简介：Epithelialovariancancerisprimarilyadiseaseofolderwomen.Advancedageisriskfactorfordecreasedsurvival.Optimalsurgeryandthesafeandeffectiveadministrationofchemotherapyareessentialforprolongedprogression-freeandoverallsurvival(OS).Inthisarticle,theavailableregimensinboththeprimarytreatmentandrelapsedsettingarereviewed.

简介：DuringGHtherapyfor2.3-9.6years,maleadult-onsetGH-deficientpatientswithadiagnosisofanonfunctioningadenomahavenoincreasedall-causemortality.However,womenwithadult-onsetGHdeficiency(GHD)arestillatslightlyhigherrisk.Thisgeneralimprovementinmortalityisduetoamorecontemporaryregimenofcardiovasculardrugs,arefinementofsurgicalprocedures,besidestheintroductionofGHtherapyimprovedhormonereplacementregimenswithloweredglucocorticoidreplacement,updatedapproachesofsexsteroidsforwomen,andlessuseofcranialradiotherapy.Theunderlyingdiseaseisthemostimportantpredictorformortality:eg,acraniopharyngioma,malignantcausesofhypopituitarism,previousCushing'sdisease,andthepresenceofdiabetesinsipidus/

简介：Objective:Implantableportthrombosis(IPT)incancerpatientsisarelativelyrarebutseverecomplication.Severalfactorsarereportedlyassociatedwiththeoccurrenceofthrombosis.WeaimedtodescribetheprevalenceandtheanatomoclinicalfeaturesofIPTobservedincancerpatientswhoweretreatedinamedicaloncologydepartmentinTunisia.Methods:Atotalof600cancerpatientswhohadportimplantationfromJanuary2013toDecember2015wereretrospectivelyidentified.Caseswithsymptomatic/incidentalIPT(radiologicallyconfirmed)werefurtheridentified.Epidemiologicalandanatomoclinicalfeatureswerecollectedfrompatientrecordsandthedepartmentdatabase.Results:Weobservedthat33ofthe600patientshadIPT;thus,theprevalencewas5.5%.Themedianagewas57years,andthegenderratiowas0.43.Overweightorobesitywasobservedin73%ofthepatients.IPToccurredmainlyinpatientswithbreast(36.4%)andcolorectal(33.3%)cancers,whichweremostlynonmetastatic(79%).Atleastoneidentifiedclassicalthromboembolicriskfactorwasfoundin13patients(smokingin9,tamoxifenin2).IPTwassymptomaticin93%ofthecases,occurringwithinanaveragetimeof56days.Implantableportswereremovedbecauseofinfectionin2casesandnonfunctionalityin3cases.IPTtreatmentwasbasedonlow-molecular-weightheparins(94%)andantivitaminK(6%)foranaverageof130days.Fourpatientshadpost-therapycomplications:onethrombosisrecurrenceandthreeinfections.Conclusions:IPTcasesinthe600patientswereobservedtooccurinobesenonmetastaticcancerpatientswithinthefirst3monthsafterIPimplantation.

简介：OBJECTIVE:Evenduringthemicrosurgicalera,tentorialmeningiomaspresentaformidablesurgicalchallengewhentumorinvolvescriticalneurovascularstructures.Wereportourexperiencewithtentorialmeningiomawithregardtoclinicalpresentation,diagnosticworkup,microsurgicaltechnique,complications,andfollow-upresults.METHODS:Inaretrospectivestudy,wereviewedthemedical

简介：Thefibroblastgrowthfactorreceptor(FGFR)familyplaysimportantrolesinregulatingcellgrowth,proliferation,survival,differentiationandangiogenesis.DeregulationoftheFGF/FGFRsignalingpathwayhasbeenassociatedwithmultipledevelopmentsyndromesandcancers,andthustherapeuticstrategiestargetingFGFsandFGFRinhumancancerarecurrentlybeingexplored.However,fewstudiesontheFGF/FGFRpathwayhavebeenconductedinsarcoma,whichhasapooroutcomewithtraditionaltreatmentssuchassurgery,chemotherapy,andradiotherapy.Hence,inthepresentreview,weprovideanoverviewoftheroleoftheFGF/FGFRpathwaysignalinsarcomaandFGFRinhibitors,whichmightbenewtargetsforthetreatmentofsarcomasaccordingtorecentresearch.

