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Luo XJ, Lu YX, Wang Y, Huang R, Liu J, Jin Y, Liu ZK, Liu ZX, Huang QT, Pu HY, Zeng ZL, Xu R, Zhao Q, Wu QN. M6A-modified lncRNA FAM83H-AS1 promotes colorectal cancer progression through PTBP1. Cancer Lett 2024; 598:217085. [PMID: 38964733 DOI: 10.1016/j.canlet.2024.217085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/16/2024] [Accepted: 06/25/2024] [Indexed: 07/06/2024]
Abstract
LncRNA plays a crucial role in cancer progression and targeting, but it has been difficult to identify the critical lncRNAs involved in colorectal cancer (CRC) progression. We identified FAM83H-AS1 as a tumor-promoting associated lncRNA using 21 pairs of stage IV CRC tissues and adjacent normal tissues. In vitro and in vivo experiments revealed that knockdown of FAM83H-AS1 in CRC cells inhibited tumor proliferation and metastasis, and vice versa. M6A modification is critical for FAM83H-AS1 RNA stability through the writer METTL3 and the readers IGF2BP2/IGFBP3. PTBP1-an RNA binding protein-is responsible for the FAM83H-AS1 function in CRC. T4 (1770-2440 nt) and T5 (2440-2743 nt) on exon 4 of FAM83H-AS1 provide a platform for PTBP1 RRM2 interactions. Our results demonstrated that m6A modification dysregulated the FAM83H-AS1 oncogenic role by phosphorylated PTBP1 on its RNA splicing effect. In patient-derived xenograft models, ASO-FAM83H-AS1 significantly suppressed the growth of gastrointestinal (GI) tumors, not only CRC but also GC and ESCC. The combination of ASO-FAM83H-AS1 and oxaliplatin/cisplatin significantly suppressed tumor growth compared with treatment with either agent alone. Notably, there was pathological complete response in all these three GI cancers. Our findings suggest that FAM83H-AS1 targeted therapy would benefit patients primarily receiving platinum-based therapy in GI cancers.
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Affiliation(s)
- Xiao-Jing Luo
- Department of Pathology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, PR China
| | - Yun-Xin Lu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, PR China
| | - Yun Wang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, PR China
| | - Runjie Huang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, PR China
| | - Jia Liu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, PR China
| | - Ying Jin
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, PR China
| | - Ze-Kun Liu
- Department of Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, PR China
| | - Ze-Xian Liu
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, PR China
| | - Qi-Tao Huang
- Department of Pathology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, PR China
| | - Heng-Ying Pu
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, PR China
| | - Zhao-Lei Zeng
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, PR China
| | - Ruihua Xu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, PR China; Research Unit of Precision Diagnosis and Treatment for Gastrointestinal Cancer, Chinese Academy of Medical Sciences, Guangzhou, 510060, PR China.
| | - Qi Zhao
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, PR China.
| | - Qi-Nian Wu
- Department of Pathology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, PR China.
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Chen G, Xie J, Li P, Wang Q, Ye Q, Feng S. A combined nutritional risk index and carcinoembryonic antigen score predicts the outcome in radically resected colorectal cancer. ANZ J Surg 2024. [PMID: 39016342 DOI: 10.1111/ans.19161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 06/20/2024] [Accepted: 06/30/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Nutritional risk index (NRI) and carcinoembryonic antigen (CEA) are useful prognostic markers in colorectal cancer (CRC); however, the prognostic value of a combination of the NRI and CEA, namely, the NRI and CEA score (NCS), needs further investigation. METHODS Stage I-III CRC patients were collected and then divided into three subgroups by counting the NCS: NCS 1: high NRI with normal CEA; NCS 2: high NRI with elevated CEA or low NRI with normal CEA; and NCS 3: low NRI with elevated CEA. The differences in outcome, counted as disease-free survival (DFS) and overall survival (OS), were tested among the subgroups. RESULTS A total of 285 patients were enrolled, with 108 in NCS 1, 118 in NCS 2 and 59 in NCS 3. Patient features, including age, tumour deposit, T stage, N stage and TNM stage, were significantly different in the NCS subgroups. Both the DFS (log-rank = 26.06, P<0.001) and OS (log-rank = 39.10, P<0.001) were significant in different NCS subgroups, even in maximum tumour diameter ≤4 cm cases (DFS: log-rank = 21.42, P<0.001; OS: log-rank = 30.95, P<0.001), and NCS 1 patients displayed the best outcome compared with the rest of the subgroups. NCS was also found to be an independent risk factor for both DFS and OS. CONCLUSIONS NCS was a useful prognostic indicator in stages I-III CRC patients.
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Affiliation(s)
- Guanzhou Chen
- Department of Emergency Medicine, Hainan Hospital of PLA General Hospital, Sanya, People's Republic of China
| | - Jiang Xie
- Department of Clinical Laboratory, Hainan Hospital of PLA General Hospital, Sanya, People's Republic of China
| | - Panhua Li
- Department of Oncology, Hainan Hospital of PLA General Hospital, Sanya, People's Republic of China
| | - Qin Wang
- Department of Nursing, Hainan Hospital of PLA General Hospital, Sanya, People's Republic of China
| | - Qianwen Ye
- Department of Oncology, Hainan Hospital of PLA General Hospital, Sanya, People's Republic of China
| | - Shouhan Feng
- Department of Oncology, Huzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Huzhou, People's Republic of China
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Bao L, Jin H, Lu X, Wang F. Effectiveness of a Community-Based Ostomy Nursing Technique to Enhance the Delivery of Patient Care and Quality of Life. J Community Health Nurs 2024:1-15. [PMID: 38982794 DOI: 10.1080/07370016.2024.2370833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
This study aimed to develop and validate a community-based ostomy care training program for nursing staff, with the goal of enhancing their ostomy nursing competencies and improving patient satisfaction. Between March 2021 and October 2021, 20 registered nurses and 50 patients with enterostomy surgery who took part in the promotion of a new nursing technique in five community health service centers in the Wuxing District, Huzhou City, were enrolled in this study (forming the intervention group). In addition, 15 registered nurses and 40 patients with enterostomy surgery from four community health service centers with similar economic and health conditions in the same area were randomly selected as the control group. All community health service centers were independent institutions. The indexes before and after the promotion of the technique were compared, and the effectiveness of the training was evaluated by observing the improvement in nursing skills and changes in patient quality of life after the training. The "quality-of-life scale" was used to analyze the quality of life of patients who had undergone colostomy surgery. The new approach to ostomy care delivered in a community setting was found to improve staff knowledge and skill in ostomy care (p < 0.001), improve the quality-of-life scores of patients and reduce patient travel time and medical expenses. The promotion of ostomy nursing techniques in community health service centers has several benefits. It improves the ostomy nursing skill levels of community medical staff. This reduces the occurrence of ostomy complications. Additionally, it establishes an effective connection between tertiary hospitals and community health service centers. This connection is conducive to better nursing care for patients who have undergone ostomy surgery. The hospital - community - family nursing model can improve self-management abilities and reduce the incidence of complications of enterostomies.
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Affiliation(s)
- Lichao Bao
- Department of Anus & Intestine Surgery, The First People's Hospital of Huzhou, The First Affiliated Hospital of Huzhou Teachers' College, Huzhou, China
| | - Hong Jin
- Department of Anus & Intestine Surgery, The First People's Hospital of Huzhou, The First Affiliated Hospital of Huzhou Teachers' College, Huzhou, China
| | - Xiaoyue Lu
- Department of Anus & Intestine Surgery, The First People's Hospital of Huzhou, The First Affiliated Hospital of Huzhou Teachers' College, Huzhou, China
| | - Feifei Wang
- Department of Anus & Intestine Surgery, The First People's Hospital of Huzhou, The First Affiliated Hospital of Huzhou Teachers' College, Huzhou, China
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Yang WN, Li XM, Li CF, Chen C, Feng Y, Dai N, Yang YX, Li MX, Li CX, Qian CY, Wang D, Xiao H, Luo JM. Gustative Roussy Immune Score is a Predictor for Major Pathological Response in Rectal Cancer: A Result from the Preoperative Intraarterial Chemoembolization Combined with Radiotherapy (PCAR) Study. Cancer Invest 2024; 42:527-537. [PMID: 38965994 DOI: 10.1080/07357907.2024.2366912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 06/08/2024] [Indexed: 07/06/2024]
Abstract
Despite the emergence of various treatment strategies for rectal cancer based on neoadjuvant chemoradiotherapy, there is currently a lack of reliable biomarkers to determine which patients will respond well to neoadjuvant chemoradiotherapy. Through collecting hematological and biochemical parameters data of patients prior to receiving neoadjuvant chemoradiotherapy, we evaluated the predictive value of systemic inflammatory indices for pathological response and prognosis in rectal cancer patients. We found that baseline GRIm-Score was an independent predictor for MPR in rectal cancer patients. However, no association was observed between several commonly systemic inflammation indices and long-term outcome.
