5-year survival rate

5 年生存率
  • 文章类型: Journal Article
    在中国国家癌症中心(NCC)治疗的不同阶段胃癌患者的术后生存率尚未见报道。因此,我们评估了2011-2018年在NCC接受手术的胃癌患者的生存率,为进一步研究提供基线信息.
    我们确定了2011年1月至2018年5月期间在NCC接受手术的7301例原发性胃癌患者;其中,5,008名患者参加了这项研究。后续工作已于2020年4月30日完成。我们根据阶段分析了5年生存率,性别,年龄,和其他临床病理特征。
    pTNM分期IA患者的5年生存率,IB,IIA,IIB,IIIA,IIIB,IIIC,在NCC治疗的IV为94.9%,91.8%,86.5%,76.1%,61.1%,44.2%,29.7%,和8.1%,分别,这与同期日本报告的情况相似。ypTNMⅠ期患者的5年生存率,II,III,IV为93.1%,63.2%,27.2%,和0.0%,分别。在多变量分析中,年龄,印戒细胞癌,辅助化疗,分化程度是重要的预后因素。
    在NCC治疗的胃癌患者的生存率得到了显著提高,在同一时期达到日本的水平。
    UNASSIGNED: The postoperative survival rates of patients with gastric cancer at different stages treated at the National Cancer Center (NCC) of China have not been reported. Therefore, we evaluated the survival of patients with gastric cancer who underwent surgery at the NCC from 2011 to 2018 to provide baseline information for further studies.
    UNASSIGNED: We identified 7,301 patients with primary gastric carcinoma who underwent surgery at the NCC between January 2011 and May 2018; among these, 5,008 patients were enrolled in this study. Follow up was completed on April 30, 2020. We analyzed the 5-year survival according to the stage, sex, age, and other clinicopathological features.
    UNASSIGNED: Five-year survival rates of patients with pTNM stages IA, IB, IIA, IIB, IIIA, IIIB, IIIC, and IV treated at the NCC were 94.9%, 91.8%, 86.5%, 76.1%, 61.1%, 44.2%, 29.7%, and 8.1%, respectively, which were similar to those reported in Japan during the same period. Five-year survival rates of patients with ypTNM stages I, II, III, and IV were 93.1%, 63.2%, 27.2%, and 0.0%, respectively. In multivariable analysis, age, signet ring cell carcinoma, adjuvant chemotherapy, and degree of differentiation were revealed as important prognostic factors.
    UNASSIGNED: The survival rates of patients with gastric cancer treated at the NCC have been significantly improved, reaching the levels of Japan in the same period.
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  • 文章类型: Journal Article
    乳腺癌是一种严重的危及生命的疾病,每年都有许多妇女参与其中。最近被发现并研究作为这种类型癌症的诊断预测因子的一个因素是肿瘤芽的数量以及该因素与患者生存率的关系。
    本研究纳入150名18岁以上女性乳腺癌患者,平均年龄53.99±12.56岁,在各个医疗中心被诊断出来,包括鲁哈尼医院本身,并提到了鲁哈尼医院医疗中心,巴博尔,伊朗。在苏木精和伊红(H&E)载玻片上存档并评估患者的肿瘤内和瘤周芽的数量以及肿瘤微环境,并与其他临床病理结果进行比较。本文精确研究了肿瘤内和瘤周芽的数量与患者5年生存率之间的关系。此外,年龄之间的关系,肿瘤分期,grade,尺寸,涉及的淋巴结数量,并研究了肿瘤内芽和肿瘤周围芽的数量是否存在转移。
    结果显示肿瘤内芽和肿瘤周围芽的数量与肿瘤大小之间存在显著的统计学关联,肿瘤分期,转移的存在,涉及的淋巴结数量,5年生存率。另一方面,肿瘤内和瘤周芽的数量与年龄和肿瘤分级之间没有显著的统计学关联.
    我们的调查显示肿瘤芽的数量与患者的生存率之间存在显著的统计学关系。所以,这一因素对于帮助这些患者提高生存率具有重要意义.
    UNASSIGNED: Breast cancer is a severe life-threatening condition in which many women are involved yearly. One factor that has recently been noticed and investigated as a diagnostic predictor of this type of cancer is the number of tumor buds and the relation of this factor with a patient\'s survival rate.
