Objective: We aimed to screen the genes associated with thyroid cancer (THCA) prognosis, and construct a poly-gene risk prediction model for prognosis prediction and improvement. Methods: The HTSeq-Counts data of THCA were accessed from TCGA database, including 505 cancer samples and 57 normal tissue samples. "edgeR" package was utilized to perform differential analysis, and weighted gene co-expression network analysis (WGCNA) was applied to screen the differential co-expression genes associated with THCA tissue types. Univariant Cox regression analysis was further used for the selection of survival-related genes. Then, LASSO regression model was constructed to analyze the genes, and an optimal prognostic model was developed as well as evaluated by Kaplan-Meier and ROC curves. Results: Three thousand two hundred seven differentially expressed genes (DEGs) were obtained by differential analysis and 23 co-expression genes (|COR| > 0.5, P < 0.05) were gained after WGCNA analysis. In addition, eight genes significantly related to THCA survival were screened by univariant Cox regression analysis, and an optimal prognostic 3-gene risk prediction model was constructed after genes were analyzed by the LASSO regression model. Based on this model, patients were grouped into the high-risk group and low-risk group. Kaplan-Meier curve showed that patients in the low-risk group had much better survival than those in the high-risk group. Moreover, great accuracy of the 3-gene model was revealed by ROC curve and the remarkable correlation between the model and patients' prognosis was verified using the multivariant Cox regression analysis. Conclusion: The prognostic 3-gene model composed by GHR, GPR125, and ATP2C2 three genes can be used as an independent prognostic factor and has better prediction for the survival of THCA patients.

Abstract. Malignant obstructive jaundice comprises a group of diseases that can be caused by primary biliary and extra-biliary carcinomas. Generally, surgical resection is the primary treatment for malignant obstructive jaundice; however, for the patients that are unable to undergo surgery, urgent treatment is required to improve hepatic function. Percutaneous transhepatic biliary drainage (PTBD) and stenting are emerging alternative treatments for malignant obstructive jaundice. PTBD and stenting have exhibited good efficacy for the treatment of malignant obstructive jaundice, with few complications and reduced associated pain. IntroductionMalignant obstructive jaundice comprises a group of diseases that can be caused by primary biliary carcinomas, such as cholangiocarcinoma and gallbladder cancer, and extra-biliary carcinomas, such as ampullary, pancreatic and gastric cancer and hepatocellular carcinoma (1). Malignant obstructive jaundice can lead to hyperbilirubinemia, anorexia, pruritus, cholangitis, septicemia and liver failure. Generally, surgical resection remains the primary treatment for malignant obstructive jaundice; however, in numerous cases the malignant obstructive jaundice is detected when the disease is already at an advanced stage (2). For the patients that are unable to undergo surgery, urgent treatment is required to improve hepatic function, in order to facilitate the addition of subsequent anti-tumor therapy to their treatment regimen. The average survival time of patients with obstructive jaundice is <3 months (3). Percutaneous transhepatic biliary drainage (PTBD) and stenting are emerging alternative treatments for malignant obstructive jaundice that exhibit good clinical efficacy and few complications and lead to limited patient suffering. PTBD and stenting is the first choice for elderly patients, patients with inoperable malignant obstructive jaundice, and patients with postoperative recurrence, diabetes, or cardiovascular disease. Case reportCase 1. The patient was a 51-year-old man who presented with ~3 weeks' history of obstructive jaundice. The patient was admitted to Fuyan People's Hospital (Fuyang, China) on June 12, 2014. Liver and kidney function analyses, and routine blood tests were conducted upon admission; and heaptic bilirubin levels were higher than normal. Abdominal computed tomography (CT) showed pancreatic cancer, as well as dilation of the intra-and extrahepatic bile ducts. The patient was at an advanced disease stage and refused to undergo surgical resection. PTBD and stenting were performed in the interventional operating room following the provision of informed consent by the patient. The procedure to puncture the biliary duct was guided under ultrasound (US). An 18-G Chiba needle and a 0.035-inch guide-wire were used to gain access to the biliary system using a right-sided puncture approach. An 8-F sheath was inserted to facilitate the procedure. A 0.035-inch hydrophilic guide-wire was advanced through the stenosis into the duodenum. The hydrophilic guide-wire was...

