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Objective:To explore the prognostic value of baseline 18F-FDG PET/CT metabolic parameters in locally advanced cervical cancer (LACC) after concurrent chemoradiotherapy (CCRT). Methods:From September 2015 to October 2021, the clinical data of 180 LACC patients (age: 22-76 years) who underwent 18F-FDG PET/CT before CCRT at Affiliated Cancer Hospital of Shandong First Medical University were analyzed retrospectively. The metabolic tumor volume (MTV), total lesion glycolysis (TLG), SUV max, and SUV mean were computed by using the margin threshold of 42%SUV max. The optimal threshold for predicting progression-free survival (PFS) was obtained by ROC curve analysis. The Kaplan-Meier method was applied for survival analysis, and the log-rank test was applied to compare the survival rate between groups. Multivariate Cox proportional hazard regression was used to analyze progression for PFS. Results:The median follow-up was 19.1 months, and 54 patients (30.0%, 54/180) suffered from disease progression. ROC curve analysis showed that the optimal cut-off value of MTV was 31.145 ml, with the AUC of 0.641. Para-aortic lymph node (PALN) metastasis had the highest AUC value (0.589) among the clinical factors, followed by International Federation of Gynecology and Obstetrics (FIGO) stage (0.581). The 1-year PFS rates of patients with MTV<31.145 ml ( n=88) and MTV≥31.145 ml ( n=92) were 80.68% and 59.78%, respectively ( χ2=13.72, P<0.001). Multivariate Cox analysis demonstrated that pathological type (hazard ratio ( HR)=3.075, 95% CI: 1.370-6.901, P=0.006), FIGO stage ( HR=1.955, 95% CI: 1.031-3.707, P=0.040), PALN metastasis ( HR=2.136, 95% CI: 1.202-3.796, P=0.010) and MTV ( HR=2.449, 95% CI: 1.341-4.471, P=0.004) were the significant predictors for PFS. Conclusions:Pathological type, FIGO stage, PALN metastasis and MTV are independent prognostic risk factors for PFS. MTV as the baseline 18F-FDG PET/CT metabolic parameter, can realize prognostic stratification analysis.
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Objective:To explore the Epstein-Barr virus (EBV) latent infection membrane protein (LMP) 1 or LMP2 specific T cell immune response and clinical significance in stage III-IVa nasopharyngeal carcinoma (NPC), aiming to provide ideas and evidence for immunotherapy in NPC.Methods:Fifty-nine NPC patients admitted to the Affiliated Tumor Hospital of Xinjiang Medical University from February 2018 to October 2020 for primary treatment were collected. Peripheral blood monocytes (PBMCs) were stimulated by LMP antigen. Intracellular cytokine staining and flow cytometry were applied to study the expression levels of IL-2, IL-13, interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) from CD4 + T and CD8 + T cells, and then analyzed in conjunction with clinical factors. Results:The positive rates of total PBMCs to LMP1 and LMP2 in NPC patients were different. The positive rate of LMP1 specific CD4 + T cells was statistically higher in stage T 3-T 4 NPC than that in stage T 1-T 2 (51.0% vs. 10.0%, P=0.042). There were also differences in the expression of cytokines between LMP1 and LMP2, CD4 +T cells and CD8 +T cells. Survival analysis showed the 2-year and 3-year overall survival (OS) rates were 91.5% and 88.2%, and the 2-year and 3-year progression-free survival (PFS) rates were 83.3% and 75.3%. Univariate analysis suggested that smoking history, male and LMP1 stimulated IL-13 positive expression in CD4 + T cells affected the disease progression ( P=0.026, 0.045 and 0.006); multivariate analysis showed LMP1 stimulated IL-13 positive expression in CD4 + T cells and smoking history were the independent prognostic factors affecting PFS ( P=0.017, 0.019). Conclusions:LMP1 and LMP2 generate specific T-cell immune response in PBMCs of NPC patients, with differential expression in two T-cell subsets. LMP1 and LMP2 specific T cell immune response is associated with primary tumor size and metastatic lymph node volume. LMP1 stimulated IL-13 positive expression in CD4 + T cells and smoking history affects the disease progression.
