Effect of multidisciplinary treatment (MDT) on survival outcomes of lung cancer patients: Experiences from China.

AIM: To evaluate the effect of multidisciplinary treatment (MDT) on the survival outcomes of Chinese lung cancer patients. METHODS: Data from a Chinese tertiary cancer hospital of lung cancer patients were collected and divided into two groups (MDT+/-) according to whether the patients had received an MDT. The survival analysis was performed after propensity score matching (PSM). RESULTS: Before PSM, more patients in the MDT+ group had documented information on clinical characteristics and showed more unfavorable clinical characteristics than patients in the MDT- group. After PSM, there was no imbalance in the first-line treatment strategies between the two groups. When the patients were analyzed separately, for patients in the MDT- group, age at diagnosis, Eastern Cooperative Oncology Group (ECOG) score, stage, smoking history, and epidermal growth factor receptor (EGFR) gene status were all significant factors for survival (p < 0.05). For patients in the MDT+ group, only age at diagnosis, stage, and comorbidities were significant factors for survival (p < 0.05). Moreover, age at diagnosis, ECOG score, stage, EGFR gene status, and MDT were all significant factors for survival for all patients (p < 0.001). The results indicate that MDT was a significant prognostic factor independent of clinical characteristics (HR: 2.095, 95% CI: 1.568-2.800, p < 0.001), with a significantly improved median survival (58.0 vs. 29.0 months, p < 0.001). CONCLUSION: Based on PSM, MDT itself did have a real favorable prognostic significance for Chinese lung cancer patients in the study.

Clinical characteristics and prognosis of primary Waldeyer's ring and lymph node diffuse large B-cell lymphoma in the rituximab era.

This study was to compare the clinical characteristics and prognosis of Waldeyer's ring diffuse large B-cell lymphoma (WR-DLBCL) and lymph node DLBCL (LN-DLBCL) in the rituximab era. Before propensity score-matched (PSM), WR-DLBCL group shows more favorable clinical characteristics than LN-DLBCL group. After PSM, there was no significant difference in the response rate and survivals between them. The 5-year PFS and OS rates were 65.0% and 78.6% for WR-DLBCL group, respectively, and 53.7% and 66.1% for LN-DLBCL group, respectively. In WR-DLBCL group, ECOG score, Ann Arbor stage, B symptoms and IPI were associated with poor PFS and OS. In LN-DLBCL group, ECOG score, Ann Arbor stage, LDH, and IPI were significant factors to PFS and OS. Multivariate analysis showed that Ann Arbor stage was the only significant factor to PFS for WR-DLBCL group, for LN-DLBCL group, Ann Arbor stage and IPI were independent factors to PFS, LDH was the only significant factor to OS. WR-DLBCL was associated with more favorable clinical characteristics compared with LN-DLBCL, whereas, WR involvement itself did not have a real favorable prognostic significance. The PFS and OS of DLBCL were largely dependent on other prognostic factors such as Ann Arbor stage, LDH or IPI.

Association between neutrophil-to-lymphocyte ratio and differentiated thyroid cancer: a meta-analysis.

The association between neutrophil-to-lymphocyte ratio (NLR) and differentiated thyroid cancer (DTC) is undecided. To rectify this question, we conducted a systematic meta-analysis based on 7 prospective cohort studies published between 2013 and 2015, comprising 7349 patients. Six of these cohorts included pretreatment (baseline) NLR data for patients with thyroid nodules. The meta-analysis of these 6 cohorts showed that the NLR of patients with DTC (4617 cases) was statistically similar to patients with benign nodules only (1666 cases), with a mean difference (MD) of 0.19 (95% CI: -0.09 to 0.46; I2 = 93%; P < 0.001). No significant difference in NLR was found between patients with DTC and patients with benign nodules. Two studies addressed an association between NLR and papillary thyroid carcinoma in patients stratified by age <45 and ≥45 years (496 and 891 cases, respectively); the pooled MD was 0.09 (95% CI: -0.37 to 0.55; I2 = 92.2%, P < 0.001). An elevated NLR seems not a reliable indicator of progressing DTC in patients with goiters, and there was no difference in NLR between patients aged <45 years and those aged ≥45 years. Well-designed and large-scale investigations are warranted to understand the value of NLR in the prognosis of DTC.

Peripherally Inserted Central Catheter-Related Upper Extremity Venous Thrombosis in Oncology Patients: A Prospective Study Based on Doppler Sonography.

