Advances and Reflections on Neoadjuvant Therapy for Locally Advanced Thyroid Cancer / 肿瘤防治研究

The vast majority of thyroid cancers show a good prognosis. However, the treatment of locally advanced thyroid cancer presents a huge problem. The wide application of targeted and immunotherapy in neoadjuvant therapy for locally advanced thyroid cancer has become a new therapeutic direction. This article summarizes the research on neoadjuvant chemotherapy, radiotherapy, and targeted therapy and immunotherapy related to various pathological types of thyroid cancer, with a focus on the recent advancements and thoughts on the application of targeted and immunotherapeutic drugs in neoadjuvant therapy. The results provide additional options for the clinical treatment of locally advanced thyroid cancer.

Effects of Fuzheng Quxie Prescription Combined with Neoadjuvant Chemotherapy on Tumor Recurrence,Serum Thymidine Kinase 1 Level and Immune Function in Patients with Triple-Negative Breast Cancer / 广州中医药大学学报

Objective To investigate the effects of Fuzheng Quxie Prescription(mainly with the actions of supporting healthy qi and dispelling pathogens)combined with neoadjuvant chemotherapy on tumor recurrence,serum thymidine kinase 1(TK1)level and immune function in patients with triple-negative breast cancer(TNBC).Methods Eighty patients with TNBC of qi and yin deficiency type were randomly divided into a combination group and a control group,with 40 patients in each group.The control group was treated with AC-T sequential chemotherapy(Doxorubicin combined with Cyclophosphamide plus sequential Docetaxel),and the combination group was treated with Fuzheng Quxie Prescription on the basis of treatment for the control group.One course of treatment covered 21 days,and the two groups were treated for 4 consecutive courses.The changes of traditional Chinese medicine(TCM)syndrome scores,Karnofsky Performance Status(KPS)score,levels of tumor markers of carbohydrate antigen 125(CA125),carbohydrate antigen 153(CA153)and TK1,and T lymphocyte subset levels in the two groups were observed before and after the treatment.Moreover,the clinical efficacy and tumor metastasis and recurrence in the two groups were compared.Results(1)After 4 courses of treatment,the total effective rate of the combination group was 87.50%(35/40),and that of the control group was 67.50%(27/40),and the intergroup comparison(tested by chi-square test)showed that the efficacy of the combination group was significantly superior to that of the control group(P＜0.05).(2)After treatment,the TCM syndrome scores in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the KPS scores were significantly increased compared with those before treatment(P＜0.05),and the decrease of TCM syndrome scores and the increase of KPS scores in the combination group were significantly superior to that in the control group(P＜0.05 or P＜0.01).(3)After treatment,the serum CA125,CA153 and TK1 levels of patients in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease of serum CA125,CA153 and TK1 levels in the combination group was significantly superior to that in the control group(P＜0.01).(4)After treatment,the T lymphocyte subset CD3+,CD4+ levels and CD4+/CD8+ ratio in the two groups were significantly increased compared with those before treatment(P＜0.05),and the CD8+ level was significantly decreased compared with that before treatment(P＜0.05).The post-treatment intergroup comparison showed that the increase of the T lymphocyte subset CD3+,CD4+ levels and CD4+/CD8+ ratio as well as the decrease of the CD8+ level in the combination group was all significantly superior to that in the control group(P＜0.05 or P＜0.01).(5)The one-year follow-up showed that the tumor recurrence rate and tumor metastasis rate in the combination group were 7.50%(3/40)and 12.50%(5/40)respectively,significantly lower than 25.00%(10/40)and 35.00%(14/40)in the control group,and the differences were statistically significant when comparing between the two groups(P＜0.05).Conclusion The combination of neoadjuvant chemotherapy with Fuzheng Quxie Prescription has a better therapeutic effect on TNBC patients with qi and yin deficiency syndrome,which can effectively improve the immune function of the patients,decrease the level of serum tumor markers,improve the quality of life of the patients,and reduce the incidence of tumor recurrence and metastasis.

