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Responsible Institution:National Health Commission of the People’s Republic of China
Sponsor:Chinese Medical Doctor Association
Honorary Editor-in-Chief:Wu Yiling
Editor-in-Chief:Jia Zhenhua
Managing Director:Ma Zhi
Editing:Editorial Board of Chinese Journal of Difficult and Complicated Cases
Publishing:Publishing House of Chinese Journal of Difficult and Complicated Cases
Address:238 Tianshan Street,Shijiazhuang,Hebei Province,China
Post Code:050035
Phone Number:0311-85901735
E-mail:ynbzz@163.com
 
    Current issue
Issue 11 in 2024    Publication date:2024-11-18
 
Kong Wenjie He Huan Liu Weidong Hui Wenjia Yu Lin Hu Xinhui Zhang Mengxia Gao Feng

ObjectiveInvestigating the relationship between autoimmune gastritis, Helicobacter pylori infection and gastric cancer through a retrospective cohort study.MethodsPatients with autoimmune gastritis in our hospital were enrolled and divided into non-Hp group(n=225) and an Hp group(n=91) according to the status of Helicobacter pylori infection. The baseline characteristics, OLGA and OLGIM stages, screening indicators of gastric cancer, incidence and location of gastric cancer were statistically analyzed between the two groups. The incidence of gastric cancer was further compared between the two subgroups.ResultsCompared with non-Hp group, there were no statistically significant differences in PCA and IFA positive proportion in Hp group(χ2/P=0.191/0.662, 0.277/0.599); The level of PGⅠand PGⅠ/PGⅡin Hp group decreased(t/P=2.133/0.034, 2.001/0.046), and G-17 increased(t/P=2.045/0.042); Compared with past infection subgroups, active infection subgroup of patients with a significant rise in 14C breath test results(t/P=34.99/<0.05); The average time from infection to enrolled group in past infection subgroups was(2.12±0.94) years; Compared with the non-Hp group, the performance of OLGA and OLGIM staging in Hp group were worse(41.76% vs. 25.33%, 19.78% vs. 10.22%,χ2/P=8.314/0.004, 5.242/0.022), and the gastric cancer risk is higher(112.09% vs. 5.33%,χ2/P=4.380/0.036); The incidence of gastric body and cardia cancer in Hp group was significantly lower, and the incidence of gastric antrum cancer was significantly higher(58.33% vs. 100%, 36.36% vs. 0%, P=0.037). Compared with the previous infection subgroup, the incidence of gastric cancer in the active infection subgroup was higher(27.78% vs.8.22%, χ2/P=5.198/0.023).ConclusionThe risk of gastric cancer in AIG patients with Hp infection, especially active Hp infection, is significantly higher than that in AIG patients without HP infection.

