Downregulation of the circadian Period family genes is positively correlated with poor head and neck squamous cell carcinoma prognosis

ABSTRACT

We investigated the relationship between head and neck squamous cell carcinoma (HNSCC) and the mRNA and protein expression levels of the circadian genes of the Period (Per) family, Per1, Per2 and Per3. Tissue sections of HNSCC and normal head and neck tissues from two patient cohorts from two different hospitals were collected to assess the mRNA and protein expressions of the three Per family genes using real-time quantitative PCR (RT-PCR) and immunohistochemistry (IHC). The clinicopathological features and disease prognosis for the latter cohort were analyzed through IHC and statistical methods. Protein positive expression levels of the three Per family genes in HNSCC tissues was found to be approximately two times lower than that in normal tissues (p < .01). Moreover, patients with locally advanced HNSCC showed significantly greater downregulation of Per1, Per2 and Per3 mRNA expression levels as compared to patients with early-stage cancer (p < .05). Immunohistochemical examination of HNSCC patient tissues revealed a positive correlation between the Per family protein expression and the clinical tumor staging (p < .05). In addition, the Per protein-positive expression group showed higher 3-year survival rates [overall survival (OS) and progression-free survival (PFS)] as assessed by Kaplan-Meier plots and statistical analysis (p < .05). Our findings confirm the positive correlation between Per family gene expression and survival outcomes and support their role as prognostic markers for HNSCC.     

Markers of Epithelial to Mesenchymal Transition in Association with Survival in Head and Neck Squamous Cell Carcinoma (HNSCC)

Background

Elucidating the molecular phenotype of cancers with high metastatic potential will facilitate the development of novel therapeutic approaches to the disease. Gene expression profiles link epithelial to mesenchymal transition (EMT) phenotype with high-risk HNSCC. We sought to determine the role of protein biomarkers of EMT in head and neck squamous carcinoma (HNSC) prognosis.

Methods

Protein expression analysis of EGFR, β-catenin and E-cadherin was performed on a cohort of 102 patients with HNSCC recruited between 1992 and 2005 using automated quantitative protein analysis (AQUA). We evaluated associations with clinicopathological parameters and prognosis.

Results

There were 67 patients with primary squamous cell carcinoma of the head and neck in this cohort who met inclusion criteria and for whom we had complete E-cadherin, beta-catenin and EGFR expression data. High E-cadherin expressers had longer 5-year progression-free survival (PFS) compared to those with low E-cadherin (59.7% versus 40.6%, p = 0.04) and overall survival (OS) (69.6% versus 44.3%, p  = 0.05). Kaplan-Meier analysis showed that patients with low beta-catenin-expressing tumors trended toward worse 5-year PFS (p = 0.057). High EGFR expressers had inferior OS compared to low EGFR expressers (27.7% vs. 54%, p = 0.029). In the multivariable analysis context, E-cadherin remained an independent predictor of improved OS (HR = 0.204, 95% CI 0.043 to 0.972, p = 0.046) while EGFR trended towards significance for OS.

Conclusions

The putative markers of EMT defined within a panel of HNSCC using AQUA are associated with tumors of poor prognosis.     

NIT2 overexpression predicts poor prognosis in tongue squamous cell carcinoma patients

There is disputable on the role of nitrilase-like 2 (NIT2) in cancer. Its expression and its relationship with clinicopathological features in tongue squamous cell carcinoma (TSCC) are not yet clear. The purpose of this study is to investigate the expression of NIT2 in TSCC and its correlation with clinicopathological characteristics in TSCC patients. Through proteomic identification, we found that the protein NIT2 was related to the development of TSCC. q-PCR, western blot and immunohistochemistry techniques were applied to detect the expression of NIT2 in TSCC. The relationship between the expression of NIT2 and clinicopathological features was analyzed by Chi square tests. The results showed the expression of NIT2 in TSCC was significantly higher than that in normal tongue tissues (p?<?0.05). Univariate and multivariate analysis showed that the positive expression of NIT2 and N classification were associated with decreased disease-free survival rate (DFS) and overall survival (OS) (p?<?0.05). The results suggested that NIT2 is overexpressed in TSCC and NIT2 may be a potential therapeutic target for TSCC.

