This study sought to assess the prognostic signiifcance of the degree of extranodal extension (ENE) and several other risk factors in pathological ENE penile carcinoma. We analyzed prospectively collected data on a consecutive series of 31 chemotherapy-naive patients with proven ENE who underwent therapeutic regional lymphadenectomy. Postoperative external radiotherapy was then performed. We studied the extent of ENE utilizing a novel grading system and correlated patient grades with their outcome measures. ENE was graded as 1-if the capsule of the lymph node (LN) was ruptured less than one-third of its circumference or 2 - if the capsule was disrupted more than one-third of its circumference or the entire LN was disrupted. We estimated overall survival (OS) using the Kaplan-Meier method. Multivariate analysis was performed according to the Cox proportional hazards model using factors that were identiifed as statistically signiifcant in univariate analysis. The incidence rate of ENE was 51.8%in patients with pathological node-positive carcinoma of the penis. The median OS and 5-year survival were 18 months (95%conifdence interval (CI), 14.4-21.6) and 23%, respectively. Prognostic variables on univariate analysis were ENE grade 2,≥3 LNs with ENE, maximal LN≥35 mm,≥5 positive LNs and pelvic LN involvement. On multivariate analysis, only ENE grade 2 remained associated with decreased OS (hazard ratio (HR):6.50). In conclusion, patients with ENE have a poor outcome, and ENE grade 2 is an independent predictive factor of poor OS in patients with pathological ENE penile carcinoma.

IgA nephropathy (IgAN) or Berger's disease is the most common form of primary glomerulonephritis in many renal biopsy registries and it is very frequent in the Eastern regions of the world, such as China (32,1%), Hong Kong (35%), Japan (47,4% )[1,2].

Objective: To study the clinical significance for measuring serum immunosuppressive acidic protein(IAP) levels to diagnose and follow up survey patients with the gynecological tumor.Methods: Serum IAP levels were determined by IAP-single radial immunodiffusion test in 235 patients with the gynecological tumor,including 38 cases of benign tumor of ovary,41 cases of malignant tumor of ovary,66 cases of hysteromyoma,34 carcinomas of uterine cervix, 16 endometrial carcinomas,27 cases of chemotherapy,13 cases of recurrence, and the control group was 50 cases health women.Results: Serum IAP level was 889.4±207.8mg/L in malignant ovary tumors,which was significantly higher than that of health women and benign tumors of ovary (P＜0.01).In patients with carcinoma of uterine cervix and endometrial carcinoma, their IAP levels were 741.4±212.6mg/L and 763.3±209.4mg/L,which were higher than those of the health women and benign tumor of ovary(P＜0.01).After chemotherapy, serum IAP levels of malignant tumor of ovary were decreased;in patients with recurrence of tumor of ovary,IAP levels increased compared with the health women(P＜0.01).Incidence of the abnormal value was 100%.Conclusion:Measuring IAP level of the gynecological tumor may be an auxiliary index for monitoring gynecological tumor and identifying benign and malignant tumor.

多种生物标志物在脓毒症患者中的临床价值

目的:通过联合检测脓毒症患者血浆氨基末端脑钠肽前体(NT-proBNP)、降钙素原、乳酸及胆碱酯酶的质量浓度,研究其对脓毒症患者病情评估及预后判断的临床意义.方法:用前瞻性研究方法,以2015-01-2017-06期间在我院重症监护室住院的120例脓毒症患者为研究对象.其中一般脓毒症组51例,严重脓毒症组40例,脓毒症休克组29例.对3组患者不同时间NT-proBNP、降钙素原、乳酸及胆碱酯酶质量浓度水平变化进行比较分析,并行APACHEⅡ评分.随访严重脓毒症及脓毒症休克组患者28 d生存情况,对存活组(50例)及死亡组(19例)患者的各项指标进行比较,并比较NT-proBNP、降钙素原、乳酸、胆碱酯酶与APACHEⅡ评分的相关性.结果:与脓毒症组患者相比,严重脓毒症组和脓毒症休克组患者在不同时间血浆NT-proBNP、降钙素原、乳酸水平明显提高,而胆碱酯酶明显降低,3组间比较差异均具有统计学意义(P＜0.05);与严重脓毒症组相比,脓毒症休克组患者在不同时间血浆NT-proBNP、降钙素原、乳酸水平明显提高,而胆碱酯酶明显降低,3组间比较差异均具有统计学意义(P＜0.05);与存活组相比,死亡组血浆NT-proBNP、降钙素原、乳酸质量浓度及A-PACHEⅡ评分均明显提高,而胆碱酯酶水平明显降低,差异具有统计学意义(P＜0.05);血浆NT-proBNP、降钙素原、乳酸质量浓度与APACHEⅡ评分呈正相关,胆碱酯酶的质量浓度与APACHEⅡ评分呈负相关.结论:血浆NT-proBNP、降钙素原、乳酸、胆碱酯酶联合检测对于脓毒症患者预后的评估具有重要的临床指导意义.

