Locally advanced cervical cancer (LACC) is an early-stage cervical cancer characterized by a local tumor diameter of ≥4 cm. Patients with LACC have a relatively poor prognosis. Although preoperative radiochemotherapy (PRCT) might offer a valuable opportunity for subsequent radical surgery, surgeons should also consider the nonresponsive rate, the adverse effects of PRCT, and the surgical complications before designing a treatment plan. Therefore, biomarkers for predicting PRCT sensitivity and prognosis in patients with LACC are of high importance. We investigated the prognostic significance of vascular endothelial growth factor (VEGF) and hypoxia inducible factor-1α (HIF-1α) in patients with LACC. A total of 43 patients with LACC who underwent PRCT (one course each of intravenous chemotherapy and after-loading intracavitary brachytherapy followed by a radical hysterectomy) during the period 2009–2014 were included in this study. VEGF and HIF-1α expression levels were evaluated by immunohistochemistry in LACC lesions before and after PRCT. In addition, we analyzed the association of these proteins with the clinical response and pathological findings of pelvic lymph node metastasis (PLNM) after the subsequent surgery. The total clinical response rate was 81.39% after PRCT, including five complete responses and 30 partial responses. VEGF and HIF-1α expression before PRCT was significantly higher than after PRCT (VEGF: 85.71% vs 66.67%; HIF-1α: 83.33% vs 59.52%, P<0.05). In addition, the same trend was found in patients with PLNM compared to those without PLNM (VEGF: 100% vs 77.78%; HIF-1α: 100% vs 74.07%, P<0.05). The areas under the receiver operating characteristic curves were 0.896 and 0.835 when using pre-PRCT VEGF and HIF-1α expression levels, respectively, to diagnose PLNM in patients with LACC. Serial detection of VEGF and HIF-1α demonstrated a sensitivity of 66.67% and specificity of 88.89%. These findings suggest that VEGF and HIF-1α expressions are potential biomarkers for PRCT and have great clinical significance for the prediction of PRCT response and prognosis in patients with LACC.
Based on the current condition of Guangzhou subway network, the authors used GIS methods and extended the space syntax theory to analyze the accessibility of the subway network, and compared with actual passenger flow. The results show: 1)Space syntax is practicable to measure the accessibility of subway system; 2)Among all sections by division, the accessibility of Tiyuxilu-Chen Clan Academy is the highest, the accessibility of Yantang-Panyu Square is the second highest, while the accessibilities of Jiaokou–Xicun and Dongchong–Jinzhou are the lowest, the accessibility of Xilang -Chen Clan Academy is the second lowest; 3)The accessibility level of subway and actual passenger flow have a positive correlation, the higher the accessibility, the larger the passenger flow; 4)As a whole, line 1 has the highest accessibility and the largest passenger flow, followed closely by line 3. Their departure frequency and number of carriages should be properly increased to relieve passenger flow pressure. Line 4 has relatively low accessibility and less passenger flow, so it should appropriately decrease train frequency or extend departure interval to reduce operating cost at present. Certainly, space syntax inevitably has its limitations, but after proper extension, the space syntax method can be used to instruct traffic reconstructing and urban planning etc.
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