Home Marital status and its correlation with age, race, and gender in prognosis of tonsil squamous cell carcinomas
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Marital status and its correlation with age, race, and gender in prognosis of tonsil squamous cell carcinomas

  • Yujiao Li and Chaosu Hu EMAIL logo
Published/Copyright: November 11, 2022

Abstract

The objective of this study was to assess the impact of marital status on tonsil squamous cell carcinomas (TSCCs) prognosis and to analyze whether the impact is correlated with gender, age, and race. We examined the clinicopathological variables using Chi-squared tests and evaluated the association between survival and different variables using the methods of Kaplan–Meier. Univariate and multivariate analyses were performed to determine the effects of each variable on survival. A total of 10,720 patients were analyzed. The rate of being married was higher among Asian or Caucasian, and this rate decreased with higher tumor stage. While both married male and female survivors benefit from their marital status, we found a differential in cancer-specific survival based on gender, with males benefitting more than females (p < 0.05). The same results were found in overall survival. Subgroup analysis shows that the protective effect of marriage was consistent in all patients except for N3 groups (all, p < 0.05). While there are survival benefits for married patients with TSCCs, married/partnered males may benefit more than females. Age, race, and gender could affect the correlation between marital status and survival.

1 Introduction

Tonsil squamous cell carcinoma (TSCC) is one of the most common oropharyngeal neoplasm and the incidence rates of TSCC have significantly increased in recent decades. With the development of treatment strategies, the survival of patients with TSCC has been significantly improved. Up-front surgery followed by adjuvant therapy, if appropriate, or radiotherapy alone has been the principal treatment modality for early-stage TSCC and postoperative radiotherapy has been used for close or positive resection margins, T3–4 tumors, and neck node metastases [13].

Recent studies assessing the effect of marriage on outcomes showed that marriage was associated with better survival, and the protective effect of marriage might result from that the married people were associated with earlier stage and were more likely to receive recommended or aggressive treatment, which was known as “spousal surveillance” [49]. In addition, married patients were considered to have more emotional and financial support, which helps them to prolong their overall survival (OS) [1012]. However, analysis of marital subgroup, which might reveal the potential mechanism generating the influence of marital status on prognosis, was not further analyzed.

Understanding the correlation between marital status and gender, race and age is important for developing tailored interventions aimed at improving socio-emotional support for patients. Therefore, we investigated the clinical correlates between marital status and survival and whether the association varied by gender, race, and age for TSCC using the Surveillance, Epidemiology, and End Results (SEER) database.

2 Materials and methods

2.1 Data sources

We obtained data from the current SEER database, which consists of 18 population-based cancer registries. This database collects and publishes cancer prevalence and survival data covering approximately 28% of the total population in the United States. SEER*Stat Version 8.3.4 (http://www.seer.cancer.gov/seerstat) from the National Cancer Institute was used to identify eligible patients in this study. We included patients diagnosed with microscopically confirmed TSCC between 1 January 2004 and 31 December 2014. We selected patients with only one primary malignancy in their lifetime. We excluded patients mainly because of the lack of pathology type of tumor, unknown marital status, unknown racial information, or unstaged tumors. A total of 10,720 TSCC patients were included.

2.2 Statistical analysis

Descriptive statistics were used to examine the baseline characteristics of the patients. The primary study outcomes were OS and cancer-specific survival (CSS). OS was defined as time to the date of death due to any cause or the date of last follow-up. CSS was defined as time from initial treatment to death due to cancer. Kaplan–Meier survival curves were compared using the log-rank test. Hazard analysis was conducted using the Cox proportional hazards model. SPSS software, version 22.0 (SPSS, Chicago, IL, USA) was used for additional data processing. p-Value of <0.05 was considered statistically significant for all tests.

2.3 Bias

The main limitation is the inherent bias that exists in retrospective studies.

3 Results

3.1 Clinical characteristics of all patients

Among the 10,720 patients, the median age was 58 years old (range [interquartile range]: 17–99 [52–65] years old). More than 80% patients (8,835/82.4%) were males. Among the cohort of the patients, 6,389 (59.6%), 3,739 (34.9%), and 592 (5.5%) patients were married/partnered, divorced/separated/single, and widowed, respectively. According to the 6th or 7th edition of UICC/AJCC Staging System, 1,687 (15.8%) and 9,033 (84.2%) were stage I–II and stage III–IV, respectively. The rate of being married was higher among Asian or Caucasian, and this rate decreased with higher tumor stage. Moreover, married/partnered patients received more surgeries. The clinicopathological features stratified by marital status at diagnosis are listed in Table 1.