The functional state of local immunity in the female genital tract during the HPV-infection

Objective:To investigate the clinical significance of p53 and p16 expression in gastric carcinoma with special reference to the prognosis.Methods:One hundred and fifty-two patients with gastric carcinoma undergoing operation in our hospital between 1991 and 1998 were evaluated for expression of p53 and p16 in formalin-fixed and paraffin-embedded tumor tissue utilizing Avidin-Biotin immunohistochemistry techniques. Statistical correlations with stage, histological type, differentiation degree, location, size, and overall survival were done. The Cox proportional hazard model was also performed to evaluate which factors had an independent prognostic value.Results:In 152 cases of resected gastric cancer, 110 (72.4%) were p16 positive and 49 (32.2%) showed p53 overexpression. Differences were observed in the frequency of p16 positivity with respect to age, gender and tumor size. The frequency of p53 positivity cells in well-differentiated tumors was significantly higher than that in poorly differentiated tumors (41.9% vs. 25.6%; P= 0.034). In a multivariate analysis, tumor TNM stage, perioperation chemotherapy and the expression of p16 were independent prognostic factors in gastric cancer.Conclusions:The results of the current study suggest that expression of p16 may be a useful prognostic factor for patients with gastric carcinoma, but the expression of p53 as detected by immunohistochemistry were of no value in predicting the prognosis of patients with gastric carcinoma independently.

Objective:The therapeutic value of extensive gastric lymphadenectomy in gastric cancer is controversial.We retrospectively investigated the effect of extended lymphadenectomy on survival in 485 patients with gastric cancer.Methods:From 485 gastric cancer patients who underwent gastrectomy, extensive lymphadenectomy was performed on 341 patients and the 5-year survival rate of patiens who had undergone extensive lymphadenectomy was compared with that of patients who had not undergone extensive lymphadenctomy.Survival was estimated using the Life Table method and difference in survival was tested by the Wilcoxon (Gehan) test.Multivariate analysis was done by the Cox proportional hazard model.Results:The overall 5-year survival rate was 37.75%.For patients undergoing extensive and without extensive lymphadenectomy,the 5-year survival rates were 43.27% and 16.36%, respectively (P＜0.001).Multivariate analysis also showed that extensive lymphadenectomy was an important independent prognostic factor for survival in patients with gastric cancer after gastrectomy.Conclusions:These results indicate that extensive lymphadenectomy might provide a survival benefit for patients with gastric cancer.

Clinicopathological and Molecular Biological Studies of Primary Pulmonary Carcinoma with the p53 Gene Mutations

Objective To investigate the relationship between p53 aberrations and human pulmonary carcinoma prognosis and to evaluate as a genetic marker in the prognostic significance of the P53 mutations in the lung cancer. Methods DNAs from normal (n=5) and tumor (n=31) tissue specimens from non-small cell lung carcinomas (NSCLC), p53 exons 5-8 mutations were analyzed by polymerase chain reaction single-strand conformation polymorphism (PCR-SSCP) analysis. Results The detected mutation rate is 48.4％ (15/31) in the pulmonary carcinoma group, which was significantly higher than that in the control group. The control group showed that there is no p53 mutations. In the pulmonary carcinoma group, detection rates of p53 exons 5-8 mutations for squamous cell carcinomas, adenocarcinomas, bronchioloalveolar carcinomas and large cell carcinomas were 56.3％, 30.0％, 33.3％ and 100.0％, respectively. The incidence of p53 point mutational activation in the adenocarcinomas was lower in pulmonary carcinomas as compared to that in the squamous cell carcinomas. The level of p53 gene mutations was associated with TNM stages, the mutations of p53 gene in cancer tissues of the stages Ⅲ -Ⅳ were higher than in tumor stage Ⅰ and/or stage Ⅱ (χ2=6.556, P=0.038). The mutations in poor differentiated tumors were obviously higher than well differentiated and moderately differentiated tumors (χ2=4.045, P=0.044; χ2=4.232, P=0.040, respectively). However, statistical analysis showed that there is no significant correlations between p53 mutations and other clinical parameters, such as: age, sex, tumor size, and histological subtypes. Conclusion Detection of p53 gene mutations in lung carcinomas by PCR-SSCP can be used as a follow-up intermediate biomarker for the prognostic surveillance of human pulmonary carcinoma.

