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41.
目的:探讨含LIM域2（LIM domain containing 2,LIMD2)蛋白及E钙黏素（E-cadherin）在非小细胞肺癌(NSCLC)中的表达及临床意义。方法:采用免疫组化法对141例NSCLC肿瘤组织和25例癌旁组织中的LIMD2蛋白及E钙黏素进行检测。SPSS 21进行统计学分析,P＜0.05认为差异有统计学意义。结果:LIMD2在肿瘤组织中高表达71例（50.4%）,低表达70例（49.6%）;在癌旁组织中高表达7例（28.0%）,低表达18例（72.0%）,LIMD2在肿瘤组织中高表达较癌旁组织常见。E钙黏素在肿瘤组织中高表达75例（53.2%）,低表达66例（46.8%）;在癌旁组织中高表达13例（52.0%）,低表达12例（48.0%）,E钙黏素在两种组织中表达无差异。肿瘤组织中LIMD2表达水平在不同N分期、TNM分期及肿瘤分化程度方面存在差异,LIMD2高表达常见于术后无病生存期（DFS）短的患者中（P=0.033）。E钙黏素表达水平在不同的T分期、N分期及TNM分期中存在差异,E钙黏素高表达在术后DFS较长的患者中常见（P=0.000）。在癌组织中LIMD2表达水平与E钙黏素表达水平呈负相关（P=0.000）。多因素回归分析表明性别、T分期、TNM分期、肿瘤分化程度、LIMD2及E钙黏素表达与NSCLC术后DFS相关。结论:在NSCLC中LIMD2与E钙黏素表达呈负相关,LIMD2在肿瘤组织中表达越高术后DFS越短,LIMD2或许可以作为预测NSCLC术后复发的生物标志物。 相似文献
42.
Takashi Mizuno Jordan M. Cloyd Diego Vicente Kiyohiko Omichi Yun Shin Chun Scott E. Kopetz Dipen Maru Claudius Conrad Ching-Wei D. Tzeng Steven H. Wei Thomas A. Aloia Jean-Nicolas Vauthey 《European journal of surgical oncology》2018,44(5):684-692
Introduction
Dorsophilia protein, mothers against decapentaplegic homolog 4 (SMAD4) is a key mediator in the transforming growth factor (TGF)-β signaling pathway and SMAD4 gene mutations are thought to play a critical role in colorectal cancer (CRC) progression. However, little is known about its influence on survival in patients undergoing resection for colorectal liver metastases (CLM).Methods
Between 2005 and 2015, all patients with known SMAD4 mutation status who underwent resection of CLM were identified. Patients with SMAD4 mutation were compared to those with SMAD4 wild type. Next, the prognostic value of SMAD4 mutation was validated in a separate cohort of patients with synchronous stage IV CRC who underwent systemic therapy alone.Results
Of 278 patients, 37 (13%) were SMAD4 mutant while 241 (87%) were wild type. Overall survival (OS) after hepatic resection was worse in SMAD4-mutant patients compared to SMAD4 wild type (OS rate at 3 years, 62% vs. 82%; P < 0.0001). Independent predictors for worse OS were poor differentiation (hazard ratio [HR] 2.586; P = 0.007), multiple tumors (HR 1.970; P = 0.01), diameter greater than 3 cm (HR 1.752; P = 0.017), R1 margin status (HR 2.452; P = 0.014), RAS mutation (HR 2.044; P = 0.002), and SMAD4 mutation (HR 2.773; P < 0.0001). Among 237 patients in the validation cohort, SMAD4-mutations were significantly associated with worse 3-year OS rate (22% vs. 38%; P = 0.012) and was an independent predictor for worse OS (HR, 1.647; P = 0.032).Conclusion
SMAD4 mutation is independently associated with worse outcomes among patients undergoing resection of CLM. 相似文献43.
