• 제목/요약/키워드: prognostic scores

검색결과 90건 처리시간 0.021초

p53, Cyclin D1, p21 (WAF1) and Ki-67 (MIB1) Expression at Invasive Tumour Fronts of Oral Squamous Cell Carcinomas and Development of Local Recurrence

  • Sawair, F;Hassona, Y;Irwin, C;Stephenson, M;Hamilton, P;Maxwell, P;Gordon, D;Leonard, A;Napier, S
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권3호
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    • pp.1243-1249
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    • 2016
  • Background: Expression of p53, cyclin D1, p21 (WAF1) and Ki-67 (MIB1) was evaluated in oral squamous cell carcinoma (OSCC) to test whether levels of these markers at invasive tumour fronts (ITFs) could predict the development of local recurrence. Materials and Methods: Archived paraffin-embedded specimens from 51 patients with T1/T2 tumours were stained immunohistochemically and analysed quantitatively. Local recurrence-free survival was tested with Kaplan-Meier survival plots (log-rank test) using median values to define low and high expression groups and with a Cox's proportional hazards model in which the expression scores were entered as continuous variables. Results: The assessment of expression of all markers was highly reliable, univariate analysis showing that patients with clear surgical margins, with low cyclin D1 and high p21 expression at the ITF had the best local recurrence-free survival. Multivariate analysis showed that these three parameters were independent prognostic factors but that neither p53 nor MIB1 expression were of prognostic value. Conclusions: Assessment of p53, cyclin D1, p21 (WAF1), and Ki-67 (MIB1) at the ITF could help to predict local recurrence in early stage oral squamous cell carcinoma cases.

Lack of Effects of HER-2/neu on Prognosis in Colorectal Cancer: a Meta-analysis

  • Han, Jun;Meng, Qing-Yang;Liu, Xiao;Xi, Qiu-Lei;Zhuang, Qiu-Lin;Wu, Guo-Hao
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권14호
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    • pp.5551-5556
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    • 2014
  • Background: The prognostic value of human epidermal growth factor receptor-2 (HER-2/neu) for survival of patients with colorectal cancer (CRC) is still ambiguous. We therefore performed a meta-analysis to evaluate its prognostic significance. Materials and Methods: We searched the MEDLINE and EMBASE databases for published literature investigating associations between HER-2/neu status and overall survival of patients with CRC. A meta-analysis was performed using a DerSimonian-Laird model and publication bias was investigated by Begg's and Egger's tests. Subgroup analysis was also conducted according to the study design type, study quality score, cut-off value for HER-2/neu overexpression, publication region, patient number and publication year. Results: A total of 17 eligible studies involving 2,347 patients were identified for this meta-analysis. The combined hazard ratio (HR) was 1.31 (95% confidence interval (CI): 0.96-1.79), suggesting that HER-2/neu overexpression was not significantly associated with overall survival of patients with CRC. However, subgroup analysis revealed that HER-2/neu overexpression had an unfavorable impact on survival when the analysis was restricted to subgroups of study quality score ${\leq}5 $(HR=1.56, 95%CI: 1.17-2.10), Asian patients (HR=1.74, 95%CI: 1.22-2.49), patient number ${\leq}106$ (HR=1.57, 95%CI: 1.01-2.44), publication year before 2003 (HR=1.59, 95%CI: 1.02-2.49), and prospectively designed study (HR=3.62, 95%CI: 1.42-9.24). The effect disappeared in subgroups of study quality scores > 5 (HR=0.69, 95%CI: 0.33-1.44), non Asian patients (HR=1.14, 95%CI: 0.77-1.70), patients' number > 106 (HR=1.07, 95%CI: 0.67-1.72), publication year after 2003 (HR=1.13, 95%CI: 0.76-1.69), and retrospectively designed study (HR=1.22, 95%CI: 0.89-1.67). Conclusions: Our meta-analysis suggests that HER-2/neu overexpression might not be a significantly prognostic indicator for patients with CRC. Further studies are required to confirm these results.

