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Qin J, Dong W, Zhao F, Liu T, Chen M, Zhang R, Zhao Y, Zhang C, Wang W. Prediction of metachronous liver metastasis in mid-low rectal cancer using quantitative perirectal fat content from high-resolution MRI. Magn Reson Imaging 2025; 118:110338. [PMID: 39889974 DOI: 10.1016/j.mri.2025.110338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2024] [Revised: 01/24/2025] [Accepted: 01/26/2025] [Indexed: 02/03/2025]
Abstract
PURPOSE To investigate the relationship between perirectal fat content and metachronous liver metastasis (MLM) in patients with Mid-low rectal cancer (MLRC). MATERIALS AND METHODS A retrospective analysis was conducted on 254 patients who underwent curative surgery for MLRC between December 2016 and December 2021. Preoperative MRI measurements of the rectal mesenteric fat area (MFA), rectal posterior mesorectal thickness (PMT), and rectal mesenteric fascia envelopment volume (MFEV) were performed, along with collection of relevant clinical, pathological, and imaging data. Patients were categorized into the MLM group (Group A), other recurrence or metastasis group (Group B), and no recurrence and metastasis group (Group C). Analyze the differences between Group A and the other groups, and independent risk factors for MLM were explored. Kaplan-Meier analysis and log-rank test were used to validate independent predictive biomarkers for MLM. RESULTS Patients with MLM from MLRC had later pathological and imaging T stages and lower perirectal fat content (all P < 0.05). Compared to patients with other types of recurrent metastasis, male gender, poorly differentiated tumors, and advanced tumor N stage were more likely to develop MLM (all P < 0.05). In Cox univariate and multivariate regression analysis, smaller rectal PMT (hazard ratio (HR) 0.361 [0.154-0.846], P = 0.019) and MFEV (HR 0.983 [0.968-0.998], P = 0.022) were independently associated with MLM in MLRC (HR 0.361;0.983). Kaplan-Meier analysis showed that patients with rectal PMT <1.43 cm and rectal MFEV <137.46 cm3 had a significantly higher risk of MLM compared to patients with rectal PMT ≥1.43 cm and rectal MFEV ≥137.46 cm3 (all P < 0.05). CONCLUSION Rectal PMT and rectal MFEV can serve as novel parameters for predicting MLM in patients with MLRC.
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Affiliation(s)
- Jiaming Qin
- The School of Medicine, Nankai University, Tianjin, China
| | - Wenjin Dong
- Tianjin Union Medical Center, Nankai University, Tianjin, China
| | - Fengshu Zhao
- Tianjin Union Medical Center, Nankai University, Tianjin, China
| | - Tianqi Liu
- Graduate School of Tianjin Medical University, Tianjin, China
| | - Mengxin Chen
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Rui Zhang
- The School of Medicine, Nankai University, Tianjin, China
| | - Yumeng Zhao
- The School of Medicine, Nankai University, Tianjin, China
| | - Cheng Zhang
- Graduate School of Tianjin Medical University, Tianjin, China
| | - Wenhong Wang
- Tianjin Union Medical Center, Nankai University, Tianjin, China.
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Li X, Zhou Z, Zhang X, Cheng X, Xing C, Wu Y. Predicting 3-year all-cause mortality in rectal cancer patients based on body composition and machine learning. Front Nutr 2025; 12:1473952. [PMID: 40098743 PMCID: PMC11911182 DOI: 10.3389/fnut.2025.1473952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Accepted: 02/10/2025] [Indexed: 03/19/2025] Open
Abstract
Objectives The composition of abdominal adipose tissue and muscle mass has been strongly correlated with the prognosis of rectal cancer. This study aimed to develop and validate a machine learning (ML) predictive model for 3-year all-cause mortality after laparoscopic total mesorectal excision (LaTME). Methods Patients who underwent LaTME surgery between January 2018 and December 2020 were included and randomly divided into training and validation cohorts. Preoperative computed tomography (CT) image parameters and clinical characteristics were collected to establish seven ML models for predicting 3-year survival post-LaTME. The optimal model was determined based on the area under the receiver operating characteristic curve (AUROC). The SHAPley Additive exPlanations (SHAP) values were utilized to interpret the optimal model. Results A total of 186 patients were recruited and divided into a training cohort (70%, n = 131) and a validation cohort (30%, n = 55). In the training cohort, the AUROCs of the seven ML models ranged from 0.894 to 0.949. In the validation cohort, the AUROCs ranged from 0.727 to 0.911, with the XGBoost model demonstrating the best predictive performance: AUROC = 0.911. SHAP values revealed that subcutaneous adipose tissue index (SAI), visceral adipose tissue index (VAI), skeletal muscle density (SMD), visceral-to-subcutaneous adipose tissue ratio (VSR), and subcutaneous adipose tissue density (SAD) were the five most important variables influencing all-cause mortality post-LaTME. Conclusion By integrating body composition, multiple ML predictive models were developed and validated for predicting all-cause mortality after rectal cancer surgery, with the XGBoost model exhibiting the best performance.
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Affiliation(s)
| | | | | | | | - Chungen Xing
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yong Wu
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, China
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Liang ZY, Yu ML, Yang H, Li HJ, Xie H, Cui CY, Zhang WJ, Luo C, Cai PQ, Lin XF, Liu KF, Xiong L, Liu LZ, Chen BY. Beyond the tumor region: Peritumoral radiomics enhances prognostic accuracy in locally advanced rectal cancer. World J Gastroenterol 2025; 31:99036. [PMID: 40062323 PMCID: PMC11886509 DOI: 10.3748/wjg.v31.i8.99036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 10/09/2024] [Accepted: 11/05/2024] [Indexed: 01/23/2025] Open
Abstract
BACKGROUND The peritumoral region possesses attributes that promote cancer growth and progression. However, the potential prognostic biomarkers in this region remain relatively underexplored in radiomics. AIM To investigate the prognostic value and importance of peritumoral radiomics in locally advanced rectal cancer (LARC). METHODS This retrospective study included 409 patients with biopsy-confirmed LARC treated with neoadjuvant chemoradiotherapy and surgically. Patients were divided into training (n = 273) and validation (n = 136) sets. Based on intratumoral and peritumoral radiomic features extracted from pretreatment axial high-resolution small-field-of-view T2-weighted images, multivariate Cox models for progression-free survival (PFS) prediction were developed with or without clinicoradiological features and evaluated with Harrell's concordance index (C-index), calibration curve, and decision curve analyses. Risk stratification, Kaplan-Meier analysis, and permutation feature importance analysis were performed. RESULTS The comprehensive integrated clinical-radiological-omics model (ModelICRO) integrating seven peritumoral, three intratumoral, and four clinicoradiological features achieved the highest C-indices (0.836 and 0.801 in the training and validation sets, respectively). This model showed robust calibration and better clinical net benefits, effectively distinguished high-risk from low-risk patients (PFS: 97.2% vs 67.6% and 95.4% vs 64.8% in the training and validation sets, respectively; both P < 0.001). Three most influential predictors in the comprehensive ModelICRO were, in order, a peritumoral, an intratumoral, and a clinicoradiological feature. Notably, the peritumoral model outperformed the intratumoral model (C-index: 0.754 vs 0.670; P = 0.015); peritumoral features significantly enhanced the performance of models based on clinicoradiological or intratumoral features or their combinations. CONCLUSION Peritumoral radiomics holds greater prognostic value than intratumoral radiomics for predicting PFS in LARC. The comprehensive model may serve as a reliable tool for better stratification and management postoperatively.
