Abiraterone acetate is approved for the treatment of castration-resistant prostate cancer （CRPC）; however, its effects vary. An accurate prediction model to identify patient groups that will benefit from abiraterone...Abiraterone acetate is approved for the treatment of castration-resistant prostate cancer （CRPC）; however, its effects vary. An accurate prediction model to identify patient groups that will benefit from abiraterone treatment is therefore urgently required. The Chi model exhibits a good profile for risk classification, although its utility for the chemotherapy-naive group is unclear. This study aimed to externally validate the Chi model and develop a new nomogram to predict overall survival （OS）. We retrospectively analyzed a cohort of 110 patients. Patients were distributed among good-, intermediate-, and poor-risk groups, according to the Chi model. The good-, intermediate-, and poor-risk groups had a sample size of 59 （53.6%）, 34 （30.9%）, and 17 （15.5%） in our dataset, and a median OS of 48.4, 29.1, and 10.5 months, respectively. The C-index of external validation of Chi model was 0.726. Univariate and multivariate analyses identified low hemoglobin concentrations （〈110 g l^-1）, liver metastasis, and a short time interval from androgen deprivation therapy to abiraterone initiation （〈36 months） as predictors of OS. Accordingly, a new nomogram was developed with a C-index equal to 0.757 （95% CI, 0.678-0.836）. In conclusion, the Chi model predicted the prognosis of abiraterone-treated, chemotherapy-naive patients with mCRPC, and we developed a new nomogram to predict the overall survival of this group of patients with less parameters.展开更多
BACKGROUND Liver grafts from donation after circulatory death(DCD)are associated with a higher risk of early graft dysfunction,determined by the warm ischemia and cold ischemia times.It is essential to have precise cr...BACKGROUND Liver grafts from donation after circulatory death(DCD)are associated with a higher risk of early graft dysfunction,determined by the warm ischemia and cold ischemia times.It is essential to have precise criteria to identify this complication in order to guide therapeutic strategies.AIM To validate different graft and recipient survival scores in patients undergoing liver transplantation(LT)with DCD grafts.METHODS A retrospective and observational unicentric study was conducted on 65 LT patients with grafts obtained from controlled DCD donors from November 2013 to November 2022.The United Kingdom(UK)risk score,early allograft dysfunction(EAD)Olthoff score,and model for early allograft function(MEAF)score were used to evaluate the risk of graft and recipient survival post-transplant.For survival analysis purposes,we used the Kaplan-Meier method,and the differences between subgroups were compared using the log-rank(Mantel-Cox)test.RESULTS Sixty-five patients were included in the study.The UK risk score did not demonstrate predictive capacity for recipient or graft survival.However,in donors aged over 70 years old(18.4%),it significantly predicted graft survival(P<0.05).According to Kaplan-Meier survival curves,graft survival rates at 6 months,2 years,and 5 years in the futility group dramatically decreased to 50%compared to the other groups(log-rank 8.806,P<0.05).The EAD Olthoff and MEAF scores did not demonstrate predictive capacity for recipient or graft survival.Based on Kaplan-Meier survival curves,patients with a MEAF score≥7 had a lower graft survival rate at 6 months,2 years,and 5 years compared to patients with a lower MEAF score(log-rank 4.667,P<0.05).CONCLUSION In our series,both UK DCD risk score and MEAF score showed predictive capability for graft survival.展开更多
BACKGROUND： Cancer patients frequently visit the emergency department （ED） with various symptoms of cancer. The purpose of this study was to determine the clinical characteristics and 1-year survival rate of cancer...BACKGROUND： Cancer patients frequently visit the emergency department （ED） with various symptoms of cancer. The purpose of this study was to determine the clinical characteristics and 1-year survival rate of cancer patients in the ED of a university hospital. METHODS： We conducted a retrospective review of 408 cancer patients who visited the ED between January 2011 and December 2011. Patient information on demographics, chief complaints, findings, and survival was gathered from the hospital registry and corresponding health administration. RESULTS： The study included 240 （58.8%） males and 168 （41.2%） females with a median age of 57.9 years （range 19-87）. Regarding cancer staging, 266 patients （65.3%） had metastatic disease and 142 （34.7%） had local and Ioco-regional disease. The hospitalization rate was 59.6%. The most common symptoms were shortness of breath （23.2%）, pain （17.8%）, fever （14.2%）, and nausea/vomiting （14.4%）. The most common cancer sites were the lung （32.5%）, gastrointestinal system （25.4%）, and breast （9.3%）. The initial evaluation determined progressive disease （42.4%）, chemotherapy effects （20.7%）, infections （17.2%）, radiotherapy effects （4.7%）, extravasation （1.8%）, anemia （1.4%）, and unknown （11.3%）. During follow up, 191 （46.8%） patients died after admission to the ED. The 1-year overall survival of all patients was 7.3 months. CONCLUSIONS： Symptom management in cancer patients is a complex multifaceted concern for the emergency physician. Because of the increasing prevalence of cancer patients, emergency physicians should develop consensus algorithms in collaboration with the relevant disciplines to manage the commonly encountered problems.展开更多
Epidermal growth factor receptor (EGFR) has been shown to play an important role in the malignant progression of diffuse astrocytomas. Numerous studies have investigated the clinical significance of overexpression and...Epidermal growth factor receptor (EGFR) has been shown to play an important role in the malignant progression of diffuse astrocytomas. Numerous studies have investigated the clinical significance of overexpression and amplification of the EGFR gene in these tumours with ambiguous results. The aim of this study was therefore to review the literature to get the current prognostic and diagnostic status. The PubMed database was used to search for papers in English in the time period 1987-2010 using the following keywords: astrocytoma, glioma, c-erbB1, EGFR, glioblastoma, HER1 and prognosis. Other inclusion criteria were: 1) studies with more than 50 patients;2) patient age over 18 years;3) tumour grading according to the latest World Health Organization (WHO) classification (2007) and 4) EGFR overexpression assessed by immunohistochemistry. A total of 47 publications were included and several reported positive correlations between both EGFR gene amplification and overexpression with histological malignancy grade and survival. The results are, however, encumbered with elements of uncertainty involving for instance methodological diversities and small number of patients. Larger studies with standardized procedures are necessary to fully clarify the clinical role of EGFR in human astrocytomas.展开更多
目的探讨膜联蛋白A2(ANXA2)在胶质瘤中的表达和预后,并对相关基因进行京都基因与基因组百科全书(KEGG)分析,为探索胶质瘤的肿瘤标志物提供依据。方法通过UALCAN、GEPIA和ONCOMINE在线软件分析ANXA2在胶质瘤与癌旁组织的表达;使用UALCAN...目的探讨膜联蛋白A2(ANXA2)在胶质瘤中的表达和预后,并对相关基因进行京都基因与基因组百科全书(KEGG)分析,为探索胶质瘤的肿瘤标志物提供依据。方法通过UALCAN、GEPIA和ONCOMINE在线软件分析ANXA2在胶质瘤与癌旁组织的表达;使用UALCAN软件分析与ANXA2差异表达有相关性的基因;使用DAVID 6.8软件对ANXA2相关基因开展KEGG分析;使用Human protein atlas分析ANXA2相关基因的生存期;使用STRING软件进行ANXA2基因蛋白互作(PPI)分析。结果ANXA2在胶质瘤中表达上调。生存期分析结果显示,ANXA2在胶质瘤中高表达后生存期缩短。KEGG分析结合生存期分析结果显示,胶质瘤中高表达的15个基因的无病生存期缩短,12个基因的总生存期缩短。PPI结合这些基因的预后分析结果显示,TNFRSF1A、TGFB1、ITGB5是参与ANXA2调控表型的关键基因。结论ANXA2是胶质瘤中潜在的癌基因,并通过肿瘤相关信号通路调控TNFRSF1A、TGFB1、ITGB5参与胶质瘤的发生、发展及预后。展开更多
目的探讨腋窝淋巴结外软组织受累对三阴性乳腺癌(triple-negative breast cancer,TNBC)患者预后的影响。方法回顾性收集2017年1月至2019年1月期间南阳市中心医院收治的TNBC伴腋窝淋巴结转移患者,分析并比较腋窝淋巴结外软组织阳性和阴性...目的探讨腋窝淋巴结外软组织受累对三阴性乳腺癌(triple-negative breast cancer,TNBC)患者预后的影响。方法回顾性收集2017年1月至2019年1月期间南阳市中心医院收治的TNBC伴腋窝淋巴结转移患者,分析并比较腋窝淋巴结外软组织阳性和阴性TNBC患者的临床病理特征和预后情况并分析影响预后的因素。结果共纳入216例TNBC伴腋窝淋巴结转移患者,其中腋窝淋巴结外软组织阴性者123例、阳性者93例。相较于腋窝淋巴结外软组织阴性者,其阳性患者中组织学分级更高者(Ⅲ级)、淋巴结转移数目更多者(>10枚)、原发肿瘤直径更大者(>5 cm)占比更高(P<0.05)。多因素分析结果显示,淋巴结转移数目多(>10枚)是影响TNBC患者总生存期和无病生存期缩短的风险因素(P<0.05),腋窝淋巴结外软组织阳性是影响TNBC患者无病生存期缩短的风险因素(P<0.05),组织学分级高(Ⅲ级)和人类表皮生长因子受体2低表达是影响TNBC患者总生存期缩短的风险因素(P<0.05)。腋窝淋巴结外软组织阳性TNBC患者的5年累积无病生存率低于阴性患者且差异有统计学意义(70.2%比83.3%,χ^(2)=6.934,P=0.008),而二者的5年累积总生存率比较差异无统计学意义(75.3%比82.1%,χ^(2)=1.969,P=0.161)。结论从本研究结果看,TNBC患者中腋窝淋巴结外软组织阳性患者预后更差,尤其需多关注组织学分级Ⅲ级、淋巴结转移数目>10枚及人类表皮生长因子受体2低表达患者。展开更多