     

Clinicopathological and prognostic significance of PD-1/PD-L1 axis expression in patients with tongue squamous cell carcinoma

Tongue squamous cell carcinoma (TSCC) is more aggressive than other head and neck tumors, and the prognosis for patients with advanced TSCC is poor. At present, comprehensive treatment based on surgery as the main method is not effective for patients with advanced TSCC. The application of PD-1/PD-L1 immunocheckpoint inhibitor alone in patients with TSCC has not been reported. To explore the role of PD-1/PD-L1, we investigated the expression of PD-1 and PD-L1 in TSCC and analyzed the relationship between the expression of PD-1 and PD-L1 and the related clinicopathological parameters and survival prognosis. The expression of PD-1 was significantly associated with palindromia (p = .015) and maximum diameter (p = .043). The expression of PD-L1 in tumor cells was significantly associated with N stage (P = .024), chemotherapy (p = .032), and clinical stage (p = .019). The expression of PD-L1 in infiltrating lymphocytes was significantly associated with palindromia (p = .030). Univariate and multivariate Cox analyses for prognoses of patients showed significant prognostic factors of overall survival and relapse-free survival. The high expression of PD-L1 on infiltrating lymphocytes for OS and RFS was an independent protective factor for patients with TSCC. The high expression of PD-1 on infiltrating lymphocytes and clinical stage for OS and RFS were independent risk factors for patients with TSCC. The data provide a reference for clinical treatment of TSCC with immunotherapy.     

Systematic profiling identifies PDLIM2 as a novel prognostic predictor for oesophageal squamous cell carcinoma (ESCC)

Till now, no appropriate biomarkers for high‐risk population screening and prognosis prediction have been identified for patients with oesophageal squamous cell carcinoma (ESCC). In this study, by the combined use of data from the Gene Expression Omnibus (GEO) datasets and The Cancer Genome Atlas (TCGA)‐oesophageal carcinoma (ESCA), we aimed to screen dysregulated genes with prognostic value in ESCC and the genetic and epigenetic alterations underlying the dysregulation. About 222 genes that had at least fourfold change in ESCC compared with adjacent normal tissues were identified using the microarray data in GDS3838. Among these genes, only PDLIM2 was associated with nodal invasion and overall survival (OS) at the same time. The high PDLIM2 expression group had significantly longer OS and its expression was independently associated with better OS (HR: 0.64, 95% CI: 0.43‐0.95, P = 0.03), after adjustment for gender and pathologic stages. The expression of its exon 7/8/9/10 had the highest AUC value (0.724) and better prognostic value (HR: 0.43, 95% CI: 0.22‐0.83, P = 0.01) than total PDLIM2 expression. PDLIM2 DNA copy deletion was common in ESCC and was associated with decreased gene expression. The methylation status of two CpG sites (cg23696886 and cg20449614) in the proximal promoter region of PDLIM2 showed a moderate negative correlation with the gene expression in PDLIM2 copy neutral/amplification group. In conclusion, we infer that PDLIM2 expression might be a novel prognostic indicator for ESCC patients. Its exon 7/8/9/10 expression had the best prognostic value. Its down‐regulation might be associated with gene‐level copy deletion and promoter hypermethylation.     

The novel pretreatment immune prognostic index discriminates survival outcomes in locally advanced non-operative esophageal squamous cell carcinoma patients treated with definitive chemoradiotherapy: a 6-year retrospective study

