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Halámková J, Bohovicová L, Pehalová L, Kazda T, Goněc R, Staněk T, Mouková L, Adámková Krákorová D, Kozáková Š, Svoboda M, Demlová R, Gabrielová L, Hernychová L, Kiss I. The risk of second primary malignancies in colorectal cancer patients using calcium channel blockers. Sci Rep 2023; 13:3490. [PMID: 36859505 PMCID: PMC9977965 DOI: 10.1038/s41598-023-29535-7] [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: 10/18/2022] [Accepted: 02/06/2023] [Indexed: 03/03/2023] Open
Abstract
Calcium channel blockers are among the most commonly used agents in the treatment of cardiovascular diseases. There are several known side-effects associated with their long-term use, whereas other potential adverse effects are yet to be proven. This study aims to evaluate the association between calcium channel blockers exposure and the incidence of second primary malignancy. We established a cohort of 1401 patients with colorectal cancer diagnosed in our institution between January 2003 and December 2016. Patients were followed-up until December 2020. The tumor characteristics and basic clinical data including medication information were obtained from the hospital information system database. Second malignancy was detected in 301 patients (21.5%), and occurred in 27.8% of patients who used calcium channel blockers compared to only 19.9% among non-users. Their use was associated with an increased incidence of bladder cancer in particular. Subanalysis of patients with second malignancy displayed a higher proportion of right-sided colon cancer compared to rectal carcinoma in non-users. Survival analysis revealed significantly better outcomes in early-stage colorectal cancer patients without a history of calcium channel blockers treatment or second primary malignancy.
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Affiliation(s)
- Jana Halámková
- grid.419466.8Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Lucia Bohovicová
- grid.419466.8Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Lucie Pehalová
- grid.486651.80000 0001 2231 0366Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic ,grid.10267.320000 0001 2194 0956Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Tomáš Kazda
- grid.419466.8Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Roman Goněc
- grid.419466.8Department of Pharmacy, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Teodor Staněk
- grid.419466.8Department of General Surgical Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Department of Surgical Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Lucie Mouková
- grid.419466.8Department of Gynecologic Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Dagmar Adámková Krákorová
- grid.419466.8Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Šárka Kozáková
- grid.412554.30000 0004 0609 2751Department of Pharmacy, University Hospital Brno, Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Marek Svoboda
- grid.419466.8Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Regina Demlová
- grid.10267.320000 0001 2194 0956Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic ,grid.419466.8Clinical Trial Unit, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Lucie Gabrielová
- grid.10267.320000 0001 2194 0956Department of Surgical Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic ,grid.419466.8Department of Breast, Skin and Oncoplastic Surgery, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Lenka Hernychová
- grid.419466.8Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Igor Kiss
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic. .,Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk University, Brno, Czech Republic. .,Masaryk Memorial Cancer Institute, Žlutý Kopec 7, 656 53, Brno, Czech Republic.
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Wang L, Hu D, Fan Z, Yu J, Zhang S, Lin Y, Chen X, Lin X, Yan X, Lin J, Peng F. Prognostic value of long-term antidiabetic and antihypertensive therapy in postoperative gastric cancer patients: the FIESTA study. BMC Gastroenterol 2022; 22:429. [PMID: 36210441 PMCID: PMC9549639 DOI: 10.1186/s12876-022-02514-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/20/2022] [Indexed: 11/12/2022] Open
Abstract
Background Gastric cancer is often comorbid with hypertension and diabetes mellitus and increases the mortality risk. Materials and methods We conducted this prospective cohort study to investigate antidiabetics and antihypertensives’ impact on gastric cancer survival. 3012 patients with gastric carcinoma undergoing radical gastrectomy were enrolled since January 2000 and followed up until July 2020. Results Hypertension and diabetes patients had worse survival than patients without hypertension and diabetes [median survival time (MST): 48 versus 112.5 months, p < 0.001 for hypertension, MST: 32.7 versus 183+ months, p < 0.001 for diabetes]. Compared to untreated patients, treated patients had better survival (MST: 109.7 months versus 39.1 months, p < 0.001 for antihypertensives, MST: 120.9 months versus 22.3 months, p < 0.001 for antidiabetics). Antihypertensives and antidiabetics were related to 42% (HR 0.58, 95% CI 0.47–0.73, p < 0.001) and 70% (HR 0.30, 95% CI 0.24–0.38, p < 0.001) reduced mortality risk relative to those without medications. metformin and Calcium channel blockers can better-improved prognosis compared to others (p = 0.00029 and p = 0.015). Conclusion Post-surgical gastric cancer patients could benefit substantially from anti-diabetes and antihypertensive therapy. Metformin and Calcium channel blockers may be superior to other medications. Supplementary Information The online version contains supplementary material available at 10.1186/s12876-022-02514-4.
