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中华外科杂志 2023年第7期61卷 575-581页

作者：黄笳杨志英隗瑞丽 atyah manar 孙永亮徐力周文颖中日友好医院肝胆胰外科北京100029

目的探讨不同策略治疗胰腺癌伴同时性肝转移(sLMPC)患者的临床效果。方法回顾性分析2017年4月至2022年12月连续在中日友好医院肝胆胰外科治疗的37例sLMPC患者的病历资料。男性23例,女性14例;年龄[M(IQR)]61(10)岁(范围:45~74岁)。明确... 详细信息

目的探讨不同策略治疗胰腺癌伴同时性肝转移(sLMPC)患者的临床效果。方法回顾性分析2017年4月至2022年12月连续在中日友好医院肝胆胰外科治疗的37例sLMPC患者的病历资料。男性23例,女性14例;年龄[M(IQR)]61(10)岁(范围:45~74岁)。明确诊断后给予全身系统化疗。初始化疗方案选择改良FOLFIRINOX、白蛋白紫杉醇联合吉西他滨、多西他赛+顺铂+氟尿嘧啶或吉西他滨+替吉奥方案等,初始化疗失败后更改化疗方案,经系统治疗后判定是否达到可以手术治疗的标准。使用Kaplan-Meier法计算总体生存时间及生存率;采用Log-rank检验和Gehan-Breslow-Wilcoxon检验比较生存曲线的差异。结果37例sLMPC患者的中位随访时间39个月,中位总体生存时间为13个月(范围:2~64个月),1、3、5年总体生存率分别为59.5%、14.7%、14.7%。36例患者初始接受系统化疗,其中29例患者完成4个周期以上的化疗,部分缓解15例、疾病稳定10例、疾病进展4例,肿瘤控制率为69.4%。在初始以转化手术为目的的24例患者中,转化成功率为54.2%(13/24)。13例转化成功患者中,9例选择手术,其治疗结果优于未手术的4例患者(中位生存时间未达到比中位生存时间13个月,P0.05)。在接受手术治疗的13例患者中,转化有效组患者CA19-9水平降幅及肝转移灶退缩比例较转化无效组更为显著(P值均0.05)。结论高选择性sLMPC患者在系统治疗达部分缓解后,采取积极的手术治疗策略可能延长患者的生存时间,而系统化疗未达到缓解的患者,手术治疗并未给患者带来生存获益。

关键词：胰腺肿瘤肿瘤转移辅助化疗手术治疗生存时间

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A Novel mRNA Signature Related to Immunity to Predict Survival and Immunotherapy Response in Hepatocellular Carcinoma

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Journal of Clinical and Translational Hepatology 2022年第5期10卷 925-938页

作者： Chenhao Zhou Jialei Weng Yuan Gao Chunxiao Liu Xiaoqiang Zhu Qiang Zhou Chia-Wei Li Jialei Sun manar atyah Yong Yi Qinghai Ye Yi Shi Qiongzhu Dong Yingbin Liu Mien-Chie Hung Ning Ren Department of Liver Surgery Liver Cancer InstituteZhongshan Hospitaland Key Laboratory of Carcinogenesis and Cancer Invasion(Ministry of Education)Fudan UniversityShanghaiChina Department of Molecular and Cellular Oncology The University of Texas MD Anderson Cancer CenterHoustonTXUSA Department of Biliary-Pancreatic Surgery Renji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina School of Biomedical Sciences Li Ka Shing Faculty of MedicineThe University of Hong KongPok Fu LamHong Kong SARChina Biomedical Research Center Zhongshan HospitalFudan UniversityShanghaiChina Institute of Fudan Minhang Academic Health System and Key Laboratory of Whole-period Monitoring and Precise Intervention of Digestive Cancer(SMHC)Minhang Hospital&AHSFudan UniversityShanghaiChina Institutes of Biomedical Sciences Fudan UniversityShanghaiChina Graduate Institute of Biomedical Sciences and Center for Molecular Medicine China Medical UniversityTaichung