简介：Objective:Toanalyzethecorrelationsamongcomorbidityandoverallsurvival(OS),biochemicalprogression-freesurvival(b-PFS)andtoxicityinelderlypatientswithlocalizedprostatecancertreatedwith125Ibrachytherapy.Methods:Elderlymen,aged≥65years,withlow-intermediateriskprostatecancer,weretreatedwithpermanent125Ibrachytherapyasmonotherapy.Comorbiditydatawereobtainedfrommedicalreportsusingage-adjustedCharlsoncomorbidityindex(a-CCI).Thepatientswerecategorizedintotwoagegroups(<75and≥75yearsold),andtwocomorbidityscoregroups(a-CCI≤3and>3).ToxicitywasscoredwithRadiationTherapyOncologyGroup(RTOG)scale.Results:FromJune2003toOctober2009,atotalof92elderlypatientsunderwentprostatebrachytherapy,including57men(62%)withlow-riskprostatecancer,and35men(38%)withintermediate-riskprostatecancer.Themedianageofpatientswas75years(range,65-87years).Forty-sevenpatients(51%)hada-CCI≤3and45patients(49%)a-CCI>3.Withamedianfollow-upperiodof56months(range,24-103months),the5-yearactuarialOSandb-PFSwere91.3%and92.4%respectively,withoutstatisticalsignificancebetweentwoCharlsonscoregroups.Toxicitywasmild.Noneofthepatientsexperiencedgastrointestinal(GI)toxicity,andonly4patiens(4%)experiencedlategenitourinary(GU)grade-3(G3)toxicity.NocorrelationbetweenacuteGUandGItoxicityandcomorbiditywasshowed(P=0.50andP=0.70,respectively).Conclusions:Ourdatasuggestthatelderlymenwithlow-intermediateriskprostatecancerandcomorbiditycanbeconsideredforaradicaltreatmentas125Ilow-doseratebrachytherapy.

简介：Objective:Survivalandtreatmentofpatientswithmicroinvasivebreastcancer(MIBC)remaincontroversial.Inthispaper,weevaluatedwhetheradjuvantchemotherapyisnecessaryforpatientswithMIBCtoidentifyriskfactorsinfluencingitsprognosisanddecidetheindicationforadjuvantchemotherapy.Methods:Inthisretrospectivestudy,108patientswithMIBCwererecruitedaccordingtoseventheditionofthestagingmanualoftheAmericanJointCommitteeonCancer(AJCC).Thesubjectsweredividedintochemotherapyandnon-chemotherapygroups.Wecomparedthe5-yeardisease-freesurvival(DFS)andoverallsurvival(OS)ratesbetweengroups.Furthermore,weanalyzedthefactorsrelatedtoprognosisforpatientswithMIBCusingunivariateandmultivariateanalyses.Wealsoevaluatedtheimpactofadjuvantchemotherapyontheprognosticfactorsbysubgroupanalysisaftermedianfollow-uptimeof33months(13-104months).Results:The5-yearDFSandOSratesforthechemotherapygroupwere93.7%and97.5%,whereasthoseforthenonchemotherapygroupwere89.7%and100%.Resultsindicatethat5-yearDFSwassuperior,butOSwasinferior,intheformergroupcomparedwiththelattergroup.However,nostatisticalsignificancewasobservedinthe5-yearDFS(P=0.223)orOS(P=0.530)rateofthetwogroups.Mostrelevantpoor-prognosticfactorswereKi-67overexpressionandnegativehormonalreceptors.Cumulativesurvivalwas98.2%vs.86.5%betweenlowKi-67(≤20%)andhighKi-67(>20%).ThehazardratioofpatientswithhighKi-67was16.585[95%confidenceinterval(CI),1.969-139.724;P=0.010].Meanwhile,ER(-)/PR(-)patientswithMIBChadcumulativesurvivalof79.3%comparedwith97.5%forER(+)orPR(+)patientswithMIBC.ThehazardratioforER(-)/PR(-)patientswithMIBCwas19.149(95%CI,3.702-99.057;P<0.001).SubgroupanalysisshowedthatchemotherapycouldimprovetheoutcomesofER(-)/PR(-)patients(P=0.014),butnotthosewhooverexpressKi-67(P=0.105).Conclusions:PatientswithMIBCwhooverexpressKi-67and