Table 1

Demographic characteristics of TSCC patients who were stratified by marital status

Features n % Married/partnered Divorced/separated/single Widowed p
n n n
Gender 0.000
 Male 8,835 82.4 5,489 3,064 282
 Female 1,885 17.6 900 675 310
Age 0.000
 <58 5,165 48.2 3,127 1,964 74
 ≥58 5,555 51.8 3,262 1,775 518
Race 0.000
 Caucasian 9,385 87.5 5,794 3,097 494
 Asian 376 3.5 247 108 21
 African American 959 8.9 348 534 77
Stage 0.000
 I 683 6.4 402 213 68
 II 1,004 9.4 606 321 77
 III 2,316 21.6 1,426 756 134
 IVA 5,392 50.3 3,319 1,846 227
 IVB 1,041 9.7 498 481 62
 IVC 284 2.6 138 122 24
T classification 0.000
 T1 3,123 29.1 2,007 964 152
 T2 4,465 41.7 2,760 1,477 228
 T3 1,234 11.5 672 476 86
 T4a 1,208 11.3 623 502 83
 T4b 690 6.4 327 320 43
N classification 0.000
 N0 2,327 21.7 1,362 765 200
 N1 2,443 22.8 1,488 811 144
 N2a 1,236 11.5 794 401 41
 N2b 3,302 30.8 2,011 1,150 141
 N2c 938 8.8 503 392 43
 N3 474 4.4 231 220 23
Grade 0.000
 1 458 4.3 264 165 29
 2 4,547 42.4 2,591 1,683 273
 3 5,715 53.3 3,534 1,891 290
Surgery therapy 0.000
 Yes 5,891 55.0 3,811 1,820 260
 No 4,829 45.0 2,578 1,919 332
Tumor location 0.000
 Tonsillar fossa 1,555 14.5 876 567 112
 Tonsillar pillar 737 6.9 408 273 56
 Overlapping lesion of tonsil 121 1.1 57 60 4
 Tonsil, NOS 8,307 77.5 5,048 2,839 420

Abbreviations: NOS, not otherwise specified.

3.2 Survival

The overall mean follow-up of all patients in the cohort was 34.0 months (range [interquartile range], 0–131 [13–68] months) and mortality rate was equal to 25 per 100,000 persons-years. In the univariate analysis, age, gender, marital status, grade, T category, N category, and surgery therapies to the primary tumor were significantly associated with OS and CSS (p < 0.01) (Table 2).

Table 2

Univariate analysis of CSS stratified by gender

Prognostic factor Male Female
p-Value HR Lower 95% CI Higher 95% CI p-Value HR Lower 95% CI Higher 95% CI
Age 0.00 0.00
 <58 1 (Reference) 1 (Reference)
 ≥58 1.54 1.46 1.63 1.52 1.37 1.69
Marital status 0.00 0.00
 Married/partnered 1 (Reference) 1 (Reference)
 Divorced/separated/single 2.14 1.92 2.39 1.16 0.89 1.51
 Widowed 3.46 2.70 4.43 1.89 1.37 2.60
Race 0.00 0.01
 Caucasian 1 (Reference) 1 (Reference)
 Asian 1.11 0.83 1.49 0.78 0.40 1.51
 African American 2.42 2.09 2.81 2.31 1.71 3.12
Grade 0.00 0.00
 1 1 (Reference) 1 (Reference)
 2 0.81 0.62 1.05 0.89 0.56 1.41
 3 0.58 0.45 0.76 0.61 0.38 0.98
T classification 0.00 0.00
 T1 1 (Reference) 1 (Reference)
 T2 1.64 1.39 1.94 1.81 1.28 2.56
 T3 2.59 2.12 3.16 4.48 2.92 6.88
 T4a 4.87 4.07 5.83 5.16 3.56 7.48
 T4b 5.91 4.86 7.19 6.77 4.51 10.17
N classification 0.00 0.00
 N0 1 (Reference) 1 (Reference)
 N1 1.10 0.92 1.31 0.95 0.69 1.31
 N2a 0.51 0.40 0.66 0.74 0.47 1.19
 N2b 1.06 0.90 1.25 0.89 0.63 1.24
 N2c 2.44 2.02 2.95 2.12 1.45 3.08
 N3 1.90 1.51 2.40 3.41 2.05 5.66
Surgery therapy 0.00 3.17 2.82 3.55 0.00 3.68 2.87 4.71

Abbreviations: CI, confidence interval; HR, hazard ratio; p-values were calculated using an adjusted Cox proportional hazards model.

Kaplan–Meier analysis indicates that the married/partnered subgroup showed better OS and CSS than the unmarried groups, and the widowed patients showed worse prognosis for both genders (p < 0.001) (Figure 1).

Figure 1 
                  Kaplan–Meier analysis of OS and CSS in male and female TSCC patients: (a) OS in male TSCC patients (log rank p < 0.001), (b) OS in female TSCC patients (log rank p < 0.001), (c) CSS in male TSCC patients (log rank p < 0.001), and (d) CSS in female TSCC patients (log rank p < 0.001).
Figure 1

Kaplan–Meier analysis of OS and CSS in male and female TSCC patients: (a) OS in male TSCC patients (log rank p < 0.001), (b) OS in female TSCC patients (log rank p < 0.001), (c) CSS in male TSCC patients (log rank p < 0.001), and (d) CSS in female TSCC patients (log rank p < 0.001).

These risk factors associated with all causes and CSS, identified in the univariate Cox proportional hazards regression model, were included in the multivariate analyses and age, marital status, grade, T category, N category, and surgery therapies to the primary tumor were all independent prognostic factors in the multivariable analysis. While marriage was associated with better survival for both married male and female, subgroups’ analysis showed a differential in CSS based on gender, with males benefitting more than females (p < 0.01) (Table 3). The same results were found in OS.