ObjectiveWe aimed to construct risk stratification to help set individualized treatment strategies and intensities for different subgroups of patients.MethodsThe Esophagus Immune Prognostic Index (EIPI) scores were constructed according to the levels of derived neutrophil-to-lymphocyte ratio (dNLR) and lactate dehydrogenase (LDH) before treatment, and the patients were divided into low-, medium-, and high-risk groups. Finally, restricted cubic splines (RCS) were used to explore the relationship between dNLR, LDH, and survival outcomes.ResultsThe median follow-up period of overall survival (OS) and progression-free survival (PFS) were 25.2 and 17.6 months, respectively. Multivariate Cox regression analysis showed dNLR were the independent prognostic factors that were associated with OS and PFS. The 3-year OS and PFS rates in the low-, medium-, and high-risk groups were 44.4% and 38.2%, 26.1% and 23.6%, and 10.5% and 5.3%, respectively. Patients who received chemotherapy had better OS and PFS than those who did not receive chemotherapy in low-risk and medium/high-risk groups (all p < 0.05). Besides, the results also revealed significant differences for patients with clinical T, N, and TNM stage groups of the OS and PFS in different risk groups. Finally, RCS analysis indicated a nonlinear relationship between the dNLR, LDH, and survival for esophageal squamous cell carcinoma (ESCC) patients. The death hazard ratios of dNLR and LDH sharply increased at 1.97 and 191, respectively.ConclusionsIn summary, the EIPI, a novel inflammatory-based and immune-related prognostic score, is an independent prognostic indicator in locally advanced ESCC patients undergoing definitive chemoradiotherapy (dCRT).     

下咽鳞状细胞癌组织claudin-1和MMP-9的表达及与临床病理特征及预后的关系研究

摘要 目的：研究下咽鳞状细胞癌组织紧密连接蛋白1（claudin-1）和基质金属蛋白酶-9（MMP-9）的表达及与临床病理特征及预后的关系。方法：选取2015年1月-2017年3月我院收集的75例下咽鳞状细胞癌组织标本进行研究,同期选取60例癌旁正常黏膜组织标本作为对照。采用免疫组织化学法检测claudin-1、MMP-9在下咽鳞状细胞癌组织与癌旁正常黏膜组织中的表达差异,分析claudin-1、MMP-9阳性表达与临床病理特征关系;Spearman相关性分析癌组织claudin-1与MMP-9的相关性。对患者进行5年随访,分析claudin-1、MMP-9表达与预后的关系。结果：下咽鳞状细胞癌组织claudin-1、MMP-9阳性表达率高于癌旁正常黏膜组织（P＜0.05）。claudin-1、MMP-9阳性表达与下咽鳞状细胞癌患者组织分化程度、淋巴结转移有关（P＜0.05）。经Spearman相关性分析显示,下咽鳞状细胞癌组织中claudin-1阳性表达与MMP-9阳性表达呈正相关（rs= 0.463,P＜0.05）。术后随访5年,2例失访,73例患者获得随访。Kaplan-Meier生存曲线显示,claudin-1阳性表达患者的5年生存率为35.71%,低于阴性表达患者的66.67%（P＜0.05）,MMP-9阳性表达患者的5年生存率为34.85%,低于阴性表达患者的57.14%（P＜0.05）。结论：下咽鳞状细胞癌组织中claudin-1、MMP-9阳性表达升高,其表达与组织分化程度、淋巴结转移和预后不良有关,两者呈正相关,可能发挥协同作用促进肿瘤发生发展。     

共刺激分子B7-H4在宫颈癌中的表达及意义

目的:肿瘤微环境中免疫共刺激分子B7-H4与其配体结合后可提供免疫抑制信号,调控肿瘤组织中的免疫应答。本研究探讨B7-H4、Fas及Caspase-3裂解片段在宫颈鳞状细胞癌中的表达及其与临床病理因素的关系,分析其参与肿瘤免疫逃逸的机制。方法:应用免疫组织化学SP法检测23例正常宫颈上皮、38例宫颈上皮内瘤变(CIN)和132例宫颈鳞状细胞癌组织中B7-H4、Fas及Caspase-3裂解片段的表达水平,分析其与宫颈癌各临床病理因素的相关性。结果:B7-H4在正常宫颈上皮组织中不表达,在CIN组织中微弱表达,在宫颈鳞状细胞癌组织中高表达。B7-H4表达与肿瘤的临床分期、淋巴结转移、原发肿瘤大小和肿瘤浸润深度有关,B7-H4与Fas蛋白表达呈现负相关,与Caspase-3裂解片段存在共表达关系。结论:B7-H4在宫颈鳞状细胞癌中过表达可引起Fas蛋白表达下调和Caspase-3裂解片段增多,抑制肿瘤细胞发生凋亡,参与肿瘤逃避宿主的免疫监视,从而促发宫颈癌的发生和发展。阻断B7-H4通路途径,有望成为宫颈鳞状细胞癌治疗的新靶点。     

