prognosis factor

预后因素
  • 文章类型: Journal Article
    软组织肉瘤(STSs)代表由间充质细胞产生的不同组的肿瘤,影响人类和动物,包括狗。虽然STSs代表了一类罕见的肿瘤,尤其是在人类中,由于其局部复发和远处转移的可能性,它们构成了重大的临床挑战.狗,作为人类STS的模型,提供了几个优点,包括暴露于类似的环境风险因素,品种间的遗传多样性,和肿瘤的自发发展。此外,犬肿瘤紧密地模仿人类肿瘤的异质性和复杂性,使它们对疾病进展和治疗效果的研究有价值。目前在狗和人类中STS的治疗方法主要涉及手术。放射治疗,和化疗,根据肿瘤特征和患者因素做出治疗决定。然而,开发新的治疗策略至关重要,鉴于新药在临床试验中的高失败率。为了更好地设计新的定制治疗方法,了解肿瘤微环境(TME)是基础,因为它通过调节肿瘤行为在STS的启动和进展中起着至关重要的作用,促进血管生成,抑制免疫反应。值得注意的是,TME特征包括癌症相关成纤维细胞(CAF),细胞外基质(ECM)改变,和肿瘤相关巨噬细胞(TAMs),取决于它们的极化状态,会影响免疫反应,从而影响患者的预后。在这次审查中,基于免疫疗法的新的治疗方法将被深入研究,作为患有STSs的狗和人的潜在治疗选择。总之,这篇综述概述了目前对狗和人类STS的理解,强调TME和潜在治疗策略的重要性。
    Soft tissue sarcomas (STSs) represent a diverse group of tumors arising from mesenchymal cells, affecting both humans and animals, including dogs. Although STSs represent a class of rare tumors, especially in humans, they pose significant clinical challenges due to their potential for local recurrence and distant metastasis. Dogs, as a model for human STSs, offer several advantages, including exposure to similar environmental risk factors, genetic diversity among breeds, and the spontaneous development of tumors. Furthermore, canine tumors closely mimic the heterogeneity and complexity of human tumors, making them valuable for research into disease progression and treatment effectiveness. Current treatment approaches for STSs in both dogs and humans primarily involve surgery, radiation therapy, and chemotherapy, with treatment decisions based on tumor characteristics and patient factors. However, the development of novel therapeutic strategies is essential, given the high failure rate of new drugs in clinical trials. To better design new tailored treatments, comprehension of the tumor microenvironment (TME) is fundamental, since it plays a crucial role in STS initiation and progression by modulating tumor behavior, promoting angiogenesis, and suppressing immune responses. Notably, TME features include cancer-associated fibroblasts (CAFs), extracellular matrix (ECM) alterations, and tumor-associated macrophages (TAMs) that, depending on their polarization state, can affect immune responses and thus the patient\'s prognosis. In this review, new therapeutical approaches based on immunotherapy will be deeply explored as potential treatment options for both dogs and humans with STSs. In conclusion, this review provides an overview of the current understanding of STSs in dogs and humans, emphasizing the importance of the TME and potential treatment strategies.
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  • 文章类型: Journal Article
    甘油三酯-葡萄糖(TYG)指数是反映胰岛素抵抗的新颖且可靠的标记。其对心血管疾病发病和预后的预测能力已得到证实。然而,对于晚期慢性心力衰竭(acHF)患者,由于经常伴随的肾功能障碍(RD),TYG的预后价值受到挑战.因此,本研究以伴有RD的aHF患者为研究对象,探讨TYG指数对其预后的预测价值.纳入
    717例急性心力衰竭伴RD患者。acHF诊断基于2021年的acHFESC标准。RD定义为eGFR<90mL/(min/1.73m2)。根据TYG指数值将患者分为两组。主要终点是主要不良心血管事件(MACEs),次要终点是全因死亡率(ACM).随访时间为21.58(17.98~25.39)个月。使用ROC曲线确定预测MACE和ACM的最佳截止值。通过单因素和多因素COX回归分析揭示了MACEs和ACM的危险因素。根据单因素COX回归分析,高TyG指数被确定为MACE的危险因素(风险比=5.198;95%置信区间[CI],3.702-7.298;P<0.001)和ACM(风险比=4.461;95%CI,2.962-6.718;P<0.001)。多因素COX回归分析显示,高TyG组患者MACE风险增加440.2%(95%CI,3.771-7.739;P<0.001),ACM风险增加406.2%(95%CI,3.268-7.839;P<0.001)。Kaplan-Meier生存分析显示,TyG指数高的患者在30个月内经历MACE和ACM的风险升高。
    这项研究发现,TYG指数高的患者患MACEs和ACM的风险增加,TYG指数可作为预后的独立预测因子。
    UNASSIGNED: The triglyceride-glucose (TYG) index is a novel and reliable marker reflecting insulin resistance. Its predictive ability for cardiovascular disease onset and prognosis has been confirmed. However, for advanced chronic heart failure (acHF) patients, the prognostic value of TYG is challenged due to the often accompanying renal dysfunction (RD). Therefore, this study focuses on patients with aHF accompanied by RD to investigate the predictive value of the TYG index for their prognosis.