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Objective:To construct machine learning models based on CT imaging and clinical parameters for predicting progression-free survival (PFS) of locally advanced cervical cancer (LACC) patients after concurrent chemoradiotherapy (CCRT).Methods:Clinical data of 167 LACC patients treated with CCRT at Shandong Cancer Hospital from September 2015 to October 2021 were retrospectively analyzed. All patients were randomly divided into the training and validation cohorts according to the ratio of 7 vs. 3. Clinical features were selected by univariate and multivariate Cox proportional hazards model ( P<0.1). Radiomics models and nomograms were constructed by radiomics features which were selected by least absolute shrinkage and selection operator (LASSO) Cox regression model to predict the 1-, 3- and 5-year PFS. Combined models and nomogram models were developed by selected clinical and radiomics features. The Kaplan Meier-curve, receiver operating characteristic (ROC) curve, C-index and calibration curve were used to evaluate the model performance. Results:A total of 1 409 radiomics features were extracted based on the region of interest (ROI) in CT images. CT radiomics models showed better performance for predicting 1-, 3-and 5-year PFS than the clinical model in the training and validation cohorts. The combined model displayed the optimal performance in predicting 1-, 3-and 5-year PFS in the training cohort [area under the curve (AUC): 0.760, 0.648, 0.661, C-index: 0.740, 0.667, 0.709] and verification cohort (AUC: 0.763, 0.677, 0.648, C-index: 0.748, 0.668, 0.678).Conclusions:Combined model constructed based on CT radiomics and clinical features yield better prediction performance than that based on radiomics or clinical features alone. As an objective image analysis approach, it possesses high prediction efficiency for PFS of LACC patients after CCRT, which can provide reference for clinical decision-making.
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Primary lung cancer is the first malignant tumor in our country and in the world with an increasing mortality trend, which seriously endangers the human health. By digging the deep relationship between high-dimensional imaging features and pathophysiological features, radiomics can establish a predictive model to distinguish pathological types, tumor stages, distant metastases and survival, guide individualized diagnosis and treatment strategies, and improve prognosis. PET/CT has higher diagnostic accuracy and specificity by reflecting tumor tissue metabolism. This article reviews the application of PET/CT radiomics in the treatment of non-small-cell lung cancer (NSCLC).
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Objective:To analyze the prognostic factors of patients with locally advanced nasopharyngeal carcinoma after treatment, to develop and validate the prognostic Nomogram model.Methods:From July 2010 to June 2017, 317 patients with nasopharyngeal carcinoma who were treated with definitive intensity modulated radiation therapy were selected. The regression method of least absolute shrinkage and selection operator (LASSO) was used for univariate screening, and Cox multivariate regression analysis was performed. The prognostic Nomogram model was constructed for locally advanced nasopharyngeal carcinoma patients. C-index, calibration curve, Net Reclassification Index (NRI), integrated discrimination improvement (IDI) were used to validate and evaluate the model between Nomogram and TNM staging system. The risk evaluated through nomogram was stratified by decision tree algorithm, and the survival rate was calculated by Kaplan-Meier method and compared by Log-rank test.Results:T stage, N stage, LDH, GTVnd and pre-treated plasma EBV-DNA copy (EBV-DNA) were correlated with total survival (OS). All the above factors were included in prognostic Nomogram model, and C-index was 0.784 (95% CI: 0.736-0.831, P<0.01). The calibration curve showed that the OS probability predicted by Nomogram model was in good agreement with the actual OS, and the result were verified in the validation cohort. Furthermore, the accuracy of the Nomogram model for OS predicting was superior to AJCC 8 th version staging system judged by NRI and IDI. According to the Nomogram score, patients can be divided into four subgroups with different risk by decision tree algorithm. K-M survival curve showed that the difference of OS between different groups was statistically significant ( χ2=113.21, P<0.01), and patients in high-risk group can benefit from induction chemotherapy combined with concurrent chemoradiotherapy in survival. Conclusions:The Nomogram model established by our research group can provide information on diagnosis, treatment and prognosis evaluation for locally advanced nasopharyngeal carcinoma patients in this area.