RPA3 is a potential marker of prognosis and radioresistance for nasopharyngeal carcinoma

Radioresistance‐induced residual and recurrent tumours are the main cause of treatment failure in nasopharyngeal carcinoma (NPC). Thus, the mechanisms of NPC radioresistance and predictive markers of NPC prognosis and radioresistance need to be investigated and identified. In this study, we identified RPA3 as a candidate radioresistance marker using RNA‐seq of NPC samples. In vitro studies further confirmed that RPA3 affected the radiosensitivity of NPC cells. Specifically, the overexpression of RPA3 enhanced radioresistance and the capacity for DNA repair of NPC cells, whereas inhibiting RPA3 expression sensitized NPC cells to irradiation and decreased the DNA repair capacity. Furthermore, the overexpression of RPA3 enhanced RAD51 foci formation in NPC cells after irradiation. Immunohistochemical assays in 104 NPC specimens and 21 normal epithelium specimens indicated that RPA3 was significantly up‐regulated in NPC tissues, and a log‐rank test suggested that in patients with NPC, high RPA3 expression was associated with shorter overall survival (OS) and a higher recurrence rate compared with low expression (5‐year OS rates: 67.2% versus 86.2%; 5‐year recurrence rates: 14.8% versus 2.3%). Moreover, TCGA data also indicated that high RPA3 expression correlated with poor OS and a high recurrence rate in patients with head and neck squamous cell carcinoma (HNSC) after radiotherapy. Taken together, the results of our study demonstrated that RPA3 regulated the radiosensitivity and DNA repair capacity of NPC cells. Thus, RPA3 may serve as a new predictive biomarker for NPC prognosis and radioresistance to help guide the diagnosis and individualized treatment of patients with NPC.     

食管鳞癌血管生成拟态的组织学和细胞学研究

目的:探讨血管生成拟态(vasculogenic mimicry,VM)与食管鳞癌临床病理特征的关系及其对患者预后的影响,并分析食管癌血管生成拟态的形成机制。方法:收集57例食管鳞癌石蜡包埋样本,进行过碘酸雪夫氏(PAS)及CD34免疫组织化学双重染色,结合HE染色,观察食管鳞癌血管生成拟态的发生情况。对患者临床病理和预后信息进行单因素分析,Kaplan-Meier生存比较和Cox风险模型分析。通过食管鳞癌细胞株Eca-109三维培养建立,观察RNAi沉默VE-cadherin对食管鳞癌Eca109血管生成拟态形成的影响。结果:食管鳞癌中VM表达的阳性率为54.3%,显著高于正常食管黏膜组织;VM在病理分型为低分化食管鳞癌的阳性表达率为78.9%,显著高于中高分化组(P0.05);III-Ⅳ期食管鳞癌患者VM阳性率显著高于Ⅰ-Ⅱ期食管鳞癌患者(P0.05);有淋巴结转移的食管鳞癌者VM阳性率明显高于无淋巴结转移者(P0.05)。单因素分析结果显示食管鳞癌VM的发生率与肿瘤的分化程度、TNM分期和淋巴转移显著相关。Kaplan-Meier生存分析显示有VM组食管鳞癌患者的生存期明显短于无VM组(P0.05);Cox分析显示VM是影响食管鳞癌患者预后的独立危险因素(RF=0.67)。三维培养结果显示Eca-109细胞在基质胶上形成典型的血管网状样结构,VE-cadherin-siRNA可有效抑制VE-cadherin在Eca109的表达,抑制体外培养的Eca109细胞VM的形成。结论:血管生成拟态是食管鳞癌一种独特的血液供应模式,与食管鳞癌的分化程度、TNM分期、淋巴转移密切相关,是食管鳞癌患者术后生存期的独立危险因素。     