Using a population-based cancer registry, Thuret et al. developed 3 nomograms for estimating cancer-specific mortality in men with penile squamous cell carcinoma. In the initial cohort, only 23.0% of the patients were treated with inguinal lymphadenectomy and had pN stage. To generalize the prediction models in clinical practice, we evaluated the performance of the 3 nomograms in a series of penile cancer patients who were treated with definitive surgery. Clinicopathologic information was obtained from 160 M0 penile cancer patients who underwent primary tumor excision and regional lymphadenectomy between 1990 and 2008. The predicted probabilities of cancer-specific mortality were calculated from 3 nomograms that were based on different disease stage definitions and tumor grade. Discrimination, calibration, and clinical usefulness were assessed to compare model performance. The discrimination ability was similar in nomograms using the TNM classification or American Joint Committee on Cancer staging (Harrell’s concordance index = 0.817 and 0.832, respectively), whereas it was inferior for the Surveillance, Epidemiology and End Results staging (Harrel ’s concordance index = 0.728). Better agreement with the observed cancer-specific mortality was shown for the model consisting of TNM classification and tumor grade, which also achieved favorable clinical net benefit, with a threshold probability in the range of 0 to 42%. The nomogram consisting of TNM classification and tumor grading was shown to have better performance for predicting cancer-specific mortality in penile cancer patients who underwent definitive surgery. Our data support the integration of this model in decision-making and trial design.

Few large scale studies have reported the oncologic outcome of radical cystectomy for treating bladder cancer in China; hence, we lack long-term prognostic information. The aim of the current study was to determine the survival rate and prognostic factors of patients who underwent radical cystectomy for bladder cancer in a Chinese medical center. We retrospectively analyzed clinicopathologic data from 271 bladder cancer patients who underwent radical cystectomy between 2000 and 2011. Univariate and multivariate analyses were conducted to identify independent prognostic predictors for this cohort. Median follow-up was 31.7 months (range, 0.2-139.1 months). Thirty-day mortality was (1.4%). The 5-year recurrence-free survival, cancer-specific survival (CSS), and overall survival rates were 61.6%, 72.9%, and 68.0%, respectively. The 5-year CSS rates of patients with T1-T4 disease were 90.7%, 85.0%, 51.0%, and 18.0%, respectively. Patients with organ-confined disease had a higher 5-year CSS rate than those with extravesical disease (81.4%vs. 34.9%, P<0.001). For the 38 patients (14%) with lymph node involvement, the 5-year CSS rate was 27.7%-significantly lower than that of patients without lymph node metastasis (P < 0.001). The 5-year CSS rate was much higher in patients with low grade tumor than in those with high grade tumor (98.1%vs. 68.1%, P<0.001). Multivariate Cox regression showed that patient age (hazard ratio, 2.045; P = 0.013) and T category (hazard ratio, 2.213; P < 0.001) were independent predictors for CSS. These results suggest that radical cystectomy is a safe and effective method for treating bladder cancer in Chinese patients. Old age and high T category were associated with poor prognosis in bladder cancer patients who underwent radical cystectomy.