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Affiliation(s)
- Zhi-Ying Liang
- Department of Radiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
| | - Mao-Li Yu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
- West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Hui Yang
- Department of Radiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
| | - Hao-Jiang Li
- Department of Radiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
| | - Hui Xie
- Department of Radiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
| | - Chun-Yan Cui
- Department of Radiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
| | - Wei-Jing Zhang
- Department of Radiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
| | - Chao Luo
- Department of Radiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
| | - Pei-Qiang Cai
- Department of Radiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
| | - Xiao-Feng Lin
- Department of Radiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
| | - Kun-Feng Liu
- Department of Radiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
| | - Lang Xiong
- Department of Medical Imaging, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
| | - Li-Zhi Liu
- Department of Radiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
| | - Bi-Yun Chen
- Department of Radiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
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Becerra-Tomás N, Markozannes G, Cariolou M, Balducci K, Vieira R, Kiss S, Aune D, Greenwood DC, Dossus L, Copson E, Renehan AG, Bours M, Demark-Wahnefried W, Hudson MM, May AM, Odedina FT, Skinner R, Steindorf K, Tjønneland A, Velikova G, Baskin ML, Chowdhury R, Hill L, Lewis SJ, Seidell J, Weijenberg MP, Krebs J, Cross AJ, Tsilidis KK, Chan DSM. Post-diagnosis adiposity and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta-analysis. Int J Cancer 2024; 155:400-425. [PMID: 38692659 DOI: 10.1002/ijc.34905] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/15/2023] [Accepted: 01/17/2024] [Indexed: 05/03/2024]
Abstract
The adiposity influence on colorectal cancer prognosis remains poorly characterised. We performed a systematic review and meta-analysis on post-diagnosis adiposity measures (body mass index [BMI], waist circumference, waist-to-hip ratio, weight) or their changes and colorectal cancer outcomes. PubMed and Embase were searched through 28 February 2022. Random-effects meta-analyses were conducted when at least three studies had sufficient information. The quality of evidence was interpreted and graded by the Global Cancer Update Programme (CUP Global) independent Expert Committee on Cancer Survivorship and Expert Panel. We reviewed 124 observational studies (85 publications). Meta-analyses were possible for BMI and all-cause mortality, colorectal cancer-specific mortality, and cancer recurrence/disease-free survival. Non-linear meta-analysis indicated a reverse J-shaped association between BMI and colorectal cancer outcomes (nadir at BMI 28 kg/m2). The highest risk, relative to the nadir, was observed at both ends of the BMI distribution (18 and 38 kg/m2), namely 60% and 23% higher risk for all-cause mortality; 95% and 26% for colorectal cancer-specific mortality; and 37% and 24% for cancer recurrence/disease-free survival, respectively. The higher risk with low BMI was attenuated in secondary analyses of RCTs (compared to cohort studies), among studies with longer follow-up, and in women suggesting potential methodological limitations and/or altered physiological state. Descriptively synthesised studies on other adiposity-outcome associations of interest were limited in number and methodological quality. All the associations were graded as limited (likelihood of causality: no conclusion) due to potential methodological limitations (reverse causation, confounding, selection bias). Additional well-designed observational studies and interventional trials are needed to provide further clarification.
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Affiliation(s)
- Nerea Becerra-Tomás
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Georgios Markozannes
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Margarita Cariolou
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Katia Balducci
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Rita Vieira
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Sonia Kiss
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Nutrition, Oslo New University College, Oslo, Norway
- Department of Research, The Cancer Registry of Norway, Oslo, Norway
| | - Darren C Greenwood
- Leeds Institute for Data Analytics, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Laure Dossus
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Ellen Copson
- Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Andrew G Renehan
- The Christie NHS Foundation Trust, Manchester Cancer Research Centre, NIHR Manchester Biomedical Research Centre, Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Martijn Bours
- Department of Epidemiology, GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Wendy Demark-Wahnefried
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Melissa M Hudson
- Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Roderick Skinner
- Department of Paediatric and Adolescent Haematology/Oncology, Great North Children's Hospital and Translational and Clinical Research Institute, and Centre for Cancer, Newcastle University, Newcastle upon Tyne, UK
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Diet, Cancer and Health, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Galina Velikova
- School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | | | - Rajiv Chowdhury
- Department of Global Health, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Lynette Hill
- World Cancer Research Fund International, London, UK
| | - Sarah J Lewis
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jaap Seidell
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Matty P Weijenberg
- Department of Epidemiology, GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - John Krebs
- Department of Biology, University of Oxford, Oxford, UK
| | - Amanda J Cross
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Doris S M Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
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Xu J, Zhong M, Peng W, Wu M, Wang R, Tan S. Correlation study of functional magnetic resonance index and clinicopathological features of rectal cancer. Abdom Radiol (NY) 2024; 49:2368-2386. [PMID: 38872052 DOI: 10.1007/s00261-024-04375-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 05/03/2024] [Accepted: 05/04/2024] [Indexed: 06/15/2024]
Abstract
PURPOSE To investigate the correlation between DCE-MRI, R2*, IVIM, and clinicopathological features of rectal cancer. METHODS This was a prospective study, enrolling 42 patients with rectal cancer, 20 of whom underwent rectal mesorectal excision. Dynamic contrast-enhanced magnetic resonance imaging scanning was performed preoperatively in all patients, and additional preoperative scanning of R2* imaging and intravoxel incoherent motion was performed in those who underwent surgery. Artificially delineate the ROI around the tumor. Functional magnetic resonance index parameters Ktrans, Ve, R2*, D, D*, and f were estimated by computer software to analyze postoperative pathological reports of patients undergoing total mesenteric resection. Correlation and significance analyses of imaging metrics and pathologic features were performed by GraphPad Prism 9 to assess statistical significance. RESULTS DEC-MRI, R2*, and IVIM have certain application values in the distance from the lower margin of the tumor to the anorectal ring, imaging T stage and N stage, tumor markers CEA and CA199, immunohistochemical indexes Ki-76 and P53, lymph node cancer metastasis, and rectal fascia status (P < 0.05). CONCLUSION DEC-MRI, R2*, and IVIM provide reliable quantitative parameters for preoperative clinicopathological evaluation of patients with rectal cancer.
