Combined ultrasound endoscopy-guided fine-needle aspiration with DNA methylation of SHOX2 and RASSF1A genes to enhance the auxiliary diagnostic precision of pancreatic cancer.

The purpose of this study was to assess the influence and the clinical effectiveness of the short stature homeobox 2 (SHOX2) and ras association domain family 1A (RASSF1A) genes by tissue sampling through ultrasound endoscopy-guided fine-needle aspiration (EUS-FNA) as auxiliary diagnostic tools for pancreatic cancer (PC). Methylation markers were detected in 96 patients using real-time fluorescence quantitative PCR (qPCR), and the performance of this diagnostic assay was compared with CA19-9, CEA, and puncture fluid-based exfoliative cytology using receiver operating characteristic curve (ROC) analysis. The PC group exhibited higher methylation rates for SHOX2, RASSF1A, and the combined assay of both genes compared to the control group (95.7 % vs. 54.0 %, 78.3 % vs. 36.0 %, and 73.9 % vs. 16.0 %, P < 0.05). The areas under the ROC curve (AUC) for CA19-9, CEA, liquid-based exfoliative cytology, SHOX2, RASSF1A, the combination of SHOX2 and RASSF1A, the combination assay with CEA, CA19-9, and liquid-based exfoliative cytology were 0.827, 0.692, 0.767, 0.770, 0.732, 0.870, 0.870, 0.933, and 0.900, respectively. Therefore, the methylation assay based on the combined SHOX2 and RASSF1A genes in EUS-FNA puncture fluid is more effective than using a single gene, liquid-based exfoliative cytology, or intravenous tumor markers for diagnosing PC. Combining the conventional marker CA19-9 enhances the diagnostic value, making it a promising approach to complement histology and cytology.

Legacy of herbicides in water from Hailun City, Northeast China: Occurrence, source, and ecological risk assessment.

Herbicides (HBCs) are extensively used in modern agriculture. However, their potential negative impacts on environmental media have emerged as a significant environmental concern. In this study, we employed positive matrix factorization (PMF) to identify the potential sources of HBCs. Furthermore, we utilized a multi-matrix ecological risk model to assess the risks associated with HBCs in both surface water and groundwater in the black soil region of Northeast China. The findings revealed that the levels of ∑15HBCs in surface water and groundwater ranged from 585.84 to 6466.96 ng/L and 4.80 to 11,774.64 ng/L, respectively. The PMF results indicated that surface runoff and erosion accounted for 50% of the total HBCs in water, serving as the primary sources. All tested HBCs exhibited acute risk values within acceptable levels. The risk index for the ∑15HBCs was categorized as "moderate risk" in 31% of the surface waters and 13% of the groundwaters. However, 4% of the groundwater sampling sites reached the "high risk" level. The chronic risk quotient of ∑15HBCs in surface water and groundwater was 92% and 62% at the "high risk" level, respectively. Interestingly, non-carcinogenic HBCs contributed more significantly to the ecotoxicology of the aquatic system than carcinogenic HBCs. This study provides comprehensive information on the legacy of HBCs in water bodies and emphasizes the potential risks posed by HBCs to aquatic systems. The results obtained from this study could help relevant management authorities in developing and implementing effective regulations to mitigate the ecological and environmental risks associated with HBCs.

Microbiome resistance mediates stimulation of reduced graphene oxide to simultaneous abatement of 2,2',4,4',5-pentabromodiphenyl ether and 3,4-dichloroaniline in paddy soils.

Paddy soils near electrical and electronic waste recycling sites generally suffer from co-pollution of polybrominated diphenyl ethers and 3,4-dichloroaniline (3,4-DCA). This study tested the feasibility of reduced graphene oxide (rGO) to stimulate the simultaneous abatement of 2,2',4,4',5-pentabromodiphenyl ether (BDE99) and 3,4-DCA in percogenic paddy soil (PPS) and hydromorphic paddy soil (HPS). rGO improved the debromination extent of BDE99 and the transformation rate of 3,4-DCA in PPS, but did not affect their abatement in HPS. The inhibition of specific fermenters, acetogens, and methanogens after rGO addition contributed to BDE99 debromination by obligate organohalide-respiring bacteria (OHRB) in PPS, but relevant soil microbiomes (e.g., fermenters, acetogens, methanogens, and obligate OHRB) responded little to rGO in HPS. For 3,4-DCA, the enhanced activities of nitrogen-metabolic chloroaniline degraders by rGO increased its transformation rate in PPS, but was compensated by the decreased biotransformation from 3,4-DCA to 3,4-dichloroacetanilide after the addition of rGO to HPS. The discrepant stimulation of rGO between PPS and HPS was mediated by soil microbiome resistance. rGO has the application potential to stimulate the simultaneous abatement of polybrominated diphenyl ethers and chloroanilines in paddy soils with relatively low microbiome resistance.