Strategic planning for paying attention to anal preservation in low rectal cancer / 解放军医学杂志

Based on the background of a multidisciplinary treatment team and the increasing high-quality life aspirations of patients,the preservation of anal function for patients with low rectal cancer has undergone changes in recent years.With the optimization of neoadjuvant therapy,refinement of surgical techniques,and the deepening of the concept of anal preservation after surgery,the concept of anal preservation for low rectal cancer has gradually shifted from traditional simple surgery to comprehensive treatment,and anal preservation surgery tends to be more accurate preservation.The goal of comprehensive treatment is to preserve good anal function and reduce surgical damage.However,comprehensive treatment for anal preservation in low rectal cancer is still in its infancy,and there is no consensus on the strategy planning for anal preservation.Therefore,summarizing various preoperative,intraoperative,and postoperative treatment strategies for low rectal cancer is of great significance for the selection of anal preservation schemes for patients with low rectal cancer.This article focus on exploring the optimization of neoadjuvant therapy models,"watch and wait"plans,the development of anal preservation techniques,and postoperative and preservation strategies,aiming to review the current status of anal preservation strategy planning for low rectal cancer.

Total neoadjuvant therapy for locally advanced rectal cancer / 解放军医学杂志

Diagnosis and treatment of locally advanced rectal cancer(LARC)must be completed by a collaborative model of a multi-disciplinary team.The neoadjuvant chemoradiotherapy significantly reduced the local recurrence rate of LARC,but did not affect the occurrence of distant metastases and overall survival.Total neoadjuvant therapy(TNT),by strengthening the intensity of chemotherapy and extending the time from radiotherapy to surgery,can improve the tumor response rate as well as disease-free survival rate and metastasis-free survival rate.It offers advantages such as enhancing the compliance with chemotherapy,maximizing tumor regression,improving survival and increasing the chance of organ preservation.TNT is a promising treatment model for LARC patients with high risk of distant metastasis or strong desire for organ preservation.With the application of immunotherapy in the field of TNT,the mode of TNT continues to expand.And the exploration of therapeutic predictive markers will help to provide a personalized treatment for patients.

Efficacy of XELOX regimen neoadjuvant chemotherapy in the treatment of stage Ⅱ(T4)and Ⅲ colon cancer / 临床外科杂志

Objective To evaluate the efficacy of XELOX regimen as neoadjuvant chemotherapy in the treatment of stage Ⅱ and Ⅲ colon cancer.Methods The clinical data of 50 patients with clinical stage Ⅱ(T4)Ⅲ colon cancer who underwent laparoscopic radical resection at general surgery department of our hospital from January 1,2012 to January 1,2021 were retrospectively analyzed.Patients were divided into neoadjuvant chemotherapy group(NACT)and adjuvant chemotherapy group(ACT)according to whether they received neoadjuvant chemotherapy with XELOX regimen.The general clinical data,adverse reactions of chemotherapy,surgical complications,operation time,intraoperative blood loss,hospitalization time,hospitalization cost,negative conversion rate of tumor markers,tumor remission rate,tumor downstaging rate,tumor response grade after chemotherapy,postoperative disease-free survival curve,and overall survival curve were retrospectively analyzed and compared among the groups.Results There were no significant differences in operative complications,postoperative exhaust time and hospital stay between NACT group and ACT group(P＞0.05).The adverse reactions of chemotherapy,the negative conversion rate of postoperative CEA and CA19-9,the duration of operation,the amount of bleeding,and the hospitalization cost in NACT group were significantly better than those in ACT group(P＜0.05).In terms of DFS and OS survival curves,with the extension of time,the decline of the NACT survival curve was smaller than that of the ACT group,and there was a significant difference in DFS survival curve(P＜0.05),but no significant difference in OS survival curve(P＞0.05).Conclusion XELOX neoadjuvant chemotherapy is safe and effective in the treatment of stage Ⅱ(T4)and stage Ⅲcolon cancer.

