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Prognostic significance of grade of malignancy based on histopathological differentiation and Ki-67 in pancreatic ductal adenocarcinoma

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Cancer Biology & Medicine 2024年第5期21卷 416-432页

作者： yuexiang liang Guannan Sheng Yu Guo Yiping Zou Hanhan Guo Zhifei Li Shaofei Chang Quan Man Song Gao Jihui Hao Department of Pancreatic Cancer Tianjin Medical University Cancer Institute&HospitalNational Clinical Research Center for CancerKey Laboratory of Cancer Prevention and TherapyTianjinTianjin’s Clinical Research Center for CancerTianjin 300060China Department of Gastrointestinal Oncology The First Affiliated Hospital of Hainan Medical UniversityHaikou 570102China Department of Gastrointestinal Pancreatic Surgery Shanxi Provincial People’s HospitalTaiyuan 030012China

Objective:Tumor cell malignancy is indicated by histopathological differentiation and cell ***-67,an indicator of cellular proliferation,has been used for tumor grading and classification in breast cancer and neuroendocrine ***,its prognostic significance in pancreatic ductal adenocarcinoma(PDAC)remains ***:Patients who underwent radical pancreatectomy for PDAC were retrospectively enrolled,and relevant prognostic factors were *** of malignancy(GOM),a novel index based on histopathological differentiation and Ki-67,is proposed,and its clinical significance was ***:The optimal threshold for Ki-67 was determined to be 30%.Patients with a Ki-67 expression level>30%rather than≤30%had significantly shorter 5-year overall survival(OS)and recurrence-free survival(RFS).In multivariate analysis,both histopathological differentiation and Ki-67 were identified as independent prognostic factors for OS and *** GOM was used to independently stratify OS and RFS into 3 tiers,regardless of TNM stage and other established prognostic *** tumor-nodemetastasis-GOM stage was used to stratify survival into 5 distinct tiers,and surpassed the predictive performance of TNM stage for OS and ***:Ki-67 is a valuable prognostic indicator for *** of the GOM in the TNM staging system may potentially enhance prognostic accuracy for PDAC.

关键词： Pancreatic ductal adenocarcinoma prognosis Ki-67 differentiation TNM stage

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纳米药物递释系统在胃癌治疗中的研究进展

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海南医学院学报 2024年第13期30卷 1019-1026页

作者：黄克祥曹坤张俊伟焦斌琪梁月祥陈铭哲张彦志李井泉海南医学院第一附属医院胃肠肿瘤外科海南海口570100 海南医学院海南海口570100

胃癌是最常见的消化道肿瘤之一,发病率居第五位,死亡率居第三位。手术依然是唯一可能治愈胃癌的方法,然而,即便接受根治性切除,绝大多数患者仍然出现肿瘤复发,5年生存率仅为30%。辅助化疗在胃癌术后治疗中起主导作用,化疗虽然可以进一... 详细信息

胃癌是最常见的消化道肿瘤之一,发病率居第五位,死亡率居第三位。手术依然是唯一可能治愈胃癌的方法,然而,即便接受根治性切除,绝大多数患者仍然出现肿瘤复发,5年生存率仅为30%。辅助化疗在胃癌术后治疗中起主导作用,化疗虽然可以进一步提高胃癌患者生存,但其副反应发生率高、且需全身多次反复给药。针对传统化疗存在的弊端,开发缓释化疗制剂成为肿瘤治疗领域的热点,其中纳米药物递释系统在缓释化疗方面具有明显的优势。本文对胃癌治疗中纳米药物递释系统的研究进展进行综述。

关键词：纳米技术药物递送系统胃癌疗法

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可注射奥沙利铂缓释微粒制备及其理化性质研究

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海南医学院学报 2024年第10期30卷 779-783页

