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Objective:To investigate the value of nomograms based on clinical parameters, apparent diffusion coefficient (ADC) and MRI-derived radiomics in predicting survival of patients with locally advanced cervical cancer (LACC) after concurrent chemoradiotherapy (CCRT).Methods:Clinical data of 423 patients with IB-IVA cervical cancer treated with CCRT at Anhui Provincial Hospital Affiliated to Anhui Medical University from March 2014 to March 2020 were retrospectively analyzed and randomly divided into the training and validation groups at a ratio of 2∶1 using the simple randomization method. The values of ADC min, ADC mean, ADC max and 3D texture parameters of diffusion weighted imaging (DWI), T 2WI, T 2WI-fat suppression of pre-treatment primary lesions in all patients were measured. The least absolute shrinkage and selection operator (LASSO) algorithm and logistic regression analysis were used to screen the texture features and calculate radiomics score (Rad-score). Cox regression analysis was employed to construct nomogram models for predicting overall survival (OS) and cancer-specific survival (CS) of patients with LACC after CCRT, which were subject to internal and external validation. Results:Squamous cell carcinoma antigen (SCC-Ag), external beam radiotherapy dose, ADCmin and Rad-score were the independent prognostic factors for OS and CS of LACC patients after CCRT and constituted predictive models for OS and CS. The area under the receiver operating characteristic (ROC) curve (AUC) of two models in predicting 1-year, 3-year, 5-year OS and CS was 0.906, 0.917, 0.916 and 0.911, 0.918, 0.920, with internally validated consistency indexes (C-indexes) of 0.897 and 0.900. Then, models were brought into the validation group for external validation with AUC of 0.986, 0.942, 0.932 and 0.986, 0.933, 0.926 in predicting 1-year, 3-year, 5-year OS and CS.Conclusion:The nomograms based on clinical parameters, ADC values and MRI-derived radiomics are of high clinical value in predicting OS and CS of patients with LACC after CCRT, which can be used as prognostic markers for patients with cervical cancer to certain extent.
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The research is aimed to investigate the effect of genistein (GEN) on the apoptosis in lipopolysaccharide (LPS)-activated RAW264.7 cells and explore the pharmacological mechanism of GEN anti-atherosclerosis (AS). RAW264.7 cells were activated by LPS, the level of TNF-α and IL-6 mRNA were detected by qRT-PCR, the expression of COX-2 and iNOS were detected by Western blot. RAW264.7 cells were pretreated with GEN for 2 h, and then incubated with LPS for 24 h. After that, CCK8 kit was used for the cell viability, Annexin V-FITC/PI kit for the apoptosis of cell. qRT-PCR was used to detect the level of CHOP, caspase-3 and miR-21. Western blot was used to detect the expression of CHOP and caspase-3. Results showed that LPS (1 000 ng·mL-1) increased the expression of TNF-α, IL-6, COX-2 and iNOS in RAW264.7 cells compared with that in control group. GEN inhibited the cell activity and the level of miR-21, promoted the expression of CHOP and caspase-3 in LPS-activated RAW264.7 cells in a dose-dependent manner. miR-21 up inhibited the expression of CHOP and caspase-3 in LPS-activated RAW264.7 cells and this process was reversed by GEN treatment. miR-21 down promoted the expression of CHOP and caspase-3, which were further enhanced by GEN. These results indicate that GEN promotes the apoptosis of RAW264.7 cells activated by LPS through down regulating miR-21 and activating endoplasmic reticulum (ER) stress pathway.