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Objective:To investigate the prognostic value of absolute lymphocyte count (ALC) and neutrophil-lymphocyte ratio (NLR), macrophage-lymphocyte ratio (MLR) and platelet-lymphocyte ratio (PLR) before treatment in patients with locally advanced cervical cancer (LACC).Methods:A total of 175 patients newly-diagnosed with LACC admitted to Cancer Hospital affiliated to Xinjiang Medical University from August 2016 to October 2019 were enrolled in this study. Complete clinical data and ALC before treatment were recorded and NLR, MLR and PLR were calculated. Multivariate Cox′s proportional hazard regression model was used to analyze the prognostic factors of patients with LACC.Results:The progress-free survival (PFS) of LACC patients in the NLR reduction group (<3.34) and MLR reduction group (<0.315) were significantly higher than those in the NLR and MLR elevation groups (both P<0.05). The overall survival (OS) of LACC patients in the ALC elevation group (≥1.375 × 10 9/L) and the PLR reduction group (<160.575) were significantly higher compared with those in the ALC reduction group and PLR elevation group (both P<0.05). Univariate analysis showed that EQD 2Gy, the equivalent dose of HR-CTV, was an important prognostic factor of PFS in patients with LACC ( P=0.030). Multivariate Cox′s regression analysis demonstrated that FIGO staging ( HR=2.339, 95% CI 1.22-4.48, P=0.010) and concurrent chemoradiotherapy ( HR=0.213, 95% CI 0.11-0.43, P<0.001) were the independent predicators of PFS in patients with LACC. However, concurrent chemoradiotherapy ( HR=0.229, 95% CI 0.07-0.81, P=0.023) and MLR ( HR=4.933, 95% CI 1.39-17.54, P=0.014) before treatment were the independent predictors of OS in patients with LACC. Conclusions:Patients with locally advanced cervical cancer can benefit from concurrent chemoradiotherapy. HR-CTV EQD 2Gy is a critical prognostic factor of PFS in patients with LACC. The increase of MLR before treatment is an independent prognostic factor of OS in LACC patients.
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Objective:To investigate the relationship between human papilloma virus (HPV)16 E6/7-specific T cell immune response in the periphral blood and clinical features and prognosis of patients with cervical squamous cell carcinoma (CSCC).Methods:Seventy-two patients pathologically diagnosed with CSCC admitted to Affiliated Tumor Hospital of Xinjiang Medical University from June 2013 to October 2015, and 75 healthy controls were enrolled in this study. The special responses of peripheral blood T cells to E6 and E7 overlapping peptides before treatment were detected by enzyme-linked immunosorbent assay (ELISA). The differences of frequency and intensity expression of specific immune responses between two groups were analyzed by chi-square χ2 test and nonparametric test. The correlation between antigen-specific immune response and T cell subsets was analyzed by Spearman test. Log-rank test and Cox’s regression model were employed for univariate and multivariate prognostic analyses. Results:The frequencies of HPV16 E6-ad E7-specific T cell responses in CSCC patients were significantly higher than those in healthy controls (51.39% vs. 29.33%, P=0.006 and 45.83% vs.25.33%, P=0.009), and the mean intensities were also considerably higher than those in healthy controls (20.00 SFC/10 6vs.10.76 SFC/10 6, P<0.001 and 16.17 SFC/10 6vs.10.72 SFC/10 6, P=0.017). The intensity of HPV16 E6-specific T cell immune response was positively correlated with the CD 4+/CD 8+ ratio in the peripheral blood of CSCC patients ( r=0.279, P=0.018). And a strong correlation was noted between E7-specific T cell immune response intensity and increasing proportion of NK+ cells ( r=0.274, P=0.020). Univariate and multivariate analyses showed that therapeutic mode (radiotherapy vs. concurrent chemoradiotherapy, HR=2.918, 95% CI 1.454-5.854, P=0.003) and E6-specific T cell response (response group vs. no response group, HR=0.491, 95% CI 0.243-0.99, P=0.047) were the independent prognostic factors influencing the clinical prognosis. The 5-year overall survival in patients with HPV16 E6-specific T cell responses was significantly higher than that in the no response group (64% vs.41%, P=0.041). Conclusions:The intensity of HPV16 E6-specific T cell immune response is positively correlated with the CD 4+/CD 8+ ratio. No HPV16 E6-specific T cell response and radiotherapy alone are more likely to cause poor prognosis of CSCC patients.
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Objective:To investigate the application of radiotherapy and the basic situation of teaching and scientific research in Xinjiang.Methods:A unified questionnaire was adopted, distributed and collected by mail, instant messaging software and telephone. The basic situation of all radiotherapy affiliations in the whole region was counted.Results:The questionnaire coverage rate was 100% with a recovery rate of 100%. In 2020, 17 affiliations operated radiotherapy in Xinjiang, including 23 linear accelerators, 1 cobalt-60 therapeutic machine, 3 gamma knives, 6 post-installed therapeutic machines, 13 special analogue positioning machines, 46 treatment planning systems, and 103 sets of radiotherapy quality control equipment. It was estimated that the number of radiotherapy equipment for one million people in the whole region was approximately 0.84. In Xinjiang, 359 radiotherapy personnel were registered, including 220 physicians, 49 physicists and 90 technicians. A total of 1 270 beds were available, with an average daily treatment volume of approximately 1 255 person-times. From 2016 to 2021, 17 affiliations have undertaken 9 National Natural Science Foundation of China and 49 provincial and ministerial projects. Nineteen doctoral degrees and 87 master′s degrees were accredited. These affiliations participated in the publication of 25 articles in Chinese Journal of Radiation Oncology, of which 18 were published as the first authors and/or corresponding authors.Conclusions:The radiotherapy work in Xinjiang has developed rapidly in recent years, but there is still a certain gap with the national average level. At the same time, several problems still exist in the whole region, such as regional differences, unbalanced allocation of radiotherapy resources and scientific research and teaching resources, which need further improvement.