A multicenter prospective study of TACE combined with lenvatinib and camrelizumab for hepatocellular carcinoma with portal vein tumor thrombus.

BACKGROUND AND AIMS: Hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) predicts a poor prognosis. The aim of the present study was to evaluate the efficacy and safety of using lenvatinib and camrelizumab combined with transarterial chemoembolization (TACE) to treat HCC with PVTT. METHODS: This was a single-arm, open-label, multicenter, and prospective study. Eligible patients with advanced HCC accompanied by PVTT were enrolled to receive TACE combined with lenvatinib and camrelizumab. The primary endpoint was progression-free survival (PFS), while the secondary endpoints included objective response rate (ORR), disease control rate (DCR), overall survival (OS), and safety. RESULTS: Between April 2020 and April 2022, 69 patients were successfully enrolled. With a median follow-up time of 17.3 months, the median age of the patient cohort was 57 years (range: 49-64 years). According to modified Response Evaluation Criteria in Solid Tumors, the ORR was 26.1% (18 partial responses [PRs]) and the DCR was 78.3% (18 PRs, 36 stable diseases [SDs]). The median PFS (mPFS) and median OS (mOS) were 9.3 and 18.2 months, respectively. And tumor number >3 was identified as an adverse risk factor for both PFS and OS. The most common adverse events across all grades included fatigue (50.7%), hypertension (46.4%), and diarrhea (43.5%). Twenty-four patients (34.8%) experienced Grade 3 toxicity that was relieved by dose adjustment and symptomatic treatment. No treatment-related deaths occurred. CONCLUSIONS: TACE combined with lenvatinib and camrelizumab is a well-tolerated modality treatment with promising efficacy for advanced HCC with PVTT.

Combined effects of microplastics and cadmium on the soil-plant system: Phytotoxicity, Cd accumulation and microbial activity.

Microplastics (MPs), an emerging pollutant of concern, widely cooccurred with heavy metals in soil, however, little is known about the combined effects of the interactions of MPs and cadmium (Cd) on the soil-plant system. In this study, the combined effects of several types of MPs and soil Cd contamination on Brassica juncea growth, Cd uptake, and soil microbial carbon metabolism were investigated in a 50-day pot experiment. Aged polyethylene (PE), aged polypropylene (PP), biodegradable polybutylene adipate terephthalate (PBAT) and polylactic acid (PLA) displayed moderate phytotoxicity, with reductions in leaf chlorophyll content and shoot biomass. Compared with the control treatment without MPs or B. juncea, B. juncea growth significantly increased the soil pH by 0.3 pH units, and the growth of B. juncea in the presence of biodegradable PBAT or PLA MPs increased the soil pH by an additional 0.4 or 0.6 pH units, respectively. The presence of PBAT or PLA MPs greatly reduced soil diethylenetriamine pentaacetic acid (DTPA)-extractable Cd concentrations and plant Cd accumulation. The Cd bioconcentration factor was higher in roots than shoots in all treatments except the treatment containing PBAT MPs. The average well color development (AWCD), an indicator of metabolic activity, was highest in the treatment with B. juncea alone and was reduced by both biodegradable and conventional MPs. The microbial utilization efficiency of esters and alcohols was enhanced in the treatment with PBAT MPs, whereas carboxylic acids were preferentially utilized in the treatment with PLA MPs. These findings indicate that co-exposure to MPs and Cd may alter soil microenvironmental characteristics such as soil pH, leading to changes in Cd bioavailability, plant growth and Cd accumulation, and the microbial community's capacity to metabolize carbon. These effects of MPs in soil warrant further exploration.

Effects of cadmium on mercury accumulation and transformation by Arundo donax L.

