[Construction and evaluation of a nomogram for predicting the prognosis of patients with colorectal cancer with peritoneal carcinomatosis treated with cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy]

Objectives: To construct a nomogram incorporating important prognostic factors for predicting the overall survival of patients with colorectal cancer with peritoneal metastases treated with cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC), the aim being to accurately predict such patients' survival rates. Methods: This was a retrospective observational study. Relevant clinical and follow-up data of patients with colorectal cancer with peritoneal metastases treated by CRS + HIPEC in the Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University from 2007 January to 2020 December were collected and subjected to Cox proportional regression analysis. All included patients had been diagnosed with peritoneal metastases from colorectal cancer and had no detectable distant metastases to other sites. Patients who had undergone emergency surgery because of obstruction or bleeding, or had other malignant diseases, or could not tolerate treatment because of severe comorbidities of the heart, lungs, liver or kidneys, or had been lost to follow-up, were excluded. Factors studied included: (1) basic clinicopathological characteristics; (2) details of CRS+HIPEC procedures; (3) overall survival rates; and (4) independent factors that influenced overall survival; the aim being to identify independent prognostic factors and use them to construct and validate a nomogram. The evaluation criteria used in this study were as follows. (1) Karnofsky Performance Scale (KPS) scores were used to quantitatively assess the quality of life of the study patients. The lower the score, the worse the patient's condition. (2) A peritoneal cancer index (PCI) was calculated by dividing the abdominal cavity into 13 regions, the highest score for each region being three points. The lower the score, the greater is the value of treatment. (3) Completeness of cytoreduction score (CC), where CC-0 and CC-1 denote complete eradication of tumor cells and CC-2 and CC-3 incomplete reduction of tumor cells. (4) To validate and evaluate the nomogram model, the internal validation cohort was bootstrapped 1000 times from the original data. The accuracy of prediction of the nomogram was evaluated with the consistency coefficient (C-index), and a C-index of 0.70-0.90 suggest that prediction by the model was accurate. Calibration curves were constructed to assess the conformity of predictions: the closer the predicted risk to the standard curve, the better the conformity. Results: The study cohort comprised 240 patients with peritoneal metastases from colorectal cancer who had undergone CRS+HIPEC. There were 104 women and 136 men of median age 52 years (10-79 years) and with a median preoperative KPS score of 90 points. There were 116 patients (48.3%) with PCI≤20 and 124 (51.7%) with PCI>20. Preoperative tumor markers were abnormal in 175 patients (72.9%) and normal in 38 (15.8%). HIPEC lasted 30 minutes in seven patients (2.9%), 60 minutes in 190 (79.2%), 90 minutes in 37 (15.4%), and 120 minutes in six (2.5%). There were 142 patients (59.2%) with CC scores 0-1 and 98 (40.8%) with CC scores 2-3. The incidence of Grade III to V adverse events was 21.7% (52/240). The median follow-up time is 15.3 (0.4-128.7) months. The median overall survival was 18.7 months, and the 1-, 3- and 5-year overall survival rates were 65.8%, 37.2% and 25.7%, respectively. Multivariate analysis showed that KPS score, preoperative tumor markers, CC score, and duration of HIPEC were independent prognostic factors. In the nomogram constructed with the above four variables, the predicted and actual values in the calibration curves for 1, 2 and 3-year survival rates were in good agreement, the C-index being 0.70 (95% CI: 0.65-0.75). Conclusions: Our nomogram, which was constructed with KPS score, preoperative tumor markers, CC score, and duration of HIPEC, accurately predicts the survival probability of patients with peritoneal metastases from colorectal cancer treated with cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy.

