Platelets play important roles in tumor progression.Increased platelets count is associated with poor overall survival and prognosis.Tumor cell-induced platelet activation and platelet-induced tumor growth form a malignant amplification loop which plays a crucial role in tumor cell proliferation,metastasis and angiogenesis.Antiplatelet therapy may break the platelet-tumor amplification loop and play a key role in reducing tumor metastasis.

Circulating tumor cells (CTCs)are cancerous cells that shed from the primary tumor or metastases into the bloodstream. The currently clinical applicability of CTCs approved by the US Food and Drug Administration (FDA)is that CTCs can be prognostic biomarker for patients with metastatic breast cancer, prostate cancer and colorectal cancer. CTCs also have great potential in the prognosis assessment of other meta-static or localized tumors,as well as early screening of tumors,analysis of molecular profiling,guiding treat-ment decisions,and monitoring of treatment response. Currently,various studies are being carried out to further explore the clinical application of CTCs,and provide new strategies and new prospects for individualized and precise treatment of cancer patients.

Small cell lung cancer (SCLC) has a poor biological behavior,high probability of recurrence and metastasis,and limited treatment.The Notch signaling pathway is an evolutionarily conserved pathway that regulates the growth of many cell types through local cell-cell interactions.It controls the differentiation,proliferation and survival of cells.As a ligand for the Notch pathway,delta-like protein 3 (DLL3) is highly expressed on the membrane of SCLC cells.DLL3 plays an important role in cancer initiation and epithelial mesenchymal transition,invasion and metastasis of SCLC.Rovalpituzumab tesirine is a conjugate of directed against DLL3,which shows great potential for SCLC therapy.

Objective To investigate the prognosis factors of patients with non-functional pancreatic neuroendocrine carcinoma (NF-PanNEC).Methods The patients with NF-PanNEC confirmed by pathology from 2004 to 2015 were collected from the Surveillance,Epidemiology,and End Results (SEER) database of the American National Cancer Institute.The MatchIt package in the R software was used to perform propensitymatching analysis of surgery,radiotherapy and chemotherapy.The Kaplan-Meier method was used to calculate the cumulative survival rate,and the significant difference was evaluated by the log-rank test.Then the Cox multivariate regression analysis was applied to evaluate the prognostic factors of NF-PanNEC patients.Results A total of 2 603 NF-PanNEC patients were included in the analysis.Univariate analysis showed that the age of diagnosis (x2 =123.8,P ＜ 0.001),gender (x2 =7.3,P =0.007),marital status (x2 =26.7,P ＜ 0.001),primary site of tumor (x2 =47.8,P ＜ 0.001),degree of tumor differentiation (x2 =628.7,P ＜ 0.001),American Joint Committee on Cancer (AJCC) stage (x2 =811.7,P ＜0.001),T stage (x2 =425.9,P ＜ 0.001),N stage (x2 =272.3,P ＜ 0.001),M stage (x2 =779.8,P ＜ 0.001),surgery (x2 =962.6,P ＜ 0.001),chemotherapy (x2 =21.9,P ＜ 0.001) were associated with the prognosis of NF-PanNEC patients.No correlation was observed between radiotherapy and the prognosis of NF-PanNEC patients (x2 =0.1,P =0.750).Multivariate Cox regression analysis showed that older diagnostic age (≥74 years old vs.≤56 years old,HR =2.20,95 ％ CI:1.84-2.62,P ＜ 0.001),male (male vs.female,HR =1.14,95 ％ CI为1.01 ～1.29,P =0.035),single or divorced or widowed (single or divorced vs.married,HR =1.26,95 ％ CI:1.10-1.45,P =0.001;widowed vs.married,HR =1.29,95％ CI:1.04-1.61,P =0.022),head of pancreas (tail of pancreas vs.head of pancreas,HR =0.85,95％ CI:0.73-0.99,P =0.033),poor differentiation (grade Ⅳvs.grade Ⅰ,HR=3.75,95％CI:2.70-5.20,P＜0.001),late AJCC stage (stage Ⅳ vs.stage Ⅰ,HR =5.72,95％ CI:4.23-7.73,P ＜ 0.001),no surgery treatment (yes vs.no,HR =0.37,95％ CI:0.30-0.44,P ＜ 0.001) were significant prognostic risk factors for NF-PanNEC patients,and chemotherapy was not independent prognostic factor (yes vs.no,HR=1.00,95％CI:0.88-1.13,P=0.958).Conclusion The older diagnostic age,single or divorced or windowed,head of pancreas,poor differentiation,late AJCC stage and no surgery treatment are significant prognostic risk factors for NF-PanNEC patients.Radiotherapy and chemotherapy may not improve the prognosis of NF-PanNEC patients.

