Search

Abstract Background Neoadjuvant chemotherapy is an important part of the comprehensive treatment of advanced gastric cancer (GC). The effect of neoadjuvant chemotherapy plays a key role in the prognosis of GC patients. Pathological response can represent the effect of neoadjuvant chemotherapy. However, evidence focused on pathological response and associated clinicopathological factors in GC patients is quite little. In this retrospective study, the clinicopathological factors affecting the effect of neoadjuvant chemotherapy in GC patients were investigated, and suggestions were proposed to improve the effect of neoadjuvant chemotherapy on GC. Methods Retrospective analysis was performed on GC patients who received radical surgery after neoadjuvant chemotherapy from February 2016 to December 2019 at Peking Union Medical College Hospital. Relevant clinicopathological data was collected to analyze the factors influencing the effect of neoadjuvant chemotherapy. Chi-square test was used for univariate analysis. Logistic regression was used for multivariate analysis. Receiver operating characteristic curve (ROC) was used to determine the cutoff value of variables which significantly influenced the effect of neoadjuvant chemotherapy. Results A total of 203 GC patients were included in the study. Analyses showed that patients < 60 years old (OR = 1.840 [1.016–3.332], P = 0.044), histological type of poor differentiation or signet-ring cell carcinoma (OR = 2.606 [1.321–5.140], P = 0.006), and weight loss during neoadjuvant chemotherapy (OR = 2.110 [1.161–3.834], P = 0.014) were independent risk factors for neoadjuvant chemotherapy effect. In ROC analysis of weight change and neoadjuvant chemotherapy effect, area under the curve (AUC) was 0.593 (P = 0.024) and cutoff value of weight change was − 2.95%. Chi-square test showed that patients without weight loss during neoadjuvant chemotherapy had a higher rate of oral nutritional supplement (ONS) than patients with weight loss (P = 0.039). Conclusions Patients 2.95% during neoadjuvant may have a worse chemotherapy effect. Timely nutritional support such as ONS to maintain patients’ body weight is crucial for improving the effect of neoadjuvant chemotherapy.

Objective To evaluate the chemotherapy effect on diffuse large B-cell lymphoma(DLBCL) patients with different CD5 expression by 18F-FDG PET/CT, and discuss related influence factors. Methods We retrospectively analyzed the PET/CT manifestation of 55 patients initially diagnosed as DLBCL. Deauville 5-score(5-PS) standard was applied to compare the chemotherapy effect between DLBCL patients with CD5(+) and CD5(-), and analyze if there was difference in age, gender, Ann Arbor staging, B symptoms, invasion position, LDH, IPI or SUVmax in DLBCL patients with different CD5 expression. Results There was no significant difference in age, gender or SUVmax between CD5(+) and CD5(-) DLBCL patients (P=0.105, 0.931, 0.203); while there was significant difference in Ann Arbor staging, B symptoms, nodal or extranodal, LDH, IPI (P=0.005, 0.037, 0.014, 0.003, 0.029). The therapeutic effect on patients with CD5(-) was better than those with CD5(+) (P=0.018). Age, gender, SUVmax were not independent influence factors for chemotherapeutic effect (P=0.050, 0.230, 0.179), while Ann Arbor staging, B symptoms, nodal or extranodal, LDH and IPI were independent influence factors (P=0.007, 0.006, 0.043, 0.020, 0.015). Conclusion DLBCL patients with CD5(+) are prone to recurrence or new lesions in the follow-up period. There is no correlation between CD5 expression and gender or SUVmax. Ann Arbor staging, B symptoms, nodal or extranodal, LDH and IPI are independent influence factors for chemotherapeutic efficacy.

Objective To discuss the correlation between Ki67 expression and 18F-FDG PET/CT SUVmax in patients with diffuse large B-cell lymphoma(DLBLC) and their application in the evaluation of chemotherapy effect. Methods We retrospectively analyzed 18F-FDG PET/CT images of 55 patients initially diagnosed as DLBLC in our hospital, observed the correlation between Ki67 expression and SUVmax, evaluated the chemotherapy effect by 18F-FDG PET/CT scan, and analyzed whether age, gender, SUVmax and Ki67 expression were the independent influence factors of chemotherapy effect. Results SUVmax was positively correlated with Ki67 expression (P < 0.05), but no correlation with chemotherapy effect (P > 0.05); Age, gender, SUVmax and Ki67 were not independent influencing factors of chemotherapy effect (P > 0.05). Conclusion 18F-FDG PET/CT SUVmax could predict the proliferation and invasion of DLBCL cells, but there is no correlation between SUVmax and chemotherapy effect. Age, gender, SUVmax and Ki67 expression are not independent influencing factors of chemotherapy effect.

Abstract Wilms tumors (WT) with WT1 mutations do not respond well to preoperative chemotherapy by volume reduction, suggesting resistance to chemotherapy. The histologic pattern of this tumor subtype indicates an intrinsic mesenchymal differentiation potential. Currently, it is unknown whether cytotoxic treatments can induce a terminal differentiation state as a direct comparison of untreated and chemotherapy‐treated tumor samples has not been reported so far. We conducted gene expression profiling of 11 chemotherapy and seven untreated WT1‐mutant Wilms tumors and analyzed up‐ and down‐regulated genes with bioinformatic methods. Cell culture experiments were performed from primary Wilms tumors and genetic alterations in WT1 and CTNNB1 analyzed. Chemotherapy induced MYF6 165‐fold and several MYL and MYH genes more than 20‐fold and repressed many genes from cell cycle process networks. Viable tumor cells could be cultivated when patients received less than 8 weeks of chemotherapy but not in two cases with longer treatments. In one case, viable cells could be extracted from a lung metastasis occurring after 6 months of intensive chemotherapy and radiation. Comparison of primary tumor and metastasis cells from the same patient revealed up‐regulation of RELN and TBX2, TBX4 and TBX5 genes and down‐regulation of several HOXD genes. Our analyses demonstrate that >8 weeks of chemotherapy can induce terminal myogenic differentiation in WT1‐mutant tumors, but this is not associated with volume reduction. The time needed for all tumor cells to achieve the terminal differentiation state needs to be evaluated. In contrast, prolonged treatments can result in genetic alterations leading to resistance.