1.Risk factors and nomogram construction for predicting long-term survival in hepatoid adenocarcinoma of the stomach
Yuyuan LU ; Hao CUI ; Bo CAO ; Qixuan XU ; Jingwang GAO ; Ruiyang ZHAO ; Huiguang REN ; Zhen YUAN ; Jiajun DU ; Jiahong SUN ; Jianxin CUI ; Bo WEI
Chinese Journal of Gastrointestinal Surgery 2025;28(2):157-168
Objective:This study aimed to analyze the prognostic risk factors for hepatoid adenocarcinoma of the stomach (HAS) and construct two nomogram-based clinical prediction models to predict overall survival (OS) and recurrence-free survival (RFS) in patients with HAS.Methods:Data were retrospectively collected from 82 patients (64 males, 18 females; mean age 60.3 ± 9.4 years) who underwent radical gastrectomy and were pathologically diagnosed with gastric hepatoid adenocarcinoma at the First Medical Center of the PLA General Hospital between February 2006 and September 2023. Statistical analyses were conducted using SPSS 25.0 and R 4.3.2. Survival analyses were performed using the Kaplan-Meier method, and univariate analyses were used to identify clinical and pathological factors associated with prognosis. Variables with P<0.05 in the univariate analysis were included in multivariate Cox regression models to identify independent risk factors for OS and RFS. These factors were incorporated into the prediction models to construct nomograms. The discriminatory power of the models was assessed using the area under the curve (AUC) of receiver operating characteristic (ROC) analyses, while calibration curves, decision curve analysis (DCA), and comparisons with the 8th edition of the TNM staging system of the American Joint Committee on Cancer (AJCC) were employed to evaluate model performance. Results:Among the 82 patients, 36 (43.9%) exhibited vascular infiltration, 61 (74.4%) had nerve infiltration, and lymph node metastasis was observed in 60 cases (73.2%). Pathological stages I, II, III, and IV were distributed as 11 (13.4%), 26 (31.7%), 44 (53.7%), and 1 (1.2%) cases, respectively. Inflammatory markers included neutrophil-to-lymphocyte ratio (NLR) ≥ 4.33 in 22 cases (26.8%), platelet-to-lymphocyte ratio (PLR) ≥ 142.2 in 50 cases (61.0%), monocyte-to-lymphocyte ratio (MLR) ≥ 0.411 in 22 cases (26.8%), α-fetoprotein (AFP) ≥ 2.48 μg/L in 64 cases (78.0%), and C-reactive protein (CRP) ≥ 7.506 mg/L in 12 cases (14.6%). Among the 82 patients, 3 cases (3.6%) were lost to follow-up. The median follow-up time was 52 (range: 8–147) months, with a median OS of 61(2–147) months. The 1-year and 3-year OS rates were 78.5% and 58.5%, respectively, while the 1-year and 3-year RFS rates were 77.3% and 60.3%, respectively. Multivariate analysis identified several independent risk factors influencing OS in patients with HAS: advanced pathological stage, MLR ≥ 0.411, AFP ≥ 2.545 μg/L, and CRP ≥ 7.51 mg/L. The hazard ratios (HRs) and 95% confidence intervals (CIs) were as follows: 5.218 (1.230–22.143), 2.610 (1.287–5.294), 2.950 (1.013–8.589), and 2.594 (1.145–5.877), respectively (all P < 0.05). For RFS, advanced pathological stage, PLR ≥ 152.0, and MLR ≥ 0.411 were independent risk factors, with HRs (95% CIs) of 4.735 (1.080–20.760), 3.759 (1.259–11.226), and 2.714 (1.218–6.048), respectively (all P < 0.05). The AUC values for OS prediction at 1 year, 3 years, and 5 years were 0.7765, 0.7525, and 0.7702, respectively. For RFS, the AUC values were 0.7304, 0.8137, and 0.8307 at 1 year, 3 years, and 5 years, respectively. The calibration curves demonstrated strong agreement between nomogram- predicted outcomes and observed survival data. DCA indicated that both TNM staging and the nomogram-based clinical prediction models provided a net positive benefit in predicting OS and RFS in HAS patients, with the nomogram model demonstrating superior performance. Conclusion:The nomogram-based clinical prediction models developed in this study demonstrated robust performance in predicting long-term OS and RFS in patients with HAS.