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Affiliation(s)
- Jiaqian Xu
- Medical College, Guizhou University, No.24 Xiahui Road, Guiyang, 550025, Guizhou, China
| | - Ming Zhong
- Department of Radiology, The People's Hospital of Guizhou Province, Guiyang, 550001, Guizhou, China
| | - Wen Peng
- Department of Oncology, The People's Hospital of Guizhou Province, Guiyang, 550001, Guizhou, China
| | - Mingfeng Wu
- Department of Radiology, The People's Hospital of Guizhou Province, Guiyang, 550001, Guizhou, China
| | - Rongpin Wang
- Department of Radiology, The People's Hospital of Guizhou Province, Guiyang, 550001, Guizhou, China
| | - Shisheng Tan
- Medical College, Guizhou University, No.24 Xiahui Road, Guiyang, 550025, Guizhou, China.
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Sönmez MR, Aydin İC, Biçer G, Havan N, Sunar AO, Ademoğlu S, Özduman MÖ, Dinçer M, Polat E, Duman M. Perirenal fat thickness as a risk factor for postoperative complications in elective colorectal cancer surgery. Medicine (Baltimore) 2023; 102:e34072. [PMID: 37352080 PMCID: PMC10289549 DOI: 10.1097/md.0000000000034072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/25/2023] Open
Abstract
Visceral obesity is an important factor that increases the risk of complications after colorectal cancer surgery. As calculating visceral fat is difficult and time-consuming, more practical fat measurements that are not time-consuming have been introduced. This study aimed to investigate the effects of perirenal fat thickness on postoperative complications and prognosis in patients undergoing surgery for colorectal cancer. Perirenal fat thickness was measured from the dorsal aspect of the left kidney on preoperative computerized tomography of patients who underwent surgery for colorectal cancer. The effects of perirenal fat thickness on postoperative complications were investigated. Diagnostic test performance was examined using the Roc Curve test to determine the cutoff value for the perirenal fat thickness values according to the complication findings of the patients. The cutoff value of perirenal fat thickness was found to be above 25.1, according to the presence of complications in the patients. Those with a perirenal fat thickness greater than 25.1 mm were considered to have high perirenal fat thickness values, and those with a low perirenal fat thickness value were considered low. Multivariate analysis revealed that increased perirenal fat thickness is an independent risk factor for postoperative complications. We believe that perirenal fat thickness measurement, as an indicator of visceral fat volume, can be used to identify patients at high risk of developing complications after colorectal cancer surgery. This may change the disease management and affect the patient information process.
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Affiliation(s)
- Mehmet Reşit Sönmez
- Gastroenterological Surgery Clinic, University of Health Sciences, Ministry of Health, KartalKosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
| | - İsa Caner Aydin
- Gastroenterological Surgery Clinic, University of Health Sciences, Ministry of Health, KartalKosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
| | - Gülşah Biçer
- Department of Radiology, University of Health Sciences, Ministry of Health, KartalKosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
| | - Nuri Havan
- Department of Radiology, University of Health Sciences, Ministry of Health, KartalKosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Orhan Sunar
- Gastroenterological Surgery Clinic, University of Health Sciences, Ministry of Health, KartalKosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
| | - Serkan Ademoğlu
- Gastroenterological Surgery Clinic, University of Health Sciences, Ministry of Health, KartalKosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Ömer Özduman
- Gastroenterological Surgery Clinic, University of Health Sciences, Ministry of Health, KartalKosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
| | - Mürşit Dinçer
- Gastroenterological Surgery Clinic, University of Health Sciences, Ministry of Health, KartalKosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
| | - Erdal Polat
- Gastroenterological Surgery Clinic, University of Health Sciences, Ministry of Health, KartalKosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Duman
- Gastroenterological Surgery Clinic, University of Health Sciences, Ministry of Health, KartalKosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
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Shioi I, Yamaoka Y, Shiomi A, Kagawa H, Hino H, Manabe S, Chen K, Nanishi K, Notsu A. The impact of mesorectal fat area on recurrence following total mesorectal excision for lower rectal cancer. Langenbecks Arch Surg 2023; 408:147. [PMID: 37046049 DOI: 10.1007/s00423-023-02888-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 04/05/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND The mesorectal fat area (MFA) at the tip of the ischial spines on magnetic resonance imaging has been used to characterize mesorectal morphology. Recent studies reported that a larger MFA correlated with difficulties in rectal cancer surgery. However, the relationship between MFA and rectal cancer prognosis remains unclear. This study evaluated the impact of MFA on recurrence following robotic total mesorectal excision (TME) for rectal cancer. METHODS Patients who underwent robotic TME for lower rectal cancer from December 2011 to December 2016 were enrolled. Cox regression analysis was performed to determine variables associated with relapse-free survival (RFS). Patients were divided into groups based on MFA, and RFS was compared. RESULTS Of 230 patients, 173 (75.3%) were male. The median age was 63 years, and median MFA was 19.7 cm2. In multivariate analysis, smaller MFA (hazard ratio [HR], 0.93; 95% confidence interval [CI], 0.88-0.97; p < 0.01), p/yp stage II (HR, 3.81; 95% CI, 1.40-10.35; p < 0.01), and p/yp stage III (HR, 5.35; 95% CI, 1.88-15.27; p < 0.01) were independently associated with worse RFS. Sex, body mass index, and visceral fat area were not correlated with RFS. In the median follow-up period of 60.8 months, patients with MFA < 19.7 cm2 had a significantly lower 5-year RFS rate (72.7%) than those with MFA ≥ 19.7 cm2 (85.0%). CONCLUSIONS Smaller MFA was associated with worse RFS in patients undergoing robotic TME for lower rectal cancer. MFA is considered to be a prognostic factor in rectal cancer.
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Affiliation(s)
- Ikuma Shioi
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center, 1007 Shimo-Nagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka Pref., 411-8777, Japan
| | - Yusuke Yamaoka
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center, 1007 Shimo-Nagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka Pref., 411-8777, Japan.
| | - Akio Shiomi
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center, 1007 Shimo-Nagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka Pref., 411-8777, Japan
| | - Hiroyasu Kagawa
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center, 1007 Shimo-Nagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka Pref., 411-8777, Japan
| | - Hitoshi Hino
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center, 1007 Shimo-Nagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka Pref., 411-8777, Japan
| | - Shoichi Manabe
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center, 1007 Shimo-Nagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka Pref., 411-8777, Japan
| | - Kai Chen
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center, 1007 Shimo-Nagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka Pref., 411-8777, Japan
| | - Kenji Nanishi
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center, 1007 Shimo-Nagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka Pref., 411-8777, Japan
| | - Akifumi Notsu
- Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan
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Lu BL, Chen Y, Wen ZQ, Liu YY, Ma YR, Que YT, Zhang ZW, Wu XH, Yu SP. Quantitative assessment of the microstructure of the mesorectum with different prognostic statuses by intravoxel incoherent motion diffusion-weighed magnetic resonance imaging. BMC Gastroenterol 2022; 22:481. [PMID: 36418952 PMCID: PMC9685901 DOI: 10.1186/s12876-022-02555-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 10/26/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The mesorectum surrounding the rectum provides an ideal substrate for tumour spread. However, preoperative risk assessment is still an issue. This study aimed to investigate the microstructural features of mesorectum with different prognostic statuses by intravoxel incoherent motion diffusion-weighted imaging (IVIM DWI). METHODS Patients with pathologically proven rectal adenocarcinoma underwent routine high-resolution rectal magnetic resonance imaging (MRI) and IVIM DWI sequences were acquired. The MRI-detected circumferential resection margin (mrCRM) and extramural vascular invasion (mrEMVI) were evaluated. IVIM parameters of the mesorectum adjacent to (MAT) and distant from (MDT) the tumour were measured and compared between and within the prognostic factor groups. RESULTS The positive mrCRM (pMAT < 0.001; pMDT = 0.013) and mrEMVI (pMAT = 0.001; pMDT < 0.001) groups demonstrated higher D values in the MAT and MDT than the corresponding negative groups. Conversely, the positive mrCRM (p = 0.001) and mrEMVI (p < 0.001) groups both demonstrated lower f values in the MAT. Similarly, in the self-comparison between the MAT and MDT in the above subgroups, D showed a significant difference in all subgroups (p < 0.001 for all), and f showed a significant difference in the positive mrCRM (p = 0.001) and mrEMVI (p = 0.002) groups. Moreover, the MAT displayed a higher D* in the positive mrCRM (p = 0.014), negative mrCRM (p = 0.009) and negative mrEMVI groups (p < 0.001). CONCLUSION The microstructure of the mesorectum in patients with rectal cancer with poor prognostic status shows changes based on IVIM parameters. IVIM parameters might be promising imaging biomarkers for risk assessment of tumour spread in mesorectum preoperatively.