    UNASSIGNED: This study includes 150 female patients over 18 years old with a mean age of 53.99 ± 12.56 years old with breast cancer, which was diagnosed at various medical centers, including Rouhani Hospital itself, and referred to Rouhani Hospital Medical Center, Babol, Iran. The number of intratumoral and peritumoral buds in patients\' microscopic slides were archived and evaluated along with tumor microenvironment on hematoxylin and eosin (H&E) slides and compared to other clinicopathological findings. This article precisely investigated the relationship between the number of intratumoral and peritumoral buds with patients\' 5-year survival rate. Also, the relationship between age, tumor stage, grade, size, the number of lymph nodes involved, and the presence of metastasis with the number of intratumoral and peritumoral buds was studied.
    UNASSIGNED: The result showed a significant statistical association between the number of intratumoral and peritumoral buds with tumor size, tumor stage, presence of metastasis, the number of lymph nodes involved, and 5-year survival rate. On the other hand, there is not a significant statistical association between the number of intratumoral and peritumoral buds with age and tumor grade.
    UNASSIGNED: Our investigation revealed a significant statistical relationship between the number of tumor buds and patients\' survival rate. So, this factor should be considered significant to help those patients increase their survival ratio.
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  • 文章类型: Journal Article
    目的:这项单中心回顾性研究旨在探讨原发性玻璃体视网膜淋巴瘤(PVRL)与中枢神经系统(CNS)受累的相关因素。
    方法:PVRL患者的临床特征(第1组),原发性中枢神经系统淋巴瘤诊断后诊断为玻璃体视网膜淋巴瘤(VRL)的患者(第2组),以及同时诊断为中枢神经系统淋巴瘤和VRL的患者(第3组),进行了比较。主要结果包括性别,年龄,治疗类型,生存,视敏度,诊断方法,VRL复发,眼部表现,和房水中的白细胞介素水平。
    结果:第1、2和3组包括38例患者的66只眼,18例患者29只眼,8个病人14只眼,分别。第3组的总生存期(OS)短于第1组和第2组(分别为P=0.042和P=0.009)。三组无进展生存期无差异(P=0.060)。第1、2、3组的5年生存率为56.5%,44.0%,和25.0%,分别(P=0.001)。第1组中枢神经系统受累患者出现VRL复发(P<0.001),高白细胞介素-10(P=0.024),视网膜下色素上皮(RPE)浸润(P=0.009)。第1组中经历VRL复发的患者倾向于显示CNS受累(P<0.001)。
    结论:同时诊断为CNS淋巴瘤和VRL的患者OS较短,5年生存率较低。在PVRL患者中,VRL的复发,高白细胞介素-10和亚RPE浸润与CNS受累相关.
    OBJECTIVE: This single center retrospective study aimed to investigate the factors associated with central nervous system (CNS) involvement of primary vitreoretinal lymphoma (PVRL).
    METHODS: Clinical features of patients with PVRL (Group 1), those diagnosed with vitreoretinal lymphoma (VRL) after primary CNS lymphoma diagnosis (Group 2), and those concurrently diagnosed with CNS lymphoma and VRL (Group 3), were compared. The main outcomes included sex, age, types of treatment, survival, visual acuity, diagnostic methods, VRL recurrence, ocular manifestations, and interleukin levels in the aqueous humor.
    RESULTS: Groups 1, 2, and 3 included 66 eyes in 38 patients, 29 eyes in 18 patients, and 14 eyes in 8 patients, respectively. Group 3 had shorter overall survival (OS) than Groups 1 and 2 (P = 0.042 and P = 0.009, respectively). The three groups did not differ in progression-free survival (P = 0.060). The 5-year survival rates of Groups 1, 2, and 3 were 56.5%, 44.0%, and 25.0%, respectively (P = 0.001). Patients with CNS involvement in Group 1 exhibited VRL recurrence (P < 0.001), high interleukin-10 (P = 0.024), and sub-retinal pigment epithelium (RPE) infiltration (P = 0.009). Patients experiencing VRL recurrence in Group 1 tended to show CNS involvement (P < 0.001).
    CONCLUSIONS: Patients concurrently diagnosed with CNS lymphoma and VRL had a shorter OS and a lower 5-year survival rate. In patients with PVRL, the recurrence of VRL, high interleukin-10, and sub-RPE infiltration were associated with CNS involvement.