简介：Objective:Toinvestigatetheprevalenceoflong-termfatigue,anxiety,depressionandsocialsupport,andtherelationshipsamongthesesymptomsinpostoperativepatientswithbreastcancer.Methods:Atotalof180postoperativepatientswithbreastcancermeetingcriterionwererecruitedinthiscross-sectionalstudy.TheBriefFatigueInventory(BFI),HospitalAnxietyandDepressionScale(HADS)andTheSocialSupportSurvey-Chineseversionwereusedtoassessingthefatigue,anxietyanddepression,Socialsupportofparticipants.ThemagnitudeoftherelationshipamongthesymptomsoffatigueandothervariableswasmeasuredbySpearmanRhocorrelation.Results:Theprevalenceoflong-termfatiguewas52.7%,and18.3%occurredmoderate/severefatigue.Two-thirdsofpatientshadabasalsocialsupport,only12.8%ofpatientshadbetter-perceivedsocialsupport.ResultsofHADSshowedthat16.7%and21.1%oftheparticipantshaveanxietyordepressiondisorder.Moderate/severefatiguewasnegativelycorrelatedwithsocialsupport(r=–0.158,P=0.038)andpositivelycorrelatedwithage(r=0.132,P=0.042),chemotherapy(r=0.297,P=0.027),anxiety(r=0.324,P=0.018)anddepression(r=0.211,P=0.034).Conclusions:Long-termfatiguewashighlyprevalentamongoverhalfofpostoperativepatientswithbreastcancer,andmoderate/severefatiguewasassociatedwithsocialandpsychologicalfactorssuchassocialsupport,anxietyanddepression.Ourresultssuggestthatoverallnursingcaremaybeamoreeffectivemannerinimprovingfatigueandqualityoflife.

简介：Objective:Secretorybreastcarcinoma(SBC)isararetypeofbreastmalignancy,accountingforlessthan0.02%ofallinfiltratingbreastmalignancies.ThepureSBC,atypeofSBCwithoutanothertypeofbreastmalignantneoplasm,isparticularlyrare.ThisstudyaimedtoinvestigatetheclinicopathologicandmolecularfeaturesofpureSBC.Methods:Themainpathologicalparameterssuchasestrogenreceptor(ER),progesteronereceptor(PR),andhumanepithelialgrowthfactorreceptor2(C-erbB-2)weredetectedbyimmunohistochemistry(IHC),andtheclinicopathologicandprognosticdifferencewerecomparedwithinvasiveductalcarcinoma(IDC).Fluorescentinsituhybridization(FISH)andreversetranscriptionpolymerasechainreaction(RT-PCR)wasperformedtoidentifytheETV6-NTRK3rearrangementofSBC.Results:WefoundthatthepositivityratesofER,PR,C-erbB-2,p53,andS-100were47.7%(21/44),52.3%(23/44),36.4%(16/44),27.3%(12/44),and95.5%(42/44),respectively,whichwerehigherthanthosereportedinpreviousstudies.Specialperiodicacid-Schiffanalysiswasperformedin36patients,andthevalueoftheKi-67indexrangedfrom1%to50%(meanvalue:10%).Interestingly,mostpatientswithpureSBCharboredanETV6-NTRK3rearrangementwithan88.6%(39/44)expressionrate.ComparedwithIDC,thetumorsizeofmostpatientswithSBCwaslargerthan2cm(P=0.024).Ultrasoundshowedbenignlesions,andthetotalmisdiagnosisratewashigher(P=0.020).Althoughthepathologicalclassificationwasmostlytriple-negativebreastcancers(P=0.036),therewaslessmetastasis(P=0.029),andtheoverallprognosiswasbetterthanthatoftheIDCgroup.Conclusions:Althoughaxillarylymphnodemetastasis,localrecurrence,ordistantmetastasismayoccur,SBCisalsoconsideredanindolentneoplasmwithagoodprognosis.Oncediagnosed,surgicaltreatmentshouldbeperformedassoonaspossible,followedbyappropriateadjuvantchemotherapy,irradiation,andendocrinetherapies.