PRUNE2 plays an important role in regulating tumor celldifferentiation, proliferation, and invasiveness in neuroblastoma. Our previous study revealed that PRUNE2/OBSCN two-gene relative expression classifer accurately differentiated leiomyosarcoma from gastrointestinal stromal tumor. However, the association between PRUNE2 expression and prognosis in leiomyosarcoma is poorly understood. In this study, we evaluated the prognostic role of PRUNE2 in leiomyosarcoma. PRUNE2 expression was detected using immunohistochemistry in 30 formalin-fixed, paraffin-embedded leiomyosarcoma tissues from MD Anderson Cancer Center, and high expression was detected in 36.7%(11/30) of the samples. To validate these results, immunohistochemistry was performed on another cohort of 45 formalin-fixed, paraffin-embedded leiomyosarcoma tissues from Tianjin Medical University Cancer Institute & Hospital, and high PRUNE2 protein expression was detected in 37.8%(17/45) of the samples. Moreover, elevated PRUNE2 expression was significantly associated with tumor size (P = 0.03) and hemorrhage/cyst (P = 0.014), and was an independent favorable prognostic factor for overal survival in leiomyosarcoma patients from Tianjin Medical University Cancer Institute & Hospital (P < 0.05). These data suggest that increased PRUNE2 protein expression may serve as a favorable prognostic marker in human leiomyosarcoma.

Skp2表达在结外NK/T细胞性淋巴瘤中的意义

Background and Objective: Expression of Skp2 was related with the prognosis of several tumors. However, there was no intensive study on the relationship between Skp2 and extranodal NK/T-cell lymphoma. This study was to explore the role of Skp2 in extranodal NK/T-cell lymphoma. Methods: The clinicopathological data of 39 patients with extranodal NK/T-cell lymphoma were analyzed. The expression of Skp2 was examined by immunohistochemistry on formalin-fixed, paraffin-embedded tissue sections. Results: Among the patients with high expression of Skp2, complete remission (CR) rate was only 14.3% (2/14). However, CR rate among the patients with low expression of Skp2 was 68.0% (17/25). Significant difference was shown between these two groups (P < 0.001). In the group of low expression, the median overall survival (OS) was 85.59 months (95% Cl: 35.83-135.34 months), the 1- and 2-year OS rates were 81% and 71%, respectively. However, in the group of high expression, the median OS was only 9.73 months (95% Cl: 2.05-17.40 months), the 1- and 2-year OS rates were 42% and 14%, respectively. There was statistical difference between these two groups (P < 0.001). Muttivariate analysis showed that Skp2 expression (P < 0.001), LDH (P = 0.026) and ECOG PS (P = 0.003) were dependent prognostic factors of extranodal NK/T-cell lymphoma. Conclusion: High expression of Skp2 is an independent unfavorite adverse prognostic factor of extranodal NK/T-cell lymphoma.

The current World Health Organization classification system of primary brain tumors is solely based on morphologic criteria. However, there is accumulating evidence that tumors with similar histology have distinct molecular signatures that significantly impact treatment response and survival. Recent practice-changing clinical trials have defined a role for routine assessment of O-6-methylguanine-DNA methyltransferase (MGMT) promoter methylation in glioblastoma patients, especially in the elderly, and 1p and 19q codeletions in patients with anaplastic glial tumors. Recently discovered molecular alterations including mutations in IDH-1/2, epidermal growth factor receptor (EGFR), and BRAF also have the potential to become targets for future drug development. This article aims to summarize current knowledge on the molecular biology of high-grade gliomas relevant to daily practice.

Relationship study between platelet count and stage and grade of renal cell carcinoma in indoor patients

Objective:Thrombocytosis has been reported in many types of malignancies and has been studied as a prognostic factor.The aim of this survey iS to investigate the relation between platelet count and stage and grade of tumor in indoor patients with renal cell carcinoma(RCC)in order to evaluate the prognostic value of thrembocytosis.Methods:In a descriptive and retrospective survey 82 patients treated by radical nephreetomy for RCC were enrolled.In all cases,TNM stage,Fuhrman grade,invasion and platelet count were recorded and entered in SPSS software for analysis.Results:In this study,76 patients (92.7%)with norlnal platelet and 6 patients(7.3%)with thrombocytosis were studied.In this survey there Was no significant correlation between the thrombocytosis and pathological stage in all patients,both genders and various age groups.In addition,the correlation between thrombocytosis and nuclear grade was investigated and a significant correlation between them in all patients and both genders Was found,Finally,there was no significant correlation between thrombocytosis and nuclear grade at various age groups.Conclusion:Prognostic indicators that can accurately predict survival rates in patients with RCC can be used to select those patients most hkdy to benefit from adjuvant therapy.In this survey there was a significant correlation between thrombocytosis and nuclear grade,however,further clinical studies are needed.