만성 이첨판 폐쇄부전증 개에서 인슐린 분비기능 감소 (Decreased Insulin Secretion in Dogs with Chronic Mitral Valve Insufficiency)

  • 강종일;박성준;이승곤
    • 한국임상수의학회지
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    • 제31권3호
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    • pp.163-169
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    • 2014
  • 최근 사람연구에서는 심부전과 관련하여 발생하는 인슐린 저항성이나 공복혈당 이상과 같은 혈당 대사 이상 중요한 예후인자로 받아들여지고 있다. 그러나 심부전이 있는 개에서 이와 관련된 연구는 매우 드물다. 따라서 본 연구는 혈당대사이상이 이첨판 폐쇄 부전증이 있는 개에서도 나타날 것이라고 가정하였다. 총 113마리의 보호자가 있는 개를 대상으로 혈중 insulin, glucagon, fructosamine, glucose 를 측정하였으며, 인슐린 저항성은 homeostatic model assessment (HOMA) score를 이용하였다. 실험결과 혈중 인슐린 농도는 심장병이 심해짐에 따라서 유의성 있게 감소함을 확인하였다. 반면, fructosamine, HOMA score, and 공복 혈당은 심부전의 심각도와 어떠한 상관성도 보이지 않았다. 인슐린 농도, fructosamine, HOMA 의 경우 body condition scores (BCS)와 양의 유의적 상관관계를 보였으나, 혈당의 경우 그러지 않았다. 심부전과 BCS와의 음의 유의적 상관관계 또한 확인 되었다. 본 연구를 바탕으로 자연적으로 발생한 이첨판 폐쇄부전증에 따른 심부전 환자에서 심장 병이 심해짐에 따라서 인슐린 분비 기능이 감소함을 확인하였다.

Health-related Quality of Life After Treatment for Malignant Bone Tumors: A Follow-up Study in China

  • Sun, Yong-Jian;Hu, Yan-Jun;Jin, Dan;Li, Jian-Wei;Yu, Bin
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권7호
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    • pp.3099-3102
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    • 2012
  • Aim: We conducted the present study to assess health-related quality of life (HRQoL) among bone cancer patients after surgical treatment in one large teaching hospitals in China, and assess the risk factors for improving the physical or mental HRQoL. Methods: 344 eligible adult patients who were admitted to the hospital with malignant bone tumors during the period of Jun. 2008 to Dec. 2011, and a reference group with 361 health cases was recruited in the same hospital during the same period. All 344 patients were followed up for one year. The HRQoL before treatment and after one year was evaluated with the Medical Outcome Short Form 36 (SF-36). Results: All 8 domains of HRQoL had the lowest scores greatly improved over the first year after discharge. However, the patients still had significantly lower scores in every domain than the reference group one year after discharge. Age and type of surgery were associated with HRQoL in the mental domain. Conclusion: The HRQoL of patients with malignant bone tumors greatly improved one year after the treatment. This study also highlighted the utility of HRQoL assessment for prognostic evaluation of patients after surgical treatment for bone cancer.

아급성기 뇌졸중 환자의 체간 조절과 기능적 수행능력과의 관계 (The Relationship Between Postural Control and Functional Performance Ability in Subacute Stroke Patients)

