Attenuation of binuclear hepatocytes in the paracancerous liver tissue is associated with short-term recurrence of hepatocellular carcinoma post-radical surgery

Short-term recurrence of hepatocellular carcinoma (HCC) after radical resection leads to dismal outcomes. To screen high-recurrence risk patients to provide adjuvant treatment is necessary. Herein, based on our previous research, we further focused on the changes in the abundance of binuclear hepatocytes (ABH) in the paracancerous liver tissue to discuss the relationship between the attenuation of binuclear hepatocytes and postoperative short-term recurrence, by combining with the assessment of the value of a reported independent early recurrence risk factor in HCC, protein induced by vitamin K absence or antagonist-II (PIVKA-II). A cohort of 142 paracancerous liver tissues from HCC patients who received radical resection was collected. Binuclear hepatocytes were reduced in the paracancerous liver tissues, compared with the liver tissues from normal donors. ABH was negatively correlated with clinical features such as tumor size, TNM stages, tumor microsatellite formation, venous invasion, and Alpha-fetoprotein (AFP) level, as well as the expression of E2F7 and Anillin, which are two critical regulators concerning the hepatocyte polyploidization. According to the short-term recurrence information, ABH value was laminated, and univariate and multivariate logistic regression was performed to analyze the relationship between paracancerous ABH and short-term tumor relapse. Simultaneously, the predictive effectiveness of the ABH value was compared with the preoperative PIVKA-II value. As observed, the paracancerous ABH value below 1.5% was found to be an independent risk factor for recurrence. In conclusion, the paracancerous ABH is a credible indicator of short-term recurrence of HCC patients after radical resection, and regular assessment of ABH might help to prevent short-term HCC recurrence.

The application of decision tree model based on clinicopathological risk factors and pre-operative MRI radiomics for predicting short-term recurrence of glioblastoma after total resection: a retrospective cohort study

To develop a decision tree model based on clinical information, molecular genetics information and pre-operative magnetic resonance imaging (MRI) radiomics-score (Rad-score) to investigate its predictive value for the risk of recurrence of glioblastoma (GBM) within one year after total resection. Patients with pathologically confirmed GBM at Huashan Hospital, Fudan University between November 2017 and June 2020 were retrospectively analyzed, and the enrolled patients were randomly divided into training and test sets according to the ratio of 3:1. The relevant clinical and MRI data of patients before, after surgery and follow-up were collected, and after feature extraction on preoperative MRI, the LASSO filter was used to filter the features and establish the Rad-score. Using the training set, a decision tree model for predicting recurrence of GBM within one year after total resection was established by the C5.0 algorithm, and scatter plots were generated to evaluate the prediction accuracy of the decision tree during model testing. The prediction performance of the model was also evaluated by calculating area under the receiver operating characteristic (ROC) curve (AUC), ACC, Sensitivity (SEN), Specificity (SPE) and other indicators. Besides, two external validation datasets from Wuhan union hospital and the second affiliated hospital of Xuzhou Medical University were used to verify the reliability and accuracy of the prediction model. According to the inclusion and exclusion criteria, 134 patients with GBM were finally identified for inclusion in the study, and 53 patients recurred within one year after total resection, with a mean recurrence time of 5.6 months. According to the importance of the predictor variables, a decision tree model for predicting recurrence based on five important factors, including patient age, Rad-score, O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation, pre-operative Karnofsky Performance Status (KPS) and Telomerase reverse transcriptase (TERT) promoter mutation, was developed. The AUCs of the model in the training and test sets were 0.850 and 0.719, respectively, and the scatter plot showed excellent consistency. In addition, the prediction model achieved AUCs of 0.810 and 0.702 in two external validation datasets from Wuhan union hospital and the second affiliated hospital of Xuzhou Medical University, respectively. The decision tree model based on clinicopathological risk factors and preoperative MRI Rad-score can accurately predict the risk of recurrence of GBM within one year after total resection, which can further guide the clinical optimization of patient treatment decisions, as well as refine the clinical management of patients and improve their prognoses to a certain extent.

Predictive factors and a novel nomogram for recurrence of primary retroperitoneal liposarcoma: Comprehensive analysis of 128 cases

Since primary retroperitoneal liposarcoma (PRPLS) is rare in the clinic, related clinical studies are lacking. The present study was designed to investigate the predictive factors of short-term (≤1 year) recurrence (STR) and construct a novel nomogram of local recurrence-free survival (LRFS) for surgically resected PRPLS. A total of 128 PRPLS cases who underwent radical surgery were retrospectively analyzed. Based on the interval from the operation to tumor recurrence, the predictors of STR were screened using univariate and multivariate logistic regression analyses. Cox proportional hazard regression models were applied to identify the predictors of LRFS. Furthermore, the independent predictors acquired from multivariate analyses were used to construct a nomogram. Multivariate logistic regression analysis revealed that age ≥55 years [odds ratio (OR)=5.607, P=0.010], operative time ≥260 min (OR=9.716, P=0.005) and tumor necrosis (OR=3.781, P=0.037) were independent risk factors of STR for PRPLS. In the Cox regression analysis, clinical symptoms [hazard ratio (HR)=1.746, P=0.017], resection method (OR=0.370, P=0.021) and de-differentiated histological subtype (HR=1.975, P=0.048) were identified as independent predictors of LRFS. Subsequently, the independent predictors acquired from multivariate analyses were used to construct a nomogram for LRFS. Age, operative time, tumor necrosis, clinical symptoms, resection method and histological subtype were related to recurrence for surgically resected PRPLS and a novel nomogram was constructed based on the above predictors.

