Survival outcomes of adjuvant taxanes, platinum plus fluoropyrimidines versus platinum and fluoropyrimidines for gastric cancer patients after D2 gastrectomy: a retrospective propensity score-matched analysis.

BACKGROUND: To evaluate whether the addition of taxanes to platinum and fluoropyrimidines in adjuvant chemotherapy would result in longer survival than platinum plus fluoropyrimidines in gastric cancer patients who received D2 gastrectomy. METHODS: Data of patients with gastric adenocarcinoma who received D2 gastrectomy and adjuvant chemotherapy with platinum plus fluoropyrimidines or taxanes, platinum plus fluoropyrimidines was retrospectively collected and analyzed. 1:1 Propensity score matching analysis was used to balance baseline characteristics between two groups. Survival curves were estimated using Kaplan-Meier method, and the differences were compared using the log-rank test. RESULTS: Four hundred twenty-five patients in the platinum plus fluoropyrimidines group and 177 patients in the taxanes, platinum plus fluoropyrimidines group were included into analysis. No statistical differences in disease-free survival and overall survival were observed between two groups. After propensity score matching, 172 couples of patients were matched, the baseline characteristics were balanced. The median disease-free survival were 15.8 months (95% CI, 9.3~22.4) in the platinum plus fluoropyrimidines group and 22.6 months (95% CI, 15.9~29.4) in the taxanes, platinum plus fluoropyrimidines group (HR = 0.63; 95% CI, 0.48~0.85; P = 0.002). The median overall survival was 25.4 months for patients in the platinum plus fluoropyrimidines group (95% CI, 19.4~31.3) and 33.8 months (95% CI, 23.5~44.2) for those in the taxanes, platinum plus fluoropyrimidines group (HR = 0.68; 95% CI, 0.53-0.87; log-rank test, P = 0.002). CONCLUSIONS: For gastric adenocarcinoma patients, the adjuvant triplet combination of taxanes, platinum, and fluoropyrimidines regimen after D2 gastrectomy was superior to platinum plus fluoropyrimidines regimen in disease-free survival as well as overall survival. TRIAL REGISTRATION: This project has been registered in the Chinese Clinical Trial Registry ( ChiCTR1800019978 ).

Pretreatment BAN Score Based on Body-mass-index, Albumin and Neutrophil-lymphocyte Ratio Could Predict Long-term Survival for Patients with Operable Esophageal Squamous Cell Carcinoma.

Background: The present study was designed to examine the prognostic value of a systemic inflammation marker-BAN score, which was established based on body-mass-index (BMI), albumin (ALB) and neutrophil-lymphocyte ratio (NLR) in resectable esophageal squamous cell carcinoma (ESCC) patients. Methods: A total of 420 newly diagnosed ESCC patients in our hospital between January 2008 and December 2013 were included. Their baseline characteristics were retrospectively reviewed and collected. BAN score was calculated as (BMI × ALB/ NLR). The optimal cutoff value for BAN score was defined as 28.0 in terms of survival. Patients were then allocated to high BAN (≥ 28.0) and low BAN (< 28.0) score groups. Results: Pretreatment BAN score was significantly associated with tumor length, white blood cell count, BMI, ALB and NLR levels. However, no significant difference was observed in patients' age, gender, tumor location, degree of differentiation, depth of invasion, lymph node involvement, tumor-node-metastasis (TNM) stage or other variables between groups. Moreover, those with high pretreatment BAN scores (≥ 28.0) tended to have favorable disease free survival (DFS) [hazard ratio (HR), 0.650; 95% confidence interval (CI), 0.481-0.877; P = 0.005] and overall survival (OS) (HR, 0.608; 95% CI, 0.445-0.829; P = 0.002) by univariate analysis. Furthermore, multivariate Cox regression analysis suggested that high BAN score (≥ 28.0) could serve as an independent predictor for both DFS (HR, 0.726; 95% CI, 0.532-0.993; P = 0.045) and OS (HR, 0.670; 95% CI, 0.485-0.927; P = 0.016). Conclusions: Pretreatment BAN score could independently predict long-term survival for resectable ESCC patients.

Aberrantly upregulated FAM83H-AS1 facilitates malignant progression of esophageal squamous cell carcinoma.