2.Risk factors and nomogram construction for predicting long-term survival in hepatoid adenocarcinoma of the stomach
Yuyuan LU ; Hao CUI ; Bo CAO ; Qixuan XU ; Jingwang GAO ; Ruiyang ZHAO ; Huiguang REN ; Zhen YUAN ; Jiajun DU ; Jiahong SUN ; Jianxin CUI ; Bo WEI
Chinese Journal of Gastrointestinal Surgery 2025;28(2):157-168
Objective:This study aimed to analyze the prognostic risk factors for hepatoid adenocarcinoma of the stomach (HAS) and construct two nomogram-based clinical prediction models to predict overall survival (OS) and recurrence-free survival (RFS) in patients with HAS.Methods:Data were retrospectively collected from 82 patients (64 males, 18 females; mean age 60.3 ± 9.4 years) who underwent radical gastrectomy and were pathologically diagnosed with gastric hepatoid adenocarcinoma at the First Medical Center of the PLA General Hospital between February 2006 and September 2023. Statistical analyses were conducted using SPSS 25.0 and R 4.3.2. Survival analyses were performed using the Kaplan-Meier method, and univariate analyses were used to identify clinical and pathological factors associated with prognosis. Variables with P<0.05 in the univariate analysis were included in multivariate Cox regression models to identify independent risk factors for OS and RFS. These factors were incorporated into the prediction models to construct nomograms. The discriminatory power of the models was assessed using the area under the curve (AUC) of receiver operating characteristic (ROC) analyses, while calibration curves, decision curve analysis (DCA), and comparisons with the 8th edition of the TNM staging system of the American Joint Committee on Cancer (AJCC) were employed to evaluate model performance. Results:Among the 82 patients, 36 (43.9%) exhibited vascular infiltration, 61 (74.4%) had nerve infiltration, and lymph node metastasis was observed in 60 cases (73.2%). Pathological stages I, II, III, and IV were distributed as 11 (13.4%), 26 (31.7%), 44 (53.7%), and 1 (1.2%) cases, respectively. Inflammatory markers included neutrophil-to-lymphocyte ratio (NLR) ≥ 4.33 in 22 cases (26.8%), platelet-to-lymphocyte ratio (PLR) ≥ 142.2 in 50 cases (61.0%), monocyte-to-lymphocyte ratio (MLR) ≥ 0.411 in 22 cases (26.8%), α-fetoprotein (AFP) ≥ 2.48 μg/L in 64 cases (78.0%), and C-reactive protein (CRP) ≥ 7.506 mg/L in 12 cases (14.6%). Among the 82 patients, 3 cases (3.6%) were lost to follow-up. The median follow-up time was 52 (range: 8–147) months, with a median OS of 61(2–147) months. The 1-year and 3-year OS rates were 78.5% and 58.5%, respectively, while the 1-year and 3-year RFS rates were 77.3% and 60.3%, respectively. Multivariate analysis identified several independent risk factors influencing OS in patients with HAS: advanced pathological stage, MLR ≥ 0.411, AFP ≥ 2.545 μg/L, and CRP ≥ 7.51 mg/L. The hazard ratios (HRs) and 95% confidence intervals (CIs) were as follows: 5.218 (1.230–22.143), 2.610 (1.287–5.294), 2.950 (1.013–8.589), and 2.594 (1.145–5.877), respectively (all P < 0.05). For RFS, advanced pathological stage, PLR ≥ 152.0, and MLR ≥ 0.411 were independent risk factors, with HRs (95% CIs) of 4.735 (1.080–20.760), 3.759 (1.259–11.226), and 2.714 (1.218–6.048), respectively (all P < 0.05). The AUC values for OS prediction at 1 year, 3 years, and 5 years were 0.7765, 0.7525, and 0.7702, respectively. For RFS, the AUC values were 0.7304, 0.8137, and 0.8307 at 1 year, 3 years, and 5 years, respectively. The calibration curves demonstrated strong agreement between nomogram- predicted outcomes and observed survival data. DCA indicated that both TNM staging and the nomogram-based clinical prediction models provided a net positive benefit in predicting OS and RFS in HAS patients, with the nomogram model demonstrating superior performance. Conclusion:The nomogram-based clinical prediction models developed in this study demonstrated robust performance in predicting long-term OS and RFS in patients with HAS.