[The effect of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy on peritoneal carcinomatosis from colorectal cancer]

Objective: To evaluate the safety and efficacy of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS+ HIPEC) in patients with peritoneal carcinomatosis from colorectal carcinoma (CRC PC). Methods: The clinical and follow-up data of 90 consecutive CRC PC patients underwent CRS+ HIPEC in Beijing Shijitan Hospital from January 2015 to June 2018 were collected. Kaplan-Meier method and parallel Log rank test were used for survival analysis. Cox regression model was used for univariate and multivariate analysis. Results: A total of 90 CRC PC patients underwent CRS+ HIPEC, the median age was 53 years (rage: 13 to 81 years), and 51 cases were male, while other 39 were female. The median overall survival (mOS) was 21.9 months (95%CI: 15.7, 28.1). The 1-, 2-, 3-, and 5-year survival rates were 77.8%, 48.6%, 21.1%, and 5.5%, respectively. The incidence rate of serious adverse event (SAE) was 8.9% (8/90). The mortality rate of perioperative period was 2.2% (2/90). Univariate analysis showed the age (P=0.040), primary tumor site (P=0.020), preoperative carbohydrate antigen 125 (CA125) level (P<0.001), peritoneal cancer index (PCI) (P<0.001), completeness of cytoreduction (CC) (P<0.001), ascites (P=0.012) and postoperative adjuvant chemotherapy (P<0.001) were significantly associated with the OS. Multivariate Cox-analysis identified preoperative CA125 level(P=0.033), CC of 0 to 1 (P=0.014), and adjuvant chemotherapy postoperative (P=0.002) were independent prognostic factor for OS. Conclusions: CRS+ HIPEC can improve survival for CRC PC patients with acceptable morbidity and mortality. Stringent patient selection and complete CRS are two key factors for better survival.

Plasma soluble cluster of differentiation 147 levels are increased in breast cancer patients and associated with lymph node metastasis and chemoresistance

INTRODUCTION

Cluster of differentiation 147 (CD147) contributes to breast cancer invasion, metastasis, and multidrug resistance. Recent studies have shown that peripheral soluble CD147 (sCD147) is increased in hepatocellular tumour and multiple myeloma patients and correlated with disease severity. The primary aim of our study was to assess the level, as well as the biological and clinical significance of sCD147 in breast cancer.

METHODS

We tested plasma sCD147 levels in 308 breast cancer patients by enzyme-linked immunosorbent assay between February 2014 and February 2017. A subset of 165 cases of benign breast diseases was included as a control group at the same period. We analysed the clinical significance of plasma sCD147 with relevance to clinicopathological factors of breast cancer patients.

RESULTS

Plasma sCD147 levels were significantly higher in patients with primary breast cancer than those with benign breast diseases (P=0.001), in patients with locally advanced breast cancer (T3-T4 tumour) than those in early breast cancer (T1-T2 tumour; P=0.001), in patients with lymph node metastasis than in those without (P<0.001), and in patients with high recurrence risk than those with medium recurrence risk (P<0.001). Plasma sCD147 levels were also significantly higher in the chemotherapy-resistant group than in the chemotherapy-sensitive group (P=0.040). Plasma sCD147 was an independent predictor for lymph node metastasis in breast cancer patients (P=0.001).

CONCLUSION

This is the first study to demonstrate that plasma sCD147 levels are elevated in breast cancer patients. Soluble CD147 is also associated with tumour size, lymph node metastasis, high recurrent risk, and chemoresistance. Our findings support that plasma sCD147 is an independent predictive factor for lymph node metastasis.

Effects of fasting and feeding on the fast-start swimming performance of southern catfish Silurus meridionalis

