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Karakaya S, Karadağ İ, Yılmaz ME, Çakmak Öksüzoğlu ÖB. High Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio and Low Lymphocyte Levels Are Correlated With Worse Pathological Complete Response Rates. Cureus 2022; 14:e22972. [PMID: 35415045 PMCID: PMC8990043 DOI: 10.7759/cureus.22972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2022] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To investigate the effect of hemogram parameters on predicting pathological complete response (pCR) in locally advanced rectal cancer. METHODOLOGY A total of 227 patients with rectal cancer treated with neoadjuvant concurrent chemoradiotherapy (CRT) were retrospectively analyzed. All patients were divided into two subgroups as high or low hemogram parameters according to the cut-off value obtained using the receiver operating characteristic (ROC) curve. RESULTS In patients with low neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) levels, pCR rate was statistically significantly higher than the group with high NLR and PLR levels (for NLR: 39.77% vs. 5.34%; p<0.001, for PLR: 32.38% vs 7.01%; p<0.001 respectively). In addition, the pCR rate was significantly better in patients with high lymphocyte levels compared to the group with low lymphocyte levels (33.33% vs. 7.5%; p<0.001, respectively). According to the multivariate logistic regression analysis result, NLR and PLR levels were considered as independent predictors to predict pathological complete response [p<0.001, HR: 0.128 (95% CI=0.051 - 0.322) for NLR; p=0.017, HR: 0.332 (95% CI=0.134 - 0.821) for PLR, respectively]. CONCLUSION Our study showed that high NLR, PLR, and low lymphocyte levels were correlated with worse pCR rates. In addition to that, NLR and PLR emerged as independent predictive markers.
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Affiliation(s)
- Serdar Karakaya
- Medical Oncology, Health Science University, Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, TUR
| | - İbrahim Karadağ
- Department of Medical Oncology, Çorum Hittite University Erol Olçok Training and Research Hospital, Çorum, TUR
| | - Mehmet Emin Yılmaz
- Department of Internal Medicine, Health Sciences University, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, TUR
| | - Ömür Berna Çakmak Öksüzoğlu
- Department of Medical Oncology, Health Sciences University, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, TUR
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Morais M, Fonseca T, Machado-Neves R, Honavar M, Coelho AR, Lopes J, Barbosa E, Guerreiro E, Carneiro S. Can pretreatment blood biomarkers predict pathological response to neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer? Future Oncol 2021; 17:4947-4957. [PMID: 34734533 DOI: 10.2217/fon-2021-0707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Aims: To investigate the value of previously described pretreatment hematological and biochemical biomarkers as predictors of pathological response. Methods: The authors performed a retrospective analysis of 191 patients with locally advanced rectal cancer who underwent long-course neoadjuvant chemoradiotherapy at two Portuguese centers. The authors performed logistic regression analysis to search for predictive markers of pathological complete and good response. Results: High platelet-neutrophil index (p = 0.042) and clinical tumor stage >2 (p = 0.015) were predictive of poor response. None of the analyzed biomarkers predicted pathological complete response in this study. Conclusion: A high platelet-neutrophil index before neoadjuvant chemoradiotherapy could help predict poorer pathological response in patients with locally advanced rectal cancer. However, no other blood biomarker predicted incomplete or poor response in this study.
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Affiliation(s)
- Marina Morais
- Surgery Department, Unidade Local de Saúde de Matosinhos
| | - Telma Fonseca
- Surgery Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | | | | | - Ana Rita Coelho
- Pathologic Anatomy Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Joanne Lopes
- Pathologic Anatomy Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Elisabete Barbosa
- Surgery Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | | | - Silvestre Carneiro
- Surgery Department, Centro Hospitalar Universitário de São João, Porto, Portugal
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An inflammation index-based prediction of treatment response to neoadjuvant chemoradiotherapy for rectal mucinous adenocarcinoma. Int J Clin Oncol 2020; 25:1299-1307. [PMID: 32274615 DOI: 10.1007/s10147-020-01670-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 03/30/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This study aimed to evaluate the predictive value of hematological inflammation-based indexes in the treatment response to neoadjuvant chemoradiotherapy (NCRT) in rectal mucinous adenocarcinomas (MACs). METHODS Patients with rectal MACs undergoing NCRT and curative resection were included. Inflammation-based indexes such as systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and prognostic nutritional index (PNI) were calculated. Receiver operator characteristics analysis was used to determine the optimal cutoff points. Multivariable logistic analysis identified predictors of good response to NCRT. A nomogram was developed and validated internally. RESULTS A total of 100 patients met the inclusion criteria, with 32 patients developing good response (tumor regression grade, TRG 0 + 1) to NCRT. Lower pre-treatment SII, NLR, and PLR levels were associated with a higher probability of good response to NCRT (P = 0.025, P < 0.001, P = 0.003, respectively), and a higher pre-treatment PNI level was associated with a higher probability of good response to NCRT (P = 0.005). Logistic regression analysis demonstrated that tumor size (< 3 cm, OR = 5.489, P = 0.025), pre-treatment NLR level (< 3.05, OR = 4.025, P = 0.028), pre-treatment PLR level (< 145.98, OR = 4.337, P = 0.038), and pre-treatment PNI level (≥ 41.32, OR = 3.477, P = 0.039) were independent predictors of good response to NCRT. A nomogram was developed with a C-index of 0.827. CONCLUSION Hematological inflammation-based indexes, in terms of pre-treatment NLR, PLR, and PNI levels, can help in predicting the treatment response to NCRT for rectal MACs.