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Zhang X, Hu D, Deng X, Lin J, Zheng X, Peng F, Meng F, Niu W. Prediction of presurgical metabolic syndrome for gastric cancer-specific mortality is more evident in smokers: The FIESTA study. Cancer Med 2022; 12:3419-3432. [PMID: 36028993 PMCID: PMC9939207 DOI: 10.1002/cam4.5116] [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: 03/08/2021] [Revised: 07/22/2022] [Accepted: 07/24/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUNDS We aimed to test whether the prediction of presurgical metabolic syndrome for postsurgical survival outcomes of gastric cancer hinges upon cigarette smoking status. METHODS This study is a part of the ongoing Fujian prospective investigation of cancer (FIESTA) study. Patients with gastric cancer received radical resection of primary gastric cancer between January 2000 and December 2010, with the latest follow-up ended in December 2015. The 1:1 propensity score matching analysis was adopted to balance confounders between smokers and never-smokers. Effect-size estimates are expressed as hazard ratio (HR) with 95% confidence interval (CI). Model performance was evaluated using the Hosmer and Lemeshow test and 10-fold cross-validated area under the receiver operating characteristic curve (AUROC). Statistical analyses were completed with SAS software (v9.4). RESULTS Total 2779 patients with gastric cancer were analyzed, including 2223 smokers and 556 never-smokers. Median follow-up time was 45.6 months. Cigarette smoking was not associated with postsurgical survival differences. Presurgical metabolic syndrome complication was significantly associated with increased gastric cancer-specific mortality in smokers (HR [95% CI]: 2.73 [1.53-4.89], p < 0.001), but not in never-smokers. Relative excess risk due to interaction was estimated to be 2.43 (95% CI: 0.40-4.45). After constructing a risk assessment score, one unit increment was associated with 10% reduced risk of gastric cancer-specific mortality (HR [95% CI]: 0.90 [0.88-0.91], p < 0.001), with 10-fold cross-validated AUROC being 0.82 (95% CI: 0.74-0.92). CONCLUSIONS Our findings showed that the prediction of presurgical metabolic syndrome for gastric cancer-specific mortality was more evident in smokers. Practically, this study provides evidence base for future personalized prediction and helped risk-stratify gastric cancer patients who might experience serious postsurgical consequences.
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Affiliation(s)
- Xinran Zhang
- Institute of Clinical Medical Sciences, China‐Japan Friendship HospitalBeijingChina
| | - Dan Hu
- Department of PathologyFujian Cancer Hospital & Fujian Medical University Cancer HospitalFuzhouChina
| | - Xiangling Deng
- Institute of Clinical Medical Sciences, China‐Japan Friendship HospitalBeijingChina
| | - Jinxiu Lin
- Department of CardiologyFirst Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Xiongwei Zheng
- Department of PathologyFujian Cancer Hospital & Fujian Medical University Cancer HospitalFuzhouChina
| | - Feng Peng
- Department of CardiologyFirst Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Fanqiang Meng
- Department of General SurgeryChina‐Japan Friendship HospitalBeijingChina
| | - Wenquan Niu
- Institute of Clinical Medical Sciences, China‐Japan Friendship HospitalBeijingChina
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Hyperglycemia induces gastric carcinoma proliferation and migration via the Pin1/BRD4 pathway. Cell Death Dis 2022; 8:224. [PMID: 35461311 PMCID: PMC9035156 DOI: 10.1038/s41420-022-01030-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/18/2022]
Abstract
Diabetes is a potential risk factor for gastric cancer (GC). Pin1, a peptidyl–prolyl cis/trans isomerase, promotes GC cell proliferation and migration. The role and underlying mechanism of the Pin1/BRD4 axis in hyperglycemia-induced proliferation and migration of GC cells were analyzed in vivo and in vitro. Proliferation and migration of GC cells were measured; Pin1 and BRD4 expression of the cell cycle were determined. Pin1 and BRD4 were downregulated by transfecting Pin1 shRNA lentivirus into GC cells and JQ1-intervention GC cells. Tumor formation and lung metastasis were assessed in vivo. Inhibition of Pin1 and BRD4 significantly suppressed high-glucose (HG)-induced GC cell proliferation and migration. HG enhanced G1/S cell-cycle transition, associated with increased Pin1 and BRD4 expression. Silencing Pin1 significantly downregulated the expression of BRD4 and NAP1L1 and upregulated that of P21 in GC cells. In vivo studies indicated that hyperglycemia promotes tumor growth and lung metastasis by inducing Pin1 and BRD4 expression. Thus, Pin1/BRD4 plays an important role in hyperglycemia-promoted tumor growth. The significance of these findings toward improved prognosis of diabetic patients with GC cannot be underestimated.