Therapeutic effect of alternating red and blue light irradiation combined with collagen in patients with acne vulgaris and the risk factors of short-term recurrence

OBJECTIVE

To explore the therapeutic effect of alternating red and blue light irradiation combined with collagen in patients with acne vulgaris and the risk factors of short-term recurrence.

METHOD

A retrospective analysis was conducted on 105 patients with acne vulgaris treated in Baoji Hospital of Traditional Chinese Medicine from January 2019 to February 2020. 50 patients received conventional treatment (Pumen red and blue light) were taken as the control group, and the other 55 patients treated with collagen dressing on the basis of control group were taken as the research group. Clinical efficacy, changes of serum interleukin-1β (IL-1β) and interleukin-6 (IL-6) before and after treatment, and the occurrence of adverse reactions were compared between the two groups of patients. The scores of inflammatory skin lesions, facial seborrhea scores, stratum corneum water content and transepidermal water loss (TEWL) were compared before and after the treatment. The 1-year review records of patients were queried, and they were divided into a relapse group and a non-relapse group according to the recurrence situation. Logistic regression was used to analyze the risk factors affecting the recurrence of the patients.

RESULTS

The clinical efficacy of the patients in research group after treatment was significantly higher than that in the control group (P<0.05). IL-1β and IL-6 in the serum of patients after treatment were markedly decreased, and such decline in the research group was more evident after treatment (P<0.05). The incidence of adverse reactions, the scores of inflammatory skin lesions, and facial seborrhea and TEWL in the research group after treatment were all lower than those in the control group (all P<0.05), while the water content of the stratum corneum was higher comparatively (P<0.05). 17 patients were confirmed with recurrence within 1 year after treatment. Logistic regression analysis found that age, monthly income, pre-treatment IL-1β and pre-treatment IL-6 were risk factors for recurrence.

CONCLUSION

Alternating red and blue light irradiation combined with collagen can improve the treatment efficacy in patients with acne vulgaris. And indexes like age, monthly income, pre-treatment IL-1β and pre-treatment IL-6 are risk factors affecting the recurrence of patients.

Predictive Value of the TP53 p.G245S Mutation Frequency for the Short-Term Recurrence of Hepatocellular Carcinoma as Detected by Pyrophosphate Sequencing

Aims: We explored the relationship between the mutation of the p.G245S site in TP53 and the short-term recurrence of hepatocellular carcinoma (HCC). Materials and Methods: One hundred one HCC patients were included in this study. The TP53 p.G245S mutation frequency spectrum was examined by direct sequencing of genomic DNA from tissue specimens of HCC patients. Univariate and multivariate Cox regression were used to evaluate the independent prognostic factors of tumor recurrence. Receiver operating characteristic (ROC) curve analysis was applied to determine the cutoff value of p.G245S mutation frequency and verify the predictive ability of the Cox model compared with single risk factor indices. Results: Multivariate Cox regression analysis showed that TP53 p.G245S mutation frequency (hazard ratio [HR] = 1.231, 95% CI: 1.006-1.505, p = 0.043), alpha-fetoprotein (AFP) (HR = 2.432, 95% CI: 1.297-4.561, p = 0.006), macrotrabecular-massive (MTM) (HR = 2.656, 95% CI: 0.930-7.583, p = 0.068), and portal vein tumor thrombus (PVTT) (HR = 14.297, 95% CI: 3.085-66.243, p = 0.001) were independent prognostic factors for short-term recurrence. The cutoff value of TP53 p.G245S mutation frequency (18.5%) was determined by ROC analysis. The prediction model integrating TP53 p.G245S mutation frequency, PVTT, MTM, and AFP could be a predictive indicator of short-term recurrence in HCC patients (AUC = 0.849, 95% CI: 0.748-0.950, p = 0.000001). Survival analysis indicated that the probability of short-term recurrence-free survival was significantly different among different TP53 p.G245S mutation frequency, MTM, PVTT, and AFP risk groups (p < 0.05). Conclusion: The mutation frequency of the p.G245S site was a novel prognostic risk factor for the short-term recurrence of HCC.

A Novel Nomogram for Predicting the Risk of Short-Term Recurrence After Surgery in Glioma Patients

Objective

The aim of this study was to establish a nomogram model for predicting the risk of short-term recurrence in glioma patients.