Objective: To construct a nomogram for predicting the 1-year, 3-year, and 5-year survival of patients with rhabdomyosarco-ma. Methods: We retrieved data of patients diagnosed with rhabdomyosarcoma from The National Cancer Institute's Surveillance, Epi-demiology, and End Results (SEER) database between 1975 and 2016. After screening, 861 eligible patients were selected. The univari-ate Kaplan-Meier method and multivariate Cox model were used to determine independent prognostic factors, which were then uti-lized to construct a nomogram to predict 1-year, 3-year, and 5-year survival of patients with rhabdomyosarcoma. The resulting nomo-gram was internally verified using the consistency index (C-index) to measure its predictive accuracy. Results: Patient age, tumor histol-ogy, tumor grade, stage of the disease, surgery, radiotherapy, and chemotherapy were independent prognostic factors for patients with rhabdomyosarcoma (P<0.05). Based on these factors, the nomogram was successfully constructed. The C-index value for internal validation of the nomogram was 0.776, and the calibration curves of the model were consistent. Conclusions: The proposed nomo-gram is a reliable tool for accurate prognostic prediction in patients with rhabdomyosarcoma. It could be helpful for clinicians to indi-vidualize diagnosis, assess prognosis, and guide treatment plans for rhabdomyosarcoma patients.

Objective:The research was aimed to investigate the association between serum total homocysteine (tHcy) and subacute combined degeneration of the spinal cord (SCD).Methods:A retrospective survey of 106 newly diagnosed patients with SCD were enrolled in this research who were treated in the department of neurology of Xijing Hospital from January 2008 to February 2019, meanwhile, 121 patients with spinal cord lesion (not SCD) and 104 neurology mild outpatients were selected as controls. Serum tHcy level was determined by using the chemiluminescent immunoassay assay. A multivariate logistic regression model was used to analyze the risk factors for SCD. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve, sensitivity, specificity and Youden index were used to evaluate the diagnostic efficacy of tHcy. Spearman correlation analysis was used to observe the correlation between tHcy and SCD severity. The SCD patients were categorized into normal or mild tHcy group, moderate tHcy group, and severe tHcy group based on tHcy levels. Clinical symptoms, nerve conduction velocity, magnetic resonance imaging (MRI) findings from the patients were studied.Results:The serum tHcy levels in SCD patients were 64.3(26.5, 98.8) μmol/L, while in patients with spinal cord lesion (not SCD) group were 13.7(10.8, 19.2) μmol/L, neurology mild outpatients were 10.6(8.2, 13.0) μmol/L, which was higher in SCD group ( H=112.020, P<0.001), ( H=165.525, P<0.001).The multivariate logistic regression model showed tHcy is the impact factor of SCD ( OR=1.107, 95% CI:1.077-1.139, P<0.001). At ROC analysis, tHcy showed diagnostic value with an optimal cut-off value of 24.9 μmol/L (AUC 0.913, 95% CI: 0.875-0.951, sensitivity 79.2%, specificity 91.6%). Spearman correlation analysis showed that tHcy was positively correlated with functional disability rating scale ( r=0.254, P=0.009). Conclusions:Serum tHcy is the risk factor for SCD and related to its disability. Focus on the increased level of tHcy plays a positive role in the diagnosis of SCD.

Objective:The research was aimed to investigate the association between serum total homocysteine (tHcy) and subacute combined degeneration of the spinal cord (SCD).Methods:A retrospective survey of 106 newly diagnosed patients with SCD were enrolled in this research who were treated in the department of neurology of Xijing Hospital from January 2008 to February 2019, meanwhile, 121 patients with spinal cord lesion (not SCD) and 104 neurology mild outpatients were selected as controls. Serum tHcy level was determined by using the chemiluminescent immunoassay assay. A multivariate logistic regression model was used to analyze the risk factors for SCD. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve, sensitivity, specificity and Youden index were used to evaluate the diagnostic efficacy of tHcy. Spearman correlation analysis was used to observe the correlation between tHcy and SCD severity. The SCD patients were categorized into normal or mild tHcy group, moderate tHcy group, and severe tHcy group based on tHcy levels. Clinical symptoms, nerve conduction velocity, magnetic resonance imaging (MRI) findings from the patients were studied.Results:The serum tHcy levels in SCD patients were 64.3(26.5, 98.8) μmol/L, while in patients with spinal cord lesion (not SCD) group were 13.7(10.8, 19.2) μmol/L, neurology mild outpatients were 10.6(8.2, 13.0) μmol/L, which was higher in SCD group ( H=112.020, P<0.001), ( H=165.525, P<0.001).The multivariate logistic regression model showed tHcy is the impact factor of SCD ( OR=1.107, 95% CI:1.077-1.139, P<0.001). At ROC analysis, tHcy showed diagnostic value with an optimal cut-off value of 24.9 μmol/L (AUC 0.913, 95% CI: 0.875-0.951, sensitivity 79.2%, specificity 91.6%). Spearman correlation analysis showed that tHcy was positively correlated with functional disability rating scale ( r=0.254, P=0.009). Conclusions:Serum tHcy is the risk factor for SCD and related to its disability. Focus on the increased level of tHcy plays a positive role in the diagnosis of SCD.