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Objective:To observe the relationship between peripheral blood T cell subsets and clinical characteristics and prognosis of Uygur women with advanced cervical squamous cell carcinoma in Xinjiang.Methods:A total of 185 patients pathologically diagnosed with stage Ⅱ B-IVA cervical squamous cell carcinoma admitted to Cancer Hospital Affiliated to Xinjiang Medical University from January 2015 to December 2018 were selected. The relationship between T cell subsets in peripheral venous blood and clinical characteristics and prognosis was analyzed. Results:CD 4+ T cells, CD 8+ T cells and CD 4+/CD 8+ T cell ratio were significantly correlated with clinical stage, tumor diameter and body mass index (BMI)(all P<0.05). The later Federation International Association of Gynecology and Obstetrics (FIGO) tumor stage, the larger the tumor diameter, the higher the BMI, and the higher the CD 8+ T cells and the lower the CD 4+ T cell and CD 4+/CD 8+ T cell ratio. The count of CD 4+ T cells was decreased in patients with lymph node metastasis. Cox’s univariate analysis showed that FIGO stage, age, lymph node metastasis, tumor diameter, BMI, CD 4+ T cells, CD 8+ T cells, CD 4+/CD 8+ T cell ratio and treatment methods were the important factors affecting the overall survival (OS). Multivariate analysis showed that BMI, treatment method, CD 4+ T cells and tumor diameter were the independent prognostic factors affecting OS (all P<0.05). Conclusions:The level of T cell subsets in peripheral blood of Uygur cervical cancer patients is out of balance. CD 4+ T cells, CD 8+ T cells and CD 4+/CD 8+ T cell ratio are associated with FIGO stage, tumor diameter and BMI, and CD 4+ T cells are correlated with lymph node metastasis. BMI, treatment method, tumor diameter and CD 4+ T cell are the independent prognostic factors affecting the OS of patients with cervical cancer.
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Objective To investigate the effect of cisplatin combined with X-ray irradiation on the proliferation of human esophageal squamous cell cancer Eca109 cells and its mechanism. Methods Methyl thiazolyl tetrazolium (MTT) method was used to determine 10％ inhibitory concentration (IC10) and half inhibitory concentration (IC50) of Eca109 cells after 24 h treated with cisplatin in cisplatin group. Then the irradiation group was treated by 4 Gy 6 MV-X ray, cisplatin combined with X-ray irradiation group was treated with 4 Gy 6 MV-X ray irradiation, and IC10 or IC50 cisplatin treatment. After 24 h, 36 h and 48 h of culture, MTT method was used to detect the cell growth and inhibition in each group. Flow cytometry was used to detect cell cycle and apoptosis in each group. Results After 24 h for cisplatin treatment, IC10 and IC50 of Eca109 cells was 0.894 μg/ml and 8.654 μg/ml. After 24 h, 36 h and 48 h of culture, the inhibition rates of 4 Gy+IC10 group were (26.1 ±1.2)％, (56.4 ±4.0)％ and (75.1 ±3.2)％, respectively, and 4 Gy+IC50 group were (55.4±5.9)％, (84.7±3.1)％and (93.8±5.1)％, respectively, and irradiation group were (5.1±2.6)％, (12.2±1.3)％and (37.9±5.3)％, respectively. With the prolonged culture time, the inhibition rates of the three groups were increased gradually, and the differences were statistically significant (all P< 0.01); the inhibition rate of cisplatin combined with X-ray irradiation group was higher than that of irradiation group, and the differences were statistically significant (all P< 0.01). After 48 h of culture, the proportion of G2/M phase cells in the blank control group, irradiation group, 4 Gy+IC10 group, and 4 Gy+IC50 group was increased to (3.0 ±1.5)％, (10.4±0.8)％, (24.8±3.1)％ and (38.9±1.2)％, and the differences were statistically significant (F= 224.3, P<0.001); the proportion of S phase cells in 4 Gy+IC10 group and 4 Gy+IC50 group was (23.4±7.7)％ and (23.2± 5.2)％ respectively, which were lower than that in the blank control group [(44.5 ±2.0)％], and the differences were statistically significant (all P< 0.05). The apoptosis rate of 4 Gy+IC10 group and 4 Gy+IC50 group was (14.0±4.2)％ and (17.9±3.0)％, respectively, which was higher than that of the blank control group [(4.6± 1.8)％], and the differences were statistically significant (all P< 0.05); the apoptosis rate of 4 Gy+IC50 group was also higher than that of irradiation group [(7.1±0.9)％], and the difference was statistically significant (P=0.001). Conclusions Cisplatin combined with X-ray irradiation can significantly inhibit the proliferation of human esophageal squamous cell cancer Eca109 cells in a dose and time-dependent manner. The main mechanism may be related with the fact that low-dose or high-dose cisplatin and X-ray irradiation makes the Eca109 cells arrest at G2/M phase, so that the sensitivity of cells to irradiation can be increased.