High biomass energy plants are a promising alternative to hyperaccumulators for the remediation of heavy metals (HMs). Arundo donax L. (A. donax) is a rapidly growing rhizomatous grass with high biomass production. However, the feasibility of using A. donax for the phytoremediation of combined mercury (Hg) and cadmium (Cd) pollution under neutral conditions is unclear. In this study, a hydroponic experiment was performed to investigate the impact of Hg-Cd stress on the growth and physiological properties of A. donax and HMs accumulation and transformation. Either single Hg or Cd stress slightly enhanced stem height, fresh biomass, and chlorophyll content, whereas combined Hg-Cd stress reduced these parameters. Furthermore, combined Hg-Cd stress increased the leaf content of malondialdehyde in A. donax, indicating that the combined pollution aggravated oxidative stress in A. donax. Hg volatilization was observed during the 10-day experiment, implying that a portion of the Hg2+ was transformed into Hg0 by A. donax. The bioaccumulation factor (BAF) values of A. donax were far greater than 1 for both Hg and Cd, whereas the translocation factor (TF) values were less than 1, indicating that phytovolatilization and phytostabilization rather than phytoextraction contributed to the remediation of Hg and Cd by A. donax. The solution pH decreased at the beginning of the experiment, suggesting that acidic root exudates of A. donax facilitated the accumulation and transformation of Hg under neutral conditions. Overall, the effects of Cd on Hg accumulation and transformation by A. donax followed the rule of "low promotion and high inhibition." This study demonstrates that A. donax is a potential candidate for the phytoremediation of combined Hg-Cd pollution under neutral conditions.

Removal of cadmium and polychlorinated biphenyls by clover and the associated microbial community in a long-term co-contaminated soil.

Legumes such as clover are cost-effective and environmentally friendly components of strategies for remediating soils contaminated with heavy metals or organic pollutants. However, the mechanisms by which clover remediates co-contaminated soils are unclear. The present study explored the effects of phytoremediation by clover on pollutant removal and the microbial community in soil co-contaminated with cadmium (Cd) and polychlorinated biphenyls (PCBs). After 18 months of phytoremediation, Cd removal increased from 20.25 % in the control to 40.65 % in soil planted with clover, while PCB removal increased from 29.81 % to 60.02 %. High-throughput sequencing analysis showed that the relative abundances of the bacterial phylum Proteobacteria and the diazotrophic genus Rhizobium increased significantly after phytoremediation. Random forest analysis showed that bacterial and diazotrophic diversity significantly influenced Cd and PCB removal. Furthermore, co-occurrence network and correlation analyses revealed that Rhizobiales and Micromonosporales were the main bacteria associated with Cd removal, while Rhizobiales, Burkholderiales, and Xanthomonadales were identified as the main degraders of PCBs. PICRUSt functional prediction demonstrated that the gene bphC, which is related to PCB degradation, was significantly increased in the rhizosphere soil in the presence of clover. These results provide a better understanding for further studies of remediation efficiency by clover, rhizosphere microbial response and remediation mechanisms of co-contaminated soils under in situ conditions in the field.

Nontargeted metabolomic analysis to unravel alleviation mechanisms of carbon nanotubes on inhibition of alfalfa growth under pyrene stress.

Carbon nanotubes have displayed great potential in enhancing phytoremediation of PAHs polluted soils. However, the response of plants to the coexistence of carbon nanotubes and PAHs and the associated influencing mechanisms remain largely unknown. Here, the effect of carbon nanotubes on alfalfa growth and pyrene uptake under exposure to pyrene was evaluated through sand culture experiment and gas chromatography time-of-flight mass spectrometer (GC-TOF-MS) based metabolomics. Results showed that pyrene at 10 mg kg-1 obviously reduced the shoot fresh weight of alfalfa by 18.3 %. Multiwall carbon nanotubes (MWCNTs) at 25 and 50 mg kg-1 significantly enhanced the shoot fresh weight in a dose-dependent manner, nearly by 80 % at 50 mg kg-1. Pyrene was mainly accumulated in alfalfa roots, in which the concentration was 35 times as much as that in shoots. MWCNTs greatly enhanced the accumulation of pyrene in alfalfa roots, almost by two times at 50 mg kg-1, while decreased pyrene concentration in shoots, from 0.11 mg kg-1 to 0.044 mg kg-1 at MWCNTs concentration of 50 mg kg-1. Metabolomics data revealed that pyrene at 10 mg kg-1 trigged significant metabolic changes in alfalfa root exudates, downregulating 27 metabolites. MWCNTs generated an increase in the contents of some downregulated metabolites caused by pyrene stress, which were restored to the original level or even higher, mainly including organic acids and amino acids. MWNCTs significantly enriched some metabolic pathways positively correlated with shoot growth and pyrene accumulation in shoots under exposure to pyrene, including TCA cycle, glyoxylate and dicarboxylate metabolism, cysteine and methione metabolism as well as alanine, aspartate and glutamate metabolism. This work highlights the regulation effect of MWCNTs on the metabolism of root exudates, which are helpful for alfalfa to alleviate the stress from pyrene contamination.

