Available evidence suggests that human cytomegalovirus (HCMV) infection may be implicated in the progression of colorectal cancer (CRC). However, the correlation between HCMV infection and survival outcomes in CRC patients is unclear. Here, we constructed a ow algorithm to identify HCMV sequences based on the RNA-seq data of CRC patients derived from Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO). The patients' clinical information matrix was used to calculate Euclidean distance to lter out suitable patients not infected with HCMV, combining with the patient's survival outcome to reveal how HCMV infection is involved in CRC progression.HCMV infection is widespread in CRC patients., The prevalence of HCMV infection is ranging from 10% to 36% in 4 independent CRC datasets with infection being concentrated in carcinoma tissue rather than in normal tissue. In addition, HCMV positive patients had a poor survival prognosis, with three of the HCMV genes associated with poor patient survival outcomes, UL82, UL42 and UL117. Most importantly, we suppose that the regulation of immune function by HCMV may be the key to the poor prognosis of CRC patients. We found that HCMV infection was associated with poor prognosis in CRC patients and identi ed three prognosis associated HCMV genes. The regulation of immune function caused by HCMV infection was the key factor while HCMV positive CRC patients mostly presented a state of immunosuppression. This may provide new ideas for personalized treatment of CRC patients, especially in immunotherapy.
Purpose: Red blood cell distribution width (RDW) has been considered as a potential indicator of the effects of treatment or as a prognostic indicator for various malignancies. Most chronic myeloid leukemia (CML) patients are in the chronic phase, but some have transformed to accelerated phase or blast phase (blast crisis). However, the clinical significance of RDW in CML remains limited. Patients and Methods: In the present study, detailed clinical information and the RDW of 168 healthy people and 153 CML patients (106 patients for the training cohort and 47 patients for the validation cohort) were retrospectively assessed. Results: Multivariate analysis demonstrated that patient age (OR, 1.081; 95CI% 1.039~1.125; p < 0.001), platelet counts (OR, 0.997; 95CI% 0.994~0.999; p = 0.001) and RDW at admission (OR,1.469; 95CI% 1.121~1.925; p = 0.005) were significantly associated with the patients with advanced phase. Among CML patients in the chronic phase, higher RDW was significantly associated with overall survival (OS; p = 0.0008) and the event-free survival (EFS; p = 0.0221) among CML patients with chronic phase, but not with Transformation-free survival (TFS; p = 0.0821). Furthermore, higher RDW was associated with higher mortality compared to patients with low RDW (CML-associated deaths; p < 0.0001). In addition, a decline in RDW is associated with the treatment of CML patients with tyrosine kinase inhibitors, especially at 6 and 12 months after the start of treatment. Conclusion: Higher RDW is a potential prognostic biomarker for chronic CML patients.
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