1.The prognostic value of HALP index for overall survival after radical resection of distal cholangiocarcinoma
Feng XU ; Youwei MA ; Jincan HUANG ; Hanxuan WANG ; Shaocheng LYU ; Qiang HE
Chinese Journal of General Surgery 2025;40(7):533-538
Objective:To evaluate the value of HALP index on postoperative survival of patients with distal cholangiocarcinoma.Methods:A retrospective analysis was performed on 165 patients with distal cholangiocarcinoma who underwent surgery at Beijing Chaoyang Hospital, Capital Medical University from Jan 2011 to Dec 2022. Hemoglobin, albumin, lymphocyte count, and platelet count were recorded within one week before surgery, and hemoglobin×albumin×lymphocyte count/platelet count (HALP) was calculated. The receiver operating characteristic curve was drawn to determine the optimal cutoff value for predicting postoperative survival. According to the cutoff value, the patients were divided into high HALP group and low HALP group, and the prognosis of different groups was compared. Multivariate COX regression analysis was used to construct a prediction model for variables with statistically significant differences.Results:The median overall survival (OS) for the entire cohort was 29 months, with cumulative 1-, 3-, and 5-year survival rates of 78.2%, 38.8%, and 30.4%, respectively. The low-HALP group (median OS: 22 months) had significantly inferior survival compared to the high-HALP group (median OS: 37 months), with 1-, 3-, and 5-year survival rates of 70.1%,31.4%,22.8% vs. 89.7%,45.3%,38.1% ( χ2=7.695, P=0.006). Conclusion:The HALP index calculated from the patient's preoperative indicators can be used to predict the overall survival of patients with distal cholangiocarcinoma.
2.Construction and evaluation of a nomogram for predicting the postoperative prognosis of patients with distal cholangiocarcinoma based on the preoperative lymphocyte-to-monocyte ratio
Jun MA ; Hanxuan WANG ; Youwei MA ; Shaocheng LYU ; Qiang HE
Chinese Journal of Hepatobiliary Surgery 2025;31(7):524-528
Objective:To analyze the predictive value of the preoperative lymphocyte-to-monocyte ratio (LMR) for the postoperative prognosis of distal cholangiocarcinoma.Methods:Clinical data of 197 patients with distal cholangiocarcinoma undergoing radical surgery at Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2011 to December 2023 were retrospectively analyzed, including 118 males and 79 females, aged (65.1±10.2) years. Patients were randomly divided into the training set ( n=137) and the test set ( n=60) in a ratio of 7∶3. The training set is used to construct the nomogram, and the test set is used to evaluate the nomogram. Multivariate analysis of the influencing factors of long-term survival after surgery for distal cholangiocarcinoma was conducted using Lasso regression and Cox regression. And based on the results of multiple factors, a nomogram for predicting the postoperative prognosis of distal cholangiocarcinoma was constructed. The receiver operating characteristic (ROC) curve, conformance index, calibration curve and decision curve were used to analyze and evaluate the predictive efficacy of the model. Results:Lasso regression screening showed that smoking history, preoperative LMR, preoperative total bilirubin, preoperative carbohydrate antigen (CA) 19-9, intraoperative blood loss, tumor differentiation degree, T staging of tumor, portal vein system invasion, nerve invasion and lymph node metastasis were risk factors affecting the long-term survival after surgery (all P<0.05). Multivariate Cox regression analysis showed that preoperative LMR, CA19-9, T staging of tumor, portal vein system invasion and lymph node metastasis were the influencing factors for long-term survival after surgery for distal cholangiocarcinoma. Based on the above factors, a nomogram for predicting the postoperative prognosis of distal cholangiocarcinoma was constructed. The areas under the ROC curves of this nomogram for predicting 3-year postoperative survival in the training set and the test set were 0.806 (95% CI: 0.719-0.893) and 0.811 (95% CI: 0.696-0.927), respectively. The consistency indices of the training set and the test set were 0.730 (95% CI: 0.678-0.783) and 0.714 (95% CI: 0.637-0.790), respectively. The calibration curves of the model in the training set and test set shows that the model fits well in both sets. The decision curve analysis (DCA) shows that the model has good clinical predictive efficacy in both sets. When the threshold range in the training set is between 10% and 84% and in the test set is between 18% and 82%, the model can bring benefits in predicting postoperative prognosis. Conclusion:The preoperative LMR level is one of the influencing factors for the postoperative prognosis of patients after surgery for distal cholangiocarcinoma. LMR-based model can effectively predict postoperative prognosis of patients with distal cholangiocarcinoma.