Evaluation of early efficacy of neoadjuvant chemotherapy in patient with breast cancer based on dynamic contrast-enhanced MRI via comparing with 18F-FDG PET/CT / 实用放射学杂志

Objective To investigate the predictive value of early efficacy of neoadjuvant chemotherapy(NAC)in patient with breast cancer via full quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI).Methods Forty patients with breast cancer were selected.The 18 fluorodeoxyglucose positron emission tomography/computed tomography(18F-FDG PET/CT)and DCE-MRI were performed before and after two cycles of NAC.According to the decrease rate of maximum standardized uptake value(ΔSUVmax)of PET/CT before and after two cycles of NAC,all patients were divided into two groups,including good response group(24 cases)(ΔSUVmax>40%)and general response group(16 cases)(ΔSUVmax≤40%).The changes of full quantitative parameters of DCE-MRI between the two groups were observed and analyzed.Results There were statistically significant differences in changes of Ktrans and Kep between the two groups(P<0.05),however,there was no significant difference in the change of Ve between the two groups(P>0.05).There was a significant positive correlation between ΔKtrans and ΔSUVmax(r=0.850,P<0.001).There was a high positive correlation between ΔKtrans and ΔKep(r=0.727,P<0.001).Conclusion The full quantitative parameters of DCE-MRI are helpful to evaluate the early efficacy of NAC in breast cancer,which can reflect the changes of microcirculation in the lesion,further reflect the therapeutic effect of NAC,guide the clinical optimization of treatment plan in time,and achieve accurate evaluation and individualized treatment.

Thevalue of naples scores in predicting prognosis in breast cancer patients / 现代医院

Breast cancer is one of the most common cancers in women,but there is currently a lack of accurate prognos-tic assessment systems.The Naples Prognostic Score(NPS)is a prognostic prediction system that incorporates inflammatory and nutritional indicators.It has been proven to have important clinical utility in predicting the prognosis of patients with malignancies such as colon cancer,gallbladder cancer,endometrial cancer,and lung cancer.In recent years,research has found that NPS may be superior to TNMstaging in predicting the prognosis of breast cancer patients.It is an independent predictor of overall sur-vival(OS)and progression-free survival(PFS)in breast cancer patients.This suggests that NPS has great potential for applica-tion in predicting the prognosis of breast cancer.

A new pattern of comprehensive treatment for hepatocellular carcinoma / 中华消化外科杂志

Surgical treatment is the primary curative approach for hepatocellular carcinoma (HCC). In China, the proportion of advanced HCC is high, with a low rate of surgical removal at initial diagnosis and a high rate of postoperative recurrence, posing a serious threat to public health. With the advent of new therapeutic drugs and updated treatment concepts, the comprehensive treatment of HCC has entered a new era. Systemic treatments represented by targeted therapy and immuno-therapy, non-surgical local treatments such as interventional and radiotherapy, and the combination of systemic and local treatments, have significantly improved the treatment efficacy, bringing hope to patients. The authors review past studies, summarize diagnostic and treatment experience, and discuss the comprehensive treatment strategy for HCC in the era of targeted and immunotherapy, with surgery as the main approach.

Influencing factors and establishment of a prediction model for the tumor regression after neoadjuvant chemoradiotherapy in locally advanced rectal cancer / 中国癌症杂志