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Affiliation(s)
- Wei-Na Yang
- Cancer Center, Daping Hospital, Army Medical University, Chongqing, China
| | - Xue-Mei Li
- Cancer Center, Daping Hospital, Army Medical University, Chongqing, China
| | - Chao-Fan Li
- Cancer Center, Daping Hospital, Army Medical University, Chongqing, China
| | - Chuan Chen
- Cancer Center, Daping Hospital, Army Medical University, Chongqing, China
| | - Yan Feng
- Cancer Center, Daping Hospital, Army Medical University, Chongqing, China
| | - Nan Dai
- Cancer Center, Daping Hospital, Army Medical University, Chongqing, China
| | - Yu-Xin Yang
- Cancer Center, Daping Hospital, Army Medical University, Chongqing, China
| | - Meng-Xia Li
- Cancer Center, Daping Hospital, Army Medical University, Chongqing, China
| | - Chun-Xue Li
- Department of General Surgery, Colorectal Division, Daping Hospital, Army Medical University, Chongqing, China
| | - Cheng-Yuan Qian
- Cancer Center, Daping Hospital, Army Medical University, Chongqing, China
| | - Dong Wang
- Cancer Center, Daping Hospital, Army Medical University, Chongqing, China
| | - He Xiao
- Cancer Center, Daping Hospital, Army Medical University, Chongqing, China
| | - Jia-Min Luo
- Cancer Center, Daping Hospital, Army Medical University, Chongqing, China
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Yuan R, Xu ZJ, Zhang SK, Cao XY, Dai AG, Song L. New evidence for a role of DANCR in cancers: a comprehensive review. J Transl Med 2024; 22:569. [PMID: 38877534 PMCID: PMC11177382 DOI: 10.1186/s12967-024-05246-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 04/28/2024] [Indexed: 06/16/2024] Open
Abstract
Cancer remains a leading cause of mortality and poses a substantial threat to public health. Studies have revealed that Long noncoding RNA DANCR is a cytoplasmic lncRNA whose aberrant expression plays a pivotal role in various cancer types. Within tumour biology, DANCR exerts regulatory control over crucial processes such as proliferation, invasion, metastasis, angiogenesis, inflammatory responses, cellular energy metabolism reprogramming, and apoptosis. By acting as a competitive endogenous RNA for miRNAs and by interacting with proteins and mRNAs at the molecular level, DANCR contributes significantly to cancer progression. Elevated DANCR levels have also been linked to heightened resistance to anticancer drugs. Moreover, the detection of circulating DANCR holds promise as a valuable biomarker for aiding in the clinical differentiation of different cancer types. This article offers a comprehensive review and elucidation of the primary functions and molecular mechanisms through which DANCR influences tumours.
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Affiliation(s)
- Rong Yuan
- School of Medicine, Hunan University of Chinese Medicine, 300 Xueshi Road, Hanpu Science and Teaching Park, Changsha, 410208, Hunan, China
- Hunan Provincial Key Laboratory of Vascular Biology and Translational Medicine, 300 Xueshi Road, Hanpu Science and Teaching Park, Changsha, 410208, Hunan, China
| | - Zhao-Jun Xu
- Department of Cardiothoracic Surgery, the First Affiliated Hospital, Hunan University of Chinese Medicine, 97 Shaoshan Road, Changsha, 410007, Hunan, China
| | - Sheng-Kang Zhang
- Department of Cardiothoracic Surgery, the First Affiliated Hospital, Hunan University of Chinese Medicine, 97 Shaoshan Road, Changsha, 410007, Hunan, China
| | - Xian-Ya Cao
- Hunan Provincial Key Laboratory of Vascular Biology and Translational Medicine, 300 Xueshi Road, Hanpu Science and Teaching Park, Changsha, 410208, Hunan, China
- Department of Respiratory Diseases, School of Medicine, Hunan University of Chinese Medicine, Changsha, 410208, Hunan, China
| | - Ai-Guo Dai
- Hunan Provincial Key Laboratory of Vascular Biology and Translational Medicine, 300 Xueshi Road, Hanpu Science and Teaching Park, Changsha, 410208, Hunan, China.
- Department of Respiratory Diseases, School of Medicine, Hunan University of Chinese Medicine, Changsha, 410208, Hunan, China.
- Department of Respiratory Medicine, The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, 410021, Hunan, China.
| | - Lan Song
- Hunan Provincial Key Laboratory of Vascular Biology and Translational Medicine, 300 Xueshi Road, Hanpu Science and Teaching Park, Changsha, 410208, Hunan, China.
- Department of Biochemistry and Molecular Biology, School of Medicine, Hunan University of Chinese Medicine, Changsha, 410208, Hunan, China.
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Sun J, Wei Y, Wang J, Hou M, Su L. Treatment of colorectal cancer by traditional Chinese medicine: prevention and treatment mechanisms. Front Pharmacol 2024; 15:1377592. [PMID: 38783955 PMCID: PMC11112518 DOI: 10.3389/fphar.2024.1377592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/15/2024] [Indexed: 05/25/2024] Open
Abstract
Colorectal cancer (CRC) is a significant global health burden, with high morbidity and mortality rates. It is often diagnosed at middle to advanced stage, affecting approximately 35% of patients at the time of diagnosis. Currently, chemotherapy has been used to improve patient prognosis and increase overall survival. However, chemotherapy can also have cytotoxic effects and lead to adverse reactions, such as inhibiting bone marrow hematopoiesis, causing digestive dysfunction, hand-foot syndrome, and even life-threatening conditions. In response to these adverse effects, researchers have proposed using Traditional Chinese Medicine (TCM) as an option to treat cancer. TCM research focuses on prescriptions, herbs, and components, which form essential components of the current research in Chinese medicine. The study and implementation of TCM prescriptions and herbs demonstrate its distinctive holistic approach to therapy, characterized by applying multi-component and multi-target treatment. TMC components have advantages in developing new drugs as they consist of single ingredients, require smaller medication dosages, have a precise measure of pharmacodynamic effects, and have a clear mechanism of action compared to TCM prescriptions and herbs. However, further research is still needed to determine whether TMC components can fully substitute the therapeutic efficacy of TCM prescriptions. This paper presents a comprehensive analysis of the research advancements made in TCM prescriptions, herbs, and components. The findings of this study can serve as a theoretical basis for researchers who are interested in exploring the potential of TCM for the treatment of colorectal cancer.
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Affiliation(s)
- Jiaxin Sun
- Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia Key Laboratory of Medical Cell Biology, Hohhot, Inner Mongolia, China
| | - Ying Wei
- Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia Key Laboratory of Medical Cell Biology, Hohhot, Inner Mongolia, China
| | - Jia Wang
- Department of Gynaecology, Inner Mongolia People’s Hospital, Hohhot, Inner Mongolia, China
| | - Mingxing Hou
- Department of Gastrointestinal Surgery, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China
| | - Liya Su
- Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia Key Laboratory of Medical Cell Biology, Hohhot, Inner Mongolia, China
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Qu R, Zhang Z, Fu W. Potential of Serum Glycoproteome Profiling in Prediction of Advanced Adenomas and Colorectal Carcinoma: Individual Heterogeneity Should Be Taken Into Account. Gastroenterology 2024; 166:946. [PMID: 38147931 DOI: 10.1053/j.gastro.2023.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 12/28/2023]
Affiliation(s)
- Ruize Qu
- Department of General Surgery; Cancer Center, Peking University Third Hospital, Beijing, China
| | - Zhipeng Zhang
- Department of General Surgery; Cancer Center, Peking University Third Hospital, Beijing, China
| | - Wei Fu
- Department of General Surgery; Cancer Center, Peking University Third Hospital, Beijing, China
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Yu Z, Li B, Zhao S, Du J, Zhang Y, Liu X, Guo Q, Zhou H, He M. Uptake and detection rate of colorectal cancer screening with colonoscopy in China: A population-based, prospective cohort study. Int J Nurs Stud 2024; 153:104728. [PMID: 38461798 DOI: 10.1016/j.ijnurstu.2024.104728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/22/2024] [Accepted: 02/14/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Colorectal cancer is the leading cause of cancer-related death worldwide. Colonoscopy is widely used as a screening test for detecting colorectal cancer in many countries. However, there is little evidence regarding the uptake and diagnostic yields of colonoscopy in population-based screening programs in countries with limited medical resources. OBJECTIVE We reported the uptake of colonoscopy and the detection of colorectal lesions and explored related factors based on a colorectal cancer screening program in China. DESIGN Individuals aged 45-74 years who were asymptomatic for colorectal cancer and had no history of colorectal cancer were recruited. An established risk score system was used to identify individuals at high risk for colorectal cancer, and they were subsequently recommended for colonoscopy. SETTING A population-based, prospective cohort study was implemented in 169 communities, 14 districts of Chongqing, Southwest China. PARTICIPANTS A total of 288,150 eligible participants were recruited from November 2013 to June 2021, and 41,315 participants were identified to be at high risk of colorectal cancer. METHODS Generalized linear mixed model was used to explore the individual and community structural characteristics associated with uptake of colonoscopy. Additionally, the detection rate of colorectal lesions under colonoscopy screening was also reported, and their associated factors were explored. RESULTS 7859 subjects underwent colonoscopy, with an uptake rate of 19.02 % (95 % CI 18.64 %-19.40 %). Lower uptake rates were associated with older age, lower education, more physical activity, and structural characteristics, including residing in developing areas (OR 0.73, 95 % CI 0.69-0.78), residing more than 5 km from screening hospital (5-10 km: OR 0.85, 95 % CI 0.79-0.91; >10 km: OR 0.85, 95 % CI 0.80-0.91), and not being exposed to social media publicity (OR 0.63, 95 % CI 0.53-0.75). Overall, 8 colorectal cancers (0.10 %), 423 advanced adenomas (5.38 %), 820 nonadvanced adenomas (10.43 %), and 684 hyperplastic polyps (8.70 %) were detected, with an adenoma detection rate of 15.92 %. Several factors, including older age, male, current smoking and a family history of colorectal cancer, were positively related to colorectal neoplasms. CONCLUSIONS The uptake of colonoscopy for colorectal cancer screening was not optimal among a socioeconomically diverse high-risk population. The screening strategy should attempt to ensure equitable access to screening according to regional characteristics, and enhance the uptake of colonoscopy by recommended multifaceted interventions, which focus on individuals with poor compliance, select a closer screening hospital, and strengthen social media publicity at the structural level.