3.The prognostic value of HALP index for overall survival after radical resection of distal cholangiocarcinoma
Feng XU ; Youwei MA ; Jincan HUANG ; Hanxuan WANG ; Shaocheng LYU ; Qiang HE
Chinese Journal of General Surgery 2025;40(7):533-538
Objective:To evaluate the value of HALP index on postoperative survival of patients with distal cholangiocarcinoma.Methods:A retrospective analysis was performed on 165 patients with distal cholangiocarcinoma who underwent surgery at Beijing Chaoyang Hospital, Capital Medical University from Jan 2011 to Dec 2022. Hemoglobin, albumin, lymphocyte count, and platelet count were recorded within one week before surgery, and hemoglobin×albumin×lymphocyte count/platelet count (HALP) was calculated. The receiver operating characteristic curve was drawn to determine the optimal cutoff value for predicting postoperative survival. According to the cutoff value, the patients were divided into high HALP group and low HALP group, and the prognosis of different groups was compared. Multivariate COX regression analysis was used to construct a prediction model for variables with statistically significant differences.Results:The median overall survival (OS) for the entire cohort was 29 months, with cumulative 1-, 3-, and 5-year survival rates of 78.2%, 38.8%, and 30.4%, respectively. The low-HALP group (median OS: 22 months) had significantly inferior survival compared to the high-HALP group (median OS: 37 months), with 1-, 3-, and 5-year survival rates of 70.1%,31.4%,22.8% vs. 89.7%,45.3%,38.1% ( χ2=7.695, P=0.006). Conclusion:The HALP index calculated from the patient's preoperative indicators can be used to predict the overall survival of patients with distal cholangiocarcinoma.
4.Construction and evaluation of a nomogram for predicting the postoperative prognosis of patients with distal cholangiocarcinoma based on the preoperative lymphocyte-to-monocyte ratio
Jun MA ; Hanxuan WANG ; Youwei MA ; Shaocheng LYU ; Qiang HE
Chinese Journal of Hepatobiliary Surgery 2025;31(7):524-528
Objective:To analyze the predictive value of the preoperative lymphocyte-to-monocyte ratio (LMR) for the postoperative prognosis of distal cholangiocarcinoma.Methods:Clinical data of 197 patients with distal cholangiocarcinoma undergoing radical surgery at Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2011 to December 2023 were retrospectively analyzed, including 118 males and 79 females, aged (65.1±10.2) years. Patients were randomly divided into the training set ( n=137) and the test set ( n=60) in a ratio of 7∶3. The training set is used to construct the nomogram, and the test set is used to evaluate the nomogram. Multivariate analysis of the influencing factors of long-term survival after surgery for distal cholangiocarcinoma was conducted using Lasso regression and Cox regression. And based on the results of multiple factors, a nomogram for predicting the postoperative prognosis of distal cholangiocarcinoma was constructed. The receiver operating characteristic (ROC) curve, conformance index, calibration curve and decision curve were used to analyze and evaluate the predictive efficacy of the model. Results:Lasso regression screening showed that smoking history, preoperative LMR, preoperative total bilirubin, preoperative carbohydrate antigen (CA) 19-9, intraoperative blood loss, tumor differentiation degree, T staging of tumor, portal vein system invasion, nerve invasion and lymph node metastasis were risk factors affecting the long-term survival after surgery (all P<0.05). Multivariate Cox regression analysis showed that preoperative LMR, CA19-9, T staging of tumor, portal vein system invasion and lymph node metastasis were the influencing factors for long-term survival after surgery for distal cholangiocarcinoma. Based on the above factors, a nomogram for