Table 3

Multivariable Cox proportional hazards analysis for CSS stratified by gender

Prognostic factor Male Female
p-Value HR Lower 95% CI Higher 95% CI p-Value HR Lower 95% CI Higher 95% CI
Age 0.00 0.00
 <58 1 (Reference) 1 (Reference)
 ≥58 1.67 1.50 1.87 1.59 1.23 2.06
Marital status 0.00 0.00
 Married/partnered 1 (Reference) 1 (Reference)
 Divorced/separated/single 1.73 1.55 1.94 1.16 0.89 1.51
 Widowed 2.05 1.60 2.64 1.89 1.37 2.60
Race 0.00 0.01
 Caucasian 1 (Reference) 1 (Reference)
 Asian 1.12 0.83 1.50 0.82 0.42 1.60
 African American 1.60 1.37 1.86 1.63 1.19 2.23
Grade 0.00 0.00
 1 1 (Reference) 1 (Reference)
 2 0.88 0.68 1.15 0.84 0.52 1.35
 3 0.69 0.53 0.89 0.57 0.35 0.93
T classification 0.00 0.00
 T1 1 (Reference) 1 (Reference)
 T2 1.22 1.03 1.45 1.44 1.01 2.06
 T3 1.53 1.24 1.89 2.77 1.77 4.34
 T4a 2.77 2.29 3.35 3.36 2.26 4.98
 T4b 3.20 2.61 3.94 4.08 2.63 6.34
N classification 0.00 0.17
 N0 1 (Reference) 1 (Reference)
 N1 1.24 1.04 1.48 1.14 0.83 1.58
 N2a 0.71 0.55 0.91 0.98 0.61 1.58
 N2b 1.09 0.92 1.29 0.83 0.59 1.17
 N2c 1.64 1.35 1.99 1.48 1.00 2.19
 N3 1.43 1.13 1.81 3.30 1.97 5.55
Surgery therapy 0.00 2.04 1.80 2.31 0.00 2.40 1.84 3.14

Abbreviations: CI, confidence interval; HR, hazard ratio; p-values were calculated using an adjusted Cox proportional hazards model.

3.3 Effects of marital status stratified by subgroups

To rule out the effects of these variables and further validate the effect of marital status on OS and CSS, we conducted the subgroup analysis based on these variables (Table 4). Remarkably, the protective effect of marriage was consistent in all patients except for N3 groups (all, p < 0.05).

Table 4

Effect of marital status on OS and CSS based on different subgroup variables

Subgroups OS CSS
p-Value HR Lower 95% CI Higher 95% CI p-Value HR Lower 95% CI Higher 95% CI
Age
 <58 0.00 1.70 1.57 1.85 0.00 1.78 1.61 1.96
 ≥58 0.00 1.32 1.26 1.37 0.00 1.39 1.31 1.48
Race
 Caucasian 0.00 1.45 1.39 1.52 0.00 1.53 1.44 1.62
 Asian 0.00 1.42 1.14 1.77 0.00 1.72 1.29 2.28
 African American 0.00 1.36 1.23 1.50 0.00 1.43 1.25 1.64
Gender
 Male 0.00 1.53 1.46 1.61 0.00 1.66 1.55 1.77
 Female 0.00 1.39 1.30 1.48 0.00 1.40 1.27 1.55
Grade
 1 0.00 1.32 1.13 1.55 0.00 1.53 1.23 1.92
 2 0.00 1.46 1.38 1.54 0.00 1.56 1.45 1.68
 3 0.00 1.48 1.40 1.57 0.00 1.56 1.44 1.68
T classification
 T1 0.00 1.45 1.32 1.58 0.00 1.38 1.18 1.62
 T2 0.00 1.43 1.34 1.52 0.00 1.44 1.31 1.59
 T3 0.00 1.43 1.29 1.58 0.00 1.58 1.38 1.81
 T4a 0.00 1.48 1.36 1.62 0.00 1.63 1.46 1.82
 T4b 0.00 1.36 1.21 1.52 0.00 1.34 1.17 1.53
N classification
 N0 0.00 1.43 1.33 1.53 0.00 1.51 1.35 1.70
 N1 0.00 1.46 1.35 1.58 0.00 1.59 1.43 1.76
 N2a 0.00 1.41 1.18 1.68 0.00 1.64 1.29 2.08
 N2b 0.00 1.52 1.41 1.64 0.00 1.56 1.41 1.73
 N2c 0.00 1.51 1.35 1.69 0.00 1.62 1.40 1.87
 N3 0.04 1.21 1.01 1.46 0.06 1.22 0.99 1.50
Surgery therapy
 Yes 0.00 1.38 1.29 1.47 0.00 1.39 1.25 1.55
 No 0.00 1.43 1.37 1.50 0.00 1.51 1.42 1.61
Stage
 I 0.00 1.42 1.24 1.62 0.05 1.35 1.00 1.81
 II 0.00 1.46 1.30 1.64 0.00 1.44 1.17 1.78
 III 0.00 1.40 1.29 1.53 0.00 1.56 1.38 1.76
 IVA 0.00 1.55 1.46 1.64 0.00 1.68 1.55 1.82
 IVB 0.00 1.36 1.23 1.50 0.00 1.37 1.21 1.54
 IVC 0.00 1.31 1.12 1.52 0.00 1.34 1.11 1.61

Abbreviations: CI, confidence interval; HR, hazard ratio; p-values were calculated using an adjusted Cox proportional hazards model.