作者：张俊伟焦斌琪曹坤张彦志陈铭哲黄克祥梁月祥李井泉海南医学院第一附属医院胃肠肿瘤外科海南海口570100

目的:开发可注射奥沙利铂缓释微粒,并对其制备工艺和理化性质进行研究。方法:采用热熔挤出-冷冻研磨工艺制备可注射奥沙利铂缓释微粒,使用扫描电镜、粒度分析仪了解微粒形貌及粒径分布,采用液相色谱系统测量缓释微粒中奥沙利铂含量和微... 详细信息

目的:开发可注射奥沙利铂缓释微粒,并对其制备工艺和理化性质进行研究。方法:采用热熔挤出-冷冻研磨工艺制备可注射奥沙利铂缓释微粒,使用扫描电镜、粒度分析仪了解微粒形貌及粒径分布,采用液相色谱系统测量缓释微粒中奥沙利铂含量和微粒体外释放度。结果:可注射奥沙利铂缓释微粒粒度分布曲线稳定,微粒中奥沙利铂包封率为46.8%,包封率高;体外释放结果显示,奥沙利铂缓释微粒释放周期为144 h,最终释放度在80.0%以上,具有缓释性能;缓释微粒注射剂pH值在6.18~6.45的范围内,不会对注射部位造成损伤。结论:通过热熔挤出-冷冻研磨工艺制备的可注射奥沙利铂缓释微粒粒径分布均匀、药物包封率高,并且具有优异的缓控释特性以及稳定的理化性质。

关键词：可注射奥沙利铂缓释微粒制备工艺理化性质

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Effects of As on As uptake, speciation, and nutrient uptake by winter wheat (Triticum aestivum L.) under hydroponic conditions

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Journal of Environmental Sciences 2008年第3期20卷 326-331页

作者： LIU Quanji HU Chengxiao TAN Qiling SUN Xuecheng SU Jingjun liang yuexiang Microelement Research Center Huazhong Agricultural University Wuhan 430070 China

A hydroponic experiment was conducted to investigate the effects of arsenic （As） stress on growth, nutrition and As uptake, and speciation in shoots and roots of winter wheat （Triticum aestivum L.）. Winter wheat has high tolerance to As. Most As is accumulated in the roots, and an As concentration of 4,421 mg/kg was observed at a solution concentration of 20 mg/L As. Arsenic concentrations in roots were approximately 40-100 times greater than those in shoots. Arsenic in winter wheat roots and shoots occurred as both As^3＋ and As^5＋ species, although As^3＋ was the main species in winter wheat tissues. Arsenic significantly decreased the biomass of winter wheat shoots and roots and affected absorption and transport of micro- and macro-elements in winter wheat tissue. Arsenic treatment significantly increased the concentrations of total Magnesium （Mg） and calcium （Ca） in shoots and enhanced the transport of Mg and Ca from roots to shoots but decreased potassium （K）, nitrogen （N）, and phosphorus （P） concentrations in both shoots and roots, particularly the concentration of P. Concentrations of iron, copper, and zinc in winter wheat shoots were negatively related to As rates, with correlation coefficients （R^2） of 0.93, 0.94, and 0.97, respectively.

关键词： arsenic (As) winter wheat nutrients speciation

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Prognostic significance of lymphovascular infiltration in overall survival of gastric cancer patients after surgery with curative intent

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Chinese Journal of Cancer Research 2019年第5期31卷 785-796页

作者： liangliang Wu yuexiang liang Chen Zhang Xiaona Wang Xuewei Ding Chongbiao Huang Han liang Department of Gastric Cancer Tianjin Medical University Cancer Institute and HospitalNational Clinical Research Center of CancerKey Laboratory of Cancer Prevention and TherapyTianjin 300060China Department of Gastrointestinal Oncology the First Affiliated Hospital of Hainan Medical UniversityHaikou 570102China Nutritional Department Tianjin Beichen HospitalTianjin 300000China Senior Ward Tianjin Medical University Cancer Institute and HospitalNational Clinical Research Center of CancerKey Laboratory of Cancer Prevention and TherapyTianjin 300060China