predicting the postoperative prognosis of distal cholangiocarcinoma was constructed. The areas under the ROC curves of this nomogram for predicting 3-year postoperative survival in the training set and the test set were 0.806 (95% CI: 0.719-0.893) and 0.811 (95% CI: 0.696-0.927), respectively. The consistency indices of the training set and the test set were 0.730 (95% CI: 0.678-0.783) and 0.714 (95% CI: 0.637-0.790), respectively. The calibration curves of the model in the training set and test set shows that the model fits well in both sets. The decision curve analysis (DCA) shows that the model has good clinical predictive efficacy in both sets. When the threshold range in the training set is between 10% and 84% and in the test set is between 18% and 82%, the model can bring benefits in predicting postoperative prognosis. Conclusion:The preoperative LMR level is one of the influencing factors for the postoperative prognosis of patients after surgery for distal cholangiocarcinoma. LMR-based model can effectively predict postoperative prognosis of patients with distal cholangiocarcinoma.
5.The expression of CRIP1 and STUB1 in cancer tissues of patients with hepatocellular carcinoma and their clinical prognostic significance
Jing ZHANG ; Chen SHEN ; Pengfei MA ; Youwei ZHENG
International Journal of Laboratory Medicine 2024;45(3):266-271
Objective To investigate the expression of cysteine-rich intestinal protein 1(CRIP1),STIP1 ho-mology and U-box protein 1(STUB1)in cancer tissues of patients with hepatocellular carcinoma and their clinical prognostic significance.Methods From February 2018 to February 2020,112 patients with hepatocel-lular carcinoma were selected as the study objects.The expression of CRIP1 and STUB1 in cancer tissues and adjacent tissues of patients with hepatocellular carcinoma was detected by immunohistochemistry.To analyze the relationship between the expression of CRIP1 and STUB1 and their clinicopathological features in hepato-cellular carcinoma patients.Kaplan-Meier survival analysis of the effects of CRIP1 and STUB1 expression on the prognosis of patients with hepatocellular carcinoma.COX regression analysis was performed to analyze the prognostic factors of hepatocellular carcinoma.Results The positive rate of CRIP1 in cancer tissues of pa-tients with hepatocellular carcinoma was 62.50%(70/112),which was significantly higher than that in adja-cent tissues[7.14%(8/112)],the difference was statistically significant(x2=76.652,P<0.05).The positive rate of STUB1 in cancer tissues of patients with hepatocellular carcinoma was 26.23%(32/112),significantly lower than that in adjacent tissues[82.14%(92/112)],and the difference was statistically significant(x2=73.284,P<0.05).The expression of CRIP1 was negatively correlated with STUB1 in cancer tissues(r=-0.678,P<0.001).There were significant differences in the positive rates of CRIP1 and STUB1 in hepato-cellular carcinoma patients with different TNM stages,histological grades and maximum tumor diameter(P<0.05).The 3-year cumulative survival rate of CRIP1 positive group was significantly lower than that of CRIP1 negative group,with statistical significance(Log-rank x2=29.601,P<0.001).The 3-year cumulative survival rate of STUB1 negative group was significantly lower than that of STUB1 positive group,with statistical sig-nificance(Log-rank x2=13.590,P<0.001).TNM stage Ⅱ-Ⅲ,histological grade Ⅲ,maximum tumor diam-eter>5 cm,CRIP1 positive and STUB1 negative were independent risk factors for prognosis of hepatocellular carcinoma patients.Conclusion CRIP1 expression is up-regulated and STUB1 expression is down-regulated in hepatocellular carcinoma tissues.The prognosis of patients with hepatocellular carcinoma can be evaluated clinically based on the expression of CRIP1 and STUB1 in hepatocellular carcinoma tissues.