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  • 文章类型: Journal Article
    (1)背景:就发病率和死亡率而言,结直肠癌(CRC)是第三大常见癌症。大约90%的结直肠癌病例是腺癌。起源于结直肠粘膜的上皮细胞。上调基因4(URG4)是参与癌症发展的癌基因。该研究的目的是评估波兰结肠腺癌患者中URG4蛋白表达的免疫组织化学表达,这些患者在根治性手术前未接受任何治疗。(2)方法:该研究使用了经过彻底的组织病理学检查后,从确诊为结直肠腺癌的人身上采集的结肠组织样本。通过Chi2检验或Chi2Yatesa检验分析URG4的免疫组织化学表达与临床参数之间的关联。本研究通过应用Kaplan-Meier分析和log-rank统计检验分析URG4的表达与患者5年生存率的相关性。通过利用透射电子显微镜(TEM)方法鉴定URG4的细胞内定位。(3)结果:在单变量Cox回归分析中,URG4的免疫组织化学表达,组织学分化等级,入侵深度,血管浸润,PCNA表达,发现疾病分期和淋巴结受累是重要的预后因素。在我们的患者队列中,观察到肿瘤分化程度和URG4表达被认为是结肠腺癌患者5年生存率的不同预后因素.(4)结论:URG4免疫组化高表达与结肠腺癌患者预后不良相关。
    (1) Background: Colorectal cancer (CRC) is the third most common cancer in terms of incidence and mortality. Approximately 90% of all colorectal cancer cases are adenocarcinomas, originating from epithelial cells of the colorectal mucosa. Upregulated gene 4 (URG4) is an oncogene involved in cancer development. The aim of the study was to assess the immunohistochemical expression of URG4 protein expression in Polish patients with colon adenocarcinoma who were not treated with any therapy before radical surgery. (2) Methods: The study used colon tissue samples taken from people with a confirmed diagnosis of colorectal adenocarcinoma after a thorough histopathological examination. The associations between the immunohistochemical expression of URG4 and clinical parameters were analyzed by the Chi2 test or Chi2Yatesa test. The study conducted an analysis of the correlation between the expression of URG4 and the five-year survival rate of patients through the application of the Kaplan-Meier analysis and the log-rank statistical test. The intracellular localization of URG4 was identified through the utilization of transmission electron microscopy (TEM) methodology. (3) Results: In univariate Cox regression analyses, immuno-histochemical expression of URG4, grade of histological differentiation, depth of invasion, angioinvasion, PCNA expression, stage of disease and lymph node involvement were found to be significant prognostic factors. Within our patient cohort, it was observed that the degree of tumour differentiation and URG4 expression were found to be distinct prognostic factors in regard to the 5-year survival rates of those with colon adenocarcinoma. (4) Conclusions: High immunohistochemical expression of URG4 correlates with poor prognosis in patients with colon adenocarcinoma.
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  • 文章类型: Journal Article
    Notch信号通路是涉及细胞命运决定和许多疾病发展的最保守和特征明确的通路之一。包括癌症.其中,值得注意的是Notch4受体及其临床应用,这可能对结肠腺癌患者具有预后价值。该研究对129例结肠腺癌进行。使用Notch4抗体进行Notch4的免疫组织化学和荧光表达。使用Chi2检验或Chi2Yatesa检验分析Notch4的IHC表达与临床参数之间的关联。采用Kaplan-Meier分析和log-rank检验验证Notch4表达强度与患者5年生存率的关系。通过使用免疫金标记方法和TEM检测Notch4的细胞内定位。101例(78.29%)样本有较强的Notch4蛋白表达,和28(21.71%)样品的特征是低表达。Notch4的高表达与肿瘤的组织学分级密切相关(p<0.001)。PCNA免疫组化表达(p<0.001),侵袭深度(p<0.001)和血管侵袭(p<0.001)。我们可以得出结论,Notch4的高表达与结肠腺癌患者的不良预后相关(log-rank,p<0.001)。
    The Notch signalling pathway is one of the most conserved and well-characterised pathways involved in cell fate decisions and the development of many diseases, including cancer. Among them, it is worth noting the Notch4 receptor and its clinical application, which may have prognostic value in patients with colon adenocarcinoma. The study was performed on 129 colon adenocarcinomas. Immunohistochemical and fluorescence expression of Notch4 was performed using the Notch4 antibody. The associations between the IHC expression of Notch4 and clinical parameters were analysed using the Chi2 test or Chi2Yatesa test. The Kaplan-Meier analysis and the log-rank test were used to verify the relationship between the intensity of Notch4 expression and the 5-year survival rate of patients. Intracellular localisation of Notch4 was detected by the use of the immunogold labelling method and TEM. 101 (78.29%) samples had strong Notch4 protein expression, and 28 (21.71%) samples were characterised by low expression. The high expression of Notch4 was clearly correlated with the histological grade of the tumour (p < 0.001), PCNA immunohistochemical expression (p < 0.001), depth of invasion (p < 0.001) and angioinvasion (p < 0.001). We can conclude that high expression of Notch4 is correlated with poor prognosis of colon adenocarcinoma patients (log-rank, p < 0.001).