  • 안승헌;조규행
    • PNF and Movement
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    • 제10권3호
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    • pp.7-18
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    • 2012
  • Purpose : This study was to compare the difference Trunk Control Test(TCT), Postural Assessment Scale for Stroke(PASS-TC), and Trunk Impairment Scale(TIS) and its subscales in relation to the difference MBI(Modified Barthel Index), BBS(Berg Balance Scale), and to establish the association between MBI, BBS, Fugl Meyer-motor function(FM-M), and to predict MBI-subscales from the variables. Methods : 58 stroke patients, attending a rehabilitation programme, participated in the study. Trunk control was measured with the use of the TCT, PASS-TC, TIS, and the performance of Activities daily living was obtained by MBI, and dynamic balance ability(by BBS). Trunk control scores from the difference MBI, BBS were compared using the 1-way ANOVA(Mann Whitney U test) and the data were analyzed using Pearson product correlation. Multiple stepwise regression analyses were performed to identify prognostic factors for ADL subscale. Results : Trunk control scores showed significant differences between MBI(F=2.139~13.737, p<.05~.001), BBS(t=3.491~7.705, p<.01~.001). It was significantly related with value of the MBI(r=.25~.50), BBS(r=.38~.68), FMM( r=.31~.48). Stepwise linear regression analysis showed an additional, significant contribution of the TCT, in addition to the PASS-TC, dynamic sitting balance subscale of the TIS for measures of MBI subscales. Conclusion : Measures of trunk control were significantly related with values of MBI, BBS score, so the management of trunk rehabilitation after stroke should be emphasized. The use of both quantitative and qualitative scales was shown to be a good measuring instrument for the classification of the general performance of the stroke patients. Further study about trunk control is needed using a longitudinal study design.

Prognostic factors affecting structural integrity after arthroscopic rotator cuff repair: a clinical and histological study

  • Pei Wei Wang;Chris Hyunchul Jo
    • Clinics in Shoulder and Elbow
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    • 제26권1호
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    • pp.10-19
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    • 2023
  • Background: Tendon degeneration contributes to rotator cuff tears; however, its role in postoperative structural integrity is poorly understood. The purpose of this study was to investigate the factors associated with postoperative structural integrity after rotator cuff repair, particularly focusing on the histology of tendons harvested intraoperatively. Methods: A total of 56 patients who underwent primary arthroscopic rotator cuff repair between 2009 and 2011 were analyzed. A 3-mm-diameter sample of supraspinatus tendons was harvested en bloc from each patient after minimal debridement of the torn ends. Tendon degeneration was assessed using seven histological parameters on a semi-quantitative grading scale, and the total degeneration score was calculated. One-year postoperative magnetic resonance imaging was used to classify the patients based on retear. Results: The total degeneration scores in the healed and retear groups were 13.93±2.03 and 14.08±2.23 (P=0.960), respectively. Arthroscopically measured anteroposterior (AP) tear sizes in the healed and retear groups were 24.30±12.35 mm and 36.42±25.23 mm (P=0.026), respectively. Preoperative visual analog scale pain scores at rest in the healed and retear groups were 3.54±2.37 and 5.16±2.16 (P=0.046), respectively. Retraction sizes in the healed and retear groups were 16.02±7.587 mm and 22.33±13.364 mm (P=0.037), respectively. The odds of retear rose by 4.2% for every 1-mm increase in AP tear size (P=0.032). Conclusions: The postoperative structural integrity of the rotator cuff tendon was not affected by tendon degeneration, whereas the arthroscopically measured AP tear size of the rotator cuff tendon was an independent predictor of retear. Level of evidence: III.

급성 폐손상 소아 환자에서 조기 예후 인자로서의 antithrombin-III (Antithrombin-III as an early prognostic factor in children with acute lung injury)

