Validation of a supplementary condition of eighth AJCC staging system for stage II hepatocellular carcinoma.

INTRODUCTION: The eighth American Joint Committee on Cancer (AJCC) staging system was flawed regarding the prognosis of stage II hepatocellular carcinoma (HCC). The aims of this study were to reveal the defect and make updates. METHODS: Clinical and survival data of HCC patients from the Surveillance, Epidemiology, and End Results database were used. We re-classified stage II into T2aN0M0 (tumors >2 cm with vascular invasion) and T2bN0M0 (multiple tumors ≤5 cm). The Kaplan-Meier method and log-rank test were used to estimate differences in overall survival (OS). Three propensity score matching analyses without (PSM1) or with (PSM2 and PSM3) consideration of surgical treatment were performed. Cox regression was used to reveal risk factors. RESULTS: HCC patients identified as T1bN0M0, T2aN0M0, T2bN0M0, and T3N0M0 were recruited. OS in T2N0M0 was consistent with the eighth AJCC staging system after PSM1. T2bN0M0 had increased OS compared with T2aN0M0 after PSM2 (hazard ratio [HR] = 1.36; 95% confidence interval [CI] = 1.06-1.73; P = 0.0141) or PSM3 (HR = 1.18; 95%CI = 1.01-1.37; P = 0.0283). No survival benefit existed between T1bN0M0 and T2bN0M0 after PSM2 (HR = 0.92; 95%CI = 0.80-1.05; P = 0.2171) or PSM3 (HR = 0.92; 95%CI = 0.84-1.01; P = 0.0888). Compared with T2aN0M0, T3N0M0 had shorter OS after PSM2 (HR = 0.64; 95%CI = 0.50-0.82; P = 0.0003) or PSM3 (HR = 0.63; 95%CI = 0.54-0.73; P < 0.0001). Cox regression analysis revealed that surgical treatment was associated with better prognosis (HR = 0.3; 95%CI = 0.3-0.4; P < 0.001). CONCLUSIONS: The current staging for T2N0M0 is imprecise because surgical treatment is not adequately evaluated and would be ineffective if the proportion of T2bN0M0 patients with surgical treatment was increased.

Novel insight into the role of immunotherapy in gastrointestinal cancer (Review).

To date, great progress has been made in studying the immunology of cancer and the development of immunotherapies. Immunotherapy has become an effective clinical strategy for cancer treatment in courtesy of its unique features. It has been demonstrated to delay tumor progression, reduce tumor recurrence and metastasis, and even cure tumors through enhancing the immune response, stimulating tumor-specific immunity and breaking immune tolerance. Several different immunotherapeutic approaches and methods are in the process of being developed, including the use of cytokines, immune checkpoint inhibitors, engineered T cells (such as T-cell-receptor T cells and chimeric antigen receptor T cells) and cancer vaccines. Digestive system neoplasms pose a serious threat to human health, including esophageal cancer, gastric cancer and colorectal cancer, and immunotherapy is considered to be a promising new avenue for the treatment of digestive system neoplasms. However, certain challenges remain in terms of the broad implementation of immunotherapies due to the incompletely understood mechanisms underlying tumorigenesis. Therefore, it is crucially important to understand both the various different types of immunotherapy and the immune landscapes in digestive system neoplasms in order to reduce the side effects associated with these therapies. The present review discusses existing and newly emerging immunotherapeutic methods that may be applied in the treatment of digestive system neoplasms and how their clinical efficacy may be enhanced.

Decreased IGF-1 level is associated with restrained amino acid metabolism in NSCLC with diabetes mellitus.

The discovery of a large number of small pulmonary nodules and early diagnosis of lung cancer in the diabetic patients prompt us to re-examine the relationship between diabetes and the occurrence and development of lung cancer. The aim of this study was to explore the underlying metabolites changes in diabetes with NSCLC or benign nodule patients, and further to investigate the association of serum IGF-1 level and differentially expressed metabolites (DEMs). An untargeted metabolomics method was used to detect the changes of metabolism in diabetic patients with NSCLC on the platform of HR-MS. Serum level of IGF-1 was measured by ELISA. The patients were divided to three groups, DM, DLB (nodule), and DLC (cancer). we have identified numerous DEMs, which include amino acid, choline, and fatty acid derivatives. Further analysis of the involved metabolic pathways suggested that linoleate metabolism, tryptophan metabolism, histidine metabolism, putative anti-Inflammatory metabolites formation from EPA, and arachidonic acid metabolism were considered to be the most significant metabolic pathways between groups. Networks analysis suggested that a series of metabolites were associated with serum IGF-1among the three groups, which can be divided into 6 categories. Nine metabolites have been identified as the main DEMs among the DLC, DLB, and DM groups. In conclusion, metabolomics is a powerful and promising tool for the cancer risk evaluation in diabetic patients. Our results suggest that decreased IGF-1 level is associated with restrained amino acid metabolism in NSCLC with diabetes mellitus.

