant to the risk of progressing to ACRN (OR: 3.56, 95% CI 0.56-22.70, P = 0.180). The risk of CRN were further distinguished in patients with ulcerative colitis (UC) and Crohn's disease (CD) Our findings showed that colorectal stricture may increase the risk of progressing to CRN in patients with UC (OR = 3.53, 95%CI 1.62-7.68, P = 0.001), but was irrelevant to the risk of progressing to CRN in patients with CD (OR = 1.09, 95% CI 0.54-2.21, P = 0.811). In conclusion, colorectal stricture in patients with IBD can be used as a risk factor for predicting CRN but cannot be used as a risk factor for predicting ACRN. Stricture is a risk factor for CRN in patients with UC but not in patients with CD. More prospective, multi-center studies with large samples are expected to confirm our findings.

[Clinicopathologic features of myxoid adrenocortical adenomas]

Objective: To study the clinicopathologic characteristics, immunophenotype, pathologic diagnosis and differential diagnosis of myxoid adrenocortical adenomas. Methods: The clinical data, histological features and immunohistochemical results of 4 cases of myxoid adrenocortical adenomas were analyzed, which were collected from January 2014 to December 2016 at Guangdong General Hospital, with review of literature. Results: Four cases of myxoid adrenocortical adenomas were presented. The patients ages ranged from 26 to 45 years (mean =35 years). Microscopically, it showed a typical morphology, characterized by small-sized tumor cell cords or pseudo-glands embedded in an abundant extracellular myxoid matrix. Immunohistochemical staining showed tumor cells were strongly positive for Melan A, vimentin and focally for α-inhibin, one case showed strong and diffuse positivity for CAM5.2, and two cases showed diffuse positivity for synaptophysin, while negative for CgA, S-100 protein, epithelial antigen, CK7, CK20 and CKpan. Conclusions: Myxoid adrenocortical adenomas are extremely rare, which may cause confusion with metastatic well-differentiated neuroendocrine tumours, sex cord-stromal tumoursor metanephric adenoma. Recognition of this entity would be beneficial for pathologists to avoid misdiagnosis, and unnecessary treatment.

Laser Doping and Crystallization of Amorphous Silicon Thin Films

Fast-pulse laser crystallization of amorphous silicon thin films on non-crystalline substrates provides a low-temperature process for generating polycrystalline silicon. This process can be augmented by including laser doping to reduce the number of process steps in the fabrication of thin-film polysilicon devices. We have studied the simultaneous laser crystallization and laser doping process, starting with amorphous silicon on fused silica substrates and using the gas immersion technique for the doping. n-type and p-type doping employed PF5 and BF3 gases, respectively. Films were characterized both structurally and electrically. The grain size increases with increasing laser energy density as the film becomes fully melted and reaches a peak value, similar to laser crystallization without doping. The dopant concentration increases with the number of laser shots and, with 100 shots, achieves a high dose with a low sheet resistance below 1000 ohms/square, appropriate for devices. The dopant profile extends to a depth comparable to the melt depth, beyond which it falls off to the background level. Therefore, the doping depth and concentration can be controlled with the laser parameters.

Laser Crystallized Polysilicon Thin Films and Applications

Pulsed excimer-laser crystallization of amorphous silicon on non-crystalline substrates is an important processing technique for large-area polycrystalline silicon films and devices. Interest stems, in large part, from proposals to use polycrystalline silicon on glass in large-area electronic applications, such as flat-panel active matrix displays and two-dimensional imaging systems. The polycrystalline silicon is envisioned to increase the functionality and reduce costs over the current circuits that use amorphous silicon. Also, it is found that laser-crystallized polycrystalline silicon exhibits some interesting materials properties, such as a sharp peak in the average grain size with large lateral grain growth as a function of excimer laser energy density. The average grain size increases with increasing laser fluence and peaks on the order of several microns or two orders of magnitude larger than the film thickness. The grain size then decreases with further increases in laser fluence. This peak in grain size is accompanied by a similar peak in the Hall electron mobility. This is a significant relationship for devices since the grain structure has a substantial influence on electrical properties. But to the detriment of device parameters, this large lateral grain growth occurs over a very arrow range of laser fluences and is accompanied by a corresponding peak in the surface roughness of the films. These relationships between laser processing conditions, materials properties, and device parameters force a compromise between large grain size for high mobility and homogeneity of material for uniformity of device characteristics. A window does exist in process parameter space where good-quality devices with uniform characteristics have been obtained. In addition, these attributes have been achieved under conditions that yield good polycrystalline silicon and good amorphous silicon devices on the same wafer within a mm of one another, allowing for hybrid polycrystalline and amorphous silicon circuits.

Characterization of the Substrate Interface of Excimer Laser Crystallized Polycrystalline Silicon Thin Films

Excimer laser crystallized Si thin films on fused silica substrates exhibit a peak in the average grain size as a function of laser energy density. The average grain size increases with increasing laser fluence until a maximum value , approximately 10 microns for a 100 nm thick Si film, is achieved. The peak in grain size is accompanied by a peak in the electron Hall mobility. Further increases in the laser fluence result in a decrease in the Si grain size and an increase in the intragranular defects. A small energy range of 40 mJ/cm2 exists in which this peak in grain size can be achieved. Cross section TEM has shown that when the peak laser fluence is exceeded, the fused silica substrate can be as rough as 17 nm. Atomic force microscopy. performed on the substrate surface after the Si has been etched off, also shows that the magnitude and spatial frequency of the roughness increases when the critical laser fluence is exceeded. This degradation of the interface may also produce sites for stacking faults to form during the solidification of the Si. This result and results of simulations of the temperature of the interface during crystallization suggests that the peak energy range exists after the complete melting of the Si thin film and before the silica substrate starts to soften.