3.Clinical study of peripheral blood T cell subsets in patients with malignant lymphoma by flow cytometry
Jingsheng WANG ; Zhengjun LIU ; Nan CHENG ; Dan LI ; Huiguang GAO
Practical Oncology Journal 2017;31(5):431-435
Objective The aim of this study was to investigate the effect of flow cytometry on peripheral blood T cell subsets in patients with malignant lymphoma and its relationship with clinicopathological and tumor types.Methods Ninety-eight patients with malignant lymphoma treated in our hospital from August 2014 to September 2016 were selected as the study group.Ninety-eight healthy subjects were selected as the control group.The peripheral blood T cell subsets(CD3 +,CD4 +,CD8 +,CD4 +/CD8 +)were detected in patients and healthy controls by flow cytometry.Results The levels of CD3 +and CD4 +/CD8 +in the study group were (55.63±11.25)and(1.32±0.62),respectively,which were significantly lower than those(68.96±12.63)and (1.59±0.59)of the control group(P<0.05).The levels of CD4 +and CD8 +were(33.67±8.14)and(26.02±4.67),respectively in the study group,were no difference from the control group(34.12±8.33)and(25.67±4.53)(P>0.05).The levels of CD3+and CD4 +/CD8 +in patients with Hodgkin's lymphoma were(54.63±11.36),(1.22±0.65),respectively,and(55.52±12.02),(1.34±0.71)for non-hodgkin lymphoma.They were significantly decreoseg in the control group(68.96±12.63 for CD3 +and 1.59±0.59 for CD4 +/CD8 +) (P<0.05).The level of CD4 +and CD8 +were no difference amoupst Hodgkin's lymphoma(33.78±8.23 for CD4 +and 25.74±4.88 for CD8 +),non-Hodgkin's lymphoma(25.74±4.88 for CD4 +and 33.62±8.74 for CD8 +)and control group(34.12±8.33 for CD4 +and 25.67±4.53 for CD8 +)(P>0.05).The levels of CD3 +,CD4+and CD4 +/CD8 +in patients with Ⅲ ~Ⅳ stage malignant lymphoma were(52.66±12.47), (28.25±6.32)and(1.30±0.62),respectively,which were significantly lower than those(68.96±12.63), (34.12±8.33)and(1.59±0.59)in the control group(P<0.05).The level of CD3 +in patients with phase Ⅰ-Ⅱ malignant lymphoma(58.63±11.85)was significantly lower than that in the control group(68.96±12.63)(P<0.05).The level of CD8 +in patients with phase Ⅰ-Ⅱ malignant lymphoma(29.63±3.57)was significantly higher than that in the control group(25.67±4.53)(P<0.05).Conclusion The detection of peripheral blood T cell subsets by flow cytometry can be used as an important methods to diagnose the disease,staging and immune status of patients with malignant lymphoma,which has high application value.