4 Discussion

We confirmed what previous studies had shown that marital status impacted on treatment outcome of TSCC patients in this study. Compared to other peers, the worse prognosis of widowed patients might have resulted from negative emotions and worse economic situation due to their unfavorable marital status. We further found that married/partnered males may benefit more than females, which relates to spousal influence on adoption of healthy behaviors, as well as the support to quit harmful risk factors associated with adverse outcomes [13]. Women tend to have a greater influence on their spouse’s health than men because women exert more effort to control their partners’ health habits [13,14]. Takagi et al. found that there was a spillover effect of the wife’s non-smoking only among men. However, husband’s non-smoking was not associated with female target’s cessation [15]. Generally speaking, the support received by male patients to adopt healthier lifestyles and have a positive outlook may explain their greater survival benefit from being married, which could partly explain the observed sex-based differences. The differential protective effect of marriage based on gender among TSCC patients is a novel finding, which is important for care planning and needs further exploration of the underlying specific mechanism behind this observation.

We then explored the effect of marital status on prognosis by different subgroups, such as age, race, stage, grade, and the surgery situation of patients. Difference of protective effect of marriage was found among variable subgroups except for N3 patients. Not only cancer, marriage also played a positive role in overall health. Kubzansky reported that marriage protected people from type 2 diabetes through favorable changes in lifestyle [16]. Another study of African Americans with heart failure proved that being married and living with family independently predict lower mortality and fewer readmissions [17]. Besides, a research of East Asian populations revealed marriage and marital satisfaction was of great importance in determining self-rated health [18]. These studies were compatible with our results that the greater impact of marital status on OS than CSS among variable subgroups.

As far as we know, this is the first SEER analysis assessing impact of age, race, and gender on the association between marital status and outcomes in TSCC. Several limitations were noted in this study. First, the SEER database does not include change of marital status after cancer diagnosis. Second, the lack of data on additional predictors of OS such as human papillomavirus infection, p16 status, performance status, comorbidities, tobacco smoking, alcohol consumption, betel nut, and mieng (a fermented ea-leaf) chewing, prevented us to adjust our analyses for these important factors. Finally, also due to the data limitations of the SEER database, positive surgical margins at final pathology were not able to be analyzed between marital status and CSS in this study.

5 Conclusion

Our results showed that while there are survival benefits for married/partnered patients with TSCC, married females may benefit more than males. Age, race, and gender could affect the correlation between marital status and survival.


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Acknowledgments

We acknowledge the support of the Department of Radiation Oncology, Fudan University Shanghai Cancer Center. The views expressed in this publication are those of the authors.

  1. Funding information: None.

  2. Author contributions: Yujiao Li and Chaosu Hu have made substantial contributions to all of the following: (1) the conception and design of the study, acquisition of data, and analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, and (3) final approval of the version to be submitted.

  3. Conflict of interest: The authors declare that they have no conflict of interest.

  4. Consent for publication: Not applicable.

  5. Data availability statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

[1] Ryerson AB, Peters ES, Coughlin SS, Chen VW, Gillison ML, Reichman ME, et al. Burden of potentially human papillomavirus-associated cancers of the oropharynx and oral cavity in the US, 1998–2003. Cancer – Am Cancer Soc. 2008;113(10 Suppl):2901–9.10.1002/cncr.23745Search in Google Scholar PubMed

[2] Schantz SP, Yu GP. Head and neck cancer incidence trends in young Americans, 1973–1997, with a special analysis for tongue cancer. Arch Otolaryngol Head Neck Surg. 2002;128(3):268–74.10.1001/archotol.128.3.268Search in Google Scholar PubMed

[3] Shiboski CH, Schmidt BL, Jordan RCK. Tongue and tonsil carcinoma: increasing trends in the U.S. population ages 20–44 years. Cancer – Am Cancer Soc. 2005;103(9):1843–9.10.1002/cncr.20998Search in Google Scholar PubMed

[4] Osazuwa-Peters N, Adjei BE, Chen BY, Tobo BB, Varvares MA. Association between head and neck squamous cell carcinoma survival, smoking at diagnosis, and marital status. JAMA Otolaryngol Head Neck Surg. 2018;144(1):43–50.10.1001/jamaoto.2017.1880Search in Google Scholar PubMed PubMed Central

[5] Schaefer EW, Wilson MZ, Goldenberg D, Mackley H, Koch W, Hollenbeak CS. Effect of marriage on outcomes for elderly patients with head and neck cancer. Head Neck. 2015;37(5):735–42.10.1002/hed.23657Search in Google Scholar PubMed

[6] Inverso G, Mahal BA, Aizer AA, Donoff RB, Chau NG, Haddad RI. Marital status and head and neck cancer outcomes. Cancer – Am Cancer Soc. 2015;121(8):1273–8.10.1002/cncr.29171Search in Google Scholar PubMed

[7] Aizer AA, Chen MH, McCarthy EP, Mendu ML, Koo S, Wilhite TJ, et al. Marital status and survival in patients with cancer. J Clin Oncol. 2013;31(31):3869–76.10.1200/JCO.2013.49.6489Search in Google Scholar PubMed PubMed Central