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  • 文章类型: Journal Article
    背景:凋亡蛋白酶激活因子1(Apaf-1)蛋白,作为参与线粒体凋亡途径激活的因素之一,在癌症生物学中起着重要作用。Apaf-1在肿瘤细胞中的表达已被证明是下调的,对肿瘤进展有重大影响。因此,我们调查了Apaf-1蛋白在波兰人群中的表达结肠腺癌患者在根治性手术前未接受任何治疗.此外,我们评估了Apaf-1蛋白表达与临床病理因素之间的关系。分析了该蛋白的预后活性与患者5年生存率的关系。为了显示Apaf-1蛋白在细胞水平上的定位,使用免疫金标记方法。
    方法:本研究使用组织病理学证实的结肠腺癌患者的结肠组织材料进行。使用Apaf-1抗体以1:600稀释进行Apaf-1蛋白的免疫组织化学表达。使用Chi2检验和Chi2Yatesa检验分析Apaf-1的免疫组织化学(IHC)表达与临床参数之间的关联。采用Kaplan-Meier分析和log-rank检验验证Apaf-1表达强度与患者5年生存率的关系。当p<0.05时,认为结果具有统计学意义。
    结果:通过免疫组织化学染色在整个组织切片中评估Apaf-1的表达。39个(33.23%)样本具有强的Apaf-1蛋白表达,82个(67.77%)样本具有低表达特征。Apaf-1的高表达与肿瘤的组织学分级明显相关(p=0.001)。增殖细胞核抗原(PCNA)免疫组化表达(p=0.005),年龄(p=0.015),侵袭深度(p<0.001)和血管侵袭(p<0.001)。该蛋白高表达的患者组的5年生存率明显更高(log-rank,p<0.001)。
    结论:我们可以得出结论,Apaf-1表达与结肠腺癌患者生存率降低呈正相关。
    The Apoptotic protease activating factor 1 (Apaf-1) protein, as one of the factors involved in the activation of the mitochondrial apoptotic pathway, plays an important role in cancer biology. Apaf-1 expression in tumour cells has been shown to be downregulated, with significant implications for tumour progression. Hence, we investigated the expression of Apaf-1 protein in the Polish population of patients with colon adenocarcinoma without any therapy prior to radical surgery. Moreover, we assessed the relation between Apaf-1 protein expression and the clinicopathological factors. The prognostic activity of this protein was analyzed in relation to 5-year survival of patients. In order to show the localization of Apaf-1 protein at the cellular level, the immunogold labelling method was used.
    The study was conducted using the colon tissue material from patients with histopathologically confirmed colon adenocarcinoma. Immunohistochemical expression of Apaf-1 protein was performed using Apaf-1 antibody at dilution 1:600. The associations between the immunohistochemistry (IHC) expression of Apaf-1 and clinical parameters were analyzed using the Chi2 test and Chi2Yatesa test. Kaplan-Meier analysis and the log-rank test were used to verify the relationship between the intensity of Apaf-1 expression and 5-year survival rate of patients. The results were considered statistically significant when p < 0.05.