 
Di Liang Zhu Zizhao Guo Qingliang Zhao Xiaofei Ding Jing

ObjectiveTo explore the correlation between serum C-X-C chemokine ligand(CXCLs), matrix metalloproteinase(MMPs), peripheral blood inflammation and short-term prognosis in patients with primary liver cancer.MethodsOne hundred and seventeen patients diagnosed with primary liver cancer at our hospital between September 2021 and September 2023 were categorized into two cohorts based on their short-term prognosis: a cohort with optimistic short-term prognosis(n=90) and a cohort with unfavorable short-term prognosis(n=27) within 3 months post-treatment. Various parameters including general clinical characteristics, levels of CXCLs(CXCL2, CXCL8, CXCL9, CXCL13), levels of MMPs(MMP-2, MMP-7, MMP-9, MMP-14), and peripheral blood inflammatory markers[neutrophil/lymphocyte ratio(NLR), lymphocyte/monocyte ratio(LMR), and systemic immune inflammation index(SII)]were measured and compared between these two groups. Spearman correlation analysis was used to analyze the correlation between differential indicators and poor short-term prognosis after treatment in patients with primary liver cancer; multivariate Logistic regression analysis was used to analyze the influencing factors of poor short-term prognosis after treatment in patients with primary liver cancer.ResultsThe levels of serum CXCL8, CXCL9, and CXCL13 in the poor short-term prognosis group were higher than those in the good short-term prognosis group(t/P=3.876/<0.001, 4.779/<0.001, 5.434/<0.001); the levels of serum MMP-2, MMP-7, MMP-9, and MMP-14 in the poor short-term prognosis group were higher than those in the good short-term prognosis group(t/P=6.775/<0.001, 5.376/<0.001, 6.377/<0.001, 6.565/<0.001); the SII in the poor short-term prognosis group was higher than that in the good short-term prognosis group(t/P=5.569/<0.001); Spearman correlation analysis showed that tumor diameter, multiple tumors, cirrhosis, CXCL8, CXCL9, CXCL13, MMP-2, MMP-7, MMP-9, MMP-14, and SII were positively correlated with poor short-term prognosis after treatment in patients with primary liver cancer(r=0.286, 0.209, 0.200, 0.415, 0.417, 0.420, 0.459, 0.383, 0.493, 0.442, 0.440, all P<0.05); the results of multivariate Logistic regression analysis showed that high levels of serum CXCL8, CXCL9, CXCL13, MMP-2, MMP-7, MMP-9, MMP-14, and high SII were independent risk factors for poor short-term prognosis after treatment in patients with primary liver cancer[OR(95% CI)=1.021(1.009-1.063), 1.043(1.006-1.082), 1.087(1.011-1.170), 1.455(1.045-2.026), 1.096(1.001-1.201), 1.027(1.011-1.074), 1.128(1.083-1.295), 1.044(1.024-1.066)].ConclusionThe short-term prognosis of patients with primary liver cancer with high levels of serum CXCLs, MMPs, and SII is often poor after treatment. Closely monitoring the changes in serum CXCLs, MMPs levels, and SII has certain clinical significance for accurately assessing the prognosis of patients with primary liver cancer.

 
Zhou Lin Lu Haofeng Dong Fuqiang Zhang Tiequan

ObjectiveTo investigate the correlation between the expression of miR-122-5p and NOC2L in peripheral blood and clinicopathological characteristics and prognosis of pancreatic cancer.MethodsPatients with pancreatic cancer(PAC group, 97 cases) and patients with benign pancreatic diseases(control group, 53 cases) from January 2020 to January 2023 were selected as the research subjects. The expression of miR-122-5p and NOC2L in peripheral blood was detected by real-time fluorescence quantitative polymerase chain reaction. The differences in the expression of miR-122-5p and NOC2L in different clinicopathological characteristics were compared. The correlation between miR-122-5p and NOC2L and clinicopathological characteristics was analyzed by Spearman rank correlation. The sensitivity and specificity of miR-122-5p and NOC2L in predicting poor prognosis of pancreatic cancer were compared by ROC curve and DeLong method. Multivariate Cox regression was used to analyze the risk factors for poor prognosis of pancreatic cancer. Kaplan-Meier survival model analysis and Log Rank comparison were used to compare the differences in survival among patients with different peripheral blood miR-122-5p and NOC2L expressions.ResultsThe expression of peripheral blood miR-122-5p in the PAC group was lower than that in the control group, while the expression of NOC2L was higher than that in the control group(t/P=28.061/<0.001, 29.701/<0.001). The expression of miR-122-5p in peripheral blood of patients with histological grade 3, primary tumor size≥4 cm, number of metastatic lymph nodes N2, distant metastasis M1 and TNM stage Ⅲ-IV was lower than that of patients with histological grade 1-2, primary tumor size <4 cm, number of metastatic lymph nodes N0-1, distant metastasis M0 and TNM stage I-II(t/P=5.935/<0.001, 2.801/0.006, 3.284/0.001, 3.583/<0.001, 6.567/<0.001), while the expression of NOC2L was higher(t/P=2.039/0.044, 3.318/0.001, 2.287/0.024, 2.417/0.018, 3.943/<0.001). The peripheral blood miR-122-5p expression in pancreatic cancer patients was negatively correlated with histological grade, primary tumor size, number of metastatic lymph nodes, distant metastasis and TNM stage(rs/P=-0.713/0.016,-0.678/0.021,-0.764/0.009,-0.695/0.011,-0.732/0.004), NOC2L expression was positively correlated with histological grade, primary tumor size, number of metastatic lymph nodes, distant metastasis and TNM stage(rs/P=0.657/0.039, 0.701/0.014, 0.726/0.019, 0.672/0.028, 0.717/0.015). miR-122-5p, NOC2L and their combination had an AUC of 0.735, 0.719 and 0.863 for predicting poor prognosis of pancreatic cancer, respectively. The combination of the two was superior to their individual predictive efficacy(Z/P=9.412/<0.05, 10.013/<0.05). 4="" histological="" grade="" primary="" tumor="" number="" of="" metastatic="" lymph="" nodes="" distant="" metastasis="" and="" tnm="" stage="" -iv="" were="" independent="" risk="" factors="" for="" poor="" prognosis="" pancreatic="" .="" the="" median="" survival="" cancer="" patients="" with="" 0.69="" 1.21="" which="" was="" significantly="" lower="" than="" that="" other="" mir-122-5p="">0.69 or NOC2L<1.21)(15.61±3.08) months(Log Rank=12.573, P<0.001).ConclusionThe expression of miR-122-5p and NOC2L in peripheral blood of pancreatic cancer is closely related to clinical pathological characteristics and prognosis, and has certain clinical value in prognosis and disease prognosis. The combined detection of the two can improve the sensitivity and specificity in predicting poor prognosis of pancreatic cancer.