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Objective To evaluate the impact of simultaneous integrated boost ( SIB) with different radiotherapy plans on the dosimetry of the target volume and organs at risk ( OAR) in patients with multiple brain metastases ( MBM ) , and to provide a basis for the selection of an optimal clinical radiotherapy. Methods Ten patients with MBM who were treated with whole-brain SIB radiotherapy were randomly selected in this analysis. The local imaging data from the enrolled patients were re-planned with dynamic intensity-modulated radiotherapy ( dynamic IMRT ) , dual-arc volumetric modulated arc therapy ( dual-arc VMAT) , and hybrid-IMRT ( h-IMRT) . h-IMRT plan was created by inversely optimizing 3 and 4 fixed fields of IMRT based on conformal radiotherapy. Two-tailed Wilcoxon matched pairs signed rank sum test was performed to analyze the differences between the three radiotherapy plans in the conformity index ( CI) and homogeneity index (HI) of the planning target volumes (PTV), Dmean and Dmax of OAR, monitor units ( MU) , and delivery time. Results CI of PTVs with VMAT plan was better than that with IMRT and h-IMRT plans (P=004,000), and no significant difference in HI was observed between the three plans( P>005) . There were no significant differences in CI and HI between 3 and 4 fields in dynamic IMRT ( P>005 ) . h-IMRT 3-and 4-field plans had significantly reduced doses to the eye lens and eyeballs than dynamic IMRT and VMAT plans (all P=000), and the three plans had similar doses to the brainstem and optic nerve ( P>005) . As for the MHs and delivery time, dynamic IMRT and VMAT plans showed the highest and lowest value, respectively ( all P= 000 ) . Conclusions All the three plans meet the clinical requirements. VMAT shows the highest treatment efficiency. H-IMRT protects the eye lens and eyeballs more effectively while maintaining the doses to the PTV, with reduced MU compared with IMRT. These offer a reference for designing the radiotherapy plan in MBM patients.
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Objective To measure the expression levels of PD-1 and PD-L1 in the tumor tissues of patients with nasopharyngeal carcinoma ( NPC) and to explore the association of their expression with the clinical characteristics and prognosis of NPC patients. Methods The expression levels of PD-1 and PD-L1 in 65 NPC patients were determined by immunohistochemistry, and an analysis was performed on the association of their expression with clinical characteristics and long-term survival in NPC patients. Comparisons between groups were made by the chi-square test or Fisher′s exact test, and the Pearson' s test was used for correlation analysis. Survival rates were calculated using the Kaplan-Meier method, and the log-rank test was used for survival comparison and univariate prognostic analysis. The Cox model was used for multivariate prognostic analysis. Results Expression of PD-1 and PD-L1 was observed in 88%(57/65) and 89%( 58/65) of tumor cell surfaces using a cut-off value of 5%, and 38%( 25/65) and 58%( 38/65) using a cut-off value of 10%. PD-1 expression was significantly correlated with PD-L1 expression using the cut-off value of 5%( P=0003) , and a non-significant correlation was found between the expression levels of PD-1 and PD-L1 using the cut-off value of 10%(P=0080). There was no significant association between the positive expression rates of PD-1 and PD-L1 and clinicopathological characteristics ( P>005 ) . The univariate and multivariate survival analyses showed that using the cut-off value of 10%, the patients with positive PD-L1 expression had significantly reduced progression-free survival ( hazard ratio [ HR]=273, 95% confidence interval [ CI]:107-697, P=0035 ) and overall survival ( HR=395, 95%CI:109-1427, P=0036) compared with those with negative PD-L1 expression. Conclusions PD-1 and PD-L1 are highly expressed in NPC tissues. The expression of PD-L1 is associated with the poor prognosis in patients with stage IVa NPC, and PD-L1 can better predict the poor prognosis using the cut-off value of 10%.