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Affiliation(s)
- Zhikai Yu
- Office of Cancer Prevention and Control, Chongqing University Cancer Hospital, 400030 Chongqing, China
| | - Bibo Li
- Department of Oncology, Chongqing General Hospital, Chongqing University, 401147 Chongqing, China
| | - Shenglin Zhao
- Office of Cancer Prevention and Control, Chongqing University Cancer Hospital, 400030 Chongqing, China
| | - Jia Du
- Office of Cancer Prevention and Control, Chongqing University Cancer Hospital, 400030 Chongqing, China
| | - Yan Zhang
- Office of Cancer Prevention and Control, Chongqing University Cancer Hospital, 400030 Chongqing, China
| | - Xiu Liu
- Office of Cancer Prevention and Control, Chongqing University Cancer Hospital, 400030 Chongqing, China
| | - Qing Guo
- Office of Cancer Prevention and Control, Chongqing University Cancer Hospital, 400030 Chongqing, China
| | - Hong Zhou
- Department of Urologic Oncology Surgery, Chongqing University Cancer Hospital, 400030 Chongqing, China.
| | - Mei He
- Office of Cancer Prevention and Control, Chongqing University Cancer Hospital, 400030 Chongqing, China.
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Wang K, He H, Lin Y, Zhang Y, Chen J, Hu J, He X. A new clinical model for predicting lymph node metastasis in T1 colorectal cancer. Int J Colorectal Dis 2024; 39:46. [PMID: 38565736 PMCID: PMC10987358 DOI: 10.1007/s00384-024-04621-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/22/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE Lymph node metastasis (LNM) is a crucial factor that determines the prognosis of T1 colorectal cancer (CRC) patients. We aimed to develop a practical prediction model for LNM in T1 CRC. METHODS We conducted a retrospective analysis of data from 825 patients with T1 CRC who underwent radical resection at a single center in China. All enrolled patients were randomly divided into a training set and a validation set at a ratio of 7:3 using R software. Risk factors for LNM were identified through multivariate logistic regression analyses. Subsequently, a prediction model was developed using the selected variables. RESULTS The lymph node metastasis (LNM) rate was 10.1% in the training cohort and 9.3% in the validation cohort. In the training set, risk factors for LNM in T1 CRC were identified, including depressed endoscopic gross appearance, sex, submucosal invasion combined with tumor grade (DSI-TG), lymphovascular invasion (LVI), and tumor budding. LVI emerged as the most potent predictor for LNM. The prediction model based on these factors exhibited good discrimination ability in the validation sets (AUC: 79.3%). Compared to current guidelines, the model could potentially reduce over-surgery by 48.9%. Interestingly, we observed that sex had a differential impact on LNM between early-onset and late-onset CRC patients. CONCLUSIONS We developed a clinical prediction model for LNM in T1 CRC using five factors that are easily accessible in clinical practice. The model has better predictive performance and practicality than the current guidelines and can assist clinicians in making treatment decisions for T1 CRC patients.
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Affiliation(s)
- Kai Wang
- Department of Anaesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Hui He
- Department of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yanyun Lin
- Department of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yanhong Zhang
- Department of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Junguo Chen
- Department of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
- Department of Thoracic Surgery, Thoracic Cancer Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jiancong Hu
- Department of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
| | - Xiaosheng He
- Department of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
- Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
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Zheng HD, Huang QY, Huang QM, Ke XT, Ye K, Lin S, Xu JH. T2-weighted imaging-based radiomic-clinical machine learning model for predicting the differentiation of colorectal adenocarcinoma. World J Gastrointest Oncol 2024; 16:819-832. [PMID: 38577440 PMCID: PMC10989374 DOI: 10.4251/wjgo.v16.i3.819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/30/2023] [Accepted: 01/29/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND The study on predicting the differentiation grade of colorectal cancer (CRC) based on magnetic resonance imaging (MRI) has not been reported yet. Developing a non-invasive model to predict the differentiation grade of CRC is of great value. AIM To develop and validate machine learning-based models for predicting the differentiation grade of CRC based on T2-weighted images (T2WI). METHODS We retrospectively collected the preoperative imaging and clinical data of 315 patients with CRC who underwent surgery from March 2018 to July 2023. Patients were randomly assigned to a training cohort (n = 220) or a validation cohort (n = 95) at a 7:3 ratio. Lesions were delineated layer by layer on high-resolution T2WI. Least absolute shrinkage and selection operator regression was applied to screen for radiomic features. Radiomics and clinical models were constructed using the multilayer perceptron (MLP) algorithm. These radiomic features and clinically relevant variables (selected based on a significance level of P < 0.05 in the training set) were used to construct radiomics-clinical models. The performance of the three models (clinical, radiomic, and radiomic-clinical model) were evaluated using the area under the curve (AUC), calibration curve and decision curve analysis (DCA). RESULTS After feature selection, eight radiomic features were retained from the initial 1781 features to construct the radiomic model. Eight different classifiers, including logistic regression, support vector machine, k-nearest neighbours, random forest, extreme trees, extreme gradient boosting, light gradient boosting machine, and MLP, were used to construct the model, with MLP demonstrating the best diagnostic performance. The AUC of the radiomic-clinical model was 0.862 (95%CI: 0.796-0.927) in the training cohort and 0.761 (95%CI: 0.635-0.887) in the validation cohort. The AUC for the radiomic model was 0.796 (95%CI: 0.723-0.869) in the training cohort and 0.735 (95%CI: 0.604-0.866) in the validation cohort. The clinical model achieved an AUC of 0.751 (95%CI: 0.661-0.842) in the training cohort and 0.676 (95%CI: 0.525-0.827) in the validation cohort. All three models demonstrated good accuracy. In the training cohort, the AUC of the radiomic-clinical model was significantly greater than that of the clinical model (P = 0.005) and the radiomic model (P = 0.016). DCA confirmed the clinical practicality of incorporating radiomic features into the diagnostic process. CONCLUSION In this study, we successfully developed and validated a T2WI-based machine learning model as an auxiliary tool for the preoperative differentiation between well/moderately and poorly differentiated CRC. This novel approach may assist clinicians in personalizing treatment strategies for patients and improving treatment efficacy.
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Affiliation(s)
- Hui-Da Zheng
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Qiao-Yi Huang
- Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Qi-Ming Huang
- Department of Computed Tomography/Magnetic Resonance Imaging, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Xiao-Ting Ke
- Department of Computed Tomography/Magnetic Resonance Imaging, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Kai Ye
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Shu Lin
- Centre of Neurological and Metabolic Research, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
- Group of Neuroendocrinology, Garvan Institute of Medical Research, Sydney, NSW 2010, Australia
| | - Jian-Hua Xu
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
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11
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Gao J, Liu Y. Prediction and the influencing factor study of colorectal cancer hospitalization costs in China based on machine learning-random forest and support vector regression: a retrospective study. Front Public Health 2024; 12:1211220. [PMID: 38389946 PMCID: PMC10881792 DOI: 10.3389/fpubh.2024.1211220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Aims As people's standard of living improves, the incidence of colorectal cancer is increasing, and colorectal cancer hospitalization costs are relatively high. Therefore, predicting the cost of hospitalization for colorectal cancer patients can provide guidance for controlling healthcare costs and for the development of related policies. Methods This study used the first page of medical record data on colorectal cancer inpatient cases of a tertiary first-class hospital in Shenzhen from 2018 to 2022. The impacting factors of hospitalization costs for colorectal cancer were analyzed. Random forest and support vector regression models were used to establish predictive models of the cost of hospitalization for colorectal cancer patients and to compare and evaluate. Results In colorectal cancer inpatients, major procedures, length of stay, level of procedure, Charlson comorbidity index, age, and medical payment method were the important influencing factors. In terms of the test set, the R2 of the Random forest model was 0.833, the R2 of the Support vector regression model was 0.824; the root mean square error (RMSE) of the Random forest model was 0.029, and the RMSE of the Support vector regression model was 0.032. In the Random Forest model, the weight of the major procedure was the highest (0.286). Conclusion Major procedures and length of stay have the greatest impacts on hospital costs for colorectal cancer patients. The random forest model is a better method to predict the hospitalization costs for colorectal cancer patients than the support vector regression.