    UNASSIGNED: 717 acHF with RD patients were included. The acHF diagnosis was based on the 2021 ESC criteria for acHF. RD was defined as the eGFR < 90 mL/(min/1.73 m2). Patients were divided into two groups based on their TYG index values. The primary endpoint was major adverse cardiovascular events (MACEs), and the secondary endpoints is all-cause mortality (ACM). The follow-up duration was 21.58 (17.98-25.39) months. The optimal cutoff values for predicting MACEs and ACM were determined using ROC curves. Hazard factors for MACEs and ACM were revealed through univariate and multivariate COX regression analyses. According to the univariate COX regression analysis, high TyG index was identified as a risk factor for MACEs (hazard ratio = 5.198; 95% confidence interval [CI], 3.702-7.298; P < 0.001) and ACM (hazard ratio = 4.461; 95% CI, 2.962-6.718; P < 0.001). The multivariate COX regression analysis showed that patients in the high TyG group experienced 440.2% MACEs risk increase (95% CI, 3.771-7.739; P < 0.001) and 406.2% ACM risk increase (95% CI, 3.268-7.839; P < 0.001). Kaplan-Meier survival analysis revealed that patients with high TyG index levels had an elevated risk of experiencing MACEs and ACM within 30 months.
    UNASSIGNED: This study found that patients with high TYG index had an increased risk of MACEs and ACM, and the TYG index can serve as an independent predictor for prognosis.
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  • 文章类型: Journal Article
    原发性肿瘤切除与转移性肺腺癌(mLUAD)患者的生存获益相关。然而,目前还没有确定的方法来确定哪些个体将从手术中受益.因此,我们建立了一个模型来预测可能从手术中获益的患者的生存率.
    从监测中提取mLUAD患者的数据,流行病学,和结束结果(SEER)数据库。根据是否对原发肿瘤进行手术,患者分为两组:癌症定向手术(CDS)和非癌症定向手术(No-CDS).利用倾向评分匹配(PSM)来解决CDS组和无CDS组之间的偏差。使用Kaplan-Meier分析和Cox比例风险模型评估CDS的预后影响。随后,我们使用术前因素,根据多变量logistic回归分析,构建了一个列线图来预测手术获益的可能性.
    总共确认了89,039名合格患者,其中6.4%(5705例)接受手术。在PSM之后,与无CDS组相比,CDS组的中位总生存期(mOS)明显更长(23[21-25]vs.7[7-8]个月;P<0.001)。列线图在训练集和验证集中均显示出稳健的性能(曲线下面积[AUC]:分别为0.698和0.717),校准曲线表现出较高的一致性。根据决策曲线分析(DCA),列线图证明具有临床价值。根据这个列线图,手术患者分为两组:无获益候选人和获益候选人组.与无福利候选人组相比,受益候选组与更长的生存期相关(mOS:25vs.6个月,P<0.001)。此外,无益处候选人和无手术组之间的生存率没有差异(mOS:6vs.7个月,P=0.9)。
    开发了实用的列线图以确定mLUAD患者中的最佳CDS候选项。
    UNASSIGNED: Primary tumor resection is associated with survival benefits in patients with metastatic lung adenocarcinoma (mLUAD). However, there are no established methods to determine which individuals would benefit from surgery. Therefore, we developed a model to predict the patients who are likely to benefit from surgery in terms of survival.