6.Correlation between genes associated with serum alpha-fetoprotein positive gastric cancer and prognosis
Shunli LU ; Qinjun SU ; Jianping YU ; Ruiyu TAO ; Youwei MA ; Yanjie LI ; Hongtao LI ; Li LIN ; Xiaopeng HAN
Chinese Journal of General Surgery 2024;39(2):92-98
Objective:To analyse the differences of related genes between serum alpha-fetoprotein (AFP) positive gastric cancer and AFP negative gastric cancer, and the relationship between related genes and prognosis of serum AFP positive gastric cancer.Methods:A total of 1 144 gastric cancer patients undergoing surgery at the 940th Hospital , Joint Logistic Support Force, People's Liberation Army from Jan 2013 to Dec 2018 were retrospectively analyzed. Of them, 47 cases were of AFP positive gastric cancer, and 47 serum AFP negative case were obtained by proper matching method.Results:Forty-seven patients with serum AFP positive gastric cancer, accounting for 4.1% of all gastric cancer patients during the same period. The prognosis of serum AFP negative gastric cancer is better than that of serum AFP positive gastric cancer. The 1-, 3- and 5-year cumulative survival rates were 95.6% vs. 63.8%, 48.9% vs. 23.4% and 26.7% vs. 14.9%, respectively. There were statistical differences in the immunohistochemistry of AFP, HER2, VEGF, GPC3, SALL4, P53 and Ki67 between the two groups ( χ2=67.758, P<0.001; χ2=4.004, P=0.044; χ2=19.299, P<0.001; χ2=5.232, P=0.022; χ2=6.359, P=0.012; χ2=6.224, P=0.013; χ2=5.232, P=0.022). The more co-positive expressions of AFP, GPC3, VEGF and SALL4, the more likely they were to affect pTNM stage, vascular invasion and liver metastasis ( χ2=5.328, P=0.021; P=0.013; χ2=5.887, P=0.015; χ2=3.923, P=0.048). Univariate and multivariate survival analysis of serum AFP positive gastric cancer showed:AFP, GPC3, VEGF and SALL4 were risk factors for AFP positive gastric cancer ( HR=3.700, P=0.036; HR=4.237, P=0.003; HR=3.916, P=0.004; HR=3.412, P=0.001). Conclusions:Serum AFP positive gastric cancer is a rare and highly invasive special type of gastric cancer. AFP, GPC3, VEGF and SALL4 are overexpressed in serum AFP positive gastric cancer, which is correlated with tumor stage, vascular invasion and liver metastasis. The final diagnosis of serum AFP positive gastric cancer still needs immunohistochemical examination. Preoperative serum AFP level is an important basis for AFP positive gastric cancer screening and AFP immunohistochemical examination.