Background and purpose:The standard therapy for locally advanced rectal cancer(LARC)is neoadjuvant chemoradiotherapy(nCRT)followed by surgery.NCRT can make the tumor regress and downstage,and increase the R0 resection rate.However,individual differences in rectal cancer are large,and some patients respond poorly to nCRT and cannot benefit from nCRT.Therefore,it is necessary to establish effective screening measures to identify patients with poor response to nCRT.This study aimed to analyze the influencing factors of nCRT for LARC and construct the tumor regression prediction model.Methods:Data of 158 LARC patients who underwent total mesenteric resection after receiving nCRT at the First Hospital Affiliated to Air Force Medical University from January 2016 to December 2020 were collected.Baseline clinical indicators before nCRT were collected,including laboratory examination,tumor markers and magnetic resonance imaging(MRI).According to the tumor size reported by MRI before and after nCRT,Response Evaluation Criteria in Solid Tumors(RECIST)was used to evaluate the extent of tumor regression after nCRT.After receiver operating characteristic(ROC)curve was used to standardize the clinical baseline indicators,logistic regression analysis was carried out to screen the factors affecting the tumor regression.The tumor regression prediction model was constructed by logistic regression,and the performance of the model was evaluated based on decision curve analysis(DCA)and the calibration curve.The accuracy of the model was tested by 10-fold cross-validation.Results:This retrospective cohort study enrolled 158 patients,in which,98 patients achieved complete response(CR)or partial response(PR).The objective response rate was 62%.Sixty patients had poor response to nCRT,either stable disease(SD)or progressive disease(PD).Multivariate logistic regression analysis showed that tumor diameter before treatment(P＜0.001),time to surgery after nCRT(P = 0.006),D-dimer(P = 0.010),prognostic nutrition index(PNI)(P = 0.035),carcinoembryonic antigen(CEA)(P = 0.004)and extramural vascular invasion(EMVI)(P = 0.026)were significantly related to tumor regression after nCRT.The area under ROC curve(AUC)of tumor regression after nCRT prediction model for LARC was 0.84(95%CI:0.780-0.899),sensitivity was 85.0%,and specificity was 72.4%.In the calibration curve,the predicted results were in good agreement with the actual results,and the prediction accuracy was good.The DCA showed that the tumor regression prediction model could bring clinical net benefit to diagnosis.Conclusion:Tumor diameter before treatment,time to surgery after nCRT,D-dimer,PNI,CEA and EMVI are independent risk factors for the tumor regression after nCRT in LARC patients.The tumor regression prediction model based on the above factors has good predictive efficacy for the tumor regression after nCRT in LARC patients.

Application and challenge of immunotherapy in perioperative therapy of gastric cancer / 中国癌症杂志

Gastric cancer is one of the common malignant tumors of digestive system in our country.The proportion of patients in advanced and late stage is large,and the choice of perioperative treatment program is always difficult in clinic.For most locally advanced gastric cancer,compared with standard radical surgery combined with postoperative adjuvant chemotherapy,perioperative treatment mode may further improve the survival of patients.However,the efficacy of conventional chemotherapy regimen has reached a plateau,while the progress of traditional molecular targeted therapy is relatively slow.In recent years,with the increasing role of immunotherapy in the treatment of advanced gastric cancer,more and more clinical studies have shown that immunotherapy can also achieve better efficacy in perioperative gastric cancer patients.This article reviewed the research progress of immunotherapy in perioperative gastric cancer in recent years.

Recent progress and hotspots in colorectal surgery / 中华普通外科杂志

With the rapid development of science and technology, new technologies and methods for the diagnosis and treatment of colorectal cancer are constantly emerging, which has improved the survival of patients with colorectal cancer. At the same time, the progress in surgical technology is also changing profoundly due to information technology revolution. From open surgery to minimally invasive surgery, to robot-assisted surgery, AI technology, three-dimensional stereotactic technology, as well as the emergence of enhanced reality and digital diagnosis technology, all have greatly promoted the surgical treatment of colorectal cancer. Colorectal surgery has also become more precise, personalized, and more focused on reducing surgical trauma, protecting organ function, and improving patients' quality of life. This article aims to review the new progress and research hotspots in the surgical treatment of colorectal cancer in recent years from several aspects including organ preservation strategy, adjuvant/neoadjuvant treatment, minimally invasive surgery, difficult colorectal surgery, as well as liquid biopsy technology.

Progress of pancreatic surgical treatment in 2023 / 中华普通外科杂志

Pancreatic surgery is one of the most challenging specialties in general surgery. Due to the variety of pancreatic diseases, the difficulty of surgery, and the differences in diagnosis and treatment among different diseases, treatment strategies for these diseases remain controversial. From the aspects of surgical treatment such as pancreatitis, pancreatic cystic neoplasms, pancreatic neuroendocrine neoplasms, and pancreatic cancer, as well as neoadjuvant therapy, adjuvant therapy, immunotherapy, and targeted therapy. We review and summarize the frontier progress of clinical and translational research in pancreatic surgery in 2023, in order to further standardize the diagnosis and treatment of pancreatic surgery.