[8] Goodwin JS, Hunt WC, Key CR, Samet JM. The effect of marital status on stage, treatment, and survival of cancer patients. JAMA. 1987;258(21):3125–30.10.1001/jama.1987.03400210067027Search in Google Scholar

[9] Howren MB, Christensen AJ, Hynds KL, Van Liew JR, Funk GF. Influence of pretreatment social support on health-related quality of life in head and neck cancer survivors: results from a prospective study. Head Neck. 2013;35(6):779–87.10.1002/hed.23029Search in Google Scholar PubMed

[10] Osazuwa Peters N, Christopher KM, Cass LM, Massa ST, Hussaini AS, Behera A, et al. What’s love got to do with it? Marital status and survival of head and neck cancer. Eur J Cancer Care. 2019;28(4):e13022.10.1111/ecc.13022Search in Google Scholar PubMed

[11] Liao P, Lee C. The influence of marital status on survival for patients aged 65 years and younger with oral cavity cancer. Auris Nasus Larynx. 2018;45(6):1227–32.10.1016/j.anl.2018.03.007Search in Google Scholar PubMed

[12] Xu C, Chen YP, Liu X, Tang LL, Chen L, Mao YP, et al. Socioeconomic factors and survival in patients with non‐metastatic head and neck squamous cell carcinoma. Cancer Sci. 2017;108(6):1253–62.10.1111/cas.13250Search in Google Scholar PubMed PubMed Central

[13] Umberson D. Gender, marital status and the social control of health behavior. Soc Sci Med. 1992;34(8):907–17.10.1016/0277-9536(92)90259-SSearch in Google Scholar PubMed

[14] Reczek C, Pudrovska T, Carr D, Thomeer MB, Umberson D. Marital histories and heavy alcohol use among older adults. J Health Soc Behav. 2016;57(1):77–96.10.1177/0022146515628028Search in Google Scholar PubMed PubMed Central

[15] Takagi D, Kondo N, Takada M, Hashimoto H. Differences in spousal influence on smoking cessation by gender and education among Japanese couples. BMC Public Health. 2014;14:1184.10.1186/1471-2458-14-1184Search in Google Scholar PubMed PubMed Central

[16] Cornelis MC, Chiuve SE, Glymour MM, Chang SC, Tchetgen TE, Liang L, et al. Bachelors, divorcees, and widowers: does marriage protect men from type 2 diabetes? Plos One. 2014;9(9):e106720.10.1371/journal.pone.0106720Search in Google Scholar PubMed PubMed Central

[17] Lu M, Davila CD, Shah M, Wheeler DS, Ziccardi MR, Banerji S, et al. Marital status and living condition as predictors of mortality and readmissions among African Americans with heart failure. Int J Cardiol. 2016;222:313–8.10.1016/j.ijcard.2016.07.185Search in Google Scholar PubMed

[18] Chung W, Kim R. Does marriage really matter to health? Intra- and inter-country evidence from China, Japan, Taiwan, and the Republic of Korea. Plos One. 2014;9(8):e104868.10.1371/journal.pone.0104868Search in Google Scholar PubMed PubMed Central

Received: 2022-05-06
Revised: 2022-08-16
Accepted: 2022-08-24
Published Online: 2022-11-11