文摘Abiraterone acetate is approved for the treatment of castration-resistant prostate cancer （CRPC）; however, its effects vary. An accurate prediction model to identify patient groups that will benefit from abiraterone treatment is therefore urgently required. The Chi model exhibits a good profile for risk classification, although its utility for the chemotherapy-naive group is unclear. This study aimed to externally validate the Chi model and develop a new nomogram to predict overall survival （OS）. We retrospectively analyzed a cohort of 110 patients. Patients were distributed among good-, intermediate-, and poor-risk groups, according to the Chi model. The good-, intermediate-, and poor-risk groups had a sample size of 59 （53.6%）, 34 （30.9%）, and 17 （15.5%） in our dataset, and a median OS of 48.4, 29.1, and 10.5 months, respectively. The C-index of external validation of Chi model was 0.726. Univariate and multivariate analyses identified low hemoglobin concentrations （〈110 g l^-1）, liver metastasis, and a short time interval from androgen deprivation therapy to abiraterone initiation （〈36 months） as predictors of OS. Accordingly, a new nomogram was developed with a C-index equal to 0.757 （95% CI, 0.678-0.836）. In conclusion, the Chi model predicted the prognosis of abiraterone-treated, chemotherapy-naive patients with mCRPC, and we developed a new nomogram to predict the overall survival of this group of patients with less parameters.
文摘BACKGROUND Liver grafts from donation after circulatory death(DCD)are associated with a higher risk of early graft dysfunction,determined by the warm ischemia and cold ischemia times.It is essential to have precise criteria to identify this complication in order to guide therapeutic strategies.AIM To validate different graft and recipient survival scores in patients undergoing liver transplantation(LT)with DCD grafts.METHODS A retrospective and observational unicentric study was conducted on 65 LT patients with grafts obtained from controlled DCD donors from November 2013 to November 2022.The United Kingdom(UK)risk score,early allograft dysfunction(EAD)Olthoff score,and model for early allograft function(MEAF)score were used to evaluate the risk of graft and recipient survival post-transplant.For survival analysis purposes,we used the Kaplan-Meier method,and the differences between subgroups were compared using the log-rank(Mantel-Cox)test.RESULTS Sixty-five patients were included in the study.The UK risk score did not demonstrate predictive capacity for recipient or graft survival.However,in donors aged over 70 years old(18.4%),it significantly predicted graft survival(P<0.05).According to Kaplan-Meier survival curves,graft survival rates at 6 months,2 years,and 5 years in the futility group dramatically decreased to 50%compared to the other groups(log-rank 8.806,P<0.05).The EAD Olthoff and MEAF scores did not demonstrate predictive capacity for recipient or graft survival.Based on Kaplan-Meier survival curves,patients with a MEAF score≥7 had a lower graft survival rate at 6 months,2 years,and 5 years compared to patients with a lower MEAF score(log-rank 4.667,P<0.05).CONCLUSION In our series,both UK DCD risk score and MEAF score showed predictive capability for graft survival.
基金supported by the Baskent University Research Fund
文摘BACKGROUND： Cancer patients frequently visit the emergency department （ED） with various symptoms of cancer. The purpose of this study was to determine the clinical characteristics and 1-year survival rate of cancer patients in the ED of a university hospital. METHODS： We conducted a retrospective review of 408 cancer patients who visited the ED between January 2011 and December 2011. Patient information on demographics, chief complaints, findings, and survival was gathered from the hospital registry and corresponding health administration. RESULTS： The study included 240 （58.8%） males and 168 （41.2%） females with a median age of 57.9 years （range 19-87）. Regarding cancer staging, 266 patients （65.3%） had metastatic disease and 142 （34.7%） had local and Ioco-regional disease. The hospitalization rate was 59.6%. The most common symptoms were shortness of breath （23.2%）, pain （17.8%）, fever （14.2%）, and nausea/vomiting （14.4%）. The most common cancer sites were the lung （32.5%）, gastrointestinal system （25.4%）, and breast （9.3%）. The initial evaluation determined progressive disease （42.4%）, chemotherapy effects （20.7%）, infections （17.2%）, radiotherapy effects （4.7%）, extravasation （1.8%）, anemia （1.4%）, and unknown （11.3%）. During follow up, 191 （46.8%） patients died after admission to the ED. The 1-year overall survival of all patients was 7.3 months. CONCLUSIONS： Symptom management in cancer patients is a complex multifaceted concern for the emergency physician. Because of the increasing prevalence of cancer patients, emergency physicians should develop consensus algorithms in collaboration with the relevant disciplines to manage the commonly encountered problems.