Progress of lysine-specific demethylase 1 and its inhibitors in triple-negative breast cancer / 肿瘤研究与临床

Lysine-specific demethylase 1 (LSD1) is the firstly discovered histone demethylase. In recent years, LSD1 has become a hot topic in the study of the development and progression of malignancies, and its expression is closely related to the poor prognosis of malignancies. At present, some studies have showed that LSD1 is strongly related to the proliferation, invasion and metastasis of triple-negative breast cancer (TNBC). However, the specific mechanism is not fully understood. This article summarizes the possible mechanism of the development and progression in LSD1 and TNBC, and reviews the latest progress of LSD1 in the clinical research application of TNBC, so as to provide a reference for drug combination therapy in TNBC patients.

Progress of immune checkpoint inhibitors in neoadjuvant therapy for esophageal cancer / 中国胸心血管外科临床杂志

@#Neoadjuvant chemoradiotherapy or chemotherapy combined with surgery for locally advanced esophageal cancer has become the standard treatment, and despite the survival benefit, most patients still experience postoperative recurrence and distant metastasis. Immune checkpoint inhibitors play an anti-tumor role by activating T cells, and immunotherapy has become one of the important strategies for first-line and second-line treatment of advanced esophageal cancer with the continuous evolution of immunotherapy models. Regarding neoadjuvant immunotherapy for esophageal cancer, a large number of studies are being carried out and explored, which are expected to inject new vitality into neoadjuvant therapy for esophageal cancer. This article reviews the current clinical studies on neoadjuvant immunotherapy for esophageal cancer.

Comparison of the efficacy of neoadjuvant chemotherapy versus neoadjuvant chemoradiotherapy in locally advanced mid-low rectal cancer / 西安交通大学学报(医学版)

【Objective】 To investigate the differences in efficacy and long-term prognosis between locally progressive low and intermediate rectal cancer patients receiving fluorouracil-based neoadjuvant chemotherapy alone (mFOLFOX6/CapeOX) and neoadjuvant radiotherapy, and to compare the therapeutic efficacy in the two groups. 【Methods】 We retrospectively analyzed the clinicopathological data of 118 patients with locally progressive low and intermediate rectal cancer who received neoadjuvant therapy from January 2019 to December 2021 at The First Affiliated Hospital of Xi’an Jiaotong University, including gender, age, body mass index (BMI), and other clinicopathological parameters. The t-test, Mann Whitney test, chi-square test or Fisher’s exact test were used to compare the differences between the two groups of patients who received neoadjuvant chemotherapy alone or neoadjuvant radiochemotherapy in terms of short-term efficacy, lymph node manifestations and long-term prognosis, respectively. Survival rates were calculated and survival curves were plotted using the Kaplan-Meier method. 【Results】 In terms of efficacy, patients in the neoadjuvant radiotherapy group achieved better tumor regression (Z=-2.05, P=0.04) and solid tumor efficacy (Z=-2.42, P=0.015), but the difference between the two groups in terms of downstaging effect of clinical stage was not statistically significant. The number of lymph nodes detected was significantly lower in the neoadjuvant radiotherapy group (neoadjuvant chemotherapy vs. neoadjuvant radiochemotherapy, 13.19±3.83 vs. 9.55±4.00, t=5.02, P<0.001), but the two groups did not differ significantly in the number of lymph node positives and lymph node positive ratio. In terms of long-term prognosis, there was no statistically significant difference in the overall survival rate or disease-free survival rate of the two groups. 【Conclusion】 Compared with neoadjuvant chemotherapy alone, neoadjuvant radiotherapy showed better short-term efficacy in patients with locally progressive low and intermediate rectal cancer, but there was no statistically significant difference between the two treatment regimens in terms of long-term prognosis.

Diagnosis and treatment pathway of neoadjuvant immunotherapy for esophageal cancer in Henan province / 中国胸心血管外科临床杂志

@#Esophageal cancer is a highly prevalent tumor species in Henan province, which brings heavy medical burden to families and society. Surgical treatment plays a dominant role in the treatment of non-advanced esophageal cancer. However, cancer cells in esophageal cancer lesions are highly invasive, postoperative recurrence and metastasis rates are pretty high. More effective systemic and comprehensive treatment is urgently needed to improve the prognosis. We invited 52 doctors in esophageal surgery, oncology, pathology, imaging, and radiation therapy of 32 hospitals at all levels in Henan province, to repeatedly negotiate and fully discuss in combination with evidence and clinical practice experience. Finally, “diagnosis and treatment pathway of neoadjuvant immunotherapy for esophageal cancer in Henan province” was formulated. In this treatment pathway, seven recommendations were proposed from seven perspectives including target population, patient evaluation, protocol selection, surgical timing, postoperative management, organ preservation, and general principles to offer reference for medical personnel related to esophageal cancer surgery.