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Affiliation(s)
- Bao-Lan Lu
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road 2nd, 510080, Guangzhou, People's Republic of China
| | - Yan Chen
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road 2nd, 510080, Guangzhou, People's Republic of China
| | - Zi-Qiang Wen
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road 2nd, 510080, Guangzhou, People's Republic of China
| | - Yi-Yan Liu
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road 2nd, 510080, Guangzhou, People's Republic of China
| | - Yu-Ru Ma
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road 2nd, 510080, Guangzhou, People's Republic of China
| | - Yu-Tao Que
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road 2nd, 510080, Guangzhou, People's Republic of China
| | - Zhi-Wen Zhang
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road 2nd, 510080, Guangzhou, People's Republic of China
| | - Xue-Han Wu
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road 2nd, 510080, Guangzhou, People's Republic of China
| | - Shen-Ping Yu
- Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road 2nd, 510080, Guangzhou, People's Republic of China.
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9
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Wang X, Zheng Z, Chen M, Lin J, Lu X, Huang Y, Huang S, Chi P. Morphology of the anterior mesorectum: a new predictor for local recurrence in patients with rectal cancer. Chin Med J (Engl) 2022; 135:2453-2460. [PMID: 35861423 PMCID: PMC9945311 DOI: 10.1097/cm9.0000000000002024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Pre-operative assessment with high-resolution magnetic resonance imaging (MRI) is useful for assessing the risk of local recurrence (LR) and survival in rectal cancer. However, few studies have explored the clinical importance of the morphology of the anterior mesorectum, especially in patients with anterior cancer. Hence, the study aimed to investigate the impact of the morphology of the anterior mesorectum on LR in patients with primary rectal cancer. METHODS A retrospective study was performed on 176 patients who underwent neoadjuvant treatment and curative-intent surgery. Patients were divided into two groups according to the morphology of the anterior mesorectum on sagittal MRI: (1) linear type: the anterior mesorectum was thin and linear; and (2) triangular type: the anterior mesorectum was thick and had a unique triangular shape. Clinicopathological and LR data were compared between patients with linear type anterior mesorectal morphology and patients with triangular type anterior mesorectal morphology. RESULTS Morphometric analysis showed that 90 (51.1%) patients had linear type anterior mesorectal morphology, while 86 (48.9%) had triangular type anterior mesorectal morphology. Compared to triangular type anterior mesorectal morphology, linear type anterior mesorectal morphology was more common in females and was associated with a higher risk of circumferential resection margin involvement measured by MRI (35.6% [32/90] vs . 16.3% [14/86], P = 0.004) and a higher 5-year LR rate (12.2% vs . 3.5%, P = 0.030). In addition, the combination of linear type anterior mesorectal morphology and anterior tumors was confirmed as an independent risk factor for LR (odds ratio = 4.283, P = 0.014). CONCLUSIONS The classification established in this study was a simple way to describe morphological characteristics of the anterior mesorectum. The combination of linear type anterior mesorectal morphology and anterior tumors was an independent risk factor for LR and may act as a tool to assist with LR risk stratification and treatment selection.
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Affiliation(s)
- Xiaojie Wang
- Department of Colorectal Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian 350001, China
| | - Zhifang Zheng
- Department of Colorectal Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian 350001, China
| | - Min Chen
- Department of Gynaecology and Obstetrics, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350001, China
| | - Jing Lin
- Integrated Information Section, Fujian Children's Hospital, Fuzhou, Fujian 350001, China
| | - Xingrong Lu
- Department of Colorectal Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian 350001, China
| | - Ying Huang
- Department of Colorectal Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian 350001, China
| | - Shenghui Huang
- Department of Colorectal Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian 350001, China
| | - Pan Chi
- Department of Colorectal Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian 350001, China
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10
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Cheng E, Kirley J, Cespedes Feliciano EM, Caan BJ. Adiposity and cancer survival: a systematic review and meta-analysis. Cancer Causes Control 2022; 33:1219-1246. [PMID: 35971021 PMCID: PMC10101770 DOI: 10.1007/s10552-022-01613-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 07/07/2022] [Indexed: 10/28/2022]
Abstract
PURPOSE The increasing availability of clinical imaging tests (especially CT and MRI) that directly quantify adipose tissue has led to a rapid increase in studies examining the relationship of visceral, subcutaneous, and overall adiposity to cancer survival. To summarize this emerging body of literature, we conducted a systematic review and meta-analysis of imaging-measured as well as anthropometric proxies for adipose tissue distribution and cancer survival across a wide range of cancer types. METHODS Using keywords related to adiposity, cancer, and survival, we conducted a systematic search of the literature in PubMed and MEDLINE, Embase, and Web of Science Core Collection databases from database inception to 30 June 2021. We used a random-effect method to calculate pooled hazard ratios (HR) and corresponding 95% confidence intervals (CI) within each cancer type and tested for heterogeneity using Cochran's Q test and the I2 test. RESULTS We included 203 records for this review, of which 128 records were utilized for quantitative analysis among 10 cancer types: breast, colorectal, gastroesophageal, head and neck, hepatocellular carcinoma, lung, ovarian, pancreatic, prostate, and renal cancer. We found that imaging-measured visceral, subcutaneous, and total adiposity were not significantly associated with increased risk of overall mortality, death from primary cancer, or cancer progression among patients diagnosed with these 10 cancer types; however, we found significant or high heterogeneity for many cancer types. For example, heterogeneity was similarly high when the pooled HRs (95% CI) for overall mortality associated with visceral adiposity were essentially null as in 1.03 (0.55, 1.92; I2 = 58%) for breast, 0.99 (0.81, 1.21; I2 = 71%) for colorectal, versus when they demonstrated a potential increased risk 1.17 (0.85, 1.60; I2 = 78%) for hepatocellular carcinoma and 1.62 (0.90, 2.95; I2 = 84%) for renal cancer. CONCLUSION Greater adiposity at diagnosis (directly measured by imaging) is not associated with worse survival among cancer survivors. However, heterogeneity and other potential limitations were noted across studies, suggesting differences in study design and adiposity measurement approaches, making interpretation of meta-analyses challenging. Future work to standardize imaging measurements and data analyses will strengthen research on the role of adiposity in cancer survival.