7.The effect of preoperative cholesterol-modified prognostic nutritional index on postoperative long-term prognosis of borderline resectable pancreatic cancer
Feng XU ; Hanxuan WANG ; Youwei MA ; Zuyu WANG ; Tao JIANG ; Shaocheng LYU
Chinese Journal of Hepatobiliary Surgery 2024;30(7):520-524
Objective:To investigate the effect of cholesterol-modified prognostic nutritional index (cPNI) on postoperative long-term prognosis of the borderline resectable pancreatic cancer (BRPC).Methods:Clinical data of 173 patients with BRPC admitted to the Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University from January 2011 to September 2023 were retrospectively analyzed, including 90 males and 83 females, aged (61.7±9.8) years. The receiver operating curve (ROC) of preoperative cPNI predicting 1-year postoperative survival was drawn and the optimal cut-off value in predicting 1-year survival was 77.36. Patients were divided into low cPNI ( n=83, cPNI≤77.36) and high cPNI group ( n=90, cPNI>77.36). Kaplan-Meier method was used for survival analysis, log-rank test was used for univariate analysis, and Cox proportion hazard model was used for multivariate analysis to reveal the effect of cPNI on postoperative long-term survival in patients with BRPC. Results:The cumulative survival rates at 1, 2 and 3 years after surgery in low cPNI group and high cPNI group were 70.6%, 40.3%, 21.8%, and 48.3%, 21.5%, 9.5%, respectively ( χ2=8.49, P=0.004). Univariate analysis showed that preoperative cPNI, length of portal vein invasion, tumor differentiation degree, tumor TNM stage, tumor diameter, lymph node metastasis, and postoperative chemotherapy were correlated with long-term survival of BRPC patients (all P<0.05). Multivariate analysis showed that BRPC patients with preoperative cPNI >77.36 ( HR=1.452, 95% CI: 1.026-2.053, P=0.035) had a increased risk of postoperative death, while patients with length of portal venous invasion >3.0 cm, poorer tumor differentiation, lymph node metastasis and no postoperative chemotherapy had an increased risk of postoperative death. Conclusion:Preoperative cPNI >77.36 is a risk factor for long-term survival in BRPC patients.
8.Application of EEG in nicotine addiction research
Zhiwei REN ; Yuxin MA ; Ting XUE ; Fang DONG ; Yongxin CHENG ; Juan WANG ; Youwei DONG ; Yiming LU ; Dahua YU ; Kai YUAN
Chinese Journal of Medical Physics 2024;41(12):1537-1542
Smoking is a major concern in today's society,and the nicotine in tobacco is the major cause of addiction and difficulty in withdrawal.Long-term use of nicotine not only results in abnormal neural oscillations in the brain,but also impairs reward circuits as well as emotion regulation,thus reducing neuroplasticity and increasing susceptibility to addiction.As electrophysiological signals,electroencephalogram(EEG)signals are associated with a variety of states including cognitive function,emotion regulation,inhibitory control,and sleep.The researches on nicotine addiction reveal that changes in EEG signals are associated with abnormalities in cognitive function and inhibitory control in nicotine addicts.Therefore,exploring the abnormal neural oscillation patterns of nicotine addicts through EEG-related techniques can deepen the understanding of the intrinsic neural mechanisms of nicotine addiction and provide a scientific basis for the intervention and treatment of nicotine addiction.Herein the study summarizes the research achievements of scholars at home and abroad in recent years from the aspects of the application status of EEG in nicotine addiction researches as well as the current technology.It is found that nicotine addicts have obvious abnormalities in sleep quality,cognitive function and inhibitory control.In addition,the functional brain connectivity,event-related potentials and EEG power spectra of addicts are significantly changed.Finally,an outlook on the research prospects of EEG signals in nicotine addiction is provided,emphasizing the potential applications of EEG signals in addiction mechanisms,withdrawal responses,and assessment of treatment efficacy.
9.Application of EEG in nicotine addiction research
Zhiwei REN ; Yuxin MA ; Ting XUE ; Fang DONG ; Yongxin CHENG ; Juan WANG ; Youwei DONG ; Yiming LU ; Dahua YU ; Kai YUAN
Chinese Journal of Medical Physics 2024;41(12):1537-1542
Smoking is a major concern in today's society,and the nicotine in tobacco is the major cause of addiction and difficulty in withdrawal.Long-term use of nicotine not only results in abnormal neural oscillations in the brain,but also impairs reward circuits as well as emotion regulation,thus reducing neuroplasticity and increasing susceptibility to addiction.As electrophysiological signals,electroencephalogram(EEG)signals are associated with a variety of states including cognitive function,emotion regulation,inhibitory control,and sleep.The researches on nicotine addiction reveal that changes in EEG signals are associated with abnormalities in cognitive function and inhibitory control in nicotine addicts.Therefore,exploring the abnormal neural oscillation patterns of nicotine addicts through EEG-related techniques can deepen the understanding of the intrinsic neural mechanisms of nicotine addiction and provide a scientific basis for the intervention and treatment of nicotine addiction.Herein the study summarizes the research achievements of scholars at home and abroad in recent years from the aspects of the application status of EEG in nicotine addiction researches as well as the current technology.It is found that nicotine addicts have obvious abnormalities in sleep quality,cognitive function and inhibitory control.In addition,the functional brain connectivity,event-related potentials and EEG power spectra of addicts are significantly changed.Finally,an outlook on the research prospects of EEG signals in nicotine addiction is provided,emphasizing the potential applications of EEG signals in addiction mechanisms,withdrawal responses,and assessment of treatment efficacy.