The value of NLR in predicting the efficacy of preoperative nimotuzumab combined with neoadjuvant chemotherapy for local advanced oral squamous cell carcinoma / 口腔疾病防治

Objective@#To investigate the value of the peripheral blood neutrophil to lymphocyte ratio (NLR) before nimotuzumab combined with neoadjuvant chemotherapy in predicting the short-term efficacy of neoadjuvant therapy for advanced oral squamous cell carcinoma (OSCC).@*Methods@#With the approval of the Ethics Committee and the informed consent of the patients, 59 patients with stage Ⅲ and Ⅳ OSCC who were admitted to the Oral and Maxillofacial Surgery Department of the First Hospital of Shanxi Medical University from September 2020 to June 2023 were enrolled. All the patients had complete clinical data, were pathologically diagnosed with squamous cell carcinoma, and received preoperative and received preoperative nimotuzumab + TP (docetaxel + cisplatin) neoadjuvant chemotherapy. The clinical data were analyzed, and the neutrophil and lymphocyte counts in peripheral blood were collected before and after nimotuzumab combined with neoadjuvant chemotherapy. The NLR was calculated, and the threshold value was calculated using the receiver operating characteristic (ROC) curve. Patients were divided into a high NLR group and a low NLR group according to the NLR threshold before nimotuzumab combined with neoadjuvant chemotherapy with TP. The clinical efficacy after nimotuzumab combined with neoadjuvant chemotherapy with TP was evaluated according to the evaluation criteria for solid tumor efficacy, and the correlation between the NLR and recent neoadjuvant therapy efficacy was analyzed. Immunohistochemical staining was used to detect the expression of epidermal growth factor receptor (EGFR) in OSCC tissues before and after nimotuzumab combined with neoadjuvant chemotherapy with TP and to analyze whether the expression of EGFR differed among the different NLR groups.@*Results@#A total of 59 patients with advanced OSCC were included. According to the ROC curve, the NLR threshold was 2.377, and the patients were divided into a <2.377 group (low NLR group), with 24 patients, and a>2.377 group (high NLR group), with 35 patients. The short-term neoadjuvant therapy effect was significantly greater in the lower NLR group than in the higher NLR group (P<0.05); EGFR expression in both the low NLR group and the high NLR group decreased after nimotuzumab combined with neoadjuvant chemotherapy with TP, and the decrease in the low NLR group was significantly greater than that in the high NLR group (P<0.05).@*Conclusion@#A low NLR before nimotuzumab combined with neoadjuvant chemotherapy with TP is associated with better neoadjuvant therapy outcomes, and such patients are more likely to benefit from preoperative nimotuzumab combined with neoadjuvant chemotherapy.

Strategy and Status of Neoadjuvant Therapy for HER2-positive Breast Cancer / 肿瘤防治研究

Neoadjuvant therapy is a preoperative systemic treatment for patients with breast cancer. This therapy has greatly improved the clinical outcomes of human epidermal growth factor receptor 2 (HER2)-positive breast cancer, which is associated with poor prognosis. Currently, dual anti-HER2 antibodies, including trastuzumab and pertuzumab, combined with non-anthracycline chemotherapy is one of the standard regimens to achieve high pathologic complete response rate and satisfactory efficacy. The combination of trastuzumab with tyrosine kinase inhibitors, antibody-drug conjugate drugs, or immunotherapy combined with target therapy, under the indications of reasonable biomarkers, is effective for HER2-positive breast cancer. In this article, we briefly reviewed neoadjuvant therapy in the dual-targeting therapy era and discussed its future perspectives.