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Liang X, Yao S, Lu P, Ma Y, Xu H, Yin Z, Hu J, Liu Y, Wei S. The Prognostic Value of New Index (LANR) Composed of Pre-operative Lymphocytes, Albumin, and Neutrophils in Patients With Resectable Colorectal Cancer. Front Oncol 2021; 11:610264. [PMID: 34150609 PMCID: PMC8210780 DOI: 10.3389/fonc.2021.610264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 02/08/2021] [Indexed: 12/31/2022] Open
Abstract
Background: Inflammatory factors and nutritional status are critical to the prognosis of colorectal cancer patients. This study aimed to investigate the prognostic value of the combination of preoperative lymphocytes, albumin, and neutrophils (LANR) in patients with resectable colorectal cancer. Methods: A total of 753 patients with pathologically diagnosed primary colorectal cancer were included in the study. The value of LANR was defined as follows: LANR, lymphocyte × albumin/neutrophil. The ROC curve, subgroup analysis and Cox proportional hazard regression analysis were used to assess the prognostic value of LANR in overall survival and progression-free survival. Results: The median age of the patients was 60 years (range 52–67 years). In overall survival, the area under the curve of LANR was 0.6276, and the HR (95% CI) was 0.551 (0.393–0.772). And in progression-free survival, the area under the curve of LANR was 0.5963, and the HR (95% CI) was 0.697 (0.550–0.884). The results indicate that preoperative LANR may be a reliable predictor of overall and progression-free survival in resectable colorectal cancer patients. Conclusions: LANR is an important prognostic indicator for patients with resectable colorectal cancer, and it can also provide a reference for clinicians and patients to choose a treatment plan.
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Affiliation(s)
- Xinjun Liang
- Department of Medical Oncology, Tongji Medical College, Hubei Cancer Hospital, Huazhong University of Science and Technology, Wuhan, China.,Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China
| | - Shuang Yao
- Department of Medical Oncology, Tongji Medical College, Hubei Cancer Hospital, Huazhong University of Science and Technology, Wuhan, China.,Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China
| | - Ping Lu
- Department of Medical Oncology, Tongji Medical College, Hubei Cancer Hospital, Huazhong University of Science and Technology, Wuhan, China.,Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China
| | - Yifei Ma
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China.,Department of Gastrointestinal Surgery, Tongji Medical College, Hubei Cancer Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Hongli Xu
- Department of Medical Oncology, Tongji Medical College, Hubei Cancer Hospital, Huazhong University of Science and Technology, Wuhan, China.,Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China
| | - Zhucheng Yin
- Department of Medical Oncology, Tongji Medical College, Hubei Cancer Hospital, Huazhong University of Science and Technology, Wuhan, China.,Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China
| | - Junjie Hu
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China.,Department of Gastrointestinal Surgery, Tongji Medical College, Hubei Cancer Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Yanyan Liu
- Division of Nephrology, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Shaozhong Wei
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan, China.,Colorectal Cancer Clinical Research Center of Wuhan, Wuhan, China.,Department of Gastrointestinal Surgery, Tongji Medical College, Hubei Cancer Hospital, Huazhong University of Science and Technology, Wuhan, China
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Hu D, Peng F, Lin X, Zhang H, Xia Y, Lin J, Zheng X, Niu W. The risk trajectory between preoperative fasting glucose and common digestive tract cancer-specific mortality in the FIESTA cohort involving 6865 Chinese patients. J Cancer 2019; 10:4596-4602. [PMID: 31528223 PMCID: PMC6746143 DOI: 10.7150/jca.31184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 05/21/2019] [Indexed: 12/25/2022] Open
Abstract
Backgrounds: High blood glucose or hyperglycemia is an established risk factor for the development and progression of cancer at many sites, whereas data on the relevance between low blood glucose or hypoglycemia and cancer survival are lacking. Aims: We aimed to assess the shape of risk trajectory between preoperative fasting glucose and postoperative digestive cancer-specific mortality in Chinese. Methods: In total, 6865 patients who underwent radical surgery for esophageal cancer (n=2535), gastric cancer (n=3012) and colorectal cancer (n=1318) during 2000-2010 were followed up as of December 2015. All patients received neither chemotherapy nor radiotherapy before and after the surgery. Optimal cutoff points were determined using survival tree analysis. Results: The median follow-up time was 44.9 months (range: 0.5-188.9 months), with 1065 deaths from esophageal cancer, 1331 from gastric cancer and 412 from colorectal cancer. Using fasting glucose (4.36, 6.09] mmol/L as the reference group, hazard ratios for fasting glucose ≤4.36, (6.09, 8.95], (8.95, 11.5] and >11.5 mmol/L were 1.35 (95% confidence interval: 1.19, 1.54), 2.82 (2.57, 3.11), 3.56 (3.10, 4.08) and 4.27 (3.67, 4.97), respectively (p<0.001). Conclusions: Our findings indicate a U-shaped risk trajectory between preoperative fasting glucose and digestive tract cancer-specific mortality in Chinese. Further external validation is warranted.