    UNASSIGNED: Data on patients with mLUAD were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Depending on whether surgery was performed on the primary tumor, patients were categorized into two groups: cancer-directed surgery (CDS) and no-cancer-directed surgery (No-CDS). Propensity Score Matching (PSM) was utilized to address bias between the CDS and No-CDS groups. The prognostic impact of CDS was assessed using Kaplan-Meier analysis and Cox proportional hazard models. Subsequently, we constructed a nomogram to predict the potential for surgical benefits based on multivariable logistic regression analysis using preoperative factors.
    UNASSIGNED: A total of 89,039 eligible patients were identified, including 6.4% (5705) who underwent surgery. Following PSM, the CDS group demonstrated a significantly longer median overall survival (mOS) compared with the No-CDS group (23 [21-25] vs. 7 [7-8] months; P < 0.001). The nomogram showed robust performance in both the training and validation sets (area under the curve [AUC]: 0.698 and 0.717, respectively), and the calibration curves exhibited high consistency. The nomogram proved clinically valuable according to decision curve analysis (DCA). According to this nomogram, surgical patients were categorized into two groups: no-benefit candidates and benefit candidates groups. Compared with the no-benefit candidate group, the benefit candidate group was associated with longer survival (mOS: 25 vs. 6 months, P < 0.001). Furthermore, no difference in survival was observed between the no-benefit candidates and the no-surgery groups (mOS: 6 vs. 7 months, P = 0.9).
    UNASSIGNED: A practical nomogram was developed to identify optimal CDS candidates among patients with mLUAD.
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  • 文章类型: Observational Study
    背景:横纹肌溶解症是老年人的常见病,经常与跌倒有关。然而,横纹肌溶解症的预后因素主要在中年人群中进行研究。
    目的:验证年龄影响横纹肌溶解预后因素的假设。
    方法:这项回顾性单中心观察性研究包括所有肌酸激酶(CK)水平高于正常值五倍的患者,2013年至2019年期间入住雷恩大学医院。主要终点是30天住院死亡率。
    结果:343例患者(中位年龄:75岁)。平均峰值CK为21,825IU/L。57.7%的病例发生急性肾功能衰竭。对于70岁及以上的患者,主要病因是跌倒后长时间固定。30天住院死亡率为10.5%(23例死亡)。Charlson得分,用药数量和CK和肌酐水平因年龄而异.多变量分析显示年龄是相关因素,虽然不成比例,30天住院死亡率。
    结论:影响横纹肌溶解严重程度的因素不按年龄随机分布。术语横纹肌溶解包括各种临床现实并且与不同的机制相关。需要更多的研究来更好地了解横纹肌溶解的生理病理和预后因素,尤其是老年人。
    BACKGROUND: Rhabdomyolysis is a common condition in older adults, often associated with falls. However, prognostic factors for rhabdomyolysis have mainly been studied in middle-aged populations.
    OBJECTIVE: To test the hypothesis that age influences rhabdomyolysis prognostic factors.
    METHODS: This retrospective single-center observational study included all patients with a creatine kinase (CK) level greater than five times normal, admitted to Rennes University Hospital between 2013 and 2019. The primary endpoint was 30-day in-hospital mortality rate.
    RESULTS: 343 patients were included (median age: 75 years). The mean peak CK was 21,825 IU/L. Acute renal failure occurred in 57.7% of the cases. For patients aged 70 years and over, the main etiology was prolonged immobilization after a fall. The 30-day in-hospital mortality rate was 10.5% (23 deaths). The Charlson score, number of medications and CK and creatinine levels varied according to age. Multivariate analysis showed age to be a factor that was associated, although not proportionally, with 30-day in-hospital mortality.
    CONCLUSIONS: Factors influencing rhabdomyolysis severity were not randomly distributed according to age. The term rhabdomyolysis encompasses various clinical realities and is associated with different mechanisms. More research is needed to better understand the physio-pathological and prognostic factors of rhabdomyolysis, especially in older adults.
