Patient preferences on the use of technology in cancer surveillance after curative surgery: A cross-sectional analysis

Background

Advances in communication technology have enabled new methods of delivering test results to cancer survivors. We sought to determine patient preferences regarding the use of newer technology in delivering test results during cancer surveillance.

Presence of varicella zoster virus in zosteriform leukaemia cutis

Leukaemia cutis is a relatively rare manifestation in chronic lymphocytic leukaemia, characterized by a diverse morphology of skin lesions. We report two patients who developed zosteriform skin symptoms; however, the histological analysis revealed leukaemia infiltration as the cause of their symptoms. Contrary to previous reports, varicella zoster virus DNA was detectable in the lesions. These findings suggest that varicella zoster virus plays an active role in the development of zosteriform leukaemia cutis.     

Pathological classification and prognosis of renal damage caused by antineutrophil cytoplasmic antibody associated vasculitis

Objective To analyze the pathological characteristics and prognostic factors of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Methods A retrospective analysis of AAV patients with renal biopsy results admitted to Kidney Disease Center of the First Affiliated Hospital from January 2004 to February 2017 was performed. The patients were divided into 4 types according to Berden classification, and their clinical, pathological characteristics and prognosis were compared. The survival curves of each type of patients were plotted by Kaplan-Meier method, and the difference of survival curves was compared using Log-rank test. With entering the maintenance dialysis as the endpoint, Cox regression was used to analyze the prognostic factors. Results A total of 175 patients with AAV, including 59 cases (33.7%) of focal type, 39 cases (22.3%) of crescent type, 32 cases (18.3%) of sclerosis type, 45 cases (25.7%) of mixed type. The basal serum creatinine levels in crescent type group and sclerosis type group were significantly higher than those in the focal type group or mixed type group (all P＜0.05), and loop necrosis rate in sclerosis type group was significantly lower than chat in the focal type group or crescent type group (both P＜0.05). The median follow-up period was 11.8 (0.5-86.7) months. The event-free survival rates were 83.1%, 77.8%, 64.1% and 50.0% in the focal type, mixed type, crescent type and sclerotic type groups (Log-rank χ2=11.537, P=0.009). Cox regression analysis showed higher parathyroid hormone (HR=1.013, 95%CI 1.007-1.019, P＜0.001), glomerular sclerosis ≥50% (HR=10.532, 95%CI 2.903-38.203, P＜0.001) were independent risk factors for AAV patients entering maintenance dialysis, and higher estimated glomerular filtration rate (HR=0.943, 95%CI 0.896-0.993, P=0.025) was protective factor. Conclusion The prognosis of AAV renal damage is worsened according to focal, mixed, crescent and sclerosis types. Lower estimated glomerular filtration rate, higher parathyroid hormone and glomerular sclerosis ≥50% are independent risk factors for AAV patients entering maintenance dialysis.     

Health-Related Quality of Life in KEYNOTE-010: a Phase II/III Study of Pembrolizumab Versus Docetaxel in Patients With Previously Treated Advanced,Programmed Death Ligand 1–Expressing NSCLC

Introduction

In the phase II/III KEYNOTE-010 study (ClinicalTrials.gov, NCT01905657), pembrolizumab significantly prolonged overall survival over docetaxel in patients with previously treated, programmed death ligand 1–expressing (tumor proportion score ≥ 1%), advanced NSCLC. Health-related quality of life (HRQoL) results are reported here.

可手术非小细胞肺癌患者术前血浆中VEGF/sVEGFR-1比值与长期生存关系的初步探索

目的:检测可手术非小细胞肺癌患者术前血浆中VEGF、sVEGFR-1的表达水平，并分析其与临床病理资料和长期生存的关系。方法:收集98例可手术非小细胞肺癌患者术前静脉血，用ELISA方法检测血浆中VEGF和sVEGFR-1的表达水平，并分析其表达水平与患者临床病理资料和长期生存之间的关系。结果:可手术非小细胞肺癌患者术前血浆中VEGF、sVEGFR-1的表达水平与患者的临床病理资料没有相关性，但是多因素生存分析中，年龄、TNM分期和VEGF/sVEGFR-1比值是可手术非小细胞肺癌患者长期生存的独立预后因子。结论:血浆VEGF/sVEGFR-1比值与可手术非小细胞肺癌患者的长期生存相关，该比值在非小细胞肺癌的意义值得进一步深入研究。     

极年轻乳腺癌患者生育问题关注度的影响因素及其预后分析

目的研究极年轻乳腺癌患者生育相关问题关注度的影响因素，并分析其预后。 方法收集2009年12月至2019年1月经河北医科大学第四医院乳腺中心诊治、年龄≤25岁且有完整临床病理资料的50例极年轻乳腺癌女性患者进行回顾性研究。所有患者均完成了生育问题和结果量表(FIS)。采用单因素和多因素Logistic回归模型评估社会人口统计学因素、肿瘤因素与生育相关问题关注度之间的关系；采用Kaplan-Meier方法进行患者生存分析，用log-rank检验进行组间比较，采用Cox比例风险回归模型探讨影响极年轻乳腺癌患者预后的因素。 结果50例极年轻乳腺癌患者中，36例患者与其主管医师在确诊后/治疗前未沟通生育相关问题，仅有14例患者在确诊后/治疗前沟通过；28例患者表示乳腺癌治疗后仍有生育愿望；11例患者在治疗结束后妊娠，占全部患者的22%(11/50)，其中，有6例患者在未咨询医师的情况下，自行选择人工流产，其余5例患者均足月妊娠，新生儿健康。单因素和多因素Logistic回归分析显示确诊前生育状态是极年轻乳腺癌患者生育相关问题关注度的独立影响因素(单因素分析：OR＝0.250, 95%CI: 0.070～0.897, P＝0.033；多因素分析：OR＝0.270，95%CI：0.048～0.901，P＝0.035)。50例患者中共有9例(18%)患者复发或转移，其中，7例(14%)患者死亡，原因与乳腺癌直接相关。单因素分析显示：诊断延迟时间是极年轻乳腺癌患者DFS和OS的影响因素(χ²＝8.857、6.928，P＝0.003、0.008)，病理类型是患者DFS的影响因素(χ²＝4.824，P＝0.028)，但不是OS的影响因素(χ²＝3.339，P＝0.069)。多因素分析结果显示：诊断延迟时间是患者DFS的独立预后因素(HR＝13.121，95%CI：1.385～124.348，P＝0.025)。生存分析结果显示：诊断延迟时间>3个月组与诊断延迟时间≤3个月组比较，患者的DFS差异有统计学意义(χ²＝4.834，P＝0.025)，而OS差异无统计学意义(χ²＝1.035，P＝0.311)。 结论治疗前未生育的患者对生育相关问题关注度高。诊断延迟可能导致极年轻乳腺癌患者的预后变差，值得临床医师关注。