    Apaf-1 expression was evaluated by immunohistochemical staining in whole tissue sections. Thirty-nine (33.23%) samples had strong Apaf-1 protein expression and 82 (67.77%) samples were characterized by low expression. The high expression of Apaf-1 was clearly correlated with the histological grade of the tumour (p = 0.001), proliferating cell nuclear antigen (PCNA) immunohistochemical expression (p = 0.005), age (p = 0.015), depth of invasion (p < 0.001) and angioinvasion (p < 0.001). The 5-year survival rate was significantly higher in the group of patients with high expression of this protein (log-rank, p < 0.001).
    We can conclude that Apaf-1 expression is positively correlated with reduced survival of colon adenocarcinoma patients.
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  • 文章类型: Case Reports
    原发性胃鳞状细胞癌(GSCC)是一种极其罕见的恶性肿瘤,预后不良。尽管对其发病机理和生物学的认识有所提高,治疗选择仍然有限。本研究报道了一名79岁女性的错配修复缺陷(dMMR)原发性GSCC的独特病例,该病例报告疲劳和上消化道出血症状。体格检查发现触诊时腹痛。胃镜检查显示,外生性,肿瘤出血。医学成像证实胃腔内有一个蘑菇状息肉,没有疾病传播的迹象。进行全胃切除术和D2淋巴结清扫术。术后材料的病理检查证实分化良好的SCC侵入粘膜,粘膜下层和肌肉层。在32个切除的淋巴结中没有观察到播散的迹象。值得注意的是,根据最后的随访,病人仍然很好,支持5年GSCC生存率统计。据我们所知,这是肿瘤外科门诊报告的首例此类GSCC病例(哥白尼纪念医院,罗兹,波兰),这些发现增加了关于GSCC的有限数据。虽然这是非常罕见的情况,在胃肿瘤的诊断过程中,应始终加以考虑。
    Primary gastric squamous cell carcinoma (GSCC) is an extremely rare malignancy with a poor prognosis. Despite the improved knowledge regarding its pathogenesis and biology, the treatment options remain limited. The present study reported on the unique case of a mismatch repair-deficient (dMMR) primary GSCC in a 79-year-old woman reporting fatigue and symptoms of upper gastrointestinal tract bleeding. Physical examination revealed abdominal pain at palpation. Gastroscopy revealed a large, exophytic, bleeding tumor. Medical imaging confirmed a mushroom-like polyp in the lumen of the stomach, with no signs of disease spread. Total gastrectomy and D2 lymphadenectomy were performed. Pathological examination of the post-operational material confirmed a well-differentiated SCC invading the mucosa, submucosa and muscle layer. There were no signs of dissemination observed in any of the 32 excised lymph nodes. Notably, according to the last follow-up, the patient remains well, supporting the 5-year GSCC survival rate statistics. To the best of our knowledge, this is the first such GSCC case reported in the Surgical Oncology Outpatient Clinic (Copernicus Memorial Hospital, Lodz, Poland) and these findings add to the limited data on GSCC. Although this is a very rare condition, it should always be considered during the process of diagnosis of gastric tumors.
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  • 文章类型: Journal Article
    未经证实:抑癌基因的启动子超甲基化为肺癌诊断和预后提供了有希望的标志物。这项研究的目的是确定多个基因启动子高甲基化与非小细胞肺癌(NSCLC)患者5年生存率之间的关系。
    未经证实:原发肿瘤样本(n=65),相应的非恶性肺组织(n=65),循环血液来自接受治愈性手术的NSCLC患者。七个基因中的启动子甲基化状态(RASSF1A,CDH13,MGMT,ESR1,DAPK,SOX1和HOXA9)通过使用亚硫酸氢盐焦磷酸测序进行定量。5年生存数据由临床医生获得。Cox比例风险模型用于分析基因甲基化状态与患者总体生存之间的关联。
    UNASSIGNED:发现SOX1异常肿瘤甲基化患者的5年生存期比没有异常肿瘤甲基化患者的5年生存期短(P=0.01)。这种效应与TNM分期无关。在两种组织类型的任一种中测试的其他基因中,没有显着的生存差异与异常甲基化相关。
    UNASSIGNED:我们的研究表明,在NSCLC肿瘤中,SOX1启动子高甲基化与低生存率显著相关,有望作为NSCLC患者的有用预后生物标志物。
    UNASSIGNED: Promoter hypermethylation of tumor suppressor genes presents promising markers for lung cancer diagnosis and prognosis. The purpose of this study was to determine the association between the promoter hypermethylation of multiple genes and 5-year survival rate in patients with Non-small cell lung cancer (NSCLC).
