| Objectives:A new prognostic scoring system,the Naples Prognostic Score(NPS),was established according to nutritional or inflammatory status.It has been found that the NPS can be used to assess the prognosis of many malignancies.However,its prognosis prediction effect on gastric cancer(GC)patients is still unknown so far.The present work aimed to examine the NPS function in the prediction of GC prognosis.Methods:In this study,patients underwent surgery with no preoperative therapy were retrospectively examined from June 2011 to August 2019.Typically,the total cholesterol level,serum albumin content,neutrophil-to-lymphocyte ratio and lymphocyte-tomonocyte ratio were determined to calculate the NPS.Besides,the prognostic value of NPS was evaluated by survival analyses.Time-dependent receiver operating characteristic curve(t-ROC)analysis was also conducted to compare the prognostic value of the scoring systems.Results:Altogether 1,283 cases were enrolled into the present work.NPS was markedly related to age,gender,tumor size,body mass index,vascular invasion,perineural invasion,and pTNM stage.Upon multivariate analysis,NPS was identified as an independent prognostic factor for the prediction of overall survival(OS)(P<0.001).In subgroup analyses stratified by adjuvant chemotherapy or surgery alone,NPS was still the independent prognostic factor for OS in both groups(both P<0.001).Furthermore,NPS exhibited higher accuracy in the prediction of OS than additional prognostic factors,as revealed by the results of t-ROC curve analysis.Conclusions:NPS is a simple and useful scoring system that can be used to independently predict the survival of GC cases undergoing surgery.Objectives:The modified systemic inflammation score(mSIS),which is calculated by a composite score of the lymphocyte-to-monocyte ratio and the albumin content in serum,is identified as the new score to predict the prognosis for various cancers.However,its significance for patients with adenocarcinoma of esophagogastric junction(AEJ),who receive surgery,remains unclear.Methods:This study retrospectively analyzed 317 patients with AEJ receiving surgery between September 2010 and December 2016.The associations between the mSIS and the clinicopathological features,overall survival(OS),as well as relapse-free survival(RFS),were assessed.In addition,the time-dependent receiver operating characteristic curve(tROC)analysis was performed for comparing the value of those scoring systems in predicting patient prognosis.Results:Of the 317 cases,119 were rated as mSIS 0,123 as mSIS 1,and 75 as mSIS 2.Besides,mSIS was significantly related to age and tumor size.On multivariate analysis,mSIS was identified as a predictor to independently predict OS(p<0.001)along with RFS(p<0.001),and a significantly strong correlation was observed at the advanced pTNM stages based on the mSIS system.In the subgroup analysis of adjuvant chemotherapy and surgery alone,mSIS was still the predictor for independently predicting patient OS(p<0.001)together with RFS(p<0.001)for the two groups.T-ROC analysis showed that mSIS was more accurate than controlling nutritional status score in predicting OS and RFS.Conclusions:The mSIS can serve as an easy,useful scoring system to independently predict the postoperative survival for AEJ cases undergoing surgery.Objectives:The present work focused on assessing the role of Peking prognostic score(PPS),a novel prognostic index based on muscle atrophy and lymphocyte-to-C-reactive protein ratio(LCR),within gastric cancer patient prognosis.Methods:We analyzed data collected from 774 gastric cancer cases between April 2011 to February 2016(discovery cohort).The results were assessed in 575 gastric cancer cases from March 2016 to September 2019(validation cohort).For evaluating skeletal muscle mass,we obtained computed tomography images at the third lumbar vertebra level(L3).We defined sex-specific L3 skeletal muscle index thresholds for sarcopenia as≤32.50 cm2/m2 and≤44.77 cm2/m2 for female and male,respectively.We defined low LCR as LCR≤6000.We also performed time-dependent receiver operating characteristic curve(t-ROC)to analyze PPS’s prognostic significance with others.Results:The discovery cohort enrolled altogether 774 patients with non-metastatic