An association study on the risk, glucocorticoids effectiveness, and prognosis of systemic lupus erythematosus: insight from mitochondrial DNA copy number.

This study aimed to explore the role of mitochondrial DNA copy number (mtDNAcn) in the risk, glucocorticoid (GC) effectiveness, and prognosis of systemic lupus erythematosus (SLE) and its interactions with environmental factors and tumor necrosis factor receptor-associated protein 1 (TRAP1) genetic polymorphisms. We first conducted a case-control study of 1198 subjects (595 SLE patients and 603 healthy controls). Subsequently, we followed up with patients to assess the effectiveness of GC treatment and the prognosis of SLE. Real-time fluorescent quantitative PCR (qPCR) was used to quantify mtDNAcn. Associations were estimated using logistic regression, and prognosis analysis was performed using Kaplan-Meier analysis and Cox proportional hazards models. Interactions on multiplicative and additive scales were also evaluated. Individuals with low mtDNAcn had an increased risk of SLE (P < 0.001). Low mtDNAcn was associated with poor GC effectiveness in patients with spicy food consumption or with arthritis (P < 0.05). mtDNAcn was significantly related to the prognosis of SLE in the drinking subgroup (P = 0.018). Furthermore, we found significant interactions between mtDNAcn and environmental factors/TRAP1 genetic polymorphisms on the risk, GC effectiveness, and prognosis of SLE. Our data suggest that low mtDNAcn is associated with an increased risk of SLE. Alteration of mtDNAcn may be associated with GC effectiveness and prognosis in certain subgroups of SLE. The interactions between mtDNAcn, environmental factors, and TRAP1 gene polymorphisms may jointly affect the risk, GC effectiveness, and prognosis of SLE.

Sintilimab Combined with Lenvatinib for Advanced Intrahepatic Cholangiocarcinoma in Second-Line Setting-A Multi-Center Observational Study.

Background: Patients with advanced intrahepatic cholangiocarcinoma (iCCA) have a poor prognosis and a substantial unmet clinical need. The study was aimed to investigate the efficacy and safety of sintilimab combined with lenvatinib for advanced iCCA in second-line setting. Methods: The patients at multiple centers, who progressed after the first-line chemotherapy or could not tolerate chemotherapy, were treated with the combination of sintilimab plus lenvatinib. The primary endpoint was time to progression (TTP), and the secondary endpoints included tumor objective response rate (ORR), disease control rate (DCR), overall survival (OS), and toxicity. Prognostic factors were analyzed using Cox regression analysis. Results: A total of 41 patients with advanced iCCA were enrolled for this multi-center observational study. Under a median follow-up of 12.1 months, the median age was 59 years (range, 33-75 years). Sixteen patients died of disease progression, with a median TTP of 6.6 months (95% CI, 4.9-8.3). ORR and DCR were 46.3% and 70.3%, respectively. The patients with PD-L1 TPS ≥10% reported a significantly higher ORR compared to those with PD-L1 TPS <10%, 93.8% (15/16) vs. 16.0% (4/25), p<0.001. The median TTP was significantly improved in patients with PD-L1 TPS ≥10%, 16.9 months (95% CI, 7.5-26.3) vs. 4.1 months (95% CI, 1.8-6.4), p=0.001. Attaining treatment response predicts favorable TTP in a multivariate Cox model. Treatment-emergent adverse events occurred with 70.3% probability, and no treatment-related death had been reported. Conclusion: The combination of sintilimab plus lenvatinib is effective and well tolerated for advanced iCCA in the second-line setting. PD-L1 TPS expression may predict the efficacy of the combination therapy. Further investigation is warranted to investigate this combination regimen in advanced iCCA.