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  • 文章类型: Journal Article
    背景:探讨胃肝样腺癌(HAS)患者的CT征象与临床病理特征和疾病复发之间的关系。
    方法:回顾性收集49例接受根治性手术的HAS患者。分析CT与临床病理特征及疾病复发的关系。采用受试者工作特征(ROC)曲线建立多因素logistic模型并评价其预测复发的价值。使用Kaplan-Meier方法比较模型定义的风险组之间的生存曲线。
    结果:24例(49.0%)患者出现疾病复发。多因素Logistic分析结果显示血清CEA水平升高,瘤周脂肪间隙侵犯和病理血管癌栓阳性是疾病复发的独立因素。赔率为10.87(95CI,1.14-103.66),6.83(95CI,1.08-43.08)和42.67(95CI,3.66-496.85),分别。构建的模型显示ROC下的面积为0.912(95CI,0.825-0.999)。模型定义的高危组的总生存率和无复发生存率均低于低危组(均P<0.001)。
    结论:肿瘤周围脂肪间隙侵犯的术前CT表现,血清CEA水平升高,病理血管癌栓提示HAS患者预后不良。
    To investigate the association between CT signs and clinicopathological features and disease recurrence in patients with hepatoid adenocarcinoma of stomach (HAS).
    Forty nine HAS patients undergoing radical surgery were retrospectively collected. Association between CT and clinicopathological features and disease recurrence was analyzed. Multivariate logistic model was constructed and evaluated for predicting recurrence by using receiver operating characteristic (ROC) curve. Survival curves between model-defined risk groups was compared using Kaplan-Meier method.
    24(49.0%) patients developed disease recurrence. Multivariate logistic analysis results showed elevated serum CEA level, peritumoral fatty space invasion and positive pathological vascular tumor thrombus were independent factors for disease recurrence. Odds ratios were 10.87 (95%CI, 1.14-103.66), 6.83 (95%CI, 1.08-43.08) and 42.67 (95%CI, 3.66-496.85), respectively. The constructed model showed an area under ROC of 0.912 (95%CI,0.825-0.999). The model-defined high-risk group showed poorer overall survival and recurrence-free survival than the low-risk group (both P < 0.001).
    Preoperative CT appearance of peritumoral fatty space invasion, elevated serum CEA level, and pathological vascular tumor thrombus indicated poor prognosis of HAS patients.
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  • 文章类型: Journal Article
    简介:骨转移是导致晚期乳腺癌患者生存率下降的主要原因之一。因此,在疾病的早期阶段,找到这种类型的转移发生的预后标志物是至关重要的。目前,癌症相关成纤维细胞,它们代表了肿瘤微环境中80%的成纤维细胞,是研究新生物标志物和开发替代疗法的有趣目标。这项研究评估了早期乳腺癌患者癌症相关成纤维细胞中CD105表达的预后意义。方法:采用免疫组织化学方法评估浸润性导管癌(n=342)中CD105的表达,分析其与临床病理特征的关系。结果:CD105在癌症相关成纤维细胞中的高表达与转移发生的风险增加相关(p=0.0003)。特别是骨转移(p=0.0005)。此外,高CD105表达与较短的无转移生存期相关,无骨转移生存率,和总生存期(分别为p=0.0002,0.0006和0.0002)。CD105表达也是无转移生存的独立预后因素,无骨转移生存率,和总生存期(分别为p=0.0003,0.0006和0.0001)。讨论:CD105在癌症相关成纤维细胞中的高表达是早期乳腺癌患者骨转移的独立预后标志物。因此,CD105(+)CAF的评估对于根据BCP的个体风险状况对BM的发展进行分层至关重要,加强治疗策略和结果。
    Introduction: Bone metastasis is one of the causes that mainly decrease survival in patients with advanced breast cancer. Therefore, it is essential to find prognostic markers for the occurrence of this type of metastasis during the early stage of the disease. Currently, cancer-associated fibroblasts, which represent 80% of the fibroblasts present in the tumor microenvironment, are an interesting target for studying new biomarkers and developing alternative therapies. This study evaluated the prognostic significance of the CD105 expression in cancer-associated fibroblasts in early breast cancer patients. Methods: Immunohistochemistry was used to assess CD105 expression in invasive ductal breast carcinomas (n = 342), analyzing its association with clinical and pathological characteristics. Results: High CD105 expression in cancer-associated fibroblasts was associated with an increased risk of metastatic occurrence (p = 0.0003), particularly bone metastasis (p = 0.0005). Furthermore, high CD105 expression was associated with shorter metastasis-free survival, bone metastasis-free survival, and overall survival (p = 0.0002, 0.0006, and 0.0002, respectively). CD105 expression also constituted an independent prognostic factor for metastasis-free survival, bone metastasis-free survival, and overall survival (p = 0.0003, 0.0006, and 0.0001, respectively). Discussion: The high CD105 expression in cancer-associated fibroblasts is an independent prognostic marker for bone metastasis in early breast cancer patients. Therefore, the evaluation of CD105(+) CAFs could be crucial to stratify BCPs based on their individual risk profile for the development of BM, enhancing treatment strategies and outcomes.
