Objective To analyze the clinical characteristics and prognostic factors of small cell lung cancer(SCLC) with liver metastasis(LM) based on the SEER database.Methods Patients diagnosed with small cell lung cancer were collected from 2010 to 2015 using the United States Surveillance, Epidemiology, and Outcome Database(SEER database), and used the American Joint Commission on Cancer(AJCC) 7th edition lung cancer staging system to perform tumor TNM staging on the cases. Patients with unknown metastatic organs, survival time, and race were excluded, and a total of 26 041 patients with small cell lung cancer were ultimately screened, including 6 937 patients with liver metastasis, there were 6 247 other patients with distant metastasis, and clinical data of patients with or without liver metastasis were compared. The Kaplan Meier(KM) method and Log rank test were used to compare the overall survival rate(OS) and specific survival rate of patients with and without liver metastasis from SCLC. The COX risk model was used to evaluate independent prognostic factors in patients with liver metastasis from small cell lung cancer, and the impact of different treatment methods on patient survival time was analyzed. Results The incidence of liver metastasis in small cell lung cancer patients is 26.63%, accounting for 52.6% of all SCLC patients with distant metastasis. There were statistically significant differences in gender, radiation therapy, survival status, primary site and surgery, year of diagnosis, T stage, N stage, and median survival time among patients with or without liver metastasis(P<0.05). KM analysis found that the tumor specific survival rate and overall survival rate of patients with SCLC liver metastasis were lower than those without liver metastasis(P<0.05), while the tumor specific survival rate and overall survival rate of patients with SCLC liver metastasis were lower than those of other distant metastasis patients(P<0.01). cox="" analysis="" found="" that="" independent="" risk="" factors="" affecting="" the="" survival="" time="" of="" sclc="" with="" lm="" include="" radiation="" and="" n="" as="" well="" presence="" or="" absence="" lung="" metastases.="" radiotherapy="" chemotherapy="" can="" significantly="" improve="" prognosis="" patients="" liver="" but="" impact="" surgical="" treatment="" at="" primary="" site="" on="" overall="" rate="" was="" not="" statistically="" p="">0.05). Conclusion The survival rate of SCLC patients with liver metastasis is low and varies depending on age and gender. The prognosis of SCLC liver metastasis is worse than other distant metastasis patients. The prognosis of SCLC liver metastasis patients in different T and N stages is significantly different. Radiotherapy and chemotherapy are beneficial for the overall survival rate of liver metastasis patients.
Objective To analyze the relationship between hemoglobin(Hb), albumin(Alb), platelet to lymphocyte ratio(PLR), postoperative complications and clinical prognosis of pancreaticoduodenectomy(PD). Methods From January 2019 to January 2022, 102 patients with periampullary carcinoma(VPC) who underwent PD treatment in Hepatobiliary and Pancreatic Surgery Department of Xuzhou Cancer Hospital were selected as the study subjects. After surgery, patients were divided into an occurrence group of 38 cases and a nonoccurrence group of 64 cases based on the occurrence of complications. All patients were followed up for 1 year. According to the follow-up results, patients were divided into a poor prognosis subgroup of 35 cases and a good prognosis subgroup of 64 cases. The Hb, Alb, and PLR levels of patients in each group were compared. Use Spearman correlation analysis to investigate the correlation between Hb, Alb, PLR levels, postoperative complications, and prognosis in VPC patients; Logistic regression analysis of risk factors affecting the prognosis of VPC patients undergoing PD treatment; Draw a receiver operating characteristic curve(ROC) to analyze the predictive value of Hb, Alb, and PLR levels on poor patient prognosis. Results The Hb and Alb levels of patients in the occurrence group were lower than those in the nonoccurrence group, while the PLR levels were higher than those in the nonoccurrence group(t/P=6.454/<0.001, 20.333/<0.001, 30.371/<0.001); The Hb and Alb levels in patients with poor prognosis subgroup were lower than those in patients with good prognosis subgroup, while PLR levels were higher than those in patients with good prognosis subgroup(t/P=11.701/<0.001, 26.741/<0.001, 31.135/<0.001). Spearman correlation analysis showed that Hb and Alb were negatively correlated with postoperative complications in VPC patients undergoing PD treatment, while PLR levels were positively correlated with postoperative complications(r/P=-0.354/0.002,-0.472/<0.001, 0.513/<0.001). Hb and Alb are negatively correlated with poor prognosis of PD treatment in VPC patients, while PLR levels are positively correlated with poor prognosis(r/P=-0.326/0.003,-0.453/<0.001, 0.501/<0.001). Logistic regression analysis showed that low Hb, low Alb, and high PLR were average risk factors for poor prognosis in VPC patients undergoing PD treatment [OR(95% CI)=2.100(1.046-3.154), 2.784(1.352-4.217), 3.463(1.498-5.427)]. The Receiver operating characteristic showed that the area under the Receiver operating characteristic(AUC) predicted by low Hb, low Alb, high PLR and the combination of the three was 0.724, 0.781, 0.801, 0.867, respectively, and the AUC of the combination of the three was higher than the single prediction(Z/P=5.071/0.006, 5.687/0.001, 6.021/<0.001). Conclusion The abnormal levels of preoperative Hb, Alb, and PLR are closely related to the postoperative complications and prognosis of VPC patients with PD, and are risk factors that affect the poor prognosis of VPC patients after PD surgery. The combined detection of these indicators has high predictive value for the poor prognosis of VPC patients after PD surgery.
