[Analysis of treatment modalities and prognosis of patients with gallbladder cancer in China from 2010 to 2017]

Objective: To evaluate the clinical characteristics and prognosis of gallbladder cancer (GBC) patients in China. Methods: This retrospective multicenter cohort study enrolled 3 528 consecutive GBC patients diagnosed between January 2010 to December 2017 in 15 hospitals from 10 provinces. There were 1 345 (38.12%) males and 2 183 (61.88%) females.The age of diagnosis was (63.7±10.8) years old (range: 26 to 99 years old) .There were 213 patients (6.04%) in stage 0 to Ⅰ, whereas 1 059 (30.02%) in stage Ⅱ to Ⅲ, 1 874 (53.12%) in stage Ⅳ, and 382 (10.83%) unavailable. Surgery was performed on 2 255 patients (63.92%) . Three hundred and thirty-six patients received chemotherapy or radiotherapy (9.52%; of which 172 were palliative); 1 101 (31.21%) received only supportive treatment.The patient source, treatment and surgery, pathology, concomitant gallstone, and prognosis were analyzed. Results: Among the 3 528 GBC patients, 959 (27.18%) were from East China, 603 (17.09%) from East-North China, 1 533 (43.45%) from Central China, and 433(12.27%) from West China. Among the 1 578 resectable tumor, 665 (42.14%) underwent radical surgery, 913 (57.86%) underwent surgery that failed to follow the guidelines.Eight hundred and ninety-one (56.46%) patients were diagnosed before surgery, 254 (16.10%) during surgery, and 381 (24.14%) after surgery (time point of diagnosis couldn't be determined in 52 patients) .Among the 1 578 patients with resectable tumor, 759 (48.10%) had concomitant gallstone.Among the 665 patients underwent radical surgery, 69 (10.4%) showed positive resection margin, 510 (76.7%) showed negative resection margin, and 86 (12.9%) unreported margin status.The 5-year overall survival rate (5yOS) for the 3 528-patient cohort was 23.0%.The 5yOS for patients with resectable tumor was 39.6%, for patients with stage ⅣB tumor without surgery was 5.4%, and for patients with stage ⅣB tumor underwent palliative surgery was 4.7%. Conclusions: More than half GBC patients in China are diagnosed in stage Ⅳ.Curative intent surgery is valuable in improving prognosis of resectable GBC.The treatment of GBC needs further standardization.Effective comprehensive treatment for GBC is in urgent need.

Genome-wide identification and characterization of the Dof gene family in Medicago truncatula

The DNA-binding one zinc finger (Dof) family is a classic plant-specific zinc-finger transcription factor family, which is involved in many important processes, including seed maturation and germination, plant growth and development, and light responses. Investigation of the Medicago truncatula genome revealed 42 putative Dof genes, each of which holds one Dof domain. These genes were classified into four groups based on phylogenetic analysis, which are similar to the groups reported for Arabidopsis and rice. Based on genome duplication analysis, it was found that the MtDof genes were distributed on all chromosomes and had expanded through tandem gene duplication and segmental duplication events. Two main duplication regions were identified, one from tandem duplication and another from segmental duplication. By analyzing high-throughput sequencing data from M. truncatula, we found that most of the MtDof genes showed specific expression patterns in different tissues. According to cis-regulatory element analysis, these MtDof genes are regulated by different cis-acting motifs, which are important for the functional divergence of the MtDof genes in different processes. Thus, using genome-wide identification, evolution, and expression pattern analysis of the Dof genes in M. truncatula, our study provides valuable information for understanding the potential function of the Dof genes in regulating the growth and development of M. truncatula.

Gametocidal chromosomes enhancing chromosome aberration in common wheat induced by 5-azacytidine

The gametocidal (Gc) chromosome from Aegilops spp induces chromosome mutation, which is introduced into common wheat as a tool of chromosome manipulation for genetic improvement. The Gc chromosome functions similar to a restriction-modification system in bacteria, in which DNA methylation is an important regulator. We treated root tips of wheat carrying Gc chromosomes with the hypomethylation agent 5-azacytidine; chromosome breakage and micronuclei were observed in these root tips. The frequency of aberrations differed in wheat containing different Gc chromosomes, suggesting different functions inducing chromosome breakage. Gc chromosome 3C caused the greatest degree of chromosome aberration, while Gc chromosome 3C(SAT) and 2C caused only slight chromosome aberration. Gc chromosome 3C induced different degrees of chromosome aberration in wheat varieties Triticum aestivum var. Chinese Spring and Norin 26, demonstrating an inhibition function in common wheat.

Genomic selection of seed weight based on low-density SCAR markers in soybean

With the development of molecular marker technology, crop breeding has been accelerated by marker-assisted selection for the improvement of quantitative traits. However, due to the traits' polygenic nature, traditional marker-assisted selection methods are ill-suited for identification of quantitative trait loci. Genomic selection (GS) was introduced into crop breeding to achieve more accurate predictions by considering all genes or markers simultaneously. We used dozens of sequence-characterized amplified region (SCAR) markers for genotyping soybean varieties, and we identified markers associated with hundred-seed weight. The best linear unbiased predictor and Bayesian liner regression methods were used to construct GS models to predict the hundred-seed weight trait based upon genotype information for trait selection. Both GS models showed good prediction performance in soybean, as the correlation coefficient between genomic estimated breeding values and true breeding values was as high as 0.904. This indicated that GS was performed effectively based on dozens of SCAR markers in soybean; these markers were of low density but easily detectable. Therefore, the combination of GS modeling and highly effective molecular marker technology involving SCAR markers can facilitate genetic breeding in soybean. This approach may also be suitable for genetic selection in other crops, such as wheat, maize, and rice.

