Objective To explore the relationship between fibrinogen to albumin ratio(FAR),prognostic nutritional index(PNI),systemic immune inflammation index(SII)and prognosis of patients with lung cancer undergoing thoracoscopic surgery.Methods The clinical data of 287 patients with lung cancer who underwent thoracoscopic lobectomy in the hospital from February 2018 to February 2020 were retrospectively collected.The FAR,PNI,and SII values were measured within one week before surgery.The 3-year survival after operation was counted.The relationship between clinical data,preoperative FAR,PNI,SII and 3-year survival prognosis was observed.The receiver operating characteristic curve(ROC)was used to determine the optimal cut-off values of preoperative FAR,PNI,and SII values for predicting the 3-year survival prognosis after surgery,and the prognostic value of single index and combination of each index was observed.Multivariate Logistic regression analysis was used to evaluate the influencing factors of prognosis.Pearson correlation analysis was used to explore the correlation between FAR,PNI and SII values.Results Finally,242 patients with lung cancer were included in the study,and 199 patients survived 3 years after operation,with an overall survival rate of 82.23％.43 cases(17.77％)died in 3 years.Age,serum carcinoembryonic antigen(CEA)level,lymph node metastasis,TNM stage,preoperative FAR,PNI and SII value were related to the 3-year survival prognosis of lung cancer patients after thoracoscopic lobectomy(P＜0.05).The ROC curve showed that the preoperative FAR,PNI and SII values had certain predictive value for the 3-year survival prognosis of patients after operation.The combined prediction of the three showed better predictive efficacy,and the area under the curve(AUC)was 0.772.Multivariate Logistic regression analysis showed that lymph node metastasis,TNM stage,FAR value and SII value were independent risk factors for postoperative survival and prognosis.PNI was an independent protective factor(P＜0.05).Pearson correlation analysis showed that there was a negative correlation between FAR and PNI,PNI and SII,and a positive correlation between FAR and SII(P＜0.05).Conclusion The values of FAR,PNI and SII are independently related to the prognosis of patients with lung cancer undergoing thoracoscopic surgery.The combined application has a higher prognostic value.

Objective:To identify independent risk factors for early recurrence following curative resection of resectable pancreatic cancer and establish a nomogram prediction model.Methods:Clinical data from 405 patients with resectable pancreatic cancer treated at Renji Hospital, Shanghai Jiao Tong University School of Medicine from February 2010 to December 2020 were retrospectively reviewed. Patients were stratified into a training cohort (265 patients form February 2010 to December 2018) and a validation cohort (140 patients from January 2019 to December 2020) based on surgery dates. Optimal cutoff values for clinical variables were determined using X-tile software. Independent risk factors were identified through univariate and multivariate Cox proportional hazards regression analyses. Kaplan-Meier curves for recurrence-free survival (RFS) were generated across subgroups, and a nomogram was developed to predict early recurrence (within 1 year post-surgery). Time-dependent receiver operating characteristic (tROC) curves was drawn and area under the curve (AUC) metrics were utilized to evaluate predictive accuracy, while model reliability was assessed by calibration curves. Individualized risk scores derived from the nomogram were stratified into high- and low-risk groups using X-tile-derived cutoff values. Survival differences between groups were analyzed via log-rank tests. The clinical application value was judged by decision curve analysis (DCA) compared to TNM staging. Results:In the training cohort, 139 patients (52.45%) experienced early recurrence, with