© 2022 Yujiao Li and Chaosu Hu, published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  55. NORAD modulates miR-30c-5p-LDHA to protect lung endothelial cells damage
  56. Idiopathic pulmonary fibrosis telemedicine management during COVID-19 outbreak
  57. Risk factors for adverse drug reactions associated with clopidogrel therapy
  58. Serum zinc associated with immunity and inflammatory markers in Covid-19
  59. The relationship between night shift work and breast cancer incidence: A systematic review and meta-analysis of observational studies
  60. LncRNA expression in idiopathic achalasia: New insight and preliminary exploration into pathogenesis
  61. Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway
  62. Moscatilin suppresses the inflammation from macrophages and T cells
  63. Zoledronate promotes ECM degradation and apoptosis via Wnt/β-catenin
  64. Epithelial-mesenchymal transition-related genes in coronary artery disease
  65. The effect evaluation of traditional vaginal surgery and transvaginal mesh surgery for severe pelvic organ prolapse: 5 years follow-up
  66. Repeated partial splenic artery embolization for hypersplenism improves platelet count
  67. Low expression of miR-27b in serum exosomes of non-small cell lung cancer facilitates its progression by affecting EGFR
  68. Exosomal hsa_circ_0000519 modulates the NSCLC cell growth and metastasis via miR-1258/RHOV axis
  69. miR-455-5p enhances 5-fluorouracil sensitivity in colorectal cancer cells by targeting PIK3R1 and DEPDC1
  70. The effect of tranexamic acid on the reduction of intraoperative and postoperative blood loss and thromboembolic risk in patients with hip fracture
  71. Isocitrate dehydrogenase 1 mutation in cholangiocarcinoma impairs tumor progression by sensitizing cells to ferroptosis
  72. Artemisinin protects against cerebral ischemia and reperfusion injury via inhibiting the NF-κB pathway
  73. A 16-gene signature associated with homologous recombination deficiency for prognosis prediction in patients with triple-negative breast cancer
  74. Lidocaine ameliorates chronic constriction injury-induced neuropathic pain through regulating M1/M2 microglia polarization
  75. MicroRNA 322-5p reduced neuronal inflammation via the TLR4/TRAF6/NF-κB axis in a rat epilepsy model
  76. miR-1273h-5p suppresses CXCL12 expression and inhibits gastric cancer cell invasion and metastasis
  77. Clinical characteristics of pneumonia patients of long course of illness infected with SARS-CoV-2
  78. circRNF20 aggravates the malignancy of retinoblastoma depending on the regulation of miR-132-3p/PAX6 axis
  79. Linezolid for resistant Gram-positive bacterial infections in children under 12 years: A meta-analysis
  80. Rack1 regulates pro-inflammatory cytokines by NF-κB in diabetic nephropathy
  81. Comprehensive analysis of molecular mechanism and a novel prognostic signature based on small nuclear RNA biomarkers in gastric cancer patients
  82. Smog and risk of maternal and fetal birth outcomes: A retrospective study in Baoding, China
  83. Let-7i-3p inhibits the cell cycle, proliferation, invasion, and migration of colorectal cancer cells via downregulating CCND1
  84. β2-Adrenergic receptor expression in subchondral bone of patients with varus knee osteoarthritis
  85. Possible impact of COVID-19 pandemic and lockdown on suicide behavior among patients in Southeast Serbia
  86. In vitro antimicrobial activity of ozonated oil in liposome eyedrop against multidrug-resistant bacteria
  87. Potential biomarkers for inflammatory response in acute lung injury
  88. A low serum uric acid concentration predicts a poor prognosis in adult patients with candidemia
  89. Antitumor activity of recombinant oncolytic vaccinia virus with human IL2
  90. ALKBH5 inhibits TNF-α-induced apoptosis of HUVECs through Bcl-2 pathway
  91. Risk prediction of cardiovascular disease using machine learning classifiers
  92. Value of ultrasonography parameters in diagnosing polycystic ovary syndrome
  93. Bioinformatics analysis reveals three key genes and four survival genes associated with youth-onset NSCLC
  94. Identification of autophagy-related biomarkers in patients with pulmonary arterial hypertension based on bioinformatics analysis
  95. Protective effects of glaucocalyxin A on the airway of asthmatic mice
  96. Overexpression of miR-100-5p inhibits papillary thyroid cancer progression via targeting FZD8
  97. Bioinformatics-based analysis of SUMOylation-related genes in hepatocellular carcinoma reveals a role of upregulated SAE1 in promoting cell proliferation
  98. Effectiveness and clinical benefits of new anti-diabetic drugs: A real life experience
  99. Identification of osteoporosis based on gene biomarkers using support vector machine
  100. Tanshinone IIA reverses oxaliplatin resistance in colorectal cancer through microRNA-30b-5p/AVEN axis
  101. miR-212-5p inhibits nasopharyngeal carcinoma progression by targeting METTL3
  102. Association of ST-T changes with all-cause mortality among patients with peripheral T-cell lymphomas
  103. LINC00665/miRNAs axis-mediated collagen type XI alpha 1 correlates with immune infiltration and malignant phenotypes in lung adenocarcinoma
  104. The perinatal factors that influence the excretion of fecal calprotectin in premature-born children
  105. Effect of femoral head necrosis cystic area on femoral head collapse and stress distribution in femoral head: A clinical and finite element study
  106. Does the use of 3D-printed cones give a chance to postpone the use of megaprostheses in patients with large bone defects in the knee joint?
  107. lncRNA HAGLR modulates myocardial ischemia–reperfusion injury in mice through regulating miR-133a-3p/MAPK1 axis
  108. Protective effect of ghrelin on intestinal I/R injury in rats
  109. In vivo knee kinematics of an innovative prosthesis design
  110. Relationship between the height of fibular head and the incidence and severity of knee osteoarthritis