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Objective To evaluate the impact of simultaneous integrated boost ( SIB) with different radiotherapy plans on the dosimetry of the target volume and organs at risk ( OAR) in patients with multiple brain metastases ( MBM ) , and to provide a basis for the selection of an optimal clinical radiotherapy. Methods Ten patients with MBM who were treated with whole-brain SIB radiotherapy were randomly selected in this analysis. The local imaging data from the enrolled patients were re-planned with dynamic intensity-modulated radiotherapy ( dynamic IMRT ) , dual-arc volumetric modulated arc therapy ( dual-arc VMAT) , and hybrid-IMRT ( h-IMRT) . h-IMRT plan was created by inversely optimizing 3 and 4 fixed fields of IMRT based on conformal radiotherapy. Two-tailed Wilcoxon matched pairs signed rank sum test was performed to analyze the differences between the three radiotherapy plans in the conformity index ( CI) and homogeneity index (HI) of the planning target volumes (PTV), Dmean and Dmax of OAR, monitor units ( MU) , and delivery time. Results CI of PTVs with VMAT plan was better than that with IMRT and h-IMRT plans (P=004,000), and no significant difference in HI was observed between the three plans( P>005) . There were no significant differences in CI and HI between 3 and 4 fields in dynamic IMRT ( P>005 ) . h-IMRT 3-and 4-field plans had significantly reduced doses to the eye lens and eyeballs than dynamic IMRT and VMAT plans (all P=000), and the three plans had similar doses to the brainstem and optic nerve ( P>005) . As for the MHs and delivery time, dynamic IMRT and VMAT plans showed the highest and lowest value, respectively ( all P= 000 ) . Conclusions All the three plans meet the clinical requirements. VMAT shows the highest treatment efficiency. H-IMRT protects the eye lens and eyeballs more effectively while maintaining the doses to the PTV, with reduced MU compared with IMRT. These offer a reference for designing the radiotherapy plan in MBM patients.
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Objective To measure the expression levels of PD-1 and PD-L1 in the tumor tissues of patients with nasopharyngeal carcinoma ( NPC) and to explore the association of their expression with the clinical characteristics and prognosis of NPC patients. Methods The expression levels of PD-1 and PD-L1 in 65 NPC patients were determined by immunohistochemistry, and an analysis was performed on the association of their expression with clinical characteristics and long-term survival in NPC patients. Comparisons between groups were made by the chi-square test or Fisher′s exact test, and the Pearson' s test was used for correlation analysis. Survival rates were calculated using the Kaplan-Meier method, and the log-rank test was used for survival comparison and univariate prognostic analysis. The Cox model was used for multivariate prognostic analysis. Results Expression of PD-1 and PD-L1 was observed in 88%(57/65) and 89%( 58/65) of tumor cell surfaces using a cut-off value of 5%, and 38%( 25/65) and 58%( 38/65) using a cut-off value of 10%. PD-1 expression was significantly correlated with PD-L1 expression using the cut-off value of 5%( P=0003) , and a non-significant correlation was found between the expression levels of PD-1 and PD-L1 using the cut-off value of 10%(P=0080). There was no significant association between the positive expression rates of PD-1 and PD-L1 and clinicopathological characteristics ( P>005 ) . The univariate and multivariate survival analyses showed that using the cut-off value of 10%, the patients with positive PD-L1 expression had significantly reduced progression-free survival ( hazard ratio [ HR]=273, 95% confidence interval [ CI]:107-697, P=0035 ) and overall survival ( HR=395, 95%CI:109-1427, P=0036) compared with those with negative PD-L1 expression. Conclusions PD-1 and PD-L1 are highly expressed in NPC tissues. The expression of PD-L1 is associated with the poor prognosis in patients with stage IVa NPC, and PD-L1 can better predict the poor prognosis using the cut-off value of 10%.