Paraneoplastic Leukocytosis and Thrombocytosis as Prognostic Biomarkers in Non-small Cell Lung Cancer

BACKGROUND:?Combined? hepatocellular? carcinoma? and?cholangiocarcinoma?(cHCC-CC)?is?a?rare?subtype?of?primary?liver?cancer?consisting?of?both?hepatocellular?carcinoma?(HCC)?and?cholangiocarcinoma?(CC).?Because?of?the?rarity?of?this?tumor,?its?feature?is?poorly?understood.?The?present?study?aimed?to?evaluate?the?clinicopathological?features?and?long-term?prognosis?of?patients?with?cHCC-CC?after?surgery?and?to?compare?with?those?of?the?patients?with?stage-matched?HCC?and?CC.METHODS:?The?clinicopathological?features?of?the?patients?who?underwent?surgery?for?cHCC-CC?at?our?center?during?the?period?of?2001-2010?were?retrospectively?analyzed?and?compared?with?those?of?stage-matched?HCC?and?CC?patients.?Cancer?staging?was?performed?according?to?the?AJCC Cancer Staging Manual?(6th?ed.).?Overall?survival?and?disease-free?survival?were?compared?among?the?groups?and?prognostic?factors?of?cHCC-CC?were?evaluated. RESULTS:?Signiifcant? differences? were? observed? in? clinico-pathological?features?among?42?patients?with?cHCC-CC,?90?patients?with?HCC?and?45?patients?with?CC.?Similar?to?HCC?patients,?cHCC-CC?patients?had?frequent?hepatitis?B?virus?antigen?positivity,?microscopic?vessel?invasion,?cirrhosis?and?high?level?of?serum?alpha-fetoprotein.?Similar?to?CC?patients,?cHCC-CC?patients?showed?increased?bile?duct?invasion?and?decreased?capsule.?The?1-,?3-,?and?5-year?overall?survival?and?disease-free?survival?of?patients?with?cHCC-CC?were?not?signiifcantly?different?from?those?with?stage-matched?patients?with?CC; but?signiifcantly?poorer?than?those?with?HCC.?In?subanalysis?of?patients?with?stage?II,?the?overall?survival?in?patients?with?cHCC-CC?or?CC?was?signiifcantly?poorer?than?that?in?patients?with?HCC.?We?did?not?ifnd?the?difference?in?patients?with?other?stages.?Univariate?analysis?of?overall?and?disease-free?survival?of?patients?with?cHCC-CC?showed?that?the?vascular?invasion?and?intrahepatic?metastasis?were?the?signiifcant?predictive?factors. CONCLUSION:?Patients?with?cHCC-CC?showed?similar?clinico-pathological?features?as?those?with?HCC?or?CC,?and?patients?with?cHCC-CC?or?CC?had?a?poorer?prognosis?compared?with?those?with?HCC,?especially?at?matched?stage?II.

Clinical Significance of Biological Markers at Primary Operation for Metastatic Breast Cancer

Purpose: To identify the prognostic value of biological markers at initial operation for metastatic breast cancer, we measured the presence of estrogen receptor-alpha (ERα), progesterone receptor (PgR) and human epidermal growth factor receptor type 2 (HER2),and histological grade (HG) of tumors. Methods: One-hundred and seventy-six patients, aged 29 to 90 (median: 51 years), with recurrent breast cancer underwent primary operation at our department during the period from 1983 to 2000. Clinicopathological factors examined at primary operation included menopausal symptoms, presence of axillary lymph node metastasis, tumor size, HG, HER2, ERα and PgR.Factors examined at recurrence included site of primary recurrence, disease-free interval(DFI) and tumor markers, such as CEA and CA15-3. The relationship between these factors and prognosis following recurrence was assessed. Results: Menopausal status, axillary lymph node metastasis and tumor size at primary operation had no significant effect on prognosis. Patients with low HG, positive expession of ERα and PgR, and low HER2 expression had a good prognosis, similar to those with long DFI and distant metastases. After distant metastases, HER2 was found to be the most important prognostic factor following recurrence and in predicting response to drug therapy.Conclusion: Biological factors indicating tumor malignancy at the time of the first operation are also important prognostic factors following tumor recurrence.