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Affiliation(s)
- Dan Hu
- Department of Pathology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China
| | - Feng Peng
- Department of Cardiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Xiandong Lin
- Department of Radiobiology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China
| | - Hejun Zhang
- Department of Pathology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China
| | - Yan Xia
- Department of Pathology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China
| | - Jinxiu Lin
- Department of Cardiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Xiongwei Zheng
- Department of Pathology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China
| | - Wenquan Niu
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
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Hu D, Jia R, Zhang X, Lin X, Zhang H, Xia Y, Lin J, Zheng X, Peng F, Niu W. Identification of Optimal Baseline Blood Pressure Predicting Postoperative Digestive Tract Cancer-Specific Mortality in the FIESTA Cohort Involving 6865 Patients. J Cancer 2019; 10:1794-1799. [PMID: 31205535 PMCID: PMC6547984 DOI: 10.7150/jca.30385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 02/07/2019] [Indexed: 02/06/2023] Open
Abstract
Background and Objectives: Emerging evidence indicates that hypertension is a potential risk and prognostic factor for cancer at many sites. Currently, no data are available on optimal blood pressure target in patients with resectable digestive tract cancer. Here, we did an exploratory analysis in 6865 patients from the FIESTA cohort to identify optimal blood pressure at baseline that can better predict digestive tract cancer-specific mortality risk postoperatively. Methods and Results: Patients were enrolled between January 2000 and December 2010, with follow-up ending in December 2015. All patients received no preoperative and postoperative chemotherapy or radiotherapy. Data were analyzed using Stata software and R language. Optimal cutting points were determined using survival tree analysis. After a median follow-up of 44.9 months, there were 2808 non-survivors and 4057 survivors. Per 10 mm Hg increment, baseline systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure and mean arterial pressure were associated with the significant risk of digestive tract cancer-specific mortality, even after adjusting for confounding factors (adjusted hazard ratio: 1.06, 1.08, 1.06 and 1.09, 95% confidence interval: 1.04-1.08, 1.04-1.12, 1.03-1.09 and 1.05-1.12, P<0.001, <0.001, <0.001 and <0.001, respectively). Patients with baseline SBP of 176 mm Hg or above and DBP of 100 mm Hg or above had poor survival outcomes (median survival time: 39.6 and 37.1 months, respectively). Conclusions: We provide evidence for the use of elevated blood pressure (SBP/DBP ≥176/100 mm Hg) before surgery as a powerful harbinger to predict the survival outcomes of digestive tract cancer patients postoperatively.