    UNASSIGNED: Primary tumor samples (n = 65), corresponding nonmalignant lung tissues (n = 65), and circulating blood were obtained from NSCLC patients who underwent curative surgery. Promoter methylation status in seven genes (RASSF1A, CDH13, MGMT, ESR1, DAPK, SOX1, and HOXA9) was quantified by using bisulfite pyrosequencing. Five-year survival data were obtained by a clinician. Cox proportional hazards models were used to analyze the associations between gene methylation status and overall patient survival.
    UNASSIGNED: The 5-year survival of the patients with SOX1 aberrant tumor methylation was found to be statistically significantly shorter than for those patients without aberrant tumor methylation (P = 0.01). This effect was independent of TNM stage. No significant survival differences were associated with aberrant methylation in other genes tested in either of the two tissue types.
    UNASSIGNED: Our study shows that SOX1 promoter hypermethylation in NSCLC tumors is significantly associated with inferior survival, showing promise as a useful prognostic biomarker in patients with NSCLC.
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  • 文章类型: Journal Article
    背景:晚期胃癌的预后仍然较差。在晚期胃癌中使用5-氟尿嘧啶(5-FU)的术中缓释化疗的确切疗效仍未阐明。
    目的:探讨在II期和III期胃癌患者中使用5-FU缓释植入物的长期生存益处。
    方法:纳入2014年1月至2016年12月期间接受R0根治性切除术的局部晚期胃癌患者。除腺癌以外的病理诊断患者被排除。所有纳入的患者均根据术中是否使用5-FU缓释(SR)化疗(NSR)进行分组。主要终点是5年总生存期。采用Kaplan-Meier法结合log-rank检验分析患者的总生存期,采用Cox分析分析患者的预后因素。
    结果:总计,563例局部晚期胃癌,他接受了R0根治性切除术。309名患者纳入最终分析。219人(70.9%)为男性,平均年龄为58.25岁。此外,56例(18.1%)接受新辅助化疗,191例(61.8%)处于TNMIII期。此外,158例患者接受了术中5-FU缓释化疗,并纳入SR组。而其他161例患者被纳入NSR组。全组总并发症发生率为12.94%,为10.81%,SR和NSR组的16.46%,分别。两组总生存率和并发症发生率比较差异无统计学意义(P>0.05)。多因素Cox分析显示,只有N分期和新辅助治疗是生存的独立影响因素。
    结论:术中使用5-FU缓释化疗,没有改善局部晚期胃癌行R0根治术患者的生存率.
    BACKGROUND: The prognosis of gastric cancer in an advanced stage remains poor. The exact efficacy of the use of intraoperative sustained-release chemotherapy with 5-fluorouracil (5-FU) in advanced-stage gastric cancer is still unelucidated.
    OBJECTIVE: To explore the long-term survival benefit of using sustained-release 5-FU implants in stage II and stage III gastric cancer patients.
    METHODS: Patients with gastric cancer in a locally advanced stage and who underwent an R0 radical resection between Jan 2014, to Dec 2016, in this single institution were included. Patients with pathological diagnoses other than adenocarcinoma were excluded. All included patients were grouped according to whether intraoperative sustained-release (SR) chemotherapy with 5-FU was used or not (NSR). The primary end-point was 5-year overall survival. Kaplan-Meier method with log-rank test was used to analyze the overall survival of patients and Cox analysis was used to analyze prognosis factors of these patients.
    RESULTS: In total, there were 563 patients with gastric cancer with locally advanced stage, who underwent an R0 radical resection. 309 patients were included in the final analysis. 219 (70.9%) were men, with an average age of 58.25 years. Furthermore, 56 (18.1%) received neoadjuvant chemotherapy, and 191 (61.8%) were in TNM stage III. In addition, 158 patients received intraoperative sustained-release chemotherapy with 5-FU and were included in the SR group, while the other 161 patients were included in the NSR group. The overall complication rate was 12.94% in the whole group and 10.81%, 16.46% in SR and NSR groups, respectively. There were no significant differences between the two groups in overall survival and complication rate (P > 0.05). The multivariate cox analysis indicated that only N Stage and neoadjuvant therapy were independent influencing factors of survival.
