作者机构：
[Nie, Duorui; Wang, Fei; Gong, Chun; Lai, Guihua] Hunan Univ Chinese Med, Hosp 1, Dept Oncol, Changsha, Peoples R China.;[Zheng, Hao; Yang, Jing] Guangzhou Univ Chinese Med, Clin Med Coll 1, Guangzhou, Peoples R China.;[Cao, Jianxiong] Hunan Univ Chinese Med, Sch Continuing Educ, Changsha, Peoples R China.
通讯机构：
[Chun Gong] D;Department of Oncology, The First Hospital of Hunan University of Chinese Medicine, Changsha, China
关键词：
Nomogram;Pancreatic signet ring cell carcinoma;Prognosis;Survival;SEER
摘要：
This study aimed to compare the incidence, clinicopathological characteristics and survival results of pancreatic signet ring cell carcinoma (PSRCC) and pancreatic adenocarcinomas (PDAC), as well as to analyze the clinical characteristics related to the overall survival (OS) of PSRCC, and to establish an effective prognostic nomogram to predict the risks associated with patient outcomes. A total of 85,288 eligible patients including 425 PSRCC and 84,863 PDAC cases were retrieved from the Surveillance, Epidemiology, and End Results database. The survival curve was calculated using the Kaplan–Meier method and differences in them were measured by Log-rank tests. The Cox proportional hazards regression model was used to identify independent predictors of OS in patients with PSRCC. A nomogram was constructed to predict 1-, 3-, and 5-year OS. The performance of the nomogram was measured by C-index, receiver operating characteristic (ROC) curve, decision curve analysis (DCA). The incidence of PSRCC is much lower than that of PDAC (10.798 V.S. 0.349 per millions). PSRCC is an independent predictor of pancreatic cancer with a poorer histological grade, a higher rate of lymph node and distant metastasis, and a poorer prognosis. We identified four independent prognostic factors including grade, American Joint Committee on Cancer Tumor-Node-Metastasis (TNM) stage, surgery and chemotherapy based on the Cox regression model. The C-index and DCA curves showed better performance of the nomogram than TNM stage. ROC curve analysis also showed that the nomogram had good discrimination, with an area under the curve of 0.840, 0.896, and 0.923 for 1-, 3-, and 5-year survival. The calibration curves showed good agreement between the prediction by the nomogram and actual observations. PSRCC is a rare but fatal subtype of pancreatic cancer. The constructed nomogram in this study accurately predicted the prognosis of PSRCC, performed better than the TNM stage.
期刊：
Evidence-Based Complementary and Alternative Medicine,2022年2022:2192654 ISSN：1741-427X
通讯作者：
Zhuo-jun Wu<&wdkj&>Duo-rui Nie<&wdkj&>Shu-jun Lei<&wdkj&>Lan-lan Tang<&wdkj&>Fei Wang<&wdkj&>Gui-hua Lai<&wdkj&>Jian-xiong Cao
作者机构：
[Lei, Shu-jun; Wang, Fei; Lai, Gui-hua; Nie, Duo-rui; Wu, Zhuo-jun] Hunan Univ Chinese Med, Grad Sch, Changsha 410208, Hunan, Peoples R China.;[Lei, Shu-jun; Wang, Fei; Lai, Gui-hua; Nie, Duo-rui; Wu, Zhuo-jun] Hunan Univ Chinese Med, Hosp 1, Changsha 410021, Hunan, Peoples R China.;[Cao, Jian-xiong] Hunan Univ Chinese Med, Sch Continuing Educ, Changsha 410208, Hunan, Peoples R China.;[Tang, Lan-lan] Ningxiang Hosp Chinese Med, Ningxiang 410399, Hunan, Peoples R China.
