• Asian Pacific Journal of Cancer Prevention
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• 제16권11호
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• pp.4691-4698
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• 2015

Background: The tumor suppressor phosphatase and tensin homolog (PTEN) is an important negative regulator of cell-survival signaling. However, available results for the prognostic value of PTEN expression in patients with cancer remain controversial. Therefore, a meta-analysis of published studies investigating this issue was performed. Materials and Methods: A literature search via PubMed and EMBASE databases was conducted. Statistical analysis was performed by using the STATA 12.0 (STATA Corp., College, TX). Data from eligible studies were extracted and included into the meta-analysis using a random effects model. Results: A total of 3,810 patients from 27 studies were included in the meta-analysis, 22 investigating the relationship between PTEN expression and overall survival (OS) using univariate analysis, and nine with multivariate analysis. The pooled hazard ratio (HR) for OS was 1.64 (95% confidence interval (CI): 1.32-2.05) by univariate analysis and 1.56 (95% CI: 1.20-2.03) by multivariate analysis. In addition, eight papers including two disease-free-survival analyses (DFSs), four relapse-free-survival analyses (RFSs), three progression-free-survival analyses (PFSs) and one metastasis-free-survival analysis (MFS) reported the effect of PTEN on survival. The results showed that loss of PTEN expression was significant correlated with poor prognosis, with a combined HR of 1.74 (95% CI: 1.24-2.44). Furthermore, in the stratified analysis by the year of publication, ethnicity, cancer type, method, cut-off value, median follow-up time and neoadjuvant therapy in which the study was conducted, we found that the ethnicity, cancer type, method, median follow-up time and neoadjuvant therapy are associated with prognosis. Conclusions: Our study shows that negative or loss of expression of PTEN is associated with worse prognosis in patients with cancer. However, adequately designed prospective studies need to be performed for confirmation.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.1985-1988
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• 2013

Aim: To study any correlation of LKB1 expression with prognosis in hepatocellular carcinoma (HCC) cases. Methods: A total of 70 HCC patients and 20 primary intrahepatic stone patients in the first affiliated hospital of Wenzhou Medical College were enrolled in this study. LKB1 expression was detected by immunohistochemistry. Patients were followed-up and prognostic factors were evaluated. Result: LKB1 expression was decreased in the HCC samples. Loss of LKB1 expression in HCC was significantly related to histologic grade (P=0.010), vascular invasion (P=0.025) and TMN stage (P=0.011). Patients showing negative LKB1 expression had a significantly shorter disease-free and overall survival than those with positive expression (P = 0.001, P=0.000, respectively). Multivariate Cox regression analysis indicated that LKB1 expression level was an independent factor of survival (P = 0.033). Conclusion: HCC patients with decreased expression LKB1 have a poor prognosis. The loss of LKB1 expression is correlated with a lower survival rate.

• Tuberculosis and Respiratory Diseases
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• 제69권5호
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• pp.354-360
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• 2010

Background: Primary non-Hodgkin's lymphoma of the lung is a rare entity. It is represented commonly as marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type. Although there have been a few reviews of this lymphoma, clinical features, radiologic findings, management and prognosis have not been well defined. Methods: We reviewed the medical records of 24 patients with primary pulmonary lymphoma between January 1995 and September 2008; all diagnoses had been confirmed based on pathology. Results: The median follow-up time was 42.3 months (range, 0.1~131.2 months). Five (20.8%) patients were asymptomatic, 17 (70.8%) patients had pulmonary symptoms, and the remaining 2 (8.3%) patients presented with constitutional symptoms. There were 16 (66.7%) patients with MALT lymphoma, 4 (16.7%) patients with diffuse large B-cell lymphoma and 4 (16.7%) patients with lymphoma that had not received a WHO classification. Radiologic findings of primary pulmonary lymphoma were diverse and multiple nodule or consolidation was the most common finding regardless of pathologic lymphoma type. PET scan was carried out in 13 (54.2%) patients and all lesions showed notable FDG uptake. MALT lymphoma showed a trend of better prognosis (3-year survival, 78.8% vs. 70.0%; 5-year survival, 78.8% vs. 52.5%; p=0.310) than non-MALT lymphoma. Conclusion: Primary non-Hodgkin's lymphoma of the lung occurs with nonspecific clinical features and radiologic findings. MALT lymphoma is the most common pathologic type of primary pulmonary lymphoma. This entity of lymphoma appears to have a good prognosis and in this study, there was a trend of better outcome than non-MALT lymphoma.