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BackgroundCholangiocarcinoma (CCA) is one of the most aggressive malignancies, lacking novel diagnostic and prognostic biomarkers. Exosome noncoding RNAs (ncRNA) were previously proposed as a potential source of biomarkers in several cancers. This study aimed to interpret the value of specific bile-derived ncRNA as predictors for early diagnosis and prognosis of CCA.MethodsWe recruited 100 patients who received endoscopic retrograde cholangiopancreatography at our hospital for bile duct obstruction due to CCA (n = 50) and biliary stone (n = 50). They were further divided into training set and validation set (3:2). A panel of CCA-specific ncRNAs including 5 miRNAs (PMID: 30165035) and 2 lncRNAs (PMID: 29050258) were detected in both serum and bile exosomes. The diagnostic accuracy was assessed using the area under the receiver operating characteristic curve. Logistic analysis was used to classify the potential predictors of CCA and further establish the diagnostic model. And the prognostic value of the ncRNAs was also assessed.ResultsExosomes were successfully collected from bile and serum. Exosomal miR-141-3p, miR-200a-3p, miR-200c-3p in serum and bile, as well as miR-200b-3p and ENST00000588480.1 in bile showed AUCs of &gt;0.70 in the diagnosis of CCA. Bile exosomal miR-200c-3p displayed the best diagnostic value with the AUC of 0.87. The combination of serum CA19-9 into the model could increase the AUC to 0.906. Bile exosomal miR-200a-3p and miR-200c-3p were found to be independent predictors of CCA. Among exosomal ncRNAs in human bile and blood, 3 (serum and bile exosomal miR-200c-3p, bile exosomal miR-200a-3p) showed significant value in predicting cancer recurrence and 1 (serum exosomal miR-200c-3p) had great predictive ability of cancer death. High levels of serum exosomal miR-200c-3p showed unfavorable tumor-free survival and overall survival.ConclusionThe bile exosomal miR-200 family, particularly miR-200c-3p, was verified to be a potential biomarker for the early detection of CCA. The diagnostic ability of exosomal ncRNAs in human bile is better than that in blood. Moreover, high levels of bile exosomal miR-200a-3p, miR-200c-3p, and serum exosomal miR-200c-3p represented adverse clinical outcomes.

ObjectivesAlthough guidelines recommend extended cholecystectomy for T2 gallbladder cancer (GBC), the optimal hepatectomy strategy remains controversial. The study aims to compare the prognosis of T2 GBC patients who underwent wedge resection (WR) versus segment IVb and V resection (SR) of the liver.MethodsA specific search of online databases was performed from May 2001 to February 2023. The postoperative efficacy outcomes were synthesized and meta-analyses were conducted.ResultsA total of 9 studies involving 2,086 (SR = 627, WR = 1,459) patients were included in the study. The primary outcomes included disease-free survival (DFS) and overall survival (OS). For DFS, the 1-year DFS was statistically higher in patients undergoing SR than WR [risk ratio (RR) = 1.07, 95% confidence interval (CI) = 1.02-1.13, P = 0.007]. The 3-year DFS (P = 0.95), 5-year DFS (P = 0.77), and hazard ratio (HR) of DFS (P = 0.72) were similar between the two groups. However, the 3-year OS was significantly lower in patients who underwent SR than WR [RR = 0.90, 95% CI = 0.82-0.99, P = 0.03]. Moreover, SR had a higher hazard HR of OS [HR = 1.33, 95% CI = 1.01-1.75, P = 0.04]. No significant difference was found in 1-year (P = 0.32) and 5-year (P = 0.9) OS. For secondary outcomes, patients who received SR tended to develop postoperative complications (POC) [RR = 1.90, 95% CI = 1.00-3.60, P = 0.05]. In addition, no significant differences in intrahepatic recurrence (P = 0.12) were observed.ConclusionsIn conclusion, SR can improve the prognosis of T2 GBC patients in DFS. In contrast to WR, the high HR and complications associated with SR cannot be neglected. Therefore, surgeons should evaluate the condition of the patients and take their surgical skills into account when selecting SR.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier, CRD42022362974.