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Affiliation(s)
- En Cheng
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Jocelyn Kirley
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | | | - Bette J Caan
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
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11
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Li L, Yang Z, Zheng Y, Chen Z, Yue X, Bian E, Zhao B. Identification of an endoplasmic reticulum stress-related signature associated with clinical prognosis and immune therapy in glioma. BMC Neurol 2022; 22:192. [PMID: 35614390 PMCID: PMC9131635 DOI: 10.1186/s12883-022-02709-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 05/05/2022] [Indexed: 11/25/2022] Open
Abstract
Background Glioma is the most common brain tumor in adults and is characterized by a short survival time and high resistance to chemotherapy. It is imperative to determine the prognosis and therapy-related targets for glioma. Endoplasmic reticulum stress (ERS), as an adaptive protective mechanism, indicates the unfolded protein response (UPR) to determine cell survival and affects chemotherapy sensitivity, which is related to the prognosis of glioma. Methods Our research used the TCGA database as the training group and the CGGA database as the testing group. Lasso regression and Cox analysis were performed to construct an ERS signature-based risk score model in glioma. Three methods (time-dependent receiver operating characteristic analysis and multivariate and univariate Cox regression analysis) were applied to assess the independent prognostic effect of texture parameters. Consensus clustering was used to classify the two clusters. In addition, functional and immune analyses were performed to assess the malignant process and immune microenvironment. Immunotherapy and anticancer drug response prediction were adopted to evaluate immune checkpoint and chemotherapy sensitivity. Results The results revealed that the 7-gene signature strongly predicts glioma prognosis. The two clusters have markedly distinct molecular and prognostic features. The validation group result revealed that the signature has exceptional repeatability and certainty. Functional analysis showed that the ERS-related gene signature was closely associated with the malignant process and prognosis of tumors. Immune analysis indicated that the ERS-related gene signature is strongly related to immune infiltration. Immunotherapy and anticancer drug response prediction indicated that the ERS-related gene signature is positively correlated with immune checkpoint and chemotherapy sensitivity. Conclusions Collectively, the ERS-related risk model can provide a novel signature to predict glioma prognosis and treatment. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-022-02709-y.
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Affiliation(s)
- Lianxin Li
- Department of Neurosurgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China
| | - Zhihao Yang
- Department of Neurosurgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China
| | - Yinfei Zheng
- Department of Neurosurgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China.,Cerebral Vascular Disease Research Center, Anhui Medical University, 678 Fu Rong Road, Hefei, 230601, Anhui Province, China
| | - Zhigang Chen
- Department of Neurosurgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China.,Cerebral Vascular Disease Research Center, Anhui Medical University, 678 Fu Rong Road, Hefei, 230601, Anhui Province, China
| | - Xiaoyu Yue
- Department of Neurosurgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China.,Cerebral Vascular Disease Research Center, Anhui Medical University, 678 Fu Rong Road, Hefei, 230601, Anhui Province, China
| | - Erbao Bian
- Department of Neurosurgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China. .,Cerebral Vascular Disease Research Center, Anhui Medical University, 678 Fu Rong Road, Hefei, 230601, Anhui Province, China.
| | - Bing Zhao
- Department of Neurosurgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China. .,Cerebral Vascular Disease Research Center, Anhui Medical University, 678 Fu Rong Road, Hefei, 230601, Anhui Province, China.
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12
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Borgheresi A, De Muzio F, Agostini A, Ottaviani L, Bruno A, Granata V, Fusco R, Danti G, Flammia F, Grassi R, Grassi F, Bruno F, Palumbo P, Barile A, Miele V, Giovagnoni A. Lymph Nodes Evaluation in Rectal Cancer: Where Do We Stand and Future Perspective. J Clin Med 2022; 11:2599. [PMID: 35566723 PMCID: PMC9104021 DOI: 10.3390/jcm11092599] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/25/2022] [Accepted: 05/03/2022] [Indexed: 12/12/2022] Open
Abstract
The assessment of nodal involvement in patients with rectal cancer (RC) is fundamental in disease management. Magnetic Resonance Imaging (MRI) is routinely used for local and nodal staging of RC by using morphological criteria. The actual dimensional and morphological criteria for nodal assessment present several limitations in terms of sensitivity and specificity. For these reasons, several different techniques, such as Diffusion Weighted Imaging (DWI), Intravoxel Incoherent Motion (IVIM), Diffusion Kurtosis Imaging (DKI), and Dynamic Contrast Enhancement (DCE) in MRI have been introduced but still not fully validated. Positron Emission Tomography (PET)/CT plays a pivotal role in the assessment of LNs; more recently PET/MRI has been introduced. The advantages and limitations of these imaging modalities will be provided in this narrative review. The second part of the review includes experimental techniques, such as iron-oxide particles (SPIO), and dual-energy CT (DECT). Radiomics analysis is an active field of research, and the evidence about LNs in RC will be discussed. The review also discusses the different recommendations between the European and North American guidelines for the evaluation of LNs in RC, from anatomical considerations to structured reporting.
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Affiliation(s)
- Alessandra Borgheresi
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60121 Ancona, Italy; (A.B.); (A.A.); (A.B.); (A.G.)
| | - Federica De Muzio
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy;
| | - Andrea Agostini
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60121 Ancona, Italy; (A.B.); (A.A.); (A.B.); (A.G.)
- Department of Radiological Sciences, University Hospital Ospedali Riuniti, 60126 Ancona, Italy;
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
| | - Letizia Ottaviani
- Department of Radiological Sciences, University Hospital Ospedali Riuniti, 60126 Ancona, Italy;
| | - Alessandra Bruno
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60121 Ancona, Italy; (A.B.); (A.A.); (A.B.); (A.G.)
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale IRCCS di Napoli, 80131 Naples, Italy;
| | - Roberta Fusco
- Medical Oncology Division, Igea SpA, 80013 Napoli, Italy
| | - Ginevra Danti
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy;
| | - Federica Flammia
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy;
| | - Roberta Grassi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, 80128 Naples, Italy
| | - Francesca Grassi
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, 80128 Naples, Italy
| | - Federico Bruno
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Pierpaolo Palumbo
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
- Abruzzo Health Unit 1, Department of Diagnostic Imaging, Area of Cardiovascular and Interventional Imaging, 67100 L’Aquila, Italy
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Vittorio Miele
- Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy; (G.D.); (R.G.); (F.G.); (F.B.); (P.P.); (V.M.)
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy;
| | - Andrea Giovagnoni
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, 60121 Ancona, Italy; (A.B.); (A.A.); (A.B.); (A.G.)