Markus Bo Schoenberg Hubertus Johann Wolfgang Anger Jingcheng Hao Adrian Vater Julian Nikolaus Bucher Michael Nikolaus Thomas Michael Lauseker Markus Rentsch Tobias Simon Schiergens Martin Kurt Angele Alexandr V. Bazhin Jens Werner Markus Otto Guba 《Surgical oncology》2018,27(4):663-673
Objective
To develop criteria for safe and oncologically satisfying liver resection in case of early hepatocellular carcinoma with a 5-year overall survival (OS) similar to liver transplantation.Summary background data
Liver resection (LR) and liver transplantation (LT) are potentially curative treatment options for hepatocellular carcinoma. Generally, LT achieves better OS. Due to organ shortage, however not all patients can receive a LT.Methods
To decide which patients to resect and which to transplant we have developed biological resection criteria (BRC) as a compound out of mGPS (modified Glascow Prognostic Scale) and the Kings-Score (for HCV cirrhosis). These are based on routine clinical values that reflect both liver function and tumor biology/immunology.Results
276 patients were analyzed. Patients undergoing LR within BRC (inBRC) had a significantly better overall (73.6% vs. 35.4%, (p?<?0.001)) and disease-free survival (54.7% vs. 17.2%, (p?<?0.001)) as compared to patients outside the BRC (outBRC). The predictive value of BRC was independent of tumor burden. In a subgroup analysis outBRC patients had significantly worse outcome after major resection. In LT patients BRC had no predictive value.Conclusions
BRC may be a valuable tool to predict survival after LR for HCC. Patients resected inBRC may achieve comparable survival as LT. LR in outBRC patients are unlikely to be curative. All outBRC patients should be monitored closely for salvage LT. 相似文献44.
Marine Gilabert Olivier Turrini Jacques Ewald Laurence Moureau-Zabotto Flora Poizat Jean-Luc Raoul Jean-Robert Delpero 《Surgical oncology》2018,27(4):619-624
Background
To describe, in patients with resectable pancreatic ductal adenocarcinoma (PDAC), the laparotomy findings, treatments and outcomes before (period 1) and after 2010 (period 2).Methods
From 2000 to 2015, patients newly diagnosed with resectable PDAC at Paoli-Calmettes Institute, France, were evaluated. Survival was examined using the Kaplan-Meier method, and statistical comparisons were conducted using log rank tests.Results
Among 1175 patients diagnosed with pancreatic mass, 164 underwent laparotomy with an intention of pancreatic resection. Some of them did not undergo pancreatic resection due to peroperative discovery of advanced disease. For those who were finally resected (n?=?119), there were fewer pancreaticoduodenectomies (p?=?0.045), shorter operation times (p?<?0.01), lower mortality rates (p?=?0.02), more advanced-stage tumors (T3), more frequent perineural invasion and R1 resection in period 2. This group had a trend of better outcomes after 2010 (51 months vs. 36 months (p?=?0.065)).Conclusion
Improvement in surgical procedures and postoperative management led to prolonged survival of those who underwent surgery for resectable pancreatic cancer since 2010, despite a higher frequency of advanced tumors at the diagnosis in our institution. 相似文献45.
目的:进一步探讨急性髓细胞白血病(AML)预后的影响因素。方法:123例AML患者,年龄大于55岁的称为老年组,85例。另38例年龄小于55岁的作为年轻组。同时根据FAB协作组分型诊断标准进行分型。应用标准化疗方案即3d蒽环类药物加7d阿糖胞苷进行诱导缓解治疗,达临床完全缓解(CR)后给予大剂量阿糖胞苷(HDAC)加柔红霉素(D)和HDAC加米托蒽醌(M)交替强化治疗。结果:年轻组2年、4年预期无病生存(DFS)分别为72.54%、27.45%,老年组分别为15.62%、3.12%。其中M2,M3生存期长。结论:年龄、AML亚型的分类,对AML患者治疗预后的影响很大。当前的治疗方向,应当是针对不同患者,采取个体化的治疗。 相似文献
46.
Hyo-jae Lee Jin Woong Kim Young Hoe Hur Sung Bum Cho Byung Chan Lee Byung Kook Lee Eu Chang Hwang Yong Soo Cho Hyun Ju Seon 《Journal of vascular and interventional radiology : JVIR》2019,30(3):284-292.e1
Purpose
To retrospectively compare long-term outcomes of conventional chemoembolization plus radiofrequency (RF) ablation vs those of surgical resection in patients with a single 3–5-cm hepatocellular carcinoma (HCC).Materials and Methods
From January 2008 to December 2017, 139 of 623 patients who underwent surgical resection and 60 of 186 patients who underwent chemoembolization/RF ablation in a single center were compared with respect to local tumor progression (LTP), intrahepatic distant recurrence (IDR), disease-free survival (DFS), overall survival (OS), major complications, and hospital stay before and after propensity-score matching.Results
Mean follow-up periods were similar in the chemoembolization/RF ablation and surgical resection groups (41.9 mo vs 48.4 mo). Three (5%) and 17 (28.3%) patients in the chemoembolization/RF ablation group and 12 (8.6%) and 57 (41.0%) patients in the surgical resection group showed LTP and IDR (P = .366 and P =.114, respectively). At 1, 3, and 5 years, respective DFS rates were 88.1%, 65.3%, and 49.0% for chemoembolization/RF ablation and 84.2%, 58.2%, and 46.5% for surgical resection (P = .294). Moreover, respective OS rates were 95.0%, 73.5%, and 54.0% for chemoembolization/RF ablation and 97.1%, 87.4%, and 75.0% for surgical resection (P = .055). After matching (n = 52), therapeutic outcomes remained similar (P = .370, P = .110, P = .230, and P = .760, respectively). Surgical resection was associated with higher complication rates (P = .015) and longer hospital stays (8.4 d ± 3.7 vs 16.9 d ± 7.0; P < .001).Conclusions
Conventional chemoembolization combined with RF ablation may be feasible for single 3–5-cm HCCs, with comparable therapeutic outcomes vs surgical resection and shorter hospital stays. 相似文献47.
