Development and verification of prognostic nomogram for ampullary carcinoma based on the SEER database.

Background: Ampullary carcinoma (AC) is a rare cancer of the digestive system that occurs in the ampulla at the junction of the bile duct and pancreatic duct. However, there is a lack of predictive models for overall survival (OS) and disease -specific survival (DSS) in AC. This study aimed to develop a prognostic nomogram for patients with AC using data from the Surveillance, Epidemiology, and End Results Program (SEER) database. Methods: Data from 891 patients between 2004 and 2019 were downloaded and extracted from the SEER database. They were randomly divided into the development group (70%) and the verification group (30%), and then univariate and multivariate Cox proportional hazards regression, respectively, was used to explore the possible risk factors of AC. The factors significantly related to OS and DSS were used to establish the nomogram, which was assessed via the concordance index (C-index), and calibration curve. An internal validation was conducted to test the accuracy and effectiveness of the nomogram. Kaplan-Meier calculation was used to predict the further OS and DSS status of these patients. Results: On multivariate Cox proportional hazards regression, the independent prognostic risk factors associated with OS were age, surgery, chemotherapy, regional node positive (RNP),extension range and distant metastasis with a moderate C-index of 0.731 (95% confidence interval (CI): 0.719-0.744) and 0.766 (95% CI: 0.747-0.785) in the development and verification groups, respectively. While, marital status, surgery, chemotherapy, regional node positive (RNP),extension range and distant metastasis were significantly linked to AC patients' DSS, which have a better C-index of 0.756 (95% confidence interval (CI): 0.741-0.770) and 0.781 (95% CI: 0.757-0.805) in the development and verification groups. Both the survival calibration curves of 3- and 5-year OS and DSS brought out a high consistency. Conclusion: Our study yielded a satisfactory nomogram showing the survival of AC patients, which may help clinicians to assess the situation of AC patients and implement further treatment.

Association between gallstone and cardio-cerebrovascular disease: Systematic review and meta-analysis.

Increasing evidence connects gallstone disease (GD) to cardio-cerebrovascular disease (CVD). The aim of the present systematic review and meta-analysis was to determine whether and to what extent an association between GD and CVD existed. PubMed, EMBASE and the Cochrane Library were systemically searched up to March 3rd, 2018. A total of 10 studies (1,272,177 participants; 13,833 records; 5 prospective cohorts and 5 retrospective cohorts) were included. It was demonstrated that GD was associated with an increased risk of incidence [hazard ratio=1.24, 95% (CI) confidence interval: 1.17-1.31] and prevalence (unadjusted odds ratio=1.23, 95% CI: 1.21-1.25) of CVD. In conclusion, the presence of GD was associated with an increased risk of CVD incidence and prevalence. The association may be influenced by age and sex. These findings suggest that individuals identified with cardio-cerebrovascular disease should be evaluated for GD.

Significance of hepatitis B virus surface antigen, hepatitis C virus expression in hepatocellular carcinoma and pericarcinomatous tissues.