宫颈鳞状细胞癌中ADAM17 的表达及其临床意义

目的:探讨去整合素-金属蛋白酶17(ADAM17)在宫颈鳞状细胞癌中的表达及其临床病理意义。方法:运用免疫组织化学法分别检测正常宫颈上皮、宫颈鳞状细胞癌及宫颈上皮内瘤样变组织中ADAM17的表达,并分析其与宫颈癌临床分期及淋巴结转移的相关性。结果:ADAM17在正常宫颈上皮组织切片中无明显表达,在宫颈上皮内瘤样变组织中少部分表达,呈浅黄色,在宫颈鳞状细胞癌中癌细胞大量表达,ADAM17表达呈棕褐色,数量较多且浓染。不同临床分期的宫颈鳞状细胞癌组织中ADAM17的阳性表达率比较存在显著统计学差异(P0.05),且随临床分期的上升,ADAM17的表达逐渐升高;有淋巴结转移的宫颈鳞状细胞癌组织中ADAM17的阳性表达率显著高于无淋巴结转移的宫颈鳞状细胞癌组织,差异具有统计学意义(P0.05)。结论:ADAM17蛋白在宫颈鳞状细胞癌组织中呈异常高表达,且与宫颈鳞状细胞癌的临床分期和淋巴结转移密切相关,通过检测ADAM17蛋白的表达可能有助于宫颈鳞状细胞癌的诊断、治疗和预后预测。     

免疫检查点抑制剂联合抗血管生成二线治疗晚期食管癌患者疗效及肿瘤标志物表达、预后生存期的影响

摘要 目的：研究信迪利单抗与阿帕替尼在晚期食管癌二线治疗中的应用效果。方法：根据随机数字表法将2019年1月～2022年1月本院收治的70例食管癌患者分为对照组与观察组,每组各35例,对照组给予阿帕替尼治疗,观察组给予信迪利单抗与阿帕替尼联合治疗,观察两组患者的客观缓解率（ORR）、疾病控制率（DCR）,并在治疗前后利用酶联免疫吸附法检测其糖类抗原50（CA-50）、糖类抗原199（CA199）、癌胚抗原（CEA）、鳞癌抗原（SCC）水平;随后通过随访记录两组患者的预后生存期,并建立多因素Logistic模型分析影响患者达到中位OS、PFS的独立危险因素。结果：与对照组比较,观察组ORR、DCR率较高（P＜0.05）。与对照组相比,治疗后观察组血清CA50、CA199、CEA、SCC水平较低（P＜0.05）。与对照组比较,观察组中位OS、PFS较长（P＜0.05）。多因素Logistic分析结果显示,治疗方法、CA50、CA199、CEA、SCC是影响食管癌预后生存期的独立危险因素（P＜0.05）。结论：利用免疫检查点抑制剂与抗血管生成药物对晚期食管癌患者开展二线治疗,不仅能降低血清中的肿瘤标志物浓度,还能延长患者的预后生存期,治疗效果较为显著。     

半乳糖凝集素-3与程序性死亡受体-1在宫颈鳞癌组织中的表达及其临床意义

目的:探讨半乳糖凝集素-3(Gal-3)和程序性死亡受体-1(PD-1)在宫颈鳞癌组织中的表达及其临床意义。方法:选择2016年1月-2017年12月期间我院收治的宫颈鳞癌患者80例纳入观察组,宫颈上皮内瘤变(CIN)患者60例纳入CIN组,取同期在我院进行治疗的宫颈炎患者50例纳入对照组。采集三组患者的宫颈组织标本,采用免疫组化SP法对各组织标本中的Gal-3、PD-1的阳性率、表达水平进行检测,并分析Gal-3、PD-1与宫颈鳞癌临床病理特征的关系以及各指标表达水平的相关性。结果:观察组、CIN组的Gal-3、PD-1的阳性表达率、表达水平均高于对照组,且观察组高于CIN组(P0.05)。Gal-3、PD-1的表达与宫颈鳞癌患者的年龄、病灶大小、分化程度无关(P0.05),而与宫颈鳞癌肿瘤的分期、淋巴结转移有关(P0.05)。经Spearman相关性分析显示,宫颈鳞癌组织中Gal-3与PD-1间表达水平呈正相关性(r=0.496,P=0.000)。结论:Gal-3、PD-1的表达水平与宫颈鳞癌的发生、发展有密切关联,并且两种指标间呈明显正相关。     