    CONCLUSIONS: Intraoperative sustained-release chemotherapy usage with 5-FU, did not improve the survival of patients who underwent an R0 radical resection in locally advanced stage of gastric cancer.
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  • 文章类型: Journal Article
    抗中性粒细胞胞浆抗体(ANCA)相关血管炎(AAV)是一种涉及小血管的多系统自身免疫性疾病。在AAV中,显微镜下多血管炎(MPA)和肉芽肿性多血管炎(GPA)是主要的临床病理变异.此外,髓过氧化物酶(MPO)和蛋白酶3(PR3)是主要的靶抗原。该研究的目的是探索AAV患者长期生存的预测因素。
    在2005年至2020年期间,对407名患者进行了一项多中心回顾性研究。临床参数来自实验室测试,包括ANCA类型,抗核抗体(ANA),可提取核抗原(ENA),抗链球菌溶血素O(ASO),肾小球滤过率(GFR),和血常规的实验室检查,肝功能,肾功能,和豁免权,等。临床参数的数据是从电子病历(EMR)收集的,患者生存数据是通过定期随访获得的.分析了临床参数与总生存率(OS)以及3年和5年生存率的关系,并根据分析结果建立列线图作为预测模型。
    在本研究中,336例(82.6%)患者和46例(11.3%)患者被诊断为MPA和GPA,分别。所有患者的平均和中位OS分别为2,285天和2,290天,分别。1年,3年,5年,所有患者的10年累积生存率为84.2%,76.3%,57.2%,和32.4%,分别。单变量和多变量生存分析表明,独立的预后因素包括年龄,病理类别(MPA,GPA,和其他类型),血清ANCA类型(MPO和/或PR3阴性或阳性),安娜,ASO,GFR,淋巴细胞,中性粒细胞与淋巴细胞比率(NLR),和C反应蛋白(CRP),除ASO外,这些临床参数用于构建列线图。3年和5年生存率的列线图的C指数为0.721(95%CI0.676-0.766)。校正曲线显示,3年和5年生存率的列线图预测值与实际观测值基本一致,和决策曲线分析(DCA)进一步证明了预测模型的实用性和准确性。
    诊断时的实验室检查对预测AAV患者的长期生存具有重要意义。
    Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a multisystem autoimmune disease with small-vessel involvement. In AAV, microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) are major clinicopathologic variants. In addition, myeloperoxidase (MPO) and proteinase 3 (PR3) are major target antigens. The objective of the study was to explore the predictive factors for long-term survival in AAV patients.
    A multicenter retrospective study was carried out on 407 patients between 2005 and 2020. Clinical parameters were obtained from laboratory tests including the ANCA types, antinuclear antibody (ANA), extractable nuclear antigen (ENA), anti-streptolysin O (ASO), glomerular filtration rate (GFR), and the laboratory examinations for the blood routine, liver function, renal function, and immunity, etc. The data for clinical parameters were collected from electronic medical records (EMRs), and the data for patient survival were acquired through regular follow-up. The association of clinical parameters with overall survival (OS) along with 3-year and 5-year survival rates was analyzed, and the nomogram as a predictive model was established according to the analysis results.
    In the present study, 336 (82.6%) patients and 46 (11.3%) patients were diagnosed with MPA and GPA, respectively. The mean and median OS for all the patients were 2,285 and 2,290 days, respectively. The 1-year, 3-year, 5-year, and 10-year cumulative survival rates for all the patients were 84.2%, 76.3%, 57.2%, and 32.4%, respectively. Univariate and multivariate survival analyses indicated that the independent prognostic factors included age, pathological categories (MPA, GPA, and other types), serum ANCA types (negative or positive for MPO and/or PR3), ANA, ASO, GFR, lymphocyte, neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (CRP), and these clinical parameters except for ASO were used to construct a nomogram. The nomogram for 3-year and 5-year survival rates had a C-index of 0.721 (95% CI 0.676-0.766). The calibration curves showed that the predicted values of the nomogram for 3-year and 5-year survival rates were generally consistent with practical observed values, and decision curve analysis (DCA) further demonstrated the practicability and accuracy of the predictive model.
    Laboratory tests at diagnosis have great significance in the prediction of long-term survival in AAV patients.
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