Imaging research progress on complete pathological remission after neoadjuvant therapy for rectal cancer / 中国医师杂志

Rectal cancer is a common malignant tumor in China, with a high mortality rate ranking fifth. Neoadjuvant therapy for rectal cancer can improve patient prognosis and even achieve pathological complete remission (pCR) in some patients, thereby avoiding complications and functional damage caused by radical surgery. Therefore, how to accurately evaluate pCR before surgery is currently a research hotspot. In recent years, new imaging technologies such as endorectal ultrasound, magnetic resonance imaging (MRI), and positron emission computed tomography (PET-CT) have developed rapidly, and imaging evaluation of pCR after neoadjuvant therapy for rectal cancer has achieved good results. This article provides a review of this field, aiming to provide a basis for personalized treatment of rectal cancer patients.

Study on the relationship between CHFR and MACC1 expressions and sensitivity of patients with rectal cancer for neoadjuvant concurrent chemoradiotherapy / 中国医学装备

Objective:To investigate the relationship between the expressions of checkpoint with forkhead-associated and ring finger(CHFR)and metastasis-associated protein 1(MACC1)and the sensitivity of patients with rectal cancer for neoadjuvant concurrent chemoradiotherapy(nCRT).Methods:The medical documents of 166 patients with rectal cancer admitted to First Hospital of Qinhuangdao from March 2017 to February 2022 were collected.All patients only received nCRT before surgery,and the radiotherapy adopted three-dimensional conformal intensity modulated radiotherapy,and chemotherapy adopted Capeox scheme.All patients successfully completed total mesorectal excision after 4-6 weeks of nCRT treatment.Immunohistochemical SP staining method was used to detect the protein expressions of CHFR and MACC1 in rectal cancer and its adjacent tissues.According to the tumor regressive grading(TRG)standard of the Joint Committee on Cancer Staging in the United States,75 patients who were grade 0-2 as TRG after nCRT were included in the nCRT insensitive group,and 91 patients who were grade 3-4 as TRG were included in the nCRT sensitive group.The expression levels of CHFR and MACC1 proteins in cancer tissues before and after treatment between the two groups were compared.And then,the relationship between clinically pathological characteristics of patients and nCRT sensitivity was analyzed,and the influencing factors of nCRT sensitivity were analyzed.The receiver operating characteristic(ROC)curves of them were drawn,and area under curve(AUC)values were calculated,and the predictive values of CHFR and MACC1 for the sensitivity of patients with rectal cancer to nCRT were further analyzed.Results:The CHFR positive expression rate in rectal cancer tissue was significantly lower than that in adjacent tissues of rectal cancer,and the MACC1 positive expression rate in rectal cancer tissue was significantly higher than that in adjacent tissues of rectal cancer(x2=81.373,87.150,P＜0.05),respectively.After 166 patients completed the nCRT treatment,there were 6 cases of TRG grade 0,8 cases of TRG grade 1,61 cases of TRG grade 2,59 cases of TRG grade 3 and 32 cases of TRG grade 4.The sensitivity rate of nCRT was 54.82%(91/166).The CHFR positive expression rate in the nCRT sensitive group was significantly higher than that in the nCRT insensitive group,and the MACC1 positive expression rate in the nCRT sensitive group was significantly lower than that in the nCRT insensitive group(x2=4.613,37.509,P＜0.05).The proportions of T4 stage and N+stage in the nCRT sensitive group were higher than those in the nCRT insensitive group,and the differences were statistically significant(x2=54.432,28.912,P＜0.05),respectively.The expressions of CHFR and MACC1 were respectively independent risk factor affected the sensitivity of patients with rectal cancer to nCRT[OR=2.456(95% CI:1.294-4.563),OR=3.281(95% CI:1.472-6.479),P＜0.05].The sensitivity and specificity of the combined detection of CHFR and MACC1 were respectively 65.89% and 69.46% in predicting the nCRT sensitivity for rectal cancer.The predictive value of the combined detection was higher than that of single CHFR detection and single MACC1 detection(AUC values of them were respectively 0.713,0.564,0.589,P＜0.05),respectively.Conclusion:CHFR and MACC1 are related to the sensitivity of patients with rectal cancer to nCRT,which means patients with high expression of CHFR and low expression of MACC1 are more sensitive to nCRT.Therefore,both of them may be indicators that predict the sensitivity of patients with rectal cancer to nCRT.