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Affiliation(s)
- Jun Gao
- Department of Medical Record Statistics, Peking University Shenzhen Hospital, Shenzhen, China
- School of Public Healthy, Guilin Medical University, Guilin, China
| | - Yan Liu
- Department of Medical Record Statistics, Peking University Shenzhen Hospital, Shenzhen, China
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12
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Gao Q, Li L, Zhang QM, Sheng QS, Zhang JL, Jin LJ, Shang RY. Monotropein Induced Apoptosis and Suppressed Cell Cycle Progression in Colorectal Cancer Cells. Chin J Integr Med 2024; 30:25-33. [PMID: 37750986 DOI: 10.1007/s11655-023-3710-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE To determine whether monotropein has an anticancer effect and explore its potential mechanisms against colorectal cancer (CRC) through network pharmacology and molecular docking combined with experimental verification. METHODS Network pharmacology and molecular docking were used to predict potential targets of monotropein against CRC. Cell counting kit assay, plate monoclonal assay and microscopic observation were used to investigate the antiproliferative effects of monotropein on CRC cells HCT116, HT29 and LoVo. Flow cytometry and scratch assay were used to analyze apoptosis and cell cycle, as well as cell migration, respectively in HCT116, HT29, and LoVo cells. Western blotting was used to detect the expression of proteins related to apoptosis, cell cycle, and cell migration, and the expression of proteins key to the Akt pathway. RESULTS The Gene Ontology and Reactome enrichment analyses indicated that the anticancer potential of monotropein against CRC might be involved in multiple cancer-related signaling pathways. Among these pathways, RAC-beta serine/threonine-protein kinase (Akt1, Akt2), cyclin-dependent kinase 6 (CDK6), matrix metalloproteinase-9 (MMP9), epidermal growth factor receptor (EGFR), cell division control protein 42 homolog (CDC42) were shown as the potential anticancer targets of monotropein against CRC. Molecular docking suggested that monotropein may interact with the 6 targets (Akt1, Akt2, CDK6, MMP9, EGFR, CDC42). Subsequently, cell activity of HCT116, HT29 and LoVo cell lines were significantly suppressed by monotropein (P<0.05). Furthermore, our research revealed that monotropein induced cell apoptosis by inhibiting Bcl-2 and increasing Bax, induced G1-S cycle arrest in colorectal cancer by decreasing the expressions of CyclinD1, CDK4 and CDK6, inhibited cell migration by suppressing the expressions of CDC42 and MMP9 (P<0.05), and might play an anticancer role through Akt signaling pathway. CONCLUSION Monotropein exerts its antitumor effects primarily by arresting the cell cycle, causing cell apoptosis, and inhibiting cell migration. This indicates a high potential for developing novel medication for treating CRC.
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Affiliation(s)
- Quan Gao
- School of Pharmacy and Department of Medical Oncology, the Affiliated Hospital of Hangzhou Normal University, Hangzhou Normal University, Hangzhou, 311121, China
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines; Engineering Laboratory of Development and Application of Traditional Chinese Medicines; Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, 311121, China
| | - Lin Li
- School of Pharmacy and Department of Medical Oncology, the Affiliated Hospital of Hangzhou Normal University, Hangzhou Normal University, Hangzhou, 311121, China
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines; Engineering Laboratory of Development and Application of Traditional Chinese Medicines; Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, 311121, China
| | - Qi-Man Zhang
- School of Pharmacy and Department of Medical Oncology, the Affiliated Hospital of Hangzhou Normal University, Hangzhou Normal University, Hangzhou, 311121, China
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines; Engineering Laboratory of Development and Application of Traditional Chinese Medicines; Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, 311121, China
| | - Qin-Song Sheng
- Department of Colorectal Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ji-Liang Zhang
- Beijing Tong Ren Tang Chinese Medicine Co., Ltd., Beijing, 100000, China
| | - Li-Jun Jin
- Department of Traditional Chinese Medicine, Hangzhou Shangcheng District People's Hospital, Hangzhou, China.
| | - Rui-Yan Shang
- Department of Gynecology, Hangzhou Women's Hospital, Hangzhou, 310008, China.
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Yu S, Cheng J, Li P, Tian L, Chen Z, Chen Z, Li Y, Song J. Association study for the role of MMP8 gene polymorphisms in Colorectal cancer susceptibility. BMC Cancer 2023; 23:1169. [PMID: 38031100 PMCID: PMC10688471 DOI: 10.1186/s12885-023-11662-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/21/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is one of the most common malignant tumors, influenced by several genetic loci in its clinical phenotypes. The aim of this study was to determine the relationship between the MMP8 gene polymorphism and CRC risk in the Chinese Han population. METHOD This study recruited 688 CRC patients and 690 healthy controls. The relationship between MMP8 polymorphism and CRC susceptibility was assessed by calculating the odds ratio (OR) and 95% confidence interval (CI) after stratifying by age, gender, body mass index (BMI), smoking, and alcohol consumption under a multi-genetic model. RESULTS MMP8 rs3740938 was associated with increased CRC predisposition (p = 0.016, OR = 1.24, 95% CI: 1.04-1.48), and this association was detected particularly in subjects aged > 60 years, females, people with BMI > 24 kg/m2, smokers, and drinkers. Moreover, rs3740938 was found to be associated with the pathological type of rectal cancer. CONCLUSIONS Our results first displayed that rs3740938 in MMP8 was a risk factor for CRC predisposition. This finding may provide a new biological perspective for understanding the role of the MMP8 gene in CRC pathogenesis.
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Affiliation(s)
- Shuyong Yu
- Department of Gastrointestinal Surgery IV, Hainan Cancer Hospital, 570100, Haikou, Hainan, China
| | - Jiajia Cheng
- Department of Gastrointestinal Surgery IV, Hainan Cancer Hospital, 570100, Haikou, Hainan, China
| | - Ping Li
- Department of Digestive Endoscopy, Hainan Cancer Hospital, 570100, Haikou, Hainan, China
| | - Le Tian
- Department of Digestive Endoscopy, Hainan Cancer Hospital, 570100, Haikou, Hainan, China
| | - Zhuang Chen
- Department of Gastroenterology, Hainan Cancer Hospital, 570100, Haikou, Hainan, China
| | - Zhaowei Chen
- Department of Gastroenterology, Hainan Cancer Hospital, 570100, Haikou, Hainan, China
| | - Yongyu Li
- Department of Gastroenterology, Hainan Cancer Hospital, 570100, Haikou, Hainan, China
| | - Jian Song
- Department of Gastroenterology, Southern University of Science and Technology Hospital, No. 6019 Liuxian Avenue, Nanshan District, 518000, Shenzhen, Guangdong, China.
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Xu L, Zhao J, Li Z, Sun J, Lu Y, Zhang R, Zhu Y, Ding K, Rudan I, Theodoratou E, Song P, Li X. National and subnational incidence, mortality and associated factors of colorectal cancer in China: A systematic analysis and modelling study. J Glob Health 2023; 13:04096. [PMID: 37824177 PMCID: PMC10569376 DOI: 10.7189/jogh.13.04096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023] Open
Abstract
Background Due to their known variation by geography and economic development, we aimed to evaluate the incidence and mortality of colorectal cancer (CRC) in China over the past decades and identify factors associated with CRC among the Chinese population to provide targeted information on disease prevention. Methods We conducted a systemic review and meta-analysis of epidemiolocal studies on the incidence, mortality, and associated factors of CRC among the Chinese population, extracting and synthesising data from eligible studies retrieved from seven global and Chinese databases. We pooled age-standardised incidence rates (ASIRs) and mortality rates (ASMRs) for each province, subregion, and the whole of China, and applied a joinpoint regression model and annual per cent changes (APCs) to estimate the trends of CRC incidence and mortality. We conducted random-effects meta-analyses to assess the effect estimates of identified associated risk factors. Results We included 493 articles; 271 provided data on CRC incidence or mortality, and 222 on associated risk factors. Overall, the ASIR of CRC in China increased from 2.75 to 19.39 (per 100 000 person-years) between 1972 and 2019 with a slowed-down growth rate (APC1 = 5.75, APC2 = 0.42), while the ASMR of CRC decreased from 12.00 to 7.95 (per 100 000 person-years) between 1974 and 2020 with a slight downward trend (APC = -0.89). We analysed 62 risk factors with synthesized data; 16 belonging to the categories of anthropometrics factors, lifestyle factors, dietary factors, personal histories and mental health conditions were graded to be associated with CRC risk among the Chinese population in the meta-analysis limited to the high-quality studies. Conclusions We found substantial variation of CRC burden across regions and provinces of China and identified several associated risk factors for CRC, which could help to guide the formulation of targeted disease prevention and control strategies. Registration PROSPERO: CRD42022346558.