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Affiliation(s)
- Dan Hu
- Department of Pathology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China
| | - Rongqing Jia
- Division of Biological Sciences, University of California, San Diego, La Jolla, CA, USA
| | - Xinran Zhang
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
| | - Xiandong Lin
- Department of Radiobiology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China
| | - Hejun Zhang
- Department of Pathology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China
| | - Yan Xia
- Department of Pathology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China
| | - Jinxiu Lin
- Department of Cardiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Xiongwei Zheng
- Department of Pathology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China
| | - Feng Peng
- Department of Cardiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Wenquan Niu
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
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Zhang X, Hu D, Lin X, Zhang H, Xia Y, Lin J, Zheng X, Peng F, Jie J, Niu W. Prognostic Value of an Inflammation-Related Index in 6,865 Chinese Patients With Postoperative Digestive Tract Cancers: The FIESTA Study. Front Oncol 2019; 9:427. [PMID: 31192131 PMCID: PMC6538942 DOI: 10.3389/fonc.2019.00427] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 05/07/2019] [Indexed: 12/18/2022] Open
Abstract
Objectives: We sought to determine the optimal cutting points for two inflammatory biomarkers, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), to assess their prognostic value in patients with postoperative digestive tract cancers overall and by cancer sites, and further to construct an inflammation-related index based on the two biomarkers and assess its predictive performance. Methods: Total 6,865 assessable patients with digestive tract cancers who underwent tumor resection were consecutively enrolled from Fujian Cancer Hospital between January 2000 and December 2010, including 2535/3012/1318 patients with esophageal/gastric/colorectal cancer. The latest follow-up (median: 44.9 months) ended in December 2015. Optimal cutting points were determined using survival tree analysis overall and by cancer sites. Results: Among all study patients, the optimal cutting points were 2.07 and 168.50 to define high and low NLR and PLR, respectively. High NLR (hazard ratio [HR]: 1.48, 95% confidence interval [CI]: 1.37–1.61) and high PLR (HR: 1.41, 95% CI: 1.29–1.53) were associated with a significantly increased risk for the mortality of digestive tract cancers as a whole. By cancer sites, effect-size estimates were comparable and statistically significant. Elevation over the selected optimal cutting points for both NLR and PLR was associated with 1.69-fold increased risk of cancer-specific mortality compared to patients with simultaneously low NLR and PLR among all study patients, and this association persisted by cancer sites, especially for gastric cancer. Conclusions: Our findings demonstrate that the preoperative integrated NLR and PLR, as an inflammation-related index, is a significant independent predictor for postoperative mortality in Chinese patients with digestive tract cancers both overall and by cancer sites.
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Affiliation(s)
- Xinran Zhang
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
| | - Dan Hu
- Department of Pathology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Xiandong Lin
- Department of Radiobiology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Hejun Zhang
- Department of Pathology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Yan Xia
- Department of Pathology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Jinxiu Lin
- Department of Cardiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Xiongwei Zheng
- Department of Pathology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Feng Peng
- Department of Cardiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Jianzheng Jie
- Department of General Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Wenquan Niu
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
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9
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Fan G, Hu D, Zhang X, Peng F, Lin X, Chen G, Liang B, Zhang H, Xia Y, Zheng X, Jie J, Niu W. Interaction Between Prediabetes and the ABO Blood Types in Predicting Postsurgical Esophageal Squamous Cell Carcinoma-Specific Mortality: The FIESTA Study. Front Oncol 2018; 8:461. [PMID: 30406028 PMCID: PMC6206301 DOI: 10.3389/fonc.2018.00461] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 10/01/2018] [Indexed: 12/17/2022] Open
Abstract
Background: We aimed to investigate the interaction between prediabetes and the ABO blood types in predicting esophageal squamous cell carcinoma (ESCC)-specific mortality by analysing data from the FIESTA study on normal/prediabetic patients with ESCC. Methods: Total 1,857 normal/prediabetic patients with ESCC who underwent three-field lymphadenectomy between January 2000 and December 2010 and survived hospitalization were analyzable, with follow-up beginning in 2000 and ending in 2015. Results: At the end of the follow-up, there were 1,161 survivors and 696 non-survivors. The follow-up time ranged from 0.5 to 180 months. The cumulative survival rates in normal patients were obviously better than in prediabetic patients. The cumulative survival rates were significantly higher in normal patients than in prediabetic patients for the blood types O and A (Log-rank test P < 0.05), while no significance was detected for the blood types B and AB. Adjusted risk estimates for ESCC-specific mortality for prediabetic patients relative to normal patients were statistically significant in the blood type B− group (hazard ratio [HR]: 1.71; 95% confidence interval [CI]: 1.33–2.20; P < 0.001), but not in the blood type B+ group (HR: 1.12; 95% CI: 0.77–1.64; P = 0.5544). Conclusions: Our findings indicate that prediabetes can predict the significant risk of ESCC-specific mortality in Chinese Han patients with the blood types O and A.