a median RFS of 11.1 months [interquartile range ( IQR): 6.0-26.0]. The validation cohort reported 70 early recurrences (50.00%) and a median RFS of 11.8 months ( IQR: 4.9-21.4). Univariate analysis revealed significant associations between early recurrence and tumor diameter, carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 125 (CA125), systemic immune-inflammation index (SⅡ), and prognostic nutritional index (PNI). Multivariate analysis identified tumor diameter ≥3.75 cm ( HR=1.718, 95% CI 1.223-2.412, P=0.002), CA19-9≥218 U/ml ( HR=1.567, 95% CI 1.107-2.220, P=0.011), CA125≥20.98 U/ml ( HR=2.501, 95% CI 1.768-3.539, P<0.001), SⅡ≥388.28 ( HR=1.708, 95% CI 1.096-2.662, P=0.018), and PNI<53.18 ( HR=0.596, 95% CI 0.404-0.879, P=0.009) as independent risk factors for early recurrence. The nomogram achieved AUC values of 0.771 and 0.708 in the training and validation cohorts, respectively. Calibration curves demonstrated strong agreement between predicted and observed survival probabilities. Kaplan-Meier analysis revealed significantly lower 1-year RFS rates in high-risk versus low-risk groups for both cohorts (training: HR=3.65, 95% CI 2.45-5.44, P<0.001; validation: HR=2.37, 95% CI 1.39-4.06, P=0.001). DCA indicated superior net benefit of the nomogram over TNM staging across threshold probabilities of 0.2-0.9. Conclusions:The proposed nomogram effectively integrates clinical and serological biomarkers to preoperatively assess early recurrence risk in resectable pancreatic cancer patients, offering enhanced precision for clinical decision-making.

Objective To explore the relationship between fibrinogen to albumin ratio(FAR),prognostic nutritional index(PNI),systemic immune inflammation index(SII)and prognosis of patients with lung cancer undergoing thoracoscopic surgery.Methods The clinical data of 287 patients with lung cancer who underwent thoracoscopic lobectomy in the hospital from February 2018 to February 2020 were retrospectively collected.The FAR,PNI,and SII values were measured within one week before surgery.The 3-year survival after operation was counted.The relationship between clinical data,preoperative FAR,PNI,SII and 3-year survival prognosis was observed.The receiver operating characteristic curve(ROC)was used to determine the optimal cut-off values of preoperative FAR,PNI,and SII values for predicting the 3-year survival prognosis after surgery,and the prognostic value of single index and combination of each index was observed.Multivariate Logistic regression analysis was used to evaluate the influencing factors of prognosis.Pearson correlation analysis was used to explore the correlation between FAR,PNI and SII values.Results Finally,242 patients with lung cancer were included in the study,and 199 patients survived 3 years after operation,with an overall survival rate of 82.23％.43 cases(17.77％)died in 3 years.Age,serum carcinoembryonic antigen(CEA)level,lymph node metastasis,TNM stage,preoperative FAR,PNI and SII value were related to the 3-year survival prognosis of lung cancer patients after thoracoscopic lobectomy(P＜0.05).The ROC curve showed that the preoperative FAR,PNI and SII values had certain predictive value for the 3-year survival prognosis of patients after operation.The combined prediction of the three showed better predictive efficacy,and the area under the curve(AUC)was 0.772.Multivariate Logistic regression analysis showed that lymph node metastasis,TNM stage,FAR value and SII value were independent risk factors for postoperative survival and prognosis.PNI was an independent protective factor(P＜0.05).Pearson correlation analysis showed that there was a negative correlation between FAR and PNI,PNI and SII,and a positive correlation between FAR and SII(P＜0.05).Conclusion The values of FAR,PNI and SII are independently related to the prognosis of patients with lung cancer undergoing thoracoscopic surgery.The combined application has a higher prognostic value.

