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Immunotherapy, especially immune checkpoint inhibitor, has revolutionized the treatment mode of advanced non-small cell lung cancer. The predictive effect of programmed death-ligand 1 and tumor mutation burden for treatment response has been fully proved. Neither of which can avoid some problems, including tumor heterogeneity, inconsistent detection methods and identification standards. The studies have found that some novel biomarkers are related to the efficacy of immunotherapy, such as mismatch repair deficiency and microsatellite instability, driver gene mutation, routine peripheral blood biomarkers, circulating tumor cells, circulating tumor DNA and so on. Further research on the predictive value of biomarkers in tumor tissue and peripheral blood in immunotherapy of advanced non-small cell lung cancer can provide a reference for instituting clinical treatment plan.
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Objective:To investigate the correlations between albumin globulin ratio (AGR) , platelet lymphocyte ratio (PLR) , neutrophil lymphocyte ratio (NLR) and efficacy of chemotherapy for patients with metastatic colorectal cancer (mCRC) .Methods:The clinical data of 107 mCRC patients who were treated at the First Hospital of Shanxi Medical University for chemotherapy from January 2016 to September 2020 were selected, and the values of AGR, NLR and PLR before chemotherapy and after 3 cycles of chemotherapy were collected for retrospective analysis. After 3 cycles, patients were divided into three groups according to efficacy evaluation: partial response (PR) group, stable disease (SD) group and progressive disease (PD) group. The changes of AGR, PLR and NLR values before and after chemotherapy, and the relationships between the degrees of changes and the therapeutic effects were analyzed.Results:There were 18 cases in the PR group, 53 cases in the SD group and 36 cases in the PD group. There were no significant differences in age, sex, distant metastasis site, cancer site, T stage and N stage among the three groups ( F=0.33, P=0.721; χ2=2.94, P=0.230; χ2=2.34, P=0.674; χ2=0.80, P=0.669; χ2=5.68, P=0.224; χ2=2.06, P=0.375) . The AGR, PLR and NLR values before chemotherapy in the PR group were 1.57±0.19, 180.05±102.77 and 5.19 (4.50, 5.83) , and they were 1.45±0.23, 115.81±55.79 and 1.83 (1.06, 2.84) after chemotherapy, with statistically significant differences ( t=2.32, P=0.033; t=2.84, P=0.011; Z=-2.94, P=0.003) . In the SD group, AGR, PLR and NLR values before chemotherapy were 1.66 (1.40, 1.77) , 158.18 (103.81, 236.26) , 2.41 (1.75, 4.07) , and they were 1.35 (1.15, 1.60) , 123.85 (94.86, 176.44) , 1.49 (1.27, 2.33) after chemotherapy, with statistically significant differences ( Z=-4.51, P<0.001; Z=-3.31, P=0.001; Z=-3.90, P<0.001) . The AGR, PLR and NLR values in the PD group before chemotherapy were 1.60 (1.48, 1.87) , 122.07 (77.14, 175.72) , 2.37 (1.28, 4.20) , and they were 1.26 (1.08, 1.40) , 176.39 (139.89, 280.64) and 4.71 (3.71, 6.96) after chemotherapy, with statistically significant differences ( Z=-4.49, P<0.001; Z=-3.42, P=0.001; Z=-4.18, P<0.001) . The differences in AGR ( OR=3.66, 95% CI: 1.29-10.39, P=0.015) , PLR ( OR=0.99, 95% CI: 0.99-1.00, P<0.001) and NLR ( OR=0.59, 95% CI: 0.49-0.70, P<0.001) before and after chemotherapy were related to clinical efficacy. The greater the difference of AGR, the worse the short-term efficacy. The greater the difference of PLR and NLR, the better the short-term efficacy. The correlation between the changes in AGR, PLR and NLR before and after treatment and the clinical efficacy was sorted in descending order Δ NLR>Δ PLR>Δ AGR ( r=-0.68, P<0.001; r=-0.51, P<0.001; r=0.25, P=0.009) . Conclusion:The changes in the levels of AGR, NLR and PLR before and after chemotherapy are correlated with the short-term efficacy of mCRC, and it has certain significance for monitoring the curative effects of patients and further optimizing the treatment plan.
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Objective:To investigate the plasma expression of D-dimer in patients with colorectal cancer and its correlation with clinicopathological characteristics of patients.Methods:The clinical data of 167 patients with colorectal cancer who were admitted to the First Hospital of Shanxi Medical University from January 2014 to March 2019 was retrospectively analyzed, and 54 patients without malignant tumors in the same period were selected as the control group. The expressions of plasma D-dimer and carcinoembryonic antigen (CEA) were detected by using immunoturbidimetry and electrochemiluminescence. Mann-Whitney U test was used to analyze the relationship between D-dimer expression and clinicopathological characteristics of patients. The relationship between D-dimer and CEA expressions was analyzed by Spearman correlation analysis. Results:The level of D-dimer [median ( P25, P75)] in the colorectal cancer group [323.0 ng/ml (150.0 ng/ml, 631.0 ng/ml)] was higher than that in the control group [142.0 ng/ml (89.3 ng/ml, 232.0 ng/ml)], and the difference was statistically significant ( Z=-4.374, P < 0.05). The level of D-dimer in patients with advanced colorectal cancer [401.0 ng/ml (167.5 ng/ml, 735.5 ng/ml)] was higher than that in patients with early stage [169.5 ng/ml (25.0 ng/ml, 325.3 ng/ml)], the difference was statistically significant ( Z = -4.569, P < 0.05); the level of D-dimer in the deterioration stage after treatment [382.0 ng/ml (175.0 ng/ml, 735.3 ng/ml)] was higher than that in the improvement stage after treatment [250.0 ng/ml (163.0 ng/ml, 391.0 ng/ml)], the difference was statistically significant ( Z = -2.731, P < 0.05); the level of D-dimer before operation [220.0 ng/ml (118.0 ng/ml, 446.5 ng/ml)] was lower than that after operation [320.0 ng/ml (184.5, 489.0 ng/ml)], the difference was statistically significant ( Z = -2.182, P < 0.05). There was a positive correlation between CEA and D-dimer expressions in colorectal cancer patients ( r = 0.509, P < 0.01). Conclusions:Elevated plasma D-dimer level may indicate advanced disease and poor prognosis. The plasma D-dimer level can be used as a predictor of therapeutic effect in patients with colorectal cancer.