简介：Objective:Toevaluatethesafetyandefficacyofexternalhigh-intensityfocusedultrasound(HIFU)castrationforbreastcancerouspatientsaftermastectomyiftheyareatahighriskofrecurrence.Methods:Werecruited52consecutivepatientswithprimaryoperablebreastcancerwhoweretreatedwithmastectomywithexcisionofregionallymphnodes.PatientswerepositiveforERandPRimmuno-cytochemicalstaining,node-positive,un-menopause,over40yearsoldandweredividedintotwogroupsrandomly.Forcastration,26patientsreceivedoneortwotimesofHIFUtreatmentwithinfivedays,andtheotherpatientsreceivedradiotherapywithDT18Gy/9f/11days.Duringandafterthetreatment,localchangesandsystemicresponseofthepatientswereobserved.Results:After1monthtreatment,levelsofserumE1andE2weresignificantlydecreasedcomparedtobeforetreatmentinHIFUgroups(P<0.01andP<0.001).Thesamechangeswereoccurredinradiotherapy(RT)groups(P<0.05andP<0.01).ThelevelsofserumE1orE2inRTgroupswerehigherthaninHIFUgroups(P<0.05).Thesymptomdistributionof'climactericsyndrome'ofHIFUgroupsweresignificantlydifferentfromRTgroups(P<0.01).Thefollow-uptimewas4months.Theincidenceofamenorrheawas100%inallpatients.Noseriouscomplicationswereseen.Thetemperature,pulse,bloodpressure,andrespiratoryrateofthepatientswerealmostnormal.Conclusion:WehaveshownthattheuseofHIFUinthecastratingofpatientswithbreastcancerisfeasible,safeandeffective.ThistechnologymayprovidearapidnoninvasivealterativetoconventionalbilateraloophorectomyorRTcastration.

简介：Objective:Thisstudyaimstoinvestigatethetruth-tellingstatusandtherelevantfactorsofesophagealsquamouscellcarcinoma(ESCC)patientsinHenan,China.Methods:Across-sectionalstudyfromApriltoJune2015usingquestionnaireswasgivento301familymembersofhospitalizedESCCpatientsbasedinthreeaffiliatedhospitalsofZhengzhouUniversity(i.e.,TheFirstHospital,TheSecondHospital,andTumorHospital)andAnyangTumorHospital.Results:Amongthe41.9%(126/301)hospitalizedESCCpatientswhoknewoftheirtruediagnoses,only4.0%patientswereinformedbytheircorrespondingresponsibledoctors,39.7%bytheirfamilymembers,and56.3%bythemselves.UnivariateanalysesshowedthatdisclosureofconfirmedESCCdiagnosistopatientswascorrelatedwithgender,familyhistoryofcancer(FHC),educationlevel,vocation,hospitaladministrativelevel,andattitudesoffamilymembers(P<0.05).Furthermore,multivariateanalysisindicatedthatattitudeoffamilymemberswasthemostimportantandanindependentfactorfordiagnosisdisclosure.ThosepatientswithanegativeFHC,under-education,manualoccupation,advancedstages,andhospitalizedinmunicipalhospitalsexhibitedalowrateoftruthtelling.Conclusions:TruthtellingforESCCpatientsinHenanisnotprevalentandmaybeimprovedthroughconsultationwithfamilymembers,particularlyforpatientswithanegativeFHC,pooreducation,manualoccupation,andadvancedstages.