Proteomics analysis of cancer tissues identifies IGF2R as a potential therapeutic target in laryngeal carcinoma.

Background: Laryngeal cancer (LC) is a prevalent head and neck malignancy; however, the essential pathophysiological mechanism underlying its tumorigenesis and progression remains elusive. Due to the perduring scarcity of effective targeted drugs for laryngeal cancer, insights into the disease's pathophysiological mechanisms would substantially impact the treatment landscape of laryngeal cancer. Methods: To ensure quality consistency, 10 tumor and 9 non-tumor samples underwent proteomic analysis on a single mass spectrometer using a label-free technique. Subsequently, gene expression variations between laryngeal squamous cell carcinoma and normal tissues were analyzed using The Cancer Genome Atlas (TCGA) database. Immunohistochemical expressions of insulin-like growth factor 2 receptor (IGF2R), fibronectin (FN), vimentin, and α-smooth muscle actin (SMA) in LC tissues and normal tissues were determined. Results: In the tumor group, significant variations were detected for 433 upregulated and 61 downregulated proteins. Moreover, the heatmap revealed that the expressions of RNA translation-related proteins and proteins involved in RNA metabolism, such as IGF2R, tenascin C (TNC), periostin (POSTN), proteasome 26S subunit ATPase 4 (PSMC4), serpin family A member 3 (SERPINA3), heat shock protein family B (small) member 6 (HSPB6), osteoglycin (OGN), chaperonin containing TCP1 subunit 6A (CCT6A), and chaperonin containing TCP1 subunit 6B (CCT6B), were prominently elevated in the tumor group. Nonsense-mediated RNA decay (NMD), RNA translation, and protein stability were significantly altered in LC tumors. IGF2R was remarkably upregulated in LC tumors. In the TCGA database, the IGF2R mRNA level was significantly upregulated in LSCC tissues. Additionally, IGF2R mRNA expression was lowest in clinical grade 1 samples, with no significant difference between grades 2 and 3. In LSCC patients, a significant positive correlation between IGF2R expression and the stromal score was detected using the ESTIMATE algorithm to estimate the immune score, stromal score, and tumor purity in the tumor microenvironment. Lastly, immunohistochemical analysis revealed that IGF2R is overexpressed in LC. Conclusion: These results demonstrate the vital role of IGF2R in LC carcinogenesis and progression and may facilitate the identification of new therapeutic targets for the prevention and treatment of LC.

Accurate Determination of 12 Lactones and 11 Volatile Phenols in Nongrape Wines through Headspace-Solid-Phase Microextraction (HS-SPME) Combined with High-Resolution Gas Chromatography-Orbitrap Mass Spectrometry (GC-Orbitrap-MS).

This paper clarifies the contribution of lactones and volatile phenols to the aroma of nongrape wine. A target method for the simultaneous determination of these two kinds of volatiles in nongrape wines was developed using headspace-solid-phase microextraction (HS-SPME) combined with high-resolution gas chromatography-Orbitrap mass spectrometry (GC-Orbitrap-MS). A high-resolution mass spectrometry database including 12 lactones and 11 volatile phenols was established for qualitative accuracy. Different matrix-matched calibration standards should be prepared for specific samples due to the matrix effects. The method was successfully validated and applied in three nongrape wines. Hawthorn wine contained more lactones (δ/γ-hexalactone, δ/γ-nonalactone, δ/γ-decalactone, γ-undecalactone, δ/γ-dodecalactone, C10 massoia lactone, and whiskey lactone), while blueberry wine contained more volatile phenols (especially 4-vinylguaiacol and 4-ethylguiaiacol). Goji berry wines contained certain concentrations of δ-nonalactone, γ-nonalactone, δ-hexalactone, and 3-ethyl phenol. This study demonstrated that HS-SPME-GC-Orbitrap-MS can be applied for the accurate quantification of trace aroma compounds such as lactones and volatile phenols in fruit wines.