文摘Epidermal growth factor receptor (EGFR) has been shown to play an important role in the malignant progression of diffuse astrocytomas. Numerous studies have investigated the clinical significance of overexpression and amplification of the EGFR gene in these tumours with ambiguous results. The aim of this study was therefore to review the literature to get the current prognostic and diagnostic status. The PubMed database was used to search for papers in English in the time period 1987-2010 using the following keywords: astrocytoma, glioma, c-erbB1, EGFR, glioblastoma, HER1 and prognosis. Other inclusion criteria were: 1) studies with more than 50 patients;2) patient age over 18 years;3) tumour grading according to the latest World Health Organization (WHO) classification (2007) and 4) EGFR overexpression assessed by immunohistochemistry. A total of 47 publications were included and several reported positive correlations between both EGFR gene amplification and overexpression with histological malignancy grade and survival. The results are, however, encumbered with elements of uncertainty involving for instance methodological diversities and small number of patients. Larger studies with standardized procedures are necessary to fully clarify the clinical role of EGFR in human astrocytomas.
文摘目的探讨膜联蛋白A2(ANXA2)在胶质瘤中的表达和预后,并对相关基因进行京都基因与基因组百科全书(KEGG)分析,为探索胶质瘤的肿瘤标志物提供依据。方法通过UALCAN、GEPIA和ONCOMINE在线软件分析ANXA2在胶质瘤与癌旁组织的表达;使用UALCAN软件分析与ANXA2差异表达有相关性的基因;使用DAVID 6.8软件对ANXA2相关基因开展KEGG分析;使用Human protein atlas分析ANXA2相关基因的生存期;使用STRING软件进行ANXA2基因蛋白互作(PPI)分析。结果ANXA2在胶质瘤中表达上调。生存期分析结果显示,ANXA2在胶质瘤中高表达后生存期缩短。KEGG分析结合生存期分析结果显示,胶质瘤中高表达的15个基因的无病生存期缩短,12个基因的总生存期缩短。PPI结合这些基因的预后分析结果显示,TNFRSF1A、TGFB1、ITGB5是参与ANXA2调控表型的关键基因。结论ANXA2是胶质瘤中潜在的癌基因,并通过肿瘤相关信号通路调控TNFRSF1A、TGFB1、ITGB5参与胶质瘤的发生、发展及预后。
文摘目的探讨腋窝淋巴结外软组织受累对三阴性乳腺癌(triple-negative breast cancer,TNBC)患者预后的影响。方法回顾性收集2017年1月至2019年1月期间南阳市中心医院收治的TNBC伴腋窝淋巴结转移患者,分析并比较腋窝淋巴结外软组织阳性和阴性TNBC患者的临床病理特征和预后情况并分析影响预后的因素。结果共纳入216例TNBC伴腋窝淋巴结转移患者,其中腋窝淋巴结外软组织阴性者123例、阳性者93例。相较于腋窝淋巴结外软组织阴性者,其阳性患者中组织学分级更高者(Ⅲ级)、淋巴结转移数目更多者(>10枚)、原发肿瘤直径更大者(>5 cm)占比更高(P<0.05)。多因素分析结果显示,淋巴结转移数目多(>10枚)是影响TNBC患者总生存期和无病生存期缩短的风险因素(P<0.05),腋窝淋巴结外软组织阳性是影响TNBC患者无病生存期缩短的风险因素(P<0.05),组织学分级高(Ⅲ级)和人类表皮生长因子受体2低表达是影响TNBC患者总生存期缩短的风险因素(P<0.05)。腋窝淋巴结外软组织阳性TNBC患者的5年累积无病生存率低于阴性患者且差异有统计学意义(70.2%比83.3%,χ^(2)=6.934,P=0.008),而二者的5年累积总生存率比较差异无统计学意义(75.3%比82.1%,χ^(2)=1.969,P=0.161)。结论从本研究结果看,TNBC患者中腋窝淋巴结外软组织阳性患者预后更差,尤其需多关注组织学分级Ⅲ级、淋巴结转移数目>10枚及人类表皮生长因子受体2低表达患者。