  111. lncRNA WT1-AS attenuates hypoxia/ischemia-induced neuronal injury during cerebral ischemic stroke via miR-186-5p/XIAP axis
  112. Correlation of cardiac troponin T and APACHE III score with all-cause in-hospital mortality in critically ill patients with acute pulmonary embolism
  113. LncRNA LINC01857 reduces metastasis and angiogenesis in breast cancer cells via regulating miR-2052/CENPQ axis
  114. Endothelial cell-specific molecule 1 (ESM1) promoted by transcription factor SPI1 acts as an oncogene to modulate the malignant phenotype of endometrial cancer
  115. SELENBP1 inhibits progression of colorectal cancer by suppressing epithelial–mesenchymal transition
  116. Visfatin is negatively associated with coronary artery lesions in subjects with impaired fasting glucose
  117. Treatment and outcomes of mechanical complications of acute myocardial infarction during the Covid-19 era: A comparison with the pre-Covid-19 period. A systematic review and meta-analysis
  118. Neonatal stroke surveillance study protocol in the United Kingdom and Republic of Ireland
  119. Oncogenic role of TWF2 in human tumors: A pan-cancer analysis
  120. Mean corpuscular hemoglobin predicts the length of hospital stay independent of severity classification in patients with acute pancreatitis
  121. Association of gallstone and polymorphisms of UGT1A1*27 and UGT1A1*28 in patients with hepatitis B virus-related liver failure
  122. TGF-β1 upregulates Sar1a expression and induces procollagen-I secretion in hypertrophic scarring fibroblasts
  123. Antisense lncRNA PCNA-AS1 promotes esophageal squamous cell carcinoma progression through the miR-2467-3p/PCNA axis
  124. NK-cell dysfunction of acute myeloid leukemia in relation to the renin–angiotensin system and neurotransmitter genes
  125. The effect of dilution with glucose and prolonged injection time on dexamethasone-induced perineal irritation – A randomized controlled trial
  126. miR-146-5p restrains calcification of vascular smooth muscle cells by suppressing TRAF6
  127. Role of lncRNA MIAT/miR-361-3p/CCAR2 in prostate cancer cells
  128. lncRNA NORAD promotes lung cancer progression by competitively binding to miR-28-3p with E2F2
  129. Noninvasive diagnosis of AIH/PBC overlap syndrome based on prediction models
  130. lncRNA FAM230B is highly expressed in colorectal cancer and suppresses the maturation of miR-1182 to increase cell proliferation
  131. circ-LIMK1 regulates cisplatin resistance in lung adenocarcinoma by targeting miR-512-5p/HMGA1 axis
  132. LncRNA SNHG3 promoted cell proliferation, migration, and metastasis of esophageal squamous cell carcinoma via regulating miR-151a-3p/PFN2 axis
  133. Risk perception and affective state on work exhaustion in obstetrics during the COVID-19 pandemic
  134. lncRNA-AC130710/miR-129-5p/mGluR1 axis promote migration and invasion by activating PKCα-MAPK signal pathway in melanoma
  135. SNRPB promotes cell cycle progression in thyroid carcinoma via inhibiting p53
  136. Xylooligosaccharides and aerobic training regulate metabolism and behavior in rats with streptozotocin-induced type 1 diabetes
  137. Serpin family A member 1 is an oncogene in glioma and its translation is enhanced by NAD(P)H quinone dehydrogenase 1 through RNA-binding activity
  138. Silencing of CPSF7 inhibits the proliferation, migration, and invasion of lung adenocarcinoma cells by blocking the AKT/mTOR signaling pathway
  139. Ultrasound-guided lumbar plexus block versus transversus abdominis plane block for analgesia in children with hip dislocation: A double-blind, randomized trial
  140. Relationship of plasma MBP and 8-oxo-dG with brain damage in preterm
  141. Identification of a novel necroptosis-associated miRNA signature for predicting the prognosis in head and neck squamous cell carcinoma
  142. Delayed femoral vein ligation reduces operative time and blood loss during hip disarticulation in patients with extremity tumors
  143. The expression of ASAP3 and NOTCH3 and the clinicopathological characteristics of adult glioma patients
  144. Longitudinal analysis of factors related to Helicobacter pylori infection in Chinese adults
  145. HOXA10 enhances cell proliferation and suppresses apoptosis in esophageal cancer via activating p38/ERK signaling pathway
  146. Meta-analysis of early-life antibiotic use and allergic rhinitis
  147. Marital status and its correlation with age, race, and gender in prognosis of tonsil squamous cell carcinomas
  148. HPV16 E6E7 up-regulates KIF2A expression by activating JNK/c-Jun signal, is beneficial to migration and invasion of cervical cancer cells
  149. Amino acid profiles in the tissue and serum of patients with liver cancer
  150. Pain in critically ill COVID-19 patients: An Italian retrospective study
  151. Immunohistochemical distribution of Bcl-2 and p53 apoptotic markers in acetamiprid-induced nephrotoxicity
  152. Estradiol pretreatment in GnRH antagonist protocol for IVF/ICSI treatment
  153. Long non-coding RNAs LINC00689 inhibits the apoptosis of human nucleus pulposus cells via miR-3127-5p/ATG7 axis-mediated autophagy
  154. The relationship between oxygen therapy, drug therapy, and COVID-19 mortality
  155. Monitoring hypertensive disorders in pregnancy to prevent preeclampsia in pregnant women of advanced maternal age: Trial mimicking with retrospective data
  156. SETD1A promotes the proliferation and glycolysis of nasopharyngeal carcinoma cells by activating the PI3K/Akt pathway
  157. The role of Shunaoxin pills in the treatment of chronic cerebral hypoperfusion and its main pharmacodynamic components
  158. TET3 governs malignant behaviors and unfavorable prognosis of esophageal squamous cell carcinoma by activating the PI3K/AKT/GSK3β/β-catenin pathway
  159. Associations between morphokinetic parameters of temporary-arrest embryos and the clinical prognosis in FET cycles
  160. Long noncoding RNA WT1-AS regulates trophoblast proliferation, migration, and invasion via the microRNA-186-5p/CADM2 axis
  161. The incidence of bronchiectasis in chronic obstructive pulmonary disease