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Objective To investigate the feasibility of defining the radiotherapy target of primary liver cancer using four-dimensional computed tomography (4DCT) and T2-weighted magnetic resonance (MR-T2) deformable image registration.Methods Ten patients with hepatocellular carcinoma (HCC) who first received radiotherapy were included in this study.The 4DCT in free breathing and MR-T2 in deep breathing were acquired sequentially.4DCT were sorted into ten series of CT images according to the respiratory phase.MIM software was used for deformable image registration.The accuracy of deformable image registration was assessed by the maximal displacements in three-dimensional directions of the portal vein and the celiac trunk and the degree of liver overlapping (P-LIVER).Gross tumor volume (GTV) was delineated on different series of CT images and the internal GTV (IGTV) was merged by ten GTVs on 4DCT images in each phase.The MR-T2 image was deformably registered to 4DCT images in each phase to acquire ten GTVDR.The IGTVDRwas obtained by merging the ten GTVDR.The differences between different target volumes were compared by paired t-test.Results The maximal displacements in three-dimensional directions of the portal vein were 0.3±0.8 mm along the x-axis, 0.8±1.8 mm along the y-axis, and 0.5±1.5 mm along the z-axis.The maximal displacements in three-dimensional directions of the celiac trunk were 0.1±1.0 mm along the x-axis, 0.7±1.2 mm along the y-axis, and 0.6±2.0 mm along the z-axis.Overlapping degree was 115.4±13.8%.The volumes of GTVs obtained from 4DCT images in each phase after DR increased by an average of 8.18%(P<0.05), and were consistent with those delineated on MR-T2 images.The IGTV after DR increased by an average of 9.67%(P<0.05).Conclusions MRI image can show more information and have a higher contrast than CT image.MRI images should be combined with 4DCT images for delineating the GTV.It can better determine the scope and trajectory of the target and improve the delineation accuracy of HCC target.
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Objective To compare the differences of cytokines IFN‐γ,IL‐2 ,IL‐4 ,IL‐6 ,IL‐10 ,IL‐13 and IL‐17 expression lev‐els mainly secreted by peripheral blood Th1 ,Th2 and Th17 cells and to investigate the correlation between the cytokines in the Han and Uyghur cervical cancer patients with the clinical stage and tumor differentiation degree .Methods The blood samples in 66 ca‐ses of pathologically diagnosed cervical cancer (Han in 22 cases ,Uyghur in 44 cases) before treatment in our hospital were collect‐ed .The concentrations of IFN‐γ,IL‐2 ,IL‐4 ,IL‐6 ,IL‐10 ,IL‐13 and IL‐17 were measured by using Luminex assay ,then the differ‐ences of cytokines were compared between Han and Uyghur patients;according to the clinical stage and tumor differentiation de‐gree ,the grouping was performed ,then the differences of cytokines in different subgroups were compared between Han and Uyghur cervical cancer patients .Results The levels of IFN‐γ,IL‐2 ,IL‐4 ,IL‐6 ,IL‐10 ,IL‐13 and IL‐17 in the Uyghur cervical cancer group were higher than those in the Han cervical cancer group(P<0 .05);the levels of IL‐2 ,IL‐4 and IL‐10 secreted by Th cells in the stage Ⅰ - Ⅱ Uyghur cervical cancer group were higher than those in the stage Ⅰ - Ⅱ Han cervical cancer group(P<0 .05);the levels of IFN‐γ ,IL‐2 ,IL‐4 ,IL‐6 ,IL‐10 ,IL‐13 and IL‐17secreted by Th cells in the stage Ⅲ - Ⅳ Uyghur cervical cancer group were higher than those in the stage Ⅲ - Ⅳ Han cervical cancer group(P<0 .05);the levels of IFN‐γ,IL‐2 ,IL‐4 ,IL‐6 ,IL‐10 ,IL‐13 and IL‐17 secreted by Th cells in middle to high differentiation Uyghur cervical cancer group were higher than those in middle to high differentiation Han cervical cancer group(P<0 .05) .Conclusion In the HPV16‐positive cervical cancer patients ,the concentrations of cytokines secreted by Th cells are different between Uyghur group and Han group ,these differences are more significant in the stage Ⅲ - Ⅳ cervical cancer and in middle to high differentiated cervical cancer .
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Objective To investigate the correlation of platelets-to-lymphocyte ratio (PLR) with neutrophil-to-lymphocyte ratio (NLR) from pretreatment in the Xinjiang Uygur patients with nasopharyngeal carcinoma.Methods In this retrospective analysis,96 cases of nasopharyngeal carcinoma patients with pathologically diagnosis were collected.Receiver operating characteristic (ROC) curve analysis suggested that optimum PLR and NLR cut-off point for nasopharyngeal carcinoma.The patients were divided into high-PLR and low-PLR groups,high-NLR and low-NLR groups,respectively.The survival rate was calculated with Kaplan-Meier method.The Log rank statistics was used to test differences between groups.The prognostic factors that may affect patients with nasopharyngeal carcinoma in Uighur population of Xinjiang were analyzed by COX proportional hazards models.Results For high-PLR and low-PLR groups,5-year overall survival,and progression-free survival were 46.6％ and 79.3％,49.8％ and 82.7％,respectively;the difference was statistically significant (all P ＜ 0.01).For high-NLR and low-NLR groups,5-year overall survival rate,and progression-free survival rate were 41.3％ and 41.3％,50.8％ and 82.5％,respectively;the difference was statistically significant (all P ＜ 0.01).Univariate analysis showed that N stage,clinical stage,NLR,and PLR had significantly impact on overall survival and progression-free survival (all P ＜ 0.05);multivariate analysis showed that PLR and clinical stage had statistical significance in Uighur patients with nasopharyngeal carcinoma for progression-free survival and overall survival (all P ＜ 0.05).Conclusions PLR may be independent factor that influences the prognosis of patients with nasopharyngeal carcinoma in Uighur population of Xinjiang.