简介：OBJECT:Optimummanagementforelderlypatientswithnewlydiagnosedglioblastoma(GBM)inthetemozolomide(TMZ)eraisnotwelldefined.Theobjectofthisstudywastoclarifyoutcomesinthispopulation.METHODS:Theauthorsretrospectivelyreviewed105consecutivecasesinvolvingelderlypatients(age≥65years)withnewlydiagnosedGBMwhoweretreatedattheMayoClinicbetween2003and2008.RESULTS:Thepatients'medianagewas74years(range66-87years),andthemedianKarnofskyPerformanceStatus(KPS)scorewas80(range40-90).Halfofthepatientsunderwentbiopsyandhalfunderwentresection.Patientswithdeep-seatedlesions(19patients[18%])ormultifocallesions(34patients[32%])weremorelikelytohavebiopsythanresection(p=0.0001and0.0009,respectively).Newpersistentneurologicaldeficitsdevelopedin7patients(6.7%).Postoperativehemorrhageoccurredin6patients(5.7%),allofwhomunderwentbiopsy.Completefollow-updataregardingadjuvanttreatmentwasavailablein84patients.Forty-one(49%)weretreatedwithchemotherapy(mostlyTMZ)andradiationtherapy(RT),and23(27%)withRTalone.Nineteen(23%)receivedonlypalliativecareaftersurgery(morecommonwithbiopsy,p=0.03).Chemotherapycomplicationsoccurredin28.6%(Grade3or4hematologicalcomplicationsin11.9%).Themedianvaluesforprogression-freesurvival(PFS)andoverallsurvival(OS)were3.5and5.5months.Inamultivariateanalysis,youngerage(p=0.03,riskratio[RR]0.34,95%CI0.13-0.89),singlelesion(p=0.02,RR0.51,95%CI0.30-0.89),resection(p=0.04,RR0.54,95%CI0.31-0.94),andadjuvanttreatment(p=0.0001,RR0.24,95%CI0.11-0.49)wereassociatedwithbetterOS.OnlyadjuvanttreatmentwassignificantlyassociatedwithprolongedPFS(p=0.0007,RR0.27,95%CI0.13-0.57).Withcombinedtherapywithresection,RT,andchemotherapy,themedianPFSandOSwere8and12.5months,respectively.CONCLUSIONS:TheprognosisforGBMworsenswithincreasingageinelderlypatients.Withimportantrisks,resectionandadjuvanttreatmen

简介：Agiantcelltumoroccursmainlyintheproximaltibia,humerus,distalradiusboneandthepelvicbone.Itisrarelyobservedinsuchsitesastheribsandthetemporalbone.Theconditionisprimarilytreatedwithsurgicalexcisionandfunctionalreconstruction.Theeffectofchemotherapyonlungmetastasesandlocallyadvancedgiantcelltumorshasremainedunknown.Wecollectedandanalyzedthedataofsixpatientswithraregiantcelltumorslocatedintheheadandneckpatients.Afteranaveragefollow-upof42.6monthsaftersurgery(14to90months),nolocalrecurrenceormetastasiswasobserved.Wealsocollectedandanalyzedthedataoffivepatientswithmetastaticgiantcelltumorswhowereundergoingsurgeryfortheprimarytumorbefore;ofthreepatientswhohadexperiencedmultiplechemotherapycycles,onehadspontaneousregression,andonesurvivedforlongtimerdespiteprogression.Theothertwopatientshadtheirmajormetastaticlesionsresectedbysurgery,andpresentedlong-termsurvivalduringthefollowup.Inaddition,thisstudyreportsonepatientwithlocallyadvancedgiantcelltumoroftherib,whohasundergonesuccessfulsurgicalresectionfollowingtwocyclesofchemotherapywithifosfamideandliposomaldoxorubicin.Completeresectionofthelesionattheheadandneckisthekeytorelapse-freesurvival.Theprognosisoflungmetastasesinpatientswithgiantcelltumorsisrelativelysatisfying.Neoadjuvantchemotherapyisalsoconducivetothesurgeryforlocallyadvancedlesionsandimprovementofthequalityoflife.

简介：

简介：Cimetidine(CIM)isahistaminetype2receptorantagonistwidelyusedtotreatpepticulcers.Italsohasimportanteffectsontheimmunesystem.TheadministrationofCIMhasbeenfoundtopreserve,tosomedegree,patient’sperioperativeimmunecapability.']However,whethertheuseofCIMca...