Objective:To identify independent risk factors for early recurrence following curative resection of resectable pancreatic cancer and establish a nomogram prediction model.Methods:Clinical data from 405 patients with resectable pancreatic cancer treated at Renji Hospital, Shanghai Jiao Tong University School of Medicine from February 2010 to December 2020 were retrospectively reviewed. Patients were stratified into a training cohort (265 patients form February 2010 to December 2018) and a validation cohort (140 patients from January 2019 to December 2020) based on surgery dates. Optimal cutoff values for clinical variables were determined using X-tile software. Independent risk factors were identified through univariate and multivariate Cox proportional hazards regression analyses. Kaplan-Meier curves for recurrence-free survival (RFS) were generated across subgroups, and a nomogram was developed to predict early recurrence (within 1 year post-surgery). Time-dependent receiver operating characteristic (tROC) curves was drawn and area under the curve (AUC) metrics were utilized to evaluate predictive accuracy, while model reliability was assessed by calibration curves. Individualized risk scores derived from the nomogram were stratified into high- and low-risk groups using X-tile-derived cutoff values. Survival differences between groups were analyzed via log-rank tests. The clinical application value was judged by decision curve analysis (DCA) compared to TNM staging. Results:In the training cohort, 139 patients (52.45%) experienced early recurrence, with a median RFS of 11.1 months [interquartile range ( IQR): 6.0-26.0]. The validation cohort reported 70 early recurrences (50.00%) and a median RFS of 11.8 months ( IQR: 4.9-21.4). Univariate analysis revealed significant associations between early recurrence and tumor diameter, carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 125 (CA125), systemic immune-inflammation index (SⅡ), and prognostic nutritional index (PNI). Multivariate analysis identified tumor diameter ≥3.75 cm ( HR=1.718, 95% CI 1.223-2.412, P=0.002), CA19-9≥218 U/ml ( HR=1.567, 95% CI 1.107-2.220, P=0.011), CA125≥20.98 U/ml ( HR=2.501, 95% CI 1.768-3.539, P<0.001), SⅡ≥388.28 ( HR=1.708, 95% CI 1.096-2.662, P=0.018), and PNI<53.18 ( HR=0.596, 95% CI 0.404-0.879, P=0.009) as independent risk factors for early recurrence. The nomogram achieved AUC values of 0.771 and 0.708 in the training and validation cohorts, respectively. Calibration curves demonstrated strong agreement between predicted and observed survival probabilities. Kaplan-Meier analysis revealed significantly lower 1-year RFS rates in high-risk versus low-risk groups for both cohorts (training: HR=3.65, 95% CI 2.45-5.44, P<0.001; validation: HR=2.37, 95% CI 1.39-4.06, P=0.001). DCA indicated superior net benefit of the nomogram over TNM staging across threshold probabilities of 0.2-0.9. Conclusions:The proposed nomogram effectively integrates clinical and serological biomarkers to preoperatively assess early recurrence risk in resectable pancreatic cancer patients, offering enhanced precision for clinical decision-making.

BACKGROUND: Thymoma is the most common malignant tumor in anterior mediastinum, and its specific pathogenesis is still unclear. This limits the study of targeted drugs for thymoma. The aim of the study is to investigate the genes and signal pathways of thymoma, and provide help for the research of thymic tumor pathogenesis using the technology of second-generation genechip to analyze thymoma. METHODS: From January 2015 to December 2017, we analyzed 31 cases of thymoma by CapitaBio mRNA expression profile genechip technology, and then confirmed the genes by reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: We found some genes with different expression levels between thymoma and surrounding thymus tissue. Among them, six driving genes (FANCI, CAPD3, NCAPG, OXCT1, EPHA1 and MCM2) were significantly abnormal in thymoma. Some specific genes affected by copy-number variation were detected: E2F2, EphA1, CCL25 and MCM2 were significantly up-regulated, while IL-6, CD36, FABP4, SH2D1A and MYOC genes were significantly down-regulated. KEGG database analysis showed that the expression of 10 signaling pathway genes was generally up-regulated or down-regulated, such as systemic lupus erythematosus, viral oncogenes, primary immunodeficiency, cell cycle genes and p53 signaling pathway, which may be related to occurrence of thymoma. CONCLUSIONS We found a variety of genes abnormally expressed in thymoma, which will provide reference for the study of pathogenesis and biomarkers of thymoma in the future.