The biological roles of the newly identified long non-coding RNA family with sequence similarity 83 member H antisense 1 (FAM83H-AS1) in esophageal squamous cell carcinoma (ESCC) have remained largely elusive. In the present study, it was determined that, in comparison with paired para-tumorous tissues or normal esophageal epithelial cells, FAM83H-AS1 expression in cancer tissues and cell lines was markedly upregulated. Furthermore, FAM83H-AS1 expression was significantly elevated in patients with ESCC and lymph node metastasis or a late TNM stage, while no association with any other clinicopathological characteristics was detected. Furthermore, the overall and disease-free survival, as assessed by the Kaplan-Meier method, were significantly shortened in patients with high FAM83H-AS1 expression. A functional study then uncovered that knockdown of FAM83H-AS1 significantly suppressed the proliferation and migration of ESCC cells. The present results suggested that FAM83H-AS1 may facilitate the malignant progression of ESCC and may be utilized as a prognostic predictor and possibly a novel therapeutic target in ESCC that warrants further exploration.

Upregulation of the long non-coding RNA FAM83H-AS1 in gastric cancer and its clinical significance.

OBJECTIVES: To explore the expression level and to investigate the clinical associations of the long non-coding RNA (lncRNA) FAM83H-AS1 in gastric cancer. METHODS: The expression level of FAM83H-AS1 were explored by quantitative reverse transcription PCR (qRT-PCR). The Cox regression models as well as log-rank test were utilized to investigate whether FAM83H-AS1 expression could be used as a prognosis predictor. The value of FAM83H-AS1 as a diagnostic biomarker was evaluated by receiver operating curves (ROC). RESULTS: Aberrantly upregulation of FAM83H-AS1 was identified in gastric cancer in comparison with that in normal tissues. We also found that upregulated FAM83H-AS1 was a risk factor relating to OS and DFS. The area under curve (AUC) was 0.8603 and 0.6778 for gastric cancer and lymph node metastasis, respectively. CONCLUSION: Our results indicated that FAM83H-AS1 may function as an oncogene in gastric cancer and could be used as a prognosis predictor or diagnostic biomarker in gastric cancer.

Cumulative Score Based on Preoperative Fibrinogen and Pre-albumin Could Predict Long-term Survival for Patients with Resectable Gastric Cancer.

Background: To investigate the prognostic significance of the cumulative score based on preoperative fibrinogen and pre-albumin (FP score) in patients with gastric cancer after radical gastrectomy. Methods: Baseline characteristics, preoperative fibrinogen and pre-albumin levels were retrospectively reviewed in patients who underwent radical gastrectomy. The optimal cut-off values for fibrinogen and pre-albumin were defined as 4.0 g/L and 230.0 mg/L, respectively. Patients with elevated fibrinogen (≥ 4.0 g/L) and decreased pre-albumin (< 230.0 mg/L) levels were allocated an FP score of 2, those with only one of these two abnormalities were assigned a score of 1, and those with neither of the two abnormalities were allocated a score of 0. The prognostic value was examined by univariate and multivariate regression analyses. Results: The preoperative FP score was significantly correlated with age, tumor size, fibrinogen level, pre-albumin level and white blood cell count. No significant differences based on sex, tumor location, degree of differentiation, depth of invasion, lymph node status, tumor-node-metastasis (TNM) stage or adjuvant chemotherapy were identified between the groups. In addition, univariate survival analysis revealed that a high preoperative FP score was significantly associated with unfavorable disease-free survival (DFS) [hazard ratio (HR), 1.482; 95% confidence interval (CI), 1.222-1.796; P < 0.001] and overall survival (OS) (HR, 1.623; 95% CI, 1.315-2.002; P < 0.001). Moreover, after adjusting for other factors, a high preoperative FP score remained an independent predictor for impaired DFS (HR, 1.434; 95% CI, 1.177-1.747; P < 0.001) and OS (HR, 1.413; 95% CI, 1.136-1.758; P = 0.002) in multivariate Cox regression analysis. Conclusions: The preoperative FP score significantly predicts long-term survival for gastric cancer patients who have undergone radical gastrectomy.

The PD-1 rs36084323 A > G polymorphism decrease cancer risk in Asian: A meta-analysis.