简介：Objective:Toanalyzetheinfluencingfactorsforradiation-inducedheartdisease(RIHD)inapanelofcaseswithmalignantthymictumorstreatedbyradiotherapy.Methods:52consecutivepatientsweretreatedbyradiotherapyformalignantthymictumor(14atMasaokastageII,23atstageIIIand15atstageIV).Treatmentincludedradical(in20),postoperative(in14),preoperative(in2)andpalliative(in16)radiotherapy.Theconventionaltwo-dimension(2D)radiationtherapywasperformedinforty-sevenpatientsandthree-dimension(3D)conformalradiationtherapyhasbeenusedin5patientssinceOctober2000.Thetotaltumordoserangedfrom10Gyto84.5Gy(medianof55Gy).Chemotherapywasgivenintwenty-fivepatientsbeforeorafterradiotherapy.Theresultsoffollowing-upcouldbeobtainedfromthedatabaseandupdatedwhereappropriated.Thedosevolumehistogram(DVH)ofheartinradiotherapyforallpatientswasanalyzedfortheeffectivevolumedoseofheart.Result:Themedianfollowing-upwas14months(rangedfrom0.6to111.3months)inthestudy.RIHDwasobservedinsevenpatients.CardiactoxicityofthesesevenpatientswereevaluatedasSOMAgrade1-3.Themediantwo-thirdeffectivevolumedoseofheartwas47.2Gy(rangedfrom8.3Gyto70.1Gy)forconventional2Dradiotherapy,whichcorrelatedwiththymictumordose(P<0.0001).Themediantwo-thirdeffectivevolumedoseofheartwas35.3Gy(rangedfrom13Gyto38.7Gy)for3Dconformalradiotherapy.Theeffectivevolumedosesofheartweredecreasedbyusing3Dconformalradiotherapy(P=0.048).Asignificantassociationbetweencardiactoxicityandeffectivevolumedoseofheartwasfoundinthisstudy(P<0.0001).Cardiactoxicityaccountedfor10.4%and4.1%ofpatientsreceivingandnotreceivingadjuvantchemotherapy,respectively,andoccurredearlierinradiochemotherapygroup(P=0.0528).Multivariateanalysissuggestedthatcardiactoxicitywassignificantlyinfluencedbytheeffectivevolumedoseofheartandchemotherapy.C

简介：Objective:Tostudythechangesofthrombomodulin(TM)inbothplasmaandtissueextractsofcancerpatientsforevaluatingitsclinicalsignificance.Methods:PlasmaTMlevelsweremeasuredbyenzyme-linkedimmunosorbentassay(ELISA)inbothplasmaof188cancerpatientsand24cancertissueextractsincludingtheiradjacentnon-cancertissues.Results:TheplasmaTMlevelsbothincancerpatientsandinmetastasispatientsweresignificantlyhigherthanthatincontrols[(33.47±14.25)μg/L,(41.68±16.96)μg/L,vs(20.40±7.22)μg/L,P<0.01].TheplasmaTMlevelsincancerpatientsafteroperationdecreasedobviouslythanthatbeforeoperation[(18.45±9.96)μg/L,vs(28.29±11.74)μg/L,P<0.01],whereas,theplasmaTMlevelsinpatientswithrecurrenceandmetastasisafteroperationincreasedobviously[(34.50±12.57)μg/L].Amongthetypesofcancer,theplasmaTMlevelsinmetastasislungcancers,gastriccancersandpancreaticcancersweresignificantlyhigherthanthatinnon-metastasisrespectivecancers.Nosignificantdifferenceswerefoundbetweencontrolsandnon-metastasiscancersincludinggastriccancers,pancreaticcancers,nasopharyngealcancers,largeintestinecancersandlaryngealcancers(P>0.05).TheTMlevelsincancertissueextractsweresignificantlylowerthanthatintheiradjacentnon-cancertissueextracts[(647.71±317.51)μg/Lvs(1455.63±772.22)μg/L,P<0.01].Onthecontrary,theplasmaTMlevelsinthesecancersweresignificantlyhigherthanthatincontrols.Conclusion:TheriseofplasmaTMlevelsincancerpatientswasassociatedwithmetastasisanddiffusionofcancers.TheTMlevelscanbeservedasansensitiveindexforjudgingprogressionandmetastasisofcancers.