- Department of Radiological Sciences, University Hospital Ospedali Riuniti, 60126 Ancona, Italy;
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13
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Role of Perirectal Fat in the Carcinogenesis and Development of Early-Onset Rectal Cancer. JOURNAL OF ONCOLOGY 2022; 2022:4061142. [PMID: 35368890 PMCID: PMC8965599 DOI: 10.1155/2022/4061142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 02/24/2022] [Accepted: 03/05/2022] [Indexed: 11/17/2022]
Abstract
Purpose The incidence of early-onset rectal cancer (EORC) has been increasing since the past decade, while its underlying cause remained unknown. This study was aimed at clarifying the relationship between perirectal fat area (PFA) and EORC. Patients and Methods. All patients with rectal cancer who received radical excision between January 2016 and December 2017 at our hospital were included. The fat series images of pelvic magnetic resonance imaging scans were obtained and PFA at the ischial spine level was calculated using the ImageJ software. Results A total of 303 patients were finally included and divided into two groups according to the median PFA: Group 1 (<20.2 cm2, n = 151) and Group 2 (≥20.2 cm2, n = 152). PFA positively correlated with body weight and body mass index. PFA increased with invasion depth, lymph node metastasis, TNM stage, tumor deposits, and vascular invasion. Patients with EORC had higher PFA than those with late-onset rectal cancer (LORC; P = 0.009). Among patients with stage I–III rectal cancers, those in Group 2 had significantly shorter disease-free survival (P = 0.010) and overall survival (P = 0.034) than those in Group 1, and PFA was an independent predictor of disease-free survival (OR: 1.683 [1.126-3.015], P = 0.035) and overall survival (OR: 1.678 [1.022-2.639], P = 0.046). Conclusions Patients with EORC had significantly higher PFA than those with LORC. PFA is positively correlated with T stage, N stage, TNM stage, tumor deposit, and vascular invasion and is an independent predictor of disease-free survival and overall survival. Therefore, perirectal fat may be involved in the carcinogenesis and development of EORC.
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14
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Dilek O, Akkaya H, Parlatan C, Koseci T, Tas ZA, Soker G, Gulek B. Can the mesorectal fat tissue volume be used as a predictive factor in foreseeing the response to neoadjuvant chemoradiotherapy in rectum cancer? A CT-based preliminary study. Abdom Radiol (NY) 2021; 46:2415-2422. [PMID: 33501511 DOI: 10.1007/s00261-021-02951-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/30/2020] [Accepted: 01/02/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE This study was to investigate the effect of mesorectal fat tissue volume (MRV) on the pathological response to neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer. METHODS 88 patients who had been diagnosed with locally advanced rectal cancer between January 2017 and June 2020 were reviewed retrospectively. The total abdominal, subcutaneous, visceral, and mesorectal fatty tissue components were measured semiquantitatively by two radiologists using computed tomography (CT)-based findings. The patients were divided into two groups as those with and without a pathological response to nCRT. The relationship of MRV with the other fat tissue components of the body was also evaluated. RESULTS We performed a retrospective analysis of 88 patients (mean age 62.7 years [range, 33-90 years]; 31 males and 57 females). A positive response to nCRT was present in 47 patients. There were 59 patients with stage 3 disease. 46 patients demonstrated lymph node involvement. The mean MRV was 69.6 ± 31.0 ml in no-response group and 105.8 ± 47.5 ml in response-positive patients (p < 0.05). MRV showed the highest correlation with visceral fat volume (VFV). There was a negative correlation between the MRV and the N stage. A cut-off value of ≥ 69.4 for MRV predicted the repsonse to nCRT, with 82.9% sensitivity and 58.5% specificity [AUC: 0.757 (0.653-0.842), p < 0.001] in receiver operating characteristic (ROC) curve analysis CONCLUSIONS: MRV can be used as a novel parameter in predicting of pathological response to nCRT in locally advanced rectal cancer patients.
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Affiliation(s)
- Okan Dilek
- Department of Radiology, Adana Teaching and Research Hospital, University of Health Sciences, Kışla District, Dr. Mithat Özsan Boulevard, 4522, Street No. 1, 01230, Yüreğir, Adana, Turkey.
| | - Huseyin Akkaya
- Department of Radiology, Adana Teaching and Research Hospital, University of Health Sciences, Kışla District, Dr. Mithat Özsan Boulevard, 4522, Street No. 1, 01230, Yüreğir, Adana, Turkey
| | - Cenk Parlatan
- Department of Radiology, Adana Teaching and Research Hospital, University of Health Sciences, Kışla District, Dr. Mithat Özsan Boulevard, 4522, Street No. 1, 01230, Yüreğir, Adana, Turkey
| | - Tolga Koseci
- Department of Medical Oncology, Adana Teaching and Research Hospital, University of Health Sciences, Adana, Turkey
| | - Zeynel Abidin Tas
- Department of Pathology, Adana Teaching and Research Hospital, University of Health Sciences, Adana, Turkey
| | - Gökhan Soker
- Department of Radiology, Adana Teaching and Research Hospital, University of Health Sciences, Kışla District, Dr. Mithat Özsan Boulevard, 4522, Street No. 1, 01230, Yüreğir, Adana, Turkey
| | - Bozkurt Gulek
- Department of Radiology, Adana Teaching and Research Hospital, University of Health Sciences, Kışla District, Dr. Mithat Özsan Boulevard, 4522, Street No. 1, 01230, Yüreğir, Adana, Turkey
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15
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Delli Pizzi A, Chiarelli AM, Chiacchiaretta P, d'Annibale M, Croce P, Rosa C, Mastrodicasa D, Trebeschi S, Lambregts DMJ, Caposiena D, Serafini FL, Basilico R, Cocco G, Di Sebastiano P, Cinalli S, Ferretti A, Wise RG, Genovesi D, Beets-Tan RGH, Caulo M. MRI-based clinical-radiomics model predicts tumor response before treatment in locally advanced rectal cancer. Sci Rep 2021; 11:5379. [PMID: 33686147 PMCID: PMC7940398 DOI: 10.1038/s41598-021-84816-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/22/2021] [Indexed: 02/06/2023] Open
Abstract
Neoadjuvant chemo-radiotherapy (CRT) followed by total mesorectal excision (TME) represents the standard treatment for patients with locally advanced (≥ T3 or N+) rectal cancer (LARC). Approximately 15% of patients with LARC shows a complete response after CRT. The use of pre-treatment MRI as predictive biomarker could help to increase the chance of organ preservation by tailoring the neoadjuvant treatment. We present a novel machine learning model combining pre-treatment MRI-based clinical and radiomic features for the early prediction of treatment response in LARC patients. MRI scans (3.0 T, T2-weighted) of 72 patients with LARC were included. Two readers independently segmented each tumor. Radiomic features were extracted from both the “tumor core” (TC) and the “tumor border” (TB). Partial least square (PLS) regression was used as the multivariate, machine learning, algorithm of choice and leave-one-out nested cross-validation was used to optimize hyperparameters of the PLS. The MRI-Based “clinical-radiomic” machine learning model properly predicted the treatment response (AUC = 0.793, p = 5.6 × 10–5). Importantly, the prediction improved when combining MRI-based clinical features and radiomic features, the latter extracted from both TC and TB. Prospective validation studies in randomized clinical trials are warranted to better define the role of radiomics in the development of rectal cancer precision medicine.