Objective: To investigate the relationships between angiogenesis and development, metastasis as well as prognosis of thyroid carcinoma. Methods:48 cases of thyroid carcinoma and 5 cases of thyroid adenoma were studied.Density of microvessels of the tumors were identified by immunohistochemical staining in formalin -fixed and paraffin-embedded sections with anti-CD34 monoclonal antibody, and counted microscopically (×200).Results :The mean value of MVD in tumors＞2cm in diameter was (174.92±72.63)/field, while that in tumors≤2cm was ( 117.40± 39.95)/field ( t = 3.3298, P = 0.0026).The number of microvessels was also significantly different in respect to the histotype of the thyroid carcinomas, such as papillary thyroid carcinoma(PTC), follicular thyroid carcinoma(FTC)and medullary thyroid carcinoma(MTC) ( F = 14. 95, P = 0. 0001), but not significantly different in respect to patients'age nor sex ( P＞0.05). Conclusions:By studying microvessel density (MVD) of thyroid arcinomas and correlated with their clinical features and biological behaviors, it is concluded that ngiogenesis is important in tumor growth and metastasis as well as prognosis of thyroid carcinomas. Measures to combat angiogenesis may be beneficial in the treatment for thyroid carcinomas.

Quantitative detection of metastasis-associated1mRNA and protein expression in breast cancer

Objective Understanding the mechanism of breast cancer metastasis will benefit those patients in need of aggressive treatment and avoid side effects caused by chemotherapy over treatment.Recently,a potential metastasis-associated gene and its product,the metastasis-associated 1 (MTA1),were identified; this gene has been found to be overexpressed in a variety of cancers.Methods In the present study,therefore,the level of expression of MTA1 mRNA has been assessed by LightCycler quantitative real-time RT-PCR in 160 cases of invasive carcinoma of the breast.MTA1 protein expression level was also detected by immunohistochemistry from available paired tissues of 154 cases.Associations between MTA1 mRNA and protein expression and clinicopathological factors were analyzed.Results It was found that MTA1 mRNA was expressed at significantly higher levels in patients with negative lymph node status,with ER and PgR positive and HER2 negative tumor.No difference was found between patient age,tumor size and histological grade groups.Patients with high levels of expression of MTA1 mRNA had a better prognosis than those with low expression.However,no difference was found between the protein level and clinicopathological factors.Univariate and multivariate prognostic analysis did not demonstrate that MTA1 mRNA was an independent prognostic factor for breast cancer.Conclusion In breast cancer,inconsistent with other tumor types,MTA1 gene expression is correlated with non-invasive clinicopathological factors and longer survival,which might suggest MTA1 gene is a tumor type specific metastasis associated gene.

Quantitation of HDAC1 mRNA expression in invasive carcinoma of the breast

Estrogen is well-established as a mitogenic factor implicated in the tumorigenesis and progression of breast cancer via its binding to the estrogen receptor a(ERα). Recent data indicate that chromatin inactivation mediated by histone deacetylation(HDAC) and DNA methylation is a critical component of ERα silencing in human breast cancer cells. The aim of this study was to determine the expression of the HDAC1 gene in malignant human breast tissue and to correlate our observations with available clinical information. In the present study, the level of expression of HDAC1 mRNA was assessed by LightCycler-based quantitative real-time reverse transcriptase (RT)-PCR analvsis in 162 cases of invasive carcinoma of the breast. Associations between HDAC1 mRNA expression and different clinicopathological factors were sought. It was found that HDAC1 mRNA was expressed at significantly higher levels in tumors from patients over 50 years of age and in those tumors without axillary lymph node involvement, that are less than 2 cm, that are of a non-high histological grade, that are HER2 negative and that are ERα/PgR positive. Patients with tumors displaying high levels of HDAC1 mRNA expression tended to have a better prognosis in terms of both disease-free and overall survival. However, univariate and multivariate analysis did not show HDAC1 mRNA expression level to be an independent prognostic factor for either disease-free or overall survival. These results imply that HDAC1 mRNA expression could have potential as an endocrine response marker and may have prognostic implications for breast cancer progression.