Objective To analyze the changes of coagulation function after resection of bladder cancer and its correlation with postoperative venous thromboembolism(VTE) and local lymph node metastasis. Methods From January 2020 to October 2022, 145 patients with bladder cancer who were admitted to the Department of Urology of the New Area Hospital of the First Affiliated Hospital of Henan University of Science and Technology were selected as the study subjects. The incidence of VTE(117 patients in the non VTE group, 28 patients in the VTE group) and local lymph node metastasis within 3 months after laparoscopic radical resection of bladder cancer were counted, and the coagulation function indicators(D-dimer(D-D), platelet count(PLT), thrombin time(TT) Prothrombin time(PT), fibrinogen(FIB), activated partial thromboplastin time(APTT). Logistic regression analysis is used to analyze the influencing factors of postoperative VTE, and the predictive value of coagulation function indicators on postoperative VTE occurrence is analyzed using the receiver operating characteristic curve(ROC). Spearman correlation coefficient analysis showed the correlation between postoperative coagulation function indicators and local lymph node metastasis. Results The incidence of VTE in 145 patients with bladder cancer was 19.31%(28/145), and the incidence of local lymph node metastasis was 15.17%(22/145). Age, incidence of diabetes, operation time and postoperative D-D, PLT, Fib, APTT of VTE patients were significantly higher than those of non VTE patients [χ2(t)/P=4.390/<0.001, 8.332/0.004, 6.029/<0.001, 8.146/<0.001, 3.350/0.001, 6.265/<0.001, 2.921/0.004. The postoperative D-D, PLT, FIB, and APTT levels in patients with local lymph node metastasis were higher than those without(t=10.664, 4.300, 7.827, 5.114, P<0.001), and they were positively correlated with local lymph node metastasis(r=0.412, 0.371, 0.386, 0.403, P<0.001), while TT and PT were not correlated with local lymph node metastasis(r/P=0.191/0.413, 0.201/0.365). Diabetes, operation time, and postoperative elevation of D-D, PLT, Fib, APTT were independent risk factors for VTE [OR(95%CI)=2.879(1.267-6.543), 3.155(1.381-7.209), 4.565(2.013-10.354), 3.653(1.576-8.467), 3.926(1.652-9.331), 3.396(1.469-7.853)]. The AUC predicted by the combination of postoperative D-D, PLT, FIB, and APTT for postoperative VTE was greater than that predicted by each indicator alone(Z/P=2.945/0.003,1.994/0.046,2.011/0.042,3.186/0.001). Conclusion The coagulation function of patients with bladder cancer after electric resection is abnormal. Postoperative D-D, PLT, Fib, APTT are closely related to VTE and local lymph node metastasis. Joint detection of their levels has certain predictive value for the occurrence of VTE after operation.
Objective To study the expression of ribonucleic acid binding protein 15(RBM15) and ubiquitin specific peptidase 24(USP24) in non muscle invasive bladder cancer(NMIBC) and their relationship with clinical prognosis.Methods Ninety patients with NMIBC diagnosed and treated in the Oncology Department of Xi'an Central Hospital from January 2018 to January 2020 were selected as the research subjects. Immunohistochemical method was used to detect the expression of RBM15 and USP24 proteins in cancer and adjacent tissues. Compare the differences in protein expression of RBM15 and USP24 in NMIBC patients with different clinical and pathological characteristics. Spearman rank correlation analysis was used to analyze the correlation between RBM15 and USP24 protein expression in bladder cancer tissues. Follow up for 3 years and use Kaplan Meier curve analysis(Log Rank test) to investigate the impact of RBM15 and USP24 protein expression on the prognosis of progression free survival. Multivariate COX model analysis of the influencing factors of progression free survival prognosis in NMIBC patients. Results The positive rates of RBM15 and USP24 protein in bladder cancer tissues were 66.67%(60/90) and 74.44%(67/90), respectively, higher than that in adjacent tissues 6.67%(6/90) and 11.11%(10/90), with a statistically significant difference(χ2=69.761, 73.739, both P<0.001). There is a positive correlation between the expression of RBM15 and USP24 in NMIBC cancer tissue(r=0.716, P<0.001). The positive rates of RBM15 and USP24 in NMIBC cancer tissue were higher in tumor stage T1 and higher in pathological grading than in tumor stage Ta/tis and lower in pathological grading, respectively(χ2/P=11.903/0.001, 10.866/0.001; 17.457/<0.001, 11.433/0.001). The 3-year progression free survival rates of the RBM15 positive group and the negative group were 45.00%(27/60) and 90.00%(27/30), respectively. The 3-year progression free survival rates of the USP24 positive and negative groups were 50.75%(34/67) and 86.96%(20/23), respectively. The cumulative progression free survival rate of RBM15 positive group and USP24 positive group was significantly lower than that of RBM15 negative group and USP24 negative group(χ2/P=8.057/0.005, 15.379/<0.001). The COX model analysis results showed that tumor stage T1, high pathological grade, RBM15 positive, and USP24 positive were independent risk factors affecting the progression free survival of NMIBC patients [OR(95%CI)=1.614(1.227-2.214), 1.917(1.319-2.799), 1.839(1.228-2.753), 1.744(1.245-2.443)].Conclusion The expression of RBM15 and USP24 is elevated in NMIBC cancer tissue, which is related to tumor staging and pathological grading, and is an independent risk factor affecting the progression free survival of NMIBC patients.