Increased SEC23A Expression Correlates with Poor Prognosis and Immune Infiltration in Stomach Adenocarcinoma.

BACKGROUND: Previous studies have described that the SEC23A gene is involved in the occurrence and development of various tumor entities. However, little is known about its expression and relevance in stomach adenocarcinoma (STAD). The aim of this study was to bioinformatically analyze the role of SEC23A in STAD, followed by patient tissue sample analyses. MATERIALS AND METHODS: SEC23A expression levels in STAD and normal gastric tissues were analyzed in the Cancer Genome Atlas and Gene Expression Omnibus databases; results were verified in fresh clinical STAD specimens on both gene and protein expression levels. SEC23A expression correlated with survival parameters by Kaplan-Meier and multivariate Cox regression analyses. The top genes co-expressed with SEC23A were identified by gene set enrichment analysis (GSEA) using the clusterProfiler package in R. Furthermore, the R package (immunedeconv), integrating the CIBERSORT algorithm, was used to estimate immune cell infiltration levels in STAD. RESULTS: SEC23A gene and sec23a protein expression were both significantly upregulated in STAD, and this correlated with the pT stage. Moreover, high SEC23A expression was associated with poor disease-free and overall survival of STAD patients. Cox analyses revealed that besides age and pathologic stage, SEC23A expression is an independent risk factor for STAD. GSEA indicated that SEC23A was positively associated with ECM-related pathways. In the CIBERSORT analysis, the level of SEC23A negatively correlated with various infiltrating immune cell subsets, including follicular helper T cells, Tregs, activated NK cells and myeloid dendritic cells. Finally, the expression levels of immune checkpoint-related genes, including HAVCR2 and PDCD1LG2, were significantly increased in the high SEC23A expression group. CONCLUSIONS: We observed the significantly upregulated expression of SEC23A in STAD, an association with disease progression, patients' prognosis and infiltrating immune cell subsets. Thus, we propose SEC23A as an independent prognostic factor with a putative role in immune response regulation in STAD.

INSC Is a Prognosis-Associated Biomarker Involved in Tumor Immune Infiltration in Colon Adenocarcinoma.

Aims: The purpose of this study was to investigate the correlation of INSC gene with the level of immune infiltration and clinical prognosis in colon adenocarcinoma (COAD) patients. Materials and Methods: INSC expression profile data and clinicopathological information of COAD patients were downloaded from TCGA. Xiantao bioinformatics tool was used to analyze the expression of INSC between the COAD group and the normal control group, and GEPIA2 was used to analyze the top 100 coexpressed genes. Logistic regression analysis was performed to assess the relationship between clinicopathological features and INSC. The Kaplan-Meier method and Cox regression model were used to perform the survival analysis. CIBERSORT algorithm was used to analyze the relationship between INSC expression and immune infiltration cells. Results: The expression level of INSC in COAD was significantly downregulated. The result of logistic regression analysis confirmed that tumor stage was the final influencing factor of INSC expression. The overall survival rate of INSC in the high expression group was higher than that of the low expression group, and it was an independent risk factor of prognosis. Enrichment results indicated that INSC was enriched in the regulation of T-helper 2 cell differentiation pathway. Immune infiltration analysis showed that INSC expression was positively correlated with the B cell plasma, T cell CD4+ memory resting, activated myeloid dendritic cells, and eosinophils. Conclusions: Our study found that the expression of INSC was significantly downregulated in COAD, which regulated immune-infiltrating cells during cancer development and was associated with malignant progression in COAD patients.

S-1 Combined With Apatinib and Trans-arterial Chemotherapy and Embolization for Conversion Therapy of Unresectable Locally Advanced Gastric Cancer.

BACKGROUND: Conversion therapy is a promising option for unresectable locally advanced gastric cancer (GC) patients. This study aimed to investigate the feasibility and efficacy of conversion therapy based on S-1, apatinib combined with transarterial chemotherapy and embolization (TACE). MATERIALS AND METHODS: Twenty eligible unresectable locally advanced GC patients were enrolled in this single-arm, single-center, prospective clinical trial. Apatinib was administered orally at 0.5 g once daily and continuously for 58 d, while S-1 twice daily on d 1-14 was given at a dose calculated according to the body surface area and repeated every 3 wk for three cycles. TACE (oxaliplatin 80 mg/m2 and etoposide 80 mg/m2) was performed on d 1 and was repeated on d 31. RESULTS: Nineteen patients completed conversion therapy and no treatment-related deaths occurred. The objective response rate (ORR) was 94.7% (18/19) and noncurative factors had resolved in 13 patients (68.4%) based on imaging estimation. 18 patients received laparoscopic examination and 12 cases underwent definitive surgery. Based on the intraoperative and postoperative pathological examination, 10 patients received radical resection (R0 + D2/D2+). The patients who underwent the conversion surgery had a superior median overall survival (OS) compared with those who did not (P = 0.010). CONCLUSIONS: S-1 combined with apatinib and TACE regimen is feasible for preoperative treating initial unresectable locally advanced GC patients with high rates of objective response and radical resection which may provide a survival benefit.

Analysis of the risk factors for recurrence of gastrointestinal stromal tumors after resection / 国际外科学杂志

ObjectiveTo investigate the postoperative risk factors for gastrointestinal stromal tumors.MethodsFrom December 2005 to December 2010,sixty-one gastrointestinal stromal tumors patients of People' s Hospital of Tongling city gastrointestinal surgery department were analyzed retrospectively.Using the logistic regression model to calculate the postoperative recurrence risk factors. Results Sixty-one patients underwent operation,including gastrectomy (40 cases ),partial intestina parva resection (7 cases),partial colon resection ( 3 cases ),Dixon' s operation ( 2 cases ) and tumorectomy ( 9 cases ).Fifteen patients were given postoperative imatinib Mesylate Capsules (Glivec) treatment.Fifty-seven patients were followed-up more than 1 year and 7 cases were found palindromia ( 12％ ).Logistic model shows that the malignant degree of gastrointestinal stromal tumors is the only risk factor of postoperative palindromia.ConclusionsMalignant degree of gastrointestinal stromal tumors is the main risk factor for postoperative palindromia.Imatinib mesylate capsules treatment may be beneficial to the greater stage patients.

The impact of different hepatic vascular occlusion methods on hepatic parenchymal function in partial hepatectomy / 中华肝胆外科杂志

Objective To investigate the impact of different hepatic vascular inflow occlusion methods on hepatic parenchymal function in partial hepatectomy.Methods Between 2009 and 2010,62 hepatocellular carcinoma (HCC) patients underwent partial hepatectomy.In 13 patients,partial hepatectomy was carried out without using any inflow occlusion (group A).In 29 patients intermittent Pringle's maneuver (group B) while in 20 patients selective hepatic inflow occlusion (group C) were used.Intraoperative indocyanine green retention rate at 15 minutes (ICGR15) was measured using pulse spectrophotometry before and during hepatectomy. Results (1) Blood loss in group A was greater than group B and C (P=0.016,P=0.001).(2) There was no significant difference in the preoperative ICGR15 values among group A,B and C.The intraoperative ICGR15 for group B was significantly higher than group A and C (P=0.011,P=0.030).(3) A significant correlation was found between the level of ICGR15 and total inflow clamp time (r =0.484,P =0.001) and blood loss (r=0.349,P=0.005),respectively.(4) Compared with group A and B,postoperative liver function recovered significantly faster in group C.Conclusion Selective hepatic inflow occlusion was useful in controlling blood loss and it was beneficial to the hepatic functional reserve in the liver remnant.