Multimolecular characteristics of cell-death related hub genes in human cancers: a comprehensive pan-cancer analysis.

Failure of the normal process of cell death pathways contributes to the defection of immune systems and the occurrence of cancers. The key genes, the multimolecular mechanisms, and the immune functions of these genes in pan-cancers remain unclear. Using online databases of The Cancer Genome Atlas, GEPIA2, TISIDB, HPA, Kaplan-Meier Plotter, PrognoScan, cBioPortal, GSCALite, TIMER, and Sangerbox, we identified the key genes from the six primary cell death-related pathways and performed a comprehensive analysis to investigate the multimolecular characteristics and immunological functions of the hub genes in 33 human cancers. We identified five hub genes in the six primary cell death-related pathways (JUN, NFKB1, CASP3, PARP1, and TP53). We found that CASP3, PARP1, and TP53 were overexpressed in 28, 23, and 27 cancers. The expression of the five genes was associated with the development and prognosis of many cancers. Particularly, JUN, NFKB1, CASP3, and TP53 have prognostic values in Brain Lower Grade Glioma (LGG), while PARP1 and CASP3 could predict the survival outcomes in Adrenocortical carcinoma (ACC). In addition, an extensive association between five genes' expression, DNA methylation, and tumor-immune system interactions was noticed. The five cell death-related hub genes could function as potential biomarkers for various cancers, particularly LGG and ACC. The immunological function analysis of the five genes also proposes new targets for developing immunosuppressants and improving the immunotherapy efficacy of cancers. However, further extensive clinical and experimental research are required to validate their clinical values.

[Mechanism of acupuncture and moxibustion in ameliorating liver injury induced by DDP by regulating apoptosis factors Caspase-3, Caspase-8 and Caspase-9].

OBJECTIVE: To investigate the mechanism of the effect of acupuncture and moxibustion on improving liver injury by observing the changes of cysteine protease (Caspase) associated with hepatocyte apoptosis based on cisplatin (DDP) induced liver injury model mice. METHODS: Forty KM mice were randomly divided into control group, model group, acupuncture group and moxibustion group, with 10 mice in each group. The liver injury model was replicated by intraperitoneal injection of DDP. In the acupuncture group and the moxibustion group, acupuncture and moxibustion were performed at"Dazhui"(GV14), and bilateral "Ganshu"(BL18), "Shenshu"(BL23), and "Zusanli"(ST36), respectively, once per day for 5 d. General condition of mice in each group were observed;The activities of AST, ALT and GLDH in mice serum were detected by biochemical method. ELISA and Western blot assay were used to detect Caspase-3, Caspase-8 and Caspase-9 contents and protein expression in the liver tissues of each group of mice, respectively. RESULTS: Compared with the control group, the general condition of the mice in the model group was poorer, and the Caspase-3, Caspase-8 and Caspase-9 contents and protein expressions in liver tissues and the activities of AST, ALT and GLDH in serum were increased (P<0.05). Compared with the model group, the general condition of the mice in the acupuncture and moxibustion groups improved, and the Caspase-3, Caspase-8 and Caspase-9 contents and protein expressions in liver tissues and activities of AST, ALT and GLDH in serum were decreased (P<0.05). CONCLUSION: Acupuncture and moxibustion can reduce liver injury due to DDP chemotherapy by modulating the expression of apoptotic factors Caspase-3, Caspase-8 and Caspase-9 in liver tissues of DDP model mice and improving liver function, which may be one of the mechanisms of the effect of acupuncture and moxibustion to ameliorates liver injury after DDP chemotherapy.

The ASIC3-M-CSF-M2 macrophage-positive feedback loop modulates fibroblast-to-myofibroblast differentiation in skin fibrosis pathogenesis.

