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Dong Z, Chong W, Chen C, Qi L, Mengke L, Minghui D, Jiawei Y, Longxi Q, Hengchao L, Liu J, Zhimin G. Assessing the genomic feature of Chinese patients with ampullary adenocarcinoma: potential therapeutic targets. BMC Cancer 2024; 24:286. [PMID: 38439030 PMCID: PMC10910796 DOI: 10.1186/s12885-024-11949-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 02/04/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUNDS Ampullary adenocarcinoma (AMPAC) is a rare malignancy, treated as pancreatic or intestinal cancer based on its histologic subtype. Little is known about the genomic features of Chinese patients with AMPAC. MATERIALS AND METHODS We enrolled 145 Chinese AMPAC patients in our local cohort and performed a compressive somatic and germline genetic testing using a 156 gene panel. Expression of PD-L1 (clone 28 - 8) was also assessed in tumor specimens from 64 patients. RESULTS The frequency of genetic alterations (GAs) in Chinese patients with AMPAC was found to be distinctive, with TP53, KRAS, SMAD4, APC, CTNNB1, ARID1A, and CDKN2A emerged as the most frequently mutated genes. Comparing with Western patients, significant differences were observed in the prevalence of PIK3CA and ARID2. Furthermore, the incidence of MSI-H was lower in the Chinese cohort, with only two patients identified as MSI-H. Conversely, 11 patients (8.27%) had pathogenic/likely pathogenic germline alterations, all of which were in the DNA damage response (DDR) pathway. In our cohort, 34.48% (22/64) of patients exhibited positive PD-L1 expression in tumor cells, and this expression was associated with GAs in CTNNB1 and BLM. Importantly, over three-fourths of Chinese AMPAC patients in our study had at least one actionable GA, with more than one-fifth of them having actionable GAs classified as Level 3. These actionable GAs were primarily involved in the DDR and PI3K pathways. Notably, GAs in the DDR pathway were detected in both Chinese and Western patients, and regardless of their functional impact, these alterations demonstrated enhanced overall survival rates and higher tumor mutational burden (TMB) levels. CONCLUSION These findings underscore the distinct genomic landscape of Chinese AMPAC patients and highlight the potential for targeted therapies based on the identified GAs.
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Affiliation(s)
- Zhang Dong
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi Province, 710061, China
| | - Wan Chong
- Precision Medicine Center, Yangtze Delta Region Institute of Tsinghua University, Jiaxing, Zhejiang, China
| | - Chen Chen
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi Province, 710061, China
| | - Li Qi
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi Province, 710061, China
| | - Li Mengke
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi Province, 710061, China
| | - Dou Minghui
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi Province, 710061, China
| | - Yuan Jiawei
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi Province, 710061, China
| | - Quan Longxi
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi Province, 710061, China
| | - Liu Hengchao
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi Province, 710061, China
| | - Jia Liu
- Department of Precision medicine, Accb Biotech.Ltd, Beijing, China
| | - Geng Zhimin
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi Province, 710061, China.
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Chen C, Rui Z, Yuhan W, Yongjie Z, Yinghe Q, Ning Y, Tianqiang S, Jianying L, Jiangtao L, Xianhai M, Shengping L, Shubin S, Zhiqiang C, Zhaohui T, Zhimin G. Optimal Lymph Node Staging System in Evaluating Prognosis of Gallbladder Carcinoma: A Multi-institutional Study. Ann Surg Oncol 2021; 28:8142-8151. [PMID: 34532819 DOI: 10.1245/s10434-021-10749-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 07/24/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Lymph node (LN) involvement is a critical prognostic factor in patients with gallbladder carcinoma (GBC). Controversy exists regarding optimal categorization of nodal metastasis status, including anatomical location of positive nodes (AJCC 7th N staging), number of metastatic lymph nodes (NMLN), log odds of metastatic LNs (LODDS), and lymph node ratio (LNR). METHODS Patients who underwent curative-intent resection for GBC from six Chinese tertiary hospitals between 2008 and 2013 were analyzed retrospectively. The relative discriminative abilities of the different LN staging systems were assessed by different models including the tree-augmented naïve Bayesian (TAN) model, Cox proportional hazards regression model, and binary logistic regression model. RESULTS A total of 226 patients were involved in this cohort. Based on the TAN model and composite importance measures, the most important factor affecting the prognosis in the different LN staging systems was NMLN. Among the four TAN models which were built with 4 metastatic LN markers and baseline variables, the accuracy of the NMLN-based prognostic model was 88.15%, higher than 7th N staging (86.44%), LNR (87.34%), and LODDS (85.19%). The Cox model based on NMLN (C-index: 0.763, AIC: 1371.62) had a higher fitness than the others (7th N staging C-index: 0.756, AIC: 1375.51; LNR C-index: 0.759, AIC: 1378.82; LODDS C-index 0.748, AIC: 1390.99). The AUCs of different staging binary logistic regression models were NMLN (0.872), LNR (0.872), 7th N staging (0.869) and LODDS (0.856), respectively. CONCLUSIONS NMLN was the optimal LN staging system in evaluating prognosis of GBC.