10.Expression of 14-3-3θ protein in distal cholangiocarcinoma tissue and its clinical significance
Qiao WU ; Youwei MA ; Zhangyong REN ; Xiaoyong YE ; Xin ZHAO ; Qiang HE
International Journal of Surgery 2023;50(12):817-823
Objective:To explore the expression level and clinicopathological characteristics of 14-3-3θ protein in distal cholangiocarcinoma tissues, and further analyze the long-term prognosis of patients with different expression levels.Methods:A retrospective cohort study was conducted to collect and analyze the clinical data of 135 patients with distal cholangiocarcinoma who underwent surgical resection at the Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2015 to December 2021, including 86 males and 49 females.(65.1±10.1) years old. Immunohistochemistry was used to detect the expression level of 14-3-3θ protein in cholangiocarcinoma tissue. The postoperative pathological sections of patients were evaluated based on the immune response score(IRS). The optimal cutoff value was determined through the receiver operating characteristic(ROC) curve was 3.5. Currently, the area under the curve was 0.741, the sensitivity was 73.5%, and the specificity was 71.3%. The patients were divided into two groups: IRS<4 was the 14-3-3θ low expression group( n=81), IRS≥4 was the 14-3-3θ high expression group( n=54). After surgery, the patient′s survival status was followed up through a combination of outpatient review and telephone follow-up. Normally distributed measurement data were expressed as mean ± standard deviation( ± s), and comparisons between groups were made using the t test; non-normally distributed measurement data were expressed as M( Q1, Q3), and comparisons between groups were made using the rank sum test. The chi-square test was used to compare enumeration data between groups. Results:The preoperative CA19-9 and lymph node metastasis in the 14-3-3θ low expression group were 44.3(20.8, 132.2) U/mL and 28 cases respectively. The preoperative CA19-9 and lymph node metastasis in the 14-3-3θ high expression group were 82.3(43.4, 396.9) U/mL and 32 cases respectively. The difference between the two groups was statistically significant( P<0.05). All patients had regular postoperative telephone calls or return to the hospital for follow-up. The median postoperative survival time of the 14-3-3θ low-expression group was 36 months. The 1-, 2-, and 3-year survival rates after surgery were 88.9%, 66.5%, and 66.5%, respectively. 49.4%, the median survival time after surgery in the 14-3-3θ high expression group was 13 months, and the 1, 2, and 3-year survival rates after surgery were 53.7%, 23.3%, and 13.3% respectively. The difference between the two groups was statistically significant. significance( P<0.01). Cox proportional hazard model performed multivariate analysis, CA19-9>37 U/mL ( RR=1.970, 95% CI: 1.186-3.272, P=0.009), lymph node metastasis( RR=1.681, 95% CI: 1.035-2.729, P=0.036) and 14-3-3θ staining intensity≥4 ( RR=2.438, 95% CI: 1.546-3.845, P<0.001) have worse long-term prognosis. Conclusions:The expression level of 14-3-3θ protein is related to CA19-9 and lymph node metastasis in distal cholangiocarcinoma. A high expression of 14-3-3θ protein indicates poor long-term prognosis in patients with extrahepatic cholangiocarcinoma.

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