关键词：
Introduction;Materials and Methods;Results;Discussion;Conclusion;Abstract;Data Availability;Additional Points;Ethical Approval;Consent;Disclosure;Conflicts of Interests;Authors’ Contributions;Funding Statement;Acknowledgements;Acknowledgments;Supplementary Materials;Reference;Dataset Description;Dataset Files;Abstract;Introduction;Introduction and Materials;Introduction and Methods;Materials;Materials and Methods;Methods;Results;Discussion;Results and Discussion;Discussion and Conclusion;Results and Conclusion;Conclusion;Conclusions;Data Availability;Additional Points;Ethical Approval;Consent;Disclosure;Conflicts of Interest;Authors’ Contributions;Funding Statement;Acknowledgements;Supplementary Materials;References;Appendix;Abbreviations;Preliminaries;Introduction and Preliminaries;Notation;Proof of Theorem;Proofs;Analysis of Results;Examples;Numerical Example;Applications;Numerical Simulation;Model;Model Formulation;Systematic Palaeontology;Nomenclatural Acts;Taxonomic Implications;Experimental;Synthesis;Overview;Characterization;Background;Experimental;Theories;Calculations;Model Verification;Model Implementation;Geographic location;Study Area;Geological setting;Data Collection;Field Testing;Data and Sampling;Dataset;Literature Review;Related Works;Related Work;System Model;Methods and Data;Experimental Results;Results and Analysis;Evaluation;Implementation;Case Presentation;Case Report;Search Terms;Case Description;Case Series;Background;Limitations;Additional Points;Case;Case 1;Case 2 etc.;Concern Details;Retraction Details;Copyright;Related Articles
摘要：
Cancer is a complex disease with several distinct characteristics, referred to as "cancer markers" one of which is metabolic reprogramming, which is a common feature that drives cancer progression. Over the last ten years, researchers have focused on the reprogramming of glucose metabolism in cancer. In cancer, the oxidative phosphorylation metabolic pathway is converted into the glycolytic pathway in order to meet the growth requirements of cancer cells, thereby creating a microenvironment that promotes cancer progression. The precise mechanism of glucose metabolism in cancer cells is still unknown, but it is thought to involve the aberrant levels of metabolic enzymes, the influence of the tumor microenvironment (TME), and the activation of tumor-promoting signaling pathways. It is suggested that glucose metabolism is strongly linked to cancer progression because it provides energy to cancer cells and interferes with antitumor drug pharmacodynamics. Therefore, it is critical to unravel the mechanism of glucose metabolism in tumors in order to gain a better understanding of tumorigenesis and to lay the groundwork for future research into the identification of novel diagnostic markers and therapeutic targets for cancer treatment. Traditional Chinese Medicine (TCM) has the characteristics of multiple targets, multiple components, and less toxic side effects and has unique advantages in tumor treatment. In recent years, researchers have found that a variety of Chinese medicine monomers and compound recipes play an antitumor role by interfering with the reprogramming of tumor metabolism. The underlying mechanisms of metabolism reprogramming of tumor cells and the role of TCM in regulating glucose metabolism are reviewed in this study, so as to provide a new idea for antitumor research in Chinese medicine.
摘要：
Background Metastatic pancreatic cancer (mPC) is a highly lethal malignancy with poorer survival. However, chemotherapy alone was unable to maintain long-term survival. This study aimed to evaluate the individualized survival benefits of pancreatectomy plus chemotherapy (PCT) for mPC.</p> Methods A total of 4546 patients with mPC from 2004 to 2015 were retrieved from the Surveillance, Epidemiology, and End Results database. The survival curve was calculated using the Kaplan-Meier method and differences in survival curves were tested using log-rank tests. Cox proportional hazards regression analyses were performed to evaluate the prognostic value of involved variables. A new nomogram was constructed to predict overall survival based on independent prognosis factors. The performance of the nomogram was measured by concordance index, calibration plot, and area under the receiver operating characteristic curve.</p> Results Compared to pancreatectomy or chemotherapy alone, PCT can significantly improve the prognosis of patients with mPC. In addition, patients with well/moderately differentiated tumors, age <= 66 years, tumor size <= 42 mm, or female patients were more likely to benefit from PCT. Multivariate analysis showed that age at diagnosis, sex, marital status, grade, tumor size, and treatment were independent prognostic factors. The established nomogram has a good ability to distinguish and calibrating.</p> Conclusion PCT can prolong survival in some patients with mPC. Our nomogram can individualize predict OS of pancreatectomy combined with chemotherapy in patients with concurrent mPC.</p>