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Objective@#To observe the efficacy and safety of Brucea javanica oil injection combined with S-1 in the treatment of elderly patients with advanced gastric cancer.@*Methods@#The clinical data of 62 elderly patients with advanced gastric cancer who were admitted to Shanxi Provincial Cancer Hospital from May 2017 to May 2018 were retrospectively analyzed. Thirty-one patients in the control group treated with S-1 alone, and 31 patients in the observation group treated with S-1 combined with Brucea oil emulsion injection. The clinical efficacy, adverse reactions, immune function and quality of life of the two groups were compared.@*Results@#The total effective rates of the observation group and the control group were 70.97% (22/31) and 48.39% (15/31), respectively, and the difference was statistically significant (χ 2 = 11.889, P < 0.01). The incidence rates of gastrointestinal reaction and peripheral neurotoxicity in the observation group were 9.68% (3/31) and 3.23% (1/31), and the rates in the control group were 35.48% (11/31) and 25.81% (8/31), respectively, the differences between the two groups were statistically significant (both P < 0.05); the incidence rates of hepatotoxicity, nephrotoxicity and myelosuppression in the observation group were 3.23% (1/31), 3.23% (1/31), and 3.23% (1/31), and the rates in the control group were 22.58% (7/31), 16.13% (5/31), and 12.90% (4/31), respectively, and the differences between the two groups were not statistically significant (all P > 0.05). The Karnofsky scores of the observation group and the control group after treatment were (92±4) points and (86±3) points, respectively, and the difference was statistically significant (t = -2.075, P = 0.042). The serum levels of interleukin-2 (IL-2) and interferon-γ in the observation group after treatment were (38±4) ng/L and (51±4) ng/L, and the levels in the control group were (31±3) ng/L and (40±4) ng/L, respectively, and the differences were statistically significant (t values were -2.097 and -2.293, both P < 0.05), and the serum levels of IL-4, IL-6 and IL-10 in the observation group after treatment were (42±5) ng/L, (34±4) ng/L and (22±2) ng/L, and the levels in the control group were (59±6) ng/L, (50±5) ng/L and (30±3) ng/L, respectively, and the differences were statistically significant (t values were 2.109, 2.867 and 4.278, all P < 0.05). There was no statistical difference in the serum levels of tumor necrosis factor-α between the observation group and the control group after treatment (t = -0.922, P = 0.360).@*Conclusion@#Compared with monotherapy of S-1, the treatment of Brucea javanica oil emulsion injection combined with S-1 can improve the clinical efficacy, reduce the incidence of adverse reactions, enhance the immune function and effectively improve the quality of life of elderly patients with advanced gastric cancer.
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Objective To investigate the effect of transcatheter arterial chemoembolization (TACE)combined with radiofrequency ablation (RFA) in the treatment of liver cancer,and its influence on the serum markers.Methods 108 patients with primary liver cancer were selected as the subjects of this study.According to the random number table method,the patients were divided into two groups.The control group (54 cases) received TACE treatment,and the observation group (54 cases) received TACE combined with RFA treatment.The treatment effects,the changes of tumor recurrence related indicators and the levels of tumor related indicators were compared and analyzed.Results The effective rate of the observation group was 79.7 ％ (43/54),which was significantly higher than 50.0％ (27/54) of the control group (x2 =10.391,P =0.001).After treatment,the E-calcium protein (EC),vascular endothelial growth factor (VEGF),matrix metalloproteinase (MMP),tumor recurrence index alpha fetoprotein (AFP),CA199,glutamate transferase (GGT) levels in the observation group were (1 738.8 ± 114.8) μg/L,(207.9 ± 37.2) ng/L,(34.9 ± 4.6) ng/L,(72.2 ± 19.5) μg/L,(34.2 ± 5.1) U/L,(88.9 ± 9.4) U/L,respectively,which were significantly lower than those in the control group [(2 382.4 ± 159.4) μg/L,(367.3 ± 49.3) ng/L,(72.1 ± 7.4) ng/L,(135.2 ± 21.8) μg/L,(66.9 ± 8.2) U/L,(124.6 ± 12.5) U/L],the differences were statistically significant(t =24.076,18.967,31.373,15.828,24.884,16.774,all P ＜0.05).Conclusion TACE combined with RFA is effective in the treatment of liver cancer,which can effectively kill tumor cells and reduce the contents of serum tumor markers,and it is worthy of popularizing in clinic.
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Objective To observe the effect of Jiangzhi Yigan Chongji (JYC) on the nonalcoholic fatty liver tissue PPAR? and Trx mRNA expression,and explore the mechanism of treating fatty liver. Methods The model was made by feeding high-fat diet and the rats were divide into 3 groups:normal group,model group and treated group. Result Expression of liver tissue PPAR? and Trx mRNA in the model group were both decreased. JYC can increase their expression of liver tissue of model rats. Conclusion It is likely to be one of the important mechanisms for JYC in treating nonalcoholic fatty liver.