Outcomes after neoadjuvant or adjuvant chemotherapy for cT2-4N0-1 non–small cell lung cancer: A propensity-matched analysis

Objective

Comparative survival between neoadjuvant chemotherapy and adjuvant chemotherapy for patients with cT2-4N0-1M0 non–small cell lung cancer has not been extensively studied.

Gene deletions in an infertile man with sperm fibrous sheath dysplasia

BACKGROUND: Asthenozoospermia may sometimes be related to geneticstructural defects of the sperm tail detectable by transmissionelectron microscopy. Dysplasia of the fibrous sheath (DFS) isa genetic sperm defect, characterized by dysplastic developmentof the axonemal and periaxonemal cytoskeleton. We report thecase of an infertile man with normal sperm count and total spermimmotility in which dysplasia of the fibrous sheath, Akap3,Akap4 gene deletions, meiotic segregation of chromosomes 18,X and Y and Y microdeletions were investigated. METHODS: A 32-year-oldman with a 3-year history of primary infertility presented atour Regional Referral Center for Male Infertility. Family medicalhistory, lymphocyte karyotype, PCR analysis, physical examination,hormone assays and semen analysis were performed. RESULTS: Ultrastructuralsperm evaluation showed dysplasia of the fibrous sheath. Immunostainingof AKAP4 protein was negative in sperm tails. PCR analysis revealedintragenic deletions of the Akap3 and Akap4 genes. Fluorescencein situ hybridization on sperm showed a high frequency of XYdisomy. CONCLUSION: In this infertile patient, our results suggesta possible relationship between dysplasia of the fibrous sheath,partial deletions in the Akap3 and Akap4 genes and absence ofAKAP4 protein in the fibrous sheath. These findings, however,were not detected in another four patients with dysplasia ofthe fibrous sheath. Our results require future confirmatorymolecular analyses.     

Ki67表达比例对乳腺癌患者预后影响的Meta分析

目的:系统评价Ki67表达比例对乳腺癌患者预后的影响，尤其是对无病生存期（DFS）的影响。为临床应用提供循证医学依据。方法:计算机检索PubMed、Embase、Web of Science、Cochrane Library、中国期刊全文数据库（CNKI）、维普数据库（VIP）、万方数据库以及中国生物医学文献数据库（CBM）。应用RevMan 5.3软件对所纳入的数据进行统计学分析。结果:共纳入8篇文献，合计15 643例患者。Meta分析结果显示，纳入文献中的Ki67高比例表达组患者的DFS（HR=1.86，95%CI=1.31~2.65）要低于Ki67低比例表达组，差异有统计学意义。亚组分析中，以种族分亚组的结果与上述类似，差异也有统计学意义;以Ki67表达临界值分亚组，Ki67表达临界值为30%的亚组差异没有统计学意义，表达临界值为其他值的亚组差异有统计学意义。结论:本研究Meta分析显示，Ki67是乳腺癌的一种不良预后因子，Ki67高比例表达的患者有着更低的DFS。     

血清总胆固醇及低密度脂蛋白水平对乳腺癌预后的影响

【摘要】〓目的〓探讨血清中脂蛋白水平对乳腺癌预后的影响。方法〓回顾分析2003年11月至2008年9月在中山大学孙逸仙纪念医院初诊的244例乳腺癌患者及同期99例健康体者的临床资料。比较两者血清代谢指标的变化,Spearman相关分析总胆固醇、LDL-C与乳腺癌的肿瘤大小的关系,Cox回归模型评估影响无病生存率(DFS)的预后因素。结果〓乳腺癌患者血清总胆固醇(TC)、甘油三酯、低密度脂蛋白(LDL-C)、血糖较正常人高,而高密度脂蛋白(HDL-C)较正常人低;血清总胆固醇、LDL-C水平在ER/PR阳性乳腺癌患者中较Her-2阳性及三阴型乳腺癌低。血清总胆固醇、LDL-C与肿瘤的大小呈正相关。TC≥5.2 mmol/L 组或LDL-C>3.08 mmol/L 组的DFS较TC<5.2 mmol/L 组或LDL-C≤3.08mmol/L 组明显降低(TC 68% vs 77.7%, LDL-C 73.4% vs 86.3%, P<0.05)。结论〓高胆固醇、高LDL-C血症是乳腺癌独立的预后因素。     

术前NLR和PLR对上皮性卵巢癌患者预后的评估价值

目的:探讨术前中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)对上皮性卵巢癌患者预后的评估价值。方法:收集2005年11月至2012年12月在天津市中心妇产科医院初治且经手术治疗的153例卵巢良性肿瘤和206例上皮性卵巢癌患者的临床病理资料,比较术前NLR和PLR在卵巢良恶性肿瘤的区别,根据统计学方法选取NLR和PLR临界值,分析NLR和PLR与上皮性卵巢癌临床病理因素的关系。通过单因素及多因素分析评估术前NLR和PLR对患者术后生存的影响。结果:术前NLR和PLR水平在上皮性卵巢癌中明显高于卵巢良性肿瘤。选取NLR=2.62和PLR=173分别作为临界值。单因素分析结果显示,FIGO分期晚、中-低分化、腹水、脉管癌栓、CA125≥35、NLR≥2.62、PLR≥173是影响患者术后无病生存期(DFS)的危险因素(P0.05);FIGO分期晚、腹水、脉管癌栓、CA125≥35、PLR≥173是影响患者术后总生存期(OS)的危险因素(P0.05)。多因素分析显示,FIGO分期晚、NLR≥2.62、脉管癌栓是上皮性卵巢癌患者DFS的独立危险因素(P0.05)。结论:NLR和PLR方便测得且价格便宜,对卵巢癌的预后有一定的评估价值。     

18FDG-PET following treatment as valid predictor for disease-free survival in Hodgkin''s lymphoma.

Purpose:The value of ¹⁸FDG-PET to predict the outcomeafter therapy in Hodgkins lymphoma was compared to morphologic stagingand ESR. Patients and methods:A total of 50 concurrent¹⁸FDG-PET and CT studies were performed in 37 patients withHodgkins lymphoma. ESR was evaluated 32 times after treatment wascompleted. Results:Out of 39 residual masses found by CT 8 relapses couldbe proven. Out of 11 CT exams with CR 3 relapses occurred. CT turned out toshow a sensitivity, specificity, PPV, NPV, and accuracy of 72%,21%, 21%, 73%, and 32%, with respect to predictdisease-free survival (DFS). ¹⁸FDG-PET was positive in 22examinations with 10 recurrences in this group. Out of 28 negative¹⁸FDG-PET 1 relapse developed 3 years later. ¹⁸FDG-PETturned out to show promising sensitivity, specificity, PPV, NPV, and accuracyof 91%, 69%, 46%, 96%, 74%, with respectto predict DFS. ESR was elevated in 12 studies of which 5 relapses could beproven, while out of 20 normal ESR-studies 3 relapses occurred. Thus, ESRturned out to show sensitivity, specificity, PPV, NPV, and accuracy of63%, 71%, 42%, 85%, and 75%, with respectto predict DFS. In summary, only ¹⁸FDG-PET was able to predict DFSstatistically significant. Conclusion: ¹⁸FDG-PET can be very useful in patientswith residual masses after treatment.