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Affiliation(s)
- Andrea Delli Pizzi
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Via dei Vestini, 66100, Chieti, Italy
| | - Antonio Maria Chiarelli
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Via dei Vestini, 66100, Chieti, Italy
| | - Piero Chiacchiaretta
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Via dei Vestini, 66100, Chieti, Italy.
| | - Martina d'Annibale
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Via dei Vestini, 66100, Chieti, Italy
| | - Pierpaolo Croce
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Via dei Vestini, 66100, Chieti, Italy
| | - Consuelo Rosa
- Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Via Dei Vestini, 66100, Chieti, Italy
| | | | - Stefano Trebeschi
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | | | - Francesco Lorenzo Serafini
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Via dei Vestini, 66100, Chieti, Italy
| | - Raffaella Basilico
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Via dei Vestini, 66100, Chieti, Italy
| | - Giulio Cocco
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Science of Aging, "G. D'Annunzio" University, Chieti, Italy
| | - Pierluigi Di Sebastiano
- Department of Innovative Technologies in Medicine and Odontoiatry, "G. D'Annunzio" University, Chieti, Italy
| | - Sebastiano Cinalli
- Division of Pathology, ASST of Valtellina and Alto Lario, Sondrio, Italy
| | - Antonio Ferretti
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Via dei Vestini, 66100, Chieti, Italy
| | - Richard Geoffrey Wise
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Via dei Vestini, 66100, Chieti, Italy
| | - Domenico Genovesi
- Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Via Dei Vestini, 66100, Chieti, Italy
| | - Regina G H Beets-Tan
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands.,Department of Radiology, University of Southern Denmark, Odense, Denmark
| | - Massimo Caulo
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Via dei Vestini, 66100, Chieti, Italy
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16
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Frostberg E, Pedersen MRV, Manhoobi Y, Rahr HB, Rafaelsen SR. Three different computed tomography obesity indices, two standard methods, and one novel measurement, and their association with outcomes after colorectal cancer surgery. Acta Radiol 2021; 62:182-189. [PMID: 32338034 DOI: 10.1177/0284185120918373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Obesity can be measured by different indices, either as body mass index (BMI) or by more intuitive radiological measurements, and obesity has been shown to have an impact on outcome after colorectal cancer (CRC) surgery. PURPOSE To investigate whether the thickness of the subcutaneous adipose tissue (SAT) in the abdominal wall can be used as a surrogate for the visceral fat area (VFA)-both measured on computed tomography (CT)-in prediction of short- and long-term outcomes after elective CRC surgery. MATERIAL AND METHODS Preoperative CT scans of all patients having elective CRC surgery (stages I-III), in two consecutive years at a single-center institution, were used to measure the SAT (mm) and VFA (cm2). BMI was calculated for each patient. The three different obesity indices were used in different analyses in order to predict postoperative complications and overall survival. RESULTS A BMI >30 kg/m2 was an independent prognostic factor in postoperative complications (odds ratio 3.2, 95% confidence interval [CI] 1.43-7.03). SAT and VFA were not able to predict complications. Patients considered visceral obese according to a high VFA (>130 cm2) had poorer survival (hazard ratio 1.53, 95% CI 1.00-2.36) compared to non-obese patients, but in the adjusted model, VFA lost its predictive power. BMI and SAT were not able to predict mortality. CONCLUSION The novel measurement of the thickness of SAT in a preoperative setting before elective CRC surgery cannot predict either postoperative complications or overall survival; the other obesity indices had better predictive features.
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Affiliation(s)
- Erik Frostberg
- Department of Surgery, Colorectal Cancer Center South, Vejle Hospital, University Hospital of Southern Denmark, Odense, Denmark
- Institute of Regional Health Science, University of Southern Denmark, Odense, Denmark
| | - Malene RV Pedersen
- Institute of Regional Health Science, University of Southern Denmark, Odense, Denmark
- Department of Radiology, Colorectal Cancer Center South, Vejle Hospital, University Hospital of Southern Denmark, Odense, Denmark
| | - Yavar Manhoobi
- Department of Radiology, Colorectal Cancer Center South, Vejle Hospital, University Hospital of Southern Denmark, Odense, Denmark
| | - Hans B Rahr
- Department of Surgery, Colorectal Cancer Center South, Vejle Hospital, University Hospital of Southern Denmark, Odense, Denmark
- Institute of Regional Health Science, University of Southern Denmark, Odense, Denmark
- The Danish Colorectal Cancer Group, Copenhagen, Denmark
| | - Søren R Rafaelsen
- Institute of Regional Health Science, University of Southern Denmark, Odense, Denmark
- Department of Radiology, Colorectal Cancer Center South, Vejle Hospital, University Hospital of Southern Denmark, Odense, Denmark
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17
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Evaluation of Mesorectal Microcirculation With Quantitative Dynamic Contrast-Enhanced MRI. AJR Am J Roentgenol 2020; 215:1370-1376. [PMID: 32991218 DOI: 10.2214/ajr.19.22116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE. The purpose of this study was to use quantitative dynamic contrast-enhanced MRI (DCE-MRI) to evaluate mesorectal microcirculation in patients with rectal cancer. MATERIALS AND METHODS. A total of 53 patients with semicircular rectal tumors underwent DCE-MRI with a 3-T MRI system before surgery. ROIs were manually delineated in the mesorectum that surrounded the tumor and the mesorectum that surrounded the normal rectal wall. DCE-MRI parameters including forward volume transfer constant (Ktrans), reverse volume transfer constant (kep), and fractional extravascular extracellular space volume (Ve) were estimated using computer software. Histopathologic analysis served as the standard reference. RESULTS. Mesorectum that surrounded the tumor showed significantly higher Ktrans val ues than mesorectum that surrounded normal rectal wall (mean, 0.069 ± 0.035 [SD] vs 0.039 ± 0.020 min-1; p < 0.001). The tumor-surrounding mesorectum also showed higher Ve values than normal mesorectum (p < 0.001). An opposite trend was observed for kep, but this was not significant (p = 0.077). A lower Ktrans of the tumor-surrounding mesorectum was observed in patients with malignant lymph nodes compared with those with benign lymph nodes (mean, 0.054 ± 0.027 vs 0.076 ± 0.036 min-1; p = 0.034). Although kep values for the tumor-surrounding mesorectum were higher in patients with tumors categorized as pathologic Tis (pTis) to pT2 than in those with pT3 tumors, the p value was close to 0.05 (p = 0.047). The tumor-surrounding mesorectum showed no significant differences in the aforementioned parameters between patients with positive MRI-detected extramural vascular invasion (mrEMVI) and those with negative mrEMVI. CONCLUSION. Mesorectum that surrounded rectal tumor had a higher blood flow than that close to the normal rectal wall. The blood flow decreased in the tumor-surrounding mesorectum when there was nodal involvement.