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Affiliation(s)
- Liying Xu
- Department of Big Data in Health Science, School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianhui Zhao
- Department of Big Data in Health Science, School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zihan Li
- Department of Big Data in Health Science, School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jing Sun
- Department of Big Data in Health Science, School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ying Lu
- Department of Big Data in Health Science, School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Rongqi Zhang
- Department of Big Data in Health Science, School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yingshuang Zhu
- Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kefeng Ding
- Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Igor Rudan
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
- Algebra University, Zagreb, Croatia
| | - Evropi Theodoratou
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xue Li
- Department of Big Data in Health Science, School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- The Key Laboratory of Intelligent Preventive Medicine of Zheijang Province, Hangzhou. China
| | - Global Health Epidemiology Research Group (GHERG)
- Department of Big Data in Health Science, School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
- Algebra University, Zagreb, Croatia
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- The Key Laboratory of Intelligent Preventive Medicine of Zheijang Province, Hangzhou. China
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Lu J, Kornmann M, Traub B. Role of Epithelial to Mesenchymal Transition in Colorectal Cancer. Int J Mol Sci 2023; 24:14815. [PMID: 37834263 PMCID: PMC10573312 DOI: 10.3390/ijms241914815] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
The epithelial-mesenchymal transition (EMT) is a cellular reprogramming process that occurs during embryonic development and adult tissue homeostasis. This process involves epithelial cells acquiring a mesenchymal phenotype. Through EMT, cancer cells acquire properties associated with a more aggressive phenotype. EMT and its opposite, mesenchymal-epithelial transition (MET), have been described in more tumors over the past ten years, including colorectal cancer (CRC). When EMT is activated, the expression of the epithelial marker E-cadherin is decreased and the expression of the mesenchymal marker vimentin is raised. As a result, cells temporarily take on a mesenchymal phenotype, becoming motile and promoting the spread of tumor cells. Epithelial-mesenchymal plasticity (EMP) has become a hot issue in CRC because strong inducers of EMT (such as transforming growth factor β, TGF-β) can initiate EMT and regulate metastasis, microenvironment, and immune system resistance in CRC. In this review, we take into account the significance of EMT-MET in CRC and the impact of the epithelial cells' plasticity on the prognosis of CRC. The analysis of connection between EMT and colorectal cancer stem cells (CCSCs) will help to further clarify the current meager understandings of EMT. Recent advances affecting important EMT transcription factors and EMT and CCSCs are highlighted. We come to the conclusion that the regulatory network for EMT in CRC is complicated, with a great deal of crosstalk and alternate paths. More thorough research is required to more effectively connect the clinical management of CRC with biomarkers and targeted treatments associated with EMT.
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Affiliation(s)
| | | | - Benno Traub
- Department of General and Visceral Surgery, Ulm University Hospital, Albert-Einstein-Allee 23, 89081 Ulm, Germany; (J.L.); (M.K.)
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Hu S, Xia K, Huang X, Zhao Y, Zhang Q, Huang D, Xu W, Chen Z, Wang C, Zhang Z. Multifunctional CaCO 3@Cur@QTX125@HA nanoparticles for effectively inhibiting growth of colorectal cancer cells. J Nanobiotechnology 2023; 21:353. [PMID: 37773145 PMCID: PMC10543835 DOI: 10.1186/s12951-023-02104-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 09/11/2023] [Indexed: 10/01/2023] Open
Abstract
Colorectal cancer (CRC) is a major cause of cancer-related deaths in humans, and effective treatments are still needed in clinical practice. Despite significant developments in anticancer drugs and inhibitors, their poor stability, water solubility, and cellular membrane permeability limit their therapeutic efficacy. To address these issues, multifunctional CaCO3 nanoparticles loaded with Curcumin (Cur) and protein deacetylase (HDAC) inhibitor QTX125, and coated with hyaluronic acid (HA) (CaCO3@Cur@QTX125@HA), were prepared through a one-step gas diffusion strategy. Dynamic light scattering (DLS), transmission electron microscopy (TEM), and scanning electron microscopy (SEM) showed that CaCO3@Cur@QTX125@HA nanoparticles have uniform spherical morphology and elemental distribution, with diameters around 450 nm and a Zeta potential of - 8.11 mV. The controlled release of Cur from the nanoparticles was observed over time periods of 48 h. Cellular uptake showed that CaCO3@Cur@QTX125@HA nanoparticles were efficiently taken up by cancer cells and significantly inhibited their growth. Importantly, CaCO3@Cur@QTX125@HA nanoparticles showed specific inhibitory effects on CRC cell growth. Encouragingly, CaCO3@Cur@QTX125@HA nanoparticles successfully internalized into CRC patient-derived organoid (PDO) models and induced apoptosis of tumor cells. The multifunctional CaCO3@Cur@QTX125@HA nanoparticles hold promise for the treatment of CRC.
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Affiliation(s)
- Shengyun Hu
- Department of Colorectal and Anal Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Kunkun Xia
- Department of Colorectal and Anal Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Xiaobei Huang
- Chongqing Institute of Green and Intelligent Technology, Chinese Academy of Sciences, Chongqing, 400714, China
| | - Ye Zhao
- Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Qingqing Zhang
- Department of Colorectal and Anal Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Dongdong Huang
- Pooling Medical Research Institutes of 100Biotech, Beijing, 100006, China
| | - Weiyi Xu
- Department of Dermatology, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Zhengju Chen
- Pooling Medical Research Institutes of 100Biotech, Beijing, 100006, China.
| | - Chenfei Wang
- Department of Dermatology, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, 201102, China.
| | - Zhiyong Zhang
- Department of Colorectal and Anal Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
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Li XH, Luo MM, Wang ZX, Wang Q, Xu B. The role of fungi in the diagnosis of colorectal cancer. Mycology 2023; 15:17-29. [PMID: 38558845 PMCID: PMC10977015 DOI: 10.1080/21501203.2023.2249492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/14/2023] [Indexed: 04/04/2024] Open
Abstract
Colorectal cancer (CRC) is a prevalent tumour with high morbidity rates worldwide, and its incidence among younger populations is rising. Early diagnosis of CRC can help control the associated mortality. Fungi are common microorganisms in nature. Recent studies have shown that fungi may have a similar association with tumours as bacteria do. As an increasing number of tumour-associated fungi are discovered, this provides new ideas for the diagnosis and prognosis of tumours. The relationship between fungi and colorectal tumours has also been recently identified by scientists. Therefore, this paper describes the limitations and prospects of the application of fungi in diagnosing CRC and predicting CRC prognosis.
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Affiliation(s)
- Xu-Huan Li
- Department of General Practice, The Fourth Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ming-Ming Luo
- Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Zu-Xiu Wang
- Department of General Practice, The Fourth Affiliated Hospital of Nanchang University, Nanchang, China
| | - Qi Wang
- Department of Health Statistics, School of PubliHealth and Health Management, Gannan Medical University, Ganzhou, China
| | - Bin Xu
- Jiangxi Cancer Hospital, The Second Affiliated Hospital of Nanchang Medical College, Nanchang, China
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Peiyuan G, Xuhua H, Ganlin G, Xu Y, Zining L, Jiachao H, Bin Y, Guiying W. Construction and validation of a nomogram model for predicting the overall survival of colorectal cancer patients. BMC Surg 2023; 23:182. [PMID: 37386397 DOI: 10.1186/s12893-023-02018-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 04/26/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is a frequent cancer worldwide with varied survival outcomes. OBJECTIVE We aimed to develop a nomogram model to predict the overall survival (OS) of CRC patients after surgery. DESIGN This is a retrospective study. SETTING This study was conducted from 2015 to 2016 in a single tertiary center for CRC. PATIENTS CRC patients who underwent surgery between 2015 and 2016 were enrolled and randomly assigned into the training (n = 480) and validation (n = 206) groups. The risk score of each subject was calculated based on the nomogram. All participants were categorized into two subgroups according to the median value of the score. MAIN OUTCOME MEASURES The clinical characteristics of all patients were collected, significant prognostic variables were determined by univariate analysis. Least absolute shrinkage and selection operator (LASSO) regression was applied for variable selection. The tuning parameter (λ) for LASSO regression was determined by cross-validation. Independent prognostic variables determined by multivariable analysis were used to establish the nomogram. The predictive capacity of the model was assessed by risk group stratification. RESULTS Infiltration depth, macroscopic classification, BRAF, carbohydrate antigen 19 - 9 (CA-199) levels, N stage, M stage, TNM stage, carcinoembryonic antigen levels, number of positive lymph nodes, vascular tumor thrombus, and lymph node metastasis were independent prognostic factors. The nomogram established based on these factors exhibited good discriminatory capacity. The concordance indices for the training and validation groups were 0.796 and 0.786, respectively. The calibration curve suggested favorable agreement between predictions and observations. Moreover, the OS of different risk subgroups was significantly different. LIMITATIONS The limitations of this work included small sample size and single-center design. Also, some prognostic factors could not be included due to the retrospective design. CONCLUSIONS A prognostic nomogram for predicting the OS of CRC patients after surgery was developed, which might be helpful for evaluating the prognosis of CRC patients.