This study investigated the effects of fasting and feeding on the fast-start escape swimming performance of juvenile southern catfish Silurus meridionalis, a sit-and-wait forager that encounters extreme fasting and famine frequently during its lifespan. Ten to 30 days of fasting resulted in no significant change in most of the variables measured in the fast-start response except a 20-30% decrease in the escape distance during the first 120 ms (D_120ms ) relative to the control group (48 h after feeding). The ratio of the single-bend (SB) response (lower energetic expenditure) to the double-bend (DB) response increased significantly from 0% in the control group to 75 and 82·5% in the 20 and 30 day fasting groups, respectively. Satiated feeding (25% of body mass) resulted in a significantly lower (36·6%) maximum linear velocity (V_max ) and a significantly lower (43·3%) D_120ms than in non-fed fish (control group, 48 h after feeding). Half-satiated feeding (12·5% of body mass), however, showed no significant effects on any of the measured variables of the fast-start response relative to control fish. It is suggested that the increase in the ratio of SB:DB responses with fasting in S. meridionalis may reflect a trade-off between energy conservation and maintaining high V_max , while variables of fast-start performance were more sensitive to feeding than fasting might be an adaptive strategy to their foraging mode and food availability in their habitat.

Association of heat shock protein 90 with motility of post-thawed sperm in bulls

The correlation between the 90 kDa heat-shock protein (HSP90) and sperm quality following the process of freezing-thawing in bulls has not been studied clearly. Therefore, the objective of the present was to clarify the relationship between HSP90 level and semen parameters during the process of cryopreservation in bulls. Semen samples from 5 Holstein bulls were obtained by artificial vagina. Characteristics of these semen at three stages (fresh, after equilibration and frozen-thawed), including motility, plasma membrane integrity and acrosome integrity were evaluated. The mRNA expression level of HSP90 at the three stages was evaluated by using quantitative Real-Time PCR. Meanwhile, the protein level of HSP90 expression at the three stages was detected according to Western blot. The results showed that sperm parameters evaluated in fresh semen was the highest in the three groups. Sperm parameters in semen after equilibration were lower than those in fresh semen (P>0.05) and higher than those in post-thawed semen (P<0.05). Sperm parameters in frozen-thawed semen were the lowest among the three groups (P<0.05). This study indicated that HSP90 expression is proportional to sperm quality. HSP90 expression level in fresh semen was significantly higher than that in frozen-thawed semen (P<0.05). Although no significant differences in HSP90 expression were observed between fresh semen and semen after equilibration (P>0.05). Results in this study suggest that HSP90 level in bull spermatozoa was gradually declined following the process of freezing-thawing, and might be associated with sperm motility, plasma membrane integrity and acrosome integrity.

Improving yield and quality traits of durum wheat by introgressing chromosome segments from hexaploid wheat

Durum wheat (Triticum turgidum durum; 2n = 4x = 28; genome AABB) has long been an important food resource for human diets. The projected increase of the world's population to 9.1 billion by 2050 has highlighted the importance and urgency for improving the yield and quality performance of durum wheat. A backcrossed population, which was derived from the durum wheat variety 'Bellaroi' (recurrent parent) and the hexaploid genotype 'CSCR6' (donor parent), was used to investigate the feasibility of improving yield- and quality-related traits of durum wheat by introgressing chromosome fragments from hexaploid wheat. The population means for grain protein content, gluten content, spike length, and spikelet number were improved compared with those of the recurrent parent 'Bellaroi'. A small proportion of the backcross population lines showed significant improvements in spike length and spikelet number compared with the recurrent parent 'Bellaroi'. Some loci with significant effects for plant height, spike length, spikelet number, and thousand-grain weight were identified. Several of these loci affected more than one trait. These results showed that the introgression of chromosome fragments from 'CSCR6' into the durum genetic background could be an effective method for improving yield and quality traits of durum wheat. In addition, the loci showing significant effects on desired traits in this study could be fine mapped using an F2 population obtained by backcrossing the lines that carry the positive allele(s) with the recurrent parent.