OBJECTIVES: Peripherally inserted central catheters (PICCs) are associated with an increased risk of venous thrombosis. This study had 2 objectives: to estimate the incidence of upper extremity venous thrombosis associated with PICCs in oncology patients and to evaluate the role of Doppler sonography in antithrombotic prophylaxis. METHODS: We conducted a prospective study with each patient being followed for 6 weeks. From April 2014 to October 2014, we analyzed a series of 245 consecutive oncology patients undergoing chemotherapy via PICCs, for an overall number of 246 PICC placements. We assessed the role of Doppler sonography for initiation of antithrombotic prophylaxis. The study group encompassed 2 cohorts of patients: those who received regular weekly Doppler screening for thrombosis prophylaxis and those who did not. RESULTS: Of 246 insertions, we observed 90 episodes of upper extremity venous thrombosis (36.59%); 62 of them were asymptomatic in the Doppler group, and 28 were symptomatic in the no-Doppler group. Patients in the Doppler group had a significantly lower rate of thrombosis (0%) than those in the no-Doppler group (23.53%; P < .01). CONCLUSIONS: Our prospective study suggests that the rate of PICC-related upper extremity venous thrombosis in oncology patients is high, and the occurrence of symptomatic thrombosis could be lowered with regular weekly Doppler screening after PICC insertions.

Efficacy and tolerance of pegaspargase, gemcitabine and oxaliplatin with sandwiched radiotherapy in the treatment of newly-diagnosed extranodal nature killer (NK)/T cell lymphoma.

Extranodal nature killer (NK)/T cell lymphoma (ENKL), nasal type, is a highly aggressive and heterogeneous disease. Here we report a retrospective study of 38 newly-diagnosed ENKL patients treated with pegaspargase, gemcitabine, oxaliplatin (P-Gemox) and sandwiched radiotherapy in our department during 2012-2016. A median of 4 (range, 2-6) (total=141) cycles of P-Gemox were administered. Interim restaging after at least 2 cycles showed complete remission (CR) rate of 23.68%, partial remission (PR) rate of 63.16%, giving an overall response rate (ORR) of 86.84%. On treatment completion, the ORR became 92.1% (CR=86.84%, PR=5.26%). Only one patient experienced disease progression during therapy. Multivariate analysis showed gender was a significant independent factor impacting on CR. Hematologic toxicity was common yet nonhematologic toxicity was mild, both of them can be well controlled by supportive treatments and only one treatment-related death was observed. At a median follow-up of 15.5 months, 4 patients (10.53%) experienced disease progression and died of disease. 1-year progression-free survival (PFS) rate and 1-year overall survival (OS) rate for the whole cohort were 86.7% and 86.6%. The P-Gemox regimen with sandwiched radiotherapy may be a promising option in the treatment of newly-diagnosed ENKL due to its high efficacy yet low toxicity.

[Research on construction and expression of recombinant eukaryotic expression plasmid for mouse adiponectin].

OBJECTIVE: To construct the recombinant eukaryotic expression plasmid for mouse adiponectin so as to supply experimental basis for research further on the function of adiponectin. METHODS: Extracting the total RNA from mouse adipose tissue, applying RT-PCR to amplify the complete coding region of mouse adiponectin cDNA and connecting the amplified product with pCDNA3.1(+) vector; then verifying the recombinant plasmid by sequencing and detecting in vitro recombinant expression and cellular proliferation depression to mouse breast cancer cell 4T1. RESULTS: A 744 bp fragment was got after PCR amplification with the recombinant plasmid, which was confirmed by sequence and expression detected by Western-blot. Besides, compared with the control in vitro test, visible morphological changes of 4T1 cell could be observed after recombinant plasmid cell transfection for 48 h, with cells collapsed or shrunk and cellular proliferation inhibited. During the flow cytometry analysis, the transfected 4T1 cells could also be observed obviously to have a greater proportion of cell apoptosis than the control could be detected. CONCLUSION: The recombinant eukaryotic expression plasmid for mouse adiponectin is successfully constructed, which has an obvious inhibition effect on the proliferation of mouse breast cancer cell 4T1.

[Searching for genes interacting with human PCIA1 gene by using the bacterial two-hybrid system].

OBJECTIVE: To search for the genes which could interact with newly found homo sapiens cross-immune reaction antigen (PCIA1) gene and accordingly to provide insights into the study of the gene function. METHODS: The Stratagene's BacterioMatch Two-Hybrid System and BacterioMatch Fetal Kidney Library were adopted and the recombinant bait plasmid pBT-PCIA1 was cotransformated with the target plasmid pTRG-cDNA library DNA into the reporter stain. After screening and isolation of positive pTRG clones, the target genes were identified by DNA sequencing and bioinformation analysis. RESULTS: Among all the seven detected target genes, three genes' function were not known, the other four genes had important functions. Their mutations or abberant expression resulted in severe diseases and overexpression of ACTN4 (actinin, alpha 4), PSAP (prosaposin) or EIF3S10 (eukaryotic translation initiation factor 3, subunit 10 theta) could promote tumor development and progression. CONCLUSION: The bacterial two-hybrid system technique is an efficient method, which can provides insights into the study of novel genes' function by detecting protein-protein interactions. This study indicates that PCIA1 gene expression correlates with tumor formation, invasion and metastasis.