ABSTRACT
Circulating tumor cells (CTCs)are cancerous cells that shed from the primary tumor or metastases into the bloodstream. The currently clinical applicability of CTCs approved by the US Food and Drug Administration (FDA)is that CTCs can be prognostic biomarker for patients with metastatic breast cancer, prostate cancer and colorectal cancer. CTCs also have great potential in the prognosis assessment of other meta-static or localized tumors,as well as early screening of tumors,analysis of molecular profiling,guiding treat-ment decisions,and monitoring of treatment response. Currently,various studies are being carried out to further explore the clinical application of CTCs,and provide new strategies and new prospects for individualized and precise treatment of cancer patients.
ABSTRACT
Platelets play important roles in tumor progression.Increased platelets count is associated with poor overall survival and prognosis.Tumor cell-induced platelet activation and platelet-induced tumor growth form a malignant amplification loop which plays a crucial role in tumor cell proliferation,metastasis and angiogenesis.Antiplatelet therapy may break the platelet-tumor amplification loop and play a key role in reducing tumor metastasis.
ABSTRACT
Objective To investigate the prognosis factors of patients with non-functional pancreatic neuroendocrine carcinoma (NF-PanNEC).Methods The patients with NF-PanNEC confirmed by pathology from 2004 to 2015 were collected from the Surveillance,Epidemiology,and End Results (SEER) database of the American National Cancer Institute.The MatchIt package in the R software was used to perform propensitymatching analysis of surgery,radiotherapy and chemotherapy.The Kaplan-Meier method was used to calculate the cumulative survival rate,and the significant difference was evaluated by the log-rank test.Then the Cox multivariate regression analysis was applied to evaluate the prognostic factors of NF-PanNEC patients.Results A total of 2 603 NF-PanNEC patients were included in the analysis.Univariate analysis showed that the age of diagnosis (x2 =123.8,P ＜ 0.001),gender (x2 =7.3,P =0.007),marital status (x2 =26.7,P ＜ 0.001),primary site of tumor (x2 =47.8,P ＜ 0.001),degree of tumor differentiation (x2 =628.7,P ＜ 0.001),American Joint Committee on Cancer (AJCC) stage (x2 =811.7,P ＜0.001),T stage (x2 =425.9,P ＜ 0.001),N stage (x2 =272.3,P ＜ 0.001),M stage (x2 =779.8,P ＜ 0.001),surgery (x2 =962.6,P ＜ 0.001),chemotherapy (x2 =21.9,P ＜ 0.001) were associated with the prognosis of NF-PanNEC patients.No correlation was observed between radiotherapy and the prognosis of NF-PanNEC patients (x2 =0.1,P =0.750).Multivariate Cox regression analysis showed that older diagnostic age (≥74 years old vs.≤56 years old,HR =2.20,95 ％ CI:1.84-2.62,P ＜ 0.001),male (male vs.female,HR =1.14,95 ％ CI为1.01 ～1.29,P =0.035),single or divorced or widowed (single or divorced vs.married,HR =1.26,95 ％ CI:1.10-1.45,P =0.001;widowed vs.married,HR =1.29,95％ CI:1.04-1.61,P =0.022),head of pancreas (tail of pancreas vs.head of pancreas,HR =0.85,95％ CI:0.73-0.99,P =0.033),poor differentiation (grade Ⅳvs.grade Ⅰ,HR=3.75,95％CI:2.70-5.20,P＜0.001),late AJCC stage (stage Ⅳ vs.stage Ⅰ,HR =5.72,95％ CI:4.23-7.73,P ＜ 0.001),no surgery treatment (yes vs.no,HR =0.37,95％ CI:0.30-0.44,P ＜ 0.001) were significant prognostic risk factors for NF-PanNEC patients,and chemotherapy was not independent prognostic factor (yes vs.no,HR=1.00,95％CI:0.88-1.13,P=0.958).Conclusion The older diagnostic age,single or divorced or windowed,head of pancreas,poor differentiation,late AJCC stage and no surgery treatment are significant prognostic risk factors for NF-PanNEC patients.Radiotherapy and chemotherapy may not improve the prognosis of NF-PanNEC patients.