ObjectiveTo evaluate the effect of post mastectomy radiation therapy (PMRT) on breast reconstruction after mastectomy in breast cancer patients, in order to provide evidence support for clinical treatment decision.MethodsFive databases searched in the current study include the Cochrane Library, PubMed, CNKI, VIP and WanFang database. A systematic search for control trials was performed in each database from the starting date of each database to March 1, 2021. After the two evaluators independently selected literatures, extracted data and conducted quality evaluation according to the inclusion and exclusion criteria, the meta analysis was carried out by Revman 5.3 software.ResultsA total of 9 cohort studies (3 447 cases) were included, including 699 cases in PMRT group and2 748 cases in non-radiotherapy group. The results of meta-analysis showed that: PMRT was associated with significant increase in capsular contracture. The incidence of capsular contracture increased from 4.34% in the non-radiotherapy group to 34.10% in patients receiving PMRT [OR=9.25, 95%CI (3.76, 22.78), P<0.000 01]. In addition, PMRT was associated with a significant increase in incidences of reconstructive failure [OR=2.55, 95%CI (1.74, 3.74), P<0.000 01] and revisional surgery [OR=2.24, 95%CI (1.58, 3.18), P<0.000 01]. Moreover it was associated with a significant reduction in patient satisfaction [OR=0.29, 95%CI (0.15, 0.57), P=0.000 30] and cosmetic outcome [OR=0.26, 95%CI (0.15, 0.43), P<0.000 01].ConclusionThis meta-analysis demonstrates that breast cancer patients who received PMRT after breast reconstruction, the rate of adverse events is increased and patients’ satisfaction and cosmetic outcome are decreased.
ObjectiveTo investigate the association of lipid metabolism and other markers with microvascular invasion in hepatocellular carcinoma (HCC) and to develop a preoperative prediction model from it. MethodsData from 389 HCC patients who underwent hepatectomy at First Hospital of Lanzhou University between January 2017 and March 2023 were retrospectively analyzed. These patients were divided into training group (n=272) and validation group (n=117) with a ratio of 7 : 3. The independent risk factors of microvascular invasion (MVI) were determined by univariate and multivariate logistic regression analysis, and the MVI prediction model was established. The prediction efficiency of the model was verified by the analysis of calibration curve, receiver operating characteristic (ROC) curve and decision curve. ResultsUnivariate and multivariate logistic regression analysis showed that the risk factors independently related to MVI before operation included total cholesterol, lactate dehydrogenase, body mass index, alpha-fetoprotein, carbohydrate antigen 125, hepatitis B DNA, maximum tumor diameter and albumin-bilirubin score. MVI prediction model was established based on the above eight risk factors, and its area under ROC curve in the training group and the validation group were 0.79 [95%CI (0.74, 0.84)] and 0.75 [95%CI (0.66, 0.84)] respectively. Calibration curve analysis showed that the prediction curve fitted well with the standard curve. ROC curve analysis showed that the MVI prediction model was efficient. Decision curve analysis confirmed that the MVI prediction model had significant clinical applications. ConclusionThis study identified independent correlations between total cholesterol levels, among other things, and MVI, and successfully developed and validated novel predictive model based on these indicators that can help physicians effectively identify individuals at high risk for MVI in patients with hepatocellular carcinoma preoperatively, leading to more rational treatment choices.
ObjectiveTo investigate the safety and clinical efficacy of dendritic cell (DC)-cytokine induced killer (CIK) cell adoptive immunotherapy combined with chemotherapy in patients with gastric cancer after radical gastrectomy.MethodsForty-eight patients with gastric cancer after the radical gastrectomy receiving the DC-CIK cell adoptive immunotherapy combined with XELOX or FOLFOX chemotherapy were enrolled as a study group in the First Hospital of Lanzhou University from January 2014 to January 2016. In addition, 48 patients with gastric cancer after the radical gastrectomy in the same period and only receiving XELOX or FOLFOX chemotherapy were collected as a control group. The CD3+, CD3+CD4+, CD3+CD8+, CD3–CD56+ (NK cell), and CD3+CD56+ (NKT cell), toxic reaction, quality of life were evaluated in both groups before and after the treatment, and the long term effect were compared in both groups.Results① There were no significant differences in the gender, age, clinical stage, etc. between the two groups (P>0.05). ② The CD3+, CD3+CD4+, CD3+CD8+, CD3–CD56+, and CD3+CD56+ cells in the peripheral blood had no significant changes between before and after treatment in the study group (P>0.05), which were decreased after the treatment in the control group as compared with before the treatment and were significantly lower than those in the study group (P<0.05). ③ The levels of CEA, CA19-9, and CA724 in the peripheral blood after the treatment in the study group and the control group were significantly lower than those before the treatment (P<0.05), which in the study group were significantly lower than those in the control group after the treatment (P<0.05). ④ The incidences of leukopenia, thrombocytopenia, and diarrhea in the study group were significantly lower than those in the control group (P<0.05). ⑤ Compared with before the treatment, the body function and emotional function after the treatment were significantly improved in the study group (P<0.05). And in the body function, emotion function, role function, cognitive function, and social function were significantly improved than those in the control group (P<0.05) after the treatment. ⑥ The progression-free survival in the study group was significantly better than that in the control group (P<0.05). There was no significant difference in the overall survival between the study group and the control group (P>0.05).ConclusionDC-CIK cell adoptive immunotherapy combined with chemotherapy could significantly improve immune status and quality of life of patients with gastric cancer after radical gastrectomy, reduce adverse effects of chemotherapy, improve long term effect, and prolong progression-free survival.