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Affiliation(s)
- Guo Peiyuan
- The Second General Surgery, The Fourth Hospital of Hebei Medical University, NO.12, JianKang Road, Shijiazhuang, Hebei Province, PR China
| | - Hu Xuhua
- The Second General Surgery, The Fourth Hospital of Hebei Medical University, NO.12, JianKang Road, Shijiazhuang, Hebei Province, PR China
| | - Guo Ganlin
- The Second General Surgery, The Fourth Hospital of Hebei Medical University, NO.12, JianKang Road, Shijiazhuang, Hebei Province, PR China
| | - Yin Xu
- The Department of Gastrointestinal Surgery, The Third Hospital of Hebei Medical University, NO.139, Ziqiang Road, Shijiazhuang, Hebei Province, PR China
| | - Liu Zining
- The Second General Surgery, The Fourth Hospital of Hebei Medical University, NO.12, JianKang Road, Shijiazhuang, Hebei Province, PR China
| | - Han Jiachao
- The Second General Surgery, The Fourth Hospital of Hebei Medical University, NO.12, JianKang Road, Shijiazhuang, Hebei Province, PR China
| | - Yu Bin
- The Second General Surgery, The Fourth Hospital of Hebei Medical University, NO.12, JianKang Road, Shijiazhuang, Hebei Province, PR China.
| | - Wang Guiying
- The Second General Surgery, The Fourth Hospital of Hebei Medical University, NO.12, JianKang Road, Shijiazhuang, Hebei Province, PR China.
- The Department of General Surgery, The Second Hospital of Hebei Medical University, No. 215, Heping West Road, Shijiazhuang, Hebei Province, PR China.
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Zheng W, Guo Y, Zhang G, Bai J, Song Y, Song X, Zhu Q, Bao X, Wu G, Zhang C. Peptide encoded by lncRNA BVES-AS1 promotes cell viability, migration, and invasion in colorectal cancer cells via the SRC/mTOR signaling pathway. PLoS One 2023; 18:e0287133. [PMID: 37347740 PMCID: PMC10286995 DOI: 10.1371/journal.pone.0287133] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/31/2023] [Indexed: 06/24/2023] Open
Abstract
Long non-coding RNAs (lncRNAs) have been revealed to harbor open reading frames (ORFs) that can be translated into small peptides. The peptides may participate in the pathogenesis of colorectal cancer (CRC). Herein, we investigated the role of a lncRNA BVES-AS1-encoded peptide in colorectal tumorigenesis. Through bioinformatic analysis, lncRNA BVES-AS1 was predicted to have encoding potential and to be associated with poor prognosis of patients with CRC. In CRC cells, BVES-AS1 was validated to encode a 50-aa-length micro-peptide, named BVES-AS1-201-50aa, through a western blotting method. BVES-AS1-201-50aa enhanced cell viability and promoted the migratory and invasive capacities of HCT116 and SW480 CRC cells in vitro, validated via CCK-8 assay and transwell assay, respectively. Immunofluorescence assay showed that BVES-AS1-201-50aa increased the expression of proliferating cell nuclear antigen (PCNA) and matrix metalloproteinase 9 (MMP9) in CRC cells. We further verified that BVES-AS1-201-50aa targeted and activated the Src/mTOR signaling pathway in CRC cells by co-immunoprecipitation (Co-IP) experiment, qualitative proteomic analysis, and western blotting. Our findings demonstrated that BVES-AS1 could encode a micro-peptide, which promoted CRC cell viability, migration, and invasion in vitro. Our current work broadens the diversity and breadth of lncRNAs in human carcinogenesis.
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Affiliation(s)
- Weiwei Zheng
- Department of Gastrointestinal Surgery, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, Henan Province, China
| | - Yingchang Guo
- Department of Interventional Therapy, the First Affiliated Hospital of Xinxiang Medical College, Xinxiang, Henan Province, China
| | - Guangtan Zhang
- Department of Gastrointestinal Surgery, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, Henan Province, China
| | - Junwei Bai
- Department of Gastrointestinal Surgery, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, Henan Province, China
| | - Yucheng Song
- Department of Gastrointestinal Surgery, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, Henan Province, China
| | - Xiaofei Song
- Department of Gastrointestinal Surgery, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, Henan Province, China
| | - Qinhui Zhu
- Department of General Surgery, Shangcai People’s Hospital, Zhumadian, Henan Province, China
| | - Xuebin Bao
- Department of Gastrointestinal Surgery, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, Henan Province, China
| | - Gang Wu
- Department of Gastrointestinal Surgery, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, Henan Province, China
| | - Chao Zhang
- Department of Gastrointestinal Surgery, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, Henan Province, China
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20
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Huang J, Zhu Y, Xiao H, Liu J, Li S, Zheng Q, Tang J, Meng X. Formation of a traditional Chinese medicine self-assembly nanostrategy and its application in cancer: a promising treatment. Chin Med 2023; 18:66. [PMID: 37280646 DOI: 10.1186/s13020-023-00764-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 05/06/2023] [Indexed: 06/08/2023] Open
Abstract
Traditional Chinese medicine (TCM) has been used for centuries to prevent and treat a variety of illnesses, and its popularity is increasing worldwide. However, the clinical applications of natural active components in TCM are hindered by the poor solubility and low bioavailability of these compounds. To address these issues, Chinese medicine self-assembly nanostrategy (CSAN) is being developed. Many active components of TCM possess self-assembly properties, allowing them to form nanoparticles (NPs) through various noncovalent forces. Self-assembled NPs (SANs) are also present in TCM decoctions, and they are closely linked to the therapeutic effects of these remedies. SAN is gaining popularity in the nano research field due to its simplicity, eco-friendliness, and enhanced biodegradability and biocompatibility compared to traditional nano preparation methods. The self-assembly of active ingredients from TCM that exhibit antitumour effects or are combined with other antitumour drugs has generated considerable interest in the field of cancer therapeutics. This paper provides a review of the principles and forms of CSAN, as well as an overview of recent reports on TCM that can be used for self-assembly. Additionally, the application of CSAN in various cancer diseases is summarized, and finally, a concluding summary and thoughts are proposed. We strongly believe that CSAN has the potential to offer fresh strategies and perspectives for the modernization of TCM.
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Affiliation(s)
- Ju Huang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China
| | - Yu Zhu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China
| | - Hang Xiao
- Capital Medical University, Beijing, People's Republic of China
| | - Jingwen Liu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China
| | - Songtao Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China
| | - Qiao Zheng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China
| | - Jianyuan Tang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China.
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China.
| | - Xiangrui Meng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China.
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People's Republic of China.
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21
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Xia S. Effect of cognitive behavioral stress management on anxiety, depression, and quality of life in colorectal cancer patients post tumor resection: a randomized, controlled study. Ir J Med Sci 2023:10.1007/s11845-023-03405-7. [PMID: 37246173 DOI: 10.1007/s11845-023-03405-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/15/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Cognitive behavioral stress management (CBSM) is a psychotherapy helping individuals develop adaptive behaviors, whose application in colorectal cancer (CRC) is rare. This randomized, controlled study intended to explore the effect of CBSM on anxiety, depression, and quality of life in CRC patients post tumor resection. METHODS One hundred and sixty CRC patients who received tumor resection were randomized (1:1) to receive weekly CBSM or usual care (UC) for 10 weeks after discharge (120 min for each session). Hospital Anxiety and Depression Scale (HADS) and Quality of Life Questionnaire-Core 30 (QLQ-C30) of each patient were assessed after randomization (M0), one month (M1), three months (M3), and six months (M6). RESULTS CBSM realized decreased HADS-anxiety scores at M1 (P = 0.044), M3 (P = 0.020), M6 (P = 0.003) compared to UC, so did anxiety rates at M3 (28.0% vs. 43.6%, P = 0.045), M6 (25.7% vs. 42.5%, P = 0.035), HADS-depression scores at M3 (P = 0.017), M6 (P = 0.005), and depression rates at M3 (25.3% vs. 41.0%, P = 0.040), M6 (22.9% vs. 41.1%, P = 0.020). Concerning the quality of life, CBSM achieved elevated QLQ-C30 global health status scores at M6 (P = 0.008), QLQ-C30 functions scores at M3 (P = 0.047), M6 (P = 0.031), and decreased QLQ-C30 symptoms scores at M3 (P = 0.048) and M6 (P = 0.039) compared with UC. By subgroup analyses, CBSM had a better utility on relieving anxiety, depression and improving quality of life in patients with higher education level and patients receiving adjuvant chemotherapy. CONCLUSION CBSM program alleviates anxiety, depression, and elevates quality of life in CRC patients post tumor resection.