  • 이영승;김성국;강은경;박준동
    • Clinical and Experimental Pediatrics
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    • 제50권5호
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    • pp.443-448
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    • 2007
  • 목 적 : 급성 폐손상이 있는 소아에서 혈액 응고 과정에서 중요한 역할을 하는 AT-III의 예후인자로서의 의미를 확인하고자 대상 환자에서 진단 초기의 AT-III 값을 측정하고 사망여부에 따라 AT-III 값을 비교 분석하고 지금까지 알려진 여러 예후인자들과 비교 분석하였다. 방 법 : 2004년 6월부터 2005년 12월까지 18개월 동안 서울대학교병원 소아중환자실에 입원한 198명의 환자 중 급성 폐손상의 정의를 만족하고 기계적 환기요법을 받은 21명의 환자를 대상으로 인구의학적인 변수와 기저질환, 초기 안정화 이후의 호흡지수들, 기계적 환기요법의 여러 설정 등을 측정하였다. 중환자실 입원 24시간 이내의 PRISM-III 점수, LIS 점수를 측정하였고 입원 3시간 내의 AT-III 값을 측정하였다. 사망여부에 따라 두 군으로 분류한 후 예후인자를 비교분석하였고, PRISM-III 값과 AT-III 값에 대해서는 상관관계와 회귀분석을 함께 시행하였다. 단변수 분석에서 사망여부에 따라 통계적으로 유의한 변수에 대해서 중회귀 분석을 시행하여 상대위험도를 측정하였다. 결 과 : 18개월 동안 198명이 입원하였고 21명의 환자가 진단기준을 만족하였다. 남자가 13명(61.9%)였고 연령은 5(1-14)세였다. 급성 폐손상이 발생한 장소가 병원이 아닌 경우가 33.3%였고 기저질환이 폐 병변인 경우가 66.7%였다. 대상 환자 중 AT-III 값이 70% 이하인 경우가 10명(42.9%)이였고 8명의 환자가 사망하여 사망률은 38.1%였다. 사망에 따른 두 군 간의 비교에서 초기 안정화 이후 동맥혈 pH와 $PaO_2/FiO_2$는 사망한 환자군에서 유의하게 더 낮았고, OI와 호기말 양압은 사망한 환자군에서 유의하게 더 높았다. 폐 유순도는 사망한 환자군에서 유의하게 더 낮았다. LIS와 PRISM-III는 사망한 환자군에서 모두 유의하게 높았고 AT-III는 사망한 환자군에서 유의하게 더 낮았다. AT-III와 PRISM-III 값은 유의한 상관관계를 보였다. 중회귀분석에서 PRISM-III, LIS, OI는 모두 다른 변수에 독립적으로 유의한 사망의 위험인자였으며 70% 미만으로 정의한 AT-III 감소는 급성 폐손상 환자에서 다른 변수에 독립적으로 사망의 유의한 위험인자였다(OR 2.725, 95% CI 1.284-4.119). 결 론 : 급성 폐손상으로 기계적 환기요법을 시행 받은 소아환자를 대상으로 한 본 연구에서 초기 AT-III 값은 PRISM-III 값과 유의한 상관관계를 보였으며, 또한 사망한 환자군에서 AT-III 값이 유의하게 더 낮았고 이것은 다른 위험인자의 영향을 보정한 상태에서도 독립적인 사망의 위험인자였다. 이로써 AT-III가 급성 폐손상의 유의한 조기 예후 예측인자라는 것을 확인하였으며 향후 급성 폐손상/급성 호흡부전증후군 환자에서 응고장애를 정상화 할 수 있는 처치들이 예후를 향상시킬 수 있을 가능성을 제시하였다.

Garlic Phytocompounds Possess Anticancer Activity by Specifically Targeting Breast Cancer Biomarkers - an in Silico Study

  • Roy, Nabarun;Davis, Sangeetha;Narayanankutty, Arunaksharan;Nazeem, PA;Babu, TD;Abida, PS;Valsala, PA;Raghavamenon, Achuthan C
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권6호
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    • pp.2883-2888
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    • 2016
  • Background: Breast cancer (BC) is a serious lifestyle disease. There are several prognostic biomarkers like nuclear receptors whose over-expression is associated with BC characteristics. These biomarkers can be blocked by compounds with anti-cancer potential but selection must be made on the basis of no adverse side effects. This study is focused on finding of compounds from a plant source garlic. Materials and Methods: Twenty compounds from garlic and five targets considered involved in BC were retrieved from Pubchem database and Protein Data Bank respectively. They were docked using Accelrys Discovery Studio (DS) 4.0. The compounds which showed interaction were checked for drug likeliness. Results: Docking studies and ADMET evaluation revealed twelve compounds to be active against the targets. All the compounds displayed highly negative dock scores which indicated good interactions. Conclusions: The results of this study should help researchers and scientists in the pharmaceutical field to identify drugs based on garlic.