The rs36084323 A > G polymorphism in programmed cell death-1(PD-1) gene has been reported to be associated with cancer risk. However, the results of previous studies were inconsistent. Therefore, we performed a meta-analysis to identify the potential association, by searching the PubMed, EMBASE, Cochrane Library, and the Chinese CNKI, WANFANG and CBM databases. Data were extracted and odds ratios (ORs) with 95% confidence intervals (CIs) were estimated to assess the strength of the association. A total of 10 relevant studies involving 4445 cancer cases and 5126 controls were recruited. Overall, the results indicated that the PD-1 rs36084323 A > G polymorphism was not statistically associated with cancer risk. However, stratified analysis revealed that there was a statistically reduced cancer risk in Asians(G vs. A, OR = 0.89, 95%CI:0.81-0.97, P = 0.008, I2 = 48.8%; GG vs. AA, OR = 0.79, 95% CI:0.66-0.94, P = 0.008, I2 = 48.7%; GG/AG vs. AA, OR = 0.87, 95%CI:0.76-0.98, P = 0.017, I2 = 34.9%; GG vs. AG/AA, OR = 0.85, 95%CI:0.75-0.97, P = 0.027, I2 = 40%) and in the patients with EOC(AG vs. AA, OR = 0.69, 95%CI:0.54-0.90, P = 0.005, I2 = 0%; GG/AG vs. AA, OR = 0.67, 95%CI:0.52-0.85, P = 0.001, I2 = 0). Meta-regression showed that ethnicity (P = 0.029) but not cancer types (P = 0.792), source of controls (P = 0.207) or ample size (P = 0.585) were the sources of heterogeneity. This meta-analysis demonstrates the PD-1 rs36084323 A > G polymorphism is associated with decreased cancer risk in Asian, and suggests it could potentially serve as a biomarker to screen high-risk individuals. Large-scale and well-designed case-control studies are needed to enrich the evidence of this result.

Exosomes from Melatonin Treated Hepatocellularcarcinoma Cells Alter the Immunosupression Status through STAT3 Pathway in Macrophages.

Immunosuppression is a significant factor in the progression of tumor invasion and metastasis. Melatonin, a well-known hormone, has certain cytotoxic and immune regulatory effects to inhibit tumor function. Exosomes are small membrane vesicles released by many kinds of cells, which contain different macromolecules, such as mRNAs and microRNAs (miRNAs), and proteins that can mediate communications between cells. Tumor-derived exosomes may cause immunosuppression, however, it is unknown whether melatonin can attenuate an immunosuppressive status by altering the function of tumor-derived exosomes. In the present study, we evaluated the effects of hepatocellularcarcinoma-derived exosomes (Exo-con) and exosomes derived from hepatocellularcarcinoma cells treated with 0.1 mM melatonin (Exo-MT), on the expression of inflammatory factors and programmed death ligand 1(PD-L1) by co-culturing Exo-con and Exo-MT, respectively, with macrophages differentiated from THP-1 cells or RAW264.7 cells. Our in vitro results indicate that Exo-MT can downregulate the expression of PD-L1 on macrophages while Exo-con can upregulate the expression of PD-L1 through flow cytometry and immunofluorescence analysis. In addition, Exo-con upregulates the secretion of cytokines, such as IL-6, IL-10, IL-1ß, and TNF-α in macrophages. Accordingly, Exo-MT could attenuate the high expression of these inflammatory cytokines. Furthermore, in vivo experiments confirmed the results found in vitro. PD-L1 expression and cytokine secretion were lower in the Exo-MT group compared with those in the Exo-con group. Working to identify a specific mechanism, our research shows that Exo-MT decreases STAT3 activation compared to the Exo-con group. In summary, we found exosomes from melatonin treated hepatocellularcarcinoma cells alters the immunosupression status through STAT3 pathway in macrophages. Our study may provide a new avenue to investigate the mechanisms of melatonin in regulating an immunosuppressive status.

Serum expression and significance of MicroRNA-30d-5p in esophageal squamous cell carcinoma.

