查看更多>>摘要：Intrahepatic cholangiocarcinoma(ICC)is a relatively rare but aggressive primary liver cancer with a poor prognosis.A number of established clinical and pathologic factors correlate with prognosis,and this is reflected in the American Joint Committee on Cancer(AJCC)8th Edition staging manual.Researchers have identified areas for improvement in staging and prognostication of ICC using more nuanced tools,including serum biomarkers,molecular profiling,immunophenotyping,and multimodal prognostic scoring systems.These data have led to proposals of novel staging systems that attempt to improve the correlation between stage and prognosis.More accurate staging tools may aid in treatment decisions that are tailored to each individual patient,to maximize therapy for individuals most likely to benefit and to avoid unnecessary toxicity and decision regret in those for whom aggressive treatment is unlikely to alter outcomes.Artificial intelligence and machine learning may help researchers develop new models that predict outcomes with more accuracy and precision.
查看更多>>摘要：Aim:This study explored the prognostic value of N-glycan biosynthesis(NGB)in lower-grade glioma(LGG)and aimed to develop a machine learning model for enhanced prognostic accuracy.Method:LGG patient transcriptome data were analyzed to identify NGB-related genes.Consensus clustering identified subgroups based on NGB expression.A prognostic NGB signature(pNGB)was developed using machine learning.The pNGB score's association with cell proliferation,inflammation,treatment response,tumor recurrence,and the immune microenvironment was also explored.Results:A 22-gene pNGB signature was identified,with MGAT1 and TUSC3 having the highest and lowest hazard ratios,respectively.Two distinct clusters(C1 and C2)with differential pNGB expression and survival outcomes were revealed.NGB pathway analysis indicated an overall poor prognosis,except for MGAT4C and TUSC3.The Enet-based survival model showed superior discriminatory power and reliability.The NGB risk score correlated with increased cell proliferation,inflammation,and altered immune landscape.Additionally,the score is linked to treatment response and tumor recurrence.Conclusion:This study highlights the critical role of NGB in LGG progression and proposes a pNGB-based model for prognosis.The NGB risk score shows promise as a prognostic biomarker and potential therapeutic target in LGG.
查看更多>>摘要：Aim:Standard treatment includes post-surgical chemoradiotherapy and adjuvant temozolomide(TMZ)for glioblastoma(GBM).There is no consensus on the optimal duration for adjuvant TMZ.This study assessed whether prolonging adjuvant TMZ improved survival outcomes.Methods:We retrospectively analyzed data of GBM patients who met inclusion criteria at our institute from September 2013 to December 2022.Patients who received 6 cycles of maintenance TMZ constituted the standard group,whereas those who underwent＞6 cycles were classified into the extended group.Kaplan-Meier method was used to estimate the median progression-free survival(PFS)and overall survival(OS).Independent predictors of OS and PFS were explored by Cox regression analyses.Results:100 patients were enrolled.Extended adjuvant TMZ significantly improved OS(28.0 vs.10.0 months,P＜0.001)and PFS(22.0 vs.8.0 months,P＜0.001)in newly diagnosed GBM patients.Subgroup analysis showed that patients with MGMT promoter methylation who received＞6 cycles of adjuvant TMZ experienced a significant increase in OS(34.0 vs.9.0 months,P＜0.001)and PFS(26.0 vs.9.0 months,P=0.008).Additionally,in the extended group,patients with MGMT promoter methylation had better survival outcomes compared to MGMT promoter unmethylated patients(OS:34.0 vs.17.0 months,P=0.013;PFS:26.0 vs.12.0 months,P=0.025).In patients with solitary GBM,extended adjuvant TMZ resulted in better OS(11.0 vs.32 months,P=0.007)and PFS(9.0 vs.24.0 months,P＜0.001).For patients with multiple GBM,undergoing six or more cycles of adjuvant TMZ did not significantly impact OS(P=0.100)and PFS(P=0.067).The Karnofsky Performance Status(KPS)is employed to assess the health condition of surgical patients.Patients with KPS＞70 exhibited better survival outcomes in the extended group.Nausea and vomiting were the main adverse events reported in both cohorts.However,fatigue emerged as the most severe side effect,specifically within the extended group.Conclusion:This study indicated that prolonged adjuvant TMZ significantly enhanced OS and PFS in GBM,and the adverse events were acceptable.The benefits were particularly notable in those with MGMT promoter methylation,solitary GBM,and high KPS.The optimal cycles of adjuvant TMZ require large prospective studies to further validate and identify which patient groups benefit the most based on molecular subtyping and clinical characteristics.
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