4.Effects of health management on high-risk diabetic populations
Huiguang TIAN ; Ruolan DOU ; Chunmin HAO ; Jian WEI ; Jie WU ; Hongmin GAO ; Yu BAI
Chinese Journal of Health Management 2013;7(5):300-303
Objective To assess the effects of health management on high-risk diabetic populations.Methods A total of 307 diabetic high-risk adults from 6 communities of Tianjin were recruited by using diabetes risk screening technology.Three-month intensive health management and nine-month follow-up were conducted in this participants.Paired t test for continuous variables and paired contingency table x2 test were used for data analysis.Results Energy intake (1989.8 vs.1766.4 kcal,t =6.84,P <0.05),effective exercises (120.4 vs.157.5 kcal,t =-5.00,P < 0.05),body weight (73.0 vs.71.5 kg,t =6.92,P <0.05),systolic blood pressure (130.4 vs.124.6 mm Hg (1 mm Hg =0.133 kPa),t =8.36,P <0.05),diastolic blood pressure (81.8 vs.78.4 mm Hg,t =7.40,P < 0.05),serum total cholesterol (5.21 vs.5.08 mmol/L,t =2.73,P < 0.05),fasting plasma glucose (6.4 vs.5.8 mmol/L,t =16.37,P < 0.05)and 2 h postprandial blood glucose (7.7 vs.6.9 mmol/L,t =9.67,P < 0.05) were significantly improved after the intervention.Conclusions Community-based health management may provide an effective way to prevent and control the risk factors of diabetes.
5.Preparation and functional identification of human high mobility group box-1 protein
Xiaoru XING ; Fengtian HE ; Zhaohui YANG ; Rongfen LI ; Yingru ZHENG ; Huiguang GAO ; Song LI ; Yan ZHANG ; Li ZHANG
Journal of Third Military Medical University 2003;0(19):-
Objective To clone the cDNA encoding human HMGB1, express it in E. coli, and identify its biological activity. Methods Human HMGB1 cDNA was amplified by RT-PCR and cloned into vector pUC19. After sequence analysis, the cDNA was ligated into prokaryotic expression vector pQE-80L and induced by IPTG to express HMGB1. The protein was purified with Ni~(2+)-NTA chromatography and polymyxin B affinity column. To identify the function of purified protein, the product was co-cultured with THP1 cells. Results Recombinant expression plasmid pQE-80L/HMGB1 was constructed successfully. After purification, the protein purity reached 96%. The recombinant HMGB1 stimulated THP1 to secrete TNF-? . Conclusion The highly purified HMGB1 was obtained successfully, which showed biological activity. These results lay the foundation for further research on the function of human HMGB1.
6.Expression and identification of the soluble monoclonal antibody ScFv fragment
Xiaolin ZHONG ; Huiguang GAO ; Qing JI ; Gang HUANG ;
Journal of Third Military Medical University 2003;0(08):-
Objective To express soluble single chain variable fragments (ScFv) of monoclonal antibody MC3 recognizing colorectal carcinomas in E. coli HB2151 and to purify the soluble ScFv and identify its antigen binding activities to find new target vectors for the diagnosis and therapy of colorectal carcinomas. Methods The phage clones displaying ScFv fragment of the monoclonal antibody MC3 were used to infect E. coli HB2151 to express soluble antibodies. The soluble ScFvs were identified by Dot blot and Western blot and their antigen binding activities were determined by ELISA. The VH and VL DNAs of the ScFv DNA derived were sequenced based on the dideoxy method. Results The soluble MC3 ScFvs were expressed successfully. The expression products with a proximate MW of 32?10 3 were mainly secreted into the periplasm. The soluble ScFv containing periplasmatic extracts derived from three clones could inhibit the binding of MC3 with its antigen, and the inhibition rates were 41.19%, 36.89% and 33.77% respectively. The sequences of the VH and VL DNAs of the MC3 ScFv showed that the variable antibody genes belonged to the IgG1 subgroup and ? type. Conclusion Generation of E. coli HB2151 expressed ScFv of monoclonal antibody MC3 paves the way for further use of the antibody.

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