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  • 文章类型: Journal Article
    未经证实:我们的目的是评估首次异基因干细胞移植(allo-HSCT1)后复发的血液系统恶性肿瘤患者中第二次异基因干细胞移植(allo-HSCT2)的预后因素。
    UNASSIGNED:我们回顾性分析了199例恶性血液病患者,这些患者在2012年11月至2021年10月期间接受allo-HSCT1复发后接受allo-HSCT2作为抢救治疗。
    UNASSIGNED:allo-HSCT2的中位年龄为23岁(范围:3-60岁)。HSCT1后的中位复发时间为9个月(范围:1-72个月)。在allo-HSCT2之前,患者具有以下造血细胞移植合并症指数(HCT-CI):127评分为0,52评分为1,20评分为2或更高。50%的患者在HSCT1复发后接受了嵌合抗原受体(CAR)T细胞治疗。119例患者的疾病状态为微小残留病(MRD)阴性完全缓解(CR),37例患者中MRD阳性CR,43例患者在allo-HSCT2之前未缓解(NR)。从194例患者(97.4%)的新供体中进行了Allo-HSCT2,134例患者(67.3%)接受了具有新的不匹配单倍型的移植物。中位随访时间为24个月(6-98个月),两年OS和LFS分别为43.8%±4.0%和42.1%±4.1%,分别。2年累积复发率(CIR)和非复发死亡率(NRM)分别为30.0%±4.8%和38.5%±3.8%,分别。多因素Cox回归分析显示MRD阴性CR、与没有这些特征的患者相比,allo-HSCT2之前的HCT-CI评分为0,并且新的不匹配单倍型供体是OS和LFS改善的预测因素。基于这三个有利因素,我们为接受allo-HSCT2治疗的患者开发了一种预测评分系统.与预后评分为3的患者相比,具有这三个因素的患者的2年OS为63.3%±6.7%,LFS为63.3%±6.7%,CIR为5.5%±3.1%。0。Allo-HSCT2是可行的,并且在Allo-HSCT2之前具有良好预后特征的患者-CR/MRD-和HCT-CI评分为0的疾病状态以及具有新的不匹配单倍型的第二供体可以从第二次Allo-HSCT中获得最大益处。
    UNASSIGNED:Allo-HSCT2是可行的,并且在Allo-HSCT2疾病状态CR/MRD-和HCT-CI评分为0之前具有良好预后特征的患者以及具有新的不匹配单倍型的第二个供体可以从第二个Allo-HSCT中获得最大益处。
    We aimed to evaluate prognostic factors of a second allogeneic stem cell transplantation (allo-HSCT2) among hematological malignancy patients who have relapsed after the first allo-HSCT(allo-HSCT1).
    We retrospectively analyzed 199 hematological malignancy patients who received allo-HSCT2 as a salvage treatment post allo-HSCT1 relapse between November 2012 and October 2021.
    The median age at allo-HSCT2 was 23 (range: 3-60) years. The median time to relapse after HSCT1 was 9 (range: 1-72) months. Prior to allo-HSCT2, patients had the following hematopoietic cell transplantation-comorbidity indexes (HCT-CI): 127 with a score of 0, 52 with a score of 1, and 20 with a score of 2 or greater. Fifty percent of patients received chimeric antigen receptor (CAR) T-cell therapy following HSCT1 relapse. Disease status was minimal residual disease (MRD)-negative complete remission (CR) among 119 patients, MRD-positive CR among 37 patients and non-remission (NR) for 43 patients prior to allo-HSCT2. Allo-HSCT2 was performed from a new donor in 194 patients (97.4%) and 134 patients (67.3%) received a graft with a new mismatched haplotype. The median follow-up time was 24 months (range: 6-98 months), and the 2-year OS and LFS were 43.8% ± 4.0% and 42.1% ± 4.1%, respectively. The 2-year cumulative incidence of relapse (CIR) and non-relapse mortality (NRM) was 30.0%±4.8% and 38.5%±3.8%, respectively. Cox regression multivariate analysis showed that disease statusof MRD-negative CR, HCT-CI score of 0 prior to allo-HSCT2, and new mismatched haplotype donor were predictive factors of improved OS and LFS compared to patients without these characteristics. Based on these three favorable factors, we developed a predictive scoring system for patients who received allo-HSCT2. Patients with a prognostic score of 3 who had the three factors showed a superior 2-year OS of 63.3% ± 6.7% and LFS of 63.3% ± 6.7% and a lower CIR of 5.5% ± 3.1% than patients with a prognostic score of 0. Allo-HSCT2 is feasible and patients with good prognostic features prior to allo-HSCT2 -disease status of CR/MRD- and HCT-CI score of 0 as well as a second donor with a new mismatched haplotype could have the maximal benefit from the second allo-HSCT.