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Dudani S, Marginean H, Tang PA, Monzon JG, Raissouni S, Asmis TR, Goodwin RA, Gotfrit J, Cheung WY, Vickers MM. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as predictive and prognostic markers in patients with locally advanced rectal cancer treated with neoadjuvant chemoradiation. BMC Cancer 2019; 19:664. [PMID: 31277604 PMCID: PMC6612202 DOI: 10.1186/s12885-019-5892-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 06/28/2019] [Indexed: 12/18/2022] Open
Abstract
Background A standard therapy for locally advanced rectal cancer (LARC) includes fluoropyrimidine (FP)-based neoadjuvant chemoradiation (nCRT). Previous studies have inconsistently demonstrated that baseline neutrophil- and platelet-to-lymphocyte ratios (NLR and PLR) are predictive of response to nCRT or prognostic of outcomes in LARC. Methods We reviewed patients with LARC undergoing nCRT followed by surgery from 2005 to 2013 across 8 Canadian cancer centres. Outcome measures of interest were pathological complete response (pCR), disease-free survival (DFS) and overall survival (OS). Logistic regression and Cox proportional hazard models were used to assess for associations between baseline hematologic variables and outcomes. Results Of 1527 identified patients, 1237 (81%) were included in the DFS/OS analysis. Median age was 62 (range 23–88), 69% were male, and 80% had performance status (PS) 0–1. Twenty-six percent had elevated NLR (≥ 4), and 66% had elevated PLR (≥ 150). Ninety-seven percent of patients received FP-based nCRT, with 96% receiving ≥44 Gy. 81% completed neoadjuvant chemotherapy and 95% completed neoadjuvant radiotherapy, with a pCR rate of 18%. After a median follow-up time of 71 months, 8% developed local recurrence, 22% developed distant recurrence and 24% died. 5-year DFS and OS were 69% (95% CI 66–72%) and 79% (95% CI 77–82%), respectively. In multivariate analyses, elevated baseline NLR and PLR were neither prognostic for DFS and OS nor predictive of pCR. Conclusions NLR and PLR were not found to be independently prognostic for DFS or OS and did not predict for pCR in patients with LARC undergoing nCRT followed by surgery.
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Affiliation(s)
- Shaan Dudani
- The Ottawa Hospital Cancer Centre/University of Ottawa, Ottawa, Ontario, Canada. .,Present address: Division of Medical Oncology, Tom Baker Cancer Centre, University of Calgary, 1331 29 St NW, Calgary, AB, T2N 4N2, Canada.