gastric cancer,including 639(82.5%)males along with 135(17.5%)females.Their mean age when the surgery was performed was 62.3 years.The patients were divided into 3 groups.166 patients(21.4%)were assigned into group 0,472(60.9%)in group 1,and 136(17.7%)in group 2,respectively.An increased PPS was in direct proportion to an elder age(P<0.001),reduced body mass index(P=0.001),higher pTNM stage(P<0.001),perineural invasion(P=0.002)and vascular invasion(P<0.001).This finding was consistent with the results of the validation cohort.We identified PPS to independently estimate patient overall survival(OS)(PPS group 1:hazard ratio(HR)=2.32,P<0.001;PPS group 2:HR=4.67,P<0.001)together with disease-free survival(DFS)(PPS group 1:HR=1.86,P<0.001;PPS group 2:HR=3.43,P<0.001).Cases having sarcopenia together with a low LCR(PPS group 2)might show dismal OS together with DFS compared with cases showing no risk factor(PPS group 0).Additionally,as revealed by t-ROC analysis,PPS exhibited the highest sensitivity compared with other prognostic scoring systems in predicting patient survival.Finally,we evaluated the prognostic value of PPS in the validation cohort,and confirmed that preoperative PPS to independently estimate patient OS and DFS.Conclusions:PPS accounts for an efficient nutrition-inflammation prognostic scoring system in gastric cancer patients.Patients who have a higher PPS are associated with an increased tumor recurrence risk,and thereby customized treatment should be applied.Objective:Tumors driven by somatic mutations may express new antigens that trigger T cell immune responses.T-cell receptor(TCR)repertoire play a key role in the anti-tumor immune response of gastric cancer(GC).The purpose of this study was to explore the basic characteristics,clinical effect and prognostic significance of the TCR repertoire in patients with GC.Methods:To comprehensively characterize the TCR repertoire,we performed an in-depth analysis of the hypervariable complementarity-determining regions region 3(CDR3)of the TCRβ chain in peripheral blood,cancer tissues and paracancerous tissues of 74 gastric cancer patients and peripheral blood samples of 69 healthy controls using high-throughput sequencing.The GC patients and healthy controls were admitted from May 2020 to August 2021 at the Department of Pancreatic and Gastric Surgery,Cancer Hospital,Chinese Academy of Medical Sciences\National Cancer Center(Beijing,China).The prognostic significance of TCR repertoire in GC was explored using Cox regression models.Results:Compared to the healthy controls,peripheral blood,paracancerous tissues,and tumor tissues of GC patients in GC patients showed a decreased Shannon entropy and an increased Gini index,which implies the expansion of part of the TCR repertoire.The difference between GC patients and healthy controls in peripheral blood is more significant.For different TRBV and TRBJ genes,the samples showed significant differences between different locations.Principal component analysis indicated that there is no significant preference of J gene usage between different samples.However,the results showed an obvious difference of the usage of V gene between blood samples of healthy controls and peripheral blood,cancer tissues and paracancerous tissues of GC patients.At the same time,it was found that the number and count of TCR CDR3 related to GC were correlated with TNM stage,and the number and count of TCR CDR3 related to GC were the highest in patients with stage II.It indicated that the richness and diversity of the TCR repertoire first increased and then decreased as tumor progression.Moreover,And the results showed that patients with lower GC-related TCR counts in peripheral blood had poorer prognosis(hazard ratio[HR]=2.91,95%CI=1.02-8.30,P=0.037).At the same time,the patients with the lower diversity of GC-associated TCRs in peripheral blood also indicated poorer prognosis(HR=3.35,95%CI=1.17-9.57,P=0.017).The same trend was observed in GC tumor tissue that patients with low TCR diversity having poorer overall survival.Conclusion:TCR repertoire can be used as a meaningful indicator of GC development and prognosis,and may guide the immunotherapy of GC patients in the future. |
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