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Affiliation(s)
- Guohui Fan
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
| | - Dan Hu
- Department of Pathology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Xinran Zhang
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
| | - Feng Peng
- Department of Cardiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Xiandong Lin
- Department of Pathology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Gang Chen
- Department of Pathology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Binying Liang
- Department of Medical Record, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Hejun Zhang
- Department of Pathology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Yan Xia
- Department of Pathology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Xiongwei Zheng
- Department of Pathology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Jianzheng Jie
- Department of General Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Wenquan Niu
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
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Hu D, Peng F, Lin X, Chen G, Liang B, Chen Y, Li C, Zhang H, Fan G, Xu G, Xia Y, Lin J, Zheng X, Niu W. Prediction of three lipid derivatives for postoperative gastric cancer mortality: the Fujian prospective investigation of cancer (FIESTA) study. BMC Cancer 2018; 18:785. [PMID: 30081869 PMCID: PMC6080391 DOI: 10.1186/s12885-018-4596-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 06/14/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND As we previously reported, the presence of preoperative metabolic syndrome can predict the significant risk of gastric cancer mortality. As a further extension, we evaluated the prediction of three lipid derivatives generated from triglycerides (TG), total cholesterol (TC), high- and low-density lipoprotein cholesterol (HDLC and LDLC) at baseline for postoperative gastric cancer mortality by prospectively analysing 3012 patients. The three lipid derivatives included the ratio of TC minus HDLC to HDLC known as atherogenic index (AI), the ratio of TG to HDLC abbreviated as THR and the ratio of LDLC to HDLC abbreviated as LHR. METHODS Gastric cancer patients who received gastrectomy between January 2000 and December 2010 were consecutively recruited from Fujian Cancer Hospital. Follow-up assessment was implemented annually before December 2015. RESULTS Finally, there were 1331 deaths from gastric cancer and 1681 survivors, with a median follow-up time of 44.05 months. 3012 patients were evenly randomized into the derivation group and the validation group, and both groups were well balanced at baseline. Overall adjusted estimates in the derivation group were statistically significant for three lipid derivatives (hazard ratio [HR]: 1.20, 1.17 and 1.19 for AI, THR and LHR, respectively, all P < 0.001), and were reproducible in the validation group. The risk prediction of three lipid derivatives was more obvious in males than females, in patients with tumor-node-metastasis stage I-II than stage III-IV, in patients with intestinal-type than diffuse-type gastric cancer, in patients with normal weight than obesity, and in patients without hypertension than with hypertension, especially for AI and LHR, and all results were reproducible. Calibration and discrimination statistics showed good reclassification performance and predictive accuracy when separately adding three lipid derivatives to baseline risk model. A prognostic nomogram was accordingly built based on significant attributes to facilitate risk assessment, with a good prediction capability. CONCLUSIONS Our results indicate that preoperative lipid derivatives, especially AI and LHR, are powerful predictors of postoperative gastric cancer mortality, with more obvious prediction in patients of male gender or with tumor-node-metastasis stage I-II or intestinal-type gastric cancer, and in the absence of obesity or hypertension before gastrectomy.
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Affiliation(s)
- Dan Hu
- Department of Pathology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, No.420 Fu Ma Road, Jin An District, Fuzhou, 350014 Fujian China
| | - Feng Peng
- Department of Cardiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian China
| | - Xiandong Lin
- Department of Pathology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, No.420 Fu Ma Road, Jin An District, Fuzhou, 350014 Fujian China
| | - Gang Chen
- Department of Pathology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, No.420 Fu Ma Road, Jin An District, Fuzhou, 350014 Fujian China
| | - Binying Liang
- Department of Medical Record, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian China
| | - Ying Chen
- Department of Core Research Laboratory, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou, Fujian China
| | - Chao Li
- Department of Pathology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, No.420 Fu Ma Road, Jin An District, Fuzhou, 350014 Fujian China
| | - Hejun Zhang
- Department of Pathology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, No.420 Fu Ma Road, Jin An District, Fuzhou, 350014 Fujian China
| | - Guohui Fan
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chao Yang District, Beijing, 100029 China
| | - Guodong Xu
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chao Yang District, Beijing, 100029 China
| | - Yan Xia
- Department of Pathology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, No.420 Fu Ma Road, Jin An District, Fuzhou, 350014 Fujian China
| | - Jinxiu Lin
- Department of Cardiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian China
| | - Xiongwei Zheng
- Department of Pathology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, No.420 Fu Ma Road, Jin An District, Fuzhou, 350014 Fujian China
| | - Wenquan Niu
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chao Yang District, Beijing, 100029 China
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