Large Grain Creation and Destruction in Excimer Laser Crystallized Amorphous Silicon

For fast-pulse laser-crystallized thin-film Si on non-crystalline substrates, the average grain size exhibits a peak as a function excimer laser energy density at a characteristic laserfluence FM. The average grain size increases with increasing laser fluence and can reach a maximum value on the order of 10 pm or about 100 times the film thickness. The grain size then decreases with further increases in fluence. This peak in grain size is accompanied by a similar peak in the Hall electron mobility and x-ray scattering intensity. Our experiments have investigated as-deposited and ion-implanted samples, using a double-scan laser crystallization process. Devices have also been fabricated and studied. The results are consistent with the increase in grain size occurring because of the destruction of nucleation sites with increasing laser fluence (i.e., increased heating and complete Melting). But substrate damage occurs in the vicinity of FM, creating nucleation sites which give rise to small grain sizes in the solidified film. The disruption of the interface causes substantial current leakage through the dielectric of bottom-gate transistors, implying that devices should be laser fabricated below Fm.

Nanofabrication for transistor matrix produced by self-aligned imprint lithography

This paper describes an approach of combining nanofabrication techniques with roll-to-roll fabrication of thin film transistor backplanes for flexible display applications.

[Interactions between domains within the NH2- and COOH-terminal fragments of presenilins]

OBJECTIVE

To analyze the interactions between domains within the NH2- and COOH-terminal regions of presenilins.

METHODS

The various constructions corresponding to NH2-terminal fragment (NTF) and COOH-terminal fragment (CTF) derivatives of presenilin 1 (PS1) and presenilin 2 (PS2) were generated by RT-PCR, and their interactions were assayed by yeast two-hybrid system.

RESULTS

Domains within the NH- and COOH-terminal fragments of presenilins could directly interact with each other, and therefore form high molecular weight complex. The interaction site between domains within PS1 located at amino acid 361-447 of PS1 CTF, without the involvement of other partners. Similar interaction was not observed between PS11-360 and PS2341-448, PS2(1)-340 and PS1(361)-467.

CONCLUSIONS

Intramolecular interaction between domains within the NH2- and COOH-terminal regions of presenilins may be critical to the folding and assembly of mature PS molecules.

[Esophago-gastric mucosal anastomosis with staples after resection of cancer of the esophagus and gastric cardia]

OBJECTIVE

To delve an effective method to prevent anastomotic leakage and stenosis.

METHODS

Staples were used to carry out mucosal anastomosis between the esophagus and stomach.

RESULTS

Four hundred thirty four patients were so treated. The morbidity rate was 9.3% and the mortality rate was 1.4%. No leakage or stenosis was found in this series.

CONCLUSION

Using staples to perfonm mucosal anastomotis has the advantages of being simple and safe. Besides prevention of leakage and stenosis, sufficient length of resection of the esophagus helps reduce the likelihood of residual stump cancer recurrence.

Critical Laser Fluence Observed in (111) Texture, Grain Size and Mobility of Laser Crystallized Amorphous Silicon

This paper describes new results on the relationship between the grain size, mobility, and Si (111) x-ray peak intensity of laser crystallized amorphous silicon as a function of the laser fluence, shot density, substrate temperature, and film thickness. These observations include an unexpected narrow peak found in the silicon (111) x- ray peak intensity, which occurs at a specific laser fluence for a given film thickness and substrate temperature. Amorphous silicon materials processed at laser energy densities defined by this peak exhibit exceptionally large grain sizes and electron mobilities that cannot be obtained at any other energy and shot density combination above or below the energy at which the Si (111) x-ray peak intensity maximum occurs.

Intussusception anastomosis of the esophagus: a new method of anastomosis after resection of esophageal or cardiac carcinoma

A new method of anastomosis after resection of esophageal or cardiac carcinoma was carried out in 141 patients in Anyang Cancer Hospital from February 1983 to September 1985. After resection of the tumor, the proximal end of the esophagus was intussuscepted into the stomach lumen and extroversion sutures were applied on the esophageal mucosa to prevent bleeding and stenosis. In this series, the operative mortality was 0.7% (1/141) and no anastomotic leakage was found. We consider that this modified operative procedure is fairly easy, simple, and beneficial in reducing surgical complications.

[Invagination anastomosis of the esophagus--a new method of anastomosing after resection of esophageal or cardial carcinoma]

A new method of anastomosis after resection of esophageal or cardial carcinoma was carried out in 141 patients in our hospital from Feb. 1983 to Sept. 1985. After resection of the tumor, the proximal end of esophagus was invaginated into the stomach lumen and a tight suture was applied between the outer wall of esophagus and stomach. Extroversion suture of the mucosa in the esophageal end, being free in the stomach lumen, was made to prevent bleeding and stenosis. The operative mortality was 0.7% (1/141) and no anastomotic leak was found. Our experiences indicate that this operative procedure is easy, simple and obviously reduces the complication in the anastomotic region.