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Juszczyk K, Kang S, Putnis S, Winn R, Chen J, Aghmesheh M, Fylyk G, Brungs D. High body mass index is associated with an increased overall survival in rectal cancer. J Gastrointest Oncol 2020; 11:626-632. [PMID: 32953146 DOI: 10.21037/jgo-20-48] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background The impact of increased body mass index (BMI) on clinical outcomes in locoregional rectal cancer is unknown. Methods This is a retrospective cohort study which included 453 consecutive rectal cancer patients undergoing definitive treatment, with confirmed stage I, II or III rectal adenocarcinoma. The association of BMI at diagnosis with overall survival (OS), cancer specific survival (CSS) and disease-free survival (DFS) was explored, controlling for key covariates using multivariable analyses. BMI as defined by the World Health Organization (WHO) is as follows: BMI <18.5-underweight; 18.5-24.9-normal; 25.0-29.9-pre-obesity; >30-obese. Results Overweight and obese patients had significantly better OS than underweight/normal weight patients (5-year OS 80% for overweight, 77% for obese, and 65% for underweight/normal weight patients, P=0.02). High BMI (>25) was significantly associated with improved OS in univariate [0.62 (0.4-0.8) P=0.007] and multivariable [0.65 (0.4-0.9) P=0.023] analyses. When stratified by stage, high BMI was associated with improved OS in stage III patients (P=0.0009), but not stage II (P=0.21) or stage I (0.54). High BMI was also significantly associated with improved CSS in univariate (HR 0.62, P=0.048) and multivariable analyses (HR 0.58, P=0.03). Conclusions In our study a BMI greater than 25 is significantly associated with a longer OS and CSS in patients with locoregional rectal cancer. These findings may be due to the reduced metabolic capacity for non-obese patients to deal with rectal cancer treatment as well as the burden of disease, however further research is needed to evaluate this.
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Affiliation(s)
- Karolina Juszczyk
- Division of Surgery, Colorectal Unit, Wollongong Hospital, NSW, Australia
| | - Sharlyn Kang
- Department of Radiation Oncology, Illawarra Cancer Care Centre, Wollongong Hospital, NSW, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, NSW, Australia
| | - Soni Putnis
- Division of Surgery, Colorectal Unit, Wollongong Hospital, NSW, Australia
| | - Robert Winn
- Division of Surgery, Colorectal Unit, Wollongong Hospital, NSW, Australia
| | - James Chen
- Department of Radiation Oncology, Illawarra Cancer Care Centre, Wollongong Hospital, NSW, Australia
| | - Morteza Aghmesheh
- Illawarra Health and Medical Research Institute, University of Wollongong, NSW, Australia.,Department of Medical Oncology, Illawarra Cancer Care Centre, Wollongong Hospital, NSW, Australia
| | - Glaucia Fylyk
- Department of Radiation Oncology, Shoalhaven Cancer Care Centre, Shoalhaven Hospital, NSW, Australia
| | - Daniel Brungs
- Illawarra Health and Medical Research Institute, University of Wollongong, NSW, Australia.,Department of Medical Oncology, Illawarra Cancer Care Centre, Wollongong Hospital, NSW, Australia
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19
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Luo Q, Wang S, Han H, Xie F, Chen J. High expression of the long noncoding RNA SH3PXD2A-AS1 is associated with poor prognosis in patients with esophageal squamous cell carcinoma. J Int Med Res 2020. [PMCID: PMC7488910 DOI: 10.1177/0300060520949059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objective Our objective was to explore the prognostic role of long noncoding RNA (lncRNA) SH3PXD2A-AS1 in esophageal squamous cell carcinoma (ESCC). Methods An SH3PXD2A-AS1 expression dataset was retrieved and analyzed from The Cancer Genome Atlas database, and SH3PXD2A-AS1 expression was determined in our cohort of 134 ESCC patients by using quantitative PCR. The clinical significance of SH3PXD2A-AS1 expression was investigated by the Chi square test and its prognostic value was determined by Kaplan–Meier survival curve analysis and Cox proportional hazards analysis. RNA interference and in vitro functional experiments, including cell viability, migration, and invasion, were used to investigate effects of SH3PXD2A-AS1 on cell malignant phenotype. Results SH3PXD2A-AS1 expression was increased in ESCC tissues compared with adjacent normal tissues. A high level of SH3PXD2A-AS1 expression was associated with poor tumor differentiation and advanced T, N, and TNM stages, indicating its oncogenic role in ESCC. Moreover, its high expression predicted poor overall survival in patients with ESCC. Inhibition of SH3PXD2A-AS1 expression significantly suppressed cell viability, migration, and invasion of ESCC cells. Conclusion High SH3PXD2A-AS1 expression is a poor prognostic factor for patients with ESCC. SH3PXD2A-AS1 might function as an oncogene that can promote malignant biological characteristics of ESCC cells.
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Affiliation(s)
- Qiuli Luo
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing, China
| | - Shanshan Wang
- Department of Clinical Laboratory, Peking University Cancer Hospital & Institute, Beijing, China
| | - Haibo Han
- Department of Clinical Laboratory, Peking University Cancer Hospital & Institute, Beijing, China
| | - Fei Xie
- College of Life Science and Bioengineering, Beijing University of Technology, Beijing, China
| | - Jinfeng Chen
- Department of Thoracic Surgery II, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
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Li G, Ao S, Hou J, Lyu G. Low expression of miR-125a-5p is associated with poor prognosis in patients with gastric cancer. Oncol Lett 2019; 18:1483-1490. [PMID: 31423214 PMCID: PMC6607383 DOI: 10.3892/ol.2019.10423] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 04/16/2019] [Indexed: 12/19/2022] Open
Abstract
microRNAs (miRs) serve critical roles in tumor progression. Low expression of miR-125a in gastric carcinoma (GC) may promote tumor development. In the present study, low expression of miR-125a was confirmed in cancer tissues using The Cancer Genome Atlas database. Additionally, the expression and clinical significance of miR-125a-5p was investigated using reverse transcription-quantitative PCR in 150 cases of GC. The results of the present study demonstrated that the level of miR-125a-5p expression was decreased in GC biopsies compared with that in matched adjacent normal tissues. Low expression of miR-125a-5p was associated with increased tumor diameter, high Ki67 expression and poor overall survival of patients with GC. Multivariate survival analysis demonstrated that low miR-125a-5p expression may be used as an independent prognostic factor for patients with GC. However, no effects on the cell viability in a Cell Counting kit-8 assay, and cell migration and invasion in Transwell assays were detected in response to treatment using miR-125a-5p mimics or inhibitors in vitro. Therefore, the results of the present study provide evidence that low expression of miR-125a-5p may be associated with a poor prognosis, suggesting its value as a tumor biomarker for patients with GC.
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Affiliation(s)
- Guan Li
- Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Sheng Ao
- Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Jianing Hou
- Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Guoqing Lyu
- Department of Gastrointestinal Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
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