This study was aimed to assess serum microRNA-30d-5p (miR-30d-5p) expression in patients with esophageal squamous cell carcinoma before and after operation, exploring its associations with clinical pathological parameters. A total of 30 esophageal cancer patients who underwent radical resection and were pathologically confirmed with esophageal squamous cell carcinoma in the First Affiliated Hospital of Anhui Medical University, from April to May in 2013, were enrolled, alongside 19 healthy controls. The expression levels of miRNA in serum from patients with esophageal squamous cell carcinoma before and after operation were assessed by microarrays and real-time PCR (RT-PCR). The associations of miR-30d-5p expression with clinical pathological parameters were determined. Serum hsa-miR-30d-5p levels in patients with esophageal squamous cell carcinoma (study group) were significantly associated with the tumor depth of invasion, lymph node metastasis, tumor location and length, histopathological type and degree of differentiation, as well as history of smoking and drinking (P<0.05). Moreover, changes of serum miRNA levels were more prominent than that of thymidine kinase 1 (TK1). There were significant differences in hsa-miR-30d-5p expression levels between the study and control groups (P<0.05). These results indicated that microRNA-30d-5p is a potential marker of esophageal squamous cell carcinoma, with high expression having a certain promoting role in the occurrence and development of esophageal cancer.

Melatonin, a novel selective ATF-6 inhibitor, induces human hepatoma cell apoptosis through COX-2 downregulation.

AIM: To clarify the mechanisms involved in the critical endoplasmic reticulum (ER) stress initiating unfolded protein response pathway modified by melatonin. METHODS: Hepatoma cells, HepG2, were cultured in vitro. Flow cytometry and TUNEL assay were used to measure HepG2 cell apoptosis. Western blotting and quantitative reverse transcription-polymerase chain reaction methods were used to determine the protein and messenger RNA levels of ER stress and apoptosis related genes' expression, respectively. Tissue microarray construction from patients was verified by immunohistochemical analysis. RESULTS: In the present study, we first identified that melatonin selectively blocked activating transcription factor 6 (ATF-6) and then inhibited cyclooxygenase-2 (COX-2) expression, leading to enhanced liver cancer cell apoptosis under ER stress condition. Dramatically increased CCAAT-enhancer-binding protein homologous protein level, suppressed COX-2 and decreased Bcl-2/Bax ratio by melatonin or ATF-6 siRNA contributed the enhanced HepG2 cell apoptosis under tunicamycin (an ER stress inducer) stimulation. In clinical hepatocellular carcinoma patients, the close relationship between ATF-6 and COX-2 was further confirmed. CONCLUSION: These findings indicate that melatonin as a novel selective ATF-6 inhibitor can sensitize human hepatoma cells to ER stress inducing apoptosis.

The radiosensitizing effect of Paeonol on lung adenocarcinoma by augmentation of radiation-induced apoptosis and inhibition of the PI3K/Akt pathway.

PURPOSE: To investigate the radiosensitizing effect and mechanism of action by the natural product Paeonol on lung adenocarcinoma both in vitro and in vivo. MATERIALS AND METHODS: Two lung adenocarcinoma cell lines (human lung adenocarcinoma cell line A549 and mouse Lewis lung carcinoma (LLC) cell line) were chosen for this research. In order to select the experimental concentrations of Paeonol, cytotoxicity was determined using a MTT (3-[4,5-dimethylthiazol-2-yl]-2,5- diphenyltetrazolium bromide) assay. A clonogenic assay was performed to measure the radiosensitizing effects. Apoptosis was determined by the Tunel (terminal deoxynucleotidyl transferase-mediated dUTP nick and labeling) assay and flow cytometry. Protein expression was analyzed by Western blotting. To test the radiosensitizing effect in vivo, a transplanted tumor model was established. RESULTS: The MTT assay showed that Paeonol inhibited proliferation of cells. Paeonol concentration ranged from an IC5 (5% inhibiting concentration) to an IC20 and was used at non-toxic concentrations for subsequent experiments. The clonogenic assay showed that Paeonol enhanced the radiosensitivity of cells. Data from the Tunel assay and flow cytometry verified that Paeonol enhanced radiation-induced apoptosis. Paeonol inhibited the activation of the PI3K/AKT (Phosphatidylinositol 3-kinase/ Protein Kinase B) pathway and down-regulated the expression of COX-2 (Cyclooxygenase-2) and Survivin. Paeonol (1718 mg/kg) combined with 10 Gy irradiation inhibited the growth of a transplanted tumor model in vivo, resulting in the longest tumor growth time, tumor growth delay and the highest inhibition ratio when compared with the radiotherapy alone group. CONCLUSIONS: It is reported for the first time that Paeonol has a radiosensitizing effect on lung adenocarcinoma both in vitro and in vivo. This effect could be related to the augmentation of radiation-induced apoptosis and the inhibition of the PI3K/Akt signalling pathway and its downstream proteins: COX-2 and Survivin.