摘要
Objective To investigate the selection of treatment strategies and prognostic factors for patients with stage T3 and T4 laryngeal carcinoma. Methods A total of 132 patients with stage T3 and T4 laryngeal cancer admitted to our hospital from March 2010 to March 2019 were retrospectively selected as research objects. According to the different treatment strategies, the patients were divided into simple surgery group (group A, 57 cases), simple chemoradiotherapy group (group B, 32 cases), and surgery combined with chemoradiotherapy group (group C, 43 cases). The general data and clinicopathological features of the three groups were compared, and a survival curve was drawn by the Kaplan–Meier method. The 3-year survival rates of the three groups were compared. Then, the same 132 patients were divided into survival and death groups. The clinical data of the two groups were compared, and the prognostic factors were analyzed by multivariate logistic regression. A back propagation (BP) neural network model was constructed, and its differentiation and accuracy were evaluated. Results The proportions and 3 year survival rates of patients with poor differentiation, lymphatic vascular invasion, and involvement of lymph nodes outside the capsule in group C were significantly higher than those in groups A and B (P < 0.05). The 3 year survival rate of 132 patients was 68.94%(41/132). Poor differentiation, N2-N3 stage, lymphatic vascular invasion, and involvement of lymph nodes outside the capsule were risk factors for death (P < 0.05), whereas surgery combined with radiotherapy and chemotherapy were protective factors (P < 0.05). The BP neural network model exhibited good discrimination and high accuracy. Conclusion Surgery combined with radiotherapy and chemotherapy can significantly improve survival rate in patients with poor differentiation, lymphatic vascular invasion, and involvement of lymph nodes outside the capsule. Close attention should be paid to patients with stage N2-N3 in the formulation of reasonable treatment strategies.
摘要
Objective: To develop an oral live vaccine vector which stably carries exogenous genes.Methods:SL1344ΔsipBΔasd host-vector balanced lethal system was constructed by the method of recombinant suicide plasmid-mediated allelic exchange on the basis of attenuated Salmonella typhinurium SL1344ΔsipB.Then,the biological characteristics of SL1344ΔsipBΔasd was analyzed.Results:The results showed that the mutant was stabile with the Δasd gene in vitro;the serotype and growth rate of SL1344ΔsipBΔasd strain was almost same as the parent SL1344ΔsipB and SL1344 strain.And the mutant strains remain swim ming zones.Virulence test in mice showed that the virulence of SL1344ΔsipBΔasd which carried complementary plasmid pYA3493 by electro-transformation decreased by 1.4%compared with SL1344.Conclusion: These results showed that the SL1344ΔsipBΔasd mutant was successfully constructed.It is likely that this mutant should be used as a live vector to express foreign genes.
摘要
In order to develop a recombinant attenuated Salmonella typhimurium as oral live vaccine vector, we constructed recombinant plasmid pYA-sopENt100 by replacing the trc promoter with the sopE promoter and secretion signal sequence sopENt100 of Salmonella typhimurium on the basis of plasmid pYA3493. Then, the complementary plasmid pYA-sopENt100 was transformed into ΔcrpΔasdSL1344 by electroporation to generate attenuated Salmonella typhimurium type III secretion system ΔcrpΔasdSL1344 (pYA-sopENt100). We further characterized ΔcrpΔasdSL1344 (pYA-sopENt100). We also constructed a recombinant strain ΔcrpΔasdSL1344 (pYA-sopENt100-egfp) that harbored the reporter gene-enhanced green fluorescent protein (egfp) gene. Vero cells were infected with ΔcrpΔasdSL1344 (pYA-sopENt100-egfp) and the ability of delivery foreign antigens was tested via Western blotting analysis. The results of PCR, enzyme digestion and sequencing showed that the ΔcrpΔasdSL1344 (pYA-sopENt100) type III secretion system was constructed successfully. The serotype of ΔcrpΔasdSL1344 (pYA-sopENt100) was identical to ΔcrpΔasdSL1344 and SL1344. Compared with wild strain SL1344, the biochemical characteristics of ΔcrpΔasdSL1344 (pYA-sopENt100) had obvious change, but it was basically the same with ΔcrpΔasdSL1344. The growth speed was much slower than that of the wild strain SL1344. The chicken virulence test (LD₅₀) showed that the virulence of ΔcrpΔasdSL1344 (pYA-sopENt100) was 7×10⁴ times lower than SL1344. In addition, we observed the 37 kDa SopENt100-egfp protein in the cultured supernatant of ΔcrpΔasdSL1344 (pYA-sopENt100-egfp) strain by Western blotting analysis. However, both the 37 kDa SopENt100-egfp protein and 27 kDa EGFP protein were detected in ΔcrpΔasdSL1344 (pYA-sopENt100-egfp)-infected Vero cells. These results demonstrated that the recombinant Salmonella typhimurium type III secretion system ΔcrpΔasdSL1344 (pYA-sopENt100) was successfully constructed, and it should be used as a live vaccine vector for expressing foreign genes.