• Journal of Gastric Cancer
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• 제1권3호
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• pp.168-173
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• 2001

Purpose: A positive esophageal margin is encountered in a total gastrectomy not infrequently. The aim of this retrospective review was to evaluate whether a positive esophageal margin predisposes a patient to loco-regional recurrence and whether it has an independent impact on long-term survival. Materials and Methods: A retrospective review of 224 total gastrectomies for adenocarcinomas was undertaken. The Chisquare test was used to determine the statistical significance of differences, and the Kaplan-Meier method was used to calculate survival rates. Significant differences in the survival rates were assessed using the log-rank test, and independent prognostic significance was evaluated using the Cox regression method. Results: The prevalence of esophageal margin involvement was $3.6\%$ (8/224). Univariate analysis showed that advanced stage (stage III/IV), tumor size ($\geq$5 cm), tumor site (whole or upper one-third of the stomach), macroscopic type (Borrmann type 4), esophageal invasion, esophageal margin involvement, lymphatic invasion, and venous invasion affected survival. Multivariate analysis demonstrated that TNM stage, venous invasion, and esophageal margin involvement were the only significant factors influencing the prognosis. All patients with a positive esophageal margin died with metastasis before local recurrence became a problem. A macroscopic proximal distance of more than 6 cm of esophagus was needed to be free of tumors, excluding one exceptional case which involved 15 cm of esophagus. Conclusion: All of the patients with a positive proximal resection margin after a total gastrectomy had advanced disease with a poor prognosis, but they were not predisposed to anastomotic recurrence. Early detection and extended, but reasonable, surgical resection of curable lesions are mandatory to improve the prognosis.

• Journal of Gastric Cancer
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• 제11권1호
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• pp.38-45
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• 2011

Purpose: Bone metastasis from stomach cancer occurs only rarely and it is known to have a very poor prognosis. This study examined the clinical characteristics and prognosis of patients who were diagnosed with stomach cancer and bone metastasis. Materials and Methods: The subjects were 19 patients who were diagnosed with stomach cancer at Hanyang University Medical Center from June 1992 to August 2010 and they also had bone metastasis. The survival rate according to many clinicopathologic factors was retrospectively analyzed. Results: 11 patients out of 18 patients (61%) who received an operation were in stage IV and the most common bone metastasis location was the spine. Bone scintigraphy was mostly used for diagnosing bone metastasis and PET-CT and magnetic resonance imaging were used singly or together. The serum alkaline phosphatase at the time of diagnosis had increased in 12 cases and there were clinical symptoms (bone pain) in 16 cases. Treatment was given to 14 cases and it was mostly radiotherapy. There were 2 cases of discovering bone metastasis at the time of diagnosing stomach cancer. The interval after operation to the time of diagnosing bone metastasis for the 18 cases that received a stomach cancer operation was on average $14.9{\pm}17.3$ months and the period until death after the diagnosis of bone metastasis was on average $3.8{\pm}2.6$ months. As a result of univariate survival rate analysis, the group that was treated for bone metastasis had a significantly better survival period when the bone metastasis was singular rather than multiple, as compared to the non-treatment group, yet both factors were not independent prognosis factors on multivariate survival analysis. Conclusions: An examination to confirm the status of bone metastasis when conducting a radio-tracer test after the initial diagnosis and also after an operation is needed for stomach cancer patients, and bone scintigraphy is the most helpfully modality. Making the diagnosis at the early stage and suitable treatments are expected to enhance the survival rate and improve the quality of life even for the patients with bone metastasis.

• Tuberculosis and Respiratory Diseases
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• 제81권4호
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• pp.305-310
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• 2018

Background: Mannose-binding lectin (MBL) deficiency leads to increased susceptibility to infection. We investigated whether serial changes in MBL levels are associated with the prognosis of patients diagnosed with septic shock, and correlated with cytokine levels. Methods: We enrolled 131 patients with septic shock in the study. We analyzed the serum samples for MBL and cytokine levels at baseline and 7 days later. Samples on day 7 were available in 73 patients. Results: We divided the patients with septic shock into four groups according to serum MBL levels (< $1.3{\mu}g/mL$ or ${\geq}1.3{\mu}g/mL$) on days 1 and 7. Patients with low MBL levels on day 1 and high MBL levels on day 7 showed a favorable prognosis for 28-day survival (odds ratio, 1.96, 95% confidence interval, 1.10-2.87; p=0.087). The high MBL group on day 7 showed a significant decrease in monocyte chemoattractant protein 1, interleukin (IL)-$1{\beta}$, IL-6, IL-8, interferon-${\gamma}$, and granulocyte macrophage colony-stimulating factor levels compared with the low MBL group on day 7. Conclusion: The increase in MBL levels of patients with septic shock may suggest a favorable prognosis and attenuate pro-inflammatory and anti-inflammatory responses.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7809-7812
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• 2015