    Allo-HSCT2 is feasible and patients with good prognostic features prior to allo-HSCT2 -disease status of CR/MRD- and HCT-CI score of 0 as well as a second donor with a new mismatched haplotype could have the maximal benefit from the second allo-HSCT.
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  • 文章类型: Journal Article
    这项研究的目的是调查I期卵巢透明细胞癌(OCCC)中肿瘤大小的预后价值和分层截止点。
    这是一项使用监测的回顾性队列研究,流行病学,和最终结果数据库(版本:SEER8.3.9)。纳入1988年至2018年诊断为I期OCCC的患者进行进一步分析。X-Tile软件用于鉴定肿瘤大小的潜在截止点。分层分析,倾向得分匹配,和逆概率加权分析用于平衡潜在的混杂因素。
    共纳入1,000例I期OCCC患者。在这1000名患者中,中位随访时间为106个月(95%可信区间[CI]:89-112个月).多因素分析显示肿瘤大小,诊断时的年龄,和IC期与I期OCCC患者显著相关。八厘米是一个有希望的临界点,可以将I期OCCC患者分为预后良好或不良组。在用倾向得分匹配和逆概率加权控制潜在的混杂因素后,我们证明,肿瘤大小≤8厘米的I期OCCC患者的5年总生存率显著提高(OS,89.8%与81%,p<0.0001)。肿瘤大小≤8cm是I期OCCC患者的独立预后因素(风险比[HR]0.5608,95%CI:0.4126-0.7622,p=0.0002)。
    肿瘤大小是I期OCCC的独立预后因素,和8厘米是一个有希望的分界点肿瘤大小的风险分层。然而,在I期OCCC患者的分层管理中使用肿瘤大小值得进一步调查.
    UNASSIGNED: The aim of this study was to investigate the prognostic value and stratification cutoff point for tumor size in stage I ovarian clear cell carcinoma (OCCC).
    UNASSIGNED: This was a retrospective cohort study using the Surveillance, Epidemiology, and End Results database (version: SEER 8.3.9). Patients diagnosed with stage I OCCC from 1988 to 2018 were included for further analysis. X-Tile software was used to identify the potential cutoff point for tumor size. Stratification analysis, propensity score matching, and inverse probability weighting analysis were used to balance the potential confounding factors.
    UNASSIGNED: A total of 1,000 stage I OCCC patients were included. Of these 1,000 patients, median follow-up was 106 months (95% confidence interval [CI]: 89-112 months). Multivariate analysis showed that tumor size, age at diagnosis, and stage IC were significantly associated with stage I OCCC patients. Eight centimeters is a promising cutoff point that can divide stage I OCCC patients into a good or a poor prognosis group. After controlling potential confounding factors with propensity score matching and inverse probability weighting, we demonstrated that stage I OCCC patients with tumor size ≤ 8 cm enjoyed a significantly better 5-year overall survival (OS, 89.8% vs. 81%, p < 0.0001). Tumor size ≤ 8 cm was an independent prognostic factor of stage I OCCC patients (hazard ratio [HR] 0.5608, 95% CI: 0.4126-0.7622, p = 0.0002).
    UNASSIGNED: Tumor size is an independent prognostic factor for stage I OCCC, and 8 cm is a promising cutoff point for tumor size for risk stratification. However, using tumor size in the stratification management of stage I OCCC patients warrants further investigation.