Background and Aims:Hepatocellular carcinoma(HCC)is the most common primary liver cancer and the incidence and mortality rates are *** the limited treatments of HCC and promising application of immunotherapy for cancer,we aimed to identify an immune-related prognostic signature that can predict overall survival(OS)rates and immunotherapy response in ***:The initial signature development was conducted using a training dataset from the Cancer Genome Atlas followed by independent internal and external validations from that resource and the Gene Expression Omnibus.A signature based nomogram was generated using multivariate Cox regression *** associations of signature score with tumor immune phenotype and response to immunotherapy were analyzed using single-sample gene set enrichment analysis and tumor immune dysfunction and exclusion algorithm.A cohort from Zhongshan Hospital was employed to verify the pre dictive robustness of the signature regarding prognostic risk and immunotherapy ***:The prognostic signature,IGS_(HCC),consisting of 22 immune-related genes,had independent prognostic ability,with training and validation ***,IGS_(HCC)stratified HCC patients with different outcomes in *** prognostic accuracy of IGS_(HCC)was better than three reported prognostic *** IGS_(HCC)-based nomogram had high accuracy and significant clinical benefits in predicting 3-and 5-year ***_(HCC)reflected distinct immunosuppressive phenotypes in low-and high-score *** with low IGS_(HCC)scores were more likely than those with high scores to benefit from ***:IGS_(HCC)predicted HCC prognosis and response to immunotherapy,and contributed to individualized clinical management.

关键词： Hepatocellular carcinoma Gene signature Immune microenvironment Prognosis Immunotherapy

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Development and Validation of a Metabolic Gene-Based Prognostic Signature for Hepatocellular Carcinoma

Development and Validation of a Metabolic Gene-Based Prognos...

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2022CCTB中国肿瘤标志物学术大会暨中国整合肿瘤学大会暨第十六届肿瘤标志物青年科学家论坛暨中国肿瘤标志物产业创新大会

作者： Jialei Weng Chenhao Zhou Qiang Zhou Wanyong Chen Yirui Yin manar atyah Qiongzhu Dong Yi Shi Ning Ren Zhongshan Hospital Fudan University Department of Molecular and Cellular Oncology The University of Texas MD Anderson Cancer Center Institute of Fudan Minhang Academic Health System Minhang Hospitaland Key Laboratory of Shanghai Municipal Health CommissionFudan University Institutes of Biomedical Sciences Fudan University Biomedical Research Centre Zhongshan HospitalFudan University

Background:Hepatocellular carcinoma(HCC) is a malignant tumor with great variation in prognosis among *** in metabolism influence disease progression and clinical *** objective of this study was to determine the overall survival(OS) risk of HCC patients from a metabolic *** and Methods:The model was constructed using the least absolute shrinkage and selection operator(LASSO) COX regression based on The Cancer Genome Atlas(TCGA,n=342) *** International Cancer Genome Consortium(ICGC,n=232),GSE14520(n=242) datasets,and a clinical cohort(n=64) were then used to assess the prognostic value of the ***:A 10 metabolic gene-based signature was constructed and verified as a robust and independent prognostic classifier in public and real-world validation ***,the signature enabled the identification of HCC molecular subtypes,yielding an AUC value of0.678 [95%CI:0.592-0.763].Besides,the signature was associated with metabolic processes like glycolysis,supported by a clear correlation between the risk score and expression of rate-limiting ***,high-risk tumor was likely to have a high tumor infiltration status of immunosuppressive cells,as well as elevated expression of some immune checkpoint *** final clinical translation,a nomogram integrating the signature and tumor stage was established,and showed improved predictive accuracy of 3-and 5-year OS and brought more net benefit to ***:We developed a prognostic signature based on 10 metabolic genes,which has proven to be an independent and reliable prognostic predictor for HCC and reflects the metabolic and immune characteristics of tumors.

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