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Affiliation(s)
- Shuli Xia
- Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
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22
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Shen J, Lu S, Qu R, Zhao H, Zhang L, Chang A, Zhang Y, Fu W, Zhang Z. A boundary-guided transformer for measuring distance from rectal tumor to anal verge on magnetic resonance images. PATTERNS 2023; 4:100711. [PMID: 37123445 PMCID: PMC10140608 DOI: 10.1016/j.patter.2023.100711] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 10/17/2022] [Accepted: 02/24/2023] [Indexed: 03/29/2023]
Abstract
Accurate measurement of the distance from the tumor's lowest boundary to the anal verge (DTAV) provides an important reference value for treatment of rectal cancer, but the standard measurement method (colonoscopy) causes substantial pain. Therefore, we propose a method for automatically measuring the DTAV on sagittal magnetic resonance (MR) images. We designed a boundary-guided transformer that can accurately segment the rectum and tumor. From the segmentation results, we estimated the DTAV by automatically extracting the anterior rectal wall from the tumor's lowest point to the anal verge and then calculating its physical length. Experiments were conducted on a rectal tumor MR imaging (MRI) dataset to evaluate the efficacy of our method. The results showed that our method outperformed surgeons with 6 years of experience (p < 0.001). Furthermore, by referring to our segmentation results, attending and resident surgeons could improve their measurement precision and efficiency.
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Affiliation(s)
- Jianjun Shen
- Department of Electronics, Tsinghua University, Beijing 100084, China
| | - Siyi Lu
- Department of General Surgery, Peking University Third Hospital, Beijing 100191, China
- Cancer Center, Peking University Third Hospital, Beijing 100191 China
| | - Ruize Qu
- Department of General Surgery, Peking University Third Hospital, Beijing 100191, China
- Cancer Center, Peking University Third Hospital, Beijing 100191 China
| | - Hao Zhao
- Intel Labs, Beijing 100190, China
| | - Li Zhang
- Department of Electronics, Tsinghua University, Beijing 100084, China
| | - An Chang
- Department of Electronics, Tsinghua University, Beijing 100084, China
| | - Yu Zhang
- School of Astronautics, Beihang University, Beijing 102206, China
- Corresponding author
| | - Wei Fu
- Department of General Surgery, Peking University Third Hospital, Beijing 100191, China
- Cancer Center, Peking University Third Hospital, Beijing 100191 China
- Corresponding author
| | - Zhipeng Zhang
- Department of General Surgery, Peking University Third Hospital, Beijing 100191, China
- Cancer Center, Peking University Third Hospital, Beijing 100191 China
- Corresponding author
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23
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Shen J, Lu S, Qu R, Zhao H, Zhang Y, Chang A, Zhang L, Fu W, Zhang Z. Measuring distance from lowest boundary of rectal tumor to anal verge on CT images using pyramid attention pooling transformer. Comput Biol Med 2023; 155:106675. [PMID: 36805228 DOI: 10.1016/j.compbiomed.2023.106675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/23/2023] [Accepted: 02/11/2023] [Indexed: 02/16/2023]
Abstract
Accurately measuring the Distance from the lowest boundary of rectal tumor To the Anal Verge (DTAV) is critical for developing optimal surgical plans for treating patients with rectal cancer. DTAV was traditionally estimated by colonoscopy or manual measurement on computed tomography (CT) images. However, colonoscopy brings substantial pains to the patient. As for manual measurement on CT images, it is time-consuming and its accuracy depends on the surgeon's expertise. In this work, we present a novel method for automatically measuring DTAV from sagittal CT images. The success of our method is mainly credited to a pyramid attention pooling (PAP) transformer architecture, which naturally entangles global lesion localization and local boundary delineation. Our method automatically generates the rectum's centerline based on a segmented rectum and tumor image to simulate the manual measurement of DTAV. We conduct a comprehensive evaluation of the method with a newly collected rectum tumor CT image dataset. On a test dataset of 48 patients' CT images with rectal tumors, the mean absolute difference between our method and the gold standard is 1.74 cm, which is a significant improvement of 1.29 cm over that measured by a resident surgeon (P < 0.001). In addition, The results measured by the resident surgeon referring to our segmentation results improved by 1.46 cm compared to the results measured independently by the residents. As experimentally demonstrated, our method exhibits great application potential in clinical scenarios.
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Affiliation(s)
- Jianjun Shen
- Department of Electronic Engineering, Tsinghua University, Beijing 100084, China
| | - Siyi Lu
- Department of General Surgery, Peking University Third Hospital, Beijing 100191, China; Cancer Center, Peking University Third Hospital, Beijing 100191, China
| | - Ruize Qu
- Department of General Surgery, Peking University Third Hospital, Beijing 100191, China; Cancer Center, Peking University Third Hospital, Beijing 100191, China
| | - Hao Zhao
- Intel Lab, Beijing 100190, China
| | - Yu Zhang
- School of Astronautics, Beihang University, Beijing 100191, China
| | - An Chang
- Department of Electronic Engineering, Tsinghua University, Beijing 100084, China
| | - Li Zhang
- Department of Electronic Engineering, Tsinghua University, Beijing 100084, China.
| | - Wei Fu
- Department of General Surgery, Peking University Third Hospital, Beijing 100191, China; Cancer Center, Peking University Third Hospital, Beijing 100191, China.
| | - Zhipeng Zhang
- Department of General Surgery, Peking University Third Hospital, Beijing 100191, China; Cancer Center, Peking University Third Hospital, Beijing 100191, China.
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24
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Lu S, Li X, Li X, Zhang Q, Wang Y, Peng R, Fu W, Wang H. The preoperative geriatric nutritional risk index predicts long-term prognosis in elderly locally advanced rectal cancer patients: a two-center retrospective cohort study. Aging Clin Exp Res 2023; 35:311-321. [PMID: 36399323 DOI: 10.1007/s40520-022-02297-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/31/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND The objective is to explore the value of preoperative geriatric nutritional risk index (GNRI) in evaluating long-term prognosis in elderly locally advanced rectal cancer (LARC) patients who accepted neoadjuvant chemoradiotherapy (NCRT) and to compare GNRI with established nutritional markers, including prognostic nutritional index (PNI) and controlling nutritional status (CONUT) score. METHODS Preoperative GNRI was retrospectively assessed in 172 LARC patients aged ≥ 60 years who underwent radical resection after NCRT at two centers. Optimal cutoff value of GNRI was determined by X-tile program. The association of GNRI with clinicopathological parameters and nutritional markers was analyzed. The survival ability of markers was evaluated using time-dependent receiver-operating characteristic (ROC) curve analysis. Finally, survival analysis was performed using Kaplan-Meier and Cox regression analysis. RESULTS GNRI was highly correlated with nutritional markers. An optimal cutoff value for the GNRI was 96. In the time-dependent ROC curve, GNRI demonstrated a stable predictive ability for both disease-free survival (DFS) and overall survival (OS). Multivariate analysis showed that GNRI was the only nutritional marker that independently predicted DFS (HR 2.457, 95% CI 1.066-5.665, P = 0.035) and OS (HR 9.002, 95% CI 3.100-26.146, P < 0.001). As an additional benefit, GNRI was able to stratify survival in subgroups of ypTNM and tumor response. CONCLUSION Preoperative GNRI is a promising predictor of long-term survival for elderly LARC patients undergoing NCRT, superior to the established nutritional markers.
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Affiliation(s)
- Siyi Lu
- Cancer Center, Peking University Third Hospital, Beijing, 100191, China
- Department of General Surgery, Cancer Center, Peking University Third Hospital, Beijing, 100191, China
| | - Xianan Li
- Department of Radiation Oncology, Peking University People's Hospital, Beijing, 100044, China
| | - Xuemin Li
- Department of Radiation Oncology, Cancer Center, Peking University Third Hospital, Beijing, 100191, China
| | - Qiuxiang Zhang
- Department of Clinical Nutrition, Peking University Third Hospital, Beijing, 100191, China
| | - Yuxia Wang
- Department of Radiation Oncology, Cancer Center, Peking University Third Hospital, Beijing, 100191, China
| | - Ran Peng
- Department of Radiation Oncology, Cancer Center, Peking University Third Hospital, Beijing, 100191, China
| | - Wei Fu
- Cancer Center, Peking University Third Hospital, Beijing, 100191, China.