Inflammation is one of the main pathological features leading to skin fibrosis and a key factor leading to the progression of skin fibrosis. Acidosis caused by a decrease in extracellular pH is a sign of the inflammatory process. Acid-sensing ion channels (ASICs) are ligand-gated ion channels on the cell membrane that sense the drop in extracellular pH. The molecular mechanisms by which skin fibroblasts are regulated by acid-sensing ion channel 3 (ASIC3) remain unknown. This study investigated whether ASIC3 is related to inflammation and skin fibrosis and explored the underlying mechanisms. We demonstrate that macrophage colony-stimulating factor (M-CSF) is a direct target of ASIC3, and ASIC3 activation promotes M-CSF transcriptional regulation of macrophages for M2 polarization. The polarization of M2 macrophages transduced by the ASIC3-M-CSF signal promotes the differentiation of fibroblasts into myofibroblasts through transforming growth factor ß1 (TGF-ß1), thereby producing an ASIC3-M-CSF-TGF-ß1 positive feedback loop. Targeting ASIC3 may be a new treatment strategy for skin fibrosis.

Occurrence and health risk assessment of phthalate esters in tobacco and soils in tobacco-producing areas of Guizhou province, southwest China.

Flue-cured tobacco is one of the important sources of national economy in China. However, Phthalic acid esters (PAEs) are ubiquitous contaminants in the cultivation and growth management of flue-cured tobacco, and attracting more and more attention. Here, six priority PAEs were detected in tobacco and soils and their residue characteristics, pollution sources were analyzed, and their exposure risks to the health of farmers were assessed. The concentration of six total PAEs ranged from 0.78 to 4.79 mg/kg in tobacco with the average of 1.75 mg/kg, and 0.84-25.68 mg/kg in soils with the average of 5.40 mg/kg. Di-(2-ethylhexyl) phthalate (DEHP) and di-n-butyl phthalate (DBP) had the highest detection frequency (DF = 100%) both in soil and tobacco samples. DEHP was the most abundant of the total PAEs in soil and tobacco samples, with the mean contribution values of 71.0% and 58.8%, respectively. Principal component analysis (PCA) indicates that the major sources of PAEs in the tobacco-soil system were plastic films, fertilizers and pesticides. Health risk assessment suggests that the non-cancer hazard indexes (NCHI) of dimethyl phthalate (DMP), diethyl phthalate (DEP), DBP and di-n-octyl phthalate (DnOP) in all samples for farmers were at acceptable levels (NCHI < 1), and the average carcinogenic hazard indexes (CHI) of butyl benzyl phthalate (BBP) and DEHP for farmers were 3.79 × 10-13 and 8.54 × 10-11 in soils, respectively, 8.23 × 10-13 and 1.95 × 10-11 in tobacco, respectively, which were considered to be very low level (CHI < 10-6). This study provides data on PAEs in tobacco and soils and their health risks which may provide valuable information to aid the management of tobacco cultivation and risk avoidance.

Insight into the role of DPP-4 in fibrotic wound healing.

Wound healing is a complex and long-term process consisting of hemostasis, inflammation, proliferation, and maturation/remodeling. These four stages overlap and influence each other; they affect wound healing in different ways, and if they do not function perfectly, they may cause scarring, proliferative scarring and keloid formation. A therapeutic target affecting wound healing in multiple ways will help the healing process proceed more effectively. DPP-4/CD26 is a multifunctional dimorphic glycoprotein widely distributed on the surface of a variety of cells, including fibroblasts and keratin-forming cells. It has been found to affect periwound inflammation, re-epithelialization, extracellular matrix secretion and skin fibrosis and is a potential target for promoting wound healing and inhibiting scar formation. After presenting a brief introduction of the wound healing process and DPP-4/CD26, this paper summarizes the effects of DPP-4/CD26 on cells involved in different stages of wound healing and discusses the feasibility of DPP-4/CD26 as a multifunctional target for the treatment of wound healing and inhibition of scar formation.

Polycystic ovary syndrome and the risk of endometrial, ovarian and breast cancer: An updated meta-analysis.

BACKGROUND AND AIMS: This updated meta-analysis aimed to further quantify the risk of endometrial, ovarian, and breast cancer in patients with polycystic ovary syndrome (PCOS), thus providing updated and more reliable estimates. METHODS AND RESULTS: We identified relevant articles by searching electronic databases of PubMed, Embase, Web of Science, and Chinese Biological Medical Literature (CBM) published up to March 20, 2021. The pooled effect estimates and their 95% confidence intervals (CIs) were calculated using the random-effect model or the fixed-effect model. A total of 26 eligible studies were included. We found that PCOS was significantly associated with endometrial cancer (odds ratios [OR]: 3.66, 95%CI: 2.05-6.54, P < 0.001), but not with ovarian or breast cancer (OR: 1.23, 95%CI: 0.99-1.53, P = 0.059; OR: 0.94, 95%CI: 0.78-1.14, P = 0.551, respectively). However, in subgroups of high-quality studies, cohort studies, younger women (54 years or less or premenopausal), and studies with unadjusted body mass index (BMI), PCOS patients had a significantly higher risk of ovarian cancer. CONCLUSION: These results indicated that PCOS is a significant risk factor for endometrial cancer independent of BMI, but not for breast cancer. PCOS may increase the risk of ovarian cancer in younger women.