Interspecific variation in hypoxia tolerance, swimming performance and plasticity in cyprinids that prefer different habitats

This study quantified and compared hypoxia tolerance and swim performance among cyprinid fish species from rapid-, slow- and intermediate-flow habitats (four species per habitat) in China. In addition, we explored the effects of short-term acclimation on swim performance, maximum metabolic rate (M(O2,max)) and gill remodelling to detect habitat-associated patterns of plastic response to hypoxia. Indices of hypoxia tolerance included oxygen threshold for loss of equilibrium (LOE50) and aquatic surface respiration (ASR50), and critical oxygen tension for routine metabolic rate (Pcrit). Critical swimming speed (Ucrit) and M(O2,max) were measured under normoxic and hypoxic conditions after 48 h acclimation to normoxia and hypoxia, and gill remodelling was estimated after 48 h of hypoxia exposure. Both traditional ANCOVA and phylogenetically independent contrast (PDANOVA) analyses showed that fish species from rapid-flow habitats exhibited lower LOE50 compared with fish from intermediate- and slow-flow habitats. Habitat-specific differences in Pcrit and Ucrit were detected using PDANOVA but not traditional ANCOVA analyses, with fish species from rapid-flow habitats exhibiting lower Pcrit but higher Ucrit values compared with fish from intermediate- and slow-flow habitats. Fish species from rapid-flow habitats were also characterized by less plasticity in swim performance and gill morphology in response to hypoxia acclimation compared with species from slow-flow habitats, but a greater drop in swim performance in response to acute hypoxia exposure. The study detected a habitat-specific difference in hypoxia tolerance, swimming performance and its plasticity among fish from habitats with different flow conditions, possibly because of the long-term adaptation to the habitat caused by selection stress. The PDANOVA analyses were more powerful than traditional statistical analyses according to the habitat effects in both hypoxia tolerance and swimming performance in this study.

Plant height affects Fusarium crown rot severity in wheat

Effects of plant height on Fusarium crown rot (FCR) disease severity were investigated using 12 pairs of near-isogenic lines (NILs) for six different reduced height (Rht) genes in wheat. The dwarf isolines all gave better FCR resistance when compared with their respective tall counterparts, although the Rht genes involved in these NILs are located on several different chromosomes. Treating plants with exogenous gibberellin increased FCR severity as well as seedling lengths in all of the isolines tested. Analysis of the expression of several defense genes with known correlation with resistance to FCR pathogens between the Rht isolines following FCR inoculation indicated that the better resistance of the dwarf isolines was not due to enhanced defense gene induction. These results suggested that the difference in FCR severity between the tall and dwarf isolines is likely due to their height difference per se or to some physiological and structural consequences of reduced height. Thus, caution should be taken when considering to exploit any FCR locus located near a height gene.

Identification and validation of a major QTL conferring crown rot resistance in hexaploid wheat

Crown rot (CR), caused by various Fusarium species, is a chronic wheat disease in Australia. As part of our objective of improving the efficiency of breeding CR resistant wheat varieties, we have been searching for novel sources of resistance. This paper reports on the genetic control of one of these newly identified resistant genotypes, 'CSCR6'. A population derived from a cross between CSCR6 and an Australian variety 'Lang' was analyzed using two Fusarium isolates belonging to two different species, one Fusarium pseudograminearum and the other Fusarium graminearum. The two isolates detected QTL with the same chromosomal locations and comparable magnitudes, indicating that CR resistance is not species-specific. The resistant allele of one of the QTL was derived from 'CSCR6'. This QTL, designated as Qcrs.cpi-3B, was located on the long arm of chromosome 3B and explains up to 48.8% of the phenotypic variance based on interval mapping analysis. Another QTL, with resistant allele from the variety 'Lang', was located on chromosome 4B. This QTL explained up to 22.8% of the phenotypic variance. A strong interaction between Qcsr.cpi-3B and Qcsr.cpi-4B was detected, reducing the maximum effect of Qcrs.cpi-3B to 43.1%. The effects of Qcrs.cpi-3B were further validated in four additional populations and the presence of this single QTL reduced CR severity by up to 42.1%. The fact that significant effects of Qcrs.cpi-3B were detected across all trials with different genetic backgrounds and with the use of isolates belonging to two different Fusarium species make it an ideal target for breeding programs as well as for further characterization of the gene(s) involved in its resistance.