- Department of General Surgery, Cancer Center, Peking University Third Hospital, Beijing, 100191, China.
| | - Hao Wang
- Cancer Center, Peking University Third Hospital, Beijing, 100191, China.
- Department of Radiation Oncology, Cancer Center, Peking University Third Hospital, Beijing, 100191, China.
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25
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Wu Q, Chen P, Shu C, Chen L, Jin Z, Huang J, Wang X, Li X, Wei M, Yang T, Deng X, Wu A, He Y, Wang Z. Survival outcomes of stage I colorectal cancer: development and validation of the ACEPLY model using two prospective cohorts. BMC Med 2023; 21:3. [PMID: 36600277 PMCID: PMC9814451 DOI: 10.1186/s12916-022-02693-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 12/02/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Approximately 10% of stage I colorectal cancer (CRC) patients experience unfavorable clinical outcomes after surgery. However, little is known about the subset of stage I patients who are predisposed to high risk of recurrence or death. Previous evidence was limited by small sample sizes and lack of validation. METHODS We aimed to identify early indicators and develop a risk stratification model to inform prognosis of stage I patients by employing two large prospective cohorts. Prognostic factors for stage II tumors, including T stage, number of nodes examined, preoperative carcinoma embryonic antigen (CEA), lymphovascular invasion, perineural invasion (PNI), and tumor grade were investigated in the discovery cohort, and significant findings were further validated in the other cohort. We adopted disease-free survival (DFS) as the primary outcome for maximum statistical power and recurrence rate and overall survival (OS) as secondary outcomes. Hazard ratios (HRs) were estimated from Cox proportional hazard models, which were subsequently utilized to develop a multivariable model to predict DFS. Predictive performance was assessed in relation to discrimination, calibration and net benefit. RESULTS A total of 728 and 413 patients were included for discovery and validation. Overall, 6.7% and 4.1% of the patients developed recurrences during follow-up. We identified consistent significant effects of PNI and higher preoperative CEA on inferior DFS in both the discovery (PNI: HR = 4.26, 95% CI: 1.70-10.67, p = 0.002; CEA: HR = 1.46, 95% CI: 1.13-1.87, p = 0.003) and the validation analysis (PNI: HR = 3.31, 95% CI: 1.01-10.89, p = 0.049; CEA: HR = 1.58, 95% CI: 1.10-2.28, p = 0.014). They were also significantly associated with recurrence rate. Age at diagnosis was a prominent determinant of OS. A prediction model on DFS using Age at diagnosis, CEA, PNI, and number of LYmph nodes examined (ACEPLY) showed significant discriminative performance (C-index: 0.69, 95% CI:0.60-0.77) in the external validation cohort. Decision curve analysis demonstrated added clinical benefit of applying the model for risk stratification. CONCLUSIONS PNI and preoperative CEA are useful indicators for inferior survival outcomes of stage I CRC. Identification of stage I patients at high risk of recurrence is feasible using the ACEPLY model, although the predictive performance is yet to be improved.
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Affiliation(s)
- Qingbin Wu
- Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China.,West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Pengju Chen
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Unit III & Ostomy Service, Gastrointestinal Cancer Centre, Peking University Cancer Hospital & Institute, Beijing, China
| | - Chi Shu
- Department of Vascular Surgery, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Lin Chen
- Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China
| | - Zechuan Jin
- Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jun Huang
- Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Wang
- Department of Epidemiology and Medical Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xue Li
- Department of Big Data in Health Science, School of Public Health, Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Mingtian Wei
- Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Tinghan Yang
- Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xiangbing Deng
- Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Aiwen Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Unit III & Ostomy Service, Gastrointestinal Cancer Centre, Peking University Cancer Hospital & Institute, Beijing, China.
| | - Yazhou He
- Department of Oncology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
| | - Ziqiang Wang
- Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
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Promotion of Deoxycholic Acid Effect on Colonic Cancer Cell Lines In Vitro by Altering the Mucosal Microbiota. Microorganisms 2022; 10:microorganisms10122486. [PMID: 36557741 PMCID: PMC9788287 DOI: 10.3390/microorganisms10122486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Colorectal cancer (CRC) is the third most prevalent neoplasm and the second leading cause of cancer death worldwide. Microbiota and their products, such as bile acids (BAs), are important causal factors for the occurrence and development of CRC. Therefore, we performed 16S ribosomal RNA (16S rRNA) and liquid chromatography/mass spectrometry (LC-MS) to measure mucosal microbiota and BA composition in paired cancerous and noncancerous gut tissue samples from 33 patients with CRC at a hospital in Beijing. In cancerous tissues, we detected altered mucosal microbiota with increased levels of the genera Bacteroides, Curtobacterium, and Campylobacter and an increase in deoxycholic acid (DCA), which was the only BA elevated in cancerous tissues. Ex vivo coculture showed that the mucosal microbiota in cancerous tissues indeed had a stronger DCA production ability, indicating that DCA-producing bacteria are enriched in tumors. Results from the CCK8 and Transwell assays indicated that DCA enhances the overgrowth, migration, and invasion of CRC cell lines, and, through qPCR and Western blot analyses, downregulation of FXR was observed in CRC cell lines after DCA culture. We then verified the downregulation of FXR expression in cancerous tissues using our data and the TCGA database, and we found that FXR downregulation plays an important role in the development of CRC. In conclusion, differing mucosal microbiota, increased amounts of mucosal DCA, and lower FXR expression were demonstrated in cancerous tissues compared to normal tissue samples. The results of this study can be applied to the development of potential therapeutic targets for CRC prevention, such as altering mucosal microbiota, DCA, or FXR.
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Qu RZ, Ma YP, Bao XY, Tao LY, Zhou X, Lu SY, Zhang Y, Wang BY, Li F, Tuo L, Zhang ZP, Fu W. Features of gastric cancer by anatomic subsite in northern China: A multi-center Health Science Report database study. World J Gastrointest Oncol 2022; 14:2238-2252. [PMID: 36438702 PMCID: PMC9694278 DOI: 10.4251/wjgo.v14.i11.2238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/05/2022] [Accepted: 10/27/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The features of gastric cancer based on the anatomic site remain unknown in northern China patients.
AIM To analyze gastric cancer features and associated trends based on the anatomical site in northern China patients.
METHODS This cross-sectional study used incident gastric cancer case data from 10 Peking University-affiliated hospitals (2014 to 2018). The clinical and prevailing local features were analyzed.
RESULTS A total of 10709 patients were enrolled, including antral (42.97%), cardia (34.30%), and stomach body (18.41%) gastric cancer cases. Cancer in the cardia had the highest male:female ratio, proportion of elderly patients, and patients with complications, including hypertension, diabetes, cerebrovascular, and coronary diseases (P < 0.001). gastric cancer involving the antrum showed the lowest proportion of patients from rural areas and accounted for the highest hospitalization rate and cost (each P < 0.001). The proportion of patients with cancer involving the cardia increased with an increase in the number of gastroesophageal reflux disease cases during the same period (P < 0.001). Multivariate analysis revealed that tumor location in the cardia increased the risk of in-hospital mortality (P = 0.046). Anatomical subsite was not linked to postoperative complications.
CONCLUSION The features of gastric cancer based on the anatomical site differ between northern China and other regions, both globally and within the country. Social factors may account for these differences and should affect policy-making and clinical practice.
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Affiliation(s)
- Rui-Ze Qu
- Department of General Surgery, Cancer Center, Peking University Third Hospital, Beijing 100191, China
| | - Yan-Peng Ma
- Department of General Surgery, Cancer Center, Peking University Third Hospital, Beijing 100191, China
| | - Xiao-Yuan Bao
- Medical Informatics Center, Peking University Health Science Center, Beijing 100191, China
| | - Li-Yuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
| | - Xin Zhou
- Department of General Surgery, Cancer Center, Peking University Third Hospital, Beijing 100191, China
| | - Si-Yi Lu
- Department of General Surgery, Cancer Center, Peking University Third Hospital, Beijing 100191, China
| | - Yi Zhang
- Department of General Surgery, Cancer Center, Peking University Third Hospital, Beijing 100191, China
| | - Bing-Yan Wang
- Department of General Surgery, Cancer Center, Peking University Third Hospital, Beijing 100191, China
| | - Fei Li
- Department of General Surgery, Cancer Center, Peking University Third Hospital, Beijing 100191, China
| | - Lin Tuo
- Department of Hospital Management, Peking University Health Science Center, Beijing 100191, China
| | - Zhi-Peng Zhang
- Department of General Surgery, Cancer Center, Peking University Third Hospital, Beijing 100191, China
| | - Wei Fu
- Department of General Surgery, Cancer Center, Peking University Third Hospital, Beijing 100191, China
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