 
Liu Jun Qiao Pu Gao Xiaopeng Sun Bo Shen Leihua

ObjectiveTo explore and analyze the predictive value of serum macrophage inflammatory protein-3α(MIP-3α) and chemokine C-C-motif receptor 3(CCR3) for postoperative recurrence and metastasis of colon cancer patients.MethodsA total of 198 colon cancer patients admitted to our hospital from June 2018 to May 2021 were included as the colon cancer group. According to the follow-up results, they were grouped into a recurrence and metastasis group(n=65) and a non-recurrence and metastasis group(n=133). 192 healthy volunteers who underwent physical examinations in our hospital during the same period were included as the control group. The expression levels of serum MIP-3αand CCR3 were detected, and the general clinical data of the patients were analyzed. Multivariate logistic regression was applied to analyze the influencing factors of postoperative recurrence and metastasis in colon cancer patients. Receiver operating characteristic(ROC) curve was plotted to analyze the predictive value of serum MIP-3αand CCR3 for postoperative recurrence and metastasis in colon cancer patients.ResultsCompared with the control group, the serum levels of MIP-3α and CCR3 in the colon cancer group were obviously increased(t/P=22.813/<0.001;15.164/<0.001). The serum levels of MIP-3αand CCR3 in the recurrence and metastasis group were obviously higher than those in the non-recurrence and metastasis group(t/P=11.813/<0.001;12.545/<0.001). The differences in TNM staging, differentiation degree, and preoperative CEA levels between the recurrent and non-recurrent metastatic groups were statistically obvious(χ2/P=4.694/0.030;14.253/<0.001;5.602/0.018). TNM staging T3+T4, degree of low differentiation, and elevation of preoperative CEA, MIP-3α, and CCR3 were all risk factors for postoperative recurrence and metastasis in patients [OR(95%CI)=1.869(1.008-3.465); 1.998(1.097-3.640); 1.887(1.090-3.267);2.335(1.194-4.565); 2.318(1.200-4.478)]. ROC curve results showed that the AUC predicted by serum MIP-3α, CCR3, and their combination for postoperative recurrence and metastasis in colon cancer patients was 0.808, 0.795, and 0.899, respectively. The AUC predicted by the combination was obviously higher than that predicted by MIP-3α(Z=2.989, P=0.003) and CCR3(Z=2.575, P=0.010) alone.ConclusionThe serum levels of MIP-3αand CCR3 are elevated in patients with colon cancer, they have certain auxiliary predictive value for postoperative recurrence and metastasis, and may serve as potential biomarkers.