Clinical Grading System, Surgical Outcomes and Prognostic Analysis of Cranial Base Chordomas

  • Wang, Benlin;Tian, Fengxuan;Tong, Xiaoguang
    • Journal of Korean Neurosurgical Society
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    • 제65권3호
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    • pp.469-478
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    • 2022
  • Objective : Cranial base chordomas are rare, but their treatment is challenging. Tumor recurrence is still common despite improvements in microsurgical techniques and postoperative radiotherapy. We retrospectively analyzed the course of treatment, overall survival, and recurrence/progression of chordomas over the past 10 years. Methods : We retrospectively reviewed 50 patients who underwent surgery at Tianjin Huanhu Hospital between 2010 and 2020 and were pathologically diagnosed with chordomas. Tumor resection was performed within the maximum safe range in all patients; the extent of resection was evaluated by imaging; and the incidence of complications, recurrence or progression, and overall survival were assessed. Results : Fifty patients were divided into the low-risk group (LRG) and high-risk group (HRG) based on the cranial chordoma grading system (CCGS). The Karnofsky Performance Scale scores and gross total resection rate of the LRG were significantly higher than those of the HRG (p<0.05). The incidence of complications and mortality in the LRG were lower than those of HRG. The analysis of cumulative survival and cumulative recurrence free survival/progression free survival (RFS/PFS) showed no statistical differences in the extent of resection for survival, recurrence, or progression. Univariate and multivariate analyses showed that Ki-67 was significantly associated with tumor recurrence and was an independent hazard factor (p=0.02). Conclusion : The CCGS can help neurosurgeons anticipate surgical outcomes. Pathological results are important in evaluating the possibility of tumor recurrence, and postoperative radiotherapy improves overall survival and RFS/PFS.

간섬유화스캔을 이용한 선천성 담도 폐쇄증의 최적 수술시기 시험적 제안 (Tentative Proposal of Optimal Timing of Kasai Operation for Biliary Atresia Based on Fibroscan Results)

  • 이화영;박영아;한석주;고홍
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제14권1호
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    • pp.74-80
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    • 2011
  • 목 적: 선천성 담도폐쇄증의 일차적 치료로 알려진 Kasai 수술에서의 가장 중요한 예후 인자로 수술 시기가 중요하다는 것은 기존의 연구 결과들을 통해 잘 알려져 있다. 본 연구에서는 선천성 담도 폐쇄증 환아들을 수술 시기별로 분류하고 간섬유화 스캔을 수술 전후에 시행하여 얻어진 간탄성률값을 이용하여 수술 전후의 간 섬유화 변화를 비교함으로서 본 연구에서 도출된 최적의 수술시기가 기존의 연구와 일치하는지 재확인 하고자 한다. 방 법: 2007년 10월부터 2010년 7월까지 단일 기관에서 Kasai 수술을 시행 받은 환자 중, 수술 전후로 간섬유화 스캔을 시행한 환자 34명을 대상으로 수술 시기별 간탄성률 결과값을 비교하였다. 결 과: 환자군의 수술 시기가 빠를수록 수술 전과 후 모두에서 간탄성률 결과값은 좋았고, 특히 8주 이전에 수술을 시행 받은 경우 그 이상에서 수술을 받은 환자군보다 수술 후의 간섬유화가 적게 진행되었고 일부에서는 회복되었다. 또한 8주 수술 전후의 각 탄성률 간의 차이값 또한 통계적으로 유의하였다. 결 론: Kasai 수술의 시기가 이를수록 수술 전 간 섬유화가 적고, 적어도 8주 이전에서 Kasai 수술을 시행하였을 때 수술 이후의 간섬유화가 양호하였으며 수술전후의 간섬유화 진행 정도가 크지 않았다. 따라서 본 연구에서는 간섬유화스캔을 바탕으로 적어도 8주 미만의 연령이 Kasai 수술을 시행 받기에 최적의 시기임을 재확인하였다.