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Background: Nicotinamide adenine dinucleotide (NAD+) has emerged as a critical regulator of cell signaling and survival pathways, affecting tumor initiation and progression. In this study it was investigated whether circulating NAD+ metabolism-related genes (NMRGs) could be used to predict immunotherapy response in ovarian cancer (OC) patients. Method: In this study, NMRGs were comprehensively examined in OC patients, three distinct NMRGs subtypes were identified through unsupervised clustering, and an NAD+-related prognostic model was generated based on LASSO Cox regression analysis and generated a risk score (RS). ROC curves and an independent validation cohort were used to assess the model's accuracy. A GSEA enrichment analysis was performed to investigate possible functional pathways. Furthermore, the role of RS in the tumor microenvironment, immunotherapy, and chemotherapy was also investigated. Result: We found three different subgroups based on NMRGs expression patterns. Twelve genes were selected by LASSO regression to create a prognostic risk signature. High-RS was founded to be linked to a worse prognosis. In Ovarian Cancer Patients, RS is an independent prognostic marker. Immune infiltrating cells were considerably overexpressed in the low-RS group, as immune-related functional pathways were significantly enriched. Furthermore, immunotherapy prediction reveal that patients with low-RS are more sensitive to immunotherapy. Conclusion: For a patient with OC, NMRGs are promising biomarkers. Our prognostic signature has potential predictive value for OC prognosis and immunotherapy response. The results of this study may help improve our understanding of NMRG in OCs.
RESUMO
BACKGROUND: The study aims to evaluate the clinical features and management of postoperative lymphatic leakage (PLL) in patients with cervical cancer who received pelvic lymphadenectomy. METHODS: This retrospective study screened consecutive patients with cervical cancer (stage Ia2-IIb). RESULTS: Among 3427 cases screened, 63 patients (1.8%) were diagnosed with PLL, which manifested as persistent abdominal drainage (42/63, 66.7%), chylous ascites (12/63, 19.0%) or vaginal drainage (9/63, 14.3%). Median time from surgery to onset of PLL was 6 days (range, 4-21 days). All cases resolved in a median 10 days (range, 3-56 days) after conservative treatment; although one case experienced recurrence of vaginal drainage after 26 days, this also resolved after conservative therapy. Multivariate analysis showed that two cycles of neoadjuvant chemotherapy (odds ratio [OR], 3.283; 95% confidence interval [95%CI], 1.289-8.360; P = 0.013), a decrease in hemoglobin level of ≥20 and < 30 g/L (OR, 6.175; 95%CI, 1.033-10.919; P = 0.046) or ≥ 30 g/L (OR, 8.467; 95%CI, 1.248-17.426; P = 0.029), and postoperative albumin level ≥ 30 and < 35 g/L (OR, 2.552; 95%CI, 1.112-5.857; P = 0.027) or < 30 g/L (OR, 5.517; 95%CI, 2.047-18.148; P = 0.012) were associated with PLL. CONCLUSION: Neoadjuvant chemotherapy, postoperative anemia and postoperative hypoproteinemia are risk factors for PLL.