AIM: To investigate the correlation between hepatitis B virus surface antigen (HBsAg), hepatitis C virus (HCV) expression in hepatocellular carcinoma (HCC), the HAI score of the noncancerous region of the liver and the serum Alpha fetoprotein (AFP) level. METHODS: The patterns of HBsAg and HCV in 100 cases of HCC and their surrounding liver tissues were studied on paraffin-embedded sections with immuno-histochemistry, the histological status was determined by one pathologist and one surgeon simultaneously using the hepatitis activity index (HAI) score, and AFP was detected by radioimmunity. The study included 100 consecutive patients who underwent curative resection for HCC. Based on HBsAg and HCV expression, the patients were classified into 4 groups: patients positive for HBsAg (HBsAg group), patients positive for HCV (HCV group), patients negative for both HCV and HBsAg (NBNC group) and patients positive for both HBsAg and HCV (BC group). RESULTS: The BC group had significantly higher HAI scores than the other three groups. (BC > HCV > HBsAg > NBNC). HBV and HCV virus infection was positively correlated with HAI (r(s) = 0.39, P = 0.0001). The positive rate of AFP (85.7%) and the value of AFP (541.2 ng/mL) in the group with HBV and HCV co-infection were the highest among the four groups. The positive rate (53.3%) of AFP and the value of AFP ( 53.3 ng/mL) in the group with none-infection of HBV and HCV were the lowest. HBV and HCV virus infection was positively correlated with AFP(r(s) = 0.38, P = 0.0001). CONCLUSION: The AFP increase in patients with liver cancer was positively correlated with the infection of HBV and HCV. The serum AFP elevation by the infection of HBV and HCV is one of mechanisms which lead to hepatocarcinogenesis, and the antivirus intervening treatment of hepatitis is significant for the prognosis of liver cancer. From our Spearman's rank correlation analysis, we can conclude that the severity of virally induced inflammation is correlated with HBsAg and HCV expression in HCC tissues and noncancerous tissues. Prior co-infection of HBV in HCV patients may be an adverse risk factor for intrahepatic inflammation.

[Study on the correlations between HBsAg and hepatitis C virus expression as well as fibrotic staging in hepatocellular carcinoma and pericarcinomatous tissues].

OBJECTIVE: To study the correlation between hepatitis B virus surface antigen (HBsAg) and hepatitis C virus (HCV) expression as well as fibrosis staging in hepatocellular carcinoma (HCC) and pericarcinomatous tissues. METHODS: The patterns of HBsAg and HCV in 100 cases of HCC and their surrounding liver tissues were studied on paraffin-embeded sections with immunohistochemistry technique, and liver tissues were also staged. RESULTS: HBV, HCV virus infection were positively correlated with the fibrotic staging (r(s) = 0.32, P = 0.001). HBsAg and HCV were detected both in HCC and pericarcinomatous tissues. The positive rate of HBsAg in Pericarcinomatous Tissues (79%) was higher than that of in HCC tissues (23%). HCV expressions in HCC (15%) and pericarcinomatous tissues (23%) showed no significant differences. CONCLUSION: The fibrotic degree in the tissues of liver cancer with previous virus infection was obviously higher than that without virus infection. Viral infection seemed to be one of the reasons causing liver cancer while perennial virusemia would aggravate pathological changes of the liver tissue.

[Correlation between HBsAg, HCV expression in cancerous and pericancer tissues of hepatocellular carcinoma and liver fibrosis markers in serum].

OBJECTIVE: To study the correlation between HBsAg and HCV in hepatocellular carcinoma (HCC) pericarcinomatous tissues and serum liver fibrosis markers. METHODS: The patterns of HBsAg and HCV in 100 cases of HCC and their surrounding liver tissues were studied with paraffin sections using immunohistochemistry techniques. Hyaluronic acid (HA), procollagen III peptide (PIIIP), collagen IV (CIV), and laminin (LN) were detected by radioimmunoassay. RESULTS: The levels of HA, PIIIP, CIV and LN in the HBV and HCV coinfection group were the highest among the four groups. The levels of HA, PIIIP, CIV and LN in the groups not infected by HBV and HCV were the lowest among the four groups. HBV and HCV expressions were positively correlated with HA, LN and CIV and their Spearman's rank correlation coefficients were 0.60, 0.45, 0.46, respectively (P < 0.01). CONCLUSION: Liver cancer development follows a sequential trend of chronic hepatitis, liver cirrhosis, and liver cancer. In the tissues of liver cancer with virus infection background, the serum marker level of hepatic fibrosis is obviously higher than those without virus infection background. On the one hand, virus infection is one of the reasons causing liver cancer; and on the other hand, longstanding viremia will aggravate pathological changes of liver tissues. Therefore antivirus treatment of hepatitis is of significance for the prognosis of liver cancer.