Objective: Lymphovascular infiltration(LVI) is frequently detected in gastric cancer(GC) specimens. Studies have revealed that GC patients with LVI have a poorer prognosis than those without ***: In total, 1,007 patients with curatively resected GC at Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital were retrospectively enrolled. The patients were categorized into two groups based on the LVI status: a positive group(PG;presence of LVI) and a negative group(NG;absence of LVI). The clinicopathological factors corrected with LVI and prognostic variables were analyzed. Additionally, a pathological lymphovascular-node(lvN) classification system was proposed to evaluate the superiority of its prognostic prediction of GC patients compared with that of the eighth edition of the N staging ***: Two hundred twenty-four patients(22.2%) had LVI. The depth of invasion and lymph node metastasis were independently associated with the presence of LVI. GC patients with LVI demonstrated a significantly lower overall survival(OS) rate than those without LVI(42.8% vs. 68.9%, respectively;P<0.001). In multivariate analysis,LVI was identified as an independent prognostic factor for GC patients(hazard ratio: 1.370;95% confidence interval: 1.094-1.717;P=0.006). Using strata analysis, significant prognostic differences between the groups were only observed in patients at stage I-IIIa or N0-2. The lvN classification was found to be more appropriate to predict the OS of GC patients after curative surgery than the pN staging system. The-2 log-likelihood of lvN classification(4,746.922) was smaller than the value of pN(4,765.196), and the difference was statistically significant(χ^2=18.434, P<0.001).Conclusions: The presence of LVI influences the OS of GC patients at stage Ⅰ-Ⅲ a or N0-2. LVI should be incorporated into the pN staging system to enhance the accuracy of the prognostic prediction of GC patients.

关键词： Gastric carcinoma lymphovascular infiltration LVI prognosis risk factors

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Elevated preoperative plasma D-dimer dose not adversely affect survival of gastric cancer after gastrectomy with curative intent: A propensity score analysis

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Chinese Journal of Cancer Research 2018年第2期30卷 254-262页

作者： yuexiang liang Donglei He liangliang Wu Xuewei Ding Xiaona Wang Baogui Wang Rupeng Zhang Han liang Department of Gastrointestinal Oncology the First Affiliated Hospital of Hainan Medical College Department of Gastric Cancer Tianjin Medical University Cancer Institute & Hospital National Clinical Research Center of Cancer Tianjin's Clinical Research Cancer for Cancer Key Laboratory of Cancer Prevention and Therapy

Objective： Elevated plasma D-dimer has been reported to be associated with advanced tumor stage and poor survival in several types of malignancies. The purpose of this study was to assess the potential impact of preoperative plasma D-dimer level（PDL） on overall survival（OS） of gastric cancer（GC） patients undergoing curative surgery by applying propensity score ***： A total of 1,025 curatively resected GC patients in Tianjin Medical University Cancer Institute ＆Hospital were enrolled. Patients were categorized into two groups based on preoperative PDL： the elevated group（EG） and the normal group（NG）. To overcome bias due to the different distribution of covariates for the two groups, a one-to-one match was applied using propensity score analysis, after matching, prognostic factors were ***： In analysis for the whole study series, patients in the EG were more likely to have a larger proportion of tumor size ≥5 cm（67.5% vs. 55.8%, P=0.006）, elder mean age（64.0±10.8 years vs. 60.5±11.6 years, P〈0.001） and advanced tumor（T）, node（N）, and TNM stage. Patients with elevated PDL demonstrated a significantly lower 5-year OS than those with normal PDL（27.0% vs. 42.6%, P〈0.001）, however, the PDL was not an independent prognostic factor for OS in multivariate analysis [hazard ratio： 1.13, 95% confidence interval（95% CI）： 0.92–1.39,P=0.236]. After matching, 163 patients in the EG and 163 patients in the NG had the same characteristics. The 5-year OS rate for patients in the EG was 27.0% compared with 25.8% for those in the NG（P=0.809, log-rank）.Conclusions： The poor prognosis of GC patients with elevated preoperative PDL was due to the advanced tumor stage and elder age rather than the elevated D-dimer itself.