A Retrospective Study on Therapeutic Efficacy of Transarterial Chemoembolization Combined With Immune Checkpoint Inhibitors Plus Lenvatinib in Patients With Unresectable Hepatocellular Carcinoma.

Objective: We assessed the efficacy and safety of transarterial chemoembolization (TACE) in combination with lenvatinib plus programmed death receptor-1 (PD-1) signaling inhibitors (camrelizumab or sintilimab) in unresectable hepatocellular carcinoma (uHCC). Methods: In this retrospective study, patients with uHCC were pretreated with lenvatinib for 1 to 2 weeks before TACE. Camrelizumab or sintilimab were initially administered intravenously in 1 week after TACE of a 21-day cycle. Primary objectives were objective response rate (ORR) and disease control rate (DCR) by modified Response Evaluation Criteria in Solid Tumors (mRECIST). The secondary endpoints included the progression-free survival (PFS), overall survival (OS), and toxicity. Results: Between March 5, 2019 and February 30, 2021, 53 patients were screened for eligibility. At data cutoff, 35.8% of patients remained on treatment. Median follow-up was 15.4 months. Confirmed ORR in the 51 evaluable patients was 54.9% (95% CI 41.4%-67.7%). DCR was 84.3% (95% CI 72.0%-91.8%). Median PFS was 8.5 months (95% CI 6.4 to 10.6 months). The median OS was not estimable. Grade ≥3 treatment-related adverse events occurred in 32.1% of patients. No new safety signals were identified. Conclusion: TACE in combination with lenvatinib plus anti-PD-1 inhibitors may have promising antitumor activity in uHCC. Toxicities were manageable, with no unexpected safety signals.

Peripheral Blood-Based DNA Methylation of Long Non-Coding RNA H19 and Metastasis-Associated Lung Adenocarcinoma Transcript 1 Promoters are Potential Non-Invasive Biomarkers for Gastric Cancer Detection.

INTRODUCTION: The early diagnosis and detection could greatly improve the clinical outcome of gastric cancer (GC) patients. However, the non-invasive biomarkers for GC detection remain to be identified. METHOD: We used online databases (GEPIA, UALCAN, Kaplan-Meier plotter, TIMER, and MEXPRESS) to explore the association between H19 or metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) expression in tissues and the occurrence, development, prognosis, the levels of immune cell infiltration, and methylation of GC; the correlation between mRNA expression and DNA methylation levels of genes were also examined. Methylation levels of H19 or MALAT1 in peripheral blood were compared between 150 GC patients and 100 healthy controls (HCs). Predictive nomograms were constructed among female and male groups for GC diagnosis. The calibration curves, Hosmer-Lemeshow test, and decision curve analysis were also used to examine the nomograms' predictive ability and clinical values. RESULTS: Using multiple online databases, we found that the mRNA expressions of H19 and MALAT1 in tissues were related to the occurrence of GC, and such expressions were associated with immune cell infiltration of GC and negatively correlated with DNA methylation levels of H19 and MALAT1. H19 gene, H19C island, and MALAT1B island, as well as 20 CpG sites were hypermethylated in peripheral blood of GC patients compared with HCs; similar results were also found in female and male groups (P < .05 for all). The combination of H19c3, H19c4, MALAT1b12, and age, as well as the combination of H19b7, H19c1, H19c5, and age in the nomograms could distinguish GC patients from HCs in the female group and male group, respectively. CONCLUSION: We found statistically significant hypermethylation of H19 and MALAT1 promoters in GC patients, and meaningful sensitivity and specificity of MALAT1 and H19 methylation in discriminating GC and HCs were observed in both female and male groups, which indicates that the peripheral blood-based DNA methylation of H19 and MALAT1 could act as potential non-invasive biomarkers for the diagnosis of GC.