简介：ＡＮＴＩＣＯＭＰＬＥＭＥＮＴＡＲＹＡＣＴＩＶＩＴＹＩＮＨＵＭＡＮＳＥＲＵＭＯＦＬＵＮＧＣＡＮＣＥＲＰＡＴＩＥＮＴＳＡＮＤＩＴＳＰＯＳＳＩＢＬＥＣＬＩＮＩＣＡＬＳＩＧＮＩＦＩＣＡＮＣＥＬｉｕＨｕｉｒｏｎｇ刘慧荣ＬｉａｎｇＦｅｎｇ梁峰ＺｈａｎｇＷｅｉｆ...

简介：Objective:Hepatocellularcarcinoma(HCC)isacommonmalignancyassociatedwithhighmorbidityandmortalityratesworldwide.EarlydiagnosisplaysanimportantroleintheimprovementofHCCprognosis.Methods:Inthisstudy,weconductedacomprehensiveanalysisofHCCDNAmethylationandgeneexpressiondatasetsinTheCancerGenomeAtlas(TCGA),toidentifyaprognosticsignatureforHCCdiagnosisandsurvivalprediction.First,weidentifieddifferentialmethylationCpG(dmCpG)sitesinHCCsamplesandcomparedthemwiththoseinadjacentnormallivertissues;thiswasfollowedbyunivariateanalysisandSureIndependenceScreening(SIS)inthetrainingset.Therobustnessoftheidentifiedprognosticsignaturewasevaluatedusingthetestingset.ToexplorethebiologicalprocessesinvolvedinHCCprogression,wealsoperformedfunctionalenrichmentanalysisforoverlappinggenesbetweengenescontainingdmCpGsites(DMGs)anddifferentialexpressiongenes(DEGs)inHCCpatients,usingdatafromtheDatabaseforAnnotation,Visualization,andIntegratedDiscovery(DAVID).Results:Asaresult,weidentifiedfiveCpGsitesthatweresignificantlyassociatedwithHCCsurvivalthroughunivariateanalysisandSIS.Univariateanalysisofclinicalcharacteristicsidentifiedageandriskfactors(includingalcoholconsumptionandsmoking)asindependentfactorsthatindicatedHCCsurvival.Multivariateanalysisindicatedthattheintegratedprognosticsignature(weightedcombinationofthefiveCpGsites)thattookageandriskfactorsintoconsiderationresultedinmoreaccuratesurvivalprediction.Conclusions:ThisstudyprovidesanovelsignatureforpredictingHCCsurvival,andshouldbehelpfulforearlyHCCdiagnosisandpersonalizedtreatment.

简介：Lungcanceristhemostfrequentlydiagnosedcancerandaleadingcauseofcancermortalityworldwide,withadenocarcinomabeingthemostcommonhistologicalsubtype.Deeperunderstandingofthepathobiologyofnon-smallcelllungcancer(NSCLC)hasledtothedevelopmentofsmallmoleculesthattargetgeneticmutationsknowntoplaycriticalrolesinprogressiontometastaticdiseaseandtoinfluenceresponsetotargetedtherapies.Theprinciplegoalofprecisionmedicineistodefinethosepatientpopulationsmostlikelytorespondtotargetedtherapies.However,thecancergenomelandscapeiscomposedofrelativelyfew"mountains"[representingthemostcommonlymutatedgeneslikeKRAS,epidermalgrowthfactor(EGFR),andanaplasticlymphomakinase(ALK)]andavastnumberof"hills"(representinglowfrequencybutpotentiallyactionablemutations).Low-frequencylesionsthataffectadruggablegeneproductallowarelativelysmallpopulationofcancerpatientsfortargetedtherapytobeselected.