关键词： Gastric carcinoma D-dimer prognosis

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Positive impact of adding No.14v lymph node to D2 dissection on survival for distal gastric cancer patients after surgery with curative intent

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Chinese Journal of Cancer Research 2015年第6期27卷 580-587页

作者： yuexiang liang liangliang Wu Xiaona Wang Xuewei Ding Hongmin Liu Bin Li Baogui Wang Yuan Pan Rupeng Zhang Ning Liu Han liang Department of Gastric Cancer Tianjin Medical University Cancer Institute and HospitalNational Clinical Research Center of CancerKey Laboratory of Cancer Prevention and Therapy Department of Abdominal Cancer Hainan Province Cancer Hospital

Background： D2 lymphadenectomy has been increasingly regarded as standard surgical procedure for advanced gastric cancer （GC）, while the necessity of No.14v lymph node （14v） dissection for distal GC is still controversial. Methods： A total of 920 distal GC patients receiving at least a D2 lymph node dissection in Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital were enrolled in this study, of whom, 243 patients also had the 14v dissected. Other 677 patients without 14v dissection were used for comparison. Results： Forty-five （18.5%） patients had 14v metastasis. There was no significant difference in 3-year overall survival （OS） rate between patients with and without 14v dissection. Following stratified analysis, in TNM stages I, II, IIIa and IV, 14v dissection did not affect 3-year OS; in contrast, patients with 14v dissection had a significant higher 3-year OS than those without in TNM stages IIIb and IIIc. In multivariate analysis, 14v dissection was found to be an independent prognostic factor for GC patients with TNM stage IIIb/IIIc disease [hazard ratio （HR）, 1.568; 95% confidence interval （CI）： 1.186-2.072; P=0.002]. GC patients with 14v dissection had a significant lower locoregional, especially lymph node, recurrence rate than those without 14v dissection （11.7 % vs. 21.1%, P=0.035）. Conclusions： Adding 14v to D2 lymphadenectomy may be associated with improved 3-year OS for distal GC staged TNM IIIb/IIIc.

关键词： Gastric carcinoma No. 14v lymph node metastasis dissection prognosis

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左半结肠癌第253组淋巴结转移的临床意义

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中国肿瘤临床 2022年第21期49卷 1128-1134页

作者：李长智李平叶晓谊曾祥勇梁月祥海南医学院第二附属医院普通外科海口市570216 海南医学院第一附属医院胃肠肿瘤外科

目的:探讨左半结肠癌第253组淋巴结转移及清扫的临床价值。方法:回顾性收集2009年1月至2015年12月于海南医学院第二附属医院和海南医学院第一附属医院收治的629例左半结肠癌患者的临床病理资料,分析影响第253组淋巴结转移的临床病理因... 详细信息

目的:探讨左半结肠癌第253组淋巴结转移及清扫的临床价值。方法:回顾性收集2009年1月至2015年12月于海南医学院第二附属医院和海南医学院第一附属医院收治的629例左半结肠癌患者的临床病理资料,分析影响第253组淋巴结转移的临床病理因素及其与预后的关系。结果:629例患者中58例(9.2%)有第253组淋巴结转移。肿瘤部位、pT分期、pN分期、癌结节、脉管癌栓和术前CA19-9水平与第253组淋巴结转移独立相关。分层分析显示,第253组淋巴结转移对pN1、pN2a和pN2b期患者预后影响均具有统计学意义。单因素生存分析显示,Ⅲ期左半结肠癌第253组淋巴结转移和未转移患者5年生存率分别为25.9%和65.0%,差异具有统计学意义(P<0.001)。倾向匹配后进行多因素生存分析,证实第253组淋巴结转移是Ⅲ期左半结肠癌患者的独立预后因素(HR=1.474,95%CI:1.072~2.498;P=0.037)。结论:第253组淋巴结转移是Ⅲ期左半结肠癌患者的独立预后因素,第253组淋巴结状态对肿瘤分期、预后评估具有重要意义,存在该组淋巴结转移的患者预后不良。