Prognostic Value and Clinicopathology Significance of MicroRNA-200c Expression in Cancer: A Meta-Analysis

MiR-200c has been shown to be related to cancer formation and progression. However, the prognostic and clinicopathologic significance of miR-200c expression in cancer remain inconclusive. We carried out this systematic review and meta-analysis to investigate the prognostic value of miR-200c expression in cancer. Pooled hazard ratios (HRs) of miR-200c for overall survival (OS) and progression-free survival (PFS) were calculated to measure the effective value of miR-200c expression on prognosis. The association between miR-200c expression and clinical significance was measured by odds ratios (ORs). Twenty-three studies were included in our meta-analysis. We found that miR-200c was not significantly correlated with OS (HR = 1.41, 95%Cl: 0.95-2.10; P = 0.09) and PFS (HR = 1.12, 95%Cl: 0.68-1.84; P = 0.67) in cancer. In our subgroup analysis, higher expression of miR-200c was significantly associated with poor OS in blood (HR = 2.10, 95%CI: 1.52-2.90, P<0.00001). Moreover, in clinicopathology analysis, miR-200c expression in blood was significantly associated with TNM stage, lymph node metastasis and distant metastasis. MiR-200c may have the potential to become a new blood biomarker to monitor cancer prognosis and progression.     

基于免疫组化和癌症基因组图谱数据分析的脾酪氨酸激酶在宫颈癌中的表达研究

摘要 目的：探讨Syk 在宫颈癌中的表达及其临床意义。方法：应用免疫组化检测Syk在宫颈癌、癌前病变(CIN)和相应的正常宫颈组织中的表达。借助R2生物信息平台挖掘Syk在TCGA数据库305例宫颈鳞癌中的mRNA表达及其与预后的关系。结果：免疫组化结果显示,Syk在宫颈癌巢分化较好的中心区表达较强,在分化较低的癌巢周边区表达较弱。Syk 染色主要定位在宫颈癌和正常宫颈组织的细胞质和细胞膜,正常宫颈组织基底细胞无 Syk 表达,8例CIN组织细胞核中可见Syk表达, 但宫颈癌组织细胞核中未见Syk表达。Syk在宫颈癌、CIN和正常宫颈组织中的阳性率分别是76%、54%、40%,三组间的表达差异具有统计学意义（P=0.001）。Syk 在深度浸润和淋巴结转移中表达较强。数据挖掘结果显示,Syk mRNA在305例不同临床分期的宫颈癌中均表达,Syk mRNA高表达组219例,Syk mRNA低表达组73例,其中13例生存数据缺失,Syk高表达组的患者预后较差。结论：Syk在宫颈癌中的表达提示Syk在宫颈癌中具有致癌蛋白的作用,Syk在某些CIN中的核表达可能与更好的预后相关。     

FBXW7 suppresses epithelial‐mesenchymal transition and chemo‐resistance of non‐small‐cell lung cancer cells by targeting snai1 for ubiquitin‐dependent degradation

Objectives

FBXW7 acts as a tumour suppressor by targeting at various oncoproteins for ubiquitin‐mediated degradation. However, the clinical significance and the involving regulatory mechanisms of FBXW7 manipulation of NSCLC regeneration and therapy response are not clear.

Materials and Methods

Immunohistochemical staining and qRT‐PCR were applied to detect FBXW7 and Snai1 expression in 100 samples of NSCLC and matched tumour‐adjacent tissues. FBXW7 manipulation of cancer biological functions were studied by using MTT assay, immunoblotting, flow cytometry, transwells, wound healing assay, and sphere‐formation assays. Immunofluorescence and co‐immunoprecipitation were used to analyse the possible interaction between Snai1 and FBXW7.