48.
Prognostic impact of microsatellite instability and DNA ploidy in human colon carcinoma patients 总被引：9，自引：0，他引：9
Sinicrope FA Rego RL Halling KC Foster N Sargent DJ La Plant B French AJ Laurie JA Goldberg RM Thibodeau SN Witzig TE 《Gastroenterology》2006,131(3):729-737
BACKGROUND & AIMS: Genomic instability in colon cancers is a consequence of chromosomal instability characterized by aneuploidy or defective DNA mismatch repair (MMR) indicated by microsatellite instability (MSI). Given that high-frequency MSI (MSI-H) and diploidy are correlated, we determined whether they are independent prognostic variables. METHODS: Astler-Coller stage B2 and C colon cancers (N = 528) from patients treated in 5-fluorouracil-based adjuvant therapy trials were analyzed for MSI using 11 microsatellite markers. Immunostaining for hMLH1, hMSH2, and p53 proteins was performed. DNA ploidy was analyzed by flow cytometry. Associations with disease-free and overall survival were determined. RESULTS: MSI-H was detected in 95 tumors (18%), and 70 (74%) of these were diploid. Tumors showing MSI-H (hazard ratio, 0.65; 95% confidence interval, 0.44-0.96; P = .023) or loss of MMR proteins (P = .024) were associated with better overall survival. Improved disease-free and overall survival were found for diploid versus aneuploid/tetraploid tumors (overall survival: hazard ratio, 0.59; 95% confidence interval, 0.43-0.79; P = .0003). In the subgroups of MSI-H and microsatellite stable (MSS)/low-frequency MSI (MSI-L) tumors, diploidy was associated with better survival. The prognostic impact of ploidy was similar in stage B2 and C tumors. Ploidy did not predict the benefit of 5-fluorouracil-based treatment. When ploidy, MSI, and MMR proteins were analyzed in the same multivariate model, only ploidy remained significant. CONCLUSIONS: DNA ploidy and MSI-H status were independent prognostic variables, yet ploidy was the strongest marker. Diploidy was associated with better survival in MSI-H and in MSS/MSI-L patient subgroups. 相似文献
49.
50.
Byoung Kwan Son Dong-Hoon Kim Kyueng-Whan Min Eun-Kyung Kim Mi Jung Kwon 《Pathology, research and practice》2018,214(4):475-481
Gastric cancer is a heterogeneous disorder for which predicting clinical outcomes is challenging, although various biomarkers have been suggested. The Smad4 and Fascin proteins are known prognostic indicators of different types of malignancy. Smad4 primarily functions as a key regulator of tumor suppression, whereas Fascin exhibits oncogenic function by enhancing tumor infiltration. A combined marker based on these opposing roles may improve prognostic accuracy in gastric cancer.Smad4 and Fascin expression was assessed in tissue microarrays obtained from 285 primary gastric adenocarcinoma, 201 normal tissue, and 51 metastatic adenocarcinoma samples. A Smad4/Fascin index based on the relative expression of each protein was divided into low- and high-expression groups using receiver operating characteristic curves. We compared normal tissue, primary adenocarcinoma, and metastatic adenocarcinoma in Smad4 and Fascin expression and the differences in clinicopathological findings between low Smad4/Fascin and high Smad4/Fascin expression in gastric adenocarcinoma.High Smad4/Fascin expression was significantly associated with worse outcomes, such as old age, advanced T and N category, large tumor size, high histological grade, lymphatic and vascular invasion, and presence of Epstein–Barr virus (EBV) (all p?<?0.05). Univariate and multivariate analyses revealed a significant relationship between disease-free or overall survival and Smad4/Fascin index in diffuse-type or EBV-associated gastric cancer (all p?<?0.05).A dual marker system using Smad4 and Fascin may be a reliable indicator for predicting clinical outcomes in patients with diffuse-type or EBV-associated gastric cancer. 相似文献