Construction of a comprehensive nutritional index and its correlation with quality of life and survival in patients with nasopharyngeal carcinoma undergoing IMRT: A prospective study.

OBJECTIVES: The aim of this study was to investigate the relationship between a comprehensive nutritional index (CNI) and QoL in patients with NPC who undergo IMRT and to explore the relationship between CNI and survival. METHODS: 359 patients with newly diagnosed NPC were enrolled. QoL was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 and Quality of Life Questionnaire Head and Neck Cancer Module at three time points: before, immediately after, and 3 months after IMRT. The CNI comprised five values including body mass index, usual body weight percentage, hemoglobin, albumin, and total lymphocyte count, and was evaluated before and immediately after IMRT. The correlation between the CNI and QoL and the effect of CNI on prognosis were analysed. RESULTS: QoL and CNI scores decreased remarkably after IMRT (P < 0.05). The CNI was quite low in patients with III-IV clinical tumor stage and those undergoing induction chemotherapy plus concurrent chemotherapy. After IMRT, lower CNI score correlated worse QoL (P < 0.05). The Kaplan-Meier curve indicated that patients with lower CNI had significantly poorer survival outcomes (P = 0.02). In multivariate analysis, CNI remained an independent prognostic factor of overall survival (P = 0.046). CONCLUSIONS: CNI can be recommended as an appropriate indicator reflecting the integrated nutrition status of NPC patients. Low CNI was associated with poor QoL and predicted a poor survival outcome. More interventions should be taken to improve the nutrition status of NPC patients to improve QoL and enhance survival outcomes.

Importance of activated hepatic stellate cells and angiopoietin-1 in the pathogenesis of hepatocellular carcinoma.

Previous studies have determined that activated hepatic stellate cells (aHSCs) promote the progression of hepatocellular carcinoma (HCC) by increasing angiogenesis in cancerous tissues. In addition, angiopoietin 1 (Ang­1) has been reported to be involved in tumor growth and metastasis via the promotion of angiogenesis. It remains unclear whether aHSCs and Ang­1 are involved in the angiogenesis in HCC. A total of 25 HCC and tumor­adjacent tissues, and 21 normal liver tissues were used in the present study. Immunohistochemistry (IHC) was used to detect the expression of Ang­1 and α smooth muscle actin (α­SMA). The expression of CD34 was also analyzed using IHC to evaluate the microvessel density (MVD). The protein expression levels of Ang­1 were evaluated using western blot analysis. The association between aHSC, Ang­1 and angiogenesis was determined using Spearman's rank correlation coefficient. The present study determined that the expression of α­SMA, Ang­1 and MVD (CD34) was significantly higher in the HCC tissues when compared with tumor­adjacent tissues and normal liver tissues. Spearman's rank analysis identified a positive correlation between the expression of α­SMA, Ang­1 and CD34. This suggests that α­SMA­positive aHSCs promoted angiogenesis by expressing Ang­1, resulting in the proliferation and metastasis of HCC.