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Objective To explore the relationship between HLA?B allele polymorphisms and nasopharyngeal carcinoma ( NPC) in Xinjiang, China and its clinical significance. Methods A total of 226 patients were assigned to NPC group, while 207 healthy volunteers were assigned to control group. PCR amplification with sequence?specific primers was used to determine HLA?B alleles. Comparison of HLA?B allele frequency between the above two groups, between Han and Uygur populations, and between patients with various clinical characteristics of NPC was made by chi?square test. The Kaplan?Meier method was used to calculate the survival rates and the log?rank univariate analysis was used to explore the relationship between survival rates and HLA?B allele frequency. Results In all the subjects or Han population alone, the allele frequency of HLA?B?46 in the NPC group was significantly higher than that in the control group ( P=0. 000;P=0. 000 ) . In Uygur population, however, there was no significant difference in the allele frequency of HLA?B?46 between the NPC group and the control group (P>0. 05). In the patients with NPC, those less than 30 years old had a significantly higher allele frequency of HLA?B?44 than those no less than 30 years old (P=0. 029);those with differentiated non?keratinizing carcinoma had a significantly higher allele frequency of HLA?B?48 than those with undifferentiated non?keratinizing carcinoma ( P=0. 029);those with stage T1+T2 disease had a significantly higher allele frequency of HLA?B?48 than those with stage T3+T4 disease ( P=0. 029) . The 5?year overall survival, disease?free survival, distant metastasis?free survival, and local relapse?free survival rates had no relationship with the expression of HLA?B?46, HLA?B?44, or HLA?B?48 in NPC patients ( all P>0. 05) . Conclusions HLA?B?46 allele is probably a NPC susceptibility gene in Han population in Xinjiang. HLA?B?44 is probably associated with early age of onset, while HLA?B?48 is probably associated with the pathological type and T stage of NPC. Therefore, HLA?B alleles are probably associated with the development and progression of NPC.
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Objective To investigate the development status of tumor radiotherapy in the Xinjiang Uygur Autonomous Region.Methods A questionnaire survey we used last time was conducted by letter,Email,telephone or fax to investigate all the medical institutions in the Xinjiang Uygur Autonomous Region for researching the current status of radiotherapy academic settings,human resources,allocation of radiotherapy facilities and standardization of medical practices.Results Up to the end of January 2015,there were 30 medical electron linear accelerators,21 simulated locators,10 breach-loading brachytherapy machines,31 treatment planning systems and 5γ or X knives in Xinjiang.Radiotherapy was carried out in 20 medical institutions,including 14 three-dimensional conformal radiotherapy and 9 intensity modulated radiation therapy,8 breach-loading brachytherapy,3 stereotactic radiotherapy,and 2 volumetric modulated arc therapy.There were 280 radiation personnel (except nurses),including 159 radiation oncologists,40 radiotherapy physicists and 81 radiotherapy technologists.There were 1167 hospital beds and 855 cancer patients received radiotherapy on average every day.Conclusions Although radiation personnel has increased,radiotherapy facilities have been improved,hospital beds and patients received radiotherapy also have become more,the improvements are needed for cause of imbalance in precise radiation therapy development.
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Objective To investigate the relationship between the expression level of HOTAIR and cellular radiosensitivity in esophageal squamous cell carcinoma (ESCC). Methods Four ESCC cell lines ( K150, K450, TE-1, and Eca109 ) were used in this study. Quantitative real-time polymerase chain reaction was applied to measure the expression level of HOTAIR in the above cell lines;colony-forming assay was applied to measure the survival fraction of different cells irradiated by different doses of X-ray. The t-test or analysis of variance was applied for analysis of differences. The correlation analysis was used by Pearson methods. Results The four cell lines all showed high expression levels of HOTAIR and radioresistance. Compared with the other three cell lines, Eca109 had a lower expression level of HOTAIR, a lower survival fraction at each radiation dose point, and significantly lower D0 and Dq . The mRNA expression level of HOTAIR and radiosensitivity were K150