| | - Horia Marginean
- The Ottawa Hospital Cancer Centre/University of Ottawa, Ottawa, Ontario, Canada
| | - Patricia A Tang
- Alberta Health Services/University of Calgary, Calgary, Alberta, Canada
| | - Jose G Monzon
- Alberta Health Services/University of Calgary, Calgary, Alberta, Canada
| | - Soundouss Raissouni
- Alberta Health Services/University of Calgary, Medicine Hat, Alberta, Canada
| | - Timothy R Asmis
- The Ottawa Hospital Cancer Centre/University of Ottawa, Ottawa, Ontario, Canada
| | - Rachel A Goodwin
- The Ottawa Hospital Cancer Centre/University of Ottawa, Ottawa, Ontario, Canada
| | - Joanna Gotfrit
- The Ottawa Hospital Cancer Centre/University of Ottawa, Ottawa, Ontario, Canada
| | - Winson Y Cheung
- British Columbia Cancer Agency, Vancouver, British Columbia, Canada.,Present address: Division of Medical Oncology, Tom Baker Cancer Centre, University of Calgary, 1331 29 St NW, Calgary, AB, T2N 4N2, Canada
| | - Michael M Vickers
- The Ottawa Hospital Cancer Centre/University of Ottawa, Ottawa, Ontario, Canada
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Koyama FC, Lopes Ramos CM, Ledesma F, Alves VAF, Fernandes JM, Vailati BB, São Julião GP, Habr-Gama A, Gama-Rodrigues J, Perez RO, Camargo AA. Effect of Akt activation and experimental pharmacological inhibition on responses to neoadjuvant chemoradiotherapy in rectal cancer. Br J Surg 2018; 105:e192-e203. [PMID: 29341150 DOI: 10.1002/bjs.10695] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 08/13/2017] [Accepted: 08/14/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND Neoadjuvant chemoradiotherapy (CRT) is one of the preferred initial treatment strategies for locally advanced rectal cancer. Responses are variable, and most patients still require surgery. The aim of this study was to identify molecular mechanisms determining poor response to CRT. METHODS Global gene expression and pathway enrichment were assessed in pretreatment biopsies from patients with non-metastatic cT2-4 N0-2 rectal cancer within 7 cm of the anal verge. Downstream Akt activation was assessed in an independent set of pretreatment biopsies and in colorectal cancer cell lines using immunohistochemistry and western blot respectively. The radiosensitizing effects of the Akt inhibitor MK2206 were assessed using clonogenic assays and xenografts in immunodeficient mice. RESULTS A total of 350 differentially expressed genes were identified, of which 123 were upregulated and 199 downregulated in tumours from poor responders. Mitochondrial oxidative phosphorylation (P < 0·001) and phosphatidylinositol signalling pathways (P < 0·050) were identified as significantly enriched pathways among the set of differentially expressed genes. Deregulation of both pathways is known to result in Akt activation, and high immunoexpression of phosphorylated Akt S473 was observed among patients with a poor histological response (tumour regression grade 0-2) to CRT (75 per cent versus 48 per cent in those with a good or complete response; P = 0·016). Akt activation was also confirmed in the radioresistant cell line SW480, and a 50 per cent improvement in sensitivity to CRT was observed in vitro and in vivo when SW480 cells were exposed to the Akt inhibitor MK2206 in combination with radiation and 5-fluorouracil. CONCLUSION Akt activation is a key event in the response to CRT. Pharmacological inhibition of Akt activation may enhance the effects of CRT. Surgical relevance Organ preservation is an attractive alternative in rectal cancer management following neoadjuvant chemoradiotherapy (CRT) to avoid the morbidity of radical surgery. Molecular steps associated with tumour response to CRT may provide a useful tool for the identification of patients who are candidates for no immediate surgery. In this study, tumours resistant to CRT were more likely to have activation of specific genetic pathways that result in phosphorylated Akt (pAkt) activation. Pretreatment biopsy tissues with high immunoexpression of pAkt were more likely to exhibit a poor histological response to CRT. In addition, the introduction of a pAkt inhibitor to cancer cell lines in vitro and in vivo led to a significant improvement in sensitivity to CRT. Identification of pAkt-activated tumours may thus allow the identification of poor responders to CRT. In addition, the concomitant use of pAkt inhibitors to increase sensitivity to CRT in patients with rectal cancer may constitute an interesting strategy for increasing the chance of a complete response to treatment and organ preservation.