Methods

The clinical data of recurrent glioma patients were summarized and analyzed in this study. Univariate and multivariate logistic regression analyses were performed to analyze the correlation between clinical data and the risk of short-term recurrence after operation. A nomogram was established based on the multivariate logistic regression model results.

Results

A total of 175 patients with recurrent glioma were enrolled, with 53 patients in the short-term recurrence (STR) group (recurrent time ≤6 months) and 122 patients in the long-term recurrence (LTR) group (recurrent time ≥36 months). Univariate analysis revealed that age at diagnosis, Karnofsky performance scores (KPSs), tumor location, glioma grade, glioma type, extent of resection (EOR), adjuvant chemotherapy (ad-CT), concurrent chemotherapy (co-CT), and isocitrate dehydrogenase (IDH) status were significantly associated with the short-term glioma recurrence. Multivariate analyses revealed that age at diagnosis, KPS, glioma grade, EOR, and IDH were independent risk factors for short-term glioma recurrence. A risk nomogram for the short-term recurrence of glioma was established, with the concordance index (C-index) of 0.971. The findings of calibration and receiver operating characteristic (ROC) curves showed that our nomogram model had good performance and discrimination to estimate short-term recurrence probability.

Conclusion

This nomogram model provides reliable information about the risk of short-term glioma recurrence for oncologists and neurosurgeons. This model can predict the short-term recurrence probability and give assistance to decide the interval of follow-up or formulate individualized treatment strategies based on the predicted results. A free online prediction risk tool for this nomogram is provided: https://rj2021.shinyapps.io/Nomogram_ recurrence-risk/.

A Predictive Scoring Model for Short-Term Local Recurrent Nasopharyngeal Carcinoma Based on Magnetic Resonance Imaging

OBJECTIVE

To predict the early identification of recurrence based on magnetic resonance imaging (MRI) in nasopharyngeal cancer (NPC) patients.

METHODS

The clinical and MRI data of 215 patients with local recurrent NPC were retrospectively reviewed. Logistic regression analysis was performed to distinguish the independent risk factors for the short-term (less than 24 months) local recurrence of NPC. The predictive score model was based on the regression coefficients of significant independent variables.

RESULTS

Residual disease in the nasopharyngeal cavity (NC), masticator space invasion (MSI), skull base bone erosion (SBBE), and MRI-detected cranial nerve invasion (MDCNI) were all significant independent risk factors for the short-term recurrence of NPC (p < 0.05). The receiver operating characteristic curve showed that the total score had a maximal AUC (area under the curve) value of 0.897, with a cutoff point of 10.50. The sensitivity and specificity were 79.4% and 80.5%, respectively.

CONCLUSION

Residual lesions in NC, MSI, SBBE, and MDCNI are independent risk factors in predicting the short-term recurrence of NPC. The authors' findings suggest that patients with a score of more than 10.50 points should be hypervigilant regarding the possibility of short-term recurrence.

Prognostic effect of IL-6/JAK2/STAT3 signal-induced microRNA-21-5p expression on short term recurrence of hepatocellular carcinoma after hepatectomy

AIM

To investigate the putative role of interleukin (IL)-6/Janus Kinase (JAK) 2/Signal transducers and activators of transcription (STAT) 3 signaling pathway in hepatocellular carcinoma (HCC) short term recurrence (STR), and whether the pathway promotes HCC progression through microRNA-21-5p (miRNA-21).

METHODS

Immunohistochemistry was performed to evaluate the protein expression of IL-6, JAK2 and STAT3. Real-time PCR was used to evaluate the miRNA-21 expression. We also analyzed the correlation of IL-6, JAK2 and STAT3 protein expression with miRNA-21. Clinicopathological variables, including prognosis, were compared between low and high-expressing groups of miRNA-21.

RESULTS

miRNA-21 expression was significantly increased in the HCC tumor tissue compared to the non-tumor tissue. IL-6 and STAT3 high expression was significantly correlated to high miRNA-21 expression in HCC tumor tissues. Patients with high miRNA-21 expression have more frequent early recurrence. The 6 month overall survival and disease-free survival rate of the miRNA-21 high groups were 72.1% and 30.8%, respectively. Moreover, high miRNA-21 expression was correlated with disease-free survival (DFS) (P < 0.05) and overall survival (OS) (P < 0.05). Multivariate analysis revealed that miRNA-21 and STAT3 high expression were independent prognostic factors of DFS and OS. The area under the ROC curve (AUC) of miRNA-21 and STR, DFS, OS was 0.951 (P < 0.001), 0.847 (P < 0.001), 0.844 (P < 0.001), respectively.

CONCLUSIONS

miRNA-21 expression, induced by IL-6/JAK2/STAT3 signaling pathway, was increased in the early recurrence of HCC patients and indicated poor prognosis. Expression analysis of miRNA-21 revealed that it may be a valuable prognostic biomarker for HCC.