RESUMEN
We conducted a cohort study to investigate the prognostic significance of vascular endothelial growth factor (VEGF) polymorphisms in hepatocellular carcinoma (HCC) patients after transcatheter arterial chemoembolization (TACE). In total, 156 patients with histologically confirmed HCC within 2 months were collected from January 2007 to January 2008. The genotypes of VEGF-2578C/A, -1154G/A, -634C/G, and -1498T/C were determined from blood extracted using a blood kit on a 384-well plate. The survival rate at 5 years was 55.47%. Multivariate analysis revealed that only tumor-node-metastasis (TNM) stage, metastasis, and the VEGF-2578 AA and -1154 AA genotypes were independent prognostic factors. Patients with TNM stage III-IV and metastasis showed a greatly increased risk of death from HCC, with hazard ratios (HRs) [95% confidence interval (CI)] of 3.64 (1.67-6.79) and 2.91 (1.30-6.27), respectively. Moreover, the VEGF-2578 AA and -1154 AA genotypes showed a significantly increased risk of death compared with the wild-type genotype (HR = 3.65, 95%CI = 1.35-11.13; HR = 7.13, 95%CI = 1.46-65.8). These results will be helpful for predicting clinical outcomes of HCC patients.
Asunto(s)
Carcinoma Hepatocelular/genética , Embolización Terapéutica/métodos , Neoplasias Hepáticas/genética , Polimorfismo de Nucleótido Simple , Factor A de Crecimiento Endotelial Vascular/genética , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma Hepatocelular/patología , Carcinoma Hepatocelular/terapia , Estudios de Cohortes , Femenino , Humanos , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/terapia , Metástasis Linfática , Masculino , Persona de Mediana Edad , Análisis Multivariante , Estadificación de Neoplasias , Evaluación de Resultado en la Atención de Salud/métodos , Evaluación de Resultado en la Atención de Salud/estadística & datos numéricos , Pronóstico , Modelos de Riesgos Proporcionales , Factores de Riesgo , Análisis de Supervivencia , Adulto JovenRESUMEN
OBJECTIVE: To summarize the clinical features of ruptured cerebellar arteriovenous malformations (AVMs) and to explore surgical methods and outcomes in ruptured cerebellar AVM patients. PATIENTS AND METHODS: In the past 14 years, 67 patients with cerebellar AVMs were treated at our institution, accounting for 14.9% of the total vascular malformation patients in our department. In this study, we retrospectively analyzed the clinical characteristics, operation indication, surgery techniques, and prognoses of these cases. RESULTS: Among the 67 AVM cases, the distribution of Spetzler-Martin grades was 32 Grade I, 14 Grade II, 13 Grade III, 5 Grade IV, and 3 Grade V cases. Microsurgical treatment was carried out via the retrosigmoid approach or suboccipital midline approach. After the surgery, the distribution of GOS grades was 60 Grade V, 3 Grade IV, 1 Grade III, 2 Grade II, and 2 Grade I cases. CONCLUSIONS: Microsurgical removal should be performed in ruptured cerebellar AVM patients as early as possible once the preoperative and postoperative preparations were done. Good surgical effects were obtained by using proper surgery techniques and the right protection of critical cerebral structures. Patients with a GCS grade of ≥ 8 showed good recovery, but patients with a grade of < 8 had poor prognoses.