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  • 文章类型: Journal Article
    背景:胃腺癌(STAD)是癌症死亡的主要原因,但其分子和预后特征尚未得到充分说明。
    目的:描述原发性STAD的分子评估,开发新的疗法并确定有希望的预后特征。
    方法:我们描述了基于能量代谢相关基因(EMRG)表达谱综合分析的原发性STAD的综合分子评估。
    结果:基于86个与患者无进展生存期(PFS)显著相关的EMRGs,我们提出了一种将胃癌分为两种亚型的分子分类方法:第1组,大多数是年轻患者,在肿瘤微环境中显示出更多的免疫和基质细胞成分,并且肿瘤优先级较低;第2组,显示出早期阶段和更好的PFS。此外,我们构建了一个6基因标签,该标签可以对患者的预后风险进行3期训练测试和验证.与低风险评分患者相比,高危评分患者的总生存期较短.此外,校准和DCA分析图表明6基因签名具有出色的预测性能,与之前报道的三个预后基因标签相比,它们具有更高的稳健性和临床可用性。根据基因集富集分析,高危人群相关基因集参与ECM受体相互作用和Hedgehog信号通路。
    结论:基于EMRG的分子亚型和预后基因模型的鉴定为患者分层和靶向治疗试验提供了路线图。
    BACKGROUND: Stomach adenocarcinoma (STAD) is a leading cause of cancer deaths, but its molecular and prognostic characteristics has never been fully illustrated.
    OBJECTIVE: To describe a molecular evaluation of primary STAD and develop new therapies and identify promising prognostic signatures.
    METHODS: We describe a comprehensive molecular evaluation of primary STAD based on comprehensive analysis of energy-metabolism-related gene (EMRG) expression profiles.
    RESULTS: On the basis of 86 EMRGs that were significantly associated to patients\' progression-free survival (PFS), we propose a molecular classification dividing gastric cancer into two subtypes: Cluster 1, most of which are young patients and display more immune and stromal cell components in tumor microenvironment and lower tumor priority; and Cluster 2, which show early stages and better PFS. Moreover, we construct a 6-gene signature that can classify the prognostic risk of patients after a three-phase training test and validation process. Compared with patients with low-risk score, patients with high-risk score had shorter overall survival. Furthermore, calibration and DCA analysis plots indicate the excellent predictive performance of the 6-gene signature, and which present higher robustness and clinical usability compared with three previous reported prognostic gene signatures. According to gene set enrichment analysis, gene sets related to the high-risk group were participated in the ECM receptor interaction and hedgehog signaling pathway.
    CONCLUSIONS: Identification of the EMRG-based molecular subtypes and prognostic gene model provides a roadmap for patient stratification and trials of targeted therapies.
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  • 文章类型: Journal Article
    Cyclin-dependent-kinase 4-6 inhibitors (CDK4/6i) have improved the management of hormone receptor (HR)+/human epidermal growth factor receptor (HER)2- metastatic breast cancer (mBC). Currently, there are no valid prognostic factors for response to CDK4/6i. Baseline lymphopenia is reported as a prognostic factor in several types of cancer. The present retrospective study aimed to evaluate the effect of baseline absolute lymphocyte count (ALC) on response to palbociclib. Progression-free survival (PFS) was the primary endpoint. Secondary endpoints were overall survival (OS), best response and safety. A total of 114 patients treated for mBC between 2016 and 2019 were included. Median baseline ALC was 1.4 g/l (range, 0.2-4.3 g/l). A total of 65 (57%) and 49 (43%) patients had baseline ALC values of <1.5 and ≥1.5 g/l, respectively. Patients with baseline lymphopenia exhibited significantly shorter PFS (6 vs. 10 months; P=0.004) and OS (20 vs. 33 months; P=0.02). ALC <1.5 g/l independently predicted worse survival, as indicated by multivariate analysis (P=0.04; hazard ratio, 1.76; 95% confidence interval, 1.02-3.02). Patients with baseline ALC <1.5 g/l had significantly less partial response (14 vs. 22%; P=0.016) and more disease progression (46 vs. 20%; P=0.016) than those with ALC ≥1.5 g/l. ALC is a strong and easy-to-use dosage with prognostic factor for patients with HR+/HER2- mBC treated with palbociclib and endocrine therapy. Lymphopenia may also be a predictive factor of early progression. These data need to be verified in a larger prospective study.
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