关键词：左半结肠癌第253组淋巴结危险因素预后

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miR-650靶向PRDX2调控幽门螺旋杆菌对胃癌细胞氧化应激的机制研究

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中国普通外科杂志 2023年第2期32卷 231-238页

作者：王永琦何冬雷梁月祥刘丽杰海南医学院附属第一医院胃肠肿瘤外科海南海口570102

背景与目的:幽门螺旋杆菌(HP)在人类胃部的定植是引起胃癌发生较明确的危险因素,且研究发现,HP感染后胃癌细胞的氧化应激水平有明显改变,但机制尚未明确。因此,本研究探讨HP引起胃癌细胞氧化应激的潜在机制和作用。方法:用HP感染胃癌细... 详细信息

背景与目的:幽门螺旋杆菌(HP)在人类胃部的定植是引起胃癌发生较明确的危险因素,且研究发现,HP感染后胃癌细胞的氧化应激水平有明显改变,但机制尚未明确。因此,本研究探讨HP引起胃癌细胞氧化应激的潜在机制和作用。方法:用HP感染胃癌细胞SNU-1后,分别用DCF-DA荧光法和CCK-8法检测的活性氧(ROS)水平和增殖能力的变化;用高通量测序和siRNA筛选鉴定HP感染后引起SNU-1细胞氧化应激增强的关键基因,随后通过miRDB在线分析和荧光素酶报告系统鉴定引起胃癌细胞SNU-1氧化应激的关键上游miRNA,同时结合功能获得与功能缺失实验验证。结果:SNU-1细胞感染HP后,ROS水平升高,增殖能力增强,但同时使用氧化应激抑制剂乙酰半胱氨酸处理,SNU-1细胞的以上变化被取消(均P>0.05)。siRNA筛选结果发现,敲低过氧化氢酶2(PRDX2)时HP感染的SNU-1细胞ROS水平升高,增殖能力增强,而过表达PRDX2后则相反(均P0.05),但PRDX2的mRNA水平下降(P0.05)。结论:HP感染增加胃癌细胞氧化应激水平的机制和作用可能是其上调miR-650的表达,后者靶向PRDX2 mRNA的3’端非编码区抑制PRDX2 mRNA与蛋白表达,导致ROS水平升高,从而促进胃癌细胞的增殖。

关键词：胃肿瘤幽门螺杆菌氧化性应激细胞增殖硫氧还原蛋白过氧化物酶类微RNAs

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面向智能船舶的水面小目标检测算法

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大连理工大学学报 2021年第3期61卷 255-264页

作者：梁月翔冯辉徐海祥武汉理工大学交通学院湖北武汉430070 武汉理工大学高性能船舶技术教育部重点实验室湖北武汉430070

针对智能船舶中基于视觉传感器的水面小目标识别具有识别区域分辨率低、图像模糊、信噪比低等问题,提出了一种新的基于卷积神经网络的水面小目标检测算法——自注意力特征融合检测算法.首先,为了提高视觉信息处理的效率与准确性,在网络... 详细信息

针对智能船舶中基于视觉传感器的水面小目标识别具有识别区域分辨率低、图像模糊、信噪比低等问题,提出了一种新的基于卷积神经网络的水面小目标检测算法——自注意力特征融合检测算法.首先,为了提高视觉信息处理的效率与准确性,在网络模型中引入了自注意力模块,更多关注小目标的细节信息.其次,在网络模型中采用了结构化的特征融合算法,通过多尺度语义信息融合提升对小目标的检测性能.最后,为了解决目标检测的定位问题,在smooth L1损失函数的基础上设计了一种大梯度定位损失函数.通过与传统的Faster R-CNN目标检测算法在船舶数据库上进行仿真对比,验证了所提算法在解决水面小目标检测问题上的有效性.

关键词：智能船舶目标检测卷积神经网络

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