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Affiliation(s)
- Chen Chen
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zhang Rui
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wu Yuhan
- Department of Industrial Engineering, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, China
| | - Zhang Yongjie
- Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Affiliated to Naval Medical University, Shanghai, China
| | - Qiu Yinghe
- Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Affiliated to Naval Medical University, Shanghai, China
| | - Yang Ning
- Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Affiliated to Naval Medical University, Shanghai, China
| | - Song Tianqiang
- Department of Hepatobiliary Oncology, Tianjin Medical University Cancer Hospital, Tianjin, China
| | - Lou Jianying
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Li Jiangtao
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Mao Xianhai
- Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital, Changsha, China
| | - Li Shengping
- Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Si Shubin
- Department of Industrial Engineering, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, China
| | - Cai Zhiqiang
- Department of Industrial Engineering, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, China
| | - Tang Zhaohui
- Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
| | - Geng Zhimin
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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Chen C, Rui Z, Yuhan W, Yongjie Z, Yinghe Q, Ning Y, Tianqiang S, Jianying L, Jiangtao L, Xianhai M, Shengping L, Shubin S, Zhiqiang C, Zhaohui T, Zhimin G. ASO Visual Abstract: Optimal Lymph Node Staging System in Evaluating Prognosis of Gallbladder Carcinoma: A Multi-Institutional Study. Ann Surg Oncol 2021. [PMID: 34523006 DOI: 10.1245/s10434-021-10770-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Chen Chen
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Zhang Rui
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Wu Yuhan
- Department of Industrial Engineering, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, 710072, China
| | - Zhang Yongjie
- Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Affiliated to Naval Medical University, Shanghai, 200433, China
| | - Qiu Yinghe
- Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Affiliated to Naval Medical University, Shanghai, 200433, China
| | - Yang Ning
- Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Affiliated to Naval Medical University, Shanghai, 200433, China
| | - Song Tianqiang
- Department of Hepatobiliary Oncology, Tianjin Medical University Cancer Hospital, Tianjin, 300060, China
| | - Lou Jianying
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Li Jiangtao
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Mao Xianhai
- Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital, Changsha, 410005, China
| | - Li Shengping
- Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
| | - Si Shubin
- Department of Industrial Engineering, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, 710072, China
| | - Cai Zhiqiang
- Department of Industrial Engineering, School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, 710072, China
| | - Tang Zhaohui
- Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China.
| | - Geng Zhimin
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
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Zhimin G, Chu M. GW27-e0446 Microarray Analysis of Differential Gene Expression Profile between Human Fetal and Adult Heart. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.07.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Hilar cholangiocarcinoma (HC) is a rare tumor that causes devastating disease. In the late stages, this carcinoma primarily invades the portal vein and metastasizes to the hepatic lobes; it is associated with a poor prognosis. HC is diagnosed by its clinical manifestation and results of imaging techniques such as ultrasound, computed tomography, magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiography, and percutaneous transhepatic cholangiography. Preoperative hepatic bile drainage can improve symptoms associated with insufficient liver and kidney function, coagulopathy, and jaundice. Surgical margin-negative (R0) resection, including major liver resection, is the most effective and potentially curative treatment for HC. If the tumor is not resected, then liver transplantation with adjuvant management can improve survival. We conducted a systematic review of developments in imaging studies and major surgical hepatectomy for HC with positive outcomes regarding quality of life.
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Affiliation(s)
- Geng Zhimin
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, P.R. China
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