RAPD and ISSR-assisted identification and development of three new SCAR markers specific for the Thinopyrum elongatum E (Poaceae) genome

Diploid Thinopyrum elongatum, a wild relative of wheat, contains many agronomically desirable traits and has potential for increasing genetic variability and introducing desirable characters in this crop. Few molecular markers are available for rapid screening of T. elongatum genome segments in the wheat genetic background. We used 36 RAPD primers and 33 ISSR primers to screen for polymorphisms in the common wheat variety Chinese Spring and in T. elongatum. Two RAPD markers and one ISSR marker, designated OPF03(1407), LW10(1487) and UBC841(701), were identified and were specific for the T. elongatum E genome. Three pairs of primers flanking these specific sequences were designed to produce SCAR markers. All three SCAR markers were T. elongatum E genome-specific. Two of these SCAR markers, SCAR(807) and SCAR(577), were present in all seven T. elongatum chromosomes, while SCAR(839) was specific for T. elongatum chromosomes 2E and 3E. These newly developed SCAR markers should be useful for detecting alien genome chromatin or chromosome segments in the genetic background of common wheat.

Esophageal cytology and subsequent risk of esophageal cancer. A prospective follow-up study from Linxian, China

This paper reports a 15-year follow-up study of 12,693 persons in Linxian, China, who were originally screened by esophageal balloon cytology in 1974. The purpose of the study was to evaluate the ability of esophageal balloon cytology to identify individuals at increased risk for developing esophageal cancer. Age, sex and cytologic diagnoses were obtained from the original 1974 records, and information on vital status, cancer experience and potential confounding risk factors was collected from interviews and medical abstracts in 1989. A total of 1,162 incident cases of esophageal cancer and 993 deaths due to esophageal cancer were identified and used in this analysis. The follow-up study showed that the risk of esophageal cancer incidence and mortality increased in parallel with the presumed severity of the 1974 Chinese cytologic diagnoses. After adjusting for potential confounding factors, the relative risks (and 95% confidence intervals) for esophageal cancer incidence, by cytologic diagnosis, were: normal, 1.00; esophagitis, 1.52 (1.07-2.14); hyperplasia, 1.17 (1.02-1.33); dysplasia 1, 1.53 (1.10-2.14); dysplasia 2, 1.89 (1.47-2.41); and suspicious for cancer, 5.77 (3.79-8.80). These results suggest that esophageal balloon cytology, as performed and interpreted in Linxian in 1974, successfully identified individuals at increased risk for esophageal cancer.

Use of the esophageal balloon in the diagnosis of carcinomas of the head, neck and upper gastrointestinal tract

A study was undertaken to demonstrate the safety, efficacy and value of esophageal balloon cytology in the diagnosis of esophageal lesions and as a tool in screening a high-risk patient population. The sampling was performed 110 times on 96 patients, 11 with known obstructive carcinoma of the esophagus and 85 thought to be at risk for esophageal cancer: 74 with treated or untreated cancer of the head and neck area and 11 with dysphagia or other findings requiring clarification. The method was well tolerated by the patients, and the cytologic smears were of excellent quality. Malignant or suspicious cells were found in smears from 7 to 11 patients with documented esophageal cancer and in 7 of 85 patients believed to be at risk. In the latter group there were three unsuspected recurrent cancers of the oropharyngeal region and one unsuspected carcinoma in situ of the esophagus. There were no false-suspicious or false-positive results. This noninvasive technique of esophageal cytology obviously deserves additional trials as an adjunct in the diagnosis of carcinoma of the head and neck and upper gastrointestinal tract, especially in high-risk patients.

Cytopathology of the esophagus. An overview of esophageal cytopathology in China

Carcinoma of the esophagus is the most common malignancy in many parts of China. In an attempt to control it by early diagnosis, the balloon sampling technique was developed approximately 20 years ago. This technique is now widely used in China and is accepted as a diagnostic method by WHO. Up to 1979, more than 500,000 people were examined in China. It is routinely used for differentiation between benign and malignant lesions in the esophagus, with an accuracy in the range of 90%. In mass surveys, 73.8% of the cancers detected have been carcinoma in situ and minimally invasive carcinomas. Dysplasias have been shown to progress to invasion by cytologic studies. The utilization of this technique has made possible epidemiologic studies and, thereby, coordination of etiologic research in esophageal cancer. Detection rates of early esophageal cancer by cytologic studies are more accurate than are those with either endoscopic or radiologic methods. The instruments and technique for balloon sampling of esophageal lesions are described, as are the cellular cytomorphology and the diagnostic cytologic criteria applicable to the samples obtained.