Results

We detected the decreased FBXW7 expression in majority of the NSCLC tissues, and lower FBXW7 level was correlated with advanced TNM stage. Furthermore, those patients with decreased FBXW7 expression tend to have both poorer 5‐year survival outcomes, and shorter disease‐free survival, comparing to those with higher FBXW7 levels. Functionally, we found that FBXW7 enforcement suppressed NSCLC progression by inducing cell growth arrest, increasing chemo‐sensitivity and inhibiting Epithelial‐mesenchymal Transition (EMT) progress. Results further showed that FBXW7 could interact with Snai1 directly to degrade its expression through ubiquitylating alternation in NSCLC, which could be partially abrogated by restoring Snai1 expression.

Conclusions

FBXW7 conduction of tumour suppression was partly through degrading Snai1 directly for ubiquitylating regulation in NSCLC

     

Association of programmed death ligand‐1 (PD‐L1) expression with treatment outcomes in patients with BRAF mutation‐positive melanoma treated with vemurafenib or cobimetinib combined with vemurafenib

The prognostic significance of programmed death ligand‐1 (PD ‐L1) on treatment outcomes in patients receiving BRAF with or without MEK inhibitors is not well understood. This retrospective exploratory analysis evaluated the association of tumour PD ‐L1 expression with progression‐free survival (PFS ) and overall survival (OS ) among 210 patients in the coBRIM trial treated with cobimetinib plus vemurafenib or placebo plus vemurafenib. In the vemurafenib cohort, there was a trend of increased PFS and OS in those with PD ‐L1⁺ melanoma, with hazard ratios (HR s; PD ‐L1⁺ vs. PD ‐L1^?) of 0.70 (95% CI , 0.46–1.07) and 0.69 (95% CI , 0.42–1.13) for PFS and OS , respectively. However, in patients treated with cobimetinib plus vemurafenib, a similar trend was not observed with HR s (PD ‐L1⁺ versus PD ‐L1^?) of 1.04 (95% CI , 0.66–1.68) and 0.94 (95% CI , 0.57–1.57) for PFS and OS , respectively. The combination cobimetinib plus vemurafenib appears to overcome the poor prognosis associated with low PD ‐L1 expression.     

Integration of OV6 expression and CD68+ tumor-associated macrophages with clinical features better predicts the prognosis of patients with hepatocellular carcinoma

Background: Reliable prognostic indicators for accurately predicting postoperative outcomes in Hepatocellular carcinoma (HCC) patients are lacking. Although cancer stem-like cells (CSCs) and tumor-associated macrophages (TAMs) in tumor microenvironment are implicated in the occurrence and development of HCC, whether the combination of CSC biomarkers and TAM populations could achieve better performance in predicting the prognosis of patients with HCC has been rarely reported.Methods: A total of 306 HCC patients were randomly divided into the training and validation cohorts at a 1:1 ratio, and the expression of OV6 and CD68 was assessed using immunohistochemistry in HCC samples. The prognostic value of these biomarkers for post-surgical survival and recurrence were evaluated by the curve of receiver operating characteristic and multivariate Cox regression analyses.Results: The density of OV6⁺ CSCs was positively correlated with the infiltration of CD68⁺ TAMs in HCC. Both high OV6 expression and CD68⁺ TAM infiltration was closely associated with poor overall survival (OS) and progression-free survival (PFS) of HCC patients. Moreover, overexpression of OV6 and infiltration of CD68⁺ TAMs were identified as independent prognostic factors for OS and PFS after liver resection. The integration of OV6 and CD68 with tumor size and microvascular invasion exhibited highest C-index value for survival predictivity in HCC patients than any other biomarkers or clinical indicators alone.Conclusion: Incorporating intratumoral OV6 expression and CD68⁺ TAMs infiltration with established clinical indicators may serve as a promising prognostic signature for HCC, and could more accurately predict the clinical outcomes for HCC patients after liver resection.