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Affiliation(s)
- F C Koyama
- Molecular Oncology Centre, Hospital Sírio Libanês, São Paulo, Brazil.,Ludwig Institute for Cancer Research, São Paulo, Brazil
| | - C M Lopes Ramos
- Molecular Oncology Centre, Hospital Sírio Libanês, São Paulo, Brazil
| | - F Ledesma
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - V A F Alves
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - J M Fernandes
- Molecular Oncology Centre, Hospital Sírio Libanês, São Paulo, Brazil
| | - B B Vailati
- Instituto Angelita and Joaquim Gama, São Paulo, Brazil
| | | | - A Habr-Gama
- Instituto Angelita and Joaquim Gama, São Paulo, Brazil.,Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - J Gama-Rodrigues
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - R O Perez
- Ludwig Institute for Cancer Research, São Paulo, Brazil.,Instituto Angelita and Joaquim Gama, São Paulo, Brazil.,Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.,Digestive Surgical Oncology Division, BP - A Beneficência Portuguesa de São Paulo, São Paulo, Brazil
| | - A A Camargo
- Molecular Oncology Centre, Hospital Sírio Libanês, São Paulo, Brazil.,Ludwig Institute for Cancer Research, São Paulo, Brazil
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Hyter S, Hirst J, Pathak H, Pessetto ZY, Koestler DC, Raghavan R, Pei D, Godwin AK. Developing a genetic signature to predict drug response in ovarian cancer. Oncotarget 2018; 9:14828-14848. [PMID: 29599910 PMCID: PMC5871081 DOI: 10.18632/oncotarget.23663] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 12/13/2017] [Indexed: 12/15/2022] Open
Abstract
There is a lack of personalized treatment options for women with recurrent platinum-resistant ovarian cancer. Outside of bevacizumab and a group of poly ADP-ribose polymerase inhibitors, few options are available to women that relapse. We propose that efficacious drug combinations can be determined via molecular characterization of ovarian tumors along with pre-established pharmacogenomic profiles of repurposed compounds. To that end, we selectively performed multiple two-drug combination treatments in ovarian cancer cell lines that included reactive oxygen species inducers and HSP90 inhibitors. This allowed us to select cell lines that exhibit disparate phenotypes of proliferative inhibition to a specific drug combination of auranofin and AUY922. We profiled altered mechanistic responses from these agents in both reactive oxygen species and HSP90 pathways, as well as investigated PRKCI and lncRNA expression in ovarian cancer cell line models. Generation of dual multi-gene panels implicated in resistance or sensitivity to this drug combination was produced using RNA sequencing data and the validity of the resistant signature was examined using high-density RT-qPCR. Finally, data mining for the prevalence of these signatures in a large-scale clinical study alluded to the prevalence of resistant genes in ovarian tumor biology. Our results demonstrate that high-throughput viability screens paired with reliable in silico data can promote the discovery of effective, personalized therapeutic options for a currently untreatable disease.
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Affiliation(s)
- Stephen Hyter
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jeff Hirst
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Harsh Pathak
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS, USA.,University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Ziyan Y Pessetto
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Devin C Koestler
- University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, KS, USA.,Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Rama Raghavan
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Dong Pei
- University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, KS, USA.,Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, USA
| | - Andrew K Godwin
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS, USA.,University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, KS, USA
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Kong FY, Zhu T, Li N, Cai YF, Zhou K, Wei X, Kou YB, You HJ, Zheng KY, Tang RX. Bioinformatics analysis of the proteins interacting with LASP-1 and their association with HBV-related hepatocellular carcinoma. Sci Rep 2017; 7:44017. [PMID: 28266596 PMCID: PMC5339786 DOI: 10.1038/srep44017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 02/02/2017] [Indexed: 12/11/2022] Open
Abstract
LIM and SH3 domain protein (LASP-1) is responsible for the development of several types of human cancers via the interaction with other proteins; however, the precise biological functions of proteins interacting with LASP-1 are not fully clarified. Although the role of LASP-1 in hepatocarcinogenesis has been reported, the implication of LASP-1 interactors in HBV-related hepatocellular carcinoma (HCC) is not clearly evaluated. We obtained information regarding LASP-1 interactors from public databases and published studies. Via bioinformatics analysis, we found that LASP-1 interactors were related to distinct molecular functions and associated with various biological processes. Through an integrated network analysis of the interaction and pathways of LASP-1 interactors, cross-talk between different proteins and associated pathways was found. In addition, LASP-1 and several its interactors are significantly altered in HBV-related HCC through microarray analysis and could form a complex co-expression network. In the disease, LASP-1 and its interactors were further predicted to be regulated by a complex interaction network composed of different transcription factors. Besides, numerous LASP-1 interactors were associated with various clinical factors and related to the survival and recurrence of HBV-related HCC. Taken together, these results could help enrich our understanding of LASP-1 interactors and their relationships with HBV-related HCC.
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Affiliation(s)
- Fan-Yun Kong
- Jiangsu Key Laboratory of Brain Disease Bioinformation, Xuzhou Medical University, Xuzhou, Jiangsu, China.,Department of Pathogenic Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Ting Zhu
- Department of Pathogenic Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Nan Li
- Department of Pathogenic Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yun-Fei Cai
- Department of Pathogenic Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Kai Zhou
- Department of Pathogenic Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xiao Wei
- Department of Pathogenic Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yan-Bo Kou
- Department of Pathogenic Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Hong-Juan You
- Department of Pathogenic Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Kui-Yang Zheng
- Department of Pathogenic Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Ren-Xian Tang
- Jiangsu Key Laboratory of Brain Disease Bioinformation, Xuzhou Medical University, Xuzhou, Jiangsu, China.,Department of Pathogenic Biology and Immunology, Jiangsu Key Laboratory of Immunity and Metabolism, Xuzhou Medical University, Xuzhou, Jiangsu, China
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