  162. Integrated bioinformatics analysis shows integrin alpha 3 is a prognostic biomarker for pancreatic cancer
  163. Inhibition of miR-21 improves pulmonary vascular responses in bronchopulmonary dysplasia by targeting the DDAH1/ADMA/NO pathway
  164. Comparison of hospitalized patients with severe pneumonia caused by COVID-19 and influenza A (H7N9 and H1N1): A retrospective study from a designated hospital
  165. lncRNA ZFAS1 promotes intervertebral disc degeneration by upregulating AAK1
  166. Pathological characteristics of liver injury induced by N,N-dimethylformamide: From humans to animal models
  167. lncRNA ELFN1-AS1 enhances the progression of colon cancer by targeting miR-4270 to upregulate AURKB
  168. DARS-AS1 modulates cell proliferation and migration of gastric cancer cells by regulating miR-330-3p/NAT10 axis
  169. Dezocine inhibits cell proliferation, migration, and invasion by targeting CRABP2 in ovarian cancer
  170. MGST1 alleviates the oxidative stress of trophoblast cells induced by hypoxia/reoxygenation and promotes cell proliferation, migration, and invasion by activating the PI3K/AKT/mTOR pathway
  171. Bifidobacterium lactis Probio-M8 ameliorated the symptoms of type 2 diabetes mellitus mice by changing ileum FXR-CYP7A1
  172. circRNA DENND1B inhibits tumorigenicity of clear cell renal cell carcinoma via miR-122-5p/TIMP2 axis
  173. EphA3 targeted by miR-3666 contributes to melanoma malignancy via activating ERK1/2 and p38 MAPK pathways
  174. Pacemakers and methylprednisolone pulse therapy in immune-related myocarditis concomitant with complete heart block
  175. miRNA-130a-3p targets sphingosine-1-phosphate receptor 1 to activate the microglial and astrocytes and to promote neural injury under the high glucose condition
  176. Review Articles
  177. Current management of cancer pain in Italy: Expert opinion paper
  178. Hearing loss and brain disorders: A review of multiple pathologies
  179. The rationale for using low-molecular weight heparin in the therapy of symptomatic COVID-19 patients
  180. Amyotrophic lateral sclerosis and delayed onset muscle soreness in light of the impaired blink and stretch reflexes – watch out for Piezo2
  181. Interleukin-35 in autoimmune dermatoses: Current concepts
  182. Recent discoveries in microbiota dysbiosis, cholangiocytic factors, and models for studying the pathogenesis of primary sclerosing cholangitis
  183. Advantages of ketamine in pediatric anesthesia
  184. Congenital adrenal hyperplasia. Role of dentist in early diagnosis
  185. Migraine management: Non-pharmacological points for patients and health care professionals
  186. Atherogenic index of plasma and coronary artery disease: A systematic review
  187. Physiological and modulatory role of thioredoxins in the cellular function
  188. Case Reports
  189. Intrauterine Bakri balloon tamponade plus cervical cerclage for the prevention and treatment of postpartum haemorrhage in late pregnancy complicated with acute aortic dissection: Case series
  190. A case of successful pembrolizumab monotherapy in a patient with advanced lung adenocarcinoma: Use of multiple biomarkers in combination for clinical practice
  191. Unusual neurological manifestations of bilateral medial medullary infarction: A case report
  192. Atypical symptoms of malignant hyperthermia: A rare causative mutation in the RYR1 gene
  193. A case report of dermatomyositis with the missed diagnosis of non-small cell lung cancer and concurrence of pulmonary tuberculosis
  194. A rare case of endometrial polyp complicated with uterine inversion: A case report and clinical management
  195. Spontaneous rupturing of splenic artery aneurysm: Another reason for fatal syncope and shock (Case report and literature review)
  196. Fungal infection mimicking COVID-19 infection – A case report
  197. Concurrent aspergillosis and cystic pulmonary metastases in a patient with tongue squamous cell carcinoma
  198. Paraganglioma-induced inverted takotsubo-like cardiomyopathy leading to cardiogenic shock successfully treated with extracorporeal membrane oxygenation
  199. Lineage switch from lymphoma to myeloid neoplasms: First case series from a single institution
  200. Trismus during tracheal extubation as a complication of general anaesthesia – A case report
  201. Simultaneous treatment of a pubovesical fistula and lymph node metastasis secondary to multimodal treatment for prostate cancer: Case report and review of the literature
  202. Two case reports of skin vasculitis following the COVID-19 immunization
  203. Ureteroiliac fistula after oncological surgery: Case report and review of the literature
  204. Synchronous triple primary malignant tumours in the bladder, prostate, and lung harbouring TP53 and MEK1 mutations accompanied with severe cardiovascular diseases: A case report
  205. Huge mucinous cystic neoplasms with adhesion to the left colon: A case report and literature review
  206. Commentary
  207. Commentary on “Clinicopathological features of programmed cell death-ligand 1 expression in patients with oral squamous cell carcinoma”
  208. Rapid Communication
  209. COVID-19 fear, post-traumatic stress, growth, and the role of resilience
  210. Erratum
  211. Erratum to “Tollip promotes hepatocellular carcinoma progression via PI3K/AKT pathway”
  212. Erratum to “Effect of femoral head necrosis cystic area on femoral head collapse and stress distribution in femoral head: A clinical and finite element study”
  213. Erratum to “lncRNA NORAD promotes lung cancer progression by competitively binding to miR-28-3p with E2F2”
  214. Retraction
  215. Expression and role of ABIN1 in sepsis: In vitro and in vivo studies
  216. Retraction to “miR-519d downregulates LEP expression to inhibit preeclampsia development”
  217. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part II
  218. Usefulness of close surveillance for rectal cancer patients after neoadjuvant chemoradiotherapy
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