Background: In non-small cell lung cancer (NSCLC) patients with preoperative high serum carcinoembryonic antigen (CEA) level, patients with a persistently high serum CEA level after surgery have been reported to have a poor prognosis. In addition, in other cancers, the post/preoperative serum CEA ratio has been reported as a useful parameter. Materials and Methods: We enrolled 123 NSCLC patients with preoperative high CEA levels (${\geq}5ng/mL$) who underwent curative surgery between 2004 and 2011. Prognostic significance of postoperative serum CEA level and the CEA ratio was examined. Results: The 5-year survival of patients with persistently high serum CEA level after surgery was poor. On the other hand, patients with normal postoperative serum CEA levels had significant favorable prognosis. The patients with CEA ratio>1 had poor prognosis, however the number was only 7 (5.7%). The 5-year survival rates of patients with other subgroup based on the CEA ratio ($0.5{\geq}CEA$ ratio and $0.5{\leq}CEA$ $ratio{\leq}1$) was similar. Multivariate analysis revealed prognostic significance for the postoperative serum CEA level but not the CEA ratio. Conclusions: For NSCLC patients with preoperative high serum CEA level, their postoperative serum CEA levels is a more significant prognostic factor than the post/preoperative serum CEA ratio.

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1171-1176
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• 2012

Objective: The current study aimedto screen for possible factors which affect prognosis of chondrosarcoma. Methods: Thirty seven cases were selected and analyzed statistically. The patients received surgical treatment at our hospital between December 2005 and March 2008. All of them had complete follow-up data. The survival rates were calculated by univariate analysis using the Kaplan-Meier method and tested by Log-rank. ${\chi}^2$ or Fisher exact tests were carried out for the numeration data. The significant indexes after univariate analysis were then analyzed by multivariate analysis using COX regression model. Based on the literature, factors of gender, age, disease course, tumor location, Enneking grades, surgical approaches, distant metastasis and local recurrence were examined. Results: Univariate analysis showed that there were significant differences in Enneking grades, surgical approaches and distant metastasis related to the patients' 3-year survival rate after surgery (P<0.001). No significant difference was not found in gender, age, disease course, tumor location or local recurrence (P>0.05). Multivariate analysis showed that Enneking grade (P=0.007) and surgical approaches (P=0.010) were independent factors affecting the prognosis of chondrosarcoma, but distant metastasis was not (P=0.942). Conclusion: Enneking grades, surgical approaches and distant metastasis are risk factors for prognosis of chondrosarcoma, among which the former two are independent factors.

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7219-7222
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• 2014

Background: Early gastric cancer (EGC) is well accepted as having a favorable prognosis, but some patients experience an ominous outcome after curative resection. This study was aimed at evaluating predictive factors associated with prognosis of D2 gastrectomies in patients with early gastric cancer. Materials and Methods: A total of 518 patients with early gastric cancer who underwent D2 gastrectomies were reviewed in this study. The clinicopathological features and surgical outcomes were analyzed. The survival rate was estimated using the Kaplan-Meier method and compared by log rank test. Prognostic factors were analyzed using a multivariate Cox proportional hazards model. Results: The 5-year survival rate was 90.3%. Tumor infiltration, lymph node metastasis and lymphovascular invasion were significant prognostic factors for survival. Gender, age, tumor size, tumor location, macroscopic type and histological type were not significant prognostic factors. Multivariate analysis indicated that lymph node metastasis was an independent poor prognosis factor. Conclusions: Early gastric cancers with lymph node metastasis have a relatively poor prognosis after standard surgery. Even after curative resection, patients with EGC with positive lymph nodes should be closely followed and be considered as candidates for comprehensive therapies.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6941-6943
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• 2013

Objective: The aim of this study is to investigate the influence of pregnancy on prognosis of thyroid cancer. Methods: A total of 72 patients aged between 15-45 years who underwent total or subtotal thyroidectomy and subsequently radioablation were followed up under suppression. Individuals who had term pregnancies after diagnosis of cancer (group 1, n: 36) and who were non-pregnant (group 2, n:36) were included in the study. Both groups were compared in terms of scintigraphic relapse and metastasis, ultrasonographic relapse, stage change of lympadenopathy at the beginning and at the end of the study. Results: Relapse was detected in 4 out of 36 pregnant patients (11.1%) and in 5 out of 36 non-pregnant patients (13.9%) with no significant difference between groups (p=1.00). Pathologic lymphadenopathy was detected in 2 out of 36 pregnant patients (5.6%) and in 2 out of 36 non-pregnant patients (5.6%) (p=1.00), and metastasis in 3 (8.3%) and in 1 (2.8%), respectively (p=0.61). While stage change was detected in only one pregnant patient (2.8%), and none of the non-pregnant again there was no significant difference (p=